Nutrition supplementation plus standard of care versus standard of care alone or standard of care plus unconditional cash transfer in the prevention of chronic malnutrition in Southern Angola: study protocol for the MuCCUA study, a cluster randomized controlled trial.

BACKGROUND: Chronic malnutrition is a condition associated with negative impacts on physical and cognitive development. It is multi-causal and can start very early in life, already in utero, thus it is especially challenging to find appropriate interventions to tackle it. The government of Angola is implementing a standard of care program with potential to prevent it, and the provision of cash transfers and the supplementation with small quantity lipid-based nutrients (SQ-LNS) are also promising interventions. We aimed to evaluate the impact of the standard of care program alone and of the standard of care plus a cash transfer intervention in the lineal growth of children less than 2 years old and compare it to the effectiveness of a nutrition supplementation plus standard of care program in Southern Angola. METHODS/DESIGN: The three-arm parallel cluster randomised controlled trial is set in four communes of Huila and Cunene provinces. Clusters are villages or neighbourhoods with a population around 1075 people. A total of twelve clusters were selected per arm and forty pregnant women are expected to be recruited in each cluster. Pregnant women receive the standard of care alone, or the standard of care plus unconditional cash transfer or plus nutritional supplementation during the first 1000 days, from pregnancy to the child reaching 24 months. The primary outcome is the prevalence of stunting measured as height-for-age Z-score (HAZ) < -2 in children below 2 years. Impact will be assessed at 3, 6, 12, 18 and 24 months of children's age. Secondary outcomes include mortality, morbidity, caring, hygiene and nutrition behaviours and practices, and women and children's dietary diversity. Quantitative data are also collected on women's empowerment, household food security, expenditure and relevant clinical and social events at baseline, endline and intermediate time points. DISCUSSION: The results will provide valuable information on the impact of the standard of care intervention alone as well as combined with an unconditional cash transfer intervention compared to a nutrition supplementation plus standard of care intervention, carried out during the first 1000 days, in the children´s growth up to 2 years and related outcomes in Southern Angola. TRIAL REGISTRATION: Clinical Trials NCT05571280. Registered 7 October 2022.

Extracts of Hesperozygis ringens (Benth.) Epling: in vitro and in vivo antibacterial activity against fish pathogenic bacteria.

AIMS: This study investigated the in vitro antibacterial activity of Hesperozygis ringens (Benth.) Epling leaf extracts against fish pathogenic bacteria, as well as the in vivo activity of the most active extract in silver catfish (Rhamdia quelen) experimentally infected with Aeromonas hydrophila. Moreover, the chemical composition of the extract used in the survival assay was evaluated. METHODS AND RESULTS: Only hexane extract (HEHR) showed in vitro antibacterial activity (MIC and MBC ranging from 1600 to 3200 µg ml-1 ) against clinical isolates of A. hydrophila, Raoultella ornithinolytica and Citrobacter freundii, obtained from naturally infected silver catfish, and A. hydrophilaATCC 7966. The major compound of the volatile fraction of HEHR was determined as pulegone. HEHR promoted a 93·33% relative survival rate of silver catfish experimentally infected with A. hydrophila 7 days after a single therapeutic bath at 30 mg l-1 , while florfenicol at 4 mg l-1 , which promoted a 60% relative survival rate. CONCLUSIONS: The antibacterial activity of H. ringens (Benth.) Epling leaf extracts seems to be related to phytochemicals of apolar character, since HEHR promoted better survival rate of infected animals than florfenicol. SIGNIFICANCE AND IMPACT OF THE STUDY: The HEHR has potential to be used in the control and treatment of bacterial infections in organic aquaculture.

[Asymptomatic skull base metastases: clinical course and therapeutic alternatives]. / Metastasis asintomaticas de la base craneal: evolucion clinica y alternativas terapeuticas.

INTRODUCTION: Skull base metastases (SBM) are an infrequent and late type of cancer progression that are associated to poor prognosis. Its clinical manifestations may be grouped in five clinical syndromes and radiotherapy is its more frequent treatment. Because of the improvement in imaging tests and the close follow up of cancer patients, SBM can be diagnosed incidentally. In this group the best option of treatment has not been established. AIM: To analyze the clinical features and outcomes of patients with SBM diagnosed incidentally. PATIENTS AND METHODS: Between January 2012 and December 2015, 31 patients with diagnoses of SBM from solid primary tumor were reviewed. RESULTS: SBM were diagnosed due to skull base syndromes (n = 24) or incidentally (n = 7). Symptomatic patients were treated with radiotherapy. Patients diagnosed incidentally remained without symptoms of craneal base involvement during the follow up, although they frequently had other types of intracranial progression. A statistically significant difference in survival was observed between symptomatic and asymptomatic patients (p = 0.001). CONCLUSIONS: The incidentally diagnosed SBM were frequently associated to other types of intracranial progression, limiting the options of treatment.

TITLE: Metastasis asintomaticas de la base craneal: evolucion clinica y alternativas terapeuticas.Introduccion. Las metastasis sintomaticas de la base craneal (MBC) son una progresion infrecuente, tardia y de mal pronostico en pacientes con tumores solidos. Sus manifestaciones clinicas pueden agruparse en cinco sindromes caracteristicos, y su tratamiento mas frecuente es la radioterapia. Gracias a los progresos tecnologicos en las pruebas de imagen y al seguimiento estrecho de los pacientes con cancer, las MBC pueden diagnosticarse incidentalmente. En este subgrupo no se conoce la evolucion clinica ni se ha establecido la mejor modalidad de tratamiento. Objetivo. Analizar las caracteristicas clinicas y la evolucion de los pacientes diagnosticados incidentalmente de MBC. Pacientes y metodos. Entre enero de 2012 y diciembre de 2015, 31 pacientes con una neoplasia solida diagnosticados de MBC fueron valorados por nuestro servicio. Resultados. Las MBC se diagnosticaron por la presencia de un sindrome de base craneal (n = 24) o incidentalmente (n = 7). Los pacientes sintomaticos fueron tratados con radioterapia. Todos los pacientes diagnosticados incidentalmente permanecieron sin sintomas relacionados con la afectacion de la base craneal hasta la fecha del fallecimiento, aunque frecuentemente presentaron de forma concomitante otros tipos de progresion intracraneal de mal pronostico. Se observo una diferencia estadisticamente significativa en la supervivencia a favor de los pacientes sintomaticos (p = 0,001). Conclusiones. Las MBC diagnosticadas incidentalmente se asociaron frecuentemente a otros tipos de progresion intracraneal, limitando las opciones terapeuticas.

The role of mesoscale meteorology in modulating the (222)Rn concentrations in Huelva (Spain)--impact of phosphogypsum piles.

The combined analysis of (222)Rn activity concentrations and mesoscale meteorological conditions at Huelva city (Spain) was addressed in this study to understand the potential impact of phosphogypsum piles on the (222)Rn activity concentrations registered at this area. Hourly mean data from April 2012 to February 2013 registered at two sampling sites (Huelva city and in the background station of El Arenosillo, located 27 km to the south-east) have been used in the study. The results of the present study showed a large difference in mean radon concentrations between the two stations during the sampling period, 6.3 ± 0.4 Bq m(-3) at Huelva and 3.0 ± 0.2 Bq m(-3) at El Arenosillo. The analysis has demonstrated that hourly (222)Rn concentrations at Huelva city above 22 Bq m(-3), with nocturnal peaks up to 50 Bq/m(3), mainly coincided with the occurrence of a pure sea-land breeze cycle. Mesoscale circulations in this region are mainly characterized by two patterns of sea-land breeze, pure and non-pure, with the phosphosypsum piles directly upstream (south) of the city during the afternoon on pure sea-breeze days. The difference between mean (222)Rn activity concentrations at Huelva city were 9.9 ± 1.5 Bq m(-3) for the pure pattern and 3.3 ± 0.5 Bq m(-3) for the non-pure pattern, while in the background station concentrations were 3.9 ± 0.4 Bq m(-3) and 2.8 ± 0.4 Bq m(-3) respectively. Considering these large differences, a detailed analysis of composites and case studies of representative sea-land breeze cycles of both types and their impact on (222)Rn activity concentration was performed. The results suggested that the presence of the phosphogypsum piles was necessary in order to justify the high (222)Rn activity concentrations observed at Huelva compared with the background station in the afternoons on pure sea breeze days (1.5-2.0 Bq m(-3)). On the other hand, large night time differences between the two sites on these days were likely to be associated with a combination of shallow density currents travelling down the Guadalquivir valley and, again, the presence of phosphogypsum piles. The results have demonstrated a significant impact of the phosphogypsum piles on (222)Rn activity concentrations in Huelva city during the occurrence of pure sea breeze days.

Plant essential oils against Aeromonas hydrophila: in vitro activity and their use in experimentally infected fish.

AIMS: The aims of this study were to investigate the in vitro antibacterial activity of the essential oils (EOs) of Hesperozygis ringens (HREO), popularly known as 'espanta-pulga' and two different species of basil, Ocimum gratissimum (OGEO) and Ocimum americanum (OAEO), as well as, the potential of these products to be used in silver catfish (Rhamdia quelen) infected with Aeromonas hydrophila. METHODS AND RESULTS: OGEO and HREO showed better antibacterial activity in vitro. Subinhibitory concentrations of all EOs inhibited haemolysis caused by Aer. hydrophila in fish erythrocytes (100% reduction for OAEO at 100 µg ml(-1) and more than 90% for HREO and OGEO at 150 µg ml(-1) ). However, OAEO and HREO showed the best survival results (75 and 70% respectively) after their use as treatment (therapeutic baths-1 h daily/5 days) in silver catfish experimentally infected with Aer. hydrophila. A second in vivo assay using healthy fish was conducted to verify the potential of the EOs (preventive baths-1 h daily/5 days) to promote fish survival. Fish exposed to HREO and OAEO and their diluent (ethanol) showed significant lower haematocrit values and higher complement system activity compared to control. Plasma cortisol level was significantly higher in the groups exposed to both EOs. There was no significant difference in survival of silver catfish challenged with Aer. hydrophila after preventive baths with HREO, OAEO and control group. CONCLUSIONS: All tested EOs showed in vitro antibacterial properties against Aer. hydrophila and HREO and OAEO showed potential to be used in the treatment of infected fish. SIGNIFICANCE AND IMPACT OF THE STUDY: These products can be used in aquaculture as therapeutic and prophylactic agents against fish pathogens, with antimicrobial and/or immunostimulant properties.

Atividade de nanoformulações de Melaleuca alternifolia e terpinen-4-ol em isolados de Rhodococcus equi / Melaleuca alternifolia activity in nanoformulations and terpinen-4-ol against Rhodococcus equi isolates

Rhodococcus equi é o agente etiológico da rodococose equina, importante doença respiratória de potros. Especialmente na última década, a emergência de cepas resistentes aos antimicrobianos empregados no tratamento da rodococose tem sido relatada. Nesse sentido, há a necessidade de estudos envolvendo terapias alternativas e novas tecnologias, incluindo o uso de plantas medicinais e nanotecnologia. Neste trabalho utilizou-se Melaleuca alternifolia nas seguintes formulações: óleo livre, nanocápsula, nanoemulsão e a combinação de óleo livre com nanocápsula e com nanoemulsão, além do seu composto majoritário, terpinen-4-ol, a fim de verificar a atividade antimicrobiana frente a isolados de R. equi de diferentes origens. Utilizou-se o método de microdiluição em caldo na determinação das concentrações inibitória mínima (CIM) e bactericida mínima (CBM) das diferentes formulações frente aos isolados (n=24). Verificou-se baixo potencial para atividade antibacteriana de M. alternifolia na formulação de óleo livre. Todavia, essa atividade foi potencializada quando se incorporou o óleo essencial às nanoformulações. O composto terpinen-4-ol demonstrou potencial atividade antibacteriana quando incorporado ao óleo essencial e quando utilizado isoladamente. Verificou-se que tanto M. alternifolia quanto terpinen-4-ol testados possuem atividade antimicrobiana contra isolados de R. equi, sugerindo seu emprego em estudos avaliando seu potencial para o tratamento da rodococose.

Rhodococcus equi causes rodococose in horses, characterized by bronchopneumonia in foals. Due to reports of antimicrobial resistance, it is important to develop studies involving alternative therapies and new technologies, including the use of medicinal plants and nanotechnology. In this work, the plant Melaleuca alternifolia in oil free formulations, nanocapsule, nanoemulsion and the combination of free and nanocapsule oil nanoemulsion, besides its major compound, terpinen-4-ol, were used in order to verify antimicrobial activity against isolates of R. equi. The broth microdilution method was employed to determine the minimum inhibitory (MIC) and minimum bactericidal (MBC) concentrations of different formulations against 24 isolates. There was low antibacterial activity of M. alternifolia in oil free formulation; however, it was observed that the activity was enhanced when incorporated as essential oil the nanoformulations. The major compound, terpinen-4-ol, showed bactericidal and bacteriostatic activity when used alone. It is suggested that M. alternifolia, in association with nanocarriers systems, as well as terpinen -4-ol, presents potential for future studies concerning the equine rodococosis therapy.

Studying radon exhalation rates variability from phosphogypsum piles in the SW of Spain.

Nearly 1.0 × 10(8) tonnes of phosphogypsum were accumulated during last 50 years on a 1,200 ha disposal site near Huelva town (SW of Spain). Previous measurements of exhalation rates offered very variable values, in such a way that a worst case scenario could not be established. Here, new experimental data coupled to numerical simulations show that increasing the moisture contents or the temperature reduces the exhalation rate whilst increasing the radon potential or porosity has the contrary effect. Once the relative effects are compared, it can be drawn that the most relevant parameters controlling the exhalation rate are radon potential (product of emanation factor by (226)Ra concentration) and moisture saturation of PG. From wastes management point of view, it can be concluded that piling up the waste increasing the height instead of the surface allows the reduction of the exhalation rate. Furthermore, a proposed cover here is expected to allow exhalation rates reductions up to 95%. We established that the worst case scenario corresponds to a situation of extremely dry winter. Under these conditions, the radon exhalation rate (0.508 Bqm(-2)s(-1)) would be below though close to the upper limit established by U.S.E.P.A. for inactive phopsphogypsum piles (0.722 Bqm(-2)s(-1)).

Analysis of the neuromuscular activity during rising from a chair in water and on dry land.

PURPOSE: The purpose of the present study was to analyze the neuromuscular responses during the performance of a sit to stand [STS] task in water and on dry land. SCOPE: 10 healthy subjects, five males and five females were recruited for study. Surface electromyography sEMG was used for lower limb and trunk muscles maximal voluntarty contraction [MVC] and during the STS task. RESULTS: Muscle activity was significantly higher on dry land than in water normalized signals by MVC from the quadriceps-vastus medialis [17.3%], the quadriceps - rectus femoris [5.3%], the long head of the biceps femoris [5.5%], the tibialis anterior [13.9%], the gastrocnemius medialis [3.4%], the soleus [6.2%]. However, the muscle activity was higher in water for the rectus abdominis [-26.6%] and the erector spinae [-22.6%]. CONCLUSIONS: This study for the first time describes the neuromuscular responses in healthy subjects during the performance of the STS task in water. The differences in lower limb and trunk muscle activity should be considered when using the STS movement in aquatic rehabilitation.

Influence of the Fukushima Dai-ichi nuclear accident on Spanish environmental radioactivity levels.

This paper presents measurements of the effect of the atmospheric radioactive release from the Fukushima Dai-ichi nuclear power station at three sites belonging to the Spanish environmental monitoring system. Measured values varied depending on the locations of the sites in Spain and their respective climatic characteristics. (134)Cs, (136)Cs, (137)Cs, (131)I, and (132)Te activity concentrations in filter samples were studied and associated levels of (131)I fallout were estimated from wet and dry deposition. Particulate aerosol activity concentrations ranges, in µBq/m(3), were 1.63-3080 ((131)I), 2.8-690 ((137)Cs), 1.3-620 ((134)Cs) and 3.6-330 ((132)Te), while the associated (131)I fallout was roughly estimated to be less than 20 Bq/m(2), Gaseous (131)I was also detected and the (131)I-gaseous/(131)I-total ratio increased at the three stations from approximately 0.75 at the end of March to 0.85-0.9 during the first few days of April. Finally, the presence of (131)I in some crucial parts of the food chain was also studied. (131)I was detected in samples from goat's and cow's milk (maximum levels of 1.11 Bq/L) and in broadleaf plants (maximum level 1.42 Bq/kg).

Attitudes towards massage modify effects of manual therapy in breast cancer survivors: a randomised clinical trial with crossover design.

Our aims were to investigate the immediate effect of myofascial release on heart rate variability and mood state, and the influence of attitude towards massage in breast cancer survivors with cancer-related fatigue. Twenty breast cancer survivors reporting moderate to high cancer-related fatigue participated in this crossover study. All patients presented to the laboratory at the same time of the day on two occasions separated by a 2-week interval. At each session, they received either a massage intervention or control intervention. Holter electrocardiogram recordings and Profile of Mood States questionnaire (six domains: tension-anxiety, depression-dejection, anger-hostility, vigour, fatigue, confusion) were obtained before and immediately after each intervention. The attitude towards massage scale was collected before the first session in all breast cancer survivors. The results showed a significant session × time interaction for standard deviation of the normal-to-normal interval (SDNN) (F= 5.063, P= 0.039), square root of mean squared differences of successive normal-to-normal intervals (RMSSD) (F= 8.273, P= 0.010), high-frequency component (HF) (F= 7.571, P= 0.013), but not for index heart rate variability (F= 3.451, P= 0.080), low-frequency component (LF) (F= 0.014, P= 0.997) and ratio LF/HF (F= 3.680, P= 0.072): significant increases in SDNN, RMSSD and HF domain (P < 0.05) were observed after the manual therapy intervention, with no changes after placebo (P > 0.6). No influence of the attitude scale on heart rate variability results was found. A significant session × time interaction was also found for fatigue (F= 5.101, P= 0.036) and disturbance of mood (F= 6.690, P= 0.018) scales of the Profile of Mood States: patients showed a significant decrease in fatigue and disturbance of mood (P < 0.001) after manual therapy, with no changes after placebo (P > 0.50). A significant influence of the attitude scale was observed in tension-anxiety, depression-dejection and anger-hostility scales. This controlled trial suggests that massage leads to an immediate increase of heart rate variability and an improvement in mood in breast cancer survivors with cancer-related fatigue. Further, the positive impact of massage on cancer-related fatigue is modulated by the attitude of the patient towards massage.

Efectividad de la hidroterapia en las personas con enfermedad pulmonar obstructiva crónica / Effectiveness of hydrotherapy in people with chronic obstructive pulmonary disease

Introducción. El objetivo de este estudio es detectar los niveles de evidencia y grados de recomendación de la intervención acuática terapéutica en personas con enfermedad pulmonar obstructiva crónica (EPOC) basado en una revisión sistemática. Diseño. La bases de datos revisadas son las siguientes: Medline, Web of Knowledge, CINAHL, PsycInfo, Sport Discus, SCOPUS, Oaister, DOAJ, Cochrane, EMBASE y Pedro. Material y método. Los límites de la búsqueda son ensayos clínicos aleatorios, estudios cohortes y estudios de casos que fueron publicados desde 1996 hasta 2010. Los documentos seleccionados fueron clasificados según los grados de recomendación de la sociedad finlandesa DUODECIM. La calidad metodológica de los dieciséis ensayos seleccionados se evaluó usando la lista Delphi. Resultados. Dos documentos primarios mostraron cambios clínicos en el cuestionario de calidad de vida específico para enfermos respiratorios. Las personas que realizaron ejercicio incremental en el agua presentaron cambios funcionales en la distancia recorrida en la prueba de test de marcha, en la capacidad vital forzada y en el volumen espiratorio forzado. La intervención acuática terapéutica que se recomienda es a una intensidad del 50 al 90% del VO2max, con una frecuencia de dos a cinco días a la semana, con sesiones de 30 a 50 minutos, durante un período de tratamiento desde 8 a 24 semanas de duración y una variabilidad de la temperatura del agua desde 29°C hasta 38°C. En futuros estudios sería posible hacer subgrupos de los pacientes en función de sus condiciones físicas de partida para mejorar los resultados de la intervención (AU)

Introduction. The aim of this study is to detect the levels of evidence and grades of recommendation of therapeutic aquatic exercise interventions in patients with chronic obstructive pulmonary disease (COPD) based on a systematic review. Design. The following databases were reviewed: Medline, Web of Knowledge, CINAHL, PsycInfo, Sport Discus, SCOPUS, Oaister, DOAJ, Cochrane, EMBASE and Pedro. Material and methods. A search for randomized clinical trials, cohort studies and case studies published 1996 to 2010 was made. The documents selected were classified according to the grades of recommendation of the DUODECIM Finnish society. Methodological quality of the 16 trials selected was assessed using the Delphi list. Results. Two primary documents showed clinical changes on the quality of life of questionnaire aimed at respiratory patients. Those subjects who performed incremental exercise in the water showed functional changes in the distance walked in the walking test, in forced vital capacity and forced expiratory volume. The incremental therapeutic water exercise recommended in the articles had an intensity ranging from 50% to 90% of VO2max with a frequency of two to five days a week. The sessions ranged from 30 to 50minutes within a treatment period going from 8 to 24 weeks with water temperature varying from 29°C to 38°C. In future studies, subgroups of the patients can be made based on their initial physical condition in order to improve the outcomes of the intervention (AU)

Activity of essential oils from spices against Staphylococcus spp. isolated from bovine mastitis / Atividade de óleos essenciais de plantas condimentares frente Staphylococcus spp. isolados de mastite bovina

Avaliou-se a atividade antimicrobiana dos óleos essenciais (OE) de Origanum vulgare (orégano), Thymus vulgaris (tomilho), Lippia graveolens (lipia), Zingiber officinale (gengibre), Salvia officinalis (sálvia), Rosmarinus officinalis (alecrim) e Ocimum basilicum (manjericão), e de suas frações majoritárias, carvacrol e timol, frente a 32 isolados de Staphylococcus spp, oriundos de rebanhos leiteiros bovinos. A concentração inibitória mínima (CIM) e a concentração bactericida mínima foram determinadas por meio da técnica de microdiluição em caldo. Orégano, tomilho e lípia (Orégano Mexicano) apresentaram atividade antimicrobiana similar, médias geométrica de CIM de 1600µg mL-1; 1564µg mL-1; 1562µg mL-1, respectivamente, no entanto menos ativos que carvacrol, 584µg mL-1 e thymol, 427µg mL-1. Isolados com diferentes perfis de susceptibil idade aos antimicrobianos usados no tratamento de mastite bovina, quando subagrupados, foram inibidos por concentrações semelhantes de OE . Estes resultados confirmam a atividade antimicrobiana de OE e algumas frações majoritárias.

Revisión de ensayos clínicos sobre rehabilitación respiratoria en enfermos pulmonares obstructivos crónicos / Review about clinical control trials of respiratory rehabilitation in chronic obstructive pulmonary disease

Objetivo: Comparar los tipos de entrenamiento físico para pacientes con enfermedad pulmonar obstructiva crónica (EPOC) y analizar cuál es el más efectivo. Diseño: Revisión sistemática de la literatura médica sobre el tema. Estrategia de búsqueda Se realizó una búsqueda sistemática de los estudios relevantes publicados desde 1999 hasta 2009 en la base de datos de Medline. Selección de estudios: los límites de búsqueda son ensayos clínicos aleatorios. Los criterios de selección son artículos que muestran tipos de entrenamiento en seco o agua para pacientes con EPOC y que incluían las variables funcionales y clínicas siguientes: datos espirométricos, consumo de oxígeno y cuestionarios de calidad de vida, respectivamente. La calidad metodológica fue medida con la lista Delphi. Un total de 38 artículos fueron incluidos en la revisión sistemática y solo 9 superaron los criterios de selección. Resultados: La mayoría de los artículos defienden el ejercicio físico aeróbico resistido incremental, con una intensidad que va del 90-50% de la VO2máx, con una frecuencia entre 2-4 días a la semana, la sesión desde 30-60 min y un periodo de tratamiento desde 8-12 semanas de duración. Todos los artículos incluyen pacientes con EPOC grave y que habían dejado de fumar antes de comenzar la intervención de ejercicio físico. Los valores del tamaño del efecto en el cuestionario respiratorio y el VO2 máx no mostraron diferencias significativas. Conclusión: Existe una clara tendencia de los autores a presentar el trabajo de ejercicio físico aeróbico incremental como el de mayor efectividad en el tratamiento de los pacientes con EPOC (AU)

Objective: Compare the effectiveness various exercises training programmes in the rehabilitation of chronic obstructive pulmonary disease (COPD) patients. Desing: A systematic literature review of random control trials. Search strategy We conducted a systematic search to identify relevant studies published between 1999 and 2009 in Medline database. Selection of studies The search limits were randomised controlled trial. The selection criteria were trials using exercise training in patients with COPD on dryland or water and included the following clinical and functional outcomes: lung function, oxygen uptake and quality of life questionnaire, respectively. Methodological quality of randomized controlled trials was assessed using the Delphi list. The literature search delivered a total of 38 studies, however only nine reach eligibility selection. Results: Most trials used incremental aerobic resistance exercises at an intensity ranging from 90 to 50% of VO2max. Frequency was two or four days a weeks, in sessions of 30 to 60min over a period of 8 to 12 weeks. All studies include persons with severe COPD who had stopped smoking before beginning the intervention. The effect of exercise training in CRQ and VO2max was not significant. In summary, the systematic review shows a clear tendency toward the use of incremental physical workload as the most effective in the treatment of patients with COPD (AU)

Consequences of dietary manganese and copper imbalance on neuronal apoptosis in a murine model of scrapie.

AIMS: Copper and manganese levels are altered in mice both lacking PrPc and prion-infected brains. The aim of this study was to analyse the effects of manganese and copper imbalance on neuronal apoptosis in a scrapie-infected Tga20 mouse model. METHODS: Immunoreactivities for the apoptotic proteins Bax and active caspase-3 were evaluated in nine regions of the brain of scrapie-infected and control Tga20 mice treated with one of several diets: depleted cooper (-Cu), loaded manganese (+Mn), depleted copper/loaded manganese (-Cu+Mn) and regular diet. Immunohistochemical determination of NeuN was used to detect possible neuronal loss. RESULTS: Intracellular Bax detection was significantly decreased in animals fed with modified diets, particularly in those treated with copper-depleted diets. A decrease in active caspase-3 was primarily observed in animals fed with enhanced manganese diets. Our results show that the -Cu, -Cu+Mn and +Mn diets protected against apoptosis in scrapie-infected mice. However, NeuN immunolabelling quantification revealed that no diet was sufficient to arrest neuronal death. CONCLUSIONS: With regard to apoptosis induction, the response of Tga20 mice to prion infection was similar to that reported for other mice models. Our results demonstrate the neuroprotective effects of -Cu, -Cu+Mn and +Mn diets in a murine model of scrapie. However, neuronal death induced by infection with prions seems to be independent of apoptosis marker signalling. Moreover, copper-modified diets were neuroprotective against the possible toxicity of the prion transgene in Tga20 control and infected mice even though manganese supplementation could not counteract this toxicity.

The effect of metal imbalances on scrapie neurodegeneration.

Environmental exposure to metal appears to enhance susceptibility to Transmissible Spongiform Encephalopathies (TSEs); however, published data are not conclusive. The current study focuses on assessing the effects of copper depletion and/or manganese enhancement in the diet on susceptibility to Scrapie and this disease progression. The degree of spongiosis was the highest in the animals that received a copper- depleted diet. These observations suggest that this diet contributes to the Scrapie lesions and to the worsening of the condition in animals that have been inoculated with Scrapie. The highest intensities of GFAP immunostaining were also associated with the copper- depleted diet. Dietary supplementation with manganese had a negative effect on neuronal counts. In conclusion, this study demonstrates that certain environmental factors may aggravate neuropathological Scrapie lesions. This is consistent with reports from other neurodegenerative diseases where some metalloenzymes play a pivotal protector role against the oxidative stress associated with pathogenesis.

Ensayo preliminar de la actividad antibacteriana de extractos de Allium sativum, Coriandrum sativum, Eugenia Caryophyllata, Origanum vulgare, Rosmarinus officinalis Y Thymus vulgaris frente a Clostridium perfringens / Preliminary test of the antibacterial activity of the Allium sativum, Coriandrum sativum, Eugenia

Se evaluó la actividad antibacteriana frente a Clostridium perfringens (cepa ATCC: 13124) por el método de Kirby Bauer en agar SPS de los aceites esenciales o extractos vegetales obtenidos con solventes orgánicos de diferente polaridad a partir de Allium sativum (ajo), Coriandrum sativum (cilantro), Eugenia Caryophyllata (clavode olor), Origanum vulgare (orégano), Rosmarinus officinalis (romero) y Thymus vulgaris (tomillo), utilizando la vancomicina como control. Los extractos obtenidos por el método de lixiviación de O. vulgare y T. vulgaris no presentaron inhibición para este microorganismo; los demás extractos vegetales sí la presentaron, obteniéndose concentraciones bacteriostáticas mínimas que oscilaron entre 16 y 63 μl/ml. El extracto etanólico y el aceite esencial de E.caryophyllata fueron los que presentaron una menor concentración inhibitoria mínima (250 μl/ml). Se observan variaciones importantes enla capacidad de inhibición de dichos extractos con respecto a estudios realizados por otros grupos de investigación en el mundo, pocos de ellos utilizaron a Clostridium perfringens.

The antibacterial activity against Clostridium perfringens (ATCC: 13124) of essential oils and extracts obtained from Allium sativum (garlic), Coriandrum sativum (coriander), Eugenia Caryophyllata (clove), Origanum vulgare (oregano), Rosmarinus officinalis (rosemary) and Thymus vulgaris (thyme) tested by means of the Kirby Bauer method in SPS agar, using vancomicine as the control. The extracts obtained by the lixiviation method from Origanum vulgare and Thymus vulgaris do not show inhibition, whereas the other extracts had minimal bacteriostatical concentrations between 16 to 63 ìl/ml. The E. caryophyllata ethanolic extract and essential oil presented a lower minimal inhibitory concentration (250 ìl/ml). Important variations in the inhibitory capacity of the extracts and essential oils were observed, regarding studies carried out by other research groups in the world, few worked with Clostridium perfringes.

[Effect of an intensive nutritional treatment in nutritional status of head and neck cancer patients in stages III and IV]. / Evaluación del impacto de un tratamiento nutricional intensivo sobre el estado nutricional de pacientes con cáncer de cabeza y cuello en estadio III y IV.

OBJECTIVE: Malnutrition and accelerated weight loss are frequent secondary diagnosis in patients with cancer. Head and neck cancer (H & N Cancer) affects nutritional status because of the tumor type and localization. The aim of the study was to assess the effect of an intensive nutritional treatment (INT) on nutritional status of H & N cancer patients, stages III and IV and to compare that with a historical control whose nutritional treatment was conventional (CT). METHODS: All patients were nutritionally assessed before oncological treatment started (anthropometrical, biochemical, and dietetically). A nutritional feeding plan according to their nutritional personal need was calculated. In case it was impossible to cover all the nutritional requirements orally, a feeding tube was placed. Nutritional follow up was performed each 21 days, during their oncological treatment in four occasions. The results obtained were compared with those obtained from the patients who received the CT that consisted only in nutritional counseling by the attending physician; the statistical test used was Mann Whitney U test. RESULTS: The INT was associated with maintenance of the nutritional status along their oncological treatment. The statistical significant parameters were: weight 55 to 47 kg in the CT group vs 59 a 58 kg in the INT group (p < 0.0001), and hemoglobin: from 13 to 11 g/dl in the CT group vs 14 to 13 g/dl in the INT group (p < 0.002) as the most important ones. In the rest of the data we can observe a clear tendency of increasing the nutrition parameters in patients the INT group, while in the CT group, they showed a persistent decrease. CONCLUSION: We concluded that patients who received the INT as part of their oncological treatment deteriorated less their nutritional status than those who received a CT.

Evaluación del impacto de un tratamiento nutricional intensivo sobre el estado nutricional de pacientes con cáncer de cabeza y cuello en estadio III y IV / Effect of an intensive nutritional treatment in nutritional status of head and neck cancer patients in stages III and IV

Objetivo: La desnutrición y la pérdida acelerada de pesoson frecuentes en pacientes con cáncer. El cáncer de cabeza y cuello (cáncer de C y C) afecta el estado nutricional por la localización y estirpe del tumor. El objetivo fue evaluar el efecto de un tratamiento nutricional intensivo (TNI) sobre el estado nutricional en pacientes con cáncer de C y C en estadiosavanzados y compararlos con un grupo control históricocuyo tratamiento nutricional fue el convencional (TC).Métodos: A todos los pacientes se les realizó una evaluación del estado nutricional al ingreso (antropométrica, bioquímica y dietética). Se calculó un plan de alimentación que cubriera su requerimiento individual. En caso de que no fuera posible cubrir sus requerimientos vía oral se colocó una sonda para alimentación enteral. La evaluación del estado nutricional se realizó durante el tratamiento oncológicocada 21 días (cuatro evaluaciones). Los resultados secompararon el grupo del TC (25 pacientes) que consistió en orientación alimentaria general. El análisis de resultados se llevó a cabo con la prueba no paramétrica U de Mann Whitney. Resultados: El TNI (28 pacientes) se asoció con el mantenimiento del estado nutricional a lo largo del tratamiento oncológico. Los indicadores significativos fueron: cambio de peso 55 a 47 kg en TC contra 59 a 58 kg en TNI (p < 0,0001) y hemoglobina de 13 a 11 g/dl en TC versus 14 a 13,0 g/dl en TNI (p < 0,002) como los más importantes. En el resto de los indicadores se observó una clara tendencia aumentar poco a poco a lo largo del estudio en el grupo del TNI, mientras que en el TC la disminución de los indicadores fue constante.Conclusión:Los pacientes que se reciben un TNI como parteintegral de su tratamiento oncológico deterioraron menos su estado nutricional que aquellos que recibieron el TC

Objective: Malnutrition and accelerated weight loss arefrequent secondary diagnosis in patients with cancer.Head and neck cancer (H & N Cancer) affects nutritionalstatus because of the tumor type and localization. Theaim of the study was to assess the effect of an intensivenutritional treatment (INT) on nutritional status of H &N cancer patients, stages III and IV and to compare thatwith a historical control whose nutritional treatment wasconventional (CT).Methods: All patients were nutritionally assessed before oncological treatment started (anthropometrical,biochemical, and dietetically). A nutritionalfeeding plan according to their nutritional personalneed was calculated. In case it was impossible to cover all the nutritional requirements orally, a feeding tube was placed. Nutritional follow up was performed each 21days, during their oncological treatment in four occasions. The results obtained were compared with thoseobtained from the patients who received the CT that consisted only in nutritional counseling by the attending physician; the statistical test used was Mann Whitney U test.Results: The INT was associated with maintenance of thenutritional status along their oncological treatment. Thestatistical significant parameters were: weight 55 to 47 kg in the CT group vs 59 a 58 kg in the INT group (p <0.0001), and hemoglobin: from 13 to 11 g/dl in the CTgroup vs 14 to 13 g/dl in the INT group (p < 0.002) as the most important ones. In the rest of the data we canobserve a clear tendency of increasing the nutrition parameters in patients the INT group, while in the CT group, they showed a persistent decrease. Conclusion: We concluded that patients who received the INT as part of their oncological treatment deteriorated less their nutritional status than those who received a CT