Mechanical deformation of thin film platinum under electrical stimulation.

Thin-film-based electrodes used to interact with nervous tissue often fail quickly if used for electrical stimulation, impairing their translation into long-term clinical applications. We initiated investigations about the mechanical load on thin-film electrodes caused by the fact of electrical stimulation. Platinum electrodes of Ø 300µm on a polyimide carrier were subjected to approximately 50 000 asymmetrical, biphasic stimulation pulses in vitro. The electrode's surface was investigated optically by means of white-light interferometry. The structural expansion for the metallic surface subjected to stimulation was measured to reach roughly 30%. The study points towards a failure mechanism of thin-films being of mechanical nature, inherent to the unavoidable electrochemical processes involved (change in lattice constants) during electrical stimulation at the electrode's surface. Based on further scientific facts, we set 3 hypotheses for the exact mechanisms involved in the failure of thin-films used for electrical stimulation, opening a new door for research and improvement of novel neuroprosthetic devices.

[Effect of an oral hyperproteic nutritional supplement in malnourished elderly patients in nursing homes]. / Efecto de un suplemento nutricional oral hiperproteico en pacientes desnutridos ubicados en residencias geriátricas.

INTRODUCTION: Nutritional problems develop complications in geriatric patients and increase their morbidity and mortality. Hyperproteic nutritional supplements are one of the options to improve nutritional deficiencies. OBJECTIVES: To assess the beneficial effect and tolerance of one hyperproteic nutritional supplement (Ensure Plus High Protein, Abbott Laboratories, S.A.) in malnourished subjects over 65 years. METHODS: Observational, prospective, open, multicenter study. We included malnourished subjects over 65 years living in nursing homes located in Spain. Malnutrition was considered as GNRI score < 92 or BMI < 19. Before inclusion, we obtained signed informed consent of patients or their relatives. All participants received Ensure Plus High Protein for 8 weeks. The primary endpoints were changes observed in weight, BMI and GNRI. RESULTS: We analyzed 255 evaluable patients valid for intention-to-treat (ITT) analysis and 243 for the per-protocol (PP) analysis; 69% (n = 172) were female and 31% (n = 77) male. The average protein amount administered was 51 g/day. At the end of the study, statistically significant differences (p < 0.001) were found in weight, BMI and GNRI when compared to baseline, both in the ITT and the PP analysis. The average weight increase was (mean +/- SE) 2.86 +/- 0.13 kg for PP analysis; 80% of participants (n = 202) achieved a weight gain > 1 kg and 96 patients (39.5% PP analysis) had a weight gain > 7%. CONCLUSIONS: The addition of a hyperproteic oral nutritional supplement contributes positively in improving the nutritional status of our study malnourished geriatric patients in terms of significant increase in body weight, BMI and GNRI.

Efecto de un suplemento nutricional oral hiperproteico en pacientes desnutridos ubicados en residencias geriátricas / Effect of an oral hyperproteic nutritional supplement in malnourished elderly patients in nursing homes

Introducción: Los problemas nutricionales complican la evolución de los pacientes geriátricos y aumentan su morbilidad y mortalidad. Los suplementos nutricionales hiperproteicos constituyen una de las maneras de mejorar la ingesta nutricional. Objetivos: Determinar el efecto beneficioso y la tolerancia de un suplemento nutricional hiperprotéico (Ensure Plus High Protein®, Abbott Laboratories, S.A.) en sujetos mayores de 65 años diagnosticados de desnutrición. Métodos: Estudio observacional, prospectivo, abierto y multicéntrico. Se incluyeron sujetos > 65 años diagnosticados de desnutrición, ubicados en 59 residencias geriátricas en España. Se consideró desnutrición una puntuación GNRI < 92 ó IMC < 19. Antes de la inclusión, se obtuvo el consentimiento informado firmado de los pacientes o sus familiares. Todos los participantes tomaron Ensure Plus High Protein® durante 8 semanas. Las variables principales de valoración fueron peso, IMC y GNRI. Resultados: Se analizaron 255 pacientes válidos para el análisis ITT y 243 para el análisis PP, 69% (n = 172) mujeres y 31% (n = 77) hombres. La cantidad de proteína media administrada fue 51 gr./día. Al final del estudio, los tres parámetros principales -peso, IMC y GNRI- presentaron diferencias estadísticamente significativas (p < 0,001) con respecto a la visita basal, tanto en el análisis ITT como en el análisis por protocolo. El incremento de peso medio fue de (media ± EE) 2,86 ± 0,13 kg para el análisis PP. El 80% de los participantes (n = 202) consiguió un incremento de peso > 1 kg y 96 pacientes (39,5% análisis PP) obtuvieron una ganancia ponderal > 7%. Conclusiones: La adición de un suplemento nutricional oral hiperproteico contribuye favorablemente en la mejoría del estado nutricional de los pacientes geriátricos malnutridos en estudio en términos de incremento significativo del peso corporal, IMC y GNRI (AU)

Introduction: Nutritional problems develop complications in geriatric patients and increase their morbidity and mortality. Hyperproteic nutritional supplements are one of the options to improve nutritional deficiencies. Objectives: To assess the beneficial effect and tolerance of one hyperproteic nutritional supplement (Ensure Plus High Protein®, Abbott Laboratories, S.A.) in malnourished subjects over 65 years. Methods: Observational, prospective, open, multicenter study. We included malnourished subjects over 65 years living in nursing homes located in Spain. Malnutrition was considered as GNRI score < 92 or BMI < 19. Before inclusion, we obtained signed informed consent of patients or their relatives. All participants received Ensure Plus High Protein® for 8 weeks. The primary endpoints were changes observed in weight, BMI and GNRI. Results: We analyzed 255 evaluable patients valid for intention-to-treat (ITT) analysis and 243 for the per-protocol (PP) analysis; 69% (n = 172) were female and 31% (n = 77) male. The average protein amount administered was 51 g/day. At the end of the study, statistically significant differences (p < 0.001) were found in weight, BMI and GNRI when compared to baseline, both in the ITT and the PP analysis. The average weight increase was (mean ± SE) 2.86 ± 0.13 kg for PP analysis; 80% of participants (n = 202) achieved a weight gain > 1 kg and 96 patients (39.5% PP analysis) had a weight gain > 7%. Conclusions: The addition of a hyperproteic oral nutritional supplement contributes positively in improving the nutritional status of our study malnourished geriatric patients in terms of significant increase in body weight, BMI and GNRI (AU)

Compliance with an oral hyperproteic supplement with fibre in nursing home residents.

BACKGROUND: Undernutrition is a common problem in older individuals that may be related to a low protein dietary intake. Oral supplements may improve the health status in this population, but their use may be limited by compliance and side effects. OBJECTIVES: To evaluate effects of an oral supplement of protein and fibre on compliance, on nutritional status, and on intestinal habits in nursing home residents. METHOD: A prospective observational study was carried out in 66 Spanish nursing homes. 358 subjects undernourished or at risk of undernutrition requiring nutritional supplements. After informed consent was given, subjects received 2 daily cartons (400 ml) of a liquid oral supplement rich in protein and fibre along 3 months. Supplement intake compliance was measured at baseline and after 6 and 12 weeks. Nutritional status was assessed using the Mini- Nutritional Assessment (MNA), weight, and Body Mass Index (BMI). Changes in intestinal habits and digestive symptoms were also recorded, as well as subject's supplement acceptance. RESULTS: Compliance with the supplement intake was 97.46% at 6 weeks and 96% at 12 weeks of follow-up. Significant changes (p<0.0001) were found in nutritional status: mean value of MNA improved from baseline (MNA=14.0+/-3.9) after 12 weeks (MNA=17.0+/-4.0), as well as weight (+2.1 kg, a 4.1% increase). The BMI did not change significantly (BMI=21.43 at baseline; BMI=21.78 at 12 weeks). Undernutrition prevalence (MNA<17) decreased from 76.4 to 46.6% (p<0.0001). Intestinal habits showed a significant improvement in defecation frequency (from 4.7 to 6.1 stools per week, p<0.0001) and faeces consistency (from 53.2% to 74.5% reporting formed soft stools, p<0.0001). 48.9% of the subjects considered to have better intestinal habits after 6 weeks and 50.5% after 3 months of supplementary food intake, the rest reporting no change. Vomits and flatulence were also significantly reduced (p<0.0001). CONCLUSION: The administration of an oral hyperproteic supplement with fibre in aged subjects who are undernourished or at risk of malnutrition can be done in nursing homes with a high level of compliance. Supplements improve their nutritional status and their intestinal habits.

Community-based incidence of acute renal failure.

There is limited information about the true incidence of acute renal failure (ARF). Most studies could not quantify disease frequency in the general population as they are hospital-based and confounded by variations in threshold and the rate of hospitalization. Earlier studies relied on diagnostic codes to identify non-dialysis requiring ARF. These underestimated disease incidence since the codes have low sensitivity. Here we quantified the incidence of non-dialysis and dialysis-requiring ARF among members of a large integrated health care delivery system - Kaiser Permanente of Northern California. Non-dialysis requiring ARF was identified using changes in inpatient serum creatinine values. Between 1996 and 2003, the incidence of non-dialysis requiring ARF increased from 322.7 to 522.4 whereas that of dialysis-requiring ARF increased from 19.5 to 29.5 per 100,000 person-years. ARF was more common in men and among the elderly, although those aged 80 years or more were less likely to receive acute dialysis treatment. We conclude that the use of serum creatinine measurements to identify cases of non-dialysis requiring ARF resulted in much higher estimates of disease incidence compared with previous studies. Both dialysis-requiring and non-dialysis requiring ARFs are becoming more common. Our data underscore the public health importance of ARF.

Development of an n-3 fatty acid and α-tocopherol enriched dry fermented sausage.

Five batches of "salchichon", which is a dry fermented Spanish sausage, were manufactured using backfat and meat enriched in polyunsaturated n-3 fatty acids and α-tocopherol. Raw materials were obtained from animals fed on diets of the same ingredients with the exception of the oil source [sunflower oil (batch control, C), linseed oil (L and LE), 1/1 (w/w) linseed and olive oil (LO and LOE)] and α-tocopherol quantity [20 mg/kg diet of α-tocopherol (C, L and LO) or 200 mg/kg diet of α-tocopherol (LOE and LE)]. A final product with a healthier polyunsaturated fatty acid n-6:n-3 ratio (< 4) was obtained from all linseed oil-enriched batches as compared with the control (12). The batches of sausages manufactured with backfat and meat from animals fed on diets enriched in α-tocopherol and linseed, or linseed and olive oil with or without α-tocopherol supplementation show a higher lipid oxidative stability than those of diets enriched in linseed oil without α-tocopherol supplementation. Sausages of dietary treatment C, LE, LO and LOE did not show differences in water, protein, fat and ash contents, a(w), pH, texture profile analysis and sensory features (odour, colour, texture, juiciness and taste quality). Sausages manufactured with material from animals fed on linseed oil-enriched diets and no added α-tocopherol (L) showed an unfavourable rancidity degree detected by both 2-thiobarbituric acid-reactive substances (TBARs) index and sensory panel.

Effect of dietary linseed oil and α-tocopherol on pork tenderloin (Psoas major) muscle.

The effect of linseed oil and α-tocopheryl acetate on the fatty acid composition and the susceptibility to oxidation of lipid fraction from pork tenderloin (Psoas major) muscle has been studied. Muscles were obtained from animals fed on diets with the same ingredients excepting the oil source [sunflower (C), linseed (L) and linseed and olive (1/1, w/w) (LO)] and α-tocopherol [20 (C, L and LO) or 200 (LOE and LE) mg/kg diet]. The n-6/n-3 ratio in pork tenderloin was markedly modified by dietary linseed oil administration, which was due to the increase in the C18:3n-3 (and total n-3 fatty acids) and the decrease in the C18:2n-6 (and total n-6 fatty acids) contents (P<0.05). The α-tocopherol content of tenderloin from batches LE and LOE was about 2.8 mg/kg of muscle, significantly greater (P<0.05) than about 0.7 mg/kg muscle found in tenderloin from pigs receiving C, L and LO. Dietary supplementation with α-tocopheryl acetate markedly reduced tenderloin lipid oxidation from animals fed diets enriched in n-3 fatty acids (L or LO vs LE or LOE).

Dietary coenzyme Q10 supplementation alters platelet size and inhibits human vitronectin (CD51/CD61) receptor expression.

Improved cardiovascular morbidity and mortality have been observed in several clinical studies of dietary supplementation with coenzyme Q10 (CoQ10, ubiquinone). Several mechanisms have been proposed to explain the effects of CoQ10, but a comprehensive explanation of its cardioprotective properties is still lacking. One attractive theory links ubiquinone with the inhibition of platelets. The effect of CoQ10 intake on platelet size and surface antigens was examined in human volunteers. Study participants received 100 mg of CoQ10 twice daily in addition to their usual diet for 20 days. Receptor expression was measured by flow cytometry with monoclonal murine anti-human antibodies CD9 (p24), CD42B (Ib), CD41b (IIb), CD61 (IIIa), CD41a (IIb/IIIa), CD49b (VLA-2), CD62p (P selectin), CD31 (PECAM-1), and CD51/CD61 (vitronectin). An increase of total serum CoQ10 level (from 0.6 +/- 0.1 to 1.8 +/- 0.3 micrograms/ml; p < 0.001) was found at protocol termination. Fluorescence intensity was higher for the large platelets when compared with the whole platelet population. Significant inhibition of vitronectin-receptor expression was observed consistently throughout ubiquinone treatment. Reduction of platelet size was observed at the end of CoQ10 supplementation. Inhibition of the platelet vitronectin receptor and a reduction of the platelet size are direct evidence of a link between dietary CoQ10 intake and platelets. These findings may not be fully explained by the known antioxidant and bioenergetic properties of CoQ10. Diminished vitronectin-receptor expression and reduced platelet size resulting from CoQ10 therapy may contribute to the observed clinical benefits in patients with cardiovascular diseases.

Could coenzyme Q10 affect hemostasis by inhibiting platelet vitronectin (CD51/CD61) receptor?

Improved cardiovascular morbidity and mortality have been observed in several clinical studies of dietary supplementation with coenzyme Q10 (CoQ10, ubiquinone). Several mechanisms have been proposed to explain the effects of CoQ10. One attractive theory links ubiquinone with the inhibition of platelets. The effect of CoQ10 intake on platelet surface antigens, and certain hemostatic parameters was examined in 15 humans and 10 swine. Study participants received 100 mg of CoQ10 twice daily in addition to their usual diet for 20 days resulting in a three-fold increase of total serum CoQ10 level. We observed a decline in plasma fibronectin (-20.2%), thromboxane B2 (-20.6%), prostacyclin (-23.2%), and endothelin-1 (-17.9%) level. Significant inhibition of vitronectin receptor expression was observed consistently throughout ubiquinone treatment. Inhibition of the platelet vitronectin receptor is a direct evidence of a link between dietary CoQ10 intake, platelets, and hemostasis. These findings may contribute to the observed clinical benefits by a diminished incidence of thrombotic complications in such patients.

[Enteral nutrition and fiber in intensive care]. / Nutrición enteral y fibra en cuidados intensivos.

As in other fields of Medicine and Nutrition, the study of Alimentary Fiber or Dietary Fiber is becoming particularly intensive: its use in Intensive Care patients has however scarcely been explored. For comparison, its utility in diarrhea is assumed as main indication. This has not however been demonstrated. The scant research studies have not proven that diarrhea is controlled, particularly taking account of its complexity and multifactorial etiology. However, its utility has been shown in glucose-intolerance which is so common in Intensive Care Units, as in Diabetes. Current research is examining its bacterial fermentation products, short-chain fat acids (acetate, propionate and butyrate) and their importance as an energy source both of the intestinal and systemic mucosa. Short-chain fat acids are the preferred fuel of the colonic mucosa and an additional calorie contribution ought not to be ignored.

Resultado preliminar del estudio seminologico. pacientes ambulatorios 1984-1987 Instituto de Genetica / Preliminary report of a semiologic study in out patients 1984-87. Genetic Institute

En el laboratorio de Reproducciòn Humanadel Instituto de Genètica Humana, se procesaron cerca de 300 exàmenes semiològicos durante los ultimos años (1984-1987): en la mayoria de las consulta privada de Urologia y Ginecològia, y otras en menor proporciòn, provenientes del Ministerio de Previsiòn Social y Salud Pùblica. Para homogenizar la muestra fuè seleccionado un grupo de pacientes cuyo resultado semiològico tuviere el nùmero de variables preestablecido: los pacientes privados o no, que por cualquier circunstancia no completaron el nùmero de variables establecido, fueron excluidos. Los resultados fueron condensados en 18 diagnòsticos semiològicos (tabla No.2), donde aparecen individualmente y combinados entre ellos, hasta un màximo de 4 combinaciones posibles. Llama enormemente la atenciòn la observaciòn tan frecuente de bacterias y piocitos, en màs de 85 porciento de todas las muestras de semen examinadas, lo que supone la alta prevalencia de enfermedades infecciosas del tarcto urogenital, muchas de las cuales seguramente corresponden a enfermedades sexualmente transmitibles. Debido a las caracteristicas metodologicas de este trabajo, no se realizaron determinaciones hormonales, exàmenes anatomo-patològicos, citogeneticos, microbiològicos, etc. que coadyuven al estudiante clìinico y sus posibilidades terapèuticas. El hallazgo de combinaciones en las alteraciones del semiograma constituye una importante contribuciòn para el estudio y esclarecimiento de los transtornos de la fertilidad masculina

Phospholipids and their fatty acid composition in the muscle of trout fed on diets supplemented with olive oil bagasse or technical rendered fat.

A study to determine the effects of two by-products from the food industry (olive oil bagasse or technical rendered fat) on the phospholipid content and the fatty acid composition of the muscle of rainbow trout (Salmo gairdneri) has been made. Three batches of 150 trout were given for 100 days a commercial diet alone or supplemented either with 11% olive oil bagasse or technical rendered fat. The phospholipid content in the muscle of the three batches of trout ranged from 0.70 to 0.93% (wet weight). In this fraction, six different phospholipid classes were detected, phosphatidylcholine and phosphatidylethanolamine achieving average values of 55 and 25% of total phospholipids. Although differences in the fatty acid composition of the diet were observed, the only clear influence of diet was on the fatty acid C-22:6 of muscular phosphatidylethanolamine.