[Sacral nerve stimulation for the treatment of severe fecal incontinence: long-term quality of life and functional outcomes].

BACKGROUND: The aim is to determine whether good functional and quality of life results of sacral nerve stimulation (SNS) in patients with severe fecal incontinence are maintained in the long-term. MATERIAL AND METHODS: Consecutive cohort of patients with severe fecal incontinence not responding to conservative (drugs and/or biofeedback) or surgical (sphincteroplasty) treatment, undergoing SNS between 2002 and 2013. Patients with a definitive implant were individually assessed in consultation throughout the follow-up, until January 2016. Defeca-tory function was assessed by Wexner score and stool diary, and perceived quality of life by FIQL and EQ-5D question-naires. RESULTS: Acute percutaneous nerve evaluation (PNE) was performed on 93 patients; a temporary electrode was implanted in 91 (79.1% women, mean age 62.5 years), obtaining a good functional response in 64. A permanent implant was per-formed in 61 patients, with a mean follow-up of 78.1 months (SD: 35.4; range 1-161); at the end of the study 42 patients remained in follow-up. A significant decrease was observed in the number of days per week with an incontinent episode, from 4.98 (SD 2.1) to 1.25 (SD 1.7), and in Wexner score from 16.88 (SD 2.74) to 6.95 (SD 3.54). Specific FIQL and generic EQ-5D questionnaires showed a significant improvement in quality of life. CONCLUSION: Long-term functional and quality of life outcomes of SNS for the treatment of severe faecal incontinence is maintained, with individual follow-ups that reach 10 years.

Nanotechnology in reproduction: Vitamin E nanoemulsions for reducing oxidative stress in sperm cells.

Vitamin E is considered a powerful biological antioxidant; however, its characteristics such as high hydrophobicity and low stability limit its application. We propose to use nanotechnology as an innovative tool in spermatology, formulating nanoemulsions (NE) that accommodate vitamin E, protecting it from oxidation and promoting its release into the medium. The protective effect of the NE against oxidative stress was assessed in red deer epididymal sperm incubated at 37 °C. Cryopreserved sperm from eleven stags were thawed and extended to 400 × 106 sperm/ml in Bovine Gamete Medium (BGM). Once aliquoted, the samples were supplemented with the NE at different concentrations (0, 6 and 12 mM), with or without induced oxidative stress (100 µM Fe2+/ascorbate). The samples were evaluated after 0, 2 and 4 h of incubation at 37 °C. Motility (CASA), viability, mitochondrial membrane potential, acrosomal status, lipoperoxidation (C11 BODIPY 581/591), intracellular reactive oxygen species (ROS) production and DNA status (SCSA®) were assessed. After 2 and 4 h of incubation, the NE were able to prevent the deleterious effects of oxidative stress, thus improving total and progression motility (P ˂0.05). Moreover, the highest concentration tested (12 mM) improved almost every sperm kinematic variable (P ˂0.05) and preserved sperm viability in samples subjected to oxidative stress. In addition, 12 mM of NE protected the acrosomes integrity, maintained and protected mitochondrial activity, prevented sperm lipoperoxidation and reduced ROS production (P ˂0.05) in samples subjected to oxidative stress. This work indicates for the first time that vitamin E formulated in NE could be a new approach against sperm oxidative damage. This could be highly relevant for sperm physiology preservation in the context of assisted reproduction techniques.

Ascorbyl-dipalmitate-stabilised nanoemulsions as a potential localised treatment of inflammatory bowel diseases.

Current efforts on inflammatory bowel diseases (IBD) treatment are focused on strategies for localised drug delivery at the intestinal mucosa. Despite the potential of curcumin (CC) for IBD treatment, its low solubility and stability limit its application. Thus, the design of nanocarriers that focus CC delivery at the intestinal epithelium is an area of interest. This work proposes α-tocopherol nanoemulsions (NE) stabilised by ascorbyl-2,6-dipalmitate (ADP) as intestinal CC-carriers. The antioxidant capacity of α-tocopherol and ADP could have a synergistic effect on IBD-affected tissues, characterised by an oxidative environment. We obtained nanoemulsions (NE-ADP) with size below 200 nm, negative surface charge, stable in gastrointestinal media and no toxic in the Caco-2 cell model. Intracellular retention of NE-ADP in Caco-2 cells was observed by confocal microscopy. The extremely low Papp values obtained for CC and α-tocopherol indicated the lack of transport across the Caco-2 monolayer. Control nanoemulsion stabilised by lecithin (NE-L) was greatly transported across the Caco-2 cells monolayer, confirming the relevance of ADP on the cellular retention of NE-ADP. The therapeutic potential of NE-ADP was shown by the significant decrease of intracellular ROS levels. Altogether, these results indicate the potential of NE-ADP as a novel approach for the treatment of IBD.

A western route of prehistoric human migration from Africa into the Iberian Peninsula.

Being at the western fringe of Europe, Iberia had a peculiar prehistory and a complex pattern of Neolithization. A few studies, all based on modern populations, reported the presence of DNA of likely African origin in this region, generally concluding it was the result of recent gene flow, probably during the Islamic period. Here, we provide evidence of much older gene flow from Africa to Iberia by sequencing whole genomes from four human remains from northern Portugal and southern Spain dated around 4000 years BP (from the Middle Neolithic to the Bronze Age). We found one of them to carry an unequivocal sub-Saharan mitogenome of most probably West or West-Central African origin, to our knowledge never reported before in prehistoric remains outside Africa. Our analyses of ancient nuclear genomes show small but significant levels of sub-Saharan African affinity in several ancient Iberian samples, which indicates that what we detected was not an occasional individual phenomenon, but an admixture event recognizable at the population level. We interpret this result as evidence of an early migration process from Africa into the Iberian Peninsula through a western route, possibly across the Strait of Gibraltar.

Characteristics of the puberty in hair ram lambs and its crosses in Colombia under low altitude conditions / Características de la pubertad en corderos de pelo y sus cruces en Colombia en condiciones de baja altitud

ABSTRACT Objective. Aimed to describe the characteristics of the onset of puberty in males in Colombian hair ram lambs (Ovino de Pelo Colombiano, OPC), and their crosses with Katahdin and Santa Inés sheep in a farm located in Villavicencio, Meta. Materials and methods. 15 lambs of three biotypes: OPC x OPC (OPC), Santa Ines x OPC (SO) and Katahdin X OPC (KO) from four until 12 months old. Ram lambs were grazing and they had supplementation with commercial salt and water ad libitum. Monthly body weight (BW), scrotal circumference (SC), testicular volume (TV) were measured and testosterone level were determined by Elisa test, and ultrasound of the two testicles was performed to determine the presence of the testicular mediastinum, also evaluating the presence and detachment of the urethral prolongation and then electro ejaculation was performed to determine the macroscopic and microscopic characteristics of the semen. Results. Genotype effect was significant for evolution of body BW, SC, TV over time. The SO and KO crosses presented the highest values in BW, whereas OPC lambs maintained a lower value until the end of the assay. At six months old, the three biotypes presented a minimum concentration of 150 million of sperm per ml with 30% of individual progressive motility. Conclusions. In non-seasonal tropical conditions in Colombia (Orinoquia), depending on the variables included, body weight, testicular development, pennis morphology, semen quality, sperm concentration and testosterone levels, it is postulated that around six months of age, the onset of puberty is displayed in the three biotypes.

RESUMEN Objetivo. Describir las características del inicio de la pubertad en corderos machos (Ovino de Pelo Colombiano, OPC) y sus cruces en una granja ubicada en Villavicencio, Meta. Materiales y métodos. Se evaluaron 15 corderos de tres razas: OPC x OPC (OPC), Santa Inés x OPC (SO) y Katahdin X OPC (KO), a partir de los cuatro meses de edad, cinco corderos por cruzamiento, manejados en pastoreo rotacional, con sal mineralizada comercial y agua a voluntad. Mensualmente hasta los doce meses de edad, se evaluó el peso corporal (PC), circunferencia escrotal (CE), volumen testicular (VT), y se determinó la concentración de testosterona en suero mediante la prueba de Elisa, se determinó la presencia del mediastino testicular mediante ecografía y se evalúo el desprendimiento de la prolongación uretral. Finalmente se determinaron las características macroscópicas y microscópicas del eyaculado. Resultados. El efecto racial o de cruzamiento fue significativo para los resultados del PC, CE y VT en el tiempo. Los cruces OPC y KO presentaron los valores más altos en PC, mientras que los corderos OPC mantuvieron un valor menor de PC hasta el final de la investigación. Se realizaron al menos cuatro evaluaciones seminales hasta la presentación de una concentración mínima de 150 millones de espermatozoides por ml con un 30% de motilidad progresiva individual. Conclusiones. En condiciones tropicales no estacionales en Colombia (Orinoquia), para las variables peso corporal, desarrollo testicular, morfología del pene, calidad del semen, concentración de espermatozoides y niveles de testosterona, se postula que alrededor de los seis meses de edad, se presenta el inicio de la pubertad en los tres biotipos.

Repercusiones clínicas y económicas de la desnutrición relacionada con la enfermedad en un servicio quirúrgico / Clinical and economic implications of disease-related malnutrition in a surgical service

Introducción: la desnutrición relacionada con la enfermedad (DRE) tiene una alta prevalencia e importantes repercusiones clínicas y económicas. Nuestro objetivo es valorar la factibilidad e importancia de establecer una estrategia de cribado nutricional en nuestro medio. Pacientes y métodos: estudio prospectivo realizado en una planta quirúrgica. Se realizó el Malnutrition Universal Screening Tool (MUST) al ingreso y semanalmente, hasta el alta hospitalaria, a todos los pacientes. Cuando fue necesario, se realizó valoración e intervención nutricional así como codificación al alta de los diagnósticos y procedimientos nutricionales. Datos de estancia hospitalaria (EH), costes hospitalarios y parámetros clínicos fueron analizados posteriormente. Resultados: en un 15,6% de pacientes, el MUST detectó riesgo de desnutrición (≥ 2 puntos). Los pacientes con desnutrición al ingreso (DI) presentaron una estancia hospitalaria (EH) cuatro días superior y mayor tasa de mortalidad y de reingresos urgentes (2,4 y 2,0 veces, respectivamente), un año después del alta hospitalaria. La edad y el ingreso urgente fueron los factores asociados a mayor tasa de mortalidad anual. Un 9% de los pacientes con MUST < 2 inicial sufrieron un deterioro del estado nutricional (DEN) durante el ingreso. Estos pacientes, tuvieron mayor EH (siete días) a igualdad de comorbilidad. Considerando los costes relacionados con la EH, en los pacientes que presentaron DI o DEN se observó un sobrecoste del 57% y el 145%, respectivamente. Conclusión: los pacientes con DI presentaron mayor EH y tasa de mortalidad y de reingresos urgentes un año después del alta hospitalaria. Los pacientes con DI o DEN ocasionan un sobrecoste económico. El cribado nutricional es indispensable para el manejo y la detección precoz de la DRE

Introduction: disease-related malnutrition (DRM) is currently a major challenge in our hospitals, both because of its high prevalence and because of the clinical and economic impact. Our study aims to assess the feasibility and importance of establishing a nutritional screening strategy in our Health Care System. Patients and methods: this is a prospective study carried out in a Surgery Ward. The nutritional risk was assessed by applying to patients MUST at admission and weekly until discharge. Nutritional evaluation and nutritional intervention were performed if required, as well as coding of diagnoses and nutritional procedures at discharge. Clinical data, length of stay (LOS) and hospital costs were analyzed. Results: MUST detected 15.6% of patients at risk of malnutrition at admission. Patients with malnutrition at admission (MA) had four days longer LOS, higher annual mortality rate and urgent hospital readmissions in 2.4 and 2.0 times, respectively, one year after discharge. Age and urgent hospital admission were the factors associated with a higher annual mortality rate. Nine per cent of patients with an initial MUST < 2 suffered deterioration in their nutritional status during admission (DNS). These patients had longer LOS in seven days with equal comorbidity. Considering only the costs related to LOS in patients who presented MA or DNS, an overcost of 57% and 145%, respectively, was observed. Conclusion: patients with malnutrition on admission had longer LOS, higher mortality rate and urgent hospital readmissions one year after discharge. Patients who present MA or DNE cause an economic cost overrun. A nutritional screening tool is essential for the management and early detection of DRM

Déficit de vitamina D en pacientes en hemodiálisis y factores relacionados / Deficit of vitamin D in hemodialysis patients and related factors

Introducción: La vitamina D interviene en el metabolismo óseo-mineral, la diabetes mellitus, enfermedades inmunológicas, procesos tumorales, el sistema cardio-vascular, anemia, etc. Objetivos: Determinar la prevalencia de insuficiencia-deficiencia de vitamina D y los factores de riesgo asociados en pacientes en hemodiálisis en Reus. Material y Método: Realizamos en abril de 2017 la determinación de los niveles sanguíneos, una entrevista oral sobre hábitos estables de adquisición de vitamina D y se extrajeron de la historia clínica enfermedades relacionadas, tratamientos e IMC. Resultados: Solo el 5,88% de los pacientes presenta-ban niveles normales. El 94,14% presentaron niveles inferiores a 30 ng/ml (promedio 9,64 ng/ml). En este grupo los pacientes resultaron de mayor edad, se exponen menos al sol, utilizan protección solar, hay mayor presencia de mujeres, toman menos alimentos enriquecidos o ricos en vitamina D y menos estatinas. Entre ellos se encuentran los tres pacientes con peso insuficiente. Los dos pacientes de raza negra tenían niveles < 10 ng/ml. En nuestra situación geográfica, Latitud: 41°09’22’’ N, en invierno la fotobiosíntesis de vitamina D es escasa. Solo el 14,12% de los pacientes tienen prescrito alguna suplementación de vitamina D. Sólo una variable fue estadísticamente significativa (raza) lo que puede atribuirse al tamaño limitado de la muestra. Conclusiones: El 94,14% de los pacientes tienen niveles bajos vitamina D y parece necesaria su suplementación farmacológica si queremos normalizarlos (AU)

Introduction: Vitamin D is involved in bone-mineral metabolism, diabetes mellitus, immunological diseases, tumor processes, cardiovascular system, anemia, etc.Aims: To evaluate the prevalence of vitamin D insufficiency-deficiency and its associated risk factors in hemodialysis patients. Results: Only 5.88% of patients presented normal levels. 94.14% of patients had levels below 30 ng/ml (mean 9.64 ng/ml). In this last group, patients were older, less exposed to the sun and used sun protection. A greater presence of women was found, taking less vitamin D or VD enriched foods and fewer statins. Between them, three patients had insufficient weight. The two black patients had levels < 10 ng/ml. In our geographical situation [Latitude: 41° 09'22"N], in winter, vitamin D skin-synthesis is scarce. Only 14.12% of patients took any vitamin D supplementation. Only one variable was statistically significant (human race). We must consider that it can be attributed to our limited sample size. Conclusions: 94.14% of patients have low vitamin D levels and pharmacological supplementation seems necessary (AU)

Vitamin transporters in mice brain with aging.

Its high metabolic rate and high polyunsaturated fatty acid content make the brain very sensitive to oxidative damage. In the brain, neuronal metabolism occurs at a very high rate and generates considerable amounts of reactive oxygen species and free radicals, which accumulate inside neurons, leading to altered cellular homeostasis and integrity and eventually irreversible damage and cell death. A misbalance in redox metabolism and the subsequent neurodegeneration increase throughout the course of normal aging, leading to several age-related changes in learning and memory as well as motor functions. The neuroprotective function of antioxidants is crucial to maintain good brain homeostasis and adequate neuronal functions. Vitamins E and C are two important antioxidants that are taken up by brain cells via the specific carriers αTTP and SVCT2, respectively. The aim of this study was to use immunohistochemistry to determine the distribution pattern of these vitamin transporters in the brain in a mouse model that shows fewer signs of brain aging and a higher resistance to oxidative damage. Both carriers were distributed widely throughout the entire brain in a pattern that remained similar in 4-, 12-, 18- and 24-month-old mice. In general, αTTP and SVCT2 were located in the same regions, but they seemed to have complementary distribution patterns. Double-labeled cell bodies were detected only in the inferior colliculus, entorhinal cortex, dorsal subiculum, and several cortical areas. In addition, the presence of αTTP and SVCT2 in neurons was analyzed using double immunohistochemistry for NeuN and the results showed that αTTP but not SVCT2 was present in Bergmann's glia. The presence of these transporters in brain regions implicated in learning, memory and motor control provides an anatomical basis that may explain the higher resistance of this animal model to brain oxidative stress, which is associated with better motor performance and learning abilities in old age.

PEGylated Nanoemulsions for Oral Delivery: Role of the Inner Core on the Final Fate of the Formulation.

Since the past decade, there has been growing interest to grant nanoparticles with diffusion properties across mucosae. In this sense, the nonionic block copolymer Pluronic F127 (PF127) has emerged as a promising coating agent to formulate mucus-penetrating particles. In the journey to find efficient coating agents, researchers have focused more on the effect of the coating agent architecture rather than on the role of the physicochemical properties of the nanoparticle used as the substrate. The current knowledge about mucodiffusive particles is in general based on model-like nanoparticles, such as polystyrene or poly(lactic-co-glycolic) acid nanoparticles, but there is a lack of information about the potential of PF127 on other colloidal systems. This work aims to shed some light on this issue by selecting three oils, palm (solid), coconut (semisolid), and wheat germ (liquid), with different physicochemical properties to formulate PF127-coated nanoemulsions. The obtained nanoemulsions were characterized, and their colloidal stability was tested. Their diffusion capacity was determined by particle tracking after challenging the nanoemulsions across an intestinal porcine mucus layer. In accordance with the evidence of model-like nanoparticles, our results state that PF127 allows mucodiffusion, but its effectiveness as a coating agent clearly depends on the physicochemical properties of the nanostructure core over which PF127 is placed. Among other physicochemical properties, the results certainly showed that the hydrophobic character of the nanostructure core emerges as a critical factor in the formulation of successful PF127 coatings.

Improving green enrichment of virgin olive oil by oregano. Effects on antioxidants.

This work is about improvement of a maceration method in order to achieve a green process for the enrichment of virgin olive oil (VOO) with natural antioxidants, specifically from oregano leaves. This goal was accomplished after evaluating different mechanical methods, i.e. magnetic stirring, sonication, vertical stirring and sonication in combination with vertical stirring, for promoting the extraction of the antioxidants from oregano. The results obtained indicated that the best extraction procedure was vertical stirring at 1000 r.p.m. for 3 h. Therefore, these conditions were selected to enrich VOO with phenolic acids (mainly rosmarinic acid) and endogenous antioxidants (o-coumaric and vanillic acids), and further determine their stability at room temperature or under temperature stress (50°C) during 45 days. Quantitative analysis of rosmarinic, o-coumaric and vanillic acids was carried out by an off-line, solid phase extraction, capillary zone, electrophoresis method combined with diode-array detector (SPE-CE-DAD).

Design of the interface of edible nanoemulsions to modulate the bioaccessibility of neuroprotective antioxidants.

Most frequently the use of bioactive molecules for the supplementation of food and beverages is hampered by stability limitations or inadequate intestinal absorption. This work evaluates in vitro the role that the interface of the nanoemulsion has on the physicochemical properties, the stability behavior and the enzymatic degradation after oral intake. For that purpose three soybean oil (SB) formulations were studied. These formulations were based on the emulsifier lecithin but modified with two non-ionic surfactants Pluronic(®) F68 (PF68) or Pluronic(®) F127 (PF127) yielding (i) SB-NE (only lecithin on the interface), (ii) SB-NE PF68 (lecithin plus PF68) and 9 (iii) SB-NE PF127 (lecithin plus PF127). All the formulations tested were low polydispersed and showed a size of about 200 nm and ζ-potential of -50 mV. The in vitro colloidal stability assay showed that lecithin itself was able to promote that formulations reach unaltered to the small intestine and facilitate the absorption of the antioxidant payload on a tunable fashion there (with in vitro bioaccessibility values from around 40% up to a 70%). PF68 was able to sterically stabilize the formulation against the aggregation induced by the pH and electrolytes of the simulated gastrointestinal track; however, this surfactant was easily displaced by the lipases of the simulated intestinal milieu being unable to modulate the digestion pattern of the oil droplets in the small intestine. Finally, PF127 displayed a strong steric potential that dramatically reduced the interaction of the oil droplets with lipases in vitro, which will compromise the capacity of the formulation to improve the bioaccessibility of the loaded antioxidant.

Effect of an allostatic modulator on stress blood indicators and meat quality of commercial young bulls in Mexico.

To assess the effect of an allostatic modulator (AM) on stress blood indicators and meat quality traits, the feed of 80 non-castrated 18-20 month-old bulls was supplemented with 10 g/day of an AM for 30 days before slaughter. Another 80 bulls served as control animals. The AM was comprised of ascorbic acid, acetoxybenzoic acid and sodium and potassium chloride. Blood samples were taken at slaughter for analyses of hematocrit value, erythrocyte and leukocyte counts, and glucose, lactate and cortisol concentrations. Post-mortem measures of meat color and pH were made at 24h and color, shear force and cooking loss on meat from 20 animals at 28 days. The AM supplementation resulted in lower hematocrit value, erythrocyte count and glucose level (P<0.05), higher a* (P<0.0001) and b* (P<0.0001) at 24h and lower b* (P<0.05) at 28 days. Thus AM treatment improved some stress blood indicators and meat color and therefore merits further investigation.

Effects and interactions of tachykinins and dynorphin on FSH and LH secretion in developing and adult rats.

Kisspeptin/neurokinin B/dynorphin (KNDy) neurons, which coexpress kisspeptins (Kps), neurokinin B (NKB), and dynorphin (Dyn), regulate gonadotropin secretion. The KNDy model proposes that NKB (a stimulator, through NK3R) and Dyn (an inhibitor, through κ-opioid receptor) shape Kp secretion onto GnRH neurons. However, some aspects of this paradigm remain ill defined. Here we aimed to characterize the following: 1) the effects of NKB signaling on FSH secretion and 2) the role of Dyn in gonadotropin secretion after NK3R activation; 3) additionally, we explored the roles of other tachykinin receptors, NK1R and NK2R, on gonadotropin release. Thus, the effects of the NK3R agonist, senktide, on FSH release were explored across postnatal development in male and female rats; gonadotropin responses to agonists of NK1R substance P and NK2R [neurokinin A (NKA)] were also monitored. Moreover, the effects of senktide on gonadotropin secretion were assessed after antagonizing Dyn actions by nor-binaltorphimine didydrochloride. Before puberty, rats of both sexes showed increased FSH secretion to senktide (and Kp-10). Conversely, adult female rats were irresponsive to senktide in terms of FSH, despite proven LH responses, whereas the adult males did not display FSH or LH responses to senktide, even at high doses. In turn, substance P and NKA stimulated gonadotropin secretion in prepubertal rats, whereas in adults modest gonadotropin responses to NKA were detected. By pretreatment with a Dyn antagonist, adult males became responsive to senktide in terms of LH secretion and displayed elevated basal LH and FSH levels; nor-binaltorphimine didydrochloride treatment uncovered FSH responses to senktide in adult females. Furthermore, the expression of Pdyn and Opkr1 (encoding Dyn and κ-opioid receptor, respectively) in the mediobasal hypothalamus was greater in males than in females at prepubertal ages. Overall, our data contribute to refining our understanding on how the elements of the KNDy node and related factors (ie, other tachykinins) differentially participate in the control of gonadotropins at different stages of rat postnatal maturation.

Supernumerary fourth molar and dental pathologies in a Chalcolithic individual from the El Mirador Cave site (Sierra de Atapuerca, Burgos, Spain).

We present a middle-aged Chalcolithic male with a supernumerary distomolar in the mandible. The prevalence of supernumerary teeth in present-day populations is low, ranging from 0.1% to 3.4%; most supernumerary teeth are documented in the anterior and molar regions of the maxilla in present populations. However, the prevalence of supernumerary molars in past populations is still unknown. Moreover, a complete pathological study has been done of this individual. Maxilla, mandible and teeth have been analyzed searching for dental pathologies. A cone-beam computed tomography (CBCT) analysis of mandibular and maxillary fragments was performed to check the evidence of hyperdontia. Dental wear and maxillary alveolar bone have been analyzed with environmental scanning electron microscope (ESEM) to improve the diagnosis of an abscess and evidence of tooth picking. This individual shows a left distomolar in the mandible without any evidence of other supernumerary teeth. The fourth molar is not associated with any congenital disease. However, this individual suffered severe dental wear and a variety of oral pathologies such as, dental decay, abscesses, pulpitis, periodontal disease, toothpicking marks in an upper molar, arthritis of the temporomandibular joint and malocclusion associated with high masticatory loads. To our knowledge, this individual from El Mirador Cave (Sierra de Atapuerca, Spain) shows the most ancient case of a fourth molar documented. The poor oral health of this individual corresponds to the general dental health of Chalcolithic populations.

Evaluación de la capacidad de toma de decisiones sobre su salud en pacientes ancianos / Evaluation of the capacity of elderly patients to make decisions about their health

Objetivo. Evaluar la prevalencia de capacidad para la toma de decisiones y las variables relacionadas con ella, en pacientes ancianos de un programa de atención domiciliaria. Material y métodos. Se realiza un estudio descriptivo transversal en 130 pacientes adscritos al programa de atención domiciliaria o residentes en instituciones sociosanitarias de un centro de salud urbano. Se recogen las variables demográficas, las comorbilidades, el apoyo social, la institucionalización, el número de fármacos utilizados, el grado de dependencia (índice de Barthel), la función cognitiva (test de Pfeiffer) y la variable principal que es la capacidad para la toma de decisiones sobre su salud evaluada mediante el instrumento Aid to Capacity Evaluation (ACE). Resultados. Prevalencia de capacidad de 58,5%. Se encontró una asociación entre capacidad e independencia para las actividades de la vida diaria (odds ratio [OR]: 12.214; intervalo de confianza al 95% (IC 95%): 3,90-32,29; p < 0,0001) y función intelectual intacta (OR: 282.750; IC 95%: 34,0-2351,2; p < 0,0001). Las variables numéricas asociadas a la capacidad para la toma de decisiones que presentaron una magnitud de efecto más importante fueron el índice de Barthel (d: −1.398) y el índice de Pfeiffer (d: 3.084). Conclusiones. La prevalencia de incapacidad para la toma de decisiones sobre su salud en pacientes ancianos que son atendidos domiciliariamente es elevada. El grado de dependencia para las actividades de la vida diaria y del deterioro de la función intelectual son factores asociados a la presencia de esta capacidad (AU)

Objective. To assess the decision-making capacity and variables related to this, in elderly patients in a home care program. Material and methods. A cross-sectional study was conducted on 130 patients assigned to home care program or in social welfare residences of an urban health centre. Demographic variables, as well as comorbidities, social support, institutionalisation, number of drugs used, degree of dependence (Barthel Index), cognitive function (Pfeiffer) were collected. The primary endpoint was the capacity for decision-making about their health assessed using the Aid to Capacity Evaluation (ACE) tool. Results. There was a prevalence of 58.5% capacity. There was an association between ability and independence for activities of daily living (odds ratio (OR): 12.214; Confidence interval 95% (95% CI): 3.90 to 32.29, P <.0001) and function intellectual intact (OR: 282.750, 95% CI 34.0 to 2351.2, P <.0001). Numeric variables associated with the capacity for decision-making that had a more important effect size were the Barthel index (d: −1.398) and Pfeiffer index (d: 3.084). Conclusions. The prevalence of incapacity to make decisions about their health in elderly patients who are cared for in their homes is high. The level of dependence in activities of daily living and the deterioration of intellectual function are factors associated with the presence of this capacity (AU)

A Jerte valley cherry product provides beneficial effects on sleep quality. Influence on aging.

OBJECTIVE: In the present work, we evaluated the effect of the intake of a Jerte Valley cherry-based product (JVCP), compared to a placebo product, on sleep quality, urinary 6-sulfatoxymelatonin (aMT6-s) levels and the serum concentration of interleukin-1ß (IL-1ß), tumor necrosis factor α (TNF-α) and interleukin-8 (IL-8). DESIGN: This was a blind, placebo-controlled, randomized, crossover study. SETTING: University of Extremadura (Spain). PARTICIPANTS: Ten young (20-30 years old), ten middle-aged (35-55 years old), and ten elderly (65-85 years old) participants. INTERVENTION: A placebo (Kool-Aid®) or JVCP (patent no. ES 2342141 B1) were consumed twice a day, as lunch and dinner desserts. MEASUREMENTS: Actigraphic monitoring was used to record and display the temporal patterns of the individuals' activity and rest. Urinary aMT6-s and serum cytokines (IL-1ß, TNF-α and IL-8) were also determined. RESULTS: The consumption of the JVCP improved the nocturnal rest, measured by sleep efficiency, number of awakenings, total nocturnal activity, sleep latency, assumed sleep, actual sleep time and immobility. Moreover, it was detected an increase in both the levels of aMT6-s found in first-void morning urine and the concentrations of serum pro-somnogenic cytokines obtained from samples collected at the acrophase of the melatonin rhythm (1.00 am) in all experimental age groups after the JVCP consumption. Generally, better results were obtained with advancing age. CONCLUSION: The ingestion of the JVCP may contribute to establish a high-quality sleep and be used as a potential nutraceutical tool to prevent sleep disorders with the advance of age.

Changes in hypothalamic expression of the Lin28/let-7 system and related microRNAs during postnatal maturation and after experimental manipulations of puberty.

Lin28 and Lin28b are related RNA-binding proteins that inhibit the maturation of miRNAs of the let-7 family and participate in the control of cellular stemness and early embryonic development. Considerable interest has arisen recently concerning other physiological roles of the Lin28/let-7 axis, including its potential involvement in the control of puberty, as suggested by genome-wide association studies and functional genomics. We report herein the expression profiles of Lin28 and let-7 members in the rat hypothalamus during postnatal maturation and in selected models of altered puberty. The expression patterns of c-Myc (upstream positive regulator of Lin28), mir-145 (negative regulator of c-Myc), and mir-132 and mir-9 (putative miRNA repressors of Lin28, predicted by bioinformatic algorithms) were also explored. In male and female rats, Lin28, Lin28b, and c-Myc mRNAs displayed very high hypothalamic expression during the neonatal period, markedly decreased during the infantile-to-juvenile transition and reached minimal levels before/around puberty. A similar puberty-related decline was observed for Lin28b in monkey hypothalamus but not in the rat cortex, suggesting species conservation and tissue specificity. Conversely, let-7a, let-7b, mir-132, and mir-145, but not mir-9, showed opposite expression profiles. Perturbation of brain sex differentiation and puberty, by neonatal treatment with estrogen or androgen, altered the expression ratios of Lin28/let-7 at the time of puberty. Changes in the c-Myc/Lin28b/let-7 pathway were also detected in models of delayed puberty linked to early photoperiod manipulation and, to a lesser extent, postnatal underfeeding or chronic subnutrition. Altogether, our data are the first to document dramatic changes in the expression of the Lin28/let-7 axis in the rat hypothalamus during the postnatal maturation and after different manipulations that disturb puberty, thus suggesting the potential involvement of developmental changes in hypothalamic Lin28/let-7 expression in the mechanisms permitting/leading to puberty onset.

Different postharvest strategies to preserve broccoli quality during storage and shelf life: controlled atmosphere and 1-MCP.

Broccoli (Brassica oleracea var. italica) is a vegetable that requires the application of postharvest techniques to extend its marketability. Controlled atmosphere and 1-MCP treatments are most used to extend the shelf life of broccoli and reduce post-harvest deterioration. The aim of this study was to evaluate the visual, physicochemical and functional changes of broccoli head samples stored at 1-2 °C and 85-90% relative humidity (RH) in air (Control samples), under controlled atmospheres (10% O(2) and 5% CO(2)) (CA samples) and treated with 1-MCP (0.6 µL/L). After storage all samples were maintained at 20 °C for 2 and 4 days, in order to assess their shelf life. The most suitable postharvest treatment to extend broccoli quality during storage and shelf life, in terms of maintaining the visual quality and reducing loss of health-promoting compounds, was achieved by storage under controlled atmosphere conditions. The use of 1-MCP reduced the loss of green colour and chlorophyll pigments, but only during cold storage not during shelf life at 20 °C.

[Green tea and its role on chemoprevention in vivo of genotoxic damage induced by carcinogenic metals (chromium [VI])]. / El té verde en la quimioprevención in vivo del daño genotóxico inducido por metales cancerígenos (cromo [VI]).

BACKGROUND: Consumption of green tea, by its antioxidant properties, has been associated with beneficial health effects, because antioxidant may play a role in the risk and pathogenesis of several chronic diseases, especially cardiovascular disease and cancer. On the other hand, it has been reported that metal compounds such as chromium [VI] are carcinogenic and can induce genotoxic damage through the Oxidative Stress. Therefore, it is possible that green tea has a protective effect against the genotoxic damage induced by this compounds. OBJECTIVE: To evaluate the effect of oral administration of green tea over the genotoxic damage induced by Cr [VI] by quantification of micronucleus (MN) in polychromatic erythrocytes (EPC). MATERIALS AND METHODS: We use mice of CD-1 strain that were randomly divided into the following groups: (i) control, (ii) treatment with green tea, (iii) treatment with chromium trioxide, (iv) treatment with green tea and chromium trioxide. The green tea was administrated via intragastric tube every 12 hours over two days (4 doses of 0.25 ml infusions 1.6 g/7.5 ml) and ad libitum (5.6 ml/day for 10 days infusions of 3.2 g/100 ml), while chromium trioxide was administrated via intraperitoneal (20 mg/kg). Blood samples were obtained from the caudal vein, the number of MN in EPC was assessed at 0, 24, 48 and 72 hours after the treatments. RESULTS: The group treated with green tea showed no significant statistical changes in the average of MN. On the other hand, the group that was dosed with the chromium trioxide showed an increase between 4 and 8 MN, which was statistically significant when compared with control group, which confirmed the genotoxic damage. When the green tea treatment was administered before the application of chromium trioxide, there was a decrease in MN frequencies of 31 and 62% at 72 hours, 20 and 35% at 48 hours and 18 and 31% at 24 hours with intragastric and ad libitum respectively, compared with the group treated only with chromium trioxide. Hence, green tea reduced the genotoxic damage induced by chromium trioxide, and the highest protection was presented at 72 hours. CONCLUSIONS: Our findings support the protective effects of green tea against the damage of genetic material, induced by metal compounds such as chromium [VI], suggesting that its antioxidant compounds are those that have a chemopreventive effect on the EOX generated by the Cr [VI] during its reduction to Cr (III). The fact that the largest decrease in the frequency of MN was observed at 72 hours and ad libitum treatment, suggests that, the protective effect depends on the bioavailability, pharmacodynamics and pharmacokinetics of the active ingredient in green tea, so the administration of green tea for a long period of time before the exposure to Cr [VI] could have a more consistent preventive effect.