Grip Strength, Gait Speed and Plasma Markers of Neurodegeneration in Asymptomatic Middle-aged and Older Adults.

BACKGROUND: Pragmatic biomarkers of preclinical dementia would allow for easy and large-scale screening of risk in populations. Physical function measures like grip strength and gait speed are potential predictive biomarkers but their relationship with plasma markers of Alzheimer's Disease and neurodegeneration have not been elucidated. OBJECTIVES: To examine association between physical function measures and plasma markers of Alzheimer's Disease (AD) and neurodegeneration. DESIGN: Cross-sectional and longitudinal analyses. SETTING: Community-based cohort in the city of Framingham, Massachusetts. PARTICIPANTS: 2336 participants of the Framingham Heart Study Offspring cohort with an average age of 61. MEASUREMENTS: Plasma Aß40 and Aß42 were measured in 1998-2001 (Exam-7) and plasma total tau measured 5 years later (Exam-8). Grip strength, fast walk speed and chair stand speed were measured at both exams. Quantification of Aß isoforms in plasma was performed using INNO-BIA assays and plasma total-tau was measured using Quanterix Simoa HD-1 assay. Confounder-adjusted linear regression models examined associations between physical function and plasma markers, Results: Grip strength at Exam-7 was associated with plasma Aß40 (ß -0.006, p-value 0.032) at Exam-7 and plasma total-tau (ß -0.010, p-value 0.001) at Exam-8. Grip strength and fast walk speed at Exam-8 were associated with plasma total-tau at Exam-8 (GS: ß -0.009, p 0.0005; FWS: ß -0.226, p-value <0.0001). Chair stand speed was not associated with plasma markers; Aß42 was not associated with function. CONCLUSION: Grip strength and fast walk speed are associated with plasma markers of neurodegeneration in dementia-free middle aged and older individuals. Both these measures could be used as potential screening tools for identifying individuals at a higher risk for AD and related dementias alongside other validated markers.

Allergic rhinitis and associated factors in schoolchildren from Bogota, Colombia.

BACKGROUND: Allergic rhinitis is one of the most frequent chronic diseases among children. The objective of the study was to assess the prevalence of and the factors associated with self-reported allergic rhinitis symptoms in schoolchildren from Bogota, Colombia. METHODOLOGY/PRINCIPAL: We followed the International Study of Asthma and Allergies in Childhood (ISAAC) methodology. Our sample included 3,256 children aged 6 - 7 and 3,830 adolescents aged 13 - 14 years. RESULTS: The prevalence of self-reported allergic rhinitis symptoms was 30.8% among children and 36.6% among adolescents. Factors associated with self-reported allergic rhinitis among children included current asthma and atopic dermatitis symptoms; use of acetaminophen in the first year of life and in the last 12 months; antibiotic use in the first year of life; high- school and university maternal education; smokers at home; and caesarean delivery. Among adolescents, associated factors included current asthma and atopic dermatitis symptoms; current acetaminophen use once per month; frequent fast-food consumption; cat exposure at home; and smoking. CONCLUSION: Further exploration of factors associated with allergic rhinitis symptoms is needed.

Circulating IL-6 and CRP are associated with MRI findings in the elderly: the 3C-Dijon Study.

OBJECTIVE: The relation between inflammation and brain MRI findings in the elderly remains poorly known. We investigated the association of circulating interleukin-6 (IL-6) and C-reactive protein (CRP) levels with baseline and longitudinal white matter hyperintensities (WMH), silent brain infarction, and brain volumes in community-dwelling elderly free of dementia. METHODS: We included 1,841 participants aged 65 to 80 years from the Three City-Dijon cohort. Participants followed an MRI examination at baseline and after a 4-year follow-up (n = 1,316). IL-6 and CRP concentrations were measured at baseline from fasting blood samples. WMH were detected with an automatic imaging processing method and gray matter, hippocampal, white matter, and CSF volumes were estimated with voxel-based morphometry. Silent brain infarctions were assessed visually and defined as focal lesions of ≥3 mm in the absence of stroke. We used analysis of covariance and logistic regression to model the associations between inflammatory biomarkers and brain MRI findings adjusting for potential confounders. RESULTS: In cross-sectional analyses, higher IL-6 levels were associated with higher WMH volumes (p < 0.01), lower gray matter (p = 0.001) and hippocampal (p = 0.01) volumes, and increasing CSF volumes (p = 0.002) in a dose-relationship pattern. Similar but weaker relations were observed for CRP. We observed no associations between baseline inflammatory biomarker levels and the evolution of MRI findings over 4 years. CONCLUSIONS: IL-6, and, to a lesser degree, CRP levels were associated with WMH severity as well as global markers of brain atrophy. These results suggest that an inflammatory process may be involved in both age-associated brain alterations.

Fijador externo articulado para el manejo del trauma severo de codo / Treatment of fractures of the elbow with orthotic correction

El manejo tradicional del trauma severo de codo se ha basado en osteosintesis estables e inmovilizaciones prolongadas con yesos o fijador externo triangulado, conllevando a pobres resultados funcionales dejando como secuelas dolor cronico, rigidez articular y limitación Funcional; por lo tanto, su manejo se debe centrar en reducción anatomica, fijación estable y movilización precoz con el fin de restaurar una función adecuada. Se realizo un estudio clinico observacional prospectivo tipo serie de casos. Se manejaron 8 pacientes con trauma severo de codo quienes presentaban compromiso de mas de dos columnas del codo descritas por Heim, utilizando un fijador externo articulado complementando con fijación interna en casos indicados, en nuestra institución, entre julio de 1998 y diciembre de 1999. Se realizo seguimiento clinico y radiologico mensual. Como resultados hasta la fecha han terminado el tratamiento 8 pacientes, de los cuales 6 pacientes son hombres y 2 mujeres, con un promedio de edad de 40.6 años (23-58), siendo el miembro dominante el comprometido en 5 casos (37.5 por ciento). Dentro de las causas de trauma se encontraron: heridas por arma de fuego en 5 pacientes (62.5 por ciento), caida desde alturas en 2 pacientes (25 por ciento) y accidente en moto en 1 (12.5 por ciento). No se observo proceso infeccioso en los pacientes. El tiempo promedio de duración con el fijador fue de 11 semanas (6-24). El tiempo promedio de seguimiento fue de 14.75 meses (7-20). Como complicaciones se presento una fractura diafisiaria de humero en el sitio de inserción de los clavos posterior al retiro de los mismos despues de un trauma directo. De acuerdo con la escala funcional para codo de la Clínica Mayo se obtuvieron excelentes resultados en 6 pacientes y buenos en 2 pacientes teniendo en cuenta la movilidad, estabilidad, función y sintomatología del paciente. El uso del fijador externo articulado como tratamiento coadyuvante en los traumas severos de codo, ofrece la posibilidad de mantener los movimientos de flexoextension y pronosupinación, al igual que mantiene la estabilidad articular, utiles para la rehabilitación precoz del paciente y la disminución en la incidencia de complicaciones inherences al mismo trauma