Physicians' Perception of Oral Nutritional Supplement Acceptance and Tolerability in Malnourished Outpatients: PerceptiONS Study.

Malnutrition is a common condition associated with various pathologies such as infections, neoplasms and digestive system disorders. Patients can be managed using different strategies, which include dietary modifications or oral nutritional supplements (ONS). It is important to promote good ONS adherence in order to attain clinical efficacy and cost-effectiveness. Several factors (amount, type, duration and tolerability) may have an impact on ONS adherence. PerceptiONS is a descriptive, cross-sectional observational study based on an ad hoc electronic survey designed to explore physicians' perception of malnourished outpatients prescribed ONS. The survey considered adherence, acceptance/satisfaction, tolerability and benefits within the context of Spain's healthcare system. The perceptions of 548 physicians regarding the experience of 2516 patients were analyzed. From the physicians' perspective, 57.11% of patients adhered to over 75% of the prescribed ONS. The organoleptic properties of ONS represented the aspect with the most positive impact on adherence, with smell (43.72%) ranking as the top characteristic. In general, patients were satisfied (90.10%) with the ONS, with their related benefits (88.51%) and their organoleptic properties (90.42%), and accepted ONS in their daily diet (88.63%). ONS improved patients' general condition (87.04%), quality of life (QoL) (81.96%) and vitality/energy (81.28%). Physicians would prescribe the same ONS again in 96.4% of the cases.

Risk factors and comorbidities associated with severe aortic stenosis: A case-control study.

BACKGROUND AND OBJECTIVE: Aortic stricture (AS) is one of the most prevalent cardiovascular diseases in individuals 65 years of age or older. A number of epidemiological studies have suggested that certain cardiovascular risk factors (CRFs) and comorbidities could be associated with AS. The aim of this study was to evaluate the association between CRFs and comorbidities and severe symptomatic AS in individuals 65 years of age or older in a Spanish healthcare region. PATIENTS AND METHODS: We conducted an epidemiological case-control study from a single primary care centre. We collected information on exposure to CRFs and comorbidities and determined their association with AS, employing adjusted odds ratios (OR) and multiple logistic regression models. RESULTS: The study included 102 cases (mean age, 77.6 years) and 221 controls (mean age, 75.5 years). The CRFs significantly associated with severe symptomatic AS were hypercholesterolaemia (OR, 2.67; p < .001), tobacco use (OR, 2.60; p < .001), hypertension (OR, 2.41; p = .010) and low HDL cholesterol readings (OR, 2.20; p = .007). The comorbidities significantly associated with severe symptomatic AS were carotid stenosis (OR, 14.5; p = .017), stroke (OR, 4.14; p = .024), chronic renal failure (OR, 3.78; p < .001) and low haemoglobin levels (OR, 0.76; p < .001). CONCLUSIONS: Hypercholesterolaemia, tobacco use, arterial hypertension and low HDL cholesterol levels are the CRFs with a greater risk of severe AS. Furthermore, this disease is associated with a number of comorbidities (chronic renal failure, stroke, carotid stenosis and low haemoglobin levels), which could be markers of AS.

Factores de riesgo y comorbilidades asociadas a la estenosis aórtica grave: estudio de casos y controles / Risk factors and comorbidities associated with severe aortic stenosis: a case-control study

Antecedentes y objetivo La estenosis aórtica (EA) es una de las enfermedades cardiovasculares más prevalentes en sujetos≥65años. Algunos estudios epidemiológicos sugieren que ciertos factores de riesgo cardiovascular (FRCV) y comorbilidades pueden estar asociados con la EA. El objetivo del estudio es evaluar la asociación de FRCV y comorbilidades con la EA grave sintomática en pacientes≥65años en una región sanitaria española. Pacientes y métodos Se realizó un estudio epidemiológico de casos y controles procedentes del mismo centro de atención primaria. Se recogió información sobre la exposición a FRCV y comorbilidades, y se determinó la asociación de ambos con la EA con odds ratio ajustadas (ORa), mediante modelos de regresión logística múltiple. Resultados Se incluyeron un total de 102 casos (edad media=77,6 años) y 221 controles (edad media=75,5 años). Los FRCV significativamente asociados con la EA grave sintomática fueron hipercolesterolemia (ORa=2,67; p<0,001), tabaquismo (ORa=2,60; p<0,001), hipertensión (ORa=2,41; p=0,010) y cifras bajas de colesterol-HDL (ORa=2,20; p=0,007). Las comorbilidades significativamente asociadas con la EA grave sintomática fueron estenosis carotídea (ORa=14,5; p=0,017), accidente vascular cerebral (ORa=4,14; p=0,024), insuficiencia renal crónica (ORa=3,78; p<0,001) y bajos niveles de hemoglobina (ORa=0,76; p<0,001). Conclusiones La hipercolesterolemia, el tabaquismo, la hipertensión arterial y los niveles bajos de colesterol-HDL son los FRCV que comportan mayor riesgo de EA grave. Asimismo, esta enfermedad se asocia con algunas comorbilidades (insuficiencia renal crónica, accidente vascular cerebral, estenosis carotídea y niveles de hemoglobina más bajos) que podrían ser marcadores de E (AU)

Background and objective Aortic stricture (AS) is one of the most prevalent cardiovascular diseases in individuals 65 years of age or older. A number of epidemiological studies have suggested that certain cardiovascular risk factors (CRFs) and comorbidities could be associated with AS. The aim of this study was to evaluate the association between CRFs and comorbidities and severe symptomatic AS in individuals 65 years of age or older in a Spanish healthcare region. Patients and methods We conducted an epidemiological case-control study from a single primary care centre. We collected information on exposure to CRFs and comorbidities and determined their association with AS, employing adjusted odds ratios (OR) and multiple logistic regression models. Results The study included 102 cases (mean age, 77.6 years) and 221 controls (mean age, 75.5 years). The CRFs significantly associated with severe symptomatic AS were hypercholesterolaemia (OR, 2.67; p<.001), tobacco use (OR, 2.60; p<.001), hypertension (OR, 2.41; p=.010) and low HDL cholesterol readings (OR, 2.20; p=.007). The comorbidities significantly associated with severe symptomatic AS were carotid stenosis (OR, 14.5; p=.017), stroke (OR, 4.14; p=.024), chronic renal failure (OR, 3.78; p<.001) and low haemoglobin levels (OR, 0.76; p<.001). Conclusions Hypercholesterolaemia, tobacco use, arterial hypertension and low HDL cholesterol levels are the CRFs with a greater risk of severe AS. Furthermore, this disease is associated with a number of comorbidities (chronic renal failure, stroke, carotid stenosis and low haemoglobin levels), which could be markers of AS (AU)

Risk factors and comorbidities associated with severe aortic stenosis: a case-control study. / Factores de riesgo y comorbilidades asociadas a la estenosis aórtica grave: estudio de casos y controles.

BACKGROUND AND OBJECTIVE: Aortic stricture (AS) is one of the most prevalent cardiovascular diseases in individuals 65 years of age or older. A number of epidemiological studies have suggested that certain cardiovascular risk factors (CRFs) and comorbidities could be associated with AS. The aim of this study was to evaluate the association between CRFs and comorbidities and severe symptomatic AS in individuals 65 years of age or older in a Spanish healthcare region. PATIENTS AND METHODS: We conducted an epidemiological case-control study from a single primary care centre. We collected information on exposure to CRFs and comorbidities and determined their association with AS, employing adjusted odds ratios (OR) and multiple logistic regression models. RESULTS: The study included 102 cases (mean age, 77.6 years) and 221 controls (mean age, 75.5 years). The CRFs significantly associated with severe symptomatic AS were hypercholesterolaemia (OR, 2.67; p<.001), tobacco use (OR, 2.60; p<.001), hypertension (OR, 2.41; p=.010) and low HDL cholesterol readings (OR, 2.20; p=.007). The comorbidities significantly associated with severe symptomatic AS were carotid stenosis (OR, 14.5; p=.017), stroke (OR, 4.14; p=.024), chronic renal failure (OR, 3.78; p<.001) and low haemoglobin levels (OR, 0.76; p<.001). CONCLUSIONS: Hypercholesterolaemia, tobacco use, arterial hypertension and low HDL cholesterol levels are the CRFs with a greater risk of severe AS. Furthermore, this disease is associated with a number of comorbidities (chronic renal failure, stroke, carotid stenosis and low haemoglobin levels), which could be markers of AS.

Volume-by-volume bioprinting of chondrocytes-alginate bioinks in high temperature thermoplastic scaffolds for cartilage regeneration.

IMPACT STATEMENT: 3D bioprinting represents a novel advance in the area of regenerative biomedicine and tissue engineering for the treatment of different pathologies, among which are those related to cartilage. Currently, the use of different thermoplastic polymers, such as PLA or PCL, for bioprinting processes presents an important limitation: the high temperatures that are required for extrusion affect the cell viability and the final characteristics of the construct. In this work, we present a novel bioprinting process called volume-by-volume (VbV) that allows us to preserve cell viability after bioprinting. This procedure allows cell injection at a safe thermoplastic temperature, and also allows the cells to be deposited in the desired areas of the construct, without the limitations caused by high temperatures. The VbV process could make it easier to bring 3D bioprinting into the clinic, allowing the generation of tissue constructs with polymers that are currently approved for clinical use.

Final results of a phase II study of paclitaxel, bevacizumab, and gemcitabine as first-line therapy for patients with HER2-negative metastatic breast cancer.

BACKGROUND: Efficacy and safety data for combining bevacizumab, gemcitabine, and paclitaxel for locally advanced/metastatic breast cancer are limited. PATIENTS AND METHODS: AVALUZ trial evaluates the combination of bevacizumab 10 mg/kg, gemcitabine 2,000 mg/m(2) plus paclitaxel 150 mg/m(2), on days 1 and 15 of each 28-day course in previously untreated HER-2 negative patients. RESULTS: Median progression-free survival (PES): 12.3 months. The overall response and clinical benefit rate (CR + PR + SD) were 72 % (95 % CI 60.9-82.0 %) and 89 % (95 % CI 80.3-95.3 %), respectively. Median overall survival: 27.4 mo. Baseline circulating tumor cell (CTCs) ≥2 versus CTCs <2 was associated with lower PFS, p = 0.046. Overall response was significantly greater in patients with intense angiotensin type 1 receptor (AGTR1) expression (99 vs. 60 % [p = 0.021]). The most frequent grade 3/4 adverse events were: neutropenia (10 %); febrile neutropenia (1 %); sensory neuropathy (13 %); and asthenia (6 %). Grade 3 adverse events of interest with bevacizumab included bleeding (1 %) and hypertension (4 %). One patient developed cardiac ischemia (1 %). CONCLUSIONS: Adding bevacizumab to chemotherapy appeared feasible and well tolerated, producing toxicity comparable to other effective combined first-line regimens. Baseline circulating endothelial cells and AGTR1 expression are predictive of PFS and response.

Time-resolved laser-induced plasma spectrometry for determination of minor elements in steelmaking process samples.

A pulsed Nd:YAG laser operating on the fourth (266 nm) and second (532 nm) harmonics has been used to generate plasmas on the target surface in air at atmospheric pressure. The influence of wavelength on quantitative analysis of 4 minor elements in stainless steel samples (Si, Ti, Nb and Mo) was investigated. Stainless steel samples with different elemental concentrations were prepared and analyzed by laser-induced plasma spectrometry (LIPS). The effect of laser wavelength on analytical figures of merit (calibration curves, correlation coefficients, linear dynamic ranges, analytical precision, and accuracy values) was found to be negligible when internal standardization (an Fe line) and time-resolved laser-induced plasma are employed. For both wavelengths, the calibration curves presented a good linearity and an acceptable linear dynamic range in the concentration interval investigated. For the four elements studied, limits of detection lower than 150 microg g(-1) were achieved. To evaluate the influence of wavelength on precision and accuracy, a set of fifteen high-alloyed steel samples from different stages of steelmaking process have been analyzed. Finally, the long-term stability of the analytical measurements for Mo with 532 nm wavelength has been discussed. RSD values were lower than 5.3% for the elements studied.