¿La ingesta o suplementación con ácidos grasos omega-3 a partir de los 65 años influye en la función cognitiva? Resultados de una revisión sistemática / Does Omega-3 supplementation after the age of 65 influence cognitive function? Results of a systematic review

Fundamento: El porcentaje de poblacion de edad avanzada aumenta progresivamente y con ello las enfermedades asociadas a la edad como el deterioro cognitivo (DC) y la demencia. Distintos estudios sugieren que dietas ricas en acidos grasos poliinsaturados omega-3 (AGPI w-3) pueden reducir el riesgo de DC y demencia. El objetivo fue evaluar si existe evidencia sobre la relación entre la suplementacion con AGPI w-3 en pacientes ≥ 65 anos y la funcion cognitiva. Material y métodos: Se recuperaron 582 articulos relacionados con acidos grasos o AGPI w-3 y DC o demencia y se incluyeron seis estudios en esta revision. Resultados: Los estudios son heterogeneos respecto a poblacion estudiada, medicion de la exposicion y desenlace, no pudiendo realizarse una sintesis cuantitativa. Dos encontraron que la suplementacion con AGPI w-3 prevenia la enfermedad de Alzheimer y mejoraba el rendimiento cognitivo. Dos encontraron mejoria solo en la clasificacion analogica visual y fluencia verbal y otros dos no encontraron evidencia de proteccion. Conclusiones: No se encontro evidencia para sustentar o negar que la suplementacion con AGPI w-3 a partir de los 65 anos mejora el rendimiento cognitivo o previene la demencia (AU)

Background: The percentage of the older population is progressively increasing as are diseases associated with aging such as cognitive decline (CD) and dementia. Observational epidemiological studies suggest that diets rich in omega 3 polyunsaturated fatty acids (w3-PUFA) might reduce the risk of CD and dementia. Methods: We used the PubMed data base to search for articles related to w3-PUFA and CD or dementia. Initially we identified 582 articles, after applying the eligibility criterion we included six studies in this systematic review. Results: The studies included were heterogeneous regarding population, measurement of exposure and outcome. Therefore, it was not possible to conduct a quantitative analysis. Two studies found that w3-PUFA supplementation decreased the risk of Alzheimer and improved cognitive performance. Two studies found an improvement in only one of the domains of cognitive performance (visual analogical classification and verbal fluency) and another two did not find any evidence of protection. Conclusions: We found few studies to support or refute the evidence that w3-PUFA supplementation in patients aged 65 or older improves cognitive performance or prevents dementia (AU)

[Does Omega-3 supplementation after the age of 65 influence cognitive function? Results of a systematic review]. / ¿La ingesta o suplementación con ácidos grasos omega-3 a partir de los 65 años influye en la función cognitiva? Resultados de una revisión sistemática.

BACKGROUND: The percentage of the older population is progressively increasing as are diseases associated with aging such as cognitive decline (CD) and dementia. Observational epidemiological studies suggest that diets rich in omega 3 polyunsaturated fatty acids (w3-PUFA) might reduce the risk of CD and dementia. The main objective was to assess whether there is sufficient scientific evidence about the relationship between w3-PUFA supplementation in patients aged 65 or older and cognitive performance. METHODS: We used the Pubmed data base to search for articles related to w3-PUFA and CD or dementia. Initially we identified 582 articles, after applying the eligibility criterion we included six studies in this systematic review. RESULTS: The studies included were heterogeneous regarding population, measurement of exposure and outcome. Therefore, it was not possible to conduct a quantitative analysis. Two studies found that w3-PUFA supplementation decreased the risk of Alzheimer and improved cognitive performance. Two studies found an improvement in only one of the domains of cognitive performance (visual analogical classification and verbal fluency) and another two did not find any evidence of protection. CONCLUSIONS: We found few studies to support or refute the evidence that w3-PUFA supplementation in patients aged 65 or older improves cognitive performance or prevents dementia.

The effect of a modified meat product on nutritional status in institutionalized elderly people / Efecto de un producto cárnico modificado sobre el estado nutricional de ancianos institucionalizados

Objective: To determine whether the inclusion of a new modified meat product as a dietary supplement has a positive influence on the nutritional status and blood lipidprofile of institutionalized elderly subjects. Method: A sample population of elderly people living in institutions (9 men and 29 women aged 68-97 years) completed a crossover study with two dietary supplements. Nutritionally complete diets differed only in food supplementation, first, with a standard meat product and, subsequently ,with a modified meat product. Venous blood samples were taken prior to each of the three phases of the study: the basal phase, during which participants followed their normal, controlled diet; a control phase (3days per week for 3 weeks), during which the subjects’ normal diet was supplemented with 50 g of the standard product; and an experimental phase (3 days per week for3 weeks), when the normal diet was supplemented with 50g of the modified product. Results: Nutritional intervention did not influence hematological parameters or serum lipids. The modified meat product altered blood concentrations of urea, creatinine, GOT, transferrin, iron, and retinol-binding protein. Conclusions: Consumption of both the standard and the modified products contributes to maintaining the individuals’ nutritional status and equalizes nutritional status across the study population with no effect on blood lipid profiles. Despite the limitations of the experiment, the introduction of dietary supplements in meat products significantly increased plasma iron levels in this elderly sample (AU)

Objetivo: Determinar si la suplementación de la dieta normal con un producto cárnico modificado tiene un efecto positivo sobre el estado nutricional y el perfil lipídicosanguíneo de ancianos institucionalizados. Método: Se aplicó un diseño cruzado a una muestra poblacional de ancianos institucionalizados (9 hombres and 29 mujeres de 68-97 años) administrando dos suplementos dietéticos. Las dietas primero se suplementaron con un producto cárnico estándar y luego con un producto cárnico modificado. Previamente a cada una de las tres fases del estudio se extrajeron muestras de sangre: fase basal, en la que los participantes siguieron su dieta habitual; fase control (3 días a la semana durante 3 semanas),en la que se suplementó la dieta con 50 g de un producto cárnico estándar y una fase experimental (3 días a la semana durante 3 semanas), en la que se suplemento la dieta con 50 g de un producto cárnico modificado. Resultados: La intervención nutricional no influyó negativamente ni en los parámetros hematológicos ni en los lípidos séricos. No obstante, el consumo del producto cárnico modificado alteró las concentraciones sanguíneas de urea, creatinina, GOT, transferrina, hierro y proteína transportadora de retinol. Conclusiones: El consume de ambos productos cárnicos contribuyó a mantener el estado nutricional de los sujetos homogeneizándolo en el conjunto de los mismos sin afectar negativamente al perfil lipídico sanguíneo. No obstante las limitaciones del presente estudio, se concluye que la incorporación regular de estos suplementos cárnicos mejora los niveles de hierro plasmático de los ancianos (AU)

The effect of a modified meat product on nutritional status in institutionalized elderly people.

OBJECTIVE: To determine whether the inclusion of a new modified meat product as a dietary supplement has a positive influence on the nutritional status and blood lipid profile of institutionalized elderly subjects. METHOD: A sample population of elderly people living in institutions (9 men and 29 women aged 68-97 years) completed a crossover study with two dietary supplements. Nutritionally complete diets differed only in food supplementation, first, with a standard meat product and, subsequently, with a modified meat product. Venous blood samples were taken prior to each of the three phases of the study: the basal phase, during which participants followed their normal, controlled diet; a control phase (3 days per week for 3 weeks), during which the subjects' normal diet was supplemented with 50 g of the standard product; and an experimental phase (3 days per week for 3 weeks), when the normal diet was supplemented with 50 g of the modified product. RESULTS: Nutritional intervention did not influence hematological parameters or serum lipids. The modified meat product altered blood concentrations of urea, creatinine, GOT, transferrin, iron, and retinol-binding protein. CONCLUSIONS: Consumption of both the standard and the modified products contributes to maintaining the individuals' nutritional status and equalizes nutritional status across the study population with no effect on blood lipid profiles. Despite the limitations of the experiment, the introduction of dietary supplements in meat products significantly increased plasma iron levels in this elderly sample.

[Incidence of influenza and influenza vaccine effectiveness in the 2004-2005 season]. / Incidencia de la gripe y efectividad de la vacuna antigripal en la temporada 2004-2005.

BACKGROUND: To quantify the incidence of flu in different groups of the population of Navarra in the 2004-2005 season, and to evaluate the effectiveness of anti-flu vaccination. METHODS: The analysis of influenza cases in the system of compulsory notificable diseases was complemented by the individualised notifications in the network of sentinel doctors that covers a population of 22,339 inhabitants. The coverage and effectiveness of the vaccine was studied. RESULTS: Vaccine coverage in (3)65 year olds reached 62%. The incidence of influenza was 42.6 cases per 1,000 inhabitants. It reached a maximum in mid-January, exceeding 750 weekly cases per 100,000 inhabitants and 1,900 cases per 100,000 children. The highest rate of influenza was observed in under-15 year olds (49.4 cases per 1,000 inhabitants) and the lowest in non-institutionalised (3)65 year olds (2.6 per 1,000 inhabitants), although it was higher in geriatric residences (62.1 per 1,000; p<0.0001). Seventy-nine percent of the cases from 5 to 64 years resulted in absenteeism from school or work. The flu virus was identified in 42/65 (65%) nasopharyngeal smears, 90% being influenza virus A(H3). The incidence of influenza was 3.08% in the unvaccinated and 0.45% in the vaccinated (p<0.001). The global effectiveness of the anti-flu vaccine was 65%, and in (3)65 years old it was 73%. CONCLUSION: Although its effectiveness is not total, the vaccine is the main measure for preventing influenza. The network of sentinel doctors provide useful information for the coordination of care and public health activities against flu.

Incidencia de la gripe y efectividad de la vacuna antigripal en la temporada 2004-2005 / Incidence of influenza and influenza vaccine effectiveness in the 2004-2005 season

Fundamento. Cuantificar la incidencia de gripe en distintos grupos de la población de Navarra en la temporada 2004-2005 y evaluar la efectividad de la vacunación antigripal.Métodos. El análisis de los casos de gripe del sistema de enfermedades de declaración obligatoria se ha complementado con las notificaciones individualizadas de la red de médicos centinela que atiende a una población de 22.339 habitantes. Se estudió la cobertura y efectividad de la vacuna. Resultados. La cobertura vacunal en Ž65 años alcanzó el 62%. La incidencia de gripe fue de 42,6 casos por 1.000 habitantes. Alcanzó el máximo a mediados de enero, superando 750 casos semanales por 100.000 habitantes y 1.900 casos por 100.000 niños. La mayor tasa de gripe se observó en menores de 15 años (49,4 casos por 1.000 habitantes) y la menor en Ž65 años no institucionalizados (2,6 por 1.000 habitantes), aunque fue mayor en residencias geriátricas (62,1 por 1.000; p<0,0001). El 79% de los casos de 5 a 64 años causó absentismo escolar o laboral. Se identificó el virus de la gripe en 42/65 (65%) frotis nasofaríngeos, siendo el 90% virus gripal A(H3). La incidencia de gripe fue del 3,08% en los no vacunados y del 0,45% en vacunados (p<0,001). La efectividad global de la vacuna antigripal fue del 65%, y en Ž65 años del 73%.Conclusión. Aunque su efectividad no es total, la vacuna es la principal medida para la prevención de la gripe. La red de médicos centinela aporta información útil para la coordinación de actividades asistenciales y de salud pública frente a la gripe

Background. To quantify the incidence of flu in different groups of the population of Navarra in the 2004-2005 season, and to evaluate the effectiveness of anti-flu vaccination. Methods. The analysis of influenza cases in the system of compulsory notificable diseases was complemented by the individualised notifications in the network of sentinel doctors that covers a population of 22,339 inhabitants. The coverage and effectiveness of the vaccine was studied. Results. Vaccine coverage in Ž65 year olds reached 62%. The incidence of influenza was 42.6 cases per 1,000 inhabitants. It reached a maximum in mid-January, exceeding 750 weekly cases per 100,000 inhabitants and 1,900 cases per 100,000 children. The highest rate of influenza was observed in under-15 year olds (49.4 cases per 1,000 inhabitants) and the lowest in non-institutionalised Ž65 year olds (2.6 per 1,000 inhabitants), although it was higher in geriatric residences (62.1 per 1,000; p<0.0001). Seventy-nine percent of the cases from 5 to 64 years resulted in absenteeism from school or work. The flu virus was identified in 42/65 (65%) nasopharyngeal smears, 90% being influenza virus A(H3). The incidence of influenza was 3.08% in the unvaccinated and 0.45% in the vaccinated (p<0.001). The global effectiveness of the anti-flu vaccine was 65%, and in Ž65 years old it was 73%. Conclusion. Although its effectiveness is not total, the vaccine is the main measure for preventing influenza. The network of sentinel doctors provide useful information for the coordination of care and public health activities against flu

Brotes de gripe en población vacunada de residencias geriátricas en la temporada 2004-2005 / Influenza outbreaks in highly-vaccinated older institutionalised people in the 2004-2005 season

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Problemas de utilización de medicamentos en pacientes enterostomizados / Problems in the use of medicines in enterostomized patients

La práctica de un estoma intestinal, transitorio o permanente, conlleva una serie de implicaciones de carácter fisiológico, farmacológico, psicológico y comunitario que deben ser atendidas de manera integral e individualizada para cada paciente. Con frecuencia, el paciente ostomizado se encuentra sometido a terapia farmacológica. Sin embargo, el efecto previsible de los medicamentos administrados podría verse afectado por factores relacionados con el estoma. Así, se ha descrito que resecciones extensas de íleon afectan al proceso de absorción oral de fármacos, particularmente en formas farmacéuticas de recubrimiento entérico, liberación retardada y grageas. Esto supondría el acceso de la porción no absorbida del principio activo al dispositivo colector a través de las heces y la posible alteración de la duración e intensidad del efecto farmacológico. Por otra parte, estudios de farmacovigilancia han revelado que numerosos principios activos producen cambios en la motilidad intestinal, bien en base a su mecanismo fundamental de acción (laxantes, antidiarreicos, procinéticos), bien como efecto colateral o secundario (antiácidos, antidepresivos, antihistamínicos, analgésicos opioides). La aparición de estreñimiento y, especialmente, de diarrea puede resultar molesta y preocupante para pacientes ostomizados y de particular gravedad en pacientes ileostomizados, por la deshidratación a que puede dar lugar. Asimismo, modificaciones en el color y olor de las heces, secundarias a la administración de medicamentos (sales ferrosas, hidróxido de aluminio, compuestos de bismuto) pueden alarmar innecesariamente a los pacientes que las detectan en los dispositivos de ostomía. Todos estos factores podrían comprometer la adhesión del paciente al tratamiento prescrito y, por consiguiente, el éxito del mismo. Sin embargo, podrían evitarse, corregirse o justificarse con un buen asesoramiento por parte de los profesionales sanitarios implicados en la atención al paciente enterostomizado (AU)

[Problems in the use of medicines in enterostomized patients]. / Problemas de utilización de medicamentos en pacientes enterostomizados.

The practice of intestinal stoma, transitory or permanent, has a series of implications of a physiological, pharmacological, psychological and communitarian character that must be attended to in an integral and individualised way for each patient. Frequently, the ostomised patient is subjected to pharmacological therapy. However, the foreseeable effect of the medicines administered can be affected by factors related to the stoma. Thus, descriptions have been made of extensive resections of ileum that affect the process of the oral absorption of medicines, especially in pharmaceutical forms of enteric covering, delayed release and pills. This would mean access of the unabsorbed portion of the active principle to the collecting device through the faeces and a possible alteration of the duration and intensity of the pharmacological effect. On the other hand, pharmaco surveillance studies have revealed that numerous active principles produce changes in intestinal motility, either on the basis of its fundamental mechanism of action (laxatives, anti-diarrhoea, prokinetics), or as a collateral or secondary effect (antiacids, antidepressants, antihistamines, opioid analgesics). The appearance of constipation and, especially, of diarrhoea can be disturbing and worrying for ostomised patients, and particularly grave in ileostomised patients, due to the dehydration to which it can give rise. Similarly, changes in the colour and odour of faeces, secondary to the administration of medicines (ferrous salts, aluminium hydroxide, bismuth compounds) can needlessly alarm the patients who detect them in the ostomy collecting device (pouch). All these factors can create difficulties for the adhesion of the patient to the proscribed treatment and, as a result, affect its success. However, they can be avoided, corrected or justified with good counselling by the health professionals involved in caring for enterostomized patient.