Heart failure as a predictor of functional dependence in hospitalized elderly

OBJETIVOIdentificar se a Insuficiência Cardíaca (IC) é um preditor de dependência funcional para as Atividades Básicas de Vida Diária (AbVD) em idosos hospitalizados.MÉTODOEstudo epidemiológico, observacional em corte transversal. Foram analisados os prontuários e feita avaliação funcional através do Índice de Katz de 100 idosos em uma enfermaria geriátrica de um hospital universitário. Para verificar se a IC é um preditor de dependência funcional, foram feitas análises de regressão linear.RESULTADOSA prevalência de IC foi de 21%, sendo que 95% destes, eram dependentes para as AbVDs. Banho foi a AbVD mais comprometida. A IC aumenta em 5 vezes a chance de perda funcional (IC 95% 0,94-94,48), em 3,5 vezes a chance de piora funcional (IC95% 1,28-11,66; p < 0,02) e reduz em 0,79 pontos o escore do Índice de Katz (p < 0,05).CONCLUSÃOA IC é um preditor de dependência para AbVDs em idosos hospitalizados, que tendem a ser mais dependentes, principalmente para o banho.OBJETIVOIdentificar si la Insuficiencia Cardiaca (IC) es un pronosticador de dependencia funcional para las Actividades Básicas de Vida Diaria (AbVD) en ancianos hospitalizados.MÉTODOEstudio epidemiológico, observacional en corte transversal. Fueron analizadas las fichas y hecha la evaluación funcional mediante el Índice de Katz de 100 ancianos en una enfermería geriátrica de un hospital universitario. Para verificar si la IC es un pronosticador de dependencia funcional, se hicieron análisis de regresión lineal.RESULTADOSLa prevalencia de IC fue del 21%, siendo que el 95% de estos eran dependientes para las AbVDs. El baño fue la AbVD más comprometida. La IC aumenta 5 veces la probabilidad de pérdida funcional (IC 95% 0,94-94,48) y 3,5 veces la probabilidad de empeoramiento funcional (IC95% 1,28-11,66; p < 0,02); y reduce en 0,79 puntos el puntaje del Índice de Katz (p < 0,05).CONCLUSIÓNLa IC es un pronosticador de dependencia para AbVDs en ancianos hospitalizados, quienes tienden a ser más dependientes, especialmente para bañarse.OBJECTIVEIdentify whether Heart Failure (HF) is a predictor of functional dependence for Basic Activities of Daily Living (BADL) in hospitalized elderly.METHODSWe investigated medical records and assessed dependence to BADL (by the Katz Index) of 100 elderly admitted to a geriatric ward of a university hospital. In order to verify if HF is a predictor of functional dependence, linear regression analyzes were performed.RESULTSThe prevalence of HF was 21%; 95% of them were dependent for BADLs. Bathing was the most committed ADL. HF is a predictor of dependence in hospitalized elderlies, increasing the chance of functional decline by 5 times (95% CI, 0.94-94.48), the chance of functional deterioration by 3.5 times (95% CI, 1.28-11.66;

Cyclin E correlates with manganese superoxide dismutase expression and predicts survival in early breast cancer patients receiving adjuvant epirubicin-based chemotherapy.

Anthracycline-based chemotherapy represents a milestone in the treatment of breast cancer. We previously demonstrated in an in vitro model that cyclin E overexpression is associated with increased expression of manganese superoxide dismutase (MnSOD) and resistance to doxorubicin. In the present study, immunohistochemical expression of cyclin E and MnSOD was evaluated in 134 early breast cancer patients receiving adjuvant epirubicin-based chemotherapy regimens containing epirubicin. Both parameters were correlated with the available clinicopathological parameters and with the outcome of patients. Overexpression of cyclin E and MnSOD was detected in 46 (34.3%) and 56 (41.8%) patients, respectively, and expression levels of the two proteins were related. Disease-free and alive patients displayed a lower mean percentage of cyclin E-expressing cells than relapsed and dead patients, respectively. Kaplan-Meier survival analysis demonstrated a significant separation between high versus low cyclin E-expressing tumors in terms of overall survival (P = 0.038 by log-rank). Similar results were obtained considering the subset of node-negative patients separately. No significant relationship with patient outcome was observed for MnSOD expression levels. At multivariate analysis cyclin E failed to demonstrate an independent prognostic value. In conclusion, the results of the present study support previous evidence that increased cyclin E expression is associated with higher MnSOD expression levels and poorer outcome, at least as evaluated in terms of overall survival. Further studies are warranted to evaluate the usefulness of cyclin E as a prognostic marker to identify breast cancer patients at higher risk of death from the disease when treated with adjuvant anthracycline-based therapy

Heart failure as a predictor of functional dependence in hospitalized elderly

AbstractOBJECTIVEIdentify whether Heart Failure (HF) is a predictor of functional dependence for Basic Activities of Daily Living (BADL) in hospitalized elderly.METHODSWe investigated medical records and assessed dependence to BADL (by the Katz Index) of 100 elderly admitted to a geriatric ward of a university hospital. In order to verify if HF is a predictor of functional dependence, linear regression analyzes were performed.RESULTSThe prevalence of HF was 21%; 95% of them were dependent for BADLs. Bathing was the most committed ADL. HF is a predictor of dependence in hospitalized elderlies, increasing the chance of functional decline by 5 times (95% CI, 0.94-94.48), the chance of functional deterioration by 3.5 times (95% CI, 1.28-11.66; p <0.02) and reducing 0.79 points in the Katz Index score (p <0.05).CONCLUSIONHF is a dependency predictor of ADL in hospitalized elderly, who tend to be more dependent, especially for bathing

Comportamiento prooxidante y antioxidante de hierbas aromáticas en queso

Los quesos de cabra, con mejores cualidades funcionales provienen de leche de cabras en pastoreo, esto obedece al mayor contenido de ácidos grasos ω-3 y ω-6 en una relación óptima para la salud, sumado a un menor contenido de grasa y colesterol. Saborizar quesos con especias, otorga beneficios sensoriales y saludables al producto. Las especias son usadas para realzar el flavor de los alimentos además presentan beneficios antioxidantes. Sin embargo, se reportaron evidencias del doble papel de los flavonoides como antioxidantes o prooxidantes en función de la concentración de uso. El objetivo del trabajo es evaluar el efecto de distintas concentraciones de especias aromáticas con capacidad antioxidante, frente a las reacciones de deterioro que ocurren en el almacenamiento de quesos de cabra. Se estudió la actividad antirradicalaria (AAR) de 18 especias. Para evaluar la actividad antioxidante (AA0) se usó la técnica de desaparición de un radical libre estable el 2,2-difenil-1-picril hidrazilo (DPPH) y se calculó la AAR porcentual. Definido el queso base estándar (control), se ensayaron tres variedades con especies, elegidas de entre las de mayor AAR (orégano, romero y tomillo) y se adicionaron con las concentraciones 0,4 – 1 % p/p. Estos, fueron madurados 30 días y almacenados 7 meses a 4 °C. Se analizaron cada 4 semanas. Se realizaron pruebas sensoriales de aceptabilidad con 60 consumidores de queso (condición), usando planillas, con escala hedónica. Se trabajó sobre los lípidos extraídos de los quesos. El rancidez y deterioro fueron evaluados con análisis de acidez; índice peróxido y sustancias reactivas al ácido TBA. Los resultados se compararon con el comportamiento sensorial del producto en el tiempo de almacenamiento. En los quesos adicionados al 1 %, la acidez se incrementó con el almacenamiento. El máximo valor corresponde al queso con orégano (3,72 % de ac. láctico a los 126 días). En el control, la acidez inicial fue inferior y alcanzó 1,05 g de ác. láctico % a los 166 días. El IP más alto corresponde a los quesos con orégano al 1% , resultado que se contrapone a la actividad antirradicalaria de esta especia. Al 0,4 %, tanto el IP como el número de TBA son menores en quesos adicionados, respecto del control. En los quesos de cabra analizados las especias agregadas al 1% ejercieron acción prooxidante, mientras que al ser agregadas al 0,4% la acción es antioxidante, lo que indica la importancia de la selección de concentraciones adecuadas.Goat cheeses with better functional qualities, due to greater fatty acid content ω 3 and ω 6, come from free-range goat milk in an optimal relation for health, besides having a smaller content of fat and cholesterol. The spices, which present antioxidant benefits, are used to heighten the flavor of foods. Nevertheless, evidence of the double role of the flavonoids as antioxidant or prooxidant was reported based on their use concentration. Flavoring cheeses with spices gives sensory and healthy benefits to the product. The objective of the present work is to evaluate the effect of different aromatic spice concentrations with antioxidant capacity, as opposed to the deterioration reactions that happen in the goat cheese storage. The antiradical capacity (ARA) of 18 spices was studied. In order to evaluate the Antioxidant activity (AOA) the technique of disappearance of a stable free radical was used and the 2,2-diphenyl-2-picrylhydrazyl (DPPH) and the percentage ARA were calculated as well. Once the standard basic cheese (control) was defined, we tried three varieties with species, chosen from among those of greater AAR (oregano, rosemary and thyme) and were added with 0,4 - 1% p/p concentrations. These ripened in 30 days and were stored for 7 months at 4 °C. Every 4 weeks they were analyzed. Sensory tests of acceptability with 60 cheese consumers were carried out (condition), using checklists, with the hedonic scale. The work was performed on lipids extracted of cheeses according to Bligh Dyer method. The rancid flavor and deterioration were evaluated with the analysis of acidity; peroxide index (PI), and reactive substances to TBA acid. The results were compared with the sensory behavior of the product during the time of storage. All the assays were produced in triplicate. The data were put under the descriptive statistical and variance analysis. In cheeses, to which spices were added to 1%, the acidity increased with the storage. The maximum value was the cheese with oregano (3.72% of ac. lactic to the 126 days). In the control, the initial acidity was inferior and reached 1.05 g % of lactic acid to the 166 days. The PI in cheeses to 1% with oregano was higher, result that is opposed to the antiradical activity of this spice. To 0.4%, both the PI and the number of TBA are smaller in added cheeses, with respect to the control. In goat cheeses the spices added to 1% exert prooxidating action. However, to 0.4% it is AAO, which indicates the importance of the selection of suitable concentrations. Key words: antioxidant capacity - prooxidant- spices - goat cheese – rancid flavo

Gene symbol: IDS. Disease: mucopolysaccharidosis type II (Hunter syndrome)

We report here the first exonic splicing mutation in a 8-year old intermediate Hunter patient. Genomic DNA sequencing identified a G to C transversion involving the last nucleotide of IDS exon VI (ExVI 1003G>C). The mutation leads to the disappearance of the normal exon VI/intron 6 splice donor site, resulting in the skipping of a 28 bp fragment of exon VI and in the production of a 306 aa mutant polypeptide, shorter than the normal protein (550 aa), differing from the wild type protein for the last 22 aa. A genotype-phenotype correlation is sometimes difficult in Hunter syndrome. However, the splicing mutations seem to correlate quite well to the patient’s phenotype: for instance, mutation G374G, a splicing site creating a mutation at codon 374 that leads to the loss of 20 aa, has been reported to be associated with mild phenotypes. Other alterations, i.e. the mutation described here and a Alu-mediated skipping of exon VIII, representing more severe genetic alterations, correlated well to the intermediate phenotypes of affected patient

Analysis of lifestyle factors in patients with concomitant chronic pancreatitis and liver cirrhosis

Background & objectives: Chronic pancreatitis (CP) and liver cirrhosis (LC) are common gastroentero-logical disorders but their co-incidence is considered to be rare. This study was designed to identify lifestyle factors that are associated with the development of concomitant LC in patients with CP. Methods: In a retrospective case-control study between 2000 and 2005 122 patients with both CP and LC and 223 matched control patients with CP and no known liver disease were identified in 11 European university medical centers. Another 24 patients and 48 CP controls were identified in the period between 2006 and 2012. Results: Alcoholism was most commonly regarded as aetiology for both CP (82.2%; 95% confidence interval (CI): 75.0-88.0%) and LC (79.5%; 95% CI: 72.0-85.7%) as compared to controls with CP only (68.6%; 95% CI: 62.7-74.1%). The preferred type of alcoholic beverage and pattern of alcohol intake were the only significant lifestyle factors in multivariate analysis. Frequency of alcohol intake (p = 0.105) and smoking status (p = 0.099) were not significant in bivariate analysis and dropped out of the multivariate model. Recurrent and chronic pancreatic pain was observed more often in patients with only CP, whereas gallstones were more common in individuals with both chronic disorders. Conclusions: These findings indicate that certain lifestyle factors might be important for the development of concomitant CP and LC. More studies will be needed to identify additional genetic and environmental factors underlying this association. (C) 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.Peer reviewe

Suspected chromosomally integrated human herpes virus 6 in hematopoietic stem cell transplantation

Background and aims: We report a case of a 27-year-old male affected by acute myeloid leukaemia MLL-PTD positive. After autologous stem cell transplantation, he was monitored based on cytomegalovirus, Epstein-Barr virus and human herpes virus 6 (HHV-6) DNA quantification in blood. Relapse occurred one year after transplantation; then the patient underwent to allogenic bone marrow transplantation using genotypically HLA-identical donor (sister). HHV-6 DNAemia was positive and persistently elevated, either after autologous either after allogenic transplant suggesting the occurrence of HHV-6 chromosomally integration. The work aim is to prove the occurrence of chromosomally integrated-HHV-6 (ci-HHV-6). Materials and Methods: HHV-6 DNA extraction was performed by automated extractor and DNA was amplified-quantified by Real Time polymerase chain reaction. Species identification was performed by sequencing HHV6-U100 glycoprotein using automated sequencer and sequencing products were analysed using the Blast program. Results: After autologous transplantation HHV6-DNAemia was 5.4 log copies/mL setting to 3.9 log copies/mL for a long period post allogenic transplantation. The patient’s hair follicles were tested for HHV- 6 DNA having positive results. Sequences of both strains of HHV6 extracts from blood and hair follicles resulted species B. HHV6 viral load decreased significantly after Lymphocyte Infusion by ci-HHV6 negative donor (sister), having steady viral load during the following six months of monitoring. One year later, patient is in complete haematological remission. Conclusions: Detection of HHV-6 in hair follicles and HHV-6 DNAemia persistently elevated before allogenic transplant, confirm the occurrence of ci-HHV-6. The observed important decreasing viral load is potentially due to the successful engraftment of ci-HHV-6-negative donor marrow after allogeneic transplant