Regional differences in the profile of disabled community-dwelling older adults: a European population-based cross-sectional study

The main objective of this work was to estimate the prevalence of disability in European community-dwelling older adults, as well as to investigate differences in the profile of disabled older adults between European regions (Northern, Central, Eastern and Southern). A cross-sectional study based on wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted. Community-dwelling participants aged 65-84 were selected (n = 33,369). Disability was defined as presenting at least one functional limitation in basic activities of daily living (BADL). Sociodemographic, health services, lifestyle and health-related variables were analyzed. Statistical analysis was carried out through the Chi-square and ANOVA tests for bivariate analysis, and Poisson regression for multivariate analysis. Overall prevalence of disability was 13.8%: 9.4% in the Northern region, 13.1% in the Southern region, 13.6% in the Central region, and 16.6% in the Eastern region. Portugal, Poland, Estonia and Belgium showed the highest prevalence of BADL limitations, while Sweden, Denmark, Greece and Switzerland showed the lowest prevalence. Besides, disabled older adults from East Europe presented the most disadvantaged health profile, followed by the Southern region. On the other hand, disabled older adults living in the Northern region showed the most advantaged characteristics of most variables, except for smoking and polypharmacy

Percepción y actitud educativa de maestros en relación con el judo como recurso didáctico en el área de educación física en educación primaria

Debido a la flexibilidad y libertad que permite el currículo español, los maestros tienen la labor de adaptar las propuestas que vienen dadas, tanto a nivel nacional como a nivel autonómico, a las características concretas de cada centro educativo y a cada grupo clase. Los principales factores que llevan a los maestros a decantarse por unas propuestas didácticas concretas son sus percepciones y actitudes. A partir del estudio de diferentes autores podemos confirmar la carencia de deportes de lucha y concretamente del Judo en las sesiones de Educación Física, a pesar de todos los beneficios educativos que conlleva su práctica. Para investigar acerca de esto, se ha pasado un cuestionario a maestros en activo y a futuros maestros para conocer su percepción y actitud en relación con el Judo como recurso didáctico para el área de Educación Física en Educación Primaria. Y se ha llegado a la conclusión de que la mencionada ausencia en los centros escolares se debe, principalmente, a la percepción de insuficiencia competencial de los maestros derivada de la no vivencialidad cuando ellos han sido alumnos en las primeras etapas educativas.<br /

Testing the Cosmological Constant as a Candidate for Dark Energy

It may be difficult to single out the best model of dark energy on the basis of the existing and planned cosmological observations, because many different models can lead to similar observational consequences. However, each particular model can be studied and either found consistent with observations or ruled out. In this paper, we concentrate on the possibility to test and rule out the simplest and by far the most popular of the models of dark energy, the theory described by general relativity with positive vacuum energy (the cosmological constant). We evaluate the conditions under which this model could be ruled out by the future observations made by the Supernova/Acceleration Probe SNAP (both for supernovae and weak lensing) and by the Planck Surveyor cosmic microwave background satellite.Comment: 6 pages, 2 figures, revtex

Seguridad y eficiacia de una nueva pauta de suplementación en pacientes con fibrosis quística e insuficiencia de vitamina D

Cystic fibrosis; Vitamin D; Multicentre studyFibrosis quística; Vitamina D; Estudio multicéntricoFibrosi quística; Vitamina D; Estudi multicèntricObjectives Based on the European and American Cystic Fibrosis (CF) consensus recommendations, an increase in vitamin D (VD) supplementation in patients with CF and insufficient or defficient levels was proposed. The objective of our study was to determine the safety and efficacy of this new protocol. Material and methods Multicentre nonrandomized uncontrolled experimental study. Patients with insufficient levels (<30 ng/mL) received increasing doses of VD (between 800 and 10 000 IU/day). Patients were followed up for 12 months, during which their vitamin and nutritional status, pulmonary function and calcium and phosphate metabolism were assessed. Statistical analysis: t test for paired data and multivariate logistic regression analysis. Results Thirty patients aged 1–39 years (median, 9.1) completed the follow-up. Two patients were dropped from the study on account of 25-OH VD levels greater than 100 ng/mL at 3 months without clinical or laboratory signs of hypercalcaemia. At 12 months, we observed an increase of 7.6 ng/mL (95% CI, 4.6−10 ng/mL) in the mean 25-OH VD level and an improvement in vitamin status: 37% achieved levels of 30 ng/mL or greater, 50% levels between 20 and 30 ng/mL and 13% remained with levels of less than 20 ng/mL. We found no association between improved VD levels and pulmonary function. Conclusions The proposed protocol achieved an increase in serum VD levels and a decrease in the percentage of patients with VD insufficiency, although it was still far from reaching the percentages of sufficiency recommended for this entity.Objetivos Basándonos en los documentos de consenso europeo y americano de Fibrosis Quística (FQ) se propone un incremento de la suplementación de vitamina D (VD) en pacientes con FQ y niveles insuficientes. El objetivo de nuestro estudio fue conocer la seguridad y la eficacia de este nuevo protocolo. Material y métodos Estudio multicéntrico, experimental no aleatorizado ni controlado. A los pacientes con niveles insuficientes (<30 ng/mL) se les administró dosis crecientes de VD (entre 800 y 10000 UI/día). Se realizó seguimiento durante 12 meses analizando estatus vitamínico, nutricional, función pulmonar y metabolismo fosfo-cálcico. Análisis estadístico: pruebas t para datos apareados y regresión logística con análisis multivariable. Resultados 30 pacientes entre 1 y 39 años (mediana 9,1) completaron el estudio. Se retiraron 2 por niveles de 25 OH VD > 100 ng/mL a los 3 meses sin encontrarse signos clínicos ni analíticos de hipercalcemia. Tras 12 meses se observó un incremento de 7,6 ng/mL (IC 95% 4,6−10 ng/mL) de los niveles medios de 25 OH VD. El 37% alcanzaron niveles ≥30 ng/mL, un 13% <20 ng/mL y un 50% entre 20 y 30 ng/mL. No se observó asociación de la mejoría de los niveles de VD con la función pulmonar. Conclusiones Con el protocolo propuesto se consigue un incremento de los niveles séricos de VD y una disminución del porcentaje de pacientes con insuficiencia de la misma, aunque todavía muy lejos de alcanzar los porcentajes de suficiencia recomendados para esta entidad.This study received funding from the Fundación Ernesto Sánchez Villares (05/2015) and the Fundación Nutrición y Crecimiento

Vitamin D Status in Pediatric and Young Adult Cystic Fibrosis Patients. Are the New Recommendations Effective?

Cystic fibrosis; Multicenter study; Vitamin DFibrosis quística; Estudio multicéntrico; Vitamina DFibrosi quística; Estudi multicèntric; Vitamina DIntroduction: In recent years, guidelines for vitamin D supplementation have been updated and prophylactic recommended doses have been increased in patients with cystic fibrosis (CF). Objective: To evaluate safety and efficacy of these new recommendations. Results: Two cohorts of pancreatic insufficient CF patients were compared before (cohort 1: 179 patients) and after (cohort 2: 71 patients) American CF Foundation and European CF Society recommendations were published. Cohort 2 patients received higher Vitamin D doses: 1509 (1306-1711 95% CI) vs 1084 (983-1184 95% CI) IU/Day (p < 0.001), had higher 25 OH vitamin D levels: 30.6 (27.9-33.26 95% CI) vs. 27.4 (25.9-28.8 95% CI) ng/mL (p = 0.028), and had a lower prevalence of insufficient vitamin D levels (<30 ng/mL): 48% vs 65% (p = 0.011). Adjusted by confounding factors, patients in cohort 1 had a higher risk of vitamin D insufficiency: OR 2.23 (1.09-4.57 95% CI) (p = 0.028). Conclusion: After the implementation of new guidelines, CF patients received higher doses of vitamin D and a risk of vitamin D insufficiency decreased. Despite this, almost a third of CF patients still do not reach sufficient serum calcidiol levels.This research was partially funded by Fundación Ernesto Sánchez Villares and Fundación Nutrición y Crecimiento

The etiology, incidence, and impact of preservation fluid contamination during liver transplantation

The role of contaminated preservation fluid in the development of infection after liver transplantation has not been fully elucidated. To assess the incidence and etiology of contaminated preservation fluid and determine its impact on the subsequent development of infection after liver transplantation, we prospectively studied 50 consecutive liver transplants, and cultured the following samples in each instance: preservation fluid (immediately before and at the end of the back-table procedure, and just before implantation), blood, and bile from the donor, and ascitic fluid from the recipient. When any culture was positive, blood cultures were obtained and targeted antimicrobial therapy was started. We found that the incidence of contaminated preservation fluid was 92% (46 of 50 cases of liver transplantation per year), but only 28% (14/50) were contaminated by recognized pathogens. Blood and bile cultures from the donor were positive in 28% and 6% respectively, whereas ascitic fluid was positive in 22%. The most frequently isolated microorganisms were coagulase-negative staphylococci. In nine cases, the microorganisms isolated from the preservation fluid concurred with those grown from the donor blood cultures, and in one case, the isolate matched with the one obtained from bile culture. No liver transplant recipient developed an infection due to the transmission of an organism isolated from the preservation fluid. Our findings indicate that contamination of the preservation fluid is frequent in liver transplantation, and it is mainly caused by saprophytic skin flora. Transmission of infection is low, particularly among those recipients given targeted antimicrobial treatment for organisms isolated in the preservation fluid

New trimethoprim-like molecules: bacteriological evaluation and insights into their action

This work reports a detailed characterization of the antimicrobial profile of two trimethoprim-like molecules (compounds 1a and 1b) identified in previous studies. Both molecules displayed remarkable antimicrobial activity, particularly when combined with sulfamethoxazole. In disk difusion assays on Petri dish, compounds 1a and 1b showed synergistic effects with colistin. Specifically, in combinations with low concentrations of colistin very large increases in the activities of compounds 1a and 1b were determined, as demonstrated by alterations in the kinetics of bacterial growth despite only slight changes in the fractional inhibitory concentration index. The effect of colistin may be to increase the rate of antibiotic entry while reducing efflux pump activity. Compounds 1a and 1b were susceptible to extrusion by efflux pumps, whereas the inhibitor phenylalanine arginyl ß-naphthylamide (PAßN) exerted effects similar to those of colistin. The interactions between the target enzyme (dihydrofolate reductase), the coenzyme nicotinamide adenine dinucleotide phosphate (NADPH), and the studied molecules were explored using enzymology tools and computational chemistry. A model based on docking results is reported

Observational Bounds on Cosmic Doomsday

Recently it was found, in a broad class of models, that the dark energy density may change its sign during the evolution of the universe. This may lead to a global collapse of the universe within the time t_c ~ 10^{10}-10^{11} years. Our goal is to find what bounds on the future lifetime of the universe can be placed by the next generation of cosmological observations. As an example, we investigate the simplest model of dark energy with a linear potential V(\phi) =V_0(1+\alpha\phi). This model can describe the present stage of acceleration of the universe if \alpha is small enough. However, eventually the field \phi rolls down, V(\phi) becomes negative, and the universe collapses. The existing observational data indicate that the universe described by this model will collapse not earlier than t_c > 10 billion years from the present moment. We show that the data from SNAP and Planck satellites may extend the bound on the "doomsday" time to t_c > 40 billion years at the 95% confidence level.Comment: 11 pages, 6 figures, revtex

Novel indolic AMPK modulators induce vasodilatation through activation of the AMPK-eNOS-NO pathway

Endothelial adenosine monophosphate-activated protein kinase (AMPK) plays a critical role in the regulation of vascular tone through stimulating nitric oxide (NO) release in endothelial cells. Since obesity leads to endothelial dysfunction and AMPK dysregulation, AMPK activation might be an important strategy to restore vascular function in cardiometabolic alterations. Here, we report the identification of a novel AMPK modulator, the indolic derivative IND6, which shows affinity for AMPKα1β1γ1, the primary AMPK isoform in human EA.Hy926 endothelial cells. IND6 shows inhibitory action of the enzymatic activity in vitro, but increases the levels of p-Thr174AMPK, p-Ser1177eNOS and p-Ser79ACC in EA.Hy926. This paradoxical finding might be explained by the ability of IND6 to act as a mixed-type inhibitor, but also to promote the enzyme activation by adopting two distinct binding modes at the ADaM site. Moreover, functional assays reveal that IND6 increased the eNOS-dependent production of NO and elicited a concentration-dependent vasodilation of endothelium-intact rat aorta due to AMPK and eNOS activation, demonstrating a functional activation of the AMPK-eNOS-NO endothelial pathway. This kinase inhibition profile, combined with the paradoxical AMPK activation in cells and arteries, suggests that these new chemical entities may constitute a valuable starting point for the development of new AMPK modulators with therapeutic potential for the treatment of vascular complications associated with obesity

Auscultation of velcro crackles is associated with usual interstitial pneumonia

Auscultation of Velcro crackles has been proposed as a key finding in physical lung examination in patients with interstitial lung diseases (ILDs), especially in idiopathic pulmonary fibrosis (IPF). However, no studies have been carried out to assess the association of Velcro crackles with other clinical variables. We evaluated a cohort of 132 patients, prospectively and consecutively included in our ILD diagnostic program at a tertiary referral center. All patients were auscultated during the physical examination. The patients were divided into 2 groups: "presence" or "nonpresence" of bilateral Velcro crackles. Of all patients assessed, 83 (63%) presented Velcro crackles in the respiratory auscultation. Patients with Velcro crackles usually had more frequently cough and dyspnea at the moment of diagnosis. Forced vital capacity (P = 0.002) and lung diffusion capacity for carbon monoxide (P = 0.04) was lower in these patients. The ILD-GAP index was higher in the group with Velcro crackles (P = 0.01). All patients with usual interstitial pneumonia (UIP) in high-resolution computed tomography and all patients with final IPF diagnosis presented Velcro crackles. In multivariate analysis, the presence of Velcro crackles was independently associated with an UIP pattern. In patients suspected of having ILD, the auscultation of Velcro crackles was associated with UIP, a possibility which must be taken into consideration in early ILD detection in primary care