Body mass index and body composition in institutionalized older adults with malnutrition sarcopenia and frailty

Introduction: Malnutrition, sarcopenia and frailty are multifactorial and highly prevalent conditions among institutionalized older adults Objectives: The aim of this study was to asses body mass index and body composition in older adults, according to the diagnosis of malnutrition, sarcopenia and frailty. Methods: Institutionalized older adults with 60 or more years old were included. Nutritional status (Mini Nutritional Assessment), sarcopenia (European Working Group Sarcopenia in Older People criteria) and frailty (Fried Phenotype) were assessed. Body composition was assessed through bioelectrical impedance Results: One-hundred and forty-six individuals, with a mean age of 83 years old and mainly females (63.3%) were included. Malnutrition was diagnosed in 26.2%, sarcopenia in 25.0% and frailty in 61.0%. Mean Body Mass Index (BMI) was 20.7, 25.8 and 26.6kg/m2 in malnourished, at risk and well- nourished individuals, respectively(p = 0.000); 21.6 and 26.8 kg/m2 in sarcopenic and non-sarcopenic individuals(p = 0.000); and 24.3 and 27.7 kg/m2 in fragile and robust individuals(p=0.000). Mean Fat Mass Index was 9.6 and 13.3 kg/m2 in sarcopenic and non-sarcopenic individuals (p=0.007); and 10.3 and 16.0kg/m2 in fragile and robust individuals (p=0.000). Mean Free Fat Mass Index was 12.5, 14.9 and 17.0kg/m2 in malnourished, at risk and well- nourished individuals; 12.0 and 17.0 kg/m2 in sarcopenic and non-sarcopenic individuals(p=0.000); and 14.7 and 17.1kg/ m2 in fragile and robust individuals(p = 0.002) Conclusions: BMI, free fat mass and fat mass were significantly lower in older adults with malnutrition, sarcopenia and frailty. BMI is a practical nutritional status marker, however it needs to be interpreted cautiously in older adults, as it seems that a lower value is associated with a worse prognosis and existing cutoffs may not apply. Nutritional screening and assessment of older adults is essential for a prompt intervention, in order to prevent and reverse these conditionsinfo:eu-repo/semantics/publishedVersio

Caracterização do estado nutricional e determinantes da síndrome de fragilidade e sarcopénia na população idosa portuguesa institucionalizada

Tese de mestrado, Nutrição Clínica, Universidade de Lisboa, Faculdade de Medicina, 2018A desnutrição é um problema frequente nas pessoas idosas, com prevalência relevante em ambiente hospitalar e institucional. A fragilidade é uma síndrome multidimensional em que se reconhece um estado de extrema vulnerabilidade a fatores endógenos e exógenos, devido a declínios cumulativos associados ao processo de envelhecimento. A sarcopénia é definida como uma condição clínica que envolve a perda de massa e força muscular, resultando da interação entre processo de envelhecimento a presença de doença. O principal objetivo deste estudo foi avaliar a prevalência de desnutrição, sarcopénia e fragilidade, relacionando-a com a ingestão energética e proteica, em pessoas idosas institucionalizadas. Trata-se de um estudo transversal para o qual foram convidados a participar pessoas idosas institucionalizadas em duas instituições do distrito de Leiria. Foram recolhidos dados demográficos, assim como informação sobre a ingestão alimentar habitual (questionário frequência alimentar). A composição corporal foi estimada através de impedância bioelétrica tetrapolar. Este estudo foi aprovado pela Comissão de Ética do Centro Académico de Medicina de Lisboa. Todos os indivíduos ou tutores legais deram consentimento informado escrito para a participação. Foram avaliados 146 indivíduos com uma idade média de 83 anos. Foi diagnosticada desnutrição em 26,2%, sarcopénia em 25,4% e fragilidade em 45,5% da amostra. Foi aferida a presença simultânea de desnutrição, sarcopénia e fragilidade em 11,6% da amostra. Não foi encontrada uma associação entre o diagnóstico de desnutrição e sarcopenia, ou desnutrição e fragilidade. Verificou-se a existência de associação entre a presença de fragilidade e menor ingestão proteica. Neste estudo, os idosos institucionalizados apresentam uma elevada prevalência de desnutrição, sarcopénia e fragilidade. Estas são condições com um impacto relevante no estado nutricional e capacidade funcional das pessoas idosas, pelo que a sua presença deverá ser diagnosticada, monitorizada e intervencionada, por forma a prevenir a deterioração do estado de saúde.Malnutrition is a common problem in older adults, with a relevant prevalence in hospitals and long-term care. Frailty is a multidimensional syndrome in which a state of extreme vulnerability to internal and external stressors is recognized, due to cumulative declines associated with the aging process. Sarcopenia is a clinical condition which involves the loss of muscle mass and strength, resulting from the interaction between the aging process and the presence of disease. The main aim of this study was to assess the prevalence of malnutrition, sarcopenia and frailty, and establish a relationship with energy and protein intake in institutionalized older adults. This is a cross-sectional study for which institutionalized older adults from two institutions in Leiria district were invited to participate. Demographic data was collected, as well as information on usual food intake (food frequency questionnaire). Body composition was estimated trough tetrapolar bioelectrical impedance assessment. This study was approved by the Ethical Committee of the Centro Académico de Medicina de Lisboa. All participants or legal representatives signed the informed written consent for participation. One hundred and forty-six older adults were included, wiith a mean age of 83 years old. Malnutrition was diagnosed in 26.2%, sarcopenia in 25.4% and frailty in 45.5% of the sample. The simultaneous presence of the three conditions was verified in 11.6% of the sample. No association was found between malnutriton and sarcopenia or malnutrition and frailty. An association was found between the presence of frailty and a lower protein intake. In this study, institutionalized older adults present a high prevalence of malnutrition, sarcopenia and frailty. These conditions have a relevant impact on nutritional status and functional capacity of elders, so its presence ought to be diagnosed, monitored and interventioned, in order to prevent further decline in health status

Nutrition day em residência geriátrica: determinantes da desnutrição

info:eu-repo/semantics/publishedVersio

Meglumine antimoniate and miltefosine combined with allopurinol sustain pro-inflammatory immune environments during canine leishmaniosis treatment

Canine leishmaniosis (CanL) caused by Leishmania infantum is a zoonotic disease of global concern. Antileishmanial drug therapies commonly used to treat sick dogs improve their clinical condition, although when discontinued relapses can occur. Thus, the current study aims to evaluate the effect of CanL treatments in peripheral blood, lymph node, and bone marrow cytokine profile associated with clinical recovery. Two groups of six dogs diagnosed with CanL were treated with miltefosine combined with allopurinol and meglumine antimoniate combined with allopurinol (MT+A and MG+A), respectively. At diagnosis and after treatment, during a 3-month follow-up, clinical signs, hematological and biochemical parameters, urinalysis results and antileishmanial antibody titers were registered. Furthermore, peripheral blood, popliteal lymph node, and bone marrow samples were collected to assess the gene expression of IL-2, IL-4, IL-5, IL-10, IL-12, TNF-α, TGF-β, and IFN-γ by qPCR. In parallel, were also evaluated samples obtained from five healthy dogs. Both treatment protocols promoted the remission of clinical signs as well as normalization of hematological and biochemical parameters and urinalysis values. Antileishmanial antibodies returned to non-significant titers in all dogs. Sick dogs showed a generalized upregulation of IFN-γ and downregulation of IL-2, IL-4, and TGF-β, while gene expression of IL-12, TNF-α, IL-5, and IL-10 varied between groups and according to evaluated tissue. A trend to the normalization of cytokine gene expression was induced by both miltefosine and meglumine antimoniate combined therapies. However, IFN-γ gene expression was still up-regulated in the three evaluated tissues. Furthermore, the effect of treatment in the gene expression of cytokines that were not significantly changed by infection, indicates that miltefosine and meglumine antimoniate combined therapy directly affects cytokine generation. Both combined therapies are effective in CanL treatment, leading to sustained pro-inflammatory immune environments that can compromise parasite survival and favor dogs' clinical cure. In the current study, anti-inflammatory and regulatory cytokines do not seem to play a prominent role in CanL or during clinical recovery.publishersversionpublishe

Meglumine antimoniate and miltefosine combined with allopurinol sustain pro-inflammatory immune environments during canine leishmaniosis treatment

Research Areas: Veterinary SciencesCanine leishmaniosis (CanL) caused by Leishmania infantum is a zoonotic disease of global concern. Antileishmanial drug therapies commonly used to treat sick dogs improve their clinical condition, although when discontinued relapses can occur. Thus, the current study aims to evaluate the effect of CanL treatments in peripheral blood, lymph node, and bone marrow cytokine profile associated with clinical recovery. Two groups of six dogs diagnosed with CanL were treated with miltefosine combined with allopurinol and meglumine antimoniate combined with allopurinol (MT+A and MG+A), respectively. At diagnosis and after treatment, during a 3-month follow-up, clinical signs, hematological and biochemical parameters, urinalysis results and antileishmanial antibody titers were registered. Furthermore, peripheral blood, popliteal lymph node, and bone marrow samples were collected to assess the gene expression of IL-2, IL-4, IL-5, IL-10, IL-12, TNF-alpha, TGF-beta, and IFN-gamma by qPCR. In parallel, were also evaluated samples obtained from five healthy dogs. Both treatment protocols promoted the remission of clinical signs as well as normalization of hematological and biochemical parameters and urinalysis values. Antileishmanial antibodies returned to non-significant titers in all dogs. Sick dogs showed a generalized upregulation of IFN-gamma and downregulation of IL-2, IL-4, and TGF-beta, while gene expression of IL-12, TNF-alpha, IL-5, and IL-10 varied between groups and according to evaluated tissue. A trend to the normalization of cytokine gene expression was induced by both miltefosine and meglumine antimoniate combined therapies. However, IFN-gamma gene expression was still up-regulated in the three evaluated tissues. Furthermore, the effect of treatment in the gene expression of cytokines that were not significantly changed by infection, indicates that miltefosine and meglumine antimoniate combined therapy directly affects cytokine generation. Both combined therapies are effective in CanL treatment, leading to sustained pro-inflammatory immune environments that can compromise parasite survival and favor dogs' clinical cure. In the current study, anti-inflammatory and regulatory cytokines do not seem to play a prominent role in CanL or during clinical recovery.info:eu-repo/semantics/publishedVersio

Author Correction: Ionizing radiation modulates human macrophages towards a pro-inflammatory phenotype preserving their pro-invasive and pro-angiogenic capacities.

This Article contains an error in the description of the data presented in Figure 2. Each blot demonstrating a protein of interest, or of its phosphorylated form, is matched with the expression of β-actin, used as loading control. The majority of the proteins were separated in different gels, apart from proteins p105, p50 and Bcl-xL which were run in the same gel and have the same loading control. As a result, the Figure 2 legend, “Ionizing radiation induces macrophage NF-κB activation and increases Bcl-xL expression. (A) Evaluation of RelA phosphorylation (Ser536) and RelB, cRel, p100/p52 and p105/p50 subunit expression, 1 and 6 h after irradiation (2, 6 and 10 Gy). (B) RelB nuclear translocation 6 h after macrophage irradiation (10 Gy). Histone deacetylase 1 (HDAC1) and β-actin were used as loading controls for nuclear and cytoplasmic fractions, respectively. (C) Evaluation of Bcl2 and Bcl-xL expression after macrophage irradiation. Western blot images are representative of protein expression/phosphorylation status in distinct donors (at least n = 4), evaluated in two independent experiments.” should read: “Ionizing radiation induces macrophage NF-κB activation and increases Bcl-xL expression. (A) Evaluation of RelA phosphorylation (Ser536) and RelB, cRel, p100/p52 and p105/p50 subunit expression, 1 and 6 h after irradiation (2, 6 and 10 Gy). (B) RelB nuclear translocation 6 h after macrophage irradiation (10 Gy). Histone deacetylase 1 (HDAC1) and β-actin were used as loading controls for nuclear and cytoplasmic fractions, respectively. (C) Evaluation of Bcl2 and Bcl-xL expression after macrophage irradiation. Western blot images are representative of protein expression/phosphorylation status in distinct donors (at least n = 4), evaluated in two independent experiments. The β-actin loading control of the panels comprised by p105, p50 (2A) and Bcl-xL (2C) is the same, since proteins were separated in the same gel electrophoresis.

Intricate macrophage-colorectal cancer cell communication in response to radiation

Both cancer and tumour-associated host cells are exposed to ionizing radiation when a tumour is subjected to radiotherapy. Macrophages frequently constitute the most abundant tumour-associated immune population, playing a role in tumour progression and response to therapy. The present work aimed to evaluate the importance of macrophage-cancer cell communication in the cellular response to radiation. To address this question, we established monocultures and indirect co-cultures of human monocyte-derived macrophages with RKO or SW1463 colorectal cancer cells, which exhibit higher and lower radiation sensitivity, respectively. Mono- and co-cultures were then irradiated with 5 cumulative doses, in a similar fractionated scheme to that used during cancer patients' treatment (2 Gy/fraction/day). Our results demonstrated that macrophages sensitize RKO to radiation-induced apoptosis, while protecting SW1463 cells. Additionally, the co-culture with macrophages increased the mRNA expression of metabolism- and survival-related genes more in SW1463 than in RKO. The presence of macrophages also upregulated glucose transporter 1 expression in irradiated SW1463, but not in RKO cells. In addition, the influence of cancer cells on the expression of pro- and anti-inflammatory macrophage markers, upon radiation exposure, was also evaluated. In the presence of RKO or SW1463, irradiated macrophages exhibit higher levels of pro-inflammatory TNF, IL6, CCL2 and CCR7, and of anti-inflammatory CCL18. However, RKO cells induce an increase of macrophage pro-inflammatory IL1B, while SW1463 cells promote higher pro-inflammatory CXCL8 and CD80, and also anti-inflammatory VCAN and IL10 levels. Thus, our data demonstrated that macrophages and cancer cells mutually influence their response to radiation. Notably, conditioned medium from irradiated co-cultures increased non-irradiated RKO cell migration and invasion and did not impact on angiogenesis in a chicken embryo chorioallantoic membrane assay. Overall, the establishment of primary human macrophage-cancer cell co-cultures revealed an intricate cell communication in response to ionizing radiation, which should be considered when developing therapies adjuvant to radiotherapy

HEREDIT : um programa educativo no domínio da biologia : ensino secundário

Dissertação submetida para satisfação parcial dos requisitos do programa de mestrado em Ciências da Computação, à Faculdade de Ciências e Tecnologia da Universidade de Coimbr

HEREDIT : um programa educativo no domínio da biologia : ensino secundário

Dissertação submetida para satisfação parcial dos requisitos do programa de mestrado em Ciências da Computação, à Faculdade de Ciências e Tecnologia da Universidade de Coimbr

A review on the Ecological Quality Status assessment in aquatic systems using community based indicators and ecotoxicological tools: What might be the added value of their combination?

The European Water Framework Directive (WFD) represents a transformation of the guidelines for water quality assessment and monitoring across all EU Member States. At present, it is widely accepted that the WFD requires holistic and multidisciplinary ecological approaches by integrating multiple lines of evidence. Within the scope of the WFD, the scientific community identified clear opportunities to take advantage of an ecotoxicological line of evidence. In this context, ecotoxicological tools, namely biomarkers and bioassays, were proposed to contribute to the integration of the chemical and biological indicators, and thus to provide an overall insight into the quality of a water body. More than one decade after the publication of the WFD, we reviewed the studies that have attempted to integrate ecotoxicological tools in the assessment of surface water bodies. For this purpose, we reviewed studies providing an ecological water status assessment through more conventional community based approaches, in which biomarkers and/or bioassays were also applied to complement the evaluation. Overall, from our review emerges that studies at community level appear suitable for assessing the ecological quality of water bodies, whereas the bioassays/biomarkers are especially useful as early warning systems and to investigate the causes of ecological impairment, allowing a better understanding of the cause–effect-relationships. In this sense, community level responses and biomarkers/bioassays seem to be clearly complementary, reinforcing the need of combining the approaches of different disciplines to achieve the best evaluation of ecosystem communities’ health.S