26 research outputs found
Prevalencia de desnutrición en ancianos hospitalizados con diabetes mellitus
Background & aims: Malnutrition prevalence is unknown
among elderly patients with diabetes mellitus. Our objectives
were to determine malnutrition prevalence in
elderly in patients with diabetes, and to describe their
impact on prognosis.
Methods: An observational multicenter study was
conducted in 35 Spanish hospitals. Malnutrition was
assessed with the Mini Nutritional Assessment (MNA)
tool. Patients were followed until discharge.
Results: 1,090 subjects were included (78 ± 7.1 years;
50% males). 39.1% had risk of malnutrition, and 21.2%
malnutrition. A 15.5% of the malnourished subjects and
31.9 % of those at risk had a BMI ≥ 30 kg/m2. In multivariate
analysis, female gender (OR = 1.38; 95% CI: 1.19-
1.11), age (OR = 1.04; 95% CI: 1.02-1.06) and presence of
diabetic complications (OR = 1.97; 95% CI: 1.52-2.56)
were associated with malnutrition. Length of stay (LOS)
was longer in at-risk and malnourished patients than in
well-nourished (12.7 ± 9.9 and 15.7 ± 12.8 days vs 10.7 ±
9.9 days; p < 0.0001). After adjustment by age and
gender, MNA score (OR = 0.895; 95% CI 0.814-0.985)
and albumin (OR = 0.441; 95% CI 0.212-0.915) were
associated with mortality. MNA score was associated
with the probability of home discharge (OR = 1.150; 95%
CI 1.084-1.219).
Conclusion: A high prevalence of malnutrition among
elderly in patients with diabetes was observed, regardless
of BMI. Malnutrition, albumin, and MNA score were
related to LOS, mortality and home dischargeIntroducción: La prevalencia de desnutrición es desconocida
entre los ancianos con diabetes mellitus.
Objetivos: Determinar la prevalencia de desnutrición
en ancianos hospitalizados con diabetes mellitus, y describir
su impacto en el pronóstico clínico.
Material y métodos: Se llevó a cabo un estudio multicéntrico
en 35 hospitales españoles. La desnutrición fue
valorada mediante la herramienta Mini Nutritional
Assessment (MNA). Los pacientes fueron seguidos hasta
el alta.
Resultados: Fueron incluidos 1.090 sujetos (78 ± 7,1
años; 50% hombres). 39,1% mostraron riesgo de desnutrición
y 21,2% desnutrición establecida. El 15,5% de los
sujetos desnutridos y 31,9 % de aquellos en riesgo tenían
un IMC ≥ 30 kg/m2. En el análisis multivariante, el sexo
femenino (OR = 1,38; IC 95%: 1,19-1,11), la edad (OR =
1,04; IC 95%: 1,02-1,06) y la presencia de complicaciones
por diabetes (OR = 1,97; IC 95%: 1,52-2,56) se asociaron al
diagnóstico de desnutrición. La estancia media fue mayor
en sujetos en riesgo y con desnutrición que en los pacientes
bien nutridos (12,7 ± 9,9 y 15,7 ± 12.8 días vs 10,7 ± 9,9 días;
p < 0,0001). Tras ajustar por edad y sexo, la puntuación del
MNA (OR = 0,895; IC 95% 0,814-0,985) y el valor de albúmina
(OR = 0,441; IC 95% 0,212-0,915) se asociaron de
forma independiente con la mortalidad. La puntuación del
MNA se asoció con la probabilidad de alta a domicilio (OR
= 1,150; IC 95% 1,084-1,219).
Conclusiones: Se observó una elevada prevalencia de
desnutrición entre los ancianos hospitalizados con diabetes,
independientemente del IMC. El diagnóstico de desnutrición,
el valor de albúmina y la puntuación del MNA
se asociaron con la estancia media, mortalidad y destino
al altaThe study was supported by a grant from Abbott
Laboratories
Social factors related to the clinical severity of influenza cases in Spain during the A(H1N1)2009 virus pandemic
Background During the 2009 influenza pandemic, a change in the type of patients most often affected by influenza was observed. The objective of this study was to assess the role of individual and social determinants in hospitalizations due to influenza A (H1N1) 2009 infection. Methods We studied hospitalized patients (cases) and outpatients (controls) with confirmed influenza A (H1N1) 2009 infection. A standardized questionnaire was used to collect data. Variables that might be related to the hospitalization of influenza cases were compared by estimation of the odds ratio (OR) and 95% confidence intervals (CI) and the variables entered into binomial logistic regression models. Results Hospitalization due to pandemic A (H1N1) 2009 influenza virus infections was associated with non-Caucasian ethnicity (OR: 2.18, 95% CI 1.17 − 4.08), overcrowding (OR: 2.84, 95% CI 1.20 − 6.72), comorbidity and the lack of previous preventive information (OR: 2.69, 95% CI: 1.50 − 4.83). Secondary or higher education was associated with a lower risk of hospitalization (OR 0.56, 95% CI: 0.36 − 0.87) Conclusions In addition to individual factors such as comorbidity, other factors such as educational level, ethnicity or overcrowding were associated with hospitalization due to A (H1N1) 2009 influenza virus infections
Ensino e aprendizagem de línguas estrangeiras para pessoas com necessidades especiais: destaques
Sem resumo disponível.publishe
Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality
CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative
Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research
Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes
Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues
Chloride Anion Controlled Molecular “Switching”. Binding of 2,5,7-Trinitro-9-dicyanomethylenefluorene-C60 by Tetrathiafulvalene Calix[4]pyrrole and Photophysical Generation of Two Different Charge-Separated States
International audienceThe binding of the snake-like trinitrodicyanomethylenefluorene-C60 derivative (TNDCF-C60) to the dynamic receptor, tetrathiafulvalene calix[4]pyrrole (TTF-calix[4]pyrrole), may be controlled via the use of a chloride anion as an external trigger. Whereas, in the absence of a chloride anion, the TNDCF ?tail? of the trinitrodicyanomethylenefluorene-C60 substrate binds to the TTF?calix[4]pyrrole in a 2:1 (substrate/receptor) stoichiometry in CH2Cl2 solution, addition of a chloride anion (yellow) leads the TNDCF tail to be displaced in favor of a bound C60 ?head?, a process that leads to the formation of a complex with overall 1:2:2 substrate/receptor/chloride anion stoichiometry. These chemical switching events are reflected in easy-to-visualize color changes, as well as in the production of two different kinds of charge-separated states following selective femtosecond photoexcitation.</p