34 research outputs found
Frailty assessment based on trunk kinematic parameters during walking
Background: Physical frailty has become the center of attention of basic, clinical and demographic research due to
its incidence level and gravity of adverse outcomes with age. Frailty syndrome is estimated to affect 20 % of the
population older than 75 years. Thus, one of the greatest current challenges in this field is to identify parameters
that can discriminate between vulnerable and robust subjects. Gait analysis has been widely used to predict frailty.
The aim of the present study was to investigate whether a collection of parameters extracted from the trunk
acceleration signals could provide additional accurate information about frailty syndrome.
Methods: A total of 718 subjects from an elderly population (319 males, 399 females; age: 75.4 ± 6.1 years, mass:
71.8 ± 12.4 kg, height: 158 ± 6 cm) volunteered to participate in this study. The subjects completed a 3-m walk test
at their own gait velocity. Kinematic data were acquired from a tri-axial inertial orientation tracker.
Findings: The spatio-temporal and frequency parameters measured in this study with an inertial sensor are related
to gait disorders and showed significant differences among groups (frail, pre-frail and robust). A selection of those
parameters improves frailty classification obtained to gait velocity, compared to classification model based on gait
velocity solely.
Interpretation: Gait parameters simultaneously used with gait velocity are able to provide useful information for a
more accurate frailty classification. Moreover, this technique could improve the early detection of pre-frail status,
allowing clinicians to perform measurements outside of a laboratory environment with the potential to prescribe a
treatment for reversing their physical decline.This work was supported in part by the Spanish Department of Health and
Institute Carlos III of the Government of Spain [Spanish Net on Aging and
frailty; (RETICEF)], and Economy and Competitivity Department of the
Government of Spain, under grants numbered RD12/043/0002, and
DEP2011-24105, respectively
Analysis of Plasma MicroRNAs as Predictors and Biomarkers of Aging and Frailty in Humans
Although circulating microRNAs (miRNAs) can modulate gene expression and affect immune system response, little is known
about their participation in age-associated frailty syndrome and sarcopenia. The aim of this study was to determine miRNAs as
possible biomarkers of age and frailty and their correlation with oxidative and inflammatory state in human blood. Three
inflammation-related miRNAs (miR-21, miR-146a, and miR-223) and one miRNA related with the control of melatonin
synthesis (miR-483) were analyzed. Twenty-two healthy adults, 34 aged robust, and 40 aged fragile patients were selected for
this study. The expression of plasma miRNAs was assessed by RT-qPCR; plasma cytokines (IL-6, IL-8, IL-10, and TNFα) were
analyzed by commercial kits, and plasma advanced oxidation protein products (AOPP) and lipid oxidation (LPO) were
spectrophotometrically measured. Fragile subjects had higher miR-21 levels than control subjects, whereas miR-223 and miR-
483 levels increased at a similar extend in both aged groups. All cytokines measured increased in aged groups compared with
controls, without differences between robust and fragile subjects. The fragile group had a TNFα/IL-10 ratio significantly higher
than robust and control groups. Aged groups also had higher AOPP and LPO levels than controls. Women presented higher
AOPP and LPO levels and increased expression of miR-483 compared with men. Positive correlations between miR-21 and
AOPP and between miR-483 and IL-8 were detected. The expression of miR-21 and the TNFα/IL-10 ratio were correlated
positively with the presence of frailty, which suggests that these markers can be considered as possible biomarkers for
age-related frailty.This work was partially supported by grants from the
Ministerio de Economía, Industria y Competitividad y por
el Fondo de Desarrollo Regional Feder, Spain nos. RD12/
0043/0005, PI13-00981, and CB16-10-00238 and from the
Universidad de Granada, Spain no. CEI2014-MPBS3
Effect of a rehabilitation-based chronic disease management program targeting severe COPD exacerbations on readmission patterns
Pulmonary rehabilitation (PR) is recommended after a severe COPD exacerbation, but its short- and long-term effects on health care utilization have not been fully established. The aims of this study were to evaluate patient compliance with a chronic disease management (CDM) program incorporating home-based exercise training as the main component after a severe COPD exacerbation and to determine its effects on health care utilization in the following year. COPD patients with a severe exacerbation were included in a case-cohort study at admission. An intervention group participated in a nurse-supervised CDM program during the 2 months after discharge, comprising of home-based PR with exercise components directly supervised by a physiotherapist, while the remaining patients followed usual care. Nineteen of the twenty-one participants (90.5%) were compliant with the CDM program and were compared with 29 usual-care patients. Compliance with the program was associated with statistically significant reductions in admissions due to respiratory disease in the following year (median [interquartile range]: 0 [0-1] vs 1 [0-2.5]; P =0.022) and in days of admission (0 [0-7] vs 7 [0-12]; P =0.034), and multiple linear regression analysis confirmed the protective effect of the CDM program (β coefficient −0.785, P =0.014, and R 2 =0.219). A CDM program incorporating exercise training for COPD patients without limiting comorbidities after a severe exacerbation achieves high compliance and reduces admissions in the year following after the intervention
Usefulness of bone turnover markers as predictors of mortality risk, disease progression and skeletal-related events appearance in patients with prostate cancer with bone metastases following treatment with zoledronic acid: TUGAMO study
Owing to the limited validity of clinical data on the treatment of prostate cancer (PCa) and bone metastases,
biochemical markers are a promising tool for predicting survival, disease progression and skeletal-related events (SREs) in these
patients. The aim of this study was to evaluate the predictive capacity of biochemical markers of bone turnover for mortality risk,
disease progression and SREs in patients with PCa and bone metastases undergoing treatment with zoledronic acid (ZA).
Methods: This was an observational, prospective and multicenter study in which ninety-eight patients were included. Patients
were treated with ZA (4mg every 4 weeks for 18 months). Data were collected at baseline and 3, 6, 9, 12, 15 and 18 months after
the beginning of treatment. Serum levels of bone alkaline phosphtase (BALP), aminoterminal propeptide of procollagen type I
(P1NP) and beta-isomer of carboxiterminal telopeptide of collagen I (b-CTX) were analysed at all points in the study. Data on
disease progression, SREs development and survival were recorded.
Results: Cox regression models with clinical data and bone markers showed that the levels of the three markers studied were
predictive of survival time, with b-CTX being especially powerful, in which a lack of normalisation in visit 1 (3 months after the
beginning of treatment) showed a 6.3-times more risk for death than in normalised patients. Levels of these markers were also
predictive for SREs, although in this case BALP and P1NP proved to be better predictors. We did not find any relationship
between bone markers and disease progression.
Conclusion: In patients with PCa and bone metastases treated with ZA, b-CTX and P1NP can be considered suitable predictors for
mortality risk, while BALP and P1NP are appropriate for SREs. The levels of these biomarkers 3 months after the beginning of
treatment are especially importantThis study was supported by Novartis Oncology Spai
On twistor solutions of the DKP equation
The factorization problem for the group of canonical transformations close to the identity and the corresponding twistor equations for an ample family of canonical variables are considered. A method to deal with these reductions is developed for the construction of classes of nontrivial solutions of the dKP equation