Multifactorial assessment and targeted intervention in nutritional status among the older adults: a randomized controlled trial: the Octabaix study

Background: Malnutrition is frequent among older people and is associated with morbi-mortality.he aim of the study is to assess the effectiveness of a multifactorial and multidisciplinary intervention in the nutritional status among the elderly. Methods: Randomized, single-blind, parallel-group, clinical trial conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona). Of 696 referred people, born in 1924, 328 subjects were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both the patients and their primary care providers. The main outcome was improvement in nutritional status assessed by Mini Nutritional Assessment (MNA). Data analyses were done by intention-to-treat. Results: Two-year assessment was completed for 127 patients (77.4%) in the intervention group and 98 patients (59.7%) in the control group. In the adjusted linear mixed models for MNA, intervention showed no significant effect during all follow-up period with −0.21 (CI: − 0.96; 0.26). In subjects with nutritional risk (MNA ≤ 23.5 / 30) existed a tendency towards improvement in MNA score 1.13 (95% CI −0.48; 2.74) after 2 years. Conclusion: A universal multifactorial assessment and target intervention over a two year period in subjects at nutritional risk showed a tendency to improve nutrition but not in the rest of community-dwelling studied subjects. Cognitive impairment was an independent factor strongly associated with a decline in nutritional status

Low co-morbidity, low levels of malnutrition, and low risk of falls in a community-dwelling sample of 85-year-old are associated with succesful aging: the Octabaix study

The population is aging throughout the world. Preserving physical and cognitive functions is crucial to successful aging. The aim of this study was to determine the proportion of 85-year-old community-dwelling subjects aging successfully, applying a quantitative approach, and assessing the association of successful aging with sociodemographic data, global geriatric assessment, and co-morbidity. This was a community-based survey of inhabitants aged 85 years, with 328 out of 487 subjects born in 1924 assigned to seven primary health-care teams, representing a participation rate of 67.5%. Sociodemographic variables, Barthel index (BI), the Spanish version of the Mini-Mental State Examination (MEC), Mini Nutritional Assessment (MNA), Charlson Index, Gait Rating Scale, social risk, quality of life (QoL), and prevalent chronic diseases were assessed. Subjects scoring higher than 90 on the BI and higher than 24 on the MEC were compared with the rest. Multiple regression analysis was performed. Using these criteria, successful aging status was defined in 162 (49.3%) subjects. Using multiple logistic regression analysis, successful agers had significantly lower co-morbidity scores (p 0.0001). Almost half of the individuals presented successful aging. Successful agers had less co-morbidity and a lower risk of falls or malnutrition, and they had higher scores on the QoL scale

MRI and CFS oligoclonal bands after autologus hematopoietic stem cell transplantation in MS

To analyze the MRI and CSF oligoclonal bands (OB) changes in patients with MS who underwent an autologous hematopoietic stem cell transplantation (AHSCT). Background: AHSCT is evaluated as an alternative therapy in severe MS. In previous series of AHSCT for MS, data on MRI or OB outcome were limited or not provided. Methods: five patients with a median Kurtzke's EDSS score of 6.5, more than two attacks, and confirmed worsening of the EDSS in the previous year received an AHSCT. Hematopoietic stem cells were mobilized with cyclophosphamide (3 g/m2) and granulocyte colony-stimulating factor (5 microg/kg/d). The graft was T cell depleted by positive CD 34+ selection. Conditioning regimen included BCNU (300 mg/m(2)), cyclophosphamide (150 mg/kg in 3 days), and antithymocyte globulin (60 mg/kg in 4 days). MRI scans were scheduled at baseline and 1, 3, 6, and 12 months and OB analysis at baseline and 3 and 12 months post-AHSCT. Results: four patients had a stable or improved EDSS after a median follow-up of 18 months (range, 12 to 24 months). The fifth patient's condition deteriorated during AHSCT. She partially improved and remained stable after month 3 after AHSCT. The baseline CSF OB persisted 1 year after AHSCT. MRI studies after AHSCT showed no enhanced T1 lesions and no new or enlarging T2 lesions. The median percentage change of T2 lesion load was -11.8% (range, -26.6 to -4.0%). All patients had a decrease of corpus callosum area at 1 year (median, 12.4%; range, 7.8% to 20.5%) that did not progress in the two patients evaluated at 2 years after AHSCT. Conclusions: although the persistence of CSF OB suggests the lymphocytes were not eliminated from the CNS, the follow-up MRI studies showed no enhanced T1 brain lesions and a reduction in the T2 lesion load that correlated with the clinical stabilization of MS after AHSCT

GPR56/ADGRG1 inhibits mesenchymal differentiation and radioresistance in glioblastoma

A mesenchymal transition occurs both during the natural evolution of glioblastoma (GBM) and in response to therapy. Here, we report that the adhesion G-protein-coupled receptor, GPR56/ADGRG1, inhibits GBM mesenchymal differentiation and radioresistance. GPR56 is enriched in proneural and classical GBMs and is lost during their transition toward a mesenchymal subtype. GPR56 loss of function promotes mesenchymal differentiation and radioresistance of glioma initiating cells both in vitro and in vivo. Accordingly, a low GPR56-associated signature is prognostic of a poor outcome in GBM patients even within non-G-CIMP GBMs. Mechanistically, we reveal GPR56 as an inhibitor of the nuclear factor kappa B (NF-κB) signaling pathway, thereby providing the rationale by which this receptor prevents mesenchymal differentiation and radioresistance. A pan-cancer analysis suggests that GPR56 might be an inhibitor of the mesenchymal transition across multiple tumor types beyond GBM

Multifactorial assessment and targeted intervention in nutritional status among the older adults: a randomized controlled trial: the Octabaix study

Background: Malnutrition is frequent among older people and is associated with morbi-mortality.he aim of the study is to assess the effectiveness of a multifactorial and multidisciplinary intervention in the nutritional status among the elderly. Methods: Randomized, single-blind, parallel-group, clinical trial conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona). Of 696 referred people, born in 1924, 328 subjects were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both the patients and their primary care providers. The main outcome was improvement in nutritional status assessed by Mini Nutritional Assessment (MNA). Data analyses were done by intention-to-treat. Results: Two-year assessment was completed for 127 patients (77.4%) in the intervention group and 98 patients (59.7%) in the control group. In the adjusted linear mixed models for MNA, intervention showed no significant effect during all follow-up period with −0.21 (CI: − 0.96; 0.26). In subjects with nutritional risk (MNA ≤ 23.5 / 30) existed a tendency towards improvement in MNA score 1.13 (95% CI −0.48; 2.74) after 2 years. Conclusion: A universal multifactorial assessment and target intervention over a two year period in subjects at nutritional risk showed a tendency to improve nutrition but not in the rest of community-dwelling studied subjects. Cognitive impairment was an independent factor strongly associated with a decline in nutritional status

Implicación del patrón radiológico en el pronóstico de los tumores oligodendrogliales: correlación con el perfil genético

Introducción. La codeleción 1p19q (LOH1p19q) confiere a los tumores oligodendrogliales quimiosensibilidad y un mejor pronóstico en relación con otros gliomas. La investigación dirigida a identificar características radiológicas asociadas a LOH1p19q ha despertado gran interés en los últimos años. Objetivos. Confirmar la existencia de heterogeneidad regional de los parámetros moleculares en los gliomas oligodendrogliales, valorar la asociación entre el perfil genético y determinadas características radiológicas y clínicas, y analizar el valor pronóstico de éstas. Pacientes y métodos. Se incluyeron 54 pacientes tratados según un protocolo preestablecido común. Se valoraron las secuencias T1, con/sin gadolinio, y T2 de la resonancia magnética preoperatoria a ciegas de la información molecular y clínica. El análisis de LOH se efectuó sobre muestras pareadas de ADN tumoral y genómico. Resultados. La presencia de LOH1p se halló fuertemente asociada a LOH19q (p < 0,0001). LOH1p19q resultó más frecuente en los tumores situados en el lóbulo frontal (odds ratio, OR = 5,38; intervalo de confianza del 95%, IC 95% = 1,51-19,13; p = 0,007) y sin necrosis radiológica (OR = 0,17; IC 95% = 0,03-0,80; p = 0,02). La localización frontal (riesgo relativo, RR = 4,499; IC 95% = 1,027-193,708; p = 0,046), la necrosis radiológica (RR = 0,213; IC 95% = 0,065-0,700; p = 0,011) y el grado de resección (RR = 9,231; IC 95% = 1,737-49,050; p = 0,009) resultaron factores pronósticos independientes de supervivencia global. Conclusiones. En los tumores oligodendrogliales, además del análisis histológico y el estudio genético-molecular, la valoración de determinadas características radiológicas puede resultar de gran utilidad para definir subgrupos de pacientes con pronóstico y respuesta al tratamiento similares. Los esfuerzos deben dirigirse, por tanto, hacia la utilización combinada de todos los recursos disponibles en cada centro

Implicación del patrón radiológico en el pronóstico de los tumores oligodendrogliales: correlación con el perfil genético

Introducción. La codeleción 1p19q (LOH1p19q) confiere a los tumores oligodendrogliales quimiosensibilidad y un mejor pronóstico en relación con otros gliomas. La investigación dirigida a identificar características radiológicas asociadas a LOH1p19q ha despertado gran interés en los últimos años. Objetivos. Confirmar la existencia de heterogeneidad regional de los parámetros moleculares en los gliomas oligodendrogliales, valorar la asociación entre el perfil genético y determinadas características radiológicas y clínicas, y analizar el valor pronóstico de éstas. Pacientes y métodos. Se incluyeron 54 pacientes tratados según un protocolo preestablecido común. Se valoraron las secuencias T1, con/sin gadolinio, y T2 de la resonancia magnética preoperatoria a ciegas de la información molecular y clínica. El análisis de LOH se efectuó sobre muestras pareadas de ADN tumoral y genómico. Resultados. La presencia de LOH1p se halló fuertemente asociada a LOH19q (p < 0,0001). LOH1p19q resultó más frecuente en los tumores situados en el lóbulo frontal (odds ratio, OR = 5,38; intervalo de confianza del 95%, IC 95% = 1,51-19,13; p = 0,007) y sin necrosis radiológica (OR = 0,17; IC 95% = 0,03-0,80; p = 0,02). La localización frontal (riesgo relativo, RR = 4,499; IC 95% = 1,027-193,708; p = 0,046), la necrosis radiológica (RR = 0,213; IC 95% = 0,065-0,700; p = 0,011) y el grado de resección (RR = 9,231; IC 95% = 1,737-49,050; p = 0,009) resultaron factores pronósticos independientes de supervivencia global. Conclusiones. En los tumores oligodendrogliales, además del análisis histológico y el estudio genético-molecular, la valoración de determinadas características radiológicas puede resultar de gran utilidad para definir subgrupos de pacientes con pronóstico y respuesta al tratamiento similares. Los esfuerzos deben dirigirse, por tanto, hacia la utilización combinada de todos los recursos disponibles en cada centro

GPR56/ADGRG1 inhibits mesenchymal differentiation and radioresistance in glioblastoma

A mesenchymal transition occurs both during the natural evolution of glioblastoma (GBM) and in response to therapy. Here, we report that the adhesion G-protein-coupled receptor, GPR56/ADGRG1, inhibits GBM mesenchymal differentiation and radioresistance. GPR56 is enriched in proneural and classical GBMs and is lost during their transition toward a mesenchymal subtype. GPR56 loss of function promotes mesenchymal differentiation and radioresistance of glioma initiating cells both in vitro and in vivo. Accordingly, a low GPR56-associated signature is prognostic of a poor outcome in GBM patients even within non-G-CIMP GBMs. Mechanistically, we reveal GPR56 as an inhibitor of the nuclear factor kappa B (NF-κB) signaling pathway, thereby providing the rationale by which this receptor prevents mesenchymal differentiation and radioresistance. A pan-cancer analysis suggests that GPR56 might be an inhibitor of the mesenchymal transition across multiple tumor types beyond GBM