Are the therapeutic strategies in anorexia of ageing effective on nutritional status? A systematic review with meta-analysis

BACKGROUND: Anorexia of ageing (AA) may be considered as a risk factor for frailty and has an important impact on quality of life, morbidity and mortality. METHODS: A systematic review and a meta-analysis were performed to summarise the results from several trials on the effectiveness of treatments in AA, as associated with depression, sensory impairment of taste and smell, decreased appetite or early satiety, and disability. Eligible studies were required to report baseline and follow-up values, the mean change (∆-change) from baseline, and/or the mean difference among intervention groups versus control group, concerning food intake (kcal/daily) and/or nutritional outcomes, such as body weight, body mass index, albumin and Mini Nutritional Assessment. RESULTS: The systematic review included 20 papers based on different therapeutic approaches concerning food intake and/or nutritional outcomes. The results of the meta-analysis indicate that the interventions for AA have an important impact on body weight [+1.59 kg; 95% confidence interval (CI) = 1.48-+1.71 kg; P < 0.001) and on energy intake (+56.09 kcal; 95% CI = -54.05 to +166.25 kcal; P = 0.32). Regarding secondary outcomes, it was not possible to meta-analyse the limited amount of data availab le. CONCLUSIONS: The different variants of AA need to be defined because diverse therapeutic approaches are available. A more precise definition of the functional impairments associated with AA may allow a more correct decision about the most appropriate therapy to be prescribed. Moreover, this may allow for a more effective performance of the different therapeutic approaches once they are better targeted to the different scenarios of AA

Comment on "Clouds and the Faint Young Sun Paradox" by Goldblatt and Zahnle (2011)

Goldblatt and Zahnle (2011) raise a number of issues related to the possibility that cirrus clouds can provide a solution to the faint young sun paradox. Here, we argue that: (1) climates having a lower than present mean surface temperature cannot be discarded as solutions to the faint young sun paradox, (2) the detrainment from deep convective clouds in the tropics is a well-established physical mechanism for the formation of high clouds that have a positive radiative forcing (even if the possible role of these clouds as a negative climate feedback remains controversial) and (3) even if some cloud properties are not mutually consistent with observations in radiative transfer parameterizations, the most relevant consistency (for the purpose of hypothesis testing) is with observations of the cloud radiative forcing. Therefore, we maintain that cirrus clouds, as observed in the current climate and covering a large region of the tropics, can provide a solution to the faint young sun paradox, or at least ease the amount of CO<sub>2</sub> or other greenhouse substances needed to provide temperatures above freezing during the Archean

Polymorphous low grade adenocarcinoma : review and case report

Polymorphous Low-Grade Adenocarcinoma is a rare, malignant salivary gland tumor, which is found almost exclusively in minor salivary glands. It is more frequent in the age range from 30 to 70, with a clear female predilection in a 2:1 ratio. It is usually located in the hard or soft palate, although it may be found in the rest of the oral cavity too. It is rare in major salivary glands. In general it has good prognosis, with recurrence rates in the range of 17% - 24%. Although rare, metastasis to regional lymph nodes may occur in 9% of the cases. This report describes the case of a patient that consulted at the Military Odontological Center (Central Odontológica del Ejército) due to an esthetic alteration of her dental prosthesis, which had been made 8 years before. The patient was sent to the Maxillofacial Surgery Service, where the intraoral examination showed a big mass compromising the hard palate and the alveolar ridge. During examination, a dent in her prosthesis was found to correspond to the tumor mass; it was therefore concluded that the tumor had at least an eight-year-old evolution. An incisional biopsy was carried out, and once the polymorphous low-grade adenocarcinoma diagnosis had been stated, the patient was sent to the Head and Neck Surgery Service of the Military Hospital, where the lesion was treated by wide surgical excision followed by radiation therap

Quantitative interactions between Candida albicans and the mutans streptococci in patients with Down Syndrome

Abstract Background: Oral microorganisms produce damage through the transfer to bloodstream, colonizing other tissues or direct damage in the oral cavity. Aim to study the quantitative interactions between C. albicans and the mutans streptococci and ms serotypes in the saliva of the oral cavity of patients with Down syndrome (DS). Material and Methods: Included 120 patients of both genders, 60 patients with Down syndrome (DS) and 60 patients as a control group (CG). Samples of saliva were taken, and bacteria and fungi were grown on TYCSB and Saboureaud agar. Microbiological, serological and quantitative analyses were performed to determine the kind of isolated of microorganisms corresponding to the ms c, e, f and k for species S. mutans and d and g for S. sobrinus and C. albicans. Electronic scanning microscopy was employed to visualize and confirm the colonies under study. Statistics analysis included t-test proofs for matched data test, Scheffé and ANOVA

Latarjet Cerclage: The All-Arthroscopic Metal-Free Fixation

The Bristow-Latarjet procedure has been one of the most recognized procedures for the treatment of recurrent shoulder dislocation with anterior glenoid bone loss, revision surgery after failed Bankart repair, contact and collision sport injuries, and patients with a high risk of recurrence. Open and arthroscopic approaches have recently shown similar outcomes by several authors. However, complications related to metal implants, despite being low, are still a matter of concern. We describe an all-arthroscopic Latarjet technique with a metal-free fixation method using 2 ultra-high-strength sutures, creating a cerclage construct through 2.4mm glenoid and coracoid tunnels with a final capsulolabral complex reconstruction

Dependence of tropical cirrus clouds on sea surface temperature and consequences for the Archean climate

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Earth, Atmospheric, and Planetary Sciences, 2009.Cataloged from PDF version of thesis.Includes bibliographical references (p. 133-142).In this thesis, we study observationally the variation of upper level cloud fraction with sea surface temperature in tropical oceanic regions. We also explore the consequences of a cloud feedback, arising from variations in the coverage of thin upper level clouds, in the climate of the Archean using a simple radiative-convective model that includes the effect of the variations in the area of thin cirrus clouds. First, we look at the variation in area of upper level clouds using TRMM VIRS (Tropical Rainfall Measuring Mission, Visible Infrared Sounder) data. We quantify the effect of methodological choices on the magnitude of the observed correlations between upper level cloud cover and SST. We discuss several methodological choices that might contribute to the relatively small signals found by previous researchers (- 0%/K to 2%/K) , namely, the classification of cloudy regions into convective updrafts and anvil, the use of cloud weighted SST, and the truncation and sampling error with respect to the evolution of mesoscale convective systems. All of these contribute to some extent to the weakness of signal. We show that the coarse sampling of orbital satellites can introduce biases in the estimation of the signal. Our observational evidence shows a negative correlation between the upper level cloud fraction normalized by convection and sea surface temperatures. We also study the relation between local sea surface temperature (SST) and convective precipitation fraction and stratiform rainfall area from radar observations of precipitation, using data from the Kwajalein atoll ground-based radar as well as the precipitation radar on board of the Tropical Rainfall Measurement Mission (TRMM satellite).(cont.) We find that the fraction of convective precipitation increases with SST at a rate of about 6 to 12%/K and the area of stratiform rainfall normalized by total precipitation decreases with SST at rates between -5 to -28%/K. These relations are observed to hold for different regions over the tropical oceans and also for different periods of time. Correlations are robust to outliers and to undersampled precipitation regions. Kwajalein results are relatively insensitive to the parameters in the stratiform-convective classification algorithm. Quantitative differences between the results obtained using the two different radars could be explained by the smoothing in the reflectivity of convective regions due to the relatively large pixel size of the TRMM precipitation radar compared to the size of the convective clouds. We discuss how this observations can be interpreted as an increase in the efficiency of precipitation with temperature in mesoscale convective systems in the tropics. Finally, we explore the consequences of a negative feedback mediated through tropical cirrus clouds in the climate of the Archean, and the possibility that this feedback could explain the so-called faint young sun paradox. We assume that rates of change in the area of detrainment cloud (from the observational estimates) are characteristic also for thin cirrus clouds that have a net positive cloud radiative forcing. We find that global mean surface temperatures above freezing can indeed be found for luminosities larger than about 0.8 (corresponding to - 2.9 Ga and nearly complete tropical cirrus coverage).(cont.) For luminosities smaller than 0.8, even though global mean surface temperatures are below freezing, tropical mean temperatures are still above freezing, indicating the possibility of a partially ice-free earth for the Early Archean. While it is feasible for tropical cirrus to completely eliminate the paradox, it is similarly possible for tropical cirrus to reduce the amounts of other greenhouse gases needed for solving the paradox and therefore easing the constraints on CO 2 and CH4 that appear to be in disagreement with geological evidence.by Roberto F. Rondanelli.Ph.D

Arthroscopic "Bone Block Cerclage" Technique for Posterior Shoulder Instability

Many open and arthroscopic techniques have been described to treat posterior glenohumeral instability. Multifactorial features of posterior shoulder instability pathoanatomy and varied patient characteristics have challenged the understanding of this condition and have led to dissimilar results, without a strong consensus for the most adequate technique to treat it. We describe an arthroscopic anatomical metal-free posterior glenoid reconstruction technique, using a tricortical iliac crest allograft with 2 ultra-high strength sutures (FiberTape Cerclage System; Arthrex, Naples, FL) with concomitant posterior capsulolabral complex reconstruction procedure