Factors Associated with the Risk of Falls of Nursing Home Residents Aged 80 or Older

Background: Falls are the leading cause of mortality and morbidity in older and represents one of the major and most costly public health problems worldwide. Purpose: Evaluate the influences of lower limb muscle performance, static balance, functional independence and quality of life on fall risk as assessed with the Timed Up and Go test. Design: Crosssectional. Methods: Fifty-two residents aged 80 or older were assessed and distributed in one of the two study groups according to the time to complete the Timed Up and Go Test. A Kistler force platform and linear transducer was used to determinate lower limb muscle performance. Postural Stability was measured by recording the center of pressure. The EuroQol-5 dimension was used to assess Health-Related Quality of Life and the Barthel Index was used to examine functional status. Student t-test was performed to evaluate the differences between groups. Correlations between variables were analyzed using Spearman or Pearson coefficient. ROC analysis was used to determine the cut-off points related to a decrease in the risk of a fall. Findings: Participants of no-fall risk group showed better lower limb performance, quality of life, and functional status. Cut-off points were determined for each outcome. Conclusions: Risk of falls in nursing home residents over the age of 80 is associated with lower limb muscle performance, functional status and quality of Life. Clinical Relevance: Cut-off points can be used by clinicians when working toward fall prevention and could help in determining the optimal lower limb muscle performance level for preventing falls

High Serum Cyclophilin C levels as a risk factor marker for Coronary Artery Disease

Cyclophilins (Cyps) are ubiquitous proteins that belong to the immunophilins family consistently associated with inflammatory and cardiovascular diseases. While levels of CypA have been extensively studied, less data are available for other Cyps. The purpose of this case-control study was to determine the relationship of Cyps (A, B, C and D) with coronary artery disease (CAD) and eight inflammation markers. Serum levels of Cyps, interleukins and metalloproteinases were measured in serum collected from 84 subjects. Participants were divided into two sub-groups based on CAD diagnosis: 40 CAD patients and 44 control volunteers. Serum levels of CypA, CypB and CypC, IL-1β and IL-6 were significantly higher in CAD patients. Bivariate correlation analysis revealed a significant positive correlation between Cyps and several blood and biochemical parameters. When the ability of Cyps levels for CAD diagnosis was evaluated, higher sensitivity and selectivity values were obtained with CypC (c-statistic 0.891, p < 0.001) indicating that it is a good marker of CAD disease, while less conclusive results were obtained with CypA (c-statistic 0.748, p < 0.001) and CypB (c-statistic 0.655, p < 0.014). In addition, significant correlations of traditional CAD risk factors and CypC were observed. In summary, high levels of CypC are a risk factor for CAD and therefore it can be proposed as a new biomarker for this disease.This work could not have been done without the invaluable collaboration of the staff at the Servicio Vixilancia da Saude from Universidad de Santiago de Compostela (Andrea Vidal Dopazo) and at the Cardiology Department, Hospital Universitario Lucus Augusti (Maria Jesús Basanta-Castro, Maria del Carmen Cabarcos Leal, Clara Jimenez-Serrano, Leonor Ortega- Fernández, Maria Jesus Palacios Pool, Sofía Seco-Aldegunde). The research leading to these results has received funding from the following FEDER cofunded-grants. From Conselleria de Cultura, Educación e Ordenación Universitaria, Xunta de Galicia, 2017 GRC GI-1682 (ED431C 2017/01). From CDTI and Technological Funds, supported by Ministerio de Economía, Industria y Competitividad, AGL2016-78728-R (AEI/FEDER, UE), ISCIII/PI16/01830, ISCIII/PI16/01816 and RTC-2016-5507-2, ITC-20161072. From European Union POCTEP 0161-Nanoeaters -1-E-1, Interreg AlertoxNet EAPA-317-2016, Interreg Agritox EAPA-998-2018, and H2020 778069-EMERTOX. Sandra Gegunde was supported by a fellowship from FIDIS, Spain

Cystic fibrosis at a Brazilian center of excellence: clinical and laboratory characteristics of 104 patients and their association with genotype and disease severity

OBJECTIVE: To identify the clinical, laboratory and radiographic characteristics of the cystic fibrosis patients under care at Universidade Estadual de Campinas (UNICAMP) in the last decade of the twentieth century, and to investigate the association of these characteristics with genotype and severity of the disease as measured by the Shwachman score. METHODS: Descriptive, retrospective and cross-sectional study of the patients assisted at UNICAMP hospital's Cystic Fibrosis Clinic from July 1990 to July 2000. RESULTS: One hundred and four patients were studied; 53.8% male; 93.3% Caucasian; 89.4% presented with respiratory symptoms; 59.6% presented with digestive symptoms; 5.8% had meconium ileus ; 4.8% had diabetes. The mean age at onset of symptoms was 3 months, and the mean age at diagnosis was 2 years and 4 months. At diagnosis, 69.9 and 56.6% of the patients had weight and height below 10th percentile, respectively; in 10.6%, sweat chloride was < 60 mEq/l. Staphylococcus aureus was found in 80.2%, Pseudomonas aeruginosa in 76.0%, and Burkholderia cepacia in 5.2%. deltaF508 homozygosis was observed in 18.75%, whereas 62.50% of the patients were deltaF508 heterozygous. A moderate/severe Shwachman score was found in 15.7%. Eighteen patients died in that period (17.3%). The mean age at death was 7 years and 8 months; median survival after diagnosis was 18 years and 4 months. Patients who have at least one deltaF508 mutation have more frequent alterations in fecal fat levels when compared to patients who do not have this mutation (p < 0.05). There were no differences in any parameter between deltaF508 homozygous and heterozygous patients. CONCLUSIONS: The clinical and laboratory characteristics of the 104 patients studied were similar to the characteristics described for patients in other countries. Exceptions are the higher age at diagnosis and lower survival. Our results support the recommendation for early diagnosis and the need for more treatment opportunities in the population of cystic fibrosis patients.OBJETIVO: Estudar as características clínicas, laboratoriais e radiográficas de pacientes fibrocísticos acompanhados na última década do século 20 na UNICAMP e verificar se existe associação com o genótipo e a gravidade da doença medida pelo escore de Shwachman. MÉTODOS: Estudo descritivo, retrospectivo e de corte transversal dos pacientes fibrocísticos acompanhados na UNICAMP, que tiveram atendimento entre julho de 1990 e julho de 2000. RESULTADOS: Foram estudados 104 pacientes: sexo masculino - 53,8%; raça caucasóide - 93,3%; comprometimento pulmonar - 89,4%, comprometimento digestivo - 59,6%; íleo meconial - 5,8%; diabetes melito - 4,8%; mediana da idade de início dos sintomas - 3 meses; mediana da idade no diagnóstico - 2 anos e 4 meses; 69,9 e 56,6% apresentavam peso e estatura abaixo do percentil 10, respectivamente, na época do diagnóstico; dosagem de cloro no suor < 60 mEq/l - 10,6%; colonização: S. aureus - 80,2%, P. aeruginosa - 76,0%, B. cepacia - 5,2%; delta F508 homozigoto - 18,75%, deltaF508 heterozigoto - 62,5%; escore de Shwachman moderado/grave - 15,7%. Foram a óbito 18 pacientes (17,3%); mediana de idade do óbito de 7 anos e 8 meses; sobrevida mediana após o diagnóstico no término do estudo de 18 anos e 4 meses. Os pacientes com a mutação deltaF508 apresentaram balanço de gordura nas fezes alterado com maior freqüência que os pacientes sem essa mutação (p < 0,05). Quando comparados os pacientes que apresentavam uma ou duas mutações deltaF508, nenhum parâmetro apresentou diferença estatisticamente significativa. CONCLUSÕES: As características clínicas e laboratoriais dos pacientes estudados foram semelhantes às descritas na população fibrocística de outros países, com algumas exceções, dentre as quais destacamos maior idade no diagnóstico e menor sobrevida. Desta forma, nossos dados permitem inferir que esforços para um diagnóstico precoce e maior oportunidade de tratamento necessitam ser dirigidos aos pacientes fibrocísticos.37137

[cystic Fibrosis At A Brazilian Center Of Excellence: Clinical And Laboratory Characteristics Of 104 Patients And Their Association With Genotype And Disease Severity].

To identify the clinical, laboratory and radiographic characteristics of the cystic fibrosis patients under care at Universidade Estadual de Campinas (UNICAMP) in the last decade of the twentieth century, and to investigate the association of these characteristics with genotype and severity of the disease as measured by the Shwachman score. Descriptive, retrospective and cross-sectional study of the patients assisted at UNICAMP hospital's Cystic Fibrosis Clinic from July 1990 to July 2000. One hundred and four patients were studied; 53.8% male; 93.3% Caucasian; 89.4% presented with respiratory symptoms; 59.6% presented with digestive symptoms; 5.8% had meconium ileus; 4.8% had diabetes. The mean age at onset of symptoms was 3 months, and the mean age at diagnosis was 2 years and 4 months. At diagnosis, 69.9 and 56.6% of the patients had weight and height below 10th percentile, respectively; in 10.6%, sweat chloride was < 60 mEq/l. Staphylococcus aureus was found in 80.2%, Pseudomonas aeruginosa in 76%, and Burkholderia cepacia in 5.2%. DeltaF508 homozygosis was observed in 18.75%, whereas 62.50% of the patients were DeltaF508 heterozygous. A moderate/severe Shwachman score was found in 15.7%. Eighteen patients died in that period (17.3%). The mean age at death was 7 years and 8 months; median survival after diagnosis was 18 years and 4 months. Patients who have at least one DeltaF508 mutation have more frequent alterations in fecal fat levels when compared to patients who do not have this mutation (p < 0.05). There were no differences in any parameter between DeltaF508 homozygous and heterozygous patients. The clinical and laboratory characteristics of the 104 patients studied were similar to the characteristics described for patients in other countries. Exceptions are the higher age at diagnosis and lower survival. Our results support the recommendation for early diagnosis and the need for more treatment opportunities in the population of cystic fibrosis patients.80371-

Larval Development in Tropical Gar (Atractosteus tropicus) Is Dependent on the Embryonic Thermal Regime: Ecological Implications under a Climate Change Context

This article belongs to the Special Issue Current Advances and Challenges in Fisheries and Aquaculture Science: Feature Papers for the New Journey of Fishes[EN] In ectotherm species, environmental temperature plays a key role in development, growth, and survival. Thus, determining how temperature affects fish populations is of utmost importance to accurately predict the risk of climate change over fisheries and aquaculture, critical to warrant nutrition and food security in the coming years. Here, the potential effects of abnormal thermal regimes (24, 28 and 32 °C; TR24, TR28, and TR32, respectively) exclusively applied during embryogenesis in tropical gar (Atractosteus tropicus) has been explored to decipher the potential consequences on hatching and growth from fertilization to 16 days post-fertilization (dpf), while effects on skeletal development and body morphology were explored at fertilization and 16 dpf. Egg incubation at higher temperatures induced an early hatching and mouth opening. A higher hatching rate was obtained in eggs incubated at 28 °C when compared to those at 24 °C. No differences were found in fish survival at 16 dpf, with values ranging from 84.89 to 88.86%, but increased wet body weight and standard length were found in larvae from TR24 and TR32 groups. Thermal regime during embryogenesis also altered the rate at which the skeletal development occurs. Larvae from the TR32 group showed an advanced skeletal development, with a higher development of cartilaginous structures at hatching but reduced at 16 dpf when compared with the TR24 and TR28 groups. Furthermore, this advanced skeletal development seemed to determine the fish body morphology. Based on biometric measures, a principal component analysis showed how along development, larvae from each thermal regime were clustered together, but with each population remaining clearly separated from each other. The current study shows how changes in temperature may induce craniofacial and morphological alterations in fish during early stages and contribute to understanding the possible effects of global warming in early development of fish and its ecological implicationsSIThis work was partially funded by “Study of the digestive physiology in larvae and juveniles of tropical gar (Atractosteus tropicus) based on histological, biochemical and molecular techniques” project (Ref. CB-2016-01-282765) from the National Council for Science and Technology (CONACyT) of Mexico. I.F. acknowledges the funding from the MICIU and the European Social Fund, “The European Social Fund invests in your future” through the Ramón y Cajal (Ref. RYC2018-025337-I) contract from the Plan Estatal de Investigación Científica y Técnica e Innovación 2017–2020Authors also thanks the support from the RED LARVAplus “Estrategias de desarrollo y mejora de la producción de larvas de peces en Iberoamérica” (117RT0521) funded by the Programa Iberoamericano de Ciencia y Tecnología para el Desarrollo (CYTED

Ebola Preparedness and Risk in Latin America

Until today, February 22, 2016, no confirmed Ebola cases have been diagnosed in Americas (except USA, four cases with one death). Confusion, lack of knowledge, and fear have led to quickly misclassify cases as suspected, when in fact most of them are false alarms. Nevertheless, European governments summoned to mobilize resources to attend the Ebola outbreak in West Africa. And also Latin American governments should contribute to halt this humanitarian crisis and to be prepared for the potential arrival of this deadly virus in the Caribbean, Central, and South American mainland. In this chapter, we described the experience of preparedness as well as risk assessment done in Latin America regarding the threat of Ebola for the region

A movie of a star: multi-epoch VLBA imaging of the SiO masers towards the Mira variable TX Cam

We describe an observing campaign using the Very Long Baseline Array (VLBA) to monitor the time-evolution of the v=1, J=1-0 SiO maser emission towards the Mira variable TX Cam. The data reported here cover the period 1997 May 24 to 1999 February 19, during which the SiO maser emission was imaged at approximately bi-weekly intervals. The result is an animated movie at an angular resolution of ~500 microarcsec, over a full pulsation period, of the gas motions in the near circumstellar environment of this star, as traced by the SiO maser emission. This paper serves to release the movie and is the first in a series concerning the scientific results from this observing campaign. In this paper, we discuss the global proper motion of the SiO maser emission as a function of pulsation phase. We measure a dominant expansion mode between optical phases $\phi \sim 0.7-1.5$ confirming ballistic deceleration, and compare this to predictions from existing pulsation models for late-type, evolved stars. Local infall and outflow motions are superimposed on the dominant expansion mode, and non-radial local gas motions are also evident for individual SiO maser components. The overall morphology and evolution of the SiO emission deviates significantly from spherical symmetry, with important implications for models of pulsation kinematics in the near-circumstellar environments of Mira variables.Comment: Mpeg movie can be obtained from http://www.jb.man.ac.uk/~pdiamond/txcam_movie.mpe

Identification of the Immunological Changes Appearing in the CSF During the Early Immunosenescence Process Occurring in Multiple Sclerosis

Patients with multiple sclerosis (MS) suffer with age an early immunosenescence process, which influence the treatment response and increase the risk of infections. We explored whether lipid-specific oligoclonal IgM bands (LS-OCMB) associated with highly inflammatory MS modify the immunological profile induced by age in MS. This cross-sectional study included 263 MS patients who were classified according to the presence (M+, n=72) and absence (M-, n=191) of LS-OCMB. CSF cellular subsets and molecules implicated in immunosenescence were explored. In M- patients, aging induced remarkable decreases in absolute CSF counts of CD4+ and CD8+ T lymphocytes, including Th1 and Th17 cells, and of B cells, including those secreting TNF-alpha. It also increased serum anti-CMV IgG antibody titers (indicative of immunosenescence) and CSF CHI3L1 levels (related to astrocyte activation). In contrast, M+ patients showed an age-associated increase of TIM-3 (a biomarker of T cell exhaustion) and increased values of CHI3L1, independently of age. Finally, in both groups, age induced an increase in CSF levels of PD-L1 (an inductor of T cell tolerance) and activin A (part of the senescence-associated secretome and related to inflammaging). These changes were independent of the disease duration. Finally, this resulted in augmented disability. In summary, all MS patients experience with age a modest induction of T-cell tolerance and an activation of the innate immunity, resulting in increased disability. Additionally, M- patients show clear decreases in CSF lymphocyte numbers, which could increase the risk of infections. Thus, age and immunological status are important for tailoring effective therapies in MS.This work was supported by grants FIS-PI15/00513, FIS-PI18/00572 and RD16/0015/0001 from the Instituto de Salud Carlos III. Ministerio de Ciencia e Innovación, Spain and FEDER: "Una manera de hacer Europa"