miércoles, 22 de marzo de 2017

Clinical Nutrition


Impaired nutritional status in geriatric trauma patients

F S Müller1,2,3, O W Meyer1,2,4, P Chocano-Bedoya1,2, S Schietzel1,2,4, M Gagesch1,2,4, G Freystaetter1,2,4, V Neuhaus4,5, H-P Simmen4,5, W Langhans3 and H A Bischoff-Ferrari1,2,4

1Department of Geriatrics and Aging Research, University Hospital Zurich, Zurich, Switzerland
2Centre on Aging and Mobility, University Hospital Zurich, Zurich, Switzerland
3Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
4Centre for Geriatric Traumatology, University Hospital Zurich, Zurich, Switzerland
5Department of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland

Background/Objectives:
Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients.

Subjects/Methods:
We enrolled 169 consecutive patients (greater than or equal to70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score<17=malnourished (M), less than or equal to23.5=at risk of malnutrition (ARM), >23.5=normal). At the same examination, we assessed mental (Geriatric Depression Scale; GDS) and cognitive function (Mini-Mental State Examination; MMSE), frailty status (Fried Scale), and number of comorbidities and medications. Further, discharge destination was documented. All analyses were adjusted for age and gender.

Results:
A total of 7.1% of patients were malnourished and 49.1% were ARM. Patients with reduced mental health (GDSgreater than or equal to5: 30.5 vs 11.5%; P=0.004), impaired cognitive function (MMSEless than or equal to26: 23.6±0.5 vs 26.0±0.6; P=0.004), prevalent frailty (32.5 vs 8%; P<0.001), more comorbidities (2.3±0.1 vs 1.3±0.2; P<0.0001) and medications (5.6±0.3 vs 3.4±0.4; P<0.0001) were more likely to have an impaired nutritional status (M+ARM). Further, M+ARM patients were twice as likely to be discharged to destinations different to home (odds ratio=2.08; confidence interval 1.07−4.05).
Conclusions:
In this consecutive sample of geriatric trauma patients, 56.2% had an M+ARM upon admission to acute care, which was associated with indicators of worse physical, mental and cognitive health and predicted a more than twofold greater odds of being discharged to a destination other than home.

European Journal of Clinical Nutrition (2017) 71, 602–606; doi:10.1038/ejcn.2017.25; published online 22 March 2017

Md. PhD. Patricia Chocano. Ex miembro del GII. 

viernes, 17 de marzo de 2017

Microgravedad y Cáncer


Observation of development of breast cancer cell lines in real time by fluorescence microscopy under simulated microgravity


Lavan, David; Valdivia-Silva, Julio E.; Sanabria, Gabriela; Orihuela, Diego; Suarez, Juan; Quispe, Marco; Chuchon, Mariano; Martin, David; Maroto, Marcos; Egea, Javier

Abstract

This project consist in the implementation of a fluorescence microscope for the in real time monitoring of biological labeled samples by several fluorophores in microgravity conditions keeping the temperature, humidity, and (CO)2 controlled by an electronic platform. The system (fluorescence microscope and incubator) is integrated to a microgravity simulator machine which was presented on the "30th Annual American Society for Gravitation and Space Research Meeting" October 2014 in Pasadena, CA, USA. Currently, we have the microgravity machine biologically validated by genetic expression studies in pupal stage of Drosophila melanogaster. The fluorescence microscope has a platform designed to hold a culture flask, and a fluorescence camera (Leica DFC3000 G) connected to an optical system (Fluorescence Light source Leica EL6000, optic fiber, fiber adapter, and fluorescence filter) in order to take images in real time. The mechanical system of the fluorescence microsc ope is designed to allow the displacement of the fluorescence camera through a parallel plane to the culture flask's plane and also the movement of the platform through a perpendicular axis to the culture flask in order to focus the samples to the optical system. The mechanical system is propelled by four DC moto-reductors with encoder (A-max 26 Maxon motor, GP 32S screw and MR encoder) that generate displacements in the order of micrometers. The angular position control of the DC motoreductor's shaft of all the DC moto-reductors is done by PWM signals based on the interpretation of the signals provided by the encoders during the movement. The system is remotely operated by a graphic interface installed on a personal computer or any mobile device (smartphone, laptop or tablet) by using the internet. Acknowledgments: Grant of INNOVATE PERU (Formerly FINCYT)

Valdivia-Silva, Julio E : Fundador del GII

lunes, 27 de febrero de 2017

Clinical Nutrition



Statin Use and 25-Hydroxyvitamin D Blood Level Response to Vitamin D Treatment of Older Adults.

Bischoff-Ferrari HA1,2, Fischer K1,2, Orav EJ3, Dawson-Hughes B4, Meyer U1,2, Chocano-Bedoya PO1,2, Meyer OW1,2, Ernst R1,2, Schietzel S1,2, Eberli F5, Staehelin HB6, Freystätter G1,2, Roas S1, Theiler R1,2, Egli A1,2, Wilson NM1,2.

1. Department of Geriatrics and Aging Research, University Hospital Zurich, Zurich, Switzerland.
2. Centre on Aging and Mobility, University of Zurich and City Hospital Waid, Zurich, Switzerland.
3. Department of Biostatistics, School of Public Health, Harvard University, Boston, Massachusetts.
4. U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
5. Department of Cardiology, Triemli City Hospital, Zurich, Switzerland.
6. Department of Geriatrics, University of Basel, Basel, Switzerland.

Objectives
To determine whether statin use alters response of 25-hydroxyvitamin D (25(OH)D) level to vitamin D treatment.
Design
Pooled analysis.
Setting
Three double-blind randomized controlled trials that tested different doses of vitamin D.
Participants
Participants of three trials (N = 646; mean age 76.3 ± 8.4, 65% female).
Measurements
In all three trials, 25(OH)D status and statin use were assessed repeatedly over time (baseline, 6 and 12 months). Repeated-measures analysis was used to compare 25(OH)D response to vitamin D treatment at baseline and 6 and 12 months of statin users and nonusers, controlling for age, sex, body mass index, Charlson Comorbidity Index, vitamin D dose, trial, and season.
Results
At baseline, 17.5% were statin users, and 65% were vitamin D deficient (25(OH)D < 20 ng/mL). Baseline 25(OH)D levels did not differ significantly between groups at baseline (18.8 for statin users, 17.2 ng/mL for nonusers, P = .07), but according to the longitudinal analyses, the total increase over 12 months in 25(OH)D concentration was significantly lower in statin users (13.1 ng/L) than nonusers (15.9 ng/mL; 21.4% difference; P = .009).
Conclusion
Of persons aged 60 and older at high risk of vitamin D deficiency, statin users had a 21.4% smaller increase in 25(OH)D serum concentrations over time than nonusers, independent of vitamin D dose and other covariates.

J Am Geriatr Soc. 2017 Feb 27. doi: 10.1111/jgs.14784. [Epub ahead of print]

Md. PhD. Patricia Chocano. Ex miembro del GII. 

lunes, 13 de febrero de 2017

Factores de crecimiento y Cancer



Oncogenic growth factor signaling mediating tumor escape from cellular immunity.
Concha-Benavente F1, Ferris RL2.

1.Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA; University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
2. Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA; University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA. Electronic address: ferrisrl@upmc.edu.

Unrestrained growth factor signals can promote carcinogenesis, as well as other hallmarks of cancer such as immune evasion. Our understanding of the function and complex regulation of HER family of receptors has led to the development of targeted therapeutic agents that suppress tumor growth. However, these receptors also mediate escape from recognition by the host immune system. We discuss how HER family of oncogenic receptors downregulate tumor antigen presentation and upregulate suppressive membrane-bound or soluble secreted inhibitory molecules that ultimately lead to impaired cellular immunity mediated by cytotoxic T lymphocyte (CTL) recognition. Implementing this knowledge into new therapeutic strategies to enhance tumor immunogenicity may restore effector cell mediated immune clearance of tumors and clinical efficacy of tumor-targeted immunotherapy against HER receptor overexpression.

Curr Opin Immunol. 2017 Feb 13;45:52-59. doi: 10.1016/j.coi.2017.01.004. [Epub ahead of print]


Md. PhD. Fernando Concha. Ex-miembro del GII