Background: Providing quality end-of-life care to individuals with advanced dementia is crucial. ... more Background: Providing quality end-of-life care to individuals with advanced dementia is crucial. To date, little attention has been paid to palliative care knowledge and attitudes toward palliative care for people with advanced dementia in Spain Objectives: To investigate the knowledge of and attitudes toward palliative care for advanced dementia among registered nurses and physicians in Spain. Design and Methods: A descriptive, cross-sectional survey design was used. This study included a convenience sample of 402 nurses (n = 290) and physicians (n = 112). Two instruments were administered: demographic characteristics and Spanish version of the Questionnaire of Palliative Care for Advanced Dementia (qPAD-SV). Descriptive statistics and multiple regression were used for data analysis. Results: Overall, the nurses and physicians had moderate mean scores for both knowledge of and attitudes regarding palliative care for advanced dementia. Physicians had a higher level of knowledge (p<0.05) compared to nurses. Additionally, physicians and nursing staff who had professional experience/education in geriatrics and those who had received palliative care and hospice training had greater (p<0.01) knowledge of palliative care. In addition, healthcare professionals who had received dementia care training and who had worked in nursing homes had higher levels (p<0.05) of knowledge and attitudes toward palliative care. Conclusion: This study indicates the need to provide nurses and physicians with more education for select groups of professionals who have had limited education and experience in caring for older adults with advanced dementia.
Current reviews in clinical and experimental pharmacology, Nov 1, 2022
Background: Autism Spectrum Disorders (ASDs) are a group of prevalent neuropsychiatric disorders.... more Background: Autism Spectrum Disorders (ASDs) are a group of prevalent neuropsychiatric disorders. They present a complex and unknown etiology, which in most cases includes significant peripheral alterations outside the brain such as in the composition of gut microbiota. Because the gut microbiota is involved in modulating the gut-brain axis, several studies have suggested that the microbiome in the gut can modify metabolites which are able to cross the blood-brain barrier and modulate brain function. Methods: We reviewed the current evidence regarding microbiota alterations in patients with ASD and the effects of the administration of probiotics and prebiotics in these patients, both in terms of gastrointestinal and behavioural symptoms. Results: Administration of a probiotic formulation containing different strains of Lactobacillus (L. acidophilus, L. rhamnosus, and others) and Bifidobacteria had beneficial effects upon these aforementioned symptoms and their use is recommended in a subgroup of ASD patients that present gastrointestinal disturbances. Nonetheless, the types of gastrointestinal disturbances that most benefit from such interventions remain to be elucidated in order to personalize the medical approaches. Conclusion: Recent clinical studies have shown that probiotic treatments can regulate the gut microbiota and may result in improvements in some behavioral abnormalities associated with ASD. Trials using prebiotic fibers or synbiotics preparations are still lacking and necessary in order to deep in such therapeutic strategies in ASD with comorbid gastrointestinal disrturbances.
Neurology Psychiatry and Brain Research, Feb 1, 2018
Febrile seizures (FS) are the result of particular sensitivity to fever in the developing brain, ... more Febrile seizures (FS) are the result of particular sensitivity to fever in the developing brain, have a major genetic predisposition, and nearly always have a benign outcome. Febrile seizures are the most common for of seizures in childhood. They have been observed in 2-6% of children before the age of 5 years, but in some populations this figure increase to 15%. Febrile seizures could be the first manifestations of epilepsy. About 13% of epileptic patients have a history of febrile seizures, and 30% have had recurrent febrile seizures Their phenotypic characteristics allow, in the majority of cases, a classification of the seizure, an elaboration of a prognosis and to assume a specific therapeutic attitude. It is possible to describe a spectrum according to their severity, from the benign simple seizure to the more complex, febrile seizure plus (GEFS+), Dravet syndrome, Epilepsy syndrome related infection febrile FIRES and Idiopatic Hemiconvulsion Hemiplegia and Epilepsy syndrome (IHHE). FS has a multifactorial inheritance, suggesting that both genetic and environmental factors are causative. Five areas of the genome have shown to be linked to FS in some ways. Two of them, FEB1 and FEB2 found on chromosomes 8 and 19p, are only involved in FS. During the past decade, molecular genetic studies have contributed to identification of genetic factors involved in febrile seizure and related disorders marking the necessary of careful follow up of the patients in order to detect risk factor earlier. We have reviewed the medical literature to update current knowledge of febrile seizures, their prognosis and their relation to new epileptic syndromes.
Objective: Treating sarcopenia remains a challenge, and nutritional interventions present promisi... more Objective: Treating sarcopenia remains a challenge, and nutritional interventions present promising approaches. We summarize the effects of leucine supplementation in treating older individuals with sarcopenia associated with aging or to specific disorders, and we focus on the effect of leucine supplementation on various sarcopenia criteria, e.g., muscular strength, lean mass, and physical performance. Methods: A literature search for articles related to this topic was performed on the relevant databases, e.g., the PubMed/Medline, Embase, EBSCO, Cochrane, Lilacs, and Dialnet. The identified articles were reviewed according to Preferred Reporting Items for Systematic reviews and meta-analyses (PRISMA) guidelines. Results: Of the 163 articles we consulted, 23 met our inclusion criteria, analysing the effect of leucine or leucine-enriched protein in the treatment of sarcopenia, and 13 of these studies were based on randomized and placebo-controlled trials (RCTs). In overall terms, the published results show that administration of leucine or leucine-enriched proteins (range 1.2-6 g leucine/day) is well-tolerated and significantly improves sarcopenia in elderly individuals, mainly by improving lean muscle-mass content and in this case most protocols also include vitamin D co-administration. The effect of muscular strength showed mix results, and the effect on physical performance has seldom been studied. For sarcopenia-associated with specific disorders, the most promising effects of leucine supplementation are reported for the rehabilitation of post-stroke patients and in those with liver cirrhosis. Further placebo-controlled trials will be necessary to determine the effects of leucine and to evaluate sarcopenia with the criteria recommended by official Working Groups, thereby limiting the variability of methodological issues for sarcopenia measurement across studies.
Editorial on the Research Topic Food-polyphenol-induced modulation of neurodegeneration Neurodege... more Editorial on the Research Topic Food-polyphenol-induced modulation of neurodegeneration Neurodegenerative diseases are continuously increasing due to a number of factors, such as emotional stress, socioeconomic conditions, lifestyles such as alcohol abuse, smoking, antibiotic abuse, malnutrition, and excessive intake of junk food, as well as a lack or poor physical activity, all of which lead to several diseases such as diabetes, cardiovascular diseases, and cancer as well as a significant alteration of the homeostasis of the gut microbiota. Therefore, regarding neurodegenerative diseases, the proper function of the so-called gut microbiota-brain axis, where a bidirectional communication affecting other systems such as the neuroendocrine system, the enteric nervous system, the autonomic nervous system, and the immune system, is of great importance. During a process of intestinal dysbiosis, an altered permeability of the blood-brain barrier (BBB) takes place in which certain metabolites of the intestinal microbiota, which contains a vast variety of bacteria, viruses, and fungi, cross into the central nervous system, leading to neuroinflammatory processes also caused by an access of cells of the immune system which produce pro-inflammatory mediators. In Parkinson's disease (PD), for example, alteration of the gut microbiota would lead to the passage of lipolysaccharides (LPS) from the outer membrane of Gram-negative bacteria into the bloodstream and BBB. Microglia possess Toll-like receptor 4, which can recognize and bind to LPS, thus triggering the activation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), which, in turn, initiates the transcription of pro-inflammatory cytokines and nitric oxide, thus leading to neuroinflammation. Furthermore, LPS would give rise to the mitochondrial accumulation of α-synuclein with a subsequent increase in reactive oxygen species and reactive nitrogen species resulting in functional alterations within mitochondria. Moreover, mitochondrial accumulation of α-synuclein promotes damage to dopaminergic neurons due to reduced dopamine production (1, 2). Polyphenols are abundantly distributed in fruit and vegetables and their ingestion through food represents a healthy approach to prevent or delay several diseases due to their beneficial effects, which include anti-allergic, antioxidant, anti-cancer, and antineurodegenerative properties (3). In relation to neurodegenerative diseases, these natural compounds can, through different mechanisms, reduce and/or improve several conditions such as age-associated cognitive decline and schizophrenia (Figure 1). Li C. et al. have reported the effects of the intake of green tea rich in polyphenols on PD progression through a two-sample Mendelian randomization (MR) study using
Background: The elderly is characterized by a gradual decline in body function, which represents ... more Background: The elderly is characterized by a gradual decline in body function, which represents the clinical situation called "frailty". Prefrailty is the intermediate stage between frailty and the robust condition. L-carnitine (LC) plays an important role in energy production from long-chain fatty acids in mitochondria and its serum level is lower in prefrail and frail subjects. Objective: This study aims to evaluate the effect of Acetyl-L-carnitine (ALCAR) in pre frail older patients. Methods: We scheduled 3 months of treatment and then 3 months of follow-up. 92 subjects were selected from May 2009 to July 2017 in a randomized, observational, double-blind, placebo-controlled study. We scheduled 3 months of treatment and then 3 months of follow-up. ALCAR (oral 1.5 g/bis in die - BID) or placebo group. Results: After the treatment, only the treated group displayed a decrease in C reactive protein (CRP) p<0.001, an increase in serum free carnitine and acetyl carnitine (p<0.05), in Mini Mental state (MMSE) p<0.0001 and 6-walking distance (p<0.0001); ALCAR group vs. placebo group showed a decrease in HDL cholesterol and in CRP (p<0.01), an increase in MMSE score (p< 0.001) and in 6-walking distance (p<0.001) Conclusions: ALCAR treatment delays the incidence and severity of onset in prefrail subjects of degenerative disorders of the elderly, with improvement in memory and cognitive processes.
Endocrine, metabolic & immune disorders, Feb 7, 2019
Background and Objective: Coeliac disease (CD) is a chronic autoimmune intestinal disorder charac... more Background and Objective: Coeliac disease (CD) is a chronic autoimmune intestinal disorder characterized by intolerance to gluten, a protein contained in certain cereals. The main physiopathological basis of CD is the progressive destruction of intestinal villi caused by gluten ingestion by genetically-susceptible individuals. Patients who receive a diagnosis of CD must make significant changes to their daily habits and this can affect their quality of life. The objective of this review is to summarize the evidence regarding the economic, physical and social limitations which can affect the quality of life in patients with CD. Results: Different factors such as physical changes, psychological effects, interpersonal relationships, emotions and economic difficulties can affect the quality of life of these patients. Observations suggest that, in general, women with CD experience a greater deterioration in their quality of life than men. Lastly, complications in daily life are also associated with the reduced availability of gluten-free products which also usually cost more than standard products. Conclusions: Continuous health education and care regarding socioeconomic issues should be continuously developed and provided to people with CD.
In the present study the effect of ascorbic acid (AA) on naloxone-induced withdrawal signs in mor... more In the present study the effect of ascorbic acid (AA) on naloxone-induced withdrawal signs in morphine-dependent guinea-pigs was investigated. Animals were rendered dependent on morphine by subcutaneous (s.c.) injections of morphine sulfate 3 times a day for 3 days, and withdrawal signs were induced by intraperitoneal (i.p.) administration of naloxone (15 mg/kg) 2 h after the tenth injection of morphine sulfate on day 4. Chronic pretreatment of guinea-pigs with AA, 200 mg/kg, s.c. three times daily for 3 days, reduced withdrawal jumping, digging, writhing, rearing, face-washing, head and body shakes, penile licking and diarrhea. The mixed dopamine D 1 /D 2 receptor agonist apomorphine (0.5 mg/kg, s.c.) markedly antagonized the responses induced by AA. The effect of apomorphine was blocked by the dopamine D 1 receptor antagonist SCH23390 but not by the dopamine D 2 receptor antagonist sulpiride nor the peripheral dopamine receptor antagonist domperidone. The results suggest that chronic administration of AA inhibits opioid withdrawal, via a dopaminergic mechanism.
Urologic Oncology-seminars and Original Investigations, Dec 1, 2019
Objective: To evaluate the role of peripheral inflammation (leukocyte differential count, the pro... more Objective: To evaluate the role of peripheral inflammation (leukocyte differential count, the proinflammatory cytokines IL-beta, TNF-a, IL-6, IL-8, and the inflammatory markers fibrinogen and C-reactive protein [CRP]) in frailty syndrome in patients with prostate cancer (CaP) undergoing antiandrogen therapy (ADT). Methods: A total of 46 men between 51 and 92 years of age with CaP and receiving ADT were classified as frail, prefrail or robust according to the Fried scale. A geriatric assessment was performed, based on the Minimental State Examination for cognitive function, the Barthel index for basic activities of daily living, the Yesavage scale for geriatric depression, and the Athens insomnia scale. In addition, blood samples were collected to assess peripheral inflammation biomarkers including proinflammatory cytokines, fibrinogen, CRP and leukocyte differential count, as well as other biochemical and hematological parameters. Results: A significant negative correlation between the severity of frailty syndrome and lymphocyte count was observed (P < 0.01). The concentration of IL-6 (P < 0.05), CRP (P < 0.05), and fibrinogen (P < 0.01) were significantly associated with frailty syndrome, but not of TNF-a, IL-beta, or IL-8. The severity of frailty syndrome was not dependent upon the clinical disease stage at diagnosis, the time elapsed since CaP diagnosis, the presence of metastases, or prostatectomy. Conclusions: Further research into the role of leukocyte subtypes and peripheral inflammation and the associated adverse outcomes in patients with CaP under ADT is warranted in order to tailor interventions aimed at reducing symptoms of frailty syndrome, such as loss of muscle strength and low physical activity.
Background: We investigated the relationship between respiratory function measured by spirometry ... more Background: We investigated the relationship between respiratory function measured by spirometry analysis and anthropometric variables (skeletal and fat mass) and nutritional status in the institutionalized elderly, particularly at high-risk for adverse outcomes after respiratory infections and malnutrition. Design: This is a multicenter cross-sectional study with a quantitative approach conducted among older people institutionalized living in nursing homes. Methods: Respiratory function was assessed by measuring the forced vital capacity, forced expiratory volume in the first second, the ratio between FEV1 and FVC (FEV1/FVC), and peak expiratory flow in percentage by means of spirometric analysis (values of the forced expiratory volume measured during the first second of the forced breath (FEV1) and forced vital capacity (FVC)). Nutritional assessment and anthropometry analyses were performed to evaluate under or over nutrition/weight. Results: There was a significant (p&lt;0.05) and positive correlation between FEV1 and skeletal muscle mass index, whereas fat mass index correlated significantly (p&lt;0.01) with the FEV1/FVC index. FEV1/FVC values were both significantly (p&lt;0.05) associated with high body mass index and triglyceride levels in the blood. The prevalence of individuals with ventilator restrictive pattern (FEV1/FVC&gt;70% with FEV1 and FVC&lt;80%) was 27.6% and 12 individuals (21.1%) received daily bronchodilators as part of the pharmacological treatment for respiratory disorders. Logistic regression was performed to identify predictors of restrictive respiratory patterns. The following variables were included in the model: age group, female gender, Charlson comorbidity index, body-mass index (BMI), fat mass index, skeletal muscle mass index, total cholesterol, and triglycerides concentration. The model was statistically significant (p &lt; 0.05; R2 = 0.39), correctly classifying 70.0% of cases, with a sensitivity of 89.3% and a specificity of 50.0%. Area under curve was 0.71 (IC95% 0.54-0.88; p=0.023).The highest OR for the restrictive respiratory pattern was for BMI (OR=5.09) and triglycerides concentration in blood (&gt;150 mg/dl) (OR=5.59). Conclusion: The relationship between a restrictive pattern of respiratory function and fat mass deserves future investigation to manage these parameters as a possible modifiable factor of altered respiratory function in overweight institutionalized older individuals.
Background: Providing quality end-of-life care to individuals with advanced dementia is crucial. ... more Background: Providing quality end-of-life care to individuals with advanced dementia is crucial. To date, little attention has been paid to palliative care knowledge and attitudes toward palliative care for people with advanced dementia in Spain Objectives: To investigate the knowledge of and attitudes toward palliative care for advanced dementia among registered nurses and physicians in Spain. Design and Methods: A descriptive, cross-sectional survey design was used. This study included a convenience sample of 402 nurses (n = 290) and physicians (n = 112). Two instruments were administered: demographic characteristics and Spanish version of the Questionnaire of Palliative Care for Advanced Dementia (qPAD-SV). Descriptive statistics and multiple regression were used for data analysis. Results: Overall, the nurses and physicians had moderate mean scores for both knowledge of and attitudes regarding palliative care for advanced dementia. Physicians had a higher level of knowledge (p&lt;0.05) compared to nurses. Additionally, physicians and nursing staff who had professional experience/education in geriatrics and those who had received palliative care and hospice training had greater (p&lt;0.01) knowledge of palliative care. In addition, healthcare professionals who had received dementia care training and who had worked in nursing homes had higher levels (p&lt;0.05) of knowledge and attitudes toward palliative care. Conclusion: This study indicates the need to provide nurses and physicians with more education for select groups of professionals who have had limited education and experience in caring for older adults with advanced dementia.
Current reviews in clinical and experimental pharmacology, Nov 1, 2022
Background: Autism Spectrum Disorders (ASDs) are a group of prevalent neuropsychiatric disorders.... more Background: Autism Spectrum Disorders (ASDs) are a group of prevalent neuropsychiatric disorders. They present a complex and unknown etiology, which in most cases includes significant peripheral alterations outside the brain such as in the composition of gut microbiota. Because the gut microbiota is involved in modulating the gut-brain axis, several studies have suggested that the microbiome in the gut can modify metabolites which are able to cross the blood-brain barrier and modulate brain function. Methods: We reviewed the current evidence regarding microbiota alterations in patients with ASD and the effects of the administration of probiotics and prebiotics in these patients, both in terms of gastrointestinal and behavioural symptoms. Results: Administration of a probiotic formulation containing different strains of Lactobacillus (L. acidophilus, L. rhamnosus, and others) and Bifidobacteria had beneficial effects upon these aforementioned symptoms and their use is recommended in a subgroup of ASD patients that present gastrointestinal disturbances. Nonetheless, the types of gastrointestinal disturbances that most benefit from such interventions remain to be elucidated in order to personalize the medical approaches. Conclusion: Recent clinical studies have shown that probiotic treatments can regulate the gut microbiota and may result in improvements in some behavioral abnormalities associated with ASD. Trials using prebiotic fibers or synbiotics preparations are still lacking and necessary in order to deep in such therapeutic strategies in ASD with comorbid gastrointestinal disrturbances.
Neurology Psychiatry and Brain Research, Feb 1, 2018
Febrile seizures (FS) are the result of particular sensitivity to fever in the developing brain, ... more Febrile seizures (FS) are the result of particular sensitivity to fever in the developing brain, have a major genetic predisposition, and nearly always have a benign outcome. Febrile seizures are the most common for of seizures in childhood. They have been observed in 2-6% of children before the age of 5 years, but in some populations this figure increase to 15%. Febrile seizures could be the first manifestations of epilepsy. About 13% of epileptic patients have a history of febrile seizures, and 30% have had recurrent febrile seizures Their phenotypic characteristics allow, in the majority of cases, a classification of the seizure, an elaboration of a prognosis and to assume a specific therapeutic attitude. It is possible to describe a spectrum according to their severity, from the benign simple seizure to the more complex, febrile seizure plus (GEFS+), Dravet syndrome, Epilepsy syndrome related infection febrile FIRES and Idiopatic Hemiconvulsion Hemiplegia and Epilepsy syndrome (IHHE). FS has a multifactorial inheritance, suggesting that both genetic and environmental factors are causative. Five areas of the genome have shown to be linked to FS in some ways. Two of them, FEB1 and FEB2 found on chromosomes 8 and 19p, are only involved in FS. During the past decade, molecular genetic studies have contributed to identification of genetic factors involved in febrile seizure and related disorders marking the necessary of careful follow up of the patients in order to detect risk factor earlier. We have reviewed the medical literature to update current knowledge of febrile seizures, their prognosis and their relation to new epileptic syndromes.
Objective: Treating sarcopenia remains a challenge, and nutritional interventions present promisi... more Objective: Treating sarcopenia remains a challenge, and nutritional interventions present promising approaches. We summarize the effects of leucine supplementation in treating older individuals with sarcopenia associated with aging or to specific disorders, and we focus on the effect of leucine supplementation on various sarcopenia criteria, e.g., muscular strength, lean mass, and physical performance. Methods: A literature search for articles related to this topic was performed on the relevant databases, e.g., the PubMed/Medline, Embase, EBSCO, Cochrane, Lilacs, and Dialnet. The identified articles were reviewed according to Preferred Reporting Items for Systematic reviews and meta-analyses (PRISMA) guidelines. Results: Of the 163 articles we consulted, 23 met our inclusion criteria, analysing the effect of leucine or leucine-enriched protein in the treatment of sarcopenia, and 13 of these studies were based on randomized and placebo-controlled trials (RCTs). In overall terms, the published results show that administration of leucine or leucine-enriched proteins (range 1.2-6 g leucine/day) is well-tolerated and significantly improves sarcopenia in elderly individuals, mainly by improving lean muscle-mass content and in this case most protocols also include vitamin D co-administration. The effect of muscular strength showed mix results, and the effect on physical performance has seldom been studied. For sarcopenia-associated with specific disorders, the most promising effects of leucine supplementation are reported for the rehabilitation of post-stroke patients and in those with liver cirrhosis. Further placebo-controlled trials will be necessary to determine the effects of leucine and to evaluate sarcopenia with the criteria recommended by official Working Groups, thereby limiting the variability of methodological issues for sarcopenia measurement across studies.
Editorial on the Research Topic Food-polyphenol-induced modulation of neurodegeneration Neurodege... more Editorial on the Research Topic Food-polyphenol-induced modulation of neurodegeneration Neurodegenerative diseases are continuously increasing due to a number of factors, such as emotional stress, socioeconomic conditions, lifestyles such as alcohol abuse, smoking, antibiotic abuse, malnutrition, and excessive intake of junk food, as well as a lack or poor physical activity, all of which lead to several diseases such as diabetes, cardiovascular diseases, and cancer as well as a significant alteration of the homeostasis of the gut microbiota. Therefore, regarding neurodegenerative diseases, the proper function of the so-called gut microbiota-brain axis, where a bidirectional communication affecting other systems such as the neuroendocrine system, the enteric nervous system, the autonomic nervous system, and the immune system, is of great importance. During a process of intestinal dysbiosis, an altered permeability of the blood-brain barrier (BBB) takes place in which certain metabolites of the intestinal microbiota, which contains a vast variety of bacteria, viruses, and fungi, cross into the central nervous system, leading to neuroinflammatory processes also caused by an access of cells of the immune system which produce pro-inflammatory mediators. In Parkinson's disease (PD), for example, alteration of the gut microbiota would lead to the passage of lipolysaccharides (LPS) from the outer membrane of Gram-negative bacteria into the bloodstream and BBB. Microglia possess Toll-like receptor 4, which can recognize and bind to LPS, thus triggering the activation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), which, in turn, initiates the transcription of pro-inflammatory cytokines and nitric oxide, thus leading to neuroinflammation. Furthermore, LPS would give rise to the mitochondrial accumulation of α-synuclein with a subsequent increase in reactive oxygen species and reactive nitrogen species resulting in functional alterations within mitochondria. Moreover, mitochondrial accumulation of α-synuclein promotes damage to dopaminergic neurons due to reduced dopamine production (1, 2). Polyphenols are abundantly distributed in fruit and vegetables and their ingestion through food represents a healthy approach to prevent or delay several diseases due to their beneficial effects, which include anti-allergic, antioxidant, anti-cancer, and antineurodegenerative properties (3). In relation to neurodegenerative diseases, these natural compounds can, through different mechanisms, reduce and/or improve several conditions such as age-associated cognitive decline and schizophrenia (Figure 1). Li C. et al. have reported the effects of the intake of green tea rich in polyphenols on PD progression through a two-sample Mendelian randomization (MR) study using
Background: The elderly is characterized by a gradual decline in body function, which represents ... more Background: The elderly is characterized by a gradual decline in body function, which represents the clinical situation called "frailty". Prefrailty is the intermediate stage between frailty and the robust condition. L-carnitine (LC) plays an important role in energy production from long-chain fatty acids in mitochondria and its serum level is lower in prefrail and frail subjects. Objective: This study aims to evaluate the effect of Acetyl-L-carnitine (ALCAR) in pre frail older patients. Methods: We scheduled 3 months of treatment and then 3 months of follow-up. 92 subjects were selected from May 2009 to July 2017 in a randomized, observational, double-blind, placebo-controlled study. We scheduled 3 months of treatment and then 3 months of follow-up. ALCAR (oral 1.5 g/bis in die - BID) or placebo group. Results: After the treatment, only the treated group displayed a decrease in C reactive protein (CRP) p&lt;0.001, an increase in serum free carnitine and acetyl carnitine (p&lt;0.05), in Mini Mental state (MMSE) p&lt;0.0001 and 6-walking distance (p&lt;0.0001); ALCAR group vs. placebo group showed a decrease in HDL cholesterol and in CRP (p&lt;0.01), an increase in MMSE score (p&lt; 0.001) and in 6-walking distance (p&lt;0.001) Conclusions: ALCAR treatment delays the incidence and severity of onset in prefrail subjects of degenerative disorders of the elderly, with improvement in memory and cognitive processes.
Endocrine, metabolic & immune disorders, Feb 7, 2019
Background and Objective: Coeliac disease (CD) is a chronic autoimmune intestinal disorder charac... more Background and Objective: Coeliac disease (CD) is a chronic autoimmune intestinal disorder characterized by intolerance to gluten, a protein contained in certain cereals. The main physiopathological basis of CD is the progressive destruction of intestinal villi caused by gluten ingestion by genetically-susceptible individuals. Patients who receive a diagnosis of CD must make significant changes to their daily habits and this can affect their quality of life. The objective of this review is to summarize the evidence regarding the economic, physical and social limitations which can affect the quality of life in patients with CD. Results: Different factors such as physical changes, psychological effects, interpersonal relationships, emotions and economic difficulties can affect the quality of life of these patients. Observations suggest that, in general, women with CD experience a greater deterioration in their quality of life than men. Lastly, complications in daily life are also associated with the reduced availability of gluten-free products which also usually cost more than standard products. Conclusions: Continuous health education and care regarding socioeconomic issues should be continuously developed and provided to people with CD.
In the present study the effect of ascorbic acid (AA) on naloxone-induced withdrawal signs in mor... more In the present study the effect of ascorbic acid (AA) on naloxone-induced withdrawal signs in morphine-dependent guinea-pigs was investigated. Animals were rendered dependent on morphine by subcutaneous (s.c.) injections of morphine sulfate 3 times a day for 3 days, and withdrawal signs were induced by intraperitoneal (i.p.) administration of naloxone (15 mg/kg) 2 h after the tenth injection of morphine sulfate on day 4. Chronic pretreatment of guinea-pigs with AA, 200 mg/kg, s.c. three times daily for 3 days, reduced withdrawal jumping, digging, writhing, rearing, face-washing, head and body shakes, penile licking and diarrhea. The mixed dopamine D 1 /D 2 receptor agonist apomorphine (0.5 mg/kg, s.c.) markedly antagonized the responses induced by AA. The effect of apomorphine was blocked by the dopamine D 1 receptor antagonist SCH23390 but not by the dopamine D 2 receptor antagonist sulpiride nor the peripheral dopamine receptor antagonist domperidone. The results suggest that chronic administration of AA inhibits opioid withdrawal, via a dopaminergic mechanism.
Urologic Oncology-seminars and Original Investigations, Dec 1, 2019
Objective: To evaluate the role of peripheral inflammation (leukocyte differential count, the pro... more Objective: To evaluate the role of peripheral inflammation (leukocyte differential count, the proinflammatory cytokines IL-beta, TNF-a, IL-6, IL-8, and the inflammatory markers fibrinogen and C-reactive protein [CRP]) in frailty syndrome in patients with prostate cancer (CaP) undergoing antiandrogen therapy (ADT). Methods: A total of 46 men between 51 and 92 years of age with CaP and receiving ADT were classified as frail, prefrail or robust according to the Fried scale. A geriatric assessment was performed, based on the Minimental State Examination for cognitive function, the Barthel index for basic activities of daily living, the Yesavage scale for geriatric depression, and the Athens insomnia scale. In addition, blood samples were collected to assess peripheral inflammation biomarkers including proinflammatory cytokines, fibrinogen, CRP and leukocyte differential count, as well as other biochemical and hematological parameters. Results: A significant negative correlation between the severity of frailty syndrome and lymphocyte count was observed (P < 0.01). The concentration of IL-6 (P < 0.05), CRP (P < 0.05), and fibrinogen (P < 0.01) were significantly associated with frailty syndrome, but not of TNF-a, IL-beta, or IL-8. The severity of frailty syndrome was not dependent upon the clinical disease stage at diagnosis, the time elapsed since CaP diagnosis, the presence of metastases, or prostatectomy. Conclusions: Further research into the role of leukocyte subtypes and peripheral inflammation and the associated adverse outcomes in patients with CaP under ADT is warranted in order to tailor interventions aimed at reducing symptoms of frailty syndrome, such as loss of muscle strength and low physical activity.
Background: We investigated the relationship between respiratory function measured by spirometry ... more Background: We investigated the relationship between respiratory function measured by spirometry analysis and anthropometric variables (skeletal and fat mass) and nutritional status in the institutionalized elderly, particularly at high-risk for adverse outcomes after respiratory infections and malnutrition. Design: This is a multicenter cross-sectional study with a quantitative approach conducted among older people institutionalized living in nursing homes. Methods: Respiratory function was assessed by measuring the forced vital capacity, forced expiratory volume in the first second, the ratio between FEV1 and FVC (FEV1/FVC), and peak expiratory flow in percentage by means of spirometric analysis (values of the forced expiratory volume measured during the first second of the forced breath (FEV1) and forced vital capacity (FVC)). Nutritional assessment and anthropometry analyses were performed to evaluate under or over nutrition/weight. Results: There was a significant (p&lt;0.05) and positive correlation between FEV1 and skeletal muscle mass index, whereas fat mass index correlated significantly (p&lt;0.01) with the FEV1/FVC index. FEV1/FVC values were both significantly (p&lt;0.05) associated with high body mass index and triglyceride levels in the blood. The prevalence of individuals with ventilator restrictive pattern (FEV1/FVC&gt;70% with FEV1 and FVC&lt;80%) was 27.6% and 12 individuals (21.1%) received daily bronchodilators as part of the pharmacological treatment for respiratory disorders. Logistic regression was performed to identify predictors of restrictive respiratory patterns. The following variables were included in the model: age group, female gender, Charlson comorbidity index, body-mass index (BMI), fat mass index, skeletal muscle mass index, total cholesterol, and triglycerides concentration. The model was statistically significant (p &lt; 0.05; R2 = 0.39), correctly classifying 70.0% of cases, with a sensitivity of 89.3% and a specificity of 50.0%. Area under curve was 0.71 (IC95% 0.54-0.88; p=0.023).The highest OR for the restrictive respiratory pattern was for BMI (OR=5.09) and triglycerides concentration in blood (&gt;150 mg/dl) (OR=5.59). Conclusion: The relationship between a restrictive pattern of respiratory function and fat mass deserves future investigation to manage these parameters as a possible modifiable factor of altered respiratory function in overweight institutionalized older individuals.
Uploads
Papers by Omar Cauli