Effects of 12 Weeks of Essential Amino Acids (EAA)-Based Multi-Ingredient Nutritional Supplementation on Muscle Mass, Muscle Strength, Muscle Power and Fatigue in Healthy Elderly Subjects: A Randomized Controlled Double-Blind Study.

OBJECTIVE: To counteract muscle mass, muscle strength and power loss during aging, and to study age-related change of neuromuscular manifestation of fatigue in relation to nutritional supplementation. DESIGN: randomized controlled double-blind study. SETTING: Twice-daily consumption for 12 weeks of an Essential Amino Acids (EAA)-based multi-ingredient nutritional supplement containing EAA, creatine, vitamin D and Muscle Restore Complex®. PARTICIPANTS: 38 healthy elderly subjects (8 male, 30 female; age: 68.91±4.60 years; body weight: 69.40±15.58 kg; height: 1.60±0.09 m) were randomized and allocated in supplement (SUPP) or placebo (PLA) group. Mean Measurements: Vitamin D blood level; Appendicular Lean Mass (ALM); Visceral Adipose Tissue (VAT); Maximal Voluntary Contraction (MVC) and Peak Power (PP); myoelectric descriptors of fatigue: Fractal Dimension and Conduction Velocity initial values (FD iv, CV iv), their rates of change (FD slopes, CV slopes) and the Time to perform the Task (TtT). Mean Results: Significant changes were found in SUPP compared to baseline: Vitamin D (+8.73 ng/ml; p<0.001); ALM (+0.34 kg; p<0.001); VAT (-76.25 g; p<0.001); MVC (+0.52 kg; p<0.001); PP (+4.82 W; p<0.001). Between group analysis (SUPP Vs. PLA) showed improvements: vitamin D blood levels (+11,72 ng/ml; p<0.001); Legs FFM (+443.7 g; p<0.05); ALM (+0.53 kg; p<0.05); MVC (+1.38 kg; p<0.05); PP (+9.87 W; p<0.05). No statistical changes were found for FD iv, CV iv, FD and CV slopes and TtT, either compared to baseline or between groups. Significant correlations between mean differences in SUPP group were also found. CONCLUSION: The study demonstrates that in healthy elderly subjects an EAA-based multi-ingredient nutritional supplementation of 12 weeks is not effective to change myoelectric manifestation of fatigue and TtT failure but can positively affect muscle mass, muscle strength, muscle power and VAT, counterbalancing more than one year of age-related loss of muscle mass and strength.

[Hantavirus pulmonary syndrome in southern Argentina]. / Síndrome pulmonar por Hantavirus en el sur andino argentino.

Andes virus was identified in 1995 as the etiologic agent of Hantavirus Pulmonary Syndrome (HPS) in Southern Argentina. We describe herein the main clinical characteristics of 25 HPS confirmed cases acquired in this area between 1993 and September 1999. The mean age was 34 years (range 11-70), with 72% males. Clinical characteristics were similar to those previously reported for Sin Nombre virus (SNV) cases. However, in this group of patients we also observed conjuntival injection in 10/25 (42%), facial flushing in 8/25 (33%), pharyngeal congestion in 7/25 (29%) and petechiae in 3/25 (12%). On the other hand, BUN was increased in 83% of cases (mean 0.77 g/l range 0.31-2.01). Mean serum creatinine concentration was 26.8 mg/l (range: 8.1-110 mg/l) with serum creatinine being higher than 20 mg/l in 8/15 patients (53%). Urinalysis was abnormal in 12/12 cases and was characterized by presence of proteins, red blood cells and granular casts. Aminotransferases were increased in 90% of cases with levels 5-10 times over normal values in 50% of cases. Serum creatine kinase concentration was elevated in 11/14 cases. Two patients required hemodialysis. Case fatality rate was 44% (11/25) and 10 of these cases died among the first 10 days of illness. Mononuclear myocarditis was observed in two cases, a finding that has not been reported for SNV cases. During the 1996 HPS outbreak in Southern Argentina due to Andes virus, there were epidemiological and molecular evidences of person-to-person transmission, a feature not previously shown for other members of the hantavirus genus. These data would also be indicative of some distinctive clinical characteristics of HPS caused by Andes virus, with more frequent renal involvement than in SNV cases.

Síndrome pulmonar por Hantavirus en el sur andino argentino. / [Hantavirus pulmonary syndrome in southern Argentina]

Andes virus was identified in 1995 as the etiologic agent of Hantavirus Pulmonary Syndrome (HPS) in Southern Argentina. We describe herein the main clinical characteristics of 25 HPS confirmed cases acquired in this area between 1993 and September 1999. The mean age was 34 years (range 11-70), with 72

males. Clinical characteristics were similar to those previously reported for Sin Nombre virus (SNV) cases. However, in this group of patients we also observed conjuntival injection in 10/25 (42

), facial flushing in 8/25 (33

), pharyngeal congestion in 7/25 (29

) and petechiae in 3/25 (12

). On the other hand, BUN was increased in 83

of cases (mean 0.77 g/l range 0.31-2.01). Mean serum creatinine concentration was 26.8 mg/l (range: 8.1-110 mg/l) with serum creatinine being higher than 20 mg/l in 8/15 patients (53

). Urinalysis was abnormal in 12/12 cases and was characterized by presence of proteins, red blood cells and granular casts. Aminotransferases were increased in 90

of cases with levels 5-10 times over normal values in 50

of cases. Serum creatine kinase concentration was elevated in 11/14 cases. Two patients required hemodialysis. Case fatality rate was 44

(11/25) and 10 of these cases died among the first 10 days of illness. Mononuclear myocarditis was observed in two cases, a finding that has not been reported for SNV cases. During the 1996 HPS outbreak in Southern Argentina due to Andes virus, there were epidemiological and molecular evidences of person-to-person transmission, a feature not previously shown for other members of the hantavirus genus. These data would also be indicative of some distinctive clinical characteristics of HPS caused by Andes virus, with more frequent renal involvement than in SNV cases.

Evaluación de los conocimientos acerca de las formas de transmisión del virus de la inmunodeficiencia humana en la población de la ciudad de Neuquén / Evaluation of the knowledge about the human acquired immunodeficiency virus transmission in a populaation at Neuquen city

Presenta una encuesta realizada en noviembre de 1993 con el objeto conocer y evaluar los conocimientos que tiene la población de la ciudad de Neuquén, Argentina, sobre las formas de transmisión del SIDA. Se trató de una encuesta cerrada, cuyo cuestionario fue respondido personal y anónimante. Se investigó el conocimiento sobre posibilidades de contagio a través del contacto con personas infectadas o a partir de distintos fluídos corporales. Se obtuvieron datos sobre sexo, eda y nivel de instrucción. Se encuestaron 646 personas, el 52 por ciento de las cuales eran del sexo femenino y el otro 48 por ciento, masculino, en un rango de edades de 13 a 68 años y de 12 a 77 años, respectivamente. Los resultados mostraron una relación directa entre las respuestas correctas y el nivel de escolaridad. No parece haber una relación directa entre el nivel de información de la población con los cambios de hábitos, modas o conductas. Esto demostraría que la informacion o el conocimiento no son suficientes sino que deben tomarse como punto de partida para las campañas de prevención

Evaluación de los conocimientos acerca de las formas de transmisión del virus de la inmunodeficiencia humana en la población de la ciudad de Neuquén / Evaluation of the knowledge about the human acquired immunodeficiency virus transmission in a populaation at Neuquen city

Presenta una encuesta realizada en noviembre de 1993 con el objeto conocer y evaluar los conocimientos que tiene la población de la ciudad de Neuquén, Argentina, sobre las formas de transmisión del SIDA. Se trató de una encuesta cerrada, cuyo cuestionario fue respondido personal y anónimante. Se investigó el conocimiento sobre posibilidades de contagio a través del contacto con personas infectadas o a partir de distintos fluídos corporales. Se obtuvieron datos sobre sexo, eda y nivel de instrucción. Se encuestaron 646 personas, el 52 por ciento de las cuales eran del sexo femenino y el otro 48 por ciento, masculino, en un rango de edades de 13 a 68 años y de 12 a 77 años, respectivamente. Los resultados mostraron una relación directa entre las respuestas correctas y el nivel de escolaridad. No parece haber una relación directa entre el nivel de información de la población con los cambios de hábitos, modas o conductas. Esto demostraría que la informacion o el conocimiento no son suficientes sino que deben tomarse como punto de partida para las campañas de prevención

[Infections during the hospitalization of patients with liver cirrhosis]. / Infecciones durante la internación de pacientes con cirrosis hepática.

We studied retrospectively the clinical records of 291 hospital patients with liver cirrhosis, 95% of which was alcohol related. Within this group, 114 patients presented 155 episodes of infection in 144 separate hospital admissions. In a previous communication, we pointed out that although infection was the fourth cause of admission, it was the main cause of death in this group. The main incidence of infection was among the female group. The most common infections episodes were respiratory and bacterial spontaneous peritonitis (BSP). On admission, 57% of the patients were diagnosed as belonging to the C Child group; 38% presented sepsis and 22% were hospitalary infections. The most frequent infections were respiratory and BSP. We obtained bacteriologic documentation in 55% of the episodes with prevalence of Gram negative bacilli (E. coli), with high relative frequency of neumoccocus. The most frequent complications were related to hepatic insufficiency. Global death rate was 27.1%, while nosocomial death rates were 42.1% and 40.9% for patients with Child C. We observed the highest incidence of mortality in patients with SBP and non localized bacteriemia. Survival rates were 42% for 2 years and 18% for 5 years. In summary, we stress the relevancy of checking the presence of infection systematically in every cirrhotic patient with encephalopathy and/or renal insufficiency without justifiable cause.

Infecciones durante la internación de pacientes con cirrosis hepática. / [Infections during the hospitalization of patients with liver cirrhosis]

We studied retrospectively the clinical records of 291 hospital patients with liver cirrhosis, 95

of which was alcohol related. Within this group, 114 patients presented 155 episodes of infection in 144 separate hospital admissions. In a previous communication, we pointed out that although infection was the fourth cause of admission, it was the main cause of death in this group. The main incidence of infection was among the female group. The most common infections episodes were respiratory and bacterial spontaneous peritonitis (BSP). On admission, 57

of the patients were diagnosed as belonging to the C Child group; 38

presented sepsis and 22

were hospitalary infections. The most frequent infections were respiratory and BSP. We obtained bacteriologic documentation in 55

of the episodes with prevalence of Gram negative bacilli (E. coli), with high relative frequency of neumoccocus. The most frequent complications were related to hepatic insufficiency. Global death rate was 27.1

, while nosocomial death rates were 42.1

and 40.9

for patients with Child C. We observed the highest incidence of mortality in patients with SBP and non localized bacteriemia. Survival rates were 42

for 2 years and 18

for 5 years. In summary, we stress the relevancy of checking the presence of infection systematically in every cirrhotic patient with encephalopathy and/or renal insufficiency without justifiable cause.