Intradialytic nutrition and quality of life in Chilean older patients in hemodialysis with protein-energy wasting.

PURPOSE: The study assessed the impact of intradialytic oral nutritional supplementation on the quality of life in patients receiving hemodialysis and diagnosed with protein energy wasting. METHODS: A pre-test post-test quasi-experimental study was conducted before and after 3 months of intradialytic oral nutritional supplementation on 109 older hemodialysis patients. We measured before and after 3 months of intradialytic oral nutritional supplementation, the quality of life score, the burden of kidney disease, three quality of life scales and the mental and physical health status using KDQoL-SF™ 1.3, body composition and biochemical parameters of nutritional condition. RESULTS: The mean age of the patients was 69.4 ± 3.4 years, 59% were male, and the time on dialysis was 63.5 ± 52.6 months. Comparing the baseline with month 3 of intradialytic oral nutritional supplementation, we observed to better quality of life. In contrast to malnutrition, score, specifically increased significantly score of symptoms/problems list related to hemodialysis, sexual function, social and cognitive function, sleep, pain, energy/fatigue and general state of health. Significant changes were also found in nutritional status, energy intake and body composition indicators. After 3 months of intradialytic oral nutritional supplementation, we observed a nutritional status recovery in one or more indicators in 92% of the patients. CONCLUSION: Our findings indicate that 3 months of intradialysis oral nutritional supplementation improves the components of physical and mental quality of life and nutritional status in older patients receiving hemodialysis diagnosed with loss of protein energy. These results are relevant to improve the experience of patients with protein energy loss receiving hemodialysis.

Ciclos anuales de colibríes (Aves: Trochilidae) en un bosque nublado, Parque Nacional Henri Pittier, Venezuela

El Paso de Portachuelo es un abra utilizado por una gran diversidad de especies de aves, bien sea como residentes o para movimientos estacionales o migratorios, en el cual se han reportado 32 especies de colibríes en la familia Trochilidae. Debido a esto nos planteamos como objetivo evaluar la dinámica del ensamble de colibríes que usa dicho Paso. Se realizaron salidas de campo mensuales desde abril 1990 hasta noviembre 1994, y desde junio 2010 hasta noviembre 2013. Se capturaron 14 685 individuos, pertenecientes a 38 especies. Las especies con poblaciones que presentaron mayores abundancias fueron: Heliodoxa leadbeateri y Sternoclyta cyanopectus. Con base en los resultados obtenidos, la comunidad de colibríes del área de Portachuelo se puede dividir en: seis especies altamente abundantes y que se observan durante todo o la mayor parte del año, siete especies que utilizan el paso durante la mayor parte del año pero con densidades bajas, cuatro especies que utilizan la zona de manera estacional y siete especies raras en las capturas debido al tipo de muestreo, o a que no presentan movimientos de desplazamiento y prefieren otros hábitats.

Portachuelo Pass is an open area used by a great diversity of bird species, either as residents or for seasonal or migratory movements, reporting 32 species of hummingbirds in the Trochilidae family. Due to this, our goal was evaluating the hummingbird assemblage dynamics in Portachuelo Pass, analyzing the abundance of the captures over four years of sampling and comparing these data with samples taken between 1990 and 2013. Monthly field trips were made from April 1990 to November 1994, and from June 2010 to November 2013, between 5 and 8 mist-nets were used to catch the birds. 14 685 individuals were captured, belonging to 25 species. The relative abundance per species was estimated in each of the sampling months, separating the community into four groups: A) Hummingbirds with high abundances, B) Hummingbirds with low abundances, C) Hummingbirds rare and D) Phaethornithinae. The species with the highest abundance populations were: Heliodoxa leadbeateri and Sternoclyta cyanopectus, followed by Aglaiocercus kingi, Chalybura buffoni, Chrysuronia oenone and Coeligena coeligena. For the rest of the species the densities in the mist-net captures were from low to medium. Based on the results obtained, the community of hummingbirds in the area of Portachuelo can be divided into: six highly abundant species that are observed throughout all or most of the year, seven species that use the passage during most of the year but with low densities, four species that use the area in a seasonal manner and seven rare species in the catches due to the type of sampling, or that do not present displacement movements and prefer other habitats. Statistically significant differences were found between the abundance of hummingbirds of sampling years, being the year with the highest abundance 1991, followed by 2013.

Influence of estrogens on copper indicators: in vivo and in vitro studies.

Classic copper indicators are not sensitive and specific for detecting excess copper exposure when this is higher than customary but not markedly elevated. Serum copper and ceruloplasmin (Cp) are the most commonly used indicators to assess nutritional status of copper. The objective of this paper was to study the influence of estrogens on these indicators and others used to assess early effects of excess copper exposure in humans and the expression of a set of copper related proteins in a hepatic cellular model. For the studies in humans, 107 healthy participants (18-50 years) were allocated as follows: group 1 (n = 39), women assessed on day 7 of their hormonal cycle; group 2 (n = 34), women assessed on day 21 of their hormonal cycle, and group 3 (n = 34, comparison group), healthy men. Participants received 8 mg Cu/day (as copper sulfate) during 6 months. Serum Cp and Cu, Cu-Zn-superoxide dismutase activity, liver function indicators [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyltransferase (GGT)], and serum Fe and Zn concentrations were measured monthly. In addition, the influence of estradiol on intracellular total copper content, hctr1, dmt1 and shbg mRNA abundance and hCTR1, and DMT1 expression was measured in HepG2 cells. Serum Cu, Fe, and Zn and liver aminotransferases but not Cu-Zn-superoxide dismutase varied depending on sex. Fe nutrition indicators, GGT, and ALT activities showed significant differences between the hormonal phases. Cellular experiments showed that estradiol increased cellular Cu concentration and hCTR1 and DMT1 mRNA expression and changed these proteins expression patterns. Estradiols significantly influence the responses to copper at the whole body and the cellular levels, suggesting that they help maintaining copper availability for metabolic needs.

Copper and liver function indicators vary depending on the female hormonal cycle and serum hormone binding globulin (SHBG) concentration in healthy women.

Previous studies showed that responses to chronic administration of copper were significantly associated with gender, raising the need to better characterize the relation between the effects observed and stradiols. The objective of this study was to measure copper and liver function indicators and the sex hormone binding globulin (SHBG) serum concentrations in healthy adults exposed to copper, grouped by sex and phase of the female hormonal cycle. Healthy females on day 7 (follicular phase, Group 1, n = 39), on day 21 (secretory phase, Group 2, n = 34) and males (comparison group, Group 3, n = 34) received 8 mg Cu/day (as copper sulfate), orally, for 6 months. On days 0, 30, 60, 120, and 180, the serum concentration of copper, ceruloplasmin, liver aminotransferases, and SHBG were measured. Analysis of results included analysis of variance (ANOVA; repeated measures) and the post hoc Bonferroni correction. Participants remained healthy throughout the study period, including aminotransferases below the cut off in all measures. GGT, AST, and ALT activities were significantly different by group and by time (ANOVA repeated measures P < 0.05). Six-month curves of serum copper and ceruloplasmin concentrations were different by group, by time and interaction group x time (all P < 0.001). SHBG curves were different by group and time (P < 0.01), and interaction group x time (P < 0.009). Serum copper, ceruloplasmin, and liver aminotranferases are influenced by estrogens/progesterone, something that should be considered when these indicators are used as outcomes of effects. Time of sampling was also significantly associated with the indicators and deserves further study.