GutSelf: Interindividual Variability in the Processing of Dietary Compounds by the Human Gastrointestinal Tract.

Nutritional research is currently entering the field of personalized nutrition, to a large extent driven by major technological breakthroughs in analytical sciences and biocomputing. An efficient launching of the personalized approach depends on the ability of researchers to comprehensively monitor and characterize interindividual variability in the activity of the human gastrointestinal tract. This information is currently not available in such a form. This review therefore aims at identifying and discussing published data, providing evidence on interindividual variability in the processing of the major nutrients, i.e., protein, fat, carbohydrates, vitamins, and minerals, along the gastrointestinal tract, including oral processing, intestinal digestion, and absorption. Although interindividual variability is not a primary endpoint of most studies identified, a significant number of publications provides a wealth of information on this topic for each category of nutrients. This knowledge remains fragmented, however, and understanding the clinical relevance of most of the interindividual responses to food ingestion described in this review remains unclear. In that regard, this review has identified a gap and sets the base for future research addressing the issue of the interindividual variability in the response of the human organism to the ingestion of foods.

A mid-morning snack of almonds generates satiety and appropriate adjustment of subsequent food intake in healthy women.

PURPOSE: To assess the effect of consuming a mid-morning almond snack (28 and 42 g) tested against a negative control of no almonds on acute satiety responses. METHOD: On three test days, 32 healthy females consumed a standard breakfast followed by 0, 28 or 42 g of almonds as a mid-morning snack and then ad libitum meals at lunch and dinner. The effect of the almond snacks on satiety was assessed by measuring energy intake (kcal) at the two ad libitum meals and subjective appetite ratings (visual analogue scales) throughout the test days. RESULTS: Intake at lunch and dinner significantly decreased in a dose-dependent manner in response to the almond snacks. Overall, a similar amount of energy was consumed on all three test days indicating that participants compensated for the 173 and 259 kcals consumed as almonds on the 28 and 42 g test days, respectively. Subjective appetite ratings in the interval between the mid-morning snack and lunch were consistent with dose-dependent enhanced satiety following the almond snacks. However, in the interval between lunch and dinner, appetite ratings were not dependent on the mid-morning snack. CONCLUSION: Almonds might be a healthy snack option since their acute satiating effects are likely to result in no net increase in energy consumed over a day.

Rabdomiólisis producida por la asociación de sinvastatina y risperidona / Rhabdomyolysis caused by the association of simvastatin and risperidone

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[The application of the SCORE charts to advanced age males triple the number of high-risk subjects compared to the Framingham function]. / La aplicación de las tablas del SCORE a varones de edad avanzada triplica el número de sujetos clasificados de alto riesgo en comparación con la función de Framingham.

BACKGROUND AND OBJECTIVE: The Framingham function, recommended by the National Cholesterol Education Program in its document Adult Treatment Panel III (ATP III), and the risk charts of the Systematic Coronary Risk Evaluation (SCORE) program are the most used functions for risk stratification. In both, intensive hygienic and therapeutic measures are recommended for high risk individuals. The objective of the present study was to compare the risk stratification obtained with both functions in a population of subjects older than 60 years. SUBJECTS AND METHOD: 1001 non-diabetic subjects between 60 and 79 years old (mean: 69 years, 67% female) with no evidence of cardiovascular disease were included in the study. Participants were classified as low, moderate or high risk by ATP-III (< 10%, 10-20% y > 20% of risk at 10 years, respectively) and by SCORE (< 3%, 3-4% y > or = 5% of risk at 10 years respectively). RESULTS: 11.7% of the population was classified as high risk by Framingham and 17.6% by SCORE. Only 5% of the females were classified as high risk with either function. In males, 16.7% and a 44.4% were classified as high risk by Framingham and SCORE respectively. The results did not differ by age group. A 39% of males and a 20% of females were candidates to hypolipidemic treatment as recommended by SCORE guidelines. CONCLUSIONS: Compared to Framingham function, the application of SCORE charts to spanish males over 60 years triplicate the number of high risk individuals and candidates to intensive risk factor treatment.

La aplicación de las tablas del SCORE a varones de edad avanzada triplica el número de sujetos clasificados de alto riesgo en comparación con la función de Framingham / The application of the SCORE charts to advanced age males triple the number of high-risk subjects compared to the Framingham function

FUNDAMENTO Y OBJETIVO: La función de Framingham, recomendada por el National Cholesterol Education Program en su documento Adult Treatment Panel III (ATP-III) y las tablas de riesgodel Systematic Coronary Risk Evaluation (SCORE) son las funciones más utilizadas para la estratificación del riesgo cardiovascular, y ambas recomiendan intensificar las medidas higiénicas y terapéuticas en las personas que presenten un riesgo alto. El objetivo del presente estudio fue comparar la estratificación del riesgo obtenida con ambas clasificaciones en una población de sujetos mayores de 60 años. SUJETOS Y MÉTODO: Se incluyó en el estudio a 1.001 personas no diabéticas de entre de 60 y 79años (media de 69 años, un 67%, mujeres) sin evidencia de enfermedad vascular. Se clasificó a los participantes según su riesgo fuera bajo, medio o alto de acuerdo con el ATP-III ( 20% de riesgo a los 10 años, respectivamente) y el SCORE (< 3%, 3-4% y ≥ 5%de riesgo a los 10 años, respectivamente).RESULTADOS: Un 11,7% de la población se consideró de riesgo alto según la ecuación de Framingham,f rente a un 17,6% según el SCORE. Únicamente un 5% de las mujeres fueron clasificadas de riesgo alto con cualquiera de las funciones, frente a un 16,7 y un 44,4% de los varones según las tablas de Framingham y de SCORE, respectivamente. Los resultados fueron similares al dividir por grupos de edad. De acuerdo con las guías del SCORE, un 39% de los varones y un 20% de las mujeres eran candidatos a recibir tratamiento hipolipemiante. CONCLUSIONES: En comparación con la función de Framingham, la aplicación del SCORE en varones mayores de 60 años triplica el número de sujetos de alto riesgo candidatos a medidas de prevención enérgicas

BACKGROUND AND OBJECTIVE: The Framingham function, recommended by the National Choresterol Education Program in its document Adult Treatment Panel III (ATP III), and the risk charts ofthe Systematic Coronary Risk Evaluation (SCORE) program are the most used functions for risk stratification. In both, intensive hygienic and therapeutic measures are recommended for high risk individuals. The objective of the present study was to compare the risk stratification obtained with both functions in a population of subjects older than 60 years. SUBJECTS AND METHOD: 1001 non-diabetic subjects between 60 and 79 years old (mean: 69 years,67% female) with no evidence of cardiovascular disease were included in the study. Participants were classified as low, moderate or high risk by ATP-III ( 20% of risk at 10 years, respectively) and by SCORE (< 3%, 3-4% y ≥ 5% of risk at 10 years respectively).RESULTS: 11.7% of the population was classified as high risk by Framingham and 17.6% by SCORE. Only 5% of the females were classified as high risk with either function. In males,16.7% and a 44.4% were classified as high risk by Framingham and SCORE respectively. The results did not differ by age group. A 39% of males and a 20% of females were candidates tohypolipidemic treatment as recommended by SCORE guidelines. CONCLUSIONS: Compared to Framingham function, the application of SCORE charts to Spanish males over 60 years triplicate the number of high risk individuals and candidates to intensive risk factor treatment

[Incidence, risk factors and influence on survival of infectious complications in liver transplantation]. / Incidencia, factores de riesgo e influencia sobre la supervivencia de las complicaciones infecciosas en el trasplante hepático.

INTRODUCTION: Orthotopic liver transplantation (OLT) is successful therapy for patients with end-stage liver disease. Infection is currently a life-threatening complication for these patients. The aims of this study are to determine the incidence of various infections in patients with OLT, to study overall survival rates and survival as related to individual infections, and to investigate the risk factors associated with first episodes of bacterial (BI), fungal (FI), invasive fungal (IFI) and cytomegalovirus (CMV) infections. METHODS: The study includes 165 OLTs performed in 152 recipients from May 1994 to May 1998. A descriptive analysis estimating the 95% confidence interval was performed with 100 variables stratified according to preoperative, operative and postoperative conditions. Cox regression analysis was used to identify the variables associated with infection. Survival studies were carried out with the Kaplan-Meier method. RESULTS: Among the total, 66% of patients developed infection: 41.8% viral, 33.9% BI, 20.6% FI and 4.2% IFI. One-year and 4-year survival rates after transplantation were 90% and 75%, respectively. All the infections decreased survival. Multivariate analyses identified the following risk factors for the specific infections: BI - dialysis, mechanical ventilation, and time of organ ischemia during harvesting; FI - number of hours of surgery and pretransplantation plasma albumin concentrations; IFI - number of blood units transfused, pretransplantation plasma albumin and retransplantation. Cytomegalovirus infection was associated with FI and IFI in the univariate analysis, but the multivariate analysis identified no variables that independently increased the risk of developing this infection.

Incidencia, factores de riesgo e influencia sobre la supervivencia de las complicaciones infecciosas en el trasplante hepático / Incidence, risk factors and influence on survival of infectious complications in liver transplantation

INTRODUCCIÓN. El trasplante hepático es eficaz en pacientes con enfermedades hepáticas en situación terminal. La infección es una amenaza para la vida de los pacientes trasplantados. Los objetivos del estudio han sido estudiar la supervivencia general tras el trasplante hepático, la influencia en la supervivencia de las complicaciones infecciosas y determinar los factores de riesgo asociados con el primer episodio de infección (bacteriana, fúngica, fúngica invasora y enfermedad por citomegalovirus). MÉTODOS. Se han incluido 165 trasplantes realizados en 152 receptores en el período: mayo de 1994 hasta mayo de 1998. Se ha realizado un estudio descriptivo de 100 variables incluidas estratificadas según aspectos prequirúgicos, quirúrgicos y posquirúgicos, la determinación de las variables asociadas con la presencia de las diferentes infecciones se ha realizado con un análisis de regresión de Cox y el estudio de la supervivencia mediante la metodología de Kaplan-Meier. RESULTADOS. La infección se ha presentado en el 66 por ciento de los pacientes y se ha distribuido de la siguiente forma: viral (41,8 por ciento), bacteriana (33,9 por ciento), fúngica (20,6 por ciento) y fúngica invasora (4,2 por ciento). La supervivencia tras el trasplante ha sido del 90 por ciento al primer año y del 75 por ciento al cuarto año. Todas las infecciones han disminuido la supervivencia. Las variables asociadas con la presencia de las diferentes infecciones en el análisis multivariante han sido las siguientes; con la infección bacteriana, la diálisis, la ventilación mecánica y el tiempo de isquemia fría del injerto; con la infección fúngica; el número de horas de la cirugía y el valor de la albúmina plasmática antes del trasplante; con la infección fúngica invasora, el número de unidades de sangre transfundidas, el valor de la albúmina plasmática antes del trasplante y el retrasplante. La enfermedad por citomegalovirus se asoció en el análisis univariado con la infección fúngica y la infección fúngica invasora pero en el análisis multivariante no se encontró ninguna variable que incrementara el riesgo (AU)

Meningitis linfocitaria aguda sintomática por virus varicela zoster / Acute symptomatic lymphocytic meningitis due to varicella-zoster virus

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