Thermo-physiological changes and reproductive investment in a liolaemid lizard at the extreme of the slow-fast continuum.

Gravid female lizards often experience reduced thermal preferences and impaired locomotor performance. These changes have been attributed to the physical burden of the clutch, but some authors have suggested that they may be due to physiological adjustments. We compared the thermal biology and locomotor performance of the lizard Liolaemus wiegmannii 1 week before and 1 week after oviposition. We found that gravid females had a thermal preference 1°C lower than that of non-gravid females. This was accompanied by a change in the thermal dependence of maximum running speed. The thermal optimum for locomotor performance was 2.6°C lower before oviposition than after. At relatively low temperatures (22 and 26°C), running speeds of females before oviposition were up to 31% higher than for females after oviposition. However, at temperatures above 26°C, females achieved similar maximum running speeds (∼1.5 m s-1) regardless of reproductive stage. The magnitude of the changes in thermal parameters and locomotor performance of L. wiegmannii females was independent of relative clutch mass (clutches weighed up to 89% of post-oviposition body mass). This suggests that the changes are not simply due to the clutch mass, but are also due to physiological adjustments. Liolaemus wiegmannii females simultaneously adjusted their own physiology in a short period in order to improve locomotor performance and allocated energy for embryonic development during late gravid stage. Our findings have implications for understanding the mechanisms underlying life histories of lizards on the fast extreme of the slow-fast continuum, where physiological exhaustion could play an important role.

Molecular follow-up of first-line treatment by osimertinib in lung cancer: Importance of using appropriate tools for detecting EGFR resistance mutation C797S.

The C797S mutation encoded by EGFR exon 20 is classically observed as a tertiary event in EGFR-mutant non-small-cell lung carcinoma (NSCLC) primarily treated by first generation tyrosine kinase inhibitors (TKI) and secondarily treated by third-generation TKI, such as osimertinib, if the EGFR-T790M resistance mutation is detected. Recently, significant prolonged progression free survival has been observed following first-line osimertinib, in EGFR-mutant NSLC. While mechanisms of molecular resistance to first-generation TKI have been well studied, little is known about resistance induced by primary third-generation TKI treatments. We report the case of a 65 year-old female treated by first-line osimertinib for a multimetastatic exon 19-EGFR-mutant NSCLC. EGFR-C797S resistance mutation and PIK3CA mutation were detected together with the remaining EGFR-exon 19 deletion. This observation provides insights of acquired resistance to first line-osimertinib. It also highlights the importance of making molecular platforms which perform routine EGFR testing in lung cancer aware of the kind of therapeutic protocols given to the patient. Indeed, for rapid results or low-costs procedures, some targeted methods specifically targeting T790M may be used at relapse and may overlook alterations such as C797S or PIK3CA mutations. Targeted next generation sequencing is therefore a recommended option.

Gas exchange and breathing pattern in women with postmenopausal bone fragility.

BACKGROUND: Little is known about the relationship between bone fragility and respiratory function. We hypothesized that women with osteoporosis or osteopenia, without cardio-pulmonary disease, have perturbations in the pattern of breathing and gas exchange. METHODS: In 44 women with bone fragility (BF, T score: < -1), and 20 anthropomorphically-matched control women (T score > -1) we compared pulmonary function tests, central respiratory drive (mouth occlusion pressure or P 0.1), pattern of breathing using optoelectronic plethysmograph and arterial blood gases at rest. RESULTS: Static pulmonary function was similar in BF subjects and controls. However, the arterial blood gas measurements differed significantly. The arterial pH was significantly higher in BF subjects than in controls (P < 0.001). The partial pressure of carbon dioxide (PaCO2) and oxygen (PaO2) in arterial blood were significantly lower in BF subjects than controls (P < 0.001 and P = 0.009, respectively). The BF subjects had a shorter inspiratory fraction compared with controls (P = 0.036). Moreover, T-scores were significantly inversely correlated with the alveolar-arterial gradient of oxygen (r = -0.5; P = 0.0003) and the arterial pH (r = -0.4; P = 0.002), and positively correlated with arterial PaO2 (r = 0.3; P = 0.01) and PaCO2 (r = 0.4; P = 0.002) among all subjects. CONCLUSION: In the absence of known cardio-pulmonary disease, BF is associated with statistically significant perturbations in gas exchange and alterations in the pattern of breathing including shortening of the inspiratory time.

MET immunolabelling is a useful predictive tool for MET gene amplification in glioblastoma.

AIMS: MET gene amplification is rare in glioblastoma (GBM) and represents a potential target for MET inhibitors. An immunohistochemical screening may be useful to identify MET amplification. The aim of our study was to establish how MET immunolabelling correlates with MET amplification. METHODS: Three cohorts including 108 GBM (cohort 1, prospective), 104 GBM (cohort 2, retrospective) and 52 GBM (cohort 3, prospective) were investigated for MET expression by immunohistochemistry. MET amplification was assessed by comparative genomic hybridization on microarray (CGH-array) in all cohorts and by fluorescent in situ hybridization (FISH) in cohorts 2 and 3. Active form of MET was assessed using p-MET (Y1349) immunohistochemistry. RESULTS: Diffuse MET amplification detectable by CGH-array was associated with diffuse, strong MET immunolabelling (four cases in cohort 1 and one case in cohort 2). Focal MET amplification detectable only by FISH was observed in small foci of strongly immunopositive cells in two GBM (cohort 2). In both cohorts, MET amplification was never detected in GBM devoid of strongly immunopositive cells. MET overexpression, observed in 23% of unamplified GBM, was associated with a predominant weak-to-moderate staining intensity and with necrosis (P < 0.005). p-MET was detected in all MET-amplified GBM and in perinecrotic areas of nonamplified GBM. A strong MET immunostaining intensity, at least focal and distant from necrosis, showed 100% sensitivity and 84% specificity for predicting MET amplification in cohort 3. CONCLUSIONS: MET amplification is characterized by strongly immunopositive cells. Only GBM showing strong MET immunostaining is appropriate for the assessment of MET amplification.

Consejo nutricional en paciente oncológico / Nutritional advice in oncology

Introducción. El cáncer es la primera causa de muerte en España y es, por tanto, un problema de salud prioritario. Se sabe que la nutrición está relacionada con la incidencia de cáncer y que también puede ser un factor importante para su tratamiento. Es esencial otorgar a la nutrición el papel que merece, para llevar a cabo un tratamiento óptimo de la enfermedad y maximizar las probabilidades de curación. Objetivos: Evaluar la adecuación y la prevalencia de los consejos nutricionales que se ofrecen en materia de cáncer en distintos centros de España. Metodos: Estudio descriptivo, observacional, retrospectivo. Se realizó mediante un cuestionario Ad Hoc a una muestra incidental en pacientes con cáncer de 3 Comunidades Autónomas. Las variables estudiadas se centraron en la información sobre su tratamiento nutricional, sus características sociosanitarias, así como las de la intervención y evolución de cada participante. Resultados: La muestra estudiada es de 17 pacientes con distintos tipos de cáncer, que fueron sometidos a cirugía, quimioterapia, radioterapia y/u hormonoterapia. Refirieron haber tenido efectos secundarios 10 participantes y solo recibieron consejos adecuados para los síntomas en 2 de los casos. El 82,35% no tuvo valoración nutricional previa, solo un 5,88% fue a consulta exclusiva de nutrición y solo un 29,41% recibió alguna pauta alimentaria. Discusión: La eficacia de las recomendaciones nutricionales en la evolución y calidad de vida del paciente oncológico ha sido demostrada por diversos estudios. La malnutrición y la pérdida de peso son problemas comunes en estos pacientes y pueden dar origen a complicaciones durante la enfermedad. Por ello, es muy importante evaluar de forma correcta el estado nutricional del paciente para poder realizar la intervención nutricional oportuna, adaptada a sus necesidades, gustos y sintomatología. Lo cual no se identificó mayoritariamente en nuestra muestra. Conclusión: La evaluación, tratamiento y seguimiento del estado nutricional resulta muy importante para el paciente oncológico. Pero es a su vez un traba - jo complejo que requiere mucho tiempo y dedicación y, que debe manejarse a través de equipos especializados de nutrición con un alto grado de entrena miento en oncología (AU)

Introduction: Cancer is the main cause of death in Spain and is therefore a priority health problem. It is known that nutrition is associated with the incidence of cancer and can also be an important factor for treatment. It is essential to give the role nutrition it deserves, to perform optimal treatment of disease and maximize the chance of cure. Aim: evaluate the suitability and prevalence of nutritional advice given on cancer in different institutes in Spain. Methods: A descriptive, observational, retrospective study. Was performed using a questionnaire Ad hoc on one incidental sample in patients with cancer from 3 regions from Spain. The variables studied were focused on information about their nutritional treatment, their social and health characteristics, as well as intervention and progress of each participant. Results: The study sample of 17 patients with difference types of cancer, who underwent surgery, chemotherapy, radiotherapy and / or hormone therapy. Ten of them had effects and only 2 participants received appropriate advice for symptoms. From the sample, 82.35% had not previous nutritional assessment, only 5.88% was the exclusive nutritional consultant and only 29.41 % received any general food advices. Discussion: The effectiveness of nutritional recommendations on the development and quality of life of cancer patients has been demonstrated by several studies. Malnutrition and weight loss are common problems in these patients and can cause complications during illness. It is therefore very important to assess correctly the nutritional status of the patient in order to make timely nutrition intervention, adapted to needs, likes and symptomatology. Which is mostly not identified in our sample. Conclusion: The assessment, treatment and monitoring of nutritional status is very important to cancer patients. But it is itself a complex job that requires much time and dedication, and that must be manage by specialized teams of nutrition with a high training in oncology (AU)

Planificación alimenticia en personas mayores: aspectos nutricionales y económicos / Meal planning in the elderly: nutritional and economic aspects

La malnutrición en personas mayores es uno de los grandes síndromes, asociado a mayor prevalencia de enfermedades crónicas y aumento la morbilidad, estancia hospitalaria y mortalidad. Por otro lado, la malnutrición en el 4o mundo se asocia a otro factor de riesgo de gran importancia, la precaria situación económica. El objetivo del estudio fue elaborar un menú equilibrado para ancianos, ajustando su precio al gasto medio que esta población dedica a su alimentación. Teniendo en cuanta el Gasto del hogar 2010 del Instituto Nacional de Estadística, se estableció que el precio medio de cada menú debía ser inferior a 5,57 € al día. Se elaboraron dos menús tipos, ambos adaptados a esta población y a la dieta mediterránea. La valoración económica fue de 5,02 € y de 5,06 €, respectivamente. Debido a la prevalencia de malnutrición en esta población, es necesario poder planificar adecuadamente su alimentación, tanto a nivel nutricional como económico (AU)

Malnutrition in elderly people is one of the major syndromes associated to greater prevalence of chronic diseases and increased morbidity, hospital staying, and mortality. On the other hand, malnutrition in the fourth world is associated to another important risk factor, which is the poor economic status. The aim of this study was to elaborate a balanced menu for the elderly adjusting its price to the mean expense that this population dedicates to its feeding needs. Taking into account the Household expense for 2010 of the National Institute of Statistics, we established that the average price for each menu ought to be less than 5.57 € per day. Two type menus were elaborated, both adapted to this population and to the Mediterranean diet. The economic assessment was 5.02 € and 5.06 €, respectively. Given the prevalence of malnutrition in this population, it is essential being able to appropriately plan their feeding needs, at both the nutritional and economic levels (AU)

[Meal planning in the elderly: nutritional and economic aspects]. / Planificación alimenticia en personas mayores: aspectos nutricionales y económicos.

Malnutrition in elderly people is one of the major syndromes associated to greater prevalence of chronic diseases and increased morbidity, hospital staying, and mortality. On the other hand, malnutrition in the fourth world is associated to another important risk factor, which is the poor economic status. The aim of this study was to elaborate a balanced menu for the elderly adjusting its price to the mean expense that this population dedicates to its feeding needs. Taking into account the Household expense for 2010 of the National Institute of Statistics, we established that the average price for each menu ought to be less than 5.57 € per day. Two type menus were elaborated, both adapted to this population and to the Mediterranean diet. The economic assessment was 5.02 € and 5.06 €, respectively. Given the prevalence of malnutrition in this population, it is essential being able to appropriately plan their feeding needs, at both the nutritional and economic levels.