A cross-sectional study evaluating the exercise discussion with oncologist during cancer consultation: the CONNECT study.

BACKGROUND: Evidence demonstrates that physical exercise confers several psycho-physical benefits on patients with cancer. This study aims to investigate the role of oncologists in exercise promotion. PATIENTS AND METHODS: A multicenter, cross-sectional study was conducted by distributing an anonymous, self-administered questionnaire to patients with cancer. The questionnaire enclosed demographic, health, and exercise variables. The exercise-related questions included in the study used the Godin-Shephard Leisure-Time Physical Activity Questionnaire to measure the amount of physical exercise. In addition, the survey gathered information on whether exercise was discussed with patients, and whether oncologists followed the assess, advise, reinforce, and refer (AARR) process regarding exercise. The survey also asked if patients preferred that exercise be discussed during their consultations. Descriptive statistics and logistic regression were applied. RESULTS: With a response rate of 75%, a total of 549 patients completed the survey. Regarding the exercise discussion, 38% of patients stated that their oncologist initiated an exercise discussion, 14% started the discussion themselves, and 48% said that the issue was not considered. Overall, 35% of patients reported that the oncologist assessed their exercise level, 22% and 42% received advice or reinforcement to increase their exercise, respectively, and 10% were referred to a dedicated service. Regarding preferences, 72% of patients thought that the oncologists should initiate an exercise discussion, 2% that only patients should start the discussion, and 26% thought that the issue should not be discussed. Similarly, 74% of patients are willing to receive the exercise assessment, 59% and 75% the advice and reinforcement to increase their exercise, and 46% to be referred to an exercise service. CONCLUSIONS: Although exercise promotion rates are low, patients are willing to receive exercise information. Dedicated strategies should be developed to support oncologists in promoting exercise to their patients.

Correlación entre osteocalcina, insulinorresistencia, insulinosensibilidad y metabolismo de la glucosa en adultos mayores con síndrome metabólico / Correlation between Osteocalcin, Insulin Resistance, Insulin Sensitivity and Carbohydrate Metabolism in an Elderly Population with Metabolic Syndrome

Introducción: Recientemente han surgido nuevas evidencias que relacionan el metabolismo óseo con el energético. La osteocalcina es una proteína de la matriz ósea no colágena, sintetizada por los osteoblastos que modula localmente la mineralización ósea, tradicionalmente usada como marcador de formación ósea. Se ha demostrado tanto en modelos "in vitro" como en animales de experimentación que la osteocalcina tiene acción hormonal. Esta proteína tiene la propiedad de regular la insulinosensibilidad, la insulinosecreción y la proliferación de las células beta pancreáticas. Objetivo: Evaluar la existencia de correlación entre los niveles de osteocalcina sérica y marcadores de insulinorresistencia (IR) e insulinosensibilidad en una población de adultos mayores con síndrome metabólico. Material y métodos: En nuestro estudio prospectivo se incluyeron 88 pacientes (68 % mujeres, 32 % hombres, media de edad 73 ± 6 y 74 ± 6 años respectivamente) que concurrieron a los consultorios externos del servicio de Endocrinología y Metabolismo del hospital Dr. César Milstein. Todos cumplían con los criterios diagnósticos de síndrome metabólico del año 2009 de la Federación Internacional de Diabetes (IDF). Se midieron: osteocalcina sérica, hemoglobina glicosilada (HbA1c), HDL y triglicéridos (TG). Se calcularon QUICKI (Quantitative Insulin Sensivity Check Index) y el índice TG/HDL. Resultados: Los niveles de osteocalcina sérica se asociaron positivamente con HDL (r = 0,213, p = 0,05) y QUICKI (r = 0,212, p = 0,05) e inversamente con TG (r = -0,218, p < 0,05), con el índice TG/HDL (r = -0,217, p < 0,05) y con HbA1c (r = -0,253, p < 0,05). Conclusiones: Nuestro estudio mostró que en adultos mayores con sindrome metabólico, los niveles de osteocalcina reducidos se asociaron con un aumento en los índices de insulinorresistencia, una disminución de los de insulinosensibilidad y un peor control metabólico. Rev Argent Endocrinol Metab 52:8-13, 2015 Los autores no poseen conflictos de interés.

Introduction: In recent years there has been increasing evidence about the relationship between bone and energy metabolism. Osteocalcin is a non-collagenous bone matrix protein synthesized by osteoblasts that locally modulates bone mineralization and is traditionally used as a bone formation marker. Osteocalcin has been shown to have hormonal actions both in in vitro models and in experimental animals. This hormone has the property of regulating insulin secretion and insulin sensitivity as well as beta pancreatic cell proliferation. Aim: To evaluate the existence of correlation between serum osteocalcin levels, insulin resistance and insulin sensitivity markers in an elderly population with metabolic syndrome. Material and methods: Eighty-eight elderly patients were included in our prospective study (68 % women, mean age 73 ± 6 ; 32 % men, mean age 74 ± 6). They attended the outpatient Endocrinology and Metabo­lism service at Dr. César Milstein Hospital and met the International Diabetes Federation (IDF) criteria of metabolic syndrome. Serum Osteocalcin, Glycated haemoglobin (HbA1c), HDL and Triglycerides (TG) were measured. QUICKI and TG/HDL index were calculated. Results: Serum osteocalcin levels were positively associated with HDL (r = 0.213, p = 0.05) and QUICKI (r = 0.212, p = 0.05), and inversely associated with TG (r = -0.218, p < 0.05), TG/HDL index (r = -0.217, p < 0.05) and HbA1c (r = -0.253, p < 0.05). Conclusions: Our study showed that in elderly patients with metabolic syndrome, reduced osteocalcin levels were associated with increased insulin sensitivity, decreased insulin resistance indexes and impaired metabolic control. Rev Argent Endocrinol Metab 52:8-13, 2015 No financial conflicts of interest exist.

Correlación entre osteocalcina, insulinorresistencia, insulinosensibilidad y metabolismo de la glucosa en adultos mayores con síndrome metabólico / Correlation between Osteocalcin, Insulin Resistance, Insulin Sensitivity and Carbohydrate Metabolism in an Elderly Population with Metabolic Syndrome

Introducción: Recientemente han surgido nuevas evidencias que relacionan el metabolismo óseo con el energético. La osteocalcina es una proteína de la matriz ósea no colágena, sintetizada por los osteoblastos que modula localmente la mineralización ósea, tradicionalmente usada como marcador de formación ósea. Se ha demostrado tanto en modelos "in vitro" como en animales de experimentación que la osteocalcina tiene acción hormonal. Esta proteína tiene la propiedad de regular la insulinosensibilidad, la insulinosecreción y la proliferación de las células beta pancreáticas. Objetivo: Evaluar la existencia de correlación entre los niveles de osteocalcina sérica y marcadores de insulinorresistencia (IR) e insulinosensibilidad en una población de adultos mayores con síndrome metabólico. Material y métodos: En nuestro estudio prospectivo se incluyeron 88 pacientes (68 % mujeres, 32 % hombres, media de edad 73 ± 6 y 74 ± 6 años respectivamente) que concurrieron a los consultorios externos del servicio de Endocrinología y Metabolismo del hospital Dr. César Milstein. Todos cumplían con los criterios diagnósticos de síndrome metabólico del año 2009 de la Federación Internacional de Diabetes (IDF). Se midieron: osteocalcina sérica, hemoglobina glicosilada (HbA1c), HDL y triglicéridos (TG). Se calcularon QUICKI (Quantitative Insulin Sensivity Check Index) y el índice TG/HDL. Resultados: Los niveles de osteocalcina sérica se asociaron positivamente con HDL (r = 0,213, p = 0,05) y QUICKI (r = 0,212, p = 0,05) e inversamente con TG (r = -0,218, p < 0,05), con el índice TG/HDL (r = -0,217, p < 0,05) y con HbA1c (r = -0,253, p < 0,05). Conclusiones: Nuestro estudio mostró que en adultos mayores con sindrome metabólico, los niveles de osteocalcina reducidos se asociaron con un aumento en los índices de insulinorresistencia, una disminución de los de insulinosensibilidad y un peor control metabólico. Rev Argent Endocrinol Metab 52:8-13, 2015 Los autores no poseen conflictos de interés.(AU)

Introduction: In recent years there has been increasing evidence about the relationship between bone and energy metabolism. Osteocalcin is a non-collagenous bone matrix protein synthesized by osteoblasts that locally modulates bone mineralization and is traditionally used as a bone formation marker. Osteocalcin has been shown to have hormonal actions both in in vitro models and in experimental animals. This hormone has the property of regulating insulin secretion and insulin sensitivity as well as beta pancreatic cell proliferation. Aim: To evaluate the existence of correlation between serum osteocalcin levels, insulin resistance and insulin sensitivity markers in an elderly population with metabolic syndrome. Material and methods: Eighty-eight elderly patients were included in our prospective study (68 % women, mean age 73 ± 6 ; 32 % men, mean age 74 ± 6). They attended the outpatient Endocrinology and Metabo¡lism service at Dr. César Milstein Hospital and met the International Diabetes Federation (IDF) criteria of metabolic syndrome. Serum Osteocalcin, Glycated haemoglobin (HbA1c), HDL and Triglycerides (TG) were measured. QUICKI and TG/HDL index were calculated. Results: Serum osteocalcin levels were positively associated with HDL (r = 0.213, p = 0.05) and QUICKI (r = 0.212, p = 0.05), and inversely associated with TG (r = -0.218, p < 0.05), TG/HDL index (r = -0.217, p < 0.05) and HbA1c (r = -0.253, p < 0.05). Conclusions: Our study showed that in elderly patients with metabolic syndrome, reduced osteocalcin levels were associated with increased insulin sensitivity, decreased insulin resistance indexes and impaired metabolic control. Rev Argent Endocrinol Metab 52:8-13, 2015 No financial conflicts of interest exist.(AU)

Particularidades del síndrome metabólico en una subpoblación de adultos mayores / Particularities of metabolic syndrome in an elderly subpopulation

Introducción: El síndrome metabólico (SM) se define por un conjunto de alteraciones clínicas que aumentan el riesgo de enfermedad cardiovascular. Diferentes organizaciones internacionales de salud han ajustado progresivamente los criterios que definen al SM, con el consiguiente aumento del diagnóstico del mismo. Sin embargo, ninguno de los parámetros considerados se han adaptado a la edad ni se han tomado en cuenta las modificaciones antropométricas y metabólicas características del envejecimiento. Objetivo: Caracterizar al SM en una población de adultos mayores y evaluar si existen diferencias de género. Materiales y métodos: Se realizó un estudio prospectivo en pacientes que consultaron al Servicio de Endocrinología de la U. A. Dr. César Milstein. El 68,8 % fueron mujeres y la edad de la población fue 73 ± 6 años. Para el diagnóstico de SM se utilizaron los criterios del Joint Interim Statement de 2009. Recabamos información sobre antecedentes, medicación y se realizaron análisis de laboratorio. Se midió índice cintura/talla (ICT). Se calculó media ± desvío estándar (DS) y proporciones. Para establecer comparaciones entre varones y mujeres se utilizó Test de Student y test de Chi2. Resultados: En una muestra de 77 pacientes, 42,9 % cumplió con 3 componentes de SM, 33,8 % con 4 y 23,4 % con 5, con distribución similar en hombres y mujeres. Según el índice de masa corporal (IMC), 32,5 % de la población presentó sobrepeso; 35 % obesidad grado I; 22 % grado II y 9 % grado III. Al evaluar el perímetro de cintura (PC), el 98,7 % superó los puntos de corte. El índice cintura/ talla superó el valor normal en ambos sexos, siendo significativamente superior en las mujeres (p: 0,003). Conclusiones: En la población de adultos mayores que se estudió no se observó diferencia entre ambos sexos en el número de componentes diagnósticos de SM. En cuanto al perímetro de cintura, el valor fue similar en ambos sexos, lo que podría llevar a revisar el valor de corte del mismo en este grupo etario. El ICT estuvo aumentado en toda la población y por ser un subrogante de riesgo cardiovascular, sería otro parámetro a tener en cuenta al momento del diagnóstico de SM. Rev Argent Endocrinol Metab 51:130-135, 2014 Los autores no poseen conflictos de interés.

Introduction: The metabolic syndrome (MS) denotes an association of abnormalities that increase the risk of cardiovascular disease. With the intention of decreasing this risk, international organizations have dropped the normal range for various parameters, with a consequent increase in the diagnosis of MS. Although the changes related to age are well documented, none of these parameters has been age-adapted. Aims: to characterize MS in the elderly population and to establish possible gender differences. Materials and methods: We performed a prospective study in patients who presented at the Department of Endocrinology of the Healthcare Unit Dr. Cesar Milstein. Of the total population, 68.8 % were women and the average age was 73 ± 6 years. For the diagnosis of MS, we used the 2009 Joint Interim Statement diagnostic criteria. Information was collected on previous history and medication, and laboratory analyses were performed. The waist / height ratio was also measured. Mean ± standard deviation (SD) and proportions were calculated. For comparisons between men and women, the Student test and Chi-squared test were used. Results: Of the total population, 42.9 % fulfilled 3 criteria for MS, 33.8 % fulfilled 4 criteria and 23.4 % fulfilled 5, with similar distribution in men and women. According to body mass index (BMI), 32.5 % of the population had overweight, 35 % were grade I obese, 22 % were grade II and 9 % were grade III. As regards waist circumference, 98.7 % of the total population exceeded the established cutoffs. The waist/ height ratio exceeded normal values in both genders, being significantly higher in women (p = 0.003). Conclusions: In the elderly, there are no gender differences in the number of components of MS. As for waist circumference, values were similar in both men and women. This finding could lead to redefine the cutoff value in aged woman. The waist / height ratio, a surrogate marker of cardiovascular disease, was ...

Structural and ultrastructural alterations in BALB/c mice: effects of Penicillium citrinum metabolites.

The aims of this work were to determine the effect of feeding BALB/c mice a diet containing culture materials of a citrinin producing strain of Penicillium citrinum (Thom). Changes in hematological parameters, serum chemistry and histological changes in liver, kidney and heart were determined. After 60 days, control treated (CT) mice appeared normal in all respects, whereas, the mice fed the feeds supplemented with Penicillium (CMT) showed decreased weight gain, lower hematocrits, increased serum alanine aminotransferase (ALT) and clear signs of renal and hepatotoxicity based on histological changes. Changes observed in the liver of CMT mice included portal and lobular infiltration of polymorphonuclear cells, with concomitant hepatocellular necrosis, hepatic steatosis, prominent Kupffer's cells, hemosiderin granules in the cytoplasm of periportal hepatocytes and other lipid inclusions in the surrounding mitochondria were also observed. Our findings suggest that in vivo, P. citrinum Thom metabolites, which contain citrinin, could cause illnesses such as toxic hepatitis or intravascular hemolysis.

[Cryptosporidium y Giardia in surface water]. / Cryptosporidium y Giardia en aguas superficiales.

The aim of this work was to determine Giardia and Cryptosporidium levels in surface water used either as recreational or drinking water source, and to estimate the relationship with bacteriological and physicochemical parameters determining water quality. This study was carried out during 22 months, in Santa Fe and Santo Tomé cities (Santa Fe Province, Argentina). Cryptosporidium from 100% of the recreational samples (44-2404 oocysts/100 l) and from 92% of water sources (< 20-539 oocysts/100 l) was detected, while Giardia was found in lower concentrations and frequencies: 72% (< 20-670 cysts/100 l) and 31% (< 20-65 cysts/100 l), respectively. Statistically significant relationships were found between these parasites and organic matter, turbidity and bacteriological indicators of contamination (Escherichia coli, streptococci, Enterococcus spp, Pseudomonas aeruginosa). These relationships, however, vary according to the sampling place, the source and levels of contamination.

Cryptosporidium y Giardia en aguas superficiales / Cryptosporidium y Giardia in surface water

The aim of this work was to determine Giardia and Cryptosporidium levels in surface water used either as recreational or drinking water source, and to estimate the relationship with bacteriological and physicochemical parameters determining water quality. This study was carried out during 22 months, in Santa Fe and Santo TomÚ cities (Santa Fe Province, Argentina). Cryptosporidium from 100 of the recreational samples (44-2404 oocysts/100 l) and from 92 of water sources (< 20-539 oocysts/100 l) was detected, while Giardia was found in lower concentrations and frequencies: 72 (< 20-670 cysts/100 l) and 31 (< 20-65 cysts/100 l), respectively. Statistically significant relationships were found between these parasites and organic matter, turbidity and bacteriological indicators of contamination (Escherichia coli, streptococci, Enterococcus spp, Pseudomonas aeruginosa). These relationships, however, vary according to the sampling place, the source and levels of contamination.

Cryptosporidium y Giardia en aguas superficiales / Cryptosporidium y Giardia in surface water

The aim of this work was to determine Giardia and Cryptosporidium levels in surface water used either as recreational or drinking water source, and to estimate the relationship with bacteriological and physicochemical parameters determining water quality. This study was carried out during 22 months, in Santa Fe and Santo TomU cities (Santa Fe Province, Argentina). Cryptosporidium from 100 of the recreational samples (44-2404 oocysts/100 l) and from 92 of water sources (< 20-539 oocysts/100 l) was detected, while Giardia was found in lower concentrations and frequencies: 72 (< 20-670 cysts/100 l) and 31 (< 20-65 cysts/100 l), respectively. Statistically significant relationships were found between these parasites and organic matter, turbidity and bacteriological indicators of contamination (Escherichia coli, streptococci, Enterococcus spp, Pseudomonas aeruginosa). These relationships, however, vary according to the sampling place, the source and levels of contamination.(AU)

[Toxic activity of Penicillium citrinum metabolites on Mus musculus mice]. / Actividad de metabolitos de Penicillium citrinum sobre ratones Mus musculus.

The aims of this work were to study the influence of secondary metabolites produced by a Penicillium citrinum strain. Mus musculus mice were fed with a diet containing those metabolites to determine both its influence on their development and the pathological and biochemical changes on experimental animals. Male and female including pregnant females, were studied. One group received commercial feed (A.B.) to which the citrinin- producing mould had been added (LF), another received A.B. contaminated with commercial citrinin (LC). The last group received noncontaminated feed (LT). The animals were weighed weekly, and sacrificed after sixty days, so that they could be studied both macro and microscopically. In LF and LT mice, haematological analysis was carried out and hemosiderin was looked for in urine. The diet of the newborne mice, after weaning, was identical to that of their parent. The treated animals (LF and LC) showed morphological alterations, a significant decrease in weight and morphologic alterations and hemosiderin granules were detected in some of their organs. In LT all breeds survived, none of the mice showed neither macro nor microscopic anomalies and had normal biochemical parameters. Fewer breeds in LF survived, male infertility was detected and some of their haematologic parameters were also measurably lower.

Cryptosporidium y Giardia en aguas superficiales. / [Cryptosporidium y Giardia in surface water]

The aim of this work was to determine Giardia and Cryptosporidium levels in surface water used either as recreational or drinking water source, and to estimate the relationship with bacteriological and physicochemical parameters determining water quality. This study was carried out during 22 months, in Santa Fe and Santo Tomé cities (Santa Fe Province, Argentina). Cryptosporidium from 100

of the recreational samples (44-2404 oocysts/100 l) and from 92

of water sources (< 20-539 oocysts/100 l) was detected, while Giardia was found in lower concentrations and frequencies: 72

(< 20-670 cysts/100 l) and 31

(< 20-65 cysts/100 l), respectively. Statistically significant relationships were found between these parasites and organic matter, turbidity and bacteriological indicators of contamination (Escherichia coli, streptococci, Enterococcus spp, Pseudomonas aeruginosa). These relationships, however, vary according to the sampling place, the source and levels of contamination.

Detección de Cryptosporidium en agua de consumo de origen subterráneo / Detection of Cryptosporidium spp. in drinking water of subterranean origin

El objetivo del presente trabajo fue determinar el papel del agua de consumo de origen subterráneo en la transmisión de las enteroparasitosis. Las muestras se obtuvieron de perforaciones y tanques que abastecen a núcleos poblacionales de la provincia de Santa Fe, habiéndose determinado sus parámetros fisicoquímicos y bacteriológicos de calidad. La búsqueda de los parásitos se llevó a cabo mediante filtración, posterior lavado de los filtros con una solución de Tween 80 y concentración del líquido resultante, y exámenes microscópicos en fresco y de colores vitales, permanentes y diferenciales. Se detectaron ooquistes de Cryptosporidium spp. en el agua que abastece a uno de dichos núcleos poblacionales. El examen bacteriológico reveló la presencia de coliformes totales, no habiéndose hallado parámetros químicos de contaminación ni coliformes fecales. Este estudio demuestra que la ausencia de dichos parámetros no es suficiente para descartar la contaminación con ciertos protozoarios, por lo que se sugiere tomar medidas proteccionistas para las fuentes de agua

Detección de Cryptosporidium en agua de consumo de origen subterráneo / Detection of Cryptosporidium spp. in drinking water of subterranean origin

El objetivo del presente trabajo fue determinar el papel del agua de consumo de origen subterráneo en la transmisión de las enteroparasitosis. Las muestras se obtuvieron de perforaciones y tanques que abastecen a núcleos poblacionales de la provincia de Santa Fe, habiéndose determinado sus parámetros fisicoquímicos y bacteriológicos de calidad. La búsqueda de los parásitos se llevó a cabo mediante filtración, posterior lavado de los filtros con una solución de Tween 80 y concentración del líquido resultante, y exámenes microscópicos en fresco y de colores vitales, permanentes y diferenciales. Se detectaron ooquistes de Cryptosporidium spp. en el agua que abastece a uno de dichos núcleos poblacionales. El examen bacteriológico reveló la presencia de coliformes totales, no habiéndose hallado parámetros químicos de contaminación ni coliformes fecales. Este estudio demuestra que la ausencia de dichos parámetros no es suficiente para descartar la contaminación con ciertos protozoarios, por lo que se sugiere tomar medidas proteccionistas para las fuentes de agua (AU)

[Detection of Cryptosporidium in subterranean drinking water]. / Detección de Cryptosporidium en agua de consumo de origen subterráneo.

The objective of the present work has been to determine the role of drinking water of subterranean origin in the transmission of enteroparasitosis. The samples were obtained from wells and tanks supplying population areas in Santa Fe province. The physico-chemical and bacteriological parameters were all determined. The detection of parasites was carried out by means of filtration, the subsequent washing of the filters with a Tween 80 solution and the concentration of the remaining liquid which was then submitted to microscopic examination. This examination was made for both fresh samples and samples stained with permanent and differential staining techniques. Cryptosporidium spp. oocysts were found in the water which supplies one of those population areas. The bacteriological examination revealed the presence of total coliforms but neither chemical contamination parameters nor faecalis coliforms were found. We conclude that the absence of the latter is not enough to discard the presence of parasites and that protective measures of the water supply must be implemented.

Aislamiento, identificación y determinación de la capacidad toxicogénica de hongos contaminantes de cereales y productos alimenticios / Isolation, identification and determination of the toxicogenic capacity of fungi contaminating cereals and alimentary products

Se determinó en la ciudad de Santa Fe y su zona de influencia, la capacidad toxicogénica, mediante la aplicación de ensayos biológicos rápidos, a hongos contaminantes de cereales y productos alimenticios elaborados con ellos. Los alimentos estudiados fueron: soja, maíz, trigo y sus derivados: los géneros frecuentes aislados fueron: aspergillus, penicillium y fusarium, identificandose las especies de aquellos que resultaron toxicogénicos. Las acciones citotóxicas detectadas mediante los ensayos aplicados fueron: capacidad mutagénica, hemólisis de glóbulos rojos humanos y elongación e inhibición de células de bacillus thuringiensis