Energy expenditure at age 73 and 78--a five year follow-up.

There is limited knowledge concerning the energy turnover and energy requirements of the elderly. The aim of this study was to measure resting metabolic rate (RMR) and total energy expenditure (TEE), and to define activity energy expenditure (AEE) and physical activity level (PAL) in 11 78-year-old individuals. A further aim was to compare these measures with the same measures taken from the 11 subjects at age 73 years. Total body water (TBW) averaged 30.8 kg (SD 3.2) at age 73 and 28.8 kg (SD 3.5) at age 78 years ( p<0.01). RMR was measured with a ventilated-hood system and averaged 5.60 MJ/day (SD 0.66) at age 73 and 4.77 MJ/day (SD 0.32) at 78 years ( p<0.001). TEE, measured using the doubly labeled water method, averaged 9.64 MJ/day (SD 1.10) at age 73 and 8.30 MJ/day (SD 1.45) at 78 years ( p<0.05). AEE averaged 4.04 MJ/day (SD 0.44) at age 73 and 3.53 MJ/day (1.13) at 78 years (ns). PAL averaged 1.74 at both ages. TBW, TEE, and RMR decreased, whereas AEE and PAL did not change substantially during the 5-year follow-up. The PAL values indicated a physically active lifestyle for the age group.

Skin wrinkling: can food make a difference?

OBJECTIVES: This study addressed whether food and nutrient intakes were correlated with skin wrinkling in a sun-exposed site. METHODS: 177 Greek-born subjects living in Melbourne (GRM), 69 Greek subjects living in rural Greece (GRG), 48 Anglo-Celtic Australian (ACA) elderly living in Melbourne and 159 Swedish subjects living in Sweden (SWE) participating in the International Union of Nutritional Sciences IUNS "Food Habits in Later Life" study had their dietary intakes measured and their skin assessed. Food and nutrient intakes were assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Skin wrinkling was measured using a cutaneous microtopographic method. RESULTS: SWE elderly had the least skin wrinkling in a sun-exposed site, followed by GRM, GRG and ACA. Correlation analyses on the pooled data and using the major food groups suggested that there may be less actinic skin damage with a higher intake of vegetables (r(s)=-0.31, p<0.0001), olive oil (r(s)=-0.29, p<0.0001), fish (r(s)=-0.24, p<0.0001) and legumes (r(s)=-0.16, p<0.0001), and lower intakes of butter (r(s)=0.46, p<0.0001) and margarine (r(s)=0.24, p<0.001), milk products (r(s)=0.16, p<0.01) and sugar products (r(s)=0.12, p<0.01). Similar findings were obtained using regression analyses, except fish was no longer significant; 32% of the variance for actinic skin damage was predicted by six out of the ten major food groups. In particular, a high intake of vegetables, legumes and olive oil appeared to be protective against cutaneous actinic damage (collectively explaining 20% of the variance); a high intake of meat, dairy and butter appeared to be adverse (explaining <5% of the variance). Prunes, apples and tea explained 34% of variance amongst ACA. CONCLUSION: This study illustrates that skin wrinkling in a sun-exposed site in older people of various ethnic backgrounds may be influenced by the types of foods consumed.

Resting energy expenditure, activity energy expenditure and total energy expenditure at age 91-96 years.

There is a limited knowledge concerning energy requirements of the elderly, especially the oldest old (> 80 years). Energy requirements should be estimated from measurements of energy expenditure. For this purpose twenty-one free-living individuals (eight males, thirteen females) aged 91-96 years living in Göteborg, Sweden were studied. Total body water (TBW) measured by the doubly-labelled-water (DLW) technique was 29.5 (sd 5.4) kg in females and 35.6 (sd 4.3) kg in males. TBW measured using bioelectric impedance (BIA) was 31.6 (sd 6.4) kg in females and 42.0 (sd 7.4) kg in males. The mean difference between TBW measured by BIA and that measured by DLW was 3.54 (sd 3.6) kg (P = 0.0002). Resting metabolic rate (RMR) was measured using a ventilated-hood system and averaged 5.36 (sd 0.71) MJ/d in females (n 12) and 6.09 (sd 0.91) MJ/d in males (n 8). Difference between measured RMR and predicted BMR (n 20) was 0.015 (sd 0.86) MJ/d (NS). Total energy expenditure (TEE) measured by DLW averaged 6.3 (sd 0.81) MJ/d in females and 8.1 (sd 0.73) MJ/d in males. Activity energy expenditure (TEE - RMR), thus including diet-induced thermogenesis (DIT), averaged 0.95 (sd 0.95) MJ/d in females (n 12) and 2.02 (sd 1.13) MJ/d in males. Physical activity level (TEE/BMR) averaged 1.19 (sd 0. 19) in females and 1.36 (sd 0.21) (P = 0.08) in males. If DIT is assumed to be 10 % of the TEE, energy spent on physical activity will be very low in this population.

[A pleuropulmonary tuberculosis study in a pneumology service]. / Estudio de la tuberculosis pleuropulmonar en un servicio de Neumología.

We reviewed the records of 125 patients admitted in our Service of Pneumology from January 1985 to December 1992, which were diagnosed of pleural or pulmonary tuberculosis. Several characteristics are described, with the following findings: 1) Higher incidence among men. 2) Relevant incidence among young people. 3) Frequent association with risk factors or concomitant diseases, mainly tobacco and alcohol consumption. 4) Delay in the diagnosis, probably due to the unspecific symptoms observed; fever, cough, constitutional syndrome. 5) The must frequent radiological findings were pleural leakage and cavitated infiltrations affecting the upper lobes. 6) Sputum microbiological exam still has a high diagnostic profitability.

[Kartagener's syndrome with normal ciliary ultrastructure]. / Síndrome de Kartagener con ultraestructura ciliar normal.

We present a case of a man with Kartagener's syndrome (KS) (situs inversus, sinusitis and bronchiectasias) and with clinical signs of respiratory infection. An electronic microscopy study was conducted, showing a normal bronchial cilium. Although, traditionally, KS has been associated to ultrastructural abnormalities of the cilium, some cases similar to ours have been described, suggesting the presence of functional ciliary disorders in absence of ultrastructural defects.

[Mediastinal leiomyosarcoma]. / Leiomiosarcoma mediastínico.

Primary mediastinal leiomyosarcomas are malignant sarcomas with unknown etiology not deriving from the smooth muscle fiber of the esophagus, trachea or main vessels. Very few cases have been reported in the literature and, although they are clinically unspecific, their histology is unique. The case described here is a 66-year-old woman with a leiomyosarcoma localized at the medium and posterior mediastinum, clinically presented as a mediastinal emergency.