Promising biomarkers of human aging: In search of a multi-omics panel to understand the aging process from a multidimensional perspective.

The aging process has been linked to the occurrence of chronic diseases and functional impairments, including cancer, sarcopenia, frailty, metabolic, cardiovascular, and neurodegenerative diseases. Nonetheless, aging is highly variable and heterogeneous and represents a challenge for its characterization. In this sense, intrinsic capacity (IC) stands as a novel perspective by the World Health Organization, which integrates the individual wellbeing, environment, and risk factors to understand aging. However, there is a lack of quantitative and qualitative attributes to define it objectively. Therefore, in this review we attempt to summarize the most relevant and promising biomarkers described in clinical studies at date over different molecular levels, including epigenomics, transcriptomics, proteomics, metabolomics, and the microbiome. To aid gerontologists, geriatricians, and biomedical researchers to understand the aging process through the IC. Aging biomarkers reflect the physiological state of individuals and the underlying mechanisms related to homeostatic changes throughout an individual lifespan; they demonstrated that aging could be measured independently of time (that may explain its heterogeneity) and to be helpful to predict age-related syndromes and mortality. In summary, we highlight the areas of opportunity and gaps of knowledge that must be addressed to fully integrate biomedical findings into clinically useful tools and interventions.

Asymptomatic Severe Vagal and Sympathetic Cardiac Denervation in Holmes-Adie's Syndrome.

A 40-year-old woman was found to have bilateral Adie's pupils and generalized muscle stretch areflexia. She did not have orthostatic hypotension but, in an ECG strip in the office, she appeared to have an almost fixed heart rate. We thus studied the heart rate variability (HRV) and the systolic blood pressure variability (SBPV) in supine and standing position and also during rhythmic breathing. We found a decreased HRV in the time domain with very low standard deviation in supine and standing position and during rhythmic breathing. HRV in the frequency domain was low with a decrease in the absolute power of HF and LF and a decrease in the sympathovagal balance in supine and standing positions. SBPV in the time and frequency domains was found to be normal. This patient with Holmes-Adie syndrome had an asymptomatic severe loss of HRV and a preserved SBPV. The global decrease in the HRV in the time and frequency domains indicated that she had both vagal and sympathetic cardiac denervation, whereas the preserved SBPV suggested normal innervation of the blood vessels.

Treatment of Acute Myeloid Leukemia with the FLT3 Gene Mutation.

In acute myeloid leukemia (AML), mutations of the Fms-like tyrosine kinase 3 receptor (FLT3) and its overexpression are related with hyperleukocytosis, higher risk of relapse, and decrease of both disease-free survival and overall survival. It has been suggested that this phenomenon confers proliferative and survival advantages to the malignant blast cells. As a consequence, it is an attractive therapeutic target. As the best treatment strategy for mutated FLT3 AML remains to be defined, the addition of FLT3 inhibitor drugs to chemotherapy or to the bone marrow transplant approach has become a growing strategy. With encouraging results, this combination seems to be an attractive option. Relevant data regarding the current treatment trends on mutated FLT3 AML is reviewed here.

Synthesis and Characterization of Bimetallic Ni50Pt50 Catalyst Supported on SiO2 for N2O Decomposition.

Nanometallic and bimetallic catalyst of Ni, Pt and Ni50Pt50 were studied by the decompositions of N2O. The catalyst were prepared by incipient wetness impregnation of the silica with low superficial area of 50 m2/g supported with aqueous solution of the metal precursors, for Pt H2Pt Cl6 x 6H2O was used and for Ni, Ni(NO3)2 was used to a total metal loading of 1% wt. Catalyst were oxidized for 2 hours at 400 degrees C with O2, then the samples were reduced for 30 minutes with N2 and 2 hours with H2, all at the same temperature. The catalyst was characterized by Transmission Electron Microscopy (TEM), High Angular Annular Dark Field (HAADF), High Resolution Transmission Electron Microscopy (HR-TEM) and Termoprogramed Reduction (TPR). The mean particle sizes obtained by TEM and HAADF were about 12.5 nm for Ni/SiO2, 2.8 nm for Pt/SiO2 and 3.5 nm Ni50Pt50/SiO2 catalysts respectability. HR-TEM and HAADF analysis showed differences between Ni and Pt catalysts displaying mainly cuboctahedral shapes. Stepped surface defects were found in the Ni50Pt50/SiO2 catalyst. Finally Ni50Pt50/SiO2 was more active than Pt/SiO2 and Ni/SiO2 catalysts for the decomposition of N2O.

Productivity and Composition of Fatty Acids in Chicks fed with Azadirachta indica A. Juss / Productividad y composición de ácidos grasos en pollos alimentados con Azadirachta indica A. Juss

Objective. Evaluate the productivity and composition of fatty acids in chicks fed diets enriched with neem Azadirachta indica A. Juss seed flour. Materials and methods. 80 mixed broiler chicks of Arbor Acres stock and levels 0, 1, 3 and 5% neem seed flour added to a commercial diet were evaluated. 20 experimental units were included in each treatment for five weeks. The consumption and weight gain were recorded, as well as the composition of fatty acids in the fat by means of alkaline transesterification. Data was statistically analyzed by a completely random procedure and the measurements were compared with the Tukey test(p≤0.05). Results. The greatest weight gain, consumption and best feed conversion were found in the treatment that contains 1% neem seed flour. It also produced the increase in the proportion of polyunsaturated fatty acids, especially linoleic acid (C18:2 Omega-6) and eicosapentaenoic acid (C20:5 omega-3), and the proportion of palmitic acid (C16:0). The consumption of feed diminished when 5% of neem flour was added. Conclusions. It was demonstrated that incorporating 1% neem seed flour in the diet of broiler chicks modifies the consumption of fatty acids without harming its productive behavior.

Objetivo. Evaluar la productividad y composición de ácidos grasos en pollos alimentados con dietas adicionadas con harina de semilla de neem Azadirachta indica A. Juss. Materiales y métodos. Se emplearon 80 pollos mixtos de la estirpe Arbor Acres de engorda y se evaluaron los niveles 0, 1, 3 y 5% de harina de semilla de neem añadidos a una dieta comercial. En cada tratamiento se tuvieron 20 unidades experimentales con una duración de cinco semanas. Se registró el consumo y la ganancia de peso, así como la composición de los ácidos grasos de la grasa mediante transesterificación alcalina. Los datos se analizaron estadísticamente por el procedimiento completamente al azar y las medias se compararon con la prueba de Tukey (p≤ 0.05). Resultados. La mayor ganancia de peso, consumo y la mejor conversión alimenticia correspondió al tratamiento que contenia 1% de harina de semilla de neem. También propició el aumento en la proporción de ácidos grasos poliinsaturados especialmente en el ácido linoleico, (C18:2 omega-6) y en el ácido eicosapentaenoico (C20:5 omega-3), y de manera concomitante se redujo la proporción del ácido palmítico (C16:0). El consumo de alimento disminuyó al adicionar 5% de harina de neem. Conclusiones. Se demostró que la incorporación de 1% de harina de semilla de neem en la dieta de los pollos de engorda modifica la composición de ácidos grasos sin perjudicar su comportamiento productivo.

Placa abollonada en surco nasogeniano / Nodular Plaque in the Nasolabial Fold

No disponible

Angioqueratoma de Fordyce unilateral / Unilateral Angiokeratoma of Fordyce

No disponible

Pellagra: a clinical, histopathological, and epidemiological study of 7 cases.

BACKGROUND AND OBJECTIVES: In the developed world, pellagra is a rare condition that is restricted to a small number of at-risk groups. It mainly affects alcoholic patients and those with dietary deficiencies, with intestinal malabsorption, or in treatment with certain drugs. The aim of this study was to analyze the clinical, histopathological, and epidemiological characteristics of patients diagnosed with pellagra in our hospital and to compare the results with the findings traditionally described for this disease. PATIENTS AND METHODS: We undertook a retrospective study of patients with clinical or pathological evidence of pellagra who were seen in our hospital between 1998 and 2009. RESULTS: Seven patients met the inclusion criteria. All were men and the most common predisposing factors were alcoholism and dietary deficiency. All exhibited photosensitivity mainly affecting the forearms and the upper surface of the feet, where the lesions were more severe. The most consistent histopathological findings were the presence of dilated blood vessels with extravasation and little or no inflammatory infiltrate. Various changes were observed in the epidermis, including those suggestive of mild pellagra, such as epidermal pallor and some degree of ballooning of the keratinocytes. Other abnormalities such as epidermal necrosis and hyperkeratosis were also observed. In most patients, pellagra was not initially suspected. Additional noncutaneous findings were observed in almost all cases. CONCLUSIONS: Pellagra should be ruled out in patients with lesions on sun-exposed areas. Predisposing factors for pellagra should be assessed along with the social situation of patients and the presence of digestive or neurological abnormalities.

Pelagra: estudio clínico, histopatológico y epidemiológico de 7 casos / Pellagra: A Clinical, Histopathological, and Epidemiological Study of 7 Cases

Introducción y objetivos: En el mundo desarrollado la pelagra es una entidad rara confinada a unos pocos grupos de riesgo. Afecta especialmente a personas alcohólicas, con transgresiones dietéticas, malabsorción intestinal o en tratamiento con determinados medicamentos. El objetivo del presente trabajo es realizar un estudio de las características clínicas, histopatológicas y epidemiológicas de los pacientes diagnosticados de pelagra en nuestro centro, y compararlo con los hallazgos «clásicos» de esta entidad. Pacientes y métodos: Se realiza un estudio retrospectivo de los pacientes con hallazgos clínicos y/o patológicos de pelagra en nuestro centro en el periodo comprendido entre 1998 y 2009. Resultados: Siete pacientes cumplían los criterios de inclusión. Todos eran varones y los factores predisponentes más importantes fueron el alcoholismo y la transgresión dietética. Todos mostraban un cuadro de fotosensibilidad, donde el dorso de los antebrazos fue el área más afectada y el dorso del pie la zona donde las lesiones eran más graves. Los hallazgos histopatológicos más constantes fueron la presencia de vasos dilatados asociados a una extravasación hemática, con escaso o nulo infiltrado inflamatorio. Los cambios epidérmicos fueron variados e incluyeron cambios sugestivos de pelagra en grado leve, como una palidez de la epidermis y cierto grado de balonización de los queratinocitos, pero también otras alteraciones como ampollas con necrosis epidérmica e hiperqueratosis. En la mayoría de los pacientes la sospecha clínica inicial no fue de pelagra. Casi todos asociaban una discreta clínica extracutánea. Conclusiones: Ante pacientes con lesiones en áreas fotoexpuestas se debe descartar pelagra. Para ello se deben investigar los factores predisponentes de pelagra, la situación social del paciente y la presencia de alteraciones digestivas y/o neurológicas (AU)

Background and objectives: In the developed world, pellagra is a rare condition that is restricted to a small number of at-risk groups. It mainly affects alcoholic patients and those with dietary deficiencies, with intestinal malabsorption, or in treatment with certain drugs. The aim of this study was to analyze the clinical, histopathological, and epidemiological characteristics of patients diagnosed with pellagra in our hospital and to compare the results with the findings traditionally described for this disease. Patients and methods: We undertook a retrospective study of patients with clinical or pathological evidence of pellagra who were seen in our hospital between 1998 and 2009. Results: Seven patients met the inclusion criteria. All were men and the most common predisposing factors were alcoholism and dietary deficiency. All exhibited photosensitivity mainly affecting the forearms and the upper surface of the feet, where the lesions were more severe. The most consistent histopathological findings were the presence of dilated blood vessels with extravasation and little or no inflammatory infiltrate. Various changes were observed in the epidermis, including those suggestive of mild pellagra, such as epidermal pallor and some degree of ballooning of the keratinocytes. Other abnormalities such as epidermal necrosis and hyperkeratosis were also observed. In most patients, pellagra was not initially suspected. Additional noncutaneous findings were observed in almost all cases. Conclusions: Pellagra should be ruled out in patients with lesions on sun-exposed areas. Predisposing factors for pellagra should be assessed along with the social situation of patients and the presence of digestive or neurological abnormalities (AU)

[Pellagra: a clinical, histopathological, and epidemiological study of 7 cases]. / Pelagra: estudio clínico, histopatológico y epidemiológico de 7 casos.

BACKGROUND AND OBJECTIVES: In the developed world, pellagra is a rare condition that is restricted to a small number of at-risk groups. It mainly affects alcoholic patients and those with dietary deficiencies, with intestinal malabsorption, or in treatment with certain drugs. The aim of this study was to analyze the clinical, histopathological, and epidemiological characteristics of patients diagnosed with pellagra in our hospital and to compare the results with the findings traditionally described for this disease. PATIENTS AND METHODS: We undertook a retrospective study of patients with clinical or pathological evidence of pellagra who were seen in our hospital between 1998 and 2009. RESULTS: Seven patients met the inclusion criteria. All were men and the most common predisposing factors were alcoholism and dietary deficiency. All exhibited photosensitivity mainly affecting the forearms and the upper surface of the feet, where the lesions were more severe. The most consistent histopathological findings were the presence of dilated blood vessels with extravasation and little or no inflammatory infiltrate. Various changes were observed in the epidermis, including those suggestive of mild pellagra, such as epidermal pallor and some degree of ballooning of the keratinocytes. Other abnormalities such as epidermal necrosis and hyperkeratosis were also observed. In most patients, pellagra was not initially suspected. Additional noncutaneous findings were observed in almost all cases. CONCLUSIONS: Pellagra should be ruled out in patients with lesions on sun-exposed areas. Predisposing factors for pellagra should be assessed along with the social situation of patients and the presence of digestive or neurological abnormalities.

Cisternal neurocysticercosis.

Endoscopic third-ventriculostomy followed by removal of multiple cisternal cysts was performed in a patient with hydrocephalus secondary to cisternal cysticercosis. Adjuvant pharmacological therapy with cystocidal drugs and steroids, was administered in the postoperative period.

Role of neuroendoscopy in the treatment of large viable cysticerci in the brain parenchyma.

Neuroendoscopy has never been used for diagnosis-making and removal of large parenchymal viable parasites associated with severe mass effect. Satisfactory and complication-free removal of the parenchymal cysticerci was achieved after neuroendoscopical diagnosis in a patient with parenchymal parasites, with immediate remission of clinical alterations related to raised intracranial pressure.

Bariatric surgery patients: reasons to visit emergency department after surgery

STUDY OBJECTIVE: Morbid obesity prevalence is reaching epidemic proportions in Western society. Long-term weight loss can be achieved by bariatric surgery. This surgery also has a positive impact in the reduction of obesity related co-morbid conditions. The purpose of this study is to determine the reasons that bariatric surgery patients had to visit the emergency department within a three month period after surgery. METHODS: A retrospective chart review study was performed at the UPR Hospital in Carolina. Patients with the diagnosis of morbid obesity who had bariatric surgery were identified. Of the 283 patients who met the criteria, the following information was obtained: gender, age, height, weight, pre-operative BMI, obesity-related comorbid conditions, post operative length of stay (LOS), and reasons and length of stay of Emergency Department (ED) visits within a 3 month period after surgery. Statistical analysis was done with Statistical Package for Social Sciences (SPSS) Program. RESULTS: The same profile of gender and BMI was obtained between the population that had the surgery and the sample that visited the ED, the group of patients between 20-29 years old was more likely to visit the ED. No correlation was found between a longer post operative length of stay and an increased probability of visiting the ED. Of the population, 5% had to visit ED within a three month period. The most common post operative complications were: Abdominal Pain (46.2%), Emesis (38.5%), and Dehydration (30.8%). Other less frequent complications were nausea, DVT, pneumonia, dizziness, gastritis, infected wound and upper GI bleeding. CONCLUSION: The most common reasons that bariatric surgery patients had to visit the emergency department within a three month period after surgery were: abdominal pain, emesis, dehydration and nausea. These complications could most likely be attributed to patient poor compliance with diet, resulting in the classical symptoms of the dumping...

Evaluation of functional improvement in older patients with cognitive impairment, depression and/or delirium admitted to a geriatric convalescence hospitalization unit.

Cognitive impairment, depression and delirium are problems of high prevalence in older patients. The geriatric convalescence unit (GCU) is a hospitalization facility offering an interdisciplinary geriatric intervention program that may be more appropriate for these patients. This study intended to analyze the functional improvement (FI) in older patients with cognitive impairment, depression and/or delirium admitted to a GCU. A group of 107 patients received specific nurse care, habitually performed in GCU and they also were included in a rehabilitation program. Cognitive impairment, depression and delirium were diagnosed according to standardized protocols. The analyzed variables were: age, functional status (Barthel index) before admission (BBA), at admission (BA) and at discharge(BD), diagnostic categories, cognitive function (mini mental state examination: MMSE) and post-discharge destination. The corrected Heinemann index (CHI) was used to evaluate FI obtained during GCU-stay, where CHI = 100 x (BD-BA)/(BBA-BA), and the efficiency index(El) was used to analyze the relationship between FI and the length of stay in the GCU,where El = (BD-BA)/(days in GCU). According to CHI, patients were divided in three groups. Group I: CHI = 0 or negative (patients who lost functional capacity during hospitalization,those who died or were transferred to hospital owing to acute deterioration. Group II: CHI < 35 % (high FI). Mean age was 77.6 +/- 9.1 years, the diagnostic categories were: fractures/orthopedics 49 (45.7 %), neurological 27(25.2 %), pulmonary/cardiologic 6 (5.6 %) and other cases 25 (23.3 %). Mean MMSE and BA scores were 16.9 +/- 9.4 and 29.6 +/- 18.9, respectively. Post-discharge destinations were:63 patients (58.8 %) returned home, 28 (26.1 %) were definitively institutionalized, 11 (10.2%) died and finally 5 (4.6 %) were transferred to acute care hospital. In-Group I, there were 35 patients (32.7 %) with a mean value of the El = 0.12 +/-1.1; in Group II, 13 (12.1 %) and 0.26 +/- 0.38; in Group III, 59 (55.1 %) and 0.94 +/- 0.97, respectively. In spite of the presence of cognitive impairment, depression and/or delirium, a high proportion of patients (67.2 %)obtained a significant improvement in their functional capacity.35 % (moderate FI). Group III: CHI >/=

Evaluation of alternative algorithms used to simulate pasture intake in grazing dairy cows.

Four algorithms used to simulate pasture intake in grazing dairy cows in a dairy decision support system were proposed and evaluated with data from the literature. The algorithms proposed were: 1) an algorithm combining the approach used in a published model to determine dry matter intake based on neutral detergent fiber intake as a percentage of the BW, energy requirements, pasture availability and a standard supplementation (PIest), 2) the previous algorithm modified to consider the type and amount of supplementation (PIsup), 3) an algorithm which considers the effect of selection of pasture (PIsel), and 4) the combination of algorithms 2 and 3 (PIsupsel). Pasture intake data of 27 grazing experiments from the literature were used to evaluate those algorithms. Two methods of evaluation were used: 1) simple linear regression between reported and simulated values, and 2) analysis of variance for the difference between reported and simulated values considering pasture availability and type of supplementation. The R2 of the linear regression and average proportional bias between reported values and simulated values were 0.24 and 19% for PIest, 0.42, and 23% for PIsup, 0.45 and 2% for PIsel and 0.41 and 10% for PIsupsel. Those results showed that PIsel had the lower variability and the values closer to pasture intake. The algorithm PIsup had low variability but tended to underpredict pasture intake. The algorithm PIest values were closer to reported values for low pasture availability. The modeling results show the influence of pasture selection in grazing systems.

[Development of a canine model of chronic progressive right ventricular hypertension]. / Desarrollo de un modelo canino de hipertensión ventricular derecha crónica progresiva.

INTRODUCTION: Several animal models of right ventricle hypertension (RVH) have been produced through pulmonary artery banding with linen, tygon or teflon. Nevertheless few devices attempting a progressive, step by step graduated chronic development of RVH have been reported. The present study describes the results in our animal model of chronic RVH. MATERIAL AND METHODS: We designed a software programmed to obtain hemodynamic data and installed a small occlusive hydraulic device (OHD) at the pulmonary artery trunk producing a raise in the right ventricular systolic pressure (RVSP); this pressure can be modified externally through the OHD. We studied 12 healthy mongrel dogs (18 to 28 kg of weight) in the course of 6 months. Hemodynamic measurements were performed at different RVSP at two months intervals; (Baseline, 40 mmHg and 60 mmHg). RESULTS: The software was useful to analyze several hemodynamic variables at each RVSP. At 60 mmHg, the end diastolic pressure of the right ventricle (RVEDP) increased from 4.2 +/- 0.4 mmHg to 13.2 +/- 1.1 mmHg, p < 0.000, accompanied with a fall in cardiac output adjusted to the dogs weight from 0.16 +/- 0.03 L/min/kg to 0.09 +/- 0.01 L/min/kg, p > 0.000. Also an increase of the end diastolic pressure of the left ventricle (LVEDP) from 7.4 +/- 0.8 mmHg to 16.3 +/- 2.8 mmHg, p < 0.000, was observed. RVSP was maintained in chronic condition and the intraclass correlation coefficient was 0.83, P < 0.005. CONCLUSIONS: Right ventricular chronic hypertension is created. The device is useful and reliable to maintain chronic increments of RVSP. The software permits a versatile analysis.