Healthy brain, healthy life: a review of diet and exercise interventions to promote brain health and reduce Alzheimer's disease risk.

With the world's population aging at a rapid rate, the prevalence of Alzheimer's disease (AD) has significantly increased. These statistics are alarming given recent evidence that a third of dementia cases may be preventable. The role of lifestyle factors, such as diet and exercise, can directly alter the risk of disease development. However, an understanding of the effectiveness of dietary patterns and exercise strategies to reduce AD risk or improve brain function is not fully understood. The aim of this review is to discuss the effects of diet and exercise on AD risk. Key components of the Western and Mediterranean diets are discussed in relation to AD progression, as well as how physical activity promotes brain health. Components of the Western diet (saturated fatty acids and simple carbohydrates) are detrimental to the brain, impair cognition, and increase AD pathologies. While components of the Mediterranean diet (polyunsaturated fatty acids, polyphenols, and antioxidants) are considered to be neuroprotective. Exercise can significantly reduce the risk of AD; however, specific exercise recommendations for older adults are limited and optimal intensity, duration, and type remains unknown. This review highlights important modifiable risk factors for AD and points out potential avenues for future research. Novelty Diet and exercise are modifiable factors that can improve brain health and reduce the risk of AD. Polyunsaturated fatty acids, polyphenols, and antioxidants are neuroprotective. Exercise reduces neuroinflammation, improves brain insulin sensitivity, and increases brain derived neurotrophic factor.

The decline of dengue in the Americas in 2017: discussion of multiple hypotheses.

OBJECTIVE: Since the 1980s, dengue incidence has increased 30-fold. However, in 2017, there was a noticeable reduction in reported dengue incidence cases within the Americas, including severe and fatal cases. Understanding the mechanism underlying dengue's incidence and decline in the Americas is vital for public health planning. We aimed to provide plausible explanations for the decline in 2017. METHODS: An expert panel of representatives from scientific and academic institutions, Ministry of Health officials from Latin America and PAHO/WHO staff met in October 2017 to propose hypotheses. The meeting employed six moderated plenary discussions in which participants reviewed epidemiological evidence, suggested explanatory hypotheses, offered their expert opinions on each and developed a consensus. RESULTS: The expert group established that in 2017, there was a generalised decreased incidence, severity and number of deaths due to dengue in the Americas, accompanied by a reduction in reported cases of both Zika and chikungunya virus infections, with no change in distribution among age groups affected. This decline was determined to be unlikely due to changes in epidemiological surveillance systems, as similar designs of surveillance systems exist across the region. Although sudden surveillance disruption is possible at a country or regional level, it is unlikely to occur in all countries simultaneously. Retrospective modelling with epidemiological, immunological and entomological information is needed. Host or immunological factors may have influenced the decline in dengue cases at the population level through immunity; however, herd protection requires additional evidence. Uncertainty remains regarding the effect on the outcome of sequential infections of different dengue virus (DENV) types and Zika virus (ZIKV), and vice versa. Future studies were recommended that examine the epidemiological effect of prior DENV infection on Zika incidence and severity, the epidemiological effect of prior Zika virus infection on dengue incidence and severity, immune correlates based on new-generation ELISA assays, and impact of prior DENV/other arbovirus infection on ZIKV immune response in relation to number of infections and the duration of antibodies in relation to interval of protection. Follow-up studies should also investigate whether increased vector control intensification activities contributed to the decline in transmission of one or more of these arboviruses. Additionally, proposed studies should focus on the potential role of vector competence when simultaneously exposed to various arboviruses, and on entomological surveillance and its impact on circulating vector species, with a goal of applying specific measures that mitigate seasonal occurrence or outbreaks. CONCLUSIONS: Multifactorial events may have accounted for the decline in dengue seen in 2017. Differing elements might explain the reduction in dengue including elements of immunity, increased vector control, and even vector and\or viruses changes or adaptations. Most of the results of this expert consensus group meeting are hypothetical and based on limited evidence. Further studies are needed.

OBJECTIF: Depuis les années 1980, l'incidence de la dengue a été multipliée par 30. Cependant, en 2017, il y a eu une réduction notable du nombre de cas d'incidence de dengue rapportés dans les Amériques. Nous voulions fournir des explications plausibles à la baisse en 2017. MÉTHODES: Un groupe d'experts constitué de représentants d'institutions scientifiques et académiques, d'officiels des Ministères de la Santé d'Amérique Latine et de membres du personnel de l'OPS/OMS s'est réuni en octobre 2017 pour proposer et évaluer des hypothèses. RÉSULTATS: En 2017, il y a eu une baisse généralisée de l'incidence, de la sévérité et du nombre de décès dus à la dengue dans les Amériques, accompagnée d'une réduction des cas rapportés d'infections par le virus Zika et par le virus du chikungunya, sans modification dans la répartition entre les groupes d'âge affectés. Il a été déterminé que ce déclin était peu probablement dû aux changements dans les systèmes de surveillance épidémiologique, étant donné que des systèmes de surveillance similaires existaient dans toute la région. Bien que des perturbations soudaines dans la surveillance soient possibles au niveau national ou régional, il est peu probable que cela se produise simultanément dans tous les pays. Une modélisation rétrospective avec des informations épidémiologiques, immunologiques et entomologiques est nécessaire. Des facteurs liés à l'hôte ou immunologiques peuvent avoir influencé le déclin des cas de dengue au niveau de la population par le biais de l'immunité; cependant, l'évidence d'une protection conférée par l'effet du troupeau nécessite des données supplémentaires. Une incertitude subsiste quant à l'effet sur le résultat des infections séquentielles de différents types du virus de la dengue (DENV) et du virus Zika (ZIKV), et vice-versa. Les études à venir devraient examiner (1) l'effet épidémiologique d'une infection antérieure par le DENV sur l'incidence et la sévérité du virus Zika, (2) l'effet épidémiologique d'une infection antérieure par le virus Zika sur l'incidence et la sévérité de la dengue, (3) les corrélats immunitaires basés sur des tests ELISA de nouvelle génération, (4) l' impact d'une infection antérieure à DENV/autres arbovirus sur la réponse immunitaire au ZIKV en fonction du nombre d'infections et de la durée des anticorps en fonction de l'intervalle de protection, (5) si des activités d'intensification de la lutte antivectorielle ont contribué à la diminution de la transmission d'un ou plusieurs de ces arbovirus, (6) le rôle potentiel de la compétence vectorielle lorsqu'ils sont exposés simultanément à différents arbovirus, (7) la surveillance entomologique et son impact sur la circulation d'espèces de vecteurs, dans le but d'appliquer des mesures spécifiques qui réduisent l'occurrence saisonnière d'épidémies. CONCLUSIONS: Des événements multifactoriels pourraient expliquer le déclin observé de la dengue en 2017. La plupart des résultats de cette réunion du groupe de consensus d'experts sont hypothétiques, reposent sur des données limitées et requièrent des investigations supplémentaires.

[Benzodiazepines, cognitive decline and dementia: A review of causality criteria from published observational studies]. / Impact des benzodiazépines sur les fonctions cognitives et le risque de démence. Revue des arguments de causalité issus des études observationnelles.

OBJECTIVE: Benzodiazepines are a source of well-known adverse reactions related to their pharmacological properties: memory disorders, falls in the elderly, confusion and sedation, drug addiction. The impact of their chronic use on cognitive decline and dementia has been the subject of many studies for two decades. METHODS: From 25 studies identified in the international literature from 1997 to 2017, the Bradford-Hill causality criteria were systematically applied. RESULTS: Fifteen studies found a statistically significant association with a deleterious effect, two a protective effect and eight did not find any association. The most recent studies using a longer delay to take into account a protopathic bias did not find any association or any dose-effect relationship. The majority of studies suggest impaired cognitive functions for contemporary consumption or those closest to the event being studied. Finally, the biological plausibility remains discussed. CONCLUSION: The question of the role of benzodiazepines in the onset of dementia remains open, and other studies attempting to limit previous methodological drawbacks should be carried out.

[Medico-legal implications of coronary angioplasty among seniors]. / Quels risques médico-légaux en cardiologie interventionnelle chez les personnes âgées ?

It's commonplace to declare that seniors are more fragile, because of a higher rate of comorbidities and complex coronary lesions. However, they take great benefit from angioplasty during acute coronary syndrome, with a higher rate of complications. Based on the study of claims reported to a French medical insurer, it is found that people over 75 years old among victims of interventional cardiology accidents is proportional to the population of seniors in the French population (around 10%). Conversely, the mortality of those seniors was much higher than patients under 75 (83% versus 30%). A strategy, which involves families and anticipates the risks of those fragile patients (fragility of structures, risk of decompensation of comorbidities [kidneys, hemostasis]) can help to prevent the risk of accidents, but may also reduce medico-legal implications of cardiologists.

[Cognitive decline in geriatric oncology: Trends, evaluation and treatment]. / Cancer de la personne âgée : rechercher, évaluer et prendre en charge le déclin cognitif.

Cancer prevalence increases with aging. Prevalent or incident neurocognitive disorders are frequent in geriatric oncology. Cognitive decline associated with cancer increases the risk of under or over-cancer treatment and makes therapeutic decisions complex. In this context, we present tools to optimize cognitive impairment screening, identification of underlying mechanisms and specific treatments. Geriatric specialists intervention can help global care, social services utilization and patient's orientation when ambulatory cares become difficult.

Effects of Diabetes Mellitus on Cognitive Decline in Patients with Alzheimer Disease: A Systematic Review.

Basic and clinical research support a link between diabetes mellitus and Alzheimer disease (AD). However, the relationship with AD progression is unclear. This review focuses on the association between diabetes and cognitive decline in patients with AD. The literature published through May 2015 was searched in 3 databases: PubMed, Embase and Cochrane. Studies evaluating the effects of diabetes on patients with AD or cognitive decline were included, and extracted data were analyzed. A total of 10 articles met the inclusion criteria for review. The results of these studies were inconsistent in terms of the association between diabetes and cognitive decline. Only 2 studies demonstrated that the presence of diabetes was independently related to the progression of cognitive decline in the patients with AD, and 3 studies suggested that histories of diabetes were not correlated with the changes in cognitive function in patients with AD. Half of the included studies even indicated that histories of diabetes were associated with lesser declines in cognitive function in patients with AD. Current evidence indicates that the link between diabetes and cognitive decline in patients with AD is uncertain. Further clinical studies are needed, with larger samples, long-term follow up and an extended battery of cognitive assessments.

Sobre as selfies com os mortos: o estatuto da imagem da morte na atualidade / About the selfies with the dead: The status of the image of death in the current days / Sur les “selfies” avec les morts: le status de l’image de la mort de nos jours

Este artigo busca investigar o fenômeno contemporâneo da amplificação da captura, visualização e compartilhamento de imagens gráficas da morte pela internet, visando apreender a que se deve essa maneira de lidar com tal sorte de imagem na qual impera a obscenidade. Empreendemos esforços no sentido de elucidar o porquê desse olhar despudorado, buscando articular esse fenômeno tanto à ideia de uma suposta perversão generalizada, quanto à suposição de que o referido fenômeno seja apenas mais um índice do rebaixamento do pacto simbólico e de todas as consequências a ele vinculados(AU)

The article aims to investigate the contemporary phenomenon of the broad capture, visualization and sharing of graphic images of death on the internet, trying to apprehend the motives behind this way of dealing with this kind of image in which obscenity prevails. We make an effort to clarify the reasons of this lack of compunction, trying to articulate this phenomenon to the idea of a presumed generalized perversion and also to the supposition that the referred phenomenon is just another indication of the demotion of the symbolic pact and every consequence that is linked to it(AU)

Ce travail cherche a investiguer le phénomène contemporain de l’amplification de la capture, de la visualisation et du partage de photographies de la mort sur internet, visant comprendre ce qui motive cette manière de faire face a des images dans lesquelles l’obscenité est prevalente. Nous nous efforçons a élucider les raisons pour um tel manque de pudeur en cherchant à articuler ce phénomène a l’idée d’une possible perversion géneralisée et aussi a la supposition selon laquelle ledit phénomène n’est qu’une autre indication du rabaissement du pacte symbolique et de toutes les conséquences qui lui sont liées(AU)

Sobre as selfies com os mortos: o estatuto da imagem da morte na atualidade / About the selfies with the dead: The status of the image of death in the current days / Sur les “selfies” avec les morts: le status de l’image de la mort de nos jours

Este artigo busca investigar o fenômeno contemporâneo da amplificação da captura, visualização e compartilhamento de imagens gráficas da morte pela internet, visando apreender a que se deve essa maneira de lidar com tal sorte de imagem na qual impera a obscenidade. Empreendemos esforços no sentido de elucidar o porquê desse olhar despudorado, buscando articular esse fenômeno tanto à ideia de uma suposta perversão generalizada, quanto à suposição de que o referido fenômeno seja apenas mais um índice do rebaixamento do pacto simbólico e de todas as consequências a ele vinculados...

The article aims to investigate the contemporary phenomenon of the broad capture, visualization and sharing of graphic images of death on the internet, trying to apprehend the motives behind this way of dealing with this kind of image in which obscenity prevails. We make an effort to clarify the reasons of this lack of compunction, trying to articulate this phenomenon to the idea of a presumed generalized perversion and also to the supposition that the referred phenomenon is just another indication of the demotion of the symbolic pact and every consequence that is linked to it

Ce travail cherche a investiguer le phénomène contemporain de l’amplification de la capture, de la visualisation et du partage de photographies de la mort sur internet, visant comprendre ce qui motive cette manière de faire face a des images dans lesquelles l’obscenité est prevalente. Nous nous efforçons a élucider les raisons pour um tel manque de pudeur en cherchant à articuler ce phénomène a l’idée d’une possible perversion géneralisée et aussi a la supposition selon laquelle ledit phénomène n’est qu’une autre indication du rabaissement du pacte symbolique et de toutes les conséquences qui lui sont liées...

Intracerebral haemorrhage and cognitive decline.

Relationships between intracerebral hemorrhage (ICH) and dementia might be of interest since some causes of ICH such as cerebral amyloid angiopathy are strongly linked with dementia, especially Alzheimer's disease. The aim of this narrative review was to highlight the interesting relationship of ICH lesions and cognitive decline leading to dementia. We considered the whole spectrum of hemorrhagic lesions in the brain parenchyma, namely spontaneous ICH and brain microbleeds.

A geração criada por mulheres: o pai e o masculino no Clube da Luta / The generation raised by women: the father and the masculine in the Film Fight Club / La generación creada por mujeres: el padre y el masculino en el Club de la Pelea / La génération créée par femmes: le père et la masculinité dans le Fight Club

O presente trabalho discute questões relativas à paternidade e ao masculino. Freud iniciou sua clínica em um momento marcado por um modelo particular de família, no qual existia um discurso que delineava a masculinidade e a paternidade e as conjugava ao discurso religioso. No discurso religioso, havia um modelo consistente do que se esperava e um lugar determinado para o homem e para o pai na família e na sociedade. Desde 1938, Lacan ressaltou a degradação do papel do pai, e caracterizou a nossa época como marcada pelo declínio da função paterna. Partindo da ideia de que a crise contemporânea tem como ponto basilar esse declínio da função paterna, faz-se necessário investigar a diferença entre os conceitos que são utilizados nessa via, como os de imagem, imago, papel e função paternas. Ademais, buscamos atingir o cerne de nossa investigação verificando o modo como são trabalhadas as questões relativas à paternidade, ao masculino e ao viril no filme Clube da Luta, de 1999. O filme foi baseado no romance homônimo escrito por Chuck Palahniuk e publicado em 1996, no qual o protagonista narra sua história e os eventos que o levaram à criação de clubes de luta.(AU)

The present work discusses issues related to paternity and to masculinity. Freud started his clinic works during a moment marked for a particular family model, when there was a discourse that delineated masculinity and paternity, linked to the religious discourse. The religious discourse, at that time, provided a consistent model of what was expected, and a determined place for the man and the father in family and society. Since 1938, Lacan emphasized the degradation of the father role, pointing out that our time is marked by the declination of the father function. Starting from the idea that the contemporary crisis is based in this decline of the father function, it is necessary to investigate the differences among the concepts that are often used in this path, such as father image, imago, role and function. In addition, we attempt to get to the core of our investigation by verifying the way that issues concerning paternity, masculinity and virility are addressed in the movie Fight Club, of 1999. The movie was based on the homonymous novel written by Chuck Palahniuk and published in 1996, in which the protagonist narrates his story and the events that lead to the creation of Fight Clubs.(AU)

El presente trabajo discute cuestiones relativas a la paternidad y lo masculino. Freud empezó su práctica clínica en un momento marcado por un modelo particular de familia, en lo cual existía un discurso que delineaba la masculinidad y la paternidad y éstas se ligaban al discurso religioso. En el discurso religioso, había un modelo consistente de lo que se esperaba y un lugar determinado para el hombre y para el padre en la familia y en la sociedad. Desde 1938, Lacan ha resaltado la degradación del papel de padre, y ha caracterizado nuestro tiempo como marcado por la declinación de la función paterna. Partiendo de la idea que la crisis contemporánea tiene como punto basilar la declinación de la función paterna, se hace necesario investigar la diferencia entre los conceptos que son utilizados en esta vía, como los conceptos de imagen, imago, papel y función paternas. Además, buscamos alcanzar el núcleo de nuestra investigación verificando el modo como son trabajadas las cuestiones relativas a la paternidad, lo masculino y lo viril en la película El club de la Pelea, de 1999. La película fue basada en la novela homónima escrita por Chuck Palahniuk y publicada en 1996, en la cual el protagonista narra su historia y los eventos que llevaran a creación de clubes de pelea.(AU)

Ce travail article traite de questions relatives à la paternité et au sexe masculin. Freud a créé sa clinique dans une période marquée par le discours religieux délimitant la masculinité et la paternité et entrafnant ainsi un modèle particulier de la famille. Ce modèle était cohérent avec une place bien déterminée pour lhomme et le père dans la famille et dans la société. À partir de 1938, Lacan souligne la dégradation du róle du père dans une époque marquée par le déclin de la fonction paternelle. En partant de l'idée que ce dernier est à lorigine de la crise contemporaine, il nous reste à étudier la différence entre les concepts qui y sont liés, comme ceux de l'image, de llmago, du róle et de la fonction paternelle. De plus, nous illustrerons notre recherche en analysant la manière dont sont abordées les questions relatives à la paternité, au sexe masculin et à la virilité dans le film Fight Club, 1999. Ce film est une adaptation du roman éponyme écrit par Chuck Palahniuk (1996) dans lequel le protagoniste raconte son histoire et les événements qui lont mené à la création du Fight Club.(AU)

A geração criada por mulheres: o pai e o masculino no Clube da Luta / The generation raised by women: the father and the masculine in the Film Fight Club / La generación creada por mujeres: el padre y el masculino en el Club de la Pelea / La génération créée par femmes: le père et la masculinité dans le Fight Club

O presente trabalho discute questões relativas à paternidade e ao masculino. Freud iniciou sua clínica em um momento marcado por um modelo particular de família, no qual existia um discurso que delineava a masculinidade e a paternidade e as conjugava ao discurso religioso. No discurso religioso, havia um modelo consistente do que se esperava e um lugar determinado para o homem e para o pai na família e na sociedade. Desde 1938, Lacan ressaltou a degradação do papel do pai, e caracterizou a nossa época como marcada pelo declínio da função paterna. Partindo da ideia de que a crise contemporânea tem como ponto basilar esse declínio da função paterna, faz-se necessário investigar a diferença entre os conceitos que são utilizados nessa via, como os de imagem, imago, papel e função paternas...

The present work discusses issues related to paternity and to masculinity. Freud started his clinic works during a moment marked for a particular family model, when there was a discourse that delineated masculinity and paternity, linked to the religious discourse. The religious discourse, at that time, provided a consistent model of what was expected, and a determined place for the man and the father in family and society. Since 1938, Lacan emphasized the degradation of the father role, pointing out that our time is marked by the declination of the father function. Starting from the idea that the contemporary crisis is based in this decline of the father function, it is necessary to investigate the differences among the concepts that are often used in this path, such as father image, imago, role and function...

El presente trabajo discute cuestiones relativas a la paternidad y lo masculino. Freud empezó su práctica clínica en un momento marcado por un modelo particular de familia, en lo cual existía un discurso que delineaba la masculinidad y la paternidad y éstas se ligaban al discurso religioso. En el discurso religioso, había un modelo consistente de lo que se esperaba y un lugar determinado para el hombre y para el padre en la familia y en la sociedad. Desde 1938, Lacan ha resaltado la degradación del papel de padre, y ha caracterizado nuestro tiempo como marcado por la declinación de la función paterna. Partiendo de la idea que la crisis contemporánea tiene como punto basilar la declinación de la función paterna, se hace necesario investigar la diferencia entre los conceptos que son utilizados en esta vía, como los conceptos de imagen, imago, papel y función paternas. Además, buscamos alcanzar el núcleo de nuestra investigación verificando el modo como son trabajadas las cuestiones relativas a la paternidad, lo masculino y lo viril en la película El club de la Pelea, de 1999...

Ce travail article traite de questions relatives à la paternité et au sexe masculin. Freud a créé sa clinique dans une période marquée par le discours religieux délimitant la masculinité et la paternité et entrafnant ainsi un modèle particulier de la famille. Ce modèle était cohérent avec une place bien déterminée pour lhomme et le père dans la famille et dans la société. À partir de 1938, Lacan souligne la dégradation du róle du père dans une époque marquée par le déclin de la fonction paternelle. En partant de l'idée que ce dernier est à lorigine de la crise contemporaine, il nous reste à étudier la différence entre les concepts qui y sont liés, comme ceux de l'image, de llmago, du róle et de la fonction paternelle. De plus, nous illustrerons notre recherche en analysant la manière dont sont abordées les questions relatives à la paternité, au sexe masculin et à la virilité dans le film Fight Club, 1999...