BACKGROUND: The diagnostic delay of cardiac amyloidosis (CA) is known to be substantially long. A prolonged time from symptoms onset to diagnosis negatively impacts quality of life and life expectancy of the affected patients. We aim to describe the role of the incidental finding of amyloid deposits in prostatic tissue as an early marker of CA. METHODS: A systematic cardiological evaluation, comprising ECG, echocardiogram and 99mTc-DPD scintigraphy, was offered to a cohort of 19 patients with incidental prostatic amyloidosis (PA) findings, propectively detected between 2014-2023, to assess cardiac involvement. RESULTS: The median age of the patients was 80.2 years (IQR: 74.9 -82.6 years). Histopathological study revealed amyloid deposits within the walls of small vessels (predominantly small arteries) in 18 patients and mainly in the stroma in the remaining case. All of them were immunohistochemically positive for transthyretin (ATTR) except one patient, with known myeloma, which was unconclusive fo ATTR. Clonal dyscrasia was excluded in the rest of the patients. Thirteen patients (68.4%) underwent all cardiological tests, 4 patients (21.1%) underwent only ECG and echocardiographic evaluation and two patients (10.5%) refused to undergo any cardiological study. Among 13 individuals undergoing the complete evaluation, six patients were eventually diagnosed with CA (46.15%). All of them were asymptomatic from a cardiovascular point of view at the time of the prostate biopsy. CONCLUSION The finding of PA should prompt a complete cardiovascular examination, given the significant percentage of patients eventually diagnosed with early-stage CA. Multidisciplinary collaboration among different medical specialists must be encouraged, given the potential clinical impact of CA early diagnosis.

Purpose: Our objective was to synthesize and determine whether there are sex differences in physical function following exercise interventions in older adults. Materials and Methods: A systematic search was conducted in four databases from inception to July 8th, 2023 searching for prospective trials that conducted exercise interventions in older adults and results for physical function were reported by sex.Pooled standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were estimated using a randomeffects method. The Sidik-Jonkman estimator was used to calculate the variance of heterogeneity (I2 ). Results: A total of 19 studies involving 20,133 older adults (mean age ≥60 years, 33.7% female) were included. After exercise interventions, males reported significantly greater pre-post changes compared to females for upper body strength (SMD=-0.40, 95% CI: -0.71 to -0.09; I2 =75.6%; n=8), lower body strength (SMD=-0.32, 95% CI: -0.55 to -0.10; I2 =52.0%; n=11), and cardiorespiratory fitness (SMD=-0.29, 95% CI: -0.48 to -0.10; I2 =89.1%; n=12). Conversely, the pooled SMDs showed a significant effect favoring females for motor fitness (SMD=0.21, 95% CI: 0.03 to 0.39; I2 =0%; n=7). Limited and inconsistent results were observed for flexibility. Conclusions Our study suggests the existence of sex-related differences on physical function after an exercise intervention in the older population.

Purpose: Our objective was to synthesize and determine whether there are sex differences in physical function following exercise interventions in older adults. Materials and Methods: A systematic search was conducted in four databases from inception to July 8th, 2023 searching for prospective trials that conducted exercise interventions in older adults and results for physical function were reported by sex.Pooled standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were estimated using a randomeffects method. The Sidik-Jonkman estimator was used to calculate the variance of heterogeneity (I2 ). Results: A total of 19 studies involving 20,133 older adults (mean age ≥60 years, 33.7% female) were included. After exercise interventions, males reported significantly greater pre-post changes compared to females for upper body strength (SMD=-0.40, 95% CI: -0.71 to -0.09; I2 =75.6%; n=8), lower body strength (SMD=-0.32, 95% CI: -0.55 to -0.10; I2 =52.0%; n=11), and cardiorespiratory fitness (SMD=-0.29, 95% CI: -0.48 to -0.10; I2 =89.1%; n=12). Conversely, the pooled SMDs showed a significant effect favoring females for motor fitness (SMD=0.21, 95% CI: 0.03 to 0.39; I2 =0%; n=7). Limited and inconsistent results were observed for flexibility. Conclusions Our study suggests the existence of sex-related differences on physical function after an exercise intervention in the older population.

Purpose: Our objective was to synthesize and determine whether there are sex differences in physical function following exercise interventions in older adults. Materials and Methods: A systematic search was conducted in four databases from inception to July 8th, 2023 searching for prospective trials that conducted exercise interventions in older adults and results for physical function were reported by sex.Pooled standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were estimated using a randomeffects method. The Sidik-Jonkman estimator was used to calculate the variance of heterogeneity (I2 ). Results: A total of 19 studies involving 20,133 older adults (mean age ≥60 years, 33.7% female) were included. After exercise interventions, males reported significantly greater pre-post changes compared to females for upper body strength (SMD=-0.40, 95% CI: -0.71 to -0.09; I2 =75.6%; n=8), lower body strength (SMD=-0.32, 95% CI: -0.55 to -0.10; I2 =52.0%; n=11), and cardiorespiratory fitness (SMD=-0.29, 95% CI: -0.48 to -0.10; I2 =89.1%; n=12). Conversely, the pooled SMDs showed a significant effect favoring females for motor fitness (SMD=0.21, 95% CI: 0.03 to 0.39; I2 =0%; n=7). Limited and inconsistent results were observed for flexibility. Conclusions Our study suggests the existence of sex-related differences on physical function after an exercise intervention in the older population.

Purpose: Our objective was to synthesize and determine whether there are sex differences in physical function following exercise interventions in older adults. Materials and Methods: A systematic search was conducted in four databases from inception to July 8th, 2023 searching for prospective trials that conducted exercise interventions in older adults and results for physical function were reported by sex.Pooled standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were estimated using a randomeffects method. The Sidik-Jonkman estimator was used to calculate the variance of heterogeneity (I2 ). Results: A total of 19 studies involving 20,133 older adults (mean age ≥60 years, 33.7% female) were included. After exercise interventions, males reported significantly greater pre-post changes compared to females for upper body strength (SMD=-0.40, 95% CI: -0.71 to -0.09; I2 =75.6%; n=8), lower body strength (SMD=-0.32, 95% CI: -0.55 to -0.10; I2 =52.0%; n=11), and cardiorespiratory fitness (SMD=-0.29, 95% CI: -0.48 to -0.10; I2 =89.1%; n=12). Conversely, the pooled SMDs showed a significant effect favoring females for motor fitness (SMD=0.21, 95% CI: 0.03 to 0.39; I2 =0%; n=7). Limited and inconsistent results were observed for flexibility. Conclusions Our study suggests the existence of sex-related differences on physical function after an exercise intervention in the older population.

Purpose: Our objective was to synthesize and determine whether there are sex differences in physical function following exercise interventions in older adults. Materials and Methods: A systematic search was conducted in four databases from inception to July 8th, 2023 searching for prospective trials that conducted exercise interventions in older adults and results for physical function were reported by sex.Pooled standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were estimated using a randomeffects method. The Sidik-Jonkman estimator was used to calculate the variance of heterogeneity (I2 ). Results: A total of 19 studies involving 20,133 older adults (mean age ≥60 years, 33.7% female) were included. After exercise interventions, males reported significantly greater pre-post changes compared to females for upper body strength (SMD=-0.40, 95% CI: -0.71 to -0.09; I2 =75.6%; n=8), lower body strength (SMD=-0.32, 95% CI: -0.55 to -0.10; I2 =52.0%; n=11), and cardiorespiratory fitness (SMD=-0.29, 95% CI: -0.48 to -0.10; I2 =89.1%; n=12). Conversely, the pooled SMDs showed a significant effect favoring females for motor fitness (SMD=0.21, 95% CI: 0.03 to 0.39; I2 =0%; n=7). Limited and inconsistent results were observed for flexibility. Conclusions Our study suggests the existence of sex-related differences on physical function after an exercise intervention in the older population.

BACKGROUND: The prevalence of heart failure (HF) increases with age, and it is one of the leading causes of hospitalization and death in older patients. However, there are little data on in-hospital mortality in patients with HF ≥ 75 years in Spain. METHODS: A retrospective analysis of the Spanish Minimum Basic Data Set was performed, including all HF episodes discharged from public hospitals in Spain between 2016 and 2019. Coding was performed using the International Classification of Diseases, 10^th Revision. Patients ≥ 75 years with HF as the principal diagnosis were selected. We calculated: (1) the crude in-hospital mortality rate and its distribution according to age and sex; (2) the risk-standardized in-hospital mortality ratio; and (3) the association between in-hospital mortality and the availability of an intensive cardiac care unit (ICCU) in the hospital. RESULTS: We included 354,792 HF episodes of patients over 75 years. The mean age was 85.2 ± 5.5 years, and 59.2% of patients were women. The most frequent comorbidities were renal failure (46.1%), diabetes mellitus (35.5%), valvular disease (33.9%), cardiorespiratory failure (29.8%), and hypertension (26.9%). In-hospital mortality was 12.7%, and increased with age [odds ratio (OR) = 1.07, 95% CI: 1.07-1.07, P < 0.001] and was lower in women (OR = 0.96, 95% CI: 0.92-0.97, P < 0.001). The main predictors of mortality were the presence of cardiogenic shock (OR = 19.5, 95% CI: 16.8-22.7, P < 0.001), stroke (OR = 3.5, 95% CI: 3.0-4.0, P < 0.001) and advanced cancer (OR = 2.6, 95% CI: 2.5-2.8, P < 0.001). In hospitals with ICCU, the in-hospital risk-adjusted mortality tended to be lower (OR = 0.85, 95% CI: 0.72-1.00, P = 0.053). CONCLUSIONS In-hospital mortality in patients with HF ≥ 75 years between 2016 and 2019 was 12.7%, higher in males and elderly patients. The main predictors of mortality were cardiogenic shock, stroke, and advanced cancer. There was a trend toward lower mortality in centers with an ICCU.

PURPOSE: The delayed diagnosis of colorectal cancer (CRC) may be attributable to sociodemographic characteristics, to aspects of tumour histopathology or to the functioning of the health system. We seek to determine which of these factors most influences prolonged patient-attributable delay (PPAD) in the diagnosis and treatment of CRC. MATERIALS AND METHODS: A prospective, multicentre observational study was conducted in 22 Spanish hospitals. In total, 1,785 patients were recruited to the study between 2010 and 2012 and underwent elective or urgent surgery. PPAD is considered to occur when the time elapsed between a patient presenting the symptom and him/her seeking attention from the primary care physician or hospital emergency department exceeds 180 days. A bivariate analysis was performed to assess differences in variables segmented by tumour location and patient delay. Multivariate logistic regression analysis was performed on the outcome variable, PPAD. RESULTS: The rate of PPAD among this population was 12.1%. PPAD was significantly associated with altered bowel rhythm (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.02 to 1.83) and with adenocarcinoma histology, in comparison with mucinous adenocarcinoma (OR, 2.03; 95% CI, 1.11 to 3.71). Other sociocultural factors and clinicopathological features were not independent predictors of PPAD. CONCLUSION: Many patients do not consider altered bowel rhythm an alarming symptom, warranting a visit to the doctor. PPAD could be reduced by improving health education, raising awareness of CRC-related symptoms.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Colorectal Neoplasms* ; Delayed Diagnosis ; Diagnosis* ; Emergency Service, Hospital ; Health Education ; Humans ; Logistic Models ; Observational Study ; Physicians, Primary Care ; Prospective Studies

Objectives: The study and use of marine and fresh water microalgae in therapy is a very recent phenomenon. Fresh water microalgae are used in food and to a lesser extent in cosmetics, however, not much is known about the applications of marine microalgae.   The Department of Applied Physics at the University of Vigo (Spain) has developed a marine microalgae culture system, and the species obtained are used to prepare products fit for thalassotherapy and spa treatments.   The aim of this study is to develop a procedure for designing, manufacturing and characterising spa products made from marine microalgae. Method: The growing interest in natural tested quality products for use in Spas has stimulated the search for product mixtures frequently used in Spas, such as clays and medicinal-mineral waters, with laboratory cultivated microalgae to guarantee quality and optimum growth.   A review of scientific literature on the applications of marine microalgae in skin care was the first stage in this study.   Marine microalgae are a source of vitamins, pigments, proteins and other beneficial substances for the skin (Spolaore et al, 2006). Only a few microalgae species are consolidated in the skin care market, wherein the principal ones are Chlorella and Spirulina (Stolz et al, 2005). Protein rich extracts of Spirulina have been used in cosmetics for preventing stretch marks and extracts from Chlorella vulgaris have been used to stimulate collagen synthesis in skin, thereby fostering tissue regeneration and reduction of wrinkles (Stolz et al, 2005). Other microalgae used are Nannochloropsis oculata and Dunaliella salina. Tests done with an extract of Nannochloropsis oculata have shown that this microalga acts as an optimum protective sheath against oxidative stress and positively influences collagen synthesis (Stolz et al, 2005). An ingredient of Nannochloropsis oculata has excellent skin elasticity properties (short and long-term) and was already in the market in 2005 (Stolz et al, 2005).   Microalgae culture has been on the rise in the past years. This is generally done in tanks or pools using a controlled culture medium and with either natural or fluorescent light that imitates the natural solar cycle (photobioreactors).   A species of Nanocloropsis was selected to study its use in Spas. This is an alga which can be cultivated using photobioreactors such that its growth and profitability can be controlled.   Mixtures with varying proportions of clays and mineral waters and seawaters were prepared.   Research equipment was used to analyse the behaviour of the mixtures. To that end, density, specific heat and thermal conductivity, which are important thermophysical properties, were used to assess these products for heat therapy. Results and Discussion: The preliminary studies have provided results on culture conditions of the microalgae. Results of heat behaviour were also collected using varying mixtures of clays and waters.   These results show that marine microalgae can be used in Spa treatments either in baths or as poultices, thus indicating that thermal retention capacity is improved upon mixture with clays, an aspect which is important for their use in heat therapy.