Luis Carlos Abecia

A long‐term physical activity training program increases strength and flexibility, and improves balance in older adults

Purpose: Physical activity training programs in older adults have recognized health benefits. Evidence suggests that training should include a combination of progressive resistance, balance, and functional training. Our aim was to assess the effects of a simple physical activity program working on strength, flexibility, cardiovascular fitness, and balance in older adults, as well as the effects of a detraining period, at various different ages. Methods: This was longitudinal prospective study, including a convenience sample of 227 independent older adults (54 men, 173 women) who completed a simple 9‐month training program and 3‐month detraining follow‐up. The subjects were categorized into two age groups (65–74 [n = 180], and >74 years [n = 47]). At the beginning of the study (baseline), the end of the training period, and 3 months later (postdetraining), body mass index, body fat percentage, triceps skinfold thickness, hand grip strength, lower limb and trunk flexibility, resting heart rate, heart rate after exercise, and balance were measured, while VO2 max was estimated using the Rockport fitness test and/or measured directly. Results: Significant improvements in strength (p < .0001), flexibility (p < .0001), heart rate after exercise (p < .0001), and balance (p < .0001) were observed at the end of the training program. Flexibility and balance (p < .0001) improvements were maintained at the end of the detraining. Conclusion: A simple long‐term physical activity training program increases strength in both sexes, improves flexibility in women, and improves balance in older adults. The results also indicate the importance of beginning early in old age and maintaining long‐term training.

Sibutramine Decreases Body Weight Gain and Increases Energy Expenditure in Obese Zucker Rats without Changes in NPY and Orexins

Abstract The aim of the present work was to describe the effects of sibutramine on body weight and adiposity and to establish the potential involvement of neuropeptide Y (NPY) and orexins in the anorectic action of this drug. Male obese Zucker rats were daily administered with sibutramine (10 mg/kg, intraperitoneal) for two weeks. Carcass composition was assessed using the official methods of the Association of Official Analytical Chemists. Total body oxygen consumption was measured daily for 60 min before sibutramine or saline injection and for 30 min (from 60 to 90 min) after drug or saline injection. Hypothalamic arcuate and paraventricular nuclei, and the lateral hypothalamic area were immunostained for NPY, orexin A and orexin B. Commercial kits were used for serum determinations. Reductions in body weight and adipose tissue weights were observed after sibutramine treatment in obese Zucker rats. No changes in NPY immunostaining in the arcuate and paraventricular nuclei were found. Orexin A and orexin B immunostaining was not modified in the lateral hypothalamic area in treated rats. The reduction in body weight and adiposity induced by sibutramine was achieved by both a reduction in food intake and an increase in energy expenditure. NPY and orexins do not seem to be involved in the anorectic effect of sibutramine.

Effects of fluoxetine administration on mu-opoid receptor immunostaining in the rat forebrain

Fluoxetine is a selective serotonin reuptake inhibitor. Analysis of mu-opioid receptor immunostaining after chronic fluoxetine administration in rats revealed an increase in the density of cells expressing mu-opioid receptors in the caudatus-putamen, the dentate gyrus, the lateral septum and the frontal, parietal and piriform cortices. These data suggest that mu-opioid receptor expression in the rat forebrain is altered by in vivo chronic fluoxetine treatment.

Lithium alters mu-opioid receptor expression in the rat brain.

Lithium can potentiate the effects of antidepressant drugs and alters morphine analgesia and phosphoinositide turnover. Analysis of mu-opioid receptor immunostaining after chronic lithium administration in rats revealed an increase in the density of cells expressing mu-opioid receptors in the caudatus-putamen, the dentate gyrus, the lateral septum and the frontal, parietal and piriform cortices. These data suggest that mu-opioid receptor expression in the rat forebrain is altered by in vivo chronic lithium treatment. This could be a compensatory mechanism, induced in part by the effects of lithium on mu-opioid receptor transduction mechanism.

Coste del tratamiento del cáncer de mama por estadío clínico en el País Vasco

Fundamentos: La carga economica de la asistencia sanitaria del cancer de mama es importante. En el contexto de la evaluacion del programa de cribado de cancer de mama del Pais Vasco es importante conocer los costes unitarios actuales del diagnostico y el coste de los tratamientos desagregados por el estadio clinico de deteccion. El objetivo de este estudio fue calcular los costes total y desagregado por componentes del tratamiento del cancer de mama (CM) segun estadio clinico en el ano 2011. Metodos: Los costes sanitarios se estimaron desde el diagnostico hasta la finalizacion de los tratamientos y seguimiento a partir del consumo de recursos y los costes unitarios del Sistema Vasco de Salud. La tecnica aplicada fue el metodo de micro-costes a partir de las guias de practica clinica. Resultados: El coste inicial fue de 9.838 € en el estadio 0, de 17.273 € en el I, de 22.145 € en el II y de 28.776 € en el III. El coste del seguimiento anual fue de 172 € en el estadio 0, de 908 € en el I, de 994 € en el II y de 1.166 € en el III. El coste anual del estadio IV fue de 17.879 €. Conclusiones: El componente de mayor coste es la quimioterapia. Los dos determinantes principales del coste total del cancer de mama son el tratamiento inicial de los estadios I a III y el coste del estadio IV alcanzando este ultimo los 50.061 € por paciente.

El coste de la aplicación de la Ley de Dependencia a la enfermedad de Alzheimer

AIM To calculate the formal cost of social care for people with Alzheimer disease according to the implementation of the dependency law in Gipuzkoa (Spain). METHOD A retrospective observational study was carried out of the database of the Dependency Care Services of Gipuzkoa from 2007 to 2012, using a prevalence-based bottom-up approach. RESULTS The average annual formal cost per person was €11,730. The annual population cost was €34.7 million, representing 19% of the annual expenditure corresponding to the dependency law and 29% of the total cost of Alzheimer disease. CONCLUSIONS Despite the implementation of the new law, most of the burden of the disease is bourne by the family.

Nefazodone Alters NPY Immunostaining in Rat Arcuate-paraventricular Projection without Changes in Food Intake and Body Weight

Abstract Nefazodone is an antidepressant drug that inhibits serotonin and noradrenaline reuptake. The aim of the present work was to study the effects of nefazodone on food intake, body weight, adiposity and hypothalamic NPY immunostaining in rats. For this purpose, male Sprague-Dawley rats (3-month-old) were administered with nefazodone (20 mg/kg; i.p) daily for two weeks. The control group was given 0.9% NaCl solution. Hypothalamic arcuate, paraventricular, periventricular, supraoptic and suprachiasmatic nuclei and the lateral hypothalamic area were immunostained for NPY. Chronic nefazodone administration in rats did not modify food intake, body weight and adipose depot size (subcutaneous, perirenal and epidydimal white adipose tissues, and interscapular brown adipose tissue). However, a significant decrease in paraventricular NPY immunostaining was found in the nefazodone group compared with the control group. No changes in other hypothalamic regions such as arcuate, periventricular, supraoptic and suprachiasmatic nuclei, and lateral and medial preoptic areas were observed. Because nefazodone is an α1-adrenoceptor antagonist, it can be proposed that the expected decrease in food intake after nefazodone administration, due to its effects on NPY arcuate-paraventricular projection, could be masked by the opposite orexigenic effect of α1-adrenoceptor blockade.