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There is no specific recommendation for nutrition therapy for critically ill older adults. However, targeting energy and protein balance and avoiding fasting could improve outcomes in this population with high-risk nutrition outcomes. This study aimed to evaluate the associations between nutrition and mortality/functionality in critically ill older patients.A single-center retrospective observational study of critically ill patients aged 65 years or older was conducted. We extracted data from the dietitian evaluations on energy, protein, and the type of diet (fasting, oral, enteral, or parenteral) prescribed in the first week of intensive care unit admission. Primary outcomes were intrahospital mortality and independence and functional capacity evaluated after hospital discharge.Of the 2043 patients screened, 533 were included in the study. Most patients were men (52.1%), with a median age of 73 (68-78) years. Overall, the intrahospital mortality rate was 53.8%. Simplified Acute Physiology Score 3 (SAPS 3), serum albumin and C-reactive protein levels, and surgical patients were independently associated with fasting in a multivariate analysis. The multivariate regression analyses showed that SAPS 3, serum albumin level, and fasting were independently associated with mortality. Each fasting day increases the risk of mortality by 16.7%. Also, independence and functional capacity were not related to nutrition prescription.Older adults (65 years or older) constitute a fragile population in whom nutrition breaks were associated with increased hospital mortality. Furthermore, a prospective clinical trial is necessary to establish the best strategy to feed this population.

Background: The search for new markers for breast cancer (BC) has been sought in order to better understand this type of cancer. The Heart and Neural Crest Derivatives Expressed Transcript 2 (HAND2) has been related to endometrial cancer but there are scant data related to BC. The aim of this study is to compare the immunohistochemical expression of HßAND2 in normal breast tissue vs. BC and to correlate with the estrogen receptor (ERα). Patients and Methods: In this case-control study, 19 formalin–fixed, paraffin-embedded tissues were obtained from pathological archives. Benign (n=9; control) and cancer (n=10) breast tissue were analyzed with immunohistochemistry for HAND2 (Ab60037), at dilution 1:50 at pH 9 and ERα (SP1). ImageJ software with "color deconvolution" was used for analysis of the expression of these proteins. The sample size was calculated (power=95%, α error= 1%) to identify an increase from mean 15 DAB units (control) to 40 DAB units in cancer. Results: HAND2 expression (mean ± SD) was 15.5 ± 6.1 (cancer) versus 44.8 ± 21.1 (control) (P=0.002, Student t-test). Its expression was mainly present in the cytosol of the cells. No correlation was observed between ERα and HAND2 (Pearson r = -0.28 (95%CI=-0.6 to 0.22; P=0.2). Conclusions: The protein expression of HAND2, using Ab60037 antibody, is reduced in breast cancer, compared with normal breast tissue. The expression of HAND2 is not correlated with ERα expression.

Background & aims: Critically ill patients with body mass index (BMI) < 20 kg/m2 have worse outcomes than normal/overweight patients possibly because underweight is a marker of malnutrition. To assess the effects of nutrition therapy in this population during the first week of an ICU stay. Methods: Prospective, 2-centre, observational study. Nutritional evaluations were performed between days 2 and 3 (first) and between days 5 and 7 (second) of ICU admission. In the first evaluation, patients were divided into non-fed (without nutritional support) and early-fed (those already receiving nutritional support) groups. In the second evaluation, patients were divided according to caloric intake (≥or

Context: Resveratrol has been used for the treatment of endometriosis. Objective: To compare resveratrol (40 mg/d) with monophasic contraceptive pill (COC) to COC with placebo for the reduction of pain scores. Design: A randomized clinical trial. Setting: University Hospital. Patients: Women (ages 20 to 50) with laparoscopic diagnosis of endometriosis were eligible for the study. Exclusion criteria: pregnancy, allergy to resveratrol, or contraindications to COC, use of agonists of gonadotropin release hormone or danazol in the last month, or had used depot medroxyprogesterone acetate or Mirena®. Intervention: Subjects were randomized using a computer-generated randomization list to receive COC for 42 days to be taken with identical capsules containing 40 mg of resveratrol or placebo in coded bottles (1:1 ratio). Allocation was concealed in coded, sequenced, opaque-sealed envelopes. Main Outcome: Median pain scores measured with a visual analog scale on day 42. Results: Between 18 June and 6 November 2015, 44 subjects were enrolled. Mean [95% confidence interval (CI)] pain scores on day 0 were 5.4 (4.2 to 6.6) in the placebo group and 5.7 (4.8 to 6.6) in resveratrol groups. After treatment, pain values were [3.9 (2.2 to 5); n = 22] and [3.2 (2.1 to 4.3); n = 22] in the placebo and resveratrol groups, respectively (P = 0.7; Mann-Whitney U test). Median (95% CI) difference between groups was 0.75 (–1.6 to 2.3). Conclusion: Resveratrol is not superior to placebo for treatment of pain in endometriosis., Resveratrol, a natural phytoestrogen, has been suggested as a possible treatment option for women with endometriosis. This study is a randomized, double-blinded, placebo-controlled clinical trial.

Fiber intake is associated with better glycemic control being an important nonpharmacologicaltreatment for diabetes (DM). We hypothesize that a dietary fiber intake can bringbenefits to diabetic kidney disease (DKD), improving renal outcomes. This systematic review aimedto evaluate the effect of dietary fiber (supplemental or dietary pattern rich in fiber) on DKD. Wesearched six databases to identify clinical trials that reported fiber intake and renal outcomes(albuminuria, proteinuria, estimated glomerular filtration rate (eGFR) dialysis) in patients with DM.From 1814 studies, 48 papers were fully evaluated. In the end, seven trials (161 patients, aged 58.3years, 49% females) were included. The studies were organized into three categories (vegetarian,Dietary Approaches to Stop Hypertension (DASH) diet, and fiber supplement), two evaluatedsupplements and five dietary patterns. Vegetarian diet reduced albuminuria in three trials, two inpatients with type 1 DM and one in patients with type 2 DM; and one study demonstrated a change inthe eGFR in type 1 DM. The individual quality of the studies was low/uncertain. A vegetarian dietarypattern may have a beneficial effect on these renal outcomes. However, the individual effect of theintake of fiber on DKD not was possible to be evaluated.