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Here, we report on the role of haptoglobin (Hp), whose expression depends on the synthesis of interleukin 6 (IL-6), related to the pathogenesis of multiple sclerosis (MS), as a possible marker of muscle improvement achieved after treatment with the polyphenol epigallocatechin gallate (EGCG) and an increase in the ketone body beta-hydroxybutyrate (BHB) in the blood. After 4 months of intervention with 27 MS patients, we observed that Hp does not significantly increase, alongside a significant decrease in IL-6 and a significant increase in muscle percentage. At the same time, Hp synthesis is considerably and positively correlated with IL-6 both before and after treatment, while this correlation occurs significantly reversed with muscle percentage before treatment, no correlation is evident after the intervention. These results seem to indicate that Hp could be a marker of muscle status and could be a diagnosis tool after therapeutic intervention in MS patients.

Background: One of the pathogenic mechanisms of ALS disease is perturbed energy metabolism particularly glucose metabolism. Given the substantial difference in the severity and the prognosis of the disease, depending on whether it has a bulbar or spinal onset, the aim of the study was to determine metabolic differences between both types of ALS, as well as the possible relationship with muscle function. Materials and Methods: A descriptive, analytical, quantitative, and transversal study was carried out in hospitals and Primary Care centers in the region of Valencia, Spain. Fasting glucose and alkaline phosphatase (AP) levels in venous blood, muscle percentage, fat percentage, muscle strength (MRC scale), and functional capacity (Barthel Index) were measured in 31 patients diagnosed with ALS (20 with spinal onset ALS and 11 with bulbar onset ALS). A healthy control of 29 people was included. Results: No significant differences were observed in blood AP and glucose levels between spinal onset and bulbar onset ALS patients. However, a significant positive correlation was observed between the mean values of both substances in patients with spinal onset ALS. Moreover, a lower percentage of muscle mass and a higher percentage of fat mass were also seen in spinal ALS patients, who also presented lower muscle strength and lower functional capacity. Conclusion: The results of this study seem to point to a possible difference in the peripheral use of glucose between patients with bulbar onset ALS and spinal onset ALS, who appear to have possible insulin resistance. These metabolic differences could explain the lower muscle percentage and lower muscular function in spinal onset ALS patients, although further studies are required.

Background: Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease, characterized by progressive loss of spinal and cortical motor neurons, leading to muscular atrophy, respiratory failure, and ultimately death. There is no known cure, and the clinical benefit of the two drugs approved to treat ALS remains unclear. Novel disease-modifying therapeutics that are able to modulate the disease course are desperately needed. Our objective was to evaluate the efficacy and tolerability of Elysium Health's candidate drug EH301 in people with ALS (PALS). Methods: This was a single-center, prospective, double-blind, randomized, placebo-controlled pilot study. Thirty-two PALS were recruited thanks to the collaboration of the Spanish Foundation for ALS Research (FUNDELA). Study participants were randomized to receive either EH301 or placebo and underwent evaluation for 4 months. Differences between EH301 and placebo-treated participants were evaluated based on standard clinical endpoints, including the revised ALS functional rating scale (ALSFRS-R), forced vital capacity (FVC), and the Medical Research Council (MRC) grading scale. Results: Compared to placebo, participants treated with EH301 demonstrated significant improvements in the ALSFRS-R score, pulmonary function, muscular strength, and in skeletal muscle/fat weight ratio. EH301 was shown to significantly slow the progression of ALS relative to placebo, and even showed improvements in several key outcome measures compared with baseline. Conclusions: This study provides evidence in support of the disease-modifying effects of EH301 for the treatment of ALS. Catholic University San Vicente Mártir (grant 2017-216-001). University of Valencia (grant OTR2017-18255INVES). 3.286 JCR (2019) Q2, 68/204 Clinical Neurology 1.249 SJR (2019) Q1, 40/169 Neurology No data IDR 2019 UEV

It is known that stress and immune systems are related with Alzheimer’s disease (AD). However, the relationship of both systems in the progression of disease is not clearly demonstrated. Hair cortisol and salivary immunoglobulin A (IgA) were quantified in 49 patients with mild, moderate, and severe AD. A significant change was seen in both molecules as AD progressed from mild to moderate and severe. Low levels of cortisol were observed in mild AD patients compared with moderate and severe. However, IgA showed a contrary pattern. High levels were observed in mild AD patientes but low in moderate and severe AD subjects. The secretion of cortisol and IgA seems to be very different at the start compared with posterior development of AD suggesting that neuroinflammation can be involved. Both molecules could be used as possible therapeutical tools. Sin financiación 3.606 JCR (2019) Q2, 101/271 Neurosciences; Q3, 102/195 Cell Biology 1.126 SJR (2019) Q1, 415/2754 Medicine (miscellaneous); Q2, 136/300 Cell Biology; Q3, 48/89 Cellular and Molecular Neuroscience No data IDR 2019 UEV

OBJECTIVE: To evaluate the effectiveness of the implementation of a short protocol of music therapy as a tool to reduce stress and improve the emotional state in patients with mild Alzheimer's disease. METHODS: A sample of 25 patients with mild Alzheimer's received therapy based on the application of a music therapy session lasting 60 min. Before and after the therapy, patient saliva was collected to quantify the level of salivary cortisol using the Enzyme-Linked ImmunoSorbent Assay (ELISA) immunoassay technique and a questionnaire was completed to measure anxiety and depression (Hospital Anxiety and Depression Scale). RESULTS: The results show that the application of this therapy lowers the level of stress and decreases significantly depression and anxiety, establishing a linear correlation between the variation of these variables and the variation of cortisol. CONCLUSIONS: A short protocol of music therapy can be an alternative medicine to improve emotional variables in Alzheimer patients. Sin financiación 1.868 JCR (2018) Q2, 12/27 Integrative & Complementary Medicine 0.532 SJR (2018) Q1, 25/109 Complementary and Alternative Medicine No data IDR 2018 UEV

BackgroundChronic stress during adolescence has usually been evaluated through subjective measures, leaving aside objective measures such as hair cortisol concentrations. Therefore, the aim of this study was to provide reference ranges for hair cortisol concentrations by sex and age and to study the relationship between subjective and objective measures of stress and temporal stability.MethodsThe participants were 170 adolescents aged between 12 and 14 years (mean = 12.78 years; standard deviation = 0.71 years; 52.40% girls) who completed the Perceived Stress Scale 4 and had their hair sampled.ResultsThe results revealed hair cortisol concentrations ranging from 0.07 pg/mg to 9.54 pg/mg. Subjective and objective measures of stress were not related, nor was there intraindividual stability of the hair cortisol concentrations. Girls had higher hair cortisol concentrations, and there were no age differences.ConclusionsThis research provides cortisol reference values for adolescents that will allow the early detection of chronic stress. Such detection methods make it possible to prevent problems arising from stress because we can act more quickly and the treatments will be more effective. The study suggests that there is no relationship between perceived and objective stress; while perceived stress remained stable, the levels of hair cortisol were increased at 6 months. Despite the interesting findings of the study, there are some limitations: the sample was not obtained through probabilistic sampling, the age range was narrow, and some demographic, anthropomorphic and clinical factors are missing, which make the generalization of results difficult.

The understanding of how the immune system works, as well as its relationship with the stress level, seems to be important at the start of the Alzheimer’s disease (AD). To analyze this, immunoglobulin A (IgA) and cortisol in saliva were measured using ELISA in patients with mild AD and healthy volunteers, and the production of both biomarkers was compared and correlated. In participants without AD, IgA was higher when cortisol was lower, and the opposite happened in participants with AD, with the quantification in saliva being a suitable method to determine it. Sin financiación 1.635 SJR (2017) Q1, 12/108 Geriatrics and Gerontology, 239/2885 Medicine (miscellaneous), 64/529 Psychiatry and Mental Health, 34/154 Neuroscience (miscellaneous), 22/270 Clinical Psychology UEV

Resumen Introducción: la enfermedad de Alzheimer es a día de hoy la demencia neurodegenerativa con mayor prevalencia en el primer mundo. Este hecho, unido a la falta de tratamiento farmacológico que cure la enfermedad, hace que se estudien nuevas estrategias terapéuticas no farmacológicas como es la administración de nutrientes. En este sentido, destaca la posible influencia del aceite de coco como fuente energética alternativa, capaz de frenar la muerte neuronal que se produce de modo progresivo en esta enfermedad. Objetivos: valorar el impacto del aceite de coco a nivel cognitivo en pacientes de alzhéimer, y concretamente en las áreas de orientación, lenguaje-construcción, fijación, cálculo-concentración y memoria. Métodos: estudio prospectivo, longitudinal, cualitativo, analítico y experimental a través de un ensayo clínico, donde se seleccionaron a 44 pacientes con alzhéimer de la zona de la Ribera (Comunidad Valenciana), de los cuales a la mitad se le administró durante 21 días, 40 ml diarios de aceite de coco repartidos entre desayuno (20 ml) y comida (20 ml). Antes y después de la administración del aceite, se les valoró a través del test cognitivo Mini-Examen Cognoscitivo, para determinar los posibles cambios. Resultados: en los enfermos que tomaron el aceite de coco se observó una mejora cognitiva tras finalizar la intervención, siendo estadísticamente significativa en las áreas de orientación y lenguaje-construcción. Conclusiones: el aceite de coco parece mejorar la capacidad cognitiva de los enfermos de alzhéimer, variando la intensidad de la misma en función del área cognitiva.

Introduction: Alzheimer’s disease is one of the most prevalent neurodegenerative dementia in developed world. This fact, coupled with the lack cure, makes new no pharmacological therapeutic strategies such as nutrient management to investigate. In this regard, it stresses the possible influence of coconut oil as alternative energy source capable of stopping the progressively neuronal death that occurs in this disease. Objectives: To assess the cognitive impact of coconut oil in Alzheimer’s patients, and specifically in orientation, language-building, fixing, calculation-concentration and memory areas. Methods: Prospective, longitudinal, qualitative, analytical and experimental study through a clinical trial where 44 patients with Alzheimer’s in region of Ribera (Valencia), of which half was selected to receive during 21 days, 40 ml coconut oil daily divided between breakfast (20 ml) and food (20 ml). Before and after administration of the oil, they were evaluated through cognitive test Mini-Mental State Examination to determine possible changes. Results: It was observed in patients who received coconut oil, that cognitive improvement after completion of the intervention, statistically significant improved in the orientation and language-construction areas. Conclusions: Coconut oil appears to improve cognitive abilities of Alzheimer’s patients, with different intensity depending on the cognitive area.Introducción: la enfermedad de Alzheimer es a día de hoy la demencia neurodegenerativa con mayor prevalencia en el primer mundo. Este hecho, unido a la falta de tratamiento farmacológico que cure la enfermedad, hace que se estudien nuevas estrategias terapéuticas no farmacológicas como es la administración de nutrientes. En este sentido, destaca la posible influencia del aceite de coco como fuente energética alternativa, capaz de frenar la muerte neuronal que se produce de modo progresivo en esta enfermedad. Objetivos: valorar el impacto del aceite de coco a nivel cognitivo en pacientes de alzhéimer, y concretamente en las áreas de orientación, lenguaje-construcción, fijación, cálculo-concentración y memoria. Métodos: estudio prospectivo, longitudinal, cualitativo, analítico y experimental a través de un ensayo clínico, donde se seleccionaron a 44 pacientes con alzhéimer de la zona de la Ribera (Comunidad Valenciana), de los cuales a la mitad se le administró durante 21 días, 40 ml diarios de aceite de coco repartidos entre desayuno (20 ml) y comida (20 ml). Antes y después de la administración del aceite, se les valoró a través del test cognitivo Mini-Examen Cognoscitivo, para determinar los posibles cambios. Resultados: en los enfermos que tomaron el aceite de coco se observó una mejora cognitiva tras finalizar la intervención, siendo estadísticamente significativa en las áreas de orientación y lenguaje-construcción. Conclusiones: el aceite de coco parece mejorar la capacidad cognitiva de los enfermos de alzhéimer, variando la intensidad de la misma en función del área cognitiva.

Alzheimer's dementia is the most prevalent nowadays. As for treatment, there is no definitive cure drug, thus new therapies are needed. In this regard the medium chain triglycerides are a direct source of cellular energy and can be a nonpharmacological alternative to the neuronal death for lack of it, that occurs in Alzheimer patients.to evaluate the impact of coconut oil in the development of Alzheimer's dementia, in any degree of dementia. Also determine whether this improvement influences within variables such as sex and suffering or not Type II Diabetes Mellitus.a prospective study was conducted in patients with Alzheimer's dementia, with a control and an intervention group which was administered 40 ml/day of extra virgin coconut oil. The parameters evaluated were the mini test scores Lobo cognitive test, pre and post intervention in both groups.it was observed in subjects taking the product, a statistically significant increase in test score MECWOLF and therefore an improvement in cognitive status, improving especially women's, those without diabetes mellitus type II, and severe patients.this study, although preliminary, demonstrated the positive influence of coconut oil at the cognitive level of patients with Alzheimer's, this improvement being dependent on sex, presence or absence of diabetes and degree of dementia.Introducción: la enfermedad de Alzheimer es la demencia más prevalente en la actualidad. En cuanto al tratamiento, no existe cura farmacológica definitiva, con lo cual son necesarias nuevas alternativas terapéuticas. En este sentido, los triglicéridos de cadena media suponen una fuente directa de energía celular y pueden ser una alternativa no farmacológica a la muerte neuronal por falta de la misma, que se produce en los enfermos de Alzheimer. Objetivo: evaluar el impacto que tiene el aceite de coco en la evolución de la demencia tipo Alzheimer, en cualquier grado de demencia. Asimismo, determinar si existe influencia en dicha mejora, de variables como el sexo y padecer o no diabetes mellitus tipo II. Material y métodos: estudio prospectivo realizado en pacientes con demencia tipo Alzheimer, con un grupo control y un grupo de intervención al que se le administró 40 ml/día de aceite de coco virgen extra. Los parámetros evaluados han sido las puntuaciones del test del miniexamen cognoscitivo de Lobo, pre y postintervención en ambos grupos. Resultados: se observó en los sujetos que tomaban el producto un aumento estadísticamente significativo de la puntuación del test MEC-LOBO y, por consiguiente, una mejoría del estado cognitivo, mejorando sobre todo las mujeres, los que no tenían diabetes mellitus tipo II y los pacientes graves. Conclusión: este estudio, aunque preliminar, demuestra la influencia positiva del aceite de coco a nivel cognitivo en los pacientes con Alzheimer, siendo esta mejoría dependiente del sexo, de la existencia o no de diabetes y del grado de demencia.

Objective To determine the morbidity of malignant and pre-malignant skin lesions and people’s knowledge about preventing sun exposure and dangerous habits. Methods A retrospective longitudinal study and one descriptive transversal study were conducted with a population of 25,956 inhabitants using the Abucasis® program, and 201 questionnaires were administered to patients in an emergency department; SPSS 15.0 for Windows program was then used. Results In six years there were 228 cases of actinic keratosis, 26 melanoma and 32 malignant neoplasms of the skin. It was found that 63.7% of the population believed that sufficient solar prevention campaigns were not performed, 50.2% were unaware of the warning signs of skin cancer, and the most widely used measure used for protection was the use of sunscreens. Conclusion The morbidity of malignant and premalignant skin lesions in the Manises population quadrupled and the knowledge about preventing sun exposure is insufficient.