Geriatrics Institute

Sherbrooke, Canada

Geriatrics Institute

Sherbrooke, Canada

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Levis S.,University of Miami | Levis S.,Geriatrics Institute | Strickman-Stein N.,University of Miami | Doerge D.R.,U.S. Food and Drug Administration | Krischer J.,University of South Florida
Contemporary Clinical Trials | Year: 2010

Following the results of the Women's Health Initiative, many women now decline estrogen replacement at the time of menopause and seek natural remedies that would treat menopausal symptoms and prevent bone loss and other long-term consequences of estrogen deficiency, but without adverse effects on the breast, uterus, and cardiovascular system. The results of most soy studies in this population have had limitations because of poor design, small sample size, or short duration. This report describes the study rationale, design, and procedures of the Soy Phytoestrogens As Replacement Estrogen (SPARE) study, which was designed to determine the efficacy of soy isoflavones in preventing spinal bone loss and menopausal symptoms in the initial years of menopause. Women ages 45 to 60 without osteoporosis and within 5 years from menopause were randomized to receive soy isoflavones 200 mg daily or placebo for 2 years. Participants have yearly measurements of spine and hip bone density, urinary phytoestrogens, and serum lipids, thyroid stimulating hormone, and estradiol. Menopausal symptoms, mood changes, depression, and quality of life are assessed annually. The SPARE study recruited 283 women, 66.1% were Hispanic white. With a large cohort, long duration, and large isoflavone dose, this trial will provide important, relevant, and currently unavailable information on the benefits of purified soy isoflavones in the prevention of bone loss and menopausal symptoms in the first 5 years of menopause. Given the high proportion of Hispanics participating in the study, the results of this trial will also be applicable to this minority group.


Castellano C.-A.,Geriatrics Institute | Castellano C.-A.,Université de Sherbrooke | Plourde M.,Geriatrics Institute | Plourde M.,Université de Sherbrooke | And 5 more authors.
Food and Chemical Toxicology | Year: 2014

The aim of the present study was to perform a short-term safety evaluation of dietary mono-conjugated α-linolenic acid isomers (CLNA; c9-t11-c15-18:3. +. c9-t13-c15-18:3) using a neonatal pig model. CLNA diet was compared with three other dietary fats: (1) conjugated linoleic acid (CLA; c9-t11 18:2. +. t10-c12-18:2), (2) non-conjugated n-3 PUFA and (3) n-6 PUFA. Thirty-two piglets weaned at 3. weeks of age were distributed into four dietary groups. Diets were isoenergetic and food intake was controlled by a gastric tube. Mono-CLNA diet did not significantly change body or organ weight, carcass composition and most biochemical parameters including; glucose, cholesterol, triglycerides, creatinine, blood urea nitrogen, hepatic enzymes and electrolytes levels in blood ( P≥. 0.09). Conversely, the n-3 PUFA composition of the brain, liver and heart decreased by 6-21% in the CLNA-fed group compared to animals fed nonconjugated n-3 PUFA ( P<. 0.01). Responses to dietary treatments were tissue-specific, with the liver and the brain being the most deprived in n-3 PUFA. Our results support that short-term intake of mono-CLNA is safe in neonatal pigs but n-3 PUFA reduction in tissues deserves to be further investigated before using long-term nutritional supplementation in pigs and other animal models and before moving to clinical trials. © 2013 .


Castellano C.-A.,Geriatrics Institute | Castellano C.-A.,Université de Sherbrooke | Baillargeon J.-P.,Université de Sherbrooke | Plourde M.,Geriatrics Institute | And 6 more authors.
European Journal of Nutrition | Year: 2014

Purpose: There is an increased interest in the benefits of conjugated α-linolenic acid (CLNA) on obesity-related complications such as insulin resistance and diabetes. The aim of the study was to investigate whether a 1 % dietary supplementation of mono-CLNA isomers (c9-t11-c15-18:3 + c9-t13-c15-18:3) improved glucose and lipid metabolism in neonatal pigs. Methods: Since mono-CLNA isomers combine one conjugated two-double-bond system with an n-3 polyunsaturated fatty acid (PUFA) structure, the experimental protocol was designed to isolate the dietary structural characteristics of the molecules by comparing a CLNA diet with three other dietary fats: (1) conjugated linoleic acid (c9-t11-18:2 + t10-c12-18:2; CLA), (2) non-conjugated n-3 PUFA, and (3) n-6 PUFA. Thirty-two piglets weaned at 3 weeks of age were distributed among the four dietary groups. Diets were isoenergetic and food intake was controlled by a gastric tube. After 2 weeks of supplementation, gastro-enteral (OGTT) and parenteral (IVGTT) glucose tolerance tests were conducted. Results: Dietary supplementation with mono-CLNA did not modify body weight/fat or blood lipid profiles (p > 0.82 and p > 0.57, respectively) compared with other dietary groups. Plasma glucose, insulin, and C-peptide responses to OGTT and IVGTT in the CLNA group were not different from the three other dietary groups (p > 0.18 and p > 0.15, respectively). Compared to the non-conjugated n-3 PUFA diet, CLNA-fed animals had decreased liver composition in three n-3 fatty acids (18:3n-3; 20:3n-3; 22:5n-3; p < 0.001). Conclusions: These results suggest that providing 1 % mono-CLNA is not effective in improving insulin sensitivity in neonatal pigs. © 2013 Springer-Verlag Berlin Heidelberg.


Castellano C.-A.,Geriatrics Institute | Castellano C.-A.,Université de Sherbrooke | Nugent S.,Geriatrics Institute | Nugent S.,Université de Sherbrooke | And 12 more authors.
Journal of Alzheimer's Disease | Year: 2014

Background: The cerebral metabolic rate of glucose (CMRg) is lower in specific brain regions in Alzheimer's disease (AD). The ketones, acetoacetate and β-hydroxybutyrate, are the brain's main alternative energy substrates to glucose.Objective: To gain insight into brain fuel metabolism in mild AD dementia by determining whether the regional CMR and the rate constant of acetoacetate (CMRa and Ka, respectively) reflect the same metabolic deficit reported for cerebral glucose uptake (CMRg and Kg).Methods: Mild AD dementia (Mild AD; n = 10, age 76 y) patients were compared with gender- and age-matched cognitively normal older adults (Controls; n = 29, age 75 y) using a PET/MRI protocol and analyzed with both ROI- and voxel-based methods.Results: ROI-based analysis showed 13% lower global CMRg in the gray matter of mild AD dementia versus Controls (34.2 ± 5.0 versus 38.3 ± 4.7 μmol/100 g/min, respectively; p = 0.015), with CMRg and Kg in the parietal cortex, posterior cingulate, and thalamus being the most affected (p ≤ 0.022). Neither global nor regional CMRa or Ka differed between the two groups (all p ≥ 0.188). Voxel-based analysis showed a similar metabolic pattern to ROI-based analysis with seven clusters of significantly lower CMRg in the mild AD dementia group (uncorrected p ≤ 0.005) but with no difference in CMRa.Conclusion: Regional brain energy substrate hypometabolism in mild AD dementia may be specific to impaired glucose uptake and/or utilization. This suggests a potential avenue for compensating brain energy deficit in AD dementia with ketones. © 2015 - IOS Press and the authors.


PubMed | Geriatrics Institute and Université de Sherbrooke
Type: Journal Article | Journal: Journal of Alzheimer's disease : JAD | Year: 2014

The cerebral metabolic rate of glucose (CMRg) is lower in specific brain regions in Alzheimers disease (AD). The ketones, acetoacetate and -hydroxybutyrate, are the brains main alternative energy substrates to glucose.To gain insight into brain fuel metabolism in mild AD dementia by determining whether the regional CMR and the rate constant of acetoacetate (CMRa and Ka, respectively) reflect the same metabolic deficit reported for cerebral glucose uptake (CMRg and Kg).Mild AD dementia (Mild AD; n = 10, age 76 y) patients were compared with gender- and age-matched cognitively normal older adults (Controls; n = 29, age 75 y) using a PET/MRI protocol and analyzed with both ROI- and voxel-based methods.ROI-based analysis showed 13% lower global CMRg in the gray matter of mild AD dementia versus Controls (34.2 5.0 versus 38.3 4.7 mol/100 g/min, respectively; p = 0.015), with CMRg and Kg in the parietal cortex, posterior cingulate, and thalamus being the most affected (p 0.022). Neither global nor regional CMRa or Ka differed between the two groups (all p 0.188). Voxel-based analysis showed a similar metabolic pattern to ROI-based analysis with seven clusters of significantly lower CMRg in the mild AD dementia group (uncorrected p 0.005) but with no difference in CMRa.Regional brain energy substrate hypometabolism in mild AD dementia may be specific to impaired glucose uptake and/or utilization. This suggests a potential avenue for compensating brain energy deficit in AD dementia with ketones.


Wang Z.-W.,Geriatrics Institute | Wang Z.-W.,Henan University of Traditional Chinese Medicine | Li J.-S.,Geriatrics Institute | Li J.-S.,Henan University of Traditional Chinese Medicine | And 4 more authors.
Chinese Critical Care Medicine | Year: 2011

Objective: To investigate the common syndromes, clinical symptoms and characteristics of chronic obstructive pulmonary disease at acute exacerbation stage (AECOPD). Methods: Delphi method was used to organize the AECOPD expert questionnaire. This questionnaire was distributed to 30 selected experts of respiratory diseases. The resulting data were statistically analyzed by Chi-square test and statistical description such as mean, coefficient of variation and ratio of full marks. Common syndrome, mean ≥3.00, coefficient of variation <30% and ratio of full marks ≥ 10% and common clinical symptoms: for major symptoms present, the index mean ≥4.00 and coefficient of variation <30% and for minor symptom, index mean ≥3.00 and coefficient of variation <30% were used as criteria. Results: Twenty-nine valid expert questionnaires were received. The coefficient of positivity was 96-67%, of authority was 0-835 and of coordination equals 0.359 (χ 2 = 463. 15, P = 0.001). The mean, coefficient of variation and ratio of full marks for AECOPD syndrome of wind and cold invasion of lung were 4.12, 21.50%, and 34.48%, respectively. Those for syndrome of exogenous cold-evil and fluid-retention were 4.39, 14.32%, 48.28%; those for syndrome of wind and heat invasion of lung were 3-54, 30.77%, 6.90%(those for syndrome of phlegm-heat obstruction of the lung were 4.85, 9.23%, 89-66%; those for syndrome of pulmonary stagnation of phlegm were 4-36, 15.57%, 48.28%; those for syndrome of external cold and internal heat were 4.59, 16.27%, 65-52%; those for syndrome of retention of phlegm and blood stasis in the lung were 4. 54, 12.70%, 55.17%; those for syndrome of qi deficiency of the lung and spleen were 3-25, 27.30%, 13.79%; those for syndrome of qi deficiency of the lung and kidney were 3-32, 27.24%, 13.79%; those for syndrome of qi-yin deficiency of the lung and kidney were 3.29, 28.98%, 24-14%; those for syndrome of yin deficiency of the lung and kidney were 2.98, 32.71%, 3.45%) those for syndrome of blood stasis were 4.67, 10.29%, 62.07% and those for syndrome of fu shi were 3.07, 30.01%, 6.90%, all respectively. The blood stasis and fu shi were accompanying syndromes. Conclusion: Seven common syndromes of AECOPD are wind and cold invasion of lung, exogenous cold-evil and fluid-retention, phlegm-heat obstruction in the lung, pulmonary stagnation of phlegm qi deficiency of the lung and spleen, qi deficiency of the lung and kidney, as well as qi-yin deficiency of the lung and kidney. One additional syndrome that accompanies many of the afore-mentioned syndromes was blood stasis.


Landy D.C.,Geriatrics Institute | Landy D.C.,University of Miami | Mintzer M.J.,Geriatrics Institute | Mintzer M.J.,University of Miami | And 6 more authors.
Southern Medical Journal | Year: 2012

OBJECTIVES: Fatal falls cause more than 15,000 deaths per year in the United States. Despite this, the circumstances surrounding fatal falls in elderly adults are poorly understood. It is unknown whether these circumstances differ across ethnicities, although Hispanic American individuals are at reduced risk for fatal falls. This study sought to describe fatal falls in an urban, predominantly Hispanic, and white non-Hispanic community and to determine the association of demographics with the circumstances surrounding these falls (proximate factors). METHODS: The death certificates and medical examiners' reports for all 328 elderly individuals experiencing a fatal fall in Miami-Dade County, FL, from 2005 to 2007 were reviewed for demographic and proximate factors such as the preceding activity and fall location. RESULTS: Fatal falls in elderly adults were experienced mostly by individuals living in the community (80%) and affected all demographic subgroups, although 80% occurred in individuals older than 74 years. Most fatal falls occurred at home (74%), indoors (75%), and during nonvigorous activities such as walking (58%) and these tended to affect the oldest elderly. In addition, a significant number of fatal falls occurred in public locations, outdoors, and during vigorous activity, with these falls tending to affect younger individuals living without family. Hispanic ethnicity was not associated with proximate factors. CONCLUSIONS: Fatal fall prevention is needed for elderly individuals living in the community and should target the oldest elderly adults living at home while helping to ensure that individuals who are living without family have the appropriate support. These data suggest that Hispanic individuals may benefit from prevention strategies developed in other populations. © 2012 by The Southern Medical Association.


Li J.-S.,Geriatrics Institute | Liu J.-X.,Ningxia Medical University | Hu J.-L.,Geriatrics Institute | Shen J.-J.,Zhengzhou University
Communications in Computer and Information Science | Year: 2010

To calculate the experimental data of indexes with computer through the multi-objective decision-making, and then to make the comprehensive evaluation of effects of different Chinese Medicines combined with Bone Mesenchymal Stem Cells(BMSCs) transplantation on cerebral ischemia rats based on analytic hierarchy process(AHP). BMSCs were implanted via rats carotid artery. Rats general neural function, cerebral infarction size and brain water ratio were detected and weights of indexes were calculate by using AHP. Weight of Rhubarb aglycone was the largest in 1 w groups. In 2 w groups, Naomaitong was the largest. In 4 w groups, Rhubarb aglycone and Naomaitong combined with BMSCs transplantation were larger. It was indicated that It was feasible to make a comprehensive evaluation of effects through comparing weight indexes of experimental data by using AHP, and the combination of Chinese medicines and BMSCs transplantation showed more significant effects following the prolongation of BMSCs transplantation. © 2010 Springer-Verlag Berlin Heidelberg.

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