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 VO 2 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.

GUTIÉ RREZ, ARANTZA, GONZALO SARACÍBAR, LUIS CASIS, ENRIQUE ECHEVARRÍA, VÍCTOR MAN-UEL RODRÍGUEZ, MARIA TERESA MACARULLA, LUIS C. ABECIA, AND MARÍA P. PORTILLO. Effects of fluoxetine administration on neuropeptide Y and orexins in obese Zucker rat hypothalamus. Obes Res. 2002;10: 532-540. Objective: The aim of this work was to study the potential involvement of neuropeptide Y (NPY) and orexins in the anorexigenic mechanism of fluoxetine in obese Zucker rats, assessing the effects of chronic fluoxetine treatment on NPY and orexin immunostaining in several hypothalamic regions. Research Methods and Procedures: Male obese Zucker (fa/fa) rats were administered fluoxetine (10 mg/kg intraperitoneally) daily for 2 weeks. The control group was administered 0.9% NaCl solution. Carcass composition was assessed using the official methods of the Association of Official Analytical Chemists. To test the potential thermogenic effect of fluoxetine administration, total body oxygen consumption was measured daily for 60 minutes before fluoxetine or saline injection and for 30 minutes 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. Results: Chronic fluoxetine administration in obese Zucker rats generated a reduction in body weight gain, food intake, adipocyte size, fat mass, and body protein. A decrease in NPY immunostaining in the paraventricular nucleus, without changes in the arcuate, was observed. However, no changes were observed in the number of neural cells immunostained for orexin A or orexin B in the lateral hypothalamic area. Discussion: Due to the hyperphagic effect of NPY in the paraventricular nucleus, these results suggest that NPY, but not orexins, could be involved in the anorexigenic effect of fluoxetine in obese Zucker rats.

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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.

Hip fractures continue to increase in absolute numbers, although if the rates are adjusted for age, a downward trend is seen in certain age groups. These findings have various origins, although in the absence of great changes in population structure, we believe that drug treatments for osteoporosis may play a role. There is variability in the change in incidence of hip fractures in different parts of the country. Further studies are required to be able to identify the causes.

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RESUMENFundamentos: La carga económica de la asistencia sanitaria del cáncer de mama es importante. En el contexto de la evaluación del programa de cribado de cáncer de mama del País Vasco es importante conocer los costes unitarios actuales del diagnóstico y el coste de los tratamientos desagregados por el estadío clínico de detección. El objetivo de este estudio fue calcular los costes total y desagregado por componentes del tratamiento del cáncer de mama (CM) según estadío clínico en el año 2011. Métodos:Los costes sanitarios se estimaron desde el diagnóstico hasta la finalización de los tratamientos y seguimiento a partir del consumo de recursos y los costes unitarios del Sistema Vasco de Salud. La técnica aplicada fue el método de micro-costes a partir de las guías de práctica clínica.Resultados: El coste inicial fue de 9.838 € en el estadío 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 estadío 0, de 908 € en el I, de 994 € en el II y de 1.166€ en el III. El coste anual del estadío IV fue de 17.879 €.Conclusiones: El componente de mayor coste es la quimioterapia. Los dos determinantes principales del coste total del cáncer de mama son el tratamiento inicial de los estadíos I a III y el coste del estadío IV alcanzando este último los 50.061 € por paciente.Palabras clave: Costos y análisis de costo. Neoplasias de la mama. Detección precóz del cáncer. Estadificación de neoplasias. Quimioterapia. ABSTRACT Cost of Breast Cancer Treatment by ClinicalStage in the Basque Country, SpainBackground: The burden of breast cancer is important for the healthcare system. In the context of the evaluation of the breast cancer screening program in the Basque Country it is important to determine the unitary costs related to diagnosis as well as the treatment costs depending on the clinical stage at detection. The main objective was to calculate the total cost and the components of breast cancer (BC) treatment depending on the clinical stage by 2011.