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Objectives: To investigate the relationship between Mediterranean diet (MedDiet) adherence and response to an exercise and health education program to prevent hospitalization-associated disability (HAD) in acutely hospitalized older adults. Design: Randomized controlled trial. Setting and Participants: Secondary analysis of a subset of 109 participants from AGECAR-PLUS study with available data on MedDiet adherence (mean age 87, and range 75–98). Intervention: Participants were randomized into the control group (n = 46, usual care) or the intervention group (n = 63, supervised exercise and health education) at admission. Measurements: MedDiet adherence was measured with MEDAS and through urinary total polyphenols (UTP). Functional status was assessed with the Barthel Index. Results: At discharge, patients in the intervention group who had low levels of MedDiet or UTP showed an increase in functional status [adjusted mean (95% CI) = 77.8 (70.8–84.8) points, p = 0.005, and adjusted mean (95% CI) = 78.0 (68.3–87.7) points, p = 0.020, respectively]. Conclusion: Older individuals over age 75 with low MedDiet adherence were likely to benefit more from a physical exercise and health education intervention. [ABSTRACT FROM AUTHOR]

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Eighty-two patients have been followed for a mean period of 29 months after implantation of dura mater valvular bioprostheses (60 mitral valves, 30 aortic valves and two tricuspid valves). There have been three late deaths, two related to reoperation and one to endocarditis. Severe hemolysis, infective endocarditis and systemic emboli have been recorded twice each. There have been 20 instances of valvular dysfunction: 13 cases (15.7%) with intravalvular dysfunction, either proved at surgery (11 cases) or suggested by echocardiography (two cases). In five cases (6%) dysfunction has been due to a perivalvular leak. In two cases the mechanism of dysfunction has not been demonstrated. The most frequent causes of intravalvular dysfunction have been a tear-like rupture of an otherwise normal leaflet (five cases) and extensive valvular calcification (four cases). It is concluded that the very high rate of intravalvular dysfunction makes dura mater valves unsuitable for valvular replacement. [ABSTRACT FROM PUBLISHER]