Malnutrition and clinical outcome in urological patients

INTRODUCTION: In a previous study we evaluated the risk for malnutrition among urological patients in a German university hospital. There are published different studies in other surgical fields that could show a correlation between malnutrition and clinical outcome. As data on this issue is still rare in the urological field we aimed to correlate the risk of malnutrition with different parameters regarding clinical outcome. METHODS: In the time from 2007 to 2009 a total of 320 patients were evaluated regarding the risk of malnutrition and occurrence of complications during the time of hospitalization at our Urological department. The Nutritional risk screening 2002 (NRS) by Kondrup et al. was used for the estimation of the risk level for malnutrition. Patients of a German university hospital were included independently of intervention, age or gender. Parameters for clinical outcome were: pulmonary complications (infectious/noninfectious), cardiovascular complications (infectious/noninfectious), other infections (urinary tract infection etc.), wound healing disorders and time of hospitalization. RESULTS: In this evaluation 320 patients were included for analysis. Forty patients (13%) presented with a normal nutritional status (NRS score 0) at the time of admission to the hospital and 212 patients (66%) were at risk for forming malnutrition problems (NRS score 1-2). sixty eight patients (21%) of this urological cohort were detected with a malnutrition according to the applied NRS score (≥3). Regarding the occurrence of overall complications in this cohort the rate was rather low compared to other surgical fields. Of 320 patients only 22 patients (7%) presented with relevant complications during their hospitalization. However if data were stratified for peri- and postoperative complications in correlation to nutritional status of patients, an evident trend to a higher complication rate of 9% was obvious. CONCLUSIONS: In our cohort of exclusively urological patients, the risk for post-surgical complications was higher in patients who were malnourished as defined using the Nutritional Risc Screening System (NRS) by Kondrup et al. Further studies need to show whether an adequate nutritional supportive therapy could help to optimize the clinical outcome of malnourished urological patients

Localization of the glnD gene on a revised map of the 200-kilobase region of the Escherichia coli chromosome.

In the course of our studies on the glutamine synthetase regulatory cascade, we have characterized the physical location of the glnD gene, encoding the uridylyl-transferase which is thought to be the primary sensor of cellular nitrogen status (13). This gene is linked to dapD, and we therefore analyzed two lambda phages from the Kohara library (9, 9a), 9H2 and 21C8, mapping in the dapD region (3.8 min, 190 kb) (12). To identify the physical location ofginD, we made use of a glnD::TnlO insertion in strain RB9040 (3). Southern blotting of PstI-, EcoRI-, and EcoRI-SalI-digested genomic DNAs of RB9040 and its wild-type parent RB9010, using 21C8 phage DNA as a probe, showed that the physical map of the hybridizing region of the chromosome corresponds to the physical map of 21C8, indicating the absence of rear-rangement in phage 21C8. This experiment also located th

Mixed venous CO2 tension during exercise

A series of experiments was undertaken in a total of 95 adult subjects, of whom 25 had coronary artery disease, to evaluate the extrapolation (Defares) CO2 rebreathing method vs. the equilibrium (Collier) method for estimating mixed venous CO2 tension. Collier values were corrected for the downstream effect, whereas Defares values were uncorrected. Although the methods gave similar mean values in separate series with normal subjects walking on a treadmill set at 123 W for 3 min, Collier values had a coefficient of variation (CV) of 2.5% in duplicate determinations and Defares values had a CV of 4.5%. In paired comparisons Defares values averaged either higher or lower than Collier values depending on variations in technique and the analysis of Defares tracings. Collier values were essentially unaffected by the duration of the rebreathing period (10 vs. 15 s). The Collier technique appears to be superior for the exercise evaluation of cardiac output in healthy and diseased subjects when the goal is obtain values at 82 or 123 W in single test sessions. </jats:p