Nutritional risk in hospitalized patients: impact of nutritional status on serum prealbumin

OBJECTIVE: Poor recognition and monitoring of nutritional status is the most important cause of malnutrition in hospitalized patients. The aim of this study was to assess the nutritional status of a group of patients and compare the results with their serum prealbumin levels. METHODS: Ninety-seven patients admitted consecutively to the hospital were enrolled in the study. The risk of malnutrition was assessed according to anthropometric data and the Subjective Global Assessment and Nutrition Risk Screening 2002 tools. The nutritional statuses of the patients were compared with their age, gender, body mass index, medical history, weight loss and routine biochemical analyses, including prealbumin and length of hospital stay. RESULTS: According to the Nutrition Risk Screening 2002, 57% of the patients were malnourished or at risk of malnutrition, correlating well with the Subjective Global Assessment (pOBJETIVO: Falha no reconhecimento e acompanhamento do estado nutricional é a razão mais importante da desnutrição em pacientes hospitalizados. Este estudo objetivou avaliar o estado nutricional dos pacientes e comparar os resultados com os níveis séricos de pré-albumina. MÉTODOS: Foram incluídos 97 pacientes no estudo, internados consecutivamente. O risco de desnutrição foi avaliado de acordo com dados antropométricos e com a Avaliação Subjetiva Global e Triagem de Risco Nutricional 2002. Os estados nutricionais dos pacientes foram comparados com suas idades, sexo, índice de massa corporal, histórico médico, perda de peso e análises bioquímicas, incluindo pré-albumina e tempo de permanência hospitalar. RESULTADOS: De acordo com o Triagem de Risco Nutricional 2002, 57% dos pacientes estavam desnutridos ou em risco de desnutrição, apresentando boa correlação com o Avaliação Subjetiva Global (p<0,001, r=0,700). A análise multivariada mostrou correlações positivas entre desnutrição e idade, perda de peso, malignidade e proteína reativa-C (p=0,046, p=0,001, p=0,04 e p=0,002). Um escore ³3 no Triagem de Risco Nutricional 2002 foi associado à internação prolongada (p<0,001). Houve correlação entre pré-albumina sérica e o estado nutricional, independente do número de doenças crônicas e biomarcadores de inflamação (p=0,01). A sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e valor diagnóstico da pré-albumina na avaliação do risco de desnutrição foram de 94%, 32%, 0,67, 0,78 e 69, respectivamente. Após sete dias de suporte nutricional, o risco de desnutrição caiu em 12% (p<0,001) e os níveis séricos de pré-albumina aumentaram em 20% (p=0,003). CONCLUSÃO: Ao invés de refletir o estado nutricional global do paciente, níveis séricos baixos de séricos de pré-albumina podem ser vistos como um sinal de maior risco de desnutrição, exigindo uma avaliação nutricional mais extensa. A análise sérica de pré-albumina pode ser usada para o monitoramento de pacientes recebendo suporte nutricional

Sustainability, innovation, and efficiency:A key relationship

Sustainability has become the emerging goal for countries, companies, and people. Sustainability usually refers to the need to develop models necessary for both human beings and our planet to survive. However, sustainability is not a short-term problem; it is above all a long-term issue, posing intergenerational equity problems. Moreover, sustainability needs efficiency. The efficient use of energy, natural, material, and informational resources is vital for sustainability and sustainable development, which should be the major goal of every country, as established in Rio in 1992, and reaffirmed at Rio+ 20 in 2012. But any strategy aiming at sustainability and efficient use of resources must focus on innovation and technological progress. Consequently, innovation is fundamental to making sustainability possible and improving efficiency. Yet, innovation for sustainability must be environmentally friendly (e.g., green technologies). The principle behind such a strategy is better instead of more. This paper aims at highlighting the key relationship among sustainability, innovation, and efficiency. First, it examines the concept of sustainability, looking at the neoclassical literature on sustainability and its relationship with innovation. Then, it analyzes different theoretical approaches and discusses the policy issues for sustainability where innovation, natural capital, human capital, population, and institutions are fundamental factors

Acoustic Overexposure Increases the Expression of VGLUT-2 Mediated Projections from the Lateral Vestibular Nucleus to the Dorsal Cochlear Nucleus

The dorsal cochlear nucleus (DCN) is a first relay of the central auditory system as well as a site for integration of multimodal information. Vesicular glutamate transporters VGLUT-1 and VGLUT-2 selectively package glutamate into synaptic vesicles and are found to have different patterns of organization in the DCN. Whereas auditory nerve fibers predominantly co-label with VGLUT-1, somatosensory inputs predominantly co-label with VGLUT-2. Here, we used retrograde and anterograde transport of fluorescent conjugated dextran amine (DA) to demonstrate that the lateral vestibular nucleus (LVN) exhibits ipsilateral projections to both fusiform and deep layers of the rat DCN. Stimulating the LVN induced glutamatergic synaptic currents in fusiform cells and granule cell interneurones. We combined the dextran amine neuronal tracing method with immunohistochemistry and showed that labeled projections from the LVN are co-labeled with VGLUT-2 by contrast to VGLUT-1. Wistar rats were exposed to a loud single tone (15 kHz, 110 dB SPL) for 6 hours. Five days after acoustic overexposure, the level of expression of VGLUT-1 in the DCN was decreased whereas the level of expression of VGLUT-2 in the DCN was increased including terminals originating from the LVN. VGLUT-2 mediated projections from the LVN to the DCN are likely to play a role in the head position in response to sound. Amplification of VGLUT-2 expression after acoustic overexposure could be a compensatory mechanism from vestibular inputs in response to hearing loss and to a decrease of VGLUT-1 expression from auditory nerve fibers

In Vivo Methods to Study Uptake of Nanoparticles into the Brain

Several in vivo techniques have been developed to study and measure the uptake of CNS compounds into the brain. With these techniques, various parameters can be determined after drug administration, including the blood-to-brain influx constant (Kin), the permeability-surface area (PS) product, and the brain uptake index (BUI). These techniques have been mostly used for drugs that are expected to enter the brain via transmembrane diffusion or by carrier-mediated transcytosis. Drugs that have limitations in entering the brain via such pathways have been encapsulated in nanoparticles (based on lipids or synthetic polymers) to enhance brain uptake. Nanoparticles are different from CNS compounds in size, composition and uptake mechanisms. This has led to different methods and approaches to study brain uptake in vivo. Here we discuss the techniques generally used to measure nanoparticle uptake in addition to the techniques used for CNS compounds. Techniques include visualization methods, behavioral tests, and quantitative methods

Wood composite protection

Wood composites should be protected against microbial and insect attack when used outdoors, especially in construction applications with prolonged exposure to moisture. Preservative systems and treatment processes affect composite properties, especially adhesive/wood bonding and mechanical properties. Several common systems for preservation of composites include, 1) the use of pretreated wood, applicable particularly to some solid lumber laminates; 2) in-process preservative treatments favored for composites made from flakes, particles, and fibers where the preservative treatment is incorporated during the manufacturing process; 3) post-process preservative treatments which are generally favored for wood composites made from lumber and veneer; and 4) the use of recycled treated wood elements in manufacturing or the use of wood species with a high natural resistance against biodegradation. This chapter discusses these four preservative methods and presents a general overview of current research concerning preservation practices and techniques in North America including the effect of preservatives on composite properties, durability issues, and degradation modes.</p

Rethinking law : everyday experiences of transgender women with the law in Turkey

This paper studies how legal regulation and practices affect transwomen of Turkey in their everyday lives. Based on an ethnographic study conducted in Istanbul, it delineates instances of an experience of legality which applies only to transwomen in a given space and time and brings them the constant and pervasive risk of being deprived of their most basic rights. Such an examination not only demonstrates law\u2019s multiplicity and heterogeneity against its unitary and sovereigntist understandings but also invites for a rethinking of the intricate relation of law and its effects on lived experiences