Improving Decision-Making for Feeding Options in Advanced Dementia: A Randomized, Controlled Trial

Feeding problems are common in dementia, and decision-makers have limited understanding of treatment options

Tart cherry supplement enhances skeletal muscle glutathione peroxidase expression and functional recovery after muscle damage

Introduction: Montmorency cherry concentrate (MCC) supplementation enhances functional recovery from exercise, potentially due to antioxidant and anti-inflammatory effects. However, to date, supporting empirical evidence for these mechanistic hypotheses is reliant on indirect blood biomarkers. This study is the first to investigate functional recovery from exercise alongside molecular changes within the exercised muscle following MCC supplementation. Methods: Ten participants completed two maximal unilateral eccentric knee extension trials following MCC or placebo supplementation for 7 days prior to and 48 hours following exercise. Knee extension maximum voluntary isometric contractions (MVC), maximal isokinetic contractions, single leg jumps, and soreness measures were assessed before, immediately, 24 and 48 h after exercise. Venous blood and vastus lateralis muscle samples were collected at each time point. Plasma concentrations of IL-6, TNF-⍺, C-reactive protein, creatine kinase, and phenolic acids were quantified. Intramuscular mRNA expression of SOD 1 and 3, GPX1, 3, 4 and 7, Catalase, and Nrf2 and relative intramuscular protein expression of SOD1, Catalase and GPX3 were quantified. Results: MCC supplementation enhanced recovery of normalized MVC 1s average compared to placebo (Post- Exercise PLA: 59.5±18.0% vs MCC: 76.5±13.9%; 24 h PLA: 69.8±15.9% vs MCC: 80.5±15.3%; supplementation effect p=0.024). MCC supplementation increased plasma hydroxybenzoic, hippuric and vanillic acid concentrations (supplementation effect p = 0.028, p = 0.002, p= 0.003); SOD3, GPX3, GPX4, GPX7 (supplement effect p < 0.05) and GPX1 (interaction effect p = 0.017) gene expression; and GPX3 protein expression (supplementation effect p = 0.004) versus placebo. There were no significant differences between conditions for other outcome measures. Conclusion: MCC supplementation conserved isometric muscle strength and upregulated antioxidant gene and protein expression in parallel with increased phenolic acid concentrations

Shatavari supplementation in postmenopausal women improves handgrip strength and increases vastus lateralis myosin regulatory light chain phosphorylation but does not alter markers of bone turnover

Abstract: Shatavari has long been used as an Ayurvedic herb for women’s health, but empirical evidence for its effectiveness has been lacking. Shatavari contains phytoestrogenic compounds that bind to the estradiol receptor. Postmenopausal estradiol deficiency contributes to sarcopenia and osteoporosis. In a randomised double-blind trial, 20 postmenopausal women (68.5 ± 6 years) in-gested either placebo (N = 10) or shatavari (N = 10; 1000 mg/d, equivalent to 26,500 mg/d fresh weight shatavari) for 6 weeks. Handgrip and knee extensor strength were measured at baseline and at 6 weeks. Vastus lateralis (VL) biopsy samples were obtained. Data are presented as difference scores (Week 6 – baseline, median ± interquartile range). Handgrip, (but not knee extensor) strength was improved by shatavari supplementation (shatavari +0.7 ± 1.1 kg, placebo -0.4 ± 1.3 kg; p=0.04). Myosin regulatory light chain phosphorylation, a known marker of improved myosin contractile function, was increased in VL following shatavari supplementation (immunoblotting; placebo -0.08 ± 0.5 a.u. shatavari +0.3 ± 1 arbitrary units (a.u.); p = 0.03). Shatavari increased phosphorylation of Aktser473 (Aktser473 (placebo -0.6 ± 0.6 a.u. shatavari +0.2 ± 1.3 a.u; p = 0.03) in VL. Shatavari supplementation did not alter plasma markers of bone turnover (P1NP, β-CTX) and stimulation of human osteoblasts with pooled sera (N = 8 per condition) from placebo and shatavari supplementation conditions did not alter cytokine or metabolic markers of osteoblast activity. Shatavari may improve muscle function and contractility via myosin conformational change and warrants further investigation in larger and more diverse cohorts of its utility in conserving and enhancing musculoskeletal functio

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec