Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status

<p>Abstract</p> <p>Background</p> <p>Undernutrition among older people is a continuing source of concern, particularly among acutely hospitalized patients. The purpose of the current study is to compare malnourished elderly patients with those at nutritional risk and identify factors contributing to the variability between the groups.</p> <p>Methods</p> <p>The study was carried out at the Soroka University Medical Center in the south of Israel. From September 2003 through December 2004, all patients 65 years-of-age or older admitted to any of the internal medicine departments, were screened within 72 hours of admission to determine nutritional status using the short version of the Mini Nutritional Assessment (MNA-SF). Patients at nutritional risk were entered the study and were divided into malnourished or 'at risk' based on the full version of the MNA. Data regarding medical, nutritional, functional, and emotional status were obtained by trained interviewers.</p> <p>Results</p> <p>Two hundred fifty-nine elderly patients, 43.6% men, participated in the study; 18.5% were identified as malnourished and 81.5% were at risk for malnutrition according to the MNA. The malnourished group was less educated, had a higher depression score and lower cognitive and physical functioning. Higher prevalence of chewing problems, nausea, and vomiting was detected among malnourished patients. There was no difference between the groups in health status indicators except for subjective health evaluation which was poorer among the malnourished group. Lower dietary score indicating lower intake of vegetables fruits and fluid, poor appetite and difficulties in eating distinguished between malnourished and at-risk populations with the highest sensitivity and specificity as compare with the anthropometric, global, and self-assessment of nutritional status parts of the MNA. In a multivariate analysis, lower cognitive function, education <12 years and chewing problems were all risk factors for malnutrition.</p> <p>Conclusion</p> <p>Our study indicates that low food consumption as well as poor appetite and chewing problems are associated with the development of malnutrition. Given the critical importance of nutritional status in the hospitalized elderly, further intervention trials are required to determine the best intervention strategies to overcome these problems.</p

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Susceptibility of collection pear cultivars to the agent of scab pathogen

The objective of the research is to study the biology of the pathogen of the scab Venturia pirina Aderh depending on the agrometeorological conditions of the pear vegetation and to assess the collection cultivars for susceptibility to the disease. The biological features of the pear scab in the western foothill agro-climatic region of the Crimea are studied. The influence of climatic conditions on the occurrence of various epidemiological types of scab manifestations on pears is estimated. As a result of the research, highly resistant cultivars were found: Zhukovka, Zaporozhskaya, Triumph of Jodoin, Vodyanistaya, Dorodnaya, Bere Shibasso, Martin Sekl, which showed moderate levels of infection spread in all years of research, with the development of the disease in the range of 0.2-1.3%. Immune cultivars of pears with absolute resistance to the pathogen agent V. pirina, which was not affected by changes in weather conditions, were identified. These cultivars are the following: Zimovka, Trapezitsa, Chervona, Shara Bera, Seyanets Kolossa, Populyarnaya, Kurzemskaya Maslyanaya, Wonderful Italy, which can be used in breeding and ecologized protection systems when supplying with cuttings horticultural industries in the Crimea and the south of Russia

Adsorption and Catalytic Properties of Co/ZSM-5 Zeolite Catalysts for CO Oxidation

Studies were made of the adsorption and acidic properties, the coordination state of the Co ion in Co 2 +, Co 3 +-containing ZSM-5 zeolite systems and the catalytic activity of these zeolites in CO oxidation. A correlation was established between the catalytic activity of these Co-containing zeolites and the number of Brönsted acid sites on the surface and in the system bulk as obtained by different methods. The content of various forms of Co ion coordination states and the ratio of Brönsted to Lewis acidic sites at the surface of the Co-containing zeolites defined their activity in CO oxidation

Catalytic Activity in CO Oxidation of MnOx Supported on Oxide and Zeolite Carriers

Catalytic activity in CO oxidation was investigated for MnOx-containing materials, prepared by impregnation of SiO2, Al2O3 and zeolites (ZSM-5, ERI). The catalysts were characterized by temperature-programmed reduction (TPR) by hydrogen, diffuse-reflectance UV–Vis (DR UV–Vis) and infra-red (IR) spectroscopy of adsorbed CO. Effect of the previous treatment of the MnOx-containing systems on the catalytic performance has been established. Higher catalytic activity in CO oxidation of the materials treated with air as compared with treated with hydrogen can be explained by presences of manganese ions in +3 and +4 oxidation states. 3%Mn-SiO2 previously treated with air at 350 °C is found to be the most active catalyst among the studied ones. MnOx, CO oxidation, TPR, IR of adsorbed CO, DR UV–Vi

Diversities in the Gut Microbial Patterns in Patients with Atherosclerotic Cardiovascular Diseases and Certain Heart Failure Phenotypes

To continue progress in the treatment of cardiovascular disease, there is a need to improve the overall understanding of the processes that contribute to the pathogenesis of cardiovascular disease (CVD). Exploring the role of gut microbiota in various heart diseases is a topic of great interest since it is not so easy to find such reliable connections despite the fact that microbiota undoubtedly affect all body systems. The present study was conducted to investigate the composition of gut microbiota in patients with atherosclerotic cardiovascular disease (ASCVD) and heart failure syndromes with reduced ejection fraction (HFrEF) and HF with preserved EF (HFpEF), and to compare these results with the microbiota of individuals without those diseases (control group). Fecal microbiota were evaluated by three methods: living organisms were determined using bacterial cultures, total DNA taxonomic composition was estimated by next generation sequencing (NGS) of 16S rRNA gene (V3&ndash;V4) and quantitative assessment of several taxa was performed using qPCR (quantitative polymerase chain reaction). Regarding the bacterial culture method, all disease groups demonstrated a decrease in abundance of Enterococcus faecium and Enterococcus faecalis in comparison to the control group. The HFrEF group was characterized by an increased abundance of Streptococcus sanguinus and Streptococcus parasanguinis. NGS analysis was conducted at the family level. No significant differences between patient&rsquo;s groups were observed in alpha-diversity indices (Shannon, Faith, Pielou, Chao1, Simpson, and Strong) with the exception of the Faith index for the HFrEF and control groups. Erysipelotrichaceae were significantly increased in all three groups; Streptococcaceae and Lactobacillaceae were significantly increased in ASCVD and HFrEF groups. These observations were indirectly confirmed with the culture method: two species of Streptococcus were significantly increased in the HFrEF group and Lactobacillus plantarum was significantly increased in the ASCVD group. The latter observation was also confirmed with qPCR of Lactobacillus sp. Acidaminococcaceae and Odoribacteraceae were significantly decreased in the ASCVD and HFrEF groups. Participants from the HFpEF group showed the least difference compared to the control group in all three study methods. The patterns found expand the knowledge base on possible correlations of gut microbiota with cardiovascular diseases. The similarities and differences in conclusions obtained by the three methods of this study demonstrate the need for a comprehensive approach to the analysis of microbiota