Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

The effect of phosphorus based flame retardants on the thermal and fire retardant properties of chicken feather/thermoplastic polyurethane composites

The aim of the study was to enhance the flame-retardant properties of chicken feather (CF) reinforced thermoplastic polyurethane (TPU) composites by incorporating three different phosphorus-based flame retardants, namely aluminum hypophosphite (AHP), ammonium polyphosphate (APP), and aluminum diethyl phosphinate (AlPi), at concentrations of 5, 10, and 20 wt%. The effectiveness of the additives was evaluated through various tests, including limiting oxygen index (LOI), vertical burning test (UL 94 V), thermogravimetric analysis (TGA), and mass loss calorimeter test (MLC). The results indicated that all three additives exhibited flame retardant properties in both the condensed and gas phases, but APP and AHP performed better than AlPi due to their enhanced char formation capabilities. The flame retardant effectiveness of the additives decreased in the order of APP > AHP > AlPi

The effect of pre-impregnation with maleated coupling agents on mechanical and water absorption properties of jute fabric reinforced polypropylene and polyethylene biocomposites

Maleic anhydride functionalized polymers were used as compatibilizer in jute fabric reinforced polypropylene- and polyethylene-based composites. Composites were produced from pristine jute fabric, alkaline-treated jute fabric and compatibilizer solutions pre- impregnated jute fabrics. Polypropylene-grafted maleic anhydride and a random terpolymer of ethylene, acrylic ester and maleic anhydride were used as compatibilizer for polypropylene and polyethylene, respectively. The effect of alkaline treatment and pre-impregnation on mechanical, water absorption and morphological properties of composites were investigated. Both alkaline treatment and pre-impregnation increased the mechanical properties and reduced the water uptake of composites. The highest improvement in mechanical properties and the highest reduction in water uptake values were achieved when alkaline treatment and pre-impregnation were used together for both matrix types. Tensile strength of pristine jute fabric reinforced polypropylene- and polyethylene-based composites increased at about 90% and 40% when alkaline treatment and pre-impregnation were used together, respectively

Potential Use of Melamine Phytate as a Flame-Retardant Additive in Chicken Feather-Containing Thermoplastic Polyurethane Biocomposites

Using waste materials such as chicken feathers (CF) and biobased flame-retardant additives including melamine phytate (MPht) has become an effective approach for environmentally friendly and sustainable production in recent years. This study explores the flame retardant effectiveness of MPht in thermoplastic polyurethane (TPU)-based biocomposites containing CF. The characterizations of the composites are performed through thermal gravimetric analysis (TGA), limiting oxygen index (LOI), vertical UL-94 (UL-94 V), and mass loss calorimetry (MLC) tests. According to the test results, the highest UL-94 V rating of V0, a LOI value of 29.4%, and the lowest peak heat release rate (pHRR) (110 Kw/m2) and total heat evolved (THE) (39 MJ/m2) values are obtained with the use of 20 wt % MPht. It is demonstrated that MPht acts as an effective flame-retardant filler through the formation of intumescent char in the condensed phase and flame dilution in the gas phase

Thermal stability and flame retardant properties of calcium- and magnesium-hypophosphite-finished cotton fabrics and the evaluation of interaction with clay and POSS nanoparticles

The aim of this study was to investigate the effect of calcium hypophosphite (CaHP) and magnesium hypophosphite (MgHP) on the thermal stability and fire retardant properties of cotton fabrics. The effects of water-soluble nanoparticles, namely Na-montmorillonite and octaammonium polyhedral oligomeric silsesquioxane (OA-POSS), in the presence of CaHP were also investigated. The characterizations of flame-retardant-treated cotton fabrics were performed using thermogravimetric analysis, limiting oxygen index (LOI) and mass loss calorimeter studies. The residues remained after mass loss calorimeter test were characterized by conducting attenuated total reflectance Fourier-transform infrared spectroscopy and scanning electron microscopy with a wavelength-dispersive X-ray spectrometer. The results showed that the fire performance of cotton fabric increased as the treated amount of both hypophosphite compounds increased. CaHP showed better fire performance than MgHP. The fire retardant performance of CaHP was further improved when used with nanoparticles. The highest LOI value of 24.2 and the lowest peak heat release rate (PHRR) of 43 +/- 3 kW m(-2) were achieved with the use of CaHP and OA-POSS at a ratio of 19:1

Effect of various enzymatic treatments on the mechanical properties of coir fiber/poly(lactic acid) biocomposites

###EgeUn###The effects of enzymatic treatments on the properties of coir fiber-reinforced poly(lactic acid) (PLA) were not found in the literature. Accordingly, the effects of various enzymatic treatments on the mechanical performance of the coir fiber-reinforced PLA composites were investigated in the current study. Four different enzymes, namely lipase, lactase, pectinase, and cellulase, were used. The mechanical properties of the composites were determined by the tensile, flexural, impact tests, and dynamic mechanical analysis. According to the test results, the use of enzyme treated coir fibers affected the mechanical properties except for the flexural properties with different extents depending upon their type. The tensile strength increased with the treatments of lipase and lactase, while the treatments with pectinase and cellulase had no remarkable effect. The impact strength was improved with enzymatic treatments except for pectinase. All enzymatic treatments improved the elastic modulus below the glass transition temperature. In brief, enzymatic treatments improved the interfacial adhesion between coir fiber and PLA via the waxes and fatty acids removal and/or the increment in surface roughness.Erciyes University Scientific Research UnitErciyes University [BAP-FYL-2017-7635]The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is supported by Erciyes University Scientific Research Unit under grant no. BAP-FYL-2017-7635

Effect of carbon fiber amount and length on flame retardant and mechanical properties of intumescent polypropylene composites

The effects of carbon fiber amount and length were studied on the flame retardant, thermal, and mechanical properties of the intumescent polypropylene composites. The flame retardant properties of the intumescent polypropylene-based composites were investigated using limiting oxygen index, vertical burning test (UL-94), and mass loss calorimeter. The mechanical properties of the composites were studied using tensile test and dynamic mechanical analysis. According to the flammability tests results, the antagonistic interaction was observed between carbon fiber and ammonium polyphosphate. The limiting oxygen index value reduced steadily as the added amount of carbon fiber increased. Mechanical test results revealed that the addition of carbon fiber increased the tensile strength and the elastic modulus as the added amount increased. No effect of carbon fiber length was observed on the flammability, fire performance, and tensile properties of composites, whereas the elastic modulus increased as the carbon fiber initial length increased

Effect of various enzymatic treatments on the mechanical properties of coir fiber/poly(lactic acid) biocomposites

The effects of enzymatic treatments on the properties of coir fiber-reinforced poly(lactic acid) (PLA) were not found in the literature. Accordingly, the effects of various enzymatic treatments on the mechanical performance of the coir fiber-reinforced PLA composites were investigated in the current study. Four different enzymes, namely lipase, lactase, pectinase, and cellulase, were used. The mechanical properties of the composites were determined by the tensile, flexural, impact tests, and dynamic mechanical analysis. According to the test results, the use of enzyme treated coir fibers affected the mechanical properties except for the flexural properties with different extents depending upon their type. The tensile strength increased with the treatments of lipase and lactase, while the treatments with pectinase and cellulase had no remarkable effect. The impact strength was improved with enzymatic treatments except for pectinase. All enzymatic treatments improved the elastic modulus below the glass transition temperature. In brief, enzymatic treatments improved the interfacial adhesion between coir fiber and PLA via the waxes and fatty acids removal and/or the increment in surface roughness

Measurment of Ankle-Brachial Pressure Index, Homocystein Level, and Evaluation of Coronary Artery Disease Association with Other Macrovascular Diseases in Patients with Myocardial Infarction

We aimed to measure ankle-brachial pressure index (ABPI) and homocysteine levels, and to evaluate frequency of cerebrovascular disease (CVD) and/or peripheral arterial disease (PAD) combination of patients with myocardial infarction (MI). 39 patients (26 males, 13 females) with acute or subacute MI and 36 control cases (9 male, 27 female) were included in the study. ABPI and homocysteine levels were measured, and bilateral carotid-vertebral and bilateral lower extremity arterial Doppler ultrasonography, and coronary angiography were examined. Homocysteine was significantly higher in patient group than control group (p=0.0001). The ABPI was not significantly different in two groups (p=0.428). However the frequency of patients with lower ABPI (≤0.9) was significantly higher compared to the frequency of control patients with lower ABPI (25.6% and 3%, respectively; p=0.02). The combination of the atherosclerotic findings in the carotid artery and coronary artery disease (CAD) were found significantly higher compared to that of the bilateral lower extremity (59%, 25.6%). Screening of CVD should be done in patients with MI history. Determining carotid arterial lesions may be useful for the early diagnosis and treatment of any possible CVD in cases with CAD. Studies with larger numbers of cases are needed. [Med-Science 2013; 2(4.000): 896-906