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Sample records for prognostic nutritional index

  1. Prognostic significance of the prognostic nutritional index in esophageal cancer patients undergoing neoadjuvant chemotherapy.

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    Nakatani, M; Migita, K; Matsumoto, S; Wakatsuki, K; Ito, M; Nakade, H; Kunishige, T; Kitano, M; Kanehiro, H

    2017-08-01

    Nutritional status is one of the most important issues faced by cancer patients. Several studies have shown that a low preoperative nutritional status is associated with a worse prognosis in patients with various types of cancer, including esophageal cancer (EC). Recently, neoadjuvant chemotherapy (NAC) and/or radiotherapy have been accepted as the standard treatment for resectable advanced EC. However, NAC has the potential to deteriorate the nutritional status of a patient. This study aimed to evaluate the prognostic significance of the nutritional status for EC patients who underwent NAC. We retrospectively reviewed 66 squamous cell EC patients who underwent NAC consisting of docetaxel, cisplatin, and 5-fluorouracil followed by subtotal esophagectomy at Nara Medical University Hospital between January 2009 and August 2015. To assess the patients' nutritional status, the prognostic nutritional index (PNI) before commencing NAC and prior to the operation was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count in the peripheral blood (per mm3). The cutoff value of the PNI was set at 45. A multivariable analysis was performed to identify prognostic factors for overall survival (OS) and relapse-free survival (RFS). The mean pre-NAC and preoperative PNI were 50.2 ± 5.7 and 48.1 ± 4.7, respectively (P = 0.005). The PNI decreased following NAC in 44 (66.7%) patients. Before initiating NAC, 9 (13.6%) patients had a low PNI, and 12 (18.2%) patients had a low PNI prior to the operation. The pre-NAC PNI and preoperative PNI were significantly associated with the OS (P = 0.013 and P = 0.004, respectively) and RFS (P = 0.036 and P = 0.005, respectively) rates. The multivariable analysis identified the preoperative PNI as an independent prognostic factor for poor OS and RFS, although the pre-NAC PNI was not an independent predictor. Our results suggest that the preoperative PNI is a useful marker for predicting the long-term outcomes of EC patients

  2. Geriatric Nutritional Risk Index as a Prognostic Factor in Peritoneal Dialysis Patients

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    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2013-01-01

    ♦ Background: The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce.

  3. Prognostic nutritional index as a prognostic biomarker for survival in digestive system carcinomas.

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    Zhao, Yang; Xu, Peng; Kang, Huafeng; Lin, Shuai; Wang, Meng; Yang, Pengtao; Dai, Cong; Liu, Xinghan; Liu, Kang; Zheng, Yi; Dai, Zhijun

    2016-12-27

    The prognostic nutritional index (PNI) has been reported to correlate with the prognosis in patients with various malignancies. We performed a meta-analysis to determine the predictive potential of PNI in digestive system cancers. Twenty-three studies with a total of 7,384 patients suffering from digestive system carcinomas were involved in this meta-analysis. A lower PNI was significantly associated with the shorter overall survival (OS) [Hazard Ratio (HR) 1.83, 95% Confidence Interval (CI) 1.62-2.07], the poorer disease-free survival (DFS) (HR 1.85, 95% CI 1.19-2.89), and the higher rate of post-operative complications (HR 2.31, 95% CI 1.63-3.28). In conclusion, PNI was allowed to function as an efficient indicator for the prognosis of patients with digestive system carcinomas.

  4. Onodera's prognostic nutritional index as a risk factor for mortality in peritoneal dialysis patients.

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    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2012-11-01

    The aim of this study was to evaluate the clinical relevance and usefulness of the Onodera's prognostic nutritional index (OPNI) as a prognostic and nutritional indicator in peritoneal dialysis (PD) patients. Patients were divided into 3 groups based on the initial OPNI score: group A (n = 186, 45). Group A was associated with a higher grade according to the Davies risk index than the other groups. Serum creatinine and albumin levels, total lymphocyte count, and fat mass increased with an increase in OPNI. According to the edema index, the correlation coefficient for OPNI was -0.284 and for serum albumin was -0.322. Similarly, according to the C-reactive protein (CRP), the correlation coefficient for OPNI was -0.117 and for serum albumin was -0.169. Multivariate analysis adjusted for age, Davies risk index, CRP, and edema index revealed that the hazard ratios for low OPNI, serum albumin, and CRP were 1.672 (P = 0.003), 1.308 (P = 0.130), and 1.349 (P = 0.083), respectively. Our results demonstrate that the OPNI is a simple method that can be used for predicting the nutritional status and clinical outcome in PD patients.

  5. Prognostic Nutritional Index Predicts Severe Complications, Recurrence, and Poor Prognosis in Patients With Colorectal Cancer Undergoing Primary Tumor Resection.

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    Tokunaga, Ryuma; Sakamoto, Yasuo; Nakagawa, Shigeki; Miyamoto, Yuji; Yoshida, Naoya; Oki, Eiji; Watanabe, Masayuki; Baba, Hideo

    2015-11-01

    The prognostic nutritional index is reportedly related to postoperative outcomes. The aim of this study was to elucidate the clinical importance of the prognostic nutritional index in patients with colorectal cancer who were undergoing primary tumor resection. This is a retrospective study from a single institution. This study was conducted at a colorectal surgery service in an academic teaching hospital. The 556 patients with colorectal cancer who were undergoing surgery between March 2005 and August 2014 were eligible for this study. The preoperative prognostic nutritional index was calculated. Classification and regression tree analysis was performed to determine the prognostic nutritional index cutoff value. The associations of the prognostic nutritional index status with clinicopathological factors and postoperative outcomes were examined using univariate and multivariate analyses. Classification and regression tree analysis demonstrated that 45.5 was the optimal cutoff value. The low status (≤45.5) was correlated with older age, low BMI, low estimated glomerular filtration rate, CEA positivity, carbohydrate antigen 19-9 positivity, preoperative chemotherapy, tumors invading muscular or deeper layers, distant metastasis, poor differentiation, severe postoperative complications, tumor recurrence, and poor survival. In multivariate analysis, the low status was an independent risk factor for severe postoperative complications (OR = 2.06 [95% CI, 1.22-3.50]; p = 0.007) and low overall survival (HR =3.98 [95% CI, 2.38-6.89]; p nutritional index status, not considering the postoperative host status. The preoperative prognostic nutritional index predicts severe complications, recurrence, and poor prognosis in patients with colorectal cancer who are undergoing primary tumor resection. Investigation of the nutritional and immunologic statuses using the prognostic nutritional index could be a useful clinical approach.

  6. Novel immunological and nutritional-based prognostic index for gastric cancer.

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    Sun, Kai-Yu; Xu, Jian-Bo; Chen, Shu-Ling; Yuan, Yu-Jie; Wu, Hui; Peng, Jian-Jun; Chen, Chuang-Qi; Guo, Pi; Hao, Yuan-Tao; He, Yu-Long

    2015-05-21

    To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio in gastric cancer. We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between 1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS). Propensity score analysis was performed to adjust variables to control for selection bias. Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring (hazard ratio, 1.668; 95% confidence interval: 1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage II-III disease (P = 0.019, P index in gastric cancer.

  7. Prognostic Value of the Nutritional Risk Index in Heart Transplant Recipients.

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    Barge-Caballero, Eduardo; García-López, Fernando; Marzoa-Rivas, Raquel; Barge-Caballero, Gonzalo; Couto-Mallón, David; Paniagua-Martín, María J; Solla-Buceta, Miguel; Velasco-Sierra, Carlos; Pita-Gutiérrez, Francisco; Herrera-Noreña, José M; Cuenca-Castillo, José J; Vázquez-Rodríguez, José Manuel; Crespo-Leiro, María G

    2017-08-01

    To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT). We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression. Mean NRI before HT was 100.9 ± 9.9. According to this parameter, the prevalence of severe nutritional risk (NRI nutritional risk (83.5 ≤ NRI nutritional risk (97.5 ≤ NRI risk of postoperative infection (adjusted OR, 0.97; 95%CI, 0.95-1.00; P = .027) and prolonged postoperative ventilator support (adjusted OR, 0.96; 95%CI, 0.94-0.98; P = .001). Patients at moderate or severe nutritional risk had significantly higher 1-year post-HT mortality (adjusted HR, 1.55; 95%CI, 1.22-1.97; P risk of postoperative complications and mortality after HT. Preoperative NRI determination may help to identify HT candidates who might benefit from nutritional intervention. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Geriatric Nutritional Risk Index as a prognostic factor in peritoneal dialysis patients.

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    Kang, Seok Hui; Cho, Kyu Hyang; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2013-01-01

    The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce. We reviewed the medical records at Yeungnam University Hospital in Korea to identify all adults (>18 years) who received PD; 486 patients were enrolled in the study. The initial low, middle, and high GNRI tertiles included 162, 166, and 158 patients respectively. Significant correlations were noted between the initial GNRI and body mass index, creatinine, albumin, arm circumference, fat mass index, and comorbidities. The cut-off value for the time-averaged GNRI over 1 year was 96.4, and the sensitivity and specificity for a diagnosis of a decline in lean mass were 77.1% and 40.0% respectively. A multivariate analysis adjusted for age, risk according to the Davies comorbidity index, and C-reactive protein showed that an low initial GNRI tertile was associated with mortality in PD patients. The GNRI is a simple method for predicting nutrition status and clinical outcome in PD patients.

  9. Prognostic Nutritional Index and the Risk of Mortality in Patients With Acute Heart Failure.

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    Cheng, Yu-Lun; Sung, Shih-Hsien; Cheng, Hao-Min; Hsu, Pai-Feng; Guo, Chao-Yu; Yu, Wen-Chung; Chen, Chen-Huan

    2017-06-25

    Nutritional status has been related to clinical outcomes in patients with heart failure. We assessed the association between nutritional status, indexed by prognostic nutritional index (PNI), and survival in patients hospitalized for acute heart failure. A total of 1673 patients (age 76±13 years, 68% men) hospitalized for acute heart failure in a tertiary medical center were analyzed. PNI was calculated as 10×serum albumin (g/dL)+0.005×total lymphocyte count (per mm(3)). National Death Registry was linked to identify the clinical outcomes of all-cause and cardiovascular death. With increasing tertiles of PNI, age and N-terminal probrain natriuretic peptide decreased, and body mass index, estimated glomerular filtration rate, and hemoglobin increased. During a mean follow-up duration of 31.5 months, a higher PNI tertile was related to better survival free from all-cause and cardiovascular mortality in the total study population and in participants with either reduced or preserved left ventricular ejection fraction. After accounting for age, sex, estimated glomerular filtration rate, left ventricular ejection fraction, serum sodium level, and on-admission systolic blood pressure, PNI was independently associated with cardiovascular death and total mortality (hazard ratio per 1 SD of the natural logarithm of the PNI: 0.76 [95% CI, 0.66-0.87] and 0.79 [95% CI, 0.73-0.87], respectively). In subgroup analyses stratified by age, sex, left ventricular ejection fraction, body mass index, or estimated glomerular filtration rate, PNI was consistently related to mortality. PNI is independently associated with long-term survival in patients hospitalized for acute heart failure with either reduced or preserved left ventricular ejection fraction. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  10. Prognosis Prediction for Postoperative Esophageal Cancer Patients Using Onodera's Prognostic Nutritional Index.

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    Matsumoto, Hideo; Okamoto, Yuko; Kawai, Akimasa; Ueno, Daisuke; Kubota, Hisako; Murakami, Haruaki; Higashida, Masaharu; Hirai, Toshihiro

    2017-01-01

    Preoperative nutritional status may impact surgical outcome and prognosis. We evaluated the predictive value of Onodera's prognostic nutritional index (O's-PNI) of surgical outcome following esophagectomy in esophageal cancer patients. In total, 144 patients undergoing esophagectomy for esophageal cancer from April 2010 to May 2015 were evaluated, retrospectively. Eighty-four patients were enrolled in this study. O's-PNIs were calculated before surgery, discharge, and 1, 2, and 6 mo after discharge. The relationship between O's-PNI and occurrence of complications as classified by the Clavien-Dindo (C-D) classification, length of hospital stay, and survival time was investigated. The mean O's-PNI for patients with complications of more than Grade 2 by the C-D classification was 37.4, which was significantly lower than that for Grades 0 or 1 (40.5, P = 0.0094). A negative correlation was obtained between O's-PNI and hospital stay length (P = 0.0006), whereas a positive correlation was obtained for O's-PNI at 6 mo postsurgery and overall survival (P = 0.0171, P = 0.0201). O's-PNI may represent a useful indicator of the occurrence of complications and length of hospital stay, and may influence overall survival at 6 mo postsurgery. Nutritional management during the perioperative period could therefore contribute to satisfactory outcomes following esophagectomy in esophageal cancer patients.

  11. Prognostic Impact of the Geriatric Nutritional Risk Index on Long-Term Outcomes in Patients Who Underwent Percutaneous Coronary Intervention.

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    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Hassan, Ahmed; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-06-01

    Malnutrition has been identified as an important predictor of poor clinical outcomes in patients with heart failure. The aim of this study is to examine the prognostic impact of nutritional status in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). The impact of nutrition, assessed using the geriatric nutritional risk index (GNRI) calculated by serum albumin and body mass index, was evaluated in 2,853 patients with CAD who underwent their first PCI between 2000 and 2011. Patients were assigned to tertiles based on their GNRI levels. The incidences of all-cause death and cardiac death were assessed. The median GNRI values were 101 (interquartile range 95 to 106). Lower GNRI levels were associated with older age and higher prevalence of acute coronary syndrome and chronic kidney disease. During the median follow-up period of 7.4 years, Kaplan-Meier curves showed ongoing divergence in rates of mortality among tertiles (GNRI nutritional status was associated with long-term clinical outcomes in CAD patients after PCI. Evaluation of GNRI carries important prognostic information and may guide the therapeutic approach to such patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. [Clinical application value of prognostic nutritional index for predicting survival in patients with advanced non-small cell lung cancer].

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    Xu, W J; Kang, Y M; Zhou, L; Chen, F F; Song, Y H; Zhang, C Q

    2017-02-23

    Objective: To explore the clinical application value of prognostic nutritional index(PNI) for predicting overall survival(OS) in patients with advanced non-small cell lung cancer (NSCLC). Methods: 123 patients with histologically confirmed non-small cell lung cancer were enrolled in this study, and their clinical and laboratory data were reviewed. The PNI was calculated as 10×serum albumin value+ 5×total lymphocyte countin peripheral blood.Univariate and multivariate analyses were used to identify the potential prognostic factors for advanced NSCLC. Results: PNI of the 123 NSCLC patients was 46.24±6.56. PNI was significantly associated with age, weight loss and pleural effusion (Prelationship with sex, smoking, hemoptysis, chest pain, dyspnea, histological type, clinical stage, and administration of chemotherapy (P>0.05). The median OS of the 123 patients was 19.5 months. The median OS in the higher PNI group (PNI≥46.24) and lower PNI group(PNI<46.24) were 25.2 months and 16.4 months, respectively.The 1-year survival rates were 80.6% and 63.9%, and 2-year survival rates were 54.8% and 19.6%, respectively (P<0.01). Univariate analysis showed that PNI, age, dyspnea, and weight loss were related to the OS of the advanced NSCLC patients (P<0.05). Multivariate analysis identified PNI as an independent prognostic factor for OS of advanced NSCLC (P<0.001). Conclusion: PNI can be easily calculated, and may be used as a relatively new prognostic indicator for advanced NSCLC in clinical practice.

  13. Prognostic nutritional index serves as a predicative marker of survival and associates with systemic inflammatory response in metastatic intrahepatic cholangiocarcinoma

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    Zhang C

    2016-10-01

    Full Text Available Chenyue Zhang,1,2 Haiyong Wang,1,3 Zhouyu Ning,1,2 Litao Xu,1,2 Liping Zhuang,1,2 Peng Wang,1,2 Zhiqiang Meng1,2 1Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 3Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, People’s Republic of China Objective: The significance of the prognostic nutritional index (PNI has been widely reported and confirmed in many types of cancers. However, few studies are available indicating its prognostic power in patients with intrahepatic cholangiocarcinoma (ICC. Thus, we investigated its relationship with overall survival (OS to evaluate its role in predicting survival in patients with ICC. Patients and methods: Between October 2011 and October 2015, 173 consecutive patients with pathologically confirmed locally advanced or metastatic ICC were enrolled. First, the correlations between PNI and clinical factors were analyzed among these patients. Next, univariate and multivariate analyses were conducted to evaluate the association between PNI and OS among these patients with ICC. In addition, the relationships between PNI and three typical systemic inflammatory response (SIR markers – the neutrophil/lymphocyte ratio (NLR, the platelet/lymphocyte ratio (PLR, and the lymphocyte/monocyte ratio (LMR – were also assessed. Results: A lower PNI was linked with a shorter OS in patients with ICC, as reflected obviously in the Kaplan–Meier analyses. The patients with ICC were divided into the locally advanced group and the metastatic group. Further analyses revealed that PNI is not associated with OS in the locally advanced group. However, in the subgroup of patients with metastatic ICC, a lower PNI significantly correlated with a worsened OS. The OS for patients with a low PNI is 5 months, whereas the OS is 10.17 months for patients with a high PNI. Multivariate analyses revealed

  14. Preoperative prognostic nutritional index and nomogram predicting recurrence-free survival in patients with primary non-muscle-invasive bladder cancer without carcinoma in situ

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    Cui J

    2017-11-01

    Full Text Available Jianfeng Cui,1,* Shouzhen Chen,1,* Qiyu Bo,2 Shiyu Wang,1 Ning Zhang,1 Meng Yu,1 Wenfu Wang,1 Jie Han,3 Yaofeng Zhu,1 Benkang Shi1 1Department of Urology, 2Department of First Operating Room, Qilu Hospital of Shandong University, 3Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong University, Jinan, People’s Republic of China *These authors contributed equally to this work Background and objectives: Among the cancers of the urogenital system, bladder cancer is ranked second both in incidence and mortality, and hence, a more accurate estimate of the prognosis for individual patients with non-muscle-invasive bladder cancer (NMIBC is urgently needed. Prognostic nutritional index (PNI which is based on serum albumin levels and peripheral lymphocyte count has been confirmed to have prognostic value in various cancers. The aim of this study was to clarify the prognostic value of PNI in patients with NMIBC.Methods: Data of 329 patients with NMIBC were evaluated retrospectively. Recurrence-free survival (RFS was assessed using the Kaplan–Meier method, and the equivalences of survival curves were tested by log-rank tests. The univariate and multivariate analyses were performed using the Cox proportional hazards regression model. Discrimination of the nomogram was measured by the concordance index. A p-value of <0.05 was considered statistically significant.Results: In univariate analysis, age, tumor focality, tumor size, tumor grade, pathological T stage and preoperative PNI were significantly associated with RFS. Multivariate analysis identified PNI as an independent predictor of RFS in patients with NMIBC. According to these independent predictors, a nomogram for the prediction of recurrence was developed.Conclusion: PNI can be regarded as an independent prognostic factor for predicting RFS in NMIBC. The nomogram could be useful to improve personalized therapy for patients with NMIBC. Keywords: non

  15. The optimal cut-off value of the preoperative prognostic nutritional index for the survival differs according to the TNM stage in hepatocellular carcinoma.

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    Okamura, Yukiyasu; Sugiura, Teiichi; Ito, Takaaki; Yamamoto, Yusuke; Ashida, Ryo; Uesaka, Katsuhiko

    2017-08-01

    To establish the optimal cut-off value of the preoperative prognostic nutritional index (PNI) for prognosis according to the Tumor Node Metastasis (TNM) stage of hepatocellular carcinoma (HCC) after curative resection. This retrospective study reviewed the records of 375 patients. The optimal cut-off value of the PNI was established according to the TNM stage, and overall survival was compared between the low and high PNI groups. The optimal cut-off value of the PNI decreased with increasing TNM stage, with 52, 47, and 43 patients having stage I, II, and III HCC, respectively. A low preoperative PNI predicted a poorer overall survival than did a high PNI for stage I (P cut-off value for the PNI for prognosis differs among the TNM stages and that the preoperative PNI is a favorable prognostic factor for stage I HCC.

  16. Beyond Body Mass Index. Is the Body Cell Mass Index (BCMI) a useful prognostic factor to describe nutritional, inflammation and muscle mass status in hospitalized elderly?: Body Cell Mass Index links in elderly.

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    Rondanelli, Mariangela; Talluri, Jacopo; Peroni, Gabriella; Donelli, Chiara; Guerriero, Fabio; Ferrini, Krizia; Riggi, Emilia; Sauta, Elisabetta; Perna, Simone; Guido, Davide

    2017-03-24

    The aim of this study was to establish the effectiveness of Body Cell Mass Index (BCMI) as a prognostic index of (mal)nutrition, inflammation and muscle mass status in the elderly. A cross-sectional observational study has been conducted on 114 elderly patients (80 women and 34 men), with mean age equal to 81.07 ± 6.18 years. We performed a multivariate regression model by Structural Equation Modelling (SEM) framework. We detected the effects over a Mini Nutritional Assessment (MNA) stratification, by performing a multi-group multivariate regression model (via SEM) in two MNA nutritional strata, less and bigger (or equal) than 17. BCMI had a significant effect on albumin (β = +0.062, P = 0.001), adjusting for the other predictors of the model as Body Mass Index (BMI), age, sex, fat mass and cognitive condition. An analogous result is maintained in MNAmass (FFM) (β = +0.480, P Index (SMI) (β = +0.265, P < 0.001), assessed by DXA. BCMI also returned suggestive evidences (0.05 < P < 0.10) for both the effect on FFM and on SMI in overall sample. The main result of this study is that the BCMI, compared to BMI, proved to be significantly related to an important marker as albumin in geriatric population. Then, assessing the BCMI could be a valuable, inexpensive, easy to perform tool to investigate the inflammation status of elderly patients. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  17. Usefulness of Geriatric Nutritional Risk Index for Assessing Nutritional Status and Its Prognostic Impact in Patients Aged ≥65 Years With Acute Heart Failure.

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    Honda, Yasuyuki; Nagai, Toshiyuki; Iwakami, Naotsugu; Sugano, Yasuo; Honda, Satoshi; Okada, Atsushi; Asaumi, Yasuhide; Aiba, Takeshi; Noguchi, Teruo; Kusano, Kengo; Ogawa, Hisao; Yasuda, Satoshi; Anzai, Toshihisa

    2016-08-15

    Malnutrition is becoming one of the most important determinants of worse clinical outcomes in patients with acute heart failure (AHF). However, appropriate tools for evaluating the nutritional status in patients aged ≥65 years with AHF remain unclear. We examined 490 consecutive patients aged ≥65 years with AHF. They were divided into 2 groups according to Geriatric Nutritional Risk Index (GNRI; cut-off value = 92). During a median period of 189 days, the mortality rate was significantly higher in the lower GNRI group than the higher GNRI group (p nutritional indexes. Adding GNRI to an existing outcome prediction model for mortality in AHF significantly increased the C-statistic from 0.68 to 0.74 (p = 0.017). The net reclassification improvement afforded by GNRI was 60% overall, 27% for events, and 33% for nonevents (p nutritional parameters. Furthermore, the assessment of nutritional status using GNRI is very helpful for risk stratification. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. A preoperative low nutritional prognostic index correlates with the incidence of incisional surgical site infections after bowel resection in patients with Crohn's disease.

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    Maeda, Kiyoshi; Nagahara, Hisashi; Shibutani, Masatsune; Otani, Hiroshi; Sakurai, Katsunobu; Toyokawa, Takahiro; Tanaka, Hiroaki; Kubo, Naoshi; Muguruma, Kazuya; Kamata, Noriko; Yamagami, Hirokazu; Hirakawa, Kosei

    2015-11-01

    The incidence of incisional surgical site infections (SSIs) is reported to be higher among patients with Crohn's disease (CD) than among those with colorectal cancer. It has also been reported that the preoperative nutritional and inflammatory status is associated with the frequency of postoperative complications. Onodera's prognostic nutritional index (OPNI) is a simple and useful parameter for determining the nutritional and inflammatory status. In the present study, we retrospectively investigated the correlation between the OPNI and the incidence of incisional SSI in patients with CD who had undergone bowel resection. A total of 177 CD patients who underwent abdominal surgery were enrolled. Various clinical factors and the OPNI values were evaluated to identify risk factors for incisional SSIs. The incidence of incisional SSIs was 19.8 %. A multivariate analysis indicated that the OPNI was an independent risk factor for incisional SSIs. The results of this retrospective study suggest that the OPNI is an independent risk factor for incisional SSIs in patients with a history of bowel resection for CD.

  19. A Novel Inflammation- and Nutrition-Based Prognostic System for Patients with Laryngeal Squamous Cell Carcinoma: Combination of Red Blood Cell Distribution Width and Body Mass Index (COR-BMI)

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    Yan Fu; Yize Mao; Shiqi Chen; Ankui Yang; Quan Zhang

    2016-01-01

    Background Laryngeal squamous cell carcinoma (LSCC) is a head and neck cancer type. In this study, we introduced a novel inflammation- and nutrition-based prognostic system, referred to as COR-BMI (Combination of red blood cell distribution width and body mass index), for LSCC patients. Methods A total of 807 LSCC patients (784 male and 23 female, 22?87 y of age) who underwent surgery were enrolled in this retrospective cohort study. The patients were stratified by COR-BMI into three groups: ...

  20. A Novel Inflammation- and Nutrition-Based Prognostic System for Patients with Laryngeal Squamous Cell Carcinoma: Combination of Red Blood Cell Distribution Width and Body Mass Index (COR-BMI).

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    Fu, Yan; Mao, Yize; Chen, Shiqi; Yang, Ankui; Zhang, Quan

    Laryngeal squamous cell carcinoma (LSCC) is a head and neck cancer type. In this study, we introduced a novel inflammation- and nutrition-based prognostic system, referred to as COR-BMI (Combination of red blood cell distribution width and body mass index), for LSCC patients. A total of 807 LSCC patients (784 male and 23 female, 22-87 y of age) who underwent surgery were enrolled in this retrospective cohort study. The patients were stratified by COR-BMI into three groups: COR-BMI (0) (RDW ≤ 13.1 and BMI ≥ 25); COR-BMI (1) (RDW ≤ 13.1 and BMI 13.1 and 18.5 ≤ BMI 13.1 and BMI cancer-specific survival (CSS) rate among LSCC patients. The 5-y, 10-y, and 15-y CSS rates were 71.6%, 60.1%, and 55.4%, respectively. There were significant differences among the COR-BMI groups in age (nutrition-based prognostic system, which could predict long-term survival in LSCC patients who underwent surgery.

  1. Prognostic impact of nutritional risk assessment in patients with chronic schizophrenia.

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    Tsai, Ming-Tsun; Chang, Tien-Hao; Wu, Bo-Jian

    2017-04-22

    Protein-energy wasting is associated with poor outcome in various clinical settings. However, the prevalence of malnutrition and the prognostic impact of nutritional status are poorly understood in institutionalized patients with chronic schizophrenia. This study aimed to assess the predictive ability of the Geriatric Nutritional Risk Index and Onodera's Prognostic Nutritional Index for long-term outcomes in patients with chronic schizophrenia. All measurements, including nutritional scores, were performed at baseline after the enrollment of 542 (64.6% men, mean age 53.8±9.7years) patients with chronic schizophrenia. The median follow-up period was 408days. The endpoints were falls and infection-related hospitalizations. At study completion, 34 patients suffered falls and 40 patients were admitted to hospitals due to infection. Both indices showed significant association with infectious complications, whereas only the Onodera's Prognostic Nutritional Index was significantly associated with falls. The adjusted hazard ratios (95% confidence intervals) of low Onodera's Prognostic Nutritional Index were 2.38 (1.16-4.86) for falls and 1.99 (1.05-3.76) for infectious complications. The Onodera's Prognostic Nutritional Index is more appropriate than the Geriatric Nutritional Risk Index in identifying patients with chronic schizophrenia who are at risk for malnutrition and nutrition-related morbidity. Further studies are needed to explore whether early detection of patients with schizophrenia who are at risk for malnutrition could lead to the reduction of morbidity and mortality with the aid of appropriate interventions. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. A Novel Inflammation- and Nutrition-Based Prognostic System for Patients with Laryngeal Squamous Cell Carcinoma: Combination of Red Blood Cell Distribution Width and Body Mass Index (COR-BMI.

    Directory of Open Access Journals (Sweden)

    Yan Fu

    Full Text Available Laryngeal squamous cell carcinoma (LSCC is a head and neck cancer type. In this study, we introduced a novel inflammation- and nutrition-based prognostic system, referred to as COR-BMI (Combination of red blood cell distribution width and body mass index, for LSCC patients.A total of 807 LSCC patients (784 male and 23 female, 22-87 y of age who underwent surgery were enrolled in this retrospective cohort study. The patients were stratified by COR-BMI into three groups: COR-BMI (0 (RDW ≤ 13.1 and BMI ≥ 25; COR-BMI (1 (RDW ≤ 13.1 and BMI 13.1 and 18.5 ≤ BMI 13.1 and BMI < 18.5. Cox regression models were used to investigate the association between COR-BMI and cancer-specific survival (CSS rate among LSCC patients.The 5-y, 10-y, and 15-y CSS rates were 71.6%, 60.1%, and 55.4%, respectively. There were significant differences among the COR-BMI groups in age (< 60 versus ≥ 60 y; P = 0.005 and T stage (T1, T2, T3, or T4; P = 0.013. Based on the results, COR-BMI (1 versus 0: HR = 1.76; 95% CI = 0.98-3.15; 2 versus 0: HR = 2.91; 95% CI = 1.53-5.54, P = 0.001 was a significant independent predictor of CSS.COR-BMI is a novel inflammation- and nutrition-based prognostic system, which could predict long-term survival in LSCC patients who underwent surgery.

  3. Glycemic index in sport nutrition.

    Science.gov (United States)

    Mondazzi, Luca; Arcelli, Enrico

    2009-08-01

    Carbohydrates (CHO) can be classified on the basis of their glycemic index (GI), and the use of this classification has been increasingly supported by science. Because of its impact on blood glucose and insulin responses following the ingestion of CHO foods, the GI has been studied in many fields of medicine, including sport nutrition. As a new tool in sport nutrition, glycemic index manipulation has been evaluated to improve the first and second phases of glycogen recovery, glycogen load, and exercise metabolism, including control of rebound hypoglycemia and, it is interesting to note, stimulation of lipid oxidation for longer availability of glucose sources during endurance exercise. Although attractive, the use of GI in sport nutrition has received only partial support from available experimental evidence. At the biochemical level, consistent evidence has been attained to suggest that GI manipulation can determine variations in adipocyte lipolysis, plasma free fatty acids levels, and lipid and CHO oxidation rates during exercise. However, when the effects of GI manipulation have been assessed at the functional level, the results have been inconsistent, with evidence of improved exercise performance in some studies, but not in many others. The purpose of the current article is to review the effects and limits of GI manipulation in sport nutrition, and to propose an overall strategy for its application.

  4. A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma

    NARCIS (Netherlands)

    Hoster, Eva; Dreyling, Martin; Klapper, Wolfram; Gisselbrecht, Christian; van Hoof, Achiel; Kluin-Nelemans, Hanneke C.; Pfreundschuh, Michael; Reiser, Marcel; Metzner, Bernd; Einsele, Hermann; Peter, Norma; Jung, Wolfram; Woermann, Bernhard; Ludwig, Wolf-Dieter; Duehrsen, Ulrich; Eimermacher, Hartmut; Wandt, Hannes; Hasford, Joerg; Hiddemann, Wolfgang; Unterhalt, Michael

    2008-01-01

    There is no generally established prognostic index for patients with mantle cell lymphoma (MCL), because the International Prognostic Index (IPI) and Follicular Lymphoma International Prognostic Index (FLIPI) have been developed for diffuse large cell and follicular lymphoma patients, respectively.

  5. Validation of a prognostic index for Huntington's disease.

    Science.gov (United States)

    Long, Jeffrey D; Langbehn, Douglas R; Tabrizi, Sarah J; Landwehrmeyer, Bernhard G; Paulsen, Jane S; Warner, John; Sampaio, Cristina

    2017-02-01

    Characterizing progression in Huntington's disease is important for study the natural course and selecting appropriate participants for clinical trials. The aim was to develop a prognostic index for motor diagnosis in Huntington's disease and examine its predictive performance in external observational studies. The prediagnosis Neuro-biological Predictors of Huntington's Disease study (N = 945 gene-positive) was used to select a Cox regression model for computing a prognostic index. Cross-validation was used for selecting a model with good internal validity performance using the research sites as natural splits of the data set. Then, the external predictive performance was assessed using prediagnosis data from three additional observational studies, The Cooperative Huntington Observational Research Trial (N = 358), TRACK-HD (N = 118), and REGISTRY (N = 480). Model selection yielded a prognostic index computed as the weighted combination of the UHDRS total motor score, Symbol Digit Modalities Test, baseline age, and cytosine-adenine-guanine expansion. External predictive performance was very good for the first two of the three studies, with the third being a much more progressed cohort than the other studies. The databases were pooled and a final Cox regression model was estimated. The regression coefficients were scaled to produce the prognostic index for Huntington's disease, and a normed version, which is scaled relative to a 10-year 50% probability of motor diagnosis. The positive results of this comprehensive validity analysis provide evidence that the prognostic index is generally useful for predicting Huntington's disease progression in terms of risk of future motor diagnosis. The variables for the index are routinely collected in ongoing observational studies and the index can be used to identify cohorts for clinical trial recruitment. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  6. The prognostic impact of objective nutritional indices in elderly patients with ST-elevation myocardial infarction undergoing primary coronary intervention.

    Science.gov (United States)

    Basta, Giuseppina; Chatzianagnostou, Kyriazoula; Paradossi, Umberto; Botto, Nicoletta; Del Turco, Serena; Taddei, Alessandro; Berti, Sergio; Mazzone, Annamaria

    2016-10-15

    The prognostic impact of nutritional status in ST-elevation myocardial infarction (STEMI) patients is poorly understood. We used the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) score on outcomes of 945 patients with acute STEMI undergoing primary percutaneous coronary intervention with stent. During a median follow-up of 2years (1-3.3years, interquartile range), 56 patients (5.9%) died for all-cause of death. In the dead group, the CONUT and PNI scores were more severe than in the alive group. Elderly patients (≥71years) had nutritional indices more serious than patients nutritional status evaluated by the CONUT score, in addition to other comorbidities, can affect the prognosis in elderly patients. These results suggest a personalized nutritional treatment as well as an accurate assessment of the appropriateness of lipid-lowering treatment after coronary revascularization. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Nutritional status in the era of target therapy: poor nutrition is a prognostic factor in non-small cell lung cancer with activating epidermal growth factor receptor mutations.

    Science.gov (United States)

    Park, Sehhoon; Park, Seongyeol; Lee, Se-Hoon; Suh, Beomseok; Keam, Bhumsuk; Kim, Tae Min; Kim, Dong-Wan; Kim, Young Whan; Heo, Dae Seog

    2016-11-01

    Pretreatment nutritional status is an important prognostic factor in patients treated with conventional cytotoxic chemotherapy. In the era of target therapies, its value is overlooked and has not been investigated. The aim of our study is to evaluate the value of nutritional status in targeted therapy. A total of 2012 patients with non-small cell lung cancer (NSCLC) were reviewed and 630 patients with activating epidermal growth factor receptor (EGFR) mutation treated with EGFR tyrosine kinase inhibitor (TKI) were enrolled for the final analysis. Anemia, body mass index (BMI), and prognostic nutritional index (PNI) were considered as nutritional factors. Hazard ratio (HR), progression-free survival (PFS) and overall survival (OS) for each group were calculated by Cox proportional analysis. In addition, scores were applied for each category and the sum of scores was used for survival analysis. In univariable analysis, anemia (HR, 1.29; p = 0.015), BMI lower than 18.5 (HR, 1.98; p = 0.002), and PNI lower than 45 (HR, 1.57; p nutritional status is a prognostic marker in NSCLC patients treated with EGFR TKI. Hence, baseline nutritional status should be more carefully evaluated and adequate nutrition should be supplied to these patients.

  8. Relationship between nutritional status and the Glasgow Prognostic Score in patients with colorectal cancer.

    Science.gov (United States)

    Maurício, Sílvia Fernandes; da Silva, Jacqueline Braga; Bering, Tatiana; Correia, Maria Isabel Toulson Davisson

    2013-04-01

    The association between nutritional status and inflammation was assessed in patients with colorectal cancer and to verify their association with complications during anticancer treatment. The agreement between the Subjective Global Assessment (SGA) and different nutritional assessment methods was also evaluated. A cross-sectional, prospective, and descriptive study was performed. The nutritional status was defined by the SGA and the severity of inflammation was defined by the Glasgow Prognostic Score (GPS). The complications were classified using the Common Toxicity Criteria, version 3. Anthropometric measurements such as body mass index, triceps skinfold, midarm circumference, midarm muscle area, and adductor pollicis muscle thickness were also performed, as were handgrip strength and phase angle. The chi-square test, Fisher exact test, Spearman correlation coefficient, independent t test, analysis of variance, Gabriel test, and κ index were used for the statistical analysis. P cancer (60.4 ± 14.3 y old) were included. The nutritional status according to the SGA was associated with the GPS (P nutritional assessment methods with the SGA, there were statistically significant differences. Malnutrition is highly prevalent in patients with colorectal cancer. The nutritional status was associated with the GPS. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Improving the Prognostic Ability through Better Use of Standard Clinical Data - The Nottingham Prognostic Index as an Example.

    Directory of Open Access Journals (Sweden)

    Klaus-Jürgen Winzer

    Full Text Available Prognostic factors and prognostic models play a key role in medical research and patient management. The Nottingham Prognostic Index (NPI is a well-established prognostic classification scheme for patients with breast cancer. In a very simple way, it combines the information from tumor size, lymph node stage and tumor grade. For the resulting index cutpoints are proposed to classify it into three to six groups with different prognosis. As not all prognostic information from the three and other standard factors is used, we will consider improvement of the prognostic ability using suitable analysis approaches.Reanalyzing overall survival data of 1560 patients from a clinical database by using multivariable fractional polynomials and further modern statistical methods we illustrate suitable multivariable modelling and methods to derive and assess the prognostic ability of an index. Using a REMARK type profile we summarize relevant steps of the analysis. Adding the information from hormonal receptor status and using the full information from the three NPI components, specifically concerning the number of positive lymph nodes, an extended NPI with improved prognostic ability is derived.The prognostic ability of even one of the best established prognostic index in medicine can be improved by using suitable statistical methodology to extract the full information from standard clinical data. This extended version of the NPI can serve as a benchmark to assess the added value of new information, ranging from a new single clinical marker to a derived index from omics data. An established benchmark would also help to harmonize the statistical analyses of such studies and protect against the propagation of many false promises concerning the prognostic value of new measurements. Statistical methods used are generally available and can be used for similar analyses in other diseases.

  10. Bacterial brain abscesses: prognostic value of an imaging severity index

    Energy Technology Data Exchange (ETDEWEB)

    Demir, M.K. [Department of Radiology, Trakya University School of Medicine, Edirne (Turkey)]. E-mail: demirkemal@superonline.com; Hakan, T. [Department of Neurosurgery, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Kilicoglu, G. [Department of Radiology, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Ceran, N. [Department of Infectious Disease, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Berkman, M.Z. [Department of Neurosurgery, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Erdem, I. [Department of Infectious Disease, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Goektas, P. [Department of Infectious Disease, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey)

    2007-06-15

    Aim: To assess the correlation between imaging findings [computed tomography (CT) or magnetic resonance imaging (MRI)] and neurological status before and after the treatment of bacterial brain abscesses. Materials and methods: CT and MRI images of 96 patients with brain abscesses were retrospectively evaluated in terms of the number, location and size of lesions, and the presence and extent of perilesional oedema and midline shift. An imaging severity index (ISI) based on these different radiological parameters was calculated. Initial Glasgow Coma Scale (GCS) scores and ISI were assessed and the prognostic value of these two indices was calculated. The Pearson correlation test, Mann-Whitney test, Chi-square test, receiver-operating characteristic (ROC) analysis, together with comparison of ROC analyses and Fisher's exact test were used. Results: There was a negative correlation between ISI and the initial GCS values: ISI increased as the GCS score decreased, indicating an inverse relationship (r = -0.51, p < 0.0001). There was a significant difference between the ISI and GCS scores of patients with an adverse event compared with patients with good recovery. Outcome was significantly worse in patients with initial ISI over the calculated cut-off values of 8 points or GCS scores under the cut-off value of 13 points. Conclusion: ISI is a useful prognostic indicator for bacterial brain abscess patients and correlates strongly with the patient outcome for all parameters studied. ISI score had a better prognostic value than GCS.

  11. [Nutritional index in heart diseases in childhood].

    Science.gov (United States)

    Granzotti, J A; Falha, S L; Nunes, M D

    1990-12-01

    To study heart disease in childhood aiming to know its incidence and consequences upon the nutritional status. Two-hundred patients were distributed in three groups: 1) 113 (56.5%) with congenital acyanotic form; 2) 19 (9.5%) with congenital cyanotic form and 3) 68 (34%) with acquired forms. All of them regularly visiting the ambulatory service of Paediatric cardiology of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP from 1987 until 1990. The majority (92%) of the children (being 56% male and aging 5.1 +/- 0.4 years-old) showed nutritional indexes between 5 and 95 (percentile scale). The overall diagnosis distribution were: 1) ventricular septal defect (51 cases); 2) atrial septal defect (21 cases); 3) valvular diseases (21 cases); 4) arrhythmias (20 cases); 5) cardiac involvement of systemic diseases (20 cases); and 6) tetralogy complex (8 cases). Twelve patients (6%) were underscored (below percentile 5) and only 4 (2%) scored above percentile 95 (obese patients). The comparison of the mean indexes were found statistical different (p less than 0.05), being the cyanotic congenital forms the worst ones and the acquired forms the best one. Heart disease in childhood is associated to nutritional index deficits in the majority of the cases.

  12. Assessment of the nutritional status of grassland: nitrogen nutrition index

    Directory of Open Access Journals (Sweden)

    Laércio Ricardo Sartor

    2014-02-01

    Full Text Available The aim of this study was to assess the Nitrogen Nutrition Index (NNI of an Urochloa plantaginea pasture submitted to different nitrogen (N levels and forage mass (FM through dilution curve model. The experimental design was a random block with six treatments in a factorial scheme. The treatments combination consisted of three nitrogen levels (0, 200 and 400 kg ha-1 of N and two forage mass (low mass at 2,000 kg ha-1 of DM and high mass at 3,600 kg ha-1 of DM in a continuous stocking rate grazing method. Urochloa plantaginea forage production was higher at the nitrogen intermediate level (200 kg ha-1 of N, being 31% superior than treatment without nitrogen, which showed unsatisfactory nitrogen nutritional index and due to it, limited forage growth. This fact was not observed at the 400 kg ha-1 of N, where nitrogen luxury consumption occurred showed by the satisfactory levels of this nutrient in the plant tissue. Nitrogen dilution curve allows the diagnosis of the plants nutritional status.

  13. Postoperative outcome after oesophagectomy for cancer: Nutritional status is the missing ring in the current prognostic scores.

    Science.gov (United States)

    Filip, B; Scarpa, M; Cavallin, F; Cagol, M; Alfieri, R; Saadeh, L; Ancona, E; Castoro, C

    2015-06-01

    Several prognostic scores were designed in order to estimate the risk of postoperative adverse events. None of them includes a component directly associated to the nutritional status. The aims of the study were the evaluation of performance of risk-adjusted models for early outcomes after oesophagectomy and to develop a score for severe complication prediction with special consideration regarding nutritional status. A comparison of POSSUM and Charlson score and their derivates, ASA, Lagarde score and nutritional index (PNI) was performed on 167 patients undergoing oesophagectomy for cancer. A logistic regression model was also estimated to obtain a new prognostic score for severe morbidity prediction. Overall morbidity was 35.3% (59 cases), severe complications (grade III-V of Clavien-Dindo classification) occurred in 20 cases. Discrimination was poor for all the scores. Multivariable analysis identified pulse, connective tissue disease, PNI and potassium as independent predictors of severe morbidity. This model showed good discrimination and calibration. Internal validation using standard bootstrapping techniques confirmed the good performance. Nutrition could be an independent risk factor for major complications and a nutritional status coefficient could be included in current prognostic scores to improve risk estimation of major postoperative complications after oesophagectomy for cancer. Copyright © 2015. Published by Elsevier Ltd.

  14. The Practicability of a Novel Prognostic Index (PI) Model and Comparison with Nottingham Prognostic Index (NPI) in Stage I-III Breast Cancer Patients Undergoing Surgical Treatment.

    Science.gov (United States)

    Wen, Jiahuai; Ye, Feng; Li, Shuaijie; Huang, Xiaojia; Yang, Lu; Xiao, Xiangsheng; Xie, Xiaoming

    2015-01-01

    Previous studies have indicated the prognostic value of various laboratory parameters in cancer patients. This study was to establish a prognostic index (PI) model for breast cancer patients based on the potential prognostic factors. A retrospective study of 1661 breast cancer patients who underwent surgical treatment between January 2002 and December 2008 at Sun Yat-sen University Cancer Center was conducted. Multivariate analysis (Cox regression model) was performed to determine the independent prognostic factors and a prognostic index (PI) model was devised based on these factors. Survival analyses were used to estimate the prognostic value of PI, and the discriminatory ability of PI was compared with Nottingham Prognostic Index (NPI) by evaluating the area under the receiver operating characteristics curves (AUC). The mean survival time of all participants was 123.6 months. The preoperative globulin >30.0g/L, triglyceride >1.10mmol/L and fibrinogen >2.83g/L were identified as risk factors for shorter cancer-specific survival. The novel prognostic index model was established and enrolled patients were classified as low- (1168 patients, 70.3%), moderate- (410 patients, 24.7%) and high-risk groups (83 patients, 5.0%), respectively. Compared with the low-risk group, higher risks of poor clinical outcome were indicated in the moderate-risk group [Hazard ratio (HR): 1.513, 95% confidence interval (CI): 1.169-1.959, p = 0.002] and high-risk group (HR: 2.481, 95%CI: 1.653-3.724, p< 0.001). The prognostic index based on three laboratory parameters was a novel and practicable prognostic tool. It may serve as complement to help predict postoperative survival in breast cancer patients.

  15. Prognostic indices of poor nutritional status and their impact on prolonged hospital stay in a Greek university hospital.

    Science.gov (United States)

    Tsaousi, Georgia; Panidis, Stavros; Stavrou, George; Tsouskas, John; Panagiotou, Dimitrios; Kotzampassi, Katerina

    2014-01-01

    To ascertain the potential contributors to nutritional risk manifestation and to disclose the factors exerting a negative impact on hospital length of stay (LOS), by means of poor nutritional status, in a nonselected hospitalized population. NutritionDay project questionnaires were applied to 295 adult patients. Study parameters included anthropometric data, demographics, medical history, dietary-related factors, and self-perception of health status. Body Mass Index (BMI) and Malnutrition Universal Screening Tool (MUST) were calculated for each participant. MUST score was applied for malnutrition assessment, while hospital LOS constituted the outcome of interest. Of the total cohort, 42.3% were at nutritional risk and 21.4% malnourished. Age, gender, BMI, MUST score, autonomy, health quality, appetite, quantity of food intake, weight loss, arm or calf perimeter (P nutritional status. Poor nutrition status (P = 0.000), deteriorated appetite (P = 0.000) or food intake (P = 0.025), limited autonomy (P = 0.013), artificial nutrition (P = 0.012), weight loss (P = 0.010), and arm circumference hospital LOS >7 days. Nutritional status and nutrition-related parameters such as weight loss, quantity of food intake, appetite, arm circumference, dietary type, and extent of dependence confer considerable prognostic value regarding hospital LOS in acute care setting.

  16. Naples Prognostic Score, Based on Nutritional and Inflammatory Status, is an Independent Predictor of Long-term Outcome in Patients Undergoing Surgery for Colorectal Cancer.

    Science.gov (United States)

    Galizia, Gennaro; Lieto, Eva; Auricchio, Annamaria; Cardella, Francesca; Mabilia, Andrea; Podzemny, Vlasta; Castellano, Paolo; Orditura, Michele; Napolitano, Vincenzo

    2017-12-01

    The existing scores reflecting the patient's nutritional and inflammatory status do not include all biomarkers and have been poorly studied in colorectal cancers. The purpose of this study was to assess a new prognostic tool, the Naples prognostic score, comparing it with the prognostic nutritional index, controlling nutritional status score, and systemic inflammation score. This was an analysis of patients undergoing surgery for colorectal cancer. The study was conducted at a university hospital. A total of 562 patients who underwent surgery for colorectal cancer in July 2004 through June 2014 and 468 patients undergoing potentially curative surgery were included. MaxStat analysis dichotomized neutrophil:lymphocyte ratio, lymphocyte:monocyte ratio, prognostic nutritional index, and the controlling nutritional status score. The Naples prognostic scores were divided into 3 groups (group 0, 1, and 2). The receiver operating characteristic curve for censored survival data compared the prognostic performance of the scoring systems. Overall survival and complication rates in all patients, as well as recurrence and disease-free survival rates in radically resected patients, were measured. The Naples prognostic score correlated positively with the other scoring systems (p < 0.001) and worsened with advanced tumor stages (p < 0.001). Patients with the worst Naples prognostic score experienced more postoperative complications (all patients, p = 0.010; radically resected patients, p = 0.026). Compared with group 0, patients in groups 1 and 2 had worse overall (group 1, HR = 2.90; group 2, HR = 8.01; p < 0.001) and disease-free survival rates (group 1, HR = 2.57; group 2, HR = 6.95; p < 0.001). Only the Naples prognostic score was an independent significant predictor of overall (HR = 2.0; p = 0.03) and disease-free survival rates (HR = 2.6; p = 0.01). The receiver operating characteristic curve analysis showed that the Naples prognostic score had the best prognostic

  17. Recurrent epithelial ovarian cancer: Validation and improvement of an established prognostic index

    DEFF Research Database (Denmark)

    Gronlund, B; Christensen, Ib Jarle; Bülow-Lehnsby, A L

    2005-01-01

    OBJECTIVES: To validate and improve an established prognostic index in patients with recurrent ovarian cancer. METHODS: A Canadian three-covariate prognostic index (tumour grade at diagnosis, initial performance status, and time to relapse/primary progression (TRP)) was validated in a well...... available), 25.0 (22.1-33.6), 11.3 (8.5-12.9), and 5.2 (3.5-6.3) months, respectively. CONCLUSIONS: A novel prognostic model (the Copenhagen index) for patients with recurrent ovarian cancer is presented.......-defined cohort of comparable Danish patients. Potential parameters to be included in an improved prognostic index were revealed by univariate and multivariate analyses in the Danish validation group. RESULTS: The Canadian index validated in the Danish patient population (n=189) found a statistical significant...

  18. A prognostic index for locoregional recurrence after neoadjuvant chemotherapy.

    Science.gov (United States)

    Herrero-Vicent, C; Guerrero-Zotano, A; Gavilá-Gregori, J; Hernández-Blanquisett, A; Sandiego-Contreras, S; Samper-Hiraldo, J M; Guillem-Porta, V; Ruiz-Simón, A

    2016-01-01

    The appropriate selection criteria for breast-conserving surgery (BCS) or mastectomy after neoadjuvant chemotherapy (NAC) are poorly defined. The aim of this study is to analyse the incidence and prognostic factors for locoregional recurrence (LRR) in patients with breast cancer (BC) treated with NAC to develop a prognostic score to help with clinical decision-making. Using our retrospective maintained BC database, we identified 730 patients treated with NAC (327 patients treated with BCS and 403 patients treated with mastectomy) between 1998 and 2014. To identify variables associated with an increased LRR rate, we performed firstly Kaplan-Meier curves, with comparisons among groups using log-rank test, and then, significant variables were included in a multivariate analysis using Cox proportional hazards. The prognostic index was developed by assigning score 0 (favourable) or score 1 (unfavourable) for each significant variable of multivariate analysis and was created separately for patients with BCS and mastectomy. At a median follow-up of 72 months, the 6-year cumulative incidence of LRR was 7.2% ( ± 3%) for BCS and 7.9% ( ± 3%) for mastectomy. By univariate analysis, variables associated with an increased LRR were for BCS: HER2 positive, grade III, ductal carcinoma in situ (DCIS), No-pCR (ypTis, ypN0), and age < 40 years; and for mastectomy, HER2-positive, DCIS, No-pCR, and LVI. By multivariate analysis, variables associated with an increased LRR were for BCS: HER2 positive (HR: 11.1, p = 0.001), DCIS (HR: 3.1, p = 0.005), and age < 40 years (HR: 2.8, p = 0.02); and for mastectomy: HER2 positive (HR: 9.5, p = 0.03), DCIS (HR: 2.7, p = 0.01), No-pCR (HR: 11.4, p = 0.01), and age < 40 years (HR: 2.8, p = 0.006). The score stratified patients into three subsets with statistically different levels of risk for LRR. For BCS, the six-year LRR rates were 3%, 13%, and 33% for the low (score 0, n = 120), intermediate (score 1, n = 95) and high (score 2-3, n = 27) risk

  19. A prognostic index for locoregional recurrence after neoadjuvant chemotherapy

    OpenAIRE

    Herrero-Vicent, C; Guerrero-Zotano, A; Gavil?-Gregori, J; Hern?ndez-Blanquisett, A; Sandiego-Contreras, S; Samper-Hiraldo, JM; Guillem-Porta, V; Ruiz-Sim?n, A

    2016-01-01

    Background The appropriate selection criteria for breast-conserving surgery (BCS) or mastectomy after neoadjuvant chemotherapy (NAC) are poorly defined. The aim of this study is to analyse the incidence and prognostic factors for locoregional recurrence (LRR) in patients with breast cancer (BC) treated with NAC to develop a prognostic score to help with clinical decision-making. Materials and methods Using our retrospective maintained BC database, we identified 730 patients treated with NAC (...

  20. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease : the updated BODE index and the ADO index

    NARCIS (Netherlands)

    Puhan, Milo A.; Garcia-Aymerich, Judith; Frey, Martin; ter Riet, Gerben; Anto, Josep M.; Agusti, Alvar G.; Gomez, Federico P.; Rodriguez-Roisin, Roberto; Moons, Karel G. M.; Kessels, Alphons G.; Held, Ulrike

    2009-01-01

    Background The BODE index (including body-mass index, airflow obstruction, dyspnoea, and exercise capacity) was an important contribution to the prognostic assessment of patients with chronic obstructive pulmonary disease (COPD). However, no study has assessed whether the risk of mortality predicted

  1. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: the updated BODE index and the ADO index

    NARCIS (Netherlands)

    Puhan, Milo A.; Garcia-Aymerich, Judith; Frey, Martin; ter Riet, Gerben; Antó, Josep M.; Agustí, Alvar G.; Gómez, Federico P.; Rodríguez-Roisín, Roberto; Moons, Karel G. M.; Kessels, Alphons G.; Held, Ulrike

    2009-01-01

    Background The BODE index (including body-mass index, airflow obstruction, dyspnoea, and exercise capacity) was an important contribution to the prognostic assessment of patients with chronic obstructive pulmonary disease (COPD). However, no study has assessed whether the risk of mortality predicted

  2. Geriatric nutritional risk index as a nutritional and survival risk assessment tool in stable outpatients with systolic heart failure.

    Science.gov (United States)

    Sargento, L; Vicente Simões, A; Rodrigues, J; Longo, S; Lousada, N; Palma Dos Reis, R

    2017-05-01

    Malnutrition is frequent in heart failure (HF). However, the best tool for evaluating malnutrition in geriatric patients with HF with reduced ejection fraction (HFrEF) is unknown. This study aimed to evaluate the incremental prognostic value of the geriatric nutritional risk index (GNRI) in stable geriatric outpatients with HFrEF compared with a clinical/laboratory prognostic model. A total of 143 outpatients with HFrEF, aged >65 years, a LVEF patients were at risk of malnutrition (GNRI ≤98). Deceased patients had a lower GNRI (113.6 ± 9.1 vs. 105.6 ± 9.2; p 98 (hazard ratio = 0.29, 95% CI 0.15-0.57; p geriatric outpatients with HFrEF is a strong independent predictor of survival. The GNRI adds significant prognostic information to the clinical/laboratory model. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  3. Prognostic Indices of Poor Nutritional Status and Their Impact on Prolonged Hospital Stay in a Greek University Hospital

    Directory of Open Access Journals (Sweden)

    Georgia Tsaousi

    2014-01-01

    Full Text Available Background. To ascertain the potential contributors to nutritional risk manifestation and to disclose the factors exerting a negative impact on hospital length of stay (LOS, by means of poor nutritional status, in a nonselected hospitalized population. Materials and Methods. NutritionDay project questionnaires were applied to 295 adult patients. Study parameters included anthropometric data, demographics, medical history, dietary-related factors, and self-perception of health status. Body Mass Index (BMI and Malnutrition Universal Screening Tool (MUST were calculated for each participant. MUST score was applied for malnutrition assessment, while hospital LOS constituted the outcome of interest. Results. Of the total cohort, 42.3% were at nutritional risk and 21.4% malnourished. Age, gender, BMI, MUST score, autonomy, health quality, appetite, quantity of food intake, weight loss, arm or calf perimeter (P7 days. Conclusion. Nutritional status and nutrition-related parameters such as weight loss, quantity of food intake, appetite, arm circumference, dietary type, and extent of dependence confer considerable prognostic value regarding hospital LOS in acute care setting.

  4. Short-Term Prognostic Index for Breast Cancer: NPI or Lpi

    Directory of Open Access Journals (Sweden)

    V. Van Belle

    2011-01-01

    Full Text Available Axillary lymph node involvement is an important prognostic factor for breast cancer survival but is confounded by the number of nodes examined. We compare the performance of the log odds prognostic index (Lpi, using a ratio of the positive versus negative lymph nodes, with the Nottingham Prognostic Index (NPI for short-term breast cancer specific disease free survival. A total of 1818 operable breast cancer patients treated in the University Hospital of Leuven between 2000 and 2005 were included. The performance of the NPI and Lpi were compared on two levels: calibration and discrimination. The latter was evaluated using the concordance index (cindex, the number of patients in the extreme groups, and difference in event rates between these. The NPI had a significant higher cindex, but a significant lower percentage of patients in the extreme risk groups. After updating both indices, no significant differences between NPI and Lpi were noted.

  5. Use of the glycemic index in nutrition education

    OpenAIRE

    Flávia Galvão Cândido; Elisângela Vitoriano Pereira; Rita de Cássia Gonçalves Alfenas

    2013-01-01

    Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicated as the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of the glycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic index foods. Studies published over the past 12 years, in addition to classic studies on this topic, found in the databases MedLine, ScienceDirect, SciELO and Li...

  6. Cell Proliferation Activity and Prognostic Index in Squamous Cell Lung Carcinoma

    Directory of Open Access Journals (Sweden)

    José Antonio Alvarez-Riesgo

    1998-01-01

    Full Text Available Flow Cytometry (FC has been incorporated into cancer research in relation to its prognostic value together with histological parameters and TNM stages. We have studied by means of FC the cell cycle of 132 samples from male patients with Squamous Cell Lung Carcinoma (SQCLC. All of the patients received curative surgery and the clinical follow-up was 60 months. The clinical and cytometric parameters were evaluated in order to predict the patients’ outcome. The presence of tumoural recurrence and the tumoural stage showed statistical significance associated with survival. The multivariant analysis reveals radiotherapy (p = 0.004 as protective variable and the high S-phase fraction (SPF (p = 0.001 and stage IIIA (p = 0.012 as risk factors. The SPF appears as an independent prognostic factor for overall survival time. We can build a prognostic index representative of different prognostic groups, which allows us to improve the individual monitoring of these patients.

  7. Association between an inflammatory-nutritional index and nutritional status in cancer patients.

    Science.gov (United States)

    Alberici Pastore, Carla; Paiva Orlandi, Silvana; González, María Cristina

    2013-01-01

    Cachexia is a multifatorial syndrome characterized by loss of body weight, fat and muscle, increasing morbidity and mortality. The use of an index accounting for both serum albumin and C Reactive Protein levels could make early identification of cachexia easier. To evaluate the variation of an inflammatory nutritional index related to nutritional status in cancer patients. Cross sectional study including patients with gastrointestinal and lung cancer of a public chemotherapy service in Brazil. Serum albumin and C Reactive Protein were measured and the nutritional status was defined by Subjective Global Assessment. Statistical analyses were performed using Stata 9.2(TM). A total of 74 patients were evaluated, 58.1% of them were male, mean age 63.4 ± 11.9 years old. Gastrointestinal cancer was the most prevalent type (71.6%). Only 13.7% of the patients were well nourished and 21.9% were severely malnourished. C Reactive Protein significantly increased according to nutritional status decline (p=0.03). When the albumin from patients with systemic inflammation was evaluated, there was no significant variation in relation to nutritional status (p=0.06). The Inflammatory Nutritional Index significantly varied in relation to nutritional status independent of the systemic inflammation (p=0.02). Inflammatory Nutritional Index can be an adjuvant way for biochemical nutritional assessment and follow up in cancer patients with systemic inflammation. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  8. The Enhanced International Prognostic Index for Diffuse Large B-cell Lymphoma.

    Science.gov (United States)

    Yang, Yan; Wang, Lanlan; Ma, Yanna; Han, Tingting; Huang, Mei

    2017-05-01

    To explore the prognostic value of the enhanced International Prognostic Index (NCCN-IPI) for Asian patients with diffuse large B-cell lymphoma (DLBCL) treated in the rituximab era. We performed a retrospective analysis of 176 patients with newly diagnosed DLBCL. The estimated overall survival (OS) and progression-free survival (PFS) of the different risk groups were discriminated by the International Prognostic Index (IPI), the revised International Prognostic Index (R-IPI) and the NCCN-IPI. With a median follow-up of 18 months, at 3 years, the OS was 73% and the PFS was 65%. The 3-year OS for the 4 NCCN-IPI risk groups were 91% versus 80% versus 57% versus 45% (P < 0.001); the 3-year PFS were 77% versus 72% versus 56% versus 26% (P < 0.001). The 3-year OS of the 4 risk groups discriminated by the IPI ranged from 85-55% (P < 0.001); the 3-year PFS ranged from 81-41% (P < 0.001). The 3-year OS of the 3 distinct prognostic groups by the R-IPI ranged from 86-51% (P < 0.001); the 3-year PFS ranged from 86-47% (P < 0.001). The 3-year OS and PFS of the high-risk group according to the NCCN-IPI were lower than the IPI and R-IPI. Using the NCCN-IPI, the outcomes among the risk groups spanned a large range, and the survival of the high-risk group was significantly different from the high-intermediate risk group. The NCCN-IPI is a clinically useful prognostic index for patients with DLBCL treated in the rituximab era, especially for high-risk patients. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  9. Use of the glycemic index in nutrition education

    Directory of Open Access Journals (Sweden)

    Flávia Galvão Cândido

    2013-02-01

    Full Text Available Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicated as the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of the glycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic index foods. Studies published over the past 12 years, in addition to classic studies on this topic, found in the databases MedLine, ScienceDirect, SciELO and Lilacs exploring the importance of the glycemic index and the factors that affect the glycemic index were selected for this article. The preparation of lists grouping foods according to their glycemic index should be based on information found in tables and specific web sites. This is an interesting strategy that must be very carefully conducted, considering the eating habits of the assisted people. To reduce the postprandial blood glucose response, high glycemic index foods should be consumed in association with the following foods: high protein and low fat foods, good quality oils and unprocessed foods with high fiber content. Caffeine should also be avoided. The glycemic index should be considered as an additional carbohydrate-selection tool, which should be part of a nutritionally balanced diet capable of promoting and/or maintaining body weight and health.

  10. USEFULNESS OF A NEW PROGNOSTIC INDEX FOR ALCOHOLIC HEPATITIS

    Directory of Open Access Journals (Sweden)

    Jazon Romilson de Souza ALMEIDA

    2015-03-01

    Full Text Available Background Alcoholic liver disease is a major cause of end-stage liver disease worldwide and severe forms of alcoholic hepatitis are associated with a high short-term mortality. Objectives To analyze the importance of age-bilirubin-INR-creatinine (ABIC score as an index of mortality and predictor for complications in patients with alcoholic hepatitis. To evaluate its correlation with those complications, with risk of death, as well as the scores model for end stage liver disease (MELD and Maddrey’s discriminat function. Methods A total of 46 medical records of patients who had been hospitalized with alcoholic hepatitis were assessed retrospectively with lab tests on admission and after seven days. Score calculations were carried out and analyzed as well. Results The scores showed positive reciprocal correlation and were associated with both hepatic encephalopathy and ascites. ABIC index, which was classified as high risk, presented as a risk factor for these complications and for death. In univariate logistic regression analysis of mortality, the ABIC index at hospital admission odds ratio was 19.27, whereas after 7 days, it was 41.29. The average survival of patients with ABIC of low and intermediate risk was 61.1 days, and for those with high risk, 26.2 days. Conclusions ABIC index is a predictor factor for complications such as ascites and hepatic encephalopathy, as well as for risk of death. Thus, it is a useful tool for clinical practice.

  11. [Prognostic morbidity and mortality factors in hospital enteral nutrition: prospective study].

    Science.gov (United States)

    Moreno Pérez, O; Meoro Avilés, A; Martínez, A; Boix, E; Aznar, S; Martín, Ma D; Picó, A M

    2005-01-01

    To determine the prognostic factors that may best for see the outcome of an enteral nutritional intervention and to assess the assistance quality of a nutrition unit. Patients that required enteral nutrition during hospital admission at a third level center. Observational prospective study in which 160 patients were included by means of consecutive sampling, for a 6-months follow-up period. Underlying pathology, disability degree, nutritional assessment, type of enteral nutrition, complications, nursing care, and clinical course of patients were determined. severe caloric and protein hyponutrition was diagnosed in 48.4 and 52.9% of patients; stress degree was moderate in 52.2% and severe in 36.5%. In 88.2% of patients variation of protein parameters was unchanged or improved, with a 0.26 g/dL increase in albumin levels and 2.4 m/dL in prealbumin (p enteral nutritional intervention in the hospitalized patient (p enteral nutritional support at the hospital setting, to advance in patients care and promote the development of nutritional therapy.

  12. Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics has received considerable attention recently as an emerging sub-discipline within SHM. Prognosis is here strictly defined as “predicting the time at...

  13. Prognostic value of nutritional status in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Landbo, C; Prescott, E; Lange, P

    1999-01-01

    The association between low body mass index (BMI) and poor prognosis in patients with chronic obstructive pulmonary disease (COPD) is a common clinical observation. We prospectively examined whether BMI is an independent predictor of mortality in subjects with COPD from the Copenhagen City Heart...... Study. In total, 1,218 men and 914 women, aged 21 to 89 yr, with airway obstruction defined as an FEV(1)-to-FVC ratio of less than 0.7, were included in the analyses. Spirometric values, BMI, smoking habits, and respiratory symptoms were assessed at the time of study enrollment, and mortality from COPD...

  14. Re-evaluation of Mannheim prognostic index in perforative peritonitis: prognostic role of advanced age. A prospective cohort study.

    Science.gov (United States)

    Neri, Alessandro; Marrelli, Daniele; Scheiterle, Maximilian; Di Mare, Giulio; Sforza, Simone; Roviello, Franco

    2015-01-01

    Peritonitis from perforation of abdominal viscera is associated with high mortality. In western countries individuals older than 65 years constitute a significant proportion of the population and intra abdominal infections are more challenging to manage in these aged patients. This prospective cohort study included 143 consecutive patients operated on for primary perforative peritonitis. The aim of the study was to assess the prognostic efficacy of Mannheim Peritonitis Index (MPI) in a population with a significant proportion of older patients and to substantiate advanced age as an independent prognostic factor. Patients' informations were collected both on hospitalization and after surgical exploration; severity of peritonitis was evaluated using the MPI. The prognostic value of MPI was compared to older age and other clinical variables. The intra-hospital mortality was 25.2%. According to the MPI score, the ROC curve identified 21 as cut-off value with a sensitivity of 86% and a specificity of 59% in predicting the risk of death. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis. In the subgroup of patients with MPI score≥21, the mortality rate was 46.4% for patients older than 80 years old and 38.3% for younger patients (p=0.07); in patients with MPI score<21, the mortality of those aged more than 80 years reached 33.3% compared to 3.4% for younger patients (p=0.001). Age older than 80 years is strongly related to major increase in mortality rates and should be taken into account together with the MPI score in planning the surgical approach and the post-operative care. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Geriatric nutritional risk index accurately predicts cardiovascular mortality in incident hemodialysis patients.

    Science.gov (United States)

    Takahashi, Hiroshi; Ito, Yasuhiko; Ishii, Hideki; Aoyama, Toru; Kamoi, Daisuke; Kasuga, Hirotake; Yasuda, Kaoru; Maruyama, Shoichi; Matsuo, Seiichi; Murohara, Toyoaki; Yuzawa, Yukio

    2014-07-01

    Cardiovascular disease (CVD) is a leading cause of death in end-stage renal disease (ESRD) patients. Protein-energy wasting (PEW) or malnutrition is common in this population, and is associated with increasing risk of mortality. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk, and is associated with mortality not only in elderly patients but also in ESRD patients. However, whether the GNRI could predict the mortality due to CVD remains unclear in this population. We investigated the prognostic value of GNRI at initiation of hemodialysis (HD) therapy for CVD mortality in a large cohort of ESRD patients. Serum albumin, body weight, and height for calculating GNRI were measured in 1568 ESRD patients. Thereafter, the patients were divided into quartiles according to GNRI levels [quartile 1 (Q1): 97.3], and were followed up for up to 10 years. GNRI levels independently correlated with serum C-reactive-protein levels (β = -0.126, p index was also greater in an established CVD risk model with GNRI (0.749) compared to that with albumin (0.730), body mass index (0.732), and alone (0.710). Similar results were observed for all-cause mortality. GNRI at initiation of HD therapy could predict CVD mortality with incremental value of the predictability compared to serum albumin and body mass index in ESRD patients. Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  16. Body mass index (BMI) may be a prognostic factor for gastric cancer with peritoneal dissemination.

    Science.gov (United States)

    Chen, Shi; Nie, Run-Cong; OuYang, Li-Ying; Li, Yuan-Fang; Xiang, Jun; Zhou, Zhi-Wei; Chen, YingBo; Peng, JunSheng

    2017-02-23

    The aim of this study is to investigate whether body mass index (BMI) is a prognostic factor in gastric cancer patients with peritoneal dissemination. This is a retrospective study consisting of 518 patients with a histological diagnosis of gastric cancer with peritoneal dissemination seen at the Sixth Affiliated Hospital of Sun Yat-Sen University and Sun Yat-sen University Cancer Center between January 2010 and April 2014. Patients were followed until December 2015. Chi-square test and Kaplan-Meier survival analysis were used to compare the clinicopathological variables and prognosis. Univariate analyses showed that significant prognostic factors included palliative gastrectomy (p dissemination, especially in patients who received palliative chemotherapy. BMI is a prognostic factor for patients who have gastric cancer with peritoneal dissemination, especially in those who received palliative chemotherapy.

  17. Improved prognostic stratification using NCCN- and GELTAMO-international prognostic index in patients with diffuse large B-cell lymphoma.

    Science.gov (United States)

    Hong, Junshik; Kim, Seok Jin; Chang, Myung Hee; Kim, Jeong-A; Kwak, Jae-Yong; Kim, Jin Seok; Yoon, Dok Hyun; Lee, Won Sik; Do, Young Rok; Kang, Hye Jin; Eom, Hyeon-Seok; Park, Yong; Won, Jong-Ho; Mun, Yeung-Chul; Kim, Hyo Jung; Kwon, Jung Hye; Kong, Jee Hyun; Oh, Sung Yong; Lee, Sunah; Bae, Sung Hwa; Yang, Deok-Hwan; Jun, Hyun Jung; Lee, Ho Sup; Yun, Hwan Jung; Lee, Soon Il; Kim, Min Kyoung; Yi, Jun Ho; Lee, Jae Hoon; Kim, Won Seog; Suh, Cheolwon

    2017-11-03

    The National Comprehensive Cancer Network (NCCN)-International Prognostic Index (IPI) and GELTAMO (Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea)-IPI were developed to enable better risk prediction of patients with diffuse large B-cell lymphoma (DLBCL). The present study compared the effectiveness of risk prediction between IPI, NCCN-IPI, and GELTAMO-IPI in patients with DLBCL particularly in terms of determining high-risk patients. Among 439 patients who were enrolled to a prospective DLBCL cohort treated with R-CHOP immunochemotherapy, risk groups were classified according to the three IPIs and the prognostic significance of individual IPI factors and IPI models were analyzed and compared. All three IPI effectively separated the analyzed patients into four risk groups according to overall survival (OS). Estimated 5-year OS of patients classified as high-risk according to the IPI was 45.7%, suggesting that the IPI is limited in the selection of patients who are expected to have a poor outcome. In contrast, the 5-year OS of patients stratified as high-risk according to NCCN- and GELTAMO-IPI was 31.4% and 21.9%, respectively. The results indicate that NCCN- and GELTAMO-IPI are better than the IPI in predicting patients with poor prognosis, suggesting the superiority of enhanced, next-generation IPIs for DLBCL.

  18. Controlling Nutritional Status (CONUT) score is a prognostic marker for gastric cancer patients after curative resection.

    Science.gov (United States)

    Kuroda, Daisuke; Sawayama, Hiroshi; Kurashige, Junji; Iwatsuki, Masaaki; Eto, Tsugio; Tokunaga, Ryuma; Kitano, Yuki; Yamamura, Kensuke; Ouchi, Mayuko; Nakamura, Kenichi; Baba, Yoshifumi; Sakamoto, Yasuo; Yamashita, Yoichi; Yoshida, Naoya; Chikamoto, Akira; Baba, Hideo

    2017-06-27

    Controlling Nutritional Status (CONUT), as calculated from serum albumin, total cholesterol concentration, and total lymphocyte count, was previously shown to be useful for nutritional assessment. The current study investigated the potential use of CONUT as a prognostic marker in gastric cancer patients after curative resection. Preoperative CONUT was retrospectively calculated in 416 gastric cancer patients who underwent curative resection at Kumamoto University Hospital from 2005 to 2014. The patients were divided into two groups: CONUT-high (≥4) and CONUT-low (≤3), according to time-dependent receiver operating characteristic (ROC) analysis. The associations of CONUT with clinicopathological factors and survival were evaluated. CONUT-high patients were significantly older (p nutritional status but also for predicting long-term OS in gastric cancer patients after curative resection.

  19. The Geriatric Nutritional Risk Index Predicts Survival in Elderly Esophageal Squamous Cell Carcinoma Patients with Radiotherapy.

    Science.gov (United States)

    Bo, Yacong; Wang, Kunlun; Liu, Yang; You, Jie; Cui, Han; Zhu, Yiwei; Lu, Quanjun; Yuan, Ling

    2016-01-01

    The impact of nutritional status on survival among elderly esophageal squamous cell carcinoma (ESCC) patients undergoing radiotherapy is unclear. In this study, we aimed at validating the performance of the geriatric nutritional risk index (GNRI) in predicting overall survival time in elderly ESCC patients with radiotherapy. A retrospective cohort study was conducted on 239 ESCC patients aged 60 and over admitted consecutively from January 2008 to November 2014 in the Department of Radiotherapy, Henan Tumor Hospital (Affiliated Tumor Hospital of Zhengzhou University), Zhengzhou, Henan, China. All patients were subjected to nutritional screening using GNRI, and were followed for the occurrence of lymphatic node metastasis, radiation complication and mortality. The Kaplan-Meier method with Log-rank test was used to estimate survival curves. Univariable Cox regression analysis was used to identify variables associated with overall survival time. Among the 239 patients, 184 patients (76.9%) took no nutritional risk, 32 patients (13.4%) took moderate risk of malnutrition, and 23 patients (9.7%) took a high risk of malnutrition. Univariable Cox regression showed that both high nutritional risk group and moderate nutritional risk group were significantly less likely to survive than no nutritional risk patients (hazard ratio (HR) = 1.688, 95% confidence interval (CI) = 1.019-2.798 for moderate risk group, and HR = 2.699, 95% CI = 1.512-4.819 for high risk group, respectively). The GNRI is an independent prognostic factor for overall survival time in elderly ESCC patients with radiotherapy. A GNRI ≤98 can be suggested as an indicator of surviving less.

  20. The validity of Geriatric Nutrition Risk Index: simple tool for prediction of nutritional-related complication of hospitalized elderly patients. Comparison with Mini Nutritional Assessment.

    Science.gov (United States)

    Abd-El-Gawad, Wafaa Mostafa; Abou-Hashem, Rania Mohammed; El Maraghy, Mohamed Omar; Amin, Ghada Essam

    2014-12-01

    The Geriatric Nutritional Risk Index (GNRI) is a promising tool initially proposed to predict nutrition-related complications in sub-acute care setting. So, the main aim of this study was to validate the use of GNRI in hospitalized elderly patients by testing its ability to predict patients' outcome through the comparison with Mini Nutritional Assessment (MNA). A prospective cohort study was conducted on 131 patients aged 60 and over admitted consecutively from October 2011 to September 2012 to the acute geriatrics medical ward in Ain Shams University hospitals, Cairo, Egypt. All patients were subjected to nutritional screening using GNRI and MNA and measurement of weight, body mass index (BMI), mid arm circumference (MAC), and calf circumference (CC), serum levels of total protein, albumin and prealbumin. Patients were followed for 6 months for the occurrence of major health complications as prolonged length of stay, infectious complications and mortality. Mean age was 69.32 ± 8.17 years. Lower GNRI scores were statically significantly associated with worse MNA scores, lower weight, BMI, MAC, CC and albumin (P value nutrition-related complication (from mild to moderate to severe). ORs (95%CI) for three month mortality were 1.63(0.0.27-10.00), 5.03(1.36-18.52), and 11.24(3.03-41.67), and OR (95%CI) for six month mortality were 1.64(0.403-6.62), 4.29 (1.45-12.66), and 5.71(1.87-17.54) respectively compared to patients with no risk and. By regression, both severe and moderate grade of GNRI were independent predictors of three and six month mortality (P value for three month: 0.002, 0.015; for six month: 0.002, 0.008 respectively) after adjustment of age, sex, and cancer rather than MNA. GNRI showed a higher prognostic value for describing and classification of nutritional status and nutritional-related complications in hospitalized elderly patients in addition to its simplicity. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and

  1. Albumin-to-alkaline phosphatase ratio: a novel prognostic index for hepatocellular carcinoma.

    Science.gov (United States)

    Chan, Anthony W H; Chan, Stephen L; Mo, Frankie K F; Wong, Grace L H; Wong, Vincent W S; Cheung, Yue-Sun; Chan, Henry L Y; Yeo, Winnie; Lai, Paul B S; To, Ka-Fai

    2015-01-01

    Prognosis of patients with hepatocellular carcinoma (HCC) depends on both tumour extent and hepatic function reserve. Liver function test (LFT) is a basic routine blood test to evaluate hepatic function. We first analysed LFT components and their associated scores in a training cohort of 217 patients who underwent curative surgery to identify LFT parameters with high performance (discriminatory capacity, homogeneity, and monotonicity of gradient). We derived a novel index, albumin-to-alkaline phosphatase ratio (AAPR), which had the highest c-index (0.646) and χ(2) (24.774) among other liver biochemical parameters. The AAPR was an independent prognostic factor for overall and disease-free survival. The adjusted hazard ratio of death and tumour relapse was 2.36 (P = 0.002) and 1.85 (P = 0.010), respectively. The independent prognostic significance of AAPR on top of 5 commonly used and well established staging systems was further confirmed in 2 independent cohorts of patients receiving surgical resection (n = 256) and palliative therapy (n = 425). In summary, the AAPR is a novel index readily derived from a simple low-cost routine blood test and is an independent prognostic indicator for patients with HCC regardless of treatment options.

  2. Octogenarian patients with chronic obstructive pulmonary disease: Characteristics and usefulness of prognostic indexes.

    Science.gov (United States)

    Golpe, Rafael; Suárez-Valor, María; Veres-Racamonde, Alejandro; Cano-Jiménez, Esteban; Martín-Robles, Irene; Sanjuán-López, Pilar; Pérez-de-Llano, Luis

    2017-10-30

    Most studies on chronic obstructive pulmonary disease (COPD) exclude octogenarian patients. Therefore, the disease is not well characterized in this age group. The objective of this study is to analyze the clinical characteristics of octogenarian patients with COPD and the usefulness of the prognostic indexes used most frequently in this age group. Retrospective study of consecutive patients seen at a clinic between 2009 and 2017. The following variables were analyzed: lung function parameters, distribution of clinical phenotypes, income history, mortality, comorbidities and usefulness of the Charlson, BODEX, COTE and CODEX indexes to predict mortality. The sample comprised 698 patients, 82 aged (11.7%)≥80 years old. Mean follow-up time was 47.9±21.8 months. In octogenarian patients, the severity of the COPD, assessed by means of the FEV1% or BODEX index, was similar to that of younger patients, but dyspnea was worse in the elderly group. In these patients, the chronic bronchitis and frequent exacerbator phenotypes were the most frequent, whilst the emphysema phenotype was the least common. Octogenarians had a greater prevalence of cardiovascular comorbidities and renal diseases. Moreover, hospital admissions were more frequent and mortality was higher in these elderly patients. Most prognostic indexes were useful in predicting mortality in elderly patients. CODEX was the most useful index to predict mortality, both in octogenarian and younger patients. Octogenarian patients with COPD have differential characteristics which could imply the need for different therapeutic approaches. Prognostic indexes are useful for predicting mortality in this population. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  3. Prognostic importance of the nutritional status and systemic inflammatory response in non-small cell lung cancer.

    Science.gov (United States)

    Yildirim, M; Yildiz, M; Duman, E; Goktas, S; Kaya, V

    2013-01-01

    Despite all primary prevention and therapeutic efforts around the world, non-small cell lung cancer (NSCLC) continues to be an important public health problem. In the treatment of patients, laboratory parameters can be used for the determination of treatment intensity. These laboratory parameters should be easily accessible, cheap and easy to use. For this purpose, the prognostic importance in NSCLC of serum albumin levels, neutrophil-lymphocyte ratio (NLR) and thrombocyte-lymphocyte ratio (TLR) was investigated in the present study. Serum albumin levels and body mass index (BMI) were used to determine the nutritional status and NLR and TLR were used to determine the systemic inflammatory response (SIR). While median survival was 9.1 months in hypoalbuminemic patients, it was 16.4 months in normoalbuminemic patients (p=0.002). The relationship of positive or negative NLR as an indicator of SIR with median survival was statistically significant (p=0.006). While median survival was 7.8 months for patients with NLR ≥5, it was 14.7 for the patients with NLR nutritional status and the NLR as an indicator of SIR, are significantly related with prognosis in locally advanced and metastatic NSCLC. Serum albumin measurement and calculation of NLR are easily accessible, cheap and easy to use laboratory methods. We consider that serum albumin levels and NLR can be utilized in the treatment planning of NSCLC patients.

  4. A clinically based prognostic index for diffuse large B-cell lymphoma with a cut-off at 70 years of age significantly improves prognostic stratification

    DEFF Research Database (Denmark)

    Gang, Anne O.; Pedersen, Michael; d'Amore, Francesco

    2015-01-01

    subtypes. We applied IPI factors to a population-based rituximab-treated cohort of 1990 patients diagnosed 2000-2010 and explored new factors and the optimal prognostic age cut-off for DLBCL. Multivariate-analyses (MVA) confirmed the prognostic value of all IPI factors except the presence of > 1 extranodal...... lesion. The optimal age cut-off was 70 years. In a MVA of albumin, lymphocyte count, sex, immunoglobulin G, bulky disease, hemoglobin and B-symptoms, only albumin was prognostic. We propose: (1) a modified DLBCL prognostic index (DLBCL-PI) including: age (70 years), performance status (PS), lactate...... dehydrogenase (LDH), stage and albumin level, and (2) a separate age-adjusted DLBCL-PI for patients 1 extranodal lesion, however excluding stage....

  5. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: the updated BODE index and the ADO index.

    Science.gov (United States)

    Puhan, Milo A; Garcia-Aymerich, Judith; Frey, Martin; ter Riet, Gerben; Antó, Josep M; Agustí, Alvar G; Gómez, Federico P; Rodríguez-Roisín, Roberto; Moons, Karel G M; Kessels, Alphons G; Held, Ulrike

    2009-08-29

    The BODE index (including body-mass index, airflow obstruction, dyspnoea, and exercise capacity) was an important contribution to the prognostic assessment of patients with chronic obstructive pulmonary disease (COPD). However, no study has assessed whether the risk of mortality predicted by the BODE index matches the observed mortality in different populations. We assessed the calibration of the BODE index, updated it to improve its calibration, and developed and validated a simplified index for use in primary-care settings. We included 232 patients from the Swiss Barmelweid cohort with longstanding and severe COPD and 342 patients from the Spanish Phenotype and Course of COPD cohort study who had had their first hospital admission due to moderate-to-severe COPD. In both cohorts we compared the observed 3-year risk of all-cause mortality with the risk predicted by the BODE index. We then updated the BODE index and developed a simplified ADO index (including age, dyspnoea, and airflow obstruction) from the Swiss cohort, and validated both in the Spanish cohort. Calibration of the BODE index was poor, with relative underprediction of 3-year risk of mortality by 36% in the Swiss cohort (median predicted risk 21.7% [IQR 12.7-31.7] vs 34.1% observed risk; p=0.013) and relative overprediction by 39% in the Spanish cohort (16.7% [12.7-31.7] vs 12.0%; p=0.035). The 3-year risk of mortality predicted by both the updated BODE (median 10.7% [8.1-13.8]) and ADO indices (11.8% [9.1-14.3]) matched the observed mortality in the Spanish cohort well (p=0.99 and p=0.98, respectively). Both the updated BODE and ADO indices could lend support to the prognostic assessment of patients with COPD in specialised and primary-care settings. Such assessment enhances the targeting of treatments to individual patients. Swiss National Science Foundation; Klinik Barmelweid; Fondo de Investigación Sanitaria Ministry of Health, Spain; Agència d'Avaluació de Tecnologia i Recerca M

  6. Predicting outcome in patients with left ventricular systolic chronic heart failure using a nutritional risk index.

    Science.gov (United States)

    Al-Najjar, Yahya; Clark, Andrew L

    2012-05-01

    Mortality in patients with chronic heart failure (CHF) is high and associated with body mass. However, the best method of assessing nutritional status in patients with CHF is not clear. We sought to demonstrate the prognostic use of a nutritional risk index (NRI) in ambulatory patients with CHF. Consecutive patients attending their first quarterly review appointment in the HF clinic were recruited. All patients had systolic left ventricular (LV) dysfunction. An NRI was calculated as: (1.5 × serum albumin [grams per liter]) + (current body weight/ideal weight). Patients were followed up every 4 months. Of the 538 patients enrolled in the study 75% were men. The patients' age was 71 ± 10 years (mean ± SD) and total median follow-up in survivors was 68 months (interquartile range 54 to 74). New York Heart Association classes II and III accounted for 60% and 27%, respectively, with 80% having moderate LV impairment or worse. Based on the NRI 23% of patients were at risk of malnutrition. Severely malnourished patients were older. There was no relation between NRI and LV function. The NRI was a univariable predictor of mortality (chi-square 25, p nutritional status in trials of dietary supplementation in CHF. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Performance Status, Prognostic Scoring, and Parenteral Nutrition Requirements Predict Survival in Patients with Advanced Cancer Receiving Home Parenteral Nutrition.

    Science.gov (United States)

    Keane, Niamh; Fragkos, Konstantinos C; Patel, Pinal S; Bertsch, Friderike; Mehta, Shameer J; Di Caro, Simona; Rahman, Farooq

    2018-01-01

    We describe a cohort of Home Parenteral Nutrition (HPN) patients with advanced cancer in order to identify factors affecting prognosis. Demographic, anthropometric, biochemical and medical factors, Karnofsky Performance Status (KPS), Glasgow Prognostic Score (GPS), and PN requirements were recorded. Univariate and multivariate analyses were performed including Kaplan-Meier curves, Cox Regression, and correlation analyses. In total, 107 HPN patients (68 women, 39 men, mean age 57 yr) with advanced cancer were identified. The main indications for HPN were bowel obstruction (74.3%) and high output ostomies (14.3%). Cancer cachexia was present in 87.1% of patients. The hazard ratio (HR) for upper gastrointestinal and "other" cancers vs. gynaecological malignancy was 1.75 (p = 0.077) and 2.11 (p = 0.05), respectively. KPS score, GPS, PN volume, and PN potassium levels significantly predicted survival (HRKPS ≥50 vs 0.05). Most patients passed away in their homes or hospice (77.9%). Performance status, prognostic scoring, and PN requirements may predict survival in patients with advanced cancer receiving HPN.

  8. A combined pulmonary function and emphysema score prognostic index for staging in Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Boutou, Afroditi K; Nair, Arjun; Douraghi-Zadeh, Dariush; Sandhu, Ranbir; Hansell, David M; Wells, Athol U; Polkey, Michael I; Hopkinson, Nicholas S

    2014-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is characterized by high morbidity and mortality. Lung computed tomography parameters, individually or as part of a composite index, may provide more prognostic information than pulmonary function tests alone. To investigate the prognostic value of emphysema score and pulmonary artery measurements compared with lung function parameters in COPD and construct a prognostic index using a contingent staging approach. Predictors of mortality were assessed in COPD outpatients whose lung computed tomography, spirometry, lung volumes and gas transfer data were collected prospectively in a clinical database. Univariate and multivariate Cox proportional hazard analysis models with bootstrap techniques were used. 169 patients were included (59.8% male, 61.1 years old; Forced Expiratory Volume in 1 second % predicted: 40.5±19.2). 20.1% died; mean survival was 115.4 months. Age (HR = 1.098, 95% Cl = 1.04-1.252) and emphysema score (HR = 1.034, 95% CI = 1.007-1.07) were the only independent predictors of mortality. Pulmonary artery dimensions were not associated with survival. An emphysema score of 55% was chosen as the optimal threshold and 30% and 65% as suboptimals. Where emphysema score was between 30% and 65% (intermediate risk) the optimal lung volume threshold, a functional residual capacity of 210% predicted, was applied. This contingent staging approach separated patients with an intermediate risk based on emphysema score alone into high risk (Functional Residual Capacity ≥210% predicted) or low risk (Functional Residual Capacity Emphysema score-Functional Residual Capacity index might provide a better separation of high and low risk patients with COPD, than other individual predictors alone.

  9. Comparação entre a relação PCR/albumina e o índice prognóstico inflamatório nutricional (IPIN Comparison of PCR/albumin ratio with prognostic inflammatory nutritional index (PINI

    Directory of Open Access Journals (Sweden)

    Camila Renata Corrêa

    2002-07-01

    diferenciação G3 > (G1 = G2 e G3 > G3A. Entre todas as proteínas dosadas apenas PCR, Alb e TTR discriminaram os grupos: sendo G3 > (G1= G2 para PCR e G3 G3A (para PCR e G3D The inflammatory stress of hospitalyzed patients was quantified according to their plasma levels of acute-phase proteins (APP. The data from 54 adult (48 ± 20 yrs patients were retrospectively (1994-1998 analysed along with other 12 healthy controls. The major pathologies were peripheral vascular disease (22 , penphigus pholiaceos (7, inflammatory bowel disease (7, trauma (6 and orthognatic post surgery (3. Samples of fasting venous blood were drawn and their plasma used for positive (+ and negative (- APP by nephelometric assays. Among assayed APP+ were C-reactive protein (CRP, acid alpha-1-glycoprotein (AAG, alpha-1-antitrypsin (AAT and ceruloplasmim (CER while albumin (Alb, transthyretin (TTR, transferrin (TF and retinol-binding protein (RBP were the APP- representatives. A significant relationship (Spearman test was found between the variables CRP ´ AAG (r = 0.49, Alb ´ TTR (r = 0.60, Alb ´ RBP (0.58, Alb ´ TF (r = 0.39, TTR ´ RBP (r = 0.56 and TTR ´TF (r = 0.43. The stronger relationships between APP+ ´ APP- were found for CRP ´ Alb (r = - 0.71, CRP ´ TTR (- 0.54, CRP ´ TF (r = - 0.39 and AAG ´ Alb (r = - 0.35. By assembling the APP according to the prognostic inflammatory nutritional index (PINI proposed by Ingenbleek & Carpentier (Int. J. Vitam. Nutr. Res., 55: 91, 1985 the obtained data allowed a group distribution as healthy controls (G1, patients without (PINI 1, G3. The later was split as lower (G3A, n =16 medium (G3B, n =10 and high (G3C, n = 6 risk and mortality-risk (G3D, n =11. The PINI values differentiated (non-parametric Kruskall-Wallis test G3 > (G1= G2 and G3 > G3A. Among all assayed proteins only CRP, Alb and TTR discriminated groups as G3 > (G1= G2 for CRP or G3 G3A (for CRP and G3D < G3A (for TTR and TF. The correlation coeficient allowed only APP-- substitutions at

  10. Geriatric nutritional risk index: a mortality predictor in hemodialysis patients.

    Science.gov (United States)

    Edalat-Nejad, Mahnaz; Zameni, Fatemeh; Qlich-Khani, Mahdi; Salehi, Fatemeh

    2015-03-01

    Recently, the Geriatric Nutritional Risk Index (GNRI) has been introduced as a valuable tool to assess the nutritional status of hemodialysis (HD) patients. To determine the predictive value of the GNRI score for death in HD, we studied 145 chronic HD patients (%53 men, mean age 60 ± 16 years). The GNRI score was estimated by an equation involving serum albumin and individual's weight and height. According to the highest positive likelihood and risk ratios, the cut-off value of the GNRI for mortality was set at 100. The survival of patients on HD was examined with the Cox proportional hazards model. Mortality was monitored prospectively over an 18-month period, during which 35 patients died. The GNRI (mean 102.6 ± 5.5) was significantly positively correlated with lean body mass, hematocrit, serum lipids and presence of metabolic syndrome. Multivariate Cox proportional hazards analysis demonstrated that the GNRI risk factors that predict all-cause mortality in HD patients.

  11. Correlation analysis between molecular subtypes and Nottingham Prognostic Index in breast cancer.

    Science.gov (United States)

    Zhen, Hongchao; Yang, Liuting; Li, Li; Yu, Junxian; Zhao, Lei; Li, Yingying; Li, Qin

    2017-09-26

    Molecular subtypes and Nottingham Prognostic Index (NPI) are both prognostic models for breast cancer patients. We evaluated the association between molecular subtypes and NPI in 1042 breast cancer patients. The molecular subtypes indicating poorer prognosis were positively correlated to higher NPI (r = 0.138, P = 0.001). ER positive expression and PR high expression were positively correlated with NPI (r = 0.142, P = 0.001; r = 0.139, P = 0.001; respectively) and negatively correlated with histological grade (r = -0.233, P 5.40 were higher in the HER2 overexpression subtype, basal-like subtype, ER-, PR low/negative expression, and Ki67 high expression groups. The excellent consistence was observed between histological grade and molecular subtypes, ER, PR, Ki67. The difference of histological grade between the HER2 positive and negative group was statistically significant. In conclusion, there was closely association between molecular subtypes and NPI in breast cancer. For further comparing the prognostic significance of molecular subtypes and NPI, survival analyses should be performed on the same population in a large-scale prospective study.

  12. A laboratory prognostic index model for patients with advanced non-small cell lung cancer.

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    Arife Ulas

    Full Text Available We aimed to establish a laboratory prognostic index (LPI in advanced non-small cell lung cancer (NSCLC patients based on hematologic and biochemical parameters and to analyze the predictive value of LPI on NSCLC survival.The study retrospectively reviewed 462 patients with advanced NSCLC diagnosed between 2000 and 2010 in a single institution. We developed an LPI that included serum levels of white blood cells (WBC, lactate dehydrogenase (LDH, albumin, calcium, and alkaline phosphatase (ALP, based on the results of a Cox regression analysis. The patients were classified into 3 LPI groups as follows: LPI 0: normal; LPI 1: one abnormal laboratory finding; and LPI 2: at least 2 abnormal laboratory findings.The median follow up period was 44 months; the median overall survival (OS and median progression-free survival (PFS were 11 and 6 months, respectively. A multivariate analysis revealed that the following could be used as independent prognostic factors: an Eastern Cooperative Oncology Group performance status score (ECOG PS ≥2, a high LDH level, serum albumin 10.5 g/dL, number of metastases>2, presence of liver metastases, malignant pleural effusion, or receiving chemotherapy ≥4 cycles. The 1-year OS rates according to LPI 0, LPI 1, and LPI 2 were 54%, 34%, and 17% (p<0.001, respectively and 6-month PFS rates were 44%, 27%, and 15% (p<0.001, respectively. The LPI was a significant predictor for OS (Hazard Ratio (HR: 1.41; 1.05-1.88, p<0.001 and PFS (HR: 1.48; 1.14-1.93, p<0.001.An LPI is an inexpensive, easily accessible and independent prognostic index for advanced NSCLC and may be helpful in making individualized treatment plans and predicting survival rates when combined with clinical parameters.

  13. Medulloblastoma: evaluation of proliferative index by monoclonal antibody Mib-1, its prognostic correlation and therapeutic implications

    Directory of Open Access Journals (Sweden)

    Ferrari Antonio Fernandes

    2003-01-01

    Full Text Available In the past few years, the monoclonal antibody MIB-1 has been used by researchers in order to retrospectively study paraffin imbibed tumor fragments. The medulloblastoma is the most common malignant central nervous system tumor in childhood. The objectives were: determination of the mean Mib-1 LI value from these patients, as well as the prognostic value of the method.This retrospective study represents an analysis of the cellular proliferation index of posterior fossa medulloblastomas collected from 22 patients at A.C. Camargo Hospital, from January 1990 to December 1999. The histopathological diagnosis was confirmed by H&E and proliferative index (LI was achived with Mib-1 which detects proliferating cells during G1, G2, S and M phases.The results demostrated that the mean Mib-1 was 30,1%, and ranged from 5,2% to 62,0%.In conclusion, this method has prognostic value, has to be used as routine for patients harboring medulloblastomas and the ones who have PI greater than the mean value found in this study, should be treated aggressively.

  14. Coffee, nutritional status, and renal artery resistive index.

    Science.gov (United States)

    Trovato, Guglielmo M; Pirri, Clara; Martines, Giuseppe Fabio; Trovato, Francesca; Catalano, Daniela

    2010-01-01

    The relationship between nutrition and atherosclerosis is known, even dissociated from protein malnutrition. Cardiovascular impact of several nutrients is known; among them the action of coffee is still debated and cardiovascular effect of caffeine has been investigated without definite results. The aim of this study is to investigate whether coffee habits, and/or quantity of coffee consumption, have any relationship with renal resistive index (RRI), a hallmark of arterial stiffness (AS). The relationship of AS with nutritional status assessed by body composition and serum albumin, insulin resistance (assessed by HOMA), and renal function assessed by glomerular filtration rate (GFR) is concurrently investigated. This study was done with 221 consecutive patients, without diabetes, cancer, liver, renal, and heart disease, referred for clinical noninvasive assessment and nutritional counseling: 124 essential hypertensive and 97 nonhypertensive patients were eligible. Personalized Mediterranean diet, physical activity increase, and smoking withdrawal counseling were provided. By multiple linear regression, fat-free mass (FFM), HOMA (positive relationship), and number of cups of coffee/day (negative relationship) account for 17.2% of the variance to RRI. By odds ratios lower risk to increased RRI is associated with higher serum albumin, higher hemoglobin, and FFM; greater risk is associated with hypertension, insulin resistance (HOMA ≥ 3.0), and renal insufficiency (GFR ≤ 90); coffee, assessed by number of cups/day, reduces risk. Coffee use is inversely associated with RRI. Habitual coffee users have risk protection to higher RRI; lower serum albumin, insulin resistance, and renal insufficiency are associated with greater RRI.

  15. An intelligent prognostic system for analyzing patients with paraquat poisoning using arterial blood gas indexes.

    Science.gov (United States)

    Hu, Lufeng; Lin, Feiyan; Li, Huaizhong; Tong, Changfei; Pan, Zhifang; Li, Jun; Chen, Huiling

    The arterial blood gas (ABG) test is used to assess gas exchange in the lung, and the acid-base level in the blood. However, it is still unclear whether or not ABG test indexes correlate with paraquat (PQ) poisoning. This study investigates the predictive value of ABG tests in prognosing patients with PQ poisoning; it also identifies the most significant indexes of the ABG test. An intelligent machine learning-based system was established to effectively give prognostic analysis of patients with PQ poisoning based on ABG indexes. In the proposed system, an enhanced support vector machine combined with a feature selection strategy was developed to predict the risk status from a pool of 103 patients (56 males and 47 females); of these, 52 subjects were deceased and 51 patients were alive. The proposed method was rigorously evaluated against the real-life dataset in terms of accuracy, sensitivity, and specificity. Additionally, the feature selection was investigated to identify correlating factors for the risk status. The results demonstrated that there were significant differences in ABG indexes between deceased and alive subjects (p-value <0.01). According to the feature selection, we found that the most important correlated indexes were associated with partial pressure of carbon dioxide (PCO2). This study discovered the relationship between ABG test and poisoning degree to provide a new avenue for prognosing PQ poisoning. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Malnutrition Identified by the Nutritional Risk Index and Poor Prognosis in Advanced Epithelial Ovarian Carcinoma.

    Science.gov (United States)

    Yim, Ga Won; Eoh, Kyung Jin; Kim, Sang Wun; Nam, Eun Ji; Kim, Young Tae

    2016-07-01

    Ovarian cancer is a chronic disease with a risk of malnutrition. Nutritional Risk Index (NRI) has been reported as a simple and accurate tool to assess the nutritional status. We sought to explore the prevalence of malnutrition and its association with survival in ovarian cancer. A retrospective study was conducted in 213 advanced ovarian cancer patients. NRI was calculated before and at the end of treatment using patients' body weight and serum albumin level. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan-Meier method, and associations were assessed using a Cox proportional hazards analysis adjusted for known prognostic variables. Moderate to severely malnourished patients had lower 5-yr OS (45.3%) compared to normal to mild group (64.0%), respectively (P = 0.024). Adjusted for covariates, the relative risk of death was 5.8 times higher in moderate/severely malnourished group identified at the last course of chemotherapy (HR = 5.896, 95% CI = 2.723-12.764, P risk group (median 15 vs. 28 months, P = 0.011). Malnutrition is prevalent among ovarian cancer patients and is found to be a significant predictor for mortality.

  17. Prognostic index for chronic- and smoldering-type adult T-cell leukemia-lymphoma.

    Science.gov (United States)

    Katsuya, Hiroo; Shimokawa, Mototsugu; Ishitsuka, Kenji; Kawai, Kazuhiro; Amano, Masahiro; Utsunomiya, Atae; Hino, Ryosuke; Hanada, Shuichi; Jo, Tatsuro; Tsukasaki, Kunihiro; Moriuchi, Yukiyoshi; Sueoka, Eisaburo; Yoshida, Shinichiro; Suzushima, Hitoshi; Miyahara, Masaharu; Yamashita, Kiyoshi; Eto, Tetsuya; Suzumiya, Junji; Tamura, Kazuo

    2017-07-06

    Adult T-cell leukemia-lymphoma (ATL) has been divided into 4 clinical subtypes: acute, lymphoma, chronic, and smoldering. The aim of this study is to develop a novel prognostic index (PI) for chronic and smoldering ATL. We conducted a nationwide retrospective survey on ATL patients, and 248 fully eligible individuals were used in this analysis. In the univariate analysis, sex, performance status, log10 (soluble interleukin-2 receptor [sIL-2R]), neutrophils count, and lymphadenopathy showed values of P < .05 in training samples. A multivariate analysis was performed on these factors, and only log10 (sIL-2R) was identified as an independent prognostic factor in training samples. Using a regression coefficient of this variable, a prognostic model was formulated to identify different levels of risk: indolent ATL-PI (iATL-PI) = 1.51 × log10 (sIL-2R [U/mL]). The values calculated by iATL-PI were divided into 3 groups using a quartile point. In the validation sample, median survival times (MSTs) were 1.6 years, 5.5 years, and not reached for patients in the high-, intermediate-, and low-risk groups, respectively (P < .0001). To make the scoring system clinically practicable, we simplified iATL-PI according to trichotomizing sIL-2R at 1000 and 6000 U/mL, using a quartile point. Patients with more than 6000 U/mL sIL-2R were categorized into the high-risk group, less than and equal to 1000 U/mL into the low-risk group, and the others into the intermediate-risk group, and MSTs were 1.6 years, not reached, and 5.5 years, respectively (P < .0001). iATL-PI has potential as a novel tool for a risk-adapted therapeutic approach. © 2017 by The American Society of Hematology.

  18. Proposing a "lipemic index" as a nutritional and research tool.

    Science.gov (United States)

    Ooi, Teik Chye; Robinson, Lindsay; Graham, Terry; Kolovou, Genovefa D; Mikhailidis, Dimitri P; Lairon, Denis

    2011-05-01

    Recent studies have demonstrated the value of non-fasting serum triglycerides (TG) as risk markers for cardiovascular and cerebrovascular disease. This underscores the importance of knowing the postprandial lipid/lipoprotein responses to different foods. A systematic approach is needed to make use of postprandial lipid data as a practical nutritional tool, similar to the well known glycemic index (GI), which is a measure of the effect of carbohydrates on blood glucose levels. Using GI as a model, we propose that a similar and parallel nutritional tool called Lipemic Index (LI) be developed to facilitate the planning of a healthy diet. LI could also serve as a tool in human nutrition research. LI would refer to the postprandial increase of serum TG after a test meal with a specific food relative to a reference meal. The reference meal could take the form of a fat load that has a fixed amount (e.g. 50-70 g) of a mixture of saturated, polyunsaturated and monounsaturated fats in known proportions. It is possible that a test meal may have a greater degree of postprandial lipemia (PPL) than the reference meal and, unlike GI, the LI may exceed 100%. We recommend total plasma TG as the blood parameter to follow after consumption of the fat load. The TG incremental area under the curve (iAUC) will be calculated from the curve drawn from hourly measurements of plasma TG up to 6 hours using the trapezoid rule. The LI of the test meal (%) will equal the iAUC of the test meal divided by the iAUC of the reference meal x 100. Consideration will be given to the impact of background diet, other nutrients in the test meal and gender differences on LI testing. The establishment of LI into practice will be complicated and challenging. However, it is important for work to begin on establishing a practical and quantifiable index of PPL, in order to benefit clinical management of patients as well as research.

  19. Proposal of a Nutritional Quality Index (NQI) to Evaluate the Nutritional Supplementation of Sportspeople.

    Science.gov (United States)

    Palacin-Arce, Alba; Monteagudo, Celia; Beas-Jimenez, Juan de Dios; Olea-Serrano, Fatima; Mariscal-Arcas, Miguel

    2015-01-01

    Numerous supplements are used by sportspeople. They are not always appropriate for the individual or the sports activity and may do more harm than good. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits. A nutritional study was performed in 485 sportspeople recruited from Centros Andaluces de Medicina del Deporte, (CAMD). All completed socio-demographic, food frequency, and lifestyle questionnaires. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant. A superior mean NQI score was obtained when the supplements taken by participants were not included (16. 28 (SD of 3.52)) than when they were included (15.47 (SD: 3.08)), attributable to an excessive intake of some nutrients through supplementation. These results indicate that sportspeople with a varied and balanced diet do not need supplements, which appear to offer no performance benefits and may pose a health risk.

  20. Multicenter validation study of a prognostic index for portal vein tumor thrombosis in hepatocellular carcinoma.

    Science.gov (United States)

    Yu, Jeong Il; Yoon, Sang Min; Park, Hee Chul; Kim, Jong Hoon; Kim, Tae Hyun; Park, Joong-Won; Seong, Jinsil; Lee, Ik Jae; Jang, Hong Seok; Kay, Chul Seung; Kim, Chul Yong; Chie, Eui Kyu; Kim, Jin Hee; Kim, Mi-Sook; Choi, Young Min

    2014-10-01

    We previously reported on a staging system and prognostic index (PITH) for portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) patients treated with radiotherapy (RT) at a single institution. The aim of this study is to validate the PITH staging system using data from patients at other institutions and to compare it with other published staging systems. A total of 994 HCC patients with PVTT who were treated with RT between 1998 and 2011 by the Korean Radiation Oncology Group were analyzed retrospectively. All patients were staged using the Cancer of the Liver Italian Program (CLIP), Japanese Integrated Staging (JIS), Okuda, and PITH staging systems, and survival data were analyzed. The likelihood ratio, Akaike information criteria (AIC), time-dependent receiver operating characteristics, and prediction error curve analysis were used to determine discriminatory ability for comparison of staging systems. The median survival was 9.2 months. Compared with the other staging systems, the PITH score gave the highest values for likelihood ratio and lowest AIC values, demonstrating that PITH may be a better prognostic model. Although the values were not significant and differences were not exceptional, the PITH score showed slightly better performance with respect to time-dependent area under curve and integrated Brier score of prediction error curve. The PITH staging system was validated in this multicenter retrospective study and showed better stratification ability in HCC patients with PVTT than other systems.

  1. Validation, revision and extension of the Mantle Cell Lymphoma International Prognostic Index in a population-based setting.

    Science.gov (United States)

    van de Schans, Saskia A M; Janssen-Heijnen, Maryska L G; Nijziel, Marten R; Steyerberg, Ewout W; van Spronsen, Dick Johan

    2010-09-01

    The aim of this study was to validate the Mantle Cell Lymphoma International Prognostic Index in a population-based cohort and to study the relevance of its revisions. We analyzed data from 178 unselected patients with stage III or IV mantle cell lymphoma, registered between 1994 and 2006 in the Eindhoven Cancer Registry. Follow-up was completed up to January 1(st), 2008. Multiple imputations for missing covariates were used. Validity was assessed by comparing observed survival in our cohort with predicted survival according to the original Mantle cell lymphoma International Prognostic Index. A revised model was constructed with Cox regression analysis. Discrimination was assessed by a concordance statistic ('c'). The original Mantle cell lymphoma International Prognostic Index could stratify our cohort into three distinct risk groups based on Eastern Cooperative Group performance status, white blood cell count, lactate dehydrogenase level, and age, with the discrimination being nearly as good as in the original cohort (c 0.65 versus 0.63). A modified model including performance status in five categories (0/1/2/3/4) instead of two (0-1/2-4), the presence of B-symptoms (yes/no) and sex (male/female) in addition to the original variables resulted in a better prognostic index (c 0.75). The Mantle cell lymphoma International Prognostic Index is a valid tool for risk stratification, comparison of prognosis, and treatment decisions in an unselected Dutch population-based setting. Although the index can be significantly improved, external validation on an independent data set is warranted before broad application of the modified instrument could be recommended.

  2. Validation, revision and extension of the mantle cell lymphoma international prognostic index in a population-based setting

    NARCIS (Netherlands)

    S.A.M. van de Schans (Saskia); M.L.G. Janssen-Heijnen (Maryska); M.R. Nijzie (Marten); E.W. Steyerberg (Ewout); D.J. van Spronsen (Dick Johan)

    2010-01-01

    textabstractBackground The aim of this study was to validate the Mantle Cell Lymphoma International Prognostic Index in a population-based cohort and to study the relevance of its revisions. Design and Methods We analyzed data from 178 unselected patients with stage III or IV mantle cell lymphoma,

  3. The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a meta-analysis

    Science.gov (United States)

    2012-01-01

    Background Prognostic assessment is important for the management of patients with acute pulmonary embolism (APE). Pulmonary Embolism Severity Index (PESI) and simple PESI (sPESI) are new emerged prognostic assessment tools for APE. The aim of this meta-analysis is to assess the accuracy of the PESI and the sPESI to predict prognostic outcomes (all-cause and PE-related mortality, serious adverse events) in APE patients, and compare between these two PESIs. Methods MEDLINE and EMBASE database were searched up to June 2012 using the terms “Pulmonary Embolism Severity Index” and “pulmonary embolism”. Summary odds ratio (OR) with 95% confidence intervals (CIs) for prognostic outcomes in low risk PESI versus high risk PESI were calculated. Summary receiver operating characteristic curve (SROC) used to estimate overall predicting accuracies of prognostic outcomes. Results Twenty-one studies were included in this meta-analysis. The results showed low-risk PESI was significantly associated with lower all-cause mortality (OR 0.13; 95% CI 0.12 to 0.15), PE-related mortality (OR 0.09; 95% CI 0.05 to 0.17) and serious adverse events (OR 0.34; 95% CI 0.29 to 0.41), with no homogeneity across studies. In sPESI subgroup, the OR of all-cause mortality, PE-related mortality, and serious adverse events was 0.10 (95% CI 0.08 to 0.14), 0.09 (95% CI 0.03 to 0.26) and 0.40 (95% CI 0.31 to 0.51), respectively; while in PESI subgroup, the OR was 0.14 (95% CI 0.13 to 0.16), 0.09 (95% CI 0.04 to 0.21), and 0.30 (95% CI 0.23 to 0.38), respectively. For accuracy analysis, the pooled sensitivity, the pooled specificity, and the overall weighted AUC for PESI predicting all-cause mortality was 0.909 (95% CI: 0.900 to 0.916), 0.411 (95% CI: 0.407 to 0.415), and 0.7853±0.0058, respectively; for PE-related mortality, it was 0.953 (95% CI: 0.913 to 0.978), 0.374 (95% CI: 0.360 to 0.388), and 0.8218±0.0349, respectively; for serious adverse events, it was 0.821 (95% CI: 0.795 to 0.845), 0

  4. Geriatric nutritional risk index: A mortality predictor in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Mahnaz Edalat-Nejad

    2015-01-01

    Full Text Available Recently, the Geriatric Nutritional Risk Index (GNRI has been introduced as a valuable tool to assess the nutritional status of hemodialysis (HD patients. To determine the predictive value of the GNRI score for death in HD, we studied 145 chronic HD patients (%53 men, mean age 60 ± 16 years. The GNRI score was estimated by an equation involving serum albumin and individual′s weight and height. According to the highest positive likelihood and risk ratios, the cut-off value of the GNRI for mortality was set at 100. The survival of patients on HD was examined with the Cox proportional hazards model. Mortality was monitored prospectively over an 18-month period, during which 35 patients died. The GNRI (mean 102.6 ± 5.5 was significantly positively correlated with lean body mass, hematocrit, serum lipids and presence of metabolic syndrome. Multivariate Cox proportional hazards analysis demonstrated that the GNRI <100, serum ferritin ≥ 500 μ g/L and age 65 years or older were significant predictors for mortality (hazard ratio 3.691, 95% CI 1.751-7.779, P = 0.001; hazard ratio 3.105, 95% CI 1.536-6.277, P = 0.002; and hazard ratio 2.806, 95% CI 1.297-6.073, P = 0.009, respectively, after adjustment to gender and vintage time. It can be concluded that, in addition to old age, malnutrition (low GNRI and inflammation (high ferritin are identified as significant independent risk factors that predict all-cause mortality in HD patients.

  5. [Leuko-glycemic index as an in-hospital prognostic marker in patients with ST-segment elevation myocardial infarction].

    Science.gov (United States)

    León-Aliz, Ebrey; Moreno-Martínez, Francisco L; Pérez-Fernández, Guillermo A; Vega-Fleites, Luis F; Rabassa-López-Calleja, Magda A

    2014-01-01

    Blood glucose and white blood cell count on admission have demonstrated prognostic significance in patients with myocardial infarction; leuko-glycemic index, a recently proposed marker, still lacks enough knowledge about its value. To evaluate the leuko-glycemic index as a prognostic marker in patients with ST-segment elevation myocardial infarction. A retrospective study was carried out in 128 patients with ST-segment elevation myocardial infarction, who were admitted between January 2009 and October 2010 in the Intensive Care Unit of the Hospital Dr. Celestino Hernández Robau. Clinical and laboratory data were collected, including glucose and white blood cell count on admission, from which we calculated the leuko-glycemic index and we evaluated its prognostic value. Patients who had a poor outcome such as death, major cardiac complications and failed-thrombolysis, showed higher values of leuko-glycemic index (Pglycemic index was an independent predictor after multivariate analysis. The leuko-glycemic index was associated with an increased occurrence of hospital complications, death and failed-thrombolysis; its pathological value was an independent predictor of in-hospital death and complications in the studied sample. Copyright © 2013 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  6. Prognostic value of brachioradialis muscle oxygen saturation index and vascular occlusion test in septic shock patients.

    Science.gov (United States)

    Marín-Corral, J; Claverias, L; Bodí, M; Pascual, S; Dubin, A; Gea, J; Rodriguez, A

    2016-05-01

    To compare rSO2 (muscle oxygen saturation index) static and dynamic variables obtained by NIRS (Near Infrared Spectroscopy) in brachioradialis muscle of septic shock patients and its prognostic implications. Prospective and observational study. Intensive care unit. Septic shock patients and healthy volunteers. The probe of a NIRS device (INVOS 5100) was placed on the brachioradialis muscle during a vascular occlusion test (VOT). Baseline, minimum and maximum rSO2 values, deoxygenation rate (DeOx), reoxygenation slope (ReOx) and delta value. Septic shock patients (n=35) had lower baseline rSO2 (63.8±12.2 vs. 69.3±3.3%, p<0.05), slower DeOx (-0.54±0.31 vs. -0.91±0.35%/s, p=0.001), slower ReOx (2.67±2.17 vs. 9.46±3.5%/s, p<0.001) and lower delta (3.25±5.71 vs. 15.1±3.9%, p<0.001) when compared to healthy subjects (n=20). Among septic shock patients, non-survivors showed lower baseline rSO2 (57.0±9.6 vs. 69.8±11.3%, p=0.001), lower minimum rSO2 (36.0±12.8 vs. 51.3±14.8%, p<0.01) and lower maximum rSO2 values (60.6±10.6 vs. 73.3±11.2%, p<0.01). Baseline rSO2 was a good mortality predictor (AUC 0.79; 95%CI: 0.63-0.94, p<0.01). Dynamic parameters obtained with VOT did not improve the results. Septic shock patients present an important alteration of microcirculation that can be evaluated by NIRS with prognostic implications. Monitoring microvascular reactivity in the brachioradialis muscle using VOT with our device does not seem to improve the prognostic value of baseline rSO2. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  7. Prognostic value of an increase in post-exercise ankle-brachial index.

    Science.gov (United States)

    Hammad, Tarek A; Hiatt, William R; Gornik, Heather L; Shishehbor, Mehdi H

    2017-06-01

    Prior studies have assessed the prognostic value of a decrease, not an increase, of the post-exercise ankle-brachial index (ABI) among patients with normal resting results. Thus, we sought to evaluate the prognostic significance of an increase in post-exercise ABI among these patients. From a single center vascular laboratory database between September 2005 and January 2010, we retrospectively identified 1437 consecutive patients with a normal resting ABI (1.00-1.40) and available post-exercise results. We classified them into group 1 (normal subjects; post-exercise ABI drop ⩽ 20%, 58%) and group 2 (post-exercise ABI increase, 42%) after excluding those with an ABI drop > 20% (peripheral artery disease) as they had known disease ( n=192). The primary outcome was to assess the risk of ischemic events, defined as a composite of unadjudicated death, stroke, or myocardial infraction (MACE). Associations between groups and outcomes were examined using multivariable Cox proportional hazard and propensity analyses. Both groups had similar prevalence of cardiovascular comorbidities. In unadjusted analysis, group 2 was more likely to have MACE ( p = 0.001). After adjusting for all baseline characteristics, an increase in post-exercise ABI compared to normal subjects was associated with a higher MACE (adjusted HR: 1.70, 95% CI: 1.14-2.53; p=0.009). This association stayed statistically significant after propensity matching (adjusted HR: 1.80, 95% CI: 1.17-2.76; p=0.007). This hypothesis-generating analysis showed that an increase in post-exercise ABI appears to identify a population with a higher risk for MACE. A prospective study of this association and mechanisms of risk should be conducted.

  8. Nutritional Risk in Major Abdominal Surgery: Protocol of a Prospective Observational Trial to Evaluate the Prognostic Value of Different Nutritional Scores in Pancreatic Surgery.

    Science.gov (United States)

    Probst, Pascal; Haller, Sebastian; Dörr-Harim, Colette; Bruckner, Thomas; Ulrich, Alexis; Hackert, Thilo; Diener, Markus K; Knebel, Phillip

    2015-11-16

    The influence of patients' preoperative nutritional status on their clinical outcome has already been proven. Therefore, patients with malnutrition are in need of additional therapeutic efforts. However, for pancreatic surgery, evidence suggesting the adequacy of existing nutritional assessment scores to estimate malnutrition associated with postoperative outcome is limited. The aim of the observational trial "Nutritional Risk in Major Abdominal Surgery (NURIMAS) Pancreas" is to prospectively assess and analyze different nutritional assessment scores for their prognostic value on postoperative complications in patients undergoing pancreatic surgery. All patients scheduled to receive elective pancreatic surgery at the University Hospital of Heidelberg will be screened for eligibility. Preoperatively, 12 nutritional assessment scores will be collected and patients will be assigned either at risk or not at risk for malnutrition. The postoperative course will be followed prospectively and complications according to the Clavien-Dindo classification will be recorded. The prognostic value for complications will be evaluated for every score in a univariable and multivariable analysis corrected for known risk factors in pancreatic surgery. Final data analysis is expected to be available during Spring 2016. The NURIMAS Pancreas trial is a monocentric, prospective, observational trial aiming to find the most predictive clinical nutritional assessment score for postoperative complications. Using the results of this protocol as a knowledge base, it is possible to conduct nutritional risk-guided intervention trials to prevent postoperative complications in the pancreatic surgical population. germanctr.de: DRKS00006340; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006340 (Archived by WebCite at http://www.webcitation.org/6bzXWSRYZ).

  9. Performance of the Multidimensional Geriatric Assessment and Multidimensional Prognostic Index in predicting negative outcomes in older adults with cancer.

    Science.gov (United States)

    Giantin, V; Falci, C; De Luca, E; Valentini, E; Iasevoli, M; Siviero, P; Maggi, S; Martella, B; Crepaldi, G; Monfardini, S; Manzato, E

    2018-01-01

    The Multidimensional Geriatric Assessment (MGA) is currently used for assessing geriatric oncological patients, but a new prognostic index - the Multidimensional Prognostic Index (MPI) - has a demonstrated prognostic value in cancer patients too. The present work was designed to compare the MPI and MGA as predictors of 12-month mortality. 160 patients ≥70 years old with locally-advanced or metastatic solid cancers consecutively joining our Geriatric Oncology Program were administered a Comprehensive Geriatric Assessment to calculate their MGA and MPI scores. Geriatric Clinic, Geriatric Surgery Clinic, Medical Oncology Unit, Padova Hospital, Italy. Using Cohen's Kappa coefficient, there was a poor concordance between the MPI and MGA. Severe MPI being associated with a higher mortality risk than Frail in the MGA. The ROC curves indicated that the MPI had a greater discriminatory power for 12-month mortality than the MGA. In our population of elderly cancer patients, the MPI performed better than the MGA in predicting mortality. Further evidence from larger prospective trials is needed to establish whether other geriatric scales, such as the GDS and CIRS-SI, could enhance the value of prognostic indexes applied to elderly cancer patients. © 2016 John Wiley & Sons Ltd.

  10. Geriatric nutritional risk index, muscle function, quality of life and clinical outcome in hemodialysis patients.

    Science.gov (United States)

    Beberashvili, Ilia; Azar, Ada; Sinuani, Inna; Shapiro, Gregory; Feldman, Leonid; Sandbank, Judith; Stav, Kobi; Efrati, Shai

    2016-12-01

    The geriatric nutritional risk index (GNRI) has been reported as a useful predictor of prognosis in maintenance hemodialysis (MHD) patients, demonstrating GNRI less than 90 as a marker of a poorer nutritional status and significantly increased mortality. We tested whether GNRI as a whole associated stronger with clinical and laboratory surrogates of nutrition and inflammation, muscle function, health-related quality of life (QoL), and predicts all-cause and cardiovascular (CV) morbidity and mortality in this population better than its individual components (albumin and body weight to ideal body weight ratio). A prospective observational study with a median follow-up of 30 months (interquartile range - 19-41 months) was performed on 352 MHD outpatients (38.0% women) with a mean age of 67.4 ± 13.2 years. All-cause and cardiovascular hospitalization and mortality, GNRI, handgrip strength (HGS), body composition parameters (anthropometry and bioimpedance) and short form 36 (SF-36) quality-of-life scores were measured. Multivariate linear regression analyses were performed to obtain adjusted correlations. Receiver operating characteristic (ROC) curves were generated and multivariate Cox proportional hazards models were applied to identify the predictive value of GNRI and its components separately. GNRI positively correlated with total score (r = 0.15, P patients didn't stand up to multivariable adjustments. For each one unit increase in baseline GNRI levels, the first hospitalization hazard ratio (HR) after adjustments for confounders was 0.98 (95% confidence interval (CI), 0.97 to 0.99) and the first CV event HR was 0.98 (95% CI, 0.97 to 0.99); all-cause death HR was 0.97 (95% CI, 0.96 to 0.99) and CV death HR was 0.97 (95% CI, 0.95-0.99). Albumin was related to QoL and clinical outcomes with higher strength and magnitude than GNRI. Despite the significant relationship with clinical outcomes and QOL, GNRI is not better and is even slightly worse than albumin

  11. Prospective clarification of the utility of the palliative prognostic index for patients with advanced cancer in the home care setting.

    Science.gov (United States)

    Hamano, Jun; Kizawa, Yoshiyuki; Maeno, Takami; Nagaoka, Hiroka; Shima, Yasuo; Maeno, Tetsuhiro

    2014-12-01

    This study aimed to prospectively clarify the accuracy of the Palliative Prognostic Index (PPI) for advanced cancer patients in home care settings. The study included 66 advanced cancer patients who received home visiting services between April 2010 and June 2012, and who died at home or in the hospital. Using medical records from initial home visits, we prospectively calculated PPI scores along with sensitivity and specificity. For 3- and 6-week survival, prognostic prediction showed respective sensitivities of 60% and 70.6%, and specificities of 87.0% and 71.9%. The sensitivity of the PPI for advanced cancer patients in home care settings was lower than that reported for patients in palliative care units. Development of prognostic tools suitable for home care settings is needed. © The Author(s) 2013.

  12. Nutritional risk index is predictor of postoperative complications in operations of digestive system or abdominal wall?

    Science.gov (United States)

    Thieme, Rubia Daniela; Cutchma, Gislaine; Chieferdecker, Maria Eliana Madalozzo; Campos, Antônio Carlos Ligocki

    2013-01-01

    Malnutrition can be considered the most common disease in hospitals due to its high prevalence. To investigate the methods of evaluation of the nutritional status that better correlate with postoperative complications and the length of hospital stay in patients submitted to gastrointestinal or abdominal wall surgeries. This is a retrospective evaluation of 215 nutritional assessment records. All were submitted to traditional anthropometry (weight, height, BMI, arm circumference, triceps skinfold thickness and mid-arm muscle circumference), subjective global assessment, serum albumin and lymphocyte count. Nutritional risk index was also calculated. A total of 125 patients were included. Malnutrition was diagnosed by mid-arm muscle circumference, nutritional risk index and subjective global assessment in 46%, 88% and 66%, respectively. Severe malnutrition was found in 17,6% if considered subjective global assessment and in 42% by the nutritional risk index. Oncologic patients had a worst nutritional status according to this index (5,42 less units). There was a negative correlation between occurrence the noninfectious postoperative complications with the nutritional risk index (p=0,0016). Similarly, lower serum albumin levels were associated with higher non infectious complications (p=0,0015). The length of hospital stay was, in average, 14,24 days less in patients without complications as compared with non infectious postoperative complications (pNutritional risk index and serum albumin are the parameters with the best capacity to predict the occurrence of non infectious postoperative complications and the length of hospital stay was higher to this patients.

  13. Improved risk stratification by the integration of the revised international prognostic scoring system with the myelodysplastic syndromes comorbidity index.

    Science.gov (United States)

    van Spronsen, M F; Ossenkoppele, G J; Holman, R; van de Loosdrecht, A A

    2014-12-01

    Myelodysplastic syndromes (MDS) comprise bone marrow failure diseases with a diverse clinical outcome. For improved risk stratification, the International Prognostic Scoring System (IPSS) has recently been revised (IPSS-R). This single-centre study aimed to validate the IPSS-R and to evaluate prior prognostic scoring systems for MDS. We retrospectively analysed 363 patients diagnosed with MDS according to the FAB criteria between 2000 and 2012. The IPSS, MD Anderson Risk Model Score (MDAS), World Health Organisation (WHO)-classification based Prognostic Scoring System (WPSS), refined WPSS (WPSS-R), IPSS-R and MDS-Comorbidity Index (MDS-CI) were applied to 222 patients considered with primary MDS following the WHO criteria and their prognostic power was investigated. According to the IPSS-R, 18 (8%), 81 (37%), 50 (23%), 43 (19%) and 30 (13%) patients were classified as very low, low, intermediate, high and very high risk with, respectively, a median overall survival of 96 (95% Confidence interval (CI) not reached), 49 (95% CI 34-64), 22 (95% CI 0-49), 19 (95% CI 11-27) and 10 (95% CI 6-13) months (pMDS-CI refined the risk stratification of MDS patients stratified according to the IPSS-R. In conclusion, accounting for the disease status by means of the IPSS-R and comorbidity through the MDS-CI considerably improves the prognostic assessment in MDS patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Mannheim Peritonitis Index (MPI) and elderly population: prognostic evaluation in acute secondary peritonitis.

    Science.gov (United States)

    Salamone, G; Licari, L; Falco, N; Augello, G; Tutino, R; Campanella, S; Guercio, G; Gulotta, G

    2016-01-01

    Acute Secondary Peritonitis due to abdominal visceral perforation is characterized by high mortality and morbidity risk. Risk stratification allows prognosis prediction to adopt the best surgical treatment and clinical care support therapy. In Western countries elderly people represent a significant percentage of population Aim. Evaluation of Mannheim Peritonitis Index (MPI) and consideration upon old people. Retrospective study on 104 patients admitted and operated for "Acute Secondary Peritonitis due to visceral perforation". MPI was scored. In our study we want to demonstrate efficacy of MPI and the possibility to consider older age an independent prognostic factor. Mortality was 25.96%. Greatest sensitivity and specificity for the MPI score as a predictor of mortality was at the score of 20. MPI score of 22. Patients with MPI score 17-21 had 0.46 times lower risk of mortality compared to patients with MPI score >21. In the group of patients with MPI score of >20 the mortality rate was 48.5% for patients older than 80 years old and 12.1% for younger patients (p < 0.005); in the group with MPI score of < 20 mortality rate was respectively 8.4% and 1.4% (p < 0.005). Data confirm the accuracy of the test. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis.

  15. An inflammation-based prognostic index predicts survival advantage after transarterial chemoembolization in hepatocellular carcinoma.

    Science.gov (United States)

    Pinato, David J; Sharma, Rohini

    2012-08-01

    Transarterial chemoembolization (TACE) is the preferred treatment for unresectable, intermediate-stage hepatocellular carcinoma (HCC). However, survival after TACE can be highly variable, suggesting the need for more accurate patient selection to improve therapeutic outcome. We have explored the prognostic ability of the blood neutrophil-to-lymphocyte ratio (NLR), a biomarker of systemic inflammation, as a predictor of survival after TACE. Fifty-four patients with a diagnosis of HCC eligible for TACE were selected. Clinicopathologic variables were collected, including demographics, tumor staging, liver functional reserve, and laboratory variables. Dynamic changes in the NLR before and after TACE were studied as predictors of survival using both a univariate and multivariate Cox regression model. Patients in whom the NLR remained stable or normalized after TACE showed a significant improvement in overall survival of 26 months compared with patients showing a persistently abnormal index (P = 0.006). Other predictors of survival on univariate analysis were Cancer of the Liver Italian Program score (P = 0.05), intrahepatic spread (P = 0.01), tumor diameter > 5 cm (P = 0.02), > 1 TACE (P = 0.01), alpha-fetoprotein ≥ 400 (P = 0.002), and radiologic response to TACE (P analysis. Changes in alpha-fetoprotein after treatment did not predict survival. Patients with a persistently increased NLR have a worse outcome after TACE. NLR is a simple and universally available stratifying biomarker that can help identify patients with a significant survival advantage after TACE. Copyright © 2012 Mosby, Inc. All rights reserved.

  16. Additional predictive value of nutritional status in the prognostic assessment of heart failure patients.

    Science.gov (United States)

    La Rovere, M T; Maestri, R; Olmetti, F; Paganini, V; Riccardi, G; Riccardi, R; Pinna, G D; Traversi, E

    2017-03-01

    Nutritional status (NS) is not routinely assessed in HF. We sought to evaluate whether NS may be additive to a comprehensive pre-discharge evaluation based on a clinical score that includes BMI (MAGGIC) and on an index of functional capacity (six minute walking test, 6mWT) in HF patients. The CONUT (Controlling Nutritional Status) score (including serum albumin level, total cholesterol and lymphocyte count) was computed in 466 consecutive patients (mean age 61 ± 11 years, NYHA class 2.6 ± 0.6, LVEF 34 ± 11%, BMI 27.2 ± 4.5) who had pre-discharge MAGGIC and 6MWT. The endpoint was all-cause mortality. Mild or moderate undernourishment was present in 54% of patients with no differences across BMI strata. The 12-month event rate was 7.7%. Deceased patients had a more compromised NS (CONUT 2.8 ± 1.5 vs 1.7 ± 1.3, p assessment of NS, significantly improves prediction of 12-month mortality on top of the information provided by clinical evaluation and functional capacity and should be incorporated in the overall assessment of HF patients. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  17. Prognostic impact of nutritional status assessed by the Controlling Nutritional Status score in patients with stable coronary artery disease undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Konishi, Hirokazu; Naito, Ryo; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-11-01

    Recently, malnutrition has been shown to be related to worse clinical outcomes in patients with heart failure. However, the association between nutritional status and clinical outcomes in patients with coronary artery disease (CAD) remains unclear. We investigated the prognostic value of malnutrition assessed by the Controlling Nutritional Status (CONUT; range 0-12, higher = worse, consisting of serum albumin, cholesterol and lymphocytes) score in patients with CAD. The CONUT score was measured on admission in a total of 1987 patients with stable CAD who underwent elective percutaneous coronary intervention (PCI) between 2000 and 2011. Patients were divided into two groups according to their CONUT score (0-1 vs. ≥2). The incidence of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, was evaluated. The median CONUT score was 1 (interquartile range 0-2). During the median follow-up of 7.4 years, 342 MACE occurred (17.2%). Kaplan-Meier curves revealed that patients with high CONUT scores had higher rates of MACE (log-rank p Nutritional status assessed by the CONUT score was significantly associated with long-term clinical outcomes in patients with CAD. Pre-PCI assessment of the CONUT score may provide useful prognostic information.

  18. Comprehensive Guide and Topical Index. Nutrition in Primary Care Series.

    Science.gov (United States)

    Battafarano, Annette M.

    Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

  19. Comparison of Geriatric Nutritional Risk Index scores on physical performance among elderly patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Matsumura, Takuro; Mitani, Yuji; Oki, Yutaro; Fujimoto, Yukari; Ohira, Mineko; Kaneko, Hiromi; Kawashima, Tsunehiro; Nishio, Masato; Ishikawa, Akira

    2015-01-01

    The Geriatric Nutritional Risk Index (GNRI) is a new prognostic indicator for nutritional status-related complications and mortality among the elderly. Here we aimed to compare 6-min walk distance (6MWD) between high and low GNRI groups for patients with COPD. We enrolled 63 elderly men with COPD. These subjects were divided into two groups based on their GNRI scores: high GNRI group (≥92 points; n = 44) and low GNRI group (n = 19); we compared 6MWD between these groups. The subjects' characteristics between the high and the low GNRI groups were similar, except for BMI and serum albumin levels. 6MWD were significantly lower in the low GNRI group (279.5 ± 112.3 m versus 211.1 ± 125.3 m; p = 0.03). The GNRI has a more close relation with exercise tolerance and may be a useful nutritional assessment scale for elderly patients with COPD. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Adding items that assess changes in activities of daily living does not improve the predictive accuracy of the Palliative Prognostic Index.

    Science.gov (United States)

    Hamano, Jun; Tokuda, Yasuharu; Kawagoe, Shohei; Shinjo, Takuya; Shirayama, Hiroto; Ozawa, Taketoshi; Shishido, Hideki; Otomo, Sen; Nagayama, Jun; Baba, Mika; Tei, Yo; Hiramoto, Shuji; Suga, Akihiko; Hisanaga, Takayuki; Ishihara, Tatsuhiko; Iwashita, Tomoyuki; Kaneishi, Keisuke; Kuriyama, Toshiyuki; Maeda, Takashi; Morita, Tatsuya

    2017-03-01

    Changes in activities of daily living in cancer patients may predict their survival. The Palliative Prognostic Index is a useful tool to evaluate cancer patients, and adding an item about activities of daily living changes might improve its predictive value. To clarify whether adding an item about activities of daily living changes improves the accuracy of Palliative Prognostic Index. Multicenter prospective cohort study. A total of 58 palliative care services in Japan. Patients aged >20 years diagnosed with locally extensive or metastatic cancer (including hematological neoplasms) who had been admitted to palliative care units, were receiving care by hospital-based palliative care teams, or were receiving home-based palliative care. Palliative care physicians recorded clinical variables at the first assessment and followed up patients 6 months later. A total of 2425 subjects were recruited and 2343 of these had analyzable data. The C-statistic of the original Palliative Prognostic Index was 0.801, and those of modified Palliative Prognostic Indices ranged from 0.793 to 0.805 at 3 weeks. For 6-week survival predictions, the C-statistic of the original Palliative Prognostic Index was 0.802, and those of modified Palliative Prognostic Indices ranged from 0.791 to 0.799. The weighted kappa of the original Palliative Prognostic Index was 0.510, and those of modified Palliative Prognostic Indices ranged from 0.484 to 0.508. Adding items about activities of daily living changes to the Palliative Prognostic Index did not improve prognostic value in advanced cancer patients.

  1. The SCREEN I (Seniors in the Community: Risk Evaluation for Eating and Nutrition) index adequately represents nutritional risk.

    Science.gov (United States)

    Keller, Heather H

    2006-08-01

    Nutrition risk is a difficult and complex construct to define and measure. Exploratory factor analysis has been completed on SCREEN I, a nutrition risk screening index for community-living seniors. This analysis was completed to confirm this structure and further validate the index as a plausible measure of nutritional risk. As part of the Bringing Nutrition Screening to Seniors demonstration project, 1,218 seniors completed SCREEN I. Using structural equation modeling (Amos version 5 software), the original and alternative two-, three-, and four-factor structures were modeled and compared. The best-fitting model was a four-factor structure based on the original exploratory model. Unlike the original model, however, several SCREEN I items cross-loaded on more than one factor, demonstrating the complexity of the construct 'nutritional risk.' SCREEN I appears to represent adequately the construct 'nutritional risk' with four factors: Food Intake, Physiologic, Adaptation, and Functional. Further work should be conducted to further elucidate the complex nature of 'nutritional risk' by identifying indirect and direct relationships among the screen items and this construct.

  2. Confirmation of the mantle-cell lymphoma International Prognostic Index in randomized trials of the European Mantle-Cell Lymphoma Network

    DEFF Research Database (Denmark)

    Hoster, Eva; Klapper, Wolfram; Hermine, Olivier

    2014-01-01

    PURPOSE: Mantle-cell lymphoma (MCL) is a distinct B-cell lymphoma associated with poor outcome. In 2008, the MCL International Prognostic Index (MIPI) was developed as the first prognostic stratification tool specifically directed to patients with MCL. External validation was planned.......9) and 2.6 (2.0 to 3.3), respectively. MIPI was similarly prognostic for TTF. All four clinical baseline characteristics constituting the MIPI, age, performance status, lactate dehydrogenase level, and WBC count, were confirmed as independent prognostic factors for OS and TTF. The validity of MIPI...

  3. Complex karyotype in mantle cell lymphoma is a strong prognostic factor for the time to treatment and overall survival, independent of the MCL international prognostic index.

    Science.gov (United States)

    Sarkozy, Clémentine; Terré, Christine; Jardin, Fabrice; Radford, Isabelle; Roche-Lestienne, Catherine; Penther, Dominique; Bastard, Christian; Rigaudeau, Sophie; Pilorge, Sylvain; Morschhauser, Franck; Bouscary, Didier; Delarue, Richard; Farhat, Hassan; Rousselot, Philippe; Hermine, Olivier; Tilly, Hervé; Chevret, Sylvie; Castaigne, Sylvie

    2014-01-01

    Mantle cell lymphoma (MCL) is usually an aggressive disease. However, a few patients do have an "indolent" evolution (iMCL) defined by a long survival time without intensive therapy. Many studies highlight the prognostic role of additional genetic abnormalities, but these abnormalities are not routinely tested for and do not yet influence the treatment decision. We aimed to evaluate the prognostic impact of these additional abnormalities detected by conventional cytogenetic testing, as well as their relationships with the clinical characteristics and their value in identifying iMCL. All consecutive MCL cases diagnosed between 1995 and 2011 at four institutions were retrospectively selected on the basis of an informative karyotype with a t(11;14) translocation at the time of diagnosis. A total of 125 patients were included and followed for an actual median time of 35 months. The median overall survival (OS) and survival without treatment (TFS) were 73.7 and 1.3 months, respectively. In multivariable Cox models, a high mantle cell lymphoma international prognostic index score, a complex karyotype, and blastoid morphology were independently associated with a shortened OS. Spleen enlargement, nodal presentation, extra-hematological involvement, and complex karyotypes were associated with shorter TFS. A score based on these factors allowed for the identification of "indolent" patients (median TFS 107 months) from other patients (median TFS: 1 month). In conclusion, in this multicentric cohort of MCL patients, a complex karyotype was associated with a shorter survival time and allowed for the identification of iMCL at the time of diagnosis. Copyright © 2013 Wiley Periodicals, Inc.

  4. The preoperative alkaline phosphatase-to-platelet ratio index is an independent prognostic factor for hepatocellular carcinoma after hepatic resection.

    Science.gov (United States)

    Yu, Ya-Qun; Li, Jun; Liao, Yan; Chen, Qian; Liao, Wei-Jia; Huang, Jian

    2016-12-01

    A simple, inexpensive, and readily available prognostic index is highly needed to accurately predict the prognosis of hepatocellular carcinoma (HCC). This study aimed to develop a simple prognostic index using routine laboratory tests, alkaline phosphatase-to-platelet count ratio index (APPRI), to predict the likelihood of postoperative survival in HCC patients.A total of 246 patients with HCC undergoing curative resection were retrospectively analyzed. Cutoff point for APPRI was calculated using receiver operating characteristic curve analysis, and then the patients were divided into the low-APPRI group (APPRI ≤ 4.0) and the high-APPRI group (APPRI > 4.0). The influences of APPRI on disease-free survival (DFS) and overall survival (OS) were tested by the Kaplan-Meier method, and multivariate analysis using Cox regression. Elevated APPRI was associated with age, cirrhosis, and aspartate aminotransferase (AST) in HCC. Univariate analysis showed that APPRI > 4.0, tumor size >6 cm, multiple tumors, Barcelona-clinic liver cancer stages B to C, and AST > 40 U/L were significant predictors of worse DFS and OS. A multivariate analysis suggested that APPRI > 4.0 was an independent factor for DFS (hazard ratio [HR] = 1.689; 95% confidence interval [CI], 1.139-2.505; P = 0.009) and OS (HR = 1.664; 95% CI, 1.123-2.466; P = 0.011). Preoperative APPRI > 4.0 was a powerful prognostic predictor of adverse DFS and OS in HCC after surgery. The APPRI may be a promising prognostic marker for HCC after surgical resection.

  5. Nutritional screening and mortality in newly institutionalised elderly: a comparison between the geriatric nutritional risk index and the mini nutritional assessment.

    Science.gov (United States)

    Cereda, Emanuele; Pedrolli, Carlo; Zagami, Annunciata; Vanotti, Alfredo; Piffer, Silvano; Opizzi, Annalisa; Rondanelli, Mariangela; Caccialanza, Riccardo

    2011-12-01

    Several tools are available for nutritional screening. We evaluated the risk of mortality associated with the Geriatric Nutritional Risk Index (GNRI) and the Mini Nutritional Assessment (MNA) in newly institutionalised elderly. A prospective observational study involving 358 elderly newly admitted to a long-term care setting. Hazard ratios (HR) for mortality among GNRI categories and MNA classes were estimated by multivariable Cox's model. At baseline, 32.4% and 37.4% of the patients were classified as being malnourished (MNA nutritional risk (GNRI risk for malnutrition (MNA 17-23.5) and having low nutritional risk (GNRI 92-98). During a median follow-up of 6.5 years [25th-75th percentile, 5.9-8.6], 297 elderly died. Risk for all-cause mortality was significantly associated with nutritional risk by the GNRI tool (GNRInutritional status by the MNA. A significant association was also found with cardiovascular mortality (GNRI Nutritional risk by GNRI but not nutritional status by MNA was associated with higher mortality risk. Present data suggest that in the nutritional screening of newly institutionalised elderly the use of the GNRI should be preferred to that of the MNA. 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  6. Ki67 index is an independent prognostic factor in epithelioid but not in non-epithelioid malignant pleural mesothelioma: a multicenter study.

    Science.gov (United States)

    Ghanim, B; Klikovits, T; Hoda, M A; Lang, G; Szirtes, I; Setinek, U; Rozsas, A; Renyi-Vamos, F; Laszlo, V; Grusch, M; Filipits, M; Scheed, A; Jakopovic, M; Samarzija, M; Brcic, L; Stancic-Rokotov, D; Kern, I; Rozman, A; Dekan, G; Klepetko, W; Berger, W; Glasz, T; Dome, B; Hegedus, B

    2015-03-03

    Estimating the prognosis in malignant pleural mesothelioma (MPM) remains challenging. Thus, the prognostic relevance of Ki67 was studied in MPM. Ki67 index was determined in a test cohort of 187 cases from three centres. The percentage of Ki67-positive tumour cells was correlated with clinical variables and overall survival (OS). The prognostic power of Ki67 index was compared with other prognostic factors and re-evaluated in an independent cohort (n=98). Patients with Ki67 higher than median (>15%) had significantly (P<0.001) shorter median OS (7.5 months) than those with low Ki67 (19.1 months). After multivariate survival analyses, Ki67 proved to be-beside histology and treatment-an independent prognostic marker in MPM (hazard ratio (HR): 2.1, P<0.001). Interestingly, Ki67 was prognostic exclusively in epithelioid (P<0.001) but not in non-epithelioid subtype. Furthermore, Ki67 index was significantly lower in post-chemotherapy samples when compared with chemo-naive cases. The prognostic power was comparable to other recently published prognostic factors (CRP, fibrinogen, neutrophil-to-leukocyte ratio (NLR) and nuclear grading score) and was recapitulated in the validation cohort (P=0.048). This multicentre study demonstrates that Ki67 is an independent and reproducible prognostic factor in epithelioid but not in non-epithelioid MPM and suggests that induction chemotherapy decreases the proliferative capacity of MPM.

  7. A novel prognostic indicator for in-hospital and 4-year outcomes in patients with pulmonary embolism: TIMI risk index.

    Science.gov (United States)

    Keskin, Muhammed; Güvenç, Tolga Sinan; Hayıroğlu, Mert İlker; Kaya, Adnan; Tatlısu, Mustafa Adem; Avşar, Şahin; Öz, Ahmet; Keskin, Taha; Uzun, Ahmet Okan; Kozan, Ömer

    2017-10-01

    Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) was recently evaluated in patients with acute myocardial infarction and found as an important prognostic index. In the current study, we evaluated the prognostic value of TRI in patients with moderate-high and high risk pulmonary embolism (PE) who were treated with thrombolytic agents. We retrospectively evaluated the in-hospital and long-term (4-year) prognostic impact of TRI in a total number of 456 patients with moderate-high and high risk PE. Patients were stratified by quartiles (Q) of admission TRI. In-hospital analysis revealed significantly higher rates of in-hospital death for patients with TRI in Q4. After adjustment for confounding baseline variables, TRI in Q4 was associated with 2.8-fold hazard of in-hospital death. Upon multivariate analysis, admission TRI in Q4 vs. Q1-3 was associated with 3.1 fold hazard of 4-year mortality rate. TRI in Q4, as compared to Q1-3, was significantly predictive of short term and long-term outcomes in PE patients who treated with thrombolytic agents. Our data suggest TRI to be an independent, feasible, and cost-effective tool for rapid risk stratification in moderate-high and high risk PE patients who treated with thrombolytic agents. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Association of nutritional risk index with metabolic biomarkers, appetite-regulatory hormones and inflammatory biomarkers and outcome in patients with chronic heart failure.

    Science.gov (United States)

    Gouya, G; Voithofer, P; Neuhold, S; Storka, A; Vila, G; Pacher, R; Wolzt, M; Hülsmann, M

    2014-11-01

    We aimed to evaluate the association of the nutritional status by using the nutritional risk index (NRI) with metabolic and inflammatory biomarkers, and appetite-regulatory hormones in a cohort of stable patients with heart failure (HF), and to analyse its prognostic value. In this prospective observational cohort study, we included 137 stable chronic HF patients (median age, 60 years; median body mass index, 27 kg/m(2) ) with optimised medical treatment. Baseline NRI of index (r = 0.444; p risk of all-cause mortality (log rank = 0.031). We propose that the NRI is a useful and easily applicable tool for the early identification of nutritional depletion in patients with chronic HF as it discriminates metabolic changes prior to the clinical manifestation of body wasting. Furthermore, poor nutritional status, represented as a low NRI, is associated with an increased incidence of death in such cases. © 2014 John Wiley & Sons Ltd.

  9. Prognostic significance of Ki67 proliferation index, HIF1 alpha index and microvascular density in patients with non-small cell lung cancer brain metastases

    Energy Technology Data Exchange (ETDEWEB)

    Berghoff, A.S. [Medical University of Vienna, Institute of Neurology, Vienna (Austria); Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Department of Medicine I, Vienna (Austria); Ilhan-Mutlu, A.; Preusser, M. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Department of Medicine I, Vienna (Austria); Woehrer, A.; Hainfellner, J.A. [Medical University of Vienna, Institute of Neurology, Vienna (Austria); Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Hackl, M. [Austrian National Cancer Registry, Statistics Austria, Vienna (Austria); Widhalm, G. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Department of Neurosurgery, Vienna (Austria); Dieckmann, K. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Department of Radiotherapy, Vienna (Austria); Melchardt, T. [Paracelsus Medical University Hospital Salzburg, Third Medical Department, Salzburg (Austria); Dome, B. [Medical University of Vienna, Department of Surgery, Vienna (Austria); Heinzl, H. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Center for Medical Statistics, Informatics, and Intelligent Systems, Vienna (Austria); Birner, P. [Medical University of Vienna, Comprehensive Cancer Center CNS Tumors Unit, Vienna (Austria); Medical University of Vienna, Institute of Clinical Pathology, Vienna (Austria)

    2014-07-15

    Survival upon diagnosis of brain metastases (BM) in patients with non-small cell lung cancer (NSCLC) is highly variable and established prognostic scores do not include tissue-based parameters. Patients who underwent neurosurgical resection as first-line therapy for newly diagnosed NSCLC BM were included. Microvascular density (MVD), Ki67 tumor cell proliferation index and hypoxia-inducible factor 1 alpha (HIF-1 alpha) index were determined by immunohistochemistry. NSCLC BM specimens from 230 patients (151 male, 79 female; median age 56 years; 199 nonsquamous histology) and 53/230 (23.0 %) matched primary tumor samples were available. Adjuvant whole-brain radiation therapy (WBRT) was given to 153/230 (66.5 %) patients after neurosurgical resection. MVD and HIF-1 alpha indices were significantly higher in BM than in matched primary tumors. In patients treated with adjuvant WBRT, low BM HIF-1 alpha expression was associated with favorable overall survival (OS), while among patients not treated with adjuvant WBRT, BM HIF-1 alpha expression did not correlate with OS. Low diagnosis-specific graded prognostic assessment score (DS-GPA), low Ki67 index, high MVD, low HIF-1 alpha index and administration of adjuvant WBRT were independently associated with favorable OS. Incorporation of tissue-based parameters into the commonly used DS-GPA allowed refined discrimination of prognostic subgroups. Ki67 index, MVD and HIF-1 alpha index have promising prognostic value in BM and should be validated in further studies. (orig.) [German] Die Ueberlebensprognose von Patienten mit zerebralen Metastasen eines nicht-kleinzelligen Lungenkarzinoms (NSCLC) ist sehr variabel. Bisher werden gewebsbasierte Parameter nicht in die prognostische Beurteilung inkludiert. Neurochirurgische Resektate zerebraler NSCLC-Metastasen wurden in dieser Studie untersucht. Die Gefaessdichte (''microvascular density'', MVD), der Ki67-Proliferationsindex sowie der HIF-1α-Index wurden mittels

  10. Proliferative activity (MIB-1 index) is an independent prognostic parameter in patients with high-grade soft tissue sarcomas of subtypes other than malignant fibrous histiocytomas

    DEFF Research Database (Denmark)

    Jensen, V; Sørensen, Flemming Brandt; Bentzen, S M

    1998-01-01

    . Univariate analysis identified patient age, tumour size, histological grade of malignancy, MIB-1 index and p53 accumulation as significant prognostic parameters. Multivariate Cox analysis, including tests for interaction terms between histological subtypes and MIB-1 index, showed independent prognostic....... The proliferative activity was assessed by use of the monoclonal antibody MIB-1 and evaluated in multiple, random systematic sampled fields of vision. The percentage of proliferating cells (the MIB-1 index) ranged between 1% and 85% (median 12%). A significant increase in mean MIB-1 index was seen with increasing...

  11. Prospective trial to evaluate the prognostic value of different nutritional assessment scores in pancreatic surgery (NURIMAS Pancreas).

    Science.gov (United States)

    Probst, P; Haller, S; Bruckner, T; Ulrich, A; Strobel, O; Hackert, T; Diener, M K; Büchler, M W; Knebel, P

    2017-07-01

    Preoperative nutritional status has an impact on patients' clinical outcome. For pancreatic surgery, however, it is unclear which nutritional assessment scores adequately assess malnutrition associated with postoperative outcome. Patients scheduled for elective pancreatic surgery at the University of Heidelberg were screened for eligibility. Twelve nutritional assessment scores were calculated before operation, and patients were categorized as either at risk or not at risk for malnutrition by each score. The postoperative course was monitored prospectively by assessors blinded to the nutritional status. The primary endpoint was major complications evaluated for each score in a multivariable analysis corrected for known risk factors in pancreatic surgery. Overall, 279 patients were analysed. A major complication occurred in 61 patients (21·9 per cent). The proportion of malnourished patients differed greatly among the scores, from 1·1 per cent (Nutritional Risk Index) to 79·6 per cent (Nutritional Risk Classification). In the multivariable analysis, only raised amylase level in drainage fluid on postoperative day 1 (odds ratio (OR) 4·91, 95 per cent c.i. 1·10 to 21·84; P = 0·037) and age (OR 1·05, 1·02 to 1·09; P = 0·005) were significantly associated with major complications; none of the scores was associated with, or predicted, postoperative complications. None of the nutritional assessment scores defined malnutrition relevant to complications after pancreatic surgery and these scores may thus be abandoned. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  12. A Preliminary Study Examining Nutritional Risk Factors, Body Mass Index, and Treatment Retention in Opioid-Dependent Patients.

    Science.gov (United States)

    Richardson, Robin A; Wiest, Katharina

    2015-07-01

    Poor nutritional health among opioid-dependent individuals is well established, yet no nutritional screening tool exists for this specific population. The utility of "Determine Your Nutritional Health" developed by the Nutrition Screening Initiative is considered. The study examines the questionnaire's relevance in patients beginning opioid dependence treatment at a methadone-assisted treatment program (N = 140) by examining nutritional risk factor prevalence, body mass index, and association between nutritional risk level and treatment retention. The majority of patients reported at least one nutritional risk factor (89 %) and 59 % were at high nutritional risk. Body mass index was not related to nutritional risk; however, a trend was identified between increasing nutritional risk and decreased retention in treatment. These preliminary findings suggest the need for incorporation of nutritional screening at intake in opioid treatment programs, consideration of the effect of dietary risk on treatment retention, and the potential utility of this screening tool.

  13. Pros and cons of body mass index as a nutritional and risk assessment tool in dialysis patients.

    Science.gov (United States)

    Carrero, Juan Jesús; Avesani, Carla Maria

    2015-01-01

    Obesity is a problem of serious concern among chronic kidney disease (CKD) patients; it is a risk factor for progression to end-stage renal disease and its incidence and prevalence in dialysis patients exceeds those of the general population. Obesity, typically assessed with the simple metric of body mass index (BMI), is considered a mainstay for nutritional assessment in guidelines on nutrition in CKD. While regular BMI assessment in connection with the dialysis session is a simple and easy-to-use monitoring tool, such ease of access can lead to excess-of-use, as the value of this metric to health care professionals is overestimated. This review examines BMI as a clinical monitoring tool in CKD practice and offers a critical appraisal as to what a high or a low BMI may signify in this patient population. Topics discussed include the utility of BMI as a reflection of body size, body composition and body fat distribution, diagnostic versus prognostic performance, and consideration of temporal trends over single assessments. © 2014 Wiley Periodicals, Inc.

  14. Prognostic value of a systemic inflammatory response index in metastatic renal cell carcinoma and construction of a predictive model

    Science.gov (United States)

    Li, Hongzhao; Chen, Luyao; Li, Xintao; Zhang, Yu; Xie, Yongpeng; Zhang, Xu

    2017-01-01

    Inflammation act as a crucial role in carcinogenesis and tumor progression. In this study, we aim to investigate the prognostic significance of systemic inflammatory biomarkers in metastatic renal cell carcinoma (mRCC) and develop a survival predictive model. One hundred and sixty-one mRCC patients who had undergone cytoreductive nephrectomy were enrolled from January 2006 to December 2013. We created a systemic inflammation response index (SIRI) basing on pretreatment hemoglobin and lymphocyte to monocyte ratio (LMR), and evaluated its associations with overall survival (OS) and clinicopathological features. Pretreatment hemoglobin and LMR both remained as independent factors adjusted for other markers of systemic inflammation responses and conventional clinicopathological parameters. A high SIRI seems to be an independent prognosis predictor of worse OS and was significantly correlated with aggressive tumor behaviors. Inclusion of the SIRI into a prognostic model including Fuhrman grade, histology, tumor necrosis and targeted therapy established a nomogram, which accurately predicted 1-year survival for mRCC patients. The SIRI seems to be a prognostic biomarker in mRCC patients. The proposed nomogram can be applied to predict OS of patients with mRCC after nephrectomy. PMID:28881716

  15. Does nutritional intervention maintain its prognostic benefit in the long term for malnourished patients hospitalised for heart failure?

    Science.gov (United States)

    Bonilla-Palomas, J L; Gámez-López, A L; Castillo-Domínguez, J C; Moreno-Conde, M; López-Ibáñez, M C; Anguita-Sánchez, M

    2018-03-01

    To assess the long-term effect of nutritional intervention on malnourished, hospitalised patients with heart failure (HF). A total of 120 malnourished patients hospitalized for HF were randomised to undergo (or not) an individual nutritional intervention for 6 months. The primary event was the combination of all-cause death and readmission for HF. We performed an intent-to-treat analysis and assessed the effect of the intervention at 24 months. The combined event occurred in 47.5% of the intervention group and in 73.8% of the control group (hazard ratio: 0.45; 95% confidence interval: 0.28-0.72; P=.001). Thirty-nine percent of the intervention group and 59% of the control group died (hazard ratio: 0.53; 95% confidence interval: 0.31-0.89; P=.017). A nutritional intervention for malnourished patients hospitalised for HF maintains its prognostic benefit in the long-term follow-up. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  16. Calpain-1 Expression in Triple-Negative Breast Cancer: A Potential Prognostic Factor Independent of the Proliferative/Apoptotic Index

    Directory of Open Access Journals (Sweden)

    Shadia M. Al-Bahlani

    2017-01-01

    Full Text Available Triple-negative breast cancer (TNBC is an aggressive type of breast cancer in which calpain system plays an important role in its cellular processes including apoptosis and proliferation. Although such roles have been assessed in tumor pathogenesis, the correlation of its expression to the proliferating/apoptotic index has not been studied yet. Immunohistochemical staining of calpain-1 was performed on paraffin-embedded tissues to correlate its expression with clinicopathological variables and outcome. The proliferation activity was determined by calculating the percentage of cells expressing the Ki-67 antigen. The apoptotic index was assessed morphologically and biochemically using Haematoxylin & Eosin method and Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay, respectively. Calpain-1 was significantly expressed in TNBC tissues varying from low to high with a significant correlation to lymph node status but not with the other clinicopathological variables, suggesting its role as a prognostic factor. In addition, a positive correlation was found between both apoptotic counts assays (P<0.001, r=0.547 as well as with proliferation (P=0.045. Calpain-1 expression had no significant correlation with either proliferation (P=0.29 or apoptotic indices (P=0.071 and P=0.100. Determining calpain-1 expression may provide relevant prognostic value for TNBC cancer patients.

  17. Efficacy of NETDC (New England Trophoblastic Disease Center prognostic index score to predict gestational trophoblastic tumor from hydatidiform mole

    Directory of Open Access Journals (Sweden)

    Khrismawan Khrismawan

    2004-03-01

    Full Text Available A prospective longitudinal analytic study assessing the efficacy of NETDC (New England Trophoblastic Disease Center prognostic index score in predicting malignancy after hydatidiform mole had been performed. Of the parameter evaluated; age of patients, type of hydatidiform mole, uterine enlargement, serum hCG level, lutein cyst, and presence of complicating factors were significant risk factors for malignancy after hydatidiform mole were evacuated (p<0.032. The study were done on 50 women diagnosed with hydatidiform mole with 1 year observation (January 2001-December 2002 at the Department of Obstetrics and Gynecology, Mohammad Hoesin Hospital, Palembang. The results showed that the NETDC prognostic index score predicted malignancy in 50% of high risk group and 10% in low risk group (p<0.05. This showed a higher number than that found by the WHO (19%-30%. The risk for incidence of  malignancy after hydatidiform mole in the high risk group is 9.0 times higher compared to that of the low risk group (CI: 1.769-45.786. (Med J Indones 2004; 13: 40-6 Keywords: New England Trophoblastic Disease Center (NETDC, gestational trophoblastic tumor, hydatidiform mole, high and low risk

  18. The Prognostic Impact of Controlling Nutritional Status (CONUT) in Intrahepatic Cholangiocarcinoma Following Curative Hepatectomy: A Retrospective Single Institution Study.

    Science.gov (United States)

    Miyata, Tatsunori; Yamashita, Yo-Ichi; Higashi, Takaaki; Taki, Katsunobu; Izumi, Daisuke; Kosumi, Keisuke; Tokunaga, Ryuma; Nakagawa, Shigeki; Okabe, Hirohisa; Imai, Katsunori; Hashimoto, Daisuke; Chikamoto, Akira; Baba, Hideo

    2017-09-08

    Several studies have examined controlling nutritional status (CONUT), which is one of the useful biomarkers for predicting patients' prognosis following cancer treatment. The aim of this study was to evaluate the value of CONUT as a postoperative prognostic marker in patients with intrahepatic cholangiocarcinoma (ICC) following curative hepatectomy. We retrospectively analyzed 71 patients who underwent curative hepatectomy for ICC between May 2002 and November 2016. Patients were divided into two groups according to their preoperative CONUT score (i.e., CONUT ≧ 2 or CONUT current study, a high CONUT score was not associated with postoperative complications (Clavien-Dindo classification ≧ III or more). CONUT may be useful for the preoperative assessment of prognosis in patients with ICC who have undergone curative hepatectomy.

  19. Impact of Geriatric Nutritional Risk Index on cardiovascular outcomes in patients with stable coronary artery disease.

    Science.gov (United States)

    Kunimura, Ayako; Ishii, Hideki; Uetani, Tadayuki; Aoki, Toshijirou; Harada, Kazuhiro; Hirayama, Kenshi; Negishi, Yosuke; Shibata, Yohei; Sumi, Takuya; Kawashima, Kazuhiro; Tatami, Yosuke; Kawamiya, Toshiki; Yamamoto, Dai; Suzuki, Susumu; Amano, Tetsuya; Murohara, Toyoaki

    2017-01-01

    The association between malnutrition and cardiovascular prognosis in patients with stable coronary artery disease remains unclear. The aim of this study was to evaluate the association between Geriatric Nutritional Risk Index (GNRI), a simple tool to assess nutritional risk, and long-term outcomes after elective percutaneous coronary intervention (PCI). This study consisted of 802 patients (age, 70±10 years, male, 69%) who underwent elective PCI. GNRI was calculated at baseline as follows: GNRI=[14.89×serum albumin (g/dl)+[41.7×(body weight/body weight at body mass index of 22)

  20. Prognostic value of body mass index and waist circumference in patients with chronic heart failure (Spanish REDINSCOR Registry).

    Science.gov (United States)

    Puig, Teresa; Ferrero-Gregori, Andreu; Roig, Eulalia; Vazquez, Rafael; Gonzalez-Juanatey, Jose R; Pascual-Figal, Domingo; Delgado, Juan; Alonso-Pulpon, Luis; Borras, Xavier; Mendez, Ana; Cinca, Juan

    2014-02-01

    To analyze the association between higher body mass index and waist circumference, and the prognostic values of both indicators in total and cardiac mortality in patients with chronic heart failure. The study included 2254 patients who were followed up for 4 years. Obesity was classified as a body mass index ≥30 and overweight as a body mass index of 25.0-29.9. Central obesity was defined as waist circumference ≥88 cm for women and ≥102cm for men. Independent predictors of total and cardiac mortality were assessed in a multivariate Cox model adjusted for confounding variables. Obesity was present in 35% of patients, overweight in 43%, and central obesity in 60%. Body mass index and waist circumference were independent predictors of lower total mortality: hazard ratio=0.84 (P120cm. Mortality was significantly lower in patients with a high body mass index and waist circumference. The results also showed that this protection was lost when these indicators over a certain limit. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  1. Integration of Traditional and Metabolomics Biomarkers Identifies Prognostic Metabolites for Predicting Responsiveness to Nutritional Intervention against Oxidative Stress and Inflammation

    Directory of Open Access Journals (Sweden)

    You Jin Kim

    2017-03-01

    Full Text Available Various statistical approaches can be applied to integrate traditional and omics biomarkers, allowing the discovery of prognostic markers to classify subjects into poor and good prognosis groups in terms of responses to nutritional interventions. Here, we performed a prototype study to identify metabolites that predict responses to an intervention against oxidative stress and inflammation, using a data set from a randomized controlled trial evaluating Korean black raspberry (KBR in sedentary overweight/obese subjects. First, a linear mixed-effects model analysis with multiple testing correction showed that four-week consumption of KBR significantly changed oxidized glutathione (GSSG, q = 0.027 level, the ratio of reduced glutathione (GSH to GSSG (q = 0.039 in erythrocytes, malondialdehyde (MDA, q = 0.006 and interleukin-6 (q = 0.006 levels in plasma, and seventeen NMR metabolites in urine compared with those in the placebo group. A subsequent generalized linear mixed model analysis showed linear correlations between baseline urinary glycine and N-phenylacetylglycine (PAG and changes in the GSH:GSSG ratio (p = 0.008 and 0.004 as well as between baseline urinary adenine and changes in MDA (p = 0.018. Then, receiver operating characteristic analysis revealed that a two-metabolite set (glycine and PAG had the strongest prognostic relevance for future interventions against oxidative stress (the area under the curve (AUC = 0.778. Leave-one-out cross-validation confirmed the accuracy of prediction (AUC = 0.683. The current findings suggest that a higher level of this two-metabolite set at baseline is useful for predicting responders to dietary interventions in subjects with oxidative stress and inflammation, contributing to the emergence of personalized nutrition.

  2. Integration of Traditional and Metabolomics Biomarkers Identifies Prognostic Metabolites for Predicting Responsiveness to Nutritional Intervention against Oxidative Stress and Inflammation.

    Science.gov (United States)

    Kim, You Jin; Huh, Iksoo; Kim, Ji Yeon; Park, Saejong; Ryu, Sung Ha; Kim, Kyu-Bong; Kim, Suhkmann; Park, Taesung; Kwon, Oran

    2017-03-04

    Various statistical approaches can be applied to integrate traditional and omics biomarkers, allowing the discovery of prognostic markers to classify subjects into poor and good prognosis groups in terms of responses to nutritional interventions. Here, we performed a prototype study to identify metabolites that predict responses to an intervention against oxidative stress and inflammation, using a data set from a randomized controlled trial evaluating Korean black raspberry (KBR) in sedentary overweight/obese subjects. First, a linear mixed-effects model analysis with multiple testing correction showed that four-week consumption of KBR significantly changed oxidized glutathione (GSSG, q = 0.027) level, the ratio of reduced glutathione (GSH) to GSSG (q = 0.039) in erythrocytes, malondialdehyde (MDA, q = 0.006) and interleukin-6 (q = 0.006) levels in plasma, and seventeen NMR metabolites in urine compared with those in the placebo group. A subsequent generalized linear mixed model analysis showed linear correlations between baseline urinary glycine and N-phenylacetylglycine (PAG) and changes in the GSH:GSSG ratio (p = 0.008 and 0.004) as well as between baseline urinary adenine and changes in MDA (p = 0.018). Then, receiver operating characteristic analysis revealed that a two-metabolite set (glycine and PAG) had the strongest prognostic relevance for future interventions against oxidative stress (the area under the curve (AUC) = 0.778). Leave-one-out cross-validation confirmed the accuracy of prediction (AUC = 0.683). The current findings suggest that a higher level of this two-metabolite set at baseline is useful for predicting responders to dietary interventions in subjects with oxidative stress and inflammation, contributing to the emergence of personalized nutrition.

  3. Neuromagnetic index of hemispheric asymmetry prognosticating the outcome of sudden hearing loss.

    Science.gov (United States)

    Li, Lieber Po-Hung; Shiao, An-Suey; Chen, Kuang-Chao; Lee, Po-Lei; Niddam, David M; Chang, Shyue-Yih; Hsieh, Jen-Chuen

    2012-01-01

    The longitudinal relationship between central plastic changes and clinical presentations of peripheral hearing impairment remains unknown. Previously, we reported a unique plastic pattern of "healthy-side dominance" in acute unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). This study aimed to explore whether such hemispheric asymmetry bears any prognostic relevance to ISSNHL along the disease course. Using magnetoencephalography (MEG), inter-hemispheric differences in peak dipole amplitude and latency of N100m to monaural tones were evaluated in 21 controls and 21 ISSNHL patients at two stages: initial and fixed stage (1 month later). Dynamics/Prognostication of hemispheric asymmetry were assessed by the interplay between hearing level/hearing gain and ipsilateral/contralateral ratio (I/C) of N100m latency and amplitude. Healthy-side dominance of N100m amplitude was observed in ISSNHL initially. The pattern changed with disease process. There is a strong correlation between the hearing level at the fixed stage and initial I/C(amplitude) on affected-ear stimulation in ISSNHL. The optimal cut-off value with the best prognostication effect for the hearing improvement at the fixed stage was an initial I/C(latency) on affected-ear stimulation of 1.34 (between subgroups of complete and partial recovery) and an initial I/C(latency) on healthy-ear stimulation of 0.76 (between subgroups of partial and no recovery), respectively. This study suggested that a dynamic process of central auditory plasticity can be induced by peripheral lesions. The hemispheric asymmetry at the initial stage bears an excellent prognostic potential for the treatment outcomes and hearing level at the fixed stage in ISSNHL. Our study demonstrated that such brain signature of central auditory plasticity in terms of both N100m latency and amplitude at defined time can serve as a prognostication predictor for ISSNHL. Further studies are needed to explore the long-term temporal scenario

  4. Assessing risk screening methods of malnutrition in geriatric patients: Mini Nutritional Assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI).

    Science.gov (United States)

    Durán Alert, P; Milà Villarroel, R; Formiga, F; Virgili Casas, N; Vilarasau Farré, C

    2012-01-01

    Elderly subjects are considered a vulnerable group and they have more risk of nutritional problems. The risk of malnutrition increases in hospitalized geriatric patients. To compare the correlation between MNA and GNRI with anthropometric, biochemical and Barthel Index in hospitalized geriatric patients and to test the concordance between MNA and GNRI and between Mini Nutritional Assessment Short Form (MNA-SF) and MNA. It was a cross-sectional study on a sample of 40 hospitalized geriatric patients. For determination nutritional status we used MNA and GNRI; we evaluated the correlation between this both test with biochemical and anthropometric parameters and functional questionnaires. We used Pearson's simple correlation model, oneway ANOVA and multiple logistic regression to evaluate the relationship between MNA and GNRI. According to MNA, 17 patients (42.5%) were malnourished and according to GNRI, 13 patients (32.5%) had high risk of nutritional complications. The concordance of MNA and GNRI was 39% and between MNA-SF and MNA was 81%. The most significant differences were detected in weight, BMI, arm and calf circumference and weight loss parameters. Barthel index was significantly different in both tests. The MNA and GRNI had significant correlations with albumin, total protein, transferring, arm and calf circumference, weight loss and BMI parameters. In conclusion, it would be reasonable to use GRNI in cases where MNA is not applicable, or even use GRNI as a complement to MNA in hospitalized elderly patients. There is no reason why they should be deemed incompatible, and patients could benefit from more effective nutritional intervention.

  5. WHO European Childhood Obesity Surveillance Initiative: School Nutrition Environment and Body Mass Index in Primary Schools

    NARCIS (Netherlands)

    Wijnhoven, T.M.A.; Raaij, van J.M.A.; Sjöberg, A.; Eldin, N.; Yngve, A.; Kunesova, M.; Stare, G.; Rito, A.I.; Duleva, V.; Hassapidou, M.; Martos, E.; Pudule, I.; Petrauskiene, A.; Farrugia Sant Angelo, V.; Hovengen, R.; Breda, J.

    2014-01-01

    Background: Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. Objective: To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries.

  6. Body Mass Index, Nutrient Intakes, Health Behaviours and Nutrition Knowledge: A Quantile Regression Application in Taiwan

    Science.gov (United States)

    Chen, Shih-Neng; Tseng, Jauling

    2010-01-01

    Objective: To assess various marginal effects of nutrient intakes, health behaviours and nutrition knowledge on the entire distribution of body mass index (BMI) across individuals. Design: Quantitative and distributional study. Setting: Taiwan. Methods: This study applies Becker's (1965) model of health production to construct an individual's BMI…

  7. Dietary glycaemic index and glycaemic load in the European prospective investigation into cancer and nutrition

    NARCIS (Netherlands)

    Bakel, van M.M.; Kaaks, R.; Feskens, E.J.M.; Rohrmann, S.; Welch, A.A.; Pala, V.; Avloniti, K.; Schouw, van der Y.T.; A, van der A.D.; Du, H.; Halkjaer, J.; Tormo, M.J.

    2009-01-01

    Objectives: To describe dietary glycaemic index (GI) and glycaemic load (GL) values in the population participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study according to food groups, nutrients and lifestyle characteristics. Methods: Single 24-h dietary recalls

  8. Dietary glycaemic index and glycaemic load in the European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    van Bakel, M. M. E.; Kaaks, R.; Feskens, E. J. M.; Rohrmann, S.; Welch, A. A.; Pala, V.; Avloniti, K.; van der Schouw, Y. T.; van der A, D. L.; Du, H.; Halkjaer, J.; Tormo, M. J.; Cust, A. E.; Brighenti, F.; Beulens, J. W.; Ferrari, P.; Biessy, C.; Lentjes, M.; Spencer, E. A.; Panico, S.; Masala, G.; Bueno-de-Mesquita, H. B.; Peeters, P. H. M.; Trichopoulou, A.; Psaltopoulou, T.; Clavel-Chapelon, F.; Touvier, M.; Skeie, G.; Rinaldi, S.; Sonestedt, E.; Johansson, I.; Schulze, M.; Ardanaz, E.; Buckland, G.; Tjonneland, A.; Overvad, K.; Bingham, S.; Riboli, E.; Slimani, N.

    2009-01-01

    Objectives: To describe dietary glycaemic index (GI) and glycaemic load (GL) values in the population participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study according to food groups, nutrients and lifestyle characteristics. Methods: Single 24-h dietary recalls

  9. The nutritive value index as an indicator of the economic value of ...

    African Journals Online (AJOL)

    The nutritive value index as an indicator of the economic value of roughages. J.A. Swart, P.J. Niemann. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for ...

  10. Prognostic Factors and a New Prognostic Index Model for Children and Adolescents with Hodgkin’s Lymphoma Who Underwent Autologous Hematopoietic Stem Cell Transplantation: A Multicenter Study of the Turkish Pediatric Bone Marrow Transplantation Study

    Directory of Open Access Journals (Sweden)

    Vural Kesik

    2016-12-01

    Full Text Available Objective: The prognostic factors and a new childhood prognostic index after autologous hematopoietic stem cell transplantation (AHSCT in patients with relapsed/refractory Hodgkin’s lymphoma (HL were evaluated. Materials and Methods: The prognostic factors of 61 patients who underwent AHSCT between January 1990 and December 2014 were evaluated. In addition, the Age-Adjusted International Prognostic Index and the Childhood International Prognostic Index (CIPI were evaluated for their impact on prognosis. Results: The median age of the 61 patients was 14.8 years (minimummaximum: 5-20 years at the time of AHSCT. There were single relapses in 28 patients, ≥2 relapses in eight patients, and refractory disease in 25 patients. The chemosensitivity/chemorefractory ratio was 36/25. No pretransplant radiotherapy, no remission at the time of transplantation, posttransplant white blood cell count over 10x103/ μL, posttransplant positron emission tomography positivity at day 100, and serum albumin of <2.5 g/dL at diagnosis were correlated with progression-free survival. No remission at the time of transplantation, bone marrow positivity at diagnosis, and relapse after AHSCT were significant parameters for overall survival. Conclusion: The major factors affecting the progression-free and overall survival were clearly demonstrated. A CIPI that uses a lactate dehydrogenase level of 500 IU/L worked well for estimating the prognosis. We recommend AHSCT at first complete remission for relapsed cases, and it should also be taken into consideration for patients with high prognostic scores at diagnosis.

  11. [Using the CRIB as an early prognostic index for very low birthweight infants, treated in neonatal intensive care unites].

    Science.gov (United States)

    Vakrilova, L; Emilova, Z; Slŭncheva, B; Kalaĭdzhieva, M; Pramatarova, T; Iarŭkova, N

    2007-01-01

    The illness severity by admission in NICU reflects the intensity of the therapy, the prognosis for the newborn and the hospital costs. Using the CRIB (Clinical Risk Index for Babies) as an objective and easy method for measuring the illness severity in the first 12 h of life allows assessing the risk of death until discharge. To apply the CRIB for assessing the illness severity and to investigate its prognostic value for life and risk of permanent disabilities among very low birthweight (VLBW) and gestational age (VLGA) infants. The study includes the inborn babies in the Specialized Obstetrics & Gynaecology Hospital "Maichin dom" with birthweight 15. The infants with permanent disabilities were with significantly higher CRIB scores too: 11.7 / 11.4% among the infants with IVH III-IV compared to 6.2 / 5.2 without; 9.6 / 10.1 among infants with CLD compared to 5.7 /5.2 without; 10.1 / 10 among infants with ROP compared to 5.5 / 5.1 without. The CRIB score is useful and easy to apply early and objective prognostic criterion about the risk of in hospital death and permanent disabilities among VLBW newborns. It can be used as a basis for comparing the results of the different NICUs too.

  12. [The Association Française de Chirurgie (AFC) colorectal index: a reliable preoperative prognostic index in colorectal surgery].

    Science.gov (United States)

    Duval, H; Dumont, F; Vibert, E; Manaouil, D; Verhaeghe, P; Fuks, D; Bounicaud, D; Riboulot, M; Chatelain, D; Yzet, T; Mauvais, F; Lapôtre-Ledoux, B; Regimbeau, J-M

    2006-01-01

    Evaluation of outcome after colorectal surgery is always necessary. A new index which permits to appreciate preoperatively postoperative mortality after colorectal resection in colorectal cancer (CRC) and in diverticular disease has been published (i.e., Association Française de Chirurgie, AFC colorectal index). From November 2002 to July 2004, in-hospital mortality was analysed on 253 patients who underwent colic resection (N = 220, 87%) or rectal resection, with anastomosis (N = 175, 70%). Mortality was analysed according to emergency resection, neurological co morbidity, lost of weight more than 10% of weight, age older than 70 years. Mean age of patients was 63 +/- 18 years (17-92) (45% older than 70 years), 26% of patients were ASA >or= III, 35% underwent surgery in emergency, and 12% underwent laparoscopic surgery. One hundred and fifteen (45%) patients underwent surgery for CRC and 50 (20%), for diverticular disease and 11 patients underwent surgery for ischemic colitis. Overall mortality rate was 10% (N = 26), it was 19% in emergency surgery versus 5% after elective surgery. Global morbidity was 38%, percentage of anastomotic leak was 8% (N = 14/175), reoperation was necessary in 14%. The mean length of stay was 13 +/- 8 days. Ten percent of patients necessitated unplanned readmission. After surgery for CCR or diverticular disease. -i) overall mortality was 9% - ii) among patients who had 0, 1, 2, or 3 predictive risk factors of mortality; mortality was 0% , 5% 15% and 33%. After surgery for other aetiology than CCR or diverticular disease, among patients who had 0, 1, 2, or 3 predictive risk factors of mortality; mortality was 0%, 12% 36% and 25%. These results showed the reproducibility of the AFC colorectal index and its potential application in all aetiologies after colorectal surgery.

  13. Modified BODE indexes: Agreement between multidimensional prognostic systems based on oxygen uptake

    Directory of Open Access Journals (Sweden)

    José Luis Lopez-Campos

    2010-05-01

    Full Text Available José Luis Lopez-Campos, Pilar Cejudo, Eduardo Marquez, Francisco Ortega, Esther Quintana, Carmen Carmona, Emilia BarrotUnidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospitales Universitarios Virgen del Rocío, Seville, SpainAim: It has been recently shown that the original BODE index has a high degree of correlation with two modified BODE indexes using maximal oxygen uptake expressed either as mL/min/kg (mBODE or as the percentage predicted (mBODE%. In this study we investigated the agreement between the two modified BODE indexes (mBODE and mBODE% in patients with stable chronic obstructive pulmonary disease (COPD.Methods: A total of 169 patients with stable COPD were enrolled in this cross-sectional study. Differences between the two mBODE indexes were assessed using kappa coefficients and Bland-Altman plots. One out of every three patients underwent the six-minute walking test to investigate the agreement with the original BODE index.Results: Correlations between the two mBODE indexes with each other (r = 0.96, P < 0.001 and with the original BODE index (mBODE r = 0.88, P < 0.001; mBODE% r = 0.93, P < 0.001 were excellent. However, the two mBODE indexes were significantly different from each other (mBODE 5.27 ± 2.3 versus mBODE% 4.31 ± 2.5; P < 0.001. The kappa coefficients were significantly lower (entire study group k = 0.5, P < 0.001 for every GOLD stage. The mean difference between the two mBODE indexes was 0.8 ± 0.6 units. Differences with the original BODE were higher for the mBODE (1.8 ± 0.9 than for the mBODE% (0.6 ± 0.8.Conclusions: The new mBODE indexes are highly correlated but significantly different from each other. The differences between the novel indexes deserve further scrutiny.Keywords: BODE index, chronic obstructive pulmonary disease, exercise testing, multidimensional evaluation, oxygen uptake

  14. COMPONENTS OF THE HEALTHY EATING INDEX IN NUTRITION OF ADULT FEMALES

    Directory of Open Access Journals (Sweden)

    Katarína Fatrcová-Šramková

    2010-11-01

    Full Text Available To assess and monitor the nutriton and dietary status, the U.S. Department of Agriculture developed the Healthy Eating Index - HEI. The index consists of 10 components, each representing different aspects of a healthful diet. The aim of the study was to evaluate the nutrition in adult females and to analyze the actual nutrition according to selected four components (no. 6-9 of the Healthy Eating Index. Components 6 and 7 measure total fat and saturated fat consumption, respectively, as a percentage of total food intake (maximal 30 % and 10 % of total energy daily content respectively; in case of 31,3 % and 58,62 % females respectively. Components 8 and 9 measure total cholesterol (daily maximal 300 mg in case of 69,54 % participants and sodium intake (maximal 2400 mg a day in case of 22,99 % probands. doi:10.5219/106

  15. Development of composite index and ranking the districts using nutrition survey data in Madhya Pradesh, India

    Directory of Open Access Journals (Sweden)

    Venkaiah K.

    2015-06-01

    Full Text Available Introduction: Level of development in health and nutrition at district level is useful for planning intervention in less developed districts. Aims & Objectives: to develop composite index based on 12 variables to compare development within districts in the state of Madhya Pradesh. Material & Methods: Data collected by National Institute of Nutrition, Hyderabad during 2010-11 on nutritional status of rural children at district level in Madhya Pradesh was used. A total of 22,895 children (Boys: 12379, Girls: 10516, were covered. Results: It was observed that Indore district rank 1st as per composite index and Singrauli rank last in the district ranking. Three categories of districts were done based on percentile of composite index i.e less developed, developing and developed districts. It was observed that there was significant (p<0.01 trend in the prevalence of undernutrition among three set of districts. Similarly, significant (p<0.01 trend was observed in proportion of children participating regularly in ICDS supplementary feeding programme, use of sanitary latrine and iodized cooking salt among three sets of districts. Conclusions: Widespread disparity in health and nutrition was observed among the districts. It is quite important to examine the extent of improvements needed in different developmental indicators for enhancing the level of development of low developed districts. This will help the planners and administrators to readjust the resources for bringing about uniform development in the state.

  16. WHO European Childhood Obesity Surveillance Initiative: School Nutrition Environment and Body Mass Index in Primary Schools

    Directory of Open Access Journals (Sweden)

    Trudy M.A. Wijnhoven

    2014-10-01

    Full Text Available Background: Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. Objective: To assess differences in school nutrition environment and body mass index (BMI in primary schools between and within 12 European countries. Methods: Data from the World Health Organization (WHO European Childhood Obesity Surveillance Initiative (COSI were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively. School personnel provided information on 18 school environmental characteristics on nutrition and physical activity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children’s weight and height; BMI-for-age (BMI/A Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children’s BMI/A Z-scores was calculated. Results: Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%-95% of schools and school nutrition environment scores (range: 0.30-0.93. Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania graded less than three characteristics as supportive. High-score (≥0.70 countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.20-1.02, indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the

  17. WHO European Childhood Obesity Surveillance Initiative: School nutrition environment and body mass index in primary schools.

    Science.gov (United States)

    Wijnhoven, Trudy M A; van Raaij, Joop M A; Sjöberg, Agneta; Eldin, Nazih; Yngve, Agneta; Kunešová, Marie; Starc, Gregor; Rito, Ana I; Duleva, Vesselka; Hassapidou, Maria; Martos, Eva; Pudule, Iveta; Petrauskiene, Ausra; Sant'Angelo, Victoria Farrugia; Hovengen, Ragnhild; Breda, João

    2014-10-30

    Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively). School personnel provided information on 18 school environmental characteristics on nutrition and physical activity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children's weight and height; BMI-for-age (BMI/A) Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children's BMI/A Z-scores was calculated. Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%-95% of schools) and school nutrition environment scores (range: 0.30-0.93). Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania) graded less than three characteristics as supportive. High-score (≥0.70) countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.20-1.02), indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the school nutrition environment score and the school BMI/A Z

  18. WHO European Childhood Obesity Surveillance Initiative: School Nutrition Environment and Body Mass Index in Primary Schools

    Science.gov (United States)

    Wijnhoven, Trudy M.A.; van Raaij, Joop M.A.; Sjöberg, Agneta; Eldin, Nazih; Yngve, Agneta; Kunešová, Marie; Starc, Gregor; Rito, Ana I.; Duleva, Vesselka; Hassapidou, Maria; Martos, Éva; Pudule, Iveta; Petrauskiene, Ausra; Farrugia Sant’Angelo, Victoria; Hovengen, Ragnhild; Breda, João

    2014-01-01

    Background: Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. Objective: To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Methods: Data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively). School personnel provided information on 18 school environmental characteristics on nutrition and physical activity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children’s weight and height; BMI-for-age (BMI/A) Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children’s BMI/A Z-scores was calculated. Results: Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%−95% of schools) and school nutrition environment scores (range: 0.30−0.93). Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania) graded less than three characteristics as supportive. High-score (≥0.70) countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.20−1.02), indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the school

  19. Correlations between geriatric nutritional risk index and peripheral artery disease in elderly coronary artery disease patients.

    Science.gov (United States)

    Kawamiya, Toshiki; Suzuki, Susumu; Ishii, Hideki; Hirayama, Kenshi; Harada, Kazuhiro; Shibata, Yohei; Tatami, Yosuke; Harata, Shingo; Kawashima, Kazuhiro; Kunimura, Ayako; Takayama, Yohei; Shimbo, Yusaku; Osugi, Naohiro; Yamamoto, Dai; Ota, Tomoyuki; Kono, Chikao; Murohara, Toyoaki

    2017-07-01

    Malnutrition is associated with the development of atherosclerosis and an increased risk of cardiovascular mortality in elderly patients. The present study aimed to investigate the association between the Geriatric Nutritional Risk Index (GNRI), a simple nutritional assessment tool, and the prevalence of peripheral artery disease (PAD) in elderly coronary artery disease patients. We evaluated 228 elderly coronary artery disease patients (mean age 74.0 ± 5.7 years). Ankle-brachial index (ABI) measurements were routinely carried out to investigate the prevalence of lower extremity PAD. Patients showing ABI risk of having PAD than those with high GNRI and low C-reactive protein levels. GNRI values showed a strong relationship with PAD in elderly coronary artery disease patients. These data reinforce the utility of GNRI as a screening tool in clinical practice. Geriatr Gerontol Int 2017; 17: 1057-1062. © 2016 Japan Geriatrics Society.

  20. Preoperative Nutritional Risk Index to predict postoperative survival time in primary liver cancer patients.

    Science.gov (United States)

    Bo, Yacong; Yao, Mingjie; Zhang, Ling; Bekalo, Wolde; Lu, Weiquan; Lu, Quanjun

    2015-01-01

    We designed this study to determine the predictive value of Nutritional Risk Index (NRI) for postoperative survival time of patients who had undergone hepatectomy for primary liver cancer. The 620 patients who underwent hepatectomy for primary liver cancer (PLC) in the Department of Hepatobiliary Surgery, Cancer Hospital of Henan Province, Zhengzhou, China from December 1, 2008 to December 1, 2012 were followed up. A nutritional risk index (NRI) was used to screen the patients with malnutrition (NRI100) patients had longer postoperative survival time compared with malnourished patients. NRI values>100 was sig-nificantly associated with longer postoperative survival time. Cox proportional hazards model showed that NRI was an independent predictor of postoperative survival time and that NRI varied inversely with the risk of death. The patients with NRI values>100 survived longer than those with NRI values

  1. Geriatric nutritional risk index correlates with length of hospital stay and inflammatory markers in older inpatients.

    Science.gov (United States)

    Gärtner, Simone; Kraft, Matthias; Krüger, Janine; Vogt, Lena J; Fiene, Michael; Mayerle, Julia; Aghdassi, Ali A; Steveling, Antje; Völzke, Henry; Baumeister, Sebastian E; Lerch, Markus M; Simon, Peter

    2017-08-01

    Malnutrition is a prevalent condition in older inpatients and has been shown to increase morbidity and direct medical costs. A number of established tools to assess malnutrition are available but malnourished patients rarely receive adequate nutritional assessment and treatment. The medical and economic consequences of malnutrition in hospitalized patients are therefore often underestimated. This study investigates whether the Geriatric Nutritional Risk Index (GNRI) predicts hospital mortality, correlates with length of hospital stay (LOS) and inflammatory markers in older inpatients. We conducted a prospective monocentric study in 500 hospital patients over 65 years of age (female: 248; male: 252; age: 76.3 ± 0.31 years). GNRI was correlated to C-reactive protein (CRP), lymphocyte count, LOS and all-cause mortality, adjusted for potential confounders. The median body mass index was 24.1 (25th percentile: 21.1; 75th percentile: 27.8) kg/m(2) and the mean GNRI 82.2 ± 0.56. A higher risk GNRI was associated with increased CRP levels (p risk GNRI and length of hospital stay, whereas, the association with in-hospital mortality was not significant. The GNRI correlates well with indicators of inflammation and the length of hospital stay. The routine implementation of the GNRI for the nutritional assessment of older patients could have a significant medical and socio-economic impact. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  2. Lifestyle, nutritional status and physical fitness index among healthy male students of Private Medical College

    OpenAIRE

    Sindwani, Pooja; Kudachi, Padmashri; Jain, Piyush Kumar; Budhani, Diksha

    2016-01-01

    Aims & Objective: The aim of the study was to assess the nutritional status, lifestyle factors and physical fitness index among male medical students.Material & Method: The present study was conducted among medical students aged 17-20. A total of 73 students completed the study. American dietetic society questionnaire was modified and was given to students. It included all the questions regarding 24 hour dietary recall, junk food consumption and few lifestyle factors. Calorie intake o...

  3. Prognostic value of body mass index before treatment for laryngeal squamous cell carcinoma.

    Science.gov (United States)

    Li, Zhao-Qu; Zou, Lan; Liu, Tian-Run; Yang, An-Kui

    2015-12-01

    Patients with head and neck cancer often suffer from malnutrition. This study aims to investigate the influence of body mass index (BMI) on the prognosis of laryngeal squamous cell carcinoma (LSCC). A total of 473 patients with LSCC initially treated at Sun Yat-sen University Cancer Center between January 2005 and July 2009 were retrospectively reviewed. Survival analysis was performed by the Kaplan-Meier method and Cox regression model. Low BMI before treatment was significantly associated with poor overall survival in patients with LSCC (Pnutritional status is favorable to improve survival in patients with LSCC.

  4. Blood pyrrole-protein adducts as a diagnostic and prognostic index in pyrrolizidine alkaloid-hepatic sinusoidal obstruction syndrome.

    Science.gov (United States)

    Gao, Hong; Ruan, Jianqing Q; Chen, Jie; Li, Na; Ke, Changqiang Q; Ye, Yang; Lin, Ge; Wang, Jiyao Y

    2015-01-01

    The diagnosis of hepatic sinusoidal obstruction syndrome (HSOS) induced by pyrrolizidine alkaloids is mainly based on clinical investigation. There is currently no prognostic index. This study evaluated the quantitative measurement of blood pyrrole-protein adducts (PPAs) as a diagnostic and prognostic index for pyrrolizidine alkaloid-induced HSOS. Suspected drug-induced liver injury patients were prospectively recruited. Blood PPAs were quantitatively measured using ultra-performance liquid chromatography-tandem mass spectrometry. Patients' age, sex, biochemistry test results, and a detailed drug history were recorded. The patients were divided into two groups, ie, those with HSOS induced by pyrrolizidine alkaloid-containing drugs and those with liver injury induced by drugs without pyrrolizidine alkaloids. The relationship between herb administration, clinical outcomes, blood sampling time, and blood PPA concentration in pyrrolizidine alkaloid-associated HSOS patients was analyzed using multiple linear regression analysis. Forty patients met the entry criteria, among whom 23 had pyrrolizidine alkaloid-associated HSOS and 17 had liver injury caused by drugs without pyrrolizidine alkaloids. Among the 23 patients with pyrrolizidine alkaloid-associated HSOS, ten recovered, four developed chronic disease, eight died, and one underwent liver transplantation within 6 months after onset. Blood PPAs were detectable in 24 of 40 patients with concentrations from 0.05 to 74.4 nM. Sensitivity and specificity of the test for diagnosis of pyrrolizidine alkaloid-associated HSOS were 100% (23/23) and 94.1% (23/24), respectively. The positive predictive value was 95.8% and the negative predictive value was 100%, whereas the positive likelihood ratio was 23.81. The level of blood PPAs in the severe group (died or received liver transplantation) was significantly higher than that in the recovery/chronicity group (P=0.004). Blood PPAs measured by ultra-performance liquid

  5. Creating a school nutrition environment index and pilot testing it in elementary and middle schools in urban South Korea.

    Science.gov (United States)

    Park, Sohyun; Kwon, Kwang-Il; Kweon, Soon Ju; Wang, Youfa; Gittelsohn, Joel

    2017-10-01

    The role of a school's nutrition environment in explaining students' eating behaviors and weight status has not been examined in an Asian setting. The purpose of this study was to create a school nutrition environment index and to pilot test the index in elementary and middle schools in urban South Korea. This study used a mixed-methods approach. Environment assessment tools were developed based on formative research, which comprised literature reviews, in-depth interviews, and focus group discussions. Key elements from the formative research were included in the assessment tool, which consisted of a structured survey questionnaire for school dietitians. Fifteen school dietitians from 7 elementary and 8 middle schools in Seoul completed the questionnaire. The formative research revealed four main sections that guided a summary index to assess a school's nutrition environment: resource availability, education and programs, dietitians' perceptions and characteristics, and school lunch menu. Based on the literature reviews and interviews, an index scoring system was developed. The total possible score from the combined four index sections was 40 points. From the 15 schools participating in the pilot survey, the mean school nutrition-environment index was 22.5 (standard deviation ± 3.2; range 17-28). The majority of the schools did not offer classroom-based nutrition education or nutrition counseling for students and parents. The popular modes of nutrition education were school websites, posters, and newsletters. This paper illustrates the process used to develop an instrument to assess a school's nutrition environment. Moreover, it presents the steps used to develop a scoring system for creation of a school nutrition environment index. As pilot testing indicated the total index score has some variation across schools, we suggest applying this instrument in future studies involving a larger number of schools. Future studies with larger samples will allow investigation

  6. Evaluation of body mass index as a prognostic factor in osteoarthrosis of the knee

    Directory of Open Access Journals (Sweden)

    Fabrício Bolpato Loures

    2016-08-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the relationship between patients' body mass index (BMI and the degree of radiographic severity of knee osteoarthrosis. METHOD: 117 patients with gonarthrosis were evaluated prospectively. The patients' BMI was calculated and their knee arthrosis was classified in accordance with the modified Ahlbäck criteria. Kruskal-Wallis analysis of variance (ANOVA was used to evaluate the relationship between these two variables. RESULTS: The group classified as Ahlbäck grade V had significantly higher BMI than the others. CONCLUSION: There is a direct relationship between BMI and the degree of radiographic severity of gonarthrosis. Obesity appears to be directly related to the progression of knee osteoarthrosis.

  7. Blood pyrrole-protein adducts as a diagnostic and prognostic index in pyrrolizidine alkaloid-hepatic sinusoidal obstruction syndrome

    Directory of Open Access Journals (Sweden)

    Gao H

    2015-08-01

    Full Text Available Hong Gao,1,* Jianqing Q Ruan,2,* Jie Chen,1 Na Li,2 Changqiang Q Ke,3 Yang Ye,3–5 Ge Lin,2,4,5 Jiyao Y Wang1,61Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 2School of Biomedical Sciences, Chinese University of Hong Kong, Hong Kong; 3Shanghai Institute of Materia Medica, Shanghai, People’s Republic of China; 4Joint Research Laboratory for Promoting Globalization of Traditional Chinese Medicines, Shanghai Institute of Materia Medica, 5Chinese University of Hong Kong, Hong Kong; 6Center of Evidence-Based Medicine Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this work and share first authorship Background: The diagnosis of hepatic sinusoidal obstruction syndrome (HSOS induced by pyrrolizidine alkaloids is mainly based on clinical investigation. There is currently no prognostic index. This study evaluated the quantitative measurement of blood pyrrole-protein adducts (PPAs as a diagnostic and prognostic index for pyrrolizidine alkaloid-induced HSOS.Methods: Suspected drug-induced liver injury patients were prospectively recruited. Blood PPAs were quantitatively measured using ultra-performance liquid chromatography-tandem mass spectrometry. Patients’ age, sex, biochemistry test results, and a detailed drug history were recorded. The patients were divided into two groups, ie, those with HSOS induced by pyrrolizidine alkaloid-containing drugs and those with liver injury induced by drugs without pyrrolizidine alkaloids. The relationship between herb administration, clinical outcomes, blood sampling time, and blood PPA concentration in pyrrolizidine alkaloid-associated HSOS patients was analyzed using multiple linear regression analysis.Results: Forty patients met the entry criteria, among whom 23 had pyrrolizidine alkaloid-associated HSOS and 17 had liver injury caused by drugs without pyrrolizidine alkaloids. Among the 23

  8. Body Mass Index assessment of institutionalized aged people without cognitive impairment using clinical and nutritional factors

    Directory of Open Access Journals (Sweden)

    María del Mar Ruperto López

    2016-12-01

    Full Text Available Introduction: Overweight and obesity are recognized mortality risk factors in the general population. The aim of the study was to analyse the phenotypic distribution of body mass index (BMI, and to identify the prevalence of malnutrition and clinical and nutritional factors related to BMI in autonomous institutionalized elders. Material and Methods: Cross-sectional and descriptive study in 104 institutionalized aged people (73% female, mean of age 86.4 [±6.2] years and time on institutionalization 25.7 [±21.7] months. Mini-Nutritional Assessment (MNA, anthropometric measures and laboratory parameters were used for nutritional assessment. Bioimpedance analysis (BIA-101; RJL-System was used for body composition analysis. The sample was classified into BMI tertiles (Tn: T1=<26.2kg/m2; T2=26.3-29.7kg/m2; and T3=≥29.8kg/m2. Results: The phenotypic distribution of BMI was: overweight 51% and, prevalence of obesity 29.8%. Mean of BMI: 28.3 (±4.6 kg/m2. Nutritional risk or malnutrition were 60.6% and 11.5%, respectively in the sample. The tertiles of BMI showed significant differences with: mid-arm muscle circumference, triceps-skinfold thickness, total body water (TBW (all, p<0.001. Subjects into T1 had significantly higher nutritional risk or malnutrition compared with T2 and T3 counterparts (p=0.015. Waist-circumference, calf-circumference (at least, p<0.01, and TBW (p<0.001 were independent predictors of BMI in the linear regression analysis (R2=0.52. Conclusions: Overweight and obesity measured by BMI is not an exclusion criterion of malnutrition in the geriatric population. Nutritional screening by MNA and the conjoint use of clinical-nutritional parameters are useful for identifying at nutritional risk or malnutrition. Further studies are needed to define the potential nutritional risk factors associated with BMI in autonomous institutionalized aged.

  9. Secular Changes in Height, Weight, Body Mass Index and Daily Nutrition Preferences in Children During Soccer Recruitment Camps

    National Research Council Canada - National Science Library

    Jessenia Hernández-Elizondo; José Moncada-Jiménez

    2012-01-01

      This study was conducted to compare secular changes in height, weight, and body mass index and to survey children's daily nutrition, hydration preferences and preferred beverages while exercising...

  10. Development of an oncological-multidimensional prognostic index (Onco-MPI) for mortality prediction in older cancer patients.

    Science.gov (United States)

    Brunello, Antonella; Fontana, Andrea; Zafferri, Valeria; Panza, Francesco; Fiduccia, Pasquale; Basso, Umberto; Copetti, Massimiliano; Lonardi, Sara; Roma, Anna; Falci, Cristina; Monfardini, Silvio; Cella, Alberto; Pilotto, Alberto; Zagonel, Vittorina

    2016-05-01

    A multidimensional prognostic index (MPI) based on a comprehensive geriatric assessment (CGA) has been developed and validated in independent cohorts of older patients demonstrating good accuracy in predicting one-year mortality. The aim of this study was to develop a cancer-specific modified MPI (Onco-MPI) for mortality prediction in older cancer patients. We enrolled 658 new cancer subjects ≥70 years (mean age 77.1 years, 433 females, 65.8 %) attending oncological outpatient services from September 2004 to June 2011. The Onco-MPI was calculated according to a validated algorithm as a weighted linear combination of the following CGA domains: age, sex, basal and instrumental activities of daily living, Eastern Cooperative Oncology Group performance status, mini-mental state examination, body mass index, Cumulative Illness Rating Scale, number of drugs and the presence of caregiver. Cancer sites (breast 46.5 %, colorectal 21.3 %, lung 6.4 %, prostate 5.5 %, urinary tract 5.0 %, other 15.3 %) and cancer stages (I 37 %, II 22 %, III 19 %, IV 22 %) were also included in the model. All-cause mortality was recorded. Three grades of severity of the Onco-MPI score (low risk: 0.0-0.46, medium risk: 0.47-0.63, high risk: 0.64-1.0) were calculated using RECPAM method. Discriminatory power and calibration were assessed by estimating survival C-indices, along with 95 % confidence interval (CI) and the survival-based Hosmer-Lemeshow (HL) measures. One-year mortality incidence rate was 17.4 %. A significant difference in mortality rates was observed in Onco-MPI low risk compared to medium- and high-risk patients (2.1 vs. 17.7 vs. 80.8 %, p patients that can be useful for clinical decision making in this age group.

  11. Maximal amniotic fluid index as a prognostic factor in pregnancies complicated by polyhydramnios.

    Science.gov (United States)

    Pri-Paz, S; Khalek, N; Fuchs, K M; Simpson, L L

    2012-06-01

    Polyhydramnios is present in approximately 2% of pregnancies and has been associated with a variety of adverse pregnancy outcomes. Our aim was to evaluate the association between the maximal amniotic fluid index (AFI) and the frequency of specific adverse outcomes. This was a retrospective chart review of 524 singleton pregnancies diagnosed with polyhydramnios and delivered in a single tertiary referral center between 2003 and 2008. Polyhydramnios was defined as either AFI ≥ 25 cm or a maximum vertical pocket (MVP) ≥ 8 cm even in the presence of AFI polyhydramnios, as based on the maximal AFI (≥ 35 cm; n = 67), was associated with the highest rates of prenatally diagnosed congenital anomalies (79%), preterm delivery (46%), small-for-gestational-age neonate (16%), aneuploidy (13%) and perinatal mortality (27%). No significant association between degree of polyhydramnios and adverse outcome was demonstrated in cases of idiopathic polyhydramnios (n = 253). There is an association between the frequencies of a variety of adverse pregnancy outcomes and the severity of polyhydramnios as reflected by the maximal AFI. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  12. [Impact of pre-pregnancy body mass index on baby's physical growth and nutritional status].

    Science.gov (United States)

    Li, Hongyan; Tan, Shan; Gao, Xiao; Xiang, Shiting; Zhang, Li; Huang, Li; Xiong, Changhui; Yan, Qiang; Lin, Ling; Li, Dimin; Yi, Juan; Yan, Yan

    2015-04-01

    To explore the impact of pre-pregnancy body mass index on baby's physical growth and nutritional status. A total of 491 pairs of mother-infant were divided into 3 groups according to mother's pre-pregnancy body mass index (BMI): a pre-pregnancy low BMI group (BMIpregnancy normal BMI group (18.5 kg/m² ≤ BMIpregnancy high BMI group (BMI ≥ 24.0 kg/m², n=72). Analysis of variance of repeated measurement data and the median percentage methods were used to compare the physical growth and nutritional status of babies in different groups. Baby's weight in the high BMI group were higher than that in the normal BMI and the low BMI group (F=3.958, P=0.020). The incidence of malnutrition in the low BMI group showed a tendency to decline along with the months (χ²=5.611, P=0.018), the incidence of overweight and obesity in the high and the normal BMI groups displayed a tendency to decline along with the months (χ²=18.773, 53.248, all PPregnancy BMI was correlated with the growth of baby. Too high or too low prepregnancy BMI exerts harmful effect on baby's weight and nutritional status. Medical workers should strengthen the education on women's pre-pregnancy to remind them keeping BMI at normal level.

  13. The prognostic influence of body mass index, resting energy expenditure and fasting blood glucose on postoperative patients with esophageal cancer.

    Science.gov (United States)

    Wu, Ning; Zhu, Yongjun; Kadel, Dhruba; Pang, Liewen; Chen, Gang; Chen, Zhiming

    2016-12-21

    Body mass index (BMI), resting energy expenditure (REE) and fasting blood glucose (FBG) are major preoperative assessments of patients' nutrition and metabolic state. The relations and effects of these indices on esophageal cancer patients' postoperative short-term and long-term outcomes remain controversial and unclear. We aimed to study the impact of BMI, REE and FBG in esophageal cancer patients undergoing esophagectomy. Three hundred and six esophageal cancer patients who underwent esophagectomy were observed retrospectively. Clinical characteristics, postoperative complications and survival analysis were compared among different BMI, REE and FBG groups. There were significant linear relationships between REE, BMI and FBG indices, patients with low BMI tended to have low REE (p cancer undergoing esophagectomy and preoperative evaluation of these indices help to determine the prognosis in these patients.

  14. Relationship between Geriatric Nutritional Risk Index and total lymphocyte count and mortality of hemodialysis patients.

    Science.gov (United States)

    Jung, Yeon Soon; You, Gain; Shin, Ho Sik; Rim, Hark

    2014-01-01

    We examined the relationships between Geriatric Nutritional Risk Index (GNRI), total lymphocyte count (TLC), and mortality in hemodialysis (HD) patients. We examined GNRI and TLC in 120 maintenance HD patients and followed these patients for 120 months. Predictors of all-cause death were examined using life table analysis and the Cox proportional hazards model. TLC marginally correlated with GNRI (r = 0.176; p = 0.090) and significantly with phosphorus levels (r = 0.206; p = 0.026). Life table analysis revealed that subjects with a GNRI nutritional tool, but may not be a predictor of mortality in HD patients. These findings require confirmation by further studies. © 2013 International Society for Hemodialysis.

  15. The Geriatric Nutritional Risk Index Independently Predicts Mortality in Diabetic Foot Ulcers Patients Undergoing Amputations.

    Science.gov (United States)

    Xie, Yuanyuan; Zhang, Hailing; Ye, Tingting; Ge, Shengjie; Zhuo, Ruyi; Zhu, Hong

    2017-01-01

    Objective. Patients with diabetic foot ulcers undergoing amputations have poor prognosis. Malnutrition usually occurs in this population and is associated with increased risk of mortality. The geriatric nutritional risk index (GNRI) is a widely used, simple, and well-established tool to assess nutritional risk. The purpose of this study was to assess the association between GNRI and all-cause mortality in diabetic foot ulcers patients undergoing minor or major amputations. Methods. This was a retrospective cohort study including 271 adult patients. Patients were divided into two groups according to a GNRI cutoff value of 92, and characteristics and mortality were compared between the two groups. Cox proportional hazard analysis was performed to explore the association between GNRI and mortality. Result. GNRI (p risk factors. Conclusion. GNRI on admission might be a novel clinical predictor for the incidence of death in patients with diabetic foot ulcers who were undergoing amputations.

  16. Prognostic significance of ankle-brachial index, brachial-ankle pulse wave velocity, flow-mediated dilation, and nitroglycerin-mediated dilation in end-stage renal disease.

    Science.gov (United States)

    Morimoto, Satoshi; Yurugi, Takatomi; Aota, Yasuko; Sakuma, Takao; Jo, Fusakazu; Nishikawa, Mitsushige; Iwasaka, Toshiji; Maki, Kei

    2009-01-01

    Identifying patients at high risk of cardiovascular disease is important in managing patients undergoing hemodialysis. We evaluated a series of prognostic values: flow-mediated dilation (FMD) and nitrogen-mediated dilation (NMD), an index of endothelium-dependent and endothelium-independent function, respectively, ankle-brachial index (ABI), and brachial-ankle pulse wave velocity (baPWV) in patients undergoing chronic hemodialysis. A cohort of 199 patients was studied. At entry, these values were examined and the prognostic significances were investigated. In estimating the significance of baPWV, patients with ABI hemodialysis patients by means of ABI and baPWV but not FMD or NMD provides complementary information in identifying a high-risk population in these patients.

  17. Fortification of seaweed (Eucheuma cottonii) flour on nutrition, iodine, and glycemic index of pasta

    Science.gov (United States)

    Firdaus, Muhamad; Yahya; Raditya Hardany Nugraha, Galih; Dwi Utari, Dyah

    2017-10-01

    Pasta is a nutritious and energy product which produced from the dough of wheat flour and water. It contains less of iodine and high of glycemic index. Euchema cottonii belongs of red seaweed is food substance that contains much of iodine and dietary fiber. The objective of this study was to know the fortification effect of E. cottonii flour on the nutrition, iodine, and glycemic index of pasta. E. cottonii was collected from the culture farm of E. cottonii on the Wongsorejo beach, District of Banyuwangi, East Java on April-June 2015. Wheat flour and pasta ingredients were obtained locally at shops of Pasar Besar, Malang. Pasta was produced by weighing of components, mixing, dough, milling, steaming and drying. E. cottonii flour was added on mixing process at 0; 7; 14 and 21 % of ingredients. The parameter of this study was the level of water, lipid, protein, ash, and carbohydrate (by difference), iodine, crude fiber, the total of dietary fiber, soluble fiber, insoluble fiber, and glycemic index, respectively. Data were analyzed by variance and the least square difference used to determine the difference between treatments. The highest concentration group showed more nutritious than other treatments. The characters of its product were water 6.70%, lipid 2.26%, protein 23.09%, ash 14.11%, carbohydrate 53.84%, iodine 3.71 ppm, crude fiber 8.02%, the total of dietary fiber 20.88%, soluble fiber 11.69%, insoluble fiber 9.19%, and glycemic index 44.45, respectively. In conclusion, the fortification of E. cottonii flour enhances the nutrition value, iodine content, and glycemic index of pasta.

  18. Prognostic value of malnutrition assessed by Controlling Nutritional Status score for long-term mortality in patients with acute heart failure.

    Science.gov (United States)

    Iwakami, Naotsugu; Nagai, Toshiyuki; Furukawa, Toshiaki A; Sugano, Yasuo; Honda, Satoshi; Okada, Atsushi; Asaumi, Yasuhide; Aiba, Takeshi; Noguchi, Teruo; Kusano, Kengo; Ogawa, Hisao; Yasuda, Satoshi; Anzai, Toshihisa

    2017-03-01

    The prognostic value of nutritional status is poorly understood and evidence-based nutritional assessment indices are required in acute heart failure (AHF). We investigated the prognostic value of malnutrition assessed by the Controlling Nutritional Status (CONUT) score (range 0-12, higher=worse, consisting of serum albumin, cholesterol and lymphocytes) in AHF patients. The CONUT score was measured on admission in 635 consecutive AHF patients. The primary outcome was all-cause death. Median CONUT score was 3 (interquartile range 2 to 5). During the median follow-up of 324days, CONUT score was independently associated with death (HR 1.26, 95% CI 1.11-1.42, Pnutritional markers in HF. Furthermore, addition of the CONUT score to an established risk prediction model from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure study significantly increased the C-statistic from 0.75 to 0.77 (P=0.02). The net reclassification improvement afforded by CONUT score was 21% for all-cause death, 27% for survival and 49% overall (Pnutritional indices. Moreover, addition of the score to the existing risk prediction model significantly increased the predictive ability for death, indicating beneficial clinical application of the CONUT score in AHF patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Routine use of ancillary investigations in staging diffuse large B-cell lymphoma improves the International Prognostic Index (IPI).

    Science.gov (United States)

    Talaulikar, Dipti; Shadbolt, Bruce; Dahlstrom, Jane E; McDonald, Anne

    2009-11-22

    The International Prognostic Index (IPI) is used to determine prognosis in diffuse large B-cell lymphoma (DLBCL). One of the determinants of IPI is the stage of disease with bone marrow involvement being classified as stage IV. For the IPI, involvement on bone marrow is traditionally defined on the basis of histology with ancillary investigations used only in difficult cases to aid histological diagnosis. This study aimed to determine the effect of the routine use of flow cytometry, immunohistochemistry and molecular studies in bone marrow staging upon the IPI. Bone marrow trephines of 156 histologically proven DLBCL cases at initial diagnosis were assessed on routine histology, and immunohistochemistry using two T-cell markers (CD45RO and CD3), two B-cell markers (CD20 and CD79a) and kappa and lambda light chains. Raw flow cytometry data on all samples were reanalysed and reinterpreted blindly. DNA extracted from archived paraffin-embedded trephine biopsy samples was used for immunoglobulin heavy chain and light chain gene rearrangement analysis. Using immunophenotyping (flow cytometry and immunohistochemistry), 30 (19.2%) cases were upstaged to stage IV. A further 8 (5.1%) cases were upstaged using molecular studies. A change in IPI was noted in 18 cases (11.5%) on immunophenotyping alone, and 22 (14.1%) cases on immunophenotyping and molecular testing. Comparison of two revised IPI models, 1) using immunophenotyping alone, and 2) using immunophenotyping with molecular studies, was performed with baseline IPI using a Cox regression model. It showed that the revised IPI model using immunophenotyping provides the best differentiation between the IPI categories. Improved bone marrow staging using flow cytometry and immunohistochemistry improves the predictive value of the IPI in patients with DLBCL and should be performed routinely in all cases.

  20. Routine use of ancillary investigations in staging diffuse large B-cell lymphoma improves the International Prognostic Index (IPI

    Directory of Open Access Journals (Sweden)

    Shadbolt Bruce

    2009-11-01

    Full Text Available Abstract Background The International Prognostic Index (IPI is used to determine prognosis in diffuse large B-cell lymphoma (DLBCL. One of the determinants of IPI is the stage of disease with bone marrow involvement being classified as stage IV. For the IPI, involvement on bone marrow is traditionally defined on the basis of histology with ancillary investigations used only in difficult cases to aid histological diagnosis. This study aimed to determine the effect of the routine use of flow cytometry, immunohistochemistry and molecular studies in bone marrow staging upon the IPI. Results Bone marrow trephines of 156 histologically proven DLBCL cases at initial diagnosis were assessed on routine histology, and immunohistochemistry using two T-cell markers (CD45RO and CD3, two B-cell markers (CD20 and CD79a and kappa and lambda light chains. Raw flow cytometry data on all samples were reanalysed and reinterpreted blindly. DNA extracted from archived paraffin-embedded trephine biopsy samples was used for immunoglobulin heavy chain and light chain gene rearrangement analysis. Using immunophenotyping (flow cytometry and immunohistochemistry, 30 (19.2% cases were upstaged to stage IV. A further 8 (5.1% cases were upstaged using molecular studies. A change in IPI was noted in 18 cases (11.5% on immunophenotyping alone, and 22 (14.1% cases on immunophenotyping and molecular testing. Comparison of two revised IPI models, 1 using immunophenotyping alone, and 2 using immunophenotyping with molecular studies, was performed with baseline IPI using a Cox regression model. It showed that the revised IPI model using immunophenotyping provides the best differentiation between the IPI categories. Conclusion Improved bone marrow staging using flow cytometry and immunohistochemistry improves the predictive value of the IPI in patients with DLBCL and should be performed routinely in all cases.

  1. Body mass index, nutritional knowledge, and eating behaviors in elite student and professional ballet dancers.

    Science.gov (United States)

    Wyon, Matthew A; Hutchings, Kate M; Wells, Abigail; Nevill, Alan M

    2014-09-01

    It is recognized that there is a high esthetic demand in ballet, and this has implications on dancers' body mass index (BMI) and eating behaviors. The objective of this study was to examine the association between BMI, eating attitudes, and nutritional knowledge of elite student and professional ballet dancers. Observational design. Institutional. One hundred eighty-nine participants from an elite full-time dance school (M = 53, F = 86) and from an elite ballet company (M = 16, F = 25) volunteered for the study. There were no exclusion criteria. Anthropometric data (height and mass), General Nutrition Knowledge Questionnaire (GNKQ), and the Eating Attitude Test-26 (EAT-26) were collected from each participant. Univariate analysis of variance was used to examine differences in gender and group for BMI, GNKQ, and EAT-26. Regression analyses were applied to examine interactions between BMI, GNKQ, and EAT-26. Professional dancers had significantly greater BMI than student dancers (P Student dancers had a significant interaction between year group and gender because of significantly higher EAT-26 scores for females in years 10 and 12. Regression analysis of the subcategories (gender and group) reported a number of significant relationships between BMI, GNKQ, and EAT-26. The findings suggest that dancers with disordered eating also display lower levels of nutritional knowledge, and this may have an impact on BMI. Female students' eating attitudes and BMI should especially be monitored during periods of adolescent development.

  2. The prognostic value of pre-operative serum tetranectin, CA-125 and a combined index in women with primary ovarian cancer

    DEFF Research Database (Denmark)

    Høgdall, Claus K; Nørgaard-Pedersen, Bent; Mogensen, Ole

    2002-01-01

    OBJECTIVE: To study the prognostic value of pre-operative serum tetranectin (TN), CA125 levels and a mathematical formula (Index1) in primary ovarian cancer. MATERIALS AND METHODS: The study group consisted of sixty-six patients with varying FIGO stages I-IV. The end-point was death from ovarian....../l (relative hazard for FIGO stages = 3.3 and for TN = 2.6). CONCLUSION: TN was a strong prognostic variable in patients with advanced ovarian cancer. To the contrary, CA125 was a strong prognostic factor in patients with a localised ovarian cancer and of no prognostic value in patients with advanced cancer...... cancer. Evaluation was by univariate life-tables analyses and the multivariate Cox analysis. In the Cox analyses, the variables were tested respectively in actual values and as dichotomy variables with different cut-off levels: 6.7, 7.3 and 8.2 mg/l for TN, 35, 65, 100 and 165 U/ml for CA125. RESULTS...

  3. Nutrition Education and Body Mass Index in Grades K-12: A Systematic Review.

    Science.gov (United States)

    Price, Cayla; Cohen, Deborah; Pribis, Peter; Cerami, Jean

    2017-09-01

    Overweight and obese body mass index (BMI) status affects an increasing number of children in the United States. The school setting has been identified as a focus area to implement obesity prevention programs. A database search of PubMed, Education Search Complete, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted for peer-reviewed articles published between January 2005 and December 2015 pertaining to programs offered in the school setting to grades K-12 in the United States with a nutrition education component and measured BMI percentile or BMI z-score as an outcome. Seven studies focused on elementary (K-5) populations and 2 studies focused on grades 6-8. Among the 9 identified studies, those with long-term (greater than 1 year) implementation showed more pronounced results with positive impact on reducing overweight/obese BMI measures. This set of studies suggests that long-term nutrition education delivered in the school setting can provide children with tools to attain a healthy weight status. Additional studies examining participants' BMI status years after the initial study, and studies examining programs in grades 9-12 are needed to determine the most effective delivery time and methods. © 2017, American School Health Association.

  4. Geriatric Nutritional Risk Index (GNRI) Independently Predicts Amputation Inchronic Criticallimb Ischemia (CLI).

    Science.gov (United States)

    Luo, Han; Yang, Hongliu; Huang, Bin; Yuan, Ding; Zhu, Jingqiang; Zhao, Jichun

    2016-01-01

    General malnutrition usually occurs in critical limb ischemia (CLI) patients because of shortness of appetite and sleeplessness leaded by chronic pain. And amputation frequently is end-point of CLI patients. So the aim of this study was to assess the predictive ability of Geriatric nutritional risk index (GNRI) for predicting amputation in patients with CLI. A retrospective study was designed. Demographics, history, comorbidity, and risk factors for peripheral vascular disease of admitted patients, and laboratory study were documented. Patients' height, weight and BMI were recorded. Amputation was identified as end-point during follow-up. Patients' amputation-free survival (AFS) was recorded. 172 patients were identified, with mean age 71.98±3.12. Geriatric nutritional risk index (GNRI) = 90 was taken as cutoff value of high risk of amputation for CLI patients via using receiver operating characteristic (ROC) curve. Span of follow-up was 12-48 months. During follow-up, 60 patients (36.04%) received amputation surgery. And analyzed by Cox proportional hazards model, it is found that GNRI was the independent predictive factor for amputation in long term. This study revealed that GNRI was a reliable and effective predictive marker for AFS. GNRI could identify patients with high risk for amputation in early time.

  5. [Interest of Geriatric Nutritional Risk Index for mortality prediction in hemodialysis patients: preliminary study].

    Science.gov (United States)

    Sirajedine, Khaled; Fardous, Rida; Al Adib, Mohamad; Colomb, Henry; Maurin, Audrey

    2012-07-01

    Geriatric Nutritional Risk Index (GNRI) is a simple and quantitative method (based on three objective measurements: weight, height, albumin) for screening patients at risk for malnutrition. However no data are available regarding its relation with mortality in Caucasian hemodialysis patients. We tested the predictive value of GNRI on mortality in a hemodialysis population followed up prospectively for 18 months. A total of 46 stable prevalent (mean age: 76 ± 11 years, range: 42-95) hemodialysis patients from one center were included in the study. GNRI with other nutritional parameters were evaluated for all patients. Sixteen patients (35%) died during the 18 months of follow-up. Multiple logistic model showed that GNRI and Charlson co-morbidity score were significant predictors of mortality. Age and gender were not significant. Our preliminary study carried out on a series of prevalent hemodialysis patients suggests that GNRI is predictor of mortality. To recommend the use of this index for the screening of hemodialysis patients with malnutrition at risk of mortality, our results should be confirmed by a large cohort study. Copyright © 2012 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  6. Nutritional Risk Index predicts mortality in hospitalized advanced heart failure patients.

    Science.gov (United States)

    Adejumo, Oluwayemisi L; Koelling, Todd M; Hummel, Scott L

    2015-11-01

    Hospitalized advanced heart failure (HF) patients are at high risk for malnutrition and death. The Nutritional Risk Index (NRI) is a simple, well-validated tool for identifying patients at risk for nutrition-related complications. We hypothesized that, in advanced HF patients from the ESCAPE (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) trial, the NRI would improve risk discrimination for 6-month all-cause mortality. We analyzed the 160 ESCAPE index admission survivors with complete follow-up and NRI data, calculated as follows: NRI = (1.519 × discharge serum albumin [in g/dl]) + (41.7 × discharge weight [in kg] / ideal body weight [in kg]); as in previous studies, if discharge weight is greater than ideal body weight (IBW), this ratio was set to 1. The previously developed ESCAPE mortality model includes: age; 6-minute walk distance; cardiopulmonary resuscitation/mechanical ventilation; discharge β-blocker prescription and diuretic dose; and discharge serum sodium, blood urea nitrogen and brain natriuretic peptide levels. We used Cox proportional hazards modeling for the outcome of 6-month all-cause mortality. Thirty of 160 patients died within 6 months of hospital discharge. The median NRI was 96 (IQR 91 to 102), reflecting mild-to-moderate nutritional risk. The NRI independently predicted 6-month mortality, with adjusted HR 0.60 (95% CI 0.39 to 0.93, p = 0.02) per 10 units, and increased Harrell's c-index from 0.74 to 0.76 when added to the ESCAPE model. Body mass index and NRI at hospital admission did not predict 6-month mortality. The discharge NRI was most helpful in patients with high (≥ 20%) predicted mortality by the ESCAPE model, where observed 6-month mortality was 38% in patients with NRI 100 (p = 0.04). The NRI is a simple tool that can improve mortality risk stratification at hospital discharge in hospitalized patients with advanced HF. Published by Elsevier Inc.

  7. Body mass index is a practical preoperative nutritional index for postoperative infectious complications after intestinal resection in patients with Crohn's disease.

    Science.gov (United States)

    Zhu, Yibin; Zhou, Wei; Qi, Weilin; Liu, Wei; Chen, Mingyu; Zhu, Hepan; Xiang, Jianjian; Xie, Qingwen; Chen, Pengpeng

    2017-06-01

    The patients with Crohn's disease (CD) are often accompanied with nutritional deficiencies. Compared with other intestinal benign disease, patients with CD have the higher risk of developing postoperative complications following intestinal resection. The aim of this study was to investigate the risk factors for postoperative infectious complications (PICs) after intestinal resection for CD, as well as search a practical preoperative nutritional index for PICs in patients with CD. A total of 122 patients who underwent intestinal resection for CD during 2011 to 2015 were retrospectively analyzed. After operation, 28 (22.95%) patients experienced PICs. Compared with the non-PICs group, the patients with PICs have the lower preoperative body mass index (BMI) (16.96 ± 2.33 vs 19.53 ± 2.49 kg/m, P risk factors for PICs. Patients with a lower preoperative BMI (BMI risk of PICs. Therefore, preoperative BMI could be regarded as a practical preoperative nutritional index for evaluating the nutritional preparation sufficiency before CD operations. Preoperative treatment with the aim of reducing CRP level and improving the patient's nutritional status may be helpful to reduce the rate of PICs.

  8. Multidimensional Geriatric Prognostic Index, Based on a Geriatric Assessment, for Long-Term Survival in Older Adults in Korea.

    Directory of Open Access Journals (Sweden)

    Hee-Won Jung

    Full Text Available The patient´s survival estimate is important for clinical decision-making, especially in frail patients with multimorbidities. We aimed to develop a multidimensional geriatric prognosis index (GPI for 3- and 5-year mortality in community-dwelling elderly and to validate the GPI in a separate hospital-based population. The GPI was constructed using data for 988 participants in the Korean Longitudinal Study on Health and Aging (KLoSHA and cross-validated with 1109 patients who underwent a geriatric assessment at the Seoul National University Bundang Hospital (SNUBH. The GPI, with a total possible score of 8, included age, gender, activities of daily living, instrumental activities of daily living, comorbidities, mood, cognitive function, and nutritional status. During the 5-year observation period, 179 KLoSHA participants (18.1% and 340 SNUBH patients (30.7% died. The c-indices for 3- and 5-year mortality were 0.78 and 0.80, respectively, in the KLoSHA group and 0.73 and 0.80, respectively, in the SNUBH group. Positive linear trends were observed for GPI scores and both 3- and 5-year mortality in both groups. In conclusions, using common components of a geriatric assessment, the GPI can stratify the risk of 3- and 5-year mortality in Korean elderly people both in the community and hospital.

  9. The Social Environment of Schools and Adolescent Nutrition: Associations between the School Nutrition Climate and Adolescents' Eating Behaviors and Body Mass Index

    Science.gov (United States)

    Cvjetan, Branko; Utter, Jennifer; Robinson, Elizabeth; Denny, Simon

    2014-01-01

    Background: The aim of this study was to determine the association between the school nutrition climate and students' eating behaviors and body mass index (BMI). Methods: Data were collected as part of Youth'07, a nationally representative health survey of high school students in New Zealand. Overall, 9107 randomly selected students from 96…

  10. Prognostic value of nutritional depletion in patients with COPD treated by long-term oxygen therapy: data from the ANTADIR observatory.

    Science.gov (United States)

    Chailleux, Edmond; Laaban, Jean-Pierre; Veale, Dan

    2003-05-01

    An association between weight depletion and mortality has been demonstrated in patients with COPD, but the prognostic influence of malnutrition has not been evaluated in patients with the most severe COPD treated with home long-term oxygen therapy (LTOT). To analyze the prognostic value of nutritional depletion in patients with COPD receiving LTOT with respect to survival and hospitalization rate. Analysis of a national database (Observatory of Association Nationale pour le Traitement a Domicile de l'Insuffisance Respiratoire Chronique [ANTADIR]). The national nonprofit network for home treatment of patients with chronic respiratory insufficiency (ANTADIR) founded in France in the 1980s. A total of 4,088 patients with a diagnosis of chronic bronchitis or emphysema, FEV(1)/vital capacity ratio or = 30. Multivariate analysis using the Cox model demonstrated that the effect of BMI on survival was independent of age, FEV(1), PaO(2), and sex. Lower BMI was the most powerful predictor of duration and rate of hospitalization, independently of blood gas levels and respiratory function. The mean (+/- SD) annual time spent in the hospital was 29.6 +/- 40.4 days for patients with a BMI 30. This study showed that nutritional depletion is an independent risk factor for mortality and hospitalization in patients with COPD receiving LTOT. The best prognosis was observed in overweight and obese patients.

  11. Secondary Cutaneous Diffuse Large B-cell Lymphoma has a Higher International Prognostic Index Score and Worse Prognosis Than Diffuse Large B-cell Lymphoma, Leg Type.

    Science.gov (United States)

    Lee, Woo Jin; Won, Kwang Hee; Won, Chong Hyun; Chang, Sung Eun; Choi, Jee Ho; Moon, Kee Chan; Park, Chan-Sik; Huh, Jooryung; Suh, Cheolwon; Lee, Mi Woo

    2016-02-01

    Diffuse large B-cell lymphoma (DLBCL) can be separated into 2 groups: nodal and extranodal disease. The aim of this study was to analyse the clinical features of skin lesions and survival outcomes of cutaneous DLBCL according to the primary tumour site. A total of 44 patients with cutaneous DLBCL were classified as primary cutaneous DLBCL, leg type or cutaneous DLBCL secondary to primary disease. Although skin lesion characteristics did not differ significantly between groups, extensive cutaneous lesions were more often observed in secondary cutaneous DLBCL compared with DLBCL, leg type. Secondary cutaneous DLBCL was more commonly associated with an advanced stage and higher International Prognostic Index score than DLBCL, leg type. DLBCL, leg type demonstrated a better survival outcome than secondary cutaneous DLBCL. The multiplicity of skin lesions and time-point of cutaneous involvement were associated with prognosis in secondary cutaneous DLBCL. Survival outcomes and prognostic factors differ depending on the primary tumour site of cutaneous DLBCL.

  12. Different methods for assessment of nutritional status in newborn infants based on physical and anthropometric indexes: a short review article

    Directory of Open Access Journals (Sweden)

    Ali Asghar Rashidi

    2017-01-01

    Full Text Available Several complications during childhood is associated with nutritional status of infants at birth. Therefore, nutritional status of newborns must be evaluated properly after birth. Assessment of the nutritional status of neonates based on anthropometric and physical indices is simple and inexpensive without the need for advanced medical equipment. However, no previous studies have focused on the assessment methods of the nutritional status of infants via anthropometric and physical indices. This study aimed to review some of the key methods used to determine the nutritional status of neonates using anthropometric and physical indices. To date, most studies have focused on the diagnosis of fetal malnutrition (FM and growth monitoring. In order to diagnose FM, researchers have used growth charts and Ponderal index (PI based on anthropometric indices, as well as Clinical Assessment of Nutritional (CAN Score based on physical features. Moreover, in order to assess the growth status of infants, growth charts were used. According to the findings of this study, standard intrauterine growth curves and the PI are common measurement tools in the diagnosis of FM. Furthermore, CAN score is widely used in the evaluation of the nutritional status of neonates. Given the differences in the physical features of term and preterm infants, this index should be adjusted for preterm neonates. Longitudinal growth charts are one of the most prominent methods used for monitoring of the growth patterns of infants.

  13. Body mass index and bioelectrical impedance phase angle as potentially modifiable nutritional markers are independent risk factors for outcome in allogeneic hematopoietic cell transplantation.

    Science.gov (United States)

    Urbain, Paul; Birlinger, Jakob; Ihorst, Gabriele; Biesalski, Hans-Konrad; Finke, Juergen; Bertz, Hartmut

    2013-01-01

    Beside many risk factors in patients considered for alloHCT, only body mass index (BMI) as a broad marker of nutritional status has prognostic value in these patients. This is the first prospective study to investigate the validity of further nutritional markers: adjusted BMI, normalized for gender and age; Subjective Global Assessment questionnaire and standardized phase angle, normalized for gender, age and BMI in 105 patients as independent risk factors for outcomes [overall survival (OS), non-relapse mortality (NRM), relapse mortality (RM), progression-free survival (PFS)] until 2 years after alloHCT. In Cox proportional-hazards regression models, we included a variety of accepted risk factors. The two most influential pre-transplant risk factors identified and associated with similarly increased hazard ratios (HR) for OS, RM, and PFS were a low-standardized phase angle (HR = 1.97, P = 0.043; HR = 3.18, P = 0.017, and HR = 1.91, P = 0.039) and advanced disease. Under- and overweight according BMI percentiles (≤10th; ≥90th) revealed associations with increased risk of NRM (HR = 2.90, P = 0.018; HR = 3.02, P = 0.062), although only low BMI was weakly associated with OS (HR = 1.82, P = 0.09). In conclusion, our results demonstrate that pre-transplant phase angle is an independent predictor for 2-year outcomes in these patients. Further investigation is necessary to demonstrate whether the theoretically modifiable phase angle can be increased by physical training combined with nutritional support, and if this improves outcome after alloHCT.

  14. Methodology for adding and amending glycaemic index values to a nutrition analysis package.

    LENUS (Irish Health Repository)

    Levis, Sharon P

    2011-04-01

    Since its introduction in 1981, the glycaemic index (GI) has been a useful tool for classifying the glycaemic effects of carbohydrate foods. Consumption of a low-GI diet has been associated with a reduced risk of developing CVD, diabetes mellitus and certain cancers. WISP (Tinuviel Software, Llanfechell, Anglesey, UK) is a nutrition software package used for the analysis of food intake records and 24 h recalls. Within its database, WISP contains the GI values of foods based on the International Tables 2002. The aim of the present study is to describe in detail a methodology for adding and amending GI values to the WISP database in a clinical or research setting, using data from the updated International Tables 2008.

  15. The geriatric nutritional risk index may predict healthcare costs and health transitions during hemodialysis in China.

    Science.gov (United States)

    Dou, Yanna; Wang, Pei; Yuan, Fangfang; Liang, Xianhui; Liu, Dong; Xiao, Jing; Zhao, Zhanzheng; Liu, Zhangsuo

    2017-01-01

    The aim of the present study was to retrospectively analyze the relationship between the Geriatric Nutritional Risk Index (GNRI) at baseline and healthcare costs of three-month as well as the risk of quality-of-life score at the 6-month follow-up for Chinese hemodialysis patients. One hundred patients who had been on maintenance hemodialysis were enrolled in this study. The general characteristics, laboratory test results and GNRI of the patients at baseline were recorded. The healthcare costs and quality-of-life scores were determined at the follow-up examination. Patients were divided into two groups according to their median GNRI at baseline: a lower GNRI group (GNRI 86.4). The patients in the lower GNRI group exhibited reduced hemoglobin (74.7±13.1 g/dL vs 82.3±15.2 g/dL, prisk of higher future healthcare costs as well as worse health.

  16. Effect of Nurses Living Fit™ exercise and nutrition intervention on body mass index in nurses.

    Science.gov (United States)

    Speroni, Karen Gabel; Earley, Cynthia; Seibert, Dorothy; Kassem, Mary; Shorter, Gail; Ware, Catherine C; Kosak, Erin; Atherton, Martin

    2012-04-01

    The hospital-based Nurses Living Fit (NLF) intervention was implemented by nurses to determine its effect on decreasing body mass index (BMI) in nurse participants. Although there are limited data on obesity rates of nurses working in the United States, more than half are estimated to be overweight or obese. The NLF intervention included exercise (12 weekly sessions), yoga and nutrition (4 monthly sessions), and diary completion (exercise/yoga, food/water consumption, and sleep), addressing healthy lifestyle principles. NLF participants experienced a greater mean reduction in BMI and waist circumference inches. Ninety-three percent of NLF participants recommended the NLF program. Provision of an evidence-based program such as NLF facilitates nurse education on healthy lifestyle principles.

  17. Interaction between geriatric nutritional risk index and decoy receptor 3 predicts mortality in chronic hemodialysis patients.

    Science.gov (United States)

    Tsai, Ming-Tsun; Hu, Fen-Hsiang; Lien, Tse-Jen; Chen, Ping-Jen; Huang, Tung-Po; Tarng, Der-Cherng

    2014-01-01

    Protein-energy wasting (PEW) is common and associated with poor outcome in hemodialysis patients. In hemodialysis patients, geriatric nutritional risk index (GNRI) and decoy receptor 3 (DcR3) have been shown as the nutritional and inflammatory markers, respectively. The present study aimed to assess the predictive ability of GNRI and DcR3 for PEW status and long-term outcomes in chronic hemodialysis patients. A prospective cohort of 318 hemodialysis patients was conducted with a median follow-up of 54 months. Malnutrition-inflammation score (MIS) was used as the reference standard for the presence of PEW. Endpoints were cardiovascular and all-cause mortality. Baseline GNRI had a strong negative correlation with DcR3 and MIS score. For patients with age risk factors, GNRI together with DcR3 further significantly improved the predictability for overall mortality (c statistic, 0.823). Low GNRI and high DcR3 were the alternatives for identifying hemodialysis patients at risk of PEW and overall mortality. Further studies are needed to verify whether timely recognition of hemodialysis patients with a high malnutrition-inflammation risk could reduce their mortality by appropriate interventional strategies.

  18. The energy intake through regular nontherapeutic meals provision in long-term care: impact on nutritional status and related Geriatric Nutritional Risk Index.

    Science.gov (United States)

    Sturtzel, Baerbel; Elmadfa, Ibrahim; Ohrenberger, Gerald

    2016-01-01

    To investigate how the energy intake of institutionalized long-term-care patients through the regular nontherapeutic meals provision is associated with the nutritional status and the Geriatric Nutritional Risk Index (GNRI). A 9 month longitudinal, observational study. Long-term-care Hospital. 66 long-term-care patients with multiple medical conditions and solely oral food-intake. 47 (71 %) patients, predominantly women (n = 39/47), with a mean age of 83.04 (±9.58) years completed study time and 19 (29 %) deceased. At week 1 and week 36 of observation time energy intake was measured by means of three-days-weighing-records. Body composition was assessed with bioelectrical impedance analysis. Serum albumin, body weight and body height were taken from the medical report. Albumin content, body weight and height were used to calculate the Geriatric Nutritional Risk Index: GNRI = [1.489 × albumin (g/L)] + [41.7 × (weight/ideal body weight)]. Energy intake was significantly below 24 kcal/kg body weight per day. The GNRI of the deceased patients was significantly (p = 0.002) lower than the GNRI of the completers. During observation time energy-intake p nutritional status and likewise the GNRI. The malnourishment and the nutrition related clinical risk of the geriatric patients aggrevated during observation time.

  19. Evaluation of an Optimal Cut-Off Point for the Ki-67 Index as a Prognostic Factor in Primary Breast Cancer: A Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Rumiko Tashima

    Full Text Available The Ki-67 index is an important biomarker for indicating the proliferation of cancer cells and is considered to be an effective prognostic factor for breast cancer. However, a standard cut-off point for the Ki-67 index has not yet been established. Therefore, the aim of this retrospective study was to determine an optimal cut-off point in order to establish it as a more accurate prognostic factor. Immunohistochemical analysis of the Ki-67 index was performed on 4329 patients with primary breast cancer from August 1987 to March 2012. Out of this sample, there were 3186 consecutive cases from September 1997 with simultaneous evaluations of ER, PgR and HER2 status. Cox's proportional hazard model was used to perform univariate and multivariate analyses of the factors related to OS. The hazard ratios (HR and the p values were then compared to determine the optimal cut-off point for the Ki-67 index. The median Ki-67 index value was 20.5% (mean value 26.2%. The univariate analysis revealed that there was a statistically significant negative correlation with DFS and OS and the multivariate analysis revealed that the Ki-67 index value was a significant factor for DFS and OS. The top seven cut-off points were then carefully chosen based on the results of the univariate analysis using the lowest p-values and the highest HR as the main selection criteria. The multivariate analysis of the factors for OS showed that the cut-off point of 20% had the highest HR in all of the cases. However, the cutoff point of 20% was only a significant factor for OS in the Luminal/HER2- subtype. There was no correlation between the Ki-67 index value and OS in any of the other subtypes. These data indicate that the optimal cut-off point of 20% is the most effective prognostic factor for Luminal/HER2- breast cancer.

  20. A prognostic factor index for overall survival in patients receiving first-line chemotherapy for HER2-negative advanced breast cancer: an analysis of the ATHENA trial.

    Science.gov (United States)

    Llombart-Cussac, Antonio; Pivot, Xavier; Biganzoli, Laura; Cortes-Funes, Hernan; Pritchard, Kathleen I; Pierga, Jean-Yves; Smith, Ian; Thomssen, Christoph; Srock, Stefanie; Sampayo, Miguel; Cortes, Javier

    2014-10-01

    Evidence-based definitions of 'poor-prognosis' or 'aggressive' advanced breast cancer are lacking. We developed a prognostic factor index using data from 2203 patients treated with first-line chemotherapy plus bevacizumab for HER2-negative advanced breast cancer. The risk factors most closely associated with worse OS were: disease-free interval ≤24 months; liver metastases or ≥3 involved organ sites; prior anthracycline and/or taxane therapy; triple-negative breast cancer (TNBC); and performance status 2 or prior analgesic/corticosteroid treatment. Risk of death was increased threefold in patients with ≥3 versus ≤1 risk factors (hazard ratio 3.0 [95% CI 2.6-3.4; p < 0.001]; median 16.0 vs 38.8 months, respectively). This prognostic index may enable identification of patients with a poorer prognosis in whom more intensive systemic regimens may be appropriate. The index may also be considered in designing new trials, although it requires validation in other datasets before extrapolation to non-bevacizumab-containing therapy. ClinicalTrials.gov identifier: NCT00448591. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Prognostic value of the bone scan index using a computer-aided diagnosis system for bone scans in hormone-naive prostate cancer patients with bone metastases.

    Science.gov (United States)

    Miyoshi, Yasuhide; Yoneyama, Shuko; Kawahara, Takashi; Hattori, Yusuke; Teranishi, Jun-ichi; Kondo, Keiichi; Moriyama, Masatoshi; Takebayashi, Shigeo; Yokomizo, Yumiko; Yao, Masahiro; Uemura, Hiroji; Noguchi, Kazumi

    2016-02-19

    The bone scan index (BSI) using a computer-aided diagnosis system for bone scans is expected to be an objective and quantitative clinical tool for evaluating bone metastatic prostate cancer. This study aimed to evaluate the pretreatment BSI as a prognostic factor in hormone-naive prostate cancer patients with bone metastases. The study included 60 patients with hormone-naive, bone metastatic prostate cancer that was initially treated with combined androgen blockade therapy. The BONENAVI system was used for calculating the BSI. We evaluated the correlation between overall survival (OS) and pretreatment clinicopathological characteristics, including patients' age, initial prostate-specific antigen (PSA) value, Gleason scores, clinical TNM stage, and the BSI. Cox proportional hazards regression models were used for statistical analysis. The median follow-up duration was 21.4 months. Clinical or PSA progression occurred in 37 (61.7%) patients and 18 (30.0%) received docetaxel. Death occurred in 16 (26.7%) patients. Of these deaths, 15 (25.0%) were due to prostate cancer. The median OS was not reached. In multivariate analysis, age and the BSI were independent prognostic factors for OS. We evaluated the discriminatory ability of our models, including or excluding BSI by quantifying the C-index. The BSI improved the C-index from 0.751 to 0.801 for OS. Median OS was not reached in patients with a BSI ≤ 1.9 and median OS was 34.8 months in patients with a BSI >1.9 (p = 0.039). The pretreatment BSI and patients' age are independent prognostic factors for patients with hormone-naive, bone metastatic prostate cancer.

  2. Rural Middle School Nutrition and Physical Activity Environments and the Change in Body Mass Index during Adolescence

    Science.gov (United States)

    Demment, Margaret; Wells, Nancy; Olson, Christine

    2015-01-01

    Background: For rural adolescents, schools are among the few places where environmental interventions can promote health outside of the home. The goal of this study was to assess the nutrition and physical activity (N&PA) environments of schools attended by a birth cohort and examine the association with change in body mass index (BMI) from…

  3. Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European prospective investigation into cancer and nutrition cohort

    NARCIS (Netherlands)

    Cust, Anne E.; Slimani, Nadia; Kaaks, Rudolf; van Bakel, Marit; Biessy, Carine; Ferrari, Pietro; Laville, Martine; Tjonneland, Anne; Olsen, Anja; Overvad, Kim; Lajous, Martin; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Linseisen, Jakob; Rohrmann, Sabine; Noethlings, Ute; Boeing, Heiner; Palli, Domenico; Sieri, Sabina; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Skeie, Guri; Engeset, Dagrun; Gram, Inger Torhild; Quiros, J. Ramon; Jakszyn, Paula; Sanchez, Maria Jose; Larranaga, Nerea; Navarro, Carmen; Ardanaz, Eva; Wirfalt, Elisabet; Berglund, Goran; Lundin, Eva; Hallmans, Goeran; Bueno-de-Mesquita, H. Bas; Du, Huaidong; Peeters, Petra H. M.; Bingham, Shelia; Khaw, Kay-Tee; Allen, Naomi E.; Key, Timothy J.; Jenab, Mazda; Riboli, Elio

    2007-01-01

    The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004),

  4. The Geriatric Nutritional Risk Index predicts hospital length of stay and in-hospital weight loss in elderly patients.

    Science.gov (United States)

    Cereda, Emanuele; Klersy, Catherine; Pedrolli, Carlo; Cameletti, Barbara; Bonardi, Chiara; Quarleri, Lara; Cappello, Silvia; Bonoldi, Alberto; Bonadeo, Elisa; Caccialanza, Riccardo

    2015-02-01

    Nutritional derangements are common in elderly patients, but how nutritional risk affects outcome in this subset of hospital inpatients deserves further investigation. We evaluated the impact of nutritional risk on length of stay (LOS) and in-hospital weight loss (WL) in elderly patients (>65 yrs). Nutritional risk was assessed by the Geriatric Nutritional Risk Index (GNRI) in a prospective multicentre hospital-based cohort study. The outcomes were LOS and in-hospital WL. In the whole sample (N = 667), the prevalence of high (GNRI nutritional risk were 33% and 25%, respectively. Patients with a high nutritional risk were more likely (OR = 1.89; 95%CI: 1.22-2.92) to stay longer in hospital (fourth quartile, LOS ≥ 20 days) compared to those without. Other factors associated with prolonged LOS were cancer diagnosis (OR = 2.52; 95%CI: 1.69-3.75), the presence of comorbidities (OR = 1.24; 95%CI: 1.11-1.40) and surgical setting (OR = 1.65; 95%CI: 1.10-2.47). In-hospital WL ≥ 5% was recorded in 75 ambulant patients from a representative subgroup (N = 583). It was independently associated with prolonged LOS (OR = 1.80; 95%CI: 1.03-3.06) and was more frequent among cancer patients (OR = 1.88; 95%CI: 1.09-3.24), in patients with a high nutritional risk (OR = 2.23; 95%CI: 1.20-4.14) or those admitted to surgical units (OR = 1.77; 95%CI: 1.02-3.05). Nutritional risk assessed by the GNRI on admission, predicts LOS and in-hospital WL in elderly patients. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  5. The ability of the Geriatric Nutritional Risk Index to assess the nutritional status and predict the outcome of home-care resident elderly: a comparison with the Mini Nutritional Assessment.

    Science.gov (United States)

    Cereda, Emanuele; Pusani, Chiara; Limonta, Daniela; Vanotti, Alfredo

    2009-08-01

    The Mini Nutritional Assessment (MNA) is recommended for grading nutritional status in the elderly. A new index for predicting the risk of nutrition-related complications, the Geriatric Nutritional Risk Index (GNRI), was recently proposed but little is known about its possible use in the assessment of nutritional status. Thus, we aimed to investigate its ability to assess the nutritional status and predict the outcome when compared with the MNA. Anthropometry and biochemical parameters were determined in 241 institutionalised elderly (ninety-four males and 147 females; aged 80.1 (SD 8.3) years). Nutritional risk and nutritional state were graded by the GNRI and MNA, respectively. At 6 months outcomes were: death; infections; bedsores. According to the GNRI and MNA, the prevalence of high risk (GNRI risk (GNRI 92-98)/malnutrition at-risk (MNA 17-23.5) and no risk (GNRI > 98)/good status (MNA > 24) were 20.7/12.8%, 36.1/39% and 43.2/48.2%, respectively, with poor agreement in scoring the patient (Cohen's kappa test: kappa = 0.29; 95% CI 0.19, 0.39). GNRI categories showed a stronger association (OR) with overall outcomes than MNA classes, although no difference (P>0.05) was found between malnutrition (v. 'good status', OR 6.4; 95% CI 2.1, 71.9) and high nutritional risk (v. 'no risk', OR 9.7; 95% CI 3.0, 130). Multivariate logistic regression revealed the GNRI as an independent predictor of complications. In overall-outcome prediction, a good sensitivity was found only for GNRI 98 with an MNA > 24 seemed to exclude adverse outcomes. The GNRI showed poor agreement with the MNA in nutritional assessment, but appeared to better predict outcome. In home-care resident elderly, outcome prediction should be performed by combining the suggestions from both these tools.

  6. Geriatric Nutritional Risk Index Is a Simple Predictor of Mortality in Chronic Hemodialysis Patients.

    Science.gov (United States)

    Komatsu, Mizuki; Okazaki, Masayuki; Tsuchiya, Ken; Kawaguchi, Hiroshi; Nitta, Kosaku

    2015-01-01

    Malnutrition is common in hemodialysis (HD) patients, and it is associated with increasing risk of mortality. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. The aim of this study was to examine the reliability of the GNRI as a mortality predictor in a Japanese HD cohort. We prospectively examined the GNRI of 332 maintenance HD patients aged 65.4 ± 13.2, 213 males, and followed up on them for 36 months. The patients were divided into quartiles (Q) according to GNRI values (Q1: 102.3). Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses. The GNRI presented a normal distribution. During the follow-up period of 36 months, 76 patients died. The overall mortality at the end of the 3-year observational period was 22.3%. At the 3-year follow-up period, Kaplan-Meier survival rates for all-cause mortality were 72.3, 79.3, 84.9 and 92.6% in Q1, Q2, Q3, and Q4, respectively (p = 0.0067). Multivariate Cox proportional-hazards analysis demonstrated that the GNRI was a significant predictor of adjusted all-cause mortality (HR 0.958; 95% CI 0.929-0.989, p = 0.0073). The results of the present study demonstrate that the GNRI is a strong predictor of overall mortality in HD patients. However, cardiovascular mortality was not associated with GNRI values, and did not differ among the GNRI quartiles. The GNRI score can be considered a simple and reliable marker of predictor for mortality risk in Japanese HD patients. © 2015 S. Karger AG, Basel.

  7. A composite index to explain variations in poverty, health, nutritional status and standard of living: use of multivariate statistical methods.

    Science.gov (United States)

    Antony, G M; Rao, K Visweswara

    2007-08-01

    To calculate the Human Development Index (HDI) and Human Poverty Index (HPI) of Indian states; to trace the indicators useful for finding variations in poverty; and to develop a composite index that may explain variations in poverty, health, nutritional status and standard of living. Cross-sectional study. The HDI and HPI were calculated for different Indian states. A set of possible indicators varying between rich and poor states of India was identified with the use of discriminant function analysis. A composite index has been developed for measuring the standard of living of Indian states with the help of factor analysis. Demographic, socio-economic, health and dietary indicators play a major role in determining the real standard of living. Poverty, standard of living and human development depend on multiple factors. The existing indices, such as HDI and HPI, use income indicators to measure the standard of living, and do not take into account diet and nutritional status indicators. The proposed index was found to be more suitable for measuring the real standard of living and human development, as it is a comprehensive index of income and non-income indicators. Further validation may be carried out for different populations. Discriminant function analysis and factor analysis were used to assess health inequality and standard of living among Indian states. The proposed multi-dimensional index may provide a better picture of human development. Further work is of interest for other populations.

  8. Geriatric nutritional risk index predicts functional dependency and mortality in patients with heart failure with preserved ejection fraction.

    Science.gov (United States)

    Kinugasa, Yoshiharu; Kato, Masahiko; Sugihara, Shinobu; Hirai, Masayuki; Yamada, Kensaku; Yanagihara, Kiyotaka; Yamamoto, Kazuhiro

    2013-01-01

    The clinical significance of nutritional risk assessment in patients with heart failure with preserved ejection fraction (HFpEF) remains undefined. Geriatric nutritional risk index (GNRI) is a simple nutritional assessment tool for elderly subjects. Its predictive value was evaluated in patients with HFpEF, a common HF phenotype in the elderly population. The present study enrolled 152 consecutive patients (mean age, 77 ± 11 years; male, 53.9%) who were hospitalized with HFpEF at the authors' institution. GNRI on admission was calculated as follows: 14.89 × serum albumin (g/dl)+41.7×body mass index/22. Characteristics and mortality (median follow-up of 2.1 years) were compared between 2 groups: low GNRI (nutritional risk; and high GNRI (≥ 92) with no or low nutritional risk. Patients in the low-GNRI group were more often female, and had lower serum hemoglobin and sodium, but higher serum blood urea nitrogen (BUN), C-reactive protein, and B-type natriuretic peptide (BNP) compared to those in the high-GNRI group (Pindex was significantly lower in the low-GNRI group than the high-GNRI group (P<0.05). On Cox hazard analysis, lower GNRI predicted increased mortality independent of age, gender, prior HF hospitalization, and higher BUN and BNP (P<0.01).  GNRI may be useful for predicting functional dependency and mortality in patients with HFpEF.  

  9. Nutritional risk index as a predictor of postoperative wound complications after gastrectomy.

    Science.gov (United States)

    Oh, Cheong Ah; Kim, Dae Hoon; Oh, Seung Jong; Choi, Min Gew; Noh, Jae Hyung; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung

    2012-02-21

    To investigate the correlation between the nutritional risk index (NRI) and postoperative wound complications. From January 2008 through June 2008, 669 patients who underwent curative gastrectomy for gastric cancer were included in a retrospective study. Medical records of consecutive patients were collected and analyzed to determine postoperative wound complication rates. The NRI was assessed on the fifth postoperative day and other possible risk factors for the incidence of wound complications were analyzed to identify the factors affecting postoperative wound complications. Patients with other postoperative complications were excluded from the study. On the 5th postoperative day, the NRI sh-owed a malnutrition rate of 84.6% among postoperative patients. However, postoperative wound complications occurred in only 66/669 (9.86%) patients. Of the patients with wound complications, 62/66 (94%) belonged to the malnourished group (NRI < 97.5), and 4/66 (6%) patients to the non-malnourished group (NRI ≥ 97.5). The only factor correlated with wound complications was the NRI on the 5th postoperative day (odds ratio of NRI ≥ 97.5 vs NRI < 97.5: 0.653; 95% confidence interval: 0.326-0.974; P = 0.014) according to univariate analysis as well as multivariate analysis. This study suggests that malnutrition immediately after surgery may play a significant role in the development of wound complications.

  10. Association between nutritional screening via the Controlling Nutritional Status index and bone mineral density in chronic liver disease of various etiologies.

    Science.gov (United States)

    López-Larramona, Germán; Lucendo, Alfredo J; Tenías, José María

    2015-06-01

    Bone density disorders are prevalent in patients with chronic liver disease (CLD), who commonly present with hepatic osteodystrophy. However, the relationship between nutritional status and bone mineral density (BMD) has been scarcely studied in CLD. This single-center, cross-sectional study included outpatients consecutively diagnosed with CLD during a 1.5-year period. The nutritional status was assessed with the Controlling Nutritional Status (CONUT) index; dual-energy X-ray absorptiometry scans and parameters of bone mineral metabolism were carried out. Bone fracture risk was estimated with the World Health Organization FRAX tool. Among the 126 patients recruited (58.7% male), osteopenia and osteoporosis were present in 31.1% and 10.7%, respectively. The 10-year fracture risk was significantly higher among women. Malnutrition estimated with the CONUT index was present in 29.9% of patients and was significantly more frequent in cirrhotic patients, 63.4% of whom were malnourished. Malnutrition stage directly correlated with hepatic function as expressed by the Model for End-Stage Liver Disease index. A non-significant relationship between CONUT-assessed nutritional status and BMD was documented. 25-Hydroxyvitamin-D3 (25[OH]-D3) and fracture risk correlated positively with the CONUT stage, and total cholesterol had an inverse relationship with BMD. Malnutrition assessed by the CONUT was very frequent in patients with liver cirrhosis. The CONUT score inversely correlated with liver function, while malnutrition stage directly correlated with BMD, fracture risk and 25(OH)-D3. Total cholesterol showed a negative association with BMD in this population. © 2014 The Japan Society of Hepatology.

  11. The art versus science of predicting prognosis: can a prognostic index predict short-term mortality better than experienced nurses do?

    Science.gov (United States)

    Casarett, David J; Farrington, Sue; Craig, Teresa; Slattery, Julie; Harrold, Joan; Oldanie, Betty; Roy, Jason; Biehl, Richard; Teno, Joan

    2012-06-01

    To determine whether a prognostic index could predict one-week mortality more accurately than hospice nurses can. An electronic health record-based retrospective cohort study of 21,074 hospice patients was conducted in three hospice programs in the Southeast, Northeast, and Midwest United States. Model development used logistic regression with bootstrapped confidence intervals and multiple imputation to account for missing data. The main outcome measure was mortality within 7 days of hospice enrollment. A total of 21,074 patients were admitted to hospice between October 1, 2008 and May 31, 2011, and 5562 (26.4%) died within 7 days. An optimal predictive model included the Palliative Performance Scale (PPS) score, admission from a hospital, and gender. The model had a c-statistic of 0.86 in the training sample and 0.84 in the validation sample, which was greater than that of nurses' predictions (0.72). The index's performance was best for patients with pulmonary disease (0.89) and worst for patients with cancer and dementia (both 0.80). The index's predictions of mortality rates in each index category were within 5.0% of actual rates, whereas nurses underestimated mortality by up to 18.9%. Using the optimal index threshold (<3), the index's predictions had a better c-statistic (0.78 versus 0.72) and higher sensitivity (74.4% versus 47.8%) than did nurses' predictions but a lower specificity (80.6% versus 95.1%). Although nurses can often identify patients who will die within 7 days, a simple model based on available clinical information offers improved accuracy and could help to identify those patients who are at high risk for short-term mortality.

  12. Pretreatment depression as a prognostic indicator of survival and nutritional status in patients with head and neck cancer.

    Science.gov (United States)

    Kim, Shin-Ae; Roh, Jong-Lyel; Lee, Sang-Ah; Lee, Sang-Wook; Kim, Sung-Bae; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon

    2016-01-01

    The emotional status of cancer patients is associated with disease course and treatment outcomes. In this study, the authors evaluated associations between the presence of pretreatment depression and pretreatment quality of life (QOL), nutritional status, and survival outcomes in patients with head and neck squamous cell carcinoma (HNSCC). For this prospective study, 241 patients with previously untreated HNSCC who underwent curative treatments were enrolled. Patients completed the Beck Depression Inventory (BDI)-II, the European Organization for Research and Treatment of Cancer (EORTC) 30-item Core QOL Questionnaire (QLQ-C30), and the EORTC QLQ Head and Neck Cancer module (QLQ-H&N35). EORTC QLQ scores were compared between depressive and nondepressive patients, as determined according to pretreatment BDI-II scores ≥ 14 and nutritional status and laboratory data. Pretreatment depression was present in 60 patients (24.9%). In depressive and nondepressive patients, the 3-year overall survival rates were 70.8% and 82.7%, respectively (P = .045), and the 3-year DFS rates were 63.5% and 79.1%, respectively (P = .015). After controlling for clinical factors, the presence of depression was predictive of 3-year DFS (P = .032). EORTC QLQ-C30 and QLQ-HN35 scores on all items except feeding tube, nutritional supplement, and problem with mouth opening differed between depressive and nondepressive patients (P nutritional status, and survival outcomes in patients with HNSCC. © 2015 American Cancer Society.

  13. A Preoperative Nutritional Index for Predicting Cancer-Specific and Overall Survival in Chinese Patients With Laryngeal Cancer: A Retrospective Study.

    Science.gov (United States)

    Fu, Yan; Chen, Shu-Wei; Chen, Shi-Qi; Ou-Yang, Dian; Liu, Wei-Wei; Song, Ming; Yang, An-Kui; Zhang, Quan

    2016-03-01

    Pinato prognostic nutritional index (PNI) adequately predicts long-term outcomes of various malignancies. However, its value in predicting outcomes in laryngeal squamous cell carcinoma (LSCC) is unknown. All patients newly diagnosed with LSCC presenting to the Department of Head and Neck Oncology at Sun Yat-sen University Cancer Center between January 1, 1990 and July 31, 2010 were eligible. The PNI was calculated as serum albumin (g/L) + 5 × total lymphocyte count/L. The Cutoff Finder software program was used to classify the patients into 3 groups for which the PNI score was at least 70% sensitive, at least 70% specific, or equivocal. Cancer-specific survival was estimated using the Kaplan-Meier method, and predictors were assessed with Cox regression analysis. Median time between surgery and PNI administration for the 975 eligible patients was 83 months. Index score groups were significantly associated with age, T stage, TNM stage, and type of surgery. Five-year CSS and OS were 57.3% and 56.6% in patients with PNI scores below 48.65 (low-probability of survival), 72.8% and 71.3% with scores between 48.65 and 56.93 (moderate-probability of survival), and 77.6% and 75.3% with scores above 56.93 (high-probability of survival); 10-year CSS and OS were 44.2% and 42.7%, 61.6% and 55.6%, 68.3% and 63.5%, respectively. The PNI score groups significantly predicted CSS and OS (P < 0.001). The PNI is an inexpensive and readily available score that predicted survival in patients with LSCC after curative laryngectomy.

  14. Assessment of nutritional quality, glycaemic index, antidiabetic and sensory properties of plantain (Musa paradisiaca)-based functional dough meals.

    Science.gov (United States)

    Famakin, Opeyemi; Fatoyinbo, Akindele; Ijarotimi, Oluwole Steve; Badejo, Adebanjo Ayobamidele; Fagbemi, Tayo Nathaniel

    2016-11-01

    Nutrition transition to high energy-dense foods has been implicated as the major causes of diet related diseases. Plantain-based dough meals supplemented with soybean cake and cassava fibre were developed by combining them in different proportions using response surface methodology. The flour blends were analyzed for the nutritional composition while the glycaemic index, antidiabetic potentials and protein digestibility of the dough meals were determined in wistar rats. The nutritional and essential amino acid contents of the flour blends were comparable to that of cerolina (a commercially available food product commonly recommended for diabetic patients). The rats fed with the formulated dough meals had lower glycaemic index and glycaemic load, and the blood glucose was significantly reduced compared to cerolina and metformin (a synthetic antidiabetic drug). All the plantain-based dough meals were comparable to cerolina and metformin in terms of nutritional quality and blood glycaemic control activities, respectively. Hence, the formulated plantain-based dough meals have potential to be used for the prevention and management of diabetes mellitus.

  15. Is the Geriatric Nutritional Risk Index a Significant Predictor of Postoperative Complications in Patients with Esophageal Cancer Undergoing Esophagectomy?

    Science.gov (United States)

    Yamana, Ippei; Takeno, Shinsuke; Shibata, Ryosuke; Shiwaku, Hironari; Maki, Kenji; Hashimoto, Tatsuya; Shiraishi, Takeshi; Iwasaki, Akinori; Yamashita, Yuichi

    2015-01-01

    The Geriatric Nutritional Risk Index (GNRI) is a new index recently introduced for predicting the risk of nutrition-related complications. The GNRI has mainly been reported as a simple and accurate tool to assess the nutritional status and prognosis of elderly patients. So far, there have been no reports of the GNRI in patients with gastrointestinal cancer. Our objective was to examine the association between the GNRI and short-term outcomes, especially postoperative complications, in patients with esophageal cancer who underwent esophagectomy and gastric tube reconstruction. The present study enrolled 122 consecutive patients with esophageal cancer who underwent esophagectomy and gastric tube reconstruction. The GNRI at admission to the hospital was calculated as follows: (1.489 × albumin in g/l) + (41.7 × present/ideal body weight). The characteristics and short-term outcomes were compared between two groups: the high (GNRI ≥90) and the low (GNRI nutritional status and predict the development of postoperative respiratory complications in patients with esophageal cancer undergoing esophagectomy and gastric tube reconstruction. 2015 S. Karger AG, Basel.

  16. Nutrition.

    Science.gov (United States)

    Pfau, P R; Rombeau, J L

    2000-09-01

    The use of nutrition for the medical patient, in the inpatient setting and at home, will likely continue to increase in the future. Each patient should be evaluated in an individualized but systematic fashion. Each patient in whom malnourishment is suspected should undergo a thorough assessment for the presence and degree of malnutrition with an accurate calculation of nutritional requirements. It is important to choose the correct method of delivery of nutrition, to monitor and recognize any complications or problems that may arise, and to tailor the nutritional therapy to the unique diseases that are encountered in medicine. Although increasingly new advances and changes are occurring in the field of nutrition, nutritional support and therapy are best delivered and supplied to the patient with a network of health care workers, including the physician, the nurse, the dietitian, the social worker, and pharmacist.

  17. Simple Assessment of Nitrogen Nutrition Index in Summer Maize by Using Chlorophyll Meter Readings

    Directory of Open Access Journals (Sweden)

    Ben Zhao

    2018-01-01

    Full Text Available Rapid and non-destructive diagnostic tools to accurately assess crop nitrogen nutrition index (NNI are imperative for improving crop nitrogen (N diagnosis and sustaining crop production. This study was aimed to develop the relationships among NNI, leaf N gradient, chlorophyll meter (CM readings gradient, and positional differences chlorophyll meter index [PDCMI, the ratio of CM readings between different leaf layers (LLs of crop canopy] and to validate the accuracy and stability of these relationships across the different LLs, years, sites, and cultivars. Six multi-N rates (0–320 kg ha−1 field experiments were conducted with four summer maize cultivars (Zhengdan958, Denghai605, Xundan20, and Denghai661 at two different sites located in China. Six summer maize plants per plot were harvested at each sampling stage to assess NNI, leaf N concentration and CM readings of different LLs during the vegetative growth period. The results showed that the leaf N gradient, CM readings gradient and PDCMI of different LLs decreased, while the NNI values increased with increasing N supply. The leaf N gradient and CM readings gradient increased gradually from top to bottom of the canopy and CM readings of the bottom LL were more sensitive to changes in plant N concentration. The significantly positive relationship between NNI and CM readings of different LLs (LL1 to LL3 was observed, yet these relationships varied across the years. In contrast, the relationships between NNI and PDCMI of different LLs (LL1 to LL3 were significantly negative. The strongest relationship between PDCMI and NNI which was stable across the cultivars and years was observed for PDCMI1−3 (NNI = −5.74 × PDCMI1−3+1.5, R2 = 0.76**. Additionally, the models developed in this study were validated with the data acquired from two independent experiments to assess their accuracy of prediction. The root mean square error value of 0.1 indicated that the most accurate and robust

  18. Prognostic Significance of Bcl-2 and p53 Protein Expressions and Ki67 Proliferative Index in Diffuse Large B-cell Lymphoma

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    Betül Bolat Küçükzeybek

    2013-09-01

    Full Text Available Objective: Diffuse large B-cell lymphoma (DLBCL is a high-grade neoplasm that has heterogeneous properties in clinical, morphological, and immunophenotypic aspects. In the present study the effects of p53, Bcl-2, and Ki67 on prognosis and their relationships with clinical parameters were examined. Materials and Methods: Thirty-five patients who had been diagnosed with nodally located DLBCL at İzmir Atatürk Training and Research Hospital between January 1999 and June 2006 were included in the study. The Ann Arbor classification system was used to determine the stage of the patients. The patients were evaluated according to age, sex, stage, B symptoms, extranodal involvement, and lactate dehydrogenase (LDH level as well as immunohistochemically. P53 protein and Bcl-2 oncoprotein expressions and Ki67 proliferation index were assessed immunohistochemically. Results: High Bcl-2 expression was found in 9 patients (25.7%, high p53 expression was found in 10 patients (28.6%, and high Ki67 was observed in 23 patients (65.7%. There was no significant correlation between p53 expression, Bcl-2 expression, or Ki67 proliferation index and age, sex, stage, B symptoms, extranodal involvement, LDH level, and overall survival (p>0.05. We did not find a relationship among p53 expression, Bcl-2 expression, Ki67 proliferation index, and prognosis (p>0.05. There was no significant relationship between overall survival and age, sex, stage, B symptoms, extranodal involvement, or LDH level (p>0.05. Our results revealed that Bcl-2 and p53 protein expressions and Ki67 proliferation index have no effect on overall survival of patients with DLBCL. Conclusion: The prognostic importance of p53 and Bcl-2 protein expressions and Ki67 proliferation index in DLBCL, which has biological and clinical heterogeneity, can be understood in a large series of studies that have subclasses and immunohistochemical markers with optimal cut-off values.

  19. Long-term prognostic value of a comprehensive assessment of cardiac magnetic resonance indexes after an ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Merlos, Pilar; López-Lereu, Maria P; Monmeneu, Jose V; Sanchis, Juan; Núñez, Julio; Bonanad, Clara; Valero, Ernesto; Miñana, Gema; Chaustre, Fabián; Gómez, Cristina; Oltra, Ricardo; Palacios, Lorena; Bosch, Maria J; Navarro, Vicente; Llácer, Angel; Chorro, Francisco J; Bodí, Vicente

    2013-08-01

    A variety of cardiac magnetic resonance indexes predict mid-term prognosis in ST-segment elevation myocardial infarction patients. The extent of transmural necrosis permits simple and accurate prediction of systolic recovery. However, its long-term prognostic value beyond a comprehensive clinical and cardiac magnetic resonance evaluation is unknown. We hypothesized that a simple semiquantitative assessment of the extent of transmural necrosis is the best resonance index to predict long-term outcome soon after a first ST-segment elevation myocardial infarction. One week after a first ST-segment elevation myocardial infarction we carried out a comprehensive quantification of several resonance parameters in 206 consecutive patients. A semiquantitative assessment (altered number of segments in the 17-segment model) of edema, baseline and post-dobutamine wall motion abnormalities, first pass perfusion, microvascular obstruction, and the extent of transmural necrosis was also performed. During follow-up (median 51 months), 29 patients suffered a major adverse cardiac event (8 cardiac deaths, 11 nonfatal myocardial infarctions, and 10 readmissions for heart failure). Major cardiac events were associated with more severely altered quantitative and semiquantitative resonance indexes. After a comprehensive multivariate adjustment, the extent of transmural necrosis was the only resonance index independently related to the major cardiac event rate (hazard ratio=1.34 [1.19-1.51] per each additional segment displaying>50% transmural necrosis, P<.001). A simple and non-time consuming semiquantitative analysis of the extent of transmural necrosis is the most powerful cardiac magnetic resonance index to predict long-term outcome soon after a first ST-segment elevation myocardial infarction. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  20. Geriatric nutritional risk index as a simple tool for assessment of malnutrition among geriatrics in Northwest of Iran: comparison with mini nutritional assessment.

    Science.gov (United States)

    Saghafi-Asl, Maryam; Vaghef-Mehrabany, Elnaz; Karamzad, Nahid; Daeiefarshbaf, Lida; Kalejahi, Parinaz; Asghari-Jafarabadi, Mohammad

    2018-01-16

    Older people are more likely to develop nutritional problems and timely diagnosis of malnutrition is crucial to prevent hazardous consequences following poor nutrition. To evaluate the efficacy of Geriatric Nutritional Risk Index (GNRI) to assess nutritional status among non-hospitalized elderly, compared to mini nutritional assessment (MNA) among Iranian seniors. One hundred and sixty-four subjects, aged ≥ 65 years old were recruited to our cross-sectional study from various districts of Tabriz (Tabriz, Iran). Anthropometric and biochemical measurements were performed, short- and long-form MNAs and GNRI were assessed in our study subjects. Sensitivity, specificity and predictive values of the three indices, agreement between them, and their correlation with anthropometric and biochemical parameters were evaluated. Receiver-operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off point for GNRI in our study population. GNRI had lower sensitivity (50, 57%), but optimal specificity (94, 93%) and lower negative predictive value (NPV; 68, 71%) compared to MNA-LF and MNA-SF, respectively. We found a moderate agreement between GNRI and MNA-SF (K = 0.52) and MNA-LF (K = 0.46) scores. Significant correlations were observed between re-categorized MNAs as well as GNRI scores, and age, weight, MAC, CC, WC, albumin, and pre-albumin. The cut-off point of 110.33 was obtained for GNRI, according to the ROC curve. Although GNRI may not be an efficient tool for screening malnutrition due to its lower sensitivity, it is moderately correlated with MNAs and also more useful when limited funding needs to target the truly malnourished seniors.

  1. Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children's body mass index.

    Science.gov (United States)

    Alkon, Abbey; Crowley, Angela A; Neelon, Sara E Benjamin; Hill, Sherika; Pan, Yi; Nguyen, Viet; Rose, Roberta; Savage, Eric; Forestieri, Nina; Shipman, Linda; Kotch, Jonathan B

    2014-03-01

    To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children's body mass index (BMI). A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center's written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children's nutritional intake, physical activity, and height and weight pre- and post-intervention. Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers' and parents' knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children's zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. The NAP SACC intervention, as delivered by trained child health professionals such as child care

  2. [Index of Nutritional Purchasing Power Parity: comparison of caloric costs of a healthy versus an unhealthy diet].

    Science.gov (United States)

    Mendoza Velázquez, Alfonso

    2012-01-01

    Develop the Index of Nutritional Purchasing Power Parity (Nut3-CiO) as an instrument to compare the caloric costs of a healthy versus an unhealthy diet between regions or cities in a country over time. Indices of caloric prices were constructed and the "law of one price" was used to derive the Nut3-CiO index. Caloric inflation rates were obtained using basic descriptive statistics. The Nut3-CiO was applied in the major cities of Mexico during the period from January 1996 to December 2010. The statistical behavior of the Nut3-CiO revealed that, in Mexican cities, products for a typical diet are less expensive than products for a healthy diet. The findings showed a cyclical behavior to the index, a high correlation between inflation for the typical diet and inflation for the market basket, and a high persistence of prices. The Nut3-CiO index makes it possible to periodically compare the price differential of two types of diets-typical and healthy-between cities in a single country. This instrument could help health authorities identify the cities where it is easier or more difficult for consumers to access a typical or healthy diet in terms of cost. Furthermore, it makes it possible to estimate the percentage adjustment necessary in each city to attain levels of nutritional purchasing power parity.

  3. Glasgow outcome scale at hospital discharge as a prognostic index in patients with severe traumatic brain injury

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    Rosmari A.R.A. Oliveira

    2012-08-01

    Full Text Available OBJECTIVE: Evaluate the Glasgow outcome scale (GOS at discharge (GOS-HD as a prognostic indicator in patients with traumatic brain injury (TBI. METHOD: Retrospective data were collected of 45 patients, with Glasgow coma scale <8, age 25±10 years, 36 men, from medical records. Later, at home visit, two measures were scored: GOS-HD (according to information from family members and GOS LATE (12 months after TBI. RESULTS: At discharge, the ERG showed: vegetative state (VS in 2 (4%, severe disability (SD in 27 (60%, moderate disability (MD in 15 (33% and good recovery (GR in 1 (2%. After 12 months: death in 5 (11%, VS in 1 (2%, SD in 7 (16%, MD in 9 (20% and GR in 23 (51%. Variables associated with poor outcome were: worse GOS-HD (p=0.03, neurosurgical procedures (p=0.008 and the kind of brain injury (p=0.009. CONCLUSION: The GOS-HD was indicator of prognosis in patients with severe TBI.

  4. The prognostic value of tip-to-apex distance (TAD index in intertrochanteric fractures fixed by dynamic hip screw

    Directory of Open Access Journals (Sweden)

    Ali Sadighi

    2012-11-01

    Full Text Available Intertrochanteric fractures (ITFs are the most common type of fractures requiring surgical intervention. They also have the highest surgical mortality among orthopedic operations. Among the many different techniques used for fixation of this type of fracture, use of the Dynamic Hip Screw (DHS has gained wide acceptance. This current study was designed to assess positive predictive value of tip-to-apex distance (TAD index in the prognosis of patients treated with DHS. The study was designed according to a descriptive-analytic protocol, made up of 100 cases of ITFs caused by falling, treated in the Shohada Orthopedic Center, Tabriz, Iran. All patients underwent lateral and antero-posterior hip X-ray to measure TAD index. The cohort was followed for three months after DHS placement. Of a total of 100 cases (53 male, 47 female with a mean age of 76.7 years (range 29-100 years, 43% had grade 4, 29% grade 3, 21% grade 5, 5% grade 2 and 2% grade 6 osteoporosis. The screw position was postero-inferior in 57%, central in 40% and superior in 3% of patients. Minimum and maximum TAD index were 20 and 28 mm, respectively. Mean TAD was 23.5 mm. There were no post-operative complications in 84% of cases. Screw failure was the most common complication in the remaining 16% of patients. The study shows a statistically significant correlation between TAD index and cut-off rate in patients with intertrochanteric fractures of femoral bone treated by DHS. This validates the use of TAD index in determining the prognosis of patients treated by DHS.

  5. Role of bispectral index monitoring and burst suppression in prognostication following out-of-hospital cardiac arrest: a systematic review protocol.

    Science.gov (United States)

    Eveson, Leanne; Vizcaychipi, Marcela; Patil, Shashank

    2017-09-25

    Out-of-hospital cardiac arrest (OHCA) is associated with significant mortality or may have a poor neurological outcome. Various community-training programmes have improved practices like bystander cardiopulmonary resuscitation (CPR) and early defibrillation using automated external defibrillator (AED). Post-resuscitation care has also changed significantly in the millennium. Interventions like targeted temperature management (TTM), avoidance of hyperoxia and emergency cardiac catheterisation have given patients a chance of a better neurological outcome. Despite these timely interventions, it is still very difficult to predict neurological outcome. The European Resuscitation Council and European Society of Intensive Care Medicine (ERC-ESICM) published guidance in 2015 with a strong recommendation to delay prognostication for at least 72 h and with an emphasis to adapt a multimodal approach, which includes neurological examination, biomarkers, electroencephalogram (EEG) and radiological tests. These interventions not only have cost attached to them, but the unpredictability has a significant emotional impact on family members. Bispectral index (BIS) monitoring device acts on the principle of EEG and converts the waveform into an absolute number and also measures the burst suppression. We hypothesize that patients who have a low BIS value and high burst suppression within 24 h of presentation will have a poor neurological outcome. The primary objective of this review is to look at BIS monitor as a tool, which could help bring forward the timing of prognostication. Electronic databases will be systematically searched for randomised controlled trials and prospective or retrospective cohort studies with no language restrictions. The search will be supplemented with grey literature searches of thesis, dissertations and hand searching of relevant journals. Two independent reviewers will screen, select and perform analysis according to the Preferred Reporting Items for

  6. Mother's body mass index as a predictor of infant's nutritional status in the post-emergency phase of a flood.

    Science.gov (United States)

    Goudet, Sophie; Griffths, Paula; Bogin, Barry A

    2011-10-01

    Maternal nutritional status is a determinant of child health. This paper studies the association between a mother's body mass index (BMI) and her infant's nutritional status over a one year time frame after the 1998 flood crisis in Bangladesh. The paper uses secondary analysis of data collected from 757 households in seven rural areas of Bangladesh affected by the 1998 flood using multiple-stage probability sampling techniques (n = 143). Logistic regression models were employed to investigate the predictive impact of maternal BMI on infant's nutritional status after controlling for a range of child and maternal factors. An underweight mother was a significant factor with regard to the risk of infants suffering stunting (odds ratio (OR) = 4.45, 95 per cent confidence interval (CI) = 1.04-18.94) and being underweight (OR = 3.51, 95 per cent CI = 1.02-12.05) a year later, but not wasting (OR = 2.09, 95 per cent CI = 0.51-8.67). The findings suggest that there is a post-emergency link between maternal and infant nutritional health. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

  7. Performance of the Geriatric Nutritional Risk Index in predicting 28-day hospital mortality in older adult patients with sepsis.

    Science.gov (United States)

    Lee, Jong Seok; Choi, Han Sung; Ko, Young Gwan; Yun, Dong Hwan

    2013-10-01

    The Geriatric Nutritional Risk Index (GNRI) is a screening tool for nutrition-related risk that correlates with mortality rate in hospitalized older patients and is simple, objective, and readily available to clinicians. In this study, we aimed to validate the performance of the GNRI in predicting short-term hospital mortality in older patients with sepsis. This observational study enrolled 401 older patients presenting with infection and systemic inflammatory response syndrome in an emergency department. Demographic, physiological, and laboratory data were collected. The GNRI score was categorized into five classes. The primary outcome was 28-day hospital mortality. Univariate and multivariate analyses were performed to identify clinical predictors of outcome. A logistic regression model was used. 51 patients (12.7%) died in the hospital within 28 days. Co-morbid metastatic cancer, heart rate, respiratory rate, temperature, serum creatinine, total lymphocyte count, and GNRI (nutritional support need in an acute-care setting. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  8. Use of Fitness and Nutrition Apps: Associations With Body Mass Index, Snacking, and Drinking Habits in Adolescents.

    Science.gov (United States)

    De Cock, Nathalie; Vangeel, Jolien; Lachat, Carl; Beullens, Kathleen; Vervoort, Leentje; Goossens, Lien; Maes, Lea; Deforche, Benedicte; De Henauw, Stefaan; Braet, Caroline; Eggermont, Steven; Kolsteren, Patrick; Van Camp, John; Van Lippevelde, Wendy

    2017-04-25

    Efforts to improve snacking and drinking habits are needed to promote a healthy body mass index (BMI) in adolescents. Although commercial fitness and nutrition mobile phone apps are widely used, little is known regarding their potential to improve health behaviors, especially in adolescents. In addition, evidence on the mechanisms through which such fitness and nutrition apps influence behavior is lacking. This study assessed whether the use of commercial fitness or nutrition apps was associated with a lower BMI and healthier snacking and drinking habits in adolescents. Additionally, it explored if perceived behavioral control to eat healthy; attitudes to eat healthy for the good taste of healthy foods, for overall health or for appearance; social norm on healthy eating and social support to eat healthy mediated the associations between the frequency of use of fitness or nutrition apps and BMI, the healthy snack, and beverage ratio. Cross-sectional self-reported data on snack and beverage consumption, healthy eating determinants, and fitness and nutrition app use of adolescents (N=889; mean age 14.7 years, SD 0.8; 54.8% [481/878] boys; 18.1% [145/803] overweight) were collected in a representative sample of 20 schools in Flanders, Belgium. Height and weight were measured by the researchers. The healthy snack ratio and the healthy beverage ratio were calculated as follows: gram healthy snacks or beverages/(gram healthy snacks or beverages+gram unhealthy snacks or beverages)×100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation. A total of 27.6% (245/889) of the adolescents used fitness, nutrition apps or both. Frequency of using nutrition apps was positively associated with a higher healthy beverage ratio (b=2.96 [1.11], P=.008) and a higher body mass index z-scores (zBMI; b=0.13 [0.05], P=.008. A significant interaction was found between the frequency of using nutrition and for

  9. Use of Fitness and Nutrition Apps: Associations With Body Mass Index, Snacking, and Drinking Habits in Adolescents

    Science.gov (United States)

    Vangeel, Jolien; Lachat, Carl; Beullens, Kathleen; Vervoort, Leentje; Goossens, Lien; Maes, Lea; Deforche, Benedicte; De Henauw, Stefaan; Braet, Caroline; Eggermont, Steven; Kolsteren, Patrick; Van Camp, John; Van Lippevelde, Wendy

    2017-01-01

    Background Efforts to improve snacking and drinking habits are needed to promote a healthy body mass index (BMI) in adolescents. Although commercial fitness and nutrition mobile phone apps are widely used, little is known regarding their potential to improve health behaviors, especially in adolescents. In addition, evidence on the mechanisms through which such fitness and nutrition apps influence behavior is lacking. Objectives This study assessed whether the use of commercial fitness or nutrition apps was associated with a lower BMI and healthier snacking and drinking habits in adolescents. Additionally, it explored if perceived behavioral control to eat healthy; attitudes to eat healthy for the good taste of healthy foods, for overall health or for appearance; social norm on healthy eating and social support to eat healthy mediated the associations between the frequency of use of fitness or nutrition apps and BMI, the healthy snack, and beverage ratio. Methods Cross-sectional self-reported data on snack and beverage consumption, healthy eating determinants, and fitness and nutrition app use of adolescents (N=889; mean age 14.7 years, SD 0.8; 54.8% [481/878] boys; 18.1% [145/803] overweight) were collected in a representative sample of 20 schools in Flanders, Belgium. Height and weight were measured by the researchers. The healthy snack ratio and the healthy beverage ratio were calculated as follows: gram healthy snacks or beverages/(gram healthy snacks or beverages+gram unhealthy snacks or beverages)×100. Multilevel regression and structural equation modeling were used to analyze the proposed associations and to explore multiple mediation. Results A total of 27.6% (245/889) of the adolescents used fitness, nutrition apps or both. Frequency of using nutrition apps was positively associated with a higher healthy beverage ratio (b=2.96 [1.11], P=.008) and a higher body mass index z-scores (zBMI; b=0.13 [0.05], P=.008. A significant interaction was found between the

  10. Differences in daily in-hospital physical activity and geriatric nutritional risk index in older cardiac inpatients: preliminary results.

    Science.gov (United States)

    Izawa, Kazuhiro P; Watanabe, Satoshi; Oka, Koichiro; Osada, Naohiko; Omiya, Kazuto; Brubaker, Peter H; Shimizu, Hiroyuki

    2014-12-01

    Little is known about the differences in the geriatric nutritional risk index (GNRI) status in older patients and their relationship to accelerometer-derived measures of physical activity (PA) levels. We determined both differences in daily measured PA based on the GNRI and related cut-off values for PA in elderly cardiac inpatients. We divided 235 consecutive elderly cardiac inpatients (mean age 73.6 years, men 70.6%) into four groups by age and GNRI: older-high group, 65-74 years with high GNRI (≥92 points) (n = 111); older-low group, low GNRI (nutritional status, as indicated by a low GNRI, may be a useful predictor of step counts and PAEE. The cut-off values determined in this study might be target values to be attained by older cardiac inpatients.

  11. Nutrition screening index for older adults (SCREEN II) demonstrates sex and age invariance.

    Science.gov (United States)

    Reimer, Holly D; Keller, Heather H; Maitland, Scott B; Jackson, Jessica

    2010-04-01

    Testing and refining nutrition screening tools that have demonstrated validity and reliability is important to ensure that mechanisms for allocating nutrition resources to those most in need are as efficient as possible. Using structural equation modelling, a nutrition screening instrument for community-dwelling seniors (SCREEN II) was tested to determine its factor structure and to understand how it measures nutrition risk. Further, this analysis was completed to identify a model that works equivalently for men and women and older and younger seniors. The screening tool was completed by 190 men and 417 women. Age groups (50-74 years, and 75+ years) were evenly split. Dietary intake and challenges influencing intake were identified as two factors representing the screening items. The final model showed good fit when tested for all participants. The model contained a core group of risk factors within SCREEN II that showed sex and age invariance. This set of risk factors can help guide refinement of nutrition screening instruments and is useful for health professionals to consider regularly as they work with community-dwelling older adults.

  12. Prognostic accuracy of WHO growth standards to predict mortality in a large-scale nutritional program in Niger.

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    Nathanael Lapidus

    2009-03-01

    Full Text Available BACKGROUND: Important differences exist in the diagnosis of malnutrition when comparing the 2006 World Health Organization (WHO Child Growth Standards and the 1977 National Center for Health Statistics (NCHS reference. However, their relationship with mortality has not been studied. Here, we assessed the accuracy of the WHO standards and the NCHS reference in predicting death in a population of malnourished children in a large nutritional program in Niger. METHODS AND FINDINGS: We analyzed data from 64,484 children aged 6-59 mo admitted with malnutrition (<80% weight-for-height percentage of the median [WH]% [NCHS] and/or mid-upper arm circumference [MUAC] <110 mm and/or presence of edema in 2006 into the Médecins Sans Frontières (MSF nutritional program in Maradi, Niger. Sensitivity and specificity of weight-for-height in terms of Z score (WHZ and WH% for both WHO standards and NCHS reference were calculated using mortality as the gold standard. Sensitivity and specificity of MUAC were also calculated. The receiver operating characteristic (ROC curve was traced for these cutoffs and its area under curve (AUC estimated. In predicting mortality, WHZ (NCHS and WH% (NCHS showed AUC values of 0.63 (95% confidence interval [CI] 0.60-0.66 and 0.71 (CI 0.68-0.74, respectively. WHZ (WHO and WH% (WHO appeared to provide higher accuracy with AUC values of 0.76 (CI 0.75-0.80 and 0.77 (CI 0.75-0.80, respectively. The relationship between MUAC and mortality risk appeared to be relatively weak, with AUC = 0.63 (CI 0.60-0.67. Analyses stratified by sex and age yielded similar results. CONCLUSIONS: These results suggest that in this population of children being treated for malnutrition, WH indicators calculated using WHO standards were more accurate for predicting mortality risk than those calculated using the NCHS reference. The findings are valid for a population of already malnourished children and are not necessarily generalizable to a population of

  13. Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index.

    Science.gov (United States)

    García-Solís, Pablo; Solís-S, Juan Carlos; García-Gaytán, Ana Cristina; Reyes-Mendoza, Vanessa A; Robles-Osorio, Ludivina; Villarreal-Ríos, Enrique; Leal-García, Luisa; Hernández-Montiel, Hebert Luis

    2013-08-01

    To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

  14. Diagnostic and prognostic values of the V-index, a novel ECG marker quantifying spatial heterogeneity of ventricular repolarization, in patients with symptoms suggestive of non-ST-elevation myocardial infarction.

    Science.gov (United States)

    Abächerli, Roger; Twerenbold, Raphael; Boeddinghaus, Jasper; Nestelberger, Thomas; Mächler, Patrick; Sassi, Roberto; Rivolta, Massimo W; Roonizi, Ebadollah Kheirati; Mainardi, Luca T; Kozhuharov, Nikola; Rubini Giménez, Maria; Wildi, Karin; Grimm, Karin; Sabti, Zaid; Hillinger, Petra; Puelacher, Christian; Strebel, Ivo; Cupa, Janosch; Badertscher, Patrick; Roux, Isabelle; Schmid, Ramun; Leber, Remo; Osswald, Stefan; Mueller, Christian; Reichlin, Tobias

    2017-06-01

    The V-index is an ECG marker quantifying spatial heterogeneity of ventricular repolarization. We prospectively assessed the diagnostic and prognostic values of the V-index in patients with suspected non-ST-elevation myocardial infarction (NSTEMI). We prospectively enrolled 497 patients presenting with suspected NSTEMI to the emergency department (ED). Digital 12-lead ECGs of five-minute duration were recorded at presentation. The V-index was automatically calculated in a blinded fashion. Patients with a QRS duration >120ms were ruled out from analysis. The final diagnosis was adjudicated by two independent cardiologists. The prognostic endpoint was all-cause mortality during 24months of follow-up. NSTEMI was the final diagnosis in 14% of patients. V-index levels were higher in patients with AMI compared to other causes of chest pain (median 23ms vs. 18ms, pV-index in addition to conventional ECG-criteria improved the diagnostic accuracy for the diagnosis of NSTEMI as quantified by area under the ROC curve from 0.66 to 0.73 (p=0.001) and the sensitivity of the ECG for AMI from 41% to 86% (pV-index (pV-index remained an independent predictor of death. The V-index, an ECG marker quantifying spatial heterogeneity of ventricular repolarization, significantly improves the accuracy and sensitivity of the ECG for the diagnosis of NSTEMI and independently predicts mortality during follow-up. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. PROGNOSTIC VALUE OF THE BASELINE VALUES OF SERUM TESTOSTERONE AND FREE ANDROGEN INDEX IN PATIENTS WITH PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    M. E. Grigoryev

    2012-01-01

    Full Text Available The growing incidence of prostate cancer (PC and its variable nature are an important problem today. PC is distinguished by its latent ability in many cases, which makes its screening difficult.Prostate-specific antigen (PSA is one of the most common tumor markers of PC, which are used for mass male screening. However, the detection rate of PC in men with normal PSA values is also very high. This promotes an active search for new markers and predictors of PC.The effect of androgens on hormonal carcinogenesis in the prostate suggests that the analysis of serum testosterone concentrations and free androgen index may be made in patients with low PSA levels in the early diagnosis and prognosis of PC.

  16. Body mass index and nutritional status of the Bayash Roma from eastern Croatia.

    Science.gov (United States)

    Zajc, Matea; Narancić, Nina Smolej; Skarić-Jurić, Tatjana; Milicić, Jasna; Barbalić, Maja; Salopek, Kristina Meljanac; Klarić, Irena Martinović; Janićijević, Branka

    2006-12-01

    This study examines anthropometrically assessed nutritional status of the Bayash, the Roma population from the eastern Croatian region of Baranya, and compares it to the non-Roma general population of eastern Croatia. The analysis of nutritional status and diets is a segment of multidisciplinary anthropological and epidemiological survey of the Roma minority population in Croatia began in 2005. The Bayash are an ethnic group that arrived to Croatia from Romania most likely in the 19th century and speaks a distinct archaic dialect of the Romanian language. The Roma population of Baranya approximates 1,000 according to the 2001 census. The Bayash sample comprised 227 adults aged 18-65yrs. The women fall below the Croatian 10th percentile for stature and men track about the 10th percentile. Both sexes approximate the 25th percentile for body weight. Despite their diminutive size, the Bayash appear to have adequate nutritional status until the age of 35yrs after which their average BMI exceeds the value of 25 kg/m(2) and falls in the overweight category. However, 8% of Bayash are underweight (BMIor=30.0) of 23% is approximately equal. Overall unsatisfactory nutritional status of the Bayash merits attention. It appears to be the product of unhealthy dietary habits and their socio-economic deprivation that resulted from their poor education and extremely high unemployment.

  17. Relationship of nutritional risk, Body Mass Index (BMI), and cognitive functioning in preschoolers

    Science.gov (United States)

    Objective: To determine the relationships, if any, between nutritional risk, BMI z-score, and cognitive function in preschoolers. Background: Excessive adipose tissue found in obesity places children at increased health risk. Considerable research has documented that obesity leads to increased ri...

  18. Nutrition Education and Body Mass Index in Grades K-12: A Systematic Review

    Science.gov (United States)

    Price, Cayla; Cohen, Deborah; Pribis, Peter; Cerami, Jean

    2017-01-01

    Background: Overweight and obese body mass index (BMI) status affects an increasing number of children in the United States. The school setting has been identified as a focus area to implement obesity prevention programs. Methods: A database search of PubMed, Education Search Complete, and Cumulative Index to Nursing and Allied Health Literature…

  19. Nutrition.

    Science.gov (United States)

    Saur, Susan

    An elementary level nutrition unit provides teachers with student background information, suggested activities, and student worksheets. Part 1 focuses on the relationship of food to growth, health, and energy. In part 2, students learn about the four main food groups. Part 3 deals with nutrients and provides information about carbohydrates, fats,…

  20. Modification of Simplified Pulmonary Embolism Severity Index and its Prognostic Value in Patients with Acute Pulmonary Embolism.

    Science.gov (United States)

    Ostovan, Mohammad Ali; Ghaffari, Samad; Pourafkari, Leili; Dehghani, Pooyan; Hajizadeh, Reza; Nadiri, Mehdi; Ghaffari, Mohammad Reza

    2016-02-01

    Various risk stratification systems have been used to predict the clinical outcome of patients with pulmonary embolism (PE). In this study we present a modification of the simplified Pulmonary Embolism Severity Index (S-PESI) score and evaluate its accuracy in predicting the outcome of these patients. Patients older than 18 years with documented PE were enrolled in this study. S-PESI was calculated in all patients. We added electrocardiographic evidence of right ventricular strain as a new criteria and replaced the O2 saturation of <90% in S-PESI score with PaO2 /PaCO2 ratio obtained from the arterial blood gas analysis as two newly modified criteria to define a modified form of S-PESI system (modified s-PESI). Patients were followed for about one year in outpatient clinics. Any deaths attributable to PE or for unknown reasons were considered as PE related. We defined Major Adverse Cardio-Pulmonary Events (MACPE) as sum of one-year mortality, need for thrombolysis and mechanical ventilation during index hospitalisation. Among 300 enrolled patients, in-hospital mortality occurred in 38 (12.7%) and one-year mortality in 73 (24.3%) patients. Considering a cut-off point of 3, modified s-PESI score had a lower sensitivity (49.3% vs. 89%) and higher specificity (79.4% vs. 37.7%) than S-PESI to predict one-year mortality. Area Under Curve (AUC) to predict MACPE was significantly higher for modified s-PESI (0.692 vs 0.730, P=0.012). The modified s-PESI is superior to S-PESI in predicting one-year outcome in patients with PE and can be used for more accurate risk stratification of these patients. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  1. Nutritional risk index as an independent predictive factor for the development of surgical site infection after pancreaticoduodenectomy.

    Science.gov (United States)

    Shinkawa, Hiroji; Takemura, Shigekazu; Uenishi, Takahiro; Sakae, Masayuki; Ohata, Kazunori; Urata, Yorihisa; Kaneda, Kazuhisa; Nozawa, Akinori; Kubo, Shoji

    2013-03-01

    Malnutrition has been considered a risk factor for the development of a surgical site infection (SSI). The aim of this study was to determine the relationship between preoperative nutritional screening scores and the development of SSI after pancreaticoduodenectomy. We examined 64 patients who had undergone pancreaticoduodenectomy. Their clinical data, nutritional risk index (NRI), and nutritional risk screening 2002 (NRS-2002) score were recorded. SSIs were diagnosed according to the definitions of wound infection established by the Center for Disease Control and Prevention and were confirmed by a microbiological examination. Data were analyzed using the Fisher exact probability method and a multivariate logistic regression analysis. SSIs developed in 21 patients (33 %). Eleven patients had wound infections, and 14 patients had an intra-abdominal abscess. A univariate analysis of perioperative factors revealed that a pancreatic fistula, the NRS-2002, and the NRI were significantly associated with the development of SSI (p risk factors for SSI. By analyzing the pre- and intra-operative factors after excluding the 11 patients with pancreatic fistulas, the NRI was still an independent risk factor for SSI. The present study showed the NRI to be an independent factor for predicting the risk of SSI after pancreaticoduodenectomy.

  2. Prognostic factors in acute mesenteric ischemia and evaluation with Mannheim Peritonitis Index and platelet-to-lymphocyte ratio.

    Science.gov (United States)

    Yılmaz, Eyüp Murat; Cartı, Erdem Barış

    2017-07-01

    Acute mesenteric ischemia (AMI) is a disease that has a very high mortality rate and for which the diagnosis is frequently delayed. The aim of the present study was to assess the predictive value of the Mannheim Peritonitis Index (MPI) and platelet-to-lymphocyte (P/L) ratio in the prognosis of AMI. The files of 34 patients diagnosed with AMI between September 2014 and April 2016 were retrospectively examined. The patients were divided into 2 groups based on survival. The parameters of MPI and P/L ratio, demographic data, and duration of hospitalization were recorded and compared. In all, 19 (55.9%) patients were male, and 15 (44.1%) were female. Total of 19 patients (55.9%) were discharged with a complete recovery, while 15 (44.1%) died. MPI mean value was 21.13±7.55 and 16.00±5.24 in those who died and survived, respectively (p=0.026). P/L ratio was 288.48±233.01 and 373.82±389.62 in those who survived and died, respectively (p=0.045). MPI and P/L ratio are simple and reliable methods to predict the prognosis of AMI.

  3. Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.

    Science.gov (United States)

    Koefoed, Mette; Kromann, Charles Boy; Juliussen, Sophie Ryberg; Hvidtfeldt, Danni; Ekelund, Bo; Frandsen, Niels Erik; Marckmann, Peter

    2016-01-01

    Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment. In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences), and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12) as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44). Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55). Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19). The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.

  4. Physical Activity, Sedentary Behaviors, and Nutritional Risk Profiles and Relations to Body Mass Index, Obesity, and Overweight in Eighth Grade.

    Science.gov (United States)

    Berlin, Kristoffer S; Kamody, Rebecca C; Thurston, Idia B; Banks, Gabrielle G; Rybak, Tiffany M; Ferry, Robert J

    2017-01-01

    The objective of this article was to determine (1) the existence of individually varying patterns of physical activity, sedentary behavior, and nutrition intake risk; and (2) how these risk-patterns relate to youth's demographics, Body mass index (BMI) and psychosocial functioning. Participants (N = 9,304) from the 2007 8th Grade Early Childhood Longitudinal Study Cohort completed the revised Self-Description Questionnaire II. Age, sex, height, and weight were used to calculate body mass index (BMI) z scores and percentiles. Three risk profiles emerged via Latent Profile Analyses: "Active + Healthy Diet" (AHD; 16.3% Obese); "Sedentary + Unbalanced Diet" (SUD; 21.3% Obese); and "Screen-Time + Recreational Food" (STRF; 25.0% Obese). Significant differences in BMIs, psychosocial factors, and demographic characteristics were found across the profiles. Differential patterns of physical activity, sedentary behavior, and nutritional choices were found to predict BMI and psychosocial functioning. These findings may be helpful to refine and develop modular-based prevention and weight control intervention programs.

  5. Prognostic significance of the complex "Visceral Adiposity Index" vs. simple anthropometric measures: Tehran lipid and glucose study.

    Science.gov (United States)

    Mohammadreza, Bozorgmanesh; Farzad, Hadaegh; Davoud, Khalili; Fereidoun Prof, Azizi Fereidoun

    2012-03-07

    Visceral adiposity index (VAI) has recently been suggested to be used as a surrogate of visceral adiposity. We examined if VAI could improve predictive performances for CVD of the Framingham's general CVD algorithm (a multivariate model incorporating established CVD risk factors). We compared the predictive abilities of the VAI with those of simple anthropometric measures i.e. BMI, waist-to-height ratio (WHtR) or waist-to-hip ratio (WHpR). In a nine-year population-based follow-up, 6,407 (2,778 men) participants, free of CVD at baseline, aged≥30 years were eligible for the current analysis. The risk of CVD was estimated by incorporating VAI, BMI, WHpR, and WHtR, one at a time, into multivariate accelerated failure time models. We documented 534 CVD events with the annual incidence rate (95%CIs) being 7.3 (6.4-8.3) among women and 13.0 (11.7-14.6) among men. Risk of future CVD increased with increasing levels of VAI among both men and women. VAI was associated with multivariate-adjusted increased risk of incident CVD among women. However, the magnitude of risk conferred by VAI was not significantly higher than those conferred by BMI, WHpR, or WHtR. Among men, after adjustment for established CVD risk factors, VAI was no longer associated with increased risk of CVD. VAI failed to add to the predictive ability of the Framingham general CVD algorithm. Using VAI instead of simple anthropometric measures may lead to loss of much information needed for predicting incident CVD.

  6. Delta neutrophil index as a promising prognostic marker of emergent surgical intervention for acute diverticulitis in the emergency department.

    Science.gov (United States)

    Kang, Hee Seung; Cha, Yong Sung; Park, Kyung Hye; Hwang, Sung Oh

    2017-01-01

    Early identification of patients with acute diverticulitis who require emergent surgical intervention in the emergency department (ED) is important to the physician. Although computed tomography (CT) has an important role in evaluating the severity of diverticulitis, its findings alone may not predict the need for emergent surgical intervention in all patients with acute diverticulitis in the ED. Serum inflammation markers may help to differentiate severity of acute diverticulitis and predict the need for surgical intervention in clinical practice. No information is currently available on the clinical usefulness of the delta neutrophil index (DNI), with respect to the prediction of emergent surgical intervention in patients with acute diverticulitis at the ED. This was a retrospective observational study of consecutive adult patients with acute diverticulitis confirmed by CT in the ED, between January 2014 and December 2016. Recruited patients were divided into two groups: emergent surgical intervention and no surgical intervention. The following laboratory serum parameters were examined in the ED: DNI value, C-reactive protein (CRP) levels, white blood cell count, neutrophil count, and neutrophil-to-lymphocyte ratio (NLR). The patients were also examined for the presence or absence of complications by CT. A total of 132 patients were finally included in the study, with the emergent surgical intervention group constituting 52 patients. The median DNI value, CRP levels, neutrophil count, and NLR were significantly higher in the emergent surgical intervention group than in the no surgical intervention group. The area under the curve for predicting emergent surgical intervention, using the DNI was significantly higher than that of CRP levels, neutrophil count, or NLR. Moreover, the combination of initial DNI and CT was most powerful diagnostic modality. DNI values measured at the ED combined with CT were good predictors for emergent surgical intervention in acute

  7. Heated apple juice supplemented with onion has greatly improved nutritional quality and browning index.

    Science.gov (United States)

    Lee, Bonggi; Seo, Jeong Dae; Rhee, Jin-Kyu; Kim, Choon Young

    2016-06-15

    Although fruit juices are very popular, enzymatic browning occurs easily. Browning of fruit juice deteriorates nutrition value and product quality due to oxidation of polyphenol compounds. Therefore, development of natural food additives that reduce browning will be beneficial for improving quality of fruit juices. Onion has been reported to be a potent natural anti-browning agent. Here, we compared unheated and heated apple juices pre-supplemented with onion with respect to browning and nutritional quality. The unheated apple juice supplemented with onion showed reduced browning as well as increased total soluble solid, total phenol concentration, radical scavenging activities, and ferric reducing and copper chelating activities without any change in flavonoid concentration. On the other hand, heated juice supplemented with onion not only showed improved values for these parameters but also markedly increased flavonoid concentration. Thus, we conclude that application of heating and onion addition together may greatly improve quality of apple juice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Delta neutrophil index as a promising prognostic marker of emergent surgical intervention for acute diverticulitis in the emergency department.

    Directory of Open Access Journals (Sweden)

    Hee Seung Kang

    Full Text Available Early identification of patients with acute diverticulitis who require emergent surgical intervention in the emergency department (ED is important to the physician. Although computed tomography (CT has an important role in evaluating the severity of diverticulitis, its findings alone may not predict the need for emergent surgical intervention in all patients with acute diverticulitis in the ED. Serum inflammation markers may help to differentiate severity of acute diverticulitis and predict the need for surgical intervention in clinical practice. No information is currently available on the clinical usefulness of the delta neutrophil index (DNI, with respect to the prediction of emergent surgical intervention in patients with acute diverticulitis at the ED.This was a retrospective observational study of consecutive adult patients with acute diverticulitis confirmed by CT in the ED, between January 2014 and December 2016. Recruited patients were divided into two groups: emergent surgical intervention and no surgical intervention. The following laboratory serum parameters were examined in the ED: DNI value, C-reactive protein (CRP levels, white blood cell count, neutrophil count, and neutrophil-to-lymphocyte ratio (NLR. The patients were also examined for the presence or absence of complications by CT.A total of 132 patients were finally included in the study, with the emergent surgical intervention group constituting 52 patients. The median DNI value, CRP levels, neutrophil count, and NLR were significantly higher in the emergent surgical intervention group than in the no surgical intervention group. The area under the curve for predicting emergent surgical intervention, using the DNI was significantly higher than that of CRP levels, neutrophil count, or NLR. Moreover, the combination of initial DNI and CT was most powerful diagnostic modality.DNI values measured at the ED combined with CT were good predictors for emergent surgical intervention

  9. Effect of Parental Migration Background on Childhood Nutrition, Physical Activity, and Body Mass Index

    Directory of Open Access Journals (Sweden)

    Mohsen Besharat Pour

    2014-01-01

    Full Text Available Background. Poor nutrition, lack of physical activity, and obesity in children have important public health implications but, to date, their effects have not been studied in the growing population of children in Sweden with immigrant parents. Methods. We estimated the association between parental migration background and nutrition, physical activity, and weight in 8-year-old children born in Stockholm between 1994 and 1996 of immigrants and Swedish parents (n=2589. Data were collected through clinical examination and questionnaires filled out by parents. Odds ratios (ORs and 95% confidence intervals (95% CIs were calculated using multivariable logistic regression. Results. Children of immigrants complied more closely with Nordic Nutrition Recommendations compared with those of Swedes (OR = 1.35, 95% CI 1.11–1.64. They had higher intake of dietary fibre, vitamins C, B6, and E, folic acid, and polyunsaturated fatty acids (omega-3 and omega-6 reflecting higher consumption of foods of plant origin, but lower intake of vitamins A and D, calcium, and iron reflecting lower consumption of dairy products. Children of immigrants had higher intake of sucrose reflecting higher consumption of sugar and sweets. Furthermore, these children had a higher risk of having low physical activity (OR = 1.31, 95% CI 1.06–1.62 and being overweight (OR = 1.33, 95% CI 1.06–1.65 compared with children of Swedish parents. The odds of having low physical activity and being overweight were even higher in children whose parents were both immigrants. A low level of parental education was associated with increased risk of low physical activity regardless of immigration background. Conclusions. Culturally appropriate tools to capture the diverse range of ethnic foods and other lifestyle habits are needed. Healthcare professionals should be aware of the low levels of physical activity, increased weight, and lack of consumption of some important vitamins among children of

  10. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study

    OpenAIRE

    Kiuchi, Aki; Ohashi, Yasushi; Tai, Reibin; Aoki, Toshiyuki; Mizuiri, Sonoo; Ogura, Toyoko; Aikawa, Atsushi; Sakai, Ken

    2016-01-01

    Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005–2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) < 92; these patients were ...

  11. Prognostic significance of serum uric acid in outpatients with chronic heart failure is complex and related to body mass index: data from the IN-CHF Registry.

    Science.gov (United States)

    Baldasseroni, S; Urso, R; Maggioni, A P; Orso, F; Fabbri, G; Marchionni, N; Tavazzi, L

    2012-05-01

    In the field of cardiovascular diseases, elevated levels of serum uric acid (UA) reflect a marked activation of the xanthine oxidase pathway with increase in free radicals production; it is often associated with an inflammatory state, oxygen consumption and endothelial dysfunction. All these associations have been also confirmed in heart failure (HF) but the pathophysiological role of UA in this setting is not well understood. The aim of this study was to evaluate the prognostic role of UA in outpatients enrolled in the Italian Registry of Congestive Heart Failure (IN-CHF). All patients met the European Society of Cardiology (ESC) criteria for diagnosis of HF. We considered patients with complete clinical data and UA level available at the baseline and at 1-year follow-up. The study population was composed of 877 patients aged 63 ± 12 years. One-year mortality was 10.8% and dead patients had a higher level of UA than survivors (7.1 mg dl⁻¹ vs 6.6 mg dl⁻¹, p < 0.0207). In multivariable full model of analysis, UA did not result in an independent predictor of death in overall population, but only in patients with low body mass index (BMI) (≤22 kg m⁻²) (hazard ratio (HR): 2.38, 95% confidence interval (CI) 1.36-4.18). In this subgroup, a statistically significant gradual relationship between UA and survival was detected starting from values higher than 8 mg dl⁻¹. Elevated level of UA is not an independent predictor of mortality in chronic HF, but it markedly worsens outcome if associated with low level of BMI. This association is likely an indicator of chronic inflammatory and catabolic state. Copyright © 2010 Elsevier B.V. All rights reserved.

  12. Systematic review of prognostic roles of body mass index for patients undergoing lung cancer surgery: does the 'obesity paradox' really exist?

    Science.gov (United States)

    Li, Shuangjiang; Wang, Zhiqiang; Huang, Jian; Fan, Jun; Du, Heng; Liu, Lunxu; Che, Guowei

    2017-05-01

    The paradoxical benefit of obesity, the 'obesity paradox', has been recently identified in surgical populations. Our goal was to evaluate by a systematic review with meta-analysis the prognostic role of body mass index (BMI) and to identify whether the 'obesity paradox' exists in lung cancer surgery. Comprehensive literature retrieval was conducted in PubMed to identify the eligible articles. The odds ratios (OR) and hazard ratios (HR) with the corresponding 95% confidence intervals (CI) were used to synthesize in-hospital and long-term survival outcomes, respectively. The heterogeneity level and publication bias between studies were also estimated. Finally, 25 observational studies with 78 143 patients were included in this review. The pooled analyses showed a significantly better long-term survival rate in patients with higher BMI, but no significant benefit of increased BMI was found for in-hospital morbidity. The pooled analyses also showed that overall morbidity (OR: 0.84; 95% CI: 0.73-0.98; P  =   0.025) and in-hospital mortality (OR: 0.78; 95% CI: 0.63-0.98; P  =   0.031) were significantly decreased in obese patients. Obesity could be a strong predictor of the favourable long-term prognosis of lung cancer patients (HR: 0.69; 95% CI: 0.56-0.86; P  =   0.001). The robustness of these pooled estimates was strong. No publication bias was detected. In summary, obesity has favourable effects on in-hospital outcomes and long-term survival of surgical patients with lung cancer. The 'obesity paradox' does have the potential to exist in lung cancer surgery.

  13. Production Efficiency of Cocoon Shell of Silkworm, Bombyx mori L. (Bombycidae: Lepidoptera, as an Index for Evaluating the Nutritive Value of Mulberry, Morus sp. (Moraceae, Varieties

    Directory of Open Access Journals (Sweden)

    Jalaja Suresh Kumar

    2011-01-01

    Full Text Available The nutritional efficiency of mulberry leaves consumed by silkworms, Bombyx mori L., is usually evaluated in terms of the proportion of cocoon shell weight to the amount of food ingested. The production efficiency of cocoon shell is generally used to identify the superiority of a mulberry variety for silkworm rearing. In this study the production efficiency of cocoon shell was used as an index for evaluating the nutritive value of different mulberry varieties of India. Among the varieties, V-1, having highest production efficiency of cocoon shell with less amount of food ingested and highest digestibility, is regarded as the best suitable variety with nutritive values ideal for silkworm rearing.

  14. Impact of nutritional index on the association between phosphorus concentrations and mortality in haemodialysis patients: a cohort study from dialysis outcomes and practice pattern study in Japan.

    Science.gov (United States)

    Fukuma, Shingo; Ikenoue, Tatsuyoshi; Akizawa, Tadao; Fukuhara, Shunichi

    2017-08-07

    While maintenance of both phosphorus concentration and nutritional status is a major concern in managing haemodialysis patients, the interaction between these parameters is not well understood. The aim of this study was to assess whether or not nutritional index influences the association between phosphorus concentration and all-cause mortality. A cohort study. The Dialysis Outcomes and Practice Pattern Study, which included 99 representative dialysis facilities in Japan between 1997 and 2010. A total of 6230 adult haemodialysis patients who had spent at least 6 months on haemodialysis. Six categories based on time-averaged factors of the geriatric nutritional risk index (GNRI; the lowest two and highest tertiles) and phosphorus concentration (risk due to interaction (RERI) between high phosphorus concentrations and low-middle GNRI was -0.57, indicating an antagonistic interaction. We also observed a significant statistical multiplicative interaction between phosphorus concentrations and GNRI (p=0.05 by likelihood ratio test). The association between time-averaged serum phosphorus concentration and all-cause mortality differs across the nutritional index. Accordingly, nutritional index should be considered when the impact of phosphorus concentration on mortality in haemodialysis patients is evaluated. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  16. Comparison of the prognostic value of liver biopsy and FIB-4 index in patients coinfected with HIV and hepatitis C virus.

    Science.gov (United States)

    Berenguer, Juan; Zamora, Francisco X; Aldámiz-Echevarría, Teresa; Von Wichmann, Miguel A; Crespo, Manel; López-Aldeguer, José; Carrero, Ana; Montes, Marisa; Quereda, Carmen; Téllez, María J; Galindo, María J; Sanz, José; Santos, Ignacio; Guardiola, Josep M; Barros, Carlos; Ortega, Enrique; Pulido, Federico; Rubio, Rafael; Mallolas, Josep; Tural, Cristina; Jusdado, Juan J; Pérez, Gloria; Díez, Cristina; Álvarez-Pellicer, Julio; Esteban, Herminia; Bellón, José M; González-García, Juan

    2015-03-15

    We compared the prognostic value of liver biopsy (LB) and FIB-4 index in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection. We studied patients from the Grupo de Estudio del SIDA 3603 study cohort, in whom fibrosis was evaluated at baseline using both LB (Metavir score) and FIB-4 index. We assessed overall death (OD) and liver-related events (LREs), defined as decompensation or hepatocellular carcinoma, whichever occurred first. We used receiver operating characteristic (ROC) curves to determine the ability of LB and FIB-4 to predict outcomes. We also assessed the association between advanced fibrosis-LB (F3 or greater) or FIB-4 (≥3.25)-and outcomes using multivariate Cox regression analysis. The study sample comprised 903 patients (328 with sustained virologic response [SVR]). Baseline fibrosis by LB was as follows: F0, n = 71; F1, n = 242; F2, n = 236; F3, n = 236; F4, n = 118. Fibrosis by FIB-4 was as follows: ≤1, n = 148; >1 to <3.25, n = 597; ≥3.25, n = 158. After a median follow-up of 62 months, there were 46 deaths and 71 LREs. The area under the ROC curves for OD/LREs was 0.648 and 0.742 for LB and FIB-4, respectively (P = .006). Similar results were found for patients without SVR and for OD and LREs separately. The adjusted hazard ratios of OD or LRE were 1.740 (95% confidence interval [CI], 1.119-2.7.06; P = .014) for advanced fibrosis assessed by LB and 3.896 (95% CI, 2.463-6.160; P < .001) assessed by FIB-4. FIB-4 outperformed LB as a predictor of OD and LRE. These findings are of relevance for clinical practice and research and call into question the role of LB as a gold standard for assessing prognosis in HIV/HCV coinfection. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. Assessment of nutritional intake, body mass index and glycemic control in patients with type-2 diabetes from northern Tanzania.

    Science.gov (United States)

    Hoffmeister, Michael; Lyaruu, Isaack A; Krawinkel, Michael B

    2005-01-01

    Little information is available about the nutrition of people with diabetes from Africa. For the treatment and prevention of diabetes by nutrition, we have assessed the major local foods in a baseline study. The staple foods and meal frequencies of 53 outpatients with type-2 diabetes were assessed in a 24-hour dietary recall based on a questionnaire at a diabetes clinic in northern Tanzania in November and December 1999. In addition, data on weight and height, casual blood glucose, urinary glucose and diabetes therapy were ascertained. 72% of the patients had a body mass index of > or =25 kg/m(2); 64% of patients had casual blood glucose levels of >7.8 mmol/l, 47% had >11.1 mmol/l, and most of them were treated by sulfonylureas or conventional insulin therapy. The test for urinary glucose highly correlated with the blood glucose values, and was positive in 59% of patients. 36% of the patients had milk, amaranth leaves, orange and sunflower oil. The main beverages were water, tea and milk. The baseline data obtained enable more precise dietary assessment and emphasize the need to collect more data on local food consumption in areas where pharmacological diabetes treatment is limited. Copyright 2005 S. Karger AG, Basel.

  18. The relationship between dental status, food selection, nutrient intake, nutritional status, and body mass index in older people

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    Wagner Marcenes

    2003-05-01

    Full Text Available This paper reviewed the findings from a national survey in Great Britain which assessed whether dental status affected older people's food selection, nutrient intake, and nutritional status. The survey analyzed national random samples of free-living and institution subjects for dental examination, interview, and four-day food diary as well as blood and urine tests In the free-living sample, intakes of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C were significantly lower in edentulous as compared to dentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly non-starch polysaccharides. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and retinol were the only analytes significantly associated with dental status. Having 21 or more teeth increased the likelihood of having an acceptable body mass index (BMI. Thus, maintaining a natural and functional dentition defined as having more than twenty teeth into old age plays an important role in having a healthy diet rich in fruits and vegetables, a satisfactory nutritional status, and an acceptable BMI.

  19. Primer on dietary carbohydrates and utility of the glycemic index in equine nutrition.

    Science.gov (United States)

    Harris, Patricia; Geor, Raymond J

    2009-04-01

    The feeding of "low carbohydrate" or "low glycemic" diets has been recommended for management of horses with metabolic and endocrine disorders in which insulin resistance is a component. A "low carbohydrate" diet is a misnomer, however, because horses require that a significant proportion of their daily ration comprises structural carbohydrates (fiber/forage) to maintain gut health and mental wellbeing. This article provides a detailed description of the different carbohydrates in equine feeds. It also reviews the terminology used to describe glucose and insulin responses to the ingestion of carbohydrates, in particular the concept of the glycemic index. Some of the factors that influence glycemic index in humans and the glycemic response to a meal in horses are also discussed.

  20. Redox homeostasis in stomach medium by foods: The Postprandial Oxidative Stress Index (POSI for balancing nutrition and human health

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    Joseph Kanner

    2017-08-01

    Full Text Available Red-meat lipid peroxidation in the stomach results in postprandial oxidative stress (POS which is characterized by the generation of a variety of reactive cytotoxic aldehydes including malondialdehyde (MDA. MDA is absorbed in the blood system reacts with cell proteins to form adducts resulting in advanced lipid peroxidation end products (ALEs, producing dysfunctional proteins and cellular responses. The pathological consequences of ALEs tissue damage include inflammation and increased risk for many chronic diseases that are associated with a Western-type diet. In earlier studies we used the simulated gastric fluid (SGF condition to show that the in vitro generation of MDA from red meat closely resembles that in human blood after consumption the same amount of meat. In vivo and in vitro MDA generations were similarly suppressed by polyphenol-rich beverages (red wine and coffee consumed with the meal. The present study uses the in vitro SGF to assess the capacity of more than 50 foods of plant origin to suppress red meat peroxidation and formation of MDA. The results were calculated as reducing POS index (rPOSI which represents the capacity in percent of 100 g of the food used to inhibit lipid peroxidation of 200 g red-meat a POSI enhancer (ePOSI. The index permitted to extrapolate the need of rPOSI from a food alone or in ensemble such Greek salad, to neutralize an ePOSI in stomach medium, (ePOS–rPOSI=0. The correlation between the rPOSI and polyphenols in the tested foods was R2=0.75. The Index was validated by comparison of the predicted rPOSI for a portion of Greek salad or red-wine to real inhibition of POS enhancers. The POS Index permit to better balancing nutrition for human health.

  1. Redox homeostasis in stomach medium by foods: The Postprandial Oxidative Stress Index (POSI) for balancing nutrition and human health.

    Science.gov (United States)

    Kanner, Joseph; Selhub, Jacob; Shpaizer, Adi; Rabkin, Boris; Shacham, Inbal; Tirosh, Oren

    2017-08-01

    Red-meat lipid peroxidation in the stomach results in postprandial oxidative stress (POS) which is characterized by the generation of a variety of reactive cytotoxic aldehydes including malondialdehyde (MDA). MDA is absorbed in the blood system reacts with cell proteins to form adducts resulting in advanced lipid peroxidation end products (ALEs), producing dysfunctional proteins and cellular responses. The pathological consequences of ALEs tissue damage include inflammation and increased risk for many chronic diseases that are associated with a Western-type diet. In earlier studies we used the simulated gastric fluid (SGF) condition to show that the in vitro generation of MDA from red meat closely resembles that in human blood after consumption the same amount of meat. In vivo and in vitro MDA generations were similarly suppressed by polyphenol-rich beverages (red wine and coffee) consumed with the meal. The present study uses the in vitro SGF to assess the capacity of more than 50 foods of plant origin to suppress red meat peroxidation and formation of MDA. The results were calculated as reducing POS index (rPOSI) which represents the capacity in percent of 100g of the food used to inhibit lipid peroxidation of 200g red-meat a POSI enhancer (ePOSI). The index permitted to extrapolate the need of rPOSI from a food alone or in ensemble such Greek salad, to neutralize an ePOSI in stomach medium, (ePOS-rPOSI=0). The correlation between the rPOSI and polyphenols in the tested foods was R2=0.75. The Index was validated by comparison of the predicted rPOSI for a portion of Greek salad or red-wine to real inhibition of POS enhancers. The POS Index permit to better balancing nutrition for human health. Copyright © 2017. Published by Elsevier B.V.

  2. Multidimensional Prognostic Index in Association with Future Mortality and Number of Hospital Days in a Population-Based Sample of Older Adults: Results of the EU Funded MPI_AGE Project.

    Science.gov (United States)

    Angleman, Sara B; Santoni, Giola; Pilotto, Alberto; Fratiglioni, Laura; Welmer, Anna-Karin

    2015-01-01

    The Multidimensional Prognostic Index (MPI) has been found to predict mortality in patients with a variety of clinical conditions. We aimed to assess the association of the MPI with future mortality and number of in-hospital days for the first time in a population-based cohort. The study population consisted of 2472 persons, aged 66-99 years, from the Swedish National Study on Aging and Care in Kungsholmen, Sweden, who underwent the baseline visit 2001-4, and were followed up >10 years for in-hospital days and >12 years for mortality. The MPI was a modified version of the original and aggregated seven domains (personal and instrumental activities of daily living, cognitive function, illness severity and comorbidity, number of medications, co-habitation status, and nutritional status). The MPI score was divided into risk groups: low, medium and high. Number of in-hospital days (within 1, 3 and 10 years) and mortality data were derived from official registries. All analyses were age-stratified (sexagenarians, septuagenarians, octogenarians, nonagenarians). During the follow-up 1331 persons (53.8%) died. Laplace regression models, suggested that median survival in medium risk groups varied by age from 2.2-3.6 years earlier than for those in the corresponding low risk groups (p = 0.002-p<0.001), and median survival in high risk groups varied by age from 3.8-9.0 years earlier than for corresponding low risk groups (p<0.001). For nonagenarians, the median age at death was 3.8 years earlier in the high risk group than for the low risk group (p<0.001). The mean number of in-hospital days increased significantly with higher MPI risk score within 1 and 3 years for people of each age group. For the first time, the effectiveness of MPI has been verified in a population-based cohort. Higher MPI risk scores associated with more days in hospital and with fewer years of survival, across a broad and stratified age range.

  3. Multidimensional Prognostic Index in Association with Future Mortality and Number of Hospital Days in a Population-Based Sample of Older Adults: Results of the EU Funded MPI_AGE Project.

    Directory of Open Access Journals (Sweden)

    Sara B Angleman

    Full Text Available The Multidimensional Prognostic Index (MPI has been found to predict mortality in patients with a variety of clinical conditions. We aimed to assess the association of the MPI with future mortality and number of in-hospital days for the first time in a population-based cohort.The study population consisted of 2472 persons, aged 66-99 years, from the Swedish National Study on Aging and Care in Kungsholmen, Sweden, who underwent the baseline visit 2001-4, and were followed up >10 years for in-hospital days and >12 years for mortality. The MPI was a modified version of the original and aggregated seven domains (personal and instrumental activities of daily living, cognitive function, illness severity and comorbidity, number of medications, co-habitation status, and nutritional status. The MPI score was divided into risk groups: low, medium and high. Number of in-hospital days (within 1, 3 and 10 years and mortality data were derived from official registries. All analyses were age-stratified (sexagenarians, septuagenarians, octogenarians, nonagenarians.During the follow-up 1331 persons (53.8% died. Laplace regression models, suggested that median survival in medium risk groups varied by age from 2.2-3.6 years earlier than for those in the corresponding low risk groups (p = 0.002-p<0.001, and median survival in high risk groups varied by age from 3.8-9.0 years earlier than for corresponding low risk groups (p<0.001. For nonagenarians, the median age at death was 3.8 years earlier in the high risk group than for the low risk group (p<0.001. The mean number of in-hospital days increased significantly with higher MPI risk score within 1 and 3 years for people of each age group.For the first time, the effectiveness of MPI has been verified in a population-based cohort. Higher MPI risk scores associated with more days in hospital and with fewer years of survival, across a broad and stratified age range.

  4. Adapting the Healthy Eating Index 2010 for the Canadian Population: Evidence from the Canadian National Nutrition Survey.

    Science.gov (United States)

    Jessri, Mahsa; Ng, Alena Praneet; L'Abbé, Mary R

    2017-08-21

    important and necessary to ensure broader application and usability of dietary quality indexes developed based on this national nutrition guideline.

  5. Assessment of Under Nutrition with Composite Index of Anthropometric Failure (CIAF Among Under-Five Children in a Rural Area of West Bengal

    Directory of Open Access Journals (Sweden)

    Aparajita Dasgupta

    2014-06-01

    Full Text Available Background: Under-nutrition continues to be a major public health problem in India despite years of incessant preventive measures. Composite index of anthropometric failure (CIAF provides the burden of under-nutrition as a single measure and helps in detection of children with multiple anthropometric failures. Research with multivariate modelling for various factors associated with CIAF is limited especially in rural West Bengal. Methods: This cross-sectional community based study was done in Singur block of West Bengal to determine the prevalence of under-nutrition among the under-five children and to find out the determinants of under-nutrition assessed by CIAF using multivariate analysis. WHO Z-score system and the composite index of anthropometric failure (CIAF were used to estimate the magnitude of under-nutrition. Results: Out of 113 children, 37 (32.7% were suffering from under-nutrition according to CIAF. Both underweight and wasting was present in 17.7% while stunting was prevalent in 15%. Multivariate logistic regression model showed that high birth order, low birth weight, lesser duration of breast-feeding, and low education level of mother were significantly associated with under-nutrition assessed by CIAF after adjusting for other variables. Conclusion: CIAF gives a better estimate of under-nutrition than the currently used weight-for-age Z score, hence we recommend the inclusion of height measurement in growth monitoring activities for calculating CIAF. The study also reinforces the importance of appropriate maternal care, proper infant and child feeding practices and family planning services in prevention of under-nutrition.

  6. Body mass index: different nutritional status according to WHO, OPAS and Lipschitz classifications in gastrointestinal cancer patients

    Directory of Open Access Journals (Sweden)

    Katia Barao

    2012-06-01

    Full Text Available CONTEXT: The body mass index (BMI is the most common marker used on diagnoses of the nutritional status. The great advantage of this index is the easy way to measure, the low cost, the good correlation with the fat mass and the association to morbidity and mortality. OBJECTIVE: To compare the BMI differences according to the WHO, OPAS and Lipschitz classification. METHODS: A prospective study on 352 patients with esophageal, gastric or colorectal cancer was done. The BMI was calculated and analyzed by the classification of WHO, Lipschitz and OPAS. RESULTS: The mean age was 62.1 ± 12.4 years and 59% of them had more than 59 years. The BMI had not difference between the genders in patients <59 years (P = 0.75, but over 59 years the BMI was higher in women (P<0.01. The percentage of undernourished was 7%, 18% and 21% (P<0.01 by WHO, Lipschitz and OPAS, respectively. The overweight/obesity was also different among the various classifications (P<0.01. CONCLUSIONS: Most of the patients with gastrointestinal cancer had more than 65 years. A different cut off must be used for this patients, because undernourished patients may be wrongly considered well nourished.

  7. Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition cohort.

    Science.gov (United States)

    Cust, Anne E; Slimani, Nadia; Kaaks, Rudolf; van Bakel, Marit; Biessy, Carine; Ferrari, Pietro; Laville, Martine; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Lajous, Martin; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Linseisen, Jakob; Rohrmann, Sabine; Nöthlings, Ute; Boeing, Heiner; Palli, Domenico; Sieri, Sabina; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Skeie, Guri; Engeset, Dagrun; Gram, Inger Torhild; Quirós, J Ramón; Jakszyn, Paula; Sánchez, María José; Larrañaga, Nerea; Navarro, Carmen; Ardanaz, Eva; Wirfält, Elisabet; Berglund, Göran; Lundin, Eva; Hallmans, Göran; Bueno-de-Mesquita, H Bas; Du, Huaidong; Peeters, Petra H M; Bingham, Sheila; Khaw, Kay-Tee; Allen, Naomi E; Key, Timothy J; Jenab, Mazda; Riboli, Elio

    2007-10-15

    The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), including 710 incident cases diagnosed during a mean 6.4 years of follow-up. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. There were no statistically significant associations with endometrial cancer risk for increasing quartile intakes of any of the exposure variables. However, in continuous models calibrated by using 24-hour recall values, the multivariable relative risks were 1.61 (95% confidence interval: 1.06, 2.45) per 100 g/day of total carbohydrates, 1.40 (95% confidence interval: 0.99, 1.99) per 50 units/day of total dietary glycemic load, and 1.36 (95% confidence interval: 1.05, 1.76) per 50 g/day of total sugars. These associations were stronger among women who had never used postmenopausal hormone therapy compared with ever users (total carbohydrates p(heterogeneity) = 0.04). Data suggest no association of overall glycemic index, total starch, and total fiber with risk, and a possible modest positive association of total carbohydrates, total dietary glycemic load, and total sugars with risk, particularly among never users of hormone replacement therapy.

  8. Geriatric nutritional risk index is a strong predictor of mortality in hemodialysis patients: data from the Riscavid cohort.

    Science.gov (United States)

    Panichi, Vincenzo; Cupisti, Adamasco; Rosati, Alberto; Di Giorgio, Adriana; Scatena, Alessia; Menconi, Ophelia; Bozzoli, Laura; Bottai, Anna

    2014-04-01

    Malnutrition is a common complication in hemodialysis (HD) patients and it is related to morbidity and mortality. Although a gold standard method for diagnosis of malnutrition is not available, serum albumin, body weight and height are commonly used and are included in the calculation of the Geriatric nutritional risk index (GNRI). Recently the association between GNRI and mortality in chronic HD patients has been documented in Asian populations. Our aim was to examine the relative reliability of the GNRI as a mortality and morbidity predictor in an Italian HD cohort. We prospectively examined the GNRI of 753 maintenance HD patients aged 65.7 ± 14.1 years, 457 males, included in the Riscavid cohort, and followed them up for 84 months. Predictors for all-cause death were examined using Kaplan-Meier and Cox proportional-hazards analyses. Low GNRI was significantly associated with signs of wasting, i.e. low Body mass index, hypoalbuminemia, low normalized protein catabolic rate. Patients within the lowest GNRI quartile had a significantly lower survival rate than those in the 2nd to 4th quartile (p risk in Caucasian HD patients.

  9. CA 19-9 to peritoneal carcinomatosis index (PCI) ratio is prognostic in patients with epithelial appendiceal mucinous neoplasms and peritoneal dissemination undergoing cytoreduction surgery and intraperitoneal chemotherapy: A retrospective cohort study.

    Science.gov (United States)

    Kozman, Mathew A; Fisher, Oliver M; Rebolledo, Bree-Anne J; Valle, Sarah J; Alzahrani, Nayef; Liauw, Winston; Morris, David L

    2017-12-01

    Serum tumour levels have been shown to be prognostic in patients with epithelial appendiceal mucinous neoplasms with peritoneal dissemination (pseudomyxoma peritonei (PMP)). A singular index which incorporates both tumour activity (as depicted by serum tumour marker levels) and tumour volume (as depicted by peritoneal carcinomatosis index (PCI)), may give a more precise surrogate of tumour biological behaviour. The prognostic implication of this index has not yet been reported. A retrospective cohort study of all patients with PMP managed from 1996 to 2016 with cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) was performed by analysing the survival effect of the ratio of preoperative serum CEA, CA19.9 and CA125 to PCI. Three hundred and eighty-six patients were included. In patients with low-grade PMP, elevated CA19-9/PCI ratio resulted in poorer median overall survival times (104 months vs NR, 95%CI 83 - NR, log-rank p < 0.001) and was an independent predictor of reduced overall survival on multivariable analysis (adjusted HR 5.60, 95%CI 1.60-19.68, p = 0.007). In patients with high-grade PMP, no statistically significant difference in survival was recognised. CA19-9/PCI ratio is an independent prognostic factor for overall survival in patients with low-grade PMP undergoing CRS and IPC. By accounting for both tumour activity and tumour volume simultaneously, this novel index behaves as a surrogate of tumour biology and provides a useful adjunct for decisions regarding treatment allocation in this patient group. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  10. Assessment of nutritional status in adult patients with cystic fibrosis: whole-body bioimpedance vs body mass index, skinfolds, and leg-to-leg bioimpedance

    NARCIS (Netherlands)

    Hollander, F.M.; Roos, de N.M.; Vries, de J.H.M.; Berkhout, van F.T.

    2005-01-01

    Objective: To investigate whether body mass index (BMI) or body fat percentage estimated from BMI, skinfolds, or leg-to-leg bioimpedance are good indicators of nutritional status in adult patients with cystic fibrosis. Body fat percentage measured by whole-body bioimpedance was used as the reference

  11. Creation of a Prognostic Index for Spine Metastasis to Stratify Survival in Patients Treated With Spinal Stereotactic Radiosurgery: Secondary Analysis of Mature Prospective Trials

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    Tang, Chad [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hess, Kenneth [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Bishop, Andrew J.; Pan, Hubert Y.; Christensen, Eva N. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Yang, James N. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tannir, Nizar [Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Amini, Behrang [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tatsui, Claudio; Rhines, Laurence [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Brown, Paul [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ghia, Amol, E-mail: ajghia@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: There exists uncertainty in the prognosis of patients following spinal metastasis treatment. We sought to create a scoring system that stratifies patients based on overall survival. Methods and Materials: Patients enrolled in 2 prospective trials investigating stereotactic spine radiation surgery (SSRS) for spinal metastasis with ≥3-year follow-up were analyzed. A multivariate Cox regression model was used to create a survival model. Pretreatment variables included were race, sex, age, performance status, tumor histology, extent of vertebrae involvement, previous therapy at the SSRS site, disease burden, and timing of diagnosis and metastasis. Four survival groups were generated based on the model-derived survival score. Results: Median follow-up in the 206 patients included in this analysis was 70 months (range: 37-133 months). Seven variables were selected: female sex (hazard ratio [HR] = 0.7, P=.02), Karnofsky performance score (HR = 0.8 per 10-point increase above 60, P=.007), previous surgery at the SSRS site (HR = 0.7, P=.02), previous radiation at the SSRS site (HR = 1.8, P=.001), the SSRS site as the only site of metastatic disease (HR = 0.5, P=.01), number of organ systems involved outside of bone (HR = 1.4 per involved system, P<.001), and >5 year interval from initial diagnosis to detection of spine metastasis (HR = 0.5, P<.001). The median survival among all patients was 25.5 months and was significantly different among survival groups (in group 1 [excellent prognosis], median survival was not reached; group 2 reached 32.4 months; group 3 reached 22.2 months; and group 4 [poor prognosis] reached 9.1 months; P<.001). Pretreatment symptom burden was significantly higher in the patient group with poor survival than in the group with excellent survival (all metrics, P<.05). Conclusions: We developed the prognostic index for spinal metastases (PRISM) model, a new model that identified patient subgroups with poor and excellent prognoses.

  12. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study.

    Science.gov (United States)

    Kiuchi, Aki; Ohashi, Yasushi; Tai, Reibin; Aoki, Toshiyuki; Mizuiri, Sonoo; Ogura, Toyoko; Aikawa, Atsushi; Sakai, Ken

    2016-10-23

    Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD) may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005-2009 and were systematically followed until January 2015. Of these patients, 20 (15.9%) had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI) cardiovascular events (HR = 9.37; 95% CI = 2.49-37.34, p = 0.006), but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority.

  13. Relationship between geriatric nutritional risk index and subpopulation lymphocyte counts in patients undergoing hemodialysis and peritoneal dialysis.

    Science.gov (United States)

    Kang, Gyong Hoon; Kim, Ye Na; Shin, Ho Sik

    2016-11-01

    We investigated the relationship between geriatric nutritional risk index (GNRI) and subpopulation lymphocyte counts (SLCs) in hemodialysis (HD) and peritoneal dialysis (PD) patients and evaluated whether they can be helpful in the diagnosis of malnutrition in these patients. We examined the GNRI and SLCs of 50 HD patients (mean: 55.8 ± 12.7 years; 28 men and 22 women) and 16 Continuous Ambulatory Peritoneal Dialysis (CAPD) patients (mean: 49.8 ± 14.5 years; 10 men and six women). The GNRI is calculated based on the serum albumin level, dry weight, and ideal body weight and uses the following equation: GNRI = [14.89 × albumin (g/dL)] + [41.7 × (weight/ideal body weight)]. SLCs were evaluated using flow cytometry. T-tests and χ(2) tests were performed to compare the two groups. Logistic regression analysis was performed for predicting malnutrition in dialysis patients. The average GNRI value was 100.1 ± 8.4 in HD patients and 99.2 ± 8.1 in PD patients, and no significant differences in GNRI or SLC were observed between the two groups. SLCs were higher in patients with higher GNRI (GNRI ≥ 100) although there was no statistical difference. Logistic regression for predicting malnutrition according to GNRI revealed that age, female sex, and CD19 counts predicted malnutrition in HD and PD patients. These results suggest that GNRI and SLCs (especially CD19 count) may be significant nutritional markers in these patients.

  14. Evaluation of finger millet incorporated noodles for nutritive value and glycemic index.

    Science.gov (United States)

    Shukla, Kamini; Srivastava, Sarita

    2014-03-01

    The present study was undertaken to develop finger millet incorporated noodles for diabetic patients. Finger millet variety VL-149 was taken. The finger millet flour and refined wheat flour (RWF) were evaluated for nutrient composition. The finger millet flour (FMF) was blended in various proportions (30 to 50%) in refined wheat flour and used for the preparation of noodles. Control consisted of RWF noodles. Sensory quality and nutrient composition of finger millet noodles was evaluated. The 30% finger millet incorporated noodles were selected best on the basis of sensory evaluation. Noodles in that proportion along with control were evaluated for glycemic response. Nutrient composition of noodles showed that 50% finger millet incorporated noodles contained highest amount of crude fat (1.15%), total ash (1.40%), crude fiber (1.28%), carbohydrate (78.54%), physiological energy (351.36 kcal), insoluble dietary fiber (5.45%), soluble dietary fiber (3.71%), iron (5.58%) and calcium (88.39%), respectively. However, control RWF noodles contained highest amount of starch (63.02%), amylose (8.72%) and amylopectin (54.29%). The glycemic index (GI) of 30% finger millet incorporated noodles (best selected by sensory evaluation) was observed significantly lower (45.13) than control noodles (62.59). It was found that finger millet flour incorporated noodles were found nutritious and showed hypoglycemic effect.

  15. Comparison of Nutritional Behaviors and Body Mass Index in Patients with and without Non-Alcoholic Fatty Liver Diseases

    Directory of Open Access Journals (Sweden)

    Ali-Asghar Kolahi

    2016-03-01

    Full Text Available AbstractBackground and Objective: The prevalence of non-alcoholic fatty liver Disease (NAFLD and its complications in adults are increasing. Nutritional habits and its consequent obesity are major risk factors for developing the disease. The aim of this study was comparing nutritional habits and body mass index in two groups of participants with and without NAFLD.Materials and Methods: This case control study was performed with participation of 170 people aged 20-55, who referred to the department of sonography in the Taleghani teaching hospital of Tehran. The sampling method was convenience sampling. Data collected by interview with the individuals. Socio-demographic characteristics, reason for referring, and nutritional habits were determined. Anthropometric measurements and liver ultrasound were also performed. Data were analyzed by using t-test for comparing the means between 2 groups and chi-square test for determining the relationship between the variables. P-values of 0.05 or less were considered statistically significant.Results: The group with the disease significantly consumed more high-fat dairy products than the group without the disease (42% vs. 23% (P=0.013. The mean (SD for weekly consumption of fruits in the group with the disease was significantly higher than that in the group without the disease 11.6(6.7 vs. 8.2(5.5 unit (P=0.001. The mean (SD for BMI of the group with the disease was higher than that of the group without the disease 32.8(6.6 vs. 24.4(3 respectively (P<0.001.  Unexpectedly, the mean (SD for weekly consumption of fast foods in the group without fatty liver with 0.8(0.9 was two times more than that in the affected group with 0.4(0.8 (P=0.012.              Conclusion: The prevalence of obesity and some unhealthy eating habits in patients with NAFLD and those at risk, requires designing and implementing educational interventions for increasing individuals’ awareness and improving their attitude

  16. The Geriatric Nutritional Risk Index is Independently Associated with Prognosis in Patients with Critical Limb Ischemia Following Endovascular Therapy.

    Science.gov (United States)

    Shiraki, T; Iida, O; Takahara, M; Masuda, M; Okamoto, S; Ishihara, T; Nanto, K; Kanda, T; Fujita, M; Uematsu, M

    2016-08-01

    Patients with critical limb ischemia (CLI) have poor overall and limb prognosis. Although nutritional status influences overall prognosis, and the Geriatric Nutritional Risk Index (GNRI) is a widely used, simple and well established nutritional status screening method, the association between the GNRI and the overall and limb prognosis of patients with CLI following endovascular therapy (EVT) has not been explored. Clinical outcomes were retrospectively evaluated in 473 consecutive patients (74 ± 10 years; 59% male) with CLI who underwent EVT. The GNRI on admission was calculated as follows: [14.89 × albumin (g/dL)] + [41.7 × (body weight/ideal body weight)]. Cox proportional hazard analysis was performed to explore the independent association between the GNRI and mortality and major amputation. Patients (53% ambulatory, 38% wheelchair bound, and 9% bedridden) were divided into two groups based on the median GNRI: the higher group (GNRI ≥ 91.2, n = 237) and the lower group (GNRI < 91.2, n = 236). Median follow up duration after EVT was 11.3 months. Three years after EVT, the survival rate (74% in the higher GNRI, and 48% in the lower GNRI, respectively), and limb salvage rate (92% in the higher GNRI, and 84% in the lower GNRI) were significantly lower in the lower GNRI group. GNRI (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.01-1.05), along with being wheelchair bound (HR, 1.87; 95% CI 1.17-2.97; vs. ambulatory status), being bedridden (HR, 3.10; 95% CI, 1.63-2.97; vs. ambulatory status), being on hemodialysis (HR, 2.33; 95% CI, 1.49-3.64), and having chronic heart failure (HR, 2.22; 95% CI, 1.44-3.43) were the independent predictors of mortality. The GNRI (HR, 1.04; 95% CI, 1.01-1.07), being bedridden (HR, 4.15; 95% CI, 1.67-10.3; vs. ambulatory status), isolated below knee disease (HR, 2.49; 95% CI, 1.30-4.77), and hemodialysis (HR, 2.44; 95% CI, 1.23-4.85) were independently associated with major amputation. The GNRI on admission

  17. Dietary fiber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012

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    Nina Cecilie Øverby

    2013-03-01

    Full Text Available The aim of this study is to review recent data on dietary fiber (DF and the glycemic index (GI, with special focus on studies from the Nordic countries regarding cardiometabolic risk factors, type 2 diabetes, cardiovascular disease, cancer, and total mortality. In this study, recent guidelines and scientific background papers or updates on older reports on DF and GI published between 2000 and 2011 from the US, EU, WHO, and the World Cancer Research Fund were reviewed, as well as prospective cohort and intervention studies carried out in the Nordic countries. All of the reports support the role for fiber-rich foods and DF as an important part of a healthy diet. All of the five identified Nordic papers found protective associations between high intake of DF and health outcomes; lower risk of cardiovascular disease, type 2 diabetes, colorectal and breast cancer. None of the reports and few of the Nordic papers found clear evidence for the GI in prevention of risk factors or diseases in healthy populations, although association was found in sub-groups, e.g. overweight and obese individuals and suggestive for prevention of type 2 diabetes. It was concluded that DF is associated with decreased risk of different chronic diseases and metabolic conditions. There is not enough evidence that choosing foods with low GI will decrease the risk of chronic diseases in the population overall. However, there is suggestive evidence that ranking food based on their GI might be of use for overweight and obese individuals. Issues regarding methodology, validity and practicality of the GI remain to be clarified.

  18. Dietary fiber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012

    Science.gov (United States)

    Øverby, Nina Cecilie; Sonestedt, Emily; Laaksonen, David E.; Birgisdottir, Bryndis Eva

    2013-01-01

    The aim of this study is to review recent data on dietary fiber (DF) and the glycemic index (GI), with special focus on studies from the Nordic countries regarding cardiometabolic risk factors, type 2 diabetes, cardiovascular disease, cancer, and total mortality. In this study, recent guidelines and scientific background papers or updates on older reports on DF and GI published between 2000 and 2011 from the US, EU, WHO, and the World Cancer Research Fund were reviewed, as well as prospective cohort and intervention studies carried out in the Nordic countries. All of the reports support the role for fiber-rich foods and DF as an important part of a healthy diet. All of the five identified Nordic papers found protective associations between high intake of DF and health outcomes; lower risk of cardiovascular disease, type 2 diabetes, colorectal and breast cancer. None of the reports and few of the Nordic papers found clear evidence for the GI in prevention of risk factors or diseases in healthy populations, although association was found in sub-groups, e.g. overweight and obese individuals and suggestive for prevention of type 2 diabetes. It was concluded that DF is associated with decreased risk of different chronic diseases and metabolic conditions. There is not enough evidence that choosing foods with low GI will decrease the risk of chronic diseases in the population overall. However, there is suggestive evidence that ranking food based on their GI might be of use for overweight and obese individuals. Issues regarding methodology, validity and practicality of the GI remain to be clarified. PMID:23538683

  19. Stability of infant and child feeding index over time and its association with nutritional status of HIV exposed infants in Sidama Zone, Southern Ethiopia: a longitudinal study.

    Science.gov (United States)

    Haile, Demewoz; Belachew, Tefera; Berhanu, Getenesh; Setegn, Tesfaye; Biadgilign, Sibhatu

    2014-12-01

    Even though many studies showed that infant and child feeding index has a statistically significant association with nutritional status, there is paucity of studies on stability of infant and child feeding index over time and its association with nutritional status of HIV exposed infants. This study aimed to investigate the stability of infant and child feeding index over time that is developed based on the current recommendations and its association with nutritional status of HIV exposed infants in Sidama Zone, Southern Ethiopia. A panel study design was conducted in health institutions in Sidama Zone from February to July, 2012. Three repeated measurements of data were collected from each HIV exposed infant aged 6-17 months over the 6 month follow-up period approximately per 2 month interval. The cross-sectional index was found stable overtime with the repeatability coefficient of 0.802 which differed significantly from zero (95% CI: 0.75-0.85). A longitudinal infant and child feeding index (L-ICFI) has a statistically significant association with length for age Z scores (LAZ) and weight for age Z scores (WAZ) at visit three (β=0.262, p=0.007; β=0.226, p=0.017), respectively. But the longitudinal index has no statistically significant association with WLZ score (p=0.552). There was no significant difference in change of LAZ and WAZ over time between L-ICFI tertiles for both female and male HIV exposed infants. The index is stable overtime at individual level even though one third of the index components were not stable. The L-CFI was associated with LAZ and WAZ but not with WLZ. However there was no significant difference in change of HAZ and WAZ over time between L-ICFI tertiles for both female and male HIV exposed infants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Prognostic values of pneumonia severity index, CURB-65 and expanded CURB-65 scores in community-acquired pneumonia in Zagazig University Hospitals

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    Samah M. Shehata

    2017-07-01

    Conclusions: Expanded CURB-65 score is simple, objective and more accurate scoring system for evaluation of CAP severity and can improve the efficiency of predicting the mortality in CAP patients, better than CURB-65 and PSI scores. Also, Expanded CUEB-65 may generate new therapeutic and prognostic modality in CAP especially in patients with liver cirrhosis.

  1. Nutritional status of children and adolescents based on body mass index: agreement between World Health Organization and International Obesity Task Force.

    Science.gov (United States)

    Cavazzotto, Timothy Gustavo; Brasil, Marcos Roberto; Oliveira, Vinicius Machado; da Silva, Schelyne Ribas; Ronque, Enio Ricardo V; Queiroga, Marcos Roberto; Serassuelo Junior, Helio

    2014-03-01

    To investigate the agreement between two international criteria for classification of children and adolescents nutritional status. The study included 778 girls and 863 boys aged from six to 13 years old. Body mass and height were measured and used to calculate the body mass index. Nutritional status was classified according to the cut-off points defined by the World Health Organization and the International Obesity Task Force. The agreement was evaluated using Kappa statistic and weighted Kappa. In order to classify the nutritional status, the agreement between the criteria was higher for the boys (Kappa 0.77) compared to girls (Kappa 0.61). The weighted Kappa was also higher for boys (0.85) in comparison to girls (0.77). Kappa index varied according to age. When the nutritional status was classified in only two categories--appropriate (thinness + accentuated thinness + eutrophy) and overweight (overweight + obesity + severe obesity)--, the Kappa index presented higher values than those related to the classification in six categories. A substantial agreement was observed between the criteria, being higher in males and varying according to the age.

  2. Relationship between functional independence measure and geriatric nutritional risk index in pneumonia patients in long-term nursing care facilities.

    Science.gov (United States)

    Mitani, Yuji; Oki, Yutaro; Fujimoto, Yukari; Yamaguchi, Takumi; Iwata, Kentaro; Watanabe, Yu; Takahashi, Kazuki; Yamada, Kanji; Ishikawa, Akira

    2017-10-01

    The prevention of pneumonia is an urgent issue among Japanese older adults. However, little has been reported on the relationship between a Functional Independence Measure (FIM) and the Geriatric Nutrition Risk Index (GNRI) for the prevention of pneumonia in patients in long-term care facilities in Japan. We aimed to clarify the relevance of FIM and GNRI for inpatients with and without pneumonia. We identified 233 patients who were hospitalized in our long-term nursing hospital from April 2012 to September 2013. We compared differences in FIM among GNRI classes for four groups: (i) pneumonia/high GNRI; (ii) pneumonia/low GNRI; (iii) no pneumonia/high GNRI; and (iv) no pneumonia/low GNRI. To assess the pneumonia predictors, we used a logistic regression for long-term nursing patients. Receiver operating characteristic analysis showed cut-off values and the area under the curve. A total of 88 (37.8%) of 233 inpatients had pneumonia. FIM of the pneumonia/low GNRI groups was significantly lower than that of the no pneumonia/high and low GNRI groups. Logistic regression showed that FIM (P pneumonia. The cut-off values for FIM and GNRI were 26.6 (P pneumonia. FIM and GNRI are useful predictor tools that could help to prevent pneumonia in Japanese patients in long-term care facilities. Geriatr Gerontol Int 2017; 17: 1617-1622. © 2016 Japan Geriatrics Society.

  3. Rural middle school nutrition and physical activity environments and the change in body mass index during adolescence.

    Science.gov (United States)

    Demment, Margaret; Wells, Nancy; Olson, Christine

    2015-02-01

    For rural adolescents, schools are among the few places where environmental interventions can promote health outside of the home. The goal of this study was to assess the nutrition and physical activity (N&PA) environments of schools attended by a birth cohort and examine the association with change in body mass index (BMI) from sixth to eighth grade. Using data from adolescents of a rural New York State birth cohort (N = 281), we used linear mixed models to identify N&PA environments associated with change in BMI. We also examined family income trajectory as a potential modifier to consider how the association between school environment and change in BMI might differ depending on income. We found considerable heterogeneity in environments within and between schools. Among students with low-income trajectories, reductions in BMI z-scores were associated with school environments that promote better physical education (PE) and general (non-PE, non-sport) physical activity. Schools with better sports environments were associated with reductions in BMI for some students, but not lower-income students. School environments may have differing effects on students depending on their socioeconomic status. Strategies are needed to identify and address barriers that impair low-income students' access to health-promoting school resources. © 2015, American School Health Association.

  4. Somatic indexes, chemical-nutritive characteristics and metal content in caught and reared sharpsnout seabream (Diplodus puntazzo

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    Giuseppe Moniello

    2010-01-01

    Full Text Available The aim of this study was to compare some somatic indexes, chemical-nutritive characteristics and the contents of some metals (Pb, Cu, Cr and Zn in the whole body and fillet from caught and reared sharpsnout seabream (Diplodus puntazzo. The fish came from three different conditions: reared in marine cages (R, captured in a natural lagoon (L and in the Mediterranean sea (S. Thirty fish per group, divided into three weight categories (100±15.3, 200±18.7 and 300±20.4g, were used for the trial. Reared sharpsnout seabream showed higher amounts of celomatic fat (3.41%, 2.43%, 0.21%, respectively for R, L and S and total lipid (13.86%, 11.23% and 5.06% respectively for R, L and S, and lower moisture (64.14%, 65.54%, 71.53% and protein (17.73, 19.03 and 19.17% than those caught in the lagoon and sea. The whole body of reared fish contained lower amounts of lead (0.70, 0.75 and 0.97mg/kg, respectively for R, L and S, copper (0.15, 0.38, 0.25mg/kg chrome (2.19, 3.52, 3.77mg/kg and higher zinc contents (63.47, 53.42, 47.31mg/kg than caught fish. Fatty acids from sharpsnout seabream fillets showed a high lipid quality as confirmed also by low values of Thrombogenic index (0.36, 0.30 and 0.22, respectively for L, S, R and Atherogenic index (0.47, 0.42 and 0.33, respectively for L, S, R. Reared sharpsnout seabream showed lower saturated fatty acid values (26.44%, 32.21%, 34.85%, respectively for R, S, L and higher oleic acid amount (21.61%, 19.15%, 11.99%, respectively for R, L and S. The subjects captured in the sea had a higher arachidonic acid content (5.44%, 1.76%, 0.59%, respectively for S, L, R. In the weight categories, the 100g subjects, showed higher incidence of viscera (VSI: 4.32%, 3.12% and 2.92%, respectively for 100, 200 and 300g and liver (HIS: 2.20%, 1.97%, and 1.77%, respectively for 100, 200 and 300g, higher moisture (69.49%, 67.03%, 64.69% and lower lipid rate (7.64%, 10.18%, 12.32%.

  5. Nutritional assessment of children with cancer.

    Science.gov (United States)

    Mosby, Terezie Tolar; Barr, Ronald D; Pencharz, Paul B

    2009-01-01

    Regardless of which parts of the world they live in, most children will develop and grow at a similar rate if proper nutrition is ensured. Children from developing countries are at risk for primary malnutrition. Children undergoing anticancer therapy are at higher risk for secondary malnutrition, including obesity and growth retardation. Periodic nutritional assessments are important for planning effective dietary interventions for such children. In this review, we describe malnutrition as it occurs in children with cancer and various ways of assessing the nutritional status of these children, depending on the availability of resources in their local hospitals. Objective and subjective data should be used to complete the nutritional assessment. We discuss screening methods, including the use of subjective global assessment. Different parts of nutritional assessment include medical history; physical examination; biochemical and hematological data, such as visceral proteins, blood glucose levels, and lipid profiles, hemoglobin and hematocrit, and the lymphocyte count; anthropometric measurements; and food and nutrition history. We review medical tests and procedures to determine nutritional status, including nitrogen balance, delayed cutaneous hypersensitivity, prognostic nutritional index, creatinine height index, maldigestion and malabsorption tests, indirect calorimetry, and dual energy X ray absorptiometry (DXA scan). Evaluation and interpretation of data and estimation of nutritional risk are discussed, including proper techniques and use of anthropometric measures, selection and use of growth charts, calculation of caloric and protein needs, and the percentage of calories ingested. These methods will enable local health care providers to accurately assess the nutritional status of children with cancer, identify children at risk, and plan adequate nutritional interventions.

  6. Nutritional status and dietary intake among pregnant women in relation to pre-pregnancy body mass index in Japan.

    Science.gov (United States)

    Uno, Kaoru; Takemi, Yukari; Hayashi, Fumi; Hosokawa, Momo

    2016-01-01

    Objective The present study examined nutritional status and dietary intake of pregnant women in Japan in relation to pre-pregnancy body mass index (BMI).Methods Participants included 141 Japanese women with singleton pregnancies, from the outpatient department of the S hospital, Gunma prefecture, Japan. Two-day food records, dietary assessment questionnaires, and clinical records were obtained at 20 weeks gestation. Nine patients were excluded from the study due to morning sickness. The remaining 132 participants were divided into 3 groups according to pre-pregnancy BMI: underweight, normal weight, and overweight. Nutritional status and dietary intake were analyzed in relation to BMI using the chi-square test, Fisher's exact test, Kruskal-Wallis test, one-way analysis of variance, and analysis of covariance with adjustment for age, employment status, and total energy intake.Results Women who were underweight before pregnancy were more frequently working full-time than normal weight and overweight women. Underweight women were also more frequently anemic (P=0.038, underweight 39.3%, normal weight 24.7%, overweight 0%) and had lower mean hemoglobin (Hb) (P=0.021, underweight 11.3 g/dL, normal weight 11.6 g/dL, overweight 12.1 g/dL) and hematocrit (Hct) levels (P=0.025, underweight 33.7%, normal weight 34.3%, overweight 36.0%). Their dietary intake of protein, iron, magnesium, and folic acid was lower than that of normal weight and overweight women. Their meals tended to include fewer meat, fish, egg, and soybean dishes (underweight, mean of 4.7 servings per day; normal weight, 6.1 servings; overweight, 6.1 servings).Conclusion Pregnant women who were underweight before pregnancy had increased risk of anemia as well as reduced Hb and Hct levels. They had lower dietary intake of protein, iron and folic acid compared to women in the other BMI categories. Anemia and these nutrient deficiencies are known risk factors for low birth weight. Our findings suggest

  7. Association between Low Dietary Protein Intake and Geriatric Nutrition Risk Index in Patients with Chronic Kidney Disease: A Retrospective Single-Center Cohort Study

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    Aki Kiuchi

    2016-10-01

    Full Text Available Reduced dietary protein intake in malnourished patients with chronic kidney disease (CKD may be associated with adverse clinical outcomes, which may mask any efficacy of a low-protein diet. The study included 126 patients with CKD who attended a dedicated dietary counseling clinic in 2005–2009 and were systematically followed until January 2015. Of these patients, 20 (15.9% had moderate or severe nutrition-related risk of geriatric nutritional risk index (GNRI < 92; these patients were more likely to be older, have a greater proteinuria, and have lower body mass index and serum albumin concentration. Dietary protein intake was significantly lower in older patients (r = −0.33, p < 0.001 and those with lower glomerular filtration rate (r = 0.47, p < 0.001. The non-protein to nitrogen calorie ratio was independently associated with GNRI. Reduced GNRI was significantly associated with mortality (hazard ratio (HR = 4.94; 95% confidence interval (CI = 1.61–15.42, p = 0.012 and cardiovascular events (HR = 9.37; 95% CI = 2.49–37.34, p = 0.006, but not with adverse renal outcomes. Restricting protein intake may be harmful to patients with any nutrition-related risk, suggesting that improvement of nutritional status should be a high priority.

  8. Profiles of body mass index and the nutritional status among children and adolescents categorized by waist-to-height ratio cut-offs.

    Science.gov (United States)

    Zhang, Ying-Xiu; Wang, Zhao-Xia; Chu, Zun-Hua; Zhao, Jin-Shan

    2016-11-15

    Waist-to-height ratio (WHtR) is proposed as a simple, valid and convenient measure of abdominal obesity and health risks in practice. The present study examined the distribution of nutritional status among children and adolescents categorized by WHtR cut-offs. A total of 30,459 students (15,249 boys and 15,210 girls) aged 7-18years participated in the study. Height, weight and waist circumference (WC) of all subjects were measured, body mass index (BMI) and WHtR were calculated. The grades of nutritional status (thinness, normal weight, overweight and obesity) was defined by the international BMI cut-offs. All subjects were divided into three groups (low, moderate and high) according to their WHtR, BMI level and the distribution of nutritional status among the three groups were compared. In both boys and girls, significant differences in BMI level and the nutritional status were observed among the three groups. Children and adolescents aged 7-18years in the 'high WHtR group' (≥0.5) had higher BMI than those in the 'low WHtR group' (nutritional status is found in the 'moderate WHtR group' (between 0.4 and 0.5) with the highest proportion of normal weight and low prevalence of thinness and obesity. WHtR is associated with nutritional status, which could be an indicator of nutritional status and early health risk. It is necessary to develop optimal boundary values in the future. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children’s body mass index

    Science.gov (United States)

    2014-01-01

    Background To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children’s body mass index (BMI). Methods A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center’s written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children’s nutritional intake, physical activity, and height and weight pre- and post-intervention. Results Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers’ and parents’ knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children’s zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. Conclusions The NAP SACC intervention, as delivered by

  10. Malnutrition as assessed by nutritional risk index is associated with worse outcome in patients admitted with acute decompensated heart failure. An ACAP-HF data analysis

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    Marrick L. Kukin

    2011-06-01

    Full Text Available Malnutrition is common at hospital admission and tends to worsen during hospitalization. This controlled population study aimed to determine if serum albumin or moderate and severe nutritional depletion by Nutritional Risk Index (NRI at hospital admission are associated with increased length of hospital stay (LOS in patients admitted with acute decompensated heart failure (ADHF. Serum albumin levels and lymphocyte counts were retrospectively determined at hospital admission in 1740 consecutive patients admitted with primary and secondary diagnosis of ADHF. The Nutrition Risk Score (NRI developed originally in AIDS and cancer populations was derived from the serum albumin concentration and the ratio of actual to usual weight, as follows: NRI = (1.519 × serum albumin, g/dL + {41.7 × present weight (kg/ideal body weight(kg}. Patients were classified into four groups as no, mild, moderate or severe risk by NRI. Multiple logistic regressions were used to determine the association between nutritional risk category and LOS. 381 Patients (34% were at moderate or severe nutritional risk by NRI score. This cohort had lower BMI (24 ± 5.6 kg/m2, albumin (2.8±0.5 g/dL, mean NRI (73.5±9 and Lower eGFR (50±33 mL/min per 1.73 m2. NRI for this cohort, adjusted for age, was associated with LOS of 10.1 days. Using the Multiple Logistic regression module, NRI was the strongest predictor for LOS (OR 1.7, 95% CI: 1.58-1.9; P=0.005, followed by TIMI Risk Score [TRS] (OR 1.33, 95% CI: 1.03-1.71; P=0.02 and the presence of coronary artery disease (OR 2.29, 95%CI: 1.03-5.1; P=0.04. Moderate and severe NRI score was associated with higher readmission and death rates as compared to the other two groups. Nutritional depletion as assessed by Nutritional Risk Index is associated with worse outcome in patients admitted with ADHF. Therefore; we recommend adding NRI to further risk stratify these patients.

  11. Malnutrition as assessed by nutritional risk index is associated with worse outcome in patients admitted with acute decompensated heart failure: an ACAP-HF data analysis.

    Science.gov (United States)

    Aziz, Emad F; Javed, Fahad; Pratap, Balaji; Musat, Dan; Nader, Amjad; Pulimi, Sandeep; Alivar, Carlos L; Herzog, Eyal; Kukin, Marrick L

    2011-01-01

    Malnutrition is common at hospital admission and tends to worsen during hospitalization. This controlled population study aimed to determine if serum albumin or moderate and severe nutritional depletion by Nutritional Risk Index (NRI) at hospital admission are associated with increased length of hospital stay (LOS) in patients admitted with acute decompensated heart failure (ADHF). Serum albumin levels and lymphocyte counts were retrospectively determined at hospital admission in 1740 consecutive patients admitted with primary and secondary diagnosis of ADHF. The Nutrition Risk Score (NRI) developed originally in AIDS and cancer populations was derived from the serum albumin concentration and the ratio of actual to usual weight, as follows: NRI = (1.519 × serum albumin, g/dL) + {41.7 × present weight (kg)/ideal body weight(kg)}. Patients were classified into four groups as no, mild, moderate or severe risk by NRI. Multiple logistic regressions were used to determine the association between nutritional risk category and LOS.Three hundred and eighty-one patients (34%) were at moderate or severe nutritional risk by NRI score. This cohort had lower BMI (24 ± 5.6 kg/m(2)), albumin (2.8±0.5 g/dL), mean NRI (73.5±9) and lower eGFR (50±33 mL/min per 1.73 m(2)). NRI for this cohort, adjusted for age, was associated with LOS of 10.1 days. Using the Multiple Logistic regression module, NRI was the strongest predictor for LOS (OR 1.7, 95% CI: 1.58-1.9; P=0.005), followed by TIMI Risk Score [TRS] (OR 1.33, 95% CI: 1.03-1.71; P=0.02) and the presence of coronary artery disease (OR 2.29, 95%CI: 1.03-5.1; P=0.04). Moderate and severe NRI score was associated with higher readmission and death rates as compared to the other two groups.Nutritional depletion as assessed by Nutritional Risk Index is associated with worse outcome in patients admitted with ADHF. Therefore; we recommend adding NRI to further risk stratify these patients.

  12. Effects of nutrition and exercise health behaviors on predicted risk of cardiovascular disease among workers with different body mass index levels.

    Science.gov (United States)

    Huang, Jui-Hua; Huang, Shu-Ling; Li, Ren-Hau; Wang, Ling-Hui; Chen, Yu-Ling; Tang, Feng-Cheng

    2014-04-29

    Workplace health promotion programs should be tailored according to individual needs and efficient intervention. This study aimed to determine the effects of nutrition and exercise health behaviors on predicted risk for cardiovascular disease (CVD) when body mass index (BMI) is considered. In total, 3350 Taiwanese workers were included in this cross-sectional study. A self-reported questionnaire was used to measure their nutrition and exercise behaviors. Data on anthropometric values, biochemical blood determinations, and predicted CVD risk (using the Framingham risk score) were collected. In multiple regression analyses, the nutrition behavior score was independently and negatively associated with CVD risk. Exercise was not significantly associated with the risk. However, the interactive effect of exercise and BMI on CVD risk was evident. When stratified by BMI levels, associations between exercise and CVD risk were statistically significant for ideal weight and overweight subgroups. In conclusion, nutrition behavior plays an important role in predicting the CVD risk. Exercise behavior is also a significant predictor for ideal weight and overweight workers. Notably, for underweight or obese workers, maintaining health-promoting exercise seems insufficient to prevent the CVD. In order to improve workers' cardiovascular health, more specific health-promoting strategies should be developed to suit the different BMI levels.

  13. Effects of Nutrition and Exercise Health Behaviors on Predicted Risk of Cardiovascular Disease among Workers with Different Body Mass Index Levels

    Directory of Open Access Journals (Sweden)

    Jui-Hua Huang

    2014-04-01

    Full Text Available Workplace health promotion programs should be tailored according to individual needs and efficient intervention. This study aimed to determine the effects of nutrition and exercise health behaviors on predicted risk for cardiovascular disease (CVD when body mass index (BMI is considered. In total, 3350 Taiwanese workers were included in this cross-sectional study. A self-reported questionnaire was used to measure their nutrition and exercise behaviors. Data on anthropometric values, biochemical blood determinations, and predicted CVD risk (using the Framingham risk score were collected. In multiple regression analyses, the nutrition behavior score was independently and negatively associated with CVD risk. Exercise was not significantly associated with the risk. However, the interactive effect of exercise and BMI on CVD risk was evident. When stratified by BMI levels, associations between exercise and CVD risk were statistically significant for ideal weight and overweight subgroups. In conclusion, nutrition behavior plays an important role in predicting the CVD risk. Exercise behavior is also a significant predictor for ideal weight and overweight workers. Notably, for underweight or obese workers, maintaining health-promoting exercise seems insufficient to prevent the CVD. In order to improve workers’ cardiovascular health, more specific health-promoting strategies should be developed to suit the different BMI levels.

  14. Prognostic, quantitative histopathologic variables in lobular carcinoma of the breast

    DEFF Research Database (Denmark)

    Ladekarl, M; Sørensen, Flemming Brandt

    1993-01-01

    of disease, vv(nuc), MI, and NI were of significant independent, prognostic value. On the basis of the multivariate analyses, a prognostic index with highly distinguishing capacity between prognostically poor and favorable cases was constructed. CONCLUSION: Quantitative histopathologic variables are of value...

  15. Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma [v2; ref status: indexed, http://f1000r.es/4k6

    Directory of Open Access Journals (Sweden)

    Tianhua Guo

    2014-10-01

    Full Text Available Thrombocytosis portends adverse prognostic significance in many types of cancers including ovarian and lung carcinoma. In this study, we determined the prevalence and prognostic significance of thrombocytosis (defined as platelet count in excess of 400 × 103/μl in patients with colorectal cancer. We performed a retrospective analysis of 310 consecutive patients diagnosed at our Institution between 2004 and 2013. The patients (48.7% male and 51.3% female had a mean age of 69.9 years (+/- 12.7 years at diagnosis. Thrombocytosis was found in a total of 25 patients, with a higher incidence in those with stage III and IV disease (14.4% of patients. Although the mean platelet count increased with the depth of tumor invasion (pT, its values remained within normal limits in the whole patient cohort. No patient with stage I cancer (n=57 had elevated platelet count at diagnosis. By contrast, five of the 78 patients (6.4% with stage II cancer showed thrombocytosis, and four of these patients showed early recurrence and/or metastatic disease, resulting in shortened survival (they died within one year after surgery. The incidence of thrombocytosis increased to 12.2% and 20.6%, respectively, in patients with stage III and IV disease. The overall survival rate of patients with thrombocytosis was lower than those without thrombocytosis in the stage II and III disease groups, but this difference disappeared in patients with stage IV cancer who did poorly regardless of their platelet count. We concluded that thrombocytosis at diagnosis indicates adverse clinical outcome in colorectal cancer patients with stage II or III disease. This observation is especially intriguing in stage II patients because the clinical management of these patients is controversial. If our data are confirmed in larger studies, stage II colon cancer patients with thrombocytosis may be considered for adjuvant chemotherapy.

  16. El soporte nutrimental y su relación con algunos indicadores pronósticos del niño quemado Nutritional support and its relation to some prognostic indicators of burnt child

    Directory of Open Access Journals (Sweden)

    Alejandro Torres Amaro

    2011-12-01

    between the nutritional support established during the firsts hours after resuscitation with some prognostic indicators in burnt children. Methods: an analytical and retrospective study was conducted including 252 children admitted in the burn service of the "Juan Manuel Márquez" Teaching Children Hospital of Marianao in La Habana with a stay higher of 7 days during the decade of 2000 to 2009. From the audit of medical records it was obtained the following prognostic indicators of burnt child: burnt body surface, stay time, weight loss percentage and mortality. Likewise it was possible to obtain information about the type of metabolic nutritional support used during treatment. Results: the above mentioned more used support was mixed where is combined the peripheral enteral and parenteral modality covering the 52 % of treated patients. The children with less percentage of weight loss (under 10 % received the exclusive enteral way (53,1 % of treated cases and in the 37,4 % the support was mixed, but using the peripheral modality of parenteral use. Conclusions: the nutritional strategy used in burnt child may to modify some prognostic indicators and must to be a therapeutical priority to prevent the clinical deterioration of these patients.

  17. Nutritional status of geriatric outpatients with systolic heart failure and its prognostic value regarding death or hospitalization, biomarkers and quality of life.

    Science.gov (United States)

    Sargento, L; Satendra, M; Almeida, I; Sousa, C; Gomes, S; Salazar, F; Lousada, N; Palma Dos Reis, R

    2013-04-01

    The prevalence of malnutrition in ambulatory patients with heart failure is difficult to determine, depending on the timing and methodology. To determine the nutritional status of outpatients with systolic heart failure with the Mini Nutritional Assessment (MNA) full and short-form versions, and evaluate its relationship with the short-term prognosis, biomarkers and quality of life. Fifty consecutive (70% male), geriatric (74.3+ 6.2years old) stable outpatient with heart failure (NYHA class II 68%, III 32%) and left ventricular ejection fraction of 26.7 +11.5% were included and followed during 12 months. At a routine visit to the heart failure clinic, the MNA, the Minnesota Living with Heart Failure questionnaire (MLHFQ) were applied. According to the MNA screening score the nutritional status was classified using the MNA full (MNA-F) and the short-form (MNA-F) versions of the questionnaire. The recorded events were death and hospitalization. The survival and hospitalizations curves were evaluated with the Log-Rank test and Cox Regression analysis. The association between parameters was analyzed with the Pearson and Spearmann correlation coefficient. (1) The mortality and hospitalization rates were 12% and 42%, respectively. (2) With the MNA-SF 7.6% of the patients had malnutrition and 20% were at risk of malnutrition. There was a good agreement (90%) between the MNA-SF and the MNA-F classifications. (3) There was a significant relationship between the MNA screening score and the MLHFQ (rs= -0.592 ppatients with malnutrition by the MNA-SF were at greater risk of death (HR= 8.0 p=0.059) and hospitalization (HR 8.1 p=0.008). The MNA is useful for the evaluation of the nutritional status of elderly outpatients with systolic heart failure. It is a good predictor of the short-term outcome and is also associated with the quality of life and Nt-ProBNP.

  18. Need-based nutritional intervention is effective in improving handgrip strength and Barthel Index scores of older people living in a nursing home: a randomized controlled trial.

    Science.gov (United States)

    Lee, Li-Chin; Tsai, Alan C; Wang, Jiun-Yi

    2015-05-01

    Nutritional status is associated with physical functioning in older people. Protein-energy malnutrition can limit functional performance. This study examined the effectiveness of a "need-based intervention" on improving the physical functioning of older adults living in nursing homes. A 24-week randomized, double-blind, controlled trial. A privately managed geriatric nursing home in Taiwan. Ninety-two persons who were ≥65 years old, ≤25 kg/m(2), >1 month residence, non-bed-ridden, without acute infection, and able to self-feed or receive oral feeding. Qualified participants were stratified by gender and then randomly assigned to either the control group (n=45) or the intervention group (n=47). Each participant in the intervention group would receive a 50 g/day soy-protein-based nutritional supplement when he/she was rated as undernourished, defined as Mini Nutritional Assessment score ≤24 and body mass index ≤24 kg/m(2). The supplement contained 9.5 g protein, 250 kcal energy, and all essential micronutrients. The supplementation would be suspended if either one of the two "at risk" conditions was not met at the next measurement (every 4 weeks). Handgrip strength and Barthel Index were measured at baseline, mid-point (week 12), and end-point (week 24) of the trial. Results were analyzed with Student's t-test and by the Generalized Estimating Equations controlled for nutritional status. The intervention significantly improved (a) handgrip strength of the older adults at weeks 12 and 24, and (b) the overall Barthel Index at week 24 (all pintervention" can be an effective and useful strategy for improving the physical functioning of older adults living in nursing homes, without adverse effects. The results probably are the indirect results of the improved nutritional status. The study highlights the importance of routine screening and timely intervention in geriatric care. The applicability of this need-based strategy to community-living older adults is an

  19. Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma.

    Science.gov (United States)

    Gu, Weijie; Zhang, Guiming; Sun, Lijiang; Ma, Qi; Cheng, Yue; Zhang, Hailiang; Shi, Guohai; Zhu, Yao; Ye, Dingwei

    2015-09-01

    Although commonly observed, malnutrition is poorly characterized and frequently underdiagnosed in patients with metastatic renal cell carcinoma (RCC). The ability of nutritional screening tools to predict overall survival (OS) in patients with RCC has not been adequately validated. The objective of this study was to investigate the performance of nutritional screening tools and their additional prognostic value in patients with metastatic RCC treated with targeted therapies. Patients were prospectively recruited from three tertiary hospitals between 2009 and 2013. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI) and the Mini Nutritional Assessment-Short Form (MNA-SF). Their OS and early grade 3/4 adverse events were recorded as outcomes of interest, and their associations with nutritional status were assessed using Cox regression and logistic regression, respectively. The incremental value in prognostication was evaluated using concordance index and decision curve analyses. Of the 300 enrolled patients, 95 (31.7%) and 64 (21.3%) were classified as being at risk of malnutrition according to the GNRI and MNA-SF, respectively. Both GNRI and MNA-SF were independent predictors of OS in multivariate analyses and provided significant added benefit to Heng risk classification. Compared with the MNA-SF, the GNRI contributed a higher increment to the concordance index (0.041 vs. 0.016). Nutritional screening, however, was not associated with early grade 3/4 adverse events in multivariate analyses. Further investigations are needed using more comprehensive and accurate assessment tools. This prospective study confirmed the importance of nutritional screening tools in survival prognostication in patients with metastatic RCC. The standardized and objective measurements would allow clinicians to identify metastatic RCC patients at risk of poor survival outcomes. Individualized nutritional assessment and intervention strategies may be included in

  20. Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma

    Science.gov (United States)

    Gu, Weijie; Zhang, Guiming; Sun, Lijiang; Ma, Qi; Cheng, Yue; Zhang, Hailiang; Shi, Guohai; Zhu, Yao; Ye, Dingwei

    2015-01-01

    Background Although commonly observed, malnutrition is poorly characterized and frequently underdiagnosed in patients with metastatic renal cell carcinoma (RCC). The ability of nutritional screening tools to predict overall survival (OS) in patients with RCC has not been adequately validated. The objective of this study was to investigate the performance of nutritional screening tools and their additional prognostic value in patients with metastatic RCC treated with targeted therapies. Methods Patients were prospectively recruited from three tertiary hospitals between 2009 and 2013. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI) and the Mini Nutritional Assessment–Short Form (MNA–SF). Their OS and early grade 3/4 adverse events were recorded as outcomes of interest, and their associations with nutritional status were assessed using Cox regression and logistic regression, respectively. The incremental value in prognostication was evaluated using concordance index and decision curve analyses. Results Of the 300 enrolled patients, 95 (31.7%) and 64 (21.3%) were classified as being at risk of malnutrition according to the GNRI and MNA–SF, respectively. Both GNRI and MNA–SF were independent predictors of OS in multivariate analyses and provided significant added benefit to Heng risk classification. Compared with the MNA–SF, the GNRI contributed a higher increment to the concordance index (0.041 vs. 0.016). Nutritional screening, however, was not associated with early grade 3/4 adverse events in multivariate analyses. Further investigations are needed using more comprehensive and accurate assessment tools. Conclusions This prospective study confirmed the importance of nutritional screening tools in survival prognostication in patients with metastatic RCC. The standardized and objective measurements would allow clinicians to identify metastatic RCC patients at risk of poor survival outcomes. Individualized nutritional

  1. What effect do attempts to lose weight have on the observed relationship between nutrition behaviors and body mass index among adolescents?

    Science.gov (United States)

    Utter, Jennifer; Scragg, Robert; Ni Mhurchu, Cliona; Schaaf, David

    2007-09-19

    Little research has given consideration to how people's weight control behaviors may moderate the relationships between nutrition and body mass index (BMI) in large cross-sectional studies. The objective of the current study is to determine how attempts to lose weight confound the relationships between nutrition behaviors and BMI among a population of predominately overweight adolescents. Data were drawn from the baseline measurements of the Pacific OPIC (Obesity Prevention In Communities). Participants included approximately 3500 high school students in New Zealand. Students in the sample primarily identified as a Pacific Island ethnicity (57%) and the mean age for participants was 14.8 years. Participants completed a questionnaire about nutrition and physical activity patterns and were weighed and measured for height. In our sample, 57% of students were overweight/obese, with the highest prevalence among Pacific Island students (71%). Approximately 50% of students were currently trying to lose weight, and this was more common among females, Pacific Island students and overweight/obese students. Examination of the nutritional correlates of BMI in the total population found inverse relationships between BMI and consumption of high-fat/high-sugar foods and positive relationships between BMI and eating 5 or more fruits and vegetables a day (all significant after controlling for age, sex, and ethnicity). For example, students who drank the most soft drinks or ate fruit and vegetables infrequently had the lowest mean BMI. Students' attempts to change their weight significantly moderated the relationships between most nutritional behaviors and BMI. In most cases, among students not trying to change their weight, expected relationships were observed; among students trying to lose weight, unexpected or no relationships were observed. Our findings suggest that among this population of predominately overweight students, solely relying on cross-sectional findings between

  2. The prognostic value of the neoadjuvant response index in triple-negative breast cancer : validation and comparison with pathological complete response as outcome measure

    NARCIS (Netherlands)

    Jebbink, M.; van Werkhoven, E.; Mandjes, I. A. M.; Wesseling, J.; Lips, E. H.; Peeters, M. -J. T. D. F. Vrancken; Loo, C. E.; Sonke, G. S.; Linn, S. C.; Falo Zamora, C.; Rodenhuis, S.

    The Neoadjuvant response index (NRI) has been proposed as a simple measure of downstaging by neoadjuvant treatment in breast cancer. It was previously found to predict recurrence-free survival (RFS) in triple-negative (TN) breast cancer. It was at least as accurate as the standard binary system, the

  3. Work ability as prognostic risk marker of disability pension : Single-item work ability score versus multi-item work ability index

    NARCIS (Netherlands)

    Roelen, C.A.M.; Rhenen, van W.; Groothoff, J.W.; Klink, van der J.J.L.; Twisk, W.R.; Heymans, M.W.

    2014-01-01

    Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP.

  4. Serial changes and prognostic implications of a Doppler-derived index of combined left ventricular systolic and diastolic myocardial performance in acute myocardial infarction

    DEFF Research Database (Denmark)

    Poulsen, Steen H; Jensen, Svend E; Nielsen, Jens C

    2000-01-01

    relaxation time divided by ejection time was measured from mitral inflow and left ventricular outflow Doppler velocity profiles. The index was significantly higher in patients with AMI than in control subjects at days 1 and 360 (day 1, 0.58 +/- 0.09 vs 0.41 +/- 0.08, p

  5. Aircraft Anomaly Prognostics Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Ridgetop Group will leverage its proven Electromechanical Actuator (EMA) prognostics methodology to develop an advanced model-based actuator prognostic reasoner...

  6. Nutritional Assessment of Patients with Head and Neck Cancer in North-East India and Dietary Intervention.

    Science.gov (United States)

    Bhattacharjee, Abhinandan; Bahar, Iqbal; Saikia, Abijit

    2015-01-01

    Head and neck cancer (HNCA) patients have poor nutritional status which clearly bears a negative prognosis in cancer. There is no study and consensus on nutritional assessment tools and diet structure for such patients. This study intends to determine the prevalence of malnutrition and formulate a diet chart keeping in view the general food habit and economic condition of HNCA patients of North East (NE) region. To find out an affordable dietary intervention for HNCA patients based on dietary principles. To assess the role of nutritional assessment tools in these group of patients. This is a 1-year prospective interventional study on HNCA patients attending the Dept of ENT of a teaching hospital. The outcome of the nutritional intervention using a specific diet were assessed using clinical, laboratory and anthropomorphic assessment tools and indices like Prognostic Nutritional Index (PNI) and Nutritional Assessment Index (NAI). The study diet provided appropriate amounts of nutrients to HNCA patients as evident from improvements in anthropomorphic parameters and nutritional indices. Clinically, Hemoglobin percentage (Hb%), Body Mass Index (BMI), Mid Arm Circumference (MAC) and triceps skin fold thickness (TST) were found to be reliable malnutrition markers. Nutritional Assessment Index has been found to be the best index to evaluate malnutrition. The daily requirement of nutrients for HNCA patients can be satisfactorily met by adopting specific diet chart presented in our study. As no structured diet plan are available in literature, our diet chart can act as a template diet appropriate for HNCA patients of this region.

  7. Effect of a child care center-based obesity prevention program on body mass index and nutrition practices among preschool-aged children.

    Science.gov (United States)

    Natale, Ruby A; Lopez-Mitnik, Gabriela; Uhlhorn, Susan B; Asfour, Lila; Messiah, Sarah E

    2014-09-01

    This study examined the effect of an early childhood obesity prevention program on changes in Body Mass Index (BMI) z-score and nutrition practices. Eight child care centers were randomly assigned to an intervention or attention control arm. Participants were a multiethnic sample of children aged 2 to 5 years old (N = 307). Intervention centers received healthy menu changes and family-based education focused on increased physical activity and fresh produce intake, decreased intake of simple carbohydrate snacks, and decreased screen time. Control centers received an attention control program. Height, weight, and nutrition data were collected at baseline and at 3, 6, and 12 months. Analysis examined height, weight, and BMI z-score change by intervention condition (at baseline and at 3, 6, and 12 months). Pearson correlation analysis examined relationships among BMI z-scores and home activities and nutrition patterns in the intervention group. Child BMI z-score was significantly negatively correlated with the number of home activities completed at 6-month post intervention among intervention participants. Similarly, intervention children consumed less junk food, ate more fresh fruits and vegetables, drank less juice, and drank more 1% milk compared to children at control sites at 6 months post baseline. Ninety-seven percent of those children who were normal weight at baseline were still normal weight 12 months later. Findings support child care centers as a promising setting to implement childhood obesity prevention programs in this age group. © 2014 Society for Public Health Education.

  8. HIGH BODY MASS INDEX AMONG PATIENTS UNDERGOING HEMATOPOIETIC STEM CELL TRANSPLANTATION: RESULTS OF A CROSS-SECTIONAL EVALUATION OF NUTRITIONAL STATUS IN A PRIVATE HOSPITAL.

    Science.gov (United States)

    Pereira, Andrea Z; Victor, Elivane S; Vidal Campregher, Paulo; Piovacari, Silvia M F; Bernardo Barban, Juliana S; Pedreira, Wilson L; Hamerschlak, Nelson

    2015-12-01

    nutritional status before hematopoietic stem cell transplantation (HSCT) affects prognosis: better nourished patients have shorter time to engraftment, while malnutrition is associated with increase of mortality rates, complications, medical costs, poor quality of life and hospitalization stay. Furthermore, underweight patients have increased risk of death in the early post- HSCT period, and non-relapse mortality is greater for those who are extremely underweight, overweight and obese. Obesity is associated with treatment-related toxicity, higher incidence of grade II-IV acute graft-versus- host disease (GVHD), infections and mortality. The objective of this study was to investigate the nutritional status of patients undergoing HSCT between 2007-2013 in a private hospital, by calculating the body mass index (BMI), to verify the prevalence of any nutritional imbalances, especially obesity. in this retrospective study, based on medical records, we analyzed data from all patients with malignant and nonmalignant diseases who underwent HSCT from January 2007 to February 2014 in the Hematology- Oncology and Bone Marrow Transplantation Center at a large, tertiary referral center in Brazil. a total of 257 cases were treated in the period and analyzed, of which 79% were aged up to 65 years old. Among these, 56% were overweight or obese. We observed a higher prevalence of obesity in elderly patients (P underweight and more overweight and obesity rates in men and elderly patients undergoing HSCT. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Pre-therapeutic nutritional assessment for predicting severe adverse events in patients with head and neck cancer treated by radiotherapy.

    Science.gov (United States)

    Kono, Takeyuki; Sakamoto, Koji; Shinden, Seiichi; Ogawa, Kaoru

    2017-12-01

    Malnutrition is common in patients with head and neck cancer (HNSCC). It may be related to severe adverse toxicity as a result of radiotherapy. The aim was to investigate nutritional screening factors for severe adverse events. A retrospective chart review of 101 patients who underwent radiotherapy from 2009 to 2013 was performed. The relationships among severe adverse events and pretreatment nutritional parameters, including static variables (serum albumin, total protein, total lymphocyte counts, body mass index), dynamic variables (retinol-binding protein, transferrin, pre-albumin), and nutritional screening tools (Onodera's Prognostic Nutrition Index [O-PNI]; Nutrition Risk Index; Controlling Nutritional Status [CONUT] score; Nutritional Risk Screening 2002) were evaluated in addition to patient and treatment factors. According to the static parameters, approximately 30% of patients were malnourished before treatment. Twenty-four patients exhibited severe adverse events. On univariate analysis, combined chemotherapy, advanced staging, O-PNI nutritional factor for predicting severe adverse events in HNSCC patients undergoing chemoradiotherapy and facilitates the planning of aggressive nutritional interventions prior to treatment. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. Standardized uptake value for (18)F-fluorodeoxyglucose is correlated with a high International Prognostic Index and the presence of extranodal involvement in patients with diffuse large B-cell lymphoma.

    Science.gov (United States)

    Akkas, B E; Vural, G U

    2014-01-01

    The aim of this study was to evaluate whether the maximum standardized uptake value (SUVmax) of (18)F-fluorodeoxyglucose (FDG) correlates with the International Prognostic Index (IPI) and the presence of extranodal involvement in patients with Diffuse Large B-Cell Lymphoma (DLBCL). 77 patients (age: 57.2±18.5, 40F, 37M) with DLBCL who underwent FDG PET/CT for initial staging were included. SUVmax of the predominant lesions were compared to Ann Arbor stage, IPI scores, the presence of extranodal involvement and the number extranodal sites. PET/CT detected nodal (n:25) and extranodal involvement (n:52) in all the patients. In 27 patients, extranodal disease could only be detected by PET. SUVmax of the predominant lesion in patients with extranodal disease was significantly higher than that of the patients who had only nodal disease (25±12 vs. 15.3±10 respectively, p=0.001). SUVmax significantly correlated with IPI scores; the average SUVmax was significantly correlated with the IPI: Mean SUVmax of the predominant lesion was 13.9±9.5 in patients with low risk (IPI=0-1), 14.2±8.8 in low-intermediate risk group (IPI=2) whereas 26.6±9.5 in high-intermediate risk group (IPI=3) and 25±13.6 in high risk group patients (IPI=4-5) (p=0.002). SUVmax was not correlated with clinical stage, the number of extranodal sites and serum LDH levels. FDG uptake correlates with IPI and the presence of extranodal involvement in DLBCL. PET is a powerful method to detect extranodal disease in DLBCL. The correlation of SUVmax with these prognostic factors may highlight the importance of pretreatment FDG uptake as a metabolic marker of poor prognosis for patients with DLBCL. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  11. Relative chlorophyll contents in the evaluation of the nutritional status of nitrogen from xaraes palisade grass and determination of critical nitrogen sufficiency index

    Directory of Open Access Journals (Sweden)

    Joao Paulo Ramos Costa

    2015-05-01

    Full Text Available The nutritional status of xaraes palisade grass with SPAD chlorophyll meter and the critical nitrogen sufficiency index (cNSI in the dry and rainy seasons were assessed. The experiment was conducted in a completely randomized design with four treatments (50, 100, 200 and 400 kg N ha-1, three replicates and two seasons: dry and rainy. All variables had a high nonlinear relationship with their predictors (p < 0.001. Total nitrogen (TN reached a plateau at doses 262.0 and 514.8 kg of N ha-1 and the concentration of TN in the plant was 1.88 and 1.93% respectively during the rainy and dry season. Relative chlorophyll content (RCC reached a plateau at 46.05 and 53.65 SPAD units in the rainy and dry seasons, respectively. The production of dry matter (DM showed maximum response to nitrogen fertilization at 209.5 and 229.1 kg N ha-1 during the rainy and dry season respectively. The nitrogen sufficiency index (NSI reached the plateau at 0.85 and 0.99 in the rainy and dry season respectively. All variables showed high linear correlation (r = 0.71 to 0.99. The xaraés palisade grass’s cNSI is 0.85 and the chlorophyll meter may be used as a nutritional N management tool for the grass.

  12. The Association of Geriatric Nutritional Risk Index and Total Lymphocytes Count with Mortality in Korean Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Kiryong Park, M.D.

    2012-06-01

    Conclusion: These results demonstrate that the GNRI may be a significant predictor of mortality in Korean hemodialysis patients. However, the use of TLC might improve the evaluation of nutritional risk and the identification of patients at risk of malnutrition.Figure 1. Total lymphocytes count and 120-month survival of hemodialysis patients. In both groups, survival rate during the follow-up period was similar. (life table analysis, P = 0.500.fx1

  13. A comparison of the prognostic value of preoperative inflammation-based scores and TNM stage in patients with gastric cancer

    Directory of Open Access Journals (Sweden)

    Pan QX

    2015-06-01

    Full Text Available Qun-Xiong Pan,* Zi-Jian Su,* Jian-Hua Zhang, Chong-Ren Wang, Shao-Ying KeDepartment of Oncosurgery, Quanzhou First Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, People’s Republic of China*These authors contributed equally to this workBackground: People’s Republic of China is one of the countries with the highest incidence of gastric cancer, accounting for 45% of all new gastric cancer cases in the world. Therefore, strong prognostic markers are critical for the diagnosis and survival of Chinese patients suffering from gastric cancer. Recent studies have begun to unravel the mechanisms linking the host inflammatory response to tumor growth, invasion and metastasis in gastric cancers. Based on this relationship between inflammation and cancer progression, several inflammation-based scores have been demonstrated to have prognostic value in many types of malignant solid tumors.Objective: To compare the prognostic value of inflammation-based prognostic scores and tumor node metastasis (TNM stage in patients undergoing gastric cancer resection.Methods: The inflammation-based prognostic scores were calculated for 207 patients with gastric cancer who underwent surgery. Glasgow prognostic score (GPS, neutrophil lymphocyte ratio (NLR, platelet lymphocyte ratio (PLR, prognostic nutritional index (PNI, and prognostic index (PI were analyzed. Linear trend chi-square test, likelihood ratio chi-square test, and receiver operating characteristic were performed to compare the prognostic value of the selected scores and TNM stage.Results: In univariate analysis, preoperative serum C-reactive protein (P<0.001, serum albumin (P<0.001, GPS (P<0.001, PLR (P=0.002, NLR (P<0.001, PI (P<0.001, PNI (P<0.001, and TNM stage (P<0.001 were significantly associated with both overall survival and disease-free survival of patients with gastric cancer. In multivariate analysis, GPS (P=0.024, NLR (P=0.012, PI (P=0.001, TNM stage (P<0.001, and degree of

  14. Use of the glycemic index in nutrition education Uso do índice glicêmico na educação nutricional

    Directory of Open Access Journals (Sweden)

    Flávia Galvão Cândido

    2013-02-01

    Full Text Available Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicated as the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of the glycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic index foods. Studies published over the past 12 years, in addition to classic studies on this topic, found in the databases MedLine, ScienceDirect, SciELO and Lilacs exploring the importance of the glycemic index and the factors that affect the glycemic index were selected for this article. The preparation of lists grouping foods according to their glycemic index should be based on information found in tables and specific web sites. This is an interesting strategy that must be very carefully conducted, considering the eating habits of the assisted people. To reduce the postprandial blood glucose response, high glycemic index foods should be consumed in association with the following foods: high protein and low fat foods, good quality oils and unprocessed foods with high fiber content. Caffeine should also be avoided. The glycemic index should be considered as an additional carbohydrate-selection tool, which should be part of a nutritionally balanced diet capable of promoting and/or maintaining body weight and health.Recentemente, a falta de artigos que visam fornecer orientação quanto ao uso do índice glicêmico foi apontada como causa de sua baixa utilização na educação nutricional. O objetivo do presente trabalho é oferecer suporte para o uso do índice glicêmico como ferramenta a ser adotada na educação nutricional, para estimular o consumo preferencial de alimentos que apresentem menores valores nesse indicador. Foram selecionados estudos publicados nos últimos doze anos, além de estudos clássicos referentes ao tema, indexados nos bancos de dados MedLine, ScienceDirect, SciELO e Lilacs, que

  15. The prediction role of indexes of circulating adipokines for common anthropometric and nutritional characteristics of obesity in the obese Central European population.

    Science.gov (United States)

    Bienertová-Vašků, Julie; Novák, Jan; Zlámal, Filip; Forejt, Martin; Havlenová, Soňa; Jackowská, Aneta; Tomandl, Josef; Tomandlová, Marie; Šplíchal, Zbyněk; Vašků, Anna

    2014-04-01

    This study was designed to investigate the relationship between 8 selected adipokines (leptin, leptin receptor, adiponectin, agouti-related peptide, omentin, visfatin, adipsin and resistin), dietary composition and anthropometric parameters found in the Central European obese population. A total of 65 unrelated obese Central European Caucasian individuals were recruited for the study. Phenotypic measurements included weight, height, BMI, lean body mass, fat mass, body fat, waist and hip circumference, waist-hip ratio (WHR) and skinfold thickness. Participants completed standardized self-reported 7-day food records. Plasma levels of leptin, leptin receptor, adiponectin, agouti-related peptide (AgRP), resistin, adipsin, omentin and visfatin were examined using ELISA. Multiple associations (weight, height, percentage of body fat, waist circumference, hip circumference, WHR and sum of skinfold thickness) with the circulation levels of the investigated adipokines were identified. Leptin-Leptin receptor (L-LR) levels were found to correlate with total energy intake and macronutrients while adipsin was found to strongly correlate with multiple adipokines. Furthermore, the L-LR index was found to constitute a more accurate description of the relationship between BMI and body weight than individual measurements and the Ag-LR index was found to strongly correlate with both anthropometric and dietary characteristics. Following confirmation on larger population samples and on samples of different ethnicities, the reported adipokine indexes could become a useful tool for estimating nutritional status and predicting the body composition of specific patient groups. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. IMPACT OF NUTRITIONAL COUNSELLING ON BODY MASS INDEX (BMI AND NUTRIENT INTAKE OF THE NON - COMMUNICABLE DISEASE PATIENTS (NCD.

    Directory of Open Access Journals (Sweden)

    Manisha Singh

    2011-12-01

    Full Text Available Good health is an important discussion of the quality of life. Health problem is a major concern in all over the world but especially in developing countries. Non-communicable diseases ( NCDs contribute the ill health. Diabetes, coronary heart disease, various forms of cancer, gastro intestinal disorder and various diseases of bones and joints are diet related NCDs. Nutritional counselling is one of the effective tools of changing the food habits of people. The data for this study is taken from the out patients services of Department of Endocrinology & Metabolism and Cardiology of Sir Sunder Lal Hospital, Banaras Hindu University, Varanasi-5. Total 250 samples were included in the study. Age group 40 – 60 years were considered as study samples who attended the Endocrinology and Cardiology departments. Purposive sampling method was used in the study. Questionnaire cum interview method was adopted in the study. Anthropametric measurements were taken by using standard techniques. 24 hours diet recall method was also used in this study. Evaluation of councelling was done on basis of changes in BMI and nutrient intake. Result shows the positive impact of nutritional counselling in BMI and nutrient intake of NCD patients.

  17. Prognostic role of left atrial strain and its combination index with transmitral E-wave velocity in patients with atrial fibrillation.

    Science.gov (United States)

    Hsu, Po-Chao; Lee, Wen-Hsien; Chu, Chun-Yuan; Lee, Hung-Hao; Lee, Chee-Siong; Yen, Hsueh-Wei; Lin, Tsung-Hsien; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung; Su, Ho-Ming

    2016-02-01

    Left atrial (LA) strain can reflect LA remodeling and is reduced in atrial fibrillation (AF) patients with prior stroke. This study sought to examine the ability of LA strain in predicting subsequent stroke event in AF and also evaluated whether E/LA strain could predict cardiovascular (CV) events in these patients. In 190 persistent AF patients, we performed comprehensive echocardiography with assessment of LA strain. There were 69 CV events including 19 CV death, 32 hospitalizations for heart failure, 3 myocardial infarctions, and 15 strokes during an average follow-up of 29 months. Multivariate analysis showed old age, chronic heart failure, increased left ventricular (LV) mass index, and increased E/LA strain were associated with CV events and decreased LA strain was associated with subsequent stroke event. The addition of E/LA strain and LA strain to a model containing CHA2DS2-VASc score and LV function significantly improved the values in predicting CV events and subsequent stroke event, respectively. In conclusion, E/LA strain and LA strain were respectively useful in predicting CV events and subsequent stroke event in AF. E/LA strain and LA strain could provide incremental values for CV outcome and subsequent stroke outcome prediction over conventional clinical and echocardiographic parameters in AF, respectively.

  18. Prognostic Value of Ankle-Brachial Index in Patients Undergoing Percutaneous Coronary Intervention: In-Hospital and 1-Year Outcomes From the SHINANO Registry.

    Science.gov (United States)

    Hashizume, Naoto; Miura, Takashi; Miyashita, Yusuke; Motoki, Hirohiko; Ebisawa, Soichiro; Izawa, Atsushi; Koyama, Jun; Ikeda, Uichi; Kuwahara, Koichiro

    2017-11-01

    Concomitant coronary and peripheral artery disease is associated with higher periprocedural and long-term percutaneous coronary intervention (PCI) complication rates. We evaluated in-hospital and 1-year clinical outcomes of patients with low or borderline ankle-brachial indexes (ABIs) undergoing PCIs in the drug-eluting stent era. We divided 1370 SHINANO registry patients into 3 groups-low (ABI ≤ 0.9), borderline (0.9 < ABI ≤ 1.0), and normal (1.0 ≤ ABI < 1.4). During the 1-year follow-up, more PCI-related complications occurred in the low and borderline ABI groups than in the normal ABI group (7.7% vs 8.8% vs 4.0%, respectively). Low ABI patients were more likely to experience adverse clinical events (6.3% vs 3.6% vs 3.0%, respectively; log-rank P = .020 for low vs normal ABI), with a hazard ratio of 2.27 (95% confidence interval, 1.12-4.61; P = .023), compared with patients with normal ABIs. Patients with abnormal ABIs had a significantly higher incidence of PCI-related complications and a less favorable 1-year prognosis. Routine ABI measurement before PCI may help predict PCI-related complication incidence and 1-year prognosis.

  19. Re-operative abdominal predictive score: a prognostic model combining Acute Re-intervention Predictive Index and intra-abdominal pressure.

    Science.gov (United States)

    Soler-Morejón, Caridad de Dios; Lombardo-Vaillant, Tomás Ariel; Tamargo-Barbeito, Teddy Osmín; Wise, Robert; Malbrain, Manu L N G

    2017-11-22

    The decision to re-operate after abdominal surgery is still difficult, especially in the setting of intra-abdominal sepsis. Mathematical models provide a good aid to both diagnosis and decision-making. A prospective observational study was conducted with 300 patients consecutively admitted to the intensive care unit of an academic institution affiliated to Calixto García Medical Faculty following abdominal surgery from January 2008 to January 2010. The patients were randomly separated (2:1) into estimation and validation groups. Logistic regression analysis was used in the estimation group to develop three models for decision-making related to re-operation including related factors such as age, ARPI, IAP, type of surgery (elective or emergency), and the duration of surgery. The three models developed were validated on the other group. The acute re-operation predictive index-intra-abdominal pressure (ARPI-IAP) model was the best of the three models, with an excellent calibration, using the Hossmer-Lemeshow goodness-of-fit statistical test (C = 9.976, P = 0.267), as well as discrimination (AUC = 0.989; 95% CI: 0.976-1.000). The combination of IAP with ARPI in a mathematical model can add accuracy to the prediction of need for re-operation related to intra-abdominal infectious complications in patients following abdominal surgery. This may be useful in all medical settings, but especially those with limited resources.

  20. Prognostic role of a new risk index for the prediction of 30-day cardiovascular mortality in patients with acute pulmonary embolism: the Age-Mean Arterial Pressure Index (AMAPI).

    Science.gov (United States)

    Zuin, Marco; Rigatelli, Gianluca; Picariello, Claudio; Carraro, Mauro; Zonzin, Pietro; Roncon, Loris

    2017-12-01

    Acute pulmonary embolism (PE) is the third cause of cardiovascular (CV) mortality. We evaluated a new risk index, named Age-Mean Arterial Pressure Index (AMAPI), to predict 30-day CV mortality in patients with acute PE. Data of 209 patients (44.0% male and 56.0% female, mean age 70.58 ± 14.14 years) with confirmed acute PE were retrospectively analysed. AMAPI was calculated as the ratio between age and mean arterial pressure (MAP), which was defined as [systolic blood pressure + (2 × diastolic blood pressure)]/3. To test AMAPI accuracy, a comparison with shock index (SI) and simplified pulmonary embolism severity index (sPESI) was performed. Patients were divided in two groups according their hemodynamic stability, or not, at admission. 30-day mortality rate, in all cases for CV events, was 10.5% (n = 22). Hemodynamically unstable patients had a higher AMAPI compare to those without hypotension at admission (1.28 ± 0.39 vs 0.78 ± 0.27, p < 0.0001). Receiving operative curve analyses (ROC) found the optimal cut-off for AMAPI in hemodynamically stable and unstable patients ≥0.9 and ≥0.92, respectively. In both groups, patients with an AMAPI over the cut-off were significantly older, hypotensive (both systolic and diastolic blood pressure), with a higher SI and lower MAP. In hemodynamically stable patients, 30-day CV mortality risk prediction was improved adding AMAPI ≥0.9 to both SI and sPESI (net reclassification improvement-NRI-of 14.2%, p = 0.0006 and 11.5%, p = 0.0002, respectively). In hemodynamically unstable patients NRI was 19.2%, p = 0.006. Mantel-Cox analysis revealed a statistical significant difference in the distribution of survival between hemodynamically stable patients with an AMAPI index ≥0.9 compared to those with an AMAPI <0.89 [log rank (Mantel-Cox) p < 0.0001] and in hemodynamically unstable patients with an AMAPI ≥0.92 [log rank (Mantel-Cox) p = 0.001]. AMAPI ≥0.90 and ≥0.92 predict 30-day CV mortality

  1. Effects of a physical activity and nutrition program for seniors on body mass index and waist-to-hip ratio: a randomised controlled trial.

    Science.gov (United States)

    Burke, Linda; Lee, Andy H; Pasalich, Maria; Jancey, Jonine; Kerr, Deborah; Howat, Peter

    2012-06-01

    To investigate whether a home-based program, physical activity and nutrition for seniors (PANS), made positive changes to central obesity, measured by body mass index (BMI) and waist-to-hip ratio (WHR). A 6-month randomised controlled trial was conducted targeting overweight and sedentary older adults aged 60 to 70 years residing in low to medium socio-economic suburbs within metropolitan Perth. Intervention participants (n=248) received mailed materials and telephone/email support to improve nutrition and physical activity levels. Controls (n=230) received small incentives to complete baseline and post-intervention questionnaires. Both groups reported anthropometric measures following specific written instructions. Generalised estimating equation models were used to assess repeated outcomes of BMI and WHR over both time points. 176 intervention and 199 controls (response rate 78.5%) with complete data were available for analysis. After controlling for demographic and other confounding factors, the intervention group demonstrated a small (0.02) but significant reduction in WHR (p=0.03) compared to controls, no apparent change in BMI was evident for both groups. The 0.02 reduction in mean WHR corresponded to a 2.11 cm decrease in waist circumference for a typical hip circumference. PANS appears to improve the WHR of participants. Changes in BMI might require a longer term intervention to take effect, and/or a follow-up study to confirm its sustainability. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Diagnostic and prognostic value of brain natriuretic peptide (BNP) concentrations in very elderly heart disease patients: specific geriatric cut-off and impacts of age, gender, renal dysfunction, and nutritional status.

    Science.gov (United States)

    Blondé-Cynober, F; Morineau, G; Estrugo, B; Fillie, E; Aussel, C; Vincent, J-P

    2011-01-01

    Confirming the presence of heart failure (HF) in geriatric patients is made difficult by the overlapping symptoms with other diseases and by limited access to investigative techniques such as echography, and the clinical signs are either non-constant or difficult to interpret. In this context, BNP measurement could prove highly useful. We determined a cut-off value of BNP for diagnosing HF in geriatric patients and gauged its predictive power in terms of cardiovascular events, dependence and death within a 6-month timeframe. This clinical and biological study was performed in patients, 44 women and 20 men, age>65 years with suspected HF hospitalized in the geriatric unit at Emile-Roux hospital. Echography was performed at baseline examination. BNP concentrations were determined at baseline examination and at 2 and 6 months later. Renal function was assessed via the Cockroft-Gault formula. Nutritional status was assessed using the geriatric nutritional risk index (GNRI). Final reference diagnosis was established by both cardiologist and geriatrician. The diagnostic value of BNP was assessed by area under the ROC curve. The average age of the 64 patients was 84.3±7.4 years. The final diagnosis was HF in 26 patients (41%). A BNPnutritional and renal dysfunctions. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Prognostic evaluation of DNA index in HIV-HPV co-infected women cervical samples attending in reference centers for HIV-AIDS in Recife.

    Directory of Open Access Journals (Sweden)

    Albert Eduardo Silva Martins

    Full Text Available INTRODUCTION: Persistence of cervical infection caused by human papillomavirus (HPV types with high oncogenic risk may lead to cervical intraepithelial neoplasia (CIN. The aim of the present study was to evaluate whether, in HIV-positive women, the presence of aneuploidy in cervical cell samples is associated with presence and evolution of CIN. METHODS: The present study had two stages. In the first stage, comprising a cross-sectional study, the association between the presence of aneuploidy seen via flow cytometry and sociodemographic characteristics, habits and characteristics relating to HPV and HIV infection was analyzed. In the second stage, comprising a cohort study, it was investigated whether aneuploidy was predictive of CIN evolution. RESULTS: No association was observed between the presence of aneuploidy and HPV infection, or between its presence and alterations seen in oncotic cytological analysis. On the other hand, aneuploidy was associated with the presence of CIN (p = 0.030 in histological analysis and with nonuse of antiretroviral therapy (p = 0.001. Most of the HIV-positive women (234/272 presented normal CD4+ T lymphocyte counts (greater than 350 cells/mm3 and showed a greater aneuploidy regression rate (77.5% than a progression rate (23.9% over a follow-up of up to two years. CONCLUSION: Although there was an association between the presence of cervical tissue lesions and the DNA index, the latter was not predictive of progression of the cervical lesion. This suggests that progression of the cervical lesion to cancer in HIV-positive women may also be changed through improvement of the immunological state enabled by using antiretroviral therapy.

  4. Interaction between body mass index and hormone-receptor status as a prognostic factor in lymph-node-positive breast cancer.

    Directory of Open Access Journals (Sweden)

    Il Yong Chung

    Full Text Available The aim of this study was to determine the relationship between the body mass index (BMI at a breast cancer diagnosis and various factors including the hormone-receptor, menopause, and lymph-node status, and identify if there is a specific patient subgroup for which the BMI has an effect on the breast cancer prognosis. We retrospectively analyzed the data of 8,742 patients with non-metastatic invasive breast cancer from the research database of Asan Medical Center. The overall survival (OS and breast-cancer-specific survival (BCSS outcomes were compared among BMI groups using the Kaplan-Meier method and Cox proportional-hazards regression models with an interaction term. There was a significant interaction between BMI and hormone-receptor status for the OS (P = 0.029, and BCSS (P = 0.013 in lymph-node-positive breast cancers. Obesity in hormone-receptor-positive breast cancer showed a poorer OS (adjusted hazard ratio [HR] = 1.51, 95% confidence interval [CI] = 0.92 to 2.48 and significantly poorer BCSS (HR = 1.80, 95% CI = 1.08 to 2.99. In contrast, a high BMI in hormone-receptor-negative breast cancer revealed a better OS (HR = 0.44, 95% CI = 0.16 to 1.19 and BCSS (HR = 0.53, 95% CI = 0.19 to 1.44. Being underweight (BMI < 18.50 kg/m2 with hormone-receptor-negative breast cancer was associated with a significantly worse OS (HR = 1.98, 95% CI = 1.00-3.95 and BCSS (HR = 2.24, 95% CI = 1.12-4.47. There was no significant interaction found between the BMI and hormone-receptor status in the lymph-node-negative setting, and BMI did not interact with the menopause status in any subgroup. In conclusion, BMI interacts with the hormone-receptor status in a lymph-node-positive setting, thereby playing a role in the prognosis of breast cancer.

  5. Nutritional risk assessment in critically ill cancer patients: systematic review.

    Science.gov (United States)

    Fruchtenicht, Ana Valéria Gonçalves; Poziomyck, Aline Kirjner; Kabke, Geórgia Brum; Loss, Sérgio Henrique; Antoniazzi, Jorge Luiz; Steemburgo, Thais; Moreira, Luis Fernando

    2015-01-01

    To systematically review the main methods for nutritional risk assessment used in critically ill cancer patients and present the methods that better assess risks and predict relevant clinical outcomes in this group of patients, as well as to discuss the pros and cons of these methods according to the current literature. The study consisted of a systematic review based on analysis of manuscripts retrieved from the PubMed, LILACS and SciELO databases by searching for the key words "nutritional risk assessment", "critically ill" and "cancer". Only 6 (17.7%) of 34 initially retrieved papers met the inclusion criteria and were selected for the review. The main outcomes of these studies were that resting energy expenditure was associated with undernourishment and overfeeding. The high Patient-Generated Subjective Global Assessment score was significantly associated with low food intake, weight loss and malnutrition. In terms of biochemical markers, higher levels of creatinine, albumin and urea were significantly associated with lower mortality. The worst survival was found for patients with worse Eastern Cooperative Oncologic Group - performance status, high Glasgow Prognostic Score, low albumin, high Patient-Generated Subjective Global Assessment score and high alkaline phosphatase levels. Geriatric Nutritional Risk Index values Nutritional Index score was associated with abnormal nutritional status in critically ill cancer patients. Among the reviewed studies that examined weight and body mass index alone, no significant clinical outcome was found. None of the methods reviewed helped to define risk among these patients. Therefore, assessment by a combination of weight loss and serum measurements, preferably in combination with other methods using scores such as Eastern Cooperative Oncologic Group - performance status, Glasgow Prognostic Score and Patient-Generated Subjective Global Assessment, is suggested given that their use is simple, feasible and useful in such

  6. Nutritional risk assessment in critically ill cancer patients: systematic review

    Science.gov (United States)

    Fruchtenicht, Ana Valéria Gonçalves; Poziomyck, Aline Kirjner; Kabke, Geórgia Brum; Loss, Sérgio Henrique; Antoniazzi, Jorge Luiz; Steemburgo, Thais; Moreira, Luis Fernando

    2015-01-01

    Objective To systematically review the main methods for nutritional risk assessment used in critically ill cancer patients and present the methods that better assess risks and predict relevant clinical outcomes in this group of patients, as well as to discuss the pros and cons of these methods according to the current literature. Methods The study consisted of a systematic review based on analysis of manuscripts retrieved from the PubMed, LILACS and SciELO databases by searching for the key words “nutritional risk assessment”, “critically ill” and “cancer”. Results Only 6 (17.7%) of 34 initially retrieved papers met the inclusion criteria and were selected for the review. The main outcomes of these studies were that resting energy expenditure was associated with undernourishment and overfeeding. The high Patient-Generated Subjective Global Assessment score was significantly associated with low food intake, weight loss and malnutrition. In terms of biochemical markers, higher levels of creatinine, albumin and urea were significantly associated with lower mortality. The worst survival was found for patients with worse Eastern Cooperative Oncologic Group - performance status, high Glasgow Prognostic Score, low albumin, high Patient-Generated Subjective Global Assessment score and high alkaline phosphatase levels. Geriatric Nutritional Risk Index values Nutritional Index score was associated with abnormal nutritional status in critically ill cancer patients. Among the reviewed studies that examined weight and body mass index alone, no significant clinical outcome was found. Conclusion None of the methods reviewed helped to define risk among these patients. Therefore, assessment by a combination of weight loss and serum measurements, preferably in combination with other methods using scores such as Eastern Cooperative Oncologic Group - performance status, Glasgow Prognostic Score and Patient-Generated Subjective Global Assessment, is suggested given that

  7. Prognostic Impact of Visceral Fat Amount and Branched-Chain Amino Acids (BCAA) in Hepatocellular Carcinoma.

    Science.gov (United States)

    Higashi, Takaaki; Hayashi, Hiromitsu; Kaida, Takayoshi; Arima, Kota; Takeyama, Hideaki; Taki, Katsunobu; Izumi, Daisuke; Tokunaga, Ryuma; Kosumi, Keisuke; Nakagawa, Shigeki; Okabe, Hirohisa; Imai, Katsunobu; Nitta, Hidetoshi; Hashimoto, Daisuke; Chikamoto, Akira; Beppu, Toru; Baba, Hideo

    2015-12-01

    Dysregulation of lipid and amino acid metabolism in patients with liver diseases results in obesity-related carcinogenesis and decreased levels of branched-chain amino acids (BCAA), respectively. This study assessed the clinical and prognostic impact of visceral fat amount (VFA) and its association with amino acid metabolism in patients with hepatocellular carcinoma (HCC). In this study, 215 patients who underwent hepatic resection for HCC were divided into two groups based on VFA criteria for metabolic abnormalities in Japan. Computed tomography was used to measure VFA at the third lumbar vertebra in the inferior direction. Of the 215 patients, 132 had high and 83 had low VFA. High VFA was significantly associated with older age and higher body mass index (BMI), subcutaneous fat amount, and BCAA, but not with liver function, nutrient status, or tumoral factors. VFA was positively correlated with BMI (P BCAA levels (P BCAA, serum albumin, and prognostic nutritional index were not. High VFA was associated with a high BCAA level, with high VFA prognostic of improved overall survival in Japanese patients with HCC.

  8. Oatmeal consumption is associated with better diet quality and lower body mass index in adults: the National Health and Nutrition Examination Survey (NHANES), 2001-2010.

    Science.gov (United States)

    Fulgoni, Victor L; Chu, YiFang; O'Shea, Marianne; Slavin, Joanne L; DiRienzo, Maureen A

    2015-12-01

    Data from the 2001-2010 National Health and Nutrition Examination Survey were analyzed to assess the relationship between oatmeal consumption and nutrient intake, diet quality, and physiological measures in adults 19 years and older (n = 22,823). We hypothesized that oatmeal consumption is associated with a more favorable nutrient intake profile, better diet quality, and healthier physiological end points. Oatmeal consumers (n = 1429) were defined as those who had consumed any amount of cooked oatmeal cereal during a 24-hour recall period. Multiple regression analysis, after transforming variables to normality and using appropriate sample weights to ensure national representation, was used to assess differences between oatmeal consumers and nonconsumers in terms of demographics, and covariate-adjusted analysis of variance was used to assess differences between consumers and nonconsumers in nutrient intakes, diet quality (calculated using the Healthy Eating Index-2010), and physiological measures. Our results show that oatmeal consumers were older than nonconsumers and more likely to be female; they also were less likely to smoke and consumed less alcohol. Consumers had higher intakes of protein, dietary fiber, vitamin A, thiamin, calcium, phosphorus, magnesium, iron, copper, selenium, and potassium and lower intakes of total, monounsaturated, and saturated fats; cholesterol; and vitamin B12. Oatmeal consumers had higher Healthy Eating Index-2010 scores and lower body weights, waist circumferences, and body mass indices. To conclude, our results suggest that consuming oatmeal is consistent with better nutrient intakes and a higher diet quality. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Nutritional Status Based on Body Mass Index Is Associated With Morbidity and Mortality in Mechanically Ventilated Critically Ill Children in the PICU.

    Science.gov (United States)

    Bechard, Lori J; Duggan, Christopher; Touger-Decker, Riva; Parrott, J Scott; Rothpletz-Puglia, Pamela; Byham-Gray, Laura; Heyland, Daren; Mehta, Nilesh M

    2016-08-01

    To determine the influence of admission anthropometry on clinical outcomes in mechanically ventilated children in the PICU. Data from two multicenter cohort studies were compiled to examine the unique contribution of nutritional status, defined by body mass index z score, to 60-day mortality, hospital-acquired infections, length of hospital stay, and ventilator-free days, using multivariate analysis. Ninety PICUs from 16 countries with eight or more beds. Children aged 1 month to 18 years, admitted to each participating PICU and requiring mechanical ventilation for more than 48 hours. Data from 1,622 eligible patients, 54.8% men and mean (SD) age 4.5 years (5.1), were analyzed. Subjects were classified as underweight (17.9%), normal weight (54.2%), overweight (14.5%), and obese (13.4%) based on body mass index z score at admission. After adjusting for severity of illness and site, the odds of 60-day mortality were higher in underweight (odds ratio, 1.53; p underweight (odds ratio, 1.88; p = 0.008) and obese (odds ratio, 1.64; p underweight (hazard ratio, 0.71; p Underweight was associated with 1.3 (p = 0.001) and 1.6 (p underweight or obese was associated with higher risk of hospital-acquired infections and lower likelihood of hospital discharge. Underweight children had a higher risk of mortality and fewer ventilator-free days.

  10. Bioimpedance index for measurement of total body water in severely malnourished children: Assessing the effect of nutritional oedema.

    Science.gov (United States)

    Girma, Tsinuel; Kæstel, Pernille; Workeneh, Netsanet; Mølgaard, Christian; Eaton, Simon; Andersen, Gregers S; Michaelsen, Kim F; Friis, Henrik; Wells, Jonathan C K

    2016-06-01

    Restoration of body composition indicates successful management of severe acute malnutrition (SAM). Bioimpedance (BI) index (height(2)/resistance) is used to predict total body water (TBW) but its performance in SAM, especially with oedema, requires further investigation. Children with SAM (mid-arm circumference measured at 50 and 200 kHzs. Pre- and post-deuterium dose saliva samples were analysed using isotope-ratio mass spectrometry. TBW was regressed on H(2)/Z. Xc and R were height (H)-indexed, and Xc/H plotted against R/H. Thirty five children (16 non-oedematous and 19 oedematous) with median (interquartile range) age of 42 (26-54) months were studied. Height-for-age z-score (mean ± SD) was low in both non-oedematous (-3.9 ± 2.8) and oedematous (-3.6 ± 1.7) children. Oedematous children had lower BI parameters than non-oedematous (p measurement at 50 kHz is still practical for TBW estimation. Copyright © 2015. Published by Elsevier Ltd.

  11. Clinical nutrition scores are superior for the prognosis of haemodialysis patients compared to lab markers and bioelectrical impedance.

    Science.gov (United States)

    Fiedler, Roman; Jehle, Peter M; Osten, Bernd; Dorligschaw, Otgontogoo; Girndt, Matthias

    2009-12-01

    Malnutrition is closely related to inflammation and atherosclerosis in uraemic patients. There is still debate on how to quantify nutritional status in order to achieve the best prediction of mortality and hospitalization. Different methods to detect malnutrition were prospectively investigated for their prognostic impact on mortality and hospitalization of haemodialysis (HD) patients. We compared clinical nutrition scores (body mass index, BMI; subjective global assessment, SGA; malnutrition inflammation score, MIS; and nutritional risk screening, NRS) to lab parameters of protein and lipid metabolism, or bioelectrical impedance analysis (BIA) in 90 HD patients. Over a 3-year follow-up, all-cause mortality and hospitalization were evaluated using a Cox regression model. The scores SGA, NRS, MIS, serum albumin, prealbumin, transferrin and BIA were predictive of both mortality and hospitalization. Elevated CRP predicted only a significantly higher mortality. After adjustment for age, gender, dialysis vintage and diabetes status, the best prognostic parameters for mortality were the clinical nutrition scores, MIS-Index > or = 10 [HR 6.25 (2.82-13.87), P clinical nutrition scores are superior compared to lab markers and BIA. To confirm malnutrition, we propose using clinical nutrition score generally or at least in the case of two malnutrition-positive parameters (lab, BIA, BMI).

  12. Lowering dietary glycaemic index through nutrition education among Malaysian women with a history of gestational diabetes mellitus.

    Science.gov (United States)

    Sangeetha-Shyam; Fatimah, A; Rohana, A G; Norasyikin, A W; Karuthan, C; Nik, Shanita S; Mohd, Yusof B N; Nor, Azmi K

    2013-04-01

    Gestational diabetes mellitus (GDM) increases risks for type 2 diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve cardio-metabolic outcomes in insulin-resistant individuals. We examined the feasibility of lowering GI through GI-based-education among Asian post-GDM women. A 3-month investigation was carried out on 60 Malaysian women with a mean age of 31.0 +/- 4.5 years and a history of GDM. Subjects were randomised into two groups: LGIE and CHDR. The CHDR group received conventional healthy dietary recommendations only. The LGIE group received GI based-education in addition to conventional healthy dietary recommendations. At baseline and after 3-months, dietary intake of energy and macronutrient intakes including GI diet and glycaemic load was assessed using 3-day food records. Diabetes-Diet and GI-concept scores and physical activity levels were assessed using a questionnaire. Adherence to dietary instructions was measured at the end of 3 months. At the end of 3 months, the LGIE group had significant reductions in energy intake (241.7 +/- 522.4Kcal, P = 0.037, ES=0.463), total carbohydrate (48.7 +/- 83.5g, P = 0.010, ES = 0.583), GI (3.9 +/- 7.1, P = 0.017, ES = 0.549) and GL (39.0 +/- 55.3, P = 0.003, ES = 0.705) and significant increases in protein (3.7 +/- 5.4g, 0.003, ES = 0.685) and diet fibre (4.6 +/- 7.3g, P = 0.06). The CHDR group had a significant reduction in fat only (5.7 +/- 9.4g, P = 0.006, ES = 0.606). There was a 30% increase in GI-concept scores in the LGIE group (p < 0.001). Changes in GI-concept scores correlated significantly to the reduction in dietary GI (r = -0.642, P = 0.045). Dietary adherence was comparable in both groups. GI-education improves GI-concept knowledge and helps lower dietary glycaemic index among women with a history of GDM.

  13. Associations of Body Mass Index and Body Fat With Markers of Inflammation and Nutrition Among Patients Receiving Hemodialysis.

    Science.gov (United States)

    Delgado, Cynthia; Chertow, Glenn M; Kaysen, George A; Dalrymple, Lorien S; Kornak, John; Grimes, Barbara; Johansen, Kirsten L

    2017-12-01

    Understanding the extent to which visceral and subcutaneous body fat are associated with markers of nutrition and inflammation in patients on dialysis therapy could shed light on the obesity paradox and the biology of subcutaneous fat. Cross-sectional. 609 adults receiving hemodialysis who participated in the ACTIVE/ADIPOSE Study. Body mass index (BMI), waist circumference, and bioelectrical impedance spectroscopy-derived estimates of percent body fat. C-Reactive protein (CRP), interleukin 6 (IL-6), prealbumin, albumin, leptin, and adiponectin concentrations. We performed linear regression analyses to examine the extent to which proxies of visceral and subcutaneous fat were associated with inflammation, nutrition, and adiposity-related hormones. BMI was directly associated with markers of inflammation (standardized estimate for ln[CRP in mg/L]: 0.30 [95% CI, 0.22-0.38] per 10kg/m2; for ln[IL-6 in pg/mL]: 0.10 [95% CI, 0.02-0.18] per 10kg/m2), but was not associated with markers of nutrition. BMI was also inversely associated with adiponectin and directly associated with leptin. With waist circumference and percent body fat (as a proxy of visceral and subcutaneous fat, respectively) modeled together, waist circumference was associated with markers of inflammation (standardized estimate for ln[CRP in mg/L]: 0.21 [95% CI, 0.09-0.34] per 10cm; for ln[IL-6 in pg/mL]: 0.18 [95% CI, 0.07-0.29] per 10cm), whereas percent body fat was not associated with CRP (standardized estimate for ln[CRP in mg/L]: 0.03 [95% CI, -0.10 to 0.15] per 1%) and was inversely associated with IL-6 (standardized estimate for ln[IL-6 in pg/mL]: -0.15 [95% CI, -0.27 to -0.02] per 1%). In addition, waist circumference was inversely associated with prealbumin and albumin (standardized estimates of -0.12 [95% CI, -0.23 to -0.02] mg/dL per 10cm and -0.17 [95% CI, -0.28 to -0.06] g/dL per 10cm, respectively), and percent body fat was directly associated with prealbumin and albumin (0.20 [95

  14. Nutritional status, Healthy Eating Index and eating attitudes of the adolescents in Istanbul: a cross-sectional study.

    Science.gov (United States)

    Bakir, Binnur Okan; Akan, Hulya; Akman, Mehmet; Zahmacioglu, Oguzhan; Hayran, Osman

    2015-11-13

    The aim of this study was to evaluate dietary quality of adolescents by using the Healthy Eating Index (HEI) and to assess their eating attitudes by the EAT-26 Eating Attitude Test. Eight schools; four primary schools and four secondary schools were randomly selected from the school list of official website of Istanbul Education National Directorate. Five hundred and ninety-eight students who met the inclusion criteria included in the study, 24 h dietary recalls were collected to calculate their HEI scores and eating attitudes were evaluated by EAT-26 Eating Attitude Test. Their weight, height and waist circumference were measured. According to HEI scores, only two (0.3%) of adolescents had high quality diet, 379 (63.4%) had diet quality that needed improvement and 217 (36.3%) had poor diet. Regarding Eating Attitude Test scores, 513 (85.8%) had normal attitudes regarding eating behaviors. Almost all of the participants need either development or major changes in their eating behaviors. Interventions aiming high quality diet among adolescents are strongly recommended.

  15. Dietary glycemic index, glycemic load, and nutritional correlates in free-living elderly Brazilians: a population-based survey.

    Science.gov (United States)

    Castro, Michelle A; Carlos, Jackeline V; Lopes, Raíssa C V; Januário, Bruna L; Marchioni, Dirce M L; Fisberg, Regina M

    2014-01-01

    To investigate the association of dietary glycemic index (GI) and glycemic load (GL) with nutrient intake and to describe the foods that contribute to dietary GI and GL in elderly subjects. This is a cross-sectional population-based survey performed in 2003, which enrolled 804 free-living Brazilian subjects aged 60 years or older. Dietary intake was measured by a single 24-hour dietary recall applied at the subjects' homes. The usual dietary GI and GL as well as the usual energy and nutrient intakes were estimated using external variance components. Dietary GI and GL were categorized in tertiles and the usual mean of nutrient intake was described accordingly. Linear association between dietary GI and GL and nutrient intake was investigated before and after energy adjustment. Foods that contributed with at least 1% of dietary GI and GL were described. Dietary GI was positively associated with starch, total fat, monounsaturated fatty acids (MUFA), and polyunsaturated fatty acids (PUFA) and inversely associated with total sugar, protein, fiber, and calcium. Dietary GL was strongly and positively associated with total and available carbohydrates, starch, and total sugar and inversely associated with protein, total fat, MUFA, PUFA, and cholesterol. White breads and white rice were the major contributors to dietary GI and GL in the studied population. Dietary GI and GL are important indicators of overall quality and quantity of carbohydrates from elderly Brazilians diet and are also associated with other macronutrients such as protein, fat, and fiber. The overall dietary GI and GL reflects other dietary aspects, such as composition of the diet and combination of foods consumed.

  16. Food insecurity, diet quality and body mass index of women participating in the Supplemental Nutrition Assistance Program: The role of intrapersonal, home environment, community and social factors.

    Science.gov (United States)

    Sanjeevi, Namrata; Freeland-Graves, Jeanne; Hersh, Matthew

    2018-02-07

    Obesity is a public health problem that disproportionately affects low-income populations. Moreover, participation in Supplemental Nutrition Assistance Program (SNAP) has been associated with obesity among low-income women. The goal of this study was to determine the impact of intrapersonal, home environment, community and social factors on diet quality and body mass index (BMI) of low-income women participating in SNAP. This study also aimed to examine the role of these factors in mediating the relationship between food insecurity and diet quality, and BMI. A total of 152 women receiving SNAP benefits were recruited from low-income neighborhood centers and housing communities, and administered a demographics questionnaire, the United States adult food security scale, food frequency questionnaire, and multi-dimensional home environment scale (MHES). They also were measured for height and weight to calculate BMI. The Dietary Guidelines Adherence Index 2015 was used to measure diet quality. Regression analyses were conducted to determine the MHES subscales that were significant predictors of diet quality and BMI. The Preacher and Hayes mediation model was used to evaluate the mediation of the relationship between food insecurity and diet quality, and BMI by the MHES. Emotional eating resistance and favorable social eating behaviors were positively associated with diet quality; whereas emotional eating resistance, lower availability of unhealthy food at home, neighborhood safety and favorable social eating behaviors were inversely associated with BMI in women participating in SNAP. The MHES significantly mediated the relationship between food insecurity and BMI. These results emphasize the importance of intrapersonal, home environment, community and social factors in mediating the relationship between food insecurity and BMI in low-income women. Copyright © 2018. Published by Elsevier Ltd.

  17. The influence of the initial state of nutrition on the lifespan of patients with amyotrophic lateral sclerosis (ALS) during home enteral nutrition

    Science.gov (United States)

    Sznajder, Janusz; S Lefarska-Wasilewska, Marta; Kłek, Stanisław

    2016-02-16

    Aim: Amyotrophic lateral sclerosis (ALS) is a chronic, neurodegenerative disease, which leads to development of malnutrition. The main purpose of this research was to analyze the impact of malnutrition on the course of the disease and long-term survival. Material and methods: A retrospective analysis has been performed on 48 patients (22 F [45,83%] and 26 M [54,17%], the average age of patients: 66,2 [43-83]) in 2008-2014.The analysis of the initial state of nutrition was measured by body mass index (BMI), nutritional status according to NRS 2002, SGA and concentration of albumin in blood serum. Patients were divided into two groups, depending on the state of nutrition: well-nourished and malnourished. The groups were created separately for each of these, which allowed an additional comparative analysis of techniques used for the assessment of nutritional status. Results: Proper state of nutrition was interrelated with longer survival (SGA: 456 vs. 679 days, NRS: 312vs. 659vs. 835 days, BMI: respectively, 411, 541, 631 days, results were statistically significant for NRS and BMI). Concentration of albumin was not a prognostic factor, but longer survival was observed when level of albumin was increased during nutritional therapy. Conclusions: The initial nutrition state and positive response to enteral feeding is associated with better survival among patients with ALS. For this reason, nutritional therapy should be introduced as soon as possible.

  18. A systematic review and meta-analysis of applications of the Self-Report Habit Index to nutrition and physical activity behaviours.

    Science.gov (United States)

    Gardner, Benjamin; de Bruijn, Gert-Jan; Lally, Phillippa

    2011-10-01

    Health behaviour models typically neglect habitual action. The Self-Report Habit Index (SRHI) permits synthesis of evidence of the influence of habit on behaviour. The purpose of this study is to review evidence around mean habit strength, habit-behaviour correlations, and habit x intention interactions, from applications of the SRHI to dietary, physical activity, and active travel behaviour. Electronic database searches identified 126 potentially relevant papers. Twenty-two papers (21 datasets) passed eligibility screening. Mean scores and correlations were meta-analysed using fixed, random and mixed effects, and interactions were synthesised via narrative review. Twenty-three habit-behaviour correlations and nine habit x intention interaction tests were found. Typical habit strength was located around the SRHI midpoint. Weighted habit-behaviour effects were medium-to-strong (fixed: r + = 0.44; random: r + = 0.46). Eight tests found that habit moderated the intention-behaviour relation. More comprehensive understanding of nutrition and activity behaviours will be achieved by accounting for habitual responses to contextual cues.

  19. Joint effects of age and body mass index on the incidence of hypertension subtypes in the China Health and Nutrition Survey: A cohort study over 22years.

    Science.gov (United States)

    Qi, Su-Fen; Zhang, Bing; Wang, Hui-Jun; Yan, Jing; Du, Pei; Zhang, Wei; Mi, Ying-Jun; Zhao, Jing-Jing; Liu, Dian-Wu; Tian, Qing-Bao

    2016-08-01

    We seek to investigate the joint effects of age and body mass index (BMI) on the incident hypertension subtypes among Chinese adults during 1989-2011. We investigated the Incidence rates (IRs, per 100person-years) of hypertension subtypes, adjusted relative risks (RRs) and population attributable risk percent (PAR%) of BMI for hypertension, and clarified the age-specific effect of BMI on incident hypertension utilizing a dynamic cohort study from the China Health and Nutrition Survey (CHNS) 1989-2011. Normotensive participants (n=53,028) at baseline were included, with mean age was 41.7 (95% CI, 41.6-41.7)years old. During a total of 118,694person years (average was 6.38years) of follow-up, a total of 5208 incident cases of hypertension were documented. The IRs of hypertension were 4.4 (95% CI, 4.3-4.5), which increased gradually by age and BMI (Ptrend22 vs. BMI22 vs. IR for BMI<22) of elevated body weight for hypertension was 32% in Chinese population. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Concordance among methods of nutritional assessment in patients included on the waiting list for liver transplantation.

    Science.gov (United States)

    García-Rodríguez, María Teresa; López-Calviño, Beatriz; Piñón-Villar, María Del Carmen; Otero-Ferreiro, Alejandra; Suárez-López, Francisco; Gómez-Gutiérrez, Manuel; Pértega-Díaz, Sonia; Seoane-Pillado, María Teresa; Pita-Fernández, Salvador

    2017-10-01

    The aim of the present study was to determine the extent of malnutrition in patients waiting for a liver transplant. The agreement among the methods of nutritional assessment and their diagnostic validity were evaluated. Patients on the waiting list for liver transplantation (n = 110) were studied. The variables were: body mass index, analytical parameters, liver disease etiology, and complications. Liver dysfunction was evaluated using the Child-Pugh Scale. Nutritional state was studied using the Controlling Nutritional Status (CONUT), the Spanish Society of Parenteral and Enteral Nutrition (SENPE) criteria, the Nutritional Risk Index (NRI), the Prognostic Nutritional Index (PNI-O), and the Subjective Global Assessment (SGA). Agreement was determined using the Kappa index. Area under receiver operator characteristic curves (AUCs), the Youden index (J), and likelihood ratios were computed. Malnutrition varied depending on the method of evaluation. The highest value was detected using the CONUT (90.9%) and the lowest using the SGA (50.9%). The pairwise agreement among the methods ranged from K = 0.041 to K = 0.826, with an overall agreement of each criteria with the remaining methods between K = 0.093 and K = 0.364. PNI-O was the method with the highest overall agreement. Taking this level of agreement into account, we chose the PNI-O as a benchmark method of comparison. The highest positive likelihood ratio for the diagnosis of malnutrition was obtained from the Nutritional Risk Index (13.56). Malnutrition prevalence is high and prevalence estimates vary according the method used, with low concordance among methods. PNI-O and NRI are the most consistent methods to identify malnutrition in these patients. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  1. Concordance among methods of nutritional assessment in patients included on the waiting list for liver transplantation

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    María Teresa García-Rodríguez

    2017-09-01

    Full Text Available Background: The aim of the present study was to determine the extent of malnutrition in patients waiting for a liver transplant. The agreement among the methods of nutritional assessment and their diagnostic validity were evaluated. Methods: Patients on the waiting list for liver transplantation (n = 110 were studied. The variables were: body mass index, analytical parameters, liver disease etiology, and complications. Liver dysfunction was evaluated using the Child–Pugh Scale. Nutritional state was studied using the Controlling Nutritional Status (CONUT, the Spanish Society of Parenteral and Enteral Nutrition (SENPE criteria, the Nutritional Risk Index (NRI, the Prognostic Nutritional Index (PNI-O, and the Subjective Global Assessment (SGA. Agreement was determined using the Kappa index. Area under receiver operator characteristic curves (AUCs, the Youden index (J, and likelihood ratios were computed. Results: Malnutrition varied depending on the method of evaluation. The highest value was detected using the CONUT (90.9% and the lowest using the SGA (50.9%. The pairwise agreement among the methods ranged from K = 0.041 to K = 0.826, with an overall agreement of each criteria with the remaining methods between K = 0.093 and K = 0.364. PNI-O was the method with the highest overall agreement. Taking this level of agreement into account, we chose the PNI-O as a benchmark method of comparison. The highest positive likelihood ratio for the diagnosis of malnutrition was obtained from the Nutritional Risk Index (13.56. Conclusions: Malnutrition prevalence is high and prevalence estimates vary according the method used, with low concordance among methods. PNI-O and NRI are the most consistent methods to identify malnutrition in these patients.

  2. No prognostic value added by vitamin D pathway SNPs to current prognostic system for melanoma survival.

    Science.gov (United States)

    Luo, Li; Orlow, Irene; Kanetsky, Peter A; Thomas, Nancy E; Fang, Shenying; Lee, Jeffrey E; Berwick, Marianne; Lee, Ji-Hyun

    2017-01-01

    The prognostic improvement attributed to genetic markers over current prognostic system has not been well studied for melanoma. The goal of this study is to evaluate the added prognostic value of Vitamin D Pathway (VitD) SNPs to currently known clinical and demographic factors such as age, sex, Breslow thickness, mitosis and ulceration (CDF). We utilized two large independent well-characterized melanoma studies: the Genes, Environment, and Melanoma (GEM) and MD Anderson studies, and performed variable selection of VitD pathway SNPs and CDF using Random Survival Forest (RSF) method in addition to Cox proportional hazards models. The Harrell's C-index was used to compare the performance of model predictability. The population-based GEM study enrolled 3,578 incident cases of cutaneous melanoma (CM), and the hospital-based MD Anderson study consisted of 1,804 CM patients. Including both VitD SNPs and CDF yielded C-index of 0.85, which provided slight but not significant improvement by CDF alone (C-index = 0.83) in the GEM study. Similar results were observed in the independent MD Anderson study (C-index = 0.84 and 0.83, respectively). The Cox model identified no significant associations after adjusting for multiplicity. Our results do not support clinically significant prognostic improvements attributable to VitD pathway SNPs over current prognostic system for melanoma survival.

  3. No prognostic value added by vitamin D pathway SNPs to current prognostic system for melanoma survival.

    Directory of Open Access Journals (Sweden)

    Li Luo

    Full Text Available The prognostic improvement attributed to genetic markers over current prognostic system has not been well studied for melanoma. The goal of this study is to evaluate the added prognostic value of Vitamin D Pathway (VitD SNPs to currently known clinical and demographic factors such as age, sex, Breslow thickness, mitosis and ulceration (CDF. We utilized two large independent well-characterized melanoma studies: the Genes, Environment, and Melanoma (GEM and MD Anderson studies, and performed variable selection of VitD pathway SNPs and CDF using Random Survival Forest (RSF method in addition to Cox proportional hazards models. The Harrell's C-index was used to compare the performance of model predictability. The population-based GEM study enrolled 3,578 incident cases of cutaneous melanoma (CM, and the hospital-based MD Anderson study consisted of 1,804 CM patients. Including both VitD SNPs and CDF yielded C-index of 0.85, which provided slight but not significant improvement by CDF alone (C-index = 0.83 in the GEM study. Similar results were observed in the independent MD Anderson study (C-index = 0.84 and 0.83, respectively. The Cox model identified no significant associations after adjusting for multiplicity. Our results do not support clinically significant prognostic improvements attributable to VitD pathway SNPs over current prognostic system for melanoma survival.

  4. Association between the Infant and Child Feeding Index (ICFI) and nutritional status of 6- to 35-month-old children in rural western China.

    Science.gov (United States)

    Qu, Pengfei; Mi, Baibing; Wang, Duolao; Zhang, Ruo; Yang, Jiaomei; Liu, Danmeng; Dang, Shaonong; Yan, Hong

    2017-01-01

    The objective of this study was to determine the relationship between the quality of feeding practices and children's nutritional status in rural western China. A sample of 12,146 pairs of 6- to 35-month-old children and their mothers were recruited using stratified multistage cluster random sampling in rural western China. Quantile regression was used to analyze the relationship between the Infant and Child Feeding Index (ICFI) and children's nutritional status. In rural western China, 24.37% of all infants and young children suffer from malnutrition. Of this total, 19.57%, 8.74% and 4.63% of infants and children are classified as stunting, underweight and wasting, respectively. After adjusting for covariates, the quantile regression results suggested that qualified ICFI (ICFI > 13.8) was associated with all length and HAZ quantiles (P<0.05) and had a greater effect on the following: poor length and HAZ, the β-estimates (length) from 0.76 cm (95% CI: 0.53 to 0.99 cm) to 0.34 cm (95% CI: 0.09 to 0.59 cm) and the β-estimates (HAZ) from 0.17 (95% CI: 0.10 to 0.24) to 0.11 (95% CI: 0.04 to 0.19). Qualified ICFI was also associated with most weight quantiles (P<0.05 except the 80th and 90th quantiles) and poor and intermediate WAZ quantiles (P<0.05 including the 10th, 20th 30th and 40th quantiles). Additionally, qualified ICFI had a greater effect on poor weight and WAZ quantiles in which the β-estimates (weight) were from 0.20 kg (95% CI: 0.14 to 0.26 kg) to 0.06 kg (95% CI: 0.00 to 0.12 kg) and the β-estimates (WAZ) were from 0.14 (95% CI: 0.08 to 0.21) to 0.05 (95% CI: 0.01 to 0.10). Feeding practices were associated with the physical development of infants and young children, and proper feeding practices had a greater effect on poor physical development in infants and young children. For mothers in rural western China, proper guidelines and messaging on complementary feeding practices are necessary.

  5. Prognostic Performance Metrics

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    National Aeronautics and Space Administration — This chapter presents several performance metrics for offline evaluation of prognostics algorithms. A brief overview of different methods employed for performance...

  6. Prognostics for Microgrid Components

    Science.gov (United States)

    Saxena, Abhinav

    2012-01-01

    Prognostics is the science of predicting future performance and potential failures based on targeted condition monitoring. Moving away from the traditional reliability centric view, prognostics aims at detecting and quantifying the time to impending failures. This advance warning provides the opportunity to take actions that can preserve uptime, reduce cost of damage, or extend the life of the component. The talk will focus on the concepts and basics of prognostics from the viewpoint of condition-based systems health management. Differences with other techniques used in systems health management and philosophies of prognostics used in other domains will be shown. Examples relevant to micro grid systems and subsystems will be used to illustrate various types of prediction scenarios and the resources it take to set up a desired prognostic system. Specifically, the implementation results for power storage and power semiconductor components will demonstrate specific solution approaches of prognostics. The role of constituent elements of prognostics, such as model, prediction algorithms, failure threshold, run-to-failure data, requirements and specifications, and post-prognostic reasoning will be explained. A discussion on performance evaluation and performance metrics will conclude the technical discussion followed by general comments on open research problems and challenges in prognostics.

  7. The impact of body mass index and Western advertising and media on eating style, body image and nutrition transition among Jordanian women.

    Science.gov (United States)

    Madanat, Hala N; Brown, Ralph B; Hawks, Steven R

    2007-10-01

    To identify the impact of body mass index (BMI) and Western advertising and media on the stage of the nutrition transition among Jordanian women, and to evaluate their impact on eating styles and body image. A randomised cross-sectional survey that included a variety of culturally measured Likert-type scales and body size images. In addition, BMI was calculated based on measured height and weight. In the homes of the participants. The data were collected by female interviewers who worked for the Jordan Department of Statistics. The sample was based on a random and representative selection of 800 mostly urban Jordanian women. A pre-test sample of 100 women was also used to validate the instruments. Women tended to agree that they ate based on emotional cues. They had high levels of disordered eating attitudes and behaviours and 42.1% were considered restrained eaters. However, these women also had higher than expected body esteem levels and desired a healthy body size. As expected, being obese was associated with a desire to lose weight, being a restrained and emotional eater, and having more disordered eating attitudes and behaviours. Similarly, Western advertising and media were associated with restrained and emotional eating, desired weight loss, and disordered eating attitudes and behaviours. There is a need to develop health education materials that explain the influence of obesity on health and the negative psychological and physical consequences of restrained and emotional eating, building on the current cultural preferences of healthy body size. Further implications and suggestions for future research are discussed.

  8. Characterization of Patients with Type 2 Diabetes according to Body Mass Index: Korea National Health and Nutrition Examination Survey from 2007 to 2011

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    Dong-Hwa Lee

    2015-12-01

    Full Text Available BackgroundThe present study aimed to investigate the clinical characteristics of type 2 diabetes mellitus (T2DM in Korean adults according to body mass index (BMI and to analyze the association with cardiovascular disease (CVD.MethodsWe conducted a cross-sectional study of data from the Korea National Health and Nutrition Examination Survey from 2007 to 2011. A total of 3,370 patients with T2DM were divided into categories according to BMI. We conducted a comparison of the T2DM patient population composition by BMI category between different countries. We investigated the prevalence of awareness, treatment, and target control of T2DM according to BMI.ResultsPatients with T2DM had a higher BMI, and were more likely to have a history of CVD than healthy controls. For Korean adults with T2DM, 8% had BMI ≥30 kg/m2. By contrast, the population of patients with T2DM and BMI ≥30 kg/m2 was 72% in patients in the USA and 56% in the UK. The rate of recognition, treatment, and control has worsened in parallel with increasing BMI. Even in patients with BMI 25 to 29.9 kg/m2, the prevalence of CVD or high risk factors for CVD was significantly higher than in patients with BMI 18.5 to 22.9 kg/m2 (odds ratio, 2.07.ConclusionKorean patients with T2DM had lower BMI than those in Western countries. Higher BMI was associated with lower awareness, treatment, and control of diabetes, and a positive association was observed between CVD or high risk factors for CVD and BMI, even for patients who were overweight but not obese.

  9. GPU Accelerated Prognostics

    Science.gov (United States)

    Gorospe, George E., Jr.; Daigle, Matthew J.; Sankararaman, Shankar; Kulkarni, Chetan S.; Ng, Eley

    2017-01-01

    Prognostic methods enable operators and maintainers to predict the future performance for critical systems. However, these methods can be computationally expensive and may need to be performed each time new information about the system becomes available. In light of these computational requirements, we have investigated the application of graphics processing units (GPUs) as a computational platform for real-time prognostics. Recent advances in GPU technology have reduced cost and increased the computational capability of these highly parallel processing units, making them more attractive for the deployment of prognostic software. We present a survey of model-based prognostic algorithms with considerations for leveraging the parallel architecture of the GPU and a case study of GPU-accelerated battery prognostics with computational performance results.

  10. [Nutrition in the critically ill].

    Science.gov (United States)

    Weimann, A; Andrä, J; Sablotzki, A

    2011-11-01

    The prognostic impact of inadequate energy and protein supply in malnourished intensive care patients has been recently reemphasized. Consent exists about the beneficial effects of early enteral nutrition in the critically ill. However, gastrointestinal intolerance of the critically ill may be a major problem for the feasibility of enteral nutrition bearing additional risks. In case adequate enteral nutrition cannot be realized, there is controversy about the appropriate time to start total parenteral or combined enteral / parenteral nutrition. Due to potential adverse effects immune-enhancing substrates have to be cautiously administered. For standardization implementation of a guideline based nutritional protocol is recommended. The review refers to the recent guidelines of the European Society for Clinical Nutrition and Metabolism (2009), the American Society for Parenteral and Enteral Nutrition (ASPEN) (2009) and the German Sepsis Society (DSG) (2010). © Georg Thieme Verlag KG Stuttgart · New York.

  11. Impact of Moringa oleifera lam. Leaf powder supplementation versus nutritional counseling on the body mass index and immune response of HIV patients on antiretroviral therapy: a single-blind randomized control trial.

    Science.gov (United States)

    Tshingani, Koy; Donnen, Philippe; Mukumbi, Henri; Duez, Pierre; Dramaix-Wilmet, Michèle

    2017-08-22

    To achieve effective antiretroviral therapy (ART) outcomes, adherence to an antiretroviral regimen and a good immunometabolic response are essential. Food insecurity can act as a real barrier to adherence to both of these factors. Many people living with human immunodeficiency virus (PLHIV) treated with ART in the Democratic Republic of the Congo (DRC) are faced with nutritional challenges. A significant proportion are affected by under nutrition, which frequently leads to therapeutic failure. Some HIV care facilities recommend supplementation with Moringa oleifera (M.O.) Lam. leaf powder to combat marginal and major nutritional deficiencies. This study aims to assess the impact of M.O. Lam. leaf powder supplementation compared to nutritional counseling on the nutritional and immune status of PLHIV treated with ART. A single-blind randomized control trial was carried out from May to September 2013 at an outpatient clinic for HIV-infected patients in Kinshasa (DRC). Sixty adult patients who were at stable HIV/AIDS clinical staging 2, 3 or 4 according to the World Health Organization (WHO), and were undergoing ART were recruited. After random allocation, 30 patients in the Moringa intervention group (MG) received the M.O. Lam. leaf powder daily over 6 months, and 30 in the control group (CG) received nutritional counseling over the same period. Changes in the body mass index (BMI) were measured monthly and biological parameters were measured upon admission and at the end of the study for the patients in both groups. The two study groups were similar in terms of long-term nutritional exposure, sociodemographic, socioeconomic, clinical, and biological features. At 6 months follow-up, patients in the MG exhibited a significantly greater increase in BMI and albumin levels than those in the CG. The interaction between the sociodemographic, clinical, and biological characteristics of patients in the two groups was not significant, with the exception of professional

  12. Prognostics of Power MOSFET

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    National Aeronautics and Space Administration — This paper demonstrates how to apply prognostics to power MOSFETs (metal oxide field effect transistor). The methodology uses thermal cycling to age devices and...

  13. Palliative medicine review: prognostication.

    Science.gov (United States)

    Glare, Paul A; Sinclair, Christian T

    2008-01-01

    Prognostication, along with diagnosis and treatment, is a traditional core clinical skill of the physician. Many patients and families receiving palliative care want information about life expectancy to help plan realistically for their futures. Although underappreciated, prognosis is, or at least should be, part of every clinical decision. Despite this crucial role, expertise in the art and science of prognostication diminished during the twentieth century, due largely to the ascendancy of accurate diagnostic tests and effective therapies. Consequently, "Doctor, how long do I have?" is a question most physicians find unprepared to answer effectively. As we focus on palliative care in the twenty-first century, prognostication will need to be restored as a core clinical proficiency. The discipline of palliative medicine can provide leadership in this direction. This paper begins by discussing a framework for understanding prognosis and how its different domains might be applied to all patients with life limiting illness, although the main focus of the paper is predicting survival in patients with cancer. Examples of prognostic tools are provided, although the subjective assessment of prognosis remains important in the terminally ill. Other issues addressed include: the importance of prognostication in terms of clinical decision-making, discharge planning, and care planning; the impact of prognosis on hospice referrals and patient/family satisfaction; and physicians' willingness to prognosticate.

  14. Escore para avaliação do estado nutricional: seu valor na estratificação prognóstica de portadores de cardiomiopatia dilatada e insuficiência cardíaca avançada Score for nutritional status evaluation: the role played in the prognostic stratification of dilated cardiomyopathy and advanced heart failure patients

    Directory of Open Access Journals (Sweden)

    Luiz Guilherme Veloso

    2006-08-01

    Full Text Available OBJETIVO: Desenvolver método de avaliação do estado nutricional do paciente através de escore que expresse o estado nutricional de maneira universal e verificar se esse escore seria eficaz na estratificação prognóstica de pacientes com insuficiência cardíaca (IC avançada. MÉTODOS: Para compor o escore foram selecionados métodos de avaliação que procurassem quantificar forma de medida do estado nutricional: a porcentagem ideal do peso, a espessura da prega tricipital, os percentis da circunferência da massa muscular do braço, os níveis séricos de albumina, a contagem global de linfócitos. Para validá-lo, aplicou-se o escore num grupo de 95 pacientes com idade inferior a 65 anos, sem evidências de doenças consumptivas e analisou-se se esse escore manteria correlação com os dados clínicos da IC e permitiria estratificar o prognóstico. RESULTADOS: A situação nutricional esteve alterada nos pacientes e escore elevado sugerindo desnutrição moderada ou intensa foi observado em 31/95 (32,6% dos casos. Não houve correlação entre os valores do escore nutricional, duração dos sintomas e grau de disfunção ventricular. Os pacientes com escore nutricional elevado apresentaram tendência de maior mortalidade (p=0,0606. CONCLUSÕES: Os dados sugerem que a desnutrição atinge cerca de 1/3 dos pacientes com IC avançada. Um escore que englobou cinco parâmetros de avaliação nutricional teve boa correlação com a avaliação clínica e permitiu avaliar globalmente a desnutrição de portadores de IC. Escore superior a 8 identificou pacientes com maior probabilidade de morrer, confirmando que pacientes mais desnutridos têm pior evolução.OBJECTIVE: Develop a method for the evaluation of patient’s nutritional status through a score that expresses universal nutritional status, as well as investigate if that score would be efficient for the prognostic stratification of advanced heart failure (HF pts. METHODS: The score was

  15. Prognostic radiographic aspects of spondylolisthesis

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    Saraste, H.; Brostroem, L.A.; Aparisi, T.

    1984-01-01

    A series of 202 patients (133 men, 69 women) with lumbar spondylolysis were examined radiographically on two occasions, first at the time of diagnosis and later at a follow-up, after an observation period of 20 years or more. The films from patients in groups without and with moderate and severe olisthesis were evaluated with respect to variables describing lumbosacral lordosis, wedging of the spondylolytic vertebra, lengths of the transverse processes and iliolumbar ligaments, disk height, progression of slipping, and influence on measured olisthesis of lumbar spine flexion and extension at the radiographic examination. The evaluation was made with special attention to possible signs which could be predictive for the prognosis of vertebral slipping. Progression of slipping did not differ between patients diagnosed as adults or adolescents. Reduction of disk height was correlated to the degree of slipping present at the initial examination and to the progression of olisthesis. Flexion and extension of the lumbar spine did not modify the degree of olisthesis. Data concerning the lengths of the transverse processes and the iliolumbar ligaments, and lumbar lordosis, cannot be used for prognostic purposes. The lumbar index reflecting the degree of wedge deformity of the spondylolytic vertebra was shown to be the only variable of prognostic value for the development of vertebral slipping.

  16. On the Study of Pre-Pregnancy Body Mass Index (BMI) and Weight Gain as Indicators of Nutritional Status of Pregnant Women Belonging to Low Socio-Economic Category: A Study from Assam

    OpenAIRE

    Mahanta, Lipi B.; Manisha Choudhury; Arundhuti Devi; Arunima Bhattacharya

    2015-01-01

    Women, particularly pregnant women, are the most vulnerable population of the society and their health status is one of the major indicators of development. There were enough studies on pre pregnancy body mass index (IPBMI) and inadequate weight gain during pregnancy (IWGP) of women in other part of the world and India, but none in Assam. In Assam a large number of population are in the category of low socio-economic group, a group most vulnerable to under nutrition. Thus this study was frame...

  17. Albumin and Neutrophil Combined Prognostic Grade as a New Prognostic Factor in Non-Small Cell Lung Cancer: Results from a Large Consecutive Cohort.

    Directory of Open Access Journals (Sweden)

    Haifeng Sun

    Full Text Available It has been reported nutritional status and systemic inflammation were associated with the outcome of patients with malignancies. However, the prognostic value of combination of them was really scarce, especially in non-small cell lung cancer (NSCLC. In order to find a more simple and efficient predictor, we hypothesized that pretreatment albumin and neutrophil combined prognostic grade (ANPG could offer an improved prognostic ability in NSCLC patients.We collected pretreatment albumin and neutrophil, clinicopathological, treatment and follow-up data of 1033 consecutive NSCLC patients treated between 2006 and 2011 in this retrospective study. The ANPG was calculated according to pretreatment albumin and neutrophil levels dichotomized by the optimal cut-off values, the quartile values and the clinical reference values. Kaplan-Meier (K-M curves and Cox proportional regression were used for survival analyses. All the data was analyzed by SPSS 20.0.According to optimal cut-off values and quartile values, significant differences were found in different pretreatment albumin, neutrophil levels and ANPG from the K-M curve (all p<0.05. Univariate analyses and multivariate analyses disclosed ANPG was a more sensitive independent predictor for both overall survival (OS and progression free survival (PFS than either albumin level or neutrophil level (HRs were higher for ANPG. As for clinical reference values, no significant difference of pretreatment albumin levels was found in K-M curve and univariate analyses. All three indexes lost their significance in multivariate analyses.Higher ANPG predicts worse OS and PFS in NSCLC patients independently, and it is more sensitive than hypoalbuminaemia and neutrophilia. It might be used as a reliable, convenient and more sensitive predictor to assist the identification of patients with poor prognosis and be a hierarchical factor in the future NSCLC clinical trials.

  18. Application of a functional mathematical index (FMI) for predicting effects of the composition of jujube fruit on nutritional quality and health

    Science.gov (United States)

    In the present study, we extend the concept of a Functional Mathematical Index (FMI) for the assessment and prediction of food quality and safety of jujube fruit, a medicinal food widely consumed in Asian countries. In this study the index has been applied to one field-grown jujube fruit harvested a...

  19. Effect of an intensive nutrition intervention of a high protein and low glycemic-index diet on weight of kidney transplant recipients: study protocol for a randomized clinical trial.

    Science.gov (United States)

    Pedrollo, Elis Forcellini; Nicoletto, Bruna Bellincanta; Carpes, Larissa Salomoni; de Freitas, Júlia de Melo Cardoso; Buboltz, Julia Roberta; Forte, Cristina Carra; Bauer, Andrea Carla; Manfro, Roberto Ceratti; Souza, Gabriela Corrêa; Leitão, Cristiane Bauermann

    2017-09-06

    Excessive weight gain is commonly observed within the first year after kidney transplantation and is associated with negative outcomes, such as graft loss and cardiovascular events. The purpose of this study is to evaluate the effect of a high protein and low glycemic-index diet on preventing weight gain after kidney transplantation. We designed a prospective, single-center, open-label, randomized controlled study to compare the efficacy of a high protein (1.3-1.4 g/kg/day) and low-glycemic index diet versus a conventional diet (0.8-1.0 g/kg/day of protein) on preventing weight gain after kidney transplantation. A total of 120 eligible patients 2 months after transplantation will be recruited. Patients with an estimated glomerular filtration rate through the modification of diet of renal disease (MDRD) formula  300 mg/24 h will be excluded. Patients' diets will be allocated through simple sequential randomization. Patients will be followed-up for 12 months with nine clinic appointments with a dietitian and the evaluations will include nutritional assessment (anthropometrics, body composition, and resting metabolic rate) and laboratory tests. The primary outcome is weight maintenance or body weight gain under 5% after 12 months. Secondary outcomes include body composition, resting metabolic rate, satiety sensation, kidney function, and other metabolic parameters. Diets with higher protein content and lower glycemic index may lead to weight loss because of higher satiety sensation. However, there is a concern about the association of high protein intake and kidney damage. Nevertheless, there is little evidence on the impact of high protein intake on long-term kidney function outcome. Therefore, we designed a study to test if a high protein diet with low-glycemic index will be an effective and safe nutritional intervention to prevent weight gain in kidney transplant patients. ClinicalTrials.gov identifier, NCT02883777 . Registered on 3 August 2016.

  20. Prognostics of Power MOSFET

    Science.gov (United States)

    Celaya, Jose Ramon; Saxena, Abhinav; Vashchenko, Vladislay; Saha, Sankalita; Goebel, Kai Frank

    2011-01-01

    This paper demonstrates how to apply prognostics to power MOSFETs (metal oxide field effect transistor). The methodology uses thermal cycling to age devices and Gaussian process regression to perform prognostics. The approach is validated with experiments on 100V power MOSFETs. The failure mechanism for the stress conditions is determined to be die-attachment degradation. Change in ON-state resistance is used as a precursor of failure due to its dependence on junction temperature. The experimental data is augmented with a finite element analysis simulation that is based on a two-transistor model. The simulation assists in the interpretation of the degradation phenomena and SOA (safe operation area) change.

  1. The Geriatric Nutritional Risk Index predicts increased healthcare costs and hospitalization in a cohort of community-dwelling older adults: results from the MONICA/KORA Augsburg cohort study, 1994-2005.

    Science.gov (United States)

    Baumeister, Sebastian E; Fischer, Beate; Döring, Angela; Koenig, Wolfgang; Zierer, Astrid; John, Jürgen; Heier, Margit; Meisinger, Christa

    2011-05-01

    To determine if the Geriatric Nutritional Risk Index (GNRI), an index for the risk of nutrition-related complications, is associated with healthcare costs and risk of hospitalization at baseline and after 10 y. Data from a German population-based cohort of 1999 subjects 55 to 74 y of age at baseline were used. Self-reported physician visits, length of hospital stay, and drug intake were used to estimate costs. The GNRI is based on serum albumin values and the discrepancy between real and ideal body weights. Low GNRI values were defined as mean minus 2 times standard deviation. Mean GNRI values were regarded as normal. Low baseline GNRI was consistently associated with increased total costs, probability of hospitalization, inpatient costs, and pharmaceutical costs at baseline and follow-up, after adjustment for socioeconomic characteristics, lifestyle factors, and coexisting conditions. Subjects with low GNRI at baseline had approximately 47% higher total costs, 50% higher risk of hospitalization, 62% higher inpatient costs and 27% higher pharmaceutical costs at follow-up than subjects with normal GNRI values. The GNRI risk predicted increased future healthcare costs and higher risk of hospitalization in independent-living older adults. The GNRI is a rapid and low-cost tool that might be routinely used in population-based settings. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Using prognostic models in CLL to personalize approach to clinical care: Are we there yet?

    Science.gov (United States)

    Mina, Alain; Sandoval Sus, Jose; Sleiman, Elsa; Pinilla-Ibarz, Javier; Awan, Farrukh T; Kharfan-Dabaja, Mohamed A

    2017-10-28

    Four decades ago, two staging systems were developed to help stratify CLL into different prognostic categories. These systems, the Rai and the Binet staging, depended entirely on abnormal exam findings and evidence of anemia and thrombocytopenia. Better understanding of biologic, genetic, and molecular characteristics of CLL have contributed to better appreciating its clinical heterogeneity. New prognostic models, the GCLLSG prognostic index and the CLL-IPI, emerged. They incorporate biologic and genetic information related to CLL and are capable of predicting survival outcomes and cases anticipated to need therapy earlier in the disease course. Accordingly, these newer models are helping develop better informed surveillance strategies and ultimately tailor treatment intensity according to presence (or lack thereof) of certain prognostic markers. This represents a step towards personalizing care of CLL patients. We anticipate that as more prognostic factors continue to be identified, the GCLLSG prognostic index and CLL-IPI models will undergo further revisions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Nutritional quality of meals and snacks assessed by the Food Standards Agency nutrient profiling system in relation to overall diet quality, body mass index, and waist circumference in British adults.

    Science.gov (United States)

    Murakami, Kentaro

    2017-09-13

    Studies examining meal and snack eating behaviors in relation to overall diet and health markers are limited, at least partly because there is no definitive consensus about what constitutes a snack, a meal, or an eating occasion. This cross-sectional study examined how nutritional quality of meals and snacks is associated with overall diet quality, body mass index (BMI), and waist circumference. Based on 7-d weighed dietary record data, all eating occasions were divided into meals or snacks based on time (meals: 0600-1000, 1200-1500, and 1800-2100 h; snacks: others) or contribution to energy intake (EI) (meals: ≥15%; snacks: <15%) in 1451 British adults aged 19-64 years participating in the National Diet and Nutrition Survey. Nutritional quality of meals and snacks was assessed as the arithmetic EI-weighted means of the British Food Standards Agency (FSA) nutrient profiling system score of each food and beverage consumed, based on the contents of energy, saturated fatty acid, total sugar, sodium, fruits/vegetables/nuts, dietary fiber, and protein per 100 g. Irrespective of the definition of meals and snacks, higher FSA scores (lower nutritional quality) of both meals and snacks were associated with unfavorable profiles of individual components of overall diet, including lower intakes of fruits/vegetables/nuts and higher intakes of biscuits/cakes/pastries, total fat, and saturated fatty acid. The FSA scores of meals and snacks were also inversely associated with overall diet quality assessed by the healthy diet indicator (regression coefficient (β) = -0.22 to -0.17 and -0.06 to -0.03, respectively) and Mediterranean diet score (β = -0.25 to -0.19 and -0.08 to -0.05, respectively) in both sexes (P ≤ 0.005). However, the associations were stronger for meals, mainly due to their larger contribution to total EI (64% to 84%). After adjustment for potential confounders, only the FSA score of snacks based on EI contribution was positively associated with BMI

  4. Validity of predictive equations for resting energy expenditure according to the body mass index in a population of 1726 patients followed in a Nutrition Unit.

    Science.gov (United States)

    Jésus, Pierre; Achamrah, Najate; Grigioni, Sébastien; Charles, Jocelyne; Rimbert, Agnès; Folope, Vanessa; Petit, André; Déchelotte, Pierre; Coëffier, Moïse

    2015-06-01

    The resting energy expenditure (REE) predictive formulas are often used in clinical practice to adapt the nutritional intake of patients or to compare to REE measured by indirect calorimetry. We aimed to evaluate which predictive equations was the best alternative to REE measurements according to the BMI. 28 REE prediction equations were studied in a population of 1726 patients without acute or chronic high-grade inflammatory diseases followed in a Nutrition Unit for malnutrition, eating disorders or obesity. REE was measured by indirect calorimetry for 30 min after a fasting period of 12 h. Some formulas requiring fat mass and free-fat mass, body composition was measured by bioelectrical impedance analysis. The percentage of accurate prediction (±10%/REE measured) and Pearson r correlations were calculated. Original Harris & Benedict equation provided 73.0% of accurate predictions in normal BMI group but only 39.3% and 62.4% in patients with BMI equation overestimated the REE in 51.74% of patients with BMI equation involving body composition provided the highest percent of accurate prediction, 42.7% and 66.0% in patients with BMI 40 kg m(-2), respectively. Usual predictive equations of REE are not suitable for predicting REE in patients with extreme BMI, in particularly in patients with BMI equation. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  5. [Detection of opportunities for improvement of the quality of parenteral nutrition in patients subjected to gastrointestinal surgery].

    Science.gov (United States)

    Schoenenberger Arnaiz, J A; Rodríguez Pozo, A; Sales Rufi, S; García, F; Cano Marrón, S M

    1999-01-01

    The nutritional support team must justify its role by proving that it provides an adequate quality control and supervises the administration of the nutritional support to avoid its inappropriate use. The measures based on the process reported on the improvement opportunities while those based on the results allow an evaluation of the quality. The objective of this study is to present the results of a systematic search for improvement opportunities in two fundamental activities of the nutritional support team: the evaluation of the patient needs, and the adequation of the caloric supply to these needs. The data corresponding to nutritional support and nutritional assessment of 217 patients who initiated central parenteral nutrition during the perioperative surgery period for a laparotomy were registered between January of 1996 and June of 1997. These data were used to calculate 8 selected quality indicators to report on the quality of the activities subject to the evaluation. Moreover, the initial and final values of the nutritional assessment parameters of a sub-group of patients were compared with the aim of obtaining a measure of the result of parenteral nutrition. The final average levels of albumin, prealbumin, transferin, and the Nutritional Prognostic Index were significantly better than the initial data in the subgroup in which these data were available. The analysis of the process indicators allowed the detection of the need to reduce the caloric supply in relation to the protein supply and to promote the use of programs with a caloric supply that was better adjusted to the BMI and/or the patients' weight. It was also shown that it is necessary to increase the number of patients assessed from a nutritional point of view at the beginning and at the end of parenteral nutrition.

  6. Prognostic factors in oligodendrogliomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1997-01-01

    An outcome analysis was performed on 96 patients with pure cerebral oligodendrogliomas operated in the 30-year period 1962 to 1991. The most important predictive prognostic factors were youth and no neurological deficit, demonstrated as a median survival for the group younger than 20 years of 17...

  7. Accelerated Aging with Electrical Overstress and Prognostics for Power MOSFETs

    Science.gov (United States)

    Saha, Sankalita; Celaya, Jose Ramon; Vashchenko, Vladislav; Mahiuddin, Shompa; Goebel, Kai F.

    2011-01-01

    Power electronics play an increasingly important role in energy applications as part of their power converter circuits. Understanding the behavior of these devices, especially their failure modes as they age with nominal usage or sudden fault development is critical in ensuring efficiency. In this paper, a prognostics based health management of power MOSFETs undergoing accelerated aging through electrical overstress at the gate area is presented. Details of the accelerated aging methodology, modeling of the degradation process of the device and prognostics algorithm for prediction of the future state of health of the device are presented. Experiments with multiple devices demonstrate the performance of the model and the prognostics algorithm as well as the scope of application. Index Terms Power MOSFET, accelerated aging, prognostics

  8. Prognostic, quantitative histopathologic variables in lobular carcinoma of the breast

    DEFF Research Database (Denmark)

    Ladekarl, M; Sørensen, Flemming Brandt

    1993-01-01

    BACKGROUND: A retrospective investigation of 53 consecutively treated patients with operable lobular carcinoma of the breast, with a median follow-up of 6.6 years, was performed to examine the prognostic value of quantitative histopathologic parameters.METHODS: The measurements were performed...... of disease, vv(nuc), MI, and NI were of significant independent, prognostic value. On the basis of the multivariate analyses, a prognostic index with highly distinguishing capacity between prognostically poor and favorable cases was constructed.CONCLUSION: Quantitative histopathologic variables are of value...... for objective grading of malignancy in lobular carcinomas. The new parameter--estimates of the mean nuclear volume--is highly reproducible and suitable for routine use. However, larger and prospective studies are needed to establish the true value of the quantitative histopathologic variables in the clinical...

  9. [Prognostic factors of early breast cancer].

    Science.gov (United States)

    Almagro, Elena; González, Cynthia S; Espinosa, Enrique

    2016-02-19

    Decision about the administration of adjuvant therapy for early breast cancer depends on the evaluation of prognostic factors. Lymph node status, tumor size and grade of differentiation are classical variables in this regard, and can be complemented by hormonal receptor status and HER2 expression. These factors can be combined into prognostic indexes to better estimate the risk of relapse or death. Other factors are less important. Gene profiles have emerged in recent years to identify low-risk patients who can forgo adjuvant chemotherapy. A number of profiles are available and can be used in selected cases. In the future, gene profiling will be used to select patients for treatment with new targeted therapies. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  10. Significance analysis of prognostic signatures.

    Directory of Open Access Journals (Sweden)

    Andrew H Beck

    Full Text Available A major goal in translational cancer research is to identify biological signatures driving cancer progression and metastasis. A common technique applied in genomics research is to cluster patients using gene expression data from a candidate prognostic gene set, and if the resulting clusters show statistically significant outcome stratification, to associate the gene set with prognosis, suggesting its biological and clinical importance. Recent work has questioned the validity of this approach by showing in several breast cancer data sets that "random" gene sets tend to cluster patients into prognostically variable subgroups. This work suggests that new rigorous statistical methods are needed to identify biologically informative prognostic gene sets. To address this problem, we developed Significance Analysis of Prognostic Signatures (SAPS which integrates standard prognostic tests with a new prognostic significance test based on stratifying patients into prognostic subtypes with random gene sets. SAPS ensures that a significant gene set is not only able to stratify patients into prognostically variable groups, but is also enriched for genes showing strong univariate associations with patient prognosis, and performs significantly better than random gene sets. We use SAPS to perform a large meta-analysis (the largest completed to date of prognostic pathways in breast and ovarian cancer and their molecular subtypes. Our analyses show that only a small subset of the gene sets found statistically significant using standard measures achieve significance by SAPS. We identify new prognostic signatures in breast and ovarian cancer and their corresponding molecular subtypes, and we show that prognostic signatures in ER negative breast cancer are more similar to prognostic signatures in ovarian cancer than to prognostic signatures in ER positive breast cancer. SAPS is a powerful new method for deriving robust prognostic biological signatures from clinically

  11. Role of nutritional status and intervention in oesophageal cancer treated with definitive chemoradiotherapy: outcomes from SCOPE1.

    Science.gov (United States)

    Cox, S; Powell, C; Carter, B; Hurt, C; Mukherjee, Somnath; Crosby, Thomas David Lewis

    2016-07-12

    Malnutrition is common in oesophageal cancer. We aimed to identify nutritional prognostic factors and survival outcomes associated with nutritional intervention in the SCOPE1 (Study of Chemoradiotherapy in OesoPhageal Cancer with or without Erbitux) trial. Two hundred and fifty eight patients were randomly allocated to definitive chemoradiotherapy (dCRT) +/- cetuximab. Nutritional Risk Index (NRI) scores were calculated; NRINutritional intervention included dietary advice, oral supplementation or major intervention (enteral feeding/tube placement). Univariable and multivariable analyses using Cox proportional hazard modelling were conducted. At baseline NRINutritional intervention improved survival if provided at baseline (dietary advice (HR 0.12, P=0.004), oral supplementation (HR 0.13, Pintervention (HR 0.13, P=0.003)), but not if provided later in the treatment course. Cetuximab patients receiving major nutritional intervention had worse outcomes compared with controls (13 vs 28 months, P=0.003). Pre-treatment assessment and correction of malnutrition may improve survival outcomes in oesophageal cancer patients treated with dCRT. Nutritional Risk Index is a simple and objective screening tool to identify patients at risk of malnutrition.

  12. A systematic review and meta-analysis of applications of the self-report habit index to nutrition and physical activity behaviours

    NARCIS (Netherlands)

    Gardner, B.; de Bruijn, G.-J.; Lally, P.

    2011-01-01

    Background: Health behaviour models typically neglect habitual action. The Self-Report Habit Index (SRHI) permits synthesis of evidence of the influence of habit on behaviour. Purpose: The purpose of this study is to review evidence around mean habit strength, habit-behaviour correlations, and habit

  13. INDEXING AND INDEX FUNDS

    Directory of Open Access Journals (Sweden)

    HAKAN SARITAŞ

    2013-06-01

    Full Text Available Proponents of the efficient market hypothesis believe that active portfolio management is largely wasted effort and unlikely to justify the expenses incurred. Therefore, they advocate a passive investment strategy that makes no attempt to outsmart the market. One common strategy for passive management is indexing where a fund is designed to replicate the performance of a broad-based index of stocks and bonds. Traditionally, indexing was used by institutional investors, but today, the use of index funds proliferated among individual investors. Over the years, both international and domestic index funds have disproportionately outperformed the market more than the actively managed funds have.

  14. Diet & Nutrition

    Science.gov (United States)

    ... Nutrition Share this page Facebook Twitter Email Diet & Nutrition Eating healthy to take charge of your health. Shelly Diagnosed in 2006 Diet & Nutrition Take Control of Your Weight Portion Control Low ...

  15. Assessment of dietary intake and nutritional status (MNA) in Polish free-living elderly people from rural environments.

    Science.gov (United States)

    Wyka, Joanna; Biernat, Jadwiga; Mikołajczak, Jolanta; Piotrowska, Ewa

    2012-01-01

    The proportion of elderly people in the global population is rapidly increasing. Their nutritional status indicates many deficiencies that are risky to health. The aim of this paper was to assess the nutrition and nutritional status in elderly individuals above 60 years old living in their family houses in rural areas. Dietary intake and nutritional status were measured in 174 elderly women and 64 men living in the rural areas of Oleśnica (near Wrocław, SW Poland). Energy intake, consumption of nutrients, selected anthropometric and biochemical indicators, were measured in two groups: one at risk of malnutrition and one with adequate nutrition. Using the mini nutritional assessment (MNA) questionnaire, 238 persons over 60 years of age were qualified according to their nutritional status. Anthropometric and biochemical parameters were measured. The group of women at risk of malnutrition (n=30) showed a statistically significantly lower energy intake in their diet (1,127 kcal) compared to women with adequate nutrition (1,351 kcal). The entire group of examined individuals showed a too low consumption of fiber, calcium, vitamins C and D, and folates. Most of the examined women had a too high body mass index (BMI) (on average 28.8), waist circumference was 96.3 cm, and the triceps skinfold (TSF) was 25.2mm thick. Women at a risk of malnutrition had statistically significantly lower lipid parameters than those with adequate nutrition (respectively: TC 191.1 vs. 219.1m/dl, pnutrition. According to the Charlson comorbidity index (CCI), 8.2% of person with adequate nutrition had poor prognostic indicator for overall survival. All the examined individuals showed many significant nutritional deficiencies. The group with nutritional risk had more pronounced nutritional deficiencies. Despite a too low energy value of foods among individuals with correct nutrition, their anthropometric parameters paradoxically showed the presence of excessive fatty tissue. The most frequent

  16. Prognostic value of Child-Turcotte criteria in medically treated cirrhosis

    DEFF Research Database (Denmark)

    Christensen, E; Schlichting, P; Fauerholdt, L

    1984-01-01

    The Child- Turcotte criteria (CTC) (based on serum bilirubin and albumin, ascites, neurological disorder and nutrition) are established prognostic factors in patients with cirrhosis having portacaval shunt surgery. The objective of this study was to evaluate the prognostic value of CTC in conserv......The Child- Turcotte criteria (CTC) (based on serum bilirubin and albumin, ascites, neurological disorder and nutrition) are established prognostic factors in patients with cirrhosis having portacaval shunt surgery. The objective of this study was to evaluate the prognostic value of CTC...... in conservatively treated cirrhosis. Patients (n = 245) with histologically verified cirrhosis from a control group of a controlled clinical trial were studied. Data at entry into the trial were used to classify patients according to CTC. Survival curves for up to 16 years were made, and survival rates were...

  17. Effects of smoking on nutrition status and response to dietary supplements during acute illness.

    Science.gov (United States)

    Gariballa, Salah; Forster, Sarah

    2009-01-01

    Although smokers have poor health and consequently poor dietary intake compared with nonsmokers, no study has examined the effects of smoking on nutrition status during acute illness. The purpose of this study is to measure the effect of smoking on nutrition status in hospitalized patients. Four hundred and thirty-four patients in a randomized, double-blind, placebo-controlled trial of nutrition supplementation were nutritionally assessed based on anthropometric, hematological, and biochemical data at baseline and 6 weeks later. Nutrition status was compared between current smokers, ex-smokers, and those who never smoked. Mortality was evaluated during the hospital stay and at 6 and 12 months after hospitalization. The association between smoking and nutrition status and mortality was measured after adjustment for poor prognostic indicators. Body weight, body mass index, mid-upper arm circumference, triceps skinfold thickness, serum albumin level, and plasma concentrations of vitamin C, red-cell folate, and vitamin B12 were all lower in current smokers compared with those who never smoked. Being a current smoker was associated with lower body weight, mid-upper arm circumference, and plasma vitamin C concentration compared with those patients who never smoked. Logistic regression analysis showed that smoking and increasing age were significantly and independently related to 1-year mortality. No significant difference in nutrition status between the supplement and the placebo group was found at the end of 6 weeks. Smoking was independently associated with poor nutrition status in hospitalized patients. This may partly explain the poor clinical outcome associated with smoking.

  18. Prognostic indicators in alcoholic cirrhotic men

    DEFF Research Database (Denmark)

    Gluud, C; Henriksen, Jens Henrik Sahl; Nielsen, G

    1988-01-01

    The relationships between portal pressure, liver function and clinical variables on one hand and development of variceal hemorrhage and death on the other were investigated in 58 men with newly diagnosed alcoholic cirrhosis. Portal pressure was determined during hepatic vein catheterization...... information regarding development of variceal hemorrhage, even when easily obtained variables with known prognostic information were included [modified Child-Turcotte's criteria and incapacitation index (a weighted sum of days without normal health)]. During follow-up, 17 patients (29%) died. Applying Cox...... of prognosis in alcoholic cirrhotic men may be significantly improved by information about size of esophageal varices and level of portal pressure....

  19. Use of a new availability index to evaluate the effect of policy changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on the food environment in New Orleans.

    Science.gov (United States)

    O'Malley, Keelia; Luckett, Brian G; Dunaway, Lauren Futrell; Bodor, J Nicholas; Rose, Donald

    2015-01-01

    Changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) occurred in 2009 when supplemental foods offered through the programme were updated to align with current dietary recommendations. The present study reports on a new index developed to monitor the retail environment's adoption of these new food supply requirements in New Orleans. A 100-point WIC Availability Index (WIC-AI) was derived from new minimum state stocking requirements for WIC vendors. A sample of supermarkets, medium and small food stores was assessed in 2009 before changes were implemented and in 2010 after revisions had gone into effect. WIC-AI scores were utilized to compare differences in meeting requirements by store type, WIC vendor status and year of measurement. Supermarkets, medium and small WIC and non-WIC food stores in New Orleans, Louisiana, USA. At baseline supermarkets had the highest median WIC-AI score (93·3) followed by medium (69·8) and small food stores (48·0). Small WIC stores had a higher median WIC-AI score at baseline than small non-WIC stores (66·9 v. 38·0). Both medium and small WIC stores significantly increased their median WIC-AI scores between 2009 and 2010 (Ppolicy decisions and direction.

  20. Nutritional status based on Body Mass Index is associated with morbidity and mortality in mechanically ventilated critically ill children in the PICU

    Science.gov (United States)

    Bechard, Lori J.; Duggan, Christopher; Touger-Decker, Riva; Parrott, J. Scott; Rothpletz-Puglia, Pamela; Byham-Gray, Laura; Heyland, Daren; Mehta, Nilesh M.

    2016-01-01

    Objective To determine the influence of admission anthropometry on clinical outcomes in mechanically ventilated children in the pediatric intensive care unit (PICU). Design Data from 2 multicenter cohort studies were compiled to examine the unique contribution of nutritional status, defined by BMI Z-score, to 60-day mortality, hospital-acquired infections, length of hospital stay, and ventilator free days (VFD), using multivariate analysis. Setting 90 PICUs from 16 countries with 8 beds. Patients Children aged 1 month to 18 years, admitted to each participating PICU and requiring mechanical ventilation for more that 48 hours Measurements and Main Results Data from 1622 eligible patients, 54.8% male and mean (SD) age 4.5 (5.1) years, were analysed. Subjects were classified as underweight (17.9%), normal weight (54.2%), overweight (14.5%), and obese (13.4%) based on BMI Z-score at admission. After adjusting for severity of illness and site, the odds of 60-day mortality were higher in underweight (OR 1.53, PClassification as underweight or obese was associated with higher risk of hospital-acquired infections and lower likelihood of hospital discharge. Underweight children had a higher risk of mortality and fewer ventilator-free days. PMID:26985636

  1. Prognostic factors in oligodendrogliomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1997-01-01

    .5 years and for the group older than 60 years of 13 months. The group without neurological deficits had a 5-years survival of 43 per cent while the group with deficits had a 5-years survival of 5 per cent. The 5-years survival for oligodendroglioma of grade II was 46 per cent and for grade III 10 per cent......An outcome analysis was performed on 96 patients with pure cerebral oligodendrogliomas operated in the 30-year period 1962 to 1991. The most important predictive prognostic factors were youth and no neurological deficit, demonstrated as a median survival for the group younger than 20 years of 17...

  2. Lifecycle Prognostics Architecture for Selected High-Cost Active Components

    Energy Technology Data Exchange (ETDEWEB)

    N. Lybeck; B. Pham; M. Tawfik; J. B. Coble; R. M. Meyer; P. Ramuhalli; L. J. Bond

    2011-08-01

    There are an extensive body of knowledge and some commercial products available for calculating prognostics, remaining useful life, and damage index parameters. The application of these technologies within the nuclear power community is still in its infancy. Online monitoring and condition-based maintenance is seeing increasing acceptance and deployment, and these activities provide the technological bases for expanding to add predictive/prognostics capabilities. In looking to deploy prognostics there are three key aspects of systems that are presented and discussed: (1) component/system/structure selection, (2) prognostic algorithms, and (3) prognostics architectures. Criteria are presented for component selection: feasibility, failure probability, consequences of failure, and benefits of the prognostics and health management (PHM) system. The basis and methods commonly used for prognostics algorithms are reviewed and summarized. Criteria for evaluating PHM architectures are presented: open, modular architecture; platform independence; graphical user interface for system development and/or results viewing; web enabled tools; scalability; and standards compatibility. Thirteen software products were identified and discussed in the context of being potentially useful for deployment in a PHM program applied to systems in a nuclear power plant (NPP). These products were evaluated by using information available from company websites, product brochures, fact sheets, scholarly publications, and direct communication with vendors. The thirteen products were classified into four groups of software: (1) research tools, (2) PHM system development tools, (3) deployable architectures, and (4) peripheral tools. Eight software tools fell into the deployable architectures category. Of those eight, only two employ all six modules of a full PHM system. Five systems did not offer prognostic estimates, and one system employed the full health monitoring suite but lacked operations and

  3. Prognostic impact of absolute lymphocyte count/absolute monocyte count ratio and prognostic score in patients with nasal-type, extranodal natural killer/T-cell lymphoma.

    Science.gov (United States)

    Li, Na; Zhang, Li; Song, Hao-Lan; Zhang, Jing; Weng, Hua-Wei; Zou, Li-Qun

    2017-05-01

    Nasal-type, extranodal natural killer/T-cell lymphoma is a heterogeneous disorder with poor prognosis, requiring risk stratification in this population. The combined value of baseline absolute lymphocyte count and absolute monocyte count provided prognostic information in some malignancies. However, the evidence requires validation in extranodal natural killer/T-cell lymphoma. Aiming to investigate the prognostic significance of absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte count prognostic score for extranodal natural killer/T-cell lymphoma, a retrospective research was carried out. A total of 264 patients with newly diagnosed extranodal natural killer/T-cell lymphoma were analyzed in this study. The patients' absolute lymphocyte count and absolute monocyte count tested at initial diagnosis were collected. Receiver operating curve analysis showed that the optimal cut-off values for absolute lymphocyte count and absolute monocyte count were 1.0 × 10(9) and 0.5 × 10(9)L(-1), respectively, and for absolute lymphocyte count/absolute monocyte count ratio was 2.85. After a median follow-up of 27 months (range 1-87 months), the 3-year overall survival and progression-free survival was 75.4% and 67.6%, respectively. Patients with absolute lymphocyte count/absolute monocyte count ratio ≥ 2.85 had better 3-year overall survival and progression-free survival than those with absolute lymphocyte count/absolute monocyte count ratio lymphocyte count/absolute monocyte count prognostic score, significant difference has been noticed in 3-year overall survival and progression-free survival (p lymphocyte count/absolute monocyte count prognostic score was associated with poorer survival. The International Prognostic Index and Korean Prognostic Index were used for prognosis and showed no significant difference. When adding absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte

  4. Body mass index history and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study.

    Science.gov (United States)

    Schienkiewitz, Anja; Schulze, Matthias B; Hoffmann, Kurt; Kroke, Anja; Boeing, Heiner

    2006-08-01

    Obesity and increases in body weight in adults are considered to be among the most important risk factors for type 2 diabetes. The objective was to evaluate and compare the associations between weight changes during 2 different periods of adult life and the risk of type 2 diabetes and age at diagnosis. The study included 7720 men and 10 371 women from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study with information on weight history; 390 men and 303 women of these participants received a clinical diagnosis of type 2 diabetes during 7 y of follow-up. Multivariate Cox regression models were used to estimate the relative risk (RR) of weight changes between ages 25 and 40 y and ages 40 and 55 y. RR estimates in men and women were slightly higher for each unit of BMI gain between ages 25 and 40 y [men: 1.25 (95% CI: 1.21, 1.30); women: 1.24 (1.20, 1.27)] than between ages 40 and 55 y [men: 1.13 (1.10, 1.16); women: 1.11 (1.08, 1.14)]. Severe weight gain between ages 25 and 40 y was associated with a higher diabetes risk in men (1.5 times) and in women (4.3 times) than were stable weight in early adulthood and weight gain in later life, and it resulted in an average lower age at diabetes diagnosis in men (5 y) and in women (3 y). Weight gain in early adulthood is related to a higher risk and earlier onset of type 2 diabetes than is weight gain between 40 and 55 y of age.

  5. Discrepant body mass index: behaviors associated with height and weight misreporting among US adolescents from the National Youth Physical Activity and Nutrition Study.

    Science.gov (United States)

    Jayawardene, Wasantha; Lohrmann, David; YoussefAgha, Ahmed

    2014-06-01

    The accuracy and reliability of self-reported height and weight among adolescents in the process of calculating BMI is usually subject to bias. The aim of this study was to determine whether over- and under-reporting of self-reported height and weight existed among US high school students by weight category; if so, to examine anthropometric, behavioral, and demographic factors associated with over- and under-reporting. Data were retrieved from the National Youth Physical Activity and Nutrition Study, 2010, a nationally representative sample (7160 students, grades 9-12). Analysis of variance was performed to determine any significant difference between weight categories in misreporting. Discriminant function analysis and sequential logistic regression were executed to detect behavioral and demographic predictors of reporting accuracy, respectively. The mean over-reporting of height and under-reporting of weight were 1.1 cm and 1.020 kg, respectively, which underestimated BMI and BMI percentile by 0.671 and 2.734, respectively. Use of self-reported height and weight for BMI calculation overestimated prevalence of healthy weight by 3.8% and underestimated prevalence of obesity by 4.1%. Underweight students under-reported height and over-reported weight, whereas overweight and obese students over-reported height and under-reported weight. Reporting accuracy of females was significantly higher. Weight loss behaviors, both healthy and unhealthy, were associated with BMI underestimation, whereas fast foods and screen time were associated with overestimation. Whenever possible, measuring height and weight is essential. However, because many studies must rely on self-reported values alone, additional research should examine the relationships between misreport of anthropometric data and lifestyle features in diverse adolescent samples to better interpret self-reported anthropometric data.

  6. Cumulative Intracranial Tumor Volume Augments the Prognostic Value of Diagnosis-Specific Graded Prognostic Assessment Model for Survival in Patients with Melanoma Cerebral Metastases

    DEFF Research Database (Denmark)

    Hirshman, Brian R; Wilson, Bayard R; Ali, Mir Amaan

    2017-01-01

    intracranial tumor volume (CITV) into the ds-GPA model for melanoma augmented its prognostic value. OBJECTIVE: To determine whether or not CITV augments the ds-GPA prognostic scale for melanoma. METHODS: We analyzed the survival pattern of 344 melanoma patients with BM treated with stereotactic radiosurgery...... (SRS) at separate institutions and validated our findings in an independent cohort of 201 patients. The prognostic value of ds-GPA for melanoma was quantitatively compared with and without the addition of CITV using the net reclassification index (NRI > 0) and integrated discrimination improvement (IDI...... validated these findings that CITV improves the prognostic utility of melanoma ds-GPA in an independent cohort of 201 melanoma cohort. CONCLUSION: The prognostic value of the ds-GPA scale for melanoma BM is enhanced by the incorporation of CITV....

  7. Prognostic factors in lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Starklint, Henrik; Halberg, Poul

    2006-01-01

    To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis.......To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis....

  8. Requirements Specifications for Prognostics: An Overview

    Data.gov (United States)

    National Aeronautics and Space Administration — With recent advancements in prognostics methodologies there has been a significant interest in maturing Prognostics and Health Management (PHM) to increase its...

  9. On Applying the Prognostic Performance Metrics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics performance evaluation has gained significant attention in the past few years. *As prognostics technology matures and more sophisticated methods for...

  10. Metrics for Offline Evaluation of Prognostic Performance

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostic performance evaluation has gained significant attention in the past few years.*Currently, prognostics concepts lack standard definitions and suffer from...

  11. Nutritional assessment of amyotrophic lateral sclerosis in routine practice: value of weighing and bioelectrical impedance analysis.

    Science.gov (United States)

    Roubeau, Vincent; Blasco, Hélène; Maillot, François; Corcia, Philippe; Praline, Julien

    2015-04-01

    We evaluated clinical and bioelectrical impedance (BIA) parameters at the time of diagnosis and during follow-up and associated these parameters with survival in amyotrophic lateral sclerosis (ALS) patients. One hundred seventeen patients were enrolled and were evaluated prospectively every 3 months. All patients underwent at least 1 BIA-based assessment, and 73 underwent at least 2 assessments. Data regarding the site of onset, age at onset, weight, body mass index (BMI), amyotrophic lateral sclerosis functional rating scale score (ALSFRS), fat-free mass (FFM), fat mass (FM), and phase angle (PA) were collected. At the time of diagnosis, weight loss exceeding 5% of the premorbid weight and low PA were poor prognostic factors. During follow-up, a decrease of PA and FFM were associated with shorter survival, regardless of weight loss. These results confirm that BIA is useful to identify poor prognostic factors at the time of diagnosis and during follow-up and thus could be used to monitor patients during follow-up. Early identification of poor prognostic factors enables nutritional management and might improve patient survival. © 2014 Wiley Periodicals, Inc.

  12. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age--Analysis from the ROLO Randomised Controlled Trial.

    LENUS (Irish Health Repository)

    Horan, Mary K

    2016-01-04

    Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142) and intervention group (n = 138), who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle) were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age.

  13. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age—Analysis from the ROLO Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Mary K. Horan

    2016-01-01

    Full Text Available Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI, remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142 and intervention group (n = 138, who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age.

  14. The prognostic value of FET PET at radiotherapy planning in newly diagnosed glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Hoejklint Poulsen, Sidsel [The Finsen Center, Rigshospitalet, Department of Radiation Biology, Copenhagen (Denmark); Center of Diagnostic Investigation, Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen (Denmark); Urup, Thomas; Grunnet, Kirsten; Skovgaard Poulsen, Hans [The Finsen Center, Rigshospitalet, Department of Radiation Biology, Copenhagen (Denmark); The Finsen Center, Rigshospitalet, Department of Oncology, Copenhagen (Denmark); Jarle Christensen, Ib [University of Copenhagen, Hvidovre Hospital, Laboratory of Gastroenterology, Copenhagen (Denmark); Larsen, Vibeke Andree [Center of Diagnostic Investigation, Rigshospitalet, Department of Radiology, Copenhagen (Denmark); Lundemann Jensen, Michael; Munck af Rosenschoeld, Per [The Finsen Center, Rigshospitalet, Department of Oncology, Copenhagen (Denmark); The Finsen Center, Rigshospitalet, Section of Radiotherapy, Copenhagen (Denmark); Law, Ian [Center of Diagnostic Investigation, Rigshospitalet, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen (Denmark)

    2017-03-15

    Glioblastoma patients show a great variability in progression free survival (PFS) and overall survival (OS). To gain additional pretherapeutic information, we explored the potential of O-(2-{sup 18}F-fluoroethyl)-L-tyrosine (FET) PET as an independent prognostic biomarker. We retrospectively analyzed 146 consecutively treated, newly diagnosed glioblastoma patients. All patients were treated with temozolomide and radiation therapy (RT). CT/MR and FET PET scans were obtained postoperatively for RT planning. We used Cox proportional hazards models with OS and PFS as endpoints, to test the prognostic value of FET PET biological tumor volume (BTV). Median follow-up time was 14 months, and median OS and PFS were 16.5 and 6.5 months, respectively. In the multivariate analysis, increasing BTV (HR = 1.17, P < 0.001), poor performance status (HR = 2.35, P < 0.001), O(6)-methylguanine-DNA methyltransferase protein status (HR = 1.61, P = 0.024) and higher age (HR = 1.32, P = 0.013) were independent prognostic factors of poor OS. For poor PFS, only increasing BTV (HR = 1.18; P = 0.002) was prognostic. A prognostic index for OS was created based on the identified prognostic factors. Large BTV on FET PET is an independent prognostic factor of poor OS and PFS in glioblastoma patients. With the introduction of FET PET, we obtain a prognostic index that can help in glioblastoma treatment planning. (orig.)

  15. [Prognostic factors in multiple myeloma. Review of the literature].

    Science.gov (United States)

    Bauduer, F; Troussard, X; Delmer, A

    1993-12-01

    Apparition of new tools in the therapy of multiple (MM) strengthens the need for valuable prognostic categorization of each patient in order to propose the most adequate treatment. Prognostic factors in MM can be divided in four groups. The first, including beta 2 microglobulin (beta 2m), hemopoiesis impairment, osteolytic lesions, calcemia and albuminemia, reflects the tumor mass. The second: type of monoclonal component, labeling index (LI), C-reactive protein (CRP), cytologic, histologic and immunophenotypic aspects of plasmocytes, renal biology, ADN and ARN, contents of malignant cells, LDH levels, activation of ras oncogene represents the intrinsic malignancy of the clone. The third illustrates the type of response to chemotherapy. Finally, the last group characterizes the host and his reactivity against the disease. Thus, the referential prognostic classification of Durie and Salmon representing only the tumor burden, seems to be now insufficient. New classifications including CRP, beta 2m and LI as more discriminant parameters are currently proposed.

  16. Assessment of nutritional status in cancer--the relationship between body composition and pharmacokinetics.

    Science.gov (United States)

    Prado, Carla M M; Maia, Yara L M; Ormsbee, Michael; Sawyer, Michael B; Baracos, Vickie E

    2013-10-01

    Several nutritional assessment tools have been used in oncology settings to monitor nutritional status and its associated prognostic significance. Body composition is fundamental for the assessment of nutritional status. Recently, the use of accurate and precise body composition tools has significantly added to the value of nutritional assessment in this clinical setting. Computerized tomography (CT) is an example of a technique which provides state-of-the-art assessment of body composition. With use of CT images, a great variability in body composition of cancer patients has been identified even in people with identical body weight or body mass index. Severe muscle depletion (sarcopenia) has emerged as a prevalent body composition phenotype which is predictive of poor functional status, shorter time to tumor progression, shorter survival, and higher incidence of dose-limiting toxicity. Variability in body composition of cancer patients may be a source of disparities in the metabolism of cytotoxic agents. Future clinical trials investigating dose reductions in patients with sarcopenia and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms.

  17. Nutritional supplements

    DEFF Research Database (Denmark)

    Petersen, Gry Bjerg; Andersen, Jens Rikardt

    2015-01-01

    Background: Several studies have indicated that cancer patients have significantly altered taste sensitivity without specifying the preferences. One of the related problems is low compliance to nutritional therapy with oral nutritional supplements (ONS) in patients suffering severe weight loss...

  18. Nutritional Support

    Science.gov (United States)

    Nutritional support is therapy for people who cannot get enough nourishment by eating or drinking. You may need it ... nutrients through your digestive system You receive nutritional support through a needle or catheter placed in your ...

  19. Impact of intensive school-based nutrition education and lifestyle interventions on insulin resistance, β-cell function, disposition index, and subclinical inflammation among Asian Indian adolescents: a controlled intervention study.

    Science.gov (United States)

    Singhal, Neha; Misra, Anoop; Shah, Priyali; Gulati, Seema; Bhatt, Suryaprakash; Sharma, Suresh; Pandey, Ravindra Mohan

    2011-04-01

    The present study was designed to assess the impact of intensive and repetitive nutrition education and lifestyle interventions on insulin resistance, β-cell function, disposition index (DI), and subclinical inflammation in Asian Indian adolescents (15-17 years) residing in North India. In this prospective study, two matched schools were randomly allocated to the intervention (n = 56; 31 boys and 25 girls) or control group (n = 50; 30 boys and 20 girls). The intervention consisted of seven components: (1) Dissemination of health-related information through lectures and focused group discussions, (2) planning of activities such as quizzes, (3) individual counseling of students, (4) promotion of physical activity, (5) change in the canteen menu to healthier alternatives, (6) conducting health camps involving parents and teachers, and (7) training of student volunteers for sustainability of the program in school. Impact of intervention was studied on surrogate markers of insulin resistance, β-cell function, disposition index, and subclinical inflammation. At 6 months follow-up, significantly higher (P = 0.037) mean value of homeostasis model assessment denoting β-cell function (HOMA-βCF) was seen in the intervention group compared to the control group, whereas high sensitivity C-reactive protein (hs-CRP) was significantly lowered (P < 0.001). The increase (30.3 ± 73.4; P < 0.037) observed in the DI in adolescents in the intervention group was significantly higher compared to the control group. The Pearson's coefficient of correlation in the intervention group showed that the Δ-decrease in mean waist circumference was significantly correlated (r = 0.267, P < 0.05) with Δ-decrease in homeostasis model assessment of insulin resistance (HOMA-IR). The intervention model developed by us could be used for amelioration of insulin resistance with potential of preventing type 2 diabetes mellitus in Asian Indian adolescents.

  20. Effects of an after-school care-administered physical activity and nutrition protocol on body mass index, fitness levels, and targeted psychological factors in 5- to 8-year-olds.

    Science.gov (United States)

    Annesi, James J; Smith, Alice E; Walsh, Stephanie M; Mareno, Nicole; Smith, Kathleen R

    2016-09-01

    Over one third of U.S. youth are overweight or obese. Treatments typically have had unreliable effects, inconsistently incorporating behavior-change theory. After-school care might be a viable setting for health behavior-change programs. We evaluated effects of two consecutive 12-week segments of a revised self-efficacy/social cognitive theory-based physical activity and nutrition treatment on fitness levels, body mass index (BMI), and targeted psychosocial factors in after-school care participants, ages 5-8 years. Changes in physiological measures, exercise self-efficacy (ESE), and physical self-concept over 9 months were contrasted in experimental (n = 72) vs. typical-care (n = 42) groups. Mediation of the group-BMI change relationship by the psychosocial factors was also assessed. Improvements in physiological measures and ESE were significantly greater in the experimental group. ESE change completely mediated the association of treatment type with BMI change. The experimental group demonstrated significantly greater improvements in the physiological measures, with its treatment's theoretical basis and application within after-school care supported.

  1. On the Study of Pre-Pregnancy Body Mass Index (BMI) and Weight Gain as Indicators of Nutritional Status of Pregnant Women Belonging to Low Socio-Economic Category: A Study from Assam.

    Science.gov (United States)

    Mahanta, Lipi B; Choudhury, Manisha; Devi, Arundhuti; Bhattacharya, Arunima

    2015-01-01

    Women, particularly pregnant women, are the most vulnerable population of the society and their health status is one of the major indicators of development. There were enough studies on pre pregnancy body mass index (IPBMI) and inadequate weight gain during pregnancy (IWGP) of women in other part of the world and India, but none in Assam. In Assam a large number of population are in the category of low socio-economic group, a group most vulnerable to under nutrition. Thus this study was framed with the said indicators to throw light on the factors affecting the health status of pregnant women to accordingly address the situation. A cross sectional study using multistage sampling design with probability proportional to size was made comprising of 461 pregnant women belonging to low socio-economic status. Responses regarding their socio-economic, socio-cultural, health, diet and environmental background were collected and coded. The study revealed that although IPBMI (34.06%) was slightly lower than the reported state, national and global percentage the revealed IWGP (82%) was an astounding figure. The blood samples analyzed showed a high degree of inadequacy in almost all micronutrients (iron 63.1%, calcium 49.5% and copper 39.9%) studied in our survey.

  2. Advantages of enteral nutrition over parenteral nutrition

    OpenAIRE

    Seres, David S.; Valcarcel, Monika; Guillaume, Alexandra

    2013-01-01

    It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition.

  3. Advantages of enteral nutrition over parenteral nutrition

    Science.gov (United States)

    Valcarcel, Monika; Guillaume, Alexandra

    2013-01-01

    It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition. PMID:23503324

  4. DAILY MEAL FREQUENCY OF SECONDARY SCHOOL STUDENTS FROM LJUBLJANA IN RELATION TO SOME OF THEIR OTHER NUTRITIONAL AND LIFE-STYLE CHARACTERISTICS AND BODY MASS INDEX – PRELIMINARY RESULTS

    Directory of Open Access Journals (Sweden)

    Mojca Gabrijelčič-Blenkuš

    2001-05-01

    Full Text Available Background. The recommended number of daily meals is three to five. The aim of this study was to establish the number of meals, daily consumed by secondary school students from Ljubljana, and the relationship with nutritional and other habits, including bad habits, demographic and socio-economic characteristics of the secondary school students and their body mass index.Methods. In 1999, an cross-section epidemiological study was performed on a proportional sample of 296 pupils attending the third class of Ljubljana secondary schools. The applied dietary data collection methods were the survey and the 24-hour dietary recall. The body mass index was calculated on the basis of the measured body height and body mass values. The Chi-square test, t-test, variance analysis and the multivariant linear regression method were used for the analysis.Results. The students consume 3.16 meals per day on average (boys 3.44, girls 2.87. The students who reported a smaller number of meals per day consume statistically significantly less fruit, vegetables, milk, milk products and fish. They take hot meals less frequently, consume less often all daily meals, their daily meals are of a poorer quality in respect to their composition, they eat less often their meals in a sitting position, they feel a greater difference in diet between working week days and weekends, their regular nourishment is more influenced by school obligations, they have poorer knowledge of healthy dietary practices, smoke more often, are less satisfied with their weight, are less physically active and girls sleep less at nights. The inverse proportional relationship between the number of daily meals and the body mass index was not statistically significant. The multivariant linear regression model explained the low variance percentage (R2 = 0.28.Conclusions. The average number of daily meals consumed by schoolboys is at the lower border of recommendations, while the average number of daily meals

  5. Towards Prognostics for Electronics Components

    Data.gov (United States)

    National Aeronautics and Space Administration — Electronics components have an increasingly critical role in avionics systems and in the development of future aircraft systems. Prognostics of such components is...

  6. Standardizing Research Methods for Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics and health management (PHM) is a maturing system engineering discipline. As with most maturing disciplines, PHM does not yet have a universally accepted...

  7. Malnutrition is a prognostic factor in patients with hepatocellular carcinoma (HCC).

    Science.gov (United States)

    Schütte, Kerstin; Tippelt, Bernadett; Schulz, Christian; Röhl, Friedrich-Wilhelm; Feneberg, Anja; Seidensticker, Ricarda; Arend, Jörg; Malfertheiner, Peter

    2015-12-01

    Malnutrition is a common, hence frequently underdiagnosed condition in patients with liver cirrhosis as well as in patients with cancer and has been shown to have a negative impact on survival in these patients. Frequently applied screening tools including anthropometric measurements or laboratory parameters to screen for malnutrition are not suitable for patients with liver cirrhosis with additional pathophysiological mechanisms leading to hypoalbuminemia and edema. Prospective data on the prevalence and prognostic impact of malnutrition in patients with HCC are scarce. Fifty-one consecutive patients with hepatocellular carcinoma were prospectively enrolled into this study and screened for malnutrition by anthropometric measurements, the MNA score, the NRS score, laboratory work-up, and BIA measurement. The results of the different screening tools were compared to each other and with the BIA assessment and correlated with the outcome of patients. The calculation of a body mass index (BMI) was not suitable to identify malnourished patients with HCC. The MNA identified 19, the NRS score 17 patients at a risk for malnutrition. BIA revealed a reduction in relative body cell mass in 12 patients. Univariate Cox regression analyses identified tumor stage, MNA score, and phase angle obtained by BIA as significant factors with influence on survival. Multivariate analyses confirmed the phase angle at a cut-off of 4.8 to be an independent factor. A significant proportion of patients with HCC is malnourished or at risk for malnutrition. Screening questionnaires and BIA measurement are superior to pure anthropometric measurements to identify the condition that negatively influences survival. The phase angle derived from body impedance analysis is an independent prognostic factor in patients with HCC. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  8. Nutrition Labeling

    DEFF Research Database (Denmark)

    Grunert, Klaus G

    2013-01-01

    because consumers will avoid products that the label shows to be nutritionally deficient, but also because food producers will try to avoid marketing products that appear, according to the label, as nutritionally problematic, for example, because of a high content of saturated fat or salt. Nutrition......Nutrition labeling refers to the provision of information on a food product’s nutritional content on the package label. It can serve both public health and commercial purposes. From a public health perspective, the aim of nutrition labeling is to provide information that can enable consumers...... to make healthier choices when choosing food products. Nutrition labeling is thus closely linked to the notion of the informed consumer, that chooses products according to their aims, on the basis of the information at their disposal. Because many consumers are assumed to be interested in making healthy...

  9. [Expression and prognostic significance of microenvironment related prognostic factors in patients with classical Hodgkin's lymphoma].

    Science.gov (United States)

    Wang, T T; Li, S X; Xia, B; Zhao, H F; Xu, W; Yang, H L; Wang, X F; Yu, Y; Sun, B C; Zhang, Y Z

    2017-05-16

    Objective: To observe the expression of three microenvironment related prognostic factors, i. e. programmed death 1 (PD-1), forkhead box protein 3(FOXP3) and colony-stimulating factor 1 receptor(CSF-1R) protein in classical Hodgkin's lymphoma (CHL) patients, and to explore the correlation between the protein expression and the prognosis of the patients. Methods: A total of 45 cases of CHL patients, who had been admitted to the Tianjin Medical University Cancer Institute and Hospital and Chinese PLA General Hospital from February 2005 to August 2010 were analyzed, including clinical features, prognostic factors, and treatment regimens. CHL patients' specimens were collected and the expression of PD-1, FOXP3, and CSF-1R proteins analyzed by immunohistochemical staining. Epstein-Barr virus encoded mRNA (EBER) was detected by in situ hybridization analysis. The relationship between the protein expression of PD-1, FOXP3 and CSF-1R and the patients' outcome was analyzed with clinical and follow-up data. Survival analysis was performed by Kaplan-Meier method, the Cox proportional hazard model was used to perform multivariate analysis. Results: In this cohort of 45 CHL patients, PD-1 positive was found in 7 cases (15.6%), FOXP3 high expression in 23 cases (51.1%), CSF-1R positive in 18 cases (40.0%). In the univariate analysis, the expression of FOXP3 and CSF-1R, International Prognostic Index (IPI) score, Ann Arbor stage and EBER were related with the patients' 5-year overall survival (OS); IPI score, the expression of FOXP3 and EBER were related with the patients' 5-year progress-free survival (PFS). Multivariate analysis indicated that CSF-1R protein expression was the independent prognostic factor affecting the patients' 5-year OS(HR: 8.918, P=0.020), and FOXP3 protein expression was the independent prognostic factor affecting the patients' 5-year PFS (HR: 0.122, PCSF-1R and EBV may be independent prognostic factors of CHL and this study may provide novel strategies

  10. Prognostic biomarkers in osteoarthritis

    Science.gov (United States)

    Attur, Mukundan; Krasnokutsky-Samuels, Svetlana; Samuels, Jonathan; Abramson, Steven B.

    2013-01-01

    Purpose of review Identification of patients at risk for incident disease or disease progression in osteoarthritis remains challenging, as radiography is an insensitive reflection of molecular changes that presage cartilage and bone abnormalities. Thus there is a widely appreciated need for biochemical and imaging biomarkers. We describe recent developments with such biomarkers to identify osteoarthritis patients who are at risk for disease progression. Recent findings The biochemical markers currently under evaluation include anabolic, catabolic, and inflammatory molecules representing diverse biological pathways. A few promising cartilage and bone degradation and synthesis biomarkers are in various stages of development, awaiting further validation in larger populations. A number of studies have shown elevated expression levels of inflammatory biomarkers, both locally (synovial fluid) and systemically (serum and plasma). These chemical biomarkers are under evaluation in combination with imaging biomarkers to predict early onset and the burden of disease. Summary Prognostic biomarkers may be used in clinical knee osteoarthritis to identify subgroups in whom the disease progresses at different rates. This could facilitate our understanding of the pathogenesis and allow us to differentiate phenotypes within a heterogeneous knee osteoarthritis population. Ultimately, such findings may help facilitate the development of disease-modifying osteoarthritis drugs (DMOADs). PMID:23169101

  11. Functional assessment of nutrition status.

    Science.gov (United States)

    Russell, Mary Krystofiak

    2015-04-01

    Functional status assessment has been recommended as a part of a complete nutrition assessment for decades, but the specific components of this assessment have eluded a consensus definition. The recent Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition consensus criteria for identification of malnutrition include functional assessment determined by handgrip dynamometry, with the understanding that this technique is not practical for use in some patient populations. Other techniques for functional assessment include physical performance measures such as timed gait and chair stands, as well as activities of daily living tools such as the Katz Index, Lawton Scale, and Karnofsky Scale Index. Manual muscle testing and computed tomography scan assessment of lean tissue are other tools that show promise in correlating functional and nutrition assessments. Functional assessment parameters may be least well correlated with nutrition status in older individuals. Despite a number of scientific studies of a variety of tools for functional assessment, there is to date no definitive tool for use in all individuals in all settings. Nutrition scientists and clinicians must continue to collaborate with colleagues in physical and occupational therapy, geriatrics, and nursing to refine current functional assessment tools to more effectively correlate with nutrition and malnutrition assessment parameters. © 2015 American Society for Parenteral and Enteral Nutrition.

  12. Comparison of two nutritional assessment methods in gastroenterology patients

    OpenAIRE

    Filipović, Branka F; Gajić, Milan; Milinić, Nikola; Milovanović, Branislav; Filipović, Branislav R; Cvetković, Mirjana; Šibalić, Nela

    2010-01-01

    AIM: To investigate and compare efficacy and differences in the nutritional status evaluation of gastroenterology patients by application of two methods: subjective global assessment (SGA) and nutritional risk index (NRI).

  13. Oral squamous cell carcinoma. Cytometric parameters of prognostic interest.

    Science.gov (United States)

    Saiz-Bustillo, Ramón; Corchero-Martín, Guadalupe; García-Montesinos-Perea, Belén; Gonzalez-Terán, Tomás; Sánchez-Santolino, Sergio

    2005-01-01

    The present study was made in order to find possible prognostic factors in oral squamous cell carcinoma, given that it is a frequent disease (3-4% of all malignant tumors) and is the cause of a high morbidity and mortality which justifies any attempt to contribute something towards the understanding of this pathology. 81 oral squamous cell carcinomas, treated with the same procedure, and retrieved from the archive of the Hospital Universitario Marqués de Valdecilla (Santander) were studied. Flow cytometry was carried out on 67 of the samples. No statistically significant differences were found between the cellular proliferative index and the mitotic index, ploidy and the S-phase factor. Likewise, none of the cytometric variables studied presented any association with the appearance of local relapse, distant metastases or survival. These variables cannot be used as a prognostic factors in squamous cell carcinomas of the oral cavity.

  14. Validación del índice nutricional en preadolescentes mexicanos con el método de sensibilidad y especificidad Validation of the nutritional index in Mexican preadolescents with the sensitivity and specificity method

    Directory of Open Access Journals (Sweden)

    Teresita de Jesús Saucedo-Molina

    1998-09-01

    Full Text Available Objetivo. Determinar la validez diagnóstica del índice nutricional (IN en una muestra de preadolescentes mexicanos. Material y métodos. Se trabajó con un grupo de 256 escolares de la Ciudad de México, de entre 10 y 12 años de edad, de ambos sexos. Se utilizó el método de sensibilidad y especificidad para establecer la validez diagnóstica del IN. Resultados. Los puntos de corte convencionales para el IN tienen buena sensibilidad y especificidad para el diagnóstico de bajo peso, normalidad y obesidad, no así para sobrepeso. Estos valores, así como los de la potencia de predicción, se optimizaron en todas las categorías cuando se utilizaron puntos de corte normalizados. Conclusiones. En el diagnóstico del estado de nutrición de los preadolescentes, los nuevos puntos de corte del IN resultan más confiables que los tradicionales.Objective. To determine the diagnostic validity of the nutritional index (NI in a sample of Mexican preadolescents. Material and methods. A total of 256 preadolescents, between 10 and 12 years old, male and female, students from Mexico City, were used to establish the diagnostic validity of NI using the sensitivity and specificity method. Results. The findings show that the conventional NI cut-off points showed good sensitivity and specificity for the diagnosis of low weight, normality and obesity but not for overweight. When the cut-off points of NI were normalized, the sensitivity, specificity and prediction potency values were more suitable in all categories. Conclusions. When working with preadolescents, it is better to use the new cut-off points of NI, to obtain more reliable diagnosis.

  15. Association between Body Mass Index, Waist Circumference and Prevalence of Microalbuminuria in Korean Adults of Age 30 Years and Older without Diabetes, Hypertension, Renal Failure, or Overt Proteinuria: The 2013 Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Seo, Woo-Jeong; Lee, Gong-Myung; Hwang, Ji-Hye; Lee, Mi-Na; Kang, Hee-Cheol

    2016-01-01

    Microalbuminuria and obesity markers are known risk factors for cardiovascular or renal disease. This study aimed to evaluate the prevalence of microalbuminuria according to body mass index (BMI) and abdominal obesity criteria. The study subjects included 3,979 individuals aged 30 years or older who did not have diabetes, hypertension, renal failure, or overt proteinuria, from among those who participated in The Korean National Health and Nutrition Examination Survey in 2013, a cross-sectional, nationally representative, stratified survey. Microalbuminuria was defined as a urinary albumin to creatinine ratio of 30 to 300 mg/g. BMI and waist circumference were classified according to the Asia-Pacific criteria. The prevalence of microalbuminuria was found to be 5.1%. In the normoalbuminuria group, 3.4%, 41.7%, 24%, 27.6%, and 3.2% of participants were included in the underweight, normal, overweight, obesity 1, and obesity 2 groups, respectively. These percentages in the microalbuminuria group were 7.1%, 34.5%, 19.2%, 28.6%, and 10.6%, respectively (P<0.001). The waist circumference in men was 21.4% in the normoalbuminuria group and 36.5% in the microalbuminuria group (P=0.004). Logistic regression analyses were performed to evaluate the relationship between the presence of microalbuminuria and BMI or waist circumference groups. The risk of microalbuminuria was significant only in the underweight group (odds ratio, 13.22; 95% confidence interval, 2.55-68.63; P=0.002) after adjusting for confounding factors, abdominal obesity was not significantly associated with microalbuminuria. The prevalence of microalbuminuria in a general population in Korea was associated with underweight in men and was not associated with waist circumference in either men or women.

  16. [Low doses of megestrol acetate increase weight and improve nutrition status in patients with severe chronic obstructive pulmonary disease and weight loss].

    Science.gov (United States)

    Herrejón, Alberto; Palop, Julio; Inchaurraga, Ignacio; López, Antonio; Bañuls, Celia; Hernández, Antonio; Blanquer, Rafael; Están, Nuria; Anguera, Anna

    2011-07-23

    Weight loss in patients with severe chronic obstructive pulmonary disease (COPD) is a prognostic bad factor. The objective of this study is to analyze the effectively of megestrol acetate (MA) to increase appetite of these patients. Randomized double blind placebo controlled trial to study the effect of 160 mg/bid of MA, for 8 weeks, on nutritional, functional, analytical and quality of life parameters, in 38 patients with severe COPD and body mass index (BMI) leptin did increase (pCOPD patients with weight loss. MA improves blood gases and nutritional parameters and the sense of wellbeing, but it does not improve the respiratory muscular function or exercise tolerance. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  17. Prognostic accuracy of electroencephalograms in preterm infants

    DEFF Research Database (Denmark)

    Fogtmann, Emilie Pi; Plomgaard, Anne Mette; Greisen, Gorm

    2017-01-01

    CONTEXT: Brain injury is common in preterm infants, and predictors of neurodevelopmental outcome are relevant. OBJECTIVE: To assess the prognostic test accuracy of the background activity of the EEG recorded as amplitude-integrated EEG (aEEG) or conventional EEG early in life in preterm infants...... for predicting neurodevelopmental outcome. DATA SOURCES: The Cochrane Library, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: We included observational studies that had obtained an aEEG or EEG within 7 days of life in preterm infants and reported.......77-0.87). LIMITATIONS: All studies were at high risk of bias. Heterogeneity was evident among the studies with regard to the investigated aEEG and EEG variables, neurodevelopmental outcomes, and cutoff values. CONCLUSIONS: AEEG or EEG recorded within the first 7 days of life in preterm infants may have potential...

  18. Nutrition Labeling

    Science.gov (United States)

    Metzger, Lloyd E.

    Nutrition labeling regulations differ in countries around the world. The focus of this chapter is on nutrition labeling regulations in the USA, as specified by the Food and Drug Administration (FDA) and the Food Safety and Inspection Service (FSIS) of the United States Department of Agriculture (USDA). A major reason for analyzing the chemical components of foods in the USA is nutrition labeling regulations. Nutrition label information is not only legally required in many countries, but also is of increasing importance to consumers as they focus more on health and wellness.

  19. Risco nutricional em cirurgia avaliado pelo índice de massa corporal ajustado ou não para pacientes idosos Nutritional risk in surgery evaluated by body mass index adjusted or not to elderly patients

    Directory of Open Access Journals (Sweden)

    Alberto Bicudo-Salomão

    2006-09-01

    Full Text Available RACIONAL: O índice de massa corporal vem sendo usado indistintamente entre idosos ou não para a avaliação do estado nutricional. A hipótese deste trabalho é a de que em pacientes idosos um ponto de corte mais alto para o índice de massa corporal pode ter maior validade na aferição do risco nutricional em cirurgia. OBJETIVO: Avaliar a morbimortalidade em pacientes cirúrgicos idosos comparada a pacientes mais jovens e sua associação com valores baixos de índice de massa corporal utilizando-se um ponto de corte convencional (18,5 kg/m² e outro adaptado para pacientes com idade avançada (24 kg/m². PACIENTES E MÉTODOS: Um mil e novecentos e doze pacientes foram divididos em dois grupos: 65 anos (n = 285. Comparou-se nos dois grupos o tempo de internação e a morbimortalidade. Pacientes com idade >65 anos foram estratificados segundo o índice de massa corporal 65 anos (6 [1-75] dias vs. 4 [1-137] dias, assim como as complicações pós-operatórias (37/285; 13,0% vs. 109/1627; 6,7%; OR 2,1; IC95% 1,40-3,09 e óbitos (15/285; 5,3% vs. 34/1627; 2,1%; OR 2,6; IC95% 1,40-4,84. Em pacientes com índice de massa corporal BACKGROUND: Standard body mass index cut-off points for malnutrition are routinely used for adults independently of their age. The hypothesis of this study was that a cut-off point higher than the usual for the diagnosis of malnutrition might be more precise to access the nutritional risk of aged surgical patients. AIM: To evaluate the morbimortality in aged surgical patients and its association with nutritional status assessed by body mass index using either the standard and a higher cut-off point for malnutrition. PATIENTS AND METHODS: All patients admitted for operative procedures (n = 1,912 were allocated to either two groups: 65 years old (n = 285. The body mass index was used to access the nutritional status. Two different cut-off points for malnutrition (18.5 or 24 kg/m² were used in the group of older patients

  20. [Nutritional assessment and perioperative nutritional support in gastric cancer patients].

    Science.gov (United States)

    Seo, Kyung Won; Yoon, Ki Young

    2013-04-01

    Weight loss and malnutrition are common in cancer patients. Although weight loss is predominantly due to loss of fat mass, the morbidity risk is given by the decrease in muscle mass. The assessment of nutritional status is essential for a diagnosis of nutritional compromise and required for the multidisciplinary approach. Subjective global assessment (SGA) is made by the patients nutritional symptoms and weight loss. The objective assessment, a significant weight loss (>10%) for 6 months is considered an indicator of nutritional deficiency. The mean body index, body fat mass and body protein mass are decreased as cancer stage increases. The biochemical data of albumin, cholesterol, triglyceride, Zn, transferrin, total lymphocyte count are decreased in advanced cancer stage. Daily energy intake, cabohyderate and Vit B1 intake is decreased according to cancer stage. The patients are divided into three groups according to SGA. The three groups showed a significant difference in body weight, 1 month weight loss%, 6 month weight loss%, body mass index, mid arm circumference, albumin, energy intake, as well as carbohyderate intake protein and energy malnutrition. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increase in stomach cancer associated morbidity and mortality. The authors concluded that nutritional assessment should be done in cancer patients preoperatively, and with adequate nutritional support, the morbidity and mortality would be decreased.

  1. Validation of the new graded prognostic assessment scale for brain metastases: a multicenter prospective study

    Directory of Open Access Journals (Sweden)

    Cuadras Patricia

    2011-03-01

    Full Text Available Abstract Background Prognostic indexes are useful to guide tailored treatment strategies for cancer patients with brain metastasis (BM. We evaluated the new Graded Prognostic Assessment (GPA scale in a prospective validation study to compare it with two published prognostic indexes. Methods A total of 285 newly diagnosed BM (n = 85 with synchronous BM patients, accrued prospectively between 2000 and 2009, were included in this analysis. Mean age was 62 ± 12.0 years. The median KPS and number of BM was 70 (range, 20-100 and 3 (range, 1-50, respectively. The majority of primary tumours were lung (53%, or breast (17% cancers. Treatment was administered to 255 (89.5% patients. Only a minority of patients could be classified prospectively in a favourable prognostic class: GPA 3.5-4: 3.9%; recursive partitioning analysis (RPA 1, 8.4% and Basic Score for BM (BSBM 3, 9.1%. Mean follow-up (FU time was 5.2 ± 4.7 months. Results During the period of FU, 225 (78.9% patients died. The 6 months- and 1 year-OS was 36.9% and 17.6%, respectively. On multivariate analysis, performance status (P P P = 0.007, RPA (P = 0.02 and GPA (P = 0.03 were statistically significant for OS. The survival prediction performances' of all indexes were identical. Noteworthy, the significant OS difference observed within 3 months of diagnosis between the BSBM, RPA and GPA classes/groups was not observed after this cut-off time point. Harrell's concordance indexes C were 0.58, 0.61 and 0.58 for the GPA, BSBM and RPA, respectively. Conclusions Our data suggest that the new GPA index is a valid prognostic index. In this prospective study, the prediction performance was as good as the BSBM or RPA systems. These published indexes may however have limited long term prognostication capability.

  2. The prognosis of incurable cachectic cancer patients on home parenteral nutrition

    DEFF Research Database (Denmark)

    Bozzetti, F; Santarpia, L; Pironi, L

    2014-01-01

    BACKGROUND: The role of home parenteral nutrition (HPN) in incurable cachectic cancer patients unable to eat is extremely controversial. The aim of this study is to analyse which factors can influence the outcome. PATIENTS AND METHODS: We studied prospectively 414 incurable cachectic (sub......)obstructed cancer patients receiving HPN and analysed the association between patient or clinical characteristics and surviving status. RESULTS: Median weight loss, versus pre-disease and last 6-month period, was 24% and 16%, respectively. Median body mass index was 19.5, median KPS was 60, median life expectancy...... was 3 months. Mean/median survival was 4.7/3.0 months; 50.0% and 22.9% of patients survived 3 and 6 months, respectively. At the multivariable analysis, the variables significantly associated with 3- and 6-month survival were Glasgow Prognostic Score (GPS) and KPS, and GPS, KPS and tumour spread...

  3. Association of Preoperative Nutritional Status with Prognosis in Patients with Esophageal Cancer Undergoing Salvage Esophagectomy.

    Science.gov (United States)

    Sakai, Makoto; Sohda, Makoto; Miyazaki, Tatsuya; Yoshida, Tomonori; Kumakura, Yuji; Honjo, Hiroaki; Hara, Keigo; Ozawa, Daigo; Suzuki, Shigemasa; Tanaka, Naritaka; Yokobori, Takehiko; Kuwano, Hiroyuki

    2018-02-01

    To investigate whether malnutrition is associated with poor prognosis of patients who undergo salvage esophagectomy. We examined the association between the preoperative prognostic nutritional index (PNI) and prognosis of patients who undergo salvage esophagectomy. We conducted a single-center retrospective study and reviewed hospital patient records for tumor characteristics and patient outcomes. Univariate and multivariate survival analyses were carried out using the Cox proportional hazards regression model. Thirty-two patients with esophageal squamous cell carcinoma (ESCC) who underwent salvage esophagectomy between 1998 and 2015 at our Institute were included in this study. Univariate analysis revealed that clinical response (p=0.045), preoperative PNI (pnutritional status is associated with the prognosis of patients undergoing salvage esophagectomy. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  4. Nutrition in the elderly.

    Science.gov (United States)

    Pirlich, M; Lochs, H

    2001-12-01

    Malnutrition is more common in elderly persons than in younger adults. Ageing itself, however, neither leads to malabsorption nor to malnutrition with the exception of a higher frequency of atrophic gastritis in older persons. Malnutrition in elderly people is therefore a consequence of somatic, psychic or social problems. Typical causes are chewing or swallowing disorders, cardiac insufficiency, depression, social deprivation and loneliness. Undernutrition is associated with a worse prognosis and is an independent risk factor for morbidity and mortality. Awareness of this problem is therefore important. For the evaluation of nutritional status, it must be remembered that most normal values are derived from younger adults and may not necessarily be suitable for elderly persons. Suitable tools for evaluating the nutritional status of elderly persons are e.g. the body mass index, weight loss within the last 6 months, the Mini Nutritional Assessment (MNA) or the Subjective Global Assessment (SGA). An improvement in the nutritional status can be achieved by simple methods such as the preparation of an adequate diet, hand feeding, additional sip feeding or enteral nutrition. Copyright 2001 Harcourt Publishers Ltd.

  5. [Community Nutrition].

    Science.gov (United States)

    Aranceta, Javier

    2004-06-01

    In the last 20 years, Public Health Nutrition focused mainly on the qualitative aspects which may influence the onset of chronic diseases, quality of life, physical and mental performance and life expectancy. This applied knowledge organised as part of preventive and health promotion programs led to the development of Community Nutrition. The aim of Community Nutrition actions is to adequate lifestyles related to food consumption patterns in order to improve the quality of life and contribute to health promotion of the population in the community where programs and services are delivered. Key functions to develop in a Community Nutrition Unit consist in the identification and assessment of nutrition problems in the community as well as the design, implementation and evaluation of intervention programs by means of appropriate strategies. These should aim at different populations groups and settings, such as work places, schools, high risk groups or the general public. Nowadays, Community Nutrition work efforts should focus on three main aspects: nutrition education in schools and in the community; food safety and food security and the development and reinforcement of food preparation skills across all age groups. Social catering services, either in schools, the work place or at the community level, need to ensure adequate nutritional supply, provide foods contributing to healthy eating practices as well as to enhance culinary traditions and social learning. Food safety and food security have become a top priority in Public Health. The concepts referes to the availability of food safe and adequate as well as in sufficient amount in order to satisfy nutrition requirements of all individuals in the community. Social changes along new scientific developments will introduce new demands in Community Nutrition work and individual dietary counselling will become a key strategy. In order to face new challenges, community nutrition pactitioners require a high quality

  6. Nutritional depletion in relation to mortality in patients with chronic respiratory insufficiency treated with long-term oxygen therapy.

    Science.gov (United States)

    Tóth, Stefan; Tkácová, Ruzena; Matula, Pavol; Stubna, Ján

    2004-09-30

    An association between malnutrition, weight loss and mortality has been demonstrated in patients with chronic obstructive pulmonary disease (COPD), but the prognostic influence of low body-mass index (BMI) and plasma concentrations of albumin and cholesterol is less clear in patients with chronic respiratory insufficiency treated with domiciliary long-term oxygen therapy (LTOT). We therefore analysed the prognostic value of BMI, plasma albumin and cholesterol concentrations in patients receiving LTOT. From 1996 to 2001, LTOT was initiated in 255 patients. Analysis of the impact of nutritional status on survival was confined to a study group of 108 patients in whom the main outcomes, i.e. BMI, plasma cholesterol and albumin, were measured. Standard laboratory methods were used in the biochemical analyses. Pulmonary function was assessed with bodyplethysmography. 63 patients (58.3%) survived for two years post-initiation of LTOT and 45 patients (41.7%) did not. There were no differences between these two groups in pulmonary function tests and arterial blood gases at the start of LTOT. Overall, 10.2% of the study population were underweight, defined as BMI nutritional status is closely linked with prognosis in patients with chronic respiratory insufficiency treated with domiciliary LTOT: low BMI, low plasma cholesterol and low albumin are related to worse 2-year survival in such patients.

  7. Predictive Potential of Preoperative Nutritional Status in Long-Term Outcome Projections for Patients with Gastric Cancer.

    Science.gov (United States)

    Sakurai, Katsunobu; Ohira, Masaichi; Tamura, Tatsuro; Toyokawa, Takahiro; Amano, Ryosuke; Kubo, Naoshi; Tanaka, Hiroaki; Muguruma, Kazuya; Yashiro, Masakazu; Maeda, Kiyoshi; Hirakawa, Kosei

    2016-02-01

    Preoperative nutritional status not only correlates with the incidence of postoperative complications but also may be indicative of long-term outcomes for patients with cancer. The impact of preoperative nutritional status on outcomes for patients undergoing gastrectomy for gastric cancer (GC) was investigated. The study reviewed 594 patients treated for GC by gastrectomy at the authors' hospital between January, 2004 and December, 2010. Onodera's prognostic nutritional index (PNI) was invoked, using an optimal cut point to group patients as having high (PNI > 45; n = 449) or low (PNI ≤ 45; n = 145) nutritional status. Clinicopathologic features, perioperative results, and long-term outcomes, including cause of death, were compared. Multivariate analysis of 5-year overall survival (OS) and disease-specific survival (DSS) indicated that low PNI was independently associated with unfavorable outcomes for patients with GC. In subgroup analysis, the 5-year OS and DSS rates for patients with GC at stages 1 and 2 were significantly worse in the low PNI group than in the high PNI group. Although wound and extrasurgical field infections also tended to be more frequent in the low PNI group, postoperative intraabdominal infections did not differ significantly by group. Preoperative PNI may have merit as a gauge of prognosis for patients with GC at stages 1 and 2, but PNI and postoperative morbidity showed no correlation in this setting.

  8. Sports Nutrition.

    Science.gov (United States)

    Missouri State Dept. of Health, Jefferson City.

    This guide deals with various aspects of sports and nutrition. Twelve chapters are included: (1) "Sports and Nutrition"; (2) "Eat to Compete"; (3) "Fit Folks Need Fit Food"; (4) "The Food Guide Pyramid"; (5) "Fat Finder's Guide"; (6) "Pre- and Post-Event Meals"; (7) "Tips for the…

  9. Nutritional epigenetics

    Science.gov (United States)

    This chapter is intended to provide a timely overview of the current state of research at the intersection of nutrition and epigenetics. I begin by describing epigenetics and molecular mechanisms of eigenetic regulation, then highlight four classes of nutritional exposures currently being investiga...

  10. Development and Evaluation of a Dietary Approaches to Stop Hypertension Dietary Index with Calorie-Based Standards in Equivalent Units: A Cross-Sectional Study with 24-Hour Dietary Recalls from Adult Participants in the National Health and Nutrition Examination Survey 2007-2010.

    Science.gov (United States)

    Matsunaga, Masako; Hurwitz, Eric L; Li, Dongmei

    2018-01-01

    Dietary indexes to assess accordance with the Dietary Approaches to Stop Hypertension (DASH) dietary pattern are useful tools in studies with health-related outcomes. However, scoring algorithms of the dietary index can affect the range of its applications. The purposes of this study were to develop a DASH dietary index with calorie-based standards in equivalent units and to evaluate the validity and reliability of the index. Calorie-based standards for nine components were determined based on recommended intakes in the DASH eating plan and dietary intakes estimated from two 24-hour dietary recalls of adult participants in the National Health and Nutrition Examination Survey 2007-2008, 2009-2010 (n=9,720). Evaluation tests included descriptive analyses of index scores among US adults stratified by sex and smoking status. Spearman's rank correlations were used to examine the relationships among components and total scores. The developed index was compared with two DASH dietary indexes that use different scoring algorithms to examine the association between total scores and blood pressure status through multivariable regression models. The newly developed index consisted of seven food group and two nutrient components. The mean and median of total scores among US adults were 42.3 (95% CI 41.6 to 43.0) and 41.6 of 90 points, respectively. The mean total scores among adult women and non-current smokers were higher than their counterparts (P<0.001). The absolute correlation coefficients among the components and between each component and the sum of other components were ≤0.33 and ≤0.35, respectively. After adjusting for age and race/ethnicity, an association between total scores and blood pressure status was found in adult women (P<0.001), but not in adult men. The same pattern was found when the two indexes were used, but the strength of the association varied across the three indexes. The developed index appeared to measure accordance with the DASH dietary pattern

  11. Sports nutrition

    Directory of Open Access Journals (Sweden)

    Tomanić Milena

    2016-01-01

    Full Text Available Due to higher energy consumption, physically active people have higher nutritional requirements. In addition to other important factors for sports, such as good health and physical predisposition, adequate nutrition is a fundamental component. Sports nutrition must be well planned and individually adapted based on physical characteristics, tendencies towards gaining or losing weight, frequency, duration and intensity of training sessions. Studies have shown that a well-balanced ratio of macro and micronutrients, with the support of supplements and adequate hydration, can significantly improve athletic performance and plays a key role in achieving better results. An optimally designed nutritional program, with realistic and achievable goals, which complements a well-planned training program, is the basis for success in sports. Only when nutritional requirements are met, deficits can be prevented and performance in sport pushed to the limit.

  12. SURGICAL NUTRITION

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    Danny Kurniawan Darianto

    2015-07-01

    Full Text Available A patient undergoing surgery faces great physiologic and psychologic stress. so nutritional demands are greatly increased during this period and deficiencies can easily develop. If these deficiencies are allowed to develop and are not in screening, serious malnutrition and clinical problem can occur. Therefore careful attention must be given to a patient's nutritional status in preparation of surgery, as well as to the individual nutritional needs. If these needs are met, complications are less likely developing. Natural resources provide for rapid recovery. Proper nutrition can speed healing in surgical patients with major trauma, severe malnutition, burns, and other severe illnesses. New techniques for tube feeding, intravenous nutrition for patients with serious weight loss due to gastrointestinal disorders, and use of supplements can hasten wound healing and shorten recovery times.

  13. A Generic Software Architecture For Prognostics

    Science.gov (United States)

    Teubert, Christopher; Daigle, Matthew J.; Sankararaman, Shankar; Goebel, Kai; Watkins, Jason

    2017-01-01

    Prognostics is a systems engineering discipline focused on predicting end-of-life of components and systems. As a relatively new and emerging technology, there are few fielded implementations of prognostics, due in part to practitioners perceiving a large hurdle in developing the models, algorithms, architecture, and integration pieces. As a result, no open software frameworks for applying prognostics currently exist. This paper introduces the Generic Software Architecture for Prognostics (GSAP), an open-source, cross-platform, object-oriented software framework and support library for creating prognostics applications. GSAP was designed to make prognostics more accessible and enable faster adoption and implementation by industry, by reducing the effort and investment required to develop, test, and deploy prognostics. This paper describes the requirements, design, and testing of GSAP. Additionally, a detailed case study involving battery prognostics demonstrates its use.

  14. Distributed Prognostics Based on Structural Model Decomposition

    Data.gov (United States)

    National Aeronautics and Space Administration — Within systems health management, prognostics focuses on predicting the remaining useful life of a system. In the model-based prognostics paradigm, physics-based...

  15. Homogeneous datasets of triple negative breast cancers enable the identification of novel prognostic and predictive signatures.

    Directory of Open Access Journals (Sweden)

    Thomas Karn

    Full Text Available BACKGROUND: Current prognostic gene signatures for breast cancer mainly reflect proliferation status and have limited value in triple-negative (TNBC cancers. The identification of prognostic signatures from TNBC cohorts was limited in the past due to small sample sizes. METHODOLOGY/PRINCIPAL FINDINGS: We assembled all currently publically available TNBC gene expression datasets generated on Affymetrix gene chips. Inter-laboratory variation was minimized by filtering methods for both samples and genes. Supervised analysis was performed to identify prognostic signatures from 394 cases which were subsequently tested on an independent validation cohort (n = 261 cases. CONCLUSIONS/SIGNIFICANCE: Using two distinct false discovery rate thresholds, 25% and <3.5%, a larger (n = 264 probesets and a smaller (n = 26 probesets prognostic gene sets were identified and used as prognostic predictors. Most of these genes were positively associated with poor prognosis and correlated to metagenes for inflammation and angiogenesis. No correlation to other previously published prognostic signatures (recurrence score, genomic grade index, 70-gene signature, wound response signature, 7-gene immune response module, stroma derived prognostic predictor, and a medullary like signature was observed. In multivariate analyses in the validation cohort the two signatures showed hazard ratios of 4.03 (95% confidence interval [CI] 1.71-9.48; P = 0.001 and 4.08 (95% CI 1.79-9.28; P = 0.001, respectively. The 10-year event-free survival was 70% for the good risk and 20% for the high risk group. The 26-gene signatures had modest predictive value (AUC = 0.588 to predict response to neoadjuvant chemotherapy, however, the combination of a B-cell metagene with the prognostic signatures increased its response predictive value. We identified a 264-gene prognostic signature for TNBC which is unrelated to previously known prognostic signatures.

  16. Associations of Alcoholic Beverage Consumption with Dietary Intake, Waist Circumference, and Body Mass Index in US Adults: National Health and Nutrition Examination Survey 2003-2012.

    Science.gov (United States)

    Butler, Lauren; Popkin, Barry M; Poti, Jennifer M

    2018-03-01

    Findings from studies of alcohol and obesity measures (eg, waist circumference [WC] and body mass index [BMI; calculated as kg/m 2 ]) are conflicting. Residual confounding by dietary intake, inconsistent definitions of alcohol consumption across studies, and the inclusion of former drinkers in the nondrinking comparison group can contribute to the mixed literature. This study examines associations of alcoholic beverage consumption with dietary intake, WC, and BMI. Cross-sectional data from the 2003-2012 National Health and Nutrition Examination Survey were analyzed. Adults 20 to 79 years of age (n=7,436 men; n=6,939 women) were studied. Associations of alcoholic beverage consumption with energy (kcal), macronutrient and sugar intakes (% kcal), WC, and BMI were determined. Multivariable linear regression models were used to determine associations of average daily volume and drinking quantity (ie, drinks per drinking day) with dietary intake and obesity measures. Former and never drinkers were analyzed as distinct categories; associations of drinking with WC and BMI were examined with and without adjustment for dietary intake variables. Heavier-drinking men (≥3 drinks/day) and women (≥2 drinks/day) consumed less nonalcoholic energy (β -252 kcal/day, 95% CI -346 to -159 kcal/day and β -159 kcal/day, 95% CI -245 to -73 kcal/day, respectively) than moderate drinkers (1 to 2 drinks/day in men and 1 drink/day in women). By average daily drinking volume, differences in WC and BMI between former and moderate drinkers were +1.78 cm (95% CI 0.51 to 3.05 cm) and +0.65 (95% CI 0.12 to 1.18) in men and +4.67 cm (95% CI 2.95 to 6.39 cm) and +2.49 (95% CI 1.64 to 3.34) in women. Compared with moderate drinking, heavier drinking volume was not associated with WC or BMI among men or women. In men, drinking ≥5 drinks/drinking day was associated with higher WC (β 3.48 cm, 95% CI 1.97 to 5.00 cm) and BMI (β 1.39, 95% CI 0.79 to 2.00) compared with men who consumed 1

  17. Nutritional risk and body mass index predict hospitalization, nursing home admissions, and mortality in community-dwelling older adults: results from the UAB Study of Aging with 8.5 years of follow-up.

    Science.gov (United States)

    Buys, David R; Roth, David L; Ritchie, Christine S; Sawyer, Patricia; Allman, Richard M; Funkhouser, Ellen M; Hovater, Martha; Locher, Julie L

    2014-09-01

    Nutritional risk and low BMI are common among community-dwelling older adults, but it is unclear what associations these factors have with health services utilization and mortality over long-term follow-up. The aim of this study was to assess prospective associations of nutritional risk and BMI with all-cause, nonsurgical, and surgical hospitalization; nursing home admission; and mortality over 8.5 years. Data are from 1,000 participants in the University of Alabama at Birmingham Study of Aging, a longitudinal, observational study of older black and white residents of Alabama aged 65 and older. Nutritional risk was assessed using questions associated with the DETERMINE checklist. BMI was categorized as underweight (risk of all-cause, nonsurgical, and surgical hospitalization; nursing home admission; and mortality. Covariates included social support, social isolation, comorbidities, and demographic measures. In adjusted models, persons with high nutritional risk had 51% greater risk of all-cause hospitalization (95% confidence interval: 1.14-2.00) and 50% greater risk of nonsurgical hospitalizations (95% confidence interval: 1.11-2.01; referent: low nutritional risk). Persons with moderate nutritional risk had 54% greater risk of death (95% confidence interval: 1.19-1.99). BMI was not associated with any outcomes in adjusted models. Nutritional risk was associated with all-cause hospitalizations, nonsurgical hospitalizations, and mortality. Nutritional risk may affect the disablement process that leads to health services utilization and death. These findings point to the need for more attention on nutritional assessment, interventions, and services for community-dwelling older adults. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Aplicação do índice prognóstico internacional em pacientes com linfoma difuso de grandes células B em uma instituição brasileira The use of the international prognostic index in a Brazilian institution for patients suffering from diffuse large B-cell lymphoma

    Directory of Open Access Journals (Sweden)

    Abrahão E. Hallack Neto

    2005-03-01

    Full Text Available O linfoma difuso de grandes células B (LDGCB corresponde a 50% dos casos de linfoma não-Hodgkin (LNH. A partir de 1993, o tratamento destes pacientes passou a ser direcionado pelo Índice Internacional de Prognóstico (IPI validado em vários estudos. Entretanto a aplicação do IPI ainda não foi avaliada em nossa população e em nossas condições socioeconômicas. Neste estudo avaliamos o impacto do IPI ajustado para a idade (IPIa na remissão completa (RC, sobrevida global (SG e sobrevida livre de doença (SLD dos portadores de LDGCB com idade inferior a 60 anos, tratados no Serviço de Hematologia do HCFMUSP. Dos 111 pacientes avaliados, 60 foram classificados com IPIa de risco baixo e intermediário e 51 IPIa de risco intermediário alto e alto. Os pacientes de risco baixo e intermediário foram analisados em conjunto no grupo de baixo risco adaptado e os de risco intermediário alto e alto no grupo de alto risco adaptado. Verificamos que a SG e a SLD foram influenciadas pelo estádio clínico, DHL e o estado funcional dos pacientes. Recomendamos o uso sistemático do IPI no tratamento dos nossos pacientes com LDGCB em nossa instituição.Diffuse Large B-Cell Lymphomas (DLBCL correspond to 50% of non-Hodgkin's lymphomas. Since 1993 the treatment of these patients has been directed by the International Prognostic Index (IPI, validated in several studies. However, the use of the IPI has not been evaluated in our population and social-economical conditions. In this study, we evaluate the impact of the age-adapted IPI (aIPI in the complete response, overall survival and disease-free survival in under 60-year-old DLBCL sufferers treated in the Hematology Service of HCFMUSP. Of the 111 evaluated patients, 60 were classified as aIPI low and intermediate risk and 51 as aIPI intermediate-high and high risk. The patients with low and intermediate risk were analyzed as a whole with adapted low risk and patients with intermediate-high and high risk

  19. An educational model for improving diet counselling in primary care. A case study of the creative use of doctors' own diet, their attitudes to it and to nutritional counselling of their patients with diabetes

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Palmvig, Birthe; Andreasen, Anne Helms

    2005-01-01

    Nutritional counseling; Nutritional education; Nutritional assessment; Primary care; Continuing medical education; Doctors' diet; Doctors attitudes; Doctors' knowledge; Body mass index; Educational model; Food frequency questionaire......Nutritional counseling; Nutritional education; Nutritional assessment; Primary care; Continuing medical education; Doctors' diet; Doctors attitudes; Doctors' knowledge; Body mass index; Educational model; Food frequency questionaire...

  20. The Clinicopathologic Heterogeneity of Grade 3 Gastroenteropancreatic Neuroendocrine Neoplasms: Morphological Differentiation and Proliferation Identify Different Prognostic Categories.

    Science.gov (United States)

    Milione, Massimo; Maisonneuve, Patrick; Spada, Francesca; Pellegrinelli, Alessio; Spaggiari, Paola; Albarello, Luca; Pisa, Eleonora; Barberis, Massimo; Vanoli, Alessandro; Buzzoni, Roberto; Pusceddu, Sara; Concas, Laura; Sessa, Fausto; Solcia, Enrico; Capella, Carlo; Fazio, Nicola; La Rosa, Stefano

    2017-01-01

    Gastroenteropancreatic (GEP) neuroendocrine carcinomas (NECs) are defined as neuroendocrine neoplasms (NENs) with a Ki-67 index >20% according to the 2010 WHO classification. Some reports suggest that this category is heterogeneous. We retrospectively studied a series of 136 patients affected by grade 3 GEP-NECs with the aim to clarify the prognostic role of tumor morphological differentiation, proliferation, defect in mismatch repair proteins (MMRd), CD117 expression, and site of origin. The primary endpoint was the correlation between these parameters and the overall survival (OS). Univariate and multivariable Cox proportional hazards regression analyses were used to assess the prognostic significance of various clinical and histopathologic features. With a median follow-up of 81 months, the median OS was 12.9 months. At multivariate analysis, morphological differentiation, Ki-67 index, MMRd, stage, and CD117 expression were independent prognostic markers in NECs. Three different prognostic categories of NECs were identified according to the degree of morphologic differentiation (well vs. poorly differentiated) and Ki-67 index (neoplasms with a Ki-67 index 20-55% (named type A), 24.5 months in poorly differentiated neoplasms with a Ki-67 index 20-55% (type B), and 5.3 months (p neoplasms with a Ki-67 index ≥55% (type C). The present study suggests that GEP-NECs represent a heterogeneous group of neoplasms which can be better classified in different prognostic categories using both tumor morphology and Ki-67 index. © 2016 S. Karger AG, Basel.

  1. Endocrine and Nutritional Management After Bariatric Surgery

    Science.gov (United States)

    ... malabsorptive procedures. Weight loss depends on following a strict diet. • Roux-en-Y gastric bypass (RYGB). RYGB ... index.cfm). www.hormone.org Endocrine and Nutritional Management After Bariatric Surgery Patient Guide November 2010

  2. Cytogenetic Prognostication Within Medulloblastoma Subgroups

    Science.gov (United States)

    Shih, David J.H.; Northcott, Paul A.; Remke, Marc; Korshunov, Andrey; Ramaswamy, Vijay; Kool, Marcel; Luu, Betty; Yao, Yuan; Wang, Xin; Dubuc, Adrian M.; Garzia, Livia; Peacock, John; Mack, Stephen C.; Wu, Xiaochong; Rolider, Adi; Morrissy, A. Sorana; Cavalli, Florence M.G.; Jones, David T.W.; Zitterbart, Karel; Faria, Claudia C.; Schüller, Ulrich; Kren, Leos; Kumabe, Toshihiro; Tominaga, Teiji; Shin Ra, Young; Garami, Miklós; Hauser, Peter; Chan, Jennifer A.; Robinson, Shenandoah; Bognár, László; Klekner, Almos; Saad, Ali G.; Liau, Linda M.; Albrecht, Steffen; Fontebasso, Adam; Cinalli, Giuseppe; De Antonellis, Pasqualino; Zollo, Massimo; Cooper, Michael K.; Thompson, Reid C.; Bailey, Simon; Lindsey, Janet C.; Di Rocco, Concezio; Massimi, Luca; Michiels, Erna M.C.; Scherer, Stephen W.; Phillips, Joanna J.; Gupta, Nalin; Fan, Xing; Muraszko, Karin M.; Vibhakar, Rajeev; Eberhart, Charles G.; Fouladi, Maryam; Lach, Boleslaw; Jung, Shin; Wechsler-Reya, Robert J.; Fèvre-Montange, Michelle; Jouvet, Anne; Jabado, Nada; Pollack, Ian F.; Weiss, William A.; Lee, Ji-Yeoun; Cho, Byung-Kyu; Kim, Seung-Ki; Wang, Kyu-Chang; Leonard, Jeffrey R.; Rubin, Joshua B.; de Torres, Carmen; Lavarino, Cinzia; Mora, Jaume; Cho, Yoon-Jae; Tabori, Uri; Olson, James M.; Gajjar, Amar; Packer, Roger J.; Rutkowski, Stefan; Pomeroy, Scott L.; French, Pim J.; Kloosterhof, Nanne K.; Kros, Johan M.; Van Meir, Erwin G.; Clifford, Steven C.; Bourdeaut, Franck; Delattre, Olivier; Doz, François F.; Hawkins, Cynthia E.; Malkin, David; Grajkowska, Wieslawa A.; Perek-Polnik, Marta; Bouffet, Eric; Rutka, James T.; Pfister, Stefan M.; Taylor, Michael D.

    2014-01-01

    Purpose Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication. Patients and Methods Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models. Results Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas. Conclusion Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials. PMID

  3. Clinical gestalt versus prognostic scores for prognostication of patients with acute symptomatic pulmonary embolism.

    Science.gov (United States)

    Quezada, Carlos Andrés; Zamarro, Celia; Gómez, Vicente; Guerassimova, Ina; Nieto, Rosa; Barbero, Esther; Chiluiza, Diana; Barrios, Deisy; Morillo, Raquel; Jiménez, David

    2017-12-21

    To determine the accuracy of clinical gestalt to identify patients with acute symptomatic pulmonary embolism (PE) at low-risk for short-term complications. This study included a total of 154 consecutive patients diagnosed with acute symptomatic PE in a tertiary university hospital. We compared the prognostic accuracy of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI), and clinical gestalt of 1) 2senior physicians (one with and one without experience in the management of patients with PE), 2) a fourth-year resident of Pneumology, 3) a third-year resident of Pneumology, and 4) a second-year resident of Pneumology. The primary outcome was all-cause mortality during the first month after the diagnosis of PE. Thirty-day all-cause mortality was 8.4% (13/154; 8.4%; 95% confidence interval [CI], 4.1-12.8%). The PESI and clinical gestalt classified more patients as low-risk, compared to the sPESI (36.4%, 31.3% y 28.6%, respectively). There were no deaths in the sPESI low-risk category (negative predictive value 100%). Prognostic accuracy increased with increasing experience (84.6 vs. 92.3%; P=.049). The sPESI showed the best accuracy at correctly identifying low-risk patients with acute symptomatic PE. Clinical gestalt is not inferior to standardized clinical prediction rules to prognosticate patients with acute PE. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. Impact of Moringa oleifera lam. Leaf powder supplementation versus nutritional counseling on the body mass index and immune response of HIV patients on antiretroviral therapy: a single-blind randomized control trial

    OpenAIRE

    Tshingani Koy, Ange; Donnen, Philippe; Mukumbi, Henri H.; Duez, Pierre; Dramaix Wilmet, Michèle

    2017-01-01

    Background To achieve effective antiretroviral therapy (ART) outcomes, adherence to an antiretroviral regimen and a good immunometabolic response are essential. Food insecurity can act as a real barrier to adherence to both of these factors. Many people living with human immunodeficiency virus (PLHIV) treated with ART in the Democratic Republic of the Congo (DRC) are faced with nutritional challenges. A significant proportion are affected by under nutrition, which frequently leads to therapeu...

  5. Nutritional Assessment.

    Science.gov (United States)

    Eirmann, Laura

    2016-09-01

    Nutritional assessment focuses on evaluation of animal-specific, diet-specific, feeding management, and environmental factors. Assessment includes evaluation of a patient's medical history, comprehensive diet history, and physical examination including body weight, body condition, and muscle condition. Diagnostic testing may identify comorbidities associated with obesity or concurrent health conditions that need to be considered when developing a nutrition plan. When obesity is diagnosed during the nutritional assessment this finding along with health implications must be clearly communicated to the pet owner. Careful consideration of animal-specific, diet-specific, owner-specific, and environmental factors allows the clinician to develop a specific nutrition plan tailored to the needs of pet and owner. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Parenteral nutrition

    National Research Council Canada - National Science Library

    Inayet, N; Neild, P

    2015-01-01

    Over the last 50 years, parenteral nutrition has been recognised as an invaluable and potentially lifesaving tool in the physician's arsenal in the management of patients with intestinal failure or inaccessibility...

  7. Space Nutrition

    Science.gov (United States)

    Smith, Scott M.

    2009-01-01

    Optimal nutrition will be critical for crew members who embark on space exploration missions. Nutritional assessment provides an opportunity to ensure that crewmembers begin their missions in optimal nutritional status, to document changes during a mission and, if necessary, to provide intervention to maintain that status throughout the mission, and to assesses changes after landing in order to facilitate the return to their normal status as soon as possible after landing. We report here the findings from our nutritional assessment of astronauts who participated in the International Space Station (ISS) missions, along with flight and ground-based research findings. We also present ongoing and planned nutrition research activities. These studies provide evidence that bone loss, compromised vitamin status, and oxidative damage are the critical nutritional concerns for space travelers. Other nutrient issues exist, including concerns about the stability of nutrients in the food system, which are exposed to longterm storage and radiation during flight. Defining nutrient requirements, and being able to provide and maintain those nutrients on exploration missions, will be critical for maintaining crew member health.

  8. Radiotherapy for carcinoma of the vagina. Immunocytochemical and cytofluorometric analysis of prognostic factors

    Energy Technology Data Exchange (ETDEWEB)

    Blecharz, P. [Maria Sklodowska-Curie Memorial Institute, Krakow (Poland). Dept. of Gynecological Oncology; Reinfuss, M.; Jakubowicz, J. [Maria Sklodowska-Curie Memorial Institute, Krakow (Poland). Dept. of Radiation Oncology; Rys, J. [Maria Sklodowska-Curie Memorial Institute, Krakow (Poland). Dept. of Tumor Pathology Oncology; Skotnicki, P.; Wysocki, W. [Maria Sklodowska-Curie Memorial Institute, Krakow (Poland). Dept. of Oncological Surgery

    2013-05-15

    Background and purpose: The aim of this study was to assess the potential prognostic factors in patients with primary invasive vaginal carcinoma (PIVC) treated with radical irradiation. Patients and methods: The analysis was performed on 77 patients with PIVC treated between 1985 and 2005 in the Maria Sklodowska-Curie Memorial Institute of Oncology, Cancer Center in Krakow. A total of 36 patients (46.8 %) survived 5 years with no evidence of disease (NED). The following groups of factors were assessed for potential prognostic value: population-based (age), clinical (Karnofsky Performance Score [KPS], hemoglobin level, primary location of the vaginal lesion, macroscopic type, length of the involved vaginal wall, FIGO stage), microscopic (microscopic type, grade, mitotic index, presence of atypical mitoses, lymphatic vessels invasion, lymphocytes/plasmocytes infiltration, focal necrosis, VAIN-3), immunohistochemical (protein p53 expression, MIB-1 index), cytofluorometric (ploidity, index DI, S-phase fraction, proliferation index SG2M) factors. Results: Significantly better 5-year NED was observed in patients: < 60 years, KPS {<=} 80, FIGO stage I and II, grade G1-2, MIB-1 index < 70, S-phase fraction < 10, and proliferation index < 25. Independent factors for better prognosis in the multivariate Cox analysis were age < 60 years, FIGO stage I or II, and MIB-1 index < 70. Conclusion: Independent prognostic factors in the radically irradiated PIVC patients were as follows: age, FIGO stage, MIB-1 index. (orig.)

  9. Somatotype, nutrition, and obesity.

    Science.gov (United States)

    Koleva, M; Nacheva, A; Boev, M

    2000-01-01

    The purpose of this investigation is to evaluate the somatotype characteristics of the studied group and search for a relation between somatotype, obesity, and particular features of nutrition. Somatotype after Health & Carter (1990), nutritional status according to Body mass index (BMI), and nutrition determined by food-frequency questionnaires. Over 94% of the subjects in this study were distributed into five somatotype categories: 51.6% endomorphic mesomorphs, 17.1% mesomorph-endomorphs, 16.7% mesomorphic endomorphs, 6.1% balanced mesomorphs, and 3.0% ectomorphic mesomorphs, with a pronounced sexual dimorphism. Males were distributed into five categories: over 65% were endomorphic mesomorphs, and above 40 years of age the mesomorphy increased. Females were distributed into three somatotype categories: up to and above 40 years of age over 44% were mesomorphic endomorphs. In the most common somatotype categories, 1 of 5 subjects (from 21.4% to 19.9%) had normal body mass ( 25 kg/m2) or obese (> 30 kg/m2) kg/m2 (from 44.4% to 27.5%). In the remaining eight categories, all subjects had normal body mass. Hyperenergetic, sodium- and fat-excess nutrition had an especially unfavorable influence.

  10. Risk factors and prognostic indicators for medial tibial stress syndrome.

    Science.gov (United States)

    Moen, M H; Bongers, T; Bakker, E W; Zimmermann, W O; Weir, A; Tol, J L; Backx, F J G

    2012-02-01

    The objective of the study was to examine the risk factors and prognostic indicators for medial tibial stress syndrome (MTSS). In total, 35 subjects were included in the study. For the risk factor analysis, the following parameters were investigated: hip internal and external ranges of motion, knee flexion and extension, dorsal and plantar ankle flexion, hallux flexion and extension, subtalar eversion and inversion, maximal calf girth, lean calf girth, standing foot angle and navicular drop test. After multivariate regression decreased hip internal range of motion, increased ankle plantar flexion and positive navicular drop were associated with MTSS. A higher body mass index was associated with a longer duration to full recovery. For other prognostic indicators, no relationship was found. © 2010 John Wiley & Sons A/S.

  11. Addition of rituximab to chemotherapy overcomes the negative prognostic impact of cyclin E expression in diffuse large B-cell lymphoma

    DEFF Research Database (Denmark)

    Frei, E; Visco, C; Xu-Monette, Z Y

    2013-01-01

    High levels of cyclin E (CCNE) are accompanied by shorter survival in cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone (CHOP)-treated diffuse large B-cell lymphomas (DLBCL), independent of the international prognostic index (IPI). Data on the prognostic role of CCNE in the 'rituximab...

  12. [ENTERAL NUTRITION ON THE NUTRITIONAL STATUS OF CANCER].

    Science.gov (United States)

    Escortell Sánchez, Raquel; Reig García-Galbis, Manuel

    2015-10-01

    to identify what effect causes enteral nutrition on nutritional status of cancer. a search was performed using the keywords "Cancer" AND "Enteral Nutrition" AND "Supplementation" in four document databases: Pubmed, EBSCO, ProQuest, and Web of Science. age of the sample, major than 18 years; submitted to surgery for cancer; that the intervention program was including diet and employment or not of nutritional Supplementation; clinical trials published between January 2004 and December 2014, in scientific journals indexed. we analyzed 660 articles, of which only 2% has been included. 58% of intervention programs are applied outside Spain; 84% of the interventions was carried out in a hospitable ambient; 58% of the sample is formed by adults older than 54 years; 33% of the interventions were multidisciplinary and its duration ranges between 1 and 4 years. we found just a few national interventions in cancer participants and there two types of interventions: by exclusive polymeric enteral formula or mixed with immunonutrition. enteral nutrition shows against the parenteral and its introduction at an early stage, it helps to improve nutritional status of the patient; polymeric formulas next immunonutrition, it helps to reduce the time of hospitalization; the analytical parameters are shown as a measurement pattern when assessing the improvement in nutritional status in cancer. It is recommended to increase the research in this field, especially in children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  13. The obesity paradox in elderly patients with heart failure: analysis of nutritional status.

    Science.gov (United States)

    Casas-Vara, Antonio; Santolaria, Francisco; Fernández-Bereciartúa, Ainhoa; González-Reimers, Emilio; García-Ochoa, Alfonso; Martínez-Riera, Antonio

    2012-06-01

    The obesity paradox refers to the improved survival of obese compared with non-obese elderly or diseased patients for reasons that are not clear. To assess the relative roles of fat and other factors in this improved survival, we analyzed the prognostic value of overweight and obesity elderly patients with heart failure (HF), controlling for other nutritional data such as midarm anthropometrics, serum proteins, and muscle strength. Two hundred forty-four patients (83.2 ± 0.5 y old) hospitalized for HF were included. A nutritional survey was performed in all patients. After discharge, the patients were followed up by telephone. Fourteen patients (5.7%) died during hospitalization. The median survival was 984 d. Patients with better nutritional status as assessed by the body mass index (BMI), subjective score, midarm muscle area, triceps skinfold thickness, handgrip, lymphocyte count, and serum albumin, prealbumin, and cholesterol levels showed better short- and long-term prognoses. Obese patients with a BMI above 30 kg/m(2) showed a better long-term prognosis than those with a BMI from 25 to 30 kg/m(2), those with a BMI from 20 to 25 kg/m(2), and those with a BMI lower than 20 kg/m(2). However, survival was not significantly related to a triceps skinfold thickness above the 95th percentile. Obese and overweight patients were younger and had better a nutritional status than those with a normal or decreased BMI as shown by the anthropometrics, subjective score, handgrip, lymphocyte count, hemoglobin, and serum albumin, prealbumin, and cholesterol levels. All the nutritional data correlated closely with each other. New York Heart Association class also correlated with nutrition-derived data: as the HF class increased, the nutritional status deteriorated. On multivariate analysis, to predict long-term survival, neither BMI nor triceps skinfold thickness showed an independent predictive value, whereas a larger midarm muscle area did. The obesity paradox was confirmed in

  14. Analytic prognostic for petrochemical pipelines

    CERN Document Server

    Jaoude, Abdo Abou; El-Tawil, Khaled; Noura, Hassan; Ouladsine, Mustapha

    2012-01-01

    Pipelines tubes are part of vital mechanical systems largely used in petrochemical industries. They serve to transport natural gases or liquids. They are cylindrical tubes and are submitted to the risks of corrosion due to high PH concentrations of the transported liquids in addition to fatigue cracks due to the alternation of pressure-depression of gas along the time, initiating therefore in the tubes body micro-cracks that can propagate abruptly to lead to failure. The development of the prognostic process for such systems increases largely their performance and their availability, as well decreases the global cost of their missions. Therefore, this paper deals with a new prognostic approach to improve the performance of these pipelines. Only the first mode of crack, that is, the opening mode, is considered.

  15. Prognostic stratification of ulcerated melanoma

    DEFF Research Database (Denmark)

    Bønnelykke-Behrndtz, Marie L; Schmidt, Henrik; Christensen, Ib J

    2014-01-01

    OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We...... stratification of ulcerated lesions. METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma. RESULTS: The presence...... of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal...

  16. An investigation into utilising gestational body mass index as a ...

    African Journals Online (AJOL)

    2012-10-14

    Oct 14, 2012 ... 5Philani Child Health and Nutrition Centre, Khayelitsha. Correspondence to: Hilary Davies, e-mail: h.davies.12@ucl.ac.uk. Keywords: maternal nutritional status, birth outcomes, gestational body mass index, maternal morbidities. An investigation into utilising gestational body mass index as a screening tool ...

  17. Prognostic information in administrative co-morbidity data following coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Hvelplund, Anders; Rasmussen, Søren

    2010-01-01

    Objectives: The aim of this study was to evaluate the prognostic information obtainable from administrative data with respect to 30-day mortality following coronary artery bypass grafting (CABG) and to compare it with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) recorded...... in a clinical database. Methods: We used a co-morbidity index calculated from administrative data in the Danish National Patient Register by means of all admissions 1 year prior to CABG. In addition, each CABG was categorised as being isolated or not, and acute or not. The prognostic power of the co......-morbidity index was compared to that achieved using EuroSCORE from a clinical database comprising information on all patients treated with CABG in Denmark. The outcome was all-cause mortality within 30 days after CABG and the prognostic power was evaluated using logistic regression analyses. Results: We...

  18. Walkability Index

    Science.gov (United States)

    The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of the built environment that influence the likelihood of walking being used as a mode of travel. The Walkability Index is based on the EPA's previous data product, the Smart Location Database (SLD). Block group data from the SLD was the only input into the Walkability Index, and consisted of four variables from the SLD weighted in a formula to create the new Walkability Index. This dataset shares the SLD's block group boundary definitions from Census 2010. The methodology describing the process of creating the Walkability Index can be found in the documents located at ftp://newftp.epa.gov/EPADataCommons/OP/WalkabilityIndex.zip. You can also learn more about the Smart Location Database at https://edg.epa.gov/data/Public/OP/Smart_Location_DB_v02b.zip.

  19. [Nutritional therapy of gout].

    Science.gov (United States)

    Nickolai, Beate; Kiss, Caroline

    2016-01-01

    Nutrition and nutritional behaviours have been found to play a major role in the development of gout. Studies show that body mass index (BMI), as well as excessive intake of alcoholic beverages, meat, soft drinks and fruit juices increase the risk of developing gout. Similarly, dairy products and coffee have been seen to decrease the risk of hyperuricemia and gout, as they increase the excretion of uric acid. Flares of gout are often caused by large meals and high alcohol consumption. Each additional intake of meat portion per day increases the risk of gout by 21 %. Taking total alcohol consumption into account, the risk of gout increases after one to two standard drinks. In contrast to previous assumptions purine-rich plant foods like legumes and vegetables do not increase the risk of gout. The current dietary guidelines take into account nutritional factors, which not only consider purine intake, but also their endogenous production and their influence on renal excretion. A balanced diet based on the Swiss healthy eating guideline pyramid as well as the Mediterranean diet is appropriate for this patient population. The treatment of gout is multi-faceted, since this patient population presents other comorbidities such as obesity, diabetes mellitus, dyslipidemia and hypertension. Collectively, these risk factors are diet dependent and require a treatment strategy that is centered on modifying one's nutrition and nutritional behaviours. The aim of such therapy is to educate the patient as well as treat the accompanying comorbidities with the goal of decreasing serum uric acid values. Motivated patients require consultation and follow-up care in order to be able to actively decrease the serum uric acid.

  20. Afghanistan Index

    DEFF Research Database (Denmark)

    Linnet, Poul Martin

    2007-01-01

    The Afghanistan index is a compilation of quantitative and qualitative data on the reconstruction and security effort in Afghanistan. The index aims at providing data for benchmarking of the international performance and thus provides the reader with a quick possibility to retrieve valid...... information on progress or lack of progress in the reconstruction of the post Taliban Afghanistan. The index is mainly based on information collected on the internet in order to provide quick access to the original source. The index is under development and thus new information will be added on a continuous...

  1. Nutritional status of maintenance dialysis patients

    DEFF Research Database (Denmark)

    Koefoed, Mette Juul; Kromann, Charles Boy; Juliussen, Sophie Ryberg

    2016-01-01

    Background and Aims Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean bodymass index and obesity in maint......Background and Aims Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean bodymass index and obesity...... protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Results Seventy-nine eligible maintenance dialysis patients participated. The prevalence of proteinenergy wasted patients was 4%(95%CI: 2-12) as assessed......-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Conclusions Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase...

  2. Parenteral nutrition.

    Science.gov (United States)

    Inayet, N; Neild, P

    2015-03-01

    Over the last 50 years, parenteral nutrition has been recognised as an invaluable and potentially lifesaving tool in the physician's arsenal in the management of patients with intestinal failure or inaccessibility; however, it may also be associated with a number of potentially life-threatening complications. A recent NCEPOD report (2010) identified a number of inadequacies in the overall provision and management of parenteral nutrition and recommendations were made with the aim of improving clinical practice in the future. This paper focuses on the practical aspects relating to parenteral nutrition for adults, including important concepts, such as patient selection, as well as general management. We also explore the various pitfalls and potential complications and how these may be minimised.

  3. Systemic inflammation, nutritional status and tumor immune microenvironment determine outcome of resected non-small cell lung cancer.

    Science.gov (United States)

    Alifano, Marco; Mansuet-Lupo, Audrey; Lococo, Filippo; Roche, Nicolas; Bobbio, Antonio; Canny, Emelyne; Schussler, Olivier; Dermine, Hervé; Régnard, Jean-François; Burroni, Barbara; Goc, Jérémy; Biton, Jérôme; Ouakrim, Hanane; Cremer, Isabelle; Dieu-Nosjean, Marie-Caroline; Damotte, Diane

    2014-01-01

    Hypothesizing that nutritional status, systemic inflammation and tumoral immune microenvironment play a role as determinants of lung cancer evolution, the purpose of this study was to assess their respective impact on long-term survival in resected non-small cell lung cancers (NSCLC). Clinical, pathological and laboratory data of 303 patients surgically treated for NSCLC were retrospectively analyzed. C-reactive protein (CRP) and prealbumin levels were recorded, and tumoral infiltration by CD8+ lymphocytes and mature dendritic cells was assessed. We observed that factors related to nutritional status, systemic inflammation and tumoral immune microenvironment were correlated; significant correlations were also found between these factors and other relevant clinical-pathological parameters. With respect to outcome, at univariate analysis we found statistically significant associations between survival and the following variables: Karnofsky index, American Society of Anesthesiologists (ASA) class, CRP levels, prealbumin concentrations, extent of resection, pathologic stage, pT and pN parameters, presence of vascular emboli, and tumoral infiltration by either CD8+ lymphocytes or mature dendritic cells and, among adenocarcinoma type, tumor grade (all p285 mg/L) prealbumin levels and high (>96/mm2) CD8+ cell count had a 5-year survival rate of 80% [60.9-91.1] as compared to 18% [7.9-35.6] in patients with an opposite pattern of values. When stages I-II were considered alone, the prognostic significance of these factors was even more pronounced. Our data show that nutrition, systemic inflammation and tumoral immune contexture are prognostic determinants that, taken together, may predict outcome.

  4. Systemic inflammation, nutritional status and tumor immune microenvironment determine outcome of resected non-small cell lung cancer.

    Directory of Open Access Journals (Sweden)

    Marco Alifano

    Full Text Available BACKGROUND: Hypothesizing that nutritional status, systemic inflammation and tumoral immune microenvironment play a role as determinants of lung cancer evolution, the purpose of this study was to assess their respective impact on long-term survival in resected non-small cell lung cancers (NSCLC. METHODS AND FINDINGS: Clinical, pathological and laboratory data of 303 patients surgically treated for NSCLC were retrospectively analyzed. C-reactive protein (CRP and prealbumin levels were recorded, and tumoral infiltration by CD8+ lymphocytes and mature dendritic cells was assessed. We observed that factors related to nutritional status, systemic inflammation and tumoral immune microenvironment were correlated; significant correlations were also found between these factors and other relevant clinical-pathological parameters. With respect to outcome, at univariate analysis we found statistically significant associations between survival and the following variables: Karnofsky index, American Society of Anesthesiologists (ASA class, CRP levels, prealbumin concentrations, extent of resection, pathologic stage, pT and pN parameters, presence of vascular emboli, and tumoral infiltration by either CD8+ lymphocytes or mature dendritic cells and, among adenocarcinoma type, tumor grade (all p285 mg/L prealbumin levels and high (>96/mm2 CD8+ cell count had a 5-year survival rate of 80% [60.9-91.1] as compared to 18% [7.9-35.6] in patients with an opposite pattern of values. When stages I-II were considered alone, the prognostic significance of these factors was even more pronounced. CONCLUSIONS: Our data show that nutrition, systemic inflammation and tumoral immune contexture are prognostic determinants that, taken together, may predict outcome.

  5. Assessment of nutritional status and health-related quality of life before and after liver transplantation.

    Science.gov (United States)

    García-Rodríguez, María Teresa; Piñón-Villar, María Del Carmen; López-Calviño, Beatriz; Otero-Ferreiro, Alejandra; Suárez-López, Francisco; Gómez-Gutiérrez, Manuel; Pita-Fernández, Salvador

    2015-01-22

    nutritional status and interobserver agreement regarding nursing diagnoses will be studied using the statistical Kappa index and Bland Altman method. The risk of malnutrition can be considered as a possible prognostic factor in transplant outcomes, associated with anxiety, health-related quality of life and dependence. For this reason we consider interesting to perform a prospective follow-up study of patients who require a transplant to survive, studying their nutritional status and health-related quality of life.

  6. Nutritional Therapy.

    Science.gov (United States)

    Schwartz, Julie

    2016-03-01

    This article provides the reader with steps needed to accurately assess patient nutrition behaviors that contribute to weight gain, inability to lose weight, or inability to sustain weight loss. Evidence-based approaches in nutrition therapy that can create the daily energy deficit needed to produce 1/2 to 2 pounds of weight loss per week, and the strategies to create the energy deficit, are presented. To optimize health, long-term weight loss maintenance is needed. The benefits of using a multidisciplinary team approach in treating obesity are highlighted. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Stereological estimates of nuclear volume and other quantitative variables in supratentorial brain tumors. Practical technique and use in prognostic evaluation

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Braendgaard, H; Chistiansen, A O

    1991-01-01

    the practical technique. The continuous variables were correlated with the subjective, qualitative WHO classification of brain tumors, and the prognostic value of the parameters was assessed. Well differentiated astrocytomas (n = 14) had smaller estimates of the volume-weighted mean nuclear volume and mean...... was significantly increased in glioblastomas (2p = 0.01). Three-dimensional, shape-independent estimates of macroscopical tumor volume were not different in anaplastic astrocytomas and glioblastomas (2p = 0.39). Histological type of tumor and mitotic index were of significant prognostic value (2p = 8.2.10(-6) and 2...... techniques in the prognostic evaluation of primary brain tumors....

  8. The prognostic value of MRI in determining reinjury risk following acute hamstring injury: a systematic review

    NARCIS (Netherlands)

    van Heumen, Moniek; Tol, Johannes L.; de Vos, Robert-Jan; Moen, Maarten H.; Weir, Adam; Orchard, John; Reurink, Gustaaf

    2017-01-01

    A challenge for sports physicians is to estimate the risk of a hamstring re-injury, but the current evidence for MRI variables as a risk factor is unknown. To systematically review the literature on the prognostic value of MRI findings at index injury and/or return to play for acute hamstring

  9. AP Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Planetary Amplitude index - Bartels 1951. The a-index ranges from 0 to 400 and represents a K-value converted to a linear scale in gammas (nanoTeslas)--a scale that...

  10. Generic Software Architecture for Prognostics (GSAP) User Guide

    Science.gov (United States)

    Teubert, Christopher Allen; Daigle, Matthew John; Watkins, Jason; Sankararaman, Shankar; Goebel, Kai

    2016-01-01

    The Generic Software Architecture for Prognostics (GSAP) is a framework for applying prognostics. It makes applying prognostics easier by implementing many of the common elements across prognostic applications. The standard interface enables reuse of prognostic algorithms and models across systems using the GSAP framework.

  11. Medical Issues: Nutrition

    Science.gov (United States)

    ... support & care > living with sma > medical issues > nutrition Nutrition Good nutrition is essential to health and growth. ... must make decisions based on their own needs. Nutrition Considerations Since we are still waiting for clinical ...

  12. Nutrition and Diet

    Science.gov (United States)

    ... Thai HbH:Vietnamese Relevant links Living with Thalassemia NUTRITION AND EXERCISE ▶ Nutrition and Diet ▶ Diet for the ... MS, RD: Dec 2016: Diet Dec 2017: Supplements Nutrition and Diet Nutritional deficiencies are common in thalassemia, ...

  13. PrognosticValue of PINP,BoneAlkaline Phosphatase, CTX-I, andYKL-40 in Patients With Metastatic Prostate Carcinoma

    DEFF Research Database (Denmark)

    Brasso, Klaus; Christensen, Ib Jarle; Johansen, Julia S

    2006-01-01

    Prognostic value of PINP, bone alkaline phosphatase, CTX-I, and YKL-40 in patients with metastatic prostate carcinoma. Prostate. 2006 Apr 1;66(5):503-13. PMID: 16372331 [PubMed - indexed for MEDLINE]......Prognostic value of PINP, bone alkaline phosphatase, CTX-I, and YKL-40 in patients with metastatic prostate carcinoma. Prostate. 2006 Apr 1;66(5):503-13. PMID: 16372331 [PubMed - indexed for MEDLINE]...

  14. Prognostic value of weight change in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Prescott, E; Almdal, T; Mikkelsen, K L

    2002-01-01

    An association between low body mass index (BMI) and poor prognosis in patients with chronic obstructive pulmonary disease (COPD) has been found in a number of studies. The prevalence and prognostic importance of weight change in unselected subjects with COPD was examined. Subjects with COPD...... change: in the normal-to-underweight (BMI or = 25), best survival was seen in stable weight. A high proportion of subjects with chronic obstructive pulmonary disease experienced a significant weight loss......, which was associated with increased mortality. The results support further intervention studies that aim at avoiding weight loss in normal-to-underweight chronic obstructive pulmonary disease patients....

  15. Metrics for Evaluating Performance of Prognostic Techniques

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics is an emerging concept in condition basedmaintenance(CBM)ofcriticalsystems.Alongwith developing the fundamentals of being able to confidently predict...

  16. Health Monitoring and Prognostics for Computer Servers

    Data.gov (United States)

    National Aeronautics and Space Administration — Abstract Prognostics solutions for mission critical systems require a comprehensive methodology for proactively detecting and isolating failures, recommending and...

  17. Embedded Diagnostics & Prognostics Wireless Sensing Platforms

    National Research Council Canada - National Science Library

    Ousachi, Mark; Scott, Andrew; Yee, David; Hosmer, Thomas; Daniszewski, Dave

    2004-01-01

    An embedded diagnostics and prognostics architecture affects several aspects associated with military ground vehicles such as improved safety, reduction in maintenance times, weapon system readiness...

  18. A DISTRIBUTED PROGNOSTIC HEALTH MANAGEMENT ARCHITECTURE

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper introduces a generic distributed prognostic health management (PHM) architecture with specific application to the electrical power systems domain. Current...

  19. Simulating Degradation Data for Prognostic Algorithm Development

    Data.gov (United States)

    National Aeronautics and Space Administration — PHM08 Challenge Dataset is now publicly available at the NASA Prognostics Respository + Download INTRODUCTION - WHY SIMULATE DEGRADATION DATA? Of various challenges...

  20. A Survey of Artificial Intelligence for Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Integrated Systems Health Management includes as key elements fault detection, fault diagnostics, and failure prognostics. Whereas fault detection and diagnostics...

  1. Clinical and Histopathological Prognostic Factors in Chondrosarcomas

    Directory of Open Access Journals (Sweden)

    Bjarne Lund

    1997-01-01

    Full Text Available Purpose. In an attempt to identify clinical and histopathological factors of prognostic importance in chondrosarcomas, 115 cases of malignant and borderline chondromatous tumours were reviewed.

  2. Systematic review of prognostic factors predicting outcome in non-surgically treated patients with sciatica.

    Science.gov (United States)

    Verwoerd, A J H; Luijsterburg, P A J; Lin, C W C; Jacobs, W C H; Koes, B W; Verhagen, A P

    2013-09-01

    Identification of prognostic factors for surgery in patients with sciatica is important to be able to predict surgery in an early stage. Identification of prognostic factors predicting persistent pain, disability and recovery are important for better understanding of the clinical course, to inform patient and physician and support decision making. Consequently, we aimed to systematically review prognostic factors predicting outcome in non-surgically treated patients with sciatica. A search of Medline, Embase, Web of Science and Cinahl, up to March 2012 was performed for prospective cohort studies on prognostic factors for non-surgically treated sciatica. Two reviewers independently selected studies for inclusion and assessed the risk of bias. Outcomes were pain, disability, recovery and surgery. A best evidence synthesis was carried out in order to assess and summarize the data. The initial search yielded 4392 articles of which 23 articles reporting on 14 original cohorts met the inclusion criteria. High clinical, methodological and statistical heterogeneity among studies was found. Reported evidence regarding prognostic factors predicting the outcome in sciatica is limited. The majority of factors that have been evaluated, e.g., age, body mass index, smoking and sensory disturbance, showed no association with outcome. The only positive association with strong evidence was found for leg pain intensity at baseline as prognostic factor for subsequent surgery. © 2013 European Federation of International Association for the Study of Pain Chapters.

  3. A Survey of Attitudes towards the Clinical Application of Systemic Inflammation Based Prognostic Scores in Cancer

    Directory of Open Access Journals (Sweden)

    David G. Watt

    2015-01-01

    Full Text Available Introduction. The systemic inflammatory response (SIR plays a key role in determining nutritional status and survival of patients with cancer. A number of objective scoring systems have been shown to have prognostic value; however, their application in routine clinical practice is not clear. The aim of the present survey was to examine the range of opinions internationally on the routine use of these scoring systems. Methods. An online survey was distributed to a target group consisting of individuals worldwide who have reported an interest in systemic inflammation in patients with cancer. Results. Of those invited by the survey (n=238, 65% routinely measured the SIR, mainly for research and prognostication purposes and clinically for allocation of adjuvant therapy or palliative chemotherapy. 40% reported that they currently used the Glasgow Prognostic Score/modified Glasgow Prognostic Score (GPS/mGPS and 81% reported that a measure of systemic inflammation should be incorporated into clinical guidelines, such as the definition of cachexia. Conclusions. The majority of respondents routinely measured the SIR in patients with cancer, mainly using the GPS/mGPS for research and prognostication purposes. The majority reported that a measure of the SIR should be adopted into clinical guidelines.