Nutrition risk factors for survival in the elderly living in Canadian long-term care facilities

OBJECTIVES: To determine the role of nutritional parameters in influencing the risk of mortality in institutionalized elderly. DESIGN: A prospective cohort study in which subjects had several nutritional parameters measured at baseline and were followed for 19 months. Time to death and mortality were recorded starting immediately after enrollment. SETTING: Fourteen long-term care facilities (LTCFs). PARTICIPANTS: Four hundred eight elderly long-term care residents aged 60 and older who resided in the facility for more than 6 weeks. MEASUREMENTS: At baseline, knee height, weight, mid-arm circumference (MAC), skin-fold thickness, and fat-free mass using bioelectric impedance analysis were measured. Covariates included demographic factors, length of stay in the facility, functional status, and medical diagnoses. Cox proportional hazards regression analysis was used to identify independent predictors of mortality. Results are reported as mean+/-standard error of the mean (SEM). RESULTS: Overall, mortality rate was 28.4%. Univariate predictors included male sex, body mass index, MAC, and triceps skin fold. In multivariate analysis, male sex (hazard ratio (HR)=1.7, 95% confidence interval (CI)=1.2-2.7, P=.0096) and MAC less than 26 cm were significantly associated with increased risk of mortality (HR=4.8, 95% CI: 2.8-8.3, P<.0001). CONCLUSION: Among this elderly population living in LTCFs, MAC is the best nutritional predictor of mortality.     

Cement Selection for Cement‐Retained Implant‐Supported Prostheses: A Literature Review

Cement‐retained implant‐supported prostheses are widely used for restoring missing teeth; however, they show some complications in comparison to screw‐retained restorations, such as difficulty in retrieving the restoration and biocompatibility of cement. Therefore, the practitioner should consider several important aspects when using this type of restoration. In this regard, one major concern is appropriate cement selection, with considerations including cement biologic compatibility, methods for limiting the excess cement, ease of removing the excess cement, radiographic view of the cement, and also the possibility of future retrieval of the prosthesis. The aim of this review article was to address most aspects related to this type of prosthesis in terms of cementation.     

The effect of working memory intervention on the gait patterns of the elderly

Introduction

The purpose of this study was to evaluate the role of working memory (WM) training on walking patterns in elderly people.

Relationship between serum IL10 level and p38MAPK enzyme activity on behavioral and cellular aspects of variation of hyperalgesia during different stages of arthritis in rats

Objects and design

Regarding to anti-inflammatory role of interleukin (IL) 10, its inhibitory effects on p38MAPK activity and, different pro and anti-inflammatory roles of activated p38MAPK in cells, this study was aimed to investigate relationship between serum IL10 level and p38MAPK enzyme activity on behavioral and cellular aspects variation of hyperalgesia during different stages of arthritis in rats.

Materials and methods

Adjuvant arthritis (AA) was induced by a single subcutaneous injection of complete Freund’s adjuvant into the rats’ hind paw. Behavioral and inflammatory responses were assessed at 0, 3, 7, 14, and 21 days of study. Receptor and other protein enzyme expression variations were detected by western blotting. Anti-IL10 and p38MAPK inhibitor were administered daily during the 21 days of study.

Result

Daily treatment with anti-IL10 antibody significantly increased paw edema and hyperalgesia in the AA group compared with the AA control group. Administration of anti-IL10 antibody caused significant increase in the ratio of phosphorylated p38 to p38MAPK enzyme level expression on 14th and 21st days of study compared with the AA control group.

Conclusion

Our study confirmed that a part of anti- inflammatory effects of serum IL10 during AA inflammation was mediated via inhibition of p38MAPK enzyme phosphorylation. Moreover, these findings suggest that increase in the level of spinal mu opioid receptor expression during AA inflammation is not mediated via the direct effect of serum IL10 on spinal p38MAPK.     

Pulsatile blood flow in total cavopulmonary connection: a comparison between Y-shaped and T-shaped geometry

Single-ventricle anomaly is a hereditary heart disease that is characterized by anatomical malformations. The main consequence of this malformation is desaturated blood flow, which without proper treatment increases the risk of death. The classical treatment is based on a three-stage palliative procedure which should begin from the first few days of patient’s life. The final stage is known as Fontan procedure, in which inferior vena cava is directly connected to pulmonary arteries without going through the ventricle. This connection is called total cavopulmonary connection (TCPC). After surgery, the single ventricle supplies adequate and saturated systemic blood flow to the body; however, TCPC contains low pressure and low flow pulsatility. To overcome this problem, a new method is proposed wherein pulsatile blood will be directed to the TCPC through the stenosed main pulmonary artery. In this study, through the use of Computational Fluid Dynamics, T-shaped (MRI-based) and Y-shaped (computer-generated) geometries are compared in order to determine the influence of this modification on pulsation of blood flow as well as energy loss in pulmonary arteries. The results indicate that energy loss in Y-shaped geometry is far less than T-shaped geometry, while the difference in flow pulsatility is insignificant.     

The effect of electromagnetic fields on survival and proliferation rate of dental pulp stem cells

Abstract

Aims: Extremely low-frequency electromagnetic fields (ELF-EMF) can affect biological systems and alter some cell functions like proliferation rate. Dental pulp tissue is known as a source of multipotent stromal stem cells (MSCs), which can be obtained by a less invasive and more available process compared to bone marrow-derived stem cells (BMSCs). This study aimed to consider the effect of ELF-EMF on proliferation rates of human dental pulp stem cells (hDPSCs).

Material and methods: ELF-EMF was generated by a system including autotransformer, multi-meter, solenoid coils, teslameter and its probe. The effect of ELF-EMF with the intensity of 0.5 and 1?mT and 50?Hz on the proliferation rate of hDPSCs was assessed in 20 and 40?min per day for 7?days. MTT assay and DAPI test were used to determine the growth and proliferation of DPSCs.

Results: Based on MTT, ELF-EMF has maximum effect with the intensity of 1?mT for 20?min/day on the proliferation of hDPSCs. The survival and proliferation rate in all exposure groups were significantly higher than the control group. Based on the data obtained from MTT and DAPI assay, the number of viable cells in the group exposed to 1?mT for 20?min/day was higher than other groups (p?<?.05).

Conclusions: Regarding to the results of this study, 0.5 and 1?mT ELF-EMF can enhance survival and proliferation rates of hDPSCs.     

Glycemic Gap Predicts in-Hospital Mortality in Diabetic Patients with Intracerebral Hemorrhage

Background and PurposeThe relationship between admission hyperglycemia and intracerebral hemorrhage (ICH) outcome remains controversial. Glycemic gap (GG) is a superior indicator of glucose homeostatic response to physical stress compared to admission glucose levels. We aimed to evaluate the association between GG and in-hospital mortality in ICH.MethodsWe retrospectively identified consecutive patients hospitalized for spontaneous ICH at the 2 healthcare systems in the Twin Cities area, MN, between January 2008 and December 2017. Patients without glycosylated hemoglobin (HbA1c) test or those admitted beyond 24 hours post-ICH were excluded. Demographics, medical history, admission tests, and computed tomography data were recorded. GG was computed using admission glucose level minus HbA1c-derived average glucose. The association between GG and time to in-hospital mortality was evaluated by Cox regression analysis. Receiver operating characteristic (ROC) analysis with the DeLong test was used to evaluate the ability of GG to predict in-hospital death.ResultsAmong 345 included subjects, 63 (25.7%) died during the hospital stay. Compared with survivors, non-survivors presented with a lower Glasgow coma scale score, larger hematoma volume, and higher white blood cells count, glucose, and GG levels at admission (p<0.001). GG remained an independent predictor of in-hospital mortality after adjusting for known ICH outcome predictors and potential confounders [adjusted hazard ratio: 1.09, 95% confidence interval (CI): 1.02-1.18, p = 0.018]. GG showed a good discriminative power (area under the ROC curve: 0.75, 95% CI: 0.68-0.82) in predicting in-hospital death and performed better than admission glucose levels in diabetic patients (p = 0.030 for DeLong test).ConclusionsAdmission GG is associated with the risk of in-hospital mortality and can potentially represent a useful prognostic biomarker for ICH patients with diabetes.     

Trend of smoking among students of Tehran University of Medical Sciences: results from four consecutive surveys from 2006 to 2009

Background

Smoking within students community of the medical sciences can negatively impact the attitudesof the society in future. The objectives of this study were to assess the prevalence and trends of smoking amongstudents of Tehran University of Medical Sciences.

Method

This study was conducted in four consecutive years from 2006 to 2009. The study sample was takenfrom the first- to fourth-year, undergraduate and graduate (doctorate) students of Tehran University of MedicalSciences. Census was applied for sampling. Structured questionnaires were distributed to students of each class.The study was anonymous and self-administered.

Results

From 2006 to 2009, a total of 1568 to 1761 students participated in the study each year. Over thestudy period, i.e. 2006-2009, the prevalence of cigarette smoking was decreased (the overall prevalence was12.5% in 2006, 12.9% in 2007, 10.8% in 2008, and 10.5% in 2009). The corresponding values for the onemonth prevalence were 8.2%, 7.8%, 6.1%, and 5.8%, while those for the prevalence of daily smoking were3.4%, 4.0%, 2.9%, and 1.8%, respectively. The decreasing trend was particularly more significant for femalestudents.

Conclusion

The findings suggest that the prevalence of smoking among students of Tehran University ofMedical Sciences was in the lower end of the spectrum, in comparison to other universities in Iran and othercountries. Additionally, similar to the pattern observed in the developed world, this trend was decreasing, particularlyamong girls. Implementing preventive measures for accelerating the decreasing trend, as well as continuousmonitoring is recommended.