Changes in body weight and physical performance after receiving dietary advice in patients with chronic obstructive pulmonary disease (COPD): 1-year follow-up

Nutritional studies in patients with chronic obstructive pulmonary disease (COPD) are often based on oral nutritional supplementation and are of short duration. Our aim was to study the changes in body weight and physical performance in COPD patients after receiving the dietary advice for 1 year. Thirty-six patients with COPD as a primary diagnosis (mean age: 68.5 ± 7.8 years), referred to a pulmonary rehabilitation program were studied. Each patient received dietary advice individually. Body weight had increased significantly by 1.3 kg (p = 0.02) and walking distance by 83.2 m (p = 0.007) after 1 year. There was an increase in mean handgrip strength after 1 year (1.6 kg, p = 0.07). The mean intake of energy and protein expressed as percent of energy and protein requirement had increased after 1 year (15%, p < 0.001, and 5.6%, p = 0.09, respectively). Handgrip strength correlated significantly with energy (r = 0.53, p = 0.002), fat (r = 0.50, p = 0.02) and protein intake (r = 0.41, p = 0.002) after 1 year. In conclusion, positive effects on body weight, handgrip strength and walking distance in patients with COPD were seen after receiving dietary advice with a 1-year follow-up.     

Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka,Bangladesh

Malnutrition is associated with high rates of mortality among patients with end stage kidney disease (ESKD). There is a paucity of data from Bangladesh, where around 35,000–40,000 people reach ESKD annually. We assessed protein-energy wasting (PEW) amongst 133 patients at a single hemodialysis setting in Dhaka. Patients were 49% male, age 50 ± 13 years, 62% were on twice-weekly hemodialysis. Anthropometric, biochemical, and laboratory evaluations revealed: BMI 24.1 ± 5.2 kg/m², mid-arm muscle circumference (MAMC) 21.6 ± 3.6 cm, and serum albumin 3.7 ± 0.6 g/dL. Based on published criteria, 18% patients had PEW and for these patients, BMI (19.8 ± 2.4 vs. 25.2 ± 5.2 kg/m²), MAMC (19.4 ± 2.4 vs. 22.2 ± 3.8 cm), serum albumin (3.5 ± 0.7 vs. 3.8 ± 0.5 g/dL), and total cholesterol (135 ± 34 vs. 159 ± 40 mg/dL), were significantly lower as compared to non-PEW patients, while hand grip strength was similar (19.5 ± 7.6 vs. 19.7 ± 7.3 kg). Inflammatory C-reactive protein levels tended to be higher in the PEW group (20.0 ± 34.8 vs. 10.0 ± 13.9 p = 0.065). Lipoprotein analyses revealed PEW patients had significantly lower low density lipoprotein cholesterol (71 ± 29 vs. 88 ± 31 mg/dL, p < 0.05) and plasma triglyceride (132 ± 51 vs. 189 ± 103 mg/dL, p < 0.05), while high density lipoprotein cholesterol was similar. Nutritional assessments using a single 24 h recall were possible from 115 of the patients, but only 66 of these were acceptable reporters. Amongst these, while no major differences were noted between PEW and non-PEW patients, the majority of patients did not meet dietary recommendations for energy, protein, fiber, and several micronutrients (in some cases intakes were 60–90% below recommendations). Malnutrition Inflammation Scores were significantly higher in PEW patients (7.6 ± 3.1 vs. 5.3 ± 2.7 p < 0.004). No discernible differences were apparent in measured parameters between patients on twice- vs. thrice-weekly dialysis. Data from a larger cohort are needed prior to establishing patient-management guidelines for PEW in this population.     

Restoration by aspirin of impaired plasma maspin level in human breast cancer

Maspin, an anti breast cancer protein, is produced in the normal mammary cells but not in malignant cells in breast cancer. We investigated the effect of aspirin induced increase of plasma nitric oxide (NO) on plasma maspin production in breast cancer patients. Fifteen breast cancer patients (35-65 years), who had not yet undergone any cancer therapy, and an equal number of age matched normal female volunteers participated in the study. They were asked not to take any medication for two weeks. All participants then ingested 150 mg of aspirin. Plasma NO and maspin levels were determined before and at 60 min after the ingestion of aspirin. It was found that the maspin level in plasma increased to 4.63+/-0.02 nM from the basal 0.95+/-0.012 nM (p<0.001) with increase of plasma NO from 0.60+/-0.03 microM to 2.08+/-0.030 microM (p<0.001) in breast cancer patients. In normal volunteers the basal maspin increased from 4.76+/-0.041 to 9.36+/-0.036 nM (p<0.001) with increase of NO from 2.15+/-0.08 to 3.36+/-0.04 microM (p<0.001) at the same period. These results indicated that the ingestion of aspirin might be beneficial for breast cancer through increased maspin production.     

Effects of oxandrolone, an anabolic steroid, on hemostasis

This study evaluated the short-term effects of oxandrolone, an anabolic androgenic synthetic steroid, on blood coagulation and the hemostatic/fibrinolytic system in healthy individuals. Subjects (n = 14) were administered oxandrolone (10 mg twice daily) for 14 days. Blood was obtained on days 0, 1, 3, 7, 9, 14, and then at day 42 (28 days after discontinuation of the drug). Samples were analyzed for the plasma plasminogen, plasminogen activator inhibitor (PAI-1), fibrinogen, and coagulation factors (II, V, VII, VIII, and X). After 7 days of administration of oxandrolone, the plasma plasminogen level significantly increased [100% +/- 21% to 174% +/- 21% (P < 0.0001)]. PAI-1 was significantly decreased at day 3 [16 +/- 9 to 7 +/- 4 mg/dL (P < 0.01)]. Coagulation factors II and V significantly increased at day 14 [88 +/- 15 to 122 +/- 11 (P < 0.005) and 105 +/- 21 to 179 +/- 36% (P < 0.0001)], respectively. Factor VII level decreased by day 3 [91% +/- 26% to 83% +/- 18%, NS], but after 14 days factor VII level returned to baseline (91% +/- 26% to 93% +/- 19%, NS). The increase of factor VIII level was not significant (111% +/- 64% to 125% +/- 55%, NS). Factor X increased steadily over 14 days of drug treatment [96% +/- 11% to 107% +/- 25%, NS] and after discontinuation, decreased and returned to baseline by day 42 [107% +/- 25% to 89% +/- 25%, NS]. Fibrinogen decreased by 22% +/- 12%, (NS). Administration of oxandrolone, to healthy young men was associated with a significant increase in select blood coagulation factors and plasminogen. These changes create a state of potential hypercoagulability that appears to be counterbalanced by increased fibrinolytic activity to maintain homeostasis.     

Antioxidant and urease inhibitory C-glycosylflavonoids from Celtis africana

Two new C-glycosylflavonoids celtisides A (1) and B (2) have been isolated from n-butanol-soluble fraction of Celtis africana, along with five known C-glycosylflavonoids vitexin (3), orientin (4), isoswertiajaponin (5), isoswertisin (6), and 2″-O-rhamnosyl vitexin (7) reported for the first time from this species. Their structures were assigned from 1D and 2D NMR spectra. These compounds were investigated for biological activities and showed significant antioxidant and urease inhibitory activities.     

Antioxidant constituents from Cotoneaster racemiflora

A new lignan rhamnoside, racemiside (1), has been isolated from the ethyl acetate-soluble fraction of Cotoneaster racemiflora, along with scopoletin (2), 7,8-dimethoxy-6-hydroxycoumarin (3), 3,3′,4′-tri-O-methylellagic acid (4), and cereotagloperoxide (5), reported for the first time from this species. All of them showed profound antioxidative activities in the DPPH assay.