Assessment of Nutrient Levels Provided by General Hospital Patient Menus: A Cross-Sectional Study Carried Out in the Region of Murcia (Spain).

Disease-related malnutrition remains a health problem with a high prevalence that increases the risk of poor patient outcomes, in addition to an elevation of healthcare costs. The aim of this study was to evaluate the nutritional quality of the menus at Ribera Molina Hospital, including their adequacy regarding recommended daily nutrient intakes and the agreement with the theoretical nutrition information provided by catering. The mean levels of energy, macronutrients, vitamins, and minerals provided by the basal, diabetic, and soft diets were calculated through the weighing of plated food served throughout the first 14 days of February 2020. A nutritional overestimation was seen in the nutrition information provided by the catering compared to the values derived from weighing foods (p < 0.01). Despite this, the nutritional content calculated by weighing satisfied the energy and protein requirements of 203 hospitalized patients previously studied in the internal medicine area of the hospital. The mean age of these patients was 62 years, and the main causes of admission were lung, cardiovascular, renal, and digestive diseases. There seems to be an insufficient amount of vitamins E and D, as well as magnesium, on all the menus. A possible insufficient amount of calcium, potassium, zinc, and copper was observed in some of the menus studied. It is necessary to update the hospital prescription manual so the nutritional contents of the diets are accurate and based on the weighted and calculated values to improve the adequacy of diets prescribed to patients.

A Systematic Review of Clinical Trials on the Efficacy and Safety of CRLX101 Cyclodextrin-Based Nanomedicine for Cancer Treatment.

CRLX101 is a cyclodextrin-based nanopharmaceutical designed to improve the delivery and efficacy of the anti-cancer drug camptothecin. Cyclodextrins have unique properties that can enhance drug solubility, stability, and bioavailability, making them an attractive option for drug delivery. The use of cyclodextrin-based nanoparticles can potentially reduce toxicity and increase the therapeutic index compared to conventional chemotherapy. CRLX101 has shown promise in preclinical studies, demonstrating enhanced tumor targeting and prolonged drug release. This systematic review followed PRISMA guidelines, assessing the efficacy and toxicity of CRLX101 in cancer treatment using clinical trials. Studies from January 2010 to April 2023 were searched in PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews, using specific search terms. The risk of bias was assessed using ROBINS-I and Cochrane risk-of-bias tools. After screening 6018 articles, 9 were included in the final review. These studies, conducted between 2013 and 2022, focused on patients with advanced or metastatic cancer resistant to standard therapies. CRLX101 was often combined with other therapeutic agents, resulting in improvements such as increased progression-free survival and clinical benefit rates. Toxicity was generally manageable, with common adverse events including fatigue, nausea, and anemia.

Phase Angle, Handgrip Strength, and Other Indicators of Nutritional Status in Cancer Patients Undergoing Different Nutritional Strategies: A Systematic Review and Meta-Analysis.

Malnutrition in cancer patients is one of the most influential factors in the evolution and mortality of such patients. To reduce the incidence of malnutrition, it is necessary to establish a correct nutritional intervention. For this purpose, precise tools and indicators must be developed to determine the patient's condition. The main objective of this systematic review and meta-analysis was to analyze the relationship between different nutritional strategies, phase angle (PA), and handgrip strength in patients with cancer, with the secondary objectives being the modification of other indicators of nutritional status, such as weight and body mass index (BMI). A systematic review of randomized clinical trials was carried out in March 2023 in the databases PubMed, Web of Science, Cochrane, and Scopus. As a risk-of-bias tool, RoB 2.0 was utilized. A total of 8 studies with a total of 606 participants were included in the analysis. A significant increase in PA was observed after the different nutritional strategies (SMD: 0.43; 95% CI: 0.10 to 0.77; p = 0.01; I2 = 65.63%), also detecting a significant increase in handgrip strength (SMD: 0.27, 95% CI: 0.08 to 0.47; p = 0.01; I2 = 30.70%). A significant increase in PA and handgrip were observed in cancer patients subjected to different nutritional strategies. These results suggest that these indicators could be used in the nutritional and functional assessment of the patients.

Carvacrol and HP-ß-Cyclodextrin Complexes: Extensive Characterization and Potential Cytotoxic Effect in Human Colorectal Carcinoma Cells.

The aim of this study was to obtain solid carvacrol-cyclodextrin (CD) complexes for use in the pharmaceutical industry. To this end, the complexation of carvacrol at different pH values was studied in detail, to determine the type of CD and the reaction environment that supported the highest amount of encapsulated carvacrol. Evidence of the capability of hydroxypropyl-ß-cyclodextrins (HP-ß-CD) to form inclusion complexes with carvacrol (KC = 5042 ± 176 L mol-1) and more high complexation efficiency (2.824) was demonstrated for HP-ß-CDs using two different energy sources, ultrasound (US) (KC = 8129 ± 194 L mol-1 24 h) and microwave irradiation (MWI) (KC = 6909 ± 161 L mol-1), followed by spraying the resulting solution in a spray dryer. To confirm complex formation, the complexes were characterized using various instrumental methods to corroborate the carvacrol incorporation into the hydrophobic cavity of HP-ß-CD. The obtained carvacrol solid complexes were analyzed by 1H nuclear magnetic resonance (1H-NMR) and 2D nuclear magnetic resonance (ROSEY), differential scanning calorimetry (DSC), thermogravimetric analysis (TG) and Fourier transform infrared spectroscopy (FTIR) characterization. The structures of the resulting complexes were also characterized by molecular modeling. Furthermore, 1 mM HP-ß-CD-carvacrol complex has been shown to reduce cell proliferation in HCT-116 colorectal cancer cells by 43%, much more than in a healthy lung fibroblast MRC-5 cell line (11%).

[Disease-related malnutrition, functional parameters, and associated costs in a genaral hospital]. / Desnutrición relacionada con la enfermedad, parámetros funcionales y costes asociados en un hospital general.

INTRODUCTION: Introduction: disease-related malnutrition (DRM) affects more than 30 million people in Europe, representing about 170 billion euros each year. Despite the growing consensus for the diagnosis of DRM, it is still necessary to implement multidisciplinary and coordinated protocols for a comprehensive approach to DRM in hospitals. Objetive: to study the proportion of patients affected by DRM upon admission, as well as the duration and the cost of their stay in a general hospital. Methods: an observational cross-sectional study with a sample size of 203 subjects. From June to December 2018, a nutritional screening was carried out according to the Nutritional Risk Screening 2002 (NRS-2002); diagnoses were made according to the Global Leadership Initiative on Malnutrition (GLIM) criteria, length of stay was recorded, and the cost of stay was estimated for all patients admitted to Internal Medicine who met the selection criteria. Results: the proportion of people at risk of DRM was 28 % (57/203; 95 % CI: 22 % to 34 %). The proportion of patients diagnosed with DRM was 19 % (36/192; 95 % CI: 13 % to 24 %). Patients classified with risk or diagnosis of DRM upon admission had a longer stay than those with normal nutrition by 3 days (p < 0.01), and a higher cost by €1,803.66 (p < 0.01). Conclusions: a comprehensive, multidisciplinary approach to DRM coordinated from Primary Care to hospitals is necessary, especially in women aged ≥ 70 years with pulmonary disease.

INTRODUCCIÓN: Introducción: la desnutrición relacionada con la enfermedad (DRE) afecta en Europa a más de 30 millones de personas, lo que supone cada año unos 170.000 millones de euros. Es necesario implantar protocolos multidisciplinares para el abordaje de la DRE. Objetivo: estudiar la proporción de pacientes afectados o en riesgo de DRE al ingreso, la duración y el coste de su estancia en un hospital general. Métodos: estudio observacional de corte transversal con un tamaño muestral de 203 sujetos. De junio a diciembre de 2018 se realizó un cribado nutricional conforme al Nutritional Risk Screening 2002 (NRS-2002), se hizo un diagnóstico según los criterios de la Iniciativa de Liderazgo Mundial en Desnutrición (GLIM), se registró la duración del ingreso y se efectuó una estimación del coste de la estancia de todos los pacientes que ingresaron en medicina interna y cumplían los criterios de selección. Resultados: la proporción de personas en riesgo de DRE fue del 28 % (57/203; IC 95 %: 22 % a 34 %). La proporción de pacientes con diagnóstico de DRE fue del 19 % (36/192; IC 95 %: 13 % a 24 %). Los pacientes clasificados con riesgo o diagnóstico de DRE al ingreso tuvieron una estancia 3 días mayor que la de los normonutridos (p < 0,01) y un coste mayor que el de los normonutridos en 1.803,66 euros (p < 0,01). Conclusiones: se hace necesario un abordaje integral y multidisciplinar de la DRE coordinada desde la Comunidad, la Atención Primaria y los hospitales, especialmente en las mujeres de ≥ 70 años con patología pulmonar.

Comprehensive Characterization of Linalool-HP-ß-Cyclodextrin Inclusion Complexes.

The objective of the present study is to obtain linalool- cyclodextrin (CDs) solid complexes for possible applications in the food industry. For this purpose, a detailed study of linalool complexation was carried out at different pH values, to optimize the type of CDs and reaction medium that support the highest quantity of encapsulated linalool. Once demonstrated the ability of hydroxypropyl-ß-cyclodextrin (HP-ß-CDs), to form inclusion complexes with linalool (KC = 921 ± 21 L mol-1) and given their greater complexation efficacy (6.788) at neutral pH, HP-ß-CDs were selected to produce solid inclusion complexes by using two different energy sources, ultrasounds and microwave irradiation, subsequently spraying the solutions obtained in the Spray Dryer. To provide scientific solidity to the experimental results, the complexes obtained were characterized by using different instrumental techniques in order to confirm the inclusion of linalool in the HP-ß-CDs hydrophobic cavity. The linalool solid complexes obtained were characterized by using 1H nuclear magnetic resonance (1H-NMR) and 2D nuclear magnetic resonance (ROSEY), differential scanning calorimetry, thermogravimetry and Fourier transform infrared spectrometry. Moreover, the structure of the complex obtained were also characterized by molecular modeling.

Encapsulation of finasteride with native and modified γ-cyclodextrins. Extensive characterization of the complexes.

The aim of this work was to study the complexation process of FIN with native and modified CDs, to develop an aqueous solution for the topical treatment of male androgenic alopecia. The effect of pH and temperature in the complexation process were studied by solubility studies. The complexes FIN-CDs were characterized by 1HNMR and 2-D NMR (ROESY) spectroscopy. Molecular modeling studies and NMR data were used to build three-dimensional models of the complexes. FTIR, DSC and SEM techniques were also applied to strengthen physicochemical characterization, geometry as well as structural aspects evidencing the effective inclusion of FIN into the CDs' hydrophobic cavity. The most effective CDs in the FIN complexation were γ-CDs, and their modified HP-γ- and methyl-γ-CDs by forming 1:1 complexes. The Kc value obtained for γ-CDs was 9687 ± 51 M-1, whereas the Kc values obtained for HP-γ- and methyl-γ-CDs were lower, indicating that the presence of HP or methyl groups hinder the entry of FIN in the hydrophobic cavity of γ-CDs. In conclusion, FIN aqueous solubility could be increased by complexation with CDs and the aqueous solutions obtained can be used to improve FIN therapeutic possibilities in a pleasant preparation for the patient that guarantees the adherence to the treatment.

Adsorption Properties of ß- and Hydroxypropyl-ß-Cyclodextrins Cross-Linked with Epichlorohydrin in Aqueous Solution. A Sustainable Recycling Strategy in Textile Dyeing Process.

ß-cyclodextrin (ß-CD) and hydroxypropyl-ß-cyclodextrin (HP-ß-CD) were used to prepare insoluble polymers using epichlorohydrin as a cross-linking agent and the azo dye Direct Red 83:1 was used as target adsorbate. The preliminary study related to adsorbent dosage, pH, agitation or dye concentration allowed us to select the best conditions to carry out the rest of experiments. The kinetics was evaluated by Elovich, pseudo first order, pseudo second order, and intra-particle diffusion models. The results indicated that the pseudo second order model presented the best fit to the experimental data, indicating that chemisorption is controlling the process. The results were also evaluated by Freundlich, Langmuir and Temkin isotherms. According to the determination coefficient (R²), Freunlich gave the best results, which indicates that the adsorption process is happening on heterogeneous surfaces. One interesting parameter obtained from Langmuir isotherm is qmax (maximum adsorption capacity). This value was six times higher when a ß-CDs-EPI polymer was employed. The cross-linked polymers were fully characterized by nuclear magnetic resonance (NMR), Fourier transform infrared spectroscopy (FTIR), thermal gravimetric analysis (TGA). Also, morphology and particle size distribution were both assessed. Under optimized conditions, the ß-CDs-EPI polymer seems to be a useful device for removing Direct Red 83:1 (close 90%), from aqueous solutions and industrial effluents. Complementarily, non-adsorbed dye was photolyzed by a pulsed light driven advanced oxidation process. The proposed methodology is environmental and economically advantageous, considering the point of view of a sustainable recycling economy in the textile dyeing process.

Kaempferol complexation in cyclodextrins at basic pH.

The complexation of kaempferol with cyclodextrins (CDs) (beta-, G(2)-beta-, and HP-beta-CDs) in basic medium was studied, and the complexation constants (K(c)) were calculated by using enzymatic, solubility, and fluorometric methods. This is the first time that a decrease in fluorescence has been observed as result of the analyte complexation by CDs. The highest K(c) value for kaempferol complexation was obtained for HP-beta-CDs. To establish the validity of the fluorometric method for determining the K(c) between kaempferol and CDs, the same parameters were also determined by enzymatic and solubility methods. The enzymatic method was carried out by using horseradish peroxidase as oxidative enzyme, and the K(c) values obtained were similar to those obtained by using the solubility method. However, the fluorometric method underestimated the K(c) value by about 1.2-fold with respect to the other methods used. In all cases HP-beta-CDs showed the highest K(c) value, indicating that they are more efficient in the formation of inclusion complexes with kaempferol.

Encapsulation of quercetin and myricetin in cyclodextrins at acidic pH.

The in vitro formation of quercetin- and myricetin-cyclodextrin inclusion complexes in acidic medium has been characterized using the enzymatic system horseradish peroxidase, which oxidizes those flavonols in the presence of H2O2. The presence of cyclodextrins (CDs) in the reaction medium inhibited flavonol oxidation due to the complexation of the flavonol in the hydrophobic cavity of CDs. This inhibitory effect depends on the complexation constant Kc between flavonol and the CD type used. The Kc for quercetin and myricetin with the different types of CD used was calculated by nonlinear regression of the inhibition curves obtained in the presence of CDs. In both cases (quercetin and myricetin), the Kc values obtained followed the order hydroxypropyl-beta-CDs > maltosyl-beta-CDs > beta-CDs, reflecting the greater affinity of modified cyclodextrins for the studied flavonols compared with their parental beta-CDs. Moreover, the complexation efficiency (CE) values for HP-beta-CDs and quercetin or myricetin were calculated (267.4 and 5.3, respectively), indicating that HP-beta-CDs are more efficient for the complexation of quercetin than myricetin in the studied conditions, despite of the K c values being very similar in both cases.