Effectiveness of adductor pollicis muscle thickness as risk marker for sarcopenia in Central-West Brazilian elderly communities.

OBJECTIVES: The aim of this study was to determine sensitivity, specificity, and best cutoff point for adductor pollicis muscle thickness (APMT) for diagnosis of sarcopenia in elderly community centers. METHODS: This was a cross-sectional study comprising 321 elderly individuals from four community centers in Cuiabá, Central-West region of Brazil. The main outcome variables were calf circumference (CC; cm) and the APMT (mm). A receiver operating characteristic curve was built to assess the accuracy of APMT having CC as a golden pattern for sarcopenia. The best cutoff point was defined by Youden's J statistic. RESULTS: The area under curve of APMT was 0.70 (95% confidence interval [CI], 0.63-0.76; P < 0.001) for all individuals, 0.74 (95% CI, 0.67-0.81; P < 0.001) for women, and 0.71 (95% CI, 0.58-0.85; P =.01) for men. The best cutoff point defined by Youden's J statistic was 17.63 mm for all individuals, the same for women. and 18.51 mm for men. CONCLUSION: The APMT can be used for the diagnosis of sarcopenia. The optimal cutoff points for APMT are 17.63 mm for women and 18.51 mm for men in elderly communities in the Central-West Region of Brazil.

Shrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to cancer.

OBJECTIVE: Prolonged preoperative fasting increases postoperative hospital length of stay and current evidence recommends patients drink a carbohydrate-based liquid drink 2 h before surgery. The aim of this study was to investigate whether the addition of hydrolyzed protein to a carbohydrate-based drink would reduce both the inflammatory response and hospital length of stay. METHODS: We evaluated 22 patients of both sexes, undergoing gastrointestinal resection due to cancer. Patients were randomized into two groups: control group (n = 12; 6-8 h fast) and the intervention group (n = 10; fasted to solids for 6 h; and given a beverage containing 11% pea protein hydrolysate and 89% carbohydrates (79% maltodextrin and 21% sucrose), 400 mL the night before and 200 mL 3 h before surgery. Blood samples were collected the morning before surgery and on postoperative day 2. RESULTS: Overall mortality was 4.5% (one case, control group). The duration of postoperative hospital stay was twofold longer in the control group (P = 0.04). A significant increase of serum C-reactive protein/albumin ratio was observed in controls compared with the intervention group (P = 0.04). CONCLUSION: The abbreviation of preoperative fasting time to 3 h using a solution containing carbohydrates and hydrolyzed pea proteins reduces the acute-phase inflammatory response and decreases the postoperative length of stay in patients undergoing major surgery for a malignancy.