Nutritional status in patients aged over 65 years and its influence on the quantity and type of complications occurring 3, 6 and 12 months after hospitalisation: a clinical prospective study.

BACKGROUND: Malnutrition in hospitalised patients is associated with frequent complications and increased mortality. The present study aimed to determine the prevalence of abnormal nutritional status in patients aged over 65 years with a diagnosis of cardiovascular diseases and also to determine its relationship with the duration of hospitalisation and the incidence of complications over 3, 6 and 12 months of observation. A comparison was also made of diagnostic performance between the various classifications used to diagnose abnormal nutritional status. METHODS: In total, 76 patients aged over 65 years with cardiovascular conditions were involved in the study. Abnormal nutritional status was identified on the basis of Mini-Nutritional Assessment-Short Form (MNA-SF) test results, laboratory tests and European Society for Clinical Nutrition and Metabolism (ESPEN) nutritional status assessment criteria. During 3, 6 and 12 months of observation, data were collected concerning the number of re-hospitalisations and the presence of complications. RESULTS: Abnormal nutritional status was reported in 78% of participants. Malnutrition, as diagnosed on the basis of laboratory findings and also on the basis of ESPEN criteria comprising the value of fat free mass index (FFMI), was significantly related to prolonged hospitalisation and an increased complication rate. The results of the MNA-SF test performed at baseline revealed no relationship with the incidence of complications during the first stage of the study. CONCLUSIONS: Abnormal nutritional status was a common phenomenon in the group of patients under investigation. The set of criteria for assessing the nutritional status that had the highest association with the duration of hospitalisation and the incidence of complications includes laboratory tests and ESPEN criteria comprising the value of FFMI.

[Importance of proper nutrition before and during pregnancy]. / Znaczenia prawidlowego zywieni kobiety przed oraz w czasie ciazy.

Maternal nutrition before and during pregnancy may influence the course of the pregnancy, foetal development and the child's health in its early and also adult life. Maternal underweight before pregnancy (BMI<19.8 kg/m2) and low pregnancy weight gain may increase the risk of low infant birth weight. There is accumulating evidence that persons who were born with low body mass are more susceptible to insulin-independent diabetes, arterial hypertension, hypercholesterolemia and ischaemic heart disease, than those whose birth weight was normal. Recommendations concerning pregnancy weight gain are discussed. Folic acid deficiency during the periconceptional period may cause neural tube defects in the offspring. Full cover of folic acid requirement is necessary. This may be achieved only by diet supplementation or food fortification. Recommendations concerning folic acid supplementation during the periconceptional period are discussed. Folic acid deficiency during pregnancy may also contribute to the preterm delivery and low infant birth weight. The importance of antioxidant vitamins in the prevention of pregnancy hypertension and the consequences of vitamin A overdosage are discussed. Protective calcium activity against pregnancy hypertension and preterm delivery, the importance of maternal iron supplementation in the prevention of low infant birth weight, and also the problem of maternal zinc deficiency which increases the risk of the low infant birth weight, preterm delivery, malformations, post-term delivery and pregnancy hypertension were discussed as well as the consequences of deficiency of the iodine and n-3 fatty acids in the diet.

Influence of smoking on hormone secretion in obese and lean female smokers.

Smoking exerts influences on the secretion of several hormones which are abnormal in obesity. Previous studies have mainly been performed in non-obese men, and data from non-obese and obese women are scarce. The aim of the present study was therefore to identify the effect of smoking on hormone secretions in obese and lean female smokers. The study was performed in 10 obese and 8 lean, premenopausal, healthy smokers. All subjects were tested once under experimental and once under control conditions (not smoking) in randomized order. The women smoked two non-filtered cigarettes during 4 minutes each. Blood pressure and heart rate were measured 30 minutes before smoking, at the start of smoking (time 0) and then after 5, 10, 20, 30, 45 and 60 minutes. Blood samples were taken for determination of serum concentrations of adrenocorticotropic hormone (ACTH), cortisol, prolactin (PRL), growth hormone (GH) and thyroid stimulating hormone (TSH) at the same time points except at 5 minutes. Heart rate rose in both groups during smoking. Systolic and diastolic blood pressure was increased only in the obese subjects. Cortisol and ACTH increased in both groups, while TSH, PRL and GH were unchanged in both groups. We conclude that lean and obese smoking women seem to respond rather similarly to smoking in the hemodynamic and endocrine variables measured in this report with the possible exception of blood pressure where the obese women tended to show more pronounced increases.

[Influence of fish oil on serum lipoprotein level in endogenous hypertriglyceridemia]. / Wplyw oleju rybnego na poziom lipoprotein surowicy w hipertriglicerydemii endogennej.

The influence of fish oil on the level and composition of lipoprotein fractions in hypertriglyceridemic men was evaluated. The observation was performed in 2 groups of patients, 10 cases each (a cross-over study). In the group I subjects received fish oil first, in the dose of 12 grams daily (3.6 g of EPA and DHA) for 3 weeks, and then, for the next 3 weeks, olive oil in the same dose. Patients from the group II received the same oil but in the inverse order. Results after olive oil were a control for fish oil. Marked decreases in the serum and VLDL triglycerides and also VLDL-cholesterol level after fish oil was shown. Increases in LDL and HDL cholesterol were observed. In 9 patients fish oil was given for 6 weeks. No differences in the serum lipid levels after this period of time in comparison with results after 3 weeks were observed.

[Comparative study of the influence of fish oil and gemfibrozil on levels of serum lipoprotein in endogenous hypertriglyceridemia]. / Badanie porównawcze wplywu oleju rybnego i gemfibrozilu na poziom lipoprotein surowicy w hipertriglicerydemii endogennej.

Hypolipemic action of fish oil and gemfibrozil was compared. The study was performed in 12 men with endogenous hypertriglyceridemia. Subjects received fish oil 12 grams daily (3.6 g of eicosapentaenoic and docosahexaenoic fatty acids) for 3 weeks, and then, after an interval of at least 6 weeks, gemfibrozil in the dose of 900 mg daily. Results after gemfibrozil were compared with those after fish oil. Fish oil was shown to be less effective than gemfibrozil in decreasing concentrations of serum triglycerides and triglycerides and cholesterol in VLDL. However, the difference did not reach the level of statistical significance. The agents differed significantly in their influence on the LDL fraction. Fish oil slightly increased and gemfibrozil significantly decreased LDL-chol level. LDL-apoB increased after fish oil, but did not change after gemfibrozil. It may be concluded that fish oils, although effective in decreasing concentrations of serum triglycerides and lipid components of the VLDL fraction, are not alternative for gemfibrozil in monotherapy of endogenous hypertriglyceridemia.

[Effect of CRP preparation on serum lipids in patients with hyperlipidemia]. / Wplyw preparatu CRP na lipidy surowicy u pacjentów z hiperlipidemia.

In a group of 18 patients with essential hyperlipidaemia the influence was studied of multivitamin CRP preparation given for 12 weeks, on lipid peroxides, cholesterol and triglycerides in the serum. The level of lipid peroxides was decreased significantly. This effect was associated with the increase of the serum level of vitamin E. A decrease was also found of the levels of total cholesterol and LDL-cholesterol.