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1.
J Nutr Health Aging ; 15(8): 624-30, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21968856

RESUMO

BACKGROUND: Clinical trials that have assessed the best approach for treating under-nutrition in old age are scarce. OBJECTIVE: To determine the impact of an intensive nutritional intervention program led by a dietitian on the health and nutritional status of malnourished community dwelling older adults. METHODS: Sixty-eight eligible participants (age<75) were randomly assigned to a Dietetic Intervention Treatment (DIT), an intensive nutritional intervention led by a dietitian, or a Medical Treatment (MT), a physician-led standard care group, with an educational booklet regarding dietary requirements and recommendations for older adults. An additional 59 eligible participants who were unable to participate in the randomization were included as a non-randomized "untreated nutrition" group (UNG). RESULTS: Over the 6-month follow-up, the DIT group showed significant improvement in cognitive function (from 25.8±4.5 to 26.8±4, p=0.04), and depression score (from 7.3±3.9 to 5.4±3.9, p=0.04) compared with the change in the other 2 groups. The DIT group showed a significant improvement in intake of carbohydrates (+15% vs. +1% in the MT and +3% in the UNG), protein (+8% vs. +2% in the MT and -3% in the UNG), vitamin B6 (+20% vs. +7% in the MT and +8% in the UNG), and vitamin B1 (+22% vs. +11% in the MT and 0% in the UNG). The DIT group had a significantly lower cost of physician visits than the other 2 groups ($172.1±232.0 vs. $417.2±368.0 in the MT and $428.1±382.3 in the UNG, p=0.005). CONCLUSION: Intensive dietary intervention was moderately effective in lowering cost of services used and improving medical and nutritional status among community dwelling older adults.


Assuntos
Transtornos Cognitivos/prevenção & controle , Cognição/fisiologia , Depressão/dietoterapia , Ingestão de Energia , Educação em Saúde/métodos , Desnutrição/dietoterapia , Estado Nutricional , Idoso , Idoso de 80 Anos ou mais , Administração de Caso , Transtornos Cognitivos/economia , Depressão/economia , Carboidratos da Dieta/administração & dosagem , Proteínas Alimentares/administração & dosagem , Dietética/métodos , Feminino , Educação em Saúde/economia , Humanos , Masculino , Desnutrição/economia , Visita a Consultório Médico/economia , Padrão de Cuidado/economia , Tiamina/administração & dosagem , Vitamina B 6/administração & dosagem
2.
J Nutr Health Aging ; 13(6): 485-9, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19536416

RESUMO

BACKGROUND/AIMS: Nurses in the community are in contact with the elderly at different levels of care. The aim of this study was to assess nurses' knowledge and attitudes regarding nutritional-care for the elderly, and the impact of their attitude on the quality of assessment-care they provide to this growing population in need of nutritional-care. METHODS: A structured questionnaire was distributed by mail to 600 nurses working in Maccabi-Health-Care-Services (MHS). The questionnaire assessed different aspects of elderly nutrition. RESULTS: The vast majority (91%) of the participants reported treating elderly in their practice. Religious nurses and the nurses with an individual orientation specialty reported more positive attitudes about nutritional-care for the elderly than others did (p=0.05). Nurses with a bachelor's degree had better attitudes than registered nurses about the importance of nutrition for the elderly (p < 0.01). Younger nurses were found to be more knowledgeable than older ones (p < 0.04). The nurses perceived nutrition as influencing different health conditions, and 85% pointed to the importance of feeding at the end of life. CONCLUSIONS: Nurses working in the community recognize the impact of proper nutrition on elderly patients' health, but need more training in screening for nutritional problems in the elderly.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica/estatística & dados numéricos , Enfermeiras e Enfermeiros/normas , Ciências da Nutrição , Adulto , Fatores Etários , Idoso , Competência Clínica/normas , Coleta de Dados , Humanos , Israel , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Inquéritos e Questionários , Adulto Jovem
3.
Infection ; 36(3): 226-30, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18454342

RESUMO

BACKGROUND: Studies showed that diabetes mellitus (DM) is often accompanied by impaired cell-mediated immunity, which potentially may increase the risk for infectious diseases, including herpes zoster (HZ). However, data on the relation between DM and HZ are scarce. This case-control study explored the association between DM and HZ. PATIENTS AND METHODS: This study was nested within a cohort of all members of a large health maintenance organization (HMO) in Israel. Cases totaled 22,294 members who were diagnosed with HZ between 2002 and 2006. Controls (n=88,895) were randomly selected from the remaining HMO population using frequency-matched age, sex, and duration of follow-up. Personal data on history of DM, lymphoma, leukemia, or AIDS, were obtained from computerized medical records. RESULTS: Adjusted analyses showed that the risk of HZ was associated with history of leukemia, lymphoma, use of steroids or antineoplastic medications, and AIDS, particularly among patients below 45 years of age. In a multivariate analysis, DM was associated with an increased risk of HZ (OR=1.53; 95% CI: 1.44-1.62). CONCLUSIONS: The data suggest that individuals with DM are at increased risk of HZ. Well-designed cohort studies may help to clarify the nature of this association.


Assuntos
Complicações do Diabetes/epidemiologia , Herpes Zoster/epidemiologia , Herpes Zoster/etiologia , Adulto , Idoso , Estudos de Casos e Controles , Complicações do Diabetes/imunologia , Feminino , Humanos , Incidência , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco
4.
Clin Immunol ; 90(1): 108-14, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9884358

RESUMO

Linomide is a synthetic immunomodulator which was shown to protect animals against a wide range of experimental autoimmune diseases. In this study we have investigated the effects of Linomide on the thymus in an effort to elucidate the mechanisms by which this immunomodulator suppresses autoimmune reactivity. Normal or adrenalectomized SJL/J mice were treated orally for 10 days with linomide (80 mg/kg/day). Thymocytes were tested by FACS for the analysis of the CD4 and CD8 markers and TCR expression on their surface. Thymuses from these animals were examined for size and cellularity and immunohistopathologically for the detection of apoptosis and for the expression of the markers CD4 and CD8. A significant reduction in the thymus size and cellularity was observed in mice treated with Linomide, starting from day 3 after treatment, accompanied by an enhanced apoptotic death of cortical thymocytes, which was first noted on day 1 of treatment and peaked on day 3. FACS analysis and immunohistochemistry revealed a significant depletion of the CD4(+)/CD8(+) (double positive) cells with a parallel relative increase of the more mature, medullar, single positive, lymphocytes. These effects on the thymus were not mediated through a corticosteroid-dependent pathway, and were also observed in adrenalectomized and Linomide-treated animals. These observations may be of importance for the clarification of the role of thymus in autoimmunity and the possible ways for immune intervention with immunomodulators like Linomide at this level.


Assuntos
Adjuvantes Imunológicos/farmacologia , Corticosteroides/fisiologia , Apoptose/efeitos dos fármacos , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD8-Positivos/efeitos dos fármacos , Hidroxiquinolinas/farmacologia , Timo/efeitos dos fármacos , Timo/patologia , Animais , Atrofia/induzido quimicamente , Autoimunidade/efeitos dos fármacos , Linfócitos T CD4-Positivos/patologia , Linfócitos T CD8-Positivos/patologia , Feminino , Camundongos , Camundongos Endogâmicos , Timo/imunologia
5.
Immunol Lett ; 63(3): 141-5, 1998 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9840682

RESUMO

Experimental autoimmune neuritis (EAN) is an animal model that shares clinical, pathological and electrophysiological features with the human disease Guillain-Barre syndrome. The synthetic immunomodulatory substance linomide has been successfully used to prevent the development of several experimental autoimmune models in laboratory animals and has been proved to be beneficial in modulating the course of multiple sclerosis in humans. In the present study we demonstrate that oral administration of linomide prevents the development of clinical and histopathological signs of EAN in Lewis rats, inoculated with the P2 (60-70) synthetic peptide. The immunomodulatory effect of linomide on this experimental model of disease was associated with marked apoptosis of lymphocytes in thymus and spleen early after starting the treatment. Furthermore, a downregulation of the endothelial expression of the adhesion molecules ICAM-1 at the target site and LFA-1 on lymphocytes could also contribute to the absence of inflammatory cells in the neuraxis.


Assuntos
Adjuvantes Imunológicos/farmacologia , Hidroxiquinolinas/farmacologia , Neurite Autoimune Experimental/imunologia , Neurite Autoimune Experimental/prevenção & controle , Animais , Apoptose , Feminino , Imuno-Histoquímica , Molécula 1 de Adesão Intercelular/análise , Antígeno-1 Associado à Função Linfocitária/análise , Linfócitos/imunologia , Proteína P2 de Mielina/síntese química , Proteína P2 de Mielina/imunologia , Neurite Autoimune Experimental/patologia , Ratos , Ratos Endogâmicos Lew , Nervo Isquiático/imunologia , Nervo Isquiático/patologia
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