A prospective study of nutrition education and oral nutritional supplementation in patients with Alzheimer's disease.

BACKGROUND: Weight loss in patients with Alzheimer's disease (AD) is a common clinical manifestation that may have clinical significance. OBJECTIVES: To evaluate if there is a difference between nutrition education and oral nutritional supplementation on nutritional status in patients with AD. METHODS: A randomized, prospective 6-month study which enrolled 90 subjects with probable AD aged 65 years or older divided into 3 groups: Control Group (CG) [n = 27], Education Group (EG) [n = 25], which participated in an education program and Supplementation Group (SG) [n = 26], which received two daily servings of oral nutritional supplementation. Subjects were assessed for anthropometric data (weight, height, BMI, TSF, AC and AMC), biochemical data (total protein, albumin, and total lymphocyte count), CDR (Clinical Dementia Rating), MMSE (Mini-mental state examination), as well as dependence during meals. RESULTS: The SG showed a significant improvement in the following anthropometric measurements: weight (H calc = 22.12, p =< 0.001), BMI (H calc = 22.12, p =< 0.001), AC (H calc = 12.99, p =< 0.002), and AMC (H calc = 8.67, p =< 0.013) compared to the CG and EG. BMI of the EG was significantly greater compared to the CG. There were significant changes in total protein (H calc = 6.17, p =< 0.046), and total lymphocyte count in the SG compared to the other groups (H cal = 7.94, p = 0.019). CONCLUSION: Oral nutritional supplementation is more effective compared to nutrition education in improving nutritional status.

The value of adenosine deaminase (ADA) determination in the diagnosis of tuberculous ascites

Com o objetivo de avaliar o papel da determinacao da atividade da enzima adenosina deaminase (ADA) no diagnostico da peritonite tuberculosa, foram estudados 44 pacientes. De acordo com os resultados das determinacoes bioquimicas, citologicas, histopatologicas e microbiologicas, os pacientes foram divididos em dois grupos: G1 - ascite tuberculosa (n=8); G2 - neoplasica (n=13); G3 - peritonite baracteriana espontanea (n=6); G4 - ascite pancreatica (n=2); G5 - miscelania (n=15). A concentracao de ADA no grupo de pacientes com peritonite tuberculosa foi de 133.50+-24.74 U/l, significantemente mais elevada que nos outros grupos (G2=41.85+-52.07; G3=10.63+-5.87; G4=18.00+-7.07; G5=11.23+-7.66). Com um limite de corte de 31 U/l, a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo para diagnostico de tuberculose foram, respectivamente 100, 92, 72 e 100 por cento...