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Tanrıverdi M, Heybeli C, Çalım ÖF, Durna M, Özturan O, Soysal P. The relationship between oropharyngeal dysphagia and dehydration in older adults. BMC Geriatr 2024; 24:885. [PMID: 39462372 PMCID: PMC11512474 DOI: 10.1186/s12877-024-05492-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 10/17/2024] [Indexed: 10/29/2024] Open
Abstract
BACKGROUND Relationship between dysphagia and dehydration has not been studied widely. The aim of this study is to determine the frequency of dysphagia and dehydration in geriatric outpatient clinic, to evaluate the relationship between these two conditions. METHODS The cross-sectional study included 1345 patients. Plasma osmolarity (Posm) was calculated using the following formula: [1.86 x (Na + K) + 1.15 x glucose + urea + 14]. Overt dehydration was defined as a calculated Posm of > 300 mmol/L. Eating Assessment Tool (EAT-10) score of ≥ 3 was accepted as dysphagia. Associations between dehydration and dysphagia was evaluated. RESULTS Mean age was 78 ± 8 years, and 71% were females. Dysphagia was observed in 27% of patients. Dysphagia was associated with a higher number of drug exposure, dependency on basic activities of daily living and geriatric depression (p < 0.05). Overt dehydration was found in 29% of patients with dysphagia, and 21% of patients with no dysphagia (p = 0.002); and dysphagia was significantly associated with overt dehydration mmol/L (OR 1.49, 95% CI 1.13-1.96, p = 0.005) after adjustments for age and sex. In another model, EAT-10 score was found as one of the independent predictors of overt dehydration (OR1.03, 95% CI 1.00-1.06, p = 0.38), along with diabetes mellitus (OR 2.32, 95% CI 1.72-3.15, p < 0.001), chronic kidney disease (OR 3.05, 95% CI 2.24-4.15, p < 0.001), and MNA score (OR 0.97, 95% CI 0.94-1.00, p = 0.031). CONCLUSION EAT-10 scale was independently associated with overt dehydration among older adults, as MNA score was. Correction of both dysphagia and malnutrition might improve overt dehydration to a better extent than correction either of these factors alone. Future studies are needed to test cause and effect relationships.
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Affiliation(s)
- Müberra Tanrıverdi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
| | - Cihan Heybeli
- Division of Nephrology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ömer Faruk Çalım
- Department of Otolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Merve Durna
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Orhan Özturan
- Department of Otolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
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Pisos-Álamo E, Hernández-Cabrera M, López-Delgado L, Jaén-Sánchez N, Betancort-Plata C, Lavilla Salgado C, Suárez-Hormiga L, Briega-Molina M, Carranza-Rodríguez C, Bolaños-Rivero M, Hernández-Betancor A, Pérez-Arellano JL. 'Patera syndrome' during the COVID-19 pandemic in the Canary Islands (Spain). PLoS One 2024; 19:e0312355. [PMID: 39446793 PMCID: PMC11500946 DOI: 10.1371/journal.pone.0312355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 10/05/2024] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND The number of migrants arriving on the shores of the Canary Islands continues to increase. The conditions under which the crossing is made, in small crowded, unsanitary boats (pateras or cayucos), have many and significant health problems. OBJECTIVE To describe the demographic, clinical, microbiological characteristics and evolution of a series of patients who recently arrived by patera and required hospitalization. PATIENTS AND METHODS This observational, cross-sectional, and retrospective study included all patients newly arrived in Gran Canaria (Spain) by patera or cayuco from 2020 to 2022. Acute patera syndrome (APS) was defined as one or more of the following: dehydration, hypothermia, shock or rhabdomyolysis. Skin and soft tissue or musculoskeletal patera syndrome (SSTMSPS) was defined as conditions characterized by lesions of the skin, subcutaneous tissue, bone, or joint, excluding superficial erosions. RESULTS During the study period, 193 migrants were admitted, mostly males with a median age of 23 years from West Africa. A total of 36.99% presented with APS with a single diagnostic criterion (most commonly dehydration, 86.9%), 11.56% with SSTMPS and 51.44% with both syndromes. A total of 109 patients presented with SSTMSPS, the most common being lower extremity ulcers. The most frequently isolated microorganisms were gram-negative (i.e. Shewanella algae). The McMahon score effectively predicted the need for renal replacement therapy in cases of rhabdomyolysis. Twenty patients presented with pneumomediastinum, which was benign. SARS-CoV-2 infection was not a problem in any of them. Surgical intervention was required in 22% of cases, including 8 amputations, all of which were minor. No patient died during admission. CONCLUSION Patera syndrome has specific characteristics that should be identified promptly to initiate the most effective treatment for optimal outcomes.
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Affiliation(s)
- Elena Pisos-Álamo
- Unit of Infectious Diseases and Tropical Medicine, University Insular Hospital of Gran Canaria and Department of Medical & Surgical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Michele Hernández-Cabrera
- Unit of Infectious Diseases and Tropical Medicine, University Insular Hospital of Gran Canaria and Department of Medical & Surgical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Laura López-Delgado
- Unit of Infectious Diseases and Tropical Medicine, University Insular Hospital of Gran Canaria and Department of Medical & Surgical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Nieves Jaén-Sánchez
- Unit of Infectious Diseases and Tropical Medicine, University Insular Hospital of Gran Canaria and Department of Medical & Surgical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Christian Betancort-Plata
- Unit of Infectious Diseases and Tropical Medicine, University Insular Hospital of Gran Canaria and Department of Medical & Surgical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Carmen Lavilla Salgado
- Unit of Infectious Diseases and Tropical Medicine, University Insular Hospital of Gran Canaria and Department of Medical & Surgical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Laura Suárez-Hormiga
- Unit of Infectious Diseases and Tropical Medicine, University Insular Hospital of Gran Canaria and Department of Medical & Surgical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Marta Briega-Molina
- Unit of Infectious Diseases and Tropical Medicine, University Insular Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Cristina Carranza-Rodríguez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Margarita Bolaños-Rivero
- Microbiology and Parasitology Service, University Insular Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Araceli Hernández-Betancor
- Microbiology and Parasitology Service, University Insular Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - José-Luis Pérez-Arellano
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Soós R, Bakó C, Gyebrovszki Á, Gordos M, Csala D, Ádám Z, Wilhelm M. Nutritional Habits of Hungarian Older Adults. Nutrients 2024; 16:1203. [PMID: 38674893 PMCID: PMC11053580 DOI: 10.3390/nu16081203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
There are many nutritional changes that come with aging, mostly as consequences of health regression. Malnutrition and overweight often start with inadequate food consumption, followed by alterations in biochemical indices and body composition. In our study, we aimed to analyze the feeding habits and energy and nutrient intake of a Hungarian elderly population, focusing on macronutrient, water, fruit, and vegetable consumption while searching for possible nutritional factors leading to NCD and many other chronic diseases in this population. Two questionnaires were used. These were the Mini Nutritional Assessment (MNA) and one asking about nutritional habits, and a 3-day feeding diary was also filled. Subjects (n = 179, 111; females (F), 68 males (M), older than 50 years were recruited. Based on MNA results, 78 adults (43.57% of the studied population) were malnourished or at risk of malnutrition, although, according to BMI categories, 69% were overweight and 7.3% were obese among M, while 42.3% were overweight among F. The average daily meal number was diverse. The amount of people consuming fruit (11.7%) and vegetables (8.93%) several times a day was extremely low (15.3% of F and 4.4% of M). Daily fruit consumption in the whole sample was 79.3%. Overall, 36.3% consumed 1 L of liquid and 0.5 L of consumption was found in 15.1% of participants. A significant gender difference was found in water consumption, with F drinking more than M (p ≤ 0.01). In our sample, 27.93% of the respondents took dietary supplements. Further analysis and research are needed to explore the specific health implications of and reasons behind these findings.
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Affiliation(s)
- Rita Soós
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
| | - Csilla Bakó
- Institute of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary;
| | - Ádám Gyebrovszki
- Doctoral School of Biology and Sportbiology, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary; (Á.G.); (D.C.)
| | - Mónika Gordos
- Doctoral School of Biology and Sportbiology, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary; (Á.G.); (D.C.)
| | - Dávid Csala
- Doctoral School of Biology and Sportbiology, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary; (Á.G.); (D.C.)
| | - Zoltán Ádám
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, University of Pécs, 7624 Pécs, Hungary;
- Wnt-Signaling Research Group, Szentagothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Márta Wilhelm
- Institute of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary;
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Van Wicklin SA. Fundamentals of Plastic and Aesthetic Nursing: Postoperative Management of Older Adult Patients Undergoing Plastic Surgical Procedures. Pediatr Phys Ther 2024; 44:99-115. [PMID: 38639967 DOI: 10.1097/psn.0000000000000561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Affiliation(s)
- Sharon Ann Van Wicklin
- Sharon Ann Van Wicklin, PhD, RN, CNOR, CRNFA(E), CPSN-R, PLNC, ISPAN-F, FAORN, FAAN, is Editor in Chief, Plastic and Aesthetic Nursing, and is a Perioperative and Legal Nurse Consultant, Aurora, CO
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Tian M, Qian Z, Long Y, Yu F, Yuan J, Zha Y. Decreased Intracellular to Total Body Water Ratio and Depressive Symptoms in Patients with Maintenance Hemodialysis. Psychol Res Behav Manag 2023; 16:4367-4376. [PMID: 37908680 PMCID: PMC10615096 DOI: 10.2147/prbm.s436574] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/11/2023] [Indexed: 11/02/2023] Open
Abstract
Objective Depression is a common psychiatric disorder and related to poor outcomes in patients undergoing maintenance hemodialysis (MHD). Previous studies have reported some associations between sarcopenia and depressive symptoms. Recently, intracellular water (ICW) and total body water (TBW) have been found to reflect muscle function and muscle mass. ICW/TBW ratio is a marker of sarcopenia that is simple to assess. However, the relationship between ICW/TBW ratio and depression has not been explored in MHD patients. Methods In our cross-sectional and multi-center study, 3300 adult MHD patients were included from June 1, 2021, to August 30, 2021. Depressive symptoms were evaluated using the Beck Depression Inventory-II (BDI-II). TBW and ICW were measured by Body Composition Monitor (BCM). Multivariable logistic regression, stratified analyses, and interactive analyses were conducted to assess the relationship between ICW/TBW ratio and depression. Results About 16.5% of the 3300 MHD patients were found to have depressive symptoms. The prevalence of depression increased with decreasing quartiles of ICW/TBW ratios, and decreased ICW/TBW ratio was independently associated with depression after adjusting for potential confounders. Patients in Quartile 1 of ICW/TBW ratios were more likely to have depressive symptoms (odds ratio 1.55, 95% confidence interval 1.07-2.22; p=0.002) than those in Quartile 4. History of diabetes and education status had interactive roles in the relationship between depression and ICW/TBW ratios (p < 0.05). The association of ICW/TBW ratios and depression existed in patients of both genders and different education levels, but only in non-diabetic patients. Conclusion In MHD patients, the decreased ratio of ICW/TBW was independently related to high depression rates.
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Affiliation(s)
- Maolu Tian
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
- Medical College, Guizhou University, Guiyang, Guizhou, People’s Republic of China
| | - Zuping Qian
- Clinical Medical College, Zunyi Medical University, Zunyi, Guizhou, People’s Republic of China
| | - Yanjun Long
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Fangfang Yu
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Jing Yuan
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Yan Zha
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
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Hoen L, Pfeffer D, Schmidt JR, Kraft J, Hildebrand J, Kalkhof S. Hydration Status of Geriatric Patients Is Associated with Changes in Plasma Proteome, Especially in Proteins Involved in Coagulation. Nutrients 2023; 15:3789. [PMID: 37686821 PMCID: PMC10490147 DOI: 10.3390/nu15173789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 09/10/2023] Open
Abstract
Due to multifactorial reasons, such as decreased thirst and decreased total body water, elderly patients are vulnerable to dehydration. The study aims to investigate whether moderate dehydration or hyperhydration affects the blood proteome. Blood samples, medication, and bioelectrical impedance analysis (BIA) details were collected from 131 geriatric patients (77 women and 54 men aged 81.1 ± 7.2 years). Based on an evaluation by Bioelectrical Impedance Vector Analyses (BIVAs) of this cohort, for each hydration status (dehydrated, hyperhydrated, and control), five appropriate blood plasma samples for both males and females were analyzed by liquid chromatography-mass spectrometry (LC-MS). Overall, 262 proteins for female patients and 293 proteins for male patients could be quantified. A total of 38 proteins had significantly different abundance, showing that hydration status does indeed affect the plasma proteome. Protein enrichment analysis of the affected proteins revealed "Wound Healing" and "Keratinization" as the two main biological processes being dysregulated. Proteins involved in clot formation are especially affected by hydration status.
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Affiliation(s)
- Laura Hoen
- Institute for Bioanalysis, Coburg University of Applied Sciences and Arts, Friedrich-Streib-Str. 2, 96450 Coburg, Germany
| | - Daniel Pfeffer
- Institute for Bioanalysis, Coburg University of Applied Sciences and Arts, Friedrich-Streib-Str. 2, 96450 Coburg, Germany
- Division of Geriatrics, Klinikum Coburg GmbH, 96450 Coburg, Germany
| | - Johannes R. Schmidt
- Proteomics Unit, Department of Preclinical Development and Validation, Fraunhofer Institute for Cell Therapy and Immunology—IZI, Perlickstr. 1, 04103 Leipzig, Germany
| | - Johannes Kraft
- Division of Geriatrics, Klinikum Coburg GmbH, 96450 Coburg, Germany
| | - Janosch Hildebrand
- Institute for Bioanalysis, Coburg University of Applied Sciences and Arts, Friedrich-Streib-Str. 2, 96450 Coburg, Germany
| | - Stefan Kalkhof
- Institute for Bioanalysis, Coburg University of Applied Sciences and Arts, Friedrich-Streib-Str. 2, 96450 Coburg, Germany
- Proteomics Unit, Department of Preclinical Development and Validation, Fraunhofer Institute for Cell Therapy and Immunology—IZI, Perlickstr. 1, 04103 Leipzig, Germany
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Sanghavi F, Jinadu O, Oludare V, Panetta K, Kezebou L, Roberts SB. An Individualized Machine Learning Approach for Human Body Weight Estimation Using Smart Shoe Insoles. SENSORS (BASEL, SWITZERLAND) 2023; 23:7418. [PMID: 37687875 PMCID: PMC10490636 DOI: 10.3390/s23177418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023]
Abstract
Rapid significant weight fluctuations can indicate severe health conditions such as edema due to congestive heart failure or severe dehydration that could require prompt intervention. Daily body weighing does not accurately represent the patient's body weight fluctuations occurring within a day. The patient's lack of compliance with tracking their weight measurements is also a predominant issue. Using shoe insole sensors embedded into footwear could achieve accurate real-time monitoring systems for estimating continuous body weight changes. Here, the machine learning models' predictive capabilities for continuous real-time weight estimation using the insole data are presented. The lack of availability of public datasets to feed these models is also addressed by introducing two novel datasets. The proposed framework is designed to adapt to the patient, considering several unique factors such as shoe type, posture, foot shape, and gait pattern. The proposed framework estimates the mean absolute percentage error of 0.61% and 0.74% and the MAE of 1.009 lbs. and 1.154 lbs. for the less controlled and more controlled experimental settings, respectively. This will help researchers utilize machine learning techniques for more accurate real-time continuous weight estimation using sensor data and enable more reliable aging-in-place monitoring and telehealth.
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Affiliation(s)
- Foram Sanghavi
- Department of Electrical and Computer Engineering, Tufts University, Medford, MA 02155, USA; (O.J.); (K.P.)
| | - Obafemi Jinadu
- Department of Electrical and Computer Engineering, Tufts University, Medford, MA 02155, USA; (O.J.); (K.P.)
| | - Victor Oludare
- Department of Electrical and Computer Engineering, Tufts University, Medford, MA 02155, USA; (O.J.); (K.P.)
| | - Karen Panetta
- Department of Electrical and Computer Engineering, Tufts University, Medford, MA 02155, USA; (O.J.); (K.P.)
| | - Landry Kezebou
- Department of Electrical and Computer Engineering, Tufts University, Medford, MA 02155, USA; (O.J.); (K.P.)
| | - Susan B. Roberts
- Friedman School of Nutrition Science and Policy, Tufts University, Medford, MA 02155, USA;
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Gray M, Birkenfeld JS, Butterworth I. Noninvasive Monitoring to Detect Dehydration: Are We There Yet? Annu Rev Biomed Eng 2023; 25:23-49. [PMID: 36854261 DOI: 10.1146/annurev-bioeng-062117-121028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
The need for hydration monitoring is significant, especially for the very young and elderly populations who are more vulnerable to becoming dehydrated and suffering from the effects that dehydration brings. This need has been among the drivers of considerable effort in the academic and commercial sectors to provide a means for monitoring hydration status, with a special interest in doing so outside the hospital or clinical setting. This review of emerging technologies provides an overview of many technology approaches that, on a theoretical basis, have sensitivity to water and are feasible as a routine measurement. We review the evidence of technical validation and of their use in humans. Finally, we highlight the essential need for these technologies to be rigorously evaluated for their diagnostic potential, as a necessary step to meet the need for hydration monitoring outside of the clinical environment.
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Affiliation(s)
- Martha Gray
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA;
- MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Judith S Birkenfeld
- MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas, Madrid, Spain;
| | - Ian Butterworth
- MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Leuko Labs Inc., Boston, Massachusetts, USA
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Bogari MH, Munshi A, Almuntashiri S, Bogari A, Abdullah AS, Albadri M, Hashim A, AlZahrani MS. Acute gastroenteritis-related acute kidney injury in a tertiary care center. Ann Saudi Med 2023; 43:82-89. [PMID: 37031372 PMCID: PMC10082947 DOI: 10.5144/0256-4947.2023.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2023] Open
Abstract
BACKGROUND Acute gastroenteritis (AGE) can cause acute kidney injury (AKI) via hypoperfusion mechanisms. Early detection of AKI caused by AGE can significantly decrease mortality rates. In Saudi Arabia, studies investigating the association between AGE and AKI are limited; thus, we aimed to fill this knowledge gap. OBJECTIVES Analyze all cases of AGE reported in tertiary-care hospitals to assess the prevalence of AKI among AGE patients. DESIGN Retrospective cohort SETTINGS: Single tertiary-care center PATIENTS AND METHODS: The study included patients treated for AGE between October 2017 and October 2022. Stool culture was used to diagnose AGE. Inclusion criteria were infective diarrhea and/ or vomiting, and availability of data (demographics, comorbidities, malignancies, length of hospital stay, vital signs at the time of diagnosis, dehydration, causative agents of diarrhea, hemodialysis status, and laboratory data. MAIN OUTCOME MEASURES Prevalence of AKI among AGE patients and factors associated with development of AKI. SAMPLE SIZE 300 patients diagnosed with AGE. RESULTS Of the 300 patients with AGE, 41 (13.6%) had AKI, those older than 60 years were more likely to develop AKI. The most frequent cause of AGE was Salmonella spp. (n=163, 53.3%), whereas AKI was most common in Clostridium difficile AGE patients (n=21, 51.2%). Furthermore, the most common comorbidity in the present study was malignancy, especially leukemia and lymphoma the risk of AKI was independently associated with mild dehydration, higher serum urea concentrations and low GFR values. CONCLUSIONS Patients hospitalized for diarrheal disease are at an increased risk of developing AKI due to dehydration and comorbid conditions. It is crucial to keep kidney function in mind for AGE patients as this is associated with a high mortality rate and poor prognosis. LIMITATIONS The main limitation of this study was its retrospective design. Another limitation is that it is limited to a single center. CONFLICTS OF INTEREST None.
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Affiliation(s)
- Mohammed Hisham Bogari
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Adeeb Munshi
- From the Department of Infectious Diseases, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Saleh Almuntashiri
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Asim Bogari
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdullah Shaker Abdullah
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mohammed Albadri
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ameer Hashim
- From the Department of Internal Medicine, Makkah Al-Mukarramah Region General Directorate of Health Affairs, Makkah, Saudi Arabia
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Turner SG, Jarrott SE, Katz B. Intergenerational Programming Increases Solid Food Consumption for Adult Day Center Attendees. J Appl Gerontol 2023; 42:160-169. [PMID: 36255041 DOI: 10.1177/07334648221134179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
We examined whether participation in intergenerational programming would impact daily food and liquid intake for adult day service center (ADSC) participants, many of whom are at risk for malnutrition and dehydration. Data came from 75 ADSC participants who, on average, attended the center for 472.32 days between 2007 and 2018. We analyzed daily data using multilevel modeling, nesting attending days within ADSC participants. On days when participants joined intergenerational programming, they consumed significantly more solid food (β = 1.54, SD = .37, p < .001), but no different liquid (β = -.16, SD = .09, p = .06), than their own average across all days they attended the ADSC. Intergenerational programming may be an effective way to support ADSCs participants' nutrition. Future research is needed to determine the longer-term health benefits of daily increases in food consumption and to explore why intergenerational programming may differentially impact eating and drinking.
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Affiliation(s)
- Shelbie G Turner
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Shannon E Jarrott
- College of Social Work, 2647The Ohio State University, Columbus, OH, USA
| | - Benjamin Katz
- College of Liberal Arts and Human Sciences, 1757Virginia Tech, Blacksburg, VA, USA
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Urinary Hydration Biomarkers and Water Sources in Older Adults with Neurocognitive Disorder. Nutrients 2023; 15:nu15030548. [PMID: 36771256 PMCID: PMC9921382 DOI: 10.3390/nu15030548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
The risk of dehydration in older adults with neurocognitive disorder (NCD) is controversial. The purpose of this study was to assess hydration status, its determinants, and water intake sources in older adults with NCD. A sample of 30 participants (≥60 years) was included. Sociodemographic, clinical data and one 24-h urine sample were collected. Urinary osmolality, sodium, potassium, volume, and creatinine were quantified. Inadequate hydration status corresponded to urine osmolality > 500 mOsm/Kg, or a negative Free Water Reserve (FWR). Two 24-h food recalls were used to assess dietary intake and water sources. The adequacy of total water intake (TWI) was estimated according to EFSA. The contribution of food and beverages to TWI was calculated, and their associations with the urinary osmolality median were tested. Of the total number of participants, 30% were classified as having inadequate hydration status, with no differences between sexes. Regarding TWI, 68.4% of women and 77.8% of men did not reach the reference values. Water (23%), followed by soup (17%), contributed the most to TWI, while vegetables (2%) and alcoholic/other beverages (3%) contributed the least. According to the median urinary osmolality, there was no significant difference in sociodemographic/clinical characteristics. It is critical not to overlook hydration in this vulnerable population.
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Zhang J, Ren Z, Zhang Q, Zhang R, Zhang C, Liu J. Lower hydration status increased diabetic retinopathy among middle-aged adults and older adults: Results from NHANES 2005-2008. Front Public Health 2022; 10:1023747. [PMID: 36388275 PMCID: PMC9643860 DOI: 10.3389/fpubh.2022.1023747] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/10/2022] [Indexed: 01/28/2023] Open
Abstract
Background Diabetic retinopathy (DR) is a common complication of diabetic patients. Retinal physiological function is affected by hydration status. We aimed to explore the association between hydration status and DR. Methods National Health and Nutrition Examination Survey (NHANES) 2005-2008 was used to perform this cross-sectional study. Serum osmolality was used to assess hydration status for all participants and calculated osmolality was evaluated for only older people. DR and its severity were evaluated and graded into mild non-proliferative retinopathy, moderate/severe non-proliferative retinopathy, and proliferative diabetic retinopathy by the Early Treatment for Diabetic Retinopathy Study protocol and NHANES Digital Grading Protocol. Fully adjusted multivariable logistic regression models were used by SAS OnDemand for Academics. Results Among the 5,220 United States adults aged 40 or older, compared with the lowest osmolality group, participants with the highest quartile of serum osmolarity had higher odds of DR (OR: 1.371, 95% CI: 1.001-1.876). For participants with DR, the adjusted OR (95 % CI) of moderate/severe non-proliferative retinopathy and proliferative diabetic retinopathy in the higher serum osmolarity group was 2.119 (1.200-3.741) and 7.001 (3.175-15.438), respectively. Furthermore, in older people, higher calculated osmolarity was significantly associated with increased occurrence of DR (OR: 2.039, 95% CI: 1.305-3.186). Conclusions Adults with lower hydration status had higher risk of DR, moderate/severe non-proliferative retinopathy, and proliferative diabetic retinopathy. Dehydration in older adults, classified by calculated osmolality, is associated with a higher rate of DR. There was consistent trend in the results between the two methods.
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Affiliation(s)
- Jiayu Zhang
- Department of Nutrition, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Ziyang Ren
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Qiang Zhang
- Department of Nutrition, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Rui Zhang
- Department of Nutrition, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Chunmei Zhang
- Department of Nutrition, Beijing Luhe Hospital, Capital Medical University, Beijing, China,*Correspondence: Chunmei Zhang
| | - Jufen Liu
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China,Jufen Liu
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Çetin P, Eşer I. Effect of an Audible Alarm on the Fluid Consumption of Older Adults Living in a Nursing Home: A Randomized Controlled Trial. J Gerontol Nurs 2022; 48:39-46. [PMID: 36007210 DOI: 10.3928/00989134-20220808-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of the current study was to investigate the effect of an audible alarm on fluid consumption among older adults living in a nursing home. This single-blind, randomized controlled, prospective experimental study was performed between July 27, 2017, and February 1, 2018. This study comprised 100 participants (intervention group, n = 50; control group, n = 50). The amount of fluid consumed by older adults in the intervention group in relation to the audible alarm increased significantly compared to the control group, and the deficiency of fluid consumption decreased. It was determined that the wristwatch with audible alarm was effective when used as a reminder to increase fluid consumption among older adults with fluid deficiency. [Journal of Gerontological Nursing, 48(9), 39-46.].
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The relationship between ocular and oral dryness in a cohort from the 65-year-old population in Norway. Sci Rep 2022; 12:9805. [PMID: 35697848 PMCID: PMC9191758 DOI: 10.1038/s41598-022-13985-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
In the present study, the relationship between dry eyes and dry mouth was explored in 150 65-year-old subjects randomly selected from the general population in Oslo, Norway. The number of drugs, including xerogenic drugs, and current and previous systemic diseases were recorded. Ocular parameters recorded were the McMonnies Dry Eye Questionnaire, the Ocular Surface Disease Index, the Schirmer I Test, tear film break-up time and ocular surface staining. The oral parameters were xerostomia frequency, Summated Xerostomia Inventory, Clinical Oral Dryness Score, and unstimulated and stimulated whole saliva. The participants with current or previous systemic diseases had significantly more ocular and oral symptoms and significantly more oral clinical findings than the participants without a history of disease. Moreover, correlation and factor analyses demonstrated an association between subjective ocular and oral parameters. A significant correlation between the total number of drugs and the presence of ocular and oral symptoms was also noted. When the participants were categorized based on their ocular symptoms, poorer values were found for the oral parameters among the participants more troubled with dry eyes. The results in the present study call for increased awareness and an interdisciplinary approach in matters related to dry eyes and dry mouth.
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Rauf S, Achmad I, Lestaluhu SA. WATER SUPPLEMENTATION AFFECTS THE FLUID INTAKE AND SERUM LEVELS OF BDNF AMONG THE ELDERLY IN NURSING HOME. Nutrition 2022; 101:111700. [DOI: 10.1016/j.nut.2022.111700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/29/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
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An On-Device Learning System for Estimating Liquid Consumption from Consumer-Grade Water Bottles and Its Evaluation. SENSORS 2022; 22:s22072514. [PMID: 35408129 PMCID: PMC9003493 DOI: 10.3390/s22072514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 12/10/2022]
Abstract
A lightweight on-device liquid consumption estimation system involving an energy-aware machine learning algorithm is developed in this work. This system consists of two separate on-device neural network models that carry out liquid consumption estimation with the result of two tasks: the detection of sip from gestures with which the bottle is handled by its user and the detection of first sips after a bottle refill. This predictive volume estimation framework incorporates a self-correction mechanism that can minimize the error after each bottle fill-up cycle, which makes the system robust to errors from the sip classification module. In this paper, a detailed characterization of sip detection is performed to understand the accuracy-complexity tradeoffs by developing and implementing a variety of different ML models with varying complexities. The maximum energy consumed by the entire framework is around 119 mJ during a maximum computation time of 300 μs. The energy consumption and computation times of the proposed framework is suitable for implementation in low-power embedded hardware that can be incorporated in consumer grade water bottles.
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Osmotic Stress Interferes with DNA Damage Response and H2AX Phosphorylation in Human Keratinocytes. Cells 2022; 11:cells11060959. [PMID: 35326410 PMCID: PMC8946833 DOI: 10.3390/cells11060959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 12/07/2022] Open
Abstract
The human skin and in particular its outermost layer, the epidermis, protects the body from potentially harmful substances, radiation as well as excessive water loss. However, the interference between the various stress responses of the epidermal keratinocytes, which often occur simultaneously, is largely unknown. The focus of this study was to investigate the interference between osmotic stress and DNA damage response. In addition to revealing the already well-described regulation of diverse gene sets, for example, cellular processes such as transcription, translation, and metabolic pathways (e.g., the KEGG citrate cycle and Reactome G2/M checkpoints), gene expression analysis of osmotically stressed keratinocytes revealed an influence on the transcription of genes also related to UV-induced DNA damage response. A gene network regulating the H2AX phosphorylation was identified to be regulated by osmotic stress. To analyze and test the interference between osmotic stress and DNA damage response, which can be triggered by UV stress on the one hand and oxidative stress on the other, in more detail, primary human keratinocytes were cultured under osmotic stress conditions and subsequently exposed to UV light and H2O2, respectively. γH2AX measurements revealed lower γH2AX levels in cells previously cultured under osmotic stress conditions.
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18
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do Nascimento NC, Dos Santos AP, Mohallem R, Aryal UK, Xie J, Cox A, Sivasankar MP. Furosemide-induced systemic dehydration alters the proteome of rabbit vocal folds. J Proteomics 2022; 252:104431. [PMID: 34823036 DOI: 10.1016/j.jprot.2021.104431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 12/15/2022]
Abstract
Whole-body dehydration (i.e., systemic dehydration) leads to vocal fold tissue dehydration. Furosemide, a common diuretic prescribed to treat hypertension and edema-associated conditions, induces systemic dehydration. Furosemide also causes voice changes in human speakers, making this method of systemic dehydration particularly interesting for vocal fold dehydration studies. Our objective was to obtain a comprehensive proteome of vocal folds following furosemide-induced systemic dehydration. New Zealand White rabbits were used as the animal model and randomly assigned to euhydrated (control) or furosemide-dehydrated groups. Systemic dehydration, induced by injectable furosemide, was verified by an average body weight loss of -5.5% and significant percentage changes in blood analytes in the dehydrated rabbits compared to controls. Vocal fold specimens, including mucosa and muscle, were processed for proteomic analysis using label-free quantitation LC-MS/MS. Over 1600 proteins were successfully identified across all vocal fold samples; and associated with a variety of cellular components and ubiquitous cell functions. Protein levels were compared between groups showing 32 proteins differentially regulated (p ≤ 0.05) in the dehydrated vocal folds. These are mainly involved with mitochondrial translation and metabolism. The downregulation of proteins involved in mitochondrial metabolism in the vocal folds suggests a mechanism to prevent oxidative stress associated with systemic dehydration. SIGNIFICANCE: Voice disorders affect different population demographics worldwide with one in 13 adults in the United States reporting voice problems annually. Vocal fold systemic hydration is clinically recognized for preventing and treating voice problems and depends on optimal body hydration primarily achieved by water intake. Herein, we use the rabbit as a translatable animal model, and furosemide as a translatable method of systemic dehydration, to reveal a comprehensive proteomic profile of vocal fold mucosa and muscle in response to systemic dehydration. The significant subset of proteins differentially regulated due to furosemide-induced dehydration offer novel insights into the molecular mechanisms of systemic dehydration in the vocal folds. These findings also deepen our understanding of changes to tissue biology after diuretic administration.
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Affiliation(s)
- Naila Cannes do Nascimento
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette 47907, IN, United States.
| | - Andrea Pires Dos Santos
- Department of Comparative Pathobiology, Purdue University, West Lafayette 47907, IN, United States
| | - Rodrigo Mohallem
- Department of Comparative Pathobiology, Purdue University, West Lafayette 47907, IN, United States; Purdue Proteomics Facility, Bindley Bioscience Center, Discovery Park, Purdue University, West Lafayette 47907, IN, United States
| | - Uma K Aryal
- Department of Comparative Pathobiology, Purdue University, West Lafayette 47907, IN, United States; Purdue Proteomics Facility, Bindley Bioscience Center, Discovery Park, Purdue University, West Lafayette 47907, IN, United States
| | - Jun Xie
- Department of Statistics, Purdue University, West Lafayette 47907, IN, United States
| | - Abigail Cox
- Department of Comparative Pathobiology, Purdue University, West Lafayette 47907, IN, United States
| | - M Preeti Sivasankar
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette 47907, IN, United States
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Shaban M, Mohammed H, Hassan S. Role of community health nurse in the prevention of elderly dehydration: A mini-review. JOURNAL OF INTEGRATIVE NURSING 2022. [DOI: 10.4103/jin.jin_36_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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20
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Lehmann F, Schenk LM, Bernstock JD, Bode C, Borger V, Gessler F, Güresir E, Hamed M, Potthoff AL, Putensen C, Schneider M, Zimmermann J, Vatter H, Schuss P, Hadjiathanasiou A. Admission Dehydration Status Portends Adverse Short-Term Mortality in Patients with Spontaneous Intracerebral Hemorrhage. J Clin Med 2021; 10:jcm10245939. [PMID: 34945232 PMCID: PMC8708142 DOI: 10.3390/jcm10245939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 01/25/2023] Open
Abstract
The impact of dehydration at admission of patients with spontaneous intracerebral hemorrhage (ICH) on short-term mortality remains ambiguous due to scarce data. All of the consecutive patients with spontaneous ICH, who were referred to our neurovascular center in 2018/19, were assessed for hydration status on admission. Dehydration was defined by a blood urea-to-creatinine ratio > 80. In a cohort of 249 patients, 76 patients (31%) were dehydrated at the time of admission. The following factors were significantly and independently associated with increased 30-day mortality in multivariate analysis: “signs of cerebral herniation” (p = 0.008), “initial midline shift > 5 mm” (p < 0.001), “ICH score > 3” (p = 0.007), and “admission dehydration status” (p = 0.007). The results of the present study suggest that an admission dehydration status might constitute a significant and independent predictor of short-term mortality in patients with spontaneous ICH.
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Affiliation(s)
- Felix Lehmann
- Department of Anesthesiology and Intensive Care, University Hospital Bonn, 53127 Bonn, Germany; (C.B.); (C.P.)
- Correspondence: ; Tel.: +49-228-287-14119
| | - Lorena M. Schenk
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany; (L.M.S.); (V.B.); (E.G.); (M.H.); (A.-L.P.); (M.S.); (H.V.); (P.S.); (A.H.)
| | - Joshua D. Bernstock
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Christian Bode
- Department of Anesthesiology and Intensive Care, University Hospital Bonn, 53127 Bonn, Germany; (C.B.); (C.P.)
| | - Valeri Borger
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany; (L.M.S.); (V.B.); (E.G.); (M.H.); (A.-L.P.); (M.S.); (H.V.); (P.S.); (A.H.)
| | - Florian Gessler
- Department of Neurosurgery, University Hospital Rostock, 18055 Rostock, Germany;
| | - Erdem Güresir
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany; (L.M.S.); (V.B.); (E.G.); (M.H.); (A.-L.P.); (M.S.); (H.V.); (P.S.); (A.H.)
| | - Motaz Hamed
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany; (L.M.S.); (V.B.); (E.G.); (M.H.); (A.-L.P.); (M.S.); (H.V.); (P.S.); (A.H.)
| | - Anna-Laura Potthoff
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany; (L.M.S.); (V.B.); (E.G.); (M.H.); (A.-L.P.); (M.S.); (H.V.); (P.S.); (A.H.)
| | - Christian Putensen
- Department of Anesthesiology and Intensive Care, University Hospital Bonn, 53127 Bonn, Germany; (C.B.); (C.P.)
| | - Matthias Schneider
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany; (L.M.S.); (V.B.); (E.G.); (M.H.); (A.-L.P.); (M.S.); (H.V.); (P.S.); (A.H.)
| | - Julian Zimmermann
- Department of Neurology, University Hospital Bonn, 53127 Bonn, Germany;
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany; (L.M.S.); (V.B.); (E.G.); (M.H.); (A.-L.P.); (M.S.); (H.V.); (P.S.); (A.H.)
| | - Patrick Schuss
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany; (L.M.S.); (V.B.); (E.G.); (M.H.); (A.-L.P.); (M.S.); (H.V.); (P.S.); (A.H.)
| | - Alexis Hadjiathanasiou
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany; (L.M.S.); (V.B.); (E.G.); (M.H.); (A.-L.P.); (M.S.); (H.V.); (P.S.); (A.H.)
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21
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Lee JA, Qu K, Gainey M, Kanekar SS, Barry MA, Nasrin S, Alam NH, Schmid CH, Levine AC. Continuous diagnostic models for volume deficit in patients with acute diarrhea. Trop Med Health 2021; 49:70. [PMID: 34488910 PMCID: PMC8422628 DOI: 10.1186/s41182-021-00361-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/27/2021] [Indexed: 12/30/2022] Open
Abstract
Background Episodes of acute diarrhea lead to dehydration, and existing care algorithms base treatment around categorical estimates for fluid resuscitation. This study aims to develop models for the percentage dehydration (fluid deficit) in individuals with acute diarrhea, to better target treatment and avoid the potential sequelae of over or under resuscitation.
Methods This study utilizes data from two prospective cohort studies of patients with acute diarrhea in Dhaka, Bangladesh. Data were collected on patient arrival, including weight, clinical signs and symptoms, and demographic information. Consecutive weights were obtained to determine the true volume deficit of each patient. Data were entered into two distinct forward stepwise regression logistic models (DHAKA for under 5 years and NIRUDAK for 5 years and over). Results A total of 782 patients were included in the final analysis of the DHAKA data set, and 2139 were included in the final analysis of the NIRUDAK data set. The best model for the DHAKA data achieved an R2 of 0.27 and a root mean square error (RMSE) of 3.7 (compared to R2 of 0.06 and RMSE of 5.5 with the World Health Organization child care algorithm) and selected 6 predictors. The best performance model for the NIRUDAK data achieved an R2 of 0.28 and a RMSE of 2.6 (compared to R2 of 0.08 and RMSE of 4.3 with the World Health Organization adolescent/adult care algorithm) and selected 7 predictors with 2 interactions. Conclusions These are the first mathematical models for patients with acute diarrhea that allow for the calculation of a patient’s percentage dehydration (fluid deficit) and subsequent targeted treatment with fluid resuscitation. These findings are an improvement on existing World Health Organization care algorithms. Supplementary Information The online version contains supplementary material available at 10.1186/s41182-021-00361-9.
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Affiliation(s)
- J Austin Lee
- Department of Emergency Medicine, Warren Alpert Medical School, Brown University, 55 Claverick Street, Providence, RI, 02903, USA.
| | - Kexin Qu
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
| | | | | | - Meagan A Barry
- Department of Emergency Medicine, Warren Alpert Medical School, Brown University, 55 Claverick Street, Providence, RI, 02903, USA
| | - Sabiha Nasrin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nur H Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Christopher H Schmid
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
| | - Adam C Levine
- Department of Emergency Medicine, Warren Alpert Medical School, Brown University, 55 Claverick Street, Providence, RI, 02903, USA
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Mullins RM, Mohamed N, Brock AT, Wilhelms KW. Unexpectedly Abnormal Electrolytes in a 60 Year Old Man with Dementia. Lab Med 2021; 53:e14-e18. [PMID: 34388258 DOI: 10.1093/labmed/lmab058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ryan M Mullins
- Department of Laboratory Services, Banner Estrella Medical Center, Phoenix, Arizona, US
| | - Nasrin Mohamed
- Department of Laboratory Services, Banner Estrella Medical Center, Phoenix, Arizona, US
| | - Ashton T Brock
- General Laboratory, Sonora Quest Laboratories/Laboratory Sciences of Arizona, Phoenix, Arizona, US
| | - Kelly W Wilhelms
- General Laboratory, Sonora Quest Laboratories/Laboratory Sciences of Arizona, Phoenix, Arizona, US
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Bruno RR, Masyuk M, Muessig JM, Binneboessel S, Bernhard M, Bäz L, Franz M, Kelm M, Jung C. Sublingual microcirculation detects impaired perfusion in dehydrated older patients. Clin Hemorheol Microcirc 2020; 75:475-487. [DOI: 10.3233/ch-200859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Dehydration occurs frequently in older patients and constitutes a significant clinical problem. OBJECTIVE: This proof-of-concept study examines whether 1) sublingual measurement in dehydrated old patients is feasible, 2) frailty and incompliance in old, awake patients affects video-quality, 3) dehydration impacts microcirculation METHODS: This prospective observational study included clinically dehydrated patients aged ≥65 years immediately after admission. Dehydration was assessed clinically. A sidestream dark field camera (SDF) was used for measurement. Video-quality was evaluated with MIQS (microcirculation image quality score). Both AVA 4.3C- and AVA POEM-software analyzed the videos. Seventeen patients ≥65 years not showing dehydration served as control. RESULTS: Thirteen patients (8 female) were included. The average age was 83±8 years. The mini-mental test was 17±15 points, the Clinical Frailty Scale 4±3, the Barthel-Index 59±39. None of these parameters correlated with MIQS (3.4±4.2 SD (“acceptable”)). Dehydrated patients had a slightly impaired microcirculation, with a significantly lower percentage of perfused small vessels compared to control (83.1±7.7% versus 88.0±6.0%, P < 0.05). After rehydration, there was acute improvement in the microcirculation. CONCLUSIONS: Sublingual microcirculatory SDF-measurement is both, safe and valid for dehydrated old patients - regardless of frailty, age or cognitive performance. Dehydration leads to an impaired microcirculation.
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Affiliation(s)
- Raphael Romano Bruno
- Department of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Maryna Masyuk
- Department of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Johanna M. Muessig
- Department of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Stephan Binneboessel
- Department of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Michael Bernhard
- Emergency Department, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Laura Bäz
- Department of Internal Medicine I, University Hospital Jena, Jena, Germany
| | - Marcus Franz
- Department of Internal Medicine I, University Hospital Jena, Jena, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany
| | - Christian Jung
- Department of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
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Cannes do Nascimento N, dos Santos AP, Sivasankar MP, Cox A. Unraveling the molecular pathobiology of vocal fold systemic dehydration using an in vivo rabbit model. PLoS One 2020; 15:e0236348. [PMID: 32735560 PMCID: PMC7394397 DOI: 10.1371/journal.pone.0236348] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/03/2020] [Indexed: 01/03/2023] Open
Abstract
Vocal folds are a viscoelastic multilayered structure responsible for voice production. Vocal fold epithelial damage may weaken the protection of deeper layers of lamina propria and thyroarytenoid muscle and impair voice production. Systemic dehydration can adversely affect vocal function by creating suboptimal biomechanical conditions for vocal fold vibration. However, the molecular pathobiology of systemically dehydrated vocal folds is poorly understood. We used an in vivo rabbit model to investigate the complete gene expression profile of systemically dehydrated vocal folds. The RNA-Seq based transcriptome revealed 203 differentially expressed (DE) vocal fold genes due to systemic dehydration. Interestingly, function enrichment analysis showed downregulation of genes involved in cell adhesion, cell junction, inflammation, and upregulation of genes involved in cell proliferation. RT-qPCR validation was performed for a subset of DE genes and confirmed the downregulation of DSG1, CDH3, NECTIN1, SDC1, S100A9, SPINK5, ECM1, IL1A, and IL36A genes. In addition, the upregulation of the transcription factor NR4A3 gene involved in epithelial cell proliferation was validated. Taken together, these results suggest an alteration of the vocal fold epithelial barrier independent of inflammation, which could indicate a disruption and remodeling of the epithelial barrier integrity. This transcriptome provides a first global picture of the molecular changes in vocal fold tissue in response to systemic dehydration. The alterations observed at the transcriptional level help to understand the pathobiology of dehydration in voice function and highlight the benefits of hydration in voice therapy.
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Affiliation(s)
- Naila Cannes do Nascimento
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana, United States of America
- * E-mail: (NCN); (AC)
| | - Andrea P. dos Santos
- Department of Comparative Pathobiology, Purdue University, West Lafayette, Indiana, United States of America
| | - M. Preeti Sivasankar
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana, United States of America
| | - Abigail Cox
- Department of Comparative Pathobiology, Purdue University, West Lafayette, Indiana, United States of America
- * E-mail: (NCN); (AC)
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Konkel L. Diabetes in Brazil: The Association between Extreme Heat and Hospitalization. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:74004. [PMID: 32706264 PMCID: PMC7380260 DOI: 10.1289/ehp6853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 06/11/2023]
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A Brief Intervention for Malnutrition among Older Adults: Stepping Up Your Nutrition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103590. [PMID: 32443789 PMCID: PMC7277589 DOI: 10.3390/ijerph17103590] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/16/2020] [Accepted: 05/17/2020] [Indexed: 12/19/2022]
Abstract
Despite a multitude of nutritional risk factors among older adults, there is a lack of community-based programs and activities that screen for malnutrition and address modifiable risk among this vulnerable population. Given the known association of protein and fluid consumption with fall-related risk among older adults and the high prevalence of falls among Americans age 65 years and older each year, a brief intervention was created. Stepping Up Your Nutrition (SUYN) is a 2.5 h workshop developed through a public/private partnership to motivate older adults to reduce their malnutrition risk. The purposes of this naturalistic workshop dissemination were to: (1) describe the SUYN brief intervention; (2) identify participant characteristics associated with malnutrition risk; and (3) identify participant characteristics associated with subsequent participation in Stepping On (SO), an evidence-based fall prevention program. Data were analyzed from 429 SUYN participants, of which 38% (n = 163) subsequently attended SO. As measured by the SCREEN II®, high and moderate malnutrition risk scores were reported among approximately 71% and 20% of SUYN participants, respectively. Of the SUYN participants with high malnutrition risk, a significantly larger proportion attended a subsequent SO workshop (79.1%) compared to SUYN participants who did not proceed to SO (65.8%) (χ2 = 8.73, p = 0.013). Findings suggest SUYN may help to identify malnutrition risk among community-dwelling older adults and link them to needed services like evidence-based programs. Efforts are needed to expand the delivery infrastructure of SUYN to reach more at-risk older adults.
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Nakanishi K, Kanda T, Kobata T, Mori M, Yamada S, Kasamaki Y. New score including daily life independence levels with dementia is associated with the onset of deep vein thrombosis in frail older adults. Geriatr Gerontol Int 2020; 20:414-421. [PMID: 32077247 DOI: 10.1111/ggi.13873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 12/24/2019] [Accepted: 01/07/2020] [Indexed: 11/29/2022]
Abstract
AIM The detailed risk factors of deep vein thrombosis (DVT) remain unknown, and no efficient tool to assess the risk of the development of DVT among older adults has been established. This study aimed to clarify the risk factors, including the level of daily life independence, and develop an assessment score for DVT in older patients. METHODS We recruited 252 patients aged ≧65 years with suspected deep vein thrombosis. Risk factors for deep vein thrombosis, cognitive impairment, laboratory data and level of daily life independence were analyzed to calculate the odds ratios for the onset of DVT with logistic regressions. The Himi score was generated with factors significantly related to DVT by adjusting the respective odds ratios. The discrimination accuracy of the Himi score associated with the onset of DVT was compared with those of conventional scores (Wells score, Padua score) based on the area under the receiver operating characteristic curve. RESULTS Low levels of daily life independence, D-dimer level >3.0 μg/mL, anticoagulant use, cancer and immobilization or symptoms of the lower limbs were associated with the onset of DVT. The discrimination accuracy of Himi scores composed of these related factors was significantly higher than those of the Wells and Padua scores. CONCLUSIONS Achieving a better performance than did the Wells and Padua scores, the Himi score could be used to assess the risk of DVT in frail older adults. Geriatr Gerontol Int 2020; 20: 414-421.
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Affiliation(s)
- Keisuke Nakanishi
- Department of Rehabilitation, Kanazawa Medical University Himi Municipal Hospital, Toyama, Japan.,Community Medicine, Kanazawa Medical University Graduate School of Medical Sciences, Uchinada, Japan
| | - Tsugiyasu Kanda
- Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Takashi Kobata
- Community Medicine, Kanazawa Medical University Graduate School of Medical Sciences, Uchinada, Japan.,Department of Cardiovascular Surgery, Kanazawa Medical University Himi Municipal Hospital, Toyama, Japan
| | - Masayuki Mori
- Department of Rehabilitation, Kanazawa Medical University Himi Municipal Hospital, Toyama, Japan
| | - Shinya Yamada
- Community Medicine, Kanazawa Medical University Graduate School of Medical Sciences, Uchinada, Japan.,Department of Respiratory Medicine, Kanazawa Medical University Hospital, Uchinada, Japan
| | - Yuji Kasamaki
- Community Medicine, Kanazawa Medical University Graduate School of Medical Sciences, Uchinada, Japan.,Department of General Medicine, Kanazawa Medical University Himi Municipal Hospital, Toyama, Japan
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Haileka V, George S, Steinbrecht S, Jung F, Reinehr R, Küpper JH. Colon cancer cells cultured under hyperosmotic conditions as in vitro model to investigate dehydration effects on cancer drug susceptibility. Clin Hemorheol Microcirc 2019; 73:169-176. [PMID: 31561339 DOI: 10.3233/ch-199210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In most clinical studies older people are underrepresented compared to the demographic reality. However, risk for some severe diseases like cancer typically increase with age. Most insight into cancer treatment comes from mixed-age patient cohorts, leading to a lack of detailed understanding of cancer drug effects in the elderly population. There is growing evidence that cancer drug effects can be influenced by dehydration conditions often found in older people. Colon cancer remains the second leading cause of death by cancer in Europe. Inter- and intra-heterogeneity of tumors contribute to why some individuals do not respond to specific cancer therapies or may often suffer a relapse. OBJECTIVE Our study applies an in vitro drug test system for simulating treatment with cytostatics of colorectal cancer in elderly patients with dehydration condition. METHODS Two well-known colon cancer cell lines, Caco-2 and RKO, harboring defined cancer-related mutations, were step-wisely adapted from routine culture medium to a severe hyperosmotic condition (397 mOmol/kg) by adding sodium chloride to the medium. We investigated the effects of these cell culture conditions, which should mimic cellular dehydration in elderly people, on the growth characteristics of the cells. Therefore, cell proliferation was investigated by measuring population doubling times. Furthermore, we investigated how the metabolic activity of the cells was influenced by treatment with different concentrations of cyclophosphamide (CPA) under normal and hyperosmotic conditions. RESULTS We found that Caco-2 and RKO cell lines have an identical cell doubling time of 23 hours in normosmotic medium. However, hyperosmotic medium lifted the doubling time of Caco-2 cells to 31 hours while that of RKO cells did not change. Despite reduced cell proliferation rates, hyperosmotic medium sensitized Caco-2 cells to treatment with 10 mM CPA for 48 hours as measured by metabolic activity assays on ATP levels. CONCLUSIONS The two investigated colon cancer cells lines reacted differently to hyperosmotic conditions. Only the growth of Caco-2 cells was reduced by increased osmolality. Despite this reduced growth their sensitivity to an alkylating cytostatic agent was even slightly increased. We are now in line to examine these effects in more detail and with more tumor cell lines.
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Affiliation(s)
- V Haileka
- Institute of Biotechnology, Brandenburg University of Technology Cottbus-Senftenberg, Germany
| | - S George
- Institute of Biotechnology, Brandenburg University of Technology Cottbus-Senftenberg, Germany
| | - S Steinbrecht
- Institute of Biotechnology, Brandenburg University of Technology Cottbus-Senftenberg, Germany
| | - F Jung
- Institute of Biotechnology, Brandenburg University of Technology Cottbus-Senftenberg, Germany
| | - R Reinehr
- Elbe Elster Klinikum, Fachbereich Innere Medizin, Herzberg, Germany
| | - J-H Küpper
- Institute of Biotechnology, Brandenburg University of Technology Cottbus-Senftenberg, Germany
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A Container-Attachable Inertial Sensor for Real-Time Hydration Tracking. SENSORS 2019; 19:s19184008. [PMID: 31533275 PMCID: PMC6767290 DOI: 10.3390/s19184008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/12/2019] [Accepted: 09/16/2019] [Indexed: 11/16/2022]
Abstract
Various sensors have been proposed to address the negative health ramifications of inadequate fluid consumption. Amongst these solutions, motion-based sensors estimate fluid intake using the characteristics of drinking kinematics. This sensing approach is complicated due to the mutual influence of both the drink volume and the current fill level on the resulting motion pattern, along with differences in biomechanics across individuals. While motion-based strategies are a promising approach due to the proliferation of inertial sensors, previous studies have been characterized by limited accuracy and substantial variability in performance across subjects. This research seeks to address these limitations for a container-attachable triaxial accelerometer sensor. Drink volume is computed using support vector machine regression models with hand-engineered features describing the container's estimated inclination. Results are presented for a large-scale data collection consisting of 1908 drinks consumed from a refillable bottle by 84 individuals. Per-drink mean absolute percentage error is reduced by 11.05% versus previous state-of-the-art results for a single wrist-wearable inertial measurement unit (IMU) sensor assessed using a similar experimental protocol. Estimates of aggregate consumption are also improved versus previously reported results for an attachable sensor architecture. An alternative tracking approach using the fill level from which a drink is consumed is also explored herein. Fill level regression models are shown to exhibit improved accuracy and reduced inter-subject variability versus volume estimators. A technique for segmenting the entire drink motion sequence into transport and sip phases is also assessed, along with a multi-target framework for addressing the known interdependence of volume and fill level on the resulting drink motion signature.
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Mendes J, Padrão P, Moreira P, Santos A, Borges N, Afonso C, Negrão R, Amaral TF. Handgrip Strength and Its Association With Hydration Status and Urinary Sodium-to-Potassium Ratio in Older Adults. J Am Coll Nutr 2019; 39:192-199. [PMID: 31381481 DOI: 10.1080/07315724.2019.1633439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Older adults present higher risk of functional disability detected by handgrip strength and an increased risk of poor health conditions, such as dehydration and low values of the sodium-to-potassium (Na/K) ratio. This study aimed to quantify the association of hydration status and Na/K ratio with handgrip strength, based on the urinary excretion of older adults.Methods: A cross-sectional study was conducted in 735 older adults ≥ 65 years old. Handgrip strength was measured with a Jamar Dynamometer and low values were defined according to body mass index and to sex-specific cutoff points. The hydration status was evaluated based on free water reserve. Sodium and potassium intake were evaluated after converting 24-hour urinary sodium and potassium excretion, respectively. A logistic regression model was used to estimate the probability of presenting low handgrip strength, according to risk of hypohydration and to quartiles of Na/K, stratified by sex and adjusted for potential confounders.Results: The adjusted odds ratio (OR) for presenting low handgrip strength was higher in women at risk of hypohydration, but this association was not found in men. Both women and men with the highest values of Na/K ratio presented higher adjusted OR for low handgrip strength (OR in women was 2.03; 95% confidence interval [CI]: 1.12-3.68, and in men was 2.19; 95% CI: 1.11-4.29).Conclusions: The risk of hypohydration was directly associated with low handgrip strength in older women. In older adults, higher values of urinary Na/K ratio were also directly associated with low handgrip strength.
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Affiliation(s)
- Joana Mendes
- Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Porto, Portugal.,I3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal.,EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal.,EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal.,The Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| | - Alejandro Santos
- I3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.,Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
| | - Nuno Borges
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal.,CINTESIS-Centre for Health Technology and Services Research, Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
| | - Rita Negrão
- Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Porto, Portugal.,I3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Teresa F Amaral
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Porto, Portugal
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Serra-Prat M, Lorenzo I, Palomera E, Ramírez S, Yébenes JC. Total Body Water and Intracellular Water Relationships with Muscle Strength, Frailty and Functional Performance in an Elderly Population. J Nutr Health Aging 2019; 23:96-101. [PMID: 30569076 DOI: 10.1007/s12603-018-1129-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND As a person ages, total body water (TBW), intracellular water (ICW), muscle mass and muscle strength tend to decline. The decline in ICW may reflect losses in the number of muscle cells but may also be responsible for less hydrated muscle cells. AIM To assess whether TBW and ICW are associated with muscle strength, functional performance and frailty in an aged population, independently of muscle mass. METHODOLOGY Design: An observational cross-sectional study of community-dwelling individuals aged 75 years and older. TBW, ICW, fat mass, lean mass and muscle mass were assessed by bioelectrical impedance analysis, frailty status was measured according to Fried criteria, handgrip strength was measured using the hand-held JAMAR dynamometer, and functional performance was measured according to the Barthel index and gait speed. RESULTS A total of 324 subjects were recruited (mean age 80.1 years, 47.5% women). TBW and ICW were closely correlated with muscle mass in both sexes. ICW was also associated with Barthel score, gait speed and frailty in both sexes and with handgrip in men. Considerable variability in ICW was observed for the same muscle mass. Multivariate analysis showed a positive effect of ICW on handgrip, functional performance and gait speed and a protective effect of ICW on frailty, independently of age, sex, body mass index and number of comorbidities. CONCLUSIONS In elderly individuals with similar muscle mass, those with higher ICW had a better functional performance and a lower frailty risk, suggesting a protective effect of cell hydration, independently of muscle mass.
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Affiliation(s)
- M Serra-Prat
- Mateu Serra Prat, Research Unit, Hospital of Mataró, Carretera de Cirera s/n, 08304 Mataró, Barcelona, Spain, Tel. 34 93 741 77 30, Fax. 34 93 757 33 21, e-mail:
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Butcher L. Eczematous conditions in the older person. Br J Community Nurs 2018; 23:395-398. [PMID: 30063388 DOI: 10.12968/bjcn.2018.23.8.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Lesley Butcher
- Lecturer in Adult Nursing, Communications Champion, Healthcare Sciences
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Puga AM, Partearroyo T, Varela-Moreiras G. Hydration status, drug interactions, and determinants in a Spanish elderly population: a pilot study. J Physiol Biochem 2017; 74:139-151. [PMID: 28799126 DOI: 10.1007/s13105-017-0585-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/24/2017] [Indexed: 11/27/2022]
Abstract
Proper hydration is essential to maintain optimal health and well-being at all stages of life, especially for the elderly. Side effects of certain drugs that affect hydration status may compromise the health of the ancients, who also constitute the most vulnerable group. No studies have been carried out, to our knowledge, at the intersection of drugs and hydration status. Our study aimed to evaluate the effects of chronic use of certain drugs (diuretics, corticoids and metformin) in the hydration status of the elderly. Results were obtained from a cross-sectional study with 96 volunteers (65-93 years) selected based on their pharmacological treatment. It included a validated food and drink frequency questionnaire and water removal, dehydration signs and symptoms assessment and urine analysis. All data were analysed by age and sex. Water balance decreased with advanced age, especially in men's group. Results were confirmed by means of the evaluation of dehydration signs and symptoms and colorimetric and chemical analysis of urine. Correlations between consumption of corticoids and hydration status were found, with different signs depending on the administration route (Rho = 0.522 and Rho = - 0,522 for oral and pulmonary corticoids, respectively). Furthermore, correlations between diuretics (Rho = - 0.343, p < 0.05) and metformin (Rho = - 0.802, p < 0.01) consumption and different urine markers were determined. In conclusion, the predominant dehydration state of the volunteers of the study is affected by drugs consumption and their route of administration. Hence, there is an urgent need for monitorization of hydration status based on drugs consumption.
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Affiliation(s)
- A M Puga
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Boadilla del Monte, 28668, Madrid, Spain
| | - T Partearroyo
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Boadilla del Monte, 28668, Madrid, Spain
| | - G Varela-Moreiras
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Boadilla del Monte, 28668, Madrid, Spain.
- Spanish Nutrition Foundation (FEN), 28010, Madrid, Spain.
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Chang LH, Guo YW, Chen HS. Hyperglycemic Hyperosmolar Status Is Associated with Subsequent All-Cause Mortality in Elderly Adults with Type 2 Diabetes Mellitus. J Am Geriatr Soc 2016; 64:e218-e219. [PMID: 27673279 DOI: 10.1111/jgs.14431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Li-Hsin Chang
- Tao-Yuan Branch, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Wun Guo
- Department of Medicine, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
| | - Harn-Shen Chen
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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