Cognitive deterioration upon admission is an important risk indicator of falls in the respiratory ward

INTRODUCTION: Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. Deterioration of the nutritional status results in an increase in chemo radiotherapy related toxicity and this may increase the prolonged treatment time, which has been associated with poor clinical outcome. The present study aims to do nutritional assessment before and after chemo radiotherapy in head and neck cancer patients. MATERIAL AND METHODS: The present study was undertaken at the Department of Radiation Oncology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly. In this study, 50 patients of Head and neck tumours were enrolled and their nutrition was assessed before and after chemoradiotherapy. Nutrition assessment was done using different laboratory parameters like haemoglobin, total leukocyte count, blood urea, serum creatinine and serum bilirubin. Anthropometric parameters used are Body mass index, Skin fold thickness, and Mid-arm circumference. Nutritional risk indicator and PG-SGA score is measured before and after chemoradiotherapy. All the parameters were assessed and analysed using different statistical tests- Chi-square test, Fisher Exact test and paired t test.RESULTS: Haemoglobin decrease was statistically significant during treatment (p less than 0.001) and the decrease in total leukocyte count during treatment was showing trend towards significance (p value-0.056). There was deterioration in other parameters like blood urea, serum creatinine and serum bilirubin but was not statistically significant. Anthropometric parameters- Body mass index, mid-arm circumference and skin fold thickness and percent body fat showed a significant change (p less than 0.00001). Nutritional risk indicator and PG-SGA class has decreased for majority of patients during treatment, the change is statistically significant (p less than 0.00001 and p=0.0251) respectively.CONCLUSION: The nutrition has important role to play in the management of head and neck cancers by chemo radiotherapy. It helps to reduce the complications and improve the tolerance of chemo radiotherapy, thus avoiding treatment breaks which may lead to failure of treatment.

Download Full-text

Soluble urokinase-type plasminogen activator receptor (suPAR) is a risk indicator for eGFR loss in kidney transplant recipients

Scientific Reports ◽

10.1038/s41598-021-83333-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ulrich Jehn ◽

Katharina Schütte-Nütgen ◽

Ute Henke ◽

Hermann Pavenstädt ◽

Barbara Suwelack ◽

...

Keyword(s):

Kidney Transplantation ◽

Cox Regression ◽

Kidney Diseases ◽

Prognostic Significance ◽

Risk Indicator ◽

Kidney Transplant Recipients ◽

Supar Level ◽

Type Plasminogen Activator ◽

Urokinase Type Plasminogen Activator ◽

One Year

AbstractThe prognostic significance of suPAR in various kidney diseases has recently been demonstrated. Its role in transplantation-specific outcomes is still largely unknown. Therefore, we prospectively investigated the prognostic relevance of suPAR in patients before and one year after kidney transplantation (KTx). We included 100 patients who had received a kidney transplantation between 2013 and 2015. The plasma concentration of suPAR was measured by ELISA assay. In recipients of living donations (LD), pre-transplant suPAR levels were significantly lower than those of recipients of deceased donations (DD). After KTx, suPAR levels significantly declined in LD and DD recipients, without a detectable difference between both groups any more. Higher suPAR levels in recipients one year after KTx were associated with a more severe eGFR loss in the following three years in multivariable cox-regression (n = 82, p = 0.021). suPAR-levels above 6212 pg/ml one year after KTx are associated with eGFR loss > 30%, which occurred almost twice as fast as in patients with suPAR ≤ 6212 pg/ml (p < 0.001). Hence, suPAR level at one year mark might be a risk indicator of increased eGFR loss.

Download Full-text

The Impact of SARS-CoV-2 (COVID-19) and its Lockdown Measures on the Mental and Functional Health of Older Individuals

Psychiatric Quarterly ◽

10.1007/s11126-021-09943-6 ◽

2021 ◽

Author(s):

Maria Chiara Fastame ◽

Ilaria Mulas ◽

Valeria Putzu ◽

Gesuina Asoni ◽

Daniela Viale ◽

...

Keyword(s):

Cognitive Decline ◽

Wearable Sensors ◽

Well Being ◽

Functional Health ◽

Cognitive Deterioration ◽

Older Individuals ◽

Physical And Mental Health ◽

Psychological Well Being ◽

The Impact ◽

Healthy Participants

AbstractThe effect of the COVID-19 on the physical and mental health of Italian older individuals displaying signs of cognitive deterioration has not been deeply investigated. This longitudinal study examined the impact of COVID-19 lockdown measures on the psychological well-being and motor efficiency of a sample of Italian community-dwellers with and without cognitive decline. Forty-seven participants underwent instrumental gait analysis performed in ecological setting using wearable sensors, and completed a battery of tasks assessing cognitive functioning and psychological well-being, before and after the full lockdown due to the COVID-19 spreading. A series of Multivariate Analyses of Variance (MANOVAs) documented that the superior gait performance of the cognitively healthy participants exhibited before the COVID-19 spread, vanished when they were tested at the end of the lockdown period. Moreover, before the outbreak of the COVID-19, cognitively healthy participants and those with signs of cognitive decline reported similar levels of psychological well-being, whereas, after the lockdown, the former group reported better coping, emotional competencies, and general well-being than the participants displaying signs of cognitive decline. In conclusion, the full COVID-19 outbreak had a significant impact on the mental and motor functioning of older individuals with and without signs of cognitive deterioration living in Italy.

Download Full-text

Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy

Clinical Oral Investigations ◽

10.1007/s00784-021-04060-x ◽

2021 ◽

Author(s):

Sonja Rahim-Wöstefeld ◽

Dorothea Kronsteiner ◽

Shirin ElSayed ◽

Nihad ElSayed ◽

Peter Eickholz ◽

...

Keyword(s):

Risk Factors ◽

Decision Making ◽

Tooth Loss ◽

Treatment Plan ◽

Periodontal Therapy ◽

Outcome Variable ◽

Individual Treatment ◽

Risk Indicator ◽

Related Factors ◽

Prognostic Tool

Abstract Objectives The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.

Download Full-text