scholarly journals Effect of preoperative carbohydrate intake on inflammatory factors and clinical outcomes in elderly patients undergoing radical prostatectomy: a single-center, double-blind randomized controlled trial

2020 ◽  
Author(s):  
Zhen Hu ◽  
Ji Liu ◽  
Wenchao Ma ◽  
Fen Wang
Keyword(s):  
Radical Prostatectomy ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Body Mass ◽  
Inflammatory Markers ◽  
Controlled Trial ◽  
Operation Time ◽  
Inflammatory Factors ◽  
Water Group ◽  
First Time

Abstract BACKGROUND: To investigate the advantages of Carbohydrate (CHO) in inflammatory markers, comfort and clinical outcomes in elderly patients undergoing open radical prostatectomy.METHODS: Patients of ≥65 years old with radical prostatectomy who underwent open radical prostatectomy were randomized to the CHO group, water group, and fasted group. Patients in the CHO group and water group received oral CHO, 800 ml of placebo water before surgery, and oral CHO and placebo water 400 ml 2 to 3 hours before surgery; the fasted group did not drink any liquid. The main outcomes are inflammatory markers. The secondary outcomes are cellular immunity, comfort, the index of grip strength of body mass and clinical outcomes.RESULTS: A total of 90 patients were included in current study (i.e., CHO group, n=28; water group, n=30; fasted group, n=32). The three groups matched well in age, body mass index, the grade of (American Society of Anesthesiologists) ASA, operation time, blood loss, and fluid volume. CHO reduces IL-6 of Day1 and Day7 (P = 0.009, 0.005, respectively), IL-8 (P=0.005) of Day1, Day1, Day 3, and Day 7 TNF (P = 0.001, 0.006, 0.003 respectively) compared with the fasted group ; placebo water reduced Day 1 and Day 7 TNF (P = 0.005, 0.038, respectively), Day 1of IL-8 (P = 0.045). CHO reduced Day3 of TNF (P=0.026) compared to placebo water. In the CHO group and the water group, the morning thirst scores (0.68, 1.26, respectively) and starvation (0.24, 0.47, respectively) were decreased. The first time to leave bed in the fasted group (39.21 (15-93) h) was much later than in the CHO group (28.57 (10-100) h) and the water group (28.71 (12-70) h).Conclusion: Compared with routine water ban, preoperative CHO and placebo water can reduce the levels of IL-6, IL-8 and TNF in elderly patients undergoing radical prostatectomy, which can improve the patient's preoperative comfort and shorten the patient's first time to leave bed. Compared with placebo water, CHO has no significant advantage in improving inflammatory markers and clinical outcomes.

scholarly journals Effect of preoperative carbohydrate intake on inflammatory factors and clinical outcomes in elderly patients undergoing radical prostatectomy: a single-center, double-blind randomized controlled trial

2020 ◽  
Author(s):  
Zhen Hu ◽  
Ji Liu ◽  
Wenchao Ma ◽  
Fen Wang
Keyword(s):  
Placebo Group ◽  
Radical Prostatectomy ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Operation Time ◽  
Inflammatory Factors ◽  
Blocking Group ◽  
Open Radical Prostatectomy ◽  
Water Blocking ◽  
First Time

Abstract BACKGROUND To investigate the advantages of Carbohydrate (CHO) in inflammatory factors, comfort and clinical outcomes in elderly patients with open radical prostatectomy. METHODS Patients of ≥ 65 years old with radical prostatectomy who underwent open radical prostatectomy were randomized to the CHO group, placebo group, and conventional water-blocking group. Patients in the CHO group and placebo group received oral CHO, 800 ml of placebo water before surgery,and oral CHO and placebo water 400 ml 2 to 3 hours before surgery; the water-free group did not drink any liquid. The main test indicators are inflammatory factors, comfort and clinical outcomes. RESULTS 28 patients in the CHO group, 30 in the placebo group, and 32 in the conventional water-blocking group were included in the study. The three groups matched well in age, body mass index, the grade of (American Society of Anesthesiologists)ASA, operation time, blood loss, and fluid volume.CHO reduces IL-6 of Day1 and Day7 (P = 0.009, 0.005, respectively), IL-8 (P = 0.005) of Day1, Day1, Day 3, and Day 7 TNF (P = 0.001, 0.006, 0.003 respectively) compared with the water-stopping group ; placebo water reduced Day 1 and Day 7 TNF (P = 0.005, 0.038, respectively), Day 1of IL-8 (P = 0.045). CHO reduced Day3 of TNF (P = 0.026) compared to placebo. In the CHO group and the placebo group, the morning thirst scores (0.68, 1.26, respectively) and starvation (0.24, 0.47, respectively)were decreased. The first time to leave bed in the conventional water-blocking group (39.21 (15–93) h) was much later than in the CHO group (28.57 (10–100) h) and the placebo group (28.71 (12–70) h). Conclusion Compared with routine water ban, preoperative CHO and placebo water can reduce the levels of IL-6, IL-8 and TNF in elderly patients undergoing radical prostatectomy, which can improve the patient's preoperative comfort and shorten the patient's first time to leave bed. Compared with placebo water, CHO has no significant advantage in improving inflammatory factors and clinical outcomes.

scholarly journals Effects of Preoperative Carbohydrate Intake on Inflammatory Markers and Clinical Outcomes in Elderly Patients Undergoing Radical Prostatectomy: A Single-Centre, Double-Blind Randomised Controlled Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhen Hu ◽  
Ji Liu ◽  
Fen Wang
Keyword(s):  
Drinking Water ◽  
Placebo Group ◽  
Radical Prostatectomy ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Inflammatory Markers ◽  
Controlled Trial ◽  
Double Blind ◽  
Clinical Trial Registration ◽  
Open Radical Prostatectomy

Background: This study aimed to analyse the effects of carbohydrate (CHO) intake on inflammatory markers, comfort, and clinical outcomes in elderly patients undergoing open radical prostatectomy.Methods: Patients aged ≥65 years who underwent open radical prostatectomy were randomly divided into CHO, drinking water, and fasting groups. A total of 90 patients were enrolled in this study (CHO group, n = 28; placebo group, n = 30 and fasting group, n = 32). Patients in the CHO group were given 800 and 400 ml of carbohydrates 8 and 2–3 h before surgery, respectively. Patients in the placebo group were given 800 and 400 ml of water 8 and 2–3 h before surgery, respectively. Patients in the fasting group did not consume any liquids. The main result is levels of inflammation markers. Secondary results included cellular immunity, comfort, body weight, grip index, and clinical results.Results: Compared with the fasting group, the CHO group exhibited a decrease in interleukin 6 (IL-6) levels on days 1 and 7 (75.47 and 7.06 pg/mL, respectively), IL-8 levels on day 1 (274.61 pg/mL) and tumour necrosis factor (TNF) levels on days 1, 3, and 7 (11.16, 9.55, and 9.67 pg/mL, respectively). The placebo group exhibited a decrease in IL-8 (390.26 pg/mL) and TNF levels (13.99 pg/mL) on day 1. Compared with the placebo group, the CHO group exhibited a decrease in IL-6 levels on day 1 and TNF levels on day 3. In the CHO and placebo groups, the thirst and hunger scores decreased on the morning of surgery.Conclusion: Preoperative CHO and drinking water are associated with decreased levels of IL-6, IL-8, and TNF. CHO and water can also reduce thirst and hunger scores. Therefore, we recommend that patients without contraindications should be given 200–400 ml of fluid 2–3 h before surgery, preferably CHO.Clinical Trial Registration:http://www.chictr.org.cn/edit.aspx?pid=21783&htm=4; ChiCTR-INR-17012867.

scholarly journals Effects of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Dan Zhang ◽  
Hongli Li ◽  
Xiang Tian ◽  
Sujuan Zhang
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Enteral Nutrition ◽  
Elderly Patients ◽  
Immune Function ◽  
Inflammatory Markers ◽  
Heart Function ◽  
Inflammatory Factors ◽  
Control Group ◽  
Experimental Group

Objectives: To evaluate the effect of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure and its clinical significance. Methods: Eighty patients with moderate and severe heart failure admitted to the Cardiology Intensive Care Unit (CCU) of Baoding First Central Hospital from May 2019 to May 2020 were included in this study and randomly divided into two groups: the experimental group and the control group, with 40 patients in each group. The experimental group was given enteral nutrition support therapy on the basis of conventional therapy for one month, while the control group was given restricted salt and water intake on the basis of conventional therapy, and patients were given free diet according to their wishes. The changes in heart function before and after treatment, changes in inflammatory factors such as TNF-a, CRP, IL-6, changes in levels of immunoglobulins such as IgA, IgM, and IgG, and the improvement of the performance status of the two groups were compared and analyzed. Results: After treatment, indicators such as BNP, LVEDD, LVEF and 6min walking distance in the experimental group were significantly improved compared with the control group, with statistically significant differences (p<0.05), and the levels of inflammatory factors such as TNF-a, CRP and IL-6 in the experimental group were significantly reduced compared with those in the control group (p=0.00). The levels of IgG, IgA, IgM and other immunoglobulins in the experimental group improved more significantly after treatment than those in the control group, with statistically significant differences (IgG, IgA, p=0.00; IgM, p=0.01). Moreover, the experimental group was significantly superior to the control group in the improvement rate of performance status score (ECOG) after treatment (p=0.04); The incidence of gastrointestinal adverse reactions in the experimental group was 20%, and that in the control group was 15%. No statistically significant difference can be observed in the gastrointestinal tolerance of both groups (p=0.56). Conclusions: Reasonable enteral nutrition boasts a variety of benefits for the recovery of elderly patients with chronic heart failure. With reasonable enteral nutrition, the heart function of elderly patients with chronic heart failure can be significantly improved, inflammatory factors can be reduced, immunity and performance status can be enhanced, and gastrointestinal tolerance can be ameliorated without obvious gastrointestinal reactions. doi: https://doi.org/10.12669/pjms.38.1.4451 How to cite this:Zhang D, Li H, Tian X, Zhang S. Effects of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure. Pak J Med Sci. 2022;38(1):---------.  doi: https://doi.org/10.12669/pjms.38.1.4451 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The relationship between body-mass index, physical activity, and pathologic and clinical outcomes after radical prostatectomy for prostate cancer

2018 ◽  
Vol 37 (5) ◽  
pp. 789-798 ◽  
Author(s):  
Michel Wissing ◽  
Simone Chevalier ◽  
Ginette McKercher ◽  
Claudie Laprise ◽  
Saro Aprikian ◽  
...  
Keyword(s):  
Physical Activity ◽  
Prostate Cancer ◽  
Body Mass Index ◽  
Radical Prostatectomy ◽  
Clinical Outcomes ◽  
Body Mass ◽  
The Relationship

A randomized, double-blind, placebo-controlled trial of the effect of dried purple carrot on body mass, lipids, blood pressure, body composition, and inflammatory markers in overweight and obese adults: The QUENCH Trial

2013 ◽  
Vol 91 (6) ◽  
pp. 480-488 ◽  
Author(s):  
Olivia R.L. Wright ◽  
Gabriele A. Netzel ◽  
Amy R. Sakzewski
Keyword(s):  
Blood Pressure ◽  
Body Composition ◽  
Body Mass ◽  
Phenolic Acids ◽  
Inflammatory Markers ◽  
Controlled Trial ◽  
Intervention Group ◽  
Density Lipoprotein ◽  
Low Grade ◽  
Metabolic Alterations

Obesity is a significant health issue worldwide and is associated with chronic, low-grade inflammation predisposing the individual to cardiovascular disease and impaired blood glucose homeostasis. Anthocyanins and phenolic acids from purple carrots are effective at reversing inflammation and metabolic alterations in animal models, potentially through inhibition of inflammatory pathways. The effects of dried purple carrot on body mass, body composition, blood pressure, lipids, inflammatory markers, liver function tests, and appetite were investigated in 16 males (aged 53.1 ± 7.6 years and with a mean BMI of 32.8 ± 4.6 kg/m2) with normal lipid and inflammatory markers. There was no evidence that 118.5 mg/day of anthocyanins and 259.2 mg/day of phenolic acids for 4 weeks resulted in statistically significant changes in body mass, body composition, appetite, dietary intake, low density lipoprotein, total cholesterol, blood pressure, or C-reactive protein in these obese participants at the dose and length of intervention used in this trial. High density lipoprotein cholesterol was lower in the intervention group (p < 0.05). Aspartate amino transferase and alanine amino transferase did not change, indicating that the intervention was safe. More studies are required to establish the bioavailability and pharmacokinetic effects of purple carrot anthocyanins and phenolic acids prior to further trials of efficacy with respect to treating inflammation and metabolic alterations.

scholarly journals Effects of dexmedetomidine on postoperative delirium and expression of IL-1, IL-6, and TNF-α in elderly patients after hip fracture operation

2020 ◽  
Author(s):  
Wenchao Zhang ◽  
Tianlong Wang ◽  
Geng Wang ◽  
Minghui Yang ◽  
Yan Zhou ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Early Stage ◽  
Surgical Complication ◽  
Controlled Trial ◽  
Venous Blood ◽  
Inflammatory Factors ◽  
Double Blind ◽  
Tnf Α

Abstract Background: Postoperative delirium (POD) is a common surgical complication in elderly patients. This study investigated the effects of dexmedetomidine on POD and inflammatory factors in elderly patients with hip fracture.Methods: The randomized, double-blind, controlled trial enrolled patients aged ≥65 years who underwent operation for hip fracture in the Department of Anesthesiology in Beijing JiShuiTan Hospital from October 2016 to January 2017. The patients were divided into the DEX group and the NS group and were intravenously infused with dexmedetomidine or an equal volume of normal saline, respectively. After surgery, the incidence of delirium at postoperative day 1 (T1), day 2 (T2) and day 3 (T3) were assessed using the Ramsay score and Confusion Assessment Method (CAM) delirium scale. Interleukin (IL)-1, IL-6 and tumor necrosis factor (TNF)-α concentrations in the venous blood of the two groups of patients were detected at T0 (before surgery), T1 and T3.Results: Data from 218 patients were analyzed with 110 patients in the DEX group and 108 in the NS group. Dexmedetomidine decreased POD incidence (18.2% vs. 30.6%, P=0.033). Compared to T0, all three inflammatory factors increased at T1 and then decreased at T3 and changes with time were significant (all P<0.001). IL-6 (P<0.001) and TNF-α (P=0.003) levels were lower in the DEX group, but IL-1 levels were similar. The rate of adverse events was similar in the two groups.Conclusions: Dexmedetomidine reduced the incidence of POD in elderly patients with hip fracture at an early stage, and reduced short-term IL-6 and TNF-α concentrations.

A New Ceramic Interspinous Process Spacer for Lumbar Spinal Canal Stenosis

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONS108-ONS114 ◽  
Author(s):  
Shunsuke Yano ◽  
Kazutoshi Hida ◽  
Toshitaka Seki ◽  
Takeshi Aoyama ◽  
Minoru Akino ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Operation Time ◽  
Magnetic Resonance Images ◽  
Disc Height ◽  
Analog Scale ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis

Abstract Objective: Because surgery in elderly patients should be minimally invasive, interspinous process distraction has been widely used in this group to treat lumbar canal stenosis. We developed a new interspinous process distraction spacer composed of hydroxyapatite ceramic. In this work, we demonstrate the usefulness of this novel device. Methods: Since 2003, we operated on 19 elderly patients with lumbar canal stenosis, including 14 men and five women. Their mean age was 70.1 years. We compared the intervertebral angle, posterior disc height, and interspinous process distance on midsagittal magnetic resonance images obtained before and after the surgery. We also assessed clinical outcomes by using the Visual Analog Scale and the Zurich Claudication Questionnaire. Results: The average operation time per level was 44.7 minutes. Postoperatively, there were significant changes in the angle (from 12.5 to 8.6 degrees, P &lt; 0.0001), the posterior disc height (from 10.6 to 13.1 mm, P &lt; 0.0001), and the interspinous process distance (from 9.7 to 14.1 mm, P &lt; 0.0001). The clinical outcomes, which we assessed by using the Visual Analog Scale and the Zurich Claudication Questionnaire, were considered satisfactory. (Visual Analog Scale, from 6.88 to 3.00; Zurich Claudication Questionnaire, symptom severity domain from 2.94 to 1.92, physical function from 2.51 to 1.73.) Conclusion: Our ceramic spacer is useful in the treatment of elderly patients with lumbar canal stenosis. Treatment comprises an easy surgical procedure and produces no metal artifact on radiological evaluations, such as magnetic resonance imaging and computed tomographic scans.

Ultrasound-guided proximal versus distal axillary vein puncture in elderly patients: A randomized controlled trial

2020 ◽  
Vol 21 (6) ◽  
pp. 854-860
Author(s):  
Hai-Yan Wang ◽  
Ruan-Mei Sheng ◽  
Yan-Ding Gao ◽  
Xue-Min Wang ◽  
Wen-Biao Zhao
Keyword(s):  
Elderly Patients ◽  
Controlled Trial ◽  
Operation Time ◽  
Maximum Diameter ◽  
Axillary Vein ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Randomized Controlled ◽  
Venous Catheterization ◽  
Senior Patients

Background: Ultrasound-guided axillary vein catheterization is now widely used in hospital, but it remains uncertain whether the distal axillary vein approach is more beneficial for seniors than the proximal axillary vein approach. This study aims to compare the puncture success rate and anatomical characteristics between these two approaches. Methods: Senior patients requiring central venous catheterization were enrolled and randomized to the proximal axillary vein group ( n = 49) or the distal axillary vein group ( n = 50). Proximal axillary vein and distal axillary vein location time, venous depth, maximum diameter, and collapse index (defined as the percentage change in vein width caused by respiration) were recorded for all patients. The rate of puncture success and operation time were compared between groups. Results: Mean venous depth was 1.93 ± 0.45 cm for proximal axillary vein and 1.79 ± 0.46 cm for distal axillary vein ( p < 0.001). Maximum diameter was 0.80 ± 0.33 cm for proximal axillary vein and 0.61 ± 0.33 cm for distal axillary vein ( p < 0.001). Collapse indices were 20% ± 27% and 56% ± 34%, respectively ( p < 0.001). Also, location time was significantly shorter for proximal axillary vein than for distal axillary vein ( p < 0.001). One attempt and overall success rates were significantly higher in the proximal axillary vein group, compared with the distal axillary vein group (71.4% vs 42.0%, p = 0.003; 79.6% vs 54.0%, p = 0.007). Conclusion: For catheterization under ultrasound guidance in elderly patients, the proximal axillary vein approach is superior to the distal axillary vein approach.

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