Prevalence of sarcopenia and associated factors in patients in hemodialysis

Objective: To assess the prevalence of sarcopenia and associated factors in patients with chronic kidney disease (CKD) undergoing hemodialysis (HD). Methods: This cross-sectional study evaluated patients with CKD undergoing HD from January to October 2016 in two dialysis centers located in Recife, Pernambuco. For the diagnosis of sarcopenia, the criteria proposed by the 2019 European Consensus on Sarcopenia, which advocates low muscle strength as the main criterion, were considered. Demographic, clinical, anthropometric, and behavioral covariates were evaluated. Results: 108 patients were included, with a mean age of 51.4 ± 17.0 years and homogeneous distribution between the sexes.Sarcopenia was present in 38.9% of the population, of which 69% had severe sarcopenia. A higher prevalence of sarcopenia was observed among men (60% vs. 17%; p < 0.001), in those without a partner (48.1% vs. 30.4%; p < 0.045), in smokers (50% vs. 30%; p < 0.034), with low weight (underweight 73.3%, eutrophic 33.9%, overweight 32.4%; p = 0.001) and those with normal albumin levels (47.5% vs. 28.6%; p = 0.045). Conclusion: Approximately one in three nephropathic patients on hemodialysis presented sarcopenia and, among these, most had the severe form of this condition.Uremic sarcopenia was more prevalent in males, in individuals without partners, underweight, in smokers, and among those with normal albumin levels.

Systematical Review Efektivitas Pemberian Kapsul Ekstrak Channa striata Terhadap Kadar Albumin pada Kasus Luka Bakar

Latar Belakang: Luka bakar adalah cedera pada kulit atau jaringan organik lainnya yang disebabkan oleh panas, radiasi, zat radioaktif, listrik, gesekan atau kontak dengan bahan kimia. Cedera pada saluran pernapasan akibat inhalasi asap, juga dianggap sebagai luka bakar (WHO, 2018). Bagian tubuh yang mengalami luka bakar akan vasodilatasi akibat adanya stimulus mediator inflamasi yang dilepaskan oleh sel endotel, platelet dan leukosit yang rusak, mengakibatkan peningkatan tekanan hidrostatik kapiler yang menyebabkan meningkatnya permeabilitas membran kapiler. Keadaan ini membuat cairan dan elektrolit di intravaskuler keluar ke ekstravaskuler. Albumin juga ikut keluar ke ekstraseluler pada proses ini, sehingga terjadi hipoalbuminemia. Hipoalbuminemia adalah kondisi dimana kadar albumin dalam darah berada dibawah 3,5 g/dl, sedangkan kadar normal albumin normal dalam darah adalah 3,8-5,0 g/dl. Berdasarkan Formularium Nasional sesuai Kepmenkes 2017 perihal pembatasan pemberian albumin infus yang didukung oleh JKN-KIS, ditetapkan bahwa pasien luka bakar diberikan transfusi human albumin bila kadar albumin kurang 2,5 g/dl. Diperlukan adanya solusi untuk peningkatan kadar albumin selain melalui transfusi, dengan syarat alternatif transfusi albumin ini diharapkan lebih hemat dan efisien dibandingkan dengan albumin transfusi yang terkenal mahal. Ekstrak Channa striata merupakan sebuah produk baru yang diharapkan dapat menjadi alternatif albumin transfusi ini. Tujuan: Tujuan penelitian adalah untuk mengetahui apakah pemberian kapsul ekstrak Channa striata dapat meningkatkan kadar albumin dalam darah pada kasus luka bakar. Metode: Metode penelitian ini menggunakan metode systematical review dengan mengambil jurnal melalui Google Scholer, PubMed dan ScienceDirect. Kesimpulan: Kesimpulan dari penelitian ini adalah kapsul ekstrak Channa striata dapat meningkatkan kadar albumin dalam tubuh serta mempercepat penyembuhan luka pasien luka bakar. Kapsul ekstrak Channa striata biasanya diberikan sebagai suplementasi bersama bahan lain untuk memenuhi kebutuhan gizi pasien. Penelitian yang saya temukan selain membuktikan efek kapsul ekstrak Channa striata terhadap kadar albumin juga memberikan hasil lain mengenai pemberian ekstrak Channa striata pada luka bakar yaitu penurunan kadar MDA serum dan meningkatkan balans nitrogen ke arah positif.

Oxidized Albumin and Cartilage Acidic Protein-1 as Blood Biomarkers to Predict Ischemic Stroke Outcomes

Background: There is high demand for blood biomarkers that reflect the therapeutic response or predict the outcomes of patients with acute ischemic stroke (AIS); however, few biomarkers have been evidentially verified to date. This study evaluated two proteins, oxidized albumin (OxHSA) and cartilage acidic protein-1 (CRTAC1), as potential prognostic markers of AIS.Methods: The ratio of OxHSA to normal albumin (%OxHSA) and the level of CRTAC1 in the sera of 74 AIS patients were analyzed on admission (day 0), and at 1 and 7 days after admission. AIS patients were divided into two groups according to their modified Rankin Scale (mRS) at 3 months after discharge: the low-mRS (mRS &lt; 2) group included 48 patients and the high-mRS (mRS ≥ 2) group included 26 patients. The differences in %OxHSA and CRTAC1 between the two groups on days 0, 1, and 7 were evaluated.Results: The mean %OxHSA values of the high-mRS group on days 0, 1, and 7 were significantly higher than those of the low-mRS group (p &lt; 0.05). The CRTAC1 levels continuously increased from day 0 to day 7, and those of the high-mRS group were significantly higher than those of the low-mRS group on day 7 (p &lt; 0.05).Conclusions: These results suggest that higher %OxHSA and CRTAC1 are associated with poor outcomes in AIS patients. An index that combines %OxHSA and CRTAC1 can accurately predict the outcomes of AIS patients.

Serum Albumin As a Prognostic Factor for Overall Survival at 6-Months in Acute Myeloid Leukemia (AML)

Introduction: The role of serum albumin as a prognostic factor has been well established in various medical conditions including some hematologic malignancies such as multiple myeloma and myelodysplastic syndromes . In this retrospective analysis, we examined the prognostic value of serum albumin at diagnosis prior to any therapy in a cohort of patients with acute myeloid leukemia (AML) irrespective of treatment modality. Methods: Data were collected retrospectively in a cohort of 257 AML patients who received treatment between 2002 to 2019. The cohort included patients who received conventional 7+3 induction, patients who were not candidates for induction receiving lower intensity chemotherapy +/- targeted drug, and patients who were placed on clinical trials. Patients under the age of 17 were excluded, as well as patients who received their initial diagnosis and induction at an outside hospital whose initial laboratory data for albumin were not available. We excluded patients who were not identified as Caucasian or African American in our final analysis. 46 patients were lost to follow up before 6-months and were excluded from all analysis. Analysis were performed with Epi Info software. Our patients were dichotomized by serum albumin ≥3.5 (normal albumin) and &lt;3.5 (hypoalbuminemia [HA]). Chi-square test was performed for univariate analysis of categorical variables and logistic regression was performed for multivariable analysis. Results: Of the 211 patients, the median age was 59.4 years (17 - 83.4) with 1:1 male to female ratio. 171 patients survived to 6 months and were included in our analysis. There was no significant age difference between normal albumin and HA groups (median age 59 and 59.7 respectively, p=0.854). There was an equal distribution of patients with HA with respect to sex (33.0% male and 36.9% female, p=0.560). With regards to race, more African Americans were found to have hypoalbuminemia compared to Caucasians (46% African Americans vs. 30% Caucasians, p=0.027). Patients with HA had an overall survival rate of 72.2% at 6 months while those with normal albumin levels had a survival rate of 85.1% (p=0.027). Multivariate logistic regression analysis including age, race, sex and albumin levels showed that age, sex and albumin levels were statistically significant independent predictors of survival at 6 months [Table 1]. Patients with albumin ≥3.5 were significantly more likely to survive controlling for age, race, and sex (OR=2.16, p=0.044). Multivariate analysis additionally showed that age was inversely associated with survival at 6-months (p=0.003) and males were more likely to survive than females (p=0.034). Though African Americans were shown to have a higher incidence of HA in univariate analysis, race was not an independent predictor for survival in the multivariate analysis when controlling for age, sex, and albumin level. Conclusions: In this cohort of AML patients, we found that hypoalbuminemia is an independent predictor survival. Serum albumin &lt;3.5 was associated with a significantly decreased overall survival at 6-months. Age and sex were additional independent predictors of 6-month survival. This data suggests that hypoalbuminemia, defined as albumin &lt;3.5, has prognostic utility in AML patients. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

EFFECT OF HYPOALBUMINEMIA IN WOUND HEALING AND ITS RELATED COMPLICATIONS IN SURGICAL PATIENTS.

This prospective study used hypoalbuminemia as one of the indicator of nutritional status for patients who are admitted for elective or emergency surgery. It will be invaluable to have the predictors that can assess the complication before the operation procedure,so that deciet factors can be corrected in order to reduce wound healing complications (like wound infection,wound dehiscence and anastomotic leak). Effect of Hypoalbuminemia in wound healing and AIM: related complications in surgical patients. MATERIAL AND METHODS:This study conducted on patients admitted in surgery deparment of Dr. PDMMC & Hospital Amravati,for major elective or emergency surgery between 1Jan2021 to 30Aug2021 over 100 patients. Pati RESULT: ents with hypoalbuminemia are more tends to develop wound related complications than patients with normal albumin level. Serum albumin levels can be consider CONCLUSION: one of best predictor for wound related complication.

UTILITY OF ALBUMIN CREATININE RATIO (ACR) IN MONITORING DIABETIC RETINOPATHY AND NEPHROPATHY

Objective: To evaluate Albumin Creatinine Ratio (ACR) as a screening marker for detection of early diabetic retinopathy in parallel with diabetic nephropathy. Study Design: Comparative cross sectional study. Place and Duration of Study: Department of Ophthalmology and Chemical Pathology & Endocrinology, Combined Military Hospital, Multan, from Jul 2017 to Jul 2019. Methodology: A total of 386 diagnosed patients of type II diabetes mellitus who reported for follow up and monitoring in Combined Military Hospital Multan, underwent initial screening with urine dip strip, if protein positive patients were excluded if negative patients were included in the study. Urinary albumin creatinine ratio was calculated as mg/mmol of creatinine. For staging of diabetic retinopathy; participants underwent ocular examinations. Pearson correlation was performed and ROC was constructed at different cut-offs. Results: Out of the 386 (100%) patients with type II diabetes 284 (74%) had albumin creatinine ratio <3 mg/mmol and 102 (26%) had micro albuminuria i.e. albumin creatinine ratio 3-30 mg/mmol. Among normal albumin uric cases (284) only 52 (18%) patients had mild to moderate non-proliferative diabetic retinopathy. Conclusion: Albumin creatinine ratio is associated with severity of diabetic retinopathy. Since diabetic retinopathy stages have been identified in normal albumin uric range, there is need to determine a definite cut off value (<3 mg/mmol) of ACR for using it as a screening marker for diabetic retinopathy.

A Method for Assessing the Severity of Obstructive Jaundice of Non-Neoplastic Origin

AIM OF STUDY To develop a method for assessing the severity of obstructive jaundice (OJ) of non-neoplastic orogin on the basis of functional parameters of the liver and the activity of pathogenetic agents of hepatodepression.MATERIAL AND METHODS Clinical and laboratory studies of 142 patients with breast cancer of non-tumor origin. The indicators of the functional state of the liver, the index of plasma toxicity for albumin, and the content of malondialdehyde (MDA) were evaluated.RESUlTS Based on the assessment of a number of blood parameters - the content of total bilirubin (TB), the plasma toxicity index for albumin, the MDA level — the severity index of obstructive jaundice of non-neoplastic origin (SIOJ) was developed:SIOJ = IT1/ITn + TB1/TB + 5(MDA1/MDAn)where IT 1 is the plasma albumin toxicity index at the current moment, ITn is the normal albumin plasma toxicity index, TB1 is the current bilirubin content, TBn is the normal bilirubin content, MDA1 is the current malondialdehyde content, MDAn is the normal value. The index less than 13 indicates a mild severity, 14–21 is moderate severity, 22 and higher indicates a severe degree of OJ. The method increases the objectivity of determining the severity of non-neoplastic origin by establishing the severity of liver damage and the processes underlying it.CONClUSiON The suggested clinical and laboratory index allows the severity of obstructive jaundice to be objectively and quickly determined upon admission of a patient to the hospital and also adequate therapy to be initiated in case of severe degree for anticipation of possible post-operative complications, so the treatment should be focused on managing triggers of hepatodepression. The method is simple and available in medical institutions of various levels. The method is especially valuable when used in the dynamics of the early postoperative period.

Selected Biochemical Blood Parameters and a Risk of Pressure Ulcers in Patients Receiving Treatment in Intensive Care Units

Background and Objectives: This study aimed to assess the level of selected biochemical parameters in venous blood and their potential effects on the development of pressure ulcers in patients treated in intensive care settings. Materials and Methods: Fifty patients hospitalised in an intensive care unit (ICU) were enrolled for the study. The methods used included controlled observation, literature review and medical record analysis. The observation protocol applied in the study consisted of two parts comprising the basic information, sociodemographic data, results of laboratory tests (CRP, PCT, albumin, protein and haemoglobin concentrations) as well as the Braden Scale for Predicting Pressure Ulcer Risk. Results: The subjects presented moderate to high risk of pressure ulcers, reflected by the mean score of 8.18 ± 1.3 points, with minimum and maximum scores of 6 and 12 points, respectively. Normal albumin level was identified in only five subjects (10.0%) while 45 subjects (90.0%) were found with results below the norm. A statistical relationship was observed between such variables as albumin concentration (p < 0.01) and total protein level (p = 0.007). The findings show a strong correlation between the score in the Braden Scale and the level of albumins (R = 0.55). Conclusions: In our study, lower concentrations of albumins and total proteins correspond to a greater risk of pressure ulcers.

Serum albumin is a predictor of respiratory hospitalization in patients with bronchiectasis

We evaluated serum albumin as an index for predicting respiratory hospitalization in patients with bronchiectasis. We retrospectively reviewed the medical records of 177 patients with bronchiectasis, categorized them into low and normal albumin groups, and compared their clinical characteristics. The prediction of respiratory hospitalization by factors such as serum albumin level, bronchiectasis severity index (BSI), and FACED score (an acronym derived from five variables of forced expiratory volume in 1 s; FEV1, age, chronic colonization of Pseudomonas aeruginosa, extent of bronchiectasis, and dyspnea) was assessed. There were 15 and 162 patients categorized in the low and normal albumin groups, respectively. The low albumin group had lower body mass index and forced expiratory volume in 1 s, and higher age, frequency of previous respiratory hospitalization, percentage of Pseudomonas colonization, number of affected lobes, BSI and FACED scores, and C-reactive protein (CRP) level, than the normal albumin group. The areas under the receiver operating characteristic curve of serum albumin level and BSI and FACED scores for predicting respiratory hospitalization were 0.732 (95% confidence interval (CI), 0.647–0.816), 0.873 (95% CI, 0.817–0.928), and 0.708 (95% CI, 0.618–0.799), respectively. Albumin level, CRP, modified Medical Research Council score, and chronic Pseudomonas aeruginosa (and other organisms) colonization were independent risk factors for respiratory hospitalization. Low serum albumin level was associated with worse clinical condition, higher severity scores, and respiratory hospitalization in patients with bronchiectasis.

Study of biochemical parameters in farmers exposed to pesticides used in cotton growing around the Bala hippopotamus pond

Repeated exposure to pesticides can cause a variety of human health problems, particularly among farmers. This work consisted in studying biochemical parameters and their evolution in cotton farmers exposed to pesticides. A longitudinal study was conducted during and after the 2018/2019 cotton season on a cohort of cotton farmers around the Bala hippopotamus pond in the department of Satiri. Biochemical parameters were measured during and after the crop year on the Architect ci 4100. The majority of the farmers had high uric acid (UA) and low blood sugar (Gluc) concentrations. A few had concentrations of Cholinesterase (ChE) (6.19%); Direct Bilirubin (BilD) (23.01%); Gamma Glutamyl Transferase (GGT) (8.85%); Alkaline Phosphatase (ALkP) (4.42%); Cholesterol (Chol) (4.42%); triglycerides (Trig) (4.42%); aspartate aminotransferase (AST) (4.42%) higher than normal and lower than normal albumin (Alb) (13.27%) and total protein (TP) (13.27%) concentrations. Analysis of the evolution of biochemical parameters showed that none of the producers had higher than normal ChE and TP concentrations. After the campaign, the number of producers with lower than normal values increased for AST, AlkP, Alb and Urea while those with higher than normal values increased for GGT, UA, Gluc, Chol, Trig and BilD. Also, a significant decrease in AST, ALT and creatinine (CreaC) concentrations and a significant increase in GGT and BilD concentrations were observed. The existence of some disturbances of biochemical parameters in farmers should encourage to test the hypothesis of a link between pesticide exposure and the appearance of biochemical disorders in clinical trials.