Formula In Patients Research Articles

Accuracy of Intraoperative Aberrometry, Barrett True-K With and Without Posterior Cornea Measurements, Shammas-PL, and Haigis-L Formulas After Myopic Refractive Surgery.

To assess the accuracy of intraoperative aberrometry, the Barrett True-K No History (Barrett TKNH), Barrett TKNH with posterior corneal measurements (Barrett TKNH with PC), Shammas-PL, and Haigis-L formulas in patients with cataract who had prior myopic refractive surgery. This was a retrospective consecutive case series of patients with prior myopic refractive surgery undergoing cataract extraction. Mean absolute error (MAE) and median absolute error (MedAE) of refraction prediction were compared for each formula. Interactions of each biometry measurement were modeled for each formula to evaluate those with the most significant impact on refraction prediction. One hundred sixteen eyes of 79 patients were analyzed. MAE was 0.40 ± 0.33 diopters (D) for intraoperative aberrometry and 0.42 ± 0.31 D for the Barrett TKNH, 0.38 ± 0.30 D for the Barrett TKNH with PC, 0.47 ± 0.38 D for the Shammas-PL, and 0.56 ± 0.39 D for the Haigis-L formulas. Comparisons between formulas were significant for Barrett TKNH versus Barrett TKNH with PC formulas (P = .046), Barrett TKNH with PC versus Shammas-PL formulas (P = .023), and for all comparisons with the Haigis-L formula (P < .001), and not significant for all other comparisons (P > .05). Eyes were within ±0.50 D of prediction 73%, 72%, 69%, 62%, and 52% of the time for intraoperative aberrometry, the Barrett TKNH with PC, Barrett TKNH, Shammas-PL, and Haigis-L formulas, respectively. Corneal asphericity (Q value) was significantly associated with prediction error for all five methods. Changes in anterior chamber depth had a significant impact on Shammas-PL prediction errors. Newer technology using information from the posterior cornea modestly improved outcomes when compared to established methods for intraocular lens selection in eyes that had previous laser refractive surgery for myopia. [J Refract Surg. 2021;37(1):60-68.].

Real-life study of the effectiveness of a high calorie and high protein formula in the maintenance and improvement of nutritional state in patients with an indication of long-term enteral nutrition

The selection of the most appropriate formula in long-term home enteral nutrition is a controversial issue. Our objective was to study a high protein hypercaloric enteral nutrition formula in patients with long-term feeding (180 days). MethodsProspective observational multicenter real-life study with high-protein hypercaloric formula (2kcal/ml and 20% protein). General, anthropometric, analytical and quality of life data were collected by visual analog scale of the European Quality of Life-5 Dimensions at the beginning, 60, 120 and 180 days. Gastrointestinal tolerance was assessed with a visual analog scale and Bristol Stool Scale and the risk of malnutrition was assessed using NRS-2002. Results51 patients (88.2% men, mean age 62.0 years), with oncological diseases in 72.5%. No differences in anthropometric data were observed, although the percentage of patients at risk of malnutrition according to NRS 2002 was reduced from 75% to 8.3% (p<0.0001). No differences were observed in albumin, prealbumin, transferrin, lymphocytes or hematocrit. The quality of life improved from 3.84 (1.27) to 5.37 (1.12) on the visual analog scale (p<0.0001). A reduction in gastrointestinal symptoms was observed throughout the period of enteral nutrition. Both the number and percentage of stools considered normal according to the Bristol scale remained stable. ConclusionOur study supports that the use of high-protein hypercaloric formulas during a 6-month nutritional treatment allows an adequate nutritional evolution without risk of dehydration and with a good tolerance, even improvement of gastrointestinal symptoms, and can contribute to an improvement in the quality of lifetime.

Clinical observation of individualized nutritional formula on inflammation index, immune status and gastrointestinal tolerance in patients with severe head injury.

Objectives:To evaluate the clinical significance of individualized nutritional formulas on inflammatory factors, immune status and gastrointestinal tolerance in patients with severe head injury.Methods:A total of 80 patients with severe head injury who were hospitalized in Baoding No.1 Central Hospital from March 2017 to March 2020 were randomly divided into two groups with 40 cases in each group. Patients in both groups were given enteral nutrition (EN), the control group was given conventional enteral nutrition formula through nasointestinal tube, and the experimental group was given individualized nutrition formula. All patients were tested for tumor necrosis factor(TNF-α), C-reactive protein(CRP), interleukin 6(IL-6), IgA, IgM, IgG, serum intestinal fatty acid binding protein(I-FABP) and D-lactic acid concentration before and after enteral nutrition treatment. The incidence of adverse reactions such as abdominal distension, diarrhea, constipation, and gastric retention within seven days after treatment of two groups were compared and analyzed.Results:There was no significant difference in inflammatory factors such as TNF-a, CRP, IL-6, immunoglobulin levels, I-FABP and D-lactic acid concentration between the two groups before treatment (p>0.05). After treatment, the above indicators of the two groups of patients were better than before treatment, the difference was statistically significant (p<0.05), and the experimental group was significantly better than the control group (p<0.05). The experimental group had a gastrointestinal adverse reaction rate of 10%, and the control group had 27.5%, the difference was statistically significant (p=0.04).Conclusions:Individualized nutritional formula has more significant advantages than conventional nutritional formula for patients with severe head injury, which can reduce inflammatory response, increase the patient’s immune level, improve the intestinal mucosal barrier function, have good gastrointestinal tolerance, and have a low incidence of adverse reactions.

Value of l-alanyl-l-glutamine parenteral formula in patients with head and neck cancer receiving radiotherapy

Objective The aim was to determine the effect of administration of parenteral l-alanyl-l-glutamine-containing formula on occurrence of treatment-related malnutrition and acute radiotherapy (RT)-related toxicities in patients with head and neck cancer. Background Studies have shown that glutamine-containing nutritional therapy can improve the nutritional status of adult patients with cancer. Patients and methods A total of 40 patients with head and neck carcinoma were randomized to receive either parenteral l-alanyl-l-glutamine-containing formula (0.4 mg/kg) during the first 2 weeks of RT (with or without chemotherapy) or placebo. Nutritional assessment was done for all patients at diagnosis and on weekly basis till end of treatment using subjective global assessment tool and anthropometric measures. Treatment-related toxicity was reported and graded. Quality of life (QoL) was assessed using Functional Assessment of Cancer Therapy for patients with head and neck cancer. Results There was a significant difference between the studied groups regarding subjective global assessment tool score from third week till 7th week (P = 0.019, 0.005, <0.001, <0.001, and 0.021, respectively). Low BMI was more frequent in group 2 patients. Conversely, severe weight loss was significantly different between both groups starting from third week (P = 0.020, 0.010, 0.004, 0.031, and 0.044). There was higher frequency and severity of acute RT toxicities in group 2 patients. There was a significant difference between the two groups regarding QoL as well (P = 0.005). Conclusion l-alanyl-l-glutamine nutritional supplement resulted not only in better nutritional status but also in improved treatment tolerance and QoL.

Efficacy and safety of Jia Wei Bushen Yiqi formulas as an adjunct therapy to systemic glucocorticoids on acute exacerbation of COPD: study protocol for a randomized, double-blinded, multi-center, placebo-controlled clinical trial

BackgroundSystemic glucocorticoids are effective for the management of chronic obstructive pulmonary disease (COPD) exacerbation but have serious adverse effects. Traditional Chinese medicine (TCM) can bring additional benefits to these patients but has few adverse effects. The present study aims to evaluate the efficacy and safety of Jia Wei Bushen Yiqi (JWBY) formulas in patients who suffer from COPD exacerbations and to investigate whether the short-term (5-days) systemic glucocorticoid therapy is non-inferior to the long-term (9-day) regime.MethodsIn this multi-center, randomized, double-blinded trial, eligible inpatients with COPD exacerbation are randomly assigned to four groups (A, B, C, and D). Group A will receive placebo plus 5-day prednisone, group B will receive placebo plus 9-day prednisone, group C will receive JWBY formulas plus 5-day prednisone, and group D will receive JWBY formulas plus 9-day prednisone. The primary outcomes are the time interval to the patient’s next exacerbation during a 180-day following up and the COPD assessment test (CAT) during treatment. Secondary outcomes include lung function, TCM syndrome assessment, laboratory tests, and safety. The changes of the hypothalamic pituitary adrenaline axis (HPA axis) and inflammatory cytokine will be measured as well.DiscussionBy demonstrating the advantages of utilizing TCM and an appropriate duration of systemic glucocorticoids, this effectiveness comparison trial will provide new references to physicians on how to improve the management of COPD exacerbation. The results of HPA axis and inflammation cytokine measurements will shed light on the molecular mechanisms and entail further mechanism studies.Trial registrationwww.chictr.org.cn ChiCTR1900023364. Registered on 24 May 2019.

Improved nutritional support with immune-modulating formula in patients with head and neck and esophageal cancer undergoing radiochemotherapy: A retrospective clinical study.

Malnutrition is frequent in patients with head and neck (HN) and esophageal cancer, aggravated by radiochemotherapy (RCT), and increases morbidity and mortality and treatment toxicity. Recent studies suggest that the immune, nutritional, or inflammatory status can be modulated by the use of pharmaconutrients in RCT-treated patients. In this study, the effect of immunonutrition, including arginine, ω-3 fatty acid, and nucleotide enriched diet, on nutritional status in patients with HN or esophageal cancer undergoing RCT was investigated. A retrospective review of 88 patients undergoing RCT was conducted. Either an immune-modulating enteral nutrition (IEN) (Impact formula) or a standard enteral nutrition (SEN) (isonitrogenous and isoenergetic formula) was administered. Anthropometric parameters, nutritional risk index (NRI), serum albumin, and functional capacity were recorded at the beginning and end of the RCT. Approximately 45% of patients were moderate to severely malnourished (NRI <97.5) at the beginning of the RCT in the SEN (n=19) and IEN (n=21) groups alike. Significant improvement was observed in the NRI of malnourished patients of the IEN group (97.3±11.9 vs 98.0±12.0, p=0.021). Additionally, a significant difference in the body weight (BW) between the two groups was observed, and BW increased (65.4±14.8 kg vs 66.3±14.3 kg, p=0.03) in the IEM group but decreased (62.3±12.3 kg vs 61.7±12.0 kg, p=0.023) in the SEM group. Pharmaconutrient- enriched IEN had a more potent effect than SEN in preventing deterioration of nutritional status during RCT.

Prognostic of different glomerular filtration rate formulas in patients receiving percutaneous coronary intervention: insights from a multicenter observational cohort

BackgroundThe relationships of renal dysfunction (RD) and chronic kidney disease (CKD) with prognosis have been well established among non-ST elevation acute coronary syndrome (NSTE-ACS) patients who receive percutaneous coronary intervention (PCI), but the efficacy of different estimated glomerular filtration rate (eGFR) formulas for predicting the prognosis is unknown.MethodsThe cohort originated from a retrospective data, which consecutively enrolled 8197 patients. The eGFR was calculated by the Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD), CKD Epidemiology Collaboration-creatinine, CKD Epidemiology Collaboration-Cys-C, CKD Epidemiology Collaboration-Cys-C-creatinine and a modified abbreviated MDRD (c-aGFR) equations in Chinese CKD patients. Patients were excluded if the eGFR could not be obtained by one of the formulas. Patients were categorized as having normal renal function, mild RD, moderate RD, severe RD, or kidney failure to compare prognosis. The primary outcome was the in-hospital net adverse clinical events (NACE). The secondary outcomes were NACE and all-cause death during follow-up.ResultsIn total, 2159 NSTE-ACS patients (age: 64.23 ± 10.25 years; males: 73.7%) were enrolled. 39 (1.8%) patients with in-hospital NACE were observed. During the 3.23 ± 1.55-year follow-up, 1.7% death and 4.2% NACE were observed in 1 year. The percentage of severe RD patients ranged from 15.4 to 39.2% according to different calculation formulas. A high prevalence of in-hospital NACE was observed in the severe RD groups (ranging from 8 to 14.3% for different formulas). Multiple regression analysis showed that a high eGFR is a protect factor against NACE and all-cause death regardless of the formula use. Receiver operating characteristic curves showed similar predictive performance of the c-aGFR when compared to other formulas (in-hospital NACE: AUC = 0.612, follow-up NACE: AUC = 0.622, and follow-up death: AUC = 0.711).ConclusionsSevere RD results in a high prevalence of in-hospital NACE in NSTE-ACS patients after PCI regardless of the formulas use. Different formulas have a similar ability to predict in-hospital and long-term prognosis in NSTE-ACS patients. The c-aGFR formula is the simplest and a more convenient formula for use in practice.

Changes in metabolic parameters and glomerular filtration rate in patients with morbid obesity after bariatric surgery

To study the effect of weight loss in the short term after bariatric surgery (BO) on metabolic parameters and glomerular filtration rate (GFR) in patients with morbid obesity. We studied 40 adult (over 18 years) patients with morbid obesity who underwent bariatric surgery. Metabolic indices and calculated GFR according to the CKD-EPI formula in patients before and after bariatric surgery were compared. In the whole group of operated patients, the average body mass index (BMI) after surgery decreased from 45.8 to 30.5 kg/m2. In 11 (92%) patients with impaired carbohydrate metabolism, remission of diabetes mellitus was achieved and sugar-lowering drugs were canceled. In patients with baseline GFR90 ml/min/1.73 m2 after surgery, there is a tendency towards a decrease in GFR, probably due to a decrease in hyperfiltration. In patients with baseline GFR90 ml/min/1.73 m2 after surgery, a statistically significant increase in the level of GFR was noted. The greater metabolic efficacy of combined operations (mini-gastric bypass, biliopancreatic diversion) in relation to the correction of carbohydrate and fat metabolism was revealed. Obesity is a modifiable risk factor for decreased kidney function and the progression of chronic kidney disease. Bariatric surgery is an effective treatment for morbid obesity. The study proved the positive effect of weight loss after BO on renal function, including by improving the course of diseases associated with obesity.

Estudio en vida real de efectividad de una fórmula hipercalórica hiperproteica en el mantenimiento y mejora del estado nutricional en pacientes con indicación de nutrición enteral a largo plazo

The selection of the most appropriate formula in long-term home enteral nutrition is a controversial issue. Our objective was to study a high protein hypercaloric enteral nutrition formula in patients with long-term feeding (180 days). MethodsProspective observational multicenter real-life study with high-protein hypercaloric formula (2kcal/ml and 20% protein). General, anthropometric, analytical and quality of life data were collected by visual analog scale of the European Quality of Life-5 Dimensions at the beginning, 60, 120 and 180 days. Gastrointestinal tolerance was assessed with a visual analog scale and Bristol Stool Scale and the risk of malnutrition was assessed using NRS-2002. Results51 patients (88.2% men, mean age 62.0 years), with oncological diseases in 72.5%. No differences in anthropometric data were observed, although the percentage of patients at risk of malnutrition according to NRS 2002 was reduced from 75% to 8.3% (p<0.0001). No differences were observed in albumin, prealbumin, transferrin, lymphocytes or hematocrit. The quality of life improved from 3.84 (1.27) to 5.37 (1.12) on the visual analog scale (p<0.0001). A reduction in gastrointestinal symptoms was observed throughout the period of enteral nutrition. Both the number and percentage of stools considered normal according to the Bristol scale remained stable. ConclusionOur study supports that the use of high-protein hypercaloric formulas during a 6-month nutritional treatment allows an adequate nutritional evolution without risk of dehydration and with a good tolerance, even improvement of gastrointestinal symptoms, and can contribute to an improvement in the quality of lifetime.

P0715SUPERB MICROVASCULAR IMAGING: AN INNOVATIVE ULTRASOUND TECHNIQUE FOR EARLY DETECTION OF KIDNEY DYSFUNCTION AND RENAL FIBROSIS

Abstract Background and Aims Superb microvascular imaging (SMI) is an innovative ultrasound image processing technique that shows greater details and better visualization of small branching vessels by using a unique algorithm that offer high frame rates, less clutter, and fewer tissue motion artefact that were not previously possible without the use of contrast agent. We assume that SMI provides superb information regarding the severity of chronic kidney disease (CKD) and associated the fibrotic changes. Therefore, the present study was designed to examine whether SMI can detect early renal fibrosis as compared with the reference standard renal biopsy. Method The SMI was performed in patients (n=47) with CKD stage 2-4, where some of them underwent biopsy proven chronic renal dysfunction and fibrosis as part of the diagnosis and therapeutic judgment as needed. In addition, biochemical tests were performed in order to obtain the serum parameters of kidney function (BUN, Serum Creatinine), a urine collection test for the assessment of proteinuria, and estimation of GFR by MDRD formula in patients with CKD of various severity and healthy controls (n=17). In addition, all patients underwent SMI US imaging, where vascularity is expressed as SMI index (low index reflects low vascularity/fibrosis and vice versa). Results As expected, SMI vascular index was significantly lower in CKD patients as compared with healthy control (72.2±3.1 Vs 49.1±2.6 %, P&amp;lt;0.001). Interestingly, strong correlation between the SMI index and eGFR was found among the CKD patients (r=0.595, P&amp;lt;0.001). Similarly, a keen correlation was found between the SCr and SMI index of the diseased subjects. Among those who underwent renal biopsy, SMI index corresponds with the histological alterations as well as CKD staging. Conclusion This study demonstrates that in patients with CKD of various stages, SMI imaging may be utilized as a simple and practical method for evaluation of the chronic renal morphological changes and for the differentiation between CKD grades.

Efficacy and safety of Shu-gan-qing-re formula for generalized anxiety disorder: study protocol for a multi-center, prospective, double-blind, double-dummy, randomized controlled trial

BackgroundGeneralized anxiety disorder (GAD) is a persistent and common mental disorder that entails significant impairments in role functioning and quality of life. Currently available effective interventions include psychological therapies, self-help approaches, and pharmacological treatments, which do not quite meet clinical needs, and the ideal anxiolytic is still being sought. Shu-gan-qing-re (SGQR) formula, a Chinese patent medicine, has been well received by patients with GAD in Chinese clinical practice for years. The present prospective, double-blind, double-dummy, randomized controlled trial is designed to investigate the efficacy and safety of SGQR formula for GAD.Methods/designA total of 200 eligible participants will be recruited from four hospitals in different parts of China. They will be randomly assigned to either the study group or the control group in a ratio of 1:1. Participants allocated to the study group will receive SGQR formula and buspirone placebo, while buspirone and SGQR placebo will be applied in the control group. Six scheduled visits will be conducted over the course of 8 weeks. Outcome measurements include Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale-17 (HAMD-17), Clinical Global Impression-Improvement Scale (CGI-I), Traditional Chinese Medicine Syndrome Scale for GAD, and pro-inflammatory cytokine tests: interleukin-1 beta (IL-1β), IL-6, and tumor necrosis factor-alpha. Adverse reactions will be evaluated by using the Treatment Emergent Symptom Scale (TESS). Safety outcomes and adverse events will also be recorded.DiscussionThe study will provide scientific and objective assessments for the efficacy and safety of SGQR formula for patients with GAD, hopefully offering clinicians an alternative approach to GAD.Trial registrationChinese Clinical Trial Registry, ID: ChiCTR-IPR-17013058. Registered on October 20, 2017.

Comparison of Barrett Universal II and Hill-RBF 2.0 Formulas In Patients Undergoing Routine Cataract Surgery

Comparison of Barrett Universal II and Hill-RBF 2.0 Formulas In Patients Undergoing Routine Cataract Surgery

739: Comparison of sonographic fetal weight estimation formulas in patients with preterm premature rupture of membranes

739: Comparison of sonographic fetal weight estimation formulas in patients with preterm premature rupture of membranes

Discrepancies and Validation of Ethanol Level Determination with Osmolar Gap Formula in Patients with Suspected Acute Poisoning

Purpose: Osmolar gap (OG) has been used for decades to screen for toxic alcohol levels. However, its reliability may vary due to several reasons. We validated the estimated ethanol concentration formula for patients with suspected poisoning and who visited the emergency department. We examined discrepancies in the ethanol level and patient characteristics by applying this formula when it was used to screen for intoxication due to toxic levels of alcohol. Methods: We retrospectively reviewed 153 emergency department cases to determine the measured levels of toxic ethanol ingestion and we calculated alcohol ingestion using a formula based on serum osmolality. Those patients who were subjected to simultaneous measurements of osmolality, sodium, urea, glucose, and ethanol were included in this study. Patients with exposure to other toxic alcohols (methanol, ethylene glycol, or isopropanol) or poisons that affect osmolality were excluded. OG (the measured-calculated serum osmolality) was used to determine the calculated ethanol concentration. Results: Among the 153 included cases, 114 had normal OGs (OG≤14 mOsm/kg), and 39 cases had elevated OGs (OG&gt;14). The mean difference between the measured and estimated (calculated ethanol using OG) ethanol concentration was -9.8 mg/dL. The 95% limits of agreement were -121.1 and 101.5 mg/dL, and the correlation coefficient R was 0.7037. For the four subgroups stratified by comorbidities and poisoning, the correlation coefficients R were 0.692, 0.588, 0.835, and 0.412, respectively, and the mean differences in measurement between the measured and calculated ethanol levels were -2.4 mg/dL, -48.8 mg/dL, 9.4 mg/dL, and -4.7 mg/dL, respectively. The equation plots had wide limits of agreement. Conclusion: We found that there were some discrepancies between OGs and the calculated ethanol concentrations. Addition of a correction factor for unmeasured osmoles to the equation of the calculated serum osmolality would help mitigate these discrepancies.

The Error of Estimated GFR in Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus represents 30–50% of the cases of end stage renal disease worldwide. Thus, a correct evaluation of renal function in patients with diabetes is crucial to prevent or ameliorate diabetes-associated kidney disease. The reliability of formulas to estimate renal function is still unclear, in particular, those new equations based on cystatin-C or the combination of creatinine and cystatin-C. We aimed to assess the error of the available formulas to estimate glomerular filtration rate in diabetic patients. We evaluated the error of creatinine and/or cystatin-C based formulas in reflecting real renal function over a wide range of glomerular filtration rate (from advanced chronic kidney disease to hyperfiltration). The error of estimated glomerular filtration rate by any equation was common and wide averaging 30% of real renal function, and larger in patients with measured glomerular filtration rate below 60 mL/min. This led to chronic kidney disease stages misclassification in about 30% of the individuals and failed to detect 25% of the cases with hyperfiltration. Cystatin-C based formulas did not outperform creatinine based equations, and the reliability of more modern algorithms proved to be as poor as older equations. Formulas failed in reflecting renal function in type 2 diabetes mellitus. Caution is needed with the use of these formulas in patients with diabetes, a population at high risk for kidney disease. Whenever possible, the use of a gold standard method to measure renal function is recommended.

Calcium state estimation by total calcium: the evidence to end the never-ending story

Background Total blood calcium (TCa) is routinely used to diagnose and manage mineral and bone metabolism disorders. Numerous laboratories adjust TCa by albumin, though literature suggests there are some limits to this approach. Here we report a large retrospective study on agreement rate between ionized calcium (iCa) measurement and TCa or albumin-adjusted calcium measurements. Methods We retrospectively selected 5055 samples with simultaneous measurements of iCa, TCa, albumin and pH. We subgrouped our patients according to their estimated glomerular filtration rate (eGFR), albumin levels and pH. We analyzed each patient's calcium state with iCa as reference to determine agreement rate with TCa and albumin-adjusted calcium using Payne, Clase, Jain and Ridefelt formulas. Results The Payne formula performed poorly in patients with abnormal albumin, eGFR or pH levels. In patients with low albumin levels or blood pH disorders, Payne-adjusted calcium may overestimate the calcium state in up to 80% of cases. Similarly, TCa has better agreement with iCa in the case of hypoalbuminemia, but performed similarly to the Payne formula in patients with physiological albumin levels. The global agreement rate for Clase, Jain and Ridefelt formulas suggests significant improvement compared to Payne calcium adjustment but no significant improvement compared to TCa. Conclusions Total and albumin-adjusted calcium measurement leads to a misclassification of calcium status. Moreover, accurate calcium state determination depends on blood pH levels, whose measurement requires the same pre-analytical restrictions as iCa measurement. We propose that iCa should instead become the reference method to determine the real calcium state.

Effciency of a rehabilitation training method by means of special infant formulas in patients with ischemic stroke and neurogenic dysphagia as part of combined therapy

Objective: to evaluate the efficiency of a training method using special infant formulas as part of combined rehabilitation for patients with ischemic stroke and neurogenic dysphagia.Patients and methods. The investigation enrolled 55 patients (30 men and 25 women) aged 45–80 years with dysphagia during the acute period of ischemic stroke. Thirty patients used special astringent formulas as part of combined therapy and 25 patients did not. The investigators studied the time of course of changes in the restoration of swallowing function, by using the Penetration-Aspiration Scale (PAS) and the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), as well as the transition from probe feeding to independent one.Results and discussion. The best restoration of swallowing function was shown to be achieved through training using formulas with different astringency. Stronger astringent formulas, like solid foods, stimulate better the pharyngeal receptor apparatus; the most active restoration of a dynamic swallowing stereotype occurs. The gradual transition to a milder astringent formula allows restoration of the skill to swallow thinner liquid foods. It takes 10 days to achieve a significant clinical effect in most patients, mainly in those with pseudobulbar disorders. Training may be prolonged to 2 weeks or more in severe cases, in bulbar dysfunctions.Conclusion. The training rehabilitation method using special infant formulas in combination with electrical stimulation in patients with ischemic stroke and neurogenic dysphagia allows achieving the significantly better indicators of restoration of swallowing function in accordance with the PAS scale. The application of the method contributes to the significantly better transition from probe feeding to independent one.

The Prevalence of Sarcopenia Using Different Formulas in Patients with Prediabetes

The Prevalence of Sarcopenia Using Different Formulas in Patients with Prediabetes

FEATURES OF THE FUNCTIONAL STATE OF KIDNEYS AT CHRONIC RENAL DISEASE IN PATIENTS WITH NON-ALCOHOLIC STEATOHEPATITIS

The purpose. To establish the changes in the functional state of kidneys, depending on the stage of chronic renal disease in comorbidity with non-alcoholic steatohepatitis against a background of obesity.Material and methods. 240 patients with chronic kidney disease (chronic bilateral pyelonephritis) of the I-III stage were studied: 145 patients had comorbid non-alcoholic steatohepatitis (NASH) and obesity (1 group), 95 patients were diagnosed with CKD I-III stages without comorbid pathology . Depending on the stage of the CKD, the groups of patients were divided as follows: group 1 was divided into 3 subgroups: CKD stage I - 51 patients, CKD stage II - 53 patients, CKD stage III - 41 patients. The 2nd group was divided into 3 subgroups: CKD of the Ist stage - 32 patients, CKD of the IInd stage - 35 patients, CKD of the IIIrd stage - 28 patients. The control group consisted of 30 practically healthy persons (PHPs).Results. The analysis of indices of the kidneys’ functional state showed that creatinine content in the blood of group I patients exceeded the data in the PHPs in 1,5 times (p &lt;0,05), in group II - 1,3 times (p &lt;0,05) . In patients with CKD, stage III, blood creatinine in group I exceeded the data in PHPs by 2.3 times (p &lt;0.05), in group 2 - by 1.9 times (p &lt;0.05) respectively. So, comorbidity with NASH significantly affects the kidneys functional state indicators, in particular, their nitrogen-excretory function. Thus, the content of blood urea in patients with CKD I stage exceeded the indicators in PHPs, respectively, in groups I, II - in 2,4 and 2,2 times (p &lt;0,05). In patients with CKD II stage in group 1 the urea content exceeded the index in PHPs by 2.5 times compared with 2.4 times in group 2 (p &lt;0.05). As a result of the established changes, a significant decrease in GFR (Glomerular filtration rate) was obtained for creatinine clearance using the Cockroft-Gaulta formula. Thus, the indicator of creatinine clearance by the Cockroft-Gaulta formula in patients with CKD I stage was lower than that in PHPs only in group 1 patients (11.8%) (p &lt;0.05); in patients of group 2, changes were unlikely and no significant difference was found between the groups (p&gt; 0.05). In patients with CKD II stage in group 1, the creatinine clearance score was lower than the PHPs index by 39.2% versus a decrease of 25.5% in group 2 (p &lt;0.05) with a confirmation of statistically significant difference between the groups (p &lt;0.05). At the same time, patients with CKH III stage, the rate of creatinine clearance in patients in group 1 was lower than the normative at 55.9% (p &lt;0.05), in group 2 - by 44.1% (p &lt;0.05), with the presence of a probable difference between patients with a combined course NASH and CKD in comparison with patients with CKD without comorbid diseases (p &lt;0,05). Conclusions. Non-alcoholic steatohepatitis significantly aggravates the course of chronic kidney disease of І-ІІІ stages with a possible decrease in nitrogen excretory function, glomerular filtration rate, hypopaluminemia than in the isolated course of chronic kidney disease.

Effect of baroreflex activation therapy on renal sodium excretion in patients with resistant hypertension.

Activation of the sympathetic nervous system increases sodium retention in resistant hypertension. Baroreflex activation therapy (BAT) is an interventional method to reduce sympathetic overactivity in patients with resistant hypertension. This study aimed to assess the effect of BAT on urinary sodium excretion. From 2012 to 2015, consecutive patients with resistant hypertension and blood pressure (BP) above target despite polypharmacy strategies were consecutively included in this observational study. BAT was provided with the individual adaption of programmed parameters over the first months. 24-h urinary sodium excretion (UNa) was estimated at baseline and after 6 months using the Kawasaki formula in patients undergoing BAT. Additionally, the fractional sodium excretion, plasma renin activity, and aldosterone levels were assessed. Forty-two patients completed the 6-month follow-up period. Office systolic and ambulatory 24-h systolic BP at baseline were 169 ± 27mmHg and 148 ± 16mmHg despite a median intake of 7(3-9) antihypertensive drugs. After 6 months of BAT, systolic office BP decreased to 150 ± 29mmHg (p < 0.01), 24-h systolic BP to 142 ± 22mmHg (p = 0.04) and 24-h UNa increased by 37% compared to baseline (128 ± 66 vs. 155 ± 83mmol/day, p < 0.01). These findings were accompanied by a significant increase in fractional sodium excretion (0.74% [0.43-1.47] to 0.92% [0.61-1.92]; p = 0.02). However, in contrast to the significant BP reduction, eGFR, plasma sodium, renin activity and aldosterone levels did not change during BAT. The increase in sodium excretion was correlated with the change in eGFR (r = 0.371; p = 0.015). The present study revealed a significant increase of estimated 24-h UNa which may contribute to the long-term BP-lowering effects of this interventional method.