Indicator Of Nutritional Status Research Articles

Prognostic significance of inflammation scores in malignant mesothelioma.

The relationship between inflammatory markers and survival in many cancers has been investigated previously. Inflammatory markers may also offer the possibility of predicting surveillance in patients with malignant mesothelioma. Our study seeks to enhance comprehension of how variables such as the nutritional status and inflammation indices of malignant mesothelioma patients impact the disease's progression and prognosis. This study included patients who were treated at the Erciyes University Medical Oncology Clinic between 2010 and 2022 and diagnosed with malignant mesothelioma. This is a retrospective single-center cohort study. Receiver Operating Characteristic (ROC) analysis was applied to determine the inflammation markers' optimal cut-off values with high sensitivity and specificity. Patients were categorized based on these values. The differences in overall survival (OS) and progression-free survival (PFS) between categorized groups were assessed using Log-rank curves and Kaplan-Meier tests. Multivariate analysis was performed using Cox regression analysis on statistically significant data. The relationship between inflammation markers and malignant mesothelioma survival was evaluated. There are 115 patients in this study. Pre-treatment high neutrophil to lymphocyte ratio (NLR) (HR: 1.34, 95% CI: 1.12-2.83, p=0.04), high pan-immune inflammation value (PIIV) (HR: 2.01, 95% CI: 1.32-4.79, p=0.03), and high systemic inflammation response index (SIRI) (HR: 1.34, 95% CI: 1.2-2.78, p=0.04) were associated with poor OS. Conversely, high advanced lung cancer inflammation index (ALI) (HR: 0.73, 95% CI: 0.53-0.84, p=0.03) and high hemoglobin-albumin-lymphocyte and platelet (HALP) (HR: 0.67, 95% CI: 0.23-0.78, p=0.02) were associated with favorable survival. Our study investigated the prognostic value of various inflammation markers in malignant mesothelioma patients and suggests that composite formulas like NLR, PIIV, SIRI, ALI, and HALP that incorporate CBC cells and nutritional parameters like albumin, height, and weight could more consistently and accurately predict malignant mesothelioma prognosis.

Bone Mineral Disorders in Children with Predialysis Chronic Kidney Disease Correlates with Short Stature

Background: The increasing prevalence of malnutrition and growth impairment among children with CKD could impact the prognosis and the preferred intervention. Therefore, this study aimed to identify the nutritional status of children with CKD and its relating factors. Method: A cross-sectional study was conducted in a tertiary, national-referral teaching hospital in Jakarta. Sociodemographic and laboratory data were obtained from medical records. Body weight and height of participants were measured using digital scale and stadiometer, respectively. Growth and nutritional status indicators such as BMI-for-age, weight-for-height, height for age, and weight for age were quantified and plotted using WHO Anthro and Anthroplus application. Result: A total of 18 participants aged 3-17 years old with CKD stage 3 – 5 were included in this study. BMI measurements showed a z-score average of -1.02, while the mean z-score for height-for-age was of -2.71. Our study demonstrated a significant association between the height-for-age and mineral bone in children with CKD (p = 0.005). However, we found no association between mineral bone disorder with other indicators of nutritional status. Furthermore, our study also found no significant relation between nutritional status and other influencing factors including the stage of CKD, duration of CKD, age, gender, primary etiological factor, hypertension, anemia, age, familial economic status, disease duration, and parental education level demonstrates no significant correlation (p > 0.05). Conclusion: Children with stage 3 – 5 CKD in the pre-dialysis phase are shown to be underweight and short statured but with normal nutritional status. Mineral bone disorder was revealed to be significantly associated with height-for-age in children with CKD.

Bioelectrical impedance vector analysis as an indicator of malnutrition in children under five years with and without pneumonia in Mchinji District, Malawi: An exploratory mixed-methods analysis

Background Bioelectrical impedance vector analysis (BIVA) is a non-invasive approach to assessing body composition and cellular health, which may improve the assessment of nutritional status in sick children. We explored the reliability, clinical utility, and acceptability of BIVA, as an indicator of nutritional status for children under five years with and without pneumonia, in Malawi. Methods We conducted a parallel convergent mixed-methods exploratory study in Mchinji District Hospital, Malawi, in 2017. We recruited a convenience sample of children aged 0–59 months with clinical pneumonia, and without an acute illness. Children had duplicate anthropometric and BIVA measurements taken. BIVA measurements of phase angle were taken of the whole body, and trunk and arm segments. Reliability was assessed by comparing the variability in the two measures, and clinical utility by estimating the association between anthropometry and phase angle using linear regression. Focus group discussions with healthcare workers who had not previously used BIVA instrumentation were conducted to explore acceptability. Results A total of 52 children (24 with pneumonia and 28 healthy) were analysed. The reliability of sequential phase angle measurements was lower than anthropometric measurements, but trunk and arm segments performed better. The largest associations with phase angle were a negative relationship with weight-for-age z-score (WAZ) in children with pneumonia in the trunk segment, and a positive association with WAZ in the full body measurement in healthy children. Healthcare workers in focus group discussions expressed trust in BIVA technology and that it would enable more accurate diagnosis of malnutrition; however, they raised concerns about the sustainability and necessary resources to implement BIVA. Conclusions While healthcare workers were positive towards BIVA as a novel technology, implementation challenges should be expected. The differential direction of association between anthropometry and phase angle for children with pneumonia warrants further investigation.

Diagnosis and prevention of osteoporosis in children with cystic fibrosis

Osteoporosis is a metabolic disease of the skeleton characterized by a decrease in bone mass, a disruption of the microarchitecture of bone tissue and, as a result, fractures with minimal trauma. The urgency of the problem of osteoporosis in children with cystic fibrosis arises from the high risk of a decrease in bone mineral density (BMD) in this category of patients.The aim is to investigate the patterns and mechanisms of bone mineral density reduction in children with cystic fibrosis.Methods. 100 patients with cystic fibrosis were examined. The control group included 61 healthy children aged 6 to 17 years. Alimentary and biochemical risk factors for the decrease in BMD were analyzed. X-ray densitometry was performed in children over 6 years of age using a DEXXUM device (South Korea). The concentration of calcidiol 25(OH)D and other biochemical parameters in blood were determined using the enzyme immunoassay method.Results. 62% of patients with CF and 82% of healthy children had normal BMD. The leading factors affecting BMD in patients with cystic fibrosis are: history of meconium ileus, chronic infection with Pseudomonas aeruginosa, lower indicators of nutritional status, and lower lung function (FEV1, %pred). The biochemical markers of osteoremodeling that determine the risk group for osteoporosis in patients with CF are osteocalcin and acid phosphatase. Healthy children who consumed more dietary calcium had better BMD. The effect of dietary calcium intake and vitamin D dose on BMD in patients with CF was not observed.Conclusion. The features of inflammatory and catabolic processes in cystic fibrosis influence the remodeling processes by reducing osteosynthesis and activating osteoresorption. In both groups of children studied, low nutritional status had a negative effect on BMD.

Prognostic significance of body mass index and serum albumin as the indicators of nutritional status in small cell lung cancer

ABSTRACT Background Body mass index (BMI) and serum albumin (ALB) level are long-established markers that reflect the nutritional status and eventually the prognosis of cancer patients. The objective of the study was to determine the clinical significance of these factors and specify their roles in outcomes compared with performance status (PS) and weight loss (WL), which are considered the most significant patient-related prognostic factors in small cell lung cancer (SCLC) treated with platinum-etoposide-based chemotherapy. Methods A total of 378 patients with SCLC were enrolled in the study and analyzed retrospectively. Results BMI values were similar by clinical stage, whereas the percentages of the patients with WL, low serum ALB, and particularly poor (≥2) PS were significantly higher in patients with extended disease SCLC (ED-SCLC) compared to those with limited disease SCLC (LD-SCLC). In LD-SCLC, patients with poor PS lived for a significantly shorter time than patients with good PS (HR: 7.791, p = 0.0001); however, BMI (HR: 1.035, p = 0.8), WL (HR: 0.857, p = 0.5), and ALB (HR: 0.743, p = 0.3) had no significant effect on the outcome. In ED-SCLC, PS (HR: 4.257, p = 0.0001), WL (HR: 1.677, p = 0.001), and ALB (HR: 0.680, p = 0.007) had an impact on survival, but BMI did not (HR: 0.791, p = 0.08). In LD-SCLC, the univariate analysis showed that only poor PS was correlated with increased mortality (HR: 7.791, p = 0.0001); yet it lost significance in multivariate analysis. In ED-SCLC, poor PS (HR: 4.257, p = 0.0001), WL (HR: 1.667, p = 0.001), and a low ALB level (HR: 0.680, p = 0.007) were shown to be factors for poor prognosis in the univariate analysis; yet only PS remained significant in multivariate analysis (HR: 2.286, p = 0.001). Conclusion Even though BMI and serum albumin showed no prognostic value in SCLC patients treated with chemotherapy, PS was found to be the most significant prognostic factor in both LD- and ED-SCLC stages.

Prognostic value of inflammatory nutritional scores in locally advanced esophageal squamous cell carcinoma patients undergoing neoadjuvant chemoimmunotherapy: a multicenter study in China.

This study investigates the prognostic significance of inflammatory nutritional scores in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC) undergoing neoadjuvant chemoimmunotherapy. A total of 190 LA-ESCC patients were recruited from three medical centers across China. Pre-treatment laboratory tests were utilized to calculate inflammatory nutritional scores. LASSO regression and multivariate logistic regression analyses were conducted to pinpoint predictors of pathological response. Kaplan-Meier and Cox regression analyses were employed to assess disease-free survival (DFS) prognostic factors. The cohort comprised 154 males (81.05%) and 36 females (18.95%), with a median age of 61.4 years. Pathological complete response (pCR) was achieved in 17.38% of patients, while 44.78% attained major pathological response (MPR). LASSO and multivariate logistic regression analyses identified that hemoglobin, albumin, lymphocyte, and platelet (HALP) (P=0.02) as an independent predictors of MPR in LA-ESCC patients receiving neoadjuvant chemoimmunotherapy. Kaplan-Meier and log-rank tests indicated that patients with low HALP, MPR, ypT1-2, ypN0 and, ypTNM I stages had prolonged DFS (P < 0.05). Furthermore, univariate and multivariate Cox regression analyses underscored HALP (P = 0.019) and ypT (P = 0.029) as independent predictive factors for DFS in ESCC. Our study suggests that LA-ESCC patients with lower pre-treatment HALP scores exhibit improved pathological response and reduced recurrence rate. As a comprehensive index of inflammatory nutritional status, pre-treatment HALP may be a reliable prognostic marker in ESCC patients undergoing neoadjuvant chemoimmunotherapy.

Phase Angle and Bioelectrical Impedance Vector Analysis (BIVA) in Amyotrophic Lateral Sclerosis (ALS) Patients

Phase angle (PhA) and bioelectrical impedance vector analysis (BIVA) have emerged as valuable tools for assessing nutritional status and prognosis in various patient populations, but there is a lack of studies in rare neurodegenerative diseases. The purpose of this cross-sectional study was to investigate these bioelectrical parameters in patients with amyotrophic lateral sclerosis (ALS), compared with healthy peers. The tetrapolar impedance method was applied and bioimpedance analysis (BIA) was performed. Bioelectrical parameters were obtained (Resistance—R; Reactance—Xc) or calculated (PhA; BIVA). For BIVA, bivariate vectors and confidence ellipses were graphically represented. In addition, R and Xc were used to determine body composition (BC) (Fat Mass—FM; Fat-Free Mass—FFM; and Total Body Water—TBW). In this study, 40 participants were divided into two groups: case group (n = 20, ALS patients) and control group (n = 20, healthy subjects. Our main results showed that ALS patients presented low levels of BMI, FFM, R, and Xc adjusted by height (R/H, Xc/H), hydration, and cellularity, compared to the healthy subjects. Our findings highlight BC and bioelectrical parameters, including PhA and BIVA, as valuable indicators of nutrition status, which should be implemented in the nutrition care process of ALS patients during the disease course.

Salivary iodine concentration in pregnant women and its association with iodine status and thyroid function.

There have been no reports on the application of salivary iodine concentration (SIC) in evaluating iodine nutrition in pregnant women. This study aimed to clarify the relationship between SIC and indicators of iodine nutritional status and thyroid function during pregnancy, to investigate whether salivary iodine can be applied to the evaluation of iodine nutritional status in pregnant women, and to provide a reference basis for establishing a normal range of salivary iodine values during pregnancy. Pregnant women were enrolled in the Department of Obstetrics, the people's hospital of Yuncheng Country, Shandong Province, from July 2021 to December 2022, using random cluster sampling. Saliva, urine, and blood samples were collected from pregnant women to assess iodine nutritional status, and venous blood was collected to determine thyroid function. A total of 609 pregnant women were included in this study. The median spot urinary iodine concentration (SUIC) was 261μg/L. The median SIC was 297μg/L. SIC was positively correlated with SUIC (r = 0.46, P < 0.0001), 24-h UIC (r = 0.30, P < 0.0001), 24-h urinary iodine excretion (24-h UIE) (r = 0.41, P < 0.0001), and estimated iodine intake (EII) (r = 0.52, P < 0.0001). After adjusting for confounders, there was a weak correlation between SIC and serum total iodine and serum non-protein-bound iodine (P = 0.02, P = 0.04, respectively). Pregnant women with a SIC < 176μg/L had a higher risk of insufficient iodine status (OR = 2.07, 95% CI 1.35-3.19) and thyroid dysfunction (OR = 2.71, 95% CI 1.18-6.21) compared to those with higher SIC. Those having SIC > 529μg/L were more likely to have excessive iodine status (OR = 2.82, 95% CI 1.81-4.38) and thyroid dysfunction (OR = 3.04, 95% CI 1.36-6.78) than those with lower SIC values. SIC is associated with urinary iodine concentration and thyroid function in pregnant women. SIC < 176μg/L was associated with an increased risk for iodine deficiency and hypothyroxinemia, while SIC > 529μg/L was related to excess and thyrotoxicosis. SIC can be used as a reference indicator for evaluating the iodine nutrition status of pregnant women, but it needs further investigation and verification. NCT04492657(Aug 9, 2022).

Relevance of Individual Data When Assessing the Gastrointestinal Nematode Infection Level, Nutritional and Productive Variables in a Tropical Farm Context: The Median Isn't the Message.

We evaluated the relationship between individual and herd GIN infection level, nutrition, production performance and anemia parameters in a tropical farm context. Fifty-four female goats were monitored to assess their body condition score (BCS, nutritional status indicator), live weight (LW) and LW gain (LWG, both used as production level indicators), FAMACHA© and hematocrit (HT, both used as anemia indicators). Goats browsed for 4 h in a tropical forest and received balanced feed and chopped grass. The eggs per gram of feces (EPG) indicated the GIN burden, with fecal samples obtained at 7:00 (AM) and 15:00 h (PM.) from each goat at six sampling points during the study. The variables and their relationship with GIN burdens were analyzed using Kruskall-Wallis, ANOVA and Friedman tests and Spearman correlations. The fecal samples obtained in the AM and PM can be equally representative of parasitic burdens (similar and highly correlated). However, the EPG of individual goats from periods of 30 days apart can be considered independent. The BCS and LWG varied between sampling times (p < 0.05), whereas EPG, LW and HT did not (p > 0.05). The GIN burden was negatively correlated with HT and BCS (-0.21, p = 0.01 for each one). The individual pattern of infection demonstrates the true impact of GINs on their hosts. Additionally, feeding and nutritional status may present important variations influencing the performance of the goats more than the impact of GINs under the farm conditions of the present study. However, GIN infection contributed to the variation in goat health and productivity in this tropical farm.

Effectiveness, safety and indications of acute normovolemic haemodilution in total knee arthroplasty

Total knee arthroplasty (TKA) is the most cost-effective, and potent method for the treatment of end-stage knee osteoarthritis. Acute normovolemic haemodilution (ANH) can effectively replace the need for allogeneic transfusions due to the high amount of bleeding during TKA. However, more studies are needed to prove the efficacy and safety of ANH and to clarify its indications in the field of knee replacement. Medical records from June 1, 2019 to June 1, 2021 were searched and grouped according to inclusion and exclusion criteria. PART I: 58 patients with ANH during TKA were selected as the ANH group (n = 58), and 58 patients with allogeneic transfusion were chosen as the control group (n = 58). PART II: Patients with anaemia were divided into the ANH group (n = 18) and the control group (n = 12). PART I: The postoperative inflammatory index and serum albumin in the ANH group were significantly lower than those in the control group. No significant difference was observed in the theoretical loss of red blood cells, postoperative renal function, liver function, cardiac function and biochemical ion index between the two groups. The effective rate of ANH in the normal haemoglobin group was significantly lower than that in the anaemia group. PART II: In patients with anaemia, the theoretical loss of red blood cells in patients with ANH was less than that in the control group. The postoperative inflammation, renal function, liver function and cardiac function in the ANH group were better than those in the control group, and no significant difference was noted in biochemical ions and nutritional status indicators. This paper shows that ANH not only can replace allogeneic transfusion in TKA, especially in patients with anaemia, but also has lower inflammatory indicators than allogeneic transfusion. From a security perspective, the body’s tolerance to ANH is within the body’s compensation range.

Temporal trend in the nutritional status of children in a Brazilian metropolis in light of food and nutrition policies

Introduction. Brazil’s health system offers insights into addressing the double burden of malnutrition by proper population monitoring, coupled with local policies and national guidelines. Objective. To investigate the recent temporal trends in nutritional status indicators and its coverage of children aged two to five years from Campinas, a metropolis in the state of São Paulo, Brazil. Material and methods. The analysis of time series from 2018 to 2022 were conducted by accessing data from the Brazilian Food and Nutrition Surveillance System (SISVAN) due to regression analysis. Results. The number of children aged two to five in the SISVAN registry rose from 7,300 in 2018 to 11,171 in 2022, forming the study sample. In 2018, 700 were chronically undernourished, 306 underweight, and 977 overweight; by 2022, 530 showed stunting, 457 were underweight, and 1,084 overweight. Stunting prevalence declined from 9.6% (2018) to 4.7% (2022). Underweight dropped slightly from 4.2% to 4.1% over the years and overweight, consistently the highest indicator, ranged from 13.4% (2018) to 9.7% (2022). SISVAN’s coverage varied between 16.6% (2018) and 26.1% (2022), the lowest at 12.3% in 2020. The trend for stunting decreased significantly (APV: -15.01; CI95% -22.64; -6.62). Adding SISVAN’s coverage variable the model slightly reduced the declining stunting trend (APV: -12.12; CI95% -13.19; -11.04). Conclusions. Coordinated efforts to address nutritional challenges, from adequate population monitoring to the interaction between local policies and national guidelines, have shown positive health outcomes.

Reappraisal of a Renovated Cell-free and Concentrated Ascites Reinfusion Therapy for Malignant Ascites.

Cell-free and concentrated ascites reinfusion therapy (CART) was established for refractory ascites and renovated CART (Keisuke Matsusaki (KM) -CART) has been recently developed especially for malignant ascites; however, the actual clinical efficacy of KM-CART has been rarely reported. We performed 226 KM-CART procedures in 104 patients with malignant ascites in three hospitals from August 2013 to September 2018. Medical records were retrospectively reviewed for ascites data, related complications, symptoms before and after each CART and prognosis after the first CART. The modified Glasgow Prognostic Score (mGPS) was reviewed before every procedure, as an indicator of nutritional status. Pancreatic cancer was the most common indication for the KM-CART procedure, followed by gastric cancer, hepatocellular carcinoma, ovarian cancer, and cholangiocarcinoma (five major diseases). The 50% survival times of these five major diseases after the first procedure were 25, 39, 31, 49, and 33 days, respectively. The mean survival time for all patients was 73.5 days, and 75.6 days for those with the five major diseases. All patients experienced symptomatic relief, and complications were rare. Repeated KM-CART was performed in 47.1% of the patients, most often in those with ovarian cancer (66.7%). Regarding the mGPS at the first CART procedure, 89% of patients were in the group with the poorest nutritional status. Patients who underwent KM-CART three or more times had longer survival than those who were treated once or twice. Repeated KM-CART provides a survival benefit for patients with malignant ascites, even in cases of poor nutritional status.

Blood-urea-nitrogen-to-serum-albumin ratio in predicting the value of patients with contrast-induced nephropathy for coronary heart disease.

The blood-urea-nitrogen (BUN)-to-serum-albumin (ALB) ratio (BAR) has been identified as a novel indicator of both inflammatory and nutritional status, exhibiting a correlation with adverse cardiovascular outcomes. This study aims to investigate the potential predictive value of BAR levels at admission for the development of CIN in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Retrospective data were collected from patients who were admitted and underwent CAG or PCI between January 2018 and December 2022 at the Cardiac Medical Center of Union Hospital of Fujian Medical University, and the patients were divided into CIN and non-CIN groups. The BAR was computed by dividing the BUN count by the ALB count. Using multiple variable logistic regression, risk variables associated with the development of CIN were found. A total of 156 patients developed CIN (7.78%). The development of CIN was predicted by a BAR ratio > 4.340 with a sensitivity of 84.0% and a specificity of 70.2%, according to receiver operating characteristic (ROC) analysis. BAR, female gender, diuretic use, and statin medication use were found to be independent predictors of CIN using multifactorial analysis. When patients are receiving CAG/PCI, BAR is a simple-to-use marker that can be used independently to predict the presence of CIN.

P730 Edema index as a more sensitive indicator of nutritional status with Crohn’s disease

Abstract Background Crohn's disease (CD) often presents with malnutrition due to the impaired mucosal barrier accelerating the loss of protein. The edema index can indicate protein consumption. This study aims to confirm whether the edema index could be a nutritional assessment for CD patients. Methods The study was conducted at Xiangya Hospital Central South University between May 2023 and July 2023, including CD patients and the control group. In both groups, bioelectrical impedance analysis was performed, and the edema index defined as extracelluar water/total body water (ECW/TBW) was calculated. The demographic data and body composition parameters were collected through the medical system. The control group consisted of healthy adults, strictly matched for gender, age, and BMI in a 1:1 case-control manner. Univariate analysis and multivariate analysis were used to compare the differences in nutrition-related indicators between both groups. Results A total of 128 subjects were included in the final cohort with 50% each of CD patients and healthy individuals. There were no significant differences in gender, age, BMI. Fat free mass, muscle mass, basal metabolic rate (BMR), and visceral fat rating were similar in both groups (P &amp;gt; 0.05). Compared to the control group, CD patients had significantly lower fat mass (9.26 ± 5.38 vs.16.63 ± 10.67, P = 0.006), bone mass (2.16 ± 0.41 vs. 2.52 ± 0.57, P = 0.019), but a higher level of edema index (41.07 ± 2.38 vs. 38.53 ± 5.62, P = 0.015). Multivariate logistic regression analysis revealed that edema index was an independent factor to malnutrition in CD patients (OR: 1.665, 95% CI: 1.158-2.395, P = 0.006). Conclusion A higher edema index in CD patients demonstrates their worse nutritional status compared to healthy subjects. The edema index may serve as a more sensitive and noninvasive indicator to assess nutritional status in CD patients.

Construction and validation of a prognostic nutritional index-based nomogram for predicting pathological complete response in breast cancer: a two-center study of 1,170 patients.

Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) is associated with favorable outcomes in breast cancer patients. Identifying reliable predictors for pCR can assist in selecting patients who will derive the most benefit from NAC. The prognostic nutritional index (PNI) serves as an indicator of nutritional status and systemic immune competence. It has emerged as a prognostic biomarker in several malignancies; however, its predictive value for pCR in breast cancer remains uncertain. The objective of this study is to assess the predictive value of pretreatment PNI for pCR in breast cancer patients. A total of 1170 patients who received NAC in two centers were retrospectively analyzed. The patients were divided into three cohorts: a training cohort (n=545), an internal validation cohort (n=233), and an external validation cohort (n=392). Univariate and multivariate analyses were performed to assess the predictive value of PNI and other clinicopathological factors. A stepwise logistic regression model for pCR based on the smallest Akaike information criterion was utilized to develop a nomogram. The C-index, calibration plots and decision curve analysis (DCA) were used to evaluate the discrimination, calibration and clinical value of the model. Patients with a high PNI (≥53) had a significantly increased pCR rate (OR 2.217, 95% CI 1.215-4.043, p=0.009). Tumor size, clinical nodal status, histological grade, ER, Ki67 and PNI were identified as independent predictors and included in the final model. A nomogram was developed as a graphical representation of the model, which incorporated the PNI and five other factors (AIC=356.13). The nomogram demonstrated satisfactory calibration and discrimination in the training cohort (C-index: 0.816, 95% CI 0.765-0.866), the internal validation cohort (C-index: 0.780, 95% CI 0.697-0.864) and external validation cohort (C-index: 0.714, 95% CI 0.660-0.769). Furthermore, DCA indicated a clinical net benefit from the nomogram. The pretreatment PNI is a reliable predictor for pCR in breast cancer patients. The PNI-based nomogram is a low-cost, noninvasive tool with favorable predictive accuracy for pCR, which can assist in determining individualized treatment strategies for breast cancer patients.

Impact of Serum Albumin Levels and Body Mass Index on Outcomes of Open Abdominal Aortic Aneurysm Repair in Korean Population

Although obese patients seem to be susceptible to chronic diseases, obesity paradox has been observed in the field of vascular surgery, in which many previous studies have reported that overweight patients have good postoperative outcomes and underweight patients have poor postoperative outcomes. The purpose of our study is to evaluate the impact of body mass index (BMI) and serum albumin levels, which are evaluated as indicators of nutritional status, on outcomes of open abdominal aortic aneurysm (AAA) repair. We reviewed the vascular surgery database of a single tertiary referral center for all patients who underwent open AAA repair due to degenerative etiology from 1996 to 2021. To analyze the effect of BMI, patients were classified into 4 groups according to the Asian-Pacific classification of BMI: underweight (UW) (<18.5kg/m2), normal weight (NW) (18.5-22.9kg/m2), overweight (OW) (23-24.9kg/m2), and obese (OB) (≥25kg/m2). The χ2, Fisher's exact, and Kruskal-Wallis tests were used to compare demographics, comorbidities, radiologic findings, surgical details, and 1-year mortality rates between the 4 groups. We also compared the preoperative serum albumin levels of each group to assess nutritional status indirectly. Cox's proportional hazards model was performed to determine factors associated with mortality. A Kaplan-Meier survival analysis was performed, and the differences were analyzed by a log-rank test. We did not perform an analysis for 30-day mortality because cases of 30-day mortality in UW patients were rare due to the unbalanced distribution of the number of patients in the 4 groups. Among a total of 678 patients, 22 were classified as UW (3.2%), 200 as NW (29.5%), 183 as OW (27.1%), and 273 as OB (40.1%). The median age was 70 (64-75) years and 577 of 678 (85.1%) patients were male gender. Higher serum albumin level was associated with decreased 1-year mortality (hazard ratio [HR], 0.3; 95% confidence interval [CI], 0.15-0.63; P=0.001). UW patients had a higher 1-year mortality rate than NW patients (HR, 3.67; 95% CI, 1.02-13.18; P=0.046). OB patients had a lower overall mortality rate than NW patients (HR, 0.73; 95% CI, 0.53-1; P=0.05). Low BMI (<18.5kg/m2) and low serum albumin level were associated with poor 1-year survival after elective open AAA repair. These patients also need more careful preoperative intervention, like weight gain or nutritional support, for better outcomes. The obesity paradox existed in our study; high BMI (≥25kg/m2) was associated with better overall survival after elective open AAA repair.

Overview of Worm Infections and Hemoglobin Levels in Children Living in TPA (Final Waste Disposal Site) Tamangapa Makassar, Indonesia

Introduction: Children who live around TPA Tamangapa often play and do activities around the TPA. This can increase their risk of being exposed to worm eggs or larvae in the garbage. Lack of public knowledge and awareness about the dangers of worm infections. Hemoglobin (Hb) levels are an indicator of a child's nutritional status. This study aims to present an overview of worm infections and hemoglobin levels in children living in TPA (final waste disposal site) Tamangapa Makassar, Indonesia.&#x0D; Methods: This study is a descriptive observational research. This study uses primary data from observations of research subjects. A total of 10 research subjects participated in this study.&#x0D; Results: The results of microscopic examination of fecal samples showed that 6 were positive for worm infections and 4 were negative for worm infections. The positive results were found to be intestinal nematodes, namely Ascaris lumbricoides and Tricuris trichiura. Examination of hemoglobin levels in blood samples with the results obtained were normal in all samples.&#x0D; Conclusion: The majority of subjects experienced worm infections with the worm species found being A. lumbricoides and T. trichiura. All samples showed blood hemoglobin levels within normal limits.

Trends of eating out among males in China and its correlation with nutrition and health during 2000 to 2018

To analyze the trend of eating out among Chinese male adults and explore the association between eating out and dietary nutrition and health. Males aged 18 and above with complete data were selected from China Health and Nutrition Survey 2000, 2004, 2006, 2009, 2011, 2015 and 2018. Eating out behavior was defined as having consumption of food prepared outside the home during the three consecutive 24-h dietary recalls period. Cochran-Armitage trend test was used to analyze the trend of prevalence of eating out and the energy contribution from eating out foods in males from 2000 to 2018. Analysis of covariance was used to compare the differences in several food and dietary nutrient intakes and nutritional indicators by eating out in 2018. The prevalence of eating out among Chinese male adults increased from 48.49% in 2000 to 57.51% in 2018, showing an increased trend followed by a decreased trend. Males in the 18-29 years old group, urban group, high income group, and high education level group had a higher rate of eating out(P&lt;0.05). The energy contribution from eating out foods increased from 21.80% in 2000 to 28.77% in 2018, showing a slow upward trend. In 2018, the intake of rice, tubers and vegetables was lower in the eating out group, while intake of wheat, fruits, livestock and poultry meat, aquatic products, eggs and milk in eating out group was higher than those in the non-eating out group(P&lt;0.05). The eating out group had a higher intake of energy, fat, protein, cholesterol, calcium, zinc, vitamin B_1 and vitamin B_2 than the non-eating out group(P&lt;0.05). The eating out group had lower levels of systolic blood pressure, HDL-C, blood glucose and glycosylated hemoglobin than the counterparts. The levels of BMI, waist, body fat percentage, diastolic blood pressure and TG were higher in the eating out group than in the non-eating out group. From 2000 to 2011, the eating out rate of males in China showed an upward trend, and a downward trend after 2011. At the same time, the energy contribution of eating out foods is increasing. Eating out was associated with major food and nutrients intake and indicators of nutritional status in male adults.

The fascinating theory of fetal programming of adult diseases: A review of the fundamentals of the Barker hypothesis.

The theory of fetal programming of adult diseases was first proposed by David J.P. Barker in the eighties of the previous century, to explain the higher susceptibility of some people toward the development of ischemic heart disease. According to his hypothesis, poor maternal living conditions during gestation represent an important risk factor for the onset of atherosclerotic heart disease later in life. The analysis of the early phases of fetal development is a fundamental tool for the risk stratification of children and adults, allowing the identification of susceptible or resistant subjects to multiple diseases later in life. Here, we provide a narrative summary of the most relevant evidence supporting the Barker hypothesis in multiple fields of medicine, including neuropsychiatric disorders, such as Parkinson disease and Alzheimer disease, kidney failure, atherosclerosis, coronary heart disease, stroke, diabetes, cancer onset and progression, metabolic syndrome, and infectious diseases including COVID-19. Given the consensus on the role of body weight at birth as a practical indicator of the fetal nutritional status during gestation, every subject with a low birth weight should be considered an "at risk" subject for the development of multiple diseases later in life. The hypothesis of the "physiological regenerative medicine," able to improve fetal organs' development in the perinatal period is discussed, in the light of recent experimental data indicating Thymosin Beta-4 as a powerful growth promoter when administered to pregnant mothers before birth.

Several laboratory variables indicate severity and prognosis of COVID-19.

While several laboratory variables have been used to assess COVID-19 disease, to our knowledge, no attempt has previously been made to compare differences across different patient groups. We attempted to evaluate the relationship between laboratory variables and severity of the disease as well as on prognosis. We searched BioLINCC database and identified three studies which had separately included outpatients, inpatients, and ICU patients. For this re-analysis, we extracted data on general demography, laboratory variables and outcome. In total, 2454 participants (496 outpatients [Study 1], 478 inpatients [Study 2], and 1480 ICU patients [Study 3]) were included in the analysis. We found three laboratory variables (i.e., creatinine, aspartate transferase, and albumin) were not only prognostic factors for outcome of inpatients with COVID-19, but also reflected disease severity as they were significantly different between inpatients and ICU patients. These three laboratory variables are an indication of kidney function, liver function, and nutritional status. For patients with COVID-19, in addition to monitoring infectious disease indicators, we need to pay attention to liver function, renal function, and take timely measures to correct them to improve prognosis.