Unwanted Weight Research Articles

BODY WEIGHT CHANGE IN OLDER PEOPLE DURING THE COVID-19 PANDEMIC: RESULTS FROM THE BERLIN AGING STUDY II (BASE-II)

Abstract Low body weight and especially unwanted weight loss were shown to be associated with higher mortality in older adults. Change in body weight was reported to be one of the unintended side effects of lockdown measures that were put in place to combat the COVID-19 pandemic. In this study, we first describe weight change in 472 participants (mean age: 67.5 years, 48% women) of the Berlin Aging Study-II (BASE-II) that was collected at four timepoints over an average total follow-up time of 10 years. In a second step we examine differences in weight change between groups defined by socio-economic, cognitive, and psychosocial variables as well as morbidity burden, biological aging markers (epigenetic clocks, telomere length), and frailty. During the follow-up period, which includes the first six months of the pandemic, women and men lost on average 0.87% and 0.5% of their body weight per year. A statistically significantly higher rate of weight loss was detected for men with low positive affect, accelerated epigenetic age (7-CpG clock), diagnosed metabolic syndrome as well as a more masculine gender score (all p< 0.05). Although the literature generally suggests an increase in body weight during the pandemic, older participants of the BASE-II sample lost 2.5-times (women) and 2-times (men) more weight than expected in this age group. Our explorative analysis of additional variables assessed during an examination directly before the pandemic’s onset could inform future studies that aim at a more in depth understanding of the matter.

Letting go of self-transformation? lurkers’ tactics of body acceptance in and against an online support group for polycystic ovary syndrome

ABSTRACT Research often suggests that online support groups validate their members’ experiences, but feminists and sociologists have argued that they may also embrace individualistic or biomedical perspectives. Interviews with women with polycystic ovary syndrome (PCOS), associated with weight gain, highlighted that reading other women’s painful experiences in a Facebook support group helped them to accept their bodies, but that the group was replete with unwanted weight loss advice. Making sense of these contradictions this article makes three contributions. First, the findings illustrate that the way in which online support groups validate their members’ experiences may be more subterfuge and contradictory than previously thought. Second, the observations contribute to feminist research on online body positivity, as the women articulated an ambiguous desire to let themselves be rather than sought to become either traditionally thin and beautiful or in a popular feminist spirit confidently big and beautiful. Following from this observation, the article draws on and contributes to feminist media studies discussions on post- and popular feminism, suggesting that the women articulated a barely articulable emerging structure of feeling of yearning to let go of self-transformation, which pervades official health advice, support groups and much feminist content online.

Eating disorder symptoms and diagnoses in adults with celiac disease

Introduction: Treatment for Celiac Disease (CeD) includes strict adherence to a Gluten-Free Diet (GFD) which may result in preoccupation with food choice, unwanted weight gain, and body dissatisfaction. Objective: To determine frequency of Eating Disorder (ED) diagnoses and symptoms in adults with CeD. Method: The Eating Disorder Diagnostic Scale (EDDS-DSM-5) and the Eating Pathology Symptoms Inventory (EPSI) were administered in a cross-sectional study of 50 adults with biopsy-confirmed CeD on a GFD for >1 year attending their routine clinic visits. Results: Based on the EDDS, one participant met criteria for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of binge eating disorder and four met criteria for possible diagnosis of Other Specified Feeding and Eating Disorders; none had previously been diagnosed with an ED. EDDS symptom scores were lower (i.e., better) than established cut-points, yet females scored higher than males when asked if they felt fat (p<0.001), feared weight gain (p<0.001), and felt undue influence of weight/ shape (p=0.034). EPSI scores were lower (i.e., better) than normative values, yet females scored significantly higher than males on body dissatisfaction (p<0.001), cognitive restraint (p=0.011), and purging (p=0.044) subscales. Conclusion: Although disordered eating behaviors and weight/ shape concerns were apparent, only one patient met full criteria for an ED diagnosis. The EDDS and EPSI may be useful in screening for comorbidity among adults with CeD; however, clinical assessment is needed to assign a DSM-5 ED diagnosis.

Polypharmacy in psychiatry and weight gain: longitudinal study of 832 patients hospitalized for depression or schizophrenia, along with data of 3180 students from Europe, the U.S., South America, and China.

Epidemiologic data indicate that overweight and obesity are on the rise worldwide. Psychiatric patients are particularly vulnerable in this respect as they have an increased prevalence of overweight and obesity, and often experience rapid, highly undesirable weight gain under psychotropic drug treatment. Current treatment strategies in psychiatry are oriented towards polypharmacy, so that the information on drug-induced weight gain from earlier monotherapy studies is of very limited validity. We have analyzed the longitudinal data of 832 inpatients with ICD-10 diagnoses of either F2 (schizophrenia; n = 282) or F3 (major depression; n = 550) with the goal of ranking treatment regimens in terms of weight gain, side effects, and response to treatment. The patient data were complemented by the data of 3180 students aged 18-22 years, with which we aimed to identify factors that enable the early detection and prevention of obesity and mental health problems. After 3 weeks of treatment, 47.7% of F2 patients and 54.9% of F3 patients showed a weight gain of 2kg and more. Major predictive factors were "starting weight" (r = 0.115), "concurrent medications" (r = 0.176), and "increased appetite"(r = 0.275). Between 11 and 30% of the observed variance in weight gain could be explained by these factors, complemented by sex and age. The comparison between monotherapy (n = 409) and polypharmacy (n = 399) revealed significant drawbacks for polypharmacy: higher weight gain (p = 0.0005), more severe side effects (p = 0.0011), and lower response rates (F2: p = 0.0008); F3: p = 0.0101). The data of 3180 students made it clear that overweight and obesity often begin early in life among those affected, and are interconnected with personality traits, while increasing the risk of developing psychosomatic disturbances, mental health problems, or somatic illnesses. Although the available data did not readily lead to a comprehensive, clinically applicable model of unwanted weight gain, our results have nevertheless demonstrated that there are ways to successfully counteract such weight gain at early stages of treatment.

Attitudes, subjective norms and perceived behavioural control factors influencing Canadian secondary school students' milk and milk alternatives consumption.

The research objectives were to evaluate factors that influence Canadian secondary school students' milk and milk alternatives (MMA) consumption and to explore associations through age and gender lenses. A qualitative design was used, consisting of semi-structured interviews and photo-elicitation methods. Analysis was guided by the Theory of Planned Behaviour (TPB). Deductive and inductive thematic analyses were used to generate themes, charting data based on attributes such as gender and age. Interviews were held virtually or via telephone. Participants were twenty-eight high school students from Ontario, Canada, diverse in terms of gender and age. Both desirable and undesirable beliefs about the health outcomes of consuming MMA were commonly discussed. These included health benefits such as strong bones, muscular strength, and growth, and health consequences like unwanted skin conditions, weight gain, and diseases. While boys and girls associated MMA consumption with muscular strength, boys predominantly considered this favourable, while girls discussed outcomes like unwanted skin conditions and weight gain more often. Adolescents' perspectives on taste/perceived enjoyment, environmentally friendly choices and animal welfare also influenced their MMA preferences. Parental influences were most cited among social factors, which appeared to be stronger during early adolescence. Factors involving cost, time and accessibility affected adolescents' beliefs about how difficult it was to consume MMA. Recommendations for shifting attitudes towards MMA are provided to address unfavourable beliefs towards these products. Interventions to increase MMA consumption among adolescents should include parents and address cost barriers.

THE IMPACT OF AGING ON ATTITUDES TOWARD WEIGHT CHANGE AND BODY IMAGE AMONG ADULTS LIVING WITH HIV

Abstract Some newer HIV antiretroviral therapy regimens have been associated with weight gain in populations at risk for obesity. This study examined perspectives on weight change and body image among people living with HIV and the extent to which age and gender have an impact on those attitudes. We conducted interviews with 61 individuals in a Medicaid managed care plan. The age range was 23 to 65 years; 49% were aged 50 or older. The sample was 56% non-Hispanic Black and 31% Hispanic. About half were cisgender men, 36% were cisgender women, and 13% were transgender/nonbinary individuals. Many participants had weight gain they associated with HIV medications. While experiences varied widely, we found that older and younger participants offered some different perspectives. Younger people, including transgender individuals, more often welcomed weight gain, associating it with better health. Participants aged 50 and older sometimes saw weight gain as a natural part of aging, and spoke of acceptance, whereas younger participants tended to focus on their appearance. Among those with unwanted weight gain, older participants expressed concerns about its negative effect on mobility and comorbid health conditions. Some older women in particular struggled with improving their diets. Healthcare providers should consider these different perspectives and the various challenges individuals face associated with age when advising patients with HIV about weight management. For providers working with older patients with HIV, specific considerations of how increased weight affects mobility and risk for comorbid conditions are warranted.

Feasibility and therapeutical potential of local intracerebral encapsulated cell biodelivery of BDNF to AppNL-G-F knock-in Alzheimer mice.

Alzheimer's disease (AD) is an age-related disease characterized by altered cognition, neuroinflammation, and neurodegeneration against which there is presently no effective cure. Brain-derived neurotrophic factor (BDNF) is a key neurotrophin involved in the learning and memory process, with a crucial role in synaptic plasticity and neuronal survival. Several findings support that a reduced BDNF expression in the human brain is associated with AD pathogenesis. BDNF has been proposed as a potential therapy for AD, but BDNF has low brain penetration. In this study, we used an innovative encapsulated cell biodelivery (ECB) device, containing genetically modified cells capable of releasing BDNF and characterized its feasibility and therapeutic effects in the novel App knock-in AD mouse model (AppNL-G-F). ECB's containing human ARPE-19 cells genetically modified to release BDNF (ECB-BDNF devices) were stereotactically implanted bilaterally into hippocampus of 3-month-old AppNL-G-F mice. The stability of BDNF release and its effect on AD pathology were evaluated after 1, 2-, and 4-months post-implantation by immunohistochemical and biochemical analyses. Exploratory and memory performance using elevated plus maze (EPM) and Y-maze test were performed in the 4-months treatment group. Immunological reaction towards ECB-BDNF devices were studied under ex vivo and in vivo settings. The surgery and the ECB-BDNF implants were well tolerated without any signs of unwanted side effects or weight loss. ECB-BDNF devices did not induce host-mediated immune response under ex vivo set-up but showed reduced immune cell attachment when explanted 4-months post-implantation. Elevated BDNF staining around ECB-BDNF device proximity was detected after 1, 2, and 4months treatment, but the retrieved devices showed variable BDNF release. A reduction of amyloid-β (Aβ) plaque deposition was observed around ECB-BDNF device proximity after 2-months of BDNF delivery. The result of this study supports the use of ECB device as a promising drug-delivery approach to locally administer BBB-impermeable factors for treating neurodegenerative conditions like AD. Optimization of the mouse-sized devices to reduce variability of BDNF release is needed to employ the ECB platform in future pre-clinical research and therapy development studies.

Special features of the perioperative course in patients with frailty syndrome

The demographic change with an increase in the number of geriatric patients presents major challenges for perioperative medicine. Frailty is a multimorbidity complex that incorporates a combination of various factors, such as physical weakness, slower walking speed and unwanted weight loss. It is of great importance that these patients receive an individually adapted perioperative care. This includes, among others, a preoperative examination for frailty, a structured prehabilitation according to the concept of better in, better out, the compliance with the guidelines on prevention and timely treatment of postoperative delirium as well as the continuous maintenance of the body's homeostasis. By means of these measures the risk of complications in this patient group can be reduced and the best possible postoperative results can be achieved.

A Mixed-Method Study Exploring Patient-Experienced and Caregiver-Reported Benefits and Side Effects of Corticosteroid Use in Duchenne Muscular Dystrophy.

Corticosteroids are recommended to all people with Duchenne as standard of care; patient experience data is important to guide corticosteroid decision making and as a comparator for new treatment options. This study assesses patient and caregiver-reported benefits and side effects from corticosteroids to treat Duchenne muscular dystrophy, their importance, and satisfaction. Using one-on-one interviews (n = 28) and an online survey (n = 236), parents and adults with Duchenne reported corticosteroid benefits and side effects rated as both experienced and important. Benefits to breathing, heart function, arm strength, slowing progression of weakness, and getting around were rated as particularly important, regardless of ambulatory status. Important side effects included increased fracture risk, unwanted weight gain, and diabetes/prediabetes. Parents rated behavior issues and adults rated delayed puberty as having high importance. Being ambulatory was independently associated with reporting more net benefit (p = 0.02). For side effects, parent scores were significantly higher than adult score (p = 0.02). Corticosteroid type was not significant. Participants were, overall, satisfied with corticosteroids (means ranging from 6.2 to 7.7 on a scale of 0-10), with no significant differences based on corticosteroid type. Overall, most participants were satisfied with the use of corticosteroids. While a range of side effects were rated as important and relatively common, individuals using corticosteroids and their caregivers indicate that benefits outweigh the side effects. Qualitative data indicate that high acceptability is influenced by lack of treatment alternatives. Patient experience data on use of corticosteroids in Duchenne may be relevant to drug development, regulatory assessment of new treatments, and to families making decisions about corticosteroid use.

24/m-Increased waistline circumference and unwanted weight loss : Preparation for the medical specialist examination: part38

24/m-Increased waistline circumference and unwanted weight loss : Preparation for the medical specialist examination: part38

Hippocampal BDNF encapsulated cell bio‐delivery improves spontaneous behavioral alternations in the Y‐maze test in AppNL‐G‐F mice.

AbstractBackgroundAlzheimer’s disease (AD) is an age‐related disease characterized by synaptic dysfunction, brain inflammation, and neurodegeneration against which there is no effective cure available. Brain‐Derived Neurotrophic Factor (BDNF) is a key molecule involved in the learning and memory process, with a crucial role in synaptic plasticity and neuronal survival. Several findings support that a reduced BDNF expression in the human brain is associated with AD pathogenesis. BDNF has been proposed as a potential therapy for AD, but BDNF has low brain permeability. In this study, we used an innovative encapsulated cell biodelivery (ECB) device containing cells capable of locally delivering BDNF to characterize its neuroprotective effects in the novel AD APP‐knock‐in mouse model AppNL‐G‐F.MethodECB devices with human ARPE‐19 cells modified to release BDNF were surgically bilaterally implanted in the hippocampus of 3‐month‐old AppNL‐G‐F mice. BDNF effects on AD pathology were evaluated after 1, 2, and 3 months of treatment by immunohistochemical and biochemical analysis. In the 3‐month‐treated groups, exploratory and memory performances were also evaluated using Elevated Plus Maze (EPM) and Y‐maze tests.ResultThe ECB implants were well tolerated with no signs of unwanted side effects or weight loss. A high BDNF staining was detected in most of the brains in the area surrounding the devices at 1‐3 months, but retrieved devices showed variability of BDNF release. Interestingly, three months of BDNF treatment significantly improved AppNL‐G‐F mice´s anxiety behavior in EPM and improved the spontaneous behavioral alternations in the Y‐maze test.ConclusionThe results of this study are encouraging and support the BDNF device as a promising approach for treating cognitive AD decline. Optimization of the mouse‐sized devices to reduce the variability of BDNF release is needed for future experiments and translated to larger devices for clinical translation.

Dampak Penyakit KEK Pada Ibu Hamil

Chronic energy shortage in pregnant women can have a number of consequences significant negative impacts on the health and development of the mother and the fetus. The study aims to analyze the impact of chronic energy deficiency on pregnant women based on an overview of the existing literature. The study involved analysis and synthesis of a variety of reliable sources that included scientific research and related health reports. Results of literature reviews suggest that chronic energy deficiency in pregnant women can lead to a variety of health problems. Pregnant women who experience chronic energy shortages have a higher risk of experiencing persistent fatigue, unwanted weight loss, and a decrease in physical strength. In addition, chronic energy shortages can also cause problems on the mother’s immune system, increase the risk of infection, and affect the body’s ability to recover after childbirth. To raise awareness about the dangers of chronic energy shortages on pregnant women, further research is needed to understand the underlying mechanisms and the effectiveness of appropriate interventions. Thus, this information can be used to improve prenatal care and provide the necessary support for pregnant women to ensure optimal health and development for the mother and fetus.

Differences in Eating Habits, Lifestyle, and Weight Changes of Indonesian College Students Based on Their Residence During The COVID-19 Pandemic

The COVID-19 pandemic has indirectly forced people to adapt to the new normal, doing activities outside the home with proper health protocols or not leaving the house to reduce the spread of the virus; this also affects food consumption and sedentary behavior. For some people, the pandemic causes anxiety and even stress. The design of this study was cross cross-sectional, using a survey method online with Google Form carried out from April to September 2021. Descriptive analysis was conducted on 1185 respondents who are currently studying at universities in Indonesia., The results of the study stated that the pandemic had an impact on Indonesian students. This survey researched the differences in eating habits, changes in body weight, and lifestyle in Indonesian students based on where they lived during the Covid-19 pandemic. From the results of data analysis, it is known that most of the respondents experienced changes in body weight during the Covid-19 pandemic, whether they lived together or alone. However, more than half of the respondents have a habit of weighing their body weight irregularly. The results showed that the COVID-19 pandemic influenced eating habits, lifestyle, and changes in body weight. The community, especially students, both living alone (dormitory/boarding/apartments) or living with family or relatives should have sufficient knowledge and attitudes about nutrition to maintain unwanted weight changes during the pandemic.

Case Report OCLC Number/Unique Identifier: Unusual Thrombosis Despite Anticoagulation

Background: Pulmonary Embolism (PE) is a life-threatening condition with annual incidence ranging from 39 to 115 cases per 100,000 population [1]. Along with many other causes, neoplasia is one of the highest risk factors for pancreatic, lung, gastric, cerebral and haematological cancer [2]. Patients with neoplasia often have venous thromboembolism (VTE) during the course of the disease, but occasionally neoplasia is diagnosed as secondary to VTE. Case Presentation: A 55-year-old man known with high blood pressure and dyslipidaemia is diagnosed with bilateral distal Deep Venous Thrombosis (DVT) and treated with a factor Xa inhibitor. Two months later he is admitted for fatigue, dry cough, unwanted weight loss of approximately 5kg for a month and progressive exertion dyspnea. The echocardiographic examination reveals dilated right chambers with thrombus in the Right Ventricle (RV). The suspicion of pulmonary embolism it was confirmed on thoracic contrast CT examination. Large bilateral mediastinal adenopathies and a right lung nodule were also visualised on lung CT scan. The patient was treated with unfractionated heparin, slow-acting nitrate, aspirin, calcium blocker, with the disappearance of the thrombus from the right ventricle. Bronchoscopy showed a lesion near the right main bronchus. The diagnosis of pulmonary adenocarcinoma is confirmed histopathologically on the sample obtained at bronchoscopy and from the mediastinal lymph node obtained at mediastinoscopy. The patient was referred to the oncology service for specialised treatment. Conclusion: VTE under anticoagulant treatment should always raise some suspicions and other causes should be sought. Undiagnosed neoplasms , drug resistance or drug interactions, thrombophilias are some of the causes that should be suspected in case of thrombosis under therapeutic anticoagulant.

NUTRITIONAL STATUS OF PATIENTS BEFORE GASTROINTESTINAL SURGERY PREPARED AT VIETNAM-GERMANY FRIENDSHIP HOSPITAL IN 2021-2022

The study describes cross-sectional crossings on 90 patients before prepared gastrointestital surgery at Vietnam-Germany Friendship Hospital. The study subjects were assessed for nutritional status on multiplication index such as BMI, mid-upper arm circumference, test index and risk assessment of malnutrition according to the subjective global assessment (SGA). The results showed that the rate of malnutrition according to BMI of patients before surgery was 17,8%, the rate of overweight and obesity was 4,4%, in which patients before gastric surgery have the highest risk of malnutrition. The rate of malnutrition by mid-upper arm circumference was 23,3%. Patients had a 55,6% risk of malnutrition under the SGA, moderate and severe malnutrition 34,5% and 21,1%, respectively. The rate of unwanted weight loss >10% was 26,7%. Blood albumin levels <35g/l and anemia at the time of surgery were 28,3% and 51,8%, respectively. Malnutrition accounts for a fairly high proportian in patients before gastrointestinal surgery, high rates of weight loss and anemia.

Could a Dolutegravir-Based Antiretroviral Therapy Lead to Clinical Obesity? A Retrospective Cohort Study Conducted at Hawassa University Comprehensive Specialized Hospital in Hawassa, Sidama, Ethiopia.

Background As of April 2019, the dolutegravir (DTG)-based regimen is replacing the efavirenz-based regimen in Ethiopia, mainly due to its superiority in viral load suppression. However, there is a growing concern about this medication-based regimen, the most serious of which is excessive weight gain. In this study, we looked at weight gain disparities among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients on antiretroviral therapy (ART) who have been shifted to tenofovir/lamivudine/dolutegravir (TLD) from a tenofovir/lamivudine/efavirenz (TLE)-based regimen versus those who are maintained on a tenofovir/lamivudine/efavirenz-based regimen. Methods A facility-based retrospective observational cohort study was conducted in pursuit of weight change disparities between tenofovir/lamivudine/dolutegravir and tenofovir/lamivudine/efavirenz-based regimens among patients who have attained optimal viral suppression at Hawassa University Comprehensive Specialized Hospital antiretroviral clinic. Chi-square and logistic regression were used as appropriate using an SPSS version 21 program to test the association of specific variables to outcome variables, and a P value <0.05 was considered statistically significant. Results This study included 422 patients, 211 of whom were switched from tenofovir/lamivudine/efavirenz to tenofovir/lamivudine/dolutegravir and the remaining were who kept on a tenofovir/lamivudine/efavirenz-based regimen. Patients on a tenofovir/lamivudine/dolutegravir-based regimen had a mean weight gain of 3.88 ± 2.021 kg in one year compared to those on TLE (2.26 ± 2.39). In a bivariate analysis, being male was found to protect against unwanted weight gain at COR 0.531 (0.345, 0.816). A current CD4 count of more than 500 has been found to be strongly correlated with weight gain in multivariate analysis at an AOR of 0.315 (0.188, 0.527) at a P value ≤0.001. Conclusion According to this study, tenofovir/lamivudine/dolutegravir (TLD)-based antiretroviral medication (ART) users are more likely to gain weight, and clinicians should advise them of the risks of weight gain as well as cost-effective ways to prevent weight gain linked to poor health outcomes in these patients. Future investigations should confirm the findings of this study, and more research into the effects of weight gain in these people is required.

Common bean (Phaseolus vulgaris L.) α-amylase inhibitors as safe nutraceutical strategy against diabetes and obesity: An update review.

Overweight and obesity are constantly increasing, not only in Western countries but also in low‐middle‐income ones. The decrease of both the intake of carbohydrates and their assimilation are among the main dietary strategies to counter these conditions. α‐Amylase, a key enzyme involved in the digestion of carbohydrates, is the target enzyme to reduce the absorption rate of carbohydrates. α‐Amylase inhibitors (α‐AIs) can be found in plants. The common bean, Phaseolus vulgaris is of particular interest due to the presence of protein‐based α‐AIs which, through a protein–protein interaction, reduce the activity of this enzyme. Here we describe the nature of the various types of common bean seed extracts, the type of protein inhibitors they contain, reviewing the recent Literature about their molecular structure and mechanism of action. We also explore the existing evidence (clinical trials conducted on both animals and humans) supporting the potential benefits of this protein inhibitors from P. vulgaris, also highlighting the urgent need of further studies to confirm the clinical efficacy of the commercial products. This work could contribute to summarize the knowledge and application of P. vulgaris extract as a nutraceutical strategy for controlling unwanted weight gains, also highlighting the current limitations.

Nutrition-related problems, nutritional support practices and barriers to adherence to nutritional guidelines during intensive treatment for acute myeloid leukemia: Patients' and hematology nurses' perspectives and experiences.

The updated guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) and for Blood and Marrow Transplantation (EBMT) on nutrition in intensively treated acute myeloid leukemia (AML) patients recommend enteral nutrition (EN) instead of parenteral nutrition (PN) as the first-choice medical nutrition therapy. Despite this, PN remains the preferred route of nutrition administration in daily practice. The aim of this qualitative study was to gain insight into the patients' and hematology nurses' experiences and perceptions regarding nutritional problems and nutritional support and the reasons for the low adherence to the ESPEN/EBMT guidelines. Semi-structured interviews were conducted in 23 patients from various Dutch hospitals who had completed intensive AML treatment. Interviews with 22 patients were audio-recorded and transcribed, one interview was summarized. The transcripts and summary were thematically analyzed using Atlas.ti. From each of the 22 Dutch hospitals providing intensive AML treatment, one hematology nurse participated in a telephone questionnaire survey. The results of this survey are presented in a descriptive way. Nutritional problems were a major source of distress in most participating patients. Nutritional support often led to peace of mind and less concerns, provided that there were no conflicting nutritional support practices among treating hospitals. Patients perceived PN and EN as a life-line and necessary for the prevention of or recovery from physical decline, but they also experienced loss of independence, limited mobility, fear of unwanted body weight gain and problems related to the feeding equipment. Both patients and hematology nurses regarded PN as an easy method of nutrition administration, while EN was often seen as a necessary evil or was even refused by patients, owing to tube-related physical discomfort and EN intolerance. Both patients' and hematology nurses' reluctance to administer EN proved to be barriers to the ESPEN/EBMT nutritional guideline adherence. Among the surveyed hematology nurses, barriers to adherence included personal factors related to their knowledge (lack of awareness) and attitudes (negative outcome expectancy and lack of agreement), guideline-related factors (lack of evidence) and external factors (lack of collaboration). Individualized nutritional support, including EN and PN, may reduce nutrition-related distress in intensively treated AML patients, provided that conflicting nutritional support practices among hospitals are avoided or explained. The barriers to adherence to the ESPEN/EBMT guidelines on EN and PN in this patient group may be reduced by enhancing hematology nurses' awareness and knowledge of the guidelines, incorporating the guidelines into multidisciplinary clinical pathways, improving outcome of EN by proper triage of patients eligible for EN and increasing the level of evidence of the guidelines.

The Effect of Short-Term Conditional-Equilibrium Exercises on Balance and Functional Limitations in Aged Women With Frailty Syndrome: A Randomized Controlled Trail

Objectives Increasing frailty syndrome is one consequence of the aging population. Frailty syndrome can adversely affect the independent life and social activities of the elderly by threatening their balance and mobility. This study aimed to investigate the effect of short-term postural-balance training on balance and functional limitations in elderly women with frailty syndrome. Methods &amp; Materials The present clinical trial study was performed on 54 elderly women with frailty syndrome. Participants were randomly selected from one of the daycare centers for the elderly in Shiraz and were divided into two groups intervention (n=27) and control (n=27). For the intervention group, 12 sessions of short-term postural-balance exercises were held. Data were collected using the Fried Frailty Index, berg balance scale (BBS-9), and the survey of activities and fear of falling in the elderly (SAFE) Questionnaire at the beginning of the study and the end of the intervention and analyzed using SPSS software v. 25. Results The mean age of participants was 66.77 years, and 94.4% had at least one chronic disease. Following the intervention, there was a significant improvement in the mean scores of frailties such as physical activity, walk time, balance, and motor limitation of the elderly in the intervention group. In contrast, the intervention could not significantly affect other frailty indicators, i.e., unwanted weight loss, exhaustion, and grip strength in the intervention group Conclusion Postural-balance exercises significantly improve the physical characteristics of malnutrition and motor and functional limitations in daily life activities in the elderly.

Obesogens: How They Are Identified and Molecular Mechanisms Underlying Their Action.

Adult and childhood obesity have reached pandemic level proportions. The idea that caloric excess and insufficient levels of physical activity leads to obesity is a commonly accepted answer for unwanted weight gain. This paradigm offers an inconclusive explanation as the world continually moves towards an unhealthier and heavier existence irrespective of energy balance. Endocrine disrupting chemicals (EDCs) are chemicals that resemble natural hormones and disrupt endocrine function by interfering with the body’s endogenous hormones. A subset of EDCs called obesogens have been found to cause metabolic disruptions such as increased fat storage, in vivo. Obesogens act on the metabolic system through multiple avenues and have been found to affect the homeostasis of a variety of systems such as the gut microbiome and adipose tissue functioning. Obesogenic compounds have been shown to cause metabolic disturbances later in life that can even pass into multiple future generations, post exposure. The rising rates of obesity and related metabolic disease are demanding increasing attention on chemical screening efforts and worldwide preventative strategies to keep the public and future generations safe. This review addresses the most current findings on known obesogens and their effects on the metabolic system, the mechanisms of action through which they act upon, and the screening efforts through which they were identified with. The interplay between obesogens, brown adipose tissue, and the gut microbiome are major topics that will be covered.