Obesity is positively Associated with Depression in Older Adults: Role of Systemic Inflammation.

Objective: We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults. Methods: Adults ≥ 65 years old ( n = 1,973) were interviewed at baseline in 2018 and 1,459 were followed up in 2021. General and abdominal obesity were assessed, and serum C-reactive protein (CRP) levels were measured at baseline. Depression status was assessed at baseline and at follow-up. Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms, as well as the relationship between obesity and CRP levels. The associations of CRP levels with the geriatric depression scale, as well as with its three dimensions, were investigated using multiple linear regressions. Results: General obesity was associated with worsening depression symptoms and incident depression, with an odds ratio ( OR) [95% confidence interval ( CI)] of 1.53 (1.13-2.12) and 1.80 (1.23-2.63), especially among old male subjects, with OR (95% CI) of 2.12 (1.25-3.58) and 2.24 (1.22-4.11), respectively; however, no significant relationship was observed between abdominal obesity and depression. In addition, general obesity was associated with high levels of CRP, with OR (95% CI) of 2.58 (1.75-3.81), especially in subjects free of depression at baseline, with OR (95% CI) of 3.15 (1.97-5.04), and CRP levels were positively correlated with a score of specific dimension (life satisfaction) of depression, P < 0.05. Conclusion: General obesity, rather than abdominal obesity, was associated with worsening depressive symptoms and incident depression, which can be partly explained by the systemic inflammatory response, and the impact of obesity on depression should be taken more seriously in the older male population.

Bedside ultrasonic localization of the nasogastric tube in a patient with severe COVID-19: A case report.

BACKGROUND: The indwelling nasogastric tube is commonly used for supplying enteral nutrition to patients who are unable to feed themselves, and accurate positioning is essential in the indwelling nasogastric tube in the body of the aforementioned patients. In clinical practice, abdominal radiography, auscultation, and clinical determination of the pH of the gastric juice are routinely used by medical personnel to determine the position of the tube; however, those treatments have proved limitations in specific cases. There are few case reports on the precise positioning of the nasogastric tube in patients with coronavirus disease 2019 (COVID-19), for whom a supply of necessary nutrition support is significant throughout the process of treatment. CASE SUMMARY: A 79-year-old patient, diagnosed with COVID-19 at the stage of combined syndromes with severe bacterial lung infection, respiratory failure, multiple co-morbidities, and a poor nutritional status, was presented to us and required an indwelling nasogastric tube for enteral nutrition support. After pre-treatment assessments including observation of the patient's nasal feeding status and examination of the nasal septal deviation, inflammation, obstruction, nasal leakage of cerebrospinal fluid, and other disorders that might render intubation inappropriate, we measured and marked the length of the nasogastric tube to be placed and delivered the tube to the intended length in the standard manner. Then further scrutiny was conducted to ensure that the tube was not coiled in the mouth, and gentle movements were made to avoid damage to the esophageal mucosa. However, back draw of the gastric juice using an empty needle failed, and the stethoscope could not be used for auscultation due to the specific condition presented by the internal organs of the patient, and the end of the tube was placed in saline with no bubbles spilling out. Therefore, it was not possible to determine whether the nasogastric tube was placed exactly in the stomach and no nutrient infusion was performed for the time being. Subsequently, the ultrasound probe was utilized to view the condition of the patient's stomach, where the nasogastric tube was found to be translucent and running parallel to the esophagus shaped as "=". The pre-conditions were achieved and 100 mL nutritional fluid was fed to the patient, who did not experience any discomfort throughout the procedure. His vital signs were stable with no adverse effects. CONCLUSION: We achieved successfully used ultrasound to position the nasogastric tube in a 79-year-old patient with COVID-19. The repeatable ultrasound application does not involve radiation and causes less disturbance in the neck, making it advantageous for rapid positioning of the nasogastric tube and worthy of clinical promotion and application.

Effect of expanded cottonseed meal on laying performance, egg quality, concentrations of free gossypol in tissue, serum and egg of laying hens.

Three hundred and sixty Hy-Line Brown hens, 40 week of age, were allocated to five treatments, each of which included four replicates of 18 hens. After an expanded process of cottonseed meal (CSM), free gossypol content in CSM was decreased from 1.24 to 0.40 g/kg. The dietary treatments were corn-soybean meal based diets including 6% CSM and 6%, 8% and 10% expanded cottonseed meal (ECSM). Hens fed 8% ECSM had higher (P<0.05) laying rate and average egg weight than those fed 6% CSM. The albumen height and Haugh unit in the control group, 6% and 8% ECSM groups were superior (P<0.05) to other treatments. Hens fed 6% CSM resulted in severe (P<0.05) egg yolk discoloration. Free gossypol (FG) concentrations in yolk and albumen and tissues of the 6% CSM group were greater (P<0.05) than those in any ECSM treatments. Hens fed 6% CSM and 10% ECSM had the highest (P<0.05) FG concentrations in the liver compared with those in the kidney and muscle, and higher (P<0.05) FG residues in yolk than those in albumen. In conclusion, FG in CSM can be reduced by 68% through an expanded process and ECSM can be available in laying hens at up to 10% of the total diet and an appropriate replacement of soybean meal with ECSM may improve performance in laying hens.