Malnutrition risk frequency and independent risk factors associated with mortality in hospitalized elderly patients with COVID-19 in Turkey.

BACKGROUND AND OBJECTIVES: Malnutrition is common in elderly patients and is an important geriatric syndrome that increases mortality. We aim to examine the frequency of malnutrition and independent risk factors associated with mortality in hospitalized elderly patients with COVID-19. METHODS AND STUDY DESIGN: Patients aged 65 years and older with COVID-19, who were hospitalized between 15th March and 30th April 2020, were included. Demographic characteristics of the patients, their comorbid diseases, medications, malnutrition, and mortality status were recorded. Nutritional Risk Screening-2002 was used as a malnutrition risk screening tool. The factors affecting mortality were analyzed using multivariate Binary Logistic regression analysis. RESULTS: Of the 451 patients included in the study, the mean age was 74.8±7.46 and 51.2% of them were female. The mean number of comorbid diseases was 1.9±1.28. Malnutrition risk was 64.7%, polymorbidity rate was 57.6% and polypharmacy was 19.3%. Mortality rate was found 18.4%. The risk factors affecting mortality were presented as malnutrition risk (OR: 3.26, p=0.013), high number of comorbid diseases (OR: 1.48, p=0.006), and high neutrophil/lymphocyte ratio (OR: 1.18, p<0.001), C-reactive protein (OR: 1.01, p<0.001), and ferritin (OR: 1.01, p=0.041) in elderly patients with COVID-19. Malnutrition risk (3.3 times), multiple comorbid diseases (1.5 times), and high neutrophil/lymphocyte ratio (1.2 times) were independent risk factors that increased the mortality. CONCLUSIONS: The frequency of malnutrition risk and mortality in elderly patients with COVID-19 is high. The independent risk factors affecting mortality in these patients are the risk of malnutrition, multiple comorbid diseases, and a high neutrophil/lymphocyte ratio.

High versus Moderate Dosage of Daily and Weekly Administration of Vitamin D Supplements in the Form of Oil Drop in Nursing Home Residents.

OBJECTIVE: To investigate the effectiveness of daily (800 IU), weekly-moderate (5600 IU) and weekly-high (8000 IU) supplementation of Vitamin D in nursing home residents. STUDY DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Nursing Home, MEVA, Istanbul, Turkey, from July 2016 to July 2017. METHODOLOGY: Nursing home residents were divided into 3 groups for supplementation of Vitamin D: Daily Dose Group (DDG), Weekly Dose Group-moderate (WDG-moderate) and Weekly Dose Group-high (WDG-high). Blood and physical performance tests were done initially to obtain a baseline value and the tests were repeated at 13th and 26th weeks of supplementation. Statistical analysis was conducted only on patients who were able to complete the 6-month-long study. RESULTS: WDG-moderate (5600 IU/week) supplementation is found to be the most effective intervention in our study [25 (OH) D from 23.50 ±12.67 ng/mL to 37.38 ±14.42 ng/mL]. In WDG-moderate, the resulting Vitamin D level was found to reach near-optimum therapeutic levels. Only a limited increase was observed in 25 (OH) D level of DDG and WDG- high at the end of 26 weeks. CONCLUSION: Weekly (5600 IU/week) moderate supplementation of Vitamin D could be more beneficial than weekly (8000/week) high supplementation among nursing home residents. Multi-drug use among nursing home residents may hinder the therapeutic efficiency of Vitamin D administration. Physical performance tests may fail to demonstrate increased performance in mobility after Vitamin D administration in nursing home residents.

The effects of lipoic acid on redox status in brain regions and systemic circulation in streptozotocin-induced sporadic Alzheimer's disease model.

While the deterioration of insulin-glucose metabolism (IGM), impaired redox homeostasis (IRH), ß-amyloid accumulation was reported in Sporadic Alzheimer's Disease (SAD) model, aforementioned factors related to lipoic acid administration and anthropometric indexes (AIs) are not yet studied with integrative approach. ß-amyloid accumulation, redox homeostasis biomarkers and AIs are investigated in SAD model. Streptozotocin-induced inhibition of insulin-signaling cascade but not GLUT-2 and GLUT-3 transporters takes a role in ß-amyloid accumulation. Inhibition types are related to IRH in cortex, hippocampus and systemic circulation. Lipoic acid (LA) shows both antioxidant and prooxidant effect according to the anatomical location. LA administration also leads to improved AIs during GLUT-2 inhibition and cortical redox status in GLUT-3 inhibited group. Optimal LA action could be possible if its redox behavior is balanced to antioxidant effect. Diagnostic usage of systemic IRH parameters as biomarkers and their possible correlations with deteriorated IGM should be investigated. Graphical abstract ᅟ.

Ameliorative Effects of Testosterone Administration on Renal Redox Homeostasis in Naturally Aged Rats.

BACKGROUND: Testosterone biosynthesis gradually decreases with age. Impaired redox homeostasis-related oxidative damage in cellular macromolecules has a high risk for the development of renal insufficiency. Our aim was to study the effects of testosterone replacement therapy on redox homeostasis. METHODS: We investigated various oxidative damage biomarkers in kidney. Experimental animals were separated into three groups-naturally aged rats, testosterone-administered naturally aged rats (single dose of 25 mg/kg testosterone enanthate), and their respective young controls. RESULTS: Our results showed that the testosterone-administered naturally aged group shared significant similarities with the young rats with respect to their redox status. In testosterone-administered naturally aged rats, kynurenine, protein carbonyl, advanced oxidation protein products, lipid peroxidation markers, and xanthine oxidase activities were significantly lower and Cu-Zn superoxide dismutase activities and testosterone levels were higher than naturally aged rats. In testosterone-administered naturally aged rats, catalase activities, ferric reducing anti-oxidant power, and testosterone levels were significantly lower and dityrosine, N-formyl kynurenine, protein carbonyl, and protein hydroperoxides were significantly higher than in young rats. On the other hand, in naturally aged rats, Cu-Zn superoxide dismutase, catalase activities, ferric reducing anti-oxidant power, and testosterone levels were lower and dityrosine, kynurenine, protein carbonyl, protein hydroperoxide, advanced oxidation protein products, lipid peroxidation markers, advanced glycation end products, and xanthine oxidase activities were higher than controls. CONCLUSIONS: Our results showed that a single dose of testosterone administration has a positive effect on the redox status of the aged kidney. Future studies are needed to clarify the exact molecular mechanism(s) involved in the action of testosterone in maintaining kidney redox homeostasis.