Effect of malnutrition and body composition on the quality of life of COPD patients.

BACKGROUND: Pathological alterations in nutritional status may develop in Chronic Obstructive Pulmonary Disease (COPD) patients through production of inflammatory cytokines and inadequate diet. OBJECTIVE: The aim of our study was to determine the correlation between nutritional status and quality of life of COPD patients. METHODS: We evaluated the nutritional status of COPD patients of Hungarian National Koranyi Institute for Pulmonology using the Malnutrition Universal Screening Tool (MUST) and bioelectrical impedance analysis (BIA) between January 1 and June 1, 2019. Lung function, physical fitness, and respiratory muscle strength were included in the assessment. RESULTS: Fifty patients (mean age was 66.3 ± 9.6 years) participated in our study. Mean body mass index (BMI) was 26.2 ± 6.1 kg/m2 and mean fat-free mass index (FFMI) was 16.8 ± 2.4 kg/m2. Overweight patients had better lung function values (FEV1ref%: 46.3 ± 15.2) than normal (FEV1ref%: 45.1 ± 20.9) and underweight patients (FEV1ref%: 43.8 ± 16.0). The Modified Medical Research Council Dyspnea Scale (mMRC) was significantly associated with various parameters; strongest correlation was found with FFMI (r = -0.537, P < 0.001), skeletal muscle mass index (SMMI) (r = -0.530, P < 0.001), and 6-minute walking distance (6MWD) (r = -0.481, P < 0.001). CONCLUSIONS: Our results indicate that malnourished COPD patients may have reduced lung function and lower quality of life compared to normal weight patients. Thus, our findings suggest that nutritional therapy be included in the treatment of COPD patients combined with nutritional risk screening and BIA during the follow-up.

Regulatory T Cells in the Context of New-Onset Diabetes After Renal Transplant: A Single-Center Experience.

BACKGROUND: New-onset diabetes mellitus after transplant (NODAT) is a well-known complication of renal transplant that severely affects graft and patient survival. It is necessary to explore further risk factors and reveal the underlying pathomechanism. METHODS: Renal transplants performed between January 2010 and June 2018 were involved. Exclusion criteria were the recipient age younger than 18 years, follow-up period less than 6 months, and patients with diabetes at the time of transplant. Only primary kidney transplants were involved in our study, which totaled 223 cases. Besides donor and recipient demographic data, the type of immunosuppression, the average fasting glucose level, and T-subset profiles were compared. RESULTS: Of 223 cases there were 33 patients (14.8%) with NODAT (17 female; mean age, 54.2 [SD, 10.3] years; mean body mass index [calculated as weight in kilograms divided by height in meters squared], 27.8 [SD, 5.1]; mean follow-up, 43.3 [SD, 25.5] months). The control group consisted of 190 patients. The average fasting blood glucose level was higher in the NODAT group vs the control group (P < .001). The average fasting blood glucose level above diabetic threshold (≥7 mmol/L) was in association with a 6-fold higher risk of NODAT (odds ratio, 5.86; 95% CI, 2.46-13.97; P < .001). Absolute value of CD4+CD25brightCD127dim regulatory T cells was lower in the NODAT group at the first month after transplant (P = .048) Immunosuppressive protocol and survival data did not differ. CONCLUSIONS: Intensive management of the carbohydrate excursions during the early post-transplant period may decrease the incidence of NODAT. Further investigations will be required to decide whether the reduced CD4+CD25brightCD127dim/regulatory T-cell count contributes the development of NODAT.

Phase transition in the collective migration of tissue cells: experiment and model.

We have recorded the swarming-like collective migration of a large number of keratocytes (tissue cells obtained from the scales of goldfish) using long-term videomicroscopy. By increasing the overall density of the migrating cells, we have been able to demonstrate experimentally a kinetic phase transition from a disordered into an ordered state. Near the critical density a complex picture emerges with interacting clusters of cells moving in groups. Motivated by these experiments we have constructed a flocking model that exhibits a continuous transition to the ordered phase, while assuming only short-range interactions and no explicit information about the knowledge of the directions of motion of neighbors. Placing cells in microfabricated arenas we found spectacular whirling behavior which we could also reproduce in simulations.

Enantioselective Michael addition catalyzed by cinchona alkaloids.

Enantioselective Michael additions of cyclic beta-ketoesters to methyl vinyl ketone catalyzed by cinchona alkaloids were studied. The results revealed that the induced enantioselectivity was significantly influenced by both the structure of the catalyst and that of the substrate. Interesting differences in the effect of the structure of the alkaloid on the enantioselectivity of this reaction in the case of three beta-ketoesters were discovered. High enantioselectivities were obtained in the reaction of ethyl 2-oxocyclopentanecarboxylate and ethyl 2-oxocyclohexanecarboxylate (up to 83 and 80%, respectively) at a low cinchona:reactant ratio of 1:500. As the specific rotations of the product enantiomers were unknown, they were determined by optical rotation and chiral GC measurements and verified by NMR experiments.

Heterogeneous asymmetric reactions. Part 24. Heterogeneous catalytic enantioselective hydrogenation of the C==N group over cinchona alkaloid modified palladium catalyst.

The enantioselective hydrogenation of C==N-C group containing compounds over modified metal catalysts is as yet an uninvestigated research area. This work contains results obtained on the hydrogenation of 1-pyrroline-2-carboxylate esters and sodium salt over cinchona alkaloid-modified alumina-supported Pd catalyst. The effect of the reaction parameters and the structure of the alkaloid molecule on hydrogenation rate and enantioselectivity allowed us to assume that on the catalyst surface only a weak interaction exists between the modifier and the substrate, resulting in the low enantiomeric excesses (up to 20%) obtainable in these reactions.

Asymmetric sonochemical reactions enantioselective hydrogenation of alpha-ketoesters over platinum catalysts.

The sonochemical enantioselective hydrogenation of different alpha-ketoesters to the corresponding hydroxy derivatives over cinchona modified Pt catalysts is described. Ultrasonic irradiation was found to be beneficial in improving the optical yields. Besides studying the reaction rates and enantioselectivities, the effect of ultrasonics on the catalyst-modifier system and the scale-up of the process will also be considered.

Ultrasonics in chemoselective heterogeneous metal catalysis sonochemical hydrogenation of unsaturated carbonyl compounds over platinum catalysts.

The hydrogenation of unsaturated aldehydes was studied over ultrasonically pretreated silica supported platinum catalyst. In the hydrogenation of cinnamaldehyde a remarkable reaction rate and cinnamyl alcohol selectivity increase was observed. Using other unsaturated aldehydes the reaction rate and unsaturated alcohol selectivity increased moderately.

New results on the mass spectra of cinchona alkaloids

The electrospray ionization (ESI) mass spectra of 16 cinchona alkaloid compounds were studied for the first time. The electron ionization (EI) spectra of 22 cinchona alkaloids were also recorded, 14 of which had not been examined previously. In the case of EI the characteristic direction of the fragmentation is the scission of the C8-C9 bond. Under EI the cleavage of the C4'-C9 bond occurs only in the case of hydrogenated cinchona alkaloids, whereas the C9-O bond cleavage can be observed in the case of ester and ether derivatives. At a low capillary exit voltage (CapEx) in the ESI measurements there is no fragmentation, and only the [M + H](+) and in some cases the double protonated [M + 2H](2+) ions can be detected. On increasing the CapEx the characteristic primary direction is the cleavage of the C9-O bond, which was observed in the case of epialkaloids and esterified or etherified cinchona derivatives, respectively. Copyright 2000 John Wiley & Sons, Ltd.

Identification of ethyl pyruvate and dihydrocinchonidine adducts by electrospray ionization mass spectrometry.

Several ethyl pyruvate and dihydrocinchonidine adducts, formed by non-covalent interactions with alkali cations, have been identified for the first time using electrospray ionization mass and tandem mass spectrometry. This type of adduct may have an important role in asymmetric reactions of pyruvates in the presence of cinchonas.

Ultrasonics in heterogeneous metal catalysis: sonochemical chemo- and enantioselective hydrogenations over supported platinum catalysts.

Sonochemical chemo- and enantioselective hydrogenations over supported platinum catalysts are described. We disclose our results with respect to a sonochemical modification of the chemoselective hydrogenation of cinnamaldehyde over supported platinum catalysts, and the asymmetric hydrogenation of ethyl pyruvate promoted by various ultrasonic pretreatments. The ultrasonic pretreatment of the supported platinum catalysts was found to be highly beneficial in almost every case, improving both the catalytic activity and selectivity. The effect of additional experimental variables, such as hydrogen pressure, catalyst support, temperature and the ultrasonic insonation time were also studied. The enantioselectivity of the hydrogenation of ethyl pyruvate increased up to 97.1% ee. In the case of cinnamaldehyde hydrogenation, the selective preparation of cinnamyl alcohol became possible. The theoretical aspects of the working mechanisms in comparison with 'silent' reactions will also be provided.

Combined peritoneal and haemodialysis therapy for chronic renal insufficiency.

Twenty-three patients with chronic uraemia were treated for an average of 8.5 months with intermittent peritoneal dialysis. When hypervolaemia developed and/or the volume of low-molecular weight substances increased, the therapy was complemented by one or two sessions of haemodialysis per week. The combined treatment was carried on for 4.1 months on average, in consequence of which the general condition improved, body weight reached the optimum, blood pressure diminished, turned normal and could be controlled by drugs. In the wake of the therapy carbamide nitrogen and creatinine levels dropped significantly, serum total protein and albumin values increased. At the close of the observation period 3 patients remained under combined therapy, 2 had undergone cadaveric kidney transplantation, 18 were transferred to chronic haemodialysis. Thoughts are evolved about the advisability of intermittent peritoneal dialysis and combined therapy in the care for uraemic patients.

[Combination of peritoneal dialysis and hemodialysis in the treatment of chronic renal insufficiency]. / Peritonealis dialízis és haemodializis kombinációja a krónikus veseelégtelenség kezelésében.

In case of 23 patients, who had been treated for 8.5 (2-10) months with intermittent peritoneal dialysis, the peritoneal dialysis was supplemented once or twice a week by haemodialysis for 8.5 months. This combined way of treatment was favourable in cases of hypervolemia and/or of increased level of substances of small molecular weight. The average duration of this kind of treatment was 4.1 (1.5-11) months. In the course of treatment the general condition of the patients improved. When they regained their optimal bodyweight, their blood pressure got normalized or their hypertony decreased or it could be regulated by drug therapy. At the effect of this treatment, the carbamid nitrate and serum creatinin significantly decreased and the serum total protein and albumin levels increased. Two of the patients underwent cadaver kidney transplantation, and 18 of them have been treated by hemodialysis, 3 of them are being treated in this combined way even now. The authors discuss the role of intermittent peritoneal dialysis and that of the combined treatment in the management of uremic patients.