Malnutrition is prevalent among hospitalized patients in developed countries, contributing to negative health outcomes and increased healthcare costs. Timely identification and management of ...malnutrition are crucial. The lack of a universally accepted definition and standardized diagnostic criteria for malnutrition has led to the development of various screening tools, each with varying validity. This complicates early identification of malnutrition, hindering effective intervention strategies. This systematic review and meta-analysis aimed to identify the most valid and reliable nutritional screening tool for assessing the risk of malnutrition in hospitalized adults.
A systematic literature search was conducted to identify validation studies published from inception to November 2023, in the Pubmed/MEDLINE, Embase, and CINAHL databases. This systematic review was registered in INPLASY (INPLASY202090028). The risk of bias and quality of included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2). Meta-analyses were performed for screening tools accuracy using the symmetric hierarchical summary receiver operative characteristics models.
Of the 1646 articles retrieved, 60 met the inclusion criteria and were included in the systematic review, and 21 were included in the meta-analysis. A total of 51 malnutrition risk screening tools and 9 reference standards were identified. The meta-analyses assessed four common malnutrition risk screening tools against two reference standards (Subjective Global Assessment SGA and European Society for Clinical Nutrition and Metabolism ESPEN criteria). The Malnutrition Universal Screening Tool (MUST) vs SGA had a sensitivity (95% Confidence Interval) of 0.84 (0.73–0.91), and specificity of 0.85 (0.75–0.91). The MUST vs ESPEN had a sensitivity of 0.97 (0.53–0.99) and specificity of 0.80 (0.50–0.94). The Malnutrition Screening Tool (MST) vs SGA had a sensitivity of 0.81 (0.67–0.90) and specificity of 0.79 (0.72–0.74). The Mini Nutritional Assessment-Short Form (MNA-SF) vs ESPEN had a sensitivity of 0.99 (0.41–0.99) and specificity of 0.60 (0.45–0.73). The Nutrition Universal Screening Tool-2002 (NRS-2002) vs SGA had a sensitivity of 0.76 (0.58–0.87) and specificity of 0.86 (0.76–0.93).
The MUST demonstrated high accuracy in detecting malnutrition risk in hospitalized adults. However, the quality of the studies included varied greatly, possibly introducing bias in the results. Future research should compare tools within a specific patient population using a valid and universal gold standard to ensure improved patient care and outcomes.
Malnutrition is a clinical problem with a high prevalence in hospitalized adult patients. Many nutritional screening tools have been developed but there is no consensus on which 1 is more useful. The ...purpose of this review protocol is to provide an overview of which nutritional screening tool is most valid to identify malnutritional risk in hospitalized adult patients and to analyze the sensitivity and specificity of the different tools.
The protocol of this systematic review and meta-analysis was registered on the INPLASY website (https://inplasy.com/inplasy-2020-9-0028/) and INPLASY registration number is INPLASY202090028. We will perform a systematic literature search of main databases: PubMed, EMBASE, CINAHL and Web of Science and the Cochrane database. Also, grey literature will be search. Peer-reviewed studies published in English, Portuguese or Spanish language will be selected. Screening of titles, abstract and full text will be assessed for eligibility by 2 independent blinded reviewers and any discrepancies will be resolved via consensus. After screening the studies, a meta-analysis will be conducted, if it is possible.
Results from this systematic review will help health professionals to identify malnutrition in hospitalized patients and to make decisions to prevent or treat it as well as provide new clues to researchers.
Our systematic review will provide aknowledge about the most valid malnutrition risk screening tool in hospitalized adult patients.
To assess the prevalence of malnutrition in hospitalised adult patients, and to evaluate the accuracy of the most commonly used nutritional screening tools for identifying individuals at risk of ...malnutrition.
A prospective cross-sectional study was conducted on a total of 248 hospitalised patients in internal medicine wards (mean age: 75.2 years; 39.5% females). Nutritional screening was performed within 48 h of admission using the following tools: Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening Tool (NRS-2002), Malnutrition Screening Tool (MST), Short Nutritional Assessment Questionnaire (SNAQ), and Mini Nutritional Assessment Short Form (MNA-SF). The criteria of the European Society for Clinical Nutrition and Metabolism (ESPEN) were used as the gold standard for defining malnutrition. Patients were also evaluated using the Subjective Global Assessment (SGA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Accuracy was determined by examining sensitivity, specificity, and positive and negative predictive values, and diagnostic agreement was determined by calculation of Cohen's kappa (κ). The study is reported as per the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
The ESPEN criteria classified 20.2% of the hospitalised patients as malnourished. Overall, the MUST had the highest sensitivity (80.0%), specificity (74.7%) and positive predictive value (44.4%). For the subgroup of patients aged >65 years, the MNA-SF had high sensitivity (94.4%) but low specificity (39.0%). Based on Cohen's κ, the SGA and GLIM criteria showed low agreement with the ESPEN criteria.
The MUST was the most accurate nutritional screening tool, through the MST is more easily applied in many clinical settings. A comprehensive assessment of malnutrition that considers muscle mass is crucial for the reliable diagnosis of malnutrition.
The present findings underscore the importance of accurate assessment of the malnutrition status of hospitalised patients and the need for a reliable screening tool. No patient or public contribution.
Entre los aspectos de la conducta social alterados en las personas con trastorno del espectro autista y lenguaje funcional (TEA grado 1, también diagnosticado como síndrome de Asperger) la ...competencia pragmática es uno de los más estudiados. No obstante, faltan trabajos empíricos sobre la posible mejora de los aspectos comunicativos problemáticos con el desarrollo evolutivo y la praxis comunicativa. El objetivo de esta investigación es revisar los déficits pragmáticos más habituales en niños y adolescentes con TEA y lenguaje funcional y comprobar si la práctica del uso social del lenguaje puede implicar una mejora en su competencia pragmática. Para llevar a cabo esta investigación, se ha realizado una recogida de datos a través de un cuestionario de 26 preguntas entre 110 padres y madres de niños y jóvenes de edades comprendidas entre los 6 y los 18 años diagnosticados con TEA grado 1. Los resultados confirman, en línea con trabajos anteriores, cuáles son los aspectos de la competencia pragmática más problemáticos en estos niños y adolescentes -asociados a la comprensión y expresión de la intención comunicativa, la dinámica conversacional, la comunicación no verbal y la comprensión del lenguaje figurado-, a la par que revelan que algunas de las habilidades alteradas se pueden adquirir o mejorar con el paso de los años. El estudio confirma, asimismo, el hecho de que la adquisición o mejora de ciertas destrezas no garantiza que puedan ponerse en práctica en todos los contextos, dadas las dificultades para generalizar aprendizajes que presentan las personas con TEA.
Clove(Syzygium aromaticum):a precious spice Cortés-Rojas, Diego Francisco; de Souza, Claudia Regina Fernandes; Oliveira, Wanderley Pereira
Asian Pacific journal of tropical biomedicine,
02/2014, Letnik:
4, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Clove(Syzygium aromaticum) is one of the most valuable spices that has been used for centuries as food preservative and Tor many medicinal purposes.Clove is native of Indonesia but nowadays is ...cultured in several parts of the world including Brazil in the slate of Bahia.This plant represents one of the richest source of phenolic compounds such as eugenol,eugenol acetate and gallic acid and posses great potential for pharmaceutical,cosmetic,food and agricultural applications.This review includes the main studies reporting the biological activities of clove and eugennl.The antioxidant and antimicrobial activity of clove is higher than many fruits,vegetables and other spices and should deserve special attention.A new application of clove as larvicidal agent is an interesting strategy to combat dengue which is a serious health problem in Brazil and other tropical countries.Pharmacokinetics and lexicological studies were also mentioned.The different studies reviewed in this work confirm the traditional use of clove as food preservative and medicinal plant standing out the importance of this plant for different applications.
Access conditions to information kept in public archival institutions are analyzed In this research through the study of Brazilian state public archives. The theoretical framework of this research is ...centered in a real and common concern in Brazil related to the contradiction between the rights one has to get information and one's real access to information. The research method adopted was the survey and the data v^s collected through a questionnaire sent by mail and answered by fifteen out
of the twenty five existing Brazilian state public archives. After the study of federal and some state archival legislation, data analysis was carried out focusing on aspects winich affect significantly the access to the archives, such as: the location of the archival institution within the administrative structure of the state, the existence ofrecords management and transfer programs, the ways of organizing, storing and describing holdings, the existence of finding aids and, finally, the availability of human and technological resources. It was concluded that the access to the archives
kept in Brazilian state public archives is limited, to a great extent, although
guaranteed by law. Either federal and some state legislation analyzed ensure that any citizen has the nght of accessing the archives. Nevertheless, it has been found several obstacles which prevent archival institutions of making the documents available to Brazilian citizens, either for research purposes or as evidence of rights.
As condições de acesso à informação nos arquivos públicos são analisadas nesta pesquisa, através de estudo realizado nos Arquivos Públicos Estaduais brasileiros. O eixo teórico da pesquisa foi o questionamento ocorrente hoje no Brasil, que consiste na contradição existente entre o direito à informação e de acesso pleno aos documentos produzidos e acumulados pela administração
pública e a realidade das instituições arquivístivas brasileiras, com dificuldade em tornar essas informações acessíveis para o público. A pesquisa de campo, utilizando o questionário, como instrumento de coleta de dados, analisou 15. instituições arquivísticas estaduais, dentre as 25 existentes no país. Após o estudo da legislação arquivística federal e de algumas leis estaduais, enviadas pelas instituições pesquisadas, procedeu-se à análise dos fatores considerados
importantes no que tange à organização e as condições de acesso aos arquivos. Entre eles. a inserção dos Arquivos dentro da estrutura administrativa do Estado, a existência de programas de gestão de documentos e de recolhimento, as formas de organização, descrição e consen/ação do acervo, assim como a infra-estrutura dos arquivos, a existência de instrumentos de pesquisa e as possibilidades de recursos humanos e tecnológicos. Os resultados obtidos indicam que o acesso aos conjuntos de documentos, hoje, sob custódia dos. Arquivos Públicos Estaduais do Brasil encontra-se bastante limitado, apesar degarantido por lei. A legislação federal e as diversas leis estaduais estudadas, são suficientes para garantir ao cidadão o acesso aos arquivos. No entanto, são inúmeras as dificuldades encontradas pelas instituições arquivísticas para manter seus acervos disponíveis para consulta e para atender ao cidadão que procura os Arquivos, seja com o objetivo de realizar pesquisa cientifica ou de buscar a comprovação de direitos.
Abuse during early life, especially from the caregiver, increases vulnerability to develop later-life psychopathologies such as depression. Although signs of depression are typically not expressed ...until later life, signs of dysfunctional social behavior have been found earlier. How infant abuse alters the trajectory of brain development to produce pathways to pathology is not completely understood. Here we address this question using two different but complementary rat models of early-life abuse from postnatal day 8 (P8) to P12: a naturalistic paradigm, where the mother is provided with insufficient bedding for nest building; and a more controlled paradigm, where infants undergo olfactory classical conditioning. Amygdala neural assessment (c-Fos), as well as social behavior and forced swim tests were performed at preweaning (P20) and adolescence (P45). Our results show that both models of early-life abuse induce deficits in social behavior, even during the preweaning period; however, depressive-like behaviors were observed only during adolescence. Adolescent depressive-like behavior corresponds with an increase in amygdala neural activity in response to forced swim test. A causal relationship between the amygdala and depressive-like behavior was suggested through amygdala temporary deactivation (muscimol infusions), which rescued the depressive-like behavior in the forced swim test. Our results indicate that social behavior deficits in infancy could serve as an early marker for later psychopathology. Moreover, the implication of the amygdala in the ontogeny of depressive-like behaviors in infant abused animals is an important step toward understanding the underlying mechanisms of later-life mental disease associated with early-life abuse.
Histopathology has been used as a very useful tool to provide information on the severity of tissue damage, injuries, and organ functionality. Thus, this work aimed to assess whether seasonal ...variations (summer and winter) in water quality had consequences on the liver histology of Iberian barbel (Luciobarbus bocagei) and Douro nase (Pseudochondrostoma duriense). The research was carried out in the Vilariça River, a tributary of the Sabor River in Portugal, which is used as spawning grounds by these endemic cyprinids. The liver histopathological changes, assessed through a semi-quantitative system, allowed the identification of 13 histopathological changes located in the hepatic parenchyma, bile duct, and blood vessels. The histopathological changes with a higher prevalence in both species were vacuolization of hepatocytes, endothelial rupture, necrosis, fibrosis, and degenerative vacuolization. The results showed that the severity degree of liver histological alterations ranged between moderate and severe, and the major severity degree was observed in L. bocagei, in the summer season, and at the sampling points located in the downstream and middle stream. The canonical analysis indicated that the exposure of fish to metals may increase the potential risk of liver damage. Thus, in the summer, the high concentrations of Fe, Cu, Zn, As, and Mn justified the prevalence of the biliary duct epithelial detachment, in both species, and the hyperplasia of biliary epithelium, in L. bocagei. In the winter, the high TSS and Cd, Ni, and Cr concentrations justified the prevalence of congestion of blood vessels and degenerative vacuolization in both species. The higher hepatosomatic index of fish caught in the winter was due to the high presence of degenerative vacuolization and hepatocyte vacuolization. The severity of liver histopathological changes reflected differences in the type of contaminants in different seasons and sampling periods, and was thus proven as a valuable indicator of water quality.
Throughout life, rats emit ultrasonic vocalizations (USV) when confronted with an aversive situation. However, the conditions classically used to elicit USV vary greatly with the animal's age ...(isolation from the dam in infancy, versus nociceptive stimulation in adults). The present study is the first to characterize USV responses to the same aversive event throughout development. Specifically, infant, juvenile and adult rats were presented with mild foot-shocks and their USV frequency, duration, and relationship with respiration and behavior were compared. In juvenile and adult rats, a single class of USV is observed with an age-dependent main frequency and duration (30 kHz/400 ms in juveniles, 22 kHz/900 ms in adults). In contrast, infant rat USV were split into two classes with specific relationships with respiration and behavior: 40 kHz/300 ms and 66 kHz/21 ms. Next, we questioned if these infant USV were also emitted in a more naturalistic context by exposing pups to interactions with the mother treating them roughly. This treatment enhanced 40-kHz USV while leaving 66-kHz USV unchanged suggesting that the use of USV goes far beyond a signal studied in terms of amount of emission, and can inform us about some aspects of the infant's affective state.
Cell-free circulating tumour DNA (ctDNA) in plasma has been shown to be informative of the genomic alterations present in tumours and has been used to monitor tumour progression and response to ...treatments. However, patients with brain tumours do not present with or present with low amounts of ctDNA in plasma precluding the genomic characterization of brain cancer through plasma ctDNA. Here we show that ctDNA derived from central nervous system tumours is more abundantly present in the cerebrospinal fluid (CSF) than in plasma. Massively parallel sequencing of CSF ctDNA more comprehensively characterizes the genomic alterations of brain tumours than plasma, allowing the identification of actionable brain tumour somatic mutations. We show that CSF ctDNA levels longitudinally fluctuate in time and follow the changes in brain tumour burden providing biomarkers to monitor brain malignancies. Moreover, CSF ctDNA is shown to facilitate and complement the diagnosis of leptomeningeal carcinomatosis.
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