To analyze how different thermal processing methods affect the protein, calcium, and phosphorus content of hospital food served to dialysis patients and to generate recommendations for preparing ...menus that optimize nutritional content while minimizing the risk of hyperphosphatemia.
Standard Official Methods of Analysis (AOAC) methods were used to determine dry matter, protein, calcium, and phosphorus content in potatoes, fresh and frozen carrots, frozen green beans, chicken, beef and pork, frozen hake, pasta, and rice. These levels were determined both before and after boiling in water, steaming, stewing in oil or water, or roasting.
Most of the thermal processing methods did not significantly reduce protein content. Boiling increased calcium content in all foodstuffs because of calcium absorption from the hard water. In contrast, stewing in oil containing a small amount of water decreased the calcium content of vegetables by 8% to 35% and of chicken meat by 12% to 40% on a dry weight basis. Some types of thermal processing significantly reduced the phosphorus content of the various foodstuffs, with levels decreasing by 27% to 43% for fresh and frozen vegetables, 10% to 49% for meat, 7% for pasta, and 22.8% for rice on a dry weight basis. On the basis of these results, we modified the thermal processing methods used to prepare a standard hospital menu for dialysis patients. Foodstuffs prepared according to the optimized menu were similar in protein content, higher in calcium, and significantly lower in phosphorus than foodstuffs prepared according to the standard menu.
Boiling in water and stewing in oil containing some water significantly reduced phosphorus content without affecting protein content. Soaking meat in cold water for 1 h before thermal processing reduced phosphorus content even more. These results may help optimize the design of menus for dialysis patients.
Pravilna prehrana iznimno je važna u prevenciji šećerne bolesti i regulaciji glikemije. Šećerna bolest ubraja se u kategoriju bolesti koje se uspješno mogu prevenirati, dobro liječiti te im se može ...spriječiti ili odgoditi razvoj kroničnih komplikacija. Edukacija o pravilnoj prehrani treba biti individualno prilagođena, pri čemu treba obratiti pozornost na dob bolesnika, način života, socioekonomski status, tjelesnu aktivnost i komplikacije vezane uz šećernu bolest. Kod šećerne bolesti promjena životnih navika, što uključuje pravilnu prehranu, redovitu tjelesnu aktivnost i regulaciju tjelesne mase, može uvelike pridonijeti regulaciji glikemije, a u tipu 2 u nekim slučajevima može dovesti i do njene remisije. Smjernice su rezultat suradnje zdravstvenih stručnjaka koji sudjeluju u liječenju i edukaciji osoba koje boluju od šećerne bolesti. Utemeljene su na dokazima, prema metodologiji GRADE (engl. grading of recommendations, assessment, development and evaluation) koja uz snagu dokaza opisuje i razinu preporuke. Temeljni zaključci ovih smjernica odnose se na procjenu nutritivnih potreba te primjenu medicinske nutritivne terapije, individualno prilagođene osobama sa šećernom bolešću kao i onima koji imaju i neke od
vezanih komorbiditeta.
Malnutrition in vulnerable patient populations must be rapidly detected using techniques that are easy to incorporate into everyday clinical practice.
The new recommendations defined the 7-point ...Subjective Global Assessment (SGA) as optimal for nutritional assessment in chronic kidney disease
(CKD), while Geriatric Nutrition Risk Index (GNRI) demands additional examination in elderly. This study aimed to determine the accuracy of
several concise tools used in the clinical practice and the correlation of this tools with functional method hand grip strength (HGS) in elderly patients
with CKD. In this cross-sectional study, anthropometric and functional data for 50 elderly hemodialysis patients were analyzed using numerous
survey-based tools for screening nutritional status (Malnutrition Screening Tool – MST, Nutritional Risk Screening 2002 - NRS2002, Malnutrition
Universal Screening Tool - MUST, Mini Nutritional Assessment - MNA, GNRI), which we compared to the standard 7-point SGA nutritional
assessment tool. The sensitivity, specificity, and accuracy of these tools for detecting malnutrition were compared with the standard by using receiver
operating characteristic (ROC) curve analysis. 7-point SGA classified 36.6% of participants as well nourished, and 63.4% as mildly to moderately
malnourished, while the simplest alternative methods showed lower accuracy, classifying much higher proportions of participants as well nourished
(MST, 92.0%; NRS2002, 80.4%). MNA had the highest accuracy based on receiver operating characteristic curves. HGS correlated moderately with
7-point SGA (r = 0.331), MNA (r = 0.410), and GNRI (r = 0.320). Our small study suggests that MNA is the best tool for malnutrition risk screening
in elderly with CKD. Combining HGS with concise tools, such as GNRI, may provide better results and unburden healthcare professionals.
Introduction: Control of serum phosphate is important for patients on hemodialysis. The aim of the study was to determine if education based on phosphorus‐reducing techniques in food preparation and ...thermal processing, and accordingly prepared and applied diets, will lead to better outcomes than a standard education program to improve phosphate control in patients on hemodialysis.
Methods: Forty‐seven patients on hemodialysis were divided between an intervention and a control group. All subjects received training about nutrition for hemodialysis patients by trained dietitian. In addition, subjects in the intervention group received additional training in phosphorus‐reducing techniques in food preparation and received two hospital meals prepared using suggested cooking methods to reduce the phosphate content of food during dialysis treatment. Serum phosphate, serum albumin, and anthropometric parameters were measured, while nPCR was calculated, at the baseline and during the 1‐year study.
Findings: No differences in serum phosphate levels were observed between intervention (1.68 mmol/L 1.48–2.03) and control group (1.88 mmol/L 1.57–2.2) at baseline (P = 0.130). Although not statistically significant between groups the mean reduction was more apparent in the intervention group (−0.3 mmol/L (−0.4 to 0.1) vs. −0.2 (−0.5 to 0.1)), and lead to significantly reduction of phosphate binder therapy. During the study, the nPCR and anthropometric status of the patients did not change significantly.
Discussion: Providing additional education to hemodialysis patients on the specific cooking methods and accordingly prepared meals may decrease serum phosphate levels without significantly affecting nutritional status which may be useful in helping to prevent and treat hyperphosphatemia.
Nutritional status of hemodialysis patients Panjkota Krbavčić, Ines; Vrdoljak, Ivica; Bituh, Martina ...
Hrvatski časopis za prehrambenu tehnologiju, biotehnologiju i nutricionizam,
12/2018, Letnik:
13, Številka:
3-4
Journal Article, Paper
Odprti dostop
Hemodialysis patients are vulnerable population group and they, among other, should take special care on food and fluid intake with emphasis on energy, potassium, phosphorus, sodium and protein ...intake. The nutritional status of patients (n=14) was assessed through measurement of body weight, body height, upper arm circumference, lower leg circumference and handgrip dynamometry; as well as selected biochemical parameters: urate concentration, calcium and phosphate levels, total protein, creatinine, albumin and globulin ratio and C-reactive protein; and dietary assessment method: 3-day food record (3DD). Using range between 18.5 and 24.9 kg/m2 as cut-off, 35.7 and 57% of patients were classified as adequately nourished and overweight, respectively. According to results of 3DD, most of the subjects are supposed to align their micro- and macro- nutrients intake with the recommendations, with emphasis on the increasing intake of protein and energy as well as on decreasing intake of potassium, phosphorus, sodium and energy.
Progression of chronic kidney disease often results with developing hyperkalemia; the increased serum level of potassium, which causes cardiac, neuromuscular and gastrointestinal complications. ...Hyperkalemia is generally associated with cardiac arhythmias and higher risk of mortality in patients on hemodialysis. The aim was to determine the impact of education on potassium control among patients on hemodialysis, while basing additional education on potassium-reducing techniques during food preparation and applying diet prepared accordingly to learned techniques. Participants were 47 patients on hemodialysis divided in control (n=22) and intervention (n=25) groups. All participants were educated by trained dietitian and received materials about proper nutrition at the beginning of the 1-year longitudinal study. The intervention group was educated additionally on potassium-reducing food preparation techniques. While both groups received two hospital meals per day during hemodialysis, meals for the intervention group were prepared accordingly to suggested food preparation techniques. Biochemical parameters were monitored during the study according to standard methods. The results showed that there was significant change in reduction of serum levels of potassium in intervention group compared to control group after one year of the study (p=0.037). Also, monthly serum levels of potassium were significantly reduced (p<0.05), compared to baseline of the study, during first 8 months in the control group and during all 12 months in the intervention group. Education about food preparation, proper diet alterations and its implementation can be useful in decreasing serum potassium levels and preventing hyperkalemia in patients on hemodialysis.
This contribution describes the synthesis, characterization, and catalytic implementation of the highly constrained molybdenum(VI) polymers MoO2(LR) n (with R = H (1), 3OMe (2), and 4OMe (3)) and ...cyclic tetramer MoO2(L4OMe)4 ·0.5MeCN (3′·0.5MeCN) with nicotinoyl hydrazonato ligands (LR) derived from salicylaldehyde (LH), 3-methoxy-2-hydroxybenaldehyde (L3OMe), or 4-methoxy-2-hydroxybenzaldehyde (L4OMe). In order to determine the most stable geometries, conformational analysis of the free and coordinated ligands in these assemblies was carried out through the potential energy surface scans using quantum-chemical methods. The mononuclear analogues MoO2(HLR)(MeOH)Cl (R = H (1a) and 3OMe (2a)), MoO2(HLR)Cl (R = 3OMe (2b) and 4OMe (3b)), and MoO2(LR)(MeOH) (R = H (1c), and 4OMe (3c-α and 3c-β)) were also synthesized and evaluated as potential precursors for reactions in the solid state. Vapor induced transformation of 2a quantitatively afforded complex 2b. The chemometric analysis using principal component analysis was applied to provide insight into the reaction profile. Thermally induced solid-state reactions resulted in the transformation of metallocycle 3′·0.5MeCN and monomeric complexes 1c, 2a, 3c-α, and 3c-β into the corresponding coordination polymers. The structural features responsible for these conversions are discussed in detail. Lastly, the metallosupramolecular architectures were tested as catalysts for cyclooctene epoxidation by using tert-butyl hydroperoxide as an oxidant in water or decane. Compound 3′ is shown to be the most effective and selective catalyst.
Synthesis of hydrazones (
1a-4a
and
1b-4b
), quinazolines (
3c·MeOH
and
3d·MeOH
), and hydrazone-Schiff bases (
4c
and
4d
) is achieved by combining suitable aldehydes (2,3- or ...2,4-dihydroxybenzaldehyde) with four hydrazides (isonicotinic, nicotinic, and 2- or 4-aminobenzoic acid hydrazide). A suite of approaches for their preparation is described: solution-based synthesis, mechanosynthesis, and solid-state melt reactions. The mechanochemical approach is generally a better choice for the quinazolines, while the solid-state melt reaction is more efficient for derivatives of (iso)nicotinic based hydrazones. Crystalline amine-functionalised hydrazones
4a
and
4b
undergo post-synthetic modifications in reactions with 3- or 4-pyridinecarbaldehyde vapours to form hydrazone-Schiff bases
4a-3py
,
4b-3py
,
4a-4py
, and
4b-4py
. Mechanochemical and vapour-mediated reactions are followed by
ex situ
powder X-ray diffraction and IR-ATR methods, respectively. The chemometric analysis of these data using principal component analysis provided an insight into the reaction profiles and reaction times. Azines (
5a
and
5b
), achieved from aldehydes and hydrazine, reversibly change colour in response to temperature changes. The structures of all products are ascertained by a combined use of spectroscopic and X-ray diffraction methods. The cytotoxic and antimicrobial activities of all compounds against selected human cancer cell lines and bacterial strains are evaluated.
We compare different routes to prepare hydrazones, quinazolines, and hydrazone-Schiff bases: solution-based, vapor-mediated, mechanochemical, and solid-state melt synthesis.
The paper describes synthesis of several novel thiosemicarbazone derivatives. Furthermore, crystal and molecular structure of 4-diethylamino-salicylaldehyde 4-phenylthiosemicarbazone revealed ...planarity of conjugated aromatic system, which suggested the possibility of DNA binding by intercalation, especially for here studied naphthalene derivatives. However, here presented DNA binding studies excluded this mode of action. Physicochemical and structural properties of novel derivatives were compared with previously studied analogues, taken as reference compounds, revealing distinctive differences. In addition, novel thiosemicarbazone derivatives (
1,
2 and
5–
8) clearly display stronger antiproliferative activity on five tumor cell lines than the reference compounds
3 and
4, which supports their further investigation as potential antitumor agents.
The study describes recent decadal changes (2008–2017) in the landing biomass, fishing effort and CPUE (kg/day) data of European lobster
Homarus gammarus
in the eastern Adriatic Sea region, and ...relates these changes to increases of sea bottom temperatures detected at long-term
in situ
stations and modelled by an ocean numerical model (ROMS, Regional Ocean Modelling System). Modelling results were further used to quantify spatial and temporal differences of bottom temperature changes over different fishing zones. Trends of sea bottom temperature were positive and statistically significant between stations. Temporal trends of landing, effort and CPUE were also positive and significant for the northern Adriatic. Correlation analysis was used to test the relationship between winter and spring sea bottom temperatures and CPUE data of
H. gammarus
, separately for the northern and central Adriatic Sea, resulting in statistically significant correlations for both areas. Whether the increased CPUE in the northern Adriatic is due to increased abundance or catchability is discussed. The observed temperature changes likely reflect climate system changes recognised at the regional level and as such, lobster management measures will need to be revised and updated in the future.
PDF
