Teslime Atli

Effects of garlic consumption on plasma and erythrocyte antioxidant parameters in elderly subjects.

Background: The oxidative stress theory of aging is one of the most widely acknowledged theories of aging. The intake of fruits and vegetables with antioxidant power is associated with a reduced incidence of many chronic diseases of aging. Objective: The effects of ingesting garlic on plasma and erythrocyte antioxidant parameters of elderly subjects were investigated in this study. Methods: 13 subjects (mean age 70.69 ± 4.23) participated in the study. They ingested garlic at the daily dose of 0.1 g/kg b.w. for 1 month. Before and after this period, fasting blood samples were obtained, and oxidant [malondialdehyde (MDA) and xanthine oxidase (XO)] and antioxidant [superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT)] parameters were studied in erythrocytes, and MDA levels were studied in plasma samples obtained from the subjects. Routine blood biochemical parameters were also measured in blood samples. Results: In the plasma fraction and erythrocyte hemolysate, MDA levels were found to be significantly lower, but erythrocyte GSH-Px and SOD activities were significantly higher in the second samples relative to the first ones. XO activity was found to be lower in the second samples, but this decrease was not statistically meaningful. LDL cholesterol was found to be significantly lower in the second samples relative to the first ones. Conclusion: Our results show that ingestion of garlic leads to significantly lowered plasma and erythrocyte MDA levels and to increased activities of some antioxidant enzymes, which indicates that consumption of garlic decreases oxidation reactions. It is quite possible that reduced peroxidation processes due to garlic consumption may play a part in some of the beneficial effects of garlic in elderly subjects.

RECOGNITION OF NEUROCOGNITIVE DYSFUNCTION IN CHRONIC HEMODIALYSIS PATIENTS

We sought to determine the prevalence, recognition, and consequences of mental impairment among chronic hemodialysis patients. We administered the Mini Mental Status Exam (MMSE), a brief validated method for assessing cognitive mental status that is commonly used by clinicians, to 84 patients from our dialysis units. To determine the clinical implications of mental impairment, we obtained Kt/V, albumin, protein catabolic rate, blood pressure, and hematocrit values. We found that 21% of subjects had mild mental impairment (MMSE 18 to 23) and that 11% had moderate-severe mental impairment (MMSE 0 to 17). We found no relationship between MMSE score and years on dialysis, Kt/V value, hematocrit value, or erythropoietin use. On univariate analysis, MMSE score was associated with albumin, protein catabolic rate, inter-dialytic weight gain, number of co-morbid conditions, number of hospitalizations. Outcomes on univariate analysis were further analyzed by multivariate analysis. There was an independent relationship between decrement in MMSE score and lower protein catabolic rate and increased hospitalization number and number of co-morbid conditions. Based on our findings, we recommend that clinicians routinely screen hemodialysis patients for mental impairment and target impaired patients for interventions to improve mental status and associated adverse outcomes.

Effects of apple consumption on plasma and erythrocyte antioxidant parameters in elderly subjects

The effects of apple consumption on plasma and erythrocyte antioxidant parameters of elderly subjects were investigated in this study. Fifteen elderly subjects (mean age 71.86 ± 4.17) participated in the study. They consumed an apple a day for 1 month. Before and after this period, fasting blood samples were obtained, and oxidant (malondialdehyde [MDA]) and antioxidant (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], catalase [CAT], and antioxidant potential [AOP]) parameters were studied. MDA and AOP levels were studied in plasma, and SOD, GSH-Px, and CAT activities and MDA levels were measured in the erythrocytes. In the erythrocytes, GSH-Px and SOD activities were found to be higher (p < .001 and p < .01), but MDA levels were lower in the second samples relative to the first ones. In the plasma, AOP value was found to be higher in the second samples relative to first ones (p < .001). No differences were found, however, between the routine blood parameters such as total cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, high-density-lipoprotein cholesterol, and triglyceride levels. The results show that consumption of apple leads to significant increases in the activities of some antioxidant enzymes and in the antioxidant potential values of the blood, and that decreases oxidation reactions in the body in significant amount. It is quite possible that reduced peroxidation processes owing to consumption of this fruit may play a part in some of their beneficial effects in the elderly subjects.

PREVALENCE OF CRYPTOSPORIDIUM INFECTION IN HEMODIALYSIS PATIENTS

The prevalence of Cryptosporidium infection in patients who are on chronic hemodialysis due to end-stage renal failure is investigated and compared with the incidence in the healthy population. Stool specimens of 74 adult hemodialysis patients treated on an outpatient basis and 50 healthy individuals are examined for Cryptosporidium oocysts by using the modified acid-fast method. While 20.27% (15/74) of patients in the dialysis group had Cryptosporidium oocysts in their stools, none (0/50) of the controls had such an infection (p < 0.001). Ten of 15 patients who had Cryptosporidium oocysts in their stool specimens were asymptomatic and the remaining 5 had diarrhea. Four of these 5 diarrheic patients had Cryptosporidium oocysts in their stools and 1 had both Cryptosporidium oocysts and Giardia trophozoites. Since hemodialysis patients with chronic renal failure are candidates for renal transplantation, general preventive measures against infection must be taken and these patients must be screened for their carrier state before transplantation.

Sarcopenia prevalence and factors associated with sarcopenia in older people living in a nursing home in Ankara Turkey

Sarcopenia is prevalent in older people, and is related to survival and disability. There are no data on sarcopenia evaluated according to European Working Group on Sarcopenia in Older People criteria for nursing home residents in Turkey. We aimed to evaluate the prevalence of sarcopenia according to European Working Group on Sarcopenia in Older People criteria and associated factors with sarcopenia among nursing home residents in Turkey.

General or Disease Specific Questionnaire? A Comparative Study in Hemodialysis Patients

Objective. Today questionnaires developed to assess important outcome measures such as health-related quality of life are widely used. In this study we evaluated the construct validity of the Nottingham Health Profile (NHP) and the reliability of its Turkish version in hemodialysis patients. Methods. In a sample of patients on renal dialysis (n = 94) the quality of life is measured by the NHP. The validity of this questionnaire is evaluated by using the Kidney Disease Questionnaire (KDQ) in the same patient group. The NHP is administered twice to each patient, at dialysis intervals two weeks apart. Results. NHP scores at both administrations are similar in both assessments. Pearsons correlation coefficients range from 0.61 to 0.84. Cronbachs alpha coefficients for the NHP sections range between 0.64 and 0.79. The alpha coefficients for three of the NHP scales (energy, sleep and social isolation) are well below 0.7. In the KDQ the mean values obtained for the five dimensions are: 4.2 ± 1.5 for physical symptoms, 4.8 ± 1.7 for fatigue, 4.9 ± 1.9 for depression, 4.2 ± 1.2 for relationship with others, and 4.8 ± 1.5 for frustration. In general the correlation between the dimensions of the NHP and KDQ is good and the correlation coefficients varies from 0.18 to 0.73. Clinical validity is assessed by examining the correlation between the results obtained for the two questionnaires (components of the NHP and KDQ) and hemoglobin level, number of the co-morbid conditions and educational level. Conclusions. The NHP is shown to have construct validity when used in patients with end-stage renal disease (ESRD) in Turkey. The application of the NHP in patients with ESRD is easy, fast and the questions are not difficult to understand. The multiple-degree scoring in the KDQ causes a complexity in answering. The correlation between the dimensions of the NHP and KDQ is good. Our results show better correlations between disease specific questionnaires and clinical parameters.

Comparison of different glomerular filtration methods in the elderly: which formula provides better estimates?

Objectives: Technetium-99m diethylenetriaminepentaacetic acid (99mTc-DTPA) is an ideal radioisotopic method having a high correlation with inulin clearance for the determination of glomerular filtration rate (GFR). Different formulas like creatinine clearance (CrCl) in 24 h urine samples, Cockroft–Gault formula (CGF), and modification of diet in renal disease (MDRD) are being used to come up with an estimate. In this study, we compared 99mTc-DTPA with the formulas mentioned above in an attempt to best identify the method that would yield the nearly ideal GFR estimates in the elderly. Materials and methods: In 76 patients who were admitted to our clinic, we measured 24 h urine volume (V), urine creatinine (Ucr), and serum creatinine (Scr) levels together with CrCl, Scr, serum urea (Su), and albumin (Alb) levels. By using coefficients identified for age, gender, and race, we calculated modification of diet in renal disease 1 (MDRD1). Different from MDRD1, we calculated modification of diet in renal disease 2 (MDRD2) that does not include Su and Alb parameters and formulas like CGF that include Scr, age, gender, and weight parameters to come up with GFR levels. All patients underwent 99mTc-DTPA procedure. Results: The mean of the GFR values measured by 99mTc-DTPA was 54.3 ± 19.9. The means of GFR values calculated by CrCl, MDRD1, MDRD2, and CGF were 58.0 ± 30.5, 60.9 ± 22.1, 54.4 ± 20.1, and 57.9 ± 22.4, respectively. GFR as measured by 99mTc-DTPA showed statistically significant correlations with the results of other methods (p < 0.001 for all methods). The most significant correlation was with MDRD1. Conclusion: MDRD1 can be used for next to ideal and accurate predictions of GFR in the elderly in the daily practice.

Effects of weight loss on ventricular systolic and diastolic functions and left ventricular mass assessed by tissue doppler imaging in obese geriatric women: preliminary report

Background and aims: Obesity is one of the most common diseases in the world. Particularly in elderly subjects, the effects of weight loss on cardiac functions have not been previously investigated by means of pulsed wave tissue doppler imaging (PWTDI). Using PWTDI, we examined the effects of weight loss on cardiac functions and left ventricular (LV) mass in obese geriatric women. Methods: Thirteen obese women aged 66–83 years (mean age 71.2±4.9 yrs) with a body mass index 35.&49 kg/m2 (mean body mass index 39.9±4.3 kg/m2) were evaluated by echocardiography and PWTDI. Only subjects with uncomplicated obesity were included. All measurements, including anthropometric variables, systolic and diastolic indices, and LV mass, were made before and after a 6-month Orlistat plus hypocaloric diet. Myocardial systolic wave (Sm) velocity, isovolumic acceleration (IVA), myocardial precontraction time (PCTm) and the PCTm to contraction time (CTm) ratio were calculated as systolic indices. Early diastolic wave (Em), late diastolic wave (Am), Em to Am ratio, myocardial relaxation time (RTm), deceleration time (DT) and isovolumic relaxation time (IVRT) were determined as diastolic measurements. Results: Subjects lost an average of 8.4±1.2 kg. LV mass decreased significantly after weight loss (p<0.001). In addition, IVRT decreased significantly (p=0.038). Only RTm decreased significantly (p=0.016), whereas other PWTDI parameters of LV remained the same. In the right ventricle, Sm velocity, IVA, Em, and Am velocities were similar. However, the PCTm to Am ratio decreased significantly (p=0.006), and the Em to Am ratio increased (p=0.04) and RTm decreased significantly (p=0.016) after weight loss. Conclusions: In obese geriatric women, weight loss improves ventricular diastolic functions and decreases LV mass. It also contributes to partial improvement in right ventricular systolic function.

Sarcopenia and mortality in older people living in a nursing home in Turkey

The aim of the present study was to evaluate the relationship between mortality and sarcopenia defined by the criteria of the European Working Group on Sarcopenia in Older People in older nursing home residents in Turkey.

Evaluation of Cardiac Autonomic Functions in Older Parkinson’s Disease Patients: a Cross-Sectional Study

In Parkinsons disease (PD), non-motor symptoms may occur such as autonomic dysfunction. We aimed to evaluate both parasympathetic and sympathetic cardiovascular autonomic dysfunction in older PD cases. 84 PD cases and 58 controls, for a total of 142, participated in the study. Parasympathetic tests were performed using electrocardiography. Sympathetic tests were assessed by blood pressure measurement and 24-hour ambulatory blood pressure measurement. The prevalence of orthostatic hypotension in PD patients was 40.5% in PD patients and 24.1% in the control group (p> 0.05). The prevalence of postprandial hypotension was 47.9% in the PD group and 27.5% in the controls (p <0.05). The prevalence of impairment in heart rate response to deep breathing was 26.2% in the PD group and 6.9% in the control group (p <0.05). The prevalence of postprandial hypotension in PD with orthostatic hypotension was 94% and 16% in PD patients without orthostatic hypotension (p <0.05). The prevalence of impairment in heart rate response to deep breathing was 52.9% in PD patients with orthostatic hypotension and 8% in PD cases without orthostatic hypotension (p<0.05). The prevalence of impairment in heart rate response to postural change was 41% in PD cases with orthostatic hypotension and 12% in PD cases without orthostatic hypotension (p <0.05).Although there are tests for assessing cardiovascular autonomic function that are more reliable, they are more complicated, and evaluation of orthostatic hypotension by blood pressure measurement and cardiac autonomic tests by electrocardiography are recommended since these tests are cheap and easy.