Impact of premorbid undernutrition on outcome in stroke patients

Background and Purpose - To assess the prevalence of premorbid undernutrition and its impact on outcomes 1 month after stroke. Methods - The study recruited from consecutive stroke admissions during a 10-month period. Premorbid nutritional status ( using the subjective global assessment [SGA]), premorbid functioning ( modified Rankin scale [MRS]), and stroke severity ( National Institutes of Health Stroke Scale [NIHSS] score) were assessed at admission. The associations between premorbid nutritional status, poor outcome ( defined as MRS greater than or equal to 3), and mortality were examined before and after adjustment for confounding variables, including age, gender, stroke risk factors, stroke severity, and admission serum albumin. Results - Thirty of 185 patients were assessed as having undernutrition at admission. Significant unadjusted associations were observed between undernutrition and poor outcome (odds ratio [OR], 3.4; 95% CI, 1.3 to 8.7; P = 0.01), and mortality (OR, 3.1, 95% CI, 1.3 to 7.7; P = 0.02) at 1 month. NIHSS, age, and premorbid MRS were also significantly associated with poor outcomes. After adjustment for these factors, the effect size of associations remained important but not significant ( poor outcome: OR, 2.4; 95% CI, 0.7 to 9.0, P = 0.18; mortality: OR, 3.2; 95% CI, 1.0 to 10.4, P = 0.05). Conclusions - Premorbid undernutrition, as assessed using the SGA, appears to be an independent predictor of poor stroke outcome. Stroke prevention strategies should target undernutrition in the population at risk for stroke to improve outcomes.

The effect of grain refinement and silicon content on grain formation in hypoeutectic Al-Si alloys

The effect of increasing the amount of added grain refiner on grain size and morphology has been investigated for a range of hypoeutectic Al-Si alloys. The results show a transition in grain size at a silicon concentration of about 3 wt% in unrefined alloys; the grain size decreasing with silicon content before the transition, and increasing beyond the transition point. A change in morphology also occurs with increased silicon content. The addition of grain refiner leads to greater refinement for silicon contents below the transition point than for those contents above the transition point, while the transition point seems to remain unchanged. The slope of the grain size versus silicon content curve after the transition seems to be unaffected by the degree of grain refinement. The results are related to the competitive processes of nucleation and constitutional effects during growth and their impact on nucleation kinetics. (C) 1999 Elsevier Science S.A. All rights reserved.

Tuna fishmeal as a source of DHA for n-3 PUFA enrichment of pork, chicken, and eggs

Enriching foods with long-chain n-3 PUFA (LC n-3 PUFA) is an important approach to increasing the dietary intake of these beneficial nutrients. Enrichment of meat and eggs can be achieved by adding flaxseed, fish oil, or fishmeal to pig or poultry feeds. However, utilization of these sources, particularly fishmeal, has been limited by concerns about adverse effects on sensory qualities, In this study, we evaluated the use of PorcOmega(TM) (POM), a stabilized tuna fishmeal formulation, as a source of DHA for enrichment of park and poultry products, Pigs, broilers, and laying hens were fed rations containing varying levels of POM for varying time periods, and its impact on the LC n-3 PUFA content and sensory qualities of cooked meat and eggs was examined. Pork and chicken products, including chops, sausages, and eggs, with substantially increased (up to sevenfold) levels of LC n-3 PUFA (predominantly DHA) were achieved by including up to 10% POM in rations. The increases were retained after cooking. Some sensory deficits were noted when using higher levels of POM (exceeding 15% in meat and 10% in eggs). However, at modest rates of feeding (5-10% POM), palatable meat and eggs were obtained with worthwhile levels of enrichment. The fishmeal feeding strategy used in this study offers a viable means of producing a range of alternative dietary sources of LC n-3 PUFA. Paper no.