Supplementation of women with low antioxidant status with micronutrients containing antioxidants during early gestation might reduce the risk of pre-eclampsia.

Background Readmission is related to high cost, high burden, and high risk for mortality in geriatric patients. A scoring system can be developed to predict the readmission of older inpatients to perform earlier interventions and prevent readmission. Methods We followed prospectively inpatients aged 60 years and older for 30 days, with initial comprehensive geriatric assessment (CGA) on admission in a tertiary referral centre. Patients were assessed with CGA tools consisting of FRAIL scale (fatigue, resistance, ambulation, illness, loss of weight), the 15-item Geriatric Depression Scale, Mini Nutritional Assessment short-form (MNA-SF), the Barthel index for activities of daily living (ADL), Charlson Comorbidity Index (CCI), caregiver burden based on 4-item Zarit Burden Index (ZBI), and cognitive problem with Abbreviated Mental Test (AMT). Demographic data, malignancy diagnosis, and number of drugs were also recorded. We excluded data of deceased patients and patients transferred to other hospitals. We conducted stepwise multivariate regression analysis to develop the scoring system. Results Thirty-day unplanned readmission rate was 37.6 %. Among 266 patients, 64.7 % of them were malnourished, and 46.5 % of them were readmitted. About 24 % were at risk for depression or having depressed mood, and 53.1 % of them were readmitted. In multivariate analysis, nutritional status (OR 2.152, 95 %CI 1.151–4.024), depression status (OR 1.884, 95 %CI 1.071–3.314), malignancy (OR 1.863 95 %CI 1.005–3.451), and functional status (OR 1.584, 95 %CI 0.885–2.835) were included in derivation of 7 score system. The scoring system had maximum score of 7 and incorporated malnutrition (2 points), depression (2 points), malignancy (2 points), and dependent functional status (1 point). A score of 3 or higher suggested 82 % probability of readmission within 30 days following discharge. Area under the curve (AUC) was 0.694 (p = 0.001). Conclusions Malnutrition, depression, malignancy and functional problem are predictors for 30-day readmission. A practical CGA-based 7 scoring system had moderate accuracy and strong calibration in predicting 30-day unplanned readmission for older patients.

<p>Latar Belakang: Demensia adalah salah satu penyakit kronik degeneratif yang hingga saat ini belum memiliki tatalaksana definitif. Beberapa suplementasi yang menjanjikan untuk meningkatkan fungsi kognitif, salah satunya adalah vitamin D3. Tujuan: Membuat telaah sistematis studi terkait suplementasi vitamin D3 dan peranannya dalam meningkatkan fungsi kognitif. Metode: Pencarian sistematis dilakukan pada tiga database yaitu PubMed, CENTRAL, dan ScienceDirect untuk memilih studi eksperimental sesuai kriteria inklusi dan eksklusi. Artikel yang terpilih kemudian ditelaah kritis dan dianalisis lebih lanjut. Hasil: Pada analisis akhir didapatkan 5 artikel untuk telaah kritis, hanya satu studi memiliki risiko bias rendah. Empat studi populasi lansia tanpa gangguan kognitif menunjukkan tidak ada perbedaan signifikan fungsi kognitif kelompok suplementasi vitamin D dibandingkan kelompok plasebo. Satu studi populasi lansia penderita Alzheimer menunjukkan peningkatan signifikan nilai total IQ setelah suplementasi vitamin D3 800 IU per hari selama 12 bulan. Simpulan: Suplementasi vitamin D3 pada lansia dengan fungsi kognitif baik tidak menghasilkan perubahan fungsi kognitif bermakna. Namun, menjaga fungsi kognitif harus dilakukan secara komprehensif, dimulai dari pola diet seimbang, aktivitas fisik, serta latihan kognitif rutin.</p><p>Background: Dementia is one of the chronic degenerative diseases which does not have a definitive therapy. Several supplements are promising to increase cognitive function, including vitamin D3. Objective: Systematic review on studies related to vitamin D3 supplementation and its role in increasing cognitive function. Method: Systematic searching was performed on three databases, which are PubMed, CENTRAL, and ScienceDirect to include experimental studies based on the inclusion and exclusion criteria. The chosen articles would be critically appraised and further analyzed. Results: Five articles were included in the final analysis to be critically appraised, only one study has low risk of bias. Four studies regarding elderlies without cognitive dysfunction showed no significant differences between group with vitamin D supplementation and placebo in terms of cognitive function. One study with Alzheimer elderlies as the population showed a significant increase in total IQ score after vitamin D3 800 IU supplementation every day for 12 months. Conclusion: Vitamin D3 supplementation for elderlies with good cognitive function showed no significant difference. Maintaining cognitive function needs a comprehensive management i.e. balanced diet, physical activity, and routine cognitive training.</p><p> </p>