Nutritional status is an important prognostic factor in patients with multiple myeloma (MM). The Controlling Nutritional Status (CONUT) score has shown promise in predicting outcomes in various malignancies; however, its role in autologous stem cell transplantation (ASCT) in patients with MM remains unclear. This study aimed to evaluate the significance of pre-transplant CONUT scores in predicting post-transplant engraftment kinetics and early complications in patients with MM undergoing ASCT. This single-center, retrospective study analyzed 59 multiple myeloma patients who underwent ASCT between 1 October 2022, and 1 July 2024. Pre-transplant CONUT scores were calculated, and their associations with various post-transplant outcomes were assessed using statistical analyses. Higher CONUT scores were independently associated with longer neutrophil engraftment times (p = 0.012). Patients who developed oral mucositis (OM) had significantly higher CONUT scores than those without OM (p = 0.028). A CONUT score cut-off of 2.5 demonstrated 100% sensitivity and 57.14% specificity in predicting OM (Area Under the Curve (AUC) 0.792, 95% CI: 0.654–0.930, p = 0.033). Our study demonstrates that a higher pre-transplant CONUT score is significantly associated with a delay in neutrophil engraftment and an increased risk of developing oral mucositis. These findings suggest that the CONUT score can serve as a valuable predictive tool for early post-transplant complications, thereby guiding targeted interventions and improving patient management.

Background: This study investigated the relationship between mortality and numerous characteristics in geriatric patients with osteoporosis, including nutritional, clinical, anthropometric, and biochemical factors. Methods: This retrospective cohort comprised geriatric patients diagnosed with osteoporosis between January 2016 and December 2019. Demographics, anthropometrics, comorbidities, laboratory results, bone mineral density (DEXA) analyses, fracture history, and mortality data were obtained. In addition, nutritional status, hand grip strength, and gait speed were measured. The Geriatric Depression Scale (GDS) was applied and nutritional status was assessed using multiple tools: Mini Nutritional Assessment (MNA) Short and Long Forms, Controlling Nutritional Status (CONUT), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI). Results: Among the 752 patients (mean age 75.3 ± 6.8 years, 69.7% female), the mortality rate was 18.1% during a median follow-up of 55 months. Nutritional assessments significantly predicted both fracture occurrence and mortality. Optimal cut-offs for predicting mortality were: MNA Short Form ≤ 11, MNA Long Form ≤ 24, CONUT > 1.5, GNRI ≤ 105.5, and PNI ≤ 49.9. Independent predictors of mortality included increasing age ( p < 0.001), male sex ( p = 0.005), higher body shape index ( p = 0.006), slower gait speed ( p = 0.001), MNA Long Form score ≤ 24 ( p = 0.002), and PNI score ≤ 49.9 ( p < 0.001). Conclusion: Malnutrition is strongly associated with higher mortality risk in older osteoporosis patients. Early identification of malnutrition is critical to administering appropriate interventions, and our results show that malnutrition deserves greater attention to understand its broader impacts on outcomes in geriatric patients, particularly those with osteoporosis.

Background: Gender dysphoria (GD) refers to the clinically significant distress or discomfort that may arise from a marked incongruence between an individual’s gender identity and the sex assigned at birth, involving primary and/or secondary sex characteristics and social roles. Gender-affirming hormone therapy (GAHT) aims to alleviate this distress by aligning secondary sex characteristics with gender identity and improving psychological well-being. This study examined the effects of GAHT on metabolic and body composition changes in assigned male at birth (AMAB) individuals. Methods: This single-center longitudinal study (2019–2022) followed 20 GAHT-naïve AMAB individuals with gender dysphoria, reassessed after 12 months of GAHT, with 24 cisgender women serving as a reference group. GAHT included estradiol with cyproterone acetate or spironolactone. Outcomes included bioelectrical impedance analysis (BIA)-derived phase angle (PhA) and body cell mass, as well as handgrip strength and gait speed. Results: After 12 months of GAHT, AMAB participants receiving hormone therapy showed significant reductions in fat-free mass (49.9 [39.4–54.6] kg, p = 0.01), fat-free mass index (FFMI) (18.4 [16.5–19.4] kg/m², p = 0.04), body cell mass (25.7 [20.6–29.3] kg, p = 0.04), and phase angle (6.9 [6.0–7.6], p = 0.04). Fat mass increased from 10.6 [8.9–13.8] to 12.9 [10.8–16.1] kg, although this change did not reach statistical significance (p = 0.07). Grip strength showed a non-significant decline (32.5 ± 6.6 kg, p = 0.20), while gait speed remained stable (1.52 [1.30–1.80] m/s, p = 0.60). Despite these changes, lean mass indices and phase angle remained higher than in cisgender women at follow-up (all p < 0.001). Hormonal and metabolic markers remained stable over the one-year follow-up. Conclusion: During the first year of GAHT, AMAB participants exhibited notable physiological changes, including decreases in fat-free mass (FFM) and phase angle. Because phase angle is an indicator of cellular integrity and muscle quality, its decline during GAHT warrants careful monitoring in future long-term studies. These findings underscore the importance of comprehensive body composition assessments in AMAB individuals receiving feminizing GAHT. Further studies with longer follow-up periods and larger cohorts are needed to elucidate the long-term clinical significance of these changes.

The objective of this study is to examine the association between nutritional status and the incidence of fractures in elderly patients with osteoporosis, while also evaluating other clinical, anthropometric, and biochemical factors related to these outcomes. Geriatric patients diagnosed with osteoporosis who presented to the outpatient clinic were included from January 2016 to December 2019. In addition to demographic, clinical, anthropometric, and laboratory data, we examined bone mineral density (via DEXA), nutritional status, sarcopenia assessment, and the presence and types of fractures. Nutritional status was assessed using multiple validated tools, including the Geriatric Nutritional Risk Index (GNRI). A total of 181 patients (79% females) with a mean age of 78.12±6.65 years were included in the study. The fracture incidence recorded during follow-up was 40.88% (n=74). The mean age of the fracture group was significantly higher than that of the non-fracture group. GNRI, with a cut-off value of ≤100.6, significantly distinguished patients without fracture. Sarcopenia was present in 57.46% of patients, with no significant difference between fracture and non-fracture groups (p=0.642). Multivariable logistic regression indicated that older age (OR: 1.090, 95% CI: 1.022–1.162, p=0.009), fewer medications (OR: 0.868, 95% CI: 0.791–0.953, p=0.003), and low DEXA vertebra T-score (OR: 0.436, 95% CI: 0.285–0.668, p<0.001) were independently associated with fracture likelihood. Malnutrition is correlated with increased fracture risk among older adults with osteoporosis, whereas sarcopenia prevalence was high but not independently associated with fractures.

Objectives: Inappropriate medication use is highly prevalent in nursing home residents and contributes to adverse drug events, falls, and increased healthcare utilization. The Turkish Inappropriate Medication use in oldEr adults (TIME) criteria provide a comprehensive framework for identifying both potentially inappropriate medications and prescribing omissions. We aimed to evaluate the outcomes of a Medication Therapy Management (MTM) intervention by use of TIME criteria among nursing home residents in Türkiye. Methods: This single-arm before–after observational study included 232 adults aged 60–110 years residing in the Bursa Metropolitan Municipality Nursing Home. Medication use patterns were evaluated using the TIME criteria and prescriptions were optimized through a Medication Therapy Management (MTM) intervention. Fall frequency and healthcare utilization outcomes were recorded during the 1 year before and after MTM implementation. Results: Following implementation of the Medication Therapy Management (MTM) approach based on TIME criteria, the median number of medications increased from 5 (IQR: 3–8) to 8 (IQR: 5–10) over one year (p < 0.001). During the post-implementation period, fall frequency, emergency department visits, family medicine visits, and non-geriatric specialist visits were lower compared with the pre-intervention year, whereas hospitalization rates did not significantly change. Conclusions: Among nursing home residents, the total number of medications was higher and fall frequency and selected healthcare utilization measures were lower during the year following implementation of MTM based on TIME criteria. These findings suggest that MTM-guided prescription optimization may be associated with changes in clinical and healthcare utilization outcomes; however, the absence of a control group precludes causal inference, and randomized controlled trials are required to confirm these associations.