Background: Malnutrition is a widespread but largely unrecognized problem in aged patients, more so as it is a contributing factor to the increased morbidity and mortality in this age group. Since direct measurements of body composition are not possible in a large number of patients, good anthropometric reference data are fundamental in assessing the nutritional state of elderly people. Objective: To examine the efficacy of calf circumference (CC) measurement for assessing the nutritional state of the elderly. Methods: The nutritional state was assessed by anthropometric and biological measurements in 911 elderly patients consecutively admitted to a geriatric unit. In the first instance, univariate analysis was performed for CC and other nutritional parameters. Linear and multiple stepwise regressions were performed to study the association between anthropometric or biological parameters and CC. At a later stage, the specificity, sensitivity and the optimal cutoff CC were established for 2 groups of patients: malnourished and controls. Finally, patients were classified according to this cutoff in order to verify the efficacy of CC in assessing their nutritional state. Results: The results of univariate analysis showed significant correlations between CC and other nutritional anthropometric markers (r = 0.706, p < 0.0001 with body mass index (BMI) and r = 0.661, p < 0.0001 with fat free mass) and biological markers (r = 0.219, p < 0.0001 with albumin and r = 0.162, p < 0.0001 with transthyretin). Multiple regression confirmed associations between CC and tricipital skinfold thickness (p < 0.0001), fat free mass (p < 0.0001), BMI (p < 0.0001), and serum albumin (p < 0.0001; r2 = 0.561). The optimal cutoff for CC was found to be 30.5 cm for both men (sensitivity 73.2%, specificity 72.8%) and women (sensitivity 78.8%, specificity 61.1%). The classification of patients according to this discriminating factor was confirmed for the optimal cutoff value. Conclusion: Calf circumference is a pertinent marker of nutritional state. The cutoff of 30.5 cm provides a good diagnostic capacity.

2,2-Diphenyl-1-picryl-hydrazyl (DPPH) radical decomposition in alcohol solution is widely used, characterizing plant antioxidants that can rise in serum after fruit and vegetable intake. However, this test failed reproducible results with serum due to protein precipitation. We describe the application of serum deproteinization with acetonitrile relating to the DPPH test. Assay sensitivity, linearity, repeatability and storage effect were determined in serum samples deproteinized with an equal volume of acetonitrile. Associations between the DPPH test and the ferric reducing ability of serum (FRAP) method, measuring total antioxidant potential, were evaluated in sera from 78 healthy non-smoking men. The effect of a single ingestion of 1 L of cloudy apple juice on the serum DPPH radical scavenging activity in healthy volunteers was also investigated. Assay linearity was within 5-25 microL (r=0.99, p<0.01). With 25 microL-deproteinized serum, coefficient of variation was 4.2% and detection limit was 0.5% of the initial amount of decomposed DPPH radical over 30 min incubation. There was no sera activity decrease over 14 days storage at -20 degrees C. Mean values of DPPH radical scavenging activity and FRAP obtained in human serum were 11.2+/-3.3% and 382.0+/-88.1 micromol/L, respectively. A positive significant linear correlation was observed between these two methods (r=0.42, p<0.01). Serum supplementation with 50 micromol/L of catechin, gallic acid, ascorbic acid or uric acid enhanced DPPH test results. One brisk serving of 1 L of apple juice caused a significant increment of serum DPPH radical scavenging activity (1.9+/-1.9%, p<0.01) in 12 healthy subjects 1 h after juice ingestion. Applicability of the DPPH test to deproteinized serum with acetonitrile revealed numerous advantages, validating its practicability, simplicity and cost effectiveness as a tool in the estimation of antioxidant status in humans.

Neuroplasticity is a natural process occurring in the brain for the entire life. Stroke is the leading cause of long term disability and a huge medical and financial problem throughout the world. Research conducted over the past decade focused mainly on neuroprotection in the acute phase of stroke while very little studies target the chronic stage. Recovery after stroke depends on the ability of our brain to reestablish the structural and functional organization of neurovascular networks. Combining adjuvant therapies and drugs may enhance the repair processes and restore impaired brain functions. Currently, there are some drugs and rehabilitative strategies that can facilitate brain repair and improve clinical effect even years after stroke onset. Moreover, some of the compounds such as citicoline, fluoxetine, niacin, levodopa, etc. are already in clinical use or are being trialed in clinical issues. Many studies are also testing cell therapies; in our review, we focused on studies where cells have been implemented at the early stage of stroke. Next, we discuss pharmaceutical interventions. In this section, we selected methods of cognitive, behavioral, and physical rehabilitation as well as adjuvant interventions for neuroprotection including noninvasive brain stimulation and extremely low-frequency electromagnetic field. The modern rehabilitation represents a new model of physical interventions with the limited therapeutic window up to six months after stroke. However, previous studies suggest that the time window for stroke recovery is much longer than previously thought. This review attempts to present the progress in neuroprotective strategies, both pharmacological and non-pharmacological that can stimulate the endogenous neuroplasticity in post-stroke patients.