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BACKGROUND AND AIMS: Triaxial accelerometry may provide a simple measure of physical activity in older people, but the effect of different walking aids and accelerometer placements on measurement is not known. This study aimed to examine the effect of accelerometer placement, use of walking aids, and different types of physical activity on Stay- Healthy RT3 triaxial accelerometer readings in older people. METHODS: Twenty subjects aged over 65 years and five younger volunteers were recruited from Medicine for the Elderly services. Subjects performed six minutes each of standardized standing activity, sitting activity, sitting at rest, walking, and stair climbing. Counts generated from RT3 accelerometers worn anteriorly over both hips were recorded in subjects using different walking aids during these standardized activities. RESULTS: There were significant differences between counts generated by the left and right hip positions. The intraclass correlation coefficient of RT3 counts between left and right hip positions was 0.48, 0.39 and 0.99 for sedentary tasks (standing, sitting and rest), stair and walking tasks respectively. Counts ranged between 250-3000 min-1 during the walking task. Counts were proportional to the distance walked. Resting, sitting or standing all generated counts below 250 min-1, but there was no clear demarcation between these activities. The use of different walking aids did not affect the counts generated for any activity. CONCLUSIONS: Walking can be distinguished from other activities by upper and lower cutoffs. The RT3 accelerometer should be used on the same side of the body. Different walking aids do not appear to affect RT3 counts in older people. [ABSTRACT FROM AUTHOR]

Introduction: With advancing age, frailty, multi-morbidity and need for care, elderly patients are some of the most vulnerable to Covid-19 disease. In NHS Tayside, a dedicated Covid-19 Medicine for the Elderly (MFE) Team was formed to care for patients identified as frail and likely to benefit from comprehensive geriatric assessment. Methods: All Covid-19 patients meeting frailty criteria1, cared for by the Covid-19 MFE Team were identified. Data on outcomes and clinical characteristics for all (140) patients admitted during the first pandemic wave (March–July 2020) was collected using electronic patient records and analysed. Results: Patients were predominantly male (58.6%). Ages ranged from 65–99 years, with 43.6% aged ≥85 years. 82.1% had one or more of cough, fever and anosmia on admission fitting Covid-19 case definition 2. Lymphopenia was present in 92.1%. Of note, 26.5% of patients had a normal or unchanged chest x-ray report, with only 10.2% showing bilateral peripheral infiltrates. 28-day mortality was 37.1% with Covid-19 Disease listed as primary cause of death in 90.4%. Conclusion(s): Entering further “waves” of infection, it is vital that we understand the clinical presentation and course of Covid-19 disease in elderly patients. Our data highlights that any Covid-19 symptom, even in isolation, should raise suspicion of disease. Chest xrays should not be used alone as a diagnostic tool.The presence of lymphopenia should raise suspicion of Covid-19 infection. In developing an understanding of how elderly patients with Covid-19 present, we can ensure early identification and initiation of appropriate infection control measures. [ABSTRACT FROM AUTHOR]

The effects of beta-endorphin and various enkephalins on protein synthesis in eukaryotic cell-free systems have been examined. Beta-Endorphin, Leu-enkephalin, and Met-enkephalin inhibit the incorporation of radioactive leucine into globin in the presence of reticulocyte poly(A)+ RNA and of radioactive phenylalanine into polyphenylalanine in the presence of poly(U); however, the poly(U)-dependent synthesis of polyphenylalanine from Phe-tRNA is not inhibited. the aminoacylation of tRNAPhe is markedly inhibited by enkephalin, indicating that the sensitive component is Phe-tRNA synthetase. Other aminoacyl-tRNA synthetases are not significantly affected. The interaction between enkephalin and Phe-tRNA synthetase is reversible; activity is restored by dialysis of enzyme-enkephalin reaction mixtures. Morphine, vasopressin and analogues of vasopressin, and enkephalin analogues such as [D-Ala2,D-Leu5]enkephalin and [D-Ala2,Met]enkephalinamide have no effect on translation. The results suggest that the effects on protein synthesis are probably not related to opiate effects.

Taurine concentrations in plasma, platelets, lymphocytes, granulocytes, erythrocytes, and urine were measured in 19 children who were undergoing long-term home parenteral nutrition for 27.4 +/- 7.1 (SEM) months. The parenteral solutions contained methionine, but not taurine or cysteine. The patients' plasma, platelet, and urine taurine concentrations were significantly reduced to 54, 48, and 16%, respectively, of the values from normal children of similar ages. The most significant reductions in plasma and platelet taurine concentrations were observed in the children who were estimated to absorb less than 5% of their daily calorie needs from the enteral tract. Lymphocyte and erythrocyte taurine levels tended to be lower but were not significantly different from those in normal children. The patients' plasma methionine and cystine levels were not different from normal. There was a direct correlation between plasma and platelet taurine concentrations and between plasma and urine taurine. Both plasma and platelet taurine tended to be directly correlated with age and, after the 1st yr of total parenteral nutrition, with the duration of total parenteral nutrition therapy.

Although nondialyzed, chronically uremic patients and patients undergoing maintenance hemodialysis often show evidence for wasting and calorie malnutrition and have low dietary energy intakes, their energy expenditure has never been systematically evaluated. It is possible that low energy intakes are an adaptive response to reduced energy needs; alternatively, energy expenditure could be normal or high and the low energy intakes would be inappropriate. Energy expenditure was therefore measured by indirect calorimetry in 12 normal individuals, 10 nondialyzed patients with chronic renal failure, and 16 patients undergoing maintenance hemodialysis. Energy expenditure was measured in the resting state, during quiet sitting, during controlled exercise on an exercise bicycle, and for four hours after ingestion of a test meal. Resting energy expenditure (kcal/min/1.73 m2) in the normal subjects, chronically uremic patients and hemodialysis patients was, respectively, 0.94 +/- 0.24 (SD), 0.91 +/- 0.20, and 0.97 +/- 0.10. There was also no difference among the three groups in energy expenditure during sitting, exercise, or the postprandial state. Within each group, energy expenditure during resting and sitting was directly correlated. During bicycling, energy expenditure was directly correlated with work performed, and the regression equation for this relationship was similar in each of the three groups. These findings suggest that for a given physical activity, energy expenditure in nondialyzed, chronically uremic patients and maintenance hemodialysis patients is not different from normal. The low energy intakes of many of these patients may be inadequate for their needs.

Although maintenance hemodialysis (MHD) patients are often wasted, little is known about their dietary energy needs. We studied four men and two women in a clinical research center while they received diets providing 45, 35 and 25 kcal/kg desirable body weight/day; diets were fed, in random order, for 21 to 23 days each. Protein intake, 1.13 +/- 0.02 (SEM) g protein/kg/day, was similar with all three diets. Body weight rose with 45 and 35 kcal/kg/day (P less than 0.05) and fell with 25 kcal/kg/day (P less than 0.05). Nitrogen balance, adjusted for estimated unmeasured losses, was neutral with 45 and 35 kcal/kg/day and negative with 25 kcal/kg/day. Balance was neutral or positive in 6 of 6, 4 of 6, and 0 of 6 patients fed 45, 35, 25 kcal/kg/day, respectively. Nitrogen balance, many plasma amino acids and changes in body weight, mid-arm circumference, mid-arm muscle area and body fat each correlated with energy intake. Resting energy expenditure was normal. The energy intake estimated from regression equations to maintain neutral nitrogen balance was 38.5 kcal/kg desirable weight/day; for body fat and weight, it was 32 kcal/kg/day. These data suggest that MHD patients have normal energy expenditure and approximately normal requirements for maintenance of protein balance, body weight and body fat. An average energy intake of about 38 kcal/kg desirable weight/day may be necessary to maintain nitrogen balance in these patients.

Taurine (2-aminoethanesulfonic acid) was evaluated as an antimutagen in the Ames Salmonella tester strain assay. Taurine inhibited mutagenesis by doxorubicin (-74%), bleomycin (-55%), mitomycin C (-56%), and 2-aminofluorene (-52%), but not danthrone or benzo(a)pyrene, in strain TA102. In strain TA98, doxorubicin mutagenicity, but not that of 2-aminofluorene or benzo(a)pyrene, was inhibited by taurine. N-Methyl-N'-nitro-N-nitrosoguanidine (-73%), but not dexon, mutagenicity was inhibited by taurine in strain TA100. Taurine inhibited those mutagens against which it was effective in a dose-related fashion. Taurine was more effective in inhibiting doxorubicin mutagenicity in strain TA102 than its analogues hypotaurine, beta-alanine, and guanidinoethanesulfonic acid or alanine or glycine. The observed inhibition may indicate a role for taurine in modulating the activity of oxidant species.