Biomedical subjects

A J Rosenthal

Publications and source records attributed to A J Rosenthal.

10 recordsLinked to original sources

PubMed1999

Interleukin-2, its receptor and nutrition in older adults: a review.

It is well recognized that malnutrition can impair immune function. Conversely, immune activity may influence measures of malnutrition, such as serum albumin and prealbumin. Interleukin-2 (lL-2) and its receptor are key components of immune function. Recent evidence has expanded our understanding of the interaction between nutrition and this cytokine system. particularly in older adults. (A cytokine is a protein that acts as a "hormone" regulator of the immune system.) This paper will summarize more recent findings regarding the relationship between nutrition and the IL-2/IL-2 receptor system.

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PubMed1998

Is malnutrition overdiagnosed in older hospitalized patients? Association between the soluble interleukin-2 receptor and serum markers of malnutrition.

BACKGROUND: Many researchers have speculated that markers of malnutrition such as albumin, prealbumin, cholesterol, and transferrin are influenced by inflammation. The mechanism of this interaction has not been well understood. METHODS: This was a prospective cross-sectional study. We evaluated 72 male patients older than 60 years admitted to a geriatric rehabilitation unit. Subjects with severe hepatic or renal diseases were excluded. We measured body mass index, caloric intake, serum albumin, prealbumin, cholesterol, transferrin, hemoglobin, and total lymphocyte count. To detect inflammation, we measured C-reactive protein, Westergren sedimentation rate, fibrinogen, and cytokines including tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), IL-6, IL-2, and the soluble IL-2 receptor. RESULTS: Soluble IL-2 receptor was negatively associated with albumin (r = -.479, p < .0001), prealbumin (r = -.520, p = < .0001), cholesterol (r = -.487, p = .0001), transferrin (r = -.455, p = .0002), and hemoglobin (r = -.371, p = .002). TNF-alpha, IL-1 beta, IL-6, and IL-2 were not associated with these measures. CONCLUSIONS: Inflammation increases the incidence of hypoalbuminemia and hypocholesterolemia, potentially leading to overdiagnosis of malnutrition. We suggest that albumin, cholesterol, prealbumin, and transferrin be used with caution when assessing the nutritional status of older hospitalized patients. In the future, soluble IL-2 receptor levels might be used to correct for the impact of inflammation on these markers of malnutrition.

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PubMed1997

The soluble interleukin-2 receptor predicts mortality in older hospitalized men.

BACKGROUND: There is an inverse relationship between the soluble interleukin-2 receptor (sIL-2R) and serum albumin, cholesterol, transferrin, prealbumin, and hemoglobin. Inasmuch as low serum albumin and cholesterol have been associated with excess mortality, we hypothesized that elevated sIL-2R would predict mortality in older adults. OBJECTIVE: To determine if elevated sIL-2R predicts mortality in patients on a geriatric rehabilitation unit. DESIGN: Prospective cohort. SETTING: University-affiliated VA medical center. PARTICIPANTS: Seventy-two male patients aged greater than 60 years admitted to a geriatric rehabilitation unit. Patients with severe hepatic or renal disease were excluded. MEASUREMENTS: We measured serum albumin, prealbumin, cholesterol, transferrin, hemoglobin, body mass index (BMI), C-reactive protein (CRP), and sIL-2R upon admission. Subjects were followed for 1 year. RESULTS: Low serum albumin, prealbumin, and hemoglobin and high sIL-2R and CRP predicted 1-year mortality on univariate analysis. When these predictors were included as covariates in a Cox regression model, only sIL-2R was a significant independent predictor of mortality (P = .043). Multiple linear regression with the above covariates revealed that only sIL-2R predicted time to death at (P = .003). CONCLUSIONS: High sIL-2R and CRP and low albumin, prealbumin, and hemoglobin predicted mortality using univariate analysis on a rehabilitation unit. However, with multivariate analysis, sIL-2R was the sole predictor of mortality.

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PubMed1995

Urinary incontinence in the elderly. Often simple to treat when properly evaluated.

Urinary incontinence is a prevalent problem in the elderly, and its medical, social, and economic costs are significant. Incontinence may be transient or long-standing; reversible causes must be ruled out. Thorough history taking, a targeted physical examination, and simple office tests usually lead to a diagnosis. When the type of incontinence is known, appropriate treatment may bring improvement in symptoms or a return to continence. Clinicians and patients alike benefit from the realization that urinary incontinence is a treatable problem.

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PubMed1971