Gohar Azhar - Academia.edu (original) (raw)
Papers by Gohar Azhar
International Journal of Molecular Sciences, Jan 4, 2023
International Journal of Molecular Sciences, Jan 4, 2023
International Journal of Molecular Sciences, Jan 4, 2023
Innovation in Aging, 2021
CCG-1423 is a Rho A pathway inhibitor which has been reported to inhibit Rho/SRF-mediated transcr... more CCG-1423 is a Rho A pathway inhibitor which has been reported to inhibit Rho/SRF-mediated transcriptional regulation. SRF and SRF cofactors, which include ternary complex factors (TCFs) and myocardin-related transcription factor (MRTF), regulate various cellular functions. The Rho/SRF signaling pathway also regulates the sirtuin 2 (SIRT2) gene that contains a classic serum response element (SRE) sequence. Current research on CCG-1423 focuses on gene expression levels of SRF in response to CCG-1423 and how SRF levels affect the cells; the studies are focused on cell morphology, migration, viability/reproduction, and overall function. The pathways of this inhibitor have yet to be fully elucidated, but several have been suggested with good evidence. Our goal is to study the effect of CCG-1423 on mitochondrial function and gene expression of cells. In this work C2C12 myoblast cells have been used as an in-vitro model to study cellular bioenergetics and variations in gene expressions ind...
International Journal of Molecular Sciences
CCG-1423 is a Rho A pathway inhibitor that has been reported to inhibit Rho/SRF-mediated transcri... more CCG-1423 is a Rho A pathway inhibitor that has been reported to inhibit Rho/SRF-mediated transcriptional regulation. Serum response factor and its cofactors, which include ternary complex factors and myocardin-related transcription factors, regulate various cellular functions. In this study, we observed that CCG-1423 modulates the mitochondrial functions. The effect of this small molecule drug was determined by measuring mitochondrial function using an XFe96 Analyzer and an Oxygraph 2k (O2k) high-resolution respirometer. CCG-1423 treatment significantly reduced oxidative phosphorylation in a dose-dependent manner. However, CCG-1423 increased the glycolytic rate. We also observed that histone 4 at lysine-16 underwent hyperacetylation with the treatment of this drug. Immunolabeling with F-actin and MitoTracker revealed the alteration in the actin cytoskeleton and mitochondria. Taken together, our findings highlight a critical role of CCG-1423 in inhibiting the transcription of SRF/p49...
American Heart Journal, 2000
Inflammation associated with acute myocardial infarction (AMI) is frequently marked by a peripher... more Inflammation associated with acute myocardial infarction (AMI) is frequently marked by a peripheral leukocytosis and relative neutrophilia. Whether this process may contribute to the development of postinfarction congestive heart failure (CHF) is not established. The objective of this study was to examine the association between hospital admission peripheral total leukocyte count and the neutrophil percentage and the subsequent development of CHF in patients with AMI. The study was designed as a retrospective cohort study in the setting of a tertiary referral hospital. Participants included 185 patients discharged with a diagnosis of AMI between May 1 and Sept 30, 1996. Outcome measures included clinical episodes of CHF with confirmatory chest roentgenogram findings and/or echocardiographic evidence of contractile dysfunction. Multivariable logistic regression analyses were performed to examine the relation between the total leukocyte count, neutrophil percentage, and the development of CHF in the first 4 days after AMI while controlling for baseline characteristics and early therapeutic interventions. Thirty-one percent of the cohort had a leukocyte count >11.0 x10(9)/L on admission to the hospital; 65% had a neutrophil percentage >65%, and 61% had a lymphocyte percentage </=25%. CHF developed in 43% of the cohort. Of these, 92. 5% had relative neutrophilia (neutrophil percentage >65%) compared with 45% of those in whom CHF did not develop. Multivariable analysis revealed a highly significant association between relative neutrophilia and the subsequent development of CHF (odds ratio 14.3; 95% confidence interval 5.2 to 39.3). Relative neutrophilia on admission to the hospital in patients with AMI is significantly associated with the early development of CHF. This association may help in the identification of individuals at high risk who might benefit from more aggressive interventions to prevent or reduce the risk of CHF.
To demonstrate that a mild reduction of SRF protein expression in the hearts by over-expression o... more To demonstrate that a mild reduction of SRF protein expression in the hearts by over-expression of antisense SRF, could have beneficial effects. Anti-sense SRF transgenic (Anti-S SRF Tg) mice were generated using standard technology, by over-expressing full-length anti-sense SRF under control of the alpha myosin heavy chain promoter in mouse hearts. The mice were administered beta adrenergic stress and 45 min after that the hearts were harvested for mRNA and protein expression. The older Anti-S SRF transgenic mice (18 mo) appeared to have a better cardiac molecular profile vs. age-matched Non-Tg mice. SERCA2a was higher while ANF was lower in the older Anti-S-SRF Tg vs. age-matched Non-Tg hearts (p<0.05). In addition, β-MHC levels showed a marked age-associated increase in the Non-Tg hearts which resulted in a significant decrease of the α-MHC/β-MHC ratio in the old Non-Tg hearts(p<0.05). However, α-MHC/β-MHC ratio was maintained with age in the Anti-S SRF Tg mice. In response to isoproterenol stress, phosphorylated JNK was significantly lower in the 18 month old Anti-sense vs age-matched Non-Tg hearts (p<0.05). The present study demonstrates that a mild reduction of SRF protein in aged hearts might be feasible and beneficial. Further work on determining a safe range of SRF modulation could serve as a therapeutic target for achieving positive cardiac effects in the aged adult hearts.
![Research paper thumbnail of A Response to: Quality Improvement in Delirium Health Literacy in Older Adult Patients and Their Caregivers Attending a Geriatric Clinic [Response to Letter]](https://attachments.academia-assets.com/102212767/thumbnails/1.jpg)
](Clinical Interventions in Aging
We thank Mr. Colombo for their interest in our manuscript. In this project, we opted to treat the... more We thank Mr. Colombo for their interest in our manuscript. In this project, we opted to treat the pre-and post-education surveys as independent samples because we could not ascertain how many post-survey questions were answered by patients alone, without the involvement or help from their caregivers. The overall objective of this quality improvement project was to disseminate information about delirium to older adults, which we feel was achieved in the study. We appreciate and agree with their comments. Thank you very much for taking an interest in our manuscript.
Clinical Interventions in Aging
Background: Delirium is a common medical condition that is highly prevalent in older adults who a... more Background: Delirium is a common medical condition that is highly prevalent in older adults who are at increased risk for its development with any illness, post-surgery or during hospitalization. The purpose of our study was to evaluate the health literacy of older adult patients and their caregivers about delirium, offer a brief educational intervention, and reevaluate their knowledge post intervention. Materials and Methods: We conducted a quality improvement project, focused on delirium health literacy in older adult patients ≥60 years and their caregivers. Delirium knowledge of participants was evaluated in a pre-education survey after which they were given a delirium education booklet to read. A post-education delirium survey was conducted within 2-3 weeks of the educational intervention. Chi-square test was used to analyze the knowledge base of older adults. Results: The study population consisted of a total of 70 older adults who participated in pre-education (n=35) and post-education (n=35) surveys. Older adult patients and their caregivers had significant knowledge gaps about the potential causes or etiologies, risk factors, symptomatology, and prevention of delirium in the pre-education survey. After the educational intervention, in the posteducation survey, there were overall improvements in knowledge base of older adults in differentiating delirium with dementia (43% vs 94%, p<0.01) recognizing signs and symptoms (77% vs 94%, p<0.05), complications (76% vs 100%, p<0.01) and identifying the etiological factors associated with delirium. Conclusion: The quality improvement project demonstrated that older adults and caregivers have significant knowledge deficits about the common condition of delirium. This study also demonstrated that older adults were able to improve their health literacy regarding delirium after the intervention. Appropriate education on delirium for patients and caregivers might help in earlier identification, prevention, and better overall management of delirium.
The Journal of Nutrition
Background The Dietary Guidelines for Americans (DGAs) published an “ounce equivalents” recommend... more Background The Dietary Guidelines for Americans (DGAs) published an “ounce equivalents” recommendation to help consumers meet protein requirements with a variety of protein food sources. However, the metabolic equivalency of these varied protein food sources has not been established. Objective We have investigated the hypothesis that the anabolic responses to consumption of ounce equivalents of protein food sources would be directly related to the essential amino acid (EAA) content of the protein food source. Methods Following 3 d of dietary control, a total of 56 healthy young adults underwent an 8.5-h metabolic study using stable isotope tracer methodology. The changes from baseline following consumption of 1 of 7 different protein food sources were compared with the baseline value for that individual (n = 8 per group). Results Consumption of ounce equivalents of animal-based protein food sources (beef sirloin, pork loin, eggs) resulted in a greater gain in whole-body net protein ...
The FASEB Journal, Apr 1, 2017
Our recent metabolic study demonstrated in young healthy adults that whole body net protein accre... more Our recent metabolic study demonstrated in young healthy adults that whole body net protein accretion was greater with ingestion of a mixed meal containing ~70g vs. ~40g protein, the latter of which has previously been shown to stimulate a near maximal synthetic response in muscle. To test this relationship in aging adults, we determined whole body protein kinetics in eight older adults (69±5y, 83±14kg, 27±10kg/m2) with a crossover design in the fasted state and following ingestion of 35g (moderate protein, or MP) or 70g (higher protein, HP) protein in mixed meals. Whole body protein kinetics [i.e., protein synthesis (PS), breakdown (PB), and net balance (NB)] (mg/kg LBM/min)] were expressed as changes from fasted to fed states. Feeding resulted in positive NB at both levels of protein intake (for all; p<0.0001) but to a greater extent with HP (p<0.0001). NB was increased primarily through a greater reduction in PB (p<0.0001) and to a lesser extent the stimulation of PS (p<0.01). The increase in NB in the...
Gerontology and Geriatric Medicine, 2020
Approximately half of heart failure patients in the US have heart failure with preserved ejection... more Approximately half of heart failure patients in the US have heart failure with preserved ejection fraction (HFpEF). HFpEF impairs physical performance and thus reduces quality of life. Increasing dietary protein intake can increase lean body mass and physical performance in healthy elderly individuals, but the effect of a high-quality protein supplement, with or without a structured exercise program, has not been investigated in HFpEF patients. Twenty-three obese elderly HFpEF patients with grade 1 or 2 diastolic dysfunction were randomized into three groups: control, protein supplementation alone, and protein plus exercise. Protein supplementation involved providing sufficient whey protein so that total intake was 1.2 g protein/kg/day. The exercise intervention was 2 days of hydrotherapy and 1 day of gym sessions per week under supervision of a fitness expert. Physical parameters and functional tests were performed at baseline and at 12 weeks. Protein supplementation alone failed t...
Background: Heart failure continues to be the leading cause of hospital admissions in adults over... more Background: Heart failure continues to be the leading cause of hospital admissions in adults over 65, most commonly due to poor medication compliance, lack of adequate self-care, and inadequate awareness of heart failure. Hospital admissions for heart failure are higher and health literacy is lower in Arkansas than the national average. We surveyed the heart failure knowledge level in the geriatric patients and caregivers at the University of Arkansas for Medical Sciences geriatric out-patient clinic. Methods: 182 individuals responded to an anonymous survey regarding their knowledge of heart failure, including its etiology, risk factors, symptoms, and management. Results: The subjects included patients and caregivers. About half the subjects were older than 70 and the majority were white women. Approximately 70% of the subjects had the incorrect understanding of the term “heart failure” and thought it meant that the heart had actually stopped working. A vast majority of the subject...
Objective: Heart failure (HF) is a frequent co morbid condition in the geriatric population and i... more Objective: Heart failure (HF) is a frequent co morbid condition in the geriatric population and is the most common cause for hospitalizations and readmission in the elderly. The objective of this study was to attempt to define the impact of HF and its common co-morbid conditions on development of dementia. Research Design & Methods: This was a retrospective study of elderly patients attending the out-patient geriatric clinic at the University of Arkansas for Medical Sciences. We analyzed the electronic health records of 252 HF patients with a mean age of 83 years for co-morbid conditions of hypertension, hyperlipidemia, diabetes mellitus and dementia. The relationship of BMI with these conditions was also determined. Results: The most common co-morbid condition associated with HF was hypertension (97.2%), followed by hyperlipidemia (73.4%), diabetes (35.3%), and dementia (38.8%). Patients on average had 2 -3 co-morbid conditions in addition to HF. In the group with two co-morbid con...
Neuropsychiatric symptoms (NPS) occur in almost all persons living with dementia. Antipsychotic m... more Neuropsychiatric symptoms (NPS) occur in almost all persons living with dementia. Antipsychotic medications are often prescribed inappropriately for persons living with dementia who experience NPS. Adverse side effects of antipsychotic medications include falls, sedation, cognitive dysfunction, prolonged QTc interval, extrapyramidal side effects, cerebrovascular events, metabolic changes, infection, and mortality. The purpose of this descriptive quality improvement project was to test the feasibility and preliminary effectiveness of using the Psychiatric Background Assessment Recommendation (PBAR) Interprofessional Communication Tool (ICT). The PBAR-ICT was adapted from the Situation Background Assessment Recommendation (SBAR) Protocol by the Principal Investigator and was used to report critical NPS in the nursing home. After approval from the university institutional review board, an education program on identifying NPS was provided to the nursing staff. The education program focu...
6 BACKGROUND: Inadequate hydration in the elderly is associated with increased morbidity and mort... more 6 BACKGROUND: Inadequate hydration in the elderly is associated with increased morbidity and mortality. However, few studies have addressed the knowledge of elderly individuals regarding hydration in health and disease. Gaps in health literacy have been identified as a critical component in health maintenance, and promoting health literacy should improve outcomes related to hydration associated illnesses in the elderly. 7
Nutrients, 2020
We have recently demonstrated in young adults that an anabolic response with mixed meal protein i... more We have recently demonstrated in young adults that an anabolic response with mixed meal protein intake above ~35 g/meal, previously recognized as an “optimal” protein dose, was further stimulated. However, it is unknown if this applies to older adults. We therefore examined anabolic response to a mixed meal containing either 35 g (MOD, moderate amount of protein) or 70 g (HIGH, high amount of protein) in a randomized cross-over metabolic study in older adults (n = 8). Primed continuous infusions of L-[2H5] phenylalanine and L-[2H2]tyrosine were performed to determine whole-body protein kinetics and muscle protein fractional synthesis rate (MPS) in basal fasted and fed states. Whole-body protein kinetics (NB, net protein balance; PS, protein synthesis; PB, protein breakdown) and MPS was expressed as changes from the baseline post-absorptive state. Consistent with our previous findings in young adults, both feedings resulted in a positive NB, with HIGH being more positive than MOD. Fu...
The Journals of Gerontology: Series A, 2021
We have investigated the hypothesis that nutritional supplementation of the diet in low-physical-... more We have investigated the hypothesis that nutritional supplementation of the diet in low-physical-functioning older individuals with a specially formulated composition based on essential amino acids (EAAs) would improve physical function as compared to supplementation with the same amount of whey protein. A third group of comparable volunteers were given nutrition education but no supplementation of the diet. After 6 weeks of whey protein supplementation (n = 32), there was no effect on the distance walked in 6 minutes, but the distance walked improved significantly from the pre-value after 12 weeks of whey supplementation. EAA consumption (n = 28) significantly improved walking distance at both 6 and 12 weeks. The distance walked at 12 weeks (419.0 ± 25.0 m) was 35.4 m greater than the pre-value of 384.0 ± 23.0 m (p < .001). The increase in distance walked by the EAA group was also significantly greater than that in the whey group at both 6 and 12 weeks (p < .01). In contrast,...
International Journal of Molecular Sciences, 2021
Alternative splicing generates multiple distinct isoforms that increase transcriptome and proteom... more Alternative splicing generates multiple distinct isoforms that increase transcriptome and proteome diversity. There are seven sirtuin genes in humans, each consists of multiple exons that are likely to undergo alternative splicing. Our aim was to characterize the effect of alternative splicing on the sirtuin genes. Here, we report the identification of 23 human sirtuin isoforms, most of which were not previously reported. Five of the sirtuin genes had more than one isoform, whereas sirtuin-6 had nine isoforms. Exon skipping was the main event. Most of the sirtuin isoforms were deficient in parts of the protein domains, including the catalytic domain, the N- or C-terminus, nuclear localization signal or mitochondrial targeting signal. The domain loss caused potential structural changes. Three SIRT1 isoforms had a differential effect on the mitochondrial oxygen consumption rate. Age-related changes in the expression of SIRT1 isoforms were observed in the human heart in fetus, adults, ...
Geriatric Orthopaedic Surgery & Rehabilitation, 2021
Introduction Public health achievements throughout the last century have resulted in a steady inc... more Introduction Public health achievements throughout the last century have resulted in a steady increase in life expectancy. An emergent subset has distinguished themselves, living well beyond the ninth decade by avoiding or delaying the onset of most age-related diseases, including bone diseases and fractures. In this study, we evaluated the bone health of the oldest community-dwelling individuals living in rural Arkansas. Methods 299 patients aged ≥90 years were retrospectively reviewed for recorded fractures within 12 years prior to the investigation period. Records were also examined for medications and test results pertinent to bone health, including thyroid stimulating hormone, vitamin D levels, hematocrit, hemoglobin, body mass index, and bone densitometric values. Results 68 patients (23%) had at least one fracture documented, and 15 had >1 fracture. 40% of patients with fractures had osteoporosis and 28% had osteopenia, respectively. 232 patients (78%) had no documented fr...
International Journal of Molecular Sciences, Jan 4, 2023
International Journal of Molecular Sciences, Jan 4, 2023
International Journal of Molecular Sciences, Jan 4, 2023
Innovation in Aging, 2021
CCG-1423 is a Rho A pathway inhibitor which has been reported to inhibit Rho/SRF-mediated transcr... more CCG-1423 is a Rho A pathway inhibitor which has been reported to inhibit Rho/SRF-mediated transcriptional regulation. SRF and SRF cofactors, which include ternary complex factors (TCFs) and myocardin-related transcription factor (MRTF), regulate various cellular functions. The Rho/SRF signaling pathway also regulates the sirtuin 2 (SIRT2) gene that contains a classic serum response element (SRE) sequence. Current research on CCG-1423 focuses on gene expression levels of SRF in response to CCG-1423 and how SRF levels affect the cells; the studies are focused on cell morphology, migration, viability/reproduction, and overall function. The pathways of this inhibitor have yet to be fully elucidated, but several have been suggested with good evidence. Our goal is to study the effect of CCG-1423 on mitochondrial function and gene expression of cells. In this work C2C12 myoblast cells have been used as an in-vitro model to study cellular bioenergetics and variations in gene expressions ind...
International Journal of Molecular Sciences
CCG-1423 is a Rho A pathway inhibitor that has been reported to inhibit Rho/SRF-mediated transcri... more CCG-1423 is a Rho A pathway inhibitor that has been reported to inhibit Rho/SRF-mediated transcriptional regulation. Serum response factor and its cofactors, which include ternary complex factors and myocardin-related transcription factors, regulate various cellular functions. In this study, we observed that CCG-1423 modulates the mitochondrial functions. The effect of this small molecule drug was determined by measuring mitochondrial function using an XFe96 Analyzer and an Oxygraph 2k (O2k) high-resolution respirometer. CCG-1423 treatment significantly reduced oxidative phosphorylation in a dose-dependent manner. However, CCG-1423 increased the glycolytic rate. We also observed that histone 4 at lysine-16 underwent hyperacetylation with the treatment of this drug. Immunolabeling with F-actin and MitoTracker revealed the alteration in the actin cytoskeleton and mitochondria. Taken together, our findings highlight a critical role of CCG-1423 in inhibiting the transcription of SRF/p49...
American Heart Journal, 2000
Inflammation associated with acute myocardial infarction (AMI) is frequently marked by a peripher... more Inflammation associated with acute myocardial infarction (AMI) is frequently marked by a peripheral leukocytosis and relative neutrophilia. Whether this process may contribute to the development of postinfarction congestive heart failure (CHF) is not established. The objective of this study was to examine the association between hospital admission peripheral total leukocyte count and the neutrophil percentage and the subsequent development of CHF in patients with AMI. The study was designed as a retrospective cohort study in the setting of a tertiary referral hospital. Participants included 185 patients discharged with a diagnosis of AMI between May 1 and Sept 30, 1996. Outcome measures included clinical episodes of CHF with confirmatory chest roentgenogram findings and/or echocardiographic evidence of contractile dysfunction. Multivariable logistic regression analyses were performed to examine the relation between the total leukocyte count, neutrophil percentage, and the development of CHF in the first 4 days after AMI while controlling for baseline characteristics and early therapeutic interventions. Thirty-one percent of the cohort had a leukocyte count &amp;gt;11.0 x10(9)/L on admission to the hospital; 65% had a neutrophil percentage &amp;gt;65%, and 61% had a lymphocyte percentage &amp;lt;/=25%. CHF developed in 43% of the cohort. Of these, 92. 5% had relative neutrophilia (neutrophil percentage &amp;gt;65%) compared with 45% of those in whom CHF did not develop. Multivariable analysis revealed a highly significant association between relative neutrophilia and the subsequent development of CHF (odds ratio 14.3; 95% confidence interval 5.2 to 39.3). Relative neutrophilia on admission to the hospital in patients with AMI is significantly associated with the early development of CHF. This association may help in the identification of individuals at high risk who might benefit from more aggressive interventions to prevent or reduce the risk of CHF.
To demonstrate that a mild reduction of SRF protein expression in the hearts by over-expression o... more To demonstrate that a mild reduction of SRF protein expression in the hearts by over-expression of antisense SRF, could have beneficial effects. Anti-sense SRF transgenic (Anti-S SRF Tg) mice were generated using standard technology, by over-expressing full-length anti-sense SRF under control of the alpha myosin heavy chain promoter in mouse hearts. The mice were administered beta adrenergic stress and 45 min after that the hearts were harvested for mRNA and protein expression. The older Anti-S SRF transgenic mice (18 mo) appeared to have a better cardiac molecular profile vs. age-matched Non-Tg mice. SERCA2a was higher while ANF was lower in the older Anti-S-SRF Tg vs. age-matched Non-Tg hearts (p<0.05). In addition, β-MHC levels showed a marked age-associated increase in the Non-Tg hearts which resulted in a significant decrease of the α-MHC/β-MHC ratio in the old Non-Tg hearts(p<0.05). However, α-MHC/β-MHC ratio was maintained with age in the Anti-S SRF Tg mice. In response to isoproterenol stress, phosphorylated JNK was significantly lower in the 18 month old Anti-sense vs age-matched Non-Tg hearts (p<0.05). The present study demonstrates that a mild reduction of SRF protein in aged hearts might be feasible and beneficial. Further work on determining a safe range of SRF modulation could serve as a therapeutic target for achieving positive cardiac effects in the aged adult hearts.
Clinical Interventions in Aging
We thank Mr. Colombo for their interest in our manuscript. In this project, we opted to treat the... more We thank Mr. Colombo for their interest in our manuscript. In this project, we opted to treat the pre-and post-education surveys as independent samples because we could not ascertain how many post-survey questions were answered by patients alone, without the involvement or help from their caregivers. The overall objective of this quality improvement project was to disseminate information about delirium to older adults, which we feel was achieved in the study. We appreciate and agree with their comments. Thank you very much for taking an interest in our manuscript.
Clinical Interventions in Aging
Background: Delirium is a common medical condition that is highly prevalent in older adults who a... more Background: Delirium is a common medical condition that is highly prevalent in older adults who are at increased risk for its development with any illness, post-surgery or during hospitalization. The purpose of our study was to evaluate the health literacy of older adult patients and their caregivers about delirium, offer a brief educational intervention, and reevaluate their knowledge post intervention. Materials and Methods: We conducted a quality improvement project, focused on delirium health literacy in older adult patients ≥60 years and their caregivers. Delirium knowledge of participants was evaluated in a pre-education survey after which they were given a delirium education booklet to read. A post-education delirium survey was conducted within 2-3 weeks of the educational intervention. Chi-square test was used to analyze the knowledge base of older adults. Results: The study population consisted of a total of 70 older adults who participated in pre-education (n=35) and post-education (n=35) surveys. Older adult patients and their caregivers had significant knowledge gaps about the potential causes or etiologies, risk factors, symptomatology, and prevention of delirium in the pre-education survey. After the educational intervention, in the posteducation survey, there were overall improvements in knowledge base of older adults in differentiating delirium with dementia (43% vs 94%, p<0.01) recognizing signs and symptoms (77% vs 94%, p<0.05), complications (76% vs 100%, p<0.01) and identifying the etiological factors associated with delirium. Conclusion: The quality improvement project demonstrated that older adults and caregivers have significant knowledge deficits about the common condition of delirium. This study also demonstrated that older adults were able to improve their health literacy regarding delirium after the intervention. Appropriate education on delirium for patients and caregivers might help in earlier identification, prevention, and better overall management of delirium.
The Journal of Nutrition
Background The Dietary Guidelines for Americans (DGAs) published an “ounce equivalents” recommend... more Background The Dietary Guidelines for Americans (DGAs) published an “ounce equivalents” recommendation to help consumers meet protein requirements with a variety of protein food sources. However, the metabolic equivalency of these varied protein food sources has not been established. Objective We have investigated the hypothesis that the anabolic responses to consumption of ounce equivalents of protein food sources would be directly related to the essential amino acid (EAA) content of the protein food source. Methods Following 3 d of dietary control, a total of 56 healthy young adults underwent an 8.5-h metabolic study using stable isotope tracer methodology. The changes from baseline following consumption of 1 of 7 different protein food sources were compared with the baseline value for that individual (n = 8 per group). Results Consumption of ounce equivalents of animal-based protein food sources (beef sirloin, pork loin, eggs) resulted in a greater gain in whole-body net protein ...
The FASEB Journal, Apr 1, 2017
Our recent metabolic study demonstrated in young healthy adults that whole body net protein accre... more Our recent metabolic study demonstrated in young healthy adults that whole body net protein accretion was greater with ingestion of a mixed meal containing ~70g vs. ~40g protein, the latter of which has previously been shown to stimulate a near maximal synthetic response in muscle. To test this relationship in aging adults, we determined whole body protein kinetics in eight older adults (69±5y, 83±14kg, 27±10kg/m2) with a crossover design in the fasted state and following ingestion of 35g (moderate protein, or MP) or 70g (higher protein, HP) protein in mixed meals. Whole body protein kinetics [i.e., protein synthesis (PS), breakdown (PB), and net balance (NB)] (mg/kg LBM/min)] were expressed as changes from fasted to fed states. Feeding resulted in positive NB at both levels of protein intake (for all; p<0.0001) but to a greater extent with HP (p<0.0001). NB was increased primarily through a greater reduction in PB (p<0.0001) and to a lesser extent the stimulation of PS (p<0.01). The increase in NB in the...
Gerontology and Geriatric Medicine, 2020
Approximately half of heart failure patients in the US have heart failure with preserved ejection... more Approximately half of heart failure patients in the US have heart failure with preserved ejection fraction (HFpEF). HFpEF impairs physical performance and thus reduces quality of life. Increasing dietary protein intake can increase lean body mass and physical performance in healthy elderly individuals, but the effect of a high-quality protein supplement, with or without a structured exercise program, has not been investigated in HFpEF patients. Twenty-three obese elderly HFpEF patients with grade 1 or 2 diastolic dysfunction were randomized into three groups: control, protein supplementation alone, and protein plus exercise. Protein supplementation involved providing sufficient whey protein so that total intake was 1.2 g protein/kg/day. The exercise intervention was 2 days of hydrotherapy and 1 day of gym sessions per week under supervision of a fitness expert. Physical parameters and functional tests were performed at baseline and at 12 weeks. Protein supplementation alone failed t...
Background: Heart failure continues to be the leading cause of hospital admissions in adults over... more Background: Heart failure continues to be the leading cause of hospital admissions in adults over 65, most commonly due to poor medication compliance, lack of adequate self-care, and inadequate awareness of heart failure. Hospital admissions for heart failure are higher and health literacy is lower in Arkansas than the national average. We surveyed the heart failure knowledge level in the geriatric patients and caregivers at the University of Arkansas for Medical Sciences geriatric out-patient clinic. Methods: 182 individuals responded to an anonymous survey regarding their knowledge of heart failure, including its etiology, risk factors, symptoms, and management. Results: The subjects included patients and caregivers. About half the subjects were older than 70 and the majority were white women. Approximately 70% of the subjects had the incorrect understanding of the term “heart failure” and thought it meant that the heart had actually stopped working. A vast majority of the subject...
Objective: Heart failure (HF) is a frequent co morbid condition in the geriatric population and i... more Objective: Heart failure (HF) is a frequent co morbid condition in the geriatric population and is the most common cause for hospitalizations and readmission in the elderly. The objective of this study was to attempt to define the impact of HF and its common co-morbid conditions on development of dementia. Research Design & Methods: This was a retrospective study of elderly patients attending the out-patient geriatric clinic at the University of Arkansas for Medical Sciences. We analyzed the electronic health records of 252 HF patients with a mean age of 83 years for co-morbid conditions of hypertension, hyperlipidemia, diabetes mellitus and dementia. The relationship of BMI with these conditions was also determined. Results: The most common co-morbid condition associated with HF was hypertension (97.2%), followed by hyperlipidemia (73.4%), diabetes (35.3%), and dementia (38.8%). Patients on average had 2 -3 co-morbid conditions in addition to HF. In the group with two co-morbid con...
Neuropsychiatric symptoms (NPS) occur in almost all persons living with dementia. Antipsychotic m... more Neuropsychiatric symptoms (NPS) occur in almost all persons living with dementia. Antipsychotic medications are often prescribed inappropriately for persons living with dementia who experience NPS. Adverse side effects of antipsychotic medications include falls, sedation, cognitive dysfunction, prolonged QTc interval, extrapyramidal side effects, cerebrovascular events, metabolic changes, infection, and mortality. The purpose of this descriptive quality improvement project was to test the feasibility and preliminary effectiveness of using the Psychiatric Background Assessment Recommendation (PBAR) Interprofessional Communication Tool (ICT). The PBAR-ICT was adapted from the Situation Background Assessment Recommendation (SBAR) Protocol by the Principal Investigator and was used to report critical NPS in the nursing home. After approval from the university institutional review board, an education program on identifying NPS was provided to the nursing staff. The education program focu...
6 BACKGROUND: Inadequate hydration in the elderly is associated with increased morbidity and mort... more 6 BACKGROUND: Inadequate hydration in the elderly is associated with increased morbidity and mortality. However, few studies have addressed the knowledge of elderly individuals regarding hydration in health and disease. Gaps in health literacy have been identified as a critical component in health maintenance, and promoting health literacy should improve outcomes related to hydration associated illnesses in the elderly. 7
Nutrients, 2020
We have recently demonstrated in young adults that an anabolic response with mixed meal protein i... more We have recently demonstrated in young adults that an anabolic response with mixed meal protein intake above ~35 g/meal, previously recognized as an “optimal” protein dose, was further stimulated. However, it is unknown if this applies to older adults. We therefore examined anabolic response to a mixed meal containing either 35 g (MOD, moderate amount of protein) or 70 g (HIGH, high amount of protein) in a randomized cross-over metabolic study in older adults (n = 8). Primed continuous infusions of L-[2H5] phenylalanine and L-[2H2]tyrosine were performed to determine whole-body protein kinetics and muscle protein fractional synthesis rate (MPS) in basal fasted and fed states. Whole-body protein kinetics (NB, net protein balance; PS, protein synthesis; PB, protein breakdown) and MPS was expressed as changes from the baseline post-absorptive state. Consistent with our previous findings in young adults, both feedings resulted in a positive NB, with HIGH being more positive than MOD. Fu...
The Journals of Gerontology: Series A, 2021
We have investigated the hypothesis that nutritional supplementation of the diet in low-physical-... more We have investigated the hypothesis that nutritional supplementation of the diet in low-physical-functioning older individuals with a specially formulated composition based on essential amino acids (EAAs) would improve physical function as compared to supplementation with the same amount of whey protein. A third group of comparable volunteers were given nutrition education but no supplementation of the diet. After 6 weeks of whey protein supplementation (n = 32), there was no effect on the distance walked in 6 minutes, but the distance walked improved significantly from the pre-value after 12 weeks of whey supplementation. EAA consumption (n = 28) significantly improved walking distance at both 6 and 12 weeks. The distance walked at 12 weeks (419.0 ± 25.0 m) was 35.4 m greater than the pre-value of 384.0 ± 23.0 m (p < .001). The increase in distance walked by the EAA group was also significantly greater than that in the whey group at both 6 and 12 weeks (p < .01). In contrast,...
International Journal of Molecular Sciences, 2021
Alternative splicing generates multiple distinct isoforms that increase transcriptome and proteom... more Alternative splicing generates multiple distinct isoforms that increase transcriptome and proteome diversity. There are seven sirtuin genes in humans, each consists of multiple exons that are likely to undergo alternative splicing. Our aim was to characterize the effect of alternative splicing on the sirtuin genes. Here, we report the identification of 23 human sirtuin isoforms, most of which were not previously reported. Five of the sirtuin genes had more than one isoform, whereas sirtuin-6 had nine isoforms. Exon skipping was the main event. Most of the sirtuin isoforms were deficient in parts of the protein domains, including the catalytic domain, the N- or C-terminus, nuclear localization signal or mitochondrial targeting signal. The domain loss caused potential structural changes. Three SIRT1 isoforms had a differential effect on the mitochondrial oxygen consumption rate. Age-related changes in the expression of SIRT1 isoforms were observed in the human heart in fetus, adults, ...
Geriatric Orthopaedic Surgery & Rehabilitation, 2021
Introduction Public health achievements throughout the last century have resulted in a steady inc... more Introduction Public health achievements throughout the last century have resulted in a steady increase in life expectancy. An emergent subset has distinguished themselves, living well beyond the ninth decade by avoiding or delaying the onset of most age-related diseases, including bone diseases and fractures. In this study, we evaluated the bone health of the oldest community-dwelling individuals living in rural Arkansas. Methods 299 patients aged ≥90 years were retrospectively reviewed for recorded fractures within 12 years prior to the investigation period. Records were also examined for medications and test results pertinent to bone health, including thyroid stimulating hormone, vitamin D levels, hematocrit, hemoglobin, body mass index, and bone densitometric values. Results 68 patients (23%) had at least one fracture documented, and 15 had >1 fracture. 40% of patients with fractures had osteoporosis and 28% had osteopenia, respectively. 232 patients (78%) had no documented fr...