The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.

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Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association

Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia.

Resistant starch (RS) is starch and products of its small intestinal digestion that enter the large bowel. It occurs for various reasons including chemical structure, cooking of food, chemical modification, and food mastication. Human colonic bacteria ferment RS and nonstarch polysaccharides (NSP; major components of dietary fiber) to short-chain fatty acids (SCFA), mainly acetate, propionate, and butyrate. SCFA stimulate colonic blood flow and fluid and electrolyte uptake. Butyrate is a preferred substrate for colonocytes and appears to promote a normal phenotype in these cells. Fermentation of some RS types favors butyrate production. Measurement of colonic fermentation in humans is difficult, and indirect measures (e.g., fecal samples) or animal models have been used. Of the latter, rodents appear to be of limited value, and pigs or dogs are preferable. RS is less effective than NSP in stool bulking, but epidemiological data suggest that it is more protective against colorectal cancer, possibly via butyrate. RS is a prebiotic, but knowledge of its other interactions with the microflora is limited. The contribution of RS to fermentation and colonic physiology seems to be greater than that of NSP. However, the lack of a generally accepted analytical procedure that accommodates the major influences on RS means this is yet to be established.

Short-Chain Fatty Acids and Human Colonic Function: Roles of Resistant Starch and Nonstarch Polysaccharides

Accurate assessment is required to assess current and changing physical activity levels, and to evaluate the effectiveness of interventions designed to increase activity levels. This study systematically reviewed the literature to determine the extent of agreement between subjectively (self-report e.g. questionnaire, diary) and objectively (directly measured; e.g. accelerometry, doubly labeled water) assessed physical activity in adults. Eight electronic databases were searched to identify observational and experimental studies of adult populations. Searching identified 4,463 potential articles. Initial screening found that 293 examined the relationship between self-reported and directly measured physical activity and met the eligibility criteria. Data abstraction was completed for 187 articles, which described comparable data and/or comparisons, while 76 articles lacked comparable data or comparisons, and a further 30 did not meet the review's eligibility requirements. A risk of bias assessment was conducted for all articles from which data was abstracted. Correlations between self-report and direct measures were generally low-to-moderate and ranged from -0.71 to 0.96. No clear pattern emerged for the mean differences between self-report and direct measures of physical activity. Trends differed by measure of physical activity employed, level of physical activity measured, and the gender of participants. Results of the risk of bias assessment indicated that 38% of the studies had lower quality scores. The findings suggest that the measurement method may have a significant impact on the observed levels of physical activity. Self-report measures of physical activity were both higher and lower than directly measured levels of physical activity, which poses a problem for both reliance on self-report measures and for attempts to correct for self-report – direct measure differences. This review reveals the need for valid, accurate and reliable measures of physical activity in evaluating current and changing physical activity levels, physical activity interventions, and the relationships between physical activity and health outcomes.

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A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review

http://drop-kicker.com/wp-content/uploads/2014/01/kyle-bia.pdf

Bioelectrical impedance analysis--part I: review of principles and methods.

Inulin and oligofructose do not influence the absorption of cholesterol, or the excretion of cholesterol, Ca, Mg, Zn, Fe, or bile acids but increases energy excretion in ileostomy subjects

Objective: To examine the relationship between body mass index (BMI) at age 70, weight change between age 70 and 75, and 15 y mortality. Design: Cohort study of 70-y-olds. Setting: Geriatric Medicine Department, Goteborg University, Sweden. Subjects: A total of 2628 (1225 males and 1403 females) 70-y-olds examined in 1971–1981 in Gothenburg, Sweden. Results: The relative risks (RRs) for 15 y mortality were highest in the lowest BMI quintiles of males 1.20 (95% CI 0.96–1.51) and females 1.49 (95% CI 1.14–1.96). In non-smoking males, no significant differences were observed across the quintiles for 5, 10 and 15 y mortality. In non-smoking females, the highest RR (1.58, 95% CI 1.15–2.16) for 15 y mortality was in the lowest quintile. After exclusion of first 5 y death, no excess risks were found in males for following 5 and 10 y mortality across the quintiles. In females, a U-shaped relation was observed after such exclusions. BMI ranges with lowest 15 y mortality were 27–29 and 25–27 kg/m2 in non-smoking males and females, respectively. A weight loss of≥10% between age 70 and 75 meant a significantly higher risk for subsequent 5 and 10 y mortality in both sexes relative to individuals with ‘stable’ weights. Conclusion: Low BMI and weight loss are risk factors for mortality in the elderly and smoking habits did not significantly modify that relationship. The BMI ranges with lowest risks for 15 y mortality are relatively higher in elderly. Exclusion of early deaths from the analysis modified the weight–mortality relationship in elderly males but not in females. Sponsorship: See Acknowledgements. European Journal of Clinical Nutrition (2001) 55, 482–492

Body mass index, weight change and mortality in the elderly. A 15 y longitudinal population study of 70 y olds

Height and body weight in the elderly. I. A 25-year longitudinal study of a population aged 70 to 95 years

Changes in body composition and its relation to muscle strength in 75-year-old men and women: A 5-year prospective follow-up study of the NORA cohort in Göteborg, Sweden

In a consecutive series of 107 patients operated on for Crohn's disease involving the distal ileum, the overall incidence of gallstones was 17% and of renal stones 12%. Whereas the frequency of gallstone disease was 9% in patients with minor resections, patients with more than 100 cm diseased or resected small bowel had a frequency of 35%. The probability of gallstone development in both sexes was calculated to be approximately 50% after 20 years of distal ileopathy. The frequency of renal stone disease in patients with minor resection was comparable to that of a population in Sweden but was significantly commoner in patients with resection of more than 100 cm (28%), provided they were not colectomized. The high frequency of stone disease after resection of distal ileum is attributed to metabolic disturbances due to steatorrhea and bile salt malabsorption.

Ingvar Bosaeus

Papers

Inulin and oligofructose do not influence the absorption of cholesterol, or the excretion of cholesterol, Ca, Mg, Zn, Fe, or bile acids but increases energy excretion in ileostomy subjects

Body mass index, weight change and mortality in the elderly. A 15 y longitudinal population study of 70 y olds

Height and body weight in the elderly. I. A 25-year longitudinal study of a population aged 70 to 95 years

Changes in body composition and its relation to muscle strength in 75-year-old men and women: A 5-year prospective follow-up study of the NORA cohort in Göteborg, Sweden

Cholelithiasis and Urolithiasis in Crohn's Disease