BACKGROUND/OBJECTIVES: The objectives of this study were to evaluate the accuracy of the Dietary Reference Intakes (DRI) for estimating the energy requirements of older adults, and to develop and validate new equations for predicting the energy requirements of this population group. MATERIALS/METHODS: The study subjects were 25 men and 23 women with a mean age of 72.2 ± 3.9 years and 70.0 ± 3.3 years, and mean BMI of 24.0 ± 2.1 and 23.9 ± 2.7, respectively. The total energy expenditure (TEE) was measured by using the doubly labeled water (DLW) method, and used to validate the DRI predictive equations for estimated energy requirements (EER) and to develop new EER predictive equations. These developed equations were cross-validated by using the leave-one-out technique. RESULTS: In men, the DRI equation had a −7.2% bias and accurately predicted the EER (meaning EER values within ±10% of the measured TEE) for 64% of the subjects, whereas our developed equation had a bias of −0.1% and an accuracy rate of 84%. In women, the bias was −6.6% for the DRI equation and 0.2% for our developed equation, and the accuracy rate was 74% and 83%, respectively. The predicted EER was strongly correlated with the measured TEE, for both the DRI equations and our developed equations (Pearson's r = 0.915 and 0.908, respectively). CONCLUSIONS: The DRI equations provided an acceptable prediction of EER in older adults and these study results therefore support the use of these equations in this population group. Our developed equations had a better predictive accuracy than the DRI equations, but more studies need to be performed to assess the performance of these new equations when applied to an independent sample of older adults.
Adult ; Aged ; Bias (Epidemiology) ; Energy Metabolism ; Female ; Humans ; Male ; Methods ; Nutritional Requirements ; Population Groups ; Recommended Dietary Allowances ; Water

PURPOSE: There have been many reports that point to the increasing death and emergency operation rate in traumatic hemorrhagic shock patients. The purpose of this study was to discover the clinical difference between the hypotensive traumatic patients and the non-hypotensive traumatic patients that had been managed in intensive care unit (ICU). METHODS: We retrospectively reviewed the medical records of 122 patients admitted to ICU for trauma from January 2001 to December 2002. We compared the hypotensive (systolic blood pressure (SBP) < 90 mmHg) group with the non-hypotensive group about age, diastolic blood pressure, initial hemoglobin, Injury Severity Score (ISS), Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), transfusion volume at emergency department, blood pH, blood base deficit, duration of admission, ICU stay, death rate, transfusion volume and others. RESULTS: There was no difference between two groups in age, causes of injury, situation whether or not the patient was directly transported from the scene and ISS. But there were differences between two groups in initial hemoglobins, GCS, RTS, blood pH, blood base deficit, duration of admission, ICU stay, and death rate. It was documented that the ICU stay correlated with systolic blood pressure, diastolic blood pressure, initial hemoglobin, blood base deficit, ISS, GCS, and RTS but not correlated with transfusion volume in emergency department. CONCLUSION: Systolic blood pressure is not the sensitive parameter of blood loss. Various kinds of indices of hypotensive group are more severe than non-hypotensive group. If traumatic patients are hypotensive blood pressure on arrival at emergency department, we should be careful of the state of these patients.
Blood Pressure ; Emergencies ; Emergency Service, Hospital ; Glasgow Coma Scale ; Humans ; Hydrogen-Ion Concentration ; Injury Severity Score ; Intensive Care Units ; Medical Records ; Mortality ; Retrospective Studies ; Shock, Hemorrhagic

PURPOSE: The purpose of this study was to assess the reliability of ultrasonography to image the epiglottis and to determine a thickness range based on healthy Korean adults. METHODS: Anterior neck images were obtained in 100 healthy Koreans (52 males and 48 females) using ultrasonography. Sonographically, the epiglottis appeared as a curvilinear, hypoechoic structure with an echogenic preepiglottic space. 20 of 100 subjects, each patient underwent two ultrasound measurements by the same examiner to assess for intra-examiner reliability, followed by two additional measurements performed by a second examiner to assess for inter-examiner reliability. RESULTS: Intraclass correlation coefficient revealed excellent reliability (intra-examiner 0.901, inter-examiner 0.887). The average Korean epiglottis thickness was measured to be 2.31+/-0.22 mm (range: 1.88 mm to 2.84 mm), with greater thickness noted in men (2.41+/-0.21 mm) when compared to women (2.21+/-0.18 mm) (p <0.001). There was significant correlation between epiglottis thickness and body surface area (r=0.533), weight (0.517), height (0.437) and body mass index (0.372). Average examination time was recoded to be 17.84+/-13.09 seconds. CONCLUSION: Bedside ultrasonography is rapid, safe, easy to perform and can accurately evaluate the epiglottis as seen in our study. Because of excellent reliability, it is possible to establish diagnostic criteria.
Adult* ; Body Mass Index ; Body Surface Area ; Epiglottis* ; Female ; Humans ; Male ; Neck ; Ultrasonography*