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Nutrition in Clinical Practice

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https://www.readbyqxmd.com/read/28636832/nutrient-deficiencies-are-common-prior-to-bariatric-surgery
#1
Leigh A Frame-Peterson, Robin D Megill, Suzanne Carobrese, Michael Schweitzer
Obesity, defined as a body mass index >30 kg/m(2), is a growing worldwide epidemic currently effecting 1 in 10 adults, with rates as high as 40% in the United States. The only proven long-term treatment of severe obesity on a population level is surgical modification of the gastrointestinal anatomy to induce weight loss, termed bariatric surgery. With adequate physician guidance and appropriate candidate criteria, bariatric surgery is an option for effective long-term treatment of obesity and its related comorbidities...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28633000/nutrition-support-for-critically-ill-patients-with-cancer
#2
Kristen Lach, Sarah J Peterson
Oncology patients often experience the classic signs of malnutrition-weight loss as well as fat and muscle wasting, which have been associated with poor tolerance to treatment and increased morbidity and mortality. Nutrition status may be an important factor in determining tolerance to treatment and outcomes associated with it. Thus, identification of those with preexisting malnutrition or who are at risk for developing malnutrition is crucial not only at time of cancer diagnosis but also throughout the treatment course so that nutrition interventions may be implemented to prevent development or worsening of malnutrition in this high-risk population...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28632997/epidemiology-of-obesity-and-pharmacologic-treatment-options
#3
Vignesh Shettar, Sarang Patel, Srividya Kidambi
Prevalence of obesity and its related morbidity have increased to alarming levels in adults and children in the United States and globally. Weight loss results in improvement of much of the obesity-related morbidity. Lifestyle changes such as dietary modifications, increased physical activity, and behavioral therapy form the crux of weight management. However, many individuals need additional assistance (pharmacologic or surgical) to initiate or sustain weight loss. Pharmacologic therapy consists of a number of agents that work by decreasing appetite, gastric emptying, or nutrient absorption or by increasing satiety...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28628362/weight-loss-surgery-in-adolescents
#4
Amy L Christison, Sandeep K Gupta
Childhood obesity continues to be a national health problem, with growing numbers of adolescents (8.7%) affected by severe obesity and its associated cardiometabolic risks. Since current nonsurgical methods for treating these adolescents have only modest effects, weight loss surgery (WLS) is an alternative treatment. An overview of the literature was conducted describing the selection, management, and outcomes of adolescents undergoing WLS. Adolescent guidelines require physical and emotional maturity as well as serious comorbidities associated with body mass index cutoffs higher than those used for adults...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28628353/effect-of-early-vs-late-start-of-oral-intake-on-anastomotic-leakage-following-elective-lower-intestinal-surgery-a-systematic-review
#5
Boudewijn J J Smeets, Emmeline G Peters, Eelco C J Horsten, Teus J Weijs, Harm J T Rutten, Willem A Buurman, Wouter J de Jonge, Misha D P Luyer
BACKGROUND: Experimental and clinical studies have demonstrated a beneficial effect of early enteral nutrition (EN) on anastomotic leakage following colorectal surgery. Early oral intake is a common form of early EN with various clinical benefits, but the effect on anastomotic leakage is unclear. This systematic review investigates the effect of early vs late start of oral intake on anastomotic leakage following lower intestinal surgery. METHODS: A systematic literature search was performed using the PubMed, Embase, Medline, and Cochrane databases...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28622478/novel-nonsurgical-endoscopic-approaches-for-the-treatment-of-obesity
#6
Ryan T Hurt, Thomas H Frazier, Manpreet S Mundi
Globally, obesity is a leading cause of preventable death and is associated with >60 comorbid medical conditions, including 10 types of cancer that are strongly associated with body mass index. There are a number of traditional obesity treatments-for example, lifestyle management (eg, decreased caloric intake and increased expenditure), pharmacotherapy, and bariatric surgery. Recently, endoscopic approaches have emerged as a viable alternative for weight loss. Endoscopically placed intragastric balloons were introduced in the early 1980s for the treatment of medically complicated obesity but, unfortunately, had high rates of complications, such as premature deflation leading to obstruction...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28609642/micronutrient-deficiencies-after-bariatric-surgery-an-emphasis-on-vitamins-and-trace-minerals
#7
Jayshil J Patel, Manpreet S Mundi, Ryan T Hurt, Bruce Wolfe, Robert G Martindale
Obesity has become a worldwide epidemic with a disproportionate increase in grade III obesity. Bariatric surgery offers an attractive option for sustained weight loss compared with traditional methods such as exercise and diet. Micronutrient deficiencies are common and clinically significant after bariatric surgery. These deficiencies are related to a combination of patient and surgical variables. A thorough understanding of specific micronutrient deficiencies is necessary for early recognition and optimal management...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28570117/effects-of-chromium-on-glucose-tolerance-in-infants-receiving-parenteral-nutrition-therapy
#8
Kristin Capone, Sudhir Sriram, Tiffany Patton, Dana Weinstein, Ellen Newton, Kristen Wroblewski, Timothy Sentongo
OBJECTIVES: Early hyperglycemia is prevalent in preterm infants receiving parenteral nutrition (PN) therapy. Chromium improves glucose tolerance by potentiating the action of insulin. Therefore, we hypothesized that supplementing PN with chromium would improve glucose tolerance and PN calorie delivery in infants during the first week of life. METHODS: We collected data on neonates receiving PN initiated at birth with chromium (0.2 mcg/kg/d) started either on days 5-7 (group A) vs day 1 (group B) on PN and compared glucose tolerance and PN calorie administration over the first week of life...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28549221/preventing-underfeeding-and-overfeeding-a-clinician-s-guide-to-the-acquisition-and-implementation-of-indirect-calorimetry
#9
Amy K Ladd, Heather E Skillman, Matthew A Haemer, Peter M Mourani
BACKGROUND: In critically ill patients, indirect calorimetry (IC) is the gold standard to determine energy needs, as the use of predictive equations can result in underfeeding or overfeeding. The aim of this quality improvement (QI) initiative was to describe the rationale for and implementation of a process to target energy provision according to IC measurements in a tertiary academic medical center pediatric intensive care unit (PICU). MATERIALS AND METHODS: To justify the purchase of an indirect calorimeter for clinical use, a needs assessment was conducted, followed by a training and implementation period...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28537849/efficacy-safety-and-preparation-of-standardized-parenteral-nutrition-regimens-three-chamber-bags-vs-compounded-monobags-a-prospective-multicenter-randomized-single-blind-clinical-trial
#10
Jianchun Yu, Guohao Wu, Yun Tang, Yingjiang Ye, Zhongtao Zhang
BACKGROUND: Parenteral nutrition (PN) covering the need for carbohydrates, amino acids, and lipids can either be compounded from single nutrients or purchased as an industrially manufactured ready-to-use regimen. This study compares a commercially available 3-chamber bag (study group) with a conventionally compounded monobag regarding nutrition efficacy, safety, and regimen preparation time. MATERIALS AND METHODS: This prospective, randomized, single-blind study was conducted at 5 Chinese hospitals from October 2010-October 2011...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28535359/association-between-nutrition-status-and-survival-in-elderly-patients-with-colorectal-cancer
#11
Katia Barao, Mariana Abe Vicente Cavagnari, Patricia Silva Fucuta, Nora Manoukian Forones
BACKGROUND: Aging patients with cancer have a higher risk of mortality and treatment-associated morbidity than younger patients. Nutrition status may play an important role in cancer mortality. We aimed to evaluate the survival time of elderly patients with colorectal cancer and its association with body mass index (BMI), the patient-generated subjective global assessment (PG-SGA), and phase angle (PA). MATERIALS AND METHODS: BMI, PG-SGA, and PA were determined for all patients (n = 250) at first assessment...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28530846/monitoring-nutrition-in-critical-illness-what-can-we-use
#12
Suzie Ferrie, Erica Tsang
BACKGROUND: Nutrition monitoring in the context of critical care presents unique challenges. Traditionally used anthropometric and biochemical markers may be difficult to obtain or confounded by factors such as fluid status and the inflammatory response. A previous survey identified 15 parameters in common use, all of which have confounding influences during critical illness. MATERIALS AND METHODS: A literature search was conducted to assess current use of commonly used nutrition-monitoring parameters and to explore other possible methods that might be more useful...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28521656/oral-feeding-difficulties-in-children-with-short-bowel-syndrome-a-narrative-review
#13
Judy Hopkins, Sharon A Cermak, Russell J Merritt
Children with short bowel syndrome (SBS) with associated intestinal failure may be unable to absorb sufficient nutrients to sustain life. Improvements in the medical management of SBS, including use of parenteral nutrition, has significantly increased life expectancy. Independence from parenteral nutrition further improves quality of life. However, children living with SBS often develop oral aversions and feeding difficulties. There is limited research and information on which to base interventions that will preserve and develop oral motor and feeding skills...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28459652/handgrip-strength-is-associated-with-treatment-modifications-during-neoadjuvant-chemoradiation-in-patients-with-esophageal-cancer
#14
Patty Lakenman, Karen Ottens-Oussoren, Jill Witvliet-van Nierop, Donald van der Peet, Marian de van der Schueren
RATIONALE: It has been shown that early nutrition intervention improves nutrition status (NS) and treatment tolerance in patients with esophageal cancer. However, it remains unknown whether pretreatment parameters of NS are associated with treatment modifications (TMs) during neoadjuvant chemoradiation (CR) in patients who are intensively nutritionally supervised during treatment. METHODS: All outpatients with esophageal cancer who were scheduled for CR in the VU medical center from 2006-2015 were included...
April 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28459651/handgrip-strength-and-malnutrition-undernutrition-in-hospitalized-versus-nonhospitalized-children-aged-6-14-years
#15
Kayla Camille Jensen, Sarah Gunnell Bellini, Jennifer Willahan Derrick, Susan Fullmer, Dennis Eggett
BACKGROUND: Diagnosing undernutrition in hospitalized pediatric populations is crucial to provide timely nutrition interventions. Handgrip strength (HGS), a measurement of muscle function, is a reliable indicator of undernutrition. However, limited research exists on HGS in hospitalized pediatric patients. The primary aim of this study was to determine if HGS differed between hospitalized children within 48 hours of admission and nonhospitalized children. A secondary purpose was to describe the association of HGS with height, weight, body mass index (BMI), mid upper arm circumference (MUAC), activity level, disease severity, nutrition risk, and nutrition intervention...
April 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28459649/a-necessary-evil-patients-experiences-receiving-tube-feeding-in-acute-care
#16
Cara Green, Virginia Vandall-Walker
BACKGROUND: Tube feeding (TF) is frequently prescribed for adults admitted to acute care facilities to prevent or ameliorate malnutrition, yet little is known about patients' needs and experiences with receiving this therapy. Patients' perspectives regarding the factors influencing their experiences, as well as their information and support needs, are required to inform healthcare providers' (HCPs') patient-centered practices. METHODS: Based on an interpretive description qualitative approach, 12 unstructured face-to-face interviews were conducted with participants admitted to acute care hospitals in Northwestern Ontario, Canada...
April 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28445108/manganese-provision-in-parenteral-nutrition-an-update
#17
Callum Livingstone
Manganese (Mn) is an essential micronutrient required for the activity of metalloenzymes. It is an essential component of parenteral nutrition (PN), but requirements are low. Mn status is difficult to assess, with the commonest method being measurement of its concentration in whole blood. This method has limitations, including artifactually high concentrations resulting from contamination of specimen tubes. Mn toxicity is a well-recognized complication of PN, the risk of which increases if there is cholestasis or if the patient has received high doses...
April 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28437132/home-enteral-nutrition-updates-trends-and-challenges
#18
Karen Martin, Gabriela Gardner
The true prevalence of home enteral nutrition (HEN) utilization is unclear and requires further study. HEN therapy has remained virtually unchanged for several decades. However, new trends in HEN are evolving; enteral nutrition is undergoing changes ranging from enteral feeding devices, ingredients used, practice innovations, and challenges with reimbursement. A 2006 Joint Commission call to action that reported 2 sentinel events related to misconnections set things into motion for the transition of enteral device connectors to become specific for enteral nutrition use, which will affect patients who receive HEN...
April 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28426396/current-status-of-and-recommendations-for-nutrition-education-in-gastroenterology-fellowship-training-in-canada
#19
Jing Hu, Maitreyi Raman, Leah Gramlich
PURPOSE: Knowledge and skill in the area of nutrition are a key competency for the gastroenterologist. However, standards for nutrition education for gastroenterology fellows in Canada do not exist, and gastroenterologists in training and in practice do not feel confident in their knowledge or skill as it relates to nutrition. This study was undertaken to identify the current status of nutrition education in gastroenterology (GI) fellowship training programs in Canada and to provide insight into the development of nutrition educational goals, processes, and evaluation...
April 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28537519/burden-and-outcome-of-vitamin-d-deficiency-among-critically-ill-patients-a-prospective-study
#20
Enas Anwar, Gehan Hamdy, Eman Taher, Esmat Fawzy, Sherif Abdulattif, Mohamed H Attia
BACKGROUND: Vitamin D deficiency is a prevalent condition among critically ill patients. Information about the relationship between vitamin D levels and outcomes in the intensive care unit (ICU) is sparse. PURPOSE: To evaluate vitamin D status among critically ill patients and its relevance to severity of illness, ICU stay period, and mortality. METHODS: This prospective multicenter study was conducted in the ICUs of Fayoum, Cairo, Alazhar, and Ain Shams university hospitals...
June 2017: Nutrition in Clinical Practice
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