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Nutrition in Clinical Practice

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https://www.readbyqxmd.com/read/28549221/preventing-underfeeding-and-overfeeding-a-clinician-s-guide-to-the-acquisition-and-implementation-of-indirect-calorimetry
#1
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
#2
Yu Jianchun, Wu Guohao, Tang Yun, Ye Yingjiang, Zhang Zhongtao
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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/28466665/comparison-of-skinfold-thicknesses-and-bioimpedance-spectroscopy-to-dual-energy-x-ray-absorptiometry-for-the-body-fat-measurement-in-patients-with-chronic-kidney-disease
#12
Aleksandra Rymarz, Katarzyna Szamotulska, Stanisław Niemczyk
BACKGROUND/OBJECTIVES: The aim of the study was to compare the amount of body fat measured by skinfold thickness (SFT) and bioimpedance spectroscopy (BIS) with dual-energy x-ray absorptiometry (DXA) as a reference method. METHODS: Forty-eight patients undergoing hemodialysis treatment thrice-weekly for at least 3 months (HD group) with a mean age of 59.8 ± 15.5 years, 61 patients with chronic kidney disease (CKD) with an estimated glomerular filtration rate (eGFR) <30 mL/min/1...
March 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28358595/treatment-of-enterocutaneous-fistulas-then-and-now
#13
Luis Alfonso Ortiz, Bin Zhang, Maureen Walsh McCarthy, Haytham M A Kaafarani, Peter Fagenholz, David R King, Marc De Moya, George Velmahos, Daniel Dante Yeh
BACKGROUND: An enterocutaneous fistula (ECF) is an aberrant connection between the gastrointestinal tract and the skin or atmosphere (enteroatmospheric fistula [EAF]). Multimodal treatment includes surgical procedures, nutrition support, and wound care. We evaluated our practice and compared our outcomes with previous results published from our institution. MATERIALS AND METHODS: We performed a retrospective analysis of hospitalized ECF/EAF patients admitted between January 2011 and November 2015...
March 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28350525/hang-height-of-enteral-nutrition-influences-the-delivery-of-enteral-nutrition
#14
Renee Walker, Lauren Probstfeld, Anne Tucker
PURPOSE: Adequate enteral nutrition (EN) delivery to critically ill patients is difficult to achieve. Given the large number of unpreventable influences affecting adequate caloric intake, further research on preventable influences of adequate EN administration is warranted. The purpose of this study was to evaluate whether hang height of EN formula, formula viscosity, or flow rate influences pump accuracy and formula delivery. METHODS: Formulas of varying viscosities (1...
March 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28350517/anti-inflammatory-diet-in-clinical-practice
#15
Mari Anoushka Ricker, William Christian Haas
Recently, there has been an increase in the research regarding the impact of acute and chronic inflammation on health and disease. Specific foods are now known to exert strong effects on inflammatory pathways within the body. Carefully selecting foods that are anti-inflammatory in nature while avoiding foods that are proinflammatory is central to an anti-inflammatory diet plan. Ultimately, the plan models a pattern of eating that (1) focuses on eating whole, plant-based foods that are rich in healthy fats and phytonutrients and (2) maintains a stable glycemic response...
March 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28350508/role-of-nutrition-support-in-inflammatory-conditions
#16
Olivier Lheureux, Jean-Charles Preiser
This review intends to summarize recent development on the potential nutrition implications of acute inflammation encountered during critical illness. Different aspects of the inflammatory response and their impact on nutrition management during critical illness will be discussed: the timing of the postinjury metabolic response, the integration of regulatory mechanisms involved in the metabolic response to stress, the oxidative stress, the metabolic and clinical consequences in terms of energy expenditure, use of energy, changes in body composition, and behavior...
March 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
#17
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
https://www.readbyqxmd.com/read/28537518/parenteral-nutrition-lipid-injectable-emulsion-products-shortage-considerations
#18
Steve Plogsted, Stephen C Adams, Karen Allen, M Petrea Cober, June Greaves, Amy Ralph, Daniel T Robinson, Kim Sabino, Renee Walker, Ceressa T Ward, Joe Ybarra, Beverly Holcombe
No abstract text is available yet for this article.
June 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28537517/sepsis-current-definition-pathophysiology-diagnosis-and-management
#19
Abdalsamih M Taeb, Michael H Hooper, Paul E Marik
Sepsis is a clinical syndrome that results from the dysregulated inflammatory response to infection that leads to organ dysfunction. The resulting losses to society in terms of financial burden, morbidity, and mortality are enormous. We provide a review of sepsis, its underlying pathophysiology, and guidance for diagnosis and management of this common disease. Current established treatments include appropriate antimicrobial agents to target the underlying infection, optimization of intravascular volume to improve stroke volume, vasopressors to counteract vasoplegic shock, and high-quality supportive care...
June 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28537516/role-of-vitamin-d-in-inflammatory-bowel-disease
#20
Berkeley N Limketkai, Gerard E Mullin, David Limsui, Alyssa M Parian
Vitamin D is a secosteroid hormone that possesses immunomodulatory properties and has been demonstrated to potentially influence inflammatory bowel disease (IBD) pathogenesis and activity. Epidemiologic data have associated vitamin D deficiency with an increased risk of IBD, hospitalizations, surgery, and loss of response to biologic therapy. Conversely, IBD itself can lead to vitamin D deficiency. This bidirectional relationship between vitamin D and IBD suggests the need for monitoring and repletion of vitamin D, as needed, in the IBD patient...
June 2017: Nutrition in Clinical Practice
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