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Medical nutrition

Gregory Plotnikoff, Melissa Barber
INTRODUCTION: Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. CASE PRESENTATION: A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine...
October 14, 2016: Permanente Journal
Shih-Lun Lo, Yu-Hsiu Yen, Pi-Jung Lee, Charles Chih-Ho Liu, Chi-Ming Pu
PURPOSE: The present study aimed to analyze multiple variables and to determine the factors influencing postoperative complications in reconstructive microsurgeries for head and neck cancer. MATERIALS AND METHODS: This was a retrospective review of the medical records of patients with head and neck cancer who underwent free flap reconstruction after ablation surgery at the Cathay General Hospital (Taipei, Taiwan) from January 2010 to December 2014. Clinical and surgical procedure-related factors were retrieved from a database and analyzed...
September 23, 2016: Journal of Oral and Maxillofacial Surgery
Yin-Yi Han, Sheng-Ru Lai, Jamie S Partridge, Michael Y Wang, Suela Sulo, Fang-Wei Tsao, Refaat A Hegazi
BACKGROUND & AIMS: Patients admitted to intensive care units (ICUs) often need enteral nutrition (EN) support. For patients with type 2 diabetes (T2D), standard EN formulas may not provide ideal nutrients. The purpose was to investigate whether use of a diabetes-specific formula (DSF) could provide clinical and health economic benefits (compared to standard formulas) in critically ill patients with T2D. METHODS: This study was a retrospective analysis of medical records and expenditure data covering a 5-year period (2009-2013) from the hospitalization database of the National Taiwan University Hospital...
October 6, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Lori Jane Curtis, Paule Bernier, Khursheed Jeejeebhoy, Johane Allard, Donald Duerksen, Leah Gramlich, Manon Laporte, Heather H Keller
BACKGROUND & AIMS: Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data...
September 19, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Anand Pandey, Vipin Gupta, Shailendra P Singh, Vijendra Kumar, Rajesh Verma
A trophic ulcer is a pressure ulcer caused by external trauma to a part of the body that is compromised due to disease, vascular insufficiency, or loss of afferent nerve fibers. Spinal dysraphism (ie, neural tube defects [NTD]) such as meningomyelocele is a risk factor for developing these ulcers in adults and pediatric patients. Information regarding the occurrence of trophic ulcers in pediatric patients with NTD is lacking. A review of the English-language literature on skin/neuropathic ulcers in patients with NTDs, irrespective of study design, published between 1975 and 2014, was undertaken using the PubMed database...
December 2015: Ostomy/wound Management
Frank A Scannapieco, Summar Amin, Marc Salme, Mine Tezal
PURPOSE: To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. METHODS AND MATERIALS: A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts...
October 20, 2016: Special Care in Dentistry
Y Yu, S Cnattingius, J Olsen, E T Parner, M Vestergaard, Z Liew, N Zhao, J Li
BACKGROUND: The loss of a close relative is one of the most stressful life events. In pregnancy, this experience has been associated with a higher risk of fetal death and under-five mortality, but little is known about potential effects on long-term mortality in offspring. We examined the association between prenatal maternal bereavement and mortality in a cohort of 5.3 million children followed until up to 37 years of age. METHOD: The population-based cohort study included 5 253 508 live singleton births in Denmark (1973-2004) and Sweden (1973-2006)...
October 20, 2016: Psychological Medicine
Richard S Finkel, Kathie M Bishop, Robert M Nelson
The natural history of spinal muscular atrophy type I (SMA-I) has changed as improved medical support has become available. With investigational drugs for spinal muscular atrophy now in clinical trials, efficient trial design focuses on enrolling recently diagnosed infants, providing best available supportive care, and minimizing subject variation. The quandary has arisen whether it is ethically appropriate to specify a predefined level of nutritional and/or ventilation support for spinal muscular atrophy type I subjects while participating in these studies...
October 19, 2016: Journal of Child Neurology
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Maria Luisa Fonte, Lauren Fietchner, Matteo Manuelli, Hellas Cena
BACKGROUND: The aim of this case report is to discuss the issue of nutritional therapy in patients taking warfarin. Patients are often prescribed vitamin K free diets without nutritional counseling, leading to possible health consequences. CASE PRESENTATION: A 52-year-old woman with obesity and hypertension was prescribed a low calorie diet by her family doctor in an effort to promote weight loss. After a pulmonary embolism, she was placed on anticoagulant therapy and on hospital discharge she was prescribed a vitamin K free diet to avoid interactions...
October 19, 2016: Nutrition Journal
Mojtaba Farjam, Hossein Bahrami, Ehsan Bahramali, Javad Jamshidi, Alireza Askari, Habibollah Zakeri, Reza Homayounfar, Hossein Poustchi, Reza Malekzadeh
BACKGROUND: Non-communicable diseases (NCDs) have become the main causes of morbidity and mortality even in rural areas of many developing countries, including Iran. In view of this increased risk, Fasa Cohort Study (FACS) has been established to assess the risk factors for NCDs with the ultimate goal of providing optimal risk calculators for Iranian population and finding grounds for interventions at the population level. METHODS: In a population-based cohort, at least 10,000 people within the age range of 35 to 70 years old from Sheshdeh, the suburb of Fasa city and its 24 satellite villages are being recruited...
October 18, 2016: BMC Public Health
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
Amal A Wanigatunga, Paul V Nickerson, Todd M Manini, Parisa Rashidi
The objective of this analysis was to apply symbolic aggregate approximation (SAX) time-series analysis to accelerometer data for activity pattern visualization stratified by self-reported mobility difficulty. A total of 2393 (71.6  ±  7.9 years old) participants wore an accelerometer on the hip (4  +  d; 10  +  h) during the national health and nutrition examination survey (NHANES), a biannual series of health assessments of the US population. One minute epoch data was used to perform SAX, which converted accelerometry time series data into four activity levels...
October 18, 2016: Physiological Measurement
Vildan Kaya, Aynur Aytekin
AIMS AND OBJECTIVES: To determine the effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants. BACKGROUND: Feeding problems in preterm infants cause delays in hospital discharge, extend mother-infant reunification, and increase medical cost. Nutritive sucking skills of preterm infants may develop by improving non-nutritive sucking skills and increasing sucking experiences. DESIGN: A prospective, randomised controlled trial conducted in the Eastern Turkey...
October 18, 2016: Journal of Clinical Nursing
Gustavo Bergonzoli, Luis G Castellanos, Rodolfo Rodríguez, Lina María Garcia
Objectives To explore the relationships among social, economic, environmental, and health services determinants of tuberculosis (TB) morbidity and mortality, and to identify the mechanisms that mediate such associations in countries of Latin America and the Caribbean (LAC). Methods This was an ecological study of 26 LAC countries that had accurate data available on 38 selected variables for the year 2010. The countries represented 99% of the TB burden in LAC. Multivariate linear regression was used to identify associations among determinants of health and TB morbidity and mortality...
February 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Yongsoon Park
A healthy lifestyle is important in CVD prevention and treatment through effects on modifiable CVD risk factors, particularly blood pressure. Although the major drawback is the low level of adherence over time, appropriate lifestyle changes may safely and effectively prevent and treat hypertension. The recommended dietary approaches that have been shown to be capable of reducing blood pressure are: salt restriction, moderation of alcohol consumption, high consumption of vegetables and fruits and low-fat and other types of diet, and weight reduction...
September 2016: Journal of Hypertension
Chun Chang, Qingqi Zeng, Ying Ji, Xinying Sun, Yuhui Shi, Yanlin Wang, Chengcheng Han, Xiuqin Wen
OBJECTIVE: To exam whether health literacy mediated the association between intervention and blood pressure control and to better understand the relationship between health literacy and health outcome for hypertensive. DESIGN AND METHOD: A before-after designed one-year community-based intervention program including patient education and patient-centered goal support were conducted in a primary care setting. A face-to-face interview were completed among 468 hypertensives before intervention and 406 after intervention...
September 2016: Journal of Hypertension
Longjian Liu, Jessica Dow, Barbara Simon, Howard Eisen
OBJECTIVE: Multiple medication use in patients with hypertension (HTN) is a common clinical problem faced by both primary and specialists. Patients who remain to have higher BP in spite of the concurrent use of 3 antihypertensive agents of different classes are defined as resistant hypertension (RH). In the study we aimed to identify the prevalence of RH, and examined its association with mortality from all-cause and cardiovascular disease (CVD). DESIGN AND METHOD: Data from the U...
September 2016: Journal of Hypertension
Kerryn L Story, Asma S Bukhari, Maria Bovill
Military dietitians have long been valued members of the health care team, called on for their expertise as early as World War I. However, in the more recent conflicts over the past two decades, their role in health care delivery as a component of medical stability operations has been largely undefined. The purpose of this study was to explore the types of missions supported by U.S. military dietitians and characterize any unique competencies critical to their success during these missions using an online questionnaire...
October 2016: Military Medicine
Deborah G Loman, Christina G Kwong, Lisa D Henry, Christina Mahl, Lisa Meadows, Alysa G Ellis
OBJECTIVE: To examine the relationship between body mass index (BMI), gender, age, controller medication use, household smoke exposure, season, and allergic rhinitis status with asthma control in a group of lower income, African American children. We hypothesized that non-obese children would have better asthma control. METHODS: Baseline data from a longitudinal study of children in a school-based asthma program in a Midwest urban area were analyzed. 360 children, ages 4-15 years, who were enrolled in either the 2012-2013 or 2013-2014 program were included...
October 18, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
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