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https://www.readbyqxmd.com/read/28531775/a-protocol-for-sustained-reduction-of-total-parenteral-nutrition-and-cost-savings-by-improvement-of-nutritional-care-in-hospitals
#1
Rian van Schaik, Kurt Van den Abeele, Glenn Melsens, Peter Schepens, Truus Lanssens, Bernadette Vlaemynck, Maria Devisch, Theo A Niewold
BACKGROUND AND AIMS: Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14)...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28503669/dietary-diversity-and-child-malnutrition-in-ghana
#2
Raymond Boadi Frempong, Samuel Kobina Annim
The health of children in Ghana has improved in recent years. However, the current prevalence rates of malnutrition remain above internationally acceptable levels. This study, therefore, revisits the determinants of child health by using Ghana's Multiple Indicator Cluster Survey to investigate the effect of infant feeding practices on child health. We used the World Health Organization's Infant and Young Children Feeding guidelines to measure dietary quality. The econometric analyses show that dietary diversity may cause improvement in children's health in Ghana...
May 2017: Heliyon
https://www.readbyqxmd.com/read/28499361/dietary-diversity-scores-an-indicator-of-micronutrient-inadequacy-instead-of-obesity-for-chinese-children
#3
Wenzhi Zhao, Kai Yu, Shengjie Tan, Yingdong Zheng, Ai Zhao, Peiyu Wang, Yumei Zhang
BACKGROUND: Micronutrient malnutrition affects the well-being of both adults and children. Dietary diversity score (DDS) is a useful evaluation index with a relatively well-developed guideline by FAO. It's meaningful to assess and predict inadequate micronutrient intakes using DDS in Chinese children, after ruling out the risk of obesity coming with more dietary diversity. METHODS: Data for evaluation were extracted from the Nutrition Study of Preschool Children and School Children, which is a cross-sectional study covering 8 cities of China, including 1694 children in kindergartens and primary schools...
May 12, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28469357/healthcare-maintenance-in-elderly-patients-with-inflammatory-bowel-disease
#4
REVIEW
Manish P Shrestha, Joannie Ruel, Sasha Taleban
The increasing number of older patients (age ≥60 years) with inflammatory bowel disease (IBD) highlights the importance of healthcare maintenance in this vulnerable population. Older IBD patients are more susceptible and have higher rates of many disease- and treatment-related adverse effects. Compared to younger IBD patients, older patients are at increased risk for infection, malignancy, bone disease, eye disease, malnutrition and thrombotic complications. Preventive strategies in the elderly differ from those in younger adults and are imperative...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28468633/myocardial-and-haemodynamic-responses-to-two-fluid-regimens-in-african-children-with-severe-malnutrition-and-hypovolaemic-shock-afrim-study
#5
Nchafatso Obonyo, Bernadette Brent, Peter Olupot-Olupot, Michael Boele van Hensbroek, Irene Kuipers, Sidney Wong, Kenji Shiino, Jonathan Chan, John Fraser, Job B M van Woensel, Kathryn Maitland
BACKGROUND: Fluid therapy in severely malnourished children is hypothesized to be deleterious owing to compromised cardiac function. We evaluated World Health Organization (WHO) fluid resuscitation guidelines for hypovolaemic shock using myocardial and haemodynamic function and safety endpoints. METHODS: A prospective observational study of two sequential fluid management strategies was conducted at two East African hospitals. Eligible participants were severely malnourished children, aged 6-60 months, with hypovolaemic shock secondary to gastroenteritis...
May 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28459036/consensus-statement-on-dose-modifications-of-antidiabetic-agents-in-patients-with-hepatic-impairment
#6
REVIEW
Kalyan Kumar Gangopadhyay, Parminder Singh
Liver disease is an important cause of mortality in type 2 diabetes mellitus (T2DM). It is estimated that diabetes is the most common cause of liver disease in the United States. Virtually, entire spectrum of liver disease is seen in T2DM including abnormal liver enzymes, nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, and acute liver failure. The treatment of diabetes mellitus (DM) in cirrhotic patients has particular challenges as follows: (1) about half the patients have malnutrition; (2) patients already have advanced liver disease when clinical DM is diagnosed; (3) most of the oral antidiabetic agents (ADAs) are metabolized in the liver; (4) patients often have episodes of hypoglycemia...
March 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28444362/burden-of-severe-acute-malnutrition-in-under-five-children-2-59%C3%A2-months-admitted-in-a-tertiary-care-hospital-of-delhi
#7
Alka Mathur, Geetanjali Tahilramani, Sonia Makhija, Veena Devgan
Objective: The aim of the present study is to assess the burden of severe acute malnutrition (SAM) and other malnutrition in a tertiary care hospital in Delhi. Methods: All patients aged 2-59 months admitted from August 2012 to July 2014 were screened for malnutrition by anthropometry using standard techniques, and SAM was diagnosed as per guidelines [1, 2]. Results: During the study period, 4520 children of age 2-59 months were admitted and complete data of 4354 children were available, which were analysed...
April 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28436099/review-of-nutrition-guidelines-relevant-for-adolescents-in-low-and-middle-income-countries
#8
REVIEW
Zohra S Lassi, Tarab Mansoor, Rehana A Salam, Shereen Z Bhutta, Jai K Das, Zulfiqar A Bhutta
The economic and social well-being of any country will one day depend on its current adolescent population. To provide a good foundation for healthy adolescent development, healthy diet, along with physical activity and adequate nutrients, is necessary. Therefore, addressing the nutrition needs of adolescents could be an important step toward breaking the vicious cycle of intergenerational malnutrition, chronic diseases, and poverty. These problems could be addressed with timely recognition and appropriately delivered interventions...
April 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28425762/the-evaluation-of-bulbar-dysfunction-in-amyotrophic-lateral-sclerosis-survey-of-clinical-practice-patterns-in-the-united-states
#9
Emily K Plowman, Lauren C Tabor, James Wymer, Gary Pattee
OBJECTIVE: Speech and swallowing impairments are highly prevalent in individuals with amyotrophic lateral sclerosis (ALS) and contribute to reduced quality of life, malnutrition, aspiration, pneumonia and death. Established practice parameters for bulbar dysfunction in ALS do not currently exist. The aim of this study was to identify current practice patterns for the evaluation of speech and swallowing function within participating Northeast ALS clinics in the United States. METHODS AND RESULTS: A 15-item survey was emailed to all registered NEALS centres...
April 20, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28408415/impact-of-international-quality-improvement-collaborative-on-congenital-heart-surgery-in-pakistan
#10
Amina Khan, Ahmed Abdullah, Huzaifa Ahmad, Arjumand Rizvi, Sehrish Batool, Kathy J Jenkins, Kimberlee Gauvreau, Muneer Amanullah, Anwar Haq, Nadeem Aslam, Fauzia Minai, Babar Hasan
BACKGROUND: The International Quality Improvement Collaborative (IQIC) was formed to reduce mortality and morbidity from congenital heart disease (CHD) surgeries in low/middle-income countries. OBJECTIVES: We conducted this study to compare the postoperative outcomes of CHD surgeries at a centre in Pakistan before and after joining IQIC. METHODS: The IQIC provides guidelines targeting key drivers responsible for morbidity and mortality in postoperativepatients with CHD...
April 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28394304/the-diet-and-haemodialysis-dyad-three-eras-four-open-questions-and-four-paradoxes-a-narrative-review-towards-a-personalized-patient-centered-approach
#11
REVIEW
Giorgina Barbara Piccoli, Maria Rita Moio, Antioco Fois, Andreea Sofronie, Lurlinys Gendrot, Gianfranca Cabiddu, Claudia D'Alessandro, Adamasco Cupisti
The history of dialysis and diet can be viewed as a series of battles waged against potential threats to patients' lives. In the early years of dialysis, potassium was identified as "the killer", and the lists patients were given of forbidden foods included most plant-derived nourishment. As soon as dialysis became more efficient and survival increased, hyperphosphatemia, was identified as the enemy, generating an even longer list of banned aliments. Conversely, the "third era" finds us combating protein-energy wasting...
April 10, 2017: Nutrients
https://www.readbyqxmd.com/read/28388376/how-much-and-what-type-of-protein-should-a-critically-ill-patient-receive
#12
Juan B Ochoa Gautier, Robert G Martindale, Saúl J Rugeles, Ryan T Hurt, Beth Taylor, Daren K Heyland, Stephen A McClave
Protein loss, manifested as loss of muscle mass, is observed universally in all critically ill patients. Depletion of muscle mass is associated with impaired function and poor outcomes. In extreme cases, protein malnutrition is manifested by respiratory failure, lack of wound healing, and immune dysfunction. Protecting muscle loss focused initially on meeting energy requirements. The assumption was that protein was being used (through oxidation) as an energy source. In healthy individuals, small amounts of glucose (approximately 400 calories) protect muscle loss and decrease amino acid oxidation (protein-sparing effect of glucose)...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28385477/espen-guideline-clinical-nutrition-in-surgery
#13
Arved Weimann, Marco Braga, Franco Carli, Takashi Higashiguchi, Martin Hübner, Stanislaw Klek, Alessandro Laviano, Olle Ljungqvist, Dileep N Lobo, Robert Martindale, Dan L Waitzberg, Stephan C Bischoff, Pierre Singer
Early oral feeding is the preferred mode of nutrition for surgical patients. Avoidance of any nutritional therapy bears the risk of underfeeding during the postoperative course after major surgery. Considering that malnutrition and underfeeding are risk factors for postoperative complications, early enteral feeding is especially relevant for any surgical patient at nutritional risk, especially for those undergoing upper gastrointestinal surgery. The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e...
June 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28382486/-guideline-conform-diagnostics-for-dysphagia-a%C3%A2-representative-survey-of-speech-therapists-at-certified-stroke-units-in-germany
#14
C M Flader, C Rosendahl, T Günther
BACKGROUND: Almost 260,000 people in Germany suffer from a stroke each year. As a consequence, for more than 60% this leads to dysphagia. In order to prevent secondary diseases, such as pneumonia, malnutrition and dehydration, a differentiated diagnosis by a multiprofessional team in a stroke unit is required. The guidelines in 2015 for diagnosing neurologic dysphagia by the German Society of Neurology recommend a detailed anamnesis, a standardized screening, a clinical swallowing examination and additional instrumental diagnostics...
April 5, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28365665/nutrition-support-protocols-enhancing-delivery-of-enteral-nutrition
#15
Colleen O'Leary-Kelley, Karen Bawel-Brinkley
In critical care, malnutrition has a significant, negative impact on a patient's ability to respond to medical treatment. Enteral nutrition is known to counteract the metabolic changes associated with critical illness that increase the risk for serious complications and poor clinical outcomes. Inadequate delivery of nutrition support and underfeeding persist in intensive care units despite the availability of guidelines and current research for best practice. Recent studies have shown that nutrition support protocols are effective in promoting nutritional goals in a wide variety of intensive care patients...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28361743/the-role-of-nutritional-assessment-and-early-enteral-nutrition-for-combined-pancreas-and-kidney-transplant-candidates
#16
Sally Finlay, Argiris Asderakis, Adel Ilham, Doruk Elker, Dawn Chapman, Elijah Ablorsu
BACKGROUND: Early post-operative enteral nutrition is an important part of perioperative management and is strongly supported by ESPEN Guidelines. However, there is limited evidence into the use of Early Enteral Nutrition (EEN) after combined Pancreas and Kidney Transplantation (PKT). We know malnutrition in type-1 diabetics with end stage renal failure (ESRF) is a common problem and a significant risk factor. Therefore, we introduced EEN in our patients. METHOD: We monitored and recorded nutritional data on 29 PKT recipients who underwent transplantation between Oct 2007 and Jan 2010 without a nutritional assessment or EEN [Monitored Group (MG)] and on 30 PKT recipients between Feb 2010 and Dec 2013 who received a nutritional assessment and EEN (Naso-jejunal feed or oral intake with supplementation, according to their nutritional status) [Fed Group (FG)]...
February 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28359355/is-the-presence-of-a-validated-malnutrition-screening-tool-associated-with-better-nutritional-care-in-hospitalized-patients
#17
Doris Eglseer, Ruud J G Halfens, Christa Lohrmann
OBJECTIVE: The aims of this study were to evaluate the association between the use of clinical guidelines and the use of validated screening tools, evaluate the nutritional screening policy in hospitals, and examine the association between the use of validated screening tools and the prevalence of malnutrition and nutritional interventions in hospitalized patients. METHODS: This was a cross-sectional, multicenter study. Data were collected using a standardized questionnaire on three levels: institution (presence of a guideline for malnutrition), department (use of a validated screening tool), and patient (e...
May 2017: Nutrition
https://www.readbyqxmd.com/read/28344786/united-european-gastroenterology-evidence-based-guidelines-for-the-diagnosis-and-therapy-of-chronic-pancreatitis-hapaneu
#18
REVIEW
J Matthias Löhr, Enrique Dominguez-Munoz, Jonas Rosendahl, Marc Besselink, Julia Mayerle, Markus M Lerch, Stephan Haas, Fatih Akisik, Nikolaos Kartalis, Julio Iglesias-Garcia, Jutta Keller, Marja Boermeester, Jens Werner, Jean-Marc Dumonceau, Paul Fockens, Asbjorn Drewes, Gürlap Ceyhan, Björn Lindkvist, Joost Drenth, Nils Ewald, Philip Hardt, Enrique de Madaria, Heiko Witt, Alexander Schneider, Riccardo Manfredi, Frøkjer J Brøndum, Sasa Rudolf, Thomas Bollen, Marco Bruno
BACKGROUND: There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach. METHODS: Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28257500/pediatric-emergency-care-capacity-in-a-low-resource-setting-an-assessment-of-district-hospitals-in-rwanda
#19
Celestin Hategeka, Jean Shoveller, Lisine Tuyisenge, Cynthia Kenyon, David F Cechetto, Larry D Lynd
BACKGROUND: Health system strengthening is crucial to improving infant and child health outcomes in low-resource countries. While the knowledge related to improving newborn and child survival has advanced remarkably over the past few decades, many healthcare systems in such settings remain unable to effectively deliver pediatric advance life support management. With the introduction of the Emergency Triage, Assessment and Treatment plus Admission care (ETAT+)-a locally adapted pediatric advanced life support management program-in Rwandan district hospitals, we undertook this study to assess the extent to which these hospitals are prepared to provide this pediatric advanced life support management...
2017: PloS One
https://www.readbyqxmd.com/read/28247320/nutrient-deficiency-10%C3%A2-years-following-roux-en-y-gastric-bypass-who-s-responsible
#20
J Hunter Mehaffey, Rachel L Mehaffey, Mathew G Mullen, Florence E Turrentine, Steven K Malin, Bruce Schirmer, Andrew M Wolf, Peter T Hallowell
OBJECTIVE(S): Monitoring and prevention of long-term nutrient deficiency after laparoscopic Roux-en-Y gastric bypass (LRYGB) remains ill defined due to limited surgical follow-up after bariatric surgery. This study compared nutrient supplementation as well as surgeon and primary care physician (PCP) follow-up between patients with short-term versus long-term follow-up. METHODS: All patients undergoing LRYGB at a single institution in 2004 (long-term group, n = 281) and 2012-2013 (short-term group, n = 149) were evaluated...
May 2017: Obesity Surgery
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