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Nutritional support and complications

Brent C Lampert
Left ventricular assist devices (LVADs) improve survival in select advanced heart failure patients and rates of LVAD implantation are growing. LVAD support carries significant morbidity and mortality with the greatest risk in the perioperative period. Strategies have evolved to minimize this risk. Medical and mechanical support is used for right and left ventricular optimization. Other strategies emphasize improving nutrition, hematologic abnormalities, infection risk, and renal function. Intraoperative approaches highlight anesthesia-related issues, management of concomitant valve disease, right ventricular failure, and weaning from cardiopulmonary bypass...
November 2018: Cardiology Clinics
Nedim Ongun
OBJECTIVES: The aim of this study was to determine the relationship between nutritional status and Parkinson's Disease (PD) features in association with depression, anxiety and quality of life in people with PD. MATERIALS AND METHODS: This study was conducted on 96 patients with idiopathic PD to whom the following scales were applied: Unified Parkinson's Disease Rating Scale (UPDRS), 39-item PD questionnaire (PDQ-39), Hospital Anxiety and Depression Score (HADS), Mini Nutritional Assessment (MNA)...
2018: PloS One
Hiroshi Fukushima, Kosuke Takemura, Hiroaki Suzuki, Fumitaka Koga
Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, indicates patient frailty and impaired physical function. Sarcopenia can be caused by multiple factors, including advanced age, lack of exercise, poor nutritional status, inflammatory diseases, endocrine diseases, and malignancies. In patients with cancer cachexia, anorexia, poor nutrition and systemic inflammation make the metabolic state more catabolic, resulting in sarcopenia. Thus, sarcopenia is considered as one of manifestations of cancer cachexia...
October 1, 2018: International Journal of Molecular Sciences
Noriko Wada, Yukinori Kurokawa, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Hiroshi Wada, Makoto Yamasaki, Makoto Yamasaki, Kiyokazu Nakajima, Hidetoshi Eguchi, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
Although beta-hydroxy-beta-methylbutyrate (HMB), arginine (Arg), and glutamine (Gln) may contribute to wound healing, no prospective studies have investigated the efficacy of a compound consisting of HMB, Arg, and Gln (HMB/Arg/Gln) for reducing wound complications following open abdominal surgery. OBJECTIVE: This study evaluates the usefulness of perioperative nutrition using HMB/Arg/Gln in patients who were scheduled to undergo open surgery for abdominal malignancies in a randomized controlled trial...
September 2018: Wounds: a Compendium of Clinical Research and Practice
Keith I Block, Penny B Block, Charlotte Gyllenhaal
A comprehensive approach to integrative treatment of colorectal cancer (CRC) patients involves three spheres of intervention: lifestyle, biology, and conventional treatment. Individualization of treatment is emphasized. The lifestyle sphere includes nutritional therapies, biobehavioral strategies with circadian interventions, and physical care modalities. The biology sphere comprises six host factors in the patient's internal biochemical environment or "terrain": inflammation, glycemia, oxidative stress, immune dysregulation, coagulopathy, and stress chemistries...
September 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
D Soma, Y I Kawamura, S Yamashita, H Wake, K Nohara, K Yamada, N Kokudo
Surgery for esophageal carcinoma is known to be associated with high morbidity. Recent studies have reported a correlation of nutritional and inflammatory parameters with postoperative course. This study aims to clarify the risk factors for operative morbidity after resection of esophageal carcinoma. Consecutive patients who underwent esophagectomy for esophageal squamous cell carcinoma at our institute were included (n = 102; 89 males and 13 females; mean age: 67.3 years). Clinicopathological characteristics, presence or absence of sarcopenia, and modified Glasgow prognostic score were assessed, and their correlation with postoperative complications was investigated using univariate and multivariate analyses...
September 17, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Emma Osland, Breda Memon, Muhammed Ashraf Memon
The last 25 years have seen an increasing number of publications attesting the benefits of pharmaconutrition in the management of patients undergoing elective oncological gastrointestinal surgery. A number of randomized controlled trials and meta-analyses suggest the use of pharmaconutrition in this group of patients produces superior outcomes to standard nutritional formulations in terms of postoperative infective complications, anastomotic breakdown and length of hospital stay. The use of pharmaconutrition products, therefore, has gained increasing acceptance for use in elective gastrointestinal oncological surgical populations and been incorporated into practice guidelines...
2018: Translational Gastroenterology and Hepatology
Norberto Perico, David Askenazi, Monica Cortinovis, Giuseppe Remuzzi
Acute kidney injury (AKI) is a common and life-threatening complication in critically ill neonates. Gestational risk factors for AKI include premature birth, intrauterine growth restriction and low birthweight, which are associated with poor nephron development and are often the consequence of pre-gestational and gestational factors, such as poor nutritional status. Our understanding of how to best optimize renal development and prevent AKI is in its infancy; however, the identification of pre-gestational and gestational factors that increase the risk of adverse neonatal outcomes and the implementation of interventions, such as improving nutritional status early in pregnancy, have the potential to optimize fetal growth and reduce the risk of preterm birth, thereby improving kidney health...
September 17, 2018: Nature Reviews. Nephrology
Hong Pu, Gordon S Doig, Philippa T Heighes, Matilde J Allingstrup
OBJECTIVES: To identify, appraise, and synthesize current evidence to determine whether early enteral nutrition alters patient outcomes from major burn injury. DATA SOURCES: Medline, Embase, and the China National Knowledge Infrastructure were searched. The close out date was May 1, 2018. STUDY SELECTION: Early enteral nutrition was defined as a standard formula commenced within 24 hours of injury or admission to ICU or burn unit. Comparators included any form of nutrition support "except" early enteral nutrition...
September 14, 2018: Critical Care Medicine
Chandrika Kumar, Brooke Salzman, Jessica L Colburn
Surgical outcomes are significantly influenced by patients' overall health, function, and life expectancy. A comprehensive geriatric preoperative assessment of older adults requires expanding beyond an organ-based or disease-based assessment. At a preoperative visit, it is important to establish the patient's goals and preferences, and to determine whether the risks and benefits of surgery match these goals and preferences. These discussions should cover the possibility of resuscitation and ventilator support, prolonged rehabilitation, and loss of independence...
August 15, 2018: American Family Physician
Ming Chi, Ya-Bo Mei, Zhi-Chun Feng
Acute respiratory distress syndrome (ARDS) is a common clinical critical disease and is one of the main causes of death and disability in neonates. The etiology and pathogenesis of neonatal ARDS are complicated. It is an acute pulmonary inflammatory disease caused by the lack of pulmonary surfactant (PS) related to various pathological factors. It is difficult to distinguish neonatal ARDS from other diseases. At present, there is no specific treatment method for this disease. Respiratory support, PS replacement, extracorporeal membrane oxygenation, nutrition support and liquid management are main treatment strategies...
September 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Seema Mihrshahi, Megan L Gow, Louise A Baur
Of the 34 member countries of the Organisation for Economic Co-operation and Development, obesity prevalence is highest in the United States, with Australia ranking fifth for girls and eighth for boys. Curbing the problem is achievable and can be realised through a combination of smart governance across many sectors, community initiatives, the support of individual efforts, and clinical leadership. At 5 years of age, one in five Australian children are already affected by overweight or obesity; obesity prevention strategies must therefore start before this age...
September 17, 2018: Medical Journal of Australia
Anna Wiernicka, Małgorzata Matuszczyk, Agnieszka Szlagatys-Sidorkiewicz, Piotr Landowski, Ewa Toporowska-Kowalska, Beata Gębora-Kowalska, Katarzyna Popińska, Marta Sibilska, Urszula Grzybowska-Chlebowczyk, Sabina Więcek, Ewa Hapyn, Karolina Blimke-Kozieł, Jarosław Kierkuś
BACKGROUND & AIMS: We assessed the tolerability and safety of implementing early enteral nutrition in children at 3 h after percutaneous endoscopic gastrostomy (PEG) placement to establish an optimum feeding mode in paediatric patients that reduced the fasting period, the inadequate nutritional support interval, and the hospitalisation time. METHODS: Children with clinical indications for PEG placement were recruited from six medical centres in Poland to participate in the study...
August 28, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Johannes Kufeldt, Marén Viehrig, Daniela Schweikert, Andreas Fritsche, Michael Bamberg, Michael Adolph
PURPOSE: The nutritional status of inpatients influences the therapeutic outcome. Malnutrition is a common comorbidity in oncological patients. Both radio- and radiochemotherapy may contribute to the additional deterioration of the nutritional status. The aim of this study was to evaluate the impact of specialized treatment of malnutrition as a clinical routine. METHODS: The nutritional status of inpatients was assessed by the Nutritional risk screening (NRS-2002) on the day of admission to the University Department of Radiation Oncology...
September 4, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Zhuoshi Zhang, John Monro, Bernard J Venn
Despite availability of diabetes and nutrition information for people with pre- and type 2 diabetes, the uptake and understanding of these resources may differ among ethnic groups. Our objective was to explore dietary knowledge and diabetes experiences amongst Māori, European, Pacific Island, Indian and East Asian people living in New Zealand with a focus on carbohydrate-containing foods. A registered diabetes dietitian led ethnic-specific discussions in groups involving 29 people with pre- or type 2 diabetes...
September 4, 2018: Nutrients
Maria Vasco, Rossella Paolillo, Concetta Schiano, Linda Sommese, Oreste Cuomo, Claudio Napoli
BACKGROUND: Patients with end-stage liver disease (ESLD) have a compromised nutritional status because of the liver crucial role in regulating metabolic homeostasis and energy balance. DATA SOURCES: A systematic review of literature based on extensive relevant articles published from 2001 to 2017 in English in PubMed database was performed by searching keywords such as liver disease, non-alcoholic liver disease, alcoholic liver disease, malnutrition, epigenetics, gut microbiota, and probiotics...
August 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Anna Palatnik, Matthew Loichinger, Amy Wagner, Erika Peterson
OBJECTIVE: The objective of this study was to examine the association between gestational age at delivery and closure type for neonates with gastroschisis. In addition, we compared perinatal outcomes among the cases of gastroschisis based on the following two factors: gestational age at delivery and abdominal wall closure technique. METHODS: This was a retrospective cohort study of all fetuses with isolated gastroschisis that were diagnosed prenatally and delivered between September 2000 and January 2017, in a single tertiary care center...
October 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
Jonathan C K Wells, Jane E Williams, Rina Y Quek, Mary S Fewtrell
BACKGROUND/OBJECTIVES: Bio-electrical impedance (BI) analysis is a simple body composition method ideal for children. However, its utility in sick or malnourished children is complicated by variability in hydration. BI vector analysis (BIVA) potentially resolves this, using a theoretical model that differentiates hydration from cell mass. We tested this model against reference methods in healthy children varying widely in age and nutritional status. SUBJECTS/METHODS: We compiled body composition data from 291 children and adolescents (50% male) aged 4-20 years of European ancestry...
August 30, 2018: European Journal of Clinical Nutrition
Roland N Dickerson
Adiposity-based chronic disease, critical illness, and nutrition therapy increase the risk for overfeeding and worsened nutritional and clinical outcomes. Hypocaloric, high-protein nutrition therapy provides critically ill obese patients the opportunity to achieve net protein anabolism with a reduced risk for overfeeding-related complications. The intent of this review is to discuss the impact of obesity on clinical outcomes, describe the consequences of obesity that increase complications associated with nutrition therapy, provide the framework to develop a hypocaloric, high-protein regimen, review the scientific evidence to support this mode of therapy, and discuss its limitations...
June 7, 2018: Nutrition
Michael J Minarich, Roderich E Schwarz
Background: Background: Perioperative nutrition support has been shown to impact on outcomes for patients with gastrointestinal cancer. Postoperative benefits of feeding tubes must be weighed against morbidity related to placement and use. A simplified jejunostomy tube technique was evaluated for outcomes. Methods: A 16-Fr rubber tube is secured at the jejunal entry site without Witzel tunnel, followed by a continuous, circumferential and alternating suture between jejunal wall and parietal peritoneum...
2018: Translational Gastroenterology and Hepatology
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