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Klek S, Del Rio Requejo IM, Hardy G, Francisco LMP, Abbasoglu O, Acosta JCA, Granados LMB, Boeykens K, Carey S, Chourdakis M, Compher C, De Cloet J, Dubrov S, Fuentes C, Sámano AKG, Velasquez MEG, Goos C, Reyes JGG, Joon LV, Klimasauskas A, Komsa R, Krznaric Z, Ljubas D, Moscoso CPM, Larreategui R, Mirea L, Meier R, Nyulasi I, Oivind I, Panisic-Sekeljic M, Poulia KA, Rasmussen HH, Savino P, Singer P, Tamasi P, Uyar M, Thu NVQ, Waitzberg D, Weimann A, Wong T, Yu J, Wojcik P, Schneider S. Global availability of parenteral nutrition: Pre- and post-COVID-19 pandemic surveys. Nutrition 2024; 123:112396. [PMID: 38554461 DOI: 10.1016/j.nut.2024.112396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/04/2024] [Accepted: 02/10/2024] [Indexed: 04/01/2024]
Abstract
OBJECTIVE Parenteral nutrition represents a therapeutic option for patients with type 3 intestinal failure. If used exclusively, parenteral nutrition has to be complete to provide all essential nutrients. The aim was to assess the availability of parenteral nutrition in all parts of the world, to better comprehend the global situation, and to prepare an action plan to increase access to parenteral nutrition. METHODS An international survey using an electronic questionnaire was conducted in August 2019 and repeated in May 2022. An electronic questionnaire was sent to 52 members or affiliates of the International Clinical Nutrition Section of the American Society for Parenteral and Enteral Nutrition. Questions addressed the availability of parenteral nutrition admixtures and their components, reimbursement, and prescribing pre- and post-COVID-19 pandemic. All participating countries were categorized by their economic status. RESULTS Thirty-six country representatives responded, answering all questions. Parenteral nutrition was available in all countries (100%), but in four countries (11.1%) three-chamber bags were the only option, and in six countries a multibottle system was still used. Liver-sparing amino acids were available in 18 (50%), kidney-sparing in eight (22.2%), and electrolyte-free in 11 (30.5%) countries (30.5%). In most countries (n = 28; 79.4%), fat-soluble and water-soluble vitamins were available. Trace elements solutions were unavailable in four (11.1%) countries. Parenteral nutrition was reimbursed in most countries (n = 33; 91.6%). No significant problems due to the coronavirus pandemic were reported. CONCLUSIONS Despite the apparent high availability of parenteral nutrition worldwide, there are some factors that may have a substantial effect on the quality of parenteral nutrition admixtures. These shortages create an environment of inequality.
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Affiliation(s)
- Stanislaw Klek
- Surgical Oncology Clinic, Maria Sklodowska-Curie National Cancer Research Institute, Krakow, Poland.
| | - Isabel Martinez Del Rio Requejo
- Clinical Nutrition Team, Centro Médico Nacional 20 de Noviembre, Institute for Social Security and Services for State Workers (ISSSTE), Mexico City, Mexico
| | - Gil Hardy
- Ipanema Research Trust, Auckland, New Zealand
| | - Liza Mei P Francisco
- Nutrition Support Committee, Asian Hospital and Medical Center, Manila, Philippines
| | - Osman Abbasoglu
- Clinical Nutrition Master's Program, Hacettepe University, Ankara, Turkey
| | | | | | - Kurt Boeykens
- Nutrition Support Team, Vitaz Hospital, Sint-Niklaas, Belgium
| | - Sharon Carey
- Royal Prince Alfred Hospital University, Sydney, Australia
| | - Michael Chourdakis
- School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki Greece
| | - Charlene Compher
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Clinical Nutrition Support Service, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Joeri De Cloet
- Hospital Pharmacy, Ghent University Hospital, Gent, Belgium
| | | | - Catalina Fuentes
- Nutrition Support Team, Internal Medicine Department, Hospital Cliníço de la Fuerza Aérea, Las Condes, Chile; Nutrition Department, School of Medicine, Universidad de Chile, Indepencia, Chile
| | - Ana Karina García Sámano
- Clinical Nutrition Team, Centro Médico Nacional 20 de Noviembre, Institute for Social Security and Services for State Workers (ISSSTE), Mexico City, Mexico
| | | | | | | | - Lee V Joon
- Aseptic Unit, Pharmacy Department, Hospital Sungai Buloh, Kuala Lumpur, Malaysia
| | - Andrius Klimasauskas
- Center of Anaesthesiology, Intensive Therapy and Pain Management, Vilnius University, Vilnius, Lithuania
| | | | | | - Dina Ljubas
- Unit of Clinical Nutrition, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Rosa Larreategui
- Nutritional Support Unit, Ciudad de la Salud, Caja de Seguro Social, Panama City, Panama
| | - Liliana Mirea
- Anaesthesia and Intensive Care Clinic, University of General Medicine, Clinical Emergency Hospital, Bucharest, Romania
| | - Remy Meier
- Gastroenterology Unit, University of Basel, Basel, Switzerland
| | - Ibolya Nyulasi
- La Trobe University, Melbourne, Australia; Monash University, Melbourne, Australia
| | - Irtun Oivind
- Department of Gastroenterological Surgery, University Hospital of North Norway, Tromso, Norway
| | | | - Kalliopi Anna Poulia
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, Athens, Greece
| | - Henrik Højgaard Rasmussen
- Center for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg University, Aalborg, Norway; Dietitians and Nutritional Research Unit, EATEN, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
| | - Patricia Savino
- Centro Latinoamericano de Nutrición (CELAN), Colombian National Academy for Medicine, Bogotá, Colombia
| | - Pierre Singer
- Intensive Care Unit, Herzlia Medical Center, Ramat Gan, Israel; Department of Critical Care, Rabin Medical Center, Petah Tikva, Israel; Institute for Nutrition Research, Beilinson Hospital Israel, Rabin Medical Center, Petah Tikva, Israel; Department of Anesthesia and Critical Care, School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Peter Tamasi
- Intensive Care Unit, Peterfy Hospital, Budapest, Hungary
| | - Mehmet Uyar
- Department of Anesthesiology and Intensive Care, Ege University Hospital, Bornova, Turkey
| | | | - Dan Waitzberg
- Gastroenterology Department, University of São Paulo School of Medicine, São Paulo, Brasil
| | - Arved Weimann
- Department of General, Visceral and Oncological Surgery, Hospital St. George, Leipzig, Germany
| | - Theodoric Wong
- Department of Gastroenterology and Nutrition, Birmingham Women's & Children's, Birmingham, UK
| | - Jianchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Paulina Wojcik
- University Clinical Center, Medical University of Warsaw, Warsaw, Poland
| | - Stephane Schneider
- Gastroenterology and Nutrition, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
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Chaloulakou S, Poulia KA, Karayiannis D. Physiological Alterations in Relation to Space Flight: The Role of Nutrition. Nutrients 2022; 14:nu14224896. [PMID: 36432580 PMCID: PMC9699067 DOI: 10.3390/nu14224896] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Astronauts exhibit several pathophysiological changes due to a variety of stressors related to the space environment, including microgravity, space radiation, isolation, and confinement. Space motion sickness, bone and muscle mass loss, cardiovascular deconditioning and neuro-ocular syndrome are some of the spaceflight-induced effects on human health. Optimal nutrition is of the utmost importance, and-in combination with other measures, such as physical activity and pharmacological treatment-has a key role in mitigating many of the above conditions, including bone and muscle mass loss. Since the beginning of human space exploration, space food has not fully covered astronauts' needs. They often suffer from menu fatigue and present unintentional weight loss, which leads to further alterations. The purpose of this review was to explore the role of nutrition in relation to the pathophysiological effects of spaceflight on the human body.
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Affiliation(s)
- Stavroula Chaloulakou
- Department of Clinical Nutrition, “Evangelismos” General Hospital of Athens, 10676 Athens, Greece
| | - Kalliopi Anna Poulia
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece
| | - Dimitrios Karayiannis
- Department of Clinical Nutrition, “Evangelismos” General Hospital of Athens, 10676 Athens, Greece
- Correspondence: ; Tel.: +30-213-2045035
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Bakaloudi DR, Chrysoula L, Poulia KA, Dounousi E, Liakopoulos V, Chourdakis M. AGREEing on Nutritional Management of Patients with CKD-A Quality Appraisal of the Available Guidelines. Nutrients 2021; 13:nu13020624. [PMID: 33671901 PMCID: PMC7918946 DOI: 10.3390/nu13020624] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 01/19/2023] Open
Abstract
Chronic kidney disease (CKD) is an important public health issue with increasing prevalence worldwide. Several clinical practice guidelines have been recently published regarding the nutritional management of CKD patients. The purpose of the present study is to evaluate the quality of the published guidelines and provide recommendation for future updates. PubMed, Scopus and Google Scholar were searched for relevant guidelines and 11 clinical practice guidelines were finally included. Guidelines developed by the American Society for Parenteral and Enteral nutrition (ASPEN), the Dietitians Association of Australia (DAA), the German Society for Nutritional Medicine (DGEM), the European Best Practice Guidelines (EBPG), the European Dialysis and Transplantation Nurses Association-European Renal Care Association (EDTNA-ERCA), the European Society for Clinical Nutrition and Metabolism (ESPEN), the Andalusian Group for Nutrition Reflection and Investigation (GARIN) group, the National Kidney foundation-Kidney Disease Outcomes Quality Initiative (KDOQI), the Italian Society of Nephrology-Association of Dieticians-Italian Association of Hemodialysis, Dialysis and Transplant (SIN-ANDID-ANED), and the Renal Association were assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. Guidelines by KDOQI, ESPEN, and DAA were of moderate quality and the rest of them were low-quality guidelines. Our study demonstrates gaps related to the development of guidelines and therefore greater emphasis on methodological approaches is recommended. AGREE II tool can be useful to improve quality of guidelines.
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Affiliation(s)
- Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (L.C.); (M.C.)
| | - Lydia Chrysoula
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (L.C.); (M.C.)
| | - Kalliopi Anna Poulia
- Department of Nutrition and Dietetics, Laiko General Hospital, 11527 Athens, Greece;
| | - Evangelia Dounousi
- Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-2310-994694
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (L.C.); (M.C.)
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Kakavas S, Karayiannis D, Bouloubasi Z, Poulia KA, Kompogiorgas S, Konstantinou D, Vougas V. Global Leadership Initiative on Malnutrition Criteria Predict Pulmonary Complications and 90-Day Mortality after Major Abdominal Surgery in Cancer Patients. Nutrients 2020; 12:nu12123726. [PMID: 33287107 PMCID: PMC7761640 DOI: 10.3390/nu12123726] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 12/11/2022] Open
Abstract
Although several studies have reported an association between malnutrition and the risk of severe complications after abdominal surgery, there have been no studies evaluating the use of Global Leadership Initiative on Malnutrition (GLIM) criteria for predicting postoperative pulmonary complications (PPCs) following major abdominal surgery in cancer patients. This study aimed to investigate the association among the diagnosis of malnutrition by GLIM criteria, PPCs risk and 90-day all-cause mortality rate following major abdominal surgery in cancer patients. We prospectively analyzed 218 patients (45% male, mean age 70.6 ± 11.2 years) with gastrointestinal cancer who underwent major abdominal surgery at our hospital between October 2018 and December 2019. Patients were assessed preoperatively using GLIM criteria of malnutrition, and 90-day all-cause mortality and PPCs were recorded. In total, 70 patients (32.1%) were identified as malnourished according to GLIM criteria, of whom 41.1% fulfilled the criteria for moderate and 12.6% for severe malnutrition. PPCs were detected in 48 of 218 patients (22%) who underwent major abdominal surgery. Univariate logistic regression analysis revealed that the diagnosis of malnutrition was significantly associated with the risk of PPCs. Furthermore, in multivariate model analysis adjusted for other clinical confounding factors, malnutrition remained an independent factor associated with the risk of PPCs (RR = 1.82; CI = 1.21–2.73) and 90-day all-cause mortality (RR = 1.97; CI = 1.28–2.63, for severely malnourished patients). In conclusion, preoperative presence of malnutrition, diagnosed by the use of GLIM criteria, is associated with the risk of PPCs and 90-day mortality rate in cancer patients undergoing major abdominal surgery.
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Affiliation(s)
- Sotirios Kakavas
- 1st Pulmonary Department, Evangelismos General Hospital of Athens, Ypsilantou 45-47, 10676 Athens, Greece; (S.K.); (S.K.)
| | - Dimitrios Karayiannis
- Department of Clinical Nutrition, Evangelismos General Hospital of Athens, Ypsilantou 45-47, 10676 Athens, Greece;
- Correspondence: ; Tel.: +3-021-320-450-35; Fax: +3-021-320-413-85
| | - Zoi Bouloubasi
- Department of Clinical Nutrition, Evangelismos General Hospital of Athens, Ypsilantou 45-47, 10676 Athens, Greece;
| | - Kalliopi Anna Poulia
- Department of Nutrition and Dietetics, Laiko General Hospital, 11527 Athens, Greece;
| | - Steven Kompogiorgas
- 1st Pulmonary Department, Evangelismos General Hospital of Athens, Ypsilantou 45-47, 10676 Athens, Greece; (S.K.); (S.K.)
| | - Dimitrios Konstantinou
- Transplant Unit, 1st Department of Surgery, Evangelismos General Hospital of Athens, 10676 Athens, Greece; (D.K.); (V.V.)
| | - Vasileios Vougas
- Transplant Unit, 1st Department of Surgery, Evangelismos General Hospital of Athens, 10676 Athens, Greece; (D.K.); (V.V.)
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Bakaloudi DR, Siargkas A, Poulia KA, Dounousi E, Chourdakis M. The Effect of Exercise on Nutritional Status and Body Composition in Hemodialysis: A Systematic Review. Nutrients 2020; 12:E3071. [PMID: 33050111 PMCID: PMC7601723 DOI: 10.3390/nu12103071] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/27/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023] Open
Abstract
Chronic kidney disease (CKD) is associated with aggravating factors which can affect both body composition and nutritional status. The purpose of the present systematic review was to investigate the potential effects of any physical activity on body composition or nutritional status among patients with stage 5 CKD undergoing hemodialysis (HD). A literature search on PubMed, Scopus, Web of Science, Google Scholar, and Cochrane was conducted and 14 randomized clinical trials were included. Skeletal muscle index and mid-arm muscular circumference increased after resistance exercise, and the results on body mass index, % body fat, and lean body mass varied. Serum albumin and C-reactive protein, in most cases, showed a slight increase and decrease, respectively. An improvement was also observed in body strength and overall performance status. The results suggest that physical activity can be beneficial for both the body composition and nutritional status of patients undergoing HD and can help in the prevention of sarcopenia. However, further research is needed mainly in the field of nutritional status.
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Affiliation(s)
- Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (A.S.)
| | - Antonios Siargkas
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (A.S.)
| | - Kalliopi Anna Poulia
- Department of Nutrition and Dietetics, Laiko General Hospital, 11527 Athens, Greece;
| | - Evangelia Dounousi
- Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (A.S.)
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Kontogianni MD, Poulia KA, Bersimis F, Sulz I, Schindler K, Hiesmayr M, Chourdakis M. Exploring factors influencing dietary intake during hospitalization: Results from analyzing nutritionDay's database (2006–2013). Clin Nutr ESPEN 2020; 38:263-270. [DOI: 10.1016/j.clnesp.2020.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
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Poulia KA, Sarantis P, Antoniadou D, Koustas E, Papadimitropoulou A, Papavassiliou AG, Karamouzis MV. Pancreatic Cancer and Cachexia-Metabolic Mechanisms and Novel Insights. Nutrients 2020; 12:E1543. [PMID: 32466362 PMCID: PMC7352917 DOI: 10.3390/nu12061543] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/15/2020] [Accepted: 05/25/2020] [Indexed: 02/06/2023] Open
Abstract
Cachexia is a major characteristic of multiple non-malignant diseases, advanced and metastatic cancers and it is highly prevalent in pancreatic cancer, affecting almost 70-80% of the patients. Cancer cachexia is a multifactorial condition accompanied by compromised appetite and changes in body composition, i.e., loss of fat. It is associated with lower effectiveness of treatment, compromised quality of life, and higher mortality. Understanding the complex pathways underlying the pathophysiology of cancer cachexia, new therapeutic targets will be unraveled. The interplay between tumor and host factors, such as cytokines, holds a central role in cachexia pathophysiology. Cytokines are possibly responsible for anorexia, hypermetabolism, muscle proteolysis, and apoptosis. In particular, cachexia in pancreatic cancer might be the result of the surgical removal of pancreas parts. In recent years, many studies have been carried out to identify an effective treatment algorithm for cachexia. Choosing the most appropriate treatment, the clinical effect and the risk of adverse effects should be taken under consideration. The purpose of this review is to highlight the pathophysiological mechanisms as well as the current ways of cachexia treatment in the pharmaceutical and the nutrition field.
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Affiliation(s)
- Kalliopi Anna Poulia
- Department of Nutrition and Dietetics, Laiko General Hospital, 11527 Athens, Greece;
| | - Panagiotis Sarantis
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.S.); (E.K.); (A.G.P.)
| | - Dimitra Antoniadou
- Oncology Department of Daily Hospitality, Laiko General Hospital, 11527 Athens, Greece;
| | - Evangelos Koustas
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.S.); (E.K.); (A.G.P.)
| | - Adriana Papadimitropoulou
- Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece;
| | - Athanasios G. Papavassiliou
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.S.); (E.K.); (A.G.P.)
| | - Michalis V. Karamouzis
- Molecular Oncology Unit, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.S.); (E.K.); (A.G.P.)
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Chourdakis M, Grammatikopoulou MG, Poulia KA, Passakiotou M, Pafili ZK, Bouras E, Doundoulakis I, Galitsianos I, Lappa T, Karakatsanis A, Heyland DK. Translation of the modified NUTRIC score and adaptation to the Greek ICU setting. Clin Nutr ESPEN 2019; 29:72-76. [DOI: 10.1016/j.clnesp.2018.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 12/05/2018] [Indexed: 01/04/2023]
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Doundoulakis I, Poulia KA, Antza C, Bouras E, Kasapidou E, Klek S, Chourdakis M. Screening for Malnutrition Among People Accessing Health Services at Greek Public Hospitals: Results From an Observational Multicenter Study. JPEN J Parenter Enteral Nutr 2017; 42:709-718. [DOI: 10.1177/0148607117722748] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/30/2017] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Christina Antza
- Third Department of Internal Medicine, Aristotle University, Papageorgiou Hospital, Thessaloniki, Greece
| | - Emmanouil Bouras
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eirini Kasapidou
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stanislaw Klek
- General and Oncology Surgery Unit, Stanley Dudrick’s Memorial Hospital, Skawina, Poland
| | - Michael Chourdakis
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Klek S, Chourdakis M, Bischoff S, Dubrov S, Forbes A, Galas A, Genton L, Gundogdu HR, Irtun O, Jagmane I, Jakobson-Forbes T, Jirka A, Kennedy N, Klimasauskas A, Khoroshilov I, Leon-Sanz M, Muscaritoli M, Panisic-Sekeljic M, Poulia KA, Schneider S, Siljamäki-Ojansuu U, Uyar M, Wanten G, Krznaric Z. Economy matters to fight against malnutrition: Results from a multicenter survey. Clin Nutr 2015; 36:162-169. [PMID: 26586302 DOI: 10.1016/j.clnu.2015.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 09/24/2015] [Accepted: 10/20/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIM Malnutrition represents a serious health care threat, as it increases morbidity, mortality and health care cost. The effective screening and treatment with enteral (EN) or parenteral (PN) nutrition are the key elements of the policy called Optimal Nutrition Care for All (ONCA). The study tried to analyze the impact of the state's economy on the implementation of EN and PN to define its role in ONCA. MATERIAL AND METHODS an international survey in twenty two European countries was performed between January and December 2014. An electronic questionnaire was distributed to 22 representatives of clinical nutrition (PEN) societies. The questionnaire comprised questions regarding country economy, reimbursement, education and the use EN and PN. Return rate was 90.1% (n = 20). RESULTS EN and PN were used in all countries surveyed (100%), but to different extent. The country's income significantly influenced the reimbursement for EN and PN (p < 0.05). It was also associated with the overall use of tube feeding and PN (p = 0.05), but not with the use of oral nutritional supplements (p = 0.165). The use of both, EN and PN at hospitals was not depended on the economy (p > 0.05). Education was actively carried out in all countries, however the teaching at the pre-graduate level was the least widespread, and also correlated with the country income (p = 0.042). CONCLUSIONS Results indicated that economic situation influences all aspects of ONCA, including education and treatment. The reimbursement for EN and PN seemed to be the key factor of effective campaign against malnutrition.
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Affiliation(s)
- Stanislaw Klek
- Stanley Dudrick's Memorial Hospital, General Surgery Unit, Skawina, Poland.
| | | | - Stephan Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Sergiej Dubrov
- National O. Bohomolets Medical University, Department of Anesthesiology and Intensive Care, Kyiv, Ukraine
| | - Alastair Forbes
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Aleksander Galas
- Jagiellonian University Medical College, Chair of Epidemiology and Preventive Medicine, Department of Epidemiology, Krakow, Poland
| | - Laurence Genton
- Clinical Nutrition, University Hospital, Geneva, Switzerland
| | - Haldun R Gundogdu
- General Surgery and Gastrointestinal Surgery Atatürk Teaching and Research Hospital, Ankara, Turkey
| | - Oivind Irtun
- Gastrosurgery Research Group, UiT The Arctic University of Norway and Division of Surgery, Oncology and Women's Health, University Hospital of North Norway, Norway
| | - Ilze Jagmane
- The Riga East Clinical University Hospital, Riga, Latvia
| | - Triin Jakobson-Forbes
- Tartu University Hospital, Anaesthesiology and Intensive Care Clinic, Tartu, Estonia
| | - Adam Jirka
- Kralovske Vinohrady University Hospital, Internal Medicine Department, Prague, Czech Republic
| | | | - Andrius Klimasauskas
- Vilnius University, Medical Faculty, Clinic of Anaesthesiology and Reanimatology, Vilnius, Lithuania
| | - Igor Khoroshilov
- North-Western State Medical University named after I.I.Mechnikoff, Saint-Petersburg, Russian Federation
| | - Miguel Leon-Sanz
- Servicio de Endocrinologia y Nutrition, Hospital Universitatrio 12 de Octubre, Madrid, Spain
| | | | - Marina Panisic-Sekeljic
- Medical Academy University Clinic for General Surgery Department for Perioperative Nutrition, Belgrade, Serbia
| | | | - Stephane Schneider
- Gastroenterology and Nutrition, Archet University Hospital, Nice, France
| | | | - Mehmet Uyar
- Ege University Hospital, Department of Anesthesiology and Intensive Care, Izmir, Turkey
| | - Geert Wanten
- Radboud University Medical Center, Nijmegen, The Netherlands
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Tsirigoti L, Kontogianni MD, Darema M, Iatridi V, Altanis N, Poulia KA, Zavos G, Boletis J. Exploring associations between anthropometric indices and graft function in patients receiving renal transplant. J Hum Nutr Diet 2014; 29:52-8. [PMID: 25522813 DOI: 10.1111/jhn.12289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of the present study was to identify indicators of malnutrition, as obtained by anthropometric measurements, that might be potential predictors of transplant outcomes. METHODS One hundred and three patients receiving a graft from a living or a deceased donor were included in this prospective study. Body mass index (BMI) based on pretransplant dry body weight, triceps skinfold, mid-arm muscle circumference and corrected mid-arm muscle area were measured. Post-transplant data on delayed graft function (DGF) and glomerular filtration rate (GFR) at discharge were collected until patient discharge. RESULTS Delayed graft function developed in 36.9% of the patients. BMI was the only anthropometric variable associated with a higher likelihood of DGF (odds ratio = 1.25, 95% confidence interval = 1.07-1.47) after adjusting for age, gender, donor group, donor age and years of dialysis before transplantation. Obesity was associated with a higher frequency of DGF (83.3% versus 31.1%, P = 0.001) compared to normal weight. GFR at discharge was negatively associated with BMI [β = -0.014 (0.005), P = 0.004], being overweight [β = -0.151 (0.041), P < 0.001] and obesity [β = -0.188 (0.053), P = 0.001], after adjusting for age, gender, donor group, donor age and years of dialysis, but was not associated with indices of muscle reserves. CONCLUSIONS The likelihood of DGF was higher among obese patients, whereas GFR at discharge was negatively associated with being overweight and obesity.
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Affiliation(s)
- L Tsirigoti
- Department of Nutrition & Dietetics, Harokopio University, Athens, Greece
| | - M D Kontogianni
- Department of Nutrition & Dietetics, Harokopio University, Athens, Greece
| | - M Darema
- Department of Nephrology & Transplantation Unit, Laiko Hospital, Athens, Greece
| | - V Iatridi
- Department of Nutrition & Dietetics, Harokopio University, Athens, Greece
| | - N Altanis
- Department of Nephrology & Transplantation Unit, Laiko Hospital, Athens, Greece
| | - K A Poulia
- Department of Nutrition & Dietetics, Laiko Hospital, Athens, Greece
| | - G Zavos
- Transplantation Unit, Laiko Hospital, Athens, Greece
| | - J Boletis
- Department of Nephrology & Transplantation Unit, Laiko Hospital, Athens, Greece
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Klek S, Krznaric Z, Gundogdu RH, Chourdakis M, Kekstas G, Jakobson T, Paluszkiewicz P, Vranesic Bender D, Uyar M, Demirag K, Poulia KA, Klimasauskas A, Starkopf J, Galas A. Prevalence of malnutrition in various political, economic, and geographic settings. JPEN J Parenter Enteral Nutr 2013; 39:200-10. [PMID: 24190900 DOI: 10.1177/0148607113505860] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Disease-related malnutrition (DRM) represents a critical public health concern. Therefore, Fight Against Malnutrition (FAM) should be a state priority, but the degree to which this is true appears to differ considerably among European countries. The aim of this study was to put the problem into perspective by comparing the prevalence of malnutrition in countries from opposite parts of the continent. METHODS Six countries-Croatia, Estonia, Greece, Lithuania, Poland, and Turkey-participated in the study. A short questionnaire was used to assess DRM: its prevalence, the current situation in hospitals, regulations for reimbursement, and general healthcare circumstances. Data from ESPEN's NutritionDay 2006 were used to broaden the perspective. RESULTS At admission in October 2012, 4068 patients were assessed. The study was performed in 160 hospitals and 225 units with 9143 beds. The highest proportions of patients with 3 or more points on the Nutritional Risk Screening 2002 were observed in Estonia (80.4%) and Turkey (39.4%), whereas the lowest were in Lithuania (14.2%). The provision of nutrition support was best in Turkey (39.4% required intervention, 34.4% received intervention) and Poland (21.9% and 27.8%, respectively). Nutrition support teams (NSTs) are active in some countries, whereas in others they virtually do not exist. CONCLUSION The prevalence of malnutrition was quite high in some countries, and the nutrition approach differed among them. It could be the result of the lack of reimbursement, inactive or nonexistent NSTs, and low nutrition awareness. Those facts confirmed that the continuation of FAM activities is necessary.
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Affiliation(s)
- Stanislaw Klek
- General Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland
| | | | - Riza Haldun Gundogdu
- General Surgery and Gastrointestinal Surgery, Atatürk Teaching and Research Hospital, Ankara, Turkey
| | | | - Gintautas Kekstas
- Vilnius University Hospital Clinic of Anaesthesia and ICU, Vilnius, Lithuania
| | - Triin Jakobson
- Anaesthesiology and Intensive Care Clinic, Tartu University Hospital, Tartu, Estonia
| | - Piotr Paluszkiewicz
- Department of Gastrointestinal Surgery, Lublin Regional Cancer Centre, and Department of Surgery and Surgical Nursing, Medical University, Lublin, Poland
| | | | - Mehmet Uyar
- Department of Anesthesiology and Intensive Care, Ege University Hospital, Izmir, Turkey
| | - Kubilay Demirag
- Department of Anesthesiology and Intensive Care, Ege University Hospital, Izmir, Turkey
| | | | | | - Joel Starkopf
- Anaesthesiology and Intensive Care Clinic, Tartu University Hospital, Tartu, Estonia
| | - Aleksander Galas
- Department of Epidemiology, Jagiellonian University Medical College, Krakow, Poland
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