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Bischoff SC, Bager P, Escher J, Forbes A, Hébuterne X, Hvas CL, Joly F, Klek S, Krznaric Z, Ockenga J, Schneider S, Shamir R, Stardelova K, Bender DV, Wierdsma N, Weimann A. ESPEN guideline on Clinical Nutrition in inflammatory bowel disease. Clin Nutr 2023; 42:352-379. [PMID: 36739756 DOI: 10.1016/j.clnu.2022.12.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 01/15/2023]
Abstract
The present guideline is an update and extension of the ESPEN scientific guideline on Clinical Nutrition in Inflammatory Bowel Disease published first in 2017. The guideline has been rearranged according to the ESPEN practical guideline on Clinical Nutrition in Inflammatory Bowel Disease published in 2020. All recommendations have been checked and, if needed, revised based on new literature, before they underwent the ESPEN consensus procedure. Moreover, a new chapter on microbiota modulation as a new option in IBD treatment has been added. The number of recommendations has been increased to 71 recommendations in the guideline update. The guideline is aimed at professionals working in clinical practice, either in hospitals or in outpatient medicine, and treating patients with IBD. General aspects of care in patients with IBD, and specific aspects during active disease and in remission are addressed. All recommendations are equipped with evidence grades, consensus rates, short commentaries and links to cited literature.
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Affiliation(s)
- Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Palle Bager
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
| | - Johanna Escher
- Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
| | - Alastair Forbes
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
| | - Xavier Hébuterne
- Department of Gastroenterology and Clinical Nutrition, CHU of Nice, University Côte d'Azur, Nice, France.
| | - Christian Lodberg Hvas
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
| | - Francisca Joly
- Department of Gastroenterology and Nutrition Support, CHU de Beaujon, APHP, University of Paris, Paris, France.
| | - Stansilaw Klek
- Surgical Oncology Clinic, Maria Sklodowska-Curie National Cancer Institute, Krakow, Poland.
| | - Zeljko Krznaric
- Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre Zagreb, University of Zagreb, Croatia.
| | - Johann Ockenga
- Medizinische Klinik II, Klinikum Bremen-Mitte, Bremen FRG, Bremen, Germany.
| | - Stéphane Schneider
- Department of Gastroenterology and Clinical Nutrition, CHU de Nice, University Côte d'Azur, Nice, France.
| | - Raanan Shamir
- Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Kalina Stardelova
- University Clinic for Gastroenterohepatology, Clinical Campus "Mother Theresa", University St Cyrul and Methodius, Skopje, North Macedonia.
| | - Darija Vranesic Bender
- Unit of Clinical Nutrition, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Nicolette Wierdsma
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
| | - Arved Weimann
- Department of General, Visceral and Oncological Surgery, St. George Hospital, Leipzig, Germany.
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Pradelli L, Mayer K, Klek S, Omar Alsaleh A, Rosenthal M, Heller A, Muscaritoli M. SUN-LB640: Omega-3 Fatty-Acid Enriched Parenteral Nutrition Regimens in Hospitalized Patients in EU5 Countries: A Pharmacoeconomic Analysis. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32606-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pietka M, Sumlet M, Sczepanek K, Klek S. MON-PO421: Diagnosis and Management of Catheter-Related Bloodstream Infection (CRBSI) During Home Parenteral Nutrition (HPN). Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32254-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pietka M, Sumlet M, Sczepanek K, Klek S. MON-PO422: Assessment of Empirical Antibiotic Therapy for Catheter-Related Bloodstream Infection (CRBSI) During Home Parenteral Nutrition (HPN). Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32255-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pietka M, Olejko A, Sczepanek K, Klek S. MON-PO420: The Frequency of Prescription’s Modifications During Home Parenteral Nutrition (HPN). Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32253-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Klek S, Pisarska M, Cegielny T, Choruz R, Salowka J, Szybinski P, Pedziwiatr M. MON-PO604: Early Closure of the Protective Ileostomy After Rectal Resection Does not Deteriorate the Function of Gastrointestinal Tract. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32437-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Coelho Barata P, Mendiratta P, Sadaps M, Klek S, Ornstein M, Gilligan T, Grivas P, Rini B, Sohal D, Garcia J. The clinical impact of targeted next generation sequencing (tNGS) in the treatment of metastatic prostate cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pietka M, Klek S, Szczepanek K. Assurance of the microbial safety of parenteral nutrition admixtures. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Barata PC, Koshkin VS, Funchain P, Sohal D, Pritchard A, Klek S, Adamowicz T, Gopalakrishnan D, Garcia J, Rini B, Grivas P. Next-generation sequencing (NGS) of cell-free circulating tumor DNA and tumor tissue in patients with advanced urothelial cancer: a pilot assessment of concordance. Ann Oncol 2018; 28:2458-2463. [PMID: 28945843 DOI: 10.1093/annonc/mdx405] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [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: 01/04/2023] Open
Abstract
Background Advances in cancer genome sequencing have led to the development of various next-generation sequencing (NGS) platforms. There is paucity of data regarding concordance of different NGS tests carried out in the same patient. Methods Here, we report a pilot analysis of 22 patients with metastatic urinary tract cancer and available NGS data from paired tumor tissue [FoundationOne (F1)] and cell-free circulating tumor DNA (ctDNA) [Guardant360 (G360)]. Results The median time between the diagnosis of stage IV disease and the first genomic test was 23.5 days (0-767), after a median number of 0 (0-3) prior systemic lines of treatment of advanced disease. Most frequent genomic alterations (GA) were found in the genes TP53 (50.0%), TERT promoter (36.3%); ARID1 (29.5%); FGFR2/3 (20.5%), PIK3CA (20.5%) and ERBB2 (18.2%). While we identified GA in both tests, the overall concordance between the two platforms was only 16.4% (0%-50%), and 17.1% (0%-50%) for those patients (n = 6) with both tests conducted around the same time (median difference = 36 days). On the contrary, in the subgroup of patients (n = 5) with repeated NGS in ctDNA after a median of 1 systemic therapy between the two tests, average concordance was 55.5% (12.1%-100.0%). Tumor tissue mutational burden was significantly associated with number of GA in G360 report (P < 0.001), number of known GA (P = 0.009) and number of variants of unknown significance (VUS) in F1 report (P < 0.001), and with total number of GA (non-VUS and VUS) in F1 report (P < 0.001). Conclusions This study suggests a significant discordance between clinically available NGS panels in advanced urothelial cancer, even when collected around the same time. There is a need for better understanding of these two possibly complementary NGS platforms for better integration into clinical practice.
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Affiliation(s)
- P C Barata
- Department of Hematology & Medical Oncology, Taussig Cancer Institute
| | - V S Koshkin
- Department of Hematology & Medical Oncology, Taussig Cancer Institute
| | - P Funchain
- Department of Hematology & Medical Oncology, Taussig Cancer Institute
| | - D Sohal
- Department of Hematology & Medical Oncology, Taussig Cancer Institute
| | - A Pritchard
- Department of Hematology & Medical Oncology, Taussig Cancer Institute
| | - S Klek
- Department of Hematology & Medical Oncology, Taussig Cancer Institute
| | | | - D Gopalakrishnan
- Department of Internal Medicine, Cleveland Clinic, Cleveland, USA
| | - J Garcia
- Department of Hematology & Medical Oncology, Taussig Cancer Institute
| | - B Rini
- Department of Hematology & Medical Oncology, Taussig Cancer Institute
| | - P Grivas
- Department of Hematology & Medical Oncology, Taussig Cancer Institute.
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Klek S, Szczepanek K, Scislo L, Walewska E, Pietka M, Pisarska M, Pedziwiatr M. MON-P074: Parenteral Olive Oil Improves Liver Function in Intestinal Failure Patients: Randomized, Controlled Clinical Trial. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)31009-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Klek S, Scislo L, Walewska E, Choruz R, Galas A. PT04.6: Enriched Enteral Nutrition May Improve Short Term Survival in Stage IV Gastric Cancer Patients, Randomized Controlled Trial. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30307-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pietka M, Stępska-Bodzoń D, Kryjak M, Przybylo A, Kowalik A, Brniak W, Klek S. MON-P218: What is The Right Dosage of Refined Fish Oil-Based Emulsion in Neonates? Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30852-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pietka M, Klek S, Stepska-Bodzon D, Przybyto A, Kowalik A, Brniak W. SUN-P233: Safety Alert of Manganese Overdose in Infants. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30576-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vaizey CJ, Maeda Y, Barbosa E, Bozzetti F, Calvo J, Irtun Ø, Jeppesen PB, Klek S, Panisic-Sekeljic M, Papaconstantinou I, Pascher A, Panis Y, Wallace WD, Carlson G, Boermeester M. European Society of Coloproctology consensus on the surgical management of intestinal failure in adults. Colorectal Dis 2016; 18:535-48. [PMID: 26946219 DOI: 10.1111/codi.13321] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 01/22/2016] [Indexed: 12/19/2022]
Abstract
Intestinal failure (IF) is a debilitating condition of inadequate nutrition due to an anatomical and/or physiological deficit of the intestine. Surgical management of patients with acute and chronic IF requires expertise to deal with technical challenges and make correct decisions. Dedicated IF units have expertise in patient selection, operative risk assessment and multidisciplinary support such as nutritional input and interventional radiology, which dramatically improve the morbidity and mortality of this complex condition and can beneficially affect the continuing dependence on parenteral nutritional support. Currently there is little guidance to bridge the gap between general surgeons and specialist IF surgeons. Fifteen European experts took part in a consensus process to develop guidance to support surgeons in the management of patients with IF. Based on a systematic literature review, statements were prepared for a modified Delphi process. The evidence for each statement was graded using Oxford Centre for Evidence-Based Medicine Levels of Evidence. The current paper contains the statements reflecting the position and practice of leading European experts in IF encompassing the general definition of IF surgery and organization of an IF unit, strategies to prevent IF, management of acute IF, management of wound, fistula and stoma, rehabilitation, intestinal and abdominal reconstruction, criteria for referral to a specialist unit and intestinal transplantation.
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Affiliation(s)
| | - C J Vaizey
- The Lennard Jones Intestinal Failure Unit, St Mark's Hospital, Northwick Park, Harrow, UK.,Imperial College London, London, UK
| | - Y Maeda
- The Lennard Jones Intestinal Failure Unit, St Mark's Hospital, Northwick Park, Harrow, UK.,Imperial College London, London, UK
| | - E Barbosa
- Serviço de Cirurgia, Hospital Pedro Hispano, Senhora da Hora, Portugal
| | - F Bozzetti
- Faculty of Medicine, University of Milan, Milan, Italy
| | - J Calvo
- Department of General, Digestive, Hepato-Biliary-Pancreatic Surgery and Abdominal Organ Transplantation Unit, University Hospital 12 de Octubre, Madrid, Spain
| | - Ø Irtun
- Gastrosurgery Research Group, UiT the Arctic University of Norway, University Hospital North-Norway, Tromsø, Norway.,Department of Gastroenterologic Surgery, University Hospital North-Norway, Tromsø, Norway
| | - P B Jeppesen
- Department of Medical Gastroenterology CA-2121, Rigshospitalet, Copenhagen, Denmark
| | - S Klek
- General and Oncology Surgery, General and Oncology Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland
| | - M Panisic-Sekeljic
- Department for Perioperative Nutrition, Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia
| | - I Papaconstantinou
- 2nd Department of Surgery, Areteion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A Pascher
- Department of General, Visceral, Vascular, Thoracic and Transplant Surgery, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Y Panis
- Colorectal Department, Beaujon Hospital and University Paris VII, Clichy, France
| | - W D Wallace
- Northern Ireland Regional Intestinal Failure Service, Belfast City Hospital, Belfast, UK
| | - G Carlson
- National Intestinal Failure Centre, Salford Royal NHS Foundation Trust, University of Manchester, Salford, Manchester, UK
| | - M Boermeester
- Department of Surgery/Intestinal Failure Team, Academic Medical Center, Amsterdam, The Netherlands
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Klek S, Abdulqudos Abosaleh D, Amestoy A, Baik H, Baptista G, Barazzoni R, Chourdakis M, Fukushima R, Hartono J, Jayawardena R, Garcia R, Krznaric Z, Nyulasi I, Parallada G, Perez Francisco L, Panisic-Sekeljic M, Perman M, Prins A, Isabel Martinez del Rio Requejo I, Reddy R, Singer P, Sioson M, Ukleja A, Vartanian C, Velasco Fuentes N, Linetzky Waitzberg D, Zoungrana S, Galas A. MON-PP013: The Reimbursement Does not Imply the Use of Clinical Nutrition Results From an International, World-Wide Survey. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30445-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Klek S, Pawlowska D, Dziwiszek G, Komoń H, Compala P, Nawojski M. SUN-PP176: The Evolution of Home Enteral Nutrition (HEN) in Poland During Five Years After Implementation: A Multicentre Study. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30327-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Klek S, Chourdakis M, Bischoff S, Dubrov S, Forbes A, Galas A, Genton L, Gundogdu H, Irtun O, Jagmane I, Jirka A, Jakobson-Forbes T, Kennedy N, Klimasauskas A, Khoroshilov I, Leon-Sanz M, Muscaritoli M, Panisic-Sekeljic M, Poulia K, Schneider S, Siljamäki-Ojansuu U, Uyar M, Wanten G, Krznaric Z. SUN-PP013: Reimbursement Affects Prescription of Enteral and Parenteral Nutrition? Results from European Multicenter Survey. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30164-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Poulia KA, Klek S, Karagiannis D, Doundoulakis I, Baschali A, Chourdakis M. MON-PP110: Correlation of two Methods of Nutritional Screening with the New ESPEN Criteria of Defining Malnutrition. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30542-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, Muscaritoli M, Nyulasi I, Ockenga J, Schneider SM, de van der Schueren MAE, Singer P. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr 2015; 34:335-40. [PMID: 25799486 DOI: 10.1016/j.clnu.2015.03.001] [Citation(s) in RCA: 1008] [Impact Index Per Article: 112.0] [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: 02/27/2015] [Accepted: 03/03/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To provide a consensus-based minimum set of criteria for the diagnosis of malnutrition to be applied independent of clinical setting and aetiology, and to unify international terminology. METHOD The European Society of Clinical Nutrition and Metabolism (ESPEN) appointed a group of clinical scientists to perform a modified Delphi process, encompassing e-mail communications, face-to-face meetings, in group questionnaires and ballots, as well as a ballot for the ESPEN membership. RESULT First, ESPEN recommends that subjects at risk of malnutrition are identified by validated screening tools, and should be assessed and treated accordingly. Risk of malnutrition should have its own ICD Code. Second, a unanimous consensus was reached to advocate two options for the diagnosis of malnutrition. Option one requires body mass index (BMI, kg/m(2)) <18.5 to define malnutrition. Option two requires the combined finding of unintentional weight loss (mandatory) and at least one of either reduced BMI or a low fat free mass index (FFMI). Weight loss could be either >10% of habitual weight indefinite of time, or >5% over 3 months. Reduced BMI is <20 or <22 kg/m(2) in subjects younger and older than 70 years, respectively. Low FFMI is <15 and <17 kg/m(2) in females and males, respectively. About 12% of ESPEN members participated in a ballot; >75% agreed; i.e. indicated ≥7 on a 10-graded scale of acceptance, to this definition. CONCLUSION In individuals identified by screening as at risk of malnutrition, the diagnosis of malnutrition should be based on either a low BMI (<18.5 kg/m(2)), or on the combined finding of weight loss together with either reduced BMI (age-specific) or a low FFMI using sex-specific cut-offs.
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Affiliation(s)
- T Cederholm
- Departments of Geriatric Medicine, Uppsala University Hospital and Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
| | - I Bosaeus
- Clinical Nutrition Unit, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
| | - R Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - J Bauer
- Department of Geriatric Medicine, Carl von Ossietzky Universität, Oldenburg, Germany
| | - A Van Gossum
- Department of Gastroenterology, Clinic of Intestinal Diseases and Nutritional Support, Hopital Erasme, Free University of Brussels, Brussels, Belgium
| | - S Klek
- General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland
| | - M Muscaritoli
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - I Nyulasi
- Department of Nutrition and Dietetics and Department of Medicine, Monash University Central Clinical School, Prahran, Australia
| | - J Ockenga
- Department of Gastroenterology, Hepatology, Endocrinology, and Nutrition, Klinikum Bremen Mitte, Bremen, Germany
| | - S M Schneider
- Department of Gastroenterology and Clinical Nutrition, University Hospital and University of Nice Sophia-Antipolis, Nice, France
| | - M A E de van der Schueren
- Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands; Department of Nutrition, Sports and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - P Singer
- Department of General Intensive Care, Institute for Nutrition Research, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Petah Tikva 49100, Israel
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Klek S, Hermanowicz A, Matysiak K, Szybinski P. PP225-MON: Ultrasound-Guided Percutaneous ‘Push’ Introducer Gastrostomy is a Valuable Method for Accessing the Gastrointestinal Tract. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50559-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pietka M, Stepska D, Szczepanek K, Klek S. PP235-SUN: The Impact of a Standardized Electronic Parenteral Nutrition (PN) Ordering Process on PN Errors in Neonates. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50276-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Klek S, Hermanowicz A, Dziwiszek G, Szczepanek K, Szybinski P, Galas A. PP135-SUN: Home Enteral Tube Feeding Reduces Complications, Length of Stay and Health-Care Costs in Children. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50177-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Watrobska-Swietlikowska D, Kwidzynska A, Sznitowska M, Szlagatys A, Klek S. PP228-MON: Finding New Solutions in Pediatric Parenteral Admixtures: How to Improve Quality and to Deal with Shortages. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50562-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Klek S, Hermanowicz A, Dziwiszek G, Matysiak K, Szczepanek K, Szybinski P, Kowalczyk T, Figula K, Choruz R, Galas A. PP142-SUN: Home Enteral Nutrition (HEN) Helps to Reduce Complications, Length of Stay and Health-Care Costs in Adults. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50184-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bozzetti F, Santarpia L, Pironi L, Thul P, Klek S, Gavazzi C, Tinivella M, Joly F, Jonkers C, Baxter J, Gramlich L, Chicharro L, Staun M, Van Gossum A, Lo Vullo S, Mariani L. The prognosis of incurable cachectic cancer patients on home parenteral nutrition: a multi-centre observational study with prospective follow-up of 414 patients. Ann Oncol 2014; 25:487-93. [DOI: 10.1093/annonc/mdt549] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Szczepanek K, Szybinski P, Kupiec M, Klek S. PP113-SUN LOW BONE MINERAL DENSITY (BMD) IN HOME PARENTERAL NUTRITION PATIENTS – IS DENOSUMAB A SOLUTION TO THE PROBLEM? Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60158-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Klek S, Krznaric Z, Gundogdu H, Chourdakis M, Kekstas G, Jakobson T, Paluszkiewicz P, Vranesic Bender D, Uyar M, Demirag K, Poulia K, Klimasauskas A, Starkopf J, Galas A. PP184-MON FIGHT AGAINST MALNUTRITION IN EUROPE: DOES NORTH DIFFER FROM SOUTH? Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60495-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Klek S, Dziwiszek G, Matysiak K, Szybinski P, Szczepanek K, Galas A. PP119-SUN THE EVALUATION OF THE CLINICAL VALUE OF HOME ENTERAL NUTRITION (HEN). Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60164-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Baxter JP, Gillanders L, Angstmann K, Staun M, O’Hanlon C, Smith T, Joly F, Thul P, Jonkers C, Wanten G, Gardiner K, Klek S, Cuerda C, Magambo W, Hawthorne AB, Lukes A, Van Gossum A, Theilla M, Singer P, Shamir R, Pironi L. Home parenteral nutrition: An international benchmarking exercise. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.clnme.2012.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
OBJECTIVE to analyze clinical effectivity of chemotherapy based on Irinotecan, 5-Fluorouracyl and Folinic acid in patients with colorectal carcinoma. METHODS prospective, randomized, open-label trial in group of 204 patients with advanced colorectal cancer randomized to either chemotherapy with irinotecan+5-FU+leucovorin or supportive care alone (control group) between January 1999--January 2005 was performed. Efficacy and safety of treatment was analysed. RESULTS Administration of the irinotecan, 5FU, LV regimen to patients with stages II and III significantly improved 5-year survival (81% versus 66% and 66% versus 38%, respectively; p < 0.05). Palliative chemotherapy improved survivals also in stage IV, four patients survived 5 years. Adverse event occurred in 44 of 102 patients (43.1%). CONCLUSIONS study confirms benefits of irinotecan chemotherapy administered to patients with advanced colorectal cancer. Preliminary data suggests that this chemotherapy regimen should be considered for first-line therapy in the adjuvant and palliative treatment of advanced colorectal cancer.
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Affiliation(s)
- J Kulig
- 1st Department of General and GI Surgery, Jagiellonian University Medical College, Kraków Poland.
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