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De Longueville C, Robert M, Debande M, Podlubnai S, Defourny S, Namane SA, Pace A, Brans C, Cayrol E, Goyens P, De Laet C. Evaluation of nutritional care of hospitalized children in a tertiary pediatric hospital. Clin Nutr ESPEN 2018; 25:157-162. [PMID: 29779812 DOI: 10.1016/j.clnesp.2018.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 02/24/2018] [Accepted: 02/27/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS Hospitalized children are at risk of malnutrition. The aim of the present study was to evaluate a clinical practice in a tertiary hospital. The nutritional team developed a specific software for screening of malnutrition and risk of malnutrition (Evalnut) that provides also recommendations for the nutritional management of the patient. The data recorded into this program and the tool itself were analyzed and optimizations are highlighted. METHODS A retrospective study analyzed the data collected in 2015 during 4931 consecutive hospitalizations (3984 children) at the University Children's Hospital Queen Fabiola. Pivot tables analysis (Excel) of the database of the screening tool was compared with the clinical practice of the dietitians. First data processing excluded records with abnormal or missing values. Impact of nutritional care analysis needs at least 2 evaluations and a positive patient's height trend. In case of height equality, only length of hospital stays less than 2 weeks were kept. RESULTS This study highlighted inaccurate database records related to imperfections of the computer program, missing or erroneous measures and incomplete encoding. First analysis on 3219 valid hospitalizations showed statistical correlations. Prevalence of malnutrition on admission was 33%, split into 14,5% acute malnutrition, 15% chronic malnutrition and 3,5% mixed malnutrition. Overall, 30,3% of the children were categorized at risk of developing malnutrition during their stay. Positive impact of nutritional management on the resulting nutritional status was demonstrated on the second data selection (352 hospitalizations): WFH median (interquartile range) increased from 96,1% (87,1-106,4) on admission to 96,9% (89,1-106,1) (p < 0,01) on discharge. An optimization of the existing software was finally proposed. CONCLUSION In our hospital, the dietitians are the most aware on the importance of nutritional assessment and management during hospitalization. Encouraging results are obtained. Inclusion of a nutritional program in the medical file is useful to raise interest amongst caregivers and is particularly valuable for the nutritional follow up of the patients by the nutrition team.
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Affiliation(s)
- Caroline De Longueville
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
| | - Martine Robert
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
| | - Marjorie Debande
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
| | - Sylviane Podlubnai
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
| | - Sophie Defourny
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
| | - Sid-Ali Namane
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
| | - Aude Pace
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
| | - Camille Brans
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
| | - Elodie Cayrol
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
| | - Philippe Goyens
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium; Laboratory of Pediatrics, Université Libre de Bruxelles, Avenue Jean-Joseph Crocq 15 CP 402, B 1020, Brussels, Belgium.
| | - Corinne De Laet
- Hôpital Universitaire des Enfants Reine Fabiola, Avenue Jean-Joseph Crocq 15, B 1020, Brussels, Belgium.
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Valentini L, Pinto A, Bourdel-Marchasson I, Ostan R, Brigidi P, Turroni S, Hrelia S, Hrelia P, Bereswill S, Fischer A, Leoncini E, Malaguti M, Blanc-Bisson C, Durrieu J, Spazzafumo L, Buccolini F, Pryen F, Donini LM, Franceschi C, Lochs H. Impact of personalized diet and probiotic supplementation on inflammation, nutritional parameters and intestinal microbiota - The "RISTOMED project": Randomized controlled trial in healthy older people. Clin Nutr 2014; 34:593-602. [PMID: 25453395 DOI: 10.1016/j.clnu.2014.09.023] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [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: 04/06/2014] [Revised: 07/23/2014] [Accepted: 09/29/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To assess the impact of a personalized diet, with or without addition of VSL#3 preparation, on biomarkers of inflammation, nutrition, oxidative stress and intestinal microbiota in 62 healthy persons aged 65-85 years. DESIGN Open label, randomized, multicenter study. PRIMARY ENDPOINT High-sensitivity C-reactive protein. SETTING Community. INTERVENTIONS Eight week web-based dietary advice (RISTOMED platform) alone or with supplementation of VSL#3 (2 capsules per day). The RISTOMED diet was optimized to reduce inflammation and oxidative stress. MEASUREMENTS Blood and stool samples were collected on days 1 and 56. RESULTS Diet alone reduced ESR (p = 0.02), plasma levels of cholesterol (p < 0.01) and glucose (p = 0.03). Addition of VSL#3 reduced ESR (p = 0.05) and improved folate (p = 0.007), vitamin B12 (p = 0.001) and homocysteine (p < 0.001) plasma levels. Neither intervention demonstrated any further effects on inflammation. Subgroup analysis showed 40 participants without signs of low-grade inflammation (hsCRP<3 mg/l, subgroup 1) and 21 participants with low-grade inflammation at baseline (hsCRP≥3 mg/l, subgroup 2). In subgroup 2 addition of VSL#3 increased bifidobacteria (p = 0.005) in more participants and improved both folate (p = 0.015) and vitamin B12 (p = 0.035) levels compared with subgroup 1. The increases were positively correlated to the change in the bifidobacteria concentration for folate (p = 0.023) and vitamin B12 (p = 0.001). As expected change in homocysteine correlated negatively to change in folate (r = -0.629, p = 0.002) and vitamin B12 (r = -0.482, p = 0.026). CONCLUSIONS Addition of VSL#3 increased bifidobacteria and supported adequate folate and vitamin B12 concentrations in subjects with low-grade inflammation. Decrease in homocysteine with VSL#3 was clinically relevant. suggesting protective potentials for aging-associated conditions, e.g. cardiovascular or neurological diseases. ClinicalTrials.gov: NCT01069445-NCT01179789.
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Affiliation(s)
- Luzia Valentini
- Dept Gastroenterology and Hepatology, Charité-Universitätsmedizin Berlin, CCM, Charitéplatz 1, 10117 Berlin, Germany.
| | - Alessandro Pinto
- Experimental Medicine Department, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Isabelle Bourdel-Marchasson
- CHU Bordeaux, Clinical Gerontology, France; CNRS, RMSB, UMR 5536, France; University Bordeaux, RMSB, UMR 5536, Bordeaux, France
| | - Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via S. Giacomo 12, 40126 Bologna, Italy
| | - Patrizia Brigidi
- Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
| | - Silvia Turroni
- Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
| | - Silvana Hrelia
- Dept Life Quality Studies, Alma Mater Studiorum University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Patrizia Hrelia
- Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
| | - Stefan Bereswill
- Dept Microbiology and Hygiene, Charité-Universitätsmedizin Berlin, CBF, Hindenburgdamm 27, 12203 Berlin, Germany
| | - André Fischer
- Dept Microbiology and Hygiene, Charité-Universitätsmedizin Berlin, CBF, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Emanuela Leoncini
- Dept Life Quality Studies, Alma Mater Studiorum University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Marco Malaguti
- Dept Life Quality Studies, Alma Mater Studiorum University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | | | | | - Liana Spazzafumo
- Biostatistical Center INRCA, Via S. Margherita 5, 60100 Ancona, Italy
| | - Fabio Buccolini
- R&D, VoxNet CEO, Via Giovanni Paisiello 32, 00198 Rome, Italy
| | - Florence Pryen
- Actial Farmaceutica Lda, Praca Severiano Ferraz 258, 09000 082 Funchal, Portugal
| | - Lorenzo Maria Donini
- Experimental Medicine Department, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via S. Giacomo 12, 40126 Bologna, Italy
| | - Herbert Lochs
- Experimental Medicine Department, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy; Medical University of Innsbruck, Innrain 52, 6020 Innsbruck, Austria
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