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Franssen S, Beek MA, Lagarde SM. [A cachectic man with a severe vitamin deficiency]. Ned Tijdschr Geneeskd 2021; 165:D5491. [PMID: 33720560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 57-year-old man, known with severe malnutrition, vitamin E deficiency and peripheral neuropathies, presented with vomiting and abdominal tenderness. There was a suspicion of ileus and small bowel obstruction. During the exploratory laparotomy a complete brown colored bowel without peristalsis was seen.
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Affiliation(s)
- S Franssen
- Erasmus MC, afd. Heelkunde, Rotterdam
- Contact: S. Franssen
| | - M A Beek
- Erasmus MC, afd. Heelkunde, Rotterdam
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Ma J, Micieli JA. Severe Vision Loss in a Man With Heavy Tobacco and Alcohol Consumption. JAMA Ophthalmol 2020; 138:915-916. [PMID: 32556063 DOI: 10.1001/jamaophthalmol.2020.0900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Affiliation(s)
- Jingyi Ma
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Jonathan A Micieli
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
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Faverio P, Bocchino M, Caminati A, Fumagalli A, Gasbarra M, Iovino P, Petruzzi A, Scalfi L, Sebastiani A, Stanziola AA, Sanduzzi A. Nutrition in Patients with Idiopathic Pulmonary Fibrosis: Critical Issues Analysis and Future Research Directions. Nutrients 2020; 12:nu12041131. [PMID: 32316662 PMCID: PMC7231241 DOI: 10.3390/nu12041131] [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: 03/17/2020] [Revised: 04/12/2020] [Accepted: 04/15/2020] [Indexed: 02/07/2023] Open
Abstract
In idiopathic pulmonary fibrosis (IPF), several factors may have a negative impact on the nutritional status, including an increased respiratory muscles load, release of inflammation mediators, the coexistence of hypoxemia, and physical inactivity. Nutritional abnormalities also have an impact on IPF clinical outcomes. Given the relevance of nutritional status in IPF patients, we sought to focus on some critical issues, highlighting what is known and what should be further learned about these issues. We revised scientific literature published between 1995 and August 2019 by searching on Medline/PubMed and EMBASE databases including observational and interventional studies. We conducted a narrative review on nutritional assessment in IPF, underlining the importance of nutritional evaluation not only in the diagnostic process, but also during follow-up. We also highlighted the need to keep a high level of attention on cardiovascular comorbidities. We also focused on current clinical treatment in IPF with Nintedanib and Pirfenidone and management of gastrointestinal adverse events, such as diarrhea, induced by these antifibrotic drugs. Finally, we concentrated on the importance of pulmonary rehabilitation program, including nutritional assessment, education and behavioral change, and psychological support among its essential components. More attention should be devoted to the assessment of the undernutrition and overnutrition, as well as of muscle strength and physical performance in IPF patients, taking also into account that an adequate clinical management of gastrointestinal complications makes IPF drug treatments more feasible.
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Affiliation(s)
- Paola Faverio
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- Respiratory Unit, San Gerardo Hospital, ASST Monza, 20900 Monza, Italy
| | - Marialuisa Bocchino
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy;
| | - Antonella Caminati
- Unit of Pneumology and Respiratory Semi-Intensive Care Unit, Respiratory Pathophysiology and Pulmonary Hemodynamics Service, San Giuseppe Hospital—MultiMedica IRCCS, 20123 Milan, Italy;
| | - Alessia Fumagalli
- Unit of Pulmonary Rehabilitation, IRCCS INRCA (Italian National Research Centre on Aging), 23880 Casatenovo, Italy;
| | - Monica Gasbarra
- Association “Un Respiro di Speranza” in Collaboration with the Department of Pulmonary Diseases of San Camillo-Forlanini Hospital, 00152 Rome, Italy;
| | - Paola Iovino
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy;
| | - Alessandra Petruzzi
- MEDICA—Editoria e Diffusione Scientifica, 20124 Milan, Italy
- Correspondence: ; Tel.: +39-02-76281337
| | - Luca Scalfi
- Applied Nutrition and Health-Related Fitness, Department of Public Health, School of Medicine, Federico II University, 80131 Naples, Italy;
| | - Alfredo Sebastiani
- Department of Respiratory Diseases, San Camillo-Forlanini Hospital, 00152 Rome, Italy;
| | - Anna Agnese Stanziola
- Section of Respiratory Disease, Department of Clinical Medicine and Surgery, Monaldi Hospital, Federico II University, 80131 Naples, Italy; (A.A.S.); (A.S.)
| | - Alessandro Sanduzzi
- Section of Respiratory Disease, Department of Clinical Medicine and Surgery, Monaldi Hospital, Federico II University, 80131 Naples, Italy; (A.A.S.); (A.S.)
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Rozga M, Latulippe ME, Steiber A. Advancements in Personalized Nutrition Technologies: Guiding Principles for Registered Dietitian Nutritionists. J Acad Nutr Diet 2020; 120:1074-1085. [PMID: 32299678 DOI: 10.1016/j.jand.2020.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Indexed: 01/12/2023]
Abstract
Individualized nutrition counseling and care is a cornerstone of practice for registered dietitian nutritionists (RDNs). The term personalized nutrition (PN) refers to "individual-specific information founded in evidence-based science to promote dietary behavior change that may result in measurable health benefits." PN technologies, which include the "omics" approaches, may offer the potential to improve specificity of nutrition care through assessment of molecular-level data, such as genes or the microbiome, in order to determine the course for nutrition intervention. These technologies are evolving rapidly, and for many RDNs, it is unclear whether, when, or how these technologies should be incorporated into the nutrition care process. In order to provide guidance in these developing PN fields, International Life Sciences Institute North America convened a multidisciplinary panel to develop guiding principles for PN approaches. The objective of this article is to inform RDN practice decisions related to the implementation of PN technologies by examining the alignment of proposed PN guiding principles with the Code of Ethics for the Nutrition and Dietetics Profession, as well as Scope and Standards of Practice. Guiding principles are described as they apply to each stage of the nutrition care process and include identifying potential beneficiaries, communicating effects transparently, and protecting individual privacy. Guiding principles for PN augment standard guidance for RDNs to pose relevant questions, raise potential concerns, and guide evaluation of supporting evidence for specific PN technologies. RDNs have a responsibility to think critically about the application of PN technologies, including appropriateness and potential effectiveness, for the individual served.
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Kenworthy S, Agarwal E, Farlow L, Angus R, Marshall AP. Feasibility of using the "modified NUTrition Risk In the Critically ill" nutritional risk screening tool to identify nutritionally at-risk patients in an Australian intensive care unit. Aust Crit Care 2019; 33:259-263. [PMID: 31679984 DOI: 10.1016/j.aucc.2019.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 03/06/2019] [Revised: 08/07/2019] [Accepted: 08/19/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The modified NUTrition Risk In the Critically ill (mNUTRIC) score has been demonstrated to accurately quantify the risk of negative patient outcomes and discriminate which patients will benefit the most from nutrition intervention in an intensive care unit (ICU) setting. Calculation of an mNUTRIC score, however, may be time-intensive and unable to be performed within available resources. This may prevent high-risk patients from being identified and reviewed by a dietitian. OBJECTIVES The purpose of this study was to assess the feasibility of using the mNUTRIC tool to screen for patients at increased nutrition risk and to determine the proportion of those high-risk patients who were reviewed by a dietitian. SUBJECTS/METHODS A retrospective observational study of 260 critically ill patients was conducted between 01/01/2017 and 30/05/2017 in a 20-bed Australian tertiary ICU. Participants included all adults admitted to the ICU for more than 72 h. Feasible implementation was defined as calculating an mNUTRIC score in <5 min per patient where all data were available for >90% of patients. RESULTS A median time of 4 min and 54 s (interquartile range: 4.3-5.6 min) was required to calculate each mNUTRIC score, with 96% of scores calculated in <10 min. Data were available to calculate mNUTRIC scores for 93% (241/260) of patients. The mNUTRIC tool identified 81 patients at high nutrition risk, 44% (36/81) of whom were not reviewed by a dietitian. There were 21 high-risk patients who were purposefully excluded from dietetic review for various clinical reasons, leaving 15 high-risk patients (19%) who were not reviewed by a dietitian. CONCLUSIONS Implementation of the mNUTRIC tool was not feasible in our ICU, given the set dietetic resources (0.6 full-time equivalent). Shared responsibility of nutrition screening or automating the calculation may be possible solutions to increase feasibility of mNUTRIC screening.
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Affiliation(s)
- Sean Kenworthy
- Bond University, 14 University Dr, Robina QLD 4226, Australia.
| | - Ekta Agarwal
- Bond University, 14 University Dr, Robina QLD 4226, Australia.
| | - Lisa Farlow
- Gold Coast University Hospital, 1 Hospital Blvd, Southport QLD 4215, Australia; Griffith University, Gold Coast Campus; Parklands Dr, Southport QLD 4215, Australia.
| | - Rebecca Angus
- Gold Coast University Hospital, 1 Hospital Blvd, Southport QLD 4215, Australia; Griffith University, Gold Coast Campus; Parklands Dr, Southport QLD 4215, Australia.
| | - Andrea P Marshall
- Gold Coast University Hospital, 1 Hospital Blvd, Southport QLD 4215, Australia; Griffith University, Gold Coast Campus; Parklands Dr, Southport QLD 4215, Australia.
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Abstract
The aim of the present study was to identify risk factors for intestinal failure (IF) in infants who received surgery for necrotizing enterocolitis (NEC).A retrospective multicenter case-series study was conducted in a sample of 91 infants admitted to Children's Hospital of Chongqing Medical University between January 2010 and December 2017. The occurrence of IF was defined as the dependence on parenteral nutrition for ≥90 days. Logistic regression was used to investigate the predictors of IF.Of 179 patients reviewed, excluding those with intestinal malformation and inadequate information, 91 were included in the study, and of these cases, 32 (35.2%) developed IF. Controlling for other factors, multivariate analysis showed that birth weight (OR = 0.999; 95% CI, 0.998-1.000; P = .010), the length of the bowel resected (OR = 1.109; 95% CI, 1.048-1.173; P = .000), and the percentage of small bowel resected (OR = 1.305; 95% CI, 1.133-1.504; P = .000) were factors that increased the chances of IF occurrence.Our data demonstrated that variables characteristic of severe NEC, including lower birth weight, greater extent of bowel resection, and larger percentage of small bowel resection were associated with the incidence of IF.
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Affiliation(s)
- Huan Wang
- Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Yan Wang
- Department of Neonatology, Yongchuan Hospital, Chongqing Medical University
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Chun Deng
- Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Lei Li
- Department of Neonatology, Jinan Maternity and Child Care Hospital, Jinan, Shandong Province
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Chunbao Guo
- Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China
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Aliev G, Li Y, Chubarev VN, Lebedeva SA, Parshina LN, Trofimov BA, Sologova SS, Makhmutova A, Avila-Rodriguez MF, Klochkov SG, Galenko-Yaroshevsky PA, Tarasov VV. Application of Acyzol in the Context of Zinc Deficiency and Perspectives. Int J Mol Sci 2019; 20:E2104. [PMID: 31035445 PMCID: PMC6539662 DOI: 10.3390/ijms20092104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 04/22/2019] [Accepted: 04/24/2019] [Indexed: 12/23/2022] Open
Abstract
Zinc is one of the most important essential trace elements. It is involved in more than 300 enzyme systems and is an indispensable participant in many biochemical processes. Zinc deficiency causes a number of disorders in the human body, the main ones being the delay of growth and puberty, immune disorders, and cognitive dysfunctions. There are over two billion people in the world suffering from zinc deficiency conditions. Acyzol, a zinc-containing medicine, developed as an antidote against carbon monoxide poisoning, demonstrates a wide range of pharmacological activities: Anti-inflammatory, reparative, detoxifying, immunomodulatory, bacteriostatic, hepatoprotective, adaptogenic, antioxidant, antihypoxic, and cardioprotective. The presence of zinc in the composition of Acyzol suggests the potential of the drug in the treatment and prevention of zinc deficiency conditions, such as Prasad's disease, immune system pathology, alopecia, allergodermatoses, prostate dysfunction, psoriasis, stomatitis, periodontitis, and delayed mental and physical development in children. Currently, the efficiency of Acyzol in the cases of zinc deficiency is shown in a large number of experimental studies. So, Acyzol can be used as a highly effective drug for pharmacologic therapy of a wide range of diseases and conditions and it opens up new perspectives in the treatment and prevention of zinc deficiency conditions.
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Affiliation(s)
- Gjumrakch Aliev
- Department of Pharmacology and Pharmacy, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia.
- Institute of Physiologically Active Compounds Russian Academy of Sciences, Chernogolovka 142432, Russia.
- GALLY International Research Institute, 7733 Louis Pasteur Drive #330, San Antonio, TX 78229, USA.
| | - Yi Li
- Department of Biological and Health Sciences, Texas A&M University-Kingsville, TX 78363, USA.
| | - Vladimir N Chubarev
- Department of Pharmacology and Pharmacy, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia.
| | - Svetlana A Lebedeva
- Department of Pharmacology and Pharmacy, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia.
| | - Lidiya N Parshina
- A.E. Favorsky Irkutsk Institute of Chemistry, Siberian Branch of the Russian Academy of Sciences, 1 Favorsky Str., Irkutsk 664033, Russia.
| | - Boris A Trofimov
- A.E. Favorsky Irkutsk Institute of Chemistry, Siberian Branch of the Russian Academy of Sciences, 1 Favorsky Str., Irkutsk 664033, Russia.
| | - Susanna S Sologova
- Department of Pharmacology and Pharmacy, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia.
| | - Alfiya Makhmutova
- Institute of Physiologically Active Compounds Russian Academy of Sciences, Chernogolovka 142432, Russia.
| | - Marco F Avila-Rodriguez
- Universidad del Tolima, Facultad de Ciencias de la Salud, Barrio Santa Helena, Ibagué 730006, Colombia.
| | - Sergey G Klochkov
- Institute of Physiologically Active Compounds Russian Academy of Sciences, Chernogolovka 142432, Russia.
| | - Pavel A Galenko-Yaroshevsky
- Department of Pharmacology, Faculty of Pharmacy, Kuban State Medical University, 4 Sedin St., Krasnodar 350063, Russia.
| | - Vadim V Tarasov
- Department of Pharmacology and Pharmacy, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia.
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Abstract
Malnutrition in hospital is often unrecognized. A nutrition team aims to teach simple methods of detecting malnutrition. On a single day all medical in-patients underwent a nutritional assessment. Eighty-four patients (43 men), median age 71 years (range 28–97), were assessed. The most common diagnoses were cardiac disease (26), stroke/dementia (12), non-malignant lung disease (9) and malignancy (6). A weight loss of more than 10% (%WL) was found in 17/65 (26%) and a body mass index (BMI) of less than 19kg/m2 in 13/69 (19%). A mid-arm muscle circumference (MAMC) less than the fifth percentile occurred in 16/83 (19%) patients. Percentage weight loss alone detected seven patients of whom four were overweight (BMI > 25 kg/m2), BMI alone detected three patients, and MAMC alone eight patients of whom three could not be weighed and three had fluid retention. There was fluid retention in 35/84 (42%) patients of whom nine were malnourished (six detected by BMI and/or %WL, and three by MAMC alone). All three measurements were made in 64 patients, six (9%) of whom were detected as malnourished by all three methods. Combining the three measurements 29/84 (35%) of patients were malnourished and only 28% of these patients had been assessed by a dietitian. BMI and %WL detect most patients but fluid retention may limit their accuracy. MAMC is useful in those who cannot be weighed or who have fluid retention.
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Bruins MJ, Bird JK, Aebischer CP, Eggersdorfer M. Considerations for Secondary Prevention of Nutritional Deficiencies in High-Risk Groups in High-Income Countries. Nutrients 2018; 10:E47. [PMID: 29304025 PMCID: PMC5793275 DOI: 10.3390/nu10010047] [Citation(s) in RCA: 29] [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: 09/06/2017] [Revised: 12/22/2017] [Accepted: 12/28/2017] [Indexed: 12/26/2022] Open
Abstract
Surveys in high-income countries show that inadequacies and deficiencies can be common for some nutrients, particularly in vulnerable subgroups of the population. Inadequate intakes, high requirements for rapid growth and development, or age- or disease-related impairments in nutrient intake, digestion, absorption, or increased nutrient losses can lead to micronutrient deficiencies. The consequent subclinical conditions are difficult to recognize if not screened for and often go unnoticed. Nutrient deficiencies can be persistent despite primary nutrition interventions that are aimed at improving dietary intakes. Secondary prevention that targets groups at high risk of inadequacy or deficiency, such as in the primary care setting, can be a useful complementary approach to address persistent nutritional gaps. However, this strategy is often underestimated and overlooked as potentially cost-effective means to prevent future health care costs and to improve the health and quality of life of individuals. In this paper, the authors discuss key appraisal criteria to consider when evaluating the benefits and disadvantages of a secondary prevention of nutrient deficiencies through screening.
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Affiliation(s)
- Maaike J Bruins
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst CH-4303, Switzerland.
| | - Julia K Bird
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst CH-4303, Switzerland.
| | - Claude P Aebischer
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst CH-4303, Switzerland.
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Abstract
BACKGROUND Vitamin supplementation in bariatric aftercare is essential to prevent nutrient deficiencies; however, rates of vitamin adherence have been as low as 30 % 6 months post-surgery. Preliminary literature suggests non-adherence to prescribed treatments can be linked to demographic and psychological factors. We aimed to determine the relationship between these factors to vitamin adherence in post-bariatric surgery patients. METHODS A total of 92 bariatric patients were assessed 6 months post-surgery. Patients were administered a questionnaire collecting demographic information, psychological scores, and self-reported adherence. Nutrient deficiencies were analyzed through serum vitamin levels measured 3 and 6 months after surgery. Wilcoxon rank-sum and chi-square tests were used for analysis. RESULTS Non-adherence was associated with male sex and full-time employment (p = 0.027, p = 0.015). There were no differences with respect to living situation, education level, or relationship type. Non-adherent patients did not have significantly higher scores for generalized anxiety, depressive symptoms, or avoidant behaviors. However, non-adherent patients displayed greater attachment anxiety than their adherent counterparts (p = 0.0186). Non-adherence was also associated with lower vitamin B12 levels 6 months post-surgery (p = 0.001). CONCLUSIONS Male gender and full-time work have previously been shown to be associated with non-adherence. This is the first study to demonstrate that attachment anxiety is associated with poor multivitamin adherence in the post-surgical bariatric population. This result is concordant with recent literature that has demonstrated attachment anxiety is associated with poor adherence to dietary recommendations in bariatric patients 6 months postoperatively. Presurgical screening for attachment anxiety could facilitate early interventions to promote better bariatric aftercare in this group.
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Affiliation(s)
- Supreet Sunil
- Toronto Western Bariatric Surgery Program, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
| | - Vincent A Santiago
- Toronto Western Bariatric Surgery Program, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
| | - Lorraine Gougeon
- Toronto Western Bariatric Surgery Program, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
| | - Katie Warwick
- Toronto Western Bariatric Surgery Program, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
| | - Allan Okrainec
- Toronto Western Bariatric Surgery Program, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
- Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
| | - Raed Hawa
- Toronto Western Bariatric Surgery Program, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
- Centre for Mental Health, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada
| | - Sanjeev Sockalingam
- Toronto Western Bariatric Surgery Program, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.
- Centre for Mental Health, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada.
- Toronto General Hospital, University Health Network, 200 Elizabeth Street, Room 8EN-228, Toronto, Ontario, M5G 2C4, Canada.
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Nething J, Ringwald-Smith K, Williams R, Hancock ML, Hale GA. Establishing the Use of Body Mass Index as an Indicator of Nutrition Risk in Children With Cancer. JPEN J Parenter Enteral Nutr 2017; 31:53-7. [PMID: 17202441 DOI: 10.1177/014860710703100153] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The negative health consequences of malnutrition in the pediatric oncology patient are well known. The purpose of this study was to determine the usefulness of body mass index (BMI) for age as a tool to prospectively identify pediatric cancer patients at risk for malnutrition and to determine the BMI percentile that would be required to identify at-risk patients. METHODS This study was conducted by a retrospective chart review of 1839 newly diagnosed acute lymphoblastic leukemia patients at St. Jude Children's Research Hospital. Those falling below the 10(th) percentile on any one category of height for age (HFA), weight for age (WFA), or weight for height (WFH) were classified with regard to nutrition risk and compared with those identified as at risk by BMI for age (BFA). The BMI percentiles of the lower 9(th)-11(th) percentile patients on the HFA, WFA, and WFH growth charts were averaged in an attempt to determine a useful value to identify nutrition risk. RESULTS Lack of agreement was found to exist between BFA and HFA in identifying patients at risk for malnutrition, and also between BFA and WFA. Significant agreement was found to exist between BFA and WFH. The BMI percentile required to identify those at risk for malnutrition by the other growth charts would classify too many patients as being at risk for malnutrition to be considered clinically useful. CONCLUSIONS Although research has shown BMI is appropriate to use in the nutrition assessment of children, its usefulness has not been confirmed in the pediatric oncology patient; therefore, further study is warranted. BFA assessment should be included in the nutrition survey of new pediatric oncology patients, along with other parameters, but it cannot be recommended as the sole indicator of nutrition status at this time.
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Affiliation(s)
- Joshua Nething
- St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA
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12
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Kim YT, Kim JW, Kim SH. Prealbumin changes in gynecologic patients undergoing intra-abdominal surgery. Int J Gynaecol Obstet 2017; 86:63-4. [PMID: 15207683 DOI: 10.1016/j.ijgo.2004.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2004] [Revised: 03/30/2004] [Accepted: 04/06/2004] [Indexed: 10/26/2022]
Affiliation(s)
- Y T Kim
- Department of Obstetrics and Gynecology, Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, South Korea.
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13
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Abstract
Assessment of micronutrient status of patients requiring long-term parenteral nutrition (PN) continues to be a challenge for clinicians. The scientific literature primarily consists of small studies and case reports. There are no evidence-based guidelines available. Clinicians rely on clinical assessment according to the patient's disease process, medication regimen, physical examination, and history of nutrient intake to determine existence or risk of micronutrient deficiency and toxicity. This paper will examine current scientific evidence and existing recommendations for the micronutrient assessment and management of patients requiring long-term PN.
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Sugiura Y, Tanimoto Y, Imbe A, Inaba Y, Sakai S, Shishikura K, Tanimoto K, Hanafusa T. Association between Functional Capacity Decline and Nutritional Status Based on the Nutrition Screening Initiative Checklist: A 2-Year Cohort Study of Japanese Community-Dwelling Elderly. PLoS One 2016; 11:e0166037. [PMID: 27824916 PMCID: PMC5100942 DOI: 10.1371/journal.pone.0166037] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 10/21/2016] [Indexed: 11/30/2022] Open
Abstract
Aim To assess whether nutritional status based on the Nutrition Screening Initiative Checklist is useful for predicting functional capacity decline in community-dwelling Japanese elderly. Methods This two-year observational cohort study included 536 community-dwelling Japanese (65 years and older at baseline) who were independent in both activities and instrumental activities of daily living. Demographic attributes, chronic illness, lifestyle-related habits, nutritional status, functional capacity, and anthropometric measurements were assessed, with decline in functional capacity used as the outcome measure. Results Subjects were classified into three groups as follows based on the Nutrition Screening Initiative Checklist: low (59.5%), moderate (23.7%), and high (16.8%) nutritional risk. Significant differences were found between nutritional status and the following four baseline variables: age, hypertension, cerebrovascular diseases, and current smoking. However, no significant differences were evident between nutritional status and sex, body mass index, diabetes, drinking habit, or exercise habit. Logistic regression analysis adjusted for age, sex, body mass index, hypertension, cerebrovascular diseases and smoking habit showed that the high nutritional risk group was significantly associated with a decline in both activities of daily living (odds ratio: 4.96; 95% confidence interval (CI): 1.59–15.50) and instrumental activities of daily living (OR: 2.58; 95% CI: 1.31–5.06) compared with the low nutritional risk group. Conclusions Poor nutritional status based on the Nutrition Screening Initiative Checklist was associated with a decline in functional capacity over a 2-year period in community-dwelling Japanese elderly. These results suggest that the Nutrition Screening Initiative Checklist is a suitable tool for predicting functional capacity decline in community-dwelling elderly.
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Affiliation(s)
- Yumiko Sugiura
- Medical Corporation Hatsunekai Sugiura Clinic, Kariya City, Aichi, Japan
| | - Yoshimi Tanimoto
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
- * E-mail:
| | - Ayumi Imbe
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Yuiko Inaba
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Satoshi Sakai
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Kanako Shishikura
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Keiji Tanimoto
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
| | - Toshiaki Hanafusa
- Departments of Internal Medicine (I), Osaka Medical College, Takatsuki City, Osaka, Japan
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15
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Dias S, Günther V, Suter PM. [Not Available]. Praxis (Bern 1994) 2016; 105:995-1000. [PMID: 27560811 DOI: 10.1024/1661-8157/a002465] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Zusammenfassung. Eine Erhöhung der Plasma-Vitamin-B12(=Cobalamin)-Spiegel findet sich unerwartet häufig als asymptomatischer Zufallsbefund in der Routinelaboruntersuchung. Eine diagnostisch zielführende Klinik fehlt in der Regel. Der Cobalamin-Stoffwechsel und der Metabolismus seiner Transportproteine ist komplex, jedoch für das Verständnis der verschiedenen Differenzialdiagnosen einer Hypervitaminämie B12 von entscheidender Bedeutung. Neben der übermässigen Cobalaminzufuhr von aussen kann eine Vitamin-B12-Erhöhung auch bei soliden Neoplasien, hämatologischen Grunderkrankungen, Leber- und Nierenfunktionsstörungen und rheumatologischen Erkrankungen auftreten. Eine gezielte Anamnese verhindert dabei die Überdiagnostik. In diesem Artikel möchten wir auf Abklärungsstrategien und Differenzialdiagnosen einer Hypervitaminämie B12 eingehen.
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Affiliation(s)
- Saskia Dias
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Viola Günther
- 2 Institut für Klinische Chemie (IKC), Universitätsspital Zürich
| | - Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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16
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Presley CJ, Dotan E, Soto-Perez-de-Celis E, Jatoi A, Mohile SG, Won E, Alibhai S, Kilari D, Harrison R, Klepin HD, Wildes TM, Mustian K, Demark-Wahnefried W. Gaps in nutritional research among older adults with cancer. J Geriatr Oncol 2016; 7:281-92. [PMID: 27197919 PMCID: PMC4969118 DOI: 10.1016/j.jgo.2016.04.006] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 03/03/2016] [Accepted: 04/18/2016] [Indexed: 01/01/2023]
Abstract
Nutritional issues among older adults with cancer are an understudied area of research despite significant prognostic implications for treatment side effects, cancer-specific mortality, and overall survival. In May of 2015, the National Cancer Institute and the National Institute on Aging co-sponsored a conference focused on future directions in geriatric oncology research. Nutritional research among older adults with cancer was highlighted as a major area of concern as most nutritional cancer research has been conducted among younger adults, with limited evidence to guide the care of nutritional issues among older adults with cancer. Cancer diagnoses among older adults are increasing, and the care of the older adult with cancer is complicated due to multimorbidity, heterogeneous functional status, polypharmacy, deficits in cognitive and mental health, and several other non-cancer factors. Due to this complexity, nutritional needs are dynamic, multifaceted, and dependent on the clinical scenario. This manuscript outlines the proceedings of this conference including knowledge gaps and recommendations for future nutritional research among older adults with cancer. Three common clinical scenarios encountered by oncologists include (1) weight loss during anti-cancer therapy, (2) malnutrition during advanced disease, and (3) obesity during survivorship. In this manuscript, we provide a brief overview of relevant cancer literature within these three areas, knowledge gaps that exist, and recommendations for future research.
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Affiliation(s)
- Carolyn J Presley
- Yale Cancer Center/Yale University School of Medicine, New Haven, CT, USA.
| | - Efrat Dotan
- Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Enrique Soto-Perez-de-Celis
- Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Supriya G Mohile
- James Wilmot Cancer Center at the University of Rochester, Rochester, NY, USA
| | - Elizabeth Won
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shabbir Alibhai
- Department of Medicine,University Health Network and University of Toronto,Canada
| | - Deepak Kilari
- Froedtert Clinical Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Robert Harrison
- SCOREboard,University of Rochester Medical Center, Rochester, NY, USA
| | - Heidi D Klepin
- Wake Forrest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA
| | - Tanya M Wildes
- Washington University School of Medicine, St. Louis, MO, USA
| | - Karen Mustian
- James Wilmot Cancer Center at the University of Rochester, Rochester, NY, USA
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17
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McEvilly A. Identifying and managing malnutrition in the community. Br J Community Nurs 2016; Suppl Nutrition:S14-S21. [PMID: 27396860 DOI: 10.12968/bjcn.2016.21.sup7.s14] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Malnutrition affects more than 3 million people in the UK, most of whom live in the community. Malnutrition is both a cause and consequence of disease and can lead to increased mortality and morbidity, delayed recovery from illness and impaired body function which can make carrying out activities of daily living difficult. Managing malnutrition in the community involves identifying malnutrition using a universally validated screening tool and implementing appropriate care plans according to the degree of malnutrition. Regional and local guidance can be used to assist healthcare professionals to prescribe appropriate oral nutritional supplements and monitor nutritional aims and goals.
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Affiliation(s)
- Aimee McEvilly
- Community Nutrition Support Dietitian, St Patricks Centre for Community Health, Highgate, Birmingham
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18
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Abstract
Traditional tools and scoring systems for nutritional assessment have focused solely on parameters of poor nutritional status in the past, in an effort to define the elusive concept of malnutrition. Such tools fail to account for the contribution of disease severity to overall nutritional risk. High nutritional risk, caused by either deterioration of nutritional status or greater disease severity (or a combination of both factors), puts the patient in a metabolic stress state characterized by adverse outcome and increased complications. Newer scoring systems for determining nutritional risk, such as the Nutric Score and the Nutritional Risk Score-2002 have created a paradigm shift connecting assessment and treatment with quality outcome measures of success. Clinicians now have the opportunity to identify high risk patients through their initial assessment, provide adequate or sufficient nutrition therapy, and expect improved patient outcomes as a result. These concepts are supported by observational and prospective interventional trials. Greater clinical experience and refinement in these scoring systems are needed in the future to optimize patient response to nutrition therapy.
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Affiliation(s)
- Chirag Patel
- Department of Medicine, University of Louisville School of Medicine, 550 S. Jackson St, Louisville, KY, 40205, USA
| | - Endashaw Omer
- Department of Medicine, University of Louisville School of Medicine, 550 S. Jackson St, Louisville, KY, 40205, USA
| | - Sarah J Diamond
- Division of Gastroenterology and Hepatology, Oregon Health Sciences University, Portland, OR, USA
| | - Stephen A McClave
- Department of Medicine, University of Louisville School of Medicine, 550 S. Jackson St, Louisville, KY, 40205, USA.
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19
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Rifkind JB. Burning Mouth Syndrome and "Burning Mouth Syndrome". N Y State Dent J 2016; 82:36-37. [PMID: 27209717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome.
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20
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Halim A, Lamikanra OE, Sutton K. Female Athletes: Unique Challenges Facing Women Warriors. Am J Orthop (Belle Mead NJ) 2016; 45:12-15. [PMID: 26761911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | | | - Karen Sutton
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT.
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21
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Hanson C, Staskiewicz A, Woscyna G, Lyden E, Ritsema T, Norman J, Scholting P, Miller C. Frequency and Confidence of Healthcare Practitioners in Encountering and Addressing Nutrition-Related Issues. J Allied Health 2016; 45:54-61. [PMID: 26937883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/14/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Identify the frequency of nutrition issues encountered by healthcare professionals and their confidence in addressing these issues. METHODS A survey designed to assess the frequency and type of nutrition issues most often encountered in practice of a variety of healthcare professionals and the practitioners' confidence in addressing nutrition issues was developed and distributed to 5,729 graduates from an academic medical center. Descriptive statistics were calculated for all variables. Logistic regression models were used to find predictors of confidence. RESULTS The final response rate was 17.2% (n=987). The most common nutrition-related problems encountered included obesity (43.8%), diabetes mellitus (43%), and cardiovascular disease (37.1%). Nutrition issues were encountered daily or weekly by 70.5% of healthcare providers, but only 24.8% felt "very confident" in addressing nutrition issues. Significant predictors of confidence included number of years working, more frequent nutrition-related encounters, and nutrition education in professional programs. CONCLUSION Healthcare practitioners encounter nutrition issues frequently in practice and often do not have a high level of confidence in addressing these issues.
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Affiliation(s)
- Corrine Hanson
- Division of Medical Nutrition Education, College of Allied Health Professions, University of Nebraska Medical Center, 4045 Nebraska Medical Center, Omaha, NE 68198-4045, USA. Tel 402-559-3658.
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22
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El Habashy SA, Mohamed MH, Amin DA, Marzouk D, Farid MN. Evaluation of validity of Integrated Management of Childhood Illness guidelines in identifying edema of nutritional causes among Egyptian children. J Egypt Public Health Assoc 2015; 90:150-156. [PMID: 26854895 DOI: 10.1097/01.epx.0000475420.59037.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to assess the validity of the Integrated Management of Childhood Illness (IMCI) algorithm to detect edematous type of malnutrition in Egyptian infants and children ranging in age from 2 months to 5 years. MATERIALS AND METHODS This study was carried out by surveying 23 082 children aged between 2 months and 5 years visiting the pediatric outpatient clinic, Ain Shams University Hospital, over a period of 6 months. Thirty-eight patients with edema of both feet on their primary visit were enrolled in the study. Every child was assessed using the IMCI algorithm 'assess and classify' by the same physician, together with a systematic clinical evaluation with all relevant investigations. RESULTS Twenty-two patients (57.9%) were proven to have nutritional etiology. 'Weight for age' sign had a sensitivity of 95.5%, a specificity of 56%, and a diagnostic accuracy of 78.95% in the identification of nutritional edema among all cases of bipedal edema. Combinations of IMCI symptoms 'pallor, visible severe wasting, fever, diarrhea', and 'weight for age' increased the sensitivity to 100%, but with a low specificity of 38% and a diagnostic accuracy of 73.68%. CONCLUSION AND RECOMMENDATIONS Bipedal edema and low weight for age as part of the IMCI algorithm can identify edema because of nutritional etiology with 100% sensitivity, but with 37% specificity. Revisions need to be made to the IMCI guidelines published in 2010 by the Egyptian Ministry of Health in the light of the new WHO guidelines of 2014.
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Affiliation(s)
- Safinaz A El Habashy
- aPediatrics Department bCommunity Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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23
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Hawkes CP, Schnellbacher S, Singh RJ, Levine MA. 25-Hydroxyvitamin D Can Interfere With a Common Assay for 1,25-Dihydroxyvitamin D in Vitamin D Intoxication. J Clin Endocrinol Metab 2015; 100:2883-9. [PMID: 26120794 PMCID: PMC4524983 DOI: 10.1210/jc.2015-2206] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Vitamin D intoxication is characterized by elevated serum 25-hydroxyvitamin D (25(OH)D) and suppressed serum 1,25-dihydroxvitamin D (1,25(OH)2D). We evaluated two adolescents with hypercalcemia due to vitamin D intoxication; both had elevated serum 1,25(OH)2D by Diasorin RIA, but normal serum 1,25(OH)2D concentrations by liquid chromatography-tandem mass spectrometry (LC-MS/MS). OBJECTIVE This study aimed to determine the effect of 25(OH)D2 and 25(OH)D3 on 1,25(OH)2D concentration determined using RIA and LC-MS/MS. METHODS Pools of normal serum and an artificial serum matrix were prepared and aliquots were spiked with >99% pure 25(OH)D2 or 25(OH)D3 (50-700 ng/mL). Samples were maintained at 4°C or heated to 56°C, and the concentrations of vitamin D metabolites were measured by LC-MS/MS and Diasorin RIA. RESULTS Median 1,25(OH)2D increased by 114% with RIA and 21% with LC-MS/MS with addition of 100 ng/mL 25(OH)D3, and 349% (RIA) and 117% (LC-MS/MS) with 700 ng/mL of 25(OH)D3. Each 1-ng/mL increase in 25(OH)D3 increased 1,25(OH)2D by 0.231 pg/mL (RIA) and 0.121 pg/mL (LC-MS/MS). Spiking with 25(OH)D2 led to similar changes. Heat inactivation of serum, and using an artificial serum matrix, were associated with similar effects of 25(OH)D on 1,25(OH)2D assays. CONCLUSIONS Vitamin D intoxication with high serum levels of 25(OH)D2 or 25(OH)D3 can be associated with elevated levels of 1,25(OH)2D due to interference in a commonly used RIA. A similar but attenuated effect also occurs when 1,25(OH)2D is measured using LC-MS/MS but does not seem to be clinically significant. The basis for this effect on the LC-MS/MS assay is presently uncertain.
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Affiliation(s)
- Colin P Hawkes
- Division of Endocrinology and Diabetes (C.P.H., S.S., M.A.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin, Ireland; Department of Laboratory Medicine and Pathology (R.J.S.), The Mayo Clinic, Rochester, Minnesota 55905; and Department of Pediatrics (M.A.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Sarah Schnellbacher
- Division of Endocrinology and Diabetes (C.P.H., S.S., M.A.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin, Ireland; Department of Laboratory Medicine and Pathology (R.J.S.), The Mayo Clinic, Rochester, Minnesota 55905; and Department of Pediatrics (M.A.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Ravinder J Singh
- Division of Endocrinology and Diabetes (C.P.H., S.S., M.A.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin, Ireland; Department of Laboratory Medicine and Pathology (R.J.S.), The Mayo Clinic, Rochester, Minnesota 55905; and Department of Pediatrics (M.A.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Michael A Levine
- Division of Endocrinology and Diabetes (C.P.H., S.S., M.A.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; National Children's Research Centre (C.P.H.), Dublin, Ireland; Department of Laboratory Medicine and Pathology (R.J.S.), The Mayo Clinic, Rochester, Minnesota 55905; and Department of Pediatrics (M.A.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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24
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Al-Zeer O, Ozcagli TG, Uyar M. A call-to-action from the feedM.E. Middle East study group. Use of a screen-intervene-supervene strategy to address malnutrition in healthcare. Saudi Med J 2015; 36:903-10. [PMID: 26219439 PMCID: PMC4549585 DOI: 10.15537/smj.2015.8.11671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Up to 50% of hospitalized patients worldwide are malnourished or at risk of malnutrition. Guidelines recommend nutritional screening of all patients on hospital admission. Results from studies of hospitalized patients show that screening, with follow-up nutritional assessment and care when indicated, can improve patients' clinical outcomes and reduce healthcare costs. Despite compelling evidence, attention to nutritional care remains suboptimal in clinical settings worldwide. The feedM.E. Global Study Group developed a simple, stepwise Nutrition Care Pathway to facilitate best-practice nutrition care. This pathway guides clinicians to screen patients' nutritional status on hospital admission or at initiation of care; intervene promptly with nutrition care when needed; and supervene or follow-up routinely with adjustment and reinforcement of nutrition care plans. The feedM.E. Middle East Study Group seeks to extend this program to our region. We advise clinicians to adopt and adapt the Nutrition Care Pathway, bringing quality nutrition care to everyday practice.
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Affiliation(s)
- Osama Al-Zeer
- Department of Clinical Nutrition, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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25
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García de Diego L, Cuervo M, Martínez JA. Development of a learning-oriented computer assisted instruction designed to improve skills in the clinical assessment of the nutritional status: a pilot evaluation. PLoS One 2015; 10:e0126345. [PMID: 25978456 PMCID: PMC4433199 DOI: 10.1371/journal.pone.0126345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 04/01/2015] [Indexed: 11/18/2022] Open
Abstract
Computer assisted instruction (CAI) is an effective tool for evaluating and training students and professionals. In this article we will present a learning-oriented CAI, which has been developed for students and health professionals to acquire and retain new knowledge through the practice. A two-phase pilot evaluation was conducted, involving 8 nutrition experts and 30 postgraduate students, respectively. In each training session, the software developed guides users in the integral evaluation of a patient's nutritional status and helps them to implement actions. The program includes into the format clinical tools, which can be used to recognize possible patient's needs, to improve the clinical reasoning and to develop professional skills. Among them are assessment questionnaires and evaluation criteria, cardiovascular risk charts, clinical guidelines and photographs of various diseases. This CAI is a complete software package easy to use and versatile, aimed at clinical specialists, medical staff, scientists, educators and clinical students, which can be used as a learning tool. This application constitutes an advanced method for students and health professionals to accomplish nutritional assessments combining theoretical and empirical issues, which can be implemented in their academic curriculum.
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Affiliation(s)
| | - Marta Cuervo
- Department of Food Science and Physiology, University of Navarra, Pamplona, Spain
- CIBERobn, Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, ISCIII, Madrid, Spain
| | - J. Alfredo Martínez
- Department of Food Science and Physiology, University of Navarra, Pamplona, Spain
- CIBERobn, Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, ISCIII, Madrid, Spain
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26
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Locatelli L, Correia JC, Golay A. [Food addiction]. Rev Med Suisse 2015; 11:695-700. [PMID: 26027200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Food addiction is a common term used in everyday language by obese patients. Although the neurobiological evidence points to some similarities between addictive mechanisms and the consumption of certain foods, this diagnosis is not yet officially recognized. After a brief history of food addiction compared to other eating disorders, we review the neurobiological processes underlying this concept. A food addiction assessment tool is presented and discussed with the current literature and new classifications of the DSM-5. The concept of food addiction needs to be rethought and requires further research.
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Abstract
Nutritional disorders of captive reptiles remain very common despite the increasing knowledge about reptile husbandry and nutrition. Many nutritional disorders are diagnosed late in the disease process; often secondary complications, such as pathologic fractures in reptiles suffering from nutritional secondary hyperparathyroidism have occurred. Therefore, every attempt should be made to educate reptile owners and keepers about the proper care and dietary needs of reptiles under their care because all nutritional disorders seen in captive reptiles are preventable.
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Affiliation(s)
- Christoph Mans
- Special Species Health Service, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA.
| | - Jana Braun
- VCA Silver Lake Animal Hospital, 10726 19th Avenue Southeast, Everett, WA 98208, USA
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28
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Merrick S. Nutritional screening: a community dietitian's perspective. Br J Community Nurs 2014; Suppl:S9-S14. [PMID: 25039462 DOI: 10.12968/bjcn.2014.19.sup7.s9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Malnutrition in the UK is well documented and highlighted by the British Association of Parenteral and Enteral Nutrition, who advocate the use of a screening tool to facilitate the identification and subsequent management of undernutrition. Nurses are ideally placed to support this process, but their role has many conflicting priorities. For nurses working in the community, there also exists the problem of identifying those who are at risk of undernutrition but remain unknown to nursing services. This article provides a review of malnutrition and nutrition screening and aims to promote a pragmatic approach to the identification and management of undernutrition in the community. The article concludes with a brief review of current opportunities for improving nutritional care in the community.
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Affiliation(s)
- Susan Merrick
- Susan Merrick, Team Leader for Community Nutrition Support, Royal Wolverhampton NHS Trust
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29
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Edassery A, Jain Y. Approach to weight loss/wasting in adults. Natl Med J India 2014; 27:148-151. [PMID: 25668087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Aquinas Edassery
- Jan Swasthya Sahyog Community Health Centre, Ganiyari, Bilaspur 495112, Chhattisgarh, India
| | - Yogesh Jain
- Jan Swasthya Sahyog Community Health Centre, Ganiyari, Bilaspur 495112, Chhattisgarh, India
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30
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Allepaerts S, De Flines J, Paquot N. [Nutrition in the elderly]. Rev Med Liege 2014; 69:244-250. [PMID: 25065227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Ageing of the body predisposes to a high incidence of undernutrition in the elderly person wherever he or she is living, but the prevalence of malnutrition is particularly high in hospitalized or instutionalized patients. Early detection of malnutrition is important because malnutrition may have significant consequences and evaluation of nutritional status has to be a routine screening in the elderly. There is no single parameter which supplies a full assessment of the patient's nutritional status. It is then necessary to use screening tools for the identification of patients at nutritional risk, based on anamnestic, antropometric and biological data. The MNA (Mini Nutritional Assessment) test is a simple, non invasive, well-validated screening tool for malnutrition in the elderly and is recommended for early detection of risks of malnutrition. Numerous conditions in relationship with physiological ageing, comorbidity, polymedication and the way of life of the individual predispose to undernutrition. Healthy nutrition in older patients should respect the guidelines for protein and energy requirements, excepted in severely ill patients and/or in case of malnutrition in which case the protein-energy intake should be increased.
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Hiesmayr M. [Society for Clinical Nutrition (AKE)]. Wien Klin Wochenschr 2013; 126:66-7. [PMID: 24297268 DOI: 10.1007/s00508-013-0472-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Guilland JC, Aimone-Gastin I. [Vitamin B12 (cobalamin)]. Rev Prat 2013; 63:1085-1090. [PMID: 24298826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The term "vitamin B12" refers to four cobalamins (Cbl), including methyl-Cbl and adenosyl-Cbl, the two enzyme co-factors of methionine synthase and methylmalonyl-CoA mutase, respectively. Vitamin B12 deficiency produces clinical disorders that include mainly megaloblastic anaemia, peripheral and central neurological manifestations. The clinical significance of low blood B12 concentrations in the absence of manifestations of deficiency is a matter of debate. The biochemical diagnosis of the subclinical and clinical deficiency of vitamin B12 has been enriched by several parameters, including serum methylmalonic acid, homocysteine, and holo-transcobalamine, which have been evaluated over the past two decades.
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Affiliation(s)
- Jean-Claude Guilland
- Laboratoire de biochimie spécialisée, plateau technique de biologie, CHU de Dijon, 2170 Dijon Cedex, France.
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Prasad HK, Ekbote V, Rustagi V, Borade A, Chiplonkar S, Khadilkar V, Khadilkar AV. Performance of WHO growth standards on Indian children with growth related disorders. Indian J Pediatr 2012; 79:884-90. [PMID: 22361910 DOI: 10.1007/s12098-012-0687-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Accepted: 01/11/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess performance of WHO 2006 standards on anthropometric measurements of children referred for growth related disorders to a speciality pediatric clinic in Pune, India, from June 2006 through June 2010. METHODS Data presented in this study were collected retrospectively from case records of all children from birth to 60 mo (n=1840, mean age 2.7±1.3 y) who presented with growth related disorders; healthy age and sex matched children were recruited as controls (n=824, mean age 2.8±1.2 y). Children were divided as per their clinical diagnosis into eight different groups: growth hormone deficiency, bone disorders, syndromic short stature, familial short stature, hypothyroidism, nutritional and systemic disorder, other endocrinopathies and overgrowth disorders. Anthropometric parameters for all study subjects were converted to standard deviation scores (SD scores) using the WHO Anthro 2005. RESULTS Mean height SD scores of children with growth related disorders were significantly lower than that of the controls, while that of the tall children were significantly higher (p<0.05). All children who were clinically very short were below the 1st percentile, while none of the children with overgrowth or normal children were classified as stunted. Weight for height SD scores of children with nutritional and systemic disorders were the lowest, while those for the obese children were the highest. CONCLUSIONS The present results suggest that the WHO 2006 growth standards classify children with growth disorders appropriately and the classification is in concordance with the clinical assessment. They provide health practitioners in a clinical setting with an effective tool to assess growth of children.
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Affiliation(s)
- Hemchand Krishna Prasad
- Department of Pediatric Endocrinology, Bharati Vidyapeeth University Medical College, Pune, Maharashtra, India
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Abstract
Short bowel syndrome (SBS) and intestinal failure are chronic malabsorption disorders with considerable nutritional and growth consequences in children. Intestinal failure occurs when the functional gastrointestinal mass is reduced even if there is normal anatomical gastrointestinal length. A number of management strategies are often utilized to achieve successful intestinal rehabilitation and maintain adequate nutrition to avoid intestinal transplant. These strategies include minimizing the effect of parenteral associated liver disease, limiting catheter complications, and treating bacterial overgrowth in the remaining small intestine. In addition, there continues to be significant research interest in enhancing intestinal adaptation with targeted therapies. The purpose of this review is to discuss current perspectives and to highlight recent medical advances in novel investigational therapies.
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Roux C. [Osteoporosis: being able to recognize its severity]. Rev Prat 2012; 62:173-174. [PMID: 22408853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Christian Roux
- Université Paris-Descartes, faculté de médecine, AP-HP, hôpital Cochin, service de rhumatologie, 75014 Paris.
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Aparecida Leandro-Merhi V, Luiz Braga de Aquino J, Gonzaga Teixeira de Camargo J. Agreement between body mass index, calf circumference, arm circumference, habitual energy intake and the MNA in hospitalized elderly. J Nutr Health Aging 2012; 16:128-32. [PMID: 22323346 DOI: 10.1007/s12603-011-0098-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES This study aimed to assess the agreement between body mass index, calf circumference, arm circumference, habitual energy intake and the mini nutritional assessment (MNA) and then assess the accuracy of these parameters in relation to the MNA. METHOD The nutritional status of 132 hospitalized elderly was assessed with the MNA, body mass index (BMI), calf circumference (CC) and arm circumference (AC). Their habitual energy intake (HEI) was also determined. The chi-square and the Mann-Whitney tests were used. The agreement between the nutritional risk criteria and the MNA was determined by the Kappa coefficient. The ROC curve was used to determine the accuracy of the parameters in relation to the MNA and to determine the cut-off values. The significance level was set at 5% (p<0.05). RESULTS A little more than half the sample (54.5%) was well nourished, 34.9% were at risk of malnutrition and 10.6% were malnourished. There was good agreement only for BMI<22 (Kappa=0.44), with an accuracy (AUC) of 0.78. No agreement was found for the other parameters, their sensitivities were shown to be low. However, CC and AC were very specific for determining the well nourished patients: the CC specificity was 86.1% and AC specificity was 94.4%. The cut-off values determined by the ROC curve were ≤23.2 for BMI, ≤26.2 for AC and ≤32.2 for CC. CONCLUSION The best parameters to determine nutritional risk in relation to the MNA were AC, BMI and CC. However, these nutritional assessment parameters should be used to replace the MNA for the assessment of hospitalized elderly patients with their current cut-off points.
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Zabłocka-Słowińska K, Limburska J, Prescha A, Pieczyńska J, Tomczyk J, Grajeta H. [Assessment of energy and macronutrients supply in daily food rations of people exposed to hand transmitted vibrations]. Med Pr 2011; 62:583-590. [PMID: 22312950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Occupational exposure of workers to mechanical hand transmitted vibrations may result in the development of nonspecific lesions. Balanced diet is one of factors that protect human organism against abnormalities resulting from occupational exposure. The aim of this study was to assess the supply of energy and macronutrients in daily food rations (DFR) of people exposed to hand transmitted vibration. MATERIALS AND METHODS Eighty workers, including 37 men (mean age 44.6 years) and 43 women (mean age 44 years) exposed to hand transmitted vibrations were recruited in this study. Of those, 72 people worked in crystal glassworks as glass cutters, 5 people were physiotherapists and 3 were woodcutters. For all workers, there was measured exposure to hand transmitted vibration. Nutritional status was assessed using 24-hour dietary recall; the procedure was repeated 3 times. The results of the nutritional assessment were compared with recommended daily allowances (RDA) for energy, protein, minerals and vitamins, total carbohydrates, total fat, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), cholesterol and dietary fibre. RESULTS The average intake of energy in daily food rations of the women was too low while men received the appropriate amount of energy. Average protein intake by men and women was higher than the relevant RDA. The average amount of carbohydrates received by the surveyed women and men were too low, just as the consumption of PUFA, dietary fibre, potassium and calcium. We also found an excessive, average supply of total fat, MUFA, SFA, cholesterol and most of the vitamins with the DFR of the women and men. CONCLUSIONS The nutrition in the group of workers exposed to hand transmitted vibration was found to be imbalanced due to excessive intakes of total fat, saturated fatty acids and cholesterol combined with insufficient consumption of carbohydrates, dietary fibres, potassium and calcium. The co-occurrence of vibration and imbalanced diet may increase the susceptibility of the subjects to cardiovascular and bone diseases.
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Affiliation(s)
- Sherezade Khambatta
- Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
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Almoznino-Sarafian D, Shteinshnaider M, Tzur I, Bar-Chaim A, Iskhakov E, Berman S, Efrati S, Modai D, Cohen N, Gorelik O. Anemia in diabetic patients at an internal medicine ward: clinical correlates and prognostic significance. Eur J Intern Med 2010; 21:91-6. [PMID: 20206878 DOI: 10.1016/j.ejim.2009.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 10/24/2009] [Accepted: 12/02/2009] [Indexed: 11/20/2022]
Abstract
BACKGROUND Characteristics and prognostic significance of anemia in hospitalized diabetic patients are unknown. METHODS We studied 3145 unselected patients admitted to two Internal Medicine Departments, 872 (27.7%) of whom were diabetic. Forty diabetic patients died during the first hospitalization period. Out of the remaining 832 patients, 334 (40.2%) were anemic and evaluated for survival. In 87 diabetic patients, the cause of anemia was evident on admission, whereas the other 247 had to be further investigated for etiology of anemia. RESULTS Compared to non-anemic diabetic patients, the diabetic anemic patients were older (mean age 71.4 vs. 64.4 years, P<.001) and predominantly females (52.4% vs. 44.4%, P<.02). Of the 247 evaluated patients, 38% were deficient in iron, 12% in vitamin B(12) and/or folate, 54% had anemia of chronic disease, 47% suffered from heart failure, 39% had renal dysfunction and 22% were complex nursing care patients and/or had diabetic foot. On median follow-up of 19.2 months, mortality rate was higher in anemic compared to non-anemic diabetic patients (17.3% vs. 4%, P<.001), the main cause of death being infection. Male sex (P=.03), albuminuria (P=.01) and heart failure (P=.06) were associated with shorter survival, male sex being the most significant (OR 2.02, 95% CI 1.04-4.00). CONCLUSION Frequency of anemia was increased in diabetic patients admitted to the Internal Medicine Departments, compared to the studies performed on ambulatory patient populations. Anemia was multifactorial and associated with higher mortality, predominantly from infections. Males with albuminuria and heart failure were at higher risk of death.
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Affiliation(s)
- Dorit Almoznino-Sarafian
- Department of Internal Medicine F, Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel-Aviv University), 70300 Zerifin, Israel
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40
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Affiliation(s)
- W Allan Walker
- Harvard Medical School, Mucosal Immunology Laboratory, Massachusetts General Hospital for Children, Boston, Massachusetts 02129-4404, USA
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Abstract
Iodine deficiency (ID) has multiple adverse effects on growth and development due to inadequate thyroid hormone production. Methods for assessment of iodine nutrition in individuals include the urinary iodine concentration (UI), thyroid size and thyroid function tests. The UI measured in several repeat 24-h urine samples can detect inadequate iodine intake in individuals receiving enteral or parenteral nutrition (PN) and allow for iodine supplementation before the onset of hypothyroidism. A daily dose of 1 microg iodine/kg body weight is currently recommended for children receiving PN, but this is far below their requirements. Daily iodine requirements in adults receiving enteral nutrition or PN are estimated to be 70-150 microg, but most PN formulations do not contain iodine. Despite this, ID has been unlikely because absorption from iodine-containing skin antiseptics and other adventitious sources can provide sufficient iodine. However, if chlorhexidine replaces iodine-containing antiseptics for catheter care, ID may occur during long-term PN, and periodic testing of UI and thyroid function may be prudent. Infants may be particularly vulnerable to ID because of their small thyroidal iodine store. In this review, we describe three recent patients (an infant, a child and an adult) who developed ID and thyroid hypofunction during PN.
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Affiliation(s)
- Michael B Zimmermann
- Human Nutrition Laboratory, Swiss Federal Institute of Technology Zürich, Zürich, Switzerland.
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Abstract
Iodine deficiency is the most common cause of preventable brain damage in the newborn. The indicators for assessing iodine nutritional status include urinary iodine excretion, thyroid size, thyroid stimulating hormone (TSH) and thyroglobulin (Tg) concentrations in the blood. Neonatal TSH concentration is increased when the supply of thyroid hormone and iodine from the maternal circulation to the foetus has been compromised. The World Health Organization (WHO) has suggested that when a sensitive assay is used on samples collected 3-4 days after birth, a <3% frequency of TSH concentrations >5 mIUl(-1) indicates iodine sufficiency in a population. However, many studies have attempted to apply the frequency of neonatal TSH values >5 mIUl(-1) in determining population iodine status and monitoring intervention programmes, and although some have proven to be successful, most have provided conflicting or uncertain data. This is due to the many technical issues that remain unresolved on the use of neonatal TSH screening for monitoring iodine status, making it doubtful as a sensitive and reliable quantitative tool. More research is required to resolve these issues. In the interim, WHO should consider withdrawing its current guidelines for neonatal TSH screening for monitoring iodine deficiency in populations.
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Affiliation(s)
- Mu Li
- School of Public Health, the University of Sydney, Sydney, NSW 2006, Australia.
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Abstract
Endemic cretinism includes two syndromes: a more common neurological disorder with brain damage, deaf mutism, squint and spastic paresis of the legs and a less common syndrome of severe hypothyroidism, growth retardation and less severe mental defect. Both conditions are due to dietary iodine deficiency and can be prevented by correction of iodine deficiency before pregnancy. Endemic cretinism is now included in the spectrum of the effects of iodine deficiency in a population termed the 'iodine deficiency disorders (IDDs)', which also includes a wide range of lesser degrees of cognitive defect that can be prevented by the correction of iodine deficiency. Iodine deficiency is now recognised by the World Health Organization (WHO) as the most common preventable cause of brain damage with in excess of 2 billion at risk from 130 countries. A global United Nations (UN) programme of prevention has achieved 68% household usage of iodised salt by the year 2000 compared with less than 20% prior to 1990.
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Affiliation(s)
- Zu-Pei Chen
- National IDD Advisory Committee to Ministry of Health, P. R. China.
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Zadik Z. Unbalanced nutrition might change the clinical picture of endocrine diseases. J Pediatr Endocrinol Metab 2009; 22:677. [PMID: 19845118 DOI: 10.1515/jpem.2009.22.8.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Most reptile emergencies are the result of improper husbandry and nutrition. Reptiles are good at masking disease, and owners, failing to recognize early signs of illness, only seek veterinary assistance when issues are advanced and near terminal. The veterinarian should be familiar with reptile species-specific husbandry and nutritional requirements and basic clinical techniques. The same principles and techniques used in small animal medicine can be applied to reptile emergencies. This article reviews general emergency principles that apply to the reptilian patient and common emergency presentations. The main areas of discussion focus on cardiopulmonary resuscitation, fluid therapy, and analgesia.
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Affiliation(s)
- David Martinez-Jimenez
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390, USA.
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Michalsen A. [Nutritional therapy: queen or Cinderella of naturopathy and complementary medicine?]. Forsch Komplementmed 2009; 16:144-145. [PMID: 19657197 DOI: 10.1159/000218146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Abstract
OBJECTIVE To document mineral contents iron, zinc, calcium, energy contents and nutrient densities in complementary foods commonly given to young urban slum children. METHODS Information on dietary intake was collected from 892 mothers of children aged 13-24 months, using 24 hour dietary recall and standardized measures. Three variations of 27 most commonly prepared recipes were analyzed and their energy (Kcal/g) and nutrient densities (mg/100 Kcal) were calculated. RESULTS Considerable variations were observed in preparation of all items fed to the children. Cereal-based items predominated their diets with only small amount of vegetables/fruits. Fenugreek was the only leafy vegetable included, but was given to only 1-2% of children. Iron, calcium, zinc contents of staple complementary foods ranged from: 0.33 mg to 3.73 mg, 4 mg to 64 mg, and 0.35 mg to 2.99 mg/100 respectively. Recipes diluted with less water and containing vegetables, spices had higher mineral content. Minerals densities were higher for dals, fenugreek vegetable, khichdi and chapatti. Using the median amounts of the various recipes fed to children, intakes of all nutrients examined especially calcium and iron was low. CONCLUSION There is an urgent need to educate mothers about consistency, dilution, quantity, frequency, method of preparation, inclusion of micronutrient-rich foods, energy-dense complementary foods and gender equality.
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Affiliation(s)
- Rati Jani
- Department of Food Science and Nutrition, S.N.D.T Women's University, Mumbai, India.
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Sacks GS. Refeeding syndrome: awareness is the first step in preventing complications. J Support Oncol 2009; 7:19-20. [PMID: 19278173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Gordon S Sacks
- Harrison School of Pharmacy, Auburn University, Auburn, Alabama, USA.
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Pogozheva AV, Derbeneva SA, Bogdanov AR, Kaganov BS. [The system of multilevel diagnostics and corrections of nutrition status disorders in the patients with cardiovascular diseases]. Vopr Pitan 2009; 78:43-51. [PMID: 19663303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
As is known, the pathology of cardiovascular systems depends on nutrition and occupies leading positions in structure general morbidity and mortality of the population of Russian Federation. The system of nutritional and medical aids--"Nutritest" and "Nutricor", represent the technology of diagnostics of infringements the status of nutrition, estimations of risk of development of cardiovascular diseases, and ways of their high-grade correction.
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Himeno M, Tsugawa N, Kuwabara A, Fujii M, Kawai N, Kato Y, Kihara N, Toyoda T, Kishimoto M, Ogawa Y, Kido S, Noike T, Okano T, Tanaka K. Effect of vitamin D supplementation in the institutionalized elderly. J Bone Miner Metab 2009; 27:733-7. [PMID: 19444379 DOI: 10.1007/s00774-009-0081-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2008] [Accepted: 03/10/2009] [Indexed: 11/29/2022]
Abstract
An intervention study with vitamin D supplementation was conducted in order to study the amount of vitamin D required in the elderly. Sixty-four institutionalized elderly were randomly assigned to two groups: group (A) to take a beverage containing 200 mg calcium daily, and group (B) to take a beverage containing 200 mg calcium and 5 microg vitamin D daily for 30 days. Prior to the study, the subjects' average vitamin D intake was 7.3 microg/day, which is approximately 150% of the current adequate intake (AI), however their mean plasma 25 OH-D level at baseline was only 12 ng/mL, strongly indicating hypovitaminosis D. During the study, average plasma 25 OH-D concentration significantly increased to 14.7 ng/mL in group (B), but not in group (A). However, group (B) was still in the hypovitaminosis range. Thus, daily intake exceeding the current AI of 5 microg is required for the institutionalized elderly.
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Affiliation(s)
- Masako Himeno
- Department of Food and Nutrition, Kyoto Women's University, Kyoto 605-8501, Japan
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