Clinical nutrition ESPEN最新文献

{"title":"Improving 30-day mortality after radiologically inserted gastrostomy tube from 2007-2019: a population-based study of 15,605 patients.","authors":"Syed Shezal Hussain, Nosheen Umar, Umair Kamran, Benjamin Coupland, Fumi Varyani, Nigel Trudgill","doi":"10.1016/j.clnesp.2025.01.061","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.01.061","url":null,"abstract":"<p><strong>Background and aims: </strong>Radiologically inserted gastrostomy (RIG) allows long-term enteral nutrition when percutaneous endoscopic gastrostomy (PEG) tube insertion is not feasible either due to technical difficulty or a higher risk of complications. The aims of this study were to examine mortality associated with RIG insertion.</p><p><strong>Methods: </strong>Adult patients with RIG insertion from 2007 and 2019 were identified in the Hospital Episode Statistics database. Indications and adverse events were identified using International Statistical Classification of Diseases and Related Health Problems, 10^th Revision codes. Provider nutrition support data were available from the Getting It Right First Time in Gastroenterology Report 2021. Multivariable logistic regression analysis examined factors associated with 30-day mortality following a RIG.</p><p><strong>Results: </strong>15,605 patients were studied (68.0% male; age 64(Interquartile range (IQR) 56-73)). There was a steady increase in the number of RIGs inserted from 510 per year in 2007 to 1787 per year in 2019. 59.9% of RIGs were inserted as an outpatient. 63.3% of RIGs were inserted in head and neck cancer patients. Of the patients who had a RIG insertion, 4.7% had pneumonia within 7 days and 6.9% died within 30 days of RIG insertion. Thirty-day mortality fell from 12.2% in 2007 to 5.8% in 2019. Higher 30-day mortality rates were observed in patients with Dementia (16.4%) and in NHS providers without a nutrition support nurse (11.5%). Factors associated with 30 day mortality included: increasing age (>81 years odds ratio (OR) 13.67 (95% confidence interval (CI) 4.99-37.48), p<0.001); increasing NHS provider volume of RIG insertion >12 per year (OR 0.69 (95% CI (0.55-0.88), p=0.003); RIG insertion during an emergency admission (OR 2.53 (95% CI 2.19-2.93), p <0.001); increasing comorbidity Charlson score >5 (OR 1.38 (95% CI 1.10-1.75), p=0.006); NHS provider without a nutrition support nurse (OR 1.38 (95%CI 1.09-1.75), p=0.007) and other neurological conditions than stroke as indication for RIG (OR 1.55 (95%CI 1.24-1.95), p <0.001).</p><p><strong>Conclusions: </strong>Despite an increase in RIG insertion over the study period, 30-day mortality has fallen by 52%. Providers without a nutrition support nurse and providers with a lower volume of RIG insertions were associated with higher mortality.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Kidney Disease - Epidemiology Collaboration equations even using cystatin C overestimate renal function in patients with chronic intestinal failure on long-term parenteral nutrition.","authors":"Georges Kosmadakis, Laurence Derain-Dubourg, Madeleine Lauverjat, Charlotte Bergoin, Sandrine Lemoine, Cécile Chambrier","doi":"10.1016/j.clnesp.2025.01.059","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.01.059","url":null,"abstract":"<p><strong>Background & aims: </strong>Accurate determination of renal function is of utmost importance in chronic intestinal failure (CIF) patients on parenteral nutrition (PN) and creatinine based glomerular filtration rate (GFR) estimating equation is used in clinical practice. The aim of the present study is to evaluate the reliability of 3 CKD-EPI GFR estimating equations (eGFR) (creatinine, cystatin C or combined creatinine/cystatin C) compared with the reference method which is Iohexol plasma clearance (mGFR) in patients on long-term PN (>6 months) owing to CIF.</p><p><strong>Methods: </strong>Forty-eight patients (25 F) with a median age of 58 years (Interquartile Range:15) presenting CIF on PN for a median duration of 93 months (75) were included in this retrospective study. Concordance studies were performed by Pearson correlation and Bland-Altman method (Mean bias-Confidence Interval). Accuracy of the formulas was estimated with P30 representing the proportion of eGFR within 30% of mGFR (±30%).</p><p><strong>Results: </strong>Median mGFR was 65 (29) ml/min/1.73m² and the median eGFR was 85 (43) ml/min/1.73m² with 2009 CKD-EPIcreatinine, 74 (47) ml/min/1.73m² with 2012 CKD-EPIcystatin and 75 (48) ml/min/1.73m² with 2012 CKD-EPIcombined Cystatin C/Creatinine based formulas. The agreements were not acceptable for clinical practice. Median bias as well as lower and upper confidence intervals were for mGFR vs. eGFR (2009 CKD-EPIcreat): +21,1 (16.7,25.3), for mGFR vs. eGFR (2012 CKD-EPIcyst): +14.4 (12.9,20.5) and for mGFR vs. eGFR (2012 CKD-EPIcomb): +9.3 (7.9,15.5). Accuracy of all formulas estimated by P30 was less than 80%. With the 3 eGFR equations, more than 46% of patients were poorly stratified according to the classification of chronic kidney disease (CKD) with an overall tendency towards underestimation of the disease severity. Forty-seven percent of the patients had mGFR<60 ml/min/1.73m² corresponding to CKD Stage III or worse.</p><p><strong>Conclusions: </strong>The eGFR estimating CKD-EPI equations significantly miscalculate the true levels of renal function in patients with CIF on PN and should be used with caution in daily clinical practice.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of acute bouts of exercise in fasted vs. fed states on glucose and lipid metabolism in healthy adults: a systematic review and meta-analysis of randomized clinical trials.","authors":"Fatemeh Kazeminasab, Pegah Rafiee, Maryam Miraghajani, Heitor O Santos, Michael E Symonds, Sara K Rosenkranz","doi":"10.1016/j.clnesp.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.02.002","url":null,"abstract":"<p><strong>Aims: </strong>Exercise while fasted is often promoted as beneficial for lipid metabolism, as it may confer superior metabolic adaptations compared with exercise performed in the fed state. The aim of this systematic review and meta-analysis was to determine the effects of acute exercise in fasted versus fed states on glucose and lipid metabolism in healthy adults.</p><p><strong>Data extraction: </strong>A systematic review and meta-analysis was performed by searching PubMed, Scopus, and Web of Science databases up to July 2023, for randomized clinical trials that determined the effects of exercise in fasted vs. fed states on glucose and lipid metabolism (serum glucose, insulin, triacylglycerol, free fatty acid (FFA) concentrations, and respiratory exchange ratio (RER)) in healthy adults. Meta-analyses were conducted to determine weighted mean differences (WMD) and 95% confidence intervals.</p><p><strong>Analysis: </strong>The current meta-analysis included 28 studies with a total sample of 302 healthy adults, with exercise durations ranging from 36 to 150 min. Acute exercise performed while fasted was associated with significant increases from pre- to post-exercise in fasted serum glucose [WMD=0.263 mmol/L, p=0.009] and insulin [WMD=8.84 mU/mL, p=0.001], and significantly decreases in FFA [WMD=-0.121 mmol/L, p=0.019] when compared with exercise in the fed state. However, no significant differences were reported for changes in triacylglycerol or RER from pre- to post-exercise when comparing fasted vs. fed states.</p><p><strong>Conclusion: </strong>When compared with exercise in the fed state, exercise performed while fasted was associated with larger increases in glucose and insulin levels, along with larger decreases in FFA levels. Thus, our results do not suggest that acute fasted exercise is necessarily better for glucose or lipid metabolism when compared with exercise performed in the fed state. It is possible, albeit unlikely, that acute bouts of exercise performed while fasted may result in some degree of metabolic impairment.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A high prevalence of stunting was observed among under-five Children: a community-based cross-sectional study.","authors":"Sileshi Mulatu, Azeb Gedif, Fikir Tadesse, Workie Zemene, Mengstu Berhanu, Hailemariam Mekonnen Workie","doi":"10.1016/j.clnesp.2025.01.060","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.01.060","url":null,"abstract":"<p><strong>Background: </strong>In low-income countries, stunting remains a major public health problem. It contributes to 50% of all morbidity and mortality of under-five children and results in diminished mental and physical development.</p><p><strong>Objectives: </strong>This study aims to determine the prevalence of stunting and identify the key socio-demographic, clinical, and environmental factors that associated with stunting among children aged 6-59 months in Pawie District, Ethiopia.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted from March 1^st to April 1^st, 2019 among 841 children aged 6-59 months. An anthropometric measurement was taken for all children to determine their nutritional status, but demographic, clinical, and associated factor data were obtained through face-to-face interviews with the mother of the child using a structured questionnaire. Before analysis, the data was cleaned thoroughly to check for completeness. Then, enter into Epi Info version 7 and export to SPSS v25 for analyses. Frequencies mean, SD, percentage, and cross-tabulations were used to summarize the descriptive statistics of the data. Bi-variable and multi-variable logistic regression was employed to identify the associated factors of stunting. Lastly, results were presented using tables, charts, graphs, and result statements.</p><p><strong>Results: </strong>A total of 841 respondents were included in this study, with a 99% response rate. The prevalence of stunting among children aged 6-59 months was 37.2% (95% CI: 33.9-40.4). Of these, half (50.1%) were female. Child age (AOR =1.988 [95% CI: 1.140, 3.465]), maternal education (AOR = 5.164 [95% CI: 1.207, 22.099]), maternal occupation (AOR: 4.975 [95% CI: 1.720, 14.385]), episodes of malaria (AOR = 1.900 [95% CI: 1.262, 2.862]), colostrum feeding (AOR = 2.519 [95% CI: 1.310, 4.846]), and meal frequency (AOR = 1.857 [95% CI: 1.084,3.179]) were factors significantly associated with stunting.</p><p><strong>Conclusions: </strong>In this study, a relatively high prevalence of stunting and many factors associated with it were observed. Therefore, confirming food security at the household level and creating awareness among mothers and guardians are the best methods to reverse under-5 stunting.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year survival in patients with oncological disease with low muscle reserve, risk of sarcopenia and probable sarcopenia: A post hoc analysis.","authors":"Carolina Pinzón Ospina, Daniela Ballen Castañeda, María Paula Cubillos-Carreño, Daniela Alejandra Acero Alfonso, Yeny Marjorie Cuellar Fernandez, Jorge Medina-Parra, Montserrat Montes-Ibarra, Ricardo Alfonso Merchán-Chaverra","doi":"10.1016/j.clnesp.2025.01.051","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.01.051","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia is a clinical syndrome characterized by the loss of muscle mass quantity and quality. Our objective was to establish the prevalence of low muscle reserve, risk of sarcopenia (RIS) and probable sarcopenia (PS) and their associations with survival at two years in hospitalized patients with cancer.</p><p><strong>Methods: </strong>This was a post hoc analysis of the Nutri-Score and Malnutrition Screening Tool (MST) operational characteristics. Adjusted calf circumference (CC) was used as an indicator of muscle reserve. The RIS was determined using cut-off points of the CC. PS was defined as low hand grip strength (HGS) according to Working Groups on Sarcopenia also the presence of RIS with PS was analysed. A 2-year survival model was constructed.</p><p><strong>Results: </strong>A total of 137 patients were included: 54% were women, with a mean age of 54.7 ± 15.4 years; 61% had some degree of malnutrition; 48% had low muscle reserve; 42% had RIS; 28% and 38% had PS and 25% had RIS with PS. Severe muscle reserve deficit (Hazard Ratio (HR) = 2.71, 95% Interval Confidence (95% CI) 1.37-5.37), RIS (HR = 2.94 95% 1.66-5.21), PS (HR = 1.85 95% 1.06-3.22) and (HR = 1.94 95% 1.09-3.41) by tow different consensus and RIS with PS (HR = 2.36 95% CI CI 1.33-4.19) were associated with survival.</p><p><strong>Conclusion: </strong>Severe muscle reserve deficit, RIS and PS are associated with decreased survival in hospitalized patients with oncological disease.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehabilitation improves preoperative fitness and reduced emergency admissions post operatively.","authors":"Melissa Taylor ∗","doi":"10.1016/j.clnesp.2024.10.014","DOIUrl":"10.1016/j.clnesp.2024.10.014","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 493-494"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical nutrition in patients with Acute Kidney Injury: Traditional approaches and emerging perspectives","authors":"Francesca Di Mario ,&nbsp;Alice Sabatino ,&nbsp;Enrico Fiaccadori","doi":"10.1016/j.clnesp.2024.12.015","DOIUrl":"10.1016/j.clnesp.2024.12.015","url":null,"abstract":"<div><div>Acute kidney injury (AKI) is a complex clinical syndrome characterized by a rapid decline in kidney function, often resulting in complex metabolic and hormonal derangements. A major concern in managing AKI patients is the development of protein energy wasting (PEW), a condition marked by loss of lean body mass and negative impact on overall health outcomes. Additionally, the need of Kidney Replacement Therapy (KRT) for the most severe forms of AKI may further increase the risk of PEW, with a substantial impact on fluid and metabolic balance. Adequate nutritional support is crucial in the management of AKI, as it plays a pivotal role in muscle mass preservation, morbidity reduction and recovery of renal function.</div><div>This paper aims to evaluate the current evidence regarding nutritional strategies in AKI patients, focusing on energy and protein requirements, timing and route of nutritional intervention, and impact of individualized nutrition plans on PEW prevention and management.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 348-356"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumption of ultra-processed foods is associated with dietary iron availability, anemia, and excess weight in socially vulnerable children","authors":"Jonatan Christian de Lima Santos Queiroz ,&nbsp;Luis Carlos Rey ,&nbsp;Terezinha da Rocha Ataide ,&nbsp;Telma Maria de Menezes Toledo Florêncio ,&nbsp;Luiz Gonzaga Ribeiro Silva-Neto","doi":"10.1016/j.clnesp.2024.12.023","DOIUrl":"10.1016/j.clnesp.2024.12.023","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Eating habits during childhood have undergone significant changes, with a notable increase in the consumption of ultra-processed foods (UPF). This situation deserves attention, given the close relationship between UPF and adverse health outcomes. This is due to the nutritional composition of UPF, which has high levels of health-critical nutrients such as sugar, fat, and sodium, thus compromising the overall quality of the diet. An excess of these nutrients can increase the risk of developing excess weight, nutritional deficiencies, and chronic diseases during childhood. Among the nutritional deficiencies is iron. This is due to the fact that UPF are not good sources of iron. This, combined with the fact that UPF is low in nutrients that help make iron more available, such as vitamin C, increases the risk of developing anemia. Therefore, this study aimed to assess the availability of iron, as well as the presence of anemia and excess weight in children living in situations of social vulnerability, and to determine their association with the consumption of UPF.</div></div><div><h3>Methods</h3><div>This is a population-based cross-sectional study. Children aged between 6 and 59 months living in slums were included. The presence of excess weight was assessed by measuring weight and height, and the presence of anemia was determined by hemoglobin concentration, assessed using the HemoCue portable hemoglobinometer. A 24-h food recall was also used to assess the relative calorie intake of UFP and the dietary availability of iron using an algorithm. All statistical analyses were carried out using the statistical software Jamovi.</div></div><div><h3>Results</h3><div>In this study, 443 children were included; 19.2 % were classified as with excess weight, and 55.6 % were anemic; the average absorbable iron content was 0.54 (SD ± 0.42) mg, and 39.2 % of the calories consumed came from UPF. The association analysis showed that children with calorie share relative to UPF had a decrease of −0.12 mg of bioavailable iron (β: −0.12; 95 % CI: −0.23; −0.01). It was also possible to identify that the higher calorie share of UPF increased their chances of being classified as with excess weight and anemic by up to 116 % (OR: 2.16; 95 % CI 1.05; 4.46) and 145 % (OR: 2.45; 95 % CI: 1.26; 4.78), respectively.</div></div><div><h3>Conclusions</h3><div>The relationship found between UPF consumption and the availability of iron in the diet, excess weight, and anemia calls for attention, especially in contexts of social vulnerability. These findings demonstrate the need for greater attention to nutrition in childhood to promote an adequate and healthy diet. This can help to change the nutritional and epidemiological panorama of the population, contributing to a better general state of health for future generations of adults.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 461-468"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between probiotics and prebiotics, kidney dysfunction and mortality – Results from a longitudinal cohort study and Mendelian randomization","authors":"Ruiyan Xie ,&nbsp;Sze Kit Yuen ,&nbsp;Zoe Tsang ,&nbsp;William C.S. Tai ,&nbsp;Desmond Y.H. Yap","doi":"10.1016/j.clnesp.2024.11.035","DOIUrl":"10.1016/j.clnesp.2024.11.035","url":null,"abstract":"<div><h3>Introduction</h3><div>The benefits of probiotics/prebiotics consumption on chronic kidney disease (CKD) and mortality remains controversial.</div></div><div><h3>Objectives</h3><div>This study investigates the association of probiotics/prebiotics consumption with chronic kidney disease (CKD) and mortality.</div></div><div><h3>Methods</h3><div>Clinical data were retrieved from the National Health and Nutrition Examination Survey (NHANES) 2005–2016 database. Weighted multivariable logistic and liner regression models, cox proportional hazards models and stratified analysis were used to analyse the relationships between consumption of probiotics/prebiotics, renal parameters, CKD and mortality. We also conducted a two-sample Mendelian randomization (MR) analysis of single nucleotide polymorphisms (SNPs) related to different genera of gut microbiota to assess their causal relationships with CKD and mortality.</div></div><div><h3>Results</h3><div>15,291 subjects were analysed (897 with consumption of probiotics/prebiotics and 14,394 without). The use of probiotics/prebiotics showed an inverse correlation with urinary albumin-to-creatinine ratio (UACR) (<em>P</em> &lt; 0.05). Probiotics/prebiotics use was associated with lower risk of CKD in subjects with hypertension, hyperlipidaemia and diabetes mellitus. The consumption of probiotics/prebiotics was associated with a significantly lower risk of all-cause mortality in different regression models (<em>P</em> &lt; 0.001, for all), but the lower risk of cardiovascular mortality did not reach statistical significance (<em>P</em> &gt; 0.05, for all)]. <em>MR</em> analysis showed negative associations between the genetically predicted genus <em>Flavonifractor</em> and risk of CKD and diabetic kidney disease (DKD).</div></div><div><h3>Conclusion</h3><div>After multivariable regression, and cox proportional hazards analysis, we found that the use of probiotics/prebiotics was associated with improved kidney and mortality outcomes in the general population from NHANES database. The two-sample <em>MR</em> analysis provided further genetic evidence that a distinct genus of gut microbiota was associated with reduced risk of CKD, DKD and mortality.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 272-281"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exploratory Study Of Enhanced Recovery After Surgery(ERAS) Protocol In Children Undergoing Urologic Complex Procedure","authors":"Kaiyun Fang ∗ ,&nbsp;Nini An ,&nbsp;Xiong zhan ,&nbsp;Weijing Zhang ,&nbsp;Li Gui ,&nbsp;Yi Ma ,&nbsp;Shaopeng Gang","doi":"10.1016/j.clnesp.2024.10.035","DOIUrl":"10.1016/j.clnesp.2024.10.035","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 502-503"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}