Journal of Parenteral and Enteral Nutrition最新文献

{"title":"Outcomes of early compared with delayed initiation of feeding after placement of percutaneous endoscopic gastrostomy tube: A systematic review and meta-analysis","authors":"Mudathir Ibrahim MD,&nbsp;Ceilidh McKenney MD,&nbsp;Camilla Sophia Rossi MD,&nbsp;Susan Khader Ibrahim BDS, MSc,&nbsp;Ahmed Alnajar MD, MSPH, MS-BST,&nbsp;Gianmarco Cancelli MD,&nbsp;Matthew McKenney MS,&nbsp;Michelle Demetres MLIS,&nbsp;Zi Yuan MD, MPH,&nbsp;Jeffrey Nicastro MD, FACS,&nbsp;Joel Horovitz MD, FACS","doi":"10.1002/jpen.2774","DOIUrl":"10.1002/jpen.2774","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Certain guidelines consider feeding within 4 h of percutaneous endoscopic gastrostomy tube (PEG) placement to be safe. However, the evidence supporting the recommendations has been questioned and variation in feeding initiation practices persists, with feeding delayed up to 24 h after PEG placement. Our objective was to systematically review the current literature on early vs delayed feeding after PEG placement and compare their outcome in a meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ovid MEDLINE, EMBASE, Cochrane Library, CINAHL, and Web of Science were searched from inception until December 4, 2023. Randomized and nonrandomized studies comparing feeding initiation ≤4 vs &gt;4 h post-PEG in adults were included. Independent extraction was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis reporting guidelines and data were pooled using fixed or random-effects models. Measured outcomes were the odds of postoperative vomiting, diarrhea, stoma leakage, stoma infection, bleeding, intra-abdominal infection, aspiration pneumonia, and 30-day mortality. Assessment of risk of bias was completed using the Cochrane risk of bias tool 2 (RoB 2) for randomized studies and the Newcastle-Ottawa scale for nonrandomized studies. GRADE was used to assess evidence certainty. PROSPERO registration: CRD42023483520.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 4751 studies, 11 with 2880 patients met inclusion. There was no significant difference in all the measured outcomes between groups, but the evidence certainty was low to very low. Intra-abdominal infection couldn't be examined because of scarce reporting by authors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This robust meta-analysis suggests early feeding after PEG placement is likely safe but uncertain, highlighting the need for a high-quality randomized trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"682-691"},"PeriodicalIF":4.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term home parenteral nutrition in chronic intestinal failure following metabolic and bariatric surgery and its clinical outcomes: A descriptive cohort study","authors":"Dane Christina Daoud MD,&nbsp;Katherine J. P. Schwenger RD, PhD,&nbsp;Yasaman Ghorbani MSc,&nbsp;Leah Gramlich MD,&nbsp;George Ou MD,&nbsp;David Armstrong MD,&nbsp;Maitreyi Raman MD,&nbsp;Johane P. Allard MD,&nbsp;Barbara Bielawska MD, MSc","doi":"10.1002/jpen.2772","DOIUrl":"10.1002/jpen.2772","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic and bariatric surgery is one of the most efficacious treatments for obesity. The increasing incidence of referrals to intestinal rehabilitation programs and the necessity for long-term parenteral nutrition because of bariatric surgery complications have gained attention, yet data remain limited. Our objectives were to (1) assess parenteral nutrition-related complication rates of patients requiring long-term parenteral nutrition because of bariatric surgery complications and (2) compare outcomes between types of metabolic and bariatric surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a descriptive cohort (<i>n</i> = 25) study, which gathered data from patients enrolled in the national registry with a history of metabolic and bariatric surgery at baseline and 2 years and included demographics, biochemical parameters, parenteral regimens, line sepsis, hospitalizations, and functional status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, 92% were women with a mean age of 53.8 ± 8.6 years. The most prevalent procedure performed was Roux-en-Y gastric bypass (60%). Short bowel syndrome was observed in 40% of our cohort (<i>n</i> = 10). After 2 years, there was a significant reduction in the need for parenteral nutrition compared with baseline, with 37.5% of patients achieving weaning. No significant disparities were observed in the incidence of line sepsis, hospitalizations, or Karnofsky performance status between baseline and the 2-year follow-up, regardless of the type of surgery. Roux-en-Y gastric bypass was associated with lower body mass index at the 2-year mark.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In post-metabolic and bariatric surgery patients, long-term parenteral nutrition is well tolerated based on clinical outcomes and functional status is not influenced by the type of surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"773-782"},"PeriodicalIF":4.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2772","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between handgrip strength asymmetry and all-cause mortality in United States–based older adults: A cross-sectional study","authors":"Xiufang Kong MD, PhD,&nbsp;Wei Wang MD, PhD","doi":"10.1002/jpen.2777","DOIUrl":"10.1002/jpen.2777","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although handgrip strength is commonly measured in both hands for sarcopenia screening, the nonmaximum readings are frequently discarded. We aimed to evaluate whether handgrip strength asymmetry, in addition to weakness, could provide additional prognostic information in older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants aged ≥60 years from the 2011–2014 National Health and Nutrition Examination Survey with available handgrip strength measurements were included. Study outcomes are all-cause and cardiovascular disease mortality. Participants were categorized into the weakness−/asymmetry− (reference), weakness−/asymmetry+, weakness+/asymmetry−, and weakness+/asymmetry+ groups based on the status of handgrip weakness and asymmetry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 3116 older adults (mean age, 69.47 years) were included. Weighted percentages of participants in the reference, weakness−/asymmetry+, weakness+/asymmetry−, and weakness+/asymmetry+ groups were 54.28%, 39.88%, 2.86%, and 2.97%, respectively. During a median follow-up of 79 months, 679 deaths (232 from cardiovascular causes) occurred. Compared with the reference group, hazard ratios (HRs) and 95% confidence intervals (CIs) for the weakness−/asymmetry+, weakness+/asymmetry−, and weakness+/asymmetry+ groups were 1.02 (95% CI 0.84–1.24), 1.57 (95% CI 1.09–2.26), and 2.34 (95% CI 1.47–3.71), respectively, for all-cause mortality (<i>P</i> for trend &lt; 0.01) and 1.19 (95% CI 0.78–1.81), 1.22 (95% CI 0.54–2.78), and 2.30 (95% CI 1.20–4.39), respectively, for cardiovascular disease mortality (<i>P</i> for trend = 0.03). Subgroup analysis indicated anemia and diabetes significantly modified the associations between handgrip strength and/or weakness status with all-cause and cardiovascular disease mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Handgrip strength asymmetry, in addition to weakness, provided additional prognostic information for all-cause and cardiovascular mortality in older adults in the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"758-767"},"PeriodicalIF":4.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between virtual visits and central line–associated complications in adult patients receiving home parenteral nutrition: A retrospective cohort study","authors":"Kristin Munroe RD,&nbsp;Anna Bestic RD,&nbsp;Samantha Feczko RD,&nbsp;Jamie Davila RD,&nbsp;Mandy L. Corrigan RD,&nbsp;Donald F. Kirby MD","doi":"10.1002/jpen.2771","DOIUrl":"10.1002/jpen.2771","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In response to coronavirus disease 19, healthcare organizations made dramatic and immediate shifts from in-person office to telehealth visits to provide care to patients while adhering to social distancing restrictions. The objective of this study was to test the efficacy of virtual visits compared with “brick and mortar” (in-person visits) for patients receiving home parenteral nutrition for clinical outcomes of the incidence of catheter complications and 30-day readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted between January 2020 and December 2020 on eligible patients managed by the Cleveland Clinic Home Nutrition Support and the Center Gut Rehabilitation and Transplant teams. Those receiving home parenteral nutrition who were seen in a follow-up clinic appointment were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 189 patients studied, 103 had in-person visits and 86 had virtual visits. A total of 7.9% (<i>n</i> = 15) of patients had catheter complications. Virtual visits demonstrated statistical noninferiority of the incidence of catheter-related complications when compared with in-person visits (90% CI, −0.051 to 0.106; margin &lt;0.1). Readmission incidence for in-person visits was 8.5% (<i>n</i> = 16) and 6.3% (<i>n</i> = 12) for virtual visits. Virtual visits demonstrated statistical noninferiority to in-person visits for incidence of readmissions after the visit (90% CI, −0.094 to 0.106; margin &lt;0.1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Virtual visits demonstrate noninferiority to in-person visits based on the incidence of catheter complications and readmission rates. New evaluation techniques need to be developed for this high-risk populations in virtual visits to establish effective and safe patient management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 5","pages":"643-649"},"PeriodicalIF":4.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2771","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing growth impairment in infants undergoing intestinal surgery: A quality improvement initiative","authors":"Julie D. Thai MD,&nbsp;Jessica Liu PhD,&nbsp;Caroline Toney-Noland MSc,&nbsp;Courtney C. Breault MS, RN,&nbsp;Mark V. Speziale MD, PhD,&nbsp;Shannon L. Burke RD,&nbsp;Gina M. O'Toole MPH, RD,&nbsp;Peggy P. Chen MD,&nbsp;Ching Ching Tay MS,&nbsp;Jochen Profit MD,&nbsp;Irfan Ahmad MD","doi":"10.1002/jpen.2765","DOIUrl":"10.1002/jpen.2765","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Infants undergoing intestinal surgery are at risk for impaired growth. Our objective was to reduce growth impairment in these infants by 20% in a 12-month period and sustain over 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eight neonatal intensive care units (NICUs) participated in the California Perinatal Quality Care Collaborative–led multisite quality improvement (QI) project, comprising a baseline, active, and sustainability phase. Eligible infants underwent intestinal surgery in the NICU between January 2021 to June 2023. Outcome measure was infants leaving the NICU with a weight <i>z</i>-score decline exceeding (&gt;)1.2 standard deviations from birthweight. Process measures included adherence to parenteral nutrition (PN) guidelines, nutrition rounds, and feeding guidelines. Balancing measures included necrotizing enterocolitis, metabolic acidosis, and feeding intolerance rates. Multisite learning sessions and meetings were held. Each NICU implemented local QI strategies. Measures were analyzed in control charts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>581 infants were included. During the active phase, growth impairment remained unchanged at 25%. Adherence to PN guidelines increased from 49% to 68%, nutrition rounds increased from 82% to 91%, and feeding guideline increased from 28% to 68%. In the sustainability phase, growth impairment worsened to 27%. Adherence to nutrition rounds decreased to 82%, PN guidelines increased to 95%, and feeding guidelines sustained at 68%. Balancing measures remained unchanged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite no change in growth impairment, multiple centers implemented strategies to optimize nutrition in infants who underwent surgery. Additional data on nutrient delivery, other anthropometrics, and nonnutrition factors should be considered in future studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 5","pages":"580-588"},"PeriodicalIF":4.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of muscularity status with clinical and physical function outcomes in critically ill patients with COVID-19: A systematic review and meta-analysis","authors":"Carolyn Tze Ing Loh BSc,&nbsp;Zheng-Yii Lee PhD,&nbsp;Nor'azim Mohd Yunos PhD,&nbsp;Rafidah Atan PhD,&nbsp;Daren K. Heyland MSc,&nbsp;Christian Stoppe MD, PhD,&nbsp;M. Shahnaz Hasan MAnes","doi":"10.1002/jpen.2767","DOIUrl":"10.1002/jpen.2767","url":null,"abstract":"<p>Pre–coronavirus disease 2019 (COVID-19) critical care research underscored the importance of muscularity on patient outcomes. This study investigates the association between skeletal muscle mass and quality with clinical and physical function outcomes in critically ill patients with COVID-19. We systematically searched MEDLINE, EMBASE, and CINAHL from database inception to April 24, 2024, for studies using objective methods to evaluate muscularity in critically ill adults with COVID-19, without language restrictions. Co–primary outcomes were overall mortality and muscle strength. Random-effect meta-analyses were performed in RevMan 5.4.1. We included 20 studies (<i>N</i> = 1818), assessing muscularity via computed tomography (twelve studies), ultrasound (seven studies), and bioelectrical impedance analysis (one study); none had low risk of bias. In analyses of high vs low muscularity, high muscle mass was significantly associated with lower overall mortality (nine studies; risk ratio = 0.74; 95% CI, 0.57–0.98; <i>P</i> = 0.03). When muscularity was analyzed as a continuous variable, COVID-19 survivors had higher skeletal muscle area (SMA) (13 studies; mean difference [MD] = 1.18; 95% CI, 0.03–2.33; <i>P</i> = 0.05) confirmed by sensitivity analysis using standardized MD (0.23, 95% CI 0.05–0.42, <i>P</i> = 0.01) and significantly higher muscle quality (five studies; standardized MD = 0.45; 95% CI, 0.20–0.70; <i>P</i> = 0.0004). Muscle strength findings were inconsistent: one study showed significant correlations between muscle strength with muscle mass parameters (<i>r</i> = 0.365–0.375, <i>P</i> &lt; 0.001) whereas another found no association. In critically ill adults with COVID-19, high muscle mass was associated with lower mortality risk. Survivors had significantly higher SMA and muscle quality. Findings on physical function outcomes remain inconclusive (PROSPERO ID: CRD42022384155).</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"692-706"},"PeriodicalIF":4.1,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current nutrition practices in premature and low-birth-weight newborns: A descriptive cohort study","authors":"Luciana de Paula MSc,&nbsp;Diana Silva PhD,&nbsp;Cláudia Camila Dias PhD,&nbsp;Rita Moita MD,&nbsp;Susana Pissarra MSc","doi":"10.1002/jpen.2770","DOIUrl":"10.1002/jpen.2770","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aims to describe the nutrition approach to preterm and low-birth-weight infants during hospitalization in a level 3 neonatal intensive care unit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Descriptive cohort study on preterm infants with gestational age ≤34 weeks or birth weight ≤1500 g admitted for hospitalization between January 2021 and December 2022. Data were collected from medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sample consisted of 85 preterm infants. All received parenteral nutrition, which was started on the first day of life in 98.8% of them. Trophic nutrition was started by the third day of life in 74.7% of the preterm infants. The median start of trophic nutrition was 5 days in infants with a birth weight &lt;1000 g, 3 days in infants with a birth weight from 1000 to &lt;1500 g, and 2 days in infants with birth weight ≥1500 g (<i>P</i> &lt; 0.001). Preterm infants with a birth weight ≥1500 g started enteral nutrition and reached full enteral nutrition earlier (<i>P</i> &lt; 0.001) than the other birth weight subgroups. The diet was suspended for &gt;24 h in 26 preterm infants (30.6%). At discharge, 84.7% of the infants were receiving breast milk, with 25.9% exclusively breastfeeding and 58.8% partially breastfeeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Earlier initiation of enteral feeding in line with the latest guidelines can be optimized with the availability of donor milk from a human milk bank.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 5","pages":"589-598"},"PeriodicalIF":4.1,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of adult patients with intestinal failure–associated liver disease: A descriptive cross-sectional study","authors":"Shameer J. Mehta MD,&nbsp;Alexandra Zissimopoulos MBBS,&nbsp;Konstantinos Fragkos PhD,&nbsp;Sarah Williams MSc,&nbsp;Sarah Faloon MBChB,&nbsp;Michael Taylor,&nbsp;Priya Mistry MRes,&nbsp;Vipin Gupta MD,&nbsp;Martyn Dibb MD,&nbsp;James Baker MPharm,&nbsp;Philip Smith BMBS, MSc,&nbsp;Philip Allan DPhil,&nbsp;Charlotte Rutter MBChB,&nbsp;Clare Donnellan MD,&nbsp;Arun Abraham FRCS,&nbsp;Simon Lal PhD","doi":"10.1002/jpen.2769","DOIUrl":"10.1002/jpen.2769","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>No consensus exists regarding diagnostic tools for adult intestinal failure–associated liver disease (IFALD). This study aimed to determine correlations between histological pathology, noninvasive diagnostic tools, and IFALD severity. Secondary objectives included correlations between noninvasive diagnostic tools in adult patients with a clinical diagnosis of IFALD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a multicenter, cross-sectional retrospective study conducted across six UK IF units. All patients judged to have IFALD were included. Included data were as follows: demographics, IF pathophysiological mechanism, radiological findings, blood results, elastography, and histological findings. Fisher exact tests, Kruskal-Wallis tests, and Spearman correlations were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 745 patients, 234 patients with IFALD were included (prevalence: 31.4%; median age: 56 years), with 95.3% meeting European Society of Clinical Nutrition and Metabolism criteria. Three fibrosis scores were used in 51 liver biopsies (Brunt et al.: 5 [9.8%]; Ishak et al.: 10 [19.6%]; and Metavir et al.: 10 [19.6%]). Elastography was performed in 57 patients (24.4%), with a median stiffness of 7.35 kPa. Histology grade inversely correlated with liver stiffness (<i>n</i> = 23; <i>P</i> = 0.01). No correlation was found between histology and imaging (<i>n</i> = 34; <i>P</i> = 0.22; chi-squared). Serum platelet count and enhanced liver fibrosis correlated with imaging (steatosis vs fibrosis/cirrhosis) (<i>n</i> = 85 (<i>P</i> &lt; 0.01) and <i>n</i> = 12 (<i>P</i> = 0.05), respectively; Spearman). AST:ALT and FIB-4 scores correlated with liver stiffness at a threshold of 12 kPa (Spearman correlation coefficient: 0.943 [<i>P</i> &lt; 0.01; <i>n</i> = 6]; Spearman correlation coefficient: 0.417 [<i>P</i> = 0.02; <i>n</i> = 31]; respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Variations in the use and performance of noninvasive tools and histological reporting in adult IFALD were found. Prospective studies of noninvasive tools and expert histological consensus on reporting practice are justified.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 5","pages":"650-658"},"PeriodicalIF":4.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measures of nutrition intake and growth reported in preterm nutrition studies: A scoping review","authors":"Meiliana Meiliana MS,&nbsp;Frank H. Bloomfield PhD,&nbsp;Jane E. Harding DPhil,&nbsp;Luling Lin PhD","doi":"10.1002/jpen.2768","DOIUrl":"10.1002/jpen.2768","url":null,"abstract":"<p>There are inconsistent recommendations in available guidelines and uncertainty regarding the exact nutrient requirements for preterm infants, partly because of inconsistent outcome reporting in nutrition intervention studies. To support development of a minimum reporting set, we undertook a scoping review to identify measures of nutrition intake and growth outcomes reported in recent preterm nutrition studies. We searched for publications from 2018 to 2023 reporting individuals born preterm at any gestational age and study location whose nutrition intake was assessed before first hospital discharge and whose growth was assessed at any age. One reviewer screened articles and extracted the measures. Any uncertainties were resolved by a second reviewer. The results were tabulated and analyzed descriptively. We identified 6365 records, and included 250 studies. Only 10 of 236 studies (4%) reported how nutrition intake was calculated. There were five different ways of reporting weight and 13 of weight gain, each at many different time points. Furthermore, 27 of 105 studies (26%) did not report how weight gain was calculated, and those that did reported five different calculation methods. Our findings demonstrate significant variation and incomplete reporting of nutrition intake and growth outcomes in preterm nutrition studies. This lack of standardization limits the utility of existing evidence and highlights the need for a standardized reporting framework to improve comparability and support evidence-based guidelines in preterm nutrition.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 7","pages":"806-815"},"PeriodicalIF":4.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://aspenjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central line–associated bloodstream infection rates in pediatric short bowel syndrome in the United States: A retrospective cohort study from 2016 to 2023","authors":"Susan A. Gutierrez MD,&nbsp;Vikram Raghu MD, MS,&nbsp;Stephanie B. Oliveira MD, CNSC,&nbsp;Vivien Nguyen MD,&nbsp;Amy M. Shui MA,&nbsp;Debra L. Sudan MD,&nbsp;Conrad Cole MD, MPH, MSc,&nbsp;Chiung-Yu Huang PhD,&nbsp;Sue Rhee MD,&nbsp;Jennifer C. Lai MD, MBA,&nbsp;Sharad I. Wadhwani MD, MPH","doi":"10.1002/jpen.2766","DOIUrl":"10.1002/jpen.2766","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Central line–associated bloodstream infections (CLABSIs) are the leading cause of hospitalization in pediatric short bowel syndrome, disproportionately impacting socioeconomically disadvantaged children. We examined changes in overall CLABSI rates over time and assessed whether socioeconomic disparities persist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the Pediatric Health Information System database, we studied short bowel syndrome patients aged &lt;18 years hospitalized between 2015 and 2023. Patients were stratified into neighborhood income groups based on zip code–based median household income. CLABSI rates were assessed with mixed-effects Poisson regression over four eras (2016–2017, 2018–2019, 2020–2021, 2022–2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 8772 hospitalizations of 2048 children with short bowel syndrome at 43 institutions, CLABSI was the principal diagnosis for 30% of hospitalizations. Univariable analysis showed decreased CLABSI rates during 2018–2019 (rate ratio [RR] 0.71, 95% CI 0.63–0.81; <i>P</i> &lt; 0.001), 2020–2021 (RR 0.66, 95% CI 0.57–0.75; <i>P</i> &lt; 0.001), and 2022–2023 (RR 0.60, 95% CI 0.52–0.70; <i>P</i> &lt; 0.001), relative to 2016–2017. In multivariable analyses, 2022–2023 was associated with lower CLABSI rates relative to 2016–2017 (RR 0.61, 95% CI 0.52–0.70; <i>P</i> &lt; 0.001). Low neighborhood income (RR 1.59, 95% CI 1.14–2.21; <i>P</i> &lt; 0.001), public insurance (RR 1.59, 95% CI 1.37–1.84; <i>P</i> &lt; 0.001), and non-Hispanic Black race (RR 1.19, 95% CI 1.01–1.39; <i>P</i> = 0.03) were associated with higher CLABSI rates relative to high neighborhood income, private insurance, and non-Hispanic White race, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CLABSI rates in pediatric short bowel syndrome have decreased over the past 8 years, yet socioeconomic and racial disparities persist. Efforts to prevent CLABSI across the socioeconomic spectrum should be prioritized to improve short bowel syndrome outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 5","pages":"572-579"},"PeriodicalIF":4.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}