Journal of Parenteral and Enteral Nutrition最新文献

{"title":"Chyme reinfusion therapy in adults with severe acute intestinal failure: A descriptive cohort study","authors":"Kirstine Farrer MPhil,&nbsp;Maja Kopczynska MBBCh,&nbsp;Maria Barrett MSc,&nbsp;Simon Harrison MPharm,&nbsp;Antje Teubner MD,&nbsp;Arun Abraham MD,&nbsp;Derek McWhirter MD,&nbsp;Jonathan Epstein MD,&nbsp;Simon Lal PhD,&nbsp;Gordon L. Carlson CBE, MD","doi":"10.1002/jpen.2704","DOIUrl":"10.1002/jpen.2704","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chyme reinfusion therapy treats patients with high-output fistulas or stomas by returning chyme to the distal gut. The role of this treatment in severe acute intestinal failure is currently unclear. The primary outcome of this study was a successful establishment of chyme reinfusion therapy, defined by the ability to replace parenteral nutrition for nutrition support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A descriptive cohort study of adult patients with severe acute intestinal failure due to a high-output stoma and distal mucus fistula or a high-output small intestinal fistula receiving chyme reinfusion therapy was undertaken. The effect of chyme reinfusion therapy on parenteral nutrition requirements, medication, nutrition status, liver function, and treatment cost were studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four patients commenced treatment for a median of 44 (range, 3–571; total, 2263) days. Fifteen (62.5%) were successfully established for 1208 days, and nine continued treatment at home. Parenteral requirements, including volume, energy and nitrogen content, and frequency, were significantly reduced (<i>P</i> = 0.002), whereas anthropometric measurements remained stable. However, chyme therapy was not tolerated in nine patients (37.5%), and only two (8.3%) weaned fully from parenteral nutrition. Chyme reinfusion therapy was associated with a 47.6% reduction in parenteral energy requirements, 42.8% reduction in nitrogen, and 33.3% reduction in volume of parenteral nutrition requirements. Treatment was associated with a net cost of £30.05 ($40.27) per patient per day.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Chyme reinfusion therapy was associated with reductions in the need for parenteral therapy and medication but did not replace parenteral nutrition or result in a significant cost saving.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"85-93"},"PeriodicalIF":3.2,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622494","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":"Energy and protein nutrition adequacy in general wards among intensive care unit survivors: A systematic review and meta-analysis","authors":"Zenzi Rosseel MPharm,&nbsp;Pieter-Jan Cortoos MPharm, PhD,&nbsp;Lynn Leemans PhD,&nbsp;Arthur R. H. van Zanten MD, PhD,&nbsp;Claudine Ligneel MPharm,&nbsp;Elisabeth De Waele MD, PhD","doi":"10.1002/jpen.2699","DOIUrl":"10.1002/jpen.2699","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adequate energy and protein provision is mandatory to optimize survival chances in critical illness, prevent loss of muscle mass, and reduce length of stay. Data are available concerning feeding adequacy in intensive care unit (ICU) participants, but little is known about the adequacy in post-ICU participants. This systematic review aimed to evaluate feeding adequacy in post-ICU participants and addressed causes of feeding interruption leading to suboptimal adequacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For this systematic review, a bibliographic search was performed in PubMed, Scopus, and Web of Science. Randomized controlled studies, non-randomized controlled studies, and observational studies conducted between January 1990 and November 2023 fulfilling the inclusion criteria were withheld.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies were included. Outcomes reported were energy and protein adequacy, barriers, and feeding routes. Energy and protein requirements were determined in various ways, including indirect calorimetry and standardized and weight-based formulas. Energy adequacy ranged from 52% to 102% and protein adequacy between 63% and 86%. Participants were mainly fed with enteral nutrition (EN) or a combination of oral nutrition and EN. The main barrier reported for inadequate nutrition intake was feeding tube removal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Next to different ways in calculating targets and reporting results, a wide range in energy and protein adequacy was observed, but with constant protein underfeeding. Participants fed with EN or a combination of EN and oral nutrition had the best adequacy; inappropriate tube removal is a common barrier leading to inadequate therapy. Standardized reporting and larger studies are needed to guide nutrition care for post-ICU participants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"18-32"},"PeriodicalIF":3.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583335","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":"Prognostic significance of novel muscle quality index utilization in hospitalized adults with cancer: A secondary analysis","authors":"Jarson P. da Costa Pereira RD, MSc,&nbsp;Carla M. Prado RD, PhD,&nbsp;M. Cristina Gonzalez MD, PhD,&nbsp;Poliana C. Cabral RD, PhD,&nbsp;Francisco F. de Oliveira Guedes RD,&nbsp;Alcides da Silva Diniz MD, PhD,&nbsp;Ana P. T. Fayh RD, PhD","doi":"10.1002/jpen.2701","DOIUrl":"10.1002/jpen.2701","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate and propose novel approaches to calculate muscle quality index (MQI) using muscle mass derived from single-frequency bioelectrical impedance analysis (SF-BIA) and calf circumference in both unadjusted and body mass index (BMI)–adjusted forms. In addition, we examined their prognostic significance in patients with cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A secondary analysis was conducted on a prospective cohort study of patients with cancer. Handgrip strength was measured. SF-BIA was conducted to estimate appendicular lean soft tissue (ALST, in kilograms). MQI was calculated using three approaches: (1) the ratio of handgrip strength to ALST (MQI_SF-BIA), (2) the ratio of handgrip strength to calf circumference (MQI_{calf circumference}), and (3) the ratio of handgrip strength to BMI-adjusted calf circumference (MQI_{adj. calf circumference}). Maximally selected log-rank was calculated to estimate their cutoff values to predict survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred eighty-four patients were included (51.1% men; median age, 61 years). Solid tumors were the most frequent (89.8%). All approaches to MQI (MQI_SF-BIA, MQI_{calf circumference}, and MQI_{adj. calf circumference}) were independent predictors of 6-month mortality. The found cutoffs were (1) MQI_SF-BIA (&lt;1.52 for men, &lt;0.63 for women), (2) MQI_{calf circumference} (&lt;0.74 for men, &lt;0.24 for women), and (3) MQI_{adj. calf circumference} (&lt;0.75 for men, &lt;0.25 for women).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study introduces MQI_SF-BIA, MQI_{calf circumference}, and MQI_{adj. calf circumference} as future potential surrogate methods for computing MQI in clinical practice when other robust procedures are unavailable, pending further validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"112-121"},"PeriodicalIF":3.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583339","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 the composite dietary antioxidant index and sarcopenia among United States adults: A cross-sectional study","authors":"Hao Chen MS,&nbsp;Dongze Wu MS,&nbsp;Yajin Chen MS,&nbsp;Ang Shi MS,&nbsp;Wanda Cai MS,&nbsp;Xinxin Yang MD, PhD,&nbsp;Xiaodong Chen MD, PhD","doi":"10.1002/jpen.2697","DOIUrl":"10.1002/jpen.2697","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diets high in antioxidants are associated with decreased prevalence of sarcopenia. This study aimed to investigate whether the composite dietary antioxidant index (CDAI) and sarcopenia have an underlying relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the data from the National Health and Nutrition Examination Survey 2011–2018. According to dietary antioxidant intake, the CDAI was calculated for each individual. Appendicular skeletal muscle mass index was employed to determine sarcopenia. Multivariate weighted logistic models and restricted cubic spline regression analysis was undertaken to determine the association between CDAI and sarcopenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 7012 participants were enrolled in this study, including 473 with sarcopenia (weighted percentage, 5.6%). Compared with the lowest tertile, those in the highest tertile of the CDAI exhibited a greater likelihood of being male, with lower body mass index, higher education level and economic standard, and more chance of being single or separated. In multivariate weighted logistic models, model 3 revealed a noteworthy inverse association between the CDAI and sarcopenia (odds ratio = 0.94; 95% CI, 0.91–0.98; <i>P</i> = 0.003). Compared with the lowest tertile, the highest tertile of CDAI was associated with a 0.57-fold risk of sarcopenia (95% CI, 0.42–0.77; <i>P</i> &lt; 0.001). The inverse association between CDAI and sarcopenia strengthened in the participants with elevated education levels (<i>P</i> for interaction = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CDAI was inversely correlated with the prevalence of sarcopenia. As a comprehensive measurement representing antioxidant status, the CDAI may help manage and prevent sarcopenia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"103-111"},"PeriodicalIF":3.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502425","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":"Adverse events associated with parenteral nutrition support therapy: A pharmacovigilance study","authors":"Zhou Jing MPharm,&nbsp;Xu Hongyan MPharm,&nbsp;Ma Jingjing MPharm,&nbsp;Pang Mujuan MPharm,&nbsp;Man Shiyu BD,&nbsp;Su Ying BD,&nbsp;Hu Yan MPharm","doi":"10.1002/jpen.2698","DOIUrl":"10.1002/jpen.2698","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parenteral nutrition (PN) plays a crucial role in nutrition support therapy, yet data on related adverse events (AEs) in practical settings are scarce. To address this, we analyzed AE signals associated with PN treatment from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We extracted data from the FAERS database, covering the period from the first quarter (Q1) of 2004 to Q1 of 2024. Drug names and AEs were standardized. We then conducted disproportionality analyses using four different algorithms to evaluate the association between PN and its associated AEs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We collected a total of 48,890,925 reports from the FAERS database, of which 1642 involved PN-related AEs. After categorization, we identified 21 system organ classes (SOCs), and hepatobiliary disorders were the only significant SOC across all four algorithms. At the preferred term (PT) level, we identified 99 PTs that showed significant disproportionality in all four algorithms. Fat overload syndrome, fatty acid deficiency, parenteral nutrition–associated liver disease (PNALD), <i>Malassezia</i> infection, and <i>Pantoea agglomerans</i> infection were the most prominent PTs. In addition, several potential new AE signals included nervous, cardiac, immune, psychiatric, blood, renal, urinary, and eye disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study identified several common and rare PN-related AEs reported in the FAERS database. Patients and healthcare providers should remain vigilant about these AEs. Understanding the risks of PN therapy and establishing practical procedures can help reduce AEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"122-131"},"PeriodicalIF":3.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502424","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":"Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations","authors":"Elaine B. Trujillo MS, RDN,&nbsp;Kunal C. Kadakia MD,&nbsp;Cynthia Thomson PhD, RDN,&nbsp;Fang Fang Zhang MD, PhD,&nbsp;Alicia Livinski MA, MPH,&nbsp;Kim Pollard RN,&nbsp;Todd Mattox PharmD,&nbsp;Anne Tucker PharmD,&nbsp;Valaree Williams MS, RDN,&nbsp;Declan Walsh MD,&nbsp;Steven Clinton MD, PhD,&nbsp;Aaron Grossberg MD, PhD,&nbsp;Gordon Jensen MD, PhD,&nbsp;Rhone Levin MEd, RDN,&nbsp;Jeannine Mills MS, RDN,&nbsp;Anurag Singh MD,&nbsp;Meredith Smith RN,&nbsp;Renee Stubbins PhD, RDN,&nbsp;Kathleen Wiley MSN, RN,&nbsp;Kristen Sullivan MPH, MS,&nbsp;Mary Platek PhD, RDN,&nbsp;Colleen K. Spees PhD, RDN","doi":"10.1002/jpen.2688","DOIUrl":"10.1002/jpen.2688","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malnutrition screening is not widely practiced in outpatient cancer centers. This review aims to determine the validity of malnutrition screening tools and provide recommendations for clinical use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies identified by a systematic review assessed the general validity of screening tools in adult oncology outpatients from five databases through 2022. The American Society for Parenteral and Enteral Nutrition (ASPEN) convened a working group of members from the Academy of Nutrition and Dietetics, Academy of Oncology Nurse and Patient Navigators, American Cancer Society, American Society for Clinical Oncology, American Society for Nutrition, American Society for Radiation Oncology, Association of Cancer Care Centers, and Oncology Nursing Society to answer the following questions: (1) should clinicians screen for malnutrition, (2) which malnutrition screening tools are recommended, and (3) what are the clinical applications for malnutrition risk screening in adult oncology outpatients?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty of 738 studies met the criteria and were reviewed. Six screening tools with specific cut-points demonstrated validity and are recommended, including the Mini Nutritional Assessment (≤23.5), Malnutrition Screening Tool (MST; MST ≥ 2 and patient-led MST ≥ 2), Malnutrition Universal Screening Tool (MUST; MUST ≥ 1 and MUST ≥ 2), Nutrition Risk Screening-2002 (NRS-2002; NRS-2002 ≥ 2 and NRS-2002 ≥ 3), NUTRISCORE ≥ 5, and Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF; PG-SGA SF ≥ 7 and PG-SGA SF ≥ 8).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Six screening tools are valid for malnutrition risk identification in oncology ambulatory settings and recommended before treatment initiation and regularly thereafter, depending on treatment course. Research is needed to understand to what extent early diagnosis and management of malnutrition improves the clinical care of oncology patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"48 8","pages":"874-894"},"PeriodicalIF":3.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2688","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468197","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":"Gastrointestinal ultrasound in the critically ill: A narrative review and a proposal for a protocol","authors":"Vladislav Mihnovits MD,&nbsp;Annika Reintam Blaser MD, PhD,&nbsp;Thomas Gualdi MS,&nbsp;Alastair Forbes MD, PhD,&nbsp;Gael Piton MD, PhD","doi":"10.1002/jpen.2687","DOIUrl":"10.1002/jpen.2687","url":null,"abstract":"<p>Critically ill patients are at risk of presenting with gastrointestinal dysfunction at intensive care unit admission or during their stay. However, identifying gastrointestinal dysfunction is difficult because clinical evaluation is frequently nonspecific and validated biomarkers are lacking. In this context, ultrasound of the digestive tract may help to identify gastrointestinal dysfunction. In this narrative review, we summarize available evidence and propose a protocol for assessment of the gastrointestinal tract with ultrasound. First, we report available evidence from use of four available protocols: the gastrointestinal and urinary tract sonography protocol, the acute gastrointestinal injury ultrasound score, the transabdominal gastrointestinal ultrasound protocol, and the Lai protocol, each addressing somewhat different aspects. Outputs from these protocols have been associated with clinical scores of gastrointestinal failure, feeding intolerance, and 28-day mortality. Second, we describe the potential pitfalls of using ultrasound in the critically ill, such as obesity, abdominal dressings, or the presence of intraluminal gas. Third, we suggest perspectives of ultrasound in monitoring the response to enteral nutrition and for early identification of nonocclusive mesenteric ischemia. Fourth, we propose a structured protocol for gastrointestinal ultrasound describing all the different structures that should be evaluated and provide detailed guidance for a clockwise abdominal examination. In conclusion, the use of a specific and structured protocol might help to identify patients presenting with gastrointestinal dysfunction, guide nutrition, and allow the proposal of pathophysiological hypotheses (complications of enteral nutrition, intra-abdominal infection, bowel ischemia, etc.). The benefit of using a structured protocol requires further investigation.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"48 8","pages":"895-905"},"PeriodicalIF":3.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2687","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468180","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":"JPEN Journal Club 88. Determining the hypothesis of a study.","authors":"Ronald L Koretz","doi":"10.1002/jpen.2696","DOIUrl":"https://doi.org/10.1002/jpen.2696","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400538","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":"Systemic immune-inflammation states in US adults with seropositivity to infectious pathogens: A nutrient-wide association study","authors":"He Xie MPH,&nbsp;Mairepaiti Halimulati MPH,&nbsp;Yuqi Dou MPhil, MSc,&nbsp;Hanyue Zhang PhD,&nbsp;Xiaowen Jiang MPhil, MSc,&nbsp;Lei Peng MPhil, MSc","doi":"10.1002/jpen.2695","DOIUrl":"10.1002/jpen.2695","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Limited understanding exists regarding the association between daily total dietary nutrient intakes and immune-inflammation states in US adults exposed to various pathogens. This study sought to examine the correlation between nutrient intakes and immune-inflammation indicators and to assess their performance in distinguishing immune-inflammation states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was derived from the National Health and Nutrition Examination Survey (NHANES), which included 33,804 participants aged 20 years or older between 2005 and 2018. Multivariable linear regression and restricted cubic spline regression were conducted to evaluate the association between nutrient intakes and immune-inflammation indicators. Receiver operating characteristic curve analysis was performed to evaluate the discriminatory performance of identified nutrients for various immune-inflammation states measured by the systemic immune-inflammation index (SII).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten key nutrients were significantly associated with immune-inflammation responses, including calcium, saturated fatty acid (SFA) 4:0, SFA 6:0, SFA 12:0, SFA 14:0, SFA 16:0, vitamin B₂, total SFAs, retinol, and lutein + zeaxanthin, which show potential as dietary indicators. The area under the curve for discriminating various immune-inflammation states was improved by at least 0.03 compared with a model that included only covariates, with all <i>P</i> values &lt;0.05 in the Delong tests, indicating a significant enhancement in model performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ten nutrients, including calcium, various SFAs, vitamin B₂, retinol, and lutein + zeaxanthin, exhibit significant association with SII and potential as dietary indicators for distinguishing between different immune-inflammation states in US adults with seropositivity to various viruses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"94-102"},"PeriodicalIF":3.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391296","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":"Parenteral nutrition customization in pediatrics: A descriptive cohort study","authors":"Jéssica Lavanholi Pinho MSc,&nbsp;Renata Germano Borges de Oliveira Nascimento Freitas PhD,&nbsp;Roberto Jose Negrão Nogueira PhD","doi":"10.1002/jpen.2694","DOIUrl":"10.1002/jpen.2694","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The main objective of this study was to analyze the reasons for customizing parenteral nutrition (PN) in pediatric patients admitted to a quaternary hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a descriptive cohort study on 264 hospitalized children receiving PN. Anthropometric, biochemical, and hospitalization data were collected from patient records. Unequivocal reasons for customizing PN were defined as situations precluding prescription of a standard adult/teenager PN and included renal and/or liver failure, energy-protein adequacy, and elevated mineral and triglyceride levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 264 patients, with a median age of 2.2 years (IQR: 0.3–9.0 years), comprising intensive care (<i>n</i> = 216; 81.8%) and malnourished (<i>n</i> = 91; 36.1%) patients, were evaluated. In the first 48 h, 87.9% (<i>n</i> = 232) of the sample required customized PN for energy-protein adequacy (210 of 232), maintained over subsequent days in most cases. Among patients requiring second individualization, mineral disturbance was the main reason observed, especially within the first 4 days of PN use (<i>n</i> = 21; 60%). Unequivocal reasons for customizing PN occurred in 97.4% (<i>n</i> = 226) of cases in the first 48 h; 96.2% (<i>n</i> = 177) of cases on the fourth day; and 90.1% (<i>n</i> = 92) of cases on the seventh day of PN use. An inverse correlation was found between weight/age <i>z</i> score and number of second individualizations (<i>r</i> = −0.222; <i>P</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Customized PN proved essential, especially for younger, malnourished, and intensive care patients. Investment in training a Nutritional Multidisciplinary Therapy Team and acquiring a specific electronic system for prescribing PN is suggested.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"77-84"},"PeriodicalIF":3.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391295","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}