Nutrition in Clinical Practice最新文献

{"title":"Construction and verification of discharge preparation and guidance checklist for patients requiring home enteral nutrition: A randomized control trial.","authors":"Chulin Chen, Xiaoxuan Xu, Tianling Jin, Yang Yang, Dongmei Zhu","doi":"10.1002/ncp.70004","DOIUrl":"https://doi.org/10.1002/ncp.70004","url":null,"abstract":"<p><strong>Background: </strong>To develop, implement, and evaluate a structured discharge preparation and guidance checklist for patients requiring home enteral nutrition (HEN).</p><p><strong>Methods: </strong>The HEN discharge preparation and guidance checklist was developed through a multiphase process by literature review, qualitative interview, and Delphi consultation. A randomized controlled trial was conducted with 90 patients (45 intervention, 45 control) requiring HEN at a tertiary hospital in China. The intervention group received checklist-assisted discharge education, whereas the control group received conventional verbal instructions. Outcomes were assessed using validated tools: Quality of Discharge Teaching Scale (QDTS), Readiness for Hospital Discharge Scale (RHDS), Patient Satisfaction Questionnaire-18 (PSQ-18), NutriQoL, Self-Rating Anxiety Scale (SAS), 30-day unplanned readmission rates, and patient-initiated inquiries.</p><p><strong>Results: </strong>The intervention group demonstrated significant improvements in QDTS total scores (P < 0.001), content received (P < 0.001), and delivery skills and effects (P = 0.007). RHDS scores for personal status, knowledge, perceived coping ability, and expected support were significantly higher in the intervention group (all P < 0.05). PSQ-18 (P < 0.001) and daily life and social activity domains of NutriQoL (P = 0.036) also improved. However, no significant differences were observed in physical functioning domains of NutriQoL (P = 0.217), SAS (P = 0.160), or unplanned readmission rates (P = 0.343). The intervention group reported fewer online searches for HEN management (P = 0.035).</p><p><strong>Conclusion: </strong>The HEN discharge preparation and guidance checklist effectively standardized discharge education, enhanced patient preparedness, and improved satisfaction. Although short-term physiological and psychological outcomes showed limited effects, the tool addresses critical gaps in transitional care. Future studies should explore long-term impacts and integrate financial/psychosocial support.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes in pediatric intestinal failure patients with ambulatory Candida central line-associated bloodstream infections with and without central venous line removal: A retrospective case series.","authors":"Hamza Hassan Khan, Candi S Jump, Jessica Bauer, Qian Wu, Stephen Thacker, Allison Ross Eckard","doi":"10.1002/ncp.70000","DOIUrl":"https://doi.org/10.1002/ncp.70000","url":null,"abstract":"<p><strong>Background: </strong>Lack of central venous line (CVL) sites is a common indication for intestinal transplantation in intestinal failure (IF) patients. For treatment of central line-associated bloodstream infections (CLABSIs), many pediatric gastroenterologists preserve CVL access, but line removal is typically recommended for Candida sp CLABSI due to high risk of systemic complications. However, no data exist on outcomes for IF patients treated for Candida sp CLABSI. This study aims to assess if CVL preservation increases the risk of complications or recurrence.</p><p><strong>Materials and methods: </strong>A retrospective chart review was conducted for children <18 years of age with IF and Candida sp CLABSI between 2012 and 2023. Patients with blood cultures positive for Candida sp from the CVL were included. Each CLABSI event was analyzed for key variables.</p><p><strong>Results: </strong>Twelve patients were included, with 18 events (median age 6.4 years). Candida species identified included C albicans (33.3%) and C parapsilosis (38.9%). Antifungal therapy exceeded 14 days in all events, and ethanol lock therapy (70% concentration) was used in 72%. CVL was removed in 44.4% of events. Five patients had multiple events, with Candida species identified in subsequent infections. No secondary site seeding or long-term sequelae occurred, and no patients died.</p><p><strong>Conclusion: </strong>Our data suggest that CVL preservation in pediatric IF patients with Candida sp CLABSI is feasible without increased complications or mortality. Limitations include small sample size and retrospective design.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations in nutrition support for long-term bariatric surgery care.","authors":"Colleen Tewksbury, Larissa Mahoney, Raquel Shover, Phyllis A Schiavone","doi":"10.1002/ncp.11355","DOIUrl":"https://doi.org/10.1002/ncp.11355","url":null,"abstract":"<p><p>Bariatric surgery remains a highly effective treatment for severe obesity and its related comorbidities, but long-term nutrition management poses significant challenges for a small minority of post-bariatric surgery patients. Patients may require specialized nutrition support, including exclusive parenteral nutrition or enteral nutrition, owing to complications such as malabsorption, perforated ulceration, or severe nutrient deficiencies. This narrative review outlines the best practices for assessing, implementing, and monitoring exclusive parenteral nutrition or enteral nutrition in postbariatric patients, emphasizing individualized care and the management of psychosocial factors such as weight stigma. The article highlights future directions in technology and personalized medicine to optimize outcomes in this complex population.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fish oil intravenous fat emulsion monotherapy and essential fatty acid requirements.","authors":"Anne-Sophie Otis, Flavie Pettersen-Coulombe, Emile Demers","doi":"10.1002/ncp.11353","DOIUrl":"https://doi.org/10.1002/ncp.11353","url":null,"abstract":"","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving hospital nutrition care through \"Indigenous cultural safety\" of menu options: Results of a cross-sectional survey of Indigenous people in Western Canada.","authors":"Annalijn I Conklin, Derek Tian, Victoria Janzen, Alena Spears, Naomi Johnson, Caroline Kaufman, Sinead Feeney","doi":"10.1002/ncp.11352","DOIUrl":"https://doi.org/10.1002/ncp.11352","url":null,"abstract":"<p><strong>Background: </strong>Hospital nutrition services rarely offer Indigenous-specific menu options, an essential element of delivering \"Indigenous cultural safety\" in nutrition care to Indigenous patients.</p><p><strong>Methods: </strong>Indigenous participants (n = 370) completed a semistructured Indigenous Food Ways survey (paper-based and online) from 2021 to 2022 as part of continuous healthcare quality improvement. Descriptive statistics summarized cultural/traditional foods respondents wanted to see or did not want to see as options on hospital menus.</p><p><strong>Results: </strong>A majority of respondents (83%) agreed that a menu option for cultural/traditional foods was important, with 716 unique items reported. Seafood and meat/alternatives were common cultural/traditional items for menu options, specifically salmon (22%), traditional meat (14%), moose (12%), and venison (12%). Grain items reported were mostly Bannock (22%). Nearly 20% of the sample listed traditional foods, medicine, or tea as options for hospital menus. Respondents identified 254 items they did not want to see on hospital menus, which were commonly energy-dense/processed foods (16%) or poorly prepared/flavored items (13%), as well as peas and carrots (7%). Notably, some foods (eg, Bannock, salmon, fish eggs) were listed among both desired and not desired menu options.</p><p><strong>Conclusion: </strong>Results showed that offering cultural or traditional foods on hospital menus is considered important by Indigenous people, and that a wide range of foods would be desired. Specific cultural foods to include on menus were salmon, traditional meats, or traditional teas. Foods not to include were also identified. Improving future nutrition care and services will require menu modifications to provide culturally safe options for Indigenous patients.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Untold stories of the genesis and dissemination of PEN and ASPEN.","authors":"Albert Barrocas","doi":"10.1002/ncp.11354","DOIUrl":"https://doi.org/10.1002/ncp.11354","url":null,"abstract":"","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition prevalence at hospital admission and discharge based on the two-step Global Leadership Initiative on Malnutrition: A prospective observational study in Malawian adult patients.","authors":"Getrude Mphwanthe, Triza Columbus, Limbikira Wasambo, Hailey Koster, Lustia Mndoliro, Felistace Mtande, Heather Burr, Lorraine Weatherspoon","doi":"10.1002/ncp.11347","DOIUrl":"https://doi.org/10.1002/ncp.11347","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of malnutrition at hospital admission and discharge and examine factors associated with malnutrition at discharge among adult patients.</p><p><strong>Study design: </strong>A prospective observational study was conducted at two public referral hospitals in Malawi, targeting adult patients aged 18-65 years (n = 418). Within 24-48 h of hospital admission, patients were screened for malnutrition risk using the Malnutrition Screening Tool and diagnosed with malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Patients (n = 229) with a length of stay (LOS) of ≥7 days were rescreened and reassessed at discharge.</p><p><strong>Results: </strong>According to the GLIM criteria, at admission, 74.3% (n = 150) of the patients were diagnosed with malnutrition, of which 71.3% (n = 107) were moderately malnourished and 28.7% (n = 43) were severely malnourished. At discharge (≥7-day LOS), 81.5% (n = 101) were malnourished, with 35.6% (n = 36) and 64.4% (n = 65) being moderately and severely malnourished, respectively. Among patients who were severely malnourished at discharge (≥7-day LOS), 63.1% (n = 41) and 61.5% (n = 40) exhibited three of the GLIM phenotypic and two of the etiologic characteristics, respectively. Malnutrition at discharge (≥7-day LOS) was associated with a longer LOS (adjusted odds ratio [AOR], 1.206; 95% CI, 1.062-1.370; P = 0.004) and a history of previous hospital admission within the past 6 months (AOR, 4.146; 95% CI, 1.192-14.418; P = 0.025).</p><p><strong>Conclusion: </strong>Malnutrition at admission and discharge is a serious concern in Malawi, necessitating tailored nutrition/dietetic interventions in the hospital, at discharge, and after discharge.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the ethical landscape of parenteral nutrition: Balancing care and moral principles.","authors":"Trevor Tabone, Pierre Ellul, Neville Azzopardi, Emmanuel Agius","doi":"10.1002/ncp.11350","DOIUrl":"https://doi.org/10.1002/ncp.11350","url":null,"abstract":"<p><p>Parenteral nutrition (PN) is a life-sustaining therapy for patients unable to meet nutrition needs via enteral routes, but its use presents significant ethical complexity. This narrative review provides clinicians with a practical, principle-based framework to navigate the ethical dilemmas inherent in PN across diverse clinical contexts. Grounded in the four pillars of medical ethics-autonomy, beneficence, nonmaleficence, and justice-the review explores decision-making challenges in vulnerable populations, long-term PN, and end-of-life care. Clinically relevant scenarios are examined, including initiation or withdrawal of PN in terminal illness, informed consent in cognitively impaired patients, and balancing parental wishes with a child's best interests in pediatric care. The ethical tension between prolonging life and enhancing quality of life is critically appraised, particularly in oncology and palliative settings. The review also addresses disparities in PN access and resource allocation, with actionable insights for clinicians practicing in low-resource settings. Key take-home strategies include using structured ethical frameworks such as the Four-Quadrant and Shared Decision-Making models, involving ethics committees in complex cases, and prioritizing transparent, compassionate communication. Clinicians are encouraged to consider both the clinical utility and psychosocial burden of PN, and to integrate multidisciplinary perspectives into care planning. Ultimately, this review underscores the need for ethically attuned, patient-centered PN decisions that align with individual goals, values, and context. It provides structured guidance to assist nutrition support teams in translating ethical principles into clinical practice, thereby ensuring that PN is administered judiciously, safely, and in accordance with the patient's best interests.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of octreotide in pediatric patients: Practical applications for gastrointestinal disorders and beyond: A narrative review.","authors":"Bailey Dunn, Megan Foxe, Kathy Hunter Sprott, Jessica E Hook, Candi Jump","doi":"10.1002/ncp.11348","DOIUrl":"https://doi.org/10.1002/ncp.11348","url":null,"abstract":"<p><p>Somatostatin is a naturally occurring polypeptide hormone that exerts its effect on the gastrointestinal tract by reducing exocrine and endocrine secretion, resulting in decreased motility, gastric emptying, splanchnic blood flow, fat absorption, lymphatic flow, and gallbladder contraction. Octreotide is a synthetic somatostatin analogue that has a variety of clinical applications in the gastrointestinal tract, including in the treatment of gastrointestinal bleeding, motility disorders, lymphatic disorders, pancreatic disorders, and high-output states. Clinicians may hesitate to use octreotide because of its potential side effects and the lack of robust pediatric data. Here we describe potential side effects of the drug and review the use of octreotide in the above pediatric indications.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calf circumference predicts sarcopenia and all-cause mortality in older patients undergoing maintenance hemodialysis: A prospective cohort study.","authors":"Yan Shen, Hongmin Qin, Xiaosu Liu, Lu Liu, Shuang Chen, Yuqi Yang, Jing Yuan, Yan Zha","doi":"10.1002/ncp.11337","DOIUrl":"https://doi.org/10.1002/ncp.11337","url":null,"abstract":"<p><strong>Background: </strong>The role of calf circumference (CC) in predicting sarcopenia and mortality of patients undergoing maintenance hemodialysis (MHD) remains debated. This study assessed CC's predictive value, optimal threshold, and mortality association in older patients undergoing MHD.</p><p><strong>Methods: </strong>An observational cohort study was conducted on older adult patients undergoing MHD. Sarcopenia was defined by European Working Group on Sarcopenia in Older People. Logistic regression and receiver operating characteristic (ROC) analysis were used to explore the relationship between CC and sarcopenia. Kaplan-Meier and Cox regression analyses assessed survival over 2 years.</p><p><strong>Results: </strong>A total of 979 older adult patients undergoing MHD treatment, with an average age of 73.4 years, were included in this study. The prevalence of sarcopenia was 61.1%. Male sex (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.04-0.45; P = 0.017) and CC (OR, 0.38; 95% CI, 0.26-0.56; P < 0.001) were identified as independent risk factors for sarcopenia through multifactorial logistic regression analysis. ROC curves for CC and sarcopenia indicated that the optimal cutoff value for men was 32.5 cm (area under the curve [AUC], 0.904; sensitivity, 0.958; specificity, 0.841), whereas for women, it was 31.9 cm (AUC, 0.884; sensitivity, 0.922; specificity: 0.756). Kaplan-Meier survival analysis demonstrated lower survival probabilities in patients with sarcopenia and low CC. After adjustment for multiple factors, Cox regression analysis revealed that patients in the sarcopenia group (hazard ratio [HR] = 2.411; P = 0.017) and those in the low-CC group (HR = 2.045; P = 0.046) had significantly shorter overall survival.</p><p><strong>Conclusions: </strong>CC is an independent predictor of sarcopenia and mortality in older patients undergoing MHD.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}