JPEN. Journal of parenteral and enteral nutrition最新文献

{"title":"Association between modified weight loss grading system and overall survival in adults with lung cancer: A retrospective cohort study.","authors":"Hao-Qing Cheng, Hong-Xia Xu, Min Weng, Lan Zhou, Fu-Xiang Zhou, Peng-Xia Guo, Ge-Ge Zhang, Chu-Ying Zhang, Han-Ping Shi, Chun-Hua Song","doi":"10.1002/jpen.2775","DOIUrl":"https://doi.org/10.1002/jpen.2775","url":null,"abstract":"<p><p>This multicenter retrospective cohort study evaluated the prognostic value of the modified weight loss grading system (mWLGS) in patients with lung cancer by analyzing data from 3601 individuals. The investigation demonstrated that mWLGS effectively stratified patient outcomes, with median overall survival progressively declining from 35.5 months for grade 0 to 26.0 months for grade 4. Multivariate Cox regression showed grades 1, 2, 3, and 4 were independently associated with reduced survival, showing incrementally worsening hazard ratios (HR) (HR 1.56, 95% CI: 1.03-2.37, P = 0.037; HR 1.87, 95% CI: 1.24-2.84, P = 0.003; HR 1.94, 95% CI: 1.27-2.96, P = 0.003; HR: 1.95, 95% CI: 1.27-3.00, P = 0.002, respectively). Sensitivity analyses, in which we excluded patients who died within 30 days, showed that mWLGS remained an independent prognostic indicator. The system significantly enhanced prognostic discrimination when combined with TNM staging, as evidenced by improved C-statistics, continuous net reclassification improvement (NRI), and integrated discriminant improvement (IDI). These findings establish that the mWLGS can better stratification the prognosis of patients with lung cancer and is an effective indicator to predict the survival time and quality of life of lung cancer patients.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164391","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":"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, Ceilidh McKenney, Camilla Sophia Rossi, Susan Khader Ibrahim, Ahmed Alnajar, Gianmarco Cancelli, Matthew McKenney, Michelle Demetres, Zi Yuan, Jeffrey Nicastro, Joel Horovitz","doi":"10.1002/jpen.2774","DOIUrl":"https://doi.org/10.1002/jpen.2774","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methods: </strong>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 >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><p><strong>Results: </strong>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><p><strong>Conclusion: </strong>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>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","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, Katherine J P Schwenger, Yasaman Ghorbani, Leah Gramlich, George Ou, David Armstrong, Maitreyi Raman, Johane P Allard, Barbara Bielawska","doi":"10.1002/jpen.2772","DOIUrl":"https://doi.org/10.1002/jpen.2772","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methods: </strong>This was a descriptive cohort (n = 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><p><strong>Results: </strong>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 (n = 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><p><strong>Conclusion: </strong>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>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129885","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":"Association between handgrip strength asymmetry and all-cause mortality in United States-based older adults: A cross-sectional study.","authors":"Xiufang Kong, Wei Wang","doi":"10.1002/jpen.2777","DOIUrl":"https://doi.org/10.1002/jpen.2777","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methods: </strong>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><p><strong>Results: </strong>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 (P for trend < 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 (P 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><p><strong>Conclusion: </strong>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>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JPEN Journal Club 93. Sarcopenia: The new malnutrition.","authors":"Ronald L Koretz","doi":"10.1002/jpen.2773","DOIUrl":"https://doi.org/10.1002/jpen.2773","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096799","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":"JPEN Journal Club 68. Type I errors.","authors":"Ronald L Koretz","doi":"10.1002/jpen.2332","DOIUrl":"https://doi.org/10.1002/jpen.2332","url":null,"abstract":"When I was in training many years ago, it was widely believed that patients with acute pancreatitis (AP) should not be fed too quickly in order to avoid stimulating that organ and creating more inflammation. This article is protected by copyright. All rights reserved.","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1736-1738"},"PeriodicalIF":3.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39854344","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":"Tribute to Kelly A. Tappenden, PhD, RD, FASPEN, JPEN Editor-in-Chief, 2010-2022.","authors":"Kenneth B Christopher","doi":"10.1002/jpen.2425","DOIUrl":"https://doi.org/10.1002/jpen.2425","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"970-971"},"PeriodicalIF":3.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40582847","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":"Antenatal corticosteroids affecting enteral feeding and growth of preterm infants: A retrospective cohort study.","authors":"Ping Luo,&nbsp;Xudong Liu,&nbsp;Liya Ma,&nbsp;You Chen,&nbsp;Kun Zhang,&nbsp;Ping Zhou,&nbsp;Yan-Nan Jiang,&nbsp;Ping-Ping Jiang","doi":"10.1002/jpen.2215","DOIUrl":"https://doi.org/10.1002/jpen.2215","url":null,"abstract":"<p><strong>Background: </strong>Treatment of antenatal corticosteroids (ACSs) to women at risk of preterm labor can decrease neonatal mortality and morbidity. However, effect of ACS exposure on enteral feeding and body growth of preterm infants remains elusive.</p><p><strong>Methods: </strong>This retrospective study collected information of eligible singleton infants born between 22⁺⁰ and 36⁺⁶ weeks' gestation from 2017 to 2019. Logistic regression and multivariate linear regression were adopted to examine the associations of the ACS exposure with various outcomes of enteral feeding and growth considering potential confounders. Stratified analysis was performed based on gestational age (GA) (<34 vs ≥34 weeks).</p><p><strong>Results: </strong>Of the 1694 preterm infants included, 1222 (72.1%) were exposed to ACSs. Infants with ACS exposure had a higher incidence of feeding intolerance (odds ratio 1.51; 95% CI, 1.05 to 2.20; P = .03), slower advancement of enteral feeding (β coefficient -0.86; 95% CI, -1.48 to -0.25; P = .01), and lower delta body-weight z-scores (β coefficient-0.13; 95% CI, -0.18 to -0.08; P < .001). Unlike in infants with GA <34 weeks, ACS exposure was associated with slower advancement of enteral feeding, longer time to regain birth weight, and lower delta body-weight z-scores in the ones with GA ≥34 weeks.</p><p><strong>Conclusion: </strong>ACS exposure is associated with poorer enteral feeding process and body growth in our study population, which is more prominent in late preterm infants. A multicenter prospective study and mechanistic studies using animal models are required.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"572-582"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39144179","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":"Knowledge of chronic intestinal failure among US gastroenterologists: Cause for concern and learning opportunity.","authors":"Kishore R Iyer,&nbsp;Marion Winkler,&nbsp;Nicole Zubizarreta,&nbsp;Marjorie Nisenholtz,&nbsp;Katie Lucero,&nbsp;Jovana Lubarda","doi":"10.1002/jpen.2283","DOIUrl":"https://doi.org/10.1002/jpen.2283","url":null,"abstract":"<p><strong>Background: </strong>Chronic intestinal failure (CIF) is an ultrarare disease, with an estimated national prevalence of ∼25,000 cases. There is a suspicion of widespread lack of expertise in CIF care, but no formal assessment tool or data exist. We developed and validated a knowledge test in CIF and now report our preliminary results from testing CIF knowledge in a cohort of US gastroenterologists.</p><p><strong>Method: </strong>We developed a 20-question knowledge test in CIF, covering four key components of IF. After internal testing, refinement, and revision, we administered the test to a convenience sample of experts and nonexperts in IF. We then deployed the validated test to a cohort of 100 US gastroenterologists.</p><p><strong>Results: </strong>The test had a Cronbach alpha of 0.74, suggesting a reliable test, with a threshold score to discriminate experts and nonexperts of 13.4 (maximum 20) and with a sensitivity of 81.3% and specificity of 86.4%. The overall mean score of 8.2 for the 100 US gastroenterologists was at the level of nonexperts in our convenience sample.</p><p><strong>Conclusion: </strong>The preliminary results of our validated knowledge test in IF among a broad group of US gastroenterologists demonstrate lack of knowledge in IF.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"730-733"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39661595","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":"Gut microbiota and its diet-related activity in children with intestinal failure receiving long-term parenteral nutrition.","authors":"Esther G Neelis,&nbsp;Barbara A E de Koning,&nbsp;Jessie M Hulst,&nbsp;Rodanthi Papadopoulou,&nbsp;Caroline Kerbiriou,&nbsp;Edmond H H M Rings,&nbsp;René M H Wijnen,&nbsp;Ben Nichols,&nbsp;Konstantinos Gerasimidis","doi":"10.1002/jpen.2188","DOIUrl":"https://doi.org/10.1002/jpen.2188","url":null,"abstract":"<p><strong>Background: </strong>This study characterized gut microbiota and its diet-related activity in children with intestinal failure (IF) receiving parenteral nutrition (PN) compared with those of healthy controls (HC) and in relation to disease characteristics.</p><p><strong>Methods: </strong>The fecal microbiota and short-chain fatty acids (SCFAs) were measured in 15 IF patients (n = 68) and 25 HC (n = 25).</p><p><strong>Results: </strong>Patients with IF had a lower bacterial load (P = .003), diversity (P < .001), evenness (P < .001) and richness (P = 0.006) than HC. Patients with surgical IF had lower diversity (P < .039) than those with functional IF. Propionic acid and butyric acid (p < .001) were lower and d-lactate and l-lactate were higher (p < 0.001) in IF patients than in HC. The energy supplied by PN (%PN) was negatively associated with microbiota diversity and SCFA profile. IF patients had more Escherichia-Shigella (P = .006), Cronobacter (P = .001), and Staphylococcus (Operational Taxonomic Unit 14, P < .001) and less Faecalibacterium (P < 0.001) and Ruminococcus 1 and 2 (P < .001). Duration of PN (P = .005), %PN (P = .005), and fiber intake (P = .011) were predictive of microbiota structure. Higher intake of enteral nutrition was associated with microbiota structure and function closer to those of HC.</p><p><strong>Conclusions: </strong>Microbiota composition and its diet-related function are altered in IF, with depletion of beneficial SCFAs and species and supraphysiological increase of potentially harmful pathobionts. The influence of this compositional and functional microbial dysbiosis on patients' outcomes and management warrants further exploration.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"693-708"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38977127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}