JPEN. Journal of parenteral and enteral nutrition最新文献

{"title":"Timing of Dysphagia Screening in Alzheimer's Dementia.","authors":"Cemile Özsürekci,&nbsp;Selen Serel Arslan,&nbsp;Numan Demir,&nbsp;Hatice Çalışkan,&nbsp;Gözde Şengül Ayçiçek,&nbsp;Hasan Erkan Kılınç,&nbsp;Ömer Faruk Yaşaroğlu,&nbsp;Cemal Kızılarslanoğlu,&nbsp;Rana Tuna Doğrul,&nbsp;Cafer Balcı,&nbsp;Fatih Sümer,&nbsp;Ayşe Karaduman,&nbsp;Burcu Balam Yavuz,&nbsp;Mustafa Cankurtaran,&nbsp;Meltem Gülhan Halil","doi":"10.1002/jpen.1664","DOIUrl":"https://doi.org/10.1002/jpen.1664","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia is an important and frequent symptom in Alzheimer's dementia (AD). We hypothesized that dysphagia could be seen in the early stages of AD and sarcopenia presence rather than the severity of the AD affecting dysphagia. The main aim of this study was to investigate swallowing functions in AD patients according to stages. The second aim was to investigate the correlation between sarcopenia and dysphagia in AD.</p><p><strong>Methods: </strong>This study involved 76 probable AD patients. For all participants, diagnosis of sarcopenia was based on definitions from the revised version of European Working Group on Sarcopenia in Older People at 2018. Dysphagia symptom severity was evaluated by the Turkish version of the Eating Assessment Tool, a videofluoroscopic swallowing study (VFSS) was performed for instrumental evaluation of swallowing. The patients were divided into 3 groups according to the clinical dementia rating (CDR) scale as CDR 1 (mild dementia), CDR 2 (moderate dementia), and CDR 3 (severe dementia). Swallowing evaluation parameters were analyzed between these groups.</p><p><strong>Results: </strong>Mean age was 78.9 ± 6.4 years, and 56.4% were female. Twenty-six patients had mild dementia, 31 patients had moderate dementia, 19 patients had severe dementia (CDR 3). We found that sarcopenia rates were similar between AD stages according to CDR in our study population and dysphagia could be seen in every stage of AD. In a multivariate analysis, polypharmacy and sarcopenia were found to be independently associated factors for dysphagia, irrespective of stage of AD (OR: 6.1, CI: 1.57-23.9, P = 0.009; OR: 4.9, CI: 1.24-19.6, P = 0.023, respectively).</p><p><strong>Conclusion: </strong>Aspirations may be subtle so that AD patients and caregivers may not be aware of swallowing difficulties. Therefore, all AD patients, especially those who have polypharmacy and/or sarcopenia (probable-sarcopenia-severe sarcopenia), should be screened for dysphagia in every stage.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"516-524"},"PeriodicalIF":3.4,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.1664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40450953","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":"Epidemiology of Infectious and Noninfectious Catheter Complications in Patients Receiving Home Parenteral Nutrition: A Systematic Review and Meta-Analysis.","authors":"Ruth A Reitzel,&nbsp;Joel Rosenblatt,&nbsp;Anne-Marie Chaftari,&nbsp;Issam I Raad","doi":"10.1002/jpen.1609","DOIUrl":"https://doi.org/10.1002/jpen.1609","url":null,"abstract":"<p><p>Patients receiving parenteral nutrition (PN) as their primary source of nutrition are at high risk for both infectious and noninfectious catheter complications (catheter-related infections, catheter occlusion, and venous thrombosis). The aim of this review was to synthesize and evaluate what is known about catheter complications and prevention strategies in the PN population. Three electronic databases (Medline, Embase, and CINAHL) were screened for studies published between January 2012 and February 2019 regarding infectious and noninfectious catheter complications in patients receiving PN. Rates of infectious and noninfectious catheter complications, prevalence of causative pathogens, potential risk factors, and prevention strategies via the use of antimicrobial lock therapy (ALT) were assessed. Fifty-three catheter complication studies and 12 ALT studies were included. Studies were grouped by definition of complication: catheter-related bloodstream infections (CRBSI) or central line-associated bloodstream infections (CLABSI). Random effects summary rates per 1000 catheter days were 0.85 CRBSI episodes (95% CI 0.27-2.64) and 1.65 CLABSI episodes (95% CI 1.09-2.48). Use of taurolidine or ethanol ALT was efficacious in reducing infectious catheter complications; however, several studies had concerns for adverse mechanical complications. Potential risk factors for catheter complications were highly varied and often contradictory between studies. The rates of catheter complications were higher among catheterized patients receiving PN compared with nationally reported rates of complications in all catheterized patients. Risk factors for catheter complications need to be better understood for targeted prophylactic use of ALT. Future studies are warranted; however, they should be conducted using more standardized definitions and criteria.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"832-851"},"PeriodicalIF":3.4,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.1609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40448993","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":"Metabolic Requirement of Septic Shock Patients Before and After Liberation From Mechanical Ventilation.","authors":"Peggy Siu-Pik Lee,&nbsp;Kar Lung Lee,&nbsp;James A Betts,&nbsp;Kin Ip Law","doi":"10.1177/0148607116672424","DOIUrl":"https://doi.org/10.1177/0148607116672424","url":null,"abstract":"<p><strong>Objectives: </strong>This study identified the difference in energy expenditure and substrate utilization of patients during and upon liberation from mechanical ventilation.</p><p><strong>Methods: </strong>Patients under intensive care who were diagnosed with septic shock and dependent on mechanical ventilation were recruited. Indirect calorimetry measurements were performed during and upon liberation from mechanical ventilation.</p><p><strong>Results: </strong>Thirty-five patients were recruited (20 men and 15 women; mean age, 69 ± 10 years). Measured energy expenditures during ventilation and upon liberation were 2090 ± 489 kcal·d^-1 and 1910 ± 579 kcal·d^-1, respectively ( P < .05). Energy intake was provided at 1148 ± 495 kcal·d^-1 and differed significantly from all measured energy expenditures ( P < .05). Mean carbohydrate utilization was 0.19 ± 0.1 g·min^-1 when patients were on mechanical ventilation compared with 0.15 ± 0.09 g·min^-1 upon liberation ( P < .05). Mean lipid oxidation was 0.08 ± 0.05 g·min^-1 during and 0.09 ± 0.07 g·min^-1 upon liberation from mechanical ventilation ( P > .05).</p><p><strong>Conclusions: </strong>Measured energy expenditure was higher during than upon liberation from mechanical ventilation. This could be the increase in work of breathing from the continuous positive pressure support, repeated weaning cycles from mechanical ventilation, and/or the asynchronization between patients' respiration and ventilator support. Future studies should examine whether more appropriately matching energy expenditure with energy intake would promote positive health outcomes.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"993-999"},"PeriodicalIF":3.4,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607116672424","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39981283","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":"Food and Drug Administration Approval of Glutamine for Sickle Cell Disease: Success and Precautions in Glutamine Research.","authors":"Douglas W Wilmore","doi":"10.1177/0148607117727271","DOIUrl":"https://doi.org/10.1177/0148607117727271","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"912-917"},"PeriodicalIF":3.4,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607117727271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35363017","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":"Does Parenteral Nutrition Increase the Risk of Catheter-Related Bloodstream Infection? A Systematic Literature Review.","authors":"Nicole Clare Gavin, Elise Button, Samantha Keogh, David McMillan, Claire Rickard","doi":"10.1177/0148607117714218","DOIUrl":"10.1177/0148607117714218","url":null,"abstract":"<p><strong>Background: </strong>Central venous access devices (CVADs) are used for parenteral nutrition (PN) delivery. We systematically reviewed research-based publications that reported comparative rates of catheter-related bloodstream infection (CRBSI) in patients with CVADs who received PN vs those who did not receive PN therapy.</p><p><strong>Materials and methods: </strong>The literature search included the Cochrane Library, MEDLINE, CINAHL, and PubMed up to July 14, 2015, to identity studies that compared patients with a CVAD who did and did not have PN therapy.</p><p><strong>Results: </strong>Eleven observational studies were identified, comprising 2854 participants with 6287 CVADs. Six studies produced significant results in favor of non-PN, 4 studies showed no evidence of a difference between PN and non-PN, and 1 study produced significant results in favor of PN when analyzed per patient with multiple CVADs. Incidence ranged from 0 to 6.6 CRBSIs per 1000 CVAD days in the PN patients and 0.39 to 3.6 CRBSIs per 1000 CVAD days in the non-PN patients. The Cochrane risk of bias assessment tool for nonrandomized studies of interventions was used. Eight studies were rated as moderate risk of bias, 2 as serious, and 1 as critical.</p><p><strong>Conclusion: </strong>The data presented in this systematic review are not sufficient to establish whether patients receiving PN are more at risk of developing CRBSI than those who do not. Future PN studies needs to adjust for baseline imbalances and improve quality and reporting.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"918-928"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35122778","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":"Revised ESPEN Clinical Classification of Chronic Intestinal Failure: From 16 to 8 Categories.","authors":"Loris Pironi","doi":"10.1177/0148607117722757","DOIUrl":"https://doi.org/10.1177/0148607117722757","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"911"},"PeriodicalIF":3.4,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607117722757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35567579","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":"Management of Recurrent Catheter-Related Bloodstream Infections in an Adult Patient Receiving Home Parenteral Nutrition: Dramatic Effect of Ethanol Lock Therapy.","authors":"Jennifer Colvine,&nbsp;Patti Thomson,&nbsp;Donald R Duerksen","doi":"10.1177/0148607115602890","DOIUrl":"https://doi.org/10.1177/0148607115602890","url":null,"abstract":"<p><p>We report the use of ethanol lock therapy to dramatically reduce the incidence of catheter-related bloodstream infections (CRBSIs) in a long-term adult home parenteral nutrition (HPN) patient. This case study demonstrates the efficacy of ethanol lock therapy in eliminating CRBSIs when other treatments have been unsuccessful. We suggest that ethanol lock therapy has an important role in decreasing CRBSI in HPN patients with recurrent CRBSIs.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1072-1074"},"PeriodicalIF":3.4,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115602890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34113300","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":"Glutamine Restores Tight Junction Protein Claudin-1 Expression in Colonic Mucosa of Patients With Diarrhea-Predominant Irritable Bowel Syndrome.","authors":"Julien Bertrand,&nbsp;Ibtissem Ghouzali,&nbsp;Charlène Guérin,&nbsp;Christine Bôle-Feysot,&nbsp;Mélodie Gouteux,&nbsp;Pierre Déchelotte,&nbsp;Philippe Ducrotté,&nbsp;Moïse Coëffier","doi":"10.1177/0148607115587330","DOIUrl":"https://doi.org/10.1177/0148607115587330","url":null,"abstract":"<p><strong>Background: </strong>Recent studies showed that patients with diarrhea-predominant irritable bowel syndrome (IBS-D) had an increased intestinal permeability as well as a decreased expression of tight junctions. Glutamine, the major substrate of rapidly dividing cells, is able to modulate intestinal permeability and tight junction expression in other diseases. We aimed to evaluate, ex vivo, glutamine effects on tight junction proteins, claudin-1 and occludin, in the colonic mucosa of patients with IBS-D.</p><p><strong>Materials and methods: </strong>Twelve patients with IBS-D, diagnosed with the Rome III criteria, were included (8 women/4 men, aged 40.7 ± 6.9 years). Colonic biopsy specimens were collected and immediately incubated for 18 hours in culture media with increasing concentrations of glutamine from 0.6-10 mmol/L. Claudin-1 and occludin expression was then measured by immunoblot, and concentrations of cytokines were assessed by multiplex technology. Claudin-1 expression was affected by glutamine (P < .05, analysis of variance). In particularly, 10 mmol/L glutamine increased claudin-1 expression compared with 0.6 mmol/L glutamine (0.47 ± 0.04 vs 0.33 ± 0.03, P < .05). In contrast, occludin expression was not significantly modified by glutamine. Interestingly, glutamine effect was negatively correlated to claudin-1 (Pearson r = -0.83, P < .001) or occludin basal expression (Pearson r = -0.84, P < .001), suggesting that glutamine had more marked effects when tight junction protein expression was altered. Cytokine concentrations in culture media were not modified by glutamine treatment.</p><p><strong>Conclusion: </strong>Glutamine increased claudin-1 expression in the colonic mucosa of patients with IBS-D. In addition, glutamine effect seems to be dependent on basal expression of tight junction proteins.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1170-1176"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115587330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33302156","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":"Pretreatment and Treatment With L-Arginine Attenuate Weight Loss and Bacterial Translocation in Dextran Sulfate Sodium Colitis.","authors":"Maria Emília Rabelo Andrade,&nbsp;Rosana das Graças Carvalho Dos Santos,&nbsp;Anne Danieli Nascimento Soares,&nbsp;Kátia Anunciação Costa,&nbsp;Simone Odília Antunes Fernandes,&nbsp;Cristina Maria de Souza,&nbsp;Geovanni Dantas Cassali,&nbsp;Adna Luciana de Souza,&nbsp;Ana Maria Caetano Faria,&nbsp;Valbert Nascimento Cardoso","doi":"10.1177/0148607115581374","DOIUrl":"https://doi.org/10.1177/0148607115581374","url":null,"abstract":"<p><strong>Background: </strong>Imbalances in a variety of factors, including genetics, intestinal flora, and mucosal immunity, can contribute to the development of ulcerative colitis and its side effects. This study evaluated the effects of pretreatment or treatment with arginine by oral administration on intestinal permeability, bacterial translocation (BT), and mucosal intestinal damage due to colitis.</p><p><strong>Methods: </strong>C57BL/6 mice were distributed into 4 groups: standard diet and water (C: control group), standard diet and dextran sodium sulfate (DSS) solution (Col: colitis group), 2% L-arginine supplementation for 7 days prior to DSS administration and during disease induction (PT: pretreated group), and 2% L-arginine supplementation during disease induction (T: treated group). Colitis was induced by administration of 1.5% DSS for 7 days. After 14 days, intestinal permeability and BT were evaluated; colons were collected for histologic analysis and determination of cytokines; feces were collected for measurement of immunoglobulin A (IgA).</p><p><strong>Results: </strong>The Col group showed increased intestinal permeability (C vs Col: P < .05) and BT (C vs Col: P < .05). In the arginine-supplemented groups (PT and T), this amino acid tended to decrease intestinal permeability. Arginine decreased BT to liver during PT (P < .05) and to blood, liver, spleen, and lung during T (P < .05). Histologic analysis showed that arginine preserved the intestinal mucosa and tended to decreased inflammation.</p><p><strong>Conclusions: </strong>Arginine attenuates weight loss and BT in mice with colitis.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1131-1139"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115581374","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33075736","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":"Randomized Clinical Trial: Impact of Oral Administration of Saccharomyces boulardii on Gene Expression of Intestinal Cytokines in Patients Undergoing Colon Resection.","authors":"Marcella Lobato D Consoli,&nbsp;Raphael Steinberg da Silva,&nbsp;Jacques Robert Nicoli,&nbsp;Oscar Bruña-Romero,&nbsp;Rodrigo Gomes da Silva,&nbsp;Simone de Vasconcelos Generoso,&nbsp;Maria Isabel T D Correia","doi":"10.1177/0148607115584387","DOIUrl":"https://doi.org/10.1177/0148607115584387","url":null,"abstract":"<p><strong>Background: </strong>When intestinal microbiota is imbalanced, a patient becomes more vulnerable to infectious complications; intervention with beneficial probiotics may help lower risk for infection. The aim of this study was to measure levels of inflammatory cytokine messenger RNA (mRNA) in surgical samples of intestinal mucosal tissues from patients who were given the probiotic Saccharomyces boulardii before undergoing colon surgery.</p><p><strong>Methods: </strong>Thirty-three patients undergoing colon resection were randomly assigned to receive at least 7-day preoperative probiotic treatment (n = 15) or conventional (n = 18) treatment. Probiotic treatment consisted of oral lyophilized S boulardii Cytokine mRNA levels (interleukin [IL]-10, IL-1β, IL-23A, tumor necrosis factor [TNF]-α, IL-12B, interferon-γ [INF-γ], and IL-17A) were measured in samples obtained during the operation. Postoperative infections were also assessed.</p><p><strong>Results: </strong>Patients who received probiotics had significantly lower mucosal IL-1β, IL-10, and IL-23A mRNA levels than the control group (P = .001, P = .04, and P = .03, respectively). However, mRNA expression of other cytokines did not differ between the 2 groups (P > .05). The incidence of postoperative infectious complications was 13.3% and 38.8% in probiotic and control groups, respectively (P > .05). There was no perioperative mortality in either group. The mean total length of hospital stay was similar between the groups (P > .05).</p><p><strong>Conclusions: </strong>Probiotic treatment with S boulardii downregulates both pro- and anti-inflammatory cytokines in the intestinal colonic mucosa with no statistical impact on postoperative infection rates.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1114-1121"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115584387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33130104","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}