JPEN. Journal of parenteral and enteral nutrition
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JPEN J Parenter Enteral Nutr · Jan 2014
Review Meta AnalysisEffect of timing of pharmaconutrition (immunonutrition) administration on outcomes of elective surgery for gastrointestinal malignancies: a systematic review and meta-analysis.
Pharmaconutrition has previously been reported in elective surgery to reduce postoperative infective complications and duration of hospital length of stay. ⋯ This meta-analysis highlights the importance of timing as a clinical consideration in the provision of pharmaconutrition in elective gastrointestinal surgical patients and identifies areas where further research is required.
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JPEN J Parenter Enteral Nutr · Jan 2014
Review Meta AnalysisEffect of timing of pharmaconutrition (immunonutrition) administration on outcomes of elective surgery for gastrointestinal malignancies: a systematic review and meta-analysis.
Pharmaconutrition has previously been reported in elective surgery to reduce postoperative infective complications and duration of hospital length of stay. ⋯ This meta-analysis highlights the importance of timing as a clinical consideration in the provision of pharmaconutrition in elective gastrointestinal surgical patients and identifies areas where further research is required.
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Established guidelines and standardized protocols exist to assist clinicians in effectively addressing disease-related malnutrition in hospitalized adults. The goals of this treatment vary according to the disease state and the severity of the malnutrition. In starvation-related malnutrition, the goal of nutrition therapy is to restore healthy levels of lean body mass and body fat. ⋯ When addressing malnutrition in hospitalized patients, oral feeding through diet enrichment or oral nutrition supplementation (ONS) is the first line of defense. ONS has consistently been demonstrated to provide nutrition, clinical, functional, and economic benefits to malnourished patients in both individual trials and meta-analyses. In an era when the cost of healthcare is rising as the population ages, addressing malnutrition in hospitalized patients is an important priority.
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JPEN J Parenter Enteral Nutr · Nov 2012
ReviewRapid enrichment of cell phospholipids in long-chain polyunsaturated ω-3 fatty acids after a bolus intravenous injection of a medium-chain triacylglycerol: fish oil emulsion in humans.
The present review aims at highlighting the use of a recently developed medium-chain triacylglycerol:fish oil (MCT:FO) emulsion for the rapid and sustained enrichment of long-chain polyunsaturated ω-3 fatty acids in cell phospholipids. Preclinical in vitro, in vivo, and ex vivo experiments are briefly considered with emphasis on the changes in the fatty acid pattern of cell phospholipids in several organs, the partial correction of liver steatosis, and the cardiovascular modification of cationic and functional variables observed in ω-3-depleted rats examined 60-120 minutes after a bolus intravenous (IV) injection (1.0 mL) of the MCT:FO emulsion. The clinical findings collected in healthy male volunteers before or after the bolus IV injection (50.0 mL) of either the MCT:FO emulsion or a control medium-chain triacylglycerol:long-chain triacylglycerol emulsion are also reviewed, with emphasis on the rapid (within 60 minutes) and sustained (up to 2-3 days) enrichment of platelet and white blood cell phospholipids in long-chain polyunsaturated ω-3 fatty acids and hemostatic safety of the present procedure proposed as a tool for the rapid prevention or correction of metabolic and functional disturbances in humans with a relative deficiency in such ω-3 fatty acids.
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JPEN J Parenter Enteral Nutr · Nov 2010
Review Comparative StudyGuidelines, guidelines, guidelines: what are we to do with all of these North American guidelines?
Over the past decade, clinical guidelines for nutrition therapy in the critically ill have been developed by different North American societies. To avoid target audience confusion and uncertainty, there is a need to undergo a review of the content of these guidelines. In this review, the authors compared the grading systems, the levels of evidence used, and the content of North American nutrition clinical guidelines. ⋯ These major differences can be attributed to the admission of different populations, lower levels of evidence or expert opinion into the guideline production process, lack of clarity in the link between the evidence and the recommendation, and lack of uniformity in the reporting of levels of evidence and grades of recommendation. The authors have identified the need for the North American nutrition organizations to harmonize the development of future nutrition guidelines in a timely way, so that they remain current and up-to-date. Furthermore, guideline users need to be aware of the dissimilarities in these guidelines before applying the recommendations to their daily practice.