Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Malnutrition-inflammation complex syndrome (MICS), hyperhomocysteinemia, calcium and phosphate levels derangement have been predicted as important contributing factors for the progression of cardiovascular burden. Among patients with earlier stage of CKD, hypoalbuminaemia and inflammation deliberated as non-traditional cardiovascular risk factors, which add more burden to circulatory disease, mortality and rapid advancement to CKD stage 5. ⋯ This study shows MIS is an important factor that determines mortality in pre-dialysis CKD patients during 36 and more months of follow-up time. Patients with MIS ≥7 have high risk for mortality and needs close monitoring. In clinical setting application of MIS has a greater utilization in pre-dialysis CKD patients. Further research with longitudinal assessment of MIS and its association with outcomes are warranted. Pre-dialysis CKD patients should be assessed for their nutritional status and inflammation using MIS regularly to prevent malnutrition and its associated complications through appropriate medical and nutritional intervention.
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Little data evaluate the enteral nutrition (EN) for patients with acute mesenteric ischaemia (AMI) in the intensive care unit (ICU). This study assessed the outcomes of EN for recanalised AMI patients in the ICU. ⋯ Acute mesenteric ischaemia (AMI) is a catastrophic abdominal vascular emergency in the surgical intensive care unit (ICU), and the mortality of AMI remains unchanged despite significant progress of endovascular techniques. A multidisciplinary and multimodal management approach of AMI in the ICU has been recently proposed to improve patient's survival and prevent the intestinal failure. Post-recanalisation nutrition therapy may significantly improve the overall survival of AMI patients is quite underemphasised in the ICU. Definitive data comparing EN with TPN for this patient population are very lacking. This study provides the clinical data to suggest that early EN starting after ICU admission represents a favourable alternative to TPN for recanalised AMI patients. The nutrition therapy protocol in the ICU for this special cohort needs to be updated with more high-level evidence in the future.
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The amount of energy required to improve clinical outcomes in critically ill adults is unknown. ⋯ The delivery of near target energy when compared to standard care in adult critically ill patients was not associated with an effect on mortality. Because the quality of the evidence across outcomes was very low there is considerable uncertainty surrounding this estimate. This has implications for clinical utility of the evidence within the included reviews.
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The purpose of this study was to investigate the prevalence of sarcopenia following stroke, musculoskeletal disease, or hospital-associated deconditioning in convalescent rehabilitation ward inpatients. The association between the activities of daily living (ADLs), dysphagia, and sarcopenia was also assessed. ⋯ The prevalence of sarcopenia in convalescent rehabilitation ward inpatients was 53.0%. ADLs and dysphagia were independently associated with sarcopenia in this study population. Sarcopenia with disabilities should be assessed for all patients in rehabilitation settings.
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Physical functioning declines with advancing age and compounds malnutrition, common in elderly populations. A dual-intervention combining oral nutritional support and exercise may delay these changes. Our aims were to assess whether exercise combined with oral nutritional support (ONS) has greater improvements on physical functioning, quality of life and nutritional status than nutrition intervention alone in nutritionally vulnerable older adults. ⋯ This trial was registered at http://www.crd.york.ac.uk/PROSPERO/ as CRD42015027323.