Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Excess weight and type 2 diabetes lead to increased susceptibility to infections. Our aim was to investigate the role of diabetes-induced decreased arginine (Arg) availability and of a possible dysregulation of Arg metabolism in macrophages favoring inflammation and dysimmunity via altered nitric oxide (NO) and cytokine productions. ⋯ This in vitro study shows that Arg metabolism is impaired in macrophages from diabetic-obese rats and that improving Arg availability for these cells restores NO production and contributes to the regulation of the inflammatory process.
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Randomized Controlled Trial
Pre-treatment with an intravenous lipid emulsion containing fish oil (eicosapentaenoic and docosahexaenoic acid) decreases inflammatory markers after open-heart surgery in infants: a randomized, controlled trial.
This study assessed the effects of administering a lipid emulsion containing eicosapentaenoic and docosahexaenoic acid before and after open-heart surgery on cytokine production and length of hospital stay in infants. ⋯ Providing a lipid emulsion containing eicosapentaenoic and docosahexaenoic acid reduces TNF-α concentrations in infants undergoing open-heart surgery. Lipid emulsions containing eicosapentaenoic and docosahexaenoic acid may ameliorate the inflammatory response among critically ill infants.
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Randomized Controlled Trial
Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs.
Older people are vulnerable to malnutrition which leads to increased health care costs. The aim of this study was to evaluate the cost-effectiveness of nutritional supplementation from a societal perspective. ⋯ A multi-component nutritional intervention to malnourished elderly patients for three months after hospital discharge leads to significant improvement in functional limitations and is neutral in costs. A follow-up of three months is probably too short to detect changes in QALYs or physical activities.
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We aimed to test the capacity in identifying patients at nutritional risk, by comparing BMI, recent %weight loss,Nutritional Risk Screening 2002(NRS-2002),Malnutrition Universal Screening Tool(MUST) and Nutritional Risk Index(NRI) with Subjective Global Assessment(SGA),considered the Standard. The main purpose was to select the most consistent screening method for effective integration in daily surgical wards' practice. ⋯ In surgical patients, MUST + NRS-2002 are valid for nutritional screening; recent weight loss ≥ 5% also proved highly efficient; its easy/quick calculation may facilitate adherence/integration by health professionals as a minimum obligatory in clinical practice.
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Large surveys auditing feeding regimen in the ICU consistently reported hypocaloric 23 enteral feedings patterns and many studies described the association between 24 energy deficit and increased complication rate. ESPEN and ASPEN experts 25 recommend early (after 48 h) or late (after 7-10 days) catch up of the 26 energy deficit with parenteral nutrition (PN) respectively, but the level of evidence 27 was poor and larger PRCT were missing. ⋯ However, weaknesses 30 in the study design and some mixing of the 3 questions have created confusion in the 31 message delivered. In addition, the severity of the acute illness was not always similar 32 in these studies, mixing short-term acutely ill patients (less than 4 days in the ICU) 33 with long term patients (more than 10 days in the ICU).