Nutrition
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Refeeding syndrome (RFS) broadly encompasses a severe electrolyte disturbance (principally low serum concentrations of intracellular ions such as phosphate, magnesium, and potassium) and metabolic abnormalities in undernourished patients undergoing refeeding whether orally, enterally, or parenterally. RFS reflects the change from catabolic to anabolic metabolism. RFS sometimes is undiagnosed and unfortunately some clinicians remain oblivious to its presence. ⋯ The presence of hypophosphatemia alone does not necessarily mean that RFS is present as there are many other causes for this, as discussed later in this article. RFS is increasingly being recognized in neonates and children. An optimal refeeding regimen for RFS is not universally agreed on due to the paucity of randomized controlled trials in the field.
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Review
Perioperative nutritional support of patients undergoing pancreatic surgery in the age of ERAS.
The results achieved through the Enhanced Recovery After Surgery (ERAS) approach in gastrointestinal surgery have led to its enthusiastic acceptance in pancreatic surgery. However, the ERAS program also involves an early oral feeding that is not always feasible after pancreatoduodenectomy. The aim of this review was to investigate in the literature whether the difficulty with early oral feeding in these patients was adequately balanced by perioperative enteral or parenteral nutritional support as recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines or whether these recommendations have lost value in the "bundle" of the ERAS. ⋯ The current practice of the ERAS program in these patients appears to neglect some ESPEN recommendations. On the other hand, both ESPEN and ERAS recommendations could be combined for a supplemental benefit for the patient.
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The growing prevalence of severe obesity, combined with the failure of conservative treatments, has led to a significant spread of bariatric surgical procedures. The aim of this study was to emphasize the need of adequate presurgery patient selection and close follow-up after malabsorptive procedures for bariatric surgery. ⋯ Nutritional deficiencies are common after malabsorptive procedures for bariatric surgery; these can be present or latent before surgery, frequently going unrecognized and/or inadequately treated particularly when patients are not strictly followed up by the operating center. Despite the adequate-even intensive-intervention, clinical nutritional status moderately improved in all patients.
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The aim of this study was to create an innovative, easy-to-use, and informative web-based application system to calculate the iron, zinc, and vitamin A intake in comparison to the recommended nutrient intake (RNI). ⋯ CIMI is a simple and rapid tool that calculates energy and nutrient intake, and also the percentage of nutrient fulfillment in comparison with the dietary recommendation.
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The aim of this study was to estimate the level of adherence to the Mediterranean diet in a group of Italian high school students, in relation to their lifestyles and social and family contexts, and to compare the nutrition habits of the sample with other similar groups. ⋯ Our sample presents a departure from the Mediterranean dietary pattern. It is certainly necessary to implement public health policies targeting teenagers to promote healthier lifestyle choices; the nutritional patterns of the Mediterranean diet should be among these choices.