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Widhalm HK, Keintzel M, Ohrenberger G, Widhalm K. The Urgent Need for Nutritional Medical Care in Geriatric Patients-Malnutrition in Nursing Homes. Nutrients 2023; 15:4367. [PMID: 37892441 PMCID: PMC10610431 DOI: 10.3390/nu15204367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Patients aged 65 and over who are accommodated in hospitals and nursing homes are at high risk of malnutrition and often show signs of it. The future relevance of this problem becomes clear, especially in view of the demographic development of the coming years and decades. In this study, the correlation between malnutrition, hypoalbuminemia, anemia, elevated CRP, and low transferrin levels, as well as mortality in seniors between 65 and 100 years, should be revealed. Therefore, the prevalence of disease-specific malnutrition (DRM), according to the criteria of the guidelines of the German Society of Nutritional Medicine (DGEM), and the prevalence of hypoalbuminemia were presented based on the data of 120 residents who were inpatients in a large Viennese nursing home between 01/2017 and 08/2020. Moreover, 86 of the inpatient residents were women and 34 were men, with a mean age of 84 years (SD: 8.7). In this examination, more than one-third of nursing home residents were malnourished. More than half of the residents were found to have low serum albumin or low transferrin saturation. However, no correlation between elevated CRP, low transferrin, or low serum albumin values and malnutrition could be established. Residents with low serum albumin or low transferrin levels, however, had a higher mortality rate. This study supports the urgent relevance of closer and individually personalized medical nutritional interventions, especially concerning hypoalbuminemic seniors aged 65 years and older.
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Affiliation(s)
- Harald K. Widhalm
- Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Maximilian Keintzel
- Clinical Division of Orthopedics, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria;
- Austrian Academic Institute for Clinical Nutrition, 1090 Vienna, Austria;
| | | | - Kurt Widhalm
- Austrian Academic Institute for Clinical Nutrition, 1090 Vienna, Austria;
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Skórka M, Więch P, Przybek-Mita J, Malisiewicz A, Pytlak K, Bazaliński D. Nutritional Status of People with a Coexisting Chronic Wound and Extended Assessment Using Bioelectrical Impedance. Nutrients 2023; 15:2869. [PMID: 37447196 DOI: 10.3390/nu15132869] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
The diagnosis of malnutrition should be one of the pillars of comprehensive patient care, especially in the case of patients with large wounds, prolonged healing, or comorbidities. The condition for a reliable and accurate nutritional diagnosis is to link it with the parameters of nutritional status assessment at the basic level (anthropometric measurements and clinical assessment) and in depth (biochemical tests and bioelectrical impedance). A prospective study included a sample of 60 patients with coexisting chronic wounds (venous ulcers, diabetic foot syndrome, pressure injury) treated at the Wound Treatment Clinic of Fr. B. Markiewicz Podkarpackie Oncology Center (Poland). The method of estimation and diagnostic survey was used; the research tool was a scientific research protocol consisting of four parts. Self-care capacity was assessed based on the Barthel scale, nutritional status using blood biochemical parameters, and electrical bioimpedance. Wounds were classified according to the extent, depth of tissue structures, and potential infection. Subjects with pressure ulcers had statistically significantly lower fat-free mass component indices compared to those with diabetic foot syndrome and venous ulceration. The subjects with pressure ulcers had significantly lower values of body composition components compared to those with diabetic foot syndrome and venous ulcers. In the group of patients with pressure ulcers, the lowest values of albumin (3.20 g/dL), hemoglobin (10.81 g/dL), and nutritional risk index (NRI) (88.13 pts.) scores were confirmed. Subjects with pressure ulcers with limited self-care presented a non-physiological nutritional status, indicating a risk of malnutrition. Local actions related to wound treatment should be preceded by a general examination, considering the state of augmented nutrition with the use of electrical bioimpedance.
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Affiliation(s)
- Mateusz Skórka
- St. Hedvig Clinical Provincial Hospital, 35-301 Brzozów, Poland
| | - Paweł Więch
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Brzozów, Poland
- Institute of Health Protection, State University of Applied Sciences in Przemyśl, 37-700 Przemyśl, Poland
| | - Joanna Przybek-Mita
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Brzozów, Poland
- Center for Postgraduate Education of Nurses and Midwives, 35-083 Brzozów, Poland
| | - Anna Malisiewicz
- St. Hedvig Clinical Provincial Hospital, 35-301 Brzozów, Poland
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Brzozów, Poland
| | - Kamila Pytlak
- Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów, 36-200 Brzozów, Poland
| | - Dariusz Bazaliński
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-959 Brzozów, Poland
- Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów, 36-200 Brzozów, Poland
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3
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Inaba Y, Hasebe D, Hashizume K, Suda D, Saito N, Saito D, Sakuma H, Funayama A, Kobayashi T. Changes in nutritional status of patients with jaw deformities due to orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:347-354. [PMID: 36244953 DOI: 10.1016/j.oooo.2022.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/23/2022] [Accepted: 07/11/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE In orthognathic surgery, it is important to carefully manage peri-operative nutrition because maxillomandibular fixation and problems such as swelling and pain after surgery may make it difficult to eat normally and may prevent adequate nutrition. This study investigated the changes in nutritional status of patients with jaw deformities due to orthognathic surgery. STUDY DESIGN The subjects were 155 jaw deformity patients, who underwent orthognathic surgery. The nutritional status was evaluated using anthropometry immediately before and 10 days after surgery and clinical laboratory results and the controlling nutritional status (CONUT) score before surgery and immediately, 1 week and >6 months after surgery. We investigated the relationship among the nutritional status, surgical procedures, and dietary intake in patients who underwent orthognathic surgery. RESULTS The surgical procedure time and amount of bleeding were significantly greater as the surgical procedure became more complex. All of the laboratory values and CONUT scores were significantly decreased immediately after surgery and then increased over time, recovering to the same level as before surgery except for serum albumin at >6 months after surgery. CONCLUSIONS Nutritional management is considered as one of the key factors for the better and faster recovery after the orthognathic surgery.
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Affiliation(s)
- Yoshinori Inaba
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Gakkocho-Dori, Niigata, Japan
| | - Daichi Hasebe
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Gakkocho-Dori, Niigata, Japan.
| | - Kosuke Hashizume
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Gakkocho-Dori, Niigata, Japan
| | - Daisuke Suda
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Gakkocho-Dori, Niigata, Japan
| | - Naoaki Saito
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Gakkocho-Dori, Niigata, Japan
| | - Daisuke Saito
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Gakkocho-Dori, Niigata, Japan
| | - Hidenobu Sakuma
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Gakkocho-Dori, Niigata, Japan
| | - Akinori Funayama
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Gakkocho-Dori, Niigata, Japan
| | - Tadaharu Kobayashi
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Gakkocho-Dori, Niigata, Japan
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4
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Frech TM, Poole JL, Murtaugh M, Matucci-Cerinic M. Expanding the Treatment Team. Rheum Dis Clin North Am 2023; 49:377-387. [PMID: 37028841 DOI: 10.1016/j.rdc.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
The optimal systemic sclerosis (SSc) care plan includes an occupational therapist and physical therapist as well as wound care experts and a registered dietitian if indicated. Screening instruments for functional and work disability, hand and mouth limitations, malnutrition, and dietary intake can identify the need for ancillary support services. Telemedicine can assist in developing effective ancillary treatment plans. Reimbursement for services may limit access for patients with SSc to expand their care team but a focus on prevention rather than management of damage is recognized as an important unmet need in SSc. In this review, the role of a comprehensive care team for SSc is discussed.
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Affiliation(s)
- Tracy M Frech
- Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Janet L Poole
- Occupational Therapy Graduate Program, Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | - Maureen Murtaugh
- Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
| | - Marco Matucci-Cerinic
- Division of Rheumatology and Scleroderma Unit, AOU Careggi, Florence and Department of Experimental and Clinical Medicine, University of Florence, Italy
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Keane N, Ghannam A, Konstantinos C. Fragkos, Rahman F. Oral, Enteral and Parenteral Nutritional Therapies in Scleroderma: a Systematic Review. Clin Nutr ESPEN 2022; 51:174-184. [DOI: 10.1016/j.clnesp.2022.06.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/16/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022]
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Bagnato G, Pigatto E, Bitto A, Pizzino G, Irrera N, Abignano G, Ferrera A, Sciortino D, Wilson M, Squadrito F, Buch MH, Emery P, Zanatta E, Gangemi S, Saitta A, Cozzi F, Roberts WN, Del Galdo F. The PREdictor of MAlnutrition in Systemic Sclerosis (PREMASS) Score: A Combined Index to Predict 12 Months Onset of Malnutrition in Systemic Sclerosis. Front Med (Lausanne) 2021; 8:651748. [PMID: 33816531 PMCID: PMC8010181 DOI: 10.3389/fmed.2021.651748] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/19/2021] [Indexed: 12/24/2022] Open
Abstract
Objective: Malnutrition is a severe complication in Systemic Sclerosis (SSc) and it is associated with significant mortality. Notwithstanding, there is no defined screening or clinical pathway for patients, which is hampering effective management and limiting the opportunity for early intervention. Here we aim to identify a combined index predictive of malnutrition at 12 months using clinical data and specific serum adipokines. Methods: This was an international, multicentre observational study involving 159 SSc patients in two independent discovery (n = 98) and validation (n = 61) cohorts. Besides routine clinical and serum data at baseline and 12 months, Malnutrition Universal Screening Tool (MUST) score and serum concentration of leptin and adiponectin were measured for each participant at baseline. The endpoint of malnutrition was defined according to European Society of Clinical Nutrition and Metabolism (ESPEN) recommendation. Significant parameters from univariate analysis were tested in logistic regression analysis to identify the predictive index of malnutrition in the derivation cohort. Results: The onset of malnutrition at 12 months correlated with adiponectin, leptin and their ratio (A/L), MUST, clinical subset, disease duration, Scl70 and Forced Vital Capaciy (FVC). Logistic regression analysis defined the formula: -2.13 + (A/L*0.45) + (Scl70*0.28) as the best PREdictor of MAlnutrition in SSc (PREMASS) (AUC = 0.96; 95% CI 0.93, 0.99). PREMASS < -1.46 had a positive predictive value (PPV) > 62% and negative predictive value (NPV) > 97% for malnutrition at 12 months. Conclusion: PREMASS is a feasible index which has shown very good performance in two independent cohorts for predicting malnutrition at 12 months in SSc. The implementation of PREMASS could aid both in clinical management and clinical trial stratification/enrichment to target malnutrition in SSc.
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Affiliation(s)
- Gianluca Bagnato
- National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals National Health Service (NHS) Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Erika Pigatto
- Department of Medicine, Villa Salus Hospital, Venice, Italy
| | - Alessandra Bitto
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gabriele Pizzino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppina Abignano
- National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals National Health Service (NHS) Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
- Rheumatology Institute of Lucania (IReL), Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy
| | - Antonino Ferrera
- National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals National Health Service (NHS) Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Davide Sciortino
- National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals National Health Service (NHS) Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Michelle Wilson
- National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals National Health Service (NHS) Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maya H. Buch
- Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine & Health, University of Manchester and NIHR Manchester Biomedical Research Centre, Manchester, United Kingdom
| | - Paul Emery
- National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals National Health Service (NHS) Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | | | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonino Saitta
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Franco Cozzi
- Department of Medicine-DIMED, University of Padova, Padova, Italy
| | | | - Francesco Del Galdo
- National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC), Leeds Teaching Hospitals National Health Service (NHS) Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
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7
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Zarshenas N, Tapsell LC, Batterham M, Neale EP, Talbot ML. Changes in Anthropometric Measures, Nutritional Indices and Gastrointestinal Symptoms Following One Anastomosis Gastric Bypass (OAGB) Compared with Roux-en-y Gastric Bypass (RYGB). Obes Surg 2021; 31:2619-2631. [PMID: 33624210 PMCID: PMC7901677 DOI: 10.1007/s11695-021-05284-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/26/2022]
Abstract
Purpose Bariatric surgery is an effective treatment for obesity with new procedures emerging. However, despite comparable weight loss and improvements in metabolic outcomes, research on nutritional and gastrointestinal symptoms remains limited. Here we compare clinical data on weight, nutritional disorders and gastrointestinal symptoms of patients before and following one anastomosis gastric bypass (OAGB) and Roux-en-Y gastric Bypass (RYGB). Materials and Methods In this retrospective study, data on anthropometry, nutritional indices, dietary intake and gastrointestinal symptoms were retrieved in cohorts of patients up to 2 years following OAGB and RYGB. Results Seventy-three patients had either a RYGB (28) or an OAGB (45), with 71% seeking these as a revisional procedure. Significant and higher weight loss was observed in the OAGB cohort at 1 year (%TWL 33.0 ± 8.5 vs. 26.6 ± 12.4), albeit comparable at 2 years postoperatively (%TWL 29.0 ± 11.1 vs. 34.1 ± 11.2). Disorders such as vitamin D, active B12, folate, homocystein (Hcy) and hyperparathyroidism were present following both surgeries. Levels of vitamin D, ferritin and total protein significantly worsened over time. Gastrointestinal symptoms of diarrhoea, steatorrhoea and reflux were higher in the OAGB cohort while the RYGB cohort reported more dumping syndrome (DS). Conclusion Significant and similar weight loss results are seen following both OAGB and RYGB. Nutritional disorders were common in both cohorts and increased over time. However, the OAGB patients reported more gastrointestinal side effects, which may contribute to poor quality of life and nutritional consequences. Prospective and longer-term studies investigating the nutritional and gastrointestinal health of patients undergoing OAGB is recommended.
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Affiliation(s)
- Nazy Zarshenas
- School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW Australia
- Shore Surgical, Suite 204, Level 2/156 Pacific Highway, Greenwich, NSW 2065 Australia
| | - Linda Clare Tapsell
- School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW Australia
| | - Marijka Batterham
- School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW Australia
| | - Elizabeth Phillipa Neale
- School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW Australia
| | - Michael Leonard Talbot
- Upper Gastrointestinal Surgery, St George Private Hospital, Kogarah, Sydney, NSW 2217 Australia
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Rosato E, Gigante A, Gasperini ML, Proietti L, Muscaritoli M. Assessing Malnutrition in Systemic Sclerosis With Global Leadership Initiative on Malnutrition and European Society of Clinical Nutrition and Metabolism Criteria. JPEN J Parenter Enteral Nutr 2020; 45:618-624. [DOI: 10.1002/jpen.1872] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/04/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Edoardo Rosato
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | | | - Lidia Proietti
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
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9
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Shibata M, Nakajima K. High Serum Aspartate Aminotransferase, Underweight, and Weight Loss in Older People: Results of the KITCHEN-4. Healthcare (Basel) 2020; 8:healthcare8020069. [PMID: 32218224 PMCID: PMC7348708 DOI: 10.3390/healthcare8020069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/15/2020] [Accepted: 03/23/2020] [Indexed: 02/05/2023] Open
Abstract
Background: Reduced muscle mass is frequently observed in older people and can lead to being underweight and/or weight loss (WL), but prediction and screening systems utilizing hematological biochemical parameters are limited. High serum aspartatSe aminotransferase in conjunction with normal serum alanine aminotransferase (HASNAL) can reflect systemic muscle damage. HASNAL and the incidence of being underweight concomitant with WL (UWWL) were investigated in the present 6-year community-based cohort study. Methods: Clinical parameters, lifestyle, the incidence of being underweight, ≥ 5% WL, and UWWL were investigated in 238,536 Japanese people aged 40-68 years who had normal serum alanine aminotransferase. HASNAL was defined as serum aspartate aminotransferase ≥ 30 U/L and serum alanine aminotransferase < 30 U/L. The subjects were divided into a younger group (< 55 years) and an older group (≥ 55 years). Results: After 6 years, overall body weight had increased by 0.4% in the younger group and decreased by 0.4% in the older group. In logistic regression analysis, in the younger group ≥ 5% WL was significantly associated with baseline HASNAL compared to baseline low serum aspartate aminotransferase (< 20 U/L). In the older group, baseline HASNAL was significantly associated with being underweight, ≥ 5% WL, and UWWL, even after adjustment for potential confounders, and UWWL was inversely associated with regular exercise and daily alcohol consumption-both of which modified the aforementioned associations. Conclusions: Older subjects with HASNAL were at an increased risk of UWWL, possibly via skeletal muscle damage, which may be affected by common lifestyles.
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Affiliation(s)
- Michi Shibata
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan;
- Department of Nutrition, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan
| | - Kei Nakajima
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan;
- Graduate School of Health Innovation, Kanagawa University of Human Services, Research Gate Building Tonomachi 2-A, 3-25-10 Tonomachi, Kawasaki, Kanagawa 210-0821, Japan
- Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
- Correspondence: ; Tel.: +81-046-828-2660; Fax: +81-046-828-2661
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Günalay S, Öztürk YK, Akar H, Mergen H. The relationship between malnutrition and quality of life in haemodialysis and peritoneal dialysis patients. ACTA ACUST UNITED AC 2019; 64:845-852. [PMID: 30673007 DOI: 10.1590/1806-9282.64.09.845] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 01/06/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND One of the most important factors affecting the quality of life of chronic kidney disease (CKD) patients is nutrition. Prevention of malnutrition increases patients' quality and length of life. In this study, we aimed to determine the frequency of malnutrition, quality of life, and the relationship between them in patients with end-stage renal disease (ESRD). METHOD The study was conducted with a total of 60 CKD patients including 50 haemodialysis patients and 10 peritoneal dialysis patients. Patients' data associated with socio-demographics, body mass index (BMI), waist circumference, triceps skin-fold thickness (TSFT), pre-dialysis systolic and diastolic blood pressure, Kt/V and urea reduction ratio (URR) values, laboratory parameters, Mini-Nutritional Assessment-Short Form (MNA-SF) and European Quality of Life 5-Dimensions (EQ5D) scale were recorded. FINDINGS Of the total 60 patients; 27 were male (45%), 33 were female (55%), 83.3% were receiving haemodialysis treatment (HD), and 16.7% were receiving peritoneal dialysis treatment (PD). The mean MNA-SF score was 10.4 ± 2.8 in the HD group and 10.5 ± 2.9 in the PD group; there was no difference between the scores of the HD and PD groups. The mean EQ5D score was 0.60 ± 0.29 in the HD group and 0.68 ± 0.33 in the PD group, no significant difference was found between the HD group and the PD group. The quality of life was found lower in malnourished group (p=0.001). CONCLUSION The quality of life needs to be increased by early diagnosis and treatment of malnutrition in patients at risk.
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Affiliation(s)
- Serkan Günalay
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center - Department of Family Medicine, Yenişehir/İzmir, Turkey
| | - Yasemin Kiliç Öztürk
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center - Department of Family Medicine, Yenişehir/İzmir, Turkey
| | - Harun Akar
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center, Department of Internal Medicine, Izmir,Turkey
| | - Haluk Mergen
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center - Department of Family Medicine, Yenişehir/İzmir, Turkey
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High burden of skin sclerosis is associated with severe organ involvement in patients with systemic sclerosis and systemic sclerosis overlap syndrome. Rheumatol Int 2018; 38:2279-2288. [DOI: 10.1007/s00296-018-4156-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/07/2018] [Indexed: 10/28/2022]
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12
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Abstract
Although classification criteria for systemic sclerosis (SSc) do not incorporate gastrointestinal tract (GIT) manifestations often present in this disease, the GIT is the most common internal organ involved. Pathophysiology of GIT involvement is thought to be similar to other organs in SSc with fibroproliferative vascular lesions of small arteries and arterioles, increased production of profibrotic growth factors, and alterations of innate, humoral, and cellular immunity. These processes result in neuropathy progressing to myopathy with eventual fibrosis. Proper diagnostics and therapeutics for SSc-GIT involvement require the treating physician to have an understanding of an integrated approach and potential medication adverse effects.
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Affiliation(s)
- Tracy M Frech
- Department of Internal Medicine, Division of Rheumatology, University of Utah, Salt Lake Veterans Affair Medical Center, Salt Lake City, UT, USA.
| | - Diane Mar
- Department of Internal Medicine, University of Colorado, Denver, 12631 East 17th Avenue, Aurora, CO 80045, USA
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Lewicki S, Leśniak M, Bertrandt J, Kalicki B, Kubiak JZ, Lewicka A. The long-term effect of a protein-deficient-diet enriched with vitamin B6 on the blood parameters in unexercised and exercised rats. FOOD AGR IMMUNOL 2018. [DOI: 10.1080/09540105.2018.1439900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Sławomir Lewicki
- Department of Regenerative Medicine and Cell Biology, Military Institute of Hygiene and Epidemiology, Warsaw, Poland
| | - Monika Leśniak
- Department of Regenerative Medicine and Cell Biology, Military Institute of Hygiene and Epidemiology, Warsaw, Poland
| | - Jerzy Bertrandt
- Department of Hygiene and Physiology, Military Institute of Hygiene and Epidemiology, Warsaw, Poland
| | - Bolesław Kalicki
- Paediatric, Nephrology and Allergology Clinic, Military Institute of Medicine, Warsaw, Poland
| | - Jacek Z. Kubiak
- Department of Regenerative Medicine and Cell Biology, Military Institute of Hygiene and Epidemiology, Warsaw, Poland
- Faculté de Medecine, CNRS UMR 6290, IGDR, Université Rennes, Rennes, France
| | - Aneta Lewicka
- Laboratory of Epidemiology, Military Institute of Hygiene and Epidemiology, Warsaw, Poland
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Zhang Z, Pereira SL, Luo M, Matheson EM. Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2017; 9:E829. [PMID: 28771192 PMCID: PMC5579622 DOI: 10.3390/nu9080829] [Citation(s) in RCA: 279] [Impact Index Per Article: 39.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 07/22/2017] [Accepted: 07/31/2017] [Indexed: 01/04/2023] Open
Abstract
Malnutrition is a common yet under-recognized problem in hospitalized patients. The aim of this paper was to systematically review and evaluate malnutrition biomarkers among order adults. Eligible studies were identified through Cochrane, PubMed and the ProQuest Dialog. A meta-regression was performed on concentrations of biomarkers according to malnutrition risks classified by validated nutrition assessment tools. A total of 111 studies were included, representing 52,911 participants (55% female, 72 ± 17 years old) from various clinical settings (hospital, community, care homes). The estimated BMI (p < 0.001) and concentrations of albumin (p < 0.001), hemoglobin (p < 0.001), total cholesterol (p < 0.001), prealbumin (p < 0.001) and total protein (p < 0.05) among subjects at high malnutrition risk by MNA were significantly lower than those without a risk. Similar results were observed for malnutrition identified by SGA and NRS-2002. A sensitivity analysis by including patients with acute illness showed that albumin and prealbumin concentrations were dramatically reduced, indicating that they must be carefully interpreted in acute care settings. This review showed that BMI, hemoglobin, and total cholesterol are useful biomarkers of malnutrition in older adults. The reference ranges and cut-offs may need to be updated to avoid underdiagnosis of malnutrition.
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Affiliation(s)
- Zhiying Zhang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA.
- Abbott Nutrition Research and Development Asia-Pacific Center, 138668 Singapore, Singapore.
| | | | - Menghua Luo
- Abbott Nutrition Research and Development, Columbus, OH 43219, USA.
| | - Eric M Matheson
- Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29412, USA.
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15
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Kim SR, Chung SJ, Yoo SH. Factors contributing to malnutrition in patients with Parkinson's disease. Int J Nurs Pract 2014; 22:129-37. [DOI: 10.1111/ijn.12377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Sung R Kim
- College of Nursing; Chonbuk National University; Jeonju Korea
| | - Sun J Chung
- Department of Neurology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - Sung-Hee Yoo
- College of Nursing; Chonnam National University; Gwangju Korea
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16
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Abstract
PURPOSE OF REVIEW Gastrointestinal tract (GIT) involvement in systemic sclerosis (scleroderma, SSc) is the most common internal complication. This review discusses the outcome measures to capture GIT involvement in clinical care and trials. RECENT FINDINGS Patient-reported outcome measures have been validated (UCLA Scleroderma Clinical Trial Consortium GIT 2.0 and NIH PROMIS scales) in SSc-GIT. Multiple objective measures are available to assess mucosal involvement and motility in GIT. However, these need to be validated in SSc for trials. SUMMARY GIT is a common cause of morbidity and has negative impact on quality of life in SSc. Recommendations are given for trial design and evaluation of GIT involvement in SSc.
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Affiliation(s)
- Ronald L. Koretz
- Olive View–UCLA Medical Center, David Geffen–UCLA School of Medicine, Sylmar and Los Angeles, California
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18
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Abstract
The management of patients with systemic sclerosis (SSc) can be challenging because disease-associated damage is often difficult to reverse and curative therapies are not yet available. Early identification and appropriate monitoring of patients with SSc is, therefore, critical so that active disease can be controlled and tissue damage prevented or delayed. However, early diagnosis of SSc is often difficult because the early clinical stages of the disease can be very similar to that of other autoimmune conditions. Screening for major organ manifestations of SSc, particularly interstitial lung disease, pulmonary hypertension, renal involvement and cardiac disease is a priority because involvement of these organs is associated with shorter life expectancies and early intervention might prevent disease progression. The prevention and management of digital ischaemia is also important as appropriate therapy often prevents substantial morbidity and functional loss. Treating gastrointestinal dysmotility can usually be managed using proton pump inhibitors and promotility agents, although in severe cases total parenteral nutrition is required. Calcinosis in patients with SSc is another common challenge that requires appropriate disease management and pain control. Each of these topics, which are relevant to both physicians and patients with SSc, are reviewed in further detail herein.
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Harrison E, Herrick AL, McLaughlin JT, Lal S. Malnutrition in systemic sclerosis. Rheumatology (Oxford) 2012; 51:1747-56. [PMID: 22850183 DOI: 10.1093/rheumatology/kes160] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
SSc is a chronic multi-system disease with wide-reaching consequences. Gastrointestinal features are present in over 90% of cases and these, together with other disease manifestations, may lead to nutritional decline. This produces substantial morbidity, including reliance on enteral support and even parenteral nutrition-dependent intestinal failure. These complications carry an associated mortality. Up to 18% of patients with SSc are reported to be at high risk of malnutrition [as assessed by Malnutrition Universal Screening Tool (MUST) criteria], with risk increasing with disease severity. Little is known about this decline, its rate of progression and how it affects the individual. Few case series report on nutritional interventions. Most current interventions are based on experience in other diseases. The development of specialist knowledge of SSc-related gastrointestinal disease management and nutritional screening and interventions is required. This paper reviews current knowledge relating to malnutrition and its management in SSc.
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Affiliation(s)
- Elizabeth Harrison
- Department of Gastroenterology, Salford Royal NHS Foundation Trust, Salford, UK.
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20
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Murtaugh MA, Frech TM. Nutritional status and gastrointestinal symptoms in systemic sclerosis patients. Clin Nutr 2012; 32:130-5. [PMID: 22770637 DOI: 10.1016/j.clnu.2012.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 05/04/2012] [Accepted: 06/12/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Gastrointestinal manifestations in systemic sclerosis (SSc) can influence the nutritional status of patients. Our objective was to examine whether nutritional status was associated with symptoms captured by the University of California Los Angeles Scleroderma Clinical Trials Consortium Gastrointestinal Tract Questionnaire (GIT 2.0). METHODS A series of 24 University of Utah SSc Center patients were assessed using the MUST, SGA, and GIT 2.0. A single evaluator administered the nutrition assessment and gastrointestinal symptom questionnaire. RESULTS Nine patients were assessed at moderate to high risk of malnutrition using the Malnutrition Universal Screening Tool (MUST) and 12 patients with moderate to severe malnutrition using Subjective Global Assessment (SGA). Neither MUST nor SGA status was associated with duration of disease. Soilage, social function and emotional subscores were associated with SGA nutritional status. Clinically significant differences in Total GIT 2.0 score, reflux, distention/bloating, soilage, diarrhea, social function and emotional well-being were observed across levels of nutritional status. CONCLUSIONS Clinically significant differences in gastrointestinal tract symptoms were observed across levels of nutritional status in patients with varying severity of SSc. These two clinically utilized tools, the SGA and the GIT 2.0, appear to be complementary in the evaluation of SSc patients.
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Affiliation(s)
- Maureen A Murtaugh
- Division of Epidemiology, Department of Internal Medicine, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84108, USA.
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21
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Bojakowski K, Dzabic M, Kurzejamska E, Styczynski G, Andziak P, Gaciong Z, Söderberg-Nauclér C, Religa P. A high red blood cell distribution width predicts failure of arteriovenous fistula. PLoS One 2012; 7:e36482. [PMID: 22574168 PMCID: PMC3344886 DOI: 10.1371/journal.pone.0036482] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 04/08/2012] [Indexed: 02/03/2023] Open
Abstract
In hemodialysis patients, a native arteriovenous fistula (AVF) is the preferred form of permanent vascular access. Despite recent improvements, vascular access dysfunction remains an important cause of morbidity in these patients. In this prospective observational cohort study, we evaluated potential risk factors for native AVF dysfunction. We included 68 patients with chronic renal disease stage 5 eligible for AVF construction at the Department of General and Vascular Surgery, Central Clinical Hospital Ministry of Internal Affairs, Warsaw, Poland. Patient characteristics and biochemical parameters associated with increased risk for AVF failure were identified using Cox proportional hazards models. Vessel biopsies were analyzed for inflammatory cells and potential associations with biochemical parameters. In multivariable analysis, independent predictors of AVF dysfunction were the number of white blood cells (hazard ratio [HR] 1.67; 95% confidence interval [CI] 1.24 to 2.25; p<0.001), monocyte number (HR 0.02; 95% CI 0.00 to 0.21; p = 0.001), and red blood cell distribution width (RDW) (HR 1.44; 95% CI 1.17 to 1.78; p<0.001). RDW was the only significant factor in receiver operating characteristic curve analysis (area under the curve 0.644; CI 0.51 to 0.76; p = 0.046). RDW>16.2% was associated with a significantly reduced AVF patency frequency 24 months after surgery. Immunohistochemical analysis revealed CD45-positive cells in the artery/vein of 39% of patients and CD68-positive cells in 37%. Patients with CD68-positive cells in the vessels had significantly higher white blood cell count. We conclude that RDW, a readily available laboratory value, is a novel prognostic marker for AVF failure. Further studies are warranted to establish the mechanistic link between high RDW and AVF failure.
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Affiliation(s)
- Krzysztof Bojakowski
- Department of General, Vascular and Oncologic Surgery, Warsaw University of Medicine, Warsaw, Poland
- Department of Internal Medicine and Hypertension, Warsaw University of Medicine, Warsaw, Poland
| | - Mensur Dzabic
- Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- * E-mail: (MD); (PR)
| | - Ewa Kurzejamska
- Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Grzegorz Styczynski
- Department of Internal Medicine and Hypertension, Warsaw University of Medicine, Warsaw, Poland
| | - Piotr Andziak
- Department of General, Vascular and Oncologic Surgery, Warsaw University of Medicine, Warsaw, Poland
| | - Zbigniew Gaciong
- Department of Internal Medicine and Hypertension, Warsaw University of Medicine, Warsaw, Poland
| | | | - Piotr Religa
- Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- * E-mail: (MD); (PR)
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JAWA HANI, FERNANDES GAIL, SAQUI OLIVIA, ALLARD JOHANNEP. Home Parenteral Nutrition in Patients with Systemic Sclerosis: A Retrospective Review of 12 Cases. J Rheumatol 2012; 39:1004-7. [DOI: 10.3899/jrheum.110896] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective.To evaluate the effect of home total parenteral nutrition (HTPN) on the nutritional and functional status of patients with systemic sclerosis (SSc).Methods.Retrospective review of SSc patients from the HTPN database at the University Health Network, Toronto, Canada, from 1998 to 2010.Results:In total 12 subjects (9 females, 3 males) with SSc were identified. At initiation of HTPN, the age was 48.75 ± 3.94 years and the median body mass index was 16.8 kg/m2 (range 12.3–21.3). This significantly increased to 18.3 kg/m2 (17.0–21.7) at 6 months and to 19.7 kg/m2 (17.0–24.6) at 12 months. The mean Karnofsky score at baseline was 58.00 ± 3.27, and the score at 12 months of 39.00 ± 13.29 did not change significantly.Conclusion.HTPN improved the nutritional status of these patients with SSc but it did not improve their functional status.
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Biology-based nutritional support of critically ill and injured patients. Eur Surg 2011. [DOI: 10.1007/s10353-011-0587-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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