|
1
|
Lopes S, Tavares V, Mascarenhas P, Lopes M, Cardote C, Godinho C, Oliveira C, Santos CA, Oom M, Grillo-Evangelista J, Fonseca J. Oral Health Status of Adult Dysphagic Patients That Undergo Endoscopic Gastrostomy for Long Term Enteral Feeding. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084827. [PMID: 35457695 PMCID: PMC9028949 DOI: 10.3390/ijerph19084827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/09/2022] [Accepted: 04/13/2022] [Indexed: 12/03/2022]
Abstract
Background: Endoscopic Gastrostomy (PEG) is required to maintain a feeding route when neurological or cancer dysphagia impact oral intake. This study aimed to evaluate the oral health and oral changes of PEG-patients without oral feeding for three months. Methods: Prospective observational study, with a PEG-patients convenience sample. Data were obtained before PEG (T0) and 3 months after gastrostomy (T1). Initial oral hygiene habits were collected through a questionnaire. Intra-oral evaluation was performed using: Plaque Index (IP), Gingival Index (IG), Decayed, Missing and Filled Teeth Index (DMF), Community Periodontal Index (CPI), and Attachment Loss (AL). T0 and T1 were compared to evaluate oral health evolution. Results: Thirty-nine patients aged 65.3 ± 17.4 years were included. Initial (T0) oral health was worse than expectable. Between assessments period, oral indexes suffered a general deterioration with statistical relevance to the DMF. The frequency of deep periodontal pockets and attachment loss remained stable. Conclusions: PEG-patients presented poor oral health and insufficient oral hygiene habits, even before gastrostomy. After three months of PEG feeding, oral health suffered a general deterioration. This outcome was probably associated with the absence of oral feeding activity, which is beneficial to oral homeostasis, and further reduced oral hygiene. Improved oral daily care and dental appointments should become part of the PEG-patients follow-up.
Collapse
Affiliation(s)
- Sara Lopes
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Vitor Tavares
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Paulo Mascarenhas
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal; (P.M.); (C.G.)
| | - Marta Lopes
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Carolina Cardote
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal; (P.M.); (C.G.)
| | - Cátia Oliveira
- Artificial Feeding Team (GENE), Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (C.O.); (C.A.S.)
| | - Carla Adriana Santos
- Artificial Feeding Team (GENE), Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (C.O.); (C.A.S.)
| | - Madalena Oom
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - José Grillo-Evangelista
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Jorge Fonseca
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal; (P.M.); (C.G.)
- Artificial Feeding Team (GENE), Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (C.O.); (C.A.S.)
- Correspondence:
| |
Collapse
|
|
2
|
Carman KB, Aydın K, Kilic Aydin B, Cansu A, Direk MC, Durmus S, Dündar NO, Gencpinar P, Gungor S, Gurkas E, Hur O, Karadag M, Karademir CN, Ozkan Kart P, Okuyaz C, Oz NA, Peduk Y, Per H, Serin MH, Tekgul H, Unay B, Yarar C, Yildirim GK. Evaluation of micronutrient levels in children with cerebral palsy. Pediatr Int 2022; 64:e15005. [PMID: 34585809 DOI: 10.1111/ped.15005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/08/2021] [Accepted: 08/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Many studies evaluating the nutritional status of children with cerebral palsy (CP) have focused on energy requirements and protein intake. The present work aimed to assess nutritional status and micronutrient levels of children with (CP). METHODS This multicenter, cross-sectional and observational study was conducted in 10 different cities in Turkey. Data were available for 398 participants. Anthropometric measurements, feeding mode, nutritional status, and micronutrient levels were evaluated. RESULTS The study was conducted with 398 participants (303 patients and 95 healthy controls). Statistical analysis showed that according to the Gomez Classification, weight-for-age (WFA) revealed malnutrition in 92.6% of children with CP, based on Centers for Disease Control and Prevention percentiles. Measurements of micronutrient levels showed that zinc levels were low in patients, whereas vitamin A levels were low in controls. Phosphorous and manganese levels were significantly lower in malnourished children than in typical children. The results revealed that children consuming enteral nutrition solutions had higher selenium and lower zinc levels than non-consumers. CONCLUSIONS Malnutrition is not only a protein- or calorie-based problem; micronutrient deficiencies might cause severe health problems. Children with chronic neurological disabilities must be carefully evaluated for these issues. Therefore, nutritional interventions should be adapted to nutrition.
Collapse
Affiliation(s)
- Kursat Bora Carman
- Departments of Pediatric Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Kursad Aydın
- Department of Pediatric Neurology, Medipol University, Istanbul, Turkey
| | - Betul Kilic Aydin
- Department of Pediatric Neurology, Medipol University, Istanbul, Turkey
| | - Ali Cansu
- Department of Pediatric Neurology, Karadeniz Technical University, Trabzon, Turkey
| | | | - Selver Durmus
- Department of Pediatric Neurology, Erciyes University, Kayseri, Turkey
| | - Nihal Olgaç Dündar
- Department of Pediatric Neurology, Katip Celebi University, Izmir, Turkey
| | - Pinar Gencpinar
- Department of Pediatric Neurology, Katip Celebi University, Izmir, Turkey
| | - Serdal Gungor
- Department of Pediatric Neurology, Inonu University, Malatya, Turkey
| | - Esra Gurkas
- Departments of Pediatric Neurology, Saglik Bilimleri University Gulhane Faculty of Medicine, Ankara, Turkey
| | - Ozgen Hur
- Pediatric Neurology, Saglik Bilimleri University Gulhane Faculty of Medicine, Ankara, Turkey
| | - Meral Karadag
- Department of Pediatric Neurology, Inonu University, Malatya, Turkey
| | - Cefa Nil Karademir
- Departments of Pediatric Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Pinar Ozkan Kart
- Departments of Pediatric Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Cetin Okuyaz
- Department of Pediatric Neurology, Mersin University, Mersin, Turkey
| | - Nefise Arıbas Oz
- Departments of Pediatric Neurology, Saglik Bilimleri University Gulhane Faculty of Medicine, Ankara, Turkey
| | - Yakup Peduk
- Department of Pediatric Neurology, Erciyes University, Kayseri, Turkey
| | - Huseyin Per
- Department of Pediatric Neurology, Erciyes University, Kayseri, Turkey
| | | | - Hasan Tekgul
- Department of Pediatric Neurology, Ege University, Izmir, Turkey
| | - Bulent Unay
- Pediatric Neurology, Saglik Bilimleri University Gulhane Faculty of Medicine, Ankara, Turkey
| | - Coskun Yarar
- Departments of Pediatric Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Gonca Kilic Yildirim
- Pediatric Metabolic Diseases and Nutrition, Eskisehir Osmangazi University, Eskisehir, Turkey
| |
Collapse
|
|
3
|
Nutritional Assessment in Adult Patients with Dysphagia: A Scoping Review. Nutrients 2021; 13:nu13030778. [PMID: 33673581 PMCID: PMC7997289 DOI: 10.3390/nu13030778] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/06/2023] Open
Abstract
Malnutrition negatively affects the quality of life of patients with dysphagia. Despite the need for nutritional status assessment in patients with dysphagia, standard, effective nutritional assessments are not yet available, and the identification of optimal nutritional assessment items for patients with dysphagia is inadequate. We conducted a scoping review of the use of nutritional assessment items in adult patients with oropharyngeal and esophageal dysphagia. The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched to identify articles published in English within the last 30 years. Twenty-two studies met the inclusion criteria. Seven nutritional assessment categories were identified: body mass index (BMI), nutritional screening tool, anthropometric measurements, body composition, dietary assessment, blood biomarkers, and other. BMI and albumin were more commonly assessed in adults. The Global Leadership Initiative on Malnutrition (GLIM), defining new diagnostic criteria for malnutrition, includes the categories of BMI, nutritional screening tool, anthropometric measurements, body composition, and dietary assessment as its required components, but not the blood biomarkers and the “other” categories. We recommend assessing nutritional status, including GLIM criteria, in adult patients with dysphagia. This would standardize nutritional assessments in patients with dysphagia and allow future global comparisons of the prevalence and outcomes of malnutrition, as well as of appropriate interventions.
Collapse
|