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AlHilli MM, Rhoades EE, Chau D, Tewari S, Reich A, Myers A, Lindner DJ, Lathia JD, Zhang R, Willard B, Cresci G, Berger NA, Reizes O. Unrestricted Ketogenic Diet Feeding Enhances Epithelial Ovarian Cancer Growth In Vivo. Nutrients 2023; 15:2730. [PMID: 37375634 DOI: 10.3390/nu15122730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/27/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
The ketogenic diet (KD) is hypothesized to impact tumor progression by altering tumor metabolism. In this study, we assessed the impact of an unrestricted KD on epithelial ovarian cancer (EOC) tumor growth, gene expression, and metabolite concentration in a mouse model. ID8 EOC cells, which were syngeneic with C57Bl/6J mouse strain and transfected with luciferase (ID8-luc), were injectedand monitored for tumor development. Female mice were fed either a strict KD, a high fat/low carbohydrate (HF/LC) diet, or a low fat/high carbohydrate (LF/HC) diet (n = 10 mice per group) ad libitum. EOC tumor growth was monitored weekly, and tumor burden was determined based on luciferase fluorescence (photons/second). At the endpoint (42 days), tumors were collected and processed for RNA sequencing. Plasma and tumor metabolites were evaluated using LC-MS. The KD-fed mice exhibited a statistically significant increase in tumor progression in comparison to the HF/LC- and LF/HC-fed groups (9.1 vs. 2.0 vs. 3.1-fold, respectively, p < 0.001). The EOC tumors of the KD-fed mice exhibited significant enrichment of the peroxisome proliferator-activated receptor (PPAR) signaling and fatty acid metabolism pathways based on the RNA sequencing analysis when compared to the LF/HC- and HF/LC-fed mice. Thus, unrestricted KD diet enhanced tumor progression in our mouse EOC model. KD was associated with the upregulation of fatty acid metabolism and regulation pathways, as well as enrichment of fatty acid and glutamine metabolites.
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Affiliation(s)
- Mariam M AlHilli
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
- Case Comprehensive Cancer Center, Cleveland, OH 44106, USA
| | - Emily E Rhoades
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
| | - Danielle Chau
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Surabhi Tewari
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Adrian Reich
- Department of Bioinformatics, Florida Research and Innovations Center, Cleveland Clinic, Port St. Lucie, FL 34987, USA
| | - Alex Myers
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
| | - Daniel J Lindner
- Case Comprehensive Cancer Center, Cleveland, OH 44106, USA
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
- Department of Translational Hematology Oncology Research, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Justin D Lathia
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
- Case Comprehensive Cancer Center, Cleveland, OH 44106, USA
| | - Renliang Zhang
- Proteomics and Metabolic Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
| | - Belinda Willard
- Proteomics and Metabolic Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
| | - Gail Cresci
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
| | - Nathan A Berger
- Case Comprehensive Cancer Center, Cleveland, OH 44106, USA
- Department of Medicine, Division of Hematology and Oncology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Ofer Reizes
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44196, USA
- Case Comprehensive Cancer Center, Cleveland, OH 44106, USA
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2
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Axelrod CL, Brennan CJ, Cresci G, Paul D, Hull M, Fealy CE, Kirwan JP. UCC118 supplementation reduces exercise-induced gastrointestinal permeability and remodels the gut microbiome in healthy humans. Physiol Rep 2020; 7:e14276. [PMID: 31758610 PMCID: PMC6874782 DOI: 10.14814/phy2.14276] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 10/04/2019] [Accepted: 10/05/2019] [Indexed: 01/25/2023] Open
Abstract
Dysregulation of gut microbiota and intestinal barrier function has emerged as potential mechanisms underlying digestive diseases, yet targeted therapies are lacking The purpose of this investigation was to assess the efficacy of UCC118, a characterized probiotic strain, on exercise‐induced GI permeability in healthy humans. In a randomized, double‐blind, placebo‐controlled crossover study, seven healthy adults received 4 weeks of daily UCC118 or placebo supplementation. GI hyperpermeability was induced by strenuous treadmill running performed before and after each supplementation period. While running, participants ingested 5 g of lactulose, rhamnose, and sucrose. Urine was collected before, immediately after, and every hour for 5 h after exercise to assess GI permeability. Metagenomic sequencing was performed on fecal homogenates collected prior to exercise to identify changes in microbial diversity and taxon abundances. Inflammatory biomarkers were assessed from blood and fecal homogenates collected prior to and immediately following the cessation of exercise. Exercise significantly induced intestinal permeability of lactulose, rhamnose, and sucrose (P < 0.001). UCC118 significantly reduced sucrose (Δ = −0.38 ± 0.13 vs. 1.69 ± 0.79; P < 0.05) recovery, with no substantial change in lactulose (Δ = −0.07 ± 0.23 vs. 0.35 ± 0.15; P = 0.16) or rhamnose (Δ = −0.06 ± 0.22 vs. 0.48 ± 0.28; P = 0.22). Taxonomic sequencing revealed 99 differentially regulated bacteria spanning 6 taxonomic ranks (P < 0.05) after UCC118 supplementation. No differences in plasma IL‐6 or fecal zonulin were observed after UCC118 supplementation. The results described herein provide proof of principle that 4 weeks of UCC118 supplementation attenuated exercise‐induced intestinal hyperpermeability. Further research is warranted to investigate the as‐yet‐to‐be defined molecular processes of intestinal hyperpermeability and the effects of probiotic supplementation. Dysregulation of gut microbiota and intestinal barrier function have emerged as potential mechanisms underlying digestive diseases, yet targeted therapies are lacking. In a randomized, double‐blind, placebo‐controlled crossover study, 7 healthy adults 30 received 4 weeks of daily UCC118 or placebo supplementation. UCC118 significantly reduced sucrose recovery. Taxonomic sequencing revealed 99 differentially regulated gut microbes by UCC118. The results herein provide proof of principle that UCC118 supplementation can reduce intestinal hyperpermeability.![]()
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Affiliation(s)
- Christopher L Axelrod
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio.,Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Los Angeles.,Department of Translational Services, Pennington Biomedical Research Center, Baton Rouge, Los Angeles
| | - Connery J Brennan
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Gail Cresci
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Deborah Paul
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Michaela Hull
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Ciarán E Fealy
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - John P Kirwan
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio.,Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Los Angeles
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3
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Bury C, DeChicco R, Nowak D, Lopez R, He L, Jacob S, Kirby DF, Rahman N, Cresci G. Use of Bedside Ultrasound to Assess Muscle Changes in the Critically Ill Surgical Patient. JPEN J Parenter Enteral Nutr 2020; 45:394-402. [PMID: 32391964 DOI: 10.1002/jpen.1840] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 02/25/2020] [Accepted: 03/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Critical illness causes hypercatabolism, loss of lean body mass (LBM), and poor outcomes. Evaluating LBM in the critically ill is challenging, and it is uncertain whether nutrition support (NS) impacts LBM. This study measured quadriceps muscle layer thickness (QMLT) by bedside ultrasound (US) to estimate LBM changes in surgical intensive care unit (SICU) patients and healthy controls (HCs). METHODS Trained RDNs measured QMLT via US at the midpoint and one-third distance between the superior margin of the patella and the anterior superior iliac spine. QMLT measurements were taken upon enrollment and repeated 1-2 times over 10 days. RESULTS Fifty-two SICU patients and 15 HCs were enrolled. Average SICU percent QMLT loss per day at the midpoint and one-third landmarks was 3.2 ± 3.8 (P < 0.001) and 2.9 ± 5.7 (P = 0.001); and QMLT loss was higher between the second and third measurements (4.0 ± 8.0, P = 0.005 and 4.3 ± 9.8, P = 0.017 at the midpoint and one-third landmarks) compared with that at the first and second measurements (1.7 ± 9.2, P = 0.20 & 1.7 ± 9.4, P = 0.22). Changes were not associated with NS received. No significant QMLT change was found in HCs. CONCLUSIONS SICU patients significantly lost QMLT over 10 days, with greater losses occurring after 5 days. These results support RDNs performing USs to detect QMLT changes and suggest this technique could be valuable to evaluate LBM changes in critically ill patients.
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Affiliation(s)
| | | | - Diane Nowak
- Cleveland Clinic in Cleveland, Cleveland, Ohio, USA
| | - Rocio Lopez
- Cleveland Clinic in Cleveland, Cleveland, Ohio, USA
| | - Lulu He
- Cleveland Clinic in Cleveland, Cleveland, Ohio, USA
- St. Clair Hospital, Pittsburgh, Pennsylvania, USA
| | | | | | - Nadeem Rahman
- Cleveland Clinic in Cleveland, Cleveland, Ohio, USA
- Cleveland Clinic in, Abu Dhabi, United Arab Emirates
| | - Gail Cresci
- Cleveland Clinic in Cleveland, Cleveland, Ohio, USA
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4
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Hipskind P, Rath M, JeVenn A, Galang M, Nawaya A, Smith E, Lopez R, Cresci G. Correlation of New Criteria for Malnutrition Assessment in Hospitalized Patients: AND-ASPEN Versus SGA. J Am Coll Nutr 2019; 39:518-527. [DOI: 10.1080/07315724.2019.1699476] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Peggy Hipskind
- Cleveland Clinic, Center for Human Nutrition, Cleveland, Ohio, USA
| | - Mary Rath
- Cleveland Clinic, Center for Human Nutrition, Cleveland, Ohio, USA
| | - Andrea JeVenn
- Cleveland Clinic, Center for Human Nutrition, Cleveland, Ohio, USA
| | - Marianne Galang
- Cleveland Clinic, Center for Human Nutrition, Cleveland, Ohio, USA
| | - Alaa Nawaya
- Cleveland Clinic, Center for Human Nutrition, Cleveland, Ohio, USA
| | - Elizabeth Smith
- Cleveland Clinic, Center for Human Nutrition, Cleveland, Ohio, USA
| | - Rocio Lopez
- Cleveland Clinic, Quantitative Health Sciences, Cleveland, Ohio, USA
| | - Gail Cresci
- Cleveland Clinic, Center for Human Nutrition, Cleveland, Ohio, USA
- Pediatric Gastroenterology, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA
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5
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Abstract
The need to educate and train future physicians about nutrition and wellness has become increasingly apparent in the past decade. A rising incidence of chronic health conditions with a nutrition background (e.g., obesity, cardiovascular disease, type 2 diabetes) has led to an even greater need for nutrition educational content in medical school curricula so that physicians may counsel patients regarding their lifestyle factors. This review provides an overview of the successful development and integration of a nutrition thread in a 5-year medical school curriculum. Based on a survey conducted in our medical school program, students beginning medical school are lacking formal nutrition education, as only 8% arrived with some form of exposure. Despite this, nearly 85% of these medical students recognized that nutrition education is necessary in their training, and 70% state that the nutrition education they have received has influenced the way they care for patients. Key teaching points Physicians are faced with rising incidence of chronic health conditions that have a nutritional risk factor Physician self-care including optimal nutrition to support resilience is gaining importance. Nutrition education in medical schools is inadequate to address these rising needs. Implementing a comprehensive nutrition curricula that addresses personal wellness strategies, basic science concepts related to nutrition, and diagnosis and management of diseases that can be modified by or are related to nutrition as a topic thread that is woven throughout all years of the curriculum highlights the importance of nutrition in health and disease.
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Affiliation(s)
- Gail Cresci
- a Department of Pediatric Gastroenterology , Cleveland Clinic , Cleveland , Ohio , USA
| | | | - Julie Tebo
- c Department of Education , Cleveland Clinic , Cleveland , Ohio , USA
| | - Alan Hull
- d Department of Internal Medicine , Cleveland Clinic , Cleveland , Ohio , USA
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6
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Boule LA, Ju C, Agudelo M, Parira T, Cannon A, Davis B, Eby J, Cresci G, Samuelson DR, Shukla P, Alrefai WA, Sureshchandra S, Pandey SC, Schnabl B, Curtis BJ, Wyatt TA, Choudhry MA, Kovacs EJ. Summary of the 2016 Alcohol and Immunology Research Interest Group (AIRIG) meeting. Alcohol 2018; 66:35-43. [PMID: 29127885 DOI: 10.1016/j.alcohol.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 07/21/2017] [Indexed: 02/06/2023]
Abstract
On November 18, 2016 the 21st annual Alcohol and Immunology Research Interest Group (AIRIG) meeting was held at the Center for Translational Research and Education at Loyola University Chicago's Health Sciences Campus in Maywood, IL. The 2016 meeting focused broadly on alcohol and inflammation, epigenetics, and the microbiome. The four plenary sessions of the meeting were Alcohol, Inflammation, and Immunity; Alcohol and Epigenetics; Alcohol, Transcriptional Regulation, and Epigenetics; and Alcohol, Intestinal Mucosa, and the Gut Microbiome. Presentations in all sessions of the meeting explored putative underlying causes for chronic diseases and mortality associated with alcohol consumption, shedding light on future work and potential therapeutic targets to alleviate the negative effects of alcohol misuse.
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7
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Affiliation(s)
- Jeremy Warren
- From the Department of Surgery, Medical College of Georgia, Augusta
| | - Varun Bhalla
- From the Department of Surgery, Medical College of Georgia, Augusta
| | - Gail Cresci
- Department of Gastroenterology and Nutrition and Learner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio,
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8
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Abstract
Specialized nutrition support, particularly enteral feeding, has been used for centuries. Technologic advancements have affected the provision of enteral feeding. Feeding solutions and devices, as well as the techniques to place the feeding devices, have evolved. This article reviews the history of bedside placement methods for short-term enteral access devices.
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Affiliation(s)
- Gail Cresci
- Department of Surgery, Room 4072, Medical College of Georgia, 1120 15 Street, Augusta, 30912, USA.
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9
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Vallabh H, Konrad D, DeChicco R, Cresci G, Lopez R, Steiger E, Kirby DF. Thirty-Day Readmission Rate Is High for Hospitalized Patients Discharged With Home Parenteral Nutrition or Intravenous Fluids. JPEN J Parenter Enteral Nutr 2016; 41:1278-1285. [PMID: 27540042 DOI: 10.1177/0148607116664785] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Reducing hospital readmissions decreases healthcare costs and improves quality of care. There are no published studies examining the rate of, and risk factors for, 30-day readmissions for patients discharged with home parenteral support (HPS). OBJECTIVE Determine the rate of 30-day readmissions for patients discharged with HPS and whether malnutrition and other demographic or clinical factors increase the risk. MATERIALS AND METHODS Retrospective review of patients discharged with HPS from the Cleveland Clinic between July 1, 2013, and June 30, 2014, and followed by the Cleveland Clinic Home Nutrition Support Service. RESULTS Of the 224 patients studied, 31.6% (n = 71) had unplanned readmissions within 30 days of hospital discharge. Of these, 21.1% (n = 15) were HPS related, with catheter-related bloodstream infection (n = 5) and dehydration (n = 5) the most common. The majority of patients (84.4%) were diagnosed with malnutrition, but the presence or degree did not influence the readmission rate ( P = .41). According to univariable analysis, patients with an ostomy ( P = .037), a small bowel resection ( P = .002), a higher HPS volume at discharge ( P < .001), and a shorter period between HPS consult and hospital discharge ( P < .026) had a lower risk of 30-day readmission than their counterparts. On multivariable analysis, patients had a higher risk of 30-day readmission if they had a history of heart disease ( P = .048) and for every 1-unit increase in white blood cells ( P = .026). CONCLUSIONS Patients discharged with HPS have a high 30-day readmission rate, although most readmissions were not related to the HPS itself. The presence and degree of malnutrition were not associated with 30-day readmissions.
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Affiliation(s)
- Hiren Vallabh
- 1 Department of Gastroenterology, West Virginia University-Ruby Memorial Hospital, Morgantown, West Virginia, USA.,2 Center for Human Nutrition, Cleveland Clinic, Cleveland, Ohio, USA
| | - Denise Konrad
- 2 Center for Human Nutrition, Cleveland Clinic, Cleveland, Ohio, USA
| | - Robert DeChicco
- 2 Center for Human Nutrition, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gail Cresci
- 3 Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rocio Lopez
- 3 Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ezra Steiger
- 4 Department of General Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Donald F Kirby
- 3 Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
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10
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Nagy LE, Ding WX, Cresci G, Saikia P, Shah VH. Linking Pathogenic Mechanisms of Alcoholic Liver Disease With Clinical Phenotypes. Gastroenterology 2016; 150:1756-68. [PMID: 26919968 PMCID: PMC4887335 DOI: 10.1053/j.gastro.2016.02.035] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/28/2016] [Accepted: 02/09/2016] [Indexed: 02/07/2023]
Abstract
Alcoholic liver disease (ALD) develops in approximately 20% of alcoholic patients, with a higher prevalence in females. ALD progression is marked by fatty liver and hepatocyte necrosis, as well as apoptosis, inflammation, regenerating nodules, fibrosis, and cirrhosis.(1) ALD develops via a complex process involving parenchymal and nonparenchymal cells, as well as recruitment of other cell types to the liver in response to damage and inflammation. Hepatocytes are damaged by ethanol, via generation of reactive oxygen species and induction of endoplasmic reticulum stress and mitochondrial dysfunction. Hepatocyte cell death via apoptosis and necrosis are markers of ethanol-induced liver injury. We review the mechanisms by which alcohol injures hepatocytes and the response of hepatic sinusoidal cells to alcohol-induced injury. We also discuss how recent insights into the pathogenesis of ALD will affect the treatment and management of patients.
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Affiliation(s)
- Laura E. Nagy
- Department of Pathobiology, Cleveland Clinic, Cleveland, OH 44195,Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH 44195,Department of Medicine, Cleveland Clinic, Cleveland, OH 44195
| | - Wen-Xing Ding
- Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS 66160
| | - Gail Cresci
- Department of Pathobiology, Cleveland Clinic, Cleveland, OH 44195,Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH 44195,Department of Medicine, Cleveland Clinic, Cleveland, OH 44195
| | - Paramananda Saikia
- Department of Pathobiology, Cleveland Clinic, Cleveland, OH 44195,Department of Medicine, Cleveland Clinic, Cleveland, OH 44195
| | - Vijay H. Shah
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905
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11
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Austhof SI, DeChicco R, Cresci G, Corrigan ML, Lopez R, Steiger E, Kirby DF. Expediting Transition to Home Parenteral Nutrition With Fast-Track Cycling. JPEN J Parenter Enteral Nutr 2015; 41:446-454. [PMID: 26187939 DOI: 10.1177/0148607115595620] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Delivery of home parenteral nutrition (PN) is typically cycled over 12 hours. Discharge to home on PN is often delayed due to potential adverse events (AEs) associated with cycling PN. The purpose was to determine whether patients requiring long-term PN can be cycled from 24 hours to 12 hours in 1 day instead of 2 days without increasing the risk of PN-related AEs. METHODS Hospitalized patients receiving PN at goal calories infused over 24 hours without severe electrolyte or blood glucose abnormalities were eligible. Patients were randomly assigned to a 1-step "fast-track" protocol or 2-step "standard" protocol. AEs were defined as hypoglycemia or hyperglycemia, new-onset or worsening dyspnea, tachycardia, tachypnea, lower extremity or sacral edema, pulmonary edema, or abdominal ascites and were graded as minor or major. RESULTS In the 63 patients studied, the most prevalent PN-related AE was hyperglycemia, occurring in 24.2% and 30.0% of patients in the fast-track and standard groups, respectively. Overall, there was no significant difference in the prevalence of PN-related minor AEs between fast-track and standard groups (33.3% and 53.3%, P = .5). No major PN-related AEs occurred in the fast-track group, while 1 major PN-related AE (pulmonary edema) occurred in the standard group. CONCLUSIONS Fast-track cycling is as safe as standard cycling in patients without diabetes mellitus or major organ dysfunction requiring long-term PN. Fast-track cycling could potentially expedite hospital discharge, resulting in decreased healthcare costs and improved patient satisfaction.
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Affiliation(s)
- Sandra I Austhof
- 1 Center for Human Nutrition TT-22, Cleveland Clinic, Cleveland, Ohio, USA
| | - Robert DeChicco
- 1 Center for Human Nutrition TT-22, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gail Cresci
- 2 Gastroenterology and Hepatology M-17, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Rocio Lopez
- 4 Quantitative Health Sciences JJN3-01, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ezra Steiger
- 5 Center for Human Nutrition/General Surgery A100, Cleveland Clinic, Cleveland, Ohio, USA
| | - Donald F Kirby
- 6 Center for Human Nutrition/Gastroenterology A51, Cleveland Clinic, Cleveland, Ohio, USA
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12
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Tacchella S, Carollo CM, Renzini A, Förster Schreiber NM, Lang P, Wuyts S, Cresci G, Dekel A, Genzel R, Lilly SJ, Mancini C, Newman S, Onodera M, Shapley A, Tacconi L, Woo J, Zamorani G. Galaxy evolution. Evidence for mature bulges and an inside-out quenching phase 3 billion years after the Big Bang. Science 2015; 348:314-7. [PMID: 25883353 DOI: 10.1126/science.1261094] [Citation(s) in RCA: 185] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Most present-day galaxies with stellar masses ≥10(11) solar masses show no ongoing star formation and are dense spheroids. Ten billion years ago, similarly massive galaxies were typically forming stars at rates of hundreds solar masses per year. It is debated how star formation ceased, on which time scales, and how this "quenching" relates to the emergence of dense spheroids. We measured stellar mass and star-formation rate surface density distributions in star-forming galaxies at redshift 2.2 with ~1-kiloparsec resolution. We find that, in the most massive galaxies, star formation is quenched from the inside out, on time scales less than 1 billion years in the inner regions, up to a few billion years in the outer disks. These galaxies sustain high star-formation activity at large radii, while hosting fully grown and already quenched bulges in their cores.
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Affiliation(s)
- S Tacchella
- Department of Physics, Institute for Astronomy, ETH Zurich, CH-8093 Zurich, Switzerland.
| | - C M Carollo
- Department of Physics, Institute for Astronomy, ETH Zurich, CH-8093 Zurich, Switzerland.
| | - A Renzini
- Istituto Nazionale di Astrofisica (INAF) Osservatorio Astronomico di Padova, Vicolo dell Osservatorio 5, I-35122 Padova, Italy
| | - N M Förster Schreiber
- Max-Planck-Institut für Extraterrestrische Physik, Giessenbachstrasse 1, D-85748 Garching, Germany
| | - P Lang
- Max-Planck-Institut für Extraterrestrische Physik, Giessenbachstrasse 1, D-85748 Garching, Germany
| | - S Wuyts
- Max-Planck-Institut für Extraterrestrische Physik, Giessenbachstrasse 1, D-85748 Garching, Germany
| | - G Cresci
- INAF Osservatorio Astronomico di Arcetri, Largo Enrico Fermi 5, I-50125 Firenze, Italy
| | - A Dekel
- Racah Institute of Physics, The Hebrew University, Jerusalem 91904, Israel
| | - R Genzel
- Max-Planck-Institut für Extraterrestrische Physik, Giessenbachstrasse 1, D-85748 Garching, Germany. Department of Astronomy, Campbell Hall, University of California, Berkeley, CA 94720, USA. Department of Physics, Le Conte Hall, University of California, Berkeley, CA 94720, USA
| | - S J Lilly
- Department of Physics, Institute for Astronomy, ETH Zurich, CH-8093 Zurich, Switzerland
| | - C Mancini
- Istituto Nazionale di Astrofisica (INAF) Osservatorio Astronomico di Padova, Vicolo dell Osservatorio 5, I-35122 Padova, Italy
| | - S Newman
- Department of Astronomy, Campbell Hall, University of California, Berkeley, CA 94720, USA
| | - M Onodera
- Department of Physics, Institute for Astronomy, ETH Zurich, CH-8093 Zurich, Switzerland
| | - A Shapley
- Department of Physics and Astronomy, University of California, Los Angeles, CA 90095-1547, USA
| | - L Tacconi
- Max-Planck-Institut für Extraterrestrische Physik, Giessenbachstrasse 1, D-85748 Garching, Germany
| | - J Woo
- Department of Physics, Institute for Astronomy, ETH Zurich, CH-8093 Zurich, Switzerland
| | - G Zamorani
- INAF Osservatorio Astronomico di Bologna, Via Ranzani 1, I-40127 Bologna, Italy
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13
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Dowhan L, DeChicco R, Welsh R, Wehner R, Habib M, Hipskind P, Cresci G. Comparison Between Handgrip Dynamometry and Manual Muscle Testing Performed by Registered Dietitians in Measuring Muscle Strength and Function of Hospitalized Patients. JPEN J Parenter Enteral Nutr 2015; 40:951-8. [PMID: 25855578 DOI: 10.1177/0148607115580647] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 02/05/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Academy of Nutrition and Dietetics and American Society the Parenteral and Enteral Nutrition (ASPEN) Consensus Statement recommends a standardized set of diagnostic characteristics to identify adult malnutrition. Due to lack of a consensus definition and challenges with measurements, physical function or performance has traditionally been difficult to assess. The purpose of this study was to determine whether manual muscle testing (MMT) performed by registered dietitians (RDs) can be used as a surrogate measurement of muscle strength and function in hospitalized patients. METHOD Patients admitted to the heart failure service on the cardiac stepdown units at the Cleveland Clinic Main Campus in Cleveland, Ohio, were eligible for the study, and those who met the inclusion criteria underwent handgrip strength (HGS) testing and evaluation of nutrition status using the Academy/ASPEN Characteristics Recommended for the Identification of Adult Malnutrition. MMT was then performed within 24 hours by a different study investigator blinded to the HGS and malnutrition assessment results. RESULTS It was found that HGS and MMT overall were in agreement for 84% of patients and that MMT had a high sensitivity (98%) but low specificity (13%). CONCLUSION This study shows feasibility for RDs to perform MMT on patients to determine muscle strength and functioning. Future practice application may be to incorporate MMT into screening criteria for patients being evaluated for malnutrition and reserve HGS testing only for patients with an abnormal MMT.
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Affiliation(s)
- Lindsay Dowhan
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Robert DeChicco
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Renee Welsh
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rebecca Wehner
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Monica Habib
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Peggy Hipskind
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gail Cresci
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Cresci G, Nagy LE, Ganapathy V. Lactobacillus GG and tributyrin supplementation reduce antibiotic-induced intestinal injury. JPEN J Parenter Enteral Nutr 2013; 37:763-74. [PMID: 23630018 DOI: 10.1177/0148607113486809] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Antibiotic therapy negatively alters the gut microbiota. Lactobacillus GG (LGG) decreases antibiotic-associated diarrhea (AAD) symptoms, but the mechanisms are unknown. Butyrate has beneficial effects on gut health. Altered intestinal gene expression occurs in the absence of gut microbiota. We hypothesized that antibiotic-induced changes in gut microbiota reduce butyrate production, varying genes involved with gut barrier integrity and water and electrolyte absorption, lending to AAD, and that simultaneous supplementation with LGG and/or tributyrin would prevent these changes. METHODS C57BL/6 mice aged 6-8 weeks received a chow diet while divided into 8 treatment groups (± saline, ± LGG, ± tributyrin, or both). Mice received treatments orally for 7 days with ± broad-spectrum antibiotics. Water intake was recorded daily and body weight was measured. Intestine tissue samples were obtained and analyzed for expression of genes and proteins involved with water and electrolyte absorption, butyrate transport, and gut integrity via polymerase chain reaction and immunohistochemistry. RESULTS Antibiotics decreased messenger RNA (mRNA) expression (butyrate transporter and receptor, Na(+)/H(+) exchanger, Cl(-)/HCO3 (-), and a water channel) and protein expression (butyrate transporter, Na(+)/H(+) exchanger, and tight junction proteins) in the intestinal tract. LGG and/or tributyrin supplementation maintained intestinal mRNA expression to that of the control animals, and tributyrin maintained intestinal protein intensity expression to that of control animals. CONCLUSION Broad-spectrum antibiotics decrease expression of anion exchangers, butyrate transporter and receptor, and tight junction proteins in mouse intestine. Simultaneous oral supplementation with LGG and/or tributyrin minimizes these losses. Optimizing intestinal health with LGG and/or tributyrin may offer a preventative therapy for AAD.
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15
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Abstract
Most agree that enteral nutrition is the ideal way to feed critically ill patients who have a functional gastrointestinal tract, but selecting the appropriate enteral formula can be difficult. Specifically, the use of immune-modulating diets has brought much excitement as well as debate. Literature to date presents both positive and potential adverse effects. To aid the clinician in the decision-making process, this article reviews the current research and recommendations regarding the use of immune-modulating diets.
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Abstract
Despite acute myocardial infarction and cardiac surgery accounting for 2 of the most common reasons patients are admitted to the intensive care unit, little attention and investigation have been directed specifically for these patients. This patient population therefore deserves special attention as they are often malnourished but require emergent interventions, making nutrition intervention challenging. This article reviews current medical interventions implemented in critically ill cardiothoracic patients and discusses evidence-based nutrition therapy, including enteral and parenteral feeding, glycemic control, and antioxidant provision.
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Affiliation(s)
- Gail Cresci
- Cleveland Clinic, Gastroenterology and Pathobiology, Cleveland, OH 44195, USA.
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Cresci G, Mannucci F, Maiolino R, Marconi A, Gnerucci A, Magrini L. Gas accretion as the origin of chemical abundance gradients in distant galaxies. Nature 2010; 467:811-3. [DOI: 10.1038/nature09451] [Citation(s) in RCA: 179] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 08/20/2010] [Indexed: 11/09/2022]
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McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, Ochoa JB, Napolitano L, Cresci G. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:. JPEN J Parenter Enteral Nutr 2009; 33:277-316. [DOI: 10.1177/0148607109335234] [Citation(s) in RCA: 1284] [Impact Index Per Article: 85.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
Controversy continues to surround the appropriate form and timing of nutrition support for the patient with circulatory shock. Clinical studies have demonstrated improvements in outcome with the administration of enteral nutrition to critically ill patients; however, the provision of enteral nutrition to critically ill patients with ongoing shock remains controversial. This article reviews gut perfusion during normal states and during circulatory shock as well as alterations in perfusion when enteral feeding is provided. Pharmaconutrients studied during ischemia and reperfusion are discussed.
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Affiliation(s)
- Gail Cresci
- Medical College of Georgia, Department of Surgery, Room 4072, 1120 15th Street, Augusta, GA 30912, USA.
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20
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Thangaraju M, Cresci G, Itagaki S, Mellinger J, Browning DD, Berger FG, Prasad PD, Ganapathy V. Sodium-coupled transport of the short chain fatty acid butyrate by SLC5A8 and its relevance to colon cancer. J Gastrointest Surg 2008; 12:1773-81; discussion 1781-2. [PMID: 18661192 DOI: 10.1007/s11605-008-0573-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Accepted: 06/04/2008] [Indexed: 01/31/2023]
Abstract
INTRODUCTION SLC5A8, expressed predominantly in the colon, is a Na(+)-coupled transporter for short-chain fatty acids. In this paper, we report on the characterization of butyrate transport by SLC5A8 and the relevance of SLC5A8-mediated butyrate transport to colon cancer. RESULTS SLC5A8 transports butyrate via a Na(+)-dependent electrogenic process. Na(+) activation of the transport process exhibits sigmoidal kinetics, indicating involvement of more than one Na(+) in the activation process. SLC5A8 is silenced in colon cancer in humans, in a mouse model of intestinal/colon cancer, and in colon cancer cell lines. The tumor-associated silencing of SLC5A8 involves DNA methylation by DNA methyltransferase 1. Reexpression of SLC5A8 in colon cancer cells leads to apoptosis but only in the presence of butyrate. SLC5A8-mediated entry of butyrate into cancer cells is associated with inhibition of histone deacetylation. The changes in gene expression in SLC5A8/butyrate-induced apoptosis include upregulation of pro-apoptotic genes and downregulation of anti-apoptotic genes. In addition, the expression of phosphatidylinositol-3-kinase subunits is affected differentially, with downregulation of p85alpha and upregulation of p55alpha and p50alpha. CONCLUSION These studies show that SLC5A8 mediates the tumor-suppressive effects of the bacterial fermentation product butyrate in the colon.
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Affiliation(s)
- Muthusamy Thangaraju
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta, GA 30912, USA
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Abstract
This article discusses issues related to nutrition support for the critically ill (CCI), especially those who are dependent on ventilators for long periods. A large and growing population of patients survives acute critical illness only to become CCI with profound debilitation, weeks to months of hospitalization, and often permanent dependence on mechanical ventilation and other life-sustaining modalities. Despite resource-intensive treatment, outcomes for CCI remain poor. Topics addressed in this article include neuroendocrine profiles in CCI patients, allostatic overload, causes of prolonged mechanical ventilation, and the metabolism of chronic ventilator dependence. The article also describes issues related to assessing the nutrition, determining nutrition requirements, and deciding the route of nutrient delivery for CCI patients.
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Affiliation(s)
- Gail Cresci
- Surgical Nutrition Service, Department of Surgery, Medical College of Georgia, Augusta, GA 30912, USA.
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Strickland A, Brogan A, Krauss J, Martindale R, Cresci G. Is the use of specialized nutritional formulations a cost-effective strategy? A national database evaluation. JPEN J Parenter Enteral Nutr 2005; 29:S81-91. [PMID: 15709550 DOI: 10.1177/01486071050290s1s81] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND We apply currently published clinical outcomes data to length of stay and hospital cost to determine the potential economic benefit associated with the use of specialized nutritional formulations in elective surgical, trauma, and medical patients. Although the use of immune-modulating formulations has repeatedly shown favorable clinical outcomes, including decreased complications (both infectious and noninfectious), length of stay (both ICU and total days), and ventilator days, the cost-effectiveness of nutritional modulation of the immune response in a US-based population has not previously been explored. METHODS Data for the current study were obtained from a large national database with 126 member hospitals and data from over 1 million patients. Data extracted from the database included patient type (surgical, medical, and trauma) and subservice, whether the hospital stay was "complicated" or "uncomplicated" (as determined by diagnosis-related groups and International Classification of Diseases, Ninth Revision coding), mean length of stay, mean cost, and incremental cost per complication experienced. The clinical outcomes measures from 3 major peer-reviewed studies were then applied to the cost data in order to determine the cost savings associated with the use of specialized nutritional formulations in each of the patient populations. Additionally, cost data were segmented by region of the United States (New England, mid-Atlantic, South, Midwest, Southwest, and West) and by primary focus of the health care facility (academic, indigent care, large community) to enable more meaningful cost comparisons. RESULTS For the medical patient population, according to the published rate of 51% decrease in risk of infectious complications and a decreased length of hospital stay of 9.7 days, net cost savings (after accounting for the increased costs of administering immune modulating formula) is $2066. The same calculations were done for surgical and trauma patients, with $688 and $308 net cost savings per patient, respectively. These figures assume a base infection rate of 5%. Expected cost savings vary markedly for deviations in base infection rate and slightly for differences in facility type or region of the country. CONCLUSIONS This study demonstrates that specialized nutritional formulations are a cost-effective way for hospitals to improve clinical outcomes while reducing resource consumption and total cost. These benefits are observable in all patient types, all facility types, and all regions of the United States.
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Affiliation(s)
- Adrien Strickland
- Department of Surgery, Medical College of Georgia, Augusta, Georgia, USA.
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Affiliation(s)
- Gail Cresci
- Medical College of Georgia, Augusta, Georgia 30912, USA.
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Affiliation(s)
- R G Martindale
- Department of Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA.
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Abstract
OBJECTIVE The benefits of enteral nutrition when compared with parenteral nutrition are well established. However, provision of enteral nutrition may not occur for several reasons, including lack of optimal feeding access. Gastric feeding is easier to initiate, but many hospitalized patients are intolerant to gastric feeding, although they can tolerate small bowel feeding. Many institutions rely on costly methods for placing small bowel feeding tubes. Our goal was to evaluate the effectiveness of a hospital-developed protocol for bedside-blind placement of postpyloric feeding tubes. METHODS The Surgical Nutrition Service established a protocol for bedside placement of small bowel feeding tubes. The protocol uses a 10- or 12-French, 110-cm stylet containing the feeding tube; 10 mg of intravenous metoclopramide; gradual tube advancement followed by air injection and auscultation; and an abdominal radiograph for tube position confirmation. In a prospective manner, consults received by the surgical nutrition dietitian for feeding tube placements were followed consecutively for a 10-mo period. The registered dietitian recorded the number of radiograph examinations, the final tube position, and the time it took to achieve tube placement. RESULTS Because all consults were included, feeding tube placements occurred in surgical and medical patients in the intensive care unit and on the ward. Of the 135 tube placements performed, 129 (95%) were successfully placed postpylorically, with 84% (114 of 135) placed at or beyond D3. Average time for tube placement was 28 min (10 to 90 min). One radiograph was required for 92% of the placements; eight of 135 (6%) required two radiographs. No acute complications were associated with the tube placements. CONCLUSIONS Hospitalized patients can receive timely enteral feeding with a cost-effective feeding tube placement protocol. The protocol is easy to implement and can be taught to appropriate medical team members through proper training and certification.
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Affiliation(s)
- Gail Cresci
- Department of Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA.
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Abstract
OBJECTIVE Nutrition support in the severely injured trauma patient is crucial to minimize the hypermetabolic stress response. Even though enteral nutrition is the preferred method of feeding, it is not always feasible after multiple trauma. We present a complex nutritional case in a patient who sustained severe abdominal trauma with a severe liver injury, rib fractures, and pulmonary contusion. METHODS The patient required several repeat laparotomies, abdominal packing, and temporary abdominal closure. The clinical course was complicated by hypotension requiring multiple vasopressors; coagulopathy requiring more than 35 U of packed red cells, more than 50 U of fresh frozen plasma, and more than 80 U of platelets; acute renal failure requiring dialysis; and pneumonia and acute respiratory distress syndrome requiring intricate ventilator management. Nutrition intervention began on post-trauma day 4 with total parenteral nutrition due to hypotension, resuscitation, and massive bowel edema; by post-trauma day 8. the patient was receiving goal nutrients. RESULTS On post-trauma day 27, bowel edema was significantly less, and a nasoenteric feeding tube was placed and enteral feeding initiated. By post-trauma day 31, full enteral feeds were tolerated, and total parenteral nutrition was stopped. Nutrient provision was adjusted daily to account for organ and metabolic changes including hepatic, pulmonary, and renal dysfunction. The patient did well and was eventually extubated and eating a regular diet. CONCLUSION With careful monitoring and adjusting of the nutritional plan, a hypermetabolic complex trauma patient with an open abdomen can be fed optimally, safely, and successfully despite increased bowel edema and multiple organ dysfunction.
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Affiliation(s)
- Blake McKibbin
- Department of Surgery, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, USA
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Affiliation(s)
- Gail Cresci
- Department of Surgery, Medical College of Georgia, Augusta 30912, USA.
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Abstract
Closer attention to the clear liquid diet and its therapeutic applications has been prompted by critical reviews of nutritional enhancement in the clinical environment. The aim of ongoing research has been to uncover the optimal nutrient complement in various patient groups as well as the most beneficial mode of nutrient delivery. Route of feeding is often the essential determinant in effectiveness of nutritional support. Many studies have sought to demonstrate the superiority of enteral versus parenteral nutrition, whereas comparative studies with clear liquid diets are sparse. Recently, identification of key nutrients in the support of malnourished or immunocompromised patients has been emphasized. Although total parenteral nutrition has undisputed applications in specific patient groups, it has lost favor for general application because of its negative impact on immunocompetence. Efforts have thus been redoubled to explore the potential of the gastrointestinal tract, with the derived benefit in immunosupport for many medical and surgical disease states. Until recently, the clear liquid diet had not received close scrutiny and had retained an unchallenged position in certain applications (eg, bowel preparation). This paper summarizes the published, theorized, and potential benefits as well as the limitations of the clear liquid diet.
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Affiliation(s)
- Susan Hancock
- Department of Surgery, Medical College of Georgia, 1120 15th Street, Room 4072, Augusta, GA 30912, USA
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Cugini P, Cresci G, Di Palma L, Bruscagli G, Battisti P, Lembo T, Angeloni A, Coppola A, Leone G, Pelosio A. [24-hour blood pressure: effects of sports in aged subjects]. Recenti Prog Med 1991; 82:452-62. [PMID: 1745830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The present study deals with the blood pressure (BP) and heart rate (HR) 24-h pattern in aged people of both sexes ranging in age from 66 to 75 years. 20 subjects were active in agonistic sports (running and swimming), 20 others had sedentary habits. BP and HR were studied by non-invasive monitoring along with chronobiometric analysis. The BP and HR 24-h pattern was seen to preserve its circadian rhythm in both aged athletes and sedentary elderly. The analysis reveals that the aged athletes show a higher mesor for systolic BP and a lower mesor for diastolic BP and HR. The daily pressure load, as the integral of the BP 24-h values multiplied by the HR mesor, is lower in aged people practising sport as compared to age-matched individuals with sedentary habits. The spectral analysis reveals that physical exercise acts to change the time structure of BP and HR 24-h patterns. The conclusion is drawn that active sport plays beneficial effects in aged people because of a lower pressure load.
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Affiliation(s)
- P Cugini
- II Semeiotica medica, Università La Sapienza, Roma
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30
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Cugini P, Di Palma L, Battisti P, Coppola A, Leone G, Cresci G, Bruscagli G, Lembo T, Angeloni A, Pelosio A. [24-hour blood pressure: noninvasive monitoring and biometric analysis in relation to age]. Recenti Prog Med 1991; 82:463-74. [PMID: 1745831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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