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Sample records for postoperative nutritional evaluation

  1. [Nutritional status and postoperative complications in patients with digestive cancer].

    PubMed

    Pañella, Loreto; Jara, Marlene; Cornejo, Morelia; Lastra, Ximena; Contreras, María Gladys; Alfaro, Kattia; De La Maza, María Pía

    2014-11-01

    Risk of malnutrition is elevated among oncologic patients, and this increases postoperative morbidity and mortality. To study the association between nutritional status and postoperative outcomes in a group of patients with gastrointestinal cancers. We studied 129 patients with diagnosis of digestive cancer, previous to potentially curative surgery. Nutritional status was evaluated through anthropometric measures, Subjective Global Assessment (SGA), dietary intake recalls and routine biochemical parameters. Functional performance was assessed by the Karnofsky index (KI). Cancer stage was classified according to TNM4. During the postoperative period, complications, length of stay at the critical care ward and duration of hospitalization were registered. Thirty days after discharge, patients were contacted, and the appearance of new complications was listed. According to SGA 14.7% of patients were classified as well nourished (A), 57.3% as moderately undernourished or at risk of malnutrition (B) and 27.9% as severely malnourished (C). The incidence of total complications was 25.5%. Nutritional status was not associated with cancer stage. The frequency of complications among patients classified as A, B and C were 5.5, 25.3 and 37.1% respectively (p = 0.03). We detected a high frequency of malnutrition in this group of patients. Overall the frequency of postoperative complications was low, however malnourished patients exhibited a higher rate of surgical complications.

  2. A comparison of postoperative early enteral nutrition with delayed enteral nutrition in patients with esophageal cancer.

    PubMed

    Wang, Gongchao; Chen, Hongbo; Liu, Jun; Ma, Yongchen; Jia, Haiyong

    2015-06-02

    We examined esophageal cancer patients who received enteral nutrition (EN) to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. A total of 208 esophagectomy patients who received EN postoperatively were divided into three groups (Group 1, 2 and 3) based on whether they received EN within 48 h, 48 h-72 h or more than 72 h, respectively. The postoperative complications, length of hospital stay (LOH), days for first fecal passage, cost of hospitalization, and the difference in serum albumin values between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test, the Mann-Whitney U test and the chi square test. Statistical significance was defined as p < 0.05. Group 1 had the lowest thoracic drainage volume, the earliest first fecal passage, and the lowest LOH and hospitalization expenses of the three groups. The incidence of pneumonia was by far the highest in Group 3 (p = 0.019). Finally, all the postoperative outcomes of nutritional conditions were the worst by a significant margin in Group 3. It is therefore safe and valid to start early enteral nutrition within 48 h for postoperative esophageal cancer patients.

  3. [Postoperative nutrition in patients with head and neck cancer].

    PubMed

    Martín Villares, C; Fernández Pello, M E; San Román Carbajo, J; Tapia Risueño, M; Domínguez Calvo, J

    2003-01-01

    Patients who underwent surgery for head and neck malignant neoplasms are problematic because dysphagia, pain and postoperative secuelaes. Nutritional support is necessary in more than 90% of all patients with head and neck cancer. The purpose of this study is to determine nutritional support in these patients and problems related to nutrition. Fifty-four patients with oral and pharyngolaryngeal carcinomas underwent surgery were studied prospectively. We studied nutritional support (oral nutrition, enteral nutrition or parenteral nutrition) and problems related to nutrition: aspiration neumoniae and pharyngostoma. The 7% of the patients underwent oral feeding after surgery, 87% enteral nutrition with nasogastric tube and 6% parenteral nutrition. We identified neumoniae in 6% of patients and faringocutaneous fistula in 19%. When patients leaved the hospital, 98% of the patients underwent oral feeding and one patient had nasopharyngeal tube for enteral nutrition. 1. Artificial nutrition was necessary in 93% patients with oropharyngolaryngealcancer; 2. Enteral nutrition was the most useful modality of alimentation (87%); 3.25% of patients had postoperative complications: (18% pharyngostoma, 6% neumoniae); 4. Oral feeding was possible in 98% of patients out of hospital.

  4. [Caloric substrates in postoperative parenteral nutrition].

    PubMed

    De Salvo, L; Romairone, E; Ansaldo, G L; Mattioli, G

    1991-05-31

    The paper describes the carbohydrate, lipidic and nitrogen metabolism of the postoperative period which is subdivided into an early and a late phase. Since the metabolism of caloric substrates in the early postoperative period is a stress metabolism with glucose intolerance and wide protein catabolism, the authors emphasise that an insufficient caloric intake is worse than the fasting state and suggest that alternative caloric sources, such as branched chain amino acids, fatty acids and, even, ketonic bodies, should be used.

  5. Nutritional risk index is predictor of postoperative complications in operations of digestive system or abdominal wall?

    PubMed

    Thieme, Rubia Daniela; Cutchma, Gislaine; Chieferdecker, Maria Eliana Madalozzo; Campos, Antônio Carlos Ligocki

    2013-01-01

    Malnutrition can be considered the most common disease in hospitals due to its high prevalence. To investigate the methods of evaluation of the nutritional status that better correlate with postoperative complications and the length of hospital stay in patients submitted to gastrointestinal or abdominal wall surgeries. This is a retrospective evaluation of 215 nutritional assessment records. All were submitted to traditional anthropometry (weight, height, BMI, arm circumference, triceps skinfold thickness and mid-arm muscle circumference), subjective global assessment, serum albumin and lymphocyte count. Nutritional risk index was also calculated. A total of 125 patients were included. Malnutrition was diagnosed by mid-arm muscle circumference, nutritional risk index and subjective global assessment in 46%, 88% and 66%, respectively. Severe malnutrition was found in 17,6% if considered subjective global assessment and in 42% by the nutritional risk index. Oncologic patients had a worst nutritional status according to this index (5,42 less units). There was a negative correlation between occurrence the noninfectious postoperative complications with the nutritional risk index (p=0,0016). Similarly, lower serum albumin levels were associated with higher non infectious complications (p=0,0015). The length of hospital stay was, in average, 14,24 days less in patients without complications as compared with non infectious postoperative complications (p<0,05). Nutritional risk index and serum albumin are the parameters with the best capacity to predict the occurrence of non infectious postoperative complications and the length of hospital stay was higher to this patients.

  6. Early postoperative enteral nutrition is useful for recovering gastrointestinal motility and maintaining the nutritional status.

    PubMed

    Kawasaki, Naruo; Suzuki, Yutaka; Nakayoshi, Tomoko; Hanyu, Nobuyoshi; Nakao, Masatoshi; Takeda, Akihiro; Furukawa, Yoshiyuki; Kashiwagi, Hideyuki

    2009-01-01

    The efficacy of enteral nutrition in postoperative nutritional management is known, but the effects on gastrointestinal motility and nutrition have not yet been elucidated. The purpose of this study was to compare the effects of enteral and parenteral nutrition soon after open abdominal surgery on gastrointestinal motility and nutritional status. A partial resection of rectum models was prepared to compare two types of nutrient administration: enteral nutrition and total parenteral nutrition. The differences between the effects of nutrition types in terms of gastrointestinal motility and nutritional status were investigated. Enteral nutrition contributed to recovery of gastrointestinal motility and maintenance of nutritional status. Enteral nutrition should therefore be initiated soon after surgery if the gastrointestinal tract is available.

  7. Postoperative nutritional support using needle catheter feeding jejunostomy.

    PubMed Central

    Delany, H M; Carnevale, N; Garvey, J W; Moss, G M

    1977-01-01

    Needle catheter jejunostomy was used as an adjunctive surgical procedure in 110 patients. In 19 patients (or 17%) the jejunostomy was of value for the administration of post-operative nutritional support using an elemental diet and it may serve as an alternative route for the administration of supplementing fluids and electrolytes if intestinal function is intact. The clinical experience with the catheter jejunostomy establishes it as a satisfactory technique for postoperative nutritional support in patients requiring esophageal and proximal gastric resection and repair, and gastric surgery in the elderly and debilitated. It is also useful in patients undergoing complicated biliary, pancreatic, and duodenal surgery in whom anastomotic difficulties are anticipated. PMID:407853

  8. Effects of preoperative and postoperative enteral nutrition on postoperative nutritional status and immune function of gastric cancer patients.

    PubMed

    Ding, Dayong; Feng, Ye; Song, Bin; Gao, Shuohui; Zhao, Jisheng

    2015-03-01

    Effects of preoperative one week enteral nutrition (EN) support on the postoperative nutritional status, immune function and inflammatory response of gastric cancer patients were investigated. 106 cases of gastric cancer patients were randomly divided into preoperative one week EN group (trial group) and early postoperative EN group (control group), which were continuously treated with EN support until the postoperative 9th day according to different treatment protocols. All the patients were checked for their body weight, skinfold thickness, upper arm circumference, white blood cell count (WBC), albumin (ALB), prealbumin (PA), C-reactive protein (CRP), humoral immunity (IgA, IgG), T cell subsets (CD4, CD8 and CD4/CD8), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), etc. on the preoperative and the postoperative 1st and 10th day, respectively. PA and IgG levels of the experimental group were higher than those of the control group on the postoperative 10th day, whereas IL-6 level of the experimental group was lower than that of the control group. EN support for preoperative gastric cancer patients will improve the postoperative nutritional status and immune function, alleviate inflammatory response, and facilitate the recovery of patients.

  9. Immediate Postoperative Oral Nutrition Following Esophagectomy: A Multicenter Clinical Trial.

    PubMed

    Weijs, Teus J; Berkelmans, Gijs H K; Nieuwenhuijzen, Grard A P; Dolmans, Annemarie C P; Kouwenhoven, Ewout A; Rosman, Camiel; Ruurda, Jelle P; van Workum, Frans; van Det, Marc J; Silva Corten, Luis C; van Hillegersberg, Richard; Luyer, Misha D P

    2016-10-01

    Immediate start of oral intake is beneficial following colorectal surgery. However, following esophagectomy the safety and feasibility of immediate oral intake is unclear, thus these patients are still kept nil by mouth. This study therefore aimed to determine the feasibility and safety of oral nutrition immediately after esophagectomy. A multicenter, prospective trial was conducted in 3 referral centers between August 2013 and May 2014, including 50 patients undergoing a minimally invasive esophagectomy. Oral nutrition was started postoperatively immediately (clear liquids on postoperative day [POD] 0, liquid nutrition on POD 1 to 6, solid food from POD 7). Nonoral enteral nutrition was started when <50% of caloric need was met on postoperative day POD 5 or when oral intake was impossible. A comparison was made with a retrospective cohort (n = 50) with a per-protocol delayed start of oral intake until POD 4 to 7. The median caloric intake at POD 5 was 58% of required. In 38% of the patients nonoral nutrition was started, mainly due to complications (36%). The pneumonia rate was 28% following immediate oral intake and 40% following delayed oral intake (p = 0.202). The aspiration pneumonia rate was 4% in both groups. The anastomotic leakage rate was 14% after immediate oral intake versus 24% following delayed oral intake (p = 0.202). The 90-day mortality rate was 2% in both groups. Hospital stay and intensive care unit stay were significantly shorter following immediate oral intake. Immediate start of oral nutrition following esophagectomy seems to be feasible and does not increase complications compared to a retrospective cohort and literature. However, if complications arise an alternative nutritional route is required. This explorative study shows that a randomized controlled trial is needed. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Evaluation of the postoperative breast.

    PubMed

    Mendelson, E B

    1992-01-01

    With widespread use of mammography for breast cancer screening, the number of surgical procedures has also increased. Overlapping with radiographic signs of malignancy, including masses, areas of asymmetric density and architectural distortion, microcalcifications, and skin thickening, postsurgical changes may make mammographic evaluation difficult. After tumor excision and irradiation where breast alterations are more profound and prolonged, the task of distinguishing recurrent tumor from scarring or fat necrosis is even more challenging. Mammograms after breast conservation therapy for carcinoma or after cosmetic surgery require correlation with physical findings and the surgical procedures that were performed. Responses of tissue to lumpectomy and radiation, such as breast edema and skin thickening, are most pronounced 6 to 12 months after treatment, gradually resolving within 1 to 3 years. Carefully tailored mammographic studies will promote the dual goal of early detection of local tumor recurrence and avoidance of misinterpreting postoperative and irradiation changes as malignancy. Sequential examinations should begin with a postoperative preradiation mammogram for residual carcinoma, particularly when microcalcifications have been present, followed by the baseline postradiation examination at 6 months with the next study 6 months later (1 year after initial treatment). Mammograms of the treated breast may be performed at intervals of 6 months until radiographic stability has been recognized. Annual studies thereafter are suggested. The contralateral, unaffected breast should be evaluated mammographically according to screening guidelines or clinical concerns. Mammograms performed after cosmetic and reconstructive procedures should be correlated with the surgical techniques and clinical history. Modified views for silicone implants can maximize visualization of breast parenchyma. Ultrasonography is a useful complement to mammography in demonstrating the

  11. Morbidity and mortality predictivity of nutritional assessment tools in the postoperative care unit.

    PubMed

    Özbilgin, Şule; Hanc, Volkan; Ömür, Dilek; Özbilgin, Mücahit; Tosun, Mine; Yurtlu, Serhan; Küçükgüçlü, Semih; Arkan, Atalay

    2016-10-01

    The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count. Patients were monitored for postoperative complications until death or discharge. Correlation of complications with these parameters was also analyzed.A total of 152 patients were included in the study. In this study a positive correlation was determined between mortality and NRS-2002, SGA, CCI, Acute Physiology and Chronic Health Evaluation , Sepsis-related Organ Failure Assessment, and NUTRIC score, whereas a negative correlation was determined between mortality and NRI. There was a correlation between NUTRIC score and pneumonia, development of atrial fibrillation, delirium, renal failure, inotrope use, and duration of mechanical ventilation. In our study group of postoperative patients, MNA had no predictive properties for any complication, whereas SGA had no predictive properties for any complications other than duration of hospital stay and mortality.The NUTRIC score is an important indicator of mortality and morbidity in postoperative surgical patients. NRI correlated with many postoperative complications, and though SGA and NRS were correlated with mortality, they were not correlated with the majority of complications. MNA was determined not to have any correlation with any complication, mortality, and duration of hospital stay in our patient group.

  12. Morbidity and mortality predictivity of nutritional assessment tools in the postoperative care unit

    PubMed Central

    Özbilgin, Şule; Hancı, Volkan; Ömür, Dilek; Özbilgin, Mücahit; Tosun, Mine; Yurtlu, Serhan; Küçükgüçlü, Semih; Arkan, Atalay

    2016-01-01

    Abstract The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality. At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count. Patients were monitored for postoperative complications until death or discharge. Correlation of complications with these parameters was also analyzed. A total of 152 patients were included in the study. In this study a positive correlation was determined between mortality and NRS-2002, SGA, CCI, Acute Physiology and Chronic Health Evaluation , Sepsis-related Organ Failure Assessment, and NUTRIC score, whereas a negative correlation was determined between mortality and NRI. There was a correlation between NUTRIC score and pneumonia, development of atrial fibrillation, delirium, renal failure, inotrope use, and duration of mechanical ventilation. In our study group of postoperative patients, MNA had no predictive properties for any complication, whereas SGA had no predictive properties for any complications other than duration of hospital stay and mortality. The NUTRIC score is an important indicator of mortality and morbidity in postoperative surgical patients. NRI correlated with many postoperative complications, and though SGA and NRS were correlated with mortality, they were not correlated with the majority of complications. MNA was determined not to have any correlation with any complication, mortality, and duration of hospital stay in our patient group. PMID

  13. Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer.

    PubMed

    Garth, A K; Newsome, C M; Simmance, N; Crowe, T C

    2010-08-01

    Malnutrition and its associated complications are a considerable issue for surgical patients with upper gastrointestinal and colorectal cancer. The present study aimed to determine whether specific perioperative nutritional practices and protocols are associated with improved patient outcomes in this group. Patients admitted for elective upper gastrointestinal or colorectal cancer surgery (n = 95) over a 19-month period underwent a medical history audit assessing weight changes, nutritional intake, biochemistry, post-operative complications and length of stay. A subset of patients (n = 25) underwent nutritional assessment by subjective global assessment prior to surgery in addition to assessment of post-operative medical outcomes, nutritional intake and timing of dietetic intervention. Mean (SD) length of stay for patients was 14.0 (12.2) days, with complication rates at 35%. Length of stay was significantly longer in patients who experienced significant preoperative weight loss compared to those who did not [17.0 (15.8) days versus 10.0 (6.8) days, respectively; P < 0.05]. Low albumin and post-operative weight loss were also predictive of increased length of stay. Of patients who underwent nutritional assessment, 32% were classified as mild-moderately malnourished and 16% severely malnourished. Malnourished patients were hospitalised twice as long as well-nourished patients [15.8 (12.8) days versus 7.6 (3.5) days; P < 0.05]. Time taken [6.9 (3.6) days] to achieve adequate nutrition post surgery was a factor in post-operative outcomes, with a positive correlation with length of stay (r = 0.493; P < 0.01), a negative correlation with post-operative weight change (r = -0.417; P < 0.05) and a greater risk of complications (52% versus 13%; P < 0.01). Malnutrition is prevalent among surgical patients with gastrointestinal cancer. Poor nutritional status coupled with delayed and inadequate post-operative nutrition practices are associated with worse clinical outcomes.

  14. Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy.

    PubMed

    Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

    2017-01-14

    To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

  15. Evaluation of nutritional status.

    PubMed

    Weisberg, H F

    1983-01-01

    The assessment of nutritional status has become very popular, especially for patients undergoing stress (surgery) or potential parenteral nutrition. Evaluation of cancer patients is essentially the same as for other patients. Body fat reserves are approximated by subcutaneous skinfold measurements. Somatic protein (skeletal muscle) mass is decreased in marasmus (protein-calorie malnutrition) and is evaluated by anthropometric determinations, based upon age and sex or both. Instead of using relatively inadequate standards such as the 1959 Metropolitan Life Insurance tables for ideal weight, it is advocated to use the population percentiles derived from the Health and Nutritional Examination Survey (HANES) published in 1979. The visceral protein mass is decreased in kwashiorkor and is approximated by study of the liver transport proteins. A mixed-type of protein-calorie malnutrition may exist, e.g., cancer cachexia, with marked decrease of immunocompetence. A prognostic nutritional index, based on biologic measurements rather than true nutritional assessment, can predict the probability of complications and survival in severely ill patients. All such studies should be used to substantiate good clinical judgement, based on adequate history and physical examination with emphasis on the nutritional aspects.

  16. Postoperative total parenteral nutrition in patients with liver disorders.

    PubMed

    Okuno, M; Nagayama, M; Takai, T; Rai, A; Nakao, S; Kamino, K; Umeyama, K

    1985-08-01

    Sixty-one patients with liver disorders receiving total parenteral nutrition (TPN) for about 14 postoperative days were divided into three groups based on the parenteral nutritional regimen. The influence of these TPN solutions on the liver function tests and the nutritional assessments, and the availability of the specially formulated amino acid solution were studied. Glucose alone as energy source was infused in Group Ia. The mixture of glucose and fructose was infused in Group Ib. In these patients (Group I), a commercially available amino acid solution was administered simultaneously. A specially formulated amino acid, rich in branched-chain amino acids but poor in aromatic amino acids was infused with the mixture of glucose and fructose in Group II. There was no remarkable elevation of blood glucose and lactate levels in all patients. Blood glucose levels in Group Ib were maintained lower than that in Group Ia. Except for serum alkaline phosphatase, no remarkable abnormality was observed in liver function tests. Body weight changes were less than 5% in each group. Average nitrogen balances were -44.5 mg/kg/day in Group Ia, -5.5 mg/kg/day in Group Ib, -51.5 mg/kg/day in Group II. While the abnormalities in serum amino acid pattern and molar ratio of leucine, isoleucine, and valine to phenylalanine and tyrosine tend to be more enhanced in Group I, these abnormalities returned to near normal in Group II during TPN. By multiple linear regression analyses, 45 kcal/kg/day of energy intake would be required to maintain nitrogen equilibrium and zero body weight change. And when nitrogen intakes were 159 mg/kg/day in Group Ia, 114 mg/kg/day in Group Ib, and 189 mg/kg/day in Group II at 45 kcal/kg/day in energy intake, nitrogen balances were expected to be equivalent. These results suggest that postoperative TPN is good for nutritional support in patients with liver disorders. And also, the combination of glucose and fructose has better effect on nitrogen balance. The

  17. Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy

    PubMed Central

    Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

    2017-01-01

    AIM To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. METHODS Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. RESULTS High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. CONCLUSION At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival. PMID:28127200

  18. Postoperative complications in gastrointestinal cancer patients: the joint role of the nutritional status and the nutritional support.

    PubMed

    Bozzetti, Federico; Gianotti, Luca; Braga, Mario; Di Carlo, Valerio; Mariani, Luigi

    2007-12-01

    This study investigated the effects of nutritional support on postoperative complications, in relation with demographic and nutritional factors, intraoperative factors, type and routes of nutritional regimens. A series of 1410 subjects underwent major abdominal surgery for gastrointestinal cancer and received various types of nutritional support: standard intravenous fluids (SIF; n=149), total parenteral nutrition (TPN; n=368), enteral nutrition (EN; n=393), and immune-enhancing enteral nutrition (IEEN; n=500). Postoperative complications, considered as major (if lethal or requiring re-operation, or transfer to intensive care unit), or otherwise minor, were recorded. Major and minor complications occurred in 101 (7.2%) and 446 (31.6%) patients, respectively. Factors correlated with postoperative complications at multivariate analysis were pancreatic surgery, (p<0.001), advanced age (p=0.002), weight loss (p=0.019), low serum albumin (p=0.019) and nutritional support (p=0.001). Nutritional support reduced morbidity versus SIF with an increasing protective effect of TPN, EN, and IEEN. This effect remained valid regardless the severity of risk factors identified at the multivariate analysis and it was more evident by considering infectious complications only. Pancreatic surgery, advanced age, weight loss and low serum albumin are independent risk factors for the onset of postoperative complications. Nutritional support, particularly IEEN, significantly reduced postoperative morbidity.

  19. Post-operative rehabilitation and nutrition in osteoarthritis.

    PubMed

    Musumeci, Giuseppe; Mobasheri, Ali; Trovato, Francesca Maria; Szychlinska, Marta Anna; Imbesi, Rosa; Castrogiovanni, Paola

    2014-01-01

    Osteoarthritis (OA) is a degenerative process involving the progressive loss of articular cartilage, synovial inflammation and structural changes in subchondral bone that lead to loss of synovial joint structural features and functionality of articular cartilage. OA represents one of the most common causes of physical disability in the world. Different OA treatments are usually considered in relation to the stage of the disease. In the early stages, it is possible to recommend physical activity programs that can maintain joint health and keep the patient mobile, as recommended by OA Research Society International (OARSI) and European League Against Rheumatism (EULAR). In the most severe and advanced cases of OA, surgical intervention is necessary. After, in early postoperative stages, it is essential to include a rehabilitation exercise program in order to restore the full function of the involved joint. Physical therapy is crucial for the success of any surgical procedure and can promote recovery of muscle strength, range of motion, coordinated walking, proprioception and mitigate joint pain. Furthermore, after discharge from the hospital, patients should continue the rehabilitation exercise program at home associated to an appropriate diet. In this review, we analyze manuscripts from the most recent literature and provide a balanced and comprehensive overview of the latest developments on the effect of physical exercise on postoperative rehabilitation in OA. The literature search was conducted using PubMed, Scopus, Web of Science and Google Scholar, using the keywords 'osteoarthritis', 'rehabilitation', 'exercise' and 'nutrition'. The available data suggest that physical exercise is an effective, economical and accessible to everyone practice, and it is one of the most important components of postoperative rehabilitation for OA.

  20. Hybrid minimally invasive esophagectomy for cancer: impact on postoperative inflammatory and nutritional status.

    PubMed

    Scarpa, M; Cavallin, F; Saadeh, L M; Pinto, E; Alfieri, R; Cagol, M; Da Roit, A; Pizzolato, E; Noaro, G; Pozza, G; Castoro, C

    2016-11-01

    The purpose of this case-control study was to evaluate the impact of hybrid minimally invasive esophagectomy for cancer on surgical stress response and nutritional status. All 34 consecutive patients undergoing hybrid minimally invasive esophagectomy for cancer at our surgical unit between 2008 and 2013 were retrospectively compared with 34 patients undergoing esophagectomy with open gastric tubulization (open), matched for neoadjuvant therapy, pathological stage, gender and age. Demographic data, tumor features and postoperative course (including quality of life and systemic inflammatory and nutritional status) were compared. Postoperative course was similar in terms of complication rate. Length of stay in intensive care unit was shorter in patients undergoing hybrid minimally invasive esophagectomy (P = 0.002). In the first postoperative day, patients undergoing hybrid minimally invasive esophagectomy had lower C-reactive protein levels (P = 0.001) and white cell blood count (P = 0.05), and higher albumin serum level (P = 0.001). In this group, albumin remained higher also at third (P = 0.06) and seventh (P = 0.008) postoperative day, and C-reactive protein resulted lower at third post day (P = 0.04). Hybrid minimally invasive esophagectomy significantly improved the systemic inflammatory and catabolic response to surgical trauma, contributing to a shorter length of stay in intensive care unit. © 2015 International Society for Diseases of the Esophagus.

  1. [Hypocaloric peripheral parenteral nutrition in postoperative patients (Proyecto Europan)].

    PubMed

    Jiménez Jiménez, F J; Ortiz Leyba, C

    1992-01-01

    Hypocaloric peripheral parenteral nutrition (HPPN) appears to be indicated in patients with moderate malnutrition subjected to a short period of fasting following surgery. Our objective is to determine whether or not the intake of hypocaloric parenteral solutions containing aminoacid is useful in postsurgical patients, by means of a study of different nutritional evaluation parameters. A study was performed on 35 postsurgical patients who fulfilled at least 2 of the following criteria indicating malnutrition: 1) albumin levels less than 3 g/dl; 2) prealbumin levels less than 21 mg/; 3) body weight less than 95% of ideal weight. The patients were divided into 3 groups: Group I consisted of 15 patients treated with conventional fluid therapy, Group II consisted of 10 patients treated with nutritional support based on glucose and aminoacid and Group III was comprised of 10 patients also treated with a nutritional therapy based on glycerol and aminoacid. The most significant data included a rapid recovery of short term proteins (prealbumin and retinol-binding protein) and a less negative nitrogen balance 5 days afterwards in both the glucose and glycerol groups, both of which were statistically significant. With regard to complications studied, there was a greater incidence of suture dehiscence in the control group than in the groups under treatment (13.3% compared to 50%). Our conclusion is that HPPN is a valid nutritional support measure in postsurgical patients in certain clinical situations and circumstances, although further controlled, randomized studies should be considered, during both the pre and post operative periods of these patients in order to clearly indicate how and when nutritional therapy should be applied.

  2. Association Between Nutritional Status, Inflammatory Condition, and Prognostic Indexes with Postoperative Complications and Clinical Outcome of Patients with Gastrointestinal Neoplasia.

    PubMed

    Costa, Milena Damasceno de Souza; Vieira de Melo, Camila Yandara Sousa; Amorim, Ana Carolina Ribeiro de; Cipriano Torres, Dilênia de Oliveira; Dos Santos, Ana Célia Oliveira

    2016-10-01

    The aim of this study is to describe and relate nutritional and inflammatory status and prognostic indexes with postoperative complications and clinical outcome of patients with gastrointestinal malignancies. Twenty-nine patients were evaluated; nutritional assessment was carried out by subjective and objective parameters; albumin, pre-albumin, C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP) were determined. To assess prognosis, the Glasgow scale, the Prognostic Inflammatory Nutritional Index (PINI), and CRP/albumin ratio were used; the clinical outcomes considered were hospital discharge and death. A high Subjective Global Assessment (SGA) score was associated with the occurrence of postoperative complications: 73% of the patients with postoperative complications had the highest SGA score, but only 6% of those without postoperative complications had the highest SGA score (P < 0.001). Greater occurrence of death was observed in patients with a high SGA score, low serum albumin, increased CRP, PINI > 1, and Glasgow score 2. There was a positive correlation between weight loss percentage with serum CRP levels (P = 0.002), CRP/albumin (P = 0.002), PINI (P = 0.002), and Glasgow score (P = 0.000). This study provides evidence that the assessment of the nutritional status and the use of prognostic indexes are good tools for predicting postoperative complications and clinical outcome in patients with gastrointestinal neoplasia.

  3. The Effects of Early Post-Operative Soluble Dietary Fiber Enteral Nutrition for Colon Cancer

    PubMed Central

    Xu, Rui; Ding, Zhi; Zhao, Ping; Tang, Lingchao; Tang, Xiaoli; Xiao, Shuomeng

    2016-01-01

    We examined colon cancer patients who received soluble dietary fiber enteral nutrition (SDFEN) to evaluate the feasibility and potential benefit of early SDFEN compared to EN. Sixty patients who were confirmed as having colon cancer with histologically and accepted radical resection of colon cancer were randomized into an SDFEN group and an EN group. The postoperative complications, length of hospital stay (LOH), days for first fecal passage, and the difference in nutritional status, immune function and inflammatory reaction between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test and the chi square test. Statistical significance was defined as p < 0.05. After the nutrition support, differences in the levels of albumin, prealbumin and transferrin in each group were not statistically significant (p > 0.05); the levels of CD4+, IgA and IgM in the SDFEN group were higher than that of the EN group at seven days (p < 0.05); the levels of TNF-α and IL-6 in the SDFEN group were lower than that of the EN group at seven days (p < 0.05); and patients in the SDFEN group had a significantly shorter first flatus time than the EN group (p < 0.05). Early post-operative SDFEN used in colon cancer patients was feasible and beneficial in immune function and reducing inflammatory reaction, gastrointestinal function and speeding up the recovery. PMID:27657124

  4. Impact of enteral nutrition on postoperative immune function and nutritional status.

    PubMed

    Wang, F; Hou, M X; Wu, X L; Bao, L D; Dong, P D

    2015-06-10

    We studied the effects of enteral nutrition (EN) support initiated 1 week before surgery on postoperative nutritional status, immune function, and inflammatory response in gastric cancer patients. A total of 200 gastric cancer patients were randomly divided into two groups: EN starting 1 week before surgery (study group) and EN starting early after surgery (control group). The two groups received EN support, following different therapeutic schedules, until the 9th day after operation. In the patients, body weight, skinfold thickness, upper-arm circumference, white blood cell count, albumin, prealbumin, C-reactive protein, peripheral immunoglobulins (IgA, IgG, and IgM), T lymphocyte subsets, interleukin-6, and tumor necrosis factor-α were measured 10 days before and after surgery and on the first day after surgery. There was no statistically significant difference in the results of recovery time of passage of gas by anus, abdominal distension, stomachache, blood glucose, hepatic and renal functions, and electrolytes between the two groups of patients (P > 0. 05). Adverse reactions occurred to both groups at 1 and 2 days after operation. Such conditions was improved after the intravenous drip rate was adjusted. The albumin and prealbumin levels of the patients in both groups decreased at 1 day after operation (P < 0. 05). The levels rose when the research was finished (P < 0. 05). The prealbumin level of the study group was higher than that of the control group at 10 days after operation (P < 0. 05). The IgG level of the study group was higher than that of the control group at 10 days after operation (P < 0. 05). The two groups of inflammatory reaction indicators of the study group were lower than those of the control group at 10 days after operation (P < 0. 05). This study indicates that appropriate preoperative EN support for gastric cancer patients can improve their postoperative nutritional status and immune function, can reduce inflammatory response, and is

  5. [Influence of Lipoplus fat emulsion on postoperative nutritional status and early inflammatory response in patients with gastrointestinal malignancies].

    PubMed

    Zhang, Cai-hua; Li, Ning; Wang, Xin-ying; Li, Guo-li; Fan, Chao-gang; Li, Jie-shou

    2012-05-01

    To investigate the effect of Lipoplus on postoperative nutritional status and inflammatory response in patients with gastrointestinal malignancies. Sixty-four patients with gastrointestinal malignancies were randomized using random digit table to receive isonitrogenous, isocaloric total parenteral nutrition for 5 days including either Lipoplus or Lipofundin with 32 patients in each group. Blood samples were obtained before the surgery, postoperative days 1, 2, 3, and 6 to evaluate the nutritional status(prealbumin, retinol binding protein, and nitrogen balance) and inflammatory response [C-reaction protein(CRP), and leukotriene(LTB) 5, LTB4]. The incidence of postoperative systemic inflammatory response syndrome(SIRS), infection, postoperative complications, mortality, APACHEII score, length of hospital stay and other clinical indicators were recorded. On postoperative day 1, prealbumin and retinol binding protein were significantly lower as compared to preoperative levels. These parameters increased significantly(P<0.05) on postoperative day 6 and the nitrogen balance was positive. On postoperative day 6, CRP was significantly lower in both groups as compared to postoperative day 3 (P<0.05), and the decrease was more prominent in Lipoplus than Lipofundin(P<0.05). There was a significant increase in LTB5/LTB4 as compared to postoperative day 1(P<0.05) in the Lipoplus group, however the increase was not statistically significant in the Lipofundin group(P>0.05). The incidence of postoperative infection was significantly lower in the Lipoplus group(3.1% vs. 6.3%, P<0.05), as was that of SIRS(9.4% vs. 15.6%, P<0.05). The APACHEII score was higher in the Lipoplus group but the difference was not statistically significant(3.6±2.0 vs. 3.3±2.1, P>0.05). The length of hospital stay was significantly shorter in Lipoplus group[(6.4±1.1) d vs. (8.2±1.3) d, P<0.05]. Lipoplus can improve the postoperative nutritional status and minimize the inflammatory response in patients

  6. MR imaging evaluation of the postoperative meniscus.

    PubMed

    Russo, A; Capasso, R; Varelli, C; Laporta, A; Carbone, M; D'Agosto, G; Giovine, S; Zappia, M; Reginelli, A

    2017-03-01

    MR imaging has been widely evaluated in the assessment of patients with recurrent or residual symptoms following meniscal surgery. Importantly, the causes of such symptoms may relate to failure or complication of the surgical procedure, a possible recurrent or residual meniscal tear, or may be related to other causes of joint symptoms, including tears of the contralateral meniscus, or local hyaline cartilage, or marrow abnormalities subjacent to or distant to the meniscal surgical site. The complex diagnostic issues involved in the MR imaging evaluation of the postoperative meniscus were identified in early MR imaging studies. The knowledge of the normal MR imaging appearance of the knee after the more common repair procedures will allow radiologists to recognize complications associated with such procedures. In this article, we discuss the MR imaging evaluation of the knee after meniscal surgery.

  7. Association Between Preoperative Nutritional Status and Postoperative Outcome in Head and Neck Cancer Patients.

    PubMed

    Leung, John S L; Seto, Alfred; Li, George K H

    2017-04-01

    Head and neck cancer patients treated with surgery often experience significant postoperative morbidities. Administering preoperative nutritional intervention may improve surgical outcomes, but there is currently a paucity of data reviewing the association between preoperative nutritional status and postoperative outcome. It is therefore of importance to investigate this association among head and neck cancer patients. To assess the association between preoperative nutritional status and postoperative outcome in head and neck cancer patients treated with surgery, a retrospective study of 70 head and neck cancer patients who were surgically treated between 2013 and 2014 in a tertiary referral head and neck surgery center in Hong Kong was conducted. Clinical data regarding preoperative nutritional status and postoperative outcome were retrieved from a computer record system. Logistic and linear regressions were used to analyze the appropriate parameters. A higher preoperative albumin level was associated with lower rates of postoperative complications and better wound healing (P < 0.05). In contrast, preoperative body mass index, hemoglobin level, and absolute lymphocyte count did not demonstrate significant associations with postoperative outcome. As high albumin levels are associated with better surgical outcome in head and neck cancer patients, preoperative intervention strategies that boost albumin levels could be considered for improving surgical outcome.

  8. Postoperative Nutritional Effects of Early Enteral Feeding Compared with Total Parental Nutrition in Pancreaticoduodectomy Patients: A Prosepective, Randomized Study

    PubMed Central

    Park, Joon Seong; Chung, Hye-Kyung; Hwang, Ho Kyoung; Kim, Jae Keun

    2012-01-01

    The benefits of early enteral feeding (EEN) have been demonstrated in gastrointestinal surgery. But, the impact of EEN has not been elucidated yet. We assessed the postoperative nutritional status of patients who had undergone pancreaticoduodenectomy (PD) according to the postoperative nutritional method and compared the clinical outcomes of two methods. A prospective randomized trial was undertaken following PD. Patients were randomly divided into two groups; the EEN group received the postoperative enteral feed and the control group received the postoperative total parenteral nutrition (TPN) management. Thirty-eight patients were included in our analyses. The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than in TPN group. Prealbumin and transferrin were significantly reduced on post-operative day (POD) 7 and were slowly recovered until POD 90 in the TPN group than in the EEN group. EEN group rapidly recovered weight after POD 21 whereas it was gradually decreased in TPN group until POD 90. EEN after PD is associated with preservation of weight compared with TPN and impact on recovery of digestive function after PD. PMID:22379336

  9. Postoperative nutritional effects of early enteral feeding compared with total parental nutrition in pancreaticoduodectomy patients: a prosepective, randomized study.

    PubMed

    Park, Joon Seong; Chung, Hye-Kyung; Hwang, Ho Kyoung; Kim, Jae Keun; Yoon, Dong Sup

    2012-03-01

    The benefits of early enteral feeding (EEN) have been demonstrated in gastrointestinal surgery. But, the impact of EEN has not been elucidated yet. We assessed the postoperative nutritional status of patients who had undergone pancreaticoduodenectomy (PD) according to the postoperative nutritional method and compared the clinical outcomes of two methods. A prospective randomized trial was undertaken following PD. Patients were randomly divided into two groups; the EEN group received the postoperative enteral feed and the control group received the postoperative total parenteral nutrition (TPN) management. Thirty-eight patients were included in our analyses. The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than in TPN group. Prealbumin and transferrin were significantly reduced on post-operative day (POD) 7 and were slowly recovered until POD 90 in the TPN group than in the EEN group. EEN group rapidly recovered weight after POD 21 whereas it was gradually decreased in TPN group until POD 90. EEN after PD is associated with preservation of weight compared with TPN and impact on recovery of digestive function after PD.

  10. Postoperative outcome after oesophagectomy for cancer: Nutritional status is the missing ring in the current prognostic scores.

    PubMed

    Filip, B; Scarpa, M; Cavallin, F; Cagol, M; Alfieri, R; Saadeh, L; Ancona, E; Castoro, C

    2015-06-01

    Several prognostic scores were designed in order to estimate the risk of postoperative adverse events. None of them includes a component directly associated to the nutritional status. The aims of the study were the evaluation of performance of risk-adjusted models for early outcomes after oesophagectomy and to develop a score for severe complication prediction with special consideration regarding nutritional status. A comparison of POSSUM and Charlson score and their derivates, ASA, Lagarde score and nutritional index (PNI) was performed on 167 patients undergoing oesophagectomy for cancer. A logistic regression model was also estimated to obtain a new prognostic score for severe morbidity prediction. Overall morbidity was 35.3% (59 cases), severe complications (grade III-V of Clavien-Dindo classification) occurred in 20 cases. Discrimination was poor for all the scores. Multivariable analysis identified pulse, connective tissue disease, PNI and potassium as independent predictors of severe morbidity. This model showed good discrimination and calibration. Internal validation using standard bootstrapping techniques confirmed the good performance. Nutrition could be an independent risk factor for major complications and a nutritional status coefficient could be included in current prognostic scores to improve risk estimation of major postoperative complications after oesophagectomy for cancer. Copyright © 2015. Published by Elsevier Ltd.

  11. Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer.

    PubMed

    Kanda, Mitsuro; Mizuno, Akira; Tanaka, Chie; Kobayashi, Daisuke; Fujiwara, Michitaka; Iwata, Naoki; Hayashi, Masamichi; Yamada, Suguru; Nakayama, Goro; Fujii, Tsutomu; Sugimoto, Hiroyuki; Koike, Masahiko; Takami, Hideki; Niwa, Yukiko; Murotani, Kenta; Kodera, Yasuhiro

    2016-06-01

    Evidence indicates that impaired immunocompetence and nutritional status adversely affect short-term and long-term outcomes of patients with cancer. We aimed to evaluate the clinical significance of preoperative immunocompetence and nutritional status according to Onodera's prognostic nutrition index (PNI) among patients who underwent curative gastrectomy for gastric cancer (GC).This study included 260 patients with stage II/III GC who underwent R0 resection. The predictive values of preoperative nutritional status for postoperative outcome (morbidity and prognosis) were evaluated. Onodera's PNI was calculated as follows: 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm).The mean preoperative PNI was 47.8. The area under the curve for predicting complications was greater for PNI compared with the serum albumin concentration or lymphocyte count. Multivariate analysis identified preoperative PNI < 47 as an independent predictor of postoperative morbidity. Moreover, patients in the PNI < 47 group experienced significantly shorter overall and disease-free survival compared with those in the PNI ≥ 47 group, notably because of a higher prevalence of hematogenous metastasis as the initial recurrence. Subgroup analysis according to disease stage and postoperative adjuvant treatment revealed that the prognostic significance of PNI was more apparent in patients with stage II GC and in those who received adjuvant chemotherapy.Preoperative PNI is easy and inexpensive to determine, and our findings indicate that PNI served as a significant predictor of postoperative morbidity, prognosis, and recurrence patterns of patients with stage II/III GC.

  12. Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer

    PubMed Central

    Kanda, Mitsuro; Mizuno, Akira; Tanaka, Chie; Kobayashi, Daisuke; Fujiwara, Michitaka; Iwata, Naoki; Hayashi, Masamichi; Yamada, Suguru; Nakayama, Goro; Fujii, Tsutomu; Sugimoto, Hiroyuki; Koike, Masahiko; Takami, Hideki; Niwa, Yukiko; Murotani, Kenta; Kodera, Yasuhiro

    2016-01-01

    Abstract Evidence indicates that impaired immunocompetence and nutritional status adversely affect short-term and long-term outcomes of patients with cancer. We aimed to evaluate the clinical significance of preoperative immunocompetence and nutritional status according to Onodera's prognostic nutrition index (PNI) among patients who underwent curative gastrectomy for gastric cancer (GC). This study included 260 patients with stage II/III GC who underwent R0 resection. The predictive values of preoperative nutritional status for postoperative outcome (morbidity and prognosis) were evaluated. Onodera's PNI was calculated as follows: 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm3). The mean preoperative PNI was 47.8. The area under the curve for predicting complications was greater for PNI compared with the serum albumin concentration or lymphocyte count. Multivariate analysis identified preoperative PNI < 47 as an independent predictor of postoperative morbidity. Moreover, patients in the PNI < 47 group experienced significantly shorter overall and disease-free survival compared with those in the PNI ≥ 47 group, notably because of a higher prevalence of hematogenous metastasis as the initial recurrence. Subgroup analysis according to disease stage and postoperative adjuvant treatment revealed that the prognostic significance of PNI was more apparent in patients with stage II GC and in those who received adjuvant chemotherapy. Preoperative PNI is easy and inexpensive to determine, and our findings indicate that PNI served as a significant predictor of postoperative morbidity, prognosis, and recurrence patterns of patients with stage II/III GC. PMID:27310954

  13. [How to assess and monitor postoperative artificial nutrition?].

    PubMed

    Delafosse, B

    1995-01-01

    Quantitative and qualitative nutritional requirements depend on the level of energetic expenses. Various formulas, especially the tables by Harris and Benedict allow the estimation of the level of energetic expenses with an approximation of 14%. Corrective factors permit an adjustment of the figures, according to the level of body aggression. In complex cases, indirect calorimetry allows a more accurate appraisal of energetic expenses. This technique provides also indications on the utilisation of each substrate and allows therefore to determine the optimal carbohydrate-lipid ratio for each patient. The assessment of the direct benefit of artificial nutritional support relies on anthropometric techniques and at present on body composition appraisal by determination of its impedance. The changes in muscular strength are difficult to assess. Moreover the time course of body weight is not specific for nutritional status. Therefore other biological indicators such as the nitrogen balance, the concentration of plasma proteins and albumin are more often assessed; proteins with a short half-life depend on the body aggression level. The potassium balance, which is easy to obtain in clinical practice, is a relevant indicator for nitrogen balance and protein synthesis. Clinical monitoring includes the checking of hydratation and its impact on the circulatory, respiratory and renal functions. The tolerance of enteral nutrition is appraised by the quality of gastrointestinal function. Biological monitoring includes the electrolyte balance and various variables of carbohydrate, lipidic and proteic metabolisms. It allows to check the absence of hyperglycaemia, hyperlipidaemia and cholestasis. The daily checking of catheters is part of the monitoring of nutritional support.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Copper-deficiency anemia after esophagectomy: A pitfall of postoperative enteral nutrition through jejunostomy.

    PubMed

    Nakagawa, Masatoshi; Nagai, Kagami; Minami, Isao; Wakabayashi, Mai; Torigoe, Junko; Kawano, Tatsuyuki

    2014-01-01

    Copper deficiency leads to functional disorders of hematopoiesis and neurological system. There have been some reports of copper deficiency occurring to the patients on enteral nutrition through a jejunostomy in long-term-care hospitals. However, it is extremely rare to find patients with copper deficiency several months after esophagectomy, regardless of enteral nutrition through the jejunostomy. To the best of our knowledge, this is the first case report of a patient who experienced copper-deficiency anemia after esophagectomy and subsequent enteral nutrition through the jejunostomy. A 73-year-old man presented with pulmonary failure after esophagectomy for esophageal cancer with video-assisted thoracoscopic surgery, and needed long-term artificial ventilator support. Nutritional management included enteral nutrition through a jejunostomy from the early postoperative period. Copper-deficiency anemia was detected 3 months postoperatively; therefore, copper supplementation with cocoa powder was performed, and both serum copper and hemoglobin levels subsequently recovered. Copper-deficiency anemia has already been reported to occur in patients receiving enteral nutrition in long-term care hospitals. However, this is the first case report of copper deficiency after esophagectomy despite administration of standard enteral nutrition through the jejunostomy for several months. It is extremely rare to find copper-deficiency anemia several months after esophagectomy followed by enteral nutrition through the jejunostomy. However, if anemia of unknown origin occurs in such patients, copper-deficiency anemia must be considered among the differential diagnoses. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Post-operative rehabilitation and nutrition in osteoarthritis

    PubMed Central

    Musumeci, Giuseppe; Mobasheri, Ali; Trovato, Francesca Maria; Szychlinska, Marta Anna; Imbesi, Rosa; Castrogiovanni, Paola

    2016-01-01

    Osteoarthritis (OA) is a degenerative process involving the progressive loss of articular cartilage, synovial inflammation and structural changes in subchondral bone that lead to loss of synovial joint structural features and functionality of articular cartilage. OA represents one of the most common causes of physical disability in the world. Different OA treatments are usually considered in relation to the stage of the disease. In the early stages, it is possible to recommend physical activity programs that can maintain joint health and keep the patient mobile, as recommended by OA Research Society International (OARSI) and European League Against Rheumatism (EULAR). In the most severe and advanced cases of OA, surgical intervention is necessary. After, in early postoperative stages, it is essential to include a rehabilitation exercise program in order to restore the full function of the involved joint. Physical therapy is crucial for the success of any surgical procedure and can promote recovery of muscle strength, range of motion, coordinated walking, proprioception and mitigate joint pain. Furthermore, after discharge from the hospital, patients should continue the rehabilitation exercise program at home associated to an appropriate diet. In this review, we analyze manuscripts from the most recent literature and provide a balanced and comprehensive overview of the latest developments on the effect of physical exercise on postoperative rehabilitation in OA. The literature search was conducted using PubMed, Scopus, Web of Science and Google Scholar, using the keywords ‘osteoarthritis’, ‘rehabilitation’, ‘exercise’ and ‘nutrition’. The available data suggest that physical exercise is an effective, economical and accessible to everyone practice, and it is one of the most important components of postoperative rehabilitation for OA. PMID:26962431

  16. Preoperative prognostic nutritional index predicts postoperative surgical site infections in gastrointestinal fistula patients undergoing bowel resections

    PubMed Central

    Hu, Qiongyuan; Wang, Gefei; Ren, Jianan; Ren, Huajian; Li, Guanwei; Wu, Xiuwen; Gu, Guosheng; Li, Ranran; Guo, Kun; Deng, Youming; Li, Yuan; Hong, Zhiwu; Wu, Lei; Li, Jieshou

    2016-01-01

    Abstract Recent studies have implied a prognostic value of the prognostic nutritional index (PNI) in postoperative septic complications of elective colorectal surgeries. However, the evaluation of PNI in contaminated surgeries for gastrointestinal (GI) fistula patients is lack of investigation. The purpose of this study was to explore the predictive value of PNI in surgical site infections (SSIs) for GI fistula patients undergoing bowel resections. A retrospective review of 290 GI patients who underwent intestinal resections between November 2012 and October 2015 was performed. Univariate and multivariate analyses were conducted to identify risk factors for SSIs, and receiver operating characteristic cure was used to quantify the effectiveness of PNI. SSIs were diagnosed in 99 (34.1%) patients, with incisional infection identified in 54 patients (18.6%), deep incisional infection in 13 (4.5%), and organ/space infection in 32 (11.0%). receiver operating characteristic curve analysis defined a PNI cut-off level of 45 corresponding to postoperative SSIs (area under the curve [AUC] = 0.72, 76% sensitivity, 55% specificity). Furthermore, a multivariate analysis indicated that the PNI < 45 [odd ratio (OR): 2.24, 95% confidence interval (CI): 1.09–4.61, P = 0.029] and leukocytosis (OR: 3.70, 95% CI: 1.02–13.42, P = 0.046) were independently associated with postoperative SSIs. Preoperative PNI is a simple and useful marker to predict SSIs in GI fistula patients after enterectomies. Measurement of PNI is therefore recommended in the routine assessment of patients with GI fistula receiving surgical treatment. PMID:27399098

  17. Nutritional status and its impact on time and relocation in postoperative complications of abdominal patients undergoing surgery.

    PubMed

    Leide da Silva Nunes, Francisca; Calado Ferreira Pinheiro Gadelha, Patricia; Damasceno de Souza Costa, Milena; Carolina Ribeiro de Amorim, Ana Carolina; Bezerra da Silva, Maria da Guia

    2014-09-01

    The nutritional state is the independent factor that most influences the post-operational results in elective surgeries. to evaluate the influence of the nutritional state on the hospitalization period and on the post-operative complications of patients submitted to abdominal surgery. prospective study with 99 surgical patients over 18 years of age, submitted to abdominal surgeries in the period from April to October of 2013, in the Instituto de Medicina Integral Professor Fernando Figueira (IMIP). All patients were submitted to anthropometric nutritional evaluations through the body mass Index (BMI), arm circumference (AC) and triceps skinfold thickness (TEST). The biochemical evaluation was carried out from the leukogram and serum albumin results. The identification of candidate patients to nutritional therapy (NT) was carried out through the nutritional risk (NR) evaluation by using the BMI, loss of weight and hypoalbuminemia. The information about post-operational complications, hospitalization period and clinical diagnosis was collected from the medical records. Program SPSS version 13.0 and significance level of 5% were used for the statistical analysis. The malnutrition diagnosed by the AC showed significant positive association with the presence of post-operative complications (p=0.02) and with hospitalization period (p=0.02). The presence of NR was greater when evaluated by hypoalbuminemia (28.9%), however, only 4% of the sample carried out the NT in the pre-operational period. The hospitalization period was greater for patients with malignant neoplasia (p<0.01). The malnutrition diagnosis of patients submitted to abdominal surgeries is associated to greater risk of post-operational complications and longer hospitalization permanence. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  18. Evaluation of the postoperative lumbar spine.

    PubMed

    Herrera Herrera, I; Moreno de la Presa, R; González Gutiérrez, R; Bárcena Ruiz, E; García Benassi, J M

    2013-01-01

    Given the prevalence of low back pain, surgical interventions on the lumbar spine are becoming more common. Among the many surgical procedures available for these interventions, the most common are laminectomy and discectomy. In 10 to 40% of patients who undergo surgical interventions on the lumbar spine, low back pain is not completely alleviated or it recurs, and these cases fall into the category of « failed back surgery syndrome ». This syndrome can have many different causes and multiple factors are often involved. It is important not to confuse the normal postoperative findings with those specific to failed back surgery syndrome. Deciding which imaging technique to use will depend on the type of surgical intervention, whether metallic orthopedic material was used, and the clinical suspicion. It is essential to know the advantages and limitations of the available imaging techniques to ensure the optimal evaluation of these patients, especially after interventions carried out with instrumentation to minimize the artifacts due to these materials. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  19. Development and implementation of a dedicated postoperative evaluation service to improve compliance of postoperative visits

    PubMed Central

    Vacanti, Joshua Charles; Urman, Richard Dennis; Sarin, Pankaj; Liu, Xiaoxia; Kodali, Bhavani Shankar

    2015-01-01

    Background and Aims: Postoperative patient evaluation is an integral component of perioperative care. An audit of our anesthesia department's records demonstrated a compliance rate of <50%. We postulated that the development of clinical anesthesia service dedicated to performing such evaluations would improve compliance significantly. Materials and Methods: This retrospective study examined postoperative follow-up completion rate at a large academic center. Data were collected from 58,000 anesthetics during three periods, between each of which an intervention was introduced. The first period examined completion rate when postoperative evaluations were left to the team performing the anesthetic. During the second period, this task was delegated to groups of anesthesiologists based on surgical subspecialty; these smaller groups utilized rotating residents. The third period examined completion rate after implementation of a postoperative evaluation service. All periods utilized the department's electronics database to identify operative patients. The number of adverse anesthesia events reported was also recorded. Results: A significant difference in the proportions of compliance with postoperative evaluations among all three periods was detected. Compliance was 47% during period one and improved to 66% during period two. During period three, which employed a postoperative evaluation service, compliance was 83%. The number of adverse events reported per month increased significantly following the first study period from 95 reported monthly events to 215 and 201 in the second and third periods, respectively. Conclusion: By creating a dedicated postoperative evaluation service using available technology, we improved postoperative evaluation completion rate from 47% to 83%, and demonstrated a significant increase in the number of adverse events reported. Based on this, we support the deployment of a dedicated service as a quality improvement initiative. PMID:25788778

  20. Impact of early postoperative enteral nutrition on clinical outcomes in patients with gastric cancer.

    PubMed

    Li, B; Liu, H Y; Guo, S H; Sun, P; Gong, F M; Jia, B Q

    2015-06-29

    The impact of early enteral nutrition (EEN) on clinical outcomes of gastric cancer patients was investigated. Three hundred pa-tients undergoing gastric cancer surgery from July 2010 to May 2014 were randomly divided into experimental and control groups (n = 150/group). Experimental group patients received enteral nutrition in water during the early postoperative period. Control group patients received conventional perioperative treatment. Patients' clinical outcomes, post-operative immune function, and nutritional statuses were compared, which revealed that the postoperative fever duration (80.2 ± 6.0 vs 88.1 ± 8.1 h, P < 0.05), anal exhaust time (78.8 ± 9.3 vs 85.3 ± 8.4 h, P < 0.05), and length of hospitalization (7.73 ± 2.13 vs 9.77 ± 1.76 days, P < 0.01) differed significantly. Treatment costs in thousands of dol-lars were 31.24 ± 3.21 for the experimental group and 35.61 ± 2.32 for the control group; this difference was statistically significant (P < 0.01). The incidence of postoperative complications did not significantly differ between the experimental and control groups [14.0% (21/150) vs 17.3% (26/150), P > 0.05]. At postoperative days 3 and 7, the CD3(+), CD4(+), natural killer cell, albumin, and prealbumin levels and CD4(+)/CD8(+) ra-tio were significantly higher in the experimental group than the control group (all P < 0.05). CD8(+) cell counts were significantly lower in the experimental group than the control group (P < 0.05). Postsurgical oral EEN can improve nutritional status and immune function and promote early recovery of intestinal function in patients with gastric cancer.

  1. Effect of postoperative nutrition on muscle high energy phosphates.

    PubMed Central

    Liaw, K Y; Askanazi, J; Michelsen, C B; Furst, P F; Elwyn, D H; Kinney, J M

    1982-01-01

    This study examines the effect of hypocaloric nutritional regimens on muscle high energy phosphates in normal subjects and patients following total hip replacement. Eighteen patients undergoing total hip replacement and 11 normal subjects on a four-day period of bedrest were studied. The patients were randomly assigned to receive either: (1) 90 gms/day glucose; (2) 70 gms/day amino acids; or (3) 90 gms/day glucose + 70 gms/day amino acids. A percutaneous muscle biopsy was performed before operation and on the morning of the fourth day after operation. Samples were analyzed for adenine triphosphate (ATP), adenine diphosphate (ADP), adenine monophosphate (AMP), phosphocreatine (PC), free creatine (CR), lactate, and pyruvate. Normal subjects were assigned to receive either: (1) 90 gms/day glucose; (2) 70 gms/day amino acids; or (3) no caloric intake. The patients receiving amino acid alone demonstrated a decrease in ATP, ADP, and PC, while AMP and free creatine rose. No significant changes were seen in patients who received 90 gms/day glucose either with, or without, amino acids. There were also no significant changes in any of the normal subjects. These results suggest that a series of metabolic changes occur in skeletal muscle following injury such that small amounts of glucose are important for maintenance of cellular energy levels. PMID:7055378

  2. Preoperative Nutritional Status and Clinical Complications in the Postoperative Period of Cardiac Surgeries

    PubMed Central

    Gonçalves, Luciana de Brito; de Jesus, Natanael Moura Teixeira; Gonçalves, Maiara de Brito; Dias, Lidiane Cristina Gomes; Deiró, Tereza Cristina Bomfim de Jesus

    2016-01-01

    Objective This study aims to assess the preoperative nutritional status of patients and the role it plays in the occurrence of clinical complications in the postoperative period of major elective cardiac surgeries. Methods Cross-sectional study comprising 72 patients aged 20 years or older, who underwent elective cardiac surgery. The preoperative nutritional assessment consisted of nutritional screening, anthropometry (including the measurement of the adductor pollicis muscle thickness) and biochemical tests. The patients were monitored for up to 10 days after the surgery in order to control the occurrence of postoperative complications. The R software, version 3.0.2, was used to statistically analyze the data. Results Clinical complications were found in 62.5% (n=42) of the studied samples and complications of non-infectious nature were most often found. Serum albumin appeared to be associated with renal complications (P=0.026) in the nutritional status indicators analyzed herein. The adductor pollicis muscle thickness was associated with infectious complications and presented mean of 9.39±2.32 mm in the non-dominant hand (P=0.030). No significant correlation was found between the other indicators and the clinical complications. Conclusion The adductor pollicis muscle thickness and the serum albumin seemed be associated with clinical complications in the postoperative period of cardiac surgeries. PMID:27982346

  3. Nutritional Risk Screening 2002 as a Predictor of Postoperative Outcomes in Patients Undergoing Abdominal Surgery: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

    PubMed Central

    Sun, Zhen; Kong, Xin-Juan; Jing, Xue; Deng, Run-Jun; Tian, Zi-Bin

    2015-01-01

    Background The nutritional risk screening (NRS 2002) has been applied increasingly in patients who underwent abdominal surgery for nutritional risk assessment. However, the usefulness of the NRS 2002 for predicting is controversial. This meta-analysis was to examine whether a preoperative evaluation of nutritional risk by NRS 2002 provided prediction of postoperative outcomes in patients undergoing abdominal surgery. Methods A systematic literature search for published papers was conducted using the following online databases: MEDLINE, EMBASE, the Cochrane library, EBSCO, CRD databases, Cinahl, PsycInfo and BIOSIS previews. The pooled odds ratio (OR) or weight mean difference (WMD) was calculated using a random-effect model or a fix-effect model. Results Eleven studies with a total of 3527 patients included in this study. Postoperative overall complications were more frequent in nutritional risk patients versus patients without nutritional risk (the pooled OR 3.13 [2.51, 3.90] p<0.00001). The pooled OR of mortality for the nutritional risk group and non-nutritional risk group was 3.61 [1.38, 9.47] (p = 0.009). Furthermore, the postoperative hospital stay was significant longer in the preoperative nutritional risk group than in the nutritional normal group (WMD 5.58 [4.21, 6.95] p<0.00001). Conclusions The present study has demonstrated that patients at preoperative nutritional risk have increased complication rates, high mortality and prolonged hospital stay after surgery. However, NRS 2002 needs to be validated in larger samples of patients undergoing abdominal surgery by better reference method. PMID:26172830

  4. Preoperative Nutritional Assessment by Controlling Nutritional Status (CONUT) is Useful to estimate Postoperative Morbidity After Esophagectomy for Esophageal Cancer.

    PubMed

    Yoshida, Naoya; Baba, Yoshifumi; Shigaki, Hironobu; Harada, Kazuto; Iwatsuki, Masaaki; Kurashige, Junji; Sakamoto, Yasuo; Miyamoto, Yuji; Ishimoto, Takatsugu; Kosumi, Keisuke; Tokunaga, Ryuma; Imamura, Yu; Ida, Satoshi; Hiyoshi, Yukiharu; Watanabe, Masayuki; Baba, Hideo

    2016-08-01

    A nutritional indicator suitable for predicting complications after esophagectomy has not been confirmed. The nutritional screening tool CONUT is a potential candidate. We retrospectively analyzed 352 patients who underwent elective esophagectomy with lymphadenectomy for esophageal cancer between April 2005 and December 2014. Patients were divided into three groups according to the malnutrition degree in controlling nutritional status (CONUT): normal, light malnutrition, moderate or severe malnutrition. The numbers of patients assigned to the normal, light malnutrition, and moderate or severe malnutrition groups were 205, 126, and 21, respectively. One hundred forty-seven (41.8 %) patients were considered malnourished. Patients with moderate or severe malnutrition had a significantly high incidence of any morbidity, severe morbidities, and surgical site infection. Hospital stay in patients with moderate or severe malnutrition was significantly longer. Logistic regression analysis suggested that moderate or severe malnutrition was an independent risk factor for any morbidity [hazard ratio (HR) 2.75, 95 % confidence interval (CI) 1.081-7.020; p = 0.034] and severe morbidities (HR 3.07, 95 % CI 1.002-9.432; p = 0.049). CONUT was a convenient and useful tool to assess nutritional status before esophagectomy. Patients with moderate or severe malnutrition according to CONUT are at high risk for postoperative complications.

  5. Postoperative radionuclide evaluation of osteoid osteomas

    SciTech Connect

    Ghelman, B.; Vigorita, V.J.

    1983-02-01

    Five cases of clinically suspected osteoid osteomas were studied by preoperative injection of technetium-99m methylene disphosphonate, intraoperative localization with a radiation-sensitive scintillation probe, and postoperative examination of the entire tissue specimen (including the presumed nidus and surrounding bone). Microradiography and light microscopy were also used. In addition, a new autoradiography technique was introduced in which the excised surgical specimen was placed on undeveloped x-ray film for pathologic localization, diagnosis of the lesions, and a study of the relative intensity of radioactive uptake in the nidus vs. surrounding bone. Autoradiography revealed that the nidus showed the greatest concentration of radioactivity, followed by the surrounding bone. The authors conclude that /sup 99m/Tc can be used clinically in localizing osteoid osteomas and that preoperative and intraoperative scanning can assist in conservative surgical excision. For small lesions, autoradiography assists the pathologist in identifying an osteoid osteoma.

  6. Postoperative radionuclide evaluation of osteoid osteomas

    SciTech Connect

    Ghelman, B.; Vigorita, V.J.

    1983-02-01

    Five cases of clinically suspected osteoid osteomas were studied by preoperative injectin of technetium-99m methylene disphosphonate, intraoperative localization with a radiation-sensitive scintillation probe, and postoperative examination of the entire tissue specimen (including the presumed nidus and surrounding bone). Microradiography and light microscopy were also used. In addition, a new autoradiography technique was introduced in which the excised surgical specimen was placed on undeveloped x-ray film for pathologic localizaton, diagnosis of the lesions, and a study of the relative intensity of radioactive uptake in the nidus vs. surrounding bone. Autoradiography revealed that the nidus showed the greatest concentration of radioactivity, followed by the surrounding bone. The authors conclude that lt. slashsup 99mlt. slashTc can be used clinically in localizing osteoid osteomas and that preoperative and intraoperative scanning can assist in conservative surgical excision, e.g., minimal extirpation of bone in delicate areas such as the spine. For small lesions, autoradiography assists the pathologist in identifying an osteoid osteoma.

  7. [Postoperative early enteral nutrition in a patient with polytrauma and late duodenal perforation].

    PubMed

    Nicolau, A E; Merlan, V; Ciupan, R; Brădiş, Alexandra; Marin, Mihaela; Plugaru, G; Marinescu, L; Micu, B

    2008-01-01

    We present the case of a 51 years old multiple injured female patient who was transferred from another hospital. She suffered a car accident and at admission, the diagnosis was anterior flail chest with fractured sternum, blunt abdominal trauma with IIIrd grade kidney laceration, multiple extremities fractures, ISS = 50. We performed emergency nephrectomy, surgical fixation of the flail chest and bilateral pleurostomy. Postoperatively the evolution was difficult, she was intubated and mechanically ventilated. We started early enteral nutrition (EEN), at 24 hours with 20 ml/hour Fresubin (Fresenius-Kabi, Bad Hamburg, Germany) and then with 40 ml/hour. In the fourth postoperative day, CT scan identified no supplementary lesions. In the seventh postoperative day, jaundice became apparent and the CT exam identified gas in the retroperitoneum. At surgery, we identified a IInd degree D2 rupture. We practiced duodenal suture, pyloric exclusion, latero-lateral gastro-entero-anastomosis. We passed a naso-gastro-entero-duodenal tube into D2 for active suction and we performed a fine needle catheter jejunostomy. Difficult postoperative evolution, intubated, febrile, with hemodynamic instability. EEN on the jejunostomy at 20-40-60 ml/hour. 10 days after the reoperation, the general condition ameliorated. Enteral nutrition was continued for 22 days after reoperation. The patient was discharged after 44 days. The particularities of this case are the complexity of the traumatic lesions: anterior costal flail chest, left kidney rupture, late duodenal perforation, multiple extremities fractures (APACHE II score = 34). The treatment involved internal pneumatic stabilization and surgical fixation of the flail chest, duodenal suture with pyloric exclusion and fine needle catheter jejunostomy, left nephrectomy. We consider that the use of EEN was of real help in this case and we recommend it in all polytraumatised patients and in all the cases where it can be used.

  8. [Nutritional screening before surgery for esophageal cancer - current status and evaluation results].

    PubMed

    Shimakawa, Takeshi; Asaka, Shinich; Sagawa, Masano; Shimazaki, Asako; Yamaguchi, Kentaro; Usui, Takebumi; Yokomizo, Hajime; Shiozawa, Shunichi; Yoshimatsu, Kazuhiko; Katsube, Takao; Naritaka, Yoshihiko

    2014-10-01

    The incidence of postoperative complications and mortality are usually higher in patients with preoperative malnutrition. Malnutrition often preexists, particularly in patients undergoing surgery for esophageal cancer, which is substantially invasive. It is therefore important to understand the nutritional condition of patients and actively control perioperative nutrition.Our hospital has been providing nutritional status screening for patients before resection of esophageal cancer, and we report the current status and evaluation results in this article.This screening included 158 patients requiring radical resection of esophageal cancer.Age, comorbidity with diabetes, body mass index(BMI), serum albumin(Alb), Onodera's prognostic nutritional index(PNI), and Glasgow prognostic score(GPS)were used as nutritional indicators to stratify patients for analysis.Evaluation parameters included the incidence of postoperative complications(any complication, pulmonary complications, psychiatric disorder, and anastomotic leakage)and rates of long-term postoperative hospitalization.The analysis indicated that age, BMI, serum Alb, PNI, and GPS are useful for predicting the onset of postoperative complications and prolonged postoperative hospitalization.For such patients, more active nutritional control should be provided.

  9. SPEAC for Nutrition: Preschool Nutrition Education Project. Evaluation Report.

    ERIC Educational Resources Information Center

    Augsburg Coll., Minneapolis, Minn.

    This publication reports the Student Parent Educator Administrator Children (SPEAC) for Nutrition Program evaluation of the effectiveness of a child care food service personnel training curriculum and a model curriculum package for preschool children. Evaluation of the food service curriculum package was accomplished in part by a pre- and…

  10. Low fat-containing elemental formula is effective for postoperative recovery and potentially useful for preventing chyle leak during postoperative early enteral nutrition after esophagectomy.

    PubMed

    Moro, Kazuki; Koyama, Yu; Kosugi, Shin-Ichi; Ishikawa, Takashi; Ichikawa, Hiroshi; Hanyu, Takaaki; Miura, Kohei; Nagahashi, Masayuki; Nakajima, Masato; Tatsuda, Kumiko; Tsuchida, Junko; Toshikawa, Chie; Ikarashi, Mayuko; Shimada, Yoshifumi; Sakata, Jun; Kobayashi, Takashi; Kameyama, Hitoshi; Wakai, Toshifumi

    2016-12-01

    Transthoracic esophagectomy using 3-field lymphadenectomy (TTE-3FL) for esophageal cancer is one of the most aggressive gastrointestinal surgeries. Early enteral nutrition (EN) for TTE-3FL patients is useful and valid for early recovery; however, EN using a fat-containing formula risks inducing chyle leak. In the present study, we retrospectively examined esophageal cancer patients treated byTTE-3FL and administered postoperative EN to elucidate the validity of lowering the fat levels in elemental formulas to prevent postoperative chyle leak and improve postoperative recovery. A total of 74 patients who received TTE-3FL for esophageal cancer were retrospectively examined. Patients were classified into two groups according to the type of postoperative EN: Group LF patients received a low-fat elemental formula, and Group F patients received a standard fat-containing polymeric formula. The following clinical factors were compared between the groups: EN start day, maximum EN calories administered, duration of respirator use, length of ICU stay, incidence of postoperative infectious complications, use of parenteral nutrition (PN), and incidence of postoperative chyle leak. Patients in Group LF were started on EN significantly earlier after surgery and they consumed significantly higher maximum EN calories compared to Group F patients (P < 0.01). Duration of respirator use and length of ICU stay were also significantly shorter, and TPN was used significantly less in Group LF compared to Group F (P < 0.05). Postoperative chyle leak was observed in six patients in total (8.1%); five patients in Group F and one patient in Group LF, although there was no significant difference in frequency of chyle leak per patient between Group LF and Group F. Early EN using low-fat elemental formula after esophagectomy with three-field lymphadenectomy was safe and valid for postoperative recovery and potentially useful in preventing chyle leak. Copyright © 2016 The Authors. Published

  11. Early enteral nutrition therapy in congenital cardiac repair postoperatively: A randomized, controlled pilot study

    PubMed Central

    Sahu, Manoj Kumar; Singal, Anuradha; Menon, Ramesh; Singh, Sarvesh Pal; Mohan, Alka; Manral, Mala; Singh, Divya; Devagouru, V.; Talwar, Sachin; Choudhary, Shiv Kumar

    2016-01-01

    Background and Objectives: Adequate nutritional supplementation in infants with cardiac malformations after surgical repair is a challenge. Critically ill infants in the early postoperative period are in a catabolic stress. The mismatch between estimated energy requirement (EER) and the intake in the postoperative period is multifactorial, predisposing them to complications such as immune deficiency, more infection, and growth failure. This study aimed to assess the feasibility and efficacy of enriched breast milk feed on postoperative recovery and growth of infants after open heart surgery. Methodology: Fifty infants <6 months of age were prospectively randomized in the trial for enteral nutrition (EN) postoperatively from day 1 to 10, after obtaining the Institute Ethics Committee's approval. They were equally divided into two groups on the basis of the feed they received: Control group was fed with expressed breast milk (EBM; 0.65 kcal/ml) and intervention group was fed with EBM + energy supplementation/fortification with human milk fortifier (7.5 kcal/2 g)/Simyl medium-chain triglyceride oil (7.8 kcal/ml). Energy need for each infant was calculated as per EER at 90 kcal/kg/day, as the target requirement. The intra- and post-operative variables such as cardiopulmonary bypass and aortic cross-clamp times, ventilation duration, Intensive Care Unit (ICU), and hospital length of stay and mortality were recorded. Anthropometric and hematological parameters and infection control data were recorded in a predesigned pro forma. Data were analyzed using Stata 14.1 software. Results: The duration of mechanical ventilation, length of ICU stay (LOIS), length of hospital stay (LOHS), infection rate, and mortality rate were lower in the intervention group compared to the control group although none of the differences were statistically significant. Infants in control group needed mechanical ventilation for about a day more (i.e., 153.6 ± 149.0 h vs. 123.2 ± 107.0 h; P = 0

  12. [The role of nutritional status on serum immunoglobulins, body weight and postoperative infectious-related complications in patients with Crohn's disease receiving perioperative parenteral nutrition].

    PubMed

    Yao, Guo-xiang; Wang, Xiu-rong; Jiang, Zhu-ming; Zhang, Si-yuan; Ma, En-ling; Ni, An-ping

    2002-04-01

    To evaluate the role of nutritional status on serum immunoglobulins, body weight and postoperative infectious-related complications in patients with Crohn's disease receiving perioperative parenteral nutrition (PN). 32 patients with Crohn's disease receiving perioperative parenteral nutrition in our department between 1984 and 1994 were enrolled in this survey. 16 patients with loss of body weight in the range of 15%-30% were assigned to the malnutrition group, the other 16 patients with normal weight or loss of body weight less than 15% to the control group. Serum IgM, IgG and IgA levels were measured before and after PN by enzyme-linked immunosorbent assays. Liver function, body weight changes and postoperative complications were also analyzed. IgM levels were elevated before PN in both groups [control group: (133 +/- 16) mg/dl, malnutrition group: (139 +/- 41) mg/dl; normal value: (110 +/- 35) mg/dl; P = 0.04], decreased to normal value [(105 +/- 29) mg/dl, P = 0.02] in the malnutrition group while having no obvious changes in the control group [(129 +/- 13) mg/dl, P = 0.34]. No significant changes in concentrations of IgG and IgA were found (P in the range of 0.20-0.57). The average weight gain was 1.862 kg in malnutrition group [before PN: (45.8 +/- 8.9) kg, after PN: (48.0 +/- 8.8) kg; P = 0.005] and no significant changes in the control group [before PN: (55.6 +/- 6.1) kg, after PN: (56.3 +/- 6.0) kg; P = 0.46]. There was an increase in infectious complications in the control group (control group: 4 cases, 25%, malnourished group: 2 cases, 12.5%; P = 0.13). Perioperative parenteral nutrition ameliorated the humoral immunity, increased the body weight in patients with obvious malnutrition, whereas it had little value for those without or with mild malnutrition.

  13. Innovative Techniques for Evaluating Behavioral Nutrition Interventions.

    PubMed

    Scherr, Rachel E; Laugero, Kevin D; Graham, Dan J; Cunningham, Brian T; Jahns, Lisa; Lora, Karina R; Reicks, Marla; Mobley, Amy R

    2017-01-01

    Assessing outcomes and the impact from behavioral nutrition interventions has remained challenging because of the lack of methods available beyond traditional nutrition assessment tools and techniques. With the current high global obesity and related chronic disease rates, novel methods to evaluate the impact of behavioral nutrition-based interventions are much needed. The objective of this narrative review is to describe and review the current status of knowledge as it relates to 4 different innovative methods or tools to assess behavioral nutrition interventions. Methods reviewed include 1) the assessment of stress and stress responsiveness to enhance the evaluation of nutrition interventions, 2) eye-tracking technology in nutritional interventions, 3) smartphone biosensors to assess nutrition and health-related outcomes, and 4) skin carotenoid measurements to assess fruit and vegetable intake. Specifically, the novel use of functional magnetic resonance imaging, by characterizing the brain's responsiveness to an intervention, can help researchers develop programs with greater efficacy. Similarly, if eye-tracking technology can enable researchers to get a better sense as to how participants view materials, the materials may be better tailored to create an optimal impact. The latter 2 techniques reviewed, smartphone biosensors and methods to detect skin carotenoids, can provide the research community with portable, effective, nonbiased ways to assess dietary intake and quality and more in the field. The information gained from using these types of methodologies can improve the efficacy and assessment of behavior-based nutrition interventions.

  14. Can Postoperative Nutrition be Favourably Maintained by Oral Diet in Patients with Emergency Temporary Ileostomy? A Tertiary Hospital Based Study

    PubMed Central

    Maity, Debabrata; Dey, Ramprasad; Choudhury, Krishnangshu Bhanja; Das, Gautam; Bhattacharya, Ujjwal

    2015-01-01

    Introduction Temporary ileostomy is an emergency procedure performed in cases having septic peritonitis in presence of perforation or obstruction or gangrene of small intestine. These patients usually suffer from gross malnutrition following surgery. Aim To measure nutritional status of patients with emergency temporary ileostomy and to determine whether their postoperative nutrition can be favourably maintained by oral diet alone. Materials and Methods Sixty patients were enrolled for the study on the basis of inclusion and exclusion criteria during the study period from January 2012 to December 2013. Oral feeding was started as soon as ileostomy started functioning and patients expressed hunger, about 48-72 hours postoperatively. An individualized diet chart was formulated for each patient using Harris Benedict Equation. Nutritional assessment was done on 1) 1st day of oral feeding, 2) After 7 days of oral feeding, 3). After three months of oral feeding. Nutritional parameters (anthropometric, biochemical) employed were tabulated and statistically analysed with SPSS v 17, Chicago. Results Out of 60 patients, 36 males and 24 females were enrolled in the study. The patients were in the age group of 20-60 years with a mean age of 45 years. After 7 days of oral nutrition the nutritional status deteriorated with a significant decrease in body weight (p<0.001) and serum haemoglobin (p <0.001). However, at the end of the study, the patients had their nutritional status restored satisfactorily with normalization of basic parameters like bodyweight, haemoglobin and serum albumin (p<0.001). Conclusion Proper dietary advice and oral nutrition were found to be sufficient for gradual restoration and maintenance of satisfactory nutritional status in the postoperative period. PMID:26816941

  15. Effects of postoperative parenteral nutrition with different lipid emulsions in patients undergoing major abdominal surgery

    PubMed Central

    Demirer, Seher; Sapmaz, Ali; Kepenekci, Ilknur; Aydintug, Semih; Balci, Deniz; Sonyurek, Pinar; Kose, Kenan

    2016-01-01

    Purpose This study was designed to investigate the effects of total parenteral nutrition (PN) using different lipid emulsions in patients undergoing major abdominal surgery. Methods Fifty-two patients were randomized to receive soybean oil + medium chain triglycerides (MCT) (group I), soybean oil + olive oil (group II), soybean oil + olive oil + fish oil (group III) as a lipid source. PN was started on postoperative day 1 and patients were maintained on PN for a minimum period of 4 days. Laboratory variables (CRP, prealbumin, transferrin) were measured before surgery and on postoperative days. Results Three treatment groups were included in the study. Patients in group I received long chain triglycerides (LCT) + LCT/MCT emulsion (%75 LCT + %25 LCT/MCT); Patients in group II received olive oil based emulsion (80% olive oil + 20% soybean oil, ClinOleic); Patients in group III received fish oil in addition to olive oil based emulsion (%85 ClinOleic + %15 Omegaven; Fresenius Kabi). The following 14 parameters were assessed: body weight, CRP, prealbumin, transferrin, tumor necrosis factor-α, interleukin-6, total antioxidant status, thiobarbituric acid reactive substances, oxidized low density lipoprotein-2, complete blood cell, international normalized ratio, D-dimer, activated partially thromboplastin time, prothrombin time. All other parameters showed no differences among the groups. Conclusion The results of our trial demonstrate a potential beneficial effect of soybean oil/olive oil based lipid emulsions for use in PN regarding inflammatory response and oxidant capacity in the treatment of patients. PMID:27904853

  16. Preoperative Nutrition and Postoperative Discomfort in an ERAS Setting: A Randomized Study in Gastric Bypass Surgery.

    PubMed

    Karlsson, A; Wendel, K; Polits, S; Gislason, H; Hedenbro, J L

    2016-04-01

    Many patients experience postoperative nausea and vomiting (PONV). Preoperative treatment with carbohydrate solutions seems to improve the course after different types of surgery. This study was undertaken to investigate the potential value of different models for preoperative hydration/nutrition, in addition to our ERAS (enhanced recovery after surgery) protocol. Ninety non-diabetic women planned for elective laparoscopic gastric bypass and aged 18-65 years were included. All were on preoperative low-calorie diet (LCD). They were randomized into three arms, either a carbohydrate-rich drink, a protein-enriched drink, or tap water and instructed to drink 800 and 200 mL 16 and 2 h, respectively, prior to operation. Risk factors for PONV were recorded preoperatively. All patients were operated before lunch and received 1500-2000 mL of Ringer-Acetate solution during the 24-30-h postoperative hospital time. Four variables (nausea, pain, tiredness, and headache) were registered on 100-mm visual analog scales six times over 22 h. The need for additional medication was registered. Out of 90 patients, 73 complete datasets were obtained. Nausea peaked at 7 p.m. but with no statistically significant differences between groups for any of the variables. Pain peaked the first 2 h postoperatively, remained longer, and had not returned to baseline values at 6 a.m. the morning after surgery but with no difference between groups. Inside our ERAS protocol, additional preoperative carbohydrate- or protein-enriched fluid treatment did not further reduce immediate patient discomfort in laparoscopic gastric bypass surgery.

  17. Improved Evaluation of Postoperative Pain After Photorefractive Keratectomy.

    PubMed

    Garcia, Renato; Horovitz, Roberto Novaes Campello; Torricelli, Andre Augusto Miranda; Mukai, Adriana; Bechara, Samir Jacob

    2016-02-01

    Postoperative pain remains an important limiting factor to the selection of photorefractive keratectomy (PRK). There is a consensus in neurology pain research that pain should be evaluated as a multidimensional concept, which differs from current practice in ophthalmology. The purpose of this paper was to validate the use of multidimensional questionnaires, such as the Brief Pain Inventory (BPI) and the McGill Pain Questionnaire (MPQ), to provide an improved analysis of pain after PRK and to better describe its temporal profile. This prospective study included 43 eyes of 43 myopic patients who underwent unilateral PRK. After surgery, usual pain treatment was administered. All of the participants responded to the Visual Analogue Scale (VAS), the BPI and the MPQ 1, 24, 48, 72, and 96 hours after surgery. The internal consistency was evaluated, different postoperative periods were compared, and convergent validity was assessed using correlation testing. The Cronbach alpha test showed high internal consistency for each of the questionnaire subscales. Patients reported higher postoperative pain values at the first measurement of the VAS (4.93 ± 2.38), MPQ-pain rating index (26.95 ± 10.58), BPI-pain severity index (14.53 ± 7.36), and BPI-pain interference index (22.30 ± 15.13). Almost all of the scales and subscales showed a statistically significant direct correlation with the VAS at all of the evaluation periods. This study validated the utility of multidimensional questionnaires to expand the assessment of the PRK postoperative pain profile, including intensity and other qualitative aspects.

  18. Using a nutritional screening tool to evaluate the nutritional status of patients with colorectal cancer.

    PubMed

    Tu, Mei-Yu; Chien, Tsair-Wei; Chou, Ming-Ting

    2012-01-01

    We assessed which nutrition evaluation method [subjective global assessment (SGA); malnutrition universal screening tool (MUST); nutritional risk index (NRI)] provided the most efficacious combination of high validity, low cost, and ease of use to examine and improve the status of malnutrition for colorectal cancer (CRC) patients. The SGA, MUST, and NRI scales were used to analyze the preoperative status of malnutrition for 45 CRC patients in a medical center in Taiwan. Differences in the reliability of the 3 methods were compared using the kappa (κ) coefficient of agreement. Lengths of hospital stays were compared using the Mann-Whitney U test to examine the effect of malnutrition in CRC patients. The SGA κ coefficient was higher with the MUST than with the NRI. Preoperative and postoperative weight losses were significantly different on the NRI, and the longer the length of the hospital stay, the greater was the weight loss. Although the SGA had a higher validity and lower cost than the NRI, we recommend using the MUST method for a routine nutrition evaluation because it is easier to use and is less expensive than the SGA and the NRI.

  19. Laparoscopic ventral rectopexy for rectoanal intussusception: postoperative evaluation with proctography.

    PubMed

    Tsunoda, Akira; Ohta, Tomoyuki; Kiyasu, Yoshiyuki; Kusanagi, Hiroshi

    2015-04-01

    Laparoscopic ventral rectopexy can relieve symptoms of obstructed defecation and fecal incontinence in patients with rectoanal intussusception. However, pelvic floor imaging after surgery has not been reported. This study was designed to assess the outcome of patients who underwent laparoscopic ventral rectopexy for rectoanal intussusception, with special reference to the postoperative findings on evacuation proctography. This study was a retrospective analysis of prospectively collected data. The study was conducted from 2012 to 2013 at the Department of Surgery, Kameda Medical Center, Japan. We included 26 patients with symptomatic rectoanal intussusception. Laparoscopic ventral rectopexy was performed. Evacuation proctography was performed before and 6 months after the procedure. Defecatory function was evaluated using the Constipation Scoring System and Fecal Incontinence Severity Index. Of 26 patients with rectoanal intussusception preoperatively, 22 had symptoms of obstructed defecation and 21 complained of fecal incontinence. Postoperatively, rectoanal intussusception was eliminated in all patients, though 8 developed recto rectal intussusception. There was an overall reduction in both grade 2 rectocele size (median preop 26 mm vs. postop 11 mm; p < 0.0001) and pelvic floor descent (median preop 26 mm vs. postop 20 mm; p < 0.0001). 6 months after surgery, a reduction of at least 50% was observed in the Constipation Scoring System score for 9 patients (41%) with obstructive defecation and in the Fecal Incontinence Severity Index score for 14 incontinent patients (67%). This was a preliminary study with a small sample size, no control group, and short follow-up time. Evacuation proctography showed anatomical correction in patients with rectoanal intussusception who underwent laparoscopic ventral rectopexy. However, the data also indicate that such correction does not necessarily result in meaningful symptomatic relief.

  20. Prognosis Prediction for Postoperative Esophageal Cancer Patients Using Onodera's Prognostic Nutritional Index.

    PubMed

    Matsumoto, Hideo; Okamoto, Yuko; Kawai, Akimasa; Ueno, Daisuke; Kubota, Hisako; Murakami, Haruaki; Higashida, Masaharu; Hirai, Toshihiro

    2017-07-20

    Preoperative nutritional status may impact surgical outcome and prognosis. We evaluated the predictive value of Onodera's prognostic nutritional index (O's-PNI) of surgical outcome following esophagectomy in esophageal cancer patients. In total, 144 patients undergoing esophagectomy for esophageal cancer from April 2010 to May 2015 were evaluated, retrospectively. Eighty-four patients were enrolled in this study. O's-PNIs were calculated before surgery, discharge, and 1, 2, and 6 mo after discharge. The relationship between O's-PNI and occurrence of complications as classified by the Clavien-Dindo (C-D) classification, length of hospital stay, and survival time was investigated. The mean O's-PNI for patients with complications of more than Grade 2 by the C-D classification was 37.4, which was significantly lower than that for Grades 0 or 1 (40.5, P = 0.0094). A negative correlation was obtained between O's-PNI and hospital stay length (P = 0.0006), whereas a positive correlation was obtained for O's-PNI at 6 mo postsurgery and overall survival (P = 0.0171, P = 0.0201). O's-PNI may represent a useful indicator of the occurrence of complications and length of hospital stay, and may influence overall survival at 6 mo postsurgery. Nutritional management during the perioperative period could therefore contribute to satisfactory outcomes following esophagectomy in esophageal cancer patients.

  1. Postoperative evaluation of penetrating hepatic trauma and complications

    SciTech Connect

    Lecklitner, M.L.; Dittman, W.

    1984-09-01

    Postoperative hepatobiliary scintigraphy is recommended in selected cases of hepatic trauma to evaluate the integrity and patency of the biliary system. The authors present a patient with a traumatic hematoma that eventuated in a biloma with spontaneous biliary-cutaneous fistula. Repeat study demonstrated biliary obstruction at the canalicular level, which by more invasive imaging was found secondary to toal obstruction of the common hepatic duct. The precise anatomical level and cause of his obstruction were defined by the findings of endoscopic retrograde cannulation of the pancreas, percutaneous transhepatic cholangiongraphy, and surgery.

  2. Nutrition and Health with an Evaluation on Nutritional Surveillance in the United States.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Select Committee on Nutrition and Human Needs.

    Focusing on America's self-knowledge about its nutritional health, this report deals with the availability of nutrition evaluation and counseling to individuals and the adequacy of the national nutrition monitoring system. Bureaucratic and political problems of applying nutritional health considerations to food policy are also examined. Nutrition…

  3. Evaluation of postoperative sharp waveforms through EEG and magnetoencephalography.

    PubMed

    Lee, Jong Woo; Tanaka, Naoaki; Shiraishi, Hideaki; Milligan, Tracey A; Dworetzky, Barbara A; Khoshbin, Shahram; Stufflebeam, Steven M; Bromfield, Edward B

    2010-02-01

    EEGs obtained after craniotomy are difficult to read because of a breach rhythm consisting of unfiltered sharply contoured physiologic waveforms that can mimic interictal epileptiform discharges. Magnetoencephalography (MEG) is less affected by the skull breach. The postcraniotomy EEG and MEG scans of 20 patients were reviewed by two experienced electroencephalographers. Larger interrater variability was found for EEG as compared with MEG. Review of patients who had postoperative seizures suggested that EEG was more sensitive but less specific than MEG in detecting interictal epileptiform discharges. Furthermore, several instances of sharp waveforms that were difficult to evaluate on EEG were found to be more easily interpretable on MEG. MEG may also help determine whether asymmetries in physiologic rhythms on EEG result from the skull defect or are pathologic. MEG should be considered as an adjunctive study in patients with a breach rhythm for evaluation of interictal epileptiform discharges and cerebral dysfunction.

  4. Effect of nutritional state on postoperative axillary leakage after axillary lymph node dissection in a new rat model.

    PubMed

    Kijima, Yuko; Yoshinaka, Heiji; Owaki, Tetsuhiro; Aikou, Takashi

    2005-01-01

    Axillary leakage after axillary lymph node dissection (ALD) in breast cancer surgery is a frequent and troublesome complication. We conducted this study to establish an experimental model of axillary leakage after ALD; to evaluate axillary leakage in different nutritional states; and to examine the effects of dietary management on axillary leakage. Twenty-eight Wistar rats were divided into two groups according to whether they were fed a high-fat diet or a low-fat diet for 14 weeks before ALD. After ALD, a suction drain was placed in the axilla and continuous suction was started. Axillary leakage was monitored for 9 days, and the drainage fluid and serum were analyzed biochemically. The body weights of the two groups were not significantly different before or after ALD. The amount of cumulative drainage fluid was significantly higher on postoperative days 7 and 9 in the high-fat group. The serum phosphate lipid, total cholesterol, and free cholesterol levels, and the free cholesterol level in the drainage fluid were also significantly higher in the high-fat group. This model is useful for reproducing lymphatic leakage after ALD. Our findings also suggest that a low-fat diet may be advantageous for patients undergoing ALD as part of breast cancer surgery.

  5. [Sensory evaluation of enteral nutritional supplements].

    PubMed

    Granell Vidal, Lina; Sánchez Juan, Carlos; Alfonso García, Antonio

    2014-07-01

    Enteral nutrition (EN) is indicated in patients who, although they may not eat enough food, maintain a sufficient function to receive, digest and absorb nutrients digestive system. Oral Nutritional Supplements (SON) are nutritionally complete or incomplete formulas (depending on whether or not provide all the nutrients needed to serve as the sole source of nutrients), which supplement inadequate oral diet. This study aims to evaluate the organoleptic characteristics of hyperproteic, normoproteic and fiber-enriched oral SON. SON test, carried out at the Department of Endocrinology and Nutrition Consortium Hospital General Universitario de Valencia from October 2012 to February 2013. 137 SON were evaluated in total, of which 47 were hyperproteic, 46 normoproteic and 44 enriched in fiber. Of the SON evaluated in the group of hyperproteic the following 3 SON obtained the best scores: Fresenius Prot Energy Drink® (21,27, vanilla flavor), Avant Standard Nut® (20.3 , strawberry flavor) and Resource® Protein (20.01, chocolate flavor) In the group of normoproteic SON the 3 best rated were: Ensure Plus® (22.3, banana flavor), Ensure Plus® (21.9, peach flavor) and Fresubin Energy Drink® (21, strawberry flavor) In the group of fiber-enriched the 3 SON most appreciated were: 2 Kcal Fresubin Fibre Drink® (23.78, vanilla flavor), Ensure Plus® TwoCal (22.9, banana flavor) and Fortimel Compact® (21.5, strawberry flavor) The study aims to guide clinicians on what SON may be more acceptable to the patient, so that the SON serve their purpose and restore or improve nutritional status, as the SON intervention is safe and cost - effective, since they improve both the functionality and quality of life. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. Nutritional Risk in Major Abdominal Surgery: Protocol of a Prospective Observational Trial to Evaluate the Prognostic Value of Different Nutritional Scores in Pancreatic Surgery

    PubMed Central

    Probst, Pascal; Haller, Sebastian; Dörr-Harim, Colette; Bruckner, Thomas; Ulrich, Alexis; Hackert, Thilo; Diener, Markus K

    2015-01-01

    Background The influence of patients’ preoperative nutritional status on their clinical outcome has already been proven. Therefore, patients with malnutrition are in need of additional therapeutic efforts. However, for pancreatic surgery, evidence suggesting the adequacy of existing nutritional assessment scores to estimate malnutrition associated with postoperative outcome is limited. Objective The aim of the observational trial “Nutritional Risk in Major Abdominal Surgery (NURIMAS) Pancreas” is to prospectively assess and analyze different nutritional assessment scores for their prognostic value on postoperative complications in patients undergoing pancreatic surgery. Methods All patients scheduled to receive elective pancreatic surgery at the University Hospital of Heidelberg will be screened for eligibility. Preoperatively, 12 nutritional assessment scores will be collected and patients will be assigned either at risk or not at risk for malnutrition. The postoperative course will be followed prospectively and complications according to the Clavien-Dindo classification will be recorded. The prognostic value for complications will be evaluated for every score in a univariable and multivariable analysis corrected for known risk factors in pancreatic surgery. Results Final data analysis is expected to be available during Spring 2016. Conclusions The NURIMAS Pancreas trial is a monocentric, prospective, observational trial aiming to find the most predictive clinical nutritional assessment score for postoperative complications. Using the results of this protocol as a knowledge base, it is possible to conduct nutritional risk-guided intervention trials to prevent postoperative complications in the pancreatic surgical population. Trial Registration germanctr.de: DRKS00006340; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006340 (Archived by WebCite at http://www.webcitation.org/6bzXWSRYZ) PMID:26573991

  7. Prospective trial to evaluate the prognostic value of different nutritional assessment scores in pancreatic surgery (NURIMAS Pancreas).

    PubMed

    Probst, P; Haller, S; Bruckner, T; Ulrich, A; Strobel, O; Hackert, T; Diener, M K; Büchler, M W; Knebel, P

    2017-07-01

    Preoperative nutritional status has an impact on patients' clinical outcome. For pancreatic surgery, however, it is unclear which nutritional assessment scores adequately assess malnutrition associated with postoperative outcome. Patients scheduled for elective pancreatic surgery at the University of Heidelberg were screened for eligibility. Twelve nutritional assessment scores were calculated before operation, and patients were categorized as either at risk or not at risk for malnutrition by each score. The postoperative course was monitored prospectively by assessors blinded to the nutritional status. The primary endpoint was major complications evaluated for each score in a multivariable analysis corrected for known risk factors in pancreatic surgery. Overall, 279 patients were analysed. A major complication occurred in 61 patients (21·9 per cent). The proportion of malnourished patients differed greatly among the scores, from 1·1 per cent (Nutritional Risk Index) to 79·6 per cent (Nutritional Risk Classification). In the multivariable analysis, only raised amylase level in drainage fluid on postoperative day 1 (odds ratio (OR) 4·91, 95 per cent c.i. 1·10 to 21·84; P = 0·037) and age (OR 1·05, 1·02 to 1·09; P = 0·005) were significantly associated with major complications; none of the scores was associated with, or predicted, postoperative complications. None of the nutritional assessment scores defined malnutrition relevant to complications after pancreatic surgery and these scores may thus be abandoned. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  8. Evaluation of adjuvant postoperative radiotherapy for lung cancer

    SciTech Connect

    Chung, C.K.; Stryker, J.H.; O'Neill, M. Jr.; DeMuth, W.E. Jr.

    1982-11-01

    One hundred eighteen patients with lung cancer were retrospectively analyzed to determine whether postoperative radiotherapy (RT) improves survival. Patterns of treatment failure and three year NED (no evidence of disease) survival rates were assessed according to extent of tumor spread, histology, and treatment method. Patients with hilar or mediastinal node metastases were at higher risk of local failure compared to those with negative nodes. Postoperative RT reduced local recurrence and improved 3 year survival among patients with positive nodes. However, postoperative RT did not improve survival among those with negative nodes. Our data indicated that patients with positive hilar or mediastinal nodes may require postoperative RT to improve survival.

  9. Radionuclide studies in postoperative evaluation of the Fontan procedure

    SciTech Connect

    Brendel, A.J.; Wynchank, S.; Choussat, A.; Barat, J.L.; Deville, C.; Ducassou, D.; Fontan, F.

    1984-10-01

    Radionuclide studies were performed on 12 patients who had had a Fontan operation for cyanotic congenital heart disease, six of whom had undergone a prior palliative Glenn procedure. The patients without prior Glenn anastomoses were studied by radionuclide first-pass angiocardiography, using a right antecubital vein injection of /sup 99m/Tc pertechnetate. The patients with Glenn anastomoses required two injections, one by femoral vein to study the Fontan procedure, using bolus injection of /sup 99m/Tc pertechnetate or microspheres, and the second by right anetcubital vein to study the Glenn anastomosis and right lung, using a bolus of microspheres. Noninvasive radionuclide methods seem to be dependable in the postoperative evaluation of patients after the Fontan procedure. First-pass angiocardiography is most helpful in evaluating the dynamics and distribution of blood flow, especially the right atrial output, and gated blood-pool scintigraphy offers a better evaluation of right atrial and left ventricular contraction, so both supply complementary information.

  10. Intravenous Carnitine Administration in Addition to Parenteral Nutrition With Lipid Emulsion May Decrease the Inflammatory Reaction in Postoperative Surgical Patients.

    PubMed

    Koyama, Yu; Moro, Kazuki; Nakano, Masato; Miura, Kohei; Nagahashi, Masayuki; Kosugi, Shin-Ichi; Tsuchida, Junko; Ikarashi, Mayuko; Nakajima, Masato; Ichikawa, Hiroshi; Hanyu, Takaaki; Shimada, Yoshifumi; Sakata, Jun; Kameyama, Hitoshi; Kobayashi, Takashi; Wakai, Toshifumi

    2017-10-01

    A prospective randomized study was performed to investigate the validity of intravenous carnitine administration during postoperative parenteral nutrition (PN) with lipid emulsion. Patients undergoing surgery for gastric or colorectal cancer were enrolled in the study and were randomly divided into two groups (n = 8 in each group): 1) group L, who received a peripheral PN (PPN) solution of 7.5% glucose, 30% amino acid, and 20% lipid emulsion; and 2) group LC, who received the same PPN solution, as well as carnitine intravenously. PPN was performed from postoperative day (POD) 1 to POD4. Clinical and laboratory parameters were compared between the two groups; statistical significance was set at P < 0.05. Serum carnitine concentrations were significantly higher in group LC on POD3 (P < 0.01) and POD7 (P = 0.01). Postoperative changes in laboratory parameters and morbidity were comparable between the two groups. However, the decrease in C-reactive protein from POD3 to POD7 was significantly greater in group LC than in group L (P = 0.011). The results show that intravenous carnitine administration in addition to PN is safe and may be beneficial for recovery from postoperative inflammatory reactions.

  11. Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer.

    PubMed

    Yu, Guiping; Chen, Guoqiang; Huang, Bin; Shao, Wenlong; Zeng, Guangqiao

    2013-06-01

    To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune function in elderly patients with esophageal cancer or cardiac cancer. A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme-linked immunosorbent assay (ELISA). After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group (P<0.05), whereas the EN group had significantly higher albumin levels than the PN group (P<0.05). On the 7th postoperative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group (all P<0.05). In addition, the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group (P<0.05) but significantly lower IL-2, IL-6, and TNF-α levels (P<0.05). In elderly patients with esophageal cancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier (by reducing plasma endoxins), and enhance the immune function.

  12. Evaluation of aromatherapy in treating postoperative pain: pilot study.

    PubMed

    Kim, Jung T; Wajda, Michael; Cuff, Germaine; Serota, David; Schlame, Michael; Axelrod, Deborah M; Guth, Amber A; Bekker, Alex Y

    2006-12-01

    This study compared the analgesic efficacy of postoperative lavender oil aromatherapy in 50 patients undergoing breast biopsy surgery. Twenty-five patients received supplemental oxygen through a face mask with two drops of 2% lavender oil postoperatively. The remainder of the patients received supplemental oxygen through a face mask with no lavender oil. Outcome variables included pain scores (a numeric rating scale from 0 to 10) at 5, 30, and 60 minutes postoperatively, narcotic requirements in the postanesthesia care unit (PACU), patient satisfaction with pain control, as well as time to discharge from the PACU. There were no significant differences in narcotic requirements and recovery room discharge times between the two groups. Postoperative lavender oil aromatherapy did not significantly affect pain scores. However, patients in the lavender group reported a higher satisfaction rate with pain control than patients in the control group (P = 0.0001).

  13. [Evaluation of the postoperative acute pain after heart surgery].

    PubMed

    Navarro García, M A; Irigoyen Aristorena, M I; De Carlos Alegre, V; Martínez Oroz, A; Elizondo Sotro, A; Indurain Fernández, S; Sorbet Amóstegui, M R; Martorell Gurucharri, A; Prieto Guembe, P; Ordoñez Ortigosa, E; García Aizpún, Y

    2011-01-01

    Pain is one of the main symptoms reported by patients who have had heart surgery. To describe the pain and explain the possible association among demographics, psychological and biological variables of the patients subjected to heart surgery with pain intensity during the postoperative in the ICU. A descriptive, longitudinal study conducted between February 2008 and January 2009 on patients subjected to heart surgery with admission to the ICU of the Hospital of Navarra was conducted. A preoperatory interview was made with registration of sociodemographic, biological and psychological variables. Pain intensity was monitored during the first 48 hours of ICU stay with the Verbal Numeric Scale (VNS) of pain. Accepted level of significance was p<0.05. A sample of 69 patients with mean age of 62, 26% women and 74% men was included. A superior statistical association was found between postoperative pain levels for age<65 years, bypass grafting with internal mammary artery and preoperatory anxiety variables. There was a significant increase in analgesic consumption for incomes>1400 €/month, bypass grafting with internal mammary artery and preoperatory anxiety. Postoperative pain after heart surgery show significant individual variability. In our study, age, bypass grafting with internal mammary artery and preoperatory anxiety were shown as predictive variables of postoperative pain in patients undergoing heart surgery. Copyright © 2010 Elsevier España, S.L. y SEEIUC. All rights reserved.

  14. Liver Cirrhosis: Evaluation, Nutritional Status, and Prognosis.

    PubMed

    Nishikawa, Hiroki; Osaki, Yukio

    2015-01-01

    The liver is the major organ for the metabolism of three major nutrients: protein, fat, and carbohydrate. Chronic hepatitis C virus infection is the major cause of chronic liver disease. Liver cirrhosis (LC) results from different mechanisms of liver injury that lead to necroinflammation and fibrosis. LC has been seen to be not a single disease entity but one that can be graded into distinct clinical stages related to clinical outcome. Several noninvasive methods have been developed for assessing liver fibrosis and these methods have been used for predicting prognosis in patients with LC. On the other hand, subjects with LC often have protein-energy malnutrition (PEM) and poor physical activity. These conditions often result in sarcopenia, which is the loss of skeletal muscle volume and increased muscle weakness. Recent studies have demonstrated that PEM and sarcopenia are predictive factors for poorer survival in patients with LC. Based on these backgrounds, several methods for evaluating nutritional status in patients with chronic liver disease have been developed and they have been preferably used in the clinical field practice. In this review, we will summarize the current knowledge in the field of LC from the viewpoints of diagnostic method, nutritional status, and clinical outcomes.

  15. Liver Cirrhosis: Evaluation, Nutritional Status, and Prognosis

    PubMed Central

    Nishikawa, Hiroki; Osaki, Yukio

    2015-01-01

    The liver is the major organ for the metabolism of three major nutrients: protein, fat, and carbohydrate. Chronic hepatitis C virus infection is the major cause of chronic liver disease. Liver cirrhosis (LC) results from different mechanisms of liver injury that lead to necroinflammation and fibrosis. LC has been seen to be not a single disease entity but one that can be graded into distinct clinical stages related to clinical outcome. Several noninvasive methods have been developed for assessing liver fibrosis and these methods have been used for predicting prognosis in patients with LC. On the other hand, subjects with LC often have protein-energy malnutrition (PEM) and poor physical activity. These conditions often result in sarcopenia, which is the loss of skeletal muscle volume and increased muscle weakness. Recent studies have demonstrated that PEM and sarcopenia are predictive factors for poorer survival in patients with LC. Based on these backgrounds, several methods for evaluating nutritional status in patients with chronic liver disease have been developed and they have been preferably used in the clinical field practice. In this review, we will summarize the current knowledge in the field of LC from the viewpoints of diagnostic method, nutritional status, and clinical outcomes. PMID:26494949

  16. Markov Chain evaluation of acute postoperative pain transition states

    PubMed Central

    Tighe, Patrick J.; Bzdega, Matthew; Fillingim, Roger B.; Rashidi, Parisa; Aytug, Haldun

    2016-01-01

    Prior investigations on acute postoperative pain dynamicity have focused on daily pain assessments, and so were unable to examine intra-day variations in acute pain intensity. We analyzed 476,108 postoperative acute pain intensity ratings clinically documented on postoperative days 1 to 7 from 8,346 surgical patients using Markov Chain modeling to describe how patients are likely to transition from one pain state to another in a probabilistic fashion. The Markov Chain was found to be irreducible and positive recurrent, with no absorbing states. Transition probabilities ranged from 0.0031 for the transition from state 10 to state 1, to 0.69 for the transition from state zero to state zero. The greatest density of transitions was noted in the diagonal region of the transition matrix, suggesting that patients were generally most likely to transition to the same pain state as their current state. There were also slightly increased probability densities in transitioning to a state of asleep or zero from the current state. Examination of the number of steps required to traverse from a particular first pain score to a target state suggested that overall, fewer steps were required to reach a state of zero (range 6.1–8.8 steps) or asleep (range 9.1–11) than were required to reach a mild pain intensity state. Our results suggest that Markov Chains are a feasible method for describing probabilistic postoperative pain trajectories, pointing toward the possibility of using Markov decision processes to model sequential interactions between pain intensity ratings and postoperative analgesic interventions. PMID:26588689

  17. Food quality in the late postoperative period of bariatric surgery: an evaluation using the bariatric food pyramid.

    PubMed

    Soares, Fernando Lucas; Bissoni de Sousa, Larissa; Corradi-Perini, Carla; Ramos da Cruz, Magda Rosa; Nunes, Mario Gilberto Jesus; Branco-Filho, Alcides José

    2014-09-01

    Bariatric surgery is an effective intervention in the treatment of obesity, but lifestyle and diet should be monitored after this procedure to ensure success. The Bariatric Food Pyramid was created basing on long-term nutritional care that proposes a standard of healthy living and eating habits considering gastric capacity and specific nutritional needs. The purpose of the current study is to evaluate the life habits and diet quality of patients who have undergone bariatric surgery (who have been recovering for at least 6 months) based on the specific food pyramid. Retrospective data analysis was performed using medical records of patients who had been followed for at least 6 months after bariatric surgery. The following data were collected from patient records: age, gender, education level (years), BMI (preoperative and postoperative), percentage of excess weight loss (EWL) relative to the time of surgery, frequency of physical activity, use of nutritional supplements, usual dietary intake history, and fluid intake. Results were analyzed using descriptive statistics. We evaluated 172 patient records. In this study, there was a low prevalence of physical activity, use of vitamin-mineral supplements, and water intake. There also was low consumption of protein, fruit, vegetables, and vegetable oils. In addition, intake of carbohydrates, sugars, and fats were higher than the recommendations established by the pyramid. The results indicate that patients who have undergone bariatric surgery have an inadequate diet according to food evaluation with the specific pyramid. In the long term, this may lead to weight gain and vitamin and mineral deficiencies.

  18. Evaluation methods on the nutritional status of stroke patients.

    PubMed

    Wang, J; Luo, B; Xie, Y; Hu, H-Y; Feng, L; Li, Z-N

    2014-01-01

    This study was designed to assess the effect of particular tools on the nutritional status of patients with stroke risk factors; to analyze these risk factors; to construct an assessment table; and to enable nurses to conduct fast and accurate assessment of the nutritional status of patients with stroke. Various nutritional assessment tools were employed to assess the nutritional status of stroke patients [(Nutritional Risk Screening 2002, NRS2002); (mini nutritional assessment, MNA), (subjective global assessment SGA), (malnutrition universal screening, MUST); (body composition, BCA)]. The leading disease-related factors of cerebral apoplexy were observed in patients with malnutrition. And a statistical analysis was conducted. The significant risk factors of cerebral apoplexy in malnourished patients older than 70 years were swallowing dysfunctions, disturbance of consciousness and reliance or half-reliance on feeding practices. The significant risk factors of malnutrition in patients with cerebral apoplexy were the decline in upper limb muscle strength, decline in the performance of various activities, loss of appetite and gastrointestinal symptoms. Disorders that affect the nutritional status of stroke patients can be used as evaluation tools, as described in the evaluation table. The clinical relevance of this study includes the following: to enable the clinical nursing staff to easily assess the patient's nutritional status in a timely manner; to improve compliance with nutritional evaluation; to provide clinical nutrition support to patients with stroke; and to provide a scientific basis for the improvement of the clinical outcomes of patients with cerebral apoplexy.

  19. Innovative techniques for evaluating behavioral nutrition interventions

    USDA-ARS?s Scientific Manuscript database

    Assessing outcomes and impact from behavioral nutrition interventions in the community has remained challenging for a variety of reasons. One main reason is the lack of methods available beyond traditional nutrition assessment tools and techniques. With current global obesity and related chronic dis...

  20. Evaluation of the Louisiana Nutrition Education Program.

    ERIC Educational Resources Information Center

    Jones, J. H., Jr.

    In 1969, 385 Louisiana Cooperative Extension Service aides conducted an eight week nutrition education program (expanded to 12 weeks in three parishes) for over 18,000 low income homemakers and children in 31 parishes. Initial interviews were used to ascertain nutrition habits and influences thereon, knowledge levels, homemakers' age and…

  1. Empowerment evaluation in redesigning a public health unit nutrition program.

    PubMed

    Dwyer, John J M; Vavaroutsos, Denise; Lutterman, Ann; Hier, Michelle; Hughes, May; Makarchuk, Mary-Jo

    2006-01-01

    This article illustrates how empowerment evaluation was used in Toronto Public Health's (TPH) nutrition programming redesign to consult with staff about how roles, responsibilities, and organisational structure could be changed to improve how nutrition programs are delivered. One of three moderators facilitated the ten two-hour focus group sessions in TPH. TPH staff, namely 71 front-line staff and 13 managers who were responsible for providing community nutrition services, participated in the study. Focus group participants included Public Health Dietitians, Public Health Nutritionists, Public Health Nurses (PHNs), and paraprofessionals (i.e., community nutrition assistants). Participants' preferred roles, responsibilities, and organisational structure in TPH, which they believe would improve nutrition service delivery in the community, were examined. A constant comparison approach was used to develop themes inductively. It was found that participants wanted Dietitians and Nutritionists to provide current nutrition-related information to them. They felt that nutrition programs should be promoted better and made more accessible to the public. They suggested that Dietitians and Nutritionists and other staff should share information with each other better. They suggested that Dietitians and Nutritionists should provide nutrition services directly to the public and provide support to other staff, mainly PHNs, who deliver nutrition programs. In conclusion, this empowerment evaluation produced results that were used to assist in decision making about nutrition programming.

  2. Accuracy and Reliability of Postoperative Radiographic Evaluation of First Metatarsal-Phalangeal Joint Arthrodesis.

    PubMed

    Pirozzi, Kelly M; Meyr, Andrew J

    2017-03-03

    The clinical value of routine postoperative radiographic evaluation after orthopedic procedures has recently been called into question. The objective of the present investigation was to evaluate the ability of foot and ankle surgeons to accurately and reliably assess postoperative radiographs after first metatarsal-phalangeal joint arthrodesis. Thirty sets of digital radiographs from 11 patients who had undergone first metatarsal-phalangeal joint arthrodesis were retrospectively evaluated by 5 podiatric physicians board-certified in foot surgery. The surgeons were asked to answer several questions, including whether the radiograph appeared to be >4 or <4 postoperative weeks; whether the radiograph appeared to be >8 or <8 postoperative weeks; their estimation of the postoperative week; and whether they would allow the patient to begin weightbearing based on the radiographic findings. With respect to whether the radiographs were >4 or <4 postoperative weeks, surgeons made accurate assessments 63.33% of the time (95 of 150; range 56.67% to 73.33%), with a kappa of 0.220. With respect to whether the radiographs were >8 or <8 postoperative weeks, surgeons made accurate assessments 60.0% of the time (90 of 150; range 53.33% to 70.0%), with a kappa of 0.203. With respect to the estimation of the postoperative week of the radiograph, surgeons accurately assessed the radiographs within a 4-week period 34.0% of the time (54 of 150; range 26.67% to 46.67%), with a kappa of 0.425. With respect to allowing the patient to bear weight according to the radiographic findings, the surgeons were in complete agreement 26.67% of the time (8 of 30), with a kappa of 0.251. These results provide evidence against the serial routine use of postoperative radiographs for the first metatarsal-phalangeal joint arthrodesis in the absence of a specific clinical indication.

  3. Understanding postoperative fatigue.

    PubMed

    Rose, E A; King, T C

    1978-07-01

    Performance characteristics of the central nervous, cardiovascular, respiratory and muscular systems in man postoperatively have received little investigative attention, despite the well known syndrome of postoperative fatigue. The impairmen in perception and psychomotor skills that has been shown to result from caloric restriction, bedrest, sedation and sleep deprivation suggests that a similar deficit may occur after surgical procedures. After a simple elective surgical procedure, maximal oxygen uptake decreases and the adaptability of heart rate to submaximal workloads is impaired. Similar deleterious effects on cardiorespiratory performance have been documented with starvation and bedrest; an understanding of cardiorespiratory performance postoperatively awaits further investigation. Maximal muscular force of contraction is also impaired by caloric restriction and bedrest, suggesting that similar effects may be seen in the postoperative state, although this has not been studied. A better understanding of the syndrome of postoperative fatigue could be achieved by a descriptive analysis of physiologic performance postoperatively. Such descriptive data could form the basis for objective evaluation of therapeutic measures intended to improve performance, such as nutritional supplementation and pharmacologic intervention. The observation that exercise with the patient in the supine position may decrease the impairment in maximal aerobic power otherwise expected in immobilized patients suggests that controlled exercise therapy may be of value in reducing physiologic impairment postoperatively.

  4. Microstructural Evaluation of Porous Nutritional Sustainment Module Extrudates and Infusates

    DTIC Science & Technology

    1989-07-01

    TECHNICAL REPORT NATICK/TR-89/034 fi- MICROSTRUCTURAL EVALUATION OF POROUS NUTRITIONAL SUSTAINMENT MODULE EXTRUDATES AND INFUSATES BY SAMUEL...Security Program Regulation, Chapter IX For Unclassified/Limited Distribution Documents: Destroy by any method that prevents disclosure of contents... Nutritional Sustainment Module Extrudates and Infusates 12. PERSONAL AUTHOR(S) Samuel Cohen, Charles Voyle, Richard Harniman, Robyn Rufner, Ann

  5. ONCE UPON A TIME IN AMERICA: INTERACTIVE NUTRITION EVALUATION

    USDA-ARS?s Scientific Manuscript database

    Once Upon a Time in America (OUTIA) is an evaluation tool in which fourth and fifth grades can have fun while demonstrating personal nutrition knowledge and behavior and participating in game quizzes on food history and other social science concepts. The impact of nutrition education lessons can be ...

  6. [Nutritional evaluation and functional class in hospitalized cardiopathy patients].

    PubMed

    Herrera Franco, R; Martínez Martínez, E; López Vega, L T; Astudillo Sandoval, R; Benítez Pérez, C; Ariza Andraca, H

    1999-01-01

    The nutritional state evaluation of any patient with heart disease must include the anthropometric measures, organic metabolic and cellular immunity test. We evaluated the nutritional state of 75 hospitalized patients with heart disease, and its correlation with New York Heart Association class and heart disease type. There was 36 patients (48%) with normal nutritional state, 24 (32%) with grade I malnutrition, 12 (16%) with grade II malnutrition, and 3 (4%) with grade III malnutrition. Of 23 patients with rheumatic valvular heart disease 83.4% have some degree of malnutrition, 37 patients with ischemic heart disease 25% was under nourished. Fifty percent of patients with hypertensive cardiopathy, 75% of the patients with cardiomyopathy and 83% of the 7 patients with other type of heart disease had some degree of malnourishment. There was a direct correlation between nutritional state and functional class, we found no patient in IV class functional with normal nutritional state, or grade I malnutrition.

  7. Evaluation of postoperative handover using a tool to assess information transfer and teamwork.

    PubMed

    Nagpal, Kamal; Abboudi, May; Fischler, Lukas; Schmidt, Tanja; Vats, Amit; Manchanda, Chhavi; Sevdalis, Nick; Scheidegger, Daniel; Vincent, Charles; Moorthy, Krishna

    2011-04-01

    To assess the feasibility, validity, and reliability of a postoperative Handover Assessment Tool (PoHAT) and to evaluate the current practices of the postoperative handover at 2 large European hospitals. Postoperative handover is one of the most critical phases in the care of a patient undergoing surgery. However, handovers are largely informal and variable. A thorough understanding of the problem is necessary before safety solutions can be considered. Postoperative Handover Assessment Tool (PoHAT) was developed through task analysis, semistructured interviews, literature review, and learned society guidelines. Subsequent validation was done by the Delphi technique. Feasibility and reliability were then evaluated by direct observation of handovers at 2 large European hospitals. Outcomes measures included information omissions, task errors, teamwork evaluation, duration of handover, and number of distractions. The tool was feasible to use and inter-rater reliability was excellent (r = 0.96, P < 0.001). Evaluation of handover at the 2 study sites revealed a median of 8 information omissions per handover at both the centers (IQR 7-10). There were a median of 3 task errors per handover (IQR 2-4). Thirty-five percent of handovers had distractions, which included competing demands for nurse attention, bleeps, and case-irrelevant communication. This study has established the feasibility, validity, and reliability of a tool for evaluating postoperative handover. In addition to serving as an objective measure of postoperative handover, the tool can also be used to evaluate the efficacy of any intervention developed to improve this process. The study has also shown that postoperative handover is characterized by incomplete transfer of information and failures in the performance of key tasks.

  8. Evaluation of Factors Affecting Acute Postoperative Pain Levels After Arthroscopic Rotator Cuff Repair.

    PubMed

    Cuff, Derek J; O'Brien, Kathleen C; Pupello, Derek R; Santoni, Brandon G

    2016-07-01

    To evaluate multiple preoperative and operative factors that may be predictive of and correlate with acute postoperative pain levels after arthroscopic rotator cuff repair. One hundred eighty-one patients underwent arthroscopic rotator cuff surgery along with subacromial decompression and met the inclusion criteria for this study. Postoperative visual analog scale (VAS) scores were obtained on postoperative days 1, 7, and 90. Multivariate linear regression analysis was used to correlate postoperative VAS scores with multiple independent factors, including preoperative subjective pain tolerance, preoperative VAS score, preoperative narcotic use, sex, smoking status, number of suture anchors used, tear size, single- or double-row repair, and patient age. Preoperative subjective pain tolerance, notably those patients rating themselves as having an extremely high pain tolerance, was the most significant predictor of high VAS pain scores on both postoperative day 1 (P = .0001) and postoperative day 7 (P < .0001). Preoperative narcotic use was also significantly predictive (P = .010) of high pain scores on postoperative day 1 and day 7 (P = .019), along with nonsmokers (P = .008) and younger patients (P = .006) being predictive on day 7. There were no patient factors that were predictive of VAS scores 3 months postoperatively (P = .567). Preoperative subjective pain tolerance, notably those patients rating themselves as having an extremely high pain tolerance, was the strongest factor predicting high acute pain levels after arthroscopic rotator cuff surgery. Preoperative narcotic use, smokers, and younger patients were also predictive of higher pain levels during the first postoperative week. Level IV, prognostic case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  9. Evaluation of a computer-based nutrition education tool.

    PubMed

    Kreisel, Katrin

    2004-04-01

    To evaluate the efficacy and feasibility of using a computer-based teaching tool (http://www.coolfoodplanet.org) for nutrition and lifestyle education developed for primary school children. This was a 2-week school-based intervention in third and fourth grades. The study design was multi-factorial with repeated measures of nutrition knowledge, at three points in time, of dependent samples from control and intervention groups. Control schools (n=7) used 'traditional' nutrition education materials and intervention schools (n=8) additionally used the computer-based educational tool. Qualitative information was collected in focus group discussions with student teachers and pupils, and by observing the nutrition lessons. Pupils aged 8-11 years (n=271) from participating schools in Vienna, Austria. Nutrition knowledge increased significantly in both intervention and control schools, irrespective of the teaching tool used (P<0.001). The significant effect was maintained at 3 months' follow-up. There was no detectable difference in nutrition knowledge post intervention or at follow-up between the two study groups. In intervention schools, younger pupils (8-9 years) had better nutrition knowledge than older pupils (10-11 years) (P=0.011). This computer-based tool increases the possibilities of school-based nutrition education. If the tool's weaknesses identified during the formative evaluation are eliminated, it has the potential to make learning about nutrition more enjoyable, exciting and effective. This is of great importance considering that 'healthy' nutrition is not necessarily a topic that easily attracts pupils' attention and in view of the potential long-term health benefits of early and effective nutrition education.

  10. Nutritional intake after colorectal surgery: a comparison of a traditional and a new post-operative regimen.

    PubMed

    Wara, P; Hessov, I

    1985-11-01

    The energy and protein intake was studied for 12 days after colorectal surgery in 36 patients. Eighteen patients followed a traditional management with nasogastric suction until bowel movements occurred after which a liquid diet, protective diet and normal food were successively administered. In a subsequent period a new regimen was introduced. Nasogastric suction was not used. Instead, 18 patients received liquid diet from the first post-operative day and normal food, when the patient wanted to eat it. In addition, the nutritional intake was supplemented by protein-enriched refreshing drinks and milk products between the meals. The new regimen was tolerated without discomfort and resulted in a significant increase in protein intake (43 g/day vs. 26 g/day, p<0.001) and energy intake (78% vs. 71% of the basal metabolic rate, p<0.05). The increase was most pronounced in the first 4 days after the operation. Finally, the weight loss was significantly lower on the new regimen (1.8 kg vs. 3.9 kg, p<0.001).

  11. Long-Term Changes in Drug Craving and Nutritional Status of Opioid Addicts with Nucleus Accumbens Ablative Stereotactic Neurosurgery at Five Years Postoperatively.

    PubMed

    Wu, He-Ming; Ge, Shun-Nan; Dai, Hai-Bin; Wang, Ling; Chang, Chong-Wang; Wang, Xue-Lian; Li, Nan; Gao, Guo-Dong

    2015-01-01

    The nucleus accumbens (NAcc) has been proven to be associated with drug and food craving. NAcc ablative neurosurgery has been suggested to modulate the balance of the brain reward system and thus alleviate drug dependence in patients. It has been hypothesized that it would also alleviate food craving in patients as well as altering their nutritional status. This study aimed to estimate the effect of NAcc neurosurgery on drug craving and nutritional status in patients with drug dependence at 5 years postoperatively. The study included 100 patients with NAcc surgery and 92 patients without surgery. Body mass index (BMI) and body fat percentage (BF%) were examined to assess nutritional status, and questionnaires were administered to assess drug craving. Compared with the nonsurgery group and the relapse patients from the surgery group, the nonrelapse patients from the surgery group had higher BMI and BF% but lower drug craving. There were no significant differences between the nonsurgery group and the relapse patients in BMI, but the relapse patients had higher drug craving than the nonsurgery group. Long-term follow-up suggested that NAcc ablative neurosurgery would alleviate drug craving and yield a better nutritional status if individuals sustained abstinence. It would increase drug craving but would not ruin the nutritional status of patients even when individuals relapsed postoperatively. © 2016 S. Karger AG, Basel.

  12. Nutritional evaluation in cirrhosis: Emphasis on the phase angle

    PubMed Central

    Fernandes, Sabrina Alves; de Mattos, Angelo Alves; Tovo, Cristiane Valle; Marroni, Claudio Augusto

    2016-01-01

    Protein-calorie malnutrition (PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, there are anthropometric methods such as the evaluation of the triceps skinfold, the arm circumference, the arm muscle circumference and the body mass index, and non-anthropometric methods such as the subjective global assessment, the handgrip strength of non-dominant hand, and the bioelectrical impedance analysis (BIA). PCM is frequently under-diagnosed in clinical settings in patients with cirrhosis due to the limitations of nutritional evaluation methods in this population. BIA is a useful method, but cannot be indicated in patients with abnormal body composition. In these situations, the phase angle (PA) has been used, and can become an important tool in assessing nutritional status in any situation. The PA is superior to anthropometric methods and might be considered as a nutritional indicator in cirrhosis. The early characterization of the nutritional status in patients with cirrhosis means an early nutritional intervention, with a positive impact on patients’ overall prognosis. Among the usually accepted methods for nutritional diagnosis, the PA provides information in a quick and objective manner. PMID:27803765

  13. Monitoring and evaluating school nutrition and physical activity policies.

    PubMed

    Taylor, Jennifer P; McKenna, Mary L; Butler, Gregory P

    2010-01-01

    Given the increase in the number of Canadian jurisdictions with school nutrition and/or physical activity policies, there is a need to assess the effectiveness of such policies. The objectives of this paper are to 1) provide an overview of key issues in monitoring and evaluating school nutrition and physical activity policies in Canada and 2) identify areas for further research needed to strengthen the evidence base and inform the development of effective approaches to monitoring and evaluation. Evaluation indicators, data sources and existing tools for evaluating nutrition and physical activity are reviewed. This paper has underscored the importance of identifying common indicators and approaches, using a comprehensive approach based on the WHO framework and ensuring that research capacity and funding is in place to facilitate high-quality evaluation efforts in the future.

  14. Fused 99m-Tc-GSA SPECT/CT imaging for the preoperative evaluation of postoperative liver function: can the liver uptake index predict postoperative hepatic functional reserve?

    PubMed

    Yoshida, Morikatsu; Shiraishi, Shinya; Sakaguchi, Fumi; Utsunomiya, Daisuke; Tashiro, Kuniyuki; Tomiguchi, Seiji; Okabe, Hirohisa; Beppu, Toru; Baba, Hideo; Yamashita, Yasuyuki

    2012-04-01

    To evaluate the role of hepatic asialoglycoprotein receptor analysis in the preoperative estimation of postoperative hepatic functional reserve. We obtained technetium-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin (99mTc-GSA) SPECT/CT fusion images in 256 patients with liver disease scheduled for hepatic resection. The liver uptake value corrected for body surface area [LUV(BSA)] and liver uptake ratio (LUR) of the remnant were preoperatively estimated based on the fused images. These values were compared with the postoperative hepatic functional reserve. Significant correlations were observed between LUV(BSA), LUR, and most conventional indicators of hepatic functional reserve. Postoperatively, nonpreserved liver functional reserve was observed in 15 of the 256 patients (5.8%). Remnant LUV(BSA) showed better correlation than remnant LUR or the other indicators. No patients with remnant LUV(BSA) above 28.0 manifested poor nonpreserved functional reserve. Using a LUV(BSA) of 27.0, it was possible to predict postoperative poor hepatic functional reserve at a sensitivity of 91%, specificity of 81%, and accuracy of 81% postoperatively. According to multivariate analysis, a low remnant LUV(BSA) was the only significant independent predictor of poor hepatic functional reserve. Our 99mTc-GSA SPECT/CT fusion imaging method was clinically useful for evaluating regional hepatic function and for predicting postoperative hepatic functional reserve.

  15. Evaluation of the Readability of Dermatological Postoperative Patient Information Leaflets Across England.

    PubMed

    Hunt, William T N; McGrath, Emily J

    2016-06-01

    Postoperative patient information leaflets (PILs) provide important guidance to patients after skin surgery. Readability is a method of evaluating information for text comprehension. The recommended level for PIL readability is US grade ≤6. To evaluate the readability of public English dermatological postoperative PILs. All dermatology departments in England were requested to provide their postoperative PILs. Patient information leaflets were evaluated using Readability Studio (Oleander Software, Vandalia, OH). Two preselected parameters were also noted: whether the PIL was doctor or nurse-written, and whether the PIL was Information Standard hallmarked. Eighty-five of one hundred thirty (65.4%) of PILs were evaluated. Only 29.4% of the PILs were grade level ≤6 with Flesch-Kincaid. The mean readability levels were 7.8 for Flesch-Kincaid, 67 for Flesch reading ease, 10.5 for Simple Measure of Gobbledygook (SMOG), 9.4 for Gunning-Fog, 8 for Fry, and 9.8 for FORCAST. No instruments demonstrated a significant difference between doctor (6) and nurse-written (7) PILs. Two instruments found that the 3 Information Standard hallmarked PILs had a higher (harder) readability than ordinary PILs (n = 82) (Gunning-Fog, p = .029*; SMOG p = .049*). Most English postoperative dermatological PILs' readability levels exceed recommendations (US grade ≤6). Departmental PILs should be reviewed to ensure that they are comprehensible to their patients.

  16. An evaluation of a postoperative rehabilitation program after spinal surgery and its impact on outcome.

    PubMed

    McGregor, Alison H; Henley, Ania; Morris, Tim P; Doré, Caroline J

    2012-04-01

    This study invited patients to evaluate the content and style of a rehabilitation program used as an intervention in a multicenter, factorial, randomized controlled trial of the postoperative management of spinal surgery patients. To determine the acceptability and content of the rehabilitation program. The use of rehabilitation after spinal surgery is sporadic, and the evidence for its benefit is mixed. A randomized controlled trial was conducted to determine whether functional outcome of spinal surgery could be improved by a postoperative rehabilitation program and/or an educational booklet provided at hospital discharge, each compared with usual care. Patients randomized to postoperative rehabilitation began the course 6 weeks after surgery. At the end of the course of 12 classes, patients completed an evaluation of content, style, and length using forced choice and open questions. Patients not attending the final class completed the evaluation at their 3-month review. Compliance with rehabilitation was poor, with 41% of subjects failing to attend any classes and 16% attending less than half. Compliance with the evaluation was 100% for the 105 patients attending 1 or more classes. The length, content, and approach to the classes were rated positively, and patients gave the class a median rating of 9 of 10, range 5 to 10, with 91% rating the classes as 7 or above. Compliance with a postoperative rehabilitation program was disappointing, but the program was assessed positively and of benefit by those who attended. Issues were raised in relation to timing and location of classes.

  17. Diet and Colorectal Cancer Risk: Evaluation of a Nutrition Education Leaflet

    ERIC Educational Resources Information Center

    Dyer, K. J.; Fearon, K. C. H.; Buckner, K.; Richardson, R. A.

    2005-01-01

    Objective: To evaluate the effect of a needs-based, nutrition education leaflet on nutritional knowledge. Design: Comparison of nutritional knowledge levels before and after exposure to a nutrition education leaflet. Setting: A regional colorectal out-patient clinic in Edinburgh. Method: A nutrition education leaflet, based on an earlier…

  18. Diet and Colorectal Cancer Risk: Evaluation of a Nutrition Education Leaflet

    ERIC Educational Resources Information Center

    Dyer, K. J.; Fearon, K. C. H.; Buckner, K.; Richardson, R. A.

    2005-01-01

    Objective: To evaluate the effect of a needs-based, nutrition education leaflet on nutritional knowledge. Design: Comparison of nutritional knowledge levels before and after exposure to a nutrition education leaflet. Setting: A regional colorectal out-patient clinic in Edinburgh. Method: A nutrition education leaflet, based on an earlier…

  19. Drosophila evaluates and learns the nutritional value of sugars.

    PubMed

    Fujita, Michiko; Tanimura, Teiichi

    2011-05-10

    Living organisms need to search for and ingest nutritional chemicals, and gustation plays a major role in detecting and discriminating between chemicals present in the environment. Using Drosophila as a model organism, we asked whether animals have the ability to evaluate the nutritional value of sugars. In flies, chemosensilla on the tarsi and labellum are the gustatory organs used to discriminate between edible and nonedible compounds [1, 2]. We noticed that Drosophila do not assign nutritional values to all sweet chemicals. D-arabinose is sweet to flies, but it provides them with no nutrition. By contrast, the sugar alcohol D-sorbitol is not sensed as sweet, but flies can live on it. We performed behavioral and electrophysiological measurements to confirm these gustatory and feeding responses. We found that Drosophila can learn the nutritional value of nonsweet D-sorbitol when it is associated with an odor cue. The learning process involved the synapsin molecule, suggesting that a neuronal mechanism is involved. We propose that Drosophila uses neural machinery to detect, evaluate, and learn the nutritional value of foods after ingestion.

  20. [Reducing postoperative morbidity and mortality with preoperative risk evaluation and with refined perioperative medical care].

    PubMed

    Uchida, Kanji

    2012-05-01

    Reducing postoperative morbidity and mortality is important not only for patients' outcome but for reduction of financial burden on society. Precise and accurate preoperative evaluation of surgical risk factors is crucial to plan appropriate postoperative allocation of medical resources. American Society of Anesthesiologists physical status is a traditional measure to describe preoperative risk of patients undergoing surgery. In the last decade, several scoring systems with better sensitivity and specificity were reported and validated. Charlson Age-comorbidity Index, Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) are frequently used scoring systems. Several lines of evidence indicate that negligence of medical caregivers cause substantial numbers of errors to patients and often leads to severe complications or deaths. Full compliances to surgical checklists and implementation of medical team will help reduce these errors and lead to better patients' postoperative outcomes.

  1. Evaluation of the complexity of postoperative care following breast and gynecologic cancer surgery.

    PubMed

    Meloni Rosa, Teresa Celina; Dias de Souza, João Paulo; Sarian, Luis Otávio; Soares, Fabiano Miguel; Morais, Sirlei Siani; Mauricette Derchain, Sophie Françoise

    2006-01-01

    The purpose of this study was to evaluate the complexity of postoperative care required by women who had undergone breast or gynecologic cancer surgery, using the Therapeutic Intervention Scoring System-28. An observational, longitudinal study was carried out on 83 women admitted postoperatively to the Intensive Care Unit of the Center for Women's Integrated Healthcare. The results of this study show that women diagnosed with gynecologic cancer had a significantly higher mean Therapeutic Intervention Scoring System-28 score compared with women who had been diagnosed with breast cancer (P = .01). Women who underwent gynecologic surgery had a significantly higher mean Therapeutic Intervention Scoring System-28 score than women who had breast surgery (P = .03). Most of the activities performed by staff during the postoperative intensive care unit period involved only basic care procedures. Only advanced age and hypertension were related to death during the postoperative period. In conclusion, from the nursing standpoint, the complexity of care required in the intensive care unit during the postoperative period was moderate. Women aged 80 years or older were at the highest risk of death during this period.

  2. Cardiac surgery patients' evaluation of the quality of theatre nurse postoperative follow-up visit.

    PubMed

    Falk-Brynhildsen, Karin; Nilsson, Ulrica

    2009-06-01

    Theatre nurses at the Department of Cardiothoracic Surgery in Orebro, Sweden, have since 2001 routinely conducted a follow-up visit to postoperative cardiac patients. A model with a standardized information part and an individual-caring conversation including both a retrospective and a prospective part designed the visit. The purpose of this study was to evaluate the quality of the postoperative follow-up visit conducted by the theatre nurses and find out if the quality was related to gender or type of admission. The method was prospective and explorative, including 74 cardiac surgery patients who had had a postoperative follow-up visit by a theatre nurse in Sweden. The instrument measuring quality, from the patient's perspective, measured the quality of the visit, and consisted of 16 items modified to suit the study. The results showed an overall high quality rating, with statistically significant higher scores for six items between patients who had undergone emergency surgery, in comparison with elective patients. When comparing gender, women had statistically significant higher scores in two items. In conclusion, this postoperative follow-up visit by the theatre nurse was a valuable and useful tool especially for the patients who had undergone emergency surgery. In the follow-up visit the theatre nurse creates a caring relationship by meeting the patient as an individual with his/her own experience and needs for information about the surgery, intra and postoperative care, and recovery.

  3. Pre- and postoperative evaluation of patients with lumbosacral disc herniation by neurophysiological and clinical assessment.

    PubMed

    Wojtysiak, Magdalena; Huber, Juliusz; Wiertel-Krawczuk, Agnieszka; Szymankiewicz-Szukała, Agnieszka; Moskal, Jakub; Janicki, Jacek

    2014-10-01

    The application of complex neurophysiological examination including motor evoked potentials (MEP) for pre- and postoperative evaluation of patients experiencing acute sciatica. The assessment of sensitivity and specificity of needle electromyography, MEP, and H-reflex examinations. The comparative analysis of preoperative and postoperative neurophysiological examination. In spite of the fact that complex neurophysiological diagnostic tools seem to be important for interpretation of incompatible results of neuroimaging and clinical examination, especially in the patients qualified for surgical treatment, their application has never been completely analyzed and documented. Pre- and postoperative electromyography, electroneurography, F-waves, H-reflex, and MEP examination were performed in 23 patients with confirmed disc-root conflict at lumbosacral spine. Clinical evaluation included examination of sensory perception for L5-S1 dermatomes, muscles strength with Lovett's scale, deep tendon reflexes, pain intensity with visual analogue scale, and straight leg raising test. Sensitivity of electromyography at rest and MEP examination for evaluation of L5-S1 roots injury was 22% to 63% and 31% to 56% whereas specificity was 71% to 83% and 57% to 86%, respectively. H-reflex sensitivity and specificity for evaluation of S1 root injury were 56% and 67%, respectively. A significant improvement of root latency parameter in postoperative MEP studies as compared with preoperative was recorded for L5 (P = 0.039) and S1 root's levels (P = 0.05). The analysis of the results from neurophysiological tests together with neuroimaging and clinical examination allow for a precise preoperative indication of the lumbosacral roots injury and accurate postoperative evaluation of patients experiencing sciatica. 3.

  4. Nutritional risk and anthropometric evaluation in pediatric liver transplantation

    PubMed Central

    Zamberlan, Patrícia; Leone, Cláudio; Tannuri, Uenis; de Carvalho, Werther Brunow; Delgado, Artur Figueiredo

    2012-01-01

    OBJECTIVE: To analyze the nutritional status of pediatric patients after orthotopic liver transplantation and the relationship with short-term clinical outcome. METHOD: Anthropometric evaluations of 60 children and adolescents after orthotopic liver transplantation, during the first 24 hours in a tertiary pediatric intensive care unit. Nutritional status was determined from the Z score for the following indices: weight/age, height/age or length/age, weight/height or weight/length, body mass index/age, arm circumference/age and triceps skinfold/age. The severity of liver disease was evaluated using one of the two models which was adequated to the patients' age: 1. Pediatric End-stage Liver Disease, 2. Model for End-Stage Liver Disease. RESULTS: We found 50.0% undernutrition by height/age; 27.3% by weight/age; 11.1% by weight/height or weight/length; 10.0% by body mass index/age; 61.6% by arm circumference/age and 51.0% by triceps skinfold/age. There was no correlation between nutritional status and Pediatric End-stage Liver Disease or mortality. We found a negative correlation between arm circumference/age and length of hospitalization. CONCLUSION: Children with chronic liver diseases experience a significant degree of undernutrition, which makes nutritional support an important aspect of therapy. Despite the difficulties in assessment, anthropometric evaluation of the upper limbs is useful to evaluate nutritional status of children before or after liver transplantation. PMID:23295591

  5. Evaluation of quality of life related to nutritional status.

    PubMed

    Wanden-Berghe, Carmina; Sanz-Valero, Javier; Escribà-Agüir, Vicenta; Castelló-Botia, Isabel; Guardiola-Wanden-Berghe, Rocio

    2009-04-01

    The way in which the quality of life related to health (HRQoL) is affected by the nutritional status of the patient is a subject of constant interest and permanent debate. The purpose of the present paper is to review those studies that relate HRQoL to nutritional status and examine the tools (questionnaires) that they use to investigate this relationship. A critical review of published studies was carried out via an investigation of the following databases: MEDLINE (via PubMed); EMBASE; The Cochrane Library; Cumulative Index to Nursing and Allied Health Literature (CINAHL); Institute for Scientific Information (ISI) Web of Science; Latin American and Caribbean Health Sciences Literature (LILACS); Spanish Health Sciences Bibliographic Index (IBECS). The search was carried out from the earliest date possible until July 2007.The medical subject heading terms used were 'quality of life', 'nutritional status' and 'questionnaires'. The articles had to contain at least one questionnaire that evaluated quality of life. Twenty-eight documents fulfilling the inclusion criteria were accepted, although none of them used a specific questionnaire to evaluate HRQoL related to nutritional status. However, some of them used a combination of generic questionnaires with the intention of evaluating the same. Only three studies selectively addressed the relationship between nutritional status and quality of life, this evaluation being performed not by means of specific questionnaires but by statistical analysis of data obtained via validated questionnaires.

  6. Evaluation of Australian dermatological postoperative patient information leaflets: Should we have a national checklist?

    PubMed

    Hunt, William Tn; O'Sullivan, Niamh-Anna; Donnelly, Alan

    2017-04-20

    Patient information leaflets (PILs) are frequently provided to patients following dermatological surgery to provide advice and reassurance in the community. This evaluation reviewed the guidance specified in postoperative PILs across the 40 Australian dermatology teaching departments and clinics. All 40 departments and clinics were identified and asked to provide their postoperative information leaflets on sutured wound care (preferable) or excision biopsy (September-October 2015). For each PIL, 10 preselected parameters were evaluated. In total, 28/40 (70%) of units responded. From these units, 11/28 (39.3%) stated they do not use a postoperative PIL. Of the 17 units that provided PILs, the mode minimum dressing duration was 24 (6/17; 35.3%) and 48 h (6/17; 35.3%). For haemostatic advice, 12 PILs specified the time to press on a bleeding wound, with the most common advice being 10 (3/12; 25%) and 20 min (3/12; 25%). Of the 14 PILs that provided analgesic advice, the mode information suggested using paracetamol only and avoiding aspirin (4/14, 28.6%). Two or more signs of infection were stated in 11/17 (64.7%) PILs; 7/17 (41.2%) advised applying petroleum jelly to the wound, almost all PILs highlighted the contact for postoperative problems 16/17 (94.1%), and 5/17 (29.4%) leaflets mentioned scarring. Altogether 8/17 (47.1%) of PILs advised on the timeframe until active exercise could resume postoperatively. Guidance provided in Australian postoperative dermatological PILs is heterogeneous. A consensus checklist or template would be beneficial and ensure that advice provided to patients is more consistent; this could be adapted for local factors. © 2017 The Australasian College of Dermatologists.

  7. Pre- and post-operative evaluations of eight dogs following right nephrectomy due to Dioctophyma renale.

    PubMed

    Mesquita, L R; Rahal, S C; Faria, L G; Takahira, R K; Rocha, N S; Mamprim, M J; Oliveira, H S

    2014-01-01

    Dioctophyma renale is a large nematode distributed worldwide that may cause progressive and severe destruction of renal parenchyma. The present study aimed to evaluate pre- and post-operatively dogs submitted to right nephrectomy due to D. renale and to assess the histopathological damage of the removed kidney. Eight crossbred dogs, aged from 12 to 48 months that were unilaterally nephrectomized due to the presence of D. renale were evaluated. Physical examination, urinalysis, complete blood count, serum biochemistry, and abdominal ultrasound were performed immediately before and one month after nephrectomy. The nephrectomized right kidneys were submitted to macroscopic and microscopic evaluations. Urinalysis preoperatively detected occult blood in all dogs and D. renale eggs in five cases. Complete blood count showed all parameters within the reference range, except one dog post-operatively. Serum biochemistry performed before and after surgery verified that urea, creatinine and sodium were within the reference range values in all dogs. Other findings varied among the dogs. The length and arterial resistive index mean values of the left kidney were similar pre- and post-operatively. Thus, the inconsiderable change in laboratory findings pre- and post-operatively was attributable to compensation by left kidney function for the removed abnormal right kidney. Right kidney histology revealed chronic nephropathy due to D. renale. Imaging diagnosis should be performed on dogs suspected as carrying the disease or on those from an enzootic area since the laboratory findings are not specific except eggs in the urine.

  8. Audiovisuals for Nutrition Education; Selected Evaluative Reviews from the Journal of Nutrition Education.

    ERIC Educational Resources Information Center

    Rowe, Sue Ellen, Comp.

    Audiovisual materials suitable for the teaching of nutrition are listed. Materials include coloring books, flannelboard stories, games, kits, audiotapes, records, charts, posters, study prints, films, videotapes, filmstrips, slides, and transparencies. Each entry contains bibliographic data, educational level, price and evaluation. Mateiral is…

  9. Audiovisuals for Nutrition Education; Selected Evaluative Reviews from the Journal of Nutrition Education.

    ERIC Educational Resources Information Center

    Rowe, Sue Ellen, Comp.

    Audiovisual materials suitable for the teaching of nutrition are listed. Materials include coloring books, flannelboard stories, games, kits, audiotapes, records, charts, posters, study prints, films, videotapes, filmstrips, slides, and transparencies. Each entry contains bibliographic data, educational level, price and evaluation. Mateiral is…

  10. Conscious midazolam sedation in third molar surgery--aspects of post-operative patient evaluation.

    PubMed

    Bremerich, A; Hierl, T

    1995-09-01

    This study was conducted on 426 patients undergoing third molar surgery to evaluate their opinion on surgery and the follow-up period concerning postoperative behaviour, pain, and complaints. Two groups were formed as patients had to choose between local anaesthesia only or additional conscious sedation by means of intravenous midazolam (0.1 mg/kg). Women and younger patients preferred conscious sedation. Surgery was described as significantly less distressing by the sedated group. No difference in the evaluation of the follow-up period between both groups existed. Patients of the midazolam group took more analgesics, tended to stay longer in bed and reported on protracted cooling. Non-sedated persons older than 30 years complained about a slower decrease in postoperative pain. According to these findings, sensitive, cautious patients tend to prefer conscious sedation which is reflected in their behaviour. No relationship between the evaluation of surgery itself and the follow-up period could be found.

  11. [Nutritional evaluation of children with respiratory failure (RF): anthropometric evaluation upon admission to the pediatric intensive care units].

    PubMed

    Almeida Santos, L; Ruza, F; Guerra, A J; Alves, A; Dorao, P; García, S; Santos, N T

    1998-07-01

    Protein-energy malnutrition (PEM) constitutes an important complication in children submitted to intensive care treatment for respiratory failure (RF). This complication is not usually evaluated in assessment protocols. Nutrition assessment in a Pediatric Intensive Care Unit (PICU) was performed in children with respiratory failure. A prospective study involving 65 children (1-158 months of age) with RF at admission to the PICU was carried out. The patients studied were divided into four groups according to their etiology: Group I (n = 29) included those with acute bronchial pathology; Group II (n = 17) those with pneumonia: Group III (n = 11) those in the post-operative period following cardiac surgery; and Group IV (n = 8) those patients with multiple-organ dysfunction. All patients in Groups I, II, and III had chronic diseases. Anthropometrical and nutritional evaluation included weight, height and body mass index (w/h2). The weight for age was low (59%). Height deficit was observed in a significantly lower percentage of the patients (13.1%). The body mass index showed values in relationship to the 50th percentile that varied between 83.4 +/- 23.1% and 97.1 +/- 4.7%. In 68.9% of the patients the criteria of global malnutrition were met according to the classification of McLaren and Read. The data confirm that PEM is frequent in patients with RF in the PICU and emphasize the usefulness of anthropometrical evaluation as an important, simple and non-invasive method of nutritional evaluation. Early and intensive nutritional intervention can reduce or prevent the vicious circle of malnutrition in RF patients hospitalized in the PICU.

  12. Nutrition and shiftwork: evaluation of new paramedics' knowledge and attitudes.

    PubMed

    Macdonald, Amanda B; Rossiter, Melissa D; Jensen, Jan L

    2013-01-01

    The effect of an oral education intervention on nutrition knowledge was evaluated in new paramedic employees. The evaluation involved measuring knowledge of and attitudes toward nutrition and shiftwork before and after the directed intervention. A convenience sample of 30 new paramedic shiftworkers attended a 15-minute education session focused on nutrition management strategies. This matched cohort study included three self-administered surveys. Survey 1 was completed before education, survey 2 immediately after education, and survey 3 after one month of concurrent post-education and employment experience. Knowledge and attitude scores were analyzed for differences between all surveys. Participants were primary care paramedics, 59% of whom were male. They reported that previously they had not received this type of information or had received only a brief lecture. Mean knowledge scores increased significantly from survey 1 to survey 2; knowledge retention was identified in survey 3. A significant difference was found between surveys 2 and 3 for attitudes toward meal timing; no other significant differences were found between attitude response scores. The education session was successful in improving shiftwork nutrition knowledge among paramedics. Paramedics' attitudes toward proper nutrition practices were positive before the education intervention.

  13. Evaluation of postoperative complications according to treatment of third molars in mandibular angle fracture

    PubMed Central

    2017-01-01

    Objectives The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture. PMID:28280708

  14. Definition and application of neuropsychological test battery to evaluate postoperative cognitive dysfunction

    PubMed Central

    Valentin, Lívia Stocco Sanches; Pietrobon, Ricardo; de Aguiar, Wagner; Rios, Ruth Pinto Camarão; Stahlberg, Mariane Galzerano; de Menezes, Iolanda Valois Galvão; Osternack-Pinto, Kátia; Carmona, Maria José Carvalho

    2015-01-01

    Objective To investigate the adequacy of the neuropsychological test battery proposed by the International Study of Postoperative Cognitive Dysfunction to evaluate this disorder in Brazilian elderly patients undergoing surgery under general anesthesia. Methods A neuropsychological assessment was made in patients undergoing non-cardiac surgery under general anesthesia, aged over 65 years, literate, with no history of psychiatric or neurological problems and score on the Mini Mental State Examination at or above the cutoff point for the Brazilian population (>18 or >23) according to the schooling level of the subject. Eighty patients were evaluated by a trained team of neuropsychologists up to 24 hours before elective surgery. Results Among the patients evaluated, one was excluded due to score below the cutoff point in the Mini Mental State Examination and two did not complete the test battery, thus remaining 77 patients in the study. The mean age was 69±7.5 years, and 62.34% of the subjects had ±4 years of study. The subjects had significantly lower averages than expected (p<0.001) for normative tables on neuropsychological tests. Conclusion The study demonstrated the applicability of the instruments in the Brazilian elderly and low schooling level population, but suggested the need to determine cutoff points appropriate for these individuals, ensuring the correct interpretation of results. This battery is relevant to postoperative follow-up evaluations, favoring the diagnosis of postoperative cognitive dysfunction in patients undergoing different types of surgery and anesthetic techniques. PMID:25993064

  15. [Evaluation of nutritional Status in lung cancer using bio electrical impedance analysis and mini nutritional assessment].

    PubMed

    Daghfous, Hafaoua; El Ayeb, Wejdène; Alouane, Leila; Tritar, Fatma

    2014-12-01

    Malnutrition and cachexia were a frequent problem in lung cancer and increases the risks of morbidity and mortality in these patients. Bioelectrical impedance analysis (BIA) is easy, non-invasive and reproducible method that can be performed. Evaluate nutritional status in patients with primary lung cancer by Mini Nutritional Assessment (MNA), BIA and anthropometric values (weight, arm and calf circumferences) and correlate the nutritional parameters to severity of cancer and histopathology. The nutritional status of 73 cases of primary lung cancer was evaluated by anthropometric parameters, MNA test and impedencemetrie Results: According to body mass index (BMI), malnutrition, overweight and obesity were noted in 34,2%, 13,7% and 5,5%. According to BMI, free-fat mass index (FFMI) and fat mass index (FMI), the investigations occurred malnutrition and depletion of muscle in respectively 19,2% and 23,3% of cases. Fat depletion was noted in 21,9%. Overweight and obesity were detected in 6,8% and 5,5% of cases. Assessment by MNA, revealed that 28,7% of patients were already malnourished and 49,3% of patients were at risk of malnutrition. A significant correlation existed between the score of MNA and arm and calf circumferences, FFMI and FMI. FMI was significantly lower in group of patients with small lung carcinoma. Only FFMI allows early detection of malnutrition in cancer patients overestimated by measuring BMI and arm circumference was the better indicator of depletion of muscle.

  16. Proposal of a Nutritional Quality Index (NQI) to Evaluate the Nutritional Supplementation of Sportspeople.

    PubMed

    Palacin-Arce, Alba; Monteagudo, Celia; Beas-Jimenez, Juan de Dios; Olea-Serrano, Fatima; Mariscal-Arcas, Miguel

    2015-01-01

    Numerous supplements are used by sportspeople. They are not always appropriate for the individual or the sports activity and may do more harm than good. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits. A nutritional study was performed in 485 sportspeople recruited from Centros Andaluces de Medicina del Deporte, (CAMD). All completed socio-demographic, food frequency, and lifestyle questionnaires. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant. A superior mean NQI score was obtained when the supplements taken by participants were not included (16. 28 (SD of 3.52)) than when they were included (15.47 (SD: 3.08)), attributable to an excessive intake of some nutrients through supplementation. These results indicate that sportspeople with a varied and balanced diet do not need supplements, which appear to offer no performance benefits and may pose a health risk.

  17. Proposal of a Nutritional Quality Index (NQI) to Evaluate the Nutritional Supplementation of Sportspeople

    PubMed Central

    Palacin-Arce, Alba; Monteagudo, Celia; Beas-Jimenez, Juan de Dios; Olea-Serrano, Fatima; Mariscal-Arcas, Miguel

    2015-01-01

    Background Numerous supplements are used by sportspeople. They are not always appropriate for the individual or the sports activity and may do more harm than good. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits. Material and Methods A nutritional study was performed in 485 sportspeople recruited from Centros Andaluces de Medicina del Deporte, (CAMD). All completed socio-demographic, food frequency, and lifestyle questionnaires. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant. Results A superior mean NQI score was obtained when the supplements taken by participants were not included (16. 28 (SD of 3.52)) than when they were included (15.47 (SD: 3.08)), attributable to an excessive intake of some nutrients through supplementation. Conclusions These results indicate that sportspeople with a varied and balanced diet do not need supplements, which appear to offer no performance benefits and may pose a health risk. PMID:25938239

  18. Evaluating Nutrition Education Programming by Using a Dietary Screener

    ERIC Educational Resources Information Center

    Schultz, Jennifer; Litchfield, Ruth

    2016-01-01

    Short dietary assessment instruments known as screeners have potential for use in evaluating nutrition education programming because detecting change in dietary intake can demonstrate movement toward program goals. Using screeners results in objective dietary intake data but involves less administrative time, training, and cost than other…

  19. Evaluating Nutrition Education Programming by Using a Dietary Screener

    ERIC Educational Resources Information Center

    Schultz, Jennifer; Litchfield, Ruth

    2016-01-01

    Short dietary assessment instruments known as screeners have potential for use in evaluating nutrition education programming because detecting change in dietary intake can demonstrate movement toward program goals. Using screeners results in objective dietary intake data but involves less administrative time, training, and cost than other…

  20. Evaluation of a Nutrition Education Program for Family Practice Residents.

    ERIC Educational Resources Information Center

    Gray, David S.; And Others

    1988-01-01

    A nutrition education program at the University of South Alabama Medical Center that was based on the "co-counseling model" as described by Moore and Larsen is described. Patients with one of three problem areas were selected for evaluation: hypertension, diabetes mellitus, and pregnancy. (MLW)

  1. Evaluation of a Nutrition Education Program for Family Practice Residents.

    ERIC Educational Resources Information Center

    Gray, David S.; And Others

    1988-01-01

    A nutrition education program at the University of South Alabama Medical Center that was based on the "co-counseling model" as described by Moore and Larsen is described. Patients with one of three problem areas were selected for evaluation: hypertension, diabetes mellitus, and pregnancy. (MLW)

  2. The Evaluation of Risk Factors for Postoperative Infectious Complications after Percutaneous Nephrolithotomy

    PubMed Central

    Yang, Tian; Liu, Shenghua; Wang, Lujia

    2017-01-01

    This study was to evaluate the risk factors of infectious complications after percutaneous nephrolithotomy (PCNL) and build a prediction tool for postoperative complications based on the risk factors. A total of 110 male (67.1%) and 54 female (32.9%) patients who underwent PCNL for renal stones between 2010 and 2014 in our institute were included. A detailed clinical information and laboratory results were obtained from patients. Systemic inflammatory response syndrome (SIRS) and postoperative fever were recorded after PCNL surgery. In all, 45 cases (27.4%) developed SIRS and fever was observed in 20 cases (12.2%). In multivariate analysis, stone size (odds ratio, OR = 1.471, p = 0.009) and urine white blood cell (WBC) (OR = 1.001, p = 0.007) were related to the development of SIRS. Stone size (OR = 1.644, p = 0.024), urine WBC (OR = 1.001, p = 0.002) and serum albumin (OR = 0.807, p = 0.021) were associated with postoperative fever. We concluded that patients with larger stone size and preoperative urinary tract infection might have a higher risk of developing SIRS and fever after operation, while a high-normal level of serum albumin might be the protective factor for postoperative fever. PMID:28261611

  3. Systemic Trans- and Postoperative Evaluations of Patients Undergoing Dental Implant Surgery.

    PubMed

    Goiato, Marcelo Coelho; Santiago Junior, Joel Ferreira; Pellizzer, Eduardo Piza; Moreno, Amália; Villa, Luiz Marcelo Ribeiro; Dekon, Stefan Fiuza de Carvalho; de Carvalho, Paulo Sérgio Perri; dos Santos, Daniela Micheline

    2016-03-01

    The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State-Trait (STAI) questionnaire. A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p =0.006). A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation.

  4. Systemic Trans- and Postoperative Evaluations of Patients Undergoing Dental Implant Surgery

    PubMed Central

    Goiato, Marcelo Coelho; Junior, Joel Ferreira Santiago; Pellizzer, Eduardo Piza; Moreno, Amália; Villa, Luiz Marcelo Ribeiro; de Carvalho Dekon, Stefan Fiuza; de Carvalho, Paulo Sérgio Perri; dos Santos, Daniela Micheline

    2016-01-01

    OBJECTIVE: The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. MATERIAL AND METHODS: Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State–Trait (STAI) questionnaire. RESULTS: A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p=0.006). CONCLUSION: A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation. PMID:27074177

  5. Evaluation of the nutrition screening tool for childhood cancer (SCAN).

    PubMed

    Murphy, Alexia J; White, Melinda; Viani, Karina; Mosby, Terezie T

    2016-02-01

    Malnutrition is a serious concern for children with cancer and nutrition screening may offer a simple alternative to nutrition assessment for identifying children with cancer who are at risk of malnutrition. The present paper aimed to evaluate the nutrition screening tool for childhood cancer (SCAN). SCAN was developed after an extensive review of currently available tools and published screening recommendation, consideration of pediatric oncology nutrition guidelines, piloting questions, and consulting with members of International Pediatric Oncology Nutrition Group. In Study 1, the accuracy and validity of SCAN against pediatric subjective global nutrition assessment (pediatric SGNA) was determined. In Study 2, subjects were classified as 'at risk of malnutrition' and 'not at risk of malnutrition' according to SCAN and measures of height, weight, body mass index (BMI) and body composition were compared between the groups. The validation of SCAN against pediatric SGNA showed SCAN had 'excellent' accuracy (0.90, 95% CI 0.78-1.00; p < 0.001), 100% sensitivity, 39% specificity, 56% positive predictive value and 100% negative predictive value. When subjects in Study 2 were classified into 'at risk of malnutrition' and 'not at risk of malnutrition' according to SCAN, the 'at risk of malnutrition' group had significantly lower values for weight Z score (p = 0.001), BMI Z score (p = 0.001) and fat mass index (FMI) (p = 0.04), than the 'not at risk of malnutrition' group. This study shows that SCAN is a simple, quick and valid tool which can be used to identify children with cancer who are at risk of malnutrition. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  6. Longitudinal, observational study on associations between postoperative nutritional vitamin D supplementation and clinical outcomes in esophageal cancer patients undergoing esophagectomy

    PubMed Central

    Wang, Lu; Wang, Cong; Wang, Jiangfeng; Huang, Xiaochen; Cheng, Yufeng

    2016-01-01

    Vitamin D can exert anticancer effect beyond bone and calcium metabolism. We aimed to investigate whether postoperative vitamin D supplementation affects quality of life (QOL) and survival in esophageal cancer (EC) patients. We utilized the widely used EORTC QLQ-C30 and QLQ-OES18 to assess QOL at EC diagnosis and 24 months after surgery. Generalized estimating equations (GEEs) were used to analysis the association of vitamin D supplement use with QOL. Kaplan-Meier method and Cox regression model were used to evaluate the prognostic value of vitamin D supplementation. The notably improved QOL were found among vitamin D supplementation users compared with non-users (p < 0.05). Kaplan-Meier analysis revealed that vitamin D supplement use was significantly associated with improved disease-free survival (DFS) (p = 0.030), but not related to overall survival (OS) (p = 0.303). The multivariable analysis further demonstrated vitamin D supplement use as an independent prognostic factor for DFS (p = 0.040; HR 0.610; 95% CI 0.381–0.978). In conclusion, these results showed that vitamin D supplement use could serve as a promising intervention to enhancing QOL and prolonging DFS in EC. PMID:27958342

  7. The impact of nutritional status and appetite on the hospital length of stay and postoperative complications in elderly patients with severe aortic stenosis before aortic valve replacement

    PubMed Central

    Jagielak, Dariusz; Wernio, Edyta; Bramlage, Peter; Gruchała-Niedoszytko, Marta; Rogowski, Jan; Małgorzewicz, Sylwia

    2016-01-01

    Introduction Severe aortic stenosis (AS) is associated with the reduction of physical activity and muscle mass and may be associated with decreased appetite. Aim To assess the nutritional status and the impact of nutritional status and appetite on the hospital length of stay and postoperative complications in elderly patients with severe AS before aortic valve replacement. Material and methods Ninety-nine patients (55 male, 44 female; 74.3 ±5.2 years old) with severe AS and an indication for aortic valve replacement (AVR) were included. The nutritional status was assessed by different questionnaires (7-point Subjective Global Assessment Score – 7-SGA, full-Mini Nutritional Assessment – full-MNA) and anthropometric measurements (body mass index (BMI) kg/m2). Body composition was estimated using multi-frequency bioelectrical impedance analysis. Appetite was assessed by the Simplified Nutrition Assessment Questionnaire (SNAQ). Results The average BMI of patients was 28.8 ±5.8 kg/m2. Results of the 7-SGA and f-MNA questionnaires revealed that 39 patients (39.4%) were at risk of malnutrition. The mean SNAQ score was 15.8 ±1.8. The average length of hospital stay was 10 ±5.8 days. There was a positive correlation of LOS with age (r = 0.26, p = 0.03) and a negative correlation with fat mass (kg) (r = –0.28, p = 0.04) and BMI (r = –0.22, p = 0.03). Postoperative complications were observed in 37 patients (37.4%). Patients who developed complications were older and had poorer nutritional status according to the results of the 7-SGA. Conclusions Despite many patients undergoing AVR being overweight and obese, a considerable proportion displayed clinical signs of malnutrition. The results suggest that an assessment of nutritional status and appetite in this group of patients should be conducted regularly and that the 7-SGA scale could represent a reliable tool to assess malnutrition. PMID:27516781

  8. Comparison of postoperative magnetic resonance imaging and second-look arthroscopy for evaluating meniscal allograft transplantation.

    PubMed

    Kim, Jong-Min; Kim, Jong-Min; Jeon, Byeong-Sam; Lee, Chang-Rack; Lim, Sung-Joon; Kim, Kyung-Ah; Bin, Seong-Il

    2015-05-01

    The aim of this study was to compare the magnetic resonance imaging (MRI) evaluation of transplanted meniscal allograft with second-look arthroscopy and evaluate the sensitivity, specificity, and accuracy of MRI for assessing graft status. From 1996 to 2012, among 290 knees that underwent meniscal allograft transplantation and received follow-up examination for more than 1 year, those knees that underwent second-look arthroscopy were reviewed. Patients with no postoperative MRI and patients with a time gap between postoperative MRI and second-look arthroscopy of more than 3 months were excluded. Anatomically, the meniscus was divided into 3 segments: anterior one-third, mid body, and posterior one-third. Each part of the meniscus was evaluated using both methods. Grade 3 MRI signal intensity was diagnosed as a meniscal tear radiologically. By use of second-look arthroscopy as the standard, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of postoperative MRI were assessed in each segment of the grafts. Twenty knees were retrospectively enrolled. The specificity, PPV, and accuracy for the anterior one-third were lower than those for the mid body and posterior one-third (specificity of 35.3% v 91.7% and 90%, respectively; PPV of 21.4% v 87.5% and 90.9%, respectively; and accuracy of 45% v 90% and 95%, respectively). However, the sensitivity and NPV were similar among the anterior one-third, mid body, and posterior one-third (sensitivity of 100%, 87.5%, and 100%, respectively; and NPV of 100%, 91.7%, and 100%, respectively). There were no significant differences in the comparison between the diagnostic MRI values of lateral grafts and medial grafts. Of 5 cases that showed grade 3 signal at only the anterior one-third section, 60% had no clinical signs. There were no graft tears in any cases. The anterior one-third of grafts showed low specificity, PPV, and accuracy of postoperative MRI compared with the mid

  9. An evaluation of a public health nutrition workforce development intervention for the nutrition and dietetics workforce.

    PubMed

    Palermo, C; Hughes, R; McCall, L

    2010-06-01

    Workforce development is a key element for building the capacity to effectively address priority population nutrition issues. On-the-job learning and mentoring have been proposed as strategies for practice improvement in public health nutrition; however, there is limited evidence for their effectiveness. An evaluation of a mentoring circle workforce development intervention was undertaken. Thirty-two novice public health nutritionists participated in one of three mentoring circles for 2 h, every 6 weeks, over a 7-month period. Pre- and post-intervention qualitative (questionnaire, interview, mentor diary) and quantitative (competence, time working in public health nutrition) data were collected. The novice public health nutritionists explained the intervention facilitated sharing of ideas and strategies and promoted reflective practice. They articulated the important attributes of the mentor in the intervention as having experience in and a passion for public health, facilitating a trusting relationship and providing effective feedback. Participants reported a gain in competency and had an overall mean increase in self-reported competence of 15% (range 3-48% change; P < 0.05) across a broad range of competency elements. Many participants described re-orienting their practice towards population prevention, with quantifiable increases in work time allocated to preventive work post-intervention. Mentoring supported service re-orientation and competency development in public health nutrition. The nature of the group learning environment and the role and qualities of the mentor were important elements contributing to the interventions effects. Mentoring circles offer a potentially effective strategy for workforce development in nutrition and dietetics.

  10. Evaluation of botulinum toxin type A effectiveness in preventing postoperative intraperitoneal adhesions

    PubMed Central

    Uysal, Erdal

    2017-01-01

    Purpose Postoperative intraperitoneal adhesions (PIAs) are one of the most important problems surgeons have to face after laparotomies. In this study, we aimed to evaluate the effectiveness of local application of botulinum toxin type A (BoNT-A) in various dosages on the prevention of intra-abdominal adhesions in rats with experimental intra-abdominal adhesions. Methods Forty Wistar Albino female rats were randomly separated into 4 groups. The 4 groups were determined as follows: Control (group 1, n = 10); Sham (group 2, n = 10); 10-µg/kg low-dose BoNT-A (group 3, n = 10) and 30-µg/kg high-dose BoNT-A (group 4, n = 10). Subserosal injuries were created on the caecum of all rats. Laparotomy was performed on the fifth day. Adhesion scores, histopathological examination, and E-cadherin expression levels were evaluated. Results General adhesion scores for groups 1 and 2 were determined to be significantly high when compared to group 4 (P < 0.001). A significant difference was also determined between groups 3 and 4 in terms of general adhesion scores (P < 0.05). In pair comparisons, a significant decrease in high-dose BoNT-A group (group 4) when compared to groups 1 and 2 in terms of neovascularization, fibroblast density, collagen deposition and inflammatory cell count was determined (P < 0.05). Conclusion A significant decrease was observed only in postoperative PIAs in the high-dose BoNT-A group between all 4 rat-groups with experimentally created postoperative PIAs. In this study, high-dose BoNT-A is determined to be an effective agent in preventing postoperative PIAs. PMID:28706891

  11. Evaluation of national food and nutrition policy in Albania

    PubMed Central

    Hyska, Jolanda; Burazeri, Genc

    2017-01-01

    Abstract Introduction The paper aims to describe the progress that has been made in the implementation of the Albanian food and nutrition policy since 2003, so as to consider its impacts to date, and to identify strategic priorities/critical areas and priorities for Albania’s future policy on improving the national food and nutrition situation. Methods In 2011-2012, an expert group applied an intersectoral participatory approach to evaluate the implementation of Food and Nutrition Action Plan 2003-08 in Albania. The experts employed the quantitative method, using a 9 question logical assessment matrix to measure the achievements of the individual goals of the Plan, and a qualitative tool for the interview of an interdisciplinary sample of 68-key informants-persons operating in public health nutrition, food safety and food availability related subfields, from a wide range of pertinent institutions and stakeholders. Results The quantitative and qualitative assessment revealed that the implementation process has faced serious barriers linked to the design of the plan, which did not accurately anticipate a theoretical framework, or structured methods for its implementation. Other impeding factors included the lack of institutional/infrastructure support, lack of intersectoral coordination and motivation, as well as insufficient capacities and know-how. Intersectoral response to the multifaceted nature of double burden of malnutrition is of key importance to improve nutritional wellbeing and health outcomes in Albania. Conclusions Participatory approaches that involve all relevant sectors and actors in the development, monitoring and evaluation of the implementation of public health policies based on comprehensive action-oriented assessments are promising and should be further supported. PMID:28289471

  12. Evaluation of pirfenidone as a new postoperative antiscarring agent in experimental glaucoma surgery.

    PubMed

    Zhong, Hua; Sun, Guoying; Lin, Xianchai; Wu, Kaili; Yu, Minbin

    2011-05-16

    To investigate whether topical administration of pirfenidone eye drops could be used to prevent postoperative scarring in a rabbit model of experimental glaucoma filtration surgery. In a randomized, controlled, masked-observer study, 40 rabbits underwent trabeculectomy in the right eyes and randomly received postoperative administration of 0.1% or 0.5% pirfenidone, perioperative mitomycin C (0.25 mg/mL), or no treatment. Bleb characteristics and functions were evaluated over a period of 4 weeks. The animals were killed on days 7, 14, and 28. Histopathology and immunohistochemistry were performed to determine the amount of scarring and fibrosis. Ocular toxicity was assessed by the Draize test, histopathology, and electron microscope. The four treatment groups were similar with respect to intraocular pressure and anterior chamber depth. Pirfenidone 0.5% significantly prolonged bleb survival, and the blebs were larger and higher than those in the control group (P < 0.05); the 0.1% pirfenidone concentration was less effective. Furthermore, the histology and immunohistology results showed that the 0.5% pirfenidone and mitomycin C groups had less scarring at days 7 to 28 than did the controls. Toxicity assessments showed that pirfenidone did not damage the rabbit eyes. Postoperative use of 0.5% pirfenidone eye drops was associated with improved trabeculectomy bleb survival in a rabbit model. Pirfenidone eye drops may be a safe and effective antiscarring agent in glaucoma filtration surgery.

  13. [Evaluation of postoperative mucosa and skin temperature after surgery for impacted third molar].

    PubMed

    Sortino, F; Messina, G; Pulvirenti, G

    2003-01-01

    Surgery for impacted third molar is often characterized, in the postoperative period, by pain, trismus and swelling. The study evaluates temperature variations of mucosa and skin after application of ice packs, in three different modalities, to the region overlying the surgical site. The goal was to identify any correlation between variations of temperature and postoperative clinical symptoms. For this purpose we selected 54 patients programmed for impacted third molar surgery. The patients were divided into three groups of 18. Time and frequency of application of the ice pack varied in the three groups; 5'/30' (group 1); 10'/60' (group 2); 20'/60' (group 3). During the four hours following surgery, temperatures of mucosa and of skin at the surgical site were measured with high-precision thermocouples, maximum response 5". The results indicate that application of an ice pack for 5'/30' or for 10'/60' controls the temperature of the mucosa post-surgery more effectively, and that the duration of surgery appears not to influence temperature variations. In the postoperative phase we recommend a rational application of ice packs appropriate to the constitution of each patient.

  14. Factors influencing postoperative movement in displaced femoral neck fractures: evaluation by conventional radiography and stereoradiography.

    PubMed

    Ragnarsson, J I; Kärrholm, J

    1992-01-01

    Postoperative movement in 46 displaced femoral neck fractures was studied using roentgen stereophotogrammetric analysis (RSA). Thirty-four fractures became stable, all within 1 year. Measurements on pre- and postreduction radiographs and scintimetry were performed to evaluate factors of importance in healing, redisplacement, and nonunion. Thirty-three fractures were treated with two hook-pins with (7 cases) or without (26 cases) a plate, and 13 were treated with two cancellous screws. Presence of intermediate fracture fragments and fixation with two screws implied increased movement of the femoral head center during the postoperative period. Remaining ad latus displacement on the anteroposterior or lateral view after reduction of more than 1 mm and low scintimetric uptake implied increased risk of redisplacement or pseudarthrosis. Increased displacement of the femoral head center during the first postoperative month was recorded in fractures that did not heal. The magnitude of the femoral head rotations did not differ between the implants, but smaller screw axis rotations were noted in fractures that subsequently healed. In most hips fixated with screws, the instant center of femoral head rotation went through the femoral head or neck, whereas hook-pin fixation more commonly was associated with screw axis position within or close to the trochanteric region, suggesting a more durable fixation in the femoral head of this device.

  15. Nutrition

    MedlinePlus

    Nutrition Health Education During the 2 years preceding the study: • The percentage of states that provided funding for staff development or offered staff development on nutrition and dietary behavior to those who teach health ...

  16. Nutrition

    MedlinePlus

    ... into your diet. These include brightly colored and dark fruits and vegetables. Balance the food you eat ... can also order your free copy of Nutrition Matters and visit our Ask about Nutrition forum. << Back ...

  17. Functional and nutritional evaluation of supplementary food formulations.

    PubMed

    Khanam, Anjum; Chikkegowda, Rashmi Kumkum; Swamylingappa, Bhagya

    2013-04-01

    Two type of ready to eat supplementary food formulations were developed by roller drying based on wheat, soy protein concentrate, whey protein concentrate, and green gram flour and were fortified with vitamins and minerals to meet the one third of the Recommended daily allowance (RDA). The supplementary food formulations contained 20-21% protein, 370-390 kcal of energy and 2,300 μg of β-carotene per 100 g serving. The physico-chemical, functional and nutritional characteristics were evaluated. The chemical score indicated that sulphur containing amino acids were the first limiting in both the formulations. The calculated nutritional indices, essential amino acid index, biological value, nutritional index and C-PER were higher for formula II. Rat bioassay showed higher PER (2.3) for formula II compared to formula I (2.1). The bioaccessibility of iron was 23%. Sensory studies indicated that the products were acceptable with a shelf life of 1 year under normal storage condition. However, the formulations were nutritionally better than only cereal based supplementary food formulations available commercially. The product could be served in the form of porridge with water/milk or in the form of small laddu.

  18. Evaluation of nutritive quality of common carp, Cyprinus carpio L.

    NASA Astrophysics Data System (ADS)

    Ljubojević, D.; Đorđević, V.; Ćirković, M.

    2017-09-01

    Common carp is the most important commercial fish species in Serbia. This fish is a valuable source of nutritive components and plays a role in healthy human nutrition. This review evaluates the nutritive quality of common carp including proximate and fatty acid compositions as well as their effects on human health. The fat content and fatty acid composition of carp have been shown to vary due to different environmental factors and particularly due to nutrition. Technology of production and composition of planktonic and benthic organisms in fish ponds have been recognised as significant factors affecting carp meat quality and desirable chemical and fatty acid composition. Carp meat quality but also production parameters and fish health are positively influenced by a balanced feed mixture. Due to the low content of saturated fatty acids and cholesterol plus high levels of unsaturated fatty acids, common carp meat consumption could be linked with reduced risk of different heart diseases in humans. Also, fish proteins can have many beneficial roles in the preservation of human health. This paper emphasises the importance of consumption of common carp in order to prevent many diseases and preserve human health.

  19. Physical methods for evaluating the nutrition status of hemodialysis patients.

    PubMed

    Marcelli, Daniele; Wabel, Peter; Wieskotten, Sebastian; Ciotola, Annalisa; Grassmann, Aileen; Di Benedetto, Attilio; Canaud, Bernard

    2015-10-01

    This article aims to provide an overview of the different nutritional markers and the available methodologies for the physical assessment of nutrition status in hemodialysis patients, with special emphasis on early detection of protein energy wasting (PEW). Nutrition status assessment is made on the basis of anamnesis, physical examination, evaluation of nutrient intake, and on a selection of various screening/diagnostic methodologies. These methodologies can be subjective, e.g. the Subjective Global Assessment score (SGA), or objective in nature (e.g. bioimpedance analysis). In addition, certain biochemical tests may be employed (e.g. albumin, pre-albumin). The various subjective-based and objective methodologies provide different insights for the assessment of PEW, particularly regarding their propensity to differentiate between the important body composition compartments-fluid overload, fat mass and muscle mass. This review of currently available methods showed that no single approach and no single marker is able to detect alterations in nutrition status in a timely fashion and to follow such changes over time. The most clinically relevant approach presently appears to be the combination of the SGA method with the bioimpedance spectroscopy technique with physiological model and, additionally, laboratory tests for the detection of micro-nutrient deficiency.

  20. [Nutritional risk in surgery evaluated by body mass index adjusted or not to elderly patients].

    PubMed

    Bicudo-Salomão, Alberto; Aguilar-Nascimento, José Eduardo de; Caporossi, Cervantes

    2006-01-01

    Standard body mass index cut-off points for malnutrition are routinely used for adults independently of their age. The hypothesis of this study was that a cut-off point higher than the usual for the diagnosis of malnutrition might be more precise to access the nutritional risk of aged surgical patients. To evaluate the morbimortality in aged surgical patients and its association with nutritional status assessed by body mass index using either the standard and a higher cut-off point for malnutrition. All patients admitted for operative procedures (n = 1,912) were allocated to either two groups: <65 years (n = 1,627) or >65 years old (n = 285). The body mass index was used to access the nutritional status. Two different cut-off points for malnutrition (18.5 or 24 kg/m(2)) were used in the group of older patients. Endpoints of the study were length of stay, morbidity and mortality. Length of stay was higher in patients over 65 years (6 [1-75] days vs. 4 [1-137] days). Both postoperative complications (37/285; 13.0% vs. 109/1627; 6.7%; OR 2.1; IC95% 1.40-3.09) and deaths (15/285; 5.3% vs. 34/1627; 2.1%; OR 2.6; IC95% 1.40-4.84) were most common in the older group. Using a higher cut-off (24 kg/m(2)), the length of stay (8 [1-75] days vs. 4 [1-43] days), postoperative complications (28/152; 18.4% versus 9/133; 6.8%; OR 3,1; IC95% 1.41-6.86) and re-operations (16/152; 10.5% versus 3/133; 2.2%; OR 5.1; IC95% 1.45-17.91) were greater in malnourished patients. However these correlations were not statistically significant with the cut-off point for malnutrition in 18.5 kg/m(2). Morbimortality is higher in surgical patients over 65 years old. In these, the cut-off point set in 24 kg/m(2) was most associated with the occurrence of postoperative complications, re-operations and length of stay.

  1. Fecal calprotectin for evaluating postoperative recurrence of Crohn's disease: a meta-analysis of prospective studies.

    PubMed

    Qiu, Yun; Mao, Ren; Chen, Bai-li; He, Yao; Zeng, Zhi-rong; Xue, Ling; Song, Xin-ming; Li, Zi-ping; Chen, Min-hu

    2015-02-01

    Fecal calprotectin (FC) levels have been extensively reported to correlate with clinical and endoscopic activities in Crohn's disease (CD); however, the utility of FC levels in the postoperative setting remains to be determined. Using meta-analysis, we aimed to evaluate the utility of FC as a noninvasive marker of recurrence in patients with CD who had undergone previous surgical resection. An electronic search using keywords related to CD and FC was performed in multiple electronic resources from 1966 to March 2014. The extracted data were pooled using a hierarchical summary receiver operating curve model. Ten articles met the inclusion criteria, and methodological quality was determined in detail for each study. The 10 studies presented FC levels in 613 postoperative CD patients. The pooled sensitivity and specificity values for assessing suspected endoscopic recurrence were 0.82 (95% confidence interval (CI), 0.73-0.89, 8 studies, n = 391) and 0.61 (95% CI, 0.51-0.71), respectively. The overall positive and negative likelihood ratios were 2.11 (95% CI, 1.68-2.66) and 0.29 (95% CI, 0.197-0.44), respectively. The pooled sensitivity and specificity values for evaluating clinical relapse were 0.59 (95% CI, 0.47-0.71; 3 studies, n = 183) and 0.88 (95% CI, 0.80-0.93), respectively. The overall positive and negative likelihood ratios were 5.10 and 0.47, respectively. As a simple and noninvasive marker, FC is useful in evaluating recurrence of postoperative patients with CD.

  2. Anthropometric evaluation and micronutrients intake in patients submitted to laparoscopic Roux-en-Y gastric bypass with a postoperative period of ≥ 1 year.

    PubMed

    Mercachita, Tânia; Santos, Zélia; Limão, Jorge; Carolino, Elisabete; Mendes, Lino

    2014-01-01

    Bariatric surgery is indicated as the most effective treatment for morbid obesity; the Roux-en-Y gastric bypass (RYGB) is considered the procedure of choice. However, nutritional deficiency may occur in the postoperative period as a result of reduced gastric capacity and change in nutrients absorption in the gastrointestinal tract. The prescription of vitamin and mineral supplementation is a common practice after RYGB; however, it may not be sufficient to prevent micronutrient deficiencies. The aim of this study was to quantify the micronutrient intake in patients undergoing RYGB and verify if the intake of supplementation would be enough to prevent nutritional deficiencies. The study was conducted on 60 patients submitted to RYGB. Anthropometric, analytical, and nutritional intake data were assessed preoperatively and 1 and 2 years postoperatively. The dietary intake was assessed using 24-h food recall; the values of micronutrients evaluated (vitamin B12, folic acid, iron, and calcium) were compared to the dietary reference intakes (DRI). There were significant differences (p < 0.05) between excess weight loss at the first and second year (69.9 ± 15.3 vs 9.6 ± 62.9 %). In the first and second year after surgery, 93.3 and 94.1 % of the patients, respectively, took the supplements as prescribed. Micronutrient deficiencies were detected in the three evaluation periods. At the first year, there was a significant reduction (p < 0.05) of B12, folic acid, and iron intake. Despite taking vitamin and mineral supplementation, micronutrient deficiencies are common after RYGB. In the second year after surgery, micronutrient intake remains below the DRI.

  3. Evaluation of General Nutrition Knowledge in Australian Military Personnel.

    PubMed

    Kullen, Charina J; Iredale, Laura; Prvan, Tania; O'Connor, Helen T

    2016-02-01

    Sound nutrition knowledge and a balanced diet are essential for operational readiness and optimal health of military personnel. Few studies have examined nutrition knowledge in this population. To assess the level of general nutrition knowledge across military occupations (ie, officers [OFFRs], physical training instructors [PTIs], cooks [CKs], and soldiers [SOLs]) compared with a civilian, community (C) sample. Cross-sectional study. Convenience sample of Australian military (M) and C participants. General nutrition knowledge measured using the validated General Nutrition Knowledge Questionnaire (GNKQ). Knowledge scores and the influence of demographic characteristics (eg, age, sex, level of education, and living arrangement) within and between M and C groups were evaluated. Analysis of variance, general linear models, independent-samples median test, t tests, χ(2) test, and Spearman's correlation. A sample of 1,295 participants were recruited with 622 (48%) from C. The M sample (n=673) consisted of SOLs 62.1%, OFFRs 9.1%, PTIs 12.8%, and CKs 16.0%. Mean age was higher for C than M (35.5±14 y vs 29.7±9.2 y; P<0.001). However, SOLs were younger and OFFRs older than other groups (P<0.001). The M sample had more men (91.1% vs 39.4%; P<0.001). The OFFRs, PTIs, and C members had similar total GNKQ scores (62.8%, 61.9%, and 64.7%, respectively) with these groups higher (P<0.001) than CKs and SOLs (56.4% and 50.6%, respectively). Across all participants, there was a positive relationship between total GNKQ score and age, female sex, and tertiary education (all P values <0.001). Significant differences identified in total GNKQ score between groups remained after adjusting for demographic factors. Young men (M or C) without tertiary education had the lowest GNKQ scores. Because low general nutrition knowledge may be detrimental to dietary intake, health, and operational readiness in military personnel, nutrition education programs particularly targeted at SOLs and CKs

  4. [Evaluation of occupational risk factors, nutritional habits and nutritional status in industrial workers].

    PubMed

    Domagała-Dobrzycka, M

    2000-01-01

    The objective of this study was to examine the relationship between selected risk factors at the workplace and health indices in relation to nutritional habits and nutritional status in industrial workers. Exposure to physical and chemical risk factors and their impact on health in the province of Szczecin and in Poland was evaluated basing on data published in the Yearbooks of the Province of Szczecin, the Central Statistics Bureau (GUS) and Regional Inspectorate of Labor (OIP) in Szczecin. A random selection of plants in Szczecin was done and workplaces with chemical and physical risk levels exceeding the highest acceptable values were identified. Measurements of concentrations of chemicals and intensity of physical factors were performed by Work Environment Research Laboratories of the plants and by the laboratory of the Sanitary and Epidemiological Center in Szczecin. Eighty-eight men exposed to occupational risk factors were randomly selected. The mean period of exposure in that group was approximately ten years. The control group was composed of male workers (n = 83) not exposed to any of the risk factors in question (Tab. 3). Nutritional habits and nutritional status were studied during summer/autumn and winter/spring periods. Dietary survey consisted of the last 24-hour nutrient intake questionnaire. Nutritional status evaluation was based on body mass index (BMI) values and results of the following laboratory tests: blood cell count, levels of total protein, prealbumin, retinol binding protein (RBP), magnesium, inorganic phosphorus, and ascorbic acid. The following results were obtained: 1. Physical factors constituted the most frequent source of occupational risk in the province of Szczecin and in Poland in 1990-1994 (Tab. 1); 2. The incidence of occupational risk and occupational disease morbidity rates in 1990-1994 were lower for the province of Szczecin than the average for Poland; 3. The rate of fatal accidents at work in 1982-1994 was higher for the

  5. Evaluation of nutritional status in children with refractory epilepsy

    PubMed Central

    Bertoli, S; Cardinali, S; Veggiotti, P; Trentani, C; Testolin, G; Tagliabue, A

    2006-01-01

    Background children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting) and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy. Methods 17 children with refractory epilepsy (13 boys and 4 girls; mean age 9 ± 3,2 years; Body Mass Index 15,7 ± 3,6) underwent an anthropometric assessment, body composition evaluation by dual-energy X-ray absorptiometry, detailed dietetic survey and measurement of resting energy expenditure by indirect calorimetry. Weight-for-age, height-for-age (stunting) and weight-for-height (wasting) were estimated compared to those of a reference population of the same age. Results 40% of children were malnourished and 24% were wasted. The nutritional status was worse in the more disabled children. Dietary intake resulted unbalanced (18%, 39%, 43% of total daily energy intake derived respectively from protein, lipid and carbohydrate). Adequacy index [nutrient daily intake/recommended allowance (RDA) × 100] was < 60% for calcium iron and zinc. Conclusion many children with refractory epilepsy would benefit from individual nutritional assessment and management as part of their overall care. PMID:16640779

  6. Evaluation of Early Postoperative Neurological Complications Following Living Donor Liver Transplantation

    PubMed Central

    OTAN, Emrah; AYDIN, Cemalettin; YÖNDER, Hüseyin; KAYAALP, Cüneyt; KAPLAN, Yüksel; YILMAZ, Sezai

    2015-01-01

    Introduction Liver transplantation is one of the best treatment options for end-stage liver disease. In Turkey, living donor liver transplantation (LDLT) is performed more frequently than cadaveric transplantation, because organ donation is unpopular in our country. Neurological complications contribute to poor postoperative outcomes after liver transplantation. In the present study, we aimed to evaluate the outcomes of LDLT patients in whom such complications developed early during postoperative follow-up in the intensive care unit. Methods Of 217 LDLTs performed between August 2011 and August 2012, neurology consultations were arranged for 29 patients (13.36%) because of development of new-onset neurological symptoms and/or findings in patients with neurologically uneventful preoperative histories. We retrospectively collected data on age, gender, primary disease, Model for End-Stage Liver Disease (MELD) score, and postoperative hospitalization duration of those who survived. The indications for neurological consultation and diagnoses were categorized into acute confusion/encephalopathy, epileptic seizures, leukoencephalopathy, and focal neurological deficits. The immunosuppressive treatment regimens prescribed were also considered. The outcomes of the 2 groups (with and without neurological complications) were compared. Results The mean patient age was 44.52±16.24 years, and males predominated (65.5%, n=19). Acute confusion/encephalopathy was the most frequent complication (62.1%, n=18), followed by epileptic seizures (27.6%, n=8), cerebrovascular disease (6.9%, n=2), and leukoencephalopathy (3.4%, n=1). Statistically significant between-group differences in age (44.5±16.2 vs. 34.33±20.98 years; p<0.001), and proportions of patients with a disease of viral etiology (55.17% vs. 35.63%, p<0.05), were evident. Mortality was significantly higher in the group with neurological complications (65.5% vs. 37.32%, p<0.05). The duration of postoperative hospitalization

  7. School nutrition guidelines: overview of the implementation and evaluation.

    PubMed

    Gregorič, Matej; Pograjc, Larisa; Pavlovec, Alenka; Simčič, Marjan; Gabrijelčič Blenkuš, Mojca

    2015-06-01

    To holistically evaluate the extent of implementation of dietary guidelines in schools and present various monitoring systems. The study comprises three methods: (i) a cross-sectional survey (process evaluation); (ii) an indicator-based evaluation (menu quality); and (iii) a 5 d weighed food record of school lunches (output evaluation). Slovenian primary schools. A total 234 food-service managers from 488 schools completed a self-administrated questionnaire for process evaluation; 177 out of 194 randomly selected schools provided menus for menu quality evaluation; and 120 school lunches from twenty-four schools were measured and nutritionally analysed for output evaluation. The survey among food-service managers revealed high levels of implementation at almost all process evaluation areas of the guidelines. An even more successful implementation of these guidelines was found in relation to organization cultural issues as compared with technical issues. Differences found in some process evaluation areas were related to location, size and socio-economic characteristics of schools. Evaluation of school menu quality demonstrated that score values followed a normal distribution. Higher (better) nutrition scores were found in larger-sized schools and corresponding municipalities with higher socio-economic status. School lunches did not meet minimum recommendations for energy, carbohydrates or dietary fibre intake, nor for six vitamins and three (macro, micro and trace) elements. The implementation of the guidelines was achieved differently at distinct levels. The presented multilevel evaluation suggests that different success in implementation might be attributed to different characteristics of individual schools. System changes might also be needed to support and improve implementation of the guidelines.

  8. An Evaluation of the Nutrition Education and Training Program: Project Summary.

    ERIC Educational Resources Information Center

    St. Pierre, Robert G.

    This project summary reviews and extends the findings of prior reports made by Abt Associates, Inc. (Cambridge, Massachusetts) on the Nutrition Education and Training (NET) program, synthesizes evaluation efforts in nutrition education, and presents a set of conclusions based on the evaluations of nutrition programs. Chapter 1 presents background…

  9. A re-evaluation of energy expenditure during parenteral nutrition.

    PubMed Central

    Quebbeman, E J; Ausman, R K; Schneider, T C

    1982-01-01

    Nutritional support regimens are currently based on estimates of energy expenditure, and these estimates are then increased substantially in patients with severe trauma or sepsis because of a presumed hypermetabolic state. Forty-four patients on parenteral nutrition were evaluated using indirect calorimetry to measure actual energy expenditure, and an attempt was made to correlate metabolic rate with clinical diagnosis. We found no statistical difference in metabolic rates between groups of patients classified as malnourished, stressed, or catabolic, If high levels of nonprotein energy substrates are to be administered to a catabolic or "hypermetabolic" patient group, the justification must be on a basis other than a significant increase in actual rate of energy expenditure. PMID:6800313

  10. Acromioclavicular dislocation: postoperative evaluation of the coracoclavicular ligaments using magnetic resonance☆

    PubMed Central

    Faria, Rafael Salomon Silva; Ribeiro, Fabiano Rebouças; Amin, Bruno de Oliveira; Tenor Junior, Antonio Carlos; da Costa, Miguel Pereira; Filardi Filho, Cantídio Salvador; Batista, Cleber Gonçalves; Brasil Filho, Rômulo

    2015-01-01

    Objective To radiologically evaluate the healing of the coracoclavicular ligaments after surgical treatment for acromioclavicular dislocation. Methods Ten patients who had undergone surgical treatment for acromioclavicular dislocation via a posterosuperior route at least one year earlier were invited to return for radiological assessment using magnetic resonance. This evaluation was done by means of analogy with the scale described in the literature for studying the healing of the anterior cruciate ligament of the knee and for measuring the healed coracoclavicular ligaments. Results A scar structure of fibrous appearance had formed in 100% of the cases. In 50% of the cases, the images of this structure had a good appearance, while the other 50% were deficient. Conclusion Late postoperative evaluation using magnetic resonance, on patients who had been treated for acute acromioclavicular dislocation using a posterosuperior route in the shoulder, showed that the coracoclavicular ligaments had healed in 100% of the cases, but that this healing was deficient in 50%. PMID:26229916

  11. Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins

    PubMed Central

    Saliba Júnior, Orlando Adas; Giannini, Mariangela; Mórbio, Ana Paula; Saliba, Orlando; Rollo, Hamilton Almeida

    2014-01-01

    Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM). Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM. Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P < 0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins. Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery. PMID:24696783

  12. Nutritional evaluation of children with chronic cholestatic disease.

    PubMed

    da Silva, Francislaine Veiga; Ferri, Priscila Menezes; Nascentes Queiroz, Thaís Costa; de Souza Haueisen Barbosa, Pamela; Cassiano de Oliveira, Maria Cristina; de Melo Pereira, Laura Jácome; Simões E Silva, Ana Cristina; Penna, Francisco José; Druve Tavares Fagundes, Eleonora; Ferreira, Alexandre Rodrigues

    2016-01-01

    To evaluate the nutritional status of children with persistent cholestasis and to compare the anthropometric indices between children with and without liver cirrhosis and children with and without jaundice. Children with persistent cholestasis, i.e. increased direct bilirrubin or changes in the canalicular enzyme gamma-glutamyl transferase (GGT), were included. The anthropometric measures were weight (W), height or length (H), arm circumference (AC), triceps skinfold thickness (TST), arm muscle circumference (AMC), and body mass index (BMI). Ninety-one children with cholestasis, with current median age of 12 months, were evaluated. W/age (A) and H/A indices below -2 Z-scores were observed in 33% and 30.8% of patients, respectively. Concerning the W/H index and BMI, only 12% and 16% of patients, respectively, were below -2 Z-scores. Regarding AC, 43.8% of 89 evaluated patients had some depletion. Observing the TST, 64% of patients had depletion, and 71.1% of the 45 evaluated patients had some degree of depletion regarding the ACM index. Evaluation using weight in patients with chronic liver diseases may overestimate the nutritional status due to visceromegaly, subclinical edema, or ascites. Indices that correlate weight and height, such as W/H and BMI, may also not show depletion because of the chronic condition in which there are depletion of both weight and height. TST, AC, and ACM are parameters that better estimate nutritional status and should be part of the management of patients with liver diseases and cholestasis. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  13. CT enterography in evaluating postoperative recurrence of Crohn's disease after ileocolic resection: complementary role to endoscopy.

    PubMed

    Mao, Ren; Gao, Xiang; Zhu, Zhen-hua; Feng, Shi-ting; Chen, Bai-li; He, Yao; Cui, Yi; Li, Zi-ping; Hu, Pin-jin; Chen, Min-hu

    2013-04-01

    Ileocolonoscopy is the gold standard to assess postoperative recurrence (POR) in patients with Crohn's disease (CD) who have undergone ileocolic resection. Although computed tomographic enterography (CTE) yields striking findings in the small bowel of CD, its role in POR is undefined. The aim of this study was to compare ileocolonoscopy and CTE for evaluating POR in CD. The analysis included 32 patients with CD with ileocolic resection. Ileocolonoscopy and CTE were performed within 1 week. Endoscopic recurrence was defined using Rutgeerts score (i0-i4), whereas CTE recurrence was assessed according to a previously validated CTE score (CTE0-CTE3). Patients were followed up for a maximum of 30 months, and the primary endpoint was reoperation. There was a good correlation between endoscopic and CTE recurrence (r = 0.782, P < 0.0001). Moreover, CTE identified the presence of jejunal and proximal ileum disease (n = 7), fistula (n = 3), and abscess (n = 4). Therapeutic management was thereby modified in 8 of 32 patients (25.0%). Eleven patients received major reoperation. There was no significant difference regarding the rate of reoperation between subgroups' Rutgeerts score i3-4 and i0-2 (P > 0.05), whereas there was significant difference between subgroups' CTE2-CTE3 and CTE0-CTE1 (P < 0.05). CTE is a reliable method in assessing POR in patients with CD who have undergone ileocolic resection. CTE may serve as an important complementary tool to endoscopy for evaluation of the postoperative course of CD.

  14. A Clinical Experimental Model to Evaluate Analgesic Effect of Remote Ischemic Preconditioning in Acute Postoperative Pain

    PubMed Central

    Pereira, Francisco Elano Carvalho; Mello, Irene Lopes; Pimenta, Fernando Heladio de Oliveira Medeiros; Costa, Debora Maia; Wong, Deysi Viviana Tenazoa; Fernandes, Claudia Regina; Lima Junior, Roberto César; Gomes, Josenília M. Alves

    2016-01-01

    This study aims to evaluate the viability of a clinical model of remote ischemic preconditioning (RIPC) and its analgesic effects. It is a prospective study with twenty (20) patients randomly divided into two groups: control group and RIPC group. The opioid analgesics consumption in the postoperative period, the presence of secondary mechanical hyperalgesia, the scores of postoperative pain by visual analog scale, and the plasma levels interleukins (IL-6) were evaluated. The tourniquet applying after spinal anesthetic block was safe, producing no pain for all patients in the tourniquet group. The total dose of morphine consumption in 24 hours was significantly lower in RIPC group than in the control group (p = 0.0156). The intensity analysis of rest pain, pain during coughing and pain in deep breathing, showed that visual analogue scale (VAS) scores were significantly lower in RIPC group compared to the control group: p = 0.0087, 0.0119, and 0.0015, respectively. There were no differences between groups in the analysis of presence or absence of mechanical hyperalgesia (p = 0.0704) and in the serum levels of IL-6 dosage over time (p < 0.0001). This clinical model of remote ischemic preconditioning promoted satisfactory analgesia in patients undergoing conventional cholecystectomy, without changing serum levels of IL-6. PMID:27446611

  15. Immortal Time Bias: A Frequently Unrecognized Threat to Validity in the Evaluation of Postoperative Radiotherapy

    SciTech Connect

    Park, Henry S.; Gross, Cary P.; Makarov, Danil V.; Yu, James B.

    2012-08-01

    Purpose: To evaluate the influence of immortal time bias on observational cohort studies of postoperative radiotherapy (PORT) and the effectiveness of sequential landmark analysis to account for this bias. Methods and Materials: First, we reviewed previous studies of the Surveillance, Epidemiology, and End Results (SEER) database to determine how frequently this bias was considered. Second, we used SEER to select three tumor types (glioblastoma multiforme, Stage IA-IVM0 gastric adenocarcinoma, and Stage II-III rectal carcinoma) for which prospective trials demonstrated an improvement in survival associated with PORT. For each tumor type, we calculated conditional survivals and adjusted hazard ratios of PORT vs. postoperative observation cohorts while restricting the sample at sequential monthly landmarks. Results: Sixty-two percent of previous SEER publications evaluating PORT failed to use a landmark analysis. As expected, delivery of PORT for all three tumor types was associated with improved survival, with the largest associated benefit favoring PORT when all patients were included regardless of survival. Preselecting a cohort with a longer minimum survival sequentially diminished the apparent benefit of PORT. Conclusions: Although the majority of previous SEER articles do not correct for it, immortal time bias leads to altered estimates of PORT effectiveness, which are very sensitive to landmark selection. We suggest the routine use of sequential landmark analysis to account for this bias.

  16. The effect of preoperative nutritional status on postoperative outcomes in children undergoing surgery for congenital heart defects in San Francisco (UCSF) and Guatemala City (UNICAR).

    PubMed

    Radman, Monique; Mack, Ricardo; Barnoya, Joaquin; Castañeda, Aldo; Rosales, Monica; Azakie, Anthony; Mehta, Nilesh; Keller, Roberta; Datar, Sanjeev; Oishi, Peter; Fineman, Jeffrey

    2014-01-01

    The objective of this study was to determine the association between preoperative nutritional status and postoperative outcomes in children undergoing surgery for congenital heart defects (CHD). Seventy-one patients with CHD were enrolled in a prospective, 2-center cohort study. We adjusted for baseline risk differences using a standardized risk adjustment score for surgery for CHD. We assigned a World Health Organization z score for each subject's preoperative triceps skin-fold measurement, an assessment of total body fat mass. We obtained preoperative plasma concentrations of markers of nutritional status (prealbumin, albumin) and myocardial stress (B-type natriuretic peptide [BNP]). Associations between indices of preoperative nutritional status and clinical outcomes were sought. Subjects had a median (interquartile range [IQR]) age of 10.2 (33) months. In the University of California at San Francisco (UCSF) cohort, duration of mechanical ventilation (median, 19 hours; IQR, 29 hours), length of intensive care unit stay (median, 5 days; IQR 5 days), duration of any continuous inotropic infusion (median, 66 hours; IQR 72 hours), and preoperative BNP levels (median, 30 pg/mL; IQR, 75 pg/mL) were associated with a lower preoperative triceps skin-fold z score (P < .05). Longer duration of any continuous inotropic infusion and higher preoperative BNP levels were also associated with lower preoperative prealbumin (12.1 ± 0.5 mg/dL) and albumin (3.2 ± 0.1; P < .05) levels. Lower total body fat mass and acute and chronic malnourishment are associated with worse clinical outcomes in children undergoing surgery for CHD at UCSF, a resource-abundant institution. There is an inverse correlation between total body fat mass and BNP levels. Duration of inotropic support and BNP increase concomitantly as measures of nutritional status decrease, supporting the hypothesis that malnourishment is associated with decreased myocardial function. Copyright © 2014 The American

  17. NuFit: nutrition and fitness CBPR program evaluation.

    PubMed

    McKinney, Chelsea; Bishop, Virginia; Cabrera, Kathy; Medina, Roxane; Takawira, Desire; Donate, Nilmari; Rodriguez, Jose Luis; Guevara, Beti

    2014-01-01

    The present study combines community-based participatory research (CBPR) and peer education to create NuFit, a nutrition and fitness curriculum, adapted by community and student peer leaders for Latino and African-American high-school students in Chicago. The purpose of this pilot study was to assess the feasibility and efficacy of the NuFit curriculum to improve the knowledge, attitudes, and behaviors regarding nutrition and fitness for minority and adolescent student populations. The NuFit curriculum improved students' short-term self-reported behaviors and attitudes around nutrition and fitness. The NuFit curriculum shows promise as one mechanism to help prevent and combat childhood obesity by fostering healthy attitudes and behaviors during the critical developmental stage of adolescence. Involvement of and collaboration between community stakeholders and youth appeared to increase the likelihood of NuFit's cultural relevance and sustainability. More work is necessary to evaluate the long-term effects of NuFit.

  18. Development and evaluation of continuing education course in renal nutrition.

    PubMed

    Karavetian, Mirey; Rizk, Rana

    2016-02-01

    Competent renal dietitians are crucial for better patient compliance and clinical outcomes, specifically in critical settings. The aim of this study was to develop and evaluate an evidence-based course in renal dietetics for dietitians working in health care systems where dietetic specialization is absent. Fifteen licensed dietitians working with hemodialysis patients in Lebanon were randomly recruited to participate in the course. The latter was developed by the study's primary investigator, according to evidence-based practice guidelines, and focused on all aspects of renal nutrition. Total course duration was 28 hours spread over a 2 month period. Dietitians' knowledge in renal nutrition was tested pre- and post-training through a 23-item questionnaire; the total score was expressed in percentage (< 60% score indicated insufficient knowledge). Paired-samples t test was used for statistical analysis. Overall knowledge of the dietitians significantly improved post-training and reached satisfactory levels (pre: 38.75 ± 17.20%, post: 62.08 ± 21.85%). Sub-analysis of the change in the knowledge showed significant and satisfactory improvement only in 3 topics: 1) correct body weight use in calculations, 2) energy estimation method and 3) phosphorus management. Knowledge in the fluid management significantly improved but did not achieve a satisfactory level. The course significantly improved dietitians' knowledge in renal nutrition. If adopted as part of the continuing education of dietitians in countries that lack dietetic specializations, it may serve the first step towards improving health care practice.

  19. The association between performance parameters of physical fitness and postoperative outcomes in patients undergoing colorectal surgery: An evaluation of care data.

    PubMed

    Heldens, A F J M; Bongers, B C; Lenssen, A F; Stassen, L P S; Buhre, W F; van Meeteren, N L U

    2017-09-07

    Preoperative cardiorespiratory fitness, as measured by cardiopulmonary testing or estimated using the less sophisticated incremental shuttle walk test, timed up-and-go test or stair climb test is known to be associated with postoperative outcome. This study aimed to evaluate whether parameters of physical fitness are associated with postoperative outcome in patients with colorectal cancer scheduled for elective resection. Perioperative data of patients who underwent colorectal resection at Maastricht University Medical Center were retrospectively analyzed. Preoperative variables (e.g., age, body mass index, comorbidities, physical fitness, tumour characteristics, neoadjuvant treatment, American Society of Anesthesiologists score, level of perceived fatigue and nutritional status) were compared with postoperative outcomes. Out of 80 consecutive cases, 75 (93.8%) were available for analysis (57.3% male, median ± interquartile range age 69.2 ± 11.7 years). A higher Charlson comorbidity index (odds ratio (OR) of 1.604, 95% confidence interval (CI) 1.120-2.296), worse functional exercise capacity (in meters, OR of 0.995, 95% CI 0.991-1.000), a lower physical activity level (in min/day, OR of 0.994, 95% CI 0.988-1.000), and a higher level of perceived fatigue (OR of 1.047, 95% CI 1.016-1.078), were associated with a slower time to recovery of physical functioning. A better functional exercise capacity was associated with a lower OR (OR of 0.995, 95% CI 0.991-1.000) for non-surgical complications. There is an association between preoperative parameters and postoperative outcomes in patients with colorectal cancer scheduled for resection. Patients benefit from an optimal preoperative physical fitness level. Specific interventions can target this physical fitness level. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  20. Development and evaluation of a home enteral nutrition team.

    PubMed

    Dinenage, Sarah; Gower, Morwenna; Van Wyk, Joanna; Blamey, Anne; Ashbolt, Karen; Sutcliffe, Michelle; Green, Sue M

    2015-03-05

    The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1) prevention of hospital admission and related transport for ETF related issues; (2) effective management and reduction of waste of feed and thickener; (3) balloon gastrostomy tube replacement by the HEN Team in the patient's home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

  1. Nutrition

    NASA Technical Reports Server (NTRS)

    Lane, Helen W.

    1990-01-01

    This is a collection of viewgraphs on the Johnson Space Center's work on nutrition for long duration space missions. Nutritional requirements are affected by isolation, workloads, and cold as well as the psychological needs, metabolism, and fluid balance of an individual.

  2. Evaluation of agar films in the prevention of postoperative peritoneal adhesions in an animal model.

    PubMed

    Mamoudieh, Mohsen; Mirkheshti, Nooshin; Alavi, Sayyed Ali

    2011-03-01

    Peritoneal adhesions cause significant long-term postoperative morbidity. This study evaluates the efficacy of agar plates as the physical barrier in reducing adhesion formation after abdominal surgery in an animal model. Adhesions were induced, by cecum abrasion, in 20 C57/BL6 mice during a laparotomy procedure. Agar plates were used in 10 mice as the experimental group. At a second operation, 28 days later, the adhesions were graded, in two groups. Data were analyzed by using Student t test. There was no significant difference in weight gain of the two groups during the study period. A comparison of the morphological appearances of the adhesions demonstrated that there was no evident difference between the two groups. There was also no significant difference in the incidence ratio of adhesions or postoperative adhesion scores between the two groups (p value >0.05). Despite the hydrogel properties of agar, it was not successful in practice in the reduction of adhesion formation after peritoneal surgery. Since agar is a biological product, it may cause a hyperreactivity induced by the innate immune system in peritoneum. Therefore, agar does not appear to be useful in clinical practice for the reduction of adhesion formation after peritoneal surgery.

  3. Evaluating Persistent Postoperative Pain in One Tertiary Hospital: Incidence, Quality of Life, Associated Factors, and Treatment

    PubMed Central

    Guimaraes-Pereira, Luis; Valdoleiros, Ines; Reis, Pedro; Abelha, Fernando

    2016-01-01

    Background Persistent postoperative pain (PPP) is defined as persistent pain after surgery of greater than three months’ duration. Objectives Identify the incidence of PPP in our hospital and its associated factors; evaluate quality of life (QoL) and treatment of patients. Patients and Methods We conducted an observational prospective study in adults proposed to various types of surgery using the brief pain inventory short form preoperatively (T0), one day after surgery, and three months later (T3). If the patient had pain at T3 and other causes of pain were excluded, they were considered to have PPP, and the McGill Pain Questionnaire Short Form was applied. QoL was measured with the EuroQol 5-dimension questionnaire (EQ-5D). Results One hundred seventy-five patients completed the study. The incidence of PPP was 28%, and the affected patients presented lower QoL. The majority referred to a moderate to severe level of interference in their general activity. Cholecystectomies were less associated with PPP, and total knee/hip replacements were more associated with it. Preoperative pain, preoperative benzodiazepines or antidepressants, and more severe acute postoperative pain were associated with the development of PPP. Half of the patients with PPP were under treatment, and they refer a mean symptomatic relief of 69%. Conclusions This study, apart from attempting to better characterize the problem of PPP, emphasizes the lack of its treatment. PMID:27252908

  4. Prospective evaluation of nutritional status related to body mass indices and outcomes after modified D2 gastrectomy for carcinoma.

    PubMed

    Murphy, Paula M; Blackshaw, Guy R J C; Paris, Holly J; Edwards, Paul; Barry, Jonathan D; Lewis, Wyn G

    2004-08-01

    The aim of this study was to examine the perioperative nutritional status, body mass indices (BMI) and nutritional intakes of patients undergoing a modified D2 gastrectomy (preserving pancreas and spleen) for carcinoma to determine whether a relationship exists between the above and outcomes. Fifty consecutive patients [median age 71 years, 38 male] with gastric adenocarcinoma were studied prospectively. Seven patients (14%) were obese (BMI > 30 kg/m2), 16 patients (32%) were overweight (BMI > 25 kg/m2), 21 patients (42%) were of normal weight (BMI 20-25 kg/m2), and six patients (12%) were underweight (BMI < 20 kg/m2). Operative morbidity was commoner in underweight patients (33%) when compared with overweight patients (17%, P = 0.391) and patients of normal weight (14%, P = 0.289). Fatal complications, however (two patients, 4%) were confined to overweight patients (P = 0.118). Preoperative serum albumin levels were significantly higher in overweight patients (43 g/dl) compared to underweight patients (34.5 g/dl; P = 0.003), though no correlation was found between patients' serum albumin levels and postoperative morbidity (r = -0.023, P = 0.877). Overweight patients were significantly less likely to achieve their protein requirements postoperatively than underweight patients (P = 0.037). Early enteral feeding contributed to 56% of the median energy requirements and 45% of the median protein requirements on the seventh postoperative day. BMI alone is a poor indicator of outcomes after modified D2 gastrectomy for carcinoma. The role of early enteral nutrition in patients undergoing gastrectomy for cancer deserves further evaluation. Copyright 2003 Elsevier Ltd.

  5. Nutrition.

    PubMed

    Durnin, J V

    1976-07-01

    Nutrition appeared somewhat late on the scene in the I.B.P. projects in the U.K., but eventually it occupied an integral part of many of the H.A. (human adaptability) investigations. The nutritional data obtained in the studies of isolated and nearisolated communities in Tristan da Cunha and in New Guinea provided information of wide nutritional significance. There were also detailed and extensive studies in Israel which, similarly to those in New Guinea, attempted to relate nutritional factors to enviroment, working conditions, and physical fitness. Some extraordinarily low energy intakes found in Ethiopians have induced much speculation on the extent which man can adequately adapt to restricted food supplies. Interesting nutritional observations, of general importance, have also arisen from results obtained on such disparate groups as Glasgow adolescents, Tanzanian and Sudanese students, children in Malawi and vegans in the U.K.

  6. Validation of the nutrition screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II' among octogenarians.

    PubMed

    Wham, C A; Redwood, K M; Kerse, N

    2014-01-01

    To determine the validity of the nutrition screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II' (SCREEN II) among a purposive sample of octogenarians. Cross-sectional validation study. Bay of Plenty, New Zealand. Forty-five community-living residents aged 85-86 years. Equal proportions of participants were recruited at low, medium and high nutrition risk based on their SCREEN II score 12 months prior. Nutrition risk was assessed using SCREEN II. Demographic and health data were established. Using established criterion a dietitian's nutrition risk rating assessment ranked participants from low risk (score of 1) to high risk (score of 10). The assessment included a medical history, anthropometric measures and dietary intake. Dietary intake was established from three 24 hour multiple pass recalls (MPR). A Spearman's correlation determined the association between the SCREEN II score and the dietitian's risk score. Receiver operating characteristic (ROC) curves were completed to determine the sensitivity and specificity of the cut-off point for high nutrition risk. The SCREEN II score was significantly correlated with the dietitian's risk rating (rs = -0.76 (p<0.01). A newly defined cut-off point <49 was established for high nutrition risk derived from ROC curves and AUC (0.87, p < 0.01); sensitivity 90% and specificity 86%. SCREEN II is a simple, easy to use, 14 item questionnaire and appears to be a valid tool for detection of nutrition risk people aged 85-86 years.

  7. [Evaluating the nutritional status of a lung cancer patient is an important element in patient management].

    PubMed

    Antoun, S; Merad, M; Raynard, B; Ruffie, P

    2008-04-01

    Nutritional status assessment during the comprehensive management of patients treated for cancer is becoming increasingly necessary. Various data are currently available which show a relationship between the nutritional status and certain morbidity-mortality parameters. In contrast, there is a paucity of data concerning lung cancer. A relationship between survival and the nutritional status has been found in the literature, exclusively in advanced stages of lung cancer. Unlike that observed in oncological digestive tract surgery, where artificial nutrition is recommended preoperatively in severely malnourished patients, no link has been evidenced between postoperative morbidity and mortality and the preoperative nutritional status in lung surgery. The scientific nutritional societies simply recommend preoperative nutritional assessment. Reflection on management of malnourished patients receiving chemotherapy is still "archaic" and recent studies and recommendations are lacking. Although largely prescribed, oral nutritional supplements have not proven efficient and patient compliance will probably have to be improved. According to "good nutrition practice" rules, the digestive tube should be used when it is functional and in theory, enteral nutrition is indicated in this situation. In addition to the lack of clinical studies, one of the obstacles to its use is cultural with the need to obtain not only patient approval but also that of the prescriber. Parenteral nutrition was discredited in earlier studies. It should probably be reevaluated in the context of new chemotherapeutic molecules and a different way of handling nutrition care. The physiological concept of omega-3 fatty acid modulation of inflammation is of interest in animal studies but the clinical modalities of use remain to be defined and determined. The role of nutrition in the management of lung cancer is still very limited but there are major expectations and many solutions are awaited in the coming

  8. Evaluation of postoperative lung volume and perfusion changes by dual-energy computed tomography in patients with lung cancer.

    PubMed

    Choe, Jooae; Lee, Sang Min; Chae, Eun Jin; Lee, Sang Min; Kim, Yong-Hee; Kim, Namkug; Seo, Joon Beom

    2017-05-01

    The aim of our study was to retrospectively evaluate postoperative physiologic changes in lung cancer patients using dual-energy CT (DECT), and develop modified methods reflecting postoperative change for predicting pulmonary function. 88 patients (M:F=64:24; mean age, 63.5 years) with lung cancer who underwent DECT and pulmonary function tests before and after operation were included. Volume and iodine values for perfusion of each lobe were quantified. The predicted postoperative FEV1 using the current method was calculated by multiplying the preoperative FEV1 by the fractional contribution of perfusion of the remaining lung. The modified method reflecting postoperative volume change was compared to the current method. Postoperative lung volume showed compensatory increases in the contralateral and remaining ipsilateral lobes, with a significantly greater increase in the ipsilateral lobe than contralateral lobe (21.8%±46.2% vs. 10.0%±20.8%, P=0.031). Perfusion analysis showed blood volume increases in both ipsilateral and contralateral lobes without statistical differences (blood volume ratio difference, 29.2%±26.7 vs. 24.6%±16.5, P=0.368). The performance of the modified method considering postoperative lung volume change was comparable to that of the current method in the development and validation datasets (95% CI, -24.5% to 37.1% vs. -33.3% to 22.2% and -23.6% to 32.0% vs. -31.9% to 16.0%, respectively). Postoperative compensatory increases in lung volume and perfusion occur in different ways. Our modified method incorporating postoperative lung volume changes can be considered a comparable method for prediction of postoperative lung function. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Texas Nutrition Education and Training Program for Federal Fiscal Year 1995. Final Evaluation Report.

    ERIC Educational Resources Information Center

    Ahmad, Mahassen

    The Nutrition Education and Training (NET) program is one of the Child Nutrition Programs (CNP) of the United States Department of Agriculture (USDA). The program was established in 1977 in an amendment to the Child Nutrition Act. This report focuses on evaluation and needs assessment of the Texas state program conducted during the fiscal year…

  10. Evaluating a Nutrition Education Program for Pregnant Teen-Agers: Cognitive vs. Behavioral Outcomes.

    ERIC Educational Resources Information Center

    Perkin, Judy

    1983-01-01

    A manual on nutrition during pregnancy and lactation was developed and used with pregnant teenagers. Evaluation of the program showed that, while participants' knowledge of nutrition improved, their eating habits did not. The need for behavioral assessment of nutrition education programs is pointed out. (Author/PP)

  11. Evaluating a Nutrition Education Program for Pregnant Teen-Agers: Cognitive vs. Behavioral Outcomes.

    ERIC Educational Resources Information Center

    Perkin, Judy

    1983-01-01

    A manual on nutrition during pregnancy and lactation was developed and used with pregnant teenagers. Evaluation of the program showed that, while participants' knowledge of nutrition improved, their eating habits did not. The need for behavioral assessment of nutrition education programs is pointed out. (Author/PP)

  12. Evaluation of the taste and smell of bottled nutritive drinks.

    PubMed

    Kataoka, Masumi; Yoshida, Koichi; Miyanaga, Yohko; Tsuji, Eriko; Tokuyama, Emi; Uchida, Takahiro

    2005-11-23

    The purpose of this study was to evaluate the palatability of 15 bottled nutritive drinks, all commercially available in the Japanese market, using data from artificial taste and odor sensors. In gustatory sensation tests, well-trained healthy volunteers were asked to score the drinks in terms of palatability and of the four basic tastes. The results suggest that overall palatability is positively correlated with sourness intensity and fruitiness (R=0.82 and 0.86, respectively) and negatively correlated with bitterness intensity and the tasting of medicinal plants (R=-0.85 and -0.80, respectively). The sourness and bitterness intensity could be predicted by taste sensor and fruitiness could be predicted by odor sensor, respectively. By performing principal component analysis of the taste sensor data, the 15 drinks could be classified into four groups. The group classified as being predominantly sour had the highest palatability score, 3.8. By principal component analysis of odor sensor data, the drinks could also be classified into four groups and this time the group with a fruity flavor (smell) showed the highest palatability score, 3.4. In the combined analysis of both taste and odor data, products containing medicinal plants showed the lowest palatability. Finally, the combined usage of the taste and odor sensors gave rise to a three-group classification. Thus, not only the taste sensor but also the odor sensor may be useful in evaluating the palatability of bottled nutritive drinks.

  13. Development and evaluation of a nutritionally enhanced multigrain tortilla snack.

    PubMed

    Islas-Rubio, Alma Rosa; de la Barca, Ana María Calderón; Molina-Jacott, Luis Enrique; Del Carmen Granados-Nevárez, María; Vasquez-Lara, Francisco

    2014-06-01

    An increased consumption of healthy foods to reduce chronic diseases risks is needed. We developed and evaluated a multigrain snack as a nutritive alternative to the highly consumed corn tortilla chips. Corn, wheat, and chickpea grains were boiled in 1% calcium oxide solution, steeped, washed, and ground before being mixed with soy protein isolate and oat flour to prepare the multigrain masa. Multigrain tortillas were moulded, baked, dried, and fried. Proximate composition, dietary fiber, protein quality, sensorial, and textural properties were evaluated. A commercial tortilla chip was used as control. The multigrain snack contained 153% more protein, 53% more dietary fiber, and 43 % less fat than commercial tortilla chips. Its lysine and isoleucine contents helped to increase the corrected-net protein utilization by 10%, while digestibility increased from 83.5 to 91.8% as compared to commercial tortilla chips. The mean breaking force was 6,082 g for the multigrain snack and 4,780 g for the commercial tortilla chips. The mean acceptability score for the multigrain snack was 12.1 (unstructured line scale 0-15 cm), and 82% of the panelists rated the snack as acceptable. In conclusion, a nutritionally enhanced multigrain tortilla snack was developed which provides significantly more dietary fiber and protein and less fat than traditional commercial corn tortilla chips, but with comparable appearance and high acceptability.

  14. Evaluation of the Nutritional Knowledge of Undergraduate Nursing Students.

    PubMed

    Chepulis, Lynne M; Mearns, Gael J

    2015-09-01

    Obesity is prevalent in health care workers, but it is unknown whether a lack of nutritional knowledge contributes to this. This study measured the nutrition knowledge of undergraduate nursing students to identify knowledge gaps that could be addressed through nutrition teaching in an updated undergraduate nursing curriculum. Undergraduate nursing students (N = 197) completed a nutrition knowledge survey with questions on demographics, body composition, nutrition labels, food packaging claims, and healthy food-purchasing choices. Mean overall nutritional knowledge scores were low, but overall scores were higher for students who had received nutrition teaching (60.5% versus 52.5%; F[1, 187] = 7.2, p < 0.001). Improvements in nutrition knowledge were consistent across all ethnic groups, and no effects of age were observed. To sufficiently prepare nurses for their public health role in obesity prevention, more nutrition education is needed in undergraduate nursing education programs, with emphasis on ethnic-specific educational requirements. Copyright 2015, SLACK Incorporated.

  15. Evaluation of Nutrition Interventions in Children in Conflict Zones: A Narrative Review.

    PubMed

    Carroll, Grace J; Lama, Sonam D; Martinez-Brockman, Josefa L; Pérez-Escamilla, Rafael

    2017-09-01

    Food and nutrition insecurity becomes increasingly worse in areas affected by armed conflict. Children affected by conflict, or in war-torn settings, face a disproportionate burden of malnutrition and poor health outcomes. As noted by humanitarian response reviews, there is a need for a stronger evidence-based response to humanitarian crises. To achieve this, we systematically searched and evaluated existing nutrition interventions carried out in conflict settings that assessed their impact on children's nutrition status. To evaluate the impact of nutrition interventions on children's nutrition and growth status, we identified published literature through EMBASE, PubMed, and Global Health by using a combination of relevant text words and Medical Subject Heading terms. Studies for this review must have included children (aged ≤18 y), been conducted in conflict or postconflict settings, and assessed a nutrition intervention that measured ≥1 outcome for nutrition status (i.e., stunting, wasting, or underweight). Eleven studies met the inclusion and exclusion criteria for this review. Five different nutrition interventions were identified and showed modest results in decreasing the prevalence of stunting, wasting, underweight, reduction in severe or moderate acute malnutrition or both, mortality, anemia, and diarrhea. Overall, nutrition interventions in conflict settings were associated with improved children's nutrition or growth status. Emergency nutrition programs should continue to follow recent recommendations to expand coverage and access (beyond refugee camps to rural areas) and ensure that aid and nutrition interventions are distributed equitably in all conflict-affected populations. © 2017 American Society for Nutrition.

  16. Postoperative evaluation of the folded pharyngeal flap operation for cleft palate patients with velopharyngeal insufficiency

    PubMed Central

    Yoshimasu, Hidemi; Sato, Yutaka; Mishimagi, Takashi; Negishi, Akihide

    2015-01-01

    Background: Velopharyngeal function is very important for patients with cleft palate to acquire good speech. For patients with velopharyngeal insufficiency, prosthetic speech appliances and speech therapy are applied first, and then pharyngeal flap surgery to improve velopharyngeal function is performed in our hospital. The folded pharyngeal flap operation was first reported by Isshiki and Morimoto in 1975. We usually use a modification of the original method. Purpose: The purpose of this research was to introduce our method of the folded pharyngeal flap operation and report the results. Materials and Methods: The folded pharyngeal flap operation was performed for 110 patients with velopharyngeal insufficiency from 1982 to 2010. Of these, the 97 whose postoperative speech function was evaluated are reported. The cases included 61 males and 36 females, ranging in age from 7 to 50 years. The time from surgery to speech assessment ranged from 5 months to 6 years. In order to evaluate preoperative velopharyngeal function, assessment of speech by a trained speech pathologist, nasopharyngoscopy, and cephalometric radiography with contrast media were performed before surgery, and then the appropriate surgery was selected and performed. Postoperative velopharyngeal function was assessed by a trained speech pathologist. Results: Of the 97 patients who underwent the folded pharyngeal flap operation, 85 (87.6%) showed velopharyngeal competence, 8 (8.2%) showed marginal velopharyngeal incompetence, and only 2 (2.1%) showed velopharyngeal incompetence; in 2 cases (2.1%), hyponasality was present. Approximately 95% of patients showed improved velopharyngeal function. Conclusions: The folded pharyngeal flap operation based on appropriate preoperative assessment has been shown to be an effective method for the treatment of cleft palate patients with velopharyngeal insufficiency. PMID:26389036

  17. Development and evaluation of continuing education course in renal nutrition

    PubMed Central

    Rizk, Rana

    2016-01-01

    BACKGROUND/OBJECTIVE Competent renal dietitians are crucial for better patient compliance and clinical outcomes, specifically in critical settings. The aim of this study was to develop and evaluate an evidence-based course in renal dietetics for dietitians working in health care systems where dietetic specialization is absent. SUBJECTS/METHODS Fifteen licensed dietitians working with hemodialysis patients in Lebanon were randomly recruited to participate in the course. The latter was developed by the study's primary investigator, according to evidence-based practice guidelines, and focused on all aspects of renal nutrition. Total course duration was 28 hours spread over a 2 month period. Dietitians' knowledge in renal nutrition was tested pre- and post-training through a 23-item questionnaire; the total score was expressed in percentage (< 60% score indicated insufficient knowledge). Paired-samples t test was used for statistical analysis. RESULTS Overall knowledge of the dietitians significantly improved post-training and reached satisfactory levels (pre: 38.75 ± 17.20%, post: 62.08 ± 21.85%). Sub-analysis of the change in the knowledge showed significant and satisfactory improvement only in 3 topics: 1) correct body weight use in calculations, 2) energy estimation method and 3) phosphorus management. Knowledge in the fluid management significantly improved but did not achieve a satisfactory level. CONCLUSION The course significantly improved dietitians' knowledge in renal nutrition. If adopted as part of the continuing education of dietitians in countries that lack dietetic specializations, it may serve the first step towards improving health care practice. PMID:26865922

  18. [Postoperative mental disorders in cardiovascular surgery].

    PubMed

    Tonković, Dinko; Marinić, Dragan Korolija; Baronica, Robert; Oberhofer, Dagmar; Pavlović, Danijela Bandić; Perić, Mladen

    2012-03-01

    Postoperative mental disorders are a common complication of cardiovascular surgery, with serious consequences. The main types of postoperative mental disorders include postoperative delirium and postoperative cognitive dysfunction. Their incidence ranges up to 15%-80%. Postoperative mental disorders may be reversible and irreversible. Although reversible in most cases, postoperative mental disorders are associated with increased mortality, morbidity and increasing costs of treatment. The treatment is usually symptomatic and may be associated with dangerous side effects. Safer and more effective is preventive action. Preoperative preventive action need to recognize, avoid and optimize risk factors. Intraoperative prevention involves maintaining optimal oxygenation of the brain during cardiovascular surgery. For postoperative prevention, multimodal approach is applied. It includes early extubation, early enteral nutrition, early mobilization, regular evaluation of cognitive function, activation of cognitive function and optimal analgesia, which requires teamwork of medical staff who care for patients. Combining all these methods can show promising results in reducing the incidence of postoperative mental disorders as a complication in cardiovascular surgery.

  19. Workshop Report: concepts and methods in the economics of nutrition--gateways to better economic evaluation of nutrition interventions.

    PubMed

    Lenoir-Wijnkoop, I; Nuijten, M J C; Gutiérrez-Ibarluzea, I; Hutton, J; Poley, M J; Segal, L; Bresson, J L; van Ganse, E; Jones, P; Moreno, L; Salminen, S; Dubois, D

    2012-11-14

    Improving health through better nutrition of the population may contribute to enhanced efficiency and sustainability of healthcare systems. A recent expert meeting investigated in detail a number of methodological aspects related to the discipline of nutrition economics. The role of nutrition in health maintenance and in the prevention of non-communicable diseases is now generally recognised. However, the main scope of those seeking to contain healthcare expenditures tends to focus on the management of existing chronic diseases. Identifying additional relevant dimensions to measure and the context of use will become increasingly important in selecting and developing outcome measurements for nutrition interventions. The translation of nutrition-related research data into public health guidance raises the challenging issue of carrying out more pragmatic trials in many areas where these would generate the most useful evidence for health policy decision-making. Nutrition exemplifies all the types of interventions and policy which need evaluating across the health field. There is a need to start actively engaging key stakeholders in order to collect data and to widen health technology assessment approaches for achieving a policy shift from evidence-based medicine to evidence-based decision-making in the field of nutrition.

  20. Evaluation of adjuvant postoperative radiotherapy for lung cancer. [/sup 60/Co; X-ray

    SciTech Connect

    Chung, C.K.; Stryker, J.A.; O'Neill, M. Jr.; DeMuth, W.E. Jr.

    1982-11-01

    One hundred eighteen patients with lung cancer were retrospectively analyzed to determine whether postoperative radiotherapy (RT) improves survival. Patterns of treatment failure and three year NED (no evidence of disease) survival rates were assessed according to extent of tumor spread, histology, and treatment method. Patients with hilar or mediastinal node metastases were at higher risk of local failure compared to those with negative nodes. Postoperative RT reduced local recurrence and improved 3 year survival among patients with positive nodes. However, postoperative RT did not improve survival among those with negative nodes. Our data indicated that patients with positive hilar or mediastinal nodes may require postoperative RT to improve survival.

  1. Evaluation of Nutritional Status of Patients with Depression.

    PubMed

    Kaner, Gülşah; Soylu, Meltem; Yüksel, Nimet; Inanç, Neriman; Ongan, Dilek; Başmısırlı, Eda

    2015-01-01

    Our goal was to determine nutritional status, body composition, and biochemical parameters of patients diagnosed with depression based on DSM-IV-TR criteria. A total of 59 individuals, aged 18-60 years admitted to Mental Health Centre of Kayseri Education and Research Hospital, were included in the study. The participants were randomly assigned to two groups; depression group (n = 29) and control group (n = 30). Anthropometric measurements, some biochemical parameters, demographic data, and 24-hour dietary recall were evaluated. 65.5% of depression and 60.0% of control group were female. Intake of vitamins A, thiamine, riboflavin, B6, folate, C, Na, K, Mg, Ca, P, Fe, Zn, and fibre (p < 0.05) were lower in depression group. Median levels of body weight, waist circumference, hip circumference, waist-to-hip ratio (p < 0.05) were significantly higher in depression group. Fasting blood glucose levels, serum vitamins B12, and folic acid (p < 0.05) in depression group were lower than controls. Serum insulin and HOMA levels of two groups were similar. Some vitamin B consumption and serum vitamin B12 and folic acid levels were low while signs of abdominal obesity were high among patients with depression. Future research exploring nutritional status of individuals with depression is warranted.

  2. Evaluation of Nutritional Status of Patients with Depression

    PubMed Central

    Kaner, Gülşah; Soylu, Meltem; Yüksel, Nimet; Inanç, Neriman; Ongan, Dilek; Başmısırlı, Eda

    2015-01-01

    Aims and Objectives. Our goal was to determine nutritional status, body composition, and biochemical parameters of patients diagnosed with depression based on DSM-IV-TR criteria. Methods. A total of 59 individuals, aged 18–60 years admitted to Mental Health Centre of Kayseri Education and Research Hospital, were included in the study. The participants were randomly assigned to two groups; depression group (n = 29) and control group (n = 30). Anthropometric measurements, some biochemical parameters, demographic data, and 24-hour dietary recall were evaluated. Results. 65.5% of depression and 60.0% of control group were female. Intake of vitamins A, thiamine, riboflavin, B6, folate, C, Na, K, Mg, Ca, P, Fe, Zn, and fibre (p < 0.05) were lower in depression group. Median levels of body weight, waist circumference, hip circumference, waist-to-hip ratio (p < 0.05) were significantly higher in depression group. Fasting blood glucose levels, serum vitamins B12, and folic acid (p < 0.05) in depression group were lower than controls. Serum insulin and HOMA levels of two groups were similar. Conclusion. Some vitamin B consumption and serum vitamin B12 and folic acid levels were low while signs of abdominal obesity were high among patients with depression. Future research exploring nutritional status of individuals with depression is warranted. PMID:26413529

  3. [Echocardiography in the evaluation and pre- and postoperative follow-up of chronic aortic insufficiency].

    PubMed

    Karam, R; Esquivel-Avila, J G; Sánchez Torres, G; Sánchez Samayoa, C

    1984-01-01

    In chronic aortic regurgitation (CAoR) is difficult to determine the moment in which volume overload produces the myocardial deterioration which originates symptoms. We pretend to demonstrate the utility of echocardiography in defining the correct timing of operative correction in CAoR with pre- and post-operative comparison. Thirteen patients with CAoR (systolic ventricular-aortic gradient less than 20 mmHg) in whom the aortic valve was replaced were studied with an average of 13.7 months of follow-up. Two patients died immediately after surgery. Those remaining had a decrease in cardiomegaly grade and moved into functional class I. The echocardiogram revealed a significant reduction (P less than 0.01) in diameters of the left ventricle. The ejection fraction increased (P less than 0.05) in the post-operative period. Fractional shortening (FS) and mean velocity of circumferential shortening showed no significant change. The index end-systolic diameter over normalized velocity of the posterior wall IESD/NVPW) decreased considerably and the mean velocity of circumferential relaxation (Vcfr) increased (P less than 0.001) after surgical treatment. The preoperative ESD/NVPW index and Vcfr correlated well with the left ventricular end-diastolic pressure (r = 0.891 and r = -0.885, respectively). There was no difference in the course of those patients with diminished FS. The ESD/NVPW index and the Vcfr allowed a better evaluation of the residual volume, of the Frank-Starling law and of distensibility as an expression of the ventricular function. Consequently we conclude these indices are useful to establish the best moment for pre-operative catheterization in patients with CAoR.

  4. An Evaluation of Nutrition Support for Terminal Cancer Patients at Teaching Hospitals in Korea

    PubMed Central

    Kim, Do Yeun; Lee, Sang Min; Lee, Kyoung Eun; Lee, Hye Ran; Kim, Jee Hyun; Lee, Keun-Wook; Lee, Jong Seok

    2006-01-01

    Purpose We wanted to analyze the use of nutrition support for terminal cancer patients, the effect of discussing withdrawal of nutrition support and do-not-resuscitate (DNR) consent on the use of intravenous nutrition during the patient's last week of life and at the time of death. Materials and Methods The study involved 362 patients with terminal cancer from four teaching hospitals, and they all died between January 1 2003 and December 31 2005. The basic demographic data, the use of intravenous nutrition during the patient's last week of life and at death, discussion of terminal nutrition withdrawal and DNR consent were evaluated. Results In the week before death, the patients received artificial nutrition such as total parenteral nutrition (31%), intravenous albumin infusion (25%), and feeding tube placements (9%). A discussion concerning withdrawal of nutrition support was limited to 25 (7%) patients. DNR consent was obtained from 294 (81%) patients. None of the patients were directly involved in any of these decisions. The discussion about withdrawal of terminal nutrition and DNR consent with the patient's surrogates did not have any effect on reducing the use of parenteral nutrition. Conclusion The majority of patients dying of terminal cancer were still given potentially futile nutritional support. Modern clinical guidelines and ethical education about nutritional support at the end of life care is urgently needed in Korean medical practice to provide proper administration of terminal nutrition for end of life care. PMID:19771245

  5. Development, Evaluation, and Validation of Environmental Assessment Tools to Evaluate the College Nutrition Environment

    ERIC Educational Resources Information Center

    Freedman, Marjorie R.

    2010-01-01

    Objective: To develop, evaluate, and validate 2 nutrition environment assessment tools (surveys), for specific use in combating overweight on college/university campuses. Participants and Methods: Invitations to complete surveys were e-mailed to food service and health center directors at 47 universities, Winter 2008. Overall response rate was…

  6. An evaluation of preoperative and postoperative ventilation and perfusion lung scintigraphy in the screening for pulmonary embolism after elective orthopedic surgery

    SciTech Connect

    Keenan, A.M.; Palevsky, H.I.; Steinberg, M.E.; Hartman, K.M.; Alavi, A.; Lotke, P.A. )

    1991-01-01

    One hundred two patients undergoing elective knee or hip arthroplasty were studied with radionuclide ventilation scans (V) and perfusion scans (Q) preoperatively (preop) and postoperatively (postop) to assess their relative value in the diagnosis of asymptomatic pulmonary embolism (PE) after orthopedic surgery. Postop Q were read in combination with preop V and Q and postop V using prospective investigation of pulmonary embolism diagnosis (PIOPED) criteria. Of 25 postop Q interpreted as either high or intermediate probability for PE, preop Q were judged useful in 96%; the postop V were useful in 78%; and the preop V were not helpful in any of the cases. Of 63 postop Q interpreted as low probability, preop Q were useful in 74%; the postop V were useful in only 33%; and the preop V were useful in only one case. When postop Q were read as normal (14 cases), none of the three auxiliary studies were found to be useful. Overall, postop V were more helpful than preop Q in only 2%, and preop V contributed significantly in only 1%. This experience suggests that preop Q alone is the most useful adjunct to the postop Q in the postoperative evaluation for PE. The authors conclude that to screen for asymptomatic PE after elective orthopedic surgery, preop Q should be performed in all cases, preop V are not necessary, and postop V need be performed only if a baseline preop Q is not available.

  7. Evaluation of the postoperative patient with /sup 99m/Tc-IDA cholescintigraphy

    SciTech Connect

    Weissmann, H.S.; Gliedman, M.L.; Wilk, P.J.; Sugarman, L.A.; Badia, J.; Guglielmo, K.; Freeman, L.M.

    1982-01-01

    In order to assess the role of /sup 99m/Tc-iminodiacetic acid (IDA) cholescintigraphy in evaluating postoperative patients, a total of 213 studies were performed in 189 patients over a 3-year time period. Of these, 130 studies were obtained in 125 cases with signs and/or symptoms suggesting postcholecystectomy syndrome. A normal sized duct that emptied within an hour ruled out significant pathology with a high degree of accuracy (97%). A less reliable finding of normalcy was the combination of ductal dilatation with functional patency in that three of 20 patients (15%) who exhibited this pattern were proven to have nonobstructing calculi in their common bile duct. AZ spectrum of abnormal findings was encountered. Ductal dilatation was a most significant indicator of partial or intermittent ductal obstruction when it was associated with altered time-activity dynamics in the ducts and secondarily, delayed biliary-to-bowel transit time of the radiotracer. Patterns indicating complete common duct obstruction, cystic duct remnants, and bile leaks also proved to be very sensitive. Seventy-three studies in 56 patients very accurately evaluated the integrity of biliary-enteric bypass anastomosis. Complete and partial obstructive patterns were similar in appearance to those encountered in postcholecystectomy syndrome. Several leaks were also detected in this patient population. Ten studies were performed in eight patients who underwent Billroth II gastroenterostomies primarily to see if afferent loop obstruction was present. Three of these patients did demonstrate dilated A-loops with stasis, thereby making a positive diagnosis possible.

  8. Pre- and postoperative evaluation of renal function in patients with staghorn calculi utilizing quantitative renal scanning.

    PubMed

    Stage, K H; Lewis, S

    1981-01-01

    Differential quantitative renal scans using 99-technetium diethylene triaminepentaacetic acid (DTPA) or 131I Hippuran were obtained properatively on 12 patients with unilateral or bilateral staghorn calculi. Of the 14 renal units studied, 12 kidneys underwent anatrophic nephrolithotomy, pyelolithotomy, or a combination of both techniques; 2 patients underwent nephrectomy based on poor function of the affected side preoperatively. Postoperative follow-up scans were obtained on the 12 kidneys undergoing stone cleanout. Seven of 12 kidneys (58 per cent) studied pre- and postoperatively showed moderate to significant improvement in per cent contribution to total renal function. Seven of 10 kidneys (70 per cent) studied pre- and postoperatively showed improvement in glomerular filtration rate or effective renal plasma flow. The scans revelaed no dramatic difference in postoperative functional loss between pyelolithotomy and anatrophic nephrolithotomy. The computerizewd quantitative renal scan helps in selection of surgical technique and objective postoperative assessment of surgical results.

  9. A Comprehensive Evaluation for Aspiration After Esophagectomy Reduces the Incidence of Post-Operative Pneumonia

    PubMed Central

    Berry, Mark F.; Atkins, B. Zane; Tong, Betty C.; Harpole, David H.; D’Amico, Thomas A.; Onaitis, Mark W.

    2011-01-01

    OBJECTIVE This study assesses the impact of using a comprehensive swallowing evaluation before starting oral feedings on aspiration detection and pneumonia occurrence after esophagectomy. METHODS The records of all esophagectomy patients between January 1996 and June 2009 were reviewed. Multivariable logistic regression analysis assessed the effect of preoperative and operative variables on the incidence of aspiration and pneumonia. Separate analyses were performed on patients before (early era, 1996–2002) and after (later era, 2003–2009) a rigorous swallowing evaluation was used routinely before starting oral feedings. RESULTS During the study period, 799 patients (379 early era, 420 later era) underwent esophagectomy; 30-day mortality was 3.5% (28 patients). Cervical anastomoses were performed in 76% of patients in the later era compared with 40% of patients in the early era. Overall, 96 patients (12%) had evidence of aspiration postoperatively, and the pneumonia incidence was 14% (113 patients). Age (odds ratio 1.05 per year, p<0.0001) and later era (odds ratio 1.90, p=0.0001) predicted aspiration in all patients in a multivariable model. In the early era, cervical anastomosis and aspiration independently predicted pneumonia. With a comprehensive swallowing evaluation in the later era, the detected incidence of aspiration increased (16% vs 7%, p<0.0001) while the incidence of pneumonia declined (11% vs 18%, p=0.004) compared to the early era, such that neither anastomotic location nor aspiration predicted pneumonia in the later era. CONCLUSIONS Esophagectomy is often associated with occult aspiration. A comprehensive swallowing evaluation for aspiration prior to initiating oral feedings significantly decreases the occurrence of pneumonia. PMID:20884018

  10. Evaluation of the Postoperative Quality of Recovery Scale test and re-test in Swedish among healthy volunteers

    PubMed Central

    Jildenstål, Pether; Eriksson, Johan; Warren Stomberg, Margareta; Jakobsson, Jan G.

    2016-01-01

    Introduction Patient outcome measures are required to assess the quality of healthcare. Tools for a patients’ self-assessment of quality of recovery, during perioperative care, have been developed during the last decade. The Postoperative Quality of Recovery Scale (PostopQRS) questionnaire is one of the most well-accepted and validated tools available. Here we assess the PostopORS questionnaire in Swedish. Methods Sixty-one students from the Bachelor Program in Nursing, (50 female and 11 male; mean age, 25; range, 21-46) filled in the Swedish translation of the PostopQRS questionnaire twice. They also evaluated whether they found the queries easy to understand and respond to . Results The participants found the Swedish translation of the PostopQRS questionnaire easy to read and understand. There were minor differences in test responses between the initial test and the re-test 48 hours later. We found that the PostopQRS questionnaire has some background noise; 12 out of 61 participants (20%) reported mild pain, 25 (41%) scored some depression and 33 scored mild anxiety (54%). The cognitive domain showed a learning effect between tests in “word recall” and “word generation”, while “digit recall forward” and “digit recall backward” showed no change. We found a difference in cognitive test performance with age; younger participants had higher mean cognitive test scores compared to participants >30 years. Overall, nine participants showed a decrease in re-test scores; two experienced a mild increase in pain; one experienced a mild increase in anxiety; and six performed more poorly on cognitive tests. Conclusion The Swedish translation of the PostopQRS was found to be adequate for use in the assessment of quality of recovery, and the questions were well understood by participants. Our study shows the importance of baseline testing for assessment of recovery, since recovery is assessed as a return to or improvement in each individual’s baseline score.

  11. Evaluation of the Postoperative Quality of Recovery Scale test and re-test in Swedish among healthy volunteers.

    PubMed

    Jildenstål, Pether; Eriksson, Johan; Warren Stomberg, Margareta; Jakobsson, Jan G

    2016-01-01

    Introduction Patient outcome measures are required to assess the quality of healthcare. Tools for a patients' self-assessment of quality of recovery, during perioperative care, have been developed during the last decade. The Postoperative Quality of Recovery Scale (PostopQRS) questionnaire is one of the most well-accepted and validated tools available. Here we assess the PostopORS questionnaire in Swedish. Methods Sixty-one students from the Bachelor Program in Nursing, (50 female and 11 male; mean age, 25; range, 21-46) filled in the Swedish translation of the PostopQRS questionnaire twice. They also evaluated whether they found the queries easy to understand and respond to .Results The participants found the Swedish translation of the PostopQRS questionnaire easy to read and understand. There were minor differences in test responses between the initial test and the re-test 48 hours later. We found that the PostopQRS questionnaire has some background noise; 12 out of 61 participants (20%) reported mild pain, 25 (41%) scored some depression and 33 scored mild anxiety (54%). The cognitive domain showed a learning effect between tests in "word recall" and "word generation", while "digit recall forward" and "digit recall backward" showed no change. We found a difference in cognitive test performance with age; younger participants had higher mean cognitive test scores compared to participants >30 years. Overall, nine participants showed a decrease in re-test scores; two experienced a mild increase in pain; one experienced a mild increase in anxiety; and six performed more poorly on cognitive tests. Conclusion The Swedish translation of the PostopQRS was found to be adequate for use in the assessment of quality of recovery, and the questions were well understood by participants. Our study shows the importance of baseline testing for assessment of recovery, since recovery is assessed as a return to or improvement in each individual's baseline score.

  12. Nutrition.

    ERIC Educational Resources Information Center

    Saur, Susan

    An elementary level nutrition unit provides teachers with student background information, suggested activities, and student worksheets. Part 1 focuses on the relationship of food to growth, health, and energy. In part 2, students learn about the four main food groups. Part 3 deals with nutrients and provides information about carbohydrates, fats,…

  13. Texas Nutrition Education and Training Program for Federal Fiscal Year 1991. Final Evaluation Report.

    ERIC Educational Resources Information Center

    Ahmad, Mahassen

    The U.S. Department of Agriculture's Nutrition Education and Training Program (NET) provides nutrition information and instructional resources for children, parents, educators, and food service personnel. This document describes the evaluation methods of the NET Program in Texas in fiscal year 1991, reports evaluation results, and offers…

  14. Texas Nutrition Education and Training Program for Federal Fiscal Year 1992. Final Evaluation Report.

    ERIC Educational Resources Information Center

    Ahmad, Mahassen

    The U.S. Department of Agriculture's Nutrition Education and Training Program (NET) provides nutrition information and instructional resources for children, parents, educators, and food service personnel. This report describes the evaluation methods of the NET Program in Texas in fiscal year 1992, describes evaluation results, and offers…

  15. The National Evaluation of School Nutrition Programs. Review of Research: Executive Summary.

    ERIC Educational Resources Information Center

    Radzikowski, Jack

    Literature review components of the National Evaluation of School Nutrition Programs (a 30-month evaluation of the National School Lunch, School Breakfast, and Special Milk Programs) are summarized in this document. Chapters of the literature review describe the operations of school nutrition programs; examine the various methods for assessing the…

  16. The National Evaluation of School Nutrition Programs. Review of Research: Volume 1.

    ERIC Educational Resources Information Center

    Nelson, Kathryn, Ed.; And Others

    Findings of a review of research pertaining to federally subsidized school nutrition programs are presented in this report. The review of research, the first phase of the National Evaluation of School Nutrition Programs, is intended to provide guidance for the design of subsequent evaluation (including student, parent, and food administrator…

  17. Microbiological investigation and nutritional evaluation of selected fast food meat.

    PubMed

    Hemeda, H M

    1995-01-01

    The study was designed into two parts: the first part was to determine individual attitudes and beliefs toward fast food in general. One hundred individuals (15-45 yrs old) were involved in this study (50 males and 50 females). The second part of the study was carried out to evaluate microbiological contamination and nutritive value of the selected fast food meat (Hardee's fried burger, Saudi-American burger, kentucky fried chicken, Al-Baik broast chicken and shawerma beef). The results indicated that individuals 25-45 yrs. old were the most fast food consumers. The main reason behind increasing individual's preferences toward fast food was found to be for fun and inspiration. Among individuals under study 46% of males and 20% of females purchased fast food more than 4 times per week. Prevalence of overweight and obesity respectively were 38% and 22% among males and 34% and 14% among females. Bacillus cereus and E. coli were detected in a number of less than 10/g in all the selected fast food meat. The number of coliforms detected in Hardee's burger and Saudi-American burger were 10/g, while less than 10/g were detected in the remaining fast food meat. However, the number of Staph. aureus detected in Hardee's burger and Saudi-American burger was 20/g and 10/g respectively. On a per 100 g basis, energy (Kcal), protein (g), fat (g) and sodium (mg) content were found in the range of 179.62-295.29, 13.05-26.06, 8.9-21.13 and 640-920 respectively. Sodium content of all the selected fast food meat exceeded the recommended daily adequate intake for adults (males and females). The observations of the present study indicated the need for a nutrition education program to correct consumers' attitudes and beliefs towards fast food and to provide information on how a given menu item contributes to their dietary goal.

  18. Diagnostic considerations for evaluating nutritional problems in cattle.

    PubMed

    Maas, John

    2007-11-01

    The advances in testing methodology and in our understanding of the normal nutritional physiology of cattle have given veterinarians valuable tools to assess the nutritional status of cattle. By taking a representative number of appropriate samples, it is now relatively easy and inexpensive to determine the nutritional status of an individual or a group of animals. Also, the effectiveness of supplementation programs can be measured over time as part of an overall preventive medicine program.

  19. Evaluating the Efficacy of Levonorgestrel Intrauterine System and Danazol for Relief of Postoperative Pain in Endometriosis.

    PubMed

    Taneja, Ashima; Kaur, Satinder; Soni, R K; Bhanupriya; Kaur, Jaspreet; Singla, Laveen

    2017-07-01

    Endometriosis is an oestrogen-dependent disorder, manifests during reproductive years and is associated with pain and infertility. There is considerable debate about the effectiveness of various interventions for pain relief. To evaluate the efficacy of Levonorgestrel Intrauterine System (LNG-IUS) and Danazol in postoperative pain relief for patients with endometriosis. Hundred patients with diagnosis of endometriosis, who were treated laparoscopically, entered the study to receive either danazol (600 mg once daily) or LNG-IUS (inserted during immediate post operative period) postsurgery, for pain relief. Patients were analysed for pain relief according to VAS score and recurrence of disease using ultrasonography at third and sixth months of follow up. There were 50% patients in stage IV of endometriosis. Majority of them presented with complaint of infertility (49%) and pelvic pain (43%). It was observed that LNG-IUS was significantly more effective in relieving pain compared to danazol (65.2% vs 38.0%, p<0.05). Recurrence rate was significantly lower in LNG-IUS users compared to other group. LNG-IUS was found to be more effective in relieving pain compared to danazol.

  20. Evaluation of postoperative results from videoarthroscopic treatment for recurrent shoulder dislocation using metal anchors☆

    PubMed Central

    Martel, Éder Menegassi; Rodrigues, Airton; dos Santos Neto, Francisco José; Dahmer, Cleiton; Ranzzi, Abel; Dubiela, Rafaella Scuzziato

    2016-01-01

    Objective To clinically and radiologically evaluate the results from videoarthroscopic treatment using metal anchors in patients with recurrent shoulder dislocation and its complications. Methods This was a retrospective study on 47 patients (47 shoulders) operated by the shoulder group of the orthopedic hospital between February 2010 and February 2012. A questionnaire, interview and physical and radiographic examinations were used, with the classification of Samilson and Pietro. The mean postoperative follow-up was 33 months (range 12–47 months). The statistical analysis consisted of using Fisher's exact test through the IBM SPSS 22 statistical software. The significance level used was 5%. Results Recurrence was observed in nine cases. The patients were, on average, 26.5 years old at the first episode, and 19.1% were aged 20 years or under. Among these, 55.6% presented recurrence. In relation to age at the time of the surgical procedure, the average age was 27 years, and 12.8% were aged 20 years or under. Nineteen patients presented prominent anchors and, of these, 21% manifested arthrosis. Conclusion There was a statistically identified correlation between the recurrence rate and age less than or equal to 20 years at the times of first dislocation and the surgical procedure. Further studies should be conducted in order to compare the use of absorbable anchors, which despite higher cost, may provide lower risk of developing glenohumeral arthrosis in some cases. PMID:26962500

  1. Evaluation of Pain Preoperatively and Postoperatively in Patients with Chronic Pancreatitis Undergoing Longitudinal Pancreaticojejunostomy.

    PubMed

    Bhat, K R Seetharam; Khajanchi, Monty; Prajapati, Ram; Satoskar, R R

    2015-12-01

    Chronic pancreatitis is a fairly common condition with pain being the major symptom, and longitudinal pancreaticojejunostomy (LPJ) is performed for symptomatic relief. The aim of the study is to assess relief of pain post-LPJ for chronic pancreatitis and to evaluate the factors influencing relief of symptoms. A prospective observational non-interventional study enrolling 28 patients. This study involved a questionnaire studying various risk factors and pain related to chronic pancreatitis, pancreaticojejunostomy, and postoperative assessment of pain relief at 1 and 6 months from surgery. Pain was assessed using Visual analogue scale (VAS). In chronic pancreatitis, there is a significant relief in symptoms of pain post-LPJ; the degree of relief was less in the alcoholics vs non-alcoholics (p = 0.09) and smokers. There was also reduction in analgesic requirement and frequency of acute attacks of pain. Fifty-seven percent of patients had a complete remission of their pain after LPJ for CP. In chronic pancreatitis, there is a significant relief in symptoms of pain post-LPJ, although the degree of relief is less in the alcoholics and smokers.

  2. Preoperative and post-operative sleep quality evaluation in rotator cuff tear patients.

    PubMed

    Serbest, Sancar; Tiftikçi, Uğur; Askın, Aydogan; Yaman, Ferda; Alpua, Murat

    2017-07-01

    The aim of this study was to examine the potential relationship between subjective sleep quality and degree of pain in patients with rotator cuff repair. Thirty-one patients who underwent rotator cuff repair prospectively completed the Pittsburgh Sleep Quality Index, the Western Ontario Rotator Cuff Index, and the Constant and Murley shoulder scores before surgery and at 6 months after surgery. Preoperative demographic, clinical, and radiologic parameters were also evaluated. The study analysed 31 patients with a median age of 61 years. There was a significant difference preoperatively versus post-operatively in terms of all PSQI global scores and subdivisions (p < 0.001). A statistically significant improvement was determined by the Western Ontario Rotator Cuff Scale and the Constant and Murley shoulder scores (p ˂ 0.001). Sleep disorders are commonly seen in patients with rotator cuff tear, and after repair, there is an increase in the quality of sleep with a parallel improvement in shoulder functions. However, no statistically significant correlation was determined between arthroscopic procedures and the size of the tear and sleep quality. It is suggested that rotator cuff tear repair improves the quality of sleep and the quality of life. IV.

  3. Nutritional evaluation and functional properties of quinoa (Chenopodium quinoa) flour.

    PubMed

    Ogungbenle, H N

    2003-03-01

    The proximate analysis, evaluation of nutritionally valuable minerals, sugars, chemical properties of the oil and functional properties of the seed flour of quinoa (Chenopodium quinoa) were studied. The results showed that the quinoa flour contained 11.2% moisture, 13.5% crude protein, 6.3% ether extract, 9.5% crude fibre, 1.2% total ash and 58.3% carbohydrate. The quinoa has a high proportion of D-xylose (120.0 mg in 100 g sample) and maltose (101.0 mg in 100 g sample), and a low content of glucose (19.0 mg in 100 g sample) and fructose (19.6 mg in 100 g sample), suggesting that it would be useful in malted drink formulations. The values for the chemical properties of the oil extracted were: acid value, 0.50%; iodine value, 54.0%; peroxide value, 2.44%; and saponification value, 192.0%. Quinoa has a high water absorption capacity (147.0%) and low foaming capacity and stability (9.0%, 2.0%). The flour has a least gelation concentration of 16% w/v. Protein solubility of the flour was also evaluated and found to be pH dependent, with minimum solubility at about pH 6.0.

  4. [Evaluation of the quality of life in artificial nutrition].

    PubMed

    Zarazaga Monzón, A; Culebras, J M; Gómez Candela, C; Cos, A I

    1998-01-01

    If we define quality of life as being the social, physiological, mental intellectual, and general well being of people, we realize that there is no known health care system that is able to guarantee that well being in all its possible aspects. When we as clinicians assess the positive effects of a treatment applied to a patient, we are not only assessing the offered quality of life, but also the quantity of life, so what we are really assessing is the usefulness. We could say, therefore, that while the quality of life is subjective, not exact, and cannot be quantified, the usefulness on the other hand, can and should be measured and quantified, even though, as this is a subjective assessment, it is somewhat difficult to quantify. The object of our publication is to find an appropriate method for assessing this parameter in the area that concerns us: artificial nutrition. Artificial nutrition is indicated when the patient cannot does not want to, or does not know how to eat in the natural manner. Therefore, in principle it could seem inhuman and even unethical to deny a vital support measure that is practically without any risks in a patient who cannot feed him-or herself. However, in a situation of limited resources, if the treatment were inappropriate we should consider that possibility. Under these circumstances we could consider that even a concept as essential as nutrition (in this case artificial) would lose its inalienable character. In order to assess usefulness, one must include parameters that can be quantified in percentages and whose results can be set out in units of time (years, months, or days). We use the concept of the individual usefulness, whose unit of time is the QALY (Quality Adjusted Life Years). In 1996 we made a personal modification of Rosser's Index, which was specific for evaluating the quality of life obtained by means of artificial nutrition. This consisted of substituting the assessment parameters of intensity of pain, by other that

  5. Evaluating Patient Usability of an Image-Based Mobile Health Platform for Postoperative Wound Monitoring

    PubMed Central

    Wiseman, Jason

    2016-01-01

    Background Surgical patients are increasingly using mobile health (mHealth) platforms to monitor recovery and communicate with their providers in the postdischarge period. Despite widespread enthusiasm for mHealth, few studies evaluate the usability or user experience of these platforms. Objective Our objectives were to (1) develop a novel image-based smartphone app for postdischarge surgical wound monitoring, and (2) rigorously user test it with a representative population of vascular and general surgery patients. Methods A total of 9 vascular and general surgery inpatients undertook usability testing of an internally developed smartphone app that allows patients to take digital images of their wound and answer a survey about their recovery. We followed the International Organization for Standardization (ISO) 9241-11 guidelines, focusing on effectiveness, efficiency, and user satisfaction. An accompanying training module was developed by applying tenets of adult learning. Sessions were audio-recorded, and the smartphone screen was mirrored onto a study computer. Digital image quality was evaluated by a physician panel to determine usefulness for clinical decision making. Results The mean length of time spent was 4.7 (2.1-12.8) minutes on the training session and 5.0 (1.4-16.6) minutes on app completion. 55.5% (5/9) of patients were able to complete the app independently with the most difficulty experienced in taking digital images of surgical wounds. Novice patients who were older, obese, or had groin wounds had the most difficulty. 81.8% of images were sufficient for diagnostic purposes. User satisfaction was high, with an average usability score of 83.3 out of 100. Conclusion Surgical patients can learn to use a smartphone app for postoperative wound monitoring with high user satisfaction. We identified design features and training approaches that can facilitate ease of use. This protocol illustrates an important, often overlooked, aspect of mHealth development

  6. Evaluation of Iranian college athletes' sport nutrition knowledge.

    PubMed

    Jessri, Mahsa; Jessri, Maryam; RashidKhani, Bahram; Zinn, Caryn

    2010-06-01

    The purpose of this study was to assess the nutrition knowledge and the factors determining this knowledge in Iranian college basketball and football athletes. By highlighting gaps in nutrition knowledge of these athletes, sport nutrition professionals may begin to address these gaps by educating athletes with a view toward minimizing injury and enhancing sport performance. Sixty-six basketball and 141 football players (response rate 78.4%) from 4 medical and 8 nonmedical universities in Tehran agreed to participate in this cross-sectional study. A 2-part questionnaire was used; the first part comprised questions identifying demographic information, and the second part comprised a previously well-validated questionnaire on sport nutrition knowledge. The overall knowledge score was 33.2% (+/- 12.3%). Men scored 28.2% (+/- 12.7%), and women, 38.7% (+/- 14.2%). In both genders, the highest score was obtained for the nutrients subcategory, and the supplements subcategory was the most poorly answered. When compared with their peers, a significantly higher score was obtained by women (p < .001), athletes at medical universities (p < .001), and those obtaining nutrition information from reputable sources (p = .03). The coach was cited by 89.4% of athletes as their main source of nutrition information. This study showed that the sport nutrition knowledge of these athletes is inadequate. Considering that this substandard level of knowledge may contribute to poor dietary behaviors, these athletes would benefit from nutrition-related training and education.

  7. An Evaluation of the Expanded Nutrition Education Program in Pennsylvania.

    ERIC Educational Resources Information Center

    Hustey, Joyce

    The Nutrition Education Program, implemented in 25 Pennsylvania counties in 1969, attempted to help low-income families improve the nutritional adequacy of their diet by teaching food preparation, buying, and storing, and encouraging the use of food stamps. As of June, 1970 monthly turnover of clients stabilized at five percent, but there was a…

  8. CBCT fine preoperative evaluation of inflammatory radicular cysts and postoperative local integration appreciation of alloplastic grafts materials.

    PubMed

    Nica, Diana; Ianes, Emilia; Brad, S

    2014-01-01

    The purpose of this paper is to point out the value of CBCT exam in pre and postoperative diagnosis assessment of inflammatory radicular cysts together with full appreciation of local integration of alloplastic graft materials used to repair the osseous defects. There were statistically retrospective evaluated the pre and postoperative results of CBCT and x-ray examinations of 34 patients with inflammatory radicular cysts clinically, biologically and histopathologically assessed at Oral and Maxilo-Facial Surgery Clinic from Timisoara. In all cases we proceeded to surgical radicular cysts removement, extraction of the associated non-vital tooth together with alloplastic graft materials repairement of the osseous defects. The CBCT preoperative scans clearly showed the extent, the morphological characteristics and the topoanatomic reports, in all 34 cases of inflammatory radicular cysts together with regional endodontic status. The CBCT postoperative scans revealed the very local integration of alloplastic graft materials used to repair the osseous defects and, in some cases, the dental rehabilitation by metallic implants. CBCT scan is the imaging method of choice in pre and postoperative diagnosis assessment of inflammatory radicular cysts together with alloplastic graft materials repairement of the osseous defects and dental rehabilitation by metallic implants, due to high specific abilities in bone tissue 3D evaluation.

  9. Prospective double-blind clinical trial evaluating the effectiveness of Bromelain in the third molar extraction postoperative period

    PubMed Central

    de la Barrera-Núñez, María C.; Yáñez-Vico, Rosa M.; Batista-Cruzado, Antonio; Heurtebise-Saavedra, Jean M.; Castillo-de Oyagüe, Raquel

    2014-01-01

    Objectives: To evaluate the anti-inflammatory and analgesic effect of Bromelain (pineapple extract) administered orally in the postoperative after extraction of impacted lower molars. Study Design: This is a prospective, placebo-controlled, unicentric, double-blind study; the sample size was 34 patients. The pre and postoperative outcomes, evaluated on the third (D3) and eighth day (D8), included inflamtion, pain and oral aperture, as well as the need for analgesics. One group received bromelain 150mg per day for three days and 100mg on days 4 to 7. The other group received placebo in the same dosage. All outcomes werrecorded quantitatively and analyzed with the Mann-Whitney U test for independent samples. Results: Although there were no statistically significant differences between the treatment groups, a trend towards less inflammation and improved oral aperture was observed in the group that received bromelain, compared to the group that received placebo. This trend can be attributed completely to random reasons, since there is no statistical difference in the results. Conclusions: Further studies are necessary to analyze different administration patterns and doses of bromelain for the use in the postoperative of impacted third molars. Key words:Tooth extraction, third molar, postoperative period, bromeline, clinical study. PMID:24316697

  10. An evaluation of wheelchair basketball players' nutritional status and nutritional knowledge levels.

    PubMed

    Eskici, Günay; Ersoy, Gülgün

    2016-03-01

    This study aimed to assess the nutritional status of women paralympic athletes and their nutritional knowledge. Twenty two players of National Wheelchair Women Basketball Team (15-38 years) participated in this study and answered a questionnaire (76 questions) Players were at sport camp during the assessment where their body weight is measured regularly by the team coach. The waist, hip size and the height of the players who are able to stand have been used for the assessment, while the knee height of the players who are not able to stand have been measured for the study. SPSS 15.0 and BEBIS (Nutritional Data System) have been used for statistical assessment. The average age and sport years as a player of the participants are; respectively; 25.5±7.2 years and 3.9±2.8 years. The average daily energy consumption is 2867.8±523.6 kcal/day. The average proportion of energy, converted from carbohydrate, protein, fat are been calculated as, respectively; 42.7% (5.3±1.5 g/kg/day), 13.3% (1.6±0.3 g/kg/day), 44% (2.5±0.8 g/kg/day). It is also found that Vitamin B1, folic acid, magnesium, iron and fiber have not been consumed enough. The questions about sport nutrition have been mostly answered incorrectly. Athletes have inadequate food consumption and nutrition information. The athletes have to be educated more about nutrition and they should have nutritional counseling support.

  11. Evaluation of Viola betonicifolia for its nutrition value.

    PubMed

    Muhammad, Naveed; Saeed, Muhammad; Khan, Haroon; Hassan, Sohail; Gul, Farah

    2012-07-01

    In the present study, Viola betonicifolia (whole plant) and solvent fractions obtained thereof were evaluated for various micronutrients such as lead, copper, chromium, iron, nickel, zinc, cadmium, cobalt and macronutrients such as sodium, potassium and calcium using atomic absorption spectrophotometer and flame photometry respectively. It was observed that cobalt and cadmium were not detectible in tested samples while remaining nutrients were present in variable concentrations. The concentrations of all metals were compared with the recommended limits for plants and the daily consumption of all the nutrients were calculated on the basis of dose (15 g/70 kg/day or 214 mg/Kg body weight) prescribed by hakims in their practice. The concentration of chromium was far beyond the recommended limits in almost all the samples. Proximate analysis was carried out in the powdered form of the plant. Viola betonicifolia appeared as a good source of life essential nutrients like fats (18.70%), proteins (15.70%), carbohydrates (21.42%), fiber (39.01%) and vitamin C (150 mg/100 g). In conclusion, Viola betonicifolia is an excellent source of various micro and macronutrients for human being and can be used safely as a nutritional supplement.

  12. Comparative evaluation of ropivacaine and ropivacaine with dexamethasone in supraclavicular brachial plexus block for postoperative analgesia

    PubMed Central

    Kumar, Santosh; Palaria, Urmila; Sinha, Ajay K.; Punera, D. C.; Pandey, Vijita

    2014-01-01

    Background: Mixing of various adjuvants has been tried with local anesthetics in an attempt to prolong anesthesia from peripheral nerve blocks but have met with inconclusive success. More recent studies indicate that 8 mg dexamethasone added to perineural local anesthetic injections augment the duration of peripheral nerve block analgesia. Aims: Evaluating the hypothesis that adding dexamethasone to ropivacaine significantly prolongs the duration of analgesia in supraclavicular brachial plexus block compared with ropivacaine alone. Patients and Methods: It was a randomized, prospective, and double-blind clinical trial. Eighty patients of ASA I and II of either sex, aged 16-60 years, undergoing elective upper limb surgeries were equally divided into two groups and given supraclavicular nerve block. Group R patients (n = 40) received 30 ml of 0.5% ropivacaine with distilled water (2 ml)-control group whereas Group D patients (n = 40) received 30 ml of 0.5% ropivacaine with 8 mg dexamethasone (2 ml)-study group. The primary outcome was measured as duration of analgesia that was defined as the interval between the onset of sensory block and the first request for analgesia by the patient. The secondary outcome included maximum visual analogue scale (VAS), total analgesia consumption, surgeon satisfaction, and side effects. Results: Group R patients required first rescue analgesia earlier (557 ± 58.99 min) than those of Group D patients (1179.4 ± 108.60 min), which was found statistically significant in Group D (P < 0.000). The total dose of rescue analgesia was higher in Group R as compared to Group D, which was statistically significant (P < 0.00). Conclusion: Addition of dexamethasone (8 mg) to ropivacaine in supraclavicular brachial plexus approach significantly and safely prolongs motor blockade and postoperative analgesia (sensory) that lasted much longer than that produced by local anesthetic alone. PMID:25886227

  13. Challenges of molecular nutrition research 6: the nutritional phenotype database to store, share and evaluate nutritional systems biology studies

    PubMed Central

    Bouwman, Jildau; Dragsted, Lars O.; Drevon, Christian A.; Elliott, Ruan; de Groot, Philip; Kaput, Jim; Mathers, John C.; Müller, Michael; Pepping, Fre; Saito, Jahn; Scalbert, Augustin; Radonjic, Marijana; Rocca-Serra, Philippe; Travis, Anthony; Wopereis, Suzan; Evelo, Chris T.

    2010-01-01

    The challenge of modern nutrition and health research is to identify food-based strategies promoting life-long optimal health and well-being. This research is complex because it exploits a multitude of bioactive compounds acting on an extensive network of interacting processes. Whereas nutrition research can profit enormously from the revolution in ‘omics’ technologies, it has discipline-specific requirements for analytical and bioinformatic procedures. In addition to measurements of the parameters of interest (measures of health), extensive description of the subjects of study and foods or diets consumed is central for describing the nutritional phenotype. We propose and pursue an infrastructural activity of constructing the “Nutritional Phenotype database” (dbNP). When fully developed, dbNP will be a research and collaboration tool and a publicly available data and knowledge repository. Creation and implementation of the dbNP will maximize benefits to the research community by enabling integration and interrogation of data from multiple studies, from different research groups, different countries and different—omics levels. The dbNP is designed to facilitate storage of biologically relevant, pre-processed—omics data, as well as study descriptive and study participant phenotype data. It is also important to enable the combination of this information at different levels (e.g. to facilitate linkage of data describing participant phenotype, genotype and food intake with information on study design and—omics measurements, and to combine all of this with existing knowledge). The biological information stored in the database (i.e. genetics, transcriptomics, proteomics, biomarkers, metabolomics, functional assays, food intake and food composition) is tailored to nutrition research and embedded in an environment of standard procedures and protocols, annotations, modular data-basing, networking and integrated bioinformatics. The dbNP is an evolving enterprise

  14. Qualifying instrument for evaluation of food and nutritional care in hospital.

    PubMed

    Díez García, R W; Souza, A A; Proença, R P C

    2012-01-01

    Establishing criteria for hospital nutrition care ensures that quality care is delivered to patients. The responsibility of the Hospital Food and Nutrition Service (HFNS) is not always well defined, despite efforts to establish guidelines for patient clinical nutrition practice. This study describes the elaboration of an Instrument for Evaluation of Food and Nutritional Care (IEFNC) aimed at directing the actions of the Hospital Food and Nutrition Service. This instrument was qualified by means of a comparative analysis of the categories related to hospital food and nutritional care, published in the literature. Elaboration of the IEFNC comprised the following stages: (a) a survey of databases and documents for selection of the categories to be used in nutrition care evaluation, (b) a study of the institutional procedures for nutrition practice at two Brazilian hospitals, in order to provide a description of the sequence of actions that should be taken by the HFNS as well as other services participating in nutrition care, (c) design of the IEFNC based on the categories published in the literature, adapted to the sequence of actions observed in the routines of the hospitals under study, (d) application of the questionnaire at two different hospitals that was mentioned in the item (b), in order to assess the time spent on its application, the difficulties in phrasing the questions, and the coverage of the instrument, and (e) finalization of the instrument. The IEFNC consists of 50 open and closed questions on two areas of food and nutritional care in hospital: inpatient nutritional care and food service quality. It deals with the characterization and structure of hospitals and their HFNS, the actions concerning the patients' nutritional evaluation and monitoring, the meal production system, and the hospital diets. "This questionnaire is a tool that can be seen as a portrait of the structure and characteristics of the HFNS and its performance in clinical and meal

  15. Routine postoperative imaging early after lumbar decompression surgery: a prospective evaluation.

    PubMed

    Schubert, Gerrit Alexander; Diepers, Michaels; Hegewald, Aldemar Andres; Seiz, Marcel; Thomé, Claudius

    2013-09-15

    Prospective cohort study. To determine the value of routine postoperative magnetic resonance imaging early after lumbar decompression in patients with nonspecific symptoms. Imaging after lumbar surgery may be performed more readily in patients even with nonspecific symptoms and without neurological deficit. Patients undergoing elective lumbar decompression surgery completed standardized questionnaires, were assessed neurologically on admission, and underwent magnetic resonance scanning within 72 hours after surgery. Residual stenosis was graded as absent or mild (outcome A) or moderate to severe (outcome B). Surgical technique and intraoperative complications and postoperative neurological status were recorded. We recruited 28 consecutive patients who reported significant improvement in preoperative symptoms. In two-thirds of all patients, postoperative images showed at least one segment with moderate or severe residual stenosis (outcome B). Radiological outcome did not correlate with postoperative pain. Patient satisfaction index was comparable in groups A and B. The cross section of the spinal canal was significantly wider with a drain in situ. This did not, however, translate into a difference in overall visual analogue scale score or wound discomfort. Patients tended to report more back and leg pain with drains and were less satisfied with the result of the operation. Early postoperative magnetic resonance scans in patients with nonspecific symptoms frequently show radiologically relevant stenosis, which is associated with neither outcome nor patient satisfaction. Drain placement is associated with less radiological narrowing but with lower patient satisfaction. Imaging without clinical correlate may yield nondiscriminatory information likely to unsettle and puzzle both patients and health care providers. 3.

  16. Evaluation of anxiety-like behaviour in a rat model of acute postoperative pain.

    PubMed

    Kouya, Francois; Iqbal, Zohaib; Charen, Daniel; Shah, Mansi; Banik, Ratan K

    2015-04-01

    Unrelieved acute postoperative pain can lead to a wide range of adverse effects, such as anxiety, depression, restlessness and sleep deprivation. To investigate anxiety-like behaviour in a postoperative pain model. Mechanical hypersensitivity was assessed with an electronic von Frey device, whereas anxiety-like behaviour was measured with light/dark testing and elevated plus maze testing. Rats developed significant mechanical hyperalgesia on 1, 3 and 8 days postsurgery compared with sham-operated rats. There was no reduction in motility between preincision and postincision when animals were allowed to move freely in an open field locomotion test. In light-dark tests, incised animals spent significantly less time than sham rats in the light compartment on the 1st and 3rd postoperative days. However, in an elevated plus maze test, differences between sham and incised rats were only observed on the 8th postoperative day as they spent significantly more time in the open arms. Pretreatment with morphine significantly increased withdrawal thresholds compared with treatment with saline (0.9% NaCl), but had no effect on light or open arm avoidance behaviour. We report that a rat model of acute postoperative pain is associated with anxiety-like increased light and open arm avoidance behaviour.

  17. [Evaluation of immediate post-operative pain in heart surgery using the Behavioural Pain Scale].

    PubMed

    Pozas Abril, J; Toraño Olivera, M J; Latorre-Marco, I

    2014-01-01

    Patients in the immediate postoperative period of cardiac surgery have abolished communication skills and therefore can not express pain. Pain produces significant adverse effects that alter the patients' course. Therefore, identifying and controlling them will lead to increased quality of care for the critical patient. To measure the degree of pain in patients in the immediate postoperative period of cardiac surgery by scaling Behavioural Pain Scale. An observational, prospective and longitudinal. Patients over 18 years in the first 24 hours of admission with no communication problems who were under sedation and subjected to mechanical ventilation were included. Twenty patients were enrolled in the study. The Behavioural Pain Scale (BPS) was used during two procedures usually considered as a painful practice in the literature, that is, mobilization and/or postural changes and aspiration of secretions. Twenty-seven measurements were made of procedures considered as painful. The results obtained by applying the scale BPS showed that 70.4% of patients had no pain, 22.2% had mild to moderate pain and 7.4% had unacceptable pain. This study has identified that the patients suffer pain during the postoperative period. Within these patients, there is a small, but not insignificant number whose pain is unacceptable during this period. This finding serves as a beginning for a line of research to improve the handling of the postoperative pain during immediate post-operative cardiac surgery. Copyright © 2013 Elsevier España, S.L. y SEEIUC. All rights reserved.

  18. Elemental, nutritional, phytochemical and biological evaluation of Hypericum perforatum Linn.

    PubMed

    Dastagir, Ghulam; Ahmed, Rizwan; Shereen, Saima

    2016-03-01

    This study was carried out to study elemental, nutritional, phytochemical and biological evaluation of Hypericum perforatum collected from Swat in 2010. The elemental analysis showed that Ca was highest (5600 μg/g) in leaves and lowest (2500 μg/g) in flowers. The potassium was highest (840 μg/g) in fruit and lowest (80 μg/g) in leaves. Magnesium was highest (260 μg/g) in stem and lowest (200 μg/g) in flowers. Sodium was highest (4900 μg/g) in stem and lowest (4700 μg/g) in leaves and flowers. Copper was highest (26 μg/g) in stem and lowest (10 μg/g) in leaves. Iron was highest (5000 μg/g) in flowers lowest (1200 μg/g) in stem. Zinc was highest (80 μg/g) in flowers and lowest (46 μg/g) in stem. Nickle, cadmium and Cobalt were <5 μg/g for all plant parts. The nutritional analysis showed that the dry matter was in the range of (97.61%) in stem and (96.38%) in leaf, ash (5.43%) in flowers and (1.90%) in stem, crude protein (12.63%) in leaf and (6.15%) in stem, crude fibre (64.74%) in flowers and (13.0%) in leaf, ether extract (10.98%) in fruit and (1.88%) in stem and nitrogen free extract was (65.80%) in leaf and (10.98%) in flower, respectively. Hypericum perforatum did not show cytotoxic, insecticidal and antibacterial activity in vitro at different doses. The % activity was zero% in cytotoxic and insecticidal activities. However, H. perforatum plant parts revealed phytotoxic activity. The phytotoxic activity of leaf and fruit remained same (44.0%) at highest dose (500 μg/ml). The phytochemical screening showed the presence of mucilage, tannins, anthraquinones, saponins, fats and oils and proteins in all parts of the plant. Calcium oxalate was found in all parts except the fruit. Lignin and catechin was found in all parts except the leaf. Cutin was found only in stem and flower while chlorophyll was found only in stem and leaf. In various localities (Shartangaar, Panj Pali and Sharanko) of Swat fresh leaves were used while in Barani and Jaba fresh as

  19. Development and evaluation of a nutritional health program for adolescents.

    PubMed

    Djalalinia, Shirin; Ramezani-Tehrani, Fahimeh; Malekafzali, Hossein; Hejazi, Farzaneh; Peykari, Niloofar

    2013-09-01

    Unhealthy nutritional behaviors are a threat to adolescents. In this regard, we compared different training methods through a participatory interventional study. Through proportional random selection, 1823 female students were selected from 15 middle schools of Tehran. Following 2 years of intervention, nutritional habits of three different interventional groups were assessed. Eating breakfast was significantly higher in the trained groups, and the use of weight loss diets was lower in them than in the control group. Also, satisfactory consumption of various kinds of nutrients in the trained groups was more than in the control group. Participatory health training, especially through parents, leads to adolescence nutritional health promotion.

  20. A Comparative Study to Evaluate a Simple Method for the Management of Postoperative Bleeding Following Palatoplasty

    PubMed Central

    Schneider, William J; Gavino-Gutierrez, Arquímedes M.

    2013-01-01

    Bleeding, is one of the most common postoperative complications after palatoplasty in patients with cleft palate. The purpose of this article is to present our experience using a Foley catheter balloon for perioperative palatoplasty bleeding management. A retrospective data analysis was performed for all cases of palatoplasty performed by the author from 1999 to 2012 that experienced postoperative hemorrhage. These patients were managed by utilizing posterior nasal compression with a Foley catheter balloon for the period 2006 to 2012. We have compared two methods (we use before 2006 the reoperative method) with regards to the later development of palatal fistulae and cases with reoperative hemostasis. The study found no statistically significant differences between the conventional and proposed method in relation to the development of palatal fistulae (P=0.7). These findings suggest that nasal packing using a Foley balloon is a safe and effective method for postoperative bleeding control after palatoplasty in patients with cleft palate. PMID:23730606

  1. Evaluation of fever in the immediate postoperative period in patients who underwent total joint arthroplasty.

    PubMed

    Athanassious, Christian; Samad, Adil; Avery, Anthony; Cohen, Jason; Chalnick, David

    2011-12-01

    Forty percent to 50% of patients may experience an immediate postoperative fever. Research suggests that these are of aseptic cause due to inflammatory mediators. This is a retrospective analysis of fevers in total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients from 2006 to 2008. Thirty-six percent of THA and 31% of TKA patients developed a fever, with most developing a maximum temperature on postoperative day (POD) 2. The maximum mean temperature between the THA and TKA group was not significantly different. Fevers in the immediate postoperative period are a normal variant in patients undergoing THA or TKA. Urinalysis, urine culture and sensitivity, and chest x-ray are not required during this period because most of these fevers stem from aseptic causes. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Texas Nutrition Education and Training Program for Federal Fiscal Year 1993. Final Evaluation Report.

    ERIC Educational Resources Information Center

    Ahmad, Mahassen

    The Nutrition Education and Training (NET) program evaluated in this report is one of the Child Nutrition Programs of the U.S. Department of Agriculture. NET's outreach to its target populations is achieved through: (1) workshops developed by NET and delivered by contract trainers; (2) circulation of a NET library collection; (3) development and…

  3. An Evaluation of a Nutrition WebQuest: The Malaysian Experience

    ERIC Educational Resources Information Center

    Wui, Lee Sheh; Saat, Rohaida Mohd.

    2008-01-01

    The main purpose of the present study was to develop and evaluate a WebQuest instruction on Nutrition using WebQuest template, known as NutriQuest. NutriQuest was developed to improve Form 2 students' understanding of fundamental nutrition concepts and its application in daily life, to improve critical and creative thinking skills and to enhance…

  4. An Evaluation of a Nutrition WebQuest: The Malaysian Experience

    ERIC Educational Resources Information Center

    Wui, Lee Sheh; Saat, Rohaida Mohd.

    2008-01-01

    The main purpose of the present study was to develop and evaluate a WebQuest instruction on Nutrition using WebQuest template, known as NutriQuest. NutriQuest was developed to improve Form 2 students' understanding of fundamental nutrition concepts and its application in daily life, to improve critical and creative thinking skills and to enhance…

  5. An Evaluation of the Influence of the Expanded Food and Nutrition Education Program in Missouri.

    ERIC Educational Resources Information Center

    Nolan, Nelda M.; Gross, John G.

    The report evaluates the Expanded Food and Nutrition Education Program (EFNEP) in Missouri by comparing the dietary adequacy and nutrition knowledge of 200 program families representative of urban, small town and rural areas with that of 200 similarly representative non-program families. Data were gathered by personal interviews taken in March,…

  6. An Economic Evaluation of the Expanded Food and Nutrition Education Program

    ERIC Educational Resources Information Center

    Dollahite, Jamie; Kenkel, Donald; Thompson, C. Scott

    2008-01-01

    Objective: To evaluate the New York State Expanded Food and Nutrition Education Program using economic methodology. Design: Data were collected by nutrition educators in a pretest, posttest design with an epidemiological modeling approach to assess costs and estimate potential health benefits of the state program. Setting: Cooperative Extension,…

  7. The Team up for School Nutrition Success Workshop Evaluation Study: Three Month Results

    ERIC Educational Resources Information Center

    Cullen, Karen Weber; Rushing, Keith

    2017-01-01

    Purpose/Objectives: The purpose of this study was to evaluate the "Team Up for School Nutrition Success" pilot initiative, conducted by the Institute of Child Nutrition (ICN), on meeting the objectives of the individual action plans created by school food authorities (SFAs) during the workshop. The action plans could address improving…

  8. Evaluation of the Implementation Grant Project of Tennessee's Nutrition Education and Training Program 1981-82.

    ERIC Educational Resources Information Center

    Banta, Trudy W.; And Others

    The Bureau of Educational Research and Service at the University of Tennessee, Knoxville (UTK) conducted the 1981-82 evaluation of the Tennessee Nutrition Education and Training Program. Instruments developed, field tested, and revised by the UTK team were used to assess the nutrition knowledge, attitudes, practices, and perceptions of students…

  9. Evaluation of the Use of Group Dynamics Training in the Expanded Food and Nutrition Education Program.

    ERIC Educational Resources Information Center

    Mortvedt, Marjory M.

    The paper evaluates the use of group dynamics training for Expanded Food and Nutrition Education Program (EFNEP) aides in Ohio and assesses low income homemakers' adoption of group participation. The treatment group of aides was given week-long experimental group dynamics training which was coupled with nutrition and money management subject…

  10. The Team Up for School Nutrition Success workshop evaluation study: 3-month results

    USDA-ARS?s Scientific Manuscript database

    The purpose of this study was to evaluate the Team Up for School Nutrition Success pilot initiative, conducted by the Institute of Child Nutrition (ICN), on meeting the objectives of the individual action plans created by school food authorities (SFAs) during the workshop. The action plans could add...

  11. An Economic Evaluation of the Expanded Food and Nutrition Education Program

    ERIC Educational Resources Information Center

    Dollahite, Jamie; Kenkel, Donald; Thompson, C. Scott

    2008-01-01

    Objective: To evaluate the New York State Expanded Food and Nutrition Education Program using economic methodology. Design: Data were collected by nutrition educators in a pretest, posttest design with an epidemiological modeling approach to assess costs and estimate potential health benefits of the state program. Setting: Cooperative Extension,…

  12. Epidural dexamethasone for post-operative analgesia in patients undergoing abdominal hysterectomy: A dose ranging and safety evaluation study

    PubMed Central

    Hefni, Amira Fathy; Mahmoud, Mohamed Sidky; Al Alim, Azza Atef Abd

    2014-01-01

    Aim: Number of studies revealed that epidural bupivacaine-dexamethasone has the same analgesic potency as bupivacaine-fentanyl with opioid sparing and antiemetic effects. Different doses of dexamethasone were used in different studies. This study was designed to evaluate the optimum dose of epidural dexamethasone for post-operative analgesia. Materials and Methods: In this double-blinded randomized controlled study, we evaluated the efficiency and safety of different doses of epidural dexamethasone for post-operative analgesia in 160 patients aged 45-60 years scheduled for total abdominal hysterectomy. Patient were randomly allocated into four groups to receive a total volume of 10 ml epidural plain bupivacaine 0.25% in the control group (Group D0) with either 4 mg dexamethasone in (Group D4) or 6 mg dexamethasone in (Group D6) or 8 mg dexamethasone in (Group D8). Patients then received general anesthesia. Sedation, satisfaction and visual analog pain scores (VAS) at rest and with effort were measured post-operatively. Meperidine was administered when VAS > or = 4. Intra-operative fentanyl dose, post-operative meperidine consumption and the time to first analgesic requirement were recorded by a blinded observer. Blood glucose was measured pre-operatively and at 4 h and 8 h after study drug administration. Wound healing and infection were assessed after 1 week. Results: Intraoperative fentanyl requirements were comparable among groups. The time to first analgesic requirement was significantly prolonged 5.5 times in D8 Group but only 1.5 times in D6 and D4 Groups more than the analgesic duration in the control Group D0, with a P < 0.01. There was a significant reduction in post-operative meperidine consumption during the first 24 h in the D8 (75%) in comparison with D6 and D4 Groups (50%), respectively, (P < 0.01) and the control Group D0 (0%) (P < 0.01). VAS scores were significantly lower and patient satisfaction score was significantly higher in the D8 and

  13. Cortical bone water changes in ovariectomized rats during the early postoperative period: Objective evaluation using sweep imaging with Fourier transform.

    PubMed

    Sukenari, Tsuyoshi; Horii, Motoyuki; Ikoma, Kazuya; Kido, Masamitsu; Hayashi, Shigeki; Hara, Yusuke; Yamasaki, Tetsuro; Matsuda, Ken-Ichi; Kawata, Mitsuhiro; Kubo, Toshikazu

    2015-07-01

    To evaluate the cortical bone signal-to-noise ratio (SNR) in ovariectomized (OVX) rats during the early postoperative period as a method to measure bone quality using the sweep imaging with Fourier transform (SWIFT) technique. Twelve-week-old female Sprague-Dawley rats (n = 64) were divided into sham and OVX groups. Preoperative tetracycline was immediately administered subcutaneously to distinguish new cortical bone area, and tibial samples were collected at 2, 4, 8, and 12 weeks postoperatively. Magnetic resonance imaging (MRI) was performed using proton density-weighted imaging (PDWI) and SWIFT to obtain cross-sectional images of the tibial diaphysis. The cortical bone SNR was calculated. Bone histomorphometry was performed. Histomorphometry findings showed that the new bone area was significantly greater at 8 and 12 weeks postoperatively in the OVX group (P < 0.05) while the porosity area decreased gradually in both groups (P < 0.001). The difference of SNR receiving PDWI did not reach statistical significance (P = 0.057). The SWIFT technique showed that the SNR was significantly higher at 8 and 12 weeks postoperatively in the OVX group (P < 0.05) and was correlated with the new bone area (R(2) = 0.430). The SWIFT findings suggest that the SWIFT technique may depict early changes in cortical bone quality. © 2014 Wiley Periodicals, Inc.

  14. Pain as a late emotional reaction. Clinical research evaluating the psychosocial expression of pain disorder in preoperative and postoperative period.

    PubMed

    Zavadovschi, Iuliana

    2014-01-01

    A comparative analysis of the influence of psychosocial factors on pain perception in preoperative and postoperative period in patients scheduled for abdominal surgery. A psychological assessment was performed in 50 patients without psychiatric history scheduled for abdominal surgery. The verbal expression of pain, intensity of anxiety, catastrophizing level, and the interpersonal relationships were assessed. Surgery has a powerful effect on the perception of pain intensity. Postoperatively patients perceive significantly lower pain than in the preoperative period (p = 0.001). In the postoperative period the patients mainly use emotional and evaluative verbal expressions (p = 0.000 and p = 0.000, respectively), have a high index of anxiety (p = 0.000), adopt a higher level of coping self-statements (p = 0.002), and have a higher level of perception of others (family, friends) (p = 0.005). In patients undergoing surgery, surgery affects their psyche, triggering a series of events that can have psychological effects on pain intensity, doctor-patient relationship, postoperative complications, and shortening of recovery time.

  15. Evaluation of the role of antibiotics in preventing postoperative complication after routine periodontal surgery: A comparative clinical study

    PubMed Central

    Mohan, Rosh Radhika; Doraswamy, Dwarakanath Chinni; Hussain, Ahad M.; Gundannavar, Gayatri; Subbaiah, Shobha Krishna; Jayaprakash, Deepika

    2014-01-01

    Background and Objectives: Aim of this randomly controlled clinical study was to evaluate the role of antibiotics to prevent postoperative complications after routine periodontal surgery and also to determine whether their administration improved the surgical outcome. Materials and Methods: Forty-five systemically healthy patients with moderate to severe chronic periodontitis requiring flap surgery were enrolled in the study. They were randomly allocated to Amoxicillin, Doxycycline, and control groups. Surgical procedures were carried out with complete asepsis as per the protocol. Postoperative assessment of patient variables like swelling, pain, temperature, infection, ulceration, necrosis, and trismus was performed at intervals of 24 h, 48 h, 1 week, and 3 months. Changes in clinical parameters such as gingival index, plaque index, probing pocket depth, and clinical attachment level were also recorded. Results: There was no incidence of postoperative infection in any of the patients. Patient variables were comparable in all the three groups. Though there was significant improvement in the periodontal parameters in all the groups, no statistically significant result was observed for any group over the others. Conclusion: Results of this study showed that when periodontal surgical procedures were performed following strict asepsis, the incidence of clinical infection was not significant among all the three groups, and also that antibiotic administration did not influence the outcome of surgery. Therefore, prophylactic antibiotics for patients who are otherwise healthy administered following routine periodontal surgery to prevent postoperative infection are unnecessary and have no demonstrable additional benefits. PMID:24872630

  16. [Evaluation of nutrition manner and nutritional status of girls during the period of adolescence, including girls who apply slimming diets].

    PubMed

    Goluch-Koniuszy, Zuzanna; Fugiel, Joanna

    2009-01-01

    The purpose of the research was the evaluation of nutrition methods and the nutrition status of girls in the age ranging between 15 and 16, who had body substance, height, waist measurements taken; and the BMI, WC, and WHtR indicators were calculated. Three day menus were also evaluated and an inquiry containing questionnaire concerning the manner of apply slimming diets. It has also been ascertained that 40.8% of fifteen year old and 31% of sixteen year old girls apply slimming diets. It was discovered that only in 76% of younger girls and in 71% of older girls the value of the BMI indicator was proper. The problem of accumulation of fat tissue (WC > or = 95 c) around the waist concerned 4% younger girls and 10% older. It was discovered that the values of WHtR > or = 90 c were almost 10% and 23% in the cases of younger and older girls, respectively. Analysis of nutrition of the girls showed low energy value of the diet, too low total protein level, too low of complex carbohydrates, minerals (K, Ca, Mg, Cu, Zn) and vitamins (A, E, B group) and also liquids shortage. The girls have been educated in the form of workshops in the matter concerning healthy nutrition.

  17. Postoperative Evaluation after Anterior Cruciate Ligament Reconstruction: Measurements and Abnormalities on Radiographic and CT Imaging.

    PubMed

    Kim, Minchul; Choi, Yun Sun; Kim, Hyoungseop; Choi, Nam-Hong

    2016-01-01

    Reconstruction of a ruptured anterior cruciate ligament (ACL) is a well-established procedure for repair of ACL injury. Despite improvement of surgical and rehabilitation techniques over the past decades, up to 25% of patients still fail to regain satisfactory function after an ACL reconstruction. With development of CT imaging techniques for reducing metal artifacts, multi-planar reconstruction, and three-dimensional reconstruction, early post-operative imaging is increasingly being used to provide immediate feedback to surgeons regarding tunnel positioning, fixation, and device placement. Early post-operative radiography and CT imaging are easy to perform and serve as the baseline examinations for future reference.

  18. [Evaluation of pain intensity and vital signs in the cardiac surgery postoperative period].

    PubMed

    Miranda, Adriana de Fátima Alencar; da Silva, Lúcia de Fátima; Caetano, Joselany Áfio; de Sousa, Ana Cláudia; Almeida, Paulo César

    2011-04-01

    The objective of this study is to analyze the changes in vital signs of postoperative cardiac surgery patients, according to the referred pain intensity. This descriptive-exploratory study was performed using quantitative analysis to investigate 38 patients submitted to a first dressing change. The analysis of the data, measured before and after performing the nursing procedure, indicated that the manifestation of pain occurred at different levels. The main changes in vital signs referred to blood pressure. In conclusion, there is a relationship between pain intensity and vital signs, and the care that is delivered is indispensible to reestablishing the health state of the postoperative patient.

  19. Evaluation of a preschool nutrition education program based on the theory of multiple intelligences.

    PubMed

    Cason, K L

    2001-01-01

    This report describes the evaluation of a preschool nutrition education program based on the theory of multiple intelligences. Forty-six nutrition educators provided a series of 12 lessons to 6102 preschool-age children. The program was evaluated using a pretest/post-test design to assess differences in fruit and vegetable identification, healthy snack choices, willingness to taste foods, and eating behaviors. Subjects showed significant improvement in food identification and recognition, healthy snack identification, willingness to taste foods, and frequency of fruit, vegetable, meat, and dairy consumption. The evaluation indicates that the program was an effective approach for educating preschool children about nutrition.

  20. Evaluation of selected dietary behaviours of students according to gender and nutritional knowledge.

    PubMed

    Zaborowicz, Katarzyna; Czarnocińska, Jolanta; Galiński, Grzegorz; Kaźmierczak, Paulina; Górska, Karolina; Durczewski, Paweł

    2016-01-01

    Nutrition is a factor influencing physical and mental fitness. In this study we examine the lifestyle of university students and its impact on nutritional errors. To evaluate the dietary behaviours of students taking into account gender and nutritional knowledge. Using a QEB questionnaire, we were able to evaluate dietary behaviours and nutritional knowledge of respondents. Our analysis was conducted on data obtained from 456 students. We found that nutritional knowledge for women was 34.7% satisfactory and 34.7% good. In contrast, nutritional knowledge for men varied, amounting to 40.2% satisfactory and 25.1% good. The number of meals and their regular consumption did not depend on gender or the nutritional knowledge of students, however, significant differences were recorded for the types of snacks they eat. A greater number of women than men snacked on sweets and biscuits, nuts and seeds, while in the case of salty snacks an opposite trend was observed. A higher level of nutritional knowledge correlated with the number of students snacking on fruit and vegetables instead of salty snacks. Moreover, it was observed that health-promoting behaviours such as not adding sugar to beverages and not adding salt to dishes were more common with women and individuals with a higher level of nutritional knowledge. Women more frequently snack on sweets, biscuits, nuts and seeds. More men snack on salty snacks, add sugar to beverages and add salt to dishes. Individuals with insufficient nutritional knowledge more frequently snack on salty snacks rather than fruit. Students with insufficient nutritional knowledge more often commit nutritional errors.

  1. [Biological evaluation of a protein mixture intended for enteral nutrition].

    PubMed

    Meneses, J Olza; Foulquie, J Porres; Valero, G Urbano; de Victoria, E Martínez; Hernández, A Gil

    2008-01-01

    Enteral nutrition is the best way to feed or supplement the diet when gastrointestinal tract functions of patients are partially or totally preserved. Whenever total enteral nutrition is needed, it represents the only source of nutrients for patients. Thus, it is mandatory to ensure that high biological value proteins are included in enteral formulae. To assess the biological quality of a protein blend constituted by 50% potassium caseinate, 25% whey protein and 25% pea protein intended to be used in enteral nutrition products. Forty Wistar rats (20 male and 20 female), with initial body weight of 51 g, where divided into four groups and feed for 10 days with: casein (Control), experimental protein blend (Experimental), liophylized normo- and hyperproteic enteral nutrition formulae adapted to the animal nutritional requirements (Normoproteic and Hyperproteic). Protein efficiency ratio (PER), apparent digestibility coefficient (ADC), relationship between retained and absorbed nitrogen (R/A) and relationship between retained and consumed nitrogen (R/I) where calculated. Experimental and control groups had similar values for all analysed indices (PER, ADC, R/A and R/I). These indices where also similar between normo and hyperproteic groups, but lower than experimental and control groups, except in PER, where normoproteic group was either similar to control and hiperproteic group. The quality of the protein blend used in this study is high. It is a good protein source to be used in the development of new enteral nutritional products.

  2. Lessons Learned From Evaluations of California's Statewide School Nutrition Standards

    PubMed Central

    Gosliner, Wendi; Samuels, Sarah E.; Craypo, Lisa; Kao, Janice; Crawford, Patricia B.

    2010-01-01

    Objectives. We assessed the impact of legislation that established nutrition standards for foods and beverages that compete with reimbursable school meals in California. Methods. We used documentation of available foods and beverages, sales accounts, and surveys of and interviews with students and food service workers to conduct 3 studies measuring pre- and postlegislation food and beverage availability, sales, and student consumption at 99 schools. Results. Availability of nutrition standard–compliant foods and beverages increased. Availability of noncompliant items decreased, with the biggest reductions in sodas and other sweetened beverages, regular chips, and candy. At-school consumption of some noncompliant foods dropped; at-home consumption of selected noncompliant foods did not increase. Food and beverage sales decreased at most venues, and food service à la carte revenue losses were usually offset by increased meal program participation. Increased food service expenditures outpaced revenue increases. Conclusions. Regulation of competitive foods improved school food environments and student nutritional intake. Improvements were modest, partly because many compliant items are fat- and sugar-modified products of low nutritional value. Additional policies and actions are needed to achieve more substantive improvements in school nutrition environments and student nutrition and health. PMID:20864696

  3. Lessons learned from evaluations of California's statewide school nutrition standards.

    PubMed

    Woodward-Lopez, Gail; Gosliner, Wendi; Samuels, Sarah E; Craypo, Lisa; Kao, Janice; Crawford, Patricia B

    2010-11-01

    We assessed the impact of legislation that established nutrition standards for foods and beverages that compete with reimbursable school meals in California. We used documentation of available foods and beverages, sales accounts, and surveys of and interviews with students and food service workers to conduct 3 studies measuring pre- and postlegislation food and beverage availability, sales, and student consumption at 99 schools. Availability of nutrition standard-compliant foods and beverages increased. Availability of noncompliant items decreased, with the biggest reductions in sodas and other sweetened beverages, regular chips, and candy. At-school consumption of some noncompliant foods dropped; at-home consumption of selected noncompliant foods did not increase. Food and beverage sales decreased at most venues, and food service à la carte revenue losses were usually offset by increased meal program participation. Increased food service expenditures outpaced revenue increases. Regulation of competitive foods improved school food environments and student nutritional intake. Improvements were modest, partly because many compliant items are fat- and sugar-modified products of low nutritional value. Additional policies and actions are needed to achieve more substantive improvements in school nutrition environments and student nutrition and health.

  4. Evaluation of midcarpal capitate contact mechanics in normal, injured and post-operative wrists.

    PubMed

    Modaresi, Saman; Kallem, Madhan S; Lee, Phil; McIff, Terence E; Toby, E Bruce; Fischer, Kenneth J

    2017-08-01

    Scapholunate ligament injury is a commonly occurring carpal ligament injury. Pathology associated with scapholunate ligament injury depends on several factors such as the time after injury, type of injury (instability) and the development of osteoarthritis. The aim of this study was to investigate and compare contact mechanics in the lunocapitate and scaphocapitate joints in the normal, injured (scapholunate dissociation) and repaired (postoperative) wrist. Four human subjects with scapholunate ligament dissociation participated in this study. MR images of normal (contralateral), injured and postoperative wrists were obtained during relaxed condition and during active light grasp. Relaxed MR images were used to construct model geometry (bones with cartilage) for the capitate, lunate and scaphoid. Kinematic transformations were obtained by using image registration between the unloaded and functionally loaded image sets. Joint surface contact mechanics were then calculated. All contact measures (contact force, pressure, mean pressure and area) tended to increase with injury in both articulations. A significantly higher contact area was found in the injured scaphocapitate joint compared to normal. A significant increase in peak pressure was observed in the postoperative state compared to normal. Injury to the scapholunate ligament increased contact measures, suggesting a risk for onset of osteoarthritis in both the scaphocapitate and lunocapitate joints. Surgical repair appeared to restore most measures of contact mechanics to near normal values, more so for the lunocapitate joint when compared to scaphocapitate joint. The elevated postoperative peak pressures indicate the difficulty to fully restore joint mechanics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. [Treating acute postoperative pain: evaluation of results on the surgical ward].

    PubMed

    Esteve, N; Ribera, H; Mora, C; Romero, O; Garrido, P; Verd, M

    2011-01-01

    To describe management of acute postoperative pain on the surgical ward. To study the relationship between pain and a variety of surgical procedures and approaches. To determine the level of information patients received, their expectations, and their satisfaction with treatment of postoperative pain. Cross-sectional observational study by survey and review of patient records. We studied 234 patients, including all who were hospitalized for more than 24 hours after scheduled or emergency operations. The main variables recorded were pain intensity at rest and during movement, including on the day after surgery, and the surgical procedure and approach. The prevalence of pain (>3 on a numerical scale) on the surgical ward was 33% at rest and 66% during movement. The prevalence of intense pain (>6 on the numerical scale) was 1.7% at rest and 7.3% during movement. Factors related to greater pain intensity were timing, that is, the first day after surgery, when 74.4% of patients experienced their most intense pain; type of surgery and approach (P<.004); and expecting to experience moderate or intense pain (P<.001). Recording the prevalence of postoperative pain on a surgical ward provides information about the real situation of acute postoperative pain control. Pain on movement is a principal indicator for detecting groups of patients for whom analgesic protocols could be improved. Type of surgery and approach is a fundamental factor to consider when comparing the results of analgesic protocols.

  6. [Measurement of postoperative pain: analysis of the sensitivity of various self-evaluation instruments].

    PubMed

    Lázaro, C; Caseras, X; Torrubia, R; Baños, J E

    2003-05-01

    This study compared the sensitivity of two one-dimensional scales (a visual analog scale [VAS] and a verbal scale of pain intensity [VSPI]) and one multidimensional scale (McGill Pain Questionnaire-Spanish Version [MPQ-SV]) for detecting changes in pain after a variety of surgical procedures with postoperative analgesia provided by one of two methods. Forty-two patients who underwent abdominal surgery, hysterectomy, cesarean, inguinal herniorrhaphy, subcostal or medial laparoscopic cholecystectomy were studied. Postoperative analgesia consisted of 1 mg/Kg of intravenous pethidine every 4 h in group one (n = 20) and intramuscular diclofenac every 12 h in group two. Assessment was at 24 h and/or at 48 and 72 h using the VAS, the VSPI and the MPQ-SV. All the scales were useful for assessing postoperative pain, giving estimates that were sensitive to variations in pain on days after the operation. The MPQ-SV was able to detect different pain-producing capacities for the surgical procedures more effectively than were the one-dimensional scales. The MPQ-SV was also able to discriminate the qualitative and quantitative differences among the mechanisms of action of opioid and nonsteroidal anti-inflammatory drugs, whereas the one-dimensional scales were unable to distinguish therapeutic approach. All the scales were sensitive to changes in postoperative pain, but the MPQ-SV gave more precise information of differences between analgesic treatments and among operations.

  7. Evaluation of nutritional status in advanced metastatic cancer.

    PubMed

    Sarhill, N; Mahmoud, F; Walsh, D; Nelson, K A; Komurcu, S; Davis, M; LeGrand, S; Abdullah, O; Rybicki, L

    2003-10-01

    Consecutive cancer referrals to a palliative medicine program were evaluated to assess nutritional status using a standard protocol. The study included 352 patients (180 men, 172 women; median age 61 years, range 22-94 years). The most common diagnosis was lung cancer. All had metastatic disease, 139 with gastrointestinal involvement. The most common gastrointestinal symptoms were weight loss ( n=307), anorexia ( n=285), and early satiety ( n=243). Of those with any weight loss, 71% had lost >or0% of their pre-illness weight. The most common factor identified which might have contributed to weight loss was hypophagia ( n=275/307). Men had lost weight more often and to a greater extent than women. Triceps skinfold (TSF) was measured in 337: 51% had values that suggested severe fat deficiency. Upper mid-arm muscle area (AMA) was measured in 349: 30% had evidence of significant muscle mass reduction. The body mass index (BMI) was normal or increased in most patients. Calculated resting energy expenditure (REE) ( n=324) was high in 41%. C-reactive protein was elevated in 74% of those measured ( n=50). We conclude that: (1).most of this group of cancer patients referred to palliative medicine had severe weight loss; (2).there was a gender difference in the severity and type of weight loss; (3).males lost more weight overall and more muscle than females; (4).males with any degree of weight loss had a higher REE than females; (5).a significant correlation existed between the time from diagnosis to death and the severity of weight loss in the prior month; (6).BMI was normal in most patients, suggesting precancer diagnosis obesity; and (7).both TSF and AMA correlated well with body composition of both fat and protein as determined by bioelectrical impedance.

  8. The Role of Extension Nutrition Education in Student Achievement of Nutrition Standards in Grades K-3: A Descriptive Evaluation of a School-Based Program

    ERIC Educational Resources Information Center

    Arnold, Mary E.; Schreiber, Debera

    2012-01-01

    This article reports the results of a descriptive evaluation of the impact of an in-school Extension nutrition education program in a small, very rural county. The evaluation focused on understanding the nature of the role the Extension educator plays in delivering nutrition education, the impact of the program on student learning and achievement…

  9. The Role of Extension Nutrition Education in Student Achievement of Nutrition Standards in Grades K-3: A Descriptive Evaluation of a School-Based Program

    ERIC Educational Resources Information Center

    Arnold, Mary E.; Schreiber, Debera

    2012-01-01

    This article reports the results of a descriptive evaluation of the impact of an in-school Extension nutrition education program in a small, very rural county. The evaluation focused on understanding the nature of the role the Extension educator plays in delivering nutrition education, the impact of the program on student learning and achievement…

  10. Applicability Evaluation of Job Standards for Diabetes Nutritional Management by Clinical Dietitian

    PubMed Central

    2017-01-01

    This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical dietitians of 40 tertiary hospitals, 47 general hospitals, and 9 hospitals. Based on each 5-point scale, the importance of overall duty was 4.4 ± 0.5, performance was 3.6 ± 0.8, and difficulty was 3.1 ± 0.7. ‘Nutrition intervention’ was 4.5 ± 0.5 for task importance, ‘nutrition assessment’ was 4.0 ± 0.7 for performance, and ‘nutrition diagnosis’ was 3.4 ± 0.9 for difficulty. These 3 items were high in each category. Based on the grid diagram, the tasks of both high importance and high performance were ‘checking basic information,’ ‘checking medical history and therapy plan,’ ‘decision of nutritional needs,’ ‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’ The tasks with high importance but low performance were ‘derivation of nutrition diagnosis,’ ‘planning of nutrition intervention,’ ‘monitoring of nutrition intervention process.’ The tasks of both high importance and high difficulty were ‘derivation of nutrition diagnosis,’ ‘planning of nutrition intervention,’ ‘supply of foods and nutrients,’ ‘education of nutrition and self-management,’ and ‘monitoring of nutrition intervention process.’ The tasks of both high performance and high difficulty were ‘documentation of nutrition assessment,’ ‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’ PMID:28503506

  11. Evaluation of food provision and nutrition support at the London 2012 Olympic Games: the opinion of sports nutrition experts.

    PubMed

    Pelly, Fiona; Meyer, Nanna L; Pearce, Jeni; Burkhart, Sarah J; Burke, Louise M

    2014-12-01

    The aim of this study was to evaluate the food provision and nutrition support at the London 2012 Olympic (OG) and Paralympic Games (PG) from the perspective of sports nutrition experts attending the event. Participants (n = 15) were asked to complete an online survey and rate on a Likert scale menu qualities, food safety, sustainability practices, nutrition labeling, and provision for cultural needs, dietary regimes and specific situations. Open-ended responses were incorporated to explore expert opinion and areas for improvement. Participants rated their overall experience of the food provision as 7.6 out of 10 (range 5 to 10), with the majority (n = 11) rating it greater than 7. The variety, accessibility, presentation, temperature, and freshness of menu items rated as average to good. A below average rating was received for recovery food and beverages, provision of food for traveling to other venues, taking suitable snacks out of the dining hall and provision of food at other venues. However, the variety and accessibility of choices for Ramadan, and provision of post-competition food were rated highly. A number of comments were received about the lack of gluten free and lower energy/fat items. The inclusion of allergens on nutrition labeling was considered more important than nutrient content. While dietetic review of the menu in advance of the OG and PG is clearly a valuable process that has resulted in improvements in the food supply, there are still areas that need to be addressed that are currently not implemented during the event.

  12. Mark, Set, Go! School-Based Nutrition and Physical Activity Program: A Five-Year Evaluation.

    PubMed

    El Rayess, Fadya; Gandhi, Meeka; Mennillo, Haran

    2017-02-01

    Mark, Set Go! is a school-based intervention addressing pediatric obesity in an urban, underserved community. This study evaluates its impact on participants' knowledge, attitudes and behavior related to nutrition, physical activity and screen time.

  13. Prospective double-blind clinical trial evaluating the effectiveness of Bromelain in the third molar extraction postoperative period.

    PubMed

    de la Barrera-Núñez, M-C; Yáñez-Vico, R-M; Batista-Cruzado, A; Heurtebise-Saavedra, J-M; Castillo-de Oyagüe, R; Torres-Lagares, D

    2014-03-01

    To evaluate the anti-inflammatory and analgesic effect of Bromelain (pineapple extract) administered orally in the postoperative after extraction of impacted lower molars. This is a prospective, placebo-controlled, unicentric, double-blind study; the sample size was 34 patients. The pre and postoperative outcomes, evaluated on the third (D3) and eighth day (D8), included inflamtion, pain and oral aperture, as well as the need for analgesics. One group received Bromelain 150mg per day for three days and 100mg on days 4 to 7. The other group received placebo in the same dosage. All outcomes werrecorded quantitatively and analyzed with the Mann-Whitney U test for independent samples. Although there were no statistically significant differences between the treatment groups, a trend towards less inflammation and improved oral aperture was observed in the group that received Bromelain, compared to the group that received placebo. This trend can be attributed completely to random reasons, since there is no statistical difference in the results. Further studies are necessary to analyze different administration patterns and doses of Bromelain for the use in the postoperative of impacted third molars.

  14. Nutritional Evaluation of Australian Microalgae as Potential Human Health Supplements

    PubMed Central

    Kent, Megan; Welladsen, Heather M.; Mangott, Arnold; Li, Yan

    2015-01-01

    This study investigated the biochemical suitability of Australian native microalgal species Scenedesmus sp., Nannochloropsis sp., Dunaliella sp., and a chlorophytic polyculture as nutritional supplements for human health. The four microalgal cultures were harvested during exponential growth, lyophilized, and analysed for proximate composition (moisture, ash, lipid, carbohydrates, and protein), pigments, and amino acid and fatty acid profiles. The resulting nutritional value, based on biochemical composition, was compared to commercial Spirulina and Chlorella products. The Australian native microalgae exhibited similar, and in several cases superior, organic nutritional properties relative to the assessed commercial products, with biochemical profiles rich in high-quality protein, nutritious polyunsaturated fats (such as α-linolenic acid, arachidonic acid, and eicosapentaenoic acid), and antioxidant pigments. These findings indicate that the microalgae assessed have great potential as multi-nutrient human health supplements. PMID:25723496

  15. Nutritional evaluation of Australian microalgae as potential human health supplements.

    PubMed

    Kent, Megan; Welladsen, Heather M; Mangott, Arnold; Li, Yan

    2015-01-01

    This study investigated the biochemical suitability of Australian native microalgal species Scenedesmus sp., Nannochloropsis sp., Dunaliella sp., and a chlorophytic polyculture as nutritional supplements for human health. The four microalgal cultures were harvested during exponential growth, lyophilized, and analysed for proximate composition (moisture, ash, lipid, carbohydrates, and protein), pigments, and amino acid and fatty acid profiles. The resulting nutritional value, based on biochemical composition, was compared to commercial Spirulina and Chlorella products. The Australian native microalgae exhibited similar, and in several cases superior, organic nutritional properties relative to the assessed commercial products, with biochemical profiles rich in high-quality protein, nutritious polyunsaturated fats (such as α-linolenic acid, arachidonic acid, and eicosapentaenoic acid), and antioxidant pigments. These findings indicate that the microalgae assessed have great potential as multi-nutrient human health supplements.

  16. Evaluation of postoperative complications following elective surgeries of dogs and cats at private practices using computer records.

    PubMed Central

    Pollari, F L; Bonnett, B N

    1996-01-01

    This study was designed to determine the frequency of postoperative complications following elective surgeries (castration, ovariohysterectomy, onychectomy) of dogs and cats from private practices and to evaluate the use of electronic medical records for this type of research. All elective surgeries performed during the study period at 5 private practices were included. The surgical techniques and materials used for each procedure were similar across practices, but the interpretation of "complication," the amount of detail recorded on the primary medical record, and the intensity of follow-up varied. The frequencies and types of complications varied by species and procedure. The postoperative complication frequencies ranged from 1% to 24% for all complications and 1% to 4% for severe complications. The results of this study describe populations of elective-surgery patients at private practices, provide data for educating clients about the risks associated with these procedures, and demonstrate how computerized records can be used to collect practice-specific medical information. PMID:8939333

  17. Inter- and intraobserver variability in the postoperative evaluation of transpedicular stabilization: computed tomography versus magnetic resonance imaging.

    PubMed

    Tohtz, Stephan W; Rogalla, Patrick; Taupitz, Matthias; Perka, Carsten; Winkler, Tobias; Putzier, Michael

    2010-04-01

    Computed tomography (CT) represents the state of the art for the postoperative verification of the implant position after transpedicular stabilizations. Magnetic resonance imaging (MRI) has not challenged the CT, yet, because of susceptibility artifacts but would be favorable as a diagnostic tool for its excellent soft-tissue qualities. A study that analyzed if an artifact-reduced MRI could overcome this problem and provide sufficient data for the postoperative assessment was conducted. The study design was a radiologic comparison of CT and MRI techniques evaluating pedicle screw placement after spinal fusion. Fifty consecutive patients were given an MRI and a CT after a transpedicular stabilization surgery. Thirty-eight patients suffered from degenerative spinal disorders; three surgeries had become necessary because of spondylodiscitis, eight patients suffered from metastatic vertebrae destruction, and one patient experienced a fracture. Any contact of a malpositioned pedicle screw with the dura and/or radicular structures was identified as an implant-associated complication and was compared with postoperative clinical patient findings. In total, 338 pedicular screws were analyzed in regard to their intrapedicular position. The double-blind evaluation of MRI and CT data was carried out by two radiologists and two spine surgeons. Accuracy of the CT analysis was calculated based on the interobserver agreement of 100%. Magnetic resonance imaging accuracy was calculated. The interobserver accuracy of the CT data amounted to a median of 89.8% and in the MRI data of 86.7%. Intraobserver comparisons showed a significant difference between CT and magnetic resonance evaluations in one observer (kappa=0.293). In all other observers, the results were concordant with kappa values from kappa=0.328 to kappa=0.702. There was a high degree of agreement regarding the diagnosis of malpositioned pedicle screw and corresponding clinical symptoms between both techniques. The

  18. [Evaluation of nutritional status of school-age children after implementation of "Nutrition Improvement Program" in rural area in Hunan, China].

    PubMed

    Deng, Zhu-Juan; Mao, Guang-Xu; Wang, Yu-Jun; Liu, Li; Chen, Yan

    2016-09-01

    To investigate the nutritional status of school-age children in rural area in Hunan, China from 2012 to 2015 and to evaluate the effectiveness of the "Nutrition Improvement Program for Compulsory Education Students in Rural Area" (hereinafter referred to as "Nutrition Improvement Program"). The nutritional status of school-age children aged 6-14 years was evaluated after the implementation of the "Nutrition Improvement Program" and the changing trend of the children's nutritional status was analyzed. The statistical analysis was performed on the monitoring data of the school-age children aged 6-14 years in rural area in Hunan, China from 2012 to 2015, which came from "The Nutrition and Health Status Monitoring and Evaluation System of Nutrition Improvement Program for Compulsory Education Students in Rural Area". In 2015, female students aged 6-7 years in rural area in Hunan, China had a significantly greater body length than the rural average in China (P<0.05). However, the other age groups had significantly smaller body length and weight than the rural averages in China (P<0.05). After the implementation of "Nutrition Improvement Program", the prevalence rate of growth retardation decreased (P<0.05), but the prevalence rate of emaciation increased (P<0.05). At the same time, the prevalence rate of overweight/obesity increased (P<0.05) and the prevalence rate of anemia decreased (P<0.05). The implementation of "Nutrition Improvement Program" has achieved some success, but the nutritional status of school-age children has not improved significantly. Overweight/obesity and malnutrition are still present. Therefore, to promote the nutritional status of school-age children it is recommended to improve the measures for the "Nutrition Improvement Program".

  19. In vivo evaluation of in situ polysaccharide based hydrogel for prevention of postoperative adhesion.

    PubMed

    Lou, Weiwei; Zhang, Hualin; Ma, Jianfeng; Zhang, Dafeng; Liu, Chuantong; Wang, Siqian; Deng, Zhennan; Xu, Haihong; Liu, Jinsong

    2012-10-01

    In this paper, the carboxymethyl chitosan/oxidized dextran hydrogel was developed and its potency application in the prevention of postoperative adhesion was investigated. The developed hydrogel showed porous and interconnected interior structure with pore size about 250 μm, which was sensitive to lysozymic solution (1.5 μg/ml) with almost complete degradation after 4 weeks of in vitro incubation. In vivo study suggested that the developed hydrogel showed the great capacity on the prevention of postoperative adhesions in rat model. According to the result of histopathological examination, it clearly showed that the mesothelial cell layer of abdominal wall and cecum were completely recovered after 7 days of surgery in 3% carboxymethyl chitosan/oxidized dextran hydrogel group, while obvious adhesion between abdominal wall and cecum was observed as treatment with saline solution or 3% carboxymethyl chitosan solution after 1 day of surgery. All these results suggested that the developed biodegradable hydrogel might have potential application in the prevention of postoperative adhesion.

  20. Evaluation of topical epidural morphine for postoperative analgesia following hemilaminectomy in dogs.

    PubMed

    Wehrenberg, Aaron; Freeman, Lynetta; Ko, Jeff; Payton, Mark; Spivack, Rebecca

    2009-01-01

    A randomized prospective study was conducted in dogs undergoing hemi-laminectomy procedures for Hansen type I disk protrusion to compare postoperative analgesia achieved with topical spinal application of morphine versus saline. An absorbable gelatin sponge was placed in the defect next to the dura and soaked with either preservative-free morphine (0.1 mg/kg) or saline (0.1 ml/kg) just before wound closure. For 48 hours after surgery, dogs were monitored for pain using visual analog and numeric descriptive scales and given rescue analgesia according to study guidelines. A Kaplan-Meier survival analysis revealed that dogs in the morphine group had a longer (13.3 +/- 3.6 hours) duration of postoperative analgesia than those in the control saline group (5.3 +/- 1.8 hours), and dogs in the morphine group also required fewer doses of additional pain medication. Preservative-free morphine administered topically via an absorbable gelatin sponge appears to be a promising method to alleviate postoperative pain in dogs undergoing hemilaminectomy procedures.

  1. Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction

    PubMed Central

    Schuepbach, Jonas; Dassonville, Olivier; Poissonnet, Gilles; Demard, Francois

    2007-01-01

    Background Bone scintigraphy was performed to monitor anastomotic patency and bone viability. Methods In this retrospective study, bone scans were carried out during the first three postoperative days in a series of 60 patients who underwent microvascular bone grafting for reconstruction of the mandible or maxilla. Results In our series, early bone scans detected a compromised vascular supply to the bone with high accuracy (p < 10-6) and a sensitivity that was superior to the sensitivity of clinical monitoring (92% and 75% respectively). Conclusion When performing bone scintigraphy during the first three postoperative days, it not only helps to detect complications with high accuracy, as described in earlier studies, but it is also an additional reliable monitoring tool to decide whether or not microvascular revision surgery should be performed. Bone scans were especially useful in buried free flaps where early postoperative monitoring depended exclusively on scans. According to our experience, we recommend bone scans as soon as possible after surgery and immediately in cases suspicious of vascularized bone graft failure. PMID:17448223

  2. [Evaluation of the nutritional state in patients with congenital cardiopathy].

    PubMed

    Bartolomé Lalanza, M L; García Vera, C; Ruiz-Echarri Zalaya, M P; Calvo Ruata, M L; Baldellou Vázquez, A

    1991-09-01

    Several anthropometrical, immunological and biochemical parameters have been utilized for the detection of chronic undernourishment and inflammation. The present work proposes a comparative study between a control group and other of 24 cardiac patients, with the intention of valuating their nutritional and inflammatory state. We have used the index proposed by Ingenbleek (PINI = prognostic inflammatory and nutritional index) in which nutritional scoreboards and biochemical inflammatories correlate. We find some statistically significant differences between cases and controls, both with regard to the value of the PINI, and with regard to each of this variables. In the same way, we do not find any important correlations within each group among the nutritional biochemical, inflammatory and anthropometrical parameters. The clinical impression shows that the classification by groups of risk obtained according to the value of the PINI is very near to reality. We consider that the PINI index is useful as a predictive and evolutive parameter, and it can be used in children with a chronic illness.

  3. [Postoperative pain in craniotomy].

    PubMed

    Peón, Andréa Ungaro; Diccini, Solange

    2005-01-01

    In the postoperative period, 47% to 75% of the patients report some degree of pain. This study aimed to evaluate pain in the pre and postoperative period of patients submitted to craniotomy. This prospective research was carried out at the neurosurgery unit of a large Brazilian hospital. For a quantitative evaluation of pain, the verbal numeric 0-10 rating scale was used. Forty patients with a mean age of 36 years were evaluated. In the preoperative period, 34 (85%) patients indicated headache as the main cause of pain. In the postoperative period, 37 (93%) patients complained of pain while three (7%) reported absence of pain. Pain peaks were observed on the 2nd postoperative day, when 12 (32%) of the patients reported severe pain and 10 (27%) moderate pain. Absence of severe pain occurred after the 8th postoperative day. It was concluded that protocols of analgesia in craniotomy are needed, such as training nurses to better evaluate and handle pain.

  4. [Hygienic evaluation of actual nutrition and health status of sales personnel in the city of Artem].

    PubMed

    Belousova, G I; Gerasimenko, T V; Volkova, N A; Gordo, G N

    2002-01-01

    Actual nutrition of saleswomen was studied in the town of Artem (Primorye territory), characterized by unfavorable demographic values. Fifty-two women aged 30-39 years were examined, all of them living in the region for at least 3 years and engaged in foodstuff sales for more than 3 years. Their nutrition was studied by 24-hour reproduction of nutrition. In addition, nutrition regimen, food preferences were evaluated and alimentary-dependent diseases were detected. The study revealed an imbalance in the nutrition structure, with low consumption of meat and fish, fruits and vegetables, vegetable oil and high consumption of sugar, potato, and bread. The consumption of the main nutrients and micronutrients was insufficient, energy value of food was low, and meals hours irregular.

  5. Evaluation of nutritional status and energy expenditure in athletes.

    PubMed

    Mielgo-Ayuso, Juan; Maroto-Sánchez, Beatriz; Luzardo-Socorro, Raquel; Palacios, Gonzalo; Palacios Gil-Antuñano, Nieves; González-Gross, Marcela

    2015-02-26

    Continuous physical exercise leads the athlete to maintain an unstable balance between dietary intake, energy expenditure and the additional demands of a high amount of physical activity. Thus, an accurate assessment of nutritional status is essential to optimize the performance, since it affects health, body composition, and the recovery of the athlete. Specific aspects like the type of sport, specialty or playing position, training schedule and competition calendar, category, specific objectives, which differ from the general population, must be considered. A biochemical assessment can give us a general idea of the nutritional status, lipid profile, liver or kidney function, if diet is too high in proteins or fats, as well as possible nutritional deficiencies and the need for supplementation. Sport kinanthropometry has great utility that enables the assessment of body mass, height, length, diameter, perimeter and skinfolds, where information is processed by applying different equations, obtaining information on somatotype, body composition, and the proportionality of different parts of the body. To give proper nutritional counselling, energy needs of the athlete must be known. If objective measurement is not possible, there are tables including theoretically established energy requirements of different sports. Dietary assessment should include information about food consumption and nutrient intake to establish the relationship between diet, health status and athlete's performance. On the other hand, an adequate hydration status in athletes is essential to maintain adequate performance. Hence, the knowledge of fluid intake by the athlete is a matter of the utmost importance. Dehydration can cause harmful effects on athletes' health. As there is no gold standard, urine gravidity and urine colour are the most extended methods for analyzing hydration status. There is consensus that due to complexity, the combination of different methods assures an effective data

  6. Pilot Evaluation of an In-Store Nutrition Label Education Program.

    PubMed

    Dukeshire, Steven; Nicks, Emily; Ferguson, Jennifer

    2014-12-01

    To describe and provide recommendations for the implementation of an evaluation for an already existing, in-store Nutrition Label Education Program (NLEP). We describe the development and implementation of an evaluation consisting of a pre- and postsurvey and one month follow-up. The evaluation was designed to assess satisfaction with the NLEP as well as changes in participant nutrition label knowledge, confidence in using nutrition labels, and actual changes in nutrition label use. Nineteen participants took part in the pilot evaluation. The evaluation was successful in demonstrating high levels of satisfaction with the NLEP as well as positive changes in participant confidence and some increased knowledge in using nutrition labels. However, only 3 people participated in the follow-up, limiting the ability to assess behaviour change. Ideally, NLEPs should include ongoing evaluation that extends beyond just assessing participant satisfaction. Recommendations are provided for conducting such evaluations, including the importance of incorporating the evaluation into the program itself, using existing questionnaires when possible, and employing pre- and postsurveys as well as follow-up interviews to assess change.

  7. Evaluation of word associations as a reliable postoperative indicator of implicit memory formation during the intraoperative period.

    PubMed

    Maye, J P; Smith, T L

    2001-02-01

    Patients expect to receive an anesthetic that prevents the formation of memories during the intraoperative period. Unfortunately, explicit memory formation occurs 40,000 times per year in the United States, while the incidence of implicit memory is thought to be greater. The purpose of the study was to evaluate the effectiveness of word associations as a reliable postoperative indicator of implicit memory formation during the intraoperative period. Forty-eight participants scheduled to undergo general anesthesia for an elective procedure were selected. During the administration of 0.77 +/- .18 microgram/kg per minute of remifentanyl and 0.31 +/- .04 end-tidal volume percent of sevoflurane in air/oxygen, word associations in the form of "Trivial Pursuit" (Hasbro, Inc, Pawtucket, RI) game statements were presented via headphones. Within 24 hours of surgery, each participant was given a postoperative word association test that included the experimental and control word associations. No reports of explicit memory were noted. The experimental word associations were correctly answered 19.3% of the time, while the control word associations were correctly answered 12.8% of the time (P = .014). The findings illustrated that the word association test in the form of Trivial Pursuit game statements/answers may serve as a reliable postoperative indicator of implicit memory formation during the intraoperative period.

  8. External rotation and active supination CT arthrography for the postoperative evaluation of type II superior labral anterior to posterior lesions.

    PubMed

    Kim, Sae Hoon; Choi, Ja-Young; Yoo, Hye Jin; Hong, Sung Hwan

    2016-01-01

    To evaluate the effectiveness of external rotation and active supination CT arthrography in postoperative evaluation by comparing it with neutral CT arthrography and analyzing its agreement with postoperative clinical results after the repair of type II superior labral anterior to posterior (SLAP) lesions. A total of 25 patients who had undergone CT arthrography in neutral, external rotation and active supination position at least 1 year after the arthroscopic repair of SLAP lesions were enrolled. Two radiologists independently evaluated the status of the repaired SLAP lesions with neutral CT arthrography and then with external rotation and active supination CT arthrography. Five patients had residual symptoms and positive findings upon SLAP-specific examinations. Agreements between the presence of symptoms and radiologic diagnoses based on neutral CT arthrography were insignificant for reader 1 (κ = 0.138, p = n.s.) and significant for reader 2 (κ = 0.328, p = 0.027). However, agreements were highly significant in the analysis following the evaluation of external rotation and active supination CT arthrography for both readers (κ = 0.694, p < 0.001 in reader 1; κ = 0.783, p < 0.001 in reader 2). The presence of contrast-filled gaps between the labrum and glenoid on neutral CT arthrography after SLAP repair is frequent with satisfactory clinical outcomes. Gaps without additional widening upon external rotation and active supination CT arthrography may suggest postoperatively stable biceps anchors, so this new method could minimize the overdiagnosis of recurrent SLAP lesions. Additional gap widening on external rotation and active supination CT arthrography could be related to a true recurrent SLAP lesion and the symptoms of the patients. Case series, Level IV.

  9. Utility of 18F sodium fluoride PET/CT imaging in the evaluation of postoperative pain following surgical spine fusion.

    PubMed

    Pouldar, D; Bakshian, S; Matthews, R; Rao, V; Manzano, M; Dardashti, S

    2017-08-01

    A retrospective case review of patients who underwent 18F sodium fluoride PET/CT imaging of the spine with postoperative pain following vertebral fusion. To determine the benefit of 18F sodium fluoride PET/CT imaging in the diagnosis of persistent pain in the postoperative spine. The diagnosis of pain generators in the postoperative spine has proven to be a diagnostic challenge. The conventional radiologic evaluation of persistent pain after spine surgery with the use of plain radiographs, MRI, and CT can often fall short of diagnosis in the complex patient. 18F sodium fluoride PET/CT imaging is an alternative tool to accurately identify a patient's source of pain in the difficult patient. This retrospective study looked at 25 adult patients who had undergone 18F sodium fluoride PET/CT imaging. All patients had persistent or recurrent back pain over the course of a 15-month period after having undergone spinal fusion surgery. All patients had inconclusive dedicated MRI. The clinical accuracy of PET/CT in identifying the pain generator and contribution to altering the decision making process was compared to the use of CT scan alone. Of the 25 patients studied, 17 patients had increased uptake on the 18F sodium fluoride PET/CT fusion images. There was a high-level correlation of radiotracer uptake to the patients' pain generator. Overall 88% of the studies were considered beneficial with either PET/CT altering the clinical diagnosis and treatment plan of the patient or confirming unnecessary surgery. 18F sodium fluoride PET/CT proves to be a useful tool in the diagnosis of complex spine pathology of the postoperative patients. In varied cases, a high correlation of metabolic activity to the source of the patient's pain was observed.

  10. Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement.

    PubMed

    Qi, A; Lin, C; Zhou, A; Du, J; Jia, X; Sun, L; Zhang, G; Zhang, L; Liu, M

    2016-01-01

    This study aimed to determine whether psychological factors affect health-related quality of life (HRQL) and recovery of knee function in total knee replacement (TKR) patients. A total of 119 TKR patients (male: 38; female: 81) completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), Eysenck Personality Questionnaire-revised (EPQR-S), Knee Society Score (KSS), and HRQL (SF-36). At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05). SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001). Preoperative Physical Component Summary Scale (PCS) and Mental Component Summary Scale (MCS) scores were negatively associated with extraversion (E score) (B=-0.986 and -0.967, respectively, both P<0.05). Postoperative PCS and State Anxiety Inventory (SAI) scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05). Postoperative MCS, SAI, Trait Anxiety Inventory (TAI), and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05). The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05), but positively associated with the E score (B=0.215, P<0.05). The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05). In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions.

  11. Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement

    PubMed Central

    Qi, A.; Lin, C.; Zhou, A.; Du, J.; Jia, X.; Sun, L.; Zhang, G.; Zhang, L.; Liu, M.

    2015-01-01

    This study aimed to determine whether psychological factors affect health-related quality of life (HRQL) and recovery of knee function in total knee replacement (TKR) patients. A total of 119 TKR patients (male: 38; female: 81) completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), Eysenck Personality Questionnaire-revised (EPQR-S), Knee Society Score (KSS), and HRQL (SF-36). At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05). SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001). Preoperative Physical Component Summary Scale (PCS) and Mental Component Summary Scale (MCS) scores were negatively associated with extraversion (E score) (B=-0.986 and -0.967, respectively, both P<0.05). Postoperative PCS and State Anxiety Inventory (SAI) scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05). Postoperative MCS, SAI, Trait Anxiety Inventory (TAI), and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05). The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05), but positively associated with the E score (B=0.215, P<0.05). The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05). In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions. PMID:26577843

  12. Evaluation of the nutritional status of older hospitalised geriatric patients: a comparative analysis of a Mini Nutritional Assessment (MNA) version and the Nutritional Risk Screening (NRS 2002).

    PubMed

    Christner, S; Ritt, M; Volkert, D; Wirth, R; Sieber, C C; Gaßmann, K-G

    2016-12-01

    The present study aimed to evaluate a short-form (MNA-SF) version of the Mini Nutritional Assessment (MNA), in which some of the items were operationalised, based on scores from tools used for a comprehensive geriatric assessment, as a method for analysing the nutritional status of hospitalised geriatric patients. We compared this MNA-SF version with the corresponding MNA long-form (MNA-LF) and Nutritional Risk Screening 2002 (NRS 2002) in terms of completion rate, prevalence and agreement regarding malnutrition and/or the risk of this. In total, 201 patients aged ≥65 years who were hospitalised in geriatric wards were included in this analysis. The MNA-SF, MNA-LF and NRS 2002 were completed in 98.0%, 95.5% and 99.5% of patients (P = 0.06), respectively. The MNA-SF, MNA-LF and NRS 2002 categorised 93.4%, 91.1% and 66.0% of patients as being malnourished or at risk of being malnourished (P < 0.001). Agreement between the MNA-SF and MNA-LF was substantial (κ = 0.70, P < 0.001). No agreement between the MNA-SF and NRS 2002 was found (κ = -0.12, P < 0.001). Interestingly, NRS 2002 part 1 (prescreening) revealed a false negative rate of 21.0% (only in patients aged ≥70 years who showed moderate disease severity) in relation to the NRS 2002 part 2. The MNA-SF version emerged as a useful tool for evaluating the nutritional status of hospitalised geriatric patients. The NRS 2002 part 1 showed limited value as a prescreening aid in relation to the NRS 2002 part 2 in the same group of patients. © 2016 The British Dietetic Association Ltd.

  13. Pre- and postoperative evaluation of partial anomalous pulmonary venous return: by 3-dimensional cardiovascular magnetic resonance imaging and cardiovascular computed tomography.

    PubMed

    Crestanello, Juan A; Daniels, Curt; Franco, Veronica; Raman, Subha V

    2010-01-01

    The pre- and postoperative evaluation of anomalous pulmonary venous return usually requires multiple invasive and noninvasive tests in order to obtain complete anatomic and functional data. Conversely, in a single setting, either cardiovascular magnetic resonance imaging or cardiovascular computed tomography can sufficiently reveal this information in adult patients. Herein, we present the cases of 2 patients with partial anomalous pulmonary venous return who underwent preoperative and postoperative evaluation by either method alone, and we discuss the benefits and limitations of each technique.

  14. Methods to evaluate the nutrition risk in hospitalized patients

    PubMed Central

    Erkan, Tülay

    2014-01-01

    The rate of malnutrition is substantially high both in the population and in chronic patients hospitalized because of different reasons. The rate of patients with no marked malnutrition at the time of hospitalization who develop malnutrition during hospitalization is also substantially high. Therefore, there are currently different screening methods with different targets to prevent malnutrition and its overlook. These methods should be simple and reliable and should not be time-consuming in order to be used in daily practice. Seven nutrition risk screening methods used in children have been established until the present time. However, no consensus has been made on any method as in adults. It should be accepted that interrogation of nutrition is a part of normal examination to increase awareness on this issue and to draw attention to this issue. PMID:26078678

  15. Nutritional Evaluation of NASA's Rodent Food Bar Diet

    NASA Technical Reports Server (NTRS)

    Barrett, Joyce E.; Yu, Diane S.; Dalton, Bonnie P.

    2000-01-01

    Tests are being conducted on NASA's rodent Food Bar in preparation for long-term use as the rat and mouse diet aboard the International Space Station. Nutritional analyses are performed after the bars are manufactured and then repeated periodically to determine nutritional stability. The primary factors analyzed are protein, ash, fat, fiber, moisture, amino acids, fatty acids, and minerals. Nutrient levels are compared to values published in the National Research Council's dietary requirements for rodents, and also to those contained in several commonly used commercial rodent lab diets. The Food Bar is manufactured from a powdered diet to which moisture is added as it is processed through an extruder. The bars are dipped into potassium sorbate, vacuum-sealed, and irradiated. In order to determine nutrient changes during extrusion and irradiation, the powdered diet, the non-irradiated bars, and the irradiated bars are all analyzed. We have observed lower values for some nutrients (iodine, vitamin K, and iron) in the Food Bars compared with NRC requirements. Many nutrients in the Food Bars are contained at a higher level than levels in the NRC requirements. An additional factor we are investigating is the 26% moisture level in the Food Bars, which drops to about 15% within a week, compared to a stable 10% moisture in many standard lab chow diets. In addition to the nutritional analyses, the food bar is being fed to several strains of rats and mice, and feeding study and necropsy results are being observed (Barrett et al, unpublished data). Information from the nutritional analyses and from the rodent studies will enable us to recommend the formulation that will most adequately meet the rodent Food Bar requirements for long-term use aboard the Space Station.

  16. Nutritional Evaluation of NASA's Rodent Food Bar Diet

    NASA Technical Reports Server (NTRS)

    Barrett, Joyce E.; Yu, Diane S.; Dalton, Bonnie P.

    2000-01-01

    Tests are being conducted on NASA's rodent Food Bar in preparation for long-term use as the rat and mouse diet aboard the International Space Station. Nutritional analyses are performed after the bars are manufactured and then repeated periodically to determine nutritional stability. The primary factors analyzed are protein, ash, fat, fiber, moisture, amino acids, fatty acids, and minerals. Nutrient levels are compared to values published in the National Research Council's dietary requirements for rodents, and also to those contained in several commonly used commercial rodent lab diets. The Food Bar is manufactured from a powdered diet to which moisture is added as it is processed through an extruder. The bars are dipped into potassium sorbate, vacuum-sealed, and irradiated. In order to determine nutrient changes during extrusion and irradiation, the powdered diet, the non-irradiated bars, and the irradiated bars are all analyzed. We have observed lower values for some nutrients (iodine, vitamin K, and iron) in the Food Bars compared with NRC requirements. Many nutrients in the Food Bars are contained at a higher level than levels in the NRC requirements. An additional factor we are investigating is the 26% moisture level in the Food Bars, which drops to about 15% within a week, compared to a stable 10% moisture in many standard lab chow diets. In addition to the nutritional analyses, the food bar is being fed to several strains of rats and mice, and feeding study and necropsy results are being observed (Barrett et al, unpublished data). Information from the nutritional analyses and from the rodent studies will enable us to recommend the formulation that will most adequately meet the rodent Food Bar requirements for long-term use aboard the Space Station.

  17. Evaluating postoperative rotator cuff healing: Prospective comparison of MRI and ultrasound.

    PubMed

    Collin, P; Yoshida, M; Delarue, A; Lucas, C; Jossaume, T; Lädermann, A

    2015-10-01

    The objective of this prospective comparative single centre study was to compare postoperative rotator cuff healing rates as assessed by magnetic resonance imaging (MRI) versus ultrasonography (US). Between October 2012 and February 2013, 61 patients underwent arthroscopic repair of postero-superior rotator cuff tears. Each patient underwent MRI and US 6 months later. The findings were assessed independently by two observers. We compared intra-observer and inter-observer levels of agreement regarding healing rates assessed by MRI and US. Intra-observer agreement regarding the MRI interpretation was 95% (κ coefficient, 0.83) for one observer and 98% (κ coefficient, 0.94) for the other. Values of κ for inter-observer agreement ranged across readings from 0.76 to 0.90. When MRI was taken as the reference, US had 80% sensitivity and 98% specificity. MRI and US provide similar assessments of postoperative rotator cuff healing, although US is less sensitive. Intra-observer and inter-observer agreements are very good. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Barriers to postoperative pain management in hip fracture patients with dementia as evaluated by nursing staff.

    PubMed

    Rantala, Maija; Kankkunen, Päivi; Kvist, Tarja; Hartikainen, Sirpa

    2014-03-01

    This paper reports a study of the perceptions of nursing staff regarding barriers to postoperative pain management in hip fracture patients with dementia, their expectations, and facilitators offered by their employers to overcome these barriers. Patients with dementia are at high risk for insufficient postoperative pain treatment, mainly owing to inability to articulate or convey their pain experience. Nursing staff have an essential role in the treatment and care of patients who are vulnerable, and therefore unable to advocate for their own pain treatment. Questionnaires with both structured and open-ended questions were used to collect data from nursing staff members in seven university hospitals and ten city-center hospitals from March to May 2011. The response rate was 52% (n = 331). According to nursing staff, the biggest barrier in pain management was the difficulty in assessing pain owing to a patient's cognitive impairment (86%). Resisting care and restlessness among patients with dementia can lead to use of restraints, although these kinds of behavioral changes can point to the occurrence of pain. There were statistically significant differences between the sufficiency of pain management and barriers. Those who expected pain management to be insufficient identified more barriers than those who expected pain management to be sufficient (p < .001). Further updating education for nursing staff in pain detection and management is needed so that nursing staff are also able to recognize behavioral symptoms as potential signs of pain and provide appropriate pain management.

  19. Evaluation of Sports Nutrition Knowledge and Recommendations Among High School Coaches.

    PubMed

    Couture, Steven; Lamarche, Benoit; Morissette, Eliane; Provencher, Veronique; Valois, Pierre; Goulet, Claude; Drapeau, Vicky

    2015-08-01

    The objectives of this study were to evaluate high school coaches' knowledge in sports nutrition and the nutritional practices they recommend to their athletes. Forty-seven high school coaches in "leanness" and "non-leanness" sports from the greater region of Quebec (women = 44.7%) completed a questionnaire on nutritional knowledge and practices. "Leanness sports" were defined as sports where leanness or/and low bodyweight were considered important (e.g., cheerleading, swimming and gymnastics), and "non-leanness sports" were defined as sports where these factors are less important (e.g., football). Participants obtained a total mean score of 68.4% for the nutrition knowledge part of the questionnaire. More specifically, less than 30% of the coaches could answer correctly some general nutrition questions regarding carbohydrates and lipids. No significant difference in nutrition knowledge was observed between coaches from "leanness" and "non-leanness" sports or between men and women. Respondents with a university education scored higher than the others (73.3% vs. 63.3%, p < .05). Coaches who participated in coaching certification also obtained better results than those without a coaching certification. The most popular source of information about nutrition used by coaches was the Internet at 55%. The two most popular nutrition practices that coaches recommended to improve athlete performance were hydration and consumption of protein-rich foods. Recommendation for nutritional supplements use was extremely rare and was suggested only by football coaches, a nonleanness sport. Findings from this study indicate that coaches need sports nutrition education and specific training.

  20. Pre- and postoperative evaluation of pelvic floor muscle function in POP patients using surface electromyography and digital palpation.

    PubMed

    Chen, Xinliang; Gong, Yao; Wu, Dan; Li, Xiaocui; Li, Huaifang; Tong, Xiaowen; Cheng, Weiwei

    2014-04-01

    The study aims to evaluate the pelvic floor muscle (PFM) function in patients with pelvic organ prolapse (POP) pre- and postoperatively using digital palpation and surface electromyography. In this non-randomized prospective study, two groups of patients were recruited for assessment. The surgical group included 74 POP patients receiving the modified pelvic reconstructive surgery and the control group consisted of 30 non-POP patients. One physiotherapist conducted the digital palpation and SEMG evaluation. The scale of PFM strength, the duration and voltage of maximum voluntary contraction (MVC) as well as numbers and voltage of short, fast contractions (SFC) by SEMG were documented and compared in both groups. For statistical analysis, t-test, Mann-Whitney U test and Wilcoxon test were used with a significant level 0.05. A total of 68 POP patients finished the two follow-ups. Sixty-four patients were objectively cured with a 94.1% cure rate. Mesh erosions happened in three patients (4.8%). By digital palpation, the PFM strength increased significantly in POP patients after surgery but still lower than non-POP patients (P<0.001). By SEMG, the electrical activity of PFM increased significantly in the surgical group postoperatively (P 0.001). The PFM function was improved 3 months after the modified pelvic reconstructive surgery in POP patients based on digital palpation and SEMG. The evaluation of PFM function should be included in the overall assessment of pelvic reconstructive surgeries. © 2013 Wiley Periodicals, Inc.

  1. Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice.

    PubMed

    Sherf Dagan, Shiri; Goldenshluger, Ariela; Globus, Inbal; Schweiger, Chaya; Kessler, Yafit; Kowen Sandbank, Galit; Ben-Porat, Tair; Sinai, Tali

    2017-03-01

    Bariatric surgery is currently the most effective treatment for morbid obesity and its associated metabolic complications. To ensure long-term postoperative success, patients must be prepared to adopt comprehensive lifestyle changes. This review summarizes the current evidence and expert opinions with regard to nutritional care in the perioperative and long-term postoperative periods. A literature search was performed with the use of different lines of searches for narrative reviews. Nutritional recommendations are divided into 3 main sections: 1) presurgery nutritional evaluation and presurgery diet and supplementation; 2) postsurgery diet progression, eating-related behaviors, and nutritional therapy for common gastrointestinal symptoms; and 3) recommendations for lifelong supplementation and advice for nutritional follow-up. We recognize the need for uniform, evidence-based nutritional guidelines for bariatric patients and summarize recommendations with the aim of optimizing long-term success and preventing complications.

  2. European Society for Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Neurological Impairment.

    PubMed

    Romano, Claudio; van Wynckel, Myriam; Hulst, Jessie; Broekaert, Ilse; Bronsky, Jiri; Dall'Oglio, Luigi; Mis, Nataša F; Hojsak, Iva; Orel, Rok; Papadopoulou, Alexandra; Schaeppi, Michela; Thapar, Nikhil; Wilschanski, Michael; Sullivan, Peter; Gottrand, Frédéric

    2017-08-01

    Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment. Thirty-one clinical questions addressing the diagnosis, treatment, and prognosis of common gastrointestinal and nutritional problems in neurological impaired children were formulated. Questions aimed to assess the nutritional management including nutritional status, identifying undernutrition, monitoring nutritional status, and defining nutritional requirements; to classify gastrointestinal issues including oropharyngeal dysfunctions, motor and sensory function, gastroesophageal reflux disease, and constipation; to evaluate the indications for nutritional rehabilitation including enteral feeding and percutaneous gastrostomy/jejunostomy; to define indications for surgical interventions (eg, Nissen Fundoplication, esophagogastric disconnection); and finally to consider ethical issues related to digestive and nutritional problems in the severely neurologically impaired children. A systematic literature search was performed from 1980 to October 2015 using MEDLINE. The approach of the Grading of Recommendations Assessment, Development, and Evaluation was applied to evaluate the outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation using the nominal voting technique. Expert opinion was applied to

  3. Evaluation of the nutrition counselling component of a fitness programme for children with disabilities.

    PubMed

    Fragala-Pinkham, Maria A; Bradford, Laura; Haley, Stephen M

    2006-01-01

    To describe and evaluate the nutrition counselling component of a fitness programme for children with disabilities. Twenty-eight children with disabilities, ages 6-14 years, participated in a 16-week comprehensive fitness programme consisting of twice weekly exercise sessions, nutrition counselling and physical activity promotion education sessions. Nutrition sessions consisted of three individual and two group sessions. Individual nutrition goals were developed for each child using 3-day food intake diaries and parent interview. Body Mass Index (BMI) and progress towards nutrition goals were documented. No significant BMI changes were recorded for the entire group (n=28) or a sub-group with a goal to decrease BMI (n=8). Most of the children made improvements in individual goals indicating improvements in healthy eating habits. This included eating the daily recommended amount of servings of each food group, trying new foods and limiting foods containing saturated and trans fats, sodium and sugar. Short-term changes were noted in eating habits and behaviours during the 16-week fitness programme, although the effects did not influence overall BMI during the 16-week programme. Children with disabilities are at nutritional risk, and long-term follow-up is needed to determine if initial changes in parent-reported child eating behaviours will impact long-term nutrition, BMI and overall health.

  4. Evaluation of enteral formulas for nutrition, health, and quality of life among stroke patients.

    PubMed

    Kang, Yunkyeong; Lee, Ho-Sun; Paik, Nam-Jong; Kim, Woo-Sub; Yang, Mihi

    2010-10-01

    Enteral nutritional support has been used via tube feeding for dysphagic stroke patients. We performed long and short term trials to evaluate the effects of commercial enteral nutritional supports on nutrition and health in stroke patients (mRS = 3~5) and quality of life in their caregivers. For a long term study, we recruited chronic (≥ 1 yrs) stroke patients (n = 6) and administered them 6 cans/day (1,200 kcal) of the commercial enteral formula N for 6 months according to IRB-approved protocol. We collected peripheral blood at 0, 2, 4 and 6 months. For a short term study, we recruited acute (≤ 3 months) stroke patients (n = 12) and randomly administered them two different commercial enteral formulas, N or J, for 2 weeks. We collected their blood at 0, 4, 7 and 14 day of the administration. Blood samples were analyzed to quantify 19 health and nutritional biomarkers and an oxidative stress biomarker, malondialdehyde (MDA). In order to evaluate quality of life, we also obtained the sense of competence questionnaire (SCQ) from all caregivers at 'before' and 'after trials'. As results, the enteral formula, N, improved hemoglobin and hematocrit levels in the long term trial and maintained most of biomarkers within normal ranges. The SCQ levels of caregivers were improved in the long term treatment (P < 0.05). In a case of the short term study, both of enteral formulas were helpful to maintain nutritional status of the patients. In addition, MDA levels were decreased in the acute patients following formula consumption (0.05 < P < 0.1). Most of health and nutrition outcomes were not different, even though there is a big difference in price of the two products. Thus, we evaluate the formula N has equal nutritional efficacy compared to the formula J. In addition, long term use of enteral formula N can be useful to health and nutrition of stroke patients, and the quality of life for their caregivers.

  5. Purposive facebook recruitment endows cost-effective nutrition education program evaluation.

    PubMed

    Lohse, Barbara; Wamboldt, Patricia

    2013-08-15

    Recent legislation established a requirement for nutrition education in federal assistance programs to be evidence-based. Recruitment of low-income persons to participate and evaluate nutrition education activities can be challenging and costly. Facebook has been shown to be a cost-effective strategy to recruit this target audience to a nutrition program. The purpose of our study was to examine Facebook as a strategy to recruit participants, especially Supplemental Nutrition Assistance Program Education (SNAP-Ed) eligible persons, to view and evaluate an online nutrition education program intended to be offered as having some evidence base for SNAP-Ed programming. English-speaking, low-income Pennsylvania residents, 18-55 years with key profile words (eg, Supplemental Nutrition Assistance Program, Food bank), responded to a Facebook ad inviting participation in either Eating Together as a Family is Worth It (WI) or Everyone Needs Folic Acid (FA). Participants completed an online survey on food-related behaviors, viewed a nutrition education program, and completed a program evaluation. Facebook set-up functions considered were costing action, daily spending cap, and population reach. Respondents for both WI and FA evaluations were similar; the majority were white, <40 years, overweight or obese body mass index, and not eating competent. A total of 807 Facebook users clicked on the WI ad with 73 unique site visitors and 47 of them completing the program evaluation (ie, 47/807, 5.8% of clickers and 47/73, 64% of site visitors completed the evaluation). Cost per completed evaluation was US $25.48; cost per low-income completer was US $39.92. Results were similar for the FA evaluation; 795 Facebook users clicked on the ad with 110 unique site visitors, and 73 completing the evaluation (ie, 73/795, 9.2% of ad clickers and 73/110, 66% of site visitors completed the evaluation). Cost per valid completed survey with program evaluation was US $18.88; cost per low

  6. Computer technology to evaluate body composition, nutrition, and exercise.

    PubMed

    Katch, F I; Katch, V L

    1983-09-01

    The use of computer technology has made it possible to make accurate determinations of body composition, nutrition, and exercise. With the FITCOMP computer assessment system, detailed measurements of physique status have been made on a variety of world-class athletes, including professional football and baseball players, as well as on diverse groups of young and older men and women throughout the United States. The FITCOMP measurement system allows the user a choice of measurement techniques: fatfolds, girths, bone diameters, and hydrostatic weighing. Combined with body composition assessment is a nutrition and exercise plan. The nutrition plan is based on guidelines formulated by the American Dietetic Association. This application of computer technology is unique, because individuals can select the foods they will eat from a list of preferred choices from the basic food groups. Individual menu plans for breakfast, lunch, and dinner are generated to provide an optimal blend of nutrients aimed at achieving ideal body mass and fat percentage. This is coupled with an aerobic exercise program that is selected by the individual from nine different forms, including walking, jogging, running, swimming, cycling, and various sport activities. The caloric output is designed to reduce total body fat through reductions in body weight of 1.4 to 2.5 pounds per week, depending on the exercise selected and total weight loss necessary to achieve a weight goal (and ideal fat percentage). The aerobic exercise plan is based on the method of overload, where intensity and duration are periodically increased dependent on individual capabilities. The use of fitness-oriented computer technology makes it possible to prepare detailed reports about current status and progress as well as to systematize record keeping.

  7. [Effect of an anabolic steroid on the cellular immunity and postoperative evaluation of uterine cervical cancer].

    PubMed

    Ooshika, Y; Umesaki, N; Sako, H; Kawabata, M; Sugana, T

    1984-10-01

    The effects of an anabolic steroid on the immune activity and clinical condition of patients with cancer of the uterine cervix were studied. The effects of the steroid on tumor growth were also studied in animals. The results obtained demonstrated that the anabolic steroid (1) enhanced the activity of macrophages and cell-mediated immune activity, (2) reduced the incidence of post-operative infection, (3) reduced pose-operative loss of weight of patients due to the intrinsic anabolic activity of the steroid, and (4) did not exert any influence on tumor growth. Judging from these results, administration of the anabolic steroid would appear to be effective for the improvement of the general condition of cancer patients following surgery or in terminal cases.

  8. Initial evaluation of a canine stifle arthrotomy post-operative pain model.

    PubMed

    Tomas, A; Bledsoe, D; Wall, S; Davidson, G; Lascelles, B D X

    2015-06-01

    Most models of acute post-operative orthopedic pain involve the injection of a clinically irrelevant pro-inflammatory agent. The ideal model should, however, be clinically relevant and allow full functional recovery of enrolled animals after research is completed. This study explored the validity of a model employing arthrotomy and objectively measured limb use. Six purpose-bred Beagles underwent arthrotomies on each stifle with a washout period in between. Using a randomized crossover design, each dog received placebo and an extended-release buprenorphine (ER-Bup) preparation. Static and dynamic ground reaction forces (GRFs) were measured prior to and for 72 h following surgery using a pressure sensitive walkway (PSW). GRFs for each hind limb were compared using difference (delta), and symmetry indices (SI). The effects of surgery and of treatment were analyzed using repeated measures ANCOVA. The results indicated significantly decreased limb use compared to baseline for placebo, and significantly increased limb use in the ER-Bup group over placebo at all times for % bodyweight distribution (%BWdistrib), peak vertical force (PVF) and vertical impulse (VI). There was a significant treatment by time interaction for velocity (P = 0.03) and %BWdistrib (P = 0.01, 0.003). Overall, the data show that reduced limb use was present for at least 72 h following arthrotomy. In addition, the use of the ER-Bup analgesic decreased lameness, confirming the validity of this approach as a model of post-operative pain. Subjective assessments did not detect the pain-inducing effects of arthrotomy or pain-alleviating effects of treatment, and subjective measures of procedural pain in research dogs need to be developed.

  9. [Pediatric lung resection. A case series and evaluation of postoperative lung function].

    PubMed

    Caussade, S; Zúñiga, S; García, C; González, S; Campos, E; Soto, G; Zúñiga, F; Sánchez, I

    2001-12-01

    The most common causes of pulmonary lobectomy in children are congenital lung malformations (CLM) and bronchiectasias. Our aim was to present the causes and clinical course and lung function of lobectomized patients. Between 1990 and July 1999 27 lobectomies were performed on patients whose ages ranged from newborn to 14 years. Lobectomies were performed to correct CLM in 124 cases and for acquired pulmonary disease (APD) in 13. Among CLM cases, half (n = 7) had cystic adenomatoid malformation. Among the APD patients, 10 had bronchiectasias, with etiological confirmation in 6 cases (3 secondary to serious adenovirus infection). Mean hospital stay was 4.6 days among those who experienced no postoperative complications. Symptoms resolved after surgery for most symptomatic patients. Lung function tests could be carried out with 8 patients over 6 years old whose operations had taken place 7 to 78 months earlier (x = 35 months) and whose age at the time of surgery was a mean 7 years 6 months (range 60 to 144 months). Spirometry showed normal forced vital capacity for 7 of 8 patients (87 to 143% of theoretical value). Arterial oxygen saturation measured during and after a 6-minute walking test was normal for 7 of 8 patients. Chest films showed reduced lung volume on the affected side in 5 of 8 patients. In summary, lobectomy is a procedure with few complications. It requires a short hospital stay and has good postoperative prognosis. Function and x-ray studies show adequate lung growth and development, with normal lung function in those who could be so examined because they were old enough to cooperate.

  10. [Postoperative hypothyroidism].

    PubMed

    Olifirova, O S; Trynov, N N

    2015-01-01

    There is a number of factors such as the thyroidectomy and limiting subtotal thyroid resection against the background of euthyroidism and initial hypothyroidism (in any extent of operation) which leads to the prediction of early postoperative hypothyroidism origin during 10 days of the postoperative peri- od. The early postoperative hypothyroidism is accompanied by activation processes of lipid peroxide oxidation and at the same time by reduction of antioxidant protection.

  11. The Baylor pediatric nutrition handbook for residents

    USDA-ARS?s Scientific Manuscript database

    The Baylor Pediatric Nutrition Handbook for Residents provides basic resource information about the assessment of growth, the nutritional status assessment and feeding guidelines, biochemical evaluation of nutritional status, infant nutrition, enteral nutrition, parenteral nutrition, nutritional man...

  12. Speech Outcome in Oral Cancer Patients – Pre- and Post-operative Evaluation: A Cross-sectional Study

    PubMed Central

    Saravanan, Gomathi; Ranganathan, Venkatesan; Gandhi, Anitha; Jaya, V

    2016-01-01

    Aim: The tongue plays a major role in articulation. Speech outcome depends on the site of lesion, extent of resection, and flexibility of the remaining structures. The aim of this study is to evaluate the speech outcome measures such as sounds that are misarticulated and speech intelligibility and its connection to tumor site before and after surgery. Methodology: Totally, 24 (12 pre- and 12 post-operative patients) patients who had buccal and tongue cancer underwent speech intelligibility rating and articulation screening. Result: The results show that the speech outcome is worse in postoperative patients when compared to preoperative patients. The articulation errors produced by tongue cancer patients were more than the errors produced in buccal cancer patients. The type of reconstruction also affects the speech outcome. Conclusion: The perceptual analysis of oral cancer patients showed specific articulation issues and reduced intelligibility of speech in regards to site of lesion and type of reconstruction surgery. To reduce the speech errors, effective rehabilitation is recommended. A comprehensive speech evaluation and analysis of error patterns would help us in planning the rehabilitative measures of speech which is the most important factor in re-establishing interpersonal communication and well-being of the individual. PMID:27803574

  13. Evaluation of Supplemental Nutrition Assistance Program Education: Application of Behavioral Theory and Survey Validation

    ERIC Educational Resources Information Center

    Wyker, Brett A.; Jordan, Patricia; Quigley, Danielle L.

    2012-01-01

    Objective: Application of the Transtheoretical Model (TTM) to Supplemental Nutrition Assistance Program Education (SNAP-Ed) evaluation and development and validation of an evaluation tool used to measure TTM constructs is described. Methods: Surveys were collected from parents of children receiving food at Summer Food Service Program sites prior…

  14. Evaluation of Supplemental Nutrition Assistance Program Education: Application of Behavioral Theory and Survey Validation

    ERIC Educational Resources Information Center

    Wyker, Brett A.; Jordan, Patricia; Quigley, Danielle L.

    2012-01-01

    Objective: Application of the Transtheoretical Model (TTM) to Supplemental Nutrition Assistance Program Education (SNAP-Ed) evaluation and development and validation of an evaluation tool used to measure TTM constructs is described. Methods: Surveys were collected from parents of children receiving food at Summer Food Service Program sites prior…

  15. [Parenteral periferic nutrition: non surgical indications].

    PubMed

    Ayúcar Ruiz de Galarreta, A; Pita Gutiérrez, F; Mosteiro Pereira, F; Cordero Lorenzana, L; Gómez Canosa, S; Seco Vilariño, C

    2011-01-01

    Peripheral Parenteral Nutrition, defined as a mixture of micronutrients, vitamins and minerals with lower osmolarity of 800 mOsm/L, it avoids the risk of the central catheter. It has traditionally been used in postoperative patients, but really medical conditions can also benefit from it either as complementary, or as the only one source of nutrients, since a high number of patients require less caloric intake than previously believed. Evaluation of the use of peripheral parenteral nutrition in non postoperative hospitalized patients, reasons for its prescription and duration. 368 patients who required peripheral parenteral nutrition were studied by the Nutrition Support Unit for 54 months, in a Tertiary Hospital of 1,560 beds, from all, specialties excluding postoperative patients. The study include the mechanisms that led to its use in all its forms: the only one nutritional support or complementing insufficient Enteral Nutrition or Oral Diet. Oncology and Critical Care were the most prescribed pathologies, followed by Pancreatitis, Inflammatory Bowel Disease and HIV and a miscellany of clinical pathologies. Gastrointestinal pathology (pain, diarrhea or vomiting) was the most frequent cause, both in critically ill as in non-critical patients. Although enteral route is preferred and raised primarily in most patients studied, there are many causes that might impair or nullify it. Peripheral parenteral nutrition is an alternative when caloric intake is impossible or insufficient or refused by the patient, as it minimizes the complications of the central catheter.

  16. A nutritional evaluation of dietary behaviour in various professional sports.

    PubMed

    Pilis, Karol; Michalski, Cezary; Zych, Michał; Pilis, Anna; Jelonek, Jakub; Kaczmarzyk, Agata; Pilis, Wiesław

    2014-01-01

    The types of physical exertion undertaken by weightlifters and race walkers markedly differ. This difference should also be reflected in their respective diets. The aim of the study was to investigate and assess the diets of professional weightlifters and race walkers, along with a comparison to the diets of those students studying physical education (PE). Materials and Methods. Subjects were respectively 12 weightlifters, 12 race walkers and 12 physical education students whose body composition and nutrition were determined by weighing the foods that were both eaten and drunk. The study groups showed body differences, which may have arisen through dietary differences. Higher calorie diets were observed for race walkers according to body mass whilst weightlifters showed no difference with the other groups. Dietary intakes of protein, fat, and carbohydrates were however inappropriate for all groups. Vitamin and mineral intakes in weightlifters and students were within tolerable limits, but the rather aggressive taking of supplements by race walkers resulted in standard/recommended consumption levels being greatly exceeded in some cases. The diets of the study groups of weightlifters and race walkers need to be corrected. nutrition in sport, weightlifting, race walking, food supplementation.

  17. Prospective evaluation of early postoperative male and female sexual function after radical prostatectomy with erectile nerves preservation.

    PubMed

    Tran, S-N; Wirth, G J; Mayor, G; Rollini, C; Bianchi-Demicheli, F; Iselin, C E

    2015-01-01

    Prostate cancer screening has led to the diagnosis of localized prostate cancer in increasingly young and sexually active men. Accordingly, the impact of cancer treatment on sexual function is gaining more attention. To prospectively evaluate the impact of radical prostatectomy (RP) on male, female and conjugal sexual function. Patients were prospectively assessed by an urologist and a sexologist before and 6 months after robot-assisted laparoscopic RP (RALP). RALP was performed with uni- or bilateral neurovascular bundle preservation by a single surgeon. Postoperatively, all patients were prescribed tadalafil 20 mg, 3 times a week during 6 months. Male and female sexual functions were evaluated by using the International Index of Erectile Function (IIEF-5), the Female Sexual Function Index (FSFI) and the Lock-Wallace Marital Adjustment Test (MAT). Continuous variables were analyzed with rank-sum and t-tests, as needed, and categorical variables with chi-squared tests. All tests were two-sided, with a P-value ⩽ 0.05 considered significant. Twenty-one couples were included. Mean patient male and female age was 62.4 and 60.7 years, respectively. Bilateral nerve sparing was performed in 12/21 (57%) patients. Median preoperative IIEF-5 was 20/25, corresponding to mild erectile dysfunction (ED). Median preoperative FSFI and MAT were both within normal range (28/36 and 114/158, respectively). Six months following surgery, both IIEF-5 (11/25) and FSFI (25/36) had significantly dropped (P=0.007 and 0.003, respectively). Postoperative decreases in IIEF-5 and FSFI scores were associated within couples. MAT scores (115/158), however, remained unaffected by RALP, showing an unmodified relationship satisfaction postoperatively. Finally, bilateral nerve sparing surgery preserved not only male but also female sexual function. This study shows that the expected short-term post-RALP ED is associated with a worsening of female sexual function, whereas nerve sparing surgery has a

  18. Predicting Pressure Ulcer Development in Clinical Practice: Evaluation of Braden Scale Scores and Nutrition Parameters.

    PubMed

    Miller, Natasha; Frankenfield, David; Lehman, Erik; Maguire, Melissa; Schirm, Victoria

    2016-01-01

    Accurate patient assessment and screening for pressure ulcer (PU) is difficult in the clinical setting, and evaluation of nutritional status is especially problematic. The aim of this retrospective study was to determine the extent to which Braden Scale scores and other nutrition screening parameters (body mass index, poor intake, and weight loss) predict PU development in general and heel and sacral ulcers specifically. Records of 230 hospitalized patients who developed PU were compared to a matched control group without PU. Logistic regression was used to determine the association of total Braden scores, Braden nutrition subscale scores, and nutrition factors with PU development at any time, within week 1, or within week 2 of hospitalization; and development of sacral and heel ulcers at these same periods. Braden Scale scores on hospital admission were predictive of hospital-acquired pressure ulcer development at some point during the hospital stay; and more specifically Braden scores on day 7 were predictive of PU development within week 2 of hospitalization. Among nutrition screening factors and PU development, a low body mass index showed a statistically significant relationship with sacral ulcer development. Findings indicate that the overall Braden score is a valid predictor of PU development. Implications for clinical practice to decrease the risk for PU development include appropriate use of reliable and valid scales by nurses along with careful evaluation of nutrition parameters.

  19. Nutrition in Patients with Gastric Cancer: An Update

    PubMed Central

    Rosania, Rosa; Chiapponi, Costanza; Malfertheiner, Peter; Venerito, Marino

    2016-01-01

    Background Nutritional management of patients with gastric cancer (GC) represents a challenge. Summary This review provides an overview of the present evidence on nutritional support in patients with GC undergoing surgery as well as in those with advanced disease Key Message For patients undergoing surgery, the preoperative nutritional condition directly affects postoperative prognosis, overall survival and disease-specific survival. Perioperative nutritional support enriched with immune-stimulating nutrients reduces overall complications and hospital stay but not mortality after major elective gastrointestinal surgery. Early enteral nutrition after surgery improves early and long-term postoperative nutritional status and reduces the length of hospitalization as well. Vitamin B12 and iron deficiency are common metabolic sequelae after gastrectomy and warrant appropriate replacement. In malnourished patients with advanced GC, short-term home complementary parenteral nutrition improves the quality of life, nutritional status and functional status. Total home parenteral nutrition represents the only modality of caloric intake for patients with advanced GC who are unable to take oral or enteral nutrition Practical Implications Early evaluations of nutritional status and nutritional support represent key aspects in the management of GC patients with both operable and advanced disease. PMID:27403412

  20. Prospective evaluation of postoperative compliance and outcomes after rotator cuff repair in patients with and without workers' compensation claims.

    PubMed

    Cuff, Derek J; Pupello, Derek R

    2012-12-01

    This study prospectively evaluated compliance and outcomes after rotator cuff repair in patients with and without Workers' Compensation claims. From December 2007 to January 2010, 42 consecutive patients with Workers' Compensation claims (Work Comp group), and 50 consecutive patients without a Workers' Compensation claim (non-Work Comp group) underwent arthroscopic rotator cuff repair and were enrolled in this study. Compliance with a postoperative protocol of shoulder immobilization and physical therapy was documented. Patients were monitored clinically for a minimum of 12 months. Noncompliance with protocol was documented in 22 of 42 patients (52%) in the Work Comp group compared with 2 of 50 (4%) in the non-Work Comp group (P < .001). The Work Comp group had less improvement in preoperative to postoperative outcome scores for the American Shoulder and Elbow Surgeons (ASES) score (40.4 to 60.1), Simple Shoulder Test (SST) score (3.9 to 6.0) and visual analog scale (VAS) for pain (7.0 to 3.5) compared with the non-Work Comp group (ASES, 41.7 to 89.2; SST, 4.3 to 10.7; VAS, 6.2 to 0.35; P < .0001). The compliant Work Comp patients had more favorable results in final outcome scores (ASES, 73.1; SST, 7.9; VAS, 1.5) than noncompliant Work Comp patients (ASES, 48.4; SST, 4.3; VAS, 5.3; P < .0001). Patients with Workers' Compensation claims demonstrated a high rate of postoperative noncompliance (52%) compared with patients without Workers' Compensation claims (4%) after rotator cuff repair. Those Workers' Compensation patients who had no evidence of noncompliance had significant improvements and more favorable outcomes than the noncompliant Workers' Compensation patients. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  1. Can the Mini Nutritional Assessment (MNA) Be Used as a Nutrition Evaluation Tool for Subacute Inpatients over an Average Length of Stay?

    PubMed

    McDougall, K E; Cooper, P L; Stewart, A J; Huggins, C E

    2015-12-01

    The prevalence of malnutrition in subacute inpatient settings has been reported to be 30-50%. While there are a number of nutrition evaluation tools which have been validated to diagnose malnutrition, the use of a validated nutrition evaluation tool to measure changes in nutritional status during an average length of stay for a subacute inpatient has not yet been tested. This study aims to determine the potential of the full MNA (full Mini Nutritional Assessment) and MNA (Mini Nutritional Assessment Short Form) scores to measure change in nutritional status over an average subacute inpatient stay (21 days). A prospective observational study. The study was performed in three Rehabilitation and Geriatric Evaluation and Management (GEM) wards of the Kingston Centre, Monash Health, Melbourne, Australia. All patients ≥65 years admitted to these wards with an expected length of stay of at least 14 days were considered for inclusion in this study. Nutritional status was assessed on admission using the full MNA as part of usual dietetic care and patients were provided with nutrition intervention/diet therapy based on full MNA classification. Full MNA score (0-30), MNA score (0-14), anthropometry (weight and height) and nutritional biochemistry (serum albumin, transthyretin and C-reactive protein) were compared between admission and day 20.5 ± 2.4. Mean age (± SD) of 83 ± 7 years, n=114. For those patients diagnosed at risk of malnutrition or malnourished (n=103), there were significant increases in full MNA score (1.8 ± 2.4, p<0.001), MNA score (0.9 ± 1.7, p<0.001), weight (0.6 ± 2.5 kg, p=0.017) and serum albumin (1.4 ± 4.4 g/L, p=0.003) over the study period. All four of the full MNA domain sub-scores, also increased significantly in those patients diagnosed at risk of malnutrition or malnourished (n=103): anthropometric assessment (p<0.001), dietary assessment (p<0.001), general status assessment (p=0.019) and self-perceived health and nutrition states (p=0

  2. Chromatographic Methods to Evaluate Nutritional Quality in Oat.

    PubMed

    Montilla-Bascón, Gracia; Broeckling, Corey D; Hoekenga, Owen A; Prats, Elena; Sorrells, Mark; Isidro-Sánchez, Julio

    2017-01-01

    Oats (A. sativa L.) have an important and positive role in human diet and health. The health benefits of oats are attributed to its multifunctional characteristic and nutritional profile, being an important source of soluble dietary fiber, well-balanced proteins, unsaturated fatty acids, vitamins, essential minerals, and a good source of natural antioxidants. These antioxidants include the avenanthramides (Avns) and avenalumic acids, which are unique to oats among cereals. High-performance liquid chromatography allows a simultaneous quantification of free amino acids and biogenic amines in oat samples as their OPA/FMOC-CL (o-phthalaldehyde/9-fluorenylmethoxycarbonyl chloride) derivatives. In addition, an ultra-performance liquid chromatography/mass spectrometry method was developed to quantify and characterize avenanthramides contained in oat samples.

  3. Postoperative Delirium

    PubMed Central

    Marcantonio, Edward R.

    2013-01-01

    Delirium (acute confusion) complicates 15% to 50% of major operations in older adults and is associated with other major postoperative complications, prolonged length of stay, poor functional recovery, institutionalization, dementia, and death. Importantly, delirium may be predictable and preventable through proactive intervention. Yet clinicians fail to recognize and address postoperative delirium in up to 80% of cases. Using the case of Ms R, a 76-year-old woman who developed delirium first after colectomy with complications and again after routine surgery, the diagnosis, prevention, and treatment of delirium in the postoperative setting is reviewed. The risk of postoperative delirium can be quantified by the sum of predisposing and precipitating factors. Successful strategies for prevention and treatment of delirium include proactive multifactorial intervention targeted to reversible risk factors, limiting use of sedating medications (especially benzodiazepines), effective management of postoperative pain, and, perhaps, judicious use of antipsychotics. PMID:22669559

  4. Evaluation of plantar pressure distributions in patients with anteriorcruciate ligament deficiency: preoperative and postoperative changes.

    PubMed

    Çetin, Engin; Deveci, Mehmet Ali; Songür, Murat; Özer, Hamza; Turanli, Sacit

    2017-04-18

    Anterior cruciate ligament (ACL) deficiency results in several kinematic changes in the lower extremities. The aim of this study is to define the plantar pressure parameters in ACL-deficient patients and to show the effect of ACL reconstruction on dynamic plantar pressure. Forty patients with unilateral ACL rupture and 40 healthy controls were included in this study. Dynamic plantar pressures of both groups were recorded by the EMED SF-2 system during level walking. Thirteen of the patients who had ACL reconstructions with hamstring autografts (HS group) were reevaluated at an average of 14.5 months following the ACL reconstructions. ACL-deficient patients had significantly lower hindfoot (P = 0.007) but higher midfoot pressure values (P = 0.03) on their ipsilateral foot compared to control group subjects. Ipsilateral hindfoot pressures were also found to be significantly lower than those of the contralateral foot (P = 0.001). Hindfoot pressure values of the HS group were increased in postoperative measurements (P = 0.01). ACL-deficient patients have altered plantar pressure distributions and ACL reconstructions restore these changes to normal. Pedobarography might be used as a practical method for dynamic functional assessment of ACL-deficient patients.

  5. Evaluation of antimicrobial prophylaxis against postoperative infection after spine surgery: Limit of the first generation cephem.

    PubMed

    Iida, Yasuaki; Inoue, Yasuhiro; Hasegawa, Keiji; Tsuge, Shintaro; Yokoyama, Yuichirou; Nakamura, Kazumasa; Fukano, Ryoichi; Takamatsu, Ryo; Wada, Akihito; Takahashi, Hiroshi

    2016-03-01

    In our department, first-generation cephem (CEZ) are generally administered for 2 days as antimicrobial prophylaxis (AMP) for spinal surgery. However, the incidence of surgical site infection (SSI) has recently increased, particularly cases involving coagulase-negative Staphylococci (CNS) as an etiologic agent. The objective was to elucidate the problems with the current AMP and the risk factors of SSI through a retrospective investigation of affected cases. The subjects were patients who underwent spine surgery at our department between August 2007 and June 2013. The subjects were divided into those who developed SSI (S group) and who did not develop SSI (non-SSI (N) group), patients who developed CNS infection in the S group was subdivided as C group, and the risk factors were investigated. The significance of each factor was analyzed using cross tabulation, and multivariate logistic regression analyses were performed with 22 of the investigation factors as explanatory variables. The incidence of SSI was 2.55%, and the etiologic agent was CNS in 17 patients. Upon comparison between the S and N groups, the presence of 3 or more underlying diseases and blood loss were extracted as significant risk factors. Upon comparison between the C and N groups, emergency surgery and intra- and postoperative steroid administration were extracted as significant risk factors, in addition to the presence of 3 or more underlying diseases and blood loss. The effect of the current AMP using first generation cephem is limited, and reconsideration of the protocol may be necessary.

  6. Intuitive Facial Imaging Method for Evaluation of Postoperative Swelling: A Combination of 3-Dimensional Computed Tomography and Laser Surface Scanning in Orthognathic Surgery.

    PubMed

    Yamamoto, Satoshi; Miyachi, Hitoshi; Fujii, Hitoshi; Ochiai, Shigeki; Watanabe, Satoshi; Shimozato, Kazuo

    2016-12-01

    Postoperative facial swelling after orthognathic surgery may be prolonged and of concern in some patients. In recent years, there have been several reports of analysis of postoperative facial swelling by volume data; however, such evaluations cannot exclude the possibility of error in the measured point because there are no clear anatomic landmarks on the cheek. Three-dimensional laser scanning is a noninvasive tool that can be used to measure surface changes in soft tissue over time. The aim of this study was to quantify postoperative swelling in orthognathic surgery by fusing surface scanned images with skin images reconstructed from 3-dimensional computed tomography data and identifying a set of reference points on the bone. The study comprised 30 patients undergoing bilateral sagittal split osteotomy. Facial scans were obtained with the Artec Eva Scan imaging system (Data Design, Aichi, Japan) at 9 time points from before surgery to 6 months postoperatively. Postoperative scan images were compared with the baseline facial scan obtained 6 months postoperatively. On average, 66% of the initial postoperative edema subsided in 1 month. After 3 months, only 5% of the swelling remained. There were statistically significant correlations between subcutaneous tissue thickness and swelling (P < .0001). We were able to monitor facial swelling after orthognathic surgery with very high precision using the described method. Subcutaneous tissue thickness is an important determinant of facial swelling. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Evaluation outcomes of a long-running adult nutrition education programme.

    PubMed

    Pettigrew, Simone; Moore, Sarah; Pratt, Iain S; Jongenelis, Michelle

    2016-03-01

    For more than 20 years, the FOODcents adult nutrition education programme has been delivered to Western Australians. The aim of the programme is to provide disadvantaged individuals with the knowledge, skills and motivation to buy healthy foods on a limited budget. The present study evaluated whether the FOODcents curriculum and the way it is delivered are effective in improving participants' nutrition-related knowledge and behaviours. Evaluation data were collected via in-session pre-post questionnaires and a post-course online questionnaire. Western Australia. Data were collected from participants attending just over one-half (54 %) of the FOODcents courses conducted over the two-year evaluation period. In total, 927 course participants provided usable data. After exposure to the course, respondents demonstrated an improved ability to: (i) categorize foods according to the frequency with which they should be consumed and the proportion of the food budget that should be allocated to them; (ii) correctly interpret nutrition labels on food products; and (iii) appreciate the link between diet/obesity and a range of diseases. Improvements in the latter were especially pronounced among participants of low socio-economic status. In terms of behaviour change, significant improvements in fruit and vegetable consumption were reported, along with reductions in the consumption of fast food. Participants of low socio-economic status reported the greatest changes. The results indicate that the FOODcents nutrition education programme improves participants' nutrition-related knowledge and behaviours.

  8. Evaluation of preemptive dexketoprofen trometamol effect on blood chemistry, vital signs and postoperative pain in dogs undergoing ovariohysterectomy.

    PubMed

    Saritas, Z K; Saritas, T B; Pamuk, K; Korkmaz, M; Yaprakci, M V; Yilmaz, O; Demirkan, I

    2015-01-01

    To investigate the postoperative analgesic effects of preemptive dexketoprofen trometamol in dogs subjected to ovariohysterectomy (OHE). Seventeen adult bitches of various breeds were used in this study. The dogs were randomly allocated into of two groups. Subjects in the dexketoprofen trometamol (DEX) group (n=10), received intravenous (i.v.) dexketoprofen trometamol, 1 mg/kg, 15 minutes before premedication, while those assigned to the control (C) group (n=7) were given no analgesics prior to premedication. Pain level was assessed by two researchers before the administration of anaesthesia (15 minutes before start) and 0, 1, 2, 4 and 6 hours after surgery. A modified University of Melbourne Pain Scale (UMPS) was used to evaluate pain in both groups. Serum cortisol level changed from 0 to 1 h and from 0 to 1 to 4 h were compared between the groups; the increase in the C group was statistically significant. The modified UMPS was applied to both groups at baseline and postoperative 1, 2, 4 and 6 h. According to this test, the values for DEX were significantly lower than controls at 4 and 6 h (p<0.001). Stable vital signs with unchanged biochemical parameters on dexketoprofen administration are a promising finding. The clinical advantage shown by the pain scale difference and the low serum cortisol levels should qualify dexketoprofen for preemptive pain management in dogs (Tab. 5, Fig. 2, Ref. 30).

  9. POSTOPERATIVE POSITIONING IN MACULAR HOLE SURGERY: An Objective Evaluation of Nonsupine Positioning and the Effect of the "Tennis Ball Technique".

    PubMed

    Forsaa, Vegard Asgeir; Krohn, Jørgen

    2016-06-01

    To objectively evaluate patients' compliance with a nonsupine positioning (NSP) regimen after macular hole surgery and to investigate whether supine positioning time during the first postoperative nights is reduced when a tennis ball is mounted onto the back of the nightshirt. A "position monitoring device" capable of recording the time the head is kept in a supine position was attached to the patient's forehead. In a randomized, controlled, crossover study, the accumulated time each patient spent in a supine position was recorded during two consecutive postoperative nights, both when the "tennis ball technique" (TBT) was used and when it was not, respectively. The study included 40 participants. A mean supine time of 14 minutes and 47 seconds was registered with the NSP regimen. When applying the TBT, the mean supine time was significantly reduced to 4 minutes and 24 seconds (P = 0.01). Seven "noncompliant" participants with >30 minutes supine time without TBT had the most marked reduction in supine time from a mean of 63 minutes and 2 seconds, to 3 minutes and 46 seconds, with TBT (P = 0.02). During an NSP regimen, patients generally maintain a high level of compliance after macular hole surgery. The TBT further improves their compliance significantly.

  10. Clinical evaluation of pranoprofen combined with fluorometholone eye drops on postoperative reaction of corneal cross-linking.

    PubMed

    Pang, Xu; Fan, Zheng Jun; Peng, Xiu Jun; Jia, Hong Zhen; Wu, Teng Fei

    2012-12-01

    To evaluate the efficacy and safety of pranoprofen eye drops for reducing postoperative ocular pain and inflammation after corneal cross-linking (CXL). Twenty-seven patients (38 eyes) with keratoconus undergoing CXL were examined and randomly divided into control (12 cases; 18 eyes) and experimental groups (15 cases; 20 eyes). The patients in the control group were given fluorometholone eye drops, and those in the experimental group were administered with fluorometholone combined with pranoprofen eye drops.Corneal irritation and haze were compared between the two groups at 1 month postoperatively. At 1 to 3 days after surgery, the corneal irritation in the experimental group was significantly reduced compared with that in the control group (P<0.05), but there was no significant difference on 5 to 7 days postoperatively (P>0.05).The average degree of haze in the experimental group was significantly lower than that in the control group 1 month after surgery (P<0.05), but there was no significant difference in the best-corrected vision acuity and intraocular pressure between the two groups. There were 2 cases with P<20 mmHg intraocular pressure in the control group. The combined use of fluorometholone and pranoprofen can significantly reduce inflammatory response, alleviate corneal irritation at early stage after CXL, effectively prevent and control the average of haze, and reduce the incidence of steroid-induced ocular hypertension after surgery.

  11. Perioperative supplementation with bifidobacteria improves postoperative nutritional recovery, inflammatory response, and fecal microbiota in patients undergoing colorectal surgery: a prospective, randomized clinical trial

    PubMed Central

    MIZUTA, Minoru; ENDO, Izuru; YAMAMOTO, Sumiharu; INOKAWA, Hidetoshi; KUBO, Masatoshi; UDAKA, Tetsunobu; SOGABE, Osanori; MAEDA, Hiroya; SHIRAKAWA, Kazutoyo; OKAZAKI, Eriko; ODAMAKI, Toshitaka; ABE, Fumiaki; XIAO, Jin-zhong

    2015-01-01

    The use of probiotics has been widely documented to benefit human health, but their clinical value in surgical patients remains unclear. The present study investigated the effect of perioperative oral administration of probiotic bifidobacteria to patients undergoing colorectal surgery. Sixty patients undergoing colorectal resection were randomized to two groups prior to resection. One group (n=31) received a probiotic supplement, Bifidobacterium longum BB536, preoperatively for 7–14 days and postoperatively for 14 days, while the other group (n=29) received no intervention as a control. The occurrences of postoperative infectious complications were recorded. Blood and fecal samples were collected before and after surgery. No significant difference was found in the incidence of postoperative infectious complications and duration of hospital stay between the two groups. In comparison to the control group, the probiotic group tended to have higher postoperative levels of erythrocytes, hemoglobin, lymphocytes, total protein, and albumin and lower levels of high sensitive C-reactive proteins. Postoperatively, the proportions of fecal bacteria changed significantly; Actinobacteria increased in the probiotic group, Bacteroidetes and Proteobacteria increased in the control group, and Firmicutes decreased in both groups. Significant correlations were found between the proportions of fecal bacteria and blood parameters; Actinobacteria correlated negatively with blood inflammatory parameters, while Bacteroidetes and Proteobacteria correlated positively with blood inflammatory parameters. In the subgroup of patients who received preoperative chemoradiotherapy treatment, the duration of hospital stay was significantly shortened upon probiotic intervention. These results suggest that perioperative oral administration of bifidobacteria may contribute to a balanced intestinal microbiota and attenuated postoperative inflammatory responses, which may subsequently promote a healthy

  12. Evaluation of Malnutrition Risk after Liver Transplantation Using the Nutritional Screening Tools.

    PubMed

    Lim, Hee-Sook; Kim, Hyung-Chul; Park, Yoon-Hyung; Kim, Soon-Kyung

    2015-10-01

    Malnutrition is a common problem in patients with end-stage liver disease requiring liver transplantation. The aim of this study was to evaluate nutritional status by using nutritional screening tools [Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)] in patients before and after liver transplantation. We analyzed medical record, blood test, nutrient intake and malnutrition rate just before transplantation and at discharge, and at 3, 6, 12 months after transplantation respectively. Initially 33 patients enrolled as study subjects and finally 28 patients completed the study. Nutrients intake such as energy, fiber, calcium, potassium, vitamin C, and folate were insufficient at 12 months after transplantation. The rates of malnutrition before transplantation were very high, reported at 81.8% for the NRS 2002, 87.9% for the MUST, and 84.8% for the SGA. By 12 months after operation, malnutrition rates reported at NRS, MUST and SGA had decreased to 6.1%, 10.7%, and 10.7%, respectively. Sensitivity was 87.1% for the NRS 2002, 82.0% for the MUST, and 92.0% for the SGA. Of these screening tools the SGA was the highest sensitive tool that predict the risk of mortality in malnutrition patients who received transplantation. Further studies on nutritional status of patients and proper tools for nutrition intervention are needed to provide adequate nutritional care for patients.

  13. Evaluation of Malnutrition Risk after Liver Transplantation Using the Nutritional Screening Tools

    PubMed Central

    Lim, Hee-Sook; Kim, Hyung-Chul; Park, Yoon-Hyung

    2015-01-01

    Malnutrition is a common problem in patients with end-stage liver disease requiring liver transplantation. The aim of this study was to evaluate nutritional status by using nutritional screening tools [Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)] in patients before and after liver transplantation. We analyzed medical record, blood test, nutrient intake and malnutrition rate just before transplantation and at discharge, and at 3, 6, 12 months after transplantation respectively. Initially 33 patients enrolled as study subjects and finally 28 patients completed the study. Nutrients intake such as energy, fiber, calcium, potassium, vitamin C, and folate were insufficient at 12 months after transplantation. The rates of malnutrition before transplantation were very high, reported at 81.8% for the NRS 2002, 87.9% for the MUST, and 84.8% for the SGA. By 12 months after operation, malnutrition rates reported at NRS, MUST and SGA had decreased to 6.1%, 10.7%, and 10.7%, respectively. Sensitivity was 87.1% for the NRS 2002, 82.0% for the MUST, and 92.0% for the SGA. Of these screening tools the SGA was the highest sensitive tool that predict the risk of mortality in malnutrition patients who received transplantation. Further studies on nutritional status of patients and proper tools for nutrition intervention are needed to provide adequate nutritional care for patients. PMID:26566519

  14. Nutritional evaluation of caseins and whey proteins and their hydrolysates from Protamex.

    PubMed

    Sindayikengera, Séverin; Xia, Wen-shui

    2006-02-01

    Whey protein concentrate (WPC 80) and sodium caseinate were hydrolyzed by Protamex to 5%, 10%, 15%, and 20% degree of hydrolysis (DH). WPC 80, sodium caseinate and their hydrolysates were then analyzed, compared and evaluated for their nutritional qualities. Their chemical composition, protein solubility, amino acid composition, essential amino acid index (EAA index), biological value (BV), nutritional index (NI), chemical score, enzymic protein efficiency ratio (E-PER) and in vitro protein digestibility (IVPD) were determined. The results indicated that the enzymatic hydrolysis of WPC 80 and sodium caseinate by Protamex improved the solubility and IVPD of their hydrolysates. WPC 80, sodium caseinate and their hydrolysates were high-quality proteins and had a surplus of essential amino acids compared with the FAO/WHO/UNU (1985) reference standard. The nutritive value of WPC 80 and its hydrolysates was superior to that of sodium caseinate and its hydrolysates as indicated by some nutritional parameters such as the amino acid composition, chemical score, EAA index and predicted BV. However, the E-PER was lower for the WPC hydrolysates as compared to unhydrolyzed WPC 80 but sodium caseinate and its hydrolysates did not differ significantly. The nutritional qualities of WPC 80, sodium caseinate and their hydrolysates were good and make them appropriate for food formulations or as nutritional supplements.

  15. Limitations of Doppler echocardiography for the post-operative evaluation of aortic coarctation.

    PubMed

    De Mey, S; Segers, P; Coomans, I; Verhaaren, H; Verdonck, P

    2001-07-01

    Doppler blood flow measurements and derived pressure differences, through the Bernoulli equation, are used in the diagnosis of aortic coarctation, a congenital stenosis distal to the left subclavian artery. Doppler velocities remain elevated at the coarctation site after successful repair of coarctation, leading to high Doppler derived pressure differences without significant arm-leg pressure differences. We studied this apparent contradiction of two diagnostic methods, in vivo using patient and control data, and in vitro using a hydraulic model. Clinical and echocardiographic data from 31 patients, aged 13.0 +/- 4.0, 10.5 +/- 4.7 yr after coarctectomy by end-to-end anastomosis, and 18 age-matched healthy subjects were reviewed. Doppler peak velocities at the aortic isthmus were elevated in patients (2.2 +/- 0.4 vs. 1.2 +/- 0.2m/s, P < 0.001), corresponding to significant Doppler differences (20 +/- 7 mmHg), however, without significant arm-leg pressure differences. In all patients, a mild anatomic stenosis could still be observed. Local stiffness was increased. The hypothesis that the less distensible surgical scar in post-coarctectomy patients leads to a significant dynamic obstruction in systole was validated in a latex model of the aorta. Rigid rings (0.5-1.5 cm), matching the unloaded aortic diameter, were mounted around the aorta. Under loading conditions, Doppler peak velocities increased by 40 +/-7%, yielding Doppler differences of 21 +/- 3 mmHg, without a significant pressure drop. An alternative expression to calculate pressure differences, using both velocity and geometric information, was validated in the model. In conclusion, post-operatively, Doppler velocities remain elevated due to a mild anatomical and significant dynamic narrowing, but the specific geometry, resembling a tubular hypoplasia rather than an abrupt stenosis, permits an almost complete pressure recovery explaining the occurrence of Doppler differences in disagreement with the

  16. Accuracy of Late-Night Salivary Cortisol in Evaluating Postoperative Remission and Recurrence in Cushing's Disease.

    PubMed

    Amlashi, Fatemeh G; Swearingen, Brooke; Faje, Alexander T; Nachtigall, Lisa B; Miller, Karen K; Klibanski, Anne; Biller, Beverly M K; Tritos, Nicholas A

    2015-10-01

    Late-night salivary cortisol (LNSC) is well-validated in the diagnosis of Cushing's disease (CD). The accuracy of LNSC during follow-up of patients undergoing transsphenoidal surgery (TSS) has not been fully characterized. We examined the accuracy of LNSC in establishing remission and identifying recurrence in postoperative patients with CD. This is a retrospective study. Records of patients with CD who underwent TSS by a single neurosurgeon in our tertiary center (2005-2014) were analyzed (N = 224). Patients were selected for further investigation (n = 165) if there was at least one available LNSC test obtained after TSS (either within 3 months or during long-term follow-up). Extracted data included demographic and clinical characteristics, magnetic resonance imaging and laboratory data (morning serum cortisol, 24-hour urine free cortisol [UFC], LNSC) . Remission was defined as nadir morning serum cortisol less than 5 mcg/dl and nadir 24-hour UFC less than 23 mcg. Recurrence was considered definite if confirmed surgically or prompted radiotherapy. Surgical remission occurred in 89% of 89 patients with available LNSC data. LNSC, obtained within 3 months of TSS, established remission with 94% sensitivity and 80% specificity at a cutpoint of 1.9 nmol/l (area under the curve [AUC] = 0.90). At a median follow-up of 53.5 months, LNSC established recurrence (75% sensitivity and 95% specificity) at a cutpoint of 7.4 nmol/l (AUC = 0.87), and 24-hour UFC established recurrence (68% sensitivity and 100% specificity) at a cutpoint of 1.6-fold above normal (AUC = 0.82). LNSC may accurately establish remission after TSS and identify recurrence more accurately than 24-hour UFC during long-term follow-up.

  17. An evaluation of enteral nutrition practices and nutritional provision in children during the entire length of stay in critical care.

    PubMed

    Mara, Jackie; Gentles, Emma; Alfheeaid, Hani A; Diamantidi, Krystalia; Spenceley, Neil; Davidson, Mark; Young, David; Gerasimidis, Konstantinos

    2014-07-21

    Provision of optimal nutrition in children in critical care is often challenging. This study evaluated exclusive enteral nutrition (EN) provision practices and explored predictors of energy intake and delay of EN advancement in critically ill children. Data on intake and EN practices were collected on a daily basis and compared against predefined targets and dietary reference values in a paediatric intensive care unit. Factors associated with intake and advancement of EN were explored. Data were collected from 130 patients and 887 nutritional support days (NSDs). Delay to initiate EN was longer in patients from both the General Surgical and congenital heart defect (CHD) Surgical groups [Median (IQR); CHD Surgical group: 20.3 (16.4) vs General Surgical group: 11.4 (53.5) vs Medical group: 6.5 (10.9) hours; p ≤ 0.001]. Daily fasting time per patient was significantly longer in patients from the General Surgical and CHD Surgical groups than those from the Medical group [% of 24 h, Median (IQR); CHD Surgical group: 24.0 (29.2) vs General Surgical group: 41.7 (66.7) vs Medical group: 9.4 (21.9); p ≤ 0.001]. A lower proportion of fluids was delivered as EN per patient (45% vs 73%) or per NSD (56% vs 73%) in those from the CHD Surgical group compared with those with medical conditions. Protein and energy requirements were achieved in 38% and 33% of the NSDs. In a substantial proportion of NSDs, minimum micronutrient recommendations were not met particularly in those patients from the CHD Surgical group. A higher delivery of fluid requirements (p < 0.05) and a greater proportion of these delivered as EN (p < 0.001) were associated with median energy intake during stay and delay of EN advancement. Fasting (31%), fluid restriction (39%) for clinical reasons, procedures requiring feed cessation and establishing EN (22%) were the most common reasons why target energy requirements were not met. Provision of optimal EN support remains challenging and varies during

  18. [Evaluation of dietary habits of a population of university students in relation with their nutritional knowledge].

    PubMed

    Montero Bravo, A; Ubeda Martín, N; García González, A

    2006-01-01

    Food behaviour is acquired in childhood and is very defficult to be changed latterly in adulthood. The aim of this study was to evaluate if food behaviour and other health habits were in accordance with the nutrition knowledge of a sample of University students from different Health Sciences Careers. We studied 105 students (aged 21 +/- 2 years) from San Pablo-CEU University (Madrid); 21 where studying Nursing (N), 32 Pharmacy (Ph); 34 Nutrition and dietetics (ND) and 18 were students of Podology (P), all of them had been studying Nutrition as subject during 2003-2004 academic year. All the students filled a questionnaire about health habits and some body image perceptions, diet was evaluated by a 3 day diet record and nutrition knowledge by a 20 questions test. Height and weight were measured using standard procedures. ND students believed they had a medium-high level of nutrition knowledge while Pharmacy and nursing students believed they had a medium-low level and the podology ones had the perception to have a low level of knowledge in the subject. Results of test were in accordance with those perceptions as highest records were obtained by the Nutrition students. Nevertheless very few differences were found in the diet of the four populations. Mean energy intake was similar in the four groups, deficiencies (<80% RDA) were observed in fibre, magnesium, folic acid and vitamin E. About body image, 67% of total population had a BMI of 19-25, no differences were appreciated between groups. Male self-reported weight and height were closer to real than those from women, who underestimated weight (p < 0.05) and overestimated height. No differences were observed between healthy living habits (tobacco, alcohol and physical activity) in the four populations. Even if N students believed and showed to have a better nutrition knowledge, no changes in food behaviour or other health habits were found. Improving knowledge does not necessary imply change in food habits.

  19. Nutritional evaluation of genetically modified maize corn performed on rats.

    PubMed

    Chrenková, Mária; Sommer, A; Ceresnáková, Zuzana; Nitrayová, Sona; Prostredná, Miroslava

    2002-06-01

    The aim of this study was to determine the composition and nutritional value of conventional and transgenic, so-called Roundup Ready (RR) maize with an introduced gene of glyphosate resistance. Crude protein, crude fibre, ash, fat, starch, sugar, amino acids, fatty acid and macroelement levels were determined by chemical analysis. In both maize lines a low level of Ca (0.15 g.kg-1 DM) and of the essential amino acids lysine and tryptophan (2.6 and 1.7 g.kg-1 DM, respectively) were observed. In the biological experiment carried out on rats the tested maize lines were the only dietary sources of nitrogen, thus, the experimental diets contained 9% CP in dietary dry matter. In the feeding experiment no significant differences in the protein efficiency ratio (PER) were observed between groups receiving conventional or transgenic maize (1.51 and 1.41, respectively). Also almost equal results were obtained in the balance experiments. Both maize lines revealed a high nitrogen digestibility (84.9 and 84.5%, respectively) and the net protein utilization amounted to 63.5 and 63.2%, respectively. From these results can be concluded that regarding nutrient composition and utilisation, genetically modified (RR) maize is equivalent to isogenic maize.

  20. Comprehensive evaluation of nutritional status before and after hematopoietic stem cell transplantation in 170 patients with hematological diseases.

    PubMed

    Liu, Peng; Wang, Boshi; Yan, Xia; Cai, Jingjing; Wang, Yu

    2016-12-01

    To investigate the nutritional status of patients before and after hematopoietic stem cell transplantation (HSCT), and explore optimal methods for assessing nutritional status in patients with hematological diseases. This cohort study enrolled 170 patients who were diagnosed with hematological diseases and underwent allogeneic HSCT in the Department of Hematology, Peking University People's Hospital between May 2011 and April 2013. We used fixed-point continuous sampling and four nutritional screening tools, Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), Subjective Global Assessment (SGA) and Malnutrition Universal Screening Tools (MUST), in combination with body measurements, to extensively screen and evaluate nutritional risks and status in patients receiving HSCT before entering and after leaving laminar air flow rooms. After HSCT, patients had significant reduction in weight, hip circumference, waist-hip ratio, calf circumference, mid-upper arm circumference, and suprailiac skinfold thickness compared with pre-HSCT measurements. Before HSCT, NRS-2002 identified that 21.2% of patients were at nutritional risks, compared with 100% after HSCT. MUST indicated that before HSCT, 11.77% of patients were at high nutritional risk, compared with 59.63% after HSCT. MNA assessed that 0.06% of patients were malnourished before HSCT, compared with 19.27% after HSCT. SGA identified that before HSCT, 1.76% of patients had mild to severe malnutrition, which increased to 83.3% after HSCT. There is a significant increase in the nutritional risk and malnutrition in patients who received HSCT. Before HSCT, some patients already had nutritional risk or nutritional deficiencies, and prompt and close nutritional screening or assessment should be performed. The nutritional status of patients after HSCT was generally deteriorated compared with that before transplantation. Body measurements should be taken more frequently during the subsequent treatment

  1. [Perioperative nutrition].

    PubMed

    Garretsen, M K; Melis, G C; Richir, M C; Boelens, P G; Vlaanderen, L; van Leeuwen, P A M

    2006-12-16

    Illness is associated with involuntary weight loss, which is often the result of malnutrition. The undernourished surgical patient runs a higher risk of postoperative morbidity and mortality. For this reason, perioperative nutrition is an important part of a patient's therapy. Supplying substrates for wound healing and maintaining existing organic structures are the major goals of nutrition. It is recommended that extremely malnourished patients be fed at least 7 days prior to surgery. It would seem sensible to give a carbohydrate-rich beverage up to 2 hours before surgery, both to decrease preoperative anxiety and to reduce postoperative insulin resistance. The Dutch tradition of fasting patients before surgery is difficult to defend any longer because this policy impairs patients' state of health as a result of which they are not optimally prepared for the surgical induced stress response. The postoperative recovery of all surgical patients can be improved by an early postoperative start of enteric nutrition. When the enteric administration of food turns out to be impossible, total parenteral nutrition can be given to bridge a long period without food.

  2. Serial structural MRI evaluation of arthroscopy rotator cuff repair: does Sugaya's classification correlate with the postoperative clinical outcomes?

    PubMed

    Malavolta, Eduardo A; Assunção, Jorge Henrique; Ramos, Frederico F; Ferreira, Thiago C; Gracitelli, Mauro E C; Bordalo-Rodrigues, Marcelo; Ferreira Neto, Arnaldo A

    2016-06-01

    Sugaya's classification is the most commonly used for postoperative evaluation of rotator cuff repairs. However, the correlation between this classification and clinical outcomes after supraspinatus tendon repair were not performed with serial MRI examinations in standardized time intervals. This prospective case series involved 54 patients undergoing repair of the supraspinatus tendon tear. Magnetic resonance imaging (MRI, 1.5 T) was used to determine the Sugaya's classifications at 3, 6, and 12 months, and these data were correlated with the visual analog scale for pain (VAS), Constant and University of California at Los Angeles (UCLA) assessments. Patients with types I, II, and ≥III of Sugaya's classification experienced pain of 1.27 ± 1.95, 1.00 ± 1.40, and 3.43 ± 3.36, respectively (p = 0.010), according to the VAS. The Constant and UCLA scales did not differ significantly. Type II predominated, though their percentage decreased over time (from 77.8 to 66.7 %), whereas type I became more frequent (from 1.9 to 20.4 %). The pain was more intense in patients classified as types III, IV, or V of Sugaya's classification. The postoperative appearance of the supraspinatus tendon was not correlated with the Constant and UCLA scales. The occurrence of type II, the most prevalent, decreased over time, whereas the occurrence of type I increased; these differences were not significant. Level de evidence: prospective cohort evaluation-level III.

  3. PIZZA PLEASE: AN INTERACTIVE NUTRITION EVALUATION FOR SECOND AND THIRD GRADE STUDENTS

    USDA-ARS?s Scientific Manuscript database

    Pizza Please is a testing tool by which nutrition education can be evaluated in an appealing and fun way for second and third grade students. The game and situational questions are developmentally appropriate and interactive. Students are not only tested but also develop social skills by working in ...

  4. Evaluating the Impacts of School Nutrition and Physical Activity Policies on Child Health. PRGS Dissertation

    ERIC Educational Resources Information Center

    Fernandes, Meenakshi Maria

    2010-01-01

    This dissertation evaluates the impact of elementary school policies on child health behaviors and obesity in the United States. Two chapters address nutrition policies, two chapters address physical activity policies, and a final chapter estimates the health care cost savings associated with a decline in childhood obesity prevalence. The use of…

  5. Promoting Healthy Food Consumption among Young Children: Evaluation of a Multi-Component Nutrition Education Program

    ERIC Educational Resources Information Center

    Blom-Hoffman, Jessica; Kelleher, Constance; Power, Thomas J.; Leff, Stephen S.

    2004-01-01

    This study was an outcome evaluation of a multi-component nutrition education program for African American kindergarten and first grade students attending an under-resourced urban school. The program focused on increasing fruit and vegetable knowledge and vegetable consumption during school lunch. It included a classroom-based knowledge change…

  6. Evaluating the Impacts of School Nutrition and Physical Activity Policies on Child Health. PRGS Dissertation

    ERIC Educational Resources Information Center

    Fernandes, Meenakshi Maria

    2010-01-01

    This dissertation evaluates the impact of elementary school policies on child health behaviors and obesity in the United States. Two chapters address nutrition policies, two chapters address physical activity policies, and a final chapter estimates the health care cost savings associated with a decline in childhood obesity prevalence. The use of…

  7. Competency-Based Performance Appraisals: Improving Performance Evaluations of School Nutrition Managers and Assistants/Technicians

    ERIC Educational Resources Information Center

    Cross, Evelina W.; Asperin, Amelia Estepa; Nettles, Mary Frances

    2009-01-01

    Purpose: The purpose of the research was to develop a competency-based performance appraisal resource for evaluating school nutrition (SN) managers and assistants/technicians. Methods: A two-phased process was used to develop the competency-based performance appraisal resource for SN managers and assistants/technicians. In Phase I, draft…

  8. Improving Staff Nutritional Practices in Community-Based Group Homes: Evaluation, Training, and Management.

    ERIC Educational Resources Information Center

    Kneringer, Mary-Jean; Page, Terry J.

    1999-01-01

    This study evaluated the effectiveness of a staff training-and-management package on nutritional practices in two community-based group homes serving adults with developmental disabilities. Food storage, menu development, and meal preparation were covered. All staff behaviors increased after training and were maintained for up to one year.…

  9. The National Evaluation of School Nutrition Programs. Final Report - Executive Summary.

    ERIC Educational Resources Information Center

    Radzikowski, Jack

    This is a summary of the final report of a study (begun in 1979) of the National School Lunch, School Breakfast, and Special Milk Programs. The major objectives of the evaluation were to (1) identify existing information on the school nutrition programs; (2) identify determinants of participation in the programs and develop statistical models for…

  10. Evaluating the Impact of School Nutrition and Physical Activity Policies on Child Health

    ERIC Educational Resources Information Center

    Fernandes, Meenakshi M.

    2009-01-01

    This dissertation evaluates the impact of elementary school policies on child health behaviors and obesity in the United States. Two chapters address nutrition policies, two chapters address physical activity policies, and a final chapter estimates the health care cost savings associated with a decline in childhood obesity prevalence. The use of…

  11. Evaluating the Impact of School Nutrition and Physical Activity Policies on Child Health

    ERIC Educational Resources Information Center

    Fernandes, Meenakshi M.

    2009-01-01

    This dissertation evaluates the impact of elementary school policies on child health behaviors and obesity in the United States. Two chapters address nutrition policies, two chapters address physical activity policies, and a final chapter estimates the health care cost savings associated with a decline in childhood obesity prevalence. The use of…

  12. Biomarker Evaluation Does Not Confirm Efficacy of Computer-Tailored Nutrition Education

    ERIC Educational Resources Information Center

    Kroeze, Willemieke; Dagnelie, Pieter C.; Heymans, Martijn W.; Oenema, Anke; Brug, Johannes

    2011-01-01

    Objective: To evaluate the efficacy of computer-tailored nutrition education with objective outcome measures. Design: A 3-group randomized, controlled trial with posttests at 1 and 6 months post-intervention. Setting: Worksites and 2 neighborhoods in the urban area of Rotterdam. Participants: A convenience sample of healthy Dutch adults (n = 442).…

  13. The Design, Implementation, and Evaluation of Online Credit Nutrition Courses: A Systematic Review

    ERIC Educational Resources Information Center

    Cohen, Nancy L.; Carbone, Elena T.; Beffa-Negrini, Patricia A.

    2011-01-01

    Objective: To assess how postsecondary online nutrition education courses (ONEC) are delivered, determine ONEC effectiveness, identify theoretical models used, and identify future research needs. Design: Systematic search of database literature. Setting: Postsecondary education. Participants: Nine research articles evaluating postsecondary ONEC.…

  14. Competency-Based Performance Appraisals: Improving Performance Evaluations of School Nutrition Managers and Assistants/Technicians

    ERIC Educational Resources Information Center

    Cross, Evelina W.; Asperin, Amelia Estepa; Nettles, Mary Frances

    2009-01-01

    Purpose: The purpose of the research was to develop a competency-based performance appraisal resource for evaluating school nutrition (SN) managers and assistants/technicians. Methods: A two-phased process was used to develop the competency-based performance appraisal resource for SN managers and assistants/technicians. In Phase I, draft…

  15. Biomarker Evaluation Does Not Confirm Efficacy of Computer-Tailored Nutrition Education

    ERIC Educational Resources Information Center

    Kroeze, Willemieke; Dagnelie, Pieter C.; Heymans, Martijn W.; Oenema, Anke; Brug, Johannes

    2011-01-01

    Objective: To evaluate the efficacy of computer-tailored nutrition education with objective outcome measures. Design: A 3-group randomized, controlled trial with posttests at 1 and 6 months post-intervention. Setting: Worksites and 2 neighborhoods in the urban area of Rotterdam. Participants: A convenience sample of healthy Dutch adults (n = 442).…

  16. The Design, Implementation, and Evaluation of Online Credit Nutrition Courses: A Systematic Review

    ERIC Educational Resources Information Center

    Cohen, Nancy L.; Carbone, Elena T.; Beffa-Negrini, Patricia A.

    2011-01-01

    Objective: To assess how postsecondary online nutrition education courses (ONEC) are delivered, determine ONEC effectiveness, identify theoretical models used, and identify future research needs. Design: Systematic search of database literature. Setting: Postsecondary education. Participants: Nine research articles evaluating postsecondary ONEC.…

  17. An Evaluation of the Nutrition Services for the Elderly. Volume II. Analytic Report.

    ERIC Educational Resources Information Center

    Kirschner Associates, Inc., Albuquerque, NM.

    This document is part of a five-volume nationwide study of Nutrition Service operations and elderly citizens participating in congregate dining and home delivery services authorized by Title III-C of the Older Americans' Act. This volume contains the analytic report, which presents the major findings of the evaluation. Chapter 1 gives a report…

  18. Consumer evaluation of food with nutritional benefits: a systematic review and narrative synthesis.

    PubMed

    Mogendi, Joseph Birundu; De Steur, Hans; Gellynck, Xavier; Makokha, Anselimo

    2016-06-01

    As a consequence of the growing interest in, and development of, various types of food with nutritional benefits, the modern consumer views their kitchen cabinet more and more as a medicine cabinet. Given that consumer evaluation of food is considered key to the successful production, marketing and finally consumption of food, a procedure commonly used in medical fields was employed to systematically review and summarize evidence of consumer evaluation studies on nutritious foods. The focus is primarily on consumer understanding of nutritious food and the underlying determinants of consumer evaluation. Our results highlight four groups of key determinants: (1) nutrition knowledge and information; (2) attitudes, beliefs, perceptions and behavioural determinants; (3) price, process and product characteristics; and (4) socio-demographics. The findings also point to the importance of understanding consumer acceptance as one many concepts in the consumer evaluation process, and provide support for developing appropriate strategies for improving health and well-being of consumers.

  19. Evaluation of dysphagia risk, nutritional status and caloric intake in elderly patients with Alzheimer's.

    PubMed

    Goes, Vanessa Fernanda; Mello-Carpes, Pâmela Billig; de Oliveira, Lilian Oliveira; Hack, Jaqueline; Magro, Marcela; Bonini, Juliana Sartori

    2014-01-01

    to evaluate the risk of dysphagia and its relationship with the stage of Alzheimer's Disease, as well as the relationship between the risk of dysphagia and nutritional status and caloric intake in elderly people with Alzheimer's disease. the sample consisted of 30 subjects of both genders with probable Alzheimer's disease. The stage of the disease, nutritional status, energy intake, and risk of dysphagia were assessed. it was found that increased risk of dysphagia is associated with the advance in the stages of Alzheimer's disease and that even patients in the early stages of disease have a slight risk of developing dysphagia. No association was found between nutritional status and the risk of dysphagia. High levels of inadequate intake of micronutrients were also verified in the patients. an association between dysphagia and the development of Alzheimer's disease was found. The results indicate the need to monitor the presence of dysphagia and the micronutrient intake in patients with Alzheimer's disease.

  20. Nutritional properties and consumer evaluation of donkey bresaola and salami: comparison with conventional products.

    PubMed

    Marino, R; Albenzio, M; Della Malva, A; Muscio, A; Sevi, A

    2015-03-01

    Nutritional properties and consumer evaluation were performed in bresaola and salami from donkey meat compared with respective conventional products. Donkey bresaola and salami showed higher content of protein and lower content of fat than beef bresaola and pork salami. Significant differences in the unsaturation level of fatty acids were found. Particularly, donkey meat products showed lower saturated fatty acids, higher polyunsatured fatty acid content and better nutritional indices than conventional beef bresaola and pork salami. Furthermore, donkey meat products, especially bresaola, showed the highest content of essential amino acids. Both donkey meat products resulted to be more tender than conventional products, in addition donkey bresaola showed also higher consumer acceptability. Our investigation demonstrates the possibility of processing donkey meat into products comparable to traditional ones with a high nutritional value.

  1. Evaluation of Timed Up and Go Test as a tool to measure postoperative function and prediction of one year walking ability for patients with hip fracture.

    PubMed

    Nygard, Heid; Matre, Kjell; Fevang, Jonas Meling

    2016-05-01

    To evaluate if the Timed Up and Go Test is a useful tool to measure postoperative function and to predict one-year results of rehabilitation in patients operated owing to hip fracture. Prospective cohort study. The department of orthopaedic surgery at five hospitals in Norway. Patients were assessed five days postoperatively and after one year. A total of 684 patients over 60 years with trochanteric or subtrochanteric hip fractures were included. A total of 171 (25%) patients died within a year and 373 (73% of patients still alive) attended follow-up one year after surgery. Timed Up and Go Test and walking ability. A total of 258 (38%) patients passed the postoperative Timed Up and Go Test. A total of 217 (56%) patients with a prefracture independent outdoor walking ability, passed the test. The average Timed Up and Go Test score was 71 seconds. A total of 171 (25%) patients could not rise from a chair without assistance; 8% of the patients with cognitive impairment, and 8% of those admitted from nursing homes, were able to pass the postoperative Timed Up and Go Test. The sensitivity and specificity of the Timed Up and Go Test in predicting walking ability one year after the operation were low. At one year follow-up, 38% of the patients not able to perform the postoperative Timed Up and Go Test, passed the test. A total of 81 (21%) patients did not use any walking-aid, 17 of them did not pass the postoperative Timed Up and Go Test. The Timed Up and Go Test performed the fifth postoperative day was not a suitable tool to assess functional mobility for the majority of the patients with hip fractures in our study. Neither was the postoperative Timed Up and Go Test a suitable tool to predict the walking ability one year after the operation. © The Author(s) 2015.

  2. Evaluation of Timed Up and Go Test as a tool to measure postoperative function and prediction of one year walking ability for patients with hip fracture

    PubMed Central

    Nygard, Heid; Matre, Kjell; Fevang, Jonas Meling

    2015-01-01

    Objective: To evaluate if the Timed Up and Go Test is a useful tool to measure postoperative function and to predict one-year results of rehabilitation in patients operated owing to hip fracture. Design: Prospective cohort study. Setting: The department of orthopaedic surgery at five hospitals in Norway. Patients were assessed five days postoperatively and after one year. Subjects: A total of 684 patients over 60 years with trochanteric or subtrochanteric hip fractures were included. A total of 171 (25%) patients died within a year and 373 (73% of patients still alive) attended follow-up one year after surgery. Main measures: Timed Up and Go Test and walking ability. Results: A total of 258 (38%) patients passed the postoperative Timed Up and Go Test. A total of 217 (56%) patients with a prefracture independent outdoor walking ability, passed the test. The average Timed Up and Go Test score was 71 seconds. A total of 171 (25%) patients could not rise from a chair without assistance; 8% of the patients with cognitive impairment, and 8% of those admitted from nursing homes, were able to pass the postoperative Timed Up and Go Test. The sensitivity and specificity of the Timed Up and Go Test in predicting walking ability one year after the operation were low. At one year follow-up, 38% of the patients not able to perform the postoperative Timed Up and Go Test, passed the test. A total of 81 (21%) patients did not use any walking-aid, 17 of them did not pass the postoperative Timed Up and Go Test. Conclusion: The Timed Up and Go Test performed the fifth postoperative day was not a suitable tool to assess functional mobility for the majority of the patients with hip fractures in our study. Neither was the postoperative Timed Up and Go Test a suitable tool to predict the walking ability one year after the operation. PMID:26109590

  3. THE EFFECT OF PRE-OPERATIVE NUTRITIONAL STATUS ON POST-OPERATIVE OUTCOMES IN CHILDREN UNDERGOING SURGERY FOR CONGENITAL HEART DEFECTS IN SAN FRANCISCO (UCSF) AND GUATEMALA CITY (UNICAR)

    PubMed Central

    Radman, Monique; Mack, Ricardo; Barnoya, Joaquin; Castañeda, Aldo; Rosales, Monica; Azakie, Anthony; Mehta, Nilesh; Keller, Roberta; Datar, Sanjeev; Oishi, Peter; Fineman, Jeffrey

    2013-01-01

    Objective To determine the association between preoperative nutritional status and postoperative outcomes in children undergoing surgery for congenital heart defects (CHD). Methods Seventy-one patients with CHD were enrolled in a prospective, two-center cohort study. We adjusted for baseline risk differences using a standardized risk adjustment score for surgery for CHD. We assigned a World Health Organization Z-score for each subjects’ preoperative triceps skinfold measurement, an assessment of total body fat mass. We obtained preoperative plasma concentrations of markers of nutritional status (prealbumin, albumin) and myocardial stress (B-type natriuretic peptide, BNP). Associations between indices of preoperative nutritional status and clinical outcomes were sought. Results Subjects had a median (IQR) age of 10.2 (33) months. In the UCSF cohort, duration of mechanical ventilation (median 19 hours, IQR 29), length of ICU stay (median 5 days, IQR 5), duration of any continuous inotropic infusion (median 66 hours, IQR 72) and preoperative BNP levels (median 30 pg/mL, IQR 75) were associated with a lower preoperative triceps skinfold Z-score (p<0.05). Longer duration of any continuous inotropic infusion and higher preoperative BNP levels were also associated with lower preoperative prealbumin (12.1 ± 0.5 mg/dL) and albumin (3.2 ± 0.1) (p<0.05). Conclusions Lower total body fat mass and acute and chronic malnourishment are associated with worse clinical outcomes in children undergoing surgery for CHD at UCSF, a resource-abundant institution. There is an inverse correlation between total body fat mass and BNP levels. Duration of inotropic support and BNP increase concomitantly as measures of nutritional status decrease, supporting the hypothesis that malnourishment is associated with decreased myocardial function. PMID:23583172

  4. Process evaluation results from the HEALTHY nutrition intervention to modify the total school food environment

    PubMed Central

    Volpe, S. L.; Hall, W. J.; Steckler, A.; Schneider, M.; Thompson, D.; Mobley, C.; Pham, T.; El ghormli, L.

    2013-01-01

    The process evaluation of HEALTHY, a large multi-center trial to decrease type 2 diabetes mellitus in middle school children, monitored the implementation of the intervention to ascertain the extent that components were delivered and received as intended. The purpose of this article is to report the process evaluation findings concerning the extent to which the HEALTHY nutrition intervention was implemented during the HEALTHY trial. Overall, the observed fidelity of implementing nutrition strategies improved from baseline to the end of the study. By the last semester, all but two nutrition process evaluation goals were met. The most challenging goal to implement was serving high fiber foods, including grain-based foods and legumes. The easiest goals to implement were lowering the fat content of foods offered and offering healthier beverages. The most challenging barriers experienced by research dietitians and food service staff were costs, availability of foods and student acceptance. Forming strong relationships between the research dietitians and food service staff was identified as a key strategy to meet HEALTHY nutrition goals. PMID:24107856

  5. [Evaluation of the nutritional status and physical performance in candidates to liver transplantation].

    PubMed

    Leitão, Ana V A; Castro, Carmen L N; Basile, Tatianna M; Souza, Thiago H S; Braulio, Valeria B

    2003-01-01

    To evaluate the physical capacity and nutritional status of patients before orthotopic liver transplantation (OLT) and to correlate these parameters to the severity of liver function. Thirty-two patients before OTL were classified as Child-Pugh A (25%), B (22%) and C (53%). Physical capacity was analyzed by the quadriceps and ankle strength, balance, coordination, gait velocity, 6 minute walk test, get up and go test, Barthel and Karnofsky indexes. Nutritional status was evaluated by using Mendenhall score and Blackburn classification. Quadriceps weakness was found in 32% of the patients. Impaired balance and coordination were detected in 34.8% and 15.6% of the patients. Low physical performance was found in 72.5% of the patients (6 min walk test: 31.6% severely; 40.9% moderately impaired) and 43.8% required considerable assistance when the Karnofsky index was applied. Malnutrition was found in 62.5% of the patients (34.37% moderately and severely malnourished and 28.13% mildly malnourished). Chi-square analysis showed no association between Child-Pugh classification and nutritional status, the 6 min walk test and Karnofsky index. The association between the two functional tests was statistically significant (p<0.001). The results show that physical impairment and nutritional deficit were highly prevalent in the patients studied, independent of the degree of hepatic dysfunction evaluated by the traditional Child-Pugh classification.

  6. The effects of using a nutrition logo on consumption and product evaluation of a sweet pastry.

    PubMed

    Steenhuis, I H M; Kroeze, W; Vyth, E L; Valk, S; Verbauwen, R; Seidell, J C

    2010-12-01

    Nutrition logos have received a great deal of attention to stimulate people to eat a healthier diet. However, very little is known neither about actual consumption behavior related to nutrition logos nor about potential compensatory eating behaviors due to nutrition logos. The aim of this study was to assess the effects of using an existing nutrition logo on consumption and product evaluation of a chocolate mousse cake. A cross-over design was applied with two conditions: a condition with a logo and a condition without a logo. Participants were females recruited in the university community (n = 36, mean age 22.6 ± 6.3). Data on consumption, tastefulness, perceived healthiness, dietary restraint and Body Mass Index were collected. No significant differences between conditions were found on consumption and tastefulness. The cake was rated as significantly less unhealthy in the logo condition. In conclusion, results cannot be extrapolated to other products, especially not to products that are perceived as healthy. In this study, the use of a nutrition logo did not result in an increased consumption and had no effect on the rating of taste of a sweet pastry among females from the university community. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. [Description and evaluation of the adequacy of parenteral nutrition in our hospital].

    PubMed

    Alcázar, V; del Olmo, D; García Benayas, E; Diago, J; Koning, M A; Icaya, P M; López del Val, T; Sola, D; Jaunsolo, M A; Vázquez, C

    1998-01-01

    Parenteral nutrition (PN) is a form of nutrition that can be very beneficial, but it does have some indications and complications that should be taken into consideration. With this work we would like to describe the characteristics of our patients with PN, as well as their follow up, and to evaluate the appropriateness of its prescription. Retrospective study carried out at a hospital with 415 beds. All patients who received PN during the first six months of 1996 were reviewed. Inadequacy criteria are established and a nutritional assessment was carried out by means of clinical and analytical parameters. Catheter infections were recorded according to specific criteria and the clinical and analytical evolution of the patients was followed. A total of 83 patients were given parenteral nutrition. The most frequent indication was prolonged fasting after a surgical resection of the digestive apparatus. The most common nutritional status when beginning the PN was severe protein malnutrition (23%). There were 33 cases (39.7%) of PN that was not indicated and/or potentially avoidable. A catheter infection was reported in 7 cases (8.4%).

  8. Retrospective evaluation of the pre- and postoperative factors influencing the sensitivity of localization studies in primary hyperparathyroidism.

    PubMed

    Medas, Fabio; Erdas, Enrico; Longheu, Alessandro; Gordini, Luca; Pisano, Giuseppe; Nicolosi, Angelo; Calò, Pietro Giorgio

    2016-01-01

    Over the last decades, mini-invasive surgery has become increasingly common for treatment of primary hyperparathyroidism; such approach requires preoperative localization of a suspected parathyroid adenoma. Neck ultrasound (US) and technetium-99 m sestamibi (MIBI) scan are the main imaging studies used for this purpose. The aim of the present study is to evaluate what pre- and post-operative factors may alter the reliability of localization studies. A retrospective analysis on 212 patients with preoperative diagnosis of primary hyperparathyroidism was conducted. Data collected included demographic data, preoperative workup, operative findings and follow-up. Univariate logistic regression was performed on pre- and postoperative variables. US sensitivity was 62.4% and MIBI sensitivity 78.9%. Cure rate after parathyroidectomy was 98.1%. Univariate logistic regression demonstrated that US sensitivity was impaired by lower levels of serum calcium (p < 0.0001), multi-gland disease (p = 0.011) and co-existence of thyroid disease (p = 0.001); MIBI sensitivity was impaired by lower levels of serum calcium (p = 0.001) and multi-gland disease (p < 0,0001). Mild hypercalcaemia, multi-gland disease and co-existing thyroid disease are the main factors affecting sensitivity of preoperative imaging studies. In such patients a mini-invasive approach is possible but the use of intraoperative PTH monitoring is mandatory to reduce the risk of unsuccessful surgery. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  9. Evaluation of caudal dexamethasone with ropivacaine for post-operative analgesia in paediatric herniotomies: A randomised controlled study

    PubMed Central

    Choudhary, Santosh; Dogra, Neelam; Dogra, Jaideep; Jain, Priyanka; Ola, Sandeep Kumar; Ratre, Brajesh

    2016-01-01

    Background and Aims: Caudal analgesia is one of the most popular regional blocks in paediatric patients undergoing infra-umbilical surgeries but with the drawback of short duration of action after single shot local anaesthetic injection. We evaluated whether caudal dexamethasone 0.1 mg/kg as an adjuvant to the ropivacaine improved analgesic efficacy after paediatric herniotomies. Methods: Totally 128 patients of 1–5 years age group, American Society of Anaesthesiologists physical status I and II undergoing elective inguinal herniotomy were randomly allocated to two groups in double-blind manner. Group A received 1 ml/kg of 0.2% ropivacaine caudally and Group B received 1 ml/kg of 0.2% ropivacaine, in which 0.1 mg/kg dexamethasone was added for caudal analgesia. Post operative pain by faces, legs, activity, cry and consolability tool score, rescue analgesic requirement and adverse effects were noted for 24 h. Results: Results were statistically analysed using Student's t-test. Pain scores measured at 1, 2, 4, and 6 h post-operative, were lower in Group B as compared to Group A. Mean duration of analgesia in Group A was 248.4 ± 54.1 min and in Group B was 478.046 ± 104.57 min with P = 0.001. Rescue analgesic requirement was more in Group A as compared to Group B. Adverse effects after surgery were comparable between the two groups. Conclusion: Caudal dexamethasone added to ropivacaine is a good alternative to prolong post-operative analgesia with less pain score compared to caudal ropivacaine alone. PMID:26962252

  10. Nutrition care for renal transplant recipients: an evaluation of service delivery and outcomes.

    PubMed

    Orazio, Linda; Chapman, Jessica; Isbel, Nicole M; Campbell, Katrina L

    2014-06-01

    Weight gain post-renal transplantation is common. Recommendations from recent guidelines include providing structured nutrition care to target risk factors for chronic disease in the early post-transplant period. This study aimed to evaluate the nutrition care provided to renal transplant recipients following implementation of a dietetic model of care and to identify predictors of weight change up to one year post-transplant. A retrospective and observational study of one hundred and fifty-six patients that received a renal transplant from a state-wide transplant service in Australia between October 2009 and December 2010. Nutrition care provided compared with guideline recommendations within the first three months post-transplant and weight change at 12 months post-transplant, significant weight gain equating to >5% pre-transplant weight. Only 35% of patients were provided with nutrition care according to guideline recommendations, were older, and had a higher BMI and diabetes. Significant weight gain was evident for half of the patients evaluated. Thirty-eight percent of healthy weight patients at transplant became overweight or obese and 23% of overweight patients at baseline became obese at 12 months. After multivariate analysis, time on dialysis was independently associated with weight change at 12 months. Nutrition care provided did not meet guideline recommendations, highlighting difficulty in implementing evidence to practice. Significant weight gain was evident particularly in patients classified as 'healthy weight' at the time of transplant. Long-term, prospective studies are needed to determine the effectiveness of implementing nutrition care to attenuate weight gain and improve clinical outcomes. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  11. Evaluation of microcomputer nutritional teaching games in 1,876 children at school.

    PubMed

    Turnin, M C; Tauber, M T; Couvaras, O; Jouret, B; Bolzonella, C; Bourgeois, O; Buisson, J C; Fabre, D; Cance-Rouzaud, A; Tauber, J P; Hanaire-Broutin, H

    2001-09-01

    We evaluated in a prospective study microcomputer nutritional teaching games and their contribution to the children's acquisition of nutritional knowledge and improvement of eating habits. One thousand eight hundred seventy-six children aged 7-12 years took part in this study at school. All 16 schools of the same school district were randomized into two groups: games group and control group, both receiving conventional nutritional teaching by their teachers. The children in the games group played computer games during the conventional nutritional teaching period (2 hours a week for 5 weeks). At completion of the study, dietetic knowledge and dietary records were evaluated in both groups. Dietary knowledge tests results were better in the games group (p<0.001). The children in the games group had a significantly better balanced diet for an energy intake of about 1900 kilocalories: more carbohydrate (46.4 +/- 0.2% vs 45.7 +/- 0.2%, p<0.05), less fat (37.1 +/- 0.1% vs 37.6 +/- 0.2%, p<0.05), less protein (16.5 +/- 0.1% vs 16.7 +/- 0.1%, p<0.05), less saccharose (11.5 +/- 0.1% vs 12.2 +/- 0.2%, p<0.001), more calcium (p<0.001) and more fiber (p<0.05). The games group had a better snack at 10 a.m., a less copious lunch and less nibbling (p<0.001). The children in the games group had slightly but significantly better nutritional knowledge and dietary intake compared to children in the control group. Using our micro computer nutritional teaching games at school provides an additional and modern support to conventional teaching.

  12. An evaluation of enteral nutrition practices and nutritional provision in children during the entire length of stay in critical care

    PubMed Central

    2014-01-01

    Background Provision of optimal nutrition in children in critical care is often challenging. This study evaluated exclusive enteral nutrition (EN) provision practices and explored predictors of energy intake and delay of EN advancement in critically ill children. Methods Data on intake and EN practices were collected on a daily basis and compared against predefined targets and dietary reference values in a paediatric intensive care unit. Factors associated with intake and advancement of EN were explored. Results Data were collected from 130 patients and 887 nutritional support days (NSDs). Delay to initiate EN was longer in patients from both the General Surgical and congenital heart defect (CHD) Surgical groups [Median (IQR); CHD Surgical group: 20.3 (16.4) vs General Surgical group: 11.4 (53.5) vs Medical group: 6.5 (10.9) hours; p ≤ 0.001]. Daily fasting time per patient was significantly longer in patients from the General Surgical and CHD Surgical groups than those from the Medical group [% of 24 h, Median (IQR); CHD Surgical group: 24.0 (29.2) vs General Surgical group: 41.7 (66.7) vs Medical group: 9.4 (21.9); p ≤ 0.001]. A lower proportion of fluids was delivered as EN per patient (45% vs 73%) or per NSD (56% vs 73%) in those from the CHD Surgical group compared with those with medical conditions. Protein and energy requirements were achieved in 38% and 33% of the NSDs. In a substantial proportion of NSDs, minimum micronutrient recommendations were not met particularly in those patients from the CHD Surgical group. A higher delivery of fluid requirements (p < 0.05) and a greater proportion of these delivered as EN (p < 0.001) were associated with median energy intake during stay and delay of EN advancement. Fasting (31%), fluid restriction (39%) for clinical reasons, procedures requiring feed cessation and establishing EN (22%) were the most common reasons why target energy requirements were not met. Conclusions Provision of optimal EN support remains

  13. Accuracy of Different Mini Nutritional Assessment Reduced Forms to Evaluate the Nutritional Status of Elderly Hospitalised Diabetic Patients.

    PubMed

    Martín, A; Ruiz, E; Sanz, A; García, J M; Gómez-Candela, C; Burgos, R; Matía, P; Ramalle-Gomera, E

    2016-04-01

    Disease-associated malnutrition (DAM) is a health problem involving all sanitary levels, especially hospitalised elderly patients. Different MNA (Mini Nutritional Assessment)-based forms have been validated in different settings, but it remains unclear if they are appropriate to evaluate the nutritional status of geriatric hospitalised patients with diabetes. The aim of this work was to analyse the accuracy of several MNA reduced forms to detect malnutrition in hospitalised elderly diabetic patients. A multicentre observational study was carried out in diabetic patients, who were over the age of 65, from 35 Spanish hospitals. Principal component analysis (PCA) selected the minimal components to elaborate the newly-proposed reduced new version of the MNA (r-MNA). Cohen's Kappa index (KI), with its 95% confidence interval (CI), was used to measure the agreement between the different reduced forms (r-MNA, MNA-SF-BMI, MNA-SF-CC, m-MNA) with the original MNA. Five hundred and ninety-one elderly diabetic patients were included in the study. ROC analysis determined the following cut-off points for the newly proposed r MNA: 0-<10 "malnourished", 10-12 "at risk" and >12-15 "well-nourished". The upper cut-off point demonstrated a sensitivity of 87.7%, a specificity of 78.3% and an area under the curve of 0.93. The lower cut-off point showed a sensitivity of 95.9%, a specificity of 78.3% and an area under the curve of 0.95. The best agreement with the original MNA was observed for the MNA-SF-BMI (Κ index 80.7; 95% CI: 77.4-84) and the worst for the r-MNA (Κ index 72; 95% CI: 68.2-75.4). This study found that MNA-SF-BMI is the most accurate screening tool for determining the nutritional status of hospitalised diabetic elderly patients. This is an easy-to-use, fast screening tool with a low risk of misclassification.

  14. Role of cardiovascular nuclear medicine in evaluating trauma and the postoperative patient

    SciTech Connect

    Simon, T.R.; Parkey, R.W.; Lewis, S.E.

    1983-04-01

    In the patient with cardiac trauma, radionuclide imaging may provide important information about cardiac mechanical function, vascular anatomy and integrity, myocardial perfusion, and myocardial metabolism. Studies require only minimal patient cooperation, can be performed relatively rapidly and often at the bedside, and may be repeated at frequent intervals for serial evaluations. These studies provide valuable adjunctive knowledge when selected and interpreted with knowledge of the mechanism of injury, timing of the examination relative to the time of injury, and most likely differential diagnoses.

  15. Development and Evaluation of the School Cafeteria Nutrition Assessment Measures

    ERIC Educational Resources Information Center

    Krukowski, Rebecca A.; Philyaw Perez, Amanda G.; Bursac, Zoran; Goodell, Melanie; Raczynski, James M.; Smith West, Delia; Phillips, Martha M.

    2011-01-01

    Background: Foods provided in schools represent a substantial portion of US children's dietary intake; however, the school food environment has proven difficult to describe due to the lack of comprehensive, standardized, and validated measures. Methods: As part of the Arkansas Act 1220 evaluation project, we developed the School Cafeteria…

  16. Development and Evaluation of the School Cafeteria Nutrition Assessment Measures

    ERIC Educational Resources Information Center

    Krukowski, Rebecca A.; Philyaw Perez, Amanda G.; Bursac, Zoran; Goodell, Melanie; Raczynski, James M.; Smith West, Delia; Phillips, Martha M.

    2011-01-01

    Background: Foods provided in schools represent a substantial portion of US children's dietary intake; however, the school food environment has proven difficult to describe due to the lack of comprehensive, standardized, and validated measures. Methods: As part of the Arkansas Act 1220 evaluation project, we developed the School Cafeteria…

  17. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk.

    PubMed

    Jie, Bin; Jiang, Zhu-Ming; Nolan, Marie T; Zhu, Shai-Nan; Yu, Kang; Kondrup, Jens

    2012-10-01

    This multicenter, prospective cohort study evaluated the effect of preoperative nutritional support in abdominal surgical patients at nutritional risk as defined by the Nutritional Risk Screening Tool 2002 (NRS-2002). A consecutive series of patients admitted for selective abdominal surgery in the Peking Union Medical College Hospital and the Beijing University Third Hospital in Beijing, China were recruited from March 2007 to July 2008. Data were collected on the nutritional risk screening (NRS-2002), the application of perioperative nutritional support, surgery, complications, and length of stay. A minimum of 7 d of parenteral nutrition or enteral nutrition before surgery was considered adequate preoperative nutritional support. In total 1085 patients were recruited, and 512 of them were at nutritional risk. Of the 120 patients with an NRS score at least 5, the complication rate was significantly lower in the preoperative nutrition group compared with the control group (25.6% versus 50.6%, P = 0.008). The postoperative hospital stay was significantly shorter in the preoperative nutrition group than in the control group (13.7 ± 7.9 versus 17.9 ± 11.3 d, P = 0.018). Of the 392 patients with an NRS score from 3 to 4, the complication rate and the postoperative hospital stay were similar between patients with and those without preoperative nutritional support (P = 1.0 and 0.770, respectively). This finding suggests that preoperative nutritional support is beneficial to patients with an NRS score at least 5 by lowering the complication rate. Copyright © 2012. Published by Elsevier Inc.

  18. 2-year postoperative evaluation of a patient with a symptomatic full-thickness patellar cartilage defect repaired with particulated juvenile cartilage tissue.

    PubMed

    Bonner, Kevin F; Daner, William; Yao, Jian Q

    2010-06-01

    This case report describes the early results of a 36-year-old man who underwent repair of a symptomatic full-thickness patellar cartilage defect with transplanted particulated juvenile articular cartilage. At 2 years postoperatively, the patient has experienced substantial clinical improvement in both pain and function when evaluated with both International Knee Documentation Committee subjective evaluation and Knee Injury and Osteoarthritis Outcome Score outcome measures. Two-year postoperative magnetic resonance imaging demonstrates fill of the defect with repair tissue and near complete resolution of preoperative subchondral bone edema. To the best of the authors' knowledge, this case report is the first to report clinical results of this new technique at 2 years postoperatively.

  19. Computed Tomography in the Preoperative and Postoperative Evaluation of Kidney Transplant Patients.

    PubMed

    Sarsengaliyev, Timur; Chuvakova, Elmira; Tsoy, Boris; Zhangalova, Aisulu; Gaipov, Abduzhappar

    2015-11-01

    Computed tomography is required for selection of living donors for kidney transplant. We assessed the diagnostic relevance and effectiveness of multiphase contrast-enhanced computed tomography angiography for evaluating patients before and after transplant. Thirty-two potentially living kidney donors (15 men and 17 women) underwent multiphase computed tomography angiography for evaluation before kidney transplant and 2 posttransplant recipients under went this test owing to abnormal vascularization. Computed tomography angio graphy was used to determine parenchymal blood-flow conditions and vascular architecture of the kidney grafts. All of the 34 patients underwent prestudy Doppler ultrasonography. Additional renal arteries were found in 11 patients (32.3%). From them, a single additional renal artery, situated from the aorta to the lower segment of the kidney, was observed in 8 (72.7%) patients; dual additional renal arteries with equivalent caliber trunks were observed in 3 (27.3%) patients. An additional renal artery occurred more often in women in 6 (54.5%) donors. Concomitant renal pathology was detected in 3 (9.3%) of 32 donors: simple cysts in 2 donors and hydro nephrosis transformation in 1 donor. These 3 cases represented an accidental discovery and were therefore excluded from the list of donors. In addition, all donors underwent excretory-phase computed tomography, and their renal function and urinary collecting system results were evaluated. Two recipients with graft dysfunction presented with decreased venous return and delayed arterial filling of the renal arteries that manifested as delayed contrast in the kidney graft medulla. Renal parenchymal ischemic zones were consistent with microvasculature thrombosis, the most common cause of vascular complications in these recipients. Multiphase computed tomography angiography is a necessary tool for assessing the structure and condition of vascular architecture in kidney donors and recipients. Individuals

  20. Evaluating Evidence-Based Nutrition Support Practice Among Healthcare Professionals With and Without the Certified Nutrition Support Clinician Credential.

    PubMed

    Brody, Rebecca; Hise, Mary; Marcus, Andrea Fleisch; Harvey-Banchik, Lillian; Matarese, Laura E

    2016-01-01

    The National Board of Nutrition Support Certification credentials healthcare professionals and certifies that holders of the Certified Nutrition Support Clinician (CNSC) credential have specialized knowledge of safe and effective nutrition support therapy. The purpose of this pilot study was to survey healthcare professionals affiliated with the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) regarding their approaches to nutrition support practice using a complex patient case scenario in accordance with established clinical guidelines. An electronic survey was emailed to individuals affiliated with A.S.P.E.N. Eight multiple-choice knowledge questions addressed evidence-based nutrition support practice issues for a patient with progressing pancreatitis. Demographic and clinical characteristic data were collected. Of 48,093 email invitations sent, 4455 (9.1%) responded and met inclusion criteria. Most respondents were dietitians (70.8%) and in nutrition support practice for 10.3 years, and 29.3% held the CNSC credential. Respondents with the CNSC credential answered 6.18 questions correctly compared with 4.56 for non-CNSC respondents (P < .001). For all 8 questions, CNSC respondents were significantly more likely to choose the correct answer compared with non-CNSC respondents (P < .001). Professionals with the CNSC credential scored significantly higher on a complex case-based knowledge assessment of guideline recommendations for the nutrition support treatment of pancreatitis compared with those without a credential. © 2015 American Society for Parenteral and Enteral Nutrition.

  1. Diagnostic accuracy of cone beam computed tomography in identification and postoperative evaluation of furcation defects

    PubMed Central

    Pajnigara, Natasha; Kolte, Abhay; Kolte, Rajashri; Pajnigara, Nilufer; Lathiya, Vrushali

    2016-01-01

    Background: Decision-making in periodontal therapeutics is critical and is influenced by accurate diagnosis of osseous defects, especially furcation involvement. Commonly used diagnostic methods such as clinical probing and conventional radiography have their own limitations. Hence, this study was planned to evaluate the dimensions of furcation defects clinically (pre- and post-surgery), intra-surgically, and by cone beam computed tomography (CBCT) (pre- and post-surgery). Materials and Methods: The study comprised a total of 200 Grade II furcation defects in forty patients, with a mean age of 38.05 ± 4.77 years diagnosed with chronic periodontitis which were evaluated clinically (pre- and post-surgically), by CBCT (pre- and post-surgically), and intrasurgically after flap reflection (40 defects in each). After the presurgical clinical and CBCT measurements, demineralized freeze-dried bone allograft was placed in the furcation defect and the flaps were sutured back. Six months later, these defects were evaluated by recording measurements clinically, i.e., postsurgery clinical measurements and also postsurgery CBCT measurements (40 defects each). Results: Presurgery clinical measurements (vertical 6.15 ± 1.71 mm and horizontal 3.05 ± 0.84 mm) and CBCT measurements (vertical 7.69 ± 1.67 mm and horizontal 4.62 ± 0.77 mm) underestimated intrasurgery measurements (vertical 8.025 ± 1.67 mm and horizontal 4.82 ± 0.67 mm) in both vertical and horizontal aspects, and the difference was statistically not significant (vertical P = 1.000, 95% confidence interval [CI], horizontal P = 0.867, 95% CI). Further, postsurgery clinical measurements (vertical 2.9 ± 0.74 mm and horizontal 1.52 ± 0.59 mm) underestimated CBCT measurements (vertical 3.67 ± 1.17 mm and horizontal 2.45 ± 0.48 mm). There was statistically significant difference between presurgery clinical–presurgery CBCT (P < 0.0001, 95% CI) versus postsurgery clinical–postsurgery CBCT (P < 0.0001, 95% CI

  2. Postoperative management.

    PubMed

    Schraag, Stefan

    2016-09-01

    Most patients undergoing major aortic surgery have multiple comorbidities and are at high risk of postoperative complications that affect multiple organ systems. Different aortic pathologies and surgical repair techniques have specific impact on the postoperative course. Ischemia-reperfusion injury is the common denominator in aortic surgery and influences the integrity of end-organ function. Common postoperative problems include hemodynamic instability due to the immediate inflammatory response, renal impairment, spinal cord ischemia, respiratory failure with prolonged mechanical ventilation, and gastrointestinal symptoms such as ileus or mesenteric ischemia. Focused care bundles to establish homeostasis and a team working toward an early functional recovery determine the success of effective rehabilitation and outcomes after aortic surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Applying the evaluability principle to nutrition table information. How reference information changes people's perception of food products.

    PubMed

    Visschers, Vivianne H M; Siegrist, Michael

    2009-04-01

    Consumers often neglect or misinterpret nutrition table information. We argue in this paper that this can be explained by the evaluability principle, which posits that people's evaluation of a product corresponds to a greater degree with the product's actual value when people receive reference information about the product than when they do not get this information. We tested this assumption concerning nutrition table information in two studies. In Study 1, respondents received one of six nutrition tables that differed on reference and summary information about either yogurt or chocolate. In the second study, we compared three nutrition tables from the previous study, as applied to either a low nutritional value yogurt or a high nutritional value yogurt. Participants were asked to rate the attractiveness and perceived healthiness of the product in both studies. Results indicated that reference information can change people's product perception. This seems to depend, however, on the product's nutritional value and on people's primary connotation for the product. In sum, the evaluability principle can explain people's perception of a food product. A nutrition table that is adapted to this principle appears to influence people's product perception so that it becomes more in line with its nutritional value. Implications for practice and further research are given.

  4. Prospective evaluation of oral gastrografin(®) in the management of postoperative adhesive small bowel obstruction.

    PubMed

    Rahmani, Nasrin; Mohammadpour, Reza Ali; Khoshnood, Peyman; Ahmadi, Amirhossein; Assadpour, Sara

    2013-06-01

    Oral Gastrografin®, a hyperosmolar water-soluble contrast medium, may have a therapeutic effect in adhesive small bowel obstruction. However, findings are still conflicting, as some authors did not find a therapeutic advantage. So, this prospective, randomized, and clinical trial study was designed to determine the value of Gastrografin in adhesive small bowel obstruction. The primary end points were the evaluation of the operative rate reduction and shortening the hospital stay after the use of Gastrografin. A total of 84 patients were randomized into two groups: the control group received conventional treatment, whereas the study group received in addition of 100 mL Gastrografin meal. Patients were followed up within 4 days after admission, and clinical and radiological (if needed) improvements were evaluated. Although the results showed that Gastrografin can decrease the need for surgical management by 14.5 %, no statistically significant differences were observed between the two groups (P = 0.07). Nevertheless, the length of hospital stay revealed a significant reduction from 4.67 ± 1.18 days to 2.69 ± 1.02 days (P = 0.00). The use of Gastrografin in adhesive small bowel obstruction is safe and reduces the length of hospital stay. As a result, the cost of hospital bed occupancy is reduced. Hence, if there was no indication of emergency surgery, administration of oral Gastrografin as a nonoperative treatment in adhesive small bowel obstruction is also recommended.

  5. Surface electromyography in preoperative evaluation and postoperative monitoring of Zenker's diverticulum.

    PubMed

    Vaiman, Michael

    2006-01-01

    Patients with Zenker's diverticulum (ZD) underwent surface electromyography (sEMG) evaluation to determine sEMG patterns specific for ZD. Group 1 comprised patients with proven long-standing ZD that refused surgical treatment (n = 11, age mean = 55.7 years). Group 2 comprised surgically operated on patients with ZD (n = 6, age mean = 61 years). The timing, amplitude, and graphic patterns of activity of the masseter, submental, and laryngeal strap muscles were examined during voluntary single water swallows ("normal"), single swallows of excessive amounts of water (20 ml, "stress test"), and continuous drinking of 100 cc of water. The muscle activity in pharyngeal and initial esophageal stages of swallowing was measured, and graphic records were evaluated in relation to timing and voltage. The data were compared with the previously established normative database. The main sEMG patterns of ZD are (1) duration of swallowing and drinking is longer than normal (p < 0.05), (2) electric amplitude of laryngeal strap muscles during swallowing activity is higher than normal (p < 0.05), and (3) regurgitation peaks immediately after swallow followed by secondary swallow of the regurgitated portion of a bolus as seen at the sEMG records are specific graphic patterns for the ZD. Zenker's diverticulum has its own specific sEMG patterns. Surface EMG, being an important screening method for patients with dysphagia, is a valuable additional diagnostic tool for ZD. Because it is noninvasive and nonradiographic, it can be used for monitoring of long-standing cases of the disease as well as monitoring of postsurgical recovery.

  6. Nutritional evaluation in cotton-top tamarins (Saguinus oedipus).

    PubMed

    Escajadillo, A; Bronson, R T; Sehgal, P; Hayes, K C

    1981-04-01

    Four cotton-top tamarins were fed a commercial biscuit diet and three others a commercial canned diet for 12 weeks. Thereafter, all seven were fed a purified diet for 12 weeks. General health, body weight, food intake, fecal output, serum biochemistry, blood count, and colonic histopathology were evaluated at various times during the experiments. The diets did not affect these parameters except the purified diet was associated with relatively reduced fecal output. Diarrhea and chronic colitis occurred independently of the diet in three tamarins in the course of the study.

  7. [Comparative evaluation of efficacy of the upper part of the face endoscopic lifting in dynamics of postoperative period].

    PubMed

    Kozynets', H P; Pinchuk, V D; Tkach, O S

    2014-05-01

    Comparative estimation of results for endoscopic lifting of the face upper part in dynamics of early and late postoperative period was adduced. In accordance to results of analysis, concerning the eyebrows height in a control terms, there was established, that through one year postoperatively the eyebrows have a tendency towards ptosis due to activity of the eyes circular muscles. Deterioration of the result achieved post-operatively is less prominent in patients after preliminary chemical denervation of mimic muscles. Chemical denervation of the eyes circular muscles, using injections of botulinic toxine type A before 2 weeks preoperatively secures a stable fixation of tissues in early postoperative period, what permits to escape loss of the result achieved, secures the results improvement in late postoperative period in 3.7 times.

  8. Integrated nutrition.

    PubMed

    Allison, S P

    2005-08-01

    There is no branch of medicine in which nutritional considerations do not play some part. Overnutrition, undernutrition or unbalanced nutrition are the major causes of ill health in the world. Conversely, illness causes important nutritional and metabolic problems. The spectrum from lack to excess of nutrients is seamless as a clinical and scientific discipline, the two extremes being linked by the Barker effect by which intrauterine malnutrition and low birth weight predispose to obesity, diabetes and CVD in later life. However, the teaching of nutrition in medical and nursing schools remains sparse. Nutritional care cannot be practised satisfactorily in isolation from other aspects of management, since factors such as drugs, surgery and fluid and electrolyte balance affect nutritional status. Nutritional treatment may also have adverse or beneficial effects according to the composition, amount and mode of delivery of the diet and the clinical context in which it is given. Any benefits of nutritional support may also be negated by shortcomings in other aspects of treatment and must therefore be fully integrated into overall care. One example of this approach is the enhanced recovery after a surgery protocol incorporating immediate pre-operative carbohydrate and early post-operative oral intake with strict attention to zero fluid balance, epidural analgesia and early mobilisation. Other examples include the deleterious effect on surgical outcome of salt and water overload or hyperglycaemia, either of which may negate the benefits of nutritional support. There is a need, therefore, to integrate clinical nutrition more closely, not just into medical and surgical practice, but also into the organisation of health services in the hospital and the community, and into the training of doctors and nurses. Societies originally devoted to parenteral and enteral nutrition need to widen their scope to embrace wider aspects of clinical nutrition.

  9. Postoperative atelectasis.

    PubMed

    Massard, G; Wihlm, J M

    1998-08-01

    Postoperative atelectasis is a common problem following any surgery. Limited atelectasis is usually well-tolerated and easily reversible. However, complete atelectasis of the remaining lung following partial lung resection may be poorly tolerated. Thoracic surgical procedures increase the risk because pain, thoracic muscle injury, chest wall instability, and diaphragmatic dysfunction impair clearance of secretions by cough. In addition, patients with lung diseases are prone to increased bronchial secretions. Prophylaxis includes preoperative and postoperative physiotherapy and medications, which should be graded in accordance to the individual patient's risk factors. Large atelectasis requires bronchoscopy to remove mucous plugs. Tracheostomy should be considered in patients with relapsing atelectasis or swallow disorders.

  10. [Postoperative evaluation of different surgical procedures in genuine stress urinary incontinence: a retrospective study].

    PubMed

    Rodríguez-Colorado, S; Pérez-Soriano, P; Alvarez-Mercado, R L; Herbert, A; Kunhardt-Rasch, J

    1996-06-01

    An evaluation of the surgical treatment for stress and mixed urinary incontinence and pelvic relaxation. One-year follow-up, was done. A retrospective study with 144 files from the surgeries performed between February 1993 and June 1994, at the Clínica de Urología Ginecológica del Instituto Nacional de Perinatología. We excluded 37 files because of incomplete information. The age, parity, hormonal stage, preoperative diagnosis by urodynamic studies, surgical treatments and one-year follow-up were analyzed. The mean age was 45.5 years. Pereyra procedure was performed in 53, Burch procedure in 47, anterior colporrhaphy in 5, and sling procedure in 2 patients. The incidence of complications was similar between the different groups. Resumption of spontaneous postsurgical voiding was delayed in the Pereyra group. The Burch urethropexy and Pereyra procedures were equally effective, with no statistical differences observed. Burch vaginal suspension was not more effective for the correction of urinary stress incontinence than Pereyra procedure.

  11. Evaluation of dexmedetomidine in combination with sufentanil or butorphanol for postoperative analgesia in patients undergoing laparoscopic resection of gastrointestinal tumors

    PubMed Central

    Zhang, Xue-Kang; Chen, Qiu-Hong; Wang, Wen-Xiang; Hu, Qian

    2016-01-01

    Abstract The aim of this study was to evaluate the efficacy of dexmedetomidine in combination with sufentanil or butorphanol for postoperative analgesia in patients undergoing laparoscopic resection of a gastrointestinal tumor. This quasi-experimental trial was conducted in Nanchang, China, from January 2014 to December 2015. Eighty patients (age 27–70 years, American Society of Anesthesiologists physical status I–II) undergoing laparoscopic resection of a gastrointestinal tumor were randomized into 4 groups and offered intravenous patient-controlled analgesia for pain control after surgery. The patients received sufentanil 2.0 μg/kg in combination with dexmedetomidine 1.5 μg/kg (group S1) or 2.0 μg/kg (group S2), or butorphanol 0.15 mg/kg in combination with dexmedetomidine 1.5 0 μg/kg (group N1) or 2.0 μg/kg (group N2). Oxygen saturation, mean arterial pressure (MAP), heart rate, visual analog scale score, and Ramsay sedation score were recorded at enrollment (T0), at extubation (T1), and 4 (T2), 8 (T3), 12 (T4), 24 (T5), and 48 (T6) hours thereafter. Side effects and satisfaction scores were evaluated after surgery. MAP increased in all groups at T1 but not significantly so when compared with T0. Heart rate decreased significantly in group S2 when compared with the other groups at T1–T5 (P < 0.05). MAP decreased significantly in group S2 when compared with group S1 at T4–T6 (P < 0.05). MAP increased significantly in group N1 when compared with group N2 at T4–T5 (P < 0.05). There was a statistically significant decrease in mean visual analog scale score in group S2 when compared with group S1 at T2 (P < 0.05) and group N2 at T1–T2 (P < 0.05). Two patients in group S1 had vomiting. There were no reports of drowsiness, respiratory depression, or other complications. The satisfaction score was higher in group S2 than in the other groups. Dexmedetomidine in combination with sufentanil or butorphanol can be used safely

  12. Development and Evaluation of Nutrition Education Competencies and a Competency-Based Resource Guide for Preschool-Aged Children

    ERIC Educational Resources Information Center

    Scherr, Rachel E.; Reed, Heather; Briggs, Marilyn; Zidenberg-Cherr, Sheri

    2011-01-01

    Purpose/Objectives: The purpose of this research was to develop and evaluate nutrition education competencies and a competency-based resource guide, Connecting the Dots...Healthy Foods, Healthy Choices, Healthy Kids (CTD), for preschool-aged children in California. Methods: Nutrition education experts and California Department of Education staff…

  13. Evaluating the Impact of Six Supplemental Nutrition Assistance Program Education Interventions on Children's At-Home Diets

    ERIC Educational Resources Information Center

    Williams, Pamela A.; Cates, Sheryl C.; Blitstein, Jonathan L.; Hersey, James C.; Kosa, Katherine M.; Long, Valerie A.; Singh, Anita; Berman, Danielle

    2015-01-01

    Background: Nutrition education in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) is designed to promote healthy eating behaviors in a low-income target population. Purpose: To evaluate the effectiveness of six SNAP-Ed interventions delivered in child care centers or elementary school settings in increasing participating…

  14. Evaluating the Impact of Six Supplemental Nutrition Assistance Program Education Interventions on Children's At-Home Diets

    ERIC Educational Resources Information Center

    Williams, Pamela A.; Cates, Sheryl C.; Blitstein, Jonathan L.; Hersey, James C.; Kosa, Katherine M.; Long, Valerie A.; Singh, Anita; Berman, Danielle

    2015-01-01

    Background: Nutrition education in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) is designed to promote healthy eating behaviors in a low-income target population. Purpose: To evaluate the effectiveness of six SNAP-Ed interventions delivered in child care centers or elementary school settings in increasing participating…

  15. Development and Evaluation of Nutrition Education Competencies and a Competency-Based Resource Guide for Preschool-Aged Children

    ERIC Educational Resources Information Center

    Scherr, Rachel E.; Reed, Heather; Briggs, Marilyn; Zidenberg-Cherr, Sheri

    2011-01-01

    Purpose/Objectives: The purpose of this research was to develop and evaluate nutrition education competencies and a competency-based resource guide, Connecting the Dots...Healthy Foods, Healthy Choices, Healthy Kids (CTD), for preschool-aged children in California. Methods: Nutrition education experts and California Department of Education staff…

  16. Evaluation of a recently described risk classification scheme for pancreatic fistulae development after pancreaticoduodenectomy without routine post-operative drainage

    PubMed Central

    Kunstman, John W; Kuo, Eric; Fonseca, Annabelle L; Salem, Ronald R

    2014-01-01

    Background Post-operative pancreatic fistula (POPF) formation occurs frequently after a pancreaticoduodenectomy (PD). Recently, a 10-point Fistula Risk Score (FRS) evaluating the likelihood of clinically relevant POPF (CR-POPF) development has been described and validated. This scheme has yet to be evaluated in PD patients managed without intra-operative drain placement. Methods Among patients undergoing PD at an academic centre since 2003, a retrospective analysis calculating FRS and its correlation with CR-POPF development was evaluated by logistic regression. Secondary analysis examined presentation and management of CR-POPF in undrained PD patients. Results FRS was calculated for 265 patients; 97.7% were managed without operative drains. The overall incidence of CR-POPF was 7.9%. Logistic regression revealed a 1.6-fold increase in CR-POPF risk per 1-point increase in FRS [95% confidence interval (CI) 1.2–2.0]. The negative predictive value in patients with FRS <3 was 100%, whereas the positive predictive value of FRS >6 was 16.7%. The median time to CR-POPF diagnosis was 18 days [interquartile range (IQR) 13–23]; 70.0% required readmission and 10.0% required a laparotomy. Conclusions Among patients without operative drainage, CR-POPF often has delayed presentations but most are managed non-operatively. The predictive value of high-risk FRS appears limited; conversely, a low-risk FRS accurately predicts the absence of CR-POPF and seems an appropriate metric for guiding care. PMID:24833603

  17. Relationship between sentinel lymph nodes and postoperative tangential fields in early breast cancer, evaluated using SPECT/CT

    PubMed Central

    Wadasaki, Koichi; Nishibuchi, Ikuno

    2015-01-01

    Single-photon emission computed tomography/computed tomography (SPECT/CT) demonstrates the precise location of the sentinel lymph nodes (SLNs) in patients with breast cancer. We evaluated the relationship between SLNs and postoperative tangential fields by using SPECT/CT images. Subjects included 72 patients with early breast cancer who underwent SPECT/CT of the SLNs and received whole-breast irradiation with tangential fields after partial mastectomy. The SLN locations evaluated by using SPECT/CT images were entered into the treatment-planning CT image with a 5-mm-diameter sphere. A 15-mm-diameter sphere including the 5-mm treatment margin around the SLNs was defined as PTV-SLN. The PTV-SLN doses with tangential irradiation were evaluated and expressed as the percentage of the prescribed dose. In 69 patients, SLNs were detected by using SPECT/CT; 68 SLNs were located at axillary lymph node Level I, and one was located at Level II. A total of 62 SLNs (90%) were determined to be located inside the tangential fields on the digitally reconstructed radiography (DRR) images. The median doses of SLN center, mean PTV-SLN dose, and PTV-SLN D95 (the minimum dose delivered to 95% of the volume) were 94.1% (range, 15.3–101.9%), 93.7% (range, 29.3–104.0%) and 84.8% (range, 6.8–99.8%). The D95 for the SLNs with treatment margins were ≤90% of the prescribed doses in more than half of the cases. Modification of the individual treatment fields seemed to be necessary to ensure coverage of the SLNs in whole-breast irradiation. PMID:26062810

  18. Cognitive and behavioral evaluation of nutritional interventions in rodent models of brain aging and dementia.

    PubMed

    Wahl, Devin; Coogan, Sean Cp; Solon-Biet, Samantha M; de Cabo, Rafael; Haran, James B; Raubenheimer, David; Cogger, Victoria C; Mattson, Mark P; Simpson, Stephen J; Le Couteur, David G

    2017-01-01

    Evaluation of behavior and cognition in rodent models underpins mechanistic and interventional studies of brain aging and neurodegenerative diseases, especially dementia. Commonly used tests include Morris water maze, Barnes maze, object recognition, fear conditioning, radial arm water maze, and Y maze. Each of these tests reflects some aspects of human memory including episodic memory, recognition memory, semantic memory, spatial memory, and emotional memory. Although most interventional studies in rodent models of dementia have focused on pharmacological agents, there are an increasing number of studies that have evaluated nutritional interventions including caloric restriction, intermittent fasting, and manipulation of macronutrients. Dietary interventions have been shown to influence various cognitive and behavioral tests in rodents indicating that nutrition can influence brain aging and possibly neurodegeneration.

  19. The Evaluation of Undergraduate Nursing Students' Knowledge of Post-op Pain Management after Participation in Simulation.

    PubMed

    Evans, Cecile B; Mixon, Diana K

    2015-12-01

    The purpose of this paper was to assess undergraduate nursing students' pain knowledge after participation in a simulation scenario. The Knowledge and Attitudes of Survey Regarding Pain (KASRP) was used to assess pain knowledge. In addition, reflective questions related to the simulation were examined. Student preferences for education method and reactions to the simulation (SIM) were described. Undergraduate nursing students' knowledge of pain management is reported as inadequate. An emerging pedagogy used to educate undergraduate nurses in a safe, controlled environment is simulation. Literature reports of simulation to educate students' about pain management are limited. As part of the undergraduate nursing student clinical coursework, a post-operative pain management simulation, the SIM was developed. Students were required to assess pain levels and then manage the pain for a late adolescent male whose mother's fear of addiction was a barrier to pain management. The students completed an anonymous written survey that included selected questions from the KASRP and an evaluation of the SIM experience. The students' mean KASRP percent correct was 70.4% ± 8.6%. Students scored the best on items specific to pain assessment and worst on items specific to opiate equivalents and decisions on PRN orders. The students' overall KASRP score post simulation was slightly better than previous studies of nursing students. These results suggest that educators should consider simulations to educate about pain assessment and patient/family education. Future pain simulations should include more opportunities for students to choose appropriate pain medications when provided PRN orders.

  20. Thresholds for Oxford Knee Score after total knee replacement surgery: a novel approach to post-operative evaluation.

    PubMed

    Petersen, Christian Lund; Kjærsgaard, Jonas Bruun; Kjærgaard, Nicolai; Jensen, Michael Ulrich; Laursen, Mogens Berg

    2017-06-12

    In a prospective cohort study, we wanted to detect thresholds distinguishing between patients with a satisfactory and an unsatisfactory outcome after total knee replacement (TKR) based on Patient-Reported Outcome Measures (PROMs), namely the Oxford Knee Score (OKS), using patient satisfaction and patient-perceived function as global transition items. Seventy-three TKR patients completed the OKS questionnaire before surgery and were invited to complete the same questionnaire again 6 (4 to 9) months after surgery. Correlations between outcome measures and anchors were calculated using Pearson's correlation coefficient. Thresholds were established by receiver operating characteristics (ROC) analysis, using multiple anchor-based approaches. Patients showed a mean increase of 16.5 (SD 9.5) in OKS following TKR. Significant positive correlations were found between outcome measures and anchors. Six different thresholds were determined for outcome measures coupled with satisfaction, patient-perceived function and a combination thereof using a cut-off of 50 and 70. This study has established a set of clinically meaningful thresholds for Oxford Knee scores that may help to detect TKR patients who might be in need of post-operative evaluation.

  1. Methylnaltrexone, a new peripherally acting mu-opioid receptor antagonist being evaluated for the treatment of postoperative ileus.

    PubMed

    Kraft, Michael D

    2008-09-01

    Postoperative ileus (POI), a transient impairment of bowel function, is considered an inevitable response after open abdominal surgery. It leads to significant patient morbidity and increased hospital costs and length of stay. The pathophysiology is multifactorial, involving neurogenic, hormonal, inflammatory and pharmacologic mediators. Several treatments have been shown to reduce the duration of POI, and a multimodal approach combining several of these interventions seems to be the most effective treatment option. Various drug therapies have been evaluated for the treatment of POI, although most have not shown any benefit. Peripherally active mu-opioid receptor antagonists are a new class of compounds that selectively block the peripheral (i.e., gastrointestinal [GI]) effects of opioids while preserving centrally mediated analgesia. Recently, alvimopan was approved in the US for the treatment of POI after abdominal surgery with bowel resection. Methylnaltrexone is a peripherally active mu-opioid receptor antagonist that has been shown to antagonize the inhibitory effects of opioids on GI transit without impairing analgesia. Phase II data indicated that methylnaltrexone was effective for improving GI recovery, reducing POI and shortening the time to discharge readiness in patients who underwent segmental colectomy. Two Phase III trials have been completed, and one is underway at present. Preliminary results from the two completed trials indicate that methylnaltrexone was not better than placebo for the primary or secondary outcomes. Further analyses of these data, clinical trial designs and the various dosage forms are necessary to determine the potential role of methylnaltrexone in the treatment of POI.

  2. Contrast-enhanced ultrasound with SonoVue in the evaluation of postoperative complications in pediatric liver transplant recipients

    PubMed Central

    Bonini, G.; Pezzotta, G.; Morzenti, C.; Agazzi, R.; Nani, R.

    2007-01-01

    Purpose To evaluate the utility of contrast-enhanced sonography in the study of pediatric liver transplant recipients and its potential impact in reducing the need for invasive diagnostic procedures. Materials and methods From October 2002 to December 2003 we performed routine color Doppler ultrasound and contrast-enhanced ultrasound studies on 30 pediatric patients who had undergone liver transplantation. Findings indicative of complications were confirmed with invasive studies (angiography, computed tomography, and PTC). Results Contrast-enhanced sonography correctly identified four of the five cases of hepatic artery thrombosis and all those involving the portal (n = 6) and hepatic vein (n = 3) thrombosis. It failed to identify one case of hepatic artery thrombosis characterized by collateral circulation arising from the phrenic artery and the single case of hepatic artery stenosis. The latter was more evident on color Doppler, which revealed a typical tardus parvus waveform. The use of contrast offered no significant advantages in the study of biliary complications although it did provide better visualization of bile leaks. Conclusions Contrast-enhanced sonography improves diagnostic confidence and reduces the need for more invasive imaging studies in the postoperative follow-up of pediatric liver transplant recipients. PMID:23396596

  3. Evaluation of nutritional status using anthropometric measurements and MQSGA in geriatric hemodialysis patients

    PubMed Central

    Yigit, Irem Pembegul; Ulu, Ramazan; Celiker, Huseyin; Dogukan, Ayhan

    2016-01-01

    OBJECTIVE: Malnutrition is common among hemodialysis patients and is associated with higher rates of morbidity and mortality. The aim of this study was to evaluate nutritional status of geriatric hemodialysis patients. METHODS: Total of 163 hemodialysis patients were initially screened, and 55 patients (28 males, 27 females; mean age: 72.9±8.4 years) met the criteria for inclusion. Patients were divided into 3 groups according to modified quantitative subjective global assessment (MQSGA) scores: Group I (n=22) normal nutrition, Group II (n=20) mild-to-moderate malnutrition, and Group III (n=13) severe malnutrition. RESULTS: When we assessed the correlation between MQSGA nutrition score and data of malnourished patients (n=33), positive significant correlation was found between age, C-reactive protein level, and malnutrition-inflammation score. Negative significant correlation was found between body mass index, bicep skinfold, tricep skinfold, mid-arm circumference, mid-arm muscle circumference, and phosphate and albumin levels. CONCLUSION: Malnutrition is very common and increasing with aging in geriatric hemodialysis patients. MQSGA score and anthropometric measurements can be used to assess nutritional status in geriatric hemodialysis patients. PMID:28058399

  4. Evaluation of the Brazilian population's intake of antioxidant nutrients and their relation with the nutritional status.

    PubMed

    Tureck, Camila; Locateli, Gelvani; Corrêa, Vanesa Gesser; Koehnlein, Eloá Angélica

    2017-01-01

    The study of dietary antioxidants has gained prominence owing to the elucidation of the deleterious effects of oxidative stress to the human body. Objective: To evaluate the Brazilian population's intake of antioxidant nutrients and their association with the nutritional status. A cross-sectional study was carried out including secondary data on food consumption of 33,459 individuals from both sexes, aged 10 years or older, from all Brazilian regions based on microdata of the "2008-2009 Household Budget Survey, Brazilian Dairy Survey." The content of vitamins E, A, and C; zinc; manganese; copper; and selenium from 188 food items, divided into 12 groups, according to the habitual consumption form was analyzed. The means of antioxidant nutrient intake according to the nutritional status were compared using Bonferroni's t-test. Higher percentages of insufficient intake of vitamins than antioxidant minerals were seen. A significant difference in the intake of vitamin E as to the nutritional status was noticed, wherein the intake in overweight individuals was lower than in those with proper weight. Participants with low weight presented lower intake of almost all antioxidant minerals, except for copper, in which the intake of participants with low weight was equal to those with normal weight. High percentages of insufficient intake of antioxidant nutrients were observed in the studied population, especially vitamins. It was also found that the intake of antioxidant nutrients varied based on nutritional status, gender, and life stage.

  5. Nutritional and microbiological evaluations of chocolate-coated Chinese chestnut (Castanea mollissima) fruit for commercial use.

    PubMed

    Gounga, Mahamadou E; Xu, Shi-ying; Wang, Zhang

    2008-09-01

    In recent years, China has become an increasingly important and the largest chestnut producer in the world. This study aimed to evaluate the nutritional value and microbiological quality of the roasted freeze-dried Chinese chestnut (Castanea mollissima) (RFDC) coated with dark chocolate (DCC) and milk chocolate (MCC) for industrial use and commercial consumption. Chocolate coating significantly improved the nutritional value of chestnut. RFDC had high levels of starch (66.23%) and fibers (3.85%) while DCC and MCC contained significantly high amounts of sucrose, protein, fat and minerals. Furthermore, the protein content doubled in MCC rather than in DCC. This could be attributed to the different formulations in the two products. Milk powder and whey protein constituted the source of protein in MCC while cocoa powder added to MCC formulation constituted an additional source of minerals. The amino acid profile showed differences in amino acid composition related to the sample's protein content, indicating their good nutritional quality. The moisture contents in all RFDC, DCC and MCC were suitable for industrial processing. These results provide information about the additional nutrients of chocolate-coated chestnut and confirm that the product is an interesting nutritional food. The combination of freeze-drying and chocolate-coating generally results in greater reductions on microbiological loads, extending shelf life of harvested chestnut for commercial application. This is an alternative strategy to add value to chestnut, minimizing the significant losses in harvested fruits and providing a wider range of choices of new products to the consumer disposal.

  6. Evaluation of physicochemical properties, proximate and nutritional composition of Gracilaria edulis collected from Palk Bay.

    PubMed

    Sakthivel, Ravi; Pandima Devi, Kasi

    2015-05-01

    Gracilaria edulis, a red alga present in southeast coast of India was evaluated for its nutritional composition. FT-IR analysis of soluble polysaccharides revealed the presence of galactans, 3,6-anhydro-α-L-galactopyranose, sulphated galactose and the gelling agent agar, with the sulphate content estimated as 51.01 μg/mg of polysaccharide. Results of physicochemical properties and nutritional profile reveal the presence of dietary fibre (8.9 ± 0.62% DW), carbohydrate (101.61 ± 1.8 mg/g DW), crude protein (6.68 ± 0.94 mg/g DW) and lipid content (8.3 ± 1.03 mg/g DW). G. edulis contains biologically important fatty acids like palmitic acid (2.06%), linolenic acid (2.56%), and oleic acid (1.98%). The other nutritional components present in high amounts are proline, chlorophyll A and B, all the essential amino acids and vitamin A, E and C. These findings suggest that G. edulis has potent nutritional value which might be used as a source of nutrients for human and animals.

  7. Evaluation of diet and nutritional status in patients aged 45+ with diagnosed, pharmacologically treated arterial hypertension

    PubMed Central

    Śmidowicz, Angelika; Suliburska, Joanna; Bogdanski, Paweł

    2014-01-01

    Introduction Diet plays a significant role in the prevention and treatment of arterial hypertension. Appropriate diet makes it possible to maintain adequate body weight and improve biochemical blood parameters. The aim of the study was to assess nutritional status of arterial hypertension patients in terms of their diet. Material and methods The study involved 55 patients diagnosed with arterial hypertension aged 45-70 years. Diet was evaluated using a 24-hour 7-day diet recall interview. In the course of the diet recall interview arterial pressure was measured three times at regular times, after a 15-minute rest period, and the recorded values were averaged. Nutritional status was assessed based on anthropometric measurements (height, body weight, waist circumference, hip circumference) and the resulting nutrition status indexes, i.e. BMI (body mass index), WHR (waist-hip ratio) as well as values of biochemical blood parameters. Conclusions It was found that a considerable proportion of patients are overweight or obese, have an inappropriate lipid profile and elevated blood glucose levels. Daily food rations (DFR) were inappropriately balanced. Daily food rations were deficient in energy, carbohydrates, dietary fibre, PUFA and folates. It was found that inadequate diet was correlated with nutritional status, lipid profile parameters and arterial blood pressure. PMID:26327839

  8. Evaluation of diet and nutritional status in patients aged 45+ with diagnosed, pharmacologically treated arterial hypertension.

    PubMed

    Reguła, Julita; Śmidowicz, Angelika; Suliburska, Joanna; Bogdanski, Paweł

    2014-05-01

    Diet plays a significant role in the prevention and treatment of arterial hypertension. Appropriate diet makes it possible to maintain adequate body weight and improve biochemical blood parameters. The aim of the study was to assess nutritional status of arterial hypertension patients in terms of their diet. The study involved 55 patients diagnosed with arterial hypertension aged 45-70 years. Diet was evaluated using a 24-hour 7-day diet recall interview. In the course of the diet recall interview arterial pressure was measured three times at regular times, after a 15-minute rest period, and the recorded values were averaged. Nutritional status was assessed based on anthropometric measurements (height, body weight, waist circumference, hip circumference) and the resulting nutrition status indexes, i.e. BMI (body mass index), WHR (waist-hip ratio) as well as values of biochemical blood parameters. It was found that a considerable proportion of patients are overweight or obese, have an inappropriate lipid profile and elevated blood glucose levels. Daily food rations (DFR) were inappropriately balanced. Daily food rations were deficient in energy, carbohydrates, dietary fibre, PUFA and folates. It was found that inadequate diet was correlated with nutritional status, lipid profile parameters and arterial blood pressure.

  9. Biomarker evaluation does not confirm efficacy of computer-tailored nutrition education.

    PubMed

    Kroeze, Willemieke; Dagnelie, Pieter C; Heymans, Martijn W; Oenema, Anke; Brug, Johannes

    2011-01-01

    To evaluate the efficacy of computer-tailored nutrition education with objective outcome measures. A 3-group randomized, controlled trial with posttests at 1 and 6 months post-intervention. Worksites and 2 neighborhoods in the urban area of Rotterdam. A convenience sample of healthy Dutch adults (n = 442). A computer-tailored intervention delivered on CD-ROM; a computer-tailored intervention delivered in print; and a generic information condition. Blood lipids (total, high-density lipoprotein, and low-density lipoprotein cholesterol, and triacylglycerol) were measured by analyzing venous blood samples. Linear mixed model procedure. There were no significant differences among the 3 intervention groups in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triacylglycerol. Contrary to results based on self-report data, no effects of the computer-tailored interventions were found based on objective outcomes. This contradiction calls for a critical reflection on the use of computer-tailored nutrition education interventions and the need to improve those interventions. Furthermore, this study indicates that feasible methods are needed to objectively assess the impact of computer-tailored nutrition education interventions in free-living subjects. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  10. [Nutritional management in geriatric traumatology].

    PubMed

    Singler, K; Goisser, S; Volkert, D

    2016-08-01

    The prevalence of malnutrition or the risk of malnourishment is high among orthogeriatric patients and a poor nutritional status is associated with a negative outcome. A comprehensive management of preoperative and postoperative nutritional and fluid intake in these patients can help to improve the situation. The management includes identification of patients affected, a thorough assessment of the nutritional status, work-up of possible underlying causes, documentation of nutritional and fluid intake and, most importantly, procedures to improve the preoperative and postoperative nutritional situation. This article gives an overview of the recently updated recommendations on nutritional management in orthogeriatric patients as published by the orthogeriatric working group of the German Geriatric Society.

  11. An Ethnographic Observational Study to Evaluate and Optimize the Use of Respiratory Acoustic Monitoring in Children Receiving Postoperative Opioid Infusions.

    PubMed

    Görges, Matthias; West, Nicholas C; Christopher, Nancy A; Koch, Jennifer L; Brodie, Sonia M; Lowlaavar, Nasim; Lauder, Gillian R; Ansermino, J Mark

    2016-04-01

    Respiratory depression in children receiving postoperative opioid infusions is a significant risk because of the interindividual variability in analgesic requirement. Detection of respiratory depression (or apnea) in these children may be improved with the introduction of automated acoustic respiratory rate (RR) monitoring. However, early detection of adverse events must be balanced with the risk of alarm fatigue. Our objective was to evaluate the use of acoustic RR monitoring in children receiving opioid infusions on a postsurgical ward and identify the causes of false alarm and optimal alarm thresholds. A video ethnographic study was performed using an observational, mixed methods approach. After surgery, an acoustic RR sensor was placed on the participant's neck and attached to a Rad87 monitor. The monitor was networked with paging for alarms. Vital signs data and paging notification logs were obtained from the central monitoring system. Webcam videos of the participant, infusion pump, and Rad87 monitor were recorded, stored on a secure server, and subsequently analyzed by 2 research nurses to identify the cause of the alarm, response, and effectiveness. Alarms occurring within a 90-second window were grouped into a single-alarm response opportunity. Data from 49 patients (30 females) with median age 14 (range, 4.4-18.8) years were analyzed. The 896 bedside vital sign threshold alarms resulted in 160 alarm response opportunities (44 low RR, 74 high RR, and 42 low SpO2). In 141 periods (88% of total), for which video was available, 65% of alarms were deemed effective (followed by an alarm-related action within 10 minutes). Nurses were the sole responders in 55% of effective alarms and the patient or parent in 20%. Episodes of desaturation (SpO2 < 90%) were observed in 9 patients: At the time of the SpO2 paging trigger, the RR was >10 bpm in 6 of 9 patients. Based on all RR samples observed, the default alarm thresholds, to serve as a starting point for each

  12. [Validity and consistency of a new scale (Faces Pain Scale) and of the Spanish version of the CHEOPS scale to evaluate postoperative pain in children].

    PubMed

    García-Galicia, Arturo; Lara-Muñoz, María del Carmen; Arechiga-Santamaría, Alejandra; Montiel-Jarquín, Álvaro José; López-Colombo, Aurelio

    2012-01-01

    one of the most used scales for the evaluation of children's pain is the CHEOPS. This is complex, reliable but not commonly used in spanish. We decided to create a new Pain Facial Scale to be considered to be used in spanish. to compare the validity and consistency of two different scales for the evaluation of post-operative pain in children. process, comparative, longitudinal, homodemic, and prolective study. It was elaborated a simple and easy scale, to evaluate the post-operative pain in children. 5 experts evaluated their appearance and content. The original version of CHEOPS was translated to the Spanish by an expert; later this version was corrected and re-translated by a native Anglo-Saxon speaker, the result submitted for evaluation by 5 experts. The validity and consistency of both scales were evaluated by two investigators in a blind way. We used Cronbach's α for the internal consistency of CHEOPS, coefficient of intraclass correlation for the external consistency (inter observer's variability), effect size for sensitivity to the change of category, change of status for internal validity and Spearman's correlation for the convergent analysis. there was great external consistency, and a good and high internal validity, for the Spanish version of the CHEOPS scale, and an excellent internal validity for the Facial Pain Scale, as well as an excellent internal validity for both scales. two scales can be used to evaluate the post-operative pain in children between 4 and 8 years old.

  13. Postoperative Evaluation of Reduction Loss in Proximal Humeral Fractures: A Comparison of Plain Radiographs and Computed Tomography.

    PubMed

    Jia, Xiao-Yang; Chen, Yan-Xi; Qiang, Min-Fei; Zhang, Kun; Li, Hao-Bo; Jiang, Yu-Chen; Zhang, Yi-Jie

    2017-05-01

    To compare postoperative CT images with plain radiographs for measuring prognostic factors of reduction loss of fractures of the proximal part of the humerus. A total of 65 patients who sustained fractures of the proximal humerus treated with locking plates from June 2012 to October 2015 were retrospectively analyzed. There were 24 men and 41 women, with a mean age of 60.0 years (range, 22-76 years). According to the Neer classification system of proximal humeral fracture, there were 26 two-part, 27 three-part and 12 four-part fractures of the proximal part of the humerus, and all fractures were treated with open reduction and internal fixation (ORIF) using locked plating. All postoperative CT images and plain radiographs of the patients were obtained. Prognostic factors of the reduction loss were the change of neck shaft angle (NSA) and the change of humeral head height (HHH). The change of NSA and HHH were evaluated by the difference between postoperative initial and final follow-up measurement. Reduction loss was defined as the change ≥10° for NSA or ≥5 mm for HHH. The NSA and HHH were measured using plain radiographs and 3-D CT images, both initially and at final follow-up. The paired t-test was used for comparison of NSA, change of NSA, HHH, and change of HHH between two image modalities. The differences between two image modalities in the assessment of reduction loss were examined using the χ(2) -test (McNemar test). Intraclass correlation coefficients (ICC) were used to assess the intra-observer and inter-observer reliability. 3-D CT images (ICC range, 0.834-0.967) were more reliable in all parameters when compared with plain radiographs (ICC range, 0.598-0.915). Significant differences were found between the two image modalities in all parameters (plain radiographs: initial NSA = 133.6° ± 3.8°, final NSA = 130.0° ± 1.9°, initial HHH = 17.9 ± 0.9 mm, final HHH = 15.8 ± 1.5 mm; 3-D CT: initial NSA = 131.4° ± 3.4°, final NSA = 128.8° ± 1.7

  14. Improving selection of markers in nutrition research: evaluation of the criteria proposed by the ILSI Europe Marker Validation Initiative.

    PubMed

    Calder, Philip C; Boobis, Alan; Braun, Deborah; Champ, Claire L; Dye, Louise; Einöther, Suzanne; Greyling, Arno; Matthys, Christophe; Putz, Peter; Wopereis, Suzan; Woodside, Jayne V; Antoine, Jean-Michel

    2017-06-01

    The conduct of high-quality nutrition research requires the selection of appropriate markers as outcomes, for example as indicators of food or nutrient intake, nutritional status, health status or disease risk. Such selection requires detailed knowledge of the markers, and consideration of the factors that may influence their measurement, other than the effects of nutritional change. A framework to guide selection of markers within nutrition research studies would be a valuable tool for researchers. A multidisciplinary Expert Group set out to test criteria designed to aid the evaluation of candidate markers for their usefulness in nutrition research and subsequently to develop a scoring system for markers. The proposed criteria were tested using thirteen markers selected from a broad range of nutrition research fields. The result of this testing was a modified list of criteria and a template for evaluating a potential marker against the criteria. Subsequently, a semi-quantitative system for scoring a marker and an associated template were developed. This system will enable the evaluation and comparison of different candidate markers within the same field of nutrition research in order to identify their relative usefulness. The ranking criteria of proven, strong, medium or low are likely to vary according to research setting, research field and the type of tool used to assess the marker and therefore the considerations for scoring need to be determined in a setting-, field- and tool-specific manner. A database of such markers, their interpretation and range of possible values would be valuable to nutrition researchers.

  15. [Evaluation of the nutrition model in students of university in Rzeszow].

    PubMed

    Głodek, Elzbieta; Gil, Marian

    2012-01-01

    Adequate nutrition is an essential factor conditioning physical and mental development of man, and poor nutrition can cause deterioration of health and occurrence of diseases related to diet. The fashion for slim body promoted in the media contributes to the youth's activities aiming to shape their bodies and, in particular, studying persons run the risk of nutritional deficiencies, which is also connected with irregular time of classes. The aim of the study was to evaluate the diet of 200 students (161 women and 39 men) in the second-year of Food Technology and Human Nutrition at the University of Rzeszow and to evaluate the extent to which nutritional standards for energy and essential nutrients in the daily food rations are kept. The tests were carried out in the years 2010-2011. Intake assessment was made by the method of current listing of products and beverages consumed in the successive three days. Portion size was estimated by using the "Album of photographs of products and dishes." Using the "Tables of the nutritional value of food products and dishes," there was calculated the energy value, content of essential nutrients and cholesterol. The obtained results of the energy value were compared with the "Human Nutrition Standards" for women and men aged 19-30 years of moderate physical activity, and the nutritional value of analyzed diets was compared with standards of recommended dietary allowance (RDA). Diets of students (women and men) were significantly different (p = 0.01) in terms of energy content and nutritional value. Food rations for women and men were characterized by low energy value not corresponding to the recommendations of the Human Nutrition Standards. The energy value of diets of tested women students was 1568,56 kcal/day, while of men students 2283,22 kcal/day. Protein supply in daily food rations for women was 56,73 g and corresponded to the recommendations of the standards, while in the group of men it exceeded the standard at the

  16. Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip

    PubMed Central

    Salimi, Fereshteh; Hekmatnia, Ali; Shahabi, Javad; Keshavarzian, Amir; Maracy, Mohammad Reza; Jazi, Amir Hosein Davarpanah

    2015-01-01

    Background: Proper placement of central venous catheter (CVC) tip could reduce early and late catheter-related complications. Although the live fluoroscopy is standard of care for placement of the catheter, it is not available in many centers. Therefore, the present study evaluated the sensitivity and specificity of bedside chest X-ray (CXR) for proper positioning of the catheter tip. Materials and Methods: A total of 82 adult patients undergoing elective placement of tunneled CVC were enrolled in this study during 2010-2012. The catheter tip position was evaluated by postoperative bedside chest radiographs as well as trans-thoracic echocardiogram as definite diagnostic tool. The catheter position was considered correct if the tip was positioned in the right atrium both in CXR or echocardiography. Finally, CXRs interpreted by expert radiologist. Thus findings were compared by echocardiography. Sensitivity, specificity, accuracy, positive, and negative predictive values were calculated. Data were analyzed using SPSS version 16 (SPSS Inc., Chicago, IL), and P < 0.05 considered as significant. Results: The patients were 57.37 ± 18.91 years of age, weighed 65.79 ± 15.58 kg and were 166.36 ± 9.91 cm tall. Sensitivity and specificity of CXR for proper catheter tip position were 74.3% and 58.3%, respectively. Positive and negative predictive values were 91.2% and 28%. In addition accuracy, positive likelihood ratio, and negative likelihood ratio were 71.9%, 1.78, and 2.27 respectively. Conclusion: Bedside CXR alone does not reliably predict malpositioning after CVC placement. PMID:25767527

  17. Evaluation of Using Behavioural Changes to Assess Post-Operative Pain in the Guinea Pig (Cavia porcellus)

    PubMed Central

    Ellen, Yvette; Flecknell, Paul; Leach, Matt

    2016-01-01

    To manage pain effectively in people and animals, it is essential to recognise when pain is present and to assess its intensity. Currently there is very little information regarding the signs of post-surgical pain or its management in guinea pigs. Studies from other rodent species indicate that behaviour-based scoring systems can be used successfully to detect pain and evaluate analgesic efficacy. This preliminary study aimed to establish whether behaviour-based scoring systems could be developed to assess post-surgical pain in guinea pigs. This prospective, randomised, placebo-controlled study used 16 guinea pigs, and evaluated changes in behaviour following either anaesthesia alone or anaesthesia and orchiectomy. Behaviour was assessed using a combination of manual and automated scoring of remotely obtained video footage. A small number of behaviours were identified that appeared to have high specificity for pain caused by orchiectomy. However, the behaviours were displayed infrequently. The most common was a change in posture from standing to recumbency, sometimes with one hind leg extended either to the side or behind the body. A composite behaviour score incorporating these abnormal behaviours differentiated between the effects of surgery and anaesthesia alone (p<0.0001), and between animals that received analgesia post-operatively compared to an untreated group (p<0.0001). Although behavioural changes occurred in these guinea pigs after orchiectomy, the changes were relatively subtle and the individual specific pain-related behaviours occurred infrequently. However, it may prove possible to develop a behaviour-based scoring system for routine use in this species using a combination of pain-related behaviours. PMID:27583446

  18. Stereotactic Radiosurgery of the Postoperative Resection Cavity for Brain Metastases: Prospective Evaluation of Target Margin on Tumor Control

    SciTech Connect

    Choi, Clara Y.H.; Chang, Steven D.; Gibbs, Iris C.; Adler, John R.; Harsh, Griffith R.; Lieberson, Robert E.; Soltys, Scott G.

    2012-10-01

    Purpose: Given the neurocognitive toxicity associated with whole-brain irradiation (WBRT), approaches to defer or avoid WBRT after surgical resection of brain metastases are desirable. Our initial experience with stereotactic radiosurgery (SRS) targeting the resection cavity showed promising results. We examined the outcomes of postoperative resection cavity SRS to determine the effect of adding a 2-mm margin around the resection cavity on local failure (LF) and toxicity. Patients and Methods: We retrospectively evaluated 120 cavities in 112 patients treated from 1998-2009. Factors associated with LF and distant brain failure (DF) were analyzed using competing risks analysis, with death as a competing risk. The overall survival (OS) rate was calculated by the Kaplan-Meier product-limit method; variables associated with OS were evaluated using the Cox proportional hazards and log rank tests. Results: The 12-month cumulative incidence rates of LF and DF, with death as a competing risk, were 9.5% and 54%, respectively. On univariate analysis, expansion of the cavity with a 2-mm margin was associated with decreased LF; the 12-month cumulative incidence rates of LF with and without margin were 3% and 16%, respectively (P=.042). The 12-month toxicity rates with and without margin were 3% and 8%, respectively (P=.27). On multivariate analysis, melanoma histology (P=.038) and number of brain metastases (P=.0097) were associated with higher DF. The median OS time was 17 months (range, 2-114 months), with a 12-month OS rate of 62%. Overall, WBRT was avoided in 72% of the patients. Conclusion: Adjuvant SRS targeting the resection cavity of brain metastases results in excellent local control and allows WBRT to be avoided in a majority of patients. A 2-mm margin around the resection cavity improved local control without increasing toxicity compared with our prior technique with no margin.

  19. Delivery and Evaluation of Training for School Nutrition Administrators and Managers on Meeting Special Food and Nutrition Needs of Students in the School Setting

    ERIC Educational Resources Information Center

    Oakley, Charlotte B.; Knight, Kathy; Hobbs, Margie; Dodd, Lacy M.; Cole, Janie

    2011-01-01

    Purpose/Objectives: The purpose of this investigation was to complete a formal evaluation of a project that provided specialized training for school nutrition (SN) administrators and managers on meeting children's special dietary needs in the school setting. Methods: The training was provided as part of the "Eating Good and Moving Like We…

  20. [Evaluation of the Food and Nutrition Surveillance System (SISVAN) in food and nutritional management services in the State of Minas Gerais, Brazil].

    PubMed

    Rolim, Mara Diana; Lima, Sheyla Maria Lemos; de Barros, Denise Cavalcante; de Andrade, Carla Lourenço Tavares

    2015-08-01

    The scope of this article is to evaluate the SISVAN as a tool for planning, management and evaluation of food and nutrition actions in primary healthcare in the Unified Health System (SUS). It involved a cross-sectional study composed of a stratified random sample of the municipalities in the State of Minas Gerais. The subjects of the research were municipal officials of SISVAN who filled out a structured questionnaire. Descriptive analysis of the data was performed with the construction of simple and bivariate tables. It was observed that those responsible for SISVAN, collect (50%) and input (55%) weight, height, and food consumption data; whereas 53%, 59% and 71% do not analyze and do not recommend or perform nutrition actions, respectively. This being the case, most of those responsible do not use the information for planning, management and evaluation of food and nutrition traits. The findings show that the SISVAN is not used to its full potential; the data generated have not been used for planning, management and evaluation of nutrition services in primary healthcare in the SUS.

  1. Delivery and Evaluation of Training for School Nutrition Administrators and Managers on Meeting Special Food and Nutrition Needs of Students in the School Setting

    ERIC Educational Resources Information Center

    Oakley, Charlotte B.; Knight, Kathy; Hobbs, Margie; Dodd, Lacy M.; Cole, Janie

    2011-01-01

    Purpose/Objectives: The purpose of this investigation was to complete a formal evaluation of a project that provided specialized training for school nutrition (SN) administrators and managers on meeting children's special dietary needs in the school setting. Methods: The training was provided as part of the "Eating Good and Moving Like We…

  2. Nutritional Status Evaluation in Patients Affected by Bethlem Myopathy and Ullrich Congenital Muscular Dystrophy

    PubMed Central

    Toni, Silvia; Morandi, Riccardo; Busacchi, Marcello; Tardini, Lucia; Merlini, Luciano; Battistini, Nino Carlo; Pellegrini, Massimo

    2014-01-01

    Collagen VI mutations lead to disabling myopathies like Bethlem myopathy (BM) and Ullrich congenital muscular dystrophy (UCMD). We have investigated the nutritional and metabolic status of one UCMD and seven BM patients (five female, three male, mean age 31 ± 9 years) in order to find a potential metabolic target for nutritional intervention. For this study, we used standard anthropometric tools, such as BMI evaluation and body circumference measurements. All results were compared to dual-energy X-ray absorptiometry (DXA), considered the “gold standard” method. Energy intake of each patient was evaluated through longitudinal methods (7-day food diary) while resting energy expenditure (REE) was predicted using specific equations and measured by indirect calorimetry. Clinical evaluation included general and nutritional blood and urine laboratory analyses and quantitative muscle strength measurement by hand-held dynamometry. BM and UCMD patients showed an altered body composition, characterized by low free fat mass (FFM) and high fat mass (FM), allowing us to classify them as sarcopenic, and all but one as sarcopenic-obese. Another main result was the negative correlation between REE/FFM ratio (basal energy expenditure per kilograms of fat-free mass) and the severity of the disease, as defined by the muscle megascore (correlation coefficient −0.955, P-value <0.001). We postulate that the increase of the REE/FFM ratio in relation to the severity of the disease may be due to an altered and pathophysiological loss of energetic efficiency at the expense of skeletal muscle. We show that a specific metabolic disequilibrium is related to the severity of the disease, which may represent a target for a nutritional intervention in these patients. PMID:25477818

  3. Fat-Free Mass Index for Evaluating the Nutritional Status and Disease Severity in COPD.

    PubMed

    Luo, Yuwen; Zhou, Luqian; Li, Yun; Guo, Songwen; Li, Xiuxia; Zheng, Jingjing; Zhu, Zhe; Chen, Yitai; Huang, Yuxia; Chen, Rui; Chen, Xin

    2016-05-01

    Despite the high prevalence of weight loss in subjects with COPD, the 2011 COPD management guidelines do not include an index measuring nutritional status. Fat-free mass index (FFMI) can accurately determine the nutritional status of subjects and may be closely correlated with COPD severity. We aimed to determine the nutritional status evaluated by FFMI according to the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) levels in stable subjects with COPD and the association between nutritional status and respiratory symptoms, exercise capacity, and respiratory muscle function. We included 235 stable subjects with COPD in this cross-sectional study. All of the subjects were divided into the 2011 GOLD Groups A, B, C, and D. FFMI (measured by bioelectrical impedance), spirometry (FEV1, percent-of-predicted FEV1, and FEV1/FVC), respiratory muscle function (peak inspiratory and peak expiratory pressures), exercise capacity (6-min walk distance), and dyspnea severity (Modified Medical Research Council dyspnea scale) were measured and compared between the GOLD groups. Malnutrition was identified in 48.5% of subjects and most prevalent in Group D (Group A: 41%, Group B: 41%, Group C: 31%, and Group D: 62%). FFMI was significantly lower in Group D (P < .001), with both sexes considered malnourished. Low FFMI significantly correlated with frequent exacerbation, older age, decreased pulmonary function, 6-min walk distance, peak inspiratory pressure, and worsened dyspnea. FFMI was significantly lower in the emphysema-dominant phenotype and mixed phenotype compared with the normal phenotype and airway-dominant phenotype. A stepwise multiple linear regression analysis identified peak inspiratory pressures and older age as independent predictors of FFMI. Malnutrition is highly prevalent in all COPD groups, particularly in Group D subjects, who warrant special attention for nutritional intervention and pulmonary rehabilitation. FFMI significantly correlated with

  4. Postoperative astigmatism.

    PubMed

    Swinger, C A

    1987-01-01

    With the numerous significant advances in surgical methodology--e.g., microinstrumentation, the operating microscope, the surgical keratometer, and intraocular lenses--that have been developed over the past two decades, both surgeons and patients have become increasingly aware of the final optic result of any surgical intervention. This is especially so since the development of refractive surgery, where good uncorrected vision is frequently the final arbiter of success. We have progressed to the stage where the optic manipulation of the cornea, whether intentional or otherwise, can be understood in terms of a number of variables. These include the preparation and closure of the surgical wound, the choice of suture material, and both intraoperative and postoperative manipulations. Where these have failed and postoperative astigmatism still occurs, a number of surgical procedures are available to reduce the astigmatic error to an acceptable level.

  5. Comparative evaluation of ventilatory function through pre and postoperative peak expiratory flow in patients submitted to elective upper abdominal surgery.

    PubMed

    Scheeren, Caio Fernando Cavanus; Gonçalves, José Júlio Saraiva

    2016-01-01

    to evaluate the ventilatory function by Peak Expiratory Flow (PEF) in the immediate pre and postoperative periods of patients undergoing elective surgical procedures in the upper abdomen. we conducted a prospective cohort study including 47 patients admitted to the Hospital Regional de Mato Grosso do Sul from July to December 2014, who underwent elective surgeries of the upper abdomen, and submiited to spirometric evaluation and measurement of PEF immediately before and after surgery. of the 47 patients, 22 (46.8%) were male and 25 (53.20%) female. The mean preoperative PEF was 412.1±91.7, and postoperative, 331.0±87.8, indicating significant differences between the two variables. Men had higher PEF values than women, both in the pre and postoperative periods. There was a reasonable inverse correlation between age and decreased PEF. Both situations showed statistical significance (p<0.001). The group of smokers had lower PEF values both before and after surgery. The group of patients with comorbidities (hypertension and/or diabetes) showed lower PEF values both pre and postoperatively (p=0.005). In both groups, surgery resulted in a significant decrease in PEF (p<0.001). The type of surgery performed and the type of anesthesia did not show significant differences. the variables most involved in decreased lung function were: advanced age, smoking and presence of comorbidities. However, there is no consistent evidence to suggest conducting routine spirometry in such patients. avaliação comparativa da função ventilatória através do Pico de Fluxo Expiratório (PFE) no pré e pós-operatório imediatos de pacientes submetidos a procedimentos cirúrgicos eletivos do andar superior do abdome. estudo prospectivo de coorte incluindo 47 pacientes internados no Hospital Regional de Mato Grosso do Sul de Julho à Dezembro de 2014, e que realizaram cirurgias eletivas do andar superior do abdome, e submetidos à avaliação espirométrica e aferição do PFE no pré e p

  6. [In-hospital malnutrition: indications of postoperative evolution].

    PubMed

    Farré Rovira, R; Frasquet Pons, I; Ibor Pica, J F

    1998-01-01

    A significant percentage of the patients admitted to our hospitals show signs of malnutrition that are neither detected nor treated and often become more severe during the hospital stay. This malnutrition can contribute to the loss of some important functions as, for instance the capacity for immune response and healing. In this study we use several simple, economical parameters to evaluate the nutritional status upon admittance and upon leaving the hospital of all the patients who in the course of a year occupied four randomly chosen beds in a general surgery ward at a county hospital in the Valencian Community. The results show that hospitalization reduced the number of over weight patients, duplicated the number of hypoalbuminemics and triplicated the number of people with body weight and body mass index (BMI) below normal levels. In patients over 40 hospitalization decrease the values of all the parameters studied, whereas in younger subjects only the weight, the BMI and serum albumin values were affected. Fifty seven percent of the patients suffer some kind of postoperative complication and this incidence is higher among patients with malnutrition upon admittance. The most common complication is the nosocomial pneumonia and urine infection. The nutritional parameters that best predict possible postoperative complications are low values of serum albumin, total lymphocyte count, tricipital fat skin fold and arm circumference. In general, postoperative complications show only a slight positive correlation with the length of the hospital stay, but the longer the stay is the worst the nutritional status becomes.

  7. [Surgery for children and adolescents. Post-operative phase].

    PubMed

    Ruzafa Martínez, María; Ruiz García, María Jesús; Gómez García, Carmen I

    2004-05-01

    The authors explain the third and last phase in the surgical process, the post-operative phase. The authors propose a standardized model of nursing care for children and adolescents. The third and last phase in the surgical process commences at the moment the child arrives in the recovery room and lasts until he/she is released from the hospital. This phase includes the treatment applied in the recovery room and later in a hospital ward or in the child's home. The authors use the Gordon Functional Health Patterns. Special emphasis is given to the perception-management health pattern, the nutritional-metabolic pattern, the elimination pattern, the exercise-activity pattern, and the cognitive-perception pattern. Of special importance is the vigilance during the first post-operative hours, as well as the child's parenteral nutrition or total parenteral nutrition, TPN, and the evaluation of pain according to the age of the child. The authors select the NANDA (North American Nursing Diagnosis Association) Nursing Diagnoses which appear most frequently in this post-operative phase.

  8. Perioperative Nutritional Status Changes in Gastrointestinal Cancer Patients

    PubMed Central

    Shim, Hongjin; Cheong, Jae Ho; Lee, Kang Young; Lee, Hosun; Noh, Sung Hoon

    2013-01-01

    Purpose The presence of gastrointestinal (GI) cancer and its treatment might aggravate patient nutritional status. Malnutrition is one of the major factors affecting the postoperative course. We evaluated changes in perioperative nutritional status and risk factors of postoperative severe malnutrition in the GI cancer patients. Materials and Methods Nutritional status was prospectively evaluated using patient-generated subjective global assessment (PG-SGA) perioperatively between May and September 2011. Results A total of 435 patients were enrolled. Among them, 279 patients had been diagnosed with gastric cancer and 156 with colorectal cancer. Minimal invasive surgery was performed in 225 patients. PG-SGA score increased from 4.5 preoperatively to 10.6 postoperatively (p<0.001). Ten patients (2.3%) were severely malnourished preoperatively, increasing to 115 patients (26.3%) postoperatively. In gastric cancer patients, postoperative severe malnourishment increased significantly (p<0.006). In univariate analysis, old age (>60, p<0.001), male sex (p=0.020), preoperative weight loss (p=0.008), gastric cancer (p<0.001), and open surgery (p<0.001) were indicated as risk factors of postoperative severe malnutrition. In multivariate analysis, old age, preoperative weight loss, gastric cancer, and open surgery remained significant as risk factors of severe malnutrition. Conclusion The prevalence of severe malnutrition among GI cancer patients in this study increased from 2.3% preoperatively to 26.3% after an operation. Old age, preoperative weight loss, gastric cancer, and open surgery were shown to be risk factors of postoperative severe malnutrition. In patients at high risk of postoperative severe malnutrition, adequate nutritional support should be considered. PMID:24142640

  9. Perioperative nutritional status changes in gastrointestinal cancer patients.

    PubMed

    Shim, Hongjin; Cheong, Jae Ho; Lee, Kang Young; Lee, Hosun; Lee, Jae Gil; Noh, Sung Hoon

    2013-11-01

    The presence of gastrointestinal (GI) cancer and its treatment might aggravate patient nutritional status. Malnutrition is one of the major factors affecting the postoperative course. We evaluated changes in perioperative nutritional status and risk factors of postoperative severe malnutrition in the GI cancer patients. Nutritional status was prospectively evaluated using patient-generated subjective global assessment (PG-SGA) perioperatively between May and September 2011. A total of 435 patients were enrolled. Among them, 279 patients had been diagnosed with gastric cancer and 156 with colorectal cancer. Minimal invasive surgery was performed in 225 patients. PG-SGA score increased from 4.5 preoperatively to 10.6 postoperatively (p<0.001). Ten patients (2.3%) were severely malnourished preoperatively, increasing to 115 patients (26.3%) postoperatively. In gastric cancer patients, postoperative severe malnourishment increased significantly (p<0.006). In univariate analysis, old age (>60, p<0.001), male sex (p=0.020), preoperative weight loss (p=0.008), gastric cancer (p<0.001), and open surgery (p<0.001) were indicated as risk factors of postoperative severe malnutrition. In multivariate analysis, old age, preoperative weight loss, gastric cancer, and open surgery remained significant as risk factors of severe malnutrition. The prevalence of severe malnutrition among GI cancer patients in this study increased from 2.3% preoperatively to 26.3% after an operation. Old age, preoperative weight loss, gastric cancer, and open surgery were shown to be risk factors of postoperative severe malnutrition. In patients at high risk of postoperative severe malnutrition, adequate nutritional support should be considered.

  10. An evaluation of the accuracy of the ORange (Gen II) by comparing it to the IOLMaster in the prediction of postoperative refraction.

    PubMed

    Chen, Ming

    2012-01-01

    The aim of this study was to evaluate the accuracy of ORange(®) Gen II (WaveTec Vision, Aliso Viejo, CA). The Surgical Suites, Honolulu, HI. The prospective 28 consecutive cataract surgical cases were selected from 85 cataract surgical cases between December 16, 2010 and February 24, 2011. With the same intraocular lens implantation, the predicted spherical equivalent refraction from IOLMaster(®) (Carl Zeiss AG, Oberkochen, Germany) and ORange Gen II were statistically compared and verified with 1-month postoperative manifest refraction. The data were put into IBM SPSS 19 (SPSS Inc, Chicago, IL) for analysis of variance. Pearson's correlation coefficient was also calculated to evaluate the correlation between the IOLMaster, ORange Gen II, and 1-month postoperative manifest refraction. There were no statistically significant differences in the mean spherical equivalent refraction from the IOLMaster, ORange Gen II, and 1-month postoperative manifest refraction (IOLMaster -0.40 diopters, P = 0.07; ORange Gen II -0.43 diopters, P = 0.16; 1-month refraction -0.41 diopters, P = 0.07). Pearson's correlation study demonstrated that all three were positively correlated (P < 0.05), with the strongest correlation between the ORange Gen II and 1-month postoperative manifest refraction (r = +0.6, P < 0.01). The ORange Gen II can be considered as an alternative method for intraocular lens selection for cataract patients.

  11. An evaluation of the accuracy of the ORange® (Gen II) by comparing it to the IOLMaster® in the prediction of postoperative refraction

    PubMed Central

    Chen, Ming

    2012-01-01

    Purpose The aim of this study was to evaluate the accuracy of ORange® Gen II (WaveTec Vision, Aliso Viejo, CA). Setting The Surgical Suites, Honolulu, HI. Methods The prospective 28 consecutive cataract surgical cases were selected from 85 cataract surgical cases between December 16, 2010 and February 24, 2011. With the same intraocular lens implantation, the predicted spherical equivalent refraction from IOLMaster® (Carl Zeiss AG, Oberkochen, Germany) and ORange Gen II were statistically compared and verified with 1-month postoperative manifest refraction. The data were put into IBM SPSS 19 (SPSS Inc, Chicago, IL) for analysis of variance. Pearson’s correlation coefficient was also calculated to evaluate the correlation between the IOLMaster, ORange Gen II, and 1-month postoperative manifest refraction. Results There were no statistically significant differences in the mean spherical equivalent refraction from the IOLMaster, ORange Gen II, and 1-month postoperative manifest refraction (IOLMaster −0.40 diopters, P = 0.07; ORange Gen II −0.43 diopters, P = 0.16; 1-month refraction −0.41 diopters, P = 0.07). Pearson’s correlation study demonstrated that all three were positively correlated (P < 0.05), with the strongest correlation between the ORange Gen II and 1-month postoperative manifest refraction (r = +0.6, P < 0.01). Conclusion The ORange Gen II can be considered as an alternative method for intraocular lens selection for cataract patients. PMID:22457590

  12. Postoperative bezoar ileus after early enteral feeding.

    PubMed

    Dedes, Konstantin J; Schiesser, Marc; Schäfer, Markus; Clavien, Pierre-Alain

    2006-01-01

    Postoperative enteral nutrition is a widely accepted route of application for nutrition formulas due to a low complication rate, a good acceptance by patients. and a favorable cost-effectiveness. We report three cases of bezoar ileus after early postoperative enteral nutrition, using a fine needle jejunostomy (FNJ) in two cases and a nasoduodenal tube in one case. A male patient who underwent gastric resection for a gastrointestinal stroma tumor and was nourished through an fine needle jejunostomy developed an acute abdomen on the seventh postoperative day. Surgical exploration revealed a mechanical ileus caused by denaturated nutrition formula distal to the catheter tip. The second case, a female patient, underwent gastric resection for a gastric cancer and on the fourth postoperative day developed acute onset of abdominal pain. Intraoperative findings were the same as described in the first case. The third case, a male patient with necrotizing cholecystitis, underwent open cholecystectomy. Postoperative enteral feeding was performed using a nasoduodenal tube. He developed a small bowel obstruction on the 17th postoperative day that was caused by an intraluminal bezoar. In conclusion, bezoar formation represents an underestimated complication of postoperative enteral feeding. Acute onset of abdominal pain and the development of small bowel obstruction are the main clinical symptoms of this severe complication. The pathogenesis of bezoar formation remains unclear.

  13. Application of Real-Time Three-Dimensional Echocardiography to Evaluate the Pre- and Postoperative Right Ventricular Systolic Function of Patients with Tetralogy of Fallot

    PubMed Central

    Cui, Cunying; Liu, Lin; Fan, Taibing; Peng, Bangtian; Cheng, Zhaoyun; Ge, Zhenwei; Li, Yanan; Liu, Yuanyuan; Zhang, Yanwei; Ai, Feng; Zhang, Lianzhong

    2015-01-01

    Tetralogy of Fallot (ToF) can be challenging for clinicians to both diagnose and treat, given the multiple heart defects that are by definition associated with the illness. This study investigates the value of real-time three- dimensional echocardiography (RT-3DE) in evaluating the pre-and postoperative right ventricular systolic function of patients with tetralogy of Fallot. A total of 41 ToF patients were divided into two groups: the child group (CG) and the adult group (AG) according to age. The right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), and the right ventricular ejection fraction (RVEF) of ToF patients were measured before surgery, 7 days, and 3 months after the surgery. The correlation between the preoperative Nakata index and RVEF was then analyzed. Compared with the RVEDV and RVESV prior to surgery, those of the postoperative 7-day and 3-month were not statistically significant (p > 0.05). However, RVEF decreased, and the difference was statistically significant (p < 0.05). The differences in RVEDV, RVESV, and RVEF between postoperative 3-month and 7-day were not significant (p > 0.05). Compared with the pre-and postoperative RVEDV and RVESV of CG, those of AG increased. However, RVEF decreased, and the differences were statistically significant (p < 0.05). Our study indicated that the correlation between preoperative Nakata index and RVEF was good. Ultimately, we did confirm that RT-3DE can quantitatively evaluate the right ventricular volume and systolic function of ToF patients, thereby providing clinical significance in determining postoperative efficacy and prognosis evaluation. PMID:27122891

  14. Application of Real-Time Three-Dimensional Echocardiography to Evaluate the Pre- and Postoperative Right Ventricular Systolic Function of Patients with Tetralogy of Fallot.

    PubMed

    Cui, Cunying; Liu, Lin; Fan, Taibing; Peng, Bangtian; Cheng, Zhaoyun; Ge, Zhenwei; Li, Yanan; Liu, Yuanyuan; Zhang, Yanwei; Ai, Feng; Zhang, Lianzhong

    2015-07-01

    Tetralogy of Fallot (ToF) can be challenging for clinicians to both diagnose and treat, given the multiple heart defects that are by definition associated with the illness. This study investigates the value of real-time three- dimensional echocardiography (RT-3DE) in evaluating the pre-and postoperative right ventricular systolic function of patients with tetralogy of Fallot. A total of 41 ToF patients were divided into two groups: the child group (CG) and the adult group (AG) according to age. The right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), and the right ventricular ejection fraction (RVEF) of ToF patients were measured before surgery, 7 days, and 3 months after the surgery. The correlation between the preoperative Nakata index and RVEF was then analyzed. Compared with the RVEDV and RVESV prior to surgery, those of the postoperative 7-day and 3-month were not statistically significant (p > 0.05). However, RVEF decreased, and the difference was statistically significant (p < 0.05). The differences in RVEDV, RVESV, and RVEF between postoperative 3-month and 7-day were not significant (p > 0.05). Compared with the pre-and postoperative RVEDV and RVESV of CG, those of AG increased. However, RVEF decreased, and the differences were statistically significant (p < 0.05). Our study indicated that the correlation between preoperative Nakata index and RVEF was good. Ultimately, we did confirm that RT-3DE can quantitatively evaluate the right ventricular volume and systolic function of ToF patients, thereby providing clinical significance in determining postoperative efficacy and prognosis evaluation. Echocardiography; Right; Tetralogy of Fallot; Three-dimensional; Ventricular function.

  15. Information design to promote better nutrition among pantry clients: four methods of formative evaluation.

    PubMed

    Evans, Susan H; Clarke, Peter; Koprowski, Carol

    2010-03-01

    To demonstrate the use of four different qualitative methods in creating content, including text and graphic design for print interventions to support better nutrition in low-income households that rely on charitable pantries. Four methods were used for measuring household cooks' responses to the content and design of recipes and food-use tips especially designed for low-income households: (i) focus groups with pantry clients; (ii) questionnaires administered at sites where the Women, Infants and Children (WIC) programme beneficiaries gather, to survey cooks' judgements about the appeal of recipes; (iii) recruitment of WIC clients to prepare recipes at home, followed by phone interviews about the cooks' actual experiences preparing and serving dishes; and (iv) a new technique to gauge pantry clients' preferred ordering of print information, using bits of content backed by Velcro strips that participants applied to felt boards. Ten sets of illustrated recipes and food-use tips were prepared, each set focusing on a different fresh vegetable that is periodically available from charitable sources. Low-income recipients of food from community pantries in the USA, and beneficiaries of the WIC programme. Illustrative findings show how the four types of qualitative evaluations can inform decisions about content and about graphic design. Discoveries from this formative research illuminate challenges of supporting better nutrition among households that depend on charitable sources of food supply. These multi-method evaluation techniques can be adapted to the development of any print material, whether intended for widespread dissemination or for field research into nutrition behaviour.

  16. Randomized trial to evaluate nutritional status and absorption of enteral feeding after brain death.

    PubMed

    Hergenroeder, Georgene W; Ward, Norman H; Yu, Xiaoying; Opekun, Antone; Moore, Anthony N; Kozinetz, Claudia A; Powner, David J

    2013-12-01

    Catecholamines and inflammatory mediators, with elevated levels after brain death, are associated with reduced function and survival of transplanted organs. Enteral nutrition reduces tissue damage and may benefit organs. To evaluate the effects of immunomodulating enteral nutrition in organ donors. Prospective, randomized, open-label study. Intensive care unit. Thirty-six brain-dead organ donors. Donors were randomized to receive enteral nutrition containing omega-3 polyunsaturated fatty acid, antioxidants, and glutamine or standard care (fasting). Donors received hormonal replacement therapy of corticosteroid, levothyroxine, dextrose, and insulin. Gastrointestinal assimilation (measured by 13 carbon-labeled uracil breath analysis), quantity of organs recovered, resting energy expenditure, urine level of urea nitrogen, and serum levels of albumin, prealbumin, interleukin 6, tumor necrosis factor-α, and C-reactive protein were evaluated. Thirteen patients (36%) assimilated 13C-labeled uracil. Resting energy expenditure was significantly higher than predicted between 10 and 14 hours after baseline in 33 donors (P= .007). Other measures were not conclusively different between fed and fasting groups. No adverse events occurred that were related to the enteral feeding. About 30% of donors metabolized 13C-labeled uracil, although no difference in oxidation rate was found between fasting and fed donors. Corticosteroid administration lowers plasma levels of interleukin 6 and most likely contributes to greater than predicted resting energy expenditure. Thus energy needs may not be met during fasting if hormones are given. Consequences of this possible energy deficit warrant further study.

  17. [Evaluation of dietary pattern and nutritional status of residents in southeast coastal area].

    PubMed

    Lü, Na; Shen, Minghao; Huang, Yixiang; Lu, Lijuan; Zheng, Shangpin; Chen, Kai

    2012-05-01

    To evaluate the dietary pattern and nutritional status of urban residents in southeast coastal area. A dietary survey concerning 1332 persons aged 18 and over was carried out with dietary inquiry and 24-hour recall methods from August to December in 2009. The intakes of cereal, meat, eggs, seafood were enough. The consumption of milk and dairy products, vegetables, fruits was insufficient while the amount of oil was too high. Among them, the intake of milk and dairy products was only 1/3 of suggested values in Dietary Guideline and Balanced Diet Pagoda for Chinese Residents. The intakes of protein, retinol, iron and selenium were sufficient, while those of calcium, thiamine, riboflavin, ascorbic acid were too less than the dietary reference intakes (DRIs). The dietary pattern of urban residents in Ningbo was not reasonable. Nutrition education should be strengthened to guide residents for planning reasonable and balanced diets.

  18. ESPGHAN- Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children with Neurological Impairment.

    PubMed

    Romano, Claudio; van Wynckel, Myriam; Hulst, Jessie; Broekaert, Ilse; Bronsky, Jiri; Dall'Oglio, Luigi; Mis, Nataša Fidler; Hojsak, Iva; Orel, Rok; Papadopoulou, Alexandra; Schaeppi, Michela; Thapar, Nikhil; Wilschanski, Michael; Sullivan, Peter; Gottrand, Frédéric

    2017-06-09

    Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia and nutritional comorbidites. Gastrointestinal problems including gastroesophageal reflux disease, constipation and dysphagia are also very frequent in this population and impact quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, ESPGHAN aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in neurologically impaired chidren. Thirty-one clinical questions addressing the diagnosis, treatment, and prognosis of common gastrointestinal and nutritional problems in neurological impaired children were formulated. Questions aimed to assess: 1) the nutritional management including nutritional status, identifying undernutrition, monitoring nutritional status, and defining nutritional requirements; 2) to classify gastrointestinal issues including oropharyngeal dysfunctions, motor and sensory function, gastroesophageal reflux disease, and constipation; 3) to evaluate the indications for nutritional rehabilitation including enteral feeding and percutaneous gastrostomy/jejunostomy; 4) to define indications for surgical interventions (e.g. Nissen Fundoplication, oesophago-gastric disconnection) and finally 5) to consider ethical issues related to digestive and nutritional problems in the severely neurologically impaired children. A systematic literature search was performed from 1980 to October 2015 using MEDLINE. The approach of the Grading of Recommendations Assessment, Development and Evaluation was applied to evaluate the outcomes. During two consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation using the nominal voting technique. Expert opinion was applied to support the recommendations where no

  19. Evaluation of nutritive value and functional qualities of sorghum subjected to different traditional processing methods.

    PubMed

    Shayo, N B; Laswai, H S; Tiisekwa, B P; Nnko, S A; Gidamis, A B; Njoki, P

    2001-03-01

    Sorghum (Sorghum bicolar L. Moench), a staple food in many parts of the world, is underutilised compared to its potential due to inherent problems. A study was conducted to evaluate the effect of different traditional processing methods on the nutritional and functional qualities of sorghum. The review of literature established the main causes of the low level of sorghum utilisation to be low nutritional and inferior organoleptic qualities. It was further established that traditional processing methods, such as germination and fermentation, can promote its utilisation. Three processing methods, namely germination (G), fermentation (F), and germination combined with fermentation (GF), were used to prepare feeds from two sorghum varieties, Tegemeo and Udo. Evaluation of the feed qualities in terms of acceptability, retention, feed efficiency ratio (FER) and protein efficiency ratio (PER), using weanling rats was carried out and compared to the untreated one which served as control. An element of functional properties was assessed in terms of diastatic power (DP). Regarding feed intake, there was no significant difference between the feeds. Body retention for Tegemeo variety was higher than that for Udo. FER ranged from 0.019 +/- 0.015 to 0.095 +/- 0.015, PER ranged from 0.113 +/- 0.089 to 0.703 +/- 0.111 and diastatic power from 15.99 +/- 1.20 to 114.58 +/- 0.95. In all the three cases, germinated feeds had the highest values and were therefore considered of higher nutritional value. It was therefore concluded that germination was superior to the other processing methods in improving the nutritional and functional qualities of sorghum.

  20. Comprehensive evaluation of nutritional status before and after hematopoietic stem cell transplantation in 170 patients with hematological diseases

    PubMed Central

    Liu, Peng; Wang, Boshi; Yan, Xia; Cai, Jingjing; Wang, Yu

    2016-01-01

    Objective To investigate the nutritional status of patients before and after hematopoietic stem cell transplantation (HSCT), and explore optimal methods for assessing nutritional status in patients with hematological diseases. Methods This cohort study enrolled 170 patients who were diagnosed with hematological diseases and underwent allogeneic HSCT in the Department of Hematology, Peking University People’s Hospital between May 2011 and April 2013. We used fixed-point continuous sampling and four nutritional screening tools, Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), Subjective Global Assessment (SGA) and Malnutrition Universal Screening Tools (MUST), in combination with body measurements, to extensively screen and evaluate nutritional risks and status in patients receiving HSCT before entering and after leaving laminar air flow rooms. Results After HSCT, patients had significant reduction in weight, hip circumference, waist-hip ratio, calf circumference, mid-upper arm circumference, and suprailiac skinfold thickness compared with pre-HSCT measurements. Before HSCT, NRS-2002 identified that 21.2% of patients were at nutritional risks, compared with 100% after HSCT. MUST indicated that before HSCT, 11.77% of patients were at high nutritional risk, compared with 59.63% after HSCT. MNA assessed that 0.06% of patients were malnourished before HSCT, compared with 19.27% after HSCT. SGA identified that before HSCT, 1.76% of patients had mild to severe malnutrition, which increased to 83.3% after HSCT. There is a significant increase in the nutritional risk and malnutrition in patients who received HSCT. Conclusions Before HSCT, some patients already had nutritional risk or nutritional deficiencies, and prompt and close nutritional screening or assessment should be performed. The nutritional status of patients after HSCT was generally deteriorated compared with that before transplantation. Body measurements should be taken more

  1. Evaluation of ferric oxalate as an agent for use during surgery to prevent post-operative root hypersensitivity.

    PubMed

    Wang, H L; Yeh, C T; Smith, F; Burgett, F G; Richards, P; Shyr, Y; O'Neal, R

    1993-11-01

    The aim of this study was to evaluate the effectiveness of a 6% ferric oxalate solution applied during periodontal surgery to prevent post-operative tooth hypersensitivity. Twenty-five adult patients with similar bilateral periodontal defects participated in this study. Data were collected at baseline (1 week prior to surgery) and 1, 2, 4, and 6 weeks following surgery. Sensitivity level was determined using the visual analog scale (VAS) with the following stimuli: 1) mechanical stimulation with a No. 23 dental explorer; 2) water at 50 degrees C; 3) ice; and 4) electric pulp tester (EPT). Teeth were randomly assigned to either test (6% ferric oxalate in 0.9% saline) or control (0.9% saline) groups. Solutions were applied to the exposed root surfaces for 1 minute during surgery. Data were analyzed by repeated measures ANOVA, paired t-test, and Pearson's correlation test. Results from this study demonstrated statistically significant reduction in the responses to thermal stimuli, especially cold, between groups treated with ferric oxalate as compared to those treated with saline. For the cold test the difference increased with time from baseline to 6 weeks. Statistically significant (P < 0.05) differences in sensitivity to heat between groups were also observed, but only at 2 and 4 weeks following surgery. There were no differences at any time period between the test and control groups when tactile or EPT techniques were used. In addition, there was no correlation between sensitivity and other clinical parameters. It was concluded from this study that 6% ferric oxalate was effective in reducing post-surgical cold sensitivity when applied during periodontal surgical procedures.

  2. [Use of protocol and evaluation of postoperative residual curarization incidence in the absence of intraoperative acceleromyography - Randomized clinical trial].

    PubMed

    Santos, Filipe Nadir Caparica; Braga, Angelica de Fátima de Assunção; Ribeiro, Carla Josefine Barbosa de Lima; Braga, Franklin Sarmento da Silva; Carvalho, Vanessa Henriques; Junqueira, Fernando Eduardo Feres

    2017-04-12

    Evaluate the incidence of postoperative residual curarization (PORC) in the post-anesthesia care unit (PACU) after the use of protocol and absence of intraoperative acceleromyography (AMG). Randomized clinical trial with 122 patients allocated into two groups (protocol and control). Protocol group received initial and additional doses of rocuronium (0.6mg.kg(-1) and 10mg, respectively); the use of rocuronium was avoided in the final 45minutes; blockade reversal with neostigmine (50μg.kg(-1)); time ≥ 15minutes between reversion and extubation. initial and additional doses of rocuronium, blockade reversal, neostigmine dose, and extubation time, all at the discretion of the anesthesiologist. AMG was used in the PACU and PORC considered at T4/T1 ratio<1.0. The incidence of PORC was lower in protocol group than in control group (25% vs. 45.2%, p=0.02). In control group, total dose of rocuronium was higher in patients with PORC than without PORC (0.43 vs. 0.35mg.kg(-1).h(-1), p=0.03) and the time interval between the last administration of rocuronium and neostigmine was lower (75.0 vs. 101.0min, p<0.01). In protocol group, there was no difference regarding the analyzed parameters (with PORC vs. without PORC). Considering the entire study population and the presence or absence of PORC, total dose of rocuronium was higher in patients with PORC (0.42 vs. 0.31mg.kg(-1).h(-1), p=0.01), while the time interval between the last administration of rocuronium and neostigmine was lower (72.5 vs. 99.0min, p ≤ 0.01). The proposed systematization reduced PORC incidence in PACU in the absence of intraoperative AMG. Copyright © 2017. Publicado por Elsevier Editora Ltda.

  3. Methodological approach to a multidimensional evaluation of food and nutrition policies.

    PubMed

    Santos, Leonor Maria Pacheco; dos Santos, Sandra Maria Chaves

    2003-01-01

    Recommendations arising from global conferences and summits, expressed the need to formulate and implement public policies to improve household food security. In the context of maximizing benefits given available resources, comprehensive evaluations of the nutrition policies and programs are needed. One obstacle to overcome was a clear definition of terminology; the words efficiency, effectiveness, efficacy and impact, widely used in the context of program evaluation, are sometimes interchanged and there is no consensus about their precise definition. Another approach to health evaluation is based in the paradigm structure-process-outcome. The level structure contemplated the installations, resources, instruments (physical and discursive), as well as the technical bureaucratic organizational structures. Process encompassed the whole set of intervention activities developed, whereas the dimension of outcome comprised the effects of interventions on the health and nutrition of beneficiaries. Each of the three dimensions constitutes a continuum in the evaluation procedure: the structure only fulfills its purposes if the processes are adequate and conversely, processes cannot alone supersede structural limitations. Moreover, all the three dimensions only reach their ultimate objectives through the completion of outcomes. The methodology proposed here has been tested in the case of Bahia, Northeast Brazil, and it was found to be adequate for this type of analysis. We hope this approach of a comprehensive multidimensional evaluation, constitutes an effective contribution for program planners and program managers, in particular with regard to the obstacles detected, some of which can surely be overcome.

  4. Modulation of postoperative immune response by enteral nutrition with a diet enriched with arginine, RNA, and omega-3 fatty acids in patients with upper gastrointestinal cancer.

    PubMed

    Senkal, M; Kemen, M; Homann, H H; Eickhoff, U; Baier, J; Zumtobel, V

    1995-02-01

    To find out whether an enteral diet supplemented with arginine, RNA, and omega-3 fatty acids modulated the production of interleukin-1 (IL-1), interleukin-2 (IL-2), IL-2 receptor, interleukin-6 (IL-6), and tumour necrosis factor alpha (TNF-alpha) after operations for upper gastrointestinal cancer. Prospective double blind clinical study. University hospital, Germany. 42 patients randomised into two groups (n = 21 each), one of which was given an isocaloric and isonitrogenous placebo diet and one of which was fed the same diet supplemented with arginine, RNA, and omega-3 fatty acids. The cytokines were measured before operation and on postoperative days 1, 3, 7, 10, and 16. Comparison of concentrations of cytokines in the two groups. Among those receiving the placebo diet (after spontaneous stimulation) IL-6 concentrations were significantly higher on days 3 and 7 (p < 0.05) and TNF-alpha concentrations on day 7. In contrast (after stimulation with phytohaemagglutinin) mean concentrations of IL-2 receptor were significantly higher on days 3 and 7, and of IL-1 beta and IL-2 on day 16 (p < 0.05) in the group receiving the supplemented diet. Supplementation of an enteral diet with arginine, RNA and omega-3 fatty acids can modulate the acute phase reaction as indicated by the reduction in concentrations of TNF-alpha and IL-6 in the group fed the supplemented diet. Patients receiving the supplemented diet also showed accelerated recovery in the concentrations of IL-1 beta and IL-2 receptor.

  5. [Postoperative pain.].

    PubMed

    Bergmann, H

    1987-07-01

    A short survey about the different methods available for producing postoperative analgesia is given, the goal being to make it clear to the clinician that there are quite a number of techniques to be used although the everyday clinical practice often sticks to simple and not too effective methods of pain treatment following surgery. Initially presenting short informations about the neurophysiology of pain and the pathogenesis and causes of postoperative pain two main groups of producing analgesia are then discussed.Thefirst group deals with the systemic use of analgesics be it nonnarcotic analgesic antipyretics or narcotic analgesics (opioids). As for the first subgroup the peripheral action of these drugs (metamizol, acetylsalicylic acid, paracetamol) is brought about by blocking the synthesis of prostaglandins. These substances can only be used for very moderate postoperative pain f.i. following head and neck surgery. The strong acting opioids belong to the second subgroup. Recent informations on receptor sites in the brain and cord and the subgrouping of the receptors throws new light on the understanding of the different effects of these drugs and on the pathomechanisms of agonistic, antagonistic and mixed activities. The clinically used opioids then are mentioned (morphine, fentanyl, methadon, pethidin, piritramide, tilidin, buprenorphin and pentazocine) and dosage, duration of action, antagonisms and untoward side effects are presented. Stress is laid on the recent development of patient-controlled analgesia with all its advantages. Thesecond main group of methods for postoperative analgesia consists of regional anesthesia techniques as there are brachial plexus block, intercostal block and the continuous epidural analgesia using both local anesthetics and spinal opioids. The brachial plexus block in continuous form is absolutely able to prevent pain after operations in the shoulder-arm-region and can be prolonged even for weeks using catheter techniques. The

  6. [Evaluation of municipal management of the Brazilian National School Nutrition Program in the largest cities of Santa Catarina State, Brazil].

    PubMed

    Gabriel, Cristine Garcia; Calvo, Maria Cristina Marino; Vasconcelos, Francisco de Assis Guedes de; Lacerda, Josimari Telino de; Freitas, Sérgio Fernando Torres de; Schmitz, Bethsáida de Abreu Soares

    2014-09-01

    This article reports on an evaluative study of municipal management of the Brazilian National School Nutrition Program in the largest cities in Santa Catarina State, Brazil. The matrix of indicators included two dimensions: political-organizational, with the sub-dimensions resources, inter-sector action, and social control, and operational-technical, organized in nutritional and feeding efficacy, nutritional monitoring, and educational activities for a healthy diet. A total of 22 indicators were determined, and data were collected through interviews with nutritionists. The political-organizational dimension showed 60% of fair cases and 40% of poor cases, while the operational-technical dimension showed 90% of poor cases, resulting from low performance in monitoring and educational activities. Although the cases showed unsatisfactory results, the evaluation provides important data on the management of the Brazilian National School Nutrition Program. The study emphasizes the importance of evaluation for alerting managers to the relevance of reviewing and upgrading activities.

  7. Cross-sectional evaluation of post-operative pain and flare-ups in endodontic treatments using a type of rotary instruments.

    PubMed

    Tanalp, Jale; Sunay, Hakki; Bayirli, Gündüz

    2013-01-01

    The purpose of this clinical study was to evaluate the general incidence of post-operative pain and flare-ups in patients who were endodontically treated by two endodontics specialists using rotary instruments (Hero 642, Micro Mega, France) with the same treatment protocol. Records of 382 teeth belonging to 268 patients treated by two endodontics specialists during a 6-month period were kept and evaluated. Post-operative pain between treatment visits was categorized using a pre-established scoring system. Ninety-five patients were males, whereas 173 were females. Pulpal necrosis without periapical pathosis was determined as the most common indication for endodontic treatment (21.7%) followed by irreversible pulpitis and re-treatment without periapical lesions (18.3%, 18.3%, respectively). The general prevalence of post-operative pain and flare-ups was determined as 8.1%, whereas cases that could be classified as real flare-ups which were severe and required an unscheduled visit (scores 2 and 3) comprised 3.4% of the cases. No statistically significant correlation was determined between gender and post-operative pain and flare-up (p = 0.05). There was a significant correlation between number of appointments and the presence of pain and flare-ups. Teeth undergoing multiple visits had a higher risk of developing post-operative pain and flare-ups compared to those with single appointments with a statistical significance (p = 0.03). Teeth with pre-operative pain were more prone to developing post-operative pain and discomfort with a statistically significant difference (p = 0.02). While no significant correlation was determined between tooth vitality and pain and flare-ups (p = 0.5), a statistically significant relationship existed between the presence of a periapical pathosis and post-operative pain and flare-ups. Cases with a periapical lesion had a higher risk of developing pain and flare-ups compared to those with no periapical involvement (p = 0.0001). Future

  8. Study Protocol Evaluating the Use of Bowel Stimulation Before Loop Ileostomy Closure to Reduce Postoperative Ileus: A Multicenter Randomized Controlled Trial.

    PubMed

    Garfinkle, Richard; Trabulsi, Nora; Morin, Nancy; Phang, Terry; Liberman, Sender; Feldman, Liane; Fried, Gerald; Boutros, Marylise

    2017-05-12

    Postoperative ileus is the most commonly observed morbidity following ileostomy closure. Studies have demonstrated that the defunctionalized bowel of a loop ileostomy undergoes a series of functional and structural changes, such as atrophy of the intestinal villi and muscular layers, which may contribute to ileus. A single-center study in Spain demonstrated that preoperative bowel stimulation via the distal limb of the loop ileostomy decreased postoperative ileus, length of stay, and time to gastrointestinal function. A multicenter randomized controlled trial involving patients from Canadian institutions was designed to evaluate the effect of preoperative bowel stimulation before ileostomy closure on postoperative ileus. Stimulation will include canalizing the distal limb of the ileostomy loop with an 18Fr Foley catheter and infusing it with a solution of 500mL of normal saline mixed with 30g of a thickening-agent (Nestle© Thicken-Up©). This will be performed 10 times over the three weeks prior to ileostomy closure on an outpatient clinic setting by a trained Enterostomal Therapy nurse. Surgeons and the treating surgical team will be blinded to their patient's group allocation. Data regarding patient demographics, operative, and postoperative variables will be collected prospectively. Primary outcome will be postoperative ileus, defined as an intolerance to oral food in the absence of clinical or radiological signs of obstruction, that either a) requires nasogastric tube insertion; or b) is associated with 2 of the following: nausea/vomiting, abdominal distension, and the absence of flatus, on or after post-operative day 3. Secondary outcomes will include length of stay, time to tolerating a regular diet, time to first passage of flatus or stool, and overall morbidity. A cost-analysis will be performed to compare the costs of conventional care to conventional care plus preoperative stimulation. This manuscript discusses the potential benefits of preoperative

  9. [Fourier analysis as a mathematical model for evaluating and presenting postoperative corneal topography data after non-mechanical perforating keratoplasty].

    PubMed

    Langenbucher, A; Seitz, B; Kus, M M; Steffen, P; Naumann, G O

    1997-04-01

    Videokeratography has given the possibility to obtain information in curvature from a much larger region of the cornea than that covered by keratometry. Fourier analysis as a mathematical model can be used to represent real physical attributes of the cornea and to divide corneal topography in its basic components: the zero-frequency component as the mean ring power, the one-cycle component as a representation of decentration and the two-cycle component as a representation of regular corneal toricity. The purpose of this study was the reconstruction of the corneal refraction after penetrating keratoplasty with a small number of characteristic parameters and the evaluation of the time course of the fourier coefficients as indices for a regular astigmatic cornea in the postkeratoplasty period including suture removal. Fourty patients (group 1: 20 primary dystrophies, group 2: 20 keratoconus) underwent nonmechanical trephination (excimer laser MEL60, Aesculap-Meditec, Heroldsberg, Germany) in penetrating keratoplasty. All procedures (7.5 mm in dystrophies, 8.0 mm in keratoconus, 8 orientation teeth, double-running 10-0 nylon suture) were performed by one surgeon. At a postoperative gate of 6 weeks, 6 months, before partial suture removal and after complete suture removal, corneal topography (TMS1, Tomey, Tennenlohe, Germany), keratometry, visual acuity and subjective refraction were assessed. Radial approximation with a 5th order polynomial fit of the refractive data on 25 non-centric rings of the TMS, within 256 hemimeridians was performed to get data at equally spaced concentric rings. Fast Fourier transformation of the data sets in the mid periphery (1.4-1.8 mm apical distance) was done to get DC-, one-cycle and two-cycle component. Fourier coefficients were correlated with keratometric readings, subjective refractive values and visual acuity. Spherical equivalent was fairly constant in the postoperative interval before suture removal. After suture removal, a

  10. From parenteral to enteral nutrition: a nutrition-based approach for evaluating postnatal growth failure in preterm infants.

    PubMed

    Miller, Malki; Vaidya, Ruben; Rastogi, Deepa; Bhutada, Alok; Rastogi, Shantanu

    2014-05-01

    Nutrition practices for preterm infants include phases of parenteral nutrition (PN), full enteral nutrition (EN), and the transitional phase in between. Our aim was to identify the nutrition phases during which infants are most likely to exhibit poor growth that would affect risk for growth failure (GF) at discharge and to examine factors associated with GF. A retrospective chart review was conducted on infants born <32 weeks' gestation. The neonatal intensive care unit stay was divided into 3 nutrition phases: (1) full PN, (2) transitional PN + EN, and (3) full EN. Weekly growth rates were calculated, and for each growth velocity <10 g/kg/d, the coinciding phase was recorded. GF was defined as a discharge weight below the 10th percentile. The nutrition phases during which growth inadequacy predicted GF at discharge were determined, correcting for other clinical factors associated with GF. In total, 156 eligible infants were identified. Seventy-six infants (49%) were discharged with weights <10%. Incidence of poor growth was highest during the transitional phase (46%) and was predictive of GF when adjusted for gestational age, birth weight, and severity of illness. Although energy intakes during the transitional phase were comparable to baseline parenteral provision, protein intakes progressively decreased ( P < .0001), consistently providing 3 g/kg/d as PN was weaned. Serum urea nitrogen also declined and was correlated with protein intake (r = -0.32, P < .001). Growth was compromised during the transitional phase, likely related to decreased protein intake. Optimizing protein provision while PN is weaned is an important strategy to prevent postnatal growth failure.

  11. Creating supportive nutrition environments for population health impact and health equity: an overview of the Nutrition and Obesity Policy Research and Evaluation Network's efforts.

    PubMed

    Blanck, Heidi M; Kim, Sonia A

    2012-09-01

    Childhood obesity is a major threat to individual health and society overall. Policies that support healthier food and beverage choices have been endorsed by many decision makers. These policies may reach a large proportion of the population or in some circumstances aim to reduce nutrition disparities to ensure health equity. The Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) evaluates policy as a tool to improve food and beverage environments where Americans live, work, play, and learn. The network aspires to address research and evaluation gaps related to relevant policies, create standardized research tools, and help build the evidence base of effective policy solutions for childhood obesity prevention with a focus on reach, equity, cost effectiveness, and sustainability. Published by Elsevier Inc.

  12. Nutritional evaluation of canola meals produced from new varieties of canola seeds for poultry.

    PubMed

    Chen, X; Parr, C; Utterback, P; Parsons, C M

    2015-05-01

    This study evaluated the nutritional value of 14 canola meals from new varieties of canola and compared them to conventional canola meal samples and soybean meals in chickens. Five experiments that included different sources of canola meals or soybean meals were conducted. For each experiment, a precision-fed rooster assay with conventional or cecectomized roosters was conducted to determine TMEn or amino acid digestibility. Analyzed nutritional composition of the canola meal samples indicated increases in crude protein and amino acids for all test canola meals (49.41 to 50.58% crude protein on a dry matter basis) compared to conventional canola meals (40.73 to 43.01%). All test canola meals also contained lower amounts of neutral detergent fiber and acid detergent fiber. Most test canola meals had significantly higher TMEn values than the conventional canola meals (P < 0.05), but all were lower than the soybean meal (P < 0.05). The test canola meals had higher amino acid digestibility coefficients than conventional canola meals in Experiments 1, 2, and 4 (P < 0.05), and higher concentrations of digestible amino acids in all 5 experiments. The results of this study indicated that nutritional value of the canola meal from new varieties of canola was greater than conventional canola meal for poultry. © 2015 Poultry Science Association Inc.

  13. Reference amounts utilised in front of package nutrition labelling; impact on product healthfulness evaluations.

    PubMed

    Raats, M M; Hieke, S; Jola, C; Hodgkins, C; Kennedy, J; Wills, J

    2015-05-01

    The research question addressed in this paper is how different reference amounts utilised in front of package nutrition labelling influence evaluation of product healthfulness. A total of 13,117 participants from six European countries (Germany, UK, Spain, France, Poland and Sweden) were recruited via online panels. A mixed between/within-subject factorial design was employed with food (biscuits, sandwiches, yogurts), healthfulness and presence of Guideline Daily Amounts as within-subjects factors and reference amount ('per 100 g', 'typical portion', 'half portion') and country as between-subjects factors. Overall, people correctly ranked foods according to their objective healthfulness as defined by risk nutrients alone, and could distinguish between more and less healthful variants of foods. General healthfulness associations with the three product categories do not appear to have had a strong influence on product ratings. This study shows that where the reference amount of 'per 100 g' is very different from the 'typical' portion size, as was the case for biscuits, products with a 'per 100 g' label are rated significantly less healthful than the 'typical' or 'half typical' portions. The results indicate that across the three food categories, consumers do factor the reference amount, that is, the quantity of food for which the nutritional information is being presented, into their judgements of healthfulness. Therefore, appropriate reference amounts are also of importance for the effective presentation of nutritional information.

  14. Evaluation of nutritional status and body composition of young Tunisian weightlifters.

    PubMed

    Serairi Beji, Raja; Megdiche Ksouri, Wided; Ben Ali, Ridha; Saidi, Oussama; Ksouri, Riadh; Jameleddine, Saloua

    2016-02-01

    to study the quantitative and qualitative aspects of daily spontaneous nutrition as well as anthropometric characteristics and body composition of young Tunisian weightlifters. Thirty one boys aged between 14 and 18 years, practicing for two hours a day, six days a week in the four weightlifting clubs in Tunis were invited to attend an evaluation session for a food survey (3 days recall, with consumption frequency over a period of 7 days) and the assessment of anthropometric measurements (Weight, height and skinfolds). Energy intake was acceptable. However, an imbalance nutrient intake was revealed. Concerning macronutrient, fat and protein were above the recommended allowances (p<0.01). Further, the percentage of saturated fatty acids was significantly above the recommended values while the percentages of polyunsaturated fatty acids and monounsaturated fatty acids were restricted. Regarding the micronutrient, the intake of calcium, magnesium and potassium were restrictive (p<0.01). As for the fluid intake, a limited contribution was observed (p<0.01). Several correlations between body composition and dietary intake have been found. Nutritional education may lead these young weightlifters to adopt appropriate nutritional habits to optimize dietary intake. This fact could be compromising of a more suitable body composition and could have a positive bearing on athletic performance.

  15. BIOCHEMICAL COMPOSITION AND NUTRITIONAL EVALUATION OF BARLEY RIHANE (HORDEUM VULGARE L.).

    PubMed

    Lahouar, Lamia; Ghrairi, Fatma; El Arem, Amira; Medimagh, Sana; El Felah, Mouledi; Salem, Hichem Ben; Achour, Lotfi

    2017-01-01

    Many experimental studies have suggested an important role for barley Rihane(BR)in the prevention of colon cancer and cardiovascular diseases. The objective of this study was to evaluate the physico-chemical properties and nutritional characterizations of BR compared to other varieties grown in Tunisia (Manel, Roho and Tej). Total, insoluble and soluble dietary fiber(β-glucan), total protein, ash and some minerals of BR and Tunisian barley varieties were determined. The results revealed that BR is good source of dietary fiber mainly β-glucan compared to the other varieties. This variety is a relatively rich source of phosphorous and potassium and it contains many important unsaturated fatty acids. BR has higher nutritional value than other varieties. Barley Rihane has significant nutritional characterizations compared to others Tunisian barleys varieties. Abbreviations: BR, Barley Rihane; LDL, low density lipoprotein; HDL, high density lipoprotein; AOM, azoxymethane; TBV, Tunisian barley varieties; TGW, thousand grain weight; SW, weight specific; TDF, total dietary fiber; IDF, insoluble dietary fiber; SDF, soluble dietary fiber; DM, Dry Matter.

  16. Design of a prospective, randomized evaluation of an integrated nutrition program in rural Viet Nam.

    PubMed

    Marsh, David R; Pachón, Helena; Schroeder, Dirk G; Ha, Tran Thu; Dearden, Kirk; Lang, Tran Thi; Hien, Nguyen Dhanh; Tuan, Doan Anh; Thach, Tran Duc; Claussenius, David R

    2002-12-01

    Few prospective studies of child growth and its determinants take place in programmatic contexts. We evaluated the effect of Save the Children's (SC) community empowerment and nutrition program (CENP) on child growth, care, morbidity, empowerment, and behavioral determinants. This paper describes the research methods of this community-based study. We used a longitudinal, prospective, randomized design. We selected 12 impoverished communes with documented child malnutrition, three comparison, and three intervention communes in each of two districts in Phu Tho Province, west of Hanoi. SC taught district trainers in November 1999 to train local health volunteers to implement the 10-month CENP, including situation analysis, positive deviance (PD) inquiry, growth monitoring and promotion, nutrition education and rehabilitation program (NERP), deworming, and monitoring. PD inquiries aim to discover successful care practices in poor households that likely promote well-nourished children. NERPs are neighborhood-based, facilitated group learning sessions where caregivers of malnourished children learn and practice PD and other healthy behaviors. We dewormed all intervention and comparison children. We randomly selected 240 children 5 to 25 months of age (120 intervention and 120 comparison). We gathered information on nutritional status, diet, illness, care, behavioral determinants, empowerment, and program quality, monthly for six months with a re-survey at 12 months. We collected most information through maternal interview but also observed hygiene and program quality, and videotaped feedings at home. Some implementation and research limitations will attenuate CENP impact and measurement of its effectiveness.

  17. Evaluation of dysphagia risk, nutritional status and caloric intake in elderly patients with Alzheimer's

    PubMed Central

    Goes, Vanessa Fernanda; Mello-Carpes, Pâmela Billig; de Oliveira, Lilian Oliveira; Hack, Jaqueline; Magro, Marcela; Bonini, Juliana Sartori

    2014-01-01

    Objective to evaluate the risk of dysphagia and its relationship with the stage of Alzheimer's Disease, as well as the relationship between the risk of dysphagia and nutritional status and caloric intake in elderly people with Alzheimer's disease. Methods the sample consisted of 30 subjects of both genders with probable Alzheimer's disease. The stage of the disease, nutritional status, energy intake, and risk of dysphagia were assessed. Results it was found that increased risk of dysphagia is associated with the advance in the stages of Alzheimer's disease and that even patients in the early stages of disease have a slight risk of developing dysphagia. No association was found between nutritional status and the risk of dysphagia. High levels of inadequate intake of micronutrients were also verified in the patients. Conclusion an association between dysphagia and the development of Alzheimer's disease was found. The results indicate the need to monitor the presence of dysphagia and the micronutrient intake in patients with Alzheimer's disease. PMID:26107841

  18. Evaluating the costs and benefits of outpatient diabetes education and nutrition counseling.

    PubMed

    Kaplan, R M; Davis, W K

    1986-01-01

    The Board of Directors of the American Diabetes Association (ADA) recently endorsed a resolution recommending third-party payment for outpatient education and nutritional counseling. One of the major rationales for the statement was that education and nutritional counseling will lead to reductions in health care costs. This article critically reviews the 13 studies cited in support of the ADA Policy Statement. Among these studies, only 2 compared a treated group with a control group. Both of the studies with control groups failed to randomly assign patients to treatment condition. Only 4 of the studies showed an accounting of program costs. Upon close inspection, it appears that some of the programs actually increased, rather than decreased, health care expenditures. Attrition from programs was reported in only a minority of cases, and was large when reported. The effect of the programs upon diabetes control was inconsistent across studies. It is suggested that the rationale for education and nutritional services be based on improved health status. In addition, the execution of a systematic experimental study to evaluate these services is urged.

  19. [Nutritional evaluation and prevalence of not transmissible chronic disease in elderly participating in an assistance program].

    PubMed

    Bueno, Júlia Macedo; Martino, Hercia Stampini Duarte; Fernandes, Maria Fernada Scareli; Costa, Luciana Silva; Silva, Roberta Ribeiro

    2008-01-01

    The purpose of this study was to evaluate the nutritional state and the prevalence of not transmissible chronic disease in elderly, who were participating in an assistance program of the Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil. Socio-economical, anthropometric and biochemical variables, as well as systemic blood pressure were collected from 82 individuals between 60 and 87 years of age, 90,2 % of them female. According to the body mass index (BMI) 52,4% of the studied sample were overweight, 28,0% eutrophic and 19,5% underweight; 37,8% presented high body fat percentage (BF%). With regard to the relation BMI/BF%, 63,4% of the elderly with overweight, 12,5% of the eutrophic and 11,8% of the underweight presented high BF%. The waist-to-hip ratio revealed 40,2% at high risk and 12,2% at very high risk of developing cardiovascular disease. In addition, 22,0% had high blood pressure. The biochemical tests revealed that 39,3%, 39,3% and 3,3% presented higher plasma cholesterol, triglyceride and glucose levels respectively. There is a need for continuous nutritional education programs and monitoring of the nutritional and health status for improving the quality of life of the studied individuals.

  20. [Preoperative screening and nutritional support of nutritional deficiencies].

    PubMed

    Zazzo, J-F

    2004-01-01

    Nutritional deficiencies have to be considered as an independent risk factor for postoperative morbidity. Peri-operative nutritional support reduce this risk in elective abdominal surgery for cancer and cardiac surgery. Preoperative nutritional support for 7-10 days reduce postoperative complications in undernourished patients by 10% but is not operant when administered after surgery. Enteral route is as effective. Recent studies using immunonutrients conclude that a short preoperative oral intake is able to reduce complications even in well-nourished patients. Then, a preoperative nutritional screening must be routinely performed leading to a nutritional programme.

  1. Evaluation of the effect of an intervention on the nutritional status of hospitalized patients.

    PubMed

    Miguel Montoya, Isabel; Ortí Lucas, Rafael; Ferrer Ferrándiz, Esperanza; Martín Baena, David; Montejano Lozoya, Raimunda

    2017-04-07

    To compare the nutritional status of a population of hospitalized patients, divided into 2 different groups, both at admission and hospital discharge, and to assess the influence of nutritional alteration during the hospital stay. Quasi-experimental study comprising 2 groups of patients (N=581); an intervention group (n=303), in which nurses received specific training on managing care methodology, and a control group (n=278), in which nurses continued their usual dynamics. Each group was made up of 2 care units with patients from both surgical and medical specialties. patients admitted to the selected units with a minimum stay of 5 days. The sample selection was performed prospectively and consecutively after implementing the training. Of the 581 patients studied, 49.4% were women and 50.6% were men. Mean patient age was 68.29 (SD 16.23) years. In the intervention group, the odds ratio (OR) associated with good nutritional status was multiplied by 1.7 (OR=1.67) compared to the control group in the first evaluation and by 1.4 times (OR=1.43) at hospital discharge. The average stay in days was higher in the control group (13.71, SD 10.19) than in the intervention group (10.89, SD 7.49) (P<.001). The systematic methodology-based intervention in the chosen units was positive. Patients admitted to the intervention units had a lower nutritional alteration and a shorter hospital stay than those admitted to the control units. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. The humanitarian emergency in Burundi: evaluation of the operational strategy for management of nutritional crisis.

    PubMed

    Rossi, Laura; Verna, Daniel; Villeneuve, Susie L

    2008-07-01

    To evaluate the impact and appropriateness of programmes for the management and treatment of severe malnutrition in emergency situations. A central unified database was set up with all data and statistics provided by nutritional centres (NC) active in Burundi. The paper describes the case of Burundi as an example of the response of the humanitarian community to nutritional crisis. Since 1999, more than one million (1,054,210) severely malnourished patients were treated in NC established in Burundi. Peaks of beneficiaries were registered in 2000 and 2001; the admission rate started to decrease in 2002. In 2004, twenty therapeutic feeding centres (TFC) and 224 supplementary feeding centres (SFC) were active for the treatment of 127,420 beneficiaries. Nutritional programmes were present in every province with a coverage rate of 55%. The most convincing impact of the nutritional programme in Burundi was the reduction of mortality rate in children under 5 years of age; an impact on the prevalence of acute malnutrition could not be demonstrated. Children under 5 years old accounted for 62% of beneficiaries in TFC and 76% in SFC. TFC performance indicators fulfilled the minimum standards in disaster response; the performance of SFC was not so optimal with a low recovery rate (69% v. >80%) and a high non-respondent rate (16% v. <5%). With the combination of coverage and cure rate, the programme met 44% of the assessed needs in 2004. In Burundi the stabilisation of security conditions permitted a combination of humanitarian responses ranging from emergency activities to strengthening of community-based initiatives that could correct the coverage and impact limitations.

  3. Retrospective Evaluation of Parenteral Nutrition in Alpacas: 22 Cases (2002–2008)

    PubMed Central

    Clore, E.R.S.; Freeman, L.M.; Bedenice, D.; Buffington, C.A. Tony; Anderson, D.E.

    2013-01-01

    Background Parenteral nutrition is an important method of nutritional support in hospitalized animals, but minimal information has been published on its use in camelids. Hypothesis/Objectives The purpose of this study was to characterize the use of total parenteral nutrition (TPN) in alpacas, evaluate the formulations used, and determine potential complications. Animals Twenty-two alpacas hospitalized at the Tufts Cummings School for Veterinary Medicine (site 1: n = 8) and the Ohio State University Veterinary Teaching Hospital (site 2: n = 14). Methods A retrospective analysis of all alpacas that received TPN between 2002 and 2008 was performed to assess clinical indications, clinical and clinicopathologic data, and outcome. Results The most common underlying diseases in animals receiving TPN were gastrointestinal dysfunction (n = 16), hepatic disease (n = 2), and neoplasia (n = 2). Several metabolic abnormalities were identified in animals (n = 20/22) before TPN was initiated, including lipemia (n = 12/22), hyperglycemia (11/22), and hypokalemia (n = 11/22). Median age was significantly lower for site 1 cases (0.1 years; range, 0.01–11.0) compared with those from site 2 (4.9 years; range, 0.1–13.7; P = .03). Animals at site 2 also had a longer duration of hospitalization (P = .01) and TPN administration (P = .004), as well as higher survival rate (P < .02). Twenty-one of 22 alpacas developed at least 1 complication during TPN administration. Metabolic complications were most prevalent (n = 21/22) and included hyperglycemia (n = 8/21), lipemia (n = 7/21), hypokalemia (n = 3/21), and refeeding syndrome (n = 3/21). Conclusions and Clinical Importance TPN is a feasible method of nutritional support for alpacas when enteral feeding is not possible. Prospective studies are warranted to determine optimal TPN formulations for alpacas. PMID:21418323

  4. Nutritional and microbiological evaluations of chocolate-coated Chinese chestnut (Castanea mollissima) fruit for commercial use

    PubMed Central

    Gounga, Mahamadou E.; Xu, Shi-ying; Wang, Zhang

    2008-01-01

    In recent years, China has become an increasingly important and the largest chestnut producer in the world. This study aimed to evaluate the nutritional value and microbiological quality of the roasted freeze-dried Chinese chestnut (Castanea mollissima) (RFDC) coated with dark chocolate (DCC) and milk chocolate (MCC) for industrial use and commercial consumption. Chocolate coating significantly improved the nutritional value of chestnut. RFDC had high levels of starch (66.23%) and fibers (3.85%) while DCC and MCC contained significantly high amounts of sucrose, protein, fat and minerals. Furthermore, the protein content doubled in MCC rather than in DCC. This could be attributed to the different formulations in the two products. Milk powder and whey protein constituted the source of protein in MCC while cocoa powder added to MCC formulation constituted an additional source of minerals. The amino acid profile showed differences in amino acid composition related to the sample’s protein content, indicating their good nutritional quality. The moisture contents in all RFDC, DCC and MCC were suitable for industrial processing. These results provide information about the additional nutrients of chocolate-coated chestnut and confirm that the product is an interesting nutritional food. The combination of freeze-drying and chocolate-coating generally results in greater reductions on microbiological loads, extending shelf life of harvested chestnut for commercial application. This is an alternative strategy to add value to chestnut, minimizing the significant losses in harvested fruits and providing a wider range of choices of new products to the consumer disposal. PMID:18763299

  5. Evaluation of phytochemical content, nutritional value and antioxidant activity of Phanji - Rivea hypocrateriformis (Desr.) Choisy leaf

    PubMed Central

    Borkar, Sneha D.; Naik, Raghavendra; Shukla, Vinay J.; Acharya, Rabinarayan

    2015-01-01

    Background: Rivea hypocrateriformis (Desr.) Choisy is known to be the source plant of Phanji, a classically delineated leafy vegetable which is till date used by some hill dwelling Kandha tribes of Odisha. Though it is in use since a long time, it is not yet evaluated for its nutritive value. Aim: The leaves of R. hypocrateriformis were evaluated for its nutritive value and antioxidant potential. Materials and Methods: The in vitro antioxidant properties of the leaf of R. hypocrateriformis were screened through 1,1-diphenyl-2-picrylhydrazyl (DPPH) and total antioxidant capacity. Phytochemicals, crude protein, fat, carbohydrate, energy value, and mineral content of the leaves of the plant were evaluated with standard procedures. Results: In phytochemical analysis, tannin, alkaloids, flavonoids, and carbohydrates were present in leaf powder of R. hypocrateriformis. Energy content was found to be highest (331.54 kcals/100 g). Carbohydrate, fat, protein, calcium, magnesium, phosphorous, and zinc were present in 57.63%, 2.66%, 19.27%, 0.99%, 0.34%, 0.32%, and 0.011%, respectively. The IC50 values of the extract and ascorbic acid were found to be 254 ± 5.29 μg/ml and 11.67 ± 0.58 μg/ml, respectively. Percentage scavenging of DPPH radical was found to rise with increasing concentration of the crude extract. Total antioxidant capacity of the extract was found to be 111.30 ± 0.003 mcg. Conclusion: The results of this study indicate that the leaves of R. hypocrateriformis contain secondary metabolites such as tannin and possess mild antioxidant properties. Nutritional analysis indicates the presence of energy in highest amount, carbohydrates, proteins, fats, calcium, phosphorous, zinc, and magnesium. PMID:27313417

  6. Exploring the moderating effect of children's nutritional knowledge on the relationship between product evaluations and food choice.

    PubMed

    Tarabashkina, Liudmila; Quester, Pascale; Crouch, Roberta

    2016-01-01

    Although the last decade has seen multiple attempts to increase consumers' nutritional knowledge in expectation that this will result in healthier diets, extant knowledge about the influence of nutritional knowledge on children's food choices remains scarce due to mixed empirical evidence and limited inquiry into the role of product evaluations on the consumption of less healthy foods. Furthermore, no research has examined whether nutritional knowledge can effectively moderate the relationship between product evaluations and food consumption, leaving a gap in our knowledge about potentially effective intervention strategies to curb childhood obesity. Using survey data from children aged 7-13 years and their parents (N = 354) recruited at an annual fair visited by families in South Australia, regressions were performed to examine how product evaluations are associated with the consumption of less healthy foods and whether nutritional knowledge reduces the strength of these associations at different ages (7-8 years, 9-10 years, and 11-13 years). While children did not view fast foods to be fun or healthy, there was a positive association between appealing taste, perceived social acceptability and consumption of less healthy foods. Higher nutritional knowledge weakened the relationship between product evaluations and consumption in children younger than 11. Parents with higher nutritional knowledge had children who tended to consume less healthy foods less frequently. Although older children (11-13 years) possessed higher nutritional knowledge, it was not associated with their consumption; instead, taste and perception of social acceptability were the only factors associated with frequent consumption of less healthy products. Practitioners are encouraged to test intervention strategies that concentrate on both product evaluations and nutritional knowledge to provide more effective outcomes. Further research about peer norms that endorse unhealthy eating is

  7. Three-dimensional analysis of accuracy of patient-matched instrumentation in total knee arthroplasty: Evaluation of intraoperative techniques and postoperative alignment.

    PubMed

    Kuwashima, Umito; Mizu-Uchi, Hideki; Okazaki, Ken; Hamai, Satoshi; Akasaki, Yukio; Murakami, Koji; Nakashima, Yasuharu

    2017-09-06

    It is questionable that the accuracies of patient-matched instrumentation (PMI) have been controversial, even though many surgeons follow manufacturers' recommendations. The purpose of this study was to evaluate the accuracy of intraoperative procedures and the postoperative alignment of the femoral side using PMI with 3-dimensional (3D) analysis. Eighteen knees that underwent total knee arthroplasty using MRI-based PMI were assessed. Intraoperative alignment and bone resection errors of the femoral side were evaluated with a CT-based navigation system. A conventional adjustable guide was used to compare cartilage data with that derived by PMI intraoperatively. Postoperative alignment was assessed using a 3D coordinate system with a computer-assisted design software. We also measured the postoperative alignments using conventional alignment guides with the 3D evaluation. Intraoperative coronal alignment with PMI was 90.9° ± 1.6°. Seventeen knees (94.4%) were within 3° of the optimal alignment. Intraoperative rotational alignment of the femoral guide position of PMI was 0.2° ± 1.6°compared with the adjustable guide, with 17 knees (94.4%) differing by 3° or less between the two methods. Maximum differences in coronal and rotation alignment before and after bone cutting were 2.0° and 2.8°, respectively. Postoperative coronal and rotational alignments were 89.4° ± 1.8° and -1.1° ± 1.3°, respectively. In both alignments, 94.4% of cases were within 3° of the optimal value. The PMI group had less outliers than conventional group in rotational alignment (p = 0.018). Our 3D analysis provided evidence that PMI system resulted in reasonably satisfactory alignments both intraoperatively and postoperatively. Surgeons should be aware that certain surgical techniques including bone cutting, and the associated errors may affect postoperative alignment despite accurate PMI positioning. Copyright © 2017 The Japanese Orthopaedic Association. Published by

  8. Impact of p16 expression in oropharyngeal cancer in the postoperative setting: the necessity of re-evaluating traditional risk stratification.

    PubMed

    Lee, Jeongshim; Chang, Jee Suk; Kwon, Hyung Joo; Kim, Se-Heon; Shin, Sang Joon; Keum, Ki Chang

    2016-10-01

    To evaluate the impact of p16 expression as a surrogate marker of human papillomavirus status in oropharyngeal squamous cell carcinoma patients underwent surgery followed by postoperative radiotherapy. We identified 126 consecutive patients with histologically confirmed, newly diagnosed oropharyngeal squamous cell carcinoma who received surgery followed by radiotherapy and had p16 expression data available. All patients were treated between 2001 and 2011. Patients with high-risk factors (positive surgical margin and/or extracapsular extension) or other risk factors (multiple positive lymph nodes, perineural/lymphovascular invasion) were offered postoperative radiotherapy with or without concurrent chemotherapy. One hundred and four (82.5%) patients were p16-positive (p16 (+)) and 22 (17.5%) were p16-negative (p16 (-)). With a median follow-up of 56 months, patients with p16 (+) oropharyngeal squamous cell carcinoma exhibited a significantly better 5-year disease-free survival (80.7% vs. 57.6%, P < 0.001) and overall survival (84.9% vs. 59.1%, P < 0.001) than those with p16 (-) tumors. The p16 (+) oropharyngeal squamous cell carcinoma with high-risk factors (n = 64) showed no difference in disease-free survival (79.7% vs. 68.3%; P = 0.531) and overall survival (82.1% vs. 76.2%; P = 0.964) between postoperative radiotherapy and postoperative radiotherapy with concurrent chemotherapy. Expression of p16 is a strong independent prognostic factor of survival in the postoperative setting of oropharyngeal squamous cell carcinoma. The favorable prognosis of p16 (+) oropharyngeal squamous cell carcinoma suggests a need to re-examine traditional risk stratification for determining optimal adjuvant treatment. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Evaluation of Nutritional Status in Children during Predialysis, or Treated By Peritoneal Dialysis or Hemodialysis.

    PubMed

    Yılmaz, Dilek; Sönmez, Ferah; Karakaş, Sacide; Yavaşcan, Önder; Aksu, Nejat; Ömürlü, İmran Kurt; Yenisey, Çiğdem

    2016-06-01

    Malnutrition is one of the major causes of morbidity and mortality in children with chronic kidney disease (CKD). The objective of this study was to evaluate nutritional status of children with stage 3-4 CKD and treated by peritoneal dialysis or hemodialysis using anthropometric measurements, biochemical parameters and bioelectrical impedance analysis. The study included a total of 52 patients and 46 healthy children. In anthropometric evaluation, the children with CKD had lower values for standard deviation score for weight, height, body mass index, skinfold thickness and mid-arm circumference than those of healthy children (p < 0.05). The fat mass (%) and the body cell mass (%) measurements performed by bioelectrical impedance analysis were lower compared with the control group (p < 0.05). It is considered that bioelectrical impedance analysis measurement should be used with anthropometric measurements, which are easy to perform, to achieve more accurate nutritional evaluation in children. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Evaluating the Role of Postoperative Oral Antibiotic Administration in Artificial Urinary Sphincter and Inflatable Penile Prosthesis Explantation: a Nationwide Analysis.

    PubMed

    Adamsky, Melanie A; Boysen, William R; Cohen, Andrew J; Ham, Sandra; Dmochowski, Roger R; Faris, Sarah F; Bales, Gregory T; Cohn, Joshua A

    2017-09-27

    To determine whether postoperative oral antibiotics are associated with decreased risk of explantation following artificial urinary sphincter (AUS) or inflatable penile prosthesis (IPP) placement. Although frequently prescribed, the role of postoperative oral antibiotics in preventing AUS or IPP explantation is unknown. We queried the MarketScan database to identify male patients undergoing AUS or IPP placement between 2003 and 2014. The primary endpoint was device explantation within 3 months of placement. Multivariate regression analysis controlling for clinical risk factors assessed the impact of postoperative oral antibiotic administration on explant rates. We identified 10847 and 3594 men who underwent IPP and AUS placement, respectively, between 2003 and 2014. Postoperative oral antibiotics were prescribed to 60.6% of patients following IPP placement and 61.1% of patients following AUS placement. The most frequently prescribed antibiotics were fluoroquinolones (35.6%), cephalexin (17.7%), trimethoprim/sulfamethoxazole (7.0%), and amoxicillin-clavulanate (3.2%). Explant rates did not differ based upon receipt of oral antibiotics (antibiotics vs. no antibiotics IPP: 2.2% vs. 1.9%, p=0.18, AUS: 3.9% vs. 4.0%, p=0.94). On multivariate analysis, no individual class of antibiotic was associated with decreased odds of device explantation. Postoperative oral antibiotics are prescribed to nearly two-thirds of patients but are not associated with reduced odds of explant following IPP or AUS placement. Given the risks to individuals associated with use of antibiotics and increasing bacterial resistance, the role of oral antibiotics after prosthetic placement should be reconsidered and further studied in a prospective fashion. Copyright © 2017. Published by Elsevier Inc.

  11. Nutritional deficiencies after bariatric surgery.

    PubMed

    Davies, D J; Baxter, J M; Baxter, J N

    2007-09-01

    A current review of nutritional complications following bariatric procedures is presented, focusing on the most common and clinically important deficiencies. A brief outline of nutritional supplementation protocol is presented, highlighting the need for a standardized, national or international set of guidelines for pre- and postoperative nutritional screening and appropriate supplementation.

  12. [Nutritional risk evaluation and establishment of nutritional support in oncology patients according to the protocol of the Spanish Nutrition and Cancer Group].

    PubMed

    Marín Caro, M M; Gómez Candela, C; Castillo Rabaneda, R; Lourenço Nogueira, T; García Huerta, M; Loria Kohen, V; Villarino Sanz, M; Zamora Auñón, P; Luengo Pérez, L; Robledo Sáenz, P; López-Portabella, C; Zarazaga Monzón, A; Espinosa Rojas, J; Nogués Boqueras, Raquel; Rodríguez Suárez, L; Celaya Pérez, S; Pardo Masferrer, J

    2008-01-01

    Cancer and its oncological treatment cause symptoms which increase the patients risk to suffer from malnutrition. This affects the patients health status negatively by increasing the number of complications, reducing the tolerance to the oncology treatment and a decrease of the patients quality of life. Motivated by this, a group of health professionals from several spanish regions met with the backing of the Sociedad Española de Nutrición Básica y Aplicada (SENBA) to address strategies to improve the quality of nutritional intervention in cancer patients. This multidisciplinary group developed a protocol describing nutritional assessment and intervention in form of algorithms based on literature and personal experience. The patients are classified in a three step process: 1. type of their oncology treatment (curative or palliative); 2. nutritional risk of the antineoplastic therapy (low, medium or high risk) and 3. depending on the Subjective Global Assessment patient-generated (SGA-pg). The patients are classified as: A. patients with adequate nutritional state, B. patients with malnutrition or risk of malnutrition and C. patients suffering from severe malnutrition. During one year, the protocol has been used for 226 randomly chosen female and male patients older than 18 years. They were treated by the Medical and Radiotherapy Oncology outpatient clinic. More than a half of the patients were suffering from malnutrition (64%) increasing up to 81% for patients undergoing palliative treatment. Most of them were treated curatively (83%) and received oncology treatment with moderate or high nutritional risk (69%). 68% of patients were affected by some feeding difficulty. The mean percentage of weight loss has been 6.64% +/- 0.87 (min 0%, max 33%). Albumin values of 32% of the patients were between 3 and 3.5 g/dl and negatively correlated with feeding difficulties (p = 0.001). The body mass index (BMI) has not found to be a significant parameter for detecting

  13. Evaluation of breakfast cereals with the current nutrition facts panel (NFP) and the Food and Drug Administration's NFP proposal.

    PubMed

    González-Vallejo, Claudia; Lavins, Bethany D

    2016-04-01

    To compare judgements of nutrition and judgement accuracy when evaluating cereals with the current US Food and Drug Administration (FDA)