BACKGROUND Gastrointestinal(GI)surgery can significantly affect the nutritional status and immune function of patients.This study aimed to investigate the effects of personalized nutritional care on the recovery of im...BACKGROUND Gastrointestinal(GI)surgery can significantly affect the nutritional status and immune function of patients.This study aimed to investigate the effects of personalized nutritional care on the recovery of immune function in patients who underwent postoperative GI surgery.AIM To study examines personalized nutritional care’s impact on immune function recovery,nutritional status,and clinical outcomes after GI surgery.METHODS This observational study included 80 patients who underwent GI surgery between 2021 and 2023.Patients received personalized nutritional care based on their individual needs and surgical outcomes.Immune function markers including lymphocyte subsets,immunoglobulins,and cytokines were measured preoperatively and at regular intervals postoperatively.Nutritional status,clinical outcomes,and quality of life were assessed.RESULTS Patients receiving personalized nutritional care showed significant improvements in immune function markers compared to baseline.At 4 weeks postoperatively,CD4+T-cell counts increased by 25%(P<0.001),while interleukin-6 levels decreased by 40%(P<0.001).Nutritional status,as measured by prealbumin and transferrin levels,improved by 30%(P<0.01).Postoperative complications reduced by 35%compared to historical controls.The quality-of-life scores improved by 40%at 3 months postoperatively.CONCLUSION Personalized nutritional care enhances immune function recovery,improves nutritional status,and reduces complications in patients undergoing postoperative GI surgery,highlighting its crucial role in optimizing patient outcomes following such procedures.展开更多
Pancreatic cancer is usually associated with a poor prognosis.Surgery is the main curative treatment but pancreatic operations are aggressive and new tools that help clinicians to predict surgical and prognostic outco...Pancreatic cancer is usually associated with a poor prognosis.Surgery is the main curative treatment but pancreatic operations are aggressive and new tools that help clinicians to predict surgical and prognostic outcomes are necessary.Lu et al recently published a retrospective,single centre cohort study evaluating the impact of seven nutritional and inflammatory markers in pancreatic cancer surgical patients:The albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),nutritional risk index,and the geriatric nutritional risk index.A significant correlation was found between the PNI,SII,NLR,and PLR and a hospital discharge of less than 15 days.In a univariable analysis,PNI,SII,NLR and PLR were significantly related to recurrence-free survival and,in a multivariable analysis PNI was associated with overall survival.Various meta-analyses corroborate the results in terms of prognosis but individual studies are discordant on their usefulness.Besides,the cut-off values for these markers vary significantly between studies and there are no clinical trials comparing them to identify the most relevant ones.These are limitations when implementing nutritional and inflammatory biomarkers into clinical practice and further studies are needed in order to answer these questions.展开更多
This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer.Lu et al evaluated the ability of seven biomarkers t...This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer.Lu et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term outcomes.These biomarkers were albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,nutritional risk index,and geriatric nutritional risk index.The PNI was found to be a strong predictor of both overall and recurrence-free survival,underscoring its clinical relevance in managing patients with pancreatic cancer.展开更多
Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January an...Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January and December 2020,were included.Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding.The ratio of beneficial bacteria at the first and second bowel movements after each patient’s admission was calculated and the patients were classified into the increase or decrease group.Among all patients,five each were in the increase and decrease groups.We investigated patient background,changes in sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation(APACHE)Ⅱscores,nutritional doses or methods,and clinical outcomes.Results:No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHEⅡscores at the time of admission.The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group(4/5 vs.0/5,P=0.01).Conclusions:An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition.In the future,accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective.展开更多
BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nu...BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.展开更多
Non-communicable diseases (NCDs) are on the rise worldwide and in developing countries like Botswana. Unhealthy eating habits and lack of proper nutrition knowledge cause non-communicable diseases and affect adolescen...Non-communicable diseases (NCDs) are on the rise worldwide and in developing countries like Botswana. Unhealthy eating habits and lack of proper nutrition knowledge cause non-communicable diseases and affect adolescents. It is in adolescence that eating habits are formed that persist till adulthood. Lifestyle interventions are needed to curb NCDs in adolescents. This paper reports the findings of a study that aimed to validate a lifestyle intervention program and its effect on food intake, physical activity, and nutrition knowledge. It was a clustered randomized control trial study conducted in four (4) junior secondary schools. There were 46 participants, 21 in the control and 25 in the intervention arm, who were blindly assigned to each arm by a statistician. Information and skills on nutrition were imparted using the Information, Motivation, and Behavioral Skills model. The program was implemented for eight (8) weeks hourly after school. A questionnaire was used to collect data pre- and post-intervention. Number, proportion, percentage, and independent t-test (mean and SD or median and IQR, p-value) were calculated using numerical and categorical data. The findings showed that the lifestyle intervention was valid, and there was a slight decrease in the intake of sweets among participants in both trial arms (p = 0.066). There was no significant difference in terms of food intake. Only a small number of participants still ate a few fruits, and there was no change in vegetable intake in both trial arms (p = 0.641). There was no change in the intake of fried foods in both trail arms (p = 0.402). Regarding nutrition knowledge, there was a slight significant difference of p = 0.079 between the trial arms. Though the effect of the lifestyle intervention program was not statistically significant, the results are promising, especially if the duration could be increased to a longer period and a larger sample size included.展开更多
Purpose: In super-aging societies, prosthodontists will have a growing role and will need to improve their nutrition knowledge. This study aimed to evaluate the effectiveness of a workshop-based model for increasing d...Purpose: In super-aging societies, prosthodontists will have a growing role and will need to improve their nutrition knowledge. This study aimed to evaluate the effectiveness of a workshop-based model for increasing dysphagia diet awareness among prosthodontists working with head and neck cancer patients. Methods: The study had a post-intervention design and included 10 maxillofacial prosthetic educators from eight countries who participated in a 120-minute workshop focused on theoretical and practical training in nutrition support for patients with dysphagia. Sessions were held in a specialized restaurant in Tokyo and included lectures, observation of Japanese cooking techniques, hands-on preparation of dysphagia-friendly foods, and cross-cultural comparisons. Knowledge, confidence, and practical application were assessed using a post-workshop questionnaire. Descriptive statistics and thematic analysis were used to evaluate outcomes. Results: Seven of the 10 prosthodontists completed the post-intervention questionnaire. All respondents reported overall satisfaction with the workshop. Session content was regarded as easy to understand by 57.14%, appropriate by 28.57%, and easy by 14.29%. Most respondents (85.71%) were “very satisfied” with the instructors’ explanations, and 100% were “very satisfied” with the workshop’s length and structure;71.42% felt they could apply the knowledge in clinical practice, while 28.58% anticipated challenges. The respondents appreciated the workshop’s focus on dysphagia, particularly in elderly patients, and valued the insights into Japanese dysphagia diets and culture. Conclusions: Workshops on nutrition provide an interactive platform for prosthodontists to enhance their knowledge and improve comprehensive patient care, highlighting the importance for prosthodontists to stay updated on developments in nutrition, particularly in dysphagia.展开更多
Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge tran...Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge translation model to guide evidence-based practice in nutrition management, and compare the nutritional status, cardiac function status, quality of life, and quality review indicators of chronic heart failure patients before and after the application of evidence. Results: After the application of evidence, the nutritional status indicators (MNA-SF score, albumin, hemoglobin) of two groups of heart failure patients significantly increased compared to before the application of evidence, with statistically significant differences (p Conclusion: The KTA knowledge translation model provides methodological guidance for the implementation of evidence-based practice for heart failure patients. This evidence-based practice project is beneficial for improving the outcomes of malnutrition in chronic heart failure patients and is conducive to standardizing nursing pathways, thereby promoting the improvement of nursing quality.展开更多
BACKGROUND Body composition analysis(BCA)is primarily used in the management of conditions such as obesity and endocrine disorders.However,its potential in providing nutritional guidance for patients with Alzheimer’s...BACKGROUND Body composition analysis(BCA)is primarily used in the management of conditions such as obesity and endocrine disorders.However,its potential in providing nutritional guidance for patients with Alzheimer’s disease(AD)remains relatively unexplored.AIM To explore the clinical efficacy of BCA-based dietary nutrition scheme on bone metabolism in AD patients.METHODS This retrospective study included 96 patients with AD complicated by osteoporosis who were admitted to The Third Hospital of Quzhou between January 2023 and December 2024.Based on data from previous similar studies,the patients were randomly assigned to either a routine diet(RD)group(n=48)or a personalized nutrition(PN)group(n=48).The RD group received conventional dietary guidance,while the PN group received individualized diet intervention measures based on human BCA.The intervention period lasted for 12 weeks.Bone mineral density(BMD),body mass index(BMI),muscle mass,mineral content,osteocalcin,25-hydroxyvitamin D,procollagen type I N-terminal propeptide(PINP),beta C-terminal telopeptide of type I collagen(β-CTX),and serum calcium were measured and compared between the two groups before and 12 weeks after the intervention.RESULTS No significant differences were observed between groups in terms of age,sex,height,BMI,or other baseline data(P>0.05).In both groups,BMI did not show significant changes after the intervention(P>0.05),whereas muscle mass and mineral content were significantly increased(P<0.05).After the intervention,BMI in the PN group did not differ significantly from that of the RD group,but muscle mass and mineral content were significantly higher in the PN group(P<0.05).After the intervention,a higher proportion of patients in the PN group had a T score>-1 compared to the RD group(P<0.05).The mini-mental state examination(MMSE)score was similar in both groups before the intervention.However,12 weeks after the intervention,the MMSE score in the PN group was significantly higher than that in the RD group(P<0.05).In both groups,the MMSE score significantly increased 12 weeks post-intervention compared to pre-intervention levels(P<0.05).Before the intervention,the levels of osteocalcin,serum calcium,PINP,β-CTX,and 25-hydroxyvitamin D were not significantly different between the two groups(P>0.05).After 12 weeks of intervention,the PN group exhibited higher levels of osteocalcin,serum calcium,and 25-hydroxyvitamin D,as well as lower levels of PINP andβ-CTX,compared to the RD group(P<0.05).In both groups,osteocalcin,serum calcium,and 25-hydroxyvitamin D levels were significantly higher,while PINP andβ-CTX levels were significantly lower after 12 weeks of intervention compared to baseline(P<0.05).CONCLUSION The human BCA-based dietary nutrition regimen plays a crucial role in improving BMD and bone metabolism,with effects that surpass those of conventional nutrition strategies.The findings of this study provide strong evidence for the nutritional management of AD patients.展开更多
BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequen...BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.AIM To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.METHODS In this study,a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients.The subjects were selected as subjects and divided into two groups based on differing nursing interventions,with each group comprising 30 patients.The control group received standard nutritional support and care,whereas the experimental group received individualized nutritional support and nursing strategies.The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices,nutritional status,quality of life(QoL),and complication rates between the two groups.RESULTS The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery,and the average liver function recovery index of the experimental group was 85.significantly higher than that of the control group(73.67±7.19).In terms of nutritional status,the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group,which were 42.33±2.4 g/L and 93.3%,respectively,compared with 36.01±3.85 g/L and 76.7%of the control group.In addition,the average QoL score of the experimental group was 84.66±3.7 points,which was significantly higher than that of the control group(70.92±4.28 points).At the psychological level,the average anxiety score of the experimental group was 1.17±0.29,and the average depression score was 1.47±0.4,which were significantly lower than the 2.26±0.42 and 2.57±0.45 of the control group.This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy.More importantly,the complication rate in the experimental group was only 10%,much lower than the 33.3%in the control group.CONCLUSION Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients.Consequently,it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.展开更多
This study was carried out with the aim of investigating the effect of indigenous microorganism (IMO), effective (EM) and mineral fertilizers (NPK) on the yield and nutritional value of groundnut (Arachis hypogaea) in...This study was carried out with the aim of investigating the effect of indigenous microorganism (IMO), effective (EM) and mineral fertilizers (NPK) on the yield and nutritional value of groundnut (Arachis hypogaea) in Western Cameroon (Baboutcha-Fongam). The study was conducted during two consecutive years, using a completely randomized block design of 8 treatments repeated three times in each subblock. The sub-plots were enriched with 0, 10, 20 and 40 g corresponding to the treatment of EM and IMO respectively and 3.2 g of NPK in 2019. Subsequently, the best dose that resulted in excellent yields was repeated for the rest of the experiment in 2020. The yield parameters and nutritional value of the two varieties of Arachis hypogaea used in the two consecutive years increase with the contribution of the different doses compared to the control. Overall, a significant increase (p A. hypogaea plants fertilized with EM 20 g (2.15 ± 0.24 and 2.01 ± 0.23 t/ha) and plants fertilized with NPK 3.2 g (2.36 ± 0.65 and 2.04 ± 0.17 t/ha) was not significant. On the other hand, there was a significant difference (P ≤ 0.05) between plants fertilized with IMO 10 g (2.65 ± 0.17 and 2.24 ± 0.2 t/ha) and plants fertilized with EM 20 g and plants fertilized with NPK 3.2 g for both varieties during the two years combined. In addition to being local and therefore adapted to environmental conditions, IMOs could be a promising biological means for improving soil fertility in Cameroon.展开更多
BACKGROUND Cirrhotic patients face heightened energy demands,leading to rapid glycogen depletion,protein degradation,oxidative stress,and inflammation,which drive disease progression and complications.These disruption...BACKGROUND Cirrhotic patients face heightened energy demands,leading to rapid glycogen depletion,protein degradation,oxidative stress,and inflammation,which drive disease progression and complications.These disruptions cause cellular damage and parenchymal changes,resulting in vascular alterations,portal hypertension,and liver dysfunction,significantly affecting patient prognosis.AIM To analyze the association between Child–Turcotte–Pugh(CTP)scores and di-fferent nutritional indicators with survival in a 15-year follow-up cohort.METHODS This was a retrospective cohort study with 129 cirrhotic patients of both sexes aged>18 years.Diagnosis of cirrhosis was made by liver biopsy.The first year of data collection was 2007,and data regarding outcomes were collected in 2023.Data were gathered from medical records,and grouped by different methods,including CTP,handgrip strength,and triceps skinfold cutoffs.The prognostic values for mortality were assessed using Kaplan–Meier curves and multivariate binary logistic regression models.RESULTS The coefficient for CTP was the only statistically significant variable(Wald=5.193,P=0.023).This suggests that with a negative change in CTP classification score,the odds of survival decrease 52.6%.The other evaluated variables did not significantly predict survival outcomes in the model.Kaplan–Meier survival curves also indicated that CTP classification was the only significant predictor.CONCLUSION Although different classifications showed specific differences in stratification,only CTP showed significant predictive potential.CTP score remains a simple and effective predictive tool for cirrhotic patients even after longer follow-up.展开更多
Objective:This article aims to elaborate the recent research status of perioperative nutrition optimization,in order to help clinical practice.Methods:This study employed a comprehensive and systematic method to searc...Objective:This article aims to elaborate the recent research status of perioperative nutrition optimization,in order to help clinical practice.Methods:This study employed a comprehensive and systematic method to search prominent databases,including PubMed and Web of Science,using carefully selected keywords.Following meticulous screening,the inclusion of high-quality studies was prioritized,and a thorough review of the references was conducted to comprehensively analyze the latest evidence on perioperative nutrition optimization.Results:The main contents include preoperative nutritional risk screening and assessment,nutritional support pathway,immune enhancing nutrition,preoperative and postoperative nutritional management,as well as personalized nutrition optimization strategies for specific populations(such as children,bariatric surgery patients,and cancer patients).Conclusions:In clinical practice,the importance of perioperative nutrition should be emphasized,and personalized nutrition management plans should be developed based on the characteristics and needs of patients.Further research and promotion of perioperative nutrition optimization strategies will help improve the overall prognosis and quality of life of surgical patients.展开更多
Cancer patients are at high risk of malnutrition,which can lead to adverse health outcomes such as prolonged hospitalization,increased complications,and increased mortality.Accurate and timely nutritional assessment p...Cancer patients are at high risk of malnutrition,which can lead to adverse health outcomes such as prolonged hospitalization,increased complications,and increased mortality.Accurate and timely nutritional assessment plays a critical role in effectively managing malnutrition in these patients.However,while many tools exist to assess malnutrition,there is no universally accepted standard.Although different tools have their own strengths and limitations,there is a lack of narrative reviews on nutritional assessment tools for cancer patients.To address this knowledge gap,we conducted a non-systematic literature search using PubMed,Embase,Web of Science,and the Cochrane Library from their inception until May 2023.A total of 90 studies met our selection criteria and were included in our narrative review.We evaluated the applications,strengths,and limitations of 4 commonly used nutritional assessment tools for cancer patients:the Subjective Global Assessment(SGA),Patient-Generated Subjective Global Assessment(PG-SGA),Mini Nutritional Assessment(MNA),and Global Leadership Initiative on Malnutrition(GLIM).Our findings revealed that malnutrition was associated with adverse health outcomes.Each of these 4 tools has its applications,strengths,and limitations.Our findings provide medical staff with a foundation for choosing the optimal tool to rapidly and accurately assess malnutrition in cancer patients.It is essential for medical staff to be familiar with these common tools to ensure effective nutritional management of cancer patients.展开更多
In this editorial we comment on the interesting article by Liu et al.The topic of discussion is the need for a cost-effective and easy-to-use scoring system for predicting the prognosis of colorectal cancer patients.I...In this editorial we comment on the interesting article by Liu et al.The topic of discussion is the need for a cost-effective and easy-to-use scoring system for predicting the prognosis of colorectal cancer patients.In this context,nutritional assessment plays a crucial role in the multimodal evaluation of patients.In particular,the controlling nutritional status score was found to be an effective tool in the clinical decision-making process,in order to customize treatment strategies and to improve patient outcomes.展开更多
Liver cancer represents a grave hepatic condition and constitutes a significant global health concern.Surgical resection remains the principal therapeutic modality for liver cancer.Nevertheless,perioperative malnutrit...Liver cancer represents a grave hepatic condition and constitutes a significant global health concern.Surgical resection remains the principal therapeutic modality for liver cancer.Nevertheless,perioperative malnutrition exerts a notable impact on patients with liver cancer,emerging as an independent risk factor for disease mortality and adverse outcomes.Hence,precise nutritional diagnosis and timely nutritional support hold the potential to enhance therapeutic efficacy and quality of life for liver cancer patients.This study represents a meticulous foray into the literature,extracting data from PubMed,Web of Science,and EMBASE databases,with a focus on the past 5 years.It scrutinizes the impact of malnutrition on patients undergoing liver cancer surgery,the etiological underpinnings of malnutrition within this patient cohort,the critical assessment of perioperative nutritional status,and the strategic approaches to nutritional support.Utilizing rigorous inclusion and exclusion criteria,the amassed scholarly works are meticulously synthesized,methodically organized,and categorically elaborated upon.Ultimately,the authors propose the incorporation of a multidisciplinary nutrition management team during the perioperative period,comprising nutritionists,pharmacists,physicians,nurses,psychologists,and rehabilitation therapists,among other specialized professionals.Together,they collaborate to devise and implement personalized nutritional support plans,monitor patients’nutritional status,and make necessary adjustments as required.Through comprehensive management and intervention,improvements in the nutritional status of liver cancer patients can be achieved,thereby enhancing surgical success rates and facilitating postoperative recovery.It is believed that this manuscript will offer valuable insights to advance the nutritional management during the perioperative phase of liver cancer,aiding in ameliorating patients'nutritional status and treatment outcomes.展开更多
Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate...Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.展开更多
BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplan...BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplant outcomes.AIM To compare the predictive value of various preoperative objective nutritional indicators for determining 30-d mortality and complications following liver transplantation(LT).METHODS A retrospective analysis was conducted on 162 recipients who underwent LT at our institution from December 2019 to June 2022.RESULTS This study identified several independent risk factors associated with 30-d mor-tality,including blood loss,the prognostic nutritional index(PNI),the nutritional risk index(NRI),and the control nutritional status.The 30-d mortality rate was 8.6%.Blood loss,the NRI,and the PNI were found to be independent risk factors for the occurrence of severe postoperative complications.The NRI achieved the highest prediction values for 30-d mortality[area under the curve(AUC)=0.861,P<0.001]and severe complications(AUC=0.643,P=0.011).Compared to those in the high NRI group,the low patients in the NRI group had lower preoperative body mass index and prealbumin and albumin levels,as well as higher alanine aminotransferase and total bilirubin levels,Model for End-stage Liver Disease scores and prothrombin time(P<0.05).Furthermore,the group with a low NRI exhibited significantly greater incidences of intraabdominal bleeding,primary graft nonfunction,and mortality.CONCLUSION The NRI has good predictive value for 30-d mortality and severe complications following LT.The NRI could be an effective tool for transplant surgeons to evaluate perioperative nutritional risk and develop relevant nutritional therapy.展开更多
BACKGROUND The population of elderly patients with gastric cancer is increasing,which is a major public health issue in China.Malnutrition is one of the greatest risk factors for adverse clinical outcomes in elderly p...BACKGROUND The population of elderly patients with gastric cancer is increasing,which is a major public health issue in China.Malnutrition is one of the greatest risk factors for adverse clinical outcomes in elderly patients with gastric cancer.AIM To investigate the preoperative nutritional status and its association with delayed discharge of elderly gastric cancer patients following radical gastrectomy.METHODS A total of 783 patients aged 65 years and older harboring gastric adenocarcinoma and following radical gastrectomy were retrospectively analyzed from the prospectively collected database of Zhongshan Hospital of Hehai University between January 2018 and May 2020.RESULTS The overall rate of malnutrition was 31.8%.The incidence of postoperative complications was significantly higher in the malnourished group compared to the well-nourished group(P<0.001).Nutritional characteristics in the malnourished group,including body mass index,prognostic nutritional index(PNI),albumin,prealbumin,and hemoglobin,were all significantly lower than those in the well-nourished group.The percentage of patients who received postoperative total nutrient admixture was lower in the malnourished group compared to the wellnourished group(22.1%vs 33.5%,P=0.001).Age≥70 years(HR=1.216,95%CI:1.048-1.411),PNI<44.5(HR=1.792,95%CI:1.058-3.032),operation time≥160 minutes(HR=1.431,95%CI:1.237-1.656),and postoperative complications grade III or higher(HR=2.191,95%CI:1.604-2.991)were all recognized as independent risk factors associated with delayed discharge.CONCLUSION Malnutrition is relatively common in elderly patients undergoing gastrectomy.Low PNI is an independent risk factor associated with delay discharge.More strategies are needed to improve the clinical outcome of these patients.展开更多
The concept of precision nutrition was first proposed almost a decade ago.Current research in precision nutrition primarily focuses on comprehending individualized variations in response to dietary intake,with little ...The concept of precision nutrition was first proposed almost a decade ago.Current research in precision nutrition primarily focuses on comprehending individualized variations in response to dietary intake,with little attention being given to other crucial aspects of precision nutrition.Moreover,there is a dearth of comprehensive review studies that portray the landscape and framework of precision nutrition.This review commences by tracing the historical trajectory of nutritional science,with the aim of dissecting the challenges encountered in nutrition science within the new era of disease profiles.This review also deconstructs the field of precision nutrition into four key components:the proposal of the theory for indi-vidualized nutritional requirement phenotypes;the establishment of precise methods for measuring dietary intake and evaluating nutritional status;the creation of multidimensional nutritional interven-tion strategies that address the aspects of what,how,and when to eat;and the construction of a pathway for the translation and integration of scientific research into healthcare practices,utilizing artificial intel-ligence and information platforms.Incorporating these four components,this review further discusses prospective avenues that warrant exploration to achieve the objective of enhancing health through pre-cision nutrition.展开更多
文摘BACKGROUND Gastrointestinal(GI)surgery can significantly affect the nutritional status and immune function of patients.This study aimed to investigate the effects of personalized nutritional care on the recovery of immune function in patients who underwent postoperative GI surgery.AIM To study examines personalized nutritional care’s impact on immune function recovery,nutritional status,and clinical outcomes after GI surgery.METHODS This observational study included 80 patients who underwent GI surgery between 2021 and 2023.Patients received personalized nutritional care based on their individual needs and surgical outcomes.Immune function markers including lymphocyte subsets,immunoglobulins,and cytokines were measured preoperatively and at regular intervals postoperatively.Nutritional status,clinical outcomes,and quality of life were assessed.RESULTS Patients receiving personalized nutritional care showed significant improvements in immune function markers compared to baseline.At 4 weeks postoperatively,CD4+T-cell counts increased by 25%(P<0.001),while interleukin-6 levels decreased by 40%(P<0.001).Nutritional status,as measured by prealbumin and transferrin levels,improved by 30%(P<0.01).Postoperative complications reduced by 35%compared to historical controls.The quality-of-life scores improved by 40%at 3 months postoperatively.CONCLUSION Personalized nutritional care enhances immune function recovery,improves nutritional status,and reduces complications in patients undergoing postoperative GI surgery,highlighting its crucial role in optimizing patient outcomes following such procedures.
文摘Pancreatic cancer is usually associated with a poor prognosis.Surgery is the main curative treatment but pancreatic operations are aggressive and new tools that help clinicians to predict surgical and prognostic outcomes are necessary.Lu et al recently published a retrospective,single centre cohort study evaluating the impact of seven nutritional and inflammatory markers in pancreatic cancer surgical patients:The albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),nutritional risk index,and the geriatric nutritional risk index.A significant correlation was found between the PNI,SII,NLR,and PLR and a hospital discharge of less than 15 days.In a univariable analysis,PNI,SII,NLR and PLR were significantly related to recurrence-free survival and,in a multivariable analysis PNI was associated with overall survival.Various meta-analyses corroborate the results in terms of prognosis but individual studies are discordant on their usefulness.Besides,the cut-off values for these markers vary significantly between studies and there are no clinical trials comparing them to identify the most relevant ones.These are limitations when implementing nutritional and inflammatory biomarkers into clinical practice and further studies are needed in order to answer these questions.
文摘This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer.Lu et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term outcomes.These biomarkers were albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,nutritional risk index,and geriatric nutritional risk index.The PNI was found to be a strong predictor of both overall and recurrence-free survival,underscoring its clinical relevance in managing patients with pancreatic cancer.
文摘Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January and December 2020,were included.Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding.The ratio of beneficial bacteria at the first and second bowel movements after each patient’s admission was calculated and the patients were classified into the increase or decrease group.Among all patients,five each were in the increase and decrease groups.We investigated patient background,changes in sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation(APACHE)Ⅱscores,nutritional doses or methods,and clinical outcomes.Results:No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHEⅡscores at the time of admission.The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group(4/5 vs.0/5,P=0.01).Conclusions:An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition.In the future,accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective.
文摘BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.
文摘Non-communicable diseases (NCDs) are on the rise worldwide and in developing countries like Botswana. Unhealthy eating habits and lack of proper nutrition knowledge cause non-communicable diseases and affect adolescents. It is in adolescence that eating habits are formed that persist till adulthood. Lifestyle interventions are needed to curb NCDs in adolescents. This paper reports the findings of a study that aimed to validate a lifestyle intervention program and its effect on food intake, physical activity, and nutrition knowledge. It was a clustered randomized control trial study conducted in four (4) junior secondary schools. There were 46 participants, 21 in the control and 25 in the intervention arm, who were blindly assigned to each arm by a statistician. Information and skills on nutrition were imparted using the Information, Motivation, and Behavioral Skills model. The program was implemented for eight (8) weeks hourly after school. A questionnaire was used to collect data pre- and post-intervention. Number, proportion, percentage, and independent t-test (mean and SD or median and IQR, p-value) were calculated using numerical and categorical data. The findings showed that the lifestyle intervention was valid, and there was a slight decrease in the intake of sweets among participants in both trial arms (p = 0.066). There was no significant difference in terms of food intake. Only a small number of participants still ate a few fruits, and there was no change in vegetable intake in both trial arms (p = 0.641). There was no change in the intake of fried foods in both trail arms (p = 0.402). Regarding nutrition knowledge, there was a slight significant difference of p = 0.079 between the trial arms. Though the effect of the lifestyle intervention program was not statistically significant, the results are promising, especially if the duration could be increased to a longer period and a larger sample size included.
文摘Purpose: In super-aging societies, prosthodontists will have a growing role and will need to improve their nutrition knowledge. This study aimed to evaluate the effectiveness of a workshop-based model for increasing dysphagia diet awareness among prosthodontists working with head and neck cancer patients. Methods: The study had a post-intervention design and included 10 maxillofacial prosthetic educators from eight countries who participated in a 120-minute workshop focused on theoretical and practical training in nutrition support for patients with dysphagia. Sessions were held in a specialized restaurant in Tokyo and included lectures, observation of Japanese cooking techniques, hands-on preparation of dysphagia-friendly foods, and cross-cultural comparisons. Knowledge, confidence, and practical application were assessed using a post-workshop questionnaire. Descriptive statistics and thematic analysis were used to evaluate outcomes. Results: Seven of the 10 prosthodontists completed the post-intervention questionnaire. All respondents reported overall satisfaction with the workshop. Session content was regarded as easy to understand by 57.14%, appropriate by 28.57%, and easy by 14.29%. Most respondents (85.71%) were “very satisfied” with the instructors’ explanations, and 100% were “very satisfied” with the workshop’s length and structure;71.42% felt they could apply the knowledge in clinical practice, while 28.58% anticipated challenges. The respondents appreciated the workshop’s focus on dysphagia, particularly in elderly patients, and valued the insights into Japanese dysphagia diets and culture. Conclusions: Workshops on nutrition provide an interactive platform for prosthodontists to enhance their knowledge and improve comprehensive patient care, highlighting the importance for prosthodontists to stay updated on developments in nutrition, particularly in dysphagia.
文摘Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge translation model to guide evidence-based practice in nutrition management, and compare the nutritional status, cardiac function status, quality of life, and quality review indicators of chronic heart failure patients before and after the application of evidence. Results: After the application of evidence, the nutritional status indicators (MNA-SF score, albumin, hemoglobin) of two groups of heart failure patients significantly increased compared to before the application of evidence, with statistically significant differences (p Conclusion: The KTA knowledge translation model provides methodological guidance for the implementation of evidence-based practice for heart failure patients. This evidence-based practice project is beneficial for improving the outcomes of malnutrition in chronic heart failure patients and is conducive to standardizing nursing pathways, thereby promoting the improvement of nursing quality.
基金Supported by Science and Technology Bureau of Quzhou,No.2022079.
文摘BACKGROUND Body composition analysis(BCA)is primarily used in the management of conditions such as obesity and endocrine disorders.However,its potential in providing nutritional guidance for patients with Alzheimer’s disease(AD)remains relatively unexplored.AIM To explore the clinical efficacy of BCA-based dietary nutrition scheme on bone metabolism in AD patients.METHODS This retrospective study included 96 patients with AD complicated by osteoporosis who were admitted to The Third Hospital of Quzhou between January 2023 and December 2024.Based on data from previous similar studies,the patients were randomly assigned to either a routine diet(RD)group(n=48)or a personalized nutrition(PN)group(n=48).The RD group received conventional dietary guidance,while the PN group received individualized diet intervention measures based on human BCA.The intervention period lasted for 12 weeks.Bone mineral density(BMD),body mass index(BMI),muscle mass,mineral content,osteocalcin,25-hydroxyvitamin D,procollagen type I N-terminal propeptide(PINP),beta C-terminal telopeptide of type I collagen(β-CTX),and serum calcium were measured and compared between the two groups before and 12 weeks after the intervention.RESULTS No significant differences were observed between groups in terms of age,sex,height,BMI,or other baseline data(P>0.05).In both groups,BMI did not show significant changes after the intervention(P>0.05),whereas muscle mass and mineral content were significantly increased(P<0.05).After the intervention,BMI in the PN group did not differ significantly from that of the RD group,but muscle mass and mineral content were significantly higher in the PN group(P<0.05).After the intervention,a higher proportion of patients in the PN group had a T score>-1 compared to the RD group(P<0.05).The mini-mental state examination(MMSE)score was similar in both groups before the intervention.However,12 weeks after the intervention,the MMSE score in the PN group was significantly higher than that in the RD group(P<0.05).In both groups,the MMSE score significantly increased 12 weeks post-intervention compared to pre-intervention levels(P<0.05).Before the intervention,the levels of osteocalcin,serum calcium,PINP,β-CTX,and 25-hydroxyvitamin D were not significantly different between the two groups(P>0.05).After 12 weeks of intervention,the PN group exhibited higher levels of osteocalcin,serum calcium,and 25-hydroxyvitamin D,as well as lower levels of PINP andβ-CTX,compared to the RD group(P<0.05).In both groups,osteocalcin,serum calcium,and 25-hydroxyvitamin D levels were significantly higher,while PINP andβ-CTX levels were significantly lower after 12 weeks of intervention compared to baseline(P<0.05).CONCLUSION The human BCA-based dietary nutrition regimen plays a crucial role in improving BMD and bone metabolism,with effects that surpass those of conventional nutrition strategies.The findings of this study provide strong evidence for the nutritional management of AD patients.
文摘BACKGROUND Hepatocellular carcinoma ranks among the most prevalent malignant neoplasms.Surgical intervention constitutes a critical therapeutic approach for this condition.Nonetheless,postoperative recovery is frequently influenced by the patient's nutritional status and the quality of nursing care provided.AIM To examine the comprehensive impact of personalized nutritional support and nursing strategies on the postoperative rehabilitation of patients with liver cancer.METHODS In this study,a retrospective comparative analysis was conducted involving 60 post-operative liver cancer patients.The subjects were selected as subjects and divided into two groups based on differing nursing interventions,with each group comprising 30 patients.The control group received standard nutritional support and care,whereas the experimental group received individualized nutritional support and nursing strategies.The study aimed to evaluate the impact of individualized nutrition by comparing the rehabilitation indices,nutritional status,quality of life(QoL),and complication rates between the two groups.RESULTS The results showed that the recovery index of the experimental group was significantly better than that of the control group 2 weeks after surgery,and the average liver function recovery index of the experimental group was 85.significantly higher than that of the control group(73.67±7.19).In terms of nutritional status,the serum albumin level and body weight stabilization rate of the experimental group were also significantly higher than those of the control group,which were 42.33±2.4 g/L and 93.3%,respectively,compared with 36.01±3.85 g/L and 76.7%of the control group.In addition,the average QoL score of the experimental group was 84.66±3.7 points,which was significantly higher than that of the control group(70.92±4.28 points).At the psychological level,the average anxiety score of the experimental group was 1.17±0.29,and the average depression score was 1.47±0.4,which were significantly lower than the 2.26±0.42 and 2.57±0.45 of the control group.This showed that patients in the experimental group were better relieved of anxiety and depression under the individualized nutrition support and nursing strategy.More importantly,the complication rate in the experimental group was only 10%,much lower than the 33.3%in the control group.CONCLUSION Personalized nutritional support and tailored nursing strategies significantly enhance the postoperative rehabilitation of liver cancer patients.Consequently,it is recommended to implement and advocate for these individualized approaches to improve both the recovery outcomes and QoL for these patients.
文摘This study was carried out with the aim of investigating the effect of indigenous microorganism (IMO), effective (EM) and mineral fertilizers (NPK) on the yield and nutritional value of groundnut (Arachis hypogaea) in Western Cameroon (Baboutcha-Fongam). The study was conducted during two consecutive years, using a completely randomized block design of 8 treatments repeated three times in each subblock. The sub-plots were enriched with 0, 10, 20 and 40 g corresponding to the treatment of EM and IMO respectively and 3.2 g of NPK in 2019. Subsequently, the best dose that resulted in excellent yields was repeated for the rest of the experiment in 2020. The yield parameters and nutritional value of the two varieties of Arachis hypogaea used in the two consecutive years increase with the contribution of the different doses compared to the control. Overall, a significant increase (p A. hypogaea plants fertilized with EM 20 g (2.15 ± 0.24 and 2.01 ± 0.23 t/ha) and plants fertilized with NPK 3.2 g (2.36 ± 0.65 and 2.04 ± 0.17 t/ha) was not significant. On the other hand, there was a significant difference (P ≤ 0.05) between plants fertilized with IMO 10 g (2.65 ± 0.17 and 2.24 ± 0.2 t/ha) and plants fertilized with EM 20 g and plants fertilized with NPK 3.2 g for both varieties during the two years combined. In addition to being local and therefore adapted to environmental conditions, IMOs could be a promising biological means for improving soil fertility in Cameroon.
文摘BACKGROUND Cirrhotic patients face heightened energy demands,leading to rapid glycogen depletion,protein degradation,oxidative stress,and inflammation,which drive disease progression and complications.These disruptions cause cellular damage and parenchymal changes,resulting in vascular alterations,portal hypertension,and liver dysfunction,significantly affecting patient prognosis.AIM To analyze the association between Child–Turcotte–Pugh(CTP)scores and di-fferent nutritional indicators with survival in a 15-year follow-up cohort.METHODS This was a retrospective cohort study with 129 cirrhotic patients of both sexes aged>18 years.Diagnosis of cirrhosis was made by liver biopsy.The first year of data collection was 2007,and data regarding outcomes were collected in 2023.Data were gathered from medical records,and grouped by different methods,including CTP,handgrip strength,and triceps skinfold cutoffs.The prognostic values for mortality were assessed using Kaplan–Meier curves and multivariate binary logistic regression models.RESULTS The coefficient for CTP was the only statistically significant variable(Wald=5.193,P=0.023).This suggests that with a negative change in CTP classification score,the odds of survival decrease 52.6%.The other evaluated variables did not significantly predict survival outcomes in the model.Kaplan–Meier survival curves also indicated that CTP classification was the only significant predictor.CONCLUSION Although different classifications showed specific differences in stratification,only CTP showed significant predictive potential.CTP score remains a simple and effective predictive tool for cirrhotic patients even after longer follow-up.
基金supported by Emerging Industry Leading Talent Project of Shanxi Province (No.2020587).
文摘Objective:This article aims to elaborate the recent research status of perioperative nutrition optimization,in order to help clinical practice.Methods:This study employed a comprehensive and systematic method to search prominent databases,including PubMed and Web of Science,using carefully selected keywords.Following meticulous screening,the inclusion of high-quality studies was prioritized,and a thorough review of the references was conducted to comprehensively analyze the latest evidence on perioperative nutrition optimization.Results:The main contents include preoperative nutritional risk screening and assessment,nutritional support pathway,immune enhancing nutrition,preoperative and postoperative nutritional management,as well as personalized nutrition optimization strategies for specific populations(such as children,bariatric surgery patients,and cancer patients).Conclusions:In clinical practice,the importance of perioperative nutrition should be emphasized,and personalized nutrition management plans should be developed based on the characteristics and needs of patients.Further research and promotion of perioperative nutrition optimization strategies will help improve the overall prognosis and quality of life of surgical patients.
基金financially supported by the Guangxi Medical University 2023 Innovation and Entrepreneurship Training Program Project(No.202310598015).
文摘Cancer patients are at high risk of malnutrition,which can lead to adverse health outcomes such as prolonged hospitalization,increased complications,and increased mortality.Accurate and timely nutritional assessment plays a critical role in effectively managing malnutrition in these patients.However,while many tools exist to assess malnutrition,there is no universally accepted standard.Although different tools have their own strengths and limitations,there is a lack of narrative reviews on nutritional assessment tools for cancer patients.To address this knowledge gap,we conducted a non-systematic literature search using PubMed,Embase,Web of Science,and the Cochrane Library from their inception until May 2023.A total of 90 studies met our selection criteria and were included in our narrative review.We evaluated the applications,strengths,and limitations of 4 commonly used nutritional assessment tools for cancer patients:the Subjective Global Assessment(SGA),Patient-Generated Subjective Global Assessment(PG-SGA),Mini Nutritional Assessment(MNA),and Global Leadership Initiative on Malnutrition(GLIM).Our findings revealed that malnutrition was associated with adverse health outcomes.Each of these 4 tools has its applications,strengths,and limitations.Our findings provide medical staff with a foundation for choosing the optimal tool to rapidly and accurately assess malnutrition in cancer patients.It is essential for medical staff to be familiar with these common tools to ensure effective nutritional management of cancer patients.
文摘In this editorial we comment on the interesting article by Liu et al.The topic of discussion is the need for a cost-effective and easy-to-use scoring system for predicting the prognosis of colorectal cancer patients.In this context,nutritional assessment plays a crucial role in the multimodal evaluation of patients.In particular,the controlling nutritional status score was found to be an effective tool in the clinical decision-making process,in order to customize treatment strategies and to improve patient outcomes.
基金National Natural Science Foundation of China,No 81701888Science and Technology Program of Sichuan Province,No.2023YFS0206Scientific Research Project of Sichuan Cadre Health Committee,No.2022-211.
文摘Liver cancer represents a grave hepatic condition and constitutes a significant global health concern.Surgical resection remains the principal therapeutic modality for liver cancer.Nevertheless,perioperative malnutrition exerts a notable impact on patients with liver cancer,emerging as an independent risk factor for disease mortality and adverse outcomes.Hence,precise nutritional diagnosis and timely nutritional support hold the potential to enhance therapeutic efficacy and quality of life for liver cancer patients.This study represents a meticulous foray into the literature,extracting data from PubMed,Web of Science,and EMBASE databases,with a focus on the past 5 years.It scrutinizes the impact of malnutrition on patients undergoing liver cancer surgery,the etiological underpinnings of malnutrition within this patient cohort,the critical assessment of perioperative nutritional status,and the strategic approaches to nutritional support.Utilizing rigorous inclusion and exclusion criteria,the amassed scholarly works are meticulously synthesized,methodically organized,and categorically elaborated upon.Ultimately,the authors propose the incorporation of a multidisciplinary nutrition management team during the perioperative period,comprising nutritionists,pharmacists,physicians,nurses,psychologists,and rehabilitation therapists,among other specialized professionals.Together,they collaborate to devise and implement personalized nutritional support plans,monitor patients’nutritional status,and make necessary adjustments as required.Through comprehensive management and intervention,improvements in the nutritional status of liver cancer patients can be achieved,thereby enhancing surgical success rates and facilitating postoperative recovery.It is believed that this manuscript will offer valuable insights to advance the nutritional management during the perioperative phase of liver cancer,aiding in ameliorating patients'nutritional status and treatment outcomes.
文摘Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.
基金Supported by The Self-Funded Research Project of the Health Commission of Guangxi Zhuang Autonomous Region,No.Z-A20230045.
文摘BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplant outcomes.AIM To compare the predictive value of various preoperative objective nutritional indicators for determining 30-d mortality and complications following liver transplantation(LT).METHODS A retrospective analysis was conducted on 162 recipients who underwent LT at our institution from December 2019 to June 2022.RESULTS This study identified several independent risk factors associated with 30-d mor-tality,including blood loss,the prognostic nutritional index(PNI),the nutritional risk index(NRI),and the control nutritional status.The 30-d mortality rate was 8.6%.Blood loss,the NRI,and the PNI were found to be independent risk factors for the occurrence of severe postoperative complications.The NRI achieved the highest prediction values for 30-d mortality[area under the curve(AUC)=0.861,P<0.001]and severe complications(AUC=0.643,P=0.011).Compared to those in the high NRI group,the low patients in the NRI group had lower preoperative body mass index and prealbumin and albumin levels,as well as higher alanine aminotransferase and total bilirubin levels,Model for End-stage Liver Disease scores and prothrombin time(P<0.05).Furthermore,the group with a low NRI exhibited significantly greater incidences of intraabdominal bleeding,primary graft nonfunction,and mortality.CONCLUSION The NRI has good predictive value for 30-d mortality and severe complications following LT.The NRI could be an effective tool for transplant surgeons to evaluate perioperative nutritional risk and develop relevant nutritional therapy.
基金Supported by National Natural Science Foundation of China,No.82373417Natural Science Foundation of Shanghai,No.23ZR1409900+1 种基金Clinical Research Plan of SHDC,No.SHDC2020CR3048BClinical Research Fund of Zhongshan Hospital,Hehai University,No.ZSLCYJ202343.
文摘BACKGROUND The population of elderly patients with gastric cancer is increasing,which is a major public health issue in China.Malnutrition is one of the greatest risk factors for adverse clinical outcomes in elderly patients with gastric cancer.AIM To investigate the preoperative nutritional status and its association with delayed discharge of elderly gastric cancer patients following radical gastrectomy.METHODS A total of 783 patients aged 65 years and older harboring gastric adenocarcinoma and following radical gastrectomy were retrospectively analyzed from the prospectively collected database of Zhongshan Hospital of Hehai University between January 2018 and May 2020.RESULTS The overall rate of malnutrition was 31.8%.The incidence of postoperative complications was significantly higher in the malnourished group compared to the well-nourished group(P<0.001).Nutritional characteristics in the malnourished group,including body mass index,prognostic nutritional index(PNI),albumin,prealbumin,and hemoglobin,were all significantly lower than those in the well-nourished group.The percentage of patients who received postoperative total nutrient admixture was lower in the malnourished group compared to the wellnourished group(22.1%vs 33.5%,P=0.001).Age≥70 years(HR=1.216,95%CI:1.048-1.411),PNI<44.5(HR=1.792,95%CI:1.058-3.032),operation time≥160 minutes(HR=1.431,95%CI:1.237-1.656),and postoperative complications grade III or higher(HR=2.191,95%CI:1.604-2.991)were all recognized as independent risk factors associated with delayed discharge.CONCLUSION Malnutrition is relatively common in elderly patients undergoing gastrectomy.Low PNI is an independent risk factor associated with delay discharge.More strategies are needed to improve the clinical outcome of these patients.
基金supported funds from the National Natural Science Foundation(U21A20398 to Changhao Sun,82173498 to Tianshu Han82204016 to Wei Wei,82204017 to Wenbo Jiang).
文摘The concept of precision nutrition was first proposed almost a decade ago.Current research in precision nutrition primarily focuses on comprehending individualized variations in response to dietary intake,with little attention being given to other crucial aspects of precision nutrition.Moreover,there is a dearth of comprehensive review studies that portray the landscape and framework of precision nutrition.This review commences by tracing the historical trajectory of nutritional science,with the aim of dissecting the challenges encountered in nutrition science within the new era of disease profiles.This review also deconstructs the field of precision nutrition into four key components:the proposal of the theory for indi-vidualized nutritional requirement phenotypes;the establishment of precise methods for measuring dietary intake and evaluating nutritional status;the creation of multidimensional nutritional interven-tion strategies that address the aspects of what,how,and when to eat;and the construction of a pathway for the translation and integration of scientific research into healthcare practices,utilizing artificial intel-ligence and information platforms.Incorporating these four components,this review further discusses prospective avenues that warrant exploration to achieve the objective of enhancing health through pre-cision nutrition.
