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Impact of sarcopenia and muscle strength on postoperative complication risk following pancreatic resection 胰腺切除术后,肌肉疏松症和肌肉力量对术后并发症风险的影响。
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-11 DOI: 10.1016/j.clnesp.2024.10.003
Sabrina Wielsøe , Anna Sundberg , Thomas S. Kristensen , Jan Christensen , Martin Sillesen , Carsten P. Hansen , Stefan K. Burgdorf , Bente K. Pedersen , Charlotte Suetta , Jesper F. Christensen , Casper Simonsen

Background and aims

The association between sarcopenia and postoperative complications has been widely reported in patients with cancer. Yet, the lack of standardized population-specific diagnostic cut-off points and assessments of muscle strength is hampering prospective clinical utilization. Therefore, we aimed to examine the impact of sarcopenia, defined by both regional and international cut-off points, along with various methods of measuring skeletal muscle and muscle strength, on the risk of postoperative complications following pancreatic resection.

Methods

The present prospective observational study enrolled patients scheduled for pancreatic resection. Body composition was assessed by DXA and CT prior to surgery. We applied the algorithm and cut-off points suggested by the European Working Group on Sarcopenia in Older People (EWGSOP) as well as cut-off points from a Danish normative reference population to classify patients as sarcopenic. Physical performance was assessed by usual gait speed while muscle strength was assessed by handgrip strength, leg extensor power, and 30-s sit-to-stand. Postoperative complications within 30 days following surgery were classified according to the Clavien-Dindo classification and the American College of Surgeons National Surgical Quality Improvement Program. Complications graded ≥3 according to Clavien-Dindo were considered major complications.

Results

A total of 134 patients with a mean age of 67 years (SD: 9) were enrolled of whom most underwent pancreaticoduodenectomy (64 %). Using international cut-off points, eight patients (7 %) were classified as sarcopenic using CT scans and sarcopenia was associated with an increased risk of major postoperative complications (RR 2.14 [1.33–3.43]). Using DXA, four patients (3 %) were classified as sarcopenic, all of whom experienced a major complication. With regional cut-off points, 16 patients (13 %) were classified as sarcopenic using CT scans, but sarcopenia was not associated with major complications (RR 1.39 [0.80–2.42]). Nine patients (7 %) were classified as sarcopenic using DXA, but sarcopenia was not associated with major complications (RR 1.15 [0.54–2.48]). Across the different muscle strength assessment methods, handgrip strength consistently demonstrated a stronger association with postoperative complications.

Conclusion

Sarcopenia defined according to the EWGSOP criteria and with international cut-off points is associated with an increased risk of postoperative complications following pancreatic resection. Using regionally based cut-off points, the prevalence of sarcopenia is higher, but it does not confer a higher postoperative complication risk. The use of different muscle strength assessment methods results in vastly different estimates of prevalence of low strength and associations with postoperative outcomes.
背景和目的:在癌症患者中,肌肉疏松症与术后并发症之间的关联已被广泛报道。然而,由于缺乏针对特定人群的标准化诊断临界点和肌肉力量评估,阻碍了前瞻性临床利用。因此,我们旨在研究根据地区和国际临界点定义的肌肉疏松症以及各种测量骨骼肌和肌力的方法对胰腺切除术后并发症风险的影响:本前瞻性观察研究招募了计划进行胰腺切除术的患者。手术前通过 DXA 和 CT 评估身体成分。我们采用了欧洲老年人肌肉疏松症工作组(EWGSOP)建议的算法和临界点,以及丹麦标准参考人群的临界点,将患者划分为肌肉疏松症患者。体能表现通过平时的步速进行评估,而肌肉力量则通过手握力量、腿部伸展力量和30秒坐立进行评估。术后30天内的并发症根据克拉维恩-丁多分类法和美国外科学院国家外科质量改进计划进行分类。根据克拉维恩-丁多分级法,并发症≥3级被视为主要并发症:共纳入 134 名患者,平均年龄为 67 岁(SD:9),其中大部分患者接受了胰十二指肠切除术(64%)。根据国际截断点,8 名患者(7%)通过 CT 扫描被归类为肌无力患者,而肌无力与术后主要并发症的风险增加有关(RR 2.14 [1.33-3.43])。使用 DXA,有四名患者(3%)被归类为肌肉疏松症患者,他们都出现了重大并发症。根据区域截断点,16 名患者(13%)通过 CT 扫描被归类为肌肉疏松症,但肌肉疏松症与主要并发症无关(RR 1.39 [0.80-2.42])。九名患者(7%)使用 DXA 被归类为肌肉疏松症,但肌肉疏松症与主要并发症无关(RR 1.15 [0.54-2.48])。在不同的肌力评估方法中,手握力始终与术后并发症有更密切的关系:结论:根据 EWGSOP 标准和国际截断点定义的肌肉疏松症与胰腺切除术后并发症风险增加有关。使用基于地区的截断点,肌肉疏松症的发生率更高,但并不会带来更高的术后并发症风险。使用不同的肌力评估方法会导致对低肌力患病率以及与术后结果相关性的估计大相径庭。
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引用次数: 0
Significance of combining sarcopenia and protein-energy wasting in patients receiving hemodialysis 血液透析患者合并肌少症和蛋白质能量消耗的意义
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-11 DOI: 10.1016/j.clnesp.2024.10.005
Takahiro Yajima
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引用次数: 0
Corrigendum to “Operational recommendations for the implementation of home parenteral nutrition program of care according to the guidelines of the European society for clinical nutrition and metabolism” [Clin Nutr ESPEN 63 (2024) 668–675] 根据欧洲临床营养与代谢学会指南实施家庭肠外营养护理计划的操作建议"[Clin Nutr ESPEN 63 (2024) 668-675]的更正。
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-10 DOI: 10.1016/j.clnesp.2024.09.028
Loris Pironi , Cristina Cuerda , Palle Bekker Jeppesen , Francisca Joly , Simon Lal , Georg Lamprecht , Manpreet S. Mundi , Kinga Szczepanek , André Van Gossum , Tim Vanuytsel , Geert Wanten , Arved Weimann , Stephan C. Bischoff
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引用次数: 0
Letter to the editor - “Dietary and lifestyle inflammation scores in relation to colorectal cancer recurrence and all-cause mortality: A longitudinal analysis” 致编辑的信--"饮食和生活方式炎症评分与结直肠癌复发和全因死亡率的关系:纵向分析"。
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-08 DOI: 10.1016/j.clnesp.2024.09.030
Jie Qin, Xueli Zheng, Juanjuan Huang, Yan Feng, Bei Feng
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引用次数: 0
Comment on “Identifying solutions to minimize meal tray waste: A mixed-method approach” Clinical Nutrition ESPEN 2024 关于 "确定最大限度减少餐盘浪费的解决方案:临床营养学 ESPEN 2024》。
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-05 DOI: 10.1016/j.clnesp.2024.09.031
Eder Magnus Almeida Alves Filho, Clarice Beatriz Gonçalves Silva, Matheus Santos de Souza Fernandes, Raphael Fabricio de Souza
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引用次数: 0
Letter to the editor: Comment on “Maternal hemoglobin and iron status in early pregnancy and childhood cardiac outcomes” 致编辑的信:就 "孕早期母体血红蛋白和铁的状况与儿童心脏预后 "发表评论。
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 DOI: 10.1016/j.clnesp.2024.09.027
Erika Vanesa Cadena-Burbano, Ana Elisa Toscano, Joaci Pereira dos Santos-Junior, Danielle da Fonseca Dourado, Isla Ariadny Amaral de Souza Gonzaga Paz, Eulália Rebeca da Silva-Araújo, Paula Brielle Pontes
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引用次数: 0
How to interpret and apply the results of indirect calorimetry studies: A case-based tutorial. 如何解释和应用间接量热法研究结果:基于案例的教程。
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 Epub Date: 2024-08-07 DOI: 10.1016/j.clnesp.2024.07.1055
Mette M Berger, Elisabeth De Waele, Leah Gramlich, Jennifer Jin, Olivier Pantet, Claude Pichard, Ashlee Jean Roffe, Lindsey Russell, Pierre Singer, Paul E Wischmeyer

Evidence is growing that the individual adjustment of energy targets guided by indirect calorimetry (IC) can improve outcome. With the development of a new generation of devices that are easier to use and rapid, it appears important to share knowledge and expertise that may be used to individualize nutrition care. Despite the focus of this tutorial being on one contemporary device, the principles of IC apply across existing devices and can assist tailoring the nutrition prescription and in assessing response to nutrition therapy. The present tutorial addresses its clinical application in intubated mechanically ventilated and spontaneously breathing adult patients (canopy), i.e. it covers the range from critical illness to outpatients. The cases that are presented show how the measured energy expenditure (mEE), and the respiratory quotient (RQ), i.e. the ratio of expired CO2 to consumed O2, should be applied in different cases, to adapt and individualize nutrition prescription, as it is a good marker of over- or underfeeding at the different stages of disease. The RQ also informs about the patient's body's capacity to use different substrates: the variations of RQ indicating the metabolic changes revealing insufficient or excessive feeding. The different cases reflect the use of a new generation device as a metabolic monitor that should be combined with other clinical observations and laboratory biomarkers. The tutorial also points to some shortcomings of the method, proposing alternatives.

越来越多的证据表明,在间接热量计(IC)的指导下对能量目标进行个体化调整可以改善治疗效果。随着更易于使用和快速的新一代设备的开发,分享可用于个体化营养护理的知识和专业技术显得尤为重要。尽管本教程的重点是当代的一种设备,但 IC 的原理适用于现有的各种设备,可以帮助定制营养处方和评估对营养治疗的反应。本教程介绍了其在插管机械通气和自主呼吸成人患者(天幕)中的临床应用,即涵盖了从危重病人到门诊病人的范围。所介绍的病例展示了如何在不同病例中应用测量的能量消耗(mEE)和呼吸商(RQ),即呼出的二氧化碳与消耗的氧气之比,以调整和个性化营养处方,因为它是疾病不同阶段过量或不足喂养的良好标志。RQ 还能反映病人身体使用不同底物的能力:RQ 的变化表明新陈代谢的变化,显示喂养不足或喂养过度。不同的病例反映了新一代设备作为代谢监测仪的使用情况,它应与其他临床观察和实验室生物标志物相结合。教程还指出了该方法的一些不足之处,并提出了替代方法。
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引用次数: 0
Retraction notice to "Corrigendum to 'The correlation of serum adiponectin and insulin resistance with the presence and severity of dementia in non-obese Alzheimer's patients'" [Clin Nutr ESPEN 53C (2023) 282 / 1590]. 非肥胖阿尔茨海默病患者血清脂肪连接蛋白和胰岛素抵抗与痴呆症的存在和严重程度的相关性 "的更正通知[Clin Nutr ESPEN 53C (2023) 282 / 1590]。
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 DOI: 10.1016/j.clnesp.2024.06.031
Seyed Amir Hejazi, Kambiz Rohampour, Ehsan Sharifipour, Soruosh Sharifimoghadam, Sepideh Paybast, Abdoreza Ghoreishi, Navid Hassanzadeh, Mostafa Vahedian
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引用次数: 0
Effect of perioperative immunonutrition intervention among gynecological cancer patients: A systematic review 妇科癌症患者围手术期免疫营养干预的效果:系统回顾
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 DOI: 10.1016/j.clnesp.2024.09.022
ChiouYi Ho , Barakatun Nisak Mohd Yusof , Hazreen Abdul Majid , Zulfitri Azuan Mat Daud

Background

Gynecologic cancer (GC) patients often experience systemic inflammation, malnutrition, and compromised postoperative outcomes. This systematic review aims to comprehensively synthesize existing data regarding the impact of perioperative immunonutrition (IMN) intervention on GC patients.

Methods

The databases of CENTRAL, EMBASE, Web of Science, and the Cochrane Library were used to conduct a literature search, supplemented by internet search engines and manual searches. Publications released between January 2009 and October 2023 was identified, reviewed, and data extracted.

Results

The review encompasses six studies involving 712 patients, comprising two randomized controlled trials (RCTs), two prospective studies, and two retrospective cohort studies. Three studies prescribed IMN perioperatively; two pre-operatively and one post-operatively. Four out of six studies reported less post-operative infection and complications. Two studies reported shorter hospitalization using the IMN formula. One study reported a longer hospitalization with IMN supplementation. Overall survival showed no significant difference in the two studies. Four studies reported positive modulation of inflammatory markers and lymphocytes as outcomes, with IMN formulas.

Discussion and conclusion

Perioperative IMN emerge as a promising intervention, demonstrating notable benefits included shortened hospitalization as well and positive modulation of inflammatory markers.
背景:妇科癌症(GC)患者经常会出现全身性炎症、营养不良和术后效果受损。本系统综述旨在全面综合围手术期免疫营养(IMN)干预对 GC 患者影响的现有数据:方法:使用 CENTRAL、EMBASE、Web of Science 和 Cochrane Library 等数据库进行文献检索,并辅以互联网搜索引擎和人工检索。对 2009 年 1 月至 2023 年 10 月间发表的文献进行了识别、审查和数据提取:综述包括六项研究,涉及 712 名患者,其中包括两项随机对照试验 (RCT)、两项前瞻性研究和两项回顾性队列研究。三项研究在围手术期使用 IMN,两项在术前使用,一项在术后使用。六项研究中有四项报告称术后感染和并发症较少。两项研究报告称,使用 IMN 配方的住院时间更短。一项研究报告称,补充 IMN 会延长住院时间。两项研究的总生存率无明显差异。四项研究报告称,IMN配方对炎症标志物和淋巴细胞有积极的调节作用:围手术期 IMN 是一种很有前景的干预措施,其显著的益处包括缩短了住院时间以及对炎症标志物有积极的调节作用。
{"title":"Effect of perioperative immunonutrition intervention among gynecological cancer patients: A systematic review","authors":"ChiouYi Ho ,&nbsp;Barakatun Nisak Mohd Yusof ,&nbsp;Hazreen Abdul Majid ,&nbsp;Zulfitri Azuan Mat Daud","doi":"10.1016/j.clnesp.2024.09.022","DOIUrl":"10.1016/j.clnesp.2024.09.022","url":null,"abstract":"<div><h3>Background</h3><div>Gynecologic cancer (GC) patients often experience systemic inflammation, malnutrition, and compromised postoperative outcomes. This systematic review aims to comprehensively synthesize existing data regarding the impact of perioperative immunonutrition (IMN) intervention on GC patients.</div></div><div><h3>Methods</h3><div>The databases of CENTRAL, EMBASE, Web of Science, and the Cochrane Library were used to conduct a literature search, supplemented by internet search engines and manual searches. Publications released between January 2009 and October 2023 was identified, reviewed, and data extracted.</div></div><div><h3>Results</h3><div>The review encompasses six studies involving 712 patients, comprising two randomized controlled trials (RCTs), two prospective studies, and two retrospective cohort studies. Three studies prescribed IMN perioperatively; two pre-operatively and one post-operatively. Four out of six studies reported less post-operative infection and complications. Two studies reported shorter hospitalization using the IMN formula. One study reported a longer hospitalization with IMN supplementation. Overall survival showed no significant difference in the two studies. Four studies reported positive modulation of inflammatory markers and lymphocytes as outcomes, with IMN formulas.</div></div><div><h3>Discussion and conclusion</h3><div>Perioperative IMN emerge as a promising intervention, demonstrating notable benefits included shortened hospitalization as well and positive modulation of inflammatory markers.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 168-176"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Retraction notice to "The correlation of serum adiponectin and insulin resistance with the presence and severity of dementia in non-obese Alzheimer's patients" [Clin Nutr ESPEN 40C (2020) 376-382/706]. 非肥胖阿尔茨海默病患者血清脂肪连接蛋白和胰岛素抵抗与痴呆症的存在和严重程度的相关性》[Clin Nutr ESPEN 40C (2020) 376-382/706]的撤稿通知。
IF 2.9 Q3 NUTRITION & DIETETICS Pub Date : 2024-10-01 DOI: 10.1016/j.clnesp.2024.06.004
Seyed Amir Hejazi, Kambiz Rohampour, Ehsan Sharifipour, Soruosh Sharifimoghadam, Sepideh Paybast, Abdoreza Ghoreishi, Navid Hassanzadeh, Mostafa Vahedian
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引用次数: 0
期刊
Clinical nutrition ESPEN
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