Journal of Parenteral and Enteral Nutrition最新文献

{"title":"Least significant change with repeat bioelectrical impedance analysis measurements in children with metabolic dysfunction–associated steatotic liver disease: A descriptive cohort study","authors":"Alexandria Speakman DO,&nbsp;Kathryn Hitchcock MS, RD,&nbsp;Emily Romantic RD,&nbsp;Venancio Quiambao RD,&nbsp;Abigail Lepolt RD, CSP,&nbsp;Ana Catalina Arce-Clachar MD,&nbsp;Kristin Bramlage MD,&nbsp;Lin Fei PhD,&nbsp;Qin Sun MS,&nbsp;Stavra Xanthakos MD, MS,&nbsp;Marialena Mouzaki MD, MSc","doi":"10.1002/jpen.2706","DOIUrl":"10.1002/jpen.2706","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bioelectrical impedance is used clinically to assess body composition. To determine true (rather than chance/measurement error) change in bioelectrical impedance analysis measurements over time, it is necessary to know their least significant change. Least significant change represents values exceeding the 95% prediction interval of the precision error of repeat measurements. The least significant change of repeat bioelectrical impedance analysis measurements in children with obesity and metabolic dysfunction–associated steatotic liver disease is currently unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a prospective, single-center, descriptive cohort study in youth 6–20 years of age with obesity and metabolic dysfunction–associated steatotic liver disease. Two same-day bioelectrical impedance analysis measurements were performed on a multifrequency, octopolar device (InBody 370). Fat mass and fat-free mass were adjusted for age using respective indices (dividing by height squared). Fasting status was determined by patient report. Descriptive statistics (medians with interquartile ranges and means with standard deviations and proportions) were used; the least significant change between repeat measurements with precision interval was calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We recruited 43 patients (81% male; 33% Hispanic; median age: 14 years [interquartile range: 11–16]; median body mass index <i>z</i> score: 2.31 [interquartile range: 2.84–2.65]). A total of 60% were fasting, for a median of 12 h. The least significant change of fat mass index was 0.5 (precision interval: −0.4 to 0.5) kg/m², fat-free mass index was 0.3 (precision interval: −0.3 to 0.3) kg/m², and body fat percent was 1.5% (precision interval: −1.3 to 1.50). Fasting status affected least significant change measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In youth with obesity and metabolic dysfunction–associated steatotic liver disease, repeat bioelectrical impedance analysis measurements beyond least significant change and precision interval determined in this study likely represent true changes in body composition over time, vs measurement error.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 2","pages":"200-206"},"PeriodicalIF":3.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between early enteral nutrition and length of stay in neonates with congenital bowel obstruction: A retrospective cohort study","authors":"Manisha B. Bhatia MD, MPH,&nbsp;Sai Nelanuthala MD,&nbsp;Tasha Sparks Joplin MD, MPH,&nbsp;Cassandra Anderson MD, MPH,&nbsp;Michael Sobolic MD,&nbsp;Brian W. Gray MD","doi":"10.1002/jpen.2702","DOIUrl":"10.1002/jpen.2702","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The optimal feeding strategy for postoperative neonatal patients with congenital bowel obstruction is widely debated. This study aims to evaluate perioperative characteristics and postoperative nutrition practices for patients with congenital bowel obstruction. We hypothesized that earlier introduction of enteral nutrition (EN) is associated with shorter hospital stays and increased weight gain velocities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study on neonatal patients (&lt;30 days old) admitted to a pediatric referral hospital who underwent an operation for bowel obstruction between 2010 and 2020. Demographic information, clinical characteristics, and feeding characteristics were collected. Associations between early EN (EEN), defined as commencement of enteral feeding within 5 days of surgery, and perioperative characteristics were analyzed with SAS 9.4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 97 neonates with congenital bowel obstruction, 36 patients received EEN. Sex, gestational age, and ethnicity were similar between groups. Patients receiving EEN were more likely to have a diagnosis of malrotation, anorectal malformation, or annular pancreas (<i>P</i> = 0.04). Patients receiving EEN weaned from parenteral nutrition earlier (9 vs 17 days, <i>P</i> = 0.005). Receiving EEN was associated with shorter median hospital stay (16 vs 29 days, <i>P</i> &lt; 0.0001). Weight gain velocities at the 2-month follow-up were greater for patients receiving EEN (8.02 vs 7.00 g/kg/day, <i>P</i> = 0.04) with the difference dissipating at 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EEN was more likely provided in patients with certain operative diagnoses and was associated with improved outcomes. Creating and implementing an EEN protocol in congenitally obstructed neonates may lead to shorter hospital stays and improved outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"69-76"},"PeriodicalIF":3.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do we know about micronutrients in critically ill patients? A narrative review","authors":"Angelique M.E. de Man MD, PhD,&nbsp;Christian Stoppe MD,&nbsp;Kristine W.A.C. Koekkoek MD,&nbsp;George Briassoulis MD, PhD,&nbsp;Lilanthi S.D.P. Subasinghe MD,&nbsp;Cristian Cobilinschi MD,&nbsp;Adam M. Deane MD, PhD,&nbsp;William Manzanares MD, PhD,&nbsp;Ioana Grințescu MD, PhD,&nbsp;Liliana Mirea MD, PhD,&nbsp;Ashraf Roshdy MD, PhD,&nbsp;Antonella Cotoia MD, PhD,&nbsp;Danielle E. Bear PhD,&nbsp;Sabrina Boraso MD, PhD,&nbsp;Vincent Fraipont MD,&nbsp;Kenneth B. Christopher MD, SM,&nbsp;Michael P. Casaer MD, PhD,&nbsp;Jan Gunst MD, PhD,&nbsp;Olivier Pantet MD,&nbsp;Muhammed Elhadi MD,&nbsp;Giuliano Bolondi MD, MSc,&nbsp;Xavier Forceville MD, PhD,&nbsp;Matthias W.A. Angstwurm MD, PhD,&nbsp;Mohan Gurjar MD,&nbsp;Rodrigo Biondi MD, MSc,&nbsp;Arthur R.H. van Zanten MD, PhD,&nbsp;Mette M. Berger MD, PhD,&nbsp;ESICM/FREM MN group","doi":"10.1002/jpen.2700","DOIUrl":"10.1002/jpen.2700","url":null,"abstract":"<p>Micronutrient (MN) status alterations (both depletion and deficiency) are associated with several complications and worse outcomes in critically ill patients. On the other side of the spectrum, improving MN status has been shown to be a potential co-adjuvant therapy. This review aims to collect existing data to better guide research in the critical care setting. This narrative review was conducted by the European Society of Intensive Care Medicine Feeding, Rehabilitation, Endocrinology, and Metabolism MN group. The primary objective was to identify studies focusing on individual MNs in critically ill patients, selecting the MNs that appear to be most relevant and most frequently investigated in the last decade: A, B₁, B₂, B₃, B₆, folate, C, D, E, copper, iron, selenium, zinc, and carnitine. Given the limited number of interventional studies for most MNs, observational studies were included. For each selected MN, the review summarizes the main form and functions, special needs and risk factors, optimal treatment strategies, pharmacological dosing, and clinical implications all specific to critically ill patients. A rigorous rebalancing of research strategies and priorities is needed to improve clinical practice. An important finding is that high-dose monotherapy of MNs is not recommended. Basal daily needs must be provided, with higher doses in diseases with known higher needs, and identified deficiencies treated. Finally, the review provides a list of ongoing trials on MNs in critically ill patients and identifies a priority list of future research topics.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"33-58"},"PeriodicalIF":3.2,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between segmental phase angles and functional independence measure scores in hospitalized adults following stroke: A retrospective cohort study","authors":"Yoshihiro Yoshimura MD, PhD,&nbsp;Hidetaka Wakabayashi MD, PhD,&nbsp;Fumihiko Nagano,&nbsp;Ayaka Matsumoto,&nbsp;Sayuri Shimazu,&nbsp;Ai Shiraishi,&nbsp;Yoshifumi Kido,&nbsp;Takahiro Bise,&nbsp;Aomi Kuzuhara,&nbsp;Takenori Hamada,&nbsp;Kouki Yoneda","doi":"10.1002/jpen.2703","DOIUrl":"10.1002/jpen.2703","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigated the association between segmental phase angles and functional outcomes in patients after stroke, hypothesizing that increased segmental phase angle correlates with improved functional status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study of 1012 patients after stroke was conducted. Whole body and segmental phase angles were measured using bioelectrical impedance analysis within 3 days of admission. Our exposure of interest was segmental phase angle measured via a multifrequency bioelectrical impedance analyzer and calculated as phase angle = arctangent (Xc/R) × (180/π), where R is the resistance of the right half of the body and Xc is the reactance measured at 50 kHz. The primary outcomes were the motor subscale of the functional independence measure (FIM) at discharge and FIM change between admission and discharge. Secondary outcomes included FIM scores for specific activities. Multiple linear regression analysis was performed to assess associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Phase angles of the healthy upper and lower limbs demonstrated stronger associations with discharge FIM motor scores (β = 0.175 and β = 0.105, respectively) and FIM motor gain (β = 0.242 and β = 0.092, respectively) compared with whole body or paretic limb phase angles. Upper limb phase angles were more closely related to grooming and toileting abilities, whereas lower limb phase angles were associated with both toileting and locomotion at discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Segmental phase angles, particularly those of the nonparetic limbs, are promising predictors of functional outcomes in patients after stroke. Assessing segmental phase angles may guide targeted interventions and rehabilitation strategies for improving specific activities of daily living.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 2","pages":"239-248"},"PeriodicalIF":3.2,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chyme reinfusion therapy in adults with severe acute intestinal failure: A descriptive cohort study","authors":"Kirstine Farrer MPhil,&nbsp;Maja Kopczynska MBBCh,&nbsp;Maria Barrett MSc,&nbsp;Simon Harrison MPharm,&nbsp;Antje Teubner MD,&nbsp;Arun Abraham MD,&nbsp;Derek McWhirter MD,&nbsp;Jonathan Epstein MD,&nbsp;Simon Lal PhD,&nbsp;Gordon L. Carlson CBE, MD","doi":"10.1002/jpen.2704","DOIUrl":"10.1002/jpen.2704","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chyme reinfusion therapy treats patients with high-output fistulas or stomas by returning chyme to the distal gut. The role of this treatment in severe acute intestinal failure is currently unclear. The primary outcome of this study was a successful establishment of chyme reinfusion therapy, defined by the ability to replace parenteral nutrition for nutrition support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A descriptive cohort study of adult patients with severe acute intestinal failure due to a high-output stoma and distal mucus fistula or a high-output small intestinal fistula receiving chyme reinfusion therapy was undertaken. The effect of chyme reinfusion therapy on parenteral nutrition requirements, medication, nutrition status, liver function, and treatment cost were studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four patients commenced treatment for a median of 44 (range, 3–571; total, 2263) days. Fifteen (62.5%) were successfully established for 1208 days, and nine continued treatment at home. Parenteral requirements, including volume, energy and nitrogen content, and frequency, were significantly reduced (<i>P</i> = 0.002), whereas anthropometric measurements remained stable. However, chyme therapy was not tolerated in nine patients (37.5%), and only two (8.3%) weaned fully from parenteral nutrition. Chyme reinfusion therapy was associated with a 47.6% reduction in parenteral energy requirements, 42.8% reduction in nitrogen, and 33.3% reduction in volume of parenteral nutrition requirements. Treatment was associated with a net cost of £30.05 ($40.27) per patient per day.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Chyme reinfusion therapy was associated with reductions in the need for parenteral therapy and medication but did not replace parenteral nutrition or result in a significant cost saving.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"85-93"},"PeriodicalIF":3.2,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energy and protein nutrition adequacy in general wards among intensive care unit survivors: A systematic review and meta-analysis","authors":"Zenzi Rosseel MPharm,&nbsp;Pieter-Jan Cortoos MPharm, PhD,&nbsp;Lynn Leemans PhD,&nbsp;Arthur R. H. van Zanten MD, PhD,&nbsp;Claudine Ligneel MPharm,&nbsp;Elisabeth De Waele MD, PhD","doi":"10.1002/jpen.2699","DOIUrl":"10.1002/jpen.2699","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adequate energy and protein provision is mandatory to optimize survival chances in critical illness, prevent loss of muscle mass, and reduce length of stay. Data are available concerning feeding adequacy in intensive care unit (ICU) participants, but little is known about the adequacy in post-ICU participants. This systematic review aimed to evaluate feeding adequacy in post-ICU participants and addressed causes of feeding interruption leading to suboptimal adequacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For this systematic review, a bibliographic search was performed in PubMed, Scopus, and Web of Science. Randomized controlled studies, non-randomized controlled studies, and observational studies conducted between January 1990 and November 2023 fulfilling the inclusion criteria were withheld.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies were included. Outcomes reported were energy and protein adequacy, barriers, and feeding routes. Energy and protein requirements were determined in various ways, including indirect calorimetry and standardized and weight-based formulas. Energy adequacy ranged from 52% to 102% and protein adequacy between 63% and 86%. Participants were mainly fed with enteral nutrition (EN) or a combination of oral nutrition and EN. The main barrier reported for inadequate nutrition intake was feeding tube removal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Next to different ways in calculating targets and reporting results, a wide range in energy and protein adequacy was observed, but with constant protein underfeeding. Participants fed with EN or a combination of EN and oral nutrition had the best adequacy; inappropriate tube removal is a common barrier leading to inadequate therapy. Standardized reporting and larger studies are needed to guide nutrition care for post-ICU participants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"18-32"},"PeriodicalIF":3.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of novel muscle quality index utilization in hospitalized adults with cancer: A secondary analysis","authors":"Jarson P. da Costa Pereira RD, MSc,&nbsp;Carla M. Prado RD, PhD,&nbsp;M. Cristina Gonzalez MD, PhD,&nbsp;Poliana C. Cabral RD, PhD,&nbsp;Francisco F. de Oliveira Guedes RD,&nbsp;Alcides da Silva Diniz MD, PhD,&nbsp;Ana P. T. Fayh RD, PhD","doi":"10.1002/jpen.2701","DOIUrl":"10.1002/jpen.2701","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate and propose novel approaches to calculate muscle quality index (MQI) using muscle mass derived from single-frequency bioelectrical impedance analysis (SF-BIA) and calf circumference in both unadjusted and body mass index (BMI)–adjusted forms. In addition, we examined their prognostic significance in patients with cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A secondary analysis was conducted on a prospective cohort study of patients with cancer. Handgrip strength was measured. SF-BIA was conducted to estimate appendicular lean soft tissue (ALST, in kilograms). MQI was calculated using three approaches: (1) the ratio of handgrip strength to ALST (MQI_SF-BIA), (2) the ratio of handgrip strength to calf circumference (MQI_{calf circumference}), and (3) the ratio of handgrip strength to BMI-adjusted calf circumference (MQI_{adj. calf circumference}). Maximally selected log-rank was calculated to estimate their cutoff values to predict survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred eighty-four patients were included (51.1% men; median age, 61 years). Solid tumors were the most frequent (89.8%). All approaches to MQI (MQI_SF-BIA, MQI_{calf circumference}, and MQI_{adj. calf circumference}) were independent predictors of 6-month mortality. The found cutoffs were (1) MQI_SF-BIA (&lt;1.52 for men, &lt;0.63 for women), (2) MQI_{calf circumference} (&lt;0.74 for men, &lt;0.24 for women), and (3) MQI_{adj. calf circumference} (&lt;0.75 for men, &lt;0.25 for women).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study introduces MQI_SF-BIA, MQI_{calf circumference}, and MQI_{adj. calf circumference} as future potential surrogate methods for computing MQI in clinical practice when other robust procedures are unavailable, pending further validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"112-121"},"PeriodicalIF":3.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the composite dietary antioxidant index and sarcopenia among United States adults: A cross-sectional study","authors":"Hao Chen MS,&nbsp;Dongze Wu MS,&nbsp;Yajin Chen MS,&nbsp;Ang Shi MS,&nbsp;Wanda Cai MS,&nbsp;Xinxin Yang MD, PhD,&nbsp;Xiaodong Chen MD, PhD","doi":"10.1002/jpen.2697","DOIUrl":"10.1002/jpen.2697","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diets high in antioxidants are associated with decreased prevalence of sarcopenia. This study aimed to investigate whether the composite dietary antioxidant index (CDAI) and sarcopenia have an underlying relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the data from the National Health and Nutrition Examination Survey 2011–2018. According to dietary antioxidant intake, the CDAI was calculated for each individual. Appendicular skeletal muscle mass index was employed to determine sarcopenia. Multivariate weighted logistic models and restricted cubic spline regression analysis was undertaken to determine the association between CDAI and sarcopenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 7012 participants were enrolled in this study, including 473 with sarcopenia (weighted percentage, 5.6%). Compared with the lowest tertile, those in the highest tertile of the CDAI exhibited a greater likelihood of being male, with lower body mass index, higher education level and economic standard, and more chance of being single or separated. In multivariate weighted logistic models, model 3 revealed a noteworthy inverse association between the CDAI and sarcopenia (odds ratio = 0.94; 95% CI, 0.91–0.98; <i>P</i> = 0.003). Compared with the lowest tertile, the highest tertile of CDAI was associated with a 0.57-fold risk of sarcopenia (95% CI, 0.42–0.77; <i>P</i> &lt; 0.001). The inverse association between CDAI and sarcopenia strengthened in the participants with elevated education levels (<i>P</i> for interaction = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CDAI was inversely correlated with the prevalence of sarcopenia. As a comprehensive measurement representing antioxidant status, the CDAI may help manage and prevent sarcopenia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"103-111"},"PeriodicalIF":3.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse events associated with parenteral nutrition support therapy: A pharmacovigilance study","authors":"Zhou Jing MPharm,&nbsp;Xu Hongyan MPharm,&nbsp;Ma Jingjing MPharm,&nbsp;Pang Mujuan MPharm,&nbsp;Man Shiyu BD,&nbsp;Su Ying BD,&nbsp;Hu Yan MPharm","doi":"10.1002/jpen.2698","DOIUrl":"10.1002/jpen.2698","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parenteral nutrition (PN) plays a crucial role in nutrition support therapy, yet data on related adverse events (AEs) in practical settings are scarce. To address this, we analyzed AE signals associated with PN treatment from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We extracted data from the FAERS database, covering the period from the first quarter (Q1) of 2004 to Q1 of 2024. Drug names and AEs were standardized. We then conducted disproportionality analyses using four different algorithms to evaluate the association between PN and its associated AEs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We collected a total of 48,890,925 reports from the FAERS database, of which 1642 involved PN-related AEs. After categorization, we identified 21 system organ classes (SOCs), and hepatobiliary disorders were the only significant SOC across all four algorithms. At the preferred term (PT) level, we identified 99 PTs that showed significant disproportionality in all four algorithms. Fat overload syndrome, fatty acid deficiency, parenteral nutrition–associated liver disease (PNALD), <i>Malassezia</i> infection, and <i>Pantoea agglomerans</i> infection were the most prominent PTs. In addition, several potential new AE signals included nervous, cardiac, immune, psychiatric, blood, renal, urinary, and eye disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study identified several common and rare PN-related AEs reported in the FAERS database. Patients and healthcare providers should remain vigilant about these AEs. Understanding the risks of PN therapy and establishing practical procedures can help reduce AEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 1","pages":"122-131"},"PeriodicalIF":3.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations","authors":"Elaine B. Trujillo MS, RDN,&nbsp;Kunal C. Kadakia MD,&nbsp;Cynthia Thomson PhD, RDN,&nbsp;Fang Fang Zhang MD, PhD,&nbsp;Alicia Livinski MA, MPH,&nbsp;Kim Pollard RN,&nbsp;Todd Mattox PharmD,&nbsp;Anne Tucker PharmD,&nbsp;Valaree Williams MS, RDN,&nbsp;Declan Walsh MD,&nbsp;Steven Clinton MD, PhD,&nbsp;Aaron Grossberg MD, PhD,&nbsp;Gordon Jensen MD, PhD,&nbsp;Rhone Levin MEd, RDN,&nbsp;Jeannine Mills MS, RDN,&nbsp;Anurag Singh MD,&nbsp;Meredith Smith RN,&nbsp;Renee Stubbins PhD, RDN,&nbsp;Kathleen Wiley MSN, RN,&nbsp;Kristen Sullivan MPH, MS,&nbsp;Mary Platek PhD, RDN,&nbsp;Colleen K. Spees PhD, RDN","doi":"10.1002/jpen.2688","DOIUrl":"10.1002/jpen.2688","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malnutrition screening is not widely practiced in outpatient cancer centers. This review aims to determine the validity of malnutrition screening tools and provide recommendations for clinical use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies identified by a systematic review assessed the general validity of screening tools in adult oncology outpatients from five databases through 2022. The American Society for Parenteral and Enteral Nutrition (ASPEN) convened a working group of members from the Academy of Nutrition and Dietetics, Academy of Oncology Nurse and Patient Navigators, American Cancer Society, American Society for Clinical Oncology, American Society for Nutrition, American Society for Radiation Oncology, Association of Cancer Care Centers, and Oncology Nursing Society to answer the following questions: (1) should clinicians screen for malnutrition, (2) which malnutrition screening tools are recommended, and (3) what are the clinical applications for malnutrition risk screening in adult oncology outpatients?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty of 738 studies met the criteria and were reviewed. Six screening tools with specific cut-points demonstrated validity and are recommended, including the Mini Nutritional Assessment (≤23.5), Malnutrition Screening Tool (MST; MST ≥ 2 and patient-led MST ≥ 2), Malnutrition Universal Screening Tool (MUST; MUST ≥ 1 and MUST ≥ 2), Nutrition Risk Screening-2002 (NRS-2002; NRS-2002 ≥ 2 and NRS-2002 ≥ 3), NUTRISCORE ≥ 5, and Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF; PG-SGA SF ≥ 7 and PG-SGA SF ≥ 8).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Six screening tools are valid for malnutrition risk identification in oncology ambulatory settings and recommended before treatment initiation and regularly thereafter, depending on treatment course. Research is needed to understand to what extent early diagnosis and management of malnutrition improves the clinical care of oncology patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"48 8","pages":"874-894"},"PeriodicalIF":3.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2688","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}