Journal of Parenteral and Enteral Nutrition最新文献_第8页

Administration of 4% tetrasodium EDTA lock solution and central venous catheter complications in high-risk pediatric patients with intestinal failure: A retrospective cohort study 在肠功能衰竭的高风险儿科患者中使用 4% 乙二胺四乙酸四钠锁定溶液与中心静脉导管并发症：一项回顾性队列研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-06-05 DOI: 10.1002/jpen.2644

Thomas I. Hirsch MD, Scott C. Fligor MD, Savas T. Tsikis MD, Paul D. Mitchell MS, Angela DeVietro BS, Sarah Carbeau BS, Sarah Z. Wang MD, Jennifer McClelland MS, Alexandra N. Carey MD, Kathleen M. Gura PharmD, Mark Puder MD, PhD

Background

Selection of central venous catheter (CVC) lock solution impacts catheter mechanical complications and central line–associated bloodstream infections (CLABSIs) in pediatric patients with intestinal failure. Disadvantages of the current clinical standards, heparin and ethanol lock therapy (ELT), led to the discovery of new lock solutions. High-risk pediatric patients with intestinal failure who lost access to ELT during a recent shortage were offered enrollment in a compassionate use trial with 4% tetrasodium EDTA (T-EDTA), a lock solution with antimicrobial, antibiofilm, and antithrombotic properties.

Methods

We performed a descriptive cohort study including 14 high-risk pediatric patients with intestinal failure receiving 4% T-EDTA as a daily catheter lock solution. CVC complications were documented (repairs, occlusions, replacements, and CLABSIs). Complication rates on 4% T-EDTA were compared with baseline rates, during which patients were receiving either heparin or ELT (designated as heparin/ELT).

Results

Patients initiated 4% T-EDTA at the time they were enrolled in the compassionate use protocol. Use of 4% T-EDTA resulted in a 50% reduction in CVC complications, compared with baseline rates on heparin/ELT (incidence rate ratio: 0.50; 95% CI, 0.25–1.004; P = 0.051).

Conclusion

In a compassionate use protocol for high-risk pediatric patients with intestinal failure, the use of 4% T-EDTA reduced composite catheter complications, including those leading to emergency department visits, hospital admissions, additional procedures, and mortality. This outcome suggests 4% T-EDTA has benefits over currently available lock solutions.

背景：选择中心静脉导管（CVC）锁定溶液会影响肠道功能衰竭儿科患者的导管机械并发症和中心静脉相关血流感染（CLABSIs）。肝素和乙醇锁定疗法（ELT）这两种现行临床标准的缺点促使人们发现了新的锁定解决方案。在最近一次ELT短缺期间，无法使用ELT的高风险儿科肠道功能衰竭患者参加了4%乙二胺四乙酸四钠（T-EDTA）的同情使用试验，这是一种具有抗菌、抗生物膜和抗血栓特性的锁定溶液：我们进行了一项描述性队列研究，研究对象包括 14 名患有肠功能衰竭的高风险儿科患者，他们每天接受 4% T-EDTA 作为导管锁定溶液。研究记录了 CVC 并发症（修复、闭塞、更换和 CLABSIs）。将 4% T-EDTA 的并发症发生率与基线发生率进行比较，在基线发生率期间，患者接受肝素或 ELT 治疗（称为肝素/ELT）：结果：患者在加入同情使用方案时开始使用 4% T-EDTA。与使用肝素/ELT的基线率相比，使用4% T-EDTA可使CVC并发症减少50%（发生率比：0.50；95% CI，0.25-1.004；P = 0.051）：结论：在一项针对肠功能衰竭的高风险儿科患者的同情使用方案中，使用 4% T-EDTA 可减少导管复合并发症，包括导致急诊就诊、住院、额外手术和死亡的并发症。这一结果表明，4% T-EDTA 比目前可用的锁定解决方案更有优势。

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引用次数: 0

Blind versus endoscopy-guided postpyloric feeding tube placement in adults with ischemic stroke: A retrospective cohort study 缺血性脑卒中成人患者在盲法与内镜引导下的幽门后食管置入：一项回顾性队列研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-05-28 DOI: 10.1002/jpen.2645

Chun Sun BSN, Kangyi Yuan BSN, Qiyuan Gao BSN, Fang Liu BSN, Yuanxi Long BSN, Li Wang BSN

Background

This study compared the one-time success rate of blind and endoscopy-guided postpyloric feeding tube placement after implementing a comprehensive nursing scheme of intestinal blind placement for patients with ischemic stroke.

Methods

This retrospective cohort study included 179 patients with blind bedside placement and 118 with endoscopy-guided placement. The primary outcome was the one-time success rate of radiologically confirmed postpyloric placement. The secondary endpoints included the position of the tube tip, length of insertion, time of placement, and expenses. The safety endpoints were the incidence of complications caused by placement.

Results

The results showed that the method of tube placement did not significantly affect the outcome of the first tube placement (odds ratio [OR] = 0.41; 95% CI = 0.137–1.207; P = 0.105). Compared with endoscopy-guided placement, blind placement was half the cost. We also found that a history of abdominal surgery (OR = 0.003; 95% CI = 0.000–0.059; P < 0.001) and longer intensive care unit (ICU) days (OR = 0.94; 95% CI = 0.903–0.981; P = 0.004) were inversely associated with the one-time success rate.

Conclusion

Our study suggested that blind intestinal feeding tube placement has an equivalent one-time success rate compared with endoscopy-guided placement in hospitalized patients with ischemic stroke if operators can be trained well. However, the expenses of endoscopy-guided placement were twice those of blind bedside methods. We also found that patients with abdominal surgery history and longer ICU stay were more likely to fail at the first placement. Further research is needed to replicate our single-center observations in a larger population of patients.

背景：本研究比较了缺血性脑卒中患者在实施综合护理方案后，盲法和内镜引导下胃管后置一次性成功率：本研究比较了缺血性脑卒中患者实施肠道盲插综合护理方案后，盲插和内镜引导下幽门后食管置管的一次性成功率：这项回顾性队列研究纳入了179例床旁盲法置管患者和118例内镜引导下置管患者。主要结果是经放射学证实的幽门后置管一次性成功率。次要终点包括管尖位置、插入长度、置管时间和费用。安全终点是置管引起的并发症发生率：结果显示，置管方法对首次置管的结果无明显影响（几率比 [OR] = 0.41；95% CI = 0.137-1.207；P = 0.105）。与内窥镜引导下的置管相比，盲置管的费用要低一半。我们还发现，腹部手术史（OR = 0.003；95% CI = 0.000-0.059；P = 0.059我们的研究表明，在缺血性脑卒中住院患者中，如果操作人员训练有素，盲法肠道喂食管置入术的一次性成功率与内镜引导下置入术相当。然而，内镜引导置管的费用是床旁盲法的两倍。我们还发现，有腹部手术史和重症监护室住院时间较长的患者首次置管失败的可能性更大。我们需要进一步研究，在更多患者中重复我们在单中心的观察结果。

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引用次数: 0

Percutaneous radiologic gastrostomy versus percutaneous endoscopic gastrostomy for enteral feeding: A systematic review and meta-analysis 经皮放射胃造瘘术与经皮内镜胃造瘘术用于肠道喂养：系统回顾和荟萃分析。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-05-28 DOI: 10.1002/jpen.2646

Matheus Coelho Meine, Isabela Ho Tusato, Nathalia Hoffmeister, Gilmara Coelho Meine MD, MSc

Background

Percutaneous radiological gastrostomy (PRG) and percutaneous endoscopic gastrostomy (PEG) are minimally invasive gastrostomy techniques for individuals requiring prolonged enteral feeding. Recent meta-analyses concerning their efficacy and safety mainly included retrospective studies and yielded conflicting results. This meta-analysis of randomized controlled trials (RCTs) aimed to compare efficacy, safety, and procedure time between PRG and PEG for enteral feeding.

Methods

MEDLINE, Embase, and the Cochrane Library were searched for eligible RCTs comparing PRG and PEG for enteral feeding through February 23, 2024. The primary outcome was technical success. The secondary outcomes were (1) adverse events (AEs), (2) mortality, and (3) procedure time. We used the random-effects model to calculate pooled risk ratio (RR) and mean difference (MD) with corresponding 95% CIs for dichotomous and continuous outcomes, respectively.

Results

Five RCTs with 544 patients (268 PRG and 276 PEG) were included. There was similar technical success (RR = 1.02; 95% CI = 0.98–1.05; I² = 35%; moderate certainty of evidence because of inconsistency), overall mortality (RR = 1.25; 95% CI = 0.63–2.47; I² = 47%; very low certainty of evidence because of inconsistency, indirectness, and imprecision), and overall AEs risk (RR = 1.06; 95% CI = 0.63–1.76; I² = 81%; low certainty of evidence because of inconsistency and imprecision) between the two groups. However, compared with PEG, the procedure time was longer in the PRG group (MD = 19.35 min; 95% CI = 0.95–37.75 min; I² = 98%; very low certainty of evidence because of inconsistency and imprecision).

Conclusion

PRG and PEG demonstrate similar efficacy and safety; however, the endoscopic technique may boast a shorter procedure time.

背景：经皮放射胃造口术（PRG）和经皮内镜胃造口术（PEG）是一种微创胃造口技术，适用于需要长期肠道喂养的患者。最近有关其疗效和安全性的荟萃分析主要包括回顾性研究，得出的结果相互矛盾。这项随机对照试验 (RCT) 的荟萃分析旨在比较 PRG 和 PEG 用于肠道喂养的疗效、安全性和手术时间：方法：检索了 MEDLINE、Embase 和 Cochrane 图书馆中截至 2024 年 2 月 23 日符合条件的 RCT，比较了 PRG 和 PEG 在肠道喂养中的应用。主要结果是技术成功率。次要结果为 (1)不良事件 (AE)、(2) 死亡率和 (3) 手术时间。我们使用随机效应模型计算了二分法和连续法结果的汇总风险比（RR）和平均差（MD），以及相应的 95% CI：共纳入了 5 项研究，544 例患者（268 例 PRG 和 276 例 PEG）。技术成功率（RR = 1.02；95% CI = 0.98-1.05；I² = 35%；由于不一致，证据的确定性为中等）、总死亡率（RR = 1.25；95% CI = 0.63-2.47；I² = 47%；由于不一致，证据的确定性为中等）均相似。47；I² = 47%；由于不一致、间接性和不精确性，证据确定性极低），以及两组间总体 AEs 风险（RR = 1.06；95% CI = 0.63-1.76；I² = 81%；由于不一致和不精确性，证据确定性低）。然而，与 PEG 相比，PRG 组的手术时间更长（MD = 19.35 分钟；95% CI = 0.95-37.75 分钟；I² = 98%；由于不一致和不精确，证据确定性很低）：结论：PRG 和 PEG 的疗效和安全性相似，但内窥镜技术的手术时间更短。

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引用次数: 0

Can caloric restriction improve outcomes of elective surgeries? 限制热量能否改善择期手术的效果？

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-05-27 DOI: 10.1002/jpen.2642

Jesse Pittard Caron MD, Helen Ernyey MD, MPH, Martin D. Rosenthal MD

Energy restriction (ER) is a nutrition method to reduce the amount of energy intake while maintaining adequate nutrition. In clinical medicine, applications of ER have been implicated in longevity, mortality, metabolic, immune, and psychological health. However, there are limited studies showing the clinical benefit of ER within the immediate surgical setting. A specific, clinically oriented summary of the potential applications of ER is needed to optimize surgery outcomes for patients. The purpose of this article is to examine how ER can be used for perioperative optimization to improve outcomes for the patient and surgeon. It will also explore how these outcomes can feasibly fit in with enhanced recovery after surgery protocols and can be used as a method for nutrition optimization in surgery. Despite evidence of caloric restriction improving outcomes in critically ill surgical patients, there is not enough evidence to conclude that ER, perioperatively across noncritically ill cohorts, improves postoperative morbidity and mortality in elective surgeries. Nevertheless, a contemporary account of how ER techniques may have a significant role in reducing risk factors of adverse surgical outcomes in this cohort, for example, by encouraging preoperative weight loss contributing to decreased operating times, is reviewed.

能量限制（ER）是一种在保持充足营养的同时减少能量摄入的营养方法。在临床医学中，能量限制的应用与长寿、死亡率、新陈代谢、免疫和心理健康有关。然而，显示 ER 在直接手术环境中的临床益处的研究有限。为了优化患者的手术效果，需要对ER的潜在应用进行具体的、以临床为导向的总结。本文旨在探讨如何将急诊室用于围手术期优化，以改善患者和外科医生的治疗效果。文章还将探讨如何将这些结果与加强术后恢复方案相结合，并将其作为手术中营养优化的一种方法。尽管有证据表明热量限制可改善重症手术患者的预后，但目前还没有足够的证据得出结论认为，在非重症患者群体中，围手术期的 ER 可改善择期手术的术后发病率和死亡率。尽管如此，本文还是对急诊室技术如何在减少这类人群不良手术结果的风险因素方面发挥重要作用进行了当代阐述，例如，通过鼓励术前减重来缩短手术时间。

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引用次数: 0

Development and evaluation of a deep learning framework for the diagnosis of malnutrition using a 3D facial points cloud: A cross-sectional study 利用三维面部点云开发和评估用于诊断营养不良的深度学习框架：横断面研究

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-05-26 DOI: 10.1002/jpen.2643

Xue Wang BM, Yan Liu MD, Zhiqin Rong BE, Weijia Wang BE, Meifen Han BM, Moxi Chen BM, Jin Fu MD, Yuming Chong MD, Xiao Long MD, Yong Tang PhD, Wei Chen MD

Background

The feasibility of diagnosing malnutrition using facial features has been validated. A tool to integrate all facial features associated with malnutrition for disease screening is still demanded. This work aims to develop and evaluate a deep learning (DL) framework to accurately determine malnutrition based on a 3D facial points cloud.

Methods

A group of 482 patients were studied in this perspective work. The 3D facial data were obtained using a 3D camera and represented as a 3D facial points cloud. A DL model, PointNet++, was trained and evaluated using the points cloud as inputs and classified the malnutrition states. The performance was evaluated with the area under the receiver operating characteristic curve, accuracy, specificity, sensitivity, and F1 score.

Results

Among the 482 patients, 150 patients (31.1%) were diagnosed as having moderate malnutrition and 54 patients (11.2%) as having severe malnutrition. The DL model achieved the performance with an area under the receiver operating characteristic curve of 0.7240 ± 0.0416.

Conclusion

The DL model achieved encouraging performance in accurately classifying nutrition states based on a points cloud of 3D facial information of patients with malnutrition.

背景利用面部特征诊断营养不良的可行性已得到验证。目前仍需要一种工具来整合与营养不良相关的所有面部特征，以便进行疾病筛查。这项工作旨在开发和评估一种深度学习（DL）框架，以便根据三维面部点云准确判断营养不良。三维面部数据由三维摄像头获取，并以三维面部点云的形式表示。使用点云作为输入对 DL 模型 PointNet++ 进行了训练和评估，并对营养不良状态进行了分类。结果在 482 名患者中，150 名患者（31.1%）被诊断为中度营养不良，54 名患者（11.2%）被诊断为重度营养不良。结论基于营养不良患者三维面部信息的点云，DL 模型在准确划分营养状态方面取得了令人鼓舞的成绩。

{"title":"Development and evaluation of a deep learning framework for the diagnosis of malnutrition using a 3D facial points cloud: A cross-sectional study","authors":"Xue Wang BM, Yan Liu MD, Zhiqin Rong BE, Weijia Wang BE, Meifen Han BM, Moxi Chen BM, Jin Fu MD, Yuming Chong MD, Xiao Long MD, Yong Tang PhD, Wei Chen MD","doi":"10.1002/jpen.2643","DOIUrl":"10.1002/jpen.2643","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The feasibility of diagnosing malnutrition using facial features has been validated. A tool to integrate all facial features associated with malnutrition for disease screening is still demanded. This work aims to develop and evaluate a deep learning (DL) framework to accurately determine malnutrition based on a 3D facial points cloud.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A group of 482 patients were studied in this perspective work. The 3D facial data were obtained using a 3D camera and represented as a 3D facial points cloud. A DL model, PointNet++, was trained and evaluated using the points cloud as inputs and classified the malnutrition states. The performance was evaluated with the area under the receiver operating characteristic curve, accuracy, specificity, sensitivity, and <i>F</i>1 score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 482 patients, 150 patients (31.1%) were diagnosed as having moderate malnutrition and 54 patients (11.2%) as having severe malnutrition. The DL model achieved the performance with an area under the receiver operating characteristic curve of 0.7240 ± 0.0416.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The DL model achieved encouraging performance in accurately classifying nutrition states based on a points cloud of 3D facial information of patients with malnutrition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"48 5","pages":"554-561"},"PeriodicalIF":3.2,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141146526","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}

引用次数: 0

Commentary on guidelines for parenteral nutrition in preterm infants: Limitations reveal opportunities 早产儿肠外营养指南评论：局限揭示机遇。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-05-18 DOI: 10.1002/jpen.2640

Megan Follett MS, RDN, Paola Bregni BS, Daniel T. Robinson MD, MSc, Kara L. Calkins MD, MS, M. Petrea Cober PharmD, Gustave H. Falcigia MD, Yimin Chen PhD, RDN

引用次数: 0

JPEN Journal Club 84. Using PICO JPEN 期刊俱乐部 84.使用 PICO。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-05-15 DOI: 10.1002/jpen.2639

Ronald L. Koretz MD

引用次数: 0

Association between isolated or combined malnutrition and sarcopenia and quality of life in heart failure outpatients: A cross-sectional study 心力衰竭门诊患者的孤立或合并营养不良、肌肉疏松症与生活质量之间的关系：一项横断面研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-05-13 DOI: 10.1002/jpen.2635

Ingrid da Silveira Knobloch RD, Gabriela Corrêa Souza PhD, RD, Marla Darlene Machado Vale RD, Édina Caroline Ternus Ribeiro MSc, RD, Flávia Moraes Silva PhD, RD

Background

Heart failure (HF) is a chronic condition with symptoms linked to worse quality of life. Malnutrition and sarcopenia are conditions frequently found in patients with HF. This study aims to evaluate the association between isolated or combined malnutrition and sarcopenia and quality of life in outpatients with HF.

Methods

This is a cross-sectional study with a sample of outpatients with HF aged ≥18 years. Malnutrition was assessed according to the criteria of the Global Leadership Initiative on Malnutrition, and sarcopenia was evaluated by the European Working Group on Sarcopenia in Older People. Quality of life was assessed using the Minnesota Living with HF questionnaire (MLHFQ). Clinical and sociodemographic data were collected.

Results

One hundred and fifty-one patients were included in this study, with a median (interquartile range) age of 58 (48–65) years, 58.9% were adults, and 68.9% were male. A total of 29.5% of the patients were malnourished, and 28.5% and 2.6% were identified with probable sarcopenia and sarcopenia, respectively. Of the total, 15.9% of patients were identified with both conditions. Sarcopenia was associated with higher odds of increase in the MLHFQ total score, indicating worse quality of life (odds ratio [OR] = 3.61; 95% CI, 1.65–7.89). The same was found in the presence of two conditions (OR 3.97; 95% CI, 1.32–11.54), whereas isolated malnutrition was not related to life quality (OR = 1.62; 95% CI, 0.73–3.60).

Conclusion

The presence of malnutrition and sarcopenia simultaneously were associated with worse quality of life scores when compared with these isolated conditions.

背景：心力衰竭（HF）是一种慢性疾病，其症状与生活质量下降有关。营养不良和肌肉疏松症是心力衰竭患者经常出现的症状。本研究旨在评估心力衰竭门诊患者单独或合并营养不良和肌肉疏松症与生活质量之间的关系：这是一项横断面研究，样本为年龄≥18 岁的高血压门诊患者。营养不良根据全球营养不良领导倡议的标准进行评估，而肌肉疏松症则由欧洲老年人肌肉疏松症工作组进行评估。生活质量采用明尼苏达高频生活问卷（MLHFQ）进行评估。此外，还收集了临床和社会人口学数据：本研究共纳入 151 名患者，中位数（四分位间距）年龄为 58（48-65）岁，58.9% 为成年人，68.9% 为男性。共有 29.5% 的患者营养不良，28.5% 和 2.6% 的患者分别被确定为可能患有肌肉疏松症和肌肉疏松症。其中 15.9% 的患者同时患有这两种疾病。肌肉疏松症与 MLHFQ 总分增加的几率较高有关，表明生活质量较差（几率比 [OR] = 3.61；95% CI，1.65-7.89）。同样的情况也出现在同时患有两种疾病的患者身上（OR 3.97；95% CI，1.32-11.54），而单独的营养不良与生活质量无关（OR = 1.62；95% CI，0.73-3.60）：结论：同时患有营养不良和肌肉疏松症的患者，其生活质量评分比单独患有营养不良和肌肉疏松症的患者要低。

{"title":"Association between isolated or combined malnutrition and sarcopenia and quality of life in heart failure outpatients: A cross-sectional study","authors":"Ingrid da Silveira Knobloch RD, Gabriela Corrêa Souza PhD, RD, Marla Darlene Machado Vale RD, Édina Caroline Ternus Ribeiro MSc, RD, Flávia Moraes Silva PhD, RD","doi":"10.1002/jpen.2635","DOIUrl":"10.1002/jpen.2635","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Heart failure (HF) is a chronic condition with symptoms linked to worse quality of life. Malnutrition and sarcopenia are conditions frequently found in patients with HF. This study aims to evaluate the association between isolated or combined malnutrition and sarcopenia and quality of life in outpatients with HF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a cross-sectional study with a sample of outpatients with HF aged ≥18 years. Malnutrition was assessed according to the criteria of the Global Leadership Initiative on Malnutrition, and sarcopenia was evaluated by the European Working Group on Sarcopenia in Older People. Quality of life was assessed using the Minnesota Living with HF questionnaire (MLHFQ). Clinical and sociodemographic data were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and fifty-one patients were included in this study, with a median (interquartile range) age of 58 (48–65) years, 58.9% were adults, and 68.9% were male. A total of 29.5% of the patients were malnourished, and 28.5% and 2.6% were identified with probable sarcopenia and sarcopenia, respectively. Of the total, 15.9% of patients were identified with both conditions. Sarcopenia was associated with higher odds of increase in the MLHFQ total score, indicating worse quality of life (odds ratio [OR] = 3.61; 95% CI, 1.65–7.89). The same was found in the presence of two conditions (OR 3.97; 95% CI, 1.32–11.54), whereas isolated malnutrition was not related to life quality (OR = 1.62; 95% CI, 0.73–3.60).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The presence of malnutrition and sarcopenia simultaneously were associated with worse quality of life scores when compared with these isolated conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"48 5","pages":"588-596"},"PeriodicalIF":3.2,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912531","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}

引用次数: 0

Associations between the composite dietary antioxidant index and abdominal aortic calcification among United States adults: A cross-sectional study 美国成年人膳食抗氧化剂综合指数与腹主动脉钙化之间的关系：一项横断面研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-05-11 DOI: 10.1002/jpen.2638

Xiufang Kong MD, PhD, Wei Wang MD, PhD

Background

Oxidative stress has previously been shown to play a pivotal role in the pathogenesis of vascular calcification. In the present study, we aimed to investigate the association between the composite dietary antioxidant index (CDAI) and abdominal aortic calcification (AAC).

Methods

We conducted a cross-sectional study of United States adults using data from the 2013–2014 National Health and Nutrition Examination Survey. The CDAI was calculated from vitamins A, C, E, selenium, zinc, and caretenoid through two rounds of 24-h dietary recall interviews. AAC was assessed by a lateral dual-energy x-ray absorptiometry scan of the thoraco-lumbar spine. The association between CDAI and AAC was evaluated with weighted multivariable logistic regression.

Results

Overall, an unweighted 1081 participants were analyzed, including 110 with AAC and 971 without AAC. In the multivariable fully adjusted logistic regression model, CDAI was significantly associated with AAC (odds ratio = 0.89, 95% CI 0.81–0.98; P = 0.02). Compared with the lowest quartile, the highest quartile of CDAI was related to a 0.33-fold risk of AAC (95% CI 0.12–0.90; P = 0.03). Subgroup analysis showed that the significant association between CDAI and AAC was only observed in participants without hypertension (P for interaction = 0.002).

Conclusion

A higher CDAI was associated with a lower prevalence of AAC among adults without hypertension in the US. Further large-scale prospective studies are required to analyze the protective role of the CDAI in AAC progression.

背景：氧化应激曾被证明在血管钙化的发病机制中起着关键作用。在本研究中，我们旨在调查复合膳食抗氧化指数（CDAI）与腹主动脉钙化（AAC）之间的关联：我们利用 2013-2014 年美国国家健康与营养调查的数据对美国成年人进行了一项横断面研究。CDAI是通过两轮24小时饮食回忆访谈，根据维生素A、C、E、硒、锌和类胡萝卜素计算得出的。通过对胸腰椎进行侧位双能 X 射线吸收扫描来评估 AAC。通过加权多变量逻辑回归评估了 CDAI 与 AAC 之间的关联：总共分析了 1081 名未加权参与者，其中 110 人患有 AAC，971 人不患有 AAC。在多变量完全调整逻辑回归模型中，CDAI 与 AAC 显著相关（几率比 = 0.89，95% CI 0.81-0.98；P = 0.02）。与最低四分位数相比，CDAI的最高四分位数与AAC风险的0.33倍相关（95% CI 0.12-0.90; P = 0.03）。亚组分析显示，CDAI与AAC之间的显著关联仅在无高血压的参与者中观察到（交互作用P = 0.002）：结论：在美国无高血压的成年人中，CDAI越高，AAC患病率越低。需要进一步开展大规模前瞻性研究，以分析 CDAI 在 AAC 进展中的保护作用。

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引用次数: 0

External validation and updating of the infusion rate individualization of soybean oil–based intravenous lipid emulsion: A descriptive cohort study 大豆油基静脉注射脂质乳剂输注速度个体化的外部验证和更新：一项描述性队列研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-05-11 DOI: 10.1002/jpen.2636

Keizo Fukushima PhD, Kenji Omura MD, Satoshi Goshi MD, Azusa Futatsugi PhD, Yoriyuki Takamori MD, Takahiro Sasamoto MD, Takae Tsujimoto PhD, Keiji Iriyama MD, Nobuyuki Sugioka PhD

Background

Safe and efficient provision of intravenous lipid emulsion (ILE) requires a strategy to individualize infusion rates. Estimating the maximum acceptable infusion rate (MaxInfRate) of soybean oil–based ILE (SO-ILE) in individuals by using a triglyceride (TG) kinetic model was reported to be feasible. In this study, we aimed to externally validate and, if needed, update the MaxInfRate estimation.

Methods

The maximum TG concentration (TG_max) in patients receiving SO-ILE at MaxInfRate was evaluated to determine if it met the definition of being <400 mg/dl for 90th percentile of patients. The TG kinetic model was evaluated through prediction performance checks and was subsequently updated using the data set of both the previous model development and present validation studies.

Results

Out of 83 patients, 74 had TG_max <400 mg/dl, corresponding to a probability of 89.2% (95% CI, 81.9%–95.2%), and the 90th percentile of TG_max was 400 mg/dl (95% CI, 328–490 mg/dl), closely aligned with the theoretical values. However, the individual TG_max values were biased by the infusion rate because the covariate effects were overestimated in the TG kinetic model, requiring a minor revision. The updated MaxInfRate with the combined data set showed unbiased and more accurate predictions.

Conclusion

The MaxInfRate was validated in external inpatients and updated with all available data. MaxInfRate estimation for individuals could be an option for the safe and efficient provision of SO-ILE.

背景：要安全有效地提供静脉注射脂质乳剂（ILE），就必须制定个体化输注速率的策略。据报道，通过使用甘油三酯（TG）动力学模型估算个体对大豆油基 ILE（SO-ILE）的最大可接受输注率（MaxInfRate）是可行的。本研究旨在从外部验证并在必要时更新 MaxInfRate 估计值：方法：对以 MaxInfRate 接受 SO-ILE 的患者的最大 TG 浓度（TGmax）进行评估，以确定其是否符合结果的定义：在 83 位患者中，74 位患者的最大总胆固醇浓度为 400 mg/dl（95% CI，328-490 mg/dl），与理论值非常接近。然而，由于 TG 动力学模型中的协变量效应被高估，因此单个 TGmax 值受到输注率的影响而出现偏差，需要进行小幅修正。综合数据集更新后的 MaxInfRate 预测无偏见且更准确：结论：MaxInfRate 已在外部住院患者中得到验证，并根据所有可用数据进行了更新。对个人的 MaxInfRate 估计可以作为安全有效地提供 SO-ILE 的一种选择。

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引用次数: 0