K. Krylov, Sergey V. Sviridov, I. Vedenina, R. Yagubyan
Ischemic stroke remains the predominant cause of disability in the population (3.2 per 1000 population). Only 8% of surviving after ischemic stroke patients can return to their previous work. An integral part of the treatment of ischemic stroke in the intensive care unit is nutritional support. Nutritional support is an integral part of a multidisciplinary approach to the treatment of a patient with ischemic stroke, both during the acute period of the disease and in the rehabilitation phase, since brain damage always has metabolic consequences for the patient's body, and both premorbid malnutrition and malnutrition after stroke, significantly impact to outcome of the disease. The prevalence of malnutrition in patients with ischemic stroke varies widely. According to various sources, it ranges from 6.1% to 62%, depending on the method for determining protein-energy malnutrition. Despite the relevance of the problem of nutritional support for patients with ischemic stroke, there are few specific recommendations in the literature for this category of patients. This review focuses on nutritional support for patients who require mechanical ventilation or stay in the intensive care unit for more than 48 hours.
{"title":"Nutritional support as part of the basic therapy of a patient in the acute period of ischemic stroke in the intensive care unit","authors":"K. Krylov, Sergey V. Sviridov, I. Vedenina, R. Yagubyan","doi":"10.17816/clinutr119857","DOIUrl":"https://doi.org/10.17816/clinutr119857","url":null,"abstract":"Ischemic stroke remains the predominant cause of disability in the population (3.2 per 1000 population). Only 8% of surviving after ischemic stroke patients can return to their previous work. An integral part of the treatment of ischemic stroke in the intensive care unit is nutritional support. Nutritional support is an integral part of a multidisciplinary approach to the treatment of a patient with ischemic stroke, both during the acute period of the disease and in the rehabilitation phase, since brain damage always has metabolic consequences for the patient's body, and both premorbid malnutrition and malnutrition after stroke, significantly impact to outcome of the disease. The prevalence of malnutrition in patients with ischemic stroke varies widely. According to various sources, it ranges from 6.1% to 62%, depending on the method for determining protein-energy malnutrition. Despite the relevance of the problem of nutritional support for patients with ischemic stroke, there are few specific recommendations in the literature for this category of patients. This review focuses on nutritional support for patients who require mechanical ventilation or stay in the intensive care unit for more than 48 hours.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85048099","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}
Anastasya S. Podkhvatilina, I. Nikitin, L. Brutskaya, N. A. Gultyaeva
This article is about vitamin D in elderly patients. We review a data about matabolism, diagnostic and treatment
这篇文章是关于老年患者的维生素D。我们回顾了有关代谢、诊断和治疗的资料
{"title":"Problematic issues of diagnostics and treatment of vitamin D deficiency in elderly patients","authors":"Anastasya S. Podkhvatilina, I. Nikitin, L. Brutskaya, N. A. Gultyaeva","doi":"10.17816/clinutr115028","DOIUrl":"https://doi.org/10.17816/clinutr115028","url":null,"abstract":"This article is about vitamin D in elderly patients. We review a data about matabolism, diagnostic and treatment","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75740337","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}
BACKGROUND: Nutritional support in abdominal surgery is a complex section of intensive care with many contradictions, both in the available recommendations and in relation to interdisciplinary interaction. The issues of assessing nutritional status, timing of the start and methods of clinical nutrition are far from being resolved. The analysis made it possible not so much to explain who and how to feed in the intensive care unit, to prove the need for an early start of enteral nutrition, as to assess the "scale of the disaster" in the form of a lack of unity of views and low adherence to clinical recommendations. AIMS: to analyze the effectiveness of early enteral nutrition in achieving optimal results in the treatment of patients with abdominal surgical pathology, to assess the depth of knowledge and adherence to clinical recommendations of specialists providing care to this cohort of patients. MATERIALS AND METHODS: The study included 50 patients, 32 of whom started early enteral nutrition, and 18 later enteral nutrition. A survey of 41 specialists (surgeons and intensivist) from three leading hospitals in Tyumen was also conducted. The main set of clinical material was conducted on the basis of the Regional Clinical Hospital No. 1. RESULTS: The study demonstrated the advantages of early enteral nutrition over delayed nutrition by an average of 48 hours in the form of reducing the duration of hospitalization, resuscitation stage of treatment and minimizing pulmonary complications. At the same time, a survey of specialists providing assistance to this cohort of patients showed a lack of unity in tactical approaches and insufficient adherence to the existing clinical recommendations on clinical nutrition in patients with abdominal surgical pathology. CONCLUSIONS: Further research in the field of nutritional support in patients with abdominal surgical pathology should be aimed at reducing the decision-making time in favor of an earlier and combined method of nutritional support, which can be facilitated by increasing literacy and adherence to clinical recommendations of specialists at the interdisciplinary level.
{"title":"Nutritional support in patients with abdominal surgical pathology. The view of a surgeon and an anesthesiologist: opponents or allies?","authors":"N. Shen, Svetlana Yurievna Mukhacheva","doi":"10.17816/clinutr110892","DOIUrl":"https://doi.org/10.17816/clinutr110892","url":null,"abstract":"BACKGROUND: Nutritional support in abdominal surgery is a complex section of intensive care with many contradictions, both in the available recommendations and in relation to interdisciplinary interaction. The issues of assessing nutritional status, timing of the start and methods of clinical nutrition are far from being resolved. The analysis made it possible not so much to explain who and how to feed in the intensive care unit, to prove the need for an early start of enteral nutrition, as to assess the \"scale of the disaster\" in the form of a lack of unity of views and low adherence to clinical recommendations. \u0000AIMS: to analyze the effectiveness of early enteral nutrition in achieving optimal results in the treatment of patients with abdominal surgical pathology, to assess the depth of knowledge and adherence to clinical recommendations of specialists providing care to this cohort of patients. \u0000MATERIALS AND METHODS: The study included 50 patients, 32 of whom started early enteral nutrition, and 18 later enteral nutrition. A survey of 41 specialists (surgeons and intensivist) from three leading hospitals in Tyumen was also conducted. The main set of clinical material was conducted on the basis of the Regional Clinical Hospital No. 1. \u0000RESULTS: The study demonstrated the advantages of early enteral nutrition over delayed nutrition by an average of 48 hours in the form of reducing the duration of hospitalization, resuscitation stage of treatment and minimizing pulmonary complications. At the same time, a survey of specialists providing assistance to this cohort of patients showed a lack of unity in tactical approaches and insufficient adherence to the existing clinical recommendations on clinical nutrition in patients with abdominal surgical pathology. \u0000CONCLUSIONS: Further research in the field of nutritional support in patients with abdominal surgical pathology should be aimed at reducing the decision-making time in favor of an earlier and combined method of nutritional support, which can be facilitated by increasing literacy and adherence to clinical recommendations of specialists at the interdisciplinary level.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88225030","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}
ABSTRACT. The article is devoted to the most difficult problem of intensive care - sepsis. The issues of the pathogenesis of the development of metabolic disorders, the significance of the syndrome of intestinal insufficiency in the formation of endogenous intoxication and multiple organ failure in sepsis are outlined. The review highlights the analysis of publications on the correction of protein-energy malnutrition in critical conditions. Currently, there are no targeted randomized clinical trials to assess the nutritional status and the adequacy of artificial therapeutic nutrition in children diagnosed with sepsis.
{"title":"Nutritional therapy for protein-energy malnutrition \u0000in sepsis in children","authors":"Elmira Samatovna Satvaldieva","doi":"10.17816/clinutr111170","DOIUrl":"https://doi.org/10.17816/clinutr111170","url":null,"abstract":"ABSTRACT. \u0000 The article is devoted to the most difficult problem of intensive care - sepsis. The issues of the pathogenesis of the development of metabolic disorders, the significance of the syndrome of intestinal insufficiency in the formation of endogenous intoxication and multiple organ failure in sepsis are outlined. The review highlights the analysis of publications on the correction of protein-energy malnutrition in critical conditions. Currently, there are no targeted randomized clinical trials to assess the nutritional status and the adequacy of artificial therapeutic nutrition in children diagnosed with sepsis.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87714538","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}
O. Obukhova, A. S. Ivanova, I. Kurmukov, Larisa Ya. Volf
Introduction. In the presented work, the discussion of the 2021 ESPEN practical recommendations for nutritional support in oncology is continued. Methods: The updated version of the 2021 ESPEN practice guidelines differs slightly from the 2017 version and contains flowcharts to facilitate the use of the guidelines in clinical practice, which is also relevant for domestic healthcare. ESPEN-2021 Clinical Guidelines, which offer practical solutions in all areas of oncology, are of particular interest to both oncologists and allied specialists working in oncology. Results. The second part of the review discusses particular issues of nutritional support for cancer patients, and also analyzes the domestic experience of their use. The review provides the main protocols for artificial nutrition in surgery, during irradiation, drug therapy, in patients in remission and at the palliative stage, and also proves the need to maintain physical activity in cancer patients. Conclusion: The presented practical guidance allows organizing an adequate supply of nutrient substrates to cancer patients receiving various types of anticancer treatment, in remission and at the stage of palliative care.
{"title":"Review of ESPEN-2021 Practice Guidelines for Cancer Patients (part two) -- interventions relevant to specific patient categories.","authors":"O. Obukhova, A. S. Ivanova, I. Kurmukov, Larisa Ya. Volf","doi":"10.17816/clinutr119059","DOIUrl":"https://doi.org/10.17816/clinutr119059","url":null,"abstract":"Introduction. In the presented work, the discussion of the 2021 ESPEN practical recommendations for nutritional support in oncology is continued. \u0000Methods: The updated version of the 2021 ESPEN practice guidelines differs slightly from the 2017 version and contains flowcharts to facilitate the use of the guidelines in clinical practice, which is also relevant for domestic healthcare. ESPEN-2021 Clinical Guidelines, which offer practical solutions in all areas of oncology, are of particular interest to both oncologists and allied specialists working in oncology. \u0000Results. The second part of the review discusses particular issues of nutritional support for cancer patients, and also analyzes the domestic experience of their use. The review provides the main protocols for artificial nutrition in surgery, during irradiation, drug therapy, in patients in remission and at the palliative stage, and also proves the need to maintain physical activity in cancer patients. \u0000Conclusion: The presented practical guidance allows organizing an adequate supply of nutrient substrates to cancer patients receiving various types of anticancer treatment, in remission and at the stage of palliative care.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88329629","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}
Osteoporosis is the most common age-related skeletal disease, which characterized by rapid loss of bone mineral density and increased risk of fragility fractures. The social significance of the disease is caused by its complications, which increase disability and mortality rates mostly among elderly people. Inadequate dietary calcium intake and vitamin D deficiency are well-known risk factors for osteoporosis. That is why for many years calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, in recent years, the efficacy and safety of calcium and vitamin D has been questioned. Since some conducted randomized clinical trials have reported only a week positive effect of calcium with or without vitamin in reducing fragility fracture risk. On the other hand, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to use of co-administered calcium and vitamin D supplements, other recent data suggested potential adverse cardiovascular effects from calcium supplementation. This article is focused on the evidence regarding both the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation.
{"title":"Calcium and vitamin D supplements for treatment ana prevention of osteoporosis. Should it be widely used?","authors":"Y. A. Kaminarskaya","doi":"10.17816/clinutr112300","DOIUrl":"https://doi.org/10.17816/clinutr112300","url":null,"abstract":"Osteoporosis is the most common age-related skeletal disease, which characterized by rapid loss of bone mineral density and increased risk of fragility fractures. The social significance of the disease is caused by its complications, which increase disability and mortality rates mostly among elderly people. Inadequate dietary calcium intake and vitamin D deficiency are well-known risk factors for osteoporosis. That is why for many years calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, in recent years, the efficacy and safety of calcium and vitamin D has been questioned. Since some conducted randomized clinical trials have reported only a week positive effect of calcium with or without vitamin in reducing fragility fracture risk. On the other hand, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to use of co-administered calcium and vitamin D supplements, other recent data suggested potential adverse cardiovascular effects from calcium supplementation. This article is focused on the evidence regarding both the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78146660","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}
O. B. Lukyanets, M. Petrova, A. Yakovleva, A. Shestopalov
BACKGROUND: The resolution of intestinal insufficiency syndrome remains one of the urgent problems of nutritional support for patients in chronic critical condition. Purpose of the study. To determine the effectiveness of intestinal lavage in restoring the basic functions of the gastrointestinal tract and microbiocenosis in patients in chronic critical condition. Materials and methods. A prospective, randomized, single-center study was performed. The study was performed in 56 affected men with TBI of various etiologies in a chronic critical condition. At the beginning of treatment and on the 10th day, the effectiveness of gastrointestinal lavage was evaluated in the complex intensive therapy of intestinal insufficiency syndrome. Results. Patients were randomized into two groups depending on the conduct of intestinal lavage. In the 1st group (27 patients), enteral tube feeding was performed according to the standard method. In the 2nd group (29 patients), intestinal lavage was additionally performed with the addition of an enterosorbent to the saline enterosorbent solution, 3 procedures with an interval of 3 days. In the 2nd group (main), there was a significant positive dynamics of carbohydrate and protein metabolism, restoration by the 10th day of the barrier function of the intestine, motility of the gastrointestinal tract, microbiocenosis compared with patients in the control (group 1). Conclusion. The inclusion of gastrointestinal lavage in the complex intensive therapy of SCI in patients in a chronic critical condition in a short time helps to resolve the main pathogenetic links of SCI - restoration of the barrier function of the intestine, digestive-transport, motor-evacuation processes in the gastrointestinal tract, normalization of microbiocenosis, metabolic parameters and nutritional status.
{"title":"The role of intestinal lavage in the normalization of the functions of the gastrointestinal tract in patients in chronic critical condition.","authors":"O. B. Lukyanets, M. Petrova, A. Yakovleva, A. Shestopalov","doi":"10.17816/clinutr111148","DOIUrl":"https://doi.org/10.17816/clinutr111148","url":null,"abstract":"BACKGROUND: The resolution of intestinal insufficiency syndrome remains one of the urgent problems of nutritional support for patients in chronic critical condition. \u0000Purpose of the study. To determine the effectiveness of intestinal lavage in restoring the basic functions of the gastrointestinal tract and microbiocenosis in patients in chronic critical condition. \u0000Materials and methods. A prospective, randomized, single-center study was performed. The study was performed in 56 affected men with TBI of various etiologies in a chronic critical condition. At the beginning of treatment and on the 10th day, the effectiveness of gastrointestinal lavage was evaluated in the complex intensive therapy of intestinal insufficiency syndrome. \u0000Results. Patients were randomized into two groups depending on the conduct of intestinal lavage. In the 1st group (27 patients), enteral tube feeding was performed according to the standard method. In the 2nd group (29 patients), intestinal lavage was additionally performed with the addition of an enterosorbent to the saline enterosorbent solution, 3 procedures with an interval of 3 days. In the 2nd group (main), there was a significant positive dynamics of carbohydrate and protein metabolism, restoration by the 10th day of the barrier function of the intestine, motility of the gastrointestinal tract, microbiocenosis compared with patients in the control (group 1). \u0000Conclusion. The inclusion of gastrointestinal lavage in the complex intensive therapy of SCI in patients in a chronic critical condition in a short time helps to resolve the main pathogenetic links of SCI - restoration of the barrier function of the intestine, digestive-transport, motor-evacuation processes in the gastrointestinal tract, normalization of microbiocenosis, metabolic parameters and nutritional status.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82489637","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}
A. Yakovleva, Zinaida M. Orehova, A. Shestopalov, M. Petrova
BACKGROUND: Fluid therapy in the intensive care unit is one of the most common components of therapy, but at the same time one of the most controversial and widely discussed. The choice of volume and type of infusion is a multifactorial issue. Currently, the search continues for a convenient non-invasive method, which can be used to assess the water composition of the patient's body. AIMS: analysis of the distribution of fluid sectors in patients in chronic critical illness using the bioimpedance with standard fluid therapy. MATERIALS AND METHODS: The study included 63 patients in CCI after brain damage, 28 men, 35 women, the average age 54 19 years. According to nosology: ischemic stroke 22, traumatic brain injury 17, hemorrhagic stroke 14, condition after brain surgery 7, post-hypoxic conditions 2. The study was carried out in the morning before breakfast using the analyzer of bioimpedance metabolic processes and body composition ABC-02 "Medass". A total of 140 measurements were conducted. RESULTS: It drew attention to the fact that in most cases the volume of the total body water (TBW) in patients was within the age and sex norm (78.6%), however, the volume of extracellular water (ECW) reached normal values only in 45.7%. Moreover, both indicators were simultaneously within the normal range only in 44.3%. Then we found that TBW and ECW did not coincide at 35.7%. The most common option for this was an increase in ECW while maintaining a normal TBW (24.3%). When conducting a correlation analysis of TBW and ECW indicators with biochemical blood test data (a decrease in the total protein level, a decrease in the albumin level), the strength of the relationship between the correlation coefficients of the samples on the Chaddock scale turned out to be very weak for all the options considered. CONCLUSIONS: In patients in CCI after brain damage, in more than 50%, there may be an accumulation of water in the extracellular space without visible edema, while in 24.3% the total body water indicator is within the age and sex norm. This indicator doesnt depend on either the level of hypoproteinemia or hypoalbuminemia.
{"title":"Distribution of water sectors in patients in chronic critical illness (early rehabilitation stage).","authors":"A. Yakovleva, Zinaida M. Orehova, A. Shestopalov, M. Petrova","doi":"10.17816/clinutr110984","DOIUrl":"https://doi.org/10.17816/clinutr110984","url":null,"abstract":"BACKGROUND: Fluid therapy in the intensive care unit is one of the most common components of therapy, but at the same time one of the most controversial and widely discussed. The choice of volume and type of infusion is a multifactorial issue. Currently, the search continues for a convenient non-invasive method, which can be used to assess the water composition of the patient's body. \u0000AIMS: analysis of the distribution of fluid sectors in patients in chronic critical illness using the bioimpedance with standard fluid therapy. \u0000MATERIALS AND METHODS: The study included 63 patients in CCI after brain damage, 28 men, 35 women, the average age 54 19 years. According to nosology: ischemic stroke 22, traumatic brain injury 17, hemorrhagic stroke 14, condition after brain surgery 7, post-hypoxic conditions 2. The study was carried out in the morning before breakfast using the analyzer of bioimpedance metabolic processes and body composition ABC-02 \"Medass\". A total of 140 measurements were conducted. \u0000RESULTS: It drew attention to the fact that in most cases the volume of the total body water (TBW) in patients was within the age and sex norm (78.6%), however, the volume of extracellular water (ECW) reached normal values only in 45.7%. Moreover, both indicators were simultaneously within the normal range only in 44.3%. Then we found that TBW and ECW did not coincide at 35.7%. The most common option for this was an increase in ECW while maintaining a normal TBW (24.3%). When conducting a correlation analysis of TBW and ECW indicators with biochemical blood test data (a decrease in the total protein level, a decrease in the albumin level), the strength of the relationship between the correlation coefficients of the samples on the Chaddock scale turned out to be very weak for all the options considered. \u0000CONCLUSIONS: In patients in CCI after brain damage, in more than 50%, there may be an accumulation of water in the extracellular space without visible edema, while in 24.3% the total body water indicator is within the age and sex norm. This indicator doesnt depend on either the level of hypoproteinemia or hypoalbuminemia.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82441674","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}
Introduction. This paper discusses the 2021 ESPEN Practical Guidelines for Nutritional Support in Oncology. Methods: The updated version of the 2021 ESPEN practice guidelines differs slightly from the 2017 version and contains flowcharts to facilitate the use of the guidelines in clinical practice, which is also relevant for domestic healthcare. ESPEN-2021 Clinical Guidelines, which offer practical solutions in all areas of oncology, are of particular interest to both oncologists and allied specialists working in oncology. Results. The first part of the review discusses general recommendations for nutritional support for cancer patients and the possibility of their use in our country: screening of nutritional status at the initial visit, indications for prescribing additional nutrition, the benefits of one or another type of nutritional support in various situations, norms for providing macronutrients, vitamins and minerals, and also substantiates the need for physical activity. Conclusion: This practical guide forms an algorithm of actions to ensure optimal nutrition for a cancer patient. The general principles of nutritional therapy applicable to all cancer patients are based on timely screening for nutritional deficiencies, adherence to proper nutritional support of patients, which can be achieved by modifying the diet or prescribing additional nutrition, mainly enteral.
{"title":"Review of ESPEN-2021 Practice Guidelines for Cancer Patients. Part one.","authors":"O. Obukhova, A. Ivanova, I. Kurmukov, L. Volf","doi":"10.17816/clinutr111900","DOIUrl":"https://doi.org/10.17816/clinutr111900","url":null,"abstract":"Introduction. This paper discusses the 2021 ESPEN Practical Guidelines for Nutritional Support in Oncology. \u0000Methods: The updated version of the 2021 ESPEN practice guidelines differs slightly from the 2017 version and contains flowcharts to facilitate the use of the guidelines in clinical practice, which is also relevant for domestic healthcare. ESPEN-2021 Clinical Guidelines, which offer practical solutions in all areas of oncology, are of particular interest to both oncologists and allied specialists working in oncology. \u0000Results. The first part of the review discusses general recommendations for nutritional support for cancer patients and the possibility of their use in our country: screening of nutritional status at the initial visit, indications for prescribing additional nutrition, the benefits of one or another type of nutritional support in various situations, norms for providing macronutrients, vitamins and minerals, and also substantiates the need for physical activity. \u0000Conclusion: This practical guide forms an algorithm of actions to ensure optimal nutrition for a cancer patient. The general principles of nutritional therapy applicable to all cancer patients are based on timely screening for nutritional deficiencies, adherence to proper nutritional support of patients, which can be achieved by modifying the diet or prescribing additional nutrition, mainly enteral.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74383204","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}
A. Martyushev-Poklad, D. Yankevich, Nataliya G. Savitskaya, M. Petrova
The existing system of prevention of age-related diseases focused on cohort-based risk factors shows insufficient effectiveness, and hence there is a need in practicable methodology of health promotion compliant with the principles of P4 medicine, with a special focus on nutritional interventions. The paper outlines an algorithm of nutritional interventions designed in accordance with the principles of person-centered organizational model of health care. The algorithm is based on the modern concept of exposome and its influence on the key mechanisms of accelerated aging and pathogenesis of age-related diseases. The proposed approach to personalized nutritional interventions is implemented in 3 steps: (1) the need in nutritional intervention is identified through evaluation of the signs and symptoms of health impairment and accelerated aging that have very probable association with suboptimal nutrition; (2) factors of individual exposome are evaluated as potential sources of health problems; (3) first line nutritional interventions are selected and implemented. The algorithm is focused on eliminating the shortcomings of the diagnosis-centered organizational model of healthcare prevailing worldwide: to enable early detection of distress, the use of the most effective and affordable interventions (diet and nutrition), maximum involvement of the patient in the management of ones health. The algorithm bears a good potential of automation in the form of decision support for the patient regarding his health. The use of original questionnaires and patient-centered data reduces the cost and expands the possibilities of scaling the algorithms of intervention. The algorithm can become the basis for wide introduction of the principles of predictive, personalized and participatory prevention of age-related diseases.
{"title":"Nutritional interventions in the framework of a person-centered model of health care and geroprotection","authors":"A. Martyushev-Poklad, D. Yankevich, Nataliya G. Savitskaya, M. Petrova","doi":"10.17816/clinutr110996","DOIUrl":"https://doi.org/10.17816/clinutr110996","url":null,"abstract":"The existing system of prevention of age-related diseases focused on cohort-based risk factors shows insufficient effectiveness, and hence there is a need in practicable methodology of health promotion compliant with the principles of P4 medicine, with a special focus on nutritional interventions. \u0000The paper outlines an algorithm of nutritional interventions designed in accordance with the principles of person-centered organizational model of health care. The algorithm is based on the modern concept of exposome and its influence on the key mechanisms of accelerated aging and pathogenesis of age-related diseases. \u0000The proposed approach to personalized nutritional interventions is implemented in 3 steps: \u0000(1) the need in nutritional intervention is identified through evaluation of the signs and symptoms of health impairment and accelerated aging that have very probable association with suboptimal nutrition; \u0000(2) factors of individual exposome are evaluated as potential sources of health problems; \u0000(3) first line nutritional interventions are selected and implemented. \u0000The algorithm is focused on eliminating the shortcomings of the diagnosis-centered organizational model of healthcare prevailing worldwide: to enable early detection of distress, the use of the most effective and affordable interventions (diet and nutrition), maximum involvement of the patient in the management of ones health. The algorithm bears a good potential of automation in the form of decision support for the patient regarding his health. The use of original questionnaires and patient-centered data reduces the cost and expands the possibilities of scaling the algorithms of intervention. \u0000The algorithm can become the basis for wide introduction of the principles of predictive, personalized and participatory prevention of age-related diseases.","PeriodicalId":92235,"journal":{"name":"Journal of clinical nutrition and metabolism","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76965454","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}
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