Home Artificial Nutrition in Polish Children: An Analysis of 9-Year National Healthcare Provider Data.

BACKGROUND: Home artificial nutrition (HAN) is a developing method of treatment that reduces the need for hospitalizations. The epidemiology of pediatric HAN in Poland has not yet been covered in detail. This study is a longitudinal nationwide analysis of incidence, prevalence, and patients' profile for HAN in Polish children. METHODS: Assessment of National Health Fund (NFZ) data covering all pediatric patients treated with HAN in Poland between 2010 and 2018. RESULTS: HAN was received by 4426 children, 65 patients were on home enteral nutrition (HEN) or home parenteral nutrition (HPN) at different times (HEN n = 3865, HPN n = 626). HAN was most frequently started before the child was 3 years old and long-term HAN programs (5-9 years) were reported. The most common principal diagnosis in HEN was food-related symptoms and signs. In HPN, it was postoperative gastrointestinal disorders. A regionally differentiated prevalence of HAN patients and centers was demonstrated. Mortality among patients was 24.9% for HEN, and 9.6% for HPN, and the main in-hospital cause of death was cardiac arrest. CONCLUSIONS: HAN's use is increasing and evolving in Poland. Uneven distribution of patients and centers results in difficult access to the nutritional procedure which, together with the increasing number of patients, highlights the need for data analysis and development of nutrition centers.

The role of oxidant-antioxidant markers and resistin in metabolic syndrome elderly individuals.

In elderly, hormones and oxidant-antioxidant interplay are suggested to mediate biochemical balance between adipose tissue to other tissues. Thus the study attempts to explore metabolic traits, plasma resistin, and oxidant-antioxidant markers in metabolic syndrome (MetS) in comparison to non-metabolic syndrome (non-MetS) elderly individuals. A total of 541 healthy elderly Caucasians, with no acute and/or chronic disorders were invited. After taking into account inclusion/exclusion criteria's the MetS was defined as the presence of three out of five abnormal findings and allowed to divided groups into: non-metabolic syndrome, non-MetS (n = 25, median age 69.0 years), and newly diagnosed MetS (n = 29; median age 70.5 years) individuals. Glucose, plasma lipids, resistin (Res), thiobarbituric acid-reacting substances (TBARS), total antioxidant status (TAS), and Cu,Zn-superoxide dismutase (SOD-1) were measured. The MetS had higher resistin than non-MetS (p < 0.04). The linear correlation (all at p < 0.05) showed correlation for Res&triacylglycerols (R = 0.44), and for Res&diastolic blood pressure (R = -0.58) and for SOD-1&fasting glucose (R = -0.34) in MetS, while in the non-MetS group fasting glucose correlates with Res (R = 0.58) and with TAS (R = -0.43). The multiple regression analysis (alone and in combination) showed that independently from other factors resistin correlated positively with fasting glucose (ß = 0.37; R = 0.58; R2 = 0.23; p < 0.01) in all investigated elderly participants. In the MetS resistin correlated negatively with diastolic blood pressure (ß = -0.68; R = 0.80; R2 = 0.53; p = 0.0004) moreover in that group TAS correlated negatively with HDL-C (ß = -0.71; R = 0.72; R2 = 0.37; p = 0.01). While age correlated negatively with systolic blood pressure (ß = -0.60; R = 0.62; R2 = 0.14; p = 0.03) independently from other factors in the non-MetS group. Various metabolic factors contribute to maintain serum resistin and oxidant-antioxidant balance in the elderly people in the presence or absence of MetS. Resistin may serve as a predictor of MetS in the elderly, while strong antioxidant defense interactions in older individuals may indicate good health.