Nutritional screening with Subjective Global Assessment predicts hospital stay in patients with digestive diseases.

OBJECTIVE: Nutritional status is an important factor that determines hospital stay, and the Subjective Global Assessment (SGA) is a candidate tool for nutritional screening on admission. However, the significance of the SGA has not been evaluated well in the ward for digestive diseases. We conducted the present study to test whether the SGA predicts hospital stay of these patients. METHODS: Two hundred sixty-two patients with digestive diseases were consecutively enrolled between July 2004 and April 2005. They consisted of 145 males and 117 females and included 110 patients with cancer. Disease category was gastrointestinal in 94, hepatic in 111, and biliary/pancreatic in 57. The SGA was performed by a certified dietician. Effects of SGA and other nutritional parameters on hospital stay were examined by simple and multiple regression analysis. RESULTS: Among tested variables, simple regression analysis identified the SGA, disease category, presence of malignancy, serum albumin level, percent triceps skinfold thickness, and percent arm muscle circumference as significant predictive parameters for hospital stay. Multiple regression analysis revealed that the SGA had the best predictive power, followed by the presence of malignancy and disease category. CONCLUSION: The SGA is a simple and reliable predictor for hospital stay in patients with digestive diseases.

Low-dose granulocyte colony-stimulating factor overcomes neutropenia in the treatment of non-Hodgkin's lymphoma with higher cost-effectiveness.

To facilitate more economical medical care, we carried out a prospective study of whether a THP-COP regimen (cyclophosphamide, pirarubicin, vincristine, and prednisolone) with low-dose granulocyte colony-stimulating factor (G-CSF) would effectively treat non-Hodgkin's lymphoma (NHL). From April 2003 through March 2004, we enrolled 19 consecutive patients with newly diagnosed NHL treated at our hospital. The patients were divided into young and elderly groups. Each patient underwent chemotherapy with 8 courses of a THP-COP regimen with a 50-microg dose of lenograstim. Age- and sex-matched historical control patients (n = 141) received NHL diagnoses between 1998 and 2003. Each patient in the control group underwent the same chemotherapy and received a 100-microg dose of lenograstim. The mean (+/-SD) total amounts of G-CSF per cycle of chemotherapy were 332 +/- 103 microg (young patients) and 345 +/- 128 microg (elderly patients) in the low-dose group and 594 +/- 439 microg (young) and 730 +/- 551 microg (elderly) in the control group. The duration of fever in 1 cycle of chemotherapy was 0.3 +/- 1.0 days (young) and 0.1 +/- 0.8 days (elderly) in the low-dose group and 0.5 +/- 1.3 days (young) and 0.8 +/- 2.0 days (elderly) in the control group. A THP-COP regimen with low-dose G-CSF could be administered to NHL patients with safety. Administration of a 50-microg dose of lenograstim is sufficient and recommended for the treatment of NHL.

Validation of a portable indirect calorimeter (Metavine) for measuring energy expenditure in an elderly population.

1. The aim of the present study was to evaluate the usefulness and reliability of a portable indirect calorimeter (Metavine; Vine, Tokyo, Japan). 2. We measured energy expenditure (EE) of elderly people (n = 191) at nursing homes using both Metavine and an authorized indirect calorimeter (Deltatrac Metabolic Monitor; Datex, Helsinki, Finland) and compared them. 3. Energy expenditure measured by Metavine significantly correlated with EE measured by the Deltatrac Metabolic Monitor (P < 0.001). 4. In particular, Metavine gave almost same results as the Deltatrac Metabolic Monitor, showing an excellent reliability, within the range of EE from 800 to 1500 kcal/day. However EE measured by Metavine below 800 kcal/day or above 1500 kcal/day required correction to agree with EE as measured by the Deltatrac Metabolic Monitor. 5. In conclusion, Metavine is a useful portable calorimeter for measuring EE in elderly people when used with sufficient recognition of its characteristics of data acquisition.

Validation of a portable indirect calorimeter (Metavine® ) for measuring energy expenditure in an elderly population.

1. The aim of the present study was to evaluate the usefulness and reliability of a portable indirect calorimeter (Metavine; Vine, Tokyo, Japan). 2. We measured energy expenditure (EE) of elderly people (n = 191) at nursing homes using both Metavine and an authorized indirect calorimeter (Deltatrac Metabolic Monitor; Datex, Helsinki, Finland) and compared them. 3. Energy expenditure measured by Metavine® significantly correlated with EE measured by the Deltatrac Metabolic Monitor (P < 0.001). 4. In particular, Metavine gave almost same results as the Deltatrac Metabolic Monitor, showing an excellent reliability, within the range of EE from 800 to 1500 kcal/day. However EE measured by Metavine below 800 kcal/day or above 1500 kcal/day required correction to agree with EE as measured by the Deltatrac Metabolic Monitor. 5. In conclusion, Metavine is a useful portable calorimeter for measuring EE in elderly people when used with sufficient recognition of its characteristics of data acquisition.