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1.
Ann Palliat Med ; 10(10): 11191-11202, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763477

RESUMO

OBJECTIVE: We aimed to summarize the enteral nutrition (EN) management of stroke patients according to recent evidence. BACKGROUND: Stroke patients have a high incidence of dysphagia, which is the main cause of malnutrition, and stroke with malnutrition leads to high recurrence and mortality. Insufficient food intake caused by dysphagia is the main cause of malnutrition in stroke patients, which is associated with poor prognosis, increased mortality, and deteriorated outcomes in patients with stroke. Dehydration is also worthy of attention. METHODS: Non-systematic searches of the PubMed database were conducted to retrieve relevant English-language articles, and the CNKI and Wanfang database were searched for relevant Chinese-language articles. Fifteen recent guidelines or expert consensuses on the clinical nutritional management of stroke patients were published between 2013 and 2021, of which eight are from China. CONCLUSIONS: Before providing nutritional support, swallowing, hydration, and risk of malnutrition need to be screened by a dietitian or professional. Although the initiation time of nutritional support is different in each guideline, tube feeding is preferable for patients with dysphagia. The appropriate dosage, formula, and treatment of complications need to be further studied. Also, nutritional support for stroke patients at different stages needs to be further improved. The continuous improvement and details of stroke nutrition guidelines contribute to standardized clinical nutrition practices and benefit patients.


Assuntos
Transtornos de Deglutição , Desnutrição , Acidente Vascular Cerebral , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Nutrição Enteral , Humanos , Apoio Nutricional , Acidente Vascular Cerebral/complicações
2.
Zhonghua Shao Shang Za Zhi ; 37(9): 805-810, 2021 Sep 20.
Artigo em Chinês | MEDLINE | ID: mdl-34645145

RESUMO

The complexity of burn metabolism and limitations of its cognition are the core factors leading to dissatisfactory efficacy of nutritional therapy in severe burn patients. Precise understanding of burn metabolic rules is a prerequisite for improving the pertinence and effectiveness of nutritional therapy. The previous division of burn metabolic stages based on energy consumption did not pay enough attention to substance metabolism, so it is difficult to fully comprehend the overall change pattern and stage characteristics of burn metabolism. Through the effective integration of the metabonomics, physiomics, and clinical data, combining the pathophysiological characteristics of burns at different clinical phases, this paper suggested that the metabolism of severe burns should be divided into four stages and proposed the corresponding nutritional strategies and measures according to different metabolic characteristics, in order to provide a basis for further enhancing the nutritional efficacy in burn patients.


Assuntos
Queimaduras , Queimaduras/terapia , Humanos , Metabolômica , Apoio Nutricional
4.
Clin Nutr ESPEN ; 45: 45-54, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34620354

RESUMO

BACKGROUND: There is increasing evidence from randomized-controlled trials demonstrating that nutritional support improves clinical outcomes in the population of malnourished medical inpatients. We investigated associations of trial characteristics including clinical setting, duration of intervention, individualization of nutritional support and amount of energy and protein, and effects on clinical outcomes in an updated meta-analysis. METHODS: We searched Cochrane Library, MEDLINE and EMBASE, from inception to December 15, 2020. Randomized-controlled trials investigating the effect of oral and enteral nutritional support interventions, when compared to usual care, on clinical outcomes of malnourished non-critically ill medical inpatients were included. Two reviewers independently extracted data and assessed risk of bias. The primary endpoint was all cause-mortality within 12-months. RESULTS: We included 29 randomized-controlled trials with a total of 7,166 patients. Heterogeneity across RCTs was high, with overall moderate study quality and mostly moderate or unclear risk of bias. Overall, there was an almost 30%-reduction in mortality in patients receiving nutritional support compared to patients not receiving nutritional support (253/2960 [8.5%] vs. 336/2976 [11.3%]) with an odds ratio of 0.72 (95% CI 0.57 to 0.91, p = 0.006). The most important predictors for the effect of nutritional trials on mortality were high protein strategies (odds ratio 0.57 vs. 0.93, I2 = 86.3%, p for heterogenity = 0.007) and long-term nutritional interventions (odds ratio 0.53 vs. 0.85, I2 = 76.2%, p for heterogenity = 0.040). Nutritional support also reduced unplanned hospital readmissions and length of hospital stay. CONCLUSIONS: There is increasing evidence from randomized trials showing that nutritional support significantly reduces mortality, unplanned hospital readmissions and length of stay in medical inpatients at nutritional risk, despite heterogeneity and varying methodological quality among trials. Trials with high-protein strategies and long-lasting nutritional support interventions were most effective.


Assuntos
Desnutrição , Apoio Nutricional , Humanos , Pacientes Internados , Tempo de Internação , Desnutrição/terapia , Fatores de Tempo
5.
Clin Nutr ESPEN ; 45: 486-491, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34620359

RESUMO

BACKGROUND: Intensive care unit (ICU) patients are at particular risk for malnutrition with major impact for outcome and prognosis. Nutrition support teams (NST) have been proposed to improve nutrition care in ICU patients. OBJECTIVE: To assess the effectiveness of an interdisciplinary NST on anthropometry and clinical outcome of ICU patients. METHODS: Before NST implementation, we assessed 120 patients (before NST group; SAPS II score 44 ± 16), afterwards 60 patients (after NST group), of whom 29 received NST guidance (after NST + group; SAPS II 65 ± 19) and 31 not (after NST - group; SAPS II, 54 ± 16). The primary outcome parameter was length of stay in the hospital (hospital-LOS). Severity of disease was assessed by the APACHE II score and the nutritional risk (NUTRIC) score. RESULTS: NST intervention resulted in a more pronounced improvement of disease severity (APACHE II, from 27 ± 8 to 18 ± 6, p < 0.001; NUTRIC, from 7 ± 2 to 4 ± 2, p < 0.001) compared to no NST intervention (APACHE II from 24 ± 7 to 21 ± 7, p < 0.05; NUTRIC from 6 ± 2 to 5 ± 2, p < 0.01). The mean hospital-LOS was not reduced, neither in the NST intervention group nor in the control group without NST intervention. NST intervention failed to improve nutritional status or mortality compared to no NST intervention. CONCLUSION: In our study the NST intervention had a positive effect on disease severity, but failed to improve mortality, hospital-LOS or nutritional status in ICU patients, likely because of a large patient heterogeneity. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02200874).


Assuntos
Estado Terminal , Desnutrição , APACHE , Humanos , Unidades de Terapia Intensiva , Desnutrição/diagnóstico , Desnutrição/terapia , Apoio Nutricional
8.
Nutrients ; 13(10)2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34684555

RESUMO

The main objective of this pilot study was to determine the association between augmented renal clearance (ARC), urinary nitrogen loss and muscle wasting in critically ill trauma patients. We conducted a retrospective analysis of a local database in 162 critically ill trauma patients without chronic renal dysfunction. Nutritional-related parameters and 24 h urinary biochemical analyses were prospectively collected and averaged over the first ten days after admission. Augmented renal clearance was defined by a mean creatinine clearance (CLCR) > 130 mL/min/1.73 m2. The main outcome was the cumulated nitrogen balance at day 10. The secondary outcome was the variation of muscle psoas cross-sectional area (ΔCSA) calculated in the subgroup of patients who underwent at least two abdominal CT scans during the ICU length of stay. Overall, there was a significant correlation between mean CLCR and mean urinary nitrogen loss (normalized coefficient: 0.47 ± 0.07, p < 0.0001). ARC was associated with a significantly higher urinary nitrogen loss (17 ± 5 vs. 14 ± 4 g/day, p < 0.0001) and a lower nitrogen balance (-6 ± 5 vs. -4 ± 5 g/day, p = 0.0002), without difference regarding the mean protein intake (0.7 ± 0.2 vs. 0.7 ± 0.3 g/kg/day, p = 0.260). In the subgroup of patients who underwent a second abdominal CT scan (N = 47), both ΔCSA and %ΔCSA were higher in ARC patients (-33 [-41; -25] vs. -15 [-29; -5] mm2/day, p = 0.010 and -3 [-3; -2] vs. -1 [-3; -1] %/day, p = 0.008). Critically ill trauma patients with ARC are thus characterized by a lower nitrogen balance and increased muscle loss over the 10 first days after ICU admission. The interest of an increased protein intake (>1.5 g/kg/day) in such patients remains a matter of controversy and must be confirmed by further randomized trials.


Assuntos
Creatinina/urina , Estado Terminal/terapia , Nitrogênio/urina , Músculos Psoas/metabolismo , Eliminação Renal , Adulto , Bases de Dados Factuais , Feminino , Humanos , Unidades de Terapia Intensiva , Rim/fisiopatologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Apoio Nutricional , Projetos Piloto , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco
9.
Clin Nutr ESPEN ; 45: 381-388, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34620344

RESUMO

BACKGROUND: The COVID-19 pandemic has been a challenge for nutrition monitoring and delivery. This study evaluates clinical and nutritional characteristics of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and investigates the relationship between nutrition delivery and clinical outcomes. METHODS: Prospective observational study of adults admitted for >24 hrs to a tertiary-care hospital during a period of 2months. Data was collected on disease severity, energy, protein delivery and adequacy, use of mechanical ventilation (MV), hospital length of stay (LOS). Multivariate logistic regression models were used to determine the associations with mortality as the primary outcome. RESULTS: 1083 patients: 69% male (n = 747), 31% females (n = 336), mean age 58.2 ± 12.8 with 26.6 ± 4.32 BMI were analysed. 1021 patients survived and 62 deaths occurred, with 183 and 900 patients in the ICU and ward, respectively. Inadequate calorie and protein delivery had significantly higher mortality than those with adequate provision (p < 0.001) among the ICU patients. In bivariate logistic regression analysis, inadequacy of energy and protein, disease severity, comorbidities ≥3, NRS score ≥3 and prone ventilation correlates with mortality (p < 0.001). In multivariate logistic regression analysis of the ICU patients, energy inadequacy (OR:3.6, 95%CI:1.25-10.2) and prone ventilation (OR:11.0, 95%CI:3.8-31.9) were significantly (p < 0.05) associated with mortality after adjusting for disease severity, comorbidities and MV days. CONCLUSION: Most patients infected with SARS-CoV-2 are at nutrition risk that can impact outcome. Our data suggest that addressing nutritional adequacy can be one of the measures to reduce hospital LOS, and mortality among nutritionally risk patients.


Assuntos
COVID-19 , Pandemias , Adulto , Idoso , Estado Terminal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Apoio Nutricional , SARS-CoV-2
10.
Nutrients ; 13(10)2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34684566

RESUMO

The role of foodservices in aged care is difficult to understand, and strategies to improve the nutritional care of residents are often unsustainable. In particular, food-first strategies such as food fortification are poorly executed in everyday practice and its execution relies upon the foodservice system in aged care homes. The aim of this study was to explore the perspective of staff on the role of foodservices in aged care and gauge the level of skills, education, access, time, and ability to deliver food fortification. Semi-structured interviews were conducted with foodservice managers, foodservice workers, dietitians, carers, and other managers who work in aged care homes across Australia. Participants were recruited purposively through email and through snowballing. Interviews (n = 21) were recorded, transcribed verbatim, and analyzed using inductive thematic analysis. Three themes and six sub-themes were identified. The three themes include the role of foodservices being more than just serving food, teamwork between all staff to champion nutrition, and workplace culture that values continuous improvement. These themes identify how staff perceive the role of foodservices in aged care and provide an important perspective on the long-term sustainability of food fortification strategies and how to improve current practice.


Assuntos
Serviços de Alimentação , Instituição de Longa Permanência para Idosos , Apoio Nutricional , Pesquisa Qualitativa , Instituições Residenciais , Participação dos Interessados , Adulto , Idoso , Feminino , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Pessoal
11.
Nutrients ; 13(10)2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34684523

RESUMO

Pancreatic cancer represents a very challenging disease, with an increasing incidence and an extremely poor prognosis. Peculiar features of this tumor entity are represented by pancreatic exocrine insufficiency and an early and intense nutritional imbalance, leading to the highly prevalent and multifactorial syndrome known as cancer cachexia. Recently, also the concept of sarcopenic obesity has emerged, making the concept of pancreatic cancer malnutrition even more multifaceted and complex. Overall, these nutritional derangements play a pivotal role in contributing to the dismal course of this malignancy. However, their relevance is often underrated and their assessment is rarely applied in clinical daily practice with relevant negative impact for patients' outcome in neoadjuvant, surgical, and metastatic settings. The proper detection and management of pancreatic cancer-related malnutrition syndromes are of primary importance and deserve a specific and multidisciplinary (clinical nutrition, oncology, etc.) approach to improve survival, but also the quality of life. In this context, the introduction of a "Nutritional Oncology Board" in routine daily practice, aimed at assessing an early systematic screening of patients and at implementing nutritional support from the time of disease diagnosis onward seems to be the right path to take.


Assuntos
Dietética/métodos , Desnutrição/terapia , Oncologia/métodos , Neoplasias Pancreáticas/complicações , Conselhos de Especialidade Profissional , Caquexia/etiologia , Caquexia/terapia , Insuficiência Pancreática Exócrina/etiologia , Insuficiência Pancreática Exócrina/terapia , Humanos , Desnutrição/etiologia , Apoio Nutricional , Sarcopenia/etiologia , Sarcopenia/terapia
12.
Rev Infirm ; 70(274): 25-27, 2021 Oct.
Artigo em Francês | MEDLINE | ID: mdl-34565532

RESUMO

Nutritional nursing care, whether prescribed or on its own role, is a fundamental aspect of the fight against undernutrition in hospital, which is a determinant of vital and functional prognosis. This care includes screening for undernutrition and its risk factors, assessment of intake and feeding difficulties, enrichment of oral nutrition, enteral and parenteral nutrition. Given the complexity and importance of these tasks, a multi-professional approach involving a transverse nutrition unit is beneficial.


Assuntos
Nutrição Enteral , Desnutrição , Humanos , Desnutrição/diagnóstico , Desnutrição/prevenção & controle , Estado Nutricional , Apoio Nutricional , Nutrição Parenteral
13.
Clin Nutr ; 40(10): 5249-5251, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34534893

RESUMO

Early identification of patients at risk of malnutrition or who are malnourished is crucial in order to start a timely and adequate nutritional therapy. Yet, despite the presence of many nutrition screening tools for use in the hospital setting, there is no consensus regarding the best tool as well as inadequate adherence to screening practices which impairs the achievement of effective nutritional therapy. In recent years, artificial intelligence and machine learning methods have been widely used, across multiple medical domains, to aid clinical decision making and to improve quality and efficiency of care. Therefore, Yin and colleagues propose a machine learning based individualized decision support system aimed to identify and grade malnutrition in cancer patients by applying unsupervised and supervised machine learning methods on nationwide cohort. This approach, demonstrate the ability of machine learning methods to create tools to recognize malnutrition. The machine learning based screening serves as a first layer in a nutritional therapy workflow and provides improved support for decision making of health professionals to fit individualized nutritional therapy in at-risk patients.


Assuntos
Inteligência Artificial , Desnutrição , Humanos , Aprendizado de Máquina , Desnutrição/diagnóstico , Desnutrição/terapia , Programas de Rastreamento , Estado Nutricional , Apoio Nutricional
14.
Pan Afr Med J ; 39: 167, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34539963

RESUMO

Multifocal tuberculosis is rare in immunocompetent subjects. It is characterized by the involvement of at least two extra-pulmonary sites, associated or not with lung disease. It is often difficult to diagnose. We here report a case of multifocal tuberculosis in a non-immunocompromised black African subject at the Hubert Koutoukou Maga National Hospital and University Center (CNHU-HKM) in Cotonou, Benin. The study involved a 23-year-old man, with no particular previous history, admitted with diffuse abdominal pain associated with alteration of general state. Clinical examination showed severe malnutrition and medium-volume ascites. Imaging tests (chest X-ray, ultrasound and computed tomography (CT) scan) showed multiple lung, liver, pancreatic, bone, lymph nodes and colic lesions suggesting multimetastatic tumor. Colonoscopy then showed budding lesion of the cecum. GeneXpert test showed Koch´s bacilli. The anatomo-pathological examination of colic biopsies and GeneXpert sputum test confirmed multifocal tuberculosis. The patient received antituberculosis treatment and nutritional support. However he died. Multifocal tuberculosis is a serious disease that is difficult to diagnose. Then it is frequently mis-diagnosed in tropical areas, especially when it occurs in immunocompetent patients.


Assuntos
Antituberculosos/administração & dosagem , Neoplasias do Colo/diagnóstico , Tuberculose/diagnóstico , Dor Abdominal/etiologia , Grupo com Ancestrais do Continente Africano , Benin , Neoplasias do Colo/patologia , Colonoscopia , Evolução Fatal , Humanos , Imunocompetência , Masculino , Desnutrição/diagnóstico , Apoio Nutricional/métodos , Tomografia Computadorizada por Raios X , Tuberculose/terapia , Adulto Jovem
15.
Nutrients ; 13(9)2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34578858

RESUMO

The virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the disease coronavirus disease 2019 (COVID-19). The cumulative number of cases reported globally is now nearly 197 million and the number of cumulative deaths is 4.2 million (26 July to 1 August 2021). Currently we are focusing primarily on keeping a safe distance from others, washing our hands, and wearing masks, and the question of the effects of diet and diet-dependent risk factors remains outside the center of attention. Nevertheless, numerous studies indicate that diet can play an important role in the course of COVID-19. In this paper, based on select scientific reports, we discuss the structure and replication cycle of SARS-CoV-2, risk factors, dietary standards for sick patients, and the roles of the microbiome and dietary components supporting the immune system in preventing COVID-19.


Assuntos
COVID-19/dietoterapia , Comportamento Alimentar , Microbioma Gastrointestinal/imunologia , Apoio Nutricional/métodos , SARS-CoV-2/imunologia , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/prevenção & controle , Humanos , Micronutrientes/administração & dosagem , Probióticos/administração & dosagem , Fatores de Risco , Índice de Gravidade de Doença , Replicação Viral/imunologia
16.
Clin Nutr ; 40(10): 5399-5406, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34571239

RESUMO

BACKGROUND & AIMS: Although nutritional care is a cornerstone in the management of pediatric intestinal failure (IF), little is known about feeding difficulty (FD) prevalence. The aim of this study was to determine the frequency of FD and associated factors and to characterize eating behaviours in two pediatric IF rehabilitation centres (Hôpital-Necker Enfants Malades (NEM), France and Alberta Children's Hospital (ACH), Canada). METHODS: Parents of children (aged 1-18 years) on home parenteral nutrition (PN) for >3 months followed at NEM and ACH completed two validated tools: Montreal Children's Feeding scale for severity of FD, Child Eating Behaviour Questionnaire and a pediatric IF-specific questionnaire for FD associated risk factors. RESULTS: In the entire cohort (n = 59, median 5.2 years), 15% had mild, 19% had moderate and 25% had severe FD. No FD was seen in 53% vs 11% and severe FD was seen in 20% vs. 39% of the NEM and ACH cohorts respectively (p = 0.003). Current ETF was less common at NEM vs. ACH (3% vs. 50%, p < 0.001). The FD score was associated with current enteral tube feed (ETF) use (p = 0.04). Compared to healthy reference children, the NEM cohort did not differ for the enjoyment of food, whereas the ACH cohort's enjoyment was lower (p < 0.0001). The ACH cohort scored higher for food avoidance behaviours: food fussiness (p < 0.02), satiety responsiveness (p < 0.0001), and slowness in eating (p < 0.0001) while the NEM cohort was not different from healthy reference children. In the entire cohort, according to parental recall, 60% were reported to be NPO for >12 weeks in the first 6 months of life, and late introduction of purees (>9 months) and lumpy textures (>1 year) were found in 40% and 58%, respectively. Parent-recalled ETF differed between NEM and ACH in the first 6 months of life (45% vs 76%, p = 0.03). CONCLUSIONS: Feeding difficulty and associated risk factors, including early ETF, prolonged NPO and delays in achieving feeding milestones were frequently reported in pediatric IF. Feeding medicalization with the use of ETF may inadvertently contribute to FD and eating disorder behavioural characteristics. This study highlights the need for FD prevention and an increased focus on establishing healthy eating. Future prospective study of FD, associated risk factors and clinical outcomes are merited.


Assuntos
Comportamento Alimentar , Apoio Nutricional , Síndrome do Intestino Curto/terapia , Canadá/epidemiologia , Criança , Pré-Escolar , Diarreia/terapia , França/epidemiologia , Hospitais Pediátricos , Humanos , Lactente , Pseudo-Obstrução Intestinal/terapia , Pais/psicologia , Inquéritos e Questionários
17.
Nutrients ; 13(9)2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34578997

RESUMO

Limited information exists on dietary practices in para-athletes. The aim of this study was to clarify the actual situation of para-athletes' dietary practice and to sort out the factors (i.e., eating perception, nutrition knowledge, and body image), that may hinder their dietary practices, and explored the practical challenges in nutritional support and improving nutrition knowledge for para-athletes. Thirty-two Japanese para-athletes (22 men) and 45 collegiate student athletes without disabilities (27 men) participated in the online survey. The questionnaire included demographic characteristics, eating perception, dietary practices, and nutrition knowledge. The Japanese version of the body appreciation scale was used to determine their body image. Para-athletes who answered that they knew their ideal amount and way of eating showed significantly higher body image scores (r = 0.604, p < 0.001). However, mean score for nutrition knowledge of para-athletes were significantly lower than collegiate student athletes (19.4 ± 6.8 vs. 24.2 ± 6.1 points, p = 0.001). Both groups did not identify a dietitian as the source of nutrition information or receiving their nutrition advice. The results indicate para-athletes have unique eating perceptions and inadequate nutrition knowledge. Future interventions are needed to examine nutritional supports and education in relation to the role of dietitians.


Assuntos
Imagem Corporal/psicologia , Dieta/psicologia , Comportamento Alimentar/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Paratletas/psicologia , Adulto , Atletas/psicologia , Feminino , Humanos , Japão , Masculino , Apoio Nutricional , Ciências da Nutrição e do Esporte , Estudantes/psicologia , Inquéritos e Questionários , Universidades , Adulto Jovem
19.
Nutrients ; 13(8)2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34444926

RESUMO

Gastric cancer treatments are rapidly evolving, leading to significant survival benefit. Recent evidence provided by clinical trials strongly encouraged the use of perioperative chemotherapy as standard treatment for the localized disease, whereas in the advanced disease setting, molecular characterization has improved patients' selection for tailored therapeutic approaches, including molecular targeted therapy and immunotherapy. The role of nutritional therapy is widely recognized, with oncologic treatment's tolerance and response being better in well-nourished patients. In this review, literature data on strategies or nutritional interventions will be critically examined, with particular regard to different treatment phases (perioperative, metastatic, and palliative settings), with the aim to draw practical indications for an adequate nutritional support of gastric cancer patients and provide an insight on future directions in nutritional strategies. We extensively analyzed the last 10 years of literature, in order to provide evidence that may fit current clinical practice both in terms of nutritional interventions and oncological treatment. Overall, 137 works were selected: 34 Randomized Clinical Trials (RCTs), 12 meta-analysis, 9 reviews, and the most relevant prospective, retrospective and cross-sectional studies in this setting. Eleven ongoing trials have been selected from clinicaltrial.gov as representative of current research. One limitation of our work lies in the heterogeneity of the described studies, in terms of sample size, study procedures, and both nutritional and clinical outcomes. Indeed, to date, there are no specific evidence-based guidelines in this fields, therefore we proposed a clinical algorithm with the aim to indicate an appropriate nutritional strategy for gastric cancer patients.


Assuntos
Neoplasias Esofágicas/terapia , Apoio Nutricional/tendências , Cuidados Paliativos/tendências , Assistência Perioperatória/tendências , Neoplasias Gástricas/terapia , Adolescente , Adulto , Estudos Transversais , Neoplasias Esofágicas/complicações , Feminino , Humanos , Masculino , Desnutrição/etiologia , Desnutrição/prevenção & controle , Pessoa de Meia-Idade , Apoio Nutricional/métodos , Cuidados Paliativos/métodos , Assistência Perioperatória/métodos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Neoplasias Gástricas/complicações , Adulto Jovem
20.
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