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1.
Nutrients ; 14(12)2022 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-35745230

RESUMO

Most hospitalized COVID-19 pneumonia patients are older adults and/or have nutrition-related issues. Many are bedridden in intensive care units (ICU), a well-documented cause of malnutrition, muscle wasting, and functional impairment. Objectives: To assess the effectiveness of an intensive rehabilitation program over the nutritional/functional status of patients recovering from COVID-19 pneumonia. Post-COVID-19 pneumonia patients underwent a 30-day intensive interdisciplinary rehabilitation program including a personalized nutritional intervention designed to achieve a minimum intake of 30 kcal/kg/day and 1 g protein/kg/day. The nutritional and functional status was assessed in each patient at three different moments. Each assessment included Body Mass Index (BMI), Mid Upper Arm Circumference (MUAC), Mid Arm Muscle Circumference (MAMC), Tricipital Skinfold (TSF), Hand Grip Strength (HGS), and Mini Nutritional Assessment (MNA®). The study included 118 patients, with ages in the range 41-90 years old. BMI increased linearly over time (0.642 units, F-test = 26.458, p < 0.001). MUAC (0.322 units, F-test = 0.515, p = 0.474) and MAMC status (F-test = 1.089, p = 0.299) improved slightly, whereas TSF decreased (F-test = 1.885, p = 0.172), but all these arm anthropometry trends did not show significant variations, while HGS (4.131 units, F-test = 82.540, p < 0.001) and MNA® (1.483 units, F-test = 217.726, p < 0.001) reported a meaningful improvement. Post-COVID-19 pneumonia patients presented malnutrition and functional impairment. An interdisciplinary rehabilitation program, including personalized nutritional intervention, was effective for post-hospital COVID-19 pneumonia nutritional/functional rehabilitation.


Assuntos
COVID-19 , Desnutrição , Distúrbios Nutricionais , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria , Índice de Massa Corporal , Estado Funcional , Força da Mão , Humanos , Desnutrição/etiologia , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional
2.
Clin Drug Investig ; 42(7): 611-622, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35696045

RESUMO

BACKGROUND AND OBJECTIVES: Novel immunotherapy-based combination treatments have drastically improved clinical outcomes for previously untreated patients with advanced/metastatic renal cell carcinoma (aRCC). This study aimed to assess the temporal trends in grade 3/4 adverse event (AE) rates and associated costs of nivolumab plus cabozantinib combination therapy versus sunitinib monotherapy in previously untreated patients with aRCC. METHODS: Individual patient data from the CheckMate 9ER trial (nivolumab plus cabozantinib: N = 320; sunitinib: N = 320) were used to calculate the proportion of patients experiencing grade 3/4 AEs. AE unit costs were obtained from the United States (US) 2017 Healthcare Cost and Utilization Project (HCUP) and inflated to 2020 US dollars. Per-patient-per-month (PPPM) all-cause and treatment-related grade 3/4 AE costs over 18-months, temporal trends, and top drivers of AE costs were evaluated in both treatment arms. RESULTS: Overall, the proportion of patients experiencing grade 3/4 AEs decreased over time, with the highest rates observed in the first 3 months for the nivolumab plus cabozantinib and sunitinib arms. Compared with sunitinib, nivolumab plus cabozantinib was associated with consistently lower average all-cause AE costs PPPM [month 3: $2021 vs. $3097 (p < 0.05); month 6: $1653 vs. $2418 (p < 0.05); month 12: $1450 vs. $1935 (p > 0.05); month 18: $1337 vs. $1755 (p > 0.05)]. Over 18 months, metabolism and nutrition disorders ($244), laboratory abnormalities ($182), and general disorders and administration site conditions ($122) were the costliest all-cause PPPM AE categories in the nivolumab plus cabozantinib arm, and laboratory abnormalities ($443), blood and lymphatic system disorders ($254), and metabolism and nutrition disorders ($177) were the costliest in the sunitinib arm. Trends of treatment-related AE costs were consistent with all-cause AE costs. CONCLUSIONS: Nivolumab plus cabozantinib was associated with lower costs of grade 3/4 AE management PPPM than sunitinib, which accumulated over the 18-month study period.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Carcinoma de Células Renais , Neoplasias Renais , Anilidas/administração & dosagem , Anilidas/efeitos adversos , Anilidas/economia , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/economia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Renais/tratamento farmacológico , Carcinoma de Células Renais/patologia , Humanos , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/patologia , Nivolumabe/administração & dosagem , Nivolumabe/efeitos adversos , Nivolumabe/economia , Distúrbios Nutricionais/etiologia , Piridinas/administração & dosagem , Piridinas/efeitos adversos , Piridinas/economia , Sunitinibe/administração & dosagem , Sunitinibe/efeitos adversos , Sunitinibe/economia
4.
Nutrients ; 14(5)2022 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-35268004

RESUMO

Cystic fibrosis (CF) is a chronic, multisystem disease with multiple comorbidities that can significantly affect nutrition and quality of life. Maintaining nutritional adequacy can be challenging in people with cystic fibrosis and has been directly associated with suboptimal clinical outcomes. Comorbidities of CF can result in significantly decreased nutritional intake and intestinal absorption, as well as increased metabolic demands. It is crucial to utilize a multidisciplinary team with expertise in CF to optimize growth and nutrition, where patients with CF and their loved ones are placed in the center of the care model. Additionally, with the advent of highly effective modulators (HEMs), CF providers have begun to identify previously unrecognized nutritional issues, such as obesity. Here, we will review and summarize commonly encountered comorbidities and their nutritional impact on this unique population.


Assuntos
Fibrose Cística , Distúrbios Nutricionais , Comorbidade , Fibrose Cística/complicações , Fibrose Cística/epidemiologia , Humanos , Distúrbios Nutricionais/epidemiologia , Estado Nutricional , Qualidade de Vida
5.
Rev Med Suisse ; 18(770): 324-327, 2022 Feb 23.
Artigo em Francês | MEDLINE | ID: mdl-35224907

RESUMO

Digestive and nutritional problems of children with cerebral palsy put them at risk of malnutrition. Identification of these problems through measurements of weight, height, and body composition is essential. Feeding difficulties may be caused by a combination of oral and digestive problems, such as swallowing difficulties, gastroesophageal reflux, and constipation. If oral feeding is difficult or unsafe, a nasogastric tube or gastrostomy may be necessary. Once the feeding regimen has been established, energy needs must be assessed on an individual basis. This nutritional management involves a multidisciplinary team of health care professionals, the child, and the family.


Les problématiques digestives et nutritionnelles des enfants avec infirmité motrice cérébrale les mettent à risque de malnutrition. L'identification de ces troubles par les mesures de poids, taille, et composition corporelle, est primordiale. Les difficultés alimentaires peuvent être causées par une combinaison de problèmes bucco-dentaires et digestifs, tels que les difficultés de déglutition et le reflux gastro-œsophagien ou la constipation. Si l'alimentation per os est difficile ou dangereuse, il peut être nécessaire de mettre en place une sonde nasogastrique ou une gastrostomie. Une fois le mode d'alimentation établi, les besoins énergétiques doivent être évalués individuellement. Cette prise en charge nutritionnelle implique une équipe multidisciplinaire composée de professionnels de la santé, de l'enfant et de sa famille.


Assuntos
Paralisia Cerebral , Transtornos de Deglutição , Desnutrição , Distúrbios Nutricionais , Paralisia Cerebral/complicações , Paralisia Cerebral/terapia , Criança , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Gastrostomia/efeitos adversos , Humanos , Desnutrição/complicações , Distúrbios Nutricionais/complicações , Estado Nutricional
6.
Nutrients ; 14(2)2022 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-35057538

RESUMO

Individuals living with cancer often experience multiple nutrition-related side effects from cancer treatment, including changes in taste and smell, nausea, diarrhea, loss of appetite, and pain during eating. These side effects can profoundly impact nutritional status and quality of life. The purpose of this study was to explore experiences with nutrition-related cancer treatment side effects among cancer patients and their family caregivers, the way they manage such side effects, and the resulting changes in food preferences and behaviors. Structured surveys and in-depth interviews were conducted. Interviews focused on the presence and management of treatment side effects, how those changes influenced food preferences, and the extent to which they interfered with quality of life. Most patients (72%) reported treatment side effects; 61% reported that these side effects impacted their eating and drinking. Common side effects included fatigue (58%), dry mouth (30%), nausea (24%), constipation (20%) and diarrhea (20%). Six overarching qualitative themes were identified: Spiral of side effects; Pain of eating; Burden of eating; Loss of taste/change in taste; Symptom management; and Solutions. The authors conclude with implications for food and nutrition practice-moving beyond traditional recommendations of what to eat or avoid-to consider the overall patient and caregiver experience.


Assuntos
Cuidadores/psicologia , Comportamento Alimentar/psicologia , Neoplasias/psicologia , Distúrbios Nutricionais/psicologia , Qualidade de Vida/psicologia , Adolescente , Adulto , Feminino , Humanos , Doença Iatrogênica , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Distúrbios Nutricionais/etiologia , Pesquisa Qualitativa , Adulto Jovem
8.
J Burn Care Res ; 43(1): 126-132, 2022 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-34520547

RESUMO

Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the Mini-Nutritional Assessment-Short Form (MNA-SF) to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound healing indicators and MNA-SF score. This was a prospective observational and cross-sectional study. This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8-11 points), and malnutrition (0-7 points). At the same time, we measured and compared the wound healing indicators among the three groups of patients, and detected the correlation. The results showed gender had a slight influence on the score of nutritional status, while age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.


Assuntos
Queimaduras/complicações , Avaliação Geriátrica , Avaliação Nutricional , Distúrbios Nutricionais/diagnóstico , Distúrbios Nutricionais/etiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
17.
Artigo em Inglês | MEDLINE | ID: mdl-34886347

RESUMO

The study of the nutritional transition in Spain must combine sources concerning the health conditions and the nutritional profile of the population. Such an approximation to the issue is, as a rule, not possible until the two final decades of the 20th century. However, the report on the nutritional status of the Spanish army, undertaken by the American Interdepartmental Committee on Nutrition for National Defence (ICNND) in 1958, combines both approaches. The report is based on the medical examination of 10727 army drafts. First, the article contextualised the report's sample geographically and demographically; second, it validated the variables used statistically; and third, it explored the relationship between the diseases diagnosed, the biomarkers yielded by blood and urine tests, and the diet. The main results were as follows: (a) the report confirmed that the military population under examination did not suffer from severe dietary shortcomings; (b) the sample presents a double bias, geographical (overrepresentation of southern provinces) and institutional (underrepresentation of the land forces).


Assuntos
Militares , Distúrbios Nutricionais , Humanos , Inquéritos Nutricionais , Estado Nutricional , Espanha
18.
Artigo em Russo | MEDLINE | ID: mdl-34882314

RESUMO

The elderly age and endocrine diseases are among death risk factors at contamination with new coronavirus infection. To reply the question of how the influence of these risk factors is summing up, differences were determined concerning patterns of changes in structure of mortality of endocrine system diseases, nutrition disorders and metabolic disturbances in individuals of able-bodied age and older against the background of COVID-19 pandemic. on the basis of information from the Moscow database of deaths of endocrine system diseases, nutrition disorders and metabolic disturbances, the changes in contribution of individual diseases to the death causes structure in 2019-2021 were analyzed. The groups of individuals of able-bodied age and older were compared. It was established that in both groups rate of indicating SARS-CoV-2 virus infection as concomitant disease decreased while rate of indicating concomitant diseases at death of COVID-19 increased. The group differences in changes of structure of death causes were established in 2021. The percentage of undetermined forms of diabetes and obesity in structure of death causes increased in the elderly, while in individuals of able-bodied age increased. The percentage of obesity as concomitant disease of death of COVID-19 in individuals of able-bodied age increased and did no change were detected in the elderly group. The input of poly-glandular dysfunction as consequence of old infection into mortality is five times higher among individuals of able-bodied age. On the basis of received results, assumption was made SARS-CoV-2 virus contamination ruinously affects development of pathological process under endocrine diseases regardless of age, while age affects spreading of endocrine diseases and degree of resistance to development of infectious process directly. The differences in patterns of changes of structure of death causes of population of able-bodied age and older are associated with low quality of diagnostics of death causes in individuals of elder age groups.


Assuntos
COVID-19 , Doenças do Sistema Endócrino , Distúrbios Nutricionais , Idoso , Doenças do Sistema Endócrino/epidemiologia , Humanos , Pandemias , SARS-CoV-2
19.
JPEN J Parenter Enteral Nutr ; 45(S2): 41-46, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34897739

RESUMO

Advances in treatment of malignancy including novel pharmacologic therapies and surgical interventions has led to significant improvement in survival. As cancer becomes a chronic disease, nutrition interventions play an increasingly important role in short- and long-term outcomes. The current manuscript presents a case of a 66-year-old male with new diagnosis of pancreatic cancer diagnosed incidentally in the setting of COVID-19. Expert panelists in the field of nutrition discuss optimal strategies for diagnosis of malnutrition along with preoperative, perioperative, and postoperative optimization of nutrition. This discussion focuses on the use of probiotics, immune-modulating nutrition, fish oil, specialized proresolving mediators, and use of enteral and parenteral nutrition support.


Assuntos
COVID-19 , Distúrbios Nutricionais , Neoplasias Pancreáticas , Idoso , Humanos , Distúrbios Nutricionais/terapia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/terapia , Nutrição Parenteral , SARS-CoV-2
20.
Nutrients ; 13(11)2021 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-34836349

RESUMO

Limited data are available on how eggs are consumed in the typical American eating pattern and the contribution to usual intakes, diet quality and in meeting recommendations. The objectives of the present analysis included identifying how eggs are consumed within U.S. dietary patterns and how these patterns are associated with the usual intakes of shortfall nutrients and diet quality (Healthy Eating Index 2015) using data from the combined National Health and Nutrition Examination Survey (NHANES) from 2001-2016. An additional objective included assessing the differences between egg consumers and egg non-consumers in nutrient intakes and nutrient adequacy. Several egg-containing dietary patterns were identified, and two egg patterns were associated with a greater diet quality compared to a no egg pattern (p < 0.0001). Most egg patterns identified were similar in diet quality scores when compared to the no egg pattern; however, the two egg patterns had lower diet quality scores. Egg consumption combined with a greater intake of total protein foods, seafood and plant protein, total vegetables, total fruit, whole fruit, whole grains and dairy foods, and a lower intake of refined grains and added sugars contributed to an improved diet quality, supporting that no one food is responsible for a healthy dietary pattern. Egg consumers demonstrated significantly higher intakes of dietary fiber, calcium, magnesium, potassium, total choline, vitamin A, vitamin C, vitamin D and vitamin E when compared to egg non-consumers. A comparison of egg consumers and egg non-consumers found egg consumers had significantly less percentages of the population below the EAR for calcium, iron, magnesium, vitamin A, vitamin C and vitamin E. Similarly, the percentage of the population above the recommendations for potassium and choline were greater for egg consumers vs. egg non-consumers. In egg consumers, 24.4% of the population was above the AI for dietary choline when compared to 4.3% of egg non-consumers (p < 0.0001). Findings from the present analysis demonstrate that eggs and egg-containing foods can be an important part of a healthy dietary pattern when balanced accordingly with other nutrient-dense foods.


Assuntos
Dieta Saudável/estatística & dados numéricos , Ovos/estatística & dados numéricos , Comportamento Alimentar , Nutrientes/análise , Distúrbios Nutricionais/epidemiologia , Dieta Saudável/métodos , Ingestão de Alimentos , Ovos/análise , Humanos , Distúrbios Nutricionais/etiologia , Inquéritos Nutricionais , Valor Nutritivo , Recomendações Nutricionais , Estados Unidos/epidemiologia
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