Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Randomized Controlled Trial
Role of glutamine administration on T-cell derived inflammatory response after cardiopulmonary bypass.
Cardiac surgery provokes an inflammatory response for which the endothelium, the myocardium, and monocytes/macrophages are primarily responsible. T cells are altered in a different way whereby the pro-inflammatory pathway is suppressed. From the results of experimental studies it was concluded that glutamine (Gln) enhances the production of T-cell cytokines in conditions of Gln deprivation. The aim of this clinical study was to evaluate the role of a perioperative Gln infusion on intracellular inflammatory T-cell cytokine expression in patients undergoing elective cardiac surgery and to evaluate the effects on systemic inflammation, organ dysfunction and ICU length of stay. ⋯ The elevation of Gln plasma levels as a result of 0.5 g/kg/day perioperative Gln infusion has no influence on the T-cell derived inflammatory response, indicating a sufficient supply of Gln. A Gln supplementation in cardiac surgery patients without a clear Gln deficiency seems not to affect the intracellular inflammatory T-cell cytokine expression.
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To investigate the relationship of neck circumference (NC) to metabolic syndrome (MetS) and obstructive sleep apnea syndrome (OSAS) and whether it adds information to that provided by waist circumference. ⋯ NC contributes to MetS likelihood beyond waist circumference and the MetS components. Regarding association with OSAS, NC is of greater value than WC among Turkish men, not women.
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Malnutrition is prevalent in hospitalized elderly people leading to complications including cognitive deficit. However, the relationship between the nutritional status and the preclinical phase of dementia in the elderly is still unclear. The aim of this study was to evaluate the prevalence of malnutrition in older patients with mild cognitive impairment. ⋯ Malnutrition is prevalent in hospitalized elderly patients with cognitive deficit, even in those with mild cognitive impairment. It remains to be demonstrated whether improvement in nutritional status may delay progression to dementia in these patients.
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It was shown that patients in the Netherlands remain exposed to unnecessarily prolonged starvation after abdominal surgery. The present study examined whether a structured collaborative effort would help to implement the early start of oral nutrition after colorectal surgery. ⋯ The present nationwide collaborative effort was successful in implementing a change towards an early start of oral nutrition after abdominal surgery.