Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Review Meta Analysis
Yogurt for treating acute gastroenteritis in children: Systematic review and meta-analysis.
In May 2014, the updated guidelines for the management of acute gastroenteritis (AGE) were published. The use of yogurt in the nutritional management of AGE was not addressed, although it is frequently used in many countries for this purpose. We aimed to systematically evaluate the efficacy of yogurt consumption for the management of AGE in children. ⋯ The consumption of yogurt had a positive effect on weight gain, but no consistent effect on AGE outcomes in hospitalized children. Given the limited data and the methodological limitations of the included trials, the evidence should be viewed with caution. The effect of yogurt consumption in the ambulatory setting is unknown.
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Patients with systemic sclerosis may develop intestinal failure requiring home parenteral nutrition. However, few outcome data have been reported. This study aimed to review the outcome of patients with systemic sclerosis receiving home parenteral nutrition. ⋯ This is the longest, largest reported series of patients with systemic sclerosis receiving home parenteral nutrition. It shows that home parenteral nutrition can be used safely and effectively in patients with very severe systemic sclerosis-related gastrointestinal involvement.
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Observational Study
Comparison of different definitions of feeding intolerance: A retrospective observational study.
While feeding intolerance (FI) is clinically important in the critically ill it is inconsistently defined. By evaluating definitions of FI based on relationships between symptoms and signs of gastrointestinal (GI) dysfunction and mortality the objective was to define FI using the definition that was most strongly associated with subsequent mortality. ⋯ FI is associated with increased mortality but the strength of this relationship depends on the definition used. The 'best' definition of FI for prediction of ICU-mortality is based on a complex assessment of GI symptoms (including large GRV), whereas enteral underfeeding is the definition of FI that is the strongest predictor of death within 90 days of admission. Our 'best' definitions are not immediately generalizable, but should help building up future studies.
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Review Meta Analysis
Antioxidant therapy for patients with chronic pancreatitis: A systematic review and meta-analysis.
Chronic pancreatitis is a progressive, inflammatory disease of pancreas characterized by significant abdominal pain, malabsorption, and diabetes mellitus. Antioxidant therapy has been proposed as an effective treatment for painful chronic pancreatitis. We performed a meta-analysis of trials in which antioxidant therapy was compared with placebo in chronic pancreatitis. ⋯ Based on current evidence, oxidative stress may play an important role in the pathophysiology of chronic pancreatitis, and administration of antioxidants to patients with painful chronic pancreatitis is effective in relieving pain. Antioxidant supplements may be advocated as one medical therapy for chronic pancreatitis patients with low antioxidant capacity in their blood.
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Multicenter Study
The prevalence of iatrogenic underfeeding in the nutritionally 'at-risk' critically ill patient: Results of an international, multicenter, prospective study.
Adverse consequences may be experienced by critically ill patients who are underfed during their stay in the intensive care unit. The objective of this study is to determine the prevalence of iatrogenic underfeeding (receiving <80% of prescribed energy requirements) and the variation of these rates in different geographic regions of the world and in different nutritionally 'at-risk' patient populations. ⋯ Worldwide, the majority of critically ill patients, including high nutritional risk patients, fail to receive adequate nutritional intake. There is low uptake of strategies designed to optimize nutrition delivery in these patients.