Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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The aim of our study was to detect differences in weigth loss with a hypocaloric diet in obese patients depending on their glycaemic status. ⋯ Ability to lose weight on a hypocaloric diet over a 3-month time period does not vary in obese patients as a function of glycaemic status. Improvement in cardiovascular risk factors is not related with glycaemic status, too.
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The extent of malnutrition in hospitalised stroke patients and its influence on outcomes including hospital complications, length of stay and discharge destination are important issues. The aim of this study was to determine the nutritional status of patients admitted to an acute stroke unit and the association between nutritional status and health outcomes. ⋯ Malnutrition on admission to hospital after acute stroke is associated with poor outcomes including increased length of stay and increased prevalence of dysphagia and complications. The scored PG-SGA is a nutrition assessment tool that allows quick identification of malnourished stroke patients.
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Low vitamin B-complex status has been associated with poorer outcome in critically-ill patients. However, these findings have been based on indirect methods. Using direct methods for assessing vitamin status, we examined the effect of B-complex vitamin supplementation by measuring plasma and red blood cell B1, B2 and B6-vitamin concentrations in critically-ill patients. ⋯ The results of the present study suggest that direct measurements of red cell FAD and PLP are more responsive to supplementation than plasma measurements in the critically-ill patient.
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Optimal management of the critically ill patient involves the initiation and rapid advancement of early enteral nutrition (EN). Compared to parenteral nutrition or no nutritional support, early enteral feeding favorably impacts patient outcome by reducing infectious morbidity and shortening hospital length of stay. Controversy exists over the true risks and benefits of pre-pyloric versus post-pyloric feeding. ⋯ Post-pyloric feeding, on the other hand, is associated with fewer interruptions once EN has been started, may reach goal calorie provision sooner, and may reduce risk for gastroesophageal reflux and aspiration. Overall differences in outcome between the two methods of feeding, however, are minimal. Thus, the final choice for the practicing clinician on the level of infusion of enteral feeding is based on institutional factors (related to protocols and available expertise) and the degree of risk and potential tolerance of the individual patient.
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Malnutrition increases morbidity and mortality in surgical patients, and for this reason, several nutritional markers have been used as prognostic tools to identify surgical patients under a higher risk to develop complications in post-operative period. Few studies show the impact of nutritional markers after controlling for others variables, such as age and severity of disease. A new method, bioelectric impedance analysis (BIA), and its parameter, phase angle, have been described as a prognostic tool in several clinical situations, but they have never been studied in surgical population. The objective of this work is to assess the importance of nutritional variables and parameters from BIA as predictors of post-operative complications in a multivariable regression model. ⋯ Phase angle remains as an important prognostic factor for postoperative complications, even after adjusting for other individual predictors and confounders. Its utility in the identification of patients eligible for nutritional therapy has now to be evaluated.