Nutrition
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Randomized Controlled Trial Clinical Trial
Enforced mobilization, early oral feeding, and balanced analgesia improve convalescence after colorectal surgery.
A postoperative regimen using a multimodal approach with enforced mobilization and early oral nutrition has been reported to improve convalescence but has not been compared with other postoperative regimens. ⋯ This active per- and postoperative regimen based on a multimodal approach improved ambulation time and muscle function during admission and late convalescence.
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Randomized Controlled Trial Clinical Trial
Glutamine supplementation and GH/IGF-I treatment in critically ill patients: effects on glutamine metabolism and protein balance.
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Renal transplantation is associated with an increased risk of atherosclerotic cardiovascular disease and marked racial and ethnic disparities in graft and patient survival. We characterized differences in racial and ethnic susceptibility to weight gain, diabetes, and alterations in circulating lipid levels and isolated independent predictors of those changes in a diverse population of kidney transplant recipients. ⋯ Multiple regression analysis confirmed the predominant independent effect of African American race or ethnicity on weight gain; however, hypercholesterolemia was independent of race or ethnicity and predicted by cyclosporine treatment and post-transplant diabetes. Therefore, kidney transplantation represents a state of accelerated atherogenic risk induced in part by the metabolic effects of immunosuppressive medications and compounded by marked racial and ethnic disparities in weight gain and diabetes risk.
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Bioelectrical impedance measurements were collected in the Third National Health and Nutrition Examination Survey (NHANES III), but their results have not been published. In the NHANES III population, resistance (R) and reactance (Xc) values at 50-kHz frequency were obtained with a Valhalla Scientific meter (model 1990B; San Diego, CA, USA). The RXc graph method was used to identify bivariate pattern distributions of mean vectors (95% confidence ellipses by sex, race, age, and body mass index [BMI]), and individual impedance vectors (50%, 75%, and 95% tolerance ellipses). ⋯ Tolerance ellipses were calculated from sex- and race-specific reference populations 20 to 69 y old and 19 < or = BMI < 30 kg/m(2) (8022 subjects, 4226 men and 3796 women). After transformation of impedance vector components into bivariate Z scores (standardized deviates, as differences from the mean divided by the standard deviation of the reference population), we constructed one standard, reference, RXc-score graph (50%, 75%, and 95% tolerance ellipses) that can be used with any analyzer in any population. The pattern of impedance vector distribution and reference bivariate intervals for the individual impedance vector are presented for comparative studies (free software at E-mail: apiccoli@unipd.it).