Nutrition
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The early provision of nutrients as part of specialized therapy for critically ill patients admitted for critical medical and surgical conditions is recommended by various international guidelines. Enteral nutrition is the first option and should be initiated 24-48 h after admission to an intensive care unit. Even after gastrointestinal anastomosis, early oral or enteral feeding is not only safe but also associated with enhanced recovery and fewer complications. ⋯ Although the precise caloric target remains controversial, the general consensus advocates the avoidance of prolonged hypocaloric or hypercaloric feeding. However, there is still debate about the timing of the initiation of parenteral nutrition when enteral nutrition either is impossible or does not meet the nutritional goals. Although controversy remains, two recent studies showed that when enteral feeding is not feasible the early initiation of parenteral nutrition was not associated with palpable benefit.
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This review aims to put an economic perspective on childhood and adolescent obesity by providing an overview on the latest literature on obesity-related costs and the cost effectiveness of interventions to prevent or manage the problem. ⋯ To design effective public policies against the obesity epidemic, a better understanding and a more precise assessment of the health care costs and the broader economic burden are necessary but, critically, depend on the collection of additional longitudinal data. The economic evaluation of childhood obesity interventions poses various methodologic challenges, which should be addressed in future research to fully use the potential of economic evaluation as an aid to decision making.
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Randomized Controlled Trial
Evaluation of oral zinc sulfate effect on obsessive-compulsive disorder: a randomized placebo-controlled clinical trial.
Obsessive-compulsive disorder is a common neuropsychiatric condition. Although various pharmaceutical agents are available for the treatment of obsessive-compulsive disorder, psychiatrists often find that many patients cannot tolerate the side effects of these medications, the patients do not respond properly to the treatment, or the medications lose their effectiveness after a period of treatment. The augmentation with safe supplementation of medication, such as with trace elements, may be a solution to some of these problems. ⋯ The results show that zinc, as adjuvant agent for obsessive-compulsive disorder, produces improved outcomes.
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Comparative Study
Adipose tissue volume is decreased in recently diagnosed cancer patients with cachexia.
Approximately 50% of patients with cancer develop cachexia. The aim of the present study was to determine if there were differences in the amount of visceral and subcutaneous adipose tissues at the time of the diagnosis among patients with cancer cachexia (CC), patients with cancer and a stable weight (WS), and patients with cancer and weight loss because of gastrointestinal obstruction (GO). ⋯ The WAT was decreased in the CC and GO groups compared with the WS group. Furthermore, patients with CC exhibited a selective decrease in visceral WAT. This may be new information regarding the WAT distribution in CC.
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Pressure ulcer (PU) is a frequent complication of hip fracture. Studies were carried out to identify the risk factors of PU development after hip fractures. The objective of the study was to determine the role of anthropometric measurements and handgrip strength as predictors of PUs in patients with hip fractures during their hospital stay and 30 d after discharge, which has not yet been established. ⋯ Handgrip strength was found to predict PU development in patients with hip fractures during their hospital stay and 30 d after discharge.