The effect of a diverting ileostomy formation on nutritional status and energy intake of patients undergoing colorectal surgery

Background and aims: The effects of ileostomy construction and colonic bypass on the general nutritional status of the patients have not yet received much attention. The aim of the present study was to assess the effect of a diverting ileostomy formation, on the nutritional intake, body composition and nutritional status biochemical markers of patients with a newly formed ileostomy. Methods: This was an observational study. Patients scheduled for elective rectosigmoid resection at a surgical unit of a public university hospital, were considered for study inclusion. Patients in whom a diverting ileostomy was created were assigned to the ileostomy group (n = 41), and patients who underwent rectosigmoid resection without requiring a diverting ileostomy served as a control group (n = 37). Anthropometric characteristics, body composition, dietary intake and biochemical markers representative of nutritional status were assessed preoperatively and at 40 days postdischarge (NCT02036346). Results: Anthropometric and body composition characteristics (weight, BMI and body fat percentage) significantly declined from 75 to 71.6 kg, 26.9 to 25.6 kg/m2 and 28.6 to 25.6% respectively (p = 0.001 for all) in the ileostomy group, between the preoperative stage and 40 days postdischarge from the hospital. Furthermore, a significant reduction in mean daily energy intake from 1871 to 1713 kcal/day (p = 0.046) was observed in the ileostomy group 40 days after discharge compared to preoperative assessment. No significant changes in the above measured parameters were observed in the non-ileostomy group. Conclusion: Diverting ileostomy can have a negative effect on general nutritional status and dietary intake of patients, during the first postoperative period. Nutritional assessment might need to be included in the routine clinical management of this patient category to prevent weight loss and impaired energy intake. © 2020 European Society for Clinical Nutrition and Metabolis

Administration of an oral hydration solution prevents electrolyte and fluid disturbances and reduces readmissions in patients with a diverting ileostomy after colorectal surgery: A prospective, randomized, controlled trial

BACKGROUND: Patients with a newly formed ileostomy often develop electrolyte abnormalities and dehydration. OBJECTIVE: The study assessed the prophylactic effect of an isotonic hydration solution on dehydration and electrolyte abnormalities in patients with a newly formed ileostomy. DESIGN: This was a prospective, randomized, controlled trial (NCT02036346). SETTINGS: The study was conducted at a single surgical unit of a public university hospital. PATIENTS: Patients scheduled for elective rectosigmoid resection were considered for study inclusion. INTERVENTION: Patients in whom a diverting ileostomy was created were randomly assigned to the intervention group (n = 39), which received an oral isotonic glucosesodium hydration solution for 40 days postdischarge and the control group (n = 41) which did not receive an intervention. The 2 groups were compared with a group of patients who underwent rectosigmoid resection without diverting ileostomy (n = 37). MAIN OUTCOME MEASURES: Serum electrolyte and renal function markers were assessed preoperatively and at 20 and 40 days postdischarge. RESULTS: At 20 days postdischarge, the serum sodium of the control group appeared lower than the serum sodium of the intervention group and the nonileostomy group (p = 0.007). At the same time point, urea and creatinine levels of the control group were higher than the urea and creatinine levels of the other 2 groups (p = 0.01 and p = 0.02). At 40 days postdischarge, mean sodium and renal function markers improved in the control group, but sodium and creatinine continued to differ in comparison with the intervention and nonileostomy groups (p = 0.01 and p = 0.04). The readmission rate for?uid and electrolyte abnormalities was higher in the control group (24%) than in the other 2 groups, where no rehospitalization for such a reason was required (p = 0.001). LIMITATIONS: The study was limited by its single-center design. CONCLUSION: An oral isotonic drink postdischarge can have a prophylactic effect on patients with a newly formed ileostomy, preventing readmission for fluid and electrolyte abnormalities. © 2018 Wolters Kluwer Health, Inc. All rights reserved

Foodborne botulism: A brief review of cases transmitted by cheese products (Review)

Food safety constitutes a basic priority for public health. Foodborne botulism occurs worldwide; it is an acute paralytic disease caused by the consumption of food containing the botulinum toxin. Growing consumer demand for cheese products could result in increased exposure of the population to this toxin, and thus the risk of foodborne botulism. The majority of cases of botulism caused by dairy products are related to cheese products specifically. Epidemic outbreaks and isolated cases have been reported over time. Domestically canned foods are still among the primary causes of the disease. Cheese products are not regularly involved in botulism incidents; it is however, necessary to take control measures for manufacturing and domestic preparation due to the high risk of occurrence of this particular disease. The aim of this review is to discuss foodborne botulism caused by cheese products, providing a brief epidemiological history, and to examine certain control measures that should be taken throughout the production process to better protect public health. © 2022, Spandidos Publications. All rights reserved

Foodborne botulism: A brief review of cases transmitted by cheese products (Review)

Food safety constitutes a basic priority for public health. Foodborne botulism occurs worldwide; it is an acute paralytic disease caused by the consumption of food containing the botulinum toxin. Growing consumer demand for cheese products could result in increased exposure of the population to this toxin, and thus the risk of foodborne botulism. The majority of cases of botulism caused by dairy products are related to cheese products specifically. Epidemic outbreaks and isolated cases have been reported over time. Domestically canned foods are still among the primary causes of the disease. Cheese products are not regularly involved in botulism incidents; it is however, necessary to take control measures for manufacturing and domestic preparation due to the high risk of occurrence of this particular disease. The aim of this review is to discuss foodborne botulism caused by cheese products, providing a brief epidemiological history, and to examine certain control measures that should be taken throughout the production process to better protect public health. © 2022, Spandidos Publications. All rights reserved

Use of Fortified Bread for Addressing Vitamin D Deficiency

Vitamin D deficiency due to inadequate sun exposure and/or inadequate intake from food is very common worldwide, consisting a major public health problem. As prolonged exposure to ultraviolet radiation involves risks, food fortification of staple foods emerges as a favorable solution for addressing vitamin D deficiency. Bread is a suitable candidate for fortification as it is consumed often and is the main carbohydrate source in European countries. The purpose of this study was the evaluation of the bioavailability of vitamin D from a fortified Greek-type bread that was developed as a means for addressing vitamin D deficiency, by comparing the absorption curve of vitamin D in fortified bread in relation to that of plain vitamin supplementation. Two groups of clinically healthy volunteers consumed 25,000 international units (IU) of vitamin D3 (cholecalciferol) either in fortified bread (Group A) or in a plain supplement form (Group B). The baseline plasma concentrations of cholecalciferol were 8.1 ± 6.0 ng/mL and 6.8 ± 3.4 ng/mL in Groups A and B, respectively. After 12, 24, and 48 h, the concentrations of cholecalciferol in Group A were 16.7 ± 4.8, 15.3 ± 8.3 and 11.9 ± 6.0 ng/mL, respectively, and in Group B, 15.2 ± 3.3, 11.6 ± 2.4, and 9.6 ± 3.6 ng/mL, respectively. In both groups, the concentrations of cholecalciferol at 12 and 24 h were significantly higher than the baseline concentrations (p < 0.01). There were no statistically significant differences between the concentrations of cholecalciferol between Groups A and B, at each time point. Cholecalciferol is bioavailable from Greek-type fortified bread and bread could be used for addressing vitamin D deficiency. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG