47 research outputs found

    ESPEN Guideline: Clinical Nutrition in inflammatory bowel disease

    Get PDF
    Introduction: The ESPEN guideline presents a multidisciplinary focus on clinical nutrition in inflammatory bowel disease (IBD). Methodology: The guideline is based on extensive systematic review of the literature, but relies on expert opinion when objective data were lacking or inconclusive. The conclusions and 64 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required. Results: IBD is increasingly common and potential dietary factors in its aetiology are briefly reviewed. Malnutrition is highly prevalent in IBD – especially in Crohn's disease. Increased energy and protein requirements are observed in some patients. The management of malnu-trition in IBD is considered within the general context of support for malnourished patients. Treatment of iron deficiency (parenterally if necessary) is strongly recommended. Routine provision of a special diet in IBD is not however supported. Parenteral nutrition is indicated only when enteral nutrition has failed or is impossible. The recommended perioperative man-agement of patients with IBD undergoing surgery accords with general ESPEN guidance for patients having abdominal surgery. Probiotics may be helpful in UC but not Crohn's disease. Primary therapy using nutrition to treat IBD is not supported in ulcerative colitis, but is mod-erately well supported in Crohn's disease, especially in children where the adverse conse-quences of steroid therapy are proportionally greater. However, exclusion diets are generally not recommended and there is little evidence to support any particular formula feed when nutritional regimens are constructed. Conclusions: Available objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 64 recommendations, of which 9 are very strong recom-mendations (grade A), 22 are strong recommendations (grade B) and 12 are based only on sparse evidence (grade 0); 21 recommendations are good practice points (GPP)

    Black is a Color / I am Color Blind ©1989 Raymond Saunders and Josine Ianco-Starrels

    No full text
    Black is a Color / I am Color Blind ©1989 Raymond Saunders and Josine Ianco-Starrels. Reproduced with Raymond Saunders permission, Grant of Permission on file

    Paleoenvironmental signature of the Selandian-Thanetian Transition Event (STTE) and Early Late Paleocene Event (ELPE) in the Contessa Road section (western Neo-Tethys)

    Get PDF
    Sedimentary records of the Early Cenozoic indicate a series of events with climatic and carbon cycle variability known as hyperthermals. A similar to 350-kyr-long event of environmental disruption during the Paleocene, not described before and here named Selandian Thanetian Transition Event (SITE), has been recognized and well constrained in the western Tethys Contessa Road section (Gubbio, Italy) through high-resolution biostratigraphic, geochemical, and rock-magnetic data. The SITE exhibits peculiar stressed ecological responses among calcareous nannofossils and foraminifera, which highlight marked environmental perturbation affecting the biosphere. The environmental instability is not confined within the photic zone but extends to the seafloor leading to little more trophic conditions of the sea surface waters with an enhanced, but of short measure, nutrient availability on the seafloor conditions and marked rise of lysocline. Magnetic Susceptibly (MS) is dominantly controlled by the balance between carbonate productivity and detrital supply, as evidenced by the strong correlation between MS and CaCO3 (%) (r(2) = 0.72). However, we also document two components in the isothermal remanent magnetization (IRM) and first-order reversal curves (FORC) diagrams that prove the occurrence of biogenic magnetite throughout the SITE. Systematic variations in bio-geochemical and magnetic parameters show the relative abundance of carbonate production (or inversely dissolution of carbonate) versus detrital supply during the SITE, which induced higher populations of magnetotactic bacteria through increased terrigenous input and, therefore, increased nutrient supply. Noteworthy, the uppermost part of the SITE includes the equivalent of the suspected hyperthermal, short-lived Early Late Paleocene Event (ELPE). The ELPE event shows an episode of increase in magnetic properties of the sediments, including an increase in magnetofossil concentration, as indicated by IRM components and FORC diagrams. The comparison of biotic and abiotic records throughout the STTE at Contessa Road section with available data across the ELPE from former investigated ocean and land-based sites provides lines of evidence that this latter event might be indeed only the terminal part of a long-lasting environmental change than hitherto supposed

    Fostering Bilingualism in Korea

    No full text
    corecore