Prevalence of malnutrition diagnosed by the Global Leadership Initiative on Malnutrition and Mini Nutritional Assessment in older adult outpatients and comparison between the Global Leadership Initiative on Malnutrition and Mini Nutritional Assessment energy-protein intake: A cross-sectional study

Background The Global Leadership Initiative on Malnutrition (GLIM) published malnutrition identification criteria. The Mini Nutritional Assessment (MNA) is malnutrition assessment tool commonly used in older adults. This study aimed to determine prevalence of malnutrition and the relationship between the GLIM and the MNA long form (MNA-LF) and short form (MNA-SF) and energy-protein intake

Effects of Ramadan fasting on lean body mass in the older people

Key summary pointsAim The purpose of this study was to evaluate the physiological effects of Ramadan fasting on muscle function and muscle mass in the older people. Findings We found that body weight and composition were not influenced by Ramadan fasting in both females and males. Message Ramadan fasting supplied no risk for muscle function and muscle mass in the older people

Frequency and Related Risk Factors of Refeeding Hypophosphatemia in Patients with Liver Cirrhosis: A Pilot Study.

Background & Aims: Refeeding hypophosphataemia (RH) is associated with poor clinical outcomes and mortality rates. However, the presence of RH in patients with cirrhosis remains unknown. This study aimed to determine the relationship among the frequency of RH, nutritional status, and disease severity in patients with liver cirrhosis.Methods: This prospective study was conducted at a single-centre gastroenterology clinic. Malnutrition was identified using the Subjective Global Assessment (SGA). Disease severity was defined using the ChildTurcotte-Pugh (CTP) and the Model for End-Stage Liver Disease (MELD) scores. Hypophosphatemia was defined as a serum phosphate level of <2.0 mg/dL.Results: Twelve of 50 cirrhotic patients (24%) had RH during hospitalization. The most common RH was determined in four patients on day four during the study follow-up. The sharpest decline in serum phosphate levels was observed on day four (median: 2.3 mg/dL). The CTP score and MELD scores did not differ significantly between RH and non-RH groups ((p=0.478 and p=0.643), respectively. The rate of malnutrition according to the SGA was 56.0%. A total of 82%, 4%, 8%, and 4% of participants received regular diet and oral nutritional supplements, only enteral tube feeding, only parenteral nutrition, and combined enteral and parenteral nutrition, respectively. In the RH group, 32% of participants received only parenteral nutrition and had a higher prevalence of RH than that of patients receiving only oral or enteral tube feeding (p=0.001). The CTP score strongly and negatively correlated with serum phosphorus levels on days two (p=0.016), three (p=0.050), and seven (p=0.017) in the RH group.Conclusions: This study showed that artificial feeding (enteral or parenteral nutrition) carries a significant risk in terms of RH. Malnourished patients with liver cirrhosis who received parenteral nutrition were closely monitored for a high risk of RH. The CTP score strongly and negatively correlated with serum phosphorus levels

Evaluation of refeeding hypophosphatemia frequency, risk factors, and nutritional status during stem cell transplantation in patients with hematologic malignancy

© 2022 European Society for Clinical Nutrition and MetabolismBackground: Refeeding Hypophosphatemia (RH) occurs with feeding after an extended period of not feeding. Hematological Stem Cell Transplantation (HSCT) is one of the effective methods for hematologic malignancy. Nutritional disorders are frequently observed in hematologic malignancies due to the disease's pathology and the treatment's effect. The study aims to determine the influencing factors by determining the frequency of RH in patients treated with HSCT. Methods: The study was conducted prospectively and randomly with 50 patients treated with HSCT for the first time. The study followed patients for 22 days, seven days before, and 14 days after. During the follow-up, data such as Scored Patient-Generated Subjective Global Assessment (PG-SGA), weight changes, nausea, vomiting, diarrhea, mucositis, infection and Graft Versus Host Disease development, need for intensive care, and 12-month mortality were recorded. RH states were evaluated during treatment. Results: RH developed in 78% of patients treated with HSCT. Pre-transplantation PGSGA score, frequency of vomiting, and development of infection were higher in patients with RH (p < 0.05). The patients had a mean weight loss of 2.9% after transplantation. Pre-transplantation, 88% of patients were well-nourished (PGSGA 0–3), post-transplantation, 70% of patients were moderately undernourished (PGSGA 4–8), and 30% were severely malnourished (PGSGA ≥ 9). While total protein and albumin decreased after transplantation, CRP increased (p < 0.05). According to multivariate logistic regression analysis, infection (95% CI: 1.375–61.379, p = 0.022) and pre-transplant PGSGA (95% CI: 1.035–45.454, p = 0.046) independently affect RH development. Conclusions: RH was detected at a high rate in patients treated with HSCT. Elevated risk of malnutrition before transplantation, frequency of vomiting, and development of infection were determined as factors affecting RH development

Serum trace elements levels in patients transferred from the intensive care unit to wards.

Background & aims: Trace elements act as co-factors and/or in co-enzymes in many metabolic pathways and its deficiency contributes to metabolic and infectious complications. The aim of this study was to determine serum zinc, selenium, cobalt, chromium, copper and ceruloplasmin levels for identify the need for post intensive care unit (ICU) nutritional follow-up

Measurement of serial serum total and acylated ghrelin levels in critically ill patients: A prospective and observational pilot study

© 2021 American Society for Parenteral and Enteral NutritionBackground: Ghrelin is a hormone that regulates appetite and energy metabolism. The change of serial serum total and acylated ghrelin levels during hospital stays of critical patients are unknown. In addition, the relationship of this change with the clinical results of patients in the intensive care unit (ICU) is also unknown. The aim of this study was to determine serum total and acylated ghrelin levels serially in critically ill patients. Methods: This prospective study was performed in the ICU. Patients who were >18 years old and stayed in ICU for >48 h were included in the study. Serum total and acylated ghrelin concentrations were measured at baseline in all participants and serially on the 2nd, 5th, and 10th day after entry into the study in those who remained in the ICU. Results: A total of 60 participants were included. The mean age was 56 ± 21 years. (Baseline, 2nd, 5th, and 10th day median serum total ghrelin levels were 3551 (1651–3995), 3485.20 (1379–4071), 3359 (1167–3919), and 3355 pg/ml (2207–3843), respectively. Baseline, 2nd, 5th, and 10th day acylated ghrelin levels were 47 (0–673), 50 (0–730), 73 (0–808), and 125 pg/ml (0–689), respectively. There was no significant difference between total ghrelin/acylated ghrelin levels and mortality (P >.05). ICU mortality was 30%. Conclusion: Ghrelin levels were decreased slightly and acylated ghrelin levels increased substantially over time in critically ill patients. There were no differences between serum total ghrelin/acylated ghrelin levels and ICU mortality

Enteral nutrition interruptions in critically ill patients: A prospective study on reasons, frequency and duration of interruptions of nutritional support during ICU stay

© 2022 European Society for Clinical Nutrition and MetabolismBackground & aims: Enteral Nutrition (EN) may be interrupted due to various reasons in the setting of intensive care unit (ICU) care. This study aimed to investigate the reasons, frequency, and duration of EN interruptions in critically ill patients within the first 7 days of ICU stay. Methods: A total of 122 critically ill patients (median age: 63 years, 57% were males) initiating EN within the first 72 h of ICU admission and continued EN for at least 48 h during ICU stay were included in this observational prospective study conducted at a Medical ICU. Patients were followed for hourly energy intake as well as the frequency, reason, and duration of EN interruptions, for the first seven nutrition days of ICU stay or until death/discharge from ICU. Results: The median APACHE II score was 22 (IQR, 17–27). The per patient EN interruption frequency was 2.74 and the median total EN interruption duration was 960 (IQR, 105–1950) minutes. The most common reason for EN interruption was radiological procedures (91 episodes) and the longest duration of EN interruption was due to tube malfunctions (1230 min). Target energy intake were achieved on the 6th day at a maximum rate of 89.4%. Logistic regression showed that there was relationship between increased mortality and patients with ≥3 EN interruptions (OR: 6.73 (2.15–30.55), p = 0.004) after adjusting for confounding variables (age and APACHE II score). According to Kaplan Meier analysis, patients with ≥3 EN interruptions had significantly lower median survival times than patients with <3 EN interruptions (24.0 (95% CI 8.5–39.5) vs 18.0 (95% CI 13–23) days, p = 0.014). Conclusion: During the first week of EN support, the most common reason of EN interruptions was related to radiological procedures and the longest EN interruptions was due to feeding tube malfunctions. There was relationship between ≥3 EN interruptions and increased mortality

Relationship between plasminogen activator inhibitor type-1 (PAI-1) gene polymorphisms and osteoporosis in Turkish women

OBJECTIVE: The development of osteoporosis is associated with several risk factors, such as genetic structures that affect bone turnover and bone mass. The impact of genetic structures on osteoporosis is not known. Plasminogen activator inhibitor type-1 regulates the bone matrix and bone balance. This study assessed the correlation between plasminogen activator inhibitor type-1 gene 4G/5G polymorphisms and osteoporosis in a population of Turkish women. METHODS: A total of 195 postmenopausal female patients who were diagnosed with osteoporosis (Group I) based on bone mineral density measurements via dual-energy x-ray absorptiometry and 90 females with no osteoporosis (Group II) were included in this study. Correlations between PAI-1 gene 4G/5G polymorphisms and osteoporosis were investigated through the identification of PAI-1 gene 4G/5G polymorphism genotypes using the polymerase chain reaction. RESULTS: No significant differences in the genotype and allele frequency of 4G/5G plasminogen activator inhibitor type-1 polymorphisms were observed between the two groups, and both groups exhibited the most frequently observed 4G5G genotype. CONCLUSION: No correlation between the development of osteoporosis in the female Turkish population and 4G/5G plasminogen activator inhibitor type-1 gene polymorphisms was observed

Wernicke's Encephalopathy: A Forgotton Disease

Wernicke's encephalopathy (WE) is an acute neurological condition characterized by ataxia, confusion, ocular findings, and impairment of consciousness due to thiamine deficiency. Although alcoholism is the most common reason, WE cases resulting from prolonged total parenteral nutrition (TPN) without multivitamin complex have been reported. Here we present a dramatic improvement in symptoms with high-dose thiamine in a patient who developed WE due to TPN after gastrointestinal surgery