Nutritional Assessment Research Articles

Balanço nutricional em mangueiras no semiárido brasileiro utilizando métodos diagnósticos nutricionais

ABSTRACT Nutritional assessment of mango trees based on diagnostic methods considering nutritional balance is recommended. This study aimed to establish optimum nutritional ranges using diagnostic methods, compare them, identify the most efficient diagnostic method, and select the nutrients responding best to the application of the diagnostic method. The study was conducted in commercial mango orchards in the São Francisco Valley. Nutritional content was calculated using the diagnosis and recommendation integrated system (DRIS-Beaufils, DRIS-Jones), modified DRIS (M-DRIS-Beaufils; M-DRIS-Jones), compositional nutrient diagnosis (CND), and mathematical chance (ChM) methods and compared using the chi-square test. Principal component analysis was applied to select the most efficient diagnostic method and the nutrients responsible for the greatest variability. The DRIS-Beaufils, M-DRIS-Beaufils, DRIS-Jones, M-DRIS-Jones, CND, and ChM methods generated nutritional sufficiency ranges for the evaluated cultivars. The nutritional diagnoses of the DRIS-Beaufils and M-DRIS-Beaufils methods were similar and discordant with those of DRIS-Jones, M-DRIS-Jones, and CND. The DRIS-Beaufils method, updated by Maia, proved to be more consistent for the nutritional assessment of mango trees. The nutrients N, P, K, Mg, and S in the Tommy Atkins cultivar; N, P, Mg, S, B, Mn, Zn, Mo, and Cl in the Kent cultivar; and N, P, K, Ca, S, B, Cu, Fe, Zn, Mo, and Cl in the Keitt cultivar showed significant responses to the application of the DRIS-Beaufils method updated by Maia.

Comparison Between Billroth II and Billroth II + Braun Anastomosis in Gastrectomy for Gastric Cancer

IntroductionDistal gastrectomy remains the predominant therapeutic approach for gastric cancer, with digestive tract reconstruction as an integral procedure. The implementation of Braun anastomosis following Billroth II anastomosis is common in distal gastrectomy. This retrospective cohort study evaluated the clinical utility of Braun anastomosis by comparing the outcomes and quality of life between Billroth II (B-II) and Billroth II with Braun (B-IIB) anastomosis in the treatment of gastric cancer. MethodsA retrospective cohort study examined clinical and pathological data from 377 patients who underwent distal gastrectomy for gastric cancer treatment at The Affiliated Lihuili Hospital, Ningbo University, from October 2016 to October 2021.185 patients received B-II anastomosis, while the other 192 received B-IIB anastomosis, forming the B-II and B-IIB groups, respectively. Baseline characteristics, perioperative variables, short-term and long-term complications, and nutritional indicators at 1 mo and 1 y postsurgery were compared across both groups. Additionally, gastric endoscopy results at 6 mo and 1 y postsurgery were evaluated. Quality of life at 1 y postsurgery was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. ResultsBaseline characteristics between the two groups revealed no statistically significant differences (all P > 0.05), confirming their equivalence. All 377 patients successfully underwent curative distal gastrectomy for gastric cancer without intraoperative procedural modifications. No intraoperative complications or perioperative mortality occurred. Notable differences included extended operative time (222.1 ± 41.0 vs. 199.4 ± 24.9 min, P < 0.001), reduced postoperative nasogastric tube removal time (1.8 ± 0.9 vs. 2.2 ± 1.1 d, P < 0.001), decreased average gastric drainage volume (100.7 ± 35.2 vs. 112.2 ± 32.0 mL, P = 0.001), and increased incidence of internal hernia and ileus (4.7% vs. 1.1% and 8.3% vs. 3.2%, P = 0.038 and P = 0.035) in the B-IIB group compared to the B-II group. No significant differences were observed in estimated blood loss, lymph node dissection, postoperative flatus time, transition to a semiliquid diet, length of hospital stay, or short-term and long-term complications (all P > 0.05). Nutritional assessments conducted 1 mo and 1 y postsurgery indicated no statistically significant differences in body mass index, total protein, and serum albumin levels between the two groups (all P > 0.05). Gastric endoscopy evaluations at 6 mo and 1 y postsurgery, including food residue grade, gastritis severity, extent of gastritis, and bile reflux, demonstrated no significant discrepancies between the groups (all P > 0.05). At the 1-y follow-up, neither group exhibited tumor recurrences, deaths from tumor-related diseases, postoperative complications, or other diseases. Additionally, quality of life assessments using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core revealed no significant differences across various domains or items between the groups (all P > 0.05). ConclusionsA comparative analysis between B-II and B-IIB anastomosis demonstrated no notable variations in intraoperative parameters, postoperative nutritional outcomes, gastric endoscopic results, or postoperative quality of life. Nevertheless, incorporating Braun anastomosis can extend the duration of surgery and may elevate the likelihood of postoperative internal hernia.

Nutritional assessment of parent-packed school lunches in selected private pre - schools in Kalingalinga, Lusaka Zambia

Background: The nutritional quality of parent-packed school lunches is crucial for the health and academic performance of children. In Lusaka's Kalingalinga area, there is limited data on the factors influencing these packed lunches, especially in private schools. This study explores the nutritional content of school lunches packed by parents, assesses their knowledge and attitudes towards nutrition, and identifies key factors influencing their food choices. Methodology: A quantitative and qualitative research design was employed, with data collected through structured questionnaires from 303 parents and guardians of children attending private schools in Kalingalinga, Lusaka. The demographic characteristics, knowledge of nutrition, and factors influencing food choices were analyzed using descriptive statistics, a 24-hour food frequency questionnaire (FFQ), and Chi-square tests. SPSS version 23.0 was used for data analysis. Results: The majority of respondents were female (67.0%) and within the 18-25 age group (39.3%). Most had completed secondary education (57.4%) and were employed full-time (67.3%). Despite 95.7% acknowledging the importance of nutrition, 78.2% lacked knowledge of the nutritional content of the foods they packed. Sugary drinks (54.5%) and processed foods (51.2%) were frequently packed, while balanced meals and fruits were less consistent. The main factors influencing food choices were cost (53.1%) and peer pressure (25.4%), with only 7.3% considering nutritional value. Chi-square tests showed that occupation had a marginal relationship with adherence to nutritional guidelines (p=0.053), while age and education had no significant association. Conclusion and Recommendations: The findings reveal a gap in parents' knowledge regarding nutrition, impacting the quality of school lunches. Targeted nutritional education and policies promoting healthier eating are recommended to improve children's health in Kalingalinga, Lusaka

Mini nutritional assessment is a predictor of mortality and morbidity in patients with pulmonary arterial hypertension

Abstract Background Malnutrition has been demonstrated as a predictor for unfavorable clinical outcomes in chronic heart failure, and may affect patients with pulmonary arterial hypertension (PAH). The Mini Nutritional Assessment (MNA) is a reliable indicator for nutritional status assessment, but its relationship with mortality risk and hospitalization in PAH patients has not yet been investigated. Purpose The study aimed to determine whether the MNA has prognostic value in stable patients with PAH. Methods A prospective multicenter study was performed. All patients completed the MNA at study entry in outpatient clinic or during planned hospitalization. The primary endpoint was all-cause mortality. Secondary end-point was the composite end-point of all cause death or PAH-related hospitalizations. Patients with malnutrition (MNA ≤17 points) or at risk of malnutrition (MNA 18-23,5 points) were considered as having abnormal nutritional status for statistical analysis. Results 182 PAH patients were included to the study (mean age 60 ± 17 years; 73% females; 57% idiopathic PAH). Abnormal nutritional status was identified in 68 (37%) patients. Median and the range of follow up period was 23 months and 0–32 months, respectively. 34 (18.7%) patients died, 53 (29.1%) were hospitalized due to PH, and 57 (31.3%) achieved the composite secondary end-point. Kaplan-Meier survival curves revealed significant differences in overall survival between patients with abnormal MNA and normal MNA, p &amp;lt;0.0001, and significant differences in composite risk of death and PAH-related hospitalization, p=0.02. In the multivariate Cox regression analysis including age, sex, and main risk factors (COMPERA 2.0 score, TAPSE/PASP, right atrial pressure, cardiac index, mix oxygen saturation), abnormal MNA remained significantly associated with all-cause mortality (HR 2.86 [95%CI: 1.29–6.38], p=0.01) and the composite end-point HR 2.39 [95% CI: 1.05–5.42], p=0.04) in PAH patients. Conclusions Using MNA as a routine screening tool allowed the detection of abnormal nutritional status in more than one third of PAH patients. Nutritional status assessed by the MNA was an independent predictor of all-cause death and the composite end-point of all-cause death and PAH-related hospitalization in patients with PAH.

Nutritional assessment of Chinese gynecologic cancer survivors with post-surgical lower limb lymphedema: a cross-sectional study

ObjectiveThis study aims to evaluate the nutritional status of Chinese gynecologic cancer survivors with post-surgical lower limb lymphedema (LLL) by analyzing serum albumin levels and the prognostic nutritional index (PNI).MethodsA retrospective cross-sectional study was conducted at two Chinese medical centers. The cohort comprised 155 gynecologic cancer survivors who developed symptomatic unilateral LLL post-surgery, during the period from September 2021 to June 2024. Nutritional status was assessed by measuring serum albumin and PNI. Statistical analysis was performed using univariate and multivariate logistic regression models to identify factors associated with low serum albumin and PNI.ResultsThe mean age of the cohort was 55.47 ± 10.56 years, and the median total survival time was 72.0 months (36.5, 111.5 months). The prevalence of low serum albumin (&amp;lt; 40 g/L) was 40.0%, and low PNI (&amp;lt; 45) was 80.6%. Significant associations were found between low hemoglobin levels and both low serum albumin (OR = 1.05, 95% CI: 1.02–1.08, p &amp;lt; 0.001) and low PNI (OR = 1.09, 95% CI: 1.04–1.13, p &amp;lt; 0.001). Advanced International Society of Lymphology stage 3 was also associated with low albumin (OR = 0.18, 95% CI: 0.03–0.99, p &amp;lt; 0.05).ConclusionThe study highlights a significant prevalence of high risk of malnutrition among Chinese gynecologic cancer survivors with LLL, underscoring the need for regular nutritional assessments and interventions.

Work and disability benefit unraveled in chronic gastrointestinal patients

Abstract Background Persons with a chronic disease, such as chronic gastrointestinal and hepato-pancreatico-biliary (GI-HPB) disease, have a lower work participation (WP) than the healthy population. Instead, they might receive a disability benefit (DB). Positive Health (PH) is a newly developed, holistic view of health and comprises six dimensions: bodily functions, mental well-being, meaningfulness, quality of life, participation, and daily functioning. In this study we aim to determine whether the dimensions of PH relate to WP and DB in persons with GI-HPB. Methods GI-HPB patients attending the outpatient clinic of the Maastricht University Medical Center between 2019-2021 received validated questionnaires (Gastrointestinal Symptom Rating Scale, Short Nutritional Assessment Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Short Form-36, Disease Experience Questionnaire, EuroQol-5D-5L) and items regarding WP and DB. The relation between the six dimensions of PH, and WP and DB, were tested with univariate and multivariate statistics. Results 448 patients (Mage = 45 years; 69% female) were included. Univariate analysis revealed that, except for meaningfulness, all dimensions were significantly associated with WP (p≤.02) and DB (p≤.005). In multivariate analyses, lower age (p=.010), better general health (p=.044) and better physical functioning (p&amp;lt;.001) related to WP. Higher age (p=.002) and lower physical functioning (p=.011) related to DB. Conclusions Among GI-HPB patients, physical functioning related to both WP and DB. The chance of working was higher among younger patients and those with better general health while those with a higher age received DB more often. The PH concept was only partially relevant to work status and DB. Key messages • Within the dimensions of Positive health, work participation was associated with a lower age, a better general health and a better physical functioning. • Within the dimensions of Positive health, disability benefit was associated with higher age and lower physical functioning.

Measurability of overall health in patients with chronic gastrointestinal disorders

Abstract Background Chronic gastrointestinal and hepato-pancreatico-biliary (GI-HPB) patients experience problems in all life areas. The Positive health (PH) concept, based on six different dimensions of health, may hold the answers for a broader understanding of the patients’ well-being. Aim To measure the overall health status of GI-HPB patients, according to the PH concept. Methods In 2019-2021, patients with GI-HPB attending the outpatient clinic of the Maastricht University Medical Center filled in questionnaires before consultation. The six dimensions of PH (bodily functions, mental well-being, meaningfulness, quality of life, participation, daily functioning) were measured by validated questionnaires (Gastrointestinal Symptom Rating Scale, Short Nutritional Assessment Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Short Form-36, Disease Experience Questionnaire, EuroQol-5D-5L). Results were compared to control groups and assessed with McDonald’s Omega, Zero-order Pearson correlations, and t-tests. Results The 235 participating patients scored lower on quality of life, participation, and daily functioning than healthy controls (p ≤ 0.001) but similar to those with other chronic conditions. Malnutrition (moderate-severe 45.6%) and depressive/anxious symptoms (35%/21.6%) were higher in the GI-HPB group compared to those with other chronic conditions. Conclusions Validated questionnaires addressing the six dimensions of PH showed a significant worse health status compared to controls, and malnutrition and depressive symptoms were higher compared to other patient groups. Key messages • GI-HPB patients have a lower quality of life, participate less, and have less daily functioning than healthy controls and higher malnutrition and depression than those with other chronic diseases. • By using validated questionnaires, an impression of the overall health status of patients can be obtained through the concept of Positive Health.

Hip fracture in elderly: malnutrition and health outcomes. A systematic review and meta-analysis

Abstract Background Hip fracture is a common condition among elderly and one of the leading causes of disability. Malnutrition is widely present in older patients and has been identified in several studies as an important and modifiable prognostic factor for several medical conditions, including hip fracture. The aim of the present study is to evaluate the association between malnutrition, assessed by validated tools, and selected health outcomes for different follow-up intervals from hip fracture, in particular: mortality, changes in mobility/living arrangements and postoperative delirium. Methods A literature search on PubMed, Web of Science and Scopus databases up to September 2023, was conducted to identify all studies involving older subjects that reported an association between MNA/GNRI/PNI/CONUT score and health outcome after hip fracture. Meta-analysis was performed by a random-effects model using risk values (RR/OR/HR) extracted from 14 eligible selected studies. Results Malnutrition significantly increased the risk of any adverse outcome by 70% at 1 month, and up to 250% at 1 year, showing an increasing trend with longer follow-up periods. One month after hip fracture, malnutrition significantly increased the risk of postoperative delirium by 275% (OR = 2.75; 95% CI 1.80-4.18; p ≤ 0.05), mortality by 342% (OR = 3.42; 95% CI 2.14-5.48; p ≤ 0.05) and mortality hazard risk by 351% (HR = 3.51; 95% CI 1.63-7.55; p ≤ 0.05). One year after hip fracture, malnutrition significantly increased the risk of transfer to more supported living arrangements by 218% (OR = 2.18; 95% CI 1.58-3.01; p ≤ 0.05), declined mobility by 41% (OR = 1.41; 95% CI 1.14-1.75; p ≤ 0.05), mortality by 368% (OR = 3.68; 95% CI 3.00-4.52; p ≤ 0.05) and mortality hazard risk by 234% (HR = 2.34; 95% CI 1.91-2.87; p ≤ 0.05). Conclusions These findings underscore that malnutrition worsens outcomes after hip fracture in elderly, emphasizing the importance of nutritional assessment to mitigate potential adverse consequences. Key messages • The results of the present study underscore that malnutrition increases the risk of death and worsens mobility and independence after hip fracture in older adults. • Routine nutritional status evaluation could prove beneficial in the management of hip fracture older patients in order to prevent potential adverse outcomes.

Nutritional management, skipping breakfast, glycemic control, and cardiovascular risk on type 2 diabetes mellitus

Abstract Background Meal timing is an emerging field that investigates the influence of eating patterns on circadian rhythm and general health. There is still disagreement in the literature as to whether eating windows could impact weight gain and biochemical markers. Purpose 1- Evaluate the impact of nutritional interventions on weight, body mass index (BMI), waist circumference (WC), fasting blood glucose (FG), glycated hemoglobin (HbA1c), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), triglycerides, systolic blood pressure (SBP), and diastolic blood pressure (DBP), between 0th and 12th month in Type 2 Diabetes Mellitus (T2D); 2-Observe breakfast skipping and sleep disorders, and also analyze the influence of these data with possible changes in anthropometric and biochemical markers. Methods This experimental and observational study recruited 44 participants with T2D. The assessments were carried out in October 2022 and 2023. The nutritional assessment consisted of prescribing a personalized eating plan (Mediterranean diet and DASH). Statistical analysis: For the variables "breakfast habits", "nocturnal awakenings", and "sleep duration", the numbers of participants were converted into percentages of the total number of individuals. Parametric variables were compared using the paired t-test and non-parametric variables were compared by the Wilcoxon test. To evaluate the influence of the habit of eating breakfast and sleep disorders on quantitative variables, variations were calculated between the 0th and 12th month between participants who had or did not have the habit of eating breakfast and had or did not have sleep disorders. Parametric variables were compared using the unpaired t test and non-parametric variables using the Mann-Whitney test. Parametric data were presented as mean ± standard deviation and non-parametric data as median ± interquartile range, both accompanied by the dispersion of all repetitions. α&amp;lt;0.05 and P&amp;lt;0.05 were adopted. Results Significant reductions were found between the 0th and 12th month of FG, HbA1c, LDL-C, triglycerides, SBP, DBP, BMI, WC, and weight (p&amp;lt;0.0001). Regarding breakfast habits, in the 1st month, 77.3% of participants skipped this meal, reducing to 13.6% in the 12th month. For sleep duration, in the 1st month, 90.9% of participants slept less than 6 hours, reducing to 40.9% in the 12th month. For nocturnal awakenings, 70.5% of participants had at least 1 awakening in the 1st month, reducing to 54.5% in the 12th month. For influence analysis, no significant differences were found between changes in FG, HbA1c, LDL-C, triglycerides, SBP, DBP, BMI, WC, and weight on breakfast habit or sleep disorders, except for HDL-C and sleep disorders (p&amp;lt;0.005). Conclusion Nutritional management improved biochemical markers, reduced anthropometric data, regulated the eating window, reduced nocturnal awakenings, and optimized sleep duration in patients with T2D.

The role of malnutrition and dependence on outside help in hospitalized elderly patients with decompensated heart failure

Abstract Introduction Despite recent achievement in the diagnosis and treatment of heart failure, the prognosis for disease remains unfavorable especially in elderly patients. It has been recently actively proposed to introduce a comprehensive geriatric assessment to determine the group of adverse outcome and frailty, however the assessment of geriatric syndromes in acute decompensated heart failure (ADHF) among hospitalized patients is poor. Aim To assess the prognostic role of malnutrition and dependence on outside help in hospitalized elderly patients with ADHF. Materials and methods The study included 60 patients over 75 years old who were hospitalized for ADHF. The median [IQR] age was 83.0 [77.0-87.0] years, 41.7% (n=25) were men. The preserved left ventricular ejection fraction (LVEF) prevailed – 51.2% (n=22), moderately reduced and low LVEF – 23.3% (n=10) and 25.6% (n=11), respectively. Total/severe dependence on outside help was determined with Barthel Index of ≤60 points, malnutrition – with a Mini Nutritional Assessment Scale of &amp;lt;17 points, sarcopenia with SARC-F ≥4 points. At discharge, all patients underwent bioimpedance analysis of body composition (BIA). The primary endpoint was hospital mortality. Results 48.3% (n=29) of hospitalized elderly patients with ADHF had total/severe dependence on outside help. This group of patients had a higher risk of malnutrition (OP 2.01, 95% CI 1.49-2.83, p=0.04) and sarcopenia (OP 8.25, 95% CI 1.55-44.02, p=0.01). Elderly patients with ADHF and malnutrition had a more severe functional class (NYHA III-IV) than patients without malnutrition (97.1% vs. 66.7%, respectively, p=0.02). There were no differences in ADHF phenotypes depending on the presence of malnutrition. The ability to self-serve according to Barthel Index has positively correlated with the BIA Index (r=0.483, p=0.04). The risk of sarcopenia on the SARC-F scale has negatively correlated with fat, lean and active cell mass according to BIA (r=-0.538, r=-0.599 and r=-0.532, respectively, p&amp;lt;0.05). Elderly patients with ADHF and a combination of total/severe dependence on outside help and malnutrition (27.9%, n=12) had higher inflammation level (neutrophil-lymphocytic index 5.6 [2.6-7.7] vs. 3.9 [2.0-6.0], p=0.03, respectively) and the need for longer intravenous diuretic therapy (OP 4.38, 95% CI 1.21-15.81, p=0.03) compared with patients without these disorders (72.1%, n=31), The primary endpoint was reached by 4 patients, in 100% of cases there was a combination of total/severe dependence on outside help and malnutrition. Conclusion The combination of total/severe dependence on outside help and malnutrition is an unfavorable prognostic marker of hospital mortality in hospitalized elderly patients with ADHF. A comprehensive geriatric assessment and determination of body composition can identify a risk group for an adverse outcome.

Al-based Techniques for Comprehensive Crop Nutrition Assessment: A Review

Artificial Intelligence (AI) methodologies, such as machine learning, deep learning, and data fusion, are transforming agricultural practices by offering advanced tools for data-driven decision-making, predictive modeling, and automated processes. This paper explores the latest AI techniques utilized in agriculture to enhance productivity, optimize resource management, and address the challenges posed by climate change. By harnessing AI-driven solutions for crop management, soil analysis, and pest control, these methods significantly contribute to sustainable agriculture, benefiting both farmers and the environment through more efficient and eco-friendly practices. However, while AI holds immense promise, challenges remain in terms of accessibility, data quality, and the adaptation of these techniques to diverse agricultural conditions. This review aims to provide a balanced overview of the current state of AI applications in agriculture, offering insights into the opportunities and limitations faced by this growing field.

Best Evidence Summary for the Prevention of Pressure Injuries in Orthopaedic Patients.

To systematically search, evaluate and synthesise the most robust evidence regarding pressure injury prevention in orthopaedic patients admitted to general wards. The present study provides an evidence-based summary of the most robust findings, adhering to the evidence guidelines established by the Center for Evidence-Based Nursing of Fudan University. According to the "6S" model, a systematic search was conducted for literature on pressure injury prevention among orthopaedic patients in general wards. The types of literature included guidelines, clinical decisions, expert Consensus, evidence summaries, etc. The search period covered the time from the beginning of the database up to December 2023. The following databases and resources were systematically searched: Up To Date, JBI, NICE, WOCN, NZWCS, etc. RESULTS: Fifteen literature sources were included, comprising one clinical decision, eight guidelines, one systematic review, and one expert Consensus. In these sources, a comprehensive collection of 34 pieces of best evidence was formed across six key topics: risk assessment, position management, skin care, device used for device-related pressure injury, nutritional assessment, and support, as well as health education and training. Among the evidence gathered, a strong recommendation was made for 18 pieces, while the remaining 16 received a weak recommendation. This study provides a comprehensive synthesis of the most robust evidence on pressure injury prevention in orthopaedic patients, encompassing 34 pieces of evidence that can serve as valuable references for clinical practice. Before implementing this evidence, it is crucial to evaluate the specific contextual factors within different countries and medical institutions, as well as the facilitators and barriers influencing its application by healthcare professionals and patient's preferences. Furthermore, targeted evidence selection should be conducted through careful screening and subsequent adjustments in implementation, thereby offering a more scientifically grounded basis for clinical nursing practice. Future research endeavours should prioritise investigating strategies for effective evidence utilisation. The prevention of pressure injuries poses a significant challenge for orthopaedic patients. This study presents a synthesis of 34 pieces of best evidence to provide guidance on preventive measures for pressure injuries in orthopaedic patients. Adhering to and implementing these 34 pieces of evidence can effectively aid in preventing pressure injuries in clinical practice. This evidence encompasses risk assessment, position management, skin care, device usage for device-related pressure injuries, nutritional support and evaluation, and health education and training, establishing a comprehensive and systematic implementation process. Assessing the risk of pressure injuries during interventions serves as an essential prerequisite for developing effective strategies to prevent such injuries among orthopaedic patients. Ultimately, this study will offer valuable guidance to healthcare professionals worldwide regarding preventing pressure injuries in orthopaedic patients. Upon admission to the hospital, it is essential to conduct a risk assessment and implement evidence-based, individualised prevention measures for pressure ulcers in patients to prevent their occurrence. This study will provide valuable insights into preventing pressure injuries in orthopaedic patients admitted to orthopaedic wards for healthcare workers worldwide. The PRIMA manifest is utilised during the text preparation process. ES20245365.

Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients

Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients

Association between malnutrition and adverse renal outcomes in patients with type 2 diabetes.

Nutritional management is crucial in patients with chronic kidney disease. Therefore, it is important to assess nutritional status and detect malnutrition, especially in patients with diabetes. However, there is currently a lack of evidence regarding the relationship between nutritional indices and renal function in patients with type 2 diabetes. This study investigated whether the geriatric nutritional risk index (GNRI) is related to renal prognosis in type 2 diabetes patients. The study included 946 type 2 diabetes patients enrolled in the Fukushima Cohort Study. The primary endpoint of this study was a renal event, defined as a combination of a 50% decline in eGFR from baseline and end-stage kidney disease. All-cause death and new cardiovascular events were also measured as secondary outcomes. The association between GNRI and these endpoints was assessed using Cox regression analysis. The median patient age was 66 years, 57% were men, the median eGFR was 67.9 mL/min/1.73 m2, and the median GNRI was 100.0. Compared to patients in the highest GNRI tertile, patients in the lowest tertile had a significantly increased risk of therenal event (HR 5.15, 95% CI 2.51-10.6) and all-cause death (HR 2.30, 95% CI 1.20-4.42). A significant association was not observed between GNRI levels and cardiovascular events. We observed an association between poor nutritional status, assessed by GNRI, and adverse outcomes in patients with type 2 diabetes. Nutritional status assessment has potential utility as a prognostic tool for individuals with type 2 diabetes.

Comparison of CIPA Nutritional Screening with GLIM Criteria for Malnutrition, Prognostic Evolution, and Association with Phase Angle in Hospitalized Patients

Background: Hospital malnutrition has high prevalence and is associated with worse clinical outcomes. The lack of standardized nutritional screening prompted the creation of the CIPA screening tool. Several studies have shown that the phase angle (PA) is associated with increased nutritional risk and worse clinical outcomes. The aim of this study was to establish the concordance between the CIPA and GLIM criteria and to assess their correlation with PA values and clinical outcomes. Methods: A cross-sectional single-center study was carried out, with a prospective six-month follow-up for the prognostic variables. On admission, the CIPA and GLIM criteria and bioimpedanciometry were assessed. Results: A total of 510 inpatients were included; 36.5% had positive CIPA outcomes and 46.1% had positive GLIM outcomes. The correlation between the CIPA and GLIM criteria had a kappa index of 0.26, p &lt; 0.01. Those with positive CIPA had a higher mortality risk (OR = 1.81) and longer mean length of stay (MLS) (OR = 1.45). The PA cut-off points were determined by sex and age for CIPA (men &gt; 65 years: 4.75°, men ≤ 65 years: 5.75°, women &gt; 65 years: 4.75°, and women ≤ 65 years: 5.45°) and GLIM (men &gt; 65 years: 4.95°, men ≤ 65 years: 5.85°, women &gt; 65 years: 4.75°, and women ≤ 65 years: 5.55°). These PA cut-off points were associated with worse clinical outcomes with CIPA (mortality OR = 4.2; MLS OR = 1.51; readmissions OR = 2.28) and GLIM (mortality OR = 2.97; MLS OR = 2.61; readmissions OR = 1.79). Conclusions: CIPA screening shows a low correlation with GLIM nutritional assessment. Positive CIPA and GLIM have lower PAs than negative and worse prognostic outcomes. The PA cut-off points associated with worse outcomes have been established.

Morbidity Profile And Nutritional Assessment Of School Children In The Rural Field Practice Area Under Government Medical College, Srikakulam, Andhra Pradesh: A Descriptive Cross‐Sectional Study

Morbidity Profile And Nutritional Assessment Of School Children In The Rural Field Practice Area Under Government Medical College, Srikakulam, Andhra Pradesh: A Descriptive Cross‐Sectional Study

Application of NRS2002 and PG-SGA in nutritional assessment for perioperative patients with head and neck squamous cell carcinoma: An observational study.

This study aimed to compare the effectiveness of 2 nutritional assessment tools, the Nutritional Risk Screening Scale 2002 (NRS2002) and the Patient-Generated Subjective Global Assessment (PG-SGA), for evaluating the nutritional status of perioperative head and neck squamous cell carcinoma (HNSCC) patients, to facilitate early nutritional interventions and improve clinical outcomes. An observational, comparative study was conducted at the Zhejiang Cancer Hospital, recruiting patients diagnosed with HNSCC scheduled for surgical treatment. The NRS2002 and PG-SGA were applied to assess patients' nutritional risk at multiple time points: upon admission, the day before surgery, 2 days after surgery, a week after surgery, and at discharge. Statistical analyses were performed using McNemar and Kappa tests to assess differences and consistency between NRS2002 and PG-SGA. A total of 209 patients were included in this study, predominantly male, with an average age of 60 years. Nutritional risk assessments identified an inverted "V" trend in nutritional risk, with the peak occurring 2 days post-surgery. PG-SGA consistently showed a higher screening positivity rate compared to NRS2002. The receiver operating characteristic curve analysis highlighted the discriminative power of both tools, with PG-SGA and NRS2002 showing high area under the curve values. Both NRS2002 and PG-SGA are effective for nutritional screening in HNSCC patients, with PG-SGA demonstrating a slightly higher sensitivity before surgery. PG-SGA may be more suitable for preoperative application, whereas NRS2002 is more appropriate for postoperative use.

The Possible Impact of COVID-19 on Glycated Hemoglobin and Systolic Blood Pressure in Type 2 Diabetes and Obesity

Background: There are still discrepancies in the literature as to whether COVID-19 infection could impact biochemical, anthropometric, and cardiovascular markers. The purpose of this study was firstly to observe the effects of COVID-19 infection over 12 months on Type 2 diabetes (T2D) and obesity. Secondarily, we analyzed the individual influence of COVID-19 infection on changes in biochemical, anthropometric, and cardiovascular markers. Methods: This study is part of a secondary analysis of a recently published article. The research involved 84 participants with T2D, divided into two groups: the control group (40 participants) received only medical care, while the intervention group (44 participants) received both medical care and nutritional assessment. Consultations were held quarterly over 12 months, with a follow-up after 3 months. Data Analysis: For influence analysis, non-normal variables were compared using the Mann–Whitney test, and normal variables were compared using unpaired t-tests. For all cases, α = 0.05 and p &lt; 0.05 were considered significant. Results: The analysis revealed a high percentage of patients in both groups who had a COVID-19 infection (70% control and 72.7% intervention) over 12 months. Regarding the influence analysis, participants in the intervention group who were infected with COVID-19 showed smaller reductions in glycated hemoglobin (HbA1c) (p = 0.0120) and systolic blood pressure (SBP) (p = 0.0460). For the other biochemical, anthropometric, and cardiovascular markers, in both groups, no significant differences were found (p &gt; 0.05). Conclusion: COVID-19 possibly influenced SBP and HbA1c levels over 12 months in people with T2D and obesity. However, caution should be exercised in generalizing these results due to the limitations of this study. Additionally, influence analysis does not establish a causal relationship, and more clinical trials in different populations are needed to fully analyze this topic.

Impact of Body Mass Index on Outcomes in Pediatric Allogeneic Hematopoietic Stem Cell Transplantation Recipients: A Single-Center Retrospective Study

Background: Pediatric patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) face several risk factors influencing transplantation success, including nutritional status as measured by body mass index (BMI). Methods: This study analyzed BMI data collected from patients transplanted between 2003 and 2023, and aimed to evaluate whether deviations from normal BMI are associated with poorer clinical outcomes. BMI levels assessed before and after first-line treatment and pre-transplantation were analyzed retrospectively to determine a correlation with survival and post-transplant complications. Results: Underweight patients had significantly lower 12- and 36-month overall survival rates compared to normal-weight and overweight patients (p = 1.22 × 10−8 and p = 8.88 × 10−8, respectively). Event-free survival was also lower for underweight patients at all time points. A higher pre-transplant BMI increases the risk of acute graft-versus-host disease (GVHD, p = 0.00068). Otherwise, pre-transplant BMI was not significantly correlated with early TRCs and cGVHD. As secondary objectives, this study identified differences in BMI across primary disease groups, with solid tumor patients having the highest BMI and myelodysplastic syndrome patients having the lowest. BMI cut-offs were identified to predict or protect against serious outcomes, including delayed engraftment, TRCs, and acute and chronic GVHD. Conclusions: This study highlights the importance of nutritional assessment and management in pediatric patients undergoing allo-HSCT to optimize post-transplant outcomes, as deviations from a normal BMI can significantly impact post-transplant health. These findings underscore the importance of integrating BMI assessment throughout the entire pre-HSCT therapeutic course to identify patients at higher risk for complications and to define more effective nutritional management strategies.

Nutritional Status Impact on Hip Fracture Patients in a Rural Environment

(1) Background: Hip fractures are highly prevalent traumatic events with significant functional consequences, particularly among the older population. These fractures are associated with increased mortality, postoperative complications, and functional dependence. Medical and nutritional factors such as malnutrition and sarcopenia are crucial for predicting functional outcomes and mortality in these patients. This study aimed to assess the nutritional status, vitamin D levels, and sarcopenia, as well as their relationship with mortality, mean hospital stay, and 30-day-readmission rate, in patients with hip fracture who underwent surgery in a rural hospital setting. (2) Methods: A longitudinal retrospective study involving 124 patients who underwent hip fracture surgery in 2021 was conducted. Sociodemographic, surgical, and nutritional data, including vitamin D, albumin, and blood urea nitrogen (BUN) levels, were collected. (3) Results: The average age of the sample was 89.1 years, with a postoperative 30-day-mortality rate of 8.1% and an average hospital stay of 10.4 days. Vitamin D deficiency was present in 79.7% of patients, and a high prevalence of malnutrition was indicated by low albumin and elevated BUN levels. Elevated BUN levels and low vitamin D levels were associated with higher mortality. (4) Conclusions: Adequate nutritional assessment in patients with hip fracture is vital for identifying the risks of complications and mortality. Understanding the current nutritional status and its associated complications will aid in developing strategies to improve health and reduce complications in the future.