Nutritional Management Research Articles

Nutritional quality of tomato in response to different fertilization doses and conduction systems

The tomato, a rich source of essential nutrients such as vitamins A and C, potassium, and antioxidants, plays a crucial role in human nutrition, promoting health and preventing diseases. In Brazil, its production is vital, involving significant resources and labor. The correct nutritional management of the crop can improve the nutritional attributes of tomato fruits, therefore the correct use of fertilizers is of great importance due to the high need for phosphorus, nitrogen and potassium, throughout the crop cycle. Nutritional management is of great importance in tomato fields due to its high fertilizer requirements throughout the entire crop cycle. This study aimed to assess the effect of different fertilizer doses and management systems on the physicochemical characteristics of tomatoes. The experiment followed a factorial design with five fertilizer doses (A0: 0%; A1: 50%; A2: 100%; A3: 150%; A4: 200% of the recommended dose) and four conduction systems, with three replications. Productivity, lycopene content, total soluble solids (TSS), nitrogen, phosphorus, potassium, calcium and magnesium fruit contents were evaluated. The results showed that higher fertilizer doses increased lycopene levels, reaching 80 μg g-1 with 200% fertilization, while 0% provided 30 μg g-1. Total soluble solids above 4°Bx were observed at doses above 150%, regardless of planting density. Nitrogen content reached 26 mg·100 g-1f.m., favored by lower densities. Calcium was influenced by fertilizer doses, with higher concentrations at 150%. In conclusion, the application of 150% fertilizer dose improved the nutritional quality of tomatoes, and the 200% dose provided suitable levels of TSS and lycopene for processing.

Exploring the Influence of Concurrent Nutritional Therapy on Children with Spinal Muscular Atrophy Receiving Nusinersen Treatment.

Background This study examines spinal muscular atrophy (SMA), a neuromuscular disease associated with malnutrition. Our goals are to assess how effectively screening tools can detect malnutrition and evaluate the impact of nutritional interventions on neurological outcomes, particularly motor functions. Methods Thirty-seven genetically diagnosed SMA patients (types 1, 2, and 3) under nusinersen therapy were included in the study. The nutritional status of these patients was assessed by using anthropometric measurements, including height for age (HFA), weight for height (WFH), and body mass index (BMI) before and after the study. Additionally, the risk of malnutrition was determined using screening tools, namely the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP). Nutritional counseling followed the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines and considered the patients' dietary history, including content and administration method. Motor functions were assessed by validated tests: the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) and the Hammersmith Functional Motor Scale-Expanded (HFMSE). Result The study showed an improvement in HFA, by a change from -0.95 to -0.65 (p = 0.015). Conversely, BMI scores decreased from 0.08 to -0.54 (p = 0.015), while WFH and MUAC showed no significant alterations (p = 0.135, p = 0.307). Following nutritional interventions, HFMSE demonstrated a median increase from 29.5 to 30.5 (p = 0.023). Patients identified as being at high risk for malnutrition based on PYMS and STAMP belonged to the moderate-to-severe malnutrition group (BMI Z-score ≤ -2, p = 0.001). Conclusions Use of screening tools in SMA patients is highly beneficial for the early detection of malnutrition. Future research should highlight the importance of combining nutritional management with nusinersen therapy to potentially alter the disease trajectory, especially in motor and neurological functions.

Analysis of the Application Effectiveness of the Pregnancy Dietary Compliance Index Scoring Tool

This study aims to conduct a dietary index score assessment for individuals with high-risk factors for gestational hyperglycemia (such as overweight, obesity, family history of diabetes, history of macrosomia, and gestational diabetes mellitus), starting from early pregnancy, and to provide personalized nutrition management based on the score to reduce pregnancy complications and adverse pregnancy outcomes. A total of 194 pregnant women who underwent routine prenatal examinations at our hospital from September 2022 to September 2023 were selected. They were randomly divided into a study group and a control group, with 97 cases in each group. The control group received simple nutritional guidance, mainly focusing on the requirements for various nutrients and nutritional supplements during each trimester. The study group received nutrition guidance based on the dietary index score, as well as personalized guidance on health education, weight management, pregnancy exercise, and lifestyle. The incidence of gestational diabetes mellitus in the intervention group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.05). The incidence of macrosomia was 1.03% in the intervention group and 8.25% in the control group, with a statistically significant difference (P < 0.05). The incidence of small-for-gestational-age infants was 2.06% in the intervention group and 10.31% in the control group, with a statistically significant difference (P < 0.05). For pregnant women with high-risk factors, early pregnancy nutrition management based on the dietary compliance index score can quickly screen for nutritional risks and provide targeted personalized nutrition management, thereby reducing the risk of pregnancy complications and adverse pregnancy outcomes and promoting the health of mothers and infants during pregnancy.

Systematic nutritional screening and assessment in older patients: Rationale for its integration into oncology practice

As the global population ages, so does the number of older people being diagnosed, treated and surviving cancer. Challenges to providing appropriate healthcare management stem from the heterogeneity common in this population. Although malnutrition is highly prevalent in older people with cancer, ranging between 30 % and 80 % according to some analyses, is associated with frailty, and has been shown to be a major risk factor for poor treatment response and worse overall survival, addressing nutrition status is not always a priority among oncology healthcare providers. Evaluation of nutritional status is a two-step process: screening identifies risk factors for reduced nutritional intake and deficits that require more in-depth assessment. Screening activities can be as simple as taking weight and BMI measurements or using short nutritional questionnaires and asking the patient about unintentional weight loss to identify potential nutritional risk. Using geriatric assessment, deficits in the nutritional domain as well as in others reveal potentially reversible geriatric and medical problems to guide specific therapeutic interventions. The authors of this paper are experts in the fields of geriatric medicine, oncology, and nutrition science and believe that there is not only substantial evidence to support regularly performing screening and assessment of nutritional status in older patients with cancer, but that these measures lead to the planning and implementation of patient-centered approaches to nutrition management and thus enhanced geriatric-oncology care. This paper presents rationale for systematic nutrition screening and assessment in older adults with cancer.

The Effect of Vitamins on the Immune Systems of Pigs.

In modern pig farming, there are many environmental, physiological or social stresses that weaken the immune response and increase susceptibility to disease. Nutritional management has a significant impact on the efficiency of the immune system in pigs. Among the various nutrients, vitamins have been shown to have specific effects on immune system activity. However, the needs of modern genetic types are not met by the dietary recommendations for vitamins in pig diets. The present study therefore summarises the data on dietary integration with supranutritional doses of vitamins in gestating and lactating sows and post-weaning piglets in terms of the immune response. The present data highlight that high doses of dietary vitamins are an effective way to improve the immune system, antioxidant status and gut health. Further studies are needed to deepen the understanding of the role of dietary supplementation with vitamins in pigs on immune system and gut functionality.

Stick-and-sensing microneedle patch for personalized nutrition management

The focus of the next-generation healthcare system has moved forward from single disease detection to comprehensive health interpretation, namely, from disease diagnosis to prophylaxis via the early management of sub-health status. Among the technologies, microneedles have emerged as an efficient and powerful tool to realize painless and real-time sensing in the interstitial fluid (ISF), offering promising solutions for dynamic and direct reflection of nutritional profiles. Herein, we present a film-like, multifunctional microneedle patch, that is composed of three laser-induced graphene (LIG) based electrodes for minimally invasive and timely detection of glucose and vitamin C in the ISF. The microneedle patch is simply fabricated with a thickness of ∼0.25 mm polyimide (PI) film by a commercial laser platform, where laser-engraving is operated to form graphene electrodes, and laser-cutting accounts for the needle-tip shaping. Such fast, low-cost, and scalable manufactured microneedle patches showed excellent performance for electrochemical sensing and therefore allowed reliable on-the-tip monitoring of changes in glucose and vitamin C levels. Long-term studies in vivo and demonstrations in planta indicated the great promise of our microneedle patch to revolutionize dietary guidelines based on individualized status for effective nutrition management.

Nutritional Profile and Topic Management for Wound Healing in Children with Epidermolysis Bullosa: What Is the Evidence? A Systematic Review

Epidermolysis Bullosa (EB) is a rare genetic disorder characterized by fragile skin that blisters and tears easily, leading to significant morbidity and mortality. Depending on the specific genetic mutations and the proteins involved, EB can be classified into several subtypes whose molecular complexity is compounded by the variability in mutation types (missense, nonsense, insertions, deletions), their locations within the genes, and the resultant effects on protein function. This systematic review aimed to identify and synthesize available evidence on wound healing interventions and the nutritional profile of children diagnosed with EB. A comprehensive search yielded 28 articles, including 21 clinical trials and seven observational studies, encompassing 994 patients with various EB subtypes. The majority of studies described subtypes such as Simplex EB (EBS), Junctional EB (JEB), Dystrophic EB (DEB), and EB Kindler. The primary interventions for wound healing included dressings with collagen, biocellulose, and various topical creams. Nutritional assessment was limited, with only six studies examining nutritional status, predominantly through anthropometry and dietary intake analysis. Subgroup analyses indicated higher malnutrition rates among patients with DEB compared to JEB. The review underscores the importance of addressing wound healing and nutritional challenges in EB management. Further research is needed to explore effective interventions and optimize care for this vulnerable population.<strong>Keyword</strong><strong>s</strong>Nutrition; pediatrics; wound healing; epidermolysis bullosa

Understanding Carbon Footprint in Sustainable Land-Based Marine Aquaculture: Exploring Production Techniques

In aquaculture, it is crucial to understand and mitigate the carbon footprint for sustainable production. As demand for seafood increases, various production techniques compete for an eco-friendly status. This review examines the carbon footprint of various land-based marine aquaculture systems, highlighting their environmental impact. Through exploring innovations and best practices, it navigates the complexities of reducing emissions and promoting carbon sequestration. Some proposals for this purpose are based on diversification through low-trophic-level species, the preservation of high-carbon sequestration sites, polyculture, organic aquaculture and improvements in nutrition, feeding, waste and energy management. In this sense, some land-based aquaculture systems are progressively adapting and updating their zootechnical procedures. Recirculating Aquaculture Systems (RASs) offer interesting advantages such as water conservation, pollution reduction and biosecurity. Integrated Multi-Trophic Aquaculture systems (IMTAs) aim to address two major issues in aquaculture: efficient water usage and the environmental impact of effluents, which are rich in organic particles and dissolved nutrients from undigested food and feces; hence, these systems involve cultivating multiple species (polyculture). Biofloc Technology (BFT) is based on the formation of bioflocs in a culture medium. These systems can enhance feeding efficiency and waste management, thus optimizing nutrient utilization and minimizing environmental impact, achieved through reduced water and fertilizer usage. Traditional (extensive) aquaculture systems operate with minimal input of feed and chemicals, relying heavily on the natural productivity of the ecosystems; thus, the need for manufactured feed, the environmental impact associated with feed production and the transportation and overall costs are significantly reduced. Overall, while RASs, BFT and extensive systems in general offer significant sustainability benefits, IMTA’s holistic approach to ecosystem management and nutrient recycling makes it, in our estimation, the most effective method in terms of ecological footprint in aquaculture. However, its quantitative evaluation is extremely complex, and there is currently a lack of references about its global carbon footprint. Therefore, further research and development are required, as well as collaboration and knowledge-sharing among stakeholders.

Nutritional management and physiological responses of Atriplex nummularia Lindl. on the improvement of phytoextraction in salt-affected soil

Soil salinity is a significant abiotic stress and poses risks to environmental sustainability. Thus, the improvement of the time for recovering the salt-affect soil is crucial for the phytoextraction process using halophytes plants, especially regarding on nutritional management. We evaluated the responses of Atriplex nummularia Lindl. to nitrogen (N) and phosphorus (P) under different salinity levels. The treatments comprised doses of N (N1 = 80 kg ha−1) and P (P1 = 60 kg ha−1): (1) without N and P (N0P0) (control); (2) with N and without P (N1P0); (3) without N and with P (N0P1); and (4) with N and P (N1P1) and five levels of electrical conductivity from irrigation water: 0.08, 1.7, 4.8, 8.6, and 12.5 dS m−1. The. We evaluated dry biomass of leaves, stems, and roots 93 days after transplantation. We also assessed the leaf and osmotic water potential, the osmotic adjustment, and the nutrient contents (N, P, Na, and K). N application increased 22.3, 17.8, and 32.8% the leaf biomass, stem biomass, and osmotic adjustment, respectively; and consequently, boosts Na extraction in 27.8%. Thus, the time of the phytoextraction process can be improved with N fertilizer at a rate of 80 kg ha−1.

Influence of Urea Foliar Nutrition and Leaf Harvesting Intensity on Growth, Yield Attributes and Yield in Cowpea [Vigna unguiculta (L.) Walp.

A field experiment was undertaken at Farming Systems Research Station (FSRS), Sadanandapuram, Kollam district, Kerala Agricultural University in summer 2022 for studying the effect of growth, yield attributes and yield of cowpea through foliar application of 2% urea and intensity of leaf harvesting. Experimental treatments comprised of 4 levels of foliar nutrition management (2% urea spray at vegetative stage (f1), 2% urea spray at flowering stage (f2), 2% urea spray at vegetative stage and flowering stage (f3), water spray control (f4) and 3 levels of leaf harvest (20% leaf harvest (l1), 40% leaf harvest (l2), and no leaf harvest (l3). Among the foliar nutrition management treatments, f3 showed significantly the taller plants (91.97 cm), more number of branches (15.13), leaves (34.76), leaf area/ plant (884.29 cm2), leaf area index (1.96) dry matter production (42.39 g) and chlorophyll content (3.544 mg/g) and were comparable with f1. The nodule parameters such as nodule number (37.44) and effective number of nodules (32.11) were the highest in treatment f3 and was on par with f1. Further, days to 50 per cent flowering (53.65 days), pod length (17.27 cm), 100 seed weight (12.40 g), pod number (24.58), foliage yield (1484.57 kg ha-1), grain yield (925.85 kg ha-1) and haulm yield (2722.70 kg ha-1) were the highest in treatment f3 and was on par with f1 except for pod weight (21.19 g). Among the leaf harvest intensity, treatment l3 recorded the taller plants (92.45 cm), leaf area per plant (902.71cm2) leaf area index (2.01), less days to 50% flowering (47.60 days) and haulm yield (2754.85 kg ha-1). It was on par with l1 pertaining to plant height. The number of branches (15.03), dry matter production per plant (40.78g), pod weight/plant (19.43 g), pod number/plant (23.59) and grain yield (925.85 kg ha-1) were the highest in treatment l1.

Expert consensus on enteral nutrition management for preterm infants in special situations (2024)

Establishing enteral nutrition after the birth of preterm infants presents numerous challenges, particularly for those in special situations. Various disease factors and medical interventions impede the establishment of enteral feeding, leading to conflicts and controversies regarding feeding goals, feeding methods, and the challenges and solutions faced by these infants. A critical issue for clinical physicians is how to safely and promptly establish enteral nutrition to achieve full enteral feeding as quickly as possible. The consensus formulation working group, based on both domestic and overseas research, adopted the Grading of Recommendations Assessment, Development and Evaluation, and formed an expert consensus on enteral nutrition management for preterm infants in special situations. This consensus provides 14 recommendations for 9 common special situations, aiming to offer guidance on enteral nutrition management for preterm infants to improve their short and long-term outcomes. Citation:Chinese Journal of Contemporary Pediatrics, 2024, 26(7): 665-676.

Implementasi Keperawatan dengan Masalah Defisit Nutrisi pada Pasien Tuberkulosis Paru

Pulmonary tuberculosis is an infectious disease that transmits the lungs caused by Mycobacterium tuberculosa which has a rod-like shape and is acid-resistant, so it is known as BTA (acid-resistant rods) which is the main factor in Pulmonary Tuberculosis. The type of research used is descriptive in the form of case studies with data collection methods by means of interviews and physical examination. The research subjects were two pulmonary tuberculosis patients with nutritional deficit problems at Muhammadiyah Hospital in Palembang. The nursing implementation approach used includes identification of nutritional status: management of oral hygiene and providing diet education. This study was conducted to compare two respondents who had been given implementation for three days where 1 day was implemented 3 times, namely nutrition management, oral hygiene and diet education and was carried out in the morning. The study showed that after three days of implementation the problem of nutritional deficit experienced by weight patients increased by 1 kg, oral hygiene improved, and knowledge increased.

The association between malnutrition risk and revised Edmonton Symptom Assessment System (ESAS-r) scores in an adult outpatient oncology population: a cross-sectional study

BackgroundCancer-associated malnutrition is associated with worse symptom severity, functional status, quality of life, and overall survival. Malnutrition in cancer patients is often under-recognized and undertreated, emphasizing the need for standardized pathways for nutritional management in this population. The objectives of this study were to (1) investigate the relationship between malnutrition risk and self-reported symptom severity scores in an adult oncology outpatient population and (2) to identify whether a secondary screening tool for malnutrition risk (abPG-SGA) should be recommended for patients with a specific ESAS-r cut-off score or group of ESAS-r cut-off scores.MethodsA single-institution retrospective cross-sectional study was conducted. Malnutrition risk was measured using the Abridged Patient-Generated Subjective Global Assessment (abPG-SGA). Cancer symptom severity was measured using the Revised Edmonton Symptom Assessment System (ESAS-r). In accordance with standard institutional practice, patients completed both tools at first consult at the cancer centre. Adult patients who completed the ESAS-r and abPG-SGA on the same day between February 2017 and January 2020 were included. Spearman’s correlation, Mann Whitney U tests, receiver operating characteristic curves, and binary logistic regression models were used for statistical analyses.Results2071 oncology outpatients met inclusion criteria (mean age 65.7), of which 33.6% were identified to be at risk for malnutrition. For all ESAS-r parameters (pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, and wellbeing), patients at risk for malnutrition had significantly higher scores (P < 0.001). All ESAS-r parameters were positively correlated with abPG-SGA score (P < 0.01). The ESAS-r parameters that best predicted malnutrition risk status were total ESAS-r score, lack of appetite, tiredness, and wellbeing (area under the curve = 0.824, 0.812, 0.764, 0.761 respectively). Lack of appetite score ≥ 1 demonstrated a sensitivity of 77.4% and specificity of 77.0%. Combining lack of appetite score ≥ 1 with total ESAS score > 14 yielded a sensitivity of 87.9% and specificity of 62.8%.ConclusionMalnutrition risk as measured by the abPG-SGA and symptom severity scores as measured by the ESAS-r are positively and significantly correlated. Given the widespread use of the ESAS-r in cancer care, utilizing specific ESAS-r cut-offs to trigger malnutrition screening could be a viable way to identify cancer patients at risk for malnutrition.

Nutritional management after necrotizing enterocolitis and focal intestinal perforation in preterm infants.

Nutritional management of preterm infants recovering from necrotizing enterocolitis (NEC) or focal intestinal perforation (FIP) is challenging, especially in infants managed surgically. The logistics of how, when, and what to feed are unclear and current nutritional practices are primarily based on physiological principles and consensus opinion in individual units, rather than high-quality evidence. The aim of this narrative review is to summarize the literature on nutritional management after NEC or FIP in preterm infants: when to restart enteral nutrition, type of enteral nutrition to use, and how to advance nutrition. We also discuss treatment of micronutrient deficiencies, cholestasis, replacement of stoma losses, and optimal time of stoma closure. In conclusion, there are insufficient high-quality studies available to provide evidence-based recommendations on the best nutritional practice after NEC or FIP in preterm infants. A local or national consensus based early nutrition guideline agreed upon by a multidisciplinary team including pediatric surgeons, pediatricians/neonatologists, nurses, and nutritionists is recommended. Further studies are urgently needed. IMPACT: There is no good quality evidence or nutritional standard across neonatal units treating infants after medical or surgical NEC or FIP. With this review we hope to start providing some consistency across patients and between providers treating patients with NEC and FIP. Mother's own milk is recommended when restarting enteral nutrition after NEC or FIP. In the absence of high-quality evidence, a consensus based early nutrition guideline agreed upon by a multidisciplinary team is recommended. Nutritional research projects are urgently needed in NEC and FIP patients.

NURSES’ KNOWLEDGE AND ATTITUDES TOWARDS DIETARY MANAGEMENT OF PATIENTS WITH DIABETES MELLITUS

Proper dietary management is crucial for patients with diabetes mellitus, and nurses play a key role in educating and managing these patients. Understanding nurses' knowledge and attitudes towards dietary management can help improve patient care. Objective: To assess the knowledge and attitudes of nurses towards dietary management of patients with diabetes mellitus. Methods: A cross-sectional study was conducted in the Nursing Department of Lahore General Hospital, Multan, from June 2023 to June 2024. A total of 150 nurses from medical and surgical wards were selected through convenience sampling. Data were collected using a self-administered questionnaire, which was anonymous and took 15-20 minutes to complete. The questionnaire was divided into three sections: demographic, social, and professional information; a modified version of the 20-item Nutritional Management of Diabetes Knowledge Test; and a 14-item Nurses’ Attitudes about Nutritional Management of Diabetes Questionnaire. Descriptive statistics were used to summarize the data, and Pearson’s correlation analysis was employed to explore the relationship between knowledge and attitudes. Results: The mean knowledge score among the nurses was 11.20 ± 1.90, with scores ranging from 5 to 17. After standardization, 90 nurses (60%) exhibited moderate knowledge of nutritional management for diabetes. The mean attitude score was 59.71 ± 5.98, with 129 participants (86%) demonstrating a favorable attitude. Pearson’s correlation analysis showed no statistically significant association between knowledge and attitude (r= -0.070, p= 0.419). Conclusion: The study found that nurses generally had moderate knowledge and a favorable attitude toward the dietary management of diabetic patients. These findings suggest a need for targeted educational interventions to enhance nurses' knowledge in this area, potentially improving patient outcomes.

Nutritional management of the child with chronic kidney disease and on dialysis.

While it is widely accepted that the nutritional management of the infant with chronic kidney disease (CKD) is paramount to achieve normal growth and development, nutritional management is also of importance beyond 1 year of age, particularly in toddlers, to support the delayed infantile stage of growth that may extend to 2-3 years of age. Puberty is also a vulnerable period when nutritional needs are higher to support the expected growth spurt. Inadequate nutritional intake throughout childhood can result in failure to achieve full adult height potential, and there is an increased risk for abnormal neurodevelopment. Conversely, the rising prevalence of overweight and obesity among children with CKD underscores the necessity for effective nutritional strategies to mitigate the risk of metabolic syndrome that is not confined to the post-transplant population. Nutritional management is of primary importance in improving metabolic equilibrium and reducing CKD-related imbalances, particularly as the range of foods eaten by the child widens as they get older (including increased consumption of processed foods), and as CKD progresses. The aim of this review is to integrate the Pediatric Renal Nutrition Taskforce (PRNT) clinical practice recommendations (CPRs) for children (1-18 years) with CKD stages 2-5 and on dialysis (CKD2-5D). We provide a holistic approach to the overall nutritional management of the toddler, child, and young person. Collaboration between physicians and pediatric kidney dietitians is strongly advised to ensure comprehensive and tailored nutritional care for children with CKD, ultimately optimizing their growth and development.

Navigating the Cow’s Milk Allergy Journey: From Diagnosis to Nutritional Optimisation

Cow’s milk allergy (CMA) currently ranks as one of the most common infant food allergies and requires timely diagnosis and appropriate management to mitigate the impact on growth and developmental outcomes and minimise patient/parent distress. During this symposium, chaired by Yvan Vandenplas, Emeritus at KidZ Health Castle, University Hospital Brussels, Belgium, leading experts in paediatric gastroenterology, allergy, and nutrition, discussed how best to navigate the CMA journey in clinical practice, from accurate differential diagnosis to nutritional optimisation. Annamaria Staiano, Professor of Paediatrics and Chief of the Department of Translational Medical Sciences at the University of Naples ‘Federico II’, Italy, discussed the complexities of differentiating disorders of gut–brain interaction (DGBI), previously known as functional gastrointestinal disorders, from CMA, and considered the potential role of the Cow’s Milk Related Symptom Score (CoMiSSTM) in ensuring infants follow the correct diagnostic pathway. Ralf Heine, Paediatric Gastroenterologist, Allergist, and Honorary Research Fellow at the Murdoch Children’s Research Institute in Melbourne, Australia, explored the immune-modulating effects of human milk oligosaccharides (HMO) and lactose on the gastrointestinal (GI) microbiota in infants, highlighting the importance of the early-life microbiome during the nutritional management of CMA. Rosan Meyer, Paediatric Dietitian and visiting Professor at both KU Leuven, Belgium, and the University of Winchester, UK, focused on the final phase of CMA management, the reintroduction of cow’s milk protein, and also examined new evidence to support the optimal timing and strategy for this key step in clinical practice.

Preventing Progression: A Comprehensive Approach to Managing Parkinson's Disease

Parkinson’s disease (PD) is the second-most common neurodegenerative disease and the most common synucleinopathy. It is a multi-system disease with both motor and non-motor disorders, cause of suffering for patients and a burden for healthcare system. Due to the constantly increasing number of patients and still unknown disease-modifying treatment, it is necessary to look for an effective way to slow down the progression. The article explores factors influencing PD progression, focusing on physical activity, nutrition, cognitive stimulation, and medical management. It underscores the need for a multidimensional approach to address the complex nature of PD and offers insights into potential strategies for slowing down Parkinson’s disease progression.

Fistuloclysis in the nutritional management of a enteroatmospheric fistula: case report and literature review

Introduction: The open abdomen (OA) strategy has been widely adopted as a life-saving intervention in critically ill patients. Initially described as part of the damage control surgery in trauma practice, OA techniques have since further expanded its indications, being successfully adapted to many non-trauma emergent surgical conditions, including abdominal compartment syndrome, severe acute pancreatitis, vascular diseases, and peritonitis/intra-abdominal sepsis. Case Report: This report presents a successful application of this technique in the management of a high-output enteroatmospheric fistula following abdominal complications in a trauma patient. Final considerations: Fistuloclysis is a promising modality for the nutritional support of complex cases of enteroatmospheric fistula in OA patients that also align with the recent efforts to ensure enteral nutrition whenever feasible. Besides its advantages over prolonged exclusive parenteral nutrition in terms of morbidity and costs, the improvement in bowel mucosal trophism is critical for the definitive reconstructive surgery. Future clinical guidelines may encourage the use of fistuloclysis as a safe and effective alternative method for the management of these challenging cases.

Examining the Impact of a Behavior Modification Program on Disease Prevention Behaviors among Individuals at Risk of Diabetes: A Quasi-Experimental Investigation.

This study aimed to develop and test a behavior modification intervention to prevent type 2 diabetes (T2DM) among at-risk individuals. The primary goal was to compare diabetes prevention behaviors and fasting blood sugar levels between the intervention and comparison groups. This study utilizes a quasi-experimental design to develop a behavior modification intervention for preventing diabetes. It involves two groups, each with pre- and post-intervention assessments, comprising 60 at-risk individuals equally divided into intervention and comparison groups. The 8-week intervention includes components like risk assessment, dietary skill enhancement, exercise, stress management, and social media platforms (data recording training, follow-up visits, reminders, and visual aids). Data collection includes self-administered questionnaires and blood sugar level measurements. Statistical analysis involved paired t-tests for within-group comparisons and independent t-tests for between-group differences. The findings showed that the intervention group achieved significantly higher average scores in nutrition, exercise, and stress management, and had significantly lower average blood sugar levels compared to the comparison group. These results suggest that healthcare providers and policymakers should develop community health programs and public health policies that incorporate integrative care, leverage social media platforms, and foster collaboration with other health professionals to improve outcomes for individuals at risk of T2DM.