Nutritional Controls Research Articles

Sociodemographic Factors and Antenatal Service Utilization among Severe Acute Malnutrition Children under 2 Years of Age, Western India (Rajkot, Gujarat) – A Hospital-based Case-Control Study

Abstract Severe Acute Malnutrition (SAM) is multifactorial including poor maternal health, sociodemographic factors, and poor quality of diet of both the mother and child. Present study was carried out to determine sociodemographic factors and antenatal service utilization for SAM occurrence. This hospital-based case-control study was carried out from April 2021 to April 2022. Cases (77) and controls (77) were matched for age and sex with 1:1 ratio. Cases were selected from Nutritional Rehabilitation Centre and controls from an immunization clinic using WHO’s Multicentric Growth Reference Study Criteria 2006. Mothers of study participants were interviewed by using semistructured questionnaires. The weight and height of study participants were measured. The odds of children having SAM increased significantly with illiterate parents, working mothers, and labor work of fathers. The absence of toilet facility at home and poor hygienic practices of mothers were significant risk factors. Mother’s <4 antenatal visits, home deliveries, and participants with low birth weight were associated with SAM. Logistic regression stated laborer fathers, poor hand washing practices of mothers, absence of toilet facility at home, and low birth weight of study participants were found independent determinants for SAM. Risk factors identified in the present study are modifiable and can be addressed through health system interventions.

Iron-depleting nutritional immunity controls extracellular bacterial replication in Legionella pneumophila infections

The accidental human pathogen Legionella pneumophila (Lp) is the etiological agent for a severe atypical pneumonia known as Legionnaires’ disease. In human infections and animal models of disease alveolar macrophages are the primary cellular niche that supports bacterial replication within a unique intracellular membrane-bound organelle. The Dot/Icm apparatus—a type IV secretion system that translocates ~300 bacterial proteins within the cytosol of the infected cell—is a central virulence factor required for intracellular growth. Mutant strains lacking functional Dot/Icm apparatus are transported to and degraded within the lysosomes of infected macrophages. The early foundational work from Dr. Horwitz’s group unequivocally established that Legionella does not replicate extracellularly during infection—a phenomenon well supported by experimental evidence for four decades. Our data challenges this paradigm by demonstrating that macrophages and monocytes provide the necessary nutrients and support robust Legionella extracellular replication. We show that the previously reported lack of Lp extracellular replication is not a bacteria intrinsic feature but rather a result of robust restriction by serum-derived nutritional immunity factors. Specifically, the host iron-sequestering protein Transferrin is identified here as a critical suppressor of Lp extracellular replication in an iron-dependent manner. In iron-overload conditions or in the absence of Transferrin, Lp bypasses growth restriction by IFNγ-primed macrophages though extracellular replication. It is well established that certain risk factors associated with development of Legionnaires’ disease, such as smoking, produce a chronic pulmonary environment of iron-overload. Our work indicates that iron-overload could be an important determinant of severe infection by allowing Lp to overcome nutritional immunity and replicate extracellularly, which in turn would circumvent intracellular cell intrinsic host defenses. Thus, we provide evidence for nutritional immunity as a key underappreciated host defense mechanism in Legionella pathogenesis.

Nutritional Considerations in Exercise-Based Heat Acclimation: A Narrative Review.

In addition to its established thermoregulatory and cardiovascular effects, heat stress provokes alterations in macronutrient metabolism, gastrointestinal integrity, and appetite. Inadequate energy, carbohydrate, and protein intake have been implicated in reduced exercise and heat tolerance. Classic exercise heat acclimation (HA) protocols employ low-to-moderate-intensity exercise for 5-14days, while recent studies have evolved the practice by implementing high-intensity and task-specific exercise during HA, which potentially results in impaired post-HA physical performance despite adequate heat adaptations. While there is robust literature demonstrating the performance benefit of various nutritional interventions during intensive training and competition, most HA studies implement few nutritional controls. This review summarizes the relationships between heat stress, HA, and intense exercise in connection with substrate metabolism, gastrointestinal function, and the potential consequences of reduced energy availability. We discuss the potential influence of macronutrient manipulations on HA study outcomes and suggest best practices to implement nutritional controls.

Interactive effects of low-volume interval exercise and nutrition on glycemic control.

Low-volume interval training has been demonstrated to improve indices of 24 h glycemic control using continuous glucose monitoring in individuals with or at risk for metabolic diseases. Nonetheless, there are inconsistencies in the literature with respect to the effects of interval exercise on 24 h glycemia, which may partly result from different nutritional conditions and/or controls adopted across various studies. This current opinion aims to provide a concise overview of the effects of acute and chronic interval exercise on 24 h glycemic control, while also describing how nutrition can influence and modify these responses. Given the distinct impact of dietary intake on blood glucose regulation, the adoption of diverse dietary control strategies during measurement of 24 h glycemia-spanning from using the participant's habitual diet to providing standardized meals customized to individual energy requirements-may contribute to varying conclusions across studies regarding the influence of interval exercise on 24 h glycemia. In addition, nutritional manipulations surrounding exercise, including whether interval exercise commences in the fasted or fed state, the macronutrient composition of post-exercise meals, and the presence of an energy and/or carbohydrate deficit among participants, offer important context when considering the effects of interval exercise on 24 h glycemia. Additional well-controlled studies are warranted to explore the interactive effects of interval exercise and nutrition on 24 h glycemia. These efforts will assist in refining exercise and nutrition recommendations aimed at improving glycemic control.

Critical period for better nutrition among severely acute malnourished children up to two years of age: a hospital-based case-control study, Gujarat, Western India

Background: Nutrition in the first two years of life is important for growth and development among children. To tackle undernutrition during this period, timely initiation of breastfeeding and quality of complementary feeding practices are essential. So, this study was planned to determine feeding practices associated with severe acute malnutrition children. Methods: This was hospital-based case-control study with 1:1 ratio of cases (77) and controls (77). Cases and controls were matched for age and sex. Cases were selected from Nutritional Rehabilitation Centre and controls from Immunization clinic. Mothers were interviewed about feeding practices, immunization status and illness of their child. Weight and height of children were also measured. Results: Children who received pre-lacteal feeding were associated with SAM. Most of cases (62.3%) and controls (70.1%) had received breastfeeding within 1 hour of birth. Among children of <7 months age, 71.4% cases breast-fed <8 times in 24 hours. Among children of 7 months to 2 years, SAM was associated with children who were not received complementary feeding (CF) at correct age, not received semi-solid/solid diet, CF not added with ghee/oil and feeding frequency <5 times in day. Among cases 18.2% and only 1.3% controls had >3 ARI episodes in last 6 months. Conclusions: Among identified independent risk factors (p<0.05), type of CF, not adding ghee/oil in CF and feeding frequency (BF+CF) <5 times were associated with SAM among 7 months to 2 years. Hospitalization history and >3 ARI episodes in last 6 months were also associated with SAM.

Фолатный статус у студентов из Индии, обучающихся в г. Архангельске

The harsh climatic conditions of the subarctic regions of Russia, followed by lifestyle and nutritional changes, put a strain on the adaptive self-regulation mechanisms of newcomers. Acclimatization of foreign students coming to these regions, along with a high mental load and significant lifestyle modifications as well as alimentary and behavioural habits, can lead to homeostatic failure, in particular, folate metabolism disorder. It is known that both genetic (alleles determining the characteristics of folate and homocysteine metabolism) and phenotypic (nutritional and behavioural) factors play an important role in regulating folate metabolism. The purpose of this study was to analyse the folate status of ethnic Indians living in a subarctic region of Russia. Materials and methods. A prospective cross-sectional population-based study was conducted on a sample of ethnic Indians (n = 117) studying at Northern State Medical University in the city of Arkhangelsk. An analysis was performed of the relationship between folate levels and the duration of living in the subarctic region of Russia, body mass index, tobacco smoking, alcohol intake and nutritional status. The results of the study showed that folate levels in Indian students living in Arkhangelsk decreased significantly (from 10.0 [9.325; 13.65] ng/ml in the first year to 4.00 [4.00; 6.00] ng/ml in the sixth year of study; р < 0.001). This can be associated with changes in their diet (less vegetables), smoking and alcohol consumption, which are risk factors for impaired homocysteine metabolism and, as a consequence, for adverse vascular events. The significant folate deficiency in Indian students during their residence in subarctic conditions requires taking a number of measures aimed to prevent maladjustment disorders of folate metabolism in foreign students, which include quality of life, health and nutritional status controls as well as maintaining a healthy lifestyle, including giving up bad habits.

Changes in serum albumin concentrations over 7 days in medical inpatients with and without nutritional support. A secondary post-hoc analysis of a randomized clinical trial.

Serum albumin concentrations are frequently used to monitor nutritional therapy in the hospital setting but supporting studies are largely lacking. Within this secondary analysis of a randomized nutritional trial (EFFORT), we assessed whether nutritional support affects short-term changes in serum albumin concentrations and whether an increase in albumin concentration has prognostic implications regarding clinical outcome and response to treatment. We analyzed patients with available serum albumin concentrations at baseline and day 7 included in EFFORT, a Swiss-wide multicenter randomized clinical trial that compared individualized nutritional therapy with usual hospital food (control group). Albumin concentrations increased in 320 of 763 (41.9%) included patients (mean age 73.3 years (SD ± 12.9), 53.6% males) with no difference between patients receiving nutritional support and controls. Compared with patients that showed a decrease in albumin concentrations over 7 days, those with an increase had a lower 180-day mortality [74/320 (23.1%) vs. 158/443 (35.7%); adjusted odds ratio 0.63, 95% CI 0.44 to 0.90; p = 0.012] and a shorter length of hospital stay [11.2 ± 7.3 vs. 8.8 ± 5.6 days, adjusted difference -2.2 days (95%CI -3.1 to -1.2)]. Patients with and without a decrease over 7 days had a similar response to nutritional support. Results from this secondary analysis indicate that nutritional support did not increase short-term concentrations of albumin over 7 days, and changes in albumin did not correlate with response to nutritional interventions. However, an increase in albumin concentrations possibly mirroring resolution of inflammation was associated with better clinical outcomes. Repeated in-hospital albumin measurements in the short-term is, thus, not indicated for monitoring of patients receiving nutritional support but provides prognostic information. ClinicalTrials.gov Identifier: NCT02517476.

Hypovitaminosis D in Young Basketball Players: Association with Jumping and Hopping Performance Considering Gender.

This study aimed to verify whether a group of young well-trained basketball players presented deficiencies in vitamin D concentration, and to analyze whether there was an association between vitamin D concentration and jumping and hopping performance. Gender differences were considered. Twenty-seven players from an international high-level basketball club (14 female, 16.00 ± 0.55 years; 13 male, 15.54 ± 0.52 years) participated in this cross-sectional study. Rate of force development was evaluated by means of the Abalakov test (bilateral: AbB; right leg: AbR; left leg: AbL); and the triple hop test (right leg: THR; left leg: THL). Blood samples were collected for the determination of serum 25-hydroxyvitamin D and nutritional status. Vitamin D insufficiency was found in both women (29.14 ± 6.08 ng/mL) and men (28.92 ± 6.40 ng/mL), with no gender differences regarding nutritional scores. Jumping and hopping performance was confirmed to be significantly larger in males (AbL, THR, and THL p < 0.005), whose CV% were always smaller. A positive correlation was found between AbB and vitamin D (r = 0.703) in males, whereas this correlation was negative (−0.611) for females, who also presented a negative correlation (r = −0.666) between THR and vitamin D. A prevalence of hypovitaminosis D was confirmed in young elite athletes training indoors. Nutritional (i.e., calciferol) controls should be conducted throughout the season. Furthermore, whilst performance seems to be affected by low levels of this vitamin in men, these deficiencies appear to have a different association with jumping and hopping in women, pointing to different performance mechanisms. Further studies accounting for differences in training and other factors might delve into these gender differences.

Water-air Carbon Dioxide Exchange and Nutritional Controls in a Typical Karst River

To explore water-air carbon dioxide (CO2) exchange and its nutritional controls in karst rivers, water sampling and analyses were conducted in the Furong River as a representative karst river system. Regional hydrometeorological characteristics, carbonate system parameters, total organic carbon (TOC), nutrients and their stoichiometric ratios, and the riverine pressure of aqueous CO2 (pCO2) and its couplings to trophic status were analyzed. The results showed that gas transfer velocity of CO2 (k) varied between 2.71 and 13.0 m·d-1. Riverine pCO2 varied from 78.5 Pa to 21491.2 Pa and was significantly higher in the tributaries than the main stem. Riverine TOC, total nitrogen (TN), and total phosphorus (TP) concentrations were (302.8±50.1), (128.9±67.9), and (0.65±0.98) μmol·L-1, respectively, demonstrating the trophic status of P-limitation. Riverine pCO2 was tightly linked to P-related parameters, suggesting that in-situ metabolism triggered aquatic CO2 supersaturation. Water-air CO2 flux (F) averaged (534.5±801.4) mmol·(m2·d)-1 in the Furong River, which is higher than most of the world's rivers, and thus indicates high potential CO2 emissions.

Limitations of Using Cultured Algae to Study Cnidarian-Algal Symbioses and Suggestions for Future Studies.

Much of our understanding of the cellular mechanisms underlying cnidarian-algal symbiosis comes from studying the biological differences between the partners when they are engaged in symbiosis and when they are isolated from one another. When comparing the in hospite and ex hospite states in Symbiodiniaceae, the in hospite state is represented by algae sampled from hosts, and the ex hospite state is commonly represented by cultured algae. The use of cultured algae in this comparison may introduce nutrition as a confounding variable because, while hosts are kept in nutrient-depleted conditions, culture media is nutrient rich and designed to facilitate algal growth. In this perspective, we reexamine how nutrition may be a confounding variable in studies that compare the biology of Symbiodiniaceae in hospite and in culture. We also suggest several innovations in experimental design to strengthen the comparison of the two lifestyles, including the adoption of nutritional controls, alternatives to culture for the representation of Symbiodiniaceae ex hospite, and the adoption of several proteomic approaches to find novel Symbiodiniaceae genes important for symbiosis.

Fulvic acid increases forage legume growth inducing preferential up-regulation of nodulation and signalling-related genes.

The use of potential biostimulants is of broad interest in plant science for improving yields. The application of a humic derivative called fulvic acid (FA) may improve forage crop production. FA is an uncharacterized mixture of chemicals and, although it has been reported to increase growth parameters in many species including legumes, its mode of action remains unclear. Previous studies of the action of FA have lacked appropriate controls, and few have included field trials. Here we report yield increases due to FA application in three European Medicago sativa cultivars, in studies which include the appropriate nutritional controls which hitherto have not been used. No significant growth stimulation was seen after FA treatment in grass species in this study at the treatment rate tested. Direct application to bacteria increased Rhizobium growth and, in M. sativa trials, root nodulation was stimulated. RNA transcriptional analysis of FA-treated plants revealed up-regulation of many important early nodulation signalling genes after only 3 d. Experiments in plate, glasshouse, and field environments showed yield increases, providing substantial evidence for the use of FA to benefit M. sativa forage production.

Trade-off between obesity and tobacco consumption

Recent evidence suggests that obesity and tobacco prevalence rates are moving in the opposite direction. This study examines the causal relationship between these variables in Argentina. The effects of tobacco consumption on body weight are estimated by using instrumental variables to address endogeneity problems. To this end, the entry into force of provincial laws on tobacco control at different times are exploited. Our results show that smoking has a negative impact on three weight measures (BMI, weight in kilograms, obesity rate). This finding suggests that anti-smoking measures should be complemented with nutritional controls and the promotion of physical exercise.

Does prenatal alcohol exposure cause a metabolic syndrome? (Non-)evidence from a mouse model of fetal alcohol spectrum disorder.

Although prenatal alcohol exposure (PAE) reduces offspring growth, it may increase obesity risk at adolescence. Animal models of PAE display glucose intolerance and increased adiposity, suggesting that PAE causes metabolic reprogramming. We tested this hypothesis in a mouse model of binge PAE, wherein pregnant C57Bl/6J females received 3 g/kg alcohol (ETOH) daily from gestational day 12.5 to 17.5; maltodextrin (MD) and medium chain triglycerides (MCT) served as isocaloric nutritional controls, and sham (H2O) treatment controlled for gavage stress. Our comprehensive assessment quantified body composition, energy expenditure, glucose tolerance, and cardiovascular function in offspring at age 17 weeks. Although ETOH pups were initially lighter than all other groups, they did not have a unique obesogenic phenotype. Instead, a similar obesogenic phenotype emerged in all three caloric groups (MCT, MD, ETOH), such that caloric groups had greater post-weaning weight gain (both sexes), reduced gonadal fat weight (males), and reduced glucose clearance (males) compared against H2O offspring. PAE did not affect body composition, respiratory exchange ratio, metabolic adaption to high-fat or low-fat diet, eating behavior, and blood pressure, and ETOH values did not differ from those obtained from isocaloric controls. Exposure to a higher alcohol dose (4.5 g/kg) or a high-fat (60%) diet did not exacerbate differences in body composition or glucose tolerance. “PAE-specific” effects on postnatal growth, glucose tolerance, adiposity, or hypertension only emerged when PAE offspring were compared just against H2O controls, or against MD controls. We conclude that prior reports of obesity and glucose intolerance in adult PAE offspring reflect the contribution of added gestational calories, and not alcohol’s pharmacologic action. Results suggest that the increased adiposity risk in FASD is not caused by metabolic reprogramming, and instead originates from behavioral, medication, and/or dietary practices. This study highlights the importance of appropriate dietary controls in nutritional studies of PAE.

Factors associated with overweight among elementary schoolchildren in Campinas, São Paulo, Brazil

ABSTRACT Objective To assess overweight/obesity of elementary schoolchildren in Campinas , São Paulo , Brazil, and its association with parental nutritional status, children's food consumption, food preferences, and level of physical activity, and familial socioeconomic status. Methods This case-control study included 509 schoolchildren aged 7 to 10 years. Body mass index Z-score was used to determine nutritional status, defining cases (&gt;+1 Z-score) and controls (³-2 ?+1 Z-score). To address association with overweight/obesity, a conceptual model was established and used for multiple analysis, performed by logistic regression. Results The children had an overweight/obesity frequency of 39.5%. Multiple analysis adjusted for socioeconomic level showed that overweight/obese children were more likely to eat at the mall (1.55; 95%CI=1.00-2.40), have overweight and obese parents (OR=1.71; 95%CI=1.08-2.71 and OR=3.55; 95%CI=2.18-5.80 respectively), report use of passive school transport (OR=1.57; 95%CI=1.04-2.36), and consume chicken nuggets on 3 or more days per week (OR=3.03; 95%CI=1.32-6.95). Conclusion These results support the urgent need of strategies to reduce overweight/obesity and promote its prevention in schoolchildren. Moreover, intervention studies involving parents and addressing environmental factors are important for the development of effective programs.

Metabolic Phenotype and Increased Adiposity in a Mouse Model of Chronic Gestational Alcohol Exposure

Fetal Alcohol Spectrum Disorder (FASD) is the largest preventable cause of neurodevelopmental disability and recent studies suggest that prenatal alcohol exposure (PAE) also increases obesity risk at adolescence. Children with FASD exhibit hyperphagia and have inappropriate dietary intake which may contribute to increased obesity risk. We developed a mouse model of gestational binge alcohol exposure (PAE) to delineate the contributions of metabolic dysregulation, eating behavior and diet response in offspring to increased obesity risk. Pregnant C57Bl/6J females were gavaged with 3 g/kg alcohol (EtOH) daily from gestational day (GD) 12.5 to 17.5 in two half doses, two hours apart. Isocaloric maltodextrin (MD) and medium chain triglycerides (MCT) were included as nutritional controls. A sham (H2O) treatment was used to control for gavage stress. At 17 weeks, sex matched pairs from each litter were investigated for the following endpoints: obesity via dual‐energy X‐ray absorptiometry (DXA), carbohydrate metabolism using glucose tolerance testing (GTT), blood pressure and heart rate using arterial probes as well as indirect calorimetry in metabolic cages. Although lighter during lactation, EtOH pups gained significantly more weight post‐weaning than MD and MCT groups (p&lt;0.05). EtOH offspring have increased fat mass compared with other groups at 17 weeks (p&lt;0.05) by DXA. Male EtOH, MD, and MCT offspring exhibited increased basal glucose levels and significantly increased tolerance during GTT in comparison with H2O offspring (p&lt;0.05) despite similar weights between groups. EtOH offspring have increased systolic blood pressure (p&lt;0.05) and heart rate (p&lt;0.05). In metabolic chambers, all offspring were challenged with high sugar (70%) and high fat (60%) diets. Metabolic parameters such as food intake, VO2, and respiratory exchange ratio were similar between groups, although slight differences were found in feeding behavior patterns and food intake during diet challenges between EtOH and all control groups. After a month on high fat diet, male EtOH offspring have exacerbated weight and fat mass gain (p&lt;0.05). After a month on high fat diet, female EtOH offspring exhibit significantly increased basal glucose levels (p&gt;0.05) and increased glucose tolerance during GTT. Taken together, these data suggest that PAE may be associated with a metabolic syndrome. Up to 1 in 3 women report drinking during pregnancy, so PAE may be a previously unrecognized factor for increased obesity risk in the context of an obesogenic environment.Support or Funding InformationAA22999. AA11085, 2T32DK007665

Influence of Transiently Increased Nutritional Risk on a Left Ventricle Myocardial Mass Assessed by Echocardiography

Background/Aim: Metabolic derangements due to increased nutritional risk lead to catabolism and loss of proteins, muscle tissue and eventually mass of parenchymatous organs. The aim of our study was to assess whether transitory nutritional risk after heart surgery influences on the left ventricle myocardial mass (LVMM), assessed by echocardiography. Methods: Consecutive sample of patients scheduled for cardiovascular rehabilitation, in period 0-3 months after surgery. Nutritional risk screening (NRS) was analyzed using the NRS-2002 tool. Results: Study sample included 330 patients after heart surgery for ischemic 186 (56.4%); valvular 91 (27.6%) and valvular plus ischemic 53 (16.1%) heart disease. Age was 65.5 ± 10.6 (range 23-84) and there were more male patients than female - 240 (72.7%) and 90 (27.3%), respectively. The percentage of unintentional loss of weight was 10.8 ± 3.4%, in range 0-23.81%, whereas NRS-2002 was 4.4 ± 1.1. LVMM was 218.7 ± 65.9 g vs. 252.3 ± 51.7 (p = 0.015); for patients with increased nutritional risk and controls, respectively. There was no significant correlation of LVMM with NRS-2002, while the percentage of unintentional loss of weight displayed only weakly inverse correlation (Rho CC = -0.197; p = 0.007). LVMM also correlated significantly with body mass index (Rho CC = 0.247; p < 0.001) and waist-to-hip ratio (Rho CC = 0.291; p < 0.001). In conclusion, LVMM was found to decrease slightly in the period of increased nutritional risk, following heart surgery. Changes in LVMM are partially consequences of systemic catabolic response, as well as anthropometric changes due to unintentional loss of weight.

The mechanism and key molecules involved in pollen tube guidance.

During sexual reproduction of flowering plants, pollen tube guidance by pistil tissue is critical for the delivery of nonmotile sperm cells to female gametes. Multistep controls of pollen tube guidance can be divided into two phases: preovular guidance and ovular guidance. During preovular guidance, various female molecules, including stimulants for pollen germination and pollen tube growth, are provided to support tube growth toward the ovary, where the ovules are located. After entering the ovary, pollen tubes receive directional cues from their respective target ovules, including attractant peptides for precise, species-preferential attraction. Successful pollen tube guidance in the pistil requires not only nutritional and directional controls but also competency controls to make pollen tubes responsive to guidance cues, regulation to terminate growth once a pollen tube arrives at the target, and strategies to stop ovular attraction depending on the fertilization of female gametes.

Nutritional Controls of Food Reward

The propensity to select and consume palatable nutrients is strongly influenced by the rewarding effects of food. Neural processes integrating reward, emotional states and decision-making can supersede satiety signals to promote excessive caloric intake and weight gain. While nutritional habits are influenced by reward-based neural mechanisms, nutrition and its impact on energy metabolism, in turn, plays an important role in the control of food reward. Feeding modulates the release of metabolic hormones that have an important influence on central controls of appetite. Nutrients themselves are also an essential source of energy fuel, while serving as key metabolites and acting as signalling molecules in the neural pathways that control feeding and food reward. Along these lines, this review discusses the impact of nutritionally regulated hormones and select macronutrients on the behavioural and neural processes underlying the rewarding effects of food.

Psychosocial issues in children with primary intestinal failure and their families

Introduction: Parenteral nutrition has significantly improved the prognosis of children with intestinal failure, but it has an inevitable impact on their lives. The aim of the present study was to assess the psychosocial well-being of these patients and their families. Materials and methods: Two groups of children (cases and controls) were enrolled with their families. Patients with primary intestinal failure aged 2-18 years who required or had previously required parenteral nutritional and healthy controls were included. We used four tests to investigate their quality of life, three administered to parents and one to children. Results: Sixteen children with primary intestinal failure (12 males; mean age 7.2 ± 4.8 years) and 12 healthy controls (6 males; mean age 9.3 ± 4.9 years) were enrolled. The International Classification of Functioning, Disability and Health, Children and Youth Version showed that specific environmental factors were perceived as barriers by patients’ caregivers (44% vs 0%; p=0.01) and 5/16 (31%) of them had medium-high levels of anxiety according to the State-Trait Anxiety Inventory. Conclusions: The quality of life of children on parenteral nutrition was only slightly impaired. Parents, instead, showed more anxious behavior related to their children’s parenteral nutrition.

Nutritional support response in critically ill patients; differences between medical and surgical patients

To assess the nutritional response of a group of critically ill patients, as well as the differences in the response to nutritional support between medical and surgical patients. One-year long retrospective study including critically ill patients on artificial nutrition for 7 days. Throughout the first week, three nutritional biochemical controls were done that included albumin, prealbumin, transferrin, cholesterol, and electrolytes. Other data gathered were: nutritional risk index, age, gender, weight, height, APACHE, delay of onset of nutritional support, access route, predicted and real caloric intake, medical or surgical patient, hospital stay, duration of the central venous catheter, urinary tube, and/or mechanical ventilation, incidence and density of incidence of nosocomial infections. Sixty-three patients were studied, 30 (47%) medical and 33 (53%) surgical/trauma patients, with a usage of EN higher among medical patients (16/30, 53% vs. 5/33, 15%), PN higher among surgical patients (25/33, 76%), and mixed nutrition similar in both groups (5 medical and 3 surgical patients) (p = 0.001). There were no differences between medical and surgical patients regarding: both predicted and real caloric and nitrogenous intake, APACHE, delay of onset of nutrition, phosphorus, magnesium or glucose levels, mortality and incidence of nosocomial infections. There were no differences either in hospital stay or use of mechanical ventilation, although these tended to be lower in surgical patients. The baseline biochemical parameters did not show differences between both groups, although they were worse among surgical patients. These patients presented during the study period steady albumin levels with improvement in the remaining parameters, whereas medical patients showed a decrease in albumin and transferrin levels, steady prealbumin levels, and slightly improvement in cholesterol levels. We have observed higher usage of PN among surgical patients, which showed worse baseline nutritional biochemical parameters and responded better to nutritional support and having a trend towards shorter hospital stay and lower mechanical ventilation use than medical patients. We have not observed differences regarding the mortality or nosocomial infection.