Nutritional Support In Patients Research Articles

Nutritional support in pancreatic cancer patients and its effect on nutritional status: an observational regional HPB network study investigating current practice

PurposePreoperative malnutrition is associated with poor postoperative outcomes in patients with pancreatic cancer. This study evaluated the effectiveness of current practice in nutritional support for patients with pancreatic cancer.MethodsObservational multicenter HPB network study conducted at the Isala Clinics Zwolle, Medical Spectrum Twente, Medical Center Leeuwarden, and University Medical Center Groningen between October 2021 and May 2023. Patients with a suspected pancreatic malignancy scheduled for surgery were screened for malnutrition using the Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire and referred to a dedicated dietician for nutritional support comprising pancreatic enzyme replacement therapy, dietary advice, and nutritional supplements to achieve adequate caloric and protein intake. At baseline, 1 day preoperatively, and 3 months postoperatively, the nutritional status and muscle thickness were evaluated.ResultsThe study included 30 patients, of whom 12 (40%) classified as malnourished (PG-SGA ≥ 4) at baseline. Compared to well-nourished patients, malnourished patients were younger, were predominantly female, and had a higher body mass index, despite having lost more body weight in the past 6 months. All malnourished patients and 78% of the well-nourished patients received nutritional support. Consequently, a preoperative increase in caloric and protein intake and body weight were observed. Postoperatively, despite a further increase in caloric intake, a considerable decrease in protein intake, body weight, and muscle thickness was observed.ConclusionMalnutrition is prevalent in patients undergoing pancreatic surgery. Nutritional support by a dedicated dietician is effective in enhancing patients’ preoperative nutritional status. However, postoperative monitoring of adequate nutritional intake in patients could be improved.

The predictive value of GLIM criteria on clinical outcomes and responses to nutritional support in patients with neurocritical illnesses

Neurocritically ill patients frequently exhibit coma, gastroparesis, and intense catabolism, leading to an increased risk of malnutrition. The Global Leadership Initiative on Malnutrition (GLIM) criteria for the diagnosis of malnutrition was created to achieve a consistent malnutrition diagnosis across diverse populations. This study aimed to validate the concurrent and predictive validity of GLIM criteria in patients with neurocritical illnesses. A total of 135 participants were followed from admission to the neurocritical unit (NCU) until discharge. Comparing GLIM criteria to the Subjective Global Assessment (SGA), sensitivity was 0.95 and specificity was 0.69. Predictive validity of GLIM criteria was assessed using a composite adverse clinical outcome, comprising mortality and various major complications. Adjusted hazard ratios for moderate and severe malnutrition were 2.86 (95% CI 1.45–5.67) and 3.88 (95% CI 1.51–9.94), respectively. Changes in indicators of nutritional status, including skeletal muscle mass and abdominal fat mass, within 7 days of admission were obtained for 61 participants to validate the predictive capability of the GLIM criteria for the patients’ response of standardized nutritional support. The GLIM criteria have a statistically significant predictive validity on changes in rectus femoris muscle thickness and midarm muscle circumference. In conclusion, the GLIM criteria demonstrate high sensitivity for diagnosing malnutrition in neurocritically ill patients and exhibit good predictive validity.

Complications and survival following percutaneous endoscopic gastrostomy tube placement.

Percutaneous endoscopic gastrostomy (PEG) is considered a safe and effective method for nutritional support in patients with malnutrition and swallowing impairment with an estimated survival of over two months. Some indications, such as advanced cognitive decline, contraindicate the technique. All patients who underwent PEG placement between January 2001 and May 2019 were included. Clinical data, indication, complications, and mortality were retrospectively analyzed. A total of 648 patients (46.5% male, mean age 70±18.5 years) were included. The most common indications for PEG were advanced cognitive decline (31.5%) and cerebrovascular disease (18.8%). The mean follow-up was 12.07 months (IQR 3.27-34.73). 39.5% of patients experienced complications (systemic 17.9%, local 28.5%). The most frequent were bronchoaspiration (9.7%) and rupture/dysfunction (13.9%), respectively. The presence of early complications (HR 1.63 [1.20-2.21]) and age (HR 1.02 [1.01-1.02]) were associated with shorter survival time, while female sex was a protective factor (HR 0.78 [0.66-0.94]). PEG is not without complications, with 39.5% of patients experiencing them. Patients with advanced dementia, male sex, older age, and systemic complications have lower survival following PEG placement.

Nutritional and Metabolic Status Control and Nutritional Support in Patients with Pancreatic Sepsis (Review)

Acute pancreatitis (AP) is associated with pancreonecrosis in 30% of patients, who may fall at 80% high risk of death when infected pancreatic necrosis progresses to sepsis. Given the catabolic nature of the disease and the significant influence of nutritional status on its course and outcome, these patients require an adequate nutritional support (NS) based on an adequate assessment and control of nutritional and metabolic status.The aim of the study: to identify trends in developing new tools for assessment of nutritional and metabolic status, and provision of NS in patients with pancreatic sepsis (PS).Materials and methods. Keyword search in the PubMed, Scopus and E-library databases for the period from 2018 to 2023 yielded 95 publications, of which 16 meta-analyses and 6 systematic reviews met the requirements.Results. all existing to date scales for assessment of nutritional deficiency in patients with PS have low prognostic value. Of them, mNUTRIC scale seems to be the most appropriate assessment tool. Recommended by EPSEN guidelines tools to assess the risk of nutritional deficiency it is not suitable for ICU patients. Indirect calorimetry should be preferred vs routine calculation formulas in assessing patient’s energy needs in case of PS. It was also found that «standard» anthropometric values, such as BMI, are not always informative and prognostically significant in patients with severe AP in the ICU. Analgesia, infusion therapy, as well as detection and correction of intraperitoneal hypertension are not only integral components of intensive care for PS but are indispensable for supplying adequate NS in PS patients. It was found that early enteral nutrition is the preferred method of NS, although questions concerning choice of tube insertion site, as well as all parameters of tube feeding remain unanswered. The optimal composition of enteral nutrition for patients with PS has not been established, which is indirectly confirmed by the variety of enteral mixtures available on the market. The refeeding syndrome that occurs at initiation of NS was characterized as a life-threatening condition.Conclusion. NS, based on adequate assessment of disorders and control of the nutritional and metabolic status is an integral component of intensive care in PS patients. It can reduce the probability and number of potential complications, time of stay in the ICU, cost of treatment, and improve patient’s prognosis.

Nutritional support in patients with acute pancreatitis. Review of published studies

Acute pancreatitis is a common disease that occurs in 5—10% of patients with urgent pathology of the abdominal cavity. The most prevalent metabolic disorders affecting this group of patients are hypermetabolism and hypercatabolism syndromes, which are accompanied by excessive consumption of carbohydrates, fats, and amino acids, increased oxygen intake, and carbon dioxide production.
 Objective — to analyse the current state of the problem of nutritional support for patients with acute pancreatitis.
 The degree of nutritional disorders in patients with acute pancreatitis varies depending on the etiological factors and severity of the disease, necessitating a differential approach to their correction. Patients with acute pancreatitis experience disruption of the intestinal microflora due to the antibiotic therapy, nutrient and fiber deficiency, and lack of microbial antagonism. This disruption leads to excessive growth of bacteria, particularly gram‑negative microflora. The effectiveness and safety of enteral tube feeding are determined by a complex of factors: the timing of recovery of peristalsis and the absorption function of the intestinal wall, the type of mixture, and the method of its administration. Restoration of intestinal absorption in patients with severe acute pancreatitis occurs on average 48 hours after the start of complex conservative therapy. The use of antiflatulents as part of a mixture for enteral nutrition allows to improve the laboratory indicators of blood serum and reduce the frequency of intestinal complications on the 7th day by 21.5% (χ2=4.88, 95% CI 2.3—39.5, p=0.03). Nasogastric nutritional support in patients with severe acute pancreatitis is safe and leads to a 25.8% reduction in the incidence of local infectious complications (χ2=4.59, 95% CI 2.43—45.53, p=0.03), length of hospital stay by 16 days (p=0.04), and deaths by 21.4% (χ2=4.13, 95% CI 0.81—39.68, p=0.04) in comparison with parenteral nutrition. Nutritional support should be started with nasogastric administration of a food mixture, and in case of complications (intolerance, aspiration, etc.), nasojejunal administration. Parenteral nutrition should be used if enteral nutrition is impossible or not tolerated.

Effectiveness of Nutritional Intervention Led by Clinical Dietitian in Patients at Risk of Malnutrition at the Primary Healthcare Level in Slovenia - Evaluation Study.

Clinical dietitians play a crucial role in the nutritional support of patients at risk of malnutrition in primary care settings. The study aimed to evaluate the effect of an individualized nutritional intervention on clinically relevant outcomes for patients with chronic disease at nutritional risk. A longitudinal evaluation study was conducted in two Slovenian primary health centres. We used pre-test and post-test design. Patients with chronic disease were screened using the Malnutrition Universal Screening Tool and additional risk factors (≥70 years and BMI <22 kg/m2; lower food intake in the last five days). Patients at nutritional risk were referred to a clinical dietitian for individual nutritional intervention. The effect of the nutritional intervention was assessed six months after the patients' first visit with a clinical dietitian. The sample included 94 patients. Nutritional risk was reduced significantly in high-risk and moderate-risk patients. In a subgroup of patients with a MUST score ≥1 (77 patients), body weight, BMI, Fat-Free Mass Index (FFMI), energy intake, and protein intake increased significantly (p<0.001). At the same time, the phase angle significantly increased (p<0.001), but there were no statistically significant changes in the improvement of grip strength. In a subgroup of patients with MUST score 0 (17 patients), we observed an increase in their median daily energy intake (p<0.001) and median protein intake (p=0.003). Nutritional intervention delivered by a clinical dietitian improved patients' nutritional intake and nutritional and functional status.

Nutritional status in patients with tuberculosis and diabetes mellitus: A comparative observational study

BackgroundIndia has been estimated to have 14 % of malnourished population and a high TB incidence burden with a 26.9 lakh cases. Malnutrition and diabetes mellitus are major risk factors for tuberculosis infection. Malnutrition in patients with both tuberculosis and diabetes (TB-DM) population worsens the disease severity, treatment outcomes and increases morbidity and mortality risk. ObjectiveTo assess the nutritional status in patients with TB-DM compared with patients with TB and DM alone. MethodRecords from January 2016 to November 2020 for patients admitted to Kasturba Hospital, Manipal were assessed. Data pertaining to glycemic parameters, nutritional parameters, and other relevant laboratory parameters were extracted for assessment. The study population were divided into three groups i.e. patients with TB-DM, TB and DM. The statistical association was carried out with one-way ANOVA method, considering p < 0.05 as statistically significant. ResultsA total of 291 patients were included, with 97 patients in each group; among those, male and female were 86.27 % and 13.73 % respectively. Cardiovascular co-morbidity was predominant in the DM (68.04 %) and TB-DM (26.8 %) group. The mean value of HbA1c (10.47 %) was found to be highest for the TB-DM group. Low levels of albumin were reported by 71.91 % of patients of the TB group, whereas 73.68 % patients in TB-DM group had vitamin D deficiency. Moreover, higher prevalence of low MCV and MCH in the TB-DM group suggest an increased risk of iron-deficiency anemia. ConclusionThe findings of our study reflect the need for implementation of nutritional support in patients with TB-DM.

Medical nutrition after cholecystectomy

Cholecystectomy (CE) is one of the most frequently performed surgical interventions and the main method of symptomatic gallstone disease treatment. Despite the widespread implementation of minimally invasive surgery techniques, significant proportion of patients develop spectrum of symptoms after CE. These manifestations require correction with different approaches including medical nutrition. The aim of the research was to perform structured review of recently published data related to diet therapy and nutritional support of patients after CE. Material and methods. A literature search was performed in PubMed/MEDLINE, EMBASE, Cyberleninka, eLibrary databases using the keywords "Cholecystectomy" in combination with "Diet", "Medical nutrition", "Nutritional support" and their Russianlanguage equivalents for the relevant databases. Correct description of interventions, analyzed outcomes, statistical processing and found effects where necessary for the inclusion to the analysis. Duplicate publications were excluded. Results and discussion. A review of the recommendations on nutritional support after CE has been conducted, including handbooks and clinical guidelines, results of relevant clinical trials evaluating the efficacy of different measures of nutritional support. The rational of traditionally used dietary approaches for the correction of symptoms that develop after CE has been assessed, as well as recently published data on the effectiveness of nutritional support methods. Conclusion. Disturbed regulation of bile secretion in the early CE postoperative period may support the need for limitation of fat consumption. Impaired circulation of bile acids and possible changes in the balance of intestinal microbiota may support the need for the use of prebiotics (like dietary fiber), as well as probiotics, especially when antibiotic treatment was administrated for the patient. These interventions may be important from the viewpoint of prevention of late complications after CE.

DMOADs and DMARDs in the treatment of patients with joint and spine diseases

The data on the classification of drugs, which are prescribed for the treatment of patients with joint and spine diseases, such as osteoarthritis (OA) and rheumatoid arthritis (RA), are presented. The groups of drugs widely used in clinical practice are disease-modifying osteoarthritis drugs (DMOADs) and disease-modifying antirheumatic drugs (DMARDs). To help the practitioner, consolidated information is provided on the main differences between these groups according to the mechanism of action (immunomodulatory vs. immunosuppressive) and the main indications for use (autoinflammatory joint diseases (OA) vs. autoimmune joint diseases (RA, psoriatic arthritis, ankylosing spondyloarthritis)). The material of the article is focused on the clinicians to help them make a right choice of OA therapy, and to identify the problem of drug choice in RA. Information about the possibility of using nutritional support in patients with OA is presented.

Summary of the Best Evidence for Nutritional Support in Patients with Acute Gastrointestinal Graft-Versus-Host Disease

[Abstract] Objective: To retrieve, evaluate and integrate the best evidence summary of nutritional support for patients with acute gastrointestinal graft-versus-host disease after hematopoietic stem cell transplantation at home and abroad. Methods: According to the “6S” model, domestic and foreign computer decision support systems, guideline networks, websites of relevant professional societies or institutions, professional books, and comprehensive databases were systematically searched to screen literatures related to nutritional support for patients with acute gastrointestinal graft-versus-host disease, including guidelines, clinical decision-making, evidence summary, expert consensus, expert opinion, systematic review, and original research. The search time limit was from the establishment of the database to March 2023. Five researchers evaluated the quality of the literature, extracted evidence and integrated it. Results: A total of 12 articles were included, including 1 clinical decision, 4 guidelines, 1 evidence summary, 1 expert consensus, 3 systematic reviews, 1 cohort study, 1 expert opinion,. A total of 14 best evidences were summarized from 4 aspects, including scientific diet and tolerance assessment, nutrient selection, nutritional support method selection, and multidisciplinary cooperation. Conclusions: This study systematically integrates the relevant evidence of nutritional support in patients with acute gastrointestinal graft-versus-host disease, and can provide evidence-based evidence for nutritional support in patients with acute gastrointestinal graft-versus-host disease. When applying evidence, it is recommended that clinical nurses comprehensively consider the actual clinical situation and the wishes of patients, and carefully select evidence. Keywords acute gastrointestinal graft-versus-host disease，nutritional support，malnutrition，evidence-based nursing

Preoperative nutritional support in patients undergoing pancreatic surgery affects PREPARE score accuracy.

This study aimed to validate the accuracy of the Preoperative Pancreatic Resection (PREPARE) risk score in pancreatic resection patients. This prospective study included 216 patients who underwent pancreatic resection between January 2015 and December 2018. All patients in our cohort with weight loss or lack of appetite received dietary advice and preoperative oral nutritional supplementation (600 kcal/day). Demographic, clinicopathological, operative, and postoperative data were collected prospectively. The PREPARE score and the predicted risk of major complications were computed for each patient. Differences in major postoperative complications were analyzed using a multivariate Cox proportional hazards regression model. The predicted and observed risks of major complications were tested using the C-statistic. The study included 216 patients [117 men (54.2%)] with a median age of 65.0 (30.0-83.0) years. The majority of patients were classified as American Society of Anesthesiologists (ASA)' Physical Status score II (N = 164/216; 75.9%) and as "low risk" PREPARE score (N = 185/216; 85.6%) before the surgery. Only 4 (1.9%) patients were malnourished, with albumin levels of less than 3.5 g/dl. The most common type of pancreatic resection was a pylorus-preserving pancreaticoduodenectomy (N = 122/216; 56.5%). Major morbidity and 30-day mortality rates were 11.1% and 1.9%, respectively. The type of surgical procedure (hazard ratio [HR]: 3.849; 95% confidence interval [CI]: 1.208-12.264) and ASA score (HR: 3.089; 95% CI: 1.067-8.947) were significantly associated with the incidence of major postoperative complications in multivariate analysis. The receiver operating characteristic curve was 0.657 for incremental values and 0.559 for risk categories, indicating a weak predictive model. The results of the present study suggest that the PREPARE risk score has low accuracy in predicting the risk of major complications in patients with consistent preoperative nutritional support. This limits the use of PREPARE risk score in future preoperative clinical routines.

Nutritional support for patients with malignant tumors

Nutritional support is an integral aspect of caring for patients burdened with advanced onсological disease. Following the development of palliative medicine, it draws a growing body of attention from medical community suggesting the expansion of practical use indications. Nowadays rational nutritional support is defined as a combined approach including wide implementation of supplementary nutrition along with physical activity, drug therapy and psychological consulting.It is usually carefully designed with a help of nutritionist, administered individually and prioritises the initial use of physiological non-invasive forms of nutrition.Artificial nutrition also appears to have benefit when used for patients at the end of life, but requires the critical consideration of indications and contraindications to minimise possible impairment of quality or even duration of life.

Multicentric, observational, longitudinal study for the evaluation of nutritional management implications in newly diagnosed Italian cancer patients: the Italian Registry of Malnutrition in Oncology (IRMO)

BackgroundMalnutrition is a frequent problem in oncology and is associated with reduced response to cancer treatments, increased drug-related toxicity, higher rates of clinical complications, reduced quality of life (QoL) and...

The Critical Exploration into Current Evidence behind the Role of the Nutritional Support in Adult Patients Who Undergo Haematogenic Stem Cell Transplantation.

Haematopoietic stem cell transplantation (HSCT) is a treatment option for many haematological conditions in patients of all ages. Nutritional support is important at each stage of treatment, but particular nutritional needs and dictated support occur during the preparatory (conditioning regimen) and post-transplant periods. Patients may require nutritional treatment by the enteral or parenteral route. The quantitative and qualitative composition of meals may change. Vitamin requirements, including vitamin D and vitamin C, might also be different. An adequately composed diet, adapted to the needs of the patient, may influence the occurrence of complications such as graft-versus-host disease (GvHD), gastrointestinal disorders, infections, and reduced survival time. Haematological diseases as well as transplantation can negatively affect the intestinal flora, with negative consequences in the form of mucosal inflammation and disorders of a functional nature. Currently, aspects related to nutrition are crucial in the care of patients after HSCT, and numerous studies, including randomized trials on these aspects, are being conducted. This study serves the critical analysis of current scientific evidence regarding nutritional support for patients after HSCT.

Метаболічні порушення, спричинені гострим панкреатитом, та їх корекція за допомогою ентерального харчування пацієнтів

The occurrence of hypermetabolism and hypercatabolism syndromes in patients with acute pancreatitis is associated with the release of pro-inflammatory cytokines, which leads to an increase in energy consumption and basic metabolism, which depend on both the severity of the course and the duration of the disease. The aim of our work was to investigate the state of the problem of nutritional support for patients with acute pancreatitis at the current stage. The degree of nutritional status disorders in patients with acute pancreatitis varies depending on the etiological factors and severity of the disease and requires a differentiated approach to their correction. With the development of hypermetabolic syndrome, energy consumption can increase by 77-158%. Nutritional support is an important component of acute pancreatitis therapy, the goal of which is to ensure adequate caloric intake, modulate the response to oxidative stress, and counteract catabolic effects during the course of the disease. Restoration of intestinal absorption in patients with severe acute pancreatitis occurs on average 48 h after the start of complex conservative therapy, which is the optimal time to start enteral nutrition. Nasogastric nutritional support in patients with severe acute pancreatitis is safe and leads to a 25.8% reduction in the incidence of local infectious complications, length of hospital stay by 16 days and deaths by 21.4% in comparison with parenteral nutrition. The use of antiflatulents as part of a mixture for enteral nutrition allows to improve the laboratory indicators of blood serum, to reduce the frequency of intestinal complications by 21.5%. Nutritional support should be started with nasogastric administration of food mixture, and in case of complications (intolerance, aspiration, etc.), nasojejunal administration. Parenteral nutrition should be used if enteral nutrition is impossible or not tolerated.

HPC+ in the medical field: Overview and current examples.

To say data is revolutionising the medical sector would be a vast understatement. The amount of medical data available today is unprecedented and has the potential to enable to date unseen forms of healthcare. To process this huge amount of data, an equally huge amount of computing power is required, which cannot be provided by regular desktop computers. These areas can be (and already are) supported by High-Performance-Computing (HPC), High-Performance Data Analytics (HPDA), and AI (together "HPC+"). This overview article aims to show state-of-the-art examples of studies supported by the National Competence Centres (NCCs) in HPC+ within the EuroCC project, employing HPC, HPDA and AI for medical applications. The included studies on different applications of HPC in the medical sector were sourced from the National Competence Centres in HPC and compiled into an overview article. Methods include the application of HPC+ for medical image processing, high-performance medical and pharmaceutical data analytics, an application for pediatric dosimetry, and a cloud-based HPC platform to support systemic pulmonary shunting procedures. This article showcases state-of-the-art applications and large-scale data analytics in the medical sector employing HPC+ within surgery, medical image processing in diagnostics, nutritional support of patients in hospitals, treating congenital heart diseases in children, and within basic research. HPC+ support scientific fields from research to industrial applications in the medical area, enabling researchers to run faster and more complex calculations, simulations and data analyses for the direct benefit of patients, doctors, clinicians and as an accelerator for medical research.

The significance of immunonutrition nutritional support in patients undergoing postoperative adjuvant chemotherapy for lung cancer: case–control study

BackgroundIn this study, the effect of postoperative early nutritional supplementation on the course of the disease was investigated in patients who were operated for non-small cell lung cancer and received adjuvant chemotherapy.MethodsThe study examined the data of patients who anatomical pulmonary resection for non-small cell lung cancer and who were treated with adjuvant chemotherapy at our clinic between January 2014 and January 2020. Patients who received early postoperative nutritional supplements and those who continued with a normal diet were compared in terms of complications, mortality, recurrence, and survival.ResultsThe study sample consisted of 68 (84%) male and 13 (16%) female patients, and the mean duration of postoperative follow-up was 31.6 ± 17.9 (4–75) months. Metastasis was identified in eight (17.4%) patients in GrupNS (Nutritional Supplements) compared to 10 (28.6%) patients in GroupC (Control) (p = 0.231). Of the total, 11 (23.9%) patients died in GroupNS compared to 13 (37.1%) in GroupC (p = 0.196). Mean survival was 58.9 ± 3.8 (95% CI: 4.0–75.0) months in GroupNS compared to 43.5 ± 4.6 (95% CI: 6.0–66.0) months in GroupC (p = 0.045).ConclusionEarly nutritional supplements should be considered as having a positive effect especially on survival in this specific patient group involving factors with high catabolic effects, such as neoplasia, operation, and chemotherapy together.

New pharmaconutraceutical Chondroguard®TRIO for the prevention of musculoskeletal diseases and nutritional support for patients with osteoarthritis and nonspecific back pain: an assessment of clinical options. Resolution of the Multidisciplinary Expert Council

In recent decades, there has been an increase in the prevalence and medical and social burden of osteoarthritis (OA) and nonspecific back pain in all countries of the world. The First Multidisciplinary Bilateral Russia-Uzbekistan Expert Council presented innovations in the prognosing, personalized prevention and adjuvant therapy of degenerative-dystrophic diseases of the joints and spine, the evidence base for the effectiveness and safety of the use of drugs that modify the course of OA (Disease-modifying osteoarthritis drugs, DMOADs): chondroitin sulfate, glucosamine sulfate, undenatured type II collagen for adjuvant pharmaconutraceutical support – prevention and adjuvant therapy (treatment) of OA and nonspecific lumbosacral pain. The expert counsil resolution presents an optimized algorithm for the management, prevention and adjuvant therapy of OA and non-specific back pain, maintaining the function of healthy joints after intense physical activity with the inclusion of the drug Chondroguard solution for intra-articular and intramuscular administration (INN – chondroitin sulfate) and a new pharmaconutraceutical from the DMOADs group – TRIO trademark Chondroguard® (Chondroguard®TRIO).

Pharmaconutraceutical Chondroguard®TRIO – a new ideology for the prevention of musculoskeletal diseases and nutritional support for patients with osteoarthritis and nonspecific back pain: an assessment of clinical options. Resolution of the First Multidisciplinary Bilateral Russia – Uzbekistan Expert Council

On April 1, 2023, experts presented a resolution of the First Multidisciplinary Bilateral Russia–Uzbekistan Expert Council, dedicated to innovations in the prediction and personalized prevention of degenerative-dystrophic diseases of the joints and spine, and the possibilities of using the new pharmaconutraceutical Chondroguard®TRIO, the components of which (chondroitin sulfate, glucosamine sulfate, undenatured collagen type II – NK-II type) can be attributed to active compounds that modify the course of the disease (Disease-modifying osteoarthritis drugs, DMOADs) through structure-modifying and immune-mediated mechanisms of action. The evidence base for the efficacy and safety of the use of the main components of the new pharmaconutraceutical Chondroguard®TRIO (chondroitin sulfate, glucosamine sulfate, type NK-II) for the prevention and adjunctive therapy of osteoarthritis and nonspecific back pain is presented in the clinical recommendations of foreign specialized associations: Osteoarthritis Research Society International (OARSI), European Alliance of Associations for Rheumatology (EULAR), European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), American College of Rheumatology (ACR), Russian Clinical Guidelines of the Russian Ministry of Health, as well as in numerous interventional and observational clinical studies.

Level of knowledge in the field of nutritional support among nurse anesthetists

Introduction. Every second patient in intensive care has a low nutritional status. Since one of the duties of a nurse is to fulfill doctor's orders, providing and maintaining nutritional support also falls on the shoulders of nursing staff. Therefore, the level of nutritional support knowledge among health workers should be sufficiently high. In our opinion, each health worker must understand the need, indications and contraindications for the medical procedures and manipulations, their complications and the ways to prevent them in order to effectively provide health care. The aim of this study is to determine the level of knowledge in the field of nutritional support among nurses who completed a certified nurse-anesthetist program in one of the Moscow medical vocational institutions.&#x0D; &#x0D; Materials and methods. Authors conducted an analytical cross-sectional study with an anonymous questionnaire. Nurses who took an advanced training were firstly asked to fill out a questionnaire reflecting a subjective assessment of their own knowledge of nutritional support, and then they were asked to answer test questions for an objective assessment of knowledge. Score of 80% and above was considered as a sufficient level of knowledge.&#x0D; &#x0D; Results. A total of 53 questionnaires were completed. The average knowledge score was 40%. Two participants achieved the target of 80% correct test responses. There was no significant difference between the level of knowledge of nutritional support and work experience. At the same time, 45% of the respondents considered their level of knowledge to be insufficient and 80% of the participants identified the importance and necessity of knowledge.&#x0D; &#x0D; Conclusion. Nursing staff has an insufficient knowledge of nutritional support regardless of age and work experience. However, authors revealed the interest, importance and desire of nurses to improve their knowledge in nutritional support of patients. In this regard, it is necessary to organize the regular training of healthcare personnel in order to reduce the gap in knowledge.