Nutritional Support In Patients Research Articles

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.
 
 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.
 
 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.
 
 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.

Effects of parent- and child-related behavioral feeding problems in early childhood on malnutrition

ObjectiveChildren's responses to food and their caregivers during normal developmental periods are known as feeding behavior. For the healthy development of these behaviors, parent and child relationships must also be healthy. Therefore, we aimed to investigate the effect of behavioral feeding problems on primary malnutrition (PM). MethodThe Behavioral Pediatric Nutrition Assessment Scale (BPFAS) was administered to 300 malnourished and 300 control pediatric patients aged from 9 months to 4 years who were referred to our pediatric gastroenterology outpatient clinic. Pre- and posttreatment data were compared between the two groups. ResultsThere was no statistically significant difference between patients with and without malnutrition in terms of gender and age (p = 0.191, p = 0.128, respectively). Total behavioral frequency (TBF) and total behavioral problem (TBP) scores were significantly higher in the malnutrition group (p < 0.001). In the logistic regression analysis of risk factors that may affect malnutrition we found that a total TBF score of ≥85 increases the risk of developing malnutrition 3.731 times, a child TBF score of ≥62 increases it 2.644 times, and a parental TBF score of ≥21 increases it 4.82 times (p < 0.001). When anthropometric measurements and BPFAS scores of 127 PM patients who received behavioral therapy with enteral products and who attended follow-up were compared with their pretreatment data, there was a significant improvement (p < 0.05). ConclusionOur study showed that behavioral feeding problems may increase the risk of PM and that behavioral therapy together with enteral products has a positive effect on treatment. Therefore, in addition to nutritional support in patients with PM, offering behavioral feeding therapy to parents will positively affect both the child's physical development and the relationship between the parents and their child.

Mapping the global research landscape on nutritional support for patients with gastrointestinal malignancy: visualization analysis.

Early nutritional treatment is crucial for the care of patients with operable and advanced gastrointestinal malignancies. Therefore, much research has focused on nutritional support for patients with gastrointestinal malignancies. Therefore, this study aimed to evaluate the global scientific output and activity with respect to nutritional support and gastrointestinal malignancy. We searched in Scopus for publications on gastrointestinal cancer and nutritional assistance published between January 2002 and December 2021. Then, using VOSviewer 1.6.18 and Microsoft Excel 2013, we conducted bibliometric analysis and visualization. A total of 906 documents were published between 2002 and 2021, including 740 original articles (81.68%) and 107 reviews (11.81%). China ranked first (298 publications, 32.89%), Japan ranked second (86 publications, 9.49%) and the USA ranked third (84 publications, 9.27%). The organisation with the highest number of publications was the Chinese Academy of Medical Sciences & Peking Union Medical College from China, with 14 articles, followed by the Peking Union Medical College Hospital from China and the Hospital Universitari Vall d'Hebron from Spain (13 publications for each). Before 2016, most studies focused on 'nutrition support for patients undergoing gastrointestinal surgery'. However, the latest trends showed that 'nutrition support and clinical outcomes in gastrointestinal malignancies' and 'malnutrition in patients with gastrointestinal cancer' would be more widespread in the future. This review is the first bibliometric study to provide a thorough and scientific analysis of gastrointestinal cancer and nutritional support trends worldwide over the last 20 years. This study can aid researchers in decision-making by helping them understand the frontiers and hotspots in nutrition support and gastrointestinal cancer research. Future institutional and international collaboration is expected to accelerate the advancement of gastrointestinal cancer and nutritional support research and investigate more efficient treatment methods.

Nutritional support for patients with abdominal surgical pathology: the view of a surgeon and an anesthesiologist — opponents or allies?

BACKGROUND: Nutritional support in abdominal surgery is a complex aspect of intensive care with many contradictions in available recommendations and in relation to interdisciplinary interaction. The challenges of assessing nutritional status and timing of the start and methods of clinical nutrition have not yet been resolved. Research has not yet explained whom and how to feed in the intensive care unit, nor has it proved the need for an early start of enteral nutrition or assessed the scale of the problems, such as the lack of uniform views and low adherence to clinical recommendations.&#x0D; AIM: To analyze the effectiveness of early enteral nutrition in achieving optimal treatment results in patients with abdominal surgical pathology and assess the depth of knowledge and adherence to clinical recommendations of specialists providing care to this cohort.&#x0D; MATERIALS AND METHODS: The study included 50 patients, 32 of whom started early enteral nutrition and 18 received later enteral nutrition. A survey of 41 specialists (surgeons and intensivists) from three leading hospitals in Tyumen was also conducted. The main set of clinical material was conducted on the basis of the Regional Clinical Hospital No. 1 (Tyumen).&#x0D; RESULTS: The study demonstrated the advantages of early enteral nutrition over delayed nutrition by an average of 48 h by reducing the length of hospital stay and resuscitation stage of treatment and minimizing pulmonary complications. Moreover, a survey of specialists assisting this cohort showed a lack of consensus in treatment approaches and insufficient adherence of patients with abdominal surgical pathology to existing clinical recommendations on clinical nutrition.&#x0D; CONCLUSIONS: Further research on nutritional support in patients with abdominal surgical pathology should aim at reducing the decision-making time in favor of an earlier and combined method of nutritional support, which can be facilitated by enhancing literacy and promoting adherence to clinical recommendations of specialists at the interdisciplinary level.

Nutritional support as part of the basic therapy of a patient in the acute period of ischemic stroke in the intensive care unit

Ischemic stroke remains the predominant cause of disability in the population (3.2 per 1000 population). Only 8% of ischemic stroke survivors can return to their previous work. Nutritional support is an integral part of the multidisciplinary approach to the treatment of ischemic stroke in the intensive care unit during the acute and rehabilitation phases. Brain damage always has metabolic consequences on the patients body, and premorbid malnutrition and stroke-stroke malnutrition significantly affect disease outcomes. The incidence of malnutrition in patients with ischemic stroke varies widely, ranging from 6.1% to 62%, depending on the method for determining protein-energy malnutrition. Despite the relevance of the problem of nutritional support in patients with ischemic stroke, only a few specific recommendations are available in the literature for this category of patients. This review focuses on nutritional support for patients who require mechanical ventilation or admission in the intensive care unit for 48 h.

Protein-energy metabolism and nutritional support in patients on extracorporeal membrane oxygenation: a systematic review

INTRODUCTION: Patients on extracorporeal membrane oxygenation (ECMO) are among the most severe in the intensive care unit (ICU), they require complex treatment, accompanied by a long stay in the hospital and rehabilitation. Nutritional support (NS) plays an important role in the intensive care program. Despite an increase in the use of ECMO in the ICU over the past decade, informative clinical data regarding the optimal methods of maintaining nutritional status and controlling metabolism are rare. The lack of evidence base and guidelines for NS for adult patients on ECMO results in heterogeneity in clinical practice regarding optimal macro and micronutrient requirements, time of NS initiation, type and amount of nutritional support solutions. OBJECTIVE: Provide a review and critical assessment of the latest data regarding NS in critically ill adult patients on ECMO. MATERIALS AND METHODS: A systematic search and selection of publications was performed using the PubMed database. Studies published from 2012 to 2021 were analyzed to explore the approaches to NS in ECMO patients. Relevant studies were limited to randomized controlled trials, observational studies and clinical trials. RESULTS: A total of 14 observational studies were selected. Early enteral nutrition has been considered safe and feasible for ECMO patients, but achieving energy and protein targets is challenging. Data on the impact of NS on clinical outcomes and complications have been conflicting. Efforts should be made to achieve an adequate patient supply on ECMO of more than 80 % of the calculated energy and protein targets. NS in ECMO patients should be carried out in accordance with current guidelines for NS in critically ill patients until further data become available. CONCLUSIONS: A personalized approach is important principle of nutritional and metabolic therapy. Further studies are needed to investigate the association of various NS methods on clinical outcome endpoints in ICU ECMO patients.

Comparison of GLIM, SGA, PG-SGA, and PNI in diagnosing malnutrition among hepatobiliary-pancreatic surgery patients.

To compare the diagnostic value of four tools-the Global Leadership Initiative on Malnutrition (GLIM) criteria, the subjective global assessment (SGA), patient-generated subjective global assessment (PG-SGA), and prognostic nutritional index (PNI) in malnutrition among hospitalized patients undergoing hepatobiliary-pancreatic surgery. Meanwhile, to observe the nutritional intervention of these patients. Present study was a cross-sectional study, including 506 hospitalized patients who underwent hepatobiliary-pancreatic surgery between December 2020 and February 2022 at Ningbo Medical Center Lihuili Hospital, China. The incidence rate of malnutrition was diagnosed using the four tools. The consistency of the four tools was analyzed by Cohen's kappa statistic. Data, including nutritional characteristics and nutritional interventions, were collected. The nutritional intervention was observed according to the principles of Five Steps Nutritional Treatment. The prevalence was 36.75, 44.58, and 60.24%, as diagnosed by the GLIM, PG-SGA, and PNI, respectively, among 332 tumor patients. Among the 174 non-tumor patients, the prevalence was 9.77, 10.92, and 32.18% as diagnosed by the GLIM, SGA, and PNI. The diagnostic concordance of PG-SGA and GLIM was higher (Kappa = 0.814, <0.001) than SGA vs. GLIM (Kappa = 0.752, P < 0.001) and PNI vs. GLIM (Kappa = 0.265, P < 0.001). The univariate analysis revealed that older age, lower BMI and tumorous were significantly associated with nutritional risks and malnutrition. Among 170 patients with nutritional risk, most of patients (118/170, 69.41%) did not meet the nutritional support standard. The incidence of nutritional risk and malnutrition is high among patients with hepatobiliary and pancreatic diseases, specifically those with tumors. The GLIM showed the lowest prevalence of malnutrition among the four tools. The PG-SGA and GLIM had a relative high level of agreement. There was a low proportion of nutritional support in patients. More prospective and well-designed cohort studies are needed to confirm the relevance of these criteria in clinical practice in the future.

Предменструальный синдром. Возможности нутриентной поддержки

Aim: Highlight the known pathogenetic mechanisms for the development of premenstrual syndrome (PMS), the possibilities of nutritional support in patients with PMS. Key points. PMS is a complex of psychological, behavioral and physical symptoms that has a significant impact on a woman's quality of life. The etiology and pathogenesis of PMS are complicated and not fully understood. There is association with imbalance of neurotransmitters and their receptors sensitivity. Nutrients are cofactors in hormonal synthesis and neurotransmitters. Long-term therapies are linked with substantial adverse effects which may reduce adherence to treatment. Nutritional supplements allow to improve compliance in patients with PMS. Conclusion. PMS is a disease characterized by numerous of clinical manifestations. Nutritional supplements have broad and specific actions, which makes them suitable for use as a nutritional support for the correction of PMS symptoms in patients with various clinical portraits. Keywords: premenstrual syndrome, premenstrual dysphoric disorder, nutrients.

Review of ESPEN-2021 Practice Guidelines for Cancer Patients: Part 1

This study discusses the 2021 ESPEN Practical Guidelines for Nutritional Support in Oncology. The updated version of the 2021 ESPEN practice guidelines differs slightly from the 2017 version and contains flowcharts to facilitate the use of the guidelines in clinical practice, which is also relevant for domestic healthcare. ESPEN-2021 Clinical Guidelines, which offer practical solutions in all areas of oncology, are of particular interest to both oncologists and allied specialists working in oncology. The first part of the review discusses general recommendations for nutritional support for patients with cancer and the possibility of their use in our country: screening of nutritional status at the initial visit, indications for prescribing additional nutrition, benefits of one or another type of nutritional support in various situations, norms for providing macronutrients, vitamins, and minerals, and need for physical activity. This practical guide forms an algorithm of actions to ensure optimal nutrition for patients with cancer. The general principles of nutritional therapy for all patients with cancer are based on timely screening for nutritional deficiencies and adherence to appropriate nutritional support of patients, which can be achieved by modifying the diet or prescribing additional nutrition, mainly enteral nutrition.

Gastrostomy tube feeding in epidermolysis bullosa: A multi-center assessment of caregiver satisfaction.

Gastrostomy tubes (G-tubes) are a feasible intervention for nutritional support in patients with epidermolysis bullosa (EB) who suffer from gastrointestinal involvement. However, some parents may be apprehensive about this surgical intervention. The purpose of this study is to assess caregiver satisfaction and experiences after G-tube insertion in children with EB. Nine institutions sent an anonymous 89-item online questionnaire to caregivers of patients with EB and active G-tubes during an 8-week study period. The questionnaire consisted of eight sections and was formatted with multiple choice, Likert scales, dichotomous scales (yes/no), and free text. Twenty caregiver surveys were completed. All caregivers were parents (100%). The average age of G-tube placement was 2.7 years (SD: 2.1, range 0-8) and duration of the G-tube utilization was an average of 12.0 years (SD: 7.8, range 1-25). EB subtypes were dystrophic (n=15/20, 75%), junctional (n=3/20, 15%), and simplex (n=2/10, 10%). Almost all caregivers (n=18/20, 90%) reported high levels of satisfaction with G-tube management (scores > 20 on the modified SAGA-8 scale). More than half of caregivers (n=12/20, 60%) reported that, retrospectively, they would have desired earlier adoption of the G-tube. Caregivers rated mealtimes as more enjoyable and easier both for themselves and the individual with EB post-G-tube placement. The survey demonstrates a high rate of satisfaction for G-tube use among caregivers of patients with EB across varying ages and household settings. The free-text responses provide unique insight into caregiver's individual experiences regarding G-tubes to be considered for future studies.

The Status of Protein Supply to Patients in the Trauma and Surgical Intensive Care Units and the Effects of Feedback on Protein Supply: A Multicenter Study

Purpose: To investigate the status of protein supply by comparing the recommended amount with the delivered amount of protein in patients in the trauma and surgical intensive care units (ICU). Feedback on the protein supply status was presented to each hospital, and we evaluated whether the protein supply had increased to an appropriate level.Methods: In this retrospective observational multicenter study, nutritional information on patients in the trauma and surgical ICUs who had received nutritional support intervention was collected on the 1st Wednesday of each month at two-month intervals from August 2020 to June 2021, from nine domestic hospitals in Korea. Every two months, the nutritional status of each hospital was shared with all hospitals, and each nutritional support team received feedback on protein supply status.Results: There were 246 patients from nine hospitals included in this study, and data over the study period from six protein days, were analyzed. The mean ratios of delivered calories to calculated required calories were 74.0%, 80.8%, 85.4%, 77.9%, 71.3%, and 82.1% on Protein Days 1, 2, 3, 4, 5, and 6, respectively. The mean ratios of delivered protein to calculated required protein were 73.0%, 77.2%, 78.9%, 79.3%, 69.4%, and 89.6% on Protein Days 1, 2, 3, 4, 5, and 6, respectively.Conclusion: Protein supply increased to an appropriate level, feedback on protein supply status may have increased the protein supply ratio and promoted appropriate protein supply and nutritional support for patients in the trauma and surgical ICUs.

Efficacy of the Chronic Disease Trajectory Model for Nutritional Support in Patients with Gastric Cancer

The purpose of this study is to explore the effect of nursing intervention based on the chronic disease trajectory model in nutritional support for patients with gastric cancer. A total of 106 patients with gastric cancer hospitalized at our surgical oncology from January to October 2018 were randomly divided into the intervention group and the control group, with 53 patients in each. The control group was treated with routine nursing methods, and the other group was given a new nursing method based on the chronic disease trajectory model. We collected the data of postoperative complications, the six-month nutritional status and the negative emotion scores from the two groups. At discharge and the first-, second-, third- and sixth-month follow-up, the measured values of albumin and prealbumin in the intervention group were significantly higher than the control group. At discharge and six months after follow-up, the SAS and SDS scores in the intervention group were lower than the control group. The nursing intervention based on the chronic disease trajectory model can improve the nutritional status and negative emotions of patients with gastric cancer and decrease the incidence of postoperative complications.

Do We Care About Nutritional Support in Patients Hospitalized with a Diagnosis of Femoral Neck Fracture?

ÖzetAmaç: Femur boyun kırıkları (FBK), proksimal femurun intrakapsüler bölgesinde oluşan kırıklardır. Femur proksimalindeki kırıkların insidansı yaşla doğru orantılı olarak artış gösterir. FBK yüksek mortalite ve morbiditeye neden olan kırıklardır. Yetersiz beslenme de bu hastaların sorunlarından biridir. Bu çalışmada FBK nedeni ile hastanemize yatışı yapılan hastalarda gerekli beslenme takibinin öneminin ortaya konulması amaçlandı.Gereç ve Yöntemler: Kütahya Sağlık Bilimleri Üniversitesi Evliya Çelebi Eğitim ve Araştırma Hastanesi’ne 2017-2018 yılları arasında FBK tanısı ile yatan hastalara ait veriler retrospektif olarak hasta dosyası ve hastane otomasyon sisteminden tarandı. Çalışmaya 229 hasta dâhil edildi. Hastaların yatış tanıları, yaşve cinsiyeti, albümin, C-reaktif protein (CRP), lenfosit tahlilleri değerlendirildi. Hastanemiz otomasyon sisteminde her yatan hasta için yapılan nutrisyon risk skorlamasına (NRS-2002) bakıldı. Nutrisyon desteği için, beslenme destek ekibinden (BDE) konsültasyon istenip-istenmediğine bakıldı.Bulgular: Çalışmaya dâhil edilen hastaların ortalama yaşları 74 olarak bulundu. Hastaların %79.3’ü 65 yaş üstündeyken, %20.97’si 65 yaş altıydı. Hastaların %65.1`inin albümin, %24.5`inin lenfosit, %88.2`sinin ise CRP değeri normal aralıklar dışında olduğu tespit edildi. Hastaların albümin ve yaş değişkeni arasında negatif yönde, istatistiksel açıdan %41`lik anlamlı bir ilişki vardı (p&amp;lt;0.05). NRS-2002`ye bakıldığında ise %94.8`i hesaplanmamış olarak görüldü. Hastaların hiçbirinden BDE›den konsültasyon istenmediği görüldü.Sonuç: Kalça kırığı hastalarının perioperatif beslenme desteğinin göz önünde bulundurulması hastalarda morbidite ve mortaliteyi azaltıp, yaşam kalitesini iyileştirebilir. Biz, çalışmamızda beslenme desteğine daha çok önem verilmesinin gerekliliğini ortaya koyduk.