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| 4. |
- Bachrach-Lindström, Margaretha, 1957-, et al.
(författare)
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Assessment of nutritional status using biochemical and anthropometric variables in a nutritional intervention study of women with hip fracture
- 2001
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Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 20:3, s. 217-223
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: The aim of this study of women with hip fracture was to describe nutritional status with biochemical markers and anthropometric variables, and to evaluate the effect of nutritional intervention with the intention of increasing protein and energy intake.Methods: The first consecutive 44 women were included, and used as controls. The next 44 were matched for age, fracture and mental state. Anthropometric variables, IGF-I, hormones and serum albumin were collected 4–6 days (baseline), 1 and 3 months after surgery. Twenty-four women filled out a 7-day food record.Results: At baseline, one fourth had BMI <20 kg/m2and subnormal triceps skinfold thickness. Baseline serum albumin, IGF-I and growth hormone levels were low, probably as an acute response to trauma. Women with BMI <20 kg/m2had lower IGF-I levels compared to those with higher BMI. At 3 months, one-third of both groups were protein and energy malnourished. The intervention group obtained higher daily energy percentage from fat but none of the groups reached their calculated energy need.Conclusions: Using biochemical markers in the acute postoperative situation to assess nutritional status is not recommended. The intervention had no impact on anthropometric or biochemical variables.
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| 6. |
- Ljungqvist, Olle, 1954-
(författare)
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Nutritional care in hospitals
- 2002
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Ingår i: Clinical Nutrition. - Edinburgh, United Kingdom : Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 21:6, s. 449-449
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Tidskriftsartikel (refereegranskat)
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| 8. |
- Persson Lintrup, Mats, et al.
(författare)
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The reproducibility of a new dietary record routine in geriatric patients.
- 2002
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Ingår i: Clinical Nutrition. - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 21:1, s. 15-25
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Malnutrition in nursing home residents is an important clinical and public health problem. Knowledge is lacking about the reproducibility of dietary recording in geriatric patients. Few studies have described water intake in this age group. The aim of this study was to test the reproducibility of a 7-day dietary record routine in a clinical setting. Methods: The dietary intake of 81 geriatric patients was recorded for two discrete periods of 7 consecutive days by the ward staff. The dietary record routine, which assessed both food and fluid intake, was based on standardized portion sizes and household measurements. Results: The mean daily energy intake during the first period was 7.07 MJ and 6.84 MJ during the second period, with a mean difference of 4%. Corresponding values and the mean difference for water intake from food and beverages were 1781 g, 1702 g and 4% respectively. Age, gender, diagnosis, length of stay, diets or ADL function did not influence the results. The correlation coefficient for fluid intake between the periods was 0.84 for women and 0.72 for men. Conclusion: The 7-day dietary record routine seems to have a good reproducibility in assessing the intake of energy and fluids in geriatric patients.
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| 9. |
- Rapp-Kesek, Doris, et al.
(författare)
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Early enteral nutrition in the cardiothoracic intensive care unit
- 2002
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 21:4, s. 303-307
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Early enteral nutrition (EN) improves intestinal integrity, motility and immunocompetence. However, technical problems such as diarrhoea and gastric residual volumes are said to be associated with the method and have prevented its implementation. We have prospectively assessed clinical problems connected to early EN. Patients and methods: Seventy-three consecutive patients eligible for EN were assessed and observed until discharge from the intensive care unit (ICU) or until they resumed oral nutrition. They had surgery for coronary artery bypass grafting and/or valvular disease, thoracic or thoracoabdominal aortic aneurysms or other combined procedures. Two cardiac patients were not subjected to surgery. Results: In 59/73 patients, EN was started within 3 days. EN was discontinued in half of the patients when they were able to feed themselves. Twelve patients vomited, one of them severely. Dislocation of the nasogastric tube occurred in 28 patients. The 15 patients with diarrhoea were treated with 2–6 broad-spectrum antibiotics during their ICU-stay. Out of 73, 40 patients did not show any gastric residual volume (GRV). GRV decreased during EN in 50% of the patients with fairly large or large residual volumes. The incidence of aspiration pneumonia was 10%. Conclusion: In the cardiothoracic ICU, individually adjusted early EN is feasible with few problems.
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| 10. |
- Rooyackers, Olav, et al.
(författare)
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Insulin stimulated glucose disposal in peripheral tissues studied with microdialysis and stable isotope tracers
- 2004
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Ingår i: Clinical Nutrition. - Edinburgh, United Kingdom : Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 23:4, s. 743-52
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Methods to study glucose kinetics in vivo in specific tissues or tissue beds in humans are often not feasible due to invasiveness or costs of equipment needed. Here we investigate whether the loss (fractional extraction) of 2H7-glucose infused via a microdialysis catheter can be used to study glucose disposal in skeletal muscle and subcutaneous adipose tissue.Methods and results: A perfusion period of 2 h was needed to ensure an isotopic steady state in the microdialysis catheters in skeletal muscle and adipose tissue. In six healthy volunteers the fractional extraction increased during a hyperinsulinemic euglycemic clamp in both skeletal muscle and adipose tissue. Following 48 h of starvation in the same subjects, insulin was not able to increase the fractional extraction of 2H7-glucose from the microdialysis in comparison with a baseline measurement.Conclusions: In response to insulin infusion, the fractional extraction of 2H7-glucose from a microdialysis catheter increases in skeletal muscle and subcutaneous adipose tissue and this increase is blunted during insulin resistance induced by starvation. These results validate that the fractional extraction of a glucose tracers infused via microdialysis can be used as an index of glucose disposal in peripheral tissues or tissue beds.
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- Soop, M., et al.
(författare)
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Preoperative oral carbohydrate treatment attenuates endogenous glucose release 3 days after surgery
- 2004
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Ingår i: Clin Nutr. - Edinburgh, United Kingdom : Elsevier BV. - 0261-5614 .- 1532-1983. ; 23:4, s. 733-41
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Postoperative metabolism is characterised by insulin resistance and a negative whole-body nitrogen balance. Preoperative carbohydrate treatment reduces insulin resistance in the first day after surgery. We hypothesised that preoperative oral carbohydrate treatment attenuates insulin resistance and improves whole-body nitrogen balance 3 days after surgery. METHODS: Fourteen patients undergoing total hip replacement were double-blindly randomised to preoperative oral carbohydrate treatment (12.5%, 800 + 400 ml, n = 8) or placebo (n = 6). Glucose kinetics (6,6-D2-glucose), substrate utilisation (indirect calorimetry) and insulin sensitivity (hyperinsulinaemic-euglycaemic clamp) were measured preoperatively and on the third day after surgery. Nitrogen losses were monitored for 3 days after surgery. Values are mean (SEM). Analysis of variance (ANOVA) statistics were used. RESULTS: Endogenous glucose release during insulin infusion increased after surgery in the placebo group. Preoperative carbohydrate treatment, as compared to placebo, significantly attenuated postoperative endogenous glucose release (0.69 (0.07) vs. 1.21 (0.13)mg kg(-1) x min(-1), P < 0.01), while whole-body glucose disposal and nitrogen balance were similar between groups. CONCLUSIONS: While insulin resistance in the first day after surgery has previously been characterised by reduced glucose disposal, enhanced endogenous glucose release was the main component of postoperative insulin resistance on the third postoperative day. Preoperative carbohydrate treatment attenuated endogenous glucose release on the third postoperative day.
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| 13. |
- Sternby, Berit, et al.
(författare)
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Degree of in vivo inhibition of human gastric and pancreatic lipases by Orlistat (Tetrahydrolipstatin, THL) in the stomach and small intestine.
- 2002
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Ingår i: Clinical Nutrition. - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 21:5, s. 395-402
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Orlistat, a lipase inhibitor, strongly inhibits the activities of all gastric/pancreatic lipases except pancreatic phospholipase A(2)in vitro. In clinical use, for obesity treatment, it induces a variable degree of weight loss and steatorrhoéa. The aim of this study was to examine the degree of in vivo inhibition of individual gastric/pancreatic lipases by Orlistat in man, when given as a capsule or mixed into a test meal in the form of an optimal substrate for the lipases.METHODS: Twelve male volunteers were intubated twice with a triple lumen nasal-gastric-duodenal tube and were given a balanced test meal with or without 60mg Orlistat. Three conditions were compared: (a) Orlistat given as a capsule with the meal, (b) Orlistat mixed into the test meal before ingestion, and (c) test meal without Orlistat. Samples were collected at six 30min intervals, from stomach, mid-duodenum, and ligament of TreitY. Activities and immune-reactive masses of gastric lipase, pancreatic lipase, carboxyl ester lipase, colipase, and mass of non-polar lipid classes were determined.RESULTS: In vivo effects on the enzyme activities were more pronounced when Orlistat was mixed with the meal than when given as a capsule (7%, 10%, 1% vs 49%, 54%, 34% of normal activity), respectively. Despite efficient inhibition of the lipases, an extensive hydrolysis of the emulsified lipids of the test meal occurred. Orlistat did not affect the immune-reactive amounts of lipases.CONCLUSIONS: Orlistat causes a pronounced in vivo inhibition of gastric and pancreatic lipases in humans. The mixing with the substrate and the fact that little residual lipase activity is necessary to hydrolyse optimally emulsified lipids are likely to be limiting factors for the effect of the drug in clinical practice.
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| 14. |
- Svanfeldt, M., et al.
(författare)
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Effects of 3 days of 'postoperative' low caloric feeding with or without bed rest on insulin sensitivity in healthy subjects
- 2003
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Ingår i: Clinical Nutrition. - Edinburgh, United Kingdom : Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 22:1, s. 31-8
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Insulin resistance after surgery is caused by the surgical trauma and presumably also by other factors, such as starvation and immobilization. The purpose of this study was to evaluate the effect of traditional postsurgical low caloric feeding and bed rest on insulin sensitivity and substrate utilization, in younger and older healthy subjects.Methods: Twelve healthy subjects underwent hyperinsulinaemic, normoglucaemic clamps and indirect calorimetry before and after 3 days of bed rest and low caloric feeding. Six of the subjects underwent a second study with 3 days of low caloric feeding without bed rest.Results: Insulin sensitivity decreased by 57+/-16 % after low caloric feeding combined with bed rest, with no difference between age groups, and by 56+/-9% after low caloric feeding only. Glucose oxidation decreased, while fat oxidation increased. No significant differences were seen between age groups or between the protocols.Conclusions: Low caloric feeding, a commonly used nutritional routine in clinical practice, induce marked alterations in insulin sensitivity and substrate utilization. Increasing age or bed rest did not seem to influence this development. These findings suggest that the routine low caloric feeding is capable of contributing to postoperative insulin resistance.
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| 20. |
- Kyle, Ursula G, et al.
(författare)
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Bioelectrical impedance analysis--part I: review of principles and methods.
- 2004
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Ingår i: Clinical nutrition (Edinburgh, Scotland). - : Elsevier BV. - 0261-5614. ; 23:5, s. 1226-43
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Forskningsöversikt (refereegranskat)abstract
- The use of bioelectrical impedance analysis (BIA) is widespread both in healthy subjects and patients, but suffers from a lack of standardized method and quality control procedures. BIA allows the determination of the fat-free mass (FFM) and total body water (TBW) in subjects without significant fluid and electrolyte abnormalities, when using appropriate population, age or pathology-specific BIA equations and established procedures. Published BIA equations validated against a reference method in a sufficiently large number of subjects are presented and ranked according to the standard error of the estimate. The determination of changes in body cell mass (BCM), extra cellular (ECW) and intra cellular water (ICW) requires further research using a valid model that guarantees that ECW changes do not corrupt the ICW. The use of segmental-BIA, multifrequency BIA, or bioelectrical spectroscopy in altered hydration states also requires further research. ESPEN guidelines for the clinical use of BIA measurements are described in a paper to appear soon in Clinical Nutrition.
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| 21. |
- Kyle, Ursula G, et al.
(författare)
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Bioelectrical impedance analysis-part II: utilization in clinical practice.
- 2004
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Ingår i: Clinical nutrition (Edinburgh, Scotland). - : Elsevier BV. - 0261-5614. ; 23:6, s. 1430-53
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Forskningsöversikt (refereegranskat)abstract
- BIA is easy, non-invasive, relatively inexpensive and can be performed in almost any subject because it is portable. Part II of these ESPEN guidelines reports results for fat-free mass (FFM), body fat (BF), body cell mass (BCM), total body water (TBW), extracellular water (ECW) and intracellular water (ICW) from various studies in healthy and ill subjects. The data suggests that BIA works well in healthy subjects and in patients with stable water and electrolytes balance with a validated BIA equation that is appropriate with regard to age, sex and race. Clinical use of BIA in subjects at extremes of BMI ranges or with abnormal hydration cannot be recommended for routine assessment of patients until further validation has proven for BIA algorithm to be accurate in such conditions. Multi-frequency- and segmental-BIA may have advantages over single-frequency BIA in these conditions, but further validation is necessary. Longitudinal follow-up of body composition by BIA is possible in subjects with BMI 16-34 kg/m(2) without abnormal hydration, but must be interpreted with caution. Further validation of BIA is necessary to understand the mechanisms for the changes observed in acute illness, altered fat/lean mass ratios, extreme heights and body shape abnormalities.
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| 31. |
- Wang, Wenhua, 1960, et al.
(författare)
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Provision of rhIGF-I/IGFBP-3 complex attenuated development of cancer cachexia in an experimental tumor model.
- 2000
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Ingår i: Clinical nutrition (Edinburgh, Scotland). - : Elsevier BV. - 0261-5614. ; 19:2, s. 127-32
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Tidskriftsartikel (refereegranskat)abstract
- Tumor growth is associated with development of cachexia which includes progressive wasting and anorexia. Our previous studies have indicated that insulin like growth factor-I (rhIGF-I) in complex with its binding protein 3 (IGFBP 3), but not free IGF-I, was a potent stimulator of muscle protein synthesis in rats with chronic undernutrition. The aim of the present study was to evaluate the effect of rhIGF-I/IGFBP-3 on the development of cancer cachexia, and to assess safety data on net tumor growth and progression during treatment.
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| 32. |
- Wernerman, J, et al.
(författare)
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Methods, who cares?
- 2000
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Ingår i: Clinical nutrition (Edinburgh, Scotland). - : Elsevier BV. - 0261-5614. ; 19:3, s. 145-146
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 33. |
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