| 1. |
- Eman, Josefin, 1983-
(författare)
-
The complexity of physical capital : How old male athletes relate to body and health
- 2013
-
Ingår i: International Journal of Men's Health. - : Men's Studies Press. - 1532-6306 .- 1933-0278. ; 12:1, s. 29-41
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present article was to explore how a relatively privileged group of old men, e.g. old athletes, relate to their bodies and health in the process of growing old. Ten male athletes from 68 to 90 years of age were interviewed in this grounded theory study. The findings suggest that the old male athletes controlled their bodies in order to gain physical capital, but that different ways of employing the body were valued in different contexts. Three such contexts were identified: the aging, athletic and masculine context. In an aging context, the men emphasized the importance of caring for one’s body and health, but in an athletic and masculine context, they expressed both a caring and a non-caring approach to body and health. In other words, on the whole the men displayed a contradictious way of relating to their bodies and health. However, they could to some extent reconcile the tensions between the different norms of body and health by emphasizing the need to preserve physical autonomy, an ideal that appeared to be valid in all three contexts.
|
|
| 2. |
|
|
| 3. |
- Månsson, Kristofer, 1983-
(författare)
-
A Wavelet-Based Approach of Testing for Granger Causality in the Presence of GARCH Effects
- 2012
-
Ingår i: Communications in Statistics - Theory and Methods. - : Taylor & Francis. - 0361-0926 .- 1532-415X. ; 41:4, s. 717-728
-
Tidskriftsartikel (refereegranskat)abstract
- The size and power of the most commonly used tests and a new wavelet-based approach of testing for Granger causality is evaluated in this paper by means of a Monte Carlo study in which the error term follows a generalized autoregressive conditional heteroscedasticity consistent (GARCH) process. In the simulation study it is shown that the commonly used causality tests tends to over-reject the true null hypothesis in the presence of GARCH errors and that the new wavelet-based approach improves the size properties of the Granger causality test for all of the different situations evaluated.
|
|
| 4. |
- Östh, Jonas, 1983, et al.
(författare)
-
Driver Kinematic and Muscle Responses in Braking Events with Standard and Reversible Pre-tensioned Restraints: Validation Data for Human Models
- 2013
-
Ingår i: Stapp car crash journal. - 400 Commonwealth Drive, Warrendale, PA, United States : SAE International. - 1532-8546. ; 57, s. 1-41
-
Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study are to generate validation data for human models intended for simulation of occupant kinematics in a pre-crash phase, and to evaluate the effect of an integrated safety system on driver kinematics and muscle responses. Eleven male and nine female volunteers, driving a passenger car on ordinary roads, performed maximum voluntary braking; they were also subjected to autonomous braking events with both standard and reversible pre-tensioned restraints. Kinematic data was acquired through film analysis, and surface electromyography (EMG) was recorded bilaterally for muscles in the neck, the upper extremities, and lumbar region. Maximum voluntary contractions (MVCs) were carried out in a driving posture for normalization of the EMG. Seat belt positions, interaction forces, and seat indentions were measured.During normal driving, all muscle activity was below 5% of MVC for females and 9% for males. The range of activity during steady state braking for males and females was 13–44% in the cervical and lumbar extensors, while antagonistic muscles showed a co-contraction of 2.3–19%. Seat belt pre-tension affects both the kinematic and muscle responses of drivers. In autonomous braking with standard restraints, muscle activation occurred in response to the inertial load. With pre-tensioned seat belts, EMG onset occurred earlier; between 71 ms and 176 ms after belt pre-tension. The EMG onset times decreased with repeated trials and were shorter for females than for males. With the results from this study, further improvement and validation of human models that incorporate active musculature will be made possible.
|
|
| 5. |
- Löfström Engdahl, Elin, 1983, et al.
(författare)
-
Comparison of the Extraction as a Function of Time in two GANEX solvents -Influence of Metal Loading, Interfacial Tension and Density
- 2013
-
Ingår i: Solvent Extraction and Ion Exchange. - : Informa UK Limited. - 0736-6299 .- 1532-2262. ; 31:6, s. 604-616
-
Tidskriftsartikel (refereegranskat)abstract
- Two Group ActiNide EXtraction solvents for the extraction of actinides from used nuclear fuel for transmutation purpose have been compared. The solvent studied more precisely comprises cyclohexanone, tributylphosphate and a molecule from the bis-triazine bi-pyridine family, whilethe alternative utilizes di-ethyl-hexyl butyramide instead of tributylphospate. The focus of the comparison has been on the kinetics of the extraction of americium and europium, and the influence of an increased metal content on their separation factor. Both systems showed to maintain the equilibrium separation factor up to an europium concentration of 1 mM and their SFAm/Eu is decreased with a prolonged phase contact.
|
|
| 6. |
- Kinzer, M., et al.
(författare)
-
Mesenchymal stromal cells from the human placenta promote neovascularization in a mouse model in vivo.
- 2014
-
Ingår i: Placenta. - London : W. B. Saunders Co Ltd. - 0143-4004 .- 1532-3102. ; 35:7, s. 517-519
-
Tidskriftsartikel (refereegranskat)abstract
- Cell transplantation is a promising strategy in regenerative medicine for revascularization of ischemic tissues. Based on our observation that placental mesenchymal stromal cells (PMSC) enhance endothelial cell viability in vitro via secretion of angiogenic factors, we asked whether PMSC support vascular growth in vivo. PMSC were isolated from amnion and placental endothelial cells (PLEC) from chorion and either separately or co-transplanted subcutaneously into immune-deficient mice. Co-transplantation resulted in a higher number of perfused human vessels (CD31+/vimentin+) containing mouse glycophorin A+ erythrocytes. Results indicate positive effects of PMSC on neovascularization in vivo, making them attractive candidates to create autologous PMSC/PLEC pairs for research and transplantation.
|
|
| 7. |
- Nordstierna, Lars, 1976, et al.
(författare)
-
New Route for Microcapsule Synthesis
- 2011
-
Ingår i: Journal of Dispersion Science and Technology. - : Informa UK Limited. - 1532-2351 .- 0193-2691. ; 32:3, s. 310-311
-
Tidskriftsartikel (refereegranskat)abstract
- Studies on the growth of microorganisms on painted surfaces and other coatings has increased during the last decades as many antigrowth agents have gradually been prohibited due to toxicity. Current applications using biocides lose the protection quite rapidly as small molecular size renders a fast diffusional biocide leakage. A promising improvement of antigrowth protection can be achieved by the use of encapsulated biocides in the paint. The candidate method to produce microcapsules has dichloromethane as a key constituent in the synthesis step.[3] Dichloromethane is hazardous and thereby often not allowed to be used at industrial scale. In this article, we show that ethyl acetate has equivalent physiochemical properties as dichloromethane in the production of microcapsules and thus can be used in order to fulfill legislative criteria.
|
|
| 8. |
|
|
| 9. |
- Retegan Vollmer, Teodora, 1979, et al.
(författare)
-
Synthesis and Screening of t-Bu-CyMe4-BTBP, and Comparison with CyMe4-BTBP
- 2014
-
Ingår i: Solvent Extraction and Ion Exchange. - : Informa UK Limited. - 0736-6299 .- 1532-2262. ; 32:7, s. 720-736
-
Tidskriftsartikel (refereegranskat)abstract
- The effect of adding a t-butyl group to the core molecule of CyMe4-BTBP, with the aim of improving solubility in organic diluents, has been studied with regard to the extraction of Am(III) and Eu(III) from HNO3. Synthesis of t-Bu-CyMe4-BTBP is described in detail. Metal nitrates are extracted from nitric acid in the form of 1:2 complexes, M(NO3)(3)(BTBP)(2). Whether in 1-octanol, kerosene, or cyclohexanone diluents, t-Bu-CyMe4-BTBP extracts with larger distribution ratios but with slower kinetics than CyMe4-BTBP. The general trends previously observed for CyMe4-BTBP regarding the diluent and modifier influence were also found for t-Bu-CyMe4-BTBP.
|
|
| 10. |
- Shukur, Ghazi, 1955-, et al.
(författare)
-
A Simulation Study of Some Ridge Regression Estimators under Different Distributional Assumptions
- 2010
-
Ingår i: Communications in statistics. Simulation and computation. - : Taylor & Francis. - 0361-0918 .- 1532-4141. ; 39:8, s. 1639-1670
-
Tidskriftsartikel (refereegranskat)abstract
- Based on the work of Khalaf and Shukur (2005), Alkhamisi et al. (2006), and Muniz et al. (2010), this article considers several estimators for estimating the ridge parameter k. This article differs from aforementioned articles in three ways: (1) Data are generated from Normal, Student's t, and F distributions with appropriate degrees of freedom; (2) The number of regressors considered are from 4-12 instead of 2-4, which are the usual practice; (3) Both mean square error (MSE) and prediction sum of square (PRESS) are considered as the performance criterion. A simulation study has been conducted to compare the performance of the estimators. Based on the simulation study we found that, increasing the correlation between the independent variables has negative effect on the MSE and PRESS. However, increasing the number of regressors has positive effect on MSE and PRESS. When the sample size increases the MSE decreases even when the correlation between the independent variables is large. It is interesting to note that the dominance pictures of the estimators are remained the same under both the MSE and PRESS criterion. However, the performance of the estimators depends on the choice of the assumption of the error distribution of the regression model.
|
|
| 11. |
- Strandroth, Johan, 1978, et al.
(författare)
-
A New Method to Evaluate Future Impact of Vehicle Safety Technology in Sweden
- 2012
-
Ingår i: SAE Technical Papers. - 400 Commonwealth Drive, Warrendale, PA, United States : SAE International. - 0148-7191 .- 2688-3627. ; 56, s. 497-509
-
Tidskriftsartikel (refereegranskat)abstract
- In the design of a safe road transport system there is a need to better understand the safety challenges lying ahead. One way of doing that is to evaluate safety technology with retrospective analysis of crashes. However, by using retrospective data there is the risk of adapting safety innovations to scenarios irrelevant in the future. Also, challenges arise as safety interventions do not act alone but are rather interacting components in a complex road transport system. The objective of this study was therefore to facilitate the prioritizing of road safety measures by developing and applying a new method to consider possible impact of future vehicle safety technology. The key point was to project the chain of events leading to a crash today into the crashes for a given time in the future. Assumptions on implementation on safety technologies were made and these assumptions were applied on the crashes of today. It was estimated which crashes would be prevented and the residual was analyzed to identify the characteristics of future crashes. The Swedish Transport Administration's in-depth studies of fatal crashes from 2010 involving car passengers (n=156) were used. This study estimated that the number of killed car occupant would be reduced with 53 percent from the year 2010 to 2020. Through this new method, valuable information regarding the characteristic of the future crashes was found. The results of this study showed that it was possible to evaluate future impact of vehicle safety technology if detailed and representative crash data is available.
|
|
| 12. |
|
|
| 13. |
- Andersson, Daniel P., et al.
(författare)
-
Omentectomy in addition to gastric bypass surgery and influence on insulin sensitivity : A randomized double blind controlled trial
- 2014
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 33:6, s. 991-996
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Accumulation of visceral adipose tissue is associated with insulin resistance and cardio-vascular disease. The aim of this study was to elucidate whether removal of a large amount of visceral fat by omentectomy in conjunction with Roux en-Y gastric bypass operation (RYGB) results in enhanced improvement of insulin sensitivity compared to gastric bypass surgery alone. Methods: Eighty-one obese women scheduled for RYGB were included in the study. They were randomized to RYGB or RYGB in conjunction with omentectomy. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp before operation and sixty-two women were also reexamined 2 years post-operatively. The primary outcome measure was insulin sensitivity and secondary outcome measures included cardio-metabolic risk factors. Results: Two-year weight loss was profound but unaffected by omentectomy. Before intervention, there were no clinical or metabolic differences between the two groups. The difference in primary outcome measure, insulin sensitivity, was not significant between the non-omentectomy (6.7 +/- 1.6 mg/kg body weight/minute) and omentectomy groups (6.6 +/- 1.5 mg/kg body weight/minute) after 2 years. Nor did any of the cardio-metabolic risk factors that were secondary outcome measures differ significantly. Conclusion: Addition of omentectomy to gastric bypass operation does not give an incremental effect on long term insulin sensitivity or cardio-metabolic risk factors. The clinical usefulness of omentectomy in addition to gastric bypass operation is highly questionable.
|
|
| 14. |
- Awad, Sherif, et al.
(författare)
-
A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery
- 2013
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 32:1, s. 34-44
-
Forskningsöversikt (refereegranskat)abstract
- BACKGROUND & AIMS: Whilst preoperative carbohydrate treatment (PCT) results in beneficial physiological effects, the effects on postoperative clinical outcomes remain unclear and were studied in this meta-analysis.METHODS: Prospective studies that randomised adult non-diabetic patients to either PCT (≥50 g oral carbohydrates 2-4 h pre-anaesthesia) or control (fasted/placebo) were included. The primary outcome was length of hospital stay. Secondary outcomes included development of postoperative insulin resistance, complications, nausea and vomiting. Methodological quality was assessed using GRADEpro(®) software.RESULTS: Twenty-one randomised studies of 1685 patients (733 PCT: 952 control) were included. No overall difference in length of stay was noted for analysis of all studies or subgroups of patients undergoing surgery with an expected hospital stay ≤2 days or orthopaedic procedures. However, patients undergoing major abdominal surgery following PCT had reduced length of stay [mean difference, 95% confidence interval: -1.08 (-1.87 to -0.29); I(2) = 60%, p = 0.007]. PCT reduced postoperative insulin resistance with no effects on in-hospital complications over control (risk ratio, 95% confidence interval, 0.88 (0.50-1.53), I(2) = 41%; p = 0.640). There was significant heterogeneity amongst studies and, therefore, quality of evidence was low to moderate.CONCLUSIONS: PCT may be associated with reduced length of stay in patients undergoing major abdominal surgery, however, the included studies were of low to moderate quality.
|
|
| 15. |
- Biolo, G, et al.
(författare)
-
Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of ageing and chronic disease : From sarcopenic obesity to cachexia
- 2014
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 33:5, s. 737-748
-
Tidskriftsartikel (refereegranskat)abstract
- Skeletal muscle is the most abundant body tissue accounting for many physiological functions. However, muscle mass and functions are not routinely assessed. Sarcopenia is defined as skeletal muscle loss and dysfunction in aging and chronic diseases. Inactivity, inflammation, age-related factors, anorexia and unbalanced nutrition affect changes in skeletal muscle. Mechanisms are difficult to distinguish in individual subjects due to the multifactorial character of the condition. Sarcopenia includes both muscle loss and dysfunction which induce contractile impairment and metabolic and endocrine abnormalities, affecting whole-body metabolism and immune/inflammatory response. There are different metabolic trajectories for muscle loss versus fat changes in aging and chronic diseases. Appetite regulation and physical activity affect energy balance and changes in body fat mass. Appetite regulation by inflammatory mediators is poorly understood. In some patients, inflammation induces anorexia and fat loss in combination with sarcopenia. In others, appetite is maintained, despite activation of systemic inflammation, leading to sarcopenia with normal or increased BMI. Inactivity contributes to sarcopenia and increased fat tissue in aging and diseases. At the end of the metabolic trajectories, cachexia and sarcopenic obesity are paradigms of the two patient categories. Pre-cachexia and cachexia are observed in patients with cancer, chronic heart failure or liver cirrhosis. Sarcopenic obesity and sarcopenia with normal/increased BMI are observed in rheumatoid arthritis, breast cancer patients with adjuvant chemotherapy and in most of patients with COPD or chronic kidney disease. In these conditions, sarcopenia is a powerful prognostic factor for morbidity and mortality, independent of BMI.
|
|
| 16. |
- Blixt, Christina, et al.
(författare)
-
The effect of perioperative glucose control on postoperative insulin resistance
- 2012
-
Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 31:5, s. 676-681
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Postoperative insulin resistance and the consequent hyperglycemia affects clinical outcome. Insulin sensitivity may be modulated by preoperative nutrition, adequate pain management and minimal invasive surgery. This study aims to disclose the impact of perioperative glucose control on postoperative insulin resistance.METHODS: Twenty patients scheduled for elective open hepatectomy were enrolled in this prospective, randomized study. In the treatment group (n = 9) insulin was administered intravenously to keep blood glucose between 6 and 8 mmol/l during surgery. The control group (n = 8) received insulin if blood glucose >14 mmol/l. Insulin sensitivity was measured by a hyperinsulinemic normoglycemic clamp (0.8 mU/kg/min), performed on all patients both on the day before surgery and immediately postoperatively. Plasma cortisol, insulin and C-peptide were measured.RESULTS: There was a significant difference in mean glucose value during surgery. In the control group 8.8 mmol/l (SD 1.5) vs. 6.9 mmol/l (SD 0.4) in the treated group, p = 0.003. In the control group insulin sensitivity decreased to 21.9% ± 16.2% of the preoperative value and in the insulin treated group to 46.8 ± 15.5%, p < 0.005. Insulin levels were significantly higher in the treatment group as well as consequently lower C-peptide levels.CONCLUSIONS: This trial revealed a significant difference in postoperative insulin resistance in the group treated with insulin during surgery.
|
|
| 17. |
- Boernhorst, C., et al.
(författare)
-
Validity of 24-h recalls in (pre-)school aged children : Comparison of proxy-reported energy intakes with measured energy expenditure
- 2014
-
Ingår i: Clinical Nutrition. - : CHURCHILL LIVINGSTONE. - 0261-5614 .- 1532-1983. ; 33:1, s. 79-84
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Little is known about the validity of repeated 24-h dietary recalls (24-HDR) as a measure of total energy intake (El) in young children. This study aimed to evaluate the validity of proxy-reported El by comparison with total energy expenditure (TEE) measured by the doubly labeled water (DLW) technique. Methods: The agreement between El and TEE was investigated in 36 (47.2% boys) children aged 4-10 years from Belgium and Spain using subgroup analyses and Bland-Altman plots. Low-energy-reporters (LER), adequate-energy-reporters (AER) and high-energy-reporters (HER) were defined from the ratio of El over TEE by application of age- and sex-specific cut-off values. Results: There was good agreement between means of El (1500 kcal/day) and TEE (1523 kcal/day) at group level though in single children, i.e. at the individual level, large differences were observed. Almost perfect agreement between El and TEE was observed in thin/normal weight children (EI: 1511 kcal/day; TEE: 1513 kcal/day). Even in overweight/obese children the mean difference between El and TEE was only 86 kcal/day. Among the participants, 28(78%) were classified as AER, five (14%) as HER and three (8%) as LER. Conclusion: Two proxy-reported 24-HDRs were found to be a valid instrument to assess El on group level but not on the individual level. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
|
|
| 18. |
- Bosaeus, Ingvar, et al.
(författare)
-
Reply to Thibault & Genton
- 2014
-
Ingår i: Clinical Nutrition. - 0261-5614 .- 1532-1983. ; 33:6, s. 1158-1159
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 19. |
- Bosaeus, Ingvar, et al.
(författare)
-
Reply to Thibault & Genton
- 2014
-
Ingår i: Clinical Nutrition. - : Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 33:6, s. 1158-1159
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 20. |
- Bosaeus, Ingvar, et al.
(författare)
-
Skeletal muscle mass in hospitalized elderly patients : comparison of measurements by single-frequency BIA and DXA
- 2014
-
Ingår i: Clinical Nutrition. - 0261-5614 .- 1532-1983. ; 33:3, s. 426-431
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: There is increasing interest in estimating skeletal muscle mass (SMM) in clinical practice. We aimed to validate a bioelectrical impedance analysis (BIA) prediction equation for SMM, developed in a different healthy elderly population, in a population of hospital patients aged 70 and over, by comparison with dual-energy X-ray absorptiometry (DXA) SMM estimates. Comparison was also made with two other previously published BIA muscle prediction equations.METHODS: Muscle measurements by BIA and DXA were compared in 117 patients with a range of clinical conditions (45 female, 72 male, mean age 75 years).RESULTS: The BIA equation used yielded an accurate estimate of DXA-derived SMM. Mean (SD) difference was 0.26(1.79) kg (ns). The two other BIA equations over-estimated SMM compared to DXA (both p < 0.001), but all equations were highly correlated.CONCLUSIONS: The BIA equation used, developed in a different healthy elderly population, gave an accurate estimate of DXA-derived SMM in a population with various clinical disorders. BIA appears potentially capable to estimate SMM in clinical disorders, but the optimal approach to its use for this purpose requires further investigation.
|
|
| 21. |
- Cerantola, Yannick, et al.
(författare)
-
Guidelines for perioperative care after radical cystectomy for bladder cancer : enhanced Recovery After Surgery (ERAS(®)) society recommendations
- 2013
-
Ingår i: Clinical Nutrition. - Edinburgh, UK : Churchill-Livingstone. - 0261-5614 .- 1532-1983. ; 32:6, s. 879-887
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Enhanced recovery after surgery (ERAS) pathways have significantly reduced complications and length of hospital stay after colorectal procedures. This multimodal concept could probably be partially applied to major urological surgery.OBJECTIVES: The primary objective was to systematically assess the evidence of ERAS single items and protocols applied to cystectomy patients. The secondary objective was to address a grade of recommendation to each item, based on the evidence and, if lacking, on consensus opinion from our ERAS Society working group.EVIDENCE ACQUISITION: A systematic literature review was performed on ERAS for cystectomy by searching EMBASE and Medline. Relevant articles were selected and quality-assessed by two independent reviewers using the GRADE approach. If no study specific to cystectomy was available for any of the 22 given items, the authors evaluated whether colorectal guidelines could be extrapolated.EVIDENCE SYNTHESIS: Overall, 804 articles were retrieved from electronic databases. Fifteen articles were included in the present systematic review and 7 of 22 ERAS items were studied. Bowel preparation did not improve outcomes. Early nasogastric tube removal reduced morbidity, bowel recovery time and length of hospital stay. Doppler-guided fluid administration allowed for reduced morbidity. A quicker bowel recovery was observed with a multimodal prevention of ileus, including gum chewing, prevention of PONV and minimally invasive surgery.CONCLUSIONS: ERAS has not yet been widely implemented in urology and evidence for individual interventions is limited or unavailable. The experience in other surgical disciplines encourages the development of an ERAS protocol for cystectomy.
|
|
| 22. |
- Deutz, M.E, et al.
(författare)
-
Protein intake and exercise for optimal muscle function with aging : Recommendations from the ESPEN Expert Group
- 2014
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 33:6, s. 929-936
-
Tidskriftsartikel (refereegranskat)abstract
- The aging process is associated with gradual and progressive loss of muscle mass along with lowered strength and physical endurance. This condition, sarcopenia, has been widely observed with aging in sedentary adults. Regular aerobic and resistance exercise programs have been shown to counteract most aspects of sarcopenia. In addition, good nutrition, especially adequate protein and energy intake, can help limit and treat age-related declines in muscle mass, strength, and functional abilities. Protein nutrition in combination with exercise is considered optimal for maintaining muscle function.With the goal of providing recommendations for health care professionals to help older adults sustain muscle strength and function into older age, the European Society for Clinical Nutrition and Metabolism (ESPEN) hosted a Workshop on Protein Requirements in the Elderly, held in Dubrovnik on November 24 and 25, 2013. Based on the evidence presented and discussed, the following recommendations are made (a) for healthy older people, the diet should provide at least 1.0–1.2 g protein/kg body weight/day, (b) for older people who are malnourished or at risk of malnutrition because they have acute or chronic illness, the diet should provide 1.2–1.5 g protein/kg body weight/day, with even higher intake for individuals with severe illness or injury, and (c) daily physical activity or exercise (resistance training, aerobic exercise) should be undertaken by all older people, for as long as possible.
|
|
| 23. |
- Faxén-Irving, Gerd, et al.
(författare)
-
Energy dense oleic acid rich formula to newly admitted geriatric patients - Feasibility and effects on energy intake
- 2011
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 30:2, s. 202-208
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Old patients seldom reach their energy requirements. The effects of an oleic acid rich formula on energy intake and appetite were studied. Methods: Recently admitted geriatric patients (n = 71), likely to stay > 1 week were randomised to receive 30 ml of a fat emulsion (Calogen (R)) 3 times daily, i.e., 420 kcal, at the regular medication rounds (intervention group (IG)) or to standard care (control group (CG)). Food intake and self-rated appetite were registered at baseline, i.e., 2-3 days after admission and on day 8 or the day prior to discharge. Nutritional risk screening (NRS) 2002, serum lipids and fatty acid profiles were analysed. Results: Fifty-one subjects fulfilled the study, i.e., 24 in the IG (83 +/- 7 y) and 27 controls (85 +/- 7 y). NRS showed that two thirds were at risk of malnutrition. Per-protocol analyses indicated that the daily energy intake was around 50% higher in IG compared to CG at the two measurements, respectively (p < 0.0001). The IG displayed a significantly improved appetite compared with the CG (P = 0.021). Serum lipids and fatty acid profile changed favourably by the intervention. Conclusions: An energy dense oleic acid rich liquid supplement given three times daily at medication rounds to geriatric patients may result in increased energy intake and better appetite with positive effects on serum lipids. ClinicalTrials.gov Identifier: NCT01042340.
|
|
| 24. |
- Guest, Julian F., et al.
(författare)
-
Health economic impact of managing patients following a community-based diagnosis of malnutrition in the UK
- 2011
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 30:4, s. 422-429
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: To examine the effect of malnutrition on clinical outcomes and healthcare resource use from initial diagnosis by a general practitioner (GP) in the UK. Methods: 1000 records of malnourished patients were randomly selected from The Health Improvement Network database and matched with a sample of 996 patients' records with no previous history of malnutrition. Patients' outcomes and resource use were quantified for six months following diagnosis. Results: Malnourished patients utilised significantly more healthcare resources (e.g. 18.90 versus 9.12 GP consultations; p < 0.001, and 13% versus 5% were hospitalised; p < 0.05). The six-monthly cost of managing the malnourished and non-malnourished group was 1753 pound and 750 pound per patient respectively, generating an incremental cost of care following a diagnosis of malnutrition of 1003 per patient. Thirteen percent and 2% of patients died in the malnourished and non-malnourished group respectively (p < 0.001). Independent predictors of mortality were: malnutrition (OR: 7.70); age (per 10 years) (OR: 10.46); and the Charlson Comorbidity Index Score (per unit score) (OR: 1.24). Conclusion: The healthcare cost of managing malnourished patients was more than twice that of managing non-malnourished patients, due to increased use of healthcare resources. After adjusting for age and comorbidity, malnutrition remained an independent predictor of mortality. (C) 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
|
|
| 25. |
- Gustafsson, U. O., et al.
(författare)
-
Guidelines for perioperative care in elective colonic surgery : enhanced recovery after surgery (ERAS®) society recommendations
- 2012
-
Ingår i: Clinical Nutrition. - Amsterdam, Netherlands : Elsevier. - 0261-5614 .- 1532-1983. ; 31:6, s. 783-800
-
Forskningsöversikt (refereegranskat)abstract
- Background: This review aims to present a consensus for optimal perioperative care in colonic surgery and to provide graded recommendations for items for an evidenced-based enhanced perioperative protocol.Methods: Studies were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts. For each item of the perioperative treatment pathway, available English-language literature was examined, reviewed and graded. A consensus recommendation was reached after critical appraisal of the literature by the group.Results: For most of the protocol items, recommendations are based on good-quality trials or meta-analyses of good-quality trials (quality of evidence and recommendations according to the GRADE system).Conclusions: Based on the evidence available for each item of the multimodal perioperative-care pathway, the Enhanced Recovery After Surgery (ERAS) Society, International Association for Surgical Metabolism and Nutrition (IASMEN) and European Society for Clinical Nutrition and Metabolism (ESPEN) present a comprehensive evidence-based consensus review of perioperative care for colonic surgery.
|
|
| 26. |
- Hamer, Henrike M., et al.
(författare)
-
Effect of butyrate enemas on inflammation and antioxidant status in the colonic mucosa of patients with ulcerative colitis in remission
- 2010
-
Ingår i: Clinical Nutrition. - Amsterdam, Netherlands : Elsevier. - 0261-5614 .- 1532-1983. ; 29:6, s. 738-744
-
Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Butyrate, produced by colonic fermentation of dietary fibers is often hypothesized to beneficially affect colonic health. This study aims to assess the effects of butyrate on inflammation and oxidative stress in subjects with chronically mildly elevated parameters of inflammation and oxidative stress.Methods: Thirty-five patients with ulcerative colitis in clinical remission daily administered 60 ml rectal enemas containing WO mM sodium butyrate (n = 17) or saline (n = 18) during 20 days (NCT00696098). Before and after the intervention feces, blood and colonic mucosal biopsies were obtained. Parameters of antioxidant defense and oxidative damage, myeloperoxidase, several cytokines, fecal calprotectin and CRP were determined.Results: Butyrate enemas induced minor effects on colonic inflammation and oxidative stress. Only a significant increase of the colonic IL-10/IL-12 ratio was found within butyrate-treated patients (p = 0.02), and colonic concentrations of CCL5 were increased after butyrate compared to placebo treatment (p = 0.03). Although in general butyrate did not affect colonic glutathione levels, the effects of butyrate enemas on total colonic glutathione appeared to be dependent on the level of inflammation.Conclusion: Although UC patients in remission were characterized by low-grade oxidative stress and inflammation, rectal butyrate enemas showed only minor effects on inflammatory and oxidative stress parameters.
|
|
| 27. |
- Hausner, Helene, et al.
(författare)
-
Effects of repeated exposure on acceptance of initially disliked and liked Nordic snack bars in 9-11 year-old children
- 2012
-
Ingår i: Clinical Nutrition. - 0261-5614 .- 1532-1983. ; 31:1, s. 137-143
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Children's food choices are guided by their preferences. It is established, however, that repeated exposure to a novel food increases children's acceptance. This study investigated how acceptance of an initially liked and disliked snack bar develops in 9-11 year-old children. Methods: 315 children were randomised into three groups: A control group (n = 111) and two groups exposed to an initially liked kamut bar (n = 94) and an initially disliked sea buckthorn bar (n = 110). Acceptance of both bars was tested before and after the exposure period, and on the 9th exposure. Results: Intake of both bars increased significantly in the exposure groups. There was no difference in the control groups' intake or liking of the bars between pre and post-testing. Liking rose significantly for children exposed to the disliked sea buckthorn bar, while this was not observed in children exposed to the liked kamut bar. In a post-test children exposed to kamut bars had higher intake of that bar than non-exposed children. This was also observed for the sea buckthorn bar that was also given significantly higher liking scores by the exposure group. Conclusions: The majority of children exposed to an initially disliked bar increase acceptance after nine exposures to the same level as an initially liked bar. Children repeatedly exposed to a liked bar show stable acceptance.
|
|
| 28. |
- Hausner, H., et al.
(författare)
-
Effects of repeated exposure on acceptance of initially disliked and liked Nordic snack bars in 9-11 year-old children
- 2012
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 31:1, s. 137-143
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Children's food choices are guided by their preferences. It is established, however, that repeated exposure to a novel food increases children's acceptance. This study investigated how acceptance of an initially liked and disliked snack bar develops in 9-11 year-old children. Methods: 315 children were randomised into three groups: A control group (n=111) and two groups exposed to an initially liked kamut bar (n=94) and an initially disliked sea buckthorn bar (n=110). Acceptance of both bars was tested before and after the exposure period, and on the 9th exposure. Results: Intake of both bars increased significantly in the exposure groups. There was no difference in the control groups' intake or liking of the bars between pre and post-testing. Liking rose significantly for children exposed to the disliked sea buckthorn bar, while this was not observed in children exposed to the liked kamut bar. In a post-test children exposed to kamut bars had higher intake of that bar than non-exposed children. This was also observed for the sea buckthorn bar that was also given significantly higher liking scores by the exposure group. Conclusions: The majority of children exposed to an initially disliked bar increase acceptance after nine exposures to the same level as an initially liked bar. Children repeatedly exposed to a liked bar show stable acceptance. © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.
|
|
| 29. |
|
|
| 30. |
|
|
| 31. |
|
|
| 32. |
- Lassen, Kristoffer, et al.
(författare)
-
Guidelines for perioperative care for pancreaticoduodenectomy : enhanced recovery after surgery (ERAS®) society recommendations
- 2012
-
Ingår i: Clinical Nutrition. - Amsterdam, Netherlands : Elsevier. - 0261-5614 .- 1532-1983. ; 31:6, s. 817-830
-
Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Protocols for enhanced recovery provide comprehensive and evidence-based guidelines for best perioperative care. Protocol implementation may reduce complication rates and enhance functional recovery and, as a result of this, also reduce length-of-stay in hospital. There is no comprehensive framework available for pancreaticoduodenectomy.Methods: An international working group constructed within the Enhanced Recovery After Surgery (ERAS®) Society constructed a comprehensive and evidence-based framework for best perioperative care for pancreaticoduodenectomy patients. Data were retrieved from standard databases and personal archives. Evidence and recommendations were classified according to the GRADE system and reached through consensus in the group. The quality of evidence was rated "high", "moderate", "low" or "very low". Recommendations were graded as "strong" or "weak".Results: Comprehensive guidelines are presented. Available evidence is summarised and recommendations given for 27 care items. The quality of evidence varies substantially and further research is needed for many issues to improve the strength of evidence and grade of recommendations.Conclusions: The present evidence-based guidelines provide the necessary platform upon which to base a unified protocol for perioperative care for pancreaticoduodenectomy. A unified protocol allows for comparison between centres and across national borders. It facilitates multi-institutional prospective cohort registries and adequately powered randomised trials.
|
|
| 33. |
- Lassen, K., et al.
(författare)
-
Pancreaticoduodenectomy : ERAS recommendations.
- 2013
-
Ingår i: Clinical Nutrition. - Edinburgh, UK : Churchill-Livingstone. - 0261-5614 .- 1532-1983. ; 32:5, s. 870-871
-
Tidskriftsartikel (refereegranskat)
|
|
| 34. |
|
|
| 35. |
- Ljunggren, Stefan, et al.
(författare)
-
Insulin sensitivity and beta-cell function after carbohydrate oral loading in hip replacement surgery : A double-blind, randomised controlled clinical trial
- 2014
-
Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 33:3, s. 392-398
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Surgery initiates a series of physiological stress processes in the body, inducing transient insulin resistance. Preoperative carbohydrate treatment can reduce the latter phenomenon. We investigated the effects of carbohydrate loading on insulin sensitivity and beta-cell function after elective hip replacement.METHODS: Twenty-three nondiabetic patients (mean age of 68 years) who underwent elective hip replacement surgery participated in this double-blind controlled study. The patients were randomised to a nutrition group, which ingested a carbohydrate-rich fluid (50 kcal/100 ml) (Preop(®)), or a control group (tap water flavoured with lemon) 800 ml + 400 ml before the surgery. The insulin response (beta-cell function) and the insulin sensitivity were measured with an intravenous glucose tolerance test (IVGTT) and a hyperinsulinaemic euglycaemic glucose clamp, respectively, one day before and two days after the surgery.RESULTS: Insulin sensitivity decreased by 51% (median; 25-75th percentiles 35-61) after ingesting Preop(®) and by 39% (21-51) after ingesting in the control group (n.s.). The postoperative IVGTT in the nutrition group was followed by a significantly larger area under the curve (AUC) for plasma insulin (+54% versus the preoperative IVGTT) compared to the control group (+7%). This difference was already apparent during the first phase (0-10 min) of insulin secretion (+20 and -21%, respectively; P < 0.05).CONCLUSIONS: The patients randomised to the carbohydrate oral fluid or the water prior to the surgery demonstrated a significant but similar decrease in insulin sensitivity. The carbohydrates increased the beta-cell function as a compensatory response to the disposition index, resulting in a smaller reduction in surgery-induced insulin resistance compared to the tap water. The study was registered at http://www.clinicaltrials.gov (NCT01774084).
|
|
| 36. |
- Ljungqvist, Olle, et al.
(författare)
-
The European fight against malnutrition
- 2010
-
Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 29:2, s. 149-150
-
Tidskriftsartikel (refereegranskat)
|
|
| 37. |
- Montelius, Caroline, et al.
(författare)
-
Dietary thylakoids suppress blood glucose and modulate appetite-regulating hormones in pigs exposed to oral glucose tolerance test.
- 2014
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 33:6, s. 1122-1126
-
Tidskriftsartikel (refereegranskat)abstract
- Dietary chloroplast thylakoids have previously been found to reduce food intake and body weight in animal models, and to change metabolic profiles in humans in mixed-food meal studies. The aim of this study was to investigate the modulatory effects of thylakoids on glucose metabolism and appetite-regulating hormones during an oral glucose tolerance test in pigs fed a high fat diet.
|
|
| 38. |
- Muscaritoli, M, et al.
(författare)
-
Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) "cachexia-anorexia in chronic wasting diseases" and "nutrition in geriatrics".
- 2010
-
Ingår i: Clinical nutrition (Edinburgh, Scotland). - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 29:2, s. 154-9
-
Tidskriftsartikel (refereegranskat)abstract
- Chronic diseases as well as aging are frequently associated with deterioration of nutritional status, loss muscle mass and function (i.e. sarcopenia), impaired quality of life and increased risk for morbidity and mortality. Although simple and effective tools for the accurate screening, diagnosis and treatment of malnutrition have been developed during the recent years, its prevalence still remains disappointingly high and its impact on morbidity, mortality and quality of life clinically significant. Based on these premises, the Special Interest Group (SIG) on cachexia-anorexia in chronic wasting diseases was created within ESPEN with the aim of developing and spreading the knowledge on the basic and clinical aspects of cachexia and anorexia as well as of increasing the awareness of cachexia among health professionals and care givers. The definition, the assessment and the staging of cachexia, were identified as a priority by the SIG. This consensus paper reports the definition of cachexia, pre-cachexia and sarcopenia as well as the criteria for the differentiation between cachexia and other conditions associated with sarcopenia, which have been developed in cooperation with the ESPEN SIG on nutrition in geriatrics.
|
|
| 39. |
- Nygren, J, et al.
(författare)
-
Guidelines for perioperative care in elective rectal/pelvic surgery : enhanced recovery after surgery (ERAS®) Society recommendations
- 2012
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 31:6, s. 801-816
-
Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: This review aims to present a consensus for optimal perioperative care in rectal/pelvic surgery, and to provide graded recommendations for items for an evidenced-based enhanced recovery protocol.METHODS: Studies were selected with particular attention paid to meta-analyses, randomized controlled trials and large prospective cohorts. For each item of the perioperative treatment pathway, available English-language literature was examined, reviewed and graded. A consensus recommendation was reached after critical appraisal of the literature by the group.RESULTS: For most of the protocol items, recommendations are based on good-quality trials or meta-analyses of good-quality trials (evidence grade: high or moderate).CONCLUSIONS: Based on the evidence available for each item of the multimodal perioperative care pathway, the Enhanced Recovery After Surgery (ERAS) Society, European Society for Clinical Nutrition and Metabolism (ESPEN) and International Association for Surgical Metabolism and Nutrition (IASMEN) present a comprehensive evidence-based consensus review of perioperative care for rectal surgery.
|
|
| 40. |
- Perez-Martinez, Pablo, et al.
(författare)
-
Gene-nutrient interactions on the phosphoenolpyruvate carboxykinase influence insulin sensitivity in metabolic syndrome subjects
- 2013
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 32:4, s. 630-635
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Genetic background may interact with habitual dietary fat composition, and affect development of the metabolic syndrome (MetS). The phosphoenolpyruvate carboxykinase gene (PCK1) plays a significant role regulating glucose metabolism, and fatty acids are key metabolic regulators, which interact with transcription factors and influence glucose metabolism. We explored genetic variability at the PCK1 gene locus in relation to degree of insulin resistance and plasma fatty acid levels in MetS subjects. Moreover, we analyzed the PCK1 gene expression in the adipose tissue of a subgroup of MetS subjects according to the PCK1 genetic variants. Methods: Insulin sensitivity, insulin secretion, glucose effectiveness, plasma concentrations of C-peptide, fatty acid composition and three PCK1 tag-single nucleotide polymorphisms (SNPs) were determined in 443 MetS participants in the UPGENE cohort. Results: The rs2179706 SNP interacted with plasma concentration of n - 3 polyunsaturated fatty acids (n - 3 PUFA), which were significantly associated with plasma concentrations of fasting insulin, peptide C, and HOMA-IR. Among subjects with n - 3 PUFA levels above the population median, carriers of the C/C genotype exhibited lower plasma concentrations of fasting insulin (P = 0.036) and HOMA-IR (P = 0.019) as compared with C/C carriers with n - 3 PUFA below the median. Moreover, homozygous C/C subjects with n - 3 PUFA levels above the median showed lower plasma concentrations of peptide C as compared to individuals with the T-allele (P = 0.006). Subjects carrying the T-allele showed a lower gene PCK1 expression as compared with carriers of the C/C genotype (P = 0.015). Conclusions: The PCK1 rs2179706 polymorphism interacts with plasma concentration of n - 3 PUFA levels modulating insulin resistance in MetS subjects.
|
|
| 41. |
- Pyshchyta, Ganna, et al.
(författare)
-
Tea consumption, incidence and long-term prognosis of a first acute myocardial infarction : The SHEEP study
- 2012
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 31:2, s. 267-272
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Results of previous studies on tea consumption and incidence or prognosis of acute myocardial infarction (AMI) are conflicting. The aim of the present study was to examine the potential role of tea consumption in the previous 12 months in primary and secondary prevention of AMI. METHODS: We studied a total of 1340 individuals with a first non-fatal AMI and 2303 frequency matched control participants on age, gender and hospital catchment area including querying their tea consumption over the previous 12 months. The cohort of AMI cases was then followed for total and cardiac mortality and for non-fatal cardiovascular events with national registers over 8 years. Estimates of relative risks for a first AMI were based on odds ratios from unconditional logistic regression and Cox proportional hazards models were used to examine the prognostic importance of tea consumption in the cohort of cases. RESULTS: The prevalence of daily tea consumption was 20.5% among cases and 21.5% among controls. Tea consumption was associated with a lower risk for a first AMI with adjustment for matching criteria alone, with an odds ratio of 0.78 (95% confidence interval, 0.64-0.95) comparing those who consumed tea daily to those never consuming tea. However, in multivariable adjusted model there was no evidence for an association, the corresponding odds ratio was 1.08(0.86-1.36). There was also no association between tea consumption and cardiac mortality and non-fatal cardiovascular events, with a corresponding adjusted hazard ratio of 0.99(0.77-1.27). CONCLUSIONS: In this epidemiological study, greater tea consumption in the previous year was associated with a lower risk of AMI. However, a clear association between tea consumption and the incidence or prognosis of AMI was not demonstrated, probably because of tea drinkers having a healthier lifestyle.
|
|
| 42. |
- Schindler, Karin, et al.
(författare)
-
How nutritional risk is assessed and managed in European hospitals : a survey of 21,007 patients findings from the 2007-2008 cross-sectional nutritionDay survey
- 2010
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 29:5, s. 552-559
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Recognition and treatment of undernutrition in hospitalized patients are not often a priority in clinical practice.OBJECTIVES: We investigated how the nutritional risk of patients is determined and whether such assessment influences daily nutritional care across Europe and in Israeli hospitals.METHODS: 1217 units from 325 hospitals in 25 countries with 21,007 patients participated in a longitudinal survey "nutritionDay" 2007/2008 undertaken in Europe and Israel. Screening practice, the type of tools used and whether energy requirements and intake are assessed and monitored were surveyed using standardized questionnaires.RESULTS: Fifty-two percent (range 21-73%) of the units in the different regions reported a screening routine which was most often performed with locally developed methods and less often with national tools, the Nutrition Risk Screening-2002, or the Malnutrition Universal Screening Tool. Twenty-seven percent of the patients were subjectively classified as being "at nutritional risk", with substantial differences existing between regions. Independent factors influencing the classification of nutritional risk included age, BMI <18.5 kg/m(2), unintentional weight loss, reduced food intake in the previous week and on nutritionDay (for all parameters, p < 0.0001). The energy goal was defined as >=1500 kcal in 76% of the patients, but 43% of patients did not reach this goal.CONCLUSIONS: The process of nutrition risk assessment varied between units and countries. Additionally, energy goals were frequently not met. More effort is needed to implement current guidelines within daily clinical practice.
|
|
| 43. |
|
|
| 44. |
- Söderström, Lisa, 1982-, et al.
(författare)
-
Mealtime habits and meal provision are associated with malnutrition among elderly patients admitted to hospital
- 2013
-
Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 32:2, s. 281-288
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Large-scale studies performed in hospitals with the validated Mini Nutritional Assessment tool (MNA) are scarce. However, factors associated with malnutrition are important for identifying individuals at risk. The aims of the present study were to estimate the prevalence of malnutrition and to examine the association between mealtime habits, meal provision, and malnutrition among elderly patients admitted to hospital.Methods: This cross-sectional study included patients aged ≥ 65 years admitted to internal medicine, surgical or orthopaedic wards. The MNA was used for their nutritional assessment, and factors potentially associated with malnutrition were recorded.Results: Of 1771 patients (mean age 78 years), 35.5% were well-nourished, 55.1% were at risk of malnutrition and 9.4% were malnourished. Overnight fasts exceeding 11 hours, fewer than four eating episodes a day, and not cooking independently were associated with both malnutrition and risk of malnutrition.Conclusions: The risk of malnutrition was high among elderly patients admitted to hospital, whereas the proportion with fully developed malnutrition was lower than expected. A long overnight fast, few eating episodes, and not cooking independently were associated with an increased risk of malnutrition. Knowledge of these factors when providing care to the elderly may assist health-care professionals to prevent malnutrition.
|
|
| 45. |
- Söderström, Lisa, 1982-, et al.
(författare)
-
Nutritional status predicts preterm death in older people : a prospective cohort study
- 2014
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 33:2, s. 354-359
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: There is an association between malnutrition and mortality. However, it is uncertain whether this association is independent of confounders. The aim of the present study was to examine whether nutritional status, defined according to the three categories in the full Mini Nutritional Assessment (MNA) instrument, is an independent predictor of preterm death in people 65 years and older. Methods: This prospective cohort study included individuals aged >= 65 years who were admitted to hospital between March 2008 and May 2009 and followed-up after 50 months (n = 1767). Nutritional status was assessed with the MNA, and possible risk factors associated with malnutrition were recorded during participants hospital stay. Main outcome measure was overall survival. Results: Based on the MNA definitions, 628 (35.5%) were well-nourished, 973 (55.1%) were at risk of malnutrition, and 166 (9.4%) of the participants were malnourished at baseline. During the follow-up period 655 (37.1%) participants died. At follow-up, the survival rates were 75.2% for well-nourished participants, 60.0% for those at risk of malnutrition, and 33.7% for malnourished participants (p < 0.001). After adjusting for confounders the hazard ratios (95% CI) for all-cause mortality were 1.56 (1.18-2.07) in the group at risk of malnutrition and 3.71 (2.28-6.04) in the malnourished group. Conclusions: Nutritional status defined according to the three categories in the full MNA independently predicts preterm death in people aged 65 years and older. These findings are clinically important and emphasise the usefulness of the MNA for screening of nutritional status.
|
|
| 46. |
- Thoresen, Lene, et al.
(författare)
-
Nutritional status, cachexia and survival in patients with advanced colorectal carcinoma. Different assessment criteria for nutritional status provide unequal results
- 2013
-
Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 32:1, s. 65-72
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Different nutrition assessment tools and definitions are proposed for cancer-associated malnutrition and wasting (cachexia). We studied the associations between these assessments and overall survival in stage IV colorectal carcinoma patients. Methods: Anthropometric measures, energy intake, biochemical variables, nutritional risk screening, assessment of malnutrition, cachexia and body composition from computed tomography images were analysed, in 77 patients from Norway and Canada. Results were dichotomized into presence or absence of nutritional risk, malnutrition, cachexia and sarcopenia (low muscle mass) and associated with survival. Results: Overall, 22% up to 55% of the patients had cachexia according to different cachexia criteria: 34% were malnourished, 42% were at nutritional risk, and 39% were sarcopenic. Forty-four percent of the patients did not meet criteria for any of these conditions. Patients with cachexia defined by Cancer Cachexia Study Group (CCSG) had shorter survival in an unadjusted analysis, [Hazard ratio (HR) = 2.43; 95% confidence interval (CI) 1.32-4.47; P = 0.005]. After adjusting for nation, age and gender, cachexia (HR = 2.26; CI 1.18-432; P = 0.014) and malnutrition (HR = 1.83; CI 1.06-3.13; P = 0.029) remained significant predictors of survival. Conclusions: Nutritional depletion in up to 55% of the patients was found. The lack of concordance between the results obtained by different assessment criteria was obvious. CCSGs cachexia score was the best prognostic factor for overall survival.
|
|
| 47. |
- Törmä, Johanna, et al.
(författare)
-
Does undernutrition still prevail among nursing home residents?
- 2013
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 32:4, s. 562-568
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMSDuring recent years public awareness about malnutrition has increased and collective initiatives have been undertaken. Simultaneously, the number of older adults is increasing, and the elderly care has been placed under pressure. The aim was to assess the nutritional situation and one-year mortality among nursing home (NH) residents, and compare with historical data.METHODSMini Nutritional Assessment-Short Form (MNA-SF), ADL Barthel Index (BI), Short Portable Mental Status Questionnaire (SPMSQ), EQ-5D, Charlson Comorbidity Index (CCI), and blood samples were collected from 172 NH residents (86.3 ± 8 years, 70% women). Mortality data was taken from NH records. Nutritional data from 166 NH residents (83.8 ± 8 years, 61% women) examined in 1996 was retrieved for historical comparison.RESULTSThe prevalence of malnutrition was 30%, as compared to 71% in the historical data set, corresponding to a present average body mass index of 23.7 ± 5.1 compared with 22.3 ± 4.2 kg/m(2) (p < 0.01). Reduced nutritional status was associated with decline in function (p < 0.001) and cognition (p < 0.01). One-year mortality was 24%. Regression analyses indicated high age (OR = 1.09, 95% CI (1.03-1.16)), high scores in CCI (OR = 1.54, (1.19-1.99)), low BMI (OR = 2.47, (1.14-5.38)) and malnutrition (OR = 2.37, (1.07-5.26)) to be independently associated with one-year mortality.CONCLUSIONSMalnutrition still prevails and is associated with deteriorated cognition, function and increased mortality. A possible improvement in nutritional status in NH residents over time was observed.
|
|
| 48. |
- Varadhan, Krishna K, et al.
(författare)
-
The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery : a meta-analysis of randomized controlled trials
- 2010
-
Ingår i: Clinical Nutrition. - Edinburgh, United Kingdom : Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 97, s. 35-36
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: The aim of the Enhanced Recovery After Surgery (ERAS) pathway is to attenuate the stress response to surgery and enable rapid recovery. The objective of this meta-analysis was to study the differences in outcomes in patients undergoing major elective open colorectal surgery within an ERAS pathway and those treated with conventional perioperative care.Methods: Medline, Embase and Cochrane database searches were performed for relevant studies published between January 1966 and November 2009. All randomized controlled trials comparing ERAS with conventional perioperative care were selected. The outcome measures studied were length of hospital stay, complication rates, readmission rates and mortality.Results: Six randomized controlled trials with 452 patients were included. The number of individual ERAS elements used ranged from 4 to 12, with a mean of 9. The length of hospital stay [weighted mean difference (95% confidence interval): -2.55 (-3.24, -1.85)] and complication rates [relative risk (95% confidence interval): 0.53 (0.44, 0.64)] were significantly reduced in the enhanced recovery group. There was no statistically significant difference in readmission and mortality rates.Conclusion: ERAS pathways appear to reduce the length of stay and complication rates after major elective open colorectal surgery without compromising patient safety.
|
|
| 49. |
- Vidlund, Mårten, et al.
(författare)
-
The S-100B substudy of the GLUTAMICS-trial : glutamate infusion not associated with sustained elevation of plasma S-100B after coronary surgery
- 2010
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 29:3, s. 358-364
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aimsConcerns have been raised about potential neurological injury related to exogenous glutamate. In cardiac surgery glutamate has been administered as a putative cardioprotective agent by cardioplegia or intravenous infusion. In the GLUTAMICS trial, in addition to surveillance of clinical neurological injuries, a prespecified subgroup was analyzed with regard to postoperative S-100B levels to detect potential subclinical neurological injury related to glutamate infusion.MethodsSixty-nine patients operated on for unstable coronary syndrome were randomized to intravenous infusion of glutamate (n=35) or saline (n=34) perioperatively. Plasma levels of S-100B were obtained on the third postoperative day.ResultsS-100B in the glutamate group and the control group were 0.079±0.034μg/L and 0.090±0.042μg/L respectively (p=0.245). There were no patients with stroke or mortality. Three patients in the control group and two in the glutamate group had postoperative confusion. These patients had significantly elevated S-100B compared with those without confusion (0.132±0.047vs 0.081±0.036μg/L; p=0.003). Overall, 21 patients had S-100B above reference level (≥0.10μg/L) and these patients had significantly more calcifications in the ascending aorta on epiaortic scanning.ConclusionsIntravenous glutamate infusion during surgery for unstable coronary artery disease did not initiate a sustained elevation of plasma S-100B. Thus, no evidence for subclinical neurological injury related to glutamate infusion was found. In contrast, postoperative elevation of plasma S-100B was linked to calcification of the ascending aorta and postoperative confusion.
|
|
| 50. |
- Vikdahl, Magdalena, et al.
(författare)
-
Weight gain and increased central obesity in the early phase of Parkinson's disease
- 2014
-
Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 33:6, s. 1132-1139
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Weight loss is strongly associated with Parkinson's disease (PD) and impacts symptoms and disease progression. The aim of this study was to describe changes in body composition and to explore how body weight (BW), relates to disease progression and medication in the early phase of PD.METHODS: Participants in a prospective community-based case-control study of PD were followed-up three years after initial diagnosis. Anthropometric and bioelectrical impedance spectroscopy (BIS) measurements were used together with Mini Nutritional Assessment (MNA), a 24-h recall (24-HR) and a 3-day food registration (3-DFR) to complete the evaluation of nutritional status. Disease severity was assessed using the Mini Mental State Examination (MMSE), the Unified Parkinson's Disease Rating Scale motor score (UPDRS III), and the Hoehn and Yahr rating.RESULTS: The PD patients' BW gained 1.62 kg (±4.60, P = 0.009), an increase that significantly correlated with fat mass (FM) (r = 0.74), waist size (r = 0.65), waist/height ratio (r = 0.64), and total skin fold (r = 0.77). Linear regression showed an association between change in BW and physical activity level (PAL) (B = -8.554; P = 0.025) confirmed by the multiple linear regression. Linear regression also revealed an association between change in FM and MMSE (B = 0.654; P = 0.027).CONCLUSION: In early PD, weight gain was revealed over three years accompanied by an increase in FM and waist circumference. An inverse relation was revealed between change in BW and PAL. The MMSE, UPDRS III, and Hoehn and Yahr rating were unchanged. Medication and swallowing difficulties were not associated with change in BW.
|
|
