The expression of IL-17 and related cytokines, such as IL-22, was demonstrated in acute eczematous lesions independent of their pathogenesis. Our results suggest a potential role for IL-17 in remodeling of the skin.

BACKGROUND: There are no specific Swiss home parenteral nutrition (HPN) data showing patient characteristics, quality of life (QoL) and complications. The goal of this study was to collect representative nationwide data on current adult HPN patients in Switzerland for international comparability and benchmarking. METHODS: This was a multicenter, nationwide, observational study. We conducted interviews for demographics, PN characteristics, QoL and complications. The data were assessed at baseline and after a follow-up of 3 months using a questionnaire. RESULTS: Thirty-three adult patients were included. The most common underlying diseases were cancer, radiation enteritis and state after bariatric surgery, and the most prevalent indication was short bowel syndrome. During the 3-month observation period, significant increase or stabilization of body weight occurred in the patients, physical activity scores improved from 34.0 to 39.4 and mental scores improved from 41.9 to 46.4. HPN dependency and traveling restrictions were of the greatest concern. Diarrhea, xerostomia and/or thirst were frequent complaints. CONCLUSION: Anthropometric parameters and QoL improved during the observational period in this HPN cohort. These Swiss HPN data are prerequisite for evaluation and comparison of HPN recommendations and best clinical practice, status of professional care instructions related to HPN effectiveness, quality of treatment and patient safety.

Background Patients undergoing salvage surgery for recurrent head and neck squamous cell carcinoma are at high risk of postoperative complications due to the adverse effects of radiotherapy on wound healing. Malnutrition is an additional risk factor and we tested the hypothesis that preoperative administration of immunonutrition would decrease complications in this high risk population. Methods This single armed study with historical control included consecutive patients undergoing salvage surgery for recurrent head and neck squamous cell carcinoma. We compared outcomes before and after implementation of preoperative immunonutrition and adjusted the regression analysis for gender, age, body mass index, Nutritional Risk Screening (NRS 2002), tobacco and alcohol consumption, tumor localization, tumor stage, and type of surgery. The primary endpoint was overall complications from surgery within a follow-up of 30 days. Results Ninety-six patients were included (intervention group: 51, control group: 45). Use of preoperative immunonutrition was associated with a significant reduction in overall complications (35% vs. 58%, fully-adjusted odds ratio 0.30 (95%CI 0.10–0.91, p = 0.034). Length of hospital stay was also significantly reduced (17 days vs. 6 days, p = < 0.001). No differences in mortality and hospital readmission were found. These results remained robust in multivariate analysis. Conclusions In patients undergoing salvage surgery for recurrent head and neck squamous cell carcinoma, preoperative immunonutrition exhibited favorable effects on the complication rate and consequently reduced the length of hospital stay. By improving both tissue regeneration and immune response, immunonutrition may help to improve surgical outcomes in this high-risk population.

Zusammenfassung Die physiologische Ern?hrung erfolgt oral. Ist eine ad?quate und ausreichende Ern?hrung ?ber den enteralen Weg nicht m?glich, erlaubt die parenterale Zufuhr eine erg?nzende oder vollst?ndige Ern?hrung. Dabei werden Fl?ssigkeit und N?hrstoffe in der Regel als AiO-Mischung (AiO: All-in-one) zentralven?s zugef?hrt. Eine parenterale Ern?hrung (PE) ist bei m?glicher enteraler Ern?hrung kontraindiziert. Sie ist aufwendiger, anspruchsvoller und potenziell mit z.?T. schweren oder sogar t?dlichen Komplikationen behaftet. Die PE erfordert ein striktes aseptisches Arbeiten, ein pharmazeutisch korrektes Zusammenmischen der gel?sten und daher reaktiven Makro- und Mikron?hrstoffe (Ber?cksichtigung der Stabilit?t und Kompatibilit?t). Die PE-Zusammensetzung muss den Bed?rfnissen und der metabolischen Kapazit?t (Toleranz) angepasst und entsprechend ?berpr?ft werden. Dies erfordert medizinischen, pharmazeutischen und pflegerischen Support sowie eine Ern?hrungsberatung. Die notwendigen administrativen und kostenbezogenen Anforderungen, die regelm??ige ?berpr?fung der Indikation, der Zusammensetzung der PE und der Art der i.?v. Zufuhr sind Teil dieser Aufgaben. PE erfordert Erfahrung, angepasste Qualit?tssicherung und eine regelm??ige, dokumentierte Schulung des begleitenden Ern?hrungsteams, des Patienten und der Angeh?rigen. Da die PE eine komplexe, therapeutisch anspruchsvolle Behandlung unter Einbezug verschiedener Partner innerhalb und au?erhalb des Krankenhauses (Schnittstellen) erfordert, ist sie auch kritisch f?r ?Medikationsfehler?, die in der Regel vermeidbar oder reduzierbar sind.