A táplálásterápia hatékonyságának vizsgálata                     gyulladásos bélbetegségben szenvedők gondozása során

Molnár, Andrea; Csontos, Á; Dakó, Sarolta; Hencz, Rita; Anton, Dániel Áron; Pálfi, Erzsébet; Miheller, Pál

doi:10.1556/650.2017.30719

Cited by 4 publications

(1 citation statement)

References 24 publications

(30 reference statements)

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“…The general nutrition screening tools cannot identify the muscle attenuation, and the harm of muscle mass reduction in the CD patients has not received extensive attention in China. The European Society for Parenteral and Enteral Nutrition defines malnutrition as a state in which nutrient deficiency or inadequate intake leads to changes in the body composition (reduction of FFMI or cell number), causing the physical and the mental dysfunction and affecting the clinical outcome of diseases (13). According to the Global Leadership Initiative on Malnutrition (GLIM) 2019, CD patients may be diagnosed with malnutrition when the skeletal muscle mass index (SMI) reduces (≤7 kg/m 2 for men and ≤5.7 kg/m 2 for women) (14).…”

Section: Introductionmentioning

confidence: 99%

Role of Human Body Composition Analysis and Malnutrition Risk Questionnaire in the Assessment of Nutritional Status of Patients With Initially Diagnosed Crohn's Disease

et al. 2020

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Objective: This study was carried out to investigate the role and necessity of human body composition analysis in assessing the nutritional status of initially diagnosed Crohn's disease (CD) patients.Methods: A total of 47 initially diagnosed CD patients were recruited. The skeletal muscle mass index (SMI), fat-free mass index (FFMI), body fat mass, body fat percent, visceral fat area (VFA), and body cell mass were determined with the Biospace Inbody S10 composition analyzer.Results: In 47 patients with initially diagnosed CD, SMI could determine the muscular mass reduction that could not be determined by the body mass index (BMI) (35.3%), albumin (ALB) (65.6%), nutrition risk screening (NRS)2002 (25.0%), and Patient-Generated Subjective Global Assessment (PG-SGA) (55.6%). FFMI could determine the malnutrition that could not be determined by the BMI (58.8%), albumin (90.6%), NRS2002 (50.0%), and PG-SGA (55.6%). VFA in the fistulizing CD patients was significantly higher than in the stricturing and non-fistulizing, non-stricturing patients (P < 0.05). SMI and BMI had the same performance (P = 1.000) and general consistence (Kappa = 0.487, P = 0.001) in the assessment of malnutrition; SMI and ALB had different performance (P < 0.001) and inconsistence was noted (Kappa = 0.069, P = 0.489) in the assessment of malnutrition; the results of the nutrition assessment were different between SMI and NRS2002 (P = 0.002), and inconsistence was observed (Kappa = 0.190, P = 0.071). SMI and PG-SGA had the same performance in the assessment of nutrition (P = 0.143), but there was inconsistence (Kappa = 0.099, P = 0.464). FFMI and BMI had general consistence in the assessment of malnutrition (Kappa = 0.472, P < 0.001), but the positive rate determined by FFMI (85.1%) was markedly higher than that by BMI (63.8%) (P = 0.002). FFMI and ALB had different performance in the assessment of malnutrition Kurban et al. Nutritional Status of Patients With CD(P < 0.001) and there was inconsistence (Kappa = −0.008, P = 0.877). FFMI and NRS2002 had the same performance in the assessment of malnutrition (P = 0.453), but the consistence was poor (Kappa = 0.286, P = 0.039). The results determined by SMI and PG-SGA were consistent (P = 0.727), but the consistence was poor (Kappa = 0.399, P = 0.006). Conclusion:Human body composition analysis can identify the patients with muscular mass reduction that cannot be identified by commonly used nutrition assessment scales/parameters. Thus, it is helpful for the assessment of disease severity and also important for the nutrition assessment in CD patients.

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Section: Introductionmentioning

confidence: 99%

Role of Human Body Composition Analysis and Malnutrition Risk Questionnaire in the Assessment of Nutritional Status of Patients With Initially Diagnosed Crohn's Disease

et al. 2020

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A dysphagia táplálásterápiája stroke-betegek esetében – 2021

Kovács

Szabó

Óváry

et al. 2021

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Összefoglaló. A neurológiai betegek körében a dysphagia előfordulása gyakori, és több oka van. Az utóbbi évek kutatásai a közvetlen neurológiai kórokok (beleértve a gyakori stroke) szerepét is részletesen feltárták. Felismerték az ún. néma aspiráció jelentőségét: ez gyakran áll az (aspirációs) pneumonia hátterében, amely sokszor halálos szövődmény lehet. Az ún. poststroke pneumonia fogalma gyökeresen más értelmezésbe helyezte a stroke-ot követő tüdőgyulladások megítélését, jellegzetessége alapján egyértelműen a stroke közvetlen cerebralis hatásaként alakul ki. Egyértelművé vált a nyelészavar korai felismerésének és ellátásának szükségessége. A stroke-betegek megfelelő tápláltsági állapota az eredményes rehabilitációnak, a szövődményszám csökkentésének, a rövidebb kórházi kezelésnek, az alacsonyabb mortalitásnak a záloga. A dysphagia a betegség kimenetelének független előrejelzője lehet, különösen az első három hónapban. A nyelészavar malnutritióval, kiszáradással és a kórházi tartózkodás hosszabb időtartamával jár együtt, emeli a gyógyszerköltségeket. A stroke-beteg ellátásának egyik első eleme a dysphagia szűrése. Táplálásterápiára akkor szorul a stroke-beteg, amikor magas a kóros tápláltsági állapot kialakulásának kockázata, és per os táplálással nem fedezhető biztonságosan a megfelelő energia-, tápanyag- és folyadékbevitel. A táplálásterápia módját, eszközeit, az energia- és tápanyagbeviteli célértékeket az orvos határozza meg, az alapbetegség súlyosságától, a társbetegségektől és a laborértékektől függően. Az étrend minden esetben individuális és progresszív, azaz alkalmazkodik a beteg állapotához és annak változásához. A dietetikus feladata a megfelelő diéta összeállítása mellett a beteg, a hozzátartozó és a kezelőszemélyzet oktatása, az állapot követése, a beteg tápláltsági állapotának, tápanyagbeviteli értékeinek gyakori elemzése, szükség esetén tápszerek ajánlása. Orv Hetil. 2021; 162(40): 1601–1609. Summary. Among neurological patients, the incidence of dysphagia is common and has several causes. Research in recent years has explored the role of direct neurological pathogens (including frequent strokes). The frequency of ’silent aspiration’, which often underlies (aspirational) pneumonia and can be a fatal complication, has been recently discovered. The concept of ’post-stroke pneumonia’ has drastically changed the assessment of post-stroke pneumonia. Based on its characteristics, it clearly develops as a direct cerebral effect of stroke. The need for early detection and early care of swallowing disorder has become clear. Adequate nutritional status of stroke patients is the key to successful rehabilitation, reduction of complications, shorter hospitalization, and lower mortality. Dysphagia can be an independent predictor of disease outcome, especially in the first three months. Swallowing disorder is associated with malnutrition, dehydration and longer lengths of hospital stay, increasing drug costs. One of the first elements in the care of a stroke patient is screening for dysphagia. The stroke patient needs nutritional therapy when the risk for abnormal nutritional condition is high or if the condition is already present, or when oral nutrition does not safely cover adequate energy, nutrient and fluid intake. The method and means of nutritional therapy, the goals of energy and nutrient intake are determined by the doctor, depending on the severity of the underlying disease, comorbidities and laboratory values.The diet is individual and progressive in each case. The dietitian’s task is not only to compile a proper diet, but also to educate the patients and relatives. The dietitian is responsible for monitoring the patient’s nutritional status. Orv Hetil. 2021; 162(40): 1601–1609.

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GLIM criteria using NRS-2002 and MUST as the first step adequately diagnose the malnutrition in Crohn’s disease inpatients: A retrospective study

Wang

Guo²,

Liu³

et al. 2023

Front. Nutr.

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ObjectiveThe Global Leader Initiative on Malnutrition (GLIM) criteria have been recommended for malnutrition diagnosis recently, for which the first step is malnutrition risk screening with any validated tool. This study aims to investigate the incidence of nutritional risk and malnutrition in Crohn’s disease inpatients and compare the suitability of Nutritional Risk Screening 2002 (NRS-2002) and Malnutrition Universal Screening Tool (MUST) as the first-step screening tool for GLIM criteria.MethodsWe retrospectively analyzed the clinical data of Crohn’s disease inpatients in our hospital from August 2016 to December 2019. NRS-2002 and MUST were used for nutritional screening at the time of admission. GLIM and Patient Generated-Subjective Global Assessment (PG-SGA) were used for malnutrition assessment, respectively. Patients without nutritional risk screened by NRS-2002 but with malnutrition risk screened by MUST were especially screened out. The appendicular skeletal muscle mass index (ASMI), fat-free mass index (FFMI), body fat percent (BFP), and body cell mass (BCM) were measured by the Biospace Inbody S10 composition analyzer.ResultsA total of 146 Crohn’s disease patients were enrolled, of which 62.3 and 89.7% had nutritional or malnutrition risk according to NRS-2002 and MUST, respectively. The prevalence of malnutrition assessed by GLIM was 59.6% (87 cases) and 82.2% (120 cases) when NRS-2002 and MUST were used as the first step of GLIM respectively. Meanwhile, 99 patients (67.8%) had malnutrition when assessed by PG-SGA. There were 41 patients who were not at nutritional risk according to NRS-2002 but were at malnutrition risk determined by MUST. At last, 33 patients were GLIM-defined, and 16 patients were PG-SGA-defined malnutrition among the 41 patients.ConclusionThe nutritional risk or malnutrition is common in Crohn’s disease inpatients. It is recommended to use a variety of nutritional assessment tools for Crohn’s disease inpatients. MUST can be used as a good supplement for the patients with a score of NRS-2002 lower than 3 in order to decrease the miss rate of GLIM-defined malnutrition.

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A táplálásterápia hatékonyságának vizsgálata gyulladásos bélbetegségben szenvedők gondozása során

Cited by 4 publications

References 24 publications

Role of Human Body Composition Analysis and Malnutrition Risk Questionnaire in the Assessment of Nutritional Status of Patients With Initially Diagnosed Crohn's Disease

Role of Human Body Composition Analysis and Malnutrition Risk Questionnaire in the Assessment of Nutritional Status of Patients With Initially Diagnosed Crohn's Disease

A dysphagia táplálásterápiája stroke-betegek esetében – 2021

GLIM criteria using NRS-2002 and MUST as the first step adequately diagnose the malnutrition in Crohn’s disease inpatients: A retrospective study

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