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Application of Global Leadership Initiative on malnutrition criteria in patients with liver cirrhosis

Chinese Medical Journal 2024年第1期137卷 97-104页

作者： Minjie Jiang Juan Chen Muchen Wu Jing Wu Xiaotong Xu Juan Li Can Liu Yaping Zhao Xin Hua Qinghua Meng Department of Hepatology Beijing You-An HospitalCapital Medical UniversityBeijing 100069China Beijing Institute of Hepatology Beijing 100069China Department of Medical Oncology Beijing You-An HospitalCapital Medical UniversityBeijing 100069China Department of Nutrition Beijing You-An HospitalCapital Medical UniversityBeijing 100069China

Background:The Global Leadership Initiative on malnutrition(GLIM)criteria were published to build a global consensus on nutritional diagnosis.Reduced muscle mass is a phenotypic criterion with strong evidence to support its inclusion in the GLIM consensus criteria.However,there is no consensus regarding how to accurately measure and define reduced muscle mass in clinical settings.This study aimed to investigate the optimal reference values of skeletal muscle mass index for diagnosing sarcopenia and GLIM-defined malnutrition,as well as the prevalence of GLIM-defined malnutrition in hospitalized cirrhotic patients.Methods:This retrospective study was conducted on 1002 adult patients with liver cirrhosis between January 1,2018,and February 28,2022,at Beijing You-An Hospital,Capital Medical University.Adult patients with a clinical diagnosis of liver cirrhosis and who underwent an abdominal computed tomography(CT)examination during hospitalization were included in the study.These patients were randomly divided into a modeling group(cohort 1,667 patients)and a validation group(cohort 2,335 patients).In cohort 1,optimal cut-off values of skeletal muscle index at the third lumbar skeletal muscle index(L3-SMI)were determined using receiver operating characteristic analyses against in-hospital mortality in different gender groups.Next,patients in cohort 2 were screened for nutritional risk using the Nutritional Risk Screening 2002(NRS-2002),and malnutrition was diagnosed by GLIM criteria.Additionally,the reference values of reduced muscle mass in GLIM criteria were derived from the L3-SMI values from cohort 1.Multivariate logistic regression analysis was used to analyze the association between GLIM-defined malnutrition and clinical outcomes.Results:The optimal cut-off values of L3-SMI were 39.50 cm 2/m 2 for male patients and 33.06 cm 2/m 2 for female patients.Based on the cut-off values,31.63%(68/215)of the male patients and 23.3%(28/120)of the female patients had CT-determined sarcopenia in cohort 2.The prevalence of GL

关键词： malnutrition Liver cirrhosis Sarcopenia Clinical outcomes GLIM criteria

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malnutrition and Its Association with the Mortality of Patients with Femoral Intertrochanteric Fractures: A Retrospective Analysis of Japanese Patients

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Open Journal of Orthopedics 2024年第1期14卷 22-31页

作者： Taizo Kaneko Kyoko Matsudaira Kentaro Hayakawa Fumiaki Tokimura Tsuyoshi Miyazaki Department of Orthopaedic Surgery Tokyo Metropolitan Institute for Geriatrics and Gerontology Tokyo Japan

Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.

关键词： Intertrochanteric Fracture Mortality Geriatric Nutritional Risk Index malnutrition Risk Factor

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Prevalence of malnutrition and Anaemia in Children ≤ 5 Years of Age in Some Conflict Hit Areas of Meme Division of the South West Region of Cameroon

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Food and Nutrition Sciences 2024年第4期15卷 235-244页

作者： Asoba Gillian Nkeudem Ebong Fidelis Sameh Samuel Metuge Teh Rene Ning Ngede Laura Senge Sumbele Irene Ngole Department of Social Economy and Family Management Higher Technical Teachers’ Training College University of Buea Kumba Cameroon Department of Zoology and Animal Physiology Faculty of Science University of Buea Buea Cameroon

malnutrition refers to the deficiency, imbalances, or excesses in a person’s intake of energy or nutrients [1]. Khan defines anaemia as below level of Haemoglobin in red blood shown by a lower number of functioning red blood cells [2]. The crisis in the North West and South West Regions of Cameroon has led to several negative effects on children’s living conditions. There has been an increase in malnutrition and anaemia in the South West Region and Kumba in particular. The main objective of this study was “to examine the prevalence of malnutrition and anaemia in children ≤ 5 years of age in some conflict-hit areas of Meme Division”. A descriptive cross-sectional study was conducted in 2023 from March to June. We recruited 200 children ≤ 5 years into the study from three hospitals. The regional hospital annex in Kumba, Presbyterian General Hospital Kumba and the Ntam Hospital in Kumba. Socio-demographic factors were assessed using questionnaire, nutritional status was assessed by the use anthropometric measurements and an auto haematology analyser was used to determine anaemia. The overall prevalence of malnutrition in the study area was 40.5%. The prevalence of malnutrition varied significantly (P malnutrition and Anaemia in children ≤ 5 years of age is very high in the Kumba municipalities. This could be attributed to the ongoing crisis which has caused a lot of social migrations from rural areas to Urban areas which are safer.

关键词： malnutrition Anaemia Prevalence Conflict Hit Areas

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Superior Mesenteric Artery Syndrome, a Rare Complication of Severe malnutrition: Two Cases from a Subsaharian Endocrinology Department

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Open Journal of Endocrine and Metabolic Diseases 2024年第4期14卷 87-93页

作者： Nafy Ndiaye Ngone Diaba Diack Yakham Mohamed Leye Sokhna Awa Balla Sall Moussa Gueye Mouhamed Fawaz Mouhamadou Moustapha Ndong Abdoulaye Leye Department of Internal Medecine and Endocrinology Teaching Hospital of Pikine Dakar Senegal

Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m2, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.

关键词： Superior Mesenteric Artery Syndrome malnutrition Pikine

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Nutritional Assessment Tools for Patients with Cancer:A Narrative Review

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Current Medical Science 2024年第1期44卷 71-80页

作者： Peng-peng WANG Kim Lam Soh Huzwah binti Khazaai Chuan-yi NING Xue-ling HUANG Jia-xiang YU Jin-lian LIAO Faculty of Medicine and Health Sciences Universiti Putra MalaysiaSerdang 43400Malaysia NursingCollege of Guangxi Medical University Nanning 530021China Department of Biomedical Sciences Universiti Putra MalaysiaSerdang 43400Malaysia Department of Nursing The First Affiliated Hospital of Guangxi Medical UniversityNanning 530021China

Cancer patients are at high risk of malnutrition,which can lead to adverse health outcomes such as prolonged hospitalization,increased complications,and increased mortality.Accurate and timely nutritional assessment plays a critical role in effectively managing malnutrition in these patients.However,while many tools exist to assess malnutrition,there is no universally accepted standard.Although different tools have their own strengths and limitations,there is a lack of narrative reviews on nutritional assessment tools for cancer patients.To address this knowledge gap,we conducted a non-systematic literature search using PubMed,Embase,Web of Science,and the Cochrane Library from their inception until May 2023.A total of 90 studies met our selection criteria and were included in our narrative review.We evaluated the applications,strengths,and limitations of 4 commonly used nutritional assessment tools for cancer patients:the Subjective Global Assessment(SGA),Patient-Generated Subjective Global Assessment(PG-SGA),Mini Nutritional Assessment(MNA),and Global Leadership Initiative on malnutrition(GLIM).Our findings revealed that malnutrition was associated with adverse health outcomes.Each of these 4 tools has its applications,strengths,and limitations.Our findings provide medical staff with a foundation for choosing the optimal tool to rapidly and accurately assess malnutrition in cancer patients.It is essential for medical staff to be familiar with these common tools to ensure effective nutritional management of cancer patients.

关键词： cancer malnutrition nutrition nutritional assessment tool

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A texture-modified dessert with high nutritional value designed for people with dysphagia:effect of refrigeration and frozen storage

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Food Science and Human Wellness 2024年第1期13卷 462-471页

作者： María Cartagena Larisa Giura Diana Ansorena Iciar Astiasaran Department of Nutrition Food Science and PhysiologyFaculty of Pharmacy and NutritionUniversidad de NavarraC/Irunlarrea s/nPamplona 31008Spain Center for Nutrition Research University of Navarrac/Irunlarrea 1Pamplona 31008Spain Instituto de Investigación Sanitaria de Navarra IDISNAPamplona 31008Spain National Centre for Food Technology and Safety(CNTA)—Technology and Knowledge for Food Sector Competitiveness NavarreCrta-Na 134-km 53San Adrian 31570Spain

Dysphagia is commonly associated with malnutrition and an increased choking risk.To overcome these complications,food designed for people with dysphagia should have an appropriate texture and a high nutritional value.In this study,six formulations of a strawberry dessert enriched in protein(calcium caseinate)and fiber(wheat dextrin or inulin)were developed using different hydrocolloids(xanthan gum,carboxymethyl cellulose or modified starch)to provide desirable texture and stability.Nutritional value was calculated and total phenolic content and antioxidant activity of the samples were analyzed.Back-extrusion test,rheological measurements and sensory analysis were performed in refrigerated and frozen samples to characterize their textural and viscoelastic properties.The high content in protein(14.7 g/100 g)and fiber(7.9-8.7 g/100 g)made possible to use the claims“high protein”and“high fiber”.Phytochemicals supplied by strawberries contributed to the antioxidant properties of the dessert.Loss tangent ranged 0.28-0.35 for all the formulations,indicating a weak gel behavior,which could be considered safe to swallow.The formulations with dextrin in combination with carboxymethyl cellulose or xanthan gum seemed to be less susceptible to structural changes during frozen storage.This work provides insights for the development of a nutrient-dense dessert that meets the requirements of people with dysphagia.

关键词： malnutrition Texture-modified-food Hydrocolloids Viscoelastic properties Food texture

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Establishment of acquired tracheoesophageal fistula using a modified magnetic compression technique in rabbits and its postmodeling evaluation

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1385-1394页

作者： Han Meng Fu-Yao Nan Na Kou Qin-Yan Hong Ming-Sheng Lv Ju-Bo Li Bao-Jie Zhang Hang Zou Lei Li Hong-Wu Wang Respiratory Disease Center Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 100029China The First Clinical Medical College Beijing University of Chinese MedicineBeijing 100700China Department of Animal Experimental Center National Center for CardiovascularFuwai HospitalBeijing 100037China

BACKGROUND Previous studies have validated the efficacy of both magnetic compression and surgical techniques in creating rabbit tracheoesophageal fistula(TEF)models.Magnetic compression achieves a 100%success rate but requires more time,while surgery,though less frequently successful,offers rapid model establishment and technical maturity in larger animal models.AIM To determine the optimal approach for rabbit disease modeling and refine the process.METHODS TEF models were created in 12 rabbits using both the modified magnetic compression technique and surgery.Comparisons of the time to model establishment,success rate,food and water intake,weight changes,activity levels,bronchoscopy findings,white blood cell counts,and biopsies were performed.In response to the failures encountered during modified magnetic compression modeling,we increased the sample size to 15 rabbit models and assessed the repeatability and stability of the models,comparing them with the original magnetic compression technique.RESULTS The modified magnetic compression technique achieved a 66.7%success rate,whereas the success rate of the surgery technique was 33.3%.Surviving surgical rabbits might not meet subsequent experimental requirements due to TEF-related inflammation.In the modified magnetic compression group,one rabbit died,possibly due to magnet corrosion,and another died from tracheal magnet obstruction.Similar events occurred during the second round of modified magnetic compression modeling,with one rabbit possibly succumbing to aggravated lung infection.The operation time of the first round of modified magnetic compression was 3.2±0.6 min,which was significantly reduced to 2.1±0.4 min in the second round,compared to both the first round and that of the original technique.CONCLUSION The modified magnetic compression technique exhibits lower stress responses,a simple procedure,a high success rate,and lower modeling costs,making it a more appropriate choice for constructing TEF models in rabbits.

关键词： Tracheoesophageal fistula Modified magnetic compression technique Post-modeling evaluation Pneumonia malnutrition

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malnutrition predicts poor outcomes in diabetic COVID-19 patients in Huangshi,Hubei

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The Journal of Biomedical Research 2022年第1期36卷 42-48页

作者： Jiao Chen Can Zhao Yingzi Huang Hao Wang Xiang Lu Wei Zhao Wei Gao Department of Intensive Care Unit the Affiliated Sir Run Run Hospital of Nanjing Medical UniversityNanjingJiangsu 211100China Department of Geriatrics the Affiliated Sir Run Run Hospital of Nanjing Medical UniversityNanjingJiangsu 211100China Key Laboratory for Aging&Disease Nanjing Medical UniversityNanjingJiangsu 211166China Jiangsu Provincial Key Laboratory of Critical Care Medicine Department of Critical Care MedicineZhongda HospitalSchool of MedicineSoutheast UniversityNanjingJiangsu 210009China.

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has spread throughout the world,which becomes a global public health emergency.Undernourishment prolongs its convalescence and has an adverse effect on its prognosis,especially in diabetic patients.The purpose of this study was to evaluate the prevalence and characteristics of undernourishment and to determine how it is related to the prognostic outcomes in the diabetic patients with coronavirus disease 2019(COVID-19).A retrospective,multicenter study was conducted in 85 diabetic COVID-19 patients from three hospitals in Hubei Province.All patients were assessed using the European Nutritional Risk Screening 2002(NRS-2002)and other nutritional assessments when admitted.Of them,35(41.18%)were at risk of malnutrition(NRS score≥3).Severe COVID-19 patients had a significantly lower level of serum albumin and prealbumin and higher NRS score than non-severe patients.Multivariate logistic regression analysis showed that serum prealbumin and NRS score increased the likelihood of progression into severe status(Pmalnutrition.Furthermore,prealbumin and NRS score could well predict severe status for COVID-19 patients.The malnutrition group(NRS score≥3)had more severe illness than the normal nutritional(NRS scoremalnutrition is highly prevalent among COVID-19 patients with diabetes.It is associated with severely ill status and poor prognosis.Evaluation of nutritional status should be strengthened,especially the indicators of NRS-2002 and the level of serum prealbumin.

关键词： NRS-2002 malnutrition COVID-19 diabetes

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Diagnosis of malnutrition in cancer patients

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Cancer Biology & Medicine 2023年第12期20卷 963-966页

作者： Chunhua Song Hanping Shi Department of Epidemiology and Statistics College of Public HealthZhengzhou UniversityZhengzhou 450001China Henan Key Laboratory of Tumor Epidemiology Zhengzhou UniversityZhengzhou 450001China State Key Laboratory of Esophageal Cancer Prevention and Treatment Zhengzhou UniversityZhengzhou 450001China Department of Gastrointestinal Surgery Department of Clinical NutritionBeijing Shijitan HospitalCapital Medical UniversityBeijing 100038China Key Laboratory of Cancer FSMP for State Market Regulation Beijing 100038China

malnutrition is a common complication in patients with malignant tumors and adversely affects treatment and prognosis1.It has been reported that the global prevalence of malnutrition in hospitalized patients with malignant tumors is approximately 70%2.Moreover,approximately 20%of cancer patient deaths are directly attributable to malnutrition3.According to the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers(INSCOC)project4,the overall prevalence of malnutrition in Chinese inpatients with common malignant tumors is 80.4%.Of the 58.

关键词： malnutrition patients cancer

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Association between depression and malnutrition in pulmonary tuberculosis patients:A cross-sectional study

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World Journal of Clinical Cases 2022年第14期10卷 4395-4403页

作者： Xue-E Fang Dan-Ping Chen Ling-Ling Tang Yan-Jun Mao Department of Tuberculosis Shanghai Pulmonary Hospital Affiliated to Tongji UniversityShanghai 200000Shanghai ProvinceChina Department of Nursing Shanghai Pulmonary Hospital Affiliated to Tongji UniversityShanghai 200000Shanghai ProvinceChina

BACKGROUND Depression has been reported to be prevalent in patients with pulmonary tuberculosis(PTB).Moreover,several clinical symptoms of PTB and depression overlap,such as loss of appetite and malnutrition.However,the association between depression and malnutrition in TB patients has not been fully elucidated.AIM To explore the association between depression and malnutrition in patients with PTB.METHODS This hospital-based cross-sectional study included patients with PTB in Shanghai Pulmonary Hospital Affiliated to Tongji University from April 2019 to July 2019.The Patient Health Questionnaire-9(PHQ-9)scale was used to evaluate depression.The cut-off value was set at 10,and the nutritional state was determined by the body mass index(BMI).In addition,the Quality of Life Instruments for Chronic Diseases was employed to establish the quality of life(QOL).Univariable analysis and multivariable analysis(forward mode)were implemented to identify the independent factors associated with depression.RESULTS A total of 328 PTB patients were screened for analysis.Eight were excluded for missing demographic data,four excluded for missing nutrition status,and sixteen for missing QOL data.Finally,300 PTB patients were subjected to analysis.We found that depressive state was present in 225 PTB patients(75%).The ratio of malnutrition in the depressive PTB patients was 45.33%.Our results revealed significantly lower BMI,hemoglobin,and prealbumin in the depression group than in the control group(Pmalnutrition and poor social function are signif

关键词： Depression Pulmonary tuberculosis malnutrition Quality of life Comorbidity China

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