• 제목/요약/키워드: Clinical nutrition management

검색결과 274건 처리시간 0.027초

복막투석 환자에서 Methoxy Polyethylene Glycol-epoetin Beta 피하 투여가 빈혈과 영양지표에 미치는 효과 (Effect of Subcutaneous Methoxy Polyethylene Glycol-epoetin Beta on Anemia and Nutritional Indices in Peritoneal Dialysis Patients)

  • 김경숙;이준섭;김혜영;이명구
    • 한국임상약학회지
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    • 제22권3호
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    • pp.202-210
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    • 2012
  • Methoxy polyethylene glycol-epoetin beta (MPG-EPO), a continuous erythropoietin receptor activator, is a new erythropoiesis-stimulating agent with a long half-life. The purpose of this prospective study is to assess the effects of once-monthly subcutaneous MPG-EPO on hematological responses and nutritional status in peritoneal dialysis patients. Forty four patients undergoing stable peritoneal dialysis were enrolled into the study. Darbepoetin alfa therapy, in peritoneal dialysis patients, was converted to the monthly administration of subcutaneous MPG-EPO for 6 months. The starting dose of MPG-EPO was based on the previous weekly dose of darbepoetin alfa. The dose adjustments were performed to maintain the hemoglobin (Hb) levels in a target range of 10.5-11.0 g/dL. If the Hb levels exceeded 11.0 g/dL, MPG-EPO was temporarily interrupted for 1 month. The mean Hb levels were stable with the values of $9.5{\pm}1.1$ g/dL at baseline, and $10.4{\pm}0.9$ g/dL at the 6th month after conversion. The mean differences in the changes of Hb levels between the baseline and the 6th month were $0.9{\pm}1.4$ g/dL, which was statistically significant. However, the mean differences of iron, transferrin saturation and ferritin concentrations were not significant. It did not show significant differences in the changes of the nutritional parameters. These results suggest that the once-monthly subcutaneous administration of MPG-EPO for 6 months effectively maintains the Hb levels and nutritional status in peritoneal dialysis patients. Taken together, the once-monthly subcutaneous administration of MPG-EPO was practical and might improve the clinical compliance for the management of renal anemia in peritoneal dialysis patients.

Case studies on prophylactic ayurvedic therapy in migraine patients

  • Prakash, Vaidya Balendu;Chandurkar, Nitin;Sanghavi, Tejashri
    • 셀메드
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    • 제2권2호
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    • pp.17.1-17.5
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    • 2012
  • Ayurveda is a nearly 3000 years old traditional medical system of India. Most of the time, people turn to ayurvedic physicians in desperate conditions. Here clinical practices of Ayurveda were initially found effective in the management of migraine among few patients. Later, it was developed as an ayurvedic treatment protocol (ATP) which consists of four herbo-mineral formulations (HMF), three meals and three snacks in a day with eight hours sleep at night. ATP brought significant relief in reducing the frequency, intensity of pain and associated symptoms in the migraine patients. IHS diagnostic criteria was followed to establish the diagnosis of migraine and uniform ATP was prescribed to each patient who were primarily treated by the ayurvedic physicians at their respective clinics. Such observations were presented at appropriate international forums. In an effort to validate the above, the present study carries the details of nine migraine patients who were first diagnosed and treated for migraine by a leading headache expert at Mumbai in India and were then referred to receive ATP. A total number of nine subjects volunteered to this program. Out of those, seven subjects completed 120 days of ATP. Five subjects reported significant improvement in overall symptoms of migraine. All subjects were followed up periodically for four years. No Grade II side effects were observed in any treated case. HMF has also been proved to be safe in experimental studies. Further pharmacological and randomized controlled clinical studies are in progress at the respective departments of a premier medical institute in India.

The fruit of Acanthopanax senticosus Harms improves arterial stiffness and blood pressure: a randomized, placebo-controlled trial

  • Oh, Eunkyoung;Kim, Youjin;Park, Soo-yeon;Lim, Yeni;Shin, Ji-yoon;Kim, Ji Yeon;Kim, Ji-Hyun;Rhee, Moo-Yong;Kwon, Oran
    • Nutrition Research and Practice
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    • 제14권4호
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    • pp.322-333
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    • 2020
  • BACKGROUND/OBJECTIVES: Arterial stiffness and endothelial dysfunction are 2 of the independent predictors for cardiovascular disease, while Acanthopanax senticosus Harms (ASH) is a traditional medicinal plant that can improve cardiovascular health. This study aimed to investigate the efficacy of the fruit of ASH on vascular function in apparently healthy subjects. SUBJECTS/METHODS: A 12-week, randomized, double-blind, placebo-controlled design, consisting of healthy adults with at least 2 of the following 3 conditions: borderline high blood pressure (BP; 120 mmHg ≤ systolic BP ≤ 160 mmHg or 80 mmHg ≤ diastolic BP ≤ 100 mmHg), smoking (≥10 cigarettes/day), and borderline blood lipid levels (220 ≤ total cholesterol ≤ 240, 130 ≤ low density lipoprotein cholesterol ≤ 165, or 150 ≤ triglyceride ≤ 220 mg/dL). Randomly assigned 76 subjects who received a placebo or 2 doses of ASH fruit (low, 500 mg/day; high, 1,000 mg/day) completed the intervention. Brachial-ankle pulse wave velocity (baPWV), flow-mediated dilation, carotid intima-media thickness, and BP were measured both at baseline and following the 12-week intervention. Endothelial nitric oxide synthase (eNOS) phosphorylation was assessed by western blotting. RESULTS: Compared with the placebo group, the low-dose group showed more significant changes after the 12-week intervention period in terms of systolic BP (0.1 vs. -7.7 mmHg; P = 0.044), baPWV (31.3 vs. -98.7 cm/s; P = 0.007), and the ratio of phospho-eNOS/eNOS (0.8 vs. 1.22; P = 0.037). CONCLUSIONS: These results suggest that ASH fruit extract at 500 mg/day has the potential to improve BP and arterial stiffness via endothelial eNOS activation in healthy adults with smoking and the tendency of having elevated BP or blood lipid parameters.

영양교육과 운동을 병행한 프로그램이 중등도비만여성의 비만도와 행동변화에 미치는 효과 (Effects of Nutrition Education and Exercise Program on Obesity Index and Behavioral Modification in Moderate Obese Women)

  • 장명희;정수진
    • 대한지역사회영양학회지
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    • 제23권4호
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    • pp.318-332
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    • 2018
  • 본 연구에서는 12주 동안 성인 여성 중 체지방률 40% 이상 또는 BMI 30 이상인 여성을 대상으로 37차시의 비만관리 프로그램일환으로 영양교육과 운동중재를 병행 실시하여 대상자의 식습관 및 운동 습관 조사, 신체성분과 식이섭취와 생화학적 지표에 미치는 효과를 살펴보고자 하였다. 1. 조사대상자의 평균 연령은 44.8세였으며 참여자의 55%가 폐경이었다. 2. 체중조절 관심도 변화에서 체중 조절 방법은 식사조절과 운동이 프로그램 참여 전 34.4%에서 프로그램 후 37.5%로 증가하였다(p<0.01). 3. 신체활동 변화에서 중등도 신체활동을 10분 이상 한날은 프로그램 참여 전 3.20일에서 프로그램 후 4.25일로 증가하고, 스트레칭 등 유연성 운동을 한 날은 프로그램 참여 전 2.60일에서 프로그램 참여 후 3.85일로 유의적으로 증가하였다(p<0.01). 4. 바른 식습관 점수 변화는 프로그램 참여 전 4.15점에서 프로그램 참여 후 7.10점으로 유의적(p<0.001)으로 증가하였다. 5. 에너지 및 다량 영양소 섭취는 프로그램 전후간 차이는 없었으나 식이섬유(p<0.01), 철, 칼륨, 비타민A, 비타민 $B_6$, 나이아신의 섭취는 프로그램 참여 전에 비해 프로그램 참여 후에 유의적으로 증가하였다(p<0.05). 6. 혈압과 혈액 생화학적 특성 지표인 TC, 공복혈당 및 TG는 프로그램 참여 전후 간 유의적인 차이는 없었다. 7. 영양교육과 운동 프로그램 종료 후 체중, 체지방률, 복부둘레 및 내방지방 수치는 유의적으로 감소하였으며, 근육양과 신체발달 점수는 유의적으로 증가하였다(p<0.001). 이상의 결과를 볼 때, 중등도 비만여성에서 12주간 영양교육과 운동 중재 프로그램 실시는 식사의 질을 향상시키고 바림직한 식습관의 변화를 유도하였으며 비만도는 감소하면서 근육양이 증가하여 요요현상이 없이 비만관리 프로그램 교육 내용이 긍정적인 영향을 미쳤으며, 향후 장기적인 비만의 지속관리와 체계적인 연구가 계속되어야 할 것으로 사료된다.

사업장(事業場) 근로여자(勤勞女子)의 영양실태(營養實態)에 관(關)한 연구(硏究) (Nutritional Survey for Working Females at a Factory)

  • 조미자
    • Journal of Nutrition and Health
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    • 제2권4호
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    • pp.143-153
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    • 1969
  • 여성(女性)의 노동(勞動)과 영양(營養)의 문제가 근로자의 건강과 생산성(生産性)과의 중요성이 있을 뿐만 아니라 다음 세대(世代)의 건강에까지 미치는 영향이 크다는 관점에서 1969년 8월 13일부터 8월 20일까지 1주일간(週日間) 서을 시내 소재 한 가발공장 여자 기숙사 근로자 949명(名)에 대하여 식품및 영양 섭취상태를 조사하였고 아울러 대상자의 신장및 체중을 조사하였다. 그리고 그 중(中) 임의유출법(任意油出法)에 의하여 선정된 44명(名)에 대하여 임상조사 및 생화학적 검사를 실시하였다. 그 결과(結果)를 요약하면 조사대상자는 체위(體位)가 표준치(標準値)에 미달(未達)이었고 16세(歲)${\sim}$20세(歲)가 전인원(全人員)의 82%이상을 차지하고 있는 여자 근로자로서, 노동정도는 중등노동(中等勞動)에 속하였다. 급식(給食)상황에 있어서는 기초식품의 배합이 고르지 못하여 누락된 식품군이 매(每)식단마다 발견할 수 있었다. 완전영양을 위한 균형식사가 여기에 강조되어야 하겠다. 식단(食單)이 너무 단순한 탓으로 저(低)칼로리와 저(低)영양상태를 초래하고 있으며 열량, 단백질의량에 있어서도 권장량보다 부족되며 특히 동물성 단백질량이 부족된다. 그러나 단백질의 질적(質的)문제에 있어서는 비록 그 양은 적으나 75의 단백가(蛋白價)로서 비교적 양질(良質)이다. 여기서 식물성단백질에서 섭취되는 좋은 현상을 발견할수 있다. 그리고 지방질의 섭취량이 평균 1일(日) 1인당(人當) 8.8g으로 매우 적고 무기질 및 비타민의 섭취량도 모두 우리나라 권장량 보다 저치(低値)를 나타내고 있다. 임상조사(臨床調査) 및 생화학적(生化學的) 검사결과(檢査結果)에 있어서도 비타민 결핍증과 빈혈(貧血) 특히 철(鐵)결핍성 빈혈을 초래하고 있는 사실을 발견할 수 있다. 이러한 급식은 장구히 계속 된다면 근로자의 체위저하(體位低下)는 물론 작업능력 및 건강에도 악(惡)영향을 미칠 것으로 본다. 이와 같은 특수환경에 있는 대상에 대해서 앞으로 영양관리와 건강관리에 대한 채선이 시급히 요망된다고 사료되는 바이다.

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경기도 안성지역 당뇨병 환자의 유병기간에 따른 영양소 섭취 실태와 혈액성상의 임상적 특징 (A Clinical Proterties on Nutrients Intake and Serum Concentration of Diabetic Subjects by Duration in Ansung Kyunggi-do)

  • 노숙령
    • Journal of Nutrition and Health
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    • 제30권10호
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    • pp.1203-1210
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    • 1997
  • This study was performed from March to June 1994 in ANsung Medical Center. We investigated serum components of 78 diabetics in the center, in addition to the nutrient intake status and anthrophometric status of 60 diabetics among them. We separated the latter into 2 groups(ⅰ) less tan 5 years of diabetic duration and ⅱ) more than 6 years of diabetic duration) and analyzed the clinical characteristics of each group. The results are as follows : \circled1 The average ages of male and female subjects were 57.1 and 58.9 years, respectively. The average diabetic duration of male subjects was 4.8 years and that of female subjects was 5.9 . The major occupational field of both male and female subjects was agriculture(33.3%, 36.1%). 50% of male and 75% of female subject's monthly incomes were less than 600, 000 won and 75% of male and 94.4% of female subjects had weekly food expense less than 40, 000 won. The nutrient intake status of the subjects was lower than RDA on the whole. There was no big differences between 2 the male groups of different diabetic duration , but calorie, protein , fat carbohydrate, phosphorus, iron and Vit B$_1$intakes of the above 6 year female group were appearently higher than those of the under 5 year female group (p<0.05). There were different intake tendencies between male and female subjects . For females. the longer the diabetic duration, the less intakes of calorie, protein , fat carbohydrate, phosphorus, iron Vit B$_1$, Vit B$_2$, and niacin were observed. Furthermore, the longer the diabetic duration in females , the more intakes of energy and nutrients, except Vit C were observed. Fasting blood glucose levels were 155mg/dl and 164mg/dl and Postprandial glucose levels were 242mg/dl and 247mg/dl for males and females respectively. Hb of both males and females , and Ht of males met the lower limit of normal status, The serum TG level was higher than normal , so that they seemed to suffer from hyperlipidemia ; their high HbAIC status indicated that the management of diabetes mellitus was poor. The total protein level of female subject was higher when compared with that of males(p<0.05). All subjects blood pressure were higher than normal , and the longer the diabetic duration, the higher was the blood pressure. The serum HDL-cholesterol levels of the above 6 year group male subjects were lower(p<0.05) than those of the under 5 year male group subjects, and the former group's systolic and diastolic blood pressures were higher than those of the latter(p<0.05). Levels of serum total protein, albumin and TG of the above 6 year female group were lower than those of the under 5 year female group(p<0.05). As the diabetic duration was extended, HDL-cholesterol and LDL-cholesterol levels showed a tendency to increase, while Hb, Ht, total protein, albumin, and A/G, which represent the nutrients state of iron and protein, were inclined to decrease. This result showed that serum lipid components went bad. To summarize the results, the longer the diabetic duration, the worse were the male subjects nutrient intake status, but those of the female subjects were good. With respect to serum components and serum lipid subjects Fe, protein, nutrition status and serum lipid component got worse as the diabetic duration was extended , implying the possibility of diabetes mellitus complication grows.

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한국 직장 여성의 건강식품 섭취 실태에 관한 연구 (Assessment of Functional Food Consumption Among the Working Women in Korea)

  • 장민기;김양하
    • Journal of Nutrition and Health
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    • 제41권8호
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    • pp.832-838
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    • 2008
  • 본 연구는 성인 직장 여성들을 대상으로 건강기능식품 섭취실태와 관련 요인들을 알아보고자 실시되었다. 서울 및 일부 경기도 지역에 거주하는 성인 직장 여성 가운데 건강기능식품을 섭취한다고 밝힌 558명의 사람들을 대상으로 건강기능식품과 관련된 설문지를 작성하도록 하여 통계 분석하였다. 건강기능식품의 섭취 목적은 피로회복과 체력증진을 위해서가 가장 많았으며, 다음으로 영양보충, 질병예방이나 치료 목적 순으로 조사되었으며, 건강기능식품의 소비 패턴과 관련된 요인으로는 연령이 높을수록 섭취가짓수와 섭취기간, 구매비용 등이 유의적으로 증가하였고 (p < 0.05), 비만도가 높을수록 섭취기간, 구매비용 등이 유의적으로 증가하였다 (p < 0.05). 건강기능식품에 대한 지식 정도는 연령이 높고 기혼자 군에서 낮았으며 통계적으로도 유의하였다 (p < 0.005). 건강기능식품 관련 정보의 출처는“가족이나 주변사람의 권유”에 의해서가 가장 많아 직장여성의 경우 건강기능식품과 관련된 정보를 유통경로나 대중매체를 통해서보다는 주변의 인적 경로를 통해 얻는 경향이 높았다. 본 조사 결과 직장 여성 가운데 연령이 높고 비만도가 높은 집단이 섭취가짓수, 최대섭취기간, 구매비용 등이 높았던 반면 건강기능식품에 대한 지식 정도는 연령이 높을수록 낮았다. 직장과 가사생활로 올바른 교육의 기회가 적은 직장 여성 중에서도 특히나 연령이 높고 비만도가 높은 집단에게 적극적인 도움을 줄 수 있는 전문 상담 영양사의 배치 등 실질적인 방법이 필요할 것이며, 잘못된 섭취로 인한 오남용을 줄이기 위해 지속적인 연구와 노력이 필요할 것으로 사료된다.

장기간 골다공증관리교육이 골밀도와 약물순응도에 미치는 효과 (The Effects of Long term Osteoporosis Management Education on BMD Level and Medication Compliance in Postmenopausal Women)

  • 김동희;배영실;이상화
    • 한국보건간호학회지
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    • 제28권1호
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    • pp.102-113
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    • 2014
  • Purpose: The purpose of this study was to evaluate the effects of long term osteoporosis management education consist of exercise, drug therapy, and nutrition on bone mineral density (BMD) and medication compliance among postmenopausal women who have just been diagnosed with osteoporosis. Methods: The research design consisted of a pre-and post-test quasi-experimental design through a nonequivalent control group. The participants in this study were 60 individuals with osteoporosis, and who were classified according to two groups; the control group (n=30) who were given general clinical guidelines, and the experimental group (n=30) who received management education once for 60 minutes every three months using a standardized educational sheet. After one year, BMD was assessed using band dual energy X-ray absorptiometry (DXA) and medication possession ratio (MPR) for medication compliance. Analysis of collected data was performed using descriptive statistics t-test, chi-test, and paired t-test. Results: No significant difference in BMD (t=-1.02, p=.311) and MPR (t=-0.77, p=.440) was observed between the two groups. However, a significant increase in femur neck BMD was observed in the experimental group compared with the control group (t=-2.18, p=.033). Conclusion: Conduct of further study will be needed for examination of the effect of long-term osteoporosis management education on BMD Level and Medication Compliance in Postmenopausal Women.

당뇨병 환자에서 당뇨관리 교육과 당뇨병성 망막병증 발생간 관련성 조사연구: 제5기 국민건강영양조사를 중심으로 (Relationship Survey Study between Diabetic Control Education and Diabetic Retinopathy: data from the Korea National Health and Nutrition Examination Survey V)

  • 장하나;한정훈;방준석;손의동
    • 한국임상약학회지
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    • 제24권1호
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    • pp.33-38
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    • 2014
  • Background: Diabetes is accompanied by complications. One of the chronic complications, diabetic retinopathy is the most common cause of the loss of eyesight and thus has enormous impacts on the quality of life to the patients. It has been reported that thorough glucose regulation can prevent or postpone the outset of diabetic retinopathy in diabetic patients and that the patients who received anti-diabetic manage & care education would be capable of more thorough glucose-level regulation than those who did not. Method: This study set out to investigate the current state of education on anti-diabetic manage & care in South Korea and connections between anti-diabetic manage & care education and occurrence of diabetic retinopathy in diabetic patients based on the Korea National Health and Nutrition Examination Survey of 2011. Results: Of the 410 diabetes patients, 74 received anti-diabetic manage & care education, which means that only 15% of diabetic patients benefited from the education in the nation. The occurrence rate of diabetic retinopathy was 28% in the education group and 24% in the non-education group with no significant differences between them. The anti-diabetic manage & care education group recorded a higher occurrence rate of diabetic retinopathy, one of the chronic diabetic complications, than the non-education group contrary to the hypothesis. One of the reasons was that the educated group had a significantly longer duration of diabetes and significantly higher HbA1c than the noneducated group, which indicates that anti-diabetic manage & care education is provided to those who have progressed farther along the course of diabetes instead of the early stage and cannot regulate their glucose-level well in the nation. Conclusion: Those findings raise a need for active educational policies in order to provide anti-diabetic manage & care education under the goals of preventing complications through anti-diabetic education for many patients in early stages of diabetes.

Homocysteine levels are associated with diabetes mellitus in Chinese with H-type hypertension

  • Dejian Fu;Wanbao Gong;Xiaomin Bao;Bo Yang;Feng Wang;Yubing Qiao;Yuanjiang Wu;Guangzhen Chen;Weixun Sun;Qiongzhi Xiao;Wenbo Zou;Ning Fang
    • Nutrition Research and Practice
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    • 제18권4호
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    • pp.511-522
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    • 2024
  • BACKGROUND/OBJECTIVES: The study examined the association between homocysteine and diabetes mellitus in patients with H-type hypertension and assessed the possible effect modifiers. SUBJECTS/METHODS: This cross-sectional study included 1,255 eligible participants in the 'H-type Hypertension Management and Stroke Prevention Strategic International Science and Technology Innovation Cooperation Project' among rural Chinese people with H-type hypertension. A multivariate logistic regression model was used to evaluate the relationship between homocysteine and diabetes mellitus. RESULTS: The mean level of total homocysteine (tHcy) in the diabetes mellitus population was 19.37 μmol/L, which was significantly higher than the non-diabetic patients (18.18 μmol/L). When tHcy was analyzed as a continuous variable, the odds ratio (OR) of diabetes was 1.17 (95% confidence interval [CI], 1.01-1.35; per interquartile range). When tHcy was stratified according to the quintile, the ORs for diabetes were 2.86 (95% CI, 1.22-6.69) in the highest quintile (tHcy ≥ 20.60 μmol/L) compared to the reference group (tHcy < 12.04 μmol/L). When tHcy was grouped by 15 μmol/L and 20 μmol/L, patients with tHcy ≥ 20 μmol/L had a significantly (P = 0.037) higher risk of diabetes (OR, 2.03; 95% CI, 1.04-3.96) than in those with tHcy < 15 μmol/L. Subgroup analysis showed that the tHcy-diabetes association was unaffected by other variables. CONCLUSION: In this study of rural Chinese people with H-type hypertension, the tHcy levels showed a positive association with diabetes mellitus. This independent association is unaffected by other potential risk factors.