• Title/Summary/Keyword: clinical nutrition

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Clinical Usefulness of Gastric Residual Volume as An Indicator to Provide Approximately Enteral Nutrition for Patients in Intensive Care Units: A Systematic Literature Review (중환자의 경관영양 공급 지표로서 위 잔여량의 임상적 효용성: 체계적 문헌고찰)

  • Kim, Hyunjung;Chang, Sun Ju
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.267-275
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    • 2014
  • Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.

Bitter Taste Receptor TAS2R38 Genetic Variation (rs10246939), Dietary Nutrient Intake, and Bio-Clinical Parameters in Koreans

  • Benish;Jeong-Hwa Choi
    • Clinical Nutrition Research
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    • v.12 no.1
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    • pp.40-53
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    • 2023
  • Differential bitterness perception associated with genetic polymorphism in the bitter taste receptor gene taste 2 receptor member 38 (TAS2R38) may influence an individual's food preferences, nutrition consumption, and eventually chronic nutrition-related disorders including cardiovascular disease. Therefore, the effect of genetic variations on nutritional intake and clinical markers needs to be elaborated for health and disease prevention. In this study, we conducted sex-stratified analysis to examine the association between genetic variant TAS2R38 rs10246939 A > G with daily nutritional intake, blood pressure, and lipid parameters in Korean adults (males = 1,311 and females = 2,191). We used the data from the Multi Rural Communities Cohort, Korean Genome and Epidemiology Study. Findings suggested that the genetic variant TAS2R38 rs10246939 was associated with dietary intake of micronutrients including calcium (adjusted p = 0.007), phosphorous (adjusted p = 0.016), potassium (adjusted p = 0.022), vitamin C (adjusted p = 0.009), and vitamin E (adjusted p = 0.005) in females. However, this genetic variant did not influence blood glucose, lipid profile parameters, and other blood pressure markers. These may suggest that this genetic variation is associated with nutritional intake, but its clinical effect was not found. More studies are needed to explore whether TAS2R38 genotype may be a potential predictive marker for the risk of metabolic diseases via modulation of dietary intake.

Effect of coadministration of enriched Korean Red Ginseng (Panax ginseng) and American ginseng (Panax quinquefolius L) on cardiometabolic outcomes in type-2 diabetes: A randomized controlled trial

  • Jovanovski, Elena;Smircic-Duvnjak, Lea;Komishon, Allison;Au-Yeung, Fei (Rodney);Sievenpiper, John L.;Zurbau, Andreea;Jenkins, Alexandra L.;Sung, Mi-Kyung;Josse, Robert;Li, Dandan;Vuksan, Vladimir
    • Journal of Ginseng Research
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    • v.45 no.5
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    • pp.546-554
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    • 2021
  • Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;

Different Perceptions of Clinical Nutrition Services between Doctors and Dietitians in the Busan-Gyeongnam Area (임상영양서비스에 대한 부산.경남지역 의료진과 영양사의 인식 차이)

  • Choi, Jiyoung;Park, Eunju
    • Journal of the Korean Dietetic Association
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    • v.19 no.1
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    • pp.69-81
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    • 2013
  • The purpose of this study was to evaluate the difference in perception of clinical nutrition service (CNS) between doctors and dietitians working in hospitals in Busan and the Gyeongnam area. Research was performed through questionnaires (from November to December 2011) at over 100 beds. 73.3% of dietitians were aware of the Nutrition Support Team (NST), while only 15.6% of doctors were aware of it. Due to heavy work and lack of medical staff, doctors didn't participate in NST, although most of them recognized the necessity of NST. 61.7% of dietitians screened and managed malnourished patients, whereas only 29.8% of doctors did. The main reason dietitians didn't treat malnourished patients was the absence of a treatment system in the hospital. Less than 50% of dietitians participated in the doctor's round to malnourished patients. As for why dietitians didn't participate in doctor's rounds, 71% of doctors chose understaffed dietitians and 38.1% of dietitians chose the doctors' unawareness of the importance of the dietitian in doctor's rounds. For the lower rate of nutrition counseling in provincial regions, compared to the capital region, 46.8% of doctors cited a lack of connection between doctors and clinical dietitians, while 43.3% of dietitians cited the lack of doctors' awareness on the importance of nutrition counseling. Although 87.3% of the doctors and 91.6% of the dietitians answered that CNS is important for treatment, the perception of onsite performance status on CNS was found to be low in both groups. 48.9% of doctors and 50.0% of dietitians regarded dietitians in the hospital as personnel in charge of food services, rather a member of the medical team. To improve the awareness of the importance of the CNS, and the image of clinical dietitians, 31.2% of doctors answered "to introduce a professional dietitian license for each disease" and 26.7% of dietitians answered "to change the system in the hospital". Most subjects found that a separation of clinical nutrition services from the food service part is needed. These results suggest that it is important to narrow the difference in perceptions of clinical nutrition services between doctors and dietitians for an organized clinical nutrition management of patients in hospitals in Busan and the Gyeongnam area.

Patient Perceptions of Clinical Nutrition Service (임상영양서비스에 대한 환자의 인식 조사)

  • Choi, Ki-Bo;Lee, Song-Mi;Lyu, Eun-Soon
    • Journal of the Korean Dietetic Association
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    • v.18 no.1
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    • pp.59-71
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    • 2012
  • The purpose of this study was to evaluate the patient perception of clinical nutrition service. The research was performed by using questionnaires and conducted from February 14 to March 15 at 42 hospitals (over 400 beds). 41.7% of patients experienced nutritional education and counseling. The mean score of the patients' perception on clinical nutritional service was 4.62/5.00 for "nutrition care is important for treatment of the disease", 4.49/5.00 for "diet therapy is necessary for treatment of the disease", 4.16/5.00 for "nutritional counseling call-centers are necessary", 4.13/5.00 for "nutritional consultation fee is required to apply insurance benefits", 4.12/5.00 for "one-to-one nutrition system is necessary", and 3.56/5.00 for "nutrition services I am willing to pay". The patients who had no past experience in nutritional education and counseling showed significantly higher scores for "nutrition care is important for treatment of the disease", "one-to-one nutritional care system is necessary", and "nutritional counseling call-centers are necessary" (P<0.05). The mean scores for the importance (4.26/5.00) and performance (3.88/5.00) of nutrition counseling service were significantly different (P<0.01). "Nutritional counseling is available whenever I want" had the highest gap score between performance and importance among nutrition counseling service items. The importance and performance grid showed that highly important items had high performance (doing great area) and less important items have low performance (low priority).

Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition (경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향)

  • Rha Mi yong;Kim Eun mi;Cho Young Y.;Seo Jeong Meen;Choi Hay mie
    • Korean Journal of Community Nutrition
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    • v.11 no.1
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    • pp.124-132
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    • 2006
  • The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

Task Analysis on Foodservice , Clinical Nutrition Service in Hospital Dietetic Departments (병원 영양부서의 급식 및 임상영양 서비스의 중점관리 요인)

  • Hong, Wan-Su;Kim, Hye-Jin;Jang, Eun-Jae
    • Journal of the Korean Dietetic Association
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    • v.6 no.2
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    • pp.148-160
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    • 2000
  • The purpose of this research was to analyze the tasks on foodservice ․ clinical nutrition service in hospital dietetic departments. A survey of 30 hospital food and nutrition service departments was undertaken and detailed informations were collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Regarding dietitian's training period, 38.6% dietitians answered that they spent 1~2 years in mastering food service management. 28.4% dietitians replied that they needed 2~3 years in learning clinical nutrition management. It was shown that 48.9% dietitians were engaged in food service management, while 26.7% were engaged in clinical nutrition and 26.7% were engaged in both. The 13 elements of food service management showed low performance level. These elements were food temperature, food intake, menu selection, contaminated substances and serving mistake and reliance on hospital food. These should be controlled with caution. The average score of dietitian's life satisfaction within the work place was 3.42 out of 5. The most dissatisfactory element was physical environment of the workplace. 5 elements for improving nutrition service activities showed low performance level with high importance score. Problem analysis showed low difference score between importance and performance level. Hospitals under contract foodservice management received higher points on clinical nutrition performance(P<.05) than hospitals under self-operated foodservice management.

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Developing standardized Clinical Dietetic Staffing Indices in Hospital Foodservice (업무분석을 통한 임상 영양사 적정인원 산출 사례연구(II))

  • 양일선
    • Journal of Nutrition and Health
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    • v.28 no.7
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    • pp.675-687
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    • 1995
  • The purpose of this study were to analyze work patterns of clinical dietitians by time study, to investigate labor time used in each clinical dietetic activity, and to develop standardized indices of clinical dietetic staffing needs. Two general hospitals(A & B) in Seoul were selected for study. The results of this study can be summarized as follows. 1) For the A hospital, the percentage of clinical dietetic activities such as attending meeting, professional research, foodservicemanagement, clerical activity for the foodservice, administrative activity and delay were 17.5%, 1.3%, 14.5%, 23.4%, 21.3%, 4.6%, and 17.3% respectively, while 22.4% 3.5%, 23.7%, 10.9%, 15.8%, 4.2%, and 19.5% respectively for the B hospital. 2) For the A hospital, the percentage of direct patient care like outpatient nutrition education, group nutrition education, and patient meal planning were 69.5%, 10.5%, 7.6%, and 12.4% respectively while 78.9%, 7.3%, 8.9%, and 5.1% respectively for the B hospital. 3) Time spent for performing direct patient care such as basic care, intermediate care, and indepth care per patient were 28.0min, 73.1min, and 53.0 min respectively for the A hospital, while 45.3 min, 76.2 min, and 52.6 min respectively for the B hospital. 4) Full time clinical dietitian staffing needs were calculated for the three parts ; basic care, intermediate care, and in-depth care. For A hspital, the appropriate numbers of full time clinical dietitian were 3.5 persons in basic care, 3.6 persons in intermediate care, and 1.3 persons in in-depth care, while 6.1 persons, 6.3 persons, 3.2 persons respectively for B hospital.

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A Study on The Performance and Importance of Clinical Nutrition Management Using IPA Analysis (IPA 분석을 활용한 임상영양관리업무의 수행도와 중요도 연구)

  • Kim, Song-Hee;Jung, Yong-Ju
    • The Journal of the Korea Contents Association
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    • v.20 no.6
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    • pp.156-166
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    • 2020
  • This study was intended to investigate differences in the recognition of the importance and performance of clinical nutrition management by using IPA. For the study, 100 clinical nutritionists working at medical institutions were analyzed. In all 17 categories of nutritional management, significant differences were observed in awareness of performance and importance. The categories with the greatest difference in importance and performance awareness were the nutritionist's participation in clinical nutrition education and related job development activities(1.38), and the lowest categories were the provision of therapeutic meals(0.69). Since IPA analysis results showed that participation in clinical nutrition education and related task development were both low in importance and performance, it should be improved first. A way to improve is for nutritionists to receive internal and external education. Above all things, for effective treatment, policies to include clinical nutritionist in the category of medical personnel, and cooperation between the medical sector and nutrition service management are necessary.

Functional Prediction of Hypothetical Proteins from Shigella flexneri and Validation of the Predicted Models by Using ROC Curve Analysis

  • Gazi, Md. Amran;Mahmud, Sultan;Fahim, Shah Mohammad;Kibria, Mohammad Golam;Palit, Parag;Islam, Md. Rezaul;Rashid, Humaira;Das, Subhasish;Mahfuz, Mustafa;Ahmeed, Tahmeed
    • Genomics & Informatics
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    • v.16 no.4
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    • pp.26.1-26.12
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    • 2018
  • Shigella spp. constitutes some of the key pathogens responsible for the global burden of diarrhoeal disease. With over 164 million reported cases per annum, shigellosis accounts for 1.1 million deaths each year. Majority of these cases occur among the children of the developing nations and the emergence of multi-drug resistance Shigella strains in clinical isolates demands the development of better/new drugs against this pathogen. The genome of Shigella flexneri was extensively analyzed and found 4,362 proteins among which the functions of 674 proteins, termed as hypothetical proteins (HPs) had not been previously elucidated. Amino acid sequences of all these 674 HPs were studied and the functions of a total of 39 HPs have been assigned with high level of confidence. Here we have utilized a combination of the latest versions of databases to assign the precise function of HPs for which no experimental information is available. These HPs were found to belong to various classes of proteins such as enzymes, binding proteins, signal transducers, lipoprotein, transporters, virulence and other proteins. Evaluation of the performance of the various computational tools conducted using receiver operating characteristic curve analysis and a resoundingly high average accuracy of 93.6% were obtained. Our comprehensive analysis will help to gain greater understanding for the development of many novel potential therapeutic interventions to defeat Shigella infection.