• Title/Summary/Keyword: clinical nutrition

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Analysis of the Prevalence and Risk Factors of Malnutrition among Hospitalized Patients in Busan

  • Lee, Ha-Kyung;Choi, Hee-Sun;Son, Eun-Joo;Lyu, Eun-Soon
    • Preventive Nutrition and Food Science
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    • v.18 no.2
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    • pp.117-123
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    • 2013
  • This study investigated the prevalence of and risk factors for malnutrition in hospitalized patients in Busan, Republic of Korea. 944 patients (440 men and 504 women) were hospitalized in four Busan general hospitals from March through April, 2011. Nutritional status was assessed on admission by the Nutritional Risk Screening 2002. Data were collected from the electronic medical records system for the characteristics of the subjects, clinical outcomes, biochemical laboratory data, and nutrition support states. Clinical dietitians interviewed the patients using structured questionnaires involving data on weight loss and problems related to oral intakes. Malnourished patients were significantly older (P<0.001) than well-nourished patients, but the values for BMI, serum albumin, total cholesterol, TLC, hemoglobin, and hematocrit were significantly lower (P<0.001) for malnourished than for well-nourished patients. Logistic regression indicated that the main determinant factors for nutritional status were the age, length of stay, BMI, serum albumin, and total cholesterol. In order to increase therapeutic effects of hospitalized patients, clinical dietitians need to offer proper nutritional intervention based on the results of nutrition assessment and identification of malnutrition.

Evaluation of Postoperative Nutrition Support after an Ivor-Lewis Esophagectomy in Patients with Esophageal Cancer (식도암 환자에서 아이보-루이스 식도절제술 시행 후 영양지원 평가)

  • Park, Su Jin;Lee, Young Mi;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.240-247
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    • 2014
  • Objective: Undernutrition is common amongst esophageal cancer patients and therefore appropriate nutrition support is critical. Nevertheless, the effectiveness of enteral nutrition (EN) versus parenteral nutrition (PN) is still controversial. The aim of this study was to investigate the effect of EN and PN on the nutritional state and the length of hospital stay for patients who underwent an Ivor-Lewis (IL) esophagectomy. Method: A retrospective clinical analysis was performed that utilized the electronic medical records of patients who underwent IL esophagectomy during a 3-year period between January 2010 and December 2012 at a tertiary teaching hospital located in Seoul, Korea. The EN group and PN group were analyzed by comparing the nutrition supply, postoperative complications, length of hospital stay, and weight variation. Results: After an IL esophagectomy, the complication rate between the EN group and PN group was insignificant and the length of hospital stay was significantly shorter for the PN group compared to the EN group (14 vs. 16 days, respectively; p<0.001). At the time of discharge, those in the PN group lost less weight postoperatively (p=0.003). Conclusion: PN may be considered as safe nutrition support for esophageal cancer patients who underwent an esophagectomy.

Clinical Nutrition Service at Medical Centers in Seoul (서울지역 의료기관의 임상영양서비스 현황조사)

  • Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.17 no.2
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    • pp.176-189
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    • 2011
  • The purpose of this study was to investigate the status of clinical nutrition services at various medical centers in Seoul, Korea. A questionnaire was distributed to the departments of nutrition at 44 hospitals in Seoul on July 2009. Nutritional screening carried out at a rate of 59.1% at the medical centers, and a significant difference was found according to the type of center, from 100% in tertiary hospitals to 18.8% in normal hospitals. On annual average, the numbers of inpatients, inpatients for malnutritional screening, inpatients with malnutrition, and inpatients for malnutrition management were 15,169.5, 10,870.9, 2,224.8, and 1,546.2, respectively. On average the group nutrition education was done 36.1 times/year for diabetes, 8.2 times/year for cancer, and 1.9 times/year for renal disease, and the numbers of participants 423.1, 95.1, and 31.5, respectively. On average the individual nutrition education of inpatients with diabetes was done 135.4 times/year for ordered-type, and 119.3 times/year for unordered-type, 106.2 times/year for paid-type, and 148.5 times/year for unpaid-type. The mean fee for education and counseling was the highest for peritoneal dialysis (73,090.9 won) but the lowest for heart disease (23,609.1 won). On average the individual nutrition education of outpatients with diabetes was done 234.6 times/year for ordered-type, and 2.5 times/year for unordered-type, 204.4 times/year for paid-type, and 32.7 times/year for unpaid-type. The mean fee for education and counseling was also the highest for peritoneal dialysis (63,500.0 won) but the lowest for heart disease (21,336.4 won). To implement more effective clinical nutrition service, a national medical insurance imbursement policy should be urgently instituted such that diseases left as unpaid are covered by health insurance, including all nutrition-related disease.

Change of Clinical Effect upon Use of Glutamine to Critically Ill Patients over Age 60 Receiving TPN (정맥영양 투여 받는 60세 이상 중환자에서 glutamine 사용에 따른 임상 효과의 변화)

  • Lee, Hye Seung;Kim, Sungtae;Min, Young Sil;Sohn, Uy Dong
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.1
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    • pp.9-14
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    • 2014
  • Background: It is known to reduce the mortality when glutamine is supplied to patients during the surgery or in intensive care unit through intravenous nutrition supply. The purpose of this study is to establish the appropriate basis for use of glutamine and guidelines of nutrition supply for critically ill patients in the hospital by examining the clinical effects of administration of glutamine with subjects of elderly critically ill patients receiving intravenous nutrition in one hospital in Korea. Method: Among elderly patients with age of 60 or more hospitalized in Yeuido St. Mary's Hospital from August 2012 to July 2013, those who stayed in the intensive care unit for more than a week and received TPN (Total Parenteral Nutrition) for more than 3 days during staying in the intensive care unit were classified to a test group using glutamine and a control group without glutamine. Duration of use of mechanical ventilator, duration of hospitalization, occurrence of infectious disease and death were compared between two groups. We would like to identify the clinical test figures affected by the use of glutamine by examining changes in SCr, Total Protein, Albumin, AST, ALT, TB, DB and GFR at the time of admission and discharge. Results: At the time of admission to intensive care unit, gender, physical measurement information and clinical test figures did not show any significant difference between 72 subjects in a test group and 24 subjects in a control group. Thus, two groups began in the same condition. There were no significant difference in duration of hospitalization, duration of intensive care unit, use of mechanical ventilator, occurrence of infectious disease and death. As the results of statistical analysis of the average changes of clinical test figures at the time of admission and discharge of intensive care unit, SCr and GFR were significantly changed in the test group. GFR was significantly changed in a control group. As the result of analysis of the clinical test figures at the time of discharge with reflection of average changes after clinical test figures were corrected at the time of admission of intensive care unit, TB and GFR were significantly increased in a test group compared with those in a control group. Other clinical test figures were not significantly changed. Conclusion: If glutamine is administered to critically ill patients over age 60 receiving TPN and careful monitoring for total bilirubin is made in the future, it is expected to give the positive effect on renal function andminimize the side effect of arise in total bilirubin.

Pharmaceutical Care for Medication Safety in Critically Ill Neonates (신생아중환자의 안전한 약물사용을 위한 약료서비스)

  • An, Sook Hee
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.143-148
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    • 2020
  • Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.

Effect of a 12-week weight management program on the clinical characteristics and dietary intake of the young obese and the contributing factors to the successful weight loss

  • Lee, AeJin;Jeon, Kyeong Jin;Kim, Hye-Kyeong;Han, Sung Nim
    • Nutrition Research and Practice
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    • v.8 no.5
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    • pp.571-579
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    • 2014
  • BACKGROUND/OBJECTIVES: The objectives were to investigate the effect of a 12-wk intervention with behavioral modification on clinical characteristics and dietary intakes of young and otherwise healthy obese and to identify factors for successful weight loss. The goal was to lose 0.5 kg per week by reducing 300-500 kcal/day and by increasing physical activities. SUBJECTS AND METHODS: Forty four obese subjects (BMI > 25) and 19 normal weight subjects (BMI 18.5-23) finished the 12-week intervention. Obese subjects participated in 5 group educations and 6 individual counseling sessions. Normal weight subjects attended 6 individual counseling sessions for evaluations of dietary intake and exercise pattern. Anthropometric and clinical characteristics and 3-day dietary records were evaluated at baseline and week12. RESULTS: Weight and serum triglyceride and free fatty acid concentrations in obese group decreased significantly with intervention. Intakes of energy, fat, and cholesterol decreased significantly in the obese. Active participation, realistic weight loss goal setting, and weight gain after high school graduation not during childhood were identified as key factors for successful weight loss. CONCLUSIONS: The 12-week intervention with behavioral modification resulted in reduced energy and fat intakes and led to significant weight loss and improvements of clinical characteristics in the obese. The finding that those who became obese during childhood lost less weight indicates the importance of 'early' intervention.

A Nutritional and Clinical Survey on people in Chung Nam Area (충남(忠南) 일부지역(一部地域)의 영양실태(營養實態) 및 임상조사(臨床調査) (청양군 운곡면을 중심으로))

  • Ha, Soon-Yong;Kim, Sang-Bo;Shin, Hyun-Soung;Ha, Chong-Chol
    • Journal of Nutrition and Health
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    • v.11 no.4
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    • pp.11-23
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    • 1978
  • This study is based on data from the nutritional and clinical survey in Chung Nam area, namely Myl-Yang-Ri, Yoon-Gok-Myon, Chyung Yang Koon. Under the direction of two Nutrition professors and two clinical pathology professors it was carried by 35 Dae Jeun medical Junior College students majoring in nutrition and clinical pathology from 18 July to 25 July 1978. The nutrition surveys were carried out with subjects in village from a total 67 households, 36 of them were randomly selected. The clinical surveys were carried out with subjects in village from a total 382 inhabitant, 154 inhabitant were randomly selected and 109 peoples were subjected to stool examination. The results obtained in this study are summarized as follows. 1) Nutritional survey a) Food Intake The average food intake per person per day in survey area was 929.9 grams (95.5% in vegetables and 4.5% in animal foods). The average consumption of the basicfood groups per person per day was 965g for meats and legumes (10.4% of the total food in take). 268.9g for fruits and vegetables (29% of the total food intake), 559.1g for cereals and potatoes(60.1% of the total food intake), 5.2g for milk and small fishes and 0.2g for fats and oils. b) Nutrient Intake The average daily consumption of calories and nutrients was 2054.1 kcal and 61.2g for total proteins, 223.2mg for calcium, 9.5mg for iron, 4914.4 IU for vitamin A, 1.5mg for thiamin, 1.2mg for riboflavin, 19.9mg for niacin and 54.7mg for ascorbic acid. When these figures are compared with the recommended allowances for Korean, the calories and nutrients intakes were insufficient. Especially the intakes of the calcium were lower than the recommended allowance which are 500 milligrams per day. c) Kinds of food stuffs consumed The kinds of food stuffs consumed by the subjects were 47 figures total. Generally these kinds of food were vegetables food. 2) Clinical Survey a) The mean value of hemoglobin from 72 males was 13.2g/dl, that of 82 females was 12.3g/dl. b) The proportion of low hemoglobin (<12.2g/dl for male and <11.3g/dl fo female) for male was 20.8%, females was 11.0% and from 24 male & female (both sexes) were 15.6% c) The mean value of Hematocrit of males was 39.6%, that of females was 37.4%. d) The mean value of MCHC of males was 33.9%, that of females was 33.6%. e) The ABO blood group was distributed as following; 30.5%, for group O, 29.2% for group A, 24.0% for group B, and 16.3% for AB group. Biochemical race index was 1.13. f) The over all prevalence rate of heminthic infectious by rate of each helminth was as following; Ascaris lumbricoides 33.9%, Thrichocephalus trichiurus 11.9%, Hookworm 0.9%, Hymenolepis diminuta 0.9%, Trichostromgylus orientalis 0.9% and the prevalence rate of two more helminthic infection was 7.2%.

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Enteral nutrition for optimal growth in preterm infants

  • Kim, Myo-Jing
    • Clinical and Experimental Pediatrics
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    • v.59 no.12
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    • pp.466-470
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    • 2016
  • Early, aggressive nutrition is an important contributing factor of long-term neurodevelopmental outcomes. To ensure optimal growth in premature infants, adequate protein intake and optimal protein/energy ratio should be emphasized rather than the overall energy intake. Minimal enteral nutrition should be initiated as soon as possible in the first days of life, and feeding advancement should be individualized according to the clinical course of the infant. During hospitalization, enteral nutrition with preterm formula and fortified human milk represent the best feeding practices for facilitating growth. After discharge, the enteral nutrition strategy should be individualized according to the infant's weight at discharge. Infants with suboptimal weight for their postconceptional age at discharge should receive supplementation with human milk fortifiers or nutrient-enriched feeding, and the enteral nutrition strategy should be reviewed and modified continuously to achieve the target growth parameters.

Relationships between the diabetes awareness and clinical indices/nutrient intakes in Korean adults: Based on the 2012-2013 Korea National Health and Nutrition Examination Survey Data

  • Lee, Seul;Park, Haeryun;Lee, Youngmi;Choi, Onjeong;Kim, Jiwon;Gray, Heewon L;Song, Kyunghee
    • Nutrition Research and Practice
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    • v.13 no.3
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    • pp.240-246
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    • 2019
  • BACKGROUND/OBJECTIVES: Diabetes is diagnosed after an average of 10-12 years of diabetic development. Strict glycemic control in diabetic patients promotes the normalization of blood glucose and reduces cardiovascular diseases (CVDs) and diabetic complications. Therefore, early diagnosis in non-aware individuals is very important. SUBJECTS/METHODS: Clinical indices and nutrient intakes in Korean diabetic adults aged 19-64 years were examined according to the awareness of diabetes, using 2012 and 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. The aware group was defined as individuals who were aware of having diabetes from diagnosis by physician before the survey and the non-aware group as individuals who were not aware of having diabetes. RESULTS: The average age was higher in the aware group compared to the non-aware group in both men (P = 0.002) and women (P = 0.004). The prevalences of hypertension and dyslipidemia were not different between the two groups, but the diagnosis rate was significantly lower in the non-aware group. In the non-aware group, total and LDL-cholesterol were significantly higher (P < 0.001), the risk for total cholesterol over 240 mg/dL was 3.4 times (95% CI: 1.58-7.52) higher (P = 0.002) and the risk for LDL-cholesterol over 160 mg/dL was 4.59 times (95% CI: 2.07-10.17) higher (P < 0.001). The calorie intake of the female non-aware group was significantly higher compared to the female aware group (P = 0.033). CONCLUSION: The results suggested that the recommendation of screening test is necessary even for young adults. Studies on the methodology for early diagnosis of diabetes are also needed.