• Title/Summary/Keyword: clinical nutrition management

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Disseminated Cytomegalovirus Infection and Protein Losing Enteropathy as Presenting Feature of Pediatric Patient with Crohn's Disease

  • Cakir, Murat;Ersoz, Safak;Akbulut, Ulas Emre
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.60-65
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    • 2015
  • We report a pediatric patient admitted with abdominal pain, diffuse lower extremity edema and watery diarrhea for two months. Laboratory findings including complete blood count, serum albumin, lipid and immunoglobulin levels were compatible with protein losing enteropathy. Colonoscopic examination revealed diffuse ulcers with smooth raised edge (like "punched out holes") in the colon and terminal ileum. Histopathological examination showed active colitis, ulcerations and inclusion bodies. Immunostaining for cytomegalovirus was positive. Despite supportive management, antiviral therapy, the clinical condition of the patient worsened and developed disseminated cytomegalovirus infection and the patient died. Protein losing enteropathy and disseminated cytomegalovirus infection a presenting of feature in steroid-naive patient with inflammatory bowel disease is very rare. Hypogammaglobulinemia associated with protein losing enteropathy in Crohn's disease may predispose the cytomegalovirus infection in previously healthy children.

Clinical results of conservative management in patients with full-thickness rotator cuff tear: a meta-analysis

  • Karasuyama, Masaki;Gotoh, Masafumi;Tahara, Keiji;Kawakami, Junichi;Madokoro, Kazuya;Nagamatsu, Takashi;Imai, Takaki;Harada, Nobuya;Kudo, Yu;Shiba, Naoto
    • Clinics in Shoulder and Elbow
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    • v.23 no.2
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    • pp.86-93
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    • 2020
  • Background: Several systematic reviews have reported on the conservative treatment of full-thickness rotator cuff tears; however, clinical results of this treatment still remain determined. Methods: PubMed, Cochrane Library, PEDro, and CINAHL databases were systematically searched for randomized clinical trials and observational studies. Two independent researchers reviewed a total of 2,981 articles, 28 of which met the criteria for inclusion in the study. Clinical outcome measures included Constant score, visual analog scale score for pain, range of motion, and short-form 36 questionnaires. The meta-analysis used a linear mixed model weighted with the variance of the estimate. Results: The meta-analysis showed a significant improvement after surgery. Pain score is 26.2 mm (1 month) to 26.4 mm (3 months), and 24.8 mm (12 months) (P<0.05); active abduction: 153.2° (2 months), 159.0° (6 months), 168.1° (12 months) (P<0.05); Constant score: 67.8 points (2 months) to 77.2 points (12 months) (P<0.05); short-form 36 questionnaires "vitality" section: 57.0 points (6 months) to 70.0 points (12 months) (P<0.05). Conclusions: Our data confirmed the effectiveness of conservative treatment in patients with full-thickness rotator cuff tears 12 months post-intervention. The results suggest that conservative treatment for patients with full-thickness rotator cuff tears should be the first line of treatment before considering surgery.

A Survey for Needs and Preference of Food and Nutrition information on Mass Media for Korean Female Adults (대중매체 식품영양정보에 대한 성인 여성의 요구도 조사)

  • Kwak, Jeong-Eun;Lee, Seo-Yeon;Lee, Sang-Hoon;Ko, Kwang Suk
    • Korean Journal of Community Nutrition
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    • v.19 no.6
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    • pp.550-557
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    • 2014
  • Objectives: This study was conducted to examine the preferences and needs of typical Korean females adults for food and nutrition information provided by the mass media. Methods: A total of 343 females (77 in their 20s, 85 in their 30s, 88 in their 40s and 93 in their 50s) residing in the Seoul/Gyeonggido area was surveyed on general characteristics, main sources of food and nutrition information and needs for sources and contents of nutrition information. Results: The survey showed that typical Korean females obtained knowledge of food and nutrition mainly through the Internet (30.4%) and broadcasting (29.0%). Typical Korean females were interested in 'dietary management for weight control' (21.9%), 'the prevention and treatment of disease' (20.0%), 'food safety' (16.8%), 'proper dietary habits' (14.6%), 'cookery' (11.8%), 'functional foods' (9.6%), 'restaurant details' (3.5%) and 'life-cycle-specific dietary guideline' (1.6%). Needs for food and nutrition program forms on TV were 'educational programs' (34.3%), 'documentaries' (20.8), 'expert lecture-style' (13.0%), 'entertainment programs' (11.9%), 'expert conversation' (11.4%), 'news-style' (4.6%) and 'public campaign advertisements' (4.0%). On the Internet, 38.6% of the respondents preferred to get information provided by food and nutrition-related institutions (38.6%) while 26.1% preferred webtoons for nutritional information. The favored forms in mobile applications were 'monitoring their diets' (29.5%), 'data-based texts information' (21.4%), 'experts feedback' (20.6%), 'communities' (15.1%) and 'games' (13.1%). The rates of the preference to obtain information from experts such as nutritionists and dietitians and doctorsor dietitian turned reporters increased markedly with older ages. Conclusions: Since the mass media is a main source of food and nutrition information for the general public, the effectiveness and accuracy of the information provided should be enhanced by taking the needs of the public into account. The quality of information should be improved by involving more nutrition experts.

Assessment of Nutrient Intake and ADHD Score in Atopic Dermatitis Preschoolers (아토피 피부염 미취학 아동의 식행동, 영양 섭취 상태 및 주의력 결핍 과잉 행동 점수 평가)

  • Kang, Myung-Hwa;Kim, Eun-Young;Choi, Mi-Kyeong
    • Journal of the East Asian Society of Dietary Life
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    • v.19 no.4
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    • pp.493-502
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    • 2009
  • This study aimed to examine the relationship between nutrient intake and attention deficit hyperactivity (ADH) of children suffering atopic dermatitis. We examined clinical symptoms as well as the status of ADH and the dietary intake of 47 children with atopic dermatitis aged between 4 and 6 against 84 children in the control group. Family history of the atopic dermatitis group was significantly higher than the control group. There was no significant difference between the diet habit of the two groups. The daily energy intake of the atopic dermatitis group and the control group were 1,189.7 kcal and 1245.0 kcal, respectively. There was no significant difference between the nutrient intake of the two groups. In regards to the clinical symptom items, the point for 'anxieties' was 0.5 in the atopic dermatitis group, which was significantly higher than 0.3 of the control group (p<0.05). In terms of the detailed items in ADH assessed by kindergarten teachers, the point for 'changeable feeling' was 0.8 in the atopic dermatitis group, which was significantly higher than 0.5 of the control group (p<0.05). As for the correlation among nutrient intake, the ADH score and clinical symptoms, total fat intake (p<0.05) and animal fat intake (p<0.05) showed a significantly negative correlation with the point of ADH assessed by the teachers, while the intake of fiber (p<0.05) displayed a significantly negative correlation with the point of ADH assessed by the parents. Since atopic dermatitis and ADH may be caused by the same dietary factors, it will be necessary to conduct more studies in this field in the future. In addition, appropriate nutrition management will be necessary for children in the growing period who suffer from atopic dermatitis.

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Effects of Alcohol Drinking Frequency and Foods Consumed Along with Alcohol on Anthropometry, Serum Lipid Levels, and Blood Pressure in Male Patients with Type 2 Diabetes Mellitus (음주빈도와 안주섭취열량이 제2형 남성 당뇨병환자의 신체계측, 혈중지질수준 및 혈압에 미치는 영향)

  • Chung, In-Bin;Chang, Nam-Soo
    • Journal of Nutrition and Health
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    • v.41 no.4
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    • pp.317-326
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    • 2008
  • This study was performed to investigate the effects of alcohol drinking frequency and foods consumed along with alcohol on anthropometry, serum lipid levels, and blood pressures in 73 male type 2 diabetic patients aged 30-59 years old. Dietary data for usual intake were obtained from the subjects by the 3-day food records. Separate data for foods consumed along with alcohol as accompaniment were collected and analyzed for energy and nutrient intakes. Both alcohol drinking frequency and/or the amount of energy consumed from accompaniment influenced clinical data as well as anthropometric measurements. The serum total- and HDL-cholesterol, triglyceride levels and systolic blood pressure were significantly higher in the group with a drinking frequency of ${\geq}$ 2/week than that of ${\leq}$ 1/week and also in the group whose daily energy intake from accompaniment was greater than the median (106.6 kcal/d) than that below the median. When the data were adjusted for age, amount of energy intake from alcohol and diet, the anothropometric measurements such as body weight, BMI, waist circumference were significantly higher in patients whose energy intake from accompaniment was greater than the median than that below the median. The results of our study suggest that both alcohol drinking frequency and the energy intake from foods consumed along with alcohol as accompanements are important contributing factors to clinical and anthropometric parameters whose associations with the cardiovascular complications are well established in patients with diabetes mellitus.

Clinical Practice Guidelines on Pediatric Gastroesophageal Reflux Disease: A Systematic Quality Appraisal of International Guidelines

  • Harris, Jacob;Chorath, Kevin;Balar, Eesha;Xu, Katherine;Naik, Anusha;Moreira, Alvaro;Rajasekaran, Karthik
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.2
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    • pp.109-120
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    • 2022
  • Purpose: While regurgitation is a common and often benign phenomenon in infants and younger children, it can also be a presenting symptom of gastroesophageal reflux disease (GERD). If untreated, GERD can lead to dangerous or lifelong complications. Clinical practice guidelines (CPGs) have been published to inform clinical diagnosis and management of pediatric GERD, but to date there has been no comprehensive review of guideline quality or methodological rigor. Methods: A systematic literature search was performed, and a total of eight CPGs pertaining to pediatric GERD were identified. These CPGs were evaluated using the Appraisal of Guidelines for Research and Evaluation instrument. Results: Three CPGs were found to be "high" quality, with 5 of 6 domains scoring >60%, one "average" quality, with 4 of 6 domains meeting that threshold, and the remaining four "low" quality. Conclusion: Areas of strength among the CPGs included "Scope and Purpose" and "Clarity and Presentation," as they tended to be well-written and easily understood. Areas in need of improvement were "Stakeholder Involvement," "Rigor of Development," and "Applicability," suggesting these CPGs may not be appropriate for all patients or providers. This analysis found that while strong CPGs pertaining to the diagnosis and treatment of pediatric GERD exist, many published guidelines lack methodological rigor and broad applicability.

A comparative study on eating habits and mental health of Korean middle school students according to their bedtime across regions: using data from the 2020-2022 Korea Youth Risk Behavior Survey

  • Sarim Kim;Jiyoung Jeong;Juyeon Kang;Jihye Kim;Yoon Jung Yang
    • Nutrition Research and Practice
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    • v.18 no.2
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    • pp.269-281
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    • 2024
  • BACKGROUND/OBJECTIVES: The objective of this study was to compare dietary habits and mental health among middle school students in urban and rural areas based on bedtime, and to provide evidence supporting appropriate bedtime for Korean middle school students in relation to their healthy dietary habits and mental well-being. SUBJECTS/METHODS: The study population consisted of 25,681 second-year middle school students who participated in the Korea Youth Risk Behavior Survey in 2020-2022. Participants were asked about their bedtime and wake-up time during the past 7 days and were classified into five categories. The study compared the general characteristics, academic factors, dietary habits, and mental health of urban and rural students based on their bedtime. RESULTS: Bedtime was found to be later in the following order: urban female students, rural female students, urban male students, and rural male students. As bedtime got later, the rates of smoking and alcohol consumption increased. Students who went to bed before 11 p.m. had lower academic performance, while rural male students who went to bed after 2 a.m. had lower academic performance. Later bedtime was associated with increased smartphone usage, skipping breakfast, consuming fast food, and drinking carbonated beverages. Later bedtime was also associated with higher perceived stress levels, particularly among students who went to bed after 2 a.m., higher rates of suicidal ideation, experiencing sadness and despair, as well as the prevalence of clinically significant anxiety disorders. CONCLUSION: These results suggest that middle school students who go to bed too late have higher rates of smoking and alcohol drinking, as well as unhealthy eating habits, stress, suicidal ideation, sadness, and anxiety. Therefore, it is necessary to provide educational and social institutional support to promote adequate sleep for the health of adolescents.

Nutritional management of breastfeeding infants for the prevention of common nutrient deficiencies and excesses

  • Moon, Jin-Soo
    • Clinical and Experimental Pediatrics
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    • v.54 no.7
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    • pp.282-286
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    • 2011
  • Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to control children's daily sedentary life style and their intakes of high caloric foods in order to prevent obesity. Recent assessment of breastfeeding in Korea has shown that the rate is between 63% and 89%; thus, up-to-dated evidence-based nutritional management of breastfeeding infants to prevent common nutrient deficiencies or excesses should be taught to all clinicians and health care providers.

Nutritional education for management of osteodystrophy (NEMO) trial: Design and patient characteristics, Lebanon

  • Karavetian, Mirey;Abboud, Saade;Elzein, Hafez;Haydar, Sarah;de Vries, Nanne
    • Nutrition Research and Practice
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    • v.8 no.1
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    • pp.103-111
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    • 2014
  • This study aims to determine the effect of a trained dedicated dietitian on clinical outcomes among Lebanese hemodialysis (HD) patients: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6). A total of 570 patients met the inclusion criteria. Patients in cluster A were randomly assigned as per dialysis shift to the following: Dedicated Dietitian (DD) (n = 133) and Existing Practice (EP) (n = 138) protocols. Cluster B patients (n = 299) received Trained Hospital Dietitian (THD) protocol. Dietitians of the DD and THD groups were trained by the research team on Kidney Disease Outcomes Quality Initiative nutrition guidelines. DD protocol included: individualized nutrition education for 2 hours/month/HD patient for 6 months focusing on renal osteodystrophy and using the Trans-theoretical theory for behavioral change. EP protocol included nutrition education given to patients by hospital dietitians who were blinded to the study. The THD protocol included nutrition education to patients given by hospital dietitian as per the training received but within hospital responsibilities, with no set educational protocol or tools. Baseline data revealed that 40% of patients were hyperphosphatemics (> 5.5 mg/dl) with low dietary adherence and knowledge of dietary P restriction in addition to inadequate daily protein intake ($58.86%{\pm}33.87%$ of needs) yet adequate dietary P intake ($795.52{\pm}366.94$ mg/day). Quality of life (QOL) ranged from 48-75% of full health. Baseline differences between the 3 groups revealed significant differences in serum P, malnutrition status, adherence to diet and P chelators and in 2 factors of the QOL: physical and social functioning. The data show room for improvement in the nutritional status of the patients. The NEMO trial may be able to demonstrate a better nutritional management of HD patients.

Analysis of Knowledge-based Environments for Knowledge Management in Hospital Dietetic Departments (병원 영양부서의 지식경영 도입을 위한 영양사의 지식기반 환경에 대한 인식 분석)

  • Lee, Eun-Jeong;Hong, Wan-Soo;Cho, Sun-Kyung;Sohn, Chun-Young
    • Korean Journal of Human Ecology
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    • v.19 no.4
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    • pp.719-732
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    • 2010
  • This study assessed knowledge-based environments for knowledge management in hospital dietetic departments. This study categorized the current knowledge management environment into routine habits, capability, culture and system. A questionnaire was conducted on dieticians in general hospitals with 400 beds in Seoul and Gyeong-in areas. Excluding responses with significant missing data, 160 usable questionnaires were analyzed by SPSS package programs for the study. The result of the study is summarized as follows. The average number of licensed beds in the hospitals was 717.5 and the average number of meals provided daily was 1,626.3. 53.2% of dieticians were aged between 26 and 35. Of the maximum score of 5 points, habits scored $3.65{\pm}.44$ points, capability scored $3.38{\pm}.44$ points, culture scored $3.21{\pm}.46$ points and system scored $2.77{\pm}.74$ points. Hospitals with a high ratio of occupied beds also had significantly higher points in capability, culture and system. The older the group the higher points it scored in habits and culture. The married group scored higher points in habits while the higher educated group scored higher points in habits and capability. The dietitians in charge of clinical nutrition scored higher points in habit, capability and culture while the higher salaried group scored higher points in habit, culture and capability. Therefore this study would provide useful information for the introduction of knowledge management in hospital dietetic departments.