• Title/Summary/Keyword: clinical nutrition support

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Effect of vitamin C on azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced colitis-associated early colon cancer in mice

  • Jeon, Hee-Jin;Yeom, Yiseul;Kim, Yoo-Sun;Kim, Eunju;Shin, Jae-Ho;Seok, Pu Reum;Woo, Moon Jea;Kim, Yuri
    • Nutrition Research and Practice
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    • v.12 no.2
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    • pp.101-109
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    • 2018
  • BACKGROUD/OBJECTIVES: The objective of this study was to investigate the effects of vitamin C on inflammation, tumor development, and dysbiosis of intestinal microbiota in an azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced inflammation-associated early colon cancer mouse model. MATERIALS/METHODS: Male BALB/c mice were injected intraperitoneally with AOM [10 mg/kg body weight (b.w)] and given two 7-d cycles of 2% DSS drinking water with a 14 d inter-cycle interval. Vitamin C (60 mg/kg b.w. and 120 mg/kg b.w.) was supplemented by gavage for 5 weeks starting 2 d after the AOM injection. RESULTS: The vitamin C treatment suppressed inflammatory morbidity, as reflected by disease activity index (DAI) in recovery phase and inhibited shortening of the colon, and reduced histological damage. In addition, vitamin C supplementation suppressed mRNA levels of pro-inflammatory mediators and cytokines, including cyclooxygenase-2, microsomal prostaglandin E synthase-2, tumor necrosis $factor-{\alpha}$, Interleukin $(IL)-1{\beta}$, and IL-6, and reduced expression of the proliferation marker, proliferating cell nuclear antigen, compared to observations of AOM/DSS animals. Although the microbial composition did not differ significantly between the groups, administration of vitamin C improved the level of inflammation-related Lactococcus and JQ084893 to control levels. CONCLUSION: Vitamin C treatment provided moderate suppression of inflammation, proliferation, and certain inflammation-related dysbiosis in a murine model of colitis associated-early colon cancer. These findings support that vitamin C supplementation can benefit colonic health. Long-term clinical studies with various doses of vitamin C are warranted.

Effect of Food Commodity Supplementary Program for Low Income Elderly People (저소득층 독거노인의 식품지원 프로그램 효과)

  • Park, Hee-Jung;Lim, Bo-Kyung;Kim, Wha-Young
    • Journal of the Korean Society of Food Culture
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    • v.22 no.1
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    • pp.149-156
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    • 2007
  • This study was performed to evaluate the effectiveness of food commodity supplementary program for low-income, living alone elderly people. The subjects were 57 low income aged females who lived alone in Bucheon city. The food commodity supplementary program lasted for 6 months, supplying one meal per day consisting with grains, meat, vegetables, dairy and fruit. Dietary intake, anthropometric measurements, and blood profiles were assessed. After 6 months of food commodity supplemented period, dietary intakes of protein(p<0.05), calcium(p<0.05), iron(p<0.05) and vitamin B(p<0.001) were significantly increased. The mean weight(p<0.05) and BMI(p<0.05) were increased, and the frequency of BMI over 25kg/m$^2$ was also raised from 54.4% to 59.7%. Serum concentrations of total protein(p<0.001) and albumin(p<0.001) were significantly increased, indicating improvement of protein status. The frequency of anemia was decreased from 45.6% to 26.3%. However, the proportion of dyslipidemia was increased. In general the stable food commodity supplementary program was effective to improve general nutritional status of the poor aged who lived alone, however, nutrient intakes still did not meet RDA for the elderly and the rates of obesity and dyslipidemia were increased. Therefore, local government should provide more active food support program and the selection of food items for commodity should be evaluated at regular intervals.

Remote Cardiac Rehabilitation With Wearable Devices

  • Atsuko Nakayama;Noriko Ishii;Mami Mantani;Kazumi Samukawa;Rieko Tsuneta;Megumi Marukawa;Kayoko Ohno;Azusa Yoshida;Emiko Hasegawa;Junko Sakamoto;Kentaro Hori;Shinya Takahashi;Kaoruko Komuro;Takashi Hiruma;Ryo Abe;Togo Norimatsu;Mai Shimbo;Miyu Tajima;Mika Nagasaki;Takuya Kawahara;Mamoru Nanasato;Toshimi Ikemage;Mitsuaki Isobe
    • Korean Circulation Journal
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    • v.53 no.11
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    • pp.727-743
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    • 2023
  • Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients' busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as cost-effectiveness and insurance coverage still persist.

Clinical Study of Nimotuzumab Combined with Chemotherapy in the Treatment of Late Stage Gastric Cancer

  • Xu, Chong-De
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10273-10276
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    • 2015
  • Objective: To explore the clinical effects of nimotuzumab combined with chemotherapy in the treatment of late gastric cancer. Methods: A total of 34 reoccurrence or metastatic patients with late stage gastric cancer who were confirmed by histopathology and/or cytology were selected and randomly divided into observational and control groups, of 17 cases each. Patients in the control group were treated with the standard DCF plan, while patients in observational group additionally received nimotuzumab. The short-term and long-term efficacy and adverse reactions in the 2 groups were followed. Results: The objective response rate (ORR) and disease control rate (DCR) were 64.7% (11/17) and 82.4% (14/17) in observational group and 25.0%(4/16) and 37.5%(6/16) in the control group(ORR and DCR between 2 groups, ${\chi}^2=5.2412$, P=0.0221 and ${\chi}^2=6.9453$, P=0.0084). The median progression-free survival (PFS) time and median overall survival (OS) time were 6.50 months and 12.50 months in observational group and 4.50 months and 8.25 months in the control group (P=0.0212; P=0.0255). The main toxic and side effects in the 2 groups were reduced leukocytes and hemoglobin, gastrointestinal reactions and hair loss and these were relieved after symptomatic treatment and nutrition support therapy. There were no differences in the occurrence of toxic and side effects between the 2 groups. Conclusions: Nimotuzumab combined with DCF plan is effective in treating late stage gastric cancer. A larger scale study is now warranted for confirmation of the findings.

An Analysis on Distribution of Handgrip Strength and Associated Factors in Korean Adults (제7기 국민건강영양조사 자료를 활용한 한국 성인의 악력 분포 및 영향요인 분석)

  • Jung, Jung Won;Park, So Young;Kim, Hyunah
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.3
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    • pp.231-236
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    • 2021
  • Background: Sarcopenia is a skeletal muscle disorder that involves the loss of muscle mass and function. Handgrip strength (HGS) is the most commonly used tool to assess muscle strength to diagnose sarcopenia. HGS is also associated with various diseases and health outcomes. Thus, we aimed this study to examine the HGS status in Korean adults and relevant factors of HGS. Methods: Data was obtained from the 7th Korea National Health and Nutrition Examination Survey (KNHANES), a population-based nationwide survey. The estimated mean value of HGS was calculated in each age group. The mean HGS in men and women aged over 40 was compared according to the household income level, lifestyle factors, and comorbidities. Results: A total of 16,708 participants were included in this study. The mean HGS showed a maximum value in the 30s for both men and women, and then tended to decrease with increasing age. When analyzed for people aged 40 or older, the mean HGS was significantly higher in the current or past smoker, drinker, and aerobic exercise groups in both men and women. The mean HGS was lower in the group with comorbidities such as hypertension, dyslipidemia, type 2 diabetes, and bone diseases. Conclusion: Our study found that the mean HGS was significantly different between those with and without underlying chronic diseases. In groups with relevant comorbidities, close monitoring for the development of sarcopenia and taking preventive measures such as exercise and nutritional support may be recommended.

Efficacy and Safety of Azithromycin for the Treatment of COVID-19: A Systematic Review and Meta-analysis

  • Mangkuliguna, Ghea;Glenardi, Glenardi;Natalia, Natalia;Pramono, Laurentius A.
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.299-316
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    • 2021
  • Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients. Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967). Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low. Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was well-tolerated and safe to use.

The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study

  • El Koofy, Nehal Mohamed;Rady, Hanaa Ibrahim;Abdallah, Shrouk Moataz;Bazaraa, Hafez Mahmoud;Rabie, Walaa Ahmed;El-Ayadi, Ahmed Ali
    • Clinical and Experimental Pediatrics
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    • v.62 no.9
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    • pp.344-352
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    • 2019
  • Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. Purpose: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. Methods: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. Results: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. Conclusion: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.

Mineral Imbalance: Bone Decalcification and Soft Tissue Calcification (무기질 불균형: 골 탈석회화와 연조직 석회화)

  • Jeong, Dae-Won;Lim, Hyun-Sook;Kang, Young-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.12
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    • pp.1815-1819
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    • 2009
  • Based on the soft and rigid extents, tissues are mainly divided into two groups in mammals, soft tissues including heart, lung, kidney and brain, and hard tissues including tendon, cartilage, teeth and bone. Among various tissues, bone, a dynamic rigid organ, is continuously remodeled by the opposing functional activity between bone formation by osteoblasts and bone destruction by osteoclasts. Bone protects the soft tissues and provides mineral reservoirs, which can supply the mineral needs of other soft tissues to normally maintain cellular function. While calcification in bone is an important action to fundamentally support the body and protect the soft tissues, calcification in soft tissues, including the heart, aorta, kidney, lung and spleen, results in severe organ damages, eventually causing sudden death. A growing body of evidence indicates that the osteoporotic patient who are aging, post-menopausal, diabetes and chronic kidney disease simultaneously represent a high clinical incidence of soft tissue calcification, illustrating a link between soft tissue calcification and bone decalcification (osteoporosis). This study will review what is currently known about the connection between bone decalcification and soft tissue calcification.

Multidisciplinary Intestinal Rehabilitation for Short Bowel Syndrome in Adults: Results in a Korean Intestinal Rehabilitation Team (성인 단장증후군 환자의 다학제 장 재활: 국내 단일 기관 다학제 장재활 클리닉의 경험)

  • Yoon, Sojeong;Lee, Sanghoon;Park, Hyo Jung;Kim, Hyun-Jung;Yoon, Jihye;Min, Ja-Kyung;Seo, Jeong-Meen
    • Journal of Clinical Nutrition
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    • v.10 no.2
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    • pp.45-50
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    • 2018
  • Purpose: Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation. Methods: In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records. Results: Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%). Conclusion: This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

Iron Status and Anemia of Middle School Girls in Ulsan Metropolitan City (울산지역 여중생의 철 영양상태와 빈혈에 관한 연구)

  • 홍순명;서영은;황혜진
    • Korean Journal of Community Nutrition
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    • v.8 no.1
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    • pp.26-32
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    • 2003
  • This study was designed to assess the nutritional iron status and anemia of middle school girls. Three-hundred-fifty- three female subjects in Ulsan metropolitan city were evaluated using a questionnaire, and hematological indices. The average height and weight of the respondents were 157.19 $\pm$ 5.57 cm and 51.06 $\pm$ 9.42 kg respectively. The average Body Mass Index (BMI, $kg/m^2$) was 20.63 $\pm$ 3.23, which was within the normal range. With regard to clinical symptoms, the greatest number of respondents reported that they experienced 'decreased ability to concentrate'. The total caloric intake of each subject was 1743.28 $\pm$ 343.47 kcal(83.01% of the Korean RDA) and the calcium intake was 634.98 $\pm$ 201.43 mg (79.37% of the Korean RDh) . The mean daily intake of iron was 14.76 : 4.36 mg (92.25% of the Korean RDh) and the heme iron intake was 6.12 $\pm$ 2.30 mg, which was 41.5% of the total iron intake. The average hemoglobin (Hb) concentration of the subjects was 13.24 $\pm$ 1.01 g/dl, and the average hematocrit (Hct) level was 37.79 $\pm$ 4.10%. The transferrin saturation {TS (%)} was 19.41 $\pm$ 9.21%, and the ferritin level was 26.26 $\pm$ 18.60 ng/ml. The iron deficiency anemia among the subjects was estimated at 6.1% by using Hb (< 12 g/ml), 20.5% by using Hct (< 36%), 30.8% by using 75 (< 14%) , and 23.1% by using ferritin (< 12 ng/ml) The total iron binding capacity (TIBC) showed a negative correlation with the Hb, iron, ferritin and 75. With regard to the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with 'pale face'(p < 0.05) . In addition, the level of iron was significantly and negatively correlated with 'poor memory' (p<0.01) and the ferritin concentration was negatively correlated with 'no appetite '(p < 0.05) ,'pale face (p < 0.05) . These results suggest that the prevalence of iron deficiency among middle school girls is very high; therefore, guidelines on dietary support and nutritional education to improve their dietary iron status should be provided.