The Experts below are selected from a list of 2262 Experts worldwide ranked by ideXlab platform
Xavier Leverve - One of the best experts on this subject based on the ideXlab platform.
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intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients a 2 year multicenter prospective randomized study
Journal of The American Society of Nephrology, 2007Co-Authors: N Cano, Denis Fouque, Hubert Roth, M Aparicio, Raymond Azar, Bernard Canaud, Philippe Chauveau, Christian Combe, M Laville, Xavier LeverveAbstract:Although intradialytic parenteral nutrition (IDPN) is a method used widely to combat Protein-Calorie Malnutrition in hemodialysis patients, its effect on survival has not been thoroughly studied. We conducted a prospective, randomized trial in which 186 malnourished hemodialysis patients received oral nutritional supplements with or without 1 year of IDPN. IDPN did not improve 2-year mortality (primary end point), hospitalization rate, Karnofsky score, body mass index, or laboratory markers of nutritional status. Instead, both groups demonstrated improvement in body mass index and the nutritional parameters serum albumin and prealbumin (P 30 mg/L within 3 months, a marker of nutritional improvement, independently predicted a 54% decrease in 2-year mortality, as well as reduced hospitalizations and improved general well-being as measured by the Karnofsky score. Therefore, although we found no definite advantage of adding IDPN to oral nutritional supplementation, this is the first prospective study demonstrating that an improvement in prealbumin during nutritional therapy is associated with a decrease in morbidity and mortality in malnourished hemodialysis patients.
Praveen S Goday - One of the best experts on this subject based on the ideXlab platform.
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intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients a 2 year multicenter prospective randomized study
Nutrition in Clinical Practice, 2008Co-Authors: Praveen S GodayAbstract:Although intradialytic parenteral nutrition (IDPN) is a method used widely to combat Protein-Calorie Malnutrition in hemodialysis patients, its effect on survival has not been thoroughly studied. We conducted a prospective, randomized trial in which 186 malnourished hemodialysis patients received oral nutritional supplements with or without 1 year of IDPN. IDPN did not improve 2-year mortality (primary end point), hospitalization rate, Karnofsky score, body mass index, or laboratory markers of nutritional status. Instead, both groups demonstrated improvement in body mass index and the nutritional parameters serum albumin and prealbumin (P 30 mg/L within 3 months, a marker of nutritional improvement, independently predicted a 54% decrease in 2-year mortality, as well as reduced hospitalizations and improved general well-being as measured by the Karnofsky score. Therefore, although we found no definite advantage of adding IDPN to oral ...
Geoffrey C Nguyen - One of the best experts on this subject based on the ideXlab platform.
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Protein Calorie Malnutrition as a prognostic indicator of mortality among patients hospitalized with cirrhosis and portal hypertension
Liver International, 2009Co-Authors: Justina Sam, Geoffrey C NguyenAbstract:Background: We conducted a nationwide analysis of the prevalence of Protein–Calorie Malnutrition (PCM) in patients with cirrhosis and portal hypertension (PHTN) and to determine its mortality and economic impact. Methods: We used the Nationwide Inpatient Sample (NIS) to identify admissions throughout the US with cirrhosis and PHTN between 1998 and 2005 using the International Classification of Diseases, 9th Revision diagnostic codes. Prevalence of PCM in this group of patients with cirrhosis was compared with that of general medical inpatients. The impact of PCM on in-hospital mortality was quantified using multiple logistic regression analysis. Results: There were 114 703 admissions with cirrhosis and PHTN in the NIS between 1998 and 2005. The prevalence of PCM was substantially higher among patients with cirrhosis and PHTN compared with general medical inpatients (6.1 vs. 1.9%, P<0.0001), with an adjusted odds ratio of 1.55 (95% CI: 1.4–1.7). There was greater prevalence of ascites (64.6 vs. 47.8%, P<0.0001) and hepatorenal syndrome (5.1 vs. 2.8%, P<0.0001) among those with PCM and cirrhosis. In-hospital mortality was two-fold higher among patients with cirrhosis and PCM (14.1 vs. 7.5%, P<0.0001), with an adjusted mortality of 1.76 (95% CI: 1.59–1.94). PCM was associated with greater length of stay (8.7 vs. 5.7 days, P<0.0001) and hospital charges (US$36 818 vs. US$22 673; P<0.0001) among patients with cirrhosis. Conclusions: PCM is more common among patients with cirrhosis and PHTN than the general medical population, and is associated with higher in-hospital mortality and resource utilization. PCM may be an indicator of greater disease severity and should be routinely assessed on admission.
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nationwide prevalence and prognostic significance of clinically diagnosable Protein Calorie Malnutrition in hospitalized inflammatory bowel disease patients
Inflammatory Bowel Diseases, 2008Co-Authors: Geoffrey C Nguyen, Melissa Munsell, Mary L HarrisAbstract:Background Inflammatory bowel disease (IBD) patients are at increased risk of Protein-Calorie Malnutrition. We sought to determine the prevalence of clinically diagnosable Malnutrition among those hospitalized for IBD throughout the United States and whether this Malnutrition influenced health outcomes. Methods We queried the Nationwide Inpatient Sample between 1998 and 2004 to identify admissions for Crohn's disease (CD) or ulcerative colitis (UC) and a representative sample of non-IBD discharges. We assessed the prevalence and predictors of Malnutrition and its association with in-hospital mortality and resource utilization. Results The prevalence of Malnutrition was greater in CD and UC patients than in non-IBD patients (6.1% and 7.2% versus 1.8%, P < 0.0001). The adjusted odds ratio for Malnutrition among IBD admissions compared with non-IBD admissions was 5.57 [95% confidence interval (CI): 5.29–5.86]. More IBD discharges than non-IBD discharges with Malnutrition received parenteral nutrition (26% versus 6%, P < 0.0001). There was increased likelihood of Malnutrition among those with fistulizing CD (OR 1.65; 95% CI: 1.50–1.82) and among those who had undergone bowel resection (OR 1.37; 95% CI: 1.27–1.48). Malnutrition was associated with increased in-hospital mortality 3.49 (95% CI: 2.89–4.23), length of stay (11.9 days versus 5.8 days, P < 0.00001), and total charges ($45,188 versus $20,295, P < 0.0001). Conclusions Clinically apparent Malnutrition is more frequent among IBD admissions than among non-IBD admissions. Its association with greater mortality and resource utilization may reflect more severe underlying disease that can lead to both Malnutrition and worse outcomes. Nonetheless, diagnosable Malnutrition may serve as a clinical marker of poor IBD prognosis in hospitalized patients. (Inflamm Bowel Dis 2008)
N Cano - One of the best experts on this subject based on the ideXlab platform.
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intradialytic parenteral nutrition does not improve survival in malnourished hemodialysis patients a 2 year multicenter prospective randomized study
Journal of The American Society of Nephrology, 2007Co-Authors: N Cano, Denis Fouque, Hubert Roth, M Aparicio, Raymond Azar, Bernard Canaud, Philippe Chauveau, Christian Combe, M Laville, Xavier LeverveAbstract:Although intradialytic parenteral nutrition (IDPN) is a method used widely to combat Protein-Calorie Malnutrition in hemodialysis patients, its effect on survival has not been thoroughly studied. We conducted a prospective, randomized trial in which 186 malnourished hemodialysis patients received oral nutritional supplements with or without 1 year of IDPN. IDPN did not improve 2-year mortality (primary end point), hospitalization rate, Karnofsky score, body mass index, or laboratory markers of nutritional status. Instead, both groups demonstrated improvement in body mass index and the nutritional parameters serum albumin and prealbumin (P 30 mg/L within 3 months, a marker of nutritional improvement, independently predicted a 54% decrease in 2-year mortality, as well as reduced hospitalizations and improved general well-being as measured by the Karnofsky score. Therefore, although we found no definite advantage of adding IDPN to oral nutritional supplementation, this is the first prospective study demonstrating that an improvement in prealbumin during nutritional therapy is associated with a decrease in morbidity and mortality in malnourished hemodialysis patients.
Stephen K Suh - One of the best experts on this subject based on the ideXlab platform.
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Protein Calorie Malnutrition nutritional intervention and personalized cancer care
Oncotarget, 2017Co-Authors: Anju Gangadharan, Sungeun Choi, Ahmed Hassan, Nehad M Ayoub, Gina Durante, Sakshi Balwani, Younghee Kim, Andrew L Pecora, Andre Goy, Stephen K SuhAbstract:// Anju Gangadharan 1 , Sung Eun Choi 2 , Ahmed Hassan 1 , Nehad M. Ayoub 3 , Gina Durante 4 , Sakshi Balwani 1 , Young Hee Kim 4 , Andrew Pecora 5 , Andre Goy 5 and K. Stephen Suh 1 1 The Genomics and Biomarkers Program, JT Cancer Center, Hackensack University Medical Center, Hackensack Meridian Health, Hackensack, NJ, USA 2 Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, USA 3 Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan 4 Department of Clinical Nutrition, Baystate Medical Center, Springfield, MA, USA 5 Clinical Divisions, JT Cancer Center, Hackensack University Medical Center, Hackensack Meridian Health, Hackensack, NJ, USA Correspondence to: K. Stephen Suh, email: // Keywords : Malnutrition, cancer therapy, chemo treatment, biomarkers, nutritional intervention Received : July 25, 2016 Accepted : January 23, 2017 Published : February 04, 2017 Abstract Cancer patients often experience weight loss caused by Protein Calorie Malnutrition (PCM) during the course of the disease or treatment. PCM is expressed as severe if the patient has two or more of the following characteristics: obvious significant muscle wasting, loss of subcutaneous fat; nutritional intake of 2% in 1 week, 5% in 1 month, or 7.5% in 3 months. Cancer anorexia-cachexia syndrome (CACS) is a multifactorial condition of advanced PCM associated with underlying illness (in this case cancer) and is characterized by loss of muscle with or without loss of fat mass. Cachexia is defined as weight loss of more than 5% of body weight in 12 months or less in the presence of chronic disease. Hence with a chronic illness on board even a small amount of weight loss can open the door to cachexia. These nutritional challenges can lead to severe morbidity and mortality in cancer patients. In the clinic, the application of personalized medicine and the ability to withstand the toxic effects of anti-cancer therapies can be optimized when the patient is in nutritional homeostasis and is free of anorexia and cachexia. Routine assessment of nutritional status and appropriate intervention are essential components of the effort to alleviate effects of Malnutrition on quality of life and survival of patients.
