39 results on '"Ellegard L"'
Search Results
2. Nutrition education in medical schools (NEMS) project: Joining ESPEN and university point of view
- Author
-
Cuerda, C., primary, Muscaritoli, M., additional, Krznaric, Z., additional, Pirlich, M., additional, Van Gossum, A., additional, Schneider, S., additional, Ellegard, L., additional, Fukushima, R., additional, Chourdakis, M., additional, Della Rocca, C., additional, Milovanovic, D., additional, Lember, M., additional, Arias-Diaz, J., additional, Stylianidis, E., additional, Anastasiadis, K., additional, Alunni, V., additional, Mars, T., additional, Hellerman, M.I., additional, Kujundžić-Tiljak, M., additional, Irtun, O., additional, Abbasoglu, O., additional, and Barazzoni, R., additional
- Published
- 2021
- Full Text
- View/download PDF
3. Food sources of plant sterols in the EPIC Norfolk population
- Author
-
Klingberg, S., Andersson, H., Mulligan, A., Bhaniani, A., Welch, A., Bingham, S., Khaw, K.-T., Andersson, S., and Ellegard, L.
- Subjects
Diet -- Evaluation ,Dietary Reference Intakes -- Usage ,Sterols -- Identification and classification - Abstract
Objective: To investigate the intake of plant sterols and identify major dietary sources of plant sterols in the British diet. Subjects: A total of 24798 men and women recruited during 1993-1997, participating in the European Prospective Investigation into Cancer (EPIC-Norfolk). Interventions: A database of the plant sterol (campesterol, [beta]-sitosterol, stigmasterol, campestanol and [beta]-sitostanol) content in foods, based on gas-liquid chromatography (GLC) analyses, was linked to nutritional intake data from food frequency questionnaires in the EPIC-Norfolk population. Results: The mean (s.d.) intake of total plant sterols was 300 (108) mg/d for men and 293 (100) mg/d for women. Bread and other cereals, vegetables and added fats were the three major food sources of plant sterols representing 18.6 (8.9), 18.4 (8.5) and 17.3 (10.4)% of the total plant sterol intake respectively. Women had a higher plant sterol density than men (36.4 vs 32.8 mg/1000 kJ, P Conclusions: The intake of plant sterols in UK, mainly from bread, cereals, fats and vegetables, is much higher than previously reported but comparable to recent European studies. doi:10.1038/sj.ejcn.1602765; published online 18 April 2007 Keywords: plant sterols; food sources; population; diet, Introduction Plant sterols are bioactive compounds found in all vegetable foods at varying concentrations. There is, however, limited information on the plant sterol intake from common foods in Britain. The [...]
- Published
- 2008
4. Minigrisen som forsogsdyr
- Author
-
Berlinger, R and Ellegard, L
- Abstract
No abstract available, Scandinavian Journal of Laboratory Animal Sciences, Vol. 11 No. 3 (1984)
- Published
- 2020
- Full Text
- View/download PDF
5. Will recommended changes in fat and fibre intake affect cholesterol absorption and sterol excretion? An ileostomy study
- Author
-
Ellegard, L., Bosaeus, I., and Andersson, H.
- Subjects
Cholesterol metabolism -- Research ,Diet therapy -- Influence - Abstract
Objective: To study cholesterol absorption and excretion in ileostomy subjects with different intakes of saturated fat and dietary fibre. Design: Short-term experimental study, with four controlled diets in repeated measurements. Setting: Out-patients at metabolic-ward kitchen. Subjects: Nine healthy volunteers with conventional ileostomy after colectomy because of ulcerative colitis. Interventions: Four diet periods, each of 3 days duration: high saturated fat and low dietary fibre (STAND); reduced saturated fat (RESAT); high saturated fat and high fibre (FATFIB); and reduced saturated fat and high fibre (RESATFIB). Main outcome measures: Absorption of cholesterol, and ileal excretion of cholesterol, bile acids, fat and energy. Differences between diets evaluated with Friedman's two-way analysis of variance by rank sum with Bonferroni adjustment, and post hoc differences assessed by rank sum comparison. Results: RESAT and RESATFIB reduced fractional cholesterol absorption by 7% and 10%; RESATFIB and FATFIB increased net cholesterol excretion by 46% and 54% respectively. Further, RESATFIB increased net sterol excretion by 18%, all compared to STAND (P < 0.05 for all). All three intervention diets contained more phytosterols than STAND (P < 0.05), and the phytosterol content was inversely correlated to fractional cholesterol absorption (r = -0.77, P < 0.01). Conclusions: Current nutrition recommendations to reduce saturated fat and increase dietary fibre affect sterol excretion additively. The effect on cholesterol absorption might be partly explained by the content of dietary plant sterols. Sponsorship: Supported by grants from the Gothenburg Medical Society, grant numbers 94/086 and 99/082, and by the University of Gothenburg. Descriptors: cholesterol absorption; sterol excretion; dietary fibre; dietary fat; plant sterols; ileostomy, Introduction Cardiovascular diseases are major health concerns in the industrialized part of the world. Hypercholesterolaemia is one of the established risk factors for the development of these diseases. Dietary interventions [...]
- Published
- 2000
6. Inulin and oligofructose do not influence the absorption of cholesterol, or the excretion of cholesterol, Ca, Mg, Zn, Fe, or bile acids but increases energy excretion in ileostomy subjects
- Author
-
Ellegard, L., Andersson, H., and Bosaeus, I.
- Subjects
Fiber in human nutrition -- Physiological aspects ,Cholesterol -- Research ,Excretion -- Research - Abstract
The effects of inulin and oligofructose on cholesterol absorption and excretion of cholesterol, bile acids, energy, nitrogen and minerals in humans were studied in a metabolic kitchen with policlinic visits in Sahlgrenska Hospital, Goteborg, Sweden. Findings indicated that inulin and oligofructose are not digested in the small intestine. They do not affect mineral excretion and therefore hardly mineral absorption. They do not increase fat or nitrogen excretion from the small intestine.
- Published
- 1997
7. Effects of low-fat milk and fermented low-fat milk on cholesterol absorption and excretion in ileostomy subjects
- Author
-
Andersson, H., Bosaeus, I., Ellegard, L., Grahn, E., Tidehag, P., Hallmans, G., Holm, S., and Sandberg, A.S.
- Subjects
Milk -- Physiological aspects ,Cholesterol -- Research ,Ileostomy -- Research - Abstract
A study on the influence of low-fat milk and fermented low-fat milk on cholesterol absorption and excretion in ileostomy subjects to understand possible serum cholesterol-lowering mechanism of low-fat milk products revealed that absorption of cholesterol by micro organisms could be the reason for the reduced uptake of cholesterol with fermented milk. The reason for the increase in endogenous cholesterol excretion effected by low-fat milk doubtful.
- Published
- 1995
8. Total energy expenditure in underweight patients with severe chronic obstructive pulmonary disease living at home
- Author
-
SLINDE, F., ELLEGÅRD, L., GRÖNBERG, A.M., LARSSON, S., and ROSSANDER-HULTHÉN, L.
- Published
- 2003
- Full Text
- View/download PDF
9. European Atherosclerosis Society Consensus Panel on Phytosterols. Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease
- Author
-
Gylling H, Plat J, Turley S, Ginsberg HN, Ellegard L, Jessup W, Jones PJ, Lutjohann D, Maerz W, Masana L, Silbernagel G, Staels B, Borén J, Catapano AL, De Baker G, Deanfield J, Descamps OS, Kovanen PT, Tokgozoglu L, Chapman M.J., RICCARDI, GABRIELE, Gylling, H, Plat, J, Turley, S, Ginsberg, Hn, Ellegard, L, Jessup, W, Jones, Pj, Lutjohann, D, Maerz, W, Masana, L, Silbernagel, G, Staels, B, Borén, J, Catapano, Al, De Baker, G, Deanfield, J, Descamps, O, Kovanen, Pt, Riccardi, Gabriele, Tokgozoglu, L, and Chapman, M. J.
- Published
- 2014
10. Oat bran rapidly increases bile acid excretion and bile acid synthesis: an ileostomy study
- Author
-
Ellegard, L and Andersson, H
- Abstract
Objective: To study whether oat bran with native [beta]-glucans increases bile acid excretion and bile acid synthesis as measured by serum concentrations of 7[alpha]-hydroxy-4-cholesten-3-one (7[alpha]-HC). Design: Short-term interventional crossover study evaluating cholesterol absorption, ileal excretion of cholesterol and bile acids, and serum levels of cholesterol and bile acid metabolites. Differences between diets evaluated with Wilcoxon's signed rank-sum test. Setting: Outpatients at a metabolic-ward kitchen. Subjects: Nine volunteers with conventional ileostomies. Methods: Two 3-day-diet periods, with controlled, blinded basal diet including 75 g extruded oat bran breakfast cereal daily, with either 11.6 g native or hydrolysed [beta]-glucans. Results: Native oat bran increased median excretion of bile acids by 144% (P=0.008). Cholesterol excretion remained unchanged, cholesterol absorption decreased by 19% (P=0.013), whereas the sum of bile acid and cholesterol excretion increased by 40% (P=0.008) compared with hydrolysed oat bran. 7[alpha]-HC reflecting bile acid synthesis increased by 57% (P=0.008) within 24 h of consumption, whereas serum lathosterol concentration reflecting cholesterol synthesis increased by 12% (P=0.015). Conclusions: Oat bran with native [beta]-glucans increases bile acid excretion within 24 h of consumption and this increase can also be detected by rising serum concentrations of 7[alpha]-HC. Thus, 7[alpha]-HC could be used for rapid detection of dietary effects on bile acid metabolism. These effects could possibly be explained by entrapment of whole micelles in the gut owing to higher viscosity. European Journal of Clinical Nutrition (2007) 61, 938-945; doi: 10.1038/sj.ejcn.1602607; published online 24 January 2007 Keywords: oat bran, [beta]-glucans, dietary fibre, bile acid excretion, cholesterol absorption, ileostomy, Author(s): L Ellegard [1]; H Andersson [1] Introduction Cholesterol metabolism is determined by diet, genetic factors, cholesterol absorption, sterol synthesis and sterol excretion. Serum cholesterol concentration is influenced by dietary [...]
- Published
- 2007
- Full Text
- View/download PDF
11. Rapeseed oil, olive oil, plant sterols, and cholesterol metabolism: an ileostomy study
- Author
-
Ellegard, L, Andersson, H, and Bosaeus, I
- Abstract
Objective: To study whether olive oil and rapeseed oil have different effects on cholesterol metabolism. Design: Short-term experimental study, with controlled diets. Setting: Outpatients at a metabolic-ward kitchen. Subjects: A total of nine volunteers with conventional ileostomies. Interventions: Two 3-day diet periods; controlled diet including 75 g of rapeseed oil or olive oil. Main outcome measures: Cholesterol absorption, ileal excretion of cholesterol, and bile acids. Serum levels of cholesterol and bile acid metabolites. Differences between diets evaluated with Wilcoxon's signed rank sum test. Results: Rapeseed oil diet contained 326 mg more plant sterols than the olive oil diet. Rapeseed oil tended to decrease cholesterol absorption by 11% (P=0.050), and increased excretion of cholesterol, bile acids, and their sum as sterols by 9% (P=0.021), 32% (P=0.038), and 51% (P=0.011) compared to olive oil. A serum marker for bile acid synthesis (7[alpha]-hydroxy-4-cholesten-3-one) increased by 28% (P=0.038) within 10 h of consumption, and serum cholesterol levels decreased by 7% (P=0.024), whereas a serum marker for cholesterol synthesis (lathosterol) as well as serum levels of plant sterols remained unchanged. Conclusions: Rapeseed oil and olive oil have different effects on cholesterol metabolism. Rapeseed oil, tends to decrease cholesterol absorption, increases excretion of cholesterol and bile acids, increases serum marker of bile acid synthesis, and decreases serum levels of cholesterol compared to olive oil. This could in part be explained by different concentrations of natural plant sterols. Sponsorship: Supported by the G#246;teborg Medical Society, the Swedish Medical Society, the Swedish Board for Agricultural Research (SJFR) grant 50.0444/98 and by University of G#246;teborg. European Journal of Clinical Nutrition (2005) 59, 1374-1378. doi: 10.1038/sj.ejcn.1602249; published online 10 August 2005 Keywords: cholesterol absorption, sterol excretion, dietary fibre, dietary fat, plant sterols, ileostomy, Author(s): L Ellegard [1]; H Andersson [1]; I Bosaeus [1] Introduction Cholesterol can only be eliminated from the body by faecal excretion, except for minor amounts of metabolites of steroid [...]
- Published
- 2005
- Full Text
- View/download PDF
12. Intake of dietary plant sterols is inversely related to serum cholesterol concentration in men and women in the EPIC Norfolk population: a cross-sectional study
- Author
-
Andersson, S W, Skinner, J, Ellegard, L, Welch, A A, Bingham, S, Mulligan, A, Andersson, H, and Shaw, K-T
- Abstract
Objective:: We examined the relation between intake of natural dietary plant sterols and serum lipid concentrations in a free-living population. Design, setting and participants:: Cross-sectional population-based study of 22 256 men and women aged 39-79 y resident in Norfolk, UK, participating in the European Prospective Investigation into Cancer (EPIC-Norfolk). Main exposure and outcome measures:: Plant sterol intake from foods and concentrations of blood lipids. Results:: Mean concentrations of total cholesterol and low-density lipoprotein cholesterol, adjusted for age, body mass index and total energy intake, decreased with increasing plant sterol intake in men and women. Mean total serum cholesterol concentration for men in the highest fifth of plant sterol intake (mean intake 463 mg daily) was 0.25 mmol/l lower and for low-density lipoprotein cholesterol 0.14 mmol/l lower than those in the lowest fifth of plant sterol consumption (mean intake 178 mg daily); the corresponding figures in women were 0.15 and 0.13 mmol/l. After adjusting for saturated fat and fibre intakes, the results for total cholesterol and low-density lipoprotein cholesterol were similar, although the strength of the association was slightly reduced. Conclusions:: In a free-living population, a high intake of plant sterols is inversely associated with lower concentrations of total and low-density lipoprotein serum cholesterol. The plant sterol content of foods may partly explain diet-related effects on serum cholesterol concentration. European Journal of Clinical Nutrition (2004) 58, 1378-1385. doi: 10.1038/sj.ejcn.1601980 Published online 31 March 2004 Keywords: phytosterols, cholesterol, lipids, diet, population, Author(s): S W Andersson [1]; J Skinner [2]; L Ellegard [1]; A A Welch [3]; S Bingham [4]; A Mulligan [3]; H Andersson [1]; K-T Shaw [3] Introduction Coronary heart [...]
- Published
- 2004
- Full Text
- View/download PDF
13. Energy intake in Swedish adolescents: validation of diet history with doubly labelled water
- Author
-
Sjoberg, A, Slinde, F, Arvidsson, D, Ellegard, L, Gramatkovski, E, Hallberg, L, and Hulthen, L
- Abstract
Objective:: To compare habitual energy intake (EI) estimated from diet history (DH) with total energy expenditure (TEE) measured with doubly labelled water (DLW) in adolescents. Design:: DH included a detailed questionnaire and an interview. TEE was measured during a 14-day period. Adequate (AR), under- (UR) and over-reporters (OR) were defined from the ratio EI/TEE: AR 0.84-1.16, UR [less than] 0.84 and OR [greater than] 1.16. Setting:: Participants were recruited from grade 9 in a compulsory school in G#246;teborg, Sweden. All data were collected at school and DLW dosages were distributed at Sahlgrenska University Hospital. Subjects:: A total of 35 adolescents (18 boys, 17 girls), 15.7 (0.4) y. Results:: EI was 11.0 (3.6) MJ and TEE was 11.4 (2.1) MJ (P=0.42). DH was able to rank EI compared to TEE (Spearman's r=0.59, P[les]0.001). For girls, EI was 18% lower (P=0.0067) and for boys, EI was 7% higher (P=0.26) compared to TEE. The 95% limits of agreement for difference between TEE and EI were -5.6 to 6.5 MJ. In total, 20 subjects were defined as AR (57%), nine as UR (26%) and six as OR (17%). Energy from in-between meals was 33% lower (P=0.0043) in UR girls and 57% higher (P=0.026) in OR boys, compared to adequate reporting girls and boys, respectively. In UR girls, energy-adjusted intake (10 MJ) of specific foods did not differ significantly, fat was lower and carbohydrate and vitamin C were higher compared to AR girls (all P [less than] 0.05). OR boys had no significant differences in food and nutrient intake in 10 MJ compared to AR boys. Conclusion:: The diet history was able to capture EI for the group and to rank subjects. There was a wide individual range in reporting- accuracy related to gender. Sponsorship:: The Ingabritt and Arne Lundberg Foundation, The Wilhelm and Martina Lundgren Foundation. European Journal of Clinical Nutrition (2003) 57, 1643-1652. doi: 10.1038/sj.ejcn.1601892 Keywords: energy intake, energy expenditure, doubly labelled water, adolescent nutrition, food habits, Author(s): A Sjoberg [1]; F Slinde [1]; D Arvidsson [1]; L Ellegard [1]; E Gramatkovski [1]; L Hallberg [1]; L Hulthen [1] Introduction Valid dietary assessment methods are important to [...]
- Published
- 2003
- Full Text
- View/download PDF
14. SUN-P024: Nutrition Practice in Nordic ICÙS- A Questionnaire Investigation Among Physicians and Nurses
- Author
-
Wichmann, H., primary, Hugdahl, L., additional, Rotko, N., additional, Mehrabi, M., additional, Holst, M., additional, and Ellegard, L., additional
- Published
- 2016
- Full Text
- View/download PDF
15. Progress and prospective of plant sterol and plant stanol research: Report of the Maastricht meeting
- Author
-
Mackay D., Clifton P.M., Jones P.J.H., Awad A., Chapman J., Baker P.C., Gylling H., Jones P., Lutjohann D., Marz W., Moreau B., Ostlund R., Plat J., Rideout T., Ros E., Schaefer E., Daniel T., Vartiainen E., Weingartner O., Zampelas A., Berger A., Wester I., Rosin S., Meijer G., Trautwein E., Ras R., Antoine J.-M., Jeansen S., Koutnikova H., Short C., Messinger H., Horlacher P., Ehrhardt C., Brañes C., Harting T., Thompson G., Tikkanen M., Shaghaghi M.A., Baer D., Ansorena D., Baumgartner S., Blanco-Vaca F., Ellegard L., Carles J., Laitinen K., Myrie S., Miettinen T., Mymin D., Robinson M., Rompelberg C., Sarkkinen E., Silbernagel G., de Smet E., and Loman S.
- Subjects
phytosterol ,food intake ,nonhuman ,concentration (parameters) ,consensus development ,antineoplastic activity ,stanozolol ,low density lipoprotein cholesterol ,unclassified drug ,drug efficacy ,drug formulation ,priority journal ,plant stanol ,lipid metabolism ,human ,Alzheimer disease ,atherosclerosis ,antilipemic agent ,antineoplastic agent ,conference paper ,Netherlands - Abstract
Abundant evidence over past decades shows that foods with added plant sterols and plant stanols lower serum LDL cholesterol concentrations. However, despite the overwhelming data, numerous scientific questions still remain. The objective of this paper is to summarize the considerations of 60 academic and industrial experts who participated in the scientific meeting in Maastricht, the Netherlands, on issues related to the health effects of plant sterols and plant stanols. The meeting participants discussed issues including efficacy profiling, heterogeneity in responsiveness, effects beyond LDL-C lowering, and food formulation aspects of plant sterol and stanol consumption. Furthermore, aspects related to the potential atherogenicity of elevated circulatory plant sterol concentrations were discussed. Until the potential atherogenicity of plant sterols is resolved, based on the results >200 clinical trials, the risk to benefit of plant sterol use is favorable. Evidence on these topics in plant sterol and plant stanol research was presented and used to reach consensus where possible. It was concluded that endpoint studies looking at plant sterol and plant stanol efficacy are needed, however, there was no clear opinion on the best marker and best design for such a study. Based on the current scientific evidence, plant sterols and plant stanols are recommended for use as dietary options to lower serum cholesterol. © 2012.
- Published
- 2012
16. Slightly superior performance of bioimpedance spectroscopy over single frequency regression equations for assessment of total body water
- Author
-
Seoane, F., primary, Abtahi, S., additional, Abtahi, F., additional, Ellegard, L., additional, Johannsson, G., additional, Bosaeus, I., additional, and Ward, Lc, additional
- Published
- 2015
- Full Text
- View/download PDF
17. PP184-SUN THE NORDIC NUTRITION ACADEMY'S POCKET GUIDE TO PARENTERAL NUTRITION
- Author
-
De Hoog, B., primary, Gessing, P., additional, Henfridsson, P., additional, Holmboe, C., additional, Larsen, L., additional, Merras-Salmio, L., additional, Rasmussen, I., additional, Ellegard, L., additional, and Rasmussen, H., additional
- Published
- 2011
- Full Text
- View/download PDF
18. PP037 ENERGY TURNOVER FROM 73 TO 86 YRS OF AGE - A LONGITUDINAL FOLLOW-UP
- Author
-
Rothenberg, E.M.C., primary, Malmros, V., additional, Ellegard, L., additional, and Bosaeus, I.G., additional
- Published
- 2010
- Full Text
- View/download PDF
19. PP054-MON: Vitamin D and Vitamin B12 Deficiencies are Common in Patients with Midgut Carcinoid, but can be Improved By Supplementation
- Author
-
Lind, A., Wängberg, B., and Ellegård, L.
- Published
- 2014
- Full Text
- View/download PDF
20. Simulation and comparison of path restoration techniques in SDH mesh networks.
- Author
-
Ruepp, S., Dittman, L., and Ellegard, L.
- Published
- 2005
- Full Text
- View/download PDF
21. PP123-MON BODY COMPOSITION AND ENERGY BALANCE IN PATIENTS ON NUTRITIONAL THERAPY DURING THE FIRST YEAR AFTER MAJOR UPPER GASTROINTESTINAL SURGERY
- Author
-
Copland, L., Rothenberg, E., Ellegârd, L., Hyltander, A., and Bosaeus, I.
- Published
- 2011
- Full Text
- View/download PDF
22. PP058-MON A MULTICENTRE COMPARISON OF DEMOGRAPHICS AND BIOCHEMISTRY IN ADULT PATIENTS RECEIVING HOME PARENTAL NUTRITION (HPN) IN DENMARK AND SWEDEN
- Author
-
Lund, P., Jensen, L., Brandt, C., Jeppesen, P.B., Ellegård, L., and Rasmussen, H.H.
- Published
- 2011
- Full Text
- View/download PDF
23. PP029-SUN VITAMIN D DEFICIENCY AND OSTEOPENIA ARE COMMON IN PATIENTS WITH MIDGUT CARCINOID
- Author
-
Lind, A., Ellegârd, L., and Wängberg, B.
- Published
- 2011
- Full Text
- View/download PDF
24. P257 DEVELOPMENT OF CACHEXIA AND DEPLETION OF FAT AND MUSCLE IN ADVANCED CANCER
- Author
-
Bosaeus, I.G., Ellegård, L., Malmros, V., Körner, U., and Lundholm, K.
- Published
- 2008
- Full Text
- View/download PDF
25. Comparison of an elemental and two polymeric diets in colectomized patients with or without intestinal resection
- Author
-
Andersson, H., primary, Bosaeus, I., additional, Ellegard, L., additional, Hallgren, B., additional, Hultén, L., additional, and Magnusson, O., additional
- Published
- 1984
- Full Text
- View/download PDF
26. Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey
- Author
-
Antonella Lezo, Antonella Diamanti, Evelyne M. Marinier, Merit Tabbers, Anat Guz-Mark, Paolo Gandullia, Maria I. Spagnuolo, Sue Protheroe, Noel Peretti, Laura Merras-Salmio, Jessie M. Hulst, Sanja Kolaček, Looi C. Ee, Joanna Lawrence, Jonathan Hind, Lorenzo D’Antiga, Giovanna Verlato, Ieva Pukite, Grazia Di Leo, Tim Vanuytsel, Maryana K. Doitchinova-Simeonova, Lars Ellegard, Luisa Masconale, María Maíz-Jiménez, Sheldon C. Cooper, Giorgia Brillanti, Elena Nardi, Anna S. Sasdelli, Simon Lal, Loris Pironi, Regione Piemonte Azienda Ospedaliera - S. Anna [Turin, Italy] (OIRM-S), Ospedale Bambin Gesù [Rome, Italy] (OBG), Centre de Référence des Maladies Digestives Rares [AP-HP Hôpital Robert-Debré] (CRMDR), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Emma Children’s Hospital, Amsterdam UMC - Amsterdam University Medical Center, Schneider Children’s Medical Center [Petah Tikva, Israel] (SCMC), Tel Aviv University (TAU), IRCCS Istituto Giannina Gaslini [Genoa, Italy], University of Naples Federico II = Università degli studi di Napoli Federico II, Birmingham Women's and Children's NHS Foundation Trust, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Helsinki University Hospital [Finland] (HUS), Eramus MC-Sophia Children’s Hospital, Partenaires INRAE, Children’s Hospital Srebrnjak [Zagreb, Croatia], Children’s Health Queensland [Brisbane] (CHQ), Royal Children’s Hospital & Department of Paediatrics [Parkville, VIC, Australia], King‘s College London, Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Azienda Ospedale Università di Padova = Hospital-University of Padua (AOUP), Children's Clinical University Hospital [Riga, Latvia] (CCUH), Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo' [Trieste], Leuven Intestinal Failure and Transplantation [Leuven, Belgium] (LIFT), University Hospitals Leuven [Leuven], Bulgarian Association of Patients with Malnutrition [Sofia, Bulgaria] (BAPM), Sahlgrenska University Hospital [Gothenburg], Ospedale Orlandi [Bussolengo, Italy] (2O), Hospital Universitario 12 de Octubre [Madrid], Alma Mater Studiorum University of Bologna (UNIBO), University of Bologna/Università di Bologna, Azienda Ospedaliero-Universitaria di Bologna [Bolohna, Italy] (AOUB), Salford Royal NHS Foundation Trust [Salford, UK], CarMeN, laboratoire, Pediatrics, Pediatric surgery, Clinicum, HUS Children and Adolescents, Children's Hospital, University of Helsinki, Paediatric Gastroenterology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ARD - Amsterdam Reproduction and Development, Lezo A., Diamanti A., Marinier E.M., Tabbers M., Guz-Mark A., Gandullia P., Spagnuolo M.I., Protheroe S., Peretti N., Merras-Salmio L., Hulst J.M., Kolacek S., Ee L.C., Lawrence J., Hind J., D'antiga L., Verlato G., Pukite I., Di Leo G., Vanuytsel T., Doitchinova-Simeonova M.K., Ellegard L., Masconale L., Maiz-Jimenez M., Cooper S.C., Brillanti G., Nardi E., Sasdelli A.S., Lal S., Pironi L., Lezo, Antonella, Diamanti, Antonella, Marinier, Evelyne M., Tabbers, Merit, Guz-Mark, Anat, Gandullia, Paolo, Spagnuolo, Maria I., Protheroe, Sue, Peretti, Noel, Merras-Salmio, Laura, Hulst, Jessie M., Kola( (c))ek, Sanja, Ee, Looi C., Lawrence, Joanna, Hind, Jonathan, D'Antiga, Lorenzo, Verlato, Giovanna, Pukite, Ieva, Di Leo, Grazia, Vanuytsel, Tim, Doitchinova-Simeonova, Maryana K., Ellegard, Lar, Masconale, Luisa, Ma('(i))z-Jim('(e))nez, Mar('(i))a, Cooper, Sheldon C., Brillanti, Giorgia, Nardi, Elena, Sasdelli, Anna S., Lal, Simon, and Pironi, Loris
- Subjects
Adult ,Male ,Short Bowel Syndrome ,[SDV]Life Sciences [q-bio] ,YOUNG-PEOPLE ,ENTERAL NUTRITION ,CLASSIFICATION ,home parenteral nutrition ,Intestinal Failure ,children ,body growth ,Humans ,chronic intestinal failure ,intravenous supplementation ,intestinal transplantation ,transition ,ADULT PATIENTS ,HEPATOLOGY ,Child ,Cross-Sectional Studie ,Nutrition and Dietetics ,Science & Technology ,Intestinal Disease ,Nutrition & Dietetics ,GASTROENTEROLOGY ,PREVALENCE ,[SDV] Life Sciences [q-bio] ,Intestinal Diseases ,Cross-Sectional Studies ,ITALIAN SOCIETY ,Chronic Disease ,HOME PARENTERAL-NUTRITION ,Female ,REHABILITATION PROGRAMS ,3143 Nutrition ,Parenteral Nutrition, Home ,Life Sciences & Biomedicine ,Food Science ,Human - Abstract
Background: The European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF) was analyzed to investigate factors associated with nutritional status and the intravenous supplementation (IVS) dependency in children. Methods: Data collected: demographics, CIF mechanism, home parenteral nutrition program, z-scores of weight-for-age (WFA), length or height-for-age (LFA/HFA), and body mass index-for-age (BMI-FA). IVS dependency was calculated as the ratio of daily total IVS energy over estimated resting energy expenditure (%IVSE/REE). Results: Five hundred and fifty-eight patients were included, 57.2% of whom were male. CIF mechanisms at age 1−4 and 14−18 years, respectively: SBS 63.3%, 37.9%; dysmotility or mucosal disease: 36.7%, 62.1%. One-third had WFA and/or LFA/HFA z-scores < −2. One-third had %IVSE/REE > 125%. Multivariate analysis showed that mechanism of CIF was associated with WFA and/or LFA/HFA z-scores (negatively with mucosal disease) and %IVSE/REE (higher for dysmotility and lower in SBS with colon in continuity), while z-scores were negatively associated with %IVSE/REE. Conclusions: The main mechanism of CIF at young age was short bowel syndrome (SBS), whereas most patients facing adulthood had intestinal dysmotility or mucosal disease. One-third were underweight or stunted and had high IVS dependency. Considering that IVS dependency was associated with both CIF mechanisms and nutritional status, IVS dependency is suggested as a potential marker for CIF severity in children. ispartof: NUTRIENTS vol:14 issue:9 ispartof: location:Switzerland status: published
- Published
- 2022
27. Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure
- Author
-
Nuria Virgili, Konrad Matysiak, Cristina Cuerda, Henrik Højgaard Rasmussen, Florian Poullenot, Ronan Thibault, Umberto Aimasso, Amelia Jukes, Andre Dong Won Lee, Brooke Chapman, Geert J. A. Wanten, Simona Di Caro, Maryana Doitchinova-Simeonova, Alastair Forbes, Corrado Spaggiari, Ezra Steiger, Elena Nardi, Cécile Chambrier, Simon Lal, Paolo Orlandoni, Peter Sahin, Marina Taus, Mireille J. Serlie, Kinga Szczepanek, A. Crivelli, Nicola Wyer, Przemysław Matras, Lynn Jones, Carmen Garde, Gabriel Olveira, Marek Kunecki, José P. Suárez-Llanos, Francisca Joly, Ana Zugasti Murillo, Joanne Daniels, Loris Pironi, Zeljko Krznaric, Emma Osland, Sheldon C. Cooper, Stéphane M. Schneider, Sarah Jane Hughes, Lars Ellegård, Miriam Theilla, Luisa Masconale, Anna Zmarzly, Aurora E. Serralde-Zúñiga, André Van Gossum, Anna Simona Sasdelli, Lidia Santarpia, Nada Rotovnik Kozjek, Francesco William Guglielmi, Margie O'Callaghan, Charlene Compher, Estrella Petrina Jáuregui, Pironi, L., Steiger, E., Joly, F., Wanten, G. J. A., Chambrier, C., Aimasso, U., Sasdelli, A. S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M. J., Cooper, S. C., Poullenot, F., Rasmussen, H. Ho., Compher, C. W., Crivelli, A., Hughes, S. -J., Santarpia, L., Guglielmi, F. W., Rotovnik Kozjek, N., Ellegard, L., Schneider, S. M., Matras, P., Forbes, A., Wyer, N., Zmarzly, A., Taus, M., O'Callaghan, M., Osland, E., Thibault, R., Cuerda, C., Jones, L., Chapman, B., Sahin, P., Virgili, N. M., Lee, A. D. W., Orlandoni, P., Matysiak, K., Di Caro, S., Doitchinova-Simeonova, M., Masconale, L., Spaggiari, C., Garde, C., Serralde-Zuniga, A. E., Olveira, G., Krznaric, Z., Petrina Jauregui, E., Zugasti Murillo, A., Suarez-Llanos, J. P., Nardi, E., Van Gossum, A., Lal, S., Pironi, Lori, Steiger, Ezra, Joly, Francisca, Wanten, Geert J A, Chambrier, Cecile, Aimasso, Umberto, Sasdelli, Anna Simona, Szczepanek, Kinga, Jukes, Amelia, Theilla, Miriam, Kunecki, Marek, Daniels, Joanne, Serlie, Mireille J, Cooper, Sheldon C, Poullenot, Florian, Rasmussen, Henrik Højgaard, Compher, Charlene W, Crivelli, Adriana, Hughes, Sarah-Jane, Santarpia, Lidia, Guglielmi, Francesco William, Rotovnik Kozjek, Nada, Ellegard, Lar, Schneider, Stéphane M, Matras, Przemysław, Forbes, Alastair, Wyer, Nicola, Zmarzly, Anna, Taus, Marina, O'Callaghan, Margie, Osland, Emma, Thibault, Ronan, Cuerda, Cristina, Jones, Lynn, Chapman, Brooke, Sahin, Peter, Virgili, Núria M, Lee, Andre Dong Won, Orlandoni, Paolo, Matysiak, Konrad, Di Caro, Simona, Doitchinova-Simeonova, Maryana, Masconale, Luisa, Spaggiari, Corrado, Garde, Carmen, Serralde-Zúñiga, Aurora E, Olveira, Gabriel, Krznaric, Zeljko, Petrina Jáuregui, Estrella, Zugasti Murillo, Ana, Suárez-Llanos, José P, Nardi, Elena, Van Gossum, André, Lal, Simon, University of Bologna, Cleveland Clinic, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Radboud university [Nijmegen], Hospices Civils de Lyon (HCL), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Aalborg University [Denmark] (AAU), Sahlgrenska Academy at University of Gothenburg [Göteborg], Centre Hospitalier Universitaire de Nice (CHU Nice), Medical University of Lublin, University of East Anglia [Norwich] (UEA), University Hospital Coventry, CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Hospital General Universitario 'Gregorio Marañón' [Madrid], Austin Health, Universidade de São Paulo (USP), Poznan University of Life Sciences (Uniwersytet Przyrodniczy w Poznaniu) (PULS), University College London Hospitals (UCLH), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán - National Institute of Medical Science and Nutrition Salvador Zubiran [Mexico], University of Manchester [Manchester], European Society for Clinical Nutrition and Metabolism (ESPEN)., Endocrinology, AGEM - Endocrinology, metabolism and nutrition, University of Bologna/Università di Bologna, Radboud University [Nijmegen], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Universidade de São Paulo = University of São Paulo (USP)
- Subjects
Male ,0301 basic medicine ,[SDV]Life Sciences [q-bio] ,Severity of Illness Index ,Liver disease ,0302 clinical medicine ,Drug Dosage Calculations ,motility disorder ,2. Zero hunger ,Gastroenterology ,Short bowel syndrome ,3. Good health ,Chronic intestinal failure ,Intestines ,Pharmaceutical Solutions ,Venous thrombosis ,Intestinal obstruction ,motility disorders ,Administration, Intravenous ,Female ,030211 gastroenterology & hepatology ,Parenteral Nutrition, Home ,Adult ,Fat Emulsions, Intravenous ,medicine.medical_specialty ,parenteral nutrition ,macromolecular substances ,Clinical nutrition ,short bowel syndrome ,03 medical and health sciences ,Cholestasis ,intestinal failure ,Internal medicine ,medicine ,Humans ,030109 nutrition & dietetics ,business.industry ,liver failure ,medicine.disease ,Intestinal Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Parenteral nutrition ,Alimentació parenteral ,Intestinal Absorption ,Catheter-Related Infections ,Parenteral feeding ,Chronic Disease ,Obstrucció intestinal ,Fluid Therapy ,business ,Body mass index - Abstract
Background and aimNo marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity.MethodsAt baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as 3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI).ResultsFifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN 1 L/day), patients’ death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2–3 and PN >3 L/day).ConclusionsThe type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols.
- Published
- 2020
28. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome:An international multicenter survey
- Author
-
Loris Pironi, Ezra Steiger, Francisca Joly, Palle B. Jeppesen, Geert Wanten, Anna S. Sasdelli, Cecile Chambrier, Umberto Aimasso, Manpreet S. Mundi, Kinga Szczepanek, Amelia Jukes, Miriam Theilla, Marek Kunecki, Joanne Daniels, Mireille Serlie, Florian Poullenot, Sheldon C. Cooper, Henrik H. Rasmussen, Charlene Compher, David Seguy, Adriana Crivelli, Lidia Santarpia, Francesco W. Guglielmi, Nada Rotovnik Kozjek, Stéphane M. Schneider, Lars Ellegard, Ronan Thibault, Przemysław Matras, Konrad Matysiak, Andrè Van Gossum, Alastair Forbes, Nicola Wyer, Marina Taus, Nuria M. Virgili, Margie O'Callaghan, Brooke Chapman, Emma Osland, Cristina Cuerda, Gábor Udvarhelyi, Lynn Jones, Andre D. Won Lee, Luisa Masconale, Paolo Orlandoni, Corrado Spaggiari, Marta Bueno Díez, Maryana Doitchinova-Simeonova, Aurora E. Serralde-Zúñiga, Gabriel Olveira, Zeljko Krznaric, Laszlo Czako, Gintautas Kekstas, Alejandro Sanz-Paris, Mª Estrella Petrina Jáuregui, Ana Zugasti Murillo, Eszter Schafer, Jann Arends, José P. Suárez-Llanos, Nader N. Youssef, Giorgia Brillanti, Elena Nardi, Simon Lal, Adriana N. Crivelli, Hector Solar Muñiz, Brooke R. Chapman, Ruth Hodgson, Siobhan Wallin, Kay Lasenby, Andre Van Gossum, Andre Dong Won Lee, Henrik Højgaard Rasmussen, Chrisoffer Brandt, Vanessa Boehm, Julie Bataille, Lore Billiauws, Tomas Molnar, Mihaly Zsilak-Urban, Ferenc Izbéki, Peter Sahin, Anna Simona Sasdelli, Merlo F. Dario, Valentino Bertasi, Nunzia Regano, Santarpia Lidia, Lucia Alfonsi, Debora Busni, Lyn Gillanders, Anna Zmarzly, Marta Bueno, Carmen Garde, Ma Estrella Petrina Jáuregui, Cora Jonker, Simona Di Caro, Niamh Keane, Pinal Patel, Sarah-Jane Nelson Hughes, Rachel Lloyd, Arun Abraham, Gerda Garside, Michael Taylor, Jian Wu, Trevor Smith, Charlotte Pither, Michael Stroud, Reena Parmar, Nicola Burch, Sarah Zeraschi, Manpreet Mundi, Denise Jezerski, Pironi L., Steiger E., Joly F., Jeppesen P.B., Wanten G., Sasdelli A.S., Chambrier C., Aimasso U., Mundi M.M., Szczepanek K., Jukes A., Theilla M., Kunecki M., Daniels J., Serlie M., Poullenot F., Cooper S.C., Rasmussen H.H., Compher C., Seguy D., Crivelli A., Santarpia L., Guglielmi F.W., Kozjek N.R., Schneider S.M., Ellegard L., Thibault R., Matras P., Matysiak K., Van Gossum A., Forbes A., Wyer N., Taus M., Virgili N.M., O'Callaghan M., Chapman B., Osland E., Cuerda C., Udvarhelyi G., Jones L., Won Lee A.D., Masconale L., Orlandoni P., Spaggiari C., Diez M.B., Doitchinova-Simeonova M., Serralde-Zuniga A.E., Olveira G., Krznaric Z., Czako L., Kekstas G., Sanz-Paris A., Jauregui M.E.P., Murillo A.Z., Schafer E., Arends J., Suarez-Llanos J.P., Youssef N.N., Brillanti G., Nardi E., Lal S., Crivelli A.N., Muniz H.S., Chapman B.R., Hodgson R., Wallin S., Lasenby K., Brandt C., Boehm V., Bataille J., Billiauws L., Molnar T., Zsilak-Urban M., Izbeki F., Sahin P., Dario M.F., Bertasi V., Regano N., Lidia S., Alfonsi L., Busni D., Gillanders L., Zmarzly A., Bueno M., Garde C., Jonker C., Di Caro S., Keane N., Patel P., Nelson Hughes S.-J., Lloyd R., Abraham A., Garside G., Taylor M., Wu J., Smith T., Pither C., Stroud M., Parmar R., Burch N., Zeraschi S., Mundi M., Jezerski D., Endocrinology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, University of Bologna, Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Cleveland Clinic, Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Rigshospitalet [Copenhagen], Copenhagen University Hospital, Radboud University Medical Center [Nijmegen], Hospices Civils de Lyon (HCL), Città della Salute e della Scienza University-Hospital, Mayo Clinic and Mayo College of Medicine, Rochester, Stanley Dudrick's Memorial Hospital, Partenaires INRAE, University Hospital of Wales, Tel Aviv University [Tel Aviv], University of Lódź, Nottingham University Hospitals NHS Trust [UK], VU University Medical Center [Amsterdam], CHU Bordeaux [Bordeaux], University Hospitals Birmingham NHS Foundation Trust, Aalborg University Hospital, Hospital of the University of Pennsylvania (HUP), Perelman School of Medicine, University of Pennsylvania [Philadelphia]-University of Pennsylvania [Philadelphia], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hospital Universitario Fundacion Favaloro, University of Naples Federico II, Monsignor di Miccoli Hospital, Institute of Oncology - Ljubljana, Institute of Oncology Ljubljana, Centre Hospitalier Universitaire de Nice (CHU Nice), University of Gothenburg (GU), The project of the ESPEN database for Chronic Intestinal Failure was promoted by the ESPEN Executive Committee in 2013, was approved by the ESPEN Council and was supported by an ESPEN grant., University of Bologna/Università di Bologna, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University Hospital of Wales (UHW), Tel Aviv University (TAU), Nottingham University Hospitals NHS Trust (NUH), University of Pennsylvania-University of Pennsylvania, University of Naples Federico II = Università degli studi di Napoli Federico II, and Institute of Oncology [Ljubljana]
- Subjects
Parenteral Nutrition ,Epidemiology ,[SDV]Life Sciences [q-bio] ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,MESH: Intestinal Diseases ,Malalties intestinals ,0302 clinical medicine ,Indicadors de salut ,Medicine ,030212 general & internal medicine ,Intestines--Diseases ,Nutrition and Dietetics ,Intestinal Disease ,Short bowel syndrome ,Intestinal failure ,Health status indicators ,3. Good health ,Chronic intestinal failure ,Intestine ,Intestines ,medicine.anatomical_structure ,Cohort ,030211 gastroenterology & hepatology ,Female ,MESH: Intestines ,Human ,Adult ,Short Bowel Syndrome ,medicine.medical_specialty ,Anastomosis ,03 medical and health sciences ,Ileocecal valve ,MESH: Cross-Sectional Studies ,epidemiology ,home parenteral nutrition ,intestinal failure ,intravenous supplementation ,short bowel syndrome ,Internal medicine ,MESH: Short Bowel Syndrome ,Humans ,Cross-Sectional Studie ,Home parenteral nutrition ,MESH: Humans ,business.industry ,MESH: Adult ,medicine.disease ,Intravenous supplementation ,Intestinal Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Parenteral nutrition ,Cross-Sectional Studies ,Jejunostomy ,business ,MESH: Female ,MESH: Parenteral Nutrition - Abstract
Contains fulltext : 244566.pdf (Publisher’s version ) (Closed access) BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as 3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.
- Published
- 2021
29. Nutrition education in medical schools (NEMS) project: Joining ESPEN and university point of view
- Author
-
Ryoji Fukushima, Øivind Irtun, M I Hellerman, Osman Abbasoglu, E Stylianidis, C. Della Rocca, K Anastasiadis, A. Van Gossum, Cristina Cuerda, Maurizio Muscaritoli, Michael Chourdakis, T Mars, J Arias-Diaz, Matthias Pirlich, D Milovanovic, V Alunni, S. Schneider, Lars Ellegård, M Kujundžić-Tiljak, Rocco Barazzoni, Zeljko Krznaric, M Lember, Cuerda, C., Muscaritoli, M., Krznaric, Z., Pirlich, M., Van Gossum, A., Schneider, S., Ellegard, L., Fukushima, R., Chourdakis, M., Della Rocca, C., Milovanovic, D., Lember, M., Arias-Diaz, J., Stylianidis, E., Anastasiadis, K., Alunni, V., Mars, T., Hellerman, M. I., Kujundzic-Tiljak, M., Irtun, O., Abbasoglu, O., and Barazzoni, R.
- Subjects
0301 basic medicine ,Manifesto ,Societies, Scientific ,Clinical nutrition ,Medical curriculum ,Universities ,Nutritional Sciences ,clinical nutrition ,curriculum ,education ,human nutrition ,medical school ,teaching ,Nutrition Education ,Curriculum ,Education ,Human nutrition ,Medical school ,Teaching ,030209 endocrinology & metabolism ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,Schools, Medical ,Medical education ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Point (typography) ,Education, Medical ,business.industry ,Clinical Practice ,Europe ,business ,Education, Medical, Undergraduate - Abstract
Summary Background & aims Nutrition education is not well represented in the medical curriculum. The aim of this original paper was to describe the Nutrition Education in Medical Schools (NEMS) Project of the European Society for Clinical Nutrition and Metabolism (ESPEN). Methods On 19 January 2020, a meeting was held on this topic that was attended by 51 delegates (27 council members) from 34 countries, and 13 European University representatives. Results This article includes the contents of the meeting that concluded with the signing of the Manifesto for the Implementation of Nutrition Education in the Undergraduate Medical Curriculum. Conclusion The meeting represented a significant step forward, moved towards implementation of nutrition education in medical education in general and in clinical practice in particular, in compliance with the aims of the ESPEN Nutrition Education Study Group (NESG).
- Published
- 2020
30. Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey
- Author
-
Pironi, Loris, Steiger, Ezra, Brandt, Chrisoffer, Joly, Francisca, Wanten, Geert, Chambrier, Cecile, Aimasso, Umberto, Sasdelli, Anna Simona, Zeraschi, Sarah, Kelly, Darlene, Szczepanek, Kinga, Jukes, Amelia, Di Caro, Simona, Theilla, Miriam, Kunecki, Marek, Daniels, Joanne, Serlie, Mireille, Poullenot, Florian, Wu, Jian, Cooper, Sheldon C, Rasmussen, Henrik H, Compher, Charlene, Seguy, David, Crivelli, Adriana, Pagano, Maria C, Hughes, Sarah-Jane, Guglielmi, Francesco W, Kozjek, Nada Rotovnik, Schneider, Stéphane M, Gillanders, Lyn, Ellegard, Lars, Thibault, Ronan, Matras, Przemysław, Zmarzly, Anna, Matysiak, Konrad, Van Gossum, Andrè, Forbes, Alastair, Wyer, Nicola, Taus, Marina, Virgili, Nuria M, O'Callaghan, Margie, Chapman, Brooke, Osland, Emma, Cuerda, Cristina, Sahin, Peter, Jones, Lynn, Won Lee, Andre Dong, Masconale, Luisa, Orlandoni, Paolo, Izbéki, Ferenc, Spaggiari, Corrado, Bueno, Marta, Doitchinova-Simeonova, Maryana, Garde, Carmen, Serralde-Zúñiga, Aurora E, Olveira, Gabriel, Krznaric, Zeljko, Czako, Laszlo, Kekstas, Gintautas, Sanz-Paris, Alejandro, Jáuregui, Estrella Petrina, Murillo, Ana Zugasti, Schafer, Eszter, Arends, Jann, Suárez-Llanos, José P, Lal, Simon, Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN, European Society for Clinical Nutrition and Metabolism, Pironi L., Steiger E., Brandt C., Joly F., Wanten G., Chambrier C., Aimasso U., Sasdelli A.S., Zeraschi S., Kelly D., Szczepanek K., Jukes A., Di Caro S., Theilla M., Kunecki M., Daniels J., Serlie M., Poullenot F., Wu J., Cooper S.C., Rasmussen H.H., Compher C., Seguy D., Crivelli A., Pagano M.C., Hughes S.-J., Guglielmi F.W., Kozjek N.R., Schneider S.M., Gillanders L., Ellegard L., Thibault R., Matras P., Zmarzly A., Matysiak K., Van Gossum A., Forbes A., Wyer N., Taus M., Virgili N.M., O'Callaghan M., Chapman B., Osland E., Cuerda C., Sahin P., Jones L., Won Lee A.D., Masconale L., Orlandoni P., Izbeki F., Spaggiari C., Bueno M., Doitchinova-Simeonova M., Garde C., Serralde-Zuniga A.E., Olveira G., Krznaric Z., Czako L., Kekstas G., Sanz-Paris A., Jauregui E.P., Murillo A.Z., Schafer E., Arends J., Suarez-Llanos J.P., Lal S., St. Orsola University Hospital, Cleveland Clinic, Rigshospitalet [Copenhagen], Copenhagen University Hospital, Radboud University Medical Center [Nijmegen], Hospices Civils de Lyon, Departement de Neurologie (HCL), Leeds Teaching Hospitals NHS Trust, University Hospital of Wales, Rabin Medical Center, Nottingham University Hospital NHS Trust, Department of Infectious Diseases [Amsterdam, Netherlands] (Academic Medical Center), University of Amsterdam [Amsterdam] (UvA)-Center for Tropical and Travel Medicine [Amsterdam, Netherlands], University Hospital Southampton NHS Foundation Trust, University Hospitals Birmingham NHS Foundation Trust, 'Federico II' University of Naples Medical School, Sahlgrenska University Hospital [Gothenburg], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), CHU Pontchaillou [Rennes], University Hospitals Birmingham NHS Foundation Trust Institut National de la Santé et de la Recherche Médicale University of Pennsylvania, PennRoyal Marsden NHS Foundation TrustNottingham University Hospitals NHS TrustCleveland Clinic FoundationUniversity Hospital Southampton NHS Foundation TrustChung Hua University Fondazione Città della SperanzaInstitut National de la Recherche Agronomique Hospices Civils de Lyon European Society for Clinical Nutrition and Metabolism, Endocrinology, AGEM - Endocrinology, metabolism and nutrition, University Hospital of Wales (UHW), Nottingham University Hospitals NHS Trust (NUH), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Internationality ,[SDV]Life Sciences [q-bio] ,030209 endocrinology & metabolism ,Pharmacy ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Health care ,Chronic renal failure ,Medicine ,Humans ,Medical prescription ,Cancer ,Home parenteral nutrition ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Modalities ,Adult patients ,Intestinal failure ,Intravenous supplementation ,business.industry ,International survey ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,Middle Aged ,Health Surveys ,3. Good health ,Chronic intestinal failure ,Intestinal Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Parenteral nutrition ,Cross-Sectional Studies ,Treatment Outcome ,Alimentació parenteral ,Chronic Disease ,Parenteral feeding ,Insuficiència renal crònica ,Female ,business ,Parenteral Nutrition, Home ,[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition - Abstract
Contains fulltext : 220087.pdf (Publisher’s version ) (Closed access) BACKGROUND & AIMS: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF). METHODS: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions. RESULTS: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p
- Published
- 2020
31. COVID-19 infection in patients on long-term home parenteral nutrition for chronic intestinal failure.
- Author
-
Pironi L, Jezerski D, Sobocki J, Lal S, Vanuytsel T, Theilla M, Sasdelli AS, Chambrier C, Matysiak K, Aimasso U, Rasmussen HH, Jukes A, Kunecki M, Seguy D, Schneider SM, Daniels J, Poullenot F, Mundi MS, Matras P, Folwarski M, Crivelli A, Wyer N, Ellegard L, Santarpia L, Arvanitakis M, Spaggiari C, Lamprecht G, Guglielmi FW, Lezo A, Layec S, Boluda ER, Guz-Mark A, Gandullia P, Cuerda C, Osland E, Spagnuolo MI, Krznaric Z, Masconale L, Chapman B, Maíz-Jiménez M, Orlandoni P, Martins da Rocha MH, Virgili-Casas MN, Doitchinova-Simeonova M, Czako L, Van Gossum A, D'Antiga L, Ee LC, Warodomwichit D, Taus M, Kolaček S, Thibault R, Verlato G, Serralde-Zúñiga AE, Botella-Carretero JI, Aguayo PS, Olveira G, Chomtho S, Pisprasert V, Moisejevs G, Murillo AZ, Jáuregui MEP, Díez MB, Jahit MS, Densupsoontorn N, Tamer A, Brillanti G, and Joly F
- Subjects
- Humans, COVID-19 epidemiology, Intestinal Failure, Intestinal Diseases epidemiology, Intestinal Diseases therapy, Parenteral Nutrition, Home adverse effects
- Abstract
Background and Aims: To investigate the incidence and the severity of COVID-19 infection in patients enrolled in the database for home parenteral nutrition (HPN) for chronic intestinal failure (CIF) of the European Society for Clinical Nutrition and Metabolism (ESPEN)., Methods: Period of observation: March 1st, 2020 March 1st, 2021., Inclusion Criteria: patients included in the database since 2015 and still receiving HPN on March 1st, 2020 as well as new patients included in the database during the period of observation. Data related to the previous 12 months and recorded on March 1st 2021: 1) occurrence of COVID-19 infection since the beginning of the pandemic (yes, no, unknown); 2) infection severity (asymptomatic; mild, no-hospitalization; moderate, hospitalization no-ICU; severe, hospitalization in ICU); 3) vaccinated against COVID-19 (yes, no, unknown); 4) patient outcome on March 1st 2021: still on HPN, weaned off HPN, deceased, lost to follow up., Results: Sixty-eight centres from 23 countries included 4680 patients. Data on COVID-19 were available for 55.1% of patients. The cumulative incidence of infection was 9.6% in the total group and ranged from 0% to 21.9% in the cohorts of individual countries. Infection severity was reported as: asymptomatic 26.7%, mild 32.0%, moderate 36.0%, severe 5.3%. Vaccination status was unknown in 62.0% of patients, non-vaccinated 25.2%, vaccinated 12.8%. Patient outcome was reported as: still on HPN 78.6%, weaned off HPN 10.6%, deceased 9.7%, lost to follow up 1.1%. A higher incidence of infection (p = 0.04), greater severity of infection (p < 0.001) and a lower vaccination percentage (p = 0.01) were observed in deceased patients. In COVID-19 infected patients, deaths due to infection accounted for 42.8% of total deaths., Conclusions: In patients on HPN for CIF, the incidence of COVID-19 infection differed greatly among countries. Although the majority of cases were reported to be asymptomatic or have mild symptoms only, COVID-19 was reported to be fatal in a significant proportion of infected patients. Lack of vaccination was associated with a higher risk of death., Competing Interests: Conflict of interest statements LP: Participation on a Data Safety Monitoring Board or Advisory Board for Takeda, Consulting fees for Takeda, Northsea, NAPO. SL: Participation on a Data Safety Monitoring Board or Advisory Board for Baxter, Takeda, NorthSea, VectivBio; Grants or contracts from any entity for Baxter, Takeda; Consulting fees for VectivBio, Takeda, Northsea; Support for attending meetings and/or travel for Takeda; Payment or honoraria for lectures for Takeda, Fresenius. PG: none. LS: none. PO: none. NW: none. RT: Royalties or licenses for Royalties for designing the Simple Evaluation of Food Intake® (SEFI®) (Knoë, le Kremlin Bicêtre, France); Consulting fees for Nestlé Health Science; Payment or honoraria for lectures for Baxter, BBraun, Fresenius-Kabi, Nutricia; Support for attending meetings for Nutricia, NHC. PS: none. LE: none. PO: none. L D’A: none. AT: none. ND: Leadership of Pediatric Nutrition Association of Thailand Society of Parenteral Enteral Nutrition of Thailand. ASZ: Payment or honoraria for lectures for Siegfried; Consulting for Takeda; Support for attending meetings for Abbott and Nestlè. MF: Payment or honoraria for lectures for Fresenius Kabi, B Braun, Baxter. GV: none. MIS: none. MT: none. ERB: none. NVC: Payment or honoraria for lectures for Takeda, Nutricia; Payment for expert testimony, Support for attending meetings and Participation on a Data Safety Monitoring Board for Takeda. AL: Consulting fees, Support for attending meetings, Participation on a Data Safety Monitoring Board or Advisory Board for Nestlè; Participation on a Data Safety Monitoring Board or Advisory Board for Takeda; Payment or honoraria for lectures for baxter. LC: none. MA: none. EO: none. AGM: none. AVG: none. VP: honoraria for lectures for Thai Otsuka Pharmaceutical Co., Ltd., Abbott Laboratories Ltd., Nestle (Thai) Ltd., Fresenius Medical Care (Thailand) Ltd., Baxter Healthcare (Thailand) Co., Ltd., Mega Lifesciences PTY Ltd., Novo Nordisk Thailand. MSM: Grants or contracts from any entity for Fresenius Kabi, Nestle, Realfood Blends, VectivBio, Rockfield, Zealand; Consulting fees, Northsea; Participation on a Data Safety Monitoring Board for EndoBarrier. M D-S: none. TV: Grants or contracts from any entity for Vectiv Bio, Takeda; Consulting fees for Vectiv Bio, Zealand Pharma, Takeda, Baxter, Hamni, NorthSea Therapeutics; Payment or honoraria for lectures for Vectiv Bio, Takeda, Baxter; Support for attending meetings for Takeda, Vectiv Bio, Zealand Pharma, Fresenius Kabi; Receipt of equipment, materials, drugs for VectivBio. ZK: Support for attending meetings for Abbott, Fresenius, Nutricia, Nestle, Takeda; Leadership for Croatian Medical Association- The President. FP: none. LM: none. LCE: Consulting fees, Payment or honoraria for lecture and Support for attending meetings for Takeda. UA: Payment or honoraria for lectures for Takeda, Baxter; Support for attending meetings and Participation on a Data Safety Monitoring for Takeda. MK: none. MMJ: none. AC: none. DW: none. GO: none. CC: none. JS: Grants or contracts from any entity and for BBraun, FreseniusKabi, Nestle; Payment or honoraria for lectures for BBraun, OlimpLabs, FreseniusKabi, Baxter, Nestle; Support for attending meetings for FreseniusKabi. FWG: none. CS: none. MBD: none. DS: none. SL: none. SK: Payment or honoraria for lectures, for Abbott, Abela Farm, Danone/Nutricia, Fresenius, GM Pharma, Nestle, Nestle Nutrition Institute, Oktal Pharma, Shire/Takeda; Non-restricted grant delivered to the hospital from BioGaia. BC: none. GM: none. MHMdC: Grants or contracts, Consulting fees, Payment or honoraria, Support for attending meetings, Participation on a Data Safety Monitoring for lectures for Takeda Pharmaceutical Brazil. EPJ: none. FJ: none. DJ: none. GL: none. AZM: none. MT: none. DZ: none. MK: Payment or honoraria for manuscript writing and educational events for Nutricia, FreseniusKabi. ASS: none. GB: none., (Copyright © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
32. Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey.
- Author
-
Lezo A, Diamanti A, Marinier EM, Tabbers M, Guz-Mark A, Gandullia P, Spagnuolo MI, Protheroe S, Peretti N, Merras-Salmio L, Hulst JM, Kolaček S, Ee LC, Lawrence J, Hind J, D'Antiga L, Verlato G, Pukite I, Di Leo G, Vanuytsel T, Doitchinova-Simeonova MK, Ellegard L, Masconale L, Maíz-Jiménez M, Cooper SC, Brillanti G, Nardi E, Sasdelli AS, Lal S, and Pironi L
- Subjects
- Adult, Child, Chronic Disease, Cross-Sectional Studies, Female, Humans, Male, Intestinal Diseases epidemiology, Intestinal Diseases therapy, Intestinal Failure, Parenteral Nutrition, Home, Short Bowel Syndrome therapy
- Abstract
Background: The European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF) was analyzed to investigate factors associated with nutritional status and the intravenous supplementation (IVS) dependency in children. Methods: Data collected: demographics, CIF mechanism, home parenteral nutrition program, z-scores of weight-for-age (WFA), length or height-for-age (LFA/HFA), and body mass index-for-age (BMI-FA). IVS dependency was calculated as the ratio of daily total IVS energy over estimated resting energy expenditure (%IVSE/REE). Results: Five hundred and fifty-eight patients were included, 57.2% of whom were male. CIF mechanisms at age 1−4 and 14−18 years, respectively: SBS 63.3%, 37.9%; dysmotility or mucosal disease: 36.7%, 62.1%. One-third had WFA and/or LFA/HFA z-scores < −2. One-third had %IVSE/REE > 125%. Multivariate analysis showed that mechanism of CIF was associated with WFA and/or LFA/HFA z-scores (negatively with mucosal disease) and %IVSE/REE (higher for dysmotility and lower in SBS with colon in continuity), while z-scores were negatively associated with %IVSE/REE. Conclusions: The main mechanism of CIF at young age was short bowel syndrome (SBS), whereas most patients facing adulthood had intestinal dysmotility or mucosal disease. One-third were underweight or stunted and had high IVS dependency. Considering that IVS dependency was associated with both CIF mechanisms and nutritional status, IVS dependency is suggested as a potential marker for CIF severity in children.
- Published
- 2022
- Full Text
- View/download PDF
33. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey.
- Author
-
Pironi L, Steiger E, Joly F, Jeppesen PB, Wanten G, Sasdelli AS, Chambrier C, Aimasso U, Mundi MS, Szczepanek K, Jukes A, Theilla M, Kunecki M, Daniels J, Serlie M, Poullenot F, Cooper SC, Rasmussen HH, Compher C, Seguy D, Crivelli A, Santarpia L, Guglielmi FW, Kozjek NR, Schneider SM, Ellegard L, Thibault R, Matras P, Matysiak K, Van Gossum A, Forbes A, Wyer N, Taus M, Virgili NM, O'Callaghan M, Chapman B, Osland E, Cuerda C, Udvarhelyi G, Jones L, Won Lee AD, Masconale L, Orlandoni P, Spaggiari C, Díez MB, Doitchinova-Simeonova M, Serralde-Zúñiga AE, Olveira G, Krznaric Z, Czako L, Kekstas G, Sanz-Paris A, Jáuregui MEP, Murillo AZ, Schafer E, Arends J, Suárez-Llanos JP, Youssef NN, Brillanti G, Nardi E, and Lal S
- Subjects
- Adult, Cross-Sectional Studies, Female, Humans, Intestines, Parenteral Nutrition, Intestinal Diseases epidemiology, Intestinal Diseases therapy, Short Bowel Syndrome epidemiology, Short Bowel Syndrome therapy
- Abstract
Background and Aims: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries., Methods: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as <1, 1-2, 2-3 and >3 L/day., Results: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland., Conclusions: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS., Competing Interests: Declaration of competing interest None declared., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
34. Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure.
- Author
-
Pironi L, Steiger E, Joly F, Wanten GJA, Chambrier C, Aimasso U, Sasdelli AS, Szczepanek K, Jukes A, Theilla M, Kunecki M, Daniels J, Serlie MJ, Cooper SC, Poullenot F, Rasmussen HH, Compher CW, Crivelli A, Hughes SJ, Santarpia L, Guglielmi FW, Rotovnik Kozjek N, Ellegard L, Schneider SM, Matras P, Forbes A, Wyer N, Zmarzly A, Taus M, O'Callaghan M, Osland E, Thibault R, Cuerda C, Jones L, Chapman B, Sahin P, Virgili NM, Lee ADW, Orlandoni P, Matysiak K, Di Caro S, Doitchinova-Simeonova M, Masconale L, Spaggiari C, Garde C, Serralde-Zúñiga AE, Olveira G, Krznaric Z, Petrina Jáuregui E, Zugasti Murillo A, Suárez-Llanos JP, Nardi E, Van Gossum A, and Lal S
- Subjects
- Administration, Intravenous methods, Adult, Catheter-Related Infections complications, Chronic Disease, Drug Dosage Calculations, Female, Humans, Intestinal Absorption, Liver Failure complications, Male, Pharmaceutical Solutions administration & dosage, Severity of Illness Index, Fat Emulsions, Intravenous administration & dosage, Fluid Therapy methods, Intestinal Diseases etiology, Intestinal Diseases physiopathology, Intestinal Diseases therapy, Intestines physiopathology, Parenteral Nutrition, Home adverse effects, Parenteral Nutrition, Home methods
- Abstract
Background and Aim: No marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity., Methods: At baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as <1, 1-2, 2-3 and >3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI)., Results: Fifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN <1 L/day than for FE and all PN >1 L/day), patients' death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2-3 and PN >3 L/day)., Conclusions: The type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
- Full Text
- View/download PDF
35. Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey.
- Author
-
Pironi L, Steiger E, Brandt C, Joly F, Wanten G, Chambrier C, Aimasso U, Sasdelli AS, Zeraschi S, Kelly D, Szczepanek K, Jukes A, Di Caro S, Theilla M, Kunecki M, Daniels J, Serlie M, Poullenot F, Wu J, Cooper SC, Rasmussen HH, Compher C, Seguy D, Crivelli A, Pagano MC, Hughes SJ, Guglielmi FW, Kozjek NR, Schneider SM, Gillanders L, Ellegard L, Thibault R, Matras P, Zmarzly A, Matysiak K, Van Gossum A, Forbes A, Wyer N, Taus M, Virgili NM, O'Callaghan M, Chapman B, Osland E, Cuerda C, Sahin P, Jones L, Won Lee AD, Masconale L, Orlandoni P, Izbéki F, Spaggiari C, Bueno M, Doitchinova-Simeonova M, Garde C, Serralde-Zúñiga AE, Olveira G, Krznaric Z, Czako L, Kekstas G, Sanz-Paris A, Jáuregui EP, Murillo AZ, Schafer E, Arends J, Suárez-Llanos JP, and Lal S
- Subjects
- Chronic Disease, Cross-Sectional Studies, Female, Health Surveys statistics & numerical data, Humans, Male, Middle Aged, Treatment Outcome, Health Surveys methods, Internationality, Intestinal Diseases diet therapy, Intestinal Diseases epidemiology, Parenteral Nutrition, Home methods, Parenteral Nutrition, Home statistics & numerical data
- Abstract
Background & Aims: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF)., Methods: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions., Results: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001)., Conclusions: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care., (Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
36. Micronutrient intake and biochemistry in adolescents adherent or nonadherent to supplements 5 years after Roux-en-Y gastric bypass surgery.
- Author
-
Henfridsson P, Laurenius A, Wallengren O, Beamish AJ, Dahlgren J, Flodmark CE, Marcus C, Olbers T, Gronowitz E, and Ellegard L
- Subjects
- Adolescent, Cohort Studies, Female, Humans, Male, Nutritional Status, Obesity, Morbid psychology, Sweden, Time Factors, Young Adult, Dietary Supplements, Gastric Bypass, Medication Adherence, Micronutrients administration & dosage, Obesity, Morbid surgery
- Abstract
Background: Roux-en-Y gastric bypass (RYGB) is an effective obesity treatment in adults and has become established in adolescents. Lower adherence to supplementation in adolescents confers a risk for long-term nutritional deficiencies., Objectives: To assess adherence to supplementation, micronutrient intake, and biochemistry in adolescents through 5 years after RYGB., Setting: University hospitals, multicenter study, Sweden., Methods: Micronutrient intake and adherence to supplementation were assessed by diet history interviews and biochemistry preoperatively, 1, 2, and 5 years after RYGB in 85 adolescents (67% females), aged 16.5 years (± 1.2) with a body mass index of 45.5 kg/m
2 (± 6.0). Adherence was defined as taking prescribed supplements ≥3 times a week. Micronutrient intake and biochemistry were compared with matched controls at 5 years., Results: Over 75% completed the dietary assessments across 5 years after RYGB. Adherence ranged between 44-61% through 5 years. At 5 years, ferritin and hemoglobin decreased (P < .04) and 61% had iron deficiency (P ≤ .001). Among females with iron deficiency, most did not adhere to supplementation (P = .005), and 59% of these had anemia (P < .001). Vitamin D insufficiency continued after surgery and 80% of participants who did not adhere to supplementation had insufficiency (P = .002). Adolescents not adhering had lower levels of vitamin D, B12 , and ferritin (females) compared with both adhering adolescents and the control group (all P < .04)., Conclusions: Half of adolescents after RYGB reported sufficient long-term adherence to supplementation. Adhering to supplements and reporting a higher micronutrient intake were associated with more favorable biochemistry. Results support the recommendations for monitoring micronutrient intake and biochemistry in all patients who have undergone RYGB surgery, and the recommendation of higher preventive supplementation of vitamin D and iron in both sexes. As hypothesized, adolescents not adhering had a higher prevalence of long-term micronutrient deficiencies., (Copyright © 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)- Published
- 2019
- Full Text
- View/download PDF
37. Clinical classification of adult patients with chronic intestinal failure due to benign disease: An international multicenter cross-sectional survey.
- Author
-
Pironi L, Konrad D, Brandt C, Joly F, Wanten G, Agostini F, Chambrier C, Aimasso U, Zeraschi S, Kelly D, Szczepanek K, Jukes A, Di Caro S, Theilla M, Kunecki M, Daniels J, Serlie M, Poullenot F, Wu J, Cooper SC, Rasmussen HH, Compher C, Seguy D, Crivelli A, Pagano MC, Hughes SJ, Guglielmi FW, Kozjek NR, Schneider SM, Gillanders L, Ellegard L, Thibault R, Matras P, Zmarzly A, Matysiak K, Van Gossum A, Forbes A, Wyer N, Taus M, Virgili NM, O'Callaghan M, Chapman B, Osland E, Cuerda C, Sahin P, Jones L, Lee ADW, Bertasi V, Orlandoni P, Izbéki F, Spaggiari C, Díez MB, Doitchinova-Simeonova M, Garde C, Serralde-Zúñiga AE, Olveira G, Krznaric Z, Czako L, Kekstas G, Sanz-Paris A, Jáuregui EP, Murillo AZ, Schafer E, Arends J, Suárez-Llanos JP, Shaffer J, and Lal S
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Australasia, Chronic Disease, Cross-Sectional Studies, Europe, Female, Humans, Intestines pathology, Israel, Male, Middle Aged, South America, United States, Young Adult, Intestinal Diseases diet therapy, Intestinal Diseases pathology, Parenteral Nutrition, Home methods
- Abstract
Background & Aims: The aim of the study was to evaluate the applicability of the ESPEN 16-category clinical classification of chronic intestinal failure, based on patients' intravenous supplementation (IVS) requirements for energy and fluids, and to evaluate factors associated with those requirements., Methods: ESPEN members were invited to participate through ESPEN Council representatives. Participating centers enrolled adult patients requiring home parenteral nutrition for chronic intestinal failure on March 1st 2015. The following patient data were recorded though a structured database: sex, age, body weight and height, intestinal failure mechanism, underlying disease, IVS volume and energy need., Results: Sixty-five centers from 22 countries enrolled 2919 patients with benign disease. One half of the patients were distributed in 3 categories of the ESPEN clinical classification. 9% of patients required only fluid and electrolyte supplementation. IVS requirement varied considerably according to the pathophysiological mechanism of intestinal failure. Notably, IVS volume requirement represented loss of intestinal function better than IVS energy requirement. A simplified 8 category classification of chronic intestinal failure was devised, based on two types of IVS (either fluid and electrolyte alone or parenteral nutrition admixture containing energy) and four categories of volume., Conclusions: Patients' IVS requirements varied widely, supporting the need for a tool to homogenize patient categorization. This study has devised a novel, simplified eight category IVS classification for chronic intestinal failure that will prove useful in both the clinical and research setting when applied together with the underlying pathophysiological mechanism of the patient's intestinal failure., (Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
38. From brain to bile. Evidence that conjugation and omega-hydroxylation are important for elimination of 24S-hydroxycholesterol (cerebrosterol) in humans.
- Author
-
Bjorkhem I, Andersson U, Ellis E, Alvelius G, Ellegard L, Diczfalusy U, Sjovall J, and Einarsson C
- Subjects
- Bile Acids and Salts metabolism, Cholestenes isolation & purification, Hepatocytes metabolism, Humans, Hydroxylation, Ileocecal Valve metabolism, Tritium, Bile metabolism, Brain metabolism, Hydroxycholesterols metabolism
- Abstract
The brain is the almost exclusive site of formation of 24S-hydroxycholesterol in man, and there is a continuous flux of this oxysterol across the blood-brain barrier into the circulation. The hepatic metabolism of 24S-hydroxycholesterol was studied here by three different approaches: incubation of tritium-labeled 24S-hydroxycholesterol with human primary hepatocytes, administration of tritium-labeled 24S-hydroxycholesterol to a human volunteer, and quantitation of free and conjugated 24S-hydroxycholesterol and its neutral metabolites in ileocecal fluid from patients with ileal fistulae. 24S-Hydroxycholesterol as well as 24R-hydroxycholesterol were converted into bile acids by human hepatocytes at a rate of about 40% of that of the normal intermediate in bile acid synthesis, 7 alpha-hydroxycholesterol. There was also a conversion of 24S-hydroxycholesterol into conjugate(s) of 5-cholestene-3 beta,24S,27-triol at a rate similar to the that of conversion into bile acids. When administered to a human volunteer, labeled 24S-hydroxycholesterol was converted into bile acids at about half the rate of simultaneously administered labeled 7 alpha-hydroxycholesterol. Free, sulfated, and glucuronidated 24S-hydroxycholesterol and 5-cholestene-3 beta,24,27-triol were identified in ileocecal fluid. The excretion of these steroids was about 3.5 mg/24 h, amounting to more than 50% of the total estimated flux of 24S-hydroxycholesterol from the brain. It is concluded that 24S-hydroxycholesterol is a less efficient precursor to bile acids and that about half of it is conjugated and eliminated in bile as such or as a conjugate of a 27-hydroxylated metabolite. The less efficient metabolism of 24S-hydroxycholesterol may explain the surprisingly high levels of this oxysterol in the circulation and is of interest in relation to the suggested role of 24S-hydroxycholesterol as a regulator of cholesterol homeostasis.
- Published
- 2001
- Full Text
- View/download PDF
39. FENS Program for nutrition education in medical schools. Federation of European Nutrition Societies.
- Author
-
Widhalm K, Miranda-da-Cruz B, Pokorny J, Tetens I, Virtanen SM, Lemonnier D, Oberritter H, Trichopoulou A, McKenna B, Battistini N, Berge S, Gronowska-Senger A, Vaz de Almeida MD, Correa F, Olmedilla B, Ellegard LH, Keller U, Vries PJ, and Edwards CA
- Subjects
- Europe, Schools, Medical, Societies, Scientific, Education, Medical, Nutritional Sciences education
- Published
- 1999
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.