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1.
J Nutr Health Aging ; 19(9): 947-54, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26482698

ABSTRACT

OBJECTIVES: To collect information on actual nutritional intervention requirements in long-term care institutions and on the role of institutional factors in nutritional care. DESIGN: A cross-sectional analysis of baseline data (collected between September 2011 and September 2013) within the context of a multicenter prospective cohort study. SETTING: Nineteen long-term care institutions. PARTICIPANTS: Thirteen hundred and ninety-four resident elderly (age ≥60 years). MEASUREMENTS: The prevalence of nutritional derangements (MNA-Short Form) and the need to introduce nutritional interventions on the residents. RESULTS: Prevalence of malnutrition and risk of malnutrition were 35.2% [95%CI, 32.8-37.8] and 52.6% [95%CI, 50.0-55.2], respectively. Malnutrition was more frequent upon admission and in larger institutions (≥50 beds). Overall, 50% of the residents requiring an individualized nutritional care plan (any type) were not receiving it. Oral diet, the use of fluid thickeners and oral nutritional supplements had to be introduced in 306 (22.5%), 201 (15%) and 175 (13%) residents, respectively. The need to implement the oral diet was mainly due to inadequacy of texture according to chewing and swallowing capabilities. In gender and age-adjusted multivariable logistic regression models, nutritional interventions were associated with worse nutritional status (P<0.001 for all). Moreover, while the duration of stay was unrelated to the need for nutritional interventions, we observed that residents living in larger long-term care institutions (≥50 beds) were more likely to require improvement in nutrition care. CONCLUSIONS: In long-term care elderly residents nutritional derangements are very common, underdiagnosed and undertreated. Nutritional screening should be part of routine care. However, also the systematic involvement of a nutritional care specialist appears to be an urgent need, particularly in larger institutions where the standards of care are likely to be lower.


Subject(s)
Diet , Health Services Needs and Demand , Long-Term Care , Malnutrition/diet therapy , Nursing Homes , Nutritional Requirements , Nutritional Status , Aged , Aged, 80 and over , Cohort Studies , Cross-Sectional Studies , Dietary Supplements , Eating , Feeding Behavior , Female , Geriatric Assessment , Humans , Male , Malnutrition/epidemiology , Malnutrition/prevention & control , Nutrition Assessment , Nutritional Support , Patient Care Planning , Prevalence , Prospective Studies
2.
Eat Weight Disord ; 17(3): e194-9, 2012 Sep.
Article in English | MEDLINE | ID: mdl-23086255

ABSTRACT

OBJECTIVE: Aim of the study was to evaluate tumour necrosis factor α (TNF-α) axis and oxidative status in patients with anorexia nervosa (AN) seeking a possible correlation with both nutritional status and evolution of the disease. SUBJECTS AND METHODS: Thirty-nine consecutive women with AN and an age-matched healthy control group were studied. Patients were 26±9 yr, with a body mass index (BMI) of 13.9±2 kg/m(2). TNF-α, its receptors TNF-R55 and TNF-R75, and oxidative status markers (selenium, ascorbic/ dehydroascorbic acid, retinol, α-tocopherol, selenium-dependent gluthatione peroxidase, reduced/oxidated gluthatione) were measured. A correlation with both nutritional indexes (body weight, BMI, albumin, prealbumin, transferrin, lymphocyte count) and disease duration was investigated. Pearson's correlation and unpaired Student's t-test were used to compare patients and controls. RESULTS: TNF-α and oxidative status markers were significantly higher in patients than controls and TNF-α was directly related to dehydroascorbic acid (p<0.05). Both TNF-R55 and TNF-R75 were higher in patients with duration of disease longer than one year as compared to controls and patients with shorter duration. Receptors inversely correlated with BMI (p<0.05 and p<0.01) and directly with disease duration (p<0.05). Inverse correlation between disease duration and BMI was present (p<0.01). CONCLUSIONS: The study showed activation of TNF-α axis and oxidative stress in AN patients, as well as correlation between the two systems. Due to the correlation between TNF receptors and both BMI and disease duration, a possible role of pro-inflammatory cytokines in the evolution of the eating disorder is suggested.


Subject(s)
Anorexia Nervosa/metabolism , Oxidative Stress , Receptors, Tumor Necrosis Factor, Type II/metabolism , Receptors, Tumor Necrosis Factor, Type I/metabolism , Tumor Necrosis Factor-alpha/metabolism , Adolescent , Adult , Body Mass Index , Body Weight , Case-Control Studies , Disease Progression , Female , Humans , Nutritional Status
3.
Minerva Gastroenterol Dietol ; 52(4): 431-5, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17108872

ABSTRACT

Anorexia nervosa is a complex mental disorder characterized by altered eating behaviour often resulting in life-threatening weight loss (<85% of expected body weight) associated with amenorrhea and a disturbance of body image. Although classified as mental health disorders, they may lead to serious medical consequences and have the highest rate of premature death of any mental health diagnosis. We report our experience with the use of enteral feeding via percutaneous endoscopic gastrostomy in a 39-year-old woman with chronic restricter anorexia nervosa treated in liaison psychiatry and psychotherapy. On admission to psychiatry unit, the patient presented seriously deteriorated general condition and a body mass index (BMI) of 10 (BMI = weight kg/height m(2)). She refused oral feeding, but eventually accepted nasogastric feeding. In preparation for her continuing long-term (>1 month) enteral feeding at home, a percutaneous endoscopic gastrostomy was performed and a home nutrition support regimen that met her energy-protein intake requirements was prescribed. During the follow-up period, an overall improvement in nutritional status, general condition, mood and cognitive functioning was observed. Patient compliance with refeeding is notoriously problematic; however, enteral feeding interventions may be feasible in the long-term treatment of selected anorexia nervosa patients when closely followed-up by a multidisciplinary medical team.


Subject(s)
Anorexia Nervosa/therapy , Enteral Nutrition , Adult , Anorexia Nervosa/psychology , Body Mass Index , Female , Follow-Up Studies , Gastrostomy , Home Care Services , Humans , Patient Compliance , Psychiatric Department, Hospital , Psychotherapy , Time Factors
7.
Riv Eur Sci Med Farmacol ; 15(5-6): 205-7, 1993.
Article in English | MEDLINE | ID: mdl-7761671

ABSTRACT

An unusual case of ileal tuberculosis presenting with only ascites, without evidence of previous or active pulmonary tuberculosis, and absence of caseous necrosis and granulomatous inflammation is discussed. Diagnosis was established on biopsy specimens of ileocaecal region collected at colonscopy: acid-fast bacilli and positive culture for Mycobacterium tuberculosis. Parenteral nutrition, surgery and antituberculous drug treatment resulted in a complete recovery of the patient.


Subject(s)
Ascites/pathology , Granuloma/pathology , Ileum/pathology , Tuberculosis, Gastrointestinal/pathology , Adult , Female , Humans , Necrosis/pathology
8.
Minerva Dietol Gastroenterol ; 35(4): 273-6, 1989.
Article in Italian | MEDLINE | ID: mdl-2622566

ABSTRACT

The influence of coffee on plasma lipids has been largely investigated during the last twenty years, but still many doubts remain about this subject. For this reason the influence of the assumption of coffee on plasma lipids, in healthy people, during six weeks has been studied. The coffee was prepared with an Italian coffee-machine (moka). No relationship was found between coffee assumption and increase of hematic cholesterol.


Subject(s)
Coffee/adverse effects , Lipids/blood , Adult , Apolipoproteins A/blood , Apolipoproteins B/blood , Cholesterol/blood , Female , Humans , Lipoproteins, HDL/blood , Lipoproteins, LDL/blood , Lipoproteins, VLDL/blood , Male , Triglycerides/blood
9.
Minerva Dietol Gastroenterol ; 35(3): 165-70, 1989.
Article in Italian | MEDLINE | ID: mdl-2557563

ABSTRACT

Constipation represents a common social phenomenon today, correlated with the habits of diet and life. Many studies have shown the lack of alimentary fiber as a cause of constipation. In analyzing the different types, the characteristics, the physical and metabolical action of fiber, it has been shown that it is necessary to introduce fiber into the everyday diet to be able to prevent or cure constipation. In addition, it has been seen that there has been a reduction in the consumption of fiber in many nations and some reasons have been investigated.


Subject(s)
Constipation/diet therapy , Dietary Fiber/therapeutic use , Dietary Fiber/metabolism , Food , Humans
13.
Ric Clin Lab ; 14(1): 21-8, 1984.
Article in English | MEDLINE | ID: mdl-6427878

ABSTRACT

An IgG1K monoclonal component with abnormal covalent H and L chains structure (LIA protein) was identified during a systematic screening of myeloma proteins by means of non-reducing/reducing SDS-polyacrylamide gel electrophoresis. Using immunochemical and immunogenetic analysis the mutation was characterized as a hinge region deletion, with loss of L-H and H-H disulphide bridges and direct L-L bonds. Moreover, non-expression of the G1m(z) allotype suggested that the deletion might start at residue 216, a preferential site previously observed in other HCD proteins. This feature is in agreement with the discontinuous structure of immunoglobulin CH genes and suggests that an abnormal switch mechanism is responsible for the deletion.


Subject(s)
Antibodies, Monoclonal/analysis , Heavy Chain Disease/blood , Immunoglobulin G/analysis , Myeloma Proteins/analysis , Aged , Electrophoresis, Cellulose Acetate , Electrophoresis, Polyacrylamide Gel , Female , Humans , Immunoglobulin Heavy Chains/analysis , Models, Molecular , Molecular Weight
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