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1.
Nutr. hosp ; 39(4): 905-909, jul. - ago. 2022.
Artigo em Inglês | IBECS | ID: ibc-212010

RESUMO

Background: nutrition therapy is a complex area of healthcare systems that encompasses patient characteristics, medical decision making, nutritional formula characteristics, and costs, composing a complex ecosystem. The integration of these different domains is actualized in medical prescription in a heuristic and iterative way, taking into account patient characteristics and formulas, with a limited capacity for in-scale calculations and inclusion of factors involved in the prescription of nutritional formulas and other ecosystem elements. From a practical standpoint, depicting the four areas as equalities could provide the necessary equivalence to study dependence and consequence from left- and right-side terms. Objectives: the objective of this theoretical study is to provide a mathematical model that describes and integrates different aspects of nutrition therapy. Methods: in this theoretical study, we deducted a mathematical representation for nutrition therapy using first-grade equations and simple calculus techniques. Results: a formula that coordinates four elements of the nutrition therapy ecosystem was found: cashflow, compliance adherence, patient, and macronutrient mass, formula density and unitary cost. Conclusion factors involving decision-making in nutrition therapy can be unified in a mathematical model (AU)


Antecedentes: la terapia nutricional es un área compleja de los sistemas de salud que abarca las características del paciente, la toma de decisiones médicas, las características de la fórmula nutricional y los costos, componiendo un ecosistema complejo. La integración de estos diferentes dominios se actualiza en la prescripción médica de forma heurística e iterativa, teniendo en cuenta las características y fórmulas del paciente, con una capacidad limitada para cálculos a escala e inclusión de otros factores relacionados con la prescripción de la terapia nutricional y los elementos del ecosistema. Desde un punto de vista práctico, describir las cuatro áreas como igualdades podría proporcionar la equivalencia necesaria para estudiar la dependencia y la consecuencia de los términos del lado izquierdo y derecho. Objetivos: el objetivo de este estudio teórico es brindar un modelo matemático que describa e integre diferentes aspectos de la terapia nutricional. Métodos: en este estudio teórico se dedujo una representación matemática para la terapia nutricional utilizando ecuaciones de primer grado y técnicas de cálculo simple. Resultados: se encontró una fórmula que coordina cuatro elementos del ecosistema de la terapia nutricional: flujo de caja, adherencia al cumplimiento, masa del paciente y macronutrientes, densidad de la fórmula y costo unitario. Conclusión: los factores que involucran la toma de decisiones en la terapia nutricional se pueden unificar en un modelo matemático (AU)


Assuntos
Humanos , Modelos Teóricos , Terapia Nutricional , Apoio Nutricional , Cooperação do Paciente
2.
Rom J Intern Med ; 58(3): 153-160, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32449700

RESUMO

BACKGROUND: We sought to evaluate the clinical impacts of the early administration of trophic doses of a glutamine/arginine enriched enteral nutrition formula (ENF) with a high protein density to cachectic hypoalbuminemic hospitalized patients intolerant to enteral nutrition. METHODS: A retrospective analysis was conducted using the nutritional and non-nutritional data of patients admitted to our institution from April 2017 through August 2019. Patients who died or were discharged before completing ≥1 weeks of hospital admission, or those whose data could not be obtained were excluded. Among other variables, percent changes in serum albumin levels (%∆ALB), C - reactive protein (CRP) and their ratios were expressed as Mean ± SD using the Independent Samples T-test, while categorical variables were expressed as numbers with percentages by using χ2 test. Two tested groups were determined based on the use of ENF: Group I received trophic doses of ENF, while Group II received no enteral nutrition. RESULTS: The overall hospital length of stay (LOS) and overall 28-day hospital mortality were significantly lower in Group I when compared with Group II with Means ± SDs of (11.32 ± 2.19 days vs 23.49 ± 4.33 days) and (13.13% vs. 28.16%), respectively. Also, significantly higher (%∆ALB) for Group I compared with group II (43.48% ± 7.89% vs. 33.45% ± 6.18%), respectively was observed. CONCLUSION: In malnourished hypoalbuminemic patients suffering from feeding intolerance, early trophic administration of glutamine/arginine enriched high protein density ENF was well tolerated and may be associated with increased plasma albumin levels, reduced LOS, and overall 28-day mortality, and hence may be considered in such patients.


Assuntos
Arginina/administração & dosagem , Caquexia/terapia , Alimentos Formulados , Glutamina/administração & dosagem , Hipoalbuminemia/terapia , Desnutrição/terapia , Idoso , Glicemia/metabolismo , Proteína C-Reativa/metabolismo , Caquexia/sangue , Caquexia/etiologia , Proteínas Alimentares/administração & dosagem , Nutrição Enteral/métodos , Feminino , Humanos , Hipoalbuminemia/sangue , Hipoalbuminemia/etiologia , Tempo de Internação , Masculino , Desnutrição/complicações , Pessoa de Meia-Idade , Estudos Retrospectivos , Albumina Sérica/metabolismo , Fatores de Tempo
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