• 제목/요약/키워드: clinical nutrition support

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국민건강증진을 위한 영양 부문의 2000년 잠정목표와 전략 (Provisional National Nutrition Targets and Strategies for Health Promotion of Koreans)

  • 김혜련
    • 대한지역사회영양학회지
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    • 제1권2호
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    • pp.161-177
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    • 1996
  • This study attempts to propose a priority of national nutrition targets and strategies for health promotion by the year 2000 in Korea, as a part of the task set for national health promotion objectives and strategies. Among all of the important health issues raised, ten were chosen, nutrition was one priority area. In the first part, the current status of the nutrition-related health problems and risk factors are reviewed, in conjunction with the newly arisen health phenomena, such as changes in prevalence of lifestyle disease and causes of death, changes of food consumption patterns in our country. In the second section this study suggests six feasible national nutrition targets, eight implementing strategies and current major tasks on the basis of the assessment of present status and in consideration of the other health promotion goals and strategies, with reference to that of other developed countries. The main targets and strategies are suggested as follows ; Firstly, the national nutrition monitoring and surveillance system should be established for identifying the nutritional problems for our people, and current National Nutrition Survey is a strong need for improvement to a more comprehensive and reliable one. Secondly, effective administrative mechanism should be operation at national level for the development of nutrition policy. Ministry of Health and Welfare (MOHW) as well as local health department must be remarkably renewed and strengthened the nutrition section. And it is recommended that MOHW organize and operate “The Council of Nutrition”, in which all government authorities related with foodstuffs and nutrition would incorporated. The Council of Nutrition would act as an adjustor as well as a coordinator in nutrition related policy-making. Thirdly, healthy eating pattern will be supported by activities of introducing a nutrition labeling for providing consumers with the necessary information and skills for food selection. Fourthly, nutrition education, and nutrition intervention programs will be carried out in various settings such as health centers, schools, and clinical fields and workplace. Fifthly, the current dietary guidelines shall be continuously improved in detail, and publicly circulated to particular levels of people by age group and by health condition. And finally, researches and epidemiological studies particularly in regard to diet for development of chronic diseases are needed for more investigation and up-to-date national health and nutrition data should be collected with the support and cooperation from the various medical professional teams . (Korean J Community Nutrition 1(2) : 161-177, 1996)

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만성 소화기 질환 환아에서 미량원소 결핍과 모발 검사의 유용성 (Trace Elements Deficiency and the Diagnostic Usefulness of Hair Mineral Analysis in Children with Chronic Gastrointestinal Disease)

  • 홍지나;이정화;이란;신지연;고재성;서정기
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제11권2호
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    • pp.122-129
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    • 2008
  • 목 적: 만성 설사, 흡수 장애 등의 소화기 질환에서 경구 영양 공급이 불충분할 경우 미량원소 결핍 발생의 빈도가 높으나, 이러한 환아에서 미량원소 결핍 증상에도 불구하고 혈액 검사 결과 정상으로 나타나기도 한다. 따라서 미량원소 결핍 고위험군 환아에서 결핍된 미량원소를 확인하고, 적절한 공급 및 추적 관찰 지표로서 모발 검사의 유용성을 알아보고자 하였다. 방 법: 서울대학교 어린이병원에 내원하여 만성 소화기 질환으로 경구 영양 장애 또는 성장 발육 부전을 보였던 13명을 대상으로 모발과 혈액의 미량원소 검사를 시행하여, 결핍 소견을 보인 모발과 혈액의 미량원소에 대해 장기 정맥영양군과 경구영양군, 그리고 증상군과 무증상군으로 나누어 비교, 분석하였다. 결 과: 전체 13명 중 11명에서 모발 또는 혈액 검사에서 미량원소 결핍이 있었으며, 결핍된 미량원소는 아연, 셀레늄, 구리였다. 모발 내 아연 결핍은 8명(62%), 모발 내 셀레늄 결핍은 6명(46%)이었고, 혈액 내 아연농도가 정상인 환자의 67% (8/12명), 혈액 내 셀레늄 농도가 정상 환자의 57% (4/7명)에서 각각 모발 내 아연, 모발 내 셀레늄 결핍을 보였다. 모발 내 아연 농도는 장기 정맥영양군에서 경구영양군에 비해 유의하게 낮았으며(p=0.015) 결핍 발생 빈도 또한 유의하게 높았다(Fisher's exact test, p=0.032). 모발 내 셀레늄 농도는 증상군에서 무증상군에 비해 유의하게 낮았다(p=0.034). 결 론: 만성 소화기 질환으로 경구 영양 장애 또는 성장 발육 부전이 있을 경우 증상 여부에 상관없이 혈액검사와 함께 모발 미네랄 검사로 결핍 여부를 평가하는 것이 필요할 것으로 보인다.

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Evaluation and Categorization of Commercially Prepared Enteral Nutrition Formulas

  • Dong-Yeon Kim;Hee-Jae Suh
    • 대한지역사회영양학회지
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    • 제3권5호
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    • pp.729-738
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    • 1998
  • In order to investigate the types of enteral nutrition formulas currently used in hospitals and evaluate and categorize the commercially prepared enteral nutrition formulas formulas available in the domestic market, we asked dietitians working in 6 hospitals in Seoul to complete the questionnaire and obtained compositional characteristics of 12 commercially prepared enteral nutrition formulas. The average proportion of patients receiving the commercially prepared enteral nutrition formulas(60.6%) was greater than that of patients receiving the in-hospital preparations(31.9%). In the group of patients receiving the in-hospital prepared formulas, the enteral feeding was mainly administered orally, whereas, in the group of patients receiving the commercially prepared formulas, tube feeding was the primary route of formula administration. In both groups, however, a greater proportion of patients received the formulas as total replacements of their meals and for the purpose of dietary supplementation. On the basis of major criteria for evaluation of the commercially prepared enteral nutrition formulas, the 6 products out of the 9 nutritionally complete products formulated for the purpose of dietary supplementation were grouped into the same category(standard protein, caloric density of 1kcal/ml, and tube/oral), so they were considered therapeutically comparable. However, the remaining 3 products were different in protein content(high protein) or route of administration(tube only). Of the 3 nutritionally complete products formulated specifically for the purpose of dietary therapy, 2 products were formulated for patients with renal disease, and the one product was formulated for diabetic patients. Therefore, the data in this study showed that the commercially prepared enteral nutriton formulas became an important part of the enteral nutrition for hospitalized patients in Korea, but the domestic market has not yet generated a wide variety of the formulas, not providing many choices for clinicians to manage the diets for their patients. The results of this study would be helpful for clinicians in choosing appropriate products for their patients, for manufactures in developing new products, and for regulatory authorities to establish the regulation for the broad group of heterogeneous products that are marketed and will be developed as medical foods. In addition, the process of maintaining the categories for evaluation of the commercially prepared enteral nutrition formulas should be dynamic because new products may not reasonably fit any of the existing categories.

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Prediction of Length of ICU Stay Using Data-mining Techniques: an Example of Old Critically Ill Postoperative Gastric Cancer Patients

  • Zhang, Xiao-Chun;Zhang, Zhi-Dan;Huang, De-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.97-101
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    • 2012
  • Objective: With the background of aging population in China and advances in clinical medicine, the amount of operations on old patients increases correspondingly, which imposes increasing challenges to critical care medicine and geriatrics. The study was designed to describe information on the length of ICU stay from a single institution experience of old critically ill gastric cancer patients after surgery and the framework of incorporating data-mining techniques into the prediction. Methods: A retrospective design was adopted to collect the consecutive data about patients aged 60 or over with a gastric cancer diagnosis after surgery in an adult intensive care unit in a medical university hospital in Shenyang, China, from January 2010 to March 2011. Characteristics of patients and the length their ICU stay were gathered for analysis by univariate and multivariate Cox regression to examine the relationship with potential candidate factors. A regression tree was constructed to predict the length of ICU stay and explore the important indicators. Results: Multivariate Cox analysis found that shock and nutrition support need were statistically significant risk factors for prolonged length of ICU stay. Altogether, eight variables entered the regression model, including age, APACHE II score, SOFA score, shock, respiratory system dysfunction, circulation system dysfunction, diabetes and nutrition support need. The regression tree indicated comorbidity of two or more kinds of shock as the most important factor for prolonged length of ICU stay in the studied sample. Conclusions: Comorbidity of two or more kinds of shock is the most important factor of length of ICU stay in the studied sample. Since there are differences of ICU patient characteristics between wards and hospitals, consideration of the data-mining technique should be given by the intensivists as a length of ICU stay prediction tool.

Digestive Tolerance and Safety of an Anti-Regurgitation Formula Containing Locust Bean Gum, Prebiotics and Postbiotics: A Real-World Study

  • Marc Bellaiche;Patrick Tounian;Raish Oozeer;Emilie Rocher;Yvan Vandenplas
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제26권5호
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    • pp.249-265
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    • 2023
  • Purpose: Infant regurgitation is associated with other functional gastrointestinal disorders and signs and symptoms that have a major impact on the quality of life of infants and their families. This study evaluated the safety, tolerance, and real-world effectiveness of an anti-regurgitation formula containing locust bean gum (LBG), prebiotics, and postbiotics to alleviate digestive symptoms beyond regurgitation. Methods: This 3-month study involved infants with regurgitation requiring the prescription of an anti-regurgitation formula according to usual clinical practice. Outcomes included evaluation of the evolution of stool consistency and frequency; occurrence of colic, constipation, and diarrhea; and assessment of regurgitation severity. Infant crying, parental assessment of infant well-being, and parental satisfaction with the stool consistency were also evaluated. Results: In total, 190 infants (average age: 1.9±1.1 months) were included. After three months, stool frequency and consistency remained within the normal physiological range, with 82.7% of infants passing one or two stools per day and 90.4% passing loose or formed stools. There was no significant increase in the number of infants with diarrhea, whereas a decrease was observed in the number of infants with constipation after 1 month (p=0.001) and with colic after both 1 and 3 months (p<0.001). Regurgitation severity and crying decreased and parental satisfaction with stool consistency, formula acceptability, infant well-being, and sleep quality increased. Monitoring of adverse events did not reveal any safety concerns. Conclusion: Formulas containing LBG, prebiotics, and postbiotics were well tolerated and provided an effective strategy for managing infant regurgitation and gastrointestinal discomfort.

The Role of Milk Products in Metabolic Health and Weight Management

  • Zemel, Michael B.
    • Journal of Dairy Science and Biotechnology
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    • 제28권1호
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    • pp.17-28
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    • 2010
  • A substantial body of evidence has emerged over the last decade in support of the novel concept that dietary calcium and dairy foods play an important role in regulating energy metabolism and thereby promote healthy weight management and reduce obesity risk. This concept has been demonstrated in experimental animals studies, cross-sectional and prospective population studies and a number of randomized clinical trials. Notably, the effects of dairy foods in weight management are more consistent than the effects of supplemental calcium across clinical trials, and calcium per se is responsible for approximately 40-50% of the effects of dairy. The calcium component is only effective in individuals with chronically low calcium intake, as it serves to prevent the endocrine response to low calcium diets which otherwise favors adipocyte energy storage; calcium also serves to promote energy loss via formation of calcium soaps in the gastrointestinal tract and thereby reduce fat absorption. The calcium-independent anti-obesity bioactivity of dairy resides primarily in whey. The key components identified to date are leucine and bioactive peptides resulting from whey protein digestion. The high concentration of leucine in whey stimulates a repartitioning of dietary energy from adipose tissue to skeletal muscle where it provides the energy required for leucine-stimulated protein synthesis, resulting in increased loss of adipose tissue and preservation of skeletal muscle mass during weight loss. Finally, dairy rich diets suppress the oxidative and inflammatory responses to obesity and thereby attenuate the diabetes and cardiovascular disease risk associated with obesity.

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Airway Management for Initial PEG Insertion in the Pediatric Endoscopy Unit: A Retrospective Evaluation of 168 Patients

  • Peck, Jacquelin;Nguyen, Anh Thy H.;Dey, Aditi;Amankwah, Ernest K.;Rehman, Mohamed;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권1호
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    • pp.100-108
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    • 2021
  • Purpose: Percutaneous endoscopic gastrostomy (PEG) tube placements are commonly performed pediatric endoscopic procedures. Because of underlying disease, these patients are at increased risk for airway-related complications. This study compares patient characteristics and complications following initial PEG insertion with general endotracheal anesthesia (GETA) vs. anesthesia-directed deep sedation with a natural airway (ADDS). Methods: All patients 6 months to 18 years undergoing initial PEG insertion within the endoscopy suite were considered for inclusion in this retrospective cohort study. Selection of GETA vs. ADDS was made by the anesthesia attending after discussion with the gastroenterologist. Results: This study included 168 patients (GETA n=38, ADDS n=130). Cohorts had similar characteristics with respect to sex, race, and weight. Compared to ADDS, GETA patients were younger (1.5 years vs. 2.9 years, p=0.04), had higher rates of severe American Society of Anesthesiologists (ASA) disease severity scores (ASA 4-5) (21% vs. 3%, p<0.001), and higher rates of cardiac comorbidities (39.5% vs. 18.5%, p=0.02). Significant associations were not observed between GETA/ADDS status and airway support, 30-day readmission, fever, or pain medication in unadjusted or adjusted models. GETA patients had significantly increased length of stay (eβ=1.55, 95% confidence interval [CI]=1.11-2.18) after adjusting for ASA class, room time, anesthesia time, fever, and cardiac diagnosis. GETA patients also had increased room time (eβ=1.20, 95% CI=1.08-1.33) and anesthesia time (eβ=1.50, 95% CI=1.30-1.74) in adjusted models. Conclusion: Study results indicate that younger and higher risk patients are more likely to undergo GETA. Children selected for GETA experienced longer room times, anesthesia times, and hospital length of stay.

Comparison of Health Status and Life Satisfaction According to Food Security in Single-Person Households of Elderly Population

  • Dong Hoon Jung;Jae Won Han;Wonha Kim;Hee-Sook Lim
    • Clinical Nutrition Research
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    • 제13권1호
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    • pp.42-50
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    • 2024
  • This study analyzed the 2019 Community Health Survey data to compare and analyze the health levels and life satisfaction of single-person elderly households based on food security. The final study subjects were 15,606 single-person elderly individuals aged 65 and above. These subjects were classified based on their response to food security into three groups: food sufficient-diverse, food sufficient-not diverse, and food insufficient. The study results showed that the proportion of the food insufficient group among single-person elderly households was 7.4% for men and 10.6% for women, with a slightly higher rate for female elderly. Both male and female elderly over 80 years of age, with low education levels, and basic living support recipients showed significantly higher proportions in the sufficient-not diverse and food insufficient groups. For male elderly, significant differences were observed in subjective health status and oral health level in the food insufficient group, and for female elderly, stress levels also showed significant differences. Life satisfaction scores were generally lower for female elderly compared to male, and significant differences were found in both male and female elderly based on food security. Common factors that significantly influence life satisfaction among single-person elderly households, both male and female, include food security, subjective health status, and living environment satisfaction, with food security being the most impactful factor. The study suggests that it is necessary to include these significant factors in the development of various social activity programs, such as dietary programs, to enhance life satisfaction and food security of single-person elderly households.

한국 표준 간호행위 분류 (The Classification of Standard Nursing Activities in Korea)

  • 박정호;성영희;송미숙;조정숙;심원희
    • 대한간호학회지
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    • 제30권6호
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    • pp.1411-1426
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    • 2000
  • A nursing activity classification for hospitalized patients was performed based on an article review regarding nursing definition and nursing activity classification system. The study was conducted as follows: 1) Taxonomy was developed by the research team through the Delphi process and review article. The taxonomy consists of four nursing processes, (assessment, diagnosis, intervention and evaluation) and twelve nursing activity domains space (resperation, nutrition, elimination, exercise/alignment maintenance, comfort, hygiene, safety, spiritual support, counseling/ education, medication, communication, patient and information management). 2) First, nursing activities of the intervention process were listed and then classified by the nursing process of assessment, diagnosis, intervention and evaluation. The list consists of twelve nursing activity domains and 136 nursing activities. 3) A pilot study was conducted in two hospitals to verify validity and appropriateness of nursing activities. 4) The content validity index, which was calculated by 6 clinical practice experts, was 0.95. Also, a nursing activity classification system should also be developed in the department of community nursing and home health care nursing.

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Metallothioneins and Oxidative Stress

  • Beattie, John H.;Trayhurn, Paul
    • Nutritional Sciences
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    • 제5권4호
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    • pp.228-233
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    • 2002
  • The low molecular weight zinc-binding protein metallothionein(MT) contains 32% cysteine and has been shown to efficiently scavenge hydroxyl radicals in vitro. MT expression is induced by oxidative stress and an antioxidant role for this protein has therefore been proposed. This review mainly focuses on the evidence for this role arising from studies using genetically modified animals and cells which either over- or under-express MT. Despite some considerable disparity of results in the literature, reported studies do generally support an antioxidant role. Nevertheless, oxidant stress at non-physiological treatment levels has been the preferred experimental model and there is little information about the role of MT in physiological oxidative stress. Although it is presumed that the mechanism by which MT has an antioxidant effect involves oxidation of cysteinal thiols, it is possible that zinc release from MT is in itself an important signalling factor.