scholarly journals P-OGC93 Weight Loss and Complications in Oesophagectomy and Gastrectomy Patients

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Ashling Ramdin ◽  
Khaled Dawas

Abstract Background Oesophagectomy and gastrectomy are major surgeries which often involve patients fasting for prolonged periods of time post operatively thus requiring alternative nutrition regimens. In addition, patients often suffer dysphagia, anorexia, chemotherapy side effects and significant weight loss prior to surgery. Post-operative concerns include delayed gastric emptying, refeeding syndrome and dumping syndrome. Whilst placement of enteral feeding tubes aids the transition back to normal diet there are often still social, physical and dietary challenges that hinder nutrition. The aim of this study was to review weight loss in patients post operatively and to optimise post-operative nutrition.  Methods The records of 113 patients who had undergone an oesophagectomy (43) or gastrectomy (64) between June 2018 and November 2019 at a single regional cancer centre were retrospectively examined. These patients’ contemporaneous weights had been recorded at set peri operative timelines and the greatest percentage weight loss calculated. The percentage weight loss was matched to the highest Clavien-Dindo post-operative complication.  Results 89 patients had weights routinely reviewed post operatively, with the remainder not having regular post operative weights documented. The median weight loss was 7.53.  For patients undergoing a total gastrectomy (27) weight loss ranged from 7.36-29.2%. Median weight loss was 11.45%. Patients who underwent subtotal gastrectomy (26) had between 0.37-18.5% with a median of 7.83% weight loss. Those who underwent an oesophagectomy (36) had between 0 - 28.67% weight loss with the median being 7.21%. 6 patients had their operations abandoned.  Post-operative complications, inclusive of Grade II and above, occurred in 16.8% of cases. Majority of complications occurred in those undergoing an oesophagectomy (64%), however complications did not correlate with percentage weight loss. The most common complication was grade IIIb (Grade I: 8, Grade II: 1, Grade IIIa: 1, Grade IIIb: 14, Grade IVa: 2, Grade V: 2).  Conclusions Significant post-operative weight loss is common after oesophagectomy or gastrectomy surgery. Postoperative weight loss did not correlate with complications. Furthermore, there did not appear to be a correlation with weight loss and type of procedure. Nutritional status plays an important prognostic role in patients undergoing oesophagectomy or gastrectomy. Optimising nutrition perioperatively and post operatively is important to enhance post-operative recovery and reduce post operative risk. Reviewing a larger cohort of patients would improve the robustness of this study.

2018 ◽  
Vol 1 (3) ◽  
pp. 176-181 ◽  
Author(s):  
E. Tettey

Under-fermentation of cocoa beans produces purple beans. The fermentation period is 6 to 7 days but some cocoa farmersunder-ferment their cocoa beans leading to the development of purple cocoa beans. This study determined the impact of insectinfestation on stored purple cocoa beans. Wet cocoa beans were fermented for 1, 2, 3, 4 and 5 days to produce the purple beans.Ephestia cautella and Tribolium castaneum, both singly and in combination, were introduced into the cocoa beans and storedfor different (30, 60, 90 and 120 days) period. Insect population, percentage weight loss and the contaminants produced bythese insects were determined. Cocoa beans infested with E. cautella alone had the highest population of 297.0 ± 22.7. Beansfermented for 3 days had the lowest insect population both singly and in combination after 120 days of storage. The highestpercentage weight loss was recorded in cocoa beans fermented for one day (10.1 ± 1.87%) and 4 days (10.1 ± 8.74%). T.castaneum did not cause much damage to the cocoa beans but E. cautella alone caused significant damage to stored cocoabeans. Insect infestation and poor fermentation contribute significantly to the reduction in quality of cocoa beans.


2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i17-i18
Author(s):  
P Crilly ◽  
E Chibueze ◽  
M Khan ◽  
J Modha ◽  
S Satwaha ◽  
...  

Abstract Introduction In the United Kingdom (UK), 63% of adults are overweight,(1) costing the NHS £6.1 billion/year. With the public using digital technology over healthcare professionals (HCPs) for health advice, this warrants an investigation of technology use in community pharmacy, given its previous successful use.(2) Aim To determine the feasibility and perceptions of a community pharmacist (CP)-led weight management programme (WMP), enhanced by a Facebook support group (FSG). Methods A proof of concept study was conducted between January-March 2020. Recruitment was via a pharmacy, the university and a community Facebook group. Inclusion criteria: over 18 years; overweight; no medical conditions. Participants attended face-to-face meetings (ftf) with a CP and final year pharmacy student (PS) on two occasions (0 (baseline) and 4 weeks). At baseline, participants were given the NHS weight loss programme and set weight loss goals. During ftf, participants had height, weight, and waist circumference (WC) measurements by a CP/PS and discussed eating habits, exercise and alcohol. In between ftf, participants accessed the FSG (created (December 2019) and moderated by a CP). Here, they received posts about diet, exercise and motivation. Participants were to have their measurements taken ftf at 8-weeks, however, COVID-19 meant participants had to self-declare these via video call. Following the 8-week programme, participants completed a 4-section survey about their experience (signing up to the service; comparison to previous weight loss attempts; the FSG and overall perceptions). Question types included multiple choice, Likert scale and free text comments. Data were analysed in Excel (Microsoft Corporation 2016) with changes in height, weight, waist circumference, alcohol and exercise being calculated. Results Fifty-five participants were recruited. 18 were lost to follow-up, most (n=12/18) citing COVID-19. Of the 37 participants remaining (70.3% female, mean age=37 years), 22 were obese, the rest overweight. Mean weight loss, mean percentage weight loss and mean WC reduction at 4-weeks was 1.6 kg (SD+/- 1.7 kg), 1.8% (SD+/- 1.9%) and 2 cm (SD+/- 1.96 cm) respectively. At week 8 measurements were self-declared. Mean weight loss at 8-weeks from baseline was 2.7 kg (SD +/- 2.6 kg) and mean percentage weight loss was 3% (SD+/- 3%). Only five participants’ self-declared WC measurements at 8-weeks with mean reduction being 3.6 cm. Five participants moved to healthier BMI classifications by week 8. All participants accessed the FSG at least weekly with 13 accessing it daily. Diet posts were the most popular (n=20/37). Participants learned about portion control and increasing fruits/vegetables intake. All participants would recommend the programme to their friends/family. Conclusion An 8-week CPWMP, enhanced with FSG, supported participants to lose a mean of 3% body weight. Participants accessed the page regularly and were positive about its usefulness. One limitation was that the COVID-19 lockdown prevented the 8-week ftf, therefore, self-declared measurements were used. The pandemic has highlighted the importance of pharmacy embracing technology for service delivery, particularly when in-person contact is limited. The implication of this study is that it provides proof that the concept of digital service delivery could work in practice. References 1. GOV.UK. Tackling obesity: empowering adults and children to live healthier lives [Internet]. Department of Health and Social Care. 2020 [cited 2020 Aug 18]. Available from: https://www.gov.uk/government/publications/tackling-obesity-government-strategy/tackling-obesity-empowering-adults-and-children-to-live-healthier-lives 2. Crilly P, Kayyali R. A Systematic Review of Randomized Controlled Trials of Telehealth and Digital Technology Use by Community Pharmacists to Improve Public Health. Pharmacy 2020;8(3):137. Available from: https://www.mdpi.com/2226–4787/8/3/137


2016 ◽  
Vol 32 (1) ◽  
pp. 198-204 ◽  
Author(s):  
Lenard I. Lesser ◽  
Caroline A. Thompson ◽  
Harold S. Luft

Purpose: To examine the characteristics of voluntary online commitment contracts that may be associated with greater weight loss. Design: Retrospective analysis of weight loss commitment contracts derived from a company that provides web-based support for personal commitment contracts. Using regression, we analyzed whether percentage weight loss differed between participants who incentivized their contract using monetary deposits and those who did not. Setting: Online. Participants: Users (N = 3857) who voluntarily signed up online in 2013 for a weight loss contract. Intervention: Participants specified their own weight loss goal, time period, and self-reported weekly weight. Deposits were available in the following 3 categories: charity, anticharity (a nonprofit one does not like), or donations made to a friend. Measures: Percentage weight loss per week. Analysis: Multivariable linear regressions. Results: Controlling for several participant and contract characteristics, contracts with anticharity, charity, and friend deposits had greater reported weight loss than nonincentivized contracts. Weight change per week relative to those without deposits was −0.33%, −0.28%, and −0.25% for anti-charity, charity, and friend, respectively ( P < 0.001). Contracts without a weight verification method claimed more weight loss than those with verification. Conclusion: Voluntary use of commitment contracts may be an effective tool to assist weight loss. Those who choose to use monetary incentives report more weight loss. It is not clear whether this is due to the incentives or higher motivation.


Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3205
Author(s):  
Irene Deftereos ◽  
Justin M.-C. Yeung ◽  
Janan Arslan ◽  
Vanessa M. Carter ◽  
Elizabeth Isenring ◽  
...  

Background: Preoperative nutrition intervention is recommended prior to upper gastrointestinal (UGI) cancer resection; however, there is limited understanding of interventions received in current clinical practice. This study investigated type and frequency of preoperative dietetics intervention and nutrition support received and clinical and demographic factors associated with receipt of intervention. Associations between intervention and preoperative weight loss, surgical length of stay (LOS), and complications were also investigated. Methods: The NOURISH Point Prevalence Study was conducted between September 2019 and May 2020 across 27 Australian tertiary centres. Subjective global assessment and weight were performed within 7 days of admission. Patients reported on preoperative dietetics and nutrition intervention, and surgical LOS and complications were recorded. Results: Two-hundred patients participated (59% male, mean (standard deviation) age 67 (10)). Sixty percent had seen a dietitian preoperatively, whilst 50% were receiving nutrition support (92% oral nutrition support (ONS)). Patients undergoing pancreatic surgery were less likely to receive dietetics intervention and nutrition support than oesophageal or gastric surgeries (p < 0.001 and p = 0.029, respectively). Neoadjuvant therapy (p = 0.003) and malnutrition (p = 0.046) remained independently associated with receiving dietetics intervention; however, 31.3% of malnourished patients had not seen a dietitian. Patients who received ≥3 dietetics appointments had lower mean (SD) percentage weight loss at the 1-month preoperative timeframe compared with patients who received 0–2 appointments (1.2 (2.0) vs. 3.1 (3.3), p = 0.001). Patients who received ONS for >2 weeks had lower mean (SD) percentage weight loss than those who did not (1.2 (1.8) vs. 2.9 (3.4), p = 0.001). In malnourished patients, total dietetics appointments ≥3 was independently associated with reduced surgical complications (odds ratio 0.2, 95% confidence interval (CI) 0.1, 0.9, p = 0.04), and ONS >2 weeks was associated with reduced LOS (regression coefficient −7.3, 95% CI −14.3, −0.3, p = 0.04). Conclusions: Despite recommendations, there are low rates of preoperative dietetics consultation and nutrition support in this population, which are associated with increased preoperative weight loss and risk of increased LOS and complications in malnourished patients. The results of this study provide insights into evidence–practice gaps for improvement and data to support further research regarding optimal methods of preoperative nutrition support.


TAPPI Journal ◽  
2012 ◽  
Vol 11 (11) ◽  
pp. 43-49 ◽  
Author(s):  
GISELY SAMISTRARO ◽  
PETER W. HART

Variability in wood properties has a major impact on pulp quality and the cost associated with pulp production. Frequently, accounting data for green tons of wood across the mill scales and the tons of pulp produced suggest that the pulp mill has affected the pulp yield because the tons of purchased wood divided by the tons of pulp produced changes. The current work examines the impact of the time — from when a tree is harvested in the forest to the time it is brought across the scales at the mill — on accounting yield and operating cost. Percentage weight loss (assumed to be changes in moisture content) were determined for Pinus taeda, Eucalyptus dunni, and Eucalyptus grandis over a 12-week period in the winter and summer seasons. Wood samples were obtained immediately after being harvested. The percentage weight loss within the first 5 days of storage varied from 2% to 13%, depending upon species and season, and reached 36% after 11 weeks of storage. For a 1000 tons/day mill with a 55% pulping yield on o.d. fiber, the difference between using fresh-cut wood verses cut trees that have been stored for 11 weeks is 1130 green tons. Assuming the mill pays $45/green ton, the change in green log usage between fresh-cut and 11-week-old logs can cost the mill US$50,850 per day.


1974 ◽  
Vol 63 (3) ◽  
pp. 513-518 ◽  
Author(s):  
E. J. Usua

AbstractExperiments were done to compare respiration rate, thermal death point, weight loss and the life span of diapause and non-diapause larvae of Busseola fusca (Fuller). The oxygen consumed by non-diapause larvae was 578–772 mm3/g/h while that by diapause larvae was 58–238 mm3/g/h. Thermal death points for both types of larvae were in the range 46·5–49·5 °C. At high and low relative humidities non-diapause larvae lost 4·4% and 16·3% of their weight, respectively, while diapause larvae lost only 1·0% and 7·0%. At 46° and 48°C the percentage weight loss by non-diapause larvae was about twice as much as that by diapause larvae. Life span was greater at a saturation deficit of 14·2–22·5 mm Hg in both types of larvae than either at 2·8–14·2 mm Hg or 22·5–28·0 mm Hg. At this range starving non-diapause larvae lived for 4·3–5·1 days and the diapause larvae for 7·7–8·7 days. The main factor enabling diapause larvae to survive adverse conditions appears to be their efficient water conservation mechanism.


2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Hemhong Anankaphong ◽  
Duanghathai Pentrakoon ◽  
Jirawut Junkasem

Poly(butylene succinate) (PBS) biocomposites incorporated with rubberwood powder (RWP) were fabricated with various RWP weight fractions (i.e., 0 to 40% wt) by injection moulding process. The soil burial test was employed to examine the biodegradability of such biocomposites under outdoor environment for 60 days. The physical appearance, percentage weight loss, chemical structure, and mechanical properties before and after the soil burial test were determined. Apparent changes in physical appearance of the biocomposites from optical micrographs were detected in terms of surface morphology and colour. The percentage of crystallinity of PBS/RWP biocomposites was studied by the X-ray diffraction (XRD) technique, and the XRD pattern revealed a decrease in percentage of crystallinity due to enhancing RWP weight fractions. This may be attributed to a presence of rubberwood powders providing more disordered molecular chain arrangement of PBS matrix and also an agglomeration of the rubberwood powder content at greater concentration as seen in SEM micrographs. With increasing RWP weight fractions and burial time, the results exhibited a considerable change in chemical structure (essentially ester linkage due to biodegradation mechanism of PBS), relatively greater percentage weight loss, and a substantial decrease in flexural properties. Consequently, the results indicate that incorporating RWP enhances biodegradability of PBS/RWP biocomposites; that is, the biodegradation rate of biocomposites increases with increasing RWP weight fractions and burial time.


2021 ◽  
Vol 23 (2) ◽  
pp. 179-184
Author(s):  
A. ESSIEN ◽  
L. EBOH ◽  
S. E. EMURASHE

A total of 144 newly - laid eggs obtained from Lohmann Brown layers were distributed and stored under three storage conditions: room temperature, polythene bag/room temperature and refrigeration. Changes in Haugh unit, yolk ), index and percentage weight loss were evaluated between 0 and 14 days at intervals of two days each, Haugh unit, yolk index, and albumen have significantly (P>0.001), while percentage weight loss increased (P<0.001) with storage duration, Generally, quality on the parameters of refrigerated eggs were significantly (P<0.05) higher than those stored used in polythene bag or those stored open in the room o. Polythene-bagged eggs had the least percentage weight loss. Significant (P<0.001) storage method x storage duration interactions were obtained. Regressing the internal egg quality measurement (Y) over storage period (X) in simple linear Y = a +bx) or the exponential (Y = ab ). regression functions showed that the predictive ability measured as also the r2 - values was generally higher with the. exponential than the simple linear model. The predictive ability of each egg quality parameter was higher with the polythene - bagged eggs than  with other storage conditions. Using the simple linear prediction model, table eggs purchased randomly from retail egg shops had quality values of eggs that were about 4 - 11 days after lay prior to purchase.


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