General Metabolism in Patients with Acute Paraplegia and Quadriplegia

Neurosurgery ◽  
1985 ◽  
Vol 16 (3) ◽  
pp. 309-313 ◽  
Author(s):  
Howard H. Kaufman ◽  
Brian J. Rowlands ◽  
Debra K. Stein ◽  
Dennis R. Kopaniky ◽  
Philip L. Gildenberg
Keyword(s):  
Spinal Cord ◽  
Nutritional Status ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
General Metabolism ◽  
Acute Paraplegia ◽  
A Prospective Study ◽  
Injured Patients ◽  
Infective Complications

Abstract This study measured the nutritional status of eight spine-injured patients during their first 10 to 14 days in the hospital. Initial and follow-up nutritional assessment showed that their nutritional status deteriorated at least partly due to an inadequate supply of protein and calories. Infective complications and prolonged respiratory support were common and may have been caused in part by impaired nutrition. This suggests that a prospective study of aggressive nutritional support for patients with spinal cord transection should be initiated to determine whether this acquired malnutrition and its associated complications can be prevented.

Association of GDF15 With Inflammation and Physical Function During Aging and Recovery After Acute Hospitalization: A Longitudinal Study of Older Patients and Age-Matched Controls

2021 ◽  
Author(s):  
Juliette Tavenier ◽  
Line Jee Hartmann Rasmussen ◽  
Aino Leegaard Andersen ◽  
Morten Baltzer Houlind ◽  
Anne Langkilde ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Physical Function ◽  
Plasma Levels ◽  
Older Patients ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Acute Illness ◽  
Urokinase Plasminogen Activator Receptor

Abstract Growth differentiation factor 15 (GDF15) is a stress-induced cytokine. Its plasma levels increase during aging and acute illness. In older Patients and age-matched Controls, we evaluated whether GDF15 levels (i) were associated with recovery after acute illness, and (ii) reflected different trajectories of aging and longitudinal changes in health measures. Fifty-two older Patients (≥65 years) were included upon admission to the emergency department (ED). At 30 days after discharge (time of matching), Patients were matched 1:1 on age and sex with Controls who had not been hospitalized within 2 years of inclusion. Both groups were followed up after 1 year. We assessed plasma levels of GDF15 and inflammatory biomarkers, frailty, nutritional status (mini nutritional assessment short-form), physical and cognitive function, and metabolic biomarkers. In Patients, elevated GDF15 levels at ED admission were associated with poorer resolution of inflammation (soluble urokinase plasminogen activator receptor [suPAR]), slowing of gait speed, and declining nutritional status between admission and 30-day follow-up. At time of matching, Patients were frailer and overall less healthy than age-matched Controls. GDF15 levels were significantly associated with participant group, on average Patients had almost 60% higher GDF15 than age-matched Controls, and this difference was partly mediated by reduced physical function. Increases in GDF15 levels between time of matching and 1-year follow-up were associated with increases in levels of interleukin-6 in Patients, and tumor necrosis factor-α and suPAR in age-matched Controls. In older adults, elevated GDF15 levels were associated with signs of accelerated aging and with poorer recovery after acute illness.

scholarly journals Comparison of two Dutch follow-up care models for spinal cord-injured patients and their impact on health problems, re-admissions and quality of care

2007 ◽  
Vol 21 (11) ◽  
pp. 997-1006 ◽  
Author(s):  
J.H.A. Bloemen-Vrencken ◽  
L.P. de Witte ◽  
M.W.M. Post ◽  
C. Pons ◽  
F.W.A. van Asbeck ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Quality Of Care ◽  
Health Problems ◽  
Follow Up Care ◽  
Care Models ◽  
Injured Patients ◽  
Spinal Cord Injured

Enteral nutritional support in patients undergoing chemoradiotherapy for esophageal carcinoma

2020 ◽  
Vol 16 (35) ◽  
pp. 2949-2957
Author(s):  
Bei Wang ◽  
Xiaowen Jiang ◽  
Dalong Tian ◽  
Wei Geng
Keyword(s):  
Esophageal Cancer ◽  
High Risk ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Assessment Tools ◽  
Tumor Patients ◽  
Selection Of

Esophageal cancer patients are at a high risk of malnutrition. Both the disease itself and chemoradiotherapy will lead to the deterioration of nutritional status. The development of nutritional oncology promotes the application of enteral nutrition in tumor patients. Through nutritional support, prognosis is improved and the incidence of adverse chemoradiotherapy reactions is reduced, especially in those with head and neck or esophageal cancer. This review summarizes enteral nutritional support in esophageal cancer patients undergoing chemoradiotherapy in recent years, including a selection of nutritional assessment tools, the causes and consequences of malnutrition in esophageal cancer patients, types of access and effects of enteral nutrition. More patients with esophageal cancer will benefit from the development of enteral nutrition technology in the future.

scholarly journals A Prospective Study on Changes in Nutritional Status and Growth Following Two Years of Ketogenic Diet (KD) Therapy in Children with Refractory Epilepsy

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1596 ◽  
Author(s):  
Marisa Armeno ◽  
Antonella Verini ◽  
Mariana del Pino ◽  
Maria Beatriz Araujo ◽  
Graciela Mestre ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Prospective Study ◽  
Ketogenic Diet ◽  
Refractory Epilepsy ◽  
Growth Monitoring ◽  
Male Predominance ◽  
History Of ◽  
A Prospective Study ◽  
Growth Deceleration

Introduction: Epilepsy is a neurological disorder characterized by an increased susceptibility to seizures. The ketogenic diet (KD) is currently the most important alternative non-pharmacological treatment. Despite its long history of clinical use, it is not clear how this diet affects longitudinal growth in children. Methods: A prospective study was designed to evaluate growth and nutritional status in 45 children on KD. Growth was assessed by measuring weight, height, and body mass index (BMI). Standard deviation scores (SDS) were calculated for all measurement parameters at KD initiation and at a two-year follow-up. Results: Overall, 45 patients who completed 24 months on KD were enrolled. Median age was 6.6 years (0.8 to 17.3), with a male predominance (n = 23); 74% of the 45 patients were responders on seizure reduction at three months; 26% of patients were non-responders. In our study, using −1 SDS as a cut-off point, growth deceleration was observed in 9% (n: 4) of the patients; however, the nutritional status was maintained or even improved. No correlation with age, sex, or ambulatory status was found. Conclusions: The nutritional follow-up of these patients was helpful to improve overweight and thinness but could not avoid growth deceleration in some of them. These findings confirm that children with refractory epilepsy on KD treatment require careful growth monitoring.

A Prospective Study of Radiofrequency Rhizotomy in the Treatment of Posttraumatic Spasticity

Neurosurgery ◽  
1984 ◽  
Vol 15 (4) ◽  
pp. 526-529 ◽  
Author(s):  
David L. Kasdon ◽  
Ellen S. Lathi
Keyword(s):  
Spinal Cord ◽  
Prospective Study ◽  
Range Of Motion ◽  
Nursing Care ◽  
Posterior Root ◽  
Severe Spasticity ◽  
Rehabilitation Potential ◽  
A Prospective Study ◽  
Ablative Procedures

Abstract Posttraumatic spasticity severely impedes rehabilitation potential and nursing care. Treatment of severe spasticity has included medical therapy, spinal cord ablative procedures, anterior and posterior root lesions and peripheral denervations, and tendon releases. Open rhizotomy and percutaneous radiofrequency rhizotomy have achieved good results. We prospectively studied 25 patients with severe spasticity to assess the efficacy of percutaneous radiofrequency rhizotomy. All or most of the prospectively identified goals were accomplished in 24 of the 25 patients, with improvement persisting during an average follow-up period of 12 months. The improvement due to decreased tone was much greater than the improvement due to increased range of motion.

Nutritional Status Deteriorates Postoperatively Despite Preoperative Nutritional Support

2016 ◽  
Vol 68 (4) ◽  
pp. 291-297 ◽  
Author(s):  
Fabian Grass ◽  
Michael Benoit ◽  
Pauline Coti Bertrand ◽  
Josep Sola ◽  
Markus Schäfer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Nutritional Status ◽  
Body Mass ◽  
Nutritional Support ◽  
Infectious Complications ◽  
Index Hospitalization ◽  
Upper Arm ◽  
Independent Risk Factors

Background/Aims: The aim of the current study was to assess the postoperative evolution of nutritional status and to relate it with postoperative outcomes. Methods: Demographic, surgical and nutritional parameters were assessed 10 days preoperatively (d-10) and 30 days postoperatively (d30) in 146 patients. Risk factors responsible for perioperative (>5% between d-10 and d30) weight loss were identified. Overall, severe (Clavien 3-5) and infectious complications were compared in patients with and without perioperative weight loss (>5%). Results: Nutritional status worsened beyond the postoperative period as reflected by decreasing weight (67 ± 13 kg at d-10 vs. 63 ± 13 kg at d30, p < 0.001), body mass index (23.4 ± 4 vs. 22.2 ± 4 kg/m2, p < 0.001) and mid upper-arm muscle circumference (MAMC, 241 ± 32 vs. 232 ± 30 mm, p < 0.001). Fifty-two patients (46%) lost >5% of their body weight between d-10 and d30. Patients who presented overall (63 vs. 36%, p = 0.004) and major (27 vs. 10%, p = 0.016) postoperative complications were at significantly higher risk to deteriorate postoperative nutritional status. Multivariate analysis identified low preoperative lean body mass (OR 3.2; 95% CI 1.2-8.9, p = 0.023) and low preoperative MAMC (OR 2.5; 95% CI 0.9-6.8, p = 0.066) as independent risk factors for perioperative weight loss. Conclusions: These data suggest continuing nutritional follow-up after the index hospitalization.

Ten‐Year Follow‐Up of Sildenafil Use in Spinal Cord‐Injured Patients with Erectile Dysfunction

2009 ◽  
Vol 6 (12) ◽  
pp. 3449-3457 ◽  
Author(s):  
Giuseppe Lombardi ◽  
Angelo Macchiarella ◽  
Filippo Cecconi ◽  
Giulio Del Popolo
Keyword(s):  
Spinal Cord ◽  
Erectile Dysfunction ◽  
Injured Patients ◽  
Spinal Cord Injured

scholarly journals Long-term follow-up study of intraurethral stents in spinal cord injured patients with detrusor-sphincter dyssynergia

Spinal Cord ◽  
2007 ◽  
Vol 45 (9) ◽  
pp. 621-626 ◽  
Author(s):  
S Seoane-Rodríguez ◽  
J Sánchez R-Losada ◽  
A Montoto-Marqués ◽  
S Salvador-de la Barrera ◽  
M E Ferreiro-Velasco ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Follow Up Study ◽  
Detrusor Sphincter Dyssynergia ◽  
Long Term Follow Up ◽  
Injured Patients ◽  
Spinal Cord Injured

The effect of nutritional support on outcome from severe head injury

1987 ◽  
Vol 67 (5) ◽  
pp. 668-676 ◽  
Author(s):  
Byron Young ◽  
Linda Ott ◽  
Diana Twyman ◽  
Jane Norton ◽  
Robert Rapp ◽  
...  
Keyword(s):  
Septic Shock ◽  
Head Injury ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Favorable Outcome ◽  
Content Type ◽  
Point Increase ◽  
Gcs Score ◽  
Tract Infections ◽  
Injured Patients

✓ Fifty-one brain-injured patients with peak 24-hour admission Glasgow Coma Scale (GCS) scores of 4 to 10 were prospectively randomly assigned to receive total parenteral (TPN) or enteral (EN) nutrition. Patients were studied from hospital admission to 18 days postinjury. Outcome was assessed by the Glasgow Outcome Scale at 3 months, 6 months, and 1 year postinjury. The TPN group received a significantly higher cumulative mean intake of protein than the EN group (mean ± standard error of the mean: 1.35 ± 0.12 vs. 0.91 ± 0.9 gm/kg/day; p = 0.004). Mean cumulative caloric balance was also significantly higher in the TPN than in the EN group (75.6% ± 5.13% vs. 59% ± 4.26%; p = 0.02). Nitrogen balance was significantly more negative in the EN group during the 1st week postinjury (p = 0.002). The incidence of pneumonia, urinary tract infections, septic shock, and infections was not significantly different between groups. Classic nutritional assessment parameters such as anergy screens, total lymphocyte counts, and albumin levels were not significantly different between groups. The 11 patients in the EN group who did not tolerate tube feedings for 1 week postinjury had a significantly higher incidence of septic shock (p = 0.008). The change over time in GCS scores between groups was significantly different, with the TPN group showing a mean four-point increase in GCS score compared with a three-point increase in the EN group (p = 0.02). At 3 months the TPN group had a significantly higher percentage of favorable outcomes (43.5% vs. 17.9%, respectively; p = 0.05). At 6 months, 43.5% of the TPN group had a favorable outcome while 32.1% of the EN group had a favorable outcome (p = 0.29). By 1 year, 47.8% of the TPN group and 32.1% of the EN group had a favorable outcome (p = 0.20). In conclusion, more calories and protein usually can be administered to acute brain injury patients via the TPN route than by EN feedings via nasogastric or nasoduodenal routes. Traditional parameters for nutritional assessment are not useful in studying the efficacy of nutritional support during the first 2 weeks after head injury. Neurological recovery from head injury occurs more rapidly in patients with better early nutritional support.

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