New coronavirus infection COVID-19: how do we feed the sick?

2021 ◽  
Author(s):  
И.Н. Пасечник ◽  
А.А. Щучко ◽  
В.В. Сазонов ◽  
Т.Б. Иванова
Keyword(s):  
Nutritional Status ◽  
European Society ◽  
Nutritional Support ◽  
Clinical Nutrition ◽  
Comprehensive Treatment ◽  
Rehabilitation Programs ◽  
Number Of Patients ◽  
Coronavirus Infection ◽  
The Uk

Повышение качества оказания помощи больным новой коронавирусной инфекцией COVID-19 возможно только на основе мультидисциплинарного подхода. Оценка пищевого статуса и при необходимости его коррекция являются важной составляющей комплексных программ лечения и реабилитации таких больных. Значительное число пациентов с COVID-19 составляют люди пожилого и старческого возраста, у которых уже есть признаки нутритивной недостаточности. Нарушения питания и сопутствующая им саркопения – факторы риска неблагоприятного течения COVID-19. Прогрессирование саркопении при COVID-19 объясняют возникновением вирусного миозита, миопатией, спровоцированной цитокинами, и иммобилизацией. Уменьшение мышечной массы ассоциировано с плохим прогнозом заболевания и снижением качества жизни. Коррекция нарушений пищевого статуса больных COVID-19 должна проводиться на всех этапах лечения. Важность проблемы нутритивной поддержки отражена во множестве публикаций, посвященных лечению больных COVID-19. Необходимо заметить, что Европейское общество клинического питания и метаболизма (European Society for Clinical Nutrition and Metabolism, ESPEN) в кратчайшие сроки выпустило рекомендации по нутритивной поддержке больных новой коронавирусной инфекцией, что лишний раз подчеркивает актуальность проблемы. Это стало логичным продолжением рекомендаций по коррекции пищевого статуса больных, находящихся на лечении в отделении реанимации и интенсивной терапии. Аналогичные клинические рекомендации были разработаны в Великобритании, Бразилии и целом ряде других стран. Использование препаратов для перорального дополнительного питания в большинстве случаев позволяет обеспечить потребности пациентов в необходимых нутриентах, уменьшить выраженность саркопении и повысить эффективность реабилитационных мероприятий. Improving the quality of care for patients with the new coronavirus infection COVID-19 is possible only on the basis of a multidisciplinary approach. Evaluation of nutritional status and, if necessary, its correction are an important component of comprehensive treatment and rehabilitation programs for such patients. A significant number of patients with COVID-19 are elderly and senile people who already have signs of nutritional deficiency. Eating disorders and accompanying sarcopenia are risk factors for the adverse course of COVID-19. The progression of sarcopenia in COVID-19 is explained by the occurrence of viral myositis, myopathy provoked by cytokines, and immobilization. Decreased muscle mass is associated with poor disease prognosis and reduced quality of life. Correction of nutritional disorders in patients with COVID-19 should be carried out at all stages of treatment. The importance of the problem of nutritional support is reflected in many publications devoted to the treatment of patients with COVID-19. It should be noted that the European Society for Clinical Nutrition and Metabolism (ESPEN) promptly issued recommendations on nutritional support for patients with new coronavirus infection, which once again emphasizes the urgency of the problem. This was a logical continuation of the recommendations for correcting the nutritional status of patients undergoing treatment in the intensive care unit. Similar clinical guidelines have been developed in the UK, Brazil and a number of other countries. The use of drugs for oral supplementary nutrition in most cases allows to meet the needs of patients for the necessary nutrients, to reduce the severity of sarcopenia and to increase the effectiveness of rehabilitation measures.

scholarly journals Nutritional support for patients with new coronavirus infection

2021 ◽  
Vol 12 (2) ◽  
pp. 102-109
Author(s):  
Igor N. Pasechnik
Keyword(s):  
Intensive Care ◽  
Nutritional Status ◽  
Nutritional Support ◽  
Energy Levels ◽  
Multiple Organ ◽  
The Novel ◽  
Coronavirus Infection ◽  
Severity Of The Disease ◽  
Novel Coronavirus

The novel coronavirus infection (COVID-19) pandemic has become an unprecedented threat to the lives of those affected and has increased the burden on the healthcare system in most countries. The severity of COVID-19 is not always predictable. However, comorbid pathology and advanced age are risk factors for a severe course of the disease with the development of multiple organ failure. When treating COVID-19, clinicians place particular emphasis on nutritional support as part of intensive care. Correction of nutritional status is also important in the rehabilitation of patients with the syndrome after intensive care. The aim of the review was to show the need for a differentiated approach to nutritional support for patients with COVID-19 during treatment and rehabilitation. From more than 200 originally selected literature sources from various databases (Scopus, Web of science, RSCI, etc.), 49 publications were selected for analysis, mostly published over the past 5 years. Earlier articles were used if they were still relevant to clinicians. The review provides methods for assessing the nutritional status of patients with COVID-19. It is emphasized that patients with comorbid pathology and elderly patients often develop malnutrition, which progresses over the disease. The article discusses in detail the issues of correction of malnutrition, depending on the severity of the disease and the stage of treatment. The effectiveness of rehabilitation is enhanced with adequate nutritional support. Current approaches to providing COVID-19 patients with nutrients and energy include a gradation of nutritional support prescription depending on the severity of the disease. Particular attention is paid to the gradual achievement of target protein and energy levels, as well as the preferential use of the enteral method of delivery of food components. Continuity of nutritional status correction at the outpatient, inpatient and rehabilitation stages improves the quality of care for patients with COVID-19.

scholarly journals The dynamics of recovery processes of physical activity of people who recovered from COVID-19

2021 ◽  
Vol 7 (3C) ◽  
pp. 607-612
Author(s):  
Sergey Kokhan ◽  
Elena Romanova ◽  
Vladislav Dychko ◽  
Elena Dychko ◽  
Danil Dychko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Life Assessment ◽  
Control Group ◽  
Breathing Exercises ◽  
Rehabilitation Programs ◽  
Recovery Processes ◽  
Coronavirus Infection ◽  
The Impact

The article shows the results of physical therapy of those who have had coronavirus infection COVID-19 and who have completed a month's course of physical rehabilitation as a part of rehabilitation measures in the conditions of the innovative clinic "Academy of Health". The aim of the research is to study the impact of pulmonary rehabilitation programs for patients with moderate to severe COVID-19. The implementation of special breathing exercises made it possible to improve the oxygen saturation in the blood, to reduce shortness of breath and indicators of respiratory symptoms.  The tolerance to exercise has increased; physical activity and the quality of life of patients with pneumonia associated with COVID-19 have improved. The best results of the EQ-5D quality of life assessment were recorded in the experimental group compared to the control group.

scholarly journals External genital endometriosis: treatment and rehabilitation

2020 ◽  
Author(s):  
A. G. Solopova ◽  
E. E. Achkasov ◽  
V. S. Moskvichyova ◽  
E. Grigorevskaya ◽  
D. M. Ampilogova
Keyword(s):  
Quality Of Life ◽  
Malignant Tumors ◽  
Pathological Process ◽  
Social Adaptation ◽  
Cochrane Library ◽  
Current View ◽  
Comprehensive Treatment ◽  
Modern Approach ◽  
Rehabilitation Programs

Aim: to systematize data on rehabilitation methods and management tactics for women with external form of genital endometriosis.Materials and Methods. We searched for publications in international scientific databases: scientific electronic library eLibrary, Scholar, ScienceDirect, Cochrane Library, PubMed/MEDLINE for the last 5 years. The data on the modern approach to the therapy and rehabilitation of women with external genital endometriosis are presented. Search terms in Russian and English were used: “endometriosis”, “rehabilitation”, “gynecology”, “quality of life”.Results. Endometriosis is considered an independent risk factor for the development of malignant tumors not only of the reproductive system, but also of the large intestine, bladder, mammary glands. The review presents a current view of the treatment and rehabilitation of women with external genital endometriosis. Endometriosis is a polyetiological disease that can manifest itself as dysmenorrhea, dyspareunia, chronic pelvic pain, as well as dysuria and dyshesia when involving adjacent organs in the pathological process. Relapses, infertility, emotional and psychosexual disorders, problems with socialization are often detected in these patients.Conclusion. It is necessary not only to conduct comprehensive treatment, but also to develop personalized rehabilitation programs that can improve the quality of life, as well as create comfortable conditions for social adaptation in society.

scholarly journals Efficacy and Efficiency of Nutritional Support Teams

2019 ◽  
Vol 8 (9) ◽  
pp. 1281 ◽  
Author(s):  
Reber ◽  
Strahm ◽  
Bally ◽  
Schuetz ◽  
Stanga
Keyword(s):  
Nutritional Status ◽  
Hospital Stay ◽  
Nutritional Support ◽  
Care Plan ◽  
Current Evidence ◽  
Nutritional Management ◽  
Complication Rates ◽  
Nutritional Care ◽  
Support Teams

Malnutrition is frequent in patients during a hospital admission and may further worsen during the hospital stay without appropriate nutritional support. Malnutrition causes greater complication rates, morbidity, and mortality rates, which increases the length of hospital stay and prolongs rehabilitation. Early recognition of individual nutritional risk and timely initiation of a tailored nutritional therapy are crucial. Recent evidence from large-scale trials suggests that efficient nutritional management not only improves the nutritional status, but also prevents negative clinical outcomes and increases patients’ quality of life. Multifaceted clinical knowledge is required to ensure optimal nutritional support, according to a patient’s individual situation and to avoid potential complications. Furthermore, clear definition of responsibilities and structuring of patient, and work processes are indispensable. Interdisciplinary and multiprofessional nutritional support teams have been built up to ensure and improve the quality and safety of nutritional treatments. These teams continuously check and optimize the quality of procedures in the core areas of nutritional management by implementing nutritional screening processes using a validated tool, nutritional status assessment, an adequate nutritional care plan development, prompt and targeted nutritional treatment delivery, and provision of accurate monitoring to oversee all aspects of care, from catering to artificial nutrition. The foundation of any nutritional care plan is the identification of patients at risk. The aim of this narrative review is to provide an overview about composition, tasks, and challenges of nutritional support teams, and to discuss the current evidence regarding their efficiency and efficacy in terms of clinical outcome and cost effectiveness.

scholarly journals Comprehensive Approaches to Improving Nutrition: Future Prospects

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1760 ◽  
Author(s):  
Syed M. Shahid ◽  
Karen S. Bishop
Keyword(s):  
Nutritional Status ◽  
Conflicts Of Interest ◽  
Poor Quality ◽  
Calorie Intake ◽  
Meaningful Change ◽  
Poor Nutritional Status ◽  
Prevalence Of Obesity ◽  
The Uk

When it comes to nutrition, nearly everyone has an opinion. In the past, nutrition was considered to be an individual’s responsibility, however, more recently governments have been expected (by some) to share that responsibility by helping to ensure that marketing is responsible, and that food chains offer healthy meal choices in addition to their standard fare, for example. In some countries, governments have gone as far as to remove tax from unprocessed foods or to introduce taxes, such as that imposed on sugary soft drinks in the UK, Mexico, France and Norway. Following on from the sugar tax, chocolate might be next! Is this the answer to our burgeoning calorie intake and increasing poor nutritional status, or is there another approach? In this narrative we will focus on some of the approaches taken by communities and governments to address excess calorie intake and improve nutritional status, as well as some of the conflicts of interest and challenges faced with implementation. It is clear that in order to achieve meaningful change in the quality of nutritional intake and to reduce the long-term prevalence of obesity, a comprehensive approach is required wherein governments and communities work in genuine partnership. To take no or little action will doom much of today’s youth to a poor quality of life in later years, and a shorter life expectancy than their grandparents.

The number of patients “worse than death” while waiting for a hip or knee arthroplasty has nearly doubled during the COVID-19 pandemic

2021 ◽  
pp. 1-9
Author(s):  
Nick D. Clement ◽  
Chloe E. H. Scott ◽  
James R. D. Murray ◽  
Colin R. Howie ◽  
David J. Deehan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Arthroplasty ◽  
Waiting List ◽  
Control Group ◽  
Health State ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Number Of Patients ◽  
The Uk

Aims The aim of this study was to assess the quality of life of patients on the waiting list for a total hip (THA) or knee arthroplasty (KA) during the COVID-19 pandemic. Secondary aims were to assess whether length of time on the waiting list influenced quality of life and rate of deferral of surgery. Methods During the study period (August and September 2020) 843 patients (THA n = 394, KA n = 449) from ten centres in the UK reported their EuroQol five dimension (EQ-5D) scores and completed a waiting list questionnaire (2020 group). Patient demographic details, procedure, and date when listed were recorded. Patients scoring less than zero for their EQ-5D score were defined to be in a health state “worse than death” (WTD). Data from a retrospective cohort (January 2014 to September 2017) were used as the control group. Results The 2020 group had a significantly worse EQ-5D score compared to the control group for both THA (p < 0.001) and KA (p < 0.001). Over one-third (35.0%, n = 138/394) of patients waiting for a THA and nearly a quarter (22.3%, n = 100/449) for KA were in a health state WTD, which was significantly greater than the control group (odds ratio 2.30 (95% confidence interval (CI) 1.83 to 2.93) and 2.08 (95% CI 1.61 to 2.70), respectively; p < 0.001). Over 80% (n = 680/843) of the 2020 group felt that their quality of life had deteriorated while waiting. Each additional month spent on the waiting list was independently associated with a decrease in quality of life (EQ-5D: -0.0135, p = 0.004). There were 117 (13.9%) patients who wished to defer their surgery and the main reason for this was health concerns for themselves and or their family (99.1%, n = 116/117). Conclusion Over one-third of patients waiting for THA and nearly one-quarter waiting for a KA were in a state WTD, which was approaching double that observed prior to the pandemic. Increasing length of time on the waiting list was associated with decreasing quality of life. Level of evidence: Level III retrospective case control study

scholarly journals Nutritional support with glutamine according to recommendations of the European Society for Clinical Nutrition and Metabolism (ESPEN)

2010 ◽  
Vol 5 ◽  
pp. 258-265
Author(s):  
Sylwia Kędziora ◽  
Robert Słotwiński ◽  
Aleksandra Dąbrowska
Keyword(s):  
European Society ◽  
Nutritional Support ◽  
Clinical Nutrition

Somatoneurological and psycho-pedagogical features of children with cerebral palsy in the context of their readiness for training in Paralympic sports

2021 ◽  
Vol 2 (4) ◽  
pp. 173-188
Author(s):  
Lale A. Pak ◽  
Svetlana B. Lazurenko ◽  
Svetlana B. Makarova ◽  
Tatyana V. Sviridova ◽  
Lyudmila M. Kuzenkova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cerebral Palsy ◽  
Nutritional Status ◽  
Support System ◽  
Rehabilitation Treatment ◽  
Rehabilitation Programs ◽  
Wide Range ◽  
Adaptive Physical Education ◽  
Children With Cerebral Palsy

Introduction. Currently, Russia does not have a scientifically grounded medical and psychological support system for disabled children (DC), which allows involving them in classes in children and youth schools of adaptive physical education, preparing the country’s Paralympic DC reserve. Aim of the study. To develop and create a medical support system for the Paralympic DC reserve, capable of improving their quality of life and forming a medical and social lift. Materials and methods. Children aged from 1 year to 18 years had cerebral palsy (CP) with impaired motor functions of levels I and II according to the global motor function assessment system and the Manual Abilities Classification system and their families were monitored. A comprehensive assessment of the somatic, neurological, mental and nutritional status of CP children) was carried out, and a wide range of comorbid pathology was described. After the rehabilitation treatment with the use of complex personalized rehabilitation programs, dynamic monitoring of the condition of patients with cerebral palsy was carried out, followed by an assessment of the effectiveness of rehabilitation treatment and the impact on it the psychological readiness of patients, their parents to engage in Paralympic sports, as well as the socio-economic level of the family. The attitude of CP children and their parents to participate in the Paralympic movement was studied. All patients underwent a comprehensive study of somatic, neurological, orthopaedic, psychological and nutritional status. The socio-hygienic characteristics of families and the rehabilitation potential of DC and their families have been determined. Results. Children with cerebral palsy have a wide range of comorbid pathology, which requires the involvement of specialists of different profiles in the curation of patients. The use of complex personalized rehabilitation programs allows achieving positive dynamics after 14 days of rehabilitation treatment. Early introduction of botulinum therapy in the rehabilitation program of CP patients provides higher efficiency of rehabilitation treatment. Treatment of protein-energy deficiency in CP children should include correction of the diet using specialized products, metabolic therapy, enzyme and complex vitamin preparations. Differentiated medical, psychological and pedagogical counselling of parents of CP children will allow optimizing the solution of the state problem regarding the timely inclusion of persons with disabilities in adaptive physical education classes. Conclusion. The development and creation of a comprehensive medical and psychological support system solve an urgent medical and social problem, ensuring the integration of DC into society and improving the quality of life of both a sick child and his family members.

scholarly journals Provision of physiotherapy rehabilitation following neck dissection in the UK

2018 ◽  
Vol 132 (7) ◽  
pp. 624-627 ◽  
Author(s):  
M Robinson ◽  
L Ward ◽  
H Mehanna ◽  
V Paleri ◽  
S C Winter
Keyword(s):  
Quality Of Life ◽  
Return To Work ◽  
Neck Dissection ◽  
Shoulder Dysfunction ◽  
Patient Request ◽  
Physiotherapy Practice ◽  
Number Of Patients ◽  
The Uk ◽  
National Practice

AbstractBackgroundNeck dissection is associated with post-operative shoulder dysfunction in a substantial number of patients, affecting quality of life and return to work. There is no current UK national practice regarding physiotherapy after neck dissection.MethodNine regional centres were surveyed to determine their standard physiotherapy practice pre- and post-neck dissection, and to determine pre-emptive physiotherapy for any patients.ResultsEighty-nine per cent of centres never arranged any pre-emptive physiotherapy for any patients. Thirty-three per cent of centres offered routine in-patient physiotherapy after surgery. No centres offered out-patient physiotherapy for all patients regardless of symptoms. Seventy-eight per cent offered physiotherapy for patients with any symptoms, with 11 per cent offering physiotherapy for those with severe dysfunction only. Eleven per cent of centres never offered physiotherapy for any dysfunction.ConclusionThe provision of physiotherapy is most commonly reactive rather than proactive, and usually driven by patient request. There is little evidence of pre-arranged physiotherapy for patients to treat or prevent shoulder dysfunction in the UK.

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