132 results on '"Cuerda,Cristina"'
Search Results
102. Calidad de vida relacionada con la salud: acuerdo entre el cuidador principal y el paciente con sporte nutricional domiciliario
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Wanden-Berghe, Carmina, primary, Nolasco, Andreu, additional, Planas, Mercè, additional, Sanz-Valero, Javier, additional, Rodríguez, Teresa, additional, NADYA-SENPE, Grupo, additional, Cuerda, Cristina, additional, Guardiola, Rocío, additional, and Castelló-Botia, Isabel, additional
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- 2008
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103. Health-related quality of life according to the main caregiver in patients with home nutritional support
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Wanden-Berghe, Carmina, primary, Nolasco, Andreu, additional, Planas, Mercè, additional, Sanz-Valero, Javier, additional, Rodríguez, Teresa, additional, Cuerda, Cristina, additional, Guardiola, Rocío, additional, and Castelló-Botia, Isabel, additional
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- 2008
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104. Anterior Pituitary Function in Cushing's Syndrome: Study of 36 Patients.
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CUERDA, CRISTINA, primary, ESTRADA, JAVIER, additional, MARAZUELA, MÓNICA, additional, VICENTE, ALMUDENA, additional, ASTIGARRAGA, BEATRIZ, additional, BERNABEU, IGNACIO, additional, DIEZ, SANTIAGO, additional, and SALTO, LUIS, additional
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- 1991
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105. Chronic radiation enteritis after ovarian cancer: From home parenteral nutrition to oral diet.
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Vidal, Alfonso, de la Cuerda, Cristina, Luis Escat, José, Bretón, Irene, Camblor, Miguel, and García-Peris, Pilar
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Summary: Introduction: External beam radiation of abdominal and pelvic cavities is a current therapy for gynaecological cancer that often produces radiation-induced bowel injury and malnutrition. Case report: A 72-year old patient underwent surgery and external beam radiation therapy for an ovarian carcinoma. Two years later she was found to have intestinal pseudoobstruction related to chronic radiation enteritis and protein-energy malnutrition. Home parenteral nutrition was prescribed due to poor oral intake, but it was discontinued after 6 catheter-related sepsis and upper cava vein thrombosis. Parenteral nutrition could be reintroduced after an angioplasty of that vein, and the patient was operated on with the finding of an incarcerated ileum eventration. Nowadays she maintains a normal nutritional status with oral diet. Discussion: Radiation enteritis can lead to perforation, fistulae or strictures of the bowel. Malnutrition is common and parenteral nutrition may be necessary. Surgery can solve these complications, achieves good survival rates and can allow stopping parenteral nutrition. [Copyright &y& Elsevier]
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- 2006
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106. Nutritional Management and Outcomes in Malnourished Medical Inpatients: Anorexia Nervosa.
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Cuerda, Cristina, Vasiloglou, Maria F., and Arhip, Loredana
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ANOREXIA nervosa , *NUTRITIONAL requirements , *BODY composition , *PHYSICAL activity , *MALNUTRITION , *MALNUTRITION treatment - Abstract
Background: Anorexia Nervosa (AN) is a psychiatric disorder characterised by a physical and psychosocial deterioration due to an altered pattern on the intake and weight control. The severity of the disease is based on the degree of malnutrition. The objective of this article is to review the scientific evidence of the refeeding process of malnourished inpatients with AN; focusing on the clinical outcome. Methods: We conducted an extensive search in Medline and Cochrane; on April 22; 2019; using different search terms. After screening all abstracts; we identified 19 papers that corresponded to our inclusion criteria. Results: The article focuses on evidence on the characteristics of malnutrition and changes in body composition; energy and protein requirements; nutritional treatment; physical activity programmes; models of organisation of the nutritional treatment and nutritional support related outcomes in AN patients. Conclusion: Evidence-based standards for clinical practice with clear outcomes are needed to improve the management of these patients and standardise the healthcare process. [ABSTRACT FROM AUTHOR]
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- 2019
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107. Two pregnancies of an ornithine carbamoyltransferase deficiency disease carrier and review of the literature.
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Arhip, Loredana, Agreda, Javier, Serrano-Moreno, Clara, Motilla, Marta, Carrascal, Maria Luisa, Bielza, Atocha, Velasco, Cristina, Camblor, Miguel, Bretón, Irene, and Cuerda, Cristina
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LITERATURE reviews , *DISEASE vectors , *DEFICIENCY diseases , *PUERPERIUM , *PARTURITION , *ORNITHINE , *PREGNANCY , *X chromosome - Abstract
Background: the underlying cause of the deficiency of ornithine carbamoyltransferase (OTCD) is a gene mutation on the X chromosome. In females, the phenotype is highly variable, ranging from asymptomatic to neurologic compromise secondary to hyperammonemia and it can be prompted by numerous triggers, including pregnancy. Objective: the objective of this article is to report a case of two pregnancies of an OTCD-carrier, and to review the literature describing OTCD and pregnancy, parturition and postpartum. Methods: an extensive search in PubMed in December 2021 was conducted using different search terms. After screening all abstracts, 23 papers that corresponded to our inclusion criteria were identified. Results: the article focuses on the management of OTCD during pregnancy, parturition, and the postpartum period in terms of clinical presentation, ammonia levels and treatment. Conclusions: females with OTCD can certainly plan a pregnancy, but they need a careful management during delivery and particularly during the immediate postpartum period. If possible, a multidisciplinary team of physicians, dietitians, obstetrician-gynecologist, neonatologists, pharmacists, etc. with expertise in this field should participate in the care of women with OTCD and their children during this period and in their adult life. [ABSTRACT FROM AUTHOR]
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- 2024
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108. Guía Práctica ESPEN: nutrición enteral domiciliaria.
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Bischoff, Stephan C., Austin, Peter, Boeykens, Kurt, Chourdakis, Michael, Cuerda, Cristina, Jonkers-Schuitema, Cora, Lichota, Marek, Nyulasi, Ibolya, Schneider, Stéphane M., Stanga, Zeno, Pironi, Loris, and Cantón, Ana
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ENTERAL feeding , *PARENTERAL feeding , *PHARMACISTS , *DIETITIANS , *PHYSICIANS , *SCIENCE publishing , *NUTRITION - Abstract
This ESPEN practical guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home enteral nutrition (HEN) providers in a concise way about the indications and contraindications for HEN, as well as its implementation and monitoring. This guideline will also inform interested patients requiring HEN. Home parenteral nutrition is not included but will be addressed in a separate ESPEN guideline. The guideline is based on the ESPEN scientific guideline published before, which consists of 61 recommendations that have been reproduced and renumbered, along with the associated commentaries that have been shorted compared to the scientific guideline. Evidence grades and consensus levels are indicated. The guideline was commissioned and financially supported by ESPEN and the members of the guideline group were selected by ESPEN. [ABSTRACT FROM AUTHOR]
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- 2023
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109. Implementation of a parenteral nutrition home care programme in a tertiary hospital.
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Arhip, Loredana, Camblor, Miguel, Bretón, Irene, Motilla, Marta, Serrano-Moreno, Clara, María Romero, Rosa, Lobato, Elena, Frías, Laura, Velasco, Cristina, Luisa Carrascal, María, and Cuerda, Cristina
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PARENTERAL feeding , *NURSING care facilities , *MALE nurses , *HOSPITAL personnel , *TERTIARY care , *INVENTORY control , *TELEPHONE calls - Abstract
Aim: the objective of this study was to describe the results of the implementation of a home parenteral nutrition (HPN) care programme (Nutrihome©) in a cohort of patients treated at a tertiary hospital. Methods: retrospective study of the patients included in Nutrihome© at Hospital General Universitario Gregorio Marañón, Madrid, Spain. Nutrihome consists of different modules including pre-discharge nursing hospital visits and nursing home visits, deliveries of the infusion pump, consumables and parenteral nutrition bags, patient training, weekly scheduled nursing home visits, scheduled nursing phone calls, stock control phone calls and 24-hour on-call line manned by the nurses. Results: the study included 8 (75 % women) and 10 (70 % women) patients in the Nutrihome© pilot and Nutrihome© programme, respectively. A total 37 adverse events were reported during Nutrihome© pilot, 26 of which were technical, 9 clinical, 1 was catheter-related and 1 other event. Nutrihome© programme registered a total of 107 adverse events reported, 57 of which were technical, 21 clinical, 16 were catheter-related and 13 were other events. A total of 99 % of these events were solved by Nutrihome© via phone calls or home visits. Conclusions: Nutrihome© programme has been extremely useful during this pandemic, facilitating both the start of HPN and training at the patient home without the need for hospitalisation. Additionally, the adverse events reported and solved by Nutrihome© not only reduced the physicians’ burden during those tough times and the patients´ stress of being hospitalised during a pandemic, but supported the entire healthcare system. [ABSTRACT FROM AUTHOR]
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- 2023
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110. COVID-19: Lessons on malnutrition, nutritional care and public health from the ESPEN-WHO Europe call for papers
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Rocco Barazzoni, Joao Breda, Cristina Cuerda, Stephane Schneider, Nicolaas E. Deutz, Kremlin Wickramasinghe, Osman Abbasoglu, Judith Beurskens Meijerink, Stephan Bischoff, Rosa Burgos Pelaez, Diana Cardenas, Tommy Cederholm, Emanuele Cereda, Michael Chourdakis, Maria Isabel Toulson Davisson Correia, Marian de van der Schuren, Nathalie Delzenne, Evelyn Frias-Toral, Laurence Genton, Gianluca Gortan Cappellari, Burcu Kelleci Cakir, Stanislaw Klek, Zeljko Krznaric, Alessandro Laviano, Dileep Lobo, Maurizio Muscaritoli, Johann Ockenga, Matthias Pirlich, Mireille JM. Serlie, Han Ping Shi, Pierre Singer, Mattias Soop, Stephane Walrand, Arved Weimann, Barazzoni, Rocco, Breda, Joao, Cuerda, Cristina, Schneider, Stephane, Deutz, Nicolaas E, Wickramasinghe, Kremlin, COVID-19 Call Editorial, Board, Gortan Cappellari, Gianluca, and UCL - SSS/LDRI - Louvain Drug Research Institute
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Public health ,Nutrition and Dietetics ,Sars-CoV-2 ,Malnutrition ,Nutritional Status ,COVID-19 ,Nutritional care ,World Health Organization ,Critical Care and Intensive Care Medicine ,Europe ,Nutrition Assessment ,Post-Acute COVID-19 Syndrome ,Communicable Disease Control ,Humans ,Obesity - Abstract
With prolonged pandemic conditions, and emerging evidence but persisting low awareness of the importance of nutritional derangements, ESPEN has promoted in close collaboration with World Health Organization-Europe a call for papers on all aspects relating COVID-19 and nutrition as well as nutritional care, in the Society Journals Clinical Nutrition and Clinical Nutrition ESPEN. Although more COVID-related papers are being submitted and continue to be evaluated, ESPEN and WHO present the current editorial to summarize the many published findings supporting major interactions between nutritional status and COVID-19. These include 1) high risk of developing the disease and high risk of severe disease in the presence of pre-existing undernutrition (malnutrition) including micronutrient deficiencies; 2) high risk of developing malnutrition during the course of COVID-19, with substantial impact on long-term sequelae and risk of long COVID; 3) persons with obesity are also prone to develop or worsen malnutrition and its negative consequences during the course of COVID-19; 4) malnutrition screening and implementation of nutritional care may improve disease outcomes; 5) social and public health determinants contribute to the interaction between nutritional status and COVID-19, including negative impact of lockdown and social limitations on nutrition quality and nutritional status. We believe the evidence supports the need to consider COVID-19 as (also) a case of malnutrition-enhanced disease and disease-related malnutrition, with added risk for persons both with and without obesity. Similarities with many other disease conditions further support recommendations to implement standard nutritional screening and care in COVID-19 patients, and they underscore the relevance of appropriate nutritional and lifestyle prevention policies to limit infection risk and mitigate the negative health impact of acute pandemic bouts.
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- 2022
111. The NutriQoL® questionnaire for assessing health-related quality of life (HRQoL) in patients with home enteral nutrition (HEN): validation and ? rst results.
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Apezetxea, Antonio, Carrillo, Lourdes, Casanueva, Felipe, Cuerda, Cristina, Cuesta, Federico, Irles, José Antonio, Virgili, María Nuria, Layola, Miquel, and Lizán, Luis
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QUALITY of life , *ENTERAL feeding , *QUESTIONNAIRES , *CAREGIVERS , *CANCER , *MALABSORPTION syndromes - Abstract
Introduction: Health-related quality of life (HRQoL) provides a global view of the state of health of a patient receiving home enteral nutrition (HEN). Objective: To evaluate the HRQoL of patients receiving HEN using the NutriQoL® questionnaire, a specific instrument regardless of the underlying disease and route of administration. Materials and methods: Observational, prospective and multicentre study conducted in the context of the validation and assessment of the NutriQoL® questionnaire's psychometric properties. Results: One-hundred-and-forty individuals [disease: cancer (58.6%), malabsorption and other (27.1%), neurological (13.6%); HEN: supplement (61.4%), sole source of nutrition (35.7%); administration route: oral (54.3%), ostomy (31.4%), nasoenteric tube (12.1%)] participated. NutriQoL® was reliable [ICC: 0.88 (95%CI: 0.80-0.93); Cronbach's α: 0.77 (1st visit) and 0.83 (2nd visit)], valid (significant Rho), lowly sensitive to changes (effect size 0.23), can be completed by either patients or caregivers (ICC: 0.82). The mean HRQoL (SD) with NutriQoL® was 14.98 (14.86), EQ-5D tariff: 53(0.25), EQ-5D VAS: 54.15(20.64) and COOP/WONCA charts: 23.32(5.66). HRQoL with NutriQoL® was better (p < 0.05) for oral HEN [19.54(13,23)], than nasoenteric tube [14(11.71)], ostomy [7.02 (15.48)]; administered orally [19.54 (13.23)], than by gravity [10.97 (14.46)], pump [8.5 (19.78)] or syringe bolus [7 (11.40)]; as a supplement [19.33 (13.73)] instead of sole source of nutrition [8.18 (14.23)]. Conclusions: NutriQoL® is valid, reliable, even if lowly sensitive to change, and useful to measure HRQoL in this population. More studies are needed to know HRQoL in routine practice. [ABSTRACT FROM AUTHOR]
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- 2016
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112. Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure
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Nuria Virgili, Konrad Matysiak, Cristina Cuerda, Henrik Højgaard Rasmussen, Florian Poullenot, Ronan Thibault, Umberto Aimasso, Amelia Jukes, Andre Dong Won Lee, Brooke Chapman, Geert J. A. Wanten, Simona Di Caro, Maryana Doitchinova-Simeonova, Alastair Forbes, Corrado Spaggiari, Ezra Steiger, Elena Nardi, Cécile Chambrier, Simon Lal, Paolo Orlandoni, Peter Sahin, Marina Taus, Mireille J. Serlie, Kinga Szczepanek, A. Crivelli, Nicola Wyer, Przemysław Matras, Lynn Jones, Carmen Garde, Gabriel Olveira, Marek Kunecki, José P. Suárez-Llanos, Francisca Joly, Ana Zugasti Murillo, Joanne Daniels, Loris Pironi, Zeljko Krznaric, Emma Osland, Sheldon C. Cooper, Stéphane M. Schneider, Sarah Jane Hughes, Lars Ellegård, Miriam Theilla, Luisa Masconale, Anna Zmarzly, Aurora E. Serralde-Zúñiga, André Van Gossum, Anna Simona Sasdelli, Lidia Santarpia, Nada Rotovnik Kozjek, Francesco William Guglielmi, Margie O'Callaghan, Charlene Compher, Estrella Petrina Jáuregui, Pironi, L., Steiger, E., Joly, F., Wanten, G. J. A., Chambrier, C., Aimasso, U., Sasdelli, A. S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M. J., Cooper, S. C., Poullenot, F., Rasmussen, H. Ho., Compher, C. W., Crivelli, A., Hughes, S. -J., Santarpia, L., Guglielmi, F. W., Rotovnik Kozjek, N., Ellegard, L., Schneider, S. M., Matras, P., Forbes, A., Wyer, N., Zmarzly, A., Taus, M., O'Callaghan, M., Osland, E., Thibault, R., Cuerda, C., Jones, L., Chapman, B., Sahin, P., Virgili, N. M., Lee, A. D. W., Orlandoni, P., Matysiak, K., Di Caro, S., Doitchinova-Simeonova, M., Masconale, L., Spaggiari, C., Garde, C., Serralde-Zuniga, A. E., Olveira, G., Krznaric, Z., Petrina Jauregui, E., Zugasti Murillo, A., Suarez-Llanos, J. P., Nardi, E., Van Gossum, A., Lal, S., Pironi, Lori, Steiger, Ezra, Joly, Francisca, Wanten, Geert J A, Chambrier, Cecile, Aimasso, Umberto, Sasdelli, Anna Simona, Szczepanek, Kinga, Jukes, Amelia, Theilla, Miriam, Kunecki, Marek, Daniels, Joanne, Serlie, Mireille J, Cooper, Sheldon C, Poullenot, Florian, Rasmussen, Henrik Højgaard, Compher, Charlene W, Crivelli, Adriana, Hughes, Sarah-Jane, Santarpia, Lidia, Guglielmi, Francesco William, Rotovnik Kozjek, Nada, Ellegard, Lar, Schneider, Stéphane M, Matras, Przemysław, Forbes, Alastair, Wyer, Nicola, Zmarzly, Anna, Taus, Marina, O'Callaghan, Margie, Osland, Emma, Thibault, Ronan, Cuerda, Cristina, Jones, Lynn, Chapman, Brooke, Sahin, Peter, Virgili, Núria M, Lee, Andre Dong Won, Orlandoni, Paolo, Matysiak, Konrad, Di Caro, Simona, Doitchinova-Simeonova, Maryana, Masconale, Luisa, Spaggiari, Corrado, Garde, Carmen, Serralde-Zúñiga, Aurora E, Olveira, Gabriel, Krznaric, Zeljko, Petrina Jáuregui, Estrella, Zugasti Murillo, Ana, Suárez-Llanos, José P, Nardi, Elena, Van Gossum, André, Lal, Simon, University of Bologna, Cleveland Clinic, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Radboud university [Nijmegen], Hospices Civils de Lyon (HCL), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Aalborg University [Denmark] (AAU), Sahlgrenska Academy at University of Gothenburg [Göteborg], Centre Hospitalier Universitaire de Nice (CHU Nice), Medical University of Lublin, University of East Anglia [Norwich] (UEA), University Hospital Coventry, CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Hospital General Universitario 'Gregorio Marañón' [Madrid], Austin Health, Universidade de São Paulo (USP), Poznan University of Life Sciences (Uniwersytet Przyrodniczy w Poznaniu) (PULS), University College London Hospitals (UCLH), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán - National Institute of Medical Science and Nutrition Salvador Zubiran [Mexico], University of Manchester [Manchester], European Society for Clinical Nutrition and Metabolism (ESPEN)., Endocrinology, AGEM - Endocrinology, metabolism and nutrition, University of Bologna/Università di Bologna, Radboud University [Nijmegen], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Universidade de São Paulo = University of São Paulo (USP)
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Male ,0301 basic medicine ,[SDV]Life Sciences [q-bio] ,Severity of Illness Index ,Liver disease ,0302 clinical medicine ,Drug Dosage Calculations ,motility disorder ,2. Zero hunger ,Gastroenterology ,Short bowel syndrome ,3. Good health ,Chronic intestinal failure ,Intestines ,Pharmaceutical Solutions ,Venous thrombosis ,Intestinal obstruction ,motility disorders ,Administration, Intravenous ,Female ,030211 gastroenterology & hepatology ,Parenteral Nutrition, Home ,Adult ,Fat Emulsions, Intravenous ,medicine.medical_specialty ,parenteral nutrition ,macromolecular substances ,Clinical nutrition ,short bowel syndrome ,03 medical and health sciences ,Cholestasis ,intestinal failure ,Internal medicine ,medicine ,Humans ,030109 nutrition & dietetics ,business.industry ,liver failure ,medicine.disease ,Intestinal Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Parenteral nutrition ,Alimentació parenteral ,Intestinal Absorption ,Catheter-Related Infections ,Parenteral feeding ,Chronic Disease ,Obstrucció intestinal ,Fluid Therapy ,business ,Body mass index - Abstract
Background and aimNo marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity.MethodsAt baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as 3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI).ResultsFifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN 1 L/day), patients’ death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2–3 and PN >3 L/day).ConclusionsThe type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols.
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- 2020
113. An international study of the quality of life of adult patients treated with home parenteral nutrition
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Darlene G. Kelly, Cristina Cuerda, Peter Fayers, Geert J. A. Wanten, C. Jonkers, Manon Jobin, Alastair Forbes, Ceferino Martinez Faedo, J.P. Baxter, Loris Pironi, Federico Bozzetti, André Van Gossum, Luigi Mariani, Marie-France Boudreault, Francisca Joly, Lyn Gillanders, Cinzia Brunelli, Margie O'Callaghan, Stanislaw Klek, Michael Staun, Alain Gilbert, Baxter, Janet P., Fayers, Peter M., Bozzetti, Federico, Kelly, Darlene, Joly, Francisca, Wanten, Geert, Jonkers, Cora, Cuerda, Cristina, van Gossum, Andre, Klek, Stanislaw, Boudreault, Marie-France, Gilbert, Alain, Jobin, Manon, Staun, Michael, Gillanders, Lyn, Forbes, Alastair, O'Callaghan, Margie, Faedo, Ceferino Martínez, Brunelli, Cinzia, Mariani, Luigi, Pironi, Loris, and Other departments
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Adult ,Male ,0301 basic medicine ,Quality of life ,medicine.medical_specialty ,Adolescent ,030209 endocrinology & metabolism ,Disease ,Critical Care and Intensive Care Medicine ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal consistency ,LIVING STATUS ,medicine ,Nutrition and Dietetic ,Humans ,Patient Reported Outcome Measures ,Patient reported outcomes ,Aged ,Aged, 80 and over ,Home parenteral nutrition ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Multivariable linear regression ,Adult patients ,business.industry ,Australia ,Discriminant validity ,Middle Aged ,Intestinal failure ,Patient reported outcome ,humanities ,Europe ,Intestinal Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Cross-Sectional Studies ,Parenteral nutrition ,North America ,Physical therapy ,Female ,Parenteral Nutrition, Home ,business - Abstract
Contains fulltext : 205187.pdf (Publisher’s version ) (Closed access) BACKGROUND & AIMS: Home parenteral nutrition-quality of life (HPN-QOL((c))) is a self-assessment tool for the measurement of QOL in patients on HPN. The aims of this study were: to re-assess the basic psychometric properties of the HPN-QOL((c)) in a multinational sample of adult patients; to provide a description of QOL dimensions by short and long HPN treatment duration; to explore clinical factors potentially associated to QOL scores. METHODS: Patients (n = 699) from 14 countries completed the HPN-QOL((c)). The questionnaires were analysed to evaluate data completeness, convergent/discriminant validity and internal-consistency reliability. The association of overall QOL and HPN treatment duration as well as other clinical factors were investigated using multivariable linear regression models. RESULTS: The analysis of the multitrait-scaling and internal consistency indicates a good fit with the questionnaire structure for most items. Item discriminant validity correlation was satisfactory and psychometric evaluation of the HPN-QOL((c)) in the different English, French and Italian language patient sub-groups confirmed psychometric equivalence of the three questionnaire versions. The results of the multivariable linear regression showed that QOL scores were significantly associated with HPN duration (better in long-term), underlying disease (better in Crohn's disease and mesenteric ischaemia) and living status (worse in living alone) and, after adjusting for the other factors, with the number of days of HPN infusion per week. CONCLUSIONS: The HPN-QOL((c)), is a valid tool for measurement of QOL in patients on HPN, to be used in the clinical practice as well as in research.
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- 2019
114. Nutrition education in medical schools (NEMS). An ESPEN position paper
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Juan A. Vargas, Lorenzo M. Donini, Marco Schetgen, Davor Jezek, Maurizio Muscaritoli, Cristina Cuerda, Eugenio Gaudio, André Van Gossum, Stéphane M. Schneider, Zeljko Krznaric, Rocco Barazzoni, Patrick Baqué, Matthias Pirlich, Cuerda, C., Muscaritoli, M., Donini, L. M., Baque, P., Barazzoni, R., Gaudio, E., Jezek, D., Krznaric, Z., Pirlich, M., Schetgen, M., Schneider, S., Vargas, J. A., Van Gossum, A., Cuerda, Cristina, Muscaritoli, Maurizio, Donini, Lorenzo Maria, Baqué, Patrick, Barazzoni, Rocco, Gaudio, Eugenio, Jezek, Davor, Krznaric, Zeljko, Pirlich, Matthia, Schetgen, Marco, Schneider, Stephane, Vargas, Juan A., and Van Gossum, André
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0301 basic medicine ,Medical curriculum ,ESPEN ,Nutritional Sciences ,Nutrition Education ,education ,MEDLINE ,030209 endocrinology & metabolism ,Clinical nutrition ,Critical Care and Intensive Care Medicine ,NEMS ,nutrition ,medical schoosl ,03 medical and health sciences ,0302 clinical medicine ,Nutrition education ,Multidisciplinary approach ,Nutrition and Dietetic ,Humans ,Medicine ,Nutrition ,Curriculum ,Human nutrition ,Medical school ,Schools, Medical ,Medical education ,Nutrition and Dietetics ,030109 nutrition & dietetics ,business.industry ,Variety (cybernetics) ,Europe ,Models, Organizational ,Position paper ,business - Abstract
Summary Background & aims Nutrition education is necessary in the training of healthcare professionals, including medical students. However, recent surveys showed that there is a high variability within Medical Schools in different countries. The aim of this ESPEN position paper is to identify a minimum curriculum knowledge in nutrition that serves to improve the training of the future doctors and how to solve the main barriers of its implementation in university centres. Methods In 2017, the ESPEN Executive Committee launched the Nutrition Education in Medical Schools (NEMS) Project and formed a core working group including members of the ESPEN Nutrition Education Study Group (NESG) and representatives of several European Medical Schools. This group met in Brussels, on 19th July 2018 and decided to prepare a position paper on this topic. Results Five main learning objectives and twenty-one topics on human nutrition, within its three domains (basic, applied and clinical nutrition) were identified to be fulfilled at the end of training in all Medical Schools. The experts showed the following key factors for its implementation: establish a nutrition curriculum committee, use different models of integration of the contents in the curriculum (vertical and horizontal), have a multidisciplinary and experienced faculty, incorporate a variety of teaching models, and evaluate the programme periodically. Conclusions Nutrition Education is necessary and should be mandatory in all Medical Schools. This position paper aims at improving this gap knowledge and gives some clues for a successful implementation of the changes in the medical curriculum at university centres.
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- 2020
115. Prospective study of catheter-related central vein thrombosis in home parenteral nutrition patients with benign disease using serial venous Doppler ultrasound
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Francisca Joly, Carmen Gil, Cristina Cuerda, Loris Pironi, Javier Concejo, C. Puiggros, Olivier Corcos, Cuerda, Cristina, Joly, Francisca, Corcos, Olivier, Concejo, Javier, Puiggrós, Carolina, Gil, Carmen, and Pironi, Loris
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Asymptomatic ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,medicine ,Central Venous Catheters ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Aged, 80 and over ,Venous Thrombosis ,Catheter ,Home parenteral nutrition ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Catheter insertion ,business.industry ,Incidence ,Anticoagulants ,Ultrasonography, Doppler ,Middle Aged ,Venous thrombosi ,medicine.disease ,Thrombosis ,Surgery ,Venous thrombosis ,Catheter-Related Infections ,Female ,medicine.symptom ,Parenteral Nutrition, Home ,business ,Lower limbs venous ultrasonography ,Follow-Up Studies - Abstract
Summary Background & aims Catheter-related central vein thrombosis (CRVT) is a severe complication of home parenteral nutrition (HPN) that may be clinically manifest or subclinical. The aims of the study were to prospectively investigate the incidence of CRVT in patients on HPN with benign disease and determine the influence of different variables on this complication. Methods A prospective, multicentre, observational study in the Home Artificial Nutrition-Chronic Intestinal Failure ESPEN group was performed. Patients with benign disease starting HPN or already on HPN after the insertion of a new catheter, were recruited and followed up with Color Doppler Duplex Sonography (CDDS) evaluations at baseline, 1 week, 3, 6 and 12 months after catheter insertion. Fisher's exact test was used to calculate the association of different variables (related to the patient, type of catheter, vascular access, insertion method, catheter care and anticoagulant treatment) with CRVT events. Results Sixty-two patients (31 males, 31 females) aged 50 ± 19 (19–83) years were included and followed for a median 363 days, with an Inter Quartile Range of 180–365 days, and a total of 16,186 catheter-days. Six patients had previous CRVT and 16 had history of thromboembolic disease (pulmonary and mesenteric). Forty one patients were receiving anticoagulant treatment. Fifty two patients had tunneled catheters and 10 implanted ports. Two patients had symptomatic thrombosis at 3 and 12 months of follow-up (2 and 3 weeks after normal routine CDDS evaluation). The incidence of CRVT was 0.045/catheter/year. CRVT was not significantly associated with any of the variables analyzed. Conclusions The incidence of CRVT in patients on HPN for benign disease followed by CDDS is low in the first year of catheterization. We did not observe any case of asymptomatic CRVT. Based on our data, CDDS seems to have low effectiveness as a screening tool for CRVT in asymptomatic patients on HPN with benign disease.
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- 2016
116. Clinical approach to the management of Intestinal Failure Associated Liver Disease (IFALD) in adults: A position paper from the Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN
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Geert J. A. Wanten, Federico Bozzetti, André Van Gossum, Jann Arends, Darlene G. Kelly, Cristina Cuerda, Stéphane M. Schneider, Francisca Joly, Kinga Szczepanek, Simon Lal, Michael Staun, Loris Pironi, Lal, Simon, Pironi, Lori, Wanten, Geert, Arends, Jann, Bozzetti, Federico, Cuerda, Cristina, Joly, Francisca, Kelly, Darlene, Staun, Michael, Szczepanek, Kinga, Van Gossum, Andre, and Schneider, Stephane Michel
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Adult ,0301 basic medicine ,medicine.medical_specialty ,Biopsy ,medicine.medical_treatment ,Autoimmune hepatitis ,Liver transplantation ,Critical Care and Intensive Care Medicine ,Chronic liver disease ,Gastroenterology ,03 medical and health sciences ,Liver disease ,Enteral Nutrition ,0302 clinical medicine ,Liver Function Tests ,Cholestasis ,Sepsis ,Internal medicine ,Nutrition and Dietetic ,medicine ,Humans ,Societies, Medical ,Hyperbilirubinemia ,030109 nutrition & dietetics ,Nutrition and Dietetics ,medicine.diagnostic_test ,business.industry ,Liver Diseases ,Intestinal failure associated liver disease (IFALD) ,Bilirubin ,Intestinal failure ,Parenteral nutrition ,medicine.disease ,Lipids ,Chronic intestinal failure ,Europe ,Intestinal Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Liver ,Liver biopsy ,Abnormal Liver Function Test ,030211 gastroenterology & hepatology ,Nutrition Therapy ,business - Abstract
Item does not contain fulltext We recommend that intestinal failure associated liver disease (IFALD) should be diagnosed by the presence of abnormal liver function tests and/or evidence of radiological and/or histological liver abnormalities occurring in an individual with IF, in the absence of another primary parenchymal liver pathology (e.g. viral or autoimmune hepatitis), other hepatotoxic factors (e.g. alcohol/medication) or biliary obstruction. The presence or absence of sepsis should be noted, along with the duration of PN administration. Abnormal liver histology is not mandatory for a diagnosis of IFALD and the decision to perform a liver biopsy should be made on a case-by-case basis, but should be particularly considered in those with a persistent abnormal conjugated bilirubin in the absence of intra or extra-hepatic cholestasis on radiological imaging and/or persistent or worsening hyperbilirubinaemia despite resolution of any underlying sepsis and/or any clinical or radiological features of chronic liver disease. Nutritional approaches aimed at minimising PN overfeeding and optimising oral/enteral nutrition should be instituted to prevent and/or manage IFALD. We further recommend that the lipid administered is limited to less than 1 g/kg/day, and the prescribed omega-6/omega-3 PUFA ratio is reduced wherever possible. For patients with any evidence of progressive hepatic fibrosis or overt liver failure, combined intestinal and liver transplantation should be considered.
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- 2018
117. Clinical classification of adult patients with chronic intestinal failure due to benign disease: An international multicenter cross-sectional survey
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Anna Zmarzly, Paolo Orlandoni, Laszlo Czako, Jian Wu, André Van Gossum, Gintautas Kekstas, Marina Taus, Ferenc Izbéki, Geert J. A. Wanten, Lynn Jones, Chrisoffer Brandt, Simona Di Caro, Alastair Forbes, Stéphane M. Schneider, A. Crivelli, Jon Shaffer, Francisca Joly, Ana Zugasti Murillo, Eszter Schafer, Gabriel Olveira, Sheldon C. Cooper, Lyn Gillanders, Henrik Erreboe Schou Rasmussen, Sarah Zeraschi, Peter Sahin, Jann Arends, Marta Bueno Díez, Brooke Chapman, Corrado Spaggiari, Cristina Cuerda, Sarah Jane Hughes, Miriam Theilla, Przemysław Matras, Denise Konrad, Nada Rotovnik Kozjek, Francesco William Guglielmi, Margie O'Callaghan, Charlene Compher, Maria Carmen Pagano, Alejandro Sanz-Paris, Cécile Chambrier, Andre Dong Won Lee, Emma Osland, Simon Lal, Valentino Bertasi, Joanne Daniels, Ronan Thibault, Carmen Garde, Lars Ellegård, Federica Agostini, Zeljko Krznaric, Aurora E. Serralde-Zúñiga, Konrad Matysiak, Umberto Aimasso, Loris Pironi, Florian Poullenot, Amelia Jukes, Marek Kunecki, Maryana Doitchinova-Simeonova, José P. Suárez-Llanos, Kinga Szczepanek, David Seguy, Mireille J. Serlie, Nicola Wyer, Estrella Petrina Jáuregui, Nuria Virgili, Darlene G. Kelly, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Endocrinology, Pironi, Lori, Konrad, Denise, Brandt, Chrisoffer, Joly, Francisca, Wanten, Geert, Agostini, Federica, Chambrier, Cecile, Aimasso, Umberto, Zeraschi, Sarah, Kelly, Darlene, Szczepanek, Kinga, Jukes, Amelia, Di Caro, Simona, Theilla, Miriam, Kunecki, Marek, Daniels, Joanne, Serlie, Mireille, Poullenot, Florian, Wu, Jian, Cooper, Sheldon C., Rasmussen, Henrik H., Compher, Charlene, Seguy, David, Crivelli, Adriana, Pagano, Maria C., Hughes, Sarah-Jane, Guglielmi, Francesco W., Kozjek, Nada Rotovnik, Schneider, Stéphane M., Gillanders, Lyn, Ellegard, Lar, Thibault, Ronan, Matras, Przemyså aw, Zmarzly, Anna, Matysiak, Konrad, Van Gossum, Andrã, Forbes, Alastair, Wyer, Nicola, Taus, Marina, Virgili, Nuria M., O'Callaghan, Margie, Chapman, Brooke, Osland, Emma, Cuerda, Cristina, Sahin, Peter, Jones, Lynn, Lee, Andre D.W., Bertasi, Valentino, Orlandoni, Paolo, Izbã©ki, Ferenc, Spaggiari, Corrado, Dãez, Marta Bueno, Doitchinova-Simeonova, Maryana, Garde, Carmen, Serralde-Zúñiga, Aurora E., Olveira, Gabriel, Krznaric, Zeljko, Czako, Laszlo, Kekstas, Gintauta, Sanz-Paris, Alejandro, Jã¡uregui, Estrella Petrina, Murillo, Ana Zugasti, Schafer, Eszter, Arends, Jann, Suárez-Llanos, José P., Shaffer, Jon, and Lal, Simon
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Male ,0301 basic medicine ,Cross-sectional study ,Critical Care and Intensive Care Medicine ,Chronic intestinal pseudo-obstruction ,0302 clinical medicine ,chronic intestinal pseudo-obstruction ,home parenteral nutrition ,intestinal failure ,intravenous supplementation ,short bowel syndrome ,Intestinal failure ,Nutrition and Dietetic ,Israel ,Aged, 80 and over ,Nutrition and Dietetics ,Benign disease ,Short bowel syndrome ,Middle Aged ,Chronic intestinal failure ,Europe ,Intestines ,Female ,030211 gastroenterology & hepatology ,Parenteral Nutrition, Home ,Adult ,medicine.medical_specialty ,Adolescent ,Energy requirement ,Young Adult ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,Internal medicine ,medicine ,Humans ,Intensive care medicine ,Aged ,Home parenteral nutrition ,030109 nutrition & dietetics ,Australasia ,Adult patients ,business.industry ,South America ,medicine.disease ,Intravenous supplementation ,United States ,Intestinal Diseases ,Cross-Sectional Studies ,Parenteral nutrition ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Chronic Disease ,business - Abstract
BACKGROUND & AIMS: The aim of the study was to evaluate the applicability of the ESPEN 16-category clinical classification of chronic intestinal failure, based on patients' intravenous supplementation (IVS) requirements for energy and fluids, and to evaluate factors associated with those requirements.METHODS: ESPEN members were invited to participate through ESPEN Council representatives. Participating centers enrolled adult patients requiring home parenteral nutrition for chronic intestinal failure on March 1st 2015. The following patient data were recorded though a structured database: sex, age, body weight and height, intestinal failure mechanism, underlying disease, IVS volume and energy need.RESULTS: Sixty-five centers from 22 countries enrolled 2919 patients with benign disease. One half of the patients were distributed in 3 categories of the ESPEN clinical classification. 9% of patients required only fluid and electrolyte supplementation. IVS requirement varied considerably according to the pathophysiological mechanism of intestinal failure. Notably, IVS volume requirement represented loss of intestinal function better than IVS energy requirement. A simplified 8 category classification of chronic intestinal failure was devised, based on two types of IVS (either fluid and electrolyte alone or parenteral nutrition admixture containing energy) and four categories of volume.CONCLUSIONS: Patients' IVS requirements varied widely, supporting the need for a tool to homogenize patient categorization. This study has devised a novel, simplified eight category IVS classification for chronic intestinal failure that will prove useful in both the clinical and research setting when applied together with the underlying pathophysiological mechanism of the patient's intestinal failure.
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- 2018
118. Five-year survival and causes of death in patients on home parenteral nutrition for severe chronic and benign intestinal failure
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Stanislaw Klek, Michael Staun, L. Chicharro, Lidia Santarpia, Cristina Cuerda, Francisca Joly, Olivier Corcos, Loris Pironi, Yi Lisa Hwa, Franco Contaldo, J. Baxter, Geert J. A. Wanten, Nuria Virgili, Darlene G. Kelly, Antonella De Francesco, Rosa Burgos, André Van Gossum, Cora Jonker, Federica Agostini, Joly, Francisca, Baxter, Janet, Staun, Michael, Kelly, Darlene G, Hwa, Yi Lisa, Corcos, Olivier, De Francesco, Antonella, Agostini, Federica, Klek, Stanislaw, Santarpia, Lidia, Contaldo, Franco, Jonker, Cora, Wanten, Geert, Chicharro, Luisa, Burgos, Rosa, Van Gossum, Andre, Cuerda, Cristina, Virgili, Nuria, Pironi, Loris, Kelly, Darlene G., and Other departments
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0301 basic medicine ,Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Intestinal failure ,Nutrition and Dietetic ,Medicine ,Humans ,In patient ,Cause of death ,Aged ,Retrospective Studies ,Home parenteral nutrition ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Short bowel syndrome ,Middle Aged ,Chronic intestinal failure ,Log-rank test ,Transplantation ,Intestinal Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Parenteral nutrition ,Cohort ,Chronic Disease ,030211 gastroenterology & hepatology ,Female ,business ,Parenteral Nutrition, Home - Abstract
Contains fulltext : 193361.pdf (Publisher’s version ) (Closed access) BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions and underlying disease are known predictors of HPN dependency and overall survival. Although the cause of death on HPN is mostly related to underlying disease in these patients, the relationship between mortality and duration of HPN use remains unclear. The purpose of the present study is to describe factors associated with survival and HPN dependency as well as causes of death in adult patients requiring HPN for chronic intestinal failure during the first 5 years of treatment with HPN. METHODS: A multicenter international (European and USA) questionnaire-based retrospective follow-up of a cohort of 472 IF patients who started HPN was conducted between June and December 2000. Study endpoint was either end of 5-year follow-up, weaned-off HPN, ITx, or death on HPN. Data were analyzed for HPN dependence and overall survival using Kaplan-Meier models and log rank tests. RESULTS: The overall survival probability was 88%, 74% and 64% at 1, 3 and 5 years respectively. Survival was inversely related to age (p < .001) and higher in patients with Crohn's disease or chronic idiopathic pseudo-obstruction. A total of 169 (36.5%) patients were weaned-off HPN mainly (80%) within the first year and most frequently in patients with fistulae. Five of the 14 patients who underwent ITx died. By the end of the study, 104 (23%) of patients died on HPN; 65% of deaths occurred within the first 2.5 years of HPN. CONCLUSIONS: Younger ages at HPN initiation and underlying pathologies are significantly predictive of survival on HPN. Risk of death is greatest during the first 2 years of HPN.
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- 2018
119. ESPEN guidelines on chronic intestinal failure in adults
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Cristina Cuerda, Lyn L. Gillanders, Loris Pironi, André Van Gossum, G. Wanten, Darlene D. Kelly, Kinga Szczepanek, Francisca Joly, Federico Bozzetti, Jann Arends, Palle Jeppesen, Michael Staun, Simon Lal, Stéphane M. Schneider, Pironi, Lori, Arends, Jann, Bozzetti, Federico, Cuerda, Cristina, Gillanders, Lyn, Jeppesen, Palle Bekker, Joly, Francisca, Kelly, Darlene, Lal, Simon, Staun, Michael, Szczepanek, Kinga, Van Gossum, André, Wanten, Geert, and Schneider, Stéphane Michel
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Short Bowel Syndrome ,0301 basic medicine ,Intestinal pseudo-obstruction ,medicine.medical_specialty ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,Guideline ,Critical Care and Intensive Care Medicine ,Teduglutide ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Nutrition and Dietetic ,medicine ,Animals ,Humans ,Disease management (health) ,Intensive care medicine ,Randomized Controlled Trials as Topic ,Home parenteral nutrition ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Animal ,business.industry ,Liver Disease ,Liver Diseases ,Intestinal Pseudo-Obstruction ,Disease Management ,Enteriti ,Intestinal failure ,Intestinal transplantation ,Short bowel syndrome ,medicine.disease ,Enteritis ,Chronic intestinal failure ,Transplantation ,Disease Models, Animal ,Parenteral nutrition ,chemistry ,Chronic Disease ,Practice Guidelines as Topic ,030211 gastroenterology & hepatology ,Parenteral Nutrition, Home ,business ,Human - Abstract
Contains fulltext : 165967.pdf (Publisher’s version ) (Closed access) BACKGROUND & AIMS: Chronic Intestinal Failure (CIF) is the long-lasting reduction of gut function, below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth. CIF is the rarest organ failure. Home parenteral nutrition (HPN) is the primary treatment for CIF. No guidelines (GLs) have been developed that address the global management of CIF. These GLs have been devised to generate comprehensive recommendations for safe and effective management of adult patients with CIF. METHODS: The GLs were developed by the Home Artificial Nutrition & Chronic Intestinal Failure Special Interest Group of ESPEN. The GRADE system was used for assigning strength of evidence. Recommendations were discussed, submitted to Delphi rounds, and accepted in an online survey of ESPEN members. RESULTS: The following topics were addressed: management of HPN; parenteral nutrition formulation; intestinal rehabilitation, medical therapies, and non-transplant surgery, for short bowel syndrome, chronic intestinal pseudo-obstruction, and radiation enteritis; intestinal transplantation; prevention/treatment of CVC-related infection, CVC-related occlusion/thrombosis; intestinal failure-associated liver disease, gallbladder sludge and stones, renal failure and metabolic bone disease. Literature search provided 623 full papers. Only 12% were controlled studies or meta-analyses. A total of 112 recommendations are given: grade of evidence, very low for 51%, low for 39%, moderate for 8%, and high for 2%; strength of recommendation: strong for 63%, weak for 37%. CONCLUSIONS: CIF management requires complex technologies, multidisciplinary and multiprofessional activity, and expertise to care for both the underlying gastrointestinal disease and to provide HPN support. The rarity of the condition impairs the development of RCTs. As a consequence, most of the recommendations have a low or very low grade of evidence. However, two-thirds of the recommendations are considered strong. Specialized management and organization underpin these recommendations.
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- 2016
120. Towards a multidisciplinary approach to understand and manage obesity and related diseases
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Carmen Gil, Tommy Cederholm, Laurence Genton, Nanette Stroebele-Benschop, Cristina Cuerda, Rocco Barazzoni, Yves Boirie, Nicolaas E. P. Deutz, Stephan C. Bischoff, Raanan Shamir, Arved Weimann, M. Leon-Sanz, Anders Thorell, Berthold Koletzko, Denis Fouque, Nathalie M. Delzenne, Joelle Singer, Michael Chourdakis, Pierre Singer, Department of Nutritional Medicine, University of Hohenheim, Unité de Nutrition Humaine (UNH), Institut National de la Recherche Agronomique (INRA)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université, Deptartment of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Medical Nutrition, School of Medicine, Aristotle University of Thessaloniki, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain = Catholic University of Louvain (UCL), Center for Translational Research in Aging and Longevity, Department Health and Kinesiology, Texas A&M University System, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical Nutrition, Geneva University Hospital (HUG), Department of Endocrinology and Nutrition, Hospital Central de la Defensa Gomez Ulla, University of Munich Medical Centre, Ludwig Maximilians University of Munich, Department of Medicine and Hospital Doce de Octubre, Endocrinology and Nutrition, Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University [Tel Aviv], Sackler School of Medicine, General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Department of Nutritional Medicine, Division of Applied Psychology, Department of Clinical Science, Danderyd Hospital and Department of Surgery, Ersta Hospital, Karolinska Institute, Department of General, Visceral and Oncological Surgery, Universität Leipzig [Leipzig], Department of Medical, Surgical and Health Sciences, Università degli studi di Trieste, ESPEN special interest group Obesity, Université Catholique de Louvain, Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Universidad Complutense de Madrid [Madrid] (UCM), Bischoff, Stephan C, Boirie, Yve, Cederholm, Tommy, Chourdakis, Michael, Cuerda, Cristina, Delzenne, Nathalie M, Deutz, Nicolaas E, Fouque, Deni, Genton, Laurence, Gil, Carmen, Koletzko, Berthold, Leon Sanz, Miguel, Shamir, Raanan, Singer, Joelle, Singer, Pierre, Stroebele Benschop, Nanette, Thorell, Ander, Weimann, Arved, Barazzoni, Rocco, Ludwig-Maximilians University [Munich] (LMU), Tel Aviv University (TAU), Danderyds sjukhus = Danderyd University Hospital, Universität Leipzig, Università degli studi di Trieste = University of Trieste, Clermont Université-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Recherche Agronomique (INRA), UCL - SSS/LDRI - Louvain Drug Research Institute, Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Institut National de la Recherche Agronomique (INRA), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Institut National de la Recherche Agronomique (INRA)
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Pediatric Obesity ,Sarcopenia ,obesity ,liver diseases ,Overweight ,Critical Care and Intensive Care Medicine ,Global Health ,Muscle Development ,weight control ,sarcopenic obesity ,Body Weight Maintenance ,0302 clinical medicine ,Weight loss ,Non-alcoholic Fatty Liver Disease ,030212 general & internal medicine ,Precision Medicine ,Fatty liver disease ,Metabolic syndrome ,Microbiota ,Multidisciplinary ,Sarcopenic obesity ,Weight maintenance ,Child ,Geriatrics ,ddc:616 ,Nutrition and Dietetics ,Evidence-Based Medicine ,syndrome métabolique ,contrôle ponderal ,metabolic x syndrome ,Middle Aged ,Prognosis ,Combined Modality Therapy ,3. Good health ,obésité ,nutrition ,medicine.symptom ,sedentariness ,Obesity paradox ,medicine.medical_specialty ,030209 endocrinology & metabolism ,Models, Biological ,metabolic syndrome ,03 medical and health sciences ,microbiote ,medicine ,microbiota ,Animals ,Humans ,Intensive care medicine ,Sedentary lifestyle ,Patient Care Team ,business.industry ,sédentarite ,medicine.disease ,Obesity ,approche multidisciplinaire ,weight maintenance ,Chronic Disease ,Physical therapy ,Dysbiosis ,fatty liver disease ,business ,maladie du foie ,[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition ,multidisciplinary - Abstract
Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens. Obesity is usually accompanied by an increased muscle mass. This might explain why obesity, under particular circumstances such as cancer or high age, might have protective effects, a phenomenon named the 'obesity paradox'. However, loss of muscle mass or function can also occur, which is associated with poor prognosis and termed 'sarcopenic obesity'. Therefore, treatment recommendations may need to be individualized and adapted to co-morbidities. Since obesity is a chronic systemic disease it requires a multidisciplinary approach, both at the level of prevention and therapy including weight loss and maintenance. In the present personal review and position paper, authors from different disciplines including endocrinology, gastroenterology, nephrology, pediatrics, surgery, geriatrics, intensive care medicine, psychology and psychiatry, sports medicine and rheumatology, both at the basic science and clinical level, present their view on the topic and underline the necessity to provide a multidisciplinary approach, to address this epidemic.
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- 2016
121. The NutriQoL ® questionnaire for assessing health-related quality of life (HRQoL) in patients with home enteral nutrition (HEN): validation and fi rst results
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Felipe F. Casanueva, Federico Cuesta, L. Carrillo, M. Layola, J. A. Irles, A. Apezetxea, Maria Nuria Virgili, Cristina Cuerda, Luis Lizán, [Apezetxea, Antonio] Org Sanitaria Integrada Bilbao Basurto, Bilbao, Spain, [Carrillo, Lourdes] Ctr Salud Victoria Acentejo, Santa Cruz De Tenerife, Spain, [Casanueva, Felipe] Univ Santiago de Compostela, CHUS, CIBER Fisiopatol Obesidad & Nutr CIBERobn, Inst Salud Carlos 3, La Coruna, Spain, [Cuerda, Cristina] Hosp Gen Univ Gregorio Maranon, Madrid, Spain, [Cuesta, Federico] Hosp Clin San Carlos, Madrid, Spain, [Antonio Irles, Jose] Hosp Univ Nuestra Senora Valme, Seville, Spain, [Nuria Virgili, Maria] Hosp Univ Bellvitge, Hosp Llobregat, Barcelona, Spain, [Layola, Miquel] Nestle Hlth Sci, Madrid, Spain, and [Lizan, Luis] Univ Jaume I Castellon, Dept Med, Castellon De La Plana, Spain
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0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,Health-related quality of life ,Population ,NutriQoL (R) ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,03 medical and health sciences ,Route of administration ,0302 clinical medicine ,Bolus (medicine) ,Cronbach's alpha ,medicine ,In patient ,education ,Home enteral nutrition ,Health related quality of life ,education.field_of_study ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Questionnaire ,business.industry ,Parenteral nutrition ,Observational study ,business - Abstract
Introduction: Health-related quality of life (HRQoL) provides a global view of the state of health of a patient receiving home enteral nutrition (HEN). Objective: To evaluate the HRQoL of patients receiving HEN using the NutriQoL® questionnaire, a specifi c instrument regardless of the underlying disease and route of administration.Materials and methods: Observational, prospective and multicentre study conducted in the context of the validation and assessment of the NutriQoL® questionnaire’s psychometric properties.Results: One-hundred-and-forty individuals [disease: cancer (58.6%), malabsorption and other (27.1%), neurological (13.6%); HEN: supplement (61.4%), sole source of nutrition (35.7%); administration route: oral (54.3%), ostomy (31.4%), nasoenteric tube (12.1%)] participated. NutriQoL® was reliable [ICC: 0.88 (95%CI: 0.80-0.93); Cronbach’s α: 0.77 (1st visit) and 0.83 (2nd visit)], valid (signifi cant Rho), lowly sensitive to changes (effect size 0.23), can be completed by either patients or caregivers (ICC: 0.82). The mean HRQoL (SD) with NutriQoL® was 14.98 (14.86), EQ-5D tariff: 53(0.25), EQ-5D VAS: 54.15 (20.64) and COOP/WONCA charts: 23.32(5.66). HRQoL with NutriQoL® was better (p < 0.05) for oral HEN [19.54 (13,23)], than nasoenteric tube [14(11.71)], ostomy [7.02 (15.48)]; administered orally [19.54 (13.23)], than by gravity [10.97 (14.46)], pump [8.5 (19.78)] or syringe bolus [7 (11.40)]; as a supplement [19.33 (13.73)] instead of sole source of nutrition [8.18 (14.23)].Conclusions: NutriQoL® is valid, reliable, even if lowly sensitive to change, and useful to measure HRQoL in this population. More studies are needed to know HRQoL in routine practice.
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- 2016
122. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults
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Stéphane M. Schneider, Stanislaw Klek, Loris Pironi, Michael Staun, Darlene G. Kelly, S. W. M. Olde Damink, Simon M. Gabe, Jon Shaffer, Francisca Joly, Alastair Forbes, J.P. Baxter, Lyn Gillanders, Geert J. A. Wanten, Federico Bozzetti, Palle Jeppesen, Marina Panisic, André Van Gossum, Jann Arends, Rosa Burgos Pelaez, Henrik Højgaard Rasmussen, Øivind Irtun, Cristina Cuerda, Kinga Szczepanek, Mette Holst, Pironi, Lori, Arends, Jann, Baxter, Janet, Bozzetti, Federico, Peláez, Rosa Burgo, Cuerda, Cristina, Forbes, Alastair, Gabe, Simon, Gillanders, Lyn, Holst, Mette, Jeppesen, Palle Bekker, Joly, Francisca, Kelly, Darlene, Klek, Stanislaw, Irtun, Øivind, Olde Damink, S.W., Panisic, Marina, Rasmussen, Henrik Højgaard, Staun, Michael, Szczepanek, Kinga, Van Gossum, André, Wanten, Geert, Schneider, Stéphane Michel, Shaffer, Jon, Surgery, and RS: NUTRIM - R2 - Gut-liver homeostasis
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Adult ,Societies, Scientific ,Parenteral Nutrition ,medicine.medical_specialty ,Soins intensifs réanimation ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,MEDLINE ,Enterocutaneous fistulas ,Clinical nutrition ,Critical Care and Intensive Care Medicine ,Chronic intestinal pseudo-obstruction ,Intestinal absorption ,Enterocutaneous fistula ,Intestinal failure ,Nutrition and Dietetic ,medicine ,Intensive care medicine ,Nutrition ,computer.programming_language ,Home parenteral nutrition ,Intestinal Disease ,Nutrition and Dietetics ,business.industry ,Medicine (all) ,Short bowel syndrome ,Guideline ,Special Interest Group ,Intestinal transplantation ,Chronic intestinal failure ,Europe ,Intestinal Absorption ,Acute Disease ,Chronic Disease ,business ,Diététique ,computer ,Delphi ,Human - Abstract
Background & aims: Intestinal failure (IF) is not included in the list of PubMed Mesh terms, as failure is the term describing a state of non functioning of other organs, and as such is not well recognized. No scientific society has yet devised a formal definition and classification of IF. The European Society for Clinical Nutrition and Metabolism guideline committee endorsed its "home artificial nutrition and chronic IF" and "acute IF" special interest groups to write recommendations on these issues. Methods: After a Medline Search, in December 2013, for "intestinal failure" and "review"[Publication Type], the project was developed using the Delphi round methodology. The final consensus was reached on March 2014, after 5 Delphi rounds and two live meetings. Results: The recommendations comprise the definition of IF, a functional and a pathophysiological classification for both acute and chronic IF and a clinical classification of chronic IF. IF was defined as "the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth". Conclusions: This formal definition and classification of IF, will facilitate communication and cooperation among professionals in clinical practice, organization and management, and research., SCOPUS: ar.j, info:eu-repo/semantics/published
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123. Guidance for assessment of the inflammation etiologic criterion for the GLIM diagnosis of malnutrition: A modified Delphi approach.
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Jensen GL, Cederholm T, Ballesteros-Pomar MD, Blaauw R, Correia MITD, Cuerda C, Evans DC, Fukushima R, Gautier JBO, Gonzalez MC, van Gossum A, Gramlich L, Hartono J, Heymsfield SB, Jager-Wittenaar H, Jayatissa R, Keller H, Malone A, Manzanares W, McMahon MM, Mendez Y, Mogensen KM, Mori N, Muscaritoli M, Nogales GC, Nyulasi I, Phillips W, Pirlich M, Pisprasert V, Rothenberg E, de van der Schueren M, Shi HP, Steiber A, Winkler MF, Compher C, and Barazzoni R
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- Humans, Consensus, Cost of Illness, Inflammation diagnosis, Weight Loss, Nutrition Assessment, Leadership, Malnutrition diagnosis, Malnutrition etiology
- Abstract
Background: The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation, and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation., Methods: A GLIM-constituted working group with 36 participants developed consensus-based guidance through a modified Delphi review. A multiround review and revision process served to develop seven guidance statements., Results: The final round of review was highly favorable, with 99% overall "agree" or "strongly agree" responses. The presence of acute or chronic disease, infection, or injury that is usually associated with inflammatory activity may be used to fulfill the GLIM disease burden/inflammation criterion, without the need for laboratory confirmation. However, we recommend that recognition of underlying medical conditions commonly associated with inflammation be supported by C-reactive protein (CRP) measurements when the contribution of inflammatory components is uncertain. Interpretation of CRP requires that consideration be given to the method, reference values, and units (milligrams per deciliter or milligram per liter) for the clinical laboratory that is being used., Conclusion: Confirmation of inflammation should be guided by clinical judgment based on underlying diagnosis or condition, clinical signs, or CRP., (© 2024 The Author(s). Published by Elsevier Limited on behalf of European Society for Clinical Nutrition and Metabolism and Elsevier Ltd and Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.)
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- 2024
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124. Analysis of clinical data associated with Essure® sterilization devices: An expanded case series.
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Sánchez-Cuerda C, Cuadra M, Cabrera Y, Duch S, Fabra S, Peay-Pinacho J, Álvarez P, Rubio J, Álvarez Bernardi J, and Lobo P
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- Pregnancy, Female, Humans, Hysteroscopy adverse effects, Hysteroscopy methods, Retrospective Studies, Pelvic Pain etiology, Pelvic Pain surgery, Sterilization, Sterilization, Tubal adverse effects
- Abstract
Objectives: To evaluate clinical data in women who underwent Essure® hysteroscopic sterilization and to determine whether this sterilization technique plays a role in developing new-onset symptoms., Study Design: An observational, retrospective, single-center study. It was conducted in a secondary level hospital. It included 804 women who had Essure® hysteroscopic sterilization from 2009 to 2017. Charts from these women were reviewed from June 2009 to November 2019, searching for the development of gynecological symptoms (pelvic pain and bleeding disorders) and non-gynecological symptoms (bloating, joint pain, fatigue, headache, alopecia, allergy and depression). The sample was divided into two groups depending on whether they had developed gynecological symptoms (symptomatic group) or not (asymptomatic group), and a descriptive and comparative analysis was made between them. The impact of the global social alarm in 2015 regarding adverse events attributed to the devices, the development of non-gynecological symptoms, and the treatments required, including conservative and surgical options, were also described., Results: Out of 804 women who had Essure® devices placed, 541(67.29%) remained asymptomatic, 263(32.71%) developed gynecological symptoms, and 41 of these (15.5% of the total sample) requested Essure® surgical removal. Pelvic pain was the most frequent symptom and the main reason for surgical removal. Bleeding alterations were the second most frequent symptom. Up to 55.89% described the symptoms after the social alarm. Non-gynecological symptoms were statistically significantly more frequent in the symptomatic group., Conclusions: More than a half of the women who underwent Essure® sterilization remained asymptomatic. The new-onset symptoms attributed to the devices are the minority and causality is difficult to establish., Implications Statement: Our research provides new follow-up data about Essure® hysteroscopic sterilization. Association between gynecological symptoms and Essure® devices is difficult to demonstrate and some confounding factors may be implicated. The results we described, may guide and counsel medical-patient decisions for the treatment of symptoms related to the devices, including surgical removal., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)
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- 2022
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125. Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey.
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Pironi L, Steiger E, Brandt C, Joly F, Wanten G, Chambrier C, Aimasso U, Sasdelli AS, Zeraschi S, Kelly D, Szczepanek K, Jukes A, Di Caro S, Theilla M, Kunecki M, Daniels J, Serlie M, Poullenot F, Wu J, Cooper SC, Rasmussen HH, Compher C, Seguy D, Crivelli A, Pagano MC, Hughes SJ, Guglielmi FW, Kozjek NR, Schneider SM, Gillanders L, Ellegard L, Thibault R, Matras P, Zmarzly A, Matysiak K, Van Gossum A, Forbes A, Wyer N, Taus M, Virgili NM, O'Callaghan M, Chapman B, Osland E, Cuerda C, Sahin P, Jones L, Won Lee AD, Masconale L, Orlandoni P, Izbéki F, Spaggiari C, Bueno M, Doitchinova-Simeonova M, Garde C, Serralde-Zúñiga AE, Olveira G, Krznaric Z, Czako L, Kekstas G, Sanz-Paris A, Jáuregui EP, Murillo AZ, Schafer E, Arends J, Suárez-Llanos JP, and Lal S
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- Chronic Disease, Cross-Sectional Studies, Female, Health Surveys statistics & numerical data, Humans, Male, Middle Aged, Treatment Outcome, Health Surveys methods, Internationality, Intestinal Diseases diet therapy, Intestinal Diseases epidemiology, Parenteral Nutrition, Home methods, Parenteral Nutrition, Home statistics & numerical data
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Background & Aims: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF)., Methods: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions., Results: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001)., Conclusions: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care., (Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)
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- 2020
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126. Spanish home enteral nutrition registry of the year 2014 and 2015 from the NADYA-SENPE Group
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Wanden-Berghe C, Luengo LM, Álvarez J, Burgos R, Cuerda C, Matía P, Gómez Candela C, Martínez Olmos MÁ, Gonzalo M, Calleja A, Campos C, Pérez de la Cruz A, Irles JA, Leyes P, Sánchez R, De Luis Román D, Cardona D, Santacruz N, Suárez JP, Ballesta C, Salas J, Penacho MÁ, Gardez C, Martínez MJ, Cánovas B, Moreno JM, Del Olmo D, Carabaña F, Virgili N, Higuera I, Mauri S, Sánchez-Vilar O, Miserachs N, Ponce MÁ, García Y, Morán JM, Apezetxea A, Tejera C, Calañas A, Cantón A, Díaz P, and Nadya-Senpe G
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- Adolescent, Age Factors, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Intubation, Gastrointestinal statistics & numerical data, Male, Middle Aged, Spain, Young Adult, Parenteral Nutrition, Home statistics & numerical data, Registries
- Abstract
Objective: To present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the years 2014 and 2015. Methods: From January 1st 2014 to December 31st 2015 the HEN registry was recorded and afterwards a further descriptive and analytical analysis was done. Results: In 2014, 3749 patients were recorded, and 4202 in 2015; prevalence was 80.58 patients/one million inhabitants in Spain in 2014 and 90.51 in 2015. There were 49.9% females in 2014 and 50.3% in 2015. Median age was 73 years (IQI 59-83) in 2014 as well as in 2015. 684 episodes finished in 2014 and 631 in 2015, with death as the main cause, in 54.9% and 50.4%, respectively. The ones who were fed through nasogastric tube had a mean age higher than the ones fed by any other route (p-value < 0.001). Sisty-seven paediatric patients were recorded in 2014 (56.7% females) and 77 in 2015 (55.8% females). Median age at the beginning of HEN among children was 5 months in 2014 and 5 months in 2015. The main route of administration was gastrostomy, in 52.5% in 2014 and nasogastric tube in 50.8% in 2015. 7 episodes finished in 2014 and 13 in 2015, having death as the main cause (57.1% in 2014 and 38.5% in 2015). It was found that were younger children the ones who were mainly fed by nasogastric tubes (p-value 0.004 vs. 0.002). Among paediatric patients as well as adults, the main diagnosis leading to HEN was neurological disease which gives aphagia or severe dysphagia. Conclusions: There has been an increase in the number of patients in the registry as well as the participating centers and the number of patients per center, without any significant change in the characteristics of the patients other than longer duration of the episodes.
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- 2017
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127. Rasch analysis in the development of the NutriQoL® questionnaire, a specific health-related quality of life instrument for home enteral nutrition.
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Apezetxea A, Carrillo L, Casanueva F, de la Cuerda C, Cuesta F, Irles JA, Virgili MN, Layola M, and Lizán L
- Abstract
Background: Home enteral nutrition (HEN) is a therapeutic method used in patients who are unable to ingest the required amounts of nutrients but retain a functional gastrointestinal tract. The objective of this study was to compose a specific questionnaire for measuring health-related quality of life (HRQoL) in HEN patients irrespective of their underlying condition and HEN route of administration., Methods: Literature review, focus groups and semi-structured interviews were used to propose an initial version of the questionnaire which was answered by 165 participants. The responses were analyzed using the Rasch methodology. Firstly, the appropriateness of response options was assessed. Then, the differential item functioning (DIF) was evaluated. Finally, the item fit statistics, infit and outfit, were determined., Results: Rasch analysis was performed on the responses given to the 43 items included in the initial questionnaire. Four items were excluded because more than 50% of respondents answered that the situation proposed did not apply to them. Seven items that showed overlapping and disordered categories were also removed. Pairwise DIF analysis were performed in subgroups defined by underlying disease and administration route. Eleven items presented DIF and were eliminated from the questionnaire. Finally, four items were deleted after analyzing the fit statistics, three of which did not fit the Rasch model and one did not belong to either of the dimensions. The final version of NutriQoL® includes 17 items., Conclusions: NutriQoL® is a useful instrument to assess the HRQoL of HEN patients with any disease and any administration route., Competing Interests: Not applicableNestlé Health Science sponsored the study. The authors Cuerda C, Apezetxea A, Carrillo L, Casanueva F, Cuesta F, Irles JA and Virgilli N, state they have no conflict of interest. Layola M works at Nestlé Health Science. Lizan L works for an independent research organization (Outcomes’10, S.L.) which has received fees for its contribution to the development and coordination of the original research project and to the writing of this manuscript.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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- 2017
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128. [In Process Citation].
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Cuerda C, Álvarez J, Ramos P, Abánades JC, García-de-Lorenzo A, Gil P, and De-la-Cruz JJ
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- Age Factors, Aged, Aged, 80 and over, Disease, Female, Humans, Male, Malnutrition etiology, Prevalence, Sex Factors, Socioeconomic Factors, Spain epidemiology, Malnutrition epidemiology
- Abstract
Introducción: la desnutrición relacionada con la enfermedad (DRE) es un problema sociosanitario frecuente que afecta preferentemente a los mayores de 65 años, que aumenta la morbimortalidad y disminuye la calidad de vida. Objetivo: estudiar la prevalencia de DRE en mayores de 65 años en diferentes centros sociosanitarios del Servicio Regional de Bienestar Social de la Comunidad de Madrid. Métodos: estudio transversal en 33 centros sociosanitarios de Madrid (6 centros de atención primaria [AP], 9 centros de mayores [CM], 9 hospitales [H] y 9 residencias [R]) seleccionados mediante muestreo polietápico. Las variables estudiadas fueron edad, sexo, nivel de dependencia según la escala de incapacidad de la Cruz Roja, motivo de ingreso y enfermedad de base, hábitat (urbano-periurbano-rural) y distribución geográfica (norte centro-sur). Como herramienta de cribado nutricional se utilizó el Mini Nutritional Assessment (MNA-cribaje) en todos los centros. En los pacientes con cribado positivo (en riesgo-desnutrición) se realizó el MNA-evaluación. El estudio estadístico se realizó con el paquete SSS 21.0 e incluyó estadística descriptiva, test de Chi-cuadrado y prueba exacta de Fisher, ANOVA de un factor, Kruskal-Wallis y análisis de regresión logística (RL) binaria univariante y multivariante. Se consideró significación estadística p < 0,05. Resultados: se reclutaron 1.103 sujetos (275 AP, 278 CM, 281 H, 269 R), edad media de 79,5 ± 8,4 años (41,2% varones, 58,8% mujeres). Los sujetos procedentes de H y R tuvieron un mayor grado de incapacidad (p < 0,001). La prevalencia global de DRE fue del 10%, encontrándose un 23,3% en riesgo de desnutrición, con diferencias entre los cuatro tipos de centros sociosanitarios (p < 0,001). El análisis univariante de RL mostró diferencia significativas en la prevalencia de desnutrición según la edad, sexo, grado de dependencia, tipo de centro sociosanitario, hábitat y zona geográfica. Sin embargo, en el análisis multivariante solo el grado de dependencia, el tipo de centro y el hábitat tuvieron significación estadística. Conclusiones: la prevalencia de DRE en mayores de 65 años en la Comunidad de Madrid es del 10%, encontrándose además un 23,3% en riesgo de desnutrición. Las únicas variables que se relacionaron de forma independiente con la desnutrición en el análisis multivariante fueron el nivel de dependencia de los pacientes y el tipo y hábitat de centro sociosanitario.
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- 2016
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129. Outcome Indicators for Home Parenteral Nutrition Care: Point of View From Adult Patients With Benign Disease.
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Dreesen M, Pironi L, Wanten G, Szczepanek K, Foulon V, Willems L, Gillanders L, Joly F, Cuerda C, and Van Gossum A
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- Adolescent, Adult, Aged, Aged, 80 and over, Catheter-Related Infections etiology, Cross-Sectional Studies, Female, Humans, Incidence, Male, Middle Aged, Patient-Centered Care methods, Quality of Life, Surveys and Questionnaires, Treatment Outcome, Young Adult, Catheter-Related Infections epidemiology, Parenteral Nutrition, Home adverse effects
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Background and Aims: Patients receiving home parenteral nutrition (HPN) deserve a high-quality and patient-centered care. Patient-centered care can be delivered only if the patient's priorities and concerns are known. Therefore, the aim is to identify the top 3 most important outcome indicators according to patients' perspectives and the differences between several centers, HPN regimen, and HPN experience., Methods: A questionnaire, based on previously developed outcome indicators, was translated into the mother tongue using forward-backward translation and distributed to adult HPN patients with benign disease in March 2013. To identify differences, a Kruskal-Wallis or Mann-Whitney test was performed with GraphPad Prism (significance level <.05) when applicable., Results: Nine centers over 8 countries (300 patients) participated. The top 3 outcome indicators for patients were (1) incidence of catheter-related infection (CRI), (2) survival, and (3) quality of life (QoL). Between the participating centers, significant differences on rating were found for 5 outcome indicators (catheter obstruction, .015; weight, .002; energy, .010; fear, <.001; and independence, .010). The independence outcome indicator (.050) was considered less important for experienced (>2 years HPN) vs less experienced patients. For this outcome indicator, patients' view also differed significantly based on number of HPN days per week (.0103)., Conclusion: A cohort of HPN patients identified incidence of CRI, survival, and QoL as the most important outcome indicators for their care; however, there were significant differences between the participating centers. For one outcome indicator (independence), there were significant differences based on experience and regimen., (© 2014 American Society for Parenteral and Enteral Nutrition.)
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- 2015
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130. Outcomes of a general hospital-based home parenteral nutrition (HPN) program; report of our experience from a 26-year period.
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Higuera I, Garcia-Peris P, Camblor M, Bretón I, Velasco C, Romero R, Frias L, and Cuerda C
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- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Hospitals, General, Humans, Infant, Longitudinal Studies, Male, Middle Aged, Program Evaluation, Retrospective Studies, Time Factors, Treatment Outcome, Young Adult, Parenteral Nutrition, Home
- Abstract
Background: Home parenteral nutrition (HPN) was introduced in Spain in the late 1980s. Our hospital was a pioneering medical centre in this field., Aim: Analyze outcomes of our HPN program., Methods: Retrospective study of patients receiving HPN between 1986-2012. Study variables are expressed as frequency, mean ± SD (range), median [interquartile range]. Parametrics, non-parametrics test and survival analysis (p < 0.05) were applied., Results: 91 patients (55 females and 36 males, mean age: 50.6 ± 5 yrs.) who received HPN for an accrual period of 55,470 days (median: 211 days [range: 63-573]) were included. The most prevalent underlying condition was cancer (49.5%), with the commonest HPN indication being short bowel syndrome (41.1%). The most frequently used catheter type was the tunneled catheter (70.7%). The complication rate was 3.58/1,000 HPN days (2.68, infection; 0.07, occlusion; 0.07 thrombosis; and 0.59, metabolic complications). Complications were consistently associated with both the underlying condition and HPN length. Infections were most frequent within the first 1,000 days of HPN. Liver disease incidence was related to HPN duration. HPN could be discontinued in 42.3% of patients. Ten-year survival rate was 42%, and varied across the underlying conditions., Conclusions: In the present series, the commonest reason for HPN was cancer. Our complication rate is in keeping with that reported in the literature. The overall survival rate was 42%, and varied across the underlying conditions., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)
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- 2014
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131. [Not Available].
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Cuerda C
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- Adult, Humans, Patient Discharge, Enteral Nutrition methods
- Published
- 2014
132. [Not Available].
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Frías L and Cuerda C
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- Algorithms, Decision Trees, Equipment Design, Humans, Intubation, Gastrointestinal instrumentation, Intubation, Gastrointestinal methods, Enteral Nutrition instrumentation, Enteral Nutrition methods
- Published
- 2014
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