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Long‐term safety of adalimumab in clinical trials in adult patients with Crohn's disease or ulcerative colitis 下载免费PDF全文
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Sofosbuvir and velpatasvir with or without voxilaprevir in direct‐acting antiviral‐naïve chronic hepatitis C: patient‐reported outcomes from POLARIS 2 and 3 下载免费PDF全文
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Cost‐Effectiveness Analysis of Sacubitril/Valsartan for the Treatment of Heart Failure with Reduced Ejection Fraction in the United States 下载免费PDF全文
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Camila L.P. Oliveira Stephanie Mattingly Ralf Schirrmacher Michael B. Sawyer Eugene J. Fine Carla M. Prado 《Journal of the Academy of Nutrition and Dietetics》2018,118(4):668-688
The predominant use of glucose anaerobically by cancer cells (Warburg effect) may be the most important characteristic the majority of these cells have in common and, therefore, a potential metabolic pathway to be targeted during cancer treatment. Because this effect relates to fuel oxidation, dietary manipulation has been hypothesized as an important strategy during cancer treatment. As such, the concept of a ketogenic diet (KD) in cancer emerged as a metabolic therapy (ie, targeting cancer cell metabolism) rather than a dietary approach. The therapeutic mechanisms of action of this high-fat, moderate-to-low protein, and very-low-carbohydrate diet may potentially influence cancer treatment and prognosis. Considering the lack of a dietetics-focused narrative review on this topic, we compiled the evidence related to the use of this diet in humans with diverse cancer types and stages, also focusing on the nutrition and health perspective. The use of KD in cancer shows potentially promising, but inconsistent, results. The limited number of studies and differences in study design and characteristics contribute to overall poor quality evidence, limiting the ability to draw evidence-based conclusions. However, the potential positive influences a KD may have on cancer treatment justify the need for well-designed clinical trials to better elucidate the mechanisms by which this dietary approach affects nutritional status, cancer prognosis, and overall health. The role of registered dietitian nutritionists is demonstrated to be crucial in planning and implementing KD protocols in oncology research settings, while also ensuring patients’ adherence and optimal nutritional status. 相似文献
99.
Conrad M. Tobert Sarah L. Mott Kenneth G. Nepple 《Journal of the Academy of Nutrition and Dietetics》2018,118(1):125-131
Background
Malnutrition is a significant problem for hospitalized patients. However, the true prevalence of reported malnutrition diagnosis in real-world clinical practice is largely unknown. Using a large collaborative multi-institutional database, the rate of malnutrition diagnosis was assessed and used to assess institutional variables associated with higher rates of malnutrition diagnosis.Objective
The aim of this study was to define the prevalence of malnutrition diagnosis reported among inpatient hospitalizations.Design
The University Health System Consortium (Vizient) database was retrospectively reviewed for reported rates of malnutrition diagnosis.Participants/setting
All adult inpatient hospitalization at 105 member institutions during fiscal years 2014 and 2015 were evaluated.Main outcome measures
Malnutrition diagnosis based on the presence of an International Classification of Diseases-Ninth Revision diagnosis code.Statistical analysis
Hospital volume and publicly available hospital rankings and patient satisfaction scores were obtained. Multiple regression analysis was performed to assess the association between these variables and reported rates of malnutrition.Results
A total of 5,896,792 hospitalizations were identified from 105 institutions during the 2-year period. It was found that 292,754 patients (5.0%) had a malnutrition diagnosis during their hospital stay. By institution, median rate of malnutrition diagnosis during hospitalization was 4.0%, whereas the rate of severe malnutrition diagnosis was 0.9%. There was a statistically significant increase in malnutrition diagnosis from 4.0% to 4.9% between 2014 and 2015 (P<0.01). Institutional factors associated with increased diagnosis of malnutrition were higher hospital volume, hospital ranking, and patient satisfaction scores (P<0.01).Conclusions
Missing a malnutrition diagnosis appears to be a universal issue because the rate of malnutrition diagnosis was consistently low across academic medical centers. Institutional variables were associated with the prevalence of malnutrition diagnosis, which suggests that institutional culture influences malnutrition diagnosis. Quality improvement efforts aimed at improved structure and process appear to be needed to improve the identification of malnutrition. 相似文献100.