Développement et validation d’une échelle de qualité de vie axée sur l’alimentation pour la population française

Dietary modifications are hard to achieve and maintain over time. They may affect the subject's quality of life. Very few scales have been developed and validated in French to measure the quality of life of healthy subjects. None of them are designed to specifically analyze quality of life as it relates to diet. Within the framework of the ELPAS study, an original scale (QV-AF) was developed to measure the effects of dietary coaching on food-related quality of life in healthy subjects. This scale underwent linguistic and psychometric validation. It may be freely used; scoring parameters are available upon request.     

两种肠内营养方式在重型颅脑损伤中的应用

[目的]探讨重型颅脑损伤患者早期肠内营养方式的可行性和临床效果。[方法]120例重型颅脑损伤患者按病人的住院号分为A、B两个观察组,每组各60例,A组应用容量泵间歇性输注肠内营养,B组用容量泵24h持续均匀输注肠内营养。对照两组营养状况指标(血红蛋白、总蛋白、血清白蛋白、氮平衡、血淋巴细胞值、TSF、AMC、血糖等)以及呕吐返流、腹泻腹胀、胃肠道出血、肝功损害及电解质紊乱等并发症发生率。[结果]营养指标观察显示两组营养效果接近,两组临床检查数据比较氮平衡、血红蛋白、白蛋白、电解质、淋巴细胞总数、TSF、AMC值,差异无统计学意义(P﹥0.05)。但血糖血糖控制、并发症比较,差异有统计学意义(P﹤0.05);两组呕吐返流发生率、肝功能异常对比,差异无统计学意义(P﹥0.05);A组胃潴留、腹泻、反复消化道出血、二重感染的发生率低于B组,差异有统计学意义(P﹤0.05)。[结论]间歇输注与连续输注营养效果接近,间歇输注比连续输注有更多活动时间,类似于正常膳食的间隔,其胃潴留、腹泻、反复消化道出血、二重感染等并发症的发生率较低。     

全髋关节结核综合治疗远期疗效分析

本文对33例全髋关节结核综合治疗的远期疗效进行了分析,从而提出了治疗髋关节结核的三个重要环节。并对晚期髋关节结核功能重建的手术方法的选择和术后患肢制动方法的改进及注意事项进行讨论。     

A real-world research about nasogastric feeding and total parenteral nutrition in moderate severe acute pancreatitis

Previous studies have suggested that enteral nasogastric nutrition is more effective and safer for patients with moderate-severe acute pancreatitis (MSAP). The aim of this study was to compare the efficacy and safety of nasogastric feeding (NGF) with total parenteral nutrition (TPN) in patients diagnosed with MSAP. Patients were divided into two groups according to the type of feeding they received (117 in the NGF group and 70 in the TPN group), after which the ratio of transferred to severe acute pancreatitis (SAP), ICU admission rate, mortality, feeding associated complications (diarrhea, abdominal distension, abdominal pain), extra-pancreatic infection, hospitalization time were compared. No difference in the ratio of transferred to SAP and the ICU admission rate was found between groups (2.7% vs. 2.6% and 2.7% vs. 2.6%, respectively). No patient died in any of the two groups. The feeding associated complications (diarrhea, abdominal distension, abdominal pain) were seen more often in the NGF group than in the TPN group, yet no significantly statistical difference was observed. Moreover, the NGF group had significantly shorter hospitalization time (8.9 d vs. 10.9 d, P = 0.032) and a lower rate of extrapancreatic infection compared to the TPN group (2.7% vs. 3.9%; P = 0.025). To sum up, NGF seems to be safer and more effective than TPN when treating patients with MSAP.     

Mécanismes moléculaires de l’altération du métabolisme cellulaire par les polluants de la chaîne alimentaire

The food can present risks if they contain a toxic molecule whose presence is either natural, or related to the human activity. Among the various toxic molecule detected in the food we found: PCB and dioxins, phthalates, organochlorine pesticides. All these molecules have the characteristic to be bioaccumulable. The dioxins act via the Ah receptor and their principal effects on the population are: attacks of the functions of reproduction, increase in cancers, chloracne, diabetes, cardiovascular diseases. The phthalates found in milk, cheese, fish, meats, activate PPARα receptor. They decrease the male fertility in animals and human and increase the animal carcinogenesis. The organochlorine pesticides are endocrine-disrupting chemicals acting through ER receptor. They lead to a reduction in the animal and human fertility and probably to an increase in breast cancer risk.     

Régime pauvre en FODMAPS,ce que doivent savoir les nutritionnistes

FODMAPs is an acronym for Fermentable Oligo-, Di-, Mono-saccharides And Polyols, and refers to rapidly fermentable carbohydrates that may be malabsorbed and induce digestive disorders such as abdominal pain, bloating, flatulence and transit disorders. Numerous studies have tested the effect of reducing foods rich in FODMAPs in patients with irritable bowel syndrome, a benign chronic gastrointestinal disease associating abdominal pain and transit disorders (diarrhea, constipation or alternating), and are in favor of a beneficial effect of this diet. The effectiveness of the low FODMAPS diet is unpredictable. This very restrictive diet is difficult to follow, can lead to weight loss, and has been associated with dysbiosis. It is therefore not recommended to follow it in the long-term. It may be offered as a second-line treatment if standard dietary recommendations fail in patients sufficiently embarrassed by their symptoms to accept its constraints. It is preferably carried out with the supervision of a dietician trained on this diet because of its complexity and the risk of long-term dietary restrictions. It is usually tested for a period of 4 weeks, followed in case of symptoms improvement by a period of gradual reintroduction of FODMAPS that allows the patient to determine the FODMAPs that cause symptoms regardless of the amount, and those tolerated but at smaller dose than those usually ingested. The patients can thus resume a varied diet with a clear decrease of their symptoms.