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est un bulletin de Journal of the academy of nutrition and dietetics / Academy of nutrition and dietetics
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Mention de date : 2018
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Dépouillements


Comparison of Nutritional and Clinical Outcomes in Patients with Head and Neck Cancer Undergoing Chemoradiotherapy Utilizing Prophylactic versus Reactive Nutrition Support Approaches / Teresa Brown in Journal of the academy of nutrition and dietetics, Vol. 118, n° 4 (2018)
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Titre : Comparison of Nutritional and Clinical Outcomes in Patients with Head and Neck Cancer Undergoing Chemoradiotherapy Utilizing Prophylactic versus Reactive Nutrition Support Approaches Type de document : Article Auteurs : Teresa Brown ; Merrilyn Banks ; Brett Hughes ; [et al.] Année de publication : 2018 Article en page(s) : 627-636 Langues : Anglais (eng) Descripteurs : HE Vinci
Gastrostomie ; Nutrition ; Nutrition entérale ; Protocole ; Tumeurs de la tête et du couRésumé : Abstract
Background
The optimal method of tube feeding for patients with head and neck cancer remains unclear. A validated protocol is available that identifies high-nutritional-risk patients who would benefit from prophylactic gastrostomy tube placement. Adherence to this protocol is ultimately determined by clinical team discretion or patient decision.
Objective
The study aim was to compare outcomes after adherence and nonadherence to this validated protocol, thus comparing a prophylactic and reactive approach to nutrition support in this patient population.
Design
We conducted a prospective comparative cohort study. Patients were observed during routine clinical practice over 2 years.
Participants/setting
Patients with head and neck cancer having curative-intent treatment between August 2012 and July 2014 at a tertiary hospital in Queensland, Australia, were included if assessed as high nutrition risk according to the validated protocol (n=130). Patients were grouped according to protocol adherence as to whether they received prophylactic gastrostomy (PEG) per protocol recommendation (prophylactic PEG group, n=69) or not (no PEG group, n=61).
Main outcome measures
Primary outcome was percentage weight change during treatment. Secondary outcomes were feeding tube use and hospital admissions.
Statistical analysis performed
Fishers exact, χ2, and two sample t tests were performed to determine differences between the groups. Linear and logistic regression were used to examine weight loss and unplanned admissions, respectively.
Results
Patients were 88% male, median age was 59 years, with predominantly stage IV oropharyngeal cancer receiving definitive chemoradiotherapy. Statistically significantly less weight loss in the prophylactic PEG group (7.0% vs 9.0%; P=0.048) and more unplanned admissions in the no PEG group (82% vs 75%; P=0.029). In the no PEG group, 26 patients (43%) required a feeding tube or had ≥10% weight loss.
Conclusions
Prophylactic gastrostomy improved nutrition outcomes and reduced unplanned hospital admissions. Additional investigation of characteristics of patients with minimal weight loss or feeding tube use could help refine and improve the protocol.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=87490
in Journal of the academy of nutrition and dietetics > Vol. 118, n° 4 (2018) . - 627-636[article]A Nutritional Perspective of Ketogenic Diet in Cancer: A Narrative Review / Camila Olivera in Journal of the academy of nutrition and dietetics, Vol. 118, n° 4 (2018)
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Titre : A Nutritional Perspective of Ketogenic Diet in Cancer: A Narrative Review Type de document : Article Auteurs : Camila Olivera ; Stéphanie Mattingly ; Ralph Schirrmacher ; [et al.] Année de publication : 2018 Article en page(s) : 68-88 Langues : Anglais (eng) Descripteurs : HE Vinci
Diétothérapie ; Nutrition ; Régime cétogène ; TumeursRésumé : 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. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=87491
in Journal of the academy of nutrition and dietetics > Vol. 118, n° 4 (2018) . - 68-88[article]Position of the Academy of Nutrition and Dietetics: Individualized Nutrition Approaches for Older Adults: Long-Term Care, Post-Acute Care, and Other Settings / B. Dorner in Journal of the academy of nutrition and dietetics, Vol. 118, n° 4 (2018)
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Titre : Position of the Academy of Nutrition and Dietetics: Individualized Nutrition Approaches for Older Adults: Long-Term Care, Post-Acute Care, and Other Settings Type de document : Article Auteurs : B. Dorner ; Elizabeth Friedrich Année de publication : 2018 Article en page(s) : 724-735 Langues : Anglais (eng) Descripteurs : HE Vinci
Maisons de repos ; Médecine individualisée ; Nutrition ; Régime alimentaire ; Sujet âgéRésumé : It is the position of the Academy of Nutrition and Dietetics that the quality of life and nutritional status of older adults in long-term care, post-acute care, and other settings can be enhanced by individualized nutrition approaches. The Academy advocates that as part of the interprofessional team, registered dietitian nutritionists assess, evaluate, and recommend appropriate nutrition interventions according to each individuals medical condition, desires, and rights to make health care choices. Nutrition and dietetic technicians, registered assist registered dietitian nutritionists in the implementation of individualized nutrition care, including the use of least restrictive diets. Health care practitioners must assess risks vs benefits of therapeutic diets, especially for frail older adults. Food is an essential component of quality of life; an unpalatable or unacceptable diet can lead to poor food and fluid intake, resulting in malnutrition and related negative health effects. Including older individuals in decisions about food can increase the desire to eat and improve quality of life. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=87492
in Journal of the academy of nutrition and dietetics > Vol. 118, n° 4 (2018) . - 724-735[article]Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Oncology Nutrition / Paula Charuhas Macris in Journal of the academy of nutrition and dietetics, Vol. 118, n° 4 (2018)
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Titre : Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Oncology Nutrition Type de document : Article Auteurs : Paula Charuhas Macris ; Karen Schilling ; Raymond Palko Année de publication : 2018 Article en page(s) : 736-748 Langues : Anglais (eng) Descripteurs : HE Vinci
Compétence professionnelle ; Diététicien ; Nutrition ; Oncologie chirurgicale ; PerformanceRésumé : Oncology nutrition encompasses nutrition care for individuals along the cancer care continuum. Nutrition is a vital component of prevention, treatment, and healthy survivorship. The practice of an oncology registered dietitian nutritionist (RDN) reflects the setting and population served with diverse cancer diagnoses, including expanded roles and responsibilities reflecting the RDNs interests and organizations activities. Provision of nutrition services in oncology requires that RDNs have advanced knowledge in the focus area of oncology nutrition. Thus, the Oncology Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as tools for RDNs currently in practice or interested in working in oncology nutrition, to address their current skill level and to identify areas for additional professional development in this practice area. The Standards of Practice address and apply the Nutrition Care Process and workflow elements, which are screening, assessment, diagnosis, intervention, evaluation/monitoring, and discharge planning and transitions of care. The Standards of Professional Performance consist of the following six domains of professionalism including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements and describe three skill levels (competent, proficient, and expert) for RDNs working in oncology nutrition. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=87493
in Journal of the academy of nutrition and dietetics > Vol. 118, n° 4 (2018) . - 736-748[article]