Kalliopi-Anna Poulia

Omega-3 Fatty Acids Supplementation Does Not Affect Serum Lipids in Chronic Hemodialysis Patients

OBJECTIVE The aim of this study was to test the hypothesis that omega-3 fatty acids have an effect on serum lipids and inflammation markers in chronic hemodialysis (HD) patients. DESIGN The study followed a single-blind, randomized, crossover design. SETTING The study was conducted at the Hemodialysis Unit of the Laikon General Hospital in Athens, Greece. PATIENTS A total of 25 chronic HD patients were included in the study (16 men, 9 women, age: 51 ± 15 years). INTERVENTION Patients were randomly assigned to one of the following 2 intervention groups: omega-3 fatty acids plus α-tocopherol (920 mg eicosapentaenoic Acid (EPA), 760 mg docosahexaenoic acid (DHA), 8 mg α-tocopherol in total per day) or α-tocopherol supplement (100 mg/week resulting in 14.2 mg/day) alone for 4 weeks. After a washout period of 4 weeks, the 2 groups were crossed. MAIN OUTCOME MEASURES Medical history data were collected and anthropometric and nutritional intake evaluation was performed at the beginning and at the end of both interventions. Hematological and biochemical parameters as well as C-reactive protein levels were measured. RESULTS No statistically significant results were recorded in the lipidemic profiles of the participants between baseline and the 2 interventions. C-reactive protein levels also did not change significantly between the 2 interventions (5.54 ± 3.33 to 6.70 ± 5.01 mg/L [P = .19] with vitamin E vs. 7.13 ± 5.04 to 6.87 ± 5.24 [P = .78] with omega-3, P overall = .53). CONCLUSION The results of this study do not provide support for the positive effects of omega-3 fatty acid supplementation in HD patients.

ESPEN guideline clinical nutrition in neurology

Neurological diseases are frequently associated with swallowing disorders and malnutrition. Moreover, patients with neurological diseases are at increased risk of micronutrient deficiency and dehydration. On the other hand, nutritional factors may be involved in the pathogenesis of neurological diseases. Multiple causes for the development of malnutrition in patients with neurological diseases are known including oropharyngeal dysphagia, impaired consciousness, perception deficits, cognitive dysfunction, and increased needs. The present evidence- and consensus-based guideline addresses clinical questions on best medical nutrition therapy in patients with neurological diseases. Among them, management of oropharyngeal dysphagia plays a pivotal role. The guideline has been written by a multidisciplinary team and offers 88 recommendations for use in clinical practice for amyotrophic lateral sclerosis, Parkinsons disease, stroke and multiple sclerosis.

Nutritional risk as predictor for healthcare-associated infection among hospitalized elderly patients in the acute care setting.

BACKGROUND Poor nutritional status is associated with high rates of healthcare-associated infections (HCAIs) among hospitalized elderly patients. Early recognition of patients at risk for HCAIs is important. The Geriatric Nutritional Risk Index (GNRI) is a screening tool able to predict nutrition-related complications. AIM To examine the use of GNRI as a predictor of HCAIs in the acute care setting. METHODS A total of 248 consecutive patients aged >65 years, admitted as emergencies to the medical ward of an acute care hospital, were enrolled. On admission, clinical and laboratory assessment, anthropometric measurements, performance status, and GNRI score estimation were performed. HCAIs were recorded during admission. FINDINGS On admission, 53.8% of the patients were not at risk, 37.2% at low or medium risk and 8.9% at high risk for nutrition-related complications, as stratified by using the GNRI. During hospitalization 23.7% of the patients developed HCAIs. Patients with HCAIs had higher mortality (P < 0.001) and longer hospital stay (P < 0.001). In multivariate analysis, a performance status >1 [hazard ratio (HR): 2.08; 95% confidence interval (CI): 1.07-4.02; P = 0.03] and diabetes (HR: 2.57; 95% CI: 1.37-4.84; P = 0.003) were associated with increased risk for HCAIs, whereas GNRI score (per unit increase) had a protective effect (HR: 0.97; 95% CI: 0.95-0.99; P = 0.01). Well-nourished patients (GNRI >98) were significantly more likely to remain free from HCAIs during hospitalization (P = 0.003). CONCLUSION GNRI can accurately stratify hospitalized elderly patients according to risk for developing HCAIs.