171,116 research outputs found
ASPEN recommendations for enteral nutrition : practice is the result of potential benefits, harms, clinical judgement and ethical issues
No full textFacing hospital malnutrition : when will we understand that a precious ally lies in our catering service leading chef?
No full textThe use of the Geriatric Nutritional Risk Index (GNRI) as simplified nutritional screening tool
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Food waste : other issues and settings should be considered : it is not just a matter of money and pollution
No full textThe Geriatric Nutritional Risk Index (GNRI)
No full textPurpose of review: A new nutrition-related risk assessment tool, the Geriatric Nutritional Risk Index (GNRI), has been recently proposed. The aim of this review is to summarize current evidences on the use of this tool with particular focus on the rationales of its application in elderly healthcare. Recent findings: Structured as a dichotomous index, based on serum albumin values and the discrepancy between real and ideal weight, the GNRI seems to account for both acute and chronic reasons of nutrition-related complications. It allows us to face the frequent difficulties in obtaining a profitable participation of the old patient to nutritional assessment. Its application appears feasible in all healthcare settings in which it shows adequacy to discriminate different profiles of nutritional risk. A GNRI less than 92 might be suggested as clinical trigger for routine nutritional support. Summary: In maths of nutrition 'recognize and treat' has become a clinical imperative. Actually, clinical judgement by an expert is still considered the reference standard to diagnose malnutrition but the use of simplified tools profitably assists in nutritional risk screening process. The GNRI is easy to use and preliminary results show that it is promising. Its routine application, next to the other validated tools already available, might be enforced in the assessment of the old patient
Disease-specific versus standard nutritional support for the treatment of pressure ulcers in institutionalised elderly : a randomized-controlled trial
No full textOBJECTIVES: To investigate whether a disease-specific nutritional approach is more beneficial than a standard dietary approach to the healing of pressure ulcers (PUs) in institutionalized elderly patients. DESIGN: Twelve-week follow-up randomized controlled trial (RCT). SETTING: Four long-term care facilities in the province of Como, Italy. PARTICIPANTS: Twenty-eight elderly subjects with Stage II, III, and IV PUs of recent onset (<1-month history). INTERVENTION: All 28 patients received 30 kcal/kg per day nutritional support; of these, 15 received standard nutrition (hospital diet or standard enteral formula; 16% calories from protein), whereas 13 were administered a disease-specific nutrition treatment consisting of the standard diet plus a 400-mL oral supplement or specific enteral formula enriched with protein (20% of the total calories), arginine, zinc, and vitamin C (P<.001 for all nutrients vs control). MEASUREMENTS: Ulcer healing was evaluated using the Pressure Ulcer Scale for Healing (PUSH; 0=complete healing, 17=greatest severity) tool and area measurement (mm2 and %). RESULTS: The sampled groups were well matched for age, sex, nutritional status, oral intake, type of feeding, and ulcer severity. After 12 weeks, both groups showed significant improvement (P<.001). The treatment produced a higher rate of healing, the PUSH score revealing a significant difference at Week 12 (-6.1±2.7 vs -3.3±2.4; P<.05) and the reduction in ulcer surface area significantly higher in the treated patients already by Week 8 (-1,140.9±669.2 mm 2 vs -571.7±391.3 mm2; P<.05 and ∼57% vs ∼33%; P<.02). CONCLUSION: The rate of PU healing appears to accelerate when a nutrition formula enriched with protein, arginine, zinc, and vitamin C is administered, making such a formula preferable to a standardized one, but the present data require further confirmation by high-quality RCTs conducted on a larger scale
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