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Furthermore symptoms 4 weeks pregnant buy secnidazole with a mastercard, butyrate is recognised as a main source of energy for colonocytes and this has efects on cell diferentiation and apoptosis that might be protective (100 symptoms zinc deficiency husky order secnidazole 1 gr otc, 101) symptoms 0f yeast infectiion in women buy secnidazole 500 mg line. Acetate and propionate are absorbed and have possible sys temic efects on carbohydrate and lipid metabolism symptoms 8 months pregnant buy secnidazole 1gr low cost. Propionate has been shown to inhibit liver cholesterol synthesis in experimental animals, but the importance of such a mechanism in humans remains to be established (92). Resistant starch and oat fbre have been shown to produce large amounts of butyrate (for a review, see (91)). There is an inverse rela tionship between faecal weight (infuenced by non-starch polysaccharide intake) and risk of colon cancer (103). Results from epidemiological studies show clear evidence of a protective efect of dietary fbre on colorectal cancer (38). No signifcant associations were seen in separate analyses of fbre from fruits, vegetables, or legumes. Fibre from cereals and fbre from fruits and vegetables were inversely as sociated with colon cancer, but for rectal cancer such an inverse association was only seen for fbre from cereals. In summary, there is convincing evidence for a protective efect of dietary fbre against colorectal cancer and limited-suggestive evidence for a protec tive efect against breast cancer. The associations for various food sources of dietary fbre were in the same direction, but not statistically signifcant. Viscous, soluble fbre intake of 4 g/d was not signifcantly associated with reduction in stroke risk and there was evidence of low heterogeneity between studies (108). Body weight Adults Several physiological efects of foods rich in dietary fbre, including di minished energy density, slower gastric emptying, short-term increase in satiety, and decreased rate of nutrient absorption, might be important for body weight regulation. Results from mainly short-term intervention studies on adults have shown that increased intake of various fbre types resulted in moderate weight loss (109, 110). Efect sizes were calculated as an average that was weighted by the number of subjects who completed the study. Study durations varied from 3 weeks to 13 weeks with large variations in fbre intakes in the intervention arm from 3. Results from prospective cohort studies on adults published since 2000 generally show that increased dietary fbre intake is associated with lower body weight (51) and waist circumference (111). In summary, there is probable evidence that dietary fbre intake is as sociated with lower weight gain in adults. A few studies, mainly on British vegan children, indicated slower growth in some of the children (112, 113), but it is not clear if this can be at tributed to the fbre content of their diet (114). Studies among children consuming a mixed diet do not indicate that a high fbre intake would compromise growth (114). A high fbre intake is ofen linked to higher intake of fruits, vegetables, and cereals and might be an indicator of more favourable dietary habits (115, 116). Increased fbre intake was associated with lower percentage of body fat among children who at 2 years of age consumed fewer than six meals per day (121). Pregnancy outcomes Intake of dietary fbre and dietary patterns characterised by vegetable foods with high content of dietary fbre (>22 g/d) have been shown to be asso 270 ciated with decreased risk of gestational diabetes (88) and preeclampsia (122, 123). Intake of wholegrain and cereal fbre has been associated with reduced risk of type-2 diabetes (125). In summary there is probable evidence that dietary fbre intake is in versely associated with type-2 diabetes. Requirement and recommended intake Glycaemic carbohydrates Only cells in the central nervous system, red blood cells, and some other cells dependent on anaerobic glycolysis have an absolute requirement for glucose. In the body, glucose can be synthesised from proteins and glycerol, and it has been assumed that there is no need for dietary carbohydrates as long as adequate amounts of fat and of protein for de novo synthesis of glucose are consumed. With prolonged glucose defcit, brain cells can partially adapt by utilising fat-derived metabolites such as? A very low carbohydrate diet (below 50 g/d), however, results in chronically increased production and increased plasma levels of these acids resulting in a condition known as ketosis. An intake of 50?100 g/d of glycaemic carbohydrates per day is sufcient to avoid ketosis among children and adults, and an intake of 130 g/d for both children older than 1 year and adults has been estimated to cover the glucose needs of the brain (5). Consumption of sugar sweetened drinks has been associated with an increased risk of type-2 diabetes and excess weight-gain and should, therefore, be limited. Frequent consumption of sugar-containing foods should be avoided to reduce the risk of dental caries. Added sugars (sucrose, fructose, and starch hydrolysates) should be kept below 10 E%. Since then, a number of studies have been published supporting the benefcial efects of dietary fbre and/or dietary fbre-rich foods such as wholegrain cereals, fruit, and vegetables on a number of diseases. There is also evidence that intake of appropriate amounts of dietary fbre from a variety of foods is important for children. Wholegrain cereals, whole fruit, vegetables, pulses, and nuts should be the major sources. From school age the intake should gradually increase to reach the recommended adult level during adolescence. Dietary patterns associated with reduced risk of chronic diseases are characterised by abundant intake of fbre-rich foods consisting mainly of slowly digestible carbohydrates such as wholegrain cereals, whole fruit, berries, vegetables, and pulses (127). Typical ranges of total carbohydrate intakes in studies on dietary patterns associated with reduced risk of chronic diseases among adults are 45?60 E%. For planning purposes, the focus should be on achieving the recom mended amounts of dietary fbre and added sugars. The ranges for total carbohydrates can be used as complementary goals using the middle value (52?53 E%) as an appropriate target. Dietary reference intakes for energy, carbohydrate, fber, fat, fatty acids, cholesterol, protein, and amino acids. Dietary reference intakes for energy, carbohydrates, fber, fat, protein and amino acids (Macronutrients). Fructans of chicory: intestinal transport and fermentation of different chain lengths and relation to fructose and sorbitol malabsorption. Lactose malabsorption and lactose intolerance in adults a cause of irritable bowel syndrome? Adaptation to lactose in lactose malabsorbers importance of the intestinal microfora. Genetics and epidemiology of adult-type hypolactasia with emphasis on the situation in Europe. Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. The use of the glycemic index in predicting the blood glucose response to mixed meals. Improved glycemic control and lipid profle and normalized fbrinolytic activity on a low-glycemic index diet in type 2 diabetic patients. The use of glycaemic index tables to predict glycaemic index of composite breakfast meals. Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease? Dietary fber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012. An eight-month controlled study of a low-fat high-fbre diet: effects on blood lipids and blood pressure in healthy young subjects. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Sugar-sweetened beverages and body mass index in children and adolescents: a meta-analysis.

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Tap water treatment 7 february buy discount secnidazole 1gr line, however symptoms esophageal cancer buy generic secnidazole 500 mg on-line, can affect urinary electrolytes in patients who form calcium stones (25) medicine vending machine cheap secnidazole 500mg with visa. The likelihood of magnesium deficiency also appears to be influenced by the area of residence treatment wrist tendonitis buy secnidazole 500 mg low cost. Leoni et al (29) studied the pattern of mortality resulting from cardiovascular diseases, ischemic heart diseases, and cerebrovascular diseases in the region of Abruzzo, Italy, which has a population of 594,323. An inverse correlation was observed between drinking water hardness and mortality due to cardiovascular disease, for individuals aged 45-64 yr. The incidence of sudden cardiac death among the population of the Media Valle del Serchio area in Italy, which made up of 35,000 residents, was found to be twice that of the European average (9 per 10,000 in the examined year). The high incidence of sudden cardiac death among the residents correlated with water that was of very low total hardness (30). The relation between death from acute myocardial infarction and the level of magnesium in drinking water was examined using mortality registers and a case-control design. The study area comprised 17 municipalities in the southern part of Sweden that have different magnesium levels in the drinking water. The odds ratios for death from acute myocardial infarction in the groups were inversely related to the amount of magnesium in drinking water. For the group with the highest levels of magnesium in drinking water, the odds ratio adjusted for age and calcium level was 0. For the magnesium/calcium quotient, the odds ratio was lower only for the group with the highest quotient. Magnesium in drinking water correlated as an important protective factor for death from acute myocardial infarction among males (31). To examine whether higher concentrations of magnesium in drinking water supplies are associated with lower mortality from acute myocardial infarction a geographical study using 13,794 census enumeration districts was studied. Water constituent concentrations (magnesium, calcium, fluoride, lead) were measured according to water supply zones in North England. The relative risk of mortality from acute myocardial infarction for a quadrupling of magnesium concentrations in drinking water (for example, 20 mg/l vs 5 mg/l) was 1. There was no evidence of a protective effect for acute myocardial infarction even among age, sex, and deprivation groups that were likely to be relatively magnesium deficient. For ischemic heart disease mortality, however, there was an apparent protective effect of magnesium and calcium (with calcium predominating in the joint model), but these were no longer significant when the geographical trends were incorporated. The authors suggested that there was no evidence of an association between magnesium concentrations in drinking water supplies and mortality from acute myocardial infarction. The main finding of this study does not support the hypothesis that magnesium is the key water factor in relation to mortality from heart disease (32). In another case control study, Rubenowitz and his colleagues investigated the levels of magnesium and calcium in drinking water and death from acute myocardial infarction among women. Cases were women who had died from acute myocardial infarction between the ages of 50 and 69 years during 1982-1993 (N = 378), and 66 controls were women who had died from cancer (N = 1,368). The results suggest that magnesium and calcium in drinking water are important protective factors for death from acute myocardial infarction among women (33). Rubenowitz et al (34) further investigated the importance of magnesium and calcium in drinking water in relation to morbidity and mortality from acute myocardial infarction. Cases were men and women 50-74 years of age living in 18 Swedish municipalities who had suffered an acute myocardial infarction some time between October 1, 1994, and June 30, 1996. The odds ratio for death from acute myocardial infarction in relation to water magnesium was 0. Multivariate analyses showed that other risk factors were not important confounders. These data suggested that magnesium in drinking water is associated with lower mortality from acute myocardial infarction (34). Drinking water could be an important source of calcium in the elderly particularly because of increased needs and decreased consumption of dairy products. Information about all deaths (14,311) occurring in 69 parishes of the South-West of France for a seven?year study period from 1990 to1996) were investigated. However, for magnesium, a U-shape effect is possible, especially for cerebrovascular mortality (35). A study was performed to evaluate the relation between calcium and magnesium in drinking water and diet and risk factors for cardiovascular disease in individuals living in hard and soft water areas with considerable differences in cardiovascular mortality in Sweden. Intake of magnesium and calcium was calculated from the diet questionnaire with special consideration to the use of local water. No correlation was seen with magnesium content in household water to any of the risk factors. This study of individuals living in soft and hard water areas showed significant correlations between the content of calcium in water and major cardiovascular risk factors. Regression analyses indicated that calcium content in water could be a factor in the complexity of relationships and importance of cardiovascular risk factors. However, based on these results the authors were unable to conclude any definite causal relation and suggest that further research is needed (36). Calcium and magnesium deficiencies in particular have been considered as risk factors for elderly people and have been implicated in the aging process. Their deficiencies in the elderly can occur due to inadequate nutrient intakes from food and water, multiple drug use, or altered gastrointestinal function. It is not known to what extent suboptimal intakes of trace elements such as calcium and magnesium may affect the aging process; however, magnesium-deficient conditions have been associated with neuromuscular and cardiovascular disorders, endocrine disturbances and insulin resistance. Data presented in a review by Costello and Moser-Veillon suggest that there was a decreased availability of magnesium in the food supply, lower intakes of magnesium by elderly people, and widespread supplementation practices (37). A study was thus carried out on 36 healthy elderly subjects and their magnesium status was assessed by serum Mg, basal urinary Mg output, and with a Mg loading test, and compared with 53 healthy younger subjects. Their study also found a significant sub-clinical Mg deficit, not detected by serum Mg, in many healthy elderly subjects. The data further indicated that Mg supplementation improved Mg status and renal function. A study aimed to examine the relationship between nitrate, zinc and magnesium in drinking water and the risk of childhood-onset Type 1 diabetes mellitus was conducted by Zhao et al. Five hundred and seventeen children, aged 0-15 years, diagnosed with Type 1 diabetes mellitus between 1975 and 1996, were identified for inclusion in the study. Poisson regression analyses showed that only zinc and magnesium were significant factors. The data suggest that the incidence rate of childhood diabetes is significantly lower when the concentrations of zinc and magnesium in the domestic drinking water are in the range 22. Their findings suggest evidence of a possible association between zinc and magnesium in the domestic drinking water and childhood diabetes. However, these possible protective effects of zinc and magnesium in domestic drinking water warrant further confirmation (39). Both amount and timing of dietary calcium intake influence the recurrence of renal calcium stones. Bellizzi et al (40) evaluated whether the hardness of drinking water modified the risk for calcium stones. As compared with both tap and soft water, hard water was associated with a significant (50%) increase of the urinary calcium concentration in the absence of changes of oxalate excretion; the calcium-citrate index revealed a significant three fold increase during ingestion of hard water as compared with respect to soft water. This study suggests that, in the preventive approach to calcium nephrolithiasis, the intake of soft water is may be preferable to hard water, since it was associated with a lower risk for recurrence of calcium stones (40). Blood pressure was measured in persons living in villages along the banks of the Wogupmeri River in New Guinea. Trace element concentrations were also determined in toenails from the same subjects to see whether a correlation existed (41). Calcium content of the river water decreased as the river flows downstream, while blood pressure of the villagers living along this river increased. The trace element analysis of toenails revealed strong correlations between aluminum and vanadium. A similarly strong correlation also existed between these two elements in staple food. This investigation tended to confirm the findings of earlier studies indicating an apparently beneficial effect of relatively hard water on cardiovascular parameters. Among various diseases studied, the cardiovascular system attracted the most attention. Most of the investigations before 1980 were with ecological design and geographical areas defined.

However symptoms 5 days before your missed period purchase secnidazole 500 mg, up to 25% of patients treated with for the production of these metabolites: thiopurine olsalazine experience watery diarrhea that may require drug methyltransferase and hypoxanthine phosphoribosyl discontinuation medicine 014 discount secnidazole 1gr otc. The accumulation of metabolites depends on the to an inactive moiety medications ocd generic 500 mg secnidazole with amex, which is cleaved by bacterial genetic polymorphism of these individual enzymes medicine park oklahoma purchase secnidazole australia. Genetic testing inflammation; however, these drugs are ineffective for for thiopurine methyltransferase polymorphisms and direct maintaining remission and often are associated with measurements of metabolites have been suggested to significant adverse effects. Short-term effects include optimize efficacy and minimize toxicity of these drugs. Patients Mesalamine is a relatively potent inhibitor of thiopurine taking corticosteroids are more prone to infection. The methyltransferase and thus increases accumulation of the National Institutes of Health has published a consensus active metabolites of mercaptopurine increasing the risk of statement regarding the prevention, diagnosis, and therapy myelosuppression. In addition, treatment with bisphosphonate therapy widely accepted because of its corticosteroid-sparing Pharmacotherapy Self-Assessment Program, 5th Edition 77 Inflammatory Bowel Disease Abbreviations efficacy. Food and Drug Administration has issued several warnings regarding the adverse effects associated with infliximab, the Left-sided Colitis most serious concerns relate to the reactivation of latent Left-sided colitis may respond to topical agents, tuberculosis, development of sepsis and other infections, depending on the severity of disease. Mild to moderate hepatic toxicity, and hematologic toxicities, including disease can be treated with mesalamine or hydrocortisone leukopenia, neutropenia, and pancytopenia. Because topical corticosteroids may produce not receive infliximab who have not been screened for systemic adverse effects, topical administration of tuberculosis; however, patients who have initially been mesalamine is considered first-line therapy. Mesalamine tuberculin skin test-negative also have development active enema 4 g/night is given with response anticipated in tuberculosis while receiving infliximab. If response does not occur in this time, a during infliximab therapy should include complete blood morning dose is added or a hydrocortisone enema may be cell counts and liver function tests, as well as clinical signs added. Mesalamine enemas cost considerably more than of toxicity, including pallor, easy bruising, fatigue, right oral mesalamine agents; however, because the enemas are upper quadrant pain, dark urine, or jaundice. Combination therapy with topical Infusion reactions such as rash, hypotension, and shortness and oral mesalamine may be more effective than either of breath occur, and drugs for treatment of hypersensitivity modality alone. Sulfasalazine, mesalamine, olsalazine, and reactions should be available during infliximab infusions. Doses of these drugs Development of antichimeric antibodies may increase the should be optimized and titrated to clinical effect before risk of infusion reactions with each subsequent infliximab concluding lack of response or treatment failure. Other adverse effects observed with the use Sulfasalazine can be titrated up to 6 g/day, mesalamine to of infliximab include neurologic disorders. A Cochrane review of mesalamine understanding of the site and severity of disease. Goals suggested that sulfasalazine was significantly more effective of treatment are directed at inducing and maintaining than the newer drugs. The newer mesalamine agents have remission of symptoms and inflammation to improve markedly fewer adverse effects in comparison with quality of life. These guidelines were developed using evidence-based higher doses of maintenance therapy to prevent recurrence. For mesalamine treatment failure and more serious cases, Proctitis corticosteroids should be considered. Prednisone Proctitis typically is treated topically with administration 40?60 mg/day orally usually is an appropriate starting dose, of mesalamine suppositories or corticosteroid foams. Local mesalamine therapy is preferred because of proven depending on severity of disease and symptoms. Remission rates are as generally is effective within 2 weeks, and subsequently the high as 90%, and remission is maintained longer than 1 year dose should be tapered by 5 mg/week. Anal irritation or discomfort may initiate maintenance therapy during corticosteroid therapy. Although corticosteroids are effective at inducing remission, Oral therapy with sulfasalazine or mesalamine also may be they are not effective in maintaining remission. Relief of symptoms typically takes 3?4 weeks of Maintenance therapy with mesalamine products can be therapy. Once remission is achieved, the dose can be tapered initiated concurrently during the taper of corticosteroids, or discontinued. Because mesalamine oral agents are and the therapeutic end point for corticosteroid use is associated with adverse effects that mimic the symptoms remission. Thirty-six mesalamine or sulfasalazine and topical therapy with either patients (86%) responded to treatment, and oral mesalamine or corticosteroid enemas. The addition of oral cyclosporine (8 mg/kg/day) was continued in 31 patients for corticosteroids, such as prednisone 40?60 mg/day, should be an overall mean of 20 weeks. Of the initial responders, 25 (69%) also response, then tapered while maintenance doses of oral received mercaptopurine or azathioprine, and the mesalamine are continued. Patients patients receiving cyclosporine without an with pancolitis also may develop iron deficiency anemia immunomodulator, 45% required colectomy compared with because of chronic blood loss. Iron replacement may be 20% in patients receiving cyclosporine and azathioprine or indicated. All colectomies occurred within antidiarrheal drug of choice because of its effectiveness and 18 months of cyclosporine initiation. Surgery is advised if cyclosporine therapy is Patients with severe or fulminant colitis are at risk for ineffective in 7?10 days. However, treatment regimens for severe 12 months was 70%, and of those, 73% continued without colitis typically include broad-spectrum antibiotic drugs for corticosteroid requirements within another year. The mean patients with worsening symptoms despite intensive time to corticosteroid withdrawal was 4. Because of may benefit from intravenous cyclosporine as a continuous the curative nature of colectomy and because of the toxic infusion of 2?4 mg/kg/day. Lower doses also are effective potential of these drugs, the risks and benefits must be with less toxicity, specifically with lower incidence of weighed by both the health care team and the patient. One trial of 30 patients demonstrated Pharmacists can play a vital role by counseling the patient evidence that monotherapy with cyclosporine in patients on the use of these drugs and discussing the anticipated never treated with corticosteroids may be as effective as course of the disease. Intravenous cyclosporine versus intravenous corticosteroids as single therapy for severe attacks of ulcerative colitis. Efficacy and safety of thiopurinic immunomodulators (azathioprine and mercaptopurine) in steroid-dependent ulcerative colitis. Adverse effects were more prominent in Decisions regarding progressive addition of antibiotic nonsmokers. Corticosteroids should be added to the regimen if oral treatment, infliximab has been suggested for use in mesalamine agents fail to induce remission. During follow-up, deficiency, and symptoms may be difficult to distinguish disease activity, quality of life, and safety were assessed. Symptoms include diarrhea, abdominal After 6 weeks, remission rate in the infliximab group was pain, and flatulence after ingestion of milk or similar compared with placebo (36% vs. Treatment can include reduction change in quality of life as measured by the Inflammatory of dietary lactose intake, substitution of alternative energy Bowel Disease Questionnaire was similar in both groups and nutrient sources, and administration of commercially from week 0?6. Calcium supplementation should be Although there currently are no reports comparing considered to prevent bone loss in patients requiring lactose infliximab with intravenous cyclosporine, in placebo restricted diets. Calcium carbonate typically is controlled trials in patients with corticosteroid-refractory recommended because it is the cheapest form available. Clinical response typically is in the nature of disease, the presenting symptoms, and the achieved in 4 weeks. Initial dosages of these drugs usually are 2 g/day the presence of systemic or extraintestinal manifestations in divided dosages, but can be titrated to 4. Several trials have consensus and evidence-based guidelines or algorithms demonstrated benefit of using ciprofloxacin 500 mg have not been endorsed in the United States. Infliximab in moderately severe glucocorticoid resistant ulcerative colitis: a randomised controlled trial. Appropriate antibiotic drug may benefit from alternating antibiotic drugs over several therapy is required after drainage. Patients with obstructive symptoms caused by stenosis or Corticosteroids may be used when mesalamine or intestinal adhesions from previous surgeries usually are antibiotic drug therapies fail. The majority of adult patients treated with oral initially be treated with sulfasalazine 1 g/day titrated up to prednisone doses of 40?60 mg/day usually respond within 6 g/day or mesalamine 2 g/day titrated up to 4. When response is achieved, the dose should be Patients who are unresponsive to one of these drugs after tapered gradually by 5 mg/week, with a goal to discontinue 3?4 weeks may benefit from antibiotic drug therapy.

Prevention of quality of life in patients with hip fractures: a controlled prospective cohort unintentional weight loss in nursing home residents: a controlled trial of study keratin intensive treatment purchase secnidazole visa. Feeding assistance needs of long-stay nursing home quality of life in malnourished medical patients medications via g tube purchase secnidazole online. Can Nurs Home 2012;23(2): prevents undernutrition medicine 003 generic secnidazole 1gr online, increases muscle strength and improves QoL 8e13 treatment abbreviation generic 1 gr secnidazole fast delivery. Older adults and the outcome of hip fracture: a randomised controlled trial of nutritional patients in need of nutritional support: review of current treatment options support in an acute trauma ward. The amount eaten in meals by humans is a power [65] Neelemaat F, van Keeken S, Langius J, de van der Schueren M, Thijs A, function of the number of people present. Sharing meals with institutionalized people with intervention among old (>65 years) Danish nursing home residents. J Nutr Multidisciplinary nutritional support for undernutritionin nursinghome and Elder 2003;22(4):1e11. Supportive interventions for performance in activities of daily living and mobility after a multidisciplinary enhancing dietary intake in malnourished or nutritionally at-risk adults. Results of a [71] Stenvall M, Olofsson B, Lundstrom M, Englund U, Borssen B, Svensson O, systematic review. Effects of two models postoperative falls and injuries after femoral neck fracture. Osteoporos Int of nutritional intervention on homebound older adults at nutritional risk. J Am Society for swallowing disorderseEuropean Union Geriatric Medicine Soci Diet Assoc 2008;108(12):2084e9. J Nutr Health Aging 2006;10(3): nity dwelling older people: a systematic review of randomised controlled 171e5. Are informal carers and community view and evidence based recommendations on texture modi? Systematic review and evi [104] Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. Clin Nutr 2017;36(1): liquids for adults (above 17 years) with oropharyngeal dysphagiaeAn 11e48. Individualised dietary counselling for nutritionally at-risk older pa frail elderly. Nutritional supple improving quality of life in malnourished care home residents. Clin Nutr mentation anddietary advice ingeriatric patients at risk of malnutrition. Effects of a physical and nutritional? Nutritional support and outcomes in malnourished medical inpatients: a intervention program for frail elderly people over age 75. Systematic review and meta-analysis of the activity level and activities of daily livingda randomized controlled pilot effects of high protein oral nutritional supplements. Should oral nutritional home visits with registered dietitians have a positive effect on the functional supplementation be given to undernourished older people upon hospital and nutritional status of geriatric medical patients after discharge: a ran discharge? Post-discharge nutritional during recovery from chest infection and the role of nutritional supple support in malnourished elderly individuals improves functional limitations. J Nutr Health treated with a specialized oral nutritional supplement: a randomized clinical Aging 2016;20(2):178e84. Effects of dietary enrichment with conventional [143] Hebuterne X, Schneider S, Peroux J-L, Rampal P. Effects of refeeding by cyclic foods on energy and protein intake in older adults: a systematic review. Nutr enteral nutrition on body composition: comparative study of elderly and Rev 2015;73(9):624e33. Am J Alzheim Dis tional status and quality of life in patients with percutaneous endoscopic 1995;10(6):20e3. Survival after percutaneous endoscopic gastrostomy [123] Wong A, Burford S, Wyles C, Mundy H, Sainsbury R. J Gerontol A Biol Sci Med Sci 2000;55(12): to improve nutrition in people with dementia in an assessment unit. Oropharyngeal dysphagia in older personsefrom pathophysiology to [151] Rimon E, Kagansky N, Levy S. Percutaneous endoscopic gastrostomy; evi adequate intervention: a review and summary of an international expert dence of different prognosis in various patient subgroups. Percutaneous endoscopic gastro impairment are not associated with earlier mortality after percutaneous stomy versus nasogastric feeding in older individuals with non-stroke endoscopic gastrostomy. The and mortality after percutaneous endoscopic gastrostomy in geriatrics: a nasal loop provides an alternative to percutaneous endoscopic gastrostomy prospective multicenter observational trial. Pathogenic colo increase weight and maintain the protein status of debilitated elderly nization of oral? Clinical outcome of geriatric patients in the United dicting the outcome of long-term care by clinical and functional indices: the States receiving home parenteral and enteral nutrition. Prevalence of malnutrition in orally [190] Thomas D, Zdrodowski C, Wilson M, Conright K, Diebold M, Morley J. Outcomes of percutaneous endoscopic gastrostomy among homeparenteral nutrition: aclinical evaluation aftera3-year experienceina older adults in a community setting. Tube feeding in the demented elderly [193] Friedli N, Stanga Z, Sobotka L, Culkin A, Kondrup J, Laviano A, et al. Hypoalbuminemia is a poor predictor of feeding initiation in long-term care elderly with oropharyngeal survival after percutaneous endoscopic gastrostomy in elderly patients with dysphagiaethecontributionofrefeedingsyndrome. Prevalence of risk factors for the refeeding syndrome in older hospi endoscopic gastrostomy placement. Risk factors of refeeding syndrome in malnourished older hospitalized J Adv Nurs 2006;56(3):270e81. Unintentional [173] Abuksis G, Mor M, Segal N, Shemesh I, Plout S, Sulkes J, et al. Percutaneous weight loss predicts decline in activities of daily living function and life endoscopic gastrostomy: high mortality rates in hospitalized patients. Singap Med J 2006;47(5): High-intensity functional exercise program and protein-enriched energy 383e7. Effects of high-intensity exercise and protein supplement gastrostomy: the role of dementia. Pulmonary complications of effects of exercise and proteineenergy supplements on body composition 9931 narrow-bore nasoenteric tubes during blind placement. Clin Nutr 2015;34(6): supplementation and resistance training in nutritionally at risk older adults 1052e73. Exercise training and nutritional supplementation for physical frailty in 2010;58(3):580e4. Dose-response relationship of resistance [230] Clegg A, Siddiqi N, Heaven A, Young J, Holt R. Med Sci Sports Exerc 2010;45(5): delirium in older people in institutional long-term care. Physical exercise interventions for improving performance-based mea Observational, longitudinal study of delirium in consecutive unselected sures of physical function in community-dwelling, frail older adults: a acute medical admissions: age-speci? Clinical guideline: the preven [212] Rondanelli M, Klersy C, Terracol G, Talluri J, Maugeri R, Guido D, et al. Diagnostic and statistical manual of patients with decreased muscle mass: a randomized controlled trial. Association between malnutrition and [214] Goisser S, Schrader E, Singler K, Bertsch T, Gefeller O, Biber R, et al. Nonpharmacologic interventions to heal pressure ulcers creases hip fracture-related complications. Enteral calorie control in geriatric patients following hip fracture decreases nutritional support in prevention and treatment of pressure ulcers: a sys complications: a randomized, controlled study. A nutritional formula [221] Liu M, Yang J, Yu X, Huang X, Vaidya S, Huang F, et al. The role of periop enriched with arginine, zinc, and antioxidants for the healing of pressure erative oral nutritional supplementation in elderly patients after hip surgery. Cost [222] Lundstrom M, Olofsson B, Stenvall M, Karlsson S, Nyberg L, Englund U, et al.

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