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  Subjects -> NUTRITION AND DIETETICS (Total: 201 journals)
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Current Opinion in Clinical Nutrition & Metabolic Care
Journal Prestige (SJR): 1.521
Citation Impact (citeScore): 4
Number of Followers: 26  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1363-1950 - ISSN (Online) 1473-6519
Published by LWW Wolters Kluwer Homepage  [330 journals]
  • Editorial introductions

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      Abstract: imageNo abstract available
      PubDate: Thu, 08 Feb 2024 00:00:00 GMT-
       
  • Editorial: Quantitative and qualitative aspects of lipids and lipoproteins
           in health and disease: nutrition, physiology and genetics

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      Authors: Calder; Philip C.; Watts, Gerald F.
      Abstract: No abstract available
      PubDate: Thu, 08 Feb 2024 00:00:00 GMT-
       
  • Editorial: The interaction between protein delivery and blood urea and
           ammonia during critical illness

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      Authors: Deane; Adam M.; Casaer, Michael P.
      Abstract: No abstract available
      PubDate: Thu, 08 Feb 2024 00:00:00 GMT-
       
  • Metabolic management of accidental intoxication

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      Authors: Khatib; Khalid; Dixit, Subhal; Telang, Madhavi
      Abstract: imagePurpose of review Unintentional intoxication comprises a major chunk of all intoxications. Most patients are in the pediatric age group with another set of patients being the elderly. Substances found to cause accidental intoxication vary from country to country and even within different regions of a country. Frequent reviews of current literature are needed to be abreast of trends.Recent findings Prescription drugs and household chemicals are major culprits when it comes to accidental intoxication. Acetaminophen, digoxin and metformin are some of the prominent prescription drugs frequently associated with unintentional intoxications. Increasingly alcohol based hand sanitizers are becoming an important etiology of these events, following their increased usage during the COVID-19 pandemic. Pattern recognition to identify class of intoxicant and supportive care including prevention of further absorption and increased excretion are cornerstones of therapy. Antidote when available should be used promptly.Summary Knowledge about current epidemiology of accidental intoxications, toxidrome pattern recognition and appropriate antidote usage beside adequate and timely supportive care help in successful management of the unfortunate victim of accidental intoxication.
      PubDate: Wed, 17 Jan 2024 00:00:00 GMT-
       
  • Metabolic failure due to thiamine deficiency during critical illness

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      Authors: Cobilinschi; Cristian; Andrei, Cosmin-Andrei; Grinţescu, Ioana Marina; Mirea, Liliana
      Abstract: imagePurpose of review Thiamine is a crucial component in cellular energy metabolism, serving as a cofactor for multiple enzymatic processes and also having a role in regulating neuronal and neuromuscular transmission. Also it exerts antioxidant proprieties. The objective of this review is to consolidate and assess the most recent research concerning the consequences of insufficient thiamine levels for critically ill patients and to examine thiamine-related interventions.Recent findings Recent studies have unveiled a noteworthy association between thiamine deficiency and unfavorable consequences, such as heightened morbidity and fatality rates. The aforementioned deficiency exhibits a significant presence in medical situations such as starvation and alcohol use disorder, but also in patients during critical illness. Thiamine deficiency can have significant metabolic implications resulting in compromised energy generation and organ dysfunction, warranting prompt recognition and management.Summary Thiamine deficiency may not be recognized in critical care. Timely identification and management are imperative to mitigate adverse outcomes and improve patient prognosis. Thiamine may offer benefits for specific patient groups at higher risk of deficiency. Future studies should focus to establish optimal dosing, timing, and monitoring strategies on understanding the pathophysiological changes associated with thiamine deficiency in ICU patients and clarify its role in improving clinical outcomes.
      PubDate: Wed, 10 Jan 2024 00:00:00 GMT-
       
  • Nutritional management during critical illness in those with previous
           obesity surgery

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      Authors: Correia; Maria Isabel Toulson Davisson; Rosenfeld, Ricardo Schilling
      Abstract: imagePurpose of review The prevalence of overweight and obesity in our society is a pressing concern that has demanded immediate attention. Traditional treatments have proven ineffective for many individuals, leading to a surge in bariatric surgery as a last resort. While the rate of early and late postoperative complications may be low, when they occur, they place these patients at higher risk of requiring intensive care treatment. Therefore, it is our aim to discuss the nutritional care of these individuals.Recent findings Nutritional management of critically ill postbariatric surgical patients is related to the difficulty of providing an adequate nutritional assessment, calculating the macro and micronutrient requirements, choosing the right therapy, and defining the timely moment to initiate it. The anatomic changes related to the bariatric operation pose a high risk for a nonfunctional gastrointestinal tract both in the early postoperative and late postoperative. Therefore, the route of nutrition will greatly rely on the absorptive capacity, as well as on the nutritional status, with parenteral nutrition being an early option, especially for those with high critical care severity scores. Also, these patients are known to have an altered microbiota which may influence the absorptive capacity. Immunonutrition, prebiotics, probiotics, and symbiotics may represent potential options, but there is currently little support for ‘one size fits all’.Summary The nutritional care of critically ill patients postbariatric surgery is a complex and nuanced process requiring a multifaceted precision approach. The distinct nutritional challenges of early and late postoperative patients necessitate a thorough nutritional assessment and a highly individualized nutritional care plan.
      PubDate: Thu, 04 Jan 2024 00:00:00 GMT-
       
  • The use of triiodothyronine during critical illness

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      Authors: Maiden; Matthew J.; Forehan, Simon
      Abstract: imagePurpose of review Thyroid hormone physiology changes during critical illness. Circulating concentration of triiodothyronine (T3), the active form of thyroid hormone decreases. It has long been uncertain whether this represents a pathologic change or if it is an adaptive phenomenon. Controlled clinical trials have been required to understand whether replacing and restoring serum T3 levels is therapeutic.Recent findings Clinical trials of T3 have recently been proposed with some completed. These have been conducted in patients with sepsis, myocardial infarction, infants undergoing cardiac surgery, and acute respiratory distress syndrome. Of the completed trials, T3 administration restored serum concentrations, but was not accompanied by significant clinical benefit. Importantly, restoring serum T3 levels did not cause any adverse effects.Summary If T3 is to be considered a therapeutic target in critical illness, further studies should consider the stage of disease it is administered, and whether there are other surrogate measures to assess adequacy of hormone replacement over and above serum T3 concentrations.
      PubDate: Wed, 03 Jan 2024 00:00:00 GMT-
       
  • Modulation of beta-hydroxybutyrate in traumatic brain injury

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      Authors: Arora; Niraj; Shastri, Dhaval Hitendrakumar; Patel, Utsav Prakashbhai; Bhatia, Kunal
      Abstract: imagePurpose of review Traumatic brain injury (TBI) is a significant public health concern with substantial morbidity and mortality rates in the United States. Current management strategies primarily focus on symptomatic approaches and prevention of secondary complications. However, recent research highlights the potential role of ketone bodies, particularly beta-hydroxybutyrate (BHB), in modulating cellular processes involved in TBI. This article reviews the metabolism of BHB, its effect in TBI, and its potential therapeutic impact in TBI.Recent findings BHB can be produced endogenously through fasting or administered exogenously through ketogenic diets, and oral or intravenous supplements. Studies suggest that BHB may offer several benefits in TBI, including reducing oxidative stress, inflammation, controlling excitotoxicity, promoting mitochondrial respiration, and supporting brain regeneration. Various strategies to modulate BHB levels are discussed, with exogenous ketone preparations emerging as a rapid and effective option.Summary BHB offers potential therapeutic advantages in the comprehensive approach to improve outcomes for TBI patients. However, careful consideration of safety and efficacy is essential when incorporating it into TBI treatment protocols. The timing, dosage, and long-term effects of ketone use in TBI patients require further investigation to fully understand its potential benefits and limitations.
      PubDate: Wed, 03 Jan 2024 00:00:00 GMT-
       
  • Can the gut microbiome inform the effects of omega-3 fatty acid
           supplementation trials on cognition'

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      Authors: Kerman; Bilal E.; Self, Wade; Yassine, Hussein N.
      Abstract: imagePurpose of review Most omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation clinical trials report inconsistent or null findings on measures of cognition or Alzheimer's disease (AD) with a relatively large variability in the response to n-3 PUFA supplementation. The purpose of this review is to identify whether the gut microbiome together with the metabolome can provide critical insights to understand this heterogeneity in the response to n-3 PUFA supplementation.Recent findings A Western diet with high saturated fat and omega-6 fatty acid content, obesity, and lack of exercise puts strain on the gut microbiome resulting in imbalance, dysbiosis, reduced bacterial diversity, and increased abundance of the pro-inflammatory taxa. A plant-based diet has beneficial effects on the gut microbiota even when deficient in n-3 PUFAs. Human and animal studies show that increased intake of the n-3 PUFAs correlates with increased beneficial intestinal bacteria when compared to a Western diet.Summary The composition of the gut microbiota can help define the effects of n-3 PUFA supplementation on the brain and lead to more personalized nutritional interventions.
      PubDate: Fri, 22 Dec 2023 00:00:00 GMT-
       
  • Alternative sources of bioactive omega-3 fatty acids: what are the
           options'

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      Authors: Baker; Ella J.
      Abstract: imagePurpose of review The very-long chain (VLC) omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) promote optimal development, physiological function and healthy ageing and help to manage disease. EPA and DHA are sourced mainly from fish, which is not sustainable. This review explores alternative sustainable sources.Recent findings Recent research confirms that higher intake and status of EPA and DHA are associated with health benefits including lower risk of incident type-2 diabetes and cardiovascular disease mortality. Meta-analyses confirm benefits of intravenous EPA and DHA in hospitalized adults. Algal oils and seed oils from some genetically modified (GM) plants are sources of EPA and DHA. An oil from GM camelina showed equivalence with fish oil in human trials. Ahiflower oil, a source of stearidonic acid, had biological effects in experimental studies that might translate into health benefits. An intravenous lipid emulsion based on Ahiflower oil has been tested in experimental research. Pine nut oil (PNO) is a source of pinolenic acid, which is not an omega-3 PUFA but has similar actions.Summary Algal oils, oils from GM seed crops, Ahiflower oil and other sources of stearidonic acid, and nonomega-3 oils including PNO, are plant-sourced sustainable alternatives to fish-sourced VLC omega-3 PUFAs.
      PubDate: Thu, 07 Dec 2023 00:00:00 GMT-
       
  • Fluid therapy in diabetic ketoacidosis

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      Authors: Ramanan; Mahesh; Delaney, Anthony; Venkatesh, Balasubramanian
      Abstract: imagePurpose of review To evaluate recent evidence (2021–2023) on fluid therapy in diabetic ketoacidosis. Key evidence gaps which require generation of new evidence are discussed.Recent findings Balanced crystalloid solutions, compared to the commonly recommended and used 0.9% sodium chloride solution (saline), may result in better outcomes for patients with diabetic ketoacidosis, including faster resolution of acidosis, less hyperchloremia and shorter hospital length of stay. Upcoming results from randomized trials may provide definitive evidence on the use of balanced crystalloid solutions in diabetic ketoacidosis. Evidence remains scarce or conflicting for the use of “two-bag” compared to conventional “one-bag” fluid, and rates of fluid administration, especially for adult patients. In children, concerns about cerebral oedema from faster fluid administration rates have not been demonstrated in cohort studies nor randomized trials.Summary Fluid therapy is a key aspect of diabetic ketoacidosis management, with important evidence gaps persisting for several aspects of management despite recent evidence.
      PubDate: Thu, 30 Nov 2023 00:00:00 GMT-
       
  • Remnant cholesterol and low-grade inflammation jointly in atherosclerotic
           cardiovascular disease: implications for clinical trials

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      Authors: Elías-López; Daniel; Doi, Takahito; Nordestgaard, Børge G.; Kobylecki, Camilla J.
      Abstract: imagePurpose of review Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death despite the development of effective treatments. Recently, elevated remnant cholesterol and low-grade inflammation have emerged as factors explaining part of the residual ASCVD risk. Interestingly, the coexistence of both high remnant cholesterol and low-grade inflammation can further increase the risk of ASCVD. The aim of this review is to describe the role of elevated remnant cholesterol and low-grade inflammation, separately and combined, in ASCVD.Recent findings Results from recently published studies, including observational and genetic Mendelian randomization studies, support a causal relationship between elevated remnant cholesterol and low-grade inflammation on risk of ASCVD in both primary and secondary prevention settings. In addition, current evidence from observational studies suggests that the coexistence of elevated remnant cholesterol and low-grade inflammation further increases the risk of ASCVD.Summary Recent observational studies suggest that high remnant cholesterol combined with low-grade inflammation may confer a particular high risk for ASCVD. Attention on the dual threat from high remnant cholesterol and low-grade inflammation is necessary, and further research in this field is warranted. The effect of remnant cholesterol-lowering drugs and anti-inflammatory drugs on ASCVD risk alone and combined remains to be elucidated.Video abstract http://links.lww.com/COCN/A20
      PubDate: Tue, 21 Nov 2023 00:00:00 GMT-
       
  • Lipid droplets in steatotic liver disease

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      Authors: Bilson; Josh; Scorletti, Eleonora
      Abstract: imagePurpose of review This review aims to discuss the most recent evidence exploring the role of lipid droplets in steatotic liver disease (SLD). We highlight the breadth of mechanisms by which lipid droplets may contribute to the progression of SLD with a particular focus on the role of lipid droplets as inducers of mechanical stress within hepatocytes and genetic mutations in lipid droplet associated proteins. Finally, this review provides an update on clinical trials exploring the therapeutic potential and strategies targeting lipid droplets.Recent findings The size, composition and location of hepatic lipid droplets strongly influence the pathological role of these organelles in SLD. Emerging studies are beginning to elucidate the importance of lipid droplet induced hepatocyte mechanical stress. Novel strategies targeting lipid droplets, including the effects of lipid droplet associated protein mutations, show promising therapeutic potential.Summary Much more than a histological feature, lipid droplets are complex heterogenous organelles crucial to cellular metabolism with important causative roles in the development and progression of SLD. Lipid droplet induced mechanical stress may exacerbate hepatic inflammation and fibrogenesis and potentially contribute to the development of a pro-carcinogenic hepatic environment. The integration of advancements in genetics and molecular biology in upcoming treatments aspires to transcend symptomatic alleviation and address the fundamental causes and pathological development of SLD.
      PubDate: Wed, 15 Nov 2023 00:00:00 GMT-
       
  • The 10 essential questions regarding lipoprotein(a)

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      Authors: Kostner; Karam M.; Kostner, Gerhard M.
      Abstract: imagePurpose of review Lp(a) is one of the most atherogenic lipoproteins, and significant progress has been made to understand its pathophysiology over the last 20 years. There are now selective therapies in late-stage clinical trials to lower Lp(a). Yet there are many outstanding questions about Lp(a). This review outlines 10 of the most burning questions and tries to answer some of them.Recent findings Antisense oligonucleotide (ASO) treatment is currently the most advanced therapy to lower plasma Lp(a) by 60–80%. There are, however, also two small molecule medications in early stage of development with similar efficacy.Summary This review aims to answer important preclinical and clinical questions about the metabolism and physiological role of Lp(a) and also outlines possible therapeutic approaches with nutraceuticals, currently available lipid-lowering therapies and new medications. In addition, ways are illustrated to use Lp(a) as a marker to better predict cardiovascular risk.
      PubDate: Tue, 14 Nov 2023 00:00:00 GMT-
       
  • Urea cycle disorders in critically Ill adults

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      Authors: Long; Micah T.; Kruser, Jacqueline M.; Quinonez, Shane C.
      Abstract: imagePurpose of review Urea cycle disorders (UCDs) cause elevations in ammonia which, when severe, cause irreversible neurologic injury. Most patients with UCDs are diagnosed as neonates, though mild UCDs can present later - even into adulthood - during windows of high physiologic stress, like critical illness. It is crucial for clinicians to understand when to screen for UCDs and appreciate how to manage these disorders in order to prevent devastating neurologic injury or death.Recent findings Hyperammonemia, particularly if severe, causes time- and concentration-dependent neurologic injury. Mild UCDs presenting in adulthood are increasingly recognized, so broader screening in adults is recommended. For patients with UCDs, a comprehensive, multitiered approach to management is needed to prevent progression and irreversible injury. Earlier exogenous clearance is increasingly recognized as an important complement to other therapies.Summary UCDs alter the core pathway for ammonia metabolism. Screening for mild UCDs in adults with unexplained neurologic symptoms can direct care and prevent deterioration. Management of UCDs emphasizes decreasing ongoing ammonia production, avoiding catabolism, and supporting endogenous and exogenous ammonia clearance. Core neuroprotective and supportive critical care supplements this focused therapy.
      PubDate: Mon, 06 Nov 2023 00:00:00 GMT-
       
  • Long-chain n-3 polyunsaturated fatty acids for the management of age- and
           disease-related declines in skeletal muscle mass, strength and physical
           function

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      Authors: Phillips; Nathan; Gray, Stuart R.; Combet, Emilie; Witard, Oliver C.
      Abstract: imagePurpose of review This review uses the hierarchy of evidence as a framework to critically evaluate the effect of long chain n-3 polyunsaturated fatty acid (LCn-3 PUFA) ingestion alone, or as an adjunctive intervention to resistance training, on muscle health-related outcomes in healthy and clinical older adult populations.Recent findings Systematic reviews and meta-analyses of randomized controlled trials consistently report small, but clinically-relevant, effects of LCn-3 PUFA ingestion on strength outcomes, whereas mixed findings have been reported regarding changes in muscle mass and physical function. Cohort studies indicate an association between higher dietary LCn-3 PUFA intake and reduced likelihood of a sarcopenia diagnosis. Acute metabolic studies provide limited evidence for an effect of LCn-3 PUFA ingestion alone, or in combination with resistance training, on free-living integrated rates of MPS, static markers of muscle protein breakdown, or satellite cell activation in healthy older adults.Summary Recent data supports the efficacy of LCn-3 PUFA ingestion to facilitate small, but clinically relevant, improvements in muscle strength in healthy and clinical older adult populations. The mechanism(s) that underpin the action of LCn-3 PUFA in promoting strength outcomes remain unknown, but likely relate to neuromuscular function.
      PubDate: Tue, 17 Oct 2023 00:00:00 GMT-
       
  • The future of artificial intelligence in clinical nutrition

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      Authors: Singer; Pierre; Robinson, Eyal; Raphaeli, Orit
      Abstract: imagePurpose of review Artificial intelligence has reached the clinical nutrition field. To perform personalized medicine, numerous tools can be used. In this review, we describe how the physician can utilize the growing healthcare databases to develop deep learning and machine learning algorithms, thus helping to improve screening, assessment, prediction of clinical events and outcomes related to clinical nutrition.Recent findings Artificial intelligence can be applied to all the fields of clinical nutrition. Improving screening tools, identifying malnourished cancer patients or obesity using large databases has been achieved. In intensive care, machine learning has been able to predict enteral feeding intolerance, diarrhea, or refeeding hypophosphatemia. The outcome of patients with cancer can also be improved. Microbiota and metabolomics profiles are better integrated with the clinical condition using machine learning. However, ethical considerations and limitations of the use of artificial intelligence should be considered.Summary Artificial intelligence is here to support the decision-making process of health professionals. Knowing not only its limitations but also its power will allow precision medicine in clinical nutrition as well as in the rest of the medical practice.
      PubDate: Tue, 29 Aug 2023 00:00:00 GMT-
       
 
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  Subjects -> NUTRITION AND DIETETICS (Total: 201 journals)
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