Malnourished patients on hemodialysis improve after receiving a nutritional intervention

INTRODUCTION: Malnutrition is multifactorial and may be modified by nutritional intervention. We aimed to assess the impact of an intervention on the nutritional status of malnourished hemodialysis patients and their acceptance of a non-industrialized nutritional supplement. METHODS: 18 patients were studied, they were selected from a previous nutritional assessment where nutritional risk was defined as: subjective global assessment > 15 plus one criterion for malnutrition. The following variables were assessed: anthropometric parameters, subjective global assessment, dietary intake, six-minute walking test, quality of life (SF-36), and biochemical tests. Patients were randomized to either Control or Intervention Groups. The Intervention Group received a dietetic supplement during dialysis containing 355 kcal, prepared from simple ingredients. After three months, subjects from the Control Group and other patients also considered at nutritional risk underwent the same intervention. The study groups were compared after three months, and all patients were analyzed before and after the intervention. RESULTS: Fifteen men and three women, aged 56.4 ± 15.6 years-old, nine in each group, were studied. The Intervention Group showed an improvement in the subjective global assessment (p = 0.04). There were differences in role physical and bodily pain domains of SF-36, with improvement in the Intervention Group and worsening in the Control Group (p = 0.034 and p = 0.021). Comparisons before and after intervention for all patients showed improvement in the subjective global assessment (16.18 ± 4.27 versus 14.37 ± 4.20, p = 0.04), and in the six-minute walking test (496.60 ± 132.59 versus 547.80 ± 132.48 m; p = 0.036). The nutritional supplement was well tolerated by all patients, and it did not cause side effects. CONCLUSIONS: The nutritional intervention improved the subjective global assessment and quality of life of hemodialysis patients at short-term. A global intervention by a dietitian produced specific and nonspecific positive effects in the whole group. Nutritional supplementation was feasible, palatable, and had low cost. Its clinical impact and effectiveness need to be further assessed in a larger group of patients at long-term.

Gemeine Beschreibung aller Mitnachtigen Länder alsz Schweden, Gothen, Norwegien, Denmark

Teoksessa: Cosmographia / Sebastian Münster vuodelta 1588.

The outtermost or the fartheste parte of the Easterne Sea eastwardly, the which lyeth inclosed with in the coastes of East Finland, Rusland, & Lyffland, and wherein lye the Narve and Wyburgh the twoo furthermost places or marchante townes of the whole Easterne Navigation, with all the circumstances of the situation, the isles and Swedish rockes called Schares

Janamittakaavat: Englishe leagues 20 in a degree ; Spanische leagues 17 1/2 in a degree ; Dutche leagues 15 in a degree.

Le Petit journal. Supplément du dimanche

1920/04/04 (Numéro 1528).

Le Petit journal illustré

1921/05/29 (Numéro 1588).

L'Écho de Paris

1888/05/28 (Numéro 1528).

L'Écho de Paris

1888/07/27 (Numéro 1588).

Trio - sonate pour flûte, violon et piano / Georg Philipp Telemann, comp. ; Trio Moyse, ens. instr.

Titre uniforme : [Sonates en trio. Flûte, violon, basse continue. TWV 42 E 4. Mi majeur]

Reliure de : El Desafio de los reyes de Francia y d'Inglaterra al emperador y rey ñro señor (Carlos V) , con sus respuestas

Numérisation partielle de reliure

Epistolae Pauli cum glossa ordinaria.

F. 1 Maximes tirées des Pères : « Mulier est caput peccati... » etc. (XIIe et XVIe s.) ; Vers rythmiques : « Vinea culta fuit... » (XVIe s.) (Hervieux, Fabulistes lat., IV, 353). F. 2v Epist. Pauli ad Laodicenses. F. 3 « Divisio prime epistole ad Romanos ». F. 5 XIV. Epist. Pauli, cum glossa ordinaria. F. 187 Note en espagnol relative au prix du blé en 1528 et à un arrêt de la cour de Navarre du 27 nov. 1530. F. 188 Fragm. de grammaire commençant par 4 distiques : « [J]anua sum rudibus... Poeta. Que pars... — ... hec manus, genitivo harum. » (Écriture bolonaise, XIIIe-XIVe s.).

Bulla aurea... innovatoria bullae Julü Secundi super sindicatu omnium magistratuū et afficialiū in terris Sanitae Romanae Ecclesiae, exceptis personis Reverendiss. legatorum Cardinalium

[Acte pontifical. 1528-12-01]