2.Clinical study on cholesterol-lowering effect of RYR Cholestin among Americans with moderate hy-percholesterolemia
Ji-Hong LU ; Bonovich KERMIT ; Colfer HARRY ; Davidson MICHAEL ; A.Dujo-Vne CARLOS ; Fried L. DAVID ; Greenspan MITCHELL ; Karlsberg P. RONALD ; King P. STEPHEN ; LaForce F. CRAIG ; Litt MARC ; McGhee J.ROBERT ; Run-Hai ZENG ; Jia-Shi ZHU ; Ning-Zhi TAN
Shanghai Journal of Preventive Medicine 2013;(9):501-506
[Objective] To evaluate lipid -lowering efficacy and safety of RYR Cholestin , or Monascus purpureus (Red Yeast) Rice, in Americans with moderate hypercholesterolemia. [Methods] This study was an open-label, self-control, and multi-center clinical trial.A total of 187 subjects were entered into this trial (serum LDL-Cholesterol 3.50~4.92 mmol/L,total cholesterol 5.18~7.25 mmol/L, male:female=116∶71) , of whom 162 completed the study .Subjects were placed on the NCEP Step I Diet throughout the study and RYR Cholestin (2.4 g/day) was administered for 8 weeks following initial 4-week diet control . [ Results] Being on the diet alone for 4 weeks resulted in no significant changes in serum lipids .RYR Cholestin treatment for 8 weeks reduced serum total cholesterol , LDL-Cholesterol and triglycerides by 16 .6%, 24 .0%, and 25 .2%, respectively , and increased HDL-Cholesterol by 14 .3%( all P<0 .001 ) .There were 97 .5% of patients having ≥10% improvement in at least one of lipid risk factors, and 79.0%having ≥20% improvement.Discontinuation of RYR Cholestin intervention for 14 d led to a return of serum lipids to baseline of pre -study .And 29 possible product -related mild adverse re-actions were reported . [ Conclusion] RYR Cholestin is well tolerated and effective in reducing total and LDL-Cholesterol, and triglycerides, as well as in increasing HDL-Cholesterol in hypercholesterolemic patients, but those indicators return to the beginning baseline when the treatment is discontinued .
3.Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy?Results from an international multicentre study
Thomas B. RUSSELL ; Peter L. LABIB ; Paula MURPHY ; Fabio AUSANIA ; Elizabeth PANDO ; Keith J. ROBERTS ; Ambareen KAUSAR ; Vasileios K. MAVROEIDIS ; Gabriele MARANGONI ; Sarah C. THOMASSET ; Adam E. FRAMPTON ; Pavlos LYKOUDIS ; Manuel MAGLIONE ; Nassir ALHABOOB ; Hassaan BARI ; Andrew M. SMITH ; Duncan SPALDING ; Parthi SRINIVASAN ; Brian R. DAVIDSON ; Ricky H. BHOGAL ; Daniel CROAGH ; Ismael DOMINGUEZ ; Rohan THAKKAR ; Dhanny GOMEZ ; Michael A. SILVA ; Pierfrancesco LAPOLLA ; Andrea MINGOLI ; Alberto PORCU ; Nehal S. SHAH ; Zaed Z. R. HAMADY ; Bilal AL-SARRIEH ; Alejandro SERRABLO ; ; Somaiah AROORI
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(1):70-79
Background:
s/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes.
Methods:
Data were extracted from the Recurrence After Whipple’s study, a retrospective multicenter study of PD outcomes.
Results:
In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was “enteral only,” “parenteral only,” and “enteral and parenteral” in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m2 (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN.
Conclusions
A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.
4.Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy?Results from an international multicentre study
Thomas B. RUSSELL ; Peter L. LABIB ; Paula MURPHY ; Fabio AUSANIA ; Elizabeth PANDO ; Keith J. ROBERTS ; Ambareen KAUSAR ; Vasileios K. MAVROEIDIS ; Gabriele MARANGONI ; Sarah C. THOMASSET ; Adam E. FRAMPTON ; Pavlos LYKOUDIS ; Manuel MAGLIONE ; Nassir ALHABOOB ; Hassaan BARI ; Andrew M. SMITH ; Duncan SPALDING ; Parthi SRINIVASAN ; Brian R. DAVIDSON ; Ricky H. BHOGAL ; Daniel CROAGH ; Ismael DOMINGUEZ ; Rohan THAKKAR ; Dhanny GOMEZ ; Michael A. SILVA ; Pierfrancesco LAPOLLA ; Andrea MINGOLI ; Alberto PORCU ; Nehal S. SHAH ; Zaed Z. R. HAMADY ; Bilal AL-SARRIEH ; Alejandro SERRABLO ; ; Somaiah AROORI
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(1):70-79
Background:
s/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes.
Methods:
Data were extracted from the Recurrence After Whipple’s study, a retrospective multicenter study of PD outcomes.
Results:
In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was “enteral only,” “parenteral only,” and “enteral and parenteral” in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m2 (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN.
Conclusions
A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.
5.Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy?Results from an international multicentre study
Thomas B. RUSSELL ; Peter L. LABIB ; Paula MURPHY ; Fabio AUSANIA ; Elizabeth PANDO ; Keith J. ROBERTS ; Ambareen KAUSAR ; Vasileios K. MAVROEIDIS ; Gabriele MARANGONI ; Sarah C. THOMASSET ; Adam E. FRAMPTON ; Pavlos LYKOUDIS ; Manuel MAGLIONE ; Nassir ALHABOOB ; Hassaan BARI ; Andrew M. SMITH ; Duncan SPALDING ; Parthi SRINIVASAN ; Brian R. DAVIDSON ; Ricky H. BHOGAL ; Daniel CROAGH ; Ismael DOMINGUEZ ; Rohan THAKKAR ; Dhanny GOMEZ ; Michael A. SILVA ; Pierfrancesco LAPOLLA ; Andrea MINGOLI ; Alberto PORCU ; Nehal S. SHAH ; Zaed Z. R. HAMADY ; Bilal AL-SARRIEH ; Alejandro SERRABLO ; ; Somaiah AROORI
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(1):70-79
Background:
s/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes.
Methods:
Data were extracted from the Recurrence After Whipple’s study, a retrospective multicenter study of PD outcomes.
Results:
In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was “enteral only,” “parenteral only,” and “enteral and parenteral” in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m2 (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN.
Conclusions
A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.
6.Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy?Results from an international multicentre study
Thomas B. RUSSELL ; Peter L. LABIB ; Paula MURPHY ; Fabio AUSANIA ; Elizabeth PANDO ; Keith J. ROBERTS ; Ambareen KAUSAR ; Vasileios K. MAVROEIDIS ; Gabriele MARANGONI ; Sarah C. THOMASSET ; Adam E. FRAMPTON ; Pavlos LYKOUDIS ; Manuel MAGLIONE ; Nassir ALHABOOB ; Hassaan BARI ; Andrew M. SMITH ; Duncan SPALDING ; Parthi SRINIVASAN ; Brian R. DAVIDSON ; Ricky H. BHOGAL ; Daniel CROAGH ; Ismael DOMINGUEZ ; Rohan THAKKAR ; Dhanny GOMEZ ; Michael A. SILVA ; Pierfrancesco LAPOLLA ; Andrea MINGOLI ; Alberto PORCU ; Nehal S. SHAH ; Zaed Z. R. HAMADY ; Bilal AL-SARRIEH ; Alejandro SERRABLO ; ; Somaiah AROORI
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(1):70-79
Background:
s/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes.
Methods:
Data were extracted from the Recurrence After Whipple’s study, a retrospective multicenter study of PD outcomes.
Results:
In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was “enteral only,” “parenteral only,” and “enteral and parenteral” in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m2 (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN.
Conclusions
A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.