ABSTRACT Introduction: Hospital malnutrition is a clinical priority and nutritional screening is ... more ABSTRACT Introduction: Hospital malnutrition is a clinical priority and nutritional screening is strongly recommended upon admission. Among the nutritional indices, the MUST (Malnutrition Universal Screening Tool for adults) is the most validated for adult inpatients. The aim of our work was to assess the risk of malnutrition upon admission and its recognition by the hospital’s health staff. Materials and methods: During a 3-month period, 307 newly admitted adult patients at the San Carlo Borromeo Hospital in Milan, Italy, were randomly screened and the MUST score was calculated within 72 hours. The number of nutritional checks for a more in-depth evaluation was also assessed. Results and conclusion: Forty-nine percent of patients presented a high risk of malnutrition on admission to hospital. In 28% of this sample, a nutritional evaluation had been requested. So 72% of patients who presented a severe risk of malnutrition (MUST ≥2) would not have been recognized and would therefore ...
Four Italian regions have cost coding for outpatient capsule-endoscopy. Elsewhere it is performed... more Four Italian regions have cost coding for outpatient capsule-endoscopy. Elsewhere it is performed in ordinary hospital admission. To identify, in a cohort of patients of a Gastroenterology Unit, those feasible for outpatient versus inpatient treatment; to analyze costs distribution in both management areas. We retrospectively analysed 100 clinical records of admissions to A.O. San-Carlo-Borromeo, Milan between 2005-2008. Hospitalization criteria (at least 3): 1) occult/obscure gastrointestinal bleeding; 2) hemoglobin ≤ 8 gr/dL; 3) indication for blood transfusions; 4) urgent hospital admission. A total of 62 patients had urgent admission, 60 blood transfusions, 81 underwent EGD and colonoscopy, 8 enteroscopy and 5 surgery. Mean haemoglobin value was 8.67 g/dL. Capsule-endoscopy was positive in 70, uncertain in 8, negative in 22. Positive cases: 33 angiodyplasia, 18 ulcers/erosions, 13 polyps/masses, 5 overt bleeding, 1 celiac disease. 47/100 were appropriate as outpatient, saving 43...
Mediterranean Journal of Nutrition and Metabolism, 2012
... In: Comi D, Crippa A, Muratori F, Noe` D, Poli M (eds) Attualita` in Nutrizione Clinica, vol ... more ... In: Comi D, Crippa A, Muratori F, Noe` D, Poli M (eds) Attualita` in Nutrizione Clinica, vol 3. Wichtig Editore, Milan, pp 44–52 8. Manore MM, Berry TE, Skinner JS, Carroll SS (1991) Energy expenditure at rest and during exercise in nonobese female cyclical dieters and in ...
Objective: Bariatric surgery, increasingly popular in recent years for treating morbid obesity, i... more Objective: Bariatric surgery, increasingly popular in recent years for treating morbid obesity, is not free of complications. This study compared clinical outcomes and long/short-term complications of malabsorptive/restrictive surgery. Methods: In the last five years, 102 severely obese patients were recruited to undergo surgery, 44 to malabsorptive surgery (Doldi biliointestinal bypass) and 58 to restrictive surgery (gastric banding). Examinations at baseline and yearly for three years included anthropometry (weight, BMI); eating behavior/habits; blood tests for nutritional status; cardiovascular risk score assessment; psychiatric/ endocrinological counseling; basal metabolism and body composition (fat/fat-free mass). After surgery, any complication that occurred was recorded and treated. Results: After three years, the mean weight loss was 46 kg (31%, p<0.01) for biliointestinal bypass and 21 kg (19%, p<0.01) for gastric banding. Lipid and glycemic profiles returned to normal and eating behavior improved after both procedures. Complications of biliointestinal bypass included nutritional deficits, mainly of liposoluble vitamins (13 patients, 29%); gallstones (5 patients, 11%); kidney stones (3 patients, 7%); arthritis and arthralgia (4 patients, 9%). One reconversion was required. Complications of gastric banding included epigastralgia (12 patients, 21%); persistent vomiting (9 patients, 16%); erosion (2 patients, 3%); slippage (1 patient). Six patients (10%) required band removal. Conclusions: Obesity surgery achieves stable weight loss, comorbidity resolution and cardiovascular risk reduction. Accurate monitoring and treatment of complications will reduce the surgery-related morbidity.
Mediterranean Journal of Nutrition and Metabolism, 2010
Lipids and glucides, the energetic compounds in artificial nutrition solutions, are not only “fue... more Lipids and glucides, the energetic compounds in artificial nutrition solutions, are not only “fuel” but possess other biologic functions which may influence disease evolution. Energy-yielding solutions should cover the patient’s metabolic needs but should also limit any inflammatory and oxidative stress or impairment of the immune system. This paper provides a concise overview of the clinical and metabolic properties of the most common energetic substrates employed both in enteral and parenteral nutrition.
ABSTRACT Introduction: Hospital malnutrition is a clinical priority and nutritional screening is ... more ABSTRACT Introduction: Hospital malnutrition is a clinical priority and nutritional screening is strongly recommended upon admission. Among the nutritional indices, the MUST (Malnutrition Universal Screening Tool for adults) is the most validated for adult inpatients. The aim of our work was to assess the risk of malnutrition upon admission and its recognition by the hospital’s health staff. Materials and methods: During a 3-month period, 307 newly admitted adult patients at the San Carlo Borromeo Hospital in Milan, Italy, were randomly screened and the MUST score was calculated within 72 hours. The number of nutritional checks for a more in-depth evaluation was also assessed. Results and conclusion: Forty-nine percent of patients presented a high risk of malnutrition on admission to hospital. In 28% of this sample, a nutritional evaluation had been requested. So 72% of patients who presented a severe risk of malnutrition (MUST ≥2) would not have been recognized and would therefore ...
Four Italian regions have cost coding for outpatient capsule-endoscopy. Elsewhere it is performed... more Four Italian regions have cost coding for outpatient capsule-endoscopy. Elsewhere it is performed in ordinary hospital admission. To identify, in a cohort of patients of a Gastroenterology Unit, those feasible for outpatient versus inpatient treatment; to analyze costs distribution in both management areas. We retrospectively analysed 100 clinical records of admissions to A.O. San-Carlo-Borromeo, Milan between 2005-2008. Hospitalization criteria (at least 3): 1) occult/obscure gastrointestinal bleeding; 2) hemoglobin ≤ 8 gr/dL; 3) indication for blood transfusions; 4) urgent hospital admission. A total of 62 patients had urgent admission, 60 blood transfusions, 81 underwent EGD and colonoscopy, 8 enteroscopy and 5 surgery. Mean haemoglobin value was 8.67 g/dL. Capsule-endoscopy was positive in 70, uncertain in 8, negative in 22. Positive cases: 33 angiodyplasia, 18 ulcers/erosions, 13 polyps/masses, 5 overt bleeding, 1 celiac disease. 47/100 were appropriate as outpatient, saving 43...
Mediterranean Journal of Nutrition and Metabolism, 2012
... In: Comi D, Crippa A, Muratori F, Noe` D, Poli M (eds) Attualita` in Nutrizione Clinica, vol ... more ... In: Comi D, Crippa A, Muratori F, Noe` D, Poli M (eds) Attualita` in Nutrizione Clinica, vol 3. Wichtig Editore, Milan, pp 44–52 8. Manore MM, Berry TE, Skinner JS, Carroll SS (1991) Energy expenditure at rest and during exercise in nonobese female cyclical dieters and in ...
Objective: Bariatric surgery, increasingly popular in recent years for treating morbid obesity, i... more Objective: Bariatric surgery, increasingly popular in recent years for treating morbid obesity, is not free of complications. This study compared clinical outcomes and long/short-term complications of malabsorptive/restrictive surgery. Methods: In the last five years, 102 severely obese patients were recruited to undergo surgery, 44 to malabsorptive surgery (Doldi biliointestinal bypass) and 58 to restrictive surgery (gastric banding). Examinations at baseline and yearly for three years included anthropometry (weight, BMI); eating behavior/habits; blood tests for nutritional status; cardiovascular risk score assessment; psychiatric/ endocrinological counseling; basal metabolism and body composition (fat/fat-free mass). After surgery, any complication that occurred was recorded and treated. Results: After three years, the mean weight loss was 46 kg (31%, p<0.01) for biliointestinal bypass and 21 kg (19%, p<0.01) for gastric banding. Lipid and glycemic profiles returned to normal and eating behavior improved after both procedures. Complications of biliointestinal bypass included nutritional deficits, mainly of liposoluble vitamins (13 patients, 29%); gallstones (5 patients, 11%); kidney stones (3 patients, 7%); arthritis and arthralgia (4 patients, 9%). One reconversion was required. Complications of gastric banding included epigastralgia (12 patients, 21%); persistent vomiting (9 patients, 16%); erosion (2 patients, 3%); slippage (1 patient). Six patients (10%) required band removal. Conclusions: Obesity surgery achieves stable weight loss, comorbidity resolution and cardiovascular risk reduction. Accurate monitoring and treatment of complications will reduce the surgery-related morbidity.
Mediterranean Journal of Nutrition and Metabolism, 2010
Lipids and glucides, the energetic compounds in artificial nutrition solutions, are not only “fue... more Lipids and glucides, the energetic compounds in artificial nutrition solutions, are not only “fuel” but possess other biologic functions which may influence disease evolution. Energy-yielding solutions should cover the patient’s metabolic needs but should also limit any inflammatory and oxidative stress or impairment of the immune system. This paper provides a concise overview of the clinical and metabolic properties of the most common energetic substrates employed both in enteral and parenteral nutrition.
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Papers by Paola Lanzi
free of complications. This study compared clinical outcomes and long/short-term complications of
malabsorptive/restrictive surgery.
Methods: In the last five years, 102 severely obese patients were recruited to undergo surgery, 44
to malabsorptive surgery (Doldi biliointestinal bypass) and 58 to restrictive surgery (gastric banding).
Examinations at baseline and yearly for three years included anthropometry (weight, BMI); eating
behavior/habits; blood tests for nutritional status; cardiovascular risk score assessment; psychiatric/
endocrinological counseling; basal metabolism and body composition (fat/fat-free mass). After surgery,
any complication that occurred was recorded and treated.
Results: After three years, the mean weight loss was 46 kg (31%, p<0.01) for biliointestinal bypass
and 21 kg (19%, p<0.01) for gastric banding. Lipid and glycemic profiles returned to normal and eating
behavior improved after both procedures. Complications of biliointestinal bypass included nutritional
deficits, mainly of liposoluble vitamins (13 patients, 29%); gallstones (5 patients, 11%); kidney stones (3
patients, 7%); arthritis and arthralgia (4 patients, 9%). One reconversion was required. Complications
of gastric banding included epigastralgia (12 patients, 21%); persistent vomiting (9 patients, 16%);
erosion (2 patients, 3%); slippage (1 patient). Six patients (10%) required band removal.
Conclusions: Obesity surgery achieves stable weight loss, comorbidity resolution and cardiovascular
risk reduction. Accurate monitoring and treatment of complications will reduce the surgery-related
morbidity.
free of complications. This study compared clinical outcomes and long/short-term complications of
malabsorptive/restrictive surgery.
Methods: In the last five years, 102 severely obese patients were recruited to undergo surgery, 44
to malabsorptive surgery (Doldi biliointestinal bypass) and 58 to restrictive surgery (gastric banding).
Examinations at baseline and yearly for three years included anthropometry (weight, BMI); eating
behavior/habits; blood tests for nutritional status; cardiovascular risk score assessment; psychiatric/
endocrinological counseling; basal metabolism and body composition (fat/fat-free mass). After surgery,
any complication that occurred was recorded and treated.
Results: After three years, the mean weight loss was 46 kg (31%, p<0.01) for biliointestinal bypass
and 21 kg (19%, p<0.01) for gastric banding. Lipid and glycemic profiles returned to normal and eating
behavior improved after both procedures. Complications of biliointestinal bypass included nutritional
deficits, mainly of liposoluble vitamins (13 patients, 29%); gallstones (5 patients, 11%); kidney stones (3
patients, 7%); arthritis and arthralgia (4 patients, 9%). One reconversion was required. Complications
of gastric banding included epigastralgia (12 patients, 21%); persistent vomiting (9 patients, 16%);
erosion (2 patients, 3%); slippage (1 patient). Six patients (10%) required band removal.
Conclusions: Obesity surgery achieves stable weight loss, comorbidity resolution and cardiovascular
risk reduction. Accurate monitoring and treatment of complications will reduce the surgery-related
morbidity.