Journal of Japanese Society for Parenteral and Enteral Nutrition

Background: At nursing homes, caregivers are providing various cares and assistance to residents. This study investigated the loss of body fluid in caregivers observed during bathing assistance. The environmental conditions at bathing rooms were also monitored for analysis.
Methods: The study was designed as an observational study. A total of 17 staff members at 3 nursing homes, who were doing bathing assistance to the elderly, were studied three times (winter, spring, and summer times) between December 1, 2011 and August 31, 2012. The staff members were studied by noninvasive evaluation methods before and after bathing assistance. Primary endpoints were body fluid loss (as calculated by body weight and estimated equation) in caregivers and changes in oral cavity fluid volume and urine specific gravity. Secondary endpoints were energy consumption, salivary amylase, physical conditions, and environmental conditions such as temperature and humidity at bathing rooms.
Results: A significant decrease was noted in oral cavity fluid volume and blood pressure (mean value) after bathing assistance, with a significant increase in salivary amylase. Pulse rate, body temperature, and urine specific gravity showed an increase but not significant. Body weight was decreased by 0.5±0.6 %, together with body fluid loss of 3.2±2.3 mL/kg/hr and energy consumption of 1.7±0.3 kcal/kg/hr. Environmental conditions at bathing rooms during the study period were 27.3±1.4°C in temperature and 85.7±15.7% in humidity.
Conclusion: Mild dehydration was observed in caregivers at the time of bathing assistance. For the correction of such condition, a supply of water at 3.2±2.3 mL/kg/hr was considered favorable.

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A research on food intake by patients receiving outpatient nutritional counselling after gastric cancer surgery was conducted on approximately 30th and 90th day after surgery. The energy intake and the dietary details were estimated using a self-administered food frequency questionnaire (FFQW82). The peak of decrease in the estimated energy intake (EEI) was observed within 90 days of the surgery. At 90th postoperative day, EEI passed nadir but was still lower than preoperative EEI. The oral intake of meet and oil was decreased, and the nutritional intake of carbohydrate was decreased. These unbalanced food intakes arose earlier from surgery, probably irrespective of the patient's intention. Therefore, to correct the postoperative dietary habits, outpatient nutritional counselling should be performed in the early postoperative period. Our research implies that a longer nutritional support is desirable because the food intake is still unsatisfactory even after 90 days from gastric surgery.

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Objectives: Postoperative steatosis is sometimes found in patients undergoing liver transplantation (LT). However, the nutritional significance is unclear. Therefore, we investigated nutritional significance and risk factor for postoperative steatosis in the early period after LT.
Methods: We retrospectively analyzed 117 patients who underwent adult living donor LT in our center between May 2010 and September 2012. Sixty-two of 117 patients underwent liver biopsy due to liver dysfunction during hospitalization. We compared various nutritional parameters including daily calorie intake per ideal body weight, ratio of non-protein calorie-to-nitrogen, and route of calorie intake between steatosis group (histologically diagnosed steatosis equal or more than 5%, n=41) and non-steatosis group (steatosis less than 5%, n=21). Moreover, the change of fatty acid level before and after the diagnosis of steatosis and risk factor for posttransplant steatosis were analyzed.
Results: Calorie intake, ratio of non-protein calorie-to-nitrogen, and bloodchemical data just before diagnosis did not differ between steatosis group and non-steatosis group. Interestingly, distribution of 2 peaks characteristics in calorie intake, namely calorie over and calorie shortage, was found in the steatosis group. Calorie over or calorie shortage was a risk factor for posttransplant steatosis. Route of calorie intake was significantly different between patients with calorie over and calorie shortage. The ratio of eicosapentaenoic acid to arachidonic acid significantly decreased after the diagnosis of steatosis.
Conclusions: Posttransplant steatosis was closely involved with calorie over or calorie shortage. Decrease in the ratio of eicosapentaenoic acid to arachidonic acid would be useful as a surrogate marker of posttransplant steatosis.

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