Medicine and Health Sciences Commons^™

Assessing Nutritional Health Knowledge In Sharing Clinic Patients With Diabetes, Minden Huntrods

Capstone Experience

Effective diabetes prevention and management relies on nutritional behaviors, thus a basic level of health knowledge is important for patients with diabetes and their caregivers in their quest to acquire acute glycemic control and minimize negative health outcomes (Ley et al., 2014). The purpose of this study was to assess the nutrition-related health knowledge of patients living with diabetes who are seen at the UNMC Sharing Clinic by use of a verbal questionnaire. This nutritional health knowledge assessment was a quantitative, prospective, survey-based study utilizing descriptive statistics. Approximately 86% of patients were proficient in food group and nutritious foods knowledge …

Diet Significantly Influences The Immunopathology And Severity Of Kidney Injury In Male C57bl/6j Mice In A Model Dependent Manner, John E. Brus, Daniel L. Quan, Kristin J. Wiley, Brittney Browning, Hannah Ter Haar, Riley Lutz, Jeffrey F. Houghton, Joseph Gigliotti

College of Osteopathic Medicine Undergraduate Publications

Diet is a leading causative risk factor for morbidity and mortality worldwide, yet it is rarely considered in the design of preclinical animal studies. Several of the nutritional inadequacies reported in Americans have been shown to be detrimental to kidney health; however, the mechanisms responsible are unclear and have been largely attributed to the development of diabetes or hypertension. Here, we set out to determine whether diet influences the susceptibility to kidney injury in male C57Bl/6 mice. Mice were fed a standard chow diet, a commercially available “Western” diet (WD), or a novel Americanized diet (AD) for 12 weeks prior …

Guide To Popular Diets, Food Choices, And Their Health Outcome, Ronald D. Hills Jr., Emily Erpenbeck

Pharmaceutical Sciences Faculty Publications

Integrative medicine is becoming increasingly important for a patient population afflicted with preventable illnesses such as cardiometabolic disease. Diet and nutrition are an under-tapped opportunity in health care for improving wellness and patient-centered health outcomes. Key nutritional principles are reviewed for alternate dietary strategies patients choose from in pursuit of healthy living or to alleviate chronic illness. Whole food eating plans are discussed including plant-based, Mediterranean, Paleo, and ketogenic diets as well as the specific carbohydrate and low FODMAP diets for colitis and irritable bowel syndrome. Opposed to the traditional categorization of diets by macronutrient composition, it is more useful …

Drug-Induced Nutrient Depletion, Rodney Richmond

College of Pharmacy Faculty Research ​and Publications

No abstract provided.

The Prevalence Of Dietary Supplement Use Among Older Adult Population Using National Health And Nutrition Examination Survey (Nhanes) 2009-2012, Fawaz M. Alotaibi

Theses and Dissertations

Background: Dietary supplements (DS) use has increased in the U.S. in the past 20 years. More than half of the U.S. population reported using DS. There are few studies to our knowledge that have assessed DS use specifically for older adults. In this study we purposed to evaluate the trend of using DS among older adults and to test the association between using DS and several demographics, socioeconomics and health characteristics. The second objective was to evaluate the reasons behind using DS among older adults using a nationally representative database.

Methods: This is a cross sectional study using the most …

Munch A Bunch, Ginger D. Cameron

Pharmacy Practice Faculty Presentations

No abstract provided.

Oxandrolone In Trauma Patients, Jane M. Gervasio, Roland N. Dickerson, Jessica Swearingen, Mary E.D. Yates, Ceaminia Yuen, Timothy C. Fabian, Martin A. Croce, Rex O. Brown

Jane M. Gervasio

Study Objective To determine the effect of oxandrolone administration on nutritional and clinical outcomes after multiple trauma. Design Prospective, randomized, double-blind, placebo-controlled study. Setting. Level 1 trauma center in a university teaching hospital. Patients Sixty-two patients requiring enteral nutrition, 60 of whom completed the study. Intervention Patients were randomized to receive either oxandrolone 10 mg or placebo twice/day for a maximum of 28 days. Measurements and Main Results Total urinary nitrogen, prealbumin, nitrogen balance, total body water, and body cell mass were measured on day 1 of enteral nutrition and then at day 7, day 10, and study exit. Patients …

A Comparison Of Renal Phosphorus Regulation In Thermally-Injured And Multiple Trauma Patients Receiving Specialized Nutrition Support, Roland N. Dickerson, Jane M. Gervasio, Justin J. Sherman, Kenneth A. Kudsk, William L. Hickerson, Rex O. Brown

Jane M. Gervasio

To compare phosphorus intake and renal phosphorus regulation between thermally injured patients and multiple trauma patients, 40 consecutive critically ill patients, 20 with thermal injury and 20 with multiple trauma, who required enteral tube feeding were evaluated. Phosphorus intakes were recorded for 14 days from the initiation of tube feeding which was started 1 to 3 days post-injury. Serum for determination of phosphorus concentrations was collected at days 1, 3, 7, and 14 of the study period. A 24-hour urine collection was obtained during the first and second weeks of nutrition support for urinary phosphorus excretion, fractional excretion of phosphorus, …

Nutrition In The Critically Ill Patient, Jane M. Gervasio

Jane M. Gervasio

Critical illness presents with the classic response to stress, including hypermetabolism and increased catabolism, resulting in a negative energy and nitrogen balance. These harmful events initiate the immunological response, starting with the systemic inflammatory response syndrome, which, if not resolved, may lead to multiple organ dysfunction syndrome (MODS). Furthermore, patients who do not develop early MODS manifest a compensation anti-inflammatory response syndrome, which suppresses immunity and predisposes the patient to sepsis, thereby ­increasing the risk of late MODS and ultimately death. The use of specialized nutrition support, including enteral nutrition (EN) and parenteral nutrition (PN), has been initiated in an …

Anabolic Agents: Adjuncts To Nutrition Support, Jane Gervasio

Jane M. Gervasio

Anabolic agents as adjuncts to nutrition support therapy have been used to improve malnutrition and establish anabolism. Growth hormone, insulin-like growth factor, and anabolic steroids have been studied for their potential to reverse the catabolic process and promote anabolism. This paper reviews several anabolic agents and their possible role in nutrition support therapy.

Nutrition Support Therapy In Acute Kidney Injury: Distinguishing Dogma From Good Practice, Jane M. Gervasio, Ann B. Cotton

Jane M. Gervasio

Acute kidney injury (AKI) is a frequently observed complication in critically ill patients. Its presentation may range from the early risk of renal dysfunction to complete renal failure. Morbidity and mortality in the AKI patient increase with the decline of renal function. Appropriate nutrition therapy is essential in the medical management of the AKI patient. Assessment of nutritional requirements should take into account the patient’s underlying complication, comorbid medical conditions, and severity of the renal dysfunction. Various stages of AKI determine the direction of nutrition therapy. Additionally, understanding the macro- and micronutrient modifications and electrolyte and vitamin alterations that should …

Nutrition Support In Acute Kidney Injury, Jane M. Gervasio, Wesley P. Garmon, Michael Holowatyj

Jane M. Gervasio

Acute kidney injury is a frequent complication affecting many hospitalized patients and is associated with increased morbidity and mortality. Acute kidney injury often occurs in conjunction with critical illness, which is a hypermetabolic state presenting with hyperglycemia, insulin resistance, hypertriglyceridemia, and increased protein catabolism. In addition to addressing these changes, the clinician should evaluate the important nutrition implications of decreased kidney function. These include vitamins, electrolytes, minerals, trace elements, and the presence and type of renal replacement therapy. Optimal nutrition management in acute kidney injury includes providing adequate macronutrient support to correct underlying conditions and prevent ongoing loss, supplementing micronutrients …

Compounding Vs Standardized Commercial Parenteral Nutrition Product: Pros And Cons, Jane M. Gervasio

Jane M. Gervasio

Standardized commercial parenteral nutrition (PN) formulations have advantages and disadvantages as compared with PN formulations compounded using an automated compounding device. These advantages and disadvantages are discussed along with the supporting available research.

A.S.P.E.N. Parenteral Nutrition Safety Consensus Recommendations, Phil Ayers, Stephen Adams, Joseph Boullata, Jane M. Gervasio, Beverly Holcombe, Michael D. Kraft, Neil Marshall, Antoinette Neal, Gordon Sacks, David S. Seres, Patricia Worthington

Jane M. Gervasio

Parenteral nutrition (PN) serves as an important therapeutic modality that is used in adults, children, and infants for a variety of indications. The appropriate use of this complex therapy aims to maximize clinical benefit while minimizing the potential risks for adverse events. Complications can occur as a result of the therapy and as the result of the PN process. These consensus recommendations are based on practices that are generally accepted to minimize errors with PN therapy, categorized in the areas of PN prescribing, order review and verification, compounding, and administration. These recommendations should be used in conjunction with other A.S.P.E.N. …

A.S.P.E.N. Parenteral Nutrition Safety Consensus Recommendations, Phil Ayers, Stephen Adams, Joseph Boullata, Jane M. Gervasio, Beverly Holcombe, Michael D. Kraft, Neil Marshall, Antoinette Neal, Gordon Sacks, David S. Seres, Patricia Worthington, American Society For Parenteral And Enteral Nutrition

Scholarship and Professional Work – COPHS

Parenteral nutrition (PN) serves as an important therapeutic modality that is used in adults, children, and infants for a variety of indications. The appropriate use of this complex therapy aims to maximize clinical benefit while minimizing the potential risks for adverse events. Complications can occur as a result of the therapy and as the result of the PN process. These consensus recommendations are based on practices that are generally accepted to minimize errors with PN therapy, categorized in the areas of PN prescribing, order review and verification, compounding, and administration. These recommendations should be used in conjunction with other A.S.P.E.N. …

Compounding Vs Standardized Commercial Parenteral Nutrition Product: Pros And Cons, Jane M. Gervasio

Scholarship and Professional Work – COPHS

Standardized commercial parenteral nutrition (PN) formulations have advantages and disadvantages as compared with PN formulations compounded using an automated compounding device. These advantages and disadvantages are discussed along with the supporting available research.

The Effects Of A Multi-Component Wellness Program On Employee Biometrics, Jennifer Erin Patrick

Electronic Theses and Dissertations

Corporate wellness initiatives are gaining momentum as a critical indicator of business performance. Metabolic Syndrome is commonly used within corporations to assess the health of their employees and estimate potential healthcare costs. Using five risk factors (blood pressure, high density lipoprotein (HDL-C), triglycerides (TG), fasting blood glucose, and waist circumference) individuals with three or more risk factors are classified as having Metabolic Syndrome. Voluntary pre and post health screenings were conducted at a rural manufacturing plant. A multi-component wellness program was conducted over six months to determine if the program would have significant beneficial effects on employee biometrics and Metabolic …

Premix Vs. Compounding, Jane Gervasio

Jane M. Gervasio

No abstract provided.

Nutrition Support In Acute Kidney Injury, Jane M. Gervasio, Wesley P. Garmon, Michael Holowatyj

Scholarship and Professional Work – COPHS

Acute kidney injury is a frequent complication affecting many hospitalized patients and is associated with increased morbidity and mortality. Acute kidney injury often occurs in conjunction with critical illness, which is a hypermetabolic state presenting with hyperglycemia, insulin resistance, hypertriglyceridemia, and increased protein catabolism. In addition to addressing these changes, the clinician should evaluate the important nutrition implications of decreased kidney function. These include vitamins, electrolytes, minerals, trace elements, and the presence and type of renal replacement therapy. Optimal nutrition management in acute kidney injury includes providing adequate macronutrient support to correct underlying conditions and prevent ongoing loss, supplementing micronutrients …

Trauma Nutrition, Jane Gervasio

Jane M. Gervasio

No abstract provided.

Healthy Weight Projects, Jane Gervasio

Jane M. Gervasio

No abstract provided.

Nutrition Support Therapy In Acute Kidney Injury: Distinguishing Dogma From Good Practice, Jane M. Gervasio, Ann B. Cotton

Scholarship and Professional Work – COPHS

Acute kidney injury (AKI) is a frequently observed complication in critically ill patients. Its presentation may range from the early risk of renal dysfunction to complete renal failure. Morbidity and mortality in the AKI patient increase with the decline of renal function. Appropriate nutrition therapy is essential in the medical management of the AKI patient. Assessment of nutritional requirements should take into account the patient’s underlying complication, comorbid medical conditions, and severity of the renal dysfunction. Various stages of AKI determine the direction of nutrition therapy. Additionally, understanding the macro- and micronutrient modifications and electrolyte and vitamin alterations that should …

A Comparison Of The Efficacy Of 0.5 Units/Ml Versus 1 Unit/Ml Of Heparin In Neonatal Parenteral Nutrition, E. Szeszycki, A. Kastner, L. Mobley, Jane Gervasio

Jane M. Gervasio

Abstract of distinction from ASPEN Nutrition Week, New Orleans, LA, February 1-4, 2009.

Permissive Underfeeding In Trauma Patients, L. Current, Jane Gervasio, J. Ash, L. Bortenschlager, T. Pohlman

Jane M. Gervasio

Abstract from the ASHP Midyear Clinical Meeting, Orlando, FL, December 6-11, 2008.

Nutrition In The Critically Ill Patient, Jane M. Gervasio

Scholarship and Professional Work – COPHS

Critical illness presents with the classic response to stress, including hypermetabolism and increased catabolism, resulting in a negative energy and nitrogen balance. These harmful events initiate the immunological response, starting with the systemic inflammatory response syndrome, which, if not resolved, may lead to multiple organ dysfunction syndrome (MODS). Furthermore, patients who do not develop early MODS manifest a compensation anti-inflammatory response syndrome, which suppresses immunity and predisposes the patient to sepsis, thereby ­increasing the risk of late MODS and ultimately death. The use of specialized nutrition support, including enteral nutrition (EN) and parenteral nutrition (PN), has been initiated in an …

Anabolic Agents: Adjuncts To Nutrition Support, Jane M. Gervasio

Scholarship and Professional Work – COPHS

Anabolic agents as adjuncts to nutrition support therapy have been used to improve malnutrition and establish anabolism. Growth hormone, insulin-like growth factor, and anabolic steroids have been studied for their potential to reverse the catabolic process and promote anabolism. This paper reviews several anabolic agents and their possible role in nutrition support therapy.

Food Based Approaches For A Healthy Nutrition In Africa, Mamoudou Hama Dicko

Pr. Mamoudou H. DICKO, PhD

The latest estimates of the FAO demonstrate the problems of the fight against hunger. These problems are manifested by the ever-increasing number of chronically undernourished people worldwide. Their numbers during the 1999-2001 period were estimated at about 840 million of which 798 million live in developing countries. Sub-Saharan Africa alone represented 198 million of those. In this part of Africa the prevalence of undernourishment ranges from 5-34%, causing growth retardation and insufficient weight gain among one third of the children under five years of age and resulting in a mortality of 5-15% among these children. Malnutrition resulting from undernourishment is …

A Comparison Of Renal Phosphorus Regulation In Thermally-Injured And Multiple Trauma Patients Receiving Specialized Nutrition Support, Roland N. Dickerson, Jane M. Gervasio, Justin J. Sherman, Kenneth A. Kudsk, William L. Hickerson, Rex O. Brown

Scholarship and Professional Work – COPHS

To compare phosphorus intake and renal phosphorus regulation between thermally injured patients and multiple trauma patients, 40 consecutive critically ill patients, 20 with thermal injury and 20 with multiple trauma, who required enteral tube feeding were evaluated. Phosphorus intakes were recorded for 14 days from the initiation of tube feeding which was started 1 to 3 days post-injury. Serum for determination of phosphorus concentrations was collected at days 1, 3, 7, and 14 of the study period. A 24-hour urine collection was obtained during the first and second weeks of nutrition support for urinary phosphorus excretion, fractional excretion of phosphorus, …

Oxandrolone In Trauma Patients, Jane M. Gervasio, Roland N. Dickerson, Jessica Swearingen, Mary E.D. Yates, Ceaminia Yuen, Timothy C. Fabian, Martin A. Croce, Rex O. Brown

Scholarship and Professional Work – COPHS

Study Objective

To determine the effect of oxandrolone administration on nutritional and clinical outcomes after multiple trauma.

Design

Prospective, randomized, double-blind, placebo-controlled study. Setting. Level 1 trauma center in a university teaching hospital.

Patients

Sixty-two patients requiring enteral nutrition, 60 of whom completed the study.

Intervention

Patients were randomized to receive either oxandrolone 10 mg or placebo twice/day for a maximum of 28 days.

Measurements and Main Results

Total urinary nitrogen, prealbumin, nitrogen balance, total body water, and body cell mass were measured on day 1 of enteral nutrition and then at day 7, day 10, and study exit. Patients …