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Introduction : Les patients ayant survécu à un séjour prolongé en soins intensifs risquent de développer une faiblesse musculaire acquise en soins intensifs ainsi qu’une dénutrition impactant négativement leur autonomie et leur qualité de vie. La période qui suit la sortie des soins intensifs (post-USI) est une période importante sur le plan nutritionnel afin de prévenir les séquelles de la dénutrition. L’objectif de ce mémoire est d’étudier la dépense énergétique mesurée par calorimétrie indirecte, ainsi que son évolution, au cours de l’hospitalisation en post-USI chez des patients ayant séjourné au moins 7 jours en soins intensifs. Actuellement aucune recommandation énergétique n’existe pour ces patients. 

Méthodes : Une étude longitudinale a été réalisée dans le but de récolter la dépense énergétique mesurée par calorimétrie indirecte à l’aide du Q-NRG de Cosmed® à deux périodes au cours de l’hospitalisation en post-USI au CHU de Liège. Les résultats ont ensuite été comparés à ceux estimés par deux équations de prédiction. 

Résultats : 40 calorimétries indirectes ont été réalisées chez 25 patients dont 10 en ont eu une et 15 en ont eu deux. Aucune évolution significative n’est observée entre les deux dépenses énergétiques durant la période en post-USI. La dépense énergétique se situe entre 1347 (1145,5-1923) et 1715 (1330-1880,5) kcal soit 18,9 à 21,9 kcal/kg par jour sur base du poids réel et 19,6 à 23,8 kcal/kg par jour sur base du poids de calcul. L’analyse de Bland et Altman a permis d’évaluer la concordance entre les résultats calorimétriques et ceux obtenus à l’aide de l’équation de Penn State et la recommandation de l’ESPEN (25 kcal/kg par jour). Cette analyse a révélé qu’aucune des deux équations n’est fiable pour déterminer les besoins énergétiques des patients en post-USI. 

Conclusion : Cette étude montre que les besoins énergétiques des patients en post-USI se situent entre 19,6 et 23,8 kcal/kg par jour sur base du poids de calcul et qu’il n’y a pas de différence au niveau de la dépense énergétique au cours de l’hospitalisation en post-USI. Introduction: Patients who have survived a prolonged ICU stay are at risk of developing ICU-acquired muscle weakness and undernutrition that negatively impacts their autonomy and quality of life. The period following discharge from the ICU (post-ICU) is an important time as far as nutrition is concerned in order to prevent the sequelae of undernutrition. The objective of this dissertation is to study the energy expenditure measured by indirect calorimetry, as well as its evolution, during the post-ICU hospitalization for patients having stayed at least 7 days in intensive care. Currently no energy recommendation exists for these patients. 

Methods: A longitudinal study was carried out with the aim of collecting energy expenditure measured by indirect calorimetry using the Cosmed® Q-NRG twice during post-ICU hospitalization at the University Hospital of Liege. The results were then compared with those estimated by two prediction equations. 

Results: 40 indirect calorimeters were performed on 25 patients. Ten of them had one and fifteen had two calorimeters. No significant changes were observed between the two energy expenditures during the post-ICU period. Energy expenditure ranged from 1347 (1145.5-1923) to 1715 (1330-1880.5) kcal, i.e., 18,9 to 21,9 kcal/kg per day based on actual weight and 19,6 to 23,8 kcal/kg per day based on calculated weight. Bland and Altman's analysis allowed to assess the consistency between the calorimetric results and those obtained using the Penn State equation and the ESPEN recommendation (25 kcal/kg per day). This analysis revealed that neither of the equations is reliable to determine the energy requirements of post-ICU patients. 

Conclusion: This study shows that the energy expenditure of post-ICU patients is between 19,6 and 23,8 kcal/kg per day based on the calculated weight and that there is no difference in energy expenditure during the post-ICU hospitalization.

dépense énergétique --- post-USI --- calorimétrie indirecte --- équations de prédiction --- energy expenditure --- post-ICU --- indirect calorimetry --- prediction equations --- Sciences de la santé humaine > Anesthésie & soins intensifs

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Energy metabolism --- Respiration --- Indirect calorimetry --- Mathematics. --- Measurement --- Animal respiration --- Animals --- Breathing --- Ventilation (Physiology) --- Physiology --- Vital signs --- Aerobic exercises --- Breathing exercises --- Respiration calorimetry --- Calorimetry --- Bioenergetics --- Metabolism --- Microbial respiration --- Mathematics --- Measurement&delete&

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Calorimetry. --- Energy Metabolism. --- Enteral Nutrition. --- Nutritional Physiological Phenomena. --- Parenteral Nutrition. --- 613.2 --- Artificial feeding --- Energy metabolism --- -Indirect calorimetry --- Nutrition --- Alimentation --- Food --- Health --- Physiology --- Diet --- Dietetics --- Digestion --- Food habits --- Malnutrition --- Respiration calorimetry --- Calorimetry --- Bioenergetics --- Metabolism --- Microbial respiration --- Artificial nutrition --- Feeding, Artificial --- Intravenous Feeding --- Nutrition, Parenteral --- Parenteral Feeding --- Feeding, Intravenous --- Feeding, Parenteral --- Feedings, Intravenous --- Feedings, Parenteral --- Intravenous Feedings --- Parenteral Feedings --- Parenteral Nutrition Solutions --- Nutrition Phenomena --- Nutrition Physiological Concepts --- Nutrition Physiological Phenomenon --- Nutritional Phenomena --- Nutritional Physiological Phenomenon --- Nutritional Physiology --- Nutritional Physiology Concepts --- Nutritional Physiology Phenomenon --- Nutrition Physiological Phenomena --- Nutrition Physiology --- Nutritional Physiology Phenomena --- Concept, Nutrition Physiological --- Concept, Nutritional Physiology --- Concepts, Nutrition Physiological --- Concepts, Nutritional Physiology --- Nutrition Physiological Concept --- Nutritional Physiology Concept --- Phenomena, Nutrition --- Phenomena, Nutrition Physiological --- Phenomena, Nutritional --- Phenomena, Nutritional Physiological --- Phenomena, Nutritional Physiology --- Phenomenon, Nutrition Physiological --- Phenomenon, Nutritional Physiological --- Phenomenon, Nutritional Physiology --- Physiological Concept, Nutrition --- Physiological Concepts, Nutrition --- Physiological Phenomena, Nutrition --- Physiological Phenomena, Nutritional --- Physiological Phenomenon, Nutrition --- Physiological Phenomenon, Nutritional --- Physiology Concept, Nutritional --- Physiology Concepts, Nutritional --- Physiology Phenomena, Nutritional --- Physiology Phenomenon, Nutritional --- Physiology, Nutrition --- Physiology, Nutritional --- Nutritional Sciences --- Gastric Feeding Tubes --- Enteral Feeding --- Force Feeding --- Nutrition, Enteral --- Tube Feeding --- Feeding Tube, Gastric --- Feeding Tubes, Gastric --- Feeding, Enteral --- Feeding, Force --- Feeding, Tube --- Feedings, Force --- Force Feedings --- Gastric Feeding Tube --- Tube, Gastric Feeding --- Tubes, Gastric Feeding --- Energy Expenditure --- Bioenergetic --- Energy Expenditures --- Energy Metabolisms --- Expenditure, Energy --- Expenditures, Energy --- Metabolism, Energy --- Metabolisms, Energy --- Basal Metabolism --- Hot Temperature --- Transition Temperature --- Voedingsleer. Dieet --- Measurement --- Health aspects --- Nutrition Process --- Nutritional Process --- Nutritional Processes --- Nutrition Processes --- Process, Nutrition --- Process, Nutritional --- Processes, Nutrition --- Processes, Nutritional --- Phototrophic Processes --- Autotrophic Processes --- Heterotrophic Processes --- Chemoautotrophic Growth --- Indirect calorimetry --- Energy Metabolism --- Enteral Nutrition --- Nutritional Physiological Phenomena --- Parenteral Nutrition --- Calorimetry, indirect --- Enteral feeding

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Malnutrition lurks in the background of hospitalized medical patients. A large proportion of patients are malnourished upon hospital admission and patients often experience further nutritional deterioration during their stay and during disease recovery. However, although the negative effects of malnutrition on the outcomes of patients are well recognized, we still struggle to identify appropriate patients and efficacious nutritional interventions to overcome this problem. Recent studies have produced convincing evidence that adequate and timely nutritional management of medical in-patients can contribute to the prevention of negative consequences and thus improve the clinical outcome of patients. This Special Issue of the Journal of Clinical Medicine focuses on multiple practical aspects of nutritional management of medical in-patients, from screening for nutritional risk to the practical implementation of nutritional therapy and its possible complications, including financial aspects, to increasing clinician awareness and knowledge of nutritional care in hospitals.

Research & information: general --- Biology, life sciences --- Food & society --- type 1 diabetes mellitus --- bioelectrical impedance analysis --- phase angle --- children --- adolescents --- protein --- malnutrition --- critical care --- mortality --- outcomes --- hospital readmission --- ICU Survivors --- inflammation --- nutritional assessment --- biomarkers --- albumin --- prealbumin --- IGF-1 --- elderly --- prognostic marker --- Pediatric Intensive Care Unit --- enteral nutrition --- early parenteral nutrition --- critical illness --- iron --- copper --- selenium --- zinc --- thiamine --- vitamin B12 --- obesity --- glucose control --- hyperglycemia --- parenteral nutrition --- nutritional support --- insulin --- Geriatric patients --- older persons --- therapy --- interventions --- chronic critical illness --- Nutrition Risk Screening (NRS-2002) --- age --- nutrition --- vasopressors --- shock --- glucose --- diabetes --- underfeeding --- economic challenges --- nutritional management --- mid-arm muscle circumference --- dual-energy X-ray absorptiometry --- computed tomography --- fat-free mass --- appendicular skeletal muscle mass --- lean soft tissue --- skeletal muscle index --- chronic disease --- old --- anorexia nervosa --- refeeding syndrome --- weight gain --- length of stay --- nutritional risk screening --- monitoring --- micronutrient deficiency --- oral nutritional supplements --- artificial nutrition --- gastroparesis --- dumping syndrome --- pathophysiology --- clinical presentation --- treatment --- nutritional therapy --- cancer --- cachexia --- sarcopenia --- survival --- nutritional support team --- efficacy --- metabolic syndrome --- insulin resistance --- dietary pattern --- carbohydrates --- fat --- indirect calorimetry --- indirect calorimeter --- resting energy expenditure --- nutrition therapy --- medical nutrition therapy --- intensive care unit --- intermediate care unit --- critically ill patients --- nutritional counselling --- nursing --- e-counselling --- dehydration --- dysphagia --- fluid intake --- water --- cirrhosis --- ascites --- sarcopenic obesity --- vitamins --- micronutrients --- all-in-one parenteral admixture --- compatibility --- stability --- pharmaceutical expertise --- drug admixing --- drug administration --- hospital --- nutrition care --- continuity of care --- process indicators --- benchmarking --- disease related malnutrition. --- diagnosis --- management --- hypophosphatemia --- n/a

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Starting from a kinase of interest, AMP-activated protein kinase (AMPK) has gone far beyond an average biomolecule. Being expressed in all mammalian cell types and probably having a counterpart in every eukaryotic cell, AMPK has attracted interest in virtually all areas of biological research. Structural and biophysical insights have greatly contributed to a molecular understanding of this kinase. From good old protein biochemistry to modern approaches, such as systems biology and advanced microscopy, all disciplines have provided important information. Thus, multiple links to cellular events and subcellular localizations have been established. Moreover, the crucial involvement of AMPK in human health and disease has been evidenced. AMPK accordingly has moved from an interesting enzyme to a pharmacological target. However, despite our extensive current knowledge about AMPK, the growing community is busier than ever. This book provides a snapshot of recent and current AMPK research with an emphasis on work providing molecular insight, including but not limited to novel physiological and pathological functions, or regulatory mechanisms. Up-to-date reviews and research articles are included.

n/a --- HDACs --- transcription --- epigenetics --- spermatozoa --- par complex --- A769662 --- MDCK --- skeletal muscle --- AID --- phosphorylation --- energy metabolism --- monocytes --- autophagy --- CML --- liver --- hindlimb suspension --- pregnancy --- preeclampsia --- gestational diabetes mellitus --- CaMKK2 --- assisted reproduction techniques --- nutrient-sensing signals --- sonic hedgehog --- protein acetylation --- glycogen storage disease --- AMPK --- adenosine monophosphate-activated protein kinase --- AICAR --- indirect calorimetry --- IL-1? --- MyHC I(?) --- HDAC4/5 --- endothelial cells --- infection --- hepatocyte --- p70S6K --- lipid metabolism --- host defense --- exercise --- kidney disease --- heat shock protein --- ?RIM --- mycobacteria --- activation loop --- developmental origins of health and disease (DOHaD) --- CREB --- TAK1 --- metabolic-inflammation --- phenylephrine --- AMP-activated protein kinase (AMPK) --- KATs --- 2-methoxyestradiol --- DNA methylation --- NLRP3 --- pump --- ?-linker --- steatosis --- AMPK kinase --- stress --- endothelial nitric-oxide synthase --- vasodilation --- adherent junctions --- epithelial cells --- glycogen --- Akt --- synaptic activation --- cellular energy sensing --- glucose uptake --- transporter --- co-expression --- atrophy --- nutrigenomics --- motility --- vasoconstriction --- fatty acid oxidation --- oxidative stress --- AS160 --- membrane --- histone modification --- sirtuin 1 (SIRT1) --- chromatin remodeling --- insulin signalling --- dietary fatty acids --- ULK --- CMML --- adaptive thermogenesis --- mTOR --- MDS --- mechanical unloading --- AML --- endothelial function --- medulloblastoma --- PKA --- adipose tissue --- NAD⁺ --- membranes --- nutrition --- ZO-1 --- TBC1D4 --- adipocyte --- soluble Adenylyl cyclase --- metabolism --- renin-angiotensin system --- energy utilization --- proteasome --- differentiation --- signaling --- peroxisome proliferator-activated receptor gamma coactivator 1-? (PGC1?) --- hypertrophy --- AMP-activated protein kinase --- metabolic disease --- LKB1 --- soleus muscle --- macrophages --- Immediate early genes --- CBS --- beiging --- motor endplate remodeling --- ionomycin --- nectin-afadin --- tight junctions --- resveratrol --- protein kinase B --- regrowth --- mitochondria --- protein synthesis --- energy deficiency --- catechol-O-methyltransferase --- fiber-type --- microarrays --- carrier --- acetyl-CoA --- hypertension --- 3T3-L1 --- hypothalamus --- food intake --- benign