Prognostic Nutritional

Buzby GP, MuUen JL, Matthews DC, Hobbs CL, Rosato EF. Prognostic nutritional index in gastrointestinal surgery. Am J Surg 1980 139 160-7. 

This process includes dietary, anthropometric, and biochemical aspects. Nutritional assessment begins with a detailed nutritional history that includes clinical, dietary, socioeconomic, and family issues. Areas of interest include present and past illnesses, family illness history, food allergies or intolerance, medications, nutritional supplements, over-the-counter medications, alcohol use, work environment, and education level. A useful standardized protocol is the Prognostic Nutritional Index (PNI), which incorporates serum albumin, serum transferrin, delayed skin hypersensitivity, and triceps skinfold thickness (20,21). The PNI has been shown to correlate with postoperative complications and mortality (22). Whole body functional assessment by examining overall activity, exercise tolerance, grip strength, respiratory function, wound healing, and plasma albumin concentration can also be useful. 

Kukharev, N.N., Rebik, S.T. and Trushin, Yu.K. (1988). On the problem of trophic activity of schooling pelagic and demersal fish inhabiting hypoxic waters of the western Arabian Sea (In Russian). In Nutrition of Marine Fish and Utilisation of the Nutritive Base as an Element of Fisheries Prognostication , pp.124-125. Murmansk. 

Exposure assessment is done under the strong assumptions that (1) an adequate model for exposure calculation is on hand and (2) sufficient data about all influential exposure factors are available. The calculation is a prognosis about the expected level of exposure or the burden. Direct methods of exposure assessment, such as personal sampling (air, radiation), duplicate studies (nutrition) and human biomonitoring, provide information on a measurement level. The exposure assessors and the risk managers should balance the reasons for using prognostic techniques instead of direct exposure measurement methods. Both should anticipate critical questions about the validity of the exposure assessment technique in the course of public risk communication. Questions heard by the authors from concerned persons include, for example ... 

Causes of fatty liver are manifold, and combinations of causes quite common. Acquired causes are by far the most frequent, but there are also rare causes, e.g. coeliac disease (9, 25), parenteral nutrition. (28, 29) Congenital metabolic disorders can also lead to the development of a fatty liver, as in the case of a rare thesaurismosis. It is of considerable therapeutic and prognostic importance to differentiate between an alcoholic fatty liver (AFL) and alcoholic steatohepatitis (ASH) (s. pp 529, 531) as well as between non-alcoholic fatty liver (NAFLD) and non-alcoholic steatohepatitis (NASH). (2, 20, 24, 36) (s. tabs. 31.5-31.7)... 

In clinical practice, only a few laboratory tests are of value in tlie assessment of protein-energy status It is particularly important to recognize that serum protein concentrations are not helpful in sick patients with any form of inflammatory process (see Chapter 20). Although serum albumin is often measured and reported as an indicator of protein-energy status, factors such as increased transcapillary escape and reduced hepatic synthesis malce it of little value as a nutritional marker. Serum albumin is, however, a valuable prognostic marker and is frequently used as part of prognostic indices. Short half-life proteins, such as transthyretin (prealbumin) also may be of some limited value in patients with no inflammatory response. 

Lobato-Mendizabal E, Lopez-Martinez B, Ruiz-Arguelles GJ. A critical review of the prognostic value of the nutritional status at diagnosis in the outcome of therapy of children with acute lymphoblastic leukemia. Rev Invest CUn 2003 55 31-35. 

Landbo C, et al. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999 160 1856-1861. 

Lima, L.F., Leite, H.P., and Taddei, J.A., 2011. Low blood thiamine concentrations in children upon admission to the intensive care unit risk factors and prognostic significance. The American Journal of Clinical Nutrition. 93 57-61. 

Asensio A, Ramos A, Nunez S. Prognostic factors for mortality related to nutritional status in the hospitalized elderly. Med Clin 2004 123 370-373. 

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