PLOS BiologySep 17, 2024
Refeeding after #fasting can lead to a "#FatOvershoot." @goldstein_lab @cumminslab &co examine the kinetics of #refeeding-induced transcriptional & chromatin changes, revealing a #lipogenic overshoot program regulated by the TF LXRα #PLOSBiology https://plos.io/4eukvi5
LXR-dependent enhancer activation regulates the temporal organization of the liver’s response to refeeding leading to lipogenic gene overshoot

Refeeding after a period of fasting induces a metabolic switch in the liver and can lead to a ’fat overshoot’, where fat mass surpasses pre-fasting levels. The study elucidates the kinetics of transcriptional and chromatin changes induced by refeeding, revealing a lipogenic overshoot program that is regulated by the transcription factor LXRα.

Show threadStefan Müller Jun 8, 2024

2/ Wie toll muss es sein, nach 92 Tagen Hungerstreik, eine Erdbeere essen zu können.

Seit vorgestern hat WMK den Hungerstreik ausgesetzt und isst wieder.

Ich habe ihn gefragt, wie das überhaupt geht, weil er ja am Anfang noch nicht so viel essen kann. Er hat bestimmte Kalorienvorgaben. Nach dem Krieg sind total ausgehungerte Heimkehrer gestorben, weil sie plötzlich zu viel zu essen hatten und der Körper damit nicht klarkam. Ich dachte, dass am Anfang wenig mehr geht als das, was der Körper direkt wieder verbraucht, aber WMK meinte, er könne wieder Gewicht aufbauen für eine eventuelle zweite Phase des Hungerstreiks.

#Refeeding

#WirWollenLeben
#HungernBisIhrEhrlichSeid #Hungerstreik2024
#Hungerstreik

Show threadAMPEL-CDSSSep 11, 2023

We found:

• Out of all prospective #CDSS alerts, 67% accurately detected #Refeeding syndrome

• In just 6 months, we identified 13 patients who would have missed out on therapy otherwise

• It was not possible to calculate sensitivity [Limitation]

https://doi.org/10.3390/nu15173712

#MedicalAI in Clinical Decision Support Systems can identify uncommon diseases, enhancing #PatientSafety. AMPEL-CDSS is an #OpenScience project, we're thrilled to provide all the details!

#AMPEL #Nutrition #AI

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Development, Design and Utilization of a CDSS for Refeeding Syndrome in Real Life Inpatient Care—A Feasibility Study

Background: The refeeding syndrome (RFS) is an oftentimes-unrecognized complication of reintroducing nutrition in malnourished patients that can lead to fatal cardiovascular failure. We hypothesized that a clinical decision support system (CDSS) can improve RFS recognition and management. Methods: We developed an algorithm from current diagnostic criteria for RFS detection, tested the algorithm on a retrospective dataset and combined the final algorithm with therapy and referral recommendations in a knowledge-based CDSS. The CDSS integration into clinical practice was prospectively investigated for six months. Results: The utilization of the RFS-CDSS lead to RFS diagnosis in 13 out of 21 detected cases (62%). It improved patient-related care and documentation, e.g., RFS-specific coding (E87.7), increased from once coded in 30 month in the retrospective cohort to four times in six months in the prospective cohort and doubled the rate of nutrition referrals in true positive patients (retrospective referrals in true positive patients 33% vs. prospective referrals in true positive patients 71%). Conclusion: CDSS-facilitated RFS diagnosis is possible and improves RFS recognition. This effect and its impact on patient-related outcomes needs to be further investigated in a large randomized-controlled trial.

MDPI
AMPEL-CDSSSep 11, 2023

Common things are common, and when you hear hoof beats, think of horses, not zebras!

With these teaching pearls, physicians are trained to focus on common and likely diagnoses. Unfortunately, the #Refeeding syndrome is not particularly common.

To explore if #MedicalAI can detect such uncommon diseases, we have developed a laboratory based algorithm for the #RefeedingSyndrome

https://doi.org/10.3238/arztebl.m2022.0381

We are now able to share prospective data:

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Refeeding Syndrome (17.02.2023)

Malnourished patients in whom feeding is resumed following significantly reduced or no caloric intake lasting at least 5 days are at risk for refeeding syndrome (RFS). Any form of feeding can cause RFS: oral, enteral, parenteral as well as simple...

Deutsches Ärzteblatt
CyrusJun 26, 2023

Isn’t it fantastic that, after having become severely malnourished from #gastroparesis, the weight that you put on from #refeeding is mostly fat mass stored in the abdomen* that is linked to obvious health risks, on top of those you have from being bedridden by #MECFS and #POTS?

(Of course, it goes without saying that being malnourished is much more of a concern and everything should be done to put enough weight back on. But still, it sucks to be sedentary…)

* https://pubmed.ncbi.nlm.nih.gov/30806320/

Body Composition in Adolescents and Young Adults with Anorexia Nervosa: A Clinical Review - PubMed

Anorexia nervosa adversely affects body composition, however this medical complication seems to be reversible through the main treatment strategy of body weight restoration followed by normal weight maintenance, and this should be openly discussed with patients.

PubMed
AMPEL-CDSSMay 26, 2023

AMPEL-CDSS detects patients with refeeding syndrome. The majority would have remained undetected without our decision support system. Here is the press release of the University Hospital Leipzig:

https://www.uniklinikum-leipzig.de/presse/Seiten/Pressemitteilung_7685.aspx

#Refeeding #RefeedingSyndrome #CDSS #AMPEL #UKL #Leipzig

Refeeding-Syndrom bleibt häufig unerkannt