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TABLE OF CONTENTS
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| 2 | Guest Editor's Column
Paula Charuhas Macris, MS, RD, CSO, CD, FADA
Children with chronic diseases often have altered nutrient
requirements and need specialized nutrition support to promote
normal growth and development. Parenteral and enteral nutrition has
improved the health outcomes and quality of life for many pediatric
patients with complex medical issues. |
| 2 | Chair's Column
Gail Cresci, PhD, RD, LD, CNSD
The spring season is upon us, and life is bursting fully and brightly. I find
it unbelievable that this is my last column to write as Chair of Dietitians
in Nutrition Support (DNS). I am proud to reflect upon all the wonderful
activities occurring within this fabulous Dietetics Practice Group (DPG). |
| 3 | Advanced Practice Residency in Nutrition Support Therapy
Jennifer Wooley, MS, RD, CNSC, Cindy Hamilton, MS, RD, LD
Introduction
Dietitians in Nutrition Support (DNS),
in alignment with the Advancement in
Dietetic Careers Initiative of the Academy
of Nutrition and Dietetics, is developing
an advanced practice residency (APR). The
programmatic goal of the residency is to
provide training, skills, and mentorship
to create advanced practice nutrition
support dietitians who can deliver safe
and evidence-based medical nutrition
therapy to patients across the health care
continuum. |
| 5 | Nutrition Support of the Pediatric Oncology Patient
Lisa Cherry, MS, RD, CNSC, Lindsay Rypkema, RD, CNSC
Cancer is the most common cause of
disease-related deaths in children younger
than the age of 15 years (1,2). Fortunately,
survival rates in children have increased
over the past few decades. Current statistics
from the National Cancer Society estimate
that childhood cancer survival rates have
increased from 58% for children diagnosed
from 1975 to 1977 to 83% for those
diagnosed between 2002 and 2008 (3). |
| 12 | Nutrition Management of Pediatric Chronic Kidney Disease
Brandis Roman, MS, RD, CNSD
Chronic kidney disease (CKD) results in
electrolyte, fluid, and metabolic abnormalities
that significantly affect nutrition status,
particularly in pediatric patients who
experience rapid periods of growth and
development. It is difficult to measure the
prevalence of undernutrition in this
population because of differing definitions
used in published reports. However, growth
failure and poor nutrition status are common
in children with CKD for a variety of reasons,
including poor intake and metabolic and
hormonal abnormalities. There is no "gold
standard" for measuring nutrition status in
patients with renal impairment. Therefore,
the clinician must synthesize information
gleaned from the nutritional intake history,
anthropometric measurements, and various
biochemical markers to arrive at a conclusion
about nutrition status. Optimization of oral
intake via energy-dense foods, nutrition
supplements, and fortified formulas is the
first line of treatment for the malnourished
patient. Enteral supplementation should be
considered in some patients, particularly
infants and young children. Intradialytic
parenteral nutrition is an option for those
receiving hemodialysis. |
| 22 | Clostridium difficile-associated Diarrhea and Probiotic Therapy: What is the Evidence?
Mary Rath, RD, LD, CNSC, Gail Cresci, PhD, RD, LD, CNSD
Diarrhea is a common adverse effect of
antibiotic administration. Antibiotics
disrupt the colonic microbiota, causing
dysbiosis that negatively alters carbohydrate
metabolism and antimicrobial activity in
the colon, leading to osmotic diarrhea or
diarrhea caused by pathogenic bacterial
overgrowth (1). The dysbiosis caused by
antibiotic therapy has resulted in toxinproducing Clostridium difficile becoming the
primary diarrheic pathogen in hospitalized
patients (2,3). In the United States, an
estimated 25% to 30% of cases of antibioticassociated
diarrhea (AAD) in hospitalized
patients involve C difficile (4). The rising
incidence is concerning because C difficile
infection complicates and prolongs hospital
stays as well as increases health care costs,
morbidity, and mortality. Various treatments
have been studied over the past decade to
potentially prevent, treat, and improve
outcomes related to AAD and C difficileassociated
diarrhea (CDAD), including
probiotic therapy. This article reviews the
evidence supporting the use of probiotics
in treating CDAD. |
Copyright 2013 Dietitians in Nutrition Support.
All material appearing in SUPPORT LINE is covered by copyright and may be
photocopied or otherwise reproduced for noncommercial scientific or educational
purposes only, provided the source is acknowledged. Written consent from the
managing editor is required for any other purpose.
Viewpoints and statements in these materials do not necessarily reflect
the policies and/or official positions of The Academy of Nutrition and Dietetics or DNS.
SUPPORT LINE (ISSN 1067-3768) is published bi-monthly. $60 for individual
non-member subscriptions, $120 for institutions per year (plus postage surcharges
for international subscriptions). Newsletter subscriptions are available to interested
parties who are ineligible for Academy membership. Published by Dietitians in
Nutrition Support, a dietetic practice group of The Academy of Nutrition and Dietetics
, 120 S. Riverside Plaza, Suite 2000, Chicago, IL 60606. For address changes: Please submit name and
address changes directly to the Membership Team of the Academy of Nutrition and Dietetics using the address change card in the Journal of the Academy of Nutrition and Dietetics. SUPPORT LINE is indexed in the Cumulative Index to Nursing and
Allied Health Literature.
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FOR THIS ISSUE: EditorMandy L. Corrigan, MPH, RD, CNSC
265 Scenic Cove Lane
St. Charles, MO 633036
Managing EditorDeborah K. Kuhlman
921 N. Western Avenue
Park Ridge, IL 60068
847/692-3407
Associate EditorsSusan Brantley, MS, RD, CNSC, LDN
Kathy Logan Coughlin,, MS, RD, CNSD
Associate Editor, Continuing Education:Neha Parekh, MS, RD, CNSD
Associate Editor, Writer's Mentoring:Rebecca Brody, PhD, RD, LD, CNSC
Contributing Editor, Inquire Here:Gail Cresci, PhD, RD, CNSD
Membership/Subscriptions:Cheryl Thompson, PhD, RD, CNSD
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