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  1. Article ; Online: To Improve the Initial Inpatient Management of Adolescents Admitted with Severe Anorexia Nervosa: A Narrative Review and a Convenient Protocol.

    Proulx-Cabana, Stephanie / Metras, Marie-Elaine / Taddeo, Danielle / Jamoulle, Olivier / Frappier, Jean-Yves / Stheneur, Chantal

    Nutrients

    2022  Volume 14, Issue 1

    Abstract: Inadequate nutritional rehabilitation of severely malnourished adolescents with Anorexia Nervosa (AN) increases the risk of medical complications. There is no consensus on best practices for inpatient nutritional rehabilitation and medical stabilization ... ...

    Abstract Inadequate nutritional rehabilitation of severely malnourished adolescents with Anorexia Nervosa (AN) increases the risk of medical complications. There is no consensus on best practices for inpatient nutritional rehabilitation and medical stabilization for severe AN. This study aimed to elaborate an admission protocol for adolescents with severe AN based on a comprehensive narrative review of current evidence. A Pubmed search was conducted in July 2017 and updated in August 2020, using the keywords severe AN or eating disorders (ED), management guidelines and adolescent. Relevant references cited in these guidelines were retrieved. A secondary search was conducted using AN or ED and refeeding protocol, refeeding syndrome (RS), hypophosphatemia, hypoglycemia, cardiac monitoring or cardiac complications. Evidence obtained was used to develop the admission protocol. Selective blood tests were proposed during the first three days of nutritional rehabilitation. Higher initial caloric intake is supported by evidence. Continuous nasogastric tube feeding was proposed for patients with a BMI < 12 kg/m2. We monitor hypoglycemia for 72 h. Continuous cardiac monitoring for bradycardia <30 BPM and systematic phosphate supplementation should be considered. Developing protocols is necessary to improve standardization of care. We provide an example of an inpatient admission protocol for adolescents with severe AN.
    MeSH term(s) Adolescent ; Anorexia Nervosa/rehabilitation ; Clinical Protocols/standards ; Feeding and Eating Disorders/rehabilitation ; Female ; Hospitalization ; Humans ; Inpatients ; Male ; Practice Guidelines as Topic
    Language English
    Publishing date 2022-01-05
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu14010229
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: To Improve the Initial Inpatient Management of Adolescents Admitted with Severe Anorexia Nervosa: A Narrative Review and a Convenient Protocol

    Proulx-Cabana, Stephanie / Metras, Marie-Elaine / Taddeo, Danielle / Jamoulle, Olivier / Frappier, Jean-Yves / Stheneur, Chantal

    Nutrients. 2022 Jan. 05, v. 14, no. 1

    2022  

    Abstract: Inadequate nutritional rehabilitation of severely malnourished adolescents with Anorexia Nervosa (AN) increases the risk of medical complications. There is no consensus on best practices for inpatient nutritional rehabilitation and medical stabilization ... ...

    Abstract Inadequate nutritional rehabilitation of severely malnourished adolescents with Anorexia Nervosa (AN) increases the risk of medical complications. There is no consensus on best practices for inpatient nutritional rehabilitation and medical stabilization for severe AN. This study aimed to elaborate an admission protocol for adolescents with severe AN based on a comprehensive narrative review of current evidence. A Pubmed search was conducted in July 2017 and updated in August 2020, using the keywords severe AN or eating disorders (ED), management guidelines and adolescent. Relevant references cited in these guidelines were retrieved. A secondary search was conducted using AN or ED and refeeding protocol, refeeding syndrome (RS), hypophosphatemia, hypoglycemia, cardiac monitoring or cardiac complications. Evidence obtained was used to develop the admission protocol. Selective blood tests were proposed during the first three days of nutritional rehabilitation. Higher initial caloric intake is supported by evidence. Continuous nasogastric tube feeding was proposed for patients with a BMI < 12 kg/m2. We monitor hypoglycemia for 72 h. Continuous cardiac monitoring for bradycardia <30 BPM and systematic phosphate supplementation should be considered. Developing protocols is necessary to improve standardization of care. We provide an example of an inpatient admission protocol for adolescents with severe AN.
    Keywords adolescents ; anorexia nervosa ; blood ; energy intake ; hypoglycemia ; malnutrition ; phosphates ; protocols ; risk
    Language English
    Dates of publication 2022-0105
    Publishing place Multidisciplinary Digital Publishing Institute
    Document type Article
    ZDB-ID 2518386-2
    ISSN 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu14010229
    Database NAL-Catalogue (AGRICOLA)

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  3. Article: Virtual Consultations: Young People and Their Parents' Experience.

    Proulx-Cabana, Stephanie / Segal, Terry Yvonne / Gregorowski, Anna / Hargreaves, Dougal / Flannery, Halina

    Adolescent health, medicine and therapeutics

    2021  Volume 12, Page(s) 37–43

    Abstract: Purpose: Evaluate the experience of virtual consultations for young people and their families and assess whether young people are being offered a confidential space as part of these virtual encounters.: Patients and methods: An anonymous online ... ...

    Abstract Purpose: Evaluate the experience of virtual consultations for young people and their families and assess whether young people are being offered a confidential space as part of these virtual encounters.
    Patients and methods: An anonymous online survey was sent to young people age 10-18 y.o. who had experienced at least one virtual consultation with an adolescent medicine tertiary service in the United Kingdom between March 13th and June 13th 2020 mostly associated with, but not exclusively, management of chronic fatigue syndrome or medically unexplained symptoms. Responses from the survey were analysed by two authors who independently coded the common themes reported by the participants.
    Results: Fifty young people and their families participated in the survey. Eighty-eight percent reported feeling prepared for virtual appointments, 90% found them helpful, 88% felt that they were private and 86% reported they would find further virtual appointments helpful. Positive impacts reported were no need to travel (38%) and the continuity of care (36%). Many of our participants reported no negative impact (39%) and felt that nothing needed to be improved (56%). The most frequent improvement reported was the provision of a quality video call (34%). Only 36% of young people had the opportunity to speak in confidence to the health care provider without their parents' presence.
    Conclusion: Virtual appointments are perceived as safe and helpful by the young people and their families. Professionals should offer a confidential remote space for young people to speak without their parents.
    Language English
    Publishing date 2021-04-28
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2587456-1
    ISSN 1179-318X
    ISSN 1179-318X
    DOI 10.2147/AHMT.S292977
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Initial inpatient management of adolescents and young adults admitted with severe malnutrition due to anorexia nervosa: protocol for a systematic review.

    Proulx-Cabana, Stéphanie / Taddeo, Danielle / Jamoulle, Olivier / Frappier, Jean-Yves / Tremblay-Racine, Fannie / Stheneur, Chantal

    Journal of eating disorders

    2021  Volume 9, Issue 1, Page(s) 36

    Abstract: Background: Anorexia Nervosa (AN) is a highly prevalent disease in adolescents and young adults (AYAs). The quality of initial inpatient medical management in a patient with severe malnutrition due to AN is crucial to prevent further medical instability. ...

    Abstract Background: Anorexia Nervosa (AN) is a highly prevalent disease in adolescents and young adults (AYAs). The quality of initial inpatient medical management in a patient with severe malnutrition due to AN is crucial to prevent further medical instability. This review aims to inventory evidence regarding initial refeeding and management of AYAs with AN in an inpatient setting, in order to avoid medical complications.
    Methods: A systematic review will be conducted using PubMed, MEDLINE, All EBM Reviews, Embase, PsycINFO, Cochrane Database and CINAHL. The search strategy consists of terms related to anorexia, hospitalization and Pediatrics. Randomized controlled trials, case-control studies, cross-sectional and cohort studies will be included. Participants will include adolescents and adults 18-24 years old diagnosed with AN and meeting criteria for severe disease. The primary outcome will be any of the following complications: hypophosphatemia, refeeding syndrome, hypoglycemia, cardiac arrythmia, hepatic cytolysis or death. Data will be extracted and the risk of bias will be assessed by one author and reviewed by a second author. Results will be presented in a systematic narrative synthesis format. The quality of evidence for all outcomes will be evaluated using the GRADE methodology.
    Discussion: This systematic review will examine current evidence on initial inpatient refeeding and help to document effectiveness of initial inpatient management in AYAs with severe AN in avoiding further medical complications.
    Trial registration: This study is registered on PROSPERO under the reference number CRD42019123608 .
    Language English
    Publishing date 2021-03-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 2699357-0
    ISSN 2050-2974
    ISSN 2050-2974
    DOI 10.1186/s40337-021-00389-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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