This prospective study investigated the levels of procalcitonin (PCT) and C-reactive protein (CRP) in patients with various types and severity of multiple trauma, and their relationship to trauma-related complications. Adult multiple-trauma patients (n = 113) admitted to the intensive care unit (ICU) in the first 24 h after trauma were included. The Injury Severity Scores (ISS), and PCT and CRP levels were measured in the first 24 h (day 1), on day 7 and on the final day of their ICU stay. Survival at 30 days was recorded. Mean PCT and CRP levels were both significantly higher on day 7 compared with day 1 and the final assessment day in patients with an ISS > 20. Levels of PCT were significantly higher in cases with sepsis, severe sepsis or septic shock compared with cases who developed systemic inflammatory response syndrome (SIRS), however levels of CRP were significantly higher only in cases with severe sepsis or septic shock, but not in cases with sepsis alone. These data support the view that PCT levels may be a better indicator than CRP levels in the early diagnosis of septic complications in patients with multiple trauma.

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The aim of this study was to use the Healthy Eating Index-2005 (HEI-2005) to assess diet quality and determine the relationship between the HEI-2005 and the energy and nutrient intakes of adolescents. A cross-sectional study was conducted on 1,104 healthy adolescents, mean age of 15.8 ± 1.24 years. Dietary intake was measured with the 24-hour dietary recall method, and dietary quality was assessed by means of the HEI-2005. Diet quality scores ranged from 23.7 to 77.5. The mean score was found to be 51.5 ± 9.07 according to the HEI-2005. There were no differences according to gender; 42.8% had a poor diet and 57.2% had a diet that needs improvement. No subjects had a "good diet". Lower mean subgroup scores were found for whole grains, total vegetables, total fruits, dairy products, and meat and beans. Fruits and vegetables scores were significantly high in girls, whereas sodium, oil, and meat and beans scores were significantly high in boys. Total HEI-2005 scores were increasingly associated with parental education level when age and gender were adjusted. There was a negative correlation between HEI-2005 scores and age, total energy intake, and fat intake. Positive correlation was only observed in the HEI-2005 scores for protein and dietary fibre intakes. Consequently, the overall diet quality and nutritional habits of Turkish adolescents need modification and improvement. In the family, measures should be initiated by the government, including advertisements and campaigns.

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This article reviews the various issues that surround the dietary planning for a patient with stoma (colostomy, ileostomy, and urostomy). The ostomy diet is necessary to keep stools normal following surgery, since the amount, frequency and consistency of stool is influenced by the diet. The goals of dietary management in stoma patients is to prevent stoma blockages after surgery, to promote healing of stoma wound and to minimise unpleasant gastrointestinal upset such as flatulence, diarrhoea, constipation and odors. On the other hand, early oral feeding in patients with colostomy is important. Since it is planned to progress from a liquid to low fiber (residue) diet. Some foods may not be as well tolerated and may cause flatulence, odors, diarrhea and/or constipation. Preoperatively, fiber and lactose intolerances are common in ileostomy patients. Postoperatively, it is important to provide a high-energy, high-protein diet for wound healing that is low in excess insoluble fiber. Certain foods and drugs can discolor the urine or produce a strong odor. In order to recognize the signs of food blockage, it is suggested to take plenty of fluids and consume a balanced diet in stoma patients.Keywords: Surgical stoma, Colostomy, Ileostomy, Urostomy, Diet therapy ÖZET Stomal› Hastalarda Beslenme: Diyet Tedavisine Pratik Bir Bak›flBu makale, stomal› bir hastan›n (kolostomi, ileostomi ve ürostomi) diyet tedavisinin planlanmas›na yönelik çeflitli bölümleri içermektedir. D›flk› miktar›, s›kl›¤› ve k›vam›n›n diyet tüketiminden etkilenmesi nedeniyle, cerrahi sonras› normal d›flk›laman›n sa¤lanmas›nda ostomi diyetinin uygulanmas› gerekmektedir. Stomal› hastalarda diyet tedavisinin amaçlar›na bak›ld›¤›nda; ameliyat sonras› stoma t›kan›kl›klar›n› önlemek, aç›lan stomadaki yara iyileflmesine katk›da bulunmak, gaz, diyare, konstipasyon, koku gibi rahats›zl›k veren gastrointestinal semptomlar› en az indirgemektir. Buna ek olarak, kolostomili hastalarda erken oral beslenme önemlidir. S›v› diyetten düflük posal› (kal›nt›l›) diyete geçifl planlanmaktad›r. Baz› besinler iyi tolere edilemedi¤inden gaz, kötü koku, diyare ve/veya konstipasyona neden olabilir. ‹leostomili hastalarda operasyon öncesinde, posa ve laktoz intolerans› s›kl›kla görülmektedir. Operasyon sonras›nda ise; çözünmez posa içeri¤i düflük, yüksek-enerji ve yüksek-protein içeren diyetin yara iyileflmesini h›zland›rmas› aç›s›ndan önemlidir. Baz› besinler ve ilaçlar idrar renginde de¤iflikli¤e ve güçlü bir koku üretimine neden olmaktad›r. Stomal› hastalarda g›da blokaj›n› fark edebilmek için bol s›v› al›m›n›n ve dengeli bir diyet tüketiminin sa¤lanmas› önemlidir.

Summary Background Non‐alcoholic fatty liver disease (NAFLD) has become the most common liver disease in children and adolescents. The optimal dietary strategy to improve hepatic stetatosis and reduce oxidative stress and inflammation in adolescents is unknown. Objective This study was conducted to evaluate the effect of Mediterranean diet (MD) versus low‐fat diet (LFD) on hepatic steatosis, inflammation, and oxidative stress in adolescents with obesity and NAFLD. Methods Adolescents diagnosed with NAFLD between the ages of 11–18 years were randomized to either a MD or conventional LFD (control diet) for 12 weeks. Dietary status, anthropometry, body composition, and biochemical parameters were evaluated. Hepatic steatosis was determined by ultrasonography. Results A total of 44 participants completed the study. At the end of the study, severity of hepatic steatosis, serum transaminase levels, and insulin resistance decreased significantly in both groups with no significant differences between groups except for aspartate aminotransferase (AST). The amount of decrease in AST levels in the MD group was greater than the LFD group (p < 0.05). In the MD group, serum total antioxidant capacity, paraoxanase‐1, and glutathione peroxidase levels increased (p < 0.05); it did not change in the LFD group compared to baseline (p > 0.05). C‐Reactive Protein (CRP) levels decreased only in the MD group (p = 0.008), interleukine‐6 decreased only in the LFD group (p = 0.031). Conclusion Consumption of MD and LFD for 12 weeks in adolescents with obesity and NAFLD reduced BMI, fat mass, hepatic steatosis, and insulin resistance, improved high transaminase levels, and had positive effects on inflammation and oxidative stress. Registered under http://clinicaltrials.gov Identifier no. NCT04845373.

Hematopoietic Stem Cell Transplantation (HSCT) is a method used for the treatment of patients with severe aplastic anemia, leukaemia and some other malignancies. As it causes many adverse sequelaes (anorexia, nausea, vomiting, diarrhea, and mucositis), adequate oral diet is usually unachievable and artificial nutrition support is required. In order to reduce the risk of infections, the protective benefit of "low-microbial / neutropenic diets" is suggested to use in immunosuppressed patients. Traditionally, total parenteral nutrition (TPN) has been the chosen method for the nutritional support of patients undergoing HSCT. Secondly enteral nutrition (especially with enteral tube feeding -ETF) is an alternative method for nutritional support. It is important that dietary guidance for HSCT patients to minimize the risk of microbial exposure, optimize nutrient consumption and energy intake is very important.Keywords: Hematopoietic Stem Cell Transplantation, Nutrition, Neutropenic diet, Nutritional support ÖZET Hematopoietik Kök Hücre Transplantasyonu (HKHT)'nda T›bbi Beslenme TedavisiHematopoietik Kök Hücre Transplantasyonu (HKHT) a¤›r aplastik anemi, lösemi ve di¤er baz› maligniteleri olan hastalar›n tedavisi için kullan›lan bir yöntemdir. Hastal›k birçok yan etkilere (ifltahs›zl›k, bulant›, kusma, ishal ve mukozit) neden oldu¤undan, ço¤unlukla yeterli oral beslenme sa¤lanamamakta ve beslenme deste¤i gerekmektedir. Ba¤›fl›kl›¤› bask›lanm›fl hastalarda enfeksiyonlar›n riskini azaltmak için "düflük-mikrobiyal / nötropenik diyetler" koruyucu yarar sa¤lamas› nedeniyle önerilmektedir. Geleneksel olarak, HKHT uygulanan hastalarda total parenteral beslenme (TPN), beslenme deste¤i için seçilen yöntem olmufltur. ‹kinci bir yöntem olan enteral beslenme uygulamas› (özellikle enteral tüp ile beslenme -ETB), beslenme deste¤i için alternatif bir yöntemdir. HKHT hastalar›na yöne-lik oluflturulan diyet rehberlerinde, enfeksiyona maruz kalma riskini en aza indirgemek amac›yla optimal besin tüketimi ve enerji al›m› çok önemlidir.