2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T5b3,We review recent evidence on the effectiveness of non-antimicrobial adjunctive interventions on the recovery of adults diagnosed with community-acquired pneumonia (CAP). Respiratory physiotherapy, early mobilization or tailored exercises may decrease length of stay (LoS), dyspnoea and readmissions, but there is little evidence of an effect on mortality. Nutritional interventions may decrease readmissions and improve 30-day mortality, but there are few studies on the effect of individual micronutrient supplementation. Strategies to improve discharge communications and patient education may decrease readmission rates, improve treatment compliance and patient satisfaction, whereas the implementation of guidelines and care bundles may decrease 30-day mortality but does not appear to affect length of stay or 30-day readmissions. For adjunctive therapeutic interventions, there is evidence that for severe CAP, corticosteroids probably decrease short-term mortality and possibly longer term mortality and LoS. Antiplatelet agents and statins may decrease short-term mortality. A wide range of adjunctive interventions have been trialled aiming to improve patient outcomes with variable results and considerable heterogeneity between studies and populations. Future studies should involve engagement with patient groups to identify uncertainties and outcomes they consider important, utilize a core set of outcome measures, and assess long-term outcomes.31:T772, Purpose of review We review recent evidence on the effectiveness of non-antimicrobial adjunctive interventions on the recovery of adults diagnosed with community-acquired pneumonia (CAP). Recent findings Respiratory physiotherapy, early mobilization or tailored exercises may decrease length of stay (LoS), dyspnoea and readmissions, but there is little evidence of an effect on mortality. Nutritional interventions may decrease readmissions and improve 30-day mortality, but there are few studies on the effect of individual micronutrient supplementation. Strategies to improve discharge communications and patient education may decrease readmission rates, improve treatment compliance and patient satisfaction, whereas the implementation of guidelines and care bundles may decrease 30-day mortality but does not appear to affect length of stay or 30-day readmissions. For adjunctive therapeutic interventions, there is evidence that for severe CAP, corticosteroids probably decrease short-term mortality and possibly longer term mortality and LoS. Antiplatelet agents and statins may decrease short-term mortality. Summary A wide range of adjunctive interventions have been trialled aiming to improve patient outcomes with variable results and considerable heterogeneity between studies and populations. Future studies should involve engagement with patient groups to identify uncertainties and outcomes they consider important, utilize a core set of outcome measures, and assess long-term outcomes. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Nutritional Support: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Nutritional Support (modality). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/modality/Nutritional%20Support\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Modalities\",\"item\":\"https://www.reachrx.ai/hub/tag/modality\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Nutritional Support\",\"item\":\"https://www.reachrx.ai/hub/tag/modality/Nutritional%20Support\"}]}}"}}]],["$","$L2f",null,{"title":"Nutritional Support: Research & Clinical Takeaways","description":"Review evidence by treatment modality: Nutritional Support — concise summaries and practical next steps.","papers":[{"doi":"10.1016/j.breast.2026.104905","pmid":"42648243","title":"Breast cancer-related fatigue: Mechanisms, biomarkers, risk factors, and intervention strategies","journal_title":"The Breast","journal_issn":"0960-9776","published_at":"2026-08-18T00:00:00.000Z","url":"https://doi.org/10.1016/j.breast.2026.104905","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-28T06:25:19.190Z","updated_at":"2026-08-28T06:25:19.190Z","tags":[{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"condition","value":"Breast Cancer-Related Fatigue","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"modality","value":"Acupuncture","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"modality","value":"Exercise Therapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"modality","value":"Microbiota Modulation","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"modality","value":"Nutritional Support","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"modality","value":"Pharmacotherapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"modality","value":"Psychotherapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"warning","value":"No sample size is applicable as this is a review article, not a primary study.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"warning","value":"The paper is dated August 2026 and was processed close to its publication date — some cited evidence may be very recent and not yet widely validated.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104905","tag_type":"warning","value":"This is a narrative review without a registered protocol or systematic search strategy; risk of selection bias in the evidence synthesized cannot be excluded.","value_numeric":null}],"summaries":{"what_studied":"This narrative review synthesizes current evidence on breast cancer-related fatigue (BCRF), covering its mechanisms (inflammation, HPA axis dysregulation, mitochondrial dysfunction, neuromuscular impairment, psychosocial factors), biomarkers, risk factors, and intervention strategies in patients during and after breast cancer treatment.","key_result":"Multiple intervention categories — including acupuncture, exercise, psychotherapy, pharmacotherapy, nutritional support, and microbiota modulation — show varying degrees of efficacy for BCRF; no single strategy is universally superior. Biomarkers such as cytokines, cortisol, leptin, and mitochondrial DNA show diagnostic and prognostic potential.","limitations":"As a narrative review, it does not perform a systematic search or meta-analysis, limiting quantitative conclusions. No head-to-head comparison of intervention efficacy with pooled effect sizes is provided. Generalizability may be constrained by the heterogeneity of included studies.","practice_takeaway":"Clinicians should consider BCRF a multimechanistic syndrome and tailor interventions — particularly exercise and psychotherapy — to individual patient risk profiles. Emerging biomarkers (cytokines, cortisol, mitochondrial DNA) may eventually guide more personalized management, but are not yet standard of care."}},{"doi":"10.1007/s12072-026-11116-1","pmid":"42533257","title":"A global consensus on the critical care management of acute-on-chronic liver failure patients: the APASL ACLF Beijing Position Paper","journal_title":"Hepatology International","journal_issn":"1936-0533","published_at":"2026-07-30T00:00:00.000Z","url":"https://doi.org/10.1007/s12072-026-11116-1","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-07T13:22:56.496Z","updated_at":"2026-08-07T13:22:56.496Z","tags":[{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"condition","value":"Acute Kidney Injury","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"condition","value":"Acute-On-Chronic Liver Failure","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"condition","value":"Alcohol-Associated Liver Disease","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"condition","value":"Hepatic Encephalopathy","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"condition","value":"Hepatorenal Syndrome","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"generic","value":"albumin","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"generic","value":"echinocandins","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"generic","value":"liposomal amphotericin B","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"generic","value":"noradrenaline","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"generic","value":"rifaximin","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"generic","value":"terlipressin","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"generic","value":"voriconazole","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"modality","value":"Antibiotic Therapy","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"modality","value":"Antifungal Therapy","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"modality","value":"Artificial Liver Support System","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"modality","value":"Liver Transplantation","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"modality","value":"Nutritional Support","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"modality","value":"Plasma Exchange","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"modality","value":"Renal Replacement Therapy","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"modality","value":"Vasopressor Therapy","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"sample_size","value":"n=109","value_numeric":109},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"study_design","value":"Clinical Practice Guideline / Consensus Statement","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"warning","value":"Evidence base is geographically skewed toward Europe (35.6%) and Asia-Pacific (34.7%); African, Latin American, and Middle Eastern data are underrepresented, limiting global applicability.","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"warning","value":"Several strong recommendations are based on low-certainty evidence, with rationale in supplementary files not fully reproduced in the main text.","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"warning","value":"The APASL ACLF definition (acute hepatic insult in chronic liver disease) differs from EASL-CLIF and AASLD definitions; some recommendations may not translate across definitional frameworks.","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11116-1","tag_type":"warning","value":"This is a consensus/position paper, not a primary clinical trial; the 'sample size' tag reflects the expert panel size, not a patient cohort.","value_numeric":null}],"summaries":{"what_studied":"This APASL consensus position paper, developed by 109 global experts using the GRADE system, establishes standardized critical care management recommendations for acute-on-chronic liver failure (ACLF). It covers ICU triage, organ-specific support (liver, kidney, brain, cardiac), infection management, bridging therapies (plasma exchange, artificial liver support), nutrition, and liver transplantation selection and timing.","key_result":"The paper delivers 104 position statements. Key actionable outputs include: use of AARC, CLIF-C ACLF, and GIC scores for ICU transfer decisions (strong, high LoE); terlipressin + albumin as first-line for HRS-AKI (strong, high LoE); CRRT preferred over intermittent RRT in hemodynamically unstable ACLF (weak, low LoE); MAP target 65–75 mmHg with lactate <2 mmol/L in shock (strong, high LoE); viscoelastic tests (TEG/ROTEM) over conventional INR to guide transfusion (strong, moderate LoE); plasma exchange as a bridge to transplant in selected patients without infection, shock, or ventilation (moderate LoE); and transplantation ideally within 30 days of listing (strong, moderate LoE).","limitations":"- Several recommendations rest on regional (Asia-Pacific or European) data and may not generalize globally.\n- Some statements carry strong recommendations despite low-certainty evidence, with justifications provided only in supplementary material.\n- No patient or public involvement in consensus development.","practice_takeaway":"Use serial prognostic scoring (AARC, CLIF-C ACLF) at days 0, 3, 7, and 14 to guide ICU-level care and transplant listing; prioritize early terlipressin + albumin for HRS-AKI, viscoelastic testing over INR for bleeding decisions, and targeted antibiotic de-escalation at 24–48 hours when cultures are negative. For alcohol-related ACLF Grade III, withhold transplant listing if active infection, inability to achieve pre-transplant abstinence, or absent psychosocial support are present."}},{"doi":"10.1001/jamasurg.2026.1519","pmid":"42160080","title":"Nationwide Implementation of Multimodal Prehabilitation and Complications After Colorectal Cancer Surgery","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-05-20T00:00:00.000Z","url":"https://doi.org/10.1001/jamasurg.2026.1519","source_score":26,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:34:50.387Z","updated_at":"2026-05-26T13:34:50.387Z","tags":[{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"condition","value":"Colorectal Cancer","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"modality","value":"Exercise Therapy","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"modality","value":"Nutritional Support","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"modality","value":"Prehabilitation","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"sample_size","value":"n=2384","value_numeric":2384},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"study_design","value":"Multicenter Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"warning","value":"Historical controls span a longer period (2014–2023) than the prehabilitation group (2020–2023), raising concern that improvements in surgical care over time may partly explain the outcome differences — not prehabilitation alone.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"warning","value":"Mean patient age was 70 years, so findings may be most generalizable to older adults; applicability to younger colorectal cancer patients is less certain.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1519","tag_type":"warning","value":"The surgical complication OR (0.82, 95% CI 0.68–1.00) just reaches the boundary of statistical significance; this finding should be interpreted cautiously.","value_numeric":null}],"summaries":{"what_studied":"A multicenter cohort study across 18 Dutch hospitals evaluated a uniform multimodal prehabilitation program (high-intensity exercise 3×/week, nutritional support, psychological counseling, comorbidity optimization) vs. historical controls in unselected adults undergoing elective colorectal cancer resection (prehab group: April 2020–June 2023; control group: June 2014–June 2023), with propensity score matching on age, sex, BMI, ASA class, procedure, and operative approach.","key_result":"Overall complications were lower in the prehabilitation group (30.1% vs 37.8%; OR 0.71, 95% CI 0.60–0.84), driven largely by fewer medical complications (15.4% vs 24.6%; OR 0.56, 95% CI 0.46–0.69); median hospital stay was 1 day shorter (4 vs 5 days; P<.001), with reduced readmission and ICU admission rates — benefits held across all age and ASA score subgroups.","limitations":"- Retrospective cohort with historical controls introduces risk of secular trends (e.g., enhanced recovery protocols evolving over time) confounding results.\n- Propensity score matching cannot fully account for unmeasured confounders such as baseline fitness or patient motivation.\n- Prehabilitation program adherence and completion rates are not reported, which limits dose-response interpretation.","practice_takeaway":"Consider integrating structured multimodal prehabilitation — combining exercise, nutrition, and comorbidity optimization — into standard preoperative care for all elective colorectal cancer surgery patients, regardless of age or ASA class. A roughly 8-percentage-point absolute reduction in overall complications and a 1-day shorter hospital stay suggest clinically meaningful benefit at scale."}},{"doi":"10.1097/qco.0000000000001182","pmid":"41518106","title":"Non-antimicrobial interventions in recovery from community-acquired pneumonia in adults","journal_title":"Current Opinion in Infectious Diseases","journal_issn":"0951-7375","published_at":"2026-01-10T00:00:00.000Z","url":"https://doi.org/10.1097/qco.0000000000001182","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-13","doi":"10.1097/qco.0000000000001182","days":"7","issn":"0951-7375","rank":"8","field":"Clinical Medicine","score":"14","category":"Infectious Diseases","categories":["Infectious Diseases"],"_categories":["Infectious Diseases"]},"pubmed":{"doi":"10.1097/QCO.0000000000001182","title":"Non-antimicrobial interventions in recovery from community-acquired pneumonia in adults.","journal":"Current opinion in 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