In view of the global demographic shift, a scientific symposium was organised by the European Society for Clinical Nutrition and Metabolism (ESPEN) to address nutrition-related challenges of the older population and provide an overview of the current state of knowledge. Eighteen nutrition-related issues of the ageing global society were presented by international experts during the symposium and summarised in this report. Anorexia of ageing, dysphagia, malnutrition, frailty, sarcopenia, sarcopenic obesity, and the metabolic syndrome were highlighted as major nutrition-related geriatric syndromes. Great progress has been made in recent years through standardised definitions of some but not all syndromes. Regarding malnutrition, the GLIM approach has shown to be suitable also in older adults, justifying its continuous implementation. For anorexia of ageing, a consensus definition is still required. Intervention approaches should be integrated and person-centered with the aim of optimizing intrinsic capacity and maintaining functional capacity. Landmark studies like EFFORT and FINGER have impressively documented the potential of individualised and multifactorial interventions for functional and health benefits. Combining nutritional intervention with physical training seems particularly important whereas restrictive diets and drug treatment should generally be used with caution because of undesirable risks. Obesity management in older adults should take into account the risk of promoting sarcopenia. In the future, even more individualised approaches like precision nutrition may enable better nutritional care. Meanwhile all stakeholders should focus on a better implementation of currently available strategies and work closely together to improve nutritional care for older adults.

Background: Xanthogranulomatous cholecystitis (XGC) etiology has not yet been precisely determined; it is often confused with gallbladder cancer (GBC) in the differential diagnosis. Methods:: This study retrospectively evaluated patients who underwent surgery with the pre-diagnosis of cholelithiasis, cholecystitis, or gallbladder carcinoma at a tertiary center, and were confirmed to have XGC or GBC according to the histological examinations. Results: In the GBC group, there was a higher number of female patients, patients with magnetic resonance imaging (MRI) and computed tomography (CT) imaging, those that directly underwent open surgery, and those requiring catheters and developed complications; while in the XGC group, there was a higher number of patients with ultrasonography (USG) imaging and those requiring conversion from laparoscopic to open surgery (P < .05). The rate of patients with a preoperative diagnosis of cholelithiasis was higher in the XGC group than in the GBC group, and cases with intrahepatic bile duct (IHBD) dilatation were higher in the GBC group than in the XGC group, and the GBC group also had a higher rate of cases with a malignant diagnosis in the preoperative examination compared to the XGC group (P < .05). Conclusion: When a suspicious malignant mass is detected in the localization of the gallbladder, XGC must be considered in the differential diagnosis. Although it is not a malignant pathology, early diagnosis and treatment are particularly important due to the associated complications and the possibility of coexistence with GBC.

Beslenme desteği, hasta tedavisinin ayrılmaz bir parçasıdır. Bununla birlikte, günlük uygulamalarda beslenme tedavisi hedeflerine ulaşıldığını söylemek zordur. Bu nedenle klinik pratikte beslenme tedavisi uygulamalarını kolaylaştırmaya yönelik girişimlere ihtiyaç vardır. Malnütrisyon tedavisinde ilk seçenekler diyet düzenlemesi ve oral tamamlayıcı nütrisyon ürünleri kullanımıdır. Ancak oral yolla beslenemeyen veya beslenme hedeflerine ulaşılamayan bazı hasta gruplarında tüple beslenme ihtiyacı gerekmektedir. Tüm dünyada tıp fakültesi, beslenme ve diyetetik fakültesi ve uzmanlık eğitimi müfredatları klinik beslenme konusunda genellikle yeterli değildir. Hekim, diyetisyen, hemşire, eczacı ve diğer sağlık profesyonellerine yönelik, enteral beslenme kullanım endikasyonları, uygulanma şekilleri, ürünlerin seçimi, hasta izlemi, komplikasyonların yönetimi ve tedavi sonlandırılmasında yol gösterecek kısa, net ve pratik önerilere odaklı bir rehberin yararlı olacağını düşündük. Bu rehber, alanında deneyimli uzman bir ekip tarafından KEPAN çatısı altında hazırlanmış ve 29 kişiden oluşan KEPAN rehber grubunca onaylanmıştır.