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Nutrition in Clinical Practice

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https://www.readbyqxmd.com/read/28829676/content-validation-of-a-home-parenteral-nutrition-patient-reported-outcome-questionnaire
#1
Tracy-Lee Miller, Geoffrey W Greene, Ingrid Lofgren, Mary L Greaney, Marion F Winkler
BACKGROUND: Patient-reported outcome (PRO) instruments collect information from patients about health conditions and disease management, including quality of life (QOL). Clinicians acknowledge patient concerns about QOL but need guidance to assess the nature and severity of individually experienced problems. The Home Parenteral Nutrition (HPN)-Patient-Reported Outcome Questionnaire (PROQ) was developed for use during medical appointments or homecare visits to address this gap. The purpose of this research was to provide evidence that the HPN-PROQ items and scale possess content validity...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28820650/critical-care-nutrition-support-best-practices-key-differences-between-canadian-and-american-guidelines
#2
Jayshil J Patel, Margot Lemieux, Stephen A McClave, Robert G Martindale, Ryan T Hurt, Daren K Heyland
Since 2015, Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition and Canadian critical care nutrition support guidelines have both been updated. Despite a similar evidentiary basis, there remain key differences between guideline recommendations. These differences in recommendations may pose confusion for the clinician and may encumber widespread applicability. The aim of this review was to enhance practitioner confidence in applying critical care nutrition support guidelines to patient care in their settings by outlining the similarities and differences between the American and Canadian methods for guideline development and describing the key differences and reasons behind the differences...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28820648/natural-bioactive-food-components-for-improving-enteral-tube-feeding-tolerance-in-adult-patient-populations
#3
Adam J Kuchnia, Beth Conlon, Norman Greenberg
Tube feeding (TF) is the most common form of nutrition support. In recent years, TF administration has increased among patient populations within and outside hospital settings, in part due to greater insurance coverage, reduced use of parenteral nutrition, and improved formularies suitable for sole source nutrition. With increasing life expectancy and improved access to TFs, the number of adults dependent on enteral nutrition is expected to grow. However, enteral TF intolerance (ETFI) is the most common complication of TFs, typically presenting with at least 1 adverse gastrointestinal event, including nausea, diarrhea, and constipation...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28817367/nutrition-implications-for-long-term-survivors-of-pancreatic-cancer-surgery
#4
Maria Q B Petzel, Leah Hoffman
With slowly increasing survival rates in pancreatic cancer and international consensus guidelines recommending surgical resection of premalignant lesions, survival post-pancreatic resection is increasing. With longer survival time, the significant comorbidities of such major surgery have far-reaching effects on the nutrition status of the survivor of pancreatic cancer. This review describes the many nutrition-related side effects of pancreatic surgery, including the development of pancreatic enzyme insufficiency, micronutrient deficiencies, diabetes, fatty liver, and metabolic bone disease...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28813230/dietary-supplements-commonly-used-by-cancer-survivors-are-there-any-benefits
#5
Mary J Marian
Following a cancer diagnosis, dietary supplements are reportedly used by 20%-80% of individuals. Supplements are most commonly used by breast cancer survivors, followed by patients with prostate, colorectal, and lung cancers, which is not surprising since these are the most common types of cancer diagnosed in adults. Reasons cited for such use include improving quality of life, reducing symptoms related to treatment and/or the disease process, and recommendation from medical practitioners; family and friends may also be an influence...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28813202/artificial-hydration-at-the-end-of-life
#6
Alexandria J Bear, Elizabeth A Bukowy, Jayshil J Patel
Initiation or continuation of artificial hydration (AH) at the end of life requires unique considerations. A combination of ethical precedents and medical literature may provide clinical guidance on how to use AH at the end of life. The purpose of this review is to describe the ethical framework for and review current literature relating to the indications, benefits, and risks of AH at the end of life. Provider, patient, and family perspectives will also be discussed.
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28731841/survey-of-nutrition-management-practices-in-centers-for-pediatric-intestinal-rehabilitation
#7
Anita M Nucci, Kipp Ellsworth, Austin Michalski, Emily Nagel, Jackie Wessel
BACKGROUND: Nutrition management of pediatric intestinal failure (IF) requires interdisciplinary coordination of parenteral nutrition (PN) and enteral nutrition (EN) support. Nutrition strategies used by specialists in pediatric intestinal rehabilitation to promote gut adaptation and manage complications have not been previously summarized. METHODS: A practice survey was distributed to members of the dietitian subgroup of the American Society for Parenteral and Enteral Nutrition Pediatric Intestinal Failure Section...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28727958/lipid-injectable-emulsion-survey-with-gap-analysis
#8
Michael L Christensen, Phil Ayers, Joseph I Boullata, Peggi Guenter, Kathleen M Gura, Beverly Holcombe, David S Seres, Gordon S Sacks
BACKGROUND: Lipid injectable emulsion (ILE) is an integral part of parenteral nutrition (PN), providing energy and essential fatty acids. With recent consensus recommendations for PN, clinical guidelines for ordering and preparation of PN, the U.S. Food and Drug Administration approval of new ILE products, and revised ILE labeling to include a 1.2-micron filter, a gap in current practice knowledge was apparent. MATERIALS AND METHODS: The American Society for Parenteral and Enteral Nutrition PN Safety Committee surveyed clinicians on how ILE products are prescribed, prepared, and administered to patients from neonates to adults...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28727954/nutrition-screening-vs-nutrition-assessment-what-s-the-difference
#9
Maria Isabel Toulson Davisson Correia
Screening and assessment imply different processes, with the former indicating risk factors for a deprived nutrition condition and the latter providing the nutrition diagnosis. Both should be routinely performed at hospital admission according to recommended guidelines; however, this is not the reality worldwide, and undernutrition remains highly prevalent in the hospital setting. Therefore, the objective of the current review is to delve into the principles leading to nutrition status deficiencies and how they should be addressed by screening and assessment...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28727945/micronutrient-alterations-during-continuous-renal-replacement-therapy-in-critically-ill-adults-a-retrospective-study
#10
Amir Y Kamel, Nisha J Dave, Vivian M Zhao, Daniel P Griffith, Michael J Connor, Thomas R Ziegler
BACKGROUND: Continuous renal replacement therapy (CRRT) is commonly used to provide renal replacement therapy in the intensive care unit. Limited published data suggest that CRRT may lead to depletion of water-soluble vitamins and trace elements. The goal of this study was to identify the incidence of trace element and vitamin deficiencies in critically ill patients during CRRT. MATERIALS AND METHODS: This study is based on a retrospective chart review of patients who were referred to Emory University Hospital's nutrition support services and had at least 1 serum micronutrient level measured during CRRT (thiamin, pyridoxine, ascorbic acid, folate, zinc, and copper) between April 1, 2009, and June 1, 2012...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28727923/height-prediction-from-ulna-length-of-critically-ill-patients
#11
Micheli S Tarnowski, Estela I Rabito, Daieni Fernandes, Mariane Rosa, Manoela L Oliveira, VĂ¢nia N Hirakata, Aline Marcadenti
BACKGROUND: Ulna length (UL) has been used in mathematical formulas to predict the body height of healthy and sick individuals. However, the evaluation of its use with patients admitted to intensive care units (ICU) is scarce. The objective of this study was to develop a mathematical equation to estimate critically ill patients' height using the UL measure and to evaluate its agreement with measured standing height. METHODS: This cross-sectional study was performed at the ICU of a tertiary hospital in Brazil...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28715295/prevalence-of-home-parenteral-and-enteral-nutrition-in-the-united-states
#12
Manpreet S Mundi, Adele Pattinson, Megan T McMahon, Jacob Davidson, Ryan T Hurt
BACKGROUND: Malnutrition is highly prevalent and associated with increased morbidity and mortality. Studies continue to reveal significant clinical benefits with nutrition support, including improved wound healing, reduction in complications and length of stay, and mortality. Due to these benefits, the prevalence of home parenteral and enteral nutrition (HPEN) continues to increase worldwide. In the United States, given our healthcare insurance landscape, it has been very difficult to ascertain the true prevalence of HPEN...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28700266/resources-for-the-provision-of-nutrition-support-to-children-in-educational-environments
#13
Mandy L Corrigan, Shirley Huang, Ann Weaver, David Keeler, Katina Rahe, Jane Balint, Michelle Marti, Brandis Goodman, Traci Nagy, Victoria DeLano, Betty Bond
The use of nutrition support outside of institutional settings has contributed to maintaining the health, well-being, and nutrition status of many medically complex children. As these children grow and enter educational settings, there is a need for awareness of the care that these children require for nutrition support therapy. This document is designed to raise awareness to these needs, provide best practice educational resources for those involved in the supervision or provision of nutrition support to children in an educational environment, and promote safe and effective care...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28671859/being-underweight-is-an-independent-risk-factor-for-poor-outcomes-among-acutely-critically-ill-children
#14
Ming-Yin Chen, Yao-Jong Yang
BACKGROUND: Malnutrition is associated with impaired immune function; thus, nutrition status assessment is crucial in critical care medicine. We aimed to investigate the impact of being underweight or overweight on major sequelae and mortality among healthy children with an intensive care unit admission. METHODS: In this retrospective study, 282 patients aged 1 month to 18 years were enrolled on intensive care unit admission between 2011 and 2012. Children were excluded if they had underlying chronic diseases and were transferred to other hospitals or discharged against medical advice...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28662613/a-pilot-study-comparing-2-oral-rehydration-solutions-in-patients-with-short-bowel-syndrome-receiving-home-parenteral-nutrition-a-prospective-double-blind-randomized-controlled-trial
#15
Ryan T Hurt, Nishanth Vallumsetla, Jithinraj Edakkanambeth Varayil, Sara L Bonnes, Sanjeev Nanda, Joseph Nadeau, Manpreet S Mundi
BACKGROUND: Short bowel syndrome (SBS) is a common indication for home parenteral nutrition (HPN). Oral rehydration solutions (ORSs) have the ability to supplement or reduce HPN dependence. However, ORSs have suffered from poor taste profiles, making long-term consumption and compliance unlikely. The goal of the current study was to assess the taste and compliance of 2 ORSs among patients with SBS requiring HPN. METHODS: All participants with SBS receiving HPN with anticipated duration >3 months were offered enrollment: 31 participants met inclusion criteria; 3 declined enrollment; and 28 were randomized to receive a modified World Health Organization ORS (group A) or a commercially available ORS (DripDrop; group B)...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28662372/parenteral-nutrition-errors-and-potential-errors-reported-over-the-past-10-years
#16
Peggi Guenter, Phil Ayers, Joseph I Boullata, Kathleen M Gura, Beverly Holcombe, Gordon S Sacks
Parenteral nutrition (PN) is a complex, high-alert medication, and errors associated with the use of this therapy may lead to significant harm to patients. This document reviews error reports from the Institute for Safe Medication Practices' Medication Errors Reporting Program that are associated with the PN use process over the past 10 years. Actual PN-related errors are outlined, with most occurring in the PN-compounding/dispensing and PN administration steps. Clinicians involved in any phase of the PN use process should review their institutional or homecare company's processes for reporting of PN errors and collaborate with their medical safety officer and/or committees involved with medication error reporting...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28659014/optimizing-nutrition-in-pediatric-heart-failure-the-crisis-is-over-and-now-it-s-time-to-feed
#17
Kylie D Lewis, Jennifer Conway, Chentel Cunningham, Bodil M K Larsen
Pediatric heart failure is a complex disease occurring when cardiac output is unable to meet the metabolic demands of the body. With improved surgical interventions and medical therapies, survival rates have improved, and care has shifted from focusing on survival to optimizing quality of life and health outcomes. Based on current literature, this review addresses the nutrition needs of infants and children in heart failure and describes the pathophysiology and metabolic implications of this disease. The prevalence of wasting in pediatric heart failure has been reported to be as high as 86%, highlighting the importance of nutrition assessment through all stages of treatment to provide appropriate intake of energy, protein, and micronutrients...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28659010/copper-deficiency-myelopathy-after-upper-gastrointestinal-surgery
#18
Dominic King, Keith Siau, Latha Senthil, Katherine F Kane, Sheldon C Cooper
A well-functioning alimentary canal is required for adequate nutrient absorption. Disruption to the upper gastrointestinal tract through surgery can lead to micronutrient malnourishment. Copper deficiency has been noted in up to 10% of those undergoing Roux-en-Y gastric bypass surgery, but sequalae are not frequently reported. The resultant deficiency states can have profound and long-term consequences if not realized early and managed appropriately. Here we present a case of copper deficiency myelopathy, a condition indistinguishable from subacute combined degeneration of the spinal cord, following upper gastrointestinal bypass surgery for gastric ulceration, further complicated by inadequate nutrition...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28633000/nutrition-support-for-critically-ill-patients-with-cancer
#19
Kristen Lach, Sarah J Peterson
Oncology patients often experience the classic signs of malnutrition-weight loss as well as fat and muscle wasting, which have been associated with poor tolerance to treatment and increased morbidity and mortality. Nutrition status may be an important factor in determining tolerance to treatment and outcomes associated with it. Thus, identification of those with preexisting malnutrition or who are at risk for developing malnutrition is crucial not only at time of cancer diagnosis but also throughout the treatment course so that nutrition interventions may be implemented to prevent development or worsening of malnutrition in this high-risk population...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28632997/epidemiology-of-obesity-and-pharmacologic-treatment-options
#20
Vignesh Shettar, Sarang Patel, Srividya Kidambi
Prevalence of obesity and its related morbidity have increased to alarming levels in adults and children in the United States and globally. Weight loss results in improvement of much of the obesity-related morbidity. Lifestyle changes such as dietary modifications, increased physical activity, and behavioral therapy form the crux of weight management. However, many individuals need additional assistance (pharmacologic or surgical) to initiate or sustain weight loss. Pharmacologic therapy consists of a number of agents that work by decreasing appetite, gastric emptying, or nutrient absorption or by increasing satiety...
June 1, 2017: Nutrition in Clinical Practice
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