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Nutrition in Clinical Practice

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https://www.readbyqxmd.com/read/29035672/overview-of-home-parenteral-nutrition-an-update
#1
Donald F Kirby, Mandy L Corrigan, Eileen Hendrickson, D Marie Emery
The trend in modern medicine is to transition care from the hospital to home or other nonacute settings as soon as possible. Increasingly, nutrition support professionals are being asked to help facilitate discharge and/or manage patients who require prolonged intravenous fluid and/or nutrition after having been stabilized during a hospitalization. This updated tutorial reviews many of the concepts and challenges that must be considered for successful care that helps to focus on the patients and their quality of life...
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29028447/complications-of-home-enteral-nutrition-mechanical-complications-and-access-issues-in-the-home-setting
#2
Brian P Strollo, Stephen A McClave, Keith R Miller
Home enteral nutrition (HEN) is an essential component in the care of patients with an array of underlying etiologies resulting in the inability to meet caloric needs through volitional intake alone. Although some would include oral nutrition supplementation as HEN, for the purposes of this review, the term is limited to a patient's requiring an enteral access device for the delivery of exogenous nutrients. Complications related to such devices remain a difficult problem in the hospital setting, and these issues are often amplified when encountered in the home setting...
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29023196/home-parenteral-nutrition-vascular-access-and-related-complications
#3
Martyn Dibb, Simon Lal
Patients with chronic intestinal failure are dependent on parenteral nutrition (PN) to maintain health and preserve life. Maintaining safe vascular access is vital to prevent life-threatening complications such as catheter-related bloodstream infection or central venous occlusion. Dedicated central venous catheters with rigorous catheter care aseptic protocols are vital in obtaining good long-term outcomes that allow continuation of PN over many years. Good catheter care requires an experienced multidisciplinary team using appropriate vascular devices, trained to identify and aggressively treat catheter-related bloodstream infections, catheter occlusions, and catheter-related thrombosis...
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29023191/use-of-nasogastric-feeding-tubes-for-children-at-home-a-template-for-caregiver-education
#4
Beth Lyman, Gina Rempel, Kerrin Windsor, Peggi Guenter
There is a lack of knowledge on the part of caregivers who need to place nasogastric (NG) tubes in children for enteral nutrition therapy. This article provides the rationale, best practices, and a template for caregiver education. Canadian and Australian programs have excellent patient education materials. They have shared these step-by-step procedures for healthcare professionals to provide to caregivers to whom they are teaching placement and care of NG tubes.
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29016235/telemedicine-support-groups-for-home-parenteral-nutrition-users
#5
Eve-Lynn Nelson, Donna Macan Yadrich, Noreen Thompson, Shawna Wright, Kathaleen Stone, Natasia Adams, Marilyn Werkowitch, Carol E Smith
Patients receiving home parenteral nutrition (HPN), a life-sustaining intravenous (IV) infusion that provides nourishment and hydration to patients with short gut or inflammatory bowel diseases, are often isolated and not in visual contact with peers or health providers. One completed clinical trial (Clinical Trials.gov NCT0190028) and 1 ongoing clinical trial (Clinical Trials.gov NCT02987569) are evaluating a mobile videoconferencing-delivered support group intervention for patients on HPN and their caregivers...
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29016233/metabolic-complications-of-home-parenteral-nutrition
#6
Jamie Davila, Denise Konrad
Home parenteral nutrition (HPN) has benefited countless patients since its initiation almost 5 decades ago. Over time, HPN has been found to be associated with various complications, including metabolic disorders. Metabolic complications can be grouped into short-term (eg, fluid imbalance, electrolyte disturbances, glucose abnormalities) and long-term (eg, hepatobiliary disorders, metabolic bone disease, iron deficiency anemia, manganese toxicity) categories. There are a number of treatment options for each complication...
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29016231/parenteral-and-enteral-nutrition-from-hospital-to-home-will-it-be-covered
#7
Sara L Bonnes, Bradley R Salonen, Ryan T Hurt, Megan T McMahon, Manpreet S Mundi
With scientific advances allowing for the safe delivery of parenteral and enteral nutrition in the home setting, challenges have risen with determining how this will be financially feasible for patients. In the United States, the government is one of the major payers for home parenteral and enteral nutrition (HPEN). Thus, it is important for nutrition providers to have an understanding of the Medicare criteria that must be met in order for these services to be covered. It can be difficult for clinicians to sift through these requirements and decipher for whom and when HPEN is covered...
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29016220/considerations-for-fueling-an-endurance-athlete-with-home-parenteral-nutrition
#8
Emma M Tillman, Marianne Opilla
The goal of clinicians managing nutrition support for patients with home parenteral nutrition (HPN) is to adapt nutrition needs to best serve the consumers, so they may have the best quality of life despite specialized nutrition needs. Some HPN consumers may desire to participate in endurance athletics, which will require special considerations. This review is intended to outline key nutrition differences in endurance athletes that a nutrition support team should consider when providing HPN.
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28968181/noncompliance-nonadherence-with-home-nutrition-support-an-underrecognized-clinical-dilemma
#9
Donald F Kirby, Ronelle Mitchell, Eileen Hendrickson
Failure to administer enteral nutrition, intravenous fluids, and/or parenteral nutrition solutions can have deleterious effects on patients who have been prescribed such therapies. However, it is not well understood why patients requiring nutrition support would be noncompliant or nonadherent to these often life-benefiting therapies. This article explores these issues in a large home nutrition support population.
September 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28850287/home-parenteral-nutrition-and-intravenous-fluid-errors-discovered-through-novel-clinical-practice-of-reconciling-compounding-records-a-case-series
#10
Margaret K Murphy, Kathleen M Gura, Christina Tascione, Alexandra N Carey, Christopher P Duggan, Bram P Raphael
Home parenteral nutrition (HPN) and home intravenous (IV) hydration are complex, high-risk life-sustaining therapies for children and adults with severe digestive disorders. HPN compounding errors have the potential to cause serious patient harm. Here we present a retrospective case series at an interdisciplinary pediatric HPN program that includes specialized pharmacists reconciling prescriptions against commercial compounding records. Seven HPN or IV hydration patients were affected by significant errors in anion balance, copper, potassium, sodium, and infusion volume...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28841088/knowledge-of-constituent-ingredients-in-enteral-nutrition-formulas-can-make-a-difference-in-patient-response-to-enteral-feeding
#11
Patricia Savino
Enteral feeding is considered the preferred method for providing a complete or supplemental source of nutrition to patients. Enteral formulas (EFs) are traditionally assessed from general information provided by the manufacturer such as caloric density, percentage of macronutrients, and micronutrients to meet the Recommended Dietary Allowance. Sometimes labeling information highlights particular ingredients to indicate specific properties at a metabolic or nutrition level. However, it is necessary to review the quality and composition of any enteral formula, since the basic components are responsible for tolerance and nutrition efficacy, and this should not be overshadowed by the benefit of a single constituent...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28829676/content-validation-of-a-home-parenteral-nutrition-patient-reported-outcome-questionnaire
#12
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/28820648/natural-bioactive-food-components-for-improving-enteral-tube-feeding-tolerance-in-adult-patient-populations
#13
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/28937926/editor-s-note
#14
Jeanette M Hasse
No abstract text is available yet for this article.
October 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28937925/effect-of-self-reported-distress-thermometer-score-on-the-maximal-handgrip-and-pinch-strength-measurements-in-hemodialysis-patients
#15
Stephanie Camilleri, Stephanie Chong, Kamonwan Tangvoraphonkchai, Suree Yoowannakul, Andrew Davenport
BACKGROUND: Muscle weakness is a risk factor for mortality in hemodialysis (HD) patients. Muscle strength measurements are routinely used as a screening tool but depend on patient cooperation and motivation. We wished to determine whether measuring maximal voluntary muscle strength was affected by patient self-reported distress. METHODS: We measured pinch strength (PS) and handgrip strength (HGS) in 382 adult HD patients with a corresponding self-reported distress thermometer (DT) scores...
October 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28850803/high-serum-essential-amino-acids-as-a-predictor-of-skeletal-muscle-depletion-in-patients-with-cachexia-and-advanced-gastrointestinal-cancers
#16
Moeko Kitagawa, Seiji Haji, Teruyoshi Amagai
BACKGROUND: In recent years, the number of patients with cancer has increased. These patients are prone to sarcopenia as a result of the decrease in muscle mass and muscle weakness that occur in cancer cachexia. Amino Index Cancer Screening is carried out to evaluate cancer cachexia risk by examining amino acid concentration and analyzing amino acid balance. METHODS: We conducted a retrospective chart review of consecutive patients with unresectable advanced gastrointestinal cancer (stage IV) receiving chemotherapy treatment (December 2012-September 2015) in an outpatient or in-hospital setting at our institution (N = 46)...
October 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28850795/performance-of-patient-generated-subjective-global-assessment-pg-sga-in-patients-with-advanced-cancer-in-palliative-care
#17
Emanuelly Varea Maria Wiegert, Patricia de Carvalho Padilha, Wilza Arantes Ferreira Peres
BACKGROUND: The purpose of this study was to evaluate the prognostic significance of the Patient-Generated Subjective Global Assessment (PG-SGA) in patients receiving palliative care for advanced cancer. METHODS: The PG-SGA was used to assess nutrition status of 120 patients admitted to the Palliative Care Unit at the National Cancer Institute in Brazil. RESULTS: According to the PG-SGA, 94.2% (n = 113) of the patients were evaluated as malnourished...
October 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28841392/nutrition-care-in-patients-with-head-and-neck-or-esophageal-cancer-the-patient-perspective
#18
Cathy Alberda, Tatjana Alvadj-Korenic, Maria Mayan, Leah Gramlich
BACKGROUND: Patients with head/neck or esophageal (HNE) cancer are likely to develop malnutrition throughout the course of their disease and its treatment. Although nutrition care is considered a cornerstone of disease management, clinical practices to treat malnutrition vary. The objective of this qualitative study is to understand the patients' experiences with nutrition care in the context of their treatment and recovery. METHODS: A descriptive qualitative study design was used to explore patients' experiences...
October 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28825869/cancer-cachexia-cause-diagnosis-and-treatment
#19
Todd W Mattox
Patients with cancer frequently experience unintended weight loss due to gastrointestinal (GI) dysfunction caused by the malignancy or treatment of the malignancy. However, others may present with weight loss related to other symptoms not clearly associated with identifiable GI dysfunction such as anorexia and early satiety. Cancer cachexia (CC) is a multifactorial syndrome that is generally characterized by ongoing loss of skeletal muscle mass with or without fat loss, often accompanied by anorexia, weakness, and fatigue...
October 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28820650/critical-care-nutrition-support-best-practices-key-differences-between-canadian-and-american-guidelines
#20
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...
October 2017: Nutrition in Clinical Practice
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