摘要:

Six patients with stable end stage chronic renal failure have been studied while receiving keto‐acid supplements that provided a daily calcium load of 42 ± 2 mM. None of the patients had intercurrent illness. All patients showed elevated serum calcium concentration levels while on keto‐acid supplements, reaching significance on 5 occasions. Reciprocal falls in serum phosphate concentrations were noted in all patients, and this observation was not due to an anabolic effect of the ketoacids. In 3 patients, the rise in serum calcium concentration was associated with marked clinical manifestations that required curtailment of treatment. The risk of hypercalcemia occurs early and certain high risk categories can be identified. Recommendations about the use of calcium salts of α‐keto‐acid analogues are given and it is suggested that a choice should be made available between calcium and sodium salt analogues.

ISSN:0148-6071    

DOI:10.1177/014860718100500152

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

This article reviews the findings of a research study which investigated the phenomenon of nausea and vomiting in cancer patients receiving radiation therapy. One of the variables studied was nutritional status and how it was related to nausea and vomiting. The relationship between treatment‐related emesis and nutritional status is described in two ways: how the patient's nutritional status may have affected the incidence of nausea and vomiting, and how the clinical occurrence of emesis affected the patient's nutritional status. Significant findings included the following. A decrease in appetite was experienced more frequently in patients undergoing therapy of either short (less than 12 days) or long duration (greater than 20 days), in comparison with those patients undergoing therapy of a moderate duration (between 14–20 days) (p = 0.05). A significant relationship was also documented between poor nutritional intake during treatment and a higher incidence of nausea and vomiting (p = 0.01). Another important finding included the fact that those patients who lost more than 5% of their total body weight prior to starting radiotherapy, went on to experience further weight loss during therapy. Recommendations for further research and implications for clinical practice are outlined.

ISSN:0148-6071    

DOI:10.1177/014860718100500157

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

A number of patients receiving continuous intravenous infusions of hyperalimentation solutions require cimetidine (CT) for treatment of gastric hypersecretory conditions. Four patients were selected to receive a CT‐hyperalimentation mixture and serial blood sampling for CT concentrations. Rates of infusion of CT ranged from 38 to 56.3 mg/hr. Average serum concentrations (Css) of CT at steady state ranged from 0.6 to 1.0 μg/ml. This concentration range is near levels reported in patients receiving long‐term oral CT and is lower than levels reported to be associated with central nervous system toxicity. No evidence of renal toxicity was noted. Pharmacokinetic parameters were comparable to previous reports in the literature. This initial investigation reveals that continuous intravenous infusion of CT in hyperalimentation solutions appears to be a safe mode of drug administration. More definitive studies are needed to assess efficacy.

ISSN:0148-6071    

DOI:10.1177/014860718100500161

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Nitrogen balance was determined in 48 patients who were entered into a randomized prospective double‐blind study, comparing anabolic steroids versus placebo in our parenteral nutritional support system. The group included both young and old patients suffering from catabolic illnesses, in whom intravenous feeding ranged from 14–21 days. All participants received the active agent or placebo biweekly throughout the study. During the period of intravenous nutrition, there was no statistically significant difference in nitrogen balance and protein conservation in the patients receiving the active agent.

ISSN:0148-6071    

DOI:10.1177/014860718100500164

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Hepatic dysfunction associated with parenteral nutrition (PN) is a well recognized occurrence. In order to define the temporal inter‐relationships of direct bilirubin to other laboratory parameters, total and direct bilirubin, serum glutamic‐pyruvic transaminase (SGPT), serum glutamic‐oxaloacetic transaminase (SGOT), and alkaline phosphatase were measured prior to beginning PN and then weekly throughout the duration of PN in 60 consecutive neonates. Cholestatic jaundice (ChJ), defined as a direct bilirubin ≥2.0 mg/dl, developed in 11 (33%) of 33 infants receiving PN for at least 2 weeks. Direct bilirubin was the most sensitive and earliest indicator of ChJ. SGOT and SGPT values in the ChJ group were not statistically different from the non‐ChJ group until 2 weeks after the onset of cholestasis. Although there was a progressive increase in alkaline phosphatase during the course of PN, the increase was not greater in the ChJ group. In summary, direct bilirubin is the only laboratory indicator of hepatic status that need be determined serially in parenterally alimented infants. Although SGPT and SGOT may be helpful in characterizing hepatic dysfunction once ChJ has occurred, alkaline phosphatase levels do not reliably assess PN‐associated liver injury.

ISSN:0148-6071    

DOI:10.1177/014860718100500167

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Instant nutritional assessment of the critically ill patient using serum albumin level and total lymphocyte count is reported. When an intensive care unit population is compared to the general hospital population a 6‐fold increase in albumin level depressions, a 2‐fold increase in lymphocyte count depression, and an 11‐fold increase in depression of both parameters was noted in the intensive care unit population. Surgical intensive care unit (SICU) patients with depressed albumin levels and total lymphocyte counts had twice the complication rate and 4.5 times the death rate of those SICU patients with normal albumin levels and lymphocyte counts. It is concluded that serum albumin levels and total lymphocyte count determinations are valuable tools for instant nutritional assessment of the critically ill patient.

ISSN:0148-6071    

DOI:10.1177/014860718100500170

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

In an effort to determine an optimal method of utilizing the gastrointestinal tract to meet the nutritional need of burn patients, a comparison was made between continuous and intermittent delivery of lactose‐free tube‐fed diets in similar groups of burn‐injured patients. It was found that significantly less stool frequency and time required to achieve the nutritional goal occurred in patients treated with continuous pump tube feeding over those fed intermittently.

ISSN:0148-6071    

DOI:10.1177/014860718100500173

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Twenty‐three adult patients with protein‐calorie malnutrition were referred for outpatient tube feeding. Initial nutritional support with hypercaloric supplemented diets did not prevent further catabolism and weight loss, as the mean protein intake was 35.2 g/24 hr and the mean calorie intake was 844 cal/24 hr. Outpatient tube feeding was then initiated to deliver a mean of 78.5 g protein/24 hr and 2248 cal/24 hr. Patients on tube feeding demonstrated an increase of serum albumin and total body weight compared to diet therapy alone. The patient and family members were instructed in the technique of outpatient enteral feeding, which included instructions in feeding tube intubation, formula aspiration, and monitoring methods to prevent gastric aspiration and pooling. No major complications were observed. Home tube feeding was concluded to be a safe, efficient, and relatively inexpensive method of hyperalimentation for selected patients.

ISSN:0148-6071    

DOI:10.1177/014860718100500176

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

A performance evaluation of a new polyurethane nasogastric feeding tube and stainless steel stylette (Nutriflex, # 8 French) was conducted at University Hospital. Thirty‐eight tubes were successfully placed in 18 patients. Tubes remained in place less than 1–29 days and feedings were administered for a total of 196 patient days. Enteral formulas commonly available were administered via continuous drip. The tube use was surveyed for ease of insertion primarily; however, patency and comfort to the patient were felt to be positive with the use of this tube. With slight modifications the new feeding tube is a welcome addition to the expanding technology associated with enteral feedings.

ISSN:0148-6071    

DOI:10.1177/014860718100500180

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Eighteen pediatric oncology inpatients had 21 Hickman right atrial catheters placed for total venous access; 16 patients received parenteral nutrition. Mean duration of catheterization was 43 ± 29 (SD) days. Four catheters had to be removed for infection or clotting. The catheter‐related sepsis rate was 10%. Serious catheter‐related complications were no more frequent in this population than in patients receiving only parenteral nutrition via Broviac or pediatric Broviac catheters.

ISSN:0148-6071    

DOI:10.1177/014860718100500183

出版商:SAGE Publications    

年代:1981

数据来源: WILEY