摘要:

A survey was conducted to ascertain research involvement and interests of dietitians. The survey questionnaire was developed and mailed to 1200 dietitian members of The American Society of Parenteral and Enteral Nutrition (A.S.P.E.N.). Usable responses numbered 424 (35.3%); 84% were A.S.P.E.N. members 5 years or less. Currently 46% and previously 17% of respondents served on nutrition support (NS) teams. Two‐thirds of the group either completed or were enrolled in a graduate program. Only one‐half of the respondents had statistics and/or research methodology courses.Half the group spent no time in research, 10% gave 10–50 hr/week and nearly 80% wanted to spend more time in this activity. One‐fifth were principal investigators (PI), 27% were co‐investigators and 29% had collected data for others. Although 16% wrote proposals, fewer than 10% had projects approved and/or funded; co‐investigators were more successful than PIs in this regard. Several (22.2%) presented research papers or posters and 36% gave seminars, case studies, or short presentations. One‐fifth (20.8%) published research articles and 20.3% published other works.More than 80% expressed interest in collaborative research, perhaps because many felt they lacked skills needed to develop research designs, write proposals, analyze data, obtain funding, and get published. Most said research was not rewarded, of a low priority, and generally ignored by the dietetics department; 60.5% had great interest in research and 37.1% had adequate research opportunities. No significant differences were observed for those with graduate degrees or for members of NS teams but A.S.P.E.N. dietitians appeared to be more active in research than other dietitians (Journal of Parenteral and Enteral Nutrition12:1–7, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200101

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/0148607188012001011

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Limited data are available concerning resting metabolic expenditure (RME) in cancer patients and the effect of RME by varying glucose intake. This study describes the measurements on 21 patients with colorectal cancer while fasting and with incremental levels of standard TPN‐glucose system by central vein. Following an overnight fast, the measured mean ± SEM percent difference from the predicted RME for the male group was 4.13 ± 1.67% and the female group, 2.09 ± 2.09%. The overall mean percent difference of 2.95 ± 1.45 suggests that colorectal cancer does not cause an increase in energy expenditure. Hepatic metastases in 11 of the patients did not influence RME. The data from the 21 patients indicate a statistically significant increase in RME with TPN compared to postabsorptive states in females of 37%, in males 21.88%, and combined of 29.88%. Progressively greater increases in RME were seen when calories provided incrementally exceeded the basal RME. Carbohydrate loading in excess of the patient's calorie need, as indicated by the respiratory quotient (RQ) greater than 1.0, results in fat synthesis and other energy‐costing processes. The basal RME demonstrates that these cancer patients are not hypercatabolic, but do respond to high‐level force‐feeding with markedly increased metabolic expenditures.(Journal of Parenteral and Enteral Nutrition12:8–14, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200108

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Conventional long chain triglyceride (LCT) was compared with a new emulsion containing 50% medium chain triglyceride (5% MCT/5% LCT) in a randomized cross‐over trial of 10 days duration. Plasma concentrations of albumin, prealbumin, the complement components C3 and C4, and pro‐thrombin times measured daily at 8 am, before lipid infusion, showed no progressive change during the 10 days of the trial, nor in each separate 5‐day period when LCT or MCT/LCT was infused. Aspartate transaminase and alkaline phosphatase activities were similar over the two periods. There was a significant increase (compared with preinfusion levels) in C3 and C4 levels after 5 hr of either lipid infusion. Nitrogen balance was improved, and plasma bilirubin levels were lower on the regimen containing MCT/LCT. (Journal of Parenteral and Enteral Nutrition12:15–19, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200115

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

At least nine different equations have been published for calculating metabolic expenditure by indirect calorimetry. This study examined the differences between equations when they are used for the nutritional assessment in an intensive care unit (ICU). Oxygen consumption and carbon dioxide production were measured in 36 ICU patients and used to calculate metabolic expenditure with the nine equations. The equations produced differences in metabolic expenditure which averaged from 0.8–96 kcal/day. The largest difference produced by any two of the nine equations was 189 kcal/day. Although differences in original stoichiometric data have resulted in numerous different equations for the calculation of metabolic expenditure, these differences are not clinically important. It makes little difference which equation is used for nutritional assessment in an ICU.(Journal of Parenteral and Enteral Nutrition12:20–24, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200120

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

The microbial contamination rate was compared for parenteral nutrition solutions prepared by patients for home use and by pharmacy personnel for inpatient use. Phase I validated the Ivex 0.22‐μm inline filter as a tool for microbiological testing by inoculating small numbers of organisms in 5% dextrose injection and testing for recovery. Phase II validated the same method for determining microbial contamination of total parenteral nutrition (TPN) solutions. Phase III compared inpatient and home TPN microbial contamination rates using the methodology validated in phase II.Test organism inocula used in phase I and II wereCandida albicans, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Proteus vulgaris, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis,andStreptococcus pyogenes.All contaminated solutions in phase I showed visual turbidity within 48 hr, and all test organisms were recovered and identified.All phase II‐contaminated TPN solutions showed visual turbidity after 96 hr, and all test organisms were recovered and identified.One hundred postinfusion TPN samples were collected randomly during phase III from inpatient parenteral nutrition patients. Six patients and two hospitals participated in the study. None of the 44 home parenteral nutrition samples and none of the 56 inpatient TPN samples developed visible turbidity. Subcultures of each sample on blood agar were negative for microbial growth.This described methodology offers an effective means to establish contamination rates of parenteral nutrition solutions after administration.(Journal of Parenteral and Enteral Nutrition12:25–28, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200125

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Endogenous and exogenous supplies of carnitine are decreased in septic patients under total parenteral nutrition, while carnitine urinary elimination is increased. But the increase of lipid role in the energetic cover requires a greater intervening role of tissue carnitine. So one may hope that in septic patients additional supply of L‐carnitine would increase the catabolism of infused lipids. Twenty‐eight septic patients, admitted in an intensive care unit were given parenteral nutrition (200 g of glucose, 12.5 g of N/24 hr). On the day of the study, 250 ml of Intralipid 20% (Kabi Vitrum) were administered in 4 hr. During the same period 13 patients were infused with 2 g of L‐carnitine (Sigma‐Tau). The remaining 15 patients constituted the control group. Basic plasma levels of triglycerides, nonesterified fatty acids, free glycerol, phospholipids, and ketone bodies remained within physiological limits. They increased during the lipid infusion and returned to initial values, 4 hr after the end of the infusion. Free and total carnitine levels and free/total carnitine ratio were comparable to healthy subjects' reference values. These parameters increased during L‐carnitine infusion. This infusion had no effect on exogenous lipid clearance. However, it seemed to increase the uptake and the hepatic oxidation of circulating fatty acids. It invalidated the increase of lactate and pyruvate that had been noticed when lipids were solely infused.(Journal of Parenteral and Enteral Nutrition12:29–34, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200129

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718801200601

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718801200602

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718801200603

出版商:SAGE Publications    

年代:1988

数据来源: WILEY