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Sample records for enteral feeding program

  1. EARLY ENTERAL FEEDING AND DELAYED ENTERAL FEEDING- A COMPARATIVE STUDY

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    Alli Muthiah

    2017-03-01

    Full Text Available BACKGROUND Nutrients form the fuel for the body, which comes in the form of carbohydrates, proteins and lipids. The body is intended to burn fuels in order to perform work. Starvation with malnutrition affects the postoperative patients and patients with acute pancreatitis. There is an increased risk of nosocomial infections and a delay in the wound healing may be noted. They are more prone for respiratory tract infections. Enteral Nutrition (EN delivers nutrition to the body through gastrointestinal tract. This also includes the oral feeding. This study will review the administration, rationale and assess the pros and cons associated with the early initiation of enteral feeding. The aim of this study is to evaluate if early commencement of enteral nutrition compared to traditional management (delayed enteral feeding is associated with fewer complications and improved outcome-  In patients undergoing elective/emergency gastrointestinal surgery.  In patients with acute pancreatitis. It is also used to determine whether a period of starvation (nil by mouth after gastrointestinal surgery or in the early days of acute pancreatitis is beneficial in terms of specific outcomes. MATERIALS AND METHODS A prospective cohort interventional study was conducted using 100 patients from July 2012 to November 2012. Patients satisfying the inclusion and exclusion criteria were included in the study. Patients admitted in my unit for GIT surgeries or acute pancreatitis constituted the test group, while patients admitted in other units for similar disease processes constituted the control group. RESULTS Our study concluded that early enteral feeding resulted in reduced incidence of surgical site infections. When the decreased length of stay, shorter convalescent period and the lesser post-interventional fatigue were taken into account, early enteral feeding has a definite cost benefit.CONCLUSION Early enteral feeding was beneficial associated with fewer

  2. Enteral feeding without pancreatic stimulation

    DEFF Research Database (Denmark)

    Kaushik, Neeraj; Pietraszewski, Marie; Holst, Jens Juul

    2005-01-01

    OBJECTIVE: All forms of commonly practiced enteral feeding techniques stimulate pancreatic secretion, and only intravenous feeding avoids it. In this study, we explored the possibility of more distal enteral infusions of tube feeds to see whether activation of the ileal brake mechanism can result...

  3. Enteral feeding pumps: efficacy, safety, and patient acceptability

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    White H

    2014-08-01

    Full Text Available Helen White, Linsey King Nutrition and Dietetic Group, School of Health and Wellbeing, Faculty Health and Social Science, Leeds Metropolitan University, Leeds, United Kingdom Abstract: Enteral feeding is a long established practice across pediatric and adult populations, to enhance nutritional intake and prevent malnutrition. Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered is more limited. The accuracy, safety, and consistency with which enteral feed pump systems dispense nutritional formulae are important determinants of their use and acceptability. Enteral feed pump safety has received increased interest in recent years as enteral pumps are used across hospital and home settings. Four areas of enteral feed pump safety have emerged: the consistent and accurate delivery of formula; the minimization of errors associated with tube misconnection; the impact of continuous feed delivery itself (via an enteral feed pump; and the chemical composition of the casing used in enteral feed pump manufacture. The daily use of pumps in delivery of enteral feeds in a home setting predominantly falls to the hands of parents and caregivers. Their understanding of the use and function of their pump is necessary to ensure appropriate, safe, and accurate delivery of enteral nutrition; their experience with this is important in informing clinicians and manufacturers of the emerging needs and requirements of this diverse patient population. The review highlights current practice and areas of concern and establishes our current knowledge in this field. Keywords: nutrition, perceptions, experience

  4. Comparison of Intermittent and Bolus Enteral Feeding Methods on Enteral Feeding Intolerance of Patients with Sepsis: A Triple-blind Controlled Trial in Intensive Care Units.

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    Nasiri, Morteza; Farsi, Zahra; Ahangari, Mojtaba; Dadgari, Fahimeh

    2017-10-01

    BACKGROUND Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis. METHODS This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension. RESULTS There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume ( p > 0.05). Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days ( p > 0.05). CONCLUSION As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly.

  5. Enteral Feeding Set Handling Techniques.

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    Lyman, Beth; Williams, Maria; Sollazzo, Janet; Hayden, Ashley; Hensley, Pam; Dai, Hongying; Roberts, Cristine

    2017-04-01

    Enteral nutrition therapy is common practice in pediatric clinical settings. Often patients will receive a pump-assisted bolus feeding over 30 minutes several times per day using the same enteral feeding set (EFS). This study aims to determine the safest and most efficacious way to handle the EFS between feedings. Three EFS handling techniques were compared through simulation for bacterial growth, nursing time, and supply costs: (1) rinsing the EFS with sterile water after each feeding, (2) refrigerating the EFS between feedings, and (3) using a ready-to-hang (RTH) product maintained at room temperature. Cultures were obtained at baseline, hour 12, and hour 21 of the 24-hour cycle. A time-in-motion analysis was conducted and reported in average number of seconds to complete each procedure. Supply costs were inventoried for 1 month comparing the actual usage to our estimated usage. Of 1080 cultures obtained, the overall bacterial growth rate was 8.7%. The rinse and refrigeration techniques displayed similar bacterial growth (11.4% vs 10.3%, P = .63). The RTH technique displayed the least bacterial growth of any method (4.4%, P = .002). The time analysis in minutes showed the rinse method was the most time-consuming (44.8 ± 2.7) vs refrigeration (35.8 ± 2.6) and RTH (31.08 ± 0.6) ( P refrigerating the EFS between uses is the next most efficacious method for handling the EFS between bolus feeds.

  6. Nutritional support of bone marrow transplant recipients: a prospective, randomized clinical trial comparing total parental nutrition to an enteral feeding program

    International Nuclear Information System (INIS)

    Szeluga, D.J.

    1985-01-01

    Allogeneic and autologous bone marrow transplantation (BMT) have been associated with nutritionally-depleting side effects. Total parental nutrition (TPN) has become the standard, but it has not been demonstrated that TPN is the appropriate method of nutritional support. Therefore, in a prospective, randomized clinical trial TPN and enteral feeding were compared for their effectiveness in maintaining the nutritional status of patients through the first 29 post-transplant days. Nutritional assessment included measurement of serum proteins, body weight, anthropometry and isotope dilution analysis of body composition. Total body water (TBW) and extracellular fluid (ECF) were quantified by standard radioisotope dilution techniques using tritiated water and 169 ytterbium-diethylenetriaminepentaacetate, respectively as the tracers. Consenting patients 10-58 years of age were stratified by type of BMT (autologous or allogeneic) and randomized to either TPN plus ad libitum oral feeding or the individualized enteral feeding program (EFP), which included one-on-one counseling, meal-by-meal menu selection, special snacks and tube feeding. There were no differences in the rate of hematologic recovery, incidence of graft-versus-host disease, organ toxicity, length of hospitalization or survival. Therefore, the observed changes in body composition were not clinically significant. Even allowing for increased dietary service, the EFP was only half as expensive as TPN. It was concluded that TPN is not superior to the EFP and therefore, TPN should be reserved for patients who demonstrate intolerance to enteral feeding

  7. Parenteral and Early Enteral Feeding in Patients with Colonic Tumor

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    O. A. Malkov

    2008-01-01

    Full Text Available Objective: to provide evidence whether it is expedient to use an early enteral feeding protocol in patients with colonic malignancies in the postoperative period to prevent and to correct hemodynamic disorders, oxygen imbalance, and malnutrition. Subjects and methods. A hundred patients (61 males and 39 females aged 66.2±5.0 years, who had Stages 2—3 colonic malignancies, were examined. Two algorithms of postoperative management were analyzed using the traditional diet and early enteral feeding. Results. The early enteral feeding protocol improves central hemodynamics and oxygen and nutritional status, prevents moderate protein-energy deficiency in the early postoperative period and reduces the number of complications and fatal outcomes in patients with colonic malignancies. Key words: malignancies, malnutrition, hemo-dynamics, oxygen status, enteral feeding.

  8. Human milk consumption and full enteral feeding among infants who weigh

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    Sisk, Paula M; Lovelady, Cheryl A; Gruber, Kenneth J; Dillard, Robert G; O'Shea, T Michael

    2008-06-01

    Establishing enteral feeding is an important goal in the care of very low birth weight infants. In such infants, receipt of >/=50 mL/kg per day human milk during hospitalization has been associated with shorter time to full enteral feeding. The objective of this study was to determine whether high proportions (>/=50%) of human milk during feeding advancement are associated with shorter time to full enteral feeding and improved feeding tolerance. This was a prospective cohort study of very low birth weight infants (n = 127) who were grouped into low (/=50%; n = 93) human milk consumption groups according to their human milk proportion of enteral feeding during the time of feeding advancement. The primary outcomes of interest were ages at which 100 and 150 mL/kg per day enteral feedings were achieved. The high human milk group reached 100 mL/kg per day enteral feeding 4.5 days faster than the low human milk group. The high human milk group reached 150 mL/kg per day enteral feeding 5 days faster than the low human milk group. After adjustment for gestational age, gender, and respiratory distress syndrome, times to reach 100 and 150 mL/kg per day were significantly shorter for those in the high human milk group. Infants in the high human milk group had a greater number of stools per day; other indicators of feeding tolerance were not statistically different. In infants who weighed milk was associated with fewer days to full enteral feedings.

  9. Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery

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    Mohammadtaghi Rajabi Mashhadi

    2015-09-01

    Full Text Available Introduction: The incidence of malnutrition in hospitalized patients is reported to be high. In particular, patients with esophageal cancer are prone to malnutrition, due to preoperative digestive system dysfunctions and short-term non-oral feeding postoperatively. Selection of an appropriate method for feeding in the postoperative period is important in these patients.   Materials and Methods: In this randomized clinical trial, 40 patients with esophageal cancer who had undergone esophagectomy between September 2008 and October 2009 were randomly assigned into either enteral feeding or parenteral feeding groups, with the same calorie intake in each group. The level of serum total protein, albumin, prealbumin, transferrin, C3, C4 and hs-C-reactive protein          (hs-CRP, as well as the rate of surgical complications, restoration of bowel movements and cost was assessed in each group.   Results: Our results showed that there was no significant difference between the groups in terms of serum albumin, prealbumin or transferrin. However, C3 and C4 levels were significantly higher in the enteral feeding group compared with the parenteral group, while hs-CRP level was significantly lower in the enteral feeding group. Bowel movements were restored sooner and costs of treatment were lower in the enteral group. Postoperative complications did not differ significantly between the groups. There was one death in the parenteral group 10 days after surgery due to myocardial infarction.   Conclusion:  The results of our study showed that enteral feeding can be used effectively in the first days after surgery, with few early complications and similar nutritional outcomes compared with the parenteral method. Enteral feeding was associated with reduced inflammation and was associated with an improvement in immunological responses, quicker return of bowel movements, and reduced costs in comparison with parenteral feeding.

  10. Pediatric Enteric Feeding Techniques: Insertion, Maintenance, and Management of Problems

    International Nuclear Information System (INIS)

    Nijs, Els L. F.; Cahill, Anne Marie

    2010-01-01

    Enteral feeding is considered a widespread, well-accepted means of delivering nutrition to adults and children who are unable to consume food by mouth or who need support in maintaining adequate nutrition for a variety of reasons, including acute and chronic disease states. Delivery of enteral feeding to nutritionally deprived patients may be achieved by several means. In this article, the indications and insertion of enteral access in children will be reviewed. In addition, common complications and management of problems will be discussed.

  11. Study on the relationship between infant rotavirus enteritis and breast feeding

    International Nuclear Information System (INIS)

    Chen Yanping; Liu Hui; Sun Xuerong; Wei Tao; Wang Bin

    2005-01-01

    Objective: To study the relationship between infant rotavirus enteritis and breast feeding, with emphasis on early immuno-protection provided by breast feeding as well as later possible hazards with rotavirus carrier mothers. Methods: Stool specimens from 520 infants with diarrhea were screened for rotavirus with colloid gold method. Positive specimens were confirmed with RT-PCR. Results: In local (Qingdao) infants with enteritis, the over-all incidence of rotavirus infection was 31.2%. Positive rate in breast-feeding infants was only 26.8%, being significantly lower than that in bottle-feeding ones (45.2%). The virus infectivity rate in both groups of breast- feeding infants (below 6 months and 7-12 months) was lower than the corresponding rate in the bottle feeding group. However, infant fed from rotavirus carriers had significantly higher fecal positive rate of rotavirus than that in infants fed from non-carriers. Conclusion: (1) At beginning, especially below 6 months, breast-feeding provided important protection again rotavirus enteritis in the infants. (2) certain infections could be transmitted through breast feedings, which deserved closer observation. (authors)

  12. In Vitro Evaluation of Eslicarbazepine Delivery via Enteral Feeding Tubes.

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    Reindel, Kristin; Zhao, Fang; Hughes, Susan; Dave, Vivek S

    2017-12-01

    Purpose: The feasibility of preparing an eslicarbazepine acetate suspension using Aptiom tablets for administration via enteral feeding tubes was evaluated. Methods: Eslicarbazepine acetate suspension (40 mg/mL) was prepared using Aptiom tablets after optimizing the tablet crushing methods and the vehicle composition. A stability-indicating high-performance liquid chromatography (HPLC) method was developed to monitor the eslicarbazepine stability in the prepared suspension. Three enteric feeding tubes of various composition and dimensions were evaluated for the delivery of the suspensions. The suspension was evaluated for the physical and chemical stability for 48 hours. Results: The reproducibility and consistency of particle size reduction was found to be best with standard mortar/pestle. The viscosity analysis and physical stability studies showed that ORA-Plus:water (50:50 v/v) was optimal for suspending ability and flowability of suspension through the tubes. The developed HPLC method was found to be stability indicating and suitable for the assay of eslicarbazepine acetate in the prepared suspension. The eslicarbazepine concentrations in separately prepared suspensions were within acceptable range (±3%), indicating accuracy and reproducibility of the procedure. The eslicarbazepine concentrations in suspensions before and after delivery through the enteric feeding tubes were within acceptable range (±4%), indicating absence of any physical/chemical interactions of eslicarbazepine with the tubes and a successful delivery of eslicarbazepine dosage via enteric feeding tubes. The stability study results showed that eslicarbazepine concentration in the suspension remained unchanged when stored at room temperature for 48 hours. Conclusion: The study presents a convenient procedure for the preparation of a stable suspension of eslicarbazepine acetate (40 mg/mL) using Aptiom tablets, for administration via enteral feeding tubes.

  13. Critical analysis of the factors associated with enteral feeding in preventing VAP: a systematic review.

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    Chen, Yu-Chih

    2009-04-01

    Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre-post) studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent), feeding site on aspiration (gastric vs. small bowel), and the timing of enteral feeding (early vs. late). The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP still need further

  14. Critical Analysis of the Factors Associated with Enteral Feeding in Preventing VAP: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Yu-Chih Chen

    2009-04-01

    Full Text Available Ventilator-associated pneumonia (VAP is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre–post studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent, feeding site on aspiration (gastric vs. small bowel, and the timing of enteral feeding (early vs. late. The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP

  15. Enteral feeding practices in preterm infants in South Africa

    African Journals Online (AJOL)

    Background. Optimal feeding regimens in babies weighing <1 000 g have not been established, and wide variations occur. In South Africa. (SA) this situation is complicated by varied resource constraints. Objective. To determine the preterm enteral feeding practices of paediatricians in SA. Methods. We invited 288 ...

  16. Implementation of enteral feeding protocol in an intensive care unit

    DEFF Research Database (Denmark)

    Padar, Martin; Uusvel, Gerli; Starkopf, Liis

    2017-01-01

    AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013......, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population...... the groups. Patients in the After group had a lower 90-d (P = 0.026) and 120-d (P = 0.033) mortality. In the After group, enteral nutrition was prescribed less frequently (P = 0.039) on day 1 but significantly more frequently on all days from day 3. Implementation of the feeding protocol resulted in a higher...

  17. Neonatal enteral feeding tubes as loci for colonisation by members of the Enterobacteriaceae

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    Smith Craig

    2009-09-01

    Full Text Available Abstract Background The objective of this study was to determine whether neonatal nasogastric enteral feeding tubes are colonised by the opportunistic pathogen Cronobacter spp. (Enterobacter sakazakii and other Enterobacteriaceae, and whether their presence was influenced by the feeding regime. Methods One hundred and twenty-nine tubes were collected from two neonatal intensive care units (NICU. A questionnaire on feeding regime was completed with each sample. Enterobacteriaceae present in the tubes were identified using conventional and molecular methods, and their antibiograms determined. Results The neonates were fed breast milk (16%, fortified breast milk (28%, ready to feed formula (20%, reconstituted powdered infant formula (PIF, 6%, or a mixture of these (21%. Eight percent of tubes were received from neonates who were 'nil by mouth'. Organisms were isolated from 76% of enteral feeding tubes as a biofilm (up to 107 cfu/tube from neonates fed fortified breast milk and reconstituted PIF and in the residual lumen liquid (up to 107 Enterobacteriaceae cfu/ml, average volume 250 μl. The most common isolates were Enterobacter cancerogenus (41%, Serratia marcescens (36%, E. hormaechei (33%, Escherichia coli (29%, Klebsiella pneumoniae (25%, Raoultella terrigena (10%, and S. liquefaciens (12%. Other organisms isolated included C. sakazakii (2%,Yersinia enterocolitica (1%,Citrobacter freundii (1%, E. vulneris (1%, Pseudomonas fluorescens (1%, and P. luteola (1%. The enteral feeding tubes were in place between 48 h (13%. All the S. marcescens isolates from the enteral feeding tubes were resistant to amoxicillin and co-amoxiclav. Of additional importance was that a quarter of E. hormaechei isolates were resistant to the 3rd generation cephalosporins ceftazidime and cefotaxime. During the period of the study, K. pneumoniae and S. marcescens caused infections in the two NICUs. Conclusion This study shows that neonatal enteral feeding tubes

  18. Age most significant predictor of requiring enteral feeding in head-and-neck cancer patients

    International Nuclear Information System (INIS)

    Sachdev, Sean; Refaat, Tamer; Bacchus, Ian D; Sathiaseelan, Vythialinga; Mittal, Bharat B

    2015-01-01

    A significant number of patients treated for head and neck squamous cell cancer (HNSCC) undergo enteral tube feeding. Data suggest that avoiding enteral feeding can prevent long-term tube dependence and disuse of the swallowing mechanism which has been linked to complications such as prolonged dysphagia and esophageal constriction. We examined detailed dosimetric and clinical parameters to better identify those at risk of requiring enteral feeding. One hundred patients with advanced stage HNSCC were retrospectively analyzed after intensity-modulated radiation therapy (IMRT) to a median dose of 70 Gy (range: 60-75 Gy) with concurrent chemotherapy in nearly all cases (97%). Patients with significant weight loss (>10%) in the setting of severely reduced oral intake were referred for placement of a percutaneous endoscopic gastrostomy (PEG) tube. Detailed DVH parameters were collected for several structures. Univariate and multivariate analyses using logistic regression were used to determine clinical and dosimetric factors associated with needing enteral feeding. Dichotomous outcomes were tested using Fisher’s exact test and continuous variables between groups using the Wilcoxon rank-sum test. Thirty-three percent of patients required placement of an enteral feeding tube. The median time to tube placement was 25 days from start of treatment, after a median dose of 38 Gy. On univariate analysis, age (p = 0.0008), the DFH (Docetaxel/5-FU/Hydroxyurea) chemotherapy regimen (p = .042) and b.i.d treatment (P = 0.040) (used in limited cases on protocol) predicted need for enteral feeding. On multivariate analysis, age remained the single statistically significant factor (p = 0.003) regardless of other clinical features (e.g. BMI) and all radiation planning parameters. For patients 60 or older compared to younger adults, the odds ratio for needing enteral feeding was 4.188 (p = 0.0019). Older age was found to be the most significant risk factor for needing enteral feeding in

  19. Enteral Nutrition for Feeding Severely Underfed Patients with Anorexia Nervosa

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    Maria Gabriella Gentile

    2012-09-01

    Full Text Available Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium. In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1 to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; (2 to avoid “underfeeding” caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI of 11.2 ± 0.7 kg/m2. The mean BMI increased from 11.2 ± 0.7 kg/m2 to 17.3 ± 1.6 kg/m2 and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p < 0.0001. Caloric intake levels were established after measuring resting energy expenditure by indirect calorimetry, and nutritional support was performed with enteral feeding. Vitamins, phosphate, and potassium supplements were administered during refeeding. All patients achieved a significant modification of BMI; none developed refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.

  20. Enteral feeding via jejunostomy as a cause of intestinal perforation and necrosis

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    María Victoria Vieiro-Medina

    Full Text Available Background: Jejunostomy for enteral feeding is excellent for patients who cannot manage oral intake, with a low complication rate. A Foley catheter, Ryle tube, Kerh tube or needle-catheter (Jejuno-Cath® are commonly used. It is a safe procedure but it can lead to severe complications. Case report: We present two cases: firstly, an 80 year old male who was admitted to the Emergency Room with a bowel perforation secondary to Jejuno-Cath® for enteral feeding after a subtotal gastrectomy with Roux-en-Y reconstruction; and secondly, a 53 year old male who was admitted to the Emergency Room due to gastric perforation developing multiple complications, including bowel necrosis and enteral feeding impaction. Discussion: We have reviewed the recent literature with regard to this rare complication.

  1. Critical Analysis of the Factors Associated with Enteral Feeding in Preventing VAP: A Systematic Review

    OpenAIRE

    Yu-Chih Chen

    2009-01-01

    Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving a...

  2. Nurses' Competency and Challenges in Enteral feeding in the ...

    African Journals Online (AJOL)

    Studies have emphasised the role of nurses in nutritional support. .... Ethical consideration. The study was ... Mann-Whitney U test was applied to make associations ..... based guidelines and critical care nurses knowledge of enteral feeding.

  3. Compounded Apixaban Suspensions for Enteral Feeding Tubes.

    Science.gov (United States)

    Caraballo, Maria L; Donmez, Seda; Nathan, Kobi; Zhao, Fang

    2017-07-01

    Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of 7 days. Methods: Apixaban suspensions were prepared from commercially available 5-mg Eliquis tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride, with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A 7-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40% to 60% Ora-Plus in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus:water, was compatible with both tubing types, retaining >98% drug in posttube samples. The stability study also confirmed that this formulation was stable physically and chemically over 7 days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus:water. The stability study results supported a beyond-use date of 7 days at room temperature.

  4. EVALUATION OF THE MICROBIAL CONTAMINATION OF HOSPITAL-MADE ENTERAL FEEDINGS

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    KATHIA ROSSI ROLIM LOPES

    2009-07-01

    Full Text Available

    ABSTRACT: The quality of enteral feeding formulations prepared at hospital, which are intended for feeding children with malnutrition and diarrhoea, was investigated. A total of eight freshly prepared samples and ten frozen samples were analised. Five of the frozen samples were thawed in the hospital, and the other five in the laboratory, in similar conditions, i. e. in water bath at 50ºC. The freshly prepared samples showed mesophilic aerobic bacteria count varying between 10 to 104 CFU/ml. The presence of total coliform (three samples, fecal coliform (two samples and B. cereus (one sample was also detected. The samples thawed in the laboratory showed a satisfactory quality whilst the formulations thawed in hospital showed higher mesophiles counts and improper counts of S. aureus (two samples and B. cereus (one sample. These results were probably due to a erroneous manipulation of some untrained personnel and emphasize the importance to keep a permanent quality control to avoid the occurrence of contamination, specially for feeding formulations intended for populations at high risk. KEYWORDS: Enteral feeding; bacterial contamination; control.

  5. Metabolic assessment and enteral tube feeding usage in children with acute neurological diseases

    Directory of Open Access Journals (Sweden)

    Heitor Pons Leite

    Full Text Available OBJECTIVE: To report on acquired experience of metabolic support for children with acute neurological diseases, emphasizing enteral tube feeding usage and metabolic assessment, and also to recommend policies aimed towards improving its implementation. DESIGN: Retrospective analysis. SETTING: Pediatric Intensive Care Unit of Hospital do Servidor Público Estadual de São Paulo. SUBJECTS: 44 patients consecutively admitted to the Pediatric ICU over a period of 3 years who were given nutrition and metabolic support for at least 72 hours. Head trauma, CNS infections and craniotomy post-operative period following tumor exeresis were the main diagnoses. MEASUREMENTS: Records of protein-energy intake, nutrient supply route, nitrogen balance and length of therapy. RESULTS: From a total of 527 days of therapy, single parenteral nutrition was utilized for 34.3% and single enteral tube feeding for 79.1% of that period. 61.4% of the children were fed exclusively via enteral tube feeding, 9.1% via parenteral and 39.5 % by both routes. The enteral tube feeding was introduced upon admission and transpyloric placement was successful in 90% of the cases. Feeding was started 48 hours after ICU admission. The caloric goal was achieved on the 7th day after admission, and thereafter parenteral nutrition was interrupted. The maximum energy supply was 104.2 ± 23.15 kcal/kg. The median length of therapy was 11 days (range 4-38. None of the patients on tube feeding developed GI tract bleeding, pneumonia or bronchoaspiration episodes and, of the 4 patients who were given exclusive TPN, 2 developed peptic ulcer. The initial urinary urea nitrogen was 7.11 g/m2 and at discharge 6.44 g/m2. The protein supply increased from 1.49 g/kg to 3.65 g/kg (p< 0.01. The nitrogen balance increased from -7.05 to 2.2 g (p< 0.01. CONCLUSIONS: Children with acute neurological diseases are hypercatabolic and have high urinary nitrogen losses. The initial negative nitrogen balance can be

  6. Enteral Feeding in Abdominal Compartment Syndrome

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    Ye. V Grigoryev

    2009-01-01

    Full Text Available Objective: to substantiate the choice of a gastrointestinal tract (GIT function support regimen as a mode for correction of the abdominal compartment syndrome (ACS. Subjects and methods. Forty-three patients with different causes of inadequate GIT function of various origin and ACS (disseminated peritonitis (45%, pancreatitis (24%, and severe concomitant injury (31% were examined. Group 1 (control received complete parenteral nutritional feeding (n=23; APACHE II scores, 21±4; calculated probability of fatal outcome, 33.5%. In Group II (study, complete parenteral feeding in the first 24 hours after stabilization was supplemented with GIT function support with Pepsisorb (Nutricia in doses of 500, 1000, and 1500 ml on days 1, 2, and 3, respectively (n=20; APACHE II scores, 20±6; calculated probability of fatal outcome, 37.1%. During early enteral nutritional support, the SOFA score was significantly less than that in Group 1 on days 2—3; the oxygenation index significantly increased on day 3; the value of intra-abdominal hypertension decreased to the control values. The positive effect of the GIT function support regimen on regression of the multiple organ dysfunction syndrome (MODS was confirmed by the lowered levels of biological markers (von Willebrand factor (WF and endothelin-1 as markers of endothelial damage of MODS. Correlation analysis showed a direct correlation between the markers of endothelial damage and the SOFA scores (r=0.34; p=0.05 for WF and r=0.49;p=0.03 for endothelin. Conclusion. The GIT function support regimen via early enteral alimentation with Peptisorb, which was initiated in the first 24 hours after admission, is able to level off the manifestations of the early stages of the abdominal compartment syndrome, with the acceptable values of oxygen balance and water-electrolyte and osmotic homeostasis being achieved. Key words: abdominal compartment syndrome, nutritional support, biological markers, oxygenation index

  7. Effect of minimal enteral feeding on recovery in a methotrexate-induced gastrointestinal mucositis rat model

    NARCIS (Netherlands)

    Kuiken, Nicoline S. S.; Rings, Edmond H. H. M.; Havinga, Rick; Groen, Albert K.; Tissing, Wim J. E.

    Patients suffering from gastrointestinal mucositis often receive parenteral nutrition as nutritional support. However, the absence of enteral nutrition might not be beneficial for the intestine. We aimed to determine the feasibility of minimal enteral feeding (MEF) administration in a methotrexate

  8. Association between illness severity and timing of initial enteral feeding in critically ill patients: a retrospective observational study

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    Huang Hsiu-Hua

    2012-05-01

    Full Text Available Abstract Background Early enteral nutrition is recommended in cases of critical illness. It is unclear whether this recommendation is of most benefit to extremely ill patients. We aim to determine the association between illness severity and commencement of enteral feeding. Methods One hundred and eight critically ill patients were grouped as “less severe” and “more severe” for this cross-sectional, retrospective observational study. The cut off value was based on Acute Physiology and Chronic Health Evaluation II score 20. Patients who received enteral feeding within 48 h of medical intensive care unit (ICU admission were considered early feeding cases otherwise they were assessed as late feeding cases. Feeding complications (gastric retention/vomiting/diarrhea/gastrointestinal bleeding, length of ICU stay, length of hospital stay, ventilator-associated pneumonia, hospital mortality, nutritional intake, serum albumin, serum prealbumin, nitrogen balance (NB, and 24-h urinary urea nitrogen data were collected over 21 days. Results There were no differences in measured outcomes between early and late feedings for less severely ill patients. Among more severely ill patients, however, the early feeding group showed improved serum albumin (p = 0.036 and prealbumin (p = 0.014 but worsened NB (p = 0.01, more feeding complications (p = 0.005, and prolonged ICU stays (p = 0.005 compared to their late feeding counterparts. Conclusions There is a significant association between severity of illness and timing of enteral feeding initiation. In more severe illness, early feeding was associated with improved nutritional outcomes, while late feeding was associated with reduced feeding complications and length of ICU stay. However, the feeding complications of more severely ill early feeders can be handled without significantly affecting nutritional intake and there is no eventual difference in length of hospital stay or mortality

  9. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition

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    Vasileios Alivizatos

    2015-04-01

    Full Text Available Aim: The aim of this study was to evaluate the long-term complications and problems related to gastrostomy and jejunostomy feeding tubes used for home enteral nutrition support and the effect these have on health care use. Materials and Methods: The medical records of 31 patients having gastrostomy (27 patients and jejunostomy (4 feeding tubes inserted in our Department were retrospectively studied. All were discharged on long-term (>3 months enteral nutrition and followed up at regular intervals by a dedicated nurse. Any problem or complication associated with tube feeding as well as the intervention, if any, that occurred, was recorded. Data were collected and analyzed. Results: All the patients were followed up for a mean of 17.5 months (4-78. The most frequent tube-related complications included inadvertent removal of the tube (broken tube, plugged tube; 45.1%, tube leakage (6.4%, dermatitis of the stoma (6.4%, and diarrhea (6.4%. There were 92 unscheduled health care contacts, with an average rate of such 2.9 contacts over the mean follow-up time of 17.5 months. Conclusion: In patients receiving long-term home enteral nutrition, feeding tube-related complications and problems are frequent and result in significant health care use. Further studies are needed to address their optimal prevention modalities and management.

  10. Carers' experiences of home enteral feeding: A survey exploring medicines administration challenges and strategies.

    Science.gov (United States)

    Alsaeed, D; Furniss, D; Blandford, A; Smith, F; Orlu, M

    2018-06-01

    The use of enteral tube feeding at home is becoming more widespread, with patients ranging in age and diseases. Dysphagia and swallowing difficulties can compromise nutritional intake and the administration of oral medications, affecting therapeutic outcomes negatively. Carers' experiences of medicines administration and medicines optimization have not been explored fully. The objectives of this study were to identify issues carers experience in medicines administration; the strategies they have developed to cope; and suggestions to improve the medicines administration process. An online survey was promoted nationally; 42 carers completed it. Descriptive statistical analysis was applied, as well as thematic analysis of open-ended responses. Results were compared against the 4 principles of medicines optimization. 93% of respondents administered medications with enteral feeding tubes, but only 62% had received advice from healthcare professionals and only 8% had received written information on how to do so. Responses identified 5 medicines administration issues experienced by carers; 4 strategies they developed to cope; and 3 main areas of suggestions to improve medicines administration via enteral feeding at home. The 4 principles of medicines optimization have not previously been applied to enteral feeding. We present a novel account of carers' experiences, for example coping with ill-suited formulations and a lack of training and support, which should inform better practice (Principle 1). Carers sometimes experience suboptimal choice of medicines (Principle 2). Carers' practices are not always well-informed and may affect therapeutic outcomes and safety (Principle 3). There is scope for improvement in carer training, education and support to better support medicines optimization (Principle 4). © 2018 The Authors. Journal of Clinical Pharmacy and Therapeutics Published by John Wiley & Sons Ltd.

  11. Combined enteral feeding and total parenteral nutritional support improves outcome in surgical intensive care unit patients.

    Science.gov (United States)

    Hsu, Min-Hui; Yu, Ying E; Tsai, Yueh-Miao; Lee, Hui-Chen; Huang, Ying-Che; Hsu, Han-Shui

    2012-09-01

    For intensive care unit (ICU) patients with gastrointestinal dysfunction and in need of total parenteral nutrition (TPN) support, the benefit of additional enteral feeding is not clear. This study aimed to investigate whether combined TPN with enteral feeding is associated with better outcomes in surgical intensive care unit (SICU) patients. Clinical data of 88 patients in SICU were retrospectively collected. Variables used for analysis included route and percentage of nutritional support, total caloric intake, age, gender, body weight, body mass index, admission diagnosis, surgical procedure, Acute Physiology and Chronic Health Evaluation (APACHE) II score, comorbidities, length of hospital stay, postoperative complications, blood glucose values and hospital mortality. Wound dehiscence and central catheter infection were observed more frequently in the group of patients receiving TPN calories less than 90% of total calorie intake (p = 0.004 and 0.043, respectively). APACHE II scores were higher in nonsurvivors than in survivors (p = 0.001). More nonsurvivors received TPN calories exceeding 90% of total calorie intake and were in need of dialysis during ICU admission (p = 0.005 and 0.013, respectively). Multivariate analysis revealed that the percentage of TPN calories over total calories and APACHE II scores were independent predictors of ICU mortality in patients receiving supplementary TPN after surgery. In SICU patients receiving TPN, patients who could be fed enterally more than 10% of total calories had better clinical outcomes than patients receiving less than 10% of total calorie intake from enteral feeding. Enteral feeding should be given whenever possible in severely ill patients. 2012 Published by Elsevier B.V

  12. Conversion of choledochojejunostomy stents to jejunal feeding tubes for postoperative enteral alimentation.

    Science.gov (United States)

    Burke, D R; Torosian, M H; McLean, G K; Meranze, S G; Rosato, E F

    1988-01-01

    The problem of protein calorie malnutrition following major gastrointestinal surgery can be treated with central venous or enteric alimentation, with the latter being preferred. The authors describe a simple technique for the conversion of biliary stents placed after pancreaticoduodenal surgery into jejunal feeding tubes when the stenting function is no longer needed. Three illustrative cases are presented. In each case, the procedure took less than 30 min and had no associated morbidity. This technique allows early conversion from central venous to enteric alimentation without the need to create a second surgical enterostomy.

  13. Mechanisms Affecting the Gut of Preterm Infants in Enteral Feeding Trials

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    Nicholas D. Embleton

    2017-05-01

    Full Text Available Large randomized controlled trials (RCTs in preterm infants offer unique opportunities for mechanistic evaluation of the risk factors leading to serious diseases, as well as the actions of interventions designed to prevent them. Necrotizing enterocolitis (NEC a serious inflammatory gut condition and late-onset sepsis (LOS are common feeding and nutrition-related problems that may cause death or serious long-term morbidity and are key outcomes in two current UK National Institutes for Health Research (NIHR trials. Speed of increasing milk feeds trial (SIFT randomized preterm infants to different rates of increases in milk feeds with a primary outcome of survival without disability at 2 years corrected age. Enteral lactoferrin in neonates (ELFIN randomizes infants to supplemental enteral lactoferrin or placebo with a primary outcome of LOS. This is a protocol for the mechanisms affecting the gut of preterm infants in enteral feeding trials (MAGPIE study and is funded by the UK NIHR Efficacy and Mechanistic Evaluation programme. MAGPIE will recruit ~480 preterm infants who were enrolled in SIFT or ELFIN. Participation in MAGPIE does not change the main trial protocols and uses non-invasive sampling of stool and urine, along with any residual resected gut tissue if infants required surgery. Trial interventions may involve effects on gut microbes, metabolites (e.g., short-chain fatty acids, and aspects of host immune function. Current hypotheses suggest that NEC and/or LOS are due to a dysregulated immune system in the context of gut dysbiosis, but mechanisms have not been systematically studied within large RCTs. Microbiomic analysis will use next-generation sequencing, and metabolites will be assessed by mass spectrometry to detect volatile organic and other compounds produced by microbes or the host. We will explore differences between disease cases and controls, as well as exploring the actions of trial interventions. Impacts of this research

  14. Delayed initiation but not gradual advancement of enteral formula feeding reduces the incidence of necrotizing enterocolitis (NEC in preterm pigs.

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    Nada Ghoneim

    Full Text Available Enteral formula feeding is a risk factor for necrotizing enterocolitis (NEC in premature infants, yet studies are conflicting regarding the safest timing for introduction and advancement of feeds. Our aim was to test the effects of early vs. late initiation and abrupt vs. gradual advancement of enteral feeding of an intact vs. hydrolyzed protein formula on NEC incidence and severity in preterm pigs. In Experiment 1, preterm pigs received total parenteral nutrition (TPN at birth with abrupt initiation of enteral formula feeds (50% full intake on d of life (DOL 2 (EA or 5 (LA while PN continued. Pigs were also fed formula containing either intact or hydrolyzed protein. In Experiment 2, preterm pigs received TPN at birth with enteral, hydrolyzed-protein formula feeds introduced on DOL 2 either abruptly (EA; 50% full feeds or gradually (EG; 10-50% full feeds over 5 d while PN continued. NEC incidence and severity were assessed based on macroscopic and histological scoring. In Experiment 1, NEC incidence (41% vs. 70%, P<0.05 and severity were reduced in LA vs. EA groups and LA was associated with a higher survival rate, daily weight gain and jejunum villus height. Piglets fed hydrolyzed vs. intact protein formula had lower stomach content weights and similar NEC incidence. In Experiment 2, NEC incidence and severity were not different between pigs the EG vs. EA group. Proinflammatory gene expression (IL-1β, IL-6 and S100A9 in the ileum was lower in both LA and EG vs. EA groups. In conclusion, delayed initiation but not gradual advancement of enteral feeding is protective against NEC in preterm pigs. Feeding hydrolyzed vs. intact protein formula improved gastric transit without affecting the NEC incidence.

  15. Enteric methane emissions from low- and high-residual feed intake beef heifers measured using GreenFeed and respiration chamber techniques.

    Science.gov (United States)

    Alemu, A W; Vyas, D; Manafiazar, G; Basarab, J A; Beauchemin, K A

    2017-08-01

    The objectives of this study were to evaluate the relationship between residual feed intake (RFI; g/d) and enteric methane (CH) production (g/kg DM) and to compare CH and carbon dioxide (CO) emissions measured using respiration chambers (RC) and the GreenFeed emission monitoring (GEM) system (C-Lock Inc., Rapid City, SD). A total of 98 crossbred replacement heifers were group housed in 2 pens and fed barley silage ad libitum and their individual feed intakes were recorded by 16 automated feeding bunks (GrowSafe, Airdrie, AB, Canada) for a period of 72 d to determine their phenotypic RFI. Heifers were ranked on the basis of phenotypic RFI, and 16 heifers (8 with low RFI and 8 with high RFI) were randomly selected for enteric CH and CO emissions measurement. Enteric CH and CO emissions of individual animals were measured over two 25-d periods using RC (2 d/period) and GEM systems (all days when not in chambers). During gas measurements metabolic BW tended to be greater ( ≤ 0.09) for high-RFI heifers but ADG tended ( = 0.09) to be greater for low-RFI heifers. As expected, high-RFI heifers consumed 6.9% more feed ( = 0.03) compared to their more efficient counterparts (7.1 vs. 6.6 kg DM/d). Average CH emissions were 202 and 222 g/d ( = 0.02) with the GEM system and 156 and 164 g/d ( = 0.40) with RC for the low- and high-RFI heifers, respectively. When adjusted for feed intake, CH yield (g/kg DMI) was similar for high- and low-RFI heifers (GEM: 27.7 and 28.5, = 0.25; RC: 26.5 and 26.5, = 0.99). However, CH yield differed between the 2 measurement techniques only for the high-RFI group ( = 0.01). Estimates of CO yield (g/kg DMI) also differed between the 2 techniques ( ≤ 0.03). Our study found that high- and low-efficiency cattle produce similar CH yield but different daily CH emissions. The 2 measurement techniques differ in estimating CH and CO emissions, partially because of differences in conditions (lower feed intakes of cattle while in chambers, fewer days

  16. Enteral tube feeding alters the oral indigenous microbiota in elderly adults.

    Science.gov (United States)

    Takeshita, Toru; Yasui, Masaki; Tomioka, Mikiko; Nakano, Yoshio; Shimazaki, Yoshihiro; Yamashita, Yoshihisa

    2011-10-01

    Enteral tube feeding is widely used to maintain nutrition for elderly adults with eating difficulties, but its long-term use alters the environment of the oral ecosystem. This study characterized the tongue microbiota of tube-fed elderly adults by analyzing the 16S rRNA gene. The terminal restriction fragment length polymorphism (T-RFLP) profiles of 44 tube-fed subjects were compared with those of 54 subjects fed orally (average age, 86.4 ± 6.9 years). Bar-coded pyrosequencing data were also obtained for a subset of the subjects from each group (15 tube-fed subjects and 16 subjects fed orally). The T-RFLP profiles demonstrated that the microbiota of the tube-fed subjects was distinct from that of the subjects fed orally (permutational multivariate analysis of variance [perMANOVA], P < 0.001). The pyrosequencing data revealed that 22 bacterial genera, including Corynebacterium, Peptostreptococcus, and Fusobacterium, were significantly more predominant in tube-fed subjects, whereas the dominant genera in the subjects fed orally, such as Streptococcus and Veillonella, were present in much lower proportions. Opportunistic pathogens rarely detected in the normal oral microbiota, such as Corynebacterium striatum and Streptococcus agalactiae, were often found in high proportions in tube-fed subjects. The oral indigenous microbiota is disrupted by the use of enteral feeding, allowing health-threatening bacteria to thrive.

  17. THAWING PROCEDURES FOR HOSPITAL-MADE ENTERAL FEEDINGS: SURVIVAL OF COLIFORM AND MESOPHILIC AEROBIC BACTERIA

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    KATHIA ROSSI ROLIM LOPES

    2009-07-01

    Full Text Available

    ABSTRACT: This study had the purpose to observe the effect of thawing procedures on survival of coliform and mesophilic aerobic bacteria in hospital-made enteral feedings. The samples are represented by three different lots. The tests were realized in three moments: immediately after the sample preparation and after freezing during 1 or 2 months. The thawing procedures were denominated convencional and alternative. The first, used by hospital, utilizes water bath at 50ºC, considering the time spent from the total thawing to its distribution in the infirmaries. The second was the fast thawing made by microwaving. The results showed that the reduction of the mesophiles and coliform was related to the time the samples were frozen. The results obtained indicate an advantage of the alternative method, which presented lower total and fecal coliform counts than the conventional one. KEYWORDS: Enteral feedings; thawing; food microbiology.

  18. Enteral feeding and its impact on family mealtime routines for caregivers of children with cerebral palsy: A mixed method study.

    Science.gov (United States)

    Russell, Marion; Jewell, Vanessa; Poskey, Gail A; Russell, Asa

    2018-02-01

    Enteral feedings are part of the daily mealtime experience for many caregivers of children with cerebral palsy. The scope of occupational therapy practice incorporates multiple aspects of the enteral feeding process. Yet, the research in this area is very limited. The purpose of this study was to provide practitioners with better understanding of the impact enteral feedings of children with cerebral palsy have on family mealtime routines. Using a complimentary mixed method approach, data were obtained through an online survey containing the Satisfaction Questionnaire with Gastrostomy Feeding (SAGA-8) and supplementary questions, and qualitative semi-structured phone interviews. Participants were caregivers of children with cerebral palsy who receive their primary nutrition through a gastrostomy tube. This study's cohort consisted of n = 36, SAGA-8, and n = 6 in-depth interviews. The mean age of children of was 9.4 (6.94 SD) with a mean age of 3.4 (5.35 SD) when enteral feeding was introduced. While families' overall situations positively changed after the gastronomy tube placement, environmental barriers and length of feeding time continued to present a challenge to mealtime routines. The mixed methods data analysis revealed that successful adjustment to having a child with a gastronomy tube and problem solving are closely linked and a consistent part of mealtime experience. Findings highlighted the necessity of comprehensive support from health professionals in achieving positive mealtime experience. Themes in this study indicated that caregivers would benefit from a professional with knowledge in the development and integration of rituals and routines to support positive outcomes. © 2017 Occupational Therapy Australia.

  19. The Challenges of Home Enteral Tube Feeding: A Global Perspective

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2015-04-01

    Full Text Available The aim of this review is to provide a global perspective of Home Enteral Tube Feeding (HETF and to outline some of the challenges of home enteral nutrition (HEN provisions. It is well established that the number of patients on HETF is on the increase worldwide due to advances in technology, development of percutaneous endoscopic gastrostomy techniques, and the shift in care provisions from acute to community settings. While the significance of home enteral nutrition in meeting the nutritional requirements of patients with poor swallowing reflexes and those with poor nutritional status is not in doubt, differences exist in terms of funding, standards, management approaches and the level of infrastructural development across the world. Strategies for alleviating some of the challenges militating against the effective delivery of HETF including the development of national and international standards, guidelines and policies for HETF, increased awareness and funding by government at all levels were discussed. Others, including development of HEN services, which should create the enabling environment for multidisciplinary team work, clinical audit and research, recruitment and retention of specialist staff, and improvement in patient outcomes have been outlined. However, more research is required to fully establish the cost effectiveness of the HEN service especially in developing countries and to compare the organization of HEN service between developing and developed countries.

  20. The early enteral feeding and rehabilitation of severely burned patients%严重烧伤患者的早期肠道营养与康复

    Institute of Scientific and Technical Information of China (English)

    邢德荣

    2002-01-01

    Objective To explore the effect of rehabilitation through analysis the early enteral feeding on the prevention of enteral infection in severely burned patients .Method A total of 22 patients with severe burns were randomly divided into an early enteral feeding group (EF) and a delayed enteral feeding group (DF). The levels of serum endotoxin were detected in the members of both groups in 1, 3, and 5 days .Result The levels of serum endotoxin in severely burned patients were significantly higher than in normal subjects (P< 0.01) . The levels of serum endotoxin in the EF group were significantly lower than in the DF group (P< 0.01). Conclusion Early enteral feeding may decrease enterogenic infection and it helps the nutrition support, improve the patient resistance, facilitate the repair of damaged tissue , so it contributes to the rehabilitation of burned patients.

  1. Compounding rifampin suspensions with improved injectability for nasogastric enteral feeding tube administration.

    Science.gov (United States)

    de Villiers, Melgardt M; Vogel, Laura; Bogenschutz, Monica C; Fingerhut, Bonnie J; D'Silva, Joseph B; Moore, Anne

    2010-01-01

    Often medications that have to be administered to patients via a nasogastric enteral feeding tubes are only available as tablets and capsules with no suitable commercial liquid alternatives. In such situations, pharmacists and nurses have to compound the tablets and capsule contents into liquid suspension formulations for dosing. The risk of occlusion of the enteral tubes during administration is reduced by employing liquid suspensions that are composed of small and uniform particles, not subject to rapid rates of settling, resistant to caking, and easily and uniformly re-suspended upon agitation. Present techniques often employ a manual process, such as a mortar and pestle, to accomplish the particle size reduction and subsequent incorporation into a suitable liquid diluent. A new compounding device has been invented that employs an automated wet-milling process in a single-use disposable plastic container to compound the suspensions. The two processes were compared using Rifampin capsules and various liquid diluents. A prototype version of the new device was employed in the experiments. The physical characteristics of the compounded suspensions were evaluated by determining sedimentation rate, sedimentation volume, and particle size and shape using laser light scattering, optical microscopy, and scanning electron microscopy techniques. The use characteristic of the compounded suspensions was evaluated using a nasogastric tube inject ability test. The results indicated that suspensions prepared using the new device were more resistant to sedimentation and caking and were easier to re-disperse into a uniform mixture by gentle shaking. The results were a consequence of the particles generated by the new device which were found to be smaller and more uniform in shape and size. The suspensions prepared using the new device did not cause blockage of the enteral feeding tubes in comparison to those prepared using a mortar and pastle. In conclusion, the results indicate

  2. Introducing enteral feeding induces intestinal subclinical inflammation and respective chromatin changes in preterm pigs

    DEFF Research Database (Denmark)

    Willems, Rhea; Krych, Lukasz; Rybicki, Verena

    2015-01-01

    AIM: To analyze how enteral food introduction affects intestinal gene regulation and chromatin structure in preterm pigs. MATERIALS & METHODS: Preterm pigs were fed parenteral nutrition plus/minus slowly increasing volumes of enteral nutrition. Intestinal gene-expression and chromatin structure......; no significant differences for colostrum) with corresponding decondensed chromatin configurations. On histology this correlated with mild mucosal lesions, particularly in formula-fed pigs. In CaCo-2 cells, histone hyperacetylation led to a marked increase in TLR4 mRNA and increased IL8 expression upon...... stimulation with lipopolysaccharide (median: 7.0; interquartile range: 5.63-8.85) compared with naive cells (median 4.2; interquartile range: 2.45-6.33; p = 0.03). CONCLUSION: Enteral feeding, particular with formula, induces subclinical inflammation in the premature intestine and more open chromatin...

  3. Predictors of Enteral Tube Feeding in Hospitalized Older Adults.

    Science.gov (United States)

    Crenitte, Milton Roberto Furst; Avelino-Silva, Thiago Junqueira; Apolinario, Daniel; Curiati, Jose Antonio Esper; Campora, Flavia; Jacob-Filho, Wilson

    2017-11-01

    Despite general recognition that enteral tube feeding (ETF) is frequently employed in long-term care facilities and patients with dementia, remarkably little research has determined which factors are associated with its use in acutely ill older adults. In this study, we aimed to investigate determinants of ETF introduction in hospitalized older adults. We examined a retrospective cohort of acutely ill patients, aged 60 years and older, admitted to a university hospital's geriatric ward from 2014-2015, in São Paulo, Brazil. The main outcome was the introduction of ETF during hospitalization. Predictors of interest included age, sex, referring unit, comorbidity burden, functional status, malnutrition, depression, dementia severity, and delirium. Multivariate analysis was performed using backward stepwise logistic regression. A total of 214 cases were included. Mean age was 81 years, and 63% were women. Malnutrition was detected in 47% of the cases, dementia in 46%, and delirium in 36%. ETF was initiated in 44 (21%) admissions. Independent predictors of ETF were delirium (odds ratio [OR], 4.83; 95% CI, 2.12-11.01; P ETF. One in five acutely ill older adults used ETF while hospitalized. Delirium and functional dependency were independent predictors of its introduction. Risks and benefits of enteral nutrition in this particular context need to be further explored.

  4. Enteral Feeding Tube Clogging: What Are the Causes and What Are the Answers? A Bench Top Analysis.

    Science.gov (United States)

    Garrison, Christopher M

    2018-02-01

    Clogged enteral feeding tubes remain a significant barrier to the delivery of nutrition, hydration, and medications to patients who cannot tolerate oral intake. There is limited research that compares the relative efficacy of different methods used to clear a clogged feeding tube. The objectives of this study were to better understand the factors that contribute to enteral feeding tube clogging and to test the efficacy of 3 methods for clearing clogged feeding tubes. Three formulations of clogs were artificially created and tested in vitro and composed of various quantities of crushed medication (ie, aspirin) and 0.15 g coagulated protein (ie, tofu). The following 3 clog clearing strategies were tested on all clog types (n = 5 clogs/formulation/treatment): warm water flushes, an enzyme treatment, and an actuated mechanical occlusion clearing device. The variable among the clog types that appears most responsible for decreased clearing success is the state of the coagulated protein. Dried-out protein appears to makes a greater difference than increasing the medication quantity. The actuated mechanical occlusion clearing device was significantly more successful (93%) when compared with warm water flushes (20%) and the commercially available enzyme treatment (33%; P Nutrition.

  5. Cup feeding versus other forms of supplemental enteral feeding for newborn infants unable to fully breastfeed.

    Science.gov (United States)

    Flint, Anndrea; New, Karen; Davies, Mark W

    2016-08-31

    Breast milk provides optimal nutrition for term and preterm infants, and the ideal way for infants to receive breast milk is through suckling at the breast. Unfortunately, this may not always be possible for medical or physiological reasons such as being born sick or preterm and as a result requiring supplemental feeding. Currently, there are various ways in which infants can receive supplemental feeds. Traditionally in neonatal and maternity units, bottles and nasogastric tubes have been used; however, cup feeding is becoming increasingly popular as a means of offering supplemental feeds in an attempt to improve breastfeeding rates. There is no consistency to guide the choice of method for supplemental feeding. To determine the effects of cup feeding versus other forms of supplemental enteral feeding on weight gain and achievement of successful breastfeeding in term and preterm infants who are unable to fully breastfeed. We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 1), MEDLINE via PubMed (1966 to 31 January 2016), Embase (1980 to 31 January 2016), and CINAHL (1982 to 31 January 2016). We also searched clinical trials' databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised or quasi-randomised controlled trials comparing cup feeding to other forms of enteral feeding for the supplementation of term and preterm infants. Data collection and analysis was performed in accordance with the methods of Cochrane Neonatal. We used the GRADE approach to assess the quality of evidence.The review authors independently conducted quality assessments and data extraction for included trials. Outcomes reported from these studies were: weight gain; proportion not breastfeeding at hospital discharge; proportion not feeding at three months of age; proportion not feeding at six

  6. Enteral feeding induces diet-dependent mucosal dysfunction, bacterial proliferation, and necrotizing enterocolitis in preterm pigs on parenteral nutrition

    DEFF Research Database (Denmark)

    Bjørnvad, Charlotte R.; Thymann, Thomas; Deutz, Nicolaas E.

    2008-01-01

    Preterm neonates have an immature gut and metabolism and may benefit from total parenteral nutrition (TPN) before enteral food is introduced. Conversely,delayed enteral feeding may inhibit gut maturation and sensitize to necrotizing enterocolitis (NEC). Intestinal mass and NEC lesions were first...... formula after TPN. Conversely, colostrum milk diets improve gut maturation and NEC resistance in preterm pigs subjected to a few days of TPN after birth....

  7. Diarrhea in enterally fed patients: blame the diet?

    Science.gov (United States)

    Chang, Sue-Joan; Huang, Hsiu-Hua

    2013-09-01

    Diarrhea has great impact on enteral nutrition. The purpose of this review is to identify the factors leading to diarrhea during enteral nutrition and to provide the published updates on diarrhea prevention through nutritional intervention. Diarrhea in enteral fed patients is attributed to multiple factors, including medications (major contributor), infections, bacterial contamination, underlying disease, and enteral feeding. Diet management can alleviate diarrhea in enteral feeding. High content of fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) in enteral formula is postulated to induce diarrhea and lower FODMAPs formula may reduce the likelihood of diarrhea in enterally fed patients. Fiber-enriched formula can reduce the incidence of diarrhea and produce short-chain fatty acids for colonocytes. Ingesting prebiotics, nonviable probiotics or probiotic derivatives, and human lactoferrin may provide alternatives for reducing/preventing diarrhea. Enteral feeding is not generally considered the primary cause of diarrhea, which is frequently linked to prescribed medications. When diarrhea is apparent, healthcare members should evaluate the possible risk factors and systematically attempt to eliminate the underlying causes of diarrhea before reducing or suspending enteral feeding. Lower FODMAPs formula, prebiotics, probiotic derivatives, and lactoferrin may be used to manage enteral feeding-related diarrhea.

  8. Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low-birthweight infants: a systematic review.

    Science.gov (United States)

    Kamphorst, Kim; Sietsma, Ydelette; Brouwer, Annemieke J; Rood, Paul J T; van den Hoogen, Agnes

    2016-11-01

    Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies published between 2007 and 2014 and covered 495 infants. Suppositories were ineffective in shortening the time to reach full enteral feeding, and the evidence on enemas was contradictory. Enemas and rectal stimulation did not shorten the time until complete meconium evacuation was reached. Further research into safe, effective interventions to accelerate meconium excretion is needed. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  9. Enteral Feeding Tubes in Patients Undergoing Definitive Chemoradiation Therapy for Head-and-Neck Cancer: A Critical Review

    Energy Technology Data Exchange (ETDEWEB)

    Koyfman, Shlomo A., E-mail: koyfmas@ccf.org [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Adelstein, David J. [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States)

    2012-11-01

    Definitive chemoradiation therapy has evolved as the preferred organ preservation strategy in the treatment of locally advanced head-and-neck cancer (LA-HNC). Dry mouth and dysphagia are among the most common and most debilitating treatment-related toxicities that frequently necessitate the placement of enteral feeding tubes (FT) in these patients to help them meet their nutritional requirements. The use of either a percutaneous endoscopic gastrostomy tube or a nasogastric tube, the choice of using a prophylactic vs a reactive approach, and the effects of FTs on weight loss, hospitalization, quality of life, and long-term functional outcomes are areas of continued controversy. Considerable variations in practice patterns exist in the United States and abroad. This critical review synthesizes the current data for the use of enteral FTs in this patient population and clarifies the relative advantages of different types of FTs and the timing of their use. Recent developments in the biologic understanding and treatment approaches for LA-HNC appear to be favorably impacting the frequency and severity of treatment-related dysphagia and may reduce the need for enteral tube feeding in the future.

  10. Enteral Tube Feeding Alters the Oral Indigenous Microbiota in Elderly Adults ▿ †

    OpenAIRE

    Takeshita, Toru; Yasui, Masaki; Tomioka, Mikiko; Nakano, Yoshio; Shimazaki, Yoshihiro; Yamashita, Yoshihisa

    2011-01-01

    Enteral tube feeding is widely used to maintain nutrition for elderly adults with eating difficulties, but its long-term use alters the environment of the oral ecosystem. This study characterized the tongue microbiota of tube-fed elderly adults by analyzing the 16S rRNA gene. The terminal restriction fragment length polymorphism (T-RFLP) profiles of 44 tube-fed subjects were compared with those of 54 subjects fed orally (average age, 86.4 ± 6.9 years). Bar-coded pyrosequencing data were also ...

  11. Identification of risk factors for enteral feeding intolerance screening in critically ill patients

    Science.gov (United States)

    Xu, Lei; Wang, Ting; Chen, Ting; Yang, Wen-Qun; Liang, Ze-Ping; Zhu, Jing-Ci

    2017-01-01

    Objectives: To identify risk factors for enteral feeding intolerance screening in critically ill patients, thereby, provide some reference for healthcare staff to assess the risk of feeding intolerance, and lay the foundation for future scale development. Methods: This study used a mixed methodology, including a literature review, semi-structured interviews, the Delphi technique, and the analytic hierarchy process. We used the literature review and semi-structured interviews (n=22) to draft a preliminarily item pool for feeding intolerance, Delphi technique (n=30) to screen and determine the items, and the analytic hierarchy process to calculate the weight of each item. The study was conducted between June 2014 and September 2015 in Daping Hospital, Third Military Medical University, Chongqing, China. Results: Twenty-three risk factors were selected for the scale, including 5 dimensions. We assigned a weight to each item according to their impact on the feeding intolerance, with a higher score indicating a greater impact. The weight of each dimension was decreasing as follows: patient conditions, weight score equals 42; general conditions, weight score equals 23; gastrointestinal functions, weight score equals 15; biochemical indexes, weight score equals 14; and treatment measures, weight score equals 6. Conclusion: Developed list of risk factors based on literature review, survey among health care professionals and expert consensus should provide a basis for future studies assessing the risk of feeding intolerance in critically ill patients. PMID:28762434

  12. Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low-birthweight infants : a systematic review

    NARCIS (Netherlands)

    Kamphorst, Kim; Sietsma, Ydelette; Brouwer, Annemieke J; Rood, Paul J T; van den Hoogen, Agnes

    2016-01-01

    Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies

  13. [Modular enteral nutrition in pediatrics].

    Science.gov (United States)

    Murillo Sanchís, S; Prenafeta Ferré, M T; Sempere Luque, M D

    1991-01-01

    Modular Enteral Nutrition may be a substitute for Parenteral Nutrition in children with different pathologies. Study of 4 children with different pathologies selected from a group of 40 admitted to the Maternal-Childrens Hospital "Valle de Hebrón" in Barcelona, who received modular enteral nutrition. They were monitored on a daily basis by the Dietician Service. Modular enteral nutrition consists of modules of proteins, peptides, lipids, glucids and mineral salts-vitamins. 1.--Craneo-encephalic traumatisms with loss of consciousness, Feeding with a combination of parenteral nutrition and modular enteral nutrition for 7 days. In view of the tolerance and good results of the modular enteral nutrition, the parenteral nutrition was suspended and modular enteral nutrition alone used up to a total of 43 days. 2.--55% burns with 36 days of hyperproteic modular enteral nutrition together with normal feeding. A more rapid recovery was achieved with an increase in total proteins and albumin. 3.--Persistent diarrhoea with 31 days of modular enteral nutrition, 5 days on parenteral nutrition alone and 8 days on combined parenteral nutrition and modular enteral nutrition. In view of the tolerance and good results of the modular enteral nutrition, the parenteral nutrition was suspended. 4.--Mucoviscidosis with a total of 19 days on modular enteral nutrition, 12 of which were exclusively on modular enteral nutrition and 7 as a night supplement to normal feeding. We administered proteic intakes of up to 20% of the total calorific intake and in concentrations of up to 1.2 calories/ml of the final preparation, always with a good tolerance. Modular enteral nutrition can and should be used as a substitute for parenteral nutrition in children with different pathologies, thus preventing the complications inherent in parenteral nutrition.

  14. Nitrate but not tea saponin feed additives decreased enteric methane emissions in nonlactating cows.

    Science.gov (United States)

    Guyader, J; Eugène, M; Doreau, M; Morgavi, D P; Gérard, C; Loncke, C; Martin, C

    2015-11-01

    Tea saponin is considered a promising natural compound for reducing enteric methane emissions in ruminants. A trial was conducted to study the effect of this plant extract fed alone or in combination with nitrate on methane emissions, total tract digestive processes, and ruminal characteristics in cattle. The experiment was conducted as a 2 × 2 factorial design with 4 ruminally cannulated nonlactating dairy cows. Feed offer was restricted to 90% of voluntary intake and diets consisted of (DM basis): 1) control (CON; 50% hay and 50% pelleted concentrates), 2) CON with 0.5% tea saponin (TEA), 3) CON with 2.3% nitrate (NIT), and 4) CON with 0.5% tea saponin and 2.3% nitrate (TEA+NIT). Tea saponin and nitrate were included in pelleted concentrates. Diets contained similar amounts of CP (12.2%), starch (26.0%), and NDF (40.1%). Experimental periods lasted 5 wk including 2 wk of measurement (wk 4 and 5), during which intake was measured daily. In wk 4, daily methane emissions were quantified for 4 d using open circuit respiratory chambers. In wk 5, total tract digestibility, N balance, and urinary excretion of purine derivatives were determined from total feces and urine collected separately for 6 d. Ruminal fermentation products and protozoa concentration were analyzed from samples taken after morning feeding for 2 nonconsecutive days in wk 5. Tea saponin and nitrate supplementation decreased feed intake ( saponin did not modify methane emissions (g/kg DMI; > 0.05), whereas nitrate-containing diets (NIT and TEA+NIT) decreased methanogenesis by 28%, on average ( saponin, whereas nitrate-containing diets increased acetate proportion and decreased butyrate proportion and ammonia concentration ( saponin alone included in pelleted concentrates failed to decrease enteric methane emissions in nonlactating dairy cows.

  15. An early feeding regime and a high-density amino acid diet on growth performance of broilers under subclinical necrotic enteritis challenge

    OpenAIRE

    Chake Keerqin; Shu-Biao Wu; Birger Svihus; Robert Swick; Natalie Morgan; Mingan Choct

    2017-01-01

    Broilers that have early access to feed have been shown to have enhanced immune system and gut development and heightened resilience against necrotic enteritis (NE). This study examined the effect of early feeding a high amino acid density diet on performance of broilers under a sub-clinical NE challenge model. Ross 308 broilers (n = 576) were assigned to a 2 × 2 × 2 factorial design with 2 feeding regimes (feed access either within 6 h post-hatch or after 48 h post-hatch), 2 diets (control d...

  16. Feeding nitrate and docosahexaenoic acid affects enteric methane production and milk fatty acid composition in lactating dairy cows

    NARCIS (Netherlands)

    Klop, G.; Hatew, B.; Bannink, A.; Dijkstra, Jan

    2016-01-01

    An experiment was conducted to study potential interaction between the effects of feeding nitrate and docosahexaenoic acid (DHA; C22:6 n-3) on enteric CH4 production and performance of lactating dairy cows. Twenty-eight lactating Holstein dairy cows were grouped into 7 blocks of 4

  17. Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit.

    Science.gov (United States)

    Herich, Lena Carolin; Cuttini, Marina; Croci, Ileana; Franco, Francesco; Di Lallo, Domenico; Baronciani, Dante; Fares, Katia; Gargano, Giancarlo; Raponi, Massimiliano; Zeitlin, Jennifer

    2017-03-01

    To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units. This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect. There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers. In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Responsive Feeding: Implications for Policy and Program Implementation12

    Science.gov (United States)

    Engle, Patrice L.; Pelto, Gretel H.

    2011-01-01

    In this article, we examine responsive feeding as a nutrition intervention, with an emphasis on the development and incorporation of responsive feeding into policies and programs over the last 2 decades and recommendations for increasing the effectiveness of responsive feeding interventions. A review of policy documents from international agencies and high-income countries reveals that responsive feeding has been incorporated into nutrition policies. Official guidelines from international agencies, nongovernmental organizations, and professional organizations often include best practice recommendations for responsive feeding. Four potential explanations are offered for the rapid development of policies related to responsive feeding that have occurred despite the relatively recent recognition that responsive feeding plays a critical role in child nutrition and growth and the paucity of effectiveness trials to determine strategies to promote responsive feeding. Looking to the future, 3 issues related to program implementation are highlighted: 1) improving intervention specificity relative to responsive feeding; 2) developing protocols that facilitate efficient adaptation of generic guidelines to national contexts and local conditions; and 3) development of program support materials, including training, monitoring, and operational evaluation. PMID:21270361

  19. Attachment of and biofilm formation by Enterobacter sakazakii on stainless steel and enteral feeding tubes.

    Science.gov (United States)

    Kim, Hoikyung; Ryu, Jee-Hoon; Beuchat, Larry R

    2006-09-01

    Enterobacter sakazakii has been reported to form biofilms, but environmental conditions affecting attachment to and biofilm formation on abiotic surfaces have not been described. We did a study to determine the effects of temperature and nutrient availability on attachment and biofilm formation by E. sakazakii on stainless steel and enteral feeding tubes. Five strains grown to stationary phase in tryptic soy broth (TSB), infant formula broth (IFB), or lettuce juice broth (LJB) at 12 and 25 degrees C were examined for the extent to which they attach to these materials. Higher populations attached at 25 degrees C than at 12 degrees C. Stainless steel coupons and enteral feeding tubes were immersed for 24 h at 4 degrees C in phosphate-buffered saline suspensions (7 log CFU/ml) to facilitate the attachment of 5.33 to 5.51 and 5.03 to 5.12 log CFU/cm(2), respectively, before they were immersed in TSB, IFB, or LJB, followed by incubation at 12 or 25 degrees C for up to 10 days. Biofilms were not produced at 12 degrees C. The number of cells of test strains increased by 1.42 to 1.67 log CFU/cm(2) and 1.16 to 1.31 log CFU/cm(2) in biofilms formed on stainless steel and feeding tubes, respectively, immersed in IFB at 25 degrees C; biofilms were not formed on TSB and LJB at 25 degrees C, indicating that nutrient availability plays a major role in processes leading to biofilm formation on the surfaces of these inert materials. These observations emphasize the importance of temperature control in reconstituted infant formula preparation and storage areas in preventing attachment and biofilm formation by E. sakazakii.

  20. Enteral nutrition in surgery

    International Nuclear Information System (INIS)

    Sucha, R.; Lichvarova, I.; Duchon, R.; Dolnik, J.; Pindak, D.

    2011-01-01

    Enteral feeding provides physiologic, metabolic, safety, and cost benefits over parenteral nutrition. There are various ways enteral nutritional is administered and scheduled. The method of administration must be individualized to each patient's specific needs. Enteral nutrition is not only the supply of exogenous substrates and to prevent depletion of endogenous sources. Today the enteral nutrition becomes part of a therapeutic strategy to influence the severity of the disease to affect the function of GIT, and to modulate immune responses of the gut and the whole organism. Early enteral nutrition in the postoperative period reduces the risk of infectious complications. (author)

  1. Infection control in enteral feed and feeding systems in the community

    OpenAIRE

    Ojo, Omorogieva; Bowden, Julie

    2013-01-01

    This article examines the infection risk to adult patients receiving home enteral nutrition (HEN) and strategies for its prevention and management. Enteral nutrition was historically associated with acute care settings owing to its invasive nature. The changing landscape of community care means that it is now likely to be administered in the patient’s home or in other community settings such as nursing homes. HEN is associated with two main routes of infection risks: the risk of gastrointesti...

  2. Prevalence, risk factors, clinical consequences, and treatment of enteral feed intolerance during critical illness.

    Science.gov (United States)

    Gungabissoon, Usha; Hacquoil, Kimberley; Bains, Chanchal; Irizarry, Michael; Dukes, George; Williamson, Russell; Deane, Adam M; Heyland, Daren K

    2015-05-01

    We aimed to determine the incidence of enteral feed intolerance and factors associated with intolerance and to assess the influence of intolerance on nutrition and clinical outcomes. We conducted a retrospective analysis of data from an international observational cohort study of nutrition practices among 167 intensive care units (ICUs). Data were collected on nutrition adequacy, ventilator-free days (VFDs), ICU stay, and 60-day mortality. Intolerance was defined as interruption of enteral nutrition (EN) due to gastrointestinal (GI) reasons (large gastric residuals, abdominal distension, emesis, diarrhea, or subjective discomfort). Logistic regression was used to determine risk factors for intolerance and their clinical significance. A sensitivity analysis restricted to sites specifying a gastric residual volume ≥200 mL to identify intolerance was also conducted. Data from 1,888 ICU patients were included. The incidence of intolerance was 30.5% and occurred after a median 3 days from EN initiation. Patients remained intolerant for a mean (±SD) duration of 1.9 ± 1.3 days . Intolerance was associated with worse nutrition adequacy vs the tolerant (56% vs 64%, P intolerance remained associated with negative outcomes. Although mortality was greater among the intolerant patients, this was not statistically significant. Intolerance occurs frequently during EN in critically ill patients and is associated with poorer nutrition and clinical outcomes. © 2014 American Society for Parenteral and Enteral Nutrition.

  3. Prevalence, Outcomes, and Management of Enteral Tube Feeding Intolerance: A Retrospective Cohort Study in a Tertiary Center.

    Science.gov (United States)

    Wang, Kailun; McIlroy, Kerry; Plank, Lindsay D; Petrov, Max S; Windsor, John A

    2017-08-01

    Enteral tube feeding (ETF) is the most common form of artificial feeding in hospitalized patients, and the development of intolerance (ETFI) is the most common complication. This study aimed to determine the prevalence of ETFI, the clinical consequences, and the current management approach to ETFI in hospitalized adult patients. Adult patients receiving ETF were identified from a prospective database in the Nutrition Services at Auckland City Hospital. Further information was obtained by the review of clinical records for a 12-month period, up to December 2014. The prevalence of ETFI was 33% among 754 patients. ETFI more frequently occurred in the intensive care unit ( P ETF were also frequently attempted. ETFI is a frequent problem in adult hospitalized patients receiving ETF, and it is associated with poor clinical outcomes such as inadequate nutrition and complications of feeding. While the pathophysiology is poorly understood, there also appears to be no standard evidence-based treatment. Studies investigating the mechanisms and optimized management are therefore indicated.

  4. Environmental impacts of precision feeding programs applied in pig production.

    Science.gov (United States)

    Andretta, I; Hauschild, L; Kipper, M; Pires, P G S; Pomar, C

    2017-12-04

    This study was undertaken to evaluate the effect that switching from conventional to precision feeding systems during the growing-finishing phase would have on the potential environmental impact of Brazilian pig production. Standard life-cycle assessment procedures were used, with a cradle-to-farm gate boundary. The inputs and outputs of each interface of the life cycle (production of feed ingredients, processing in the feed industry, transportation and animal rearing) were organized in a model. Grain production was independently characterized in the Central-West and South regions of Brazil, whereas the pigs were raised in the South region. Three feeding programs were applied for growing-finishing pigs: conventional phase feeding by group (CON); precision daily feeding by group (PFG) (whole herd fed the same daily adjusted diet); and precision daily feeding by individual (PFI) (diets adjusted daily to match individual nutrient requirements). Raising pigs (1 t pig BW at farm gate) in South Brazil under the CON feeding program using grain cultivated in the same region led to emissions of 1840 kg of CO2-eq, 13.1 kg of PO4-eq and 32.2 kg of SO2-eq. Simulations using grain from the Central-West region showed a greater climate change impact. Compared with the previous scenario, a 17% increase in climate change impact was found when simulating with soybeans produced in Central-West Brazil, whereas a 28% increase was observed when simulating with corn and soybeans from Central-West Brazil. Compared with the CON feeding program, the PFG and PFI programs reduced the potential environmental impact. Applying the PFG program mitigated the potential climate change impact and eutrophication by up to 4%, and acidification impact by up to 3% compared with the CON program. Making a further adjustment by feeding pigs according to their individual nutrient requirements mitigated the potential climate change impact by up to 6% and the potential eutrophication and acidification impact

  5. Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding

    NARCIS (Netherlands)

    Kraaijeveld, FM; de Roos, N.M.; Belle-van Meerkerk, Gerdien; Teding van Berkhout, F; Heijerman, HGM; van de Graaf, EA

    2017-01-01

    Abstract BACKGROUND: Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. OBJECTIVE: This

  6. Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding

    NARCIS (Netherlands)

    Hollander, Francis M.; Roos, de Nicole M.; Belle-Van Meerkerk, Gerdien; Teding van Berkhout, Ferdinand; Heijerman, Harry G.M.; Graaf, van de Ed A.

    2017-01-01

    Background: Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. Objective: This study

  7. Ontario feed-in-tariff programs

    International Nuclear Information System (INIS)

    Yatchew, Adonis; Baziliauskas, Andy

    2011-01-01

    Recent feed-in-tariff (FIT) programs in Ontario, Canada have elicited a very strong supply response. Within the first year of their inception, the Ontario Power Authority received applications totaling over 15,000 MW, equivalent to about 43% of current Ontario electricity generating capacity. The overwhelming share of applications is for wind-power (69%) and solar photovoltaic (28%) generating facilities. Wind generation is being remunerated at 14-19 cents /kWh. Solar facilities receive from 40 to 80 cents /kWh. The initiative, which responds to Provincial legislation is administratively divided into applications for facilities exceeding 10 kW (the FIT program) and those less than or equal to 10 kW (the microFIT program). This paper describes the programs and their features, compares them to their predecessors in Ontario as well as to programs elsewhere, analyses the reasons for the very strong response, and assesses their efficacy and sustainability. - Research highlights: → Recent feed-in-tariff (FIT) programs in Ontario, Canada have elicited a very strong supply response. Within the first year, applications totaled over 15,000 MW, equivalent to about 43% of current Ontario electricity generating capacity. → Most projects are either solar or wind. → Likely causes of strong supply response-preferred system access and favorable, secure tariffs. (Wind generation is being remunerated at 14-19 cents /kWh. Solar facilities receive from 40 to 80 cents /kWh.) → Long term political sustainability of present program is in question.

  8. Validation of a predictive model describing growth of Salmonella in enteral feeds Validação de um modelo preditivo para descrever o crescimento de Salmonella em dietas enterais

    Directory of Open Access Journals (Sweden)

    Roberta Ribeiro Silva

    2009-03-01

    Full Text Available The growth of Salmonella enterica subs. enterica sorovar Typhimurium at 25°C was monitored in industrialized and hospital formulated enteral feeds and the results were used to validate the mathematical model of Salmonella growth presented by the Pathogen Modeling Program (PMP 7.0 (USDA-USA. The generation time of Salmonella in enteral feeds ranged from 21 to 34.8 min and, the maximum growth rate (µmax varied from 1.28 to 1.95 h-1, resulting in a population increase from 5 to 6 log10 cycles within 14 to 24 h incubation. Growth was faster in the hospital formulated feed containing vegetables and eggs. The growth kinetic's parameters as lag phase; µmax and maximum population density (MPD were similar to those predicted by the PMP 7.0, with exception of lag phase in enteral diet at pH 6.3. The results of this study validated the PMP 7.0 model for describe Salmonella growth in enteral feeds and demonstrates the appropriateness of use such model to determine the pathogen behavior in a wide range of storage conditions in this food.O crescimento de Salmonella enterica subs. enterica sorovar Typhimurium a 25°C foi determinado em dietas enterais industrializadas e formuladas em hospital e os resultados obtidos foram usados para validar um modelo matemático de crescimento de Salmonella apresentado no Programa de Modelagem de Patógenos (PMP, versão 7,0 (USDA-EUA. O tempo de geração de Salmonella em dietas enterais variou de 21 a 34,8 min e a velocidade específica máxima de crescimento (µmax foi de 1,28 a 1,95 h-1, resultando em aumento de 5 a 6 ciclos logarítimos em um período de 14 a 24 h de incubação. O crescimento foi mais rápido na dieta formulada em hospital contendo vegetais e ovos. Os parâmetros cinéticos como fase lag, µmax e densidade populacional máxima (MDP foram similares aqueles previstos no PMP 7.0, com exceção da fase lag em dietas enteral com pH 6,3. Os resultados deste estudo validaram o modelo do PMP 7,0 para

  9. Gastroenteric tube feeding: Techniques, problems and solutions

    Science.gov (United States)

    Blumenstein, Irina; Shastri, Yogesh M; Stein, Jürgen

    2014-01-01

    Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake, chronic neurological or mechanical dysphagia or gut dysfunction, and patients who are critically ill. However, despite the benefits and widespread use of enteral tube feeding, some patients experience complications. This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding, together with associated complications and special aspects. We conducted an extensive literature search on PubMed, Embase and Medline using index terms relating to enteral access, enteral feeding/nutrition, tube feeding, percutaneous endoscopic gastrostomy/jejunostomy, endoscopic nasoenteric tube, nasogastric tube, and refeeding syndrome. The literature showed common routes of enteral access to include nasoenteral tube, gastrostomy and jejunostomy, while complications fall into four major categories: mechanical, e.g., tube blockage or removal; gastrointestinal, e.g., diarrhea; infectious e.g., aspiration pneumonia, tube site infection; and metabolic, e.g., refeeding syndrome, hyperglycemia. Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route, gastrointestinal complications are without doubt the most common. Complications associated with enteral tube feeding can be reduced by careful observance of guidelines, including those related to food composition, administration rate, portion size, food temperature and patient supervision. PMID:25024606

  10. Early enteral feeding in postsurgical cancer patients. Fish oil structured lipid-based polymeric formula versus a standard polymeric formula.

    Science.gov (United States)

    Kenler, A S; Swails, W S; Driscoll, D F; DeMichele, S J; Daley, B; Babineau, T J; Peterson, M B; Bistrian, B R

    1996-01-01

    OBJECTIVES: The authors compared the safety, gastrointestinal tolerance, and clinical efficacy of feeding an enteral diet containing a fish oil/medium-chain triglyceride structured lipid (FOSL-HN) versus an isonitrogenous, isocaloric formula (O-HN) in patients undergoing major abdominal surgery for upper gastrointestinal malignancies. SUMMARY BACKGROUND DATA: Previous studies suggest that feeding with n-3 fatty acids from fish oil can alter eicosanoid and cytokine production, yielding an improved immunocompetence and a reduced inflammatory response to injury. The use of n-3 fatty acids as a structured lipid can improve long-chain fatty acid absorption. METHODS: This prospective, blinded, randomized trial was conducted in 50 adult patients who were jejunally fed either FOSL-HN or O-HN for 7 days. Serum chemistries, hematology, urinalysis, gastrointestinal complications, liver and renal function, plasma and erythrocyte fatty acid analysis, urinary prostaglandins, and outcome parameters were measured at baseline and on day 7. Comparisons were made in 18 and 17 evaluable patients based a priori on the ability to reach a tube feeding rate of 40 mL/hour. RESULTS: Patients receiving FOSL-HN experienced no untoward side effects, significant incorporation of eicosapentaenoic acid into plasma and erythrocyte phospholipids, and a 50% decline in the total number of gastrointestinal complications and infections compared with patients given O-HN. The data strongly suggest improved liver and renal function during the postoperative period in the FOSL-HN group. CONCLUSION: Early enteral feeding with FOSL-HN was safe and well tolerated. Results suggest that the use of such a formula during the postoperative period may reduce the number of infections and gastrointestinal complications per patient, as well as improve renal and liver function through modulation of urinary prostaglandin levels. Additional clinical trials to fully quantify clinical benefits and optimize nutritional

  11. Benefits of postpyloric enteral access placement by a nutrition support dietitian.

    Science.gov (United States)

    Jimenez, L Lee; Ramage, James E

    2004-10-01

    Although enteral nutrition is considered the preferred strategy for nutrition support, it is often precluded by nasogastric feeding intolerance or the inability to place feeding access into the postpyloric position. In an effort to improve enteral nutrition (EN) outcomes at our institution, the nutrition support dietitian (NSD) began placing postpyloric feeding tubes (PPFT) in intensive care unit patients. Intensive care unit patients who received blind, bedside PPFT placements by the NSD (n = 18) were compared with a concurrent age- and diagnosis-matched control group that received standard nutritional care without NSD intervention (n = 18). Interruption of EN infusion, appropriateness of parenteral nutrition (PN) prescription (based on American Society of Parenteral and Enteral Nutrition guidelines), and incidence of ventilator-associated pneumonia (VAP), as defined by the American College of Chest Physicians practice guidelines, were determined in each group. The NSD was successful in positioning the PPFT at or distal to the third portion of the duodenum in 83% of attempts. The PPFT group demonstrated no interruption of enteral feeding compared with 56% in the control group (p VAP in the PPFT group (6% vs 28%, p = .07). Of the PN initiations in the control group, 88% were deemed to be potentially avoidable; 6 of 8 PNs were initiated because of gastric residuals. Enteral nutrition facilitated by NSD placement of postpyloric feeding access is associated with improved tube feeding tolerance and reduced PN use. Further studies are needed to evaluate a possible effect of postpyloric feeding on the incidence of VAP.

  12. Waste feed delivery program systems engineering implementation plan

    International Nuclear Information System (INIS)

    O'Toole, S.M.; Hendel, B.J.

    1998-01-01

    This document defines the systems engineering processes and products planned by the Waste Feed Delivery Program to develop the necessary and sufficient systems to provide waste feed to the Privatization Contractor for Phase 1. It defines roles and responsibilities for the performance of the systems engineering processes and generation of products

  13. Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program.

    Science.gov (United States)

    Bozec, Alexandre; Benezery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, Olivier; Poissonnet, Gilles; Riss, Jean-Christophe; Hannoun-Lévi, Jean-Michel; Chand, Marie-Eve; Leysalle, Axel; Saada, Esma; Sudaka, Anne; Haudebourg, Juliette; Hebert, Christophe; Falewee, Marie-Noelle; Demard, François; Santini, José; Peyrade, Frédéric

    2016-09-01

    The objective of the study is to evaluate the nutritional status and determine its impact on clinical outcomes in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program without prophylactic feeding-tube placement. All patients with locally advanced (T3/4, N0-3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngolaryngectomy, treated by docetaxel, cisplatin and 5-fluorouracil (TPF)-ICT for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Patients' nutritional status was closely monitored. Enteral nutrition was used if and when a patient was unable to sustain per-oral nutrition and hydration. The impact of nutritional status on clinical outcomes was investigated in univariate and multivariate analysis. A total of 53 patients (42 men and 11 women, mean age = 58.6 ± 8.2 years) were included in this study. Six (11.3 %) patients had lost more than 10 % of their usual body weight before therapy. Compared with patients' usual weight, the mean maximum patient weight loss during therapeutic management was 8.7 ± 4.5 kg. Enteral nutrition was required in 17 patients (32 %). We found no influence of the tested nutritional status-related factors on response to ICT, toxicity of ICT, overall, cause-specific and recurrence-free survival, and on post-therapeutic swallowing outcome. Maximum weight loss was significantly associated with a higher risk of enteral tube feeding during therapy (p = 0.03) and of complications (grade ≥3, p = 0.006) during RT. Without prophylactic feeding-tube placement, approximately one-third of the patients required enteral nutrition. There was no significant impact of nutritional status on oncologic or functional outcomes.

  14. Feeding Your Baby

    Medline Plus

    Full Text Available ... Frequently asked questions Email sign up Join our online community Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please fill in all fields. Please enter a ...

  15. Feeding Your Baby

    Medline Plus

    Full Text Available ... Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please fill in all fields. Please enter a valid e-mail address. Your information: Your recipient's information: Your ...

  16. Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly

    Directory of Open Access Journals (Sweden)

    Huan-Lin Chen

    2011-09-01

    Full Text Available Today we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by use of a gastrostomy. Percutaneous endoscopic gastrostomy (PEG was first introduced in 1980 as an alternative to the traditional operative procedure and rapidly became the preferred procedure. In geriatric patients, the principal indications are neurological dysphagia and malnutrition, related to an underlying disease or anorexia-cachexia in very elderly. PEG is contraindicated in the presence of respiratory distress, previous gastric resection, total esophageal obstruction, coagulation disorders and sepsis in the elderly. Common complications include wound infection, leakage, hemorrhage, and fistula in the general population, but aspiration pneumonia is the major case of death in this group. Risks and complications of PEG must be discussed with patients and their families; and the decision for percutaneous endoscopic gastrostomy insertion should only be made after careful consideration and discussion between managing physicians, allied health professionals, and the patient and/or family. Four ethical principles may help make feeding decisions: beneficence, non-maleficence, autonomy and justice. Attentive long-term care after tube replacement is mandatory. Acceptance of percutaneous endoscopic gastrostomy placement by patients and their families tends to increase once favorable outcomes are offered.

  17. Comparison of intraoperative versus delayed enteral feeding tube placement in patients undergoing a Whipple procedure.

    Science.gov (United States)

    Scaife, Courtney L; Hewitt, Kelly C; Mone, Mary C; Hansen, Heidi J; Nelson, Edward T; Mulvihill, Sean J

    2014-01-01

    The intraoperative placement of an enteral feeding tube (FT) during pancreaticoduodenectomy (PD) is based on the surgeon's perception of need for postoperative nutrition. Published preoperative risk factors predicting postoperative morbidity may be used to predict FT need and associated intraoperative placement. A retrospective review of patients who underwent PD during 2005-2011 was performed by querying the National Surgical Quality Improvement Program (NSQIP) database with specific procedure codes. Patients were categorized based on how many of 10 possible preoperative risk factors they demonstrated. Groups of patients with scores of ≤ 1 (low) and ≥ 2 (high), respectively, were compared for FT need, length of stay (LoS) and organ space surgical site infections (SSIs). Of 138 PD patients, 82 did not have an FT placed intraoperatively, and, of those, 16 (19.5%) required delayed FT placement. High-risk patients were more likely to require a delayed FT (29.3%) compared with low-risk patients (9.8%) (P = 0.026). The 16 patients who required a delayed FT had a median LoS of 15.5 days, whereas the 66 patients who did not require an FT had a median LoS of 8 days (P < 0.001). In this analysis, subjects considered as high-risk patients were more likely to require an FT than low-risk patients. Assessment of preoperative risk factors may improve decision making for selective intraoperative FT placement. © 2013 International Hepato-Pancreato-Biliary Association.

  18. Micosoft Excel Sensitivity Analysis for Linear and Stochastic Program Feed Formulation

    Science.gov (United States)

    Sensitivity analysis is a part of mathematical programming solutions and is used in making nutritional and economic decisions for a given feed formulation problem. The terms, shadow price and reduced cost, are familiar linear program (LP) terms to feed formulators. Because of the nonlinear nature of...

  19. Clinical review: optimizing enteral nutrition for critically ill patients - a simple data-driven formula

    Science.gov (United States)

    2011-01-01

    In modern critical care, the paradigm of 'therapeutic nutrition' is replacing traditional 'supportive nutrition'. Standard enteral formulas meet basic macro- and micronutrient needs; therapeutic enteral formulas meet these basic needs and also contain specific pharmaconutrients that may attenuate hyperinflammatory responses, enhance the immune responses to infection, or improve gastrointestinal tolerance. Choosing the right enteral feeding formula may positively affect a patient's outcome; targeted use of therapeutic formulas can reduce the incidence of infectious complications, shorten lengths of stay in the ICU and in the hospital, and lower risk for mortality. In this paper, we review principles of how to feed (enteral, parenteral, or both) and when to feed (early versus delayed start) patients who are critically ill. We discuss what to feed these patients in the context of specific pharmaconutrients in specialized feeding formulations, that is, arginine, glutamine, antioxidants, certain ω-3 and ω-6 fatty acids, hydrolyzed proteins, and medium-chain triglycerides. We summarize current expert guidelines for nutrition in patients with critical illness, and we present specific clinical evidence on the use of enteral formulas supplemented with anti-inflammatory or immune-modulating nutrients, and gastrointestinal tolerance-promoting nutritional formulas. Finally, we introduce an algorithm to help bedside clinicians make data-driven feeding decisions for patients with critical illness. PMID:22136305

  20. An anthology of advances in enteral tube feeding formulations.

    Science.gov (United States)

    Campbell, Sheila M

    2006-08-01

    This article summarizes several major advances in tube feeding formulas marketed in the United States. It traces the progress in tube feeding formulas, starting with blenderized formulas to commercially available intact-nutrient formulas and culminating in the introduction of the concept of immunonutrition. The impact of packaging is also described.

  1. Sanitation & Safety for Child Feeding Programs.

    Science.gov (United States)

    Florida State Dept. of Health and Rehabilitative Services, Tallahassee.

    In the interest of promoting good health, sanitation, and safety practices in the operation of child feeding programs, this bulletin discusses practices in personal grooming and wearing apparel; the purchasing, storage, handling, and serving of food; sanitizing equipment and utensils; procedures to follow in case of a food poisoning outbreak; some…

  2. The Effect of an Intervention Aimed at Reducing Errors when Administering Medication through Enteral Feeding Tubes in an Institution for Individuals with Intellectual Disability

    Science.gov (United States)

    Idzinga, J. C.; de Jong, A. L.; van den Bemt, P. M. L. A.

    2009-01-01

    Background: Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to…

  3. The dragnet of children's feeding programs in Atlantic Canada.

    Science.gov (United States)

    Dayle, J B; McIntyre, L; Raine-Travers, K D

    2000-12-01

    Ivan Illich's 1976 prediction that medical dragnets will continue was correct. Now quasi-health dragnets are being established ostensibly to feed children perceived to be hungry. Our qualitative, multi-site case study found that programs justify their expansion to non-target group children as a means of reducing stigmatization, while reaching only an estimated one-third of targeted children. The dragnet continues as new services are added and franchising is proposed while the purpose of the program feeding healthy foods to children ultimately succumbs to drives for efficiency and the desire to maintain the program itself. In this field of social power relations, children become commodified through dialectical interplays among fundamental needs, manipulated needs, benevolence, and domination.

  4. Continuous parenteral and enteral nutrition induces metabolic dysfunction in neonatal pigs

    DEFF Research Database (Denmark)

    Stoll, Barbara; Puiman, Patrycja Jolanta; Cui, Liwei

    2012-01-01

    We previously showed that parenteral nutrition (PN) compared with formula feeding results in hepatic insulin resistance and steatosis in neonatal pigs. The current aim was to test whether the route of feeding (intravenous [IV] vs enteral) rather than other feeding modalities (diet, pattern) had...

  5. Enteral Feeding During Chemoradiotherapy for Advanced Head-and-Neck Cancer: A Single-Institution Experience Using a Reactive Approach

    International Nuclear Information System (INIS)

    Clavel, Sebastien; Fortin, Bernard; Despres, Philippe; Donath, David; Soulieres, Denis; Khaouam, Nader; Charpentier, Danielle; Belair, Manon; Guertin, Louis; Nguyen-Tan, Phuc Felix

    2011-01-01

    Purpose: The optimal method for providing enteral nutrition to patients with head-and-neck cancer is unclear. The purpose of the present study was to evaluate the safety and efficacy of our reactive policy, which consists of the installation of a nasogastric (NG) feeding tube only when required by the patient's nutritional status. Methods and Materials: The records of all patients with Stage III and IV head-and-neck cancer treated with concomitant chemotherapy and radiotherapy between January 2003 and December 2006 were reviewed. The overall and disease-free survival rates were estimated using the Kaplan-Meier method and compared with the log-rank test. Results: The present study included 253 patients, and the median follow-up was 33 months. At 3 years, the estimated overall survival and disease-free survival rate was 82.8% and 77.8%, respectively, for the whole population. No survival difference was observed when the patients were compared according to the presence and absence of a NG tube or stratified by weight loss quartile. The mean weight loss during treatment for all patients was 10.4%. The proportion of patients requiring a NG tube was 49.8%, and the NG tube remained in place for a median duration of 40 days. No major complications were associated with NG tube installation. Only 3% of the patients were still dependent on enteral feeding at 6 months. Conclusion: These results suggest that the use of a reactive NG tube with an interdisciplinary team approach is a safe and effective method to manage malnutrition in patients treated with concomitant chemotherapy and radiotherapy for head-and-neck cancer.

  6. Enteral nutrition practices in the intensive care unit: Understanding of nursing practices and perspectives

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2012-01-01

    Full Text Available Background: Adequate nutritional support is important for the comprehensive management of patients in intensive care units (ICUs. Aim: The study was aimed to survey prevalent enteral nutrition practices in the trauma intensive care unit, nurses′ perception, and their knowledge of enteral feeding. Study Design: The study was conducted in the ICU of a level 1 trauma center, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India. The study design used an audit. Materials and Methods: Sixty questionnaires were distributed and the results analyzed. A database was prepared and the audit was done. Results: Forty-two (70% questionnaires were filled and returned. A majority (38 of staff nurses expressed awareness of nutrition guidelines. A large number (32 of staff nurses knew about nutrition protocols of the ICU. Almost all (40 opined enteral nutrition to be the preferred route of nutrition unless contraindicated. All staff nurses were of opinion that enteral nutrition is to be started at the earliest (within 24-48 h of the ICU stay. Everyone opined that the absence of bowel sounds is an absolute contraindication to initiate enteral feeding. Passage of flatus was considered mandatory before starting enteral nutrition by 86% of the respondents. Everyone knew that the method of Ryle′s tube feeding in their ICU is intermittent boluses. Only 4 staff nurses were unaware of any method to confirm Ryle′s tube position. The backrest elevation rate was 100%. Gastric residual volumes were always checked, but the amount of the gastric residual volume for the next feed to be withheld varied. The majority said that the unused Ryle′s tube feed is to be discarded after 6 h. The most preferred (48% method to upgrade their knowledge of enteral nutrition was from the ICU protocol manual. Conclusion: Information generated from this study can be helpful in identifying nutrition practices that are lacking and may be used to review and revise enteral feeding

  7. Perinatal programming of neuroendocrine mechanisms connecting feeding behavior and stress

    Directory of Open Access Journals (Sweden)

    Sarah J Spencer

    2013-06-01

    Full Text Available Feeding behavior is closely regulated by neuroendocrine mechanisms that can be influenced by stressful life events. However, the feeding response to stress varies among individuals with some increasing and others decreasing food intake after stress. In addition to the impact of acute lifestyle and genetic backgrounds, the early life environment can have a life-long influence on neuroendocrine mechanisms connecting stress to feeding behavior and may partially explain these opposing feeding responses to stress. In this review I will discuss the perinatal programming of adult hypothalamic stress and feeding circuitry. Specifically I will address how early life (prenatal and postnatal nutrition, early life stress, and the early life hormonal profile can program the hypothalamic-pituitary-adrenal (HPA axis, the endocrine arm of the body’s response to stress long-term and how these changes can, in turn, influence the hypothalamic circuitry responsible for regulating feeding behavior. Thus, over- or under-feeding and / or stressful events during critical windows of early development can alter glucocorticoid (GC regulation of the HPA axis, leading to changes in the GC influence on energy storage and changes in GC negative feedback on HPA axis-derived satiety signals such as corticotropin-releasing-hormone. Furthermore, peripheral hormones controlling satiety, such as leptin and insulin are altered by early life events, and can be influenced, in early life and adulthood, by stress. Importantly, these neuroendocrine signals act as trophic factors during development to stimulate connectivity throughout the hypothalamus. The interplay between these neuroendocrine signals, the perinatal environment, and activation of the stress circuitry in adulthood thus strongly influences feeding behavior and may explain why individuals have unique feeding responses to similar stressors.

  8. Sequential intrahepatic metabolic effects of enteric galactose alimentation in newborn rats.

    Science.gov (United States)

    Kliegman, R M; Morton, S

    1988-09-01

    We determined metabolic responses after enteric galactose alimentation in 5- to 7-day-old newborn rats fasted for 24 h. The glycemic response was attenuated after enteric galactose feeding compared with the response after enteric glucose-fed rat pups. 14C radioactivity in blood from galactose-fed pups was reduced as counts in blood galactose were lower than counts in blood glucose in glucose-fed pups. Nonetheless within 15 min, [14C] from galactose appeared in blood glucose suggesting rapid conversion of galactose to glucose. The plasma insulin response was also attenuated after galactose feeding compared with the insulin response after enteric glucose. Hepatic glycogen content increased rapidly after enteric galactose feeding and was higher than after glucose feeding at 60, 120, and 180 min. Significant glycogen synthesis after oral glucose was delayed and occurred at 240 min. Carbon radioactivity in glycogen was higher in galactose fed pups between 15 and 360 min of the study. Serial determination of hepatic metabolites revealed an increase of galactose-1-phosphate levels after oral galactose at 240 and 300 min and a transient decline of ATP at 15 min. Other hepatic metabolites did not demonstrate significant differences between the two groups. These data suggest that hepatic glycogen synthesis is more rapid and occurs sooner after galactose than after glucose alimentation in previously fasted newborn rats. Galactose may enter a more direct pathway for neonatal hepatic glycogen synthesis. The relatively delayed entry of glucose label into hepatic glycogen and the delay of net glycogen synthesis after oral glucose suggest that glucose entry is not direct and may require further metabolism before incorporation into glycogen.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Transition from tube feeding to oral feeding: experience in a tertiary care paediatric cardiology unit.

    Science.gov (United States)

    Shine, Anne Marie; Finn, Daragh Gerard; Allen, Noeleen; McMahon, Colin J

    2018-05-02

    Home enteral tube feeding (HETF) is imperative for many infants and children with congenital heart disease (CHD). Tube weaning (TW) facilitates the progression from tube feeding to oral diet. There is limited literature on TW practices, protocols and success for children with CHD that have been tube fed. The objective of this study is to assess the process of weaning HETF in a tertiary referral centre for paediatric CHD. Specifically, we aimed to assess the duration of HETF, duration of TW and the interventions involved. We retrospectively reviewed the medical and dietetic records of all infants and children that were successfully weaned off HETF over a 12-month period from January 2015 to December 2015. There were 30 children included in the study, 9 boys and 21 girls. The diagnoses included 15 septal defects, 8 univentricular diagnosis and other diagnoses in 7 children. The median age at initiation of enteral tube feeding was 45 days (range 2-169). The median duration to wean from enteral tube feeding was 52 days (range 2-359). Number of dietetic consults required for successful TW varied among patients, median 5 (range 2-23). The number of days required for successful TW was associated with age and duration on HETF. Dietetic interventions included discontinuation of nutrient dense feeds, altering feed schedule and reduction of feed volume. Weaning HETF is possible in the outpatient setting. Early and frequent dietetic intervention is recommended to ensure prompt discontinuation of HETF when appropriate.

  10. Professional practice of dietitians in the Brazilian School Feeding Program: A multiple case study

    Directory of Open Access Journals (Sweden)

    Patrícia Fernanda Ferreira PIRES

    Full Text Available ABSTRACT Objective: To assess dietician’s numerical parameters for school feeding and discuss limitations and possibilities for professional practice in the municipalities of Vale do Ivaí, in Northern Paraná, Brazil. Methods: This is a multiple case study. A semi-structured interview was administered to dietitians working at the School Feeding Program in nine cities located in Vale do Ivaí, Paraná, Brazil. Resolution nº 465/2010, from the Brazilian Federal Board of Dietitians, was used to calculate the adequacy of working hours of dietitians. The legistation of the Brazilian School Feeding Program was applied to discuss professional practice. Results: All the cities had at least one dietitian responsible for the School Feeding Program. The percentage of adequate working hours was from 20 to 66%. Some dietitians were involved in management activities, administration, procurement, and accounting, in addition to dietitian assignments for the School Feeding Program. Most dietitians worked in other sectors of the municipalities such as the health system, social assistance, and at events. This practice could compromise compliance of technical activities that must be met by the dietitians of the School Feeding Program. Conclusion: The number of dietitians in most of cities working at School Feeding Program is not sufficient to meet the number of students. The insuficient workload and excessive activities could hinder the development of dietitian’s private activities. The hiring of nutrition and dietitian technicians and administrative assistants for bureaucratic activies is recommended.

  11. Complications relating to enteral and parenteral nutrition in trauma ...

    African Journals Online (AJOL)

    Objectives: The aim of the study was to compare the incidence of complications in patients receiving enteral and parenteral nutrition (PN), and review how the early initiation of enteral feeding and early achievement of caloric goal would affect the incidence of complications. Design: The design was a retrospective audit of ...

  12. Enteric Diseases of Poultry with Special Attention to Clostridium perfringens

    Directory of Open Access Journals (Sweden)

    Hafez Mohamed Hafez

    2011-06-01

    Full Text Available The enteric heath of growing poultry is imperative to success of the production. The basic role of poultry production is turning feed stuffs into meat. Any changes in this turning process, due to mechanical, chemical or biological disturbance of digestive system (enteric disorders is mostly accompanied with high economic losses due to poor performance, increased mortality rates and increased medication costs. The severity of clinical signs and course of the disorders are influenced several factors such as management, nutrition and the involved agent(s. Several pathogens (viruses, bacteria and parasites are incriminated as possible cause of enteric disorders either alone (mono-causal, in synergy with other micro-organisms (multi-causal, or with non-infectious causes such as feed and /or management related factors. In addition, excessive levels of mycotoxins and biogenic amines in feed lead to enteric disorders. Also factors such as high stocking density, poor litter conditions, poor hygiene and high ammonia level and other stressful situation may reduce the resistance of the birds and increases their susceptibility to infections. Under field conditions, however, under filed conditions it is difficult to determine whether the true cause of enteric disorders, is of infectious or non-infectious origin. In recent years and since the ban of use of antimicrobial growth promoters in several countries the incidence of intestinal disorders especially those caused by clostridial infection was drastically increased. The present review described in general the several factors involved in enteric disorders and summarized the available literatures about Clostridium perfringens infection in poultry.

  13. Intestine, immunity, and parenteral nutrition in an era of preferred enteral feeding.

    Science.gov (United States)

    Barrett, Meredith; Demehri, Farokh R; Teitelbaum, Daniel H

    2015-09-01

    To review the benefits of enteral nutrition in contrast to the inflammatory consequences of administration of parenteral nutrition and enteral deprivation. To present the most recent evidence for the mechanisms of these immunologic changes and discuss potential areas for modification to decrease infectious complications of its administration. There is significant data supporting the early initiation of enteral nutrition in both medical and surgical patients unable to meet their caloric goals via oral intake alone. Despite the preference for enteral nutrition, some patients are unable to utilize their gut for nutritious gain and therefore require parenteral nutrition administration, along with its infectious complications. The mechanisms behind these complications are multifactorial and have yet to be fully elucidated. Recent study utilizing both animal and human models has provided further information regarding parenteral nutrition's deleterious effect on intestinal epithelial barrier function along with the complications associated with enterocyte deprivation. Changes associated with parenteral nutrition administration and enteral deprivation are complex with multiple potential areas for modification to allow for safer administration. Recent discovery of the mechanisms behind these changes present exciting areas for future study as to make parenteral nutrition administration in the enterally deprived patient safer.

  14. Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

    International Nuclear Information System (INIS)

    Fietkau, R.

    1998-01-01

    Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [de

  15. The mycotoxin deoxynivalenol predisposes for the development of Clostridium perfringens-induced necrotic enteritis in broiler chickens.

    Science.gov (United States)

    Antonissen, Gunther; Van Immerseel, Filip; Pasmans, Frank; Ducatelle, Richard; Haesebrouck, Freddy; Timbermont, Leen; Verlinden, Marc; Janssens, Geert Paul Jules; Eeckhaut, Venessa; Eeckhout, Mia; De Saeger, Sarah; Hessenberger, Sabine; Martel, An; Croubels, Siska

    2014-01-01

    Both mycotoxin contamination of feed and Clostridium perfringens-induced necrotic enteritis have an increasing global economic impact on poultry production. Especially the Fusarium mycotoxin deoxynivalenol (DON) is a common feed contaminant. This study aimed at examining the predisposing effect of DON on the development of necrotic enteritis in broiler chickens. An experimental Clostridium perfringens infection study revealed that DON, at a contamination level of 3,000 to 4,000 µg/kg feed, increased the percentage of birds with subclinical necrotic enteritis from 20±2.6% to 47±3.0% (Peffect on in vitro growth, alpha toxin production and netB toxin transcription of Clostridium perfringens. In conclusion, feed contamination with DON at concentrations below the European maximum guidance level of 5,000 µg/kg feed, is a predisposing factor for the development of necrotic enteritis in broilers. These results are associated with a negative effect of DON on the intestinal barrier function and increased intestinal protein availability, which may stimulate growth and toxin production of Clostridium perfringens.

  16. Refining low protein modular feeds for children on low protein tube feeds with organic acidaemias.

    Science.gov (United States)

    Daly, A; Evans, S; Ashmore, C; Chahal, S; Santra, S; MacDonald, A

    2017-12-01

    Children with inherited metabolic disorders (IMD) who are dependent on tube feeding and require a protein restriction are commonly fed by 'modular tube feeds' consisting of several ingredients. A longitudinal, prospective two-phase study, conducted over 18 months assessed the long-term efficacy of a pre-measured protein-free composite feed. This was specifically designed to meet the non-protein nutritional requirements of children (aged over 1 year) with organic acidaemias on low protein enteral feeds and to be used as a supplement with an enteral feeding protein source. All non-protein individual feed ingredients were replaced with one protein-free composite feed supplying fat, carbohydrate, and micronutrients. Thirteen subjects, median age 7.4y (3-15.5y), all nutritionally tube dependent (supplying nutritional intake: ≥ 90%, n = 12; 75%, n = 1), and diagnosed with organic acidaemias (Propionic acidaemia, n = 6; Vitamin B 12 non-responsive methyl malonic acidaemia, n = 4; Isovaleric acidaemia, n = 2; Glutaric aciduria type1, n = 1); were studied. Nutritional intake, biochemistry and anthropometry were monitored at week - 8, 0, 12, 26 and 79. Energy intake remained unchanged, providing 76% of estimated energy requirements. Dietary intakes of vitamins, minerals and essential fatty acids significantly increased from week 0 to week 79, but sodium, potassium, magnesium, decosahexanoic acid and fibre did not meet suggested requirements. Plasma zinc, selenium, haemoglobin and MCV significantly improved, and growth remained satisfactory. Natural protein intake met WHO/FAO/UNU 2007 recommendations. A protein-free composite feed formulated to meet the non-protein nutritional requirements of children aged over 1 year improved nutritional intake, biochemical nutritional status, and simplified enteral tube feeding regimens in children with organic acidaemias.

  17. Implementation of a Study Skills Program for Entering At-Risk Medical Students

    Science.gov (United States)

    Miller, Cynthia J.

    2014-01-01

    While the first year of medical school is challenging for all students, there may be specific issues for students from rural areas, economically disadvantaged backgrounds, ethnic minorities, or nontraditional age groups. A Summer Prematriculation Program (SPP) was created to prepare entering at-risk students for the demands of medical school. For…

  18. Methane emissions from enteric fermentation in dairy cows, 1990-2008

    NARCIS (Netherlands)

    Bannink, A.

    2011-01-01

    The Dutch protocol for the national inventory estimates the methane emission of the average Dutch dairy cow based on a Tier 3 approach. A dynamic, mechanistic model is used to represent the enteric fermentation processes, using annual national statistics on feed intake and feed composition as model

  19. The effects of necrotic enteritis, aflatoxin B1, and virginiamycin on growth performance, necrotic enteritis lesion scores, and mortality in young broilers.

    Science.gov (United States)

    Cravens, R L; Goss, G R; Chi, F; De Boer, E D; Davis, S W; Hendrix, S M; Richardson, J A; Johnston, S L

    2013-08-01

    The effects of increasing aflatoxin B1 concentration (0, 0.75, 1.5 mg/kg) on broilers with or without necrotic enteritis or virginiamycin were determined. In the 23-d study, 22 male Cobb 500 chicks per pen were allotted to 12 treatments (3 × 2 × 2 factorial arrangement) with 8 replications. Intestines of 5 birds per pen were examined for lesions on d 21. Birds were allowed to consume feed and water ad libitum. Aflatoxin was included in the diets from d 0. All birds received a 10× dose of coccidiosis vaccine on d 10. Pens of birds where necrotic enteritis was being induced were on Clostridium perfringens pathogen (CPP) contaminated litter from d 0. Aflatoxin decreased gain and feed intake and resulted in poorer feed:gain, increased mortality, and higher lesion scores. Inducing necrotic enteritis increased lesion scores and decreased feed intake and gain. Adding virginiamycin to the diets improved gain, feed intake, feed conversion, and decreased mortality. There was a 3-way interaction (aflatoxin × virginiamycin × CPP) on gain; increasing aflatoxin decreased gain and the effects of CPP and virginiamycin were dependent on aflatoxin concentration. In the absence of aflatoxin virginiamycin increased gain but was unable to prevent the growth suppression caused by CPP. At 0.75 mg/kg of aflatoxin virginiamycin no longer increased growth in non-CPP challenged birds but was able to increase growth in CPP-challenged birds. At the 1.5 mg/kg of aflatoxin concentration, virginiamycin increased gain in non-CPP-challenged birds but challenging birds with CPP had no effect on gain. Virginiamycin improved overall feed conversion with the greatest improvement at 1.5 mg/kg (aflatoxin × virginiamycin, P broiler performance and interact to decrease weight gain, virginiamycin helps improve gain in challenged birds at 0.75 mg/kg of aflatoxin, but not at 1.5 mg/kg of aflatoxin.

  20. Evaluation of the impact of a nutritional program for undernourished children in Brazil

    NARCIS (Netherlands)

    Santos, Iná S; Gigante, Denise P; Coitinho, Denise C; Haisma, Hinke; Valle, Neiva C J; Valente, Gicele

    2005-01-01

    To assess the effectiveness on child growth and body composition of a supplementary feeding program (Milk Supplement Program), a prospective, controlled study was conducted in Northeast Brazil. When entering the Program, children from 10 municipalities with the highest coverage rates in the Program

  1. Development, prevention, and treatment of feeding tube dependency.

    Science.gov (United States)

    Krom, Hilde; de Winter, J Peter; Kindermann, Angelika

    2017-06-01

    Enteral nutrition is effective in ensuring nutritional requirements and growth. However, when tube feeding lasts for a longer period, it can lead to tube dependency in the absence of medical reasons for continuation of tube feeding. Tube-dependent children are unable or refuse to start oral activities and they lack oral skills. Tube dependency has health-, psychosocial-, and economy-related consequences. Therefore, the transition to oral feeding is of great importance. However, this transition can be very difficult and needs a multidisciplinary approach. Most studies for treatment of tube dependency are based on behavioral interventions, such as family therapy, individual behavior therapy, neuro-linguistic programming, and parental anxiety reduction. Furthermore, oral motor therapy and nutritional adjustments can be helpful in tube weaning. The use of medication has been described in the literature. Although mostly chosen as the last resort, hunger-inducing methods, such as the Graz-model and the Dutch clinical hunger provocation program, are also successful in weaning children off tube feeding. The transition from tube to oral feeding is important in tube-dependent children but can be difficult. We present an overview for the prevention and treatment of tube dependency. What is known: • Longer periods of tube feeding can lead to tube dependency. • Tube weaning can be very difficult. What is new: • Weaning as soon as possible and therefore referral to a multidisciplinary team are recommended. • An overview of treatment options for tube dependency is presented in this article.

  2. Transition from parenteral to enteral nutrition induces immediate diet-dependent gut histological and immunological responses in preterm neonates

    DEFF Research Database (Denmark)

    Siggers, Jayda; Sangild, Per T.; Jensen, Tim Kåre

    2011-01-01

    bacterial groups (Clostridium, Enterococcus, Streptococcus species) increased with time. We conclude that a switch from parenteral to enteral nutrition rapidly induces diet-dependent histopathological, functional, and proinflammatory insults to the immature intestine. Great care is required when introducing......-six preterm pigs were fed total parenteral nutrition (TPN) for 48 h followed by enteral feeding for 0, 8, 17, or 34 h with either colostrum (Colos, n = 20) or formula (Form, n = 31). Macroscopic NEC lesions were detected in Form pigs throughout the enteral feeding period (20/31, 65%), whereas most Colos pigs...... no histopathological lesions, increased maltase activity, and induced changes in gene expressions related to tissue development. Total bacterial density was high after 2 days of parenteral feeding and was not significantly affected by diet (colostrum, formula) or length of enteral feeding (8–34 h), except that a few...

  3. The effect of enteral tube feeding in cystic fibrosis: A registry based study.

    Science.gov (United States)

    Libeert, Denis; Declercq, Dimitri; Wanyama, Simeon; Thomas, Muriel; Van Daele, Sabine; De Baets, Frans; Van Biervliet, Stephanie

    2018-03-01

    Long-term effect of enteral tube feeding (ETF) in cystic fibrosis (CF) remains equivocal. A Belgian CF registry based, retrospective, longitudinal study, evaluated the pre- and post- ETF (n = 113) clinical evolution and compared each patient with 2 age, gender, pancreatic status and genotype class-matched controls. At baseline ETF had a worse BMI z-score (p ETF, had already a significant worse nutritional status and pulmonary function at first entry in the registry. Both parameters displayed a significant decline before ETF-introduction. ETF had more hospitalization and intravenous antibiotic (IVAB) treatment days (p ETF introduction hospitalizations and IVAB decreased significantly. After ETF-introduction BMI z-score recuperated towards the original curve before the decline, but remained below the controls. Starting ETF had no effect on rate of height gain in children. The pre-index FEV1 decline (-1.52%/year (p = 0.002)) stabilized to +0.39%/year afterwards. Controls displayed decline of -0.48%/year (p ETF introduction improved BMI z-score and stabilized FEV1, associated with less hospitalizations and IVAB treatments. Higher mortality and transplantation in the ETF cases, leading to drop-outs, made determination of the effect size difficult. Copyright © 2018 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  4. Enteral Tube Feeding Nutritional Protein Hydrolysate Production Under Different Factors By Enzymatic Hydrolysis

    Directory of Open Access Journals (Sweden)

    Nguyen ThiQuynhHoa

    2015-01-01

    Full Text Available Abstract Hydrolysis of proteins involves the cleavage of peptide bonds to give peptides of varying sizes and amino acid composition. There are a number of types of hydrolysis enzymatic acid or alkali hydrolysis. Chemical hydrolysis is difficult to control and reduces the nutritional quality of products destroying L-form amino acids and producing toxic substances such as lysino-alanine. Enzymatic hydrolysis works without destructing amino acids and by avoiding the extreme temperatures and pH levels required for chemical hydrolysis the nutritional properties of the protein hydrolysates remain largely unaffected. In this research we investigate the fat removal and protein hydrolysis from pork meat to produce the enteral tube feeding nutritional protein hydrolysate for patient. Our results are as follows meat moisture 75.1 protein 22.6 lipid 1.71 ash 0.5 vitamin B1 1.384mg100g n hexantreatment at 80oCin 45 minutes and drying 30 minutes in 90oC.Viscosity of the hydrolysate is very low 2.240 0.092 cPand high degree of hydrolysis 31.390 0.138 . The final protein powder has balance nutritional components and acid amines low microorganisms which are safety for human consumption.

  5. An early feeding regime and a high-density amino acid diet on growth performance of broilers under subclinical necrotic enteritis challenge

    Directory of Open Access Journals (Sweden)

    Chake Keerqin

    2017-03-01

    Full Text Available Broilers that have early access to feed have been shown to have enhanced immune system and gut development and heightened resilience against necrotic enteritis (NE. This study examined the effect of early feeding a high amino acid density diet on performance of broilers under a sub-clinical NE challenge model. Ross 308 broilers (n = 576 were assigned to a 2 × 2 × 2 factorial design with 2 feeding regimes (feed access either within 6 h post-hatch or after 48 h post-hatch, 2 diets (control diet or the control diet with an additional 10% digestible amino acids [HAA] and either presence or absence of NE challenge. Oral administrations of Eimeria species (d 9 and a field strain of Clostridium perfringens (d 14 were used to induce NE. Broiler performance was analysed at d 13, 23, 30 and 35. Intestinal lesion score and bacterial count were analysed on d 16. The NE challenge reduced overall bird performance and induced severe intestinal lesions, without causing notable mortality. At d 23 bird weight was significantly lower (P < 0.001 in the challenged birds compared with the unchallenged birds, but by d 30 the challenged birds had recovered and challenge no longer had an impact on bird performance. Birds fed the HAA diet had greater body weight by d 35 and heightened Lactobacillus content in the ileum at d 16 (P < 0.05. Birds that were fed the HAA diet after a period of fasting performed better in terms of feed conversion ratio (FCR under challenge. The findings from this study suggest there are beneficial effects of feeding high amino acid diets to birds in response to external stresses, such as post-hatch fasting and subclinical NE.

  6. School feeding programs' role in forming eating habits

    Directory of Open Access Journals (Sweden)

    Ana Maria Cervato-Mancuso

    2013-09-01

    Full Text Available OBJECTIVE To identify teaching managers' perceptions regarding the relationship of school feeding and the promotion of healthy eating habits among students. METHODS A descriptive study with a qualitative approach was developed in the city of Guarulhos (Southeast Brazil. Key informants from municipal public schools were interviewed. Public schools were selected (n=13 and classified as to the level of social exclusion, size and economic activity of the region where the school was located. Pedagogic coordinators and school principals were individually interviewed with semi-structured questions. RESULTS From school principals and pedagogical coordinators' perceptions, three categories were identified: Food in the school context; School feeding program's role and the Concept of food and nutrition security, which indicate that they considered meals as part of school routine in order to attain physiological needs of energy and nutrients. Their answers also indicated that they did not consider school meals as a pedagogical action related to their specific responsibilities. CONCLUSIONS The relationship between the school feeding and the formation of eating habits is not a topic usually discussed between the different professionals involved with health and education. The implementation of health promoting policies will only be possible after a debate about how schools and their pedagogical team adopt the program guidelines and how the professionals decode these strategies in daily activities.

  7. School feeding programs' role in forming eating habits.

    Science.gov (United States)

    Cervato-Mancuso, Ana Maria; Westphal, Marcia Faria; Araki, Erica Lie; Bógus, Claudia Maria

    2013-09-01

    OBJECTIVE To identify teaching managers' perceptions regarding the relationship of school feeding and the promotion of healthy eating habits among students. METHODS A descriptive study with a qualitative approach was developed in the city of Guarulhos (Southeast Brazil). Key informants from municipal public schools were interviewed. Public schools were selected (n=13) and classified as to the level of social exclusion, size and economic activity of the region where the school was located. Pedagogic coordinators and school principals were individually interviewed with semi-structured questions. RESULTS From school principals and pedagogical coordinators' perceptions, three categories were identified: Food in the school context; School feeding program's role and the Concept of food and nutrition security, which indicate that they considered meals as part of school routine in order to attain physiological needs of energy and nutrients. Their answers also indicated that they did not consider school meals as a pedagogical action related to their specific responsibilities. CONCLUSIONS The relationship between the school feeding and the formation of eating habits is not a topic usually discussed between the different professionals involved with health and education. The implementation of health promoting policies will only be possible after a debate about how schools and their pedagogical team adopt the program guidelines and how the professionals decode these strategies in daily activities.

  8. The metabolic activity of the enteric microflora and the pattern of sensitization in different types of feeding in healthy infants

    Directory of Open Access Journals (Sweden)

    S. V. Bogdanova

    2015-01-01

    Full Text Available Objective: to investigate the metabolic activity of the enteric microflora and the rate of milk protein sensitization during different types of feeding in healthy infants of Moscow. A total of 200 apparently healthy children were followed up. According to feeding patterns, there were 100 formula-fed babies (a study group and 100 breast-fed ones (a comparison group. Subgroup 1 of the study group included 51 infants receiving formulas based on New Zealand goat's milk with prebiotics; Subgroup 2 consisted of 49 infants having formulas based on cow's milk-serum proteins with prebiotics. The metabolic activity of the enteric microflora was investigated by gas liquid chromatography; the concentrations of allergen-specific IgE and IgG antibodies against cow's and goat's milk proteins in coprofllrates were determined by noncompetitive enzyme immunoassay using special test systems (Allergopharma, Germany before and during the ingestion of the formulas with prebiotics. The use of the formulas containing prebiotics led to increases in acetic acid and butyric acid concentrations and anaerobic index in both subgroups. However, their highest values in the coproflltrates were observed in Subgroup 1 and breast-fed infants. Analysis of allergen-specific IgE and IgC antibodies before formula indigestion showed that the level of latent sensitization to goat's milk protein was substantially lower than that to cow's milk protein (+ Class 1 and + Class 2, respectively. Subgroup 1 showed a more pronounced tendency to decrease the rate of latent sensitization to these types of protein. Thus, the most pronounced positive tendency in the examined indicators was observed in babies receiving breast milk or formulas based on New Zealand goat's milk with prebiotics.

  9. Evaluation of programs to improve complementary feeding in infants and young children.

    Science.gov (United States)

    Frongillo, Edward A

    2017-10-01

    Evaluation of complementary feeding programs is needed to enhance knowledge on what works, to document responsible use of resources, and for advocacy. Evaluation is done during program conceptualization and design, implementation, and determination of effectiveness. This paper explains the role of evaluation in the advancement of complementary feeding programs, presenting concepts and methods and illustrating them through examples. Planning and investments for evaluations should occur from the beginning of the project life cycle. Essential to evaluation is articulation of a program theory on how change would occur and what program actions are required for change. Analysis of program impact pathways makes explicit the dynamic connections in the program theory and accounts for contextual factors that could influence program effectiveness. Evaluating implementation functioning is done through addressing questions about needs, coverage, provision, and utilization using information obtained from process evaluation, operations research, and monitoring. Evaluating effectiveness is done through assessing impact, efficiency, coverage, process, and causality. Plausibility designs ask whether the program seemed to have an effect above and beyond external influences, often using a nonrandomized control group and baseline and end line measures. Probability designs ask whether there was an effect using a randomized control group. Evaluations may not be able to use randomization, particularly for programs implemented at a large scale. Plausibility designs, innovative designs, or innovative combinations of designs sometimes are best able to provide useful information. Further work is needed to develop practical designs for evaluation of large-scale country programs on complementary feeding. © 2017 John Wiley & Sons Ltd.

  10. Feed-related Splanchnic Oxygenation in Preterm Infants With Abnormal Antenatal Doppler Developing Gut Complications.

    Science.gov (United States)

    Martini, Silvia; Aceti, Arianna; Beghetti, Isadora; Faldella, Giacomo; Corvaglia, Luigi

    2018-05-01

    Preterm infants with antenatal absent or reversed end diastolic flow (AREDF) in umbilical arteries are at major risk for gastrointestinal (GI) complications, such as necrotizing enterocolitis, intestinal perforation and feeding intolerance. Near-infrared spectroscopy provides continuous monitoring of splanchnic oxygenation (SrSO2) and may represent a useful tool to predict GI outcomes in this high-risk population. This observational, pilot study assessed feed-related SrSO2 patterns at enteral feeding introduction and full enteral feeding (FEF) achievement in twenty AREDF infants with gestational age ≤34 weeks. Enrolled infants were divided into 2 groups according to the development versus lack of GI complications. Infants developing GI complications showed significantly lower SrSO2 and increased splanchnic oxygen extraction in response to enteral feeds at both enteral feeding introduction and FEF. The potential role of these findings in predicting GI complications in AREDF preterm infants seems promising and deserves further evaluation.

  11. Enteral and Parenteral Nutrition in the Perioperative Period: State of the Art

    Science.gov (United States)

    Abunnaja, Salim; Cuviello, Andrea; Sanchez, Juan A.

    2013-01-01

    Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and biochemistry, have allowed clinicians to treat malnutrition and improve surgical patient’s outcomes. We reviewed the literature for the current status of perioperative nutrition comparing parenteral nutrition with enteral nutrition. In a surgical patient with established malnutrition, nutritional support should begin at least 7–10 days prior to surgery. Those patients in whom eating is not anticipated beyond the first five days following surgery should receive the benefits of early enteral or parenteral feeding depending on whether the gut can be used. Compared to parenteral nutrition, enteral nutrition is associated with fewer complications, a decrease in the length of hospital stay, and a favorable cost-benefit analysis. In addition, many patients may benefit from newer enteral formulations such as Immunonutrition as well as disease-specific formulations. PMID:23429491

  12. Feeding Your Baby

    Medline Plus

    Full Text Available ... baby Feeding your baby E-mail to a friend Please fill in all fields. Please enter a ... for your baby during the first year of life. Learn how to breastfeed and why breast milk ...

  13. Responsive versus scheduled feeding in preterm infants (Review)

    OpenAIRE

    Watson, Julie; McGuire, William

    2015-01-01

    Scheduled feeding of prescribed enteral volumes remains standard practice for preterm infants. However, feeding preterm infants in response to their feeding and satiation cues (responsive, cue-based, or infant led feeding) rather than at scheduled intervals might enhance parent experience and satisfaction, help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge.\\ud \\ud Objectives: To assess the effect of feeding pr...

  14. Meat-based enteral nutrition

    Science.gov (United States)

    Derevitskay, O. K.; Dydykin, A. S.

    2017-09-01

    Enteral nutrition is widely used in hospitals as a means of nutritional support and therapy for different diseases. Enteral nutrition must fulfil the energy needs of the body, be balanced by the nutrient composition and meet patient’s nutritional needs. Meat is a source of full-value animal protein, vitamins and minerals. On the basis of this research, recipes and technology for a meat-based enteral nutrition product were developed. The product is a ready-to-eat sterilised mixture in the form of a liquid homogeneous mass, which is of full value in terms of composition and enriched with vitamins and minerals, consists of particles with a size of not more than 0.3 mm and has the modified fat composition and rheological characteristics that are necessary for passage through enteral feeding tubes. The study presents experimental data on the content of the main macro- and micro-nutrients in the developed product. The new product is characterised by a balanced fatty acid composition, which plays an important role in correction of lipid metabolism disorders and protein-energy deficiency, and it is capable of satisfying patients’ daily requirements for vitamins and the main macro- and microelements when consuming 1500-2000 ml. Meat-based enteral nutrition can be used in diets as a standard mixture for effective correction of the energy and anabolic requirements of the body and support of the nutritional status of patients, including those with operated stomach syndrome.

  15. Early enteral nutrition prevents intra-abdominal hypertension and reduces the severity of severe acute pancreatitis compared with delayed enteral nutrition: a prospective pilot study.

    Science.gov (United States)

    Sun, Jia-Kui; Li, Wei-Qin; Ke, Lu; Tong, Zhi-Hui; Ni, Hai-Bin; Li, Gang; Zhang, Lu-Yao; Nie, Yao; Wang, Xin-Ying; Ye, Xiang-Hong; Li, Ning; Li, Jie-Shou

    2013-09-01

    To investigate the effects of early enteral nutrition (EEN) on intra-abdominal pressure (IAP) and disease severity in patients with severe acute pancreatitis (SAP). Enteral nutrition (EN) was started within 48 h after admission in the EEN group and from the 8th day in the delayed enteral nutrition (DEN) group. The IAP and intra-abdominal hypertension (IAH) incidence were recorded for 2 weeks. The caloric intake and feeding intolerance (FI) incidence were recorded daily after EN was started. The severity markers and clinical outcome variables were also recorded. Sixty patients were enrolled to this study. No difference about IAP was found. The IAH incidence of the EEN group was significantly lower than that of the DEN group from the 9th day (8/30 versus 18/30; P = 0.009) after admission. The FI incidence of the EEN group was higher than that of the DEN group during the initial 3 days of feeding (25/30 versus 12/30; P = 0.001; 22/30 versus 9/30; P = 0.001; 15/30 versus 4/30; P = 0.002). Patients with an IAP FI incidence than those with an IAP ≥15 mmHg on the 1st day (20/22 versus 17/38; P < 0.001), the 3rd day (11/13 versus 8/47; P < 0.001), and the 7th day (3/5 versus 3/55; P = 0.005) of feeding. The severity markers and clinical outcome variables of the EEN group were significantly improved. Early enteral nutrition did not increase IAP. In contrast, it might prevent the development of IAH. In addition, EEN might be not appropriate during the initial 3-4 days of SAP onset. Moreover, EN might be of benefit to patients with an IAP <15 mmHg. Early enteral nutrition could improve disease severity and clinical outcome, but did not decrease mortality of SAP.

  16. Comparison of the effects of enteral feeding with continuous and intermittent parenteral nutrition on hepatic triglyceride secretion in human beings

    International Nuclear Information System (INIS)

    Isabel-Martinez, L.; Skinner, C.; Parkin, A.; Hall, R.I.

    1989-01-01

    Plasma triglyceride turnover was measured during steady-state conditions in 22 postoperative patients. Nine had received nutritional support with an enteral regimen, seven had received an equivalent regimen as continuous parenteral nutrition, and six received the same parenteral regimen as a cyclical infusion. After 5 days of nutritional support, each patient received an intravenous bolus of tritiated glycerol. Plasma radiolabeled triglyceride content was measured during the subsequent 24 hours. The data were analyzed by means of a simple deterministic model of plasma triglyceride kinetics and compared with the results obtained by stochastic analysis. The rates of hepatic triglyceride secretion obtained by deterministic analysis were higher than those obtained by the stochastic approach. However, the mode of delivery of the nutritional regimen did not affect the rate of hepatic triglyceride secretion regardless of the method of analysis. The results suggest that neither complete nutritional bypass of the gastrointestinal tract nor interruption of parenteral nutrition in an attempt to mimic normal eating has any effect on hepatic triglyceride secretion. Any beneficial effect that enteral feeding or cyclical parenteral nutrition may have on liver dysfunction associated with standard parenteral nutrition appears to be unrelated to changes in hepatic triglyceride secretion

  17. Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit.

    Science.gov (United States)

    Lewis, Sharon R; Schofield-Robinson, Oliver J; Alderson, Phil; Smith, Andrew F

    2018-06-08

    Critically ill people are at increased risk of malnutrition. Acute and chronic illness, trauma and inflammation induce stress-related catabolism, and drug-induced adverse effects may reduce appetite or increase nausea and vomiting. In addition, patient management in the intensive care unit (ICU) may also interrupt feeding routines. Methods to deliver nutritional requirements include provision of enteral nutrition (EN), or parenteral nutrition (PN), or a combination of both (EN and PN). However, each method is problematic. This review aimed to determine the route of delivery that optimizes uptake of nutrition. To compare the effects of enteral versus parenteral methods of nutrition, and the effects of enteral versus a combination of enteral and parenteral methods of nutrition, among critically ill adults, in terms of mortality, number of ICU-free days up to day 28, and adverse events. We searched CENTRAL, MEDLINE, and Embase on 3 October 2017. We searched clinical trials registries and grey literature, and handsearched reference lists of included studies and related reviews. We included randomized controlled studies (RCTs) and quasi-randomized studies comparing EN given to adults in the ICU versus PN or versus EN and PN. We included participants that were trauma, emergency, and postsurgical patients in the ICU. Two review authors independently assessed studies for inclusion, extracted data, and assessed risk of bias. We assessed the certainty of evidence with GRADE. We included 25 studies with 8816 participants; 23 studies were RCTs and two were quasi-randomized studies. All included participants were critically ill in the ICU with a wide range of diagnoses; mechanical ventilation status between study participants varied. We identified 11 studies awaiting classification for which we were unable to assess eligibility, and two ongoing studies.Seventeen studies compared EN versus PN, six compared EN versus EN and PN, two were multi-arm studies comparing EN versus PN

  18. Radicidation and radappertization of animal feeds in Israel, 1968-1977

    International Nuclear Information System (INIS)

    Lapidot, M.

    1979-01-01

    Contamination of animal feed and animal products with salmonellae and other enteric microorganisms has considerably increased in recent years. This has resulted in commensurate increases in the incidence of salmonellosis and other enteric diseases in both animals and humans. The development of radappertization for laboratory animal feeds and of radicidation for farm animal feeds over the last ten years in Israel is reviewed. The products considered were radappertized feeds for SPF rodent colonies and for commercial SPF poultry flocks, and radicidized feed for breeder and broiler flocks. In the latter case microbiological, biological, technological and economic aspects are considered. The petition and clearance for radicidized poultry feed are briefly discussed. The potential use of radicidation in the preparation of animal feeds from organic wastes, i.e. putrescibles in household garbage and sewage sludge, is outlined, and the factors involved are evaluated. (author)

  19. [Biological evaluation of a protein mixture intended for enteral nutrition].

    Science.gov (United States)

    Meneses, J Olza; Foulquie, J Porres; Valero, G Urbano; de Victoria, E Martínez; Hernández, A Gil

    2008-01-01

    Enteral nutrition is the best way to feed or supplement the diet when gastrointestinal tract functions of patients are partially or totally preserved. Whenever total enteral nutrition is needed, it represents the only source of nutrients for patients. Thus, it is mandatory to ensure that high biological value proteins are included in enteral formulae. To assess the biological quality of a protein blend constituted by 50% potassium caseinate, 25% whey protein and 25% pea protein intended to be used in enteral nutrition products. Forty Wistar rats (20 male and 20 female), with initial body weight of 51 g, where divided into four groups and feed for 10 days with: casein (Control), experimental protein blend (Experimental), liophylized normo- and hyperproteic enteral nutrition formulae adapted to the animal nutritional requirements (Normoproteic and Hyperproteic). Protein efficiency ratio (PER), apparent digestibility coefficient (ADC), relationship between retained and absorbed nitrogen (R/A) and relationship between retained and consumed nitrogen (R/I) where calculated. Experimental and control groups had similar values for all analysed indices (PER, ADC, R/A and R/I). These indices where also similar between normo and hyperproteic groups, but lower than experimental and control groups, except in PER, where normoproteic group was either similar to control and hiperproteic group. The quality of the protein blend used in this study is high. It is a good protein source to be used in the development of new enteral nutritional products.

  20. The enter-educate approach.

    Science.gov (United States)

    Piotrow, P T; Coleman, P L

    1992-03-01

    This article describes how the Population Communication Services (PCS) has seized on the "enter-educate" approach, the blending of popular entertainment with social messages, to change reproductive health behavior. The enter-educate approach spreads its message through songs, soap operas, variety shows, and other types of popular entertainment mediums. Because they entertain, enter-educate projects can capture the attention of an audience -- such as young people -- who would otherwise scorn social messages. And the use of population mediums makes it possible to reach a variety of audiences. Funded by USAID, PCS began its first enter-educate project in response to the increasing number of teenage pregnancies in Latin America. PCS developed 2 songs and videos, which featured popular teenage singers to serve as role models, to urge abstinence. The songs became instant hits. Since then, PCS has mounted more then 80 major projects in some 40 countries. Highlights of programs range from a successful multi-media family planning campaign in Turkey to humorous television ads in Brazil promoting vasectomy. Recently, PCS initiated projects to teach AIDS awareness. At the core of the enter-educate approach is the social learning theory which holds that much behavior is learned through the observation of role-models. Health professionals work alongside entertainers to produce works that have audience appeal and factual social messages. The enter-educate approach works because it is popular, pervasive, personal, persuasive, and profitable. PCS has found that enter-educate programs pay for themselves through cost sharing and cost recovery.

  1. New benchmarks for costs and cost-efficiency of school-based feeding programs in food-insecure areas.

    Science.gov (United States)

    Gelli, Aulo; Cavallero, Andrea; Minervini, Licia; Mirabile, Mariana; Molinas, Luca; de la Mothe, Marc Regnault

    2011-12-01

    School feeding is a popular intervention that has been used to support the education, health and nutrition of school children. Although the benefits of school feeding are well documented, the evidence on the costs of such programs is remarkably thin. Address the need for systematic estimates of the cost of different school feeding modalities, and of the determinants of the considerable cost variation among countries. WFP project data, including expenditures and number of schoolchildren covered, were collected for 78 projects in 62 countries through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The standardized yearly average school feeding cost per child, not including school-level costs, was US$48. The yearly costs per child were lowest at US$23 for biscuit programs reaching school-going children and highest at US$75 for take-home rations programs reaching families of schoolgoing children. The average cost of programs combining on-site meals with extra take-home rations for children from vulnerable households was US$61. Commodity costs were on average 58% of total costs and were highest for biscuit and take-home rations programs (71% and 68%, respectively). Fortified biscuits provided the most cost-efficient option in terms of micronutrient delivery, whereas take-home rations were more cost-efficient in terms of food quantities delivered. Both costs and effects should be considered carefully when designing school feeding interventions. The average costs of school feeding estimated here are higher than those found in earlier studies but fall within the range of costs previously reported. Because this analysis does not include school-level costs, these

  2. Hanford Tank Waste Treatment and Immobilization Plant (WTP) Waste Feed Qualification Program Development Approach - 13114

    Energy Technology Data Exchange (ETDEWEB)

    Markillie, Jeffrey R.; Arakali, Aruna V.; Benson, Peter A.; Halverson, Thomas G. [Hanford Tank Waste Treatment and Immobilization Plant Project, Richland, WA 99354 (United States); Adamson, Duane J.; Herman, Connie C.; Peeler, David K. [Savannah River National Laboratory, Aiken, SC 29808 (United States)

    2013-07-01

    The Hanford Tank Waste Treatment and Immobilization Plant (WTP) is a nuclear waste treatment facility being designed and constructed for the U.S. Department of Energy by Bechtel National, Inc. and subcontractor URS Corporation (under contract DE-AC27-01RV14136 [1]) to process and vitrify radioactive waste that is currently stored in underground tanks at the Hanford Site. A wide range of planning is in progress to prepare for safe start-up, commissioning, and operation. The waste feed qualification program is being developed to protect the WTP design, safety basis, and technical basis by assuring acceptance requirements can be met before the transfer of waste. The WTP Project has partnered with Savannah River National Laboratory to develop the waste feed qualification program. The results of waste feed qualification activities will be implemented using a batch processing methodology, and will establish an acceptable range of operator controllable parameters needed to treat the staged waste. Waste feed qualification program development is being implemented in three separate phases. Phase 1 required identification of analytical methods and gaps. This activity has been completed, and provides the foundation for a technically defensible approach for waste feed qualification. Phase 2 of the program development is in progress. The activities in this phase include the closure of analytical methodology gaps identified during Phase 1, design and fabrication of laboratory-scale test apparatus, and determination of the waste feed qualification sample volume. Phase 3 will demonstrate waste feed qualification testing in support of Cold Commissioning. (authors)

  3. Enteral and Parenteral Nutrition in the Perioperative Period: State of the Art

    Directory of Open Access Journals (Sweden)

    Juan A. Sanchez

    2013-02-01

    Full Text Available Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and biochemistry, have allowed clinicians to treat malnutrition and improve surgical patient’s outcomes. We reviewed the literature for the current status of perioperative nutrition comparing parenteral nutrition with enteral nutrition. In a surgical patient with established malnutrition, nutritional support should begin at least 7–10 days prior to surgery. Those patients in whom eating is not anticipated beyond the first five days following surgery should receive the benefits of early enteral or parenteral feeding depending on whether the gut can be used. Compared to parenteral nutrition, enteral nutrition is associated with fewer complications, a decrease in the length of hospital stay, and a favorable cost-benefit analysis. In addition, many patients may benefit from newer enteral formulations such as Immunonutrition as well as disease-specific formulations.

  4. Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fietkau, R. [Strahlentherapeutische Klinik und Poliklinik, Rostock Univ. (Germany)]|[Strahlentherapeutische Klinik und Poliklinik, Erlangen Univ. (Germany)

    1998-11-01

    Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [Deutsch] Hintergrund: Der Ernaehrungsstatus von Tumorpatienten ist haeufig bereits vor jeder antitumoroesen Therapie reduziert und kann sich durch die notwendige Radio(chemo)therapie weiter verschlechtern. Methode: Im Rahmen dieses Uebersichtsartikels werden die Moeglichkeiten und Risiken der enteralen und parenteralen Ernaehrung waehrend einer Radiotherapie besprochen. Die Indikationen der enteralen Ernaehrung werden anhand von eigenen Ergebnissen begruendet. Ergebnisse: Die Langzeiternaehrung wird am besten ueber einen enteralen Zugang durchgefuehrt. In einer prospektiven, nichtrandomisierten Studie konnten wir zeigen, dass eine enterale Ernaehrung mittels perkutaner endoskopisch kontrollierter Gastrostomie (PEG) nicht nur die anthropometrischen und biochemischen Parameter waehrend einer Radio(chemo)therapie verbessert, sondern auch die Lebensqualitaet. Eine weitere Moeglichkeit besteht in der

  5. The effect of different feed restriction programs on reproductive performance, efficiency, frame size, and uniformity in broiler breeder hens.

    Science.gov (United States)

    de Beer, M; Coon, C N

    2007-09-01

    Two experiments were conducted to determine the effect of feed restriction programs on breeder reproductive performance. In experiment 1, every day (ED), skip-a-day (SK), 4-3, and 5-2 programs were compared. Diets did not differ, and feed intake was identical in all groups. Four hundred twenty pullets were reared on each program. At 21 wk, 80 breeders from each program were individually housed to record performance parameters. Body weight and frame size were larger in ED pullets than SK, 4-3, or 5-2 despite equal intakes. Hens fed ED reached sexual maturity at a younger age than other groups. Hens fed ED also produced more total and settable eggs than SK hens. Egg weight was heavier in 5-2 hens than in ED with 4-3 and SK intermediate. Efficiency of feed utilization was best in ED hens. In experiment 2 the same programs were tested, but pullets were reared to reach equal BW. One hundred seventy-five pullets were reared on each program, of which 60 were housed. Feed intake was greater for SK, 4-3, and 5-2 than ED pullets to reach the same BW. Frame size did not differ, indicating that BW was the cause of differences in experiment 1. In experiment 2, differences in performance were attenuated but not eliminated by feeding to reach equal BW, suggesting that metabolic factors aside from BW are altered by feeding programs. The 5-2 produced larger eggs than ED with the trend among programs being identical to that in experiment 1. These results suggest that metabolic changes such as increased lipogenesis or alterations in body composition may result in larger eggs in feeding programs that include off-feed days. Mortality, fertility, and hatchability were not affected by feeding programs in either experiment. Body composition analysis indicated the importance of total lean protein mass as a threshold for the onset of sexual maturity. Programs like SK are less efficient than ED and may result in reduced performance.

  6. Postoperative Feeding Difficulties after Repair of Congenital ...

    African Journals Online (AJOL)

    Of these, 24 (37.5%) developed feeding difficulties in the immediate post operative period. The causes of the feeding difficulties were Gastro-oesophageal reflux (GOR) 9, Recurrent diaphragmatic hernia 8, Adhesive intestinal obstruction 4, Poor intestinal motility 2, Campylobacter enteritis, 1, Hypertrophic pyloric stenosis, 1.

  7. Medication Errors in Patients with Enteral Feeding Tubes in the Intensive Care Unit.

    Science.gov (United States)

    Sohrevardi, Seyed Mojtaba; Jarahzadeh, Mohammad Hossein; Mirzaei, Ehsan; Mirjalili, Mahtabalsadat; Tafti, Arefeh Dehghani; Heydari, Behrooz

    2017-01-01

    Most patients admitted to Intensive Care Units (ICU) have problems in using oral medication or ingesting solid forms of drugs. Selecting the most suitable dosage form in such patients is a challenge. The current study was conducted to assess the frequency and types of errors of oral medication administration in patients with enteral feeding tubes or suffering swallowing problems. A cross-sectional study was performed in the ICU of Shahid Sadoughi Hospital, Yazd, Iran. Patients were assessed for the incidence and types of medication errors occurring in the process of preparation and administration of oral medicines. Ninety-four patients were involved in this study and 10,250 administrations were observed. Totally, 4753 errors occurred among the studied patients. The most commonly used drugs were pantoprazole tablet, piracetam syrup, and losartan tablet. A total of 128 different types of drugs and nine different oral pharmaceutical preparations were prescribed for the patients. Forty-one (35.34%) out of 116 different solid drugs (except effervescent tablets and powders) could be substituted by liquid or injectable forms. The most common error was the wrong time of administration. Errors of wrong dose preparation and administration accounted for 24.04% and 25.31% of all errors, respectively. In this study, at least three-fourth of the patients experienced medication errors. The occurrence of these errors can greatly impair the quality of the patients' pharmacotherapy, and more attention should be paid to this issue.

  8. Preliminary Assessment of the Hanford Tank Waste Feed Acceptance and Product Qualification Programs

    Energy Technology Data Exchange (ETDEWEB)

    Herman, C. C.; Adamson, Duane J.; Herman, D. T.; Peeler, David K.; Poirier, Micheal R.; Reboul, S. H.; Stone, M. E.; Peterson, Reid A.; Chun, Jaehun; Fort, James A.; Vienna, John D.; Wells, Beric E.

    2013-04-01

    The U.S. Department of Energy Office of Environmental Management (EM) is engaging the national laboratories to provide the scientific and technological rigor to support EM program and project planning, technology development and deployment, project execution, and assessment of program outcomes. As an early demonstration of this new responsibility, Savannah River National Laboratory (SRNL) and Pacific Northwest National Laboratory (PNNL) have been chartered to implement a science and technology program addressing Hanford Tank waste feed acceptance and product qualification. As a first step, the laboratories examined the technical risks and uncertainties associated with the planned waste feed acceptance and qualification testing for Hanford tank wastes. Science and technology gaps were identified for work associated with 1) feed criteria development with emphasis on identifying the feed properties and the process requirements, 2) the Tank Waste Treatment and Immobilization Plant (WTP) process qualification program, and 3) the WTP HLW glass product qualification program. Opportunities for streamlining the accetpance and qualification programs were also considered in the gap assessment. Technical approaches to address the science and technology gaps and/or implement the opportunities were identified. These approaches will be further refined and developed as strong integrated teams of researchers from national laboratories, contractors, industry, and academia are brought together to provide the best science and technology solutions. Pursuing the identified approaches will have immediate and long-term benefits to DOE in reducing risks and uncertainties associated with tank waste removal and preparation, transfers from the tank farm to the WTP, processing within the WTP Pretreatment Facility, and in producing qualified HLW glass products. Additionally, implementation of the identified opportunities provides the potential for long-term cost savings given the anticipated

  9. Comparison of respiratory quotient and resting energy expenditure in two regimens of enteral feeding - continuous vs. intermittent in head-injured critically ill patients

    Directory of Open Access Journals (Sweden)

    Indubala Maurya

    2011-01-01

    Full Text Available Introduction: Measurement of respiratory quotient (RQ and resting energy expenditure (REE has been shown to be helpful in designing nutritional regimens. There is a paucity of the literature describing the impact of a feeding regimen on the energy expenditure patterns. Therefore, we studied the effect of continuous vs. intermittent feeding regimen in head-injured patients on mechanical ventilation on RQ and REE . Methods: After institutional ethical approval, this randomized study was conducted in 40 adult male patients with head injury requiring controlled mode of ventilation. Patients were randomly allocated into two groups. Group C: Feeds (30 kcal/kg/day were given for 18 h/day, with night rest for 6 h. Group I: Six bolus feeds (30 kcal/kg/day were given three hourly for 18 h with night rest for 6 h. RQ and REE were recorded every 30 min for 24 h. Blood sugar was measured 4 hourly. Other adverse effects such as feed intolerance, aspiration were noted. Results: Demographic profile and SOFA score were comparable in the two groups. Base line RQ (0.8 vs. 0.86 and REE (1527 vs. 1599 kcal/day were comparable in both the groups (P>0.05. RQ was comparable in both groups during the study period at any time of the day (P>0.05. Base line RQ was compared with all other RQ values measured every half hour and fluctuation from the base line value was insignificant in both groups (P>0.05. REE was comparable in both the groups throughout the study period (P>0.5. Adequacy of feeding as assessed by EI/MREE was 105.7% and 105.3% in group C and group I, respectively. There was no significant difference in the blood sugar levels between the two groups (P>0.05. Conclusion: We found from our study that RQ, REE, and blood sugar remain comparable with two regimens of enteral feeding - continuous vs. intermittent in neurosurgical patients on ventilator support in a ICU setup.

  10. Randomized controlled trial: impact of glycerin suppositories on time to full feeds in preterm infants.

    Science.gov (United States)

    Khadr, Sophie N; Ibhanesebhor, Samuel E; Rennix, Connie; Fisher, Hazel E; Manjunatha, Chikkanayakanahalli M; Young, David; Abara, Rosemary C

    2011-01-01

    Feed intolerance delays achievement of enteral feeding in preterm infants. Parenteral nutrition is associated with cholestasis and increased risk of sepsis. Glycerin suppositories have been used to promote gastrointestinal motility and feed tolerance. To investigate whether daily glycerin suppositories (a) reduce the time to full enteral feeding in infants born at suppositories; 28-31(+6) weeks subgroup); controls - no intervention. The same feeding protocol and departmental guidelines for other aspects of neonatal intensive care were used in all subjects. Analysis was by intention to treat. 54 babies were recruited (31 males), 29 randomized to receive suppositories; 48 achieved full enteral feeds. The median (range) time to full feeds was 1.6 days shorter in intervention group babies than controls, but not statistically significant: 7.4 (4.6-30.9) days versus 9.0 (4.4-13.3) days (p = 0.780; 95% confidence interval: -1.917, 2.166). No significant differences were observed in secondary outcomes. Intervention group babies passed their first stool earlier than controls (median: day 2 vs. day 4; p = 0.016). Regular glycerin suppositories did not reduce the time to full enteral feeds in infants born at <32 weeks' gestation in our setting. Copyright © 2011 S. Karger AG, Basel.

  11. Results and lessons learned from UMANG program: A large scale community-managed supplementary feeding program in India

    International Nuclear Information System (INIS)

    Chockalingham, David; Gnanaraj, Grana Pu Selvi; Indriani, Esther

    2014-01-01

    Full text: India’s National Family Health Survey (2005-2006) revealed that 48% children under 5 years old were stunted while 43% were underweight. Child malnutrition is the outcome of high levels of exposure to infections, inappropriate infant and young child feeding and caring practices. It has its origins almost entirely during the first two to three years of life. Child malnutrition is responsible for 22% of India’s burden of disease. According to the Lancet journal in 2013, undernutrition during pregnancy, affecting fetal growth, and the first two years of life is a major determinant of both stunting of linear growth and subsequent obesity and non-communicable diseases in adulthood. World Vision India (WVI) is a humanitarian organization working in India since 1951 and currently serving 163 districts in 25 states. The strategic directive of WVI for 2011-2014 focuses on reducing infant mortality and eliminating hunger in communities. In March 2011, a special task force Integrated Programming - Child Health (IPCH) with the key mandates to target families of malnourished children residing in program areas towards delivering fullness of life; support Government, communities and other partners in scaling up proven multisectoral interventions; leverage multi-sectoral coalitions to combat malnutrition; advocate change in system and sustainability; and set up organizational support. A generic logframe with the intervention packages was adopted by Area Development Programs (ADPs) in 96 locations, making it the biggest nutrition program ever been implemented by WVI. After doing the nutritional assessment, 83255 children were identified to be in moderate and severe malnutrition condition. Considering that even mild to moderate malnutrition greatly increases the risk of children dying from common childhood diseases, WVI decided to set up an emergency response as an ethical and critical decision to save the lives of these children. A community managed supplementary

  12. Enteral nutrition in inflammatory bowel disease.

    Science.gov (United States)

    Gassull, M A; Abad, A; Cabré, E; González-Huix, F; Giné, J J; Dolz, C

    1986-01-01

    To assess the effect of the addition of enteral tube feeding with polymeric diets to the standard treatment of acute attacks of inflammatory bowel disease a total of 43 patients admitted to hospital (23 with Crohn's disease and 20 with ulcerative colitis) were studied retrospectively. Total enteral nutrition was given to 26 as the sole nutritional supply and to 17 in conjunction with a normal ward diet, when appropriate, according to the severity of attack (control group). Nutritional state was assessed and classified in all patients at admission and at the end of the study, by measuring the triceps skinfold thickness, mid arm muscle circumference, and serum albumin concentration as representative of body fat, muscle protein, and visceral protein, respectively. At admission the three nutritional variables were not statistically different between the groups. There was a significantly positive effect on mid arm muscle circumference in patients on total enteral nutrition compared with the control group, but there was no effect on either triceps skinfold thickness or serum albumin concentration. The percentage of subjects requiring intravenous albumin infusion, however, was significantly less in the group fed enterally than in the control group. In addition, fewer patients in the group fed enterally required surgical treatment compared with the control group, despite the fact that one of the criteria for starting enteral nutritional support was the expectancy that surgery would be needed. Total enteral nutrition was well tolerated and no major side effects arose during its use in patients with acute exacerbations of inflammatory bowel disease. PMID:3098646

  13. Low Emission Feed

    NARCIS (Netherlands)

    Klop, G.

    2016-01-01

    Research into manipulating methane (CH4) production as a result of enteric fermentation in ruminants currently receives global interest. Using feed additives may be a feasible strategy to mitigate CH4 as they are supplied in such amounts that the basal diet composition will not be largely

  14. Feeding strategies to reduce methane loss in cattle

    NARCIS (Netherlands)

    Tamminga, S.; Bannink, A.; Dijkstra, J.; Zom, R.L.G.

    2007-01-01

    This report presents an overview of the enteric methane production in cattle. The possibilities are discussed to influence methane production by feeding measures and the use of feed additives, and by management measures. The possibilities are discussed against the background of Dutch cattle

  15. Hypophosphatemia associated with enteral alimentation in cats.

    Science.gov (United States)

    Justin, R B; Hohenhaus, A E

    1995-01-01

    Hypophosphatemia is uncommon in cats, but it has been reported in association with diabetes mellitus and hepatic lipidosis, where it can cause hemolysis, rhabdomyopathy, depression, seizures, and coma. The purpose of this article is to describe 9 cats that developed low serum phosphorus concentrations (alimentation. Serum biochemical analyses from more than 6,000 cats were reviewed. The medical records of all cats with hypophosphatemia were examined for history of enteral alimentation; diabetic cats were excluded from the study. Nine cats, ranging in age from 3 to 17 years, were identified. All cats had normal serum phosphorus concentrations before tube feeding began. Onset of hypophosphatemia occurred 12 to 72 hours after initiation of enteral alimentation, and the nadir for phosphorus concentrations ranged from 0.4 to 2.4 mg/dL. Hemolysis occurred in 6 of the 9 cats. Hypophosphatemia secondary to enteral alimentation is an uncommon clinical finding in cats. Cats with high alanine aminotransferase activity, hyperbilirubinemia, and weight loss should be closely monitored for hypophosphatemia during the first 72 hours of enteral alimentation.

  16. Laparoscopic insertion of the Moss feeding tube.

    Science.gov (United States)

    Albrink, M H; Hagan, K; Rosemurgy, A S

    1993-12-01

    Placement of enteral feeding tubes is an important part of a surgeon's skill base. Surgical insertion of feeding tubes has been performed safely for many years with very few modifications. With the recent surge in interest and applicability of other laparoscopic procedures, it is well within the skills of the average laparoscopic surgeon to insert feeding tubes. We describe herein a simple technique for the insertion of the Moss feeding tube. The procedure described has a minimum of invasion, along with simplicity, safety, and accuracy.

  17. Probiotics and Time to Achieve Full Enteral Feeding in Human Milk-Fed and Formula-Fed Preterm Infants: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Aceti, Arianna; Gori, Davide; Barone, Giovanni; Callegari, Maria Luisa; Fantini, Maria Pia; Indrio, Flavia; Maggio, Luca; Meneghin, Fabio; Morelli, Lorenzo; Zuccotti, Gianvincenzo; Corvaglia, Luigi

    2016-07-30

    Probiotics have been linked to a reduction in the incidence of necrotizing enterocolitis and late-onset sepsis in preterm infants. Recently, probiotics have also proved to reduce time to achieve full enteral feeding (FEF). However, the relationship between FEF achievement and type of feeding in infants treated with probiotics has not been explored yet. The aim of this systematic review and meta-analysis was to evaluate the effect of probiotics in reducing time to achieve FEF in preterm infants, according to type of feeding (exclusive human milk (HM) vs. formula). Randomized-controlled trials involving preterm infants receiving probiotics, and reporting on time to reach FEF were included in the systematic review. Trials reporting on outcome according to type of feeding (exclusive HM vs. formula) were included in the meta-analysis. Fixed-effect or random-effects models were used as appropriate. Results were expressed as mean difference (MD) with 95% confidence interval (CI). Twenty-five studies were included in the systematic review. In the five studies recruiting exclusively HM-fed preterm infants, those treated with probiotics reached FEF approximately 3 days before controls (MD -3.15 days (95% CI -5.25/-1.05), p = 0.003). None of the two studies reporting on exclusively formula-fed infants showed any difference between infants receiving probiotics and controls in terms of FEF achievement. The limited number of included studies did not allow testing for other subgroup differences between HM and formula-fed infants. However, if confirmed in further studies, the 3-days reduction in time to achieve FEF in exclusively HM-fed preterm infants might have significant implications for their clinical management.

  18. Pharmaceutical assistance in the enteral administration of drugs: choosing the appropriate pharmaceutical formulation

    Directory of Open Access Journals (Sweden)

    Gisele de Lima

    2009-03-01

    Full Text Available Objective: To study solid medications for oral delivery on the formulary of Hospital Israelita Albert Einstein (HIAE, investigating the  possibility of using these drugs through enteral feeding tubes, and recommending appropriate administration. Methods: Study carried out through survey of solid medications for oral delivery included on the formulary of HIAE, literature review, and analysis of medication monographs, manufacturer information and pharmacotechnical data of active ingredients and excipients. It was observed the factors that might hinder or complicate the administration of these drugs though enteral tubes, and was drawn an information chart with recommendations about drug administration in this context. Rresults: The study evaluated 234 medications; and the main problems of administering these drugs through enteral feeding tubes were as follows: changes in drug pharmacokinetics (38; gastrointestinal damage (9; risk of obstruction (40, drug-nutrient interactions (7; biological hazards (5 and no information (33. Cconclusions: Compiling this information helps the healthcare team to choose the appropriate pharmaceutical formulation for medications administered through enteral tubes, and may help identify adverse events related to this technique.

  19. Feeding programs promoting daily feed intake stability in rabbit males reduce sperm abnormalities and improve fertility.

    Science.gov (United States)

    Pascual, J J; Marco-Jiménez, F; Martínez-Paredes, E; Ródenas, L; Fabre, C; Juvero, M A; Cano, J L

    2016-08-01

    Feeding programs promoting daily feed intake (DFI) stability in rabbit males could be useful to ensure successful coverage of their nutritional requirements and for continued production of quality semen. To evaluate two feeding systems designed to reduce DFI variability, 115 rabbit males at age 1.2 years were randomly assigned to three different treatments for 294 days: CS, animals fed ad libitum with a control diet (127-g starch and 281-g total soluble fiber [hemicellulose + soluble fiber] kg(-1) dry matter); SF, males fed ad libitum with diet enriched in soluble fiber (86-g starch and 330-g total soluble fiber kg(-1) dry matter); and R, animals fed with CS diet but daily restricted to maintenance requirements. Feed intake, body weight, body condition, and variability of DFI were controlled every 42 days, and individual semen volume and sperm motility, concentration, acrosome status, and abnormalities every 15 days. In six commercial farms, the number of females inseminated, pregnant and kindling, as well as the number of kits born alive, was registered for 15,893 inseminations with pooled semen from each treatment. DFI was significantly lower for R males than for the other treatments (on average, -12 ± 4 g/day; P fertility of their pooled semen. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Fermented liquid feed - Microbial and nutritional aspects and impact on enteric diseases in pigs

    DEFF Research Database (Denmark)

    Canibe, Nuria; Jensen, Bent Borg

    2012-01-01

    The use of liquid feed in pig nutrition has recently gained interest due to several reasons: (1) the political wish of decreasing the use of antibiotics in pig production; (2) the current fluctuations in feed prices what makes liquid feed, with the possibility of using cheap liquid ingredients......, an interesting feeding strategy; (3) the policies aiming at increasing production of renewable biofuel with a corresponding increase in liquid co-products from the bioethanol industry, suitable for liquid feeding; (4) environmental policies aiming at decreasing disposal of waste, for example, liquid co-products...... mixture. Several factors affect the microbial and nutritional characteristics of the final product and therefore knowledge on the impact of these factors on the characteristics of the mixture is crucial. The initial hours of incubation are characterized by high pH, low numbers of lactic acid bacteria...

  1. A Mixed Integer Programming Poultry Feed Ration Optimisation Problem Using the Bat Algorithm

    Directory of Open Access Journals (Sweden)

    Godfrey Chagwiza

    2016-01-01

    Full Text Available In this paper, a feed ration problem is presented as a mixed integer programming problem. An attempt to find the optimal quantities of Moringa oleifera inclusion into the poultry feed ration was done and the problem was solved using the Bat algorithm and the Cplex solver. The study used findings of previous research to investigate the effects of Moringa oleifera inclusion in poultry feed ration. The results show that the farmer is likely to gain US$0.89 more if Moringa oleifera is included in the feed ration. Results also show superiority of the Bat algorithm in terms of execution time and number of iterations required to find the optimum solution as compared with the results obtained by the Cplex solver. Results revealed that there is a significant economic benefit of Moringa oleifera inclusion into the poultry feed ration.

  2. Colojejunal Fistula Resulting from a D-PEJ Feeding Tube

    Directory of Open Access Journals (Sweden)

    Martin D. Zielinski

    2008-06-01

    Full Text Available Numerous procedures have been developed to provide adequate enteral nutrition to patients with gastrointestinal disorders. Previously, operative placement of a feeding gastrostomy or jejunostomy tube was the accepted means of gaining chronic enteral access. However, improved technology and experience with endoscopic techniques have quickly replaced primary operative placement of enteral access. Direct percutaneous endoscopic jejunostomy (D-PEJ is a procedure that was designed to deliver enteral feeding solutions for patients with proximal disease after unsatisfactory results from percutaneous endoscopic gastrostomy tubes with jejunal extensions (PEG-J. As with any procedure, it is associated with complications. We present the first reported case of a colojejunal fistula resulting from a D-PEJ placement. While D-PEJ has been shown to be relatively safe, complications related to the inherent limitations of the procedure need to be considered when the patient experiences unusual post-procedure symptoms and worked up appropriately.

  3. Permissive underfeeding versus target enteral feeding in adult critically ill patients (PermiT Trial: a study protocol of a multicenter randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Arabi Yaseen M

    2012-10-01

    Full Text Available Abstract Background Nutritional support is an essential part of the management of critically ill patients. However, optimal caloric intake has not been systematically evaluated. We aim to compare two strategies of enteral feeding: permissive underfeeding versus target feeding. Method/Design This is an international multi-center randomized controlled trial in critically ill medical- surgical adult patients. Using a centralized allocation, 862 patients will be randomized to permissive underfeeding or target feeding. Patients in the permissive group receive 50% (acceptable range is 40% to 60% of the calculated caloric requirement, while those in the targeted group receive 100% (acceptable range 70% to 100% of the calculated caloric requirement. The primary outcome is 90-day all-cause mortality. Secondary outcomes include ICU and hospital mortality, 28-day, and 180-day mortality as well as health care-associated infections, organ failure, and length of stay in the ICU and hospital. The trial has 80% power to detect an 8% absolute reduction in 90-day mortality assuming a baseline risk of death of 25% at an alpha level of 0.05. Discussion Patient recruitment started in November 2009 and is currently active in five centers. The Data Monitoring Committee advised continuation of the trial after the first interim analysis. The study is expected to finish by November 2013. Trial registration Current Controlled Trials ISRCTN68144998

  4. Modulation of intestinal inflammation by minimal enteral nutrition with amniotic fluid in preterm pigs

    DEFF Research Database (Denmark)

    Østergaard, Mette Viberg; Bering, Stine Brandt; Jensen, Michael Ladegaard

    2014-01-01

    Background: Necrotizing enterocolitis (NEC) is a severe inflammatory disorder, associated with the difficult transition from parenteral to enteral feeding after preterm birth. We hypothesized that minimal enteral nutrition (MEN) with amniotic fluid (AF), prior to enteral formula feeding, would...... improve resistance to NEC in preterm pigs. Methods: Experiment 1: IEC-6 cells were incubated with porcine (pAF) and human AF (hAF) to test AF-stimulated enterocyte proliferation and migration in vitro. Experiment 2: Cesarean-delivered, preterm pigs were fed parenteral nutrition and MEN with pAF, h...... fed AF as MEN, but NEC incidences were similar (NEC-pAF) or increased (NEC-hAF) compared with controls. Conclusions: Intake of pAF or hAF improved body growth and modulated intestinal inflammatory cytokines during a period of parenteral nutrition, but did not protect against later formula-induced NEC...

  5. Antibiotic-Resistant Enteric Bacteria in Environmental Waters

    OpenAIRE

    Lisa M. Casanova; Mark D. Sobsey

    2016-01-01

    Sources of antibiotic resistant organisms, including concentrated animal feeding operations (CAFOs), may lead to environmental surface and groundwater contamination with resistant enteric bacteria of public health concern. The objective of this research is to determine whether Salmonella, Escherichia coli, Yersinia enterocolitica, and enterococci resistant to clinically relevant antibiotics are present in surface and groundwater sources in two eastern North Carolina counties, Craven and Wayne...

  6. Enteral Formula Containing Egg Yolk Lecithin Improves Diarrhea.

    Science.gov (United States)

    Akashi, Tetsuro; Muto, Ayano; Takahashi, Yayoi; Nishiyama, Hiroshi

    2017-09-01

    Diarrhea often occurs during enteral nutrition. Recently, several reports showed that diarrhea improves by adding egg yolk lecithin, an emulsifier, in an enteral formula. Therefore, we evaluated if this combination could improve diarrhea outcomes. We retrospectively investigated the inhibitory effects on watery stools by replacing a polymeric fomula with that containing egg yolk lecithin. Then, we investigated the emulsion stability in vitro. Next, we examined the lipid absorption using different emulsifiers among bile duct-ligated rats and assessed whether egg yolk lecithin, medium-chain triglyceride, and dietary fiber can improve diarrhea outcomes in a rat model of short bowel syndrome. Stool consistency or frequency improved on the day after using the aforementioned combination in 13/14 patients. Average particle size of the egg yolk lecithin emulsifier did not change by adding artificial gastric juice, whereas that of soy lecithin and synthetic emulsifiers increased. Serum triglyceride concentrations were significantly higher in the egg yolk lecithin group compared with the soybean lecithin and synthetic emulsifier groups in bile duct-ligated rats. In rats with short bowels, the fecal consistency was a significant looser the dietary fiber (+) group than the egg yolk lecithin (+) groups from day 6 of test meal feedings. The fecal consistency was also a significant looser the egg yolk lecithin (-) group than the egg yolk lecithin (+) groups from day 4 of test meal feeding. The fecal consistency was no significant difference between the medium-chain triglycerides (-) and egg yolk lecithin (+) groups. Enteral formula emulsified with egg yolk lecithin promotes lipid absorption by preventing the destruction of emulsified substances by gastric acid. This enteral formula improved diarrhea and should reduce the burden on patients and healthcare workers.

  7. Case Study: Enteral formula: Selecting the right formula for your ...

    African Journals Online (AJOL)

    placed on the type of fat (mono-unsaturated fatty acids), the addition ... patient with normal GIT function, but could worsen symptoms of poor enteral feed tolerance in a .... of omega-3 fatty acids, as well as gamma-linolenic acid (GLA) reflect an ...

  8. SCHOOL FEEDING PROGRAM USING RICE-PEA BEVERAGE IN SOME PRIMARY SCHOOLS: DOES IT HAVE BENEFIT?

    Directory of Open Access Journals (Sweden)

    Satoto Satoto

    2012-04-01

    Full Text Available ABSTRACT School feeding program is believed to be one effort among others to improve attendance rate, nutritional status and cognitive function of school children, which in turn improve academic performance of them. A study was conducted to evaluate a school feeding program using rice-pea beverage in Bandung, Indonesia. Its objective is to measure effect of the program on attendance rate, nutritional status, cognitive function and academic performance of the children joining the program. A control group design was administered. A number of students of class 3,4 and 5 from schools joining the feeding program were selected as program group, and more or less same number of school children in other schools with similar socio-economic situation were selected as control group. The feeding program was organized for 6 months. Attendance rate was measured by number of absentees, total and due to sickness in one semester. Nutritional status was standardized using WHO-NCHS z-score for weight-for-age (WAZ and height-for-age (HAZ. Cognitive function was measured by Coloured Progressive Matrices (CPM, and score of Mathematics and Indonesian Language (Bahasa Indonesia were measured using specific scholastic testings. School and home learning environment, certain food consumption frequencies were collected as covariates. GLM analyses were administered. The study found that after being controlled by some covariates, at the end of the study children in the program group showed better attendance rate, nutritional status, cognitive function and school performance. It is assumed that the improvement was due to better attendance rate as the program attracted the children to attend more days in the schools and due to improvement of food consumption provided by the program and at home. More in-depth, more specific and longer study, administering randomized case-control trial is recommended. Comparison of the use of foodstuffs for the purpose is also interesting to be

  9. Genomic diversification of giant enteric symbionts reflects host dietary lifestyles

    KAUST Repository

    Ngugi, David

    2017-08-24

    Herbivorous surgeonfishes are an ecologically successful group of reef fish that rely on marine algae as their principal food source. Here, we elucidated the significance of giant enteric symbionts colonizing these fishes regarding their roles in the digestive processes of hosts feeding predominantly on polysiphonous red algae and brown Turbinaria algae, which contain different polysaccharide constituents. Using metagenomics, single-cell genomics, and metatranscriptomic analyses, we provide evidence of metabolic diversification of enteric microbiota involved in the degradation of algal biomass in these fishes. The enteric microbiota is also phylogenetically and functionally simple relative to the complex lignocellulose-degrading microbiota of terrestrial herbivores. Over 90% of the enzymes for deconstructing algal polysaccharides emanate from members of a single bacterial lineage,

  10. The incidence of infants with rotavirus enteritis combined with lactose intolerance.

    Science.gov (United States)

    Hu, Yulian; Gui, Linyan; Chang, Jing; Liu, Jingyan; Xu, Shuling; Deng, Caiyan; Yu, Fengqin; Ma, Zhanmin; Wang, Guangzhou; Zhang, Changjun

    2016-01-01

    This study was to research the incidence of infants with rotavirus enteritis combined with lactose intolerance and the clinical effect of low lactose milk powder for infantile rotavirus enteritis with lactose intolerance. The control groups were 126 cases of infants with diarrhea randomly collected from our hospital at the same period, which their rotavirus detection was negative. The observation group was 185 cases of infants with rotavirus, which was tested to be positive. Through the urine galactose determination, 62 cases of the control group were positive and 124 cases of the observation group were positive. Then 124 cases of infants with rotavirus combined with lactose intolerance were randomly divided into two groups. 60 cases in the control group were given rehydration, correction of acidosis, oral smecta, Intestinal probiotics and other conventional treatment, then continued to the original feeding method. While, 64 cases in the treatment group, on the basis of routine treatment, applied the low lactose milk feeding. To observe the total effective rate for the two groups. The incidence of lactose intolerance in children with rotavirus enteritis (67.03%) was significantly higher than that of children with diarrhea (49.2%), which was tested to be negative. And the difference was statistically significant (plactose intolerance. The low lactose milk powder could improve the therapeutic effectively and could reduce the duration of disease, and restored to normal diet for 2 weeks feeding time.

  11. Nutritional analysis and microbiological evaluation of commercially available enteral diets for cats.

    Science.gov (United States)

    Prantil, Lori R; Markovich, Jessica E; Heinze, Cailin R; Linder, Deborah E; Tams, Todd R; Freeman, Lisa M

    2016-01-01

    To determine the prevalence of nutrients less than or greater than accepted standards in commercially available enteral diets for cats, and to identify contamination incidence in enteral diets for cats. Prospective cross-sectional study. University teaching hospital. Seven commercial enteral diets for cats. Labels were evaluated to determine if diets were intended to be nutritionally complete and balanced. One diet under storage techniques partially representative of clinical conditions was sampled on days 0, 1, 3, 5, and 7 of storage for aerobic bacterial culture. All 7 diets were analyzed for key nutrients and results were compared to Association of American Feed Control Officials (AAFCO) Nutrient Profiles for Adult Cats for maintenance and National Research Council recommended allowance (NRC-RA). From label information, 4 diets were classified as complete and balanced and 3 diets were classified as not complete and balanced. All 7 diets had at least 1 nutrient less than the AAFCO minimums and the NRC-RA. The total number of nutrients less than AAFCO minimums ranged from 3 to 9 (median = 4), with iron, potassium, and manganese being the most common. Concentrations of some nutrients were undetectable. None of the samples tested had a positive aerobic culture at baseline (day 0) or on subsequent samples from days 1, 3, 5, and 7 under any storage condition. None of the diets analyzed met all of the minimum nutrient concentrations. While short-term feeding may not be of concern for an individual patient, clinicians should be aware of potential nutritional limitations when feeding enteral diets to ill or injured cats. © Veterinary Emergency and Critical Care Society 2015.

  12. Enteric methane emissions from German pigs

    DEFF Research Database (Denmark)

    Dämmgen, Ulrich; Schulz, Joachim; Klausing, Heinrich Kleine

    2012-01-01

    Methane emissions from enteric fermentation of pigs are object of emission reporting. Hitherto they were treated as part of the energy balance of pigs, in accordance with IPCC guidance documents. They were calculated from the gross energy intake rate and a constant methane conversion ratio....... Meanwhile numerous experimental data on methane emissions from enteric fermentation is available in Germany and abroad; the results are compiled in this work. These results also allow for a description of transformation processes in the hind gut and a subsequent establishment of models that relate emissions...... to feed and performance data. The model by Kirchgeßner et al. (1995) is based on German experimental data and reflects typical national diet compositions. It is used to quantify typical emissions and methane conversion ratios. The results agree with other experimental findings at home and abroad...

  13. Poultry management: a useful tool for the control of necrotic enteritis in poultry.

    Science.gov (United States)

    Tsiouris, Vasilios

    2016-06-01

    The intestinal ecosystem of poultry has been inevitably changed as a result of the ban of antimicrobial growth promoters. The re-emergence of necrotic enteritis has been the most significant threat for the poultry industry, which, in clinical form, causes high mortality and in subclinical forms, affects growth and feed conversion. It is one of the most common and economically devastating bacterial diseases in modern broiler flocks in terms of performance, welfare and mortality. Necrotic enteritis is a multi-factorial disease process, in which a number of co-factors are usually required to precipitate an outbreak of the disease. Although, Clostridium perfringens has been identified as the aetiological agent of the disease, the predisposing factors that lead to over-proliferation of C. perfringens and the subsequent progression to disease are poorly understood. Any factor that causes stress in broiler chicks could suppress the immune system and disturb the balance of the intestinal ecosystem, in such a way that the risk of a necrotic enteritis (NE) outbreak increases. Poultry management could significantly affect the pathogenesis of NE. In particular, feed restriction and coccidiosis vaccination can protect against NE, while extreme house temperature, feed mycotoxins and high stocking density predispose to NE. It becomes really important to understand the pathogenesis of the disease, as well as to clarify the interactions between husbandry, nutritional and infectious factors and the outbreak of necrotic enteritis. This is necessary and extremely important in order to develop managerial strategies at the farm level to control the incidence and severity of the disease in the post-antibiotic era.

  14. Delivered volumes of enteral nutrition exceed prescribed volumes.

    Science.gov (United States)

    Walker, Renee Nichole; Utech, Anne; Velez, Maria Eugenia; Schwartz, Katie

    2014-10-01

    Enteral nutrition (EN) provisions are typically calculated based on a 24-hour infusion period. However, feedings are often interrupted for daily activities, procedures, or gastrointestinal intolerance. The study's objective was to determine the delivered EN quantities provided to stable hospitalized patients, using cellular time and measured volumes to verify our EN calculation adjustment. A supply of consecutively numbered ready-to-hang (RTH) EN product was delivered to the bedside of 26 inpatients with established EN tolerance at goal rates on various types of nursing units. The dietitian weighed the volume remaining in the infusing product and recorded the measurement time. On the following days, the dietitian continued to weigh the infusing RTH product and the empty RTH bottles saved by nursing. The primary outcome was the difference between the prescribed and delivered EN provisions, which was calculated with a paired t test. Patients received significantly more calories in the delivered enteral feeding (mean [SD], 1678 [385] kcal) than prescribed calories in the EN order (1489 [246 kcal]; t = 3.736, P = .001), adjusting for observed time. No significant differences were found between nursing units, product, and rate. EN delivered may actually exceed ordered amounts by 5%–21% (mean, 12%) with feeding pump inaccuracy as the primary contributing factor. This differs from what others have found. Our findings support using a volume-based ordering system vs a rate-based ordering system for more accurate EN delivery.

  15. Feasibility of a web-based dementia feeding skills training program for nursing home staff.

    Science.gov (United States)

    Batchelor-Murphy, Melissa; Amella, Elaine J; Zapka, Jane; Mueller, Martina; Beck, Cornelia

    2015-01-01

    Nursing home (NH) staff do not receive adequate training for providing feeding assistance to residents with dementia who exhibit aversive feeding behaviors (e.g., clamping mouth shut). The result is often low meal intake for these residents. This feasibility study tested a web-based dementia feeding skills program for staff in two United States NHs. Randomly assigned, the intervention staff received web-based dementia feeding skills training with coaching. Both groups participated in web-based pre-/post-tests assessing staff knowledge and self-efficacy; and meal observations measured NH staff and resident feeding behaviors, time for meal assistance, and meal intake. Aversive feeding behaviors increased in both groups of residents; however, the intervention NH staff increased the amount of time spent providing assistance and meal intake doubled. In the control group, less time was spent providing assistance and meal intake decreased. This study suggests that training staff to use current clinical practice guidelines improves meal intake. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Effect of oat hulls as a free choice feeding on broiler performance, short chain fatty acids and microflora under a mild necrotic enteritis challenge

    Directory of Open Access Journals (Sweden)

    Sarbast K. Kheravii

    2018-03-01

    Full Text Available Structure of fibre has been reported to enhance performance, intestinal function and modify the composition and quantity of the microbial population in the chicken gastrointestinal tract. It is hypothesised that insoluble fibre in oat hulls may improve gut health and reduce intestinal Clostridium perfringens number. This research assessed the effect of free choice oat hulls (OH on performance and gut microbiota in broilers during a mild (subclinical necrotic enteritis (NE challenge. A total of 240 day-old male Ross 308 broiler chickens were assigned to 24 cages in a 2 × 2 factorial arrangement of treatments. Factors were challenge − or +; and OH − or +. On d 16, challenged broilers had lower weight gain and feed intake (P < 0.05 compared with unchallenged broilers. On d 16, broilers given OH had lower feed intake (P < 0.05 and tended to have lower (P = 0.062 feed conversion ratio (FCR compared with those without access to OH. Broiler performance, however, was not affected by OH nor by challenge on d 24 and 35. The broilers given OH had heavier gizzards (P < 0.05 compared with those without OH at d 35 but not at d 13 or 16. Increased numbers of C. perfringens (P < 0.001 and reduced numbers (P < 0.05 of Lactobacillus and Salmonellae were observed in the caecal contents of challenged broilers on d 16. Challenged broilers had a lower concentration of caecal acetic acid (P < 0.01 compared with unchallenged broilers at d 16. The broilers given OH had lower concentrations of caecal acetic acid (P < 0.05, propionic acid (P < 0.05, and valeric acid (P < 0.01 compared with those without access to OH. An OH by challenge interaction on succinic acid concentration was observed on d 16 (P < 0.05. Oat hulls elevated the caecal succinic acid concentration only in the unchallenged broilers. This study indicated a positive role of OH through improved gizzard function and increased succinic acid in the gut but its role in

  17. Effect of enteral IGF-1 supplementation on feeding tolerance, growth, and gut permeability in enterally fed premature neonates

    NARCIS (Netherlands)

    Corpeleijn, Willemijn E.; van Vliet, Ineke; de Gast-Bakker, Dana-Anne H.; van der Schoor, Sophie R. D.; Alles, Martine S.; Hoijer, Maarten; Tibboel, Dick; van Goudoever, Johannes B.

    2008-01-01

    The gastrointestinal tract of the premature newborn functions suboptimally with regard to digestion, absorption, and feeding tolerance. Human milk contains trophic factors, such as insulin-like growth factor-1 (IGF-1), that are believed to stimulate gut growth and function. The objective of this

  18. Feeding nitrate and docosahexaenoic acid affects enteric methane production and milk fatty acid composition in lactating dairy cows.

    Science.gov (United States)

    Klop, G; Hatew, B; Bannink, A; Dijkstra, J

    2016-02-01

    An experiment was conducted to study potential interaction between the effects of feeding nitrate and docosahexaenoic acid (DHA; C22:6 n-3) on enteric CH4 production and performance of lactating dairy cows. Twenty-eight lactating Holstein dairy cows were grouped into 7 blocks of 4 cows. Within blocks, cows were randomly assigned to 1 of 4 treatments: control (CON; urea as alternative nonprotein N source to nitrate), NO3 [21 g of nitrate/kg of dry matter (DM)], DHA (3 g of DHA/kg of DM and urea as alternative nonprotein N source to nitrate), or NO3 + DHA (21 g of nitrate/kg of DM and 3 g of DHA/kg of DM, respectively). Cows were fed a total mixed ration consisting of 21% grass silage, 49% corn silage, and 30% concentrates on a DM basis. Feed additives were included in the concentrates. Cows assigned to a treatment including nitrate were gradually adapted to the treatment dose of nitrate over a period of 21 d during which no DHA was fed. The experimental period lasted 17 d, and CH4 production was measured during the last 5d in climate respiration chambers. Cows produced on average 363, 263, 369, and 298 g of CH4/d on CON, NO3, DHA, and NO3 + DHA treatments, respectively, and a tendency for a nitrate × DHA interaction effect was found where the CH4-mitigating effect of nitrate decreased when combined with DHA. This tendency was not obtained for CH4 production relative to dry matter intake (DMI) or to fat- and protein corrected milk (FPCM). The NO3 treatment decreased CH4 production irrespective of the unit in which it was expressed, whereas DHA did not affect CH4 production per kilogram of DMI, but resulted in a higher CH4 production per kilogram of fat- and protein-corrected milk (FPCM) production. The FPCM production (27.9, 24.7, 24.2, and 23. 8 kg/d for CON, NO3, DHA, and NO3 + DHA, respectively) was lower for DHA-fed cows because of decreased milk fat concentration. The proportion of saturated fatty acids in milk fat was decreased by DHA, and the proportion of

  19. Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: A retrospective review

    International Nuclear Information System (INIS)

    Mangar, Stephen; Slevin, Nicholas; Mais, Kathleen; Sykes, Andrew

    2006-01-01

    Background and purpose: To identify objective pre-treatment clinical parameters that could be used to predict for patients at high risk of requiring enteral tube feeding prior to head and neck radiotherapy. Patients and methods: A retrospective study was conducted on 160 consecutive patients attending for radiotherapy assessment. Regression analysis was used to determine various pre-treatment nutritional and tumour specific parameters associated with the use of enteral nutrition either before (prophylactic) or during (reactive) radiotherapy (RT). The significant parameters identified were then selected into categorical variables and compared between those who needed reactive enteral nutrition and the remainder of the group who did not. These results were used to generate predictive factors that could be used to identify those at high risk of malnutrition during RT for whom early or prophylactic enteral nutrition should be considered. Results: Fifty patients required enteral feeding of which 60% required this prior to radiotherapy. Multivariate analysis identified the following factors to be significant-body mass index, performance status (PS), advanced stage, pre-treatment weight loss, low serum albumin and protein, age, and smoking. The most significant categorical predictive parameters for reactive enteral feeding were stage 3-4 disease, PS 2-3, and smoking >20/day. The combination of these factors predicted a 75% chance of needing enteral nutrition. Conclusion: Nutritional assessment is important prior to radiotherapy and is multifactorial. Using a combination of relatively simple and objective parameters (performance status, smoking and disease stage) it is possible to identify those at high risk of needing enteral nutrition prior to starting RT

  20. Transgastrostomy jejunal intubation for enteric alimentation.

    Science.gov (United States)

    McLean, G K; Rombeau, J L; Caldwell, M D; Ring, E J; Freiman, D B

    1982-12-01

    Malnourished patients who cannot maintain an adequate oral intake but have normal intestinal absorption and motility are candidates for enteric alimentation. When impaired gastric peristalsis or an increased risk for aspiration makes gastrostomy feeding unsafe, direct jejunal infusion is the preferred route of alimentation. Angiographic techniques were used to convert previously placed, simple gastrostomies to combined gastrostomy-jejunostomies in 14 patients. In 17 additional patients, a combined gastrostomy-jejunal tube was placed under local anesthesia; angiographic techniques assisted in the placement of 11 of these tubes.

  1. A dynamic programming model for optimising feeding and slaughter decisions regarding fattening pigs

    Directory of Open Access Journals (Sweden)

    J. K. NIEMI

    2008-12-01

    Full Text Available Costs of purchasing new piglets and of feeding them until slaughter are the main variable expenditures in pig fattening. They both depend on slaughter intensity, the nature of feeding patterns and the technological constraints of pig fattening, such as genotype. Therefore, it is of interest to examine the effect of production technology and changes in input and output prices on feeding and slaughter decisions. This study examines the problem by using a dynamic programming model that links genetic characteristics of a pig to feeding decisions and the timing of slaughter and takes into account how these jointly affect the quality-adjusted value of a carcass. The state of nature and the genotype of a pig are known in the analysis. The results suggest that producer can benefit from improvements in the pig’s genotype. Animals of improved genotype can reach optimal slaughter maturity quicker and produce leaner meat than animals of poor genotype. In order to fully utilise the benefits of animal breeding, the producer must adjust feeding and slaughter patterns on the basis of genotype. The results also suggest that the producer can benefit from flexible feeding technology. Typically, such a technology provides incentives to feed piglets with protein-rich feed. When the pig approaches slaughter maturity, the share of protein-rich feed in the diet gradually decreases and the amount of energy-rich feed increases. Generally, the optimal slaughter weight is within the weight range that pays the highest price per kilogram of pig meat. The optimal feeding pattern and the optimal timing of slaughter depend on price ratios. Particularly, an increase in the price of pig meat provides incentives to increase the growth rates up to the pig’s biological maximum by increasing the amount of energy in the feed. Price changes and changes in slaughter premium can also have large income effects.;

  2. The effect of commonly used anticoccidials and antibiotics in a subclinical necrotic enteritis model

    OpenAIRE

    Lanckriet , Anouk; Timbermont , Leen; De Gussem , Maarten; Marien , Maja; Vancraeynest , Dieter; Haesebrouck , Freddy; Ducatelle , Richard; Van Immerseel , Filip

    2010-01-01

    Abstract Necrotic enteritis poses an important health risk to broilers. The ionophore anticoccidials lasalocid, salinomycin, maduramicin, narasin and a combination of narasin and nicarbazin were tested in feed for their prophylactic effect on the incidence of necrotic enteritis in a subclinical experimental infection model that uses coccidia as predisposing factor. In addition, drinking water medication with the antibiotics amoxicillin, tylosin and lincomycin was evaluated as curat...

  3. [Role of donor human milk feeding in preventing nosocomial infection in very low birth weight infants].

    Science.gov (United States)

    Bi, Hong-Juan; Xu, Jing; Wei, Qiu-Fen

    2018-02-01

    To investigate the role of donor human milk in the prevention of nosocomial infection in very low birth weight infants. MeETHODS: A total of 105 hospitalized preterm infants with a very low birth weight were enrolled. They were classified into mother's own milk feeding group, donor human milk feeding group, and preterm formula feeding group, with 35 infants in each group. The three groups were compared in terms of incidence rates of nosocomial infection, necrotizing enterocolitis, and feeding intolerance, time to full enteral feeding, and early growth indices. Compared with the preterm formula feeding group, the donor human milk feeding group and the mother's own milk feeding group had significantly lower incidence rates of nosocomial infection and necrotizing enterocolitis and shorter time to full enteral feeding (Pmilk can be used in case of a lack of mother's own milk and may help to reduce nosocomial infection.

  4. Modelling the Effect of Diet Composition on Enteric Methane Emissions across Sheep, Beef Cattle and Dairy Cows

    Directory of Open Access Journals (Sweden)

    Matt Bell

    2016-09-01

    Full Text Available Enteric methane (CH 4 is a by-product from fermentation of feed consumed by ruminants, which represents a nutritional loss and is also considered a contributor to climate change. The aim of this research was to use individual animal data from 17 published experiments that included sheep ( n = 288, beef cattle ( n = 71 and dairy cows ( n = 284 to develop an empirical model to describe enteric CH 4 emissions from both cattle and sheep, and then evaluate the model alongside equations from the literature. Data were obtained from studies in the United Kingdom (UK and Australia, which measured enteric CH 4 emissions from individual animals in calorimeters. Animals were either fed solely forage or a mixed ration of forage with a compound feed. The feed intake of sheep was restricted to a maintenance amount of 875 g of DM per day (maintenance level, whereas beef cattle and dairy cows were fed to meet their metabolizable energy (ME requirement (i.e., production level. A linear mixed model approach was used to develop a multiple linear regression model to predict an individual animal’s CH 4 yield (g CH 4 /kg dry matter intake from the composition of its diet. The diet components that had significant effects on CH 4 yield were digestible organic matter (DOMD, ether extract (EE (both g/kg DM and feeding level above maintenance intake: CH 4 (g/kg DM intake = 0.046 (±0.001 × DOMD − 0.113 (±0.023 × EE − 2.47 (±0.29 × (feeding level − 1, with concordance correlation coefficient ( CCC = 0.655 and RMSPE = 14.0%. The predictive ability of the model developed was as reliable as other models assessed from the literature. These components can be used to predict effects of diet composition on enteric CH 4 yield from sheep, beef and dairy cattle from feed analysis information.

  5. Comparison of lipid and calorie loss from donor human milk among 3 methods of simulated gavage feeding: one-hour, 2-hour, and intermittent gravity feedings.

    Science.gov (United States)

    Brooks, Christine; Vickers, Amy Manning; Aryal, Subhash

    2013-04-01

    The objective of this study was to compare the differences in lipid loss from 24 samples of banked donor human milk (DHM) among 3 feeding methods: DHM given by syringe pump over 1 hour, 2 hours, and by bolus/gravity gavage. Comparative, descriptive. There were no human subjects. Twenty-four samples of 8 oz of DHM were divided into four 60-mL aliquots. Timed feedings were given by Medfusion 2001 syringe pumps with syringes connected to narrow-lumened extension sets designed for enteral feedings and connected to standard silastic enteral feeding tubes. Gravity feedings were given using the identical syringes connected to the same silastic feeding tubes. All aliquots were analyzed with the York Dairy Analyzer. Univariate repeated-measures analyses of variance were used for the omnibus testing for overall differences between the feeding methods. Lipid content expressed as grams per deciliter at the end of each feeding method was compared with the prefed control samples using the Dunnett's test. The Tukey correction was used for other pairwise multiple comparisons. The univariate repeated-measures analysis of variance conducted to test for overall differences between feeding methods showed a significant difference between the methods (F = 58.57, df = 3, 69, P gravity feeding methods (P = .3296). Pairwise comparison using the Tukey correction revealed a significant difference between both gravity and 1-hour feeding methods (P gravity and 2-hour feeding method (P gravity feedings, the timed feedings resulted in a statistically significant loss of fat as compared with their controls. These findings should raise questions about how those infants in the neonatal intensive care unit are routinely gavage fed.

  6. Use of a complete starter feed in grain adaptation programs for feedlot cattle.

    Science.gov (United States)

    Schneider, C J; Nuttelman, B L; Shreck, A L; Burken, D B; Griffin, W A; Gramkow, J L; Stock, R A; Klopfenstein, T J; Erickson, G E

    2017-08-01

    Four experiments evaluated the use of a complete starter feed (RAMP; Cargill Corn Milling, Blair, NE) for grain adaptation. In Exp. 1, 229 yearling steers (397 ± 28.4 kg BW) were used to compare a traditional adaptation program (CON) with adapting cattle with RAMP in either a 1- (RAMP-1RS) or 2- (RAMP-2RS) ration system. From d 23 to slaughter, cattle were fed a common finishing diet. In Exp. 2, 390 yearling steers (341 ± 14 kg BW) were used to compare accelerated grain adaptation programs with RAMP with 2 control treatments where RAMP was blended with a finishing diet containing either 25 (CON25) or 47.5% (CON47) Sweet Bran (Cargill Corn Milling) in 4 steps fed over 24 d to adapt cattle. Rapid adaptation treatments involved feeding RAMP for 10 d followed by a blend of RAMP and a 47% Sweet Bran finishing diet to transition cattle with 3 blends fed for 1 d each (3-1d), 2 blends fed for 2 d each (2-2d), or 1 blend fed for 4 d (1-4d). From d 29 to slaughter, all cattle were fed a common finishing diet. In Exp. 3, 300 steer calves (292 ± 21 kg BW) were used to compare the CON47 and 1-4d adaptation programs with directly transitioning cattle from RAMP, which involved feeding RAMP for 10 d and then switching directly to F1 on d 11 (1-STEP). From d 29 until slaughter, F2 was fed to all cattle. In Exp. 4, 7 ruminally fistulated steers (482 ± 49 kg BW) were used in a 35-d trial to compare the CON47 and 1-STEP adaptation programs. Ruminal pH and intake data from the first 6 d of F1and first 6 d of F2 were used to compare adaptation systems. Adaptation with RAMP-1RS and RAMP-2RS increased ( cattle adapted using CON in Exp. 1. Feeding RAMP-1RS increased ADG ( = 0.03) compared with CON. Intakes were similar ( = 0.39) among treatments. Daily gain, DMI, G:F, and carcass traits were similar ( > 0.11) among treatments in Exp. 2. Daily gain, DMI, and G:F were not different ( > 0.20) among treatments on d 39 or over the entire feeding period in Exp. 3. When F1 or F2 was being fed

  7. Successful enteral nutrition in the treatment of esophagojejunal fistula after total gastrectomy in gastric cancer patients

    Directory of Open Access Journals (Sweden)

    Portanova Michel

    2010-08-01

    Full Text Available Abstract Background Esophagojejunal fistula is a serious complication after total gastrectomy in gastric cancer patients. This study describes the successful conservative management in 3 gastric cancer patients with esophagojejunal fistula after total gastrectomy using total enteral nutrition. Methods Between January 2004 to December 2008, 588 consecutive patients with a proven diagnosis of gastric cancer were taken to the operation room to try a curative treatment. Of these, 173 underwent total gastrectomy, 9 of them had esophagojejunal fistula (5.2%. In three selected patients a trans-anastomotic naso-enteral feeding tube was placed under fluoroscopic vision when the fistula was clinically detected and a complete polymeric enteral formula was used. Results The complete closing of the esophagojejunal fistula was obtained in day 8, 14 and 25 respectively. Conclusion In some selected cases it is possible to make a successful enteral nutrition using a feeding tube distal to the leak area inserted with the help of fluoroscopic vision. The specialized management of a gastric surgery unit and nutritional therapy unit are highlighted.

  8. Blenderized feeding formulas with nutritious and inexpensive foods

    Directory of Open Access Journals (Sweden)

    Ana Paula Lança BENTO

    Full Text Available ABSTRACT Objective: To propose an inexpensive blenderized tube feeding formula consisting of foods with standard nutritional composition that meets the nutritional requirements of individuals aged more than 51 years. Methods: The enteral diets were formulated mainly with fresh foods and tested for their physical (homogeneity, stability, osmolality, pH, and flow rate and chemical (moisture, ash, protein, lipids, energy, crude fiber, vitamin C, calcium, iron, magnesium, and zinc characteristics. The cost was determined by surveying item prices in supermarkets and stores that specialize in nutritional support. Results: The blenderized tube feeding formula was stable and homogeneous, and had slightly acidic pH, hypertonic osmolality (603mOsm/kg, and flow rate comparable with gravity drip (21 minutes. Proximate composition analysis indicated appropriate levels of proteins, lipids, vitamin C, and zinc. The mean cost of 2000kcal of the standard blenderized tube feeding formula was R$ 12.3±1.4, which is 70% cheaper than the mean cost of similar commercial enteral formulas. Conclusion: The planned diet can be an excellent choice for patients using blenderized tube feeding formulas as it consisted of habitual food items, had physical and nutritional quality, and was inexpensive.

  9. Enteral nutrition for preterm infants: by bolus or continuous? An update

    Directory of Open Access Journals (Sweden)

    Valentina Bozzetti

    2017-06-01

    Full Text Available Optimization of nutritional management of preterm infants is crucial for achievement of their long-term health. Enteral nutrition is preferred to total parenteral nutrition (TPN because the former avoids complications related to vascular catheterization, sepsis, adverse effects of TPN, and fasting. Due to the lack of ability of preterm infants to coordinate suckling, swallowing, and breathing, tube feeding is necessary for most infants less than 1500 g to ensure sufficient feeding tolerance, to support optimal growth and to reduce the risk of aspiration. Therefore, feeding by orogastric or nasogastric tube using either continuous or intermittent bolus delivery of formula or human milk is common practice for these infants. Theoretical risks and benefits of both continuous nasogastric milk feeding and intermittent bolus milk feeding have been proposed. According to the literature, continuous nutrition could be preferred in smaller infants (as those with a birthweight below 1250 g or hemodynamically impaired infants; in stable growing infants nutrition can be administered intermittently as in healthy term infants.

  10. Original Article The effect of grower feed diet supplemented with ...

    African Journals Online (AJOL)

    We report a preliminary study on the effect of grower feed diet supplemented with mashed Ganoderma lucidum against some enteric zoonotic parasites of wild rock pigeons (Columba livia) in Benin City, Nigeria. The pigeons were fed ad libitum with supplemented and non-supplemented grower feed diet in sawdust-floored ...

  11. Effects of luminal nutrient absorption, intraluminal physical stimulation, and intravenous parenteral alimentation on the recovery responses of duodenal villus morphology following feed withdrawal in chickens.

    Science.gov (United States)

    Tarachai, P; Yamauchi, K

    2000-11-01

    The aim of this study was to clarify which of the following three factors induces villus morphological recovery best: enteral nutrient absorption, intraluminal physical stimulation, or intravenous parenteral alimentation. At 142 d, male White Leghorn chickens (Gallus gallus domesticus) were divided into eight groups of five birds each as follows: 1) access given ad libitum to a commercial layer mash diet (CP, 17.5%; ME, 2,830 kcal/kg) (control), 2) 5-d feed withdrawal (feed withdrawal), 3) 3-d feed withdrawal (3-FW), followed by refeeding the same diet as the control for 2 d (refeeding), 4) 3-FW followed by force-feeding enteral hyperalimentation (enteral), 5) 3-FW followed by force-feeding an indigestible (nonabsorbable) substance (kaolin), 6) 3-FW followed by force-feeding water for 2 d (force-fed control), 7) 3-FW followed by parenteral hyperalimentation (parenteral), and 8) 3-FW followed by no alimentation (sham control) for 2 d. In the refeeding and enteral groups, BW significantly recovered (P alimentation, but by enteral nutrient absorption.

  12. Feed-pump hydraulic performance and design improvement, Phase I: research program design. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brown, W.H.; Gopalakrishnan, S.; Fehlau, R.; Thompson, W.E.; Wilson, D.G.

    1982-03-01

    As a result of prior EPRI-sponsored studies, it was concluded that a research program should be designed and implemented to provide an improved basis for the design, procurement, testing, and operation of large feed pumps with increased reliability and stability over the full range of operating conditions. This two-volume report contains a research plan which is based on a review of the present state of the art and which defines the necessary R and D program and estimates the benefits and costs of the program. The recommended research program consists of 30 interrelated tasks. It is designed to perform the needed research; to verify the results; to develop improved components; and to publish computer-aided design methods, pump specification guidelines, and a troubleshooting manual. Most of the technology proposed in the research plan is applicable to nuclear power plants as well as to fossil-fired plants. This volume discusses the design, performance and failures of feed pumps, and recommendations for research on pump dynamics, design, and specifications.

  13. Management of Hyperglycemia During Enteral and Parenteral Nutrition Therapy

    Science.gov (United States)

    Umpierrez, Guillermo E.

    2013-01-01

    Hyperglycemia is a frequent complication of enteral and parenteral nutrition in hospitalized patients. Extensive evidence from observational studies indicates that the development of hyperglycemia during parenteral and enteral nutrition is associated with an increased risk of death and infectious complications. There are no specific guidelines recommending glycemic targets and effective strategies for the management of hyperglycemia during specialized nutritional support. Managing hyperglycemia in these patients should include optimization of carbohydrate content and administration of intravenous or subcutaneous insulin therapy. The administration of continuous insulin infusion and insulin addition to nutrition bag are efficient approaches to control hyperglycemia during parenteral nutrition. Subcutaneous administration of long-acting insulin with scheduled or corrective doses of short-acting insulin is superior to the sliding scale insulin strategy in patients receiving enteral feedings. Randomized controlled studies are needed to evaluate safe and effective therapeutic strategies for the management of hyperglycemia in patients receiving nutritional support. PMID:23065369

  14. Tolerance to early human milk feeding is not compromised by indomethacin in preterm infants with persistent ductus arteriosus.

    Science.gov (United States)

    Bellander, M; Ley, D; Polberger, S; Hellström-Westas, L

    2003-09-01

    Early human milk feeding is beneficial for gut and brain development. Persistent ductus arteriosus (PDA) and indomethacin may compromise enteral function in preterm infants. For many years enteral milk feedings have continued in preterm infants receiving indomethacin for PDA. The aim of this study was to investigate whether this strategy is efficient in terms of risks and tolerance to early enteral feeding. This retrospective study included 64 inborn infants of respiratory morbidity; 90.6% versus 50% of controls needed mechanical ventilation (p = 0.000). Case infants received human milk from a median (range) age of 4.0 h (1.5-27.5), and controls from 5.3 h (2.0-38.0) (p = 0.092). The first dose of indomethacin was given at a mean age of 1.7 d (1.0). There were no differences between the two groups in feeding volumes or gastric residuals on days 1 to 7. Mean (SD) feeding volume on day 7 was 64 ml/kg (31) in case infants and 76 ml/kg (30) in controls (p = 0.23). Four infants developed necrotizing enterocolitis: two case infants and two controls (p = 1.00). Early enteral feeding with human milk, starting within the first hours of life, seems to be as well tolerated in preterm infants treated with indomethacin for PDA as in their matched controls.

  15. Frequency of changing enteral alimentation bags and tubing, and adverse clinical outcomes in patients in a long term care facility.

    Science.gov (United States)

    Graham, S; McIntyre, M; Chicoine, J; Gerard, B; Laughren, R; Cowley, G; Morrison, J; Aoki, F Y; Nicolle, L E

    1993-01-01

    Enteral alimentation, given via nasogastric or gastrostomy tubes, is a well established practice to provide nutrition for patients with significant neurological injury. The frequency with which enteral feeding bags and tubes require change and potential adverse effects associated with bacterial contamination of tube feeds remain controversial. The authors studied different times between enteral feeding bag and tube changes, and the effect on adverse clinical outcomes in residents of a long term care facility. In the first study, residents were randomized to 24 h (n = 2), 48 h (n = 3) or 72 h (n = 6) tube feeding and bag changes with clinical status monitored in a standardized fashion for six months. In the second study, patients were randomized to 24 h (n = 6) or 72 h (n = 6) changes. Patient-days of follow-up were 382, 574 and 1000 for the three arms of the first study period and 556 and 496 for the two arms of the second study. No differences in potential clinical adverse events--including fever, gastrointestinal symptoms or pneumonia--were observed with different durations of tubing change. This study suggests it is appropriate to change alimentation tube and feeding bags every 72 h (rather than every 24 h). The less frequent changes will decrease supply costs and free nursing time for other activities.

  16. Fasting, circadian rhythms, and time restricted feeding in healthy lifespan

    OpenAIRE

    Longo, Valter D.; Panda, Satchidananda

    2016-01-01

    Feeding in most animals is confined to a defined period, leaving short periods of fasting that coincide with sleep. Fasting enables organisms to enter alternative metabolic phases, which rely less on glucose and more on ketone body-like carbon sources. Both intermittent and periodic fasting result in benefits ranging from prevention to the enhanced treatment of diseases. Similarly, time-restricted feeding (TRF), in which feeding time is restricted to certain hours of the day, allows the daily...

  17. 7 CFR 905.142 - Animal feed.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Animal feed. 905.142 Section 905.142 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements..., disposed of, or in any way handled so as to enter fresh fruit channels; (3) The quantity does not exceed 1...

  18. Evaluation of limit feeding corn and distillers dried grains with solubles in non-feed-withdrawal molt programs for laying hens.

    Science.gov (United States)

    Mejia, L; Meyer, E T; Utterback, P L; Utterback, C W; Parsons, C M; Koelkebeck, K W

    2010-03-01

    An experiment was conducted using 504 Hy-Line W-36 Single Comb White Leghorn hens (69 wk of age) randomly assigned to 1 of 7 treatments. These treatments consisted of a 47% corn:47% soy hulls diet (C:SH) fed ad libitum; a 94% corn diet fed at a rate of 36.3, 45.4, or 54.5 g/hen per day (CORN 36, CORN 45, and CORN 54, respectively); and a 94% corn distillers dried grains with solubles (DDGS) diet fed at the same rates as the previous corn diets (DDGS 36, DDGS 45, and DDGS 54, respectively) during the molt period of 28 d. The intent was to feed the DDGS diets for 28 d; however, all hens on these diets had very low feed intakes and greater than anticipated BW loss. Thus, they were switched to a 16% CP corn-soybean meal layer diet on d 19 of the molt period. At d 28, hens on all treatments were fed the same corn-soybean meal layer diet for 39 wk (73 to 112 wk of age). All DDGS diets and the CORN 36 diet resulted in total cessation of egg production during the molt period and egg production of hens fed the CORN 45, CORN 54, and C:SH diets had decreased to 3 and 4%, respectively, by d 28. Body weight loss during the 28-d molt period ranged from 14% for the CORN 54 diet to approximately 23% for the 3 DDGS diets. Postmolt egg production (5 to 43 wk) was higher for hens fed the DDGS molt diets than those fed the corn diets. There were no consistent differences in egg mass, egg-specific gravity, feed efficiency, or layer feed consumption among molt treatments for the postmolt period. These results indicate that limit feeding corn diet and DDGS diet in non-feed-withdrawal molt programs will yield long-term postmolt performance that is comparable to that observed by ad libitum feeding a C:SH diet.

  19. Development and Evaluation of a Home Enteral Nutrition Team

    Directory of Open Access Journals (Sweden)

    Sarah Dinenage

    2015-03-01

    Full Text Available The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1 prevention of hospital admission and related transport for ETF related issues; (2 effective management and reduction of waste of feed and thickener; (3 balloon gastrostomy tube replacement by the HEN Team in the patient’s home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

  20. Enteric glia.

    Science.gov (United States)

    Rühl, A; Nasser, Y; Sharkey, K A

    2004-04-01

    The enteric nervous system is composed of both enteric neurones and enteric glia. Enteric glial cells were first described by Dogiel and are now known to outnumber neurones approximately 4 : 1. In the past, these cells were assumed to subserve a largely supportive role; however, recent evidence indicates that enteric glial cells may play a more active role in the control of gut function. In transgenic mouse models, where enteric glial cells are selectively ablated, the loss of glia results in intestinal inflammation and disruption of the epithelial barrier. Enteric glia are activated specifically by inflammatory insults and may contribute actively to inflammatory pathology via antigen presentation and cytokine synthesis. Enteric glia also express receptors for neurotransmitters and so may serve as intermediaries in enteric neurotransmission. Thus, enteric glia may serve as a link between the nervous and immune systems of the gut and may also have an important role in maintaining the integrity of the mucosal barrier and in other aspects of intestinal homeostasis.

  1. Application of nasointestinal feeding tube in treatment of acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Li Tian

    2016-12-01

    Full Text Available Objective: To observe the clinical effect of nasointestinal feeding tube for enteral nutrition in the treatment of acute pancreatitis. Methods: A total of 128 patients with acute pancreatitis who were admitted in our hospital were included in the study and randomized into the treatment group and the control group with 64 cases in each group. Routine pancreatitis treatments after admission in the two groups were performed. On the basis, nasointestinal feeding tube was indwelled in patients in the treatment group for nutrition support. The changes of biochemical and nutritional indicators before and after treatment in the two groups were compared. Results: LC, TP, ALB, and Hb after treatment in the two groups were significantly elevated, while AMY and Lipase were significantly reduced when compared with before treatment (P0.05. Conclusions: Adoption of nasointestinal feeding tube for enteral nutrition in the treatment of acute pancreatitis can significantly improve the nutritional status; therefore, it deserves to be widely recommended in the clinic.

  2. Continuous elemental enteral alimentation in the treatment of children and adolescents with Crohn's disease.

    Science.gov (United States)

    Morin, C L; Roulet, M; Roy, C C; Weber, A; Lapointe, N

    1982-01-01

    Ten pediatric patients, aged 8.5-19 years, with active symptomatic Crohn's disease, received a three-week period of continuous elemental enteral alimentation with no other form of treatment. All patients in this study were selected according to the following criteria, which were applied consecutively: (1) newly diagnosed patients with no previous treatment for Crohn's disease, (2) disease activity index over 200, and (3) no complication requiring surgery. All patients experienced a clinical remission and improved their immunologic and nutritional status during the elemental enteral alimentation. The mean disease activity index for the whole group was 307.0 +/- 23.6 (range: 203 to 413) before and 69.2 +/- 11.4 (range: 15 to 114) after the feeding period. Significant increases in body weight, triceps skinfold, mid-arm circumference, serum transferrin and mean percentage of T lymphocytes were also observed. Following cessation of enteral alimentation, a small declining dose of prednisone was used during a one-year follow-up period. Eight of the ten patients were still in clinical remission three months after the feeding period and their nutritional status had continued to improve during that period of time.

  3. Limited utility of plain abdominal radiographs in evaluating intussusceptions secondary to long indwelling feeding tubes

    Directory of Open Access Journals (Sweden)

    Albert Yang

    2013-01-01

    Full Text Available Adult intussusception (AI is relatively rare and can be a difficult clinical diagnosis, often requiring cross-sectional imaging for confirmation. Unfortunately, intussusceptions in the setting of indwelling long enteral feeding tubes have been predominantly characterized in the pediatric population with minimal investigation in adults. We report three cases of AI in patients with long feeding catheters serving as anatomic lead points leading to intussusception diagnosed on cross-sectional imaging. We highlight the limited utility of the supine plain films for detection of AI, and it behooves the radiologist to hold a high index of suspicion if the patient has a long enteral catheter. Since the majority of these patients tend to be fairly ill and unable to stand for upright abdominal radiographs, in the setting of percutaneous feeding tubes, decubitus abdominal radiographs should always be obtained. These cases also highlight the importance of having a high clinical suspicion of intussusceptions in a patient presenting with abdominal pain in the setting of an enteral feeding tube. In post-operative patients, other factors can predispose the patient to intussusception, including adhesions. Another interesting feature in tube related AI is the reverse intussusception that may be seen with indwelling enteral tubes. Reverse intussusception is where the distal bowel telescopes into the proximal segment over the tube.

  4. Clinical and nutritional aspects of cystic fibrosis patients assisted by a home enteral nutrition program in Brazil

    OpenAIRE

    Haack, Adriana; Garbi Novaes, Maria Rita

    2013-01-01

    This study to assessed 47 cystic fibrosis (CF) patients assisted by a program of Home Enteral Nutrition. Anthropometric measurements included weight, height, triceps skinfold thickness, waist circunference and spirometry was also performed. Enzymes, nutritional and fat-soluble vitamin supplementations were recorded. There were no associations with enzymes and vitamin supplements between groups that did or did not have a nutritional deficit. Spirometry of patients without nutritional deficit, ...

  5. Gene ontology of differentially expressed genes in the Necrotic enteritis induced chicken lines

    Science.gov (United States)

    Necrotic enteritis caused by Clostridium perfringens has become prevalent in the broiler industry due to the withdrawal of antibiotics in poultry feed. The expression level of intestinal mRNA from two chicken lines (line 6.3: MD-resistant and 7.2: MD-susceptible) was significantly different followi...

  6. Infection and cross-infection in a Paediatric Gastro-enteritis unit

    Directory of Open Access Journals (Sweden)

    Jean Bowen Jones

    1989-09-01

    Full Text Available A two month study to investigate the incidence o f nosocomial infection was conducted in a paediatric gastroenteritis ward o f a black academic hospital. Enteric pathogens were identified on admission in 61 (47,2% o f 129 patients; 56 bacterial and 25 viral. Six per cent o f patients had a combination o f bacterial and viral pathogens. Enteric pathogens most frequently identified on admission were Campylobacter jejuni in 22%, Rotavirus in 19,3%, EPEC in 10,8% and Shigella spp. in 6,9% patients. Twenty six (20% patients had more than 1 enteric pathogen. The nosocomial infection rate was recorded at 17,1%. EPEC occurred most commonly in 5,3% patients, Salmonella typhimurium in 4,6% and Shigella spp. in 2,3%. Nosocomial infections increased the mean length o f hospital stay from 7,2- 20,2 days. Contributory factors to the spread o f nosocomial infection were the unsatisfactory methods o f bathing patients and giving naso-gastric feeds.

  7. Scaling-up biofortified beans high in iron and zinc through the school-feeding program

    NARCIS (Netherlands)

    Beintema, Joni J.S.; Gallego-Castillo, Sonia; Londoño-Hernandez, Luis F.; Restrepo-Manjarres, José; Talsma, Elise F.

    2018-01-01

    Iron and zinc deficiencies are global health problems, affecting mostly pregnant women and young children. In 2016, biofortified iron and zinc beans were introduced in Colombia. The incorporation of biofortified beans into the national school-feeding program could facilitate adoption and potentially

  8. Enteric methane emissions from German dairy cows

    DEFF Research Database (Denmark)

    Dammgen, U; Rosemann, C; Haenel, H D

    2012-01-01

    Up to now, the German agricultural emission inventory used a model for the assessment of methane emissions from enteric fermentation that combined an estimate of the energy and feed requirements as a function of performance parameters and diet composition, with the constant methane conversion rate......, as stated by IPCC. A methane emission model was selected here that is based on German feed data. It was combined with the hitherto applied model describing energy requirements. The emission rates thus calculated deviate from those previously obtained. In the new model, the methane conversion rate is back......-calculated from emission rates and gross energy intake rates. For German conditions of animal performance and diet composition, the national means of methane conversion rates range between 71 kJ MJ(-1) and 61 kJ MJ(-1) for low and high performances (4700 kg animal(-1) a(-1) in 1990 to 7200 kg animal(-1) a(-1...

  9. The waste minimization program at the Feed Materials Production Center

    International Nuclear Information System (INIS)

    Blasdel, J.E.; Crotzer, M.E.; Gardner, R.L.; Kato, T.R.; Spradlin, C.N.

    1987-01-01

    A waste minimization program is being implemented at the Feed Materials Production Center to reduce the generation of uranium-contaminated wastes and to comply with existing and forthcoming regulations. Procedures and plans are described which deal with process and non-process trash, contaminated wood and metals, used metal drums, and major process wastes such as contaminated magnesium fluoride and neutralized raffinate. Waste minimization techniques used include segregation, source reduction, volume reduction, material substitution and waste/product recycle. The importance of training, communication, and incentives is also covered. 5 refs., 11 figs

  10. Diet-Dependent Effects of Minimal Enteral Nutrition on Intestinal Function and Necrotizing Enterocolitis in Preterm Pigs

    DEFF Research Database (Denmark)

    Cilieborg, Malene Skovsted; Boye, Mette; Thymann, Thomas

    2011-01-01

    Background: A rapid advance in enteral feeding is associated with necrotizing enterocolitis (NEC) in preterm infants. Therefore, minimal enteral nutrition (MEN) combined with parenteral nutrition (PN) is common clinical practice, but the effects on NEC and intestinal function remain poorly...... characterized. It was hypothesized that a commonly used MEN feeding volume (16-24 mL/kg/d) prevents NEC and improves intestinal structure, function, and microbiology in preterm pigs. Methods: After preterm birth pigs were stratified into 4 nutrition intervention groups that received the following treatments: (1...... later formula-induced gut dysfunction and NEC. However, in CF pigs, intestinal lesions were restricted to the colon, compared with all regions in OF and FF pigs, which indicated proximal protection of colostrum MEN. Bacterial composition was not affected by MEN, diet, or NEC outcomes, but bacterial load...

  11. Association of a Proactive Swallowing Rehabilitation Program With Feeding Tube Placement in Patients Treated for Pharyngeal Cancer.

    Science.gov (United States)

    Ajmani, Gaurav S; Nocon, Cheryl C; Brockstein, Bruce E; Campbell, Nicholas P; Kelly, Amy B; Allison, Jamie; Bhayani, Mihir K

    2018-04-19

    A proactive speech and language pathology (SLP) program is an important component of the multidisciplinary care of patients with head and neck squamous cell carcinoma (HNSCC). Swallowing rehabilitation can reduce the rate of feeding tube placement, thereby significantly improving quality of life. To evaluate the initiation of a proactive SLP rehabilitation program at a single institution and its association with rates of feeding tube placement and dietary intake in patients with HNSCC. Cohort study at a tertiary care and referral center for patients with HNSCC serving the northern Chicago region. Patients were treated for squamous cell carcinomas of the hypopharynx, oropharynx, and nasopharynx from 2004 to 2015 with radiation or chemoradiation therapy in the definitive or adjuvant setting. Patients who received less than 5000 cGy radiation or underwent reirradiation were excluded. A proactive SLP program for patients with HNSCC was initiated in 2011. Study cohorts were divided into 2 groups: 2004 through 2010 and 2011 through 2015. Primary outcome variables were SLP referral placement and timing of the referral. Secondary outcomes were feeding tube placement and ability to tolerate any oral intake. A total of 254 patients met inclusion criteria (135 before and 119 after implementation of SLP program; median age, 60 years [range, 14-94 years]; 77% male). With the initiation of a proactive SLP program, pretreatment evaluations increased from 29 (21.5%) to 70 (58.8%; risk ratio [RR], 2.74; 95% CI, 1.92-3.91), and rate of referral overall at any time increased from 60.0% to 79.8% (RR, 1.33; 95% CI, 1.13-1.57). Feeding tube placement rates decreased from 45.9% (n = 62) to 29.4% (n = 35; RR, 0.64; 95% CI, 0.46-0.89). Among patients receiving a swallow evaluation, feeding tube requirements were less frequent for those receiving a pretreatment evaluation (31 of 99 [31%]) than for those referred during (11 of 18 [61%]) or after (38 of 59 [64%]) treatment. The rate

  12. Impact of Skip-a-Day and Every-Day Feeding Programs for Broiler Breeder Pullets on the Recovery of Salmonella and Campylobacter following challenge.

    Science.gov (United States)

    Wilson, K M; Bourassa, D V; McLendon, B L; Wilson, J L; Buhr, R J

    2018-06-08

    The impact of restrictive feeding programs on Salmonella and Campylobacter colonization and persistence after challenge was investigated for broiler breeder pullets housed in an experimental rearing facility. Pullet-chicks were placed on litter in 3 feeding program rooms and each room contained 2 replicate pens. The feeding programs were: (1) Skip-a-day in trough feeders (SAD); (2) Every-day in trough feeders (EDT); (3) Every-day on the pen litter (EDL). On d 1, an additional group of hatchmate chicks were housed in a separate room and gavaged with Salmonella Typhimurium, to later serve as seeder chicks. After seeders were confirmed Salmonella-positive at wk 4, at wk 5 seeders were placed into each feeding program pen to commingle with 135 penmates. At 7, 9, 11, 17, 18, and 20 wk the litter surface in each pen was sampled using intermittently stepped-on drag-swabs. At 8, 12, 16, and 20 wk of age the ceca were sampled from 10 penmates/pen and 2 pooled spleen samples/pen were collected. SAD litter remained Salmonella-positive through 20 wk of age while EDL and EDT pens had no detectible litter Salmonella recovery by 18 and 20 wk. EDL fed pens had no direct (days had significantly higher Salmonella recovery (40%), compared to EDT and EDL (both at 5% recovery). By 16 and 20 wk, only the SAD pullets on the on-feed day (48 h without feed) had recovery of Salmonella at 20%. Salmonella recovery in pooled spleen samples did not appear associated with feeding treatments (22% positive). The remaining pullets challenged with Campylobacter at 21 wk produced similar trends as was seen for Salmonella. SAD program pullets had significantly higher Campylobacter from ceca (80 to 100%) compared to pullets on EDL (30 to 60%) or EDT (40 to 95%). These results suggest that using a Skip-a-Day feeding program for broiler breeder pullets contributes to persistently higher Salmonella and Campylobacter ceca colonization and litter prevalence.

  13. Very early feeding in stable small for gestational age preterm infants: a randomized clinical trial.

    Science.gov (United States)

    Arnon, Shmuel; Sulam, Daniella; Konikoff, Fred; Regev, Rivka H; Litmanovitz, Ita; Naftali, Timna

    2013-01-01

    To examine the effect of initiating very early feeding on time-to-reach full feeding in stable, small for gestational age (SGA) preterm infants. Preterm infants with gestational age below 37 weeks and birth weight below the 10(th) percentile were randomly allocated to a very early (within 24 hours of birth) feeding regimen or delayed (after 24 hours of birth) feeding. All infants had in utero evidence of absent or reverse diastolic flow. Infants unable to start early feeding were excluded. Time-to-reach full feeding, feeding progression, and related morbidity were compared. Electrogastrography (EGG) was used to measure pre- and postprandial gastric motility on the second and seventh day after feeding initiation. Sixty infants were included in the study, 30 in each group. Infants included in the very early feeding regimen achieved full enteral feeding sooner than controls (98±80-157 vs. 172±123-261 hours of age, respectively; p= 0.004) and were discharged home earlier (p=0.04). No necrotizing enterocolitis (NEC) was documented in both study groups. Gastric motility was improved at day seven after feeding initiation in both study groups, with no difference between groups. Stable SGA preterm infants on a very early feeding regimen achieved full enteral feeding and were discharged home significantly earlier than those on a delayed regimen, with no excess morbidity. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  14. The Effects of Glucose Therapy Agents-Apple Juice, Orange Juice, and Cola-on Enteral Tube Flow and Patency.

    Science.gov (United States)

    Steinberg, Daphna J; Montreuil, Jasmine; Santoro, Andrea L; Zettas, Antonia; Lowe, Julia

    2016-06-01

    To develop evidence-based hypoglycemia treatment protocols in patients receiving total enteral nutrition, this study determined the effect on enteral tube flow of glucose therapy agents: apple juice, orange juice, and cola, and it also examined the effects of tube type and feed type with these glucose therapy agents. For this study, 12 gastrostomy tubes (6 polyethylene and 6 silicone) were set at 50 mL/h. Each feeding set was filled with Isosource HN with fibre or Novasource Renal. Each tube was irrigated with 1 glucose therapy agent, providing approximately 20 g of carbohydrate every 4 h. Flow-rate measurements were collected at 2 h intervals. The results showed that the glucose therapy agent choice affected flow rates: apple juice and cola had higher average flow rates than orange juice (P = 0.01). A significant difference was found between tube type and enteral formula: polyethylene tubes had higher average flow rates than silicone tubes (P orange juice, and thus may be considered as primary treatment options for hypoglycemia in enterally fed patients. Polyethylene tubes and Isosource HN with fibre were less likely to clog than silicone tubes and Novasource Renal.

  15. Enhancing the growth performance of replacement female breeder goats through modification of feeding program

    Directory of Open Access Journals (Sweden)

    A. A. A. Ghani

    2017-06-01

    Full Text Available Aim: The study was conducted at a smallholder goat farm located in Labu, Negeri Sembilan, Malaysia. The objective of this study was to evaluate the effect of proper feeding program on growth performances of replacement breeder goats. Materials and Methods: A total of 30 healthy female boer cross goats at the age of 4 months old with average initial live body weight (BW of 20.05±0.5 kg were used for on-farm feeding trial to evaluate the growth performance as preparation for breeding purposes. The experimental goats were divided into two groups of 15 animals each labeled as control and treatment groups, which were kept under intensive farming system. Goats in control group were fed with normal routine feeding protocol practiced by the farmer, while goats in the treatment group were fed with new feed formulation. Throughout the experimental period, on-farm monitoring and data collection were carried out. Initial BW and body condition score (BCS were recorded before the start of the experiment while final BW and BCS were gained after 7 months of the experimental period. Average daily gain (ADG was calculated after the experiment end. Data on BW, ADG, and BCS were recorded from both groups for every 2 weeks and reported monthly. The feed intake for the control group was 2.8 kg/animal/day which practiced by the farmer and 3.2 kg/animal/day as new feed formulation for the treatment group. Results: After 7 months of the experimental period, final BW shows an improvement in treatment group (39.1±1.53 kg compared with control group (32.3±1.23 kg. The ADG in treatment group also gives promising result when comparing with control group. Goats in treatment group significantly attained better ADG than control group which were 126.7 g/day and 83.3 g/day, respectively. For the BCS, goats in the treatment group had shown an improvement where 86.67% (13 out of 15 of the group had BCS =3 (1-5 scoring scale and only 66.67% (10 out of 15 of the control group had

  16. The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

    Directory of Open Access Journals (Sweden)

    Levent Güngör

    2011-06-01

    Full Text Available OBJECTIVE: Dysphagia and malnutrition are not so rare in stroke patients, and have an unfavorable influence on recovery. Nutritional support may reduce infections, duration of hospital stay and mortality. However, there is no clear evidence about the modality of nasogastric nutrition. In this study, intermittent and continuous enteral nutrition is compared by means of pulmonary infections and gastrointestinal tolerance, among acute cerebrovascular patients. METHODS: Sixty two acute cerebrovascular patients with dysphagia were included the study. The same volume of nutrition product was infused 4 times daily to 31 patients, and continuously for 24 hours to the remaining 31. After 10 days of follow-up, the rates of pulmonary infections, diarrhea, increased gastric residual volumes, vomiting and tube occlusion were compared between two groups. RESULTS: Twenty patients developed pneumonia (32% and 8 diarrhea (13%. Mortality due to complications associated with tube feeding was 6%. Aspiration and related pneumonia was present in 11 patients in the intermittent nutrition group (35%, and in 9 patients in the continuous nutrition group (29%. The rate of pulmonary infection was not statistically different between two groups (p>0.05. Diarrhea was observed in 7 intermittently fed patients (23%, while was present only in 1 patient (3% in the continuously fed group. Diarrhea was more common in the intermittent nutrition group, just at the statistical border (p=0.05. None of the patients developed tube occlusion, vomiting and gastric retention. The rate of mortality and the interruption of feeding was not significantly different between two groups (p>0.05. CONCLUSION: Diarrhea and pulmonary infections are more prevalent with intermittent tube feeding with respect to continuous enteral nutrition, though the difference is not so conspicuous. The reason may be contamination of the equipments and the feeding solution because of frequent manipulation and

  17. The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

    Directory of Open Access Journals (Sweden)

    Levent Güngör

    2011-06-01

    Full Text Available OBJECTIVE: Dysphagia and malnutrition are not so rare in stroke patients, and have an unfavorable influence on recovery. Nutritional support may reduce infections, duration of hospital stay and mortality. However, there is no clear evidence about the modality of nasogastric nutrition. In this study, intermittent and continuous enteral nutrition is compared by means of pulmonary infections and gastrointestinal tolerance, among acute cerebrovascular patients. METHODS: Sixty two acute cerebrovascular patients with dysphagia were included the study. The same volume of nutrition product was infused 4 times daily to 31 patients, and continuously for 24 hours to the remaining 31. After 10 days of follow-up, the rates of pulmonary infections, diarrhea, increased gastric residual volumes, vomiting and tube occlusion were compared between two groups. RESULTS: Twenty patients developed pneumonia (32% and 8 diarrhea (13%. Mortality due to complications associated with tube feeding was 6%. Aspiration and related pneumonia was present in 11 patients in the intermittent nutrition group (35%, and in 9 patients in the continuous nutrition group (29%. The rate of pulmonary infection was not statistically different between two groups (p>0.05. Diarrhea was observed in 7 intermittently fed patients (23%, while was present only in 1 patient (3% in the continuously fed group. Diarrhea was more common in the intermittent nutrition group, just at the statistical border (p=0.05. None of the patients developed tube occlusion, vomiting and gastric retention. The rate of mortality and the interruption of feeding was not significantly different between two groups (p>0.05. CONCLUSION: Diarrhea and pulmonary infections are more prevalent with intermittent tube feeding with respect to continuous enteral nutrition, though the difference is not so conspicuous. The reason may be contamination of the equipments and the feeding solution because of frequent manipulation and

  18. Achieving optimal feeds for preterm babies, recommendations and ...

    African Journals Online (AJOL)

    Preterm deaths are responsible for the highest number of neonatal mortality in Nigeria. Preterm nutrition contributes significantly to overall outcome particularly as it relates to neurodevelopment. Recently, new guidelines for enteral feedings in premature infants were issued by the American Academy of Paediatrics and ...

  19. Targeted full energy and protein delivery in critically ill patients: a study protocol for a pilot randomised control trial (FEED Trial

    Directory of Open Access Journals (Sweden)

    Kate Fetterplace

    2018-02-01

    Full Text Available Abstract Background Current guidelines for the provision of protein for critically ill patients are based on incomplete evidence, due to limited data from randomised controlled trials. The present pilot randomised controlled trial is part of a program of work to expand knowledge about the clinical effects of protein delivery to critically ill patients. The primary aim of this pilot study is to determine whether an enteral feeding protocol using a volume target, with additional protein supplementation, delivers a greater amount of protein and energy to mechanically ventilated critically ill patients than a standard nutrition protocol. The secondary aims are to evaluate the potential effects of this feeding strategy on muscle mass and other patient-centred outcomes. Methods This prospective, single-centred, pilot, randomised control trial will include 60 participants who are mechanically ventilated and can be enterally fed. Following informed consent, the participants receiving enteral nutrition in the intensive care unit (ICU will be allocated using a randomisation algorithm in a 1:1 ratio to the intervention (high-protein daily volume-based feeding protocol, providing 25 kcal/kg and 1.5 g/kg protein or standard care (hourly rate-based feeding protocol providing 25 kcal/kg and 1 g/kg protein. The co-primary outcomes are the average daily protein and energy delivered to the end of day 15 following randomisation. The secondary outcomes include change in quadriceps muscle layer thickness (QMLT from baseline (prior to randomisation to ICU discharge and other nutritional and patient-centred outcomes. Discussion This trial aims to examine whether a volume-based feeding protocol with supplemental protein increases protein and energy delivery. The potential effect of such increases on muscle mass loss will be explored. These outcomes will assist in formulating larger randomised control trials to assess mortality and morbidity. Trial registration

  20. Minimal Enteral Nutrition to Improve Adaptation After Intestinal Resection in Piglets and Infants

    DEFF Research Database (Denmark)

    Aunsholt, Lise; Qvist, Niels; Sangild, Per Torp

    2018-01-01

    BACKGROUND: Minimal enteral nutrition (MEN) may induce a diet-dependent stimulation of gut adaptation following intestinal resection. Bovine colostrum is rich in growth factors, and we hypothesized that MEN with colostrum would stimulate intestinal adaptation, compared with formula, and would...... be well tolerated in patients with short bowel syndrome. METHODS: In experiment 1, 3-day-old piglets with 50% distal small intestinal resection were fed parenteral nutrition (PN, n = 10) or PN plus MEN given as either colostrum (PN-COL, n = 5) or formula (PN-FORM, n = 9) for 7 days. Intestinal nutrient......, enteral colostrum supplementation was well tolerated, and no infants developed clinical signs of cow's milk allergy. CONCLUSION: Minimal enteral nutrition feeding with bovine colostrum and formula induced similar intestinal adaptation after resection in piglets. Colostrum was well tolerated by newly...

  1. Clostridial necrotic enteritis in chicken associated with growth rate depression

    Directory of Open Access Journals (Sweden)

    Adin Priadi

    2008-03-01

    Full Text Available Clostridium perfringens (C. perfringens is a normal inhabitant of the intestinal tract of chickens as well as a potential pathogen causing necrotic enteritis. C. perfringens only causes necrotic enteritis when it transforms from non-toxin producing type to toxin producing type. The alpha toxin, (phospholipase C is believed to be a key to the occurrence of Clostridial necrotic enteritis (CNE. The best known predisposing factor is mucosal damage, caused by coccidiosis that damages the intestinal lining, making the gut susceptible to infections including C. perfringens. The purpose of this study was to observe the chicken performance in experimental CNE and field cases of CNE. Diagnosis of CNE were made by latex agglutination test, isolation and identification of the agent. Pathological and histopathological changes were also observed. Experimentally, NE could be reproduced when Eimeria sp and C. perfringens spores are inoculated in chicken. Signs of an NE are wet litter and diarrhea, and an increase in mortality is not often obvious. The depression of growth rate and feed efficiency of chicken become noticeable by week 5 because of damage to the intestine and the subsequent reduction in digestion and absorption of food. Subclinical form of CNE was also frequently found in the field, leading to significant decreases in performance. Chicken gut samples examinations revealed that subclinical form of CNE causes damage to the intestinal mucosa caused by C. perfringens leads to decreased digestion and absorption, increased feed conversion ratio and reduced weight gain. Dual infection with C. perfringens and Eimeria sp. was frequently found in field. The results of these studies provide evidence for C. perfringens as a causative bacteria for growth depression.

  2. Invited review: Enteric methane in dairy cattle production: quantifying the opportunities and impact of reducing emissions.

    Science.gov (United States)

    Knapp, J R; Laur, G L; Vadas, P A; Weiss, W P; Tricarico, J M

    2014-01-01

    Many opportunities exist to reduce enteric methane (CH4) and other greenhouse gas (GHG) emissions per unit of product from ruminant livestock. Research over the past century in genetics, animal health, microbiology, nutrition, and physiology has led to improvements in dairy production where intensively managed farms have GHG emissions as low as 1 kg of CO2 equivalents (CO2e)/kg of energy-corrected milk (ECM), compared with >7 kg of CO2 e/kg of ECM in extensive systems. The objectives of this review are to evaluate options that have been demonstrated to mitigate enteric CH4 emissions per unit of ECM (CH4/ECM) from dairy cattle on a quantitative basis and in a sustained manner and to integrate approaches in genetics, feeding and nutrition, physiology, and health to emphasize why herd productivity, not individual animal productivity, is important to environmental sustainability. A nutrition model based on carbohydrate digestion was used to evaluate the effect of feeding and nutrition strategies on CH4/ECM, and a meta-analysis was conducted to quantify the effects of lipid supplementation on CH4/ECM. A second model combining herd structure dynamics and production level was used to estimate the effect of genetic and management strategies that increase milk yield and reduce culling on CH4/ECM. Some of these approaches discussed require further research, but many could be implemented now. Past efforts in CH4 mitigation have largely focused on identifying and evaluating CH4 mitigation approaches based on nutrition, feeding, and modifications of rumen function. Nutrition and feeding approaches may be able to reduce CH4/ECM by 2.5 to 15%, whereas rumen modifiers have had very little success in terms of sustained CH4 reductions without compromising milk production. More significant reductions of 15 to 30% CH4/ECM can be achieved by combinations of genetic and management approaches, including improvements in heat abatement, disease and fertility management, performance

  3. Parenteral lipids and partial enteral nutrition affect hepatic lipid composition but have limited short term effects on formula-induced necrotizing enterocolitis in preterm piglets

    DEFF Research Database (Denmark)

    Vegge, Andreas; Thymann, Thomas; Lauritzen, Lotte

    2015-01-01

    Rapid transition from total parenteral nutrition (TPN) to enteral feeding is a risk factor for necrotizing enterocolitis (NEC) in preterm infants. We hypothesized that partial enteral nutrition with colostrum, increased proportion of n-3 polyunsaturated fatty acids (PUFA), or exclusion of lipid...

  4. Endoscopic gastrostomy, nasojejunal and oral feeding comparison in aspiration pneumonia patients

    Directory of Open Access Journals (Sweden)

    Ozge E Onur

    2013-01-01

    Full Text Available Background: Aspiration pneumonia is a potentially preventable illness requiring attention to small details of patient care. The type, management, and care of feeding should be carried out properly. Materials andMethods: This is a prospective clinical study of enteral feeding on patients admitted to hospital with aspiration pneumonia. The known enteral nutritional methods, advantages, and disadvantages were told to the patient or proxy. If they didn′t accept Percutaneous endoscopic gastrostomy (PEG, nasojejunal tube (NJT was advised. If they denied all of the procedures, oral feeding education was given. A total of 94 patients were enrolled to the study, 29 of them accepted PEG, 42 preferred NJT, and 23 preferred oral route. Results: A total of 94 patients with a mean age of 77.84, standard deviation 10.784; 95% confidence interval (CI 75.63-80.03 were enrolled to the study of which 27 (28.7% patients had a history of aspiration pneumonia. Oral feeding was prominently preferred for patients nursed by a relative (15; 65.2% of Oral feeding group and 16% of total or a caregiver (7; 30.4% of Oral feeding group and 7.4% of total while only 1 (4.3% of Oral feeding group and 1.1% of total with a health-care worker (P = 0.001. Overall re-aspiration rates at the 6 th month were 58%, 78%, 91% in EG, NJT, oral groups, respectively. Sixth months′ survival rates of the different feeding groups were not significantly divergent from each other. History of aspiration was also found to be a significant contributor of mortality. Conclusion: In aspiration pneumonia patients′ long-term survival rates of the different feeding groups were not significantly divergent from each other.

  5. Esophagojejunostomy Feeding Tube Placement in 5 Dogs with Pancreatitis and Anorexia

    Directory of Open Access Journals (Sweden)

    Forrest Cummings

    2014-01-01

    Full Text Available Enteral feeding tube placement has been described in veterinary medicine for several years. Indications include oral, esophageal, gastrointestinal, pancreatic, hepatic, and neurologic diseases. In this paper, endoscopically assisted placement of an esophagojejunostomy (EJ feeding tube in dogs with pancreatitis and prolonged anorexia is described. To the author’s knowledge there are no published reports of this procedure. Esophagojejunostomy feeding tubes provide an alternative to other forms of postgastric feeding tube placement (e.g., nasojejunal, gastrojejunostomy, and jejunostomy tubes without the associated complications of patient discomfort, sneezing, epistaxis, and peritonitis. Tube occlusion, transient vomiting and loose stool were the most commonly reported complications.

  6. The Relationship between Glucagon-Like Peptide 2 and Feeding Intolerance in Preterm Infants

    DEFF Research Database (Denmark)

    Ozer, Esra Arun; Holst, Jens Juul; Duman, Nuray

    2008-01-01

    Glucagon-like peptide 2 (GLP-2) is a hormone produced primarily in the distal intestine, stimulated by enteral nutrients, and playing diverse roles in the intestinal adaptation and growth. We aimed to investigate whether GLP-2 may play a role in the development of feeding intolerance which is a c...... with low levels of GLP-2 carry a risk for development of feeding intolerance. It may, therefore, be of relevance to investigate the therapeutic and prophylactic effects of GLP-2 administration in the preterm babies.......Glucagon-like peptide 2 (GLP-2) is a hormone produced primarily in the distal intestine, stimulated by enteral nutrients, and playing diverse roles in the intestinal adaptation and growth. We aimed to investigate whether GLP-2 may play a role in the development of feeding intolerance which...... is a common problem in preterm newborns resulting from the intestinal immaturity. The study included 20 term and 28 preterm neonates. Of preterm babies, 13 showed feeding intolerance fulfilling at least one of the following criteria: abdominal distension, increased gastric residual volume and presence of bile...

  7. Pemberian makanan enteral berformulasi bahan pangan lokal terhadap kadar zat besi dan hemoglobin pada tikus putih (Rattus norvegicus

    Directory of Open Access Journals (Sweden)

    Dini Ariani

    2013-07-01

    Full Text Available Background: Enteral nutrition is nutrition used to fulfill the needs of nutrition entirely and as the supplement for malnutrition patient. In a certain condition of a patient, this nutrition is usually given in the form of liquid. Local material foods such as tempeh, rice, mung bean, and ganyong have adequate nutrition, therefore they are suitable for being used as main raw materials in the making of enteral nutrition. Objective: To know the influence of feeding enteral nutrition formulated with local food material toward malnutrition white rats (Rattus norvegicus of which the parameters are iron (Fe, hemoglobin (Hb level and weight. Method: This research used Completely Random Design (CRD. Twenty-seven of malnutrition male white rats were divided into 3 groups of treatment with 9 repetitions for each group of the treatment. Group A was given enteral nutrition diet of formula A (tempeh, rice, and mung bean as the main raw material, group B was given enteral nutrition diet of formula B (tempeh, rice, mung bean, and ganyong as the main raw material, and group C (as the positive control was given commercial enteral nutrition. The daily giving of enteral nutrition is 20 g/day during 30 days. The analysis of Fe and Hb level and the measurement of weight firstly were done before the treatment is given. The next measurement was conducted in 15th day and 31st day. Statistical analysis used ANOVA test dan DMRT of significance 5%. Results: The result showed that the treatment of the enteral nutrition feeding of formula B was more optimal than formula A in terms of the way to increase the level of Hb and Fe. Those two components will give positive effect toward the increasing of the weight of malnutrition white rats (Rattus norvegicus. Conclusion: The enteral nutrition of formula B is more proper to be developed as the main material of making enteral food in order to treat the malnutrition.

  8. Occurrence of ochratoxin A in poultry feeds and feed ingredients from Pakistan.

    Science.gov (United States)

    Sherazi, S T H; Shar, Z H; Sumbal, G A; Tan, Eddie T; Bhanger, M I; Kara, Huseyin; Nizamani, S M

    2015-02-01

    A study was conducted to evaluate the occurrence of ochratoxin A (OTA) in complete poultry feeds (n=80) and poultry feed ingredients (n=286) from Pakistan. All samples were first analyzed by indirect enzyme linked immunosorbent assay (ELISA), samples with OTA concentrations above the European Union maximum regulatory limit (MRL, 100 μg/kg) were further confirmed by HPLC-FLD. Contamination frequency and mean OTA levels were 31% and 51 μg/kg in feed ingredients, and the corresponding values for complete feeds were 38% and 75 μg/kg. Ten samples of complete poultry feed and 19 samples of feed ingredients contained OTA at levels higher than the MRL. The results of the present study indicate that there is a strong need for a more intense monitoring programs for OTA in poultry feed.

  9. Radiation technology and feed production

    International Nuclear Information System (INIS)

    Ershov, B.G.

    1986-01-01

    The use of radiation technology to prepare feeds and feed additions for cattle of non-feed vegetable blends is considered.Physicochemical foundations of radiation-chemical processes, possibilities of the use of various radiation devices are given. Data on practical realization of the technology are presented and prospects of its introduction to solve the tasks put forward by the USSR program on feed production are analyzed

  10. Emission of Methane From Enteric Fermentation: National Contribution and Factors Affecting it in Livestock

    Directory of Open Access Journals (Sweden)

    Budi Haryanto

    2009-12-01

    Full Text Available Changing in atmosphere condition is affected by the quantity of gases produced from all activities on the earth. Gases that have effects on global warming are CO2, N2O, H2O, and CH4 (methane. Among other sources of methane are enteric fermentation of organic material from ruminants and feces decomposition. Methane production from ruminants is affected by several factors such as breed/type of animal, feed quality, environmental temperature and physiological status of the animal. Energy as methane in ruminants may reach 2 to 15% of the total energy consumption. To reduce the emission of methane from ruminants, it is necessary to apply a strategic feeding system for more efficient utilization of feed.

  11. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer. A systematic review

    International Nuclear Information System (INIS)

    Wang Jinfeng; Liu Minjie; Ye Yun; Liu Chao; Huang Guanhong

    2014-01-01

    There are two main enteral feeding strategies—namely nasogastric (NG) tube feeding and percutaneous gastrostomy—used to improve the nutritional status of patients with head and neck cancer (HNC). But up till now there has been no consistent evidence about which method of enteral feeding is the optimal method for this patient group. To compare the effectiveness of percutaneous gastrostomy and NGT feeding in patients with HNC, relevant literature was identified through Medline, Embase, Pubmed, Cochrane, Wiley and manual searches. We included randomized controlled trials (RCTs) and non-experimental studies comparing percutaneous gastrostomy—including percutaneous endoscopic gastrostomy (PEG) and percutaneous fluoroscopic gastrostomy (PFG)—with NG for HNC patients. Data extraction recorded characteristics of intervention, type of study and factors that contributed to the methodological quality of the individual studies. Data were then compared with respect to nutritional status, duration of feeding, complications, radiotherapy delays, disease-free survival and overall survival. Methodological quality of RCTs and non-experimental studies were assessed with separate standard grading scales. It became apparent from our studies that both feeding strategies have advantages and disadvantages. (author)

  12. Rationale for the use of ionizing radiation in the elimination of enteropathogenic bacteria from feeds

    International Nuclear Information System (INIS)

    Mossel, D.A.A.

    1979-01-01

    Mixed feed ingredients and mixed feeds are often carriers of salmonellae and other enteropathogenic organisms. In turn they contaminate slaughter animals and subsequently enter the food chain. Hence there is a pressing need for the decontamination of feeds. Pelletization by heat or treatment with antimicrobial edible acids will lead to a considerable reduction of enteric pathogens, without, however, their adequate elimination. Irradiation with gamma rays is a most promising method to achieve the latter goal. Following the approach of modern Risk Analysis the dose required for the indicated purpose is calculated as being of the order of 0.30 Mrad. For the monitoring of the process the use of Enterobacteriaceae as indicator organisms is recommended. The microbiological-analytical measures required to account for sublethal lesions in survivors of the processes are indicated. (author)

  13. The Use of Plant Bioactive Compounds to Mitigate Enteric Methane in Ruminants and its Application in Indonesia

    Directory of Open Access Journals (Sweden)

    Elizabeth Wina

    2012-03-01

    Full Text Available Worldwide, increasing greenhouse gas (GHG emissions have become a major concern as they are now considered to be the cause of global warming. Several strategies have been planned and taken by different countries including Indonesia to mitigate this situation. Agriculture is considered to be one of major contributors to GHG, especially methane coming from ruminant digestive processes. More than 85% of the methane produced by ruminants comes from enteric fermentation. Several options have been proposed to lower this enteric methane production. This paper describes a review on diet manipulation using feed additives, especially plant bioactive compounds, to mitigate the GHG emission from ruminant livestock. Plant bioactive compounds have been found with various chemical structures. Some of them such as saponin, tannin, essential oils, organosulphur compounds, have been reported to have ability to reduce enteric methane production. Indonesia has many plant resources that have potential as methane reducing agents. Sapindus rarak fruit especially its methanol extract contain saponins which reduce the activity of methanogens in the rumen in vitro, hence reduce methane production (11%. Feeding S. rarak to sheep increased daily weight gain but not that of local cattle. Shrub legumes such as Calliandra calothyrsus and Leucaena leucocephala contain tannins which can reduce methanogenesis (3 – 21% methane reduction. Besides tannin, these shrub legumes are a good source of protein. Feeding shrub legumes can be beneficial as a protein source and a methane reducer. Other sources of methane reducing agents have been tested in other countries and some can be applied for Indonesian situation. The strategy to reduce methane by plant bioactive compounds should be developed to be simple and relatively cheap so it will benefit the local farmers. Extraction of these compounds may be expensive, therefore, costs should be considered carefully when proposing to use the

  14. The Feed Materials Program of the Manhattan Project: A Foundational Component of the Nuclear Weapons Complex

    Science.gov (United States)

    Reed, B. Cameron

    2014-12-01

    The feed materials program of the Manhattan Project was responsible for procuring uranium-bearing ores and materials and processing them into forms suitable for use as source materials for the Project's uranium-enrichment factories and plutonium-producing reactors. This aspect of the Manhattan Project has tended to be overlooked in comparison with the Project's more dramatic accomplishments, but was absolutely vital to the success of those endeavors: without appropriate raw materials and the means to process them, nuclear weapons and much of the subsequent cold war would never have come to pass. Drawing from information available in Manhattan Engineer District Documents, this paper examines the sources and processing of uranium-bearing materials used in making the first nuclear weapons and how the feed materials program became a central foundational component of the postwar nuclear weapons complex.

  15. Waste feed delivery test and evaluation plan

    Energy Technology Data Exchange (ETDEWEB)

    O' TOOLE, S.M.

    1999-09-30

    This plan documents the Waste Feed Delivery Program test and evaluation planning and implementation approach. The purpose of this document is to define and communicate the Waste Feed Delivery Program Test and Evaluation scope, objectives, planning and implementation approach.

  16. Waste feed delivery test and evaluation plan

    International Nuclear Information System (INIS)

    O'TOOLE, S.M.

    1999-01-01

    This plan documents the Waste Feed Delivery Program test and evaluation planning and implementation approach. The purpose of this document is to define and communicate the Waste Feed Delivery Program Test and Evaluation scope, objectives, planning and implementation approach

  17. 7 CFR 205.237 - Livestock feed.

    Science.gov (United States)

    2010-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Organic Production and Handling Requirements § 205.237 Livestock feed. (a... specific stage of life; (3) Feed plastic pellets for roughage; (4) Feed formulas containing urea or manure...

  18. The Performance and Incidence of Ascites in Broiler Chickens in Response to Feed Restriction and Meal Feeding Programs

    Directory of Open Access Journals (Sweden)

    Behrouz Dastar

    2014-04-01

    Full Text Available An experiment was conducted to evaluate the effect of feed restriction (FR and meal feeding (MF on performance, carcass characteristics and related parameters to ascites in Ross 308 male broiler chickens. Five dietary treatments were 1 the control (ad libo. feeding, 2 feed restriction from 7 to 14 days (FR14, 3 feed restriction from 7 to 21 days (FR21, 4 meal feeding from 7 to 14 days (MF14 and 5 meal feeding from 7 to 21days (MF21. All birds were fed adlibitum for the first week post hatch and after 21 days of age. Four replicate of 12 birds were allocated to each treatment. The results indicated FR and MF21 groups had significantly (p

  19. A prediction equation for enteric methane emission from dairy cows for use in NorFor

    DEFF Research Database (Denmark)

    Nielsen, N I; Volden, H; Åkerlind, M

    2013-01-01

    A data-set with 47 treatment means (N = 211) was compiled from research institutions in Denmark, Norway, and Sweden in order to develop a prediction equation for enteric methane (CH4) emissions from dairy cows. The aim was to implement the equation in the Nordic feed evaluation system NorFor. The...

  20. Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device.

    Science.gov (United States)

    Powers, Jan; Luebbehusen, Michael; Aguirre, Lillian; Cluff, Julia; David, Mary Ann; Holly, Vince; Linford, Lorraine; Park, Nancy; Brunelle, Rocco

    2018-04-01

    Early enteral nutrition has been shown to decrease complications and improve patient outcomes. Post pyloric feeding is recommended for patients with gastric intolerance or at high risk for aspiration. Feeding tube placement can be challenging and pose risk of pulmonary complications. Reliance on radiographic confirmation for feeding tube placement exposes the patient to radiation. Electromagnetic placement device (EMPD) may offer a method to minimize pulmonary complications, increase successful placement, and decrease radiation exposure to the patient. The purpose of this study was to evaluate the safety and efficacy of using EMPD verification, instead of routine abdominal radiographic confirmation, for small-bore feeding tube placement. Variables evaluated were adverse events, utilization of radiographs for confirmation, and success rate of feeding tube placement in the ordered location. Two time frames were reviewed. In a 1-year period, 3754 small-bore feeding tubes were placed using EMPD, with zero adverse events noted. Radiographic confirmation was utilized in 0%-29.2% of the EMPD placed tubes. Successful placement of feeding tubes using EMPD ranged from 94%-99.6%. During a 5-year period, 7081 EMPD feeding tubes were evaluated. One adverse event, pneumothorax, occurred during the placement of these 7081 tubes, for a rate of 0.014%. Feeding tube placement confirmation is safe and efficacious via EMPD providing an effective method of feeding tube placement with a success rate >94% into the desired location. EMPD is an accurate verification method of distal tip location, eliminating the need for routine abdominal radiographic confirmation. © 2018 American Society for Parenteral and Enteral Nutrition.

  1. Het effect van voersamenstelling op bacteriële darmaandoeningen bij varkens = The effect of feed composition on bacterial intestinal diseases in pigs

    NARCIS (Netherlands)

    Meulen, van der J.; Peet-Schwering, van der C.M.C.

    2007-01-01

    Feed composition, and especially carbohydrate composition, may affect the development of enteric bacterial diseases. Also the kind of feed ingredients (soybean or not) and feed treatment (milling size, pelletizing, fermentation) may be important. A more coarse grinding, no pelletizing and

  2. Introduction of enteral food increases plasma GLP-2 and decreases GLP-2 receptor mRNA abundance during pig development

    DEFF Research Database (Denmark)

    Petersen, Y. M.; Hartmann, B.; Holst, Jens Juul

    2003-01-01

    increased before birth, peaked in suckling 1-d-old pigs (87 +/- 14 pmol/L, P anorexia (34 +/- 5 pmol/L, P ... in these pigs. We conclude that the introduction of enteral feeding transiently increases plasma GLP-2 concentrations and decreases small intestinal GLP-2R mRNA levels during pig development. GLP-2 may play a role in the growth of the small intestine around birth and weaning via a response to enteral nutrition....

  3. Bacterial contamination of ready-to-use 1-L feeding bottles and administration sets in severely compromised intensive care patients

    NARCIS (Netherlands)

    Mathus-Vliegen, L. M.; Binnekade, J. M.; de Haan, R. J.

    2000-01-01

    OBJECTIVE: In intensive care patients, enteral feeding requires sterile feedings because of infectious complications and adequate supplements to meet nutritional needs. Heretofore, prepacked, large-volume formula containers were developed, but bacterial contamination occurred in 4% to 15%. Our

  4. The impact of feeding growing-finishing pigs with daily tailored diets using precision feeding techniques on animal performance, nutrient utilization, and body and carcass composition.

    Science.gov (United States)

    Andretta, I; Pomar, C; Rivest, J; Pomar, J; Lovatto, P A; Radünz Neto, J

    2014-09-01

    The impact of moving from conventional to precision feeding systems in growing-finishing pig operations on animal performance, nutrient utilization, and body and carcass composition was studied. Fifteen animals per treatment for a total of 60 pigs of 41.2 (SE = 0.5) kg of BW were used in a performance trial (84 d) with 4 treatments: a 3-phase (3P) feeding program obtained by blending fixed proportions of feeds A (high nutrient density) and B (low nutrient density); a 3-phase commercial (COM) feeding program; and 2 daily-phase feeding programs in which the blended proportions of feeds A and B were adjusted daily to meet the estimated nutritional requirements of the group (multiphase-group feeding, MPG) or of each pig individually (multiphase-individual feeding, MPI). Daily feed intake was recorded each day and pigs were weighed weekly during the trial. Body composition was assessed at the beginning of the trial and every 28 d by dual-energy X-ray densitometry. Nitrogen and phosphorus excretion was estimated as the difference between retention and intake. Organ, carcass, and primal cut measurements were taken after slaughter. The COM feeding program reduced (P carcass, and primal cut weights did not differ among treatments. Feeding growing-finishing pigs with daily tailored diets using precision feeding techniques is an effective approach to reduce nutrient excretion without compromising pig performance or carcass composition.

  5. [ENTERAL NUTRITION ON THE NUTRITIONAL STATUS OF CANCER].

    Science.gov (United States)

    Escortell Sánchez, Raquel; Reig García-Galbis, Manuel

    2015-10-01

    to identify what effect causes enteral nutrition on nutritional status of cancer. a search was performed using the keywords "Cancer" AND "Enteral Nutrition" AND "Supplementation" in four document databases: Pubmed, EBSCO, ProQuest, and Web of Science. age of the sample, major than 18 years; submitted to surgery for cancer; that the intervention program was including diet and employment or not of nutritional Supplementation; clinical trials published between January 2004 and December 2014, in scientific journals indexed. we analyzed 660 articles, of which only 2% has been included. 58% of intervention programs are applied outside Spain; 84% of the interventions was carried out in a hospitable ambient; 58% of the sample is formed by adults older than 54 years; 33% of the interventions were multidisciplinary and its duration ranges between 1 and 4 years. we found just a few national interventions in cancer participants and there two types of interventions: by exclusive polymeric enteral formula or mixed with immunonutrition. enteral nutrition shows against the parenteral and its introduction at an early stage, it helps to improve nutritional status of the patient; polymeric formulas next immunonutrition, it helps to reduce the time of hospitalization; the analytical parameters are shown as a measurement pattern when assessing the improvement in nutritional status in cancer. It is recommended to increase the research in this field, especially in children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. Cost-effectiveness of feeding strategies to reduce greenhouse gas emissions from dairy farming.

    Science.gov (United States)

    Van Middelaar, C E; Dijkstra, J; Berentsen, P B M; De Boer, I J M

    2014-01-01

    The objective of this paper was to evaluate the cost-effectiveness of 3 feeding strategies to reduce enteric CH4 production in dairy cows by calculating the effect on labor income at the farm level and on greenhouse gas (GHG) emissions at the chain level (i.e., from production of farm inputs to the farm gate). Strategies included were (1) dietary supplementation of an extruded linseed product (56% linseed; 1kg/cow per day in summer and 2kg/cow per day in winter), (2) dietary supplementation of a nitrate source (75% nitrate; 1% of dry matter intake), and (3) reducing the maturity stage of grass and grass silage (grazing at 1,400 instead of 1,700kg of dry matter/ha and harvesting at 3,000 instead of 3,500kg of dry matter/ha). A dairy farm linear programing model was used to define an average Dutch dairy farm on sandy soil without a predefined feeding strategy (reference situation). Subsequently, 1 of the 3 feeding strategies was implemented and the model was optimized again to determine the new economically optimal farm situation. Enteric CH4 production in the reference situation and after implementing the strategies was calculated based on a mechanistic model for enteric CH4 and empirical formulas explaining the effect of fat and nitrate supplementation on enteric CH4 production. Other GHG emissions along the chain were calculated using life cycle assessment. Total GHG emissions in the reference situation added up to 840kg of CO2 equivalents (CO2e) per t of fat- and protein-corrected milk (FPCM) and yearly labor income of €42,605. Supplementation of the extruded linseed product reduced emissions by 9kg of CO2e/t of FPCM and labor income by €16,041; supplementation of the dietary nitrate source reduced emissions by 32kg of CO2e/t of FPCM and labor income by €5,463; reducing the maturity stage of grass and grass silage reduced emissions by 11kg of CO2e/t of FPCM and labor income by €463. Of the 3 strategies, reducing grass maturity was the most cost

  7. Enteral nutrition therapy for critically ill adult patients; critical review and algorithm creation.

    Science.gov (United States)

    Araújo-Junqueira, L; De-Souza, Daurea A

    2012-01-01

    Undernutrition directly affects critically ill patient's clinical outcome and mortality rates. Interdisciplinar algorithm creation aiming to optimize the enteral nutrition therapy for critically ill adult patients. Pubmed, SciELO, Scholar Google, Web of Science, Scopus, with research of these key words: protocols, enteral nutrition, nutritional support, critical care, undernutrition, fasting. Intensive Care Unit, Hospital de Clínicas, Federal University of Uberlándia, MG, Brazil. Were established in the algorithm a following sequential steps: After a clinical-surgical diagnosis, including the assessment of hemodynamic stability, were requested passage of a feeding tube in post-pyloric position and a drainage tube in gastric position. After hemodynamic stability it should be done the nutritional status diagnosis, calculated nutritional requirements, as well as chosen formulation of enteral feeding. Unless contraindicated, aiming to increase tolerance was started infusion with small volumes (15 ml/h) of a semi-elemental diet, normocaloric, hypolipidic (also hyperproteic, with addition of glutamine). To ensure infusion of the diet, as well as the progressive increase of infusion rates, the patient was monitored for moderate or severe intestinal intolerance. The schedule and infusion rates were respected and diet was not routinely suspended for procedures and diagnostic tests, unless indicated by the medical team. For nutrition therapy success it is essential routine monitoring and extensive interaction between the professionals involved. Nutritional conducts should be reevaluated and improved, seeking complete and specialized care to the critically ill patients. Adherence to new practices is challenging, though instruments such as protocols and algorithms help making information more accessible and comprehensible.

  8. Enteral nutritional support management in a university teaching hospital: team vs nonteam.

    Science.gov (United States)

    Brown, R O; Carlson, S D; Cowan, G S; Powers, D A; Luther, R W

    1987-01-01

    Current hospital cost containment pressures have prompted a critical evaluation of whether nutritional support teams render more clinically effective and efficient patient care than nonteam management. To address this question with regard to enteral feeding, 102 consecutive hospitalized patients who required enteral nutritional support (ENS) by tube feeding during a 3 1/2-month period were prospectively studied. Fifty patients were managed by a nutritional support team; the other 52 were managed by their primary physicians. Choice of enteral formula, formula modifications, frequency of laboratory tests, and amounts of energy and protein received were recorded daily. In addition, each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. Team-managed (T) and nonteam-managed (NT) patients received ENS for 632 and 398 days, respectively. The average time period for ENS was significantly longer in the team-managed patients (12.6 +/- 12.1 days vs 7.7 +/- 6.2 days, p less than 0.01). Significantly more of the team patients attained 1.2 X basal energy expenditure (BEE) (37 vs 26, p less than 0.05). Total number of abnormalities in each group was similar (T = 398, NT = 390); however, the abnormalities per day were significantly lower in the team group (T = 0.63 vs NT = 0.98, p less than 0.01). Mechanical (T = 0.05 vs NT = 0.11, p less than 0.01), gastrointestinal (T = 0.99 vs NT = 0.14, p less than 0.05), and metabolic (T = 0.49 vs NT = 0.72, p less than 0.01) abnormalities per day all were significantly lower in the team-managed patients.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Effect Of Oligomeric Enteral Nutrition On Symptoms Of Acute Radiation Enteritis

    International Nuclear Information System (INIS)

    Dubinsky, P.

    2008-01-01

    Radiotherapy of abdominal and pelvic tumours is frequently associated with acute radiation enteritis. Predominant symptoms include diarrhea, watery stools, abdominal pain, nausea and vomiting. There are very few effective interventions available for this condition. Enteral oligomeric nutrition has been used in bowel diseases with functional failure similar to radiation enteritis. The aim of presented work was to observe occurrence of symptoms of radiation enteritis in patients undergoing abdominal or pelvic radiotherapy. Apart from diet and pharmacological therapy, oral oligomeric enteral nutrition (Peptisorb Powder Nutricia) at the dose of 1000 - 2000 ml per day was administered for minimum of 4 days. Planned period of administration was 14 days and longer. Symptoms of radiation enteritis were evaluated at the beginning and in the end of administration. Prevalence of all evaluated symptoms of radiation enteritis was decreased and difference was statistically significant for diarrhea, watery stools, abdominal pain, nausea and vomiting. The use of evaluated oligomeric nutritional support might, in conjunction with pharmacotherapy and diet, alleviate symptoms of acute radiation enteritis and maintain nutritional status of patients. (author)

  10. Ad libitum or demand/semi-demand feeding versus scheduled interval feeding for preterm infants.

    Science.gov (United States)

    McCormick, Felicia M; Tosh, Karen; McGuire, William

    2010-02-17

    Scheduled interval feeding of prescribed enteral volumes is current standard practice for preterm infants. However, feeding preterm infants in response to their hunger and satiation cues (ad libitum or demand/semi demand) rather than at scheduled intervals might help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge. To assess the effect of a policy of feeding preterm infants on an ad libitum or demand/semi-demand basis versus feeding prescribed volumes at scheduled intervals on growth rates and the time to hospital discharge. We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2009), MEDLINE (1966 to Oct 2009), EMBASE (1980 to Oct 2009), CINAHL (1982 to Oct 2009), conference proceedings, and previous reviews. Randomised or quasi-randomised controlled trials (including cluster randomised trials) that compared a policy of feeding preterm infants on an ad libitum or demand/semi-demand basis versus feeding at scheduled intervals. We used the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors. We found eight randomised controlled trials that compared ad libitum or demand/semi-demand regimens with scheduled interval regimes in preterm infants in the transition phase from intragastric tube to oral feeding. The trials were generally small and of variable methodological quality. The duration of the intervention and the duration of data collection and follow-up in most of the trials was not likely to have allowed detection of measurable effects on growth. Three trials reported that feeding preterm infants using an ad libitum or demand/semi-demand feeding regimen allowed earlier discharge from hospital (by about two to four days) but other trials did not confirm this

  11. Feeding Your Baby

    Medline Plus

    Full Text Available ... report Our work Community impact Global programs Research Need help? Frequently asked questions Contact us Tools & Resources ... Please enter a valid e-mail address. Your information: Your recipient's information: Your personal message: Thank you! ...

  12. Fetal and neonatal programming of postnatal growth and feed efficiency in swine.

    Science.gov (United States)

    Ji, Yun; Wu, Zhenlong; Dai, Zhaolai; Wang, Xiaolong; Li, Ju; Wang, Binggen; Wu, Guoyao

    2017-01-01

    Maternal undernutrition or overnutrition during pregnancy alters organ structure, impairs prenatal and neonatal growth and development, and reduces feed efficiency for lean tissue gains in pigs. These adverse effects may be carried over to the next generation or beyond. This phenomenon of the transgenerational impacts is known as fetal programming, which is mediated by stable and heritable alterations of gene expression through covalent modifications of DNA and histones without changes in DNA sequences (namely, epigenetics). The mechanisms responsible for the epigenetic regulation of protein expression and functions include chromatin remodeling; DNA methylation (occurring at the 5´-position of cytosine residues within CpG dinucleotides); and histone modifications (acetylation, methylation, phosphorylation, and ubiquitination). Like maternal malnutrition, undernutrition during the neonatal period also reduces growth performance and feed efficiency (weight gain:feed intake; also known as weight-gain efficiency) in postweaning pigs by 5-10%, thereby increasing the days necessary to reach the market body-weight. Supplementing functional amino acids (e.g., arginine and glutamine) and vitamins (e.g., folate) play a key role in activating the mammalian target of rapamycin signaling and regulating the provision of methyl donors for DNA and protein methylation. Therefore, these nutrients are beneficial for the dietary treatment of metabolic disorders in offspring with intrauterine growth restriction or neonatal malnutrition. The mechanism-based strategies hold great promise for the improvement of the efficiency of pork production and the sustainability of the global swine industry.

  13. Feeding broiler breeder males. 4. Deficient feed allocation reduces fertility and broiler progeny body weight.

    Science.gov (United States)

    Romero-Sanchez, H; Plumstead, P W; Leksrisompong, N; Brannan, K E; Brake, J

    2008-04-01

    Two experiments were conducted to evaluate the effects of male broiler breeder feed intake on broiler progeny performance. In experiment 1, a low cumulative nutrition program supplied 29,580 kcal of ME and 1,470 g of CP, whereas a high cumulative nutrition program supplied 33,500 kcal of ME and 1,730 g of CP to photostimulation at 21 wk of age. Two diets (HiDiet and LoDiet) were formulated, and a single feeding program was used to achieve the selected nutrient intakes. The HiDiet group of males in experiment 1 achieved greater BW and exhibited lower fertility when fed as the LoDiet males from the onset of egg production. The HiDiet breeder males subsequently produced male broilers from eggs laid at 29 wk of age that exhibited lower BW at 42 d. This was due to the heaviest 50% of the breeder males in this treatment not gaining BW consistently due to less-than-adequate ME intake relative to their greater BW requirements. Two feeding programs during the production period (constant or increasing) were compared in experiment 2. Broilers were hatched from eggs laid at 32 and 48 wk of age to evaluate the vertical effect of male treatments on progeny performance. No difference in fertility or broiler performance was found at 32 wk. However, the constant feeding program produced lower fertility from 36 to 55 wk of age, and this resulted in a lower male and female broiler progeny BW at 42 d of age from eggs collected at 48 wk of age. Adequate breeder male feed allocation during the production period improved fertility and favorably affected broiler progeny performance in both experiments. However, broiler progeny effects were observed only when there were differences in fertility, which suggests that the males with the greatest genetic potential were not mating at these times.

  14. Amino acid-based formula as a rescue strategy in feeding very-low-birth-weight infants with intrauterine growth restriction.

    Science.gov (United States)

    Raimondi, Francesco; Spera, Anna Maria; Sellitto, Maria; Landolfo, Francesca; Capasso, Letizia

    2012-05-01

    Very-low-birth-weight (VLBW) neonates may develop severe intolerance to standard preterm formula especially if they are associated with intrauterine growth restriction (IUGR). We tested the hypothesis that these infants may tolerate an elemental, amino acid-based formula as a rescue feeding strategy. In a prospective, case-control pilot study, we enrolled VLBW IUGR infants enterally fed with standard preterm formula (SPF) at daily increments of 16 mL/kg. If gastric residuals accounted for >70% of milk feed in the previous 24 hours, then feedings were temporarily withheld and then resumed with amino acid formula (AAF) increased at the same speed. Cases on AAF were compared to controls on SPF and with cases themselves while on SPF. Primary outcome was the time to reach full enteral feedings. Secondary outcomes were time on parenteral nutrition, time on central venous catheter, and formula tolerability based on the amount of gastric residual volume. Sixty-four infants (22 cases) were enrolled. Although during the total duration of nutrition, cases had worse primary and secondary outcomes, when on AAF, cases were comparable to controls in time to full enteral feeding (14.4 vs 14 days), time on parenteral nutrition, and time on central venous catheter. Cases on AAF and controls had similar gastric residual volumes. At day 3 after AAF introduction, cases had a significantly reduced number (%) of gastric residual volume >5 mL/kg over total number of feedings (5.6 vs 1.5%; P Growth at 12 months of corrected age was also comparable. In our population of VLBW IUGR newborns with severe feeding intolerance, a short course on AAF was a safe and effective means of nutritional rescue.

  15. Alternatives to antibiotics to prevent necrotic enteritis in broiler chickens: a microbiologist’s perspective.

    Directory of Open Access Journals (Sweden)

    Delphine Louise Caly

    2015-12-01

    Full Text Available Since the 2006 European ban on the use of antibiotics as growth promoters in animal feed, numerous studies have been published describing alternative strategies to prevent diseases in animals. A particular focus has been on prevention of necrotic enteritis in poultry caused by Clostridium perfringens by the use of microbes or microbe-derived products. Microbes produce a plethora of molecules with antimicrobial properties and they can also have beneficial effects through interactions with their host. Here we review recent developments in novel preventive treatments against C. perfringens-induced necrotic enteritis in broiler chickens that employ yeasts, bacteria and bacteriophages or secondary metabolites and other microbial products in disease control.

  16. Survival times with and without tube feeding in patients with dementia or psychiatric diseases in Japan.

    Science.gov (United States)

    Takayama, Keiko; Hirayama, Keisuke; Hirao, Akihiko; Kondo, Keiko; Hayashi, Hideki; Kadota, Koichi; Asaba, Hiroyuki; Ishizu, Hideki; Nakata, Kenji; Kurisu, Kairi; Oshima, Etsuko; Yokota, Osamu; Yamada, Norihito; Terada, Seishi

    2017-11-01

    It is widely supposed that there has been no evidence of increased survival in patients with advanced dementia receiving enteral tube feeding. However, more than a few studies have reported no harmful outcome from tube feeding in dementia patients compared to in patients without dementia. This was a retrospective study. Nine psychiatric hospitals in Okayama Prefecture participated in this survey. All inpatients fulfilling the entry criteria were evaluated. All subjects suffered from difficulty with oral intake. Attending physicians thought that the patients could not live without long-term artificial nutrition. The physicians decided whether to make use of long-term artificial nutrition between January 2012 and December 2014. We evaluated 185 patients. Their mean age was 76.6 ± 11.4 years. Of all subjects, patients with probable Alzheimer's disease (n = 78) formed the biggest group, schizophrenia patients (n = 44) the second, and those with vascular dementia (n = 30) the third. The median survival times were 711 days for patients with tube feeding and 61 days for patients without tube feeding. In a comparison different types of tube feeding, median survival times were 611 days for patients with a nasogastric tube and more than 1000 days for those with a percutaneous endoscopic gastrostomy tube. Patients with tube feeding survived longer than those without tube feeding, even among dementia patients. This study suggests that enteral nutrition for patients with dementia prolongs survival. Additionally, percutaneous endoscopic gastrostomy tube feeding may be safer than nasogastric tube feeding among patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

  17. Effect of dietary nitrate level on enteric methane production, hydrogen emission, rumen fermentation, and nutrient digestibility in dairy cows

    NARCIS (Netherlands)

    Olijhoek, D.W.; Hellwing, A.L.F.; Brask, M.; Weisbjerg, M.R.; Højberg, O.; Larsen, M.K.; Dijkstra, Jan; Erlandsen, E.J.; Lund, P.

    2016-01-01

    Nitrate may lower methane production in ruminants by competing with methanogenesis for available hydrogen in the rumen. This study evaluated the effect of 4 levels of dietary nitrate addition on enteric methane production, hydrogen emission, feed intake, rumen fermentation, nutrient

  18. Assessment of malnutrition and enteral feeding practices in the critically ill: A single-centre observational study

    Directory of Open Access Journals (Sweden)

    Prashant Paul Verghese

    2018-01-01

    Full Text Available Background and Aims: Early identification of malnutrition among hospitalised patients is essential to institute appropriate patient-specific nutritional strategies. This study was conducted to evaluate the nutritional status of medical patients at admission to the adult intensive care unit (ICU and to identify factors which prevent attainment of daily feeding goals in them. Methods: This was a 1 year prospective, observational study on 200 medical adult ICU patients. The study was carried out based on daily documentation. The primary outcome was the nutritional status of medical Patients at admission to the adult ICU. The tests for statistical analysis used were independent t test, Chi-square test, Fisher's exact test and multivariate logistic regression analysis. Results: Out of the 200 patients in our study, 45%, 48.5% and 9% of patients had mild, moderate and severe malnutrition, respectively, corresponding to subjective global assessment (SGA rating A,B and C, respectively. The most common reasons for non-attainment of daily feeding goals were delayed feed procurement (17.57%, and feeds being held for procedures (16.36%. The overall mean length of ICU stay was 8.63 ± 7.26 days, and the ICU mortality rate was 47.5% (95/200. Patients with SGA rating B and C at admission had higher risk of mortality in the ICU, with an adjusted odds ratio of 3.54 (95% confidence interval [CI]- 1.71–7.33, P = 0.001 and 11.11 (95% CI-2.26–54.66, P = 0.003, respectively. Conclusion: Malnutrition is commonly present at admission among medical ICU patients, and is associated with higher ICU mortality.

  19. FEEDING GUIDELINES FOR INFANTS AND TODDLERS (START HEALTHY PROGRAM

    Directory of Open Access Journals (Sweden)

    Nancy Butte

    2007-01-01

    Full Text Available The dietary guidelines for americans contains recommendations on diets and healthy lifestyles but it does not deal with specificities of the diet and feeding breast and small infants (to 2 years. However, parents and carecgivers need practical recommendations on feeding infants and toddlers that are necessary to ensure a normal growth and to create the basis for forming healthy food habits, which apart from other benefits might help prevent the development of obesity and other diseases in both childhood and adulthood. The feeding guidelines for infants and toddlers is aimed at providing parents and carecgivers with practical information on feeding breast and small infants. It is intendced for adding and broadening recommendations worked out by other expert groups and organizations. The article provides a substantiation of the guidelines. The methodology, results and a complete reference list used to work out the recommendations are presented in another document.Key words: infants, nutrition.

  20. Feed- and feed additives-related aspects of gut health and development in weanling pigs.

    Science.gov (United States)

    Pluske, John R

    2013-01-07

    The development of new/different management and feeding strategies to stimulate gut development and health in newly-weaned pigs, in order to improve growth performance while minimizing the use of antimicrobial compounds such as antibiotic growth promotants (AGP) and heavy mineral compounds, is essential for the long-term sustainability of the pig industry. Factors including the sub-optimal intake of nutrients and energy, inappropriate microbiota biomass and (or) balance, immature and compromised immune function, and psychosomatic factors caused by weaning can compromise both the efficiency of digestion and absorption and intestinal barrier function through mucosal damage and alteration of tight junction integrity. As a consequence, pigs at weaning are highly susceptible to pathogenic enteric conditions such as post-weaning diarrhea that may be caused by serotypes of enterotoxigenic Escherichia coli. Many dietary components, e.g., protein, fiber, feed additives and minerals, are known to influence microbial growth in the gastrointestinal tract that in turn can impact upon pig growth and health, although the relationships between these are sometimes not necessarily apparent or obvious. In a world climate of increased scrutiny over the use of antibiotics per se in pig production, certain feed additives are seen as alternatives/replacements to antibiotics, and have evolved in some cases to have important roles in everyday commercial pig nutrition. Nevertheless and in general, there remains inconsistency and variability in the efficacy of some feed additives and in cases of severe disease outbreaks, for example, therapeutic antibiotics and/or heavy minerals such as zinc oxide (ZnO) are generally relied upon. If feed ingredients and (or) feed additives are to be used with greater regularity and reliability, then it is necessary to better understand the mechanisms whereby antibiotics and minerals such as ZnO influence animal physiology, in conjunction with the use of

  1. Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses.

    Science.gov (United States)

    Lim, Mei Ling; Yong, Bei Yi Paulynn; Mar, Mei Qi Maggie; Ang, Shin Yuh; Chan, Mei Mei; Lam, Madeleine; Chong, Ngian Choo Janet; Lopez, Violeta

    2018-07-01

    To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. A mixed-method approach was adopted. (i) A face-to-face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. Ninety-nine carers (n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years (SD = 11.2), and they had been on enteral feeding for a mean of 29 months (SD = 23.0). Most were bed-bound (90%) and required full assistance with their feeding (99%). Most were not on follow-up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses (n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition. © 2018 John Wiley & Sons Ltd.

  2. Functional Organization of Neuronal and Humoral Signals Regulating Feeding Behavior

    Science.gov (United States)

    Schwartz, Gary J.; Zeltser, Lori M.

    2014-01-01

    Energy homeostasis- ensuring that energy availability matches energy requirements- is essential for survival. One way that energy balance is achieved is through coordinated action of neural and neuroendocrine feeding circuits, which promote energy intake when energy supply is limited. Feeding behavior engages multiple somatic and visceral tissues distributed throughout the body – contraction of skeletal and smooth muscles in the head and along the upper digestive tract required to consume and digest food, as well as stimulation of endocrine and exocrine secretions from a wide range of organs. Accordingly, neurons that contribute to feeding behaviors are localized to central, peripheral and enteric nervous systems. To promote energy balance, feeding circuits must be able to identify and respond to energy requirements, as well as the amount of energy available from internal and external sources, and then direct appropriate coordinated responses throughout the body. PMID:23642202

  3. Communication Skill Attributes Needed for Vocational Education enter The Workplace

    Science.gov (United States)

    Wahyuni, L. M.; Masih, I. K.; Rejeki, I. N. Mei

    2018-01-01

    Communication skills are generic skills which need to be developed for success in the vocational education entering the workforce. This study aimed to discover the attributes of communication skill considered important in entering the workforce as perceived by vocational education students. The research was conducted by survey method using questionnaire as data collecting tool. The research population is final year student of D3 Vocational education Program and D4 Managerial Vocational education in academic year 2016/2017 who have completed field work practice in industry. The sampling technique was proportional random sampling. Data were analyzed with descriptive statistics and independent sampel t-test. Have ten communication skills attributes with the highest important level required to enter the workplace as perceived by the vocational education diploma. These results indicate that there was the same need related communication skills to enter the workforce

  4. Impact of new WHO growth standards on the prevalence of acute malnutrition and operations of feeding programs - Darfur, Sudan, 2005-2007.

    Science.gov (United States)

    2009-06-05

    Acute malnutrition among children aged 6-59 months is a key indicator routinely used for describing the presence and magnitude of humanitarian emergencies. In the past, the prevalence of acute malnutrition and admissions to feeding programs has been determined using the growth reference developed by the World Health Organization (WHO), CDC, and the National Center for Health Statistics (NCHS). In 2006, WHO released new international growth standards and recommended their use in all nutrition programs. To evaluate the impact of transitioning to the new standards, CDC analyzed anthropometric data for children aged 6-59 months from Darfur, Sudan, collected during 2005-2007. This report describes the results of that analysis, which indicated that use of the new standards would have increased the prevalence of global acute malnutrition on average by 14% and would have increased the prevalence of severe acute malnutrition on average by 100%. Admissions to feeding programs would have increased by 56% for moderately malnourished children and by 260% for severely malnourished children. For programs in Darfur, this would have resulted in approximately 23,200 more children eligible for therapeutic feeding programs. For the immediate future, the prevalence of acute malnutrition in children should be reported using both the old WHO/CDC/NCHS reference and the new WHO standards. More research is needed to better ascertain the validity of the admission criteria based on the new WHO standards in predicting malnutrition-related morbidity and mortality.

  5. Enteral feeding of intrauterine growth restriction preterm infants: theoretical risks and practical implications

    Directory of Open Access Journals (Sweden)

    Valentina Bozzetti

    2017-06-01

    Full Text Available Intrauterine growth restriction (IUGR infants are thought to have impaired gut function after birth secondary to intrauterine redistribution of the blood flow, due to placental insufficiency, with a consequent reduction of gut perfusion. For this reason, infants complicated by IUGR have been considered at higher risk of feeding intolerance. Postnatal evaluation of splanchnic perfusion, through Doppler of the superior mesenteric artery, and of splanchnic oxygenation, through near infrared spectroscopy measurements, may be useful in evaluating the persistence (or not of the redistribution of blood flow occurred in utero.

  6. Análise das práticas de alimentação de prematuros em maternidade pública no Rio de Janeiro Analysis of preterm infant feeding practices in a public maternity hospital of Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Cristina Ortiz Valete

    2009-10-01

    Full Text Available OBJETIVO: Analisar as práticas precoces de alimentação e o tipo de dieta de prematuros na alta hospitalar. MÉTODOS: Estudo descritivo, a partir de uma coorte retrospectiva de dois anos, com 203 prematuros com peso menor que 1 500g, na maternidade do Hospital Geral de Bonsucesso, Rio de Janeiro. Foram avaliadas as seguintes práticas: dias para início de dieta enteral, dias para atingir a dieta enteral plena, dias para início e tempo de uso de nutrição parenteral e o tipo de dieta na alta hospitalar. RESULTADOS: O tempo médio para início de dieta enteral foi de 6,5 dias (IC95% 6,0-7,2, enquanto para atingir a dieta enteral plena levou-se, em média, 18,9 dias (IC95% 17,6-20,3. A média de dias para início de nutrição parenteral foi de 2,8 dias (IC95% 2,6-3,0 e o tempo de uso de nutrição parenteral foi de 10,8 dias (IC95% 9,7-11,9. As práticas se associaram, sendo encontrada a maior correlação entre dias para atingir dieta plena e dias de uso de nutrição parenteral (Pearson=0,69. Quanto menor o peso de nascimento, maior o tempo para início de dieta enteral, para atingir a dieta enteral plena e de uso de nutrição parenteral. Para o início de nutrição parenteral, não foi observada esta tendência. Na alta, o tipo de dieta mais freqüente foi o aleitamento complementado (61,6%, seguido da alimentação artificial (26,1% e do aleitamento materno exclusivo (12,3%. CONCLUSÃO: Este estudo revelou que há demora em iniciar a alimentação de prematuros. A proporção total de aleitamento na alta foi de 74%. Esforços merecem ser envidados para alimentar precocemente e promover o aleitamento materno nestes pacientes.OBJECTIVE: This study analyzed the early feeding practices and the type of diet at discharge of preterm infants. METHODS: This descriptive, retrospective two-year cohort study included 203 preterm infants (weight< 1 500g from the Bonsucesso General Hospital, Rio de Janeiro. The following practices were analyzed: days

  7. [Feeding practices with human milk in newborns less than 1.500 g or less than 32 weeks].

    Science.gov (United States)

    Alonso-Díaz, Clara; Utrera-Torres, Isabel; de Alba-Romero, Concepción; Flores-Antón, Beatriz; López-Maestro, María; Lora-Pablos, David; Pallás-Alonso, Carmen R

    2016-07-01

    There is currently no unified policy on either breastfeeding support or enteral nutrition practices, as regards human milk (HM) in pre-term newborns. The aim of this study was to describe breastfeeding support measures, as well as the use of HM in very preterm infants in Spanish public hospitals. A questionnaire on enteral feeding practices was distributed. Data were analysed from units caring for newborns less than 32 weeks or 1,500g. A univariate analysis was performed comparing level ii and iii care units. There was a 91% response rate. A total of 93 units cared for infants less than 32 weeks or 1,500g (17 level ii and 76 level iii), and 49% of the units recorded the breastfeeding rate on discharge. Around 75% (70/93) had a guideline on managing HM (level iii 81 vs. level ii 47%, P=.002), and 25% had access to donor human milk. Just under half (46%) started trophic feeding in the first 6h. Target enteral feeding volume in stable preterm infants was ≥ 180ml/kg/day in 89% of the units (level iii 93% vs. level ii 70%, P =.017). HM fortifier was used in 96% of the units. In 92%, it was added when the required enteral volume was tolerated. In 59% of the units, adjustments in the quantity of fortifier were made according to weight, and in 36%, it depended on analytical criteria. Some units (9%) used pure protein fortifier. There is a marked variability in breastfeeding support measures and in feeding practices of preterm infants in Spanish neonatal units. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  8. Malnutrition in the critically ill child: the importance of enteral nutrition.

    Science.gov (United States)

    Prieto, Marta Botrán; Cid, Jesús López-Herce

    2011-11-01

    Malnutrition affects 50% of hospitalized children and 25-70% of the critically ill children. It increases the incidence of complications and mortality. Malnutrition is associated with an altered metabolism of certain substrates, increased metabolism and catabolism depending on the severity of the lesion, and reduced nutrient delivery. The objective should be to administer individualized nutrition to the critically ill child and to be able to adjust the nutrition continuously according to the metabolic changes and evolving nutritional status. It would appear reasonable to start enteral nutrition within the first 24 to 48 hours after admission, when oral feeding is not possible. Parenteral nutrition should only be used when enteral nutrition is contraindicated or is not tolerated. Energy delivery must be individually adjusted to energy expenditure (40-65 kcal/100 calories metabolized/day) with a protein delivery of 2.5-3 g/kg/day. Frequent monitoring of nutritional and metabolic parameters should be performed.

  9. Recent developments in Sandia Laboratories' sewage sludge irradiation program

    International Nuclear Information System (INIS)

    Sivinski, H.D.; Brandon, J.R.; Morris, M.E.; Neuhauser, K.S.; Ward, R.L.; McCaslin, B.; Smith, G.S.

    1977-01-01

    Pathogen reduction studies show that gamma irradiation is effective in inactivating pathogenic bacteria, parasite ova, and viruses in liquid sludges. Ammonia is shown to be virucidal to poliovirus and several other enteric viruses. Sludge processing costs are relatively economical for composted or dried sludges, but only marginally competitive with costs of heat treatment for liquid sludges. Physical and chemical studies show that effects of irradiation of sludges on dewatering properties are insignificant when compared to the effects of polymer addition. Dried, irradiated undigested sludge has significant nutritional value as a feed supplement for sheep and cattle and in agronomic uses such as greenhouses and field plots. No significant harmful effects have been demonstrated in the feeding program. Product enhancement studies are under way, including schemes for removing nitrogen from wastewaters and adding it to sludges in the form of ammonium salts

  10. Clinical application of transnasal feeding tube placement under fluoroscopic guidance

    International Nuclear Information System (INIS)

    Ge Kunyuan; Ni Caifang; Liu Yizhi; Zhu Xiaoli; Zou Jianwei; Jin Yonghai; Chen Long; Sun Ge; Sun Lingfang; Zhang Dong

    2008-01-01

    Objective: To evaluate the feasibility and effectiveness of duodenal feeding tube placement under fluoroscopic guidance and its clinical application. Methods: The transnasal duodenal nutriment tubes placement under fluoroscopic guidance were performed in 59 patients from June 3th, 2003 to August 17th, 2007. The successful placement of the feeding tube was defined as that of the tube tip was fixed at or distal to the duodenojejunal junction. Results: 57 out of 59 patients were successfully managed by feeding tube placement, with primary successful rate of 96.6% (57/59). The remaining two failures were due to overdistention of the stomach and were further managed after gastrointestinal decompression thoroughly. The mean fluoroscopy time of the procedure was 17.8 minutes with no severe immediate or delayed complications. Conclusion: The transnasal duodenal nutrient feeding tube placement under fluoroscopic guidance is a safe,economic, and effective management for enteral nutrition, providing extensive clinical utilization. (authors)

  11. Pulsatile delivery of a leucine supplement during long-term continuous enteral feeding enhances lean growth in term neonatal pigs

    Science.gov (United States)

    Neonatal pigs are used as a model to study and optimize the clinical treatment of infants who are unable to maintain oral feeding. Using this model, we have previously shown that pulsatile administration of leucine during continuous feeding over 24 h via orogastric tube enhanced protein synthesis in...

  12. A Review Of Nutritional Guidelines And Menu Compositions For School Feeding Programs In 12 Countries.

    Directory of Open Access Journals (Sweden)

    Ruzky eAliyar

    2015-08-01

    Full Text Available Study objectives: To analyze the nutritional guidelines and menu compositions of school meal provision in various different countries.Background: School feeding is the provision of food on-site or to take home, which aims to increase school enrolment, attendance and retention, and exist as a social safety net for households with very low income. Home-grown school feeding (HGSF, additionally, aims to stimulate local economies by providing a source of income for local smallholder farmers. Methods: Literature searches using the Ovid MEDLINE databases, gathered information from in-country stakeholders, and accessed the programme websites of various countries. Nutrient composition of these menus was calculated from nutritional guidelines and menu compositions using a nutrition linear programming tool (NUTVAL.Country comparisons: School feeding aims differ between countries of each income group. The implementation, delivery of service and nutritional content of foods also differ considerably between countries and income groups. In high-income countries, guidelines and standards have been recommended in an attempt to combat rising levels of overweight and obesity, and to model healthier lifestyle habits. In low-income countries there is a gap in terms of guidance on nutrition standards and menu composition.Conclusions: Provision of evidence-based guidance on nutrition standards to middle and low income countries who have recently established or are planning to establish school feeding has the potential to greatly enhance and improve the quality of service and improve the life of millions of children worldwide.

  13. Online Database Allows for Quick and Easy Monitoring and Reporting of Supplementary Feeding Program Performance: An Analysis of World Vision CMAM Programs (2006-2013)

    International Nuclear Information System (INIS)

    Emary, Colleen; Aidam, Bridget; Roberton, Tim

    2014-01-01

    Full text: Background: Despite the widespread implementation of interventions to address moderate acute malnutrition (MAM), lack of robust monitoring systems have hindered evaluation of the effectiveness of approaches to prevent and treat MAM. Since 2006, World Vision (WV) has provided supplementary feeding to 280,518 children 6-59 months of age (U5) and 105,949 pregnant and lactating women (PLW) as part of Community Based Management of Acute Malnutrition (CMAM) programming. The Excel-based system initially used for monitoring individual site programs faced numerous challenges. It was time consuming, prone to human error, lost data as a result of staff turnover and hence use of data to inform program performance was limited. In 2010, World Vision International (WVI)’s Nutrition Centre of Expertise (NCOE) established an online database to overcome these limitations. The aim of the database was to improve monitoring and reporting of WV’s CMAM programs. As of December 2013, the database has been rolled out in 14 countries Burundi, Chad, DRC, Ethiopia, Kenya, Mali, Mauritania, Niger, Sudan, Pakistan, South Sudan, Somalia, Zimbabwe and Zambia. Methods: The database includes data on admissions (mid-upper arm circumference, weight for height, oedema, referral) and discharge outcomes (recovered, died, defaulted, non-recovered, referral) for Supplementary Feeding Programs (SFPs) for children U5 as well as PLWs. A quantitative analysis of the data sets available was conducted to identify issues with data quality and draw findings from the data itself. Variations in program performance as compared to Sphere standards were determined by country and aggregated over the 14 countries. In addition, time trend analyses were conducted to determine significant different and seasonality effects. Results: Most data was related to program admissions from 2010 to July 2013, though some retrospective program data was available from 2006 to 2009. The countries with the largest number

  14. Evaluation and optimization of feed-in tariffs

    International Nuclear Information System (INIS)

    Kim, Kyoung-Kuk; Lee, Chi-Guhn

    2012-01-01

    Feed-in tariff program is an incentive plan that provides investors with a set payment for electricity generated from renewable energy sources that is fed into the power grid. As of today, FIT is being used by over 75 jurisdictions around the world and offers a number of design options to achieve policy goals. The objective of this paper is to propose a quantitative model, by which a specific FIT program can be evaluated and hence optimized. We focus on payoff structure, which has a direct impact on the net present value of the investment, and other parameters relevant to investor reaction and electricity prices. We combine cost modeling, option valuation, and consumer choice so as to simulate the performance of a FIT program of interest in various scenarios. The model is used to define an optimization problem from a policy maker's perspective, who wants to increase the contribution of renewable energy to the overall energy supply, while keeping the total burden on ratepayers under control. Numerical studies shed light on the interactions among design options, program parameters, and the performance of a FIT program. - Highlights: ► A quantitative model to evaluate and optimize feed-in tariff policies. ► Net present value of investment on renewable energy under a given feed-in tariff policy. ► Analysis of the interactions of policy options and relevant parameters. ► Recommendations for how to set policy options for feed-in tariff program.

  15. Permissive or Trophic Enteral Nutrition and Full Enteral Nutrition Had Similar Effects on Clinical Outcomes in Intensive Care: A Systematic Review of Randomized Clinical Trials.

    Science.gov (United States)

    Silva, Camila F A; de Vasconcelos, Simone G; da Silva, Thales A; Silva, Flávia M

    2018-01-26

    The aim of this study was to systematically review the effect of permissive underfeeding/trophic feeding on the clinical outcomes of critically ill patients. A systematic review of randomized clinical trials to evaluate the mortality, length of stay, and mechanical ventilation duration in patients randomized to either hypocaloric or full-energy enteral nutrition was performed. Data sources included PubMed and Scopus and the reference lists of the articles retrieved. Two independent reviewers participated in all phases of this systematic review as proposed by the Cochrane Handbook, and the review was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 7 randomized clinical trials that included a total of 1,717 patients were reviewed. Intensive care unit length of stay and mechanical ventilation duration were not statistically different between the intervention and control groups in all randomized clinical trials, and mortality rate was also not different between the groups. In conclusion, hypocaloric enteral nutrition had no significantly different effects on morbidity and mortality in critically ill patients when compared with full-energy nutrition. It is still necessary to determine the safety of this intervention in this group of patients, the optimal amount of energy provided, and the duration of this therapy. © 2018 American Society for Parenteral and Enteral Nutrition.

  16. Feeding Your Baby

    Medline Plus

    Full Text Available ... Our work Community impact Global programs Research Need help? Frequently asked questions Contact us Tools & Resources Born ... your dashboard . Time to eat! Feeding your baby helps her grow healthy and strong. It’s also a ...

  17. Enteric Duplication.

    Science.gov (United States)

    Jeziorczak, Paul M; Warner, Brad W

    2018-03-01

    Enteric duplications have been described throughout the entire gastrointestinal tract. The usual perinatal presentation is an abdominal mass. Duplications associated with the foregut have associated respiratory symptoms, whereas duplications in the midgut and hindgut can present with obstructive symptoms, perforation, nausea, emesis, hemorrhage, or be asymptomatic, and identified as an incidental finding. These are differentiated from other cystic lesions by the presence of a normal gastrointestinal mucosal epithelium. Enteric duplications are located on the mesenteric side of the native structures and are often singular with tubular or cystic characteristics. Management of enteric duplications often requires operative intervention with preservation of the native blood supply and intestine. These procedures are usually very well tolerated with low morbidity.

  18. Tourist Affiliate Program while Using Online Booking System with Possibility of Entering B2B Code

    Directory of Open Access Journals (Sweden)

    Slivar Iva

    2008-01-01

    Full Text Available Affiliate marketing programs are one of the most powerful tools for online marketing since the merchant presenting a product or a service decides on the commissioning model and the commission is granted only if the desired results have been reached. Affiliate marketing is based offline as much as tourism itself and it relies on the commission that tourist companies pay to their partners (affiliates who bring new guests. This paper will present the basics of how online affiliate programs work, benefits they bring and steps for their further implementation. It will explain in detail how to establish an affiliate program for dynamic web pages which use online booking system platforms that offer a possibility of entering a B2B code. Special attention will be paid to SEO (Search Engine Optimisation. It will also present results of a research on Croatian hotels web pages and the implementation of the online booking system and affiliate programs. Having in mind the insufficient deployment of online potentials, the aim of the paper is to stress the need for setting up an effective method of monitoring changes and updates in the online world as well as implementing new promotional possibilities, all aimed at increasing sales. The goal of the paper is to explore advantages and disadvantages of the affiliate program as a new sales channel and promote the possibility to implement it in one of the biggest Croatian hotel companies, Maistra d.d. Rovinj. Along with methods of data acquiring and different techniques of creative thinking, the following scientific research methods were also used: statistic, historic, descriptive, comparison, interview, analysis and synthesis, induction and deduction.

  19. Beneficial Uses Program progress report, period ending December 31, 1976. [Gamma inactivation of microorganisms in sewage sludge

    Energy Technology Data Exchange (ETDEWEB)

    1977-03-01

    Progress is reported on a comprehensive program to develop the necessary technologies for cost/beneficial uses of existing and future surplus radioactive materials. The major portion of the work was concentrated on the testing of the effectiveness of ..gamma.. sources for the processing of sewage sludge to inactivate enteric viruses and bacteria and the subsequent testing of the biological effects of the treated sludge when used as fertilizer or additives to animal feeds.

  20. Comparative analyses of contaminant levels in bottom feeding and predatory fish using the National Contaminant Biomonitoring Program data

    Energy Technology Data Exchange (ETDEWEB)

    Kidwell, J.M. [Clement International Corp., Fairfax, VA (United States); Phillips, L.J. [Versar Inc., Springfield, VA (United States); Birchard, G.F. [George Mason Univ., Fairfax, VA (United States)

    1995-06-01

    Both bottom feeding and predatory fish accumulate chemical contaminants found in water. Bottom feeders are readily exposed to the greater quantities of chlorinated hydrocarbons and metals that accumulate in sediments. Predators, on the other hand, may bioaccumulate organochlorine pesticides, PCBs, and metals from the surrounding water or from feeding on other fish, including bottom feeders, which may result in the biomagnification of these compounds in their tissues. This study used National Contaminant Biomonitoring Program data produced by the Fish and Wildlife Service to test the hypothesis that differences exist between bottom feeders and predators in tissue levels of organochlorine pesticides, PCBs, and metals. 7 refs., 2 tabs.

  1. Nutritional and microbiological quality of commercial and homemade blenderized whole food enteral diets for home-based enteral nutritional therapy in adults.

    Science.gov (United States)

    Vieira, Maricy Machado Cavalca; Santos, Valdirene Francisca Neves; Bottoni, Andrea; Morais, Tania Beninga

    2018-02-01

    Serious nutritional and contamination risks may be involved in the preparation of blenderized tube-feeding diets and in the handling of commercial diets. Their nutritional and microbiological quality in home settings is unknown. The objective of this study was to assess the nutritional and microbiological quality of commercial enteral and homemade blenderized whole foods diets intended to adult patients in home nutritional therapy. In a cross sectional study, 66 samples of commercial (CD) and noncommercial (NCD) enteral diets were collected at the homes of patients in home enteral nutritional therapy, 33 of each type. Commercial diets were either powder (PCD; n = 13) or liquid (LCD; n = 20). The samples were analyzed in laboratory to assess their nutritional and microbiological quality. Anthropometric data of mid upper arm circumference (MUAC) and triceps skinfold (TST) thickness were obtained from the patients' medical records. NCD presented significantly lower values for protein, fat, fiber, carbohydrate and energy while water content was significantly higher. PCD and LCD did not show any statistically significant differences between them. In the NCD, the values measured for macronutrients and energy corresponded to less than 50% of the prescribed values (except for fat). In CD, protein value was about 20% more than the prescribed value; fat and energy values corresponded to approximately 100% of the prescription, while carbohydrate corresponded to 92%. Regardless the type of the diet, prevalence of undernutrition was high in both groups though patients of the NCD presented a higher percentage. Samples of NCD complied significantly less with the microbiological standards; only 6.0% complied with the standard for coliform bacteria. Escherichia coli was detected in 10, 2, and 2 samples of NCD, PCD and LCD, respectively. Homemade blenderized enteral diets showed low values of energy and macronutrients, delivered less than 50% of the prescribed values and had

  2. Plutonium-bearing materials feed report for the DOE Fissile Materials Disposition Program alternatives

    International Nuclear Information System (INIS)

    Brough, W.G.; Boerigter, S.T.

    1995-01-01

    This report has identified all plutonium currently excess to DOE Defense Programs under current planning assumptions. A number of material categories win clearly fan within the scope of the MD (Materials Disposition) program, but the fate of the other categories are unknown at the present time. MD planning requires that estimates be made of those materials likely to be considered for disposition actions so that bounding cases for the PEIS (Programmatic Environmental Impact Statement) can be determined and so that processing which may be required can be identified in considering the various alternatives. A systematic analysis of the various alternatives in reachmg the preferred alternative requires an understanding of the possible range of values which may be taken by the various categories of feed materials. One table identifies the current total inventories excess to Defense Program planning needs and represents the bounding total of Pu which may become part of the MD disposition effort for all materials, except site return weapons. The other categories, principally irradiated fuel, rich scrap, and lean scrap, are discussed. Another table summarizes the ranges and expected quantities of Pu which could become the responsibility of the MD program. These values are to be used for assessing the impact of the various alternatives and for scaling operations to assess PEIS impact. Determination of the actual materials to be included in the disposition program will be done later

  3. Role of central nervous system glucagon-like Peptide-1 receptors in enteric glucose sensing.

    Science.gov (United States)

    Knauf, Claude; Cani, Patrice D; Kim, Dong-Hoon; Iglesias, Miguel A; Chabo, Chantal; Waget, Aurélie; Colom, André; Rastrelli, Sophie; Delzenne, Nathalie M; Drucker, Daniel J; Seeley, Randy J; Burcelin, Remy

    2008-10-01

    Ingested glucose is detected by specialized sensors in the enteric/hepatoportal vein, which send neural signals to the brain, which in turn regulates key peripheral tissues. Hence, impairment in the control of enteric-neural glucose sensing could contribute to disordered glucose homeostasis. The aim of this study was to determine the cells in the brain targeted by the activation of the enteric glucose-sensing system. We selectively activated the axis in mice using a low-rate intragastric glucose infusion in wild-type and glucagon-like peptide-1 (GLP-1) receptor knockout mice, neuropeptide Y-and proopiomelanocortin-green fluorescent protein-expressing mice, and high-fat diet diabetic mice. We quantified the whole-body glucose utilization rate and the pattern of c-Fos positive in the brain. Enteric glucose increased muscle glycogen synthesis by 30% and regulates c-Fos expression in the brainstem and the hypothalamus. Moreover, the synthesis of muscle glycogen was diminished after central infusion of the GLP-1 receptor (GLP-1Rc) antagonist Exendin 9-39 and abolished in GLP-1Rc knockout mice. Gut-glucose-sensitive c-Fos-positive cells of the arcuate nucleus colocalized with neuropeptide Y-positive neurons but not with proopiomelanocortin-positive neurons. Furthermore, high-fat feeding prevented the enteric activation of c-Fos expression. We conclude that the gut-glucose sensor modulates peripheral glucose metabolism through a nutrient-sensitive mechanism, which requires brain GLP-1Rc signaling and is impaired during diabetes.

  4. Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives.

    Science.gov (United States)

    Rutkauskas, John; Seale, N Sue; Casamassimo, Paul; Rutkauskas, John S

    2015-11-01

    For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area.

  5. Jejunal feeding is followed by a greater rise in plasma cholecystokinin, peptide YY, glucagon-like peptide 1, and glucagon-like peptide 2 concentrations compared with gastric feeding in vivo in humans

    DEFF Research Database (Denmark)

    Luttikhold, Joanna; van Norren, Klaske; Rijna, Herman

    2016-01-01

    and the associated endocrine response in vivo in humans remains largely unexplored. OBJECTIVE: We compared the impact of administering enteral nutrition as either gastric feeding or jejunal feeding on endocrine responses in vivo in humans. DESIGN: In a randomized, crossover study design, 12 healthy young men (mean...... and a greater postprandial incremental AUC for GLP-1 and cholecystokinin (all P young men results in similar postprandial plasma amino acid and glucose concentrations....... However, the endocrine response differs substantially, with higher peak plasma cholecystokinin, PYY, GLP-1, and GLP-2 concentrations being attained after jejunal feeding. This effect may result in an improved anabolic response, greater insulin sensitivity, and an improved intestinotropic effect...

  6. Patient needs and research priorities in the enteral nutrition market - a quantitative prioritization analysis.

    Science.gov (United States)

    Weenen, T C; Jentink, A; Pronker, E S; Commandeur, H R; Claassen, E; Boirie, Y; Singer, P

    2014-10-01

    A quantitative systematic identification and prioritization of unmet needs and research opportunities in relation to enteral nutrition was conducted by means of a tailor-made health research prioritization process. The research objectives were reached by conducting qualitative interviews followed by quantitative questionnaires targeting enteral nutrition key opinion leaders (KOLs). (1) Define disease areas that deserve more research attention; (2) Rank importance of product characteristics of tube feeding (TF) and oral nutritional supplements (ONS); (3) Assess involvement of KOLs in enteral nutrition R&D process. KOLs ranked three product characteristics and three disease areas that deserve additional research attention. From these, overall priority scores were calculated by multiplying ranks for both product characteristics and disease areas. 17 qualitative interviews were conducted and 77 questionnaires (response rate 35%) were completed and returned. (1) Disease areas in ONS and TF with highest priorities are: ONS: general malnutrition & geriatrics, TF: intensive care. (2) TF product characteristics with highest priorities are: composition and clinical evidence from a KOL perspective; tolerance and ease of use from a patient perspective. ONS product characteristics with highest priorities are: composition, clinical evidence and taste from a KOL perspective; taste from a patient perspective. We find a high discrepancy between product characteristic prioritization from a KOL and patient perspective. (3) Although 62% of all KOLs give advice to enteral nutrition companies on patient needs, they under-influence the setting of research priorities by enteral nutrition companies. This study provides a systematic approach to achieve research prioritization in enteral nutrition. In addition to providing new directions for enteral nutrition research and development, this study highlights the relevance of involving KOLs in the identification of research priorities as they

  7. Technology advancement of the static feed water electrolysis process

    Science.gov (United States)

    Schubert, F. H.; Wynveen, R. A.

    1977-01-01

    A program to advance the technology of oxygen- and hydrogen-generating subsystems based on water electrolysis was studied. Major emphasis was placed on static feed water electrolysis, a concept characterized by low power consumption and high intrinsic reliability. The static feed based oxygen generation subsystem consists basically of three subassemblies: (1) a combined water electrolysis and product gas dehumidifier module; (2) a product gas pressure controller and; (3) a cyclically filled water feed tank. Development activities were completed at the subsystem as well as at the component level. An extensive test program including single cell, subsystem and integrated system testing was completed with the required test support accessories designed, fabricated, and assembled. Mini-product assurance activities were included throughout all phases of program activities. An extensive number of supporting technology studies were conducted to advance the technology base of the static feed water electrolysis process and to resolve problems.

  8. The Effects of Forage Policy on Feed Costs in Korea

    Directory of Open Access Journals (Sweden)

    Jae Bong Chang

    2018-05-01

    Full Text Available Feeding operations are substantial on livestock farms, besides being potentially expensive. Feeding efficiency has been considered a major influence on profits in the livestock industry. Indeed, feed costs are shown to be the largest single item of production cost in Korea. To promote production and use of domestic forage, the Korean government has enforced the forage base expansion program that strengthens the competitiveness of the livestock industry by reducing the production cost. The forage base expansion program includes three main policies: subsidized forage production, support for processing and distribution, and expanding land for forage production. This paper investigates the influence of the government’s policies often conjectured to have pronounced effects on forage production. To evaluate the forage policies, this paper uses a path-analysis approach linking government spending on forage base expansion programs and feed costs. Results indicate that the Korean government’s spending on supporting domestic forage production results in a decrease in the ratio of forage expenses to total feed cost.

  9. A very feasible alternative in patients with feeding difficulties from gastrostomy: Jejunal tube advanced through the gastrostomy

    Directory of Open Access Journals (Sweden)

    Ramazan Karabulut

    2015-01-01

    Full Text Available Background: Our aim is to share our experiences regarding patients who cannot be fed effectively through the gastrostomy tube, but were inserted feeding jejunostomy through the gastrostomy orifice using scopic fluoroscopic techniques utilised by the interventional radiology. Patients and Methods: Between January 2010 and May 2013 the patients that were inserted jejunostomy tube through the gastrostomy orifice using fluoroscopic techniques were retrospectively analysed. Data including primary indication for gastrostomy, sex, concomitant disease and the requirement for gastroesophageal reflux disease (GERD were all recorded. Results: There were five patients with these criteria. They all received either medical or surgical GERD therapy; nevertheless enteral feeding failed to reach an effective level, they all had vomiting and did not gain any weight. Following conversion, all the patients gained minimum 2 kg in 2-5 months; all the patients tolerated enteral feeding and were discharged in the early period. There were neither procedure related complications such as perforation, bleeding nor sedation related complications. Procedure took no more than 30 min as a whole. There was no need for surgical intervention. However in one patient re-intervention was required due to accidental removal of the catheter. Conclusions: In case of feeding difficulties following the gastrostomy; instead of an invasive surgical intervention; physicians should consider jejunal feeding that is advanced through the gastrostomy, which does not require any anaesthesia.

  10. Baseline evaluation of nutritional status and government feeding programs in Chiclayo, Peru.

    Science.gov (United States)

    Gross, Rainer; Lechtig, Aarón; López de Romaña, Daniel

    2006-01-01

    Because of the rapid growth of the urban population in Peru, food and nutrition insecurity will occur increasingly in this population. For appropriate policy setting and programming, the food and nutrition situation of the urban poor requires better understanding. To gain information about the nature, magnitude, severity, and causes of the nutritional problems of the population in low-income areas of the city of Chiclayo, Peru. A cross-sectional nutrition survey was conducted in 1,604 households, covering children under 5 years of age and their parents. The prevalence rates of stunting, wasting, overweight. and anemia in children were 15.4%, 1.3%, 4.6%, and 65.7%, respectively; one third of adults were overweight, and one tenth were obese; 2.1% of the mothers were underweight; and 34.3% of mothers and 12.2% of fathers had anemia. Governmental feeding programs did not address these problems adequately. Interventions must have adequate targeting; address appropriate responses at the household, community, and national levels; and reduce stunting, obesity, and iron-deficiency anemia.

  11. Engineering design of cryocondensation pumps for the DIII-D Radiative Divertor Program

    International Nuclear Information System (INIS)

    Bozek, A.S.; Baxi, C.B.; Del Bene, J.V.; Laughon, G.J.; Reis, E.E.; Shatoff, H.D.; Smith, J.P.

    1995-01-01

    A new double-null, slotted divertor configuration will be installed for the DIII-D Radiative Divertor Program at General Atomics in late 1996. Four cryocondensation pumps, three new and one existing, will be part of this new divertor. The purpose of the pumps is to provide plasma density control and to limit the impurities entering the plasma core by providing pumping at each divertor strike point. The three new pumps are based on the design of the existing pump, installed in 1992 as part of the Advanced Divertor Program. The pump continues to operate successfully. The new pumps require geometry modifications to the original design. Therefore, extensive modal and dynamic analyses were performed to determine the behavior of these pumps and their helium and nitrogen feed lines during disruption events. Thermal and fluid analyses were also performed to characterize the helium two-phase flow regime in the pumps and their feedlines. A flow testing program was completed to test the change in geometry of the pump feed lines with respect to helium flow stability. The results were compared to the helium thermal and fluid analyses to verify predicted flow regimes and flow stability

  12. Immediate preoperative enteral nutrition (preoperative enteral nutrition

    Directory of Open Access Journals (Sweden)

    Lađević Nebojša

    2017-01-01

    Full Text Available Nutritional support of surgical patients is a necessary part of the treatment. It alone cannot cure the disease but it significantly affects the recovery of patients and supports surgical interventions. Patients in malnutrition have shown to have significantly more postoperative infectious and non-infectious complications. This significantly prolongs treatment time and increases costs. However, there is one fact that cannot be expressed in money, which is the patient's impression of the surgical intervention. Adequate preoperative patient support, based on the intake of liquid nutritive solutions, reduces preoperative stress and deflects the metabolic response. Now, it is recommended for adults and children older than one year to drink clear liquid up to 2 hours before induction in anesthesia. Appropriate enteral nutrition has a significant place in the postoperative recovery of patients. Enteral nutrition is reducing complications, mainly infectious complications because the function of the digestive system as one large immune system is preserved. Perioperative enteral nutrition is a necessary part of the modern treatment of surgical patients. In addition to the significant effect on the occurrence of postoperative complications, it is also important that this type of diet improves the psychological status of patients.

  13. Enteric nervous system specific deletion of Foxd3 disrupts glial cell differentiation and activates compensatory enteric progenitors.

    Science.gov (United States)

    Mundell, Nathan A; Plank, Jennifer L; LeGrone, Alison W; Frist, Audrey Y; Zhu, Lei; Shin, Myung K; Southard-Smith, E Michelle; Labosky, Patricia A

    2012-03-15

    The enteric nervous system (ENS) arises from the coordinated migration, expansion and differentiation of vagal and sacral neural crest progenitor cells. During development, vagal neural crest cells enter the foregut and migrate in a rostro-to-caudal direction, colonizing the entire gastrointestinal tract and generating the majority of the ENS. Sacral neural crest contributes to a subset of enteric ganglia in the hindgut, colonizing the colon in a caudal-to-rostral wave. During this process, enteric neural crest-derived progenitors (ENPs) self-renew and begin expressing markers of neural and glial lineages as they populate the intestine. Our earlier work demonstrated that the transcription factor Foxd3 is required early in neural crest-derived progenitors for self-renewal, multipotency and establishment of multiple neural crest-derived cells and structures including the ENS. Here, we describe Foxd3 expression within the fetal and postnatal intestine: Foxd3 was strongly expressed in ENPs as they colonize the gastrointestinal tract and was progressively restricted to enteric glial cells. Using a novel Ednrb-iCre transgene to delete Foxd3 after vagal neural crest cells migrate into the midgut, we demonstrated a late temporal requirement for Foxd3 during ENS development. Lineage labeling of Ednrb-iCre expressing cells in Foxd3 mutant embryos revealed a reduction of ENPs throughout the gut and loss of Ednrb-iCre lineage cells in the distal colon. Although mutant mice were viable, defects in patterning and distribution of ENPs were associated with reduced proliferation and severe reduction of glial cells derived from the Ednrb-iCre lineage. Analyses of ENS-lineage and differentiation in mutant embryos suggested activation of a compensatory population of Foxd3-positive ENPs that did not express the Ednrb-iCre transgene. Our findings highlight the crucial roles played by Foxd3 during ENS development including progenitor proliferation, neural patterning, and glial

  14. Integrated Blanket Supplementary Feeding Program Reduces Levels of Stunting in Yenangyaung, Myanmar

    International Nuclear Information System (INIS)

    Aung, Thet; Baik, Diane

    2014-01-01

    were seen in the underweight and wasting levels. However, significant improvements in the median height-for-age z-score (HAZ) were found in levels of stunting on Day-1 (-2.37 SD, n = 381) vs. 6-month follow-up (-1.99 SD, n = 314)(Z = -7.683, p<0.0001). Unfortunately, there were significant increases in the levels of stunting on Day-1 (-2.37 SD, n = 381) vs. 1-Year follow-up (-2.70 SD, n = 242)(Z = -2.21, p = 0.027). CONCLUSION: An integrated blanket supplementary feeding program could possibly reduce levels of stunting in just 6-months, but continued monitoring is required of the children even if the children are discharged from the program to ensure their rehabilitation is sustained at home. The increase in levels of stunting at 1-Year follow-up may have been due to the fact that many of the rehabilitated children were discharged and not followed up for the study. Thus, further research is needed to assess the effects of integrated blanket supplementary feeding programs on reducing levels of stunting. (author)

  15. The effect of a natural food based tube feeding in minimizing diarrhea in critically ill neurological patients.

    Science.gov (United States)

    Schmidt, Simone B; Kulig, Willibald; Winter, Ralph; Vasold, Antje S; Knoll, Anette E; Rollnik, Jens D

    2018-01-09

    Diarrhea has negative consequences for patients, health care staff and health care costs when neurological patients are fed enterally over long periods. We examined the effect of tube feeding with natural foods in reducing the number of fluid stool evacuations and diarrhea in critically ill neurological patients. A multicenter, prospective, open-label and randomized controlled trial (RCT) was conducted at facilities in Germany specializing in early rehabilitation after neurological damage. Patients of the INTERVENTION group were fed by tube using a commercially available product based on real foods such as milk, meat, carrots, whereas CONTROL patients received a standard tube-feed made of powdered raw materials. All received enteral nutrition over a maximum of 30 days. The number of defecations and the consistency of each stool according to the Bristol Stool Chart (BSC) were monitored. In addition, daily calories, liquids and antibiotic-use were recorded. 118 Patients who had suffered ischemic stroke, intracerebral hemorrhage, traumatic brain injury or hypoxic brain damage and requiring enteral nutrition were enrolled; 59 were randomized to receive the intervention and 59 control feed. There were no significant differences in clinical screening data, age, sex, observation period or days under enteral nutrition between the groups. Patients in both groups received equivalent amount of calories and fluids. In both groups antibiotics were frequently prescribed (69.5% in the INTERVENTION group and 75.7% in the CONTROL group) for 10-11 days on average. In comparison to the CONTROL group, patients in the INTERVENTION group had a significant reduction of the number of watery stool evacuations (type 7 BSC) (minus 61%, IRR = 0.39, p natural based food was effective in reducing the number of watery defecations and diarrhea in long term tube-fed critically ill neurological patients, compared to those fed with standard tube feeding. Copyright © 2018 The Authors. Published

  16. Slurry feed variability in West Valley's melter feed tank and sampling system

    International Nuclear Information System (INIS)

    Fow, C.L.; Kurath, D.E.; Pulsipher, B.A.; Bauer, B.P.

    1989-04-01

    The present plan for disposal of high-level wastes at West Valley is to vitrify the wastes for disposal in deep geologic repository. The vitrification process involves mixing the high-level wastes with glass-forming chemicals and feeding the resulting slurry to a liquid-fed ceramic melter. Maintaining the quality of the glass product and proficient melter operation depends on the ability of the melter feed system to produce and maintain a homogeneous mixture of waste and glass-former materials. To investigate the mixing properties of the melter feed preparation system at West Valley, a statistically designed experiment was conducted using synthetic melter feed slurry over a range of concentrations. On the basis of the statistical data analysis, it was found that (1) a homogeneous slurry is produced in the melter feed tank, (2) the liquid-sampling system provides slurry samples that are statistically different from the slurry in the tank, and (3) analytical measurements are the major source of variability. A statistical quality control program for the analytical laboratory and a characterization test of the actual sampling system is recommended. 1 ref., 5 figs., 1 tab

  17. Mining free-text medical records for companion animal enteric syndrome surveillance.

    Science.gov (United States)

    Anholt, R M; Berezowski, J; Jamal, I; Ribble, C; Stephen, C

    2014-03-01

    Large amounts of animal health care data are present in veterinary electronic medical records (EMR) and they present an opportunity for companion animal disease surveillance. Veterinary patient records are largely in free-text without clinical coding or fixed vocabulary. Text-mining, a computer and information technology application, is needed to identify cases of interest and to add structure to the otherwise unstructured data. In this study EMR's were extracted from veterinary management programs of 12 participating veterinary practices and stored in a data warehouse. Using commercially available text-mining software (WordStat™), we developed a categorization dictionary that could be used to automatically classify and extract enteric syndrome cases from the warehoused electronic medical records. The diagnostic accuracy of the text-miner for retrieving cases of enteric syndrome was measured against human reviewers who independently categorized a random sample of 2500 cases as enteric syndrome positive or negative. Compared to the reviewers, the text-miner retrieved cases with enteric signs with a sensitivity of 87.6% (95%CI, 80.4-92.9%) and a specificity of 99.3% (95%CI, 98.9-99.6%). Automatic and accurate detection of enteric syndrome cases provides an opportunity for community surveillance of enteric pathogens in companion animals. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. The new Israeli feed safety law: challenges in relation to animal and public health.

    Science.gov (United States)

    Barel, Shimon; Elad, Dani; Cuneah, Olga; Shimshoni, Jakob A

    2017-03-01

    The Israeli feed safety legislation, which came to prominence in the early 1970s, has undergone a major change from simple feed safety and quality regulations to a more holistic concept of control of feed safety and quality throughout the whole feed production chain, from farm to the end user table. In February 2014, a new law was approved by the Israeli parliament, namely the Control of Animal Feed Law, which is expected to enter into effect in 2017. The law is intended to regulate the production and marketing of animal feed, guaranteeing the safety and quality of animal products throughout the production chain. The responsibility on the implementation of the new feed law was moved from the Plant Protection Inspection Service to the Veterinary Services and Animal Health. In preparation for the law's implementation, we have characterized the various sources and production lines of feed for farm and domestic animals in Israel and assessed the current feed safety challenges in terms of potential hazards or undesirable substances. Moreover, the basic requirements for feed safety laboratories, which are mandatory for analyzing and testing for potential contaminants, are summarized for each of the contaminants discussed. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  19. Data Analyses and Modelling for Risk Based Monitoring of Mycotoxins in Animal Feed

    Directory of Open Access Journals (Sweden)

    H.J. (Ine van der Fels-Klerx

    2018-01-01

    Full Text Available Following legislation, European Member States should have multi-annual control programs for contaminants, such as for mycotoxins, in feed and food. These programs need to be risk based implying the checks are regular and proportional to the estimated risk for animal and human health. This study aimed to prioritize feed products in the Netherlands for deoxynivalenol and aflatoxin B1 monitoring. Historical mycotoxin monitoring results from the period 2007–2016 were combined with data from other sources. Based on occurrence, groundnuts had high priority for aflatoxin B1 monitoring; some feed materials (maize and maize products and several oil seed products and complete/complementary feed excluding dairy cattle and young animals had medium priority; and all other animal feeds and feed materials had low priority. For deoxynivalenol, maize by-products had a high priority, complete and complementary feed for pigs had a medium priority and all other feed and feed materials a low priority. Also including health consequence estimations showed that feed materials that ranked highest for aflatoxin B1 included sunflower seed and palmkernel expeller/extracts and maize. For deoxynivalenol, maize products were ranked highest, followed by various small grain cereals (products; all other feed materials were of lower concern. Results of this study have proven to be useful in setting up the annual risk based control program for mycotoxins in animal feed and feed materials.

  20. Data Analyses and Modelling for Risk Based Monitoring of Mycotoxins in Animal Feed

    Science.gov (United States)

    van der Fels-Klerx, H.J. (Ine); Adamse, Paulien; Punt, Ans; van Asselt, Esther D.

    2018-01-01

    Following legislation, European Member States should have multi-annual control programs for contaminants, such as for mycotoxins, in feed and food. These programs need to be risk based implying the checks are regular and proportional to the estimated risk for animal and human health. This study aimed to prioritize feed products in the Netherlands for deoxynivalenol and aflatoxin B1 monitoring. Historical mycotoxin monitoring results from the period 2007–2016 were combined with data from other sources. Based on occurrence, groundnuts had high priority for aflatoxin B1 monitoring; some feed materials (maize and maize products and several oil seed products) and complete/complementary feed excluding dairy cattle and young animals had medium priority; and all other animal feeds and feed materials had low priority. For deoxynivalenol, maize by-products had a high priority, complete and complementary feed for pigs had a medium priority and all other feed and feed materials a low priority. Also including health consequence estimations showed that feed materials that ranked highest for aflatoxin B1 included sunflower seed and palmkernel expeller/extracts and maize. For deoxynivalenol, maize products were ranked highest, followed by various small grain cereals (products); all other feed materials were of lower concern. Results of this study have proven to be useful in setting up the annual risk based control program for mycotoxins in animal feed and feed materials. PMID:29373559

  1. Nutrient Intake and Contribution of Home Enteral Nutrition to Meeting Nutritional Requirements after Oesophagectomy and Total Gastrectomy

    Science.gov (United States)

    Baker, Melanie L; Halliday, Vanessa; Robinson, Pauline; Smith, Karen; Bowrey, David J

    2017-01-01

    Background/Objectives This study evaluated nutrition after oesophago-gastric resection and the influence of home jejunostomy feeding in the six months after surgery. Subjects/Methods Data on nutritional intake and physiologic measures were collected as part of a randomised trial with measurements taken before and up to six months after surgery. Results 41 participants (32 oesophagectomy, 9 total gastrectomy) received home jejunostomy feeding (n=18) or usual care without feeding (n=23). At hospital discharge, oral intakes were adequate for energy and protein in 9% and 6% respectively. By three and six months, these values had increased to 61% & 55%, 94% & 77% respectively. Six participants (26%) who received usual care required rescue feeding. Six weeks after hospital discharge, energy intakes were met in those who received jejunal feeding due to the contribution of enteral nutrition. Jejunal feeding did not affect oral intake, being similar in both groups (fed: 77% estimated need, usual care: 79%). At three months, inadequate micronutrient intakes were seen in over one third. Compared to baseline values, six weeks after surgery, weight loss exceeding 5% was seen in 5/18 (28%) who received feeding, 14/17 (82%) who received usual care and 5/6 (83%) of those who required rescue feeding, p=0.002. Weight loss averaged 4.1% (fed), 10.4% (usual care) and 9.2% (rescue fed), p=0.004. These trends persisted out to six months. Conclusions Supplementary jejunostomy feeding made an important contribution to meeting nutrition after oesophago-gastric resection. Importantly, oral nutritional intake was not compromised dispelling the assertion that jejunal feeding deincentivises patients from eating. PMID:28656968

  2. The Effect of Dietary Replacement of Ordinary Rice with Red Yeast Rice on Nutrient Utilization, Enteric Methane Emission and Rumen Archaeal Diversity in Goats.

    Directory of Open Access Journals (Sweden)

    L Z Wang

    Full Text Available Twenty castrated Boer crossbred goats were used in the present study with two treatments to examine the effect of dietary replacement of ordinary rice with red yeast rice on nutrient utilization, enteric methane emission and ruminal archaea structure and composition. Two treatment diets contained (DM basis 70.0% of forage, 21.8% of concentrates and 8.2% of either ordinary rice (control or red yeast rice (RYR. Nutrient utilization was measured and enteric methane emissions were determined in respiration chambers. Results showed that RYR had significantly lower digestibility of N and organic matter compared to control group. However, feeding red yeast rice did not affect N retention as g/d or a proportion of N intake, and reduced heat production as MJ/d or as a proportion of metabolizable energy intake, thus leading to a higher proportion of metabolizable energy intake to be retained in body tissue. RYR also had significantly lower methane emissions either as g/d, or as a proportion of feed intake. Although feeding red yeast rice had no negative effect on any rumen fermentation variables, it decreased serum contents of total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol. In the present study, 75616 archaeal sequences were generated and clustered into 2364 Operational Taxonomic Units. At the genus level, the predominant archaea in the rumen of goats was Methanobrevibacter, which was significantly inhibited with the supplementation of red yeast rice. In conclusion, red yeast rice is a potential feed ingredient for mitigation of enteric methane emissions of goats. However, caution should be taken when it is used because it may inhibit the digestibility of some nutrients. Further studies are required to evaluate its potential with different diets and animal species, as well as its effects on animal health and food safety.

  3. Avaliação de Programas de Alimentação para Matrizes de Corte na Fase de Produção Evaluation of Feeding Programs for Broiler Breeders Hens

    Directory of Open Access Journals (Sweden)

    João Artur Argenta

    2001-12-01

    Full Text Available O experimento foi realizado com o objetivo de verificar o melhor programa de fornecimento de ração para matrizes de corte pós - pico de produção de ovos. Três mil, cento e sessenta e oito fêmeas e 352 machos matrizes de corte da linhagem Cobb foram distribuídos em um delineamento experimental inteiramente casualizado com quatro tratamentos e oito repetições por tratamento, sendo 99 fêmeas e 11 machos por unidade experimental. Os programas avaliados consistiram em: Programa 1 - Redução de 1 g de ração/ave/dia/semana para cada redução de 0,5 pontos na massa de ovos; Programa 2 - Redução de 1 g de ração/ave/dia/semana após o pico até o final do período de produção; Programa 3 - Redução de 3 g de ração/ave/dia/semana na 1ª semana após o pico, 2 g de ração/ave/dia/semana na 2ª semana e 1 g de ração/ave/dia/semana nas semanas subsequentes; Programa 4 - Redução de 5 g de ração/ave/dia/semana na 1ª semana após o pico, 3 g de ração/ave/dia/semana na 2ª semana e 1 g de ração/ave/dia/semana nas semanas subseqüentes. De acordo com os resultados obtidos para consumo de ração por ovo produzido, característica de importância na avaliação do desempenho das matrizes de corte, o melhor programa foi o programa 1, seguido pelo 3, 2 e 4. Para matrizes de corte da linhagem Cobb que atingem pico de postura no inverno, período no qual foi realizado este experimento, recomenda-se o programa 1 para alimentação após pico por ter proporcionado uma boa relação entre consumo de ração e produção de ovos.The experiment was conducted to evaluate the best feeding program post peak egg production for broiler breeders. Cobb broiler breeders (3168 females and 352 males were distributed in a randomized experimental design with four treatments and eight replicates per treatment, with 99 females and 11 males per replicate. The evaluated programs were: Program 1 - Reduction 1 g of feed/bird/day/week for each drop of 0

  4. Kalman filtering applied to a reagent feed system

    International Nuclear Information System (INIS)

    Griffin, C.D.; Croson, D.V.; Feeley, J.J.

    1988-01-01

    Using a Kalman filter solves a troublesome measurement noise problem and, at the same time, improves nuclear safety by detecting leaks to the process' feed tanks. To demonstrate how this technology of optimal estimation can be exploited, this article presents a systematic plan and example of how a Kalman filter was proven in industrial use on a reagent analyzer. A process to recycle uranium from spent fuel elements uses a reagent stream containing boron to dissolve the fuel. The boron is the neutron poison that prevents a nuclear chain reaction during the uranium dissolution. The purpose of the Kalman filter for this system is to reduce the uncertainty in the boron concentration measurement. The filter also provides incipient fault detection by estimating the unmeasured state of any unpoisoned solution, which would dilute the boron solution, entering the feed vessel

  5. How to engage across sectors: lessons from agriculture and nutrition in the Brazilian School Feeding Program

    OpenAIRE

    Hawkes, Corinna; Brazil, Bettina Gerken; Castro, Inês Rugani Ribeiro de; Jaime, Patricia Constante

    2016-01-01

    OBJECTIVE: To provide insights for nutrition and public health practitioners on how to engage with other sectors to achieve public health goals. Specifically, this study provides lessons from the example of integrating family farming and a nutrition into a legal framework in Brazil on how to successfully shift other sectors toward nutrition goals.\\ud \\ud METHODS: The study analyzed policy processes that led to a Brazilian law linking family farming with the National School Feeding Program. Ma...

  6. Fasting, circadian rhythms, and time restricted feeding in healthy lifespan

    Science.gov (United States)

    Longo, Valter D.; Panda, Satchidananda

    2016-01-01

    Summary Feeding in most animals is confined to a defined period, leaving short periods of fasting that coincide with sleep. Fasting enables organisms to enter alternative metabolic phases, which rely less on glucose and more on ketone body-like carbon sources. Both intermittent and periodic fasting result in benefits ranging from prevention to the enhanced treatment of diseases. Similarly, time-restricted feeding (TRF), in which feeding time is restricted to certain hours of the day, allows the daily fasting period to last >12 h, thus imparting pleiotropic benefits in multiple organisms. Understanding the mechanistic link between nutrients and the fasting benefits is leading to the identification of fasting mimicking diets (FMDs) that achieve changes similar to those caused by fasting. Given the pleiotropic and sustained benefits of TRF and FMD, both basic science and translational research are warranted to develop fasting-associated interventions into effective and inexpensive treatments with the potential to improve healthspan. PMID:27304506

  7. Cost-effectiveness of feeding strategies to reduce greenhouse gas emissions from dairy farming

    NARCIS (Netherlands)

    Middelaar, van C.E.; Dijkstra, J.; Berentsen, P.B.M.; Boer, de I.J.M.

    2014-01-01

    The objective of this paper was to evaluate the cost-effectiveness of 3 feeding strategies to reduce enteric CH4 production in dairy cows by calculating the effect on labor income at the farm level and on greenhouse gas (GHG) emissions at the chain level (i.e., from production of farm inputs to the

  8. Enteric methane mitigation technologies for ruminant livestock: a synthesis of current research and future directions.

    Science.gov (United States)

    Patra, Amlan Kumar

    2012-04-01

    Enteric methane (CH(4)) emission in ruminants, which is produced via fermentation of feeds in the rumen and lower digestive tract by methanogenic archaea, represents a loss of 2% to 12% of gross energy of feeds and contributes to global greenhouse effects. Globally, about 80 million tonnes of CH(4) is produced annually from enteric fermentation mainly from ruminants. Therefore, CH(4) mitigation strategies in ruminants have focused to obtain economic as well as environmental benefits. Some mitigation options such as chemical inhibitors, defaunation, and ionophores inhibit methanogenesis directly or indirectly in the rumen, but they have not confirmed consistent effects for practical use. A variety of nutritional amendments such as increasing the amount of grains, inclusion of some leguminous forages containing condensed tannins and ionophore compounds in diets, supplementation of low-quality roughages with protein and readily fermentable carbohydrates, and addition of fats show promise for CH(4) mitigation. These nutritional amendments also increase the efficiency of feed utilization and, therefore, are most likely to be adopted by farmers. Several new potential technologies such as use of plant secondary metabolites, probiotics and propionate enhancers, stimulation of acetogens, immunization, CH(4) oxidation by methylotrophs, and genetic selection of low CH(4)-producing animals have emerged to decrease CH(4) production, but these require extensive research before they can be recommended to livestock producers. The use of bacteriocins, bacteriophages, and development of recombinant vaccines targeting archaeal-specific genes and cell surface proteins may be areas worthy of investigation for CH(4) mitigation as well. A combination of different CH(4) mitigation strategies should be adopted in farm levels to substantially decrease methane emission from ruminants. Evidently, comprehensive research is needed to explore proven and reliable CH(4) mitigation technologies

  9. Combined enteral and parenteral nutrition.

    Science.gov (United States)

    Wernerman, Jan

    2012-03-01

    To review and discuss the evidence and arguments to combine enteral nutrition and parenteral nutrition in the ICU, in particular with reference to the Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients (EPaNIC) study. The EPaNIC study shows an advantage in terms of discharges alive from the ICU when parenteral nutrition is delayed to day 8 as compared with combining enteral nutrition and parenteral nutrition from day 3 of ICU stay. The difference between the guidelines from the European Society of Enteral and Parenteral Nutrition in Europe and American Society for Parenteral and Enteral Nutrition/Society of Critical Care Medicine in North America concerning the combination of enteral nutrition and parenteral nutrition during the initial week of ICU stay was reviewed. The EPaNIC study clearly demonstrates that early parenteral nutrition in the ICU is not in the best interests of most patients. Exactly at what time point the combination of enteral nutrition and parenteral nutrition should be considered is still an open question.

  10. Comparative efficacy of a phytogenic feed additive and an antibiotic growth promoter on production performance, caecal microbial population and humoral immune response of broiler chickens inoculated with enteric pathogens

    Directory of Open Access Journals (Sweden)

    Toshi Wati

    2015-09-01

    effective replacement for common in-feed antibiotics like BMD to enhance broiler performance especially when the birds are exposed to heavy infections on fields. Keywords: Broilers, Phytogenic feed additives, Performance, Nutrient retention, Enteric challenge, Intestinal microbiology

  11. A Stepwise, Pilot Study of Bovine Colostrum to Supplement the First Enteral Feeding in Preterm Infants (Precolos)

    DEFF Research Database (Denmark)

    Li, Yanqi; Juhl, Sandra M; Ye, Xuqiang

    2017-01-01

    STUDY PROTOCOL: The optimal feeding for preterm infants during the first weeks is still debated, especially when mother's own milk is lacking or limited. Intact bovine colostrum (BC) contains high amounts of protein, growth factors, and immuno-regulatory components that may benefit protein intake...

  12. Regional Comparison of Enteral Nutrition-Related Admission Policies in Skilled Nursing Facilities.

    Science.gov (United States)

    Burgermaster, Marissa; Slattery, Eoin; Islam, Nafeesa; Ippolito, Paul R; Seres, David S

    2016-06-01

    Nursing home admission policies are one driver of increased and earlier gastrostomy placement, a procedure that is not always medically or ethically indicated among patients needing short-term nutrition support. This important clinical decision should be based upon patient prognosis, goals, and needs. We compared nursing home enteral nutrition-related admission policies in New York City and other regions of the United States. We also explored motivations for these policies. We conducted a telephone survey with skilled nursing facility administrators in New York City and a random sample of facilities throughout the United States about enteral nutrition-related admission policies. Survey data were matched with publically available data about facility characteristics from the Centers for Medicare and Medicaid Services. The relationship between facility location and admission policies was described with regression models. Reasons for these policies were thematically analyzed. New York City nursing homes were significantly less likely to admit patients with nasogastric feeding tubes than were nursing homes nationwide, after we controlled for facility characteristics (odds ratio = 0.111; 95% CI, 0.032-0.344). Reasons for refusing nasogastric tubes fell into 5 categories: safety, capacity, policy, perception of appropriate level of care, and patient quality of life. Our findings indicate that enteral nutrition-related admission policies vary greatly between nursing homes in New York City and nationwide. Many administrators cited safety and policy as factors guiding their institutional policies and practices, despite a lack of evidence. This gap in research, practice, and policy has implications for quality and cost of care, length of hospital stay, and patient morbidity and mortality. © 2016 American Society for Parenteral and Enteral Nutrition.

  13. Esophagitis and enteritis caused by herpesvirus in pigeons.

    Directory of Open Access Journals (Sweden)

    Egobol, L.

    2002-01-01

    Full Text Available The pigeon squabs, aged 5-26 day-old, showed clinical signs of dullness, anorexia, indigestion, reten-tion of feed in crop, progressive emaciation then died. The morbidity rate and mortality rate were 7.14% (50/700. The adult pigeons did not show any signs of disease. From pathological finding, pharyngitis, esophagitis were found with diphtheritic membrane covering necrotic ulcers on the mucosa of pharynx, esophagus and crop. From histopathological findings, esophagitis with epithelial hyperplasia and sloughed, lamina propria mucosa edema with lymphoid cells infiltration were found in duodenum and jejunum. The intranuclear inclusion body, Cowdry type A, was found in epithelial mucosa of esophagus, enterocyte of jejunum and lymphoid cells in spleen. FA test to duck virus enteritis and inoculation to ducklings showed negative results. Electron microscopic study revealed electron dense core sized 146-167 nm., which was identified as herpesvirus.

  14. Tread-water feeding of Bryde's whales.

    Science.gov (United States)

    Iwata, Takashi; Akamatsu, Tomonari; Thongsukdee, Surasak; Cherdsukjai, Phaothep; Adulyanukosol, Kanjana; Sato, Katsufumi

    2017-11-06

    Many previous studies have shown that rorqual whales (Balaenopteridae), including the blue whale (Balaenoptera musculus), fin whale (B. physalus), sei whale (B. borealis), Bryde's whale (B. edeni), minke whale (B. acutorostrata), and humpback whale (Megaptera novaeangliae), employ a strategy called lunge feeding to capture a large amount of krill and/or fish for nourishment [1]. Lunge feeding entails a high energetic cost due to the drag created by an open mouth at high speeds [1,2]. In the upper Gulf of Thailand, Bryde's whales, which feed on small fish species [3], predominantly anchovies, demonstrated a range of feeding behaviors such as oblique, vertical, and lateral lunging. Moreover, they displayed a novel head-lifting feeding behavior characterized by holding the vertical posture for several seconds with an open mouth at the water surface. This study describes the head-lifting feeding by Bryde's whales, which is distinct from the typical lunge feeding of rorqual whales. Whales showing this behavior were observed on 58 occasions, involving 31 whales and including eight adult-calf pairs. Whales caught their prey using a series of coordinated movements: (i) lifting the head above the water with a closed mouth, (ii) opening the mouth until the lower jaw contacted the sea surface, which created a current of water flowing into the mouth, (iii) holding their position for several seconds, (iv) waiting for the prey to enter the mouth, and (v) closing the mouth and engulfing the prey underwater (Figure 1A-F, Movie S1 in Supplemental Information published with this article online). When a whale kept its upper jaw above the sea surface, many anchovies in the targeted shoal appeared to lose orientation and flowed passively into the mouth of the whale by the current created by the lower mandible breaking the surface of the water. We measured the duration of feeding events when the whales had a wide-open mouth mostly above the sea surface. The mean and maximum feeding

  15. Responsive versus scheduled feeding for preterm infants.

    Science.gov (United States)

    Watson, Julie; McGuire, William

    2015-10-13

    results in slightly slower rates of weight gain (MD -1.4, 95% CI -2.4 to -0.3 g/kg/day), and provide some evidence that responsive feeding reduces the time taken for infants to transition from enteral tube to oral feeding (MD -5.5, 95% CI -6.8 to -4.2 days). The importance of this finding is uncertain as the trials did not find a strong or consistent effect on the duration of hospitalisation. None of the included trials reported any parent, caregiver, or staff views. Overall, the data do not provide strong or consistent evidence that responsive feeding affects important outcomes for preterm infants or their families. Some evidence exists that preterm infants fed in response to feeding and satiation cues achieve full oral feeding earlier than infants fed prescribed volumes at scheduled intervals. However, this finding should be interpreted cautiously because of methodological weaknesses in the included trials. A large RCT would be needed to confirm this finding and to determine if responsive feeding of preterm infants affects other important outcomes.

  16. Nutritional support team vs nonteam management of enteral nutritional support in a Veterans Administration Medical Center teaching hospital.

    Science.gov (United States)

    Powers, D A; Brown, R O; Cowan, G S; Luther, R W; Sutherland, D A; Drexler, P G

    1986-01-01

    One hundred one patients receiving enteral nutritional support (ENS) by tube feeding during a 5-month period were prospectively studied. Fifty patients were managed by a nutritional support team (T) and 51 patients were managed by the nonteam approach (NT). Demographics, primary diagnosis, chronic diseases, medical service, calculated basal energy expenditure (BEE), duration of ENS, and final patient disposition were recorded. Enteral formula, formula modifications, results of laboratory tests and calories delivered were obtained daily. Results of nitrogen balance studies were obtained when available and each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. No significant difference was found between the team and nonteam managed groups in regard to total feeding days, mean feeding days per patient, total laboratory tests, laboratory tests per patient or laboratory tests per day. Significantly more team patients attained 1.2 times BEE (T = 47, NT = 38, p less than 0.05) for a significantly greater period of time (T = 398 days, NT = 281 days, p less than 0.05). Significantly more team patients achieved a measured positive nitrogen balance than nonteam patients (T = 42, NT = 1, p less than 0.05). Formula modifications to correct nutritional or metabolic aberrations were made in 15 (30%) team patients and five (9.8%) nonteam patients (p less than 0.05). The number of individual abnormalities (pulmonary, mechanical, gastrointestinal, and metabolic), as well as total abnormalities occurring in the team-managed group, was significantly lower than in the nonteam managed group (160 vs 695, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Short bowel syndrome in infants: the critical role of luminal nutrients in a management program.

    Science.gov (United States)

    Roy, Claude C; Groleau, Véronique; Bouthillier, Lise; Pineault, Marjolain; Thibault, Maxime; Marchand, Valérie

    2014-07-01

    Short bowel syndrome develops when the remnant mass of functioning enterocytes following massive resections cannot support growth or maintain fluid-electrolyte balance and requires parenteral nutrition. Resection itself stimulates the intestine's inherent ability to adapt morphologically and functionally. The capacity to change is very much related to the high turnover rate of enterocytes and is mediated by several signals; these signals are mediated in large part by enteral nutrition. Early initiation of enteral feeding, close clinical monitoring, and ongoing assessment of intestinal adaptation are key to the prevention of irreversible intestinal failure. The length of the functional small bowel remnant is the most important variable affecting outcome. The major objective of intestinal rehabilitation programs is to achieve early oral nutritional autonomy while maintaining normal growth and nutrition status and minimizing total parenteral nutrition related comorbidities such as chronic progressive liver disease. Remarkable progress has been made in terms of survivability and quality of life, especially in the context of coordinated multidisciplinary programs, but much work remains to be done.

  18. Impact of Skip a Day and Every Day Feeding Programs on the Colonization Rates of Salmonella Enteritidis in Broiler Breeder Pullets

    Science.gov (United States)

    The impact of feeding programs in the colonization rate after challenge with Salmonella enteritidis was investigated. Broiler breeder pullets from were vaccinated at 19 d of incubation with herpesvirus of turkeys (HVT) + chicken herpesvirus (SB1), or a vector HVT (vHVT) + Infectious bursal disease (...

  19. The effect of commonly used anticoccidials and antibiotics in a subclinical necrotic enteritis model.

    Science.gov (United States)

    Lanckriet, A; Timbermont, L; De Gussem, M; Marien, M; Vancraeynest, D; Haesebrouck, F; Ducatelle, R; Van Immerseel, F

    2010-02-01

    Necrotic enteritis poses an important health risk to broilers. The ionophore anticoccidials lasalocid, salinomycin, maduramicin, narasin and a combination of narasin and nicarbazin were tested in feed for their prophylactic effect on the incidence of necrotic enteritis in a subclinical experimental infection model that uses coccidia as a predisposing factor. In addition, drinking water medication with the antibiotics amoxicillin, tylosin and lincomycin was evaluated as curative treatment in the same experimental model. The minimal inhibitory concentrations (MICs) of all antibiotics and anticoccidials were determined in vitro against 51 Clostridium perfringens strains isolated from broilers. The strains examined appeared uniformly susceptible to lasalocid, maduramicin, narasin, salinomycin, amoxicillin and tylosin, whereas an extended frequency distribution range of MICs for lincomycin was seen, indicating acquired resistance in 36 isolates in the higher range of MICs. Nicarbazin did not inhibit the in vitro growth of the C. perfringens strains even at a concentration of 128 microg/ml. Supplementation of the diet from day 1 onwards with lasalocid, salinomycin, narasin or maduramicin led to a reduction in birds with necrotic enteritis lesions as compared with the non-medicated infected control group. A combination product of narasin and nicarbazin had no significant protective effect. Treatment with amoxicillin, lincomycin and tylosin completely stopped the development of necrotic lesions.

  20. Enteral Nutrition Support for Abdominal Compartment Syndrome in Morbidly Obese Patient : A Case Report from a Medical Intensive Care Unit (ICU

    Directory of Open Access Journals (Sweden)

    Nurul Huda Razalli

    2018-01-01

    Full Text Available Compartment syndrome occurs when pressure within a closed muscle or bone compartment builds to dangerous levels. This pressure can decrease blood flow to nerve and muscle cells, leading to ischemia and organ dysfunction. Challenges in providing enteral nutrition for abdominal compartment syndrome (ACS patients include the increase risk for developing gastrointestinal symptoms such as diarrhea, constipation and distention. There are limited reports available on the nutritional management of ACS patients in the ICU especially those with morbid obesity condition to guide dietitians in providing nutritional support for these patients.  Here, we report the enteral nutrition management of a mechanically ventilated, morbidly obese patient with ACS in a critical care setting by adopting postpyloric feeding, using prokinetic agents and implementing PO2/FiO2 ratio calculation for prescription of most suitable enteral formula.

  1. Effect of concentrate feed level on methane emissions from grazing dairy cows.

    Science.gov (United States)

    Jiao, H P; Dale, A J; Carson, A F; Murray, S; Gordon, A W; Ferris, C P

    2014-11-01

    Although the effect of nutrition on enteric methane (CH4) emissions from confined dairy cattle has been extensively examined, less information is available on factors influencing CH4 emissions from grazing dairy cattle. In the present experiment, 40 Holstein-Friesian dairy cows (12 primiparous and 28 multiparous) were used to examine the effect of concentrate feed level (2.0, 4.0, 6.0, and 8.0 kg/cow per day; fresh basis) on enteric CH4 emissions from cows grazing perennial ryegrass-based swards (10 cows per treatment). Methane emissions were measured on 4 occasions during the grazing period (one 4-d measurement period and three 5-d measurement periods) using the sulfur hexafluoride technique. Milk yield, liveweight, and milk composition for each cow was recorded daily during each CH4 measurement period, whereas daily herbage dry matter intake (DMI) was estimated for each cow from performance data, using the back-calculation approach. Total DMI, milk yield, and energy-corrected milk (ECM) yield increased with increasing concentrate feed level. Within each of the 4 measurement periods, daily CH4 production (g/d) was unaffected by concentrate level, whereas CH4/DMI decreased with increasing concentrate feed level in period 4, and CH4/ECM yield decreased with increasing concentrate feed level in periods 2 and 4. When emissions data were combined across all 4 measurement periods, concentrate feed level (2.0, 4.0, 6.0, and 8.0 kg/d; fresh basis) had no effect on daily CH4 emissions (287, 273, 272, and 277 g/d, respectively), whereas CH4/DMI (20.0, 19.3, 17.7, and 18.1g/kg, respectively) and CH4-E/gross energy intake (0.059, 0.057, 0.053, and 0.054, respectively) decreased with increasing concentrate feed levels. A range of prediction equations for CH4 emissions were developed using liveweight, DMI, ECM yield, and energy intake, with the strongest relationship found between ECM yield and CH4/ECM yield (coefficient of determination = 0.50). These results demonstrate that

  2. The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program follow-up.

    Science.gov (United States)

    Hesketh, Kylie D; Campbell, Karen; Salmon, Jo; McNaughton, Sarah A; McCallum, Zoe; Cameron, Adrian; Ball, Kylie; Gold, Lisa; Andrianopoulos, Nick; Crawford, David

    2013-01-01

    The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program, is a community-based, cluster-randomised controlled trial of an obesity prevention intervention delivered to first-time parents of infants from age 4-20 months. Conducted from 2008 to 2010, the program had high uptake and retention and showed positive impacts on some dietary outcomes and television viewing. Funding was secured for a follow-up study of participants two and 3.5 years post intervention (at child ages ~3.5 and 5 years). The follow-up study aims to assess intervention effects, mediators and moderators of effects, and program cost-effectiveness over the longer term. The 492 families still enrolled in the Melbourne InFANT Program at intervention conclusion will be recontacted and renewed consent sought to participate in this follow-up study. No further intervention will occur. Home visit data collections will occur approximately two and 3.5 years post intervention. Main outcomes to be assessed include child body mass index, waist circumference, diet (3 × 24-hour recalls; food frequency questionnaire), physical activity (8 days ActiGraph accelerometer data; parent reported active play) and sedentary time (8days ActiGraph accelerometer and ActivPAL inclinometer data; parent reported screen time). Follow-up of participants of the Melbourne InFANT Program at two and 3.5 years post intervention will allow assessment of longer term intervention effects, investigation of potential mediators and moderators of such effects, and economic evaluation of the longer term outcomes. This information will be valuable to researchers and policy makers in progressing the field of early childhood obesity prevention. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. How EPC firms can enter the nuclear renaissance

    OpenAIRE

    Locatelli, Giorgio; Mancini, Mauro

    2012-01-01

    the so called “nuclear renaissance” is creating a millionaire market for new nuclear reactors. Few firms have the capabilities to work in this complex and highly demanding market, whereas many other are investigating the option to enter. Quite surprising the international scientific literature provides information regarding the high-level governmental aspects of nuclear power programs in different countries while the analysis at firm level is almost inexistent. Moreover the usual business mod...

  4. Identification and compensation of friction for a novel two-axis differential micro-feed system

    Science.gov (United States)

    Du, Fuxin; Zhang, Mingyang; Wang, Zhaoguo; Yu, Chen; Feng, Xianying; Li, Peigang

    2018-06-01

    Non-linear friction in a conventional drive feed system (CDFS) feeding at low speed is one of the main factors that lead to the complexity of the feed drive. The CDFS will inevitably enter or approach a non-linear creeping work area at extremely low speed. A novel two-axis differential micro-feed system (TDMS) is developed in this paper to overcome the accuracy limitation of CDFS. A dynamic model of TDMS is first established. Then, a novel all-component friction parameter identification method (ACFPIM) using a genetic algorithm (GA) to identify the friction parameters of a TDMS is introduced. The friction parameters of the ball screw and linear motion guides are identified independently using the method, assuring the accurate modelling of friction force at all components. A proportional-derivate feed drive position controller with an observer-based friction compensator is implemented to achieve an accurate trajectory tracking performance. Finally, comparative experiments demonstrate the effectiveness of the TDMS in inhibiting the disadvantageous influence of non-linear friction and the validity of the proposed identification method for TDMS.

  5. Effect of complete rumen modifier (CRM and Calliandra calothyrus on productivity and enteric methane productions of PE dairy goat

    Directory of Open Access Journals (Sweden)

    Ni Made Suci Sukmawati

    2011-10-01

    Full Text Available Methanogenesis in the rumen is thought to represent 2-12% loss of energy intake. The energy loss as methane can decrease animal productivity and feed efficiency. In addition, methane is potentially involves in global warming that affects the atmosphere adversely. A research to improve PE dairy goat productivity and reduce enteric methane emission by supplementation of calliandra and complete rumen modifier (CRM was conducted for 6 months. In this experiment 20 PE dairy goats were divided into five blocks according to body weight. The experimental design used was a randomized block design that consisted of four treatments, A. Elephant grass 50% + concentrate 50% (control, B. Elephant grass 40% + concentrate 40% + calliandra 20%, C. Elephant grass 50% + concentrate 48% + CRM 2% and D. Elephant grass 40% + concentrate 38% + calliandra 20% + CRM 2%. Data were analyzed statistically using ANOVA and Duncan test. The result showed that calliandra and CRM did not affect nutrient consumption, except that protein consumption increased (P < 0.05 in calliandra treatments (B and D. Nutrient digestibility increased in CRM (C treatment, while other treatments did not differ from control. CRM also increased total bacteria (36.84%, milk production (67.21%, milk fat (25.0%, and reduced enteric methane production (65.71%. The improvement of milk production in CRM treatment (C was followed by better feed efficiency than other treatments. In conclusion, CRM was more effective than calliandra in improving milk production of PE dairy goats and reduced enteric methane emission, but its effectivity was reduced in combination with calliandra.

  6. An evaluation of the Cortrak Enteral access system in our intensive care.

    LENUS (Irish Health Repository)

    Dolan, A M

    2012-05-01

    Appropriate nutrition is considered a cornerstone of Intensive care; however its successful initiation is frequently impeded by decreased gastric emptying secondary to opiates, sepsis, or ileus. The presence of a postpyloric tube will guarantee delivery of calories while reducing the incidence of reflux and aspiration. Enteral nutrition is approximately 100 fold cheaper than parenteral nutrition. A nasojejunal tube may be placed blindly (success 15%), by direct vision with a gastroscope, or under fluoroscopic guidance in the X-ray department. This study examines the use of the Cortrak Enteral access system (CEAS) in placement of nasojejunal tubes, a method facilitated by the use of an electromagnet. A retrospective review was conducted to evaluate the effectiveness of the CEAS for establishing nasojejunal feeding in the Intensive Care Unit (ICU) between January and December 2010. Our results found that the CEAS was successful in positioning a nasojejunal tube in ten out of twelve patients (83% success rate). Successful placement was confirmed by portable abdominal \\/ chest x-ray. Placement took an average of 30 minutes, and prokinetic agents were used to facilitate two placements. The duration of successful enteral nutrition varied from 2 to 15 days post placement. The CEAS is a simple bedside tool for placing postpyloric tubes. While there is a learning curve associated with its use, it may confer significant benefits to individual patients and also to those responsible for ever shrinking budgets.

  7. Trends in breastfeeding and complementary feeding practices in Pakistan, 1990-2007

    Directory of Open Access Journals (Sweden)

    Hanif Hafsa

    2011-10-01

    Full Text Available Abstract Background Breastfeeding and complementary feeding practices have profound implications for the maternal and child health status of a society. Feeding practices in Pakistan are suboptimal, leading to adverse outcomes on child health. In Pakistan, the Maternal, Neonatal and Child Health (MNCH Program, in collaboration with several international organizations, including WHO and UNICEF, is working to improve these feeding practices in the country. The aim of this paper is to evaluate the effectiveness of these programs. Methods Estimates on the various indicators for infant and young child feeding proposed by WHO were analyzed in light of the Pakistan Demographic and Health Surveys (1990-91 and 2006-07 and several other national studies conducted since 1995. Results Nearly half the core and optional indicators have improved over the years, though modestly; the others have demonstrated no statistically significant improvement over the years. Of the five indicators required in the WHO tool for the assessment of infant and young child feeding, introduction of complementary foods, bottle-feeding, and early initiation of breastfeeding, stand in the poor category, while exclusive breastfeeding and duration of breastfeeding fall in the fair category, suggesting an overall poor status. Conclusions There is considerable scope to improve breastfeeding and complementary feeding in Pakistan. Further programs should focus on improving the following indicators that have shown no significant development: early initiation of breastfeeding, exclusive breastfeeding under six months, continued breastfeeding at two years, age appropriate feeding, and bottle feeding. Effective implementation of interventions that are known to improve breastfeeding practices is imperative, as is further research to yield data that can lead future endeavors.

  8. Attitudes and education of pediatric house staff concerning breast-feeding.

    Science.gov (United States)

    Freed, G L; Jones, T M; Fraley, J K

    1992-05-01

    Pediatricians are expected to offer information and advice on breast-feeding to expectant and lactating mothers, but the educational experience for pediatric residents may not adequately prepare them for this responsibility. To examine knowledge and confidence regarding breast-feeding gained by pediatric house staff during their residency, a survey was administered to pediatric residents in a large, hospital-based training program. Of 108 program residents, 87 (81%) participated. Forty-one percent of the respondents were postgraduate level I (PL-I), 29% were PL-II, and 30% were PL-III. There was no evidence that PL-III residents were more competent or comfortable with routine breast-feeding counseling or intervention than their PL-I counterparts. Residents who had breast-fed, those with spouses who had breast-fed, and those with children of their own had the greatest knowledge and confidence base in several areas, such as their ability to teach breast-feeding techniques and to treat cracked nipples. They were also more familiar with different types of breastpumps. There were no significant differences among those who were or were not breast-fed as a child nor among men versus women. Residency programs must provide comprehensive education on breast-feeding to prepare future pediatricians to meet the needs of patients and their parents.

  9. A pacifier-activated music player with mother's voice improves oral feeding in preterm infants.

    Science.gov (United States)

    Chorna, Olena D; Slaughter, James C; Wang, Lulu; Stark, Ann R; Maitre, Nathalie L

    2014-03-01

    We conducted a randomized trial to test the hypothesis that mother's voice played through a pacifier-activated music player (PAM) during nonnutritive sucking would improve the development of sucking ability and promote more effective oral feeding in preterm infants. Preterm infants between 34 0/7 and 35 6/7 weeks' postmenstrual age, including those with brain injury, who were taking at least half their feedings enterally and less than half orally, were randomly assigned to receive 5 daily 15-minute sessions of either PAM with mother's recorded voice or no PAM, along with routine nonnutritive sucking and maternal care in both groups. Assignment was masked to the clinical team. Ninety-four infants (46 and 48 in the PAM intervention and control groups, respectively) completed the study. The intervention group had significantly increased oral feeding rate (2.0 vs. 0.9 mL/min, P improves oral feeding skills in preterm infants without adverse effects on hormonal stress or growth.

  10. Does the diurnal pattern of enteric methane emissions from dairy cows change over time?

    Science.gov (United States)

    Bell, M J; Craigon, J; Saunders, N; Goodman, J R; Garnsworthy, P C

    2018-02-22

    Diet manipulation and genetic selection are two important mitigation strategies for reducing enteric methane (CH4) emissions from ruminant livestock. The aim of this study was to assess whether the diurnal pattern of CH4 emissions from individual dairy cows changes over time when cows are fed on diets varying in forage composition. Emissions of CH4 from 36 cows were measured during milking in an automatic (robotic) milking station in three consecutive feeding periods, for a total of 84 days. In Periods 1 and 2, the 36 cows were fed a high-forage partial mixed ration (PMR) containing 75% forage, with either a high grass silage or high maize silage content. In Period 3, cows were fed a commercial PMR containing 69% forage. Cows were offered PMR ad libitum plus concentrates during milking and CH4 emitted by individual cows was sampled during 8662 milkings. A linear mixed model was used to assess differences among cows, feeding periods and time of day. Considerable variation was observed among cows in daily mean and diurnal patterns of CH4 emissions. On average, cows produced less CH4 when fed on the commercial PMR in feeding Period 3 than when the same cows were fed on high-forage diets in feeding Periods 1 and 2. The average diurnal pattern for CH4 emissions did not significantly change between feeding periods and as lactation progressed. Emissions of CH4 were positively associated with dry matter (DM) intake and forage DM intake. It is concluded that if the management of feed allocation remains constant then the diurnal pattern of CH4 emissions from dairy cows will not necessarily alter over time. A change in diet composition may bring about an increase or decrease in absolute emissions over a 24-h period without significantly changing the diurnal pattern unless management of feed allocation changes. These findings are important for CH4 monitoring techniques that involve taking measurements over short periods within a day rather than complete 24-h observations.

  11. Greenhouse gas emissions from the enteric fermentation and manure storage of dairy and beef cattle in China during 1961–2010

    International Nuclear Information System (INIS)

    Gao, Zhiling; Lin, Zhi; Yang, Yuanyuan; Ma, Wenqi; Liao, Wenhua; Li, Jianguo; Cao, Yufeng; Roelcke, Marco

    2014-01-01

    Due to the expanding dairy and beef population in China and their contribution to global CH 4 and N 2 O budgets, a framework considering changes in feed, manure management and herd structure was established to indicate the trends of CH 4 and N 2 O emissions from the enteric formation and manure storage in China's beef and dairy production and the underlying driving forces during the period 1961–2010. From 1961 to 2010, annual CH 4 and N 2 O emissions from beef cattle in China increased from 2.18 Mt to 5.86 Mt and from 7.93 kt–29.56 kt, respectively, while those from dairy cattle increased from 0.023 to 1.09 Mt and 0.12 to 7.90 kt, respectively. These increases were attributed to the combined changes in cattle population and management practices in feeds and manure storage. Improvement in cattle genetics during the period increased the bodyweight, required dry matter intake and gross energy and thus resulted in increased enteric CH 4 EFs for each category of beef and dairy cattle as well as the overall enteric EFs (i.e., Tier 1 in IPCC). However, for beef cattle, such an impact on the overall enteric EFs was largely offset by the herd structure transition from draft animal-oriented to meat animal-oriented during 1961–2010. Although the CO 2 -eq of CH 4 and N 2 O from manure storage was less than the enteric emissions during 1961–2010 in China, it tended to increase both in beef and dairy cattle, which was mainly driven by the changes in manure management practices. - Highlights: • CH 4 emissions dominated the CO 2 -eq emissions from dairy and beef cattle in China. • Beef herd transition played an important role in CH 4 emissions. • Changes of manure managements increased the manure EFs of CH 4 and N 2 O. • Manure contributed very less to the total CO 2 -eq emissions but tended to grow

  12. Perspectives of volunteers in emergency feeding programs on hunger, its causes, and solutions.

    Science.gov (United States)

    Edlefsen, Miriam S; Olson, Christine M

    2002-01-01

    To understand the social beliefs of volunteers in emergency feeding programs (EFPs) regarding hunger and whether volunteer experiences broadened understanding of hunger. An interpretivist paradigm and qualitative methods were used. Seventeen volunteers were recruited and interviewed from three EFPs. Interviews were analyzed using the constant comparative method. Volunteering in EFPs increased volunteers' awareness of the prevalence of hunger in their communities. More involved volunteers had a greater understanding of the life situations of the hungry. The volunteers felt that increasing self-sufficiency and private responses were appropriate solutions to hunger. The volunteers' attitudes and social beliefs were similar to those of the general public. Interventions that facilitate interaction between volunteers and clients, promote reflection on volunteer experiences, and provide alternative viewpoints on poverty are needed to broaden volunteers' understanding of hunger and food insecurity.

  13. Understanding the Concept of Food Sovereignty Using the Ghana School Feeding Program

    NARCIS (Netherlands)

    Quaye, W.; Ruivenkamp, G.T.P.; Frempong, G.; Essegbey, G.

    2010-01-01

    This article deepens the understanding of the emerging food sovereignty concept using a case study of a home-grown school feeding programme that promotes local food demand - supply linkages. A school feeding programme in four selected districts in Ghana is analysed with respect to community

  14. Seawater feed reverse osmosis preheating appraisal, Part I: leading element performance

    International Nuclear Information System (INIS)

    Karameldin, A.; Saadawy, M.S.

    2006-01-01

    This paper is concerned with the seawater reverse osmosis preheating process, and presents a parametric study of the process. The basic transport equations describing the leading element are exhibited and appraised. The leading element, which governs the whole system performance, is studied and analysed. The incorporated and investigated operating parameters are the feed pressure and the temperature for different feed salt concentrations. In addition, different feed flow rates, effects on permeate flux and permeator salt rejection, together with the permeator recovery, are studied. A seawater membrane of a well-known data, for instance FT30SW380HR, is used to perform the study. The membrane water permeability coefficient K w is determined and correlated. Furthermore, the membrane salt permeability coefficient K s from the manufacturer system analysis program (ROSA) is given and discussed. The transport governing equations are programmed in a way that facilitates the achievement of a realistic parametric study. The results showed that the permeate flux increases significantly as the feed pressure increases. Also, it increases significantly as the feed salt concentration decreases, and also as the feed temperature and pressure increase. Meanwhile, the permeator salt rejection increases significantly as the feed pressure increases, and decreases significantly as the feed temperature increases. The study of the leading element of the array showed that there are constraints that must be considered, such as maximum membrane flux, maximum applied feed pressure, maximum feed flow rate and maximum feed temperature. Therefore, to attain the maximum membrane flux, the applied feed pressure must be lowered when the feed temperature is increased. In the case where the feed temperature is increased from 18 deg.. C to 45 deg.. C, a pressure saving of between 7% and 26% is achieved, according to the feed salt concentration and feed flow rate. (author)

  15. Erythromycin for Promoting the Postpyloric Placement of Feeding Tubes: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Qing-Jun Jiang

    2018-01-01

    Full Text Available Background. Critically ill patients can benefit from enteral nutrition with postpyloric feeding tubes, but the low success rate limits its wide use. Erythromycin could elevate the success rate of tube insertion, but its clinical efficiency still remains controversial. Methods. Included studies must be RCTs which assessed the success rate of postpyloric feeding tube insertion using erythromycin. Results. 284 patients were enrolled in six studies. Meta-analysis showed that erythromycin significantly increases the rate of successful postpyloric feeding tube placement (RR 1.45, 95% CI (1.12, 1.86 and did not increase the risk of adverse effects (RR 2.15, 95% CI (0.20, 22.82. Subgroup analysis showed that unweighted feeding tubes (RR 1.47, 95% CI (1.03, 2.11 could significantly increase the success rate. Country of study, intravenous route of erythromycin, and year of participant enrollment did not influence these results. Conclusions. Erythromycin significantly increases the success rate of postpyloric feeding tube placement. This suggests that erythromycin can be used as an auxiliary method to improve the success rate of bedside insertion.

  16. Qualidade microbiológica e temperatura de dietas enterais antes e após implantação do sistema de análise de perigos e pontos críticos de controle Microbiological quality and temperatures of enteral feedings before and after implementation of hazard analysis and critical control point

    Directory of Open Access Journals (Sweden)

    Miriam Isabel Souza dos Santos Simon

    2007-04-01

    Full Text Available OBJETIVOS: Avaliar a qualidade microbiológica e a temperatura de dietas enterais antes e após a implementação do sistema Análise de Perigos e Pontos Críticos de Controle na Central de Produção de Alimentação Enteral do Hospital de Clínicas de Porto Alegre. MÉTODOS: Durante o período de setembro de 2001 a janeiro de 2002, foram coletadas 320 amostras de 4 tipos de dietas enterais produzidas na Central de Produção de Alimentação Enteral (dietas padrão I, II, III e dieta especial, as quais foram submetidas a análises microbiológicas e de temperatura. As amostras foram coletadas semanalmente em dois pontos do processo: logo após o preparo e após 16 horas de armazenamento refrigerado. Para comparação dos dados pré e pós análise dos perigos em pontos criticos e de controle, utilizou-se o teste "t" de Wilcoxon para amostras pareadas (teste não-paramétrico equivalente ao teste "t" de Student para amostras pareadas com nível de significância de 0,05. RESULTADOS: Antes da análise de perigos e pontos críticos de controle, 92% das temperaturas de armazenamento estavam acima dos valores de refererência vigentes. Após a implantação da análise de perigos e pontos críticos de controle, houve reduções significantes (pOBJECTIVE: This study evaluated microbiological quality and temperature of enteral formulas before and after the implementation of the Hazard Analysis Critical Control Points system at the Central of Enteral Feedings of Hospital de Clínicas de Porto Alegre. METHODS: During the period of September 2001 and January 2002, 320 samples of four kinds of enteral feeding identified as diets I, II, III, and Special diet were collected and submitted to temperature and microbiological analysis. Samples were collected weekly in two steps of the flow chart of production: immediately after preparation and after 16 hours of storage at refrigeration. For statistical analysis, the Wilcoxon's test was used. RESULTS: Before

  17. Nutrition accesses among patients receiving enteral treatment in the home environment.

    Science.gov (United States)

    Sznajder, Janusz; Ślefarska-Wasilewska, Marta; Wójcik, Piotr

    2017-10-31

    Enteral feeding in the home environment is connected with creating access to digestive tract, and thanks to that, this kind of treatment is possible. The gold standard in enteral nutrition is PEG, other types of access are: nasogastric tube, gastronomy and jejunostomy. In the article 851 patients who were treated nutritionally in the home environment, in the nutrition clinic, Nutrimed Górny Śląsk, were analyzed. It was described how, in practice, the schedule of nutrition access looks like in the nutrition clinic at a time of qualifying patients to the treatment (PEG 47,35%, gastronomy 18,91%, nasogastric tube 17,39%,jejunostomy 16,33%) and how it changes among patients treated in the nutrition clinic during specific period of time - to the treatment there were qualified patients with at least three-month period of therapy ( second evaluation: PEG 37,01%, gastrostomy 31,13%, nasogastric tube 16,98%, jejunostomy 15,86%). The structure of changes was described, also the routine and the place in what exchanging or changing nutrition access was analyzed. The biggest changes in quantity, among all groups of ill people concerned patients with PEG and gastronomy. In most cases the intervention connected with exchanging access to the digestive tract could be implemented at patient's home.

  18. Impacts of Nutrition and Feeding Programs on Farmers’ Management Decisions Affecting the Success of Dairy Farms with Culture Breed Cattle

    Directory of Open Access Journals (Sweden)

    Yavuz Topcu

    2016-02-01

    Full Text Available The aim of the study is to evaluate all the factors determining the milk production and yield decisions with regard to the nutrition and feeding programs affecting the integrated management strategies on the success of the dairy farms with culture breed cattle under the pasture-based and indoor barn-based production systems. For these aims, data obtained from the individual interviews conducted at the dairy farms with 100 culture breed cattle were used for Principal Component and Multiple Regression Analyses. The results of the study highlighted that while there were linear positive relationships among liquid assets of farms value, concentrate feed and fodder intake of dairy cattle, milk sale price, forage crop support, additional feeding and their types at pasture and milk yields per dairy cattle at the dairy farms; there were inverse relationships among hay intake of dairy cattle, lactation period, pasture planning, culture breed cattle support and those. The farmers could increase the successes of the dairy farms by increasing the technical and economic effectiveness under the integrated management pattern approaches at those with culture breed cattle.

  19. Identifying cost-minimizing strategies for guaranteeing target dairy income over feed cost via use of the Livestock Gross Margin dairy insurance program.

    Science.gov (United States)

    Valvekar, M; Cabrera, V E; Gould, B W

    2010-07-01

    Milk and feed price volatility are the major source of dairy farm risk. Since August 2008 a new federally reinsured insurance program has been available to many US dairy farmers to help minimize the negative effects of adverse price movements. This insurance program is referred to as Livestock Gross Margin Insurance for Dairy Cattle. Given the flexibility in contract design, the dairy farmer has to make 3 critical decisions when purchasing this insurance: 1) the percentage of monthly milk production to be covered, 3) declared feed equivalents used to produce this milk, and 3) the level of gross margin not covered by insurance (i.e., deductible). The objective of this analysis was to provide an optimal strategy of how a dairy farmer could incorporate this insurance program to help manage the variability in net farm income. In this analysis we assumed that a risk-neutral dairy farmer wants to design an insurance contract such that a target guaranteed income over feed cost is obtained at least cost. We undertook this analysis for a representative Wisconsin dairy farm (herd size: 120 cows) producing 8,873 kg (19,545 lb) of milk/cow per year. Wisconsin statistical data indicates that dairy farms of similar size must require an income over feed cost of at least $110/Mg ($5/cwt) of milk to be profitable during the coverage period. Therefore, using data for the July 2009 insurance contract to insure $110/Mg of milk, the least cost contract was found to have a premium of $1.22/Mg ($0.055/cwt) of milk produced insuring approximately 52% of the production with variable monthly production covered during the period of September 2009 to June 2010. This premium represented 1.10% of the desired IOFC. We compared the above optimal strategy with an alternative nonoptimal strategy, defined as a contract insuring the same proportion of milk as the optimal (52%) but with a constant amount insured across all contract months. The premium was found to be almost twice the level obtained

  20. Effects of a combination of feed additives on methane production, diet digestibility, and animal performance in lactating dairy cows

    NARCIS (Netherlands)

    Zijderveld, van S.M.; Fonken, B.C.J.; Dijkstra, J.; Gerrits, W.J.J.; Perdok, H.B.; Fokkink, W.B.; Newbold, J.R.

    2011-01-01

    Two experiments were conducted to assess the effects of a mixture of dietary additives on enteric methane production, rumen fermentation, diet digestibility, energy balance, and animal performance in lactating dairy cows. Identical diets were fed in both experiments. The mixture of feed additives

  1. Effect of herbal medicine daikenchuto on oral and enteral caloric intake after liver transplantation: A multicenter, randomized controlled trial.

    Science.gov (United States)

    Kaido, Toshimi; Shinoda, Masahiro; Inomata, Yukihiro; Yagi, Takahito; Akamatsu, Nobuhisa; Takada, Yasutsugu; Ohdan, Hideki; Shimamura, Tsuyoshi; Ogura, Yasuhiro; Eguchi, Susumu; Eguchi, Hidetoshi; Ogata, Satoshi; Yoshizumi, Tomoharu; Ikegami, Toshihiko; Yamamoto, Michio; Morita, Satoshi; Uemoto, Shinji

    2018-03-20

    Postoperative early oral or enteral intake is a crucial element of the Enhanced Recovery After Surgery (ERAS) protocol. However, normal food intake or enteral feeding cannot be started early in the presence of coexisting bowel dysfunction in patients undergoing liver transplantation (LT). The aim of this multicenter, randomized, double-blinded, placebo-controlled trial was to determine the enhancement effects of the Japanese herbal medicine Daikenchuto (DKT) on oral/enteral caloric intake in patients undergoing LT. A total of 112 adult patients undergoing LT at 14 Japanese centers were enrolled. The patients were randomly assigned to receive either DKT or placebo from postoperative day (POD) 1 to 14. The primary endpoints were total oral/enteral caloric intake, abdominal distension, and pain on POD 7. The secondary endpoints included sequential changes in total oral/enteral caloric intake after LT, and portal venous flow volume and velocity in the graft. A total of 104 patients (DKT, n = 55; placebo, n = 49) were included in the analyses. There were no significant differences between the two groups in terms of primary endpoints. However, postoperative total oral/enteral caloric intake was significantly accelerated in the DKT group compared with the placebo group (P = 0.023). Moreover, portal venous flow volume (POD 10, 14) and velocity (POD 14) were significantly higher in the DKT group than in the placebo group (P = 0.047, P = 0.025, P = 0.014, respectively). Postoperative administration of DKT may enhance total oral/enteral caloric intake and portal venous flow volume and velocity after LT and favorably contribute to the performance of the ERAS protocol. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. [Enteral nutrition in patients with ulcerative and postburn cicatrix strictures of the esophagus and stomach outcome region].

    Science.gov (United States)

    Abakumov, M M; Kostiuchenko, L N

    2009-01-01

    Decompensated cicatrices stricture of upper alimentary canal is a complex disease clinically presenting a high mechanical blocking and leads to expressed abnormality of homeostasis, which requires its pathogenetic correction of urgency evidence. The greatest difficulty is correct protein-energy malnutrition and water-electrolyte metabolism. Prior to the imposition of stoma for feeding should begin immediately with standard parenteral nutrition solutions. In a subsequent it is nessesary to resort more physiologecal tube alimentasion. As with esophageal postambustion stricture electrical activity of the stomach inhibiting and in essentially remains small bowel function, preference should be given to ways of enteral threpsology support. This can be used as a balanced composition in breeding (primary breeding should be 1: 2) and special blends for intraintestinal alimentation (close chyme on line carrying the major components). In the case of postambustion struck of outlet termination stomach department when identified violations of the underlying functions of the digestive canal division, rational come to gentle tactics of enteral alimentation using mixtures, completely similar in composition to himus. At stricture janitor ulcer genesis appropriate tactics is enteral correction, similar to that used in the event of postambustion strictures of the zones when bowel function is largely preserved.

  3. Chlamydia prevalence trends among women and men entering the National Job Training Program from 1990 through 2012.

    Science.gov (United States)

    Learner, Emily R; Torrone, Elizabeth A; Fine, Jason P; Pence, Brian W; Powers, Kimberly A; Miller, William C

    2018-01-26

    Evaluating chlamydia prevalence trends from sentinel surveillance is important for understanding population disease burden over time. However, prevalence trend estimates from surveillance data may be misleading if they do not account for changes in risk profiles of individuals who are screened (case mix) and changing performance of the screening tests used. We analyzed chlamydia screening data from a sentinel surveillance population of 389,555 young women (1990-2012) and 303,699 young men (2003-2012) entering the US National Job Training Program. This period follows the introduction of national chlamydia screening programs designed to prevent transmission and reduce population disease burden. After ruling out bias due to case mix, we used an expectation-maximization based maximum likelihood approach to account for measurement error from changing screening tests, and generated minimally-biased long-term chlamydia prevalence trend estimates among youth and young adults in this sentinel surveillance population. Adjusted chlamydia prevalence among women was high throughout the study period, but fell from 20% in 1990 to 12% in 2003, and remained between 12% and 14% through 2012. Adjusted prevalence among men was steady throughout the study period at approximately 7%. For both women and men, adjusted prevalence was highest among Black and American Indian youth and young adults, and in the Southern and Midwestern regions of the US throughout the study period. Our minimally-biased trend estimates provide support for an initial decrease in chlamydia prevalence among women soon after the introduction of national chlamydia screening programs. Constant chlamydia prevalence in more recent years suggests that screening may not be sufficient to further reduce chlamydia prevalence among high-risk youth and young adults.

  4. Enhancement of resistance to coccidiosis and necrotic enteritis in broiler chickens by dietary muscadine pomace.

    Science.gov (United States)

    McDougald, L R; Hofacre, C; Mathis, G; Fuller, L; Hargrove, J L; Greenspan, P; Hartle, D K

    2008-12-01

    Muscadine pomace (MP), a by-product of the production of wine and juice from Vitis rotundifolia, was dried and tested in chickens for effects on primary resistance to coccidiosis, development of protective immunity after vaccination with live coccidia, and resistance to necrotic enteritis (NE) caused by the joint action of Clostridium perfringens and coccidia. To test primary resistance to coccidiosis, 2-wk-old chicks were given 2% or 5% MP in the diet and inoculated with Eimeria acervulina and E. maxima. Birds given MP at either level had significantly (P chickens were given 2% or 5% MP and grown to 42 days to test the palatability of MP. Birds given 2% MP in feed grew similarly to untreated controls, but birds given 5% had poorer average live weight. This suggested a negative effect on feed intake at the higher level. The effects of dietary 0.5% or 2.0% MP on immune protection were tested after live coccidiosis vaccination in the hatchery. Chicks were removed from each pen at 21 days of age and challenged with E acervulina, E. maxima, and E. tenella. Resistance to infection was improved by MP as suggested by significantly (P chickens. Chicks were inoculated with live coccidia at 14 days of age and dosed orally with live cultures of C perfringens on day 19, day 20, and day 21. Enteritis caused 48% mortality in the first study and 67% mortality in the second study. Dietary MP at 0.5-2.0% significantly (P chickens.

  5. Substance P immunoreactivity in the enteric nervous system in Rett syndrome.

    Science.gov (United States)

    Deguchi, K; Reyes, C; Chakraborty, S; Antalffy, B; Glaze, D; Armstrong, D

    2001-12-01

    Rett syndrome is associated with profound mental retardation and motor disability in girls. It has a characteristic clinical phenotype which includes abnormalities of the autonomic nervous system. Feeding impairment and severe constipation are two symptoms of this autonomic dysfunction. Substance P, an important peptide in the autonomic nervous system, is decreased in the cerebrospinal fluid of Rett syndrome. We have demonstrated that substance P immunoreactivity is significantly decreased in Rett syndrome brain-stem and may be related to the autonomic dysfunction. In this study, we have continued the investigation of substance P in the enteric nervous system. We immunohistochemically examined the normal developing bowel in 22 controls (ages, 14 gestational weeks to 31 years) using formalin fixed tissue, with antibodies to substance P, tyrosine hydroxylase and vasoactive intestinal peptide. We compared the immunoreactivity of normal controls with 14 cases of Rett syndrome (ages, 5-41 years) and observed that the expression of substance P, tyrosine hydroxylase and vasoactive intestinal peptide immunoreactivity in the bowel in Rett syndrome was not significantly different from that of controls. This suggests that the feeding impairment and constipation in Rett syndrome relate to dysfunction of the autonomic nervous system originating outside of the bowel, in the brain-stem, as suggested by our previous study.

  6. School farming for school feeding: experiences from Nakuru, Kenya

    Directory of Open Access Journals (Sweden)

    Dick Foeken

    2010-11-01

    Full Text Available School feeding is an important development tool and is related to at least three Millennium Development Goals. School farming has been largely overlooked in the urban agriculture literature but with many parents nowadays unable to afford school lunches for their children, it can play a vital role in reducing the costs involved in providing nutritional meals for pupils. This paper examines school farming in an urban setting, namely Nakuru town, Kenya and looks at the current practice, the extent to which school farming contributes to school feeding programs, and the challenges it faces and how these can be overcome. Based on a survey done in almost all primary and secondary schools in Nakuru, it shows that school farming and school feeding are now common practice in the town and that in many cases school farming does indeed contribute to school feeding programs. However, much more is possible and the paper indicates how various constraints in terms of land, water, support and leadership might be overcome.

  7. Observance of who ten steps towards successful breast feeding; a survey from postpartum mothers

    International Nuclear Information System (INIS)

    Masood, S.; Rahman, M.U.; Mahmood, H.; Faisal, T.; Maroof, S.; Qureshi, A.M.

    2016-01-01

    Background: Breast feeding is a physiological phenomenon, nonetheless, this act is a learned behaviour that requires continuous active support to make it successful. This study determines the frequency of mothers practicing successful breast feeding according to the WHO ten steps at tertiary care hospital. Methods: A descriptive cross sectional study was conducted in the Obstetrics department of Military Hospital, Rawalpindi over six month duration from July to December 2014. Booked mothers aged 15-49 years, having given birth to healthy, singleton baby were included in the study. Questions were asked after taking written informed consent from the mothers after delivery. Data was entered and analysed on SPSS version 20. Results: Out of 148 mothers, 35 (23.7 percentage) mothers were following successful breast feeding, i.e., knew 7 or more steps. A total of 100 (67.6 percentage) mothers received support for breast feeding by healthcare staff during their stay in hospital while 19 (12.8 percentage) mothers started breast feeding within one hour. About 71 percentage had started formula milk along with breast feeding. About 127 (85.8 percentage) reported that they fed their children on demand and 144 (97.3 percentage) did not use dummies. Statistically significant difference was observed as housewife mothers gave no top feed (p=0.005) and multiparous mothers started breast feeding within one hour of delivery (p=0.04). Conclusion: The steps to achieve successful breast feeding are followed to a small extent among mothers. Delayed initiation of breast feeding and increasing trend towards use of formula feed was observed. Employed, primiparous mothers are the most sensitive group to be focused during antenatal period. (author)

  8. Method of measuring the mass flow rate of a substance entering a cocurrent fluid stream

    International Nuclear Information System (INIS)

    Cochran, H.D. Jr.

    1978-01-01

    An improved method of monitoring the mass flow rate of a substance entering a coherent fluid stream is described. The method very basically consists of heating equal sections of the fluid stream above and below the point of entry of the substance to be monitored, and measuring and comparing the resulting change in temperature of the sections. Advantage is taken of the difference in thermal characteristics of the fluid and the substance to be measured to correlate temperature differences in the sections above and below the substance feed point for providing an indication of the mass flow rate of the substance

  9. Enteral nutrition - child - managing problems

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000164.htm Enteral nutrition - child - managing problems To use the sharing features ... trouble breathing, call 911. References Mcclave SA. Enteral nutrition. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

  10. Radiation enteritis

    International Nuclear Information System (INIS)

    Ochsner, S.F.; Head, L.H.

    1973-01-01

    A comprehensive review of radiation enteritis is presented. Experience in clinical radiation therapy has indicated that the small bowel is the segment of the alimentary tract that is most susceptible to radiation damage. (U.S.)

  11. Enteric Methane Emission from Pigs

    DEFF Research Database (Denmark)

    Jørgensen, Henry; Theil, Peter Kappel; Knudsen, Knud Erik Bach

    2011-01-01

    per kg meat produced is increased (Fernández et al. 1983; Lekule et al. 1990). The present chapter will summarise our current knowledge concerning dietary and enteric fermentation that may influence the methane (CH4) emission in pigs. Enteric fermentation is the digestive process by which.......3 % of the worlds pig population. The main number of pigs is in Asia (59.6 %) where the main pig population stay in China (47.8 % of the worlds pig population). The objective of the chapter is therefore: To obtain a general overview of the pigs’ contribution to methane emission. Where is the pigs’ enteric gas...... produced and how is it measured. The variation in methane emission and factors affecting the emission. Possibility for reducing the enteric methane emission and the consequences....

  12. Recent developments in the Sandia Laboratories' sewage sludge irradiation program

    International Nuclear Information System (INIS)

    Sivinski, H.D.; Brandon, J.R.; Morris, M.E.; Neuhauser, K.S.; Ward, R.L.; McCaslin, B.; Smith, G.S.

    1977-11-01

    Pathogen reduction studies have shown that a 1 Mrad treatment (or less at elevated temperatures) is very effective in eliminating pathogenic bacteria and viable parasite ova in liquid sludges. Heat is effective in reducing levels not only of pathogenic bacteria and Ascaris ova, but viruses as well. Ammonia has been shown to be virucidal to poliovirus and several other enteric viruses. Sludge processing costs are seen to be marginally competitive with heat treatment for liquid sludges and relatively economical for composted or dried sludges. Physical/chemical effects studies have shown that the effects of irradiation of sludges on dewatering properties are not significant when compared to polymers, nor is the combined effect synergistic. Dried, irradiated undigested sludge has been shown to be of significant nutritional value when used as a feed supplement for sheep and cattle, as well as in agronomic uses. No significant harmful effects have been demonstrated in the feeding program thus far. Product enhancement studies are currently under way, including schemes for removing nitrogen from effluent streams for addition as ammonium salts to sludges

  13. The feeding route after esophagectomy : A review of literature

    NARCIS (Netherlands)

    Berkelmans, Gijs H K; van Workum, Frans; Weijs, Teus J.; Nieuwenhuijzen, Grard Ap; Ruurda, Jelle P.; Kouwenhoven, Ewout A; van Det, Marc J; Rosman, Camiel; van Hillegersberg, Richard; Luyer, Misha Dp

    2017-01-01

    Enhanced recovery programs effectively optimize perioperative care and reduce postoperative morbidity. In esophagectomy, several components of the ERAS program are successfully introduced. However, timing and type of postoperative feeding remain a matter of debate. Adequate nutritional support is

  14. Totally laparoscopic feeding jejunostomy – a technique modification

    Directory of Open Access Journals (Sweden)

    Maciej Bobowicz

    2011-12-01

    Full Text Available In oncological patients with upper gastrointestinal tract tumours, dysphagia and cachexy necessitate gastrostomy orjejunostomy as the only options of enteral access for long-term feeding. In this article the authors describe a modifiedtechnique of laparoscopic feeding jejunostomy applied during the staging laparoscopy. A 48-year-old male patient withgastroesophageal junction tumour and a 68-year-old male patient with oesophageal tumour were operated on usingthe described technique. Exploratory laparoscopy was performed. Then the feeding jejunostomy was made usinga Cystofix® TUR catheter. The jejunum was fixed to the abdominal wall with four 2.0 Novafil™ transabdominal stitches.Two additional sutures were placed caudally about 4 cm and 8 cm from the jejunostomy, aiming at prevention ofjejunal torsion. Total operating time was 45 min. There was no blood loss. There were no intraoperative complications.The only adverse event was one jejunostomy wound infection that responded well to oral antibiotics. There were nomortalities. The described technique has most of the benefits of laparoscopic feeding jejunostomy with some stepsadded from the open operation making the procedure easier to perform as part of a staging operation with a relativelyshort additional operating time. The proposed transabdominal stitches make the technique easier to apply. Two additional‘anti-torsion sutures’ prevent postoperative volvulus. Use of the Cystofix catheter allows easy introduction of thecatheter into the peritoneal cavity and the jejunal lumen, providing a good seal at the same time. Further studies onlarger groups of patients are required to assess long-term outcomes of the proposed modified technique.

  15. Medium-chain triglyceride-rich enteral nutrition is more effective than low-fat enteral nutrition in rat colitis, but is equal in enteritis.

    Science.gov (United States)

    Tsujikawa, T; Ohta, N; Nakamura, T; Yasuoka, T; Satoh, J; Fukunaga, T; Itohi, A; Uda, K; Ihara, T; Andoh, A; Sasaki, M; Fujiyama, Y; Bamba, T

    2001-10-01

    Although enteral nutrition (EN) therapy for Crohn's disease has been confirmed to be as effective as steroid therapy, the precise mechanism responsible for the effects of EN remains unclear, although some of the therapeutic effects of EN are believed to be due to a low dietary fat content. In order to elucidate the influence of fat in EN, it is important to investigate not only the quantity of fat, but also the source of the fat. We compared two enteral nutritional formulae: Elental (Ajinomoto) (elemental diet; ED), which contains only 1.5% fat, provided as long-chain triglycerides (LCT), versus Twinline (Snow Brand Milk Products) (TL), which contains a high percentage of fat (20.4%), provided mainly as medium-chain triglycerides (MCT). These formulae were tested on rat enteritis and rat colitis induced by trinitrobenzene sulfonic acid (TNBS). Both ED and TL reduced the manifestations of enteritis. TL had a stronger anti-inflammatory effect than ED for colitis. TL also had nutritional advantages as compared with ED, as shown by the total serum protein in the TL group being significantly higher than that in the ED group. The results indicate that intraluminal MCT is suitable as a fat energy source during intestinal inflammation in rats. We suggest that Twinline may be more useful to improve nutritional status and to reduce the mucosal inflammation in rat colitis, but that Twinline is equal in effect to Elental for rat enteritis.

  16. Zinc and copper in animal feed - development of resistance and co-resistance to antimicrobial agents in bacteria of animal origin

    OpenAIRE

    Yazdankhah, Siamak; Rudi, Knut; Bernhoft, Aksel

    2014-01-01

    Farmed animals such as pig and poultry receive additional Zn and Cu in their diets due to supplementing elements in compound feed as well as medical remedies. Enteral bacteria in farmed animals are shown to develop resistance to trace elements such as Zn and Cu. Resistance to Zn is often linked with resistance to methicillin in staphylococci, and Zn supplementation to animal feed may increase the proportion of multiresistant E. coli in the gut. Resistance to Cu in bacteria, in particular ente...

  17. Scattering Analysis of a Compact Dipole Array with Series and Parallel Feed Network including Mutual Coupling Effect

    Directory of Open Access Journals (Sweden)

    H. L. Sneha

    2013-01-01

    Full Text Available The current focus in defense arena is towards the stealth technology with an emphasis to control the radar cross-section (RCS. The scattering from the antennas mounted over the platform is of prime importance especially for a low-observable aerospace vehicle. This paper presents the analysis of the scattering cross section of a uniformly spaced linear dipole array. Two types of feed networks, that is, series and parallel feed networks, are considered. The total RCS of phased array with either kind of feed network is obtained by following the signal as it enters through the aperture and travels through the feed network. The RCS estimation of array is done including the mutual coupling effect between the dipole elements in three configurations, that is, side-by-side, collinear, and parallel-in-echelon. The results presented can be useful while designing a phased array with optimum performance towards low observability.

  18. 43 CFR 404.56 - If a financial assistance agreement is entered into for a rural water supply project that...

    Science.gov (United States)

    2010-10-01

    ... entered into for a rural water supply project that benefits more than one Indian tribe, is the approval of... Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Miscellaneous § 404.56 If a financial assistance agreement is entered into for a rural water supply project that...

  19. Economic and environmental effects of providing increased amounts of solid feed to veal calves.

    Science.gov (United States)

    Mollenhorst, H; Berentsen, P B M; Berends, H; Gerrits, W J J; de Boer, I J M

    2016-03-01

    Traditionally, veal calves receive most of their nutrients from milk replacer (MR). Nowadays, however, solid feed (SF; i.e., concentrates and roughages) increasingly substitutes for MR. Studies have shown that providing SF reduces different types of nonnutritive oral behaviors. The objective of this study was to assess the economic and environmental effects of substituting SF for MR in veal calf diets. With respect to environmental effects, we considered the emission of greenhouse gases and land occupation. Substitution rates were based on an experiment in which 160 calves were provided 2 mixtures of SF at 4 levels of dry matter (DM) intake. Mixtures of SF contained either 80% concentrates, 10% corn silage, and 10% straw on DM basis (C80) or 50% concentrates, 25% corn silage, and 25% straw (C50). The 4 levels of SF during the last 17 wk of the fattening period were 20, 100, 180, and 260 kg of DM SF. Additionally, provision of MR was adjusted to achieve equal rates of carcass gain. Substitution rates, representing the SF equivalent needed to substitute for 1 kg of DM MR, were 1.43 kg of DM for C80 and 1.61 kg of DM for C50. Economic effects were assessed based on prices and substitution rates of SF for MR and the possible penalty for carcass color. Environmental effects were assessed based on effects related to the production of feed ingredients, substitution rates, and changes in enteric methane emission and energy use for feed preparation. Costs of feeding SF needed to substitute for 1 kg of DM MR were €0.68 lower for C80 and €0.71 lower for C50, compared with the costs of feeding 1 kg of DM MR. When carcass color scores became too high, however, lower feeding costs were offset by lower revenues from meat. Emissions of greenhouse gases were hardly affected when SF intake was increased. In general, increased enteric methane emission were offset by lower emissions from feed production and energy use. Land occupation increased when intake of SF was increased

  20. Predictors of Enteral Autonomy in Children with Intestinal Failure: A Multicenter Cohort Study.

    Science.gov (United States)

    Khan, Faraz A; Squires, Robert H; Litman, Heather J; Balint, Jane; Carter, Beth A; Fisher, Jeremy G; Horslen, Simon P; Jaksic, Tom; Kocoshis, Samuel; Martinez, J Andres; Mercer, David; Rhee, Susan; Rudolph, Jeffrey A; Soden, Jason; Sudan, Debra; Superina, Riccardo A; Teitelbaum, Daniel H; Venick, Robert; Wales, Paul W; Duggan, Christopher

    2015-07-01

    In a large cohort of children with intestinal failure (IF), we sought to determine the cumulative incidence of achieving enteral autonomy and identify patient and institutional characteristics associated with enteral autonomy. A multicenter, retrospective cohort analysis from the Pediatric Intestinal Failure Consortium was performed. IF was defined as severe congenital or acquired gastrointestinal diseases during infancy with dependence on parenteral nutrition (PN) >60 days. Enteral autonomy was defined as PN discontinuation >3 months. A total of 272 infants were followed for a median (IQR) of 33.5 (16.2-51.5) months. Enteral autonomy was achieved in 118 (43%); 36 (13%) remained PN dependent and 118 (43%) patients died or underwent transplantation. Multivariable analysis identified necrotizing enterocolitis (NEC; OR 2.42, 95% CI 1.33-4.47), care at an IF site without an associated intestinal transplantation program (OR 2.73, 95% CI 1.56-4.78), and an intact ileocecal valve (OR 2.80, 95% CI 1.63-4.83) as independent risk factors for enteral autonomy. A second model (n = 144) that included only patients with intraoperatively measured residual small bowel length found NEC (OR 3.44, 95% CI 1.36-8.71), care at a nonintestinal transplantation center (OR 6.56, 95% CI 2.53-16.98), and residual small bowel length (OR 1.04 cm, 95% CI 1.02-1.06 cm) to be independently associated with enteral autonomy. A substantial proportion of infants with IF can achieve enteral autonomy. Underlying NEC, preserved ileocecal valve, and longer bowel length are associated with achieving enteral autonomy. It is likely that variations in institutional practices and referral patterns also affect outcomes in children with IF. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. AISI/DOE Advanced Process Control Program Vol. 3 of 6: Improved Liquid Steel Feeding for Slab Casters; FINAL

    International Nuclear Information System (INIS)

    Brent Isaacson; Mike Slepian; Thomas Richter

    1999-01-01

    This report describes the development, construction and testing of the Electromagnetic Valve System (EVS), conducted as a project entitled ''Improved Liquid Steel Feeding System for Slab Casters''. This program ran from November 1992 to January 1995. Many of the technical issues in bringing the EVS to the steel industry were identified and resolved during the course of the program. During this time, significant hardware improvements in Westinghouse's electromagnetic valve were made to easily integrate it with existing continuous casting processes,. An improved refractory nozzle was developed and tested which had superior thermal shock and anti-cracking performance. In addition, several trials were conducted with molten steel to verify the proof-of-principle of the electromagnetic valve and its auxiliary equipment. However, improvements in other conventional pouring technologies have greatly diminished the potential value of this project to the steel industry. A such, the program w as canceled by the American Iron and Steel Institute after the conclusion of Phase I

  2. Greenhouse gas emissions from the enteric fermentation and manure storage of dairy and beef cattle in China during 1961–2010

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Zhiling, E-mail: zhilinggao@hotmail.com [College of Resources and Environmental Sciences, Agricultural University of Hebei, 071000 Baoding (China); Lin, Zhi; Yang, Yuanyuan; Ma, Wenqi; Liao, Wenhua [College of Resources and Environmental Sciences, Agricultural University of Hebei, 071000 Baoding (China); Li, Jianguo; Cao, Yufeng [College of Animal Science and Technology, Agricultural University of Hebei, 071000 Baoding (China); Roelcke, Marco [Institute of Geoecology, Technische Universität Braunschweig, 38106 Braunschweig (Germany)

    2014-11-15

    Due to the expanding dairy and beef population in China and their contribution to global CH{sub 4} and N{sub 2}O budgets, a framework considering changes in feed, manure management and herd structure was established to indicate the trends of CH{sub 4} and N{sub 2}O emissions from the enteric formation and manure storage in China's beef and dairy production and the underlying driving forces during the period 1961–2010. From 1961 to 2010, annual CH{sub 4} and N{sub 2}O emissions from beef cattle in China increased from 2.18 Mt to 5.86 Mt and from 7.93 kt–29.56 kt, respectively, while those from dairy cattle increased from 0.023 to 1.09 Mt and 0.12 to 7.90 kt, respectively. These increases were attributed to the combined changes in cattle population and management practices in feeds and manure storage. Improvement in cattle genetics during the period increased the bodyweight, required dry matter intake and gross energy and thus resulted in increased enteric CH{sub 4} EFs for each category of beef and dairy cattle as well as the overall enteric EFs (i.e., Tier 1 in IPCC). However, for beef cattle, such an impact on the overall enteric EFs was largely offset by the herd structure transition from draft animal-oriented to meat animal-oriented during 1961–2010. Although the CO{sub 2}-eq of CH{sub 4} and N{sub 2}O from manure storage was less than the enteric emissions during 1961–2010 in China, it tended to increase both in beef and dairy cattle, which was mainly driven by the changes in manure management practices. - Highlights: • CH{sub 4} emissions dominated the CO{sub 2}-eq emissions from dairy and beef cattle in China. • Beef herd transition played an important role in CH{sub 4} emissions. • Changes of manure managements increased the manure EFs of CH{sub 4} and N{sub 2}O. • Manure contributed very less to the total CO{sub 2}-eq emissions but tended to grow.

  3. Recent developments in the Sandia Laboratories' sewage sludge irradiation program

    Energy Technology Data Exchange (ETDEWEB)

    Sivinski, H.D.; Brandon, J.R.; Morris, M.E.; Neuhauser, K.S.; Ward, R.L.; McCaslin, B.; Smith, G.S.

    1977-11-01

    Pathogen reduction studies have shown that a 1 Mrad treatment (or less at elevated temperatures) is very effective in eliminating pathogenic bacteria and viable parasite ova in liquid sludges. Heat is effective in reducing levels not only of pathogenic bacteria and Ascaris ova, but viruses as well. Ammonia has been shown to be virucidal to poliovirus and several other enteric viruses. Sludge processing costs are seen to be marginally competitive with heat treatment for liquid sludges and relatively economical for composted or dried sludges. Physical/chemical effects studies have shown that the effects of irradiation of sludges on dewatering properties are not significant when compared to polymers, nor is the combined effect synergistic. Dried, irradiated undigested sludge has been shown to be of significant nutritional value when used as a feed supplement for sheep and cattle, as well as in agronomic uses. No significant harmful effects have been demonstrated in the feeding program thus far. Product enhancement studies are currently under way, including schemes for removing nitrogen from effluent streams for addition as ammonium salts to sludges.

  4. Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding.

    Science.gov (United States)

    Hollander, Francis M; de Roos, Nicole M; Belle van Meerkerk, Gerdien; Teding van Berkhout, Ferdinand; Heijerman, Harry G M; van de Graaf, Ed A

    2017-11-01

    Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. This study investigated body weight, body mass index (BMI; calculated as kg/m 2 ), pulmonary function, and the presence of CF-related diabetes before and after the start of ETF. This was a retrospective observational study. Data from 26 adult patients in an outpatient setting who had end-stage CF (19 women) and had been using ETF for at least 6 months between 2000 and 2014 were analyzed. Body weight, BMI, pulmonary function (forced expiratory volume in 1 second as percent of predicted) and incidence of CF-related diabetes from 6 months before to 6 months after starting ETF. Time effects were tested with one-way analysis of variance for data that were normally distributed and the Friedman test for non-parametric data. Correlations were tested with Pearson's r or Spearman's ρ, depending on the distribution of the data. Mean body weight increased by 3.5 kg (95% CI 2.2 to 4.8 kg) after patients started ETF. In women, mean BMI decreased by 0.7 in the 6 months before the start of ETF (PETF to 25% after 6 months (P=0.0013), with similar trends in women and men. There was no correlation between changes in weight and lung function. CF-related diabetes was already present in 12 patients and developed in 1 more patient after the start of ETF. ETF improved body weight and BMI but not pulmonary function in 26 patients with end-stage CF. Clinical outcomes were similar in women and men, but the sample size of men was too small to determine statistical significance. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  5. Retrospective evaluation of the impact of early enteral nutrition on clinical outcomes in dogs with pancreatitis: 34 cases (2010-2013).

    Science.gov (United States)

    Harris, Jessica P; Parnell, Nolie K; Griffith, Emily H; Saker, Korinn E

    2017-07-01

    To evaluate the effect of early enteral nutritional therapy on time to return to voluntary intake, maximum food consumption, incidence of gastrointestinal intolerance (GI), and total hospitalization time for dogs with acute pancreatitis. Retrospective analysis of dogs with pancreatitis at a veterinary teaching hospital between 2010 and 2013. Thirty-four client-owned dogs diagnosed with acute or acute-on-chronic pancreatitis. Medical records of dogs evaluated for inappetence, anorexia, and GI for which a diagnosis of pancreatitis was recorded were reviewed. The time to initiation of food offerings since hospitalization were recorded in addition to signalment, historical medical conditions, chief complaint, physical examination findings, diagnostic results, treatments provided, timing of food offering (within 48 h of hospitalization, early feeding group (EFG) versus delayed feeding group (DFG), diet therapy (low fat versus high fat), caloric intake (% resting energy requirement), incidence of GI (%), and length of hospitalization (LOH) (days). A Clinical Severity Index Score (CSIS) was determined for each patient. Dogs in the EFG demonstrated a decreased time to return of voluntary intake (2.1 days, EFG versus 2.7 days, DFG; P = 0.05) and time (days) to maximum intake (3, EFG versus 3.4 DFG) as compared to the DFG dogs. The DFG exhibited more GI versus EFG irrespective of CSIS grouping (60% versus 26%, P = 0.04). A CSIS ≥ 7 was associated with prolonged LOH (P = 0.004); however, time to initiation of feeding and diet selection did not impact LOH (P = 0.8). Results of the study suggested that feeding within 48 hours of hospitalization for canine pancreatitis has a positive impact on return to voluntary intake and decreases the frequency of GI in these patients, independent of CSIS. The traditional protocol of withholding food during hospitalization may not be necessary nor yield the most benefit for patient recovery; subsequently early enteral refeeding should be

  6. Background and elements of the linkage between the Brazilian school feeding program and family farming.

    Science.gov (United States)

    Schwartzman, Flavia; Mora, Claudia Andrea Rodriguez; Bogus, Claudia Maria; Villar, Betzabeth Slater

    2017-12-18

    Since 2009, legislation of the National School Feeding Program of Brazil (PNAE) institutionalizes its linkage with family farming as it establishes the requirement that at least 30% out of the total financial resources allocated by the federal government to the states and municipalities for school feeding must be used in the purchase of products directly from this sector. This study analyzes the process of drafting this legislation, focusing on the elements related to the procurement from family farming, through a historical contextualization, and it also presents a graphical representation with the main elements of this linkage: its objectives, target population, actions implemented and expected results. Actors involved with the drafting of the legislation were interviewed. The analyses show that the procurement from family farming is a far-reaching initiative in terms of the concept, execution and results. It has also showed that a strong articulation between the actors and institutions of the different sectors involved is critical to its success. The education, agriculture, planning, procurement and civil society sectors should work articulately at national, state and local level. The results of this study demonstrate that initiatives like this, of institutional procurement from family farming, which are currently being implemented in several countries, constitute as an important strategy of food and nutrition security, for the fulfillment of the human right to adequate food and the promotion of long-term sustainable development.

  7. Beneficial uses program. Progress report ending December 31, 1979

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-06-01

    Progress is reported in research on uses of irradiated sewage sludge, particularly as a cattle feed supplement and commercial fertilizer additive, on potential sites for irradiator demonstration plants, and on the inactivation of enteric bacteria by radiation treatment. (LCL)

  8. Intestinal endocrine cells in radiation enteritis

    International Nuclear Information System (INIS)

    Pietroletti, R.; Blaauwgeers, J.L.; Taat, C.W.; Simi, M.; Brummelkamp, W.H.; Becker, A.E.

    1989-01-01

    In this study, the intestinal endocrine cells were investigated in 13 surgical specimens affected by radiation enteritis. Endocrine cells were studied by means of Grimelius' silver staining and immunostaining for chromogranin, a general marker of endocrine cells. Positively stained cells were quantified by counting their number per unit length of muscularis mucosa. Results in radiation enteritis were compared with matched control specimens by using Student's t test. Chromogranin immunostaining showed a statistically significant increase of endocrine cells in radiation enteritis specimens compared with controls both in small and large intestine (ileum, 67.5 +/- 23.5 cells per unit length of muscularis mucosa in radiation enteritis versus 17.0 +/- 6.1 in controls; colon, 40.9 +/- 13.7 cells per unit length of muscularis mucosa in radiation enteritis versus 9.5 +/- 4.1 in controls--p less than 0.005 in both instances). Increase of endocrine cells was demonstrated also by Grimelius' staining; however, without reaching statistical significance. It is not clear whether or not the increase of endocrine cells in radiation enteritis reported in this study is caused by a hyperplastic response or by a sparing phenomenon. We should consider that increased endocrine cells, when abnormally secreting their products, may be involved in some of the clinical features of radiation enteropathy. In addition, as intestinal endocrine cells produce trophic substances to the intestine, their increase could be responsible for the raised risk of developing carcinoma of the intestine in long standing radiation enteritis

  9. Interactions between optimal replacement policies and feeding strategies in dairy herds

    NARCIS (Netherlands)

    Vargas, B.; Herrero, M.; Arendonk, van J.A.M.

    2001-01-01

    A dynamic performance model was integrated with a model that optimised culling and insemination policies in dairy herds using dynamic programming. The performance model estimated daily feed intake, milk yield and body weight change of dairy cows on the basis of availability and quality of feed and

  10. 77 FR 22247 - Veterinary Feed Directive; Draft Text for Proposed Regulation

    Science.gov (United States)

    2012-04-13

    .... FDA-2010-N-0155] Veterinary Feed Directive; Draft Text for Proposed Regulation AGENCY: Food and Drug... the efficiency of FDA's Veterinary Feed Directive (VFD) program. The Agency is making this draft text..., rm. 1061, Rockville, MD 20852. FOR FURTHER INFORMATION CONTACT: Sharon Benz, Center for Veterinary...

  11. Development of Extended Length, Continuous Wire Feed Systems (The National Shipbuilding Research Program)

    Science.gov (United States)

    1974-05-01

    system employs small permanent magnet motors with a small feeding device located on one or both ends of the motor shaft. The feeding device is in...process desired. The permanent magnet motors having system used in these systems have a speed torque curve that is characteristic by a higher torque at the

  12. Early and intensive nutritional strategy combining parenteral and enteral feeding promotes neurodevelopment and growth at 18months of corrected age and 3years of age in extremely low birth weight infants.

    Science.gov (United States)

    Ohnishi, Satoshi; Ichiba, Hiroyuki; Tanaka, Yuko; Harada, Sayaka; Matsumura, Hisako; Kan, Ayako; Asada, Yuki; Shintaku, Haruo

    2016-09-01

    To evaluate whether aggressive nutrition can improve long-term neurodevelopmental outcomes and growth in extremely low birth weight (ELBW) infants born appropriate for gestational age (AGA). This single-center cohort study included 137 ELBW AGA infants born in two epochs. The first group received standard nutrition (SN; n=79) consisting of amino acids started at 0.5g/kg/day on Day 4 of life and increased to 1.0g/kg/day. The second aggressive nutrition (AN) group received amino acids started at 1.5-2.0g/kg/day within 24h of life and increased to 3.5g/kg/day. Parenteral and enteral feedings were combined in both groups. Neurodevelopmental outcomes by the Kyoto Scale of Psychological Development and growth were followed up to 18months of corrected age or 3years of age and compared by univariate and multivariate analyses. Baseline characteristics were similar between the two groups. At 3years of age, AN children had a significantly greater mean value of head circumference, but not length or weight, than SN children (49.1 vs 48.0cm, p=0.014). The cognitive-adaptive (C-A) score in the AN group was also significantly higher than that in the SN group (98.3 vs 91.9 at 18months, p=0.039 and 89.5 vs 83.1 at 3years, p=0.047). AN infants born ≥26weeks of gestation were less likely to develop borderline disability in C-A, language-social and overall developmental scores compared to gestational age-matched SN infants. Parenteral and enteral AN after birth improved the long-term cognitive neurodevelopment in ELBW AGA infants, especially in those born ≥26weeks of gestational age, however results need to be confirmed in a larger, multi-site randomized trial. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Effects of obstructive sleep apnea on hemodynamic parameters in patients entering cardiac rehabilitation.

    Science.gov (United States)

    Hargens, Trent A; Aron, Adrian; Newsome, Laura J; Austin, Joseph L; Shafer, Brooke M

    2015-01-01

    Obstructive sleep apnea (OSA) is a prevalent form of sleep-disordered breathing. Evidence suggests that OSA may lead to cardiac remodeling, although the literature is equivocal. Previous literature suggests a high percentage of individuals entering a cardiac rehabilitation (CR) program also have OSA. The objective of this study was to determine whether resting hemodynamic variables were altered in OSA subjects entering CR compared with those without OSA, as determined by impedance cardiography. Subjects entering an early outpatient CR program were screened for OSA using an at-home screening device and verified by a sleep physician. Subjects were divided into an OSA group (n = 48) or a control group (n = 25) on the basis of the screening results. Hemodynamic variables were measured during supine rest using impedance cardiography. A 6-minute walk test was performed to assess functional capacity. The proportion of cardiac diagnoses was similar between groups. Overall, 66% of the subjects were positive for OSA. Subject groups did not differ by age, body mass index, heart rate, diastolic blood pressure, or functional capacity. Cardiac output, cardiac index, stroke volume, contractility index, and left cardiac work index were all significantly decreased in the OSA group compared with the control group (P disadvantage in recovering from their cardiac event, and place them at increased risk for secondary complications.

  14. Early hybrid approach and enteral feeding algorithm could reduce the incidence of necrotising enterocolitis in neonates with ductus-dependent systemic circulation.

    Science.gov (United States)

    Manuri, Lucia; Morelli, Stefano; Agati, Salvatore; Saitta, Michele B; Oreto, Lilia; Mandraffino, Giuseppe; Iannace, Enrico; Iorio, Fiore S; Guccione, Paolo

    2017-01-01

    The reported incidence of necrotising enterocolitis in neonates with complex CHD with ductus-dependent systemic circulation ranges from 6.8 to 13% despite surgical treatment; the overall mortality is between 25 and 97%. The incidence of gastrointestinal complications after hybrid palliation for neonates with ductus-dependent systemic circulation still has to be defined, but seems comparable with that following the Norwood procedure. We reviewed the incidence of gastrointestinal complications in a series of 42 consecutive neonates with ductus-dependent systemic circulation, who received early hybrid palliation associated with a standardised feeding protocol. The median age and birth weight at the time of surgery were 3 days (with a range from 1 to 10 days) and 3.07 kg (with a range from 1.5 to 4.5 kg), respectively. The median ICU length of stay was 7 days (1-70 days), and the median hospital length of stay was 16 days (6-70 days). The median duration of mechanical ventilation was 3 days. Hospital mortality was 16% (7/42). In the postoperative period, 26% of patients were subjected to early extubation, and all of them received treatment with systemic vasodilatory agents. Feeding was started 6 hours after extubation according to a dedicated feeding protocol. After treatment, none of our patients experienced any grade of necrotising enterocolitis or major gastrointestinal adverse events. Our experience indicates that the combination of an "early hybrid approach", systemic vasodilator therapy, and dedicated feeding protocol adherence could reduce the incidence of gastrointestinal complications in this group of neonates. Fast weaning from ventilatory support, which represents a part of our treatment strategy, could be associated with low incidence of necrotising enterocolitis.

  15. Designing appropriate complementary feeding recommendations: tools for programmatic action.

    Science.gov (United States)

    Daelmans, Bernadette; Ferguson, Elaine; Lutter, Chessa K; Singh, Neha; Pachón, Helena; Creed-Kanashiro, Hilary; Woldt, Monica; Mangasaryan, Nuné; Cheung, Edith; Mir, Roger; Pareja, Rossina; Briend, André

    2013-09-01

    Suboptimal complementary feeding practices contribute to a rapid increase in the prevalence of stunting in young children from age 6 months. The design of effective programmes to improve infant and young child feeding requires a sound understanding of the local situation and a systematic process for prioritizing interventions, integrating them into existing delivery platforms and monitoring their implementation and impact. The identification of adequate food-based feeding recommendations that respect locally available foods and address gaps in nutrient availability is particularly challenging. We describe two tools that are now available to strengthen infant and young child-feeding programming at national and subnational levels. ProPAN is a set of research tools that guide users through a step-by-step process for identifying problems related to young child nutrition; defining the context in which these problems occur; formulating, testing, and selecting behaviour-change recommendations and nutritional recipes; developing the interventions to promote them; and designing a monitoring and evaluation system to measure progress towards intervention goals. Optifood is a computer-based platform based on linear programming analysis to develop nutrient-adequate feeding recommendations at lowest cost, based on locally available foods with the addition of fortified products or supplements when needed, or best recommendations when the latter are not available. The tools complement each other and a case study from Peru illustrates how they have been used. The readiness of both instruments will enable partners to invest in capacity development for their use in countries and strengthen programmes to address infant and young child feeding and prevent malnutrition. © 2013 John Wiley & Sons Ltd.

  16. Oral and Anal vaccination against enteric red mouth disease protection against yersiniosis

    DEFF Research Database (Denmark)

    Neumann, Lukas; Villumsen, Kasper Rømer; Kragelund Strøm, Helene

    dose of ERM bacterin fully protected rainbow trout when they are vaccinated anally. Oral vaccination can also induce full protection but the dose of the bacterin has to be 100 times higher than if the fish was to be vaccinated anally. This indicates that much of the oral feed bacteria is digested...... in the stomach of rainbow trout. This work has shown that it is possible to vaccinated orally against ERM, but the bacteria has to be coated in order to avoid digestion. Protection mechanisms will be discussed....... fish. The objective for this project is to investigate whether oral and anal vaccination of rainbow trout against Yersinia ruckeri O1 (biotype 1) causing Enteric Red Mouth disease (ERM) can protect rainbow trout against a subsequent experimental bath challenge.The rainbow trout were given oral...

  17. Alimentação do recém-nascido pré-termo: aleitamento materno, copo e mamadeira Feeding preterm infants: breast, cup and bottle

    Directory of Open Access Journals (Sweden)

    Andréa Monteiro Correia Medeiros

    2011-03-01

    Full Text Available OBJETIVO: Verificar a oferta de seio materno em bebês nascidos pré-termos, internados na Unidade de Terapia Intensiva do Hospital e Maternidade Neomater, relacionando este dado com a forma de oferecer a dieta (copo ou mamadeira, na ausência da mãe, e a estimulação fonoaudiológica realizada. MÉTODOS: Participaram 48 recém-nascidos prematuros, com idade gestacional inferior ou igual a 36 6/7 semanas, com peso PURPOSE: To assess the offer of the maternal breast in preterm babies hospitalized at the Intensive Care Unit of the Hospital and Maternity Neomater, linking this datum with the manner to feed them (cup or bottle in the absence of the mother, and the speech-language stimulation carried out. METHODS: Forty-eight newborn preterm infants with gestational age less than or equal to 36 6/7 weeks, weighting <2500 grams and with stable respiratory pattern participated in this study. The newborns were divided into two groups: group A (35 newborns with bottle feeding, and group B (13 newborns with cup feeding. Speech-Language Pathology monitoring was organized in Stage 1 (non-nutritive sucking in "gloved finger" or "empty breast" concomitant with enteral feeding; Stage 2 (oral feeding offer - maternal breast, bottle or cup - with complement provided by enteral feeding; Stage 3 (exclusive oral feeding offer - maternal breast, bottle or cup; Stage 4 (effective breastfeeding offer. A comparison was carried out between the groups regarding the number of days in each phase. Data were statistically analyzed using the independent t-test, with significance level of 5%. RESULTS: There were no significant differences between the groups for any of the studied parameters. Breast feeding was equally accepted by newborns in the cup and the bottle groups. CONCLUSION: Breast feeding can be equally accepted, regardless the alternative feeding form used (cup or bottle, provided that there is adequate Speech-Language Pathology monitoring and encouragement to

  18. Do enteric neurons make hypocretin? ☆

    Science.gov (United States)

    Baumann, Christian R.; Clark, Erika L.; Pedersen, Nigel P.; Hecht, Jonathan L.; Scammell, Thomas E.

    2008-01-01

    Hypocretins (orexins) are wake-promoting neuropeptides produced by hypothalamic neurons. These hypocretin-producing cells are lost in people with narcolepsy, possibly due to an autoimmune attack. Prior studies described hypocretin neurons in the enteric nervous system, and these cells could be an additional target of an autoimmune process. We sought to determine whether enteric hypocretin neurons are lost in narcoleptic subjects. Even though we tried several methods (including whole mounts, sectioned tissue, pre-treatment of mice with colchicine, and the use of various primary antisera), we could not identify hypocretin-producing cells in enteric nervous tissue collected from mice or normal human subjects. These results raise doubts about whether enteric neurons produce hypocretin. PMID:18191238

  19. Positive impact of child feeding training program for primary care health professionals: a cluster randomized field trial.

    Science.gov (United States)

    Vitolo, Márcia Regina; Louzada, Maria Laura da Costa; Rauber, Fernanda

    2014-12-01

    To assess the impact of a child feeding training program for primary care health professionals about breastfeeding and complementary feeding practices. Cluster-randomized field trial conducted in the city of Porto Alegre, (RS), Brazil. Twenty primary health care centers (HCC) were randomized into intervention (n = 9) and control (n = 11) groups. The health professionals (n = 200) at the intervention group centers received training about healthy feeding practices. Pregnant women were enrolled at the study. Up to six months of child's age, home visits were made to obtain variables related to breastfeeding and introduction of foods. 619 children were evaluated: 318 from the intervention group and 301 from the control group. Exclusive breastfeeding prevalence in the first (72.3 versus 59.4%; RR = 1.21; 95%CI 1.08 - 1.38), second (62.6 versus 48.2%; RR = 1.29; 95%CI 1.10 - 1.53), and third months of life (44.0% versus 34.6%; RR = 1.27; 95%CI 1.04 - 1.56) was higher in the intervention group compared to the control group. The prevalence of children who consumed meat four or five times per week was higher in the intervention group than in the control group (36.8 versus 22.6%; RR = 1.62; 95%CI 1.32 - 2.03). The prevalence of children who had consumed soft drinks (34.9 versus 52.5%; RR = 0.66; 95%CI 0.54 - 0.80), chocolate (24.5 versus 36.7% RR = 0.66 95%CI 0.53 - 0.83), petit suisse (68.9 versus 79.7; 95%CI 0.75 - 0.98) and coffee (10.4 versus 20.1%; RR = 0.51; 95%CI 0.31 - 0.85) in their six first months of life was lower in the intervention group. The training of health professionals had a positive impact on infant feeding practices, contributing to the promotion of child health.

  20. Positive impact of child feeding training program for primary care health professionals: a cluster randomized field trial

    Directory of Open Access Journals (Sweden)

    Márcia Regina Vitolo

    2014-12-01

    Full Text Available OBJECTIVE: To assess the impact of a child feeding training program for primary care health professionals about breastfeeding and complementary feeding practices. METHODS: Cluster-randomized field trial conducted in the city of Porto Alegre, (RS, Brazil. Twenty primary health care centers (HCC were randomized into intervention (n = 9 and control (n = 11 groups. The health professionals (n = 200 at the intervention group centers received training about healthy feeding practices. Pregnant women were enrolled at the study. Up to six months of child's age, home visits were made to obtain variables related to breastfeeding and introduction of foods. RESULTS: 619 children were evaluated: 318 from the intervention group and 301 from the control group. Exclusive breastfeeding prevalence in the first (72.3 versus 59.4%; RR = 1.21; 95%CI 1.08 - 1.38, second (62.6 versus 48.2%; RR = 1.29; 95%CI 1.10 - 1.53, and third months of life (44.0% versus 34.6%; RR = 1.27; 95%CI 1.04 - 1.56 was higher in the intervention group compared to the control group. The prevalence of children who consumed meat four or five times per week was higher in the intervention group than in the control group (36.8 versus 22.6%; RR = 1.62; 95%CI 1.32 - 2.03. The prevalence of children who had consumed soft drinks (34.9 versus 52.5%; RR = 0.66; 95%CI 0.54 - 0.80, chocolate (24.5 versus 36.7% RR = 0.66 95%CI 0.53 - 0.83, petit suisse (68.9 versus 79.7; 95%CI 0.75 - 0.98 and coffee (10.4 versus 20.1%; RR = 0.51; 95%CI 0.31 - 0.85 in their six first months of life was lower in the intervention group. CONCLUSION: The training of health professionals had a positive impact on infant feeding practices, contributing to the promotion of child health.

  1. Frequent blood feeding enables insecticide-treated nets to reduce transmission by mosquitoes that bite predominately outdoors.

    Science.gov (United States)

    Russell, Tanya L; Beebe, Nigel W; Bugoro, Hugo; Apairamo, Allan; Chow, Weng K; Cooper, Robert D; Collins, Frank H; Lobo, Neil F; Burkot, Thomas R

    2016-03-10

    The effectiveness of vector control on malaria transmission by long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) depends on the vectors entering houses to blood feed and rest when people are inside houses. In the Solomon Islands, significant reductions in malaria have been achieved in the past 20 years with insecticide-treated bed nets, IRS, improved diagnosis and treatment with artemisinin combination therapies; despite the preference of the primary vector, Anopheles farauti, to feed outdoors and early in the evening and thereby avoid potential exposure to insecticides. Rational development of tools to complement LLINs and IRS by attacking vectors outdoor requires detailed knowledge of the biology and behaviours of the target species. Malaria transmission in Central Province, Solomon Islands was estimated by measuring the components comprising the entomological inoculation rate (EIR) as well as the vectorial capacity of An. farauti. In addition, the daily and seasonal biting behaviour of An. farauti, was examined and the duration of the feeding cycle was estimated with a mark-release-recapture experiment. Anopheles farauti was highly exophagic with 72% captured by human landing catches (HLC) outside of houses. Three-quarters (76%) of blood feeding on humans was estimated to occur before 21.00 h. When the hourly location of humans was considered, the proportion of exposure to mosquito bites on humans occurring indoors (πi) was only 0.130 ± 0.129. Peak densities of host seeking An. farauti occurred between October and January. The annual EIR was estimated to be 2.5 for 2012 and 33.2 for 2013. The length of the feeding cycle was 2.1 days. The short duration of the feeding cycle by this species offers an explanation for the substantial control of malaria that has been achieved in the Solomon Islands by LLINs and IRS. Anopheles farauti is primarily exophagic and early biting, with 13% of mosquitoes entering houses to feed late at night during

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Validation Programs Accreditation, Verification, and Validation Programs Accredited Education Institutes ... Entering Resident Readiness Assessment Evidence-Based Decisions in ...

  3. Early low volume oral synbiotic/prebiotic supplemented enteral stimulation of the gut in patients with severe acute pancreatitis: a prospective feasibility study.

    Science.gov (United States)

    Plaudis, H; Pupelis, G; Zeiza, K; Boka, V

    2012-01-01

    Experience with administration of synbiotics (prebiotics/probiotics) in patients with severe acute pancreatitis (SAP) has demonstrated immunomodulatory capacity. The aim of this trial was evaluation of the feasibility and perspective of early clinical application of oral synbiotic/prebiotic supplements in patients with SAP. 90 SAP patients were enrolled during the period from 2005-2008. Patients were stratified according to the feeding mode. CONTROL (n = 32) group received standard whole protein feeding formula. SYNBIO (n = 30) and FIBRE groups (n = 28) received early (within first 24-48 hours) synbiotic or prebiotic supplements. Oral administration of synbiotics or prebiotics was commenced when patients were able to sip water. Daily provided average volume and calories of synbiotic/prebiotic blends were smaller compared to the CONTROL, p = 0.001. Oral administration of synbiotic/prebiotic supplements was associated with lower infection rate (pancreatic and peripancreatic necrosis) compared to the CONTROL, (p = 0.03; p = 0.001), lower rate of surgical interventions, p = 0.005, shorter ICU (p = 0.05) and hospital stay (p = 0.03). Synbiotic supplemented enteral stimulation of the gut resulted in reduced mortality rate compared to the CONTROL, p = 0.02. Early low volume oral synbiotic/prebiotic supplemented enteral stimulation of the gut seems to be a potentially valuable complement to the routine treatment protocol of SAP.

  4. Recommended Feeding and Dietary Practices To Improve Infant and Maternal Nutrition.

    Science.gov (United States)

    Academy for Educational Development, Washington, DC.

    The LINKAGES Project is intended to improve breastfeeding and related complementary feeding and maternal dietary practices. The project, in consultation with technical experts and program managers, identified a set of recommended feeding and dietary practices intended to break the cycle of poor health and nutrition that passes from generation to…

  5. Soya Saponins Induce Enteritis in Atlantic Salmon (Salmo salar L.).

    Science.gov (United States)

    Krogdahl, Åshild; Gajardo, Karina; Kortner, Trond M; Penn, Michael; Gu, Min; Berge, Gerd Marit; Bakke, Anne Marie

    2015-04-22

    Soybean meal-induced enteritis (SBMIE) is a well-described condition in the distal intestine of salmonids, and saponins have been implicated as the causal agent. However, the question remains whether saponins alone cause SBMIE. Moreover, the dose-response relationship has not been described. In a 10 week feeding trial with Atlantic salmon, a highly purified (95%) soya saponin preparation was supplemented (0, 2, 4, 6, or 10 g/kg) to two basal diets, one containing fishmeal as the major protein source (FM) and the other 25% lupin meal (LP). Saponins caused dose-dependent increases in the severity of inflammation independent of the basal diet, with concomitant alterations in digestive functions and immunological marker expression. Thus, saponins induced inflammation whether the diet contained other legume components or not. However, responses were often the same or stronger in fish fed the corresponding saponin-supplemented LP diets despite lower saponin exposure, suggesting potentiation by other legume component(s).

  6. Glutamine granule-supplemented enteral nutrition maintains immunological function in severely burned patients.

    Science.gov (United States)

    Peng, Xi; Yan, Hong; You, Zhongyi; Wang, Pei; Wang, Shiliang

    2006-08-01

    Glutamine is an important energy source for immune cells. It is a necessary nutrient for cell proliferation, and serves as specific fuel for lymphocytes, macrophages, and enterocytes when it is present in appropriate concentrations. The purpose of this clinical study was to observe the effects of enteral nutrition supplemented with glutamine granules on immunologic function in severely burned patients. Forty-eight severely burned patients (total burn surface area 30-75%, full thickness burn area 20-58%) who met the requirements of the protocol joined this double-blind randomized controlled clinical trail. Patients were randomly divided into two groups: burn control group (B group, 23 patients) and glutamine treated group (Gln group, 25 patients). There was isonitrogenous and isocaloric intake in both groups, Gln and B group patents were given glutamine granules or placebo (glycine) at 0.5 g/kgd for 14 days with oral feeding or tube feeding, respectively. The plasma level of glutamine and several indices of immunologic function including lymphocyte transformation ratio, neutrophil phagocytosis index (NPI), CD4/CD8 ratio, the content of immunoglobulin, complement C3, C4 and IL-2 levels were determined. Moreover, wound healing rate of burn area was observed and then hospital stay was recorded. The results showed significantly reduced plasma glutamine and damaged immunological function after severe burn Indices of cellular immunity function were remarkably decreased from normal controls. After taking glutamine granules for 14 days, plasma glutamine concentration was significantly higher in Gln group than that in B group (607.86+/-147.25 micromol/L versus 447.63+/-132.38 micromol/L, P0.05). In addition, wound healing was better and hospital stay days were reduced in Gln group (46.59+/-12.98 days versus 55.68+/-17.36 days, Pburn; supplemented glutamine granules with oral feeding or tube feeding abate the degree of immunosuppression, improve immunological function

  7. Behavioral Change Strategies for Improving Complementary Feeding and Breastfeeding.

    Science.gov (United States)

    Osendarp, Saskia J M; Roche, Marion L

    2016-01-01

    Improving infant and young child feeding (IYCF) practices, including breastfeeding and complementary feeding, has been identified as one of the most effective interventions to improve child survival, stunting and wasting. Evidence from randomized controlled trials suggests that effective promotion of breastfeeding and complementary feeding, with or without food provision, has the potential to improve IYCF practices and child nutrition. However, in many countries, breastfeeding practices and complementary feeding practices are still far from optimal. The lack of implementation of available, effective, affordable interventions in scale-up programs is in part attributed to a lack of innovative, creative and effective behavioral change strategies that enable and encourage caregivers. Successful behavioral change strategies should be based on a rigorous situational analysis and formative research, and the findings and insights of formative research should be used to further design interventions that address the identified barriers and enablers, to select delivery channels, and to formulate appropriate and effective messages. In addition, successful behavioral change interventions should a priori define and investigate the program impact pathway to target behavioral change and should assess intermediary behavioral changes and indicators to learn why the expected outcome was achieved or not achieved by testing the program theory. The design of behavioral change communication must be flexible and responsive to shifts in societies and contexts. Performance of adequate IYCF also requires investments to generate community demand through social mobilization, relevant media and existing support systems. Applying these principles has been shown to be effective in improving IYCF practices in Vietnam, Bangladesh and Ethiopia and is recommended to be adopted by other programs and countries in order to accelerate progress in improving child nutrition. © 2016 S. Karger AG, Basel.

  8. Successful Treatment of Septic Shock due to Spontaneous Esophageal Perforation 96 Hours after Onset by Drainage and Enteral Nutrition

    Directory of Open Access Journals (Sweden)

    Risako Yamashita

    2014-12-01

    Full Text Available Spontaneous esophageal perforation is relatively uncommon, but carries a high mortality rate if diagnosis or treatment is delayed. We report the case of a 68-year-old man with spontaneous esophageal perforation who was successfully treated over 96 h after onset by thoracic drainage and jejunostomy for enteral nutrition. He vomited after drinking alcohol, soon followed by epigastralgia. Heart failure was suspected on admission to another hospital. Spontaneous esophageal perforation was diagnosed 48 h after admission. Chest tube drainage was performed, but his general condition deteriorated and he was transferred to our hospital. Emergent surgery was performed and esophageal perforation combined with pyothorax and mediastinitis was identified on the left side of the lower esophagus. The left thoracic cavity was rinsed and thoracic drainage was performed. Feeding jejunostomy was performed for postoperative enteral nutrition. Effective drainage and sufficient nutrition management appear extremely valuable in treating spontaneous esophageal perforation.

  9. Impacts of Nutrition and Feeding Programs on Farmers’ Management Decisions Affecting the Success of Dairy Farms with Culture Breed Cattle

    OpenAIRE

    Yavuz Topcu; Mehmet Toparlak; Muhlis Macit

    2016-01-01

    The aim of the study is to evaluate all the factors determining the milk production and yield decisions with regard to the nutrition and feeding programs affecting the integrated management strategies on the success of the dairy farms with culture breed cattle under the pasture-based and indoor barn-based production systems. For these aims, data obtained from the individual interviews conducted at the dairy farms with 100 culture breed cattle were used for Principal Component and Multiple Reg...

  10. [Enteral nutrition in burn patients].

    Science.gov (United States)

    Pereira, J L; Garrido, M; Gómez-Cía, T; Serrera, J L; Franco, A; Pumar, A; Relimpio, F; Astorga, R; García-Luna, P P

    1992-01-01

    Nutritional support plays an important role in the treatment of patients with burns. Due to the severe hypercatabolism that develops in these patients, oral support is insufficient in most cases, and this makes it essential to initiate artificial nutritional support (either enteral or parenteral). Enteral nutrition is more physiological than parenteral, and data exist which show that in patients with burns, enteral nutrition exercises a protective effect on the intestine and may even reduce the hypermetabolic response in these patients. The purpose of the study was to evaluate the effectiveness and tolerance of enteral nutritional support with a hypercaloric, hyperproteic diet with a high content of branched amino acids in the nutritional support of patients suffering from burns. The study included 12 patients (8 males and 4 females), admitted to the Burns Unit. Average age was 35 +/- 17 years (range: 21-85 years). The percentage of body surface affected by the burns was 10% in two cases, between 10-30% in three cases, between 30-50% in five cases and over 50% in two cases. Initiation of the enteral nutrition was between twenty-four hours and seven days after the burn. The patients were kept in the unit until they were discharged, and the average time spent in the unit was 31.5 days (range: 17-63 days). Total energetic requirements were calculated based on Harris-Benedict, with a variable aggression factor depending on the body surface burned, which varied from 2,000 and 4,000 cal day. Nitrogenous balance was determined on a daily basis, and plasmatic levels of total proteins, albumin and prealbumin on a weekly basis. There was a significant difference between the prealbumin values at the initiation and finalization of the enteral nutrition (9.6 +/- 2.24 mg/dl compared with 19.75 +/- 5.48 mg/dl; p diet was very good, and only mild complications such as diarrhoea developed in two patients. Enteral nutrition is a suitable nutritional support method for patients with

  11. Alimentación enteral temprana en el paciente quirúrgico en servicios de terapia intensiva polivalente pediátrica

    Directory of Open Access Journals (Sweden)

    Enrique Guzmán Rubín

    1998-03-01

    Full Text Available Se realizó un estudio prospectivo y longitudinal de 23 pacientes quirúrgicos de Terapia Intensiva, de 3 hospitales pediátricos de Cuba, en los cuales la técnica quirúrgica incluía sutura gastrointestinal a cualquier nivel y se le iniciaba la alimentación enteral temprana, independientemente de la vía que se utilizaría, con alimentación enteral líquida, a goteo continuo, en cuanto se restableciera la dinámica intestinal, y se obtuvo disminución en la utilización de la alimentación parenteral, en la estadía, en las complicaciones de la alimentación parenteral, así como de las complicaciones infecciosas nosocomiales a punto de partida de la translocación bacteriana y de la inmunomodulación enteral. De esta manera se lograba acelerar la recuperación, mejorar la evolución del peso, la calidad de vida, disminuir las secuelas y la mortalidad, todo lo cual implicaba disminución de los costos.A prospective longitudinal study of 23 surgical patients from three Cuban Pediatric Hospitals’ Intensive Care Units was carried out. The operative surgery used in these patients was gastrointestinal suture at any level and they were enterally fed. As soon as the intestinal dynamics was re-established, they were given enteral liquid feeding by continuos drip. This led to a reduction in parenteral nutrition, stay at hospital, parenteral nutrition complications, nosocomial infection complications from bacterial translocation, and in enteral inmunomodulation. In this way, quick recovery, improved weight gain, better quality of life, lower sequelae and mortality were reached, all of which resulted in lower costs.

  12. Enteral peptide formulas inhibit radiation induced enteritis and apoptosis in intestinal epithelial cells and suppress the expression and function of Alzheimer's and cell division control gene products

    International Nuclear Information System (INIS)

    Cope, F.O.; Issinger, O.G.; McArdle, A.H.; Shapiro, J.; Tomei, L.D.

    1991-01-01

    Studies have shown that patients receiving enteral peptide formulas prior to irradiation have a significantly reduced incidence of enteritis and express a profound increase in intestinal cellularity. Two conceptual approaches were taken to describe this response. First was the evaluation in changes in programmed intestinal cell death and secondly the evaluation of a gene product controlling cell division cycling. This study provided a relationship between the ratio of cell death to cell formulations. The results indicate that in the canine and murine models, irradiation induces expression of the Alzheimer's gene in intestinal crypt cells, while the incidence of apoptosis in apical cells is significantly increased. The use of peptide enteral formulations suppresses the expression of the Alzheimer's gene in crypt cells, while apoptosis is eliminated in the apical cells of the intestine. Concomitantly, enteral peptide formulations suppress the function of the CK-II gene product in the basal and baso-lateral cells of the intestine. These data indicate that although the mitotic index is significantly reduced in enterocytes, this phenomenon alone is not sufficient to account for the peptide-induced radio-resistance of the intestine. The data also indicate a significant reduction of normal apoptosis in the upper lateral and apical cells of the intestinal villi. Thus, the ratio of cell death to cell replacement is significantly decreased resulting in an increase in villus height and hypertrophy of the apical villus cells. Thus, peptide solutions should be considered as an adjunct treatment both in radio- and chemotherapy

  13. Two Contrasting Failure Modes of Enteric Coated Beads.

    Science.gov (United States)

    Shi, Galen H; Dong, Xia; Lytle, Michelle; Kemp, Craig A J; Behme, Robert J; Hinds, Jeremy; Xiao, Zhicheng

    2018-04-09

    This study aimed to elucidate the mechanisms and kinetics of coating failure for enteric coated beads exposed to high-humidity conditions at different storage temperatures. Enteric coated beads were placed on high-humidity conditions (75 to 98% relative humidity (RH)) in the temperature range of 5 to 40°C. These stability samples of beads were tested for acid dissolution and water activity and also analyzed with SEM, X-ray CT, and DMA. Exposure of enteric coated beads to high humidity led to increased gastric release of drug which eventually failed the dissolution specification. SEM showed visible cracks on the surface of beads exposed to 5°C/high humidity and fusion of enteric beads into agglomerates at 40°C/high humidity. In a non-destructive time elapse study, X-ray CT demonstrated swelling of microcrystalline cellulose cores, crack initiation, and propagation through the API layer within days under 5°C/98% RH storage conditions and ultimately fracture through the enteric coating. DMA data showed a marked reduction in T g of the enteric coating materials after exposure to humidity. At 5°C/high humidity, the hygroscopic microcrystalline cellulose core absorbed moisture leading to core swelling and consequent fracture through the brittle API and enteric layers. At 40°C (high humidity) which is above the T g of the enteric polymer, enteric coated beads coalesced into agglomerates due to melt flow of the enteric coating. We believe it is the first report on two distinct failure models of enteric coated dosage forms.

  14. School Feeding Programmes: Myth and Potential.

    Science.gov (United States)

    Levinger, Beryl

    1984-01-01

    A review of research showed that school feeding programs (SFP) in elementary schools of developing nations do have a positive impact on student enrollment and school attendance. However, research studies examining the impact of SFP's on academic performance were inconclusive. Research findings are used to make recommendations for SFP design. (RM)

  15. Chlamydia prevalence among women and men entering the National Job Training Program: United States, 2003-2007.

    Science.gov (United States)

    Satterwhite, Catherine Lindsey; Tian, Lin H; Braxton, Jimmy; Weinstock, Hillard

    2010-02-01

    To analyze 5-year prevalence trends in Chlamydia trachomatis infections among high-risk young men and women aged 16 to 24 years entering the National Job Training Program, where universal screening is required. Entrance exams conducted in over 100 National Job Training Program centers from 2003 to 2007 were considered. Women provided cervical specimens tested using either a DNA hybridization probe (PACE 2, Gen-Probe, San Diego, CA) or a strand displacement amplification test (SDA, BD ProbeTec ET, Becton-Dickinson, Sparks, MD). In the absence of a pelvic exam, urine specimens were tested using SDA. PACE 2 testing was performed predominately from 2002 to 2005; from 2005 to 2007, SDA was used. All male testing was conducted using SDA on urine specimens. Chlamydia prevalence trends were assessed for women and men, using logistic regression models. Adjusted odds ratios (AOR), 95% confidence intervals (CI), and P-values were calculated. Approximately 15,000 women and 30,000 men were screened annually for chlamydia. Among both sexes, adjusted prevalence declined significantly from 2003 to 2007. In 2003, crude prevalence among women was 9.9%; in 2007, prevalence was 13.7%. However, after controlling for covariates, including increasingly sensitive tests, the model indicated a significant declining prevalence trend (AOR: 0.95, CI: 0.93-0.97, 4.6% decrease in odds per year). Among men, crude prevalence in 2003 was 8.4%; in 2007, prevalence was 8.3%; after controlling for possible confounding, a significant decline in prevalence was also detected (AOR: 0.98, CI: 0.96-0.99, 1.9% decrease in odds per year). In a relatively stable, high-risk population of young women and men, adjusted chlamydia prevalence declined from 2003 to 2007. Test technology plays a critical role in interpreting rates and should be considered whenever chlamydia rates are examined.

  16. Influence of feeding crimped kernel maize silage on the course of subclinical necrotic enteritis in a broiler disease model

    DEFF Research Database (Denmark)

    Sharma, Nisha; Ranjitkar, Samir; Sharma, Nishchal K

    2017-01-01

    , but feeding of CKMS30 reduced the number of coliforms in ileal contents (P = 0.01). Dietary treatments did not affect organic acid concentrations in ileum and caeca, but there was an effect of age; butyric acid was higher on days 22, 23 and 25 than on day 28 (P = 0.04). Acetic acid and propionic acid...

  17. Glycemic and lipid control in hospitalized type 2 diabetic patients: evaluation of 2 enteral nutrition formulas (low carbohydrate-high monounsaturated fat vs high carbohydrate).

    Science.gov (United States)

    León-Sanz, Miguel; García-Luna, Pedro P; Sanz-París, Alejandro; Gómez-Candela, Carmen; Casimiro, César; Chamorro, José; Pereira-Cunill, José L; Martin-Palmero, Angeles; Trallero, Roser; Martínez, José; Ordóñez, Francisco Javier; García-Peris, Pilar; Camarero, Emma; Gómez-Enterría, Pilar; Cabrerizo, Lucio; Perez-de-la-Cruz, Antonio; Sánchez, Carmen; García-de-Lorenzo, Abelardo; Rodríguez, Nelly; Usán, Luis

    2005-01-01

    Type 2 diabetic patients may need enteral nutrition support as part of their treatment. The objective was to compare glycemic and lipid control in hospitalized patients with type 2 diabetes requiring feeding via nasogastric tube using enteral feedings with either a highcarbohydrate or a high-monounsaturated-fat content. This trial included type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery who received either a low-carbohydrate-high-mono-unsaturated-fat (Glucerna) or a high-carbohydrate diet (Precitene Diabet). Glycemic and lipid control was determined weekly. Safety and gastrointestinal tolerance were also assessed. A total of 104 patients were randomized and 63 were evaluable according to preestablished protocol criteria. Median duration of therapy was 13 days in both groups. Mean glucose was significantly increased at 7 days of treatment (p = .006) in the Precitene arm, with no significant variations in the Glucerna arm. Mean weekly blood triglycerides levels in the Precitene arm were increased without reaching statistical significance, whereas patients in the Glucerna arm showed a stable trend. Patients in the Precitene arm showed a significantly higher incidence of diarrhea than patients in Glucerna arm (p = .008), whereas the incidence of nausea was smaller in the Precitene arm than in the Glucerna arm (p = .03). An enteral formula with lower carbohydrate and higher monounsaturated fat (Glucerna) has a neutral effect on glycemic control and lipid metabolism in type 2 diabetic patients compared with a high-carbohydrate and a lower-fat formula (Precitene Diabet).

  18. Overview of FEED, the feeding experiments end-user database.

    Science.gov (United States)

    Wall, Christine E; Vinyard, Christopher J; Williams, Susan H; Gapeyev, Vladimir; Liu, Xianhua; Lapp, Hilmar; German, Rebecca Z

    2011-08-01

    The Feeding Experiments End-user Database (FEED) is a research tool developed by the Mammalian Feeding Working Group at the National Evolutionary Synthesis Center that permits synthetic, evolutionary analyses of the physiology of mammalian feeding. The tasks of the Working Group are to compile physiologic data sets into a uniform digital format stored at a central source, develop a standardized terminology for describing and organizing the data, and carry out a set of novel analyses using FEED. FEED contains raw physiologic data linked to extensive metadata. It serves as an archive for a large number of existing data sets and a repository for future data sets. The metadata are stored as text and images that describe experimental protocols, research subjects, and anatomical information. The metadata incorporate controlled vocabularies to allow consistent use of the terms used to describe and organize the physiologic data. The planned analyses address long-standing questions concerning the phylogenetic distribution of phenotypes involving muscle anatomy and feeding physiology among mammals, the presence and nature of motor pattern conservation in the mammalian feeding muscles, and the extent to which suckling constrains the evolution of feeding behavior in adult mammals. We expect FEED to be a growing digital archive that will facilitate new research into understanding the evolution of feeding anatomy.

  19. Effect of feed presentation on feeding patterns of dairy calves.

    Science.gov (United States)

    Miller-Cushon, E K; Bergeron, R; Leslie, K E; Mason, G J; DeVries, T J

    2013-01-01

    The objectives of this study were to determine the effect of feed presentation on meal frequency and duration, as well as diurnal feeding patterns of dairy calves, and to assess any longer-term differences in feeding patterns resulting from previous experience. Twenty Holstein bull calves were exposed from wk 1 to 8 of life to 1 of 2 feed presentation treatments: concentrate and chopped grass hay (Feed was provided ad libitum. Calves received 8L/d of milk replacer (1.2 kg of dry matter), with the amount progressively reduced after 5 wk to facilitate weaning by the end of wk 7. At the beginning of wk 9, all calves received the MIX diet and remained on trial for an additional 3 wk. Feeding behavior was recorded from video for 4d during wk 6, 8, 9, and 11. In wk 6, calves fed MIX spent more time feeding than calves fed COM (56.7 vs. 46.8 min/d). In wk 8, calves fed MIX spent more time feeding (174.0 vs. 139.1 min/d) and had a lower rate of intake (11.5 vs. 14.7 g/min) compared with calves fed COM. Meal frequency was similar between treatments (12.2 meals/d). Diurnal feeding patterns in wk 8 were also affected by feed presentation, with calves fed MIX spending less time feeding at time of feed delivery and more time feeding throughout the rest of the daylight hours than calves fed COM. Diurnal feeding patterns of hay and concentrate in wk 8 differed for calves fed COM, with more time spent consuming hay at time of feed delivery and less time spent consuming hay throughout the rest of the day. Once calves previously fed COM were transitioned to the MIX diet in wk 9, meal frequency, meal duration, and diurnal feeding patterns were similar between treatments: both treatments spent similar amounts of time feeding (173.9 min/d) and had similar peaks in feeding activity at time of feed delivery, sunrise, and sunset. Provision of hay and concentrate to young calves as a mixed ration, compared with separate components, increases time spent feeding and results in more evenly

  20. [Post-gastrectomy reconstruction versus enteral alimentation--a one year follow-up study].

    Science.gov (United States)

    Kostov, D; Balabanova, G; Vasilev, B; Plachkov, I; Ignatov, G

    2000-01-01

    This is a report on various post-gastrectomy reconstructive procedures, proceeding from personal experience had with 14 patients undergoing gastrectomy for carcinoma of the stomach and five patients with operations of esophagus and stomach for various pathological conditions. An assessment is done of the reconstructive methods used on the ground of objective indicators. All patients are subjected to enteral alimentation through nutritive jejunostomy. In the pre- and postoperatived periods, the trophic state of patients is evaluated on basis of biochemical, anthropometric and immunologic study data. Postoperatively, in those with small-intestinal reservoir a lower degree negative symptomatology is established, along with life style improvement. Post-gastrectomy patients presenting I-II (UICC) stage of the oncological disease are indicated for small-intestinal reservoir formation. In the overall therapeutic approach to post-gastrectomy patients adequate clinical therapeutic feeding proves absolutely indispensable.

  1. Animal board invited review: genetic possibilities to reduce enteric methane emissions from ruminants.

    Science.gov (United States)

    Pickering, N K; Oddy, V H; Basarab, J; Cammack, K; Hayes, B; Hegarty, R S; Lassen, J; McEwan, J C; Miller, S; Pinares-Patiño, C S; de Haas, Y

    2015-09-01

    Measuring and mitigating methane (CH4) emissions from livestock is of increasing importance for the environment and for policy making. Potentially, the most sustainable way of reducing enteric CH4 emission from ruminants is through the estimation of genomic breeding values to facilitate genetic selection. There is potential for adopting genetic selection and in the future genomic selection, for reduced CH4 emissions from ruminants. From this review it has been observed that both CH4 emissions and production (g/day) are a heritable and repeatable trait. CH4 emissions are strongly related to feed intake both in the short term (minutes to several hours) and over the medium term (days). When measured over the medium term, CH4 yield (MY, g CH4/kg dry matter intake) is a heritable and repeatable trait albeit with less genetic variation than for CH4 emissions. CH4 emissions of individual animals are moderately repeatable across diets, and across feeding levels, when measured in respiration chambers. Repeatability is lower when short term measurements are used, possibly due to variation in time and amount of feed ingested prior to the measurement. However, while repeated measurements add value; it is preferable the measures be separated by at least 3 to 14 days. This temporal separation of measurements needs to be investigated further. Given the above issue can be resolved, short term (over minutes to hours) measurements of CH4 emissions show promise, especially on systems where animals are fed ad libitum and frequency of meals is high. However, we believe that for short-term measurements to be useful for genetic evaluation, a number (between 3 and 20) of measurements will be required over an extended period of time (weeks to months). There are opportunities for using short-term measurements in standardised feeding situations such as breath 'sniffers' attached to milking parlours or total mixed ration feeding bins, to measure CH4. Genomic selection has the potential to

  2. Thermal inactivation of enteric viruses and bioaccumulation of enteric foodborne viruses in live oysters (Crassostrea virginica)

    Science.gov (United States)

    Human enteric viruses are one of the main causative agents of shellfish associated outbreaks. In this study, the kinetics of viral bioaccumulation in live oysters and the heat stability of the most predominant enteric viruses were determined in both tissue culture and in oyster tissues. A human nor...

  3. The partnership between the Brazilian School Feeding Program and family farming: a way for reducing ultra-processed foods in school meals.

    Science.gov (United States)

    Teo, Carla Rosane Paz Arruda

    2018-01-01

    To evaluate the profile of food acquisition in the National School Feeding Program according to the extent and purpose of food processing in three municipalities of southern Brazil during the implementation period of Law 11.947/2009. Descriptive cross-sectional study. Data for 2008-2010 involved quantities, prices and types of suppliers for food items purchased. In total, 1529 purchases were analysed. The items were classified into the following groups: G1 (unprocessed/minimally processed), G2 (culinary ingredients), G3 (processed), G4 (ultra-processed). Quantities of purchased foods were converted into energy and average prices ($US/4184 kJ (1000 kcal)) were calculated. The proportion of each food group in total purchases was expressed as both a percentage of total energy and a percentage of total expenditure. Data analysis was carried out in Stata version 12.1. Three municipalities in southern Brazil. Relative contribution to total energy purchased was high for G1 (49·8 %; G2, 23·8 %; G3, 4·5 %; G4, 21·8 %). Among acquisitions from family farming, G1 represented 51·3 % of the total energy purchased; G2, 9·9 %; G3, 19·7 %; G4, 19·0 %. Total cost was as follows: G1, 61·6 %; G2, 3·9 %; G3, 18·5 %; G4, 16·0 %. Prices for food products from family farms were consistently higher. Average price from family farms was 1·3; from conventional suppliers, 0·9. The implementation of Law 11.947/2009 produced a positive effect on the regional profile of food purchases for the School Feeding Program. However, there is still considerable potential to promote health by strengthening relationships between family farming and school feeding.

  4. Parent, patient and health professional perspectives regarding enteral nutrition in paediatric oncology.

    Science.gov (United States)

    Cohen, Jennifer; Wakefield, Claire E; Tapsell, Linda C; Walton, Karen; Cohn, Richard J

    2017-11-01

    Enteral tube feeding (ETF) is an important part of treatment for paediatric cancer patients. Without nutritional therapy, the prevalence of under-nutrition during treatment for childhood cancer may be as high as 50%. To ensure that the appropriate initiation of ETF is optimised, information on the views of key stakeholders regarding ETF is needed. In total, 48 interviews were conducted with parents of paediatric cancer patients (n = 20), patients (n = 10) and members of the paediatric oncology health-care team (n = 18). Semistructured interviews were used to elicit information from participants, and the data were analysed using a content analysis approach. The interviews focused on views regarding: (i) attitude toward, and impact of, ETF; (ii) information and support regarding ETF; and (iii) clinical management of ETF. There was agreement between stakeholders on the impact of ETF on patients, both positive (good nutrition, weight gain and decreased anxiety) and negative (physical appearance, invasive insertion procedure and comfort). There were discordant perceptions regarding the timing and type of information provided on the use of ETF, as well as the decision-making process used. By standardising the information given to parents and enhancing understanding of parent, patient and health-care worker perceptions about ETF, the initiation of tube feeding may be optimised. This may positively impact patient outcomes in the future. © 2017 Dietitians Association of Australia.

  5. Pancreatitis, very early compared with normal start of enteral feeding (PYTHON trial): design and rationale of a randomised controlled multicenter trial

    NARCIS (Netherlands)

    Bakker, O.J.; van Santvoort, H.C.; van Brunschot, S.; Ali, U.A.; Besselink, M.G.; Boermeester, M.A.; Bollen, T.L.; Bosscha, K.; Brink, M.A.; Dejong, C.H.; van Geenen, E.J.; van Goor, H.; Heisterkamp, J.; Houdijk, A.P.; Jansen, J.M.; Karsten, T.M.; Manusama, E.R.; Nieuwenhuijs, V.B.; van Ramshorst, B.; Schaapherder, A.F.; van der Schelling, G.P.; Spanier, M.B.M.; Tan, A.; Vecht, J.; Weusten, B.L.; Witteman, B.J.; Akkermans, L.M.; Gooszen, H.G.

    2011-01-01

    ABSTRACT: BACKGROUND: In predicted severe acute pancreatitis, infections have a negative effect on clinical outcome. A start of enteral nutrition (EN) within 24 hours of onset may reduce the number of infections as compared to the current practice of starting an oral diet and EN if necessary at 3-4

  6. Advantages of enteral nutrition over parenteral nutrition

    OpenAIRE

    Seres, David S.; Valcarcel, Monika; Guillaume, Alexandra

    2013-01-01

    It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition.

  7. Successful use of a bulk laxative to control the diarrhea of tube feeding.

    Science.gov (United States)

    Frank, H A; Green, L C

    1979-01-01

    The greatly increased nutritional demands of the severely burned patient frequently require the use of tube feeding for enternal hyperalimentation. At a time when general patient morale is low and motivation needs to be maximally maintained, there is nothing so dispiriting as the distress of a painful perianal region and uncontrollable liquid stools. Attempts to control the diarrhea which frequently accompanies tube feeding by changing the formula or the method of administration or a wide variety of constipating drugs have all met with very limited success. Based on the clinical observation of a noted gastroenterologist (Bockus), we have administered a mucilagenous hydrophilic colloid bulk laxative (Metamucil) to patients on tube feeding formulae. The dosage and frequency are adjusted to individual patient needs, but average 7 g per liter of liquid formula. The results have been dramatic; namely, the virtual elimination of the diarrhea problem in our burn patients on enteral hyperalimentation by gastric tube feeding. Colonic transit time increases. The stools become formed but soft, cohesive but not adhesive. Perianal irritation does not occur. Neither does soilage of wound, dressings, or bed. No rebound constipation or obstructive symptoms have been encountered. We attribute this response to the same water binding mechanism that allows these colloids to prevent chronic constipation. Our patients may be given as much as 5,000 to 6,000 calories of tube feeding per day. Our patients are not distressed by diarrhea. Our nursing staff is relieved of the burden that entails.

  8. Relationship between residual feed intake and daily methane emission in young Nellore bulls

    Directory of Open Access Journals (Sweden)

    Ana Paula Melo Caliman

    2012-12-01

    Full Text Available The cattle production is a sector of agricultural activity that has impact on global warming due to enteric fermentation from digestive process that releases methane (CH4, with energy loss of food and consequent inefficiency of system. Residual feed intake (RFI is a feed efficiency trait defined as the difference between actual feed intake and the one predicted on the basis of requirements for body weight production and maintenance. There are evidences that more efficient cattle (low RFI have lower methane daily emissions than less efficient cattle (high RFI. This study aimed to evaluate the pattern of CH4 daily emission and its relationship with RFI obtained during the CH4 collection in Nelore previously evaluated for this trait. A sample of 23 from 62 young bulls, previously classified into low RFI72 and high RFI72 in the 72-days performance test (RFI72, were evaluated. After the 72-days test, the individual feed intake was recorded for a further 45 days. Another RFI was obtained from the last 32 days (RFI32, and the animals were classified into two RFI32 classes: below zero (low RFI32 and above zero (high RFI32. CH4 daily emissions of each animal were collected during the last 7 days of this period, being preceded by 7 days for adaptation of animals to the collection apparatus. The sulfur hexafluoride (SF6 tracer technique was used for estimating enteric methane emissions. CH4 and SF6 local background were also collected each day from inside of the installation using the same apparatus. The SF6 and CH4 gases were analyzed by gas chromatography. The correlation between RFI72 and RFI32 was not high (0.41 as a 32 days is a short period for accurately measuring the average daily gain. However, the additional period of 32 days is more representative of age, weight and feed intake at the time of CH4 collecting period than 72-days performance test itself. The averages of age, weight and CH4 daily emission were 351±24 days, 343±34 kg, and 155.5

  9. Laboratory Screening for Children Entering Foster Care.

    Science.gov (United States)

    Greiner, Mary V; Beal, Sarah J; Nause, Katie; Staat, Mary Allen; Dexheimer, Judith W; Scribano, Philip V

    2017-12-01

    To determine the prevalence of medical illness detected by laboratory screening in children entering foster care in a single, urban county. All children entering foster care in a single county in Ohio were seen at a consultation foster care clinic and had laboratory screening, including testing for infectious diseases such as HIV, hepatitis B, hepatitis C, syphilis, and tuberculosis as well as for hemoglobin and lead levels. Over a 3-year period (2012-2015), laboratory screening was performed on 1977 subjects entering foster care in a consultative foster care clinic. The prevalence of hepatitis B, hepatitis C, syphilis, and tuberculosis were all found to be <1%. There were no cases of HIV. Seven percent of teenagers entering foster care tested positive for Chlamydia . A secondary finding was that 54% of subjects were hepatitis B surface antibody-negative, indicating an absence of detected immunity to the hepatitis B virus. Routine laboratory screening for children entering foster care resulted in a low yield. Targeted, rather than routine, laboratory screening may be a more clinically meaningful approach for children entering foster care. Copyright © 2017 by the American Academy of Pediatrics.

  10. The Influence of Parenting Practices on Feeding Problems in Preschoolers

    Directory of Open Access Journals (Sweden)

    Nuria de la Osa

    2015-12-01

    Full Text Available The aim of the study is to estimate the prevalence of feeding problems during the preschool period and to explore the associations of feeding related behaviors with parenting practices. Participants were a large community sample of N = 622 children longitudinally assessed yearly at ages 3, 4 and 5 years-old through diagnostic interview and questionnaires reported by parents. The prevalence of children who met DSM-IV criteria for feeding disorder during the follow-up was 1.6%, the amount of children who presented feeding disorder symptoms was 33.3%, those with clinical impairment due to these symptoms were 25.7% and 11.6% reported seek for professional help related to feeding problems. Logistic regressions adjusted to children's sex and other DSM-IV diagnoses different to feeding disorder showed that the dimensions of parenting more strongly related to feeding related behaviors and impairment due to feeding problems were poor monitoring, inconsistence practices, corporal punishment, low norms and low autonomy. Although the prevalence of preschool children who met DSM-IV criteria for feeding disorder was relatively low, the presence of feeding related behaviors (symptoms, impairment and consultation was common during this developmental period. Parenting practices are associated to the presence of these behaviors, and so they must be considered into the prevention and intervention programs.

  11. WTP Waste Feed Qualification: Glass Fabrication Unit Operation Testing Report

    Energy Technology Data Exchange (ETDEWEB)

    Stone, M. E. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL). Hanford Missions Programs; Newell, J. D. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL). Process Technology Programs; Johnson, F. C. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL). Engineering Process Development; Edwards, T. B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL). Engineering Process Development

    2016-07-14

    The waste feed qualification program is being developed to protect the Hanford Tank Waste Treatment and Immobilization Plant (WTP) design, safety basis, and technical basis by assuring waste acceptance requirements are met for each staged waste feed campaign prior to transfer from the Tank Operations Contractor to the feed receipt vessels inside the Pretreatment Facility. The Waste Feed Qualification Program Plan describes the three components of waste feed qualification: 1. Demonstrate compliance with the waste acceptance criteria 2. Determine waste processability 3. Test unit operations at laboratory scale. The glass fabrication unit operation is the final step in the process demonstration portion of the waste feed qualification process. This unit operation generally consists of combining each of the waste feed streams (high-level waste (HLW) and low-activity waste (LAW)) with Glass Forming Chemicals (GFCs), fabricating glass coupons, performing chemical composition analysis before and after glass fabrication, measuring hydrogen generation rate either before or after glass former addition, measuring rheological properties before and after glass former addition, and visual observation of the resulting glass coupons. Critical aspects of this unit operation are mixing and sampling of the waste and melter feeds to ensure representative samples are obtained as well as ensuring the fabrication process for the glass coupon is adequate. Testing was performed using a range of simulants (LAW and HLW simulants), and these simulants were mixed with high and low bounding amounts of GFCs to evaluate the mixing, sampling, and glass preparation steps in shielded cells using laboratory techniques. The tests were performed with off-the-shelf equipment at the Savannah River National Laboratory (SRNL) that is similar to equipment used in the SRNL work during qualification of waste feed for the Defense Waste Processing Facility (DWPF) and other waste treatment facilities at the

  12. Alternative fish feed production from waste chicken feathers

    Directory of Open Access Journals (Sweden)

    Sri Jumini

    2017-08-01

    Full Text Available In this This devotion has been done to provide education and training of the utilization of waste chicken manure, making flour chicken feathers as a fish feed alternative, that can overcome some of the problems that waste chicken feathers from the center cutting broiler chickens in the village Krasak enough, it causes pollution, and not used optimally; Low public awareness of awareness of environmental pollution; the lack of public knowledge about the utilization of waste chicken feathers, and processing technology, as well as to address the needs of fish feed more expensive, need alternative feed ingredients. This service program has provided insight to the public about waste chicken feathers so that it can be used as a new entrepreneurial startups. To achieve these objectives have been done of activity as follows: 1 Provide counseling and understanding of the community will be a negative impact on the environment of waste chicken feathers. 2 Provide counseling utilization of waste chicken feathers for people in nearby farms. 3 Make a chicken feather meal of chicken feather waste as an alternative fish feed to improve digestibility of chicken feathers. 3 The formation of the group for increasing the economic income of the family. This service activities program runs quite well with demonstrated some activity, namely: 1 Change Behavior Society (knowledge transfer; 2 Chicken Feather Extension Waste Utilization; 3 Making Unit Waste Chicken Feathers; 4 Establishment of New Business of Diversified Waste Chicken Feathers.

  13. Using Neural Network and Logistic Regression Analysis to Predict Prospective Mathematics Teachers' Academic Success upon Entering Graduate Education

    Science.gov (United States)

    Bahadir, Elif

    2016-01-01

    The ability to predict the success of students when they enter a graduate program is critical for educational institutions because it allows them to develop strategic programs that will help improve students' performances during their stay at an institution. In this study, we present the results of an experimental comparison study of Logistic…

  14. 31 CFR 540.317 - Uranium feed; natural uranium feed.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Uranium feed; natural uranium feed... (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY HIGHLY ENRICHED URANIUM (HEU) AGREEMENT ASSETS CONTROL REGULATIONS General Definitions § 540.317 Uranium feed; natural uranium feed. The...

  15. Development of a Rapid Salivary Proteomic Platform for Oral Feeding Readiness in the Preterm Newborn

    Directory of Open Access Journals (Sweden)

    Prarthana Khanna

    2017-12-01

    Full Text Available Oral feeding competency is a major determinant of length of stay in the neonatal intensive care unit. An infant must be able to consistently demonstrate the ability to take all required enteral nutrition by mouth before discharge home. Most infants born prematurely (<37 weeks will require days, if not weeks, to master this oral feeding competency skill. Inappropriately timed feeding attempts can lead to acute and long-term morbidities, prolonged hospitalizations, and increased health-care costs. Previously, a panel of five genes involved in essential developmental pathways including sensory integration (nephronophthisis 4, Plexin A1, hunger signaling [neuropeptide Y2 receptor (NPY2R, adenosine-monophosphate-activated protein kinase (AMPK], and facial development (wingless-type MMTV integration site family, member 3 required for oral feeding success were identified in neonatal saliva. This study aimed to translate these five transcriptomic biomarkers into a rapid proteomic platform to provide objective, real-time assessment of oral feeding skills, to better inform care, and to improve neonatal outcomes. Total protein was extracted from saliva of 10 feeding-successful and 10 feeding-unsuccessful infants matched for age, sex, and post-conceptional age. Development of immunoassays was attempted for five oral feeding biomarkers and two reference biomarkers (GAPDH and YWHAZ to normalize for starting protein concentrations. Normalized protein concentrations were correlated to both feeding status at time of sample collection and previously described gene expression profiles. Only the reference proteins and those involved in hunger signaling were detected in neonatal saliva at measurable levels. Expression patterns for NPY2R and AMPK correlated with the gene expression patterns previously seen between successful and unsuccessful feeders and predicted feeding outcome. Salivary proteins associated with hunger signaling are readily quantifiable in

  16. Shaping oral feeding in a gastronomy tube-dependent child in natural settings.

    Science.gov (United States)

    Gutentag, S; Hammer, D

    2000-07-01

    A 3-year-old medically fragile girl who refused to eat after prolonged and frequent hospitalizations was started on a feeding program in the home and school settings. She exhibited food aversions and received all nourishment via a gastronomy tube. Preevaluation observations of her feeding behavior revealed that she refused all presented drinks and foods. Treatment was two-fold. First, food acceptance was followed by social praise and access to preferred toy play, and second, food refusal and disruptive behaviors were ignored. Gagging, vomiting, and crying occurred periodically during initial feedings. In addition, there were medical complications during the course of treatment necessitating continuous modifications of the program. Results of a multiple-phase design showed marked increases in the amount of food consumed at home, which then generalized to the school setting.

  17. The crisis in infant feeding practices.

    Science.gov (United States)

    Berg, A

    1978-01-01

    This article maintains that the dramatic decline in breast-feeding in low-income countries is extracting a substantial cost, both in infant health and in outright economic loss. From the 6th to 12th month of life, breast-feeding can supply up to 3/4 of a child's protein needs. The breast-fed child has received about 375 liters of breast milk by age 2. The nutritional equivalent in cow's milk would cost about $65; in packaged dried milk formulas, close to $140. Yet in the few developing countries where surveys of breast-feeding have been conducted over the years, the common pattern is one of significant decline, with greatest decline in urban areas. As communication techniques become more effective in developing countries, urban life styles will have increasing influence on rural societies. Estimates show that losses in breast milk can produce losses in the billions of dollars to developing countries. In terms of national development, lactation has another major economic asset: its link to family planning as a major form of contraception. One investigation reports that the incidence of pregnancy in the 1st 9 months after childbirth of nonnursing mothers was twice that of mothers who breast-fed, including those who simultaneously used other foods. Just as breast milk can be the major source of nutrition, the failure to provide breast milk is a major cause of infant malnutrition and mortality. Poor parents often dilute milk formulas to extend their supply; many cannot read labels and instructions; and hygienic needs often cannot be met by the parents. Breast-fed babies are more resistant to a host of diseases. The costs and obstacles of designing campaigns to encourage breast-feeding in developing countries may be less imposing than those of alternate nutrition intervention programs designed to achieve the same ends. Such a campaign calls for: 1) attracting the public's attention to the benefits of breast-feeding and the dangers of foregoing it through the media

  18. Predicting Attrition in a Military Special Program Training Command

    Science.gov (United States)

    2016-05-20

    made by assessing additional psychological factors. Specifically, motivation (s) to enter the training program (e.g., intrinsic versus extrinsic ...this and other training programs. Motivations to enter the training program could be assessed using a measure such as the Work Extrinsic and...MEDICINE GRADUATE PROGRAMS Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814 APPROVAL OF THE DOCTORAL DISSERTATION IN THE

  19. An optimist's view on limiting necrotic enteritis and maintaining broiler gut health and performance in today's marketing, food safety, and regulatory climate.

    Science.gov (United States)

    Hofacre, Charles L; Smith, John A; Mathis, Greg F

    2018-06-01

    The future poultry nutritionist, veterinarian, and husbandryman will have many new regulatory requirements and consumer preferences to navigate in addition to their normal responsibility of raising birds in a cost-efficient and wholesome manner. New challenges include changes to antibiotic use, increased food safety regulations, and more concern over how birds are raised and how to dispose of poultry house waste. All of these new programs and new regulations will alter how we have been raising birds for the last 60 years since the inception of the integrated poultry industry. The most significant change may be the voluntary or regulatory withdrawal of the use of antibiotics in poultry production. In North America, this withdrawal of antibiotic use includes removal of in-ovo antibiotics, performance-improving antibiotics or antibiotic growth promotors (AGP), and the polyether ionophore antibiotics (ionophore anticoccidials).The removal of antibiotics in poultry production may result in welfare concerns due to elevated mortality and less efficient feed conversion, resulting in greater environmental impacts from increased manure production and more use of grain per unit of meat produced. There also may be concerns with greater intestinal disease in the birds resulting in increased numbers of foodborne illness-causing bacteria such as Salmonella sp. or Campylobacter sp. on the carcass. A major impact will be the disease necrotic enteritis (NE). This review will focus on the pathophysiology of NE, the management of the disease, and the additional effects on growth rate, feed efficiency, and body weight that may be associated with NE.

  20. Zoonotic enteric parasites transmitted from dogs in Egypt with special concern to Toxocara canis infection

    Directory of Open Access Journals (Sweden)

    Maysa A. I. Awadallah

    2015-08-01

    Full Text Available Aim: This work aimed to study the role played by dogs in transmitting zoonotic enteric parasites to humans in Egypt and to analyze the risk factors associated with the occurrence of such infection in dogs. Serodiagnosis of anti-Toxocara immunoglobulin G (IgG antibodies among human beings as well as analyzing risk factors predispose to Toxocara canis infection in human beings are another objectives of this study. Materials and Methods: From June to December 2013, a total of 130 fecal samples from 4 dog populations (Military, nomadic and domiciled dogs from rural and high standard districts and 150 stool samples of 6 occupational groups were examined for the presence of enteric parasitic infection. Moreover, 150 serum samples were collected from humans from whom stool samples were collected and examined for the presence of anti-T. canis antibodies. Results: Enteric parasites were detected in 30% of fecal samples from 4 dog populations in Egypt. High infectivity had been reported in nomadic dogs (63.33% (Crude odds ratios [COR]=67.36, 95% confidence interval [CI]=8.09-560.8, p˂0.000, followed by domiciled dogs from rural areas (40% (COR=26, 95% CI=3.14-215.54, p=0.003, domiciled dogs from high standard areas (23.33% (COR=11.87, 95% CI=1.37-102.69, p=0.025 and military dogs (2.5%. Twelve species of enteric parasites were identified, Ancylostomatidae (6.15%, T. canis and Cryptosporidium spp. (5.38%, each, Heterophyes spp. (3.85%, Toxocara leonina and Blastocystis spp. (3.07%, Taenidae eggs (2.31%, Hymenolepis diminuta (1.54% and Entamoeba canis, Cyclospora cayetanensis, and Paragonimus spp. (0.77%, each. Univariate logestic regression revealed significant association of age (COR=4.73, 95% CI=2.13-10.53, p˂0.000, gender (COR=2.63, 95% CI=1.22-5.68, p˂0.014, housing system (COR=5.10, 95% CI=2.04-12.75, p˂0.000 with enteric parasitic infection in dogs. However, breeds (COR=6.91, 95% CI=0.88-54.52, p=0.067 and type of feeding (COR ranged from 3.5 to

  1. Risk management of undesirable substances in feed following updated risk assessments

    International Nuclear Information System (INIS)

    Verstraete, Frans

    2013-01-01

    Directive 2002/32/EC of 7 May 2002 of the European Parliament and of the Council on undesirable substances in animal feed is the framework for the EU action on undesirable substances in feed. This framework Directive provides: ⁎that products intended for animal feed may enter for use in the Union from third countries, be put into circulation and/or used in the Union only if they are sound, genuine and of merchantable quality and therefore when correctly used do not represent any danger to human health, animal health or to the environment or could adversely affect livestock production. ⁎that in order to protect animal and public health and the environment, maximum levels for specific undesirable substances shall be established where necessary. ⁎for mandatory consultation of a scientific body (EFSA) for all provisions which may have an effect upon public health or animal health or on the environment. ⁎that products intended for animal feed containing levels of an undesirable substance that exceed the established maximum level may not be mixed for dilution purposes with the same, or other, products intended for animal feed and may not be used for the production of compound feed. Based on the provisions and principles laid down in this framework Directive, maximum levels for a whole range of undesirable substances have been established at EU level. During the discussions in view of the adoption of Directive 2002/32/EC, the European Commission made the commitment to review all existing provisions on undesirable substances on the basis of updated scientific risk assessments. Following requests of the European Commission, the Panel on Contaminants in the Food Chain (CONTAM) from the European Food Safety Authority (EFSA) has completed a series of 30 risk assessments undertaken over the last 5 years on undesirable substances in animal feed reviewing the possible risks for animal and human health due to the presence of these substances in animal feed. EU legislation

  2. Risk management of undesirable substances in feed following updated risk assessments

    Energy Technology Data Exchange (ETDEWEB)

    Verstraete, Frans, E-mail: Frans.Verstraete@ec.europa.eu

    2013-08-01

    Directive 2002/32/EC of 7 May 2002 of the European Parliament and of the Council on undesirable substances in animal feed is the framework for the EU action on undesirable substances in feed. This framework Directive provides: ⁎that products intended for animal feed may enter for use in the Union from third countries, be put into circulation and/or used in the Union only if they are sound, genuine and of merchantable quality and therefore when correctly used do not represent any danger to human health, animal health or to the environment or could adversely affect livestock production. ⁎that in order to protect animal and public health and the environment, maximum levels for specific undesirable substances shall be established where necessary. ⁎for mandatory consultation of a scientific body (EFSA) for all provisions which may have an effect upon public health or animal health or on the environment. ⁎that products intended for animal feed containing levels of an undesirable substance that exceed the established maximum level may not be mixed for dilution purposes with the same, or other, products intended for animal feed and may not be used for the production of compound feed. Based on the provisions and principles laid down in this framework Directive, maximum levels for a whole range of undesirable substances have been established at EU level. During the discussions in view of the adoption of Directive 2002/32/EC, the European Commission made the commitment to review all existing provisions on undesirable substances on the basis of updated scientific risk assessments. Following requests of the European Commission, the Panel on Contaminants in the Food Chain (CONTAM) from the European Food Safety Authority (EFSA) has completed a series of 30 risk assessments undertaken over the last 5 years on undesirable substances in animal feed reviewing the possible risks for animal and human health due to the presence of these substances in animal feed. EU legislation

  3. A Physiological Stimulating Factor of Water Intake during and after Dry Forage Feeding in Large-type Goats.

    Science.gov (United States)

    Van Thang, Tran; Sunagawa, Katsunori; Nagamine, Itsuki; Kishi, Tetsuya; Ogura, Go

    2012-04-01

    When ruminants consume dry forage, they also drink large volumes of water. The objective of this study was to clarify which factor produced when feed boluses enter the rumen is mainly responsible for the marked increase in water intake in the second hour of the 2 h feeding period in large-type goats fed on dry forage for 2 h twice daily. Six large-type male esophageal- and ruminal-fistulated goats (crossbred Japanese Saanen/Nubian, aged 2 to 6 years, weighing 85.1±4.89 kg) were used in two experiments. In experiment 1, the water deprivation (WD) control and the water availability (WA) treatment were conducted to compare changes in water intake during and after dry forage feeding. In experiment 2, a normal feeding conditions (NFC) control and a feed bolus removal (FBR) treatment were carried out to investigate whether decrease in circulating plasma volume or increase in plasma osmolality is mainly responsible for the marked increase in water intake in the second hour of the 2 h feeding period. The results of experiment 1 showed that in the WA treatment, small amounts of water were consumed during the first hour of feeding while the majority of water intake was observed during the second hour of the 2 h feeding period. Therefore, the amounts of water consumed in the second hour of the 2 h feeding period accounted for 82.8% of the total water intake. The results of experiment 2 indicated that in comparison with the NFC control, decrease in plasma volume in the FBR treatment, which was indicated by increase in hematocrit and plasma total protein concentrations, was higher (pforage feeding in large-type goats.

  4. Gender-specific feeding rates in planktonic copepods with different feeding behavior

    DEFF Research Database (Denmark)

    van Someren Gréve, Hans; Almeda, Rodrigo; Lindegren, Martin

    2017-01-01

    Planktonic copepods have sexually dimorphic behaviors, which can cause differences in feeding efficiency between genders. Copepod feeding rates have been studied extensively but most studies have focused only on females. In this study, we experimentally quantified feeding rates of males and females...... copepods, particularly in ambush feeders, where the males must sacrifice feeding for mate searching. We conducted gender-specific functional feeding response experiments using prey of different size and motility. In most cases, gender-specific maximum ingestion and clearance rates were largely explained...... in copepods with different feeding behavior: ambush feeding (Oithona nana), feeding-current feeding (Temora longicornis) and cruising feeding (Centropages hamatus). We hypothesize that carbon-specific maximum ingestion rates are similar between genders, but that maximum clearance rates are lower for male...

  5. Mycophenolic acid agents: is enteric coating the answer?

    Directory of Open Access Journals (Sweden)

    Manitpisitkul W

    2011-03-01

    Full Text Available Wana Manitpisitkul1, Sabrina Lee2, Matthew Cooper31Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, USA; 2Solid Organ Transplant Program, University of Utah Health Care, Salt Lake City, UT, USA; 3Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Addition of mycophenolate mofetil (MMF to calcineurin-based immunosuppressive therapy has led to a significant improvement in graft survival and reduction of acute rejection in renal transplant recipients. However, in clinical practice, MMF dose reduction, interruption, or discontinuation due to hematological and gastrointestinal (GI side-effects occurred in up to 50% of the patients. Large retrospective analyses have demonstrated that patients requiring MMF dose manipulation due to adverse events experienced a higher rate of rejection and graft loss. Enteric-coated mycophenolate sodium (EC-MPS was developed with the goal of improving upper GI side-effects. Here, we review the efficacy and safety of EC-MPS in de novo kidney transplant recipient, and in stable renal transplant patients who were converted from MMF. The changes in GI-related adverse events using patient-reported outcome instruments are also reviewed.Keywords: enteric-coated mycophenolate sodium, mycophenolate mofetil, kidney transplant, efficacy, gastrointestinal tolerability

  6. Organic dairy farming in Norway under the 100% organically produced feed requirement

    OpenAIRE

    Flaten, Ola; Lien, Gudbrand

    2009-01-01

    The derogation to use a percentage of cheaper non-organic feeds in organic livestock diets for herbivores expired from January 2008. (In Norway, a maximum 15% of conventional feedstuffs per year was allowed until 24 August 2005, 5% in the interim.) This study aimed to assess changes in resource use and financial impacts for organic dairy herds of the 100% organic feeding rule (compared with 85% organic feeds) using a two-stage stochastic programming modelling framework. In this study, the obj...

  7. Prospects of complete feed system in ruminant feeding: A review

    Directory of Open Access Journals (Sweden)

    Yasir Afzal Beigh

    2017-04-01

    Full Text Available Effective utilization of available feed resources is the key for economical livestock rearing. Complete feed system is one of the latest developments to exploit the potential of animal feed resources in the best possible way. The complete feed is a quantitative mixture of all dietary ingredients, blended thoroughly to prevent separation and selection, fed as a sole source of nutrients except water and is formulated in a desired proportion to meet the specific nutrient requirements. The concentrate and roughage levels may vary according to the nutrient requirement of ruminants for different production purposes. The complete feed with the use of fibrous crop residue is a noble way to increase the voluntary feed intake and thus animal's production performance. In this system of feeding, the ruminant animals have continuous free choice availability of uniform feed mixture, resulting in more uniform load on the rumen and less fluctuation in release of ammonia which supports more efficient utilization of ruminal non-protein nitrogen. Feeding complete diet stabilizes ruminal fermentation, thereby improves nutrient utilization. This feeding system allows expanded use of agro-industrial byproducts, crop residues and nonconventional feeds in ruminant ration for maximizing production and minimizing feeding cost, thus being increasingly appreciated. However, to extend the concept extensively to the field and make this technology successful and viable for farmers, more efforts are needed to be taken.

  8. Safety of Novel Protein Sources (Insects, Microalgae, Seaweed, Duckweed, and Rapeseed) and Legislative Aspects for Their Application in Food and Feed Production

    NARCIS (Netherlands)

    Spiegel, van der M.; Noordam, M.Y.; Fels-Klerx, van der H.J.

    2013-01-01

    Novel protein sources (like insects, algae, duckweed, and rapeseed) are expected to enter the European feed and food market as replacers for animal-derived proteins. However, food safety aspects of these novel protein sources are not well-known. The aim of this article is to review the state of the

  9. Beneficial Effects of Early Enteral Nutrition After Major Rectal Surgery: A Possible Role for Conditionally Essential Amino Acids? Results of a Randomized Clinical Trial.

    Science.gov (United States)

    van Barneveld, Kevin W Y; Smeets, Boudewijn J J; Heesakkers, Fanny F B M; Bosmans, Joanna W A M; Luyer, Misha D; Wasowicz, Dareczka; Bakker, Jaap A; Roos, Arnout N; Rutten, Harm J T; Bouvy, Nicole D; Boelens, Petra G

    2016-06-01

    better clinical outcome was observed. We conclude that plasma amino acids do not provide a causal explanation for the observed beneficial effects of early enteral feeding after major rectal surgery.

  10. Parental perceptions, feeding practices, feeding styles, and level of acculturation of Chinese Americans in relation to their school-age child's weight status.

    Science.gov (United States)

    Pai, Hsiao-Liang; Contento, Isobel

    2014-09-01

    Parents influence their child's eating behavior and attitudes directly as food providers and indirectly through their parental feeding styles and feeding concerns and practices. Chinese American parents' practices are likely influenced by culture. The objective of this study was to explore the relationships between parental perceptions, feeding practices, feeding styles, level of parental acculturation (LPA), and child weight status via a self-administered questionnaire. This survey study involved a convenience sample of 712 individuals who were parents of 5- to 10-year old children attending Chinese language after-school programs. The prevalence of overweight was 11.5% and obesity was 11.1%. LPA was not directly predictive of child overweight in multiple regression but from categorical data, Chinese American parents tended to use indulgent (33.2%) and authoritarian (27.9%) feeding styles, with the former increasing with acculturation and the latter decreasing. Indulgent parents had more than expected overweight and obese children, and authoritarian and authoritative parents, fewer. LPA was negatively predictive of pressure to eat healthy foods (p Parental perceptions and concerns about child weight were predictors of child weight. Consequently, parental concerns and responsiveness to child needs without also encouragement (demandingness) to eat healthy foods (indulgent feeding style) may promote overweight. The authoritative parental feeding style may contribute to children having healthy weights and therefore healthy lives. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Coronavirus–associated enteritis in a quail farm

    Directory of Open Access Journals (Sweden)

    Antonio Camarda

    2010-01-01

    Full Text Available An enteric syndrome observed in semi-intensively reared quails is described. The affected birds showed depression, severe diarrhoea and dehydration. The mortality occurred particularly in young birds. At necropsy, the prominent lesion was catarrhal enteritis. Laboratory investigations demonstrated the presence of coronavirus in the gut of dead animals. No additional pathogens were detected. To our knowledge, this is the first evidence for the presence of CoVs in quail with enteritis.

  12. Feed-forward general-purpose computer

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, H; Yoshioka, Y; Nakamura, T; Shigei, Y

    1983-08-01

    The feed forward machine (FFM) proposed by the authors has a CPU composed of many fixed arithmetic units and registers. Many features of the FFM which are compatible with concurrent operating and reduce the instruction requirement for store are reported. In order to evaluate the FFM, the minimum execution time of instructions is discussed by using the Petri Net model. From this it is predicted that the execution time will be 0.46-0.6 times the real execution time. Furthermore, it is concluded that the program for the FFM will be reduced in size with respect to the program for the Von Neumann computers. 12 references.

  13. Adaptive immunity alters distinct host feeding pathways during nematode induced inflammation, a novel mechanism in parasite expulsion.

    Directory of Open Access Journals (Sweden)

    John J Worthington

    2013-01-01

    Full Text Available Gastrointestinal infection is often associated with hypophagia and weight loss; however, the precise mechanisms governing these responses remain poorly defined. Furthermore, the possibility that alterations in feeding during infection may be beneficial to the host requires further study. We used the nematode Trichinella spiralis, which transiently inhabits the small intestine before migrating to skeletal muscle, as a biphasic model of infection to determine the cellular and molecular pathways controlling feeding during enteric and peripheral inflammation. Through the infection of genetically modified mice lacking cholecystokinin, Tumor necrosis factor α receptors and T and B-cells, we observed a biphasic hypophagic response to infection resulting from two separate immune-driven mechanisms. The enteroendocrine I-cell derived hormone cholecystokinin is an essential mediator of initial hypophagia and is induced by CD4+ T-cells during enteritis. In contrast, the second hypophagic response is extra-intestinal and due to the anorectic effects of TNFα during peripheral infection of the muscle. Moreover, via maintaining naive levels of the adipose secreted hormone leptin throughout infection we demonstrate a novel feedback loop in the immunoendocrine axis. Immune driven I-cell hyperplasia and resultant weight loss leads to a reduction in the inflammatory adipokine leptin, which in turn heightens protective immunity during infection. These results characterize specific immune mediated mechanisms which reduce feeding during intestinal or peripheral inflammation. Importantly, the molecular mediators of each phase are entirely separate. The data also introduce the first evidence that I-cell hyperplasia is an adaptively driven immune response that directly impinges on the outcome to infection.

  14. Journey to Becoming a Neonatal Nurse Practitioner: Making the Decision to Enter Graduate School.

    Science.gov (United States)

    Brand, M Colleen; Cesario, Sandra K; Symes, Lene; Montgomery, Diane

    2016-04-01

    Neonatal nurse practitioners (NNPs) play an important role in caring for premature and ill infants. Currently, there is a shortage of NNPs to fill open positions. Understanding how nurses decide to become NNPs will help practicing nurse practitioners, managers, and faculty encourage and support nurses in considering the NNP role as a career choice. To describe how nurses decide to enter graduate school to become nurse practitioners. A qualitative study using semistructured interviews to explore how 11 neonatal intensive care unit nurses decided to enter graduate school to become NNPs. Key elements of specialization, discovery, career decision, and readiness were identified. Conditions leading to choosing the NNP role include working in a neonatal intensive care unit and deciding to stay in the neonatal area, discovering the NNP role, deciding to become an NNP, and readiness to enter graduate school. Important aspects of readiness are developing professional self-confidence and managing home, work, and financial obligations and selecting the NNP program. Neonatal nurse practitioners are both positive role models and mentors to nurses considering the role. Unit managers are obligated to provide nurses with opportunities to obtain leadership skills. Faculty of NNP programs must be aware of the impact NNP students and graduates have on choices of career and schools. Exploring the decision to become an NNP in more geographically diverse populations will enhance understanding how neonatal intensive care unit nurses decide to become NNPs.

  15. Gastrointestinal obstruction caused by solidification and coagulation of enteral nutrition: pathogenetic mechanisms and potential risk factors

    Directory of Open Access Journals (Sweden)

    Leonello G

    2018-04-01

    Full Text Available Grazia Leonello,1 Antonio Giacomo Rizzo,1 Viviane Di Dio,2 Antonio Soriano,3 Claudia Previti,3 Grazia Giulia Pantè,3 Claudio Mastrojeni,1 Sebastiano Pantè1 1Department of Human Pathology of Adults and Evolutive Era “Gaetano Barresi”, University of Messina, Messina, Italy; 2Health Research Institute Bonino Pulejo, Piemonte Hospital, Messina, Italy; 3Department of Medical and Surgery Science, University of Messina, Messina, Italy Abstract: Enteral nutrition (EN is preferred in order to provide nutrition and reduce catabolism in critically ill patients. Recent studies suggest that the use of EN is successful and complications are rare. However, an underestimated mechanical complication of tube feedings seen in critically ill patients is the coagulation and solidification of the EN causing gastrointestinal obstruction. This report describes two clinical cases (1.23% of all cases seen at our clinic of obstruction and perforation of the small bowel secondary to the solidification of EN. The understanding and early recognition of this potential complication are essential for the prevention and successful treatment of this condition. Keywords: enteral nutrition, gastrointestinal contents, intestinal obstruction, small-bowel bezoar

  16. Cancer cells enter dormancy after cannibalizing mesenchymal stem/stromal cells (MSCs).

    Science.gov (United States)

    Bartosh, Thomas J; Ullah, Mujib; Zeitouni, Suzanne; Beaver, Joshua; Prockop, Darwin J

    2016-10-18

    Patients with breast cancer often develop malignant regrowth of residual drug-resistant dormant tumor cells years after primary treatment, a process defined as cancer relapse. Deciphering the causal basis of tumor dormancy therefore has obvious therapeutic significance. Because cancer cell behavior is strongly influenced by stromal cells, particularly the mesenchymal stem/stromal cells (MSCs) that are actively recruited into tumor-associated stroma, we assessed the impact of MSCs on breast cancer cell (BCC) dormancy. Using 3D cocultures to mimic the cellular interactions of an emerging tumor niche, we observed that MSCs sequentially surrounded the BCCs, promoted formation of cancer spheroids, and then were internalized/degraded through a process resembling the well-documented yet ill-defined clinical phenomenon of cancer cell cannibalism. This suspected feeding behavior was less appreciable in the presence of a rho kinase inhibitor and in 2D monolayer cocultures. Notably, cannibalism of MSCs enhanced survival of BCCs deprived of nutrients but suppressed their tumorigenicity, together suggesting the cancer cells entered dormancy. Transcriptome profiles revealed that the resulting BCCs acquired a unique molecular signature enriched in prosurvival factors and tumor suppressors, as well as inflammatory mediators that demarcate the secretome of senescent cells, also referred to as the senescence-associated secretory phenotype. Overall, our results provide intriguing evidence that cancer cells under duress enter dormancy after cannibalizing MSCs. Importantly, our practical 3D coculture model could provide a valuable tool to understand the antitumor activity of MSCs and cell cannibalism further, and therefore open new therapeutic avenues for the prevention of cancer recurrence.

  17. At-tank Low-Activity Feed Homogeneity Analysis Verification

    International Nuclear Information System (INIS)

    DOUGLAS, J.G.

    2000-01-01

    This report evaluates the merit of selecting sodium, aluminum, and cesium-137 as analytes to indicate homogeneity of soluble species in low-activity waste (LAW) feed and recommends possible analytes and physical properties that could serve as rapid screening indicators for LAW feed homogeneity. The three analytes are adequate as screening indicators of soluble species homogeneity for tank waste when a mixing pump is used to thoroughly mix the waste in the waste feed staging tank and when all dissolved species are present at concentrations well below their solubility limits. If either of these conditions is violated, then the three indicators may not be sufficiently chemically representative of other waste constituents to reliably indicate homogeneity in the feed supernatant. Additional homogeneity indicators that should be considered are anions such as fluoride, sulfate, and phosphate, total organic carbon/total inorganic carbon, and total alpha to estimate the transuranic species. Physical property measurements such as gamma profiling, conductivity, specific gravity, and total suspended solids are recommended as possible at-tank methods for indicating homogeneity. Indicators of LAW feed homogeneity are needed to reduce the U.S. Department of Energy, Office of River Protection (ORP) Program's contractual risk by assuring that the waste feed is within the contractual composition and can be supplied to the waste treatment plant within the schedule requirements

  18. How to engage across sectors: lessons from agriculture and nutrition in the Brazilian School Feeding Program.

    Science.gov (United States)

    Hawkes, Corinna; Brazil, Bettina Gerken; Castro, Inês Rugani Ribeiro de; Jaime, Patricia Constante

    2016-08-11

    To provide insights for nutrition and public health practitioners on how to engage with other sectors to achieve public health goals. Specifically, this study provides lessons from the example of integrating family farming and a nutrition into a legal framework in Brazil on how to successfully shift other sectors toward nutrition goals. The study analyzed policy processes that led to a Brazilian law linking family farming with the National School Feeding Program. Main actors involved with the development of the law were interviewed and their narratives were analyzed using a well-established theoretical framework. The study provides five key lessons for promoting intersectorality. First, nutrition and health practitioners can afford to embrace bold ideas when working with other sectors. Second, they should engage with more powerful sectors (or subsectors) and position nutrition goals as providing solutions that meet the interests of these sector. Third is the need to focus on a common goal - which may not be explicitly nutrition-related - as the focus of the intersectoral action. Fourth, philosophical, political, and governance spaces are needed to bring together different sectors. Fifth, evidence on the success of the intersectoral approach increases the acceptance of the process. This study on policy processes shows how a convergence of factors enabled a link between family farming and school feeding in Brazil. It highlights that there are strategies to engage other sectors toward nutrition goals which provides benefits for all sectors involved.

  19. Environmentally relevant concentrations of citalopram partially inhibit feeding in the three-spine stickleback (Gasterosteus aculeatus).

    Science.gov (United States)

    Kellner, M; Porseryd, T; Porsch-Hällström, I; Hansen, S H; Olsén, K H

    2015-01-01

    Selective Serotonin Re-uptake Inhibitors (SSRI) are mood-altering, psychotropic drugs commonly used in the treatment of depression and other psychological illnesses. Many of them are poorly degraded in sewage treatment plants and enter the environment unaltered. In laboratory studies, they have been demonstrated to affect a wide range of behaviours in aquatic organisms. In this study we investigated the effect of a three-week exposure to 0.15 and 1.5 μg/l of the SSRI citalopram dissolved in the ambient water on the feeding behaviour in three-spine stickleback (Gasterosteus aculeatus). Feeding, measured as the number of attacks performed on a piece of frozen bloodworms during a 10-min period, was reduced by 30-40% in fish exposed to both 0.15 and 1.5 μg/l citalopram. The effects of the environmentally relevant concentration 0.15 μg/l on feeding, an important fitness characteristic, suggests that the ecological significance of environmental SSRI exposure may be pronounced. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Comparison of different definitions of feeding intolerance

    DEFF Research Database (Denmark)

    Reintam Blaser, Annika; Starkopf, Liis; Deane, Adam M

    2015-01-01

    BACKGROUND & AIMS: While feeding intolerance (FI) is clinically important in the critically ill it is inconsistently defined. By evaluating definitions of FI based on relationships between symptoms and signs of gastrointestinal (GI) dysfunction and mortality the objective was to define FI using...... the definition that was most strongly associated with subsequent mortality. METHODS: Data from all adult patients admitted to a single ICU between 2004 and 2011, and who were receiving enteral nutrition (EN), were analysed. The amount of EN administered, presence of absent bowel sounds (BS), vomiting and....../or regurgitation, diarrhoea, bowel distension, and large gastric residual volumes (GRVs) were documented daily. A GRV ≥500 ml/day was considered as large and the sum of gastrointestinal (GI) symptoms including large GRV was calculated daily. Various definitions of FI were modelled. Definitions using only GRV...

  1. Providers perspectives on self-regulation impact their use of responsive feeding practices in child care.

    Science.gov (United States)

    Dev, Dipti A; Speirs, Katherine E; Williams, Natalie A; Ramsay, Samantha; McBride, Brent A; Hatton-Bowers, Holly

    2017-11-01

    Supporting children's self-regulation in eating through caregivers' practice of responsive feeding is paramount to obesity prevention, and while much attention has been given to supporting children's self-regulation in eating through parents' responsive feeding practices in the home setting, little attention has been given to this issue in childcare settings. This qualitative study examines childcare providers' perspectives on using responsive feeding practices with young children (2-5years). Individual semi-structured interviews were conducted with providers until saturation was reached. Data was analyzed using thematic analysis. The final sample included 18 providers who were employed full-time in Head Start or state-licensed center-based childcare programs, cared for children (2-5y), and were directly responsible for serving meals and snacks. Providers were primarily (67%) employed in childcare programs that served children from low-income families and received reimbursement for meals and snacks from the US Department of Agriculture's Child and Adult Care Food Program. Three factors emerged that shaped childcare providers' experiences using responsive feeding practices: the providers' perspectives about whether or not young children can self-regulate food intake, their understanding of Child and Adult Care Food Program (CACFP) portion size regulations, and the availability of food at the center where they worked. Future research should examine how childcare providers' understanding of children's ability to self-regulate their food intake, the appropriate use of the CACFP regulations in relationship to serving sizes, and having food available to offer seconds promotes providers' use of responsive feeding practices in center-based childcare programs and children's dietary behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. The low-level waste handling challenge at the Feed Materials Production Center

    International Nuclear Information System (INIS)

    Harmon, J.E.; Diehl, D.E.; Gardner, R.L.

    1988-02-01

    The management of low-level wastes from the production of depleted uranium at the Feed Materials Production Center presents an enormous challenge. The recovery of uranium from materials contaminated with depleted uranium is usually not economical. As a result, large volumes of wastes are generated. The Westinghouse Materials Company of Ohio has established an aggressive waste management program. Simple solutions have been applied to problems in the areas of waste handling and waste minimization. The success of this program has been demonstrated by the reduction of low-level waste inventory at the Feed Materials Production Center. 8 refs., 4 figs

  3. The low-level waste handling challenge at the Feed Materials Production Center

    International Nuclear Information System (INIS)

    Harmon, J.E.; Diehl, D.E.; Gardner, R.L.

    1988-01-01

    The management of low-level wastes from the production of depleted uranium at the Feed Materials Production Center presents an enormous challenge. The recovery of uranium from materials contaminated with depleted uranium is usually not economical. As a result, large volumes of wastes are generated. The Westinghouse Materials Company of Ohio has established an aggressive waste management program. Simple solutions have been applied to problems in the areas of waste handling and waste minimization. The success of this program has been demonstrated by the reduction of low-level waste inventory at the Feed Materials Production Center

  4. Necrotizing enterocolitis is associated with earlier achievement of enteral autonomy in children with short bowel syndrome.

    Science.gov (United States)

    Sparks, Eric A; Khan, Faraz A; Fisher, Jeremy G; Fullerton, Brenna S; Hall, Amber; Raphael, Bram P; Duggan, Christopher; Modi, Biren P; Jaksic, Tom

    2016-01-01

    Necrotizing enterocolitis (NEC) remains one of the most common underlying diagnoses of short bowel syndrome (SBS) in children. The relationship between the etiology of SBS and ultimate enteral autonomy has not been well studied. This investigation sought to evaluate the rate of achievement of enteral autonomy in SBS patients with and without NEC. Following IRB approval, 109 patients (2002-2014) at a multidisciplinary intestinal rehabilitation program were reviewed. The primary outcome evaluated was achievement of enteral autonomy (i.e. fully weaning from parenteral nutrition). Patient demographics, primary diagnosis, residual small bowel length, percent expected small bowel length, median serum citrulline level, number of abdominal operations, status of the ileocecal valve (ICV), presence of ileostomy, liver function tests, and treatment for bacterial overgrowth were recorded for each patient. Median age at PN onset was 0 weeks [IQR 0-0]. Median residual small bowel length was 33.5 cm [IQR 20-70]. NEC was present in 37 of 109 (33.9%) of patients. 45 patients (41%) achieved enteral autonomy after a median PN duration of 15.3 [IQR 7.2-38.4]months. Overall, 64.9% of patients with NEC achieved enteral autonomy compared to 29.2% of patients with a different primary diagnosis (p=0.001, Fig. 1). Patients with NEC remained more likely than those without NEC to achieve enteral autonomy after two (45.5% vs. 12.0%) and four (35.7% vs. 6.3%) years on PN (Fig. 1). Logistic regression analysis demonstrated the following parameters as independent predictors of enteral autonomy: diagnosis of NEC (pChildren with SBS because of NEC have a significantly higher likelihood of fully weaning from parenteral nutrition compared to children with other causes of SBS. Additionally, patients with NEC may attain enteral autonomy even after long durations of parenteral support. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Mouldy feed, mycotoxins and Shiga toxin - producing Escherichia coli colonization associated with Jejunal Hemorrhage Syndrome in beef cattle

    Directory of Open Access Journals (Sweden)

    Masson Luke

    2011-06-01

    Full Text Available Abstract Background Both O157 and non-O157 Shiga toxin - producing Escherichia coli (STECs cause serious human disease outbreaks through the consumption of contaminated foods. Cattle are considered the main reservoir but it is unclear how STECs affect mature animals. Neonatal calves are the susceptible age class for STEC infections causing severe enteritis. In an earlier study, we determined that mycotoxins and STECs were part of the disease complex for dairy cattle with Jejunal Hemorrhage Syndrome (JHS. For STECs to play a role in the development of JHS, we hypothesized that STEC colonization should also be evident in beef cattle with JHS. Aggressive medical and surgical therapies are effective for JHS, but rely on early recognition of clinical signs for optimal outcomes suggesting that novel approaches must be developed for managing this disease. The main objective of this study was to confirm that mouldy feeds, mycotoxins and STEC colonization were associated with the development of JHS in beef cattle. Results Beef cattle developed JHS after consuming feed containing several types of mycotoxigenic fungi including Fusarium poae, F. verticillioides, F. sporotrichioides, Penicillium roqueforti and Aspergillus fumigatus. Mixtures of STECs colonized the mucosa in the hemorrhaged tissues of the cattle and no other pathogen was identified. The STECs expressed Stx1 and Stx2, but more significantly, Stxs were also present in the blood collected from the lumen of the hemorrhaged jejunum. Feed extracts containing mycotoxins were toxic to enterocytes and 0.1% of a prebiotic, Celmanax Trademark, removed the cytotoxicity in vitro. The inclusion of a prebiotic in the care program for symptomatic beef calves was associated with 69% recovery. Conclusions The current study confirmed that STECs and mycotoxins are part of the disease complex for JHS in beef cattle. Mycotoxigenic fungi are only relevant in that they produce the mycotoxins deposited in the feed. A

  6. An experimental study of nettle feeding in captive gorillas.

    Science.gov (United States)

    Tennie, Claudio; Hedwig, Daniela; Call, Josep; Tomasello, Michael

    2008-06-01

    Mountain gorillas (Gorilla beringei beringei) in Karisoke, Rwanda, feed on the stinging nettle Laportea alatipes by means of elaborate processing skills. Byrne [e.g. Philosophical Transactions of the Royal Society of London, Series B, Biological Sciences 358:529-536, 2003] has claimed that individuals acquire these skills by means of the so-called program-level imitation, in which the overall sequence of problem-solving steps (not the precise actions) is reproduced. In this study we present western lowland gorillas (Gorilla gorilla gorilla) with highly similar nettles. Twelve gorillas in three different groups (including also one nettle-naïve gorilla) used the same program-level technique as wild mountain gorillas (with differences mainly on the action level). Chimpanzees, orangutans, and bonobos did not show these program-level patterns, nor did the gorillas when presented with a plant similar in structural design but lacking stinging defenses. We conclude that although certain aspects (i.e. single actions) of this complex skill may be owing to social learning, at the program level gorilla nettle feeding derives mostly from genetic predispositions and individual learning of plant affordances. Copyright 2008 Wiley-Liss, Inc.

  7. Trends in MD/PhD Graduates Entering Psychiatry: Assessing the Physician-Scientist Pipeline.

    Science.gov (United States)

    Arbuckle, Melissa R; Luo, Sean X; Pincus, Harold Alan; Gordon, Joshua A; Chung, Joyce Y; Chavez, Mark; Oquendo, Maria A

    2018-06-01

    The goal of this study was to identify trends in MD/PhD graduates entering psychiatry, to compare these trends with other specialties, and to review strategies for enhancing the physician-scientist pipeline. Data on 226,588 medical students graduating from Liaison Committee on Medical Education accredited programs between 1999 and 2012 (6626 MD/PhDs) were used to evaluate the number, percentage, and proportion of MD/PhDs entering psychiatry in comparison with other specialties (neurology, neurosurgery, internal medicine, family medicine, and radiation oncology). Linear regression and multiple linear regression determined whether these values increased over time and varied by sex. Over 14 years, an average of 18 MD/PhDs (range 13-29) enrolled in psychiatry each year. The number of MD/PhDs going into psychiatry significantly increased, although these gains were modest (less than one additional MD/PhD per year). The proportion of students entering psychiatry who were MD/PhDs varied between 2.9 and 5.9 per 100 residents, with no significant change over time. There was also no change in the percentage of MD/PhDs entering psychiatry from among all MD/PhD graduates. The rate of increase in the number of MD/PhDs going into psychiatry did not differ significantly from other specialties except for family medicine, which is decreasing. The rate of MD/PhDs going into psychiatry was higher for women, suggesting closure of the sex gap in 17 years. Despite the increase in the number of MD/PhDs entering psychiatry, these numbers remain low. Expanding the cohort of physician-scientists dedicated to translational research in psychiatry will require a multipronged approach.

  8. Comparison of the EntericBio multiplex PCR system with routine culture for detection of bacterial enteric pathogens.

    LENUS (Irish Health Repository)

    O'Leary, James

    2009-11-01

    The EntericBio system uses a multiplex PCR assay for the simultaneous detection of Campylobacter spp., Salmonella enterica, Shigella spp., and Escherichia coli O157 from feces. It combines overnight broth enrichment with PCR amplification and detection by hybridization. An evaluation of this system was conducted by comparing the results obtained with the system with those obtained by routine culture, supplemented with alternative PCR detection methods. In a study of 773 samples, routine culture and the EntericBio system yielded 94.6 and 92.4% negative results, respectively. Forty-two samples had positive results by culture, and all of these were positive with the EntericBio system. This system detected an additional 17 positive samples (Campylobacter spp., n = 12; Shigella spp., n = 1; E. coli O157, n = 4), but the results for 5 samples (Campylobacter spp., n = 2; Shigella spp., n = 1; E. coli O157, n = 2) could not be confirmed. The target for Shigella spp. detected by the EntericBio system is the ipaH gene, and the molecular indication of the presence of Shigella spp. was investigated by sequence analysis, which confirmed that the ipaH gene was present in a Klebsiella pneumoniae isolate from the patient. The sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 99.3%, 91.5%, and 100%, respectively. Turnaround times were significantly reduced with the EntericBio system, and a result was available between 24 and 32 h after receipt of the sample in the laboratory. In addition, the amount of laboratory waste was significantly reduced by use of this system. In summary, the EntericBio system proved convenient to use, more sensitive than the conventional culture used in this study, and highly specific; and it generated results significantly faster than routine culture for the pathogens tested.

  9. Introduction to the Atari Computer. A Program Written in the Pilot Programming Language.

    Science.gov (United States)

    Schlenker, Richard M.

    Designed to be an introduction to the Atari microcomputers for beginners, the interactive computer program listed in this document is written in the Pilot programing language. Instructions are given for entering and storing the program in the computer memory for use by students. (MES)

  10. HWVP NCAW melter feed rheology FY 1993 testing and analyses: Letter report

    International Nuclear Information System (INIS)

    Smith, P.A.

    1996-03-01

    The Hanford Waste Vitrification Plant (HWVP) program has been established to immobilize selected Hanford nuclear wastes before shipment to a geologic repository. The HWVP program is directed by the U.S. Department of Energy (DOE). The Pacific Northwest Laboratory (PNL) provides waste processing and vitrification technology to assist the design effort. The focus of this letter report is melter feed rheology, Process/Product Development, which is part of the Task in the PNL HWVP Technology Development (PHTD) Project. Specifically, the melter feed must be transported to the liquid fed ceramic melter (LFCM) to ensure HWVP operability and the manufacture of an immobilized waste form. The objective of the PHTD Project slurry flow technology development is to understand and correlate dilute and concentrated waste, formatted waste, waste with recycle addition, and melter feed transport properties. The objectives of the work described in this document were to examine frit effects and several processing conditions on melter feed rheology. The investigated conditions included boiling time, pH, noble metal containing melter feed, solids loading, and aging time. The results of these experiments contribute to the understanding of melter feed rheology. This document is organized in eight sections. This section provides the introductory remarks, followed by Section 2.0 that contains conclusions and recommendations. Section 3.0 reviews the scientific principles, and Section 4.0 details the experimental methods. The results and discussion and the review of related rheology data are in Sections 5.0 and 6.0, respectively. Section 7.0, an analysis of NCAW melter feed rheology data, provides an overall review of melter feed with FY 91 frit. References are included in Section 8.0. This letter report satisfies contractor milestone PHTD C93-03.02E, as described in the FY 1993 Pacific Northwest Hanford Laboratory Waste Plant Technology Development (PHTD) Project Work Plan

  11. Family and Cultural Issues in a School Swallowing and Feeding Program

    Science.gov (United States)

    Davis-McFarland, Elise

    2008-01-01

    Purpose: This article presents a rationale for speech-language pathologists (SLPs) to provide culturally competent evaluation, diagnostic, and intervention services for children with oral motor, swallowing, and feeding disorders in school settings. There is also a discussion of how changing American public school demographics necessitate the…

  12. School feeding in Jamaica: a review of its evaluation.

    Science.gov (United States)

    Simeon, D T

    1998-04-01

    This paper reviews two studies that evaluated the school feeding program in Jamaica. The first examined 115 children aged 12-13 y who were enrolled in three classes in a poor, rural school. One class was served the standard school meal at 0900 whereas the other two classes served as controls. The outcome variables included school achievement, attendance, and weight gain. After one semester, the class receiving the meal showed improved arithmetic scores and school attendance compared with the control classes; however, they showed no weight gain. The academic improvement remained significant after school attendance was controlled for. It was therefore hypothesized that the gains in arithmetic resulted from the alleviation of hunger in the classroom. The other study, conducted in a metabolic ward, examined the effects of missing breakfast on cognitive function in 90 children aged 9-10 y and of differing nutritional status. Using a crossover design, the investigators tested each child on two mornings 1 wk apart, once after serving them breakfast and second without. Breakfast, consisting of the school program meal, was served at 0800. When severely malnourished, stunted, or wasted children received no breakfast, their performance in various cognitive tests deteriorated. These results indicate that alleviation of hunger was one of the mechanisms by which school feeding improved academic achievement in the previous study. Undernourished children are more likely to benefit from school feeding programs than are adequately nourished children.

  13. Foraging response and acclimation of ambush feeding and feeding-current feeding copepods to toxic dinoflagellates

    DEFF Research Database (Denmark)

    Xu, Jiayi; Nielsen, Lasse Tor; Kiørboe, Thomas

    2018-01-01

    reticulatum. We hypothesize (1) that ambush feeders are less affected by toxic algae than feeding-current feeders, (2) that copepods acclimate to the toxic algae, and (3) that phytoplankton cells previously exposed to copepod cues elicit stronger responses. Both copepod species consumed the toxic algae...... to examine the response and temporal acclimation (5 d) of two copepods with different foraging behaviors to toxic dinoflagellates. Feeding-current feeding Temora longicornis and ambush feeding Acartia tonsa were offered three strains of toxic Alexandrium tamarense and a nontoxic control Protoceratium...... at a reduced rate and there was no difference in their net-response, but the mechanisms differed. T. longicornis responded in strain-specific ways by reducing its feeding activity, by rejecting captured algae, or by regurgitating consumed cells. A. tonsa reduced its consumption rate, jump frequency, and jump...

  14. The MYRRHA ADS Project in Belgium Enters the Front End Engineering Phase

    International Nuclear Information System (INIS)

    De Bruyn, D.; Ait Abderrahim, H.; Baeten, P.; Leysen, P.

    2015-01-01

    The MYRRHA project started in 1998 by SCK.CEN. MYRRHA is a MTR, based on the ADS concept, for material and fuel research, for studying the feasibility of transmutation of minor actinides and long-lived fission products arising from radioactive waste reprocessing and finally for demonstrating at a reasonable power scale the principle of the ADS. The MYRRHA design has progressed through various framework programmes of the European Commission in the context of Partitioning and Transmutation. The design has now entered into the Front End Engineering Phase (FEED) covering the period 2012- 2015. The engineering company, which will handle this phase, has been selected and the works have begun in the late 2013. In the meantime we have made some refinements in both primary systems and plant layout, including reactor building design. In this paper, we present the most recent developments of the MYRRHA design in terms of reactor building and plant layout as existing today. (authors)

  15. A Survey of Home Enteral Nutrition Practices and Reimbursement in the Asia Pacific Region

    Directory of Open Access Journals (Sweden)

    Alvin Wong

    2018-02-01

    Full Text Available Literature regarding the use of home enteral nutrition (HEN and how it is reimbursed in the Asia Pacific region is limited. This research survey aims to determine the availability of HEN, the type of feeds and enteral access used, national reimbursement policies, the presence of nutrition support teams (NSTs, and clinical nutrition education in this region. An electronic questionnaire was sent to 20 clinical nutrition societies and leaders in the Asia Pacific region in August 2017, where thirteen countries responded. Comparison of HEN reimbursement and practice between countries of different income groups based on the World Bank’s data was investigated. Financial support for HEN is only available in 40% of the countries. An association was found between availability of financial support for HEN and health expenditure (r = 0.63, p = 0.021. High and middle-upper income countries use mainly commercial supplements for HEN, while lower-middle income countries use mainly blenderized diet. The presence of NSTs is limited, and only present mainly in acute settings. Sixty percent of the countries indicated an urgent need for funding and reimbursement of HEN. This survey demonstrates the varied clinical and economic situation in the Asia Pacific region. There is a lack of reimbursement, clinical support, and inadequate educational opportunities, especially for the lower-middle income countries.

  16. Genetic variance components for residual feed intake and feed ...

    African Journals Online (AJOL)

    Feeding costs of animals is a major determinant of profitability in livestock production enterprises. Genetic selection to improve feed efficiency aims to reduce feeding cost in beef cattle and thereby improve profitability. This study estimated genetic (co)variances between weaning weight and other production, reproduction ...

  17. Enteral Nutrition and Acute Pancreatitis: A Review

    NARCIS (Netherlands)

    Spanier, B. W. M.; Bruno, M. J.; Mathus-Vliegen, E. M. H.

    2011-01-01

    Introduction. In patients with acute pancreatitis (AP), nutritional support is required if normal food cannot be tolerated within several days. Enteral nutrition is preferred over parenteral nutrition. We reviewed the literature about enteral nutrition in AP. Methods. A MEDLINE search of the English

  18. Recycle Waste Collection Tank (RWCT) simulant testing in the PVTD feed preparation system

    International Nuclear Information System (INIS)

    Abrigo, G.P.; Daume, J.T.; Halstead, S.D.; Myers, R.L.; Beckette, M.R.; Freeman, C.J.; Hatchell, B.K.

    1996-03-01

    (This is part of the radwaste vitrification program at Hanford.) RWCT was to routinely receive final canister decontamination sand blast frit and rinse water, Decontamination Waste Treatment Tank bottoms, and melter off-gas Submerged Bed Scrubber filter cake. In order to address the design needs of the RWCT system to meet performance levels, the PNL Vitrification Technology (PVTD) program used the Feed Preparation Test System (FPTS) to evaluate its equipment and performance for a simulant of RWCT slurry. (FPTS is an adaptation of the Defense Waste Processing Facility feed preparation system and represents the initially proposed Hanford Waste Vitrification Plant feed preparation system designed by Fluor-Daniel, Inc.) The following were determined: mixing performance, pump priming, pump performance, simulant flow characterization, evaporator and condenser performance, and ammonia dispersion. The RWCT test had two runs, one with and one without tank baffles

  19. CHILD FEEDING PATTERN DURING TRANSITIONAL PERIOD (6-8 MONTHS IN JONGGAT SUB DISTRICT, CENTRAL LOMBOK, WEST NUSA TENGGARA

    Directory of Open Access Journals (Sweden)

    Karina Rahmadia Ekawidyani

    2016-01-01

    Full Text Available ABSTRACTThe objective of this study was to assess child feeding knowledge and practice in transitional period (6-8 months, mother’s information exposure and the functioning of the health system in delivering complementary feeding programs. A cross sectional study was done to 175 children aged 6-8 months at 12 villages in Jonggat Sub-district, Lombok. Structured interview to the mothers, 24 hour recalls, and in-depth interview to the cadres of Integrated Health Posts were used throughout the study. Most mothers had poor knowledge and practice on child feeding (68.0% and 75.4%, respectively. Almost all children had received complementary food (98.9%, but only less than a half children were introduced to complementary food at the appropriate age i.e. 6 months (45.7%. Only few children had good dietary diversity i.e. ≥ 4 food type in the previous day (6.9%. More than half of the mothers (52% were exposed to information related to child feeding practice. The sources of information mostly were from health officers, cadres, mother and child health book and printed media (e.g. newspaper and magazine. The local health staff and cadres had basic knowledge on child feeding programs but the practice was not adequate. Mother’s knowledge and practice on child feeding within the transitional period in Jonggat sub-district was poor. The health system was not functioning well in delivering complementary feeding programs.Keywords: cadres, child feeding pattern, complementary feeding programsABSTRAKPenelitian ini bertujuan untuk mengkaji pengetahuan dan praktek pengasuhan makan pada anak selama masa transisi (6-8 bulan, sumber informasi ibu, dan keberhasilan sistem kesehatan dalam program MP-ASI. Cross sectional study dilakukan dengan subjek 175 anak usia 6-8 bulan di 12 desa di Kecamatan Jonggat, Lombok. Pengumpulan data dilakukan dengan wawancara terstruktur kepada ibu, food recall, dan wawancara mendalam kepada kader Pos Pelayanan Terpadu (Posyandu

  20. Does Oral Vaccination Protect Rainbow Trout (Oncorhynchus mykiss) Against Enteric Red Mouth Disease?

    DEFF Research Database (Denmark)

    Neumann, Lukas; Villumsen, Kasper Rømer; Kragelund Strøm, Helene

    . ruckeri bacteria are need in order to obtain significantly increased immunity against the disease. These results suggest that a high amount of the vaccine is digested in the stomach of the rainbow trout and therefore did not reach the intestine as immunogenic antigens. The project is still ongoing....... The objective for this project is to investigate whether oral vaccination of rainbow trout against Yersinia ruckeri O1 (biotype 1) causing Enteric Red Mouth disease (ERM) can protect rainbow trout against a subsequent experimental bath challenge with Y. ruckeri. The rainbow trout were given oral vaccinations...... primary vaccination), 5) AquaVac ERM (as a primary vaccine), 6) AquaVac w/ booster, and 7) one group with 10 fold increase (w/ booster) of the experimental vaccine in the feed. The rainbow trout were bath challenged with 6.3 x108 CFU/ml Y. ruckeri 6 month post the primary oral vaccination. The challenge...

  1. PTSD Treatment Programs in the U.S. Department of Veterans Affairs

    Science.gov (United States)

    ... Programs in the U.S. Department of Veterans Affairs PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... Enter ZIP code here Enter ZIP code here PTSD Treatment Programs in the U.S. Department of Veterans ...

  2. Understanding and controlling the enteric nervous system

    NARCIS (Netherlands)

    Boeckxstaens, G. E.

    2002-01-01

    The enteric nervous system or the `Little Brain' of the gut controls gastrointestinal motility and secretion, and is involved in visceral sensation. In this chapter, new developments in understanding the function of the enteric nervous system are described. In particular, the interaction of this

  3. EFFECT OF CURRENT, TIME, FEED AND CATHODE TYPE ON ELECTROPLATING PROCESS OF URANIUM SOLUTION

    Directory of Open Access Journals (Sweden)

    Sigit Sigit

    2017-02-01

    Full Text Available ABSTRACT   EFFECT OF CURRENT, TIME, FEED AND CATHODE TYPE ON ELECTROPLATING PROCESS OF URANIUM SOLUTION. Electroplating process of uranyl nitrate and effluent process has been carried out in order to collect uranium contained therein using electrode Pt / Pt and Pt / SS at various currents and times. Material used for electrode were Pt (platinum and SS (Stainlees Steel. Feed solution of 250 mL was entered into a beaker glass equipped with Pt anode - Pt cathode or Pt anode - SS cathode, then fogged direct current from DC power supply with specific current and time so that precipitation of uranium sticking to the cathode. After the processes completed, the cathode was removed and weighed to determine weight of precipitates, while the solution was analyzed to determine the uranium concentration decreasing after and before electroplating process. The experiments showed that a relatively good time to acquire uranium deposits at the cathode was 1 hour by current 7 ampere, uranyl nitrate as feed, and Pt (platinum as cathode. In these conditions, uranium deposits attached to the cathode amounted to 74.96% of the original weight of uranium oxide in the feed or 206.5 mg weight. The use of Pt cathode for  uranyl nitrate, SS and Pt cathode for effluent process feed gave uranium specific weight at the cathode of 12.99 mg/cm2, 2.4 mg/cm2 and 5.37 mg/cm2 respectively for current 7 ampere and electroplating time 1 hour. Keywords: Electroplating, uranyl nitrate, effluent process, Pt/Pt electrode, Pt/SS electrode

  4. Regulatory aspects of nanotechnology in the agri/feed/food sector in EU and non-EU countries.

    Science.gov (United States)

    Amenta, Valeria; Aschberger, Karin; Arena, Maria; Bouwmeester, Hans; Botelho Moniz, Filipa; Brandhoff, Puck; Gottardo, Stefania; Marvin, Hans J P; Mech, Agnieszka; Quiros Pesudo, Laia; Rauscher, Hubert; Schoonjans, Reinhilde; Vettori, Maria Vittoria; Weigel, Stefan; Peters, Ruud J

    2015-10-01

    Nanotechnology has the potential to innovate the agricultural, feed and food sectors (hereinafter referred to as agri/feed/food). Applications that are marketed already include nano-encapsulated agrochemicals or nutrients, antimicrobial nanoparticles and active and intelligent food packaging. Many nano-enabled products are currently under research and development, and may enter the market in the near future. As for any other regulated product, applicants applying for market approval have to demonstrate the safe use of such new products without posing undue safety risks to the consumer and the environment. Several countries all over the world have been active in examining the appropriateness of their regulatory frameworks for dealing with nanotechnologies. As a consequence of this, different approaches have been taken in regulating nano-based products in agri/feed/food. The EU, along with Switzerland, were identified to be the only world region where nano-specific provisions have been incorporated in existing legislation, while in other regions nanomaterials are regulated more implicitly by mainly building on guidance for industry. This paper presents an overview and discusses the state of the art of different regulatory measures for nanomaterials in agri/feed/food, including legislation and guidance for safety assessment in EU and non-EU countries. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  5. The effect of chronic feeding of diacetoxyscirpenol and T-2 toxin on performance, health, small intestinal physiology and antibody production in turkey poults.

    Science.gov (United States)

    Sklan, D; Shelly, M; Makovsky, B; Geyra, A; Klipper, E; Friedman, A

    2003-03-01

    1. The effects of feeding T-2 toxin or diacetoxyscirpenol (DAS) at levels up to 1 ppm for 32 d on performance, health, small intestinal physiology and immune response to enteral and parenteral immunisation were examined in young poults. 2. Slight improvement in growth was observed in some groups of poults fed T-2 or DAS mycotoxins for 32 d, with no change in feed efficiency. Feeding both T-2 and DAS resulted in oral lesions which had maximal severity after 7-15 d. 3. Mild intestinal changes were observed at 32 d but no pathological or histopathological lesions were found. Both mycotoxins altered small intestinal morphology, especially in the jejunum where villi were shorter and thinner. In addition, both DAS and T-2 mycotoxins enhanced the proportion of proliferating cells both in the crypts and along the villi. Migration rates were reduced in the jejunum of poults fed T-2 toxin but did not change in the duodenum or in poults fed DAS. 4. No significant effects of T-2 or DAS were observed on antibody production to antigens administered by enteral or parenteral routes. 5. This study indicates that tricothecene toxins at concentrations of up to 1 ppm for more than 30 d influenced small intestinal morphology but did not affect growth or antibody production.

  6. Do enteric neurons make hypocretin? ☆

    OpenAIRE

    Baumann, Christian R.; Clark, Erika L.; Pedersen, Nigel P.; Hecht, Jonathan L.; Scammell, Thomas E.

    2007-01-01

    Hypocretins (orexins) are wake-promoting neuropeptides produced by hypothalamic neurons. These hypocretin-producing cells are lost in people with narcolepsy, possibly due to an autoimmune attack. Prior studies described hypocretin neurons in the enteric nervous system, and these cells could be an additional target of an autoimmune process. We sought to determine whether enteric hypocretin neurons are lost in narcoleptic subjects. Even though we tried several methods (including whole mounts, s...

  7. Constipation is more frequent than diarrhea in patients fed exclusively by enteral nutrition: results of an observational study.

    Science.gov (United States)

    Bittencourt, Amanda F; Martins, Juliana R; Logullo, Luciana; Shiroma, Glaucia; Horie, Lilian; Ortolani, Maria Claudia; Silva, Maria de Lourdes T; Waitzberg, Dan L

    2012-08-01

    Digestive complications in enteral nutrition (EN) can negatively affect the nutrition clinical outcome of hospitalized patients. Diarrhea and constipation are intestinal motility disorders associated with pharmacotherapy, hydration, nutrition status, and age. The aim of this study was to analyze the frequency of these intestinal motility disorders in patients receiving EN and assess risk factors associated with diarrhea and constipation in hospitalized patients receiving exclusive EN therapy in a general hospital. The authors performed a sequential and observational study of 110 hospitalized adult patients fed exclusively by EN through a feeding tube. Patients were categorized according to the type of intestinal transit disorder as follows: group D (diarrhea, 3 or more watery evacuations in 24 hours), group C (constipation, less than 1 evacuation during 3 days), and group N (absence of diarrhea or constipation). All prescription drugs were recorded, and patients were analyzed according to the type and amount of medication received. The authors also investigated the presence of fiber in the enteral formula. Patients classified in group C represented 70% of the study population; group D comprised 13%, and group N represented 17%. There was an association between group C and orotracheal intubation as the indication for EN (P constipation (logistic regression analysis: P Constipation is more frequent than diarrhea in patients fed exclusively by EN. Enteral diet with fiber may protect against medication-associated intestinal motility disorders. The addition of prokinetic drugs seems to be useful in preventing constipation.

  8. Feeding behaviors during home-based treatment of moderate acute malnutrition using corn-soy blends or lipid-based nutrient supplements

    DEFF Research Database (Denmark)

    Iuel-Brockdorff, Ann-Sophie Julie D; Ouedraogo, Albertine; Ritz, Christian

    2017-01-01

    Feeding behaviors have an important impact on children's nutritional status and are essential to consider when implementing nutrition programs. The objective of this study was to explore and compare feeding behaviors related to supplementary feeding with corn-soy blends (CSB) and lipid-based nutr...

  9. SCIENTIFIC BASIS OF ADDITIONAL FOOD INTRODUCTION, STATED IN THE NATIONAL PROGRAM OF THE INFANTS FEEDING OPTIMIZATION IN THE RUSSIAN FEDERATION. PART II

    Directory of Open Access Journals (Sweden)

    V. A. Skvortsova

    2012-01-01

    Full Text Available The article contains the results of the study of clinical and biochemical blood markers of iron metabolism in infants. This study represents a part of the research, aimed to scientific confirmation of the statements associated with additional food introduction and stated in the «National program of the infants feeding optimization in the Russian Federation». In controlled conditions the children were divided into 2 main groups: feeding with breast milk and with artificial milk formulas. Each group was divided into sub-groups according to the age of the additional food introduction: 4, 5 or 6 months. The received data suggest that the iron content was appropriate in both groups at the age of 4 months before the additional food introduction; there was a gradual decrease of several values after that, especially marked in children feeding with breast milk and later introduction of additional food. The comparative analysis showed that at the age of 9 months the lowest values were in breast-fed children with additional food introduction at the age of 6 months. This can be associated not only with late additional food introduction, but also with difficulties occurring when beginning it at this age and leading to insufficient supply with certain nutrients, including iron. The detailed analysis of diets for children of different sub-groups will be discussed in the next article.

  10. Early gradual feeding with bovine colostrum improves gut function and NEC resistance relative to infant formula in preterm pigs

    DEFF Research Database (Denmark)

    Shen, Rene L; Thymann, Thomas; Østergaard, Mette V

    2015-01-01

    It is unclear when and how to start enteral feeding for preterm infants when mother's milk is not available. We hypothesized that early and slow advancement with either formula or bovine colostrum stimulates gut maturation and prevents necrotizing enterocolitis (NEC) in preterm pigs, used as models...... for preterm infants. Pigs were given either total parenteral nutrition (TPN, n = 14) or slowly advancing volumes (16–64 ml·kg−1·day−1) of preterm infant formula (IF, n = 15) or bovine colostrum (BC, n = 13), both given as adjunct to parenteral nutrition. On day 5, both enteral diets increased intestinal mass......), and higher intestinal permeability, compared with BC pigs (all P colostrum supports gut maturation when mother's milk is absent during the first week after...

  11. Waste Feed Delivery System Phase 1 Preliminary RAM Analysis

    International Nuclear Information System (INIS)

    DYKES, A.A.

    2000-01-01

    This report presents the updated results of the preliminary reliability, availability, and maintainability (RAM) analysis of selected waste feed delivery (WFD) operations to be performed by the Tank Farm Contractor (TFC) during Phase I activities in support of the Waste Treatment and Immobilization Plant (WTP). For planning purposes, waste feed tanks are being divided into five classes in accordance with the type of waste in each tank and the activities required to retrieve, qualify, and transfer waste feed. This report reflects the baseline design and operating concept, as of the beginning of Fiscal Year 2000, for the delivery of feed from three of these classes, represented by source tanks 241-AN-102, 241-AZ-101 and 241-AN-105. The preliminary RAM analysis quantifies the potential schedule delay associated with operations and maintenance (OBM) field activities needed to accomplish these operations. The RAM analysis is preliminary because the system design, process definition, and activity planning are in a state of evolution. The results are being used to support the continuing development of an O and M Concept tailored to the unique requirements of the WFD Program, which is being documented in various volumes of the Waste Feed Delivery Technical Basis (Carlson. 1999, Rasmussen 1999, and Orme 2000). The waste feed provided to the WTP must: (1) meet limits for chemical and radioactive constituents based on pre-established compositional envelopes (i.e., feed quality); (2) be in acceptable quantities within a prescribed sequence to meet feed quantities; and (3) meet schedule requirements (i.e., feed timing). In the absence of new criteria related to acceptable schedule performance due to the termination of the TWRS Privatization Contract, the original criteria from the Tank Waste Remediation System (77443s) Privatization Contract (DOE 1998) will continue to be used for this analysis

  12. A randomised controlled trial of six weeks of home enteral nutrition versus standard care after oesophagectomy or total gastrectomy for cancer: report on a pilot and feasibility study.

    Science.gov (United States)

    Bowrey, David J; Baker, Melanie; Halliday, Vanessa; Thomas, Anne L; Pulikottil-Jacob, Ruth; Smith, Karen; Morris, Tom; Ring, Arne

    2015-11-21

    Poor nutrition in the first months after oesophago-gastric resection is a contributing factor to the reduced quality of life seen in these patients. The aim of this pilot and feasibility study was to ascertain the feasibility of conducting a multi-centre randomised controlled trial to evaluate routine home enteral nutrition in these patients. Patients undergoing oesophagectomy or total gastrectomy were randomised to either six weeks of home feeding through a jejunostomy (intervention), or treatment as usual (control). Intervention comprised overnight feeding, providing 50 % of energy and protein requirements, in addition to usual oral intake. Primary outcome measures were recruitment and retention rates at six weeks and six months. Nutritional intake, nutritional parameters, quality of life and healthcare costs were also collected. Interviews were conducted with a sample of participants, to ascertain patient and carer experiences. Fifty-four of 112 (48 %) eligible patients participated in the study over the 20 months. Study retention at six weeks was 41/54 patients (76 %) and at six months was 36/54 (67 %). At six weeks, participants in the control group had lost on average 3.9 kg more than participants in the intervention group (95 % confidence interval [CI] 1.6 to 6.2). These differences remained evident at three months (mean difference 2.5 kg, 95 % CI -0.5 to 5.6) and at six months (mean difference 2.5 kg, 95 % CI -1.2 to 6.1). The mean values observed in the intervention group for mid arm circumference, mid arm muscle circumference, triceps skin fold thickness and right hand grip strength were greater than for the control group at all post hospital discharge time points. The economic evaluation suggested that it was feasible to collect resource use and EQ-5D data for a full cost-effectiveness analysis. Thematic analysis of 15 interviews identified three main themes related to the intervention and the trial: 1) a positive experience, 2) the reasons for taking

  13. 9 CFR 113.204 - Mink Enteritis Vaccine, Killed Virus.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Mink Enteritis Vaccine, Killed Virus..., DEPARTMENT OF AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.204 Mink Enteritis Vaccine, Killed Virus. Mink Enteritis Vaccine...

  14. Noncommunicating Isolated Enteric Duplication Cyst in the ...

    African Journals Online (AJOL)

    Noncommunicating isolated enteric duplications in the abdomen are an extremely rare variant of enteric duplications with their own blood supply. We report a case of a noncommunicating isolated ileal duplication in a 10-month-old boy. He was admitted because of severe abdominal distension and developed irritability ...

  15. Early oral feeding after elective abdominal surgery--what are the issues?

    DEFF Research Database (Denmark)

    Bisgaard, Thue; Kehlet, Henrik

    2002-01-01

    This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdomin...... surgical programs in abdominal surgery provide a rational basis for future studies to investigate and facilitate enforced oral feeding after major abdominal procedures.......This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdominal...... procedures. It appears that several factors may promote postoperative oral feeding such as thoracic epidural analgesia, multimodal anti-emetic treatment, opioid-sparing analgesia, selective peripheral opioid antagonists, and enforced oral nutrition. Recent data from multimodal fast-track rehabilitation...

  16. Age, lighting treatment, feed allocation and feed form influence ...

    African Journals Online (AJOL)

    During a broiler breeder trial with 3200 Cobb 500 hens, the effects of lighting treatment after 20 weeks' feed allocation and of feed form on the length of time taken to consume the daily allocation of feed were measured. Pullets were reared on 8-hour photoperiods to 20 weeks, then transferred to one of four lighting ...

  17. Local health department food safety and sanitation expenditures and reductions in enteric disease, 2000-2010.

    Science.gov (United States)

    Bekemeier, Betty; Yip, Michelle Pui-Yan; Dunbar, Matthew D; Whitman, Greg; Kwan-Gett, Tao

    2015-04-01

    In collaboration with Public Health Practice-Based Research Networks, we investigated relationships between local health department (LHD) food safety and sanitation expenditures and reported enteric disease rates. We combined annual infection rates for the common notifiable enteric diseases with uniquely detailed, LHD-level food safety and sanitation annual expenditure data obtained from Washington and New York state health departments. We used a multivariate panel time-series design to examine ecologic relationships between 2000-2010 local food safety and sanitation expenditures and enteric diseases. Our study population consisted of 72 LHDs (mostly serving county-level jurisdictions) in Washington and New York. While controlling for other factors, we found significant associations between higher LHD food and sanitation spending and a lower incidence of salmonellosis in Washington and a lower incidence of cryptosporidiosis in New York. Local public health expenditures on food and sanitation services are important because of their association with certain health indicators. Our study supports the need for program-specific LHD service-related data to measure the cost, performance, and outcomes of prevention efforts to inform practice and policymaking.

  18. Clinical and protein metabolic efficacy of glutamine granules-supplemented enteral nutrition in severely burned patients.

    Science.gov (United States)

    Peng, Xi; Yan, Hong; You, Zhongyi; Wang, Pei; Wang, Shiliang

    2005-05-01

    As an abundant amino acid in the human body, glutamine has many important metabolic roles that may protect or promote tissue integrity and enhance the immune system. A relative deficiency of glutamine in such patients could compromise recovery and result in prolonged illness and an increase in late mortality. The purpose of this clinical study is to observe the effects of enteral supplement with glutamine granules on protein metabolism in severely burned patients. Forty-eight severe burn patients (total burn surface area 30-75%, full thickness burn area 20-58%) who met the requirements of the protocol joined this double-blind randomized controlled clinical trial. Patients were randomly divided into two groups: burn control group (B group, 23 patients) and glutamine treated group (Gln group, 25 patients). There was isonitrogenous and isocaloric intake in both groups, glutamine and B group patents were supplemented with glutamine granules or placebo (glycine) at 0.5 g/kg per day for 14 days with oral feeding or tube feeding, respectively. The level of plasma glutamine, plasma protein content, urine nitrogen and urine 3-methylhistidine (3-MTH) excretion were determined, wound healing rate of the burned area and hospital stay were recorded. The results showed that there were significant reductions in plasma glutamine level and abnormal protein metabolism. After supplement with glutamine granules for 14 days, the plasma glutamine concentration was significantly higher than that in B group (607.86+/-147.25 micromol/L versus 447.63+/-132.38 micromol/L, P0.05). On the other hand, the amount of urine nitrogen and 3-MTH excreted in Gln group were significantly lower than that in B group. In addition, wound healing was faster and hospital stay days were shorter in Gln group than B group (46.59+/-12.98 days versus 55.68+/-17.36 days, P<0.05). These indicated that supplement glutamine granules with oral feeding or tube feeding could abate the degree of glutamine depletion

  19. Feed safety in the feed supply chain

    Directory of Open Access Journals (Sweden)

    Pinotti, L.

    2011-01-01

    Full Text Available A number of issues have weakened the public's confidence in the quality and wholesomeness of foods of animal origin. As a result farmers, nutritionists, industry and governments have been forced to pay serious attention to animal feedstuff production processes, thereby acknowledging that animal feed safety is an essential prerequisite for human food safety. Concerns about these issues have produced a number of important effects including the ban on the use of processed animal proteins, the ban on the addition of most antimicrobials to farm animals diets for growth‐promotion purposes, and the implementation of feed contaminant regulations in the EU. In this context it is essential to integrate knowledge on feed safety and feed supply. Consequently, purchase of new and more economic sources of energy and protein in animal diets, which is expected to conform to adequate quality, traceability, environmental sustainability and safety standards, is an emerging issue in livestock production system.

  20. Internal Medicine Residency Program Directors' Views of the Core Entrustable Professional Activities for Entering Residency: An Opportunity to Enhance Communication of Competency Along the Continuum.

    Science.gov (United States)

    Angus, Steven V; Vu, T Robert; Willett, Lisa L; Call, Stephanie; Halvorsen, Andrew J; Chaudhry, Saima

    2017-06-01

    To examine internal medicine (IM) residency program directors' (PDs') perspectives on the Core Entrustable Professional Activities for Entering Residency (Core EPAs)-introduced into undergraduate medical education to further competency-based assessment-and on communicating competency-based information during transitions. A spring 2015 Association of Program Directors in Internal Medicine survey asked PDs of U.S. IM residency programs for their perspectives on which Core EPAs new interns must or should possess on day 1, which are most essential, and which have the largest gap between expected and observed performance. Their views and preferences were also requested regarding communicating competency-based information at transitions from medical school to residency and residency to fellowship/employment. The response rate was 57% (204/361 programs). The majority of PDs felt new interns must/should possess 12 of the 13 Core EPAs. PDs' rankings of Core EPAs by relative importance were more varied than their rankings by the largest gaps in performance. Although preferred timing varied, most PDs (82%) considered it important for medical schools to communicate Core EPA-based information to PDs; nearly three-quarters (71%) would prefer a checklist format. Many (60%) would be willing to provide competency-based evaluations to fellowship directors/employers. Most (> 80%) agreed that there should be a bidirectional communication mechanism for programs/employers to provide feedback on competency assessments. The gaps identified in Core EPA performance may help guide medical schools' curricular and assessment tool design. Sharing competency-based information at transitions along the medical education continuum could help ensure production of competent, practice-ready physicians.

  1. Genetics of enteric neuropathies

    NARCIS (Netherlands)

    Brosens, Erwin; Burns, Alan J.; Brooks, Alice S.; Matera, Ivana; Borrego, Salud; Ceccherini, Isabella; Tam, Paul K.; García-Barceló, Maria-Mercè; Thapar, Nikhil; Benninga, Marc A.; Hofstra, Robert M. W.; Alves, Maria M.

    2016-01-01

    Abnormal development or disturbed functioning of the enteric nervous system (ENS), the intrinsic innervation of the gastrointestinal tract, is associated with the development of neuropathic gastrointestinal motility disorders. Here, we review the underlying molecular basis of these disorders and

  2. 30 CFR 77.1502 - Auger holes; restriction against entering.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Auger holes; restriction against entering. 77... UNDERGROUND COAL MINES Auger Mining § 77.1502 Auger holes; restriction against entering. No person shall be permitted to enter an auger hole except with the approval of the MSHA Coal Mine Safety and Health District...

  3. Development of food-based complementary feeding recommendations for 9- to 11-month-old peri-urban Indonesian infants using linear programming.

    Science.gov (United States)

    Santika, Otte; Fahmida, Umi; Ferguson, Elaine L

    2009-01-01

    Effective population-specific, food-based complementary feeding recommendations (CFR) are required to combat micronutrient deficiencies. To facilitate their formulation, a modeling approach was recently developed. However, it has not yet been used in practice. This study therefore aimed to use this approach to develop CFR for 9- to 11-mo-old Indonesian infants and to identify nutrients that will likely remain low in their diets. The CFR were developed using a 4-phase approach based on linear and goal programming. Model parameters were defined using dietary data collected in a cross-sectional survey of 9- to 11-mo-old infants (n = 100) living in the Bogor District, West-Java, Indonesia and a market survey of 3 local markets. Results showed theoretical iron requirements could not be achieved using local food sources (highest level achievable, 63% of recommendations) and adequate levels of iron, niacin, zinc, and calcium were difficult to achieve. Fortified foods, meatballs, chicken liver, eggs, tempe-tofu, banana, and spinach were the best local food sources to improve dietary quality. The final CFR were: breast-feed on demand, provide 3 meals/d, of which 1 is a fortified infant cereal; > or = 5 servings/wk of tempe/tofu; > or = 3 servings/wk of animal-source foods, of which 2 servings/wk are chicken liver; vegetables, daily; snacks, 2 times/d, including > or = 2 servings/wk of banana; and > or = 4 servings/wk of fortified-biscuits. Results showed that the approach can be used to objectively formulate population-specific CFR and identify key problem nutrients to strengthen nutrition program planning and policy decisions. Before recommending these CFR, their long-term acceptability, affordability, and effectiveness should be assessed.

  4. Dieta enteral prescrita versus dieta infundida Prescribed enteral diet versus infused diet

    Directory of Open Access Journals (Sweden)

    Silvana Aparecida Ribeiro Simões

    2017-07-01

    Full Text Available Objetivo: Avaliar o volume prescrito de dieta enteral versus o volume infundido, identificando as causas de interrupção da dieta e os gastos gerados por essas interrupções. Métodos: Estudo observacional, com pacientes adultos e idosos, recebendo nutrição enteral em um hospital particular de São Paulo. A coleta de dados foi realizada por meio de prontuário eletrônico. Resultados: O volume infundido foi significantemente menor que o volume prescrito, nos cinco dias de acompanhamento, em toda a amostra. A principal intercorrência na administração da dieta foi a diarreia. Os gastos com a não administração da dieta somam 41,4% do valor despendido para esse serviço. Conclusão: Este estudo contribui para a atuação e desempenho do nutricionista em conjunto com a Equipe Multidisciplinar em Terapia Nutricional visando a melhora do paciente.

  5. A study to evaluate the levels of dioxin-like compounds in dairy feeds in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Lorber, M.; Ferrario, J.; Byrne, C. [United States Environmental Protection Agency, WA, DC (United States); Greene, C.; Cyrus, A. [Versar, Inc., Springfield, VA (United States)

    2004-09-15

    The primary route for general population exposure to dioxin-like compounds is through the consumption of animal fats, with bovine-derived meat, milk and dairy products comprising over 50% of total exposure in the United States. The primary route of exposure hypothesized for cattle is airborne deposition of dioxins onto the leaves of feed crops. Over the last few years additional pathways of exposure have been identified associated with contaminated feed additives such as ball clay, mineral supplements, and animal byproducts. Studies by the United States Department of Agriculture (USDA) have shown that incidental contact with pentachlorophenol (PCP)-treated wood by cattle have resulted in elevated tissue levels. Although the air-to-leaf pathway is still considered by most researchers to be the dominant pathway of exposure, the lack of any systematic examination of animal feeds to quantify the contribution of the air-to-leaf pathway has been a major gap in our empirical understanding of dioxin exposure. The Environmental Protection Agency (EPA), in cooperation with USDA and the US Food and Drug Administration (FDA), has undertaken a program to study the presence of dioxin-like compounds in animal feeds. Two phases of this program have been completed, and this paper reports on the third phase. The first phase was a study on the mass balance of dioxins in lactating cows. The objective of that study was to quantify the role feeds play in total dairy cow exposure. The second phase of the program involved the collection and measurement of dioxins in minor feed components. Dioxins in specific targeted animal feed components of interest, including animal byproducts (beef, pork, poultry by-products, fish meal) and plant byproducts (deodorizer distillates from corn, soybean, peanut, cottonseed, and canola processers; cane and beet molasses), were measured. The third phase of the project, reported here, involved component sampling of dairy feeds around the US.

  6. Cellular changes in the enteric nervous system during ageing.

    Science.gov (United States)

    Saffrey, M Jill

    2013-10-01

    The intrinsic neurons of the gut, enteric neurons, have an essential role in gastrointestinal functions. The enteric nervous system is plastic and continues to undergo changes throughout life, as the gut grows and responds to dietary and other environmental changes. Detailed analysis of changes in the ENS during ageing suggests that enteric neurons are more vulnerable to age-related degeneration and cell death than neurons in other parts of the nervous system, although there is considerable variation in the extent and time course of age-related enteric neuronal loss reported in different studies. Specific neuronal subpopulations, particularly cholinergic myenteric neurons, may be more vulnerable than others to age-associated loss or damage. Enteric degeneration and other age-related neuronal changes may contribute to gastrointestinal dysfunction that is common in the elderly population. Evidence suggests that caloric restriction protects against age-associated loss of enteric neurons, but recent advances in the understanding of the effects of the microbiota and the complex interactions between enteric ganglion cells, mucosal immune system and intestinal epithelium indicate that other factors may well influence ageing of enteric neurons. Much remains to be understood about the mechanisms of neuronal loss and damage in the gut, although there is evidence that reactive oxygen species, neurotrophic factor dysregulation and/or activation of a senescence associated phenotype may be involved. To date, there is no evidence for ongoing neurogenesis that might replace dying neurons in the ageing gut, although small local sites of neurogenesis would be difficult to detect. Finally, despite the considerable evidence for enteric neurodegeneration during ageing, and evidence for some physiological changes in animal models, the ageing gut appears to maintain its function remarkably well in animals that exhibit major neuronal loss, indicating that the ENS has considerable

  7. EVALUATION OF ERRORS OF NUTRIENTS AND BIOACTIVE SUBSTANCES IN ANIMAL FEED PRODUCTION

    Directory of Open Access Journals (Sweden)

    .

    2015-01-01

    Full Text Available The definition of feed nutrients assumes the following: assessment of its chemical composition; estimate of the amount contained therein of digestible nutrients; estimate of the amount of energy released by them. We estimate the chemical composition of the components of the indices, which balanced diet. This seemingly simple requirement is not always fulfilled. In the practice of forage production are cases when during the chemical analysis of the finished feed is a discrepancy between the estimated and actual nutritional value, and with the same probability of deviation from the declared value of both in one and in the other direction. The database of contemporary programs for compiling feed rations contained digestibility coefficients of nutrients for all types of raw materials for all kinds of animals from the program of special factors, allow to balance feed rations on digestibility of nutrients and energy value component count. The paper proposes a mathematical tool for assessing the margin of variation of content of biologically active substances in the party regarding the premix recipe data. The reasons for the variations are considered random error methods of quantitative chemical analysis of biologically active substances (BAS and random error estimates of the masses of carriers of active substances when they are dosed into the mixer.

  8. Systematic analysis of feeding behaviors and their effects on feed efficiency in Pekin ducks

    Directory of Open Access Journals (Sweden)

    Feng Zhu

    2017-11-01

    Full Text Available Abstract Background Feeding behavior study is important for animal husbandry and production. However, few studies were conducted on the feeding behavior and their relationship with feeding efficiency in Pekin ducks. In order to investigate the feeding behavior and their relationship with feed efficiency and other economic traits in Pekin ducks, we selected 358 male Pekin ducks and recorded feeding information between 3 to 6 wk of age using automatic electronic feeders, and compared the feeding behavior under different residual feed intake (RFI levels. Results We observed that total feed time, daily feed intake and feed intake per meal had strong positive correlations with feed efficiency traits; moreover, strong correlation between feed intake per meal and body weight was found (R=0.32, 0.36. Daily feeding rate meal and meal duration had weak correlations with feed efficiency (R=0.14~0.15. The phenotypic correlation of between-meal pauses, with feed efficiency was not observed. When daily changes were analyzed, high RFI ducks had the highest feed consumption over all times, and obvious differences in daily visits were found among different RFI level animals during the middle period; these differences were magnified with age, but there was no difference in daily meal number. Moreover, our data indicate that high RFI birds mainly take their meals at the edge of the population enclosure, where they are more susceptible to environmental interference. Conclusions Overall, this study suggests that the general feeding behaviors can be accurately measured using automatic electronic feeders and certain feeding behaviors in Pekin ducks are associated with improved feed efficiency.

  9. INFLUENCE OF FEEDING TIME ON FEED UTILIZATION BY SIAMESE CATFISH, Pangasius hypophthalmus JUVENILE

    Directory of Open Access Journals (Sweden)

    Nina Meilisza

    2010-06-01

    Full Text Available Siamese catfish (Pangasius hypophthalmus at juvenile stage is used as ornamental fish by fish hobbies because of their beautiful shape and movement. Feeding time is a part of feeding management to get the best and effective strategy on feed input. This study aimed to determine the growth of Siamese catfish juvenile by looking at the influence of feeding time on feed utilization. The average individual weight of juveniles used was ± 3.2 g stocked 15 fish per aquarium equipped with recirculation system. Two level factors in the factorial design consisted of 4 feeding times (at 8:00, at 12:00, at 16:00, and as control (8:00, 12:00, 16:00 and feeding level (45 g feed kg-1 fish, 90 g feed kg-1 fish. Interaction between feeding time and feeding level resulting eight types of treatments research, namely A (8/45, B (12/45, C (16/45, D (8:12:16/45, E (8:12:16/90, F (8/90, G (12/90, and H (16/90. The results showed that feeding time had significant effect on the specific growth rate, feed conversion, and protein efficiency ratio and were significantly different among the treatments (P<0.05. Besides feeding time control (treatments D and E, treatment C also showed the highest of specific growth rate (2.03%, protein efficiency ratio (1.46, and the lowest feed conversion ratio (1.85.

  10. Development of DIPRES feed for the fabrication of mixed-oxide fuels for fast breeder reactors

    International Nuclear Information System (INIS)

    Griffin, C.W.; Rasmussen, D.E.; Lloyd, M.H.

    1983-01-01

    The DIrect PREss Spheroidized feed process combines the conversion of uranium-plutonium solutions into spheres by internal gelation with conventional pellet fabrication techniques. In this manner, gel spheres could replace conventional powders as the feed material for pellet fabrication of nuclear fuels. Objective of the DIPRES feed program is to develop and qualify a process to produce mixed-oxide fuel pellets from gel spheres for fast breeder reactors. This process development includes both conversion and fabrication activities

  11. Animal Feeding Operations

    Science.gov (United States)

    ... type=”submit” value=”Submit” /> Healthy Water Home Animal Feeding Operations Recommend on Facebook Tweet Share Compartir ... of Concentrated Animal Feeding Operations (CAFOs) What are Animal Feeding Operations (AFOs)? According to the United States ...

  12. Efficiency of organic acid preparations for the elimination of naturally occurring Salmonella in feed material.

    Science.gov (United States)

    Axmann, Sonja; Kolar, Veronika; Adler, Andreas; Strnad, Irmengard

    2017-11-01

    Salmonella can enter animal stocks via feedstuffs, thus posing not only an infection risk for animals, but also threatening to contaminate food of animal origin and finally humans. Salmonella contamination in feedstuffs is still a recurring and serious issue in animal production (especially for the poultry sector), and is regularly detected upon self-monitoring by feed companies (self-checks) and official inspections authorities. Operators within the feed chain in certain cases need to use hygienic condition enhancers, such as organic acids, to improve the quality of feed for animal nutrition, providing additional guarantees for the protection of animal and public health. The present study investigated the efficiencies of five organic acid preparations. The acid products were added to three different feed materials contaminated with Salmonella (contamination occurred by recontamination in the course of the production process) at seven different inclusion rates (1-7%) and analysed after 1, 2, and 7 days' exposure time using culture method (tenfold analysis). A reliable standard was established for defining a successful decontamination under the prevailing test conditions: 10 Salmonella-negative results out of 10 tested samples (0/10: i.e. 0 positive samples and 10 negative samples). The results demonstrated that the tested preparations showed significant differences with regard to the reduction in Salmonella contamination. At an inclusion rate of 7% of the feed materials, two out of five acid preparations showed an insufficient, very small, decontamination effect, whereas two others had a relatively large partial effect. Reliable decontamination was demonstrated only for one acid preparation, however, subject to the use of the highest acid concentration.

  13. Biomass energy systems program summary

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-07-01

    Research programs in biomass which were funded by the US DOE during fiscal year 1978 are listed in this program summary. The conversion technologies and their applications have been grouped into program elements according to the time frame in which they are expected to enter the commercial market. (DMC)

  14. Sustainable Milk and Meat Production while Reducing Methane Emissions from Livestock Enteric Fermentation

    Science.gov (United States)

    Castelan-Ortega, O. A.; Molina, L. T.; Pedraza-Beltrán, P. E.; Hernández-Pineda, G.; Ku-Vera, J. C.; Benaouda, M.; Gonzalez-Ronquillo, M.

    2016-12-01

    Ruminants produce all the milk and most of the meat demanded by humans; however, ruminant production generates large quantities of greenhouse gases (GHG), around 15% of anthropogenic emissions of GHG are attributed to ruminant production. Therefore there is an urgent need to develop sustainable alternatives to mitigate GHG emissions by ruminants and to increase the supply of high quality protein for human consumption in a climate change scenario. The objective of this work is to present sustainable options to mitigate methane (CH4) production from enteric fermentation by cattle and to illustrate how productivity can be increased at the same time. We conducted several experiments to measure CH4 emission in vivo by cattle in order to estimate emission factors in the temperate and tropical climate regions of Mexico followed by inventory calculation. We then evaluated the supplementation to cattle of different tanniferous plants to reduce enteric CH4 formation and finally established two mitigation scenarios for each region. Leucaena leucocephala and Cosmos bipinnatus are the tanniferous plants that produced the largest reduction in CH4 formation. In scenario 1, a moderate mitigation scenario, it was assumed 16% reduction of enteric CH4 emission in the temperate climate regions (TEMP) and 36% in the tropical regions (TROP) with cattle population of 37.8 million heads, from which 22.3 are in the TEMP (emission factor 529 l/day/head) and 15.5 in the TROP (emission factor 137 l/day/head). Reduction potential resulting from the use of C. bipinnatus and L. Leucocephala over a year is 1,203Gg. In scenario 2, a high mitigation situation, it was assumed a 26% reduction of CH4 emission in the TEMP and 36% in the TROP and the same cattle population. The reduction potential resulting from C. bipinnatus and L. Leucocephala use in a year is 1,512 Gg. Results showed that in both scenarios the CH4 released by enteric fermentation could be reduced by the use of the plants evaluated

  15. [Indications and practice of enteral nutrition].

    Science.gov (United States)

    Hallay, Judit; Nagy, Dániel; Fülesdi, Béla

    2014-12-21

    Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient's condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy.

  16. Multi-mycotoxin analysis of animal feed and animal-derived food using LC-MS/MS system with timed and highly selective reaction monitoring.

    Science.gov (United States)

    Zhao, Zhiyong; Liu, Na; Yang, Lingchen; Deng, Yifeng; Wang, Jianhua; Song, Suquan; Lin, Shanhai; Wu, Aibo; Zhou, Zhenlei; Hou, Jiafa

    2015-09-01

    Mycotoxins have the potential to enter the human food chain through carry-over of contaminants from feed into animal-derived products. The objective of the study was to develop a reliable and sensitive method for the analysis of 30 mycotoxins in animal feed and animal-derived food (meat, edible animal tissues, and milk) using liquid chromatography-tandem mass spectrometry (LC-MS/MS). In the study, three extraction procedures, as well as various cleanup procedures, were evaluated to select the most suitable sample preparation procedure for different sample matrices. In addition, timed and highly selective reaction monitoring on LC-MS/MS was used to filter out isobaric matrix interferences. The performance characteristics (linearity, sensitivity, recovery, precision, and specificity) of the method were determined according to Commission Decision 2002/657/EC and 401/2006/EC. The established method was successfully applied to screening of mycotoxins in animal feed and animal-derived food. The results indicated that mycotoxin contamination in feed directly influenced the presence of mycotoxin in animal-derived food. Graphical abstract Multi-mycotoxin analysis of animal feed and animal-derived food using LC-MS/MS.

  17. Nutrición enteral

    OpenAIRE

    Barrachina Bellés, Lidón; García Hernández, Misericordia; Oto Cavero, Isabel

    1984-01-01

    Este trabajo nos introduce en la administración de la nutrición enteral, haciendo una revisión de los aspectos a tener en cuenta tanto en sus indicaciones, vias, tipos, métodos, cuidados y complicaciones más importantes.

  18. Feeding Your Baby

    Medline Plus

    Full Text Available ... care Is it safe? Labor & birth Postpartum care Baby Caring for your baby Feeding your baby Family ... community Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please fill in ...

  19. Feeding Your Baby

    Medline Plus

    Full Text Available ... our online community Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please ... been added to your dashboard . Time to eat! Feeding your baby helps her grow healthy and strong. ...

  20. The potential effectiveness of the nutrition improvement program on infant and young child feeding and nutritional status in the Northwest and Southwest regions of Cameroon, Central Africa.

    Science.gov (United States)

    Reinsma, Kate; Nkuoh, Godlove; Nshom, Emmanuel

    2016-11-15

    Despite the recent international focus on maternal and child nutrition, little attention is paid to nutrition capacity development. Although infant feeding counselling by health workers increases caregivers' knowledge, and improves breastfeeding, complementary feeding, and children's linear growth, most of the counselling in sub-Saharan Africa is primarily conducted by nurses or volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. The Cameroon Baptist Convention Health Services Nutrition Improvement Program (NIP) has integrated a cadre of nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices (IYCF). The study objective was to evaluate the effects of NIP's infant feeding counselors on exclusive breastfeeding (EBF), complementary feeding (CF), and children's linear growth. A cross-sectional evaluation design was used. Using systematic random sampling, caregivers were recruited from NIP sites (n = 359) and non-NIP sites (n = 415) from Infant Welfare Clinics (IWCs) in the Northwest (NWR) and Southwest Regions (SWR) of Cameroon between October 2014 and April 2015. Differences in EBF and CF practices and children's linear growth between NIP and non-NIP sites were determined using chi-square and multiple logistic regression. After adjusting for differences in religion, occupation, and number of months planning to breastfeed, children were almost seven times (Odds Ratio [OR]: 6.9; 95% Confidence Interval [CI]: 2.30, 21.09; β = 1.94) more likely to be exclusively breastfed at NIP sites compared to non-NIP sites. After adjusting for differences in occupation, religion, number of months planning to breastfeed, rural environment, economic status, attending other Infant Welfare Clinics, and non-biological caregiver, children were five times more likely to be stunted at

  1. Data analyses and modelling for risk based monitoring of mycotoxins in animal feed

    NARCIS (Netherlands)

    Ine van der Fels-Klerx, H.J.; Adamse, Paulien; Punt, Ans; Asselt, van Esther D.

    2018-01-01

    Following legislation, European Member States should have multi-annual control programs for contaminants, such as for mycotoxins, in feed and food. These programs need to be risk based implying the checks are regular and proportional to the estimated risk for animal and human health. This study

  2. Estimation of risk management effects on revenue and purchased feed costs on US dairy farms.

    Science.gov (United States)

    Hadrich, Joleen C; Johnson, Kamina K

    2015-09-01

    Variations in milk and feed prices directly affect dairy farm risk management decisions. This research used data from the 2010 US Department of Agriculture-Agricultural Resource Management Surveys phase III dairy survey to examine how risk management tools affected revenues and expenses across US dairy farms. The survey was sent to 26 states and collected information on costs and returns to individual dairy farms. This research used the information from milk sales, crops sales, feed expenses, and farm and operator characteristics, as well as the use of risk management tools. Matching methodology was used to evaluate the effect of 5 independent risk management tools on revenues and expenses: selling milk to a cooperative, using a commodity contract to sell grain, feeding homegrown forage at a basic and intensive level, and use of a nutritionist. Results showed that dairy farms located in the Midwest and East benefit from selling milk to a cooperative and using commodity contracts to sell grain. Across the United States, using a nutritionist increased total feed costs, whereas a feeding program that included more than 65% homegrown forages decreased total feed costs. Results point to benefits from educational programming on risk management tools that are region specific rather than a broad generalization to all US dairy farmers. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  3. [Infant feeding practices and deterioration of breastfeeding in Mexico].

    Science.gov (United States)

    González de Cosío, Teresita; Escobar-Zaragoza, Leticia; González-Castell, Luz Dinorah; Rivera-Dommarco, Juan Ángel

    2013-01-01

    To present data on infant and young child feeding practices (IYCFP) in Mexico from the 2012 National Health and Nutrition Survey (ENSANUT 2012) to support the development of public policy. Women 12-49y and children <2y. Indicators of IYCFP suggested by WHO were analyzed by geographic, socioeconomic, participation in food programs and health insurance variables. Median duration of breast-feeding: 10.2mo and 14.4% with exclusive breastfeeding (EBF) <6m. Breastfeeding deteriorated in most vulnerable groups. Decline in EBF<6m 2006-2012 was explained by increases in consumption of formula and other milks (4%) and water (4%). Three-quarters (74%) of 6-11mo infants had minimum food diversity, and it was lower in the most vulnerable. Complementary feeding improved but breastfeeding declined in Mexico. Promotion actions must be integral, coordinated, financed and evaluated, with Federal government leadership and should include the participation of various stakeholders.

  4. Epigenetic regulation of enteric neurotransmission by gut bacteria.

    Directory of Open Access Journals (Sweden)

    Tor eSavidge

    2016-01-01

    Full Text Available The Human Microbiome Project defined microbial community interactions with the human host, and provided important molecular insight into how epigenetic factors can influence intestinal ecosystems. Given physiological context, changes in gut microbial community structure are increasingly found to associate with alterations in enteric neurotransmission and disease. At present, it is not known whether shifts in microbial community dynamics represent cause or consequence of disease pathogenesis. The discovery of bacterial-derived neurotransmitters suggests further studies are needed to establish their role in enteric neuropathy. This mini-review highlights recent advances in bacterial communications to the autonomic nervous system and discusses emerging epigenetic data showing that diet, probiotic and antibiotic use may regulate enteric neurotransmission through modulation of microbial communities. Because of its limited scope, a particular emphasis is placed on bacterial regulation of enteric nervous system function in the intestine.

  5. Phytogenic Compounds as Alternatives to In-Feed Antibiotics: Potentials and Challenges in Application

    Directory of Open Access Journals (Sweden)

    Chengbo Yang

    2015-03-01

    Full Text Available This article summarizes current experimental knowledge on the efficacy, possible mechanisms and feasibility in the application of phytogenic products as feed additives for food-producing animals. Phytogenic compounds comprise a wide range of plant-derived natural bioactive compounds and essential oils are a major group. Numerous studies have demonstrated that phytogenic compounds have a variety of functions, including antimicrobial/antiviral, antioxidative and anti-inflammation effects and improvement in the palatability of feed and gut development/health. However, the mechanisms underlying their functions are still largely unclear. In the past, there has been a lack of consistency in the results from both laboratory and field studies, largely due to the varied composition of products, dosages, purities and growing conditions of animals used. The minimal inhibitory concentration (MIC of phytogenic compounds required for controlling enteric pathogens may not guarantee the best feed intake, balanced immunity of animals and cost-effectiveness in animal production. The lipophilic nature of photogenic compounds also presents a challenge in effective delivery to the animal gut and this can partially be resolved by microencapsulation and combination with other compounds (synergistic effect. Interestingly, the effects of photogenic compounds on anti-inflammation, gut chemosensing and possible disruption of bacterial quorum sensing could explain a certain number of studies with different animal species for the better production performance of animals that have received phytogenic feed additives. It is obvious that phytogenic compounds have good potential as an alternative to antibiotics in feed for food animal production and the combination of different phytogenic compounds appears to be an approach to improve the efficacy and safety of phytogenic compounds in the application. It is our expectation that the recent development of high-throughput and

  6. Osmolality and pH in handmade enteral diets used in domiciliary enteral nutritional therapy

    Directory of Open Access Journals (Sweden)

    Gilberto Simeone HENRIQUES

    Full Text Available Abstract Patients who need prolonged domiciliary enteral nutritional therapy may benefit from handmade diets. However, the preparation of such diets might cause insecurity with regard to their nutritional composition and physical-chemical properties. Current study analyzes the osmolality and Hydrogen-Ion concentration (pH on handmade enteral diets. To this purpose, six formulas and two juices, prescribed on discharge from hospital, were analyzed physically and chemically. Osmolality and pH were respectively determined by cryoscopy and potentiometry. Most formulations were classified as isosmolar (with less than 400 mOsm/kg solvent, and only one was classified as slightly hyperosmolar, with rates ranging from 356.7 to 403.5 mOsm/kg solvent. On average, the standard formula presented higher osmolality than similar ones prepared for hyperglycemia. Among the juices, only one registered hyperosmolar concentration of 595.54 mOsm/kg solvent. All formulas presented pH rates classified as low acidity, ranging between 6.1 and 6.6, while the two juices had the lowest results, 4.73 and 4.66 each. The blend of ingredients used in handmade formulas and juices studied presented acceptable osmolality and pH rates for a safe administration and absence of gastrointestinal complications. Data showed here are consistent with an appropriate and healthy diet and contributed towards success in domiciliary enteral nutritional therapy.

  7. Effect of concentrate supplementation during the dry period on colostrum quality and effect of colostrum feeding regimen on passive transfer of immunity, calf health, and performance.

    Science.gov (United States)

    Dunn, A; Ashfield, A; Earley, B; Welsh, M; Gordon, A; McGee, M; Morrison, S J

    2017-01-01

    The objectives were to evaluate the effect of (1) supplementing concentrates to multiparous Holstein cows during the dry period on colostral and milk immunoglobulin G (IgG) concentration; and (2) feeding calves colostrum at either 5 or 10% of their body weight (BW) on passive transfer of immunity, health, and performance. Holstein multiparous cows (n=37) were assigned to 1 of 2 nutritional treatments during an 8-wk dry period: (1) offered ad libitum grass silage only (GS) or (2) offered ad libitum access to the same grass silage plus concentrate [total mixed ration in a 75:25 dry matter (DM) ratio], providing a mean concentrate DM intake of 3.0kg/cow per day (GSC). Both treatment groups were offered identical levels of mineral and vitamin supplementation. Calves from these cows were weighed immediately after birth and fed either 5% (5BW) or 10% (10BW) of their BW in colostrum from their own dams within 2.5h of birth. Calves in the 10BW group received their second feed of colostrum from first-milking colostrum. Concentrate supplementation during the dry period had no effect on colostral IgG concentration, first-milking IgG yield, or fat, protein, and lactose contents. However, cows in GSC produced a greater mean milk yield over the first 8 milkings compared with cows in the GS group. Concentrate supplementation had no effect on calf BW or BW gain, serum IgG, or apparent efficiency of absorption (AEA) at 24h after birth. However, offspring from the GSC group had fewer cases of enteritis during the first 56d of life compared with offspring from the GS group. Calves in the 10BW group had greater mean serum IgG concentration for the first 3d following birth; however, at 24h after birth, we observed no treatment effect on AEA. The rate of enteritis was greater for calves in the 5BW treatment compared with 10BW. The colostrum-feeding regimen had no effect on BW gain or on the incidence of pneumonia among calf treatment groups. In conclusion, concentrate supplementation

  8. Evaluation of Gastrointestinal Leakage in Multiple Enteric Inflammation Models in Chickens.

    Science.gov (United States)

    Kuttappan, Vivek A; Vicuña, Eduardo A; Latorre, Juan D; Wolfenden, Amanda D; Téllez, Guillermo I; Hargis, Billy M; Bielke, Lisa R

    2015-01-01

    Enteric inflammation models can help researchers' study methods to improve health and performance and evaluate various growth promoters and dietary formulations targeted to improve performance in poultry. Oral administration of fluorescein isothiocyanate-dextran (FITC-d; 3-5 kDa) and its pericellular mucosal epithelial leakage are an established marker to evaluate enteric inflammation in multiple species. The present study evaluated different methods to induce gut inflammation in poultry based on FITC-d leakage. Four independent experiments were completed with different inflammation treatment groups, and serum FITC-d and/or retention of FITC-d in GI tract were determined. In experiment 1 (n = 10 birds/treatment, broilers, processed at 14 days), groups included control (CON), dextran sodium sulfate (DSS; drinking water at 0.75%) and feed restriction (FRS; 24 h before processing). Experiment 2 (n = 14 birds/treatment, leghorns, processed at 7 days) included CON, DSS, FRS, and rye-based diet (RBD). In experiments 3 and 4 (n = 15 birds/treatment, broilers, processed at 7 days), groups were CON, DSS, high fat diet (HFD), FRS, and RBD. In all experiments, FRS and RBD treatments showed significantly higher serum FITC-d levels compared to the respective CON. This indicates that FRS and RBD results in disruption of the intact barrier of the gastrointestinal tract (GIT), resulting in increased gut permeability. DSS and HFD groups showed elevation of serum FITC-d levels although the magnitude of difference from respective CON was inconsistent between experiments. FRS was the only treatment which consistently showed elevated retention of FITC-d in GIT in all experiments. The results from present studies showed that FRS and RBD, based on serum FITC-d levels, can be robust models to induce gut leakage in birds in different age and species/strains.

  9. Evaluation of gastrointestinal leakage in multiple enteric inflammation models in chickens

    Directory of Open Access Journals (Sweden)

    Vivek A. Kuttappan

    2015-12-01

    Full Text Available Enteric inflammation models can help researchers study methods to improve health and performance plus evaluate various growth promoters and dietary formulations targeted to improve performance in poultry. Oral administration of fluorescein isothiocyanate dextran (FITC-d; 3-5 kDa and its pericellular mucosal epithelial leakage is an established marker to evaluate enteric inflammation in multiple species. The present study evaluated different methods to induce gut inflammation in poultry based on FITC-d leakage. Four independent experiments were completed with different inflammation treatment groups; serum FITC-d and/or retention of FITC-d in GI tract was/were determined. In experiment 1 (n=10 birds/treatment; broilers; processed at 14d, groups included control (CON, Dextran sodium sulfate (DSS; drinking water at 0.75% and feed restriction (FRS; 24h before processing. Experiment 2 (n=14birds/treatment; leghorns; processed at 7d included CON, DSS, FRS, and rye based diet (RBD. In experiments 3 and 4 (n=15 birds/treatment; broilers; processed at 7d, groups were CON, DSS, high fat diet (HFD, FRS, and RBD. In all experiments, FRS and RBD treatments showed significantly higher serum FITC-d levels compared to the respective CON. This indicates that FRS and RBD results in disruption of the intact barrier of the GIT, resulting in increased gut permeability. DSS and HFD groups showed elevation of serum FITC-d levels although the magnitude of difference from respective CON were inconsistent between experiments. FRS was the only treatment which consistently showed elevated retention of FITC-d in GIT in all experiments. The results from present studies showed that FRS and RBD, based on serum FITC-d levels, can be robust models to induce gut leakage in birds in different age and species/strains.

  10. Early gradual feeding with bovine colostrum improves gut function and NEC resistance relative to infant formula in preterm pigs

    DEFF Research Database (Denmark)

    Shen, René L.; Thymann, Thomas; Østergaard, Mette V.

    2015-01-01

    It is unclear when and how to start enteral feeding for preterm infants when mother’s milk is not available. We hypothesized that early and slow advancement with either formula or bovine colostrum stimulates gut maturation and prevents necrotizing enterocolitis (NEC) in preterm pigs, used as models...... for preterm infants. Pigs were given either total parenteral nutrition (TPN, n = 14) or slowly advancing volumes (16–64 ml·kg-1·day-1) of preterm infant formula (IF, n = 15) or bovine colostrum (BC, n = 13), both given as adjunct to parenteral nutrition. On day 5, both enteral diets increased intestinal mass...... intestinal permeability, compared with BC pigs (all P colostrum supports gut maturation when mother’s milk is absent during the first week after preterm birth...

  11. Lake Roosevelt Fisheries Monitoring Program; 1988-1989 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Peone, Tim L.; Scholz, Allan T.; Griffith, James R.

    1990-10-01

    In the Northwest Power Planning Council's 1987 Columbia River Basin Fish and Wildlife Program (NPPC 1987), the Council directed the Bonneville Power Administration (BPA) to construct two kokanee salmon (Oncorhynchus nerka) hatcheries as partial mitigation for the loss of anadromous salmon and steelhead incurred by construction of Grand Coulee Dam [Section 903 (g)(l)(C)]. The hatcheries will produce kokanee salmon for outplanting into Lake Roosevelt as well as rainbow trout (Oncorhynchus mykiss) for the Lake Roosevelt net-pen program. In section 903 (g)(l)(E), the Council also directed BPA to fund a monitoring program to evaluate the effectiveness of the kokanee hatcheries. The monitoring program included the following components: (1) a year-round, reservoir-wide, creel survey to determine angler use, catch rates and composition, and growth and condition of fish; (2) assessment of kokanee, rainbow, and walleye (Stizostedion vitreum) feeding habits and densities of their preferred prey, and; (3) a mark and recapture study designed to assess the effectiveness of different locations where hatchery-raised kokanee and net pen reared rainbow trout are released. The above measures were adopted by the Council based on a management plan, developed by the Upper Columbia United Tribes Fisheries Center, Spokane Indian Tribe, Colville Confederated Tribes, Washington Department of Wildlife, and National Park Service, that examined the feasibility of restoring and enhancing Lake Roosevelt fisheries (Scholz et al. 1986). In July 1988, BPA entered into a contract with the Spokane Indian Tribe to initiate the monitoring program. The projected duration of the monitoring program is through 1995. This report contains the results of the monitoring program from August 1988 to December 1989.

  12. Parent-reported feeding and feeding problems in a sample of Dutch toddlers

    NARCIS (Netherlands)

    Moor, J.M.H. de; Didden, H.C.M.; Korzilius, H.P.L.M.

    2007-01-01

    Little is known about the feeding behaviors and problems with feeding in toddlers. In the present questionnaire study, data were collected on the feeding behaviors and feeding problems in a relatively large (n = 422) sample of Dutch healthy toddlers (i.e. 18-36 months old) who lived at home with

  13. Evaluation of PCDD/Fs characterization in animal feed and feed additives.

    Science.gov (United States)

    Kim, MeeKyung; Kim, Sooyeon; Yun, Seon Jong; Kwon, Jin-Wook; Son, Seong-Wan

    2007-09-01

    Safety control of feed and feed additives is necessary to have safe food of animal origin. Based on media reports, nine incidents regarding dioxins and/or PCBs contaminations occurred worldwide during the last decade. Korea is a country which imports feed and feed additives. In this study, various kinds of feed and feed additives were analyzed to monitor the contamination level of dioxins. The level of PCDD/Fs in fish oil was the highest with a concentration of 23.33ngkg(-1), which is equivalent to a toxicological concentration of 4.68ngWHO-TEQ/kg. Feed from animals origin such as chicken meal, animal fat, fish meal, fish oil, and shell powder showed relatively higher concentrations of PCDD/Fs. Feed from plants origin, minerals, and additives ranged from non-detects for bit pulp and ethoxyquin to 8.28ngkg(-1) for dl-methionine. From a toxicological point of view, the highest concentration in vitamins was 0.08ngWHO-TEQ/kg among the feed additives. 2,3,4,7,8-PeCDF was the dominant congener in samples of fish oil, fish meal, and shell powder. Animal fat showed that the pattern of PCDD/Fs depends on the sources of contamination. A sample of animal fat showed 1,2,3,4,7,8-HxCDF and the other sample showed 1,2,3,4,7,8-HxCDD as a primary congener. Generally, low levels of PCDDs were detected in feed additives. Patterns of PCDD/Fs in choline chloride were different with that in choline chloride from an incident in Europe in 2000.

  14. Surgical treatment of radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Cross, M.J.; Frazee, R.C. (Department of General Surgery, Scott and White Memorial Hospital, Temple TX (United States))

    1992-02-01

    Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting.

  15. Surgical treatment of radiation enteritis

    International Nuclear Information System (INIS)

    Cross, M.J.; Frazee, R.C.

    1992-01-01

    Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting

  16. Enteral alimentation and gastrointestinal bleeding in mechanically ventilated patients.

    Science.gov (United States)

    Pingleton, S K; Hadzima, S K

    1983-01-01

    The incidence of upper gastrointestinal (GI) bleeding in mechanically ventilated ICU patients receiving enteral alimentation was reviewed and compared to bleeding occurring in ventilated patients receiving prophylactic antacids or cimetidine. Of 250 patients admitted to our ICU during a 1-yr time period, 43 ventilated patients were studied. Patients in each group were comparable with respect to age, respiratory diagnosis, number of GI hemorrhage risk factors, and number of ventilator, ICU, and hospital days. Twenty-one patients had evidence of GI bleeding. Fourteen of 20 patients receiving antacids and 7 of 9 patients receiving cimetidine had evidence of GI bleeding. No bleeding occurred in 14 patients receiving enteral alimentation. Complications of enteral alimentation were few and none required discontinuation of enteral alimentation. Our preliminary data suggest the role of enteral alimentation in critically ill patients may include not only protection against malnutrition but also protection against GI bleeding.

  17. Impact of supplementary feeding on reproductive success of white storks.

    Directory of Open Access Journals (Sweden)

    Roland Hilgartner

    Full Text Available European white stork (Ciconia ciconia populations have been object to several conservation measures such as reintroduction programs, habitat improvement or supplementary feeding in the last decades. Although recent white stork censuses revealed an upward trend of most of the western populations, evaluations of the relative importance of certain conservation measures are still scarce or even lacking. In our study we analyzed the effect of supplementary feeding on the reproductive success of white storks in conjunction with other factors such as weather or nest site characteristics. We present data of 569 breeding events at 80 different nest sites located in variable distances to an artificial feeding site at Affenberg Salem (south-western Germany collected from 1990-2012. A multilevel Poisson regression revealed that in our study population (1 reproductive success was negatively affected by monthly precipitation in April, May and June, (2 pairs breeding on power poles had a lower reproductive success than pairs breeding on platforms or trees and (3 reproductive success was significantly higher in pairs breeding in close distance to the feeding site. The number of fledglings per nest decreased by 8% per kilometer distance to the feeding site. Our data suggest that supplementary feeding increases fledgling populations which may be a tool to attenuate population losses caused by factors such as habitat deterioration or unfavorable conditions in wintering habitats.

  18. Survey of contemporary feeding practices in critically ill children in the Asia-Pacific and the Middle East.

    Science.gov (United States)

    Wong, Judith J M; Ong, Chengsi; Han, Wee Meng; Mehta, Nilesh M; Lee, Jan Hau

    2016-01-01

    Nutrition is a fundamental component of care of critically ill children. Determining variation in nutritional practices within paediatric intensive care units (PICUs) allows for review and improvement of nutrition practices. The aim was to survey the nutrition practices and perspectives of paediatric intensivists and dieticians in Asia-Pacific and the Middle East. A questionnaire was developed to collect data on (1) the respondent's and institution's characteristics, (2) nutritional assessments and nutrient delivery practices, and (3) the perceived importance and barriers to optimal enteral feeding in the PICU. We analysed 47 responses from 35 centres in 18 different countries. Dedicated dietetic services were only present in 13 (37%) centres and regular nutrition assessments were conducted in only 12 (34%) centres. In centres with dedicated dieticians, we found greater use of carbohydrate, fat additives and special formulas. Two thirds [31 (66%)] of respondents used total fluids to estimate energy requirements. Only 11 (31%) centres utilized feeding protocols. These centres had higher use of small bowel feeding, acid suppressants, laxatives and gastric residual volume thresholds. When dealing with feed intolerance, they were also more likely to start a motility agent. There was also a lack of consensus on when feeding should start and the use of adjuncts. Nutrition practices and barriers are unique in Asia-Pacific and the Middle East and strongly reflect a lack of dietetic services. Future effort should focus on developing a uniform approach on nutrition practices to drive paediatric critical care nutrition research in these regions.

  19. Organic Poultry Feeding

    Directory of Open Access Journals (Sweden)

    Arda Yıldırım

    2014-02-01

    Full Text Available Many people have led to the consumption of organic animal products in the event that the increase in sensitivity to a healthy diet in developed countries, and maintaining the safety of food of animal origin. Feeding and breeding in conventional production are emerged some of the negative effects and also it is more in organic production with new restrictions. Organic production is based on animal welfare. On the basis of behaviors such as feather-pecking and cannibalism known to be low in protein level of rations and unbalanced in terms of amino acids or minerals. As of 2015, organic poultry feed provided the appropriate conditions that will be 95% organic certified in Turkey and therefore, to create a balanced ration and feed hygiene in protecting brings serious challenges. Fodder supply of organic poultry feed raw materials that make up the quality, quantity and issue forms a significant effect on the health of the poultry additives permitted. The quality of the feed raw materials that constituent diets, quantity, feed supplying form and permitted feed additives significantly affects the health of poultry. Different physiological stages of the animal's nutritional requirements in order to ensure production of quality poultry products must be met from organically produced and very well-known with the contents of feedstuff digestibility. In this study, the problems encountered in feeding can be eliminated while performing economic production with considering animal welfare, following that balanced and adequate organic ration formulations and issues such as improving the production of feed raw materials are discussed.

  20. Carnitine deficiency presenting with a decreased mental state in a patient with amyotrophic lateral sclerosis receiving long-term tube feeding: a case report.

    Science.gov (United States)

    Isse, Naohi; Miura, Yoh; Obata, Toshiyuki; Takahara, Noriko

    2013-12-30

    L-carnitine is an important metabolic mediator involved in fatty acid transport. It is obtained from the diet, particularly from animal products, such as red meat. Previous reports have revealed that long-term tube feeding with a commercial product containing no or low levels of carnitine can lead to an altered mental state caused by hyperammonemia. A 72-year-old Japanese man had a 12-year history of amyotrophic lateral sclerosis. He was bedridden and had required mechanical ventilation and enteral tube feeding for 10 years at home. His main enteral solution was a commercial product that contained low carnitine levels, and he sometimes received coffee and homemade products such as miso soup. Our patient's ability to communicate gradually deteriorated over a period of one year. His serum total carnitine level was abnormally low, at 26.7μmol/L (normal range, 45 to 91μmol/L), but his ammonium level was normal. His mental state improved dramatically after starting L-carnitine supplementation (600mg twice daily). This case highlights the importance of avoiding carnitine deficiency in patients with amyotrophic lateral sclerosis undergoing long-term tube feeding. These patients experience progressive muscle atrophy that might cause impaired carnitine storage and might manifest as communication difficulties. Carnitine deficiency can be misdiagnosed as a progression of systemic muscle atrophy. Clinicians should be aware of this disorder and should consider periodically measuring carnitine levels, regardless of the patient's serum ammonium levels.