New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition.

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Akbulut, Gamze

2011-07-01

Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer.

[Indications and practice of enteral nutrition].

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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.

New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition

Science.gov (United States)

AKBULUT, GAMZE

2011-01-01

Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer. PMID:22977559

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

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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

[Croatian guidelines for perioperative enteral nutrition of surgical patients].

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Zelić, Marko; Bender, Darija Vranesić; Kelecić, Dina Ljubas; Zupan, Zeljko; Cicvarić, Tedi; Maldini, Branka; Durut, Iva; Rahelić, Velimir; Skegro, Mate; Majerović, Mate; Perko, Zdravko; Sustić, Alan; Madzar, Tomislav; Kovacić, Borna; Kekez, Tihomir; Krznarić, Zeljko

2014-01-01

Nutritional status of patients significantly affects the outcome of surgical treatment, whether it's about being obese or malnutrition with loss of muscle mass. Inadequate nutritional support in the perioperative period compromises surgical procedures even in patients who are adequately nourished. In this paper, particular attention was paid to malnourished patients, and their incidence in population hospitalized in surgical wards can be high up to 30%. Special emphasis was paid to the appropriateness of preoperative fasting and to the acceptance of new knowledge in this area of treatment. The aim of this working group was to make guidelines for perioperative nutritional support with different modalities of enteral nutrition. The development of these guidelines was attended by representatives of Croatian Medical Association: Croatian Society for Digestive Surgery, Croatian Society for Clinical Nutrition, Croatian Society of Surgery, Croatian Society for Endoscopic Surgery, Croatian Trauma Society and the Croatian Society of Anesthesiology and Intensive Care. The guidelines are designed as a set of questions that arise daily in clinical practice when preparing patients for surgery and after the surgical treatment, which relate to the assessment of nutritional status, perioperative nutritional support, duration of preoperative fasting period and the selection of food intake route. Assessment of nutritional status and the use of different modes of enteral nutrition should enter into standard protocols of diagnosis and treatment in the Croatian hospitals.

American Society for Parenteral & Enteral Nutrition

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... Center Advertising and Sponsorship Learn More ASPEN Enteral Nutrition by the Numbers: EN Data Across the Healthcare Continuum Learn More The ASPEN Adult Nutrition Support Core Curriculum, 3rd Edition Has Arrived! The ...

IODINE CONTENT OF ENTERAL AND PARENTERAL NUTRITION SOLUTIONS.

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Willard, Devina L; Young, Lorraine S; He, Xuemei; Braverman, Lewis E; Pearce, Elizabeth N

2017-07-01

Iodine is essential for thyroid hormone synthesis, and iodine deficiency may result in thyroid disorders including goiter and hypothyroidism. Patients on long-term enteral nutrition (EN) or parenteral nutrition (PN) may be at risk for micronutrient deficiencies. The recommended daily allowance for iodine intake is 150 μg for nonpregnant adults. However, there is no current consensus among scientific societies regarding the quantity of iodine to be added in adult EN and PN formulations. The objective of this study was to determine the iodine content of U.S. adult enteral and parenteral nutrition solutions. This study also aimed to determine whether adult patients in the United States who are receiving long-term artificial nutrition may be at risk for iodine deficiency. Ten enteral nutrition solutions and 4 parenteral nutrition solutions were evaluated. The iodine contents of these solutions were measured spectrophotometrically and compared to the labeled contents. Measured and labeled EN iodine contents were similar (range 131-176 μg/L and 106-160 μg/L, respectively). In contrast, PN formulas were found to contain small, unlabeled amounts of iodine, averaging 27 μg/L. Typical fluid requirements are 30 to 40 mL/kg/day for adults receiving either total EN (TEN) or total PN (TPN). Adults on long-term TEN likely consume enough servings to meet their daily iodine requirements. However, patients on long-term TPN would require on average 5.6 L PN/day to meet the recommended daily allowance of iodine. This volume of PN is far in excess of typical consumption. Thus, U.S. patients requiring long-term TPN may be at risk for iodine deficiency. EN = enteral nutrition; PN = parenteral nutrition; TEN = total enteral nutrition; TPN = total parenteral nutrition; UIC = urinary iodine concentration.

Enteral Nutrition in Dementia: A Systematic Review

Directory of Open Access Journals (Sweden)

Joanne Brooke

2015-04-01

Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.

Standardized Competencies for Parenteral Nutrition Prescribing: The American Society for Parenteral and Enteral Nutrition Model.

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Guenter, Peggi; Boullata, Joseph I; Ayers, Phil; Gervasio, Jane; Malone, Ainsley; Raymond, Erica; Holcombe, Beverly; Kraft, Michael; Sacks, Gordon; Seres, David

2015-08-01

Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized model for PN prescribing competency is proposed based on a competency framework, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines. This framework will guide institutions and agencies in developing and maintaining competency for safe PN prescription by their staff. © 2015 American Society for Parenteral and Enteral Nutrition.

Half-elemental Nutrition Mixtures for Enteral Nutrition of Children in Critical Conditions: Features of Usage and Economic Efficiency

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L. N. Berestennikova

2015-01-01

Full Text Available Enteral (tube nutrition has demonstrated its superiority in comparison with parenteral nutrition for patients with a preserved function of gastrointestinal tract who are in intensive care units, or ICU, and who cannot eat or are not allowed to eat by medical indications. International guidelines recommend enteral injections of mixtures for patients in critical conditions in need of nutritial support. The first twenty-four hour is considered the optimal period for starting nutritional support. It is known that costs of the enteral nutrition are much lower than costs of intravascular supply for patients who are in the ICU. The usage of special-purpose dietary products — half-elemental mixtures with high energy density — is the most physiological for children in ICU from 1 year and for adults in critical conditions.

Management of Hyperglycemia During Enteral and Parenteral Nutrition Therapy

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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

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

Early enteral nutrition compared to outcome in critically ill trauma ...

African Journals Online (AJOL)

Objectives: The benefit of an early enteral nutrition start in critical ill patients is widely accepted. However, limited published data focus on trauma patients. This study aimed to investigate the effect of early enteral nutrition initiation on length of stay and mortality in an intensive care unit (ICU), as well as explore if enteral ...

Role of FODMAP content in enteral nutrition-associated diarrhea.

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Halmos, Emma P

2013-12-01

Gastrointestinal symptoms including diarrhea are common complications of enteral nutrition (EN); however, the cause is unclear. Mode of EN delivery that alters digestion and possibly absorption is suggested to contribute to the high incidence of diarrhea; however, enteral formula is frequently blamed. Most research has focused on fiber-supplemented EN, with a meta-analysis showing that fiber reduces the incidence of diarrhea in non-intensive care unit studies. Other hypotheses include formula osmolality and FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) content. FODMAPs are poorly absorbed short-chain carbohydrates that exert an osmotic effect. Dietary FODMAPs have been shown to reduce gastrointestinal symptoms, including diarrhea, in those with irritable bowel syndrome and, given a high-enough dose, will induce a laxative effect in most people. As FODMAPs are commonly added to enteral formula and EN is frequently used as the main source of nutrition, it is reasonable to hypothesize that EN provides more FODMAPs than usual dietary intake and increases risk for developing diarrhea. This hypothesis was assessed through a retrospective study showing that the standard-use enteral formula Isosource 1.5 had a protective effect of developing diarrhea. The only characteristic unique to Isosource 1.5 was the lower FODMAP content as determined through methodologies previously validated for food analysis. Methodologies for application to enteral formulas are currently undergoing formal validation. Once confirmed for application in enteral formula, future directions include FODMAP analysis of specific ingredients to increase understanding of potential problems associated with enteral formula and a randomized, controlled trial investigating the role of formula FODMAP content. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Review article: dietary fibre-microbiota interactions.

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Simpson, H L; Campbell, B J

2015-07-01

Application of modern rapid DNA sequencing technology has transformed our understanding of the gut microbiota. Diet, in particular plant-based fibre, appears critical in influencing the composition and metabolic activity of the microbiome, determining levels of short-chain fatty acids (SCFAs) important for intestinal health. To assess current epidemiological, experimental and clinical evidence of how long-term and short-term alterations in dietary fibre intake impact on the microbiome and metabolome. A Medline search including items 'intestinal microbiota', 'nutrition', 'diet', 'dietary fibre', 'SCFAs' and 'prebiotic effect' was performed. Studies found evidence of fibre-influenced differences in the microbiome and metabolome as a consequence of habitual diet, and of long-term or short-term intervention (in both animals and humans). Agrarian diets high in fruit/legume fibre are associated with greater microbial diversity and a predominance of Prevotella over Bacteroides. 'Western'-style diets, high in fat/sugar, low in fibre, decrease beneficial Firmicutes that metabolise dietary plant-derived polysaccharides to SCFAs and increase mucosa-associated Proteobacteria (including enteric pathogens). Short-term diets can also have major effects, particularly those exclusively animal-based, and those high-protein, low-fermentable carbohydrate/fibre 'weight-loss' diets, increasing the abundance of Bacteroides and lowering Firmicutes, with long-term adherence to such diets likely increasing risk of colonic disease. Interventions to prevent intestinal inflammation may be achieved with fermentable prebiotic fibres that enhance beneficial Bifidobacteria or with soluble fibres that block bacterial-epithelial adherence (contrabiotics). These mechanisms may explain many of the differences in microbiota associated with long-term ingestion of a diet rich in fruit and vegetable fibre. © 2015 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.

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

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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.

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

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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

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

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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

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.

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

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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.

[When enteral nutrition is not possible in intensive care patients: whether to wait or use parenteral nutrition?

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Habes, Q L M; Pickkers, P

2016-01-01

- Overfeeding of critically ill patients is associated with a higher incidence of infections and an increased length of ventilation. However, trophic nutrition or permissive underfeeding appears to have no negative effect on the patient and may even provide a survival benefit.- Initiation of enteral nutrition within 24-48 hours after Intensive Care Unit (ICU) admission may reduce the number of complications and increase the chance of survival.- Total parenteral nutrition is associated with a higher risk of infections than enteral nutrition. This seems to be related to the higher calorie intake with parenteral nutrition rather than the route of administration.- In previously well-nourished patients, in whom enteral nutrition is only partially successful, it is safe to wait for up to 8 days before initiating supplemental parenteral nutrition.- In critically ill children, it is also safe to start supplemental parenteral nutrition at a late (on the 8th day after admission) rather than an early stage (within 24 hours of admission). Late supplemental parenteral nutrition may even result in fewer infectious complications and shorter hospitalisation.

Nutritional assessment using stable isotope ratios of carbon and nitrogen in the scalp hair of geriatric patients who received enteral and parenteral nutrition formulas.

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Hayasaka, M; Ogasawara, H; Hotta, Y; Tsukagoshi, K; Kimura, O; Kura, T; Tarumi, T; Muramatsu, H; Endo, T

2017-12-01

The δ 13 C and δ 15 N values in the scalp hair of geriatric patients in Japan who received the enteral or parenteral nutrition formula were measured to assess nutritional status. The relations among δ 13 C, δ 15 N, calorie intake, BMI, albumin concentration, total cholesterol (T-CHO) and geriatric nutritional risk index (GNRI) in the patients were investigated. Furthermore, the enrichment of δ 13 C and δ 15 N from the nutrients to the hair was investigated. The δ 13 C values in the hair of patients who received enteral nutrition decreased with decreases in the calories received, while the δ 15 N values increased, suggesting malnutrition in some patients with a low calorie intake due to a negative nitrogen balance. The distribution of patients with a low calorie intake (below 20 kcal/kg/day) when δ 13 C was plotted against δ 15 N differed from that of control subjects, but the distribution of patients with a high calorie intake (above 20 kcal/kg/day) was similar to that of control subjects. No significant differences were observed in BMI, albumin concentration, T-CHO or GNRI between the low and high calorie groups. The enrichment of δ 13 C and δ 15 N from the enteral nutrients to the hair were inversely correlated with the δ 13 C and δ 15 N in the enteral nutrients. The enrichment levels of δ 13 C and δ 15 N tended to be higher and lower, respectively, in the high calorie group. On the other hand, the δ 13 C and δ 15 N values in the hair of patients who received parenteral nutrition were higher and lower than those in the control subjects and in the patients who received enteral nutrition, respectively, reflecting the higher δ 13 C and lower δ 15 N contents of the parenteral nutrients. The δ 13 C and δ 15 N values in the hair of patients who received enteral nutrition may be effective indicators for evaluating the long-term nutritional status of geriatric patients. A calorie intake of 20 kcal/kg/day may be a cut-off value for malnutrition in

Formulações com alimentos convencionais para nutrição enteral ou oral Formulations for enteral or oral nutrition using conventional foods

Directory of Open Access Journals (Sweden)

Edma M. Araújo

2006-09-01

were determined. The F1 and F2 formulations presented lower viscosities than FCM and improved caloric distribution (14% protein, 33% fat, 53% carbohydrate, food fibre content (8.16 g/2 L and caloric density (1 kcal/mL than FCM (19% protein, 33% fat, 48% carbohydrate, caloric density of 0.87 kcal/mL and food fibre content of 4.68 g/2 L. The formulations F1 and F2 were more fluid than FCM, dripped at 60-80 drips/minute and showed isotonic osmolalities. The addition of corn grits, Soymilk® and Nidex® improved the nutritive value and flow properties, making it possible to administer more in less time. The formulations represent options to individualise normal enteral diets in home therapy.

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

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

Enteral nutrition in the chronic obstructive pulmonary disease (COPD) patient.

Science.gov (United States)

DeBellis, Heather F; Fetterman, James W

2012-12-01

Chronic obstructive pulmonary disease (COPD) is a progressive, chronic disease, in which malnutrition can have an undesirable effect. Therefore, the patient's nutritional status is critical for optimizing outcomes in COPD. The initial nutrition assessment is focused on identifying calorically compromised COPD patients in order to provide them with appropriate nutrition. Nutritional intervention consists of oral supplementation and enteral nutrition to prevent weight loss and muscle mass depletion. Evaluation of nutritional status should include past medical history (medications, lung function, and exercise tolerance) and dietary history (patient's dietary habits, food choices, meal patterns, food allergy information, and malabsorption issues), in addition to physiological stress, visceral proteins, weight, fat-free mass, and body mass index. The current medical literature conflicts regarding the appropriate type of formulation to select for nutritional intervention, especially regarding the amount of calories from fat to provide COPD patients. This review article focuses on the enteral product formulations currently available, and how they are most appropriately utilized in patients with COPD.

Home parenteral nutrition in treatment of severe radiation enteritis

International Nuclear Information System (INIS)

Miller, D.G.; Ivey, M.; Young, J.

1979-01-01

Ten patients with radiation enteritis unresponsive to conventional medical and surgical therapy were put on long-term parenteral nutrition at home. Six of the patients are alive at home; four patients died, two from recurrent cancer. Some of the patients have been able to resume oral intake, but none have been able to discontinue parenteral nutrition. Fistulas healed or had a marked decrease in output. Two patients in our series were given prednisone and sulfasalazine without significant benefit, in contrast to previously reported clinical improvement of radiation enteritis with this therapy

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.

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

Enteral Nutrition Support to Treat Malnutrition in Inflammatory Bowel Disease

Science.gov (United States)

Altomare, Roberta; Damiano, Giuseppe; Abruzzo, Alida; Palumbo, Vincenzo Davide; Tomasello, Giovanni; Buscemi, Salvatore; Lo Monte, Attilio Ignazio

2015-01-01

Malnutrition is a common consequence of inflammatory bowel disease (IBD). Diet has an important role in the management of IBD, as it prevents and corrects malnutrition. It is well known that diet may be implicated in the aetiology of IBD and that it plays a central role in the pathogenesis of gastrointestinal-tract disease. Often oral nutrition alone is not sufficient in the management of IBD patients, especially in children or the elderly, and must be combined with oral supplementation or replaced with tube enteral nutrition. In this review, we describe several different approaches to enteral nutrition—total parenteral, oral supplementation and enteral tube feeding—in terms of results, patients compliance, risks and and benefits. We also focus on the home entaral nutrition strategy as the future goal for treating IBD while focusing on patient wellness. PMID:25816159

Nutrition and Hyperglycemia Management in the Inpatient Setting (Meals on Demand, Parenteral, or Enteral Nutrition).

Science.gov (United States)

Drincic, Andjela T; Knezevich, Jon T; Akkireddy, Padmaja

2017-08-01

The goal of this paper is to provide the latest evidence and expert recommendations for management of hospitalized patients with diabetes or hyperglycemia receiving enteral (EN), parenteral (PN) nutrition support or, those with unrestricted oral diet, consuming meals on demand. Patients with and without diabetes mellitus commonly develop hyperglycemia while receiving EN or PN support, placing them at increased risk of adverse outcomes, including in-hospital mortality. Very little new evidence is available in the form of randomized controlled trials (RCT) to guide the glycemic management of these patients. Reduction in the dextrose concentration within parenteral nutrition as well as selection of an enteral formula that diminishes the carbohydrate exposure to a patient receiving enteral nutrition are common strategies utilized in practice. No specific insulin regimen has been shown to be superior in the management of patients receiving EN or PN nutrition support. For those receiving oral nutrition, new challenges have been introduced with the most recent practice allowing patients to eat meals on demand, leading to extreme variability in carbohydrate exposure and risk of hypo and hyperglycemia. Synchronization of nutrition delivery with the astute use of intravenous or subcutaneous insulin therapy to match the physiologic action of insulin in patients receiving nutritional support should be implemented to improve glycemic control in hospitalized patients. Further RCTs are needed to evaluate glycemic and other clinical outcomes of patients receiving nutritional support. For patients eating meals on demand, development of hospital guidelines and policies are needed, ensuring optimization and coordination of meal insulin delivery in order to facilitate patient safety.

Parenteral nutrition versus enteral nutrition in severe acute pancreatitis Nutrição parenteral versus enteral em pacientes com pancreatite aguda grave

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Josiel Paiva Vieira

2010-10-01

Full Text Available PURPOSE: To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization. METHODS: The study was comprised of 31 patients, divided into a parenteral group (n=16 and an enteral group (n=15, who met severity criteria for abdominal tomography (Balthazar classes C, D, and E. The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression. RESULTS: There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10. Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006. There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group. CONCLUSION: Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support.OBJETIVO: Comparar o efeito do suporte nutricional parenteral versus enteral, em pancreatite aguda grave, com relação à eficácia, à segurança, à morbi-mortalidade e ao tempo de internação. MÉTODOS: Foram estudados 31 pacientes distribuídos em grupo parenteral (n=16, no período de 1995 a 1998 e grupo enteral (n=15, no período de 1999 a 2002, que preencheram os critérios de gravidade pela tomografia de abdome (Balthazar C,D,E. Os pacientes foram comparados quanto aos dados demográficos, etiologia, antibioticoprofilaxia, somatostatina, suporte nutricional, complicações e evolução. RESULTADOS

Metodología para la implementación del soporte nutricional enteral personalizado como alternativa de la nutrición enteral domiciliaria Methodology for implementation of personalized enteral nutritional support as an alternative for enteral nutrition at home

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Rafael Jiménez García

2012-09-01

Full Text Available Introducción: la nutrición enteral domiciliaria se realiza en la casa del paciente, y permite que disminuyan los costos hospitalarios como consecuencia de largas estadías para lograr la recuperación o mejorar el estado nutricional y su reingreso al medio familiar. Objetivo: mostrar una metodología para la implementación del soporte nutricional enteral personalizado en el hogar con recursos centralizados, como una alternativa para la nutrición domiciliaria en pediatría. Métodos: a partir del diseño de la metodología para las Unidades de Nutrición Enteral Pediátrica con objetivos de actuación de los Grupos de Apoyo Nutricional Hospitalarios, se diseñó una metodología, que, a través de acciones concretas, logra la integración entre los niveles clínico-facultativos y gerenciales. Resultados: la metodología diseñada está basada en la integración de la atención primaria de salud con la secundaria, en una relación de carácter recíproco (desde y hacia, en la que el control centralizado de los recursos permite, no solo economizarlos, sino, a la vez, su registro para organizar la demanda por la estructura administrativa. El diseño metodológico crea, a su vez, un espacio para las funciones educativas de los padres y el control sistemático del soporte, lo cual, a su vez, le da una connotación preventiva acorde con los objetivos de la medicina comunitaria. Conclusiones: la metodología propuesta por nuestro grupo de trabajo constituye una alternativa en pediatría para el desarrollo de la nutrición enteral domiciliaria, como prestación de los servicios nutricionales, con una mayor integración entre los niveles primario y secundario de salud.Introduction: home enteral nutrition is provided at the patient's house and allows reducing the hospital costs derived from long lengths of stay at hospital to attain the recovery or the improvement of the nutritional status of the patient and his/her return to the family environment

Aspects of enteral nutrition in cancer chemotherapy

NARCIS (Netherlands)

Smit, Jitske Martha

1985-01-01

This thesis deals with several aspects of the influences of intensive cancer chemotherapy on the nutritional status, the metabolism, and the gastrointestinal tract of the host and describes whether these results can be influenced by enteral hyperalimentation, We studied these aspects in patients

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 ...

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

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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

Osmolality and pH in handmade enteral diets used in domiciliary enteral nutritional therapy

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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.

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.

Clinical and nutritional implications of radiation enteritis

Energy Technology Data Exchange (ETDEWEB)

Beer, W.H.; Fan, A.; Halsted, C.H.

1985-01-01

The clinical and nutritional significance of radiation enteritis was assessed in eight patients with chronic diarrhea which followed curative doses of radiotherapy for pelvic malignancies. Steatorrhea, found in seven malnourished patients, was ascribed to ileal disease or previous surgery, or to bacterial contamination of the small intestine. Lactose intolerance, assessed by breath hydrogen excretion after oral lactose and by jejunal lactase levels, was found in six patients. In a subgroup of five patients, the administration of two different defined formula liquid diets by nasoduodenal infusion decreased fecal fluid and energy losses by about one-half. Compared to Vivonex-HN, the infusion of Criticare-HN was associated with greater likelihood of intestinal gas production but a three-fold greater utilization of protein. Intestinal malabsorption and malnutrition in radiation enteritis has diverse etiologies. Whereas nutritional support by liquid diet limits fecal fluid and energy losses, these diets differ significantly in clinical tolerance and biologic value.

Clinical and nutritional implications of radiation enteritis

International Nuclear Information System (INIS)

Beer, W.H.; Fan, A.; Halsted, C.H.

1985-01-01

The clinical and nutritional significance of radiation enteritis was assessed in eight patients with chronic diarrhea which followed curative doses of radiotherapy for pelvic malignancies. Steatorrhea, found in seven malnourished patients, was ascribed to ileal disease or previous surgery, or to bacterial contamination of the small intestine. Lactose intolerance, assessed by breath hydrogen excretion after oral lactose and by jejunal lactase levels, was found in six patients. In a subgroup of five patients, the administration of two different defined formula liquid diets by nasoduodenal infusion decreased fecal fluid and energy losses by about one-half. Compared to Vivonex-HN, the infusion of Criticare-HN was associated with greater likelihood of intestinal gas production but a three-fold greater utilization of protein. Intestinal malabsorption and malnutrition in radiation enteritis has diverse etiologies. Whereas nutritional support by liquid diet limits fecal fluid and energy losses, these diets differ significantly in clinical tolerance and biologic value

Enteral immunonutrition versus enteral nutrition for gastric cancer patients undergoing a total gastrectomy: a systematic review and meta-analysis

OpenAIRE

Cheng, Ying; Zhang, Junfeng; Zhang, Liwei; Wu, Juan; Zhan, Zhen

2018-01-01

Background Nutrition support is a common means for patients with gastric cancer, especially for those undergoing elective surgery. Recently, enteral immunonutrition (EIN) was increasingly found to be more effective than enteral nutrition (EN) in enhancing the host immunity and eventually improving the prognosis of gastric cancer patients undergoing gastrectomy. However, the results reported were not consistent. This meta-analysis aimed to assess the impact of EIN for patients with GC on bioch...

The use of specialised enteral formulae for patients with diabetes ...

African Journals Online (AJOL)

The majority of enteral nutrition products for diabetes mellitus have a carbohydrate content of 30–45% and fat between 40–49%, mainly monounsaturated fat, with a mix of soluble and insoluble fibre (total of 14–24 g/l). Does this have short- and long-term benefits and which component(s) is/are crucial for the outcome or is it ...

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.

Home Enteral Nutrition therapy: Difficulties, satisfactions and support needs of caregivers assisting older patients.

Science.gov (United States)

Jukic P, Nikolina; Gagliardi, Cristina; Fagnani, Donata; Venturini, Claudia; Orlandoni, Paolo

2017-08-01

The purpose of this study was to comprehend and describe the views, experiences and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition. The objective was to gather empirical evidence to improve the delivery of Home Enteral Nutrition for old patients taking into account the caregivers' support needs. A qualitative methodology with focus groups as data collection method was used to collect the testimonies of 30 informal and formal caregivers of older patients treated with Home Enteral Nutrition by the Clinical Nutrition Service of INRCA (Ancona) during 2014. Quantitative methodology was used to collect socio-demographic data. Partially modified Silver's "Home Enteral Nutrition Caregiver Task Checklist" was used to identify training needs. The constant comparison method was used to code and categorize data and to develop themes of focus groups. Simple descriptive statistics were used to summarize questionnaires. Five main themes were identified from focus groups: acceptance of the therapy, skill acquisition process, need for psychological and practical support at home from healthcare professionals, lifestyle adaptation, affirmation of life and family. All caregivers testified the initial fear and refusal to manage the nutrition pump and the therapy. They expressed the need to be trained gradually, starting during a patient's hospitalization, and continuing in the community. With reference to their overall QoL, it emerged that informal caregivers suffered mostly from the reduction of their free time while formal caregivers suffered social isolation and psychological burden. For both groups the monthly home visit was the most important element of the HEN service. Informal caregivers highlighted the importance of having their loved ones at home. Unsatisfied training needs were identified by the modified Silver's "Home Enteral Nutrition Caregiver Task Checklist". This qualitative study underlined the challenges and adaptations of

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, ...

Importance of nutritional status in recovery from acute cholecystitis: benefit from enteral nutrition supplementation including medium chain triglycerides.

Science.gov (United States)

Nomura, Yukinobu; Inui, Kazuo; Yoshino, Junji; Wakabayashi, Takao; Okushima, Kazumu; Kobayashi, Takashi; Miyoshi, Hironao; Nakamura, Yuta

2007-09-01

This study was undertaken to clarify the importance of nutritional status in patients with acute cholecystitis, and also evaluate whether they benefited from enteral nutrition supplementation, including medium-chain triglycerides (MCT), during the convalescent stage. Patients with acute cholecystitis admitted to our hospital between April 1994 and March 2002 were classified into a poor nutrition group (n=40; total serum proteinnutrition group (n=71; >5.0 g/dl). Patients with poor nutrition were significantly more elderly than those with fair nutrition, and had significantly higher serum C-reactive protein (CRP) concentrations. The two groups did not differ significantly with respect to other laboratory data, gender distribution, or medical treatment. We supplemented ordinary meals with enteral nutrition including MCT in 16 patients during the convalescent stage (MCT group). We compared their length of hospital stay and days required to recovery to pre-admission functional status for activities of daily living (ADL) with the same intervals in 16 patients without supplementation (non-MCT group) selected to match for age, gender, and fair or poor nutritional status from among 111 patients. Hospitalizations were significantly longer in the poor nutrition group (43.0+/-2.2 days) than in the fair nutrition group (27.0+/-8.2 days). Significantly more days were required to recover ADL status in the poor nutrition group (12.0+/-7.2 days) than in the fair group (9.4+/-5.2 days). Hospitalizations were significantly shorter in the MCT group (20.1+/-15 days) than in the non-MCT group (35.4+/-12.8 days). Significantly fewer days were required to recover ADL status in the MCT group (10.9+/-7 days) than in the non-MCT group (13.1+/-6.8 days). Administration of enteral nutrition including MCT during convalescence from acute cholecystitis thus appears to promote functional recovery shorten hospital stay.

Effects of starch and fibre in pelleted diets on nutritional status of mule deer (Odocoileus hemionus) fawns.

Science.gov (United States)

McCusker, S; Shipley, L A; Tollefson, T N; Griffin, M; Koutsos, E A

2011-08-01

To compare the effects of a low-starch, high-fibre diet [LSHF; 51.6% neutral detergent fibre (NDF), 3.0% starch, 14.8% crude protein (CP)] and a high-starch, low-fibre diet (HSLF; 33.3% NDF, 20.0% starch, 19.6% CP) on the nutritional status of captive exotic ruminants, 16 mule deer (Odocoileus hemionus) were fed one of these two diets ad libitum with ≤25% alfalfa hay cubes from 10 days to 68 weeks of age. During five sampling periods beginning in November and spaced 6-12 weeks apart thereafter, feed intake, rumen and blood chemistry, faecal scores, growth and body condition were measured. Dry matter intake, digestible energy intake, time spent ruminating and feeding and blood acetate concentration were greater for deer fed LSHF (p 0.05). These findings show pelleted diets with less starch, more fibre, and reduced protein met the energy and protein requirements of growing mule deer, a medium-sized browsing ruminant, as well as traditional grain-based diets while more closely mimicking natural forages and stimulating a more natural feeding behaviour. © 2010 Blackwell Verlag GmbH.

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.

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.

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...

Application of spiral nasointestinal tube in enteral nutrition support for patients with extensive burn

Directory of Open Access Journals (Sweden)

Lai-Ping Wang

2016-09-01

Full Text Available Objective: To observe the effect of spiral nasointestinal tube on enteral nutrition support in patients with extensive burn. Methods: A total of 60 patients with extensive burn who were admitted in our hospital from January, 2014 to June, 2015 were included in the study and divided into the observation group and the control group with 30 cases in each group according to different catheter indwelling methods. The patients in the observation group were given spiral nasointestinal tube for enteral nutrition support, while the patients in the control group were given routine gastric tube for enteral nutrition support. The nutrition status and the occurrence rate of complications before catheter indwelling, 3, 6, and 10 d after catheter indwelling in the two groups were recorded. Results: The levels of ALB, HB, PA, and Scr 6, 10 d after catheter indwelling in the observation group were significantly higher than those in the control group (P<0.05. The occurrence rate of complications during the treatment period in the observation group was significantly lower than that in the control group (P<0.05. Conclusions: The spiral nasointestinal tube can provide the patients with extensive burn a better effective enteral nutrition support and improve the nutrition support, with a lower occurrence rate of complications, which is beneficial for the patients’ rehabilitation.

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

Randomised clinical trial: enteral nutrition does not improve the long-term outcome of alcoholic cirrhotic patients with jaundice.

Science.gov (United States)

Dupont, B; Dao, T; Joubert, C; Dupont-Lucas, C; Gloro, R; Nguyen-Khac, E; Beaujard, E; Mathurin, P; Vastel, E; Musikas, M; Ollivier, I; Piquet, M-A

2012-05-01

Malnutrition and jaundice are independent prognostic factors in cirrhosis. To assess the impact of enteral nutrition on the survival of alcoholic cirrhotic patients with jaundice but without acute alcoholic hepatitis. The study was a multicentre prospective randomised controlled trial comparing effects of enteral nutrition vs. a symptomatic support in patients with alcoholic cirrhosis and jaundice (bilirubin ≥51 µmol/L) but without severe acute alcoholic hepatitis. A total of 99 patients were randomised to receive either the conventional symptomatic treatment (55 patients) or the symptomatic support associated with 35 kcal/Kg/day of enteral nutrition during 4 weeks followed by an oral nutritional support during 2 months (44 patients). Randomisation was stratified on nutritional status. One-year survival curves were compared using the Kaplan-Meier method and Logrank test. Populations in both arms were similar. One-year survival was similar in the overall population (27/44 patients (61.4%) in the enteral nutrition arm vs. 36/55 (65.5%) in the control arm; Logrank P = 0.60) and in the subgroup suffering from malnutrition [18/29 patients (62.1%) in the enteral nutrition arm vs. 20/32 (62.5%) in the control arm; Logrank P = 0.99]. There was no statistical difference for bilirubin, prothrombin rate, Child-Pugh score, albumin or nutritional assessment. Complications during treatment (bleeding, encephalopathy, infection) occurred in 23% of patients in the enteral nutrition group (10/44) vs. 16% (9/55) of the control patients (P = 0.59). Enteral nutrition does not improve the survival and hepatic or nutritional parameters of cirrhotic patients with jaundice. © 2012 Blackwell Publishing Ltd.

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.

EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary Reference Values for carbohydrates and dietary fibre

OpenAIRE

Tetens, Inge

2011-01-01

This Opinion of the EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) deals with the establishment of Dietary Reference Values for carbohydrates and dietary fibre. Nutritionally, two broad categories of carbohydrates can be differentiated: “glycaemic carbohydrates”, i.e. carbohydrates digested and absorbed in the human small intestine, and „dietary fibre‟, non-digestible carbohydrates passing to the large intestine. In this Opinion, dietary fibre is defined as non-digestible car...

Quality indicators for enteral and parenteral nutrition therapy: application in critically ill patients "at nutritional risk".

Science.gov (United States)

Oliveira Filho, Ronaldo Sousa; Ribeiro, Lia Mara Kauchi; Caruso, Lucia; Lima, Patricia Azevedo; Damasceno, Náglia Raquel Teixeira; García Soriano, Francisco

2016-09-20

Quality Indicators for Nutritional Therapy (QINT) allow a practical assessment of nutritional therapy (NT) quality. To apply and monitor QINT for critically ill patients at nutritional risk. Cross sectional study including critically ill patients > 18 years old, at nutritional risk, on exclusive enteral (ENT) or parenteral nutritional therapy (PNT) for > 72 hours. After three consecutive years, 9 QINT were applied and monitored. Statistical analysis was performed with SPSS version 17.0. A total of 145 patients were included, 93 patients were receiving ENT, among then 65% were male and the mean age was 55.7 years (± 17.4); 52 patients were receiving PNT, 67% were male and the mean age was 58.1 years (± 17.4). All patients (ENT and PNT) were nutritionally screened at admission and their energy and protein needs were individually estimated. Only ENT was early initiated, more than 70% of the prescribed ENT volume was infused and there was a reduced withdrawal of enteral feeding tube. The frequency of diarrhea episodes and digestive fasting were not adequate in ENT patients. The proper supply of energy was contemplated only for PNT patients and there was an expressive rate of oral intake recovery in ENT patients. After three years of research, the percentage of QINT adequacy varied between 55%-77% for ENT and 60%-80% for PNT. The results were only made possible by the efforts of a multidisciplinary team and the continuous re-evaluation of the procedures in order to maintain the nutritional assistance for patients at nutritional risk.

Taurine Concentrations Decrease in Critically Ill Patients With Shock Given Enteral Nutrition

NARCIS (Netherlands)

Vermeulen, Mechteld A. R.; van Stijn, Mireille F. M.; Visser, Marlieke; Lemmens, Stéphanie M. P.; Houdijk, Alexander P. J.; van Leeuwen, Paul A. M.; Oudemans-van Straaten, Heleen M.

2016-01-01

Nutrition studies in the intensive care unit (ICU) have shown that adequate enteral nutrition (EN) support has clinical benefits. However, the course of amino acid concentrations in plasma has never been investigated in patients admitted with shock receiving EN. We hypothesized that plasma

Translational Research in Enteral and Parenteral Nutrition Support for Patients with Severe Head Injury

Directory of Open Access Journals (Sweden)

Fa-liang LIN

2015-12-01

Full Text Available Abstract Objective: To explore the key points of the translational research in enteral and pareenteral nutrition support for patients with severe head injury (SHI, and to analyze the influence of different nutritional support routes on the prognosis of SHI patients. Methods: Totally 141 patients with severe craniocerebral injury were selected as study subjects, 47 cases for each group, and were given early enteral nutrition (EEN, delayed enteral nutrition (DEN, and parenteral nutrition (PN, respectively. The effect of different nutritional support routes on SHI patients was observed. Results: After 14 d of treatment, Glasgow coma scale (GCS scores of 3 groups were higher than treatment before (P<0.01, and with statistical differences among groups (P<0.05, or P<0.01. The levels of serum albumin, total serum protein and hemoglobin were higher in EEN group than the other groups (P<0.01. The level of serum albumin was lower in PN group than in DEN group (P<0.05. There were statistical differences in the incidence of complications among three groups (χ2=9.2487, P=0.0098. Conclusion: EEN support is more conductive to the improvement of the nutrition status, reduction of the incidence of complications, and promotion of the prognosis of SHI patients than DEN and PN.

Dietary Fibres: Their Analysis in Animal Feeding, and Their Role in Rabbit Nutrition and Health

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Thierry Gidenne

2013-12-01

Full Text Available Two centuries ago Heinrich Einhof developed the so-called Weende method (crude fibre, to first deals with the fibre content of the feeds for ruminants, and proposes to isolate a residue called the "crude fibre". Then, dietary fibre concepts evolve and differ in animal feeding compared to human nutrition and health. Animal nutritionists deal with various fibre sources, often from whole plants (forages, by products of seeds processing, and recover a larger range of polysaccharidic components, including other polymers, such polyphenolic (lignins, tannins or polylipidic compounds (cutins. Dietary fibres are generally defined as polysaccharides and associated substances resistant to mammal enzyme digestion and absorption that can be partially or totally fermented in the gut. However, today this topic is still subjected to very active research, because of the complexity of the physical structure and chemical composition of the plant cell walls, and in the wide and different physiological effects of these different constituents. The importance of dietary fibre in animal feeding is due to its influence on rate of passage, mucosa functionality and its role as substrate for gut microbes performances and digestive health. This review will describe the definition and different structure of fibres and cell wall constituents and their analytical methods.

Adherence to the Nordic Nutrition Recommendations in a Nordic population with metabolic syndrome: high salt consumption and low dietary fibre intake (The SYSDIET study).

Science.gov (United States)

Jonsdottir, Svandis Erna; Brader, Lea; Gunnarsdottir, Ingibjorg; Kally Magnusdottir, Ola; Schwab, Ursula; Kolehmainen, Marjukka; Risérus, Ulf; Herzig, Karl-Heinz; Cloetens, Lieselotte; Helgegren, Hannah; Johansson-Persson, Anna; Hukkanen, Janne; Poutanen, Kaisa; Uusitupa, Matti; Hermansen, Kjeld; Thorsdottir, Inga

2013-12-16

The Nordic countries collaborate in setting recommendations for intake of nutrients by publishing the Nordic Nutrition Recommendations (NNR). Studies exploring how well the Nordic population adheres to the NNR are limited and none are available for the metabolic syndrome (MetS) subgroup. Individuals with MetS are a large part of the adult Nordic population and their diet's nutritional quality is of great importance as it can affect the progression of MetS. To evaluate nutritional intake in a cohort of Nordic adults with MetS or MetS risk factors and their adherence to the NNR. A multi-centre study was carried out in six centres in four Nordic countries (SYSDIET CoE). Participants (n=175) were 30-65 years of age, with BMI 27-38 kg/m(2) and had at least two criteria for MetS. The NNR was used to evaluate the baseline nutrient intake calculated from the participants' 4-day food diaries using national nutrient databases. Less than 20% of participants consumed ≤10 E% from saturated fat as recommended in the NNR. Recommended intake (RI) of polyunsaturated fat was met by approximately one-third of participants. Only 20% of men and 26% of women met the RI of dietary fibre. Intake below the defined lower intake level of 2.5 µg/day for vitamin D was observed in nearly 20% of participants. The daily median intake of salt was 8.8 g for men and 6.7 g for women. Dietary quality of this Nordic population with Mets or MetS risk factors is unsatisfactory and characterised by high intakes of SFA and sodium and low intakes of PUFA and dietary fibre. Vitamin D intake was below RI level in a large part of the population. Authorities in the Nordic countries are encouraged to develop intervention programmes for high-risk groups.

Effectiveness of Enteral Nutritional Therapy in the Healing Process of Pressure Ulcers: A Systematic Review

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Gisely Blanc

2015-02-01

Full Text Available OBJECTIVE To evaluate the effectiveness of enteral nutritional therapy (ENT in the healing process of pressure ulcers (PU in adults and the elderly. METHOD A systematic review whose studies were identified through the databases of Cochrane, MEDLINE/PubMed, SciELO, LILACS, EMBASE, CINAHL, Web of Science, and manual searches. It included randomized clinical trials (RCTs without delimiting the period or language of publication, which addressed adults and elderly patients with pressure ulcers in a comparative treatment of enteral nutritional therapy and placebo or between enteral nutritional therapy with different compositions and dosages. RESULTS We included ten studies that considered different interventions. It resulted in more pressure ulcers healed in the groups that received the intervention. The included studies were heterogeneous with regard to patients, the type of intervention, the sample and the follow-up period, all of which made meta-analysis impossible. CONCLUSION Although the enteral nutritional therapy demonstrates a promotion of pressure ulcer healing, sufficient evidence to confirm the hypothesis was not found.

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...

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.

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

To investigate direct postoperative outcome and plasma amino acid concentrations in a study comparing early enteral nutrition versus early parenteral nutrition after major rectal surgery. Previously, it was shown that a low plasma glutamine concentration represents poor prognosis in ICU patients. A preplanned substudy of a previous prospective, randomized, open-label, single-centre study, comparing early enteral nutrition versus early parenteral nutrition in patients at high risk of postoperative ileus after surgery for locally advanced or locally recurrent rectal cancer. Early enteral nutrition reduced postoperative ileus, anastomotic leakage, and hospital stay. Tertiary referral centre for locally advanced and recurrent rectal cancer. A total of 123 patients with locally advanced or recurrent rectal carcinoma requiring major rectal surgery. Patients were randomized (ALEA web-based external randomization) preoperatively into two groups: early enteral nutrition (early enteral nutrition, intervention) by nasojejunal tube (n = 61) or early parenteral nutrition (early parenteral nutrition, control) by jugular vein catheter (n = 62). Eight hours after the surgical procedure artificial nutrition was started in hemodynamically stable patients, stimulating oral intake in both groups. Blood samples were collected to measure plasma glutamine, citrulline, and arginine concentrations using a validated ultra performance liquid chromatography-tandem mass spectrometric method. Baseline concentrations were comparable for both groups. Directly after rectal surgery, a decrease in plasma amino acids was observed. Plasma glutamine concentrations were higher in the parenteral group than in the enteral group on postoperative day 1 (p = 0.027) and day 5 (p = 0.008). Arginine concentrations were also significantly increased in the parenteral group at day 1 (p < 0.001) and day 5 (p = 0.001). Lower plasma glutamine and arginine concentrations were measured in the enteral group, whereas a

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...

[Effects of early enteral nutrition in the treatment of patients with severe burns].

Science.gov (United States)

Wu, Y W; Liu, J; Jin, J; Liu, L J; Wu, Y F

2018-01-20

Objective: To investigate the effects of early enteral nutrition (EEN) in the treatment of patients with severe burns. Methods: Medical records of 52 patients with severe burns hospitalized in the three affiliations of authors from August to September in 2014 were retrospectively analyzed and divided into EEN group ( n =28) and non-early enteral nutrition (NEEN) group ( n =24) according to the initiation time of enteral nutrition. On the basis of routine treatment, enteral nutrition was given to patients in group EEN within post injury day (POD) 3, while enteral nutrition was given to patients in group NEEN after POD 3. The following items were compared between patients of the two groups, such as the ratio of enteral nutrition intake to total energy intake, the ratio of parenteral nutrition intake to total energy intake, the ratio of total energy intake to energy target on POD 1, 2, 3, 4, 5, 6, 7, 14, 21, and 28, the levels of prealbumin, serum creatinine, blood urea nitrogen, total bilirubin, direct bilirubin, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score on POD 1, 3, 7, 14, and 28, the first operation time, the number of operations, and the frequencies of abdominal distension, diarrhea, vomiting, aspiration, catheter blockage, and low blood sugar within POD 28. Data were processed with χ (2)test, t test, Wilcoxon rank sum test, and Bonferroni correction. Results: (1) The ratio of parenteral nutrition intake to total energy intake of patients in group EEN on POD 1 was obviously lower than that in group NEEN ( Z =2.078, P 0.05). On POD 28, the prealbumin level of patients in group EEN was obviously higher than that in group NEEN ( t =3.163, P 0.05). (3) The APACHE Ⅱ scores of patients in group EEN were (22.5±3.1) and (15.6±3.8) points respectively on POD 1 and 3, which were close to (23.6±3.0) and (17.6±4.2) points of patients in group NEEN ( t =1.352, 1.733, P >0.05). The APACHE Ⅱ scores of patients in group EEN on POD 7, 14

[Enteral nutrition: reduction in the contamination risk].

Science.gov (United States)

Montemerlo, H; Menéndez, A M; Marcenac, F; Floridia, J; Esteban, L; Barbaricca, M

1996-01-01

Enteral nutrition is used as a routine therapy in patients with caloric-protein malnutrition, severe dysphagia, major burns, intestinal resection, and enterocutaneous fistulae, as long as a portion of the digestive tract still has an active absorptive function. The administration takes place by means of surgical (ostomies) or non-surgical (nasogastric) tubes. In our country, a significant number of hospitalized patients with various diseases receive this type of nutrition. Given that the colonization of the digestive tract by hospital flora is the first step towards developing intra-hospital infections, the contamination implies serious risks. The objective of this study was to study the most appropriate conditions for the manufacturing, storage and administration of the mixture of nutrients of enteral nutrition, to guarantee nutrition with a lower contamination risk. This study was conducted by the Unit of Nutritional Assistance of the Mater Dei Clinic, by means of bacteriological controls, from January 1991 to December 1992, and in 1993 in which the work systematics were reviewed. The study was prospective, and those solutions whose bacteriological counts were lower than 100.000 colony forming units (CFU), and which showed an absence of enteropathological micro-organisms, were considered acceptable, and those solutions which had a bacteriological count greater than or equal to 100.000 CFU and or the presence of enteropathological micro-organisms, were considered unacceptable. During the first period, "usual working conditions", we analyzed the infra-structure, the personnel, the constituents, and the apparatus used in the manufacturing, for which 36 samples were studied at t0 (moment of preparation). Afterwards, in the second period "special working conditions", we analyzed the manufacturing procedures, the storage and the administration of 103 solutions, corresponding to 36 patients, taking samples at t0 and t24 (after 24 hours of preparing). In the first phase

Early enteral nutrition compared to outcome in critically ill trauma ...

African Journals Online (AJOL)

2014-11-01

Nov 1, 2014 ... 16.4 days, p-value 0.00315) and mortality (9.5 % vs. 20.7 % ..... had a more complicated clinical picture, despite no significant differences in terms ... In other words, an early enteral nutrition start was associated with an almost.

Glutamine-enriched enteral nutrition in very low-birth-weight infants

NARCIS (Netherlands)

van den Berg, Anemone; van Zwol, Annelies; Moll, Henriëtte A.; Fetter, Willem P. F.; van Elburg, Ruurd M.

2007-01-01

Objective: To determine the effect of glutamine-enriched enteral nutrition in very low- birth- weight infants on the incidence of allergic and infectious diseases during the first year of life. Design: Follow- up study. Setting: Tertiary care hospital. Participants: All surviving infants who

Tolerance and efficacy of nasogastric enteral nutrition for severe acute pancreatitis: a metaanalysis

Directory of Open Access Journals (Sweden)

Shu-fen FENG

2013-02-01

Full Text Available Objective 　To evaluate the tolerance and efficacy of nasogastric enteral nutrition (NGEN in the treatment of severe acute pancreatitis (SAP. Methods 　PUBMED, Web of Science and The Cochrane Central Register of Controlled Trials from 1966 to 2011 (up to October and Chinese Journals Full-text Database (CNKI, Database for Chinese Technical Periodicals (VIP and Wanfang Digital Journal Full-text Database from 1978 to 2011 (up to October were retrieved to collect clinical randomized controlled trials of NGEN to compare with nasojejunal enteral nutrition (NJEN in the treatment of SAP. Two reviewers independently screened the literature for eligibility and evaluated the quality with confirmation of cross-check. Different opinions would be decided by the third party. Statistical analysis was performed by meta-analysis using Review Manager 4.2. Results 　Three randomized controlled trails including 159 patients with SAP met the inclusion criteria, involving 82 patients in NGEN group and 77 in NJEN group. There was no significant difference between NGEN and NJEN group in the risk of mortality of SAP (RR=0.69, 95%CI: 0.37-1.29, P=0.25, conversion to surgery (RR=2.09, 95% CI: 0.55-7.92, P=0.28, diarrhea subsequent to enteral nutrition (RR=1.43, 95% CI: 0.59-3.45, P=0.43, rate of tube displacement (RR=0.42, 95%CI: 0.08-2.17, P=0.30 and pain related with enteral nutrition (RR=0.94, 95%CI: 0.32-2.70, P=0.90. While compared with NJEN, the risk of infectious complications was lower than NGEN (RR=0.64, 95%CI: 0.42-0.99, P=0.04. Conclusion 　In enteral nutrition support of SAP, NGEN is comparable to NJEN in efficacy and tolerance, but the former has the lower rate of infectious complications and easier to operate, and there is a tendency of NEGN to replace the latter.

A Survey of Home Enteral Nutrition Practices and Reimbursement in the Asia Pacific Region

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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.

EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary Reference Values for carbohydrates and dietary fibre

DEFF Research Database (Denmark)

Tetens, Inge

This Opinion of the EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) deals with the establishment of Dietary Reference Values for carbohydrates and dietary fibre. Nutritionally, two broad categories of carbohydrates can be differentiated: “glycaemic carbohydrates”, i.e. carbohydrates...

Influence of postoperative enteral nutrition on cellular immunity. A random double-blinded placebo controlled clinical trial

DEFF Research Database (Denmark)

Beier-Holgersen, R; Brandstrup, B

2012-01-01

The aim of this study was to discover if the cellular immunological response is different in patients receiving early postoperative enteral nutrition compared to patients who only receive "water".......The aim of this study was to discover if the cellular immunological response is different in patients receiving early postoperative enteral nutrition compared to patients who only receive "water"....

Superior Mesenteric Artery Syndrome Improved by Enteral Nutritional Therapy according to the Controlling Nutritional Status Score.

Science.gov (United States)

Takehara, Kazuhiro; Sakamoto, Kazuhiro; Takahashi, Rina; Kawai, Masaya; Kawano, Shingo; Munakata, Shinya; Sugimoto, Kiichi; Takahashi, Makoto; Kojima, Yutaka; Fukunaga, Tetsu; Kajiyama, Yoshiaki; Kawasaki, Seiji

2017-01-01

Superior mesenteric artery syndrome (SMAS) is a relatively rare disease that involves bowel obstruction symptoms, such as vomiting and gastric distension, owing to the compression of the third portion of the duodenum from the front by the superior mesenteric artery (SMA) and from the rear by the abdominal aorta and the spine. SMAS is diagnosed on the basis of an upper gastrointestinal examination series indicating the obstruction of the third portion of the duodenum or a computed tomography scan indicating the narrowing of the branch angle between the aorta and the SMA (i.e., the aorta-SMA angle). Here, we report the case of a 78-year-old woman diagnosed with SMAS after a laparoscopic right hemicolectomy for cecal cancer, whose condition was improved by enteral nutritional therapy. We used her controlling nutritional status (CONUT) score as a nutrition assessment and noted the changes in the aorta-SMA angle over the course of the disease. This patient appeared to develop SMAS, on the basis of a worsened CONUT score and a decreased aorta-SMA angle, owing to the inflammation resulting from the intraoperative dissection of the tissues around the SMA and prolonged postoperative fasting. After the initiation of enteral nutritional therapy, the patient exhibited body weight gain and an improved aorta-SMA angle and CONUT score. Hence, assessment of the aorta-SMA angle and CONUT score is an important preoperative consideration.

Clinical use of enteral immune nutrition in patients with acute exacerbation of chronic obstructive pulmonary disease

Directory of Open Access Journals (Sweden)

Zhi-cheng ZHANG

2015-06-01

Full Text Available Objective　To investigate the use of enteral immune nutrition preparation in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD, regard its efficacy in improving nutritional status, and its influence on immunity and the status of acute inflammatory reaction of the patients. Methods　Sixty-two AECOPD patients requiring mechanical ventilation in ICU of our hospital were randomly divided into two groups: immune nutrition group [study group, n=32, receiving Ruineng (a product of Huarui Pharmaceutical Ltd., which contained essential fatty acids, Omega-3 fatty acids, and energy 1.3 kcal/ml] and conventional nutrition group (control group, n=30, receiving the hospital self-made homogenized diet with 1.2 kal/ml. Patients in the two groups took enteral nutrition of equal calorie, and it was given by nasointestinal tube. On the day of admission and the 14th and 18th after admission, venous blood was obtained for the determination of serum albumin, prealbumin, transferrin, C reactive protein (CRP, tumor necrosis factor-α (TNF-α, and interleukin-6 (IL-6. At the same time upper arm muscle circumference (MAMC was measured at the bed side. The 14-day off-respirator rate and mechanical ventilation time within 28 days were compared between the two groups. Results　The 14-day off-respirator rate was higher in study group than in control group (P0.05. Conclusions　Compared with homogenized diet, immune enteral nutrition could better improve the nutritional status and immune function, lower the acute inflammatory response level, increase the success rate of early off-respirator in AECOPD patients, therefore, enteral immune nutrition preparation is a better nutrition support solution for AECOPD. DOI: 10.11855/j.issn.0577-7402.2015.05.17

Nutrition support team management of enterally fed patients in a community hospital is cost-beneficial.

Science.gov (United States)

Hassell, J T; Games, A D; Shaffer, B; Harkins, L E

1994-09-01

To determine whether nutrition support team (NST) management of enterally fed patients is cost-beneficial and to compare primary outcomes of care between team and nonteam management. A quasi-experimental study was conducted over a 7-month period. A 400-bed community hospital. A convenience sample of 136 subjects who had received enteral nutrition support for at least 24 hours. Forty-two patients died; only their mortality data were used. Ninety-six patients completed the study. Outcomes, including cost, for enterally fed patients in two treatment groups--those managed by the nutrition support team and those managed by nonteam staff--were compared. Severity of illness level was determined for patients managed by the nutrition support team and those managed by nonteam staff. For each group, the following measures were adjusted to reflect a significant difference in average severity of illness and then compared: length of hospital stay, readmission rates, and mortality rates. Complication rates between the groups were also compared. The cost benefit was determined based on savings from the reduction in adjusted length of hospital stay. Parametric and nonparametric statistics were used to evaluate outcomes between the two groups. Differences were statistically significant for both severity of illness, which was at a higher level in the nutrition support team group (P group (P team-managed group, there was a 23% reduction in adjusted mortality rate, an 11.6% reduction in the adjusted length of hospital stay, and a 43% reduction in adjusted readmission rate. Cost-benefit analysis revealed that for every $1 invested in nutrition support team management, a benefit of $4.20 was realized. Financial and humanitarian benefits are associated with nutrition support team management of enterally fed hospitalized patients.

Adherence to the Nordic Nutrition Recommendations in a Nordic population with metabolic syndrome: high salt consumption and low dietary fibre intake (The SYSDIET study

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Svandis Erna Jonsdottir

2013-12-01

Full Text Available Background: The Nordic countries collaborate in setting recommendations for intake of nutrients by publishing the Nordic Nutrition Recommendations (NNR. Studies exploring how well the Nordic population adheres to the NNR are limited and none are available for the metabolic syndrome (MetS subgroup. Individuals with MetS are a large part of the adult Nordic population and their diet's nutritional quality is of great importance as it can affect the progression of MetS. Objective: To evaluate nutritional intake in a cohort of Nordic adults with MetS or MetS risk factors and their adherence to the NNR. Design: A multi-centre study was carried out in six centres in four Nordic countries (SYSDIET CoE. Participants (n=175 were 30–65 years of age, with BMI 27–38 kg/m2 and had at least two criteria for MetS. The NNR was used to evaluate the baseline nutrient intake calculated from the participants’ 4-day food diaries using national nutrient databases. Results: Less than 20% of participants consumed ≤10 E% from saturated fat as recommended in the NNR. Recommended intake (RI of polyunsaturated fat was met by approximately one-third of participants. Only 20% of men and 26% of women met the RI of dietary fibre. Intake below the defined lower intake level of 2.5 µg/day for vitamin D was observed in nearly 20% of participants. The daily median intake of salt was 8.8 g for men and 6.7 g for women. Conclusion: Dietary quality of this Nordic population with Mets or MetS risk factors is unsatisfactory and characterised by high intakes of SFA and sodium and low intakes of PUFA and dietary fibre. Vitamin D intake was below RI level in a large part of the population. Authorities in the Nordic countries are encouraged to develop intervention programmes for high-risk groups.

Impact of early postoperative enteral nutrition on clinical outcomes in patients with gastric cancer.

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Li, B; Liu, H Y; Guo, S H; Sun, P; Gong, F M; Jia, B Q

2015-06-29

The impact of early enteral nutrition (EEN) on clinical outcomes of gastric cancer patients was investigated. Three hundred pa-tients undergoing gastric cancer surgery from July 2010 to May 2014 were randomly divided into experimental and control groups (n = 150/group). Experimental group patients received enteral nutrition in water during the early postoperative period. Control group patients received conventional perioperative treatment. Patients' clinical outcomes, post-operative immune function, and nutritional statuses were compared, which revealed that the postoperative fever duration (80.2 ± 6.0 vs 88.1 ± 8.1 h, P 0.05]. At postoperative days 3 and 7, the CD3(+), CD4(+), natural killer cell, albumin, and prealbumin levels and CD4(+)/CD8(+) ra-tio were significantly higher in the experimental group than the control group (all P nutritional status and immune function and promote early recovery of intestinal function in patients with gastric cancer.

[Curative effect analysis of bile reinfusion combined with enteral nutrition support before surgery of hilar cholangiocarcinoma].

Science.gov (United States)

Song, P; Mao, L; Bian, X J; Zhou, T; Fan, Y Y; Zhang, J; Xie, M; Qiu, Y D

2018-05-01

Objective: To investigate the clinical effect of bile reinfusion combined with enteral nutrition support before surgery for hilar cholangiocarcinoma. Methods: A retrospective analysis of patients with hilar cholangiocarcinoma who underwent surgical treatment at Nanjing Drum Tower Hospital Hepato-biliary-pancreatic Surgery Department from July 2010 to August 2017 was completed.A total of 52 cases were finally enrolled in our study.All the patients included, on the basis of whether they received preoperative drainage and bile reinfusion, were divided into non-drainage group( n =15) and drainage group( n =37). Differences of clinical indicators, including operation time, intraoperative bleeding and serum liver function index levels at day 1, 3, 7 postoperative, postoperative complications(liver failure, biliary fistula, pleural effusion, peritoneal effusion, abdominal cavity infection, death in hospital), tumor classification, R0 resection, postoperative hospitalization time between the 2 groups were analyzed. At the same time, in the drainage group, patients were divided into non-enteral nutrition subgroup( n =13) and enteral nutrition subgroup( n =24) according to whether they received enteral nutrition before operation. The normal distribution data of the group was statistically analyzed by independent sample t test, the non-normal distribution data of the group was statistically analyzed by rank-sum test. The count data was statistically analyzed by non-calibration and correction of the square test. Results: There was no statistically significant difference in general infomation such as age, gender, and serum liver function between non-drainage group and drainage group( P >0.05). There was no statistically significant difference in general information such as age, gender, and serum liver function between non-enteral nutrition group and enteral nutrition group( P >0.05). The rate of vascular resection and reconstruction(33.3%) and operating time(10.8(2.2)h) in

Superior Mesenteric Artery Syndrome Improved by Enteral Nutritional Therapy according to the Controlling Nutritional Status Score

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Kazuhiro Takehara

2017-11-01

Full Text Available Superior mesenteric artery syndrome (SMAS is a relatively rare disease that involves bowel obstruction symptoms, such as vomiting and gastric distension, owing to the compression of the third portion of the duodenum from the front by the superior mesenteric artery (SMA and from the rear by the abdominal aorta and the spine. SMAS is diagnosed on the basis of an upper gastrointestinal examination series indicating the obstruction of the third portion of the duodenum or a computed tomography scan indicating the narrowing of the branch angle between the aorta and the SMA (i.e., the aorta-SMA angle. Here, we report the case of a 78-year-old woman diagnosed with SMAS after a laparoscopic right hemicolectomy for cecal cancer, whose condition was improved by enteral nutritional therapy. We used her controlling nutritional status (CONUT score as a nutrition assessment and noted the changes in the aorta-SMA angle over the course of the disease. This patient appeared to develop SMAS, on the basis of a worsened CONUT score and a decreased aorta-SMA angle, owing to the inflammation resulting from the intraoperative dissection of the tissues around the SMA and prolonged postoperative fasting. After the initiation of enteral nutritional therapy, the patient exhibited body weight gain and an improved aorta-SMA angle and CONUT score. Hence, assessment of the aorta-SMA angle and CONUT score is an important preoperative consideration.

The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

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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

The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

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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

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...

The enteral probe nutrition with Cosilat in complex therapy of patients with radiotherapeutic late effects of the colon

International Nuclear Information System (INIS)

Sloventantor, V.Yu.; Chmelevskij, Ya.M.; Bradycev, M.S.; Kurpeseva, A.K.; Artamonov, Yu.I.; Kaplan, M.A.; Sokol, N.I.; Vakulovskaja, E.G.

1990-01-01

Results are presented applying an enteral nutrition by means of probes with Cosilat in complex therapy of patients with radiotherapeutic late effects of the colon. This nutrition was prescribed with the intention to gave the colon a functional recovery and to guarantee optimal conditions for repair of radiation injuries. Good results were seen in 27 of 28 patients (96.7%), the situation of one patient (3.3%) continued without any change. Cosilat has a high nutritive value, good organoleptic qualities and is well digested without any complications. (author)

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

Impact of enteral nutrition on postoperative immune function and nutritional status.

Science.gov (United States)

Wang, F; Hou, M X; Wu, X L; Bao, L D; Dong, P D

2015-06-10

We studied the effects of enteral nutrition (EN) support initiated 1 week before surgery on postoperative nutritional status, immune function, and inflammatory response in gastric cancer patients. A total of 200 gastric cancer patients were randomly divided into two groups: EN starting 1 week before surgery (study group) and EN starting early after surgery (control group). The two groups received EN support, following different therapeutic schedules, until the 9th day after operation. In the patients, body weight, skinfold thickness, upper-arm circumference, white blood cell count, albumin, prealbumin, C-reactive protein, peripheral immunoglobulins (IgA, IgG, and IgM), T lymphocyte subsets, interleukin-6, and tumor necrosis factor-α were measured 10 days before and after surgery and on the first day after surgery. There was no statistically significant difference in the results of recovery time of passage of gas by anus, abdominal distension, stomachache, blood glucose, hepatic and renal functions, and electrolytes between the two groups of patients (P > 0. 05). Adverse reactions occurred to both groups at 1 and 2 days after operation. Such conditions was improved after the intravenous drip rate was adjusted. The albumin and prealbumin levels of the patients in both groups decreased at 1 day after operation (P gastric cancer patients can improve their postoperative nutritional status and immune function, can reduce inflammatory response, and is more conducive to the recovery of patients.

Development and Evaluation of a Home Enteral Nutrition Team

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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.

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).

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

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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.

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

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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.

[When enteral nutrition is not possible in intensive care patients: whether to wait or use parenteral nutrition?

NARCIS (Netherlands)

Habes, Q.L.M.; Pickkers, P.

2016-01-01

- Overfeeding of critically ill patients is associated with a higher incidence of infections and an increased length of ventilation. However, trophic nutrition or permissive underfeeding appears to have no negative effect on the patient and may even provide a survival benefit.- Initiation of enteral

Successful Treatment of Septic Shock due to Spontaneous Esophageal Perforation 96 Hours after Onset by Drainage and Enteral Nutrition

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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.

Serum concentrations of trace elements in patients with Crohn's disease receiving enteral nutrition.

Science.gov (United States)

Johtatsu, Tomoko; Andoh, Akira; Kurihara, Mika; Iwakawa, Hiromi; Tsujikawa, Tomoyuki; Kashiwagi, Atsunori; Fujiyama, Yoshihide; Sasaki, Masaya

2007-11-01

We investigated the trace element status in Crohn's disease (CD) patients receiving enteral nutrition, and evaluated the effects of trace element-rich supplementation. Thirty-one patients with CD were enrolled in this study. All patients were placed on an enteral nutrition regimen with Elental(R) (Ajinomoto pharmaceutical. Ltd., Tokyo, Japan). Serum selenium, zinc and copper concentrations were determined by atomic absorption spectroscopy. Serum selenoprotein P levels were determined by an ELISA system. Average serum levels of albumin, selenium, zinc and copper were 4.1 +/- 0.4 g/dl, 11.2 +/- 2.8 microg/dl, 71.0 +/- 14.8 microg/dl, and 112.0 +/- 25.6 microg/dl, respectively. In 9 patients of 31 CD patients, serum albumin levels were lower than the lower limit of the normal range. Serum selenium, zinc and copper levels were lower than lower limits in 12 patients, 9 patients and 1 patient, respectively. Serum selenium levels significantly correlated with both serum selenoprotein P levels and glutathione peroxidase activity. Supplementation of selenium (100 microg/day) and zinc (10 mg/day) for 2 months significantly improved the trace element status in CD patients. In conclusion, serum selenium and zinc levels are lower in many CD patients on long-term enteral nutrition. In these patients, supplementation of selenium and zinc was effective in improving the trace element status.

Low-FODMAP formula improves diarrhea and nutritional status in hospitalized patients receiving enteral nutrition: a randomized, multicenter, double-blind clinical trial.

Science.gov (United States)

Yoon, So Ra; Lee, Jong Hwa; Lee, Jae Hyang; Na, Ga Yoon; Lee, Kyun-Hee; Lee, Yoon-Bok; Jung, Gu-Hun; Kim, Oh Yoen

2015-11-03

Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are poorly absorbed, short-chain carbohydrates that play an important role in inducing functional gut symptoms. A low-FODMAP diet improves abdominal symptoms in patients with inflammatory bowel disease and irritable bowel syndrome. However, there were no study for the effect of FODMAP content on gastrointestinal intolerance and nutritional status in patients receiving enteral nutrition (EN). In this randomized, multicenter, double-blind, 14-day clinical trial, eligible hospitalized patients receiving EN (n = 100) were randomly assigned to three groups; 84 patients completed the trial (low-FODMAP EN, n = 30; moderate-FODMAP EN, n = 28; high-FODMAP EN, n = 26). Anthropometric and biochemical parameters were measured; stool assessment was performed using the King's Stool Chart and clinical definition. Baseline values were not significantly different among the three groups. After the 14-day intervention, diarrhea significantly improved in the low-FODMAP group than in the moderate- and high-FODMAP groups (P nutritional status and facilitating prompt recovery from illness.

A disease-specific enteral nutrition formula improves nutritional status and functional performance in patients with head and neck and esophageal cancer undergoing chemoradiotherapy: results of a randomized, controlled, multicenter trial.

Science.gov (United States)

Fietkau, Rainer; Lewitzki, Victor; Kuhnt, Thomas; Hölscher, Tobias; Hess, Clemens-F; Berger, Bernhard; Wiegel, Thomas; Rödel, Claus; Niewald, Marcus; Hermann, Robert M; Lubgan, Dorota

2013-09-15

In patients with head and neck and esophageal tumors, nutritional status may deteriorate during concurrent chemoradiotherapy (CRT). The aim of this study was to investigate the influence of enteral nutrition enriched with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on body composition and nutritional and functional status. In a controlled, randomized, prospective, double-blind, multicenter study, 111 patients with head and neck and esophageal cancer undergoing concurrent CRT received either an enteral standard nutrition (control group) or disease-specific enteral nutrition Supportan®-containing EPA+DHA (experimental group) via percutaneous endoscopic gastrostomy. The primary endpoint was the change of body cell mass (BCM) following CRT at weeks 7 and 14 compared with the baseline value. Secondary endpoints were additional parameters of body composition, anthropometric parameters, and nutritional and functional status. The primary endpoint of the study, improvement in BCM, reached borderline statistical significance. Following CRT, patients with experimental nutrition lost only 0.82 ± 0.64 kg of BCM compared with 2.82 ± 0.77 kg in the control group (P = .055). The objectively measured nutritional parameters, such as body weight and fat-free mass, showed a tendency toward improvement, but the differences were not significant. The subjective parameters, in particular the Kondrup score (P = .0165) and the subjective global assessment score (P = .0065) after follow-up improved significantly in the experimental group, compared with the control group. Both enteral regimens were safe and well tolerated. Enteral nutrition with EPA and DHA may be advantageous in patients with head and neck or esophageal cancer by improving parameters of nutritional and functional status during CRT. © 2013 American Cancer Society.

Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition).

Science.gov (United States)

Becker, Patricia; Carney, Liesje Nieman; Corkins, Mark R; Monczka, Jessica; Smith, Elizabeth; Smith, Susan E; Spear, Bonnie A; White, Jane V

2015-02-01

The Academy of Nutrition and Dietetics (the Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), utilizing an evidence-informed, consensus-derived process, recommend that a standardized set of diagnostic indicators be used to identify and document pediatric malnutrition (undernutrition) in routine clinical practice. The recommended indicators include z scores for weight-for-height/length, body mass index-for-age, or length/height-for-age or mid-upper arm circumference when a single data point is available. When 2 or more data points are available, indicators may also include weight gain velocity (nutritional risk is not the purpose of this paper. Clinicians should use as many data points as available to identify and document the presence of malnutrition. The universal use of a single set of diagnostic parameters will expedite the recognition of pediatric undernutrition, lead to the development of more accurate estimates of its prevalence and incidence, direct interventions, and promote improved outcomes. A standardized diagnostic approach will also inform the prediction of the human and financial responsibilities and costs associated with the prevention and treatment of undernutrition in this vulnerable population and help to further ensure the provision of high-quality, cost-effective nutritional care. © 2014 American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics.

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.

Engineering Performance of High Strength Concrete Containing Steel Fibre Reinforcement

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Md Azree Othuman Mydin

2013-09-01

Full Text Available The development and utilization of the high strength concrete in the construction industry have been increasing rapidly. Fiber reinforced concrete is introduced to overcome the weakness of the conventional concrete because concrete normally can crack under a low tensile force and it is known to be brittle. Steel fibre is proved to be the popular and best combination in the high strength concrete to result the best in the mechanical and durability properties of high strength concrete with consideration of curing time, steel fibre geometry, concrete grade and else more. The incorporation of steel fibre in the mortar mixture is known as steel fibre reinforced concrete have the potential to produce improvement in the workability, strength, ductility and the deformation of high strength concrete. Besides that, steel fibre also increases the tensile strength of concrete and improves the mechanical properties of the steel fibre reinforced concrete. The range for any high strength concrete is between 60MPa-100MPa. Steel fibre reinforced concrete which contains straight fibres has poorer physical properties than that containing hooked end stainless steel fibre due to the length and the hooked steel fibre provide a better effective aspects ratio. Normally, steel fibre tensile strength is in the range of 1100MPa-1700MPa. Addition of less steel fibre volumes in the range of 0.5% to 1.0% can produce better increase in the flexural fatigue strength. The strength can be increased with addition of steel fibre up to certain percentage. This paper will review and present some basic properties of steel fibre reinforced concrete such as mechanical, workability and durability properties.

Enteral versus parenteral nutrition in cancer patients: evidences and controversies.

Science.gov (United States)

Cotogni, Paolo

2016-01-01

The debate over the use of enteral nutrition (EN) and parenteral nutrition (PN) is an old but evergreen and hot topic. Since many years, studies comparing EN and PN have been a pivotal 'leitmotif' in the published literature on artificial nutrition (AN). Actually, there is a background misunderstanding in this debate; specifically, that EN and PN are competitors in the choice of the route for delivering nutrition support in cancer patients. Conversely, EN and PN have specific indications and contraindications. This review has the purpose to discuss the indications and complications as well as pros and cons of EN and PN in cancer patients, the crucial role of nutrition support in oncology patients during anticancer treatments and throughout the course of disease, and, finally, the role of AN in advanced cancer patients. In summary, we have no evidence-based data able to definitively indicate the optimal method for delivering AN in cancer patients. EN and PN have to be considered equally effective in maintaining or improving nutritional status in cancer patients. Besides, this review strongly supports the recommendation that a baseline nutritional assessment should be carried out by a healthcare professional expert in AN for all cancer patients at the time of diagnosis or anticancer treatment plan, taking the nutritional status, estimated duration of AN, AN-related potential benefits and possible complications into consideration on an individual basis. Moreover, the patient symptoms, performance status, estimated life expectancy, and mainly, will or preferences have to be evaluated and incorporated into the nutrition support plan before the definitive choice of the route for delivering nutrients is decided. Finally, applying a decision-making process tailored to patient needs-regardless of whether receiving or not anticancer treatment-allows to choose reasonably the optimal nutritional support strategy.

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.

High-temperature polyimide coating for optical fibres

Energy Technology Data Exchange (ETDEWEB)

Semjonov, S L; Dianov, E M [Fiber Optics Research Center, Russian Academy of Sciences, Moscow (Russian Federation); Sapozhnikov, D A; Erin, D Yu; Zabegaeva, O N; Kushtavkina, I A; Vygodskii, Ya S [A.N. Nesmeyanov Institute of Organoelement Compounds, Russian Academy of Sciences, Moscow (Russian Federation); Nishchev, K N [N.P. Ogarev Mordovia State University, Saransk (Russian Federation)

2015-04-30

We present our first results on the fabrication of new, high-performance polyimide coatings. The key components of the coatings are polyimides containing various cardo and/or fluoroalkylene groups, which allows the coatings to retain their high-temperature stability and facilitates the storage of the starting polymer and the optical fibre coating process owing to the good solubility of such copolymers in many organic solvents. Annealing for 30 s, 1 h and 24 h at temperatures of 430, 350 and 300 °C, respectively, reduces the strength of optical fibres having such coating by no more than 10%. (optical fibres)

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

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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)

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

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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.

[Effects of Early Enteral Immunonutrition on Postoperative Immune Function and Rehabilitation of Patients with Gastric Cancer and Nutritional Risk].

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Peng, Chang-Bing; Li, Wen-Zhong; Xu, Rui; Zhuang, Wen

2017-05-01

To investigate the effects of early enteral immunonutrition on postoperative immune function and rehabilitation of gastric cancer patients with nutritional risk. New hospitalized patients with gastric cancer were evaluated the nutrient status based on NRS 2002. The patients who scored between 3 to 5 points were randomized into two groups(30 cases for each group), and those in experimental group were given 7-d early postoperative enteral immune nutrition, those in control group were given normal nutrition. The immune indexes (CD3 + , CD4 + , CD8 + and CD4 + /CD8 + ) and nutritional indexes(transferrin, pre-albumin, albumin) were measured before operation and at the 3 rd and 7 th day postoperatively. In addition, the first flatus time, gastrointestinal adverse reactions and complications, length of hospital stays were compared between the two groups. The level of CD4 + /CD8 + and transferrin, pre-albumin, albumin in experimental group were significantly higher than those in control group at the third and seventh day postoperatively ( P 0.05). Early enteral immunonutrition can effectively promote the recovery of nutritional status and immune function in gastric cancer patients with nutrition risk.

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.

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...

Fibre characteristics and follicle activity in Angora kids as affected by diet

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O. Olivieri

2011-03-01

Full Text Available Factors that influence fibre growth in speciality fibre producing animals are not completely understood; however, this knowledge is important to develop practical and profitable production systems. The effects of nutrition on fibre growth and production in Angora goats have not been researched to the same degree as in sheep. Nutrition improvements generally result in increases in fleece weight and fibre diameter (Shahjalal et al., 1992; Galbraith, 1995...

Effect of early enteral combined with parenteral nutrition in patients undergoing pancreaticoduodenectomy.

Science.gov (United States)

Zhu, Xin-Hua; Wu, Ya-Fu; Qiu, Yu-Dong; Jiang, Chun-Ping; Ding, Yi-Tao

2013-09-21

To investigate the effect of early enteral nutrition (EEN) combined with parenteral nutritional support in patients undergoing pancreaticoduodenectomy (PD). From January 2006, all patients were given EEN combined with parenteral nutrition (PN) (EEN/PN group, n = 107), while patients prior to this date were given total parenteral nutrition (TPN) (TPN group, n = 67). Venous blood samples were obtained for a nutrition-associated assessment and liver function tests on the day before surgery and 6 d after surgery. The assessment of clinical outcome was based on postoperative complications. Follow-up for infectious and noninfectious complications was carried out for 30 d after hospital discharge. Readmission within 30 d after discharge was also recorded. Compared with the TPN group, a significant decrease in prealbumin (PAB) (P = 0.023) was seen in the EEN/PN group. Total bilirubin (TB), direct bilirubin (DB) and lactate dehydrogenase (LDH) were significantly decreased on day 6 in the EEN/PN group (P = 0.006, 0.004 and 0.032, respectively). The rate of grade I complications, grade II complications and the length of postoperative hospital stay in the EEN/PN group were significantly decreased (P = 0.036, 0.028 and 0.021, respectively), and no hospital mortality was observed in our study. Compared with the TPN group (58.2%), the rate of infectious complications in the EEN/PN group (39.3%) was significantly decreased (P = 0.042). Eleven cases of delayed gastric emptying were noted in the TPN group, and 6 cases in the EEN/PN group. The rate of delayed gastric emptying and hyperglycemia was significantly reduced in the EEN/PN group (P = 0.031 and P = 0.040, respectively). Early enteral combined with PN can greatly improve liver function, reduce infectious complications and delayed gastric emptying, and shorten postoperative hospital stay in patients undergoing PD.

Early enteral immune nutrition support after radical operation for gastric cancer on promoting the recovery of gastrointestinal function and immune function

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Zhi-Gang Li

2016-05-01

Full Text Available Objective: To analyze the effect of early enteral immune nutrition support after radical operation for gastric cancer on the recovery of gastrointestinal function and immune function. Methods: A total of 106 cases of patients received radical operation for gastric cancer in our hospital were selected as research subjects, and according to different ways of postoperative nutrition intervention, all patients were divided into observation group (n=50 and control group (n=56. Control group received conventional enteral nutrition intervention, observation group received postoperative early enteral immune nutrition support, and then differences in postoperative intestinal mucosa barrier function, gastrointestinal hormone levels, immune function levels and nutrition-related indicator values were compared between two groups. Results: After observation group received enteral immune nutrition intervention, serum DAO, PS and D-lactate levels as well as urine L/M ratio were lower than those of control group; serum GAS, CCK, MTL and SP values of observation group after intervention were higher than those of control group, and GLU, VIP, GIP and SS values were lower than those of control group; CD4, IgG, NK cell, C3, C4, CH50 and S-IgA levels of observation group after intervention were higher than those of control group; serum ALB, PRE, TRF and RBP levels of observation group after intervention were higher than those of control group. Conclusion: Early enteral immune nutrition support after radical operation for gastric cancer is conducive to the recovery of gastrointestinal function and the promotion of immune state, eventually promotes patients’ postoperative overall recovery and has active clinical significance.

Effect of three different doses of arginine enhanced enteral nutrition on nutritional status and outcomes in well nourished postsurgical cancer patients: a randomized single blinded prospective trial.

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De Luis, D A; Izaola, O; Terroba, M C; Cuellar, L; Ventosa, M; Martin, T

2015-01-01

Patients with head and neck cancer undergoing surgery have a high occurrence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using an enhanced enteral formula with three different doses of arginine could improve nutritional variables as well as clinical outcome, depending of arginine dose. A population of 84 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly assigned to three different treatment groups, each one containing at less 28 patients. Group I (28 patients) received an enteral diet supplements with a low physiological dose of arginine (5.7 g per day), group II (28 patients) received an isocaloric, isonitrogenous enteral formula with a medium dose of arginine (12.3 g per day) and group III (28 patients) received an isocaloric, isonitrogenous enteral formula with a high dose of arginine (18.9 g per day). The length of postoperative stay had a trend to be better with high dose of arginine received (31.9 ± 17.2 days in group I vs 27.8 ± 15.2 days in group II vs 24.8 ± 18.3 days in group III: p = 0.034). No differences were detected in postoperative infections complications and diarrhea. Fistula was less frequent in groups II and III than I (10.7% group I vs 3.6% group II vs 3.6% group III: p = 0.033), The length of postoperative stay had a trend to be better with high dose of arginine received (31.9 ± 17.2 days in group I vs 27.8 ± 15.2 days in group II vs 24.8 ± 18.3 days in group III: p = 0.034). Our results suggest that these patients could benefit from a high dose of arginine enhanced enteral formula to decrease length of hospital stay and fistula wound complications.

Development of Ultra-High Performance Fibre Reinforced Concrete (UHPFRC) : towards an efficient utilization of binders and fibres

NARCIS (Netherlands)

Yu, R.; Spiesz, P.R.; Brouwers, H.J.H.

2015-01-01

This paper presents a method to develop Ultra-High Performance Fibre Reinforced Concrete (UHPFRC). Towards an efficient utilization of binders and fibres in UHPFRC, the modified Andreasen & Andersen particle packing model and the hybridization design of fibres are utilized. Particularly, the UHPFRC

Effects of Delayed Enteral Nutrition on Inflammatory Responses and Immune Function Competence in Critically Ill Patients with Prolonged Fasting.

Science.gov (United States)

Xi, Fengchan; Li, Ning; Geng, Yanxia; Gao, Tao; Zhang, Juanjuan; Jun, Tanshan; Lin, Zhiliang; Li, Weiqin; Zhu, Weiming; Yu, Wenkui; Li, Jieshou

2014-05-01

Although different studies suggest that early enteral nutrition (EEN) has benefits in reducing infectious complications, there is no data that addresses whether delayed enteral nutrition (EN) is detrimental and if it may have effects on inflammatory responses and immune function. Forty-five critically ill patients with long fasting were randomly allocated in two groups according to the type of nutritional support. The first group included patients assuming a standard enteral nutrition (EN, n = 22) and the second group assuming a parenteral nutrition (PN, n = 23). The daily nutritional amount was 25 kcal (105 kJ)/kg for all patients. The inflammatory markers white blood cells (WBC), C-reactive protein (CRP), TNF-α, IL-1-β, IL-6, IL-4, IL- 10 and the immune T-lymphocyte sub-populations CD3+, CD4+, CD8+, and HLA-DR+ were evaluated at day 1, and after 2, 3 and 7 days. IL-4, IL-10, CD3+, CD4+, CD8+ and the CD4+/CD8+ ratio were not statistically different between the two groups. WBC and TNF-α in EN patients were higher than those in PN after 3 and 7 days (P fasting increased systemic inflammatory responses, whereas EN could modify immune function, therefore reducing hospital stay and costs.

Early enteral nutrition after total gastrectomy for gastric cancer.

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Chen, Wei; Zhang, Zheng; Xiong, Maoming; Meng, Xiangling; Dai, Fen; Fang, Jun; Wan, Hong; Wang, Miaofeng

2014-01-01

To assess the difference between early enteral nutrition (EEN group) and total parenteral nutrition (TPN group) after total gastrectomy for gastric cancer. The nutrition index, liver function, patient generated subjective global assessment (PG-SGA) score, the post-operation complications, the hospital stay and hospitalization expense of the postoperative patient after total gastrectomy, admitted to our Department of Surgery from May 2011 to May 2013 were analyzed retrospectively. A total of 72 patients including 37 cases in the EEN group and 35 cases in the TPN group were recruited. Hypoalbuminemia gradually improved in the EEN group about 3-5 days, but it did not increase until average 21 days in the TPN group. The body weight decreased in the EEN group during the first 2 weeks and recovered gradually in 21 days; body weight in the TPN group was significantly lower than the EEN group at 21 days (pnutrition indicators. The incidence of complications in the EEN group and TPN group were 8.1% and 25.7% respectively, with no significant differences (p>0.05). The days of hospital stays in the EEN and in the TPN group were up to 12.2 ± 2.5 d vs 14.9 ± 2.9 d (pgastric cancer.

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.

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.

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

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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.

Evolução antropométrica e sintomas gastrointestinais em pacientes que receberam suplementos nutricionais ou nutrição enteral Anthropometric evolution and gastrointestinal complaints in oral nutritional supplementation and enteral nutritional therapy

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Juliana Maria Faccioli Sicchieri

2009-01-01

Full Text Available OBJETIVO: Em pacientes hospitalizados, comparar a evolução de variáveis antropométricas e a ocorrência de efeitos adversos relacionados ao consumo de suplementos nutricionais e infusão de nutrição enteral. MÉTODOS: 10 pacientes que recebiam suplementos nutricionais (Grupo SN e 20 em nutrição enteral (Grupo NE, pareados para o gênero, idade (50 ± 21 vs 49 ± 23 anos e afecções de base foram submetidos à avaliação antropométrica ao início e término da terapêutica. Diariamente, foi aplicado um questionário semi-estruturado referente às queixas gastrointestinais. Determinaram-se as diferenças estatísticas obtidas entre o início e o final da terapêutica (teste t para amostras dependentes e entre os grupos de estudo (teste t para amostras independentes. RESULTADOS: A circunferência muscular do braço aumentou nos pacientes do Grupo NE (80 ± 15 vs 85 ± 15% de adequação, p = 0,009 e diminuiu no Grupo SN (96 ± 14 vs 92 ± 14% de adequação, p = 0,04. Náuseas e vômitos foram mais frequentes no Grupo SN (60 vs 10%, p = 0,01 e as queixas relacionadas ao sabor dos produtos ocorreram em 30% dos casos. CONCLUSÃO: Os pacientes que receberam suplementos nutricionais apresentaram maior ocorrência de queixas gastrointestinais e evolução desfavorável dos parâmetros antropométricos. Os dados obtidos no estudo não evidenciam o benefício da suplementação nutricional de rotina em pacientes hospitalizados.OBJECTIVE: To compare the evolution of anthropometric variables and the occurrence of adverse effects related to the ingestion of nutritional food supplements and enteral diet administration in hospitalized patients. METHODS: The study was performed in the Clinical Medicine wards of the Hospital of the School of Medicine of Ribeirão Preto, USP, with 10 patients receiving nutrition supplements, and 20 patients under enteral nutrition therapy, paired by gender, age (50 ± 21 vs 49 ± 23 years and basic afflictions. All

Enriched enteral nutrition may improve short-term survival in stage IV gastric cancer patients: A randomized, controlled trial.

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Klek, Stanislaw; Scislo, Lucyna; Walewska, Elzbieta; Choruz, Ryszard; Galas, Aleksander

2017-04-01

The aim of the study was to determine whether the postoperative use of enteral nutrition enriched with arginine, glutamine, and omega-3 fatty acids influences survival in patients diagnosed with stomach cancer. For the purpose of the study, the second wave of the trial performed in 2003 to 2009 was done. Ninety-nine patients who underwent surgery for gastric cancer (27 F, 72 M, mean age: 62.9 y) met the inclusion criteria. Of those, 54 were randomized to standard and 45 to enriched enteral nutrition (EEN). In all patients, short- and long-term (5 y) survival was analyzed. Analysis of the overall survival time did not reveal differences between groups (P = 0.663). Until the end of the third month, however, there were nine deaths in the standard enteral nutrition group and no deaths in the EEN group (16.7% versus 0.0%, P = 0.004). The univariate analyses suggested that the EEN group may have lower risk, especially during the first year after intervention. A significant reduction in the risk of death was seen during the early period after surgery (first 6 mo) in the EEN group in stage IV patients (hazard ratio = 0.25, P = 0.049). The use of enriched enteral diet did not influence, however, the risk of dying when patients were analyzed together. The study does not support the beneficial effect of enriched enteral nutrition in long-term survival; however, the positive impact on the stage IV patients suggests the need for further, more detailed studies. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Essential amino acid enriched high-protein enteral nutrition modulates insulin-like growth factor-1 system function in a rat model of trauma-hemorrhagic shock.

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Xianfeng Xia

Full Text Available Nutrition support for critically ill patients supplemented with additional modular protein may promote skeletal muscle protein anabolism in addition to counteracting acute nitrogen loss. The present study was designed to investigate whether the essential amino acid (EAA enriched high-protein enteral nutrition (EN modulates the insulin-like growth factor-1 (IGF-1 system and activates the mammalian target of rapamycin (mTOR anabolic signaling pathway in a trauma-hemorrhagic shock (T-HS rat model.Male Sprague-Dawley rats (n = 90, 278.18 ± 0.94 g were randomly assigned to 5 groups: (1 normal control, (2 pair-fed, (3 T-HS, (4 T-HS and standard EN, and (5 T-HS and EAA enriched high-protein EN. Six animals from each group were harvested on days 2, 4, and 6 for serum, gastrocnemius, soleus, and extensor digitorum longus sample collection. T-HS significantly reduced muscle mass. Nutrition support maintained muscle mass, especially the EAA enriched high-protein EN. Meanwhile, a pronounced derangement in IGF-1-IGFBPs axis as well as impaired mTOR transduction was observed in the T-HS group. Compared with animals receiving standard EN, those receiving EAA enriched high-protein EN presented 18% higher serum free IGF-1 levels following 3 days of nutrition support and 22% higher after 5 days. These changes were consistent with the concomitant elevation in serum insulin and reduction in corticosterone levels. In addition, phosphorylations of downstream anabolic signaling effectors - including protein kinase B, mTOR, and ribosomal protein S6 kinase1 - increased significantly in rats receiving EAA enriched high-protein EN.Our findings firstly demonstrate the beneficial effect of EAA enriched high-protein EN on the metabolic modulation of skeletal muscle protein anabolism by regulating the IGF-1 system and downstream anabolic signaling transduction.

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula.

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Sanz-Paris, Alejandro; Boj-Carceller, Diana; Lardies-Sanchez, Beatriz; Perez-Fernandez, Leticia; Cruz-Jentoft, Alfonso J

2016-03-09

Diabetes-specific formulas are an effective alternative for providing nutrients and maintaining glycemic control. This study assesses the effect of treatment with an oral enteral nutrition with a hypercaloric diabetes-specific formula (HDSF) for one year, on health-care resources use, health-care costs, glucose control and nutritional status, in 93 type-2 diabetes mellitus (T2DM) malnourished patients. Changes in health-care resources use and health-care costs were collected the year before and during the year of intervention. Glucose status and nutritional laboratory parameters were analyzed at baseline and one-year after the administration of HDSF. The administration of HDSF was significantly associated with a reduced use of health-care resources, fewer hospital admissions (54.7%; p Health-care costs were reduced by 65.6% (p nutritional parameters were improved at one year (albumin: +10.6%, p nutritional parameters. The use of health-care resources and costs were significantly reduced during the nutritional intervention.

[Clinical observation of preoperative administration of enteral nutrition support in gastric cancer patients at risk of malnutrition].

Science.gov (United States)

Chen, Bo; Zhou, Yong; Yang, Ping; Qin, Xian-peng; Li, Ning-ning; He, Dan; Feng, Jin-yan; Yan, Chuan-jing; Wu, Xiao-ting

2013-11-01

To evaluate safety and efficacy of preoperative administration of enteral nutrition support in gastric cancer patients at risk of malnutrition. A single center randomized controlled clinical trial was performed in 60 gastric cancer patients in West China Hospital from May to October 2012. Thirty patients were given enteral nutrition support(Ensure(R)) manufactured by Abbott Laboratories for ten consecutive days before surgical operation in the treatment group, and 30 patients were given an isocaloric and isonitrogenous homogenized diet in the control group for 10 days as well. The laboratory parameters of nutritional status and hepatorenal function were observed and compared between the two groups on admission, preoperative day 1 and postoperative day 3, respectively. Clinical observations, such as nausea and vomiting, were carried out until patients were discharged. Before the intervention, there were no significant differences in the baseline characteristics between the two groups. The levels of serum albumin [(33.9±5.6) g/L vs. (31.0±5.3) g/L, P0.05). Moreover, two patients with nausea and one with vomiting in each group were found. In clinical observation period, no severe treatment-related adverse event were observed. The enteral supplement with Ensure(R) in gastric cancer patients at risk of malnutrition during preoperative period is effective and safe, which is superior to homogenized diet and an appropriate choice for gastric cancer patients with nutritional risk.

Nutritional status and adequacy of enteral nutrition in pediatric cancer patients at a reference center in northeastern Brazil.

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Maciel Barbosa, J; Pedrosa, F; Coelho Cabral, P

2012-01-01

Individualized nutritional support is important to pediatric cancer patients and should be integrated to the overall treatment of these patients. Analyze the nutritional status of cancer patients submitted to enteral nutrition (EN) and assess the adequacy of this form of nutrition. A case series study was carried out at the Pediatric Oncology Unit of the Institute of Integrative Medicine Professor Fernando Figueira (IMIP, Brazil, Recife-PE) between January and December 2009. Clinical and anthropometric data were obtained from medical charts and nutritional follow-up charts. Z scores for height for age, weight for age and body mass index for age indicators (H/A, W/A and BMI/A, respectively) were calculated using the AnthroPlus program. Caloric and protein requirements were calculated based on the recommendations of the Brazilian National Council of Oncologic Nutrition. At the beginning of EN, 32.4% of the sample had short stature and 23.9% were underweight based on the BMI/A indicator. The assessment of EN adequacy demonstrated that 49.3% reached the caloric requirements and 76.1% reached the protein requirements, with maximal intakes of 65.6 Kcal/Kg/day and 1.95 g of protein/kg/day. Malnourished patients had greater mean Z scores for W/A and BMI/A at the end of EN, whereas no significant changes were found among patients with adequate nutritional status and significant reductions in these indicators were found among those with overweight or obesity. The patients either maintained or achieved a significant improvement in nutritional status, which demonstrates the importance of nutritional support and follow up during hospitalization.

Pretreatment of enteral nutrition with sodium polystyrene sulfonate: effective, but beware the high prevalence of electrolyte derangements in clinical practice.

Science.gov (United States)

Le Palma, Krisha; Pavlick, Elisha Rampolla; Copelovitch, Lawrence

2018-04-01

Current treatment options for chronic hyperkalemia in children with chronic kidney disease include dietary restrictions or enteral sodium polystyrene sulfonate (SPS); however, dietary restrictions may compromise adequate nutrition and enteral SPS may be limited by palatability, adverse effects and feeding tube obstruction. A potentially safer alternative is to pretreat enteral nutrition (EN) with SPS prior to consumption. The purpose of this study was to evaluate the efficacy and safety of pretreating EN with SPS in pediatric patients with hyperkalemia. We performed a retrospective cohort study between September 2012 and May 2016 at the Children's Hospital of Philadelphia. In all, 14 patients (age range 0.5-53.2 months) who received 19 courses of SPS pretreatment of EN were evaluated. Serum electrolytes were evaluated at baseline and within 1 week of initiating therapy. The primary endpoint was mean change in potassium at 7 days. Secondary endpoints included the mean change in serum sodium, chloride, bicarbonate, calcium, phosphorous and magnesium, as well as the percentage of patients who developed electrolyte abnormalities within the first week of treatment. Serum potassium levels decreased from 6.0 to 4.4 mmol/L (P < 0.001) and serum sodium levels increased from 135.8 to 141.3 mmol/L (P = 0.008) 1 week after initiating SPS pretreatment. No significant differences in mean serum calcium or magnesium levels were noted. Nevertheless, more than half of the courses resulted in at least one electrolyte abnormality, with hypokalemia (31.6%), hypernatremia (26.3%) and hypocalcemia (21.1%) occurring most frequently. Pretreatment of EN with SPS is an effective method for treating chronic hyperkalemia in pediatric patients; however, close monitoring of electrolytes is warranted.

Family caregivers of older adults on home enteral nutrition have multiple unmet task-related training needs and low overall preparedness for caregiving.

Science.gov (United States)

Silver, Heidi J; Wellman, Nancy S; Galindo-Ciocon, Daisy; Johnson, Paulette

2004-01-01

We used stress process theory to identify family caregiving variables that are salient to the experience of managing older adults' home enteral nutrition. In this article, we describe the specific tasks family caregivers performed and their unique training needs in the context of caregiver preparedness, competence, effectiveness, and health care use. Hospital billing lists from two university-affiliated institutions in Miami, FL, were used to identify older adults who had enteral tubes placed over a 6-month period. Consent was obtained from those older adults discharged for the first time on home enteral nutrition and their family caregivers at the first scheduled outpatient visit. In-home interviews were conducted with a diverse sample of 30 family caregivers (14 white, 8 Hispanic, 7 African-American, 1 Asian) during their first 3 months (mean=1.83+/-0.69 months) of home enteral nutrition caregiving. Descriptive statistics were used to summarize data for all variables; chi(2) analysis was conducted to analyze differences in categorical variables. One-way analysis of variance was used to analyze mean differences among caregivers grouped by ethnicity for total number of hours and tasks performed. Post hoc comparisons were conducted using the Tukey HSD test. The Spearman rho correlations were calculated to assess bivariate associations between quantitative variables. Caregivers reported providing from 6 to 168 hours of care weekly (mean=61.87+/-49.67 hours), in which they performed an average of 19.73+/-8.09 caregiving tasks daily. Training needs identified were greatest for technical and nutrition-related tasks. Preparedness for caregiving scores were low (mean=1.72, maximum=4.0) and positively correlated with caregiver competence (P<.001) and self-rated caregiver effectiveness (P=.004). Preparedness negatively correlated with health care use (P=.03). Caregivers of older adults on home enteral nutrition need training for multiple nutrition-related and caregiving

Enteral Nutrition in Pancreaticoduodenectomy: A Literature Review

Directory of Open Access Journals (Sweden)

Salvatore Buscemi

2015-04-01

Full Text Available Pancreaticoduodenectomy (PD is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30%–40% of morbidity. Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early postoperative days, affects the process of healing, the intestinal barrier function and the number of postoperative complications. Few studies focus on the relation between enteral nutrition (EN and postoperative complications. Our aim was to perform a review, including only randomized controlled trial meta-analyses or well-designed studies, of evidence regarding the correlation between EN and main complications and outcomes after pancreaticoduodenectomy, as delayed gastric emptying (DGE, postoperative pancreatic fistula (POPF, postpancreatectomy hemorrhage (PPH, length of stay and infectious complications. Several studies, especially randomized controlled trial have shown that EN does not increase the rate of DGE. EN appeared safe and tolerated for patients after PD, even if it did not reveal any advantages in terms of POPF, PPH, length of stay and infectious complications.

The renaissance and bright future of fibre lasers

International Nuclear Information System (INIS)

Tuennermann, A; Schreiber, T; Roeser, F; Liem, A; Hoefer, S; Zellmer, H; Nolte, S; Limpert, J

2005-01-01

The first rare-earth-doped fibre lasers were operated in the early 1960s and produced a few milliwatts at a wavelength around 1 μm. For the next several decades, fibre lasers were little more than a low-power laboratory curiosity. Recently, however, fibre lasers have entered the realm of kilowatt powers with diffraction-limited beam quality. In this paper we review the reasons for this power evolution. Beyond this, we will discuss how the next generation of fibres, so-called photonic crystal fibres, enable upward power scaling and therefore open up the avenue to new performance levels of solid-state lasers

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)

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...

The effect of long-term high-fibre diets in diabetic outpatients ...

African Journals Online (AJOL)

Diets containing large amounts of dietary fibre have been shown to be beneficial in improving diabetic control. We -investigated the practical aspects of administering a high-fibre diet to diabetic outpatients in Cape Town, using readily available, lowcost foodstuffs with a high dietary fibre content. Ten patients were followed ...

The potential association of later initiation of oral/enteral nutrition on euthyroid sick syndrome in burn patients.

Science.gov (United States)

Pérez-Guisado, Joaquín; de Haro-Padilla, Jesús M; Rioja, Luis F; Derosier, Leo C; de la Torre, Jorge I

2013-01-01

Objective. The aim of this study was to determine if early initiation of oral/enteral nutrition in burn patients minimizes the drop in fT3 levels, reduces the potential for euthyroid sick syndrome (ESS), and shortens the length of hospital stay (LHS). Subjects and Methods. We retrospectively evaluated the statistical association of serum fT3, fT4, and TSH at the first (2nd-5th day) and second sample collection (9th-12th day) after the burn injury in 152 burn patients. Three groups were established depending on time of initiation of the oral/enteral nutrition: 48 h after the injury (Group 3). Results. They were expressed as mean ± standard deviation. We found that LHS and the fT3 levels were statistically different in the 3 groups. The LHS (in days) was, respectively, in each group, 16.77 ± 4.56, 21.98 ± 4.86, and 26.06 ± 5.47. Despite the quantifiable drop in fT3, ESS was present only at the first sample collection (2.61 ± 0.92 days) in Group 3, but there was no group with ESS at the second sample collection (9.89 ± 1.01 days). Our data suggest that early initiation of nutritional supplementation decreases the length of hospitalization and is associated with decreasing fT3 serum concentration depression. Conclusion. Early initiation of oral/enteral nutrition counteracts ESS and improves the LHS in burn patients.

[Enteral nutrition in neurological patients: is there enough vitamin D content in commonly used formulas?].

Science.gov (United States)

Botella Romero, F; Alfaro Martínez, J J; Luna López, V; Galicia Martín, I

2012-01-01

Vitamin D deficiency produces inadequate bone mineralization, proximal muscle weakness, abnormal gait and increased risk of falls and fractures. Moreover, in epidemiological studies, has been associated with increased risk of cancer, autoimmune diseases, type 1 and 2 diabetes, rheumatoid arthritis, multiple sclerosis, infectious diseases, cardiovascular diseases and depression. When synthesis through the skin by sun exposure is not possible and the patient can not eat by mouth, as in the advanced stages of various neurological diseases, the supply of vitamin D has to be done by enteral nutrition. The aim of this study is to review the role of vitamin D in a common group of neurological conditions that often require artificial nutrition and analyze whether the vitamin D of different enteral nutrition formulas is adequate to meet the needs of this group of patients. Numerous studies have shown the association between vitamin D deficiency and increased incidence of dementia, stroke and other neurodegenerative diseases. Interventions aimed to increase levels of vit. D and its effects on functional (falls, pain, quality of life) and cardiovascular goals (cardiovascular death, stroke, myocardial infarction, cardiovascular risk factors) have obtained as highlight data a clear reduction of falls and fractures, while the evidence for the other parameters studied is still limited and inconsistent. The content of calcium and vitamin D of enteral formulas is legislated in our country. The total amount of vitamin D for a daily intake of 1,500-2,000 kcal ranges between 300 and 1,600 IU/d (mean ± SD: 32.9 ± 8.5 mg/100 kcal) in the complete formulas for enteral nutrition most commonly used. 50% of the diets studied, for an intake of 2,000 kcal/d, and 90% for an intake of 1,500 kcal/d, provide less than 600 IU/d of vitamin D. Some revised recently guidelines published recommendations of daily intake of vitamin D. The document published by the U.S. Institute of Medicine

Perioperative Alanyl-Glutamine-Supplemented Parenteral Nutrition in Chronic Radiation Enteritis Patients With Surgical Intestinal Obstruction: A Prospective, Randomized, Controlled Study.

Science.gov (United States)

Yao, Danhua; Zheng, Lei; Wang, Jian; Guo, Mingxiao; Yin, Jianyi; Li, Yousheng

2016-04-01

A prospective, randomized, controlled study was performed to evaluate the effects of perioperative alanyl-glutamine-supplemented parenteral nutrition (PN) support on the immunologic function, intestinal permeability, and nutrition status of surgical patients with chronic radiation enteritis (CRE)-induced intestinal obstruction. Patients who received 0.4 g/kg/d alanyl-glutamine and isonitrogenous PN were assigned to an alanyl-glutamine-supplemented PN (Gln-PN) group and a control group, respectively. Serum levels of alanine aminotransferase and glutamine, body fat mass (FM), immunologic function, and intestinal permeability were measured before and after surgery. Serum glutamine levels of the Gln-PN group significantly exceeded that of the control group (P nutrition state and intestinal motility of surgical patients with CRE-induced intestinal obstruction. © 2015 American Society for Parenteral and Enteral Nutrition.

Central venous catheter infections in home parenteral nutrition patients: Outcomes from Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care.

Science.gov (United States)

Ross, Vicki M; Guenter, Peggi; Corrigan, Mandy L; Kovacevich, Debra; Winkler, Marion F; Resnick, Helaine E; Norris, Tina L; Robinson, Lawrence; Steiger, Ezra

2016-12-01

Home parenteral nutrition (HPN) is a high-cost, complex nutrition support therapy that requires the use of central venous catheters. Central line-associated bloodstream infections (CLABSIs) are among the most serious risks of this therapy. Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care (Sustain registry) provides the most current and comprehensive data for studying CLABSI among a national cohort of HPN patients in the United States. This is the first Sustain registry report detailing longitudinal data on CLABSI among HPN patients. To describe CLABSI rates for HPN patients followed in the Sustain registry from 2011-2014. Descriptive, χ 2 , and t tests were used to analyze data from the Sustain registry. Of the 1,046 HPN patients from 29 sites across the United States, 112 (10.7%) experienced 194 CLABSI events during 223,493 days of HPN exposure, for an overall CLABSI rate of 0.87 episodes/1,000 parenteral nutrition-days. Although the majority of patients were female (59%), adult (87%), white (75%), and with private insurance or Medicare (69%), CLABSI episodes per 1,000 parenteral nutrition-days were higher for men (0.69 vs 0.38), children (1.17 vs 0.35), blacks (0.91 vs 0.41), and Medicaid recipients (1.0 vs 0.38 or 0.39). Patients with implanted ports or double-lumen catheters also had more CLABSIs than those with peripherally inserted or central catheters or single-lumen catheters. Staphylococci were the most commonly reported pathogens. These data support findings of smaller studies about CLABSI risk for children and by catheter type and identify new potential risk factors, including gender, race, and insurance type. Additional studies are needed to determine effective interventions that will reduce HPN-associated CLABSI. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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

High-performace cladding-pumped erbium-doped fibre laser and amplifier

International Nuclear Information System (INIS)

Kotov, L V; Likhachev, M E; Bubnov, M M; Medvedkov, O I; Lipatov, D S; Vechkanov, N N; Guryanov, Aleksei N

2012-01-01

We report cladding-pumped erbium-doped fibre laser and amplifier configurations. Through fibre design optimisation, we have achieved a record-high laser slope efficiency, 40 % with respect to absorbed pump power (λ = 976 nm), and an output power of 7.5 W. The erbium-doped fibre amplifier efficiency reaches 32 %.

Design and development of a manual pump for bolus enteral nutrition.

Science.gov (United States)

Romano-García, Judit; Fernández-Morera, Juan Luis

2018-02-01

Enteral nutrition (EN) is based on administration of liquid solutions into the gastrointestinal tract using a tube. After identifying unsolved practical difficulties in administration of EN using volume syringes, a new device to overcome such technical difficulties was proposed. Specific technologies (CAD, 3D printing) were used in collaboration with the PRODINTEC Foundation (Gijón, Asturias). Clarke Modet, a law firm specialized in intellectual property, provided legal advice on formulas for legal protection of the invention. The resulting device is a manual pump for infusion of EN to patients that solves previously identified problems and is highly functional and compact. It would allow for comfortable and safe administration of solutions. Integration of a bottle into the device itself and pump dimensions facilitate transport and patient mobility. According to the described configuration, this invention has many advantages over the previously known procedures, such as a simpler administration within the field of intermittent EN, improving the standard nutritional support technique, which in this case is use of volume syringes. This would facilitate the work of caregivers while promoting patient self-care and autonomy. The pump was accredited novelty of design, inventive activity and industrial exploitation potential by the European Patent Office (EPO), to which a patent has been requested. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Connections in Precast Buildings using Ultra High-Strength Fibre Reinforced Concrete

DEFF Research Database (Denmark)

Hansen, Lars Pilegaard

1995-01-01

Ultra high-strength concrete adds new dimensions to the design of concrete structures. It is a brittle material but introducing fibres into the matrix changes the material into a highly ductile material. Furthermore, the fibre reinforcement increases the anchorage of traditional reinforcement bar...... and the fire resistance. Such a fibre reinforced ultra high-strength material has been used to develop a simple joint solution between slab elements in a column - slab building system....

The Potential Association of Later Initiation of Oral/Enteral Nutrition on Euthyroid Sick Syndrome in Burn Patients

Directory of Open Access Journals (Sweden)

Joaquín Pérez-Guisado

2013-01-01

Full Text Available Objective. The aim of this study was to determine if early initiation of oral/enteral nutrition in burn patients minimizes the drop in fT3 levels, reduces the potential for euthyroid sick syndrome (ESS, and shortens the length of hospital stay (LHS. Subjects and Methods. We retrospectively evaluated the statistical association of serum fT3, fT4, and TSH at the first (2nd–5th day and second sample collection (9th–12th day after the burn injury in 152 burn patients. Three groups were established depending on time of initiation of the oral/enteral nutrition: 48 h after the injury (Group 3. Results. They were expressed as mean ± standard deviation. We found that LHS and the fT3 levels were statistically different in the 3 groups. The LHS (in days was, respectively, in each group, 16.77±4.56, 21.98±4.86, and 26.06±5.47. Despite the quantifiable drop in fT3, ESS was present only at the first sample collection (2.61±0.92 days in Group 3, but there was no group with ESS at the second sample collection (9.89±1.01 days. Our data suggest that early initiation of nutritional supplementation decreases the length of hospitalization and is associated with decreasing fT3 serum concentration depression. Conclusion. Early initiation of oral/enteral nutrition counteracts ESS and improves the LHS in burn patients.

High-power Yb-doped continuous-wave and pulsed fibre lasers

Indian Academy of Sciences (India)

2014-01-05

Jan 5, 2014 ... In this article, a review of Yb-doped CW and pulsed fibre lasers along with our study on self-pulsing dynamics in CW fibre lasers to find its role in high-power fibre laser development and the physical ... Solid State Laser Division, Raja Ramanna Centre for Advanced Technology, Indore 452 013, India ...

Temporary Rumenostomy for the Treatment of Forestomach Diseases and Enteral Nutrition.

Science.gov (United States)

Callan, Robert J; Applegate, Tanya J

2017-11-01

Temporary rumenostomy is a useful procedure for the treatment, management, and support of patients with forestomach disease of various types. The rumenostomy provides a mechanism for relief of chronic rumen tympany or distention, removal of rumen contents and lavage of the rumen, removal of some rumen foreign bodies, administration of rumen fluid transfaunation, and administration of enteral nutrition or other medications. When the rumenostomy is no longer necessary, it can be allowed to close by second intention or by surgical resection. Copyright © 2017 Elsevier Inc. All rights reserved.

Composite Strain Hardening Properties of High Performance Hybrid Fibre Reinforced Concrete

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Vikram Jothi Jayakumar

2014-01-01

Full Text Available Hybrid fibres addition in concrete proved to be a promising method to improve the composite mechanical properties of the cementitious system. Fibre combinations involving different fibre lengths and moduli were added in high strength slag based concrete to evaluate the strain hardening properties. Influence of hybrid fibres consisting of steel and polypropylene fibres added in slag based cementitious system (50% CRL was explored. Effects of hybrid fibre addition at optimum volume fraction of 2% of steel fibres and 0.5% of PP fibres (long and short steel fibre combinations were observed in improving the postcrack strength properties of concrete. Test results also indicated that the hybrid steel fibre additions in slag based concrete consisting of short steel and polypropylene (PP fibres exhibited a the highest compressive strength of 48.56 MPa. Comparative analysis on the performance of monofibre concrete consisting of steel and PP fibres had shown lower residual strength compared to hybrid fibre combinations. Hybrid fibres consisting of long steel-PP fibres potentially improved the absolute and residual toughness properties of concrete composite up to a maximum of 94.38% compared to monofibre concrete. In addition, the relative performance levels of different hybrid fibres in improving the matrix strain hardening, postcrack toughness, and residual strength capacity of slag based concretes were evaluated systematically.

Is Early Enteral Nutrition Better for Postoperative Course in Esophageal Cancer Patients?

Directory of Open Access Journals (Sweden)

Toshifumi Wakai

2013-09-01

Full Text Available We retrospectively examined esophageal cancer patients who received enteral nutrition (EN to clarify the validity of early EN compared with delayed EN. A total of 103 patients who underwent transthoracic esophagectomy with three-field lymphadenectomy for esophageal cancer were entered. Patients were divided into two groups; Group E received EN within postoperative day 3, and Group L received EN after postoperative day 3. The clinical factors such as days for first fecal passage, the dose of postoperative albumin infusion, differences of serum albumin value between pre- and postoperation, duration of systematic inflammatory response syndrome (SIRS, incidence of postoperative infectious complication, and use of total parenteral nutrition (TPN were compared between the groups. The statistical analyses were performed using Mann-Whitney U test and Chi square test. The statistical significance was defined as p < 0.05. Group E showed fewer days for the first fecal passage (p < 0.01, lesser dose of postoperative albumin infusion (p < 0.01, less use of TPN (p < 0.01, and shorter duration of SIRS (p < 0.01. However, there was no significant difference in postoperative complications between the two groups. Early EN started within 3 days after esophagectomy. It is safe and valid for reduction of albumin infusion and TPN, for promoting early recovery of intestinal movement, and for early recovery from systemic inflammation.

Is Early Enteral Nutrition Better for Postoperative Course in Esophageal Cancer Patients?

Science.gov (United States)

Kobayashi, Kazuaki; Koyama, Yu; Kosugi, Shin-ichi; Ishikawa, Takashi; Sakamoto, Kaoru; Ichikawa, Hiroshi; Wakai, Toshifumi

2013-01-01

We retrospectively examined esophageal cancer patients who received enteral nutrition (EN) to clarify the validity of early EN compared with delayed EN. A total of 103 patients who underwent transthoracic esophagectomy with three-field lymphadenectomy for esophageal cancer were entered. Patients were divided into two groups; Group E received EN within postoperative day 3, and Group L received EN after postoperative day 3. The clinical factors such as days for first fecal passage, the dose of postoperative albumin infusion, differences of serum albumin value between pre- and postoperation, duration of systematic inflammatory response syndrome (SIRS), incidence of postoperative infectious complication, and use of total parenteral nutrition (TPN) were compared between the groups. The statistical analyses were performed using Mann-Whitney U test and Chi square test. The statistical significance was defined as p < 0.05. Group E showed fewer days for the first fecal passage (p < 0.01), lesser dose of postoperative albumin infusion (p < 0.01), less use of TPN (p < 0.01), and shorter duration of SIRS (p < 0.01). However, there was no significant difference in postoperative complications between the two groups. Early EN started within 3 days after esophagectomy. It is safe and valid for reduction of albumin infusion and TPN, for promoting early recovery of intestinal movement, and for early recovery from systemic inflammation. PMID:24067386

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.

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

Gastrointestinal obstruction caused by solidification and coagulation of enteral nutrition: pathogenetic mechanisms and potential risk factors

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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

Dietary fibre as an important constituent of the diet

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Kalina Maćkowiak

2016-02-01

Full Text Available The intake of fibre in the diet of a child or an adult, through various foods (such as wholegrain foods, nuts, fruits and vegetables, plays an important role in reducing the risk and lowering the incidence of numerous diseases. The interest of researchers and consumers in the role of diet in the prevention or treatment of many illnesses, and maintaining the general and oral health, has been growing lately. The aim of our study was to underline the role of dietary fibre through its effects on many aspects of the human body and metabolism. Evidence has been found that dietary fibre from whole foods or supplements may reduce the risk of cardiovascular disease by improving serum lipids and reducing serum total and low-density lipoprotein (LDL cholesterol concentrations in adults and children. Increased fibre content decreases the glycaemic index of foods, which leads to a significant improvement in glycaemic response. High fibre intake is associated with reduced risk of colorectal and breast cancer. In contemporary children, the reluctance to chew raw, hard plant foods may result in a risk of malocclusion and a lack of tooth wear, which cause the need for orthodontic intervention. Fibre consumption is associated with high nutritional value and antioxidant status of the diet, enhancing the effects on human health.

Dietary fibre as an important constituent of the diet

Directory of Open Access Journals (Sweden)

Kalina Maćkowiak

2016-02-01

Full Text Available The intake of fibre in the diet of a child or an adult, through various foods (such as wholegrain foods, nuts, fruits and vegetables, plays an important role in reducing the risk and lowering the incidence of numerous diseases. The interest of researchers and consumers in the role of diet in the prevention or treatment of many illnesses, and maintaining the general and oral health, has been growing lately. The aim of our study was to underline the role of dietary fibre through its effects on many aspects of the human body and metabolism. Evidence has been found that dietary fibre from whole foods or supplements may reduce the risk of cardiovascular disease by improving serum lipids and reducing serum total and low-density lipoprotein (LDL cholesterol concentrations in adults and children. Increased fibre content decreases the glycaemic index of foods, which leads to a significant improvement in glycaemic response. High fibre intake is associated with reduced risk of colorectal and breast cancer. In contemporary children, the reluctance to chew raw, hard plant foods may result in a risk of malocclusion and a lack of tooth wear, which cause the need for orthodontic intervention. Fibre consumption is associated with high nutritional value and antioxidant status of the diet, enhancingthe effects on human health.

Influence of intestinal early enteral nutrition therapy on intestinal barrier function and immune response of patients with radiation enteritis

International Nuclear Information System (INIS)

Liu Guohui; Kang Xin; Chen Gong; Wang Guangyi

2012-01-01

Objective: To investigate the influence of early enteral nutrition therapy on the intestinal barrier function and immune response of the patients with radiation enteritis (ER) so as to find a relatively simple and effective method to treat RE. Methods: Fifty-six patients with radiation enteritis (RE) diagnosed by colonoscopy, X-rays, and pathology were randomly divided into 2 equal groups: experimental group undergoing enteral nutrition therapy, and control group undergoing conventional therapy only. Peripheral blood samples were collected 1, 11, and 21 days after admission. Plasma diamine oxidase (DAO), D-lactic acid, endotoxin, and lactulose/mannitol (L/M) ratio, and levels of IgG, IgM, and IgA, and CD4/CD8 ratio were examined. Five cases from the experimental group and 5 cases from the control group underwent second-time operation because of incomplete intestinal obstruction, intestinal stenosis, or recurrent tumor respectively. The biopsy specimens of the terminal ileum or distal descending colon taken during the first and second operations underwent pathological examination. Peripheral blood samples were collected 1, 11, and 21 days after admission. Plasma diamine oxidase (DAO), D-lactic acid, endotoxin, and lactulose/mannitol (L/M) ratio, and levels of IgG, IgM, and IgA, and CD4/CD8 ratio were examined. Results: There were no significant differences in the intestinal function and blood immunological indices between these 2 groups. The levels of DAO, D-lactic acid, and endotoxin,and the L/M ratio 11 days after admission of the experiment group were all significantly lower than those of the control group (t=2.568, 2.427, 2.143, 2.443, P<0.05), and all those indices 21 days after admission of the experiment group were all much more significantly lower in comparison with the control group (t=6.019, 12.834, 7.837, 7.997, P<0.01). The levels of IgG, IgM, and IgA, and CD4/CD8 ratio 11 days after admission of the experimental group were all significantly higher than

Effect of Immune-Enhancing Enteral Nutrition Enriched with or without Beta-Glucan on Immunomodulation in Critically Ill Patients

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Jae Gil Lee

2016-06-01

Full Text Available We investigated whether high-protein enteral nutrition with immune-modulating nutrients (IMHP enriched with β-glucan stimulates immune function in critically ill patients. In a randomized double-blind placebo-controlled study, 30 patients consumed one of three types of enteral nutrition: a control or IMHP with and without β-glucan. The IMHP with β-glucan group showed increases in natural killer (NK cell activities relative to the baseline, and greater increases were observed in NK cell activities relative to the control group after adjusting for age and gender. The IMHP groups with and without β-glucan had greater increases in serum prealbumin and decreases in high-sensitivity C-reactive protein (hs-CRP than the control group. The control group had a greater decrease in peripheral blood mononuclear cell (PBMC interleukin (IL-12 production than the IMHP with and without β-glucan groups. In all patients, the change (Δ in hs-CRP was correlated with Δ prealbumin and Δ PBMC IL-12, which were correlated with ΔNK cell activity and Δ prealbumin. This study showed beneficial effects of a combination treatment of β-glucan and IMHP on NK cell activity. Additionally, strong correlations among changes in NK cell activity, PBMC IL-12, and hs-CRP suggested that β-glucan could be an attractive candidate for stimulating protective immunity without enhanced inflammation (ClinicalTrials.gov: NCT02569203.

Can Hypocaloric, High-Protein Nutrition Support Be Used in Complicated Bariatric Patients to Promote Weight Loss?

Science.gov (United States)

Beebe, Mara Lee; Crowley, Nina

2015-08-01

Bariatric surgery, an effective treatment for morbid obesity, may result in complications that require nutrition support. Common goals for nutrition support in post-bariatric surgery patients include nutrition repletion, avoiding overfeeding, preserving lean body mass, and promoting wound healing. It is often questioned if continued weight loss can be part of the nutrition goals and if weight loss is safe for patients who become critically ill following bariatric surgery. Recent clinical practice guidelines from both the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and Society of Critical Care Medicine (SCCM) have recommended the use of hypocaloric, high-protein nutrition support in both critically and non-critically ill obese patients. Hypocaloric feedings of 50%-70% of estimated energy requirements based on predictive equations or obesity. Two small studies in complicated post-bariatric surgery patients requiring nutrition support have shown that the strategy of hypocaloric, high-protein feedings can result in positive outcomes, including positive nitrogen balance, wound healing, weight loss, and successful transition to oral diets. Additional research, including large, randomized studies, is still needed to validate these findings. However, based on a review of available clinical practice guidelines, predictive equations, indirect calorimetry, case studies, and systematic reviews, hypocaloric, high-protein nutrition support appears to at least be equal to eucaloric feedings and may be a useful tool for clinicians to achieve continued weight loss in complicated bariatric surgery patients requiring nutrition support. © 2015 American Society for Parenteral and Enteral Nutrition.

[Effect of Sijunzi Decoction and enteral nutrition on T-cell subsets and nutritional status in patients with gastric cancer after operation: a randomized controlled trial].

Science.gov (United States)

Cai, Jun; Wang, Hua; Zhou, Sheng; Wu, Bin; Song, Hua-Rong; Xuan, Zheng-Rong

2008-01-01

To observe the effect of perioperative application of Sijunzi Decoction and enteral nutrition on T-cell subsets and nutritional status in patients with gastric cancer after operation. In this prospective, single-blinded, controlled clinical trial, fifty-nine patients with gastric cancer were randomly divided into three groups: control group (n=20) and two study groups (group A, n=21; group B, n=18). Sjunzi Decoction (100 ml) was administered via nasogastric tube to the patients in the study group B from the second postoperation day to the 9th postoperation day. Patients in the two study groups were given an isocaloric and isonitrogonous enteral diet, which was started on the second day after operation, and continued for eight days. Patients in the control group were given an isocaloric and isonitrogonous parenteral diet for 9 days. All variables of nutritional status such as serum albumin (ALB), prealbumin (PA), transferrin (TRF) and T-cell subsets were measured one day before operation, and one day and 10 days after operation. All the nutritional variables and the levels of CD3(+), CD4(+), CD4(+)/CD8(+) were decreased significantly after operation. Ten days after operation, T-cell subsets and nutritional variables in the two study groups were increased as compare with the control group. The levels of ALB, TRF and T-cell subsets in the study group B were increased significantly as compared with the study group A (Pnutrition assisted with Sijunzi Decoction can positively improve and optimize cellular immune function and nutritional status in the patients with gastric cancer after operation.

Free-sugar, total-sugar, fibre, and micronutrient intake within elite youth British soccer players: a nutritional transition from schoolboy to fulltime soccer player.

Science.gov (United States)

Naughton, Robert J; Drust, Barry; O'Boyle, Andy; Abayomi, Julie; Mahon, Elizabeth; Morton, James P; Davies, Ian G

2017-05-01

It is recommended that soccer players consume a high carbohydrate diet to augment performance. However, growing evidence suggests that there is a link between high free-sugar (FS) intake (>5% total energy intake; TEI) and metabolic diseases. Furthermore, foods that are often high in sugar, such as processed foods, are typically lacking in nutrient quality. We therefore analysed total-sugar, FS, dietary fibre, and micronutrient intake of players from an English Premier League academy under (U) 18 (n = 13), U15/16 (n = 25), and U13/14 (n = 21) using a 7-day food diary. Data were compared with current United Kingdom (UK) dietary reference value (DRV) for FS via a t test. The U13/14s (10% ± 18%) and U15/16s (11% ± 30%) both consumed higher amounts of FS in comparison with the UK DRV of 5% TEI (P elite youth soccer players. We report an apparent "nutritional transition" from schoolboy to fulltime soccer player, with U18s showing a significantly lower intake of sugar in comparison with younger squads, and a similar intake of FS to the UK DRVs. Practitioners should target improving player education around sugar and fibre consumption.

High Extinction Ratio In-Fibre Polarisers by Exploiting Tilted Fibre Bragg Grating Structures for Single-Polarisation High-Power Fibre Lasers and Amplifiers

Science.gov (United States)

2009-11-01

maintaining (PM) fibre, utilising polarisation hole-burning ( PHB ) effect to reduce homogeneous linewidth of the EDFL. In our work, we demonstrate a stable...loss filter which will induce some loss to the cavity around its paired attenuation band region, thus imposing PHB effect to the gain medium. The...polarisation-hole-burning ( PHB ) effect to realise multi-wavelength switchable function in proposed fibre ring laser system. In the proposed fibre ring laser

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....

Child-directed and nutrition-focused marketing cues on food packaging: links to nutritional content.

Science.gov (United States)

Lapierre, Matthew A; Brown, Autumn M; Houtzer, Hunter V; Thomas, Tyler J

2017-04-01

We tested whether the presence of both child-targeted and nutrition-focused (i.e. parent-targeted) marketing cues on food packaging was associated with the nutritional content of these products. We conducted a quantitative content analysis of 403 food packages chosen randomly from the supermarket's online portal along with all products (n 312) from the cereal aisle in a supermarket from the Southeastern USA. We examined main and interaction effects for cues on nutritional content (e.g. energy density, sugar, sodium, fibre). A regional supermarket chain in the Southeastern USA. Tests of main effects indicated that increased presence of nutritional cues was linked to more nutritious content (e.g. less sugar, less saturated fat, more fibre) while the increased presence of child-targeted cues was uniformly associated with less nutritious content (e.g. more sugar, less protein, less fibre). Among the interaction effects, results revealed that products with increased nutrition-focused and child-targeted cues were likely to contain significantly more sugar and less protein than other products. Products that seek to engage children with their packaging in the supermarket are significantly less nutritious than foods that do not, while product packages that suggest nutritional benefits have more nutritious content. More importantly, the study provides evidence that those products which try to engage both child and parent consumers are significantly less healthy in crucial ways (e.g. more sugar, less fibre) than products that do not.

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

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

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

New radiation-induced effects in optical fibres feasible for dosimetry

International Nuclear Information System (INIS)

Tomashuk, A.L.; Golant, K.M.; Dianov, E.M.; Nikolin, I.V.; Zakharkin, I.I.; Stepanov, V.A.

1999-01-01

Three new radiation-induced effects in silica optical fibres suitable for dosimetry are proposed: 1) in fibres with a high-OH cladding and a low-OH core, ionizing radiation disrupts the O-H bonds to let hydrogen diffuse into the core. This results in an increase in the OH-group absorption band amplitude, 2) the polymers used to coat optical fibres consist of hydrogen to the extent of about 50 %. Energetic neutrons produce recoil protons in the fibre coating, which can ''stick'' in the core, turn into hydrogen, and enter the glass network in the form of OH-group, and 3) in N-doped silica fibres irradiated with thermal neutrons, the following reaction 7 N 14 ( 0 n 1 , 1 p 1 ) 6 C 14 occurs and produces protons with energy 620 keV. With this energy, propagation length of protons in silica is 7 μm which means that the escape of protons from a 50 μm core is very weak. In fact all 3 effects lead to the irreversible increase in the OH-group absorption bands, which is proportional to the absorbed dose. With the help of these effects, temperature and dose-rate independent measurements of high doses become possible

Phase Angle and Handgrip Strength Are Sensitive Early Markers of Energy Intake in Hypophagic, Non-Surgical Patients at Nutritional Risk, with Contraindications to Enteral Nutrition

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Riccardo Caccialanza

2015-03-01

Full Text Available The assessment of nutritional intakes during hospitalization is crucial, as it is known that nutritional status tends to worsen during the hospital stay, and this can lead to the negative consequences of malnutrition. International guidelines recommend the use of parenteral nutrition (PN in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. However, to date, there are no published data regarding either energy intake or objective measurements associated with it in this patient population. The aim of the present exploratory methodological study was to evaluate whether phase angle (PhA and handgrip strength normalized for skeletal muscle mass (HG/SMM are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. We evaluated 30 eligible patients, who were treated with personalized dietary modifications and supplemental PN for at least one week during hospitalization. In a liner regression model adjusted for age, gender, basal protein intake and the basal value of each variable, a trend toward improvement of PhA and preservation of HG/SMM was observed in patients satisfying the estimated calorie requirements (N = 20, while a significant deterioration of these parameters occurred in those who were not able to reach the target (N = 10. The mean adjusted difference and 95% CI were +1.4° (0.5–2.3 (p = 0.005 for PhA and +0.23 (0.20–0.43 (p = 0.033 for HG/SMM. A significant correlation between PhA and HG/SMM variations was also observed (r = 0.56 (95% CI, 0.23–0.77; p = 0.0023. PhA and HG/SMM were able to distinguish between hypophagic, non-surgical patients at nutritional risk who satisfied their estimated caloric requirements and those who did not after a one-week personalized nutritional support. Clinical studies are warranted, in order to verify these preliminary observations and to validate the role of Ph

High-intensity fibre laser design for micro-machining applications

Science.gov (United States)

Ortiz-Neria, D. I.; Martinez-Piñón, F.; Hernandez-Escamilla, H.; Alvarez-Chavez, J. A.

2010-11-01

This work is focused on the design of a 250W high-intensity continuous-wave fibre optic laser with a 15μm spot size beam and a beam parameter product (BPP) of 1.8 for its use on Laser-assisted Cold Spray process (LCS) in the micro-machining areas. The metal-powder deposition process LCS, is a novel method based on Cold Spray technique (CS) assisted by laser technology. The LCS accelerates metal powders by the use of a high-pressure gas in order to achieve flash welding of particles over substrate. In LCS, the critical velocity of impact is lower with respect with CS while the powder particle is heated before the deposition by a laser beam. Furthermore, LCS does not heat the powder to achieve high temperatures as it happens in plasma processes. This property puts aside cooling problems which normally happen in sintered processes with high oxygen/nitrogen concentration levels. LCS will be used not only in deposition of thin layers. After careful design, proof of concept, experimental data, and prototype development, it should be feasible to perform micro-machining precise work with the use of the highintensity fibre laser presented in this work, and selective deposition of particles, in a similar way to the well-known Direct Metal Laser Sintering process (DMLS). The fibre laser consists on a large-mode area, Yb3+-doped, semi-diffraction limited, 25-m fibre laser cavity, operating in continuous wave regime. The fibre shows an arguably high slope-efficiency with no signs of roll-over. The measured M2 value is 1.8 and doping concentration of 15000ppm. It was made with a slight modification of the traditional MCVD technique. A full optical characterization will be presented.

Effect of steel fibres on mechanical properties of high-strength concrete

International Nuclear Information System (INIS)

Holschemacher, K.; Mueller, T.; Ribakov, Y.

2010-01-01

Steel fibre reinforced concrete (SFRC) became in the recent decades a very popular and attractive material in structural engineering because of its good mechanical performance. The most important advantages are hindrance of macrocracks' development, delay in microcracks' propagation to macroscopic level and the improved ductility after microcracks' formation. SFRC is also tough and demonstrates high residual strengths after appearing of the first crack. This paper deals with a role of steel fibres having different configuration in combination with steel bar reinforcement. It reports on results of an experimental research program that was focused on the influence of steel fibre types and amounts on flexural tensile strength, fracture behaviour and workability of steel bar reinforced high-strength concrete beams. In the frame of the research different bar reinforcements (2o6 mm and 2o12 mm) and three types of fibres' configurations (two straight with end hooks with different ultimate tensile strength and one corrugated) were used. Three different fibre contents were applied. Experiments show that for all selected fibre contents a more ductile behaviour and higher load levels in the post-cracking range were obtained. The study forms a basis for selection of suitable fibre types and contents for their most efficient combination with regular steel bar reinforcement.

High value co-products from wine by-product's (i): dietary fibre concentrates with antioxidants properties

International Nuclear Information System (INIS)

Gonzalez-Centeno, M. R.; Simal, S.; Eim, V. S.; Castell-Palou, A.; Femenia, A.

2009-01-01

The concept of dietary fibre (DF) is well established and the nutritional benefits (protection against certain types of cancer, regulation of food transit through the digestive system, blood cholesterol lowering) of DF intake are generally accepted. Our DF intake comes primarily form cereal products, fruits and vegetables that are consumed in its traditional presentation. (Author)

Compaction in optical fibres and fibre Bragg gratings under nuclear reactor high neutron and gamma fluence

Energy Technology Data Exchange (ETDEWEB)

Remy, L.; Cheymol, G. [CEA, French Nuclear Energy Commission, Nuclear Energy Division, DPC/SEARS/LISL Bat 467 CEA Saclay 91191 Gif/Yvette Cedex (France); Gusarov, A. [SCK.CEN - Belgian Nuclear Research center, Boeretang 200 2400 Mol (Belgium); Morana, A.; Marin, E.; Girard, S. [Universite de Saint-Etienne, Laboratoire Hubert Curien, UMR CNRS5516, 18, rue du Pr. Lauras, F-42000 Saint-Etienne (France)

2015-07-01

In the framework of the development by CEA and SCK.CEN of a Fabry Perot Sensor (FPS) able to measure dimensional changes in Material Testing Reactor (MTR), the first goal of the SAKE 1 (Smirnof extention - Additional Key-tests on Elongation of glass fibres) irradiation was to measure the linear compaction of single mode fibres under high fast neutron fluence. Indeed, the compaction of the fibre which forms one side of the Fabry Perot cavity, may in particular cause a noticeable measurement error. An accurate quantification of this effect is then required to predict the radiation-induced drift and optimize the sensor design. To achieve this, an innovative approach was used. Approximately seventy uncoated fibre tips (length: 30 to 50 mm) have been prepared from several different fibre samples and were installed in the SCK.CEN BR2 reactor (Mol Belgium). After 22 days of irradiation a total fast (E > 1 MeV) fluence of 3 to 5x10{sup 19} n{sub fast}/cm{sup 2}, depending on the sample location, was accumulated. The temperature during irradiation was 291 deg. C, which is not far from the condition of the intended FPS use. A precise measurement of each fibre tip length was made before the irradiation and compared to the post irradiation measurement highlighting a decrease of the fibres' length corresponding to about 0.25% of linear compaction. The amplitude of the changes is independent of the capsule, which could mean that the compaction effect saturates even at the lowest considered fluence. In the prospect of performing distributed temperature measurement in MTR, several fibre Bragg gratings written using a femtosecond laser have been also irradiated. All the gratings were written in radiation hardened fibres, and underwent an additional treatment with a procedure enhancing their resistance to ionizing radiations. A special mounting made it possible to test the reflection and the transmission of the gratings on fibre samples cut down to 30 to 50 mm. The comparison

What Is Enteral Nutrition?

Science.gov (United States)

... Solution Center NOVEL Project Parenteral Nutrition Resources Intravenous Lipid Emulsions (ILE) Video Series SmartPN Practice and Research Toolkits Publications & ASPEN Journals Journal of Parenteral and ...

A tensile stage for high-stress low-strain fibre studies

DEFF Research Database (Denmark)

Pauw, Brian Richard; Vigild, Martin Etchells; Mortensen, Kell

2011-01-01

Determining the effects of stress on the internal structure of high-performance fibres may provide insight into their structure-property relationships. The deformation of voids inside a poly(p-phenylene terephthalamide) (PPTA) fibre upon application of stress is one such effect which may be obser...

Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury: Effects on Immune Function, Nutritional Status and Outcomes.

Science.gov (United States)

Fan, Mingchao; Wang, Qiaoling; Fang, Wei; Jiang, Yunxia; Li, Liandi; Sun, Peng; Wang, Zhihong

2016-11-20

Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN) with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patients with severe traumatic brain injury (STBI). Methods A prospective randomized control trial was carried out from January 2009 to May 2012 in Neurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow Coma Scale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were admi- nistrated EN, PN or EN+PN treatments respectively. The indexes of nutritional status, immune function, complications and clinical outcomes were examined and compared statistically. Results There were 120 patients enrolled in the study, with 40 pationts in each group. In EN+PN group, T lymthocyte subsets CD3+%, CD4+%, ratio of CD3+/CD25+, ratio of CD4+/CD8+, the plasma levels of IgA, IgM, and IgG at 20 days after nutritional treatment were significantly increased compared to the baseline(t=4.32-30.00, Pnutritional status, the serum total protein, albumin, prealbumin and hemoglobin were significantly higher in the EN (t=5.87-11.91; Pnutrition treatment. The serum prealbumin was higher in EN+PN group than that in EN group (t=2.08; Pnutritional status, decrease complications and improve the clinical outcomes in patients with severe traumatic brain injury.

The establishment of enteral nutrition with minimally-invasive interventional procedure under endoscopic or imaging guidance

International Nuclear Information System (INIS)

Li Feng; Cheng Yingsheng

2010-01-01

For patients unable to get the necessary nutrition orally, a variety of techniques,including surgical way, to make gastrostomy with tube placement have been employed. For recent years, gastrostomy and tube placement with the help of endoscopic guidance or percutaneous interventional management has been developed, which is superior to surgical procedure in minimizing injuries, decreasing cost and reducing complications. In certain clinical situations, both endoscopic method and interventional method can be employed. This paper aims to make a comprehensive review of the indications, techniques and skills, advantages and disadvantages of both the endoscopy-guided and the imaging-guided percutaneous gastrojejunostomy for the establishment of enteral nutrition. (authors)

[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.

Early enteral nutrition in critically ill patients with hemodynamic instability: an evidence-based review and practical advice.

Science.gov (United States)

Yang, Shuofei; Wu, Xingjiang; Yu, Wenkui; Li, Jieshou

2014-02-01

Early enteral nutrition (EEN) in critically ill patients is associated with significant benefit as well as elevated risk of complications. Concomitant use of EEN with vasopressors has been associated with nonocclusive bowel necrosis in critically ill patients with hemodynamic instability. The decision when to initiate enteral nutrition in hemodynamically unstable patients that require vasoactive substances remains a clinical dilemma. This review summarizes the effect of EEN and vasoactive agents on gastrointestinal blood flow and perfusion in critically ill patients, based on current evidence. Animal and clinical data involving simultaneous administration of EEN and vasoactive agents for hemodynamic instability are reviewed, and the factors related to the safety and effectiveness of EEN support in this patient population are analyzed. Moreover, practical recommendations are provided. Additional randomized clinical trials are warranted to provide cutting-edge evidence-based guidance about this issue for practitioners of critical care.

Toward Enteral Nutrition in the Treatment of Pediatric Crohn Disease in Canada: A Workshop to Identify Barriers and Enablers

Directory of Open Access Journals (Sweden)

Johan Van Limbergen

2015-01-01

Full Text Available The treatment armamentarium in pediatric Crohn disease (CD is very similar to adult-onset CD with the notable exception of the use of exclusive enteral nutrition (EEN [the administration of a liquid formula diet while excluding normal diet], which is used more frequently by pediatric gastroenterologists to induce remission. In pediatric CD, EEN is now recommended by the pediatric committee of the European Crohn’s and Colitis Organisation and the European Society for Paediatric Gastroenterology Hepatology and Nutrition as a first-choice agent to induce remission, with remission rates in pediatric studies consistently >75%. To chart and address enablers and barriers of use of EEN in Canada, a workshop was held in September 2014 in Toronto (Ontario, inviting pediatric gastroenterologists, nurses and dietitians from most Canadian pediatric IBD centres as well as international faculty from the United States and Europe with particular research and clinical expertise in the dietary management of pediatric CD. Workshop participants ranked the exclusivity of enteral nutrition; the health care resources; and cost implications as the top three barriers to its use. Conversely, key enablers mentioned included: standardization and sharing of protocols for use of enteral nutrition; ensuring sufficient dietetic resources; and reducing the cost of EEN to the family (including advocacy for reimbursement by provincial ministries of health and private insurance companies. Herein, the authors report on the discussions during this workshop and list strategies to enhance the use of EEN as a treatment option in the treatment of pediatric CD in Canada.

Hospital to home paediatric enteral nutrition--parents need support.

LENUS (Irish Health Repository)

Shortall, C

2015-02-01

This study assessed the provision of education and support to parents of children on home enteral nutrition (HEN), current dietetic support available and perceived challenges facing parents and carers. From the 39 responses (13%), 29 (83%, n = 35) parents suggested services for HEN need improvement. 29 (74%, n = 39) parents wanted more structured follow up and 22 (56%) would like one person to co-ordinate HEN, education and discharge. 7 parents (18%) reported a need for further education of health care professionals (HCP). Hospital dietitians were the most common HCPs reported to provide support to patients following discharge. Specialist paediatric HEN dietetic services working in a dedicated HEN team, who would provide accurate training and education and liaise with both parents and community care services post discharge should be in place. This would facilitate transfer to community care, reduce hospital re-admissions, outpatient department attendances and costs.

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition.

Science.gov (United States)

Mehta, Nilesh M; Skillman, Heather E; Irving, Sharon Y; Coss-Bu, Jorge A; Vermilyea, Sarah; Farrington, Elizabeth Anne; McKeever, Liam; Hall, Amber M; Goday, Praveen S; Braunschweig, Carol

2017-07-01

This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and 2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance. The PubMed/MEDLINE search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search for clinical trials culled 1661 citations. In total, the search for clinical trials yielded 1107 citations, whereas the cohort search yielded 925. After careful review, 16 randomized controlled trials and 37 cohort studies appeared to answer 1 of the 8 preidentified question groups for this guideline. We used the GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluation) to adjust the evidence grade based on assessment of the quality of study design and execution. These guidelines are not intended for neonates or adult patients. The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention. There is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake. Indirect calorimetry, where feasible, and cautious use of estimating equations and increased surveillance for unintended caloric underfeeding and overfeeding are recommended. Optimal protein intake and its correlation with clinical outcomes are areas of great interest. The optimal route and timing of nutrient delivery are areas of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The

Effects of enteral nutritional support on malnourished patients with inflammatory bowel disease by subjective global assessment.

Science.gov (United States)

Sökülmez, Pınar; Demirbağ, Ali Eba; Arslan, Perihan; Dişibeyaz, Selçuk

2014-10-01

To investigate the prevalence of malnutrition in patients with inflammatory bowel disease (IBD) by subjective global assessment (SGA) and the effects of oral nutritional support on the clinical parameters, consumption of energy, macronutrients and fiber intake in the Study and Control groups, prospectively. A total of 38 (28 Male; 10 Female) hospitalized patients with moderate or severe IBD (13 with Crohn's disease (CD); 25 with Ulcerative colitis (UC)) were included. At stage 1, the disease severity, clinical symptoms and, signs, food consumption and nutritional status by using subjective global assessment (SGA) were recorded. At stage 2, the patients were blindly randomized into a Study Group and Controls. In the Study Group, a standard enteral product was added into the regulated hospital diets, but for the Controls, deficits were regulated by only hospital diets for 3 weeks. the independent variables were the group, the disease and its activity, age, Body body mass index (BMI), weight loss history, the hospitalization period; the dependent variables were SGA, bowel movements, change in nutritional status, disease severity, clinical findings, and also consumption of macronutrients. Prevalance of malnutrition (SGA-B or SGA-C) for all the patients was 92.1% at the beginning and 71.1% at the end of study. Improvements in disease activity score for the patients with UC were statistically significant in both the Study Group and the Controls (p=0.006 for the Study Group and p=0.001 for the Controls, respectively). Macronutrients, total and water soluble fiber consumption levels improved, with statistically significant differences for all the groups. The prevalence of malnutrition is a major problem in patients with IBD. Not only the regulation of hospital food, but also enteral nutritional support, improved their levels of malnutrition, as well as their energy, macronutrients, and fiber consumption, and SGA is an easy method for nutritional monitoring.

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.

Current status of parenteral nutrition and enteral nutrition application: an assessment of nutritional prescriptions from 59 hospitals in the People’s Republic of China

Science.gov (United States)

Han, Gang; Yu, Zhenwei; Ma, Ke

2015-01-01

Purpose The aim of the study reported here was to assess the use of parenteral nutrition (PN) and enteral nutrition (EN), and the prevalence of PN and EN formulas, in the People’s Republic of China. Methods Fifty-nine hospitals in the People’s Republic of China participated in a nutrition survey. The resulting information on nutritional support was analyzed. Results We received 379,584 nutritional-support prescriptions over 40 days in 2013. PN provided approximately 63.2% and EN provided approximately 36.8% of nitrogen intake. PN provided 63.5% and EN provided 36.5% of lipid intake. There were obvious differences in nitrogen and lipid intake between PN and EN in different regions, departments, and diseases. The percentage of nourishment provided by PN in different regions was highest in Chengdu, followed by the Beijing, Guangzhou, and Hangzhou areas. The percentage of nourishment provided by PN in different departments was highest in general surgery, followed by gastroenterology and the intensive care unit. The percentage of nourishment provided by PN in different diseases/conditions was highest in acute pancreatitis, followed by cancer, and burns. The main source of nitrogen in PN was balanced amino-acid preparations, and in EN, it was protein. The main source of lipids in PN was long- and medium-chain triglyceride lipid emulsion injection. Conclusion Despite recent improvements in the application of nutritional support in the People’s Republic of China, a much higher percentage of nitrogen and lipids is delivered through PN than through EN. Furthermore, there are marked regional, departmental, and disease-based differences in the selection of PN versus EN. The rationale for use of nutritional support needs to be improved. PMID:25709462

Effects of preoperative and postoperative enteral nutrition on postoperative nutritional status and immune function of gastric cancer patients.

Science.gov (United States)

Ding, Dayong; Feng, Ye; Song, Bin; Gao, Shuohui; Zhao, Jisheng

2015-03-01

Effects of preoperative one week enteral nutrition (EN) support on the postoperative nutritional status, immune function and inflammatory response of gastric cancer patients were investigated. 106 cases of gastric cancer patients were randomly divided into preoperative one week EN group (trial group) and early postoperative EN group (control group), which were continuously treated with EN support until the postoperative 9th day according to different treatment protocols. All the patients were checked for their body weight, skinfold thickness, upper arm circumference, white blood cell count (WBC), albumin (ALB), prealbumin (PA), C-reactive protein (CRP), humoral immunity (IgA, IgG), T cell subsets (CD4, CD8 and CD4/CD8), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), etc. on the preoperative and the postoperative 1st and 10th day, respectively. PA and IgG levels of the experimental group were higher than those of the control group on the postoperative 10th day, whereas IL-6 level of the experimental group was lower than that of the control group. EN support for preoperative gastric cancer patients will improve the postoperative nutritional status and immune function, alleviate inflammatory response, and facilitate the recovery of patients.

Fibre optic connectors with high-return-loss performance

Science.gov (United States)

Knott, Michael P.; Johnson, R.; Cooke, K.; Longhurst, P. C.

1990-09-01

This paper describes the development of a single mode fibre optic connector with high return loss performance without the use of index matching. Partial reflection of incident light at a fibre optic connector interface is a recognised problem where the result can be increased noise and waveform distortion. This is particularly important for video transmission in subscriber networks which requires a high signal to noise ratio. A number of methods can be used to improve the return loss. The method described here uses a process which angles the connector endfaces. Measurements show typical return losses of -55dB can be achieved for an end angle of 6 degrees. Insertion loss results are also presented.

High strength oil palm shell concrete beams reinforced with steel fibres

Directory of Open Access Journals (Sweden)

S. Poh-Yap

2017-10-01

Full Text Available The utilization of lightweight oil palm shell to produce high strength lightweight sustainable material has led many researchers towards its commercialization as structural concrete. However, the low tensile strength of Oil Palm Shell Concrete (OPSC has hindered its development. This study aims to enhance the mechanical properties and flexural behaviours of OPSC by the addition of steel fibres of up to 3% by volume, to produce oil palm shell fibre-reinforced concrete (OPSFRC. The experimental results showed that the steel fibres significantly enhanced the mechanical properties of OPSFRC. The highest compressive strength, splitting tensile and flexural strengths of 55, 11.0 and 18.5 MPa, respectively, were achieved in the OPSFRC mix reinforced with 3% steel fibres. In addition, the flexural beam testing on OPSFRC beams with 3% steel fibres showed that the steel fibre reinforcement up to 3% produced notable increments in the moment capacity and crack resistance of OPSFRC beams, but accompanied by reduction in the ductility.

Preparation of dietary fibre-enriched materials from preharvest dropped apples and their utilisation as a high-fibre flour substitute.

Science.gov (United States)

Kim, Yujeong; Kim, Yongwook; Bae, In Young; Lee, Hyeon Gyu; Lee, Suyong

2013-06-01

Preharvest dropped apples from a weather disaster are generally discarded or used in animal feed due to reduced market value. In this study, they were utilised to produce dietary fibre-enriched materials (DFEMs) and their baking performance in a food system was then evaluated as a high-fibre and low-calorie flour substitute. Hydrothermal treatment and fractionation of preharvest dropped apple powder produced fibre-rich fractions (856.2 g kg(-1)). The use of DFEMs increased the pasting properties of wheat flour and improved dough mixing stability. When DFEMs were incorporated in the cookie formulation (2, 4 and 6 g dietary fibre per serving), the cookie dough exhibited increased elongational viscosity and solid-like behaviour which became more pronounced with increasing levels of DEFMs. After baking, reduced spread was observed in DFEM cookies which could be readily attributed to their rheological characteristics. However, greater moisture retention by DFEMs produced cookie samples with softer texture. DFEMs prepared from preharvest dropped apples could be successfully evaluated in a cookie model system as a high-fibre and low-calorie substitute for wheat flour. This study suggests a new value-added application of preharvest dropped fruits, positively extending their use for better healthful diets. © 2012 Society of Chemical Industry.

High power operation of cladding pumped holmium-doped silica fibre lasers.

Science.gov (United States)

Hemming, Alexander; Bennetts, Shayne; Simakov, Nikita; Davidson, Alan; Haub, John; Carter, Adrian

2013-02-25

We report the highest power operation of a resonantly cladding-pumped, holmium-doped silica fibre laser. The cladding pumped all-glass fibre utilises a fluorine doped glass layer to provide low loss cladding guidance of the 1.95 µm pump radiation. The operation of both single mode and large-mode area fibre lasers was demonstrated, with up to 140 W of output power achieved. A slope efficiency of 59% versus launched pump power was demonstrated. The free running emission was measured to be 2.12-2.15 µm demonstrating the potential of this architecture to address the long wavelength operation of silica based fibre lasers with high efficiency.

Validity and Reproducibility of a Habitual Dietary Fibre Intake Short Food Frequency Questionnaire.

Science.gov (United States)

Healey, Genelle; Brough, Louise; Murphy, Rinki; Hedderley, Duncan; Butts, Chrissie; Coad, Jane

2016-09-10

Low dietary fibre intake has been associated with poorer health outcomes, therefore having the ability to be able to quickly assess an individual's dietary fibre intake would prove useful in clinical practice and for research purposes. Current dietary assessment methods such as food records and food frequency questionnaires are time-consuming and burdensome, and there are presently no published short dietary fibre intake questionnaires that can quantify an individual's total habitual dietary fibre intake and classify individuals as low, moderate or high habitual dietary fibre consumers. Therefore, we aimed to develop and validate a habitual dietary fibre intake short food frequency questionnaire (DFI-FFQ) which can quickly and accurately classify individuals based on their habitual dietary fibre intake. In this study the DFI-FFQ was validated against the Monash University comprehensive nutrition assessment questionnaire (CNAQ). Fifty-two healthy, normal weight male (n = 17) and female (n = 35) participants, aged between 21 and 61 years, completed the DFI-FFQ twice and the CNAQ once. All eligible participants completed the study, however the data from 46% of the participants were excluded from analysis secondary to misreporting. The DFI-FFQ cannot accurately quantify total habitual dietary fibre intakes, however, it is a quick, valid and reproducible tool in classifying individuals based on their habitual dietary fibre intakes.

Estudo de fibras alimentares em frutas e hortaliças para uso em nutrição enteral ou oral Study of dietary fibre in fruits and vegetables for use in oral or enteral diets

Directory of Open Access Journals (Sweden)

Edma Maria de Araújo

2010-03-01

Full Text Available Dietas enterais com alimentos convencionais são usadas em nutrição domiciliar para fornecer macronutrientes, obter dietas individualizadas e de menor custo. O objetivo deste trabalho foi estudar frutas e hortaliças (alface, berinjela, cenoura, chicória, goiaba e tamarindo como fontes de fibras alimentares solúveis e insolúveis para serem usadas em nutrição enteral ou suplemento nutricional oral. As hortaliças e frutas foram adicionadas a uma formulação enteral domiciliar e também preparadas em solução com água. Foram determinadas a composição centesimal, as fibras solúveis e insolúveis dos alimentos, a atividade de água e o pH das formulações. Foram realizados testes de gotejamento das formulações com os alimentos experimentais. A melhor proporção de alimento/dieta enteral domiciliar foi de 100 g/2 L para dieta enteral e de 150 g/2 L para suplemento nutricional oral (ingestão por boca. As quantidades de cada alimento adicionadas à formulação enteral equivalem a duas porções (100 g diárias de cada alimento para 2 L e 2000 kcal. A maior contribuição para aumentar a quantidade de fibras foi da goiaba e a menor, da berinjela. Os valores de atividade de água ficaram entre 0,95 e 1,00, indicando que as dietas são susceptíveis à contaminação microbiana. Nessas condições, devem ser consumidas imediatamente após o preparo.Enteral diets based on conventional foods are used in domestic nutritional therapy to provide macronutrients, obtain individualised diets and to lower costs. Eggplant, carrot, chicory, lettuce, guava and tamarind were studied as sources of soluble and insoluble fibers for use in enteral diets or as oral nutritional supplements, added to a domestic enteral formulation and also prepared in aqueous solution. The following physical-chemical characteristics were determined: soluble and insoluble fibers, proximate composition, pH and water activity. Drip tests were carried out with the formulas

High-spatial-multiplicity multi-core fibres for future dense space-division-multiplexing system

DEFF Research Database (Denmark)

Matsuo, Shoichiro; Takenaga, Katsuhiro; Saitoh, Kunimasa

2015-01-01

Design and fabrication results of high-spatial-multiplicity multi-core fibres are presented. A 30-core single-mode multi-core fibre and a 36-spatial-channels multi-core fibre with low differential mode delay have been realized with low-crosstalk characteristics through optimisation of core struct...

Fibre-Related Dietary Patterns: Socioeconomic Barriers to Adequate Fibre Intake in Polish Adolescents. A Short Report.

Science.gov (United States)

Krusinska, Beata; Kowalkowska, Joanna; Wadolowska, Lidia; Wuenstel, Justyna Weronika; Slowinska, Malgorzata Anna; Niedzwiedzka, Ewa

2017-06-10

There is no complete explanation for the association between socioeconomic status (SES), fibre, and whole diet described by dietary patterns. The aim of this short report was to increase the understanding of adolescent dietary patterns related to fibre in their social context. A cross-sectional study was conducted involving 1176 adolescents aged 13-18 years from central and north-eastern Poland. The overall SES was composed of five single factors: place of residence, self-declared economic situation of family, self-declared economic situation of household, paternal and maternal education. The consumption frequency of nine dietary fibre sources was collected using Block's questionnaire and was expressed in points. Fibre dietary patterns (DPs) were drawn by cluster analysis and odds ratios (ORs) adjusted for age, sex, and BMI were calculated. Three fibre-related DPs were identified: "High-fibre" (mean frequency of total fibre intake 22.7 points; range: 0-36), "Average-fibre" (17.7 points), "Low-fibre" (14.6 points). The "High-fibre" DP was characterized by a relatively higher frequency consumption of white bread, fruit, fruit or vegetable juices, potatoes, green salad and prepared vegetables, and a moderate frequency consumption of high-fibre or bran cereals and wholegrain bread compared to the "Low-fibre" DP. The "Average-fibre" DP was characterized by a relatively higher frequency consumption of wholegrain bread and high-fibre or bran cereals and a moderate frequency consumption of fruit, fruit or vegetable juices, green salad and prepared vegetables compared to the "Low-fibre" DP. Less likely to adhere to the "High-fibre" DP were adolescents with low SES (OR: 0.55, 95% CI: 0.39-0.77) or average SES (0.58, 95% CI: 0.41-0.81) in comparison with high SES (reference) as a result of elementary or secondary paternal or maternal education, rural residence, and lower household economic situation. Similar associations were found for the "Average-fibre" DP. Low and average

A novel protein mixture containing vegetable proteins renders enteral nutrition products non-coagulating after in vitro gastric digestion

NARCIS (Netherlands)

Braak, van den C.C.M.; Klebach, M.; Abrahamse, E.; Minor, M.; Knol, J.; Hofman, Z.; Ludwig, T.

2013-01-01

Background & aims: Non-coagulation of protein from enteral nutrition (EN) in the stomach is considered to improve gastric emptying and may result in reduced upper gastrointestinal complications such as reflux and aspiration pneumonia. For the development of a new EN protein mixture with reduced

Limited effects of preterm birth and the first enteral nutrition on cerebellum morphology and gene expression in piglets

DEFF Research Database (Denmark)

Bergström, Anders; Kaalund, Sanne S.; Skovgaard, Kerstin

2016-01-01

three ages but the proportion of white matter increased postnatally, relative to term pigs. Early initiation of enteral nutrition had limited structural or molecular effects. The Sonic Hedgehog pathway was unaffected by preterm birth. Few differences in expression of the selected genes were found...

Early enteral nutrition and total parenteral nutrition on the nutritional status and blood glucose in patients with gastric cancer complicated with diabetes mellitus after radical gastrectomy.

Science.gov (United States)

Wang, Junli; Zhao, Jiamin; Zhang, Yanling; Liu, Chong

2018-07-01

Effects of early enteral nutrition (EEN) or total parenteral nutrition (TPN) support on nutritional status and blood glucose in patients with gastric cancer complicated with diabetes mellitus after radical gastrectomy were investigated. One hundred and twenty-nine patients with gastric cancer complicated with diabetes mellitus type 2 admitted to the First People's Hospital of Jinan (Jinan, China), from June 2012 to June 2016 were selected into the study. According to different nutrition support pathways, these patients were randomly divided into the EEN group and the TPN group. The improvement of nutritional indexes, postoperative complications, gastrointestinal function recovery and perioperative blood glucose fluctuation were compared between the two groups. On the 4th day after operation, the improvement levels of total bilirubin (TBL), alanine aminotransferase (ALT), aspartate transaminase (AST), total protein (TP), prealbumin (PAB), hemoglobin (HGB) and weight (Wt) in the EEN group were significantly higher than those in the conventional group (P0.05). No patients had complications in the EEN group, while a total of 29 patients in the TPN group suffered adverse reactions, indicating that the incidence rate of complications in the EEN group was significantly lower than that in the TPN group (Pnutrition for patients with gastric cancer complicated with diabetes mellitus after radical gastrectomy, which is worthy of clinical promotion as it maintains good nutritional status, produces few postoperative complications and keeps the blood glucose level stable, by which the postoperative evacuation time is early, the hospitalization time is short and the cost is low.

Nutritive utilization of protein and digestive utilization of fat in two commercial diets designed for clinical enteral nutrition.

Science.gov (United States)

Alférez, M J; Campos, M S; Barrionuevo, M; López-Aliaga, I

1990-01-01

The digestive and metabolic utilization of protein (50% lactoalbumin + 50% casein) and fat (43.0% butter, 29.5% olive oil, 14.7% soy oil, 9.8% MCT and 3.0% lecithin) provided by two commercial diets used in clinical enteral nutrition (normoproteic, 16.1% protein and 20.8% fat, and hyperproteic, 23.1% protein and 14.9% fat), was studied in adult rats (mean body weight 180 g). The diet containing the greater amount of protein improved the digestive utilization of nitrogen, and although nitrogen retention was optimal, it failed to rise further when the dietary protein supply was increased. The digestive utilization of fat in both diets was excellent.

Neutromat-Pfrimmer, a new transporting system for the enteral nutrition therapy of tumor patients before, during and after radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Thiel, H J

1982-03-01

Tumor patients generally suffer from malnutrition which is still aggravated by radiotherapy and its side effects. Therefore the accompanying alimentary guidance and treatment are very important factor. A plan comprising several degrees from dietary guidance, forced oral and enteral nutrition to intravenous hyperalimentation has proved to be practicable. For the ambulatory radiotherapy of our ORL-patients, we have recently been applying a Nutromat-Pfrimmer, a promoter system operating according to the Bakey pump system and serving for continuous or discontinuous enteral nutrition therapy with formula or elementary diets. The authors describe principle and function of the device and present their first experiences. By using early and consequently this device for our irradiated patients, we hope to prevent or heal malnutrition, ameliorate the tolerance of tumor therapy, reduce the incidence of complications, re-establish the immunocompetence, and improve the life quality of the patients.

High value co-products from wine by-product's (i): dietary fibre concentrates with antioxidants properties

Energy Technology Data Exchange (ETDEWEB)

Gonzalez-Centeno, M. R.; Simal, S.; Eim, V. S.; Castell-Palou, A.; Femenia, A.

2009-07-01

The concept of dietary fibre (DF) is well established and the nutritional benefits (protection against certain types of cancer, regulation of food transit through the digestive system, blood cholesterol lowering) of DF intake are generally accepted. Our DF intake comes primarily form cereal products, fruits and vegetables that are consumed in its traditional presentation. (Author)

A systematic review of high-fibre dietary therapy in diverticular disease

NARCIS (Netherlands)

Ünlü, Cagdas; Daniels, Lidewine; Vrouenraets, Bart C.; Boermeester, Marja A.

2012-01-01

The exact pathogenesis of diverticular disease of the sigmoid colon is not well established. However, the hypothesis that a low-fibre diet may result in diverticulosis and a high-fibre diet will prevent symptoms or complications of diverticular disease is widely accepted. The aim of this review is

Environment-friendly wood fibre composite with high bonding strength and water resistance

Science.gov (United States)

Ji, Xiaodi; Dong, Yue; Nguyen, Tat Thang; Chen, Xueqi; Guo, Minghui

2018-04-01

With the growing depletion of wood-based materials and concerns over emissions of formaldehyde from traditional wood fibre composites, there is a desire for environment-friendly binders. Herein, we report a green wood fibre composite with specific bonding strength and water resistance that is superior to a commercial system by using wood fibres and chitosan-based adhesives. When the mass ratio of solid content in the adhesive and absolute dry wood fibres was 3%, the bonding strength and water resistance of the wood fibre composite reached the optimal level, which was significantly improved over that of wood fibre composites without adhesive and completely met the requirements of the Chinese national standard GB/T 11718-2009. Fourier transform infrared (FTIR), X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD) characterizations revealed that the excellent performance of the binder might partly be due to the amide linkages and hydrogen bonding between wood fibres and the chitosan-based adhesive. We believe that this strategy could open new insights into the design of environment-friendly wood fibre composites with high bonding strength and water resistance for multifunctional applications.

The frequency, risk factors, and complications of gastrointestinal dysfunction during enteral nutrition in critically ill patients

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Atasever AG

2018-02-01

also showed that GI dysfunction was associated with high SOFA score, hypo-albuminemia, catecholamine use, and prolonged length of stay (LOS. GI dysfunction, on the other hand, can cause some complications including inadequate nutrition, and newly developed decubitus ulcers. Conclusion: GI dysfunction should be considered a clinical predictor of inadequate nutrition and prolonged LOS. In addition, the most dramatic risk for GI dysfunction was observed in patients with MDR bacteria growth in the culture and patients in negative fluid balance. Intensivists provide appropriate nutrition for patients, as well as prompt intervention and the development of treatment strategies in the event of GI dysfunction. Keywords: intensive care units, enteral nutrition, water–electrolyte balance, drug resistance, multiple, bacterial, gastrointestinal motility, length of stay

Properties of hemp fibre polymer composites - An optimisation of fibre properties using novel defibration methods and fibre characterisation

DEFF Research Database (Denmark)

Thygesen, Anders

2006-01-01

Characterization of hemp fibres was carried out with fibres obtained with low handling damage and defibration damage to get an indication of how strong cellulose based fibres that can be produced from hemp. Comparison was made with hemp yarn producedunder traditional conditions where damage...... obtained by steam explosion of hemp fibres prior defibrated with pectin degrading enzymes. The S2 layer in the fibre wall of the hemp fibres consisted of1-4 cellulose rich and lignin poor concentric layers constructed of ca. 100 nm thick lamellae. The microfibril angle showed values in the range 0......-10° for the main part of the S2-layer and 70-90° for the S1-layer. The microfibrils that are mainly parallelwith the fibre axis explain the high fibre stiffness, which in defibrated hemp fibres reached 94 GPa. The defibrated hemp fibres had higher fibre stiffness (88-94 GPa) than hemp yarn (60 GPa), which...

Impact of Early Enteral Nutrition on Nutritional and Immunological Outcomes of Gastric Cancer Patients Undergoing Gastrostomy: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Nikniaz, Zeinab; Somi, Mohammad Hossein; Nagashi, Shahnaz; Nikniaz, Leila

2017-07-01

The present systematic review and meta-analysis study evaluated the impact of early enteral nutrition (EN) on postoperative nutritional and immunological outcomes of gastric cancer (GC) patients. The databases of PubMed, Embase, Springer, and Cochrane library were searched till September 2016 to identify studies which evaluated the effects of EN compared with parenteral nutrition (PN) on postoperative immunological and nutritional status and hospitalization time in GC patients. Mean difference (MD) or standard mean difference (SMD) was calculated and I-square statistic test was used for heterogeneity analysis. The present systematic review and meta-analysis have consisted of seven trials, containing 835 GC patients. According to the result of meta-analysis, compared with PN, EN significantly resulted in more increase in the level of albumin [MD = 2.07 (0.49, 3.64)], prealbumin [MD = 9.41 (049, 33.55)], weight [MD = 1.52 (0.32, 2.72)], CD3+ [SMD = 1.96 (1.50, 2.43)], CD4+ [SMD = 2.45 (1.97, 2.93)], natural killers [MD = 5.80 (3.75, 7.85)], and also a decrease in the hospitalization time [MD=-2.39 (-2.74, -2.03)]. The results demonstrated that early administration of EN is more effective in improving postsurgical nutrition status and immune index in GC patients. So, based on these results, postoperative early administration of EN is recommended for GC patients where possible.

Additional oligofructose/inulin does not increase faecal bifidobacteria in critically ill patients receiving enteral nutrition: a randomised controlled trial.

Science.gov (United States)

Majid, Hazreen A; Cole, Jayne; Emery, Peter W; Whelan, Kevin

2014-12-01

Patients with diarrhoea during enteral nutrition (EN) have been shown to have low faecal bifidobacteria concentrations. Oligofructose/inulin selectively stimulate the growth of bifidobacteria in healthy humans. This study investigates the effect of additional oligofructose/inulin on the gastrointestinal microbiota, short-chain fatty acids (SCFA) and faecal output in patients receiving EN. Adult patients in the intensive care unit (ICU) who were starting EN with a formula containing fibre were randomised to receive 7 g/d of additional oligofructose/inulin or an identically packaged placebo (maltodextrin). A fresh faecal sample was collected at baseline and following at least 7 days of supplementation. Faecal microbiota were analysed using fluorescent in-situ hybridisation and faecal output was monitored daily. Twenty-two patients (mean age 71 years) completed at least 7 days of intervention (mean 12 days). At the end of the intervention, there were no significant differences in the concentrations of bifidobacteria between the groups, after adjusting for baseline values (oligofructose/inulin 6.9 + 1.4, placebo 7.8 + 1.3 log10 cells/g dry faeces, P > 0.05), but there were significantly lower concentrations of Faecalibacterium prausnitzii (7.0 + 1.0 vs. 8.4 + 1.3 log10 cells/g, P = 0.01) and Bacteroides-Prevotella (9.1 + 1.0 vs. 9.9 + 0.9 log10 cells/g, P = 0.05) in patients receiving additional oligofructose/inulin. There were no differences in faecal concentrations of any SCFA, secretory IgA, daily faecal score or incidence of diarrhoea between the two groups. Additional oligofructose/inulin did not increase faecal bifidobacteria in critically ill patients receiving EN, although it did result in lower concentrations of F. prausnitzii and Bacteroides-Prevotella. This trial is registered at http://controlled-trials.com. Identifier: ISRCTN06446184. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All

Ketogenic enteral nutrition as a treatment for obesity: short term and long term results from 19,000 patients

Directory of Open Access Journals (Sweden)

Cappello Gianfranco

2012-10-01

Full Text Available Abstract Background Only protein diet has been used successfully to prevent loss of lean body mass first in post-surgical and then in obese patients. We studied overweight and obese patients receiving short treatments of an exclusively protein-based nutritional solution as 24-hour enteral infusion. Methods 19,036 patients (age 44.3 ± 13, M:F = 2:5 with an initial body mass index of 36.5 ± 7.1 underwent 10-day cycles of enteral nutrition through a fine nasogastric tube. The nutritional solution consisted solely of 50–65 g of proteins, plus vitamins and electrolytes. The 24-hour infusion was controlled with a small portable pump. Before and after each 10-day cycle body composition was checked with a Handy 3000 impedance analyzer. At the onset of treatment, average fat mass was 40.9 ± 12.8 kg while body cell mass was 42.7 ± 7.2 kg in males and 27.4 ± 4.6 kg in females. Results After an average of 2.5 cycles the patients lost 10.2 ± 7.0 kg of body weight, 5.8 ± 5.5 kg of fat mass and 2.2 ± 3.3 kg of body cell mass. No significant adverse effects were recorded except asthenia and constipation which were easily controlled with therapy. Long-term results were obtained from 15,444 patients and after an average of 362 ± 296 days we found a mean weight regain of 15.4%. Conclusion Ketogenic Enteral Nutrition treatment of over 19,000 patients induced a rapid 10% weight loss, 57% of which was Fat Mass. No significant adverse effects were found. The treatment is safe, fast, inexpensive and has good one-year results for weight maintenance.

The MICE scintillating-fibre tracker

Energy Technology Data Exchange (ETDEWEB)

Matsushita, T [Imperial College London (United Kingdom)], E-mail: T.Matsushita@imperial.ac.uk

2008-06-15

The international Muon Ionization Cooling Experiment (MICE) collaboration will carry out a systematic investigation of the ionization cooling of a muon beam. An ionization cooling channel is required to compress the phase-space volume occupied by the muon beam prior to acceleration in the baseline conceptual designs for both the Neutrino Factory and the Muon Collider. Muons entering and leaving the cooling channel will be measured in two solenoidal spectrometers, each of which is instrumented with a scintillating-fibre tracker. Each tracker is composed of five planar scintillating fibre stations, each station being composed of three planar layers of 350 micron scintillating fibres. The devices will be read out using the Visible Light Photon Counters (VLPCs) developed for use in the D0 experiment at the Tevatron. The design of the system will be presented along with the status of the tracker-construction project. The expected performance of prototypes of the full tracker will be summarised.

Pediatric parenteral nutrition: clinical practice guidelines from the Spanish Society of Parenteral and Enteral Nutrition (SENPE), the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) and the Spanish Society of Hospital Pharmacy (SEFH)

Science.gov (United States)

Pedrón Giner, Consuelo; Cuervas-Mons Vendrell, Margarita; Galera Martínez, Rafael; Gómez López, Lilianne; Gomis Muñoz, Pilar; Irastorza Terradillos, Iñaki; Martínez Costa, Cecilia; Moreno Villares, José Manuel; Pérez-Portabella Maristany, Cleofé; Pozas Del Río, M ª Teresa; Redecillas Ferreiro, Susana E; Prieto Bozano, Gerardo; Grupo de Estandarización de la Senpe, Senpe

2017-06-05

Introduction:Parenteral nutrition (PN) in childhood is a treatment whose characteristics are highly variable depending on the age and pathology of the patient. Material and methods: The Standardization and Protocols Group of the Spanish Society for Parenteral and Enteral Nutrition (SENPE) is an interdisciplinary group formed by members of the SENPE, the Spanish Society of Gastroenterology, Hepatology and Pediatric Nutrition (SEGHNP) and the Spanish Society of Hospital Pharmacy (SEFH) that intends to update this issue. For this, a detailed review of the literature has been carried out, looking for the evidences that allow us to elaborate a Clinical Practice Guide following the criteria of the Oxford Center for Evidence-Based Medicine. Results: This manuscript summarizes the recommendations regarding indications, access routes, requirements, modifi cations in special situations, components of the mixtures, prescription and standardization, preparation, administration, monitoring, complications and home NP. The complete document is published as a monographic number. Conclusions: This guide is intended to support the prescription of pediatric PN. It provides the basis for rational decisions in the context of the existing evidence. No guidelines can take into account all of the often compelling individual clinical circumstances.

Neutromat-Pfrimmer, a new transporting system for the enteral nutrition therapy of tumor patients before, during and after radiotherapy

International Nuclear Information System (INIS)

Thiel, H.J.

1982-01-01

Tumor patients generally suffer from malnutrition which is still aggravated by radiotherapy and its side effects. Therefore the accompanying alimentary guidance and treatment are very important factor. A plan comprising several degrees from dietary guidance, forced oral and enteral nutrition to intravenous hyperalimentation has proved to be practicable. For the ambulatory radiotherapy of our ORL-patients, we have recently been applying a Nutromat-Pfrimmer, a promoter system operating according to the Bakey pump system and serving for continuous or discontinuous enteral nutrition therapy with formula or elementary diets. The authors describe principle and function of the device and present their first experiences. By using early and consequently this device for our irradiated patients, we hope to prevent or heal malnutrition, ameliorate the tolerance of tumor therapy, reduce the incidence of complications, re-establish the immunocompetence, and improve the life quality of the patients. (orig.) [de

A validation of the fibre orientation and fibre length attrition prediction for long fibre-reinforced thermoplastics

Science.gov (United States)

Hopmann, Ch.; Weber, M.; van Haag, J.; Schöngart, M.

2015-05-01

To improve the mechanical performance of polymeric parts, fibre reinforcement has established in industrial applications during the last decades. Next to the widely used Short Fibre-reinforced Thermoplastics (SFT) the use of Long Fibre-reinforced Thermoplastics (LFT) is increasingly growing. Especially for non-polar polymeric matrices like polypropylene (PP), longer fibres can significantly improve the mechanical performance. As with every kind of discontinuous fibre reinforcement the fibre orientations (FO) show a high impact on the mechanical properties. On the contrary to SFT where the local fibre length distribution (FLD) can be often neglected, for LFT the FLD show a high impact on the material's properties and has to be taken into account in equal measure to the FOD. Recently numerical models are available in commercial filling simulation software and allow predicting both the local FOD and FLD in LFT parts. The aim of this paper is to compare i.) the FOD results and ii) the FLD results from available orientation- and fibre length attrition-models to those obtained from experimental data. The investigations are conducted by the use of different injection moulded specimens made from long glass fibre reinforced PP. In order to determine the FOD, selected part sections are examined by means of Computed Tomographic (CT) analyses. The fully three dimensional measurement of the FOD is then performed by digital image processing using grey scale correlation. The FLD results are also obtained by using digital image processing after a thermal pyrolytic separation of the polymeric matrix from the fibres. Further the FOD and the FLD are predicted by using a reduced strain closure (RSC) as well as an anisotropic rotary diffusion - reduced strain closure model (ARD-RSC) and Phelps-Tucker fibre length attrition model implemented in the commercial filling software Moldflow, Autodesk Inc., San Rafael, CA, USA.

A validation of the fibre orientation and fibre length attrition prediction for long fibre-reinforced thermoplastics

International Nuclear Information System (INIS)

Hopmann, Ch.; Weber, M.; Haag, J. van; Schöngart, M.

2015-01-01

To improve the mechanical performance of polymeric parts, fibre reinforcement has established in industrial applications during the last decades. Next to the widely used Short Fibre-reinforced Thermoplastics (SFT) the use of Long Fibre-reinforced Thermoplastics (LFT) is increasingly growing. Especially for non-polar polymeric matrices like polypropylene (PP), longer fibres can significantly improve the mechanical performance. As with every kind of discontinuous fibre reinforcement the fibre orientations (FO) show a high impact on the mechanical properties. On the contrary to SFT where the local fibre length distribution (FLD) can be often neglected, for LFT the FLD show a high impact on the material’s properties and has to be taken into account in equal measure to the FOD. Recently numerical models are available in commercial filling simulation software and allow predicting both the local FOD and FLD in LFT parts. The aim of this paper is to compare i.) the FOD results and ii) the FLD results from available orientation- and fibre length attrition-models to those obtained from experimental data. The investigations are conducted by the use of different injection moulded specimens made from long glass fibre reinforced PP. In order to determine the FOD, selected part sections are examined by means of Computed Tomographic (CT) analyses. The fully three dimensional measurement of the FOD is then performed by digital image processing using grey scale correlation. The FLD results are also obtained by using digital image processing after a thermal pyrolytic separation of the polymeric matrix from the fibres. Further the FOD and the FLD are predicted by using a reduced strain closure (RSC) as well as an anisotropic rotary diffusion - reduced strain closure model (ARD-RSC) and Phelps-Tucker fibre length attrition model implemented in the commercial filling software Moldflow, Autodesk Inc., San Rafael, CA, USA

A validation of the fibre orientation and fibre length attrition prediction for long fibre-reinforced thermoplastics

Energy Technology Data Exchange (ETDEWEB)

Hopmann, Ch.; Weber, M.; Haag, J. van; Schöngart, M. [Institute of Plastics Processing (IKV) at RWTH Aachen University, Pontstr. 49, 52062 Aachen (Germany)

2015-05-22

To improve the mechanical performance of polymeric parts, fibre reinforcement has established in industrial applications during the last decades. Next to the widely used Short Fibre-reinforced Thermoplastics (SFT) the use of Long Fibre-reinforced Thermoplastics (LFT) is increasingly growing. Especially for non-polar polymeric matrices like polypropylene (PP), longer fibres can significantly improve the mechanical performance. As with every kind of discontinuous fibre reinforcement the fibre orientations (FO) show a high impact on the mechanical properties. On the contrary to SFT where the local fibre length distribution (FLD) can be often neglected, for LFT the FLD show a high impact on the material’s properties and has to be taken into account in equal measure to the FOD. Recently numerical models are available in commercial filling simulation software and allow predicting both the local FOD and FLD in LFT parts. The aim of this paper is to compare i.) the FOD results and ii) the FLD results from available orientation- and fibre length attrition-models to those obtained from experimental data. The investigations are conducted by the use of different injection moulded specimens made from long glass fibre reinforced PP. In order to determine the FOD, selected part sections are examined by means of Computed Tomographic (CT) analyses. The fully three dimensional measurement of the FOD is then performed by digital image processing using grey scale correlation. The FLD results are also obtained by using digital image processing after a thermal pyrolytic separation of the polymeric matrix from the fibres. Further the FOD and the FLD are predicted by using a reduced strain closure (RSC) as well as an anisotropic rotary diffusion - reduced strain closure model (ARD-RSC) and Phelps-Tucker fibre length attrition model implemented in the commercial filling software Moldflow, Autodesk Inc., San Rafael, CA, USA.

Enteral Nutrition in the Management of Pediatric and Adult Crohn’s Disease

Directory of Open Access Journals (Sweden)

Tawnya Hansen

2018-04-01

Full Text Available Genetic and environmental factors are thought to profoundly influence the pathophysiology of Crohn’s disease (CD. Changes in dietary and hygiene patterns affect the interactions between the immune system and environment. The gut microbiome is responsible for mediating host immune response with significant dysbiosis observed in individuals with CD. Diet therapy using exclusive enteral nutrition (EEN has been studied as primary therapy for the management of CD. EEN may cultivate the presence of beneficial microbiota, improve bile acid metabolism, and decrease the number of dietary microparticles possibly influencing disease and immune activity. In this review, we will address the current evidence on EEN in the management of adult and pediatric CD. In adults, EEN appears to be moderately beneficial for the induction of remission of CD; however, its use is understudied and underutilized. Stronger evidence is in place to support the use of EEN in pediatric CD with the added benefit of nutrition support and steroid-sparing therapy during the growth phase. Overall, EEN is an established therapy in inducing CD remission in the pediatric population while its role as primary therapy of adult Crohn’s disease remains to be defined.

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

OpenAIRE

Portanova Michel

2010-01-01

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 to...

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.

Enteral immunonutrition versus enteral nutrition for gastric cancer patients undergoing a total gastrectomy: a systematic review and meta-analysis.

Science.gov (United States)

Cheng, Ying; Zhang, Junfeng; Zhang, Liwei; Wu, Juan; Zhan, Zhen

2018-01-16

Nutrition support is a common means for patients with gastric cancer, especially for those undergoing elective surgery. Recently, enteral immunonutrition (EIN) was increasingly found to be more effective than enteral nutrition (EN) in enhancing the host immunity and eventually improving the prognosis of gastric cancer patients undergoing gastrectomy. However, the results reported were not consistent. This meta-analysis aimed to assess the impact of EIN for patients with GC on biochemical, immune indices and clinical outcomes. Four electronical databases (Medline, EMBASE, Scopus and Cochrane library) were used to search articles in peer-reviewed, English-language journals. Mean difference (MD), Relative risk (RR), or standard mean difference (SMD) with 95% confidence interval (CI) were calculated. Heterogeneity was assessed by Cochrane Q and I 2 statistic combined with corresponding P-value. The analysis was carried out with RevMan 5.3. Seven studies involving 583 patients were eligible for the pooled analysis. EIN, when beyond a 7-day time-frame post-operatively (D ≥ 7), increased level of CD4 + (SMD = 0.99; 95% CI, 0.65-1.33; P SMD = 0.34; 95% CI, 0.02-0.67; P = 0.04), the IgM (SMD = 1.15; 95% CI, 0.11-2.20; P = 0.03), the IgG (SMD = 0.98; 95% CI, 0.55-1.42; P SMD = 0.69; 95% CI, 0.32-1.06; P = 0.0003), and the proalbumin (SMD = 0.73; 95% CI, 0.33-1.14; P = 0.0004). However, those increased effects were not obvious within a 7-day time-frame post-operatively (D infection and length of hospitalization (LHS) were not improved no matter what time after surgery. EIN was found to improve the cellular immunity, modulate inflammatory reaction and reduce postoperative complication for GC patients undergoing radical gastrointestinal surgery. Exclusion of grey literature and non-English language studies was the key limitation in this study.

Early enteral nutrition compared with parenteral nutrition for esophageal cancer patients after esophagectomy: a meta-analysis.

Science.gov (United States)

Peng, J; Cai, J; Niu, Z-X; Chen, L-Q

2016-05-01

Early postoperative enteral nutrition (EN) after esophagectomy in esophageal cancer patient has been reported to be correlated with a better rehabilitation than parenteral nutrition (PN). However, a robust conclusion has not been achieved. Therefore, we performed a meta-analysis to compare the postoperative EN and PN in patients with esophageal cancer undergoing esophagectomy. Three electronic databases were searched for eligible studies to be included in the meta-analysis. The summary relative risk/weighted mean difference (RR/WMD) estimates and corresponding 95% confidence interval (CI) were calculated using fixed- and random-effects models. Ten studies met the inclusion criteria. The analysis demonstrated that the early postoperative EN could significantly decrease the pulmonary complications (RR = 0.37, 95% CI = 0.22-0.62, P = 0.00, test for heterogeneity: I(2) = 0.0%, P = 0.89) and anastomotic leakage (RR = 0.46, 95% CI = 0.22-0.96, P = 0.04, test for heterogeneity: I(2) = 0.0%, P = 0.66) compared with PN. On the eighth postoperative day, the EN group had a higher levels of albumin (WMD = 1.84, 95% CI = 0.47-3.21, P = 0.01, test for heterogeneity: I(2) = 84.5%, P = 0.00) and prealbumin (WMD = 12.96, 95% CI = 3.63-22.29, P = 0.01, test for heterogeneity: I(2) = 0.0%, P = 0.63) compared with the PN group. However, there was no difference in digestive complications between these two approaches (RR = 1.30, 95% CI = 0.79-2.13, P = 0.30, test for heterogeneity: I(2) = 0.0%, P = 0.97). For patients with esophageal cancer following esophagectomy, the early postoperative EN support could decrease the morbidity of severe complications, such as pulmonary complications and anastomotic leakage, and maintain patients at a better nutritional status than parenteral nutrion support. © 2015 International Society for Diseases of the Esophagus.

The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants : A randomized controlled trial

NARCIS (Netherlands)

van den Berg, Anemone; Fetter, Willem P. F.; Westerbeek, Elisabeth A. M.; van der Vegt, Ina M.; van der Molen, Hilda R. A.; van Elburg, Ruurd M.

2006-01-01

Background: Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion. Glutamine depletion has negative effects on intestinal integrity. The lower infection rate in VLBW infants receiving glutamine-enriched enteral nutrition may originate from improved intestinal integrity, as

The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants: A randomized controlled trial

NARCIS (Netherlands)

van den Berg, Anemone; Fetter, Willem P. F.; Westerbeek, Elisabeth A. M.; van der Vegt, Ina M.; van der Molen, Hilda R. A.; van Elburg, Ruurd M.

2006-01-01

Background: Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion. Glutamine depletion has negative effects on intestinal integrity. The lower infection rate in VLBW infants receiving glutamine-enriched enteral nutrition may originate from improved intestinal integrity, as

Enteral nutrition increases interstitial brain glucose levels in poor-grade subarachnoid hemorrhage patients.

Science.gov (United States)

Kofler, Mario; Schiefecker, Alois J; Beer, Ronny; Gaasch, Maxime; Rhomberg, Paul; Stover, John; Pfausler, Bettina; Thomé, Claudius; Schmutzhard, Erich; Helbok, Raimund

2018-03-01

Low brain tissue glucose levels after acute brain injury are associated with poor outcome. Whether enteral nutrition (EN) reliably increases cerebral glucose levels remains unclear. In this retrospective analysis of prospectively collected observational data, we investigate the effect of EN on brain metabolism in 17 poor-grade subarachnoid hemorrhage (SAH) patients undergoing cerebral microdialysis (CMD) monitoring. CMD-values were obtained hourly. A nutritional intervention was defined as the clinical routine administration of EN without supplemental parenteral nutrition. Sixty-three interventions were analyzed. The mean amount of EN per intervention was 472.4 ± 10.7 kcal. CMD-glucose levels significantly increased from 1.59 ± 0.13 mmol/l at baseline to a maximum of 2.03 ± 0.2 mmol/l after 5 h (p  40) and the microdialysis probe location. The increase in CMD-glucose was directly dependent on the magnitude of increase of serum glucose levels (p = 0.007). No change in CMD-lactate, CMD-pyruvate, CMD-LPR, or CMD-glutamate (p > 0.4) was observed. Routine EN also increased CMD-glucose even if baseline concentrations were critically low ( < 0.7 mmol/l, neuroglucopenia; p < 0.001). These results may have treatment implications regarding glucose management of poor-grade aneurysmal SAH patients.

Fibre Length Reduction in Natural Fibre-Reinforced Polymers during Compounding and Injection Moulding—Experiments Versus Numerical Prediction of Fibre Breakage

Directory of Open Access Journals (Sweden)

Katharina Albrecht

2018-03-01

Full Text Available To establish injection-moulded, natural fibre-reinforced polymers in the automotive industry, numerical simulations are important. To include the breakage behaviour of natural fibres in simulations, a profound understanding is necessary. In this study, the length and width reduction of flax and sisal fibre bundles were analysed experimentally during compounding and injection moulding. Further an optical analysis of the fibre breakage behaviour was performed via scanning electron microscopy and during fibre tensile testing with an ultra-high-speed camera. The fibre breakage of flax and sisal during injection moulding was modelled using a micromechanical model. The experimental and simulative results consistently show that during injection moulding the fibre length is not reduced further; the fibre length was already significantly reduced during compounding. For the mechanical properties of a fibre-reinforced composite it is important to overachieve the critical fibre length in the injection moulded component. The micromechanical model could be used to predict the necessary fibre length in the granules.

Extraction of High Quality RNA from Cannabis sativa Bast Fibres: A Vademecum for Molecular Biologists

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Gea Guerriero

2016-07-01

Full Text Available In plants there is no universal protocol for RNA extraction, since optimizations are required depending on the species, tissues and developmental stages. Some plants/tissues are rich in secondary metabolites or synthesize thick cell walls, which hinder an efficient RNA extraction. One such example is bast fibres, long extraxylary cells characterized by a thick cellulosic cell wall. Given the economic importance of bast fibres, which are used in the textile sector, as well as in biocomposites as green substitutes of glass fibres, it is desirable to better understand their development from a molecular point of view. This knowledge favours the development of biotechnological strategies aimed at improving specific properties of bast fibres. To be able to perform high-throughput analyses, such as, for instance, transcriptomics of bast fibres, RNA extraction is a crucial and limiting step. We here detail a protocol enabling the rapid extraction of high quality RNA from the bast fibres of textile hemp, Cannabis sativa L., a multi-purpose fibre crop standing in the spotlight of research.

Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review

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Susan Ash

2014-01-01

Full Text Available In Chronic Kidney Disease (CKD, management of diet is important in prevention of disease progression and symptom management, however evidence on nutrition prescription is limited. Recent international CKD guidelines and literature was reviewed to address the following question “What is the appropriate nutrition prescription to achieve positive outcomes in adult patients with chronic kidney disease?” Databases included in the search were Medline and CINAHL using EBSCOhost search engine, Embase and the Cochrane Database of Systematic Reviews published from 2000 to 2009. International guidelines pertaining to nutrition prescription in CKD were also reviewed from 2000 to 2013. Three hundred and eleven papers and eight guidelines were reviewed by three reviewers. Evidence was graded as per the National Health and Medical Research Council of Australia criteria. The evidence from thirty six papers was tabulated under the following headings: protein, weight loss, enteral support, vitamin D, sodium, fat, fibre, oral nutrition supplements, nutrition counselling, including protein and phosphate, nutrients in peritoneal dialysis solution and intradialytic parenteral nutrition, and was compared to international guidelines. While more evidence based studies are warranted, the customary nutrition prescription remains satisfactory with the exception of Vitamin D and phosphate. In these two areas, additional research is urgently needed given the potential of adverse outcomes for the CKD patient.

Nutrition knowledge and nutritional status of primary school children ...

African Journals Online (AJOL)

2010-01-04

Jan 4, 2010 ... are a decreased fibre intake and increased intakes of total protein and animal protein ... has implemented various national nutrition and primary health- .... fish, chicken, dried beans, legumes, peas and soy, 4) the dairy group,.

Nutritional and technological quality of the durum wheat

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Zina Flagella

Full Text Available Durum wheat quality is a complex system that combines yield characteristics, cultivation conditions and certification requirements. In this review, the technological and nutritional aspects of grain quality were evaluated in relation to the influence of climate and agronomic practices. In particular, the technological quality was investigated with regard to the kind of processed product (pasta, bread, couscous, burghul. The influence of nitrogen and sulphur nutrition, temperature, water regime and organic farming on grain quality was evaluated. Furthermore, the nutritional characteristics of durum wheat related to starch, proteins, lipids, vitamins, fibres and mineral ions content were examined. Special focus was on the antioxidant activity capable of preventing chronic and degenerative diseases thanks to the high content in bioactive compounds, as phenols, tocols, carotenoids and fibres in whole grain. In the light of the new direction of the Community agricultural policy and of the growing interest in human nutrition, two prospects for development of the durum wheat sector were delineated: i developing certified products (PGI, PDO and organic; ii promoting production and processing technologies aimed at increasing the level of bioactive compounds in durum wheat grain and its by-products.

Hagfish slime threads as a biomimetic model for high performance protein fibres

International Nuclear Information System (INIS)

Fudge, Douglas S; Hillis, Sonja; Levy, Nimrod; Gosline, John M

2010-01-01

Textile manufacturing is one of the largest industries in the world, and synthetic fibres represent two-thirds of the global textile market. Synthetic fibres are manufactured from petroleum-based feedstocks, which are becoming increasingly expensive as demand for finite petroleum reserves continues to rise. For the last three decades, spider silks have been held up as a model that could inspire the production of protein fibres exhibiting high performance and ecological sustainability, but unfortunately, artificial spider silks have yet to fulfil this promise. Previous work on the biomechanics of protein fibres from the slime of hagfishes suggests that these fibres might be a superior biomimetic model to spider silks. Based on the fact that the proteins within these 'slime threads' adopt conformations that are similar to those in spider silks when they are stretched, we hypothesized that draw processing of slime threads should yield fibres that are comparable to spider dragline silk in their mechanical performance. Here we show that draw-processed slime threads are indeed exceptionally strong and tough. We also show that post-drawing steps such as annealing, dehydration and covalent cross-linking can dramatically improve the long-term dimensional stability of the threads. The data presented here suggest that hagfish slime threads are a model that should be pursued in the quest to produce fibres that are ecologically sustainable and economically viable.

A global comparison of the nutritive values of forage plants grown in contrasting environments.

Science.gov (United States)

Lee, Mark A

2018-03-17

Forage plants are valuable because they maintain wild and domesticated herbivores, and sustain the delivery of meat, milk and other commodities. Forage plants contain different quantities of fibre, lignin, minerals and protein, and vary in the proportion of their tissue that can be digested by herbivores. These nutritive components are important determinants of consumer growth rates, reproductive success and behaviour. A dataset was compiled to quantify variation in forage plant nutritive values within- and between-plant species, and to assess variation between plant functional groups and bioclimatic zones. 1255 geo-located records containing 3774 measurements of nutritive values for 136 forage plant species grown in 30 countries were obtained from published articles. Spatial variability in forage nutritive values indicated that climate modified plant nutritive values. Forage plants grown in arid and equatorial regions generally contained less digestible material than those grown in temperate and tundra regions; containing more fibre and lignin, and less protein. These patterns may reveal why herbivore body sizes, digestion and migration strategies are different in warmer and drier regions. This dataset also revealed the capacity for variation in the nutrition provided by forage plants, which may drive consumer species coexistence. The proportion of the plant tissue that was digestible ranged between species from 2 to 91%. The amount of fibre contained within plant material ranged by 23-90%, protein by 2-36%, lignin by 1-21% and minerals by 2-22%. On average, grasses and tree foliage contained the most fibre, whilst herbaceous legumes contained the most protein and tree foliage contained the most lignin. However, there were individual species within each functional group that were highly nutritious. This dataset may be used to identify forage plant species or mixtures of species from different functional groups with useful nutritional traits which can be cultivated

Test of Fibre Bragg Gratings samples under High Fast Neutrons Fluence

Science.gov (United States)

Cheymol, G.; Remy, L.; Gusarov, A.; Kinet, D.; Mégret, P.; Laffont, G.; Blanchet, T.; Morana, A.; Marin, E.; Girard, S.

2018-01-01

Optical fibre sensors (OFS) are worthy of interest for measurements in nuclear reactor thanks to their unique features, particularly compact size and remote multi-point sensing for some of them. But besides non negligible constraints associated with the high temperature environment of the experiments of interest, it is well known that the performances of OFS can be severely affected by high level of radiations. The Radiation Induced Attenuation (RIA) in the fibre is probably most known effect, which can be to some extent circumvented by using rad hard fibres to limit the dynamic loss. However, when the fast neutron fluence reaches 1018 to 1019 n/cm2, the density and index variations associated to structural changes may deteriorate drastically the performances of OFS even if they are based on rad hard fibres, by causing direct errors in the measurements of temperature and/or strain changes. The aim of the present study is to access the effect of nuclear radiations on the Fabry Perot (FP) and of Fibre Bragg Grating (FBG) sensors through the comparison of measurements made on these OFS - or part of them - before and after irradiation [1]. In the context of development of OFS for high irradiation environment and especially for Material Testing Reactors (MTRs), Sake 2 experiment consists in an irradiation campaign at high level of gamma and neutron fluxes conducted on samples of fibre optics - bare or functionalised with FBG. The irradiation was performed at two levels of fast neutron fluence: 1 and 3.1019 n/cm2 (E>1MeV), at 250°± 25°C, in the SCK•CEN BR2 reactor (Mol Belgium). An irradiation capsule was designed to allow irradiation at the specified temperature without active control. The neutron fluence was measured with activation dosimeters and the results were compared with MCPN computations. Investigation of bare samples gives information on the density changes, while for the FBGs both density and refractive index perturbation are involved. Some results for

Properties of Fresh and Hardened High Strength Steel Fibres Reinforced Self-Compacted Concrete

Directory of Open Access Journals (Sweden)

Saad Ali Al-Ta'an

2016-10-01

Full Text Available Fresh and hardened properties of high strength steel fibrous self-compacted concrete were studied in this investigation. One reference high strength self-compacted concrete mix is used, with five percent (by weight of cement silica fume and eight percent of the cement replaced by limestone powder. Three steel fibres percentages by volume of concrete are used (0.4, 0.8, and 1.2. The used steel fibres were a shelled Harex type with irregular cross-section, equivalent diameter of 0.9278 mm, and 32 mm long. Super plasticizer was used to improve the workability and flow ability of the mixes. The test results showed that the presence of steel fibres decrease the flow ability, and increase the time of spreading, segregation, and passing ability of the fresh concrete. For the fibres percentages used, the fresh properties were within the recommended specifications for the self-compacted concrete. The test results showed an early strength development rate more than that for plain normal concrete due to the presence of the fine materials. As for normal concrete, the test results showed also that the increase in the splitting strength is more than the increase in the compressive strength due to the presence of the steel fibres. The brittle mode of failure of the plain unreinforced specimens changed to a ductile one due to the presence of the steel fibres.

Differences in outcomes over time with exclusive enteral nutrition compared to steroids in children with mild to moderate Crohn's Disease

DEFF Research Database (Denmark)

Cohen-Dolev, Noa; Sladek, Malgorata; Hussey, Seamus

2018-01-01

Background: Exclusive enteral nutrition (EEN) and corticosteroids (CS) both induce similar rates of remission in mild to moderate pediatric Crohn's disease (CD), but differ with regard to mucosal healing. Our goal was to evaluate if EEN at diagnosis was superior to CS for improving long term outc...

Nutritional evaluation of former food products (ex-food) intended for pig nutrition.

Science.gov (United States)

Giromini, C; Ottoboni, M; Tretola, M; Marchis, D; Gottardo, D; Caprarulo, V; Baldi, A; Pinotti, L

2017-08-01

Ex-food or former food products (FFPs) have been proposed as one of the categories with great promise as alternative feed ingredients. FFPs' nutritional potential is not yet fully exploited. Therefore, the aim of this study was to perform a nutritional evaluation of selected FFPs. In particular, six samples of mixed FFPs, all based on bakery products, were analysed for moisture, crude protein, ether extract, crude fibre, neutral detergent fibre, acid detergent fibre, starch and ash. Nitrogen-free extractives and non-structural carbohydrate were also determined. Based on FFPs' composition data, estimation of digestible energy and metabolisable energy values for pigs were calculated. Further, the in vitro digestibility values of FFPs were investigated using a multi-step enzymatic technique. A wheat sample was included as a control feed ingredient in the study. All data were reported on dry matter basis. FFPs have shown a nutrient composition comparable with cereal grains. In the tested FFPs, the average protein content was 10.0% and the average starch content was 52.4%. Nitrogen-free extractive ranged from 61.2% to 74.7%, whereas non-structural carbohydrate ranged from 58.5% to 79.3%. Compared with wheat, FFPs were characterised by a relative high fat content, averaging about 10.1%. The relatively high nitrogen-free extractive/non-structural carbohydrate/starch and fat concentration designated FFPs as valuable energy sources. Digestible energy and metabolisable energy averages were 17.2 and 16.9 MJ kg -1 , respectively. The average in vitro digestibility value of FFPs samples was 88.2% ± 5.8%, comparable with that of wheat (90.6% ± 1.6%). FFPs are a fat-fortified version of common cereals grains. The high energy content and digestibility values elect FFPs as promising non-traditional ingredients for swine.

A qualitative study of the perceived value of membership in The Oley Foundation by home parenteral and enteral nutrition consumers.

Science.gov (United States)

Chopy, Katelyn; Winkler, Marion; Schwartz-Barcott, Donna; Melanson, Kathleen; Greene, Geoffrey

2015-05-01

Support and educational organizations have been shown to improve quality of life of consumers of home nutrition support. One such organization, The Oley Foundation, offers resources for the home parenteral and enteral nutrition (HPEN) consumer. While research has shown proven benefits to HPEN consumers affiliated with The Oley Foundation, no studies have investigated the perceived value of membership to the consumer or the way in which consumers are introduced to the organization. Qualitative methodology was used to gain a deeper understanding of the perceived value of membership in The Oley Foundation. Audiotaped, in-depth, semistructured telephone interviews were conducted to explore participants' experiences with The Oley Foundation and HPEN. Inductive content analysis was used to analyze data and identify themes associated with membership value. The value of The Oley Foundation lies in programs and resources and the competency, inspiration, normalcy, and advocacy gained from membership, helping individuals adjust to life with HPEN dependency. More than half of participants found the organization through self-initiated Internet searches, but all participants clearly expressed the desire "I wish I knew about it sooner." This study identifies the value of membership in The Oley Foundation and the important role the organization has in the lives of HPEN-dependent consumers. Nutrition support clinicians should introduce the organization to patients when the need for HPEN is established and prior to hospital discharge. © 2014 American Society for Parenteral and Enteral Nutrition.

Beneficial effects of enteral nutrition containing with hydrolyzed whey peptide on warm ischemia/reperfusion injury in the rat liver.

Science.gov (United States)

Hanaoka, Jun; Shimada, Mitsuo; Utsunomiya, Toru; Morine, Yuji; Imura, Satoru; Ikemoto, Tetsuya; Mori, Hiroki; Sugimoto, Koji; Saito, Yu; Yamada, Shinichiro; Asanoma, Michihito

2014-01-01

This study examined the efficacy of enteral nutrition containing hydrolyzed whey peptide (HWP) on warm ischemia/reperfusion (I/R) injury in the rat liver. Male Wistar rats were subjected to 30 min of warm hepatic ischemia followed by immediate p.o. intake of enteral nutrition with WHP (HWP group) or 20% glucose solution (control group) (0.025 mL/g). The animals were killed at 6 or 12 h after reperfusion. The serum aspartate aminotransferase (AST) and alanine aminotransferase alt (ALT) levels were measured. The necrotic areas were assessed histologically. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining and caspase-3 activation were assessed to evaluate apoptosis. The expressions of hepatic tumor necrosis factor (TNF)-α, interleukin (IL)-6 and nuclear factor (NF)-κB in the liver tissue were assessed by real time reverse transcription polymerase chain reaction. Significant reductions in the serum AST and ALT levels were seen in the HWP group compared with the control group at both 6 and 12 h after reperfusion. The necrotic areas and numbers of TUNEL positive cells were significantly decreased in the HWP group at 6 and 12 h after reperfusion. The caspase-3/7 activities were significantly decreased in HWP group at 6 and 12 h after reperfusion. The mRNA expressions of TNF-α and IL-6 were significantly reduced in the HWP group at 12 h after reperfusion. NF-κB mRNA expression was significantly increased in the HWP group at 6 and 12 h after reperfusion. Enteral nutrition containing HWP ameliorated the hepatic warm I/R injury possibly through the suppression of pro-inflammatory cytokine expressions and the induction of NF-κB in the rat liver. © 2013 The Japan Society of Hepatology.

Combined Performance of Polypropylene Fibre and Weld Slag in High Performance Concrete

Science.gov (United States)

Ananthi, A.; Karthikeyan, J.

2017-12-01

The effect of polypropylene fibre and weld slag on the mechanical properties of High Performance Concrete (HPC) containing silica fume as the mineral admixtures was experimentally verified in this study. Sixteen series of HPC mixtures(70 MPa) were designed with varying fibre fractions and Weld Slag (WS). Fibre added at different proportion (0, 0.1, 0.3 and 0.6%) to the weight of cement. Weld slag was substituted to the fine aggregate (0, 10, 20 and 30%) at volume. The addition of fibre decreases the slump at 5, 9 and 14%, whereas the substitution of weld slag decreases by about 3, 11 and 21% with respect to the control mixture. Mechanical properties like compressive strength, split tensile strength, flexural strength, Ultrasonic Pulse Velocity test (UPV) and bond strength were tested. Durability studies such as Water absorption and Sorptivity test were conducted to check the absorption of water in HPC. Weld slag of 10% and fibre dosage of 0.3% in HPC, attains the maximum strength and hence this combination is most favourable for the structural applications.

Psychometric properties of DAPonDEN: definitions, attitudes and practices in relation to diarrhea during enteral nutrition questionnaire.

Science.gov (United States)

Majid, Hazreen A; Bin Sidek, Muhamad Adam; Chinna, Karuthan

2013-01-01

To investigate the psychometric properties of the developed 21 item questionnaire to measure definitions, attitudes and management practices in relation to diarrhea during enteral nutrition (DAPonDEN). Data were analyzed using exploratory factor analysis from a cross sectional study of 102 nurses aged 18 and over, conducted from December 2011 to February 2012 in Malaysia. Face and content validity of DAPonDEN were first evaluated by few expert panels and patients. For this study, adult nurses were recruited from the adult wards. In the final model, three items in DAPonDEN were dropped. In the exploratory factor analysis, five factors were extracted that explained a total of 55% of the variation in the remaining 18 items. The Kaiser-Meyer-Olkin (KMO) value was 0.723. For definition, there were two underlying factors: 'Key items in defining diarrhea' and 'non-key items in defining diarrhea'. For attitude there was a single factor. For practice, there were two underlying factors: 'enteral nutrition (EN) related' and 'awareness related'. The items in each of the underlying dimensions seem to measure the respective concepts for definition, attitude and practices adequately. The 18-items DAPonDEN instrument can be a suitable education tool to be used in relation to diarrhea during EN. Copyright © 2013 Elsevier Inc. All rights reserved.

Nutritive and Anti-nutritive Evaluation of Cnidoscolus aurifolia Leaves

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Uwemedimo Emmanuel Udo

2016-09-01

Full Text Available The leaves of Cnidoscolus aurifolia were analysed for their chemical, antinutrients, proximate and mineral element compositions using standard procedures. Phytochemical screening revealed the presence of alkaloids, saponins, flavonoids, terpenes and tannins while anthraquinones, glycosides and phlobatannins were absent. Proximate analysis indicated high protein content (59.45 ± 0.07% with crude fibre and fat also present in appreciable quantities. Mineral elements determination showed the presence of calcium, iron, magnesium, potassium and zinc. Antinutrient analysis of the leaf extract of C. aurifolia indicated low levels of phytic acid and hydrocyanide well below the lethal doses. An unusually high oxalate level of 404.80 ± 0.11 mg/100 g (dry weight was also obtained although still below toxic level. These results support the ethnomedicinal and nutritional uses of this plant and suggest that the consumption of leaves of C. aurifolia is not harmful nutritively.

Effects of high fibre diets on gut fill, behaviour and productivity in broiler breeders

DEFF Research Database (Denmark)

Steenfeldt, Sanna; Nielsen, Birte Lindstrøm

2011-01-01

diets compared to feed A was detectable in the intestinal contents, with high fibre feed staying longer in the digestive system. Birds fed fibre diets displayed more dustbathing and less stereotypic behaviour. Egg production did not differ between the diet treatments. The onset of lay was delayed......, but the hens reached maximum lay sooner than industry guidelines indicates. The results show that high fibre diets prolong the passage of feed and reduce stereotypic behaviour, indicating an improvement in the well-being of the birds, who may experience less hunger than commercially fed broiler breeders. Key...... at 19 weeks. From 19-30 weeks all groups were fed the same commercial pre-layer and layer diets. Similar growth rates were obtained on different quantities of food (eg. 75, 100, 110 and 92 g feed/bird/d in week 16 for A, B, C and D, respectively). The higher amounts of food offered on the high fibre...

FibreBags vs. FibreCaps for acid and neutral detergent fibre analysis

OpenAIRE

Koivisto , Jason

2003-01-01

International audience; A new procedure for determining acid detergent fibre and neutral detergent fibre (ADF and NDF) was developed to reduce the need for filtration and to allow for batch processing of forage samples. The FibreBag system is an economically necessary evolution of the earlier FibreCap system. The purpose of this enquiry was to determine if the FibreBag is a suitable replacement for the FibreCap. The FibreBag method produced very similar results to the FibreCap system of analy...

WORKSHOP: Scintillating fibre detectors

International Nuclear Information System (INIS)

Anon.

1989-01-01

Scintillating fibre detector development and technology for the proposed US Superconducting Supercollider, SSC, was the subject of a recent workshop at Fermilab, with participation from the high energy physics community and from industry. Sessions covered the current status of fibre technology and fibre detectors, new detector applications, fluorescent materials and scintillation compositions, radiation damage effects, amplification and imaging structures, and scintillation fibre fabrication techniques

The Chemical Composition of Grape Fibre

Directory of Open Access Journals (Sweden)

Jolana Karovičová

2015-05-01

Full Text Available Dietary fibres from cereals are much more used than dietary fibres from fruits; however, dietary fibres from fruits have better quality. In recent years, for economic and environmental reasons, there has been a growing pressure to recover and exploit food wastes. Grape fibre is used to fortify baked goods, because the fibre can lower blood sugar, cut cholesterol and may even prevent colon cancer. Grape pomace is a functional ingredient in bakery goods to increase total phenolic content and dietary fibre in nourishment. The aim of this study was to determine the chemical composition of commercial fibres, obtained from different Grape sources concerning their chemical properties such as moisture, ash, fat, protein, total dietary fibre. The chemical composition of Grape fibre is known to vary depending on the Grape cultivar, growth climates, and processing conditions. The obliged characteristics of the fibre product are: total dietary fibre content above 50%, moisture lower than 9%, low content of lipids, a low energy value and neutral flavour and taste. Grape pomace represents a rich source of various high-value products such as ethanol, tartrates and malates, citric acid, Grape seed oil, hydrocolloids and dietary fibre. Used commercial Grape fibres have as a main characteristic, the high content of total dietary fibre. Amount of total dietary fibre depends on the variety of Grapes. Total dietary fibre content (TDF in our samples of Grape fibre varied from 56.8% to 83.6%. There were also determined low contents of moisture (below 9%. In the samples of Grape fibre were determined higher amount of protein (8.6 - 10.8%, mineral (1.3 - 3.8% and fat (2.8 - 8.6%. This fact opens the possibility of using both initial by-products as ingredients in the food industry, due to the effects associated with the high total dietary fibre content.

Enhanced vaccination effect against influenza by prebiotics in elderly patients receiving enteral nutrition.

Science.gov (United States)

Akatsu, Hiroyasu; Nagafuchi, Shinya; Kurihara, Rina; Okuda, Kenji; Kanesaka, Takeshi; Ogawa, Norihiro; Kanematsu, Takayoshi; Takasugi, Satoshi; Yamaji, Taketo; Takami, Masao; Yamamoto, Takayuki; Ohara, Hirotaka; Maruyama, Mitsuo

2016-02-01

We investigated the effect of prebiotics on the immunological response after influenza vaccination in enterally fed elderly individuals. The intervention group was given an enteral formula containing lactic acid bacteria-fermented milk products. In addition, two different types of other prebiotics, galacto-oligosaccharide and bifidogenic growth stimulator, were also given. The two prebiotics improved intestinal microbiota differently. In a control group, a standard formula without prebiotics was given. An enteral formula with (intervention group [F]) or without (control group [C]) prebiotics was given through percutaneous endoscopic gastrostomy to elderly participants for 10 weeks. Influenza vaccine was inoculated at week 4. Nutritional and biochemical indices, intestinal micro bacteria and immunological indices were analyzed. The Bifidobacterium count in groups F and C at week 0 was 6.4 ± 1.9 and 6.6 ± 3.0 (log10 [count/g feces]), respectively. Although the count in group C decreased at week 10, the count in group F increased. The Bacteroides count in group F increased from 10.7 ± 0.9 to 11.4 ± 0.5, but decreased in group C from 11.2 ± 0.2 to 10.7 ± 0.4. Although the enhanced titers of H1N1, H3N2 and B antigens against the vaccine decreased thereafter in group C, these enhanced titers in group F could be maintained. Our findings suggest that prebiotics affect the intestinal microbiota and might maintain the antibody titers in elderly individuals. © 2015 Japan Geriatrics Society.

Non-interferometric determination of optical anisotropy in highly-oriented fibres using transport intensity equation technique

Science.gov (United States)

Sokkar, T. Z. N.; El-Farahaty, K. A.; El-Bakary, M. A.; Raslan, M. I.; Omar, E. Z.; Hamza, A. A.

2018-03-01

The optical setup of the transport intensity equation (TIE) technique is developed to be valid for measuring the optical properties of the highly-oriented anisotropic fibres. This development is based on the microstructure models of the highly-oriented anisotropic fibres and the principle of anisotropy. We provide the setup of TIE technique with polarizer which is controlled via stepper motor. This developed technique is used to investigate the refractive indices in the parallel and perpendicular polarization directions of light for the highly-oriented poly (ethylene terephthalate) (PET) fibres and hence its birefringence. The obtained results through the developed TIE technique for PET fibre are compared with that determined experimentally using the Mach-Zehnder interferometer under the same conditions. The comparison shows a good agreement between the obtained results from the developed technique and that obtained from the Mach-Zehnder interferometer technique.

HIPPI and Fibre Channel

International Nuclear Information System (INIS)

Tolmie, D.E.

1992-01-01

The High-Performance Parallel Interface (HIPPI) and Fibre Channel are near-gigabit per second data communications interfaces being developed in ANSI standards Task Group X3T9.3. HIPPI is the current interface of choice in the high-end and supercomputer arena, and Fibre Channel is a follow-on effort. HIPPI came from a local area network background, and Fibre Channel came from a mainframe to peripheral interface background

Effect of different processing methods on nutritional composition of ...

African Journals Online (AJOL)

ADOWIE PERE

their rich contents of essential amino acids, vitamins and minerals (Aye ... inherent toxic factors or anti-nutritional components in plants has been .... protein, crude fat, crude fibre and ash from 100. .... soluble in water, leaving insoluble fibre.

Dietary fibre fractions in cereal foods measured by a new integrated AOAC method.

Science.gov (United States)

Hollmann, Juergen; Themeier, Heinz; Neese, Ursula; Lindhauer, Meinolf G

2013-10-01

The reliable determination of soluble, insoluble and total dietary fibre in baked goods and cereal flours is an important issue for research, nutritional labelling and marketing. We compared total dietary fibre (TDF) contents of selected cereal based foods determined by AOAC Method 991.43 and the new AOAC Method 2009.01. Fifteen bread and bakery products were included in the study. Our results showed that TDF values of cereal products determined by AOAC Method 2009.01 were always significantly higher than those determined by AOAC Method 991.43. This was explained by the inclusion of low molecular weight soluble fibre fractions and resistant starch fractions in the TDF measurement by AOAC 2009.01. This documents that nutritional labelling of cereal products poses the challenge how to update TDF data in nutrient databases in a reasonable time with an acceptable expenditure. Copyright © 2013. Published by Elsevier Ltd.

Parenteral nutrition in the critically ill.

Science.gov (United States)

Gunst, Jan; Van den Berghe, Greet

2017-04-01

Feeding guidelines have recommended early, full nutritional support in critically ill patients to prevent hypercatabolism and muscle weakness. Early enteral nutrition was suggested to be superior to early parenteral nutrition. When enteral nutrition fails to meet nutritional target, it was recommended to administer supplemental parenteral nutrition, albeit with a varying starting point. Sufficient amounts of amino acids were recommended, with addition of glutamine in subgroups. Recently, several large randomized controlled trials (RCTs) have yielded important new insights. This review summarizes recent evidence with regard to the indication, timing, and dosing of parenteral nutrition in critically ill patients. One large RCT revealed no difference between early enteral nutrition and early parenteral nutrition. Two large multicenter RCTs showed harm by early supplementation of insufficient enteral nutrition with parenteral nutrition, which could be explained by feeding-induced suppression of autophagy. Several RCTs found either no benefit or harm with a higher amino acid or caloric intake, as well as harm by administration of glutamine. Although unanswered questions remain, current evidence supports accepting low macronutrient intake during the acute phase of critical illness and does not support use of early parenteral nutrition. The timing when parenteral nutrition can be initiated safely and effectively is unclear.

Inflammatory bowel diseases: principles of nutritional therapy

Directory of Open Access Journals (Sweden)

Campos Fábio Guilherme

2002-01-01

Full Text Available Inflammatory Bowel Diseases - ulcerative colitis and Crohn's disease- are chronic gastrointestinal inflammatory diseases of unknown etiology. Decreased oral intake, malabsorption, accelerated nutrient losses, increased requirements, and drug-nutrient interactions cause nutritional and functional deficiencies that require proper correction by nutritional therapy. The goals of the different forms of nutritional therapy are to correct nutritional disturbances and to modulate inflammatory response, thus influencing disease activity. Total parenteral nutrition has been used to correct and to prevent nutritional disturbances and to promote bowel rest during active disease, mainly in cases of digestive fistulae with high output. Its use should be reserved for patients who cannot tolerate enteral nutrition. Enteral nutrition is effective in inducing clinical remission in adults and promoting growth in children. Due to its low complication rate and lower costs, enteral nutrition should be preferred over total parenteral nutrition whenever possible. Both present equal effectiveness in primary therapy for remission of active Crohn's disease. Nutritional intervention may improve outcome in certain individuals; however, because of the costs and complications of such therapy, careful selection is warranted, especially in patients presumed to need total parenteral nutrition. Recent research has focused on the use of nutrients as primary treatment agents. Immunonutrition is an important therapeutic alternative in the management of inflammatory bowel diseases, modulating the inflammation and changing the eicosanoid synthesis profile. However, beneficial reported effects have yet to be translated into the clinical practice. The real efficacy of these and other nutrients (glutamine, short-chain fatty acids, antioxidants still need further evaluation through prospective and randomized trials.

Fibre gratings for high temperature sensor applications

Science.gov (United States)

Canning, J.; Sommer, K.; Englund, M.

2001-07-01

Phosphosilicate fibre gratings can be stabilized at temperatures in excess of 500 °C for sensor applications by optimizing thermal and UV presensitization recipes. Furthermore, the use of 193 nm presensitization prevents the formation of OH absorption bands, extending the use of fibre gratings across the entire wavelength spectrum. Gratings for operation at 700 °C retaining up to 70% reflectivity after 30 min are demonstrated.

Energy expenditure and body composition in children with Crohn's disease: effect of enteral nutrition and treatment with prednisolone

OpenAIRE

Azcue, M; Rashid, M; Griffiths, A; Pencharz, P

1997-01-01

Background—Malnutrition and growth retardation are common complications of Crohn's disease in children. The contribution of resting energy expenditure (REE) to malnutrition is unclear. 
Aims—To characterise the REE and body composition in children with Crohn's disease and compare them with normal controls and patients with anorexia nervosa; to compare the effects of prednisolone and enteral nutrition on energy expenditure and body composition. 
Subjects—Twenty four children wit...

Nutrition in Patients with Head Trauma

Directory of Open Access Journals (Sweden)

Burcu Totur

2013-01-01

Full Text Available The need of energy increases by 40% in patients with a head trauma, when compared to people who are living a normal life. This ratio reaches to 200% in some cases. It is important to give a nutrition support which can satisfy the energy need resulted from the hypermetabolic and hypercatabolic states and that is enough to help to fix the immunologic state and achieve a better result in healing the injury. When oral nutrition is not possible in the patient with a head trauma, their energy need is satisfied through enteral and parenteral nutrition. Though parenteral nutrition had held an important role in feeding patients with head trauma, enteral nutrition is applied much more widely today. Enteral and parenteral nutrition both has their own advantages and disadvantages. In the clinical and laboratory studies that had been held, it was found that enteral nutrition improved the systemic immunity, decreased the incidence of the major infectious complications, decreased the metabolic response to trauma, protected the intestinal mucosa, and protected the ecologic balance of the microflora. In this article, it is investigated through the importance of the feeding in patients with a head trauma and reasons to chose enteral nutrition

New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition

OpenAIRE

AKBULUT, GAMZE

2011-01-01

Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be presc...

Effects of Lipid Emulsions in Parenteral Nutrition of Esophageal Cancer Surgical Patients Receiving Enteral Nutrition: A Comparative Analysis

Directory of Open Access Journals (Sweden)

Wu-Ping Wang

2013-12-01

Full Text Available Background: Olive oil-based lipid emulsion (LE and medium chain triglyceride/long chain triglyceride (MCT/LCT emulsion are both LEs with low ω-6 polyunsaturated fat acids (PUFAs content. However, which one of these LEs is associated with a lower infection risk in patients receiving parenteral nutrition (PN remains unclear. The aim of the study was to compare the effects of the two LEs in PN in esophageal cancer patients undergoing surgery. Methods: Patients with resectable esophageal carcinoma were recruited and allocated randomly to two groups. The test group was given enteral nutrition (EN with PN containing olive oil-based LE after tumor resection for ≥7 days, and the patients in the control group were supported by EN with MCT/LCT emulsion-based PN after surgery for the same time period. Immunological markers and inflammatory indicators were tested and perioperative clinical outcomes were determined. The trial was registered in the Chinese Clinical Trial Register, number ChiCTR-TRC-13003562. 94 Patients were recruited, and grouped (olive oil-based LE, n = 46 and MCT/LCT, n = 48, matched for sex, age, body mass index, histological type, TNM stage, and nutrition risk screening (NRS 2002 score. Results: There were no differences in perioperative fever (>38 °C, infectious complications, length of hospital stay (>14 days, length of critical care stay (>2 days, time for oral food intake, and in-hospital mortality between the two groups. The test group showed a higher increase in IgG level compared with the MCT/LCT group (p = 0.028. There was no difference in other immunological markers and inflammatory indicators between the two groups. Conclusion: PN containing olive oil-based or MCT/LCT LEs had similar effects on perioperative outcome, cell-mediated immune function and inflammatory response in esophageal cancer patients who had undergone surgery and were receiving EN.

Knowledge about dietary fibre and its health benefits: A cross-sectional survey of 2536 residents from across Croatia.

Science.gov (United States)

Ljubicic, Marija; Saric, Marijana Matek; Rumbak, Ivana; Baric, Irena Colic; Komes, Drazenka; Satalic, Zvonimir; Guiné, Raquel P F

2017-08-01

This cross-sectional study is aimed at identifying the level of understanding of the health benefits of dietary fibre in the prevention of disease, as well as the association between that understanding and fibre consumption in the Croatian population. We believe that nutritional knowledge is important for the consumption of healthy food which includes also a positive reflection on food habits and health. Only well-informed consumers can shop effectively for food rich in dietary fibre and thereby derive the health benefits that fibre can offer. We suppose the association between that understanding and fibre consumption in the Croatian population. However, this knowledge is not the only important determinant; food purchases are influenced by socioeconomic and demographic factors. Our hypothesis is that the level of knowledge about fibre and fibre consumption varies with age, gender, education level and urban or rural environment. It is our assumption that life styles, environmental conditions and education can affect the level of knowledge and perception about healthy eating habits. If this assumption is accurate, targeted education campaigns to educate and sensitise the population about fibre-rich foods and the health benefits of fibre is a priority. Public health programmes are urgently needed, particularly in rural areas, to sensitise the population to fulfill the recommended fibre intake, high-fibre food sources and the mechanisms by which fibre can help prevent disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

Efficient high-power narrow-linewidth all-fibred linearly polarized ytterbium laser source

Science.gov (United States)

Bertrand, Anthony; Liégeois, Flavien; Hernandez, Yves; Giannone, Domenico

2012-06-01

We report on experimental results on a high power, all-fibred, linearly polarized, mode-locked laser at 1.03 μm. The laser generates pulses of 40 ps wide at a repetition rate of 52 MHz, exhibiting 12 kW peak power. Dispersion in optical fibres is controlled to obtain both high power and narrow spectral linewidth. The average output power reached is 25 W with a spectral linewidth of 380 pm and a near diffraction limit beam (M2 < 1.2). This laser is an ideal candidate for applications like IR spectroscopy, where high peak power and narrow linewidth are required for subsequent wavelength conversion.

Selection of appropriate medial branch of the optic tract by fibres of ventral retinal origin during development and in regeneration: an autoradiographic study in Xenopus

International Nuclear Information System (INIS)

Straznicky, C.; Gaze, R.M.; Horder, T.J.

1979-01-01

The formation of the branches of the optic tract has been studied with the use of [ 3 H] -proline autoradiography, during development and during regeneration of the optic nerve in Xenopus with one compound ventral (VV) eye made by the embryonic fusion of two ventral eye fragments. The formation of the optic pathway was abnormal in that the lateral branch failed to develop, suggesting that fibres from a VV retina selectively entered the tectum via the medial branch during development. Three months after section of the optic nerve of a VV eye, regenerated fibres were present both in the contralateral and ipsilateral tecta. On the ipsilateral side regenerated fibres entered the tectum via the medial branch only. Retinal fibres entered the contralateral tectum through both branches in some animals and through the medial branch only in others. It is concluded that mechanical factors alone are insufficient to explain the phenomenon of selection of the appropriate medial branch fibres of ventral retinal origin either during development or in regeneration. Some form of fibre-substrate interaction seems to be necessary; and this ability of fibres from a VV eye to take the path appropriate for ventral retina argues strongly that the VV eye is not a regulated system in terms of cell specificities. 8author)

The frequency, risk factors, and complications of gastrointestinal dysfunction during enteral nutrition in critically ill patients.

Science.gov (United States)

Atasever, Ayse Gulsah; Ozcan, Perihan Ergin; Kasali, Kamber; Abdullah, Taner; Orhun, Gunseli; Senturk, Evren

2018-01-01

Gastrointestinal (GI) motility disorders in intensive care patients remain relatively unexplored. Nowadays, the frequency, risk factors and complications of GI dysfunction during enteral nutrition (EN) become more questionable. To evaluate the frequency, risk factors and complications of GI dysfunction during EN in the first 2 weeks of the intensive care unit (ICU) stay and to identify precautions to prevent the development of GI dysfunction and avoid complications. In this prospective observational study, we deliberately targeted at-risk patients. A total of 137 patients who received nasogastric tube feeding in an ICU of a tertiary hospital were enrolled. The incidence of GI dysfunction that was found to be 63% which was associated mainly between MDR bacteria positivity and negative fluid balance. Diarrhea was observed in 36 patients (26%) and on 147 patient-days (incidence rate, 5.5 per 100 patient-days). The median day of diarrhea onset was 6 days after the initiation of EN. Forty patients (29%) presented with constipation (85% during the first week). Fifty patients (36%) exhibited upper digestive intolerance on 212 patient-days (incidence rate, 7.9 per 100 patient-days), after a median EN duration of 6 days (range, 2-14 days). Logistic regression analysis revealed MDR bacteria growth in the culture (OR, 1.75; 95% CI, 1.15-2.67; P =0.008) and negative fluid balance (OR, 0.57; 95% CI, 0.34-0.94; P =0.03) as the risk factors for GI dysfunction. We also showed that GI dysfunction was associated with high SOFA score, hypoalbuminemia, catecholamine use, and prolonged length of stay (LOS). GI dysfunction, on the other hand, can cause some complications including inadequate nutrition, and newly developed decubitus ulcers. GI dysfunction should be considered a clinical predictor of inadequate nutrition and prolonged LOS. In addition, the most dramatic risk for GI dysfunction was observed in patients with MDR bacteria growth in the culture and patients in negative fluid

Characterisation of Flax Fibres and Flax Fibre Composites. Being cellulose based sources of materials

DEFF Research Database (Denmark)

Aslan, Mustafa

-melting temperature polyethylene terephthalate (LPET) filaments were aligned in assemblies of different fibre weight fractions in the range 0.24 to 0.83 to manufacture unidirectional composites using two different consolidation pressures of 1.67 and 4.10 MPa. The maximum attainable fibre volume fraction is found...... to be 47% for the low pressure composites, whereas it is found to be 60% for the high pressure composites. The stiffness of the flax fibre/LPET composites is measured to be in the range 16 to 33 GPa depending on the volumetric composition of the composites. The high pressure composites are found to have...... a similar microstructure at low fibre weight fractions. However, when the fibre content is increased, a difference in porosity content can be observed from the composite cross sections. The nominal tensile strength of the unidirectional flax fibre/LPET composites is measured in the range 180 to 340 MPa...

Nutritional quality of diet and academic performance in Chilean students

OpenAIRE

Correa-Burrows, Paulina; Burrows, Raquel; Blanco, Estela; Reyes, Marcela; Gahagan, Sheila

2016-01-01

Abstract Objective To explore associations between the nutritional quality of diet at age 16?years and academic performance in students from Santiago, Chile. Methods We assessed the nutritional quality of diet, using a validated food frequency questionnaire, in 395 students aged 16.8???0.5?years. Depending on the amount of saturated fat, fibre, sugar and salt in the foods, diet was categorized as unhealthy, fair or healthy. Academic performance was assessed using high school grade-point avera...

Long-term enteral immunonutrition containing lactoferrin in tube-fed bedridden patients: immunological and nutritional status.

Science.gov (United States)

Takeuchi, Yoshiaki; Yamamura, Takuya; Takahashi, Seiichiro; Katayose, Kozo; Kohga, Shin; Takase, Mitsunori; Imawari, Michio

2012-06-01

The aim of this study was to examine the efficacy and safety of a novel immune-enhancing enteral formula, Prem-8, which contains lactoferrin as an immunonutrient. A multicenter, randomized controlled trial was conducted in 5 hospitals in Japan, and 71 tube-fed bedridden patients with serum albumin concentrations between 2.5 and 3.5 g/dL were allocated to Prem-8 (n = 38) or control formula (n = 33) groups for an observation period of 12 weeks. Efficacy was evaluated by comparing immunological (natural killer cell activity, neutrophil-phagocytic activity, neutrophil-sterilizing activity, and C-reactive protein), and nutritional (anthropometric measurements and serum levels of nutritional assessment proteins and total cholesterol) variables. Safety was assessed by comparing the incidence of adverse events. In a secondary analysis, patients were subgrouped according to the amount of protein supplemented (1 g/kg/d) so that immunological and nutritional variables and safety could be further compared. Natural killer activity and neutrophil functions were normal for both groups throughout the study period, without significant between-group differences at any point. Nutritional status was stably maintained in both groups, although the body mass index at 12 weeks was marginally lower in the Prem-8 group than in the control group (p < 0.01). The incidence of adverse events were comparable between both groups, but the incidence of fever in the Prem-8 group (7/14) was significantly lower than in the control group (10/11) in a subgroup of patients whose supplemented protein was less than 1 g/kg/d (p < 0.05). Prem-8 did not demonstrate superiority to the control formula with respect to immunological and nutritional variables, whereas the body mass index of patients in the Prem-8 group marginally decreased. However, Prem-8 had a favorable effect on the incidence of fever in a subgroup of patients with low protein intake.

Blast Resistance of Slurry Infiltrated Fibre Concrete with Waste Steel Fibres from Tires

Directory of Open Access Journals (Sweden)

Drdlová Martina

2018-01-01

Full Text Available The utilization of waste steel fibres (coming from the recycling process of the old tires in production of blast resistant cement based panels was assessed. Waste fibres were incorporated in slurry infiltrated fibre concrete (SIFCON, which is a special type of ultra-highperformance fibre reinforced concrete with high fibre content. The technological feasibility (i.e. suitability of the waste fibres for SIFCON technology was assessed using homogeneity test. Test specimens were prepared with three volume fractions (5; 7.5 and 10 % by vol. of waste unclassified fibres. SIFCON with industrial steel fibres (10% by vol. and ultra-highperformance fibre concrete with industrial fibres were also cast and tested for comparison purposes. Quasi-static mechanical properties were determined. Real blast tests were performed on the slab specimens (500x500x40 mm according to the modified methodology M-T0-VTU0 10/09. Damage of the slab, the change of the ultrasound wave velocity propagation in the slab specimen before and after the blast load in certain measurement points, the weight of fragments and their damage potential were evaluated and compared. Realized tests confirmed the possibility of using the waste fibres for SIFCON technology. The obtained results indicate, that the usage of waste fibres does not significantly reduce the values of SIFCON flexural and compressive strength at quasi-static load - the values were comparable to the specimens with industrially produced fibres. With increasing fibre content, the mechanical parameters are increasing as well. Using of the waste fibres reduces fragmentation of SIFCON at blast load due to the fibre size parameters. Using of low diameter fibres means more fibres in the matrix and thus better homogeneity of the whole composite with less unreinforced areas. Regarding the blast tests, the specimen with waste steel fibres showed the best resistance and outperformed also the specimen with commercial fibres. Using of

Early versus late enteral nutrition in intensive care units. Analysis of results

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Sara Bermejo de las Heras

2017-08-01

Full Text Available Introduction: Malnutrition is particularly prevalent in Intensive Care Units (ICU and associated with poor clinical outcomes. Enteral nutrition (EN has multiple benefits in critically ill patients, particularly when started early at the ICU. A series of studies corroborate this fact; however, other studies present conflicting results. Objective: To assess the clinical results of ICU patients receiving EN, according to EN starting time (early versus late. Patients and method: Basic variables were recorded in all ICU patients who received NE along the study period, as well as time from ICU admission to the start of EN, ICU length of stay, characteristic gastrointestinal complications of EN (gastric residue, constipation, diarrhea, vomiting, regurgitation, abdominal distension and bronchoaspiration and mortality. Results: There was a significant association between early EN and mortality reduction. However, there were no differences in ICU length of stay according to EN starting time. The most frequent complications in the sample were high gastric residue (17.9%, abdominal distension (22.5% and constipation (42.2%. However, no significant differences were observed as a function of the EN starting time. Discussion: Our results, although discrepant at times, do not contradict with those of other studies. EN has shown to be effective as a therapeutic strategy. Therefore, it is recommended the early start of EN in the ICU.

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.

Enteral bile acid treatment improves parenteral nutrition-related liver disease and intestinal mucosal atrophy in neonatal pigs

DEFF Research Database (Denmark)

Jain, Ajay Kumar; Stoll, Barbara; Burrin, Douglas G

2012-01-01

Total parenteral nutrition (TPN) is essential for patients with impaired gut function but leads to parenteral nutrition-associated liver disease (PNALD). TPN disrupts the normal enterohepatic circulation of bile acids, and we hypothesized that it would decrease intestinal expression of the newly...... described metabolic hormone fibroblast growth factor-19 (FGF19) and also glucagon-like peptides-1 and -2 (GLP-1 and GLP-2). We tested the effects of restoring bile acids by treating a neonatal piglet PNALD model with chenodeoxycholic acid (CDCA). Neonatal pigs received enteral feeding (EN), TPN, or TPN...... + CDCA for 14 days, and responses were assessed by serum markers, histology, and levels of key regulatory peptides. Cholestasis and steatosis were demonstrated in the TPN group relative to EN controls by elevated levels of serum total and direct bilirubin and also bile acids and liver triglyceride (TG...

Perioperative lipid-enriched enteral nutrition versus standard care in patients undergoing elective colorectal surgery (SANICS II): a multicentre, double-blind, randomised controlled trial

NARCIS (Netherlands)

Peters, Emmeline G.; Smeets, Boudewijn J. J.; Nors, Jesper; Back, Christian M.; Funder, Jonas A.; Sommer, Thorbjørn; Laurberg, Søren; Løve, Uffe S.; Leclercq, Wouter K. G.; Slooter, Gerrit D.; de Vries Reilingh, Tammo S.; Wegdam, Johannes A.; Nieuwenhuijzen, Grard A. P.; Hiligsmann, Mickaël; Buise, Marc P.; Buurman, Willem A.; de Jonge, Wouter J.; Rutten, Harm J. T.; Luyer, Misha D. P.

2018-01-01

Postoperative ileus and anastomotic leakage severely impair recovery after colorectal resection. We investigated the effect of perioperative lipid-enriched enteral nutrition versus standard care on the risk of postoperative ileus, anastomotic leakage, and other clinical outcomes. We did an

Development of a New Class of Scintillating Fibres with Very Short Decay Time and High Light Yield

International Nuclear Information System (INIS)

Borshchev, O.; Ponomarenko, S.; Surin, N.; Cavalcante, A.B.R.; Gavardi, L.; Gruber, L.; Joram, C.; Shinji, O.

2017-01-01

We present first studies of a new class of scintillating fibres which are characterised by very short decay times and high light yield. The fibres are based on a novel type of luminophores admixed to a polystyrene core matrix. These so-called Nanostructured Organosilicon Luminophores (NOL) have high photoluminescense quantum yield and decay times just above 1 ns. A blue and a green emitting prototype fibre with 250 μm diameter were produced and characterised in terms of attenuation length, ionisation light yield, decay time and tolerance to x-ray irradiation. The well-established Kuraray SCSF-78 and SCSF-3HF fibres were taken as references. Even though the two prototype fibres mark just an intermediate step in an ongoing development, their performance is already on a competitive level. In particular, their decay time constants are about a factor of two shorter than the fastest known fibres, which makes them promising candidates for time critical applications.

Muscle fibre capillarization is a critical factor in muscle fibre hypertrophy during resistance exercise training in older men.

Science.gov (United States)

Snijders, Tim; Nederveen, Joshua P; Joanisse, Sophie; Leenders, Marika; Verdijk, Lex B; van Loon, Luc J C; Parise, Gianni

2017-04-01

Adequate muscle fibre perfusion is critical for the maintenance of muscle mass; it is essential in the rapid delivery of oxygen, nutrients and growth factors to the muscle, stimulating muscle fibre growth. Muscle fibre capillarization is known to decrease substantially with advancing age. However, whether (relative) low muscle fibre capillarization negatively impacts the muscle hypertrophic response following resistance exercise training in older adults is unknown. Twenty-two healthy older men (71 ± 1 years) performed 24 weeks of progressive resistance type exercise training. To assess the change in muscle fibre characteristics, percutaneous biopsies from the vastus lateralis muscle were taken before and following 12 and 24 weeks of the intervention programme. A comparison was made between participants who had a relatively low type II muscle fibre capillary-to-fibre perimeter exchange index (CFPE; LOW group) and high type II muscle fibre CFPE (HIGH group) at baseline. Type I and type II muscle fibre size, satellite cell, capillary content and distance between satellite cells to the nearest capillary were determined by immunohistochemistry. Overall, type II muscle fibre size (from 5150 ± 234 to 6719 ± 446 µm 2 , P muscle fibre, P muscle fibre capillarization, whereas muscle fibre size (from 5170 ± 390 to 7133 ± 314 µm 2 , P muscle fibre, P muscle fibre capillarization were observed in response to 12 and 24 weeks of resistance exercise training in both the LOW and HIGH group. Type II muscle fibre capillarization at baseline may be a critical factor for allowing muscle fibre hypertrophy to occur during prolonged resistance exercise training in older men. © 2016 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

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

Environmentally friendly and highly productive bi-component melt spinning of thermoregulated smart polymer fibres with high latent heat capacity

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Ch. Cherif

2018-03-01

Full Text Available A stable and reproducible bi-component melt spinning process on an industrial scale incorporating Phase Change Material (PCM into textile fibres has been successfully developed and carried out using a melt spinning machine. The key factor for a successful bi-component melt spinning process is that a deep insight into the thermal and rheological behaviour of PCM using Difference Scanning Calorimetry (DSC, Thermogravimetric Analysis (TGA, and an oscillatory rheological investigation. PCM is very sensitive to the temperature and residence time of the melt spinning process. It is found that the optimal process temperature of PCM is 210 °C. The textile-physical properties and the morphology of the melt spun and further drawn bi-component core and sheath fibres (bico fibres were investigated and interpreted. The heat capacities of PCM incorporated in bico fibres were also determined by means of DSC. The melt spun bico fibres integrating PCM provide a high latent heat of up to 22 J/g, which is three times higher than that of state-of-the-art fibres, which were also obtained using the melt spinning process. Therefore, they have the potential to be used as smart polymer fibres for textile and other technical applications.

The influence of removing sizing on strength and stiffness of conventional and high modulus E-glass fibres

DEFF Research Database (Denmark)

Petersen, Helga Nørgaard; Kusano, Yukihiro; Brøndsted, Povl

2016-01-01

Two types of E-glass fibres, a conventional and a high modulus where the last one in the following will be denoted as ECR-glass fibre, were investigated regarding density, diameter, stiffness and strength. The fibres were analysed as pristine and after sizing removal treatments. The sizing was re...

Glass ceramic fibres

International Nuclear Information System (INIS)

Blaschek, O.; Paulitsch, P.

1983-01-01

As the correlation between mineralogical phase and chemical composition influences the type of application at different high temperatures, we studied the mineralogical phases of nine crystal glass fibres of the temperature ranges 1 150 degrees Celsius (Type 1), 1 400 degrees Celsius (Type 2) and 1 500 degrees Celsius (Type 3) at various high temperatures. The methods used in the study were microscopy, X-ray diffraction, transmission electron microscopy and differential thermal analysis. The investigations showed that mullite forms in glassy fibres of the system Al 2 O 3 . SiO 2 from 850 degrees Celsius to 990 degrees Celsius as 2/1 mullite; 3/2 mullite appeared above 990 degrees Celsius besides the crystallization of cristobalite. Fibres with 95 per cent Al 2 O 3 include the phases delta-Al 2 O 3 and alpha- Al 2 O 3 and mullite. Delta- Al 2 O 3 is stable up to 1 100 degrees Celsius. Alpha-Al 2 O 3 and mullite are only stable phases at 1 400 degrees Celsius. These different crystal phases influence the quality of the technical fibre according to the stability field of glass and crystals. This study has determined that it is possible to identify different fibres from different productions by their mineralogical compositions and to relate them to the high temperature application

The Effect of Emodin-Assisted Early Enteral Nutrition on Severe Acute Pancreatitis and Secondary Hepatic Injury

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Gang Wang

2007-01-01

Full Text Available Severe acute pancreatitis (SAP characterized by atrocious progression and numerous complications often leads to a high mortality rate due to hypermetabolism, systemic inflammatory response syndrome (SIRS, and multiple organs dysfunction syndrome (MODS. Studies have revealed that both early enteral nutrition (EEN and emodin are potent agents in the management of SAP. However, whether the combined strategy is rational and more effective than either one alone remains unknown. In this regard, Wistar rats were treated with emodin-assisted EEN (EAEEN through enteral nutrient tubes after induction of SAP by retrograde infusion of 5.0% sodium taurocholate into the common pancreatic duct. Serum levels of amylase, tumor necrosis factor-alpha (TNF-α, angiotensin II (AngII, maleic dialdehyde (MDA, glutamic pyruvic transaminase (ALT, glutamic oxaloacetic transaminase (AST and C-reactive protein (CRP, intestinal secretory IgA (SIgA, pancreatic and hepatic myeloperoxidase (MPO activity as well as plasma levels of D-lactate and endotoxin were measured. In addition, pathologic alterations of pancreas and liver were observed microscopically. We found that EAEEN could significantly ameliorate these parameters and prevent pancreas and liver from serious damage. In conclusion, Our results indicated that EAEEN could exert beneficial effects on experimental SAP and obviously abate the severity of secondary hepatic injury. The combined strategy was safe and more effective than either one alone in the acute stage of SAP. This study also provided an experimental base for the clinical treatment of SAP patients with EAEEN.

Nutritional support and dietary interventions following esophagectomy: challenges and solutions

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Paul M

2017-03-01

Full Text Available Melanie Paul, Melanie Baker, Robert N Williams, David J Bowrey Department of Surgery, Leicester Royal Infirmary, Leicester, UK Background and aims: Provision of adequate nutrition after esophagectomy remains a major challenge. The aims of this review were to describe the challenges facing this patient population and to determine the evidence base underpinning current nutritional and dietetic interventions after esophagectomy. Methods: Medline, Embase and CINAHL databases were searched for English language publications of the period 1990–2016 reporting on the outcome of nutritional or dietetic interventions after esophagectomy or patient-related symptoms. Results: Four studies demonstrated that early reintroduction of oral fluids was safe and was associated with a shorter hospital stay and ileus duration. One of three studies comparing in-hospital enteral nutrition against usual care showed that enteral feeding was well tolerated and was associated with a shorter hospital stay. Eight studies comparing enteral with parenteral nutrition showed similar surgical complication rates. Enteral feeding was associated with a shorter duration of ileus and lower health care costs. In hospital, all types of enteral access (nasoenteral, jejunostomy were equivalent in their safety profiles. Cohort studies indicate that technical (tube dysfunction and feed (diarrhea, distention problems were common with jejunostomies but are easily managed. The mortality risk associated with jejunostomy in hospital is 0.2% (reported range 0%–1%, principally due to small bowel ischemia. There have been no reports of serious jejunostomy complications in patients receiving home feeding. One study demonstrated the advantages of home feeding in weight, muscle and fat preservation. Studies reporting 12 months or more after esophagectomy indicate a high frequency of persistent symptoms, dumping syndrome 15%–75% (median 46%, dysphagia 11%–38% (median 27%, early satiety 40%–90

Influence of a high fibre diet on glycaemic control and quality of life in dogs with diabetes mellitus.

Science.gov (United States)

Graham, P A; Maskell, E; Rawlings, J M; Nash, A S; Markwell, P J

2002-02-01

A study was undertaken to evaluate a high fibre diet used in the management of 10 dogs with naturally occurring insulin-dependent diabetes mellitus. Following baseline measurements of health and glycaemic control, the dogs were fed a canned diet containing a blend of insoluble and soluble dietary fibres and were monitored during the ensuing four months. Switching to the high fibre diet was associated with significantly lower mean 24-hour and postprandial plasma glucose concentrations, which were maintained over the study period. The high fibre diet was also associated with significant reductions in plasma concentrations of fructosamine, glycated haemoglobin, free glycerol and cholesterol, and there were significant improvements in dog activity and demeanour. Bodyweight declined during the fourth month of feeding the diet, which is likely to have resulted from underfeeding relative to increased activity. The results indicate that a high fibre diet can significantly improve glycaemic control and quality of life in dogs with diabetes mellitus.

Evidence for Dietary Fibre Modification in the Recovery and Prevention of Reoccurrence of Acute, Uncomplicated Diverticulitis: A Systematic Literature Review

Science.gov (United States)

Dahl, Camilla; Crichton, Megan; Jenkins, Julie; Nucera, Romina; Mahoney, Sophie; Marx, Wolfgang

2018-01-01

In practice, nutrition recommendations vary widely for inpatient and discharge management of acute, uncomplicated diverticulitis. This systematic review aims to review the evidence and develop recommendations for dietary fibre modifications, either alone or alongside probiotics or antibiotics, versus any comparator in adults in any setting with or recently recovered from acute, uncomplicated diverticulitis. Intervention and observational studies in any language were located using four databases until March 2017. The Cochrane Risk of Bias tool and GRADE were used to evaluate the overall quality of the evidence and to develop recommendations. Eight studies were included. There was “very low” quality evidence for comparing a liberalised and restricted fibre diet for inpatient management to improve hospital length of stay, recovery, gastrointestinal symptoms and reoccurrence. There was “very low” quality of evidence for using a high dietary fibre diet as opposed to a standard or low dietary fibre diet following resolution of an acute episode, to improve reoccurrence and gastrointestinal symptoms. The results of this systematic review and GRADE assessment conditionally recommend the use of liberalised diets as opposed to dietary restrictions for adults with acute, uncomplicated diverticulitis. It also strongly recommends a high dietary fibre diet aligning with dietary guidelines, with or without dietary fibre supplementation, after the acute episode has resolved. PMID:29382074

Economic production and processing of agricultural fibre plants for high quality applications in automotive, building and furniture industry

Energy Technology Data Exchange (ETDEWEB)

Pecenka, R.; Furll, C.; Gusovius, H.J. [Leibniz Inst. for Agricultural Engineering, Potsdam (Germany)

2010-07-01

The demand for high-quality fibres and shives from hemp and flax as an alternative raw material for the automotive and building industry is increasing. Fibres are used primarily for composite reinforcement instead of synthetic fibres. Shives are used for animal bedding, but processing trials in wood industry for the production of low weight particle boards from shives are also very promising. Fibre producers require experience in cultivation and harvesting as well as modern processing technologies in order to supply flax fibres or shives at competitive prices under the changing conditions of international raw material markets. A complete processing line has been developed, installed and tested at the Leibniz Institute for Agricultural Engineering (ATB) to study all the processing stages of fibre production. The new ATB line can produce high quality fibres and shives from retted and unretted hemp, flax and oilseed flax straw without technical changes of the machine line. The ATB pilot plant has been operated by a cooperation of farmers since 2008. Experience from industrial operation has been used to develop a modern fibre processing line with a throughput of up to 5 t per h hemp straw in only one short line.

Iodine in Enteral and Parenteral Nutrition

NARCIS (Netherlands)

Zimmermann, M.B.; Crill, C.M.

2010-01-01

Iodine deficiency (ID) has multiple adverse effects on growth and development due to inadequate thyroid hormone production. Methods for assessment of iodine nutrition in individuals include the urinary iodine concentration (UI), thyroid size and thyroid function tests. The UI measured in several

A flexible, highly sensitive catheter for high resolution manometry based on in-fibre Bragg gratings

International Nuclear Information System (INIS)

Bueley, Christopher; Wild, Peter M

2013-01-01

This work presents a fibre optic-based flexible catheter for high resolution manometry (HRM), with sensing pods located at a pitch of 10 mm and an overall diameter of 2.8 mm. In-fibre Bragg gratings act as the sensing elements within these sensing pods. Hydrodynamic pressure resolution of 0.2 mmHg is demonstrated in conjunction with insensitivity to occlusion pressure. This result is significant in the context of HRM where independent measurement of hydrodynamic pressure is clinically relevant. The sensing system is compact, robust and flexible. Crosstalk between individual sensors is characterized and a compensation scheme is developed and validated. (paper)

Optimization of a process for high fibre and high protein biscuit.

Science.gov (United States)

Singh, Parul; Singh, Rakhi; Jha, Alok; Rasane, Prasad; Gautam, Anuj Kumar

2015-03-01

Biscuits are popular and convenient food products due to their ready to eat nature. Biscuits were prepared from sorghum and whole wheat flour with the addition of spirulina (Spirulina platensis) powder to produce high fibre and high protein biscuit. Levels of ingredients in biscuits such as spirulina powder, sorghum flour and guar gum were optimized using response surface methodology (RSM) for its sensory, textural and antioxidant attributes. Sensory attributes as colour intensity (R2 = 0.89, P powder and sorghum flour was found to have significant effect on the responses.

Fibre Concrete 2017

Science.gov (United States)

2017-09-01

9th international conference on fibre reinforced concretes (FRC), textile reinforced concretes (TRC) and ultra-high performance concretes (UHPC) Preface The Fibre Concrete Conference series is held biennially to provide a platform to share knowledge on fibre reinforced concretes, textile concretes and ultra-high performance concretes regarding material properties and behaviour, technology procedures, topics of long-term behaviour, creep, durability; sustainable aspects of concrete including utilisation of waste materials in concrete production and recycling of concrete. The tradition of Fibre Concrete Conferences started in eighties of the last century. Nowadays the conference is organized by the Department of Concrete and Masonry Structures of the Czech Technical University in Prague, Faculty of Civil Engineering. The 9th International Conference Fibre Concrete 2017 had 109 participants from 27 countries all over the world. 55 papers were presented including keynote lectures of Professor Bažant, Professor Bartoš and Dr. Broukalová. The conference program covered wide range of topics from scientific research to practical applications. The presented contributions related to performance and behaviour of cement based composites, their long-term behaviour and durability, sustainable aspects, advanced analyses of structures from these composites and successful applications. This conference was organized also to honour Professor Zděnek P. Bažant on the occasion of his jubilee and to appreciate his merits and discoveries in the field of fibre reinforced composites, structural mechanics and engineering.

DETECTORS: scintillating fibres

International Nuclear Information System (INIS)

Anon.

1994-01-01

In the continual search for improved detection techniques, new materials are continually proving profitable. A good example is scintillating plastic fibres - tiny transparent threads sometimes finer than a human hair which transmit light. The narrowness and flexibility of these fibres was a major breakthrough for endoscopy - non-invasive techniques for viewing the otherwise inaccessible in surgery or machine inspection. In a more sophisticated form, these fibres find ready application in communications technology, where the goal is to transmit information rather than electrical power, replacing conventional and unwieldy current-carrying wire conductors. In particle physics, fibres have long been used to take the tiny scintillations produced when high energy particles hit fluorescent materials and 'conduct' them to photosensitive detectors some distance away

Damage characterization of E-glass and C-glass fibre polymer composites after high velocity impact

Science.gov (United States)

Razali, N.; Sultan, M. T. H.; Cardona, F.; Jawaid, M.

2017-12-01

The purpose of this work is to identify impact damage on glass fibre reinforced polymer composite structures after high velocity impact. In this research, Type C-glass (600 g/m2) and Type E-glass (600 g/m2) were used to fabricate Glass Fibre-Reinforced Polymer composites (GFRP) plates. The panels were fabricated using a vacuum bagging and hot bounder method. Single stage gas gun (SSGG) was used to do the testing and data acquisition system was used to collect the damage data. Different types of bullets and different pressure levels were used for the experiment. The obtained results showed that the C-glass type of GFRP experienced more damage in comparison to E-glass type of materials based on the amount of energy absorbed on impact and the size of the damage area. All specimens underwent a partial fibre breakage but the laminates were not fully penetrated by the bullets. This indicated that both types of materials have high impact resistance even though the applied pressures of the gas gun were on the high range. We concluded that within the material specifications of the laminates including the type of glass fibre reinforcement and the thickness of the panels, those composite materials are safe to be applied in structural and body armour applications as an alternative to more expensive materials such as Kevlar and type S-glass fibre based panels.

Performance of a highly segmented scintillating fibres electromagnetic calorimeter

International Nuclear Information System (INIS)

Asmone, A.; Bertino, M.; Bini, C.; De Zorzi, G.; Diambrini Palazzi, G.; Di Cosimo, G.; Di Domenico, A.; Garufi, F.; Gauzzi, P.; Zanello, D.

1993-01-01

A prototype of scintillating fibres electromagnetic calorimeter has been constructed and tested with 2, 4 and 8 GeV electron beams at the CERN PS. The calorimeter modules consist of a Bi-Pb-Sn alloy and scintillating fibres. The fibres are parallel to the modules longer axis, and nearly parallel to the incident electrons direction. The calorimeter has two different segmentation regions of 24x24 mm 2 and 8x24 mm 2 cross area respectively. Results on energy and impact point space resolution are obtained and compared for the two different granularities. (orig.)

Parenteral nutrition in the ICU setting: need for a shift in utilization.

Science.gov (United States)

Oshima, Taku; Hiesmayr, Michael; Pichard, Claude

2016-03-01

The difficulties to feed the patients adequately with enteral nutrition alone have drawn the attention of the clinicians toward the use of parenteral nutrition, although recommendations by the recent guidelines are conflicting. This review focuses on the intrinsic role of parenteral nutrition, its new indication, and modalities of use for the critically ill patients. A recent trial demonstrated that selecting either parenteral nutrition or enteral nutrition for early nutrition has no impact on clinical outcomes. However, it must be acknowledged that the risk of relative overfeeding is greater when using parenteral nutrition and the risk of underfeeding is greater when using enteral nutrition because of gastrointestinal intolerance. Both overfeeding and underfeeding in the critically ill patients are associated with deleterious outcomes. Thus, early and adequate feeding according to the specific energy needs can be recommended as the optimal feeding strategy. Parenteral nutrition can be used to substitute or supplement enteral nutrition, if adequately prescribed. Testing for enteral nutrition tolerance during 2-3 days after ICU admission provides the perfect timing to start parenteral nutrition, if needed. In case of absolute contraindication for enteral nutrition, consider starting parenteral nutrition carefully to avoid overfeeding.

Standardized Competencies for Parenteral Nutrition Order Review and Parenteral Nutrition Preparation, Including Compounding: The ASPEN Model.

Science.gov (United States)

Boullata, Joseph I; Holcombe, Beverly; Sacks, Gordon; Gervasio, Jane; Adams, Stephen C; Christensen, Michael; Durfee, Sharon; Ayers, Phil; Marshall, Neil; Guenter, Peggi

2016-08-01

Parenteral nutrition (PN) is a high-alert medication with a complex drug use process. Key steps in the process include the review of each PN prescription followed by the preparation of the formulation. The preparation step includes compounding the PN or activating a standardized commercially available PN product. The verification and review, as well as preparation of this complex therapy, require competency that may be determined by using a standardized process for pharmacists and for pharmacy technicians involved with PN. An American Society for Parenteral and Enteral Nutrition (ASPEN) standardized model for PN order review and PN preparation competencies is proposed based on a competency framework, the ASPEN-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines, and is intended for institutions and agencies to use with their staff. © 2016 American Society for Parenteral and Enteral Nutrition.

Engagement with dietary fibre and receptiveness to resistant starch in Australia.

Science.gov (United States)

Mohr, Philip; Quinn, Sinéad; Morell, Matthew; Topping, David

2010-11-01

To investigate community engagement with the health benefits of dietary fibre (DF) and its potential as a framework for the promotion of increased consumption of resistant starch (RS). A nationwide postal Food and Health Survey conducted in Australia by CSIRO Human Nutrition. Adults aged 18 years and above, selected at random from the Australian Electoral Roll (n 849). A cross-sectional design was employed to analyse ratings of (i) the importance of various RS health and functional claims and (ii) receptiveness to different foods as RS delivery vehicles, according to the respondents' level of fibre engagement as classified under the Precaution Adoption Process Model (PAPM) of Health Behaviour. There was a high level of recognition (89·5 %) of DF as being important for health. Significant gender differences were found for ratings of RS attributes and RS delivery options. Women were both more fibre-engaged than men and more receptive than men to RS and its potential benefits. Ratings of the acceptability of several foods as means of delivering RS revealed a general preference for healthy staples over indulgences, with the margin between acceptability of staples and indulgences increasing markedly with increased fibre engagement. Application of the PAPM to awareness of DF reveals a ready-made target group for health messages about RS and pockets of differential potential receptiveness. The findings support the promotion of RS as providing health benefits of DF with the added reduction of risk of serious disease, its delivery through healthy staples and the targeting of messages at both fibre-engaged individuals and women in general.

Does the diet of the Balearic population, a Mediterranean-type diet, ensure compliance with nutritional objectives for the Spanish population?

Science.gov (United States)

Tur, Josep A; Romaguera, Dora; Pons, Antoni

2005-05-01

To assess the dietary habits of Balearic Islands' consumers who are successful in meeting current nutritional recommendations, to find clues for the development of future food-based dietary guidelines (FBDG) that would be relevant to this population. Cross-sectional nutritional survey carried out in the Balearic Islands between 1999 and 2000. Dietary habits were assessed by means of 24-hour recall (two non-consecutive days: warm and cold season) and a food-frequency questionnaire in a random sample (n=1200, aged 16-65 years) living in private households. Differences in percentage of compliers with the intermediate nutritional objectives for the Spanish population and differences in food consumption patterns between genders and between high (above the upper quartile of intake) and low (below the lower quartile of intake) consumers of fat, saturated fatty acids (SFA), fibre, and fruit and vegetables were analysed. Gender differences were observed in nutrient and energy intakes, as well as in attainment of the recommendations. Less than 25% of the population reached the intermediate nutritional recommendations for iodine, fruit, carbohydrates, SFA, fibre and vegetables. Low fat/SFA and high fruit and vegetables/fibre consumers kept a diet in line with the traditional Balearic diet and prevailing dietary pyramids, which ensured better compliance with the nutritional goals. The intermediate nutritional objectives for the Spanish population could be achieved through maintenance of the traditional Balearic diet, a Mediterranean-type diet in the Balearic population. Therefore, this dietary model could be used to develop FBDG relevant to this population.

Vibrated and self-compacting fibre reinforced concrete: experimental investigation on the fibre orientation

Science.gov (United States)

Conforti, A.; Plizzari, G. A.; Zerbino, R.

2017-09-01

In addition to the fibre type and content, the residual properties of fibre reinforced concrete are influenced by fibre orientation. Consequently, the performance fibre reinforced concrete can be affected by its fresh properties (workability, flowing capacity) and by casting and compaction processes adopted. This paper focuses on the study of the orientation of steel or macro-synthetic fibres in two materials characterized by very different fresh properties: vibrated and self-compacting concrete. Four rectangular slabs 1800 mm long, 925 mm wide and 100 mm high were produced changing concrete and fibre type. From each slab, eighteen small prisms (550 mm long) were firstly cut either orthogonal or parallel to casting direction and, secondly, notched and tested in bending according to EN 14651. Experimental results showed that the toughness properties of a thin slab significantly varies both in vibrated and self-compacting concrete, even if in case of self-compacting concrete this variation resulted higher. Steel fibres led to greater variability of results compared to polymer one, underlining a different fibre orientation. A discussion on the relative residual capacity measured on the prisms sawn from the slabs and the parameters obtained from standard specimens is performed.

Altered fibre types in gastrocnemius muscle of high wheel-running selected mice with mini-muscle phenotypes.

Science.gov (United States)

Guderley, Helga; Joanisse, Denis R; Mokas, Sophie; Bilodeau, Geneviève M; Garland, Theodore

2008-03-01

Selective breeding of mice for high voluntary wheel running has favoured characteristics that facilitate sustained, aerobically supported activity, including a "mini-muscle" phenotype with markedly reduced hind limb muscle mass, increased mass-specific activities of oxidative enzymes, decreased % myosin heavy chain IIb, and, in the medial gastrocnemius, reduced twitch speed, reduced mass-specific isotonic power, and increased fatigue resistance. To evaluate whether selection has altered fibre type expression in mice with either "mini" or normal muscle phenotypes, we examined fibre types of red and white gastrocnemius. In both the medial and lateral gastrocnemius, the mini-phenotype increased activities of oxidative enzymes and decreased activities of glycolytic enzymes. In red muscle samples, the mini-phenotype markedly changed fibre types, with the % type I and type IIA fibres and the surface area of type IIA fibres increasing; in addition, mice from selected lines in general had an increased % type IIA fibres and larger type I fibres as compared with mice from control lines. White muscle samples from mini-mice showed dramatic structural alterations, with an atypical distribution of extremely small, unidentifiable fibres surrounded by larger, more oxidative fibres than normally present in white muscle. The increased proportion of oxidative fibres and these atypical small fibres together may explain the reduced mass and increased mitochondrial enzyme activities in mini-muscles. These and previous results demonstrate that extension of selective breeding beyond the time when the response of the selected trait (i.e. distance run) has levelled off can still modify the mechanistic underpinnings of this behaviour.

Electrostatic flocking of chitosan fibres leads to highly porous, elastic and fully biodegradable anisotropic scaffolds.

Science.gov (United States)

Gossla, Elke; Tonndorf, Robert; Bernhardt, Anne; Kirsten, Martin; Hund, Rolf-Dieter; Aibibu, Dilibar; Cherif, Chokri; Gelinsky, Michael

2016-10-15

Electrostatic flocking - a common textile technology which has been applied in industry for decades - is based on the deposition of short polymer fibres in a parallel aligned fashion on flat or curved substrates, covered with a layer of a suitable adhesive. Due to their highly anisotropic properties the resulting velvet-like structures can be utilised as scaffolds for tissue engineering applications in which the space between the fibres can be defined as pores. In the present study we have developed a fully resorbable compression elastic flock scaffold from a single material system based on chitosan. The fibres and the resulting scaffolds were analysed concerning their structural and mechanical properties and the biocompatibility was tested in vitro. The tensile strength and Young's modulus of the chitosan fibres were analysed as a function of the applied sterilisation technique (ethanol, supercritical carbon dioxide, γ-irradiation and autoclaving). All sterilisation methods decreased the Young's modulus (from 14GPa to 6-12GPa). The tensile strength was decreased after all treatments - except after the autoclaving of chitosan fibres submerged in water. Compressive strength of the highly porous flock scaffolds was 18±6kPa with a elastic modulus in the range of 50-100kPa. The flocked scaffolds did not show any cytotoxic effect during indirect or direct culture of human mesenchymal stem cells or the sarcoma osteogenic cell line Saos-2. Furthermore cell adhesion and proliferation of both cell types could be observed. This is the first demonstration of a fully biodegradable scaffold manufactured by electrostatic flocking. Most tissues possess anisotropic fibrous structures. In contrast, most of the commonly used scaffolds have an isotropic morphology. By utilising the textile technology of electrostatic flocking, highly porous and clearly anisotropic scaffolds can be manufactured. Flocking leads to parallel aligned short fibres, glued on the surface of a substrate

Effect of type and level of dietary fibre supplements in rats

Directory of Open Access Journals (Sweden)

Moharib, Sorial A.

2003-09-01

Full Text Available Both experimental and clinical studies have indicated that a novel source of dietary fibres is potentially hypolipidemic. In the present study, turnip, sugar beet, cabbage and fenugreek green leaves were used as natural new sources of dietary fibres, to examine their effects on nutritional parameters and lipid metabolism in rats fed for 8 weeks comparing with a control diet (fibre-free control. Chemical analyses of the 4 plants revealed that there are differences between the ratios of soluble and insoluble non - starch polysaccharides (NSP and their monomers constituents. Higher levels of uronic acid were present in soluble fibre (NSP in all fibre sources than that of insoluble one. Generally, highly significant decrease in the weight gain and food intake of the rats fed the 4 experimental diets after 8 weeks feeding comparing with those fed control diet. Rats fed turnip diet exhibited a highly significant decrease in all the nutritional parameters through the feeding period. Rats fed a diet supplemented with sugar beet fibre, have a highly significant decrease in the value of weight gain, food intake and Dapp over the feeding period. Sugar beet, cabbage and fenugreek green fibre-containing diets had lowering effect on serum total lipid, total cholesterol, LDL-C (except sugar beet and triglycerides levels than that of control diet fed rats. Supplemented the diet with turnip fibre had only lowering effect on serum triglycerides over the feeding period. Hepatic total lipid and total cholesterol levels were significantly lower when rats fed cabbage and fenugreek green fiber-containing diets. Highly significant decrease in the level of triglycerides was achieved in the liver of rats fed turnip fibre supplemented diet comparing with the experimental period (8 weeks.Estudios clínicos y experimentales han indicado que nuevas fuentes de fibras dietéticas son potencialmente hipolipídicas. En el presente estudio nabo, remolacha, col y fenogreco verde

Nutritional status and nutritional support before and after pancreatectomy for pancreatic cancer and chronic pancreatitis.

Science.gov (United States)

Karagianni, Vasiliki Th; Papalois, Apostolos E; Triantafillidis, John K

2012-12-01

Cachexia, malnutrition, significant weight loss, and reduction in food intake due to anorexia represent the most important pathophysiological consequences of pancreatic cancer. Pathophysiological consequences result also from pancreatectomy, the type and severity of which differ significantly and depend on the type of the operation performed. Nutritional intervention, either parenteral or enteral, needs to be seen as a method of support in pancreatic cancer patients aiming at the maintenance of the nutritional and functional status and the prevention or attenuation of cachexia. Oral nutrition could reduce complications while restoring quality of life. Enteral nutrition in the post-operative period could also reduce infective complications. The evidence for immune-enhanced feed in patients undergoing pancreaticoduodenectomy for pancreatic cancer is supported by the available clinical data. Nutritional support during the post-operative period on a cyclical basis is preferred because it is associated with low incidence of gastric stasis. Postoperative total parenteral nutrition is indicated only to those patients who are unable to be fed orally or enterally. Thus nutritional deficiency is a relatively widesoread and constant finding suggesting that we must optimise the nutritional status both before and after surgery.

Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC.

Directory of Open Access Journals (Sweden)

Neil Murphy

Full Text Available Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location.After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs and 95% confidence intervals (CIs were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96. Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals.Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

The postoperative clinical outcomes and safety of early enteral nutrition in operated gastric cancer patients.

Science.gov (United States)

Li, Bing; Liu, Hong-Yi; Guo, Shao-Hua; Sun, Peng; Gong, Fang-Ming; Jia, Bao-Qing

2015-01-01

This study investigated the impact of early enteral nutrition (EEN) on the clinical outcomes of gastric cancer patients after radical gastrectomy. Four hundred gastric cancer patients undergoing radical gastrectomy of any extend with D2 nodal dissection were randomly divided into an experimental and a control group with 200 cases in each group. Patients in the control group received postoperative parenteral nutrition (PN), while patients in the experimental group received postoperative EEN. After treatment, the clinical outcomes, postoperative immune function, and nutritional status of the two groups were evaluated. The postoperative fever time, intestinal function recovery time, anal exhaust time, and the length of hospital stay for patients in the experimental group were significantly shorter than those of the control group. We did not find significant differences in anastomotic leak, postoperative ileus and regurgitation between the two groups. The activities of multiple immune cell types, including CD3⁺, CD4⁺, CD4⁺/CD8⁺, and natural killer (NK) cells, were significantly lower in both groups on postoperative day 1 when compared with the preoperative levels (p0.05). After treatment, levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺, and NK cells in the experimental group patients were 35.6 ± 4.2, 42.2 ± 3.0, 1.7 ± 0.3, and 27.3 ± 5.3%, respectively, on postoperative day 7, which were similar to the preoperative levels. The immune cell levels from the control group patients remained significantly lower when compared with preoperative values; in addition, these values were also significantly lower when compared with the EEN patients (pgastric cancer patients undergoing radical gastrectomy, the clinical outcome, immune function and nutritional status after EEN were significantly improved. These data suggest the widespread use of EEN in clinical practice.

Clinical application of immune-enhanced enteral nutrition in patients with advanced gastric cancer after total gastrectomy.

Science.gov (United States)

Liu, Hua; Ling, Wei; Shen, Zhi Yong; Jin, Xin; Cao, Hui

2012-08-01

To determine whether immune-enhanced enteral nutrition (EN) was effective on nutritional status, immune function, surgical outcomes and days of hospitalization after total gastrectomy for patients with advanced gastric cancer (AGC). From August 2005 to May 2011, 78 patients with AGC who underwent a total gastrectomy were enrolled and divided randomly into three groups: immune-enhanced EN (EN + glutamine [Gln]) group, standard EN group and control group. Serum parameters including total protein, albumin, proalbumin and transferrin were examined on preoperative day 1, postoperative day 2 and day 12. Levels of immunoglobulin M (IgM), immunoglobulin G (IgG), natural killer (NK) cells, CD4⁺ and CD8⁺ T cells were also compared. The formulas were tolerated well in all the patients except 5 with mild complications. The EN + Gln and EN groups showed a faster onset of flatus and shorter hospitalization duration than the control group. On postoperative day 12, serum total protein, albumin, proalbumin and transferrin levels of the EN + Gln and EN groups were significantly higher than those of the control group (P nutritional status and immune function for the patients with AGC after total gastrectomy. © 2012 The Authors. Journal of Digestive Diseases © 2012 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.

Sobrevida e complicações em idosos com doenças neurológicas em nutrição enteral Occurrence of complications and survival rates in elderly with neurological disorders undergoing enteral nutrition therapy

Directory of Open Access Journals (Sweden)

Aline Stangherlin Martins

2012-12-01

Full Text Available OBJETIVO: Avaliar a sobrevida e complicações de pacientes idosos com doenças neurológicas em uso de nutrição enteral (NE. MÉTODOS: Avaliaram-se pacientes acima de 60 anos acompanhados pelo serviço de atenção domiciliar de um plano de saúde de Belo Horizonte, MG, Brasil. A avaliação ocorreu no domicílio após a alta hospitalar com NE, após três e seis meses e ao término do estudo. Foram realizadas avaliação nutricional, coleta de dados em prontuários e entrevistas com familiares ou cuidadores. RESULTADOS: Foram avaliados 79 pacientes, idade 82,9 ± 10,4 anos, 49,4% com demência e 50,6% com outros diagnósticos neurológicos, 100% com elevado grau de dependência avaliada pelo índice de Katz. A maioria dos pacientes (91,2% apresentou complicações (pneumonia, perda da sonda, diarreia, constipação, vômito, extravasamento periostomia, obstrução da sonda, refluxo e miíase. Pneumonia foi a mais frequente, ocorrendo em 55,9%. A mortalidade foi de 15,2% aos três meses, 22,8% aos 6 meses e 43% ao término do estudo. A mediana de sobrevida após iniciada a NE foi de 364 dias. Não se observaram diferenças entre mortalidade e diagnóstico neurológico, vias de acesso de NE e complicações. A sobrevida foi menor em pacientes com estado nutricional inadequado e albumina OBJECTIVE: To evaluate the occurrence of complications, as well as the survival rates, in elderly people having neurological diseases and undergoing enteral nutrition therapy (ENT. METHODS: Patients aged over 60 years, assisted by a home medical service from a healthcare plan in the city of Belo Horizonte, MG, Brazil, were thoroughly evaluated. The mentioned evaluation occurred at their homes after hospital discharge with enteral nutrition (EN after a three-month period, a six-month period, and at the end of the study. A nutritional assessment was performed along with data collection performed on the patients' electronic medical records, and interviews

Malnutrition risk predicts recovery of full oral intake among older adult stroke patients undergoing enteral nutrition: Secondary analysis of a multicentre survey (the APPLE study).

Science.gov (United States)

Nishioka, Shinta; Okamoto, Takatsugu; Takayama, Masako; Urushihara, Maki; Watanabe, Misuzu; Kiriya, Yumiko; Shintani, Keiko; Nakagomi, Hiromi; Kageyama, Noriko

2017-08-01

Whether malnutrition risk correlates with recovery of swallowing function of convalescent stroke patients is unknown. This study was conducted to clarify whether malnutrition risks predict achievement of full oral intake in convalescent stroke patients undergoing enteral nutrition. We conducted a secondary analysis of 466 convalescent stroke patients, aged 65 years or over, who were undergoing enteral nutrition. Patients were extracted from the "Algorithm for Post-stroke Patients to improve oral intake Level; APPLE" study database compiled at the Kaifukuki (convalescent) rehabilitation wards. Malnutrition risk was determined by the Geriatric Nutritional Risk Index as follows: severe (malnutrition risks (≥98). Swallowing function was assessed by Fujishima's swallowing grade (FSG) on admission and discharge. The primary outcome was achievement of full oral intake, indicated by FSG ≥ 7. Binary logistic regression analysis was performed to identify predictive factors, including malnutrition risk, for achieving full oral intake. Estimated hazard risk was computed by Cox's hazard model. Of the 466 individuals, 264 were ultimately included in this study. Participants with severe malnutrition risk showed a significantly lower proportion of achievement of full oral intake than lower severity groups (P = 0.001). After adjusting for potential confounders, binary logistic regression analysis showed that patients with severe malnutrition risk were less likely to achieve full oral intake (adjusted odds ratio: 0.232, 95% confidence interval [95% CI]: 0.047-1.141). Cox's proportional hazard model revealed that severe malnutrition risk was an independent predictor of full oral intake (adjusted hazard ratio: 0.374, 95% CI: 0.166-0.842). Compared to patients who did not achieve full oral intake, patients who achieved full oral intake had significantly higher energy intake, but there was no difference in protein intake and weight change. Severe malnutrition risk independently

Noninvasive and invasive ventilation and enteral nutrition for ALS in Italy.

Science.gov (United States)

Fini, Nicola; Georgoulopoulou, Eleni; Vinceti, Marco; Monelli, Marco; Pinelli, Giovanni; Vacondio, Paolo; Giovannini, Michele; Dallari, Rossano; Marudi, Andrea; Mandrioli, Jessica

2014-10-01

We performed a population-based study to assess amyotrophic lateral sclerosis (ALS) survival after noninvasive ventilation (NIV), invasive ventilation (IV), and enteral nutrition (EN). We included patients diagnosed from 2000 to 2009 in Modena, where a prospective registry and a Motor Neuron Diseases Centre have been active since 2000. Of the 193 incident cases, 47.7% received NIV, 24.3% received tracheostomy, and 49.2% received EN. A total of 10.4% of the patients refused NIV, 31.6% refused IV, and 8.7% refused EN. The median survival times after NIV, IV, and EN were 15, 19, and 9 months, respectively. Of the tracheostomized patients, 79.7% were discharged from the hospital; 73.0% were discharged to home. The median survival times for tracheostomized patients who were cared for at home and in nursing homes were 43 and 2 months, respectively. The multivariate analysis demonstrated that the place of discharge was the only independent prognostic factor after IV (PNIV, IV, EN, and influence postprocedure survival. These data may be useful in defining health plans regarding advanced ALS care and in patient counseling. © 2014 Wiley Periodicals, Inc.

Processing of oats and the impact of processing operations on nutrition and health benefits.

Science.gov (United States)

Decker, Eric A; Rose, Devin J; Stewart, Derek

2014-10-01

Oats are a uniquely nutritious food as they contain an excellent lipid profile and high amounts of soluble fibre. However, an oat kernel is largely non-digestible and thus must be utilised in milled form to reap its nutritional benefits. Milling is made up of numerous steps, the most important being dehulling to expose the digestible groat, heat processing to inactivate enzymes that cause rancidity, and cutting, rolling or grinding to convert the groat into a product that can be used directly in oatmeal or can be used as a food ingredient in products such as bread, ready-to-eat breakfast cereals and snack bars. Oats can also be processed into oat bran and fibre to obtain high-fibre-containing fractions that can be used in a variety of food products.

Plant fibre composites - porosity and volumetric interaction

DEFF Research Database (Denmark)

Madsen, Bo; Thygesen, Anders; Lilholt, Hans

2007-01-01

the combination of a high fibre volume fraction, a low porosity and a high composite density is optimal. Experimental data from the literature on volumetric composition and density of four types of plant fibre composites are used to validate the model. It is demonstrated that the model provides a concept......Plant fibre composites contain typically a relative large amount of porosity, which considerably influences properties and performance of the composites. The large porosity must be integrated in the conversion of weight fractions into volume fractions of the fibre and matrix parts. A model...... is presented to predict the porosity as a function of the fibre weight fractions, and to calculate the related fibre and matrix volume fractions, as well as the density of the composite. The model predicts two cases of composite volumetric interaction separated by a transition fibre weight fraction, at which...

Optimizing Perioperative Nutrition in Pediatric Populations.

Science.gov (United States)

Canada, Nicki L; Mullins, Lucille; Pearo, Brittany; Spoede, Elizabeth

2016-02-01

Nutrition status prior to surgery and nutrition rehabilitation after surgery can affect the morbidity and mortality of pediatric patients. A comprehensive approach to nutrition in pediatric surgical patients is important and includes preoperative assessment, perioperative nutrition considerations, and postoperative recovery. A thorough nutrition assessment to identify patients who are at nutrition risk prior to surgery is important so that the nutrition status can be optimized prior to the procedure to minimize suboptimal outcomes. Preoperative malnutrition is associated with increased complications and mean hospital days following surgery. Enteral and parenteral nutrition can be used in cases where food intake is inadequate to maintain and possibly improve nutrition status, especially in the 7-10 days prior to surgery. In the perioperative period, fasting should be limited to restricting solid foods and non-human milk 6 hours prior to the procedure and allowing clear liquids until 2 hours prior to the procedure. Postoperatively, early feeding has been shown to resolve postoperative ileus earlier, decrease infection rates, promote wound healing, and reduce length of hospital stay. If nutrition cannot be provided orally, then nutrition through either enteral or parenteral means should be initiated within 24-48 hours of surgery. Practitioners should identify those patients who are at the highest nutrition risk for postsurgical complications and provide guidance for optimal nutrition during the perioperative and postoperative period. © 2015 American Society for Parenteral and Enteral Nutrition.

A novel fibre Bragg grating sensor packaging design for ultra-high temperature sensing in harsh environments

Science.gov (United States)

Azhari, Amir; Liang, Richard; Toyserkani, Ehsan

2014-07-01

The aim of this article is to introduce a novel packaging of conventional Corning SMF-28™ single-mode fibre Bragg grating sensors for ultra-high temperature sensing. The package is in a cylindrical shape made of yttria-stabilized zirconia tubes. The fibre optic sensor is epoxied to one end inside the tube to be protected from high external temperatures and also harsh environments. Highly-oriented pyrolytic graphite tube with an exceptional anisotropic thermal conductivity with higher conductivity in transverse than radial direction is positioned around the fibre to protect it from high temperatures. Air cooling system is also provided from the other end to dissipate the transferred heat from inside the tube. The shift in the Bragg wavelength is influenced by the thermal expansion of the package and internal temperature variations, which translates into thermal expansion of the fibre. The modelling and experimental results revealed that the Bragg wavelength shift increases to 1.4 pm °C-1 at higher temperatures with linear behaviour at temperatures above 600 °C. The finite element modelling and the experimental results are also in good proximity indicating the similar trend for the shift in the Bragg wavelength.

Individual fibre segmentation from 3D X-ray computed tomography for characterising the fibre orientation in unidirectional composite materials

DEFF Research Database (Denmark)

Emerson, Monica Jane; Jespersen, Kristine Munk; Dahl, Anders Bjorholm

2017-01-01

The aim of this paper is to characterise the fibre orientation in unidirectional fibre reinforced polymers, namely glass and carbon fibre composites. The compression strength of the composite is related to the orientation of the fibres. Thus the orientation is essential when designing materials...... of composites with high fibre volume fraction. From the individual fibre orientations, it is possible to obtain results which are independent of the scanning quality. The compression strength for both composites is estimated from the average fibre orientations and is found to be of the same order of magnitude...

Physicochemical characteristics of Bambara groundnut dietary fibres extracted using wet milling

Directory of Open Access Journals (Sweden)

Yvonne Maphosa

2016-02-01

Full Text Available The objectives of this study were to extract soluble and insoluble dietary fibres from four Bambara groundnut (BGN varieties (black-eye, brown-eye, brown and red using the wet milling method and evaluate their physicochemical properties. The swelling capacities of brown-eye (6.5 g/mL and black-eye (6.2 g/mL fibres were higher (p≤0.05 than those of red (6.0 g/mL and brown (5.5 g/mL fibres while the water holding capacities of black-eye and brown-eye fibres (2.84 g and 2.83 g water/g sample were higher (p≤0.05 than those of brown and red fibres. The bulk densities of insoluble dietary fibres (IDFs and soluble dietary fibres (SDFs ranged between 0.57 g/mL (red to 0.67 g/mL (brown-eye and 0.46 g/mL (brown-eye to 0.57 g/mL (black-eye, respectively. The oil binding capacities (OBCs of SDFs ranged between 2.78 g oil/g sample (brown and 4.03 g oil/g sample (brown-eye while the OBC of all IDFs did not differ (p>0.05, ranging between 1.52 g oil/g sample (brown and 1.40 g oil/g sample (brown-eye and black-eye. Black-eye and brown-eye dietary fibres had higher phenolic and total sugar content. The findings of this study indicate the potential of BGN fibres in food systems as fat replacers, emulsion stabilisers, water binders, bulking agents, thickeners and nutritional additives.

Development of high temperature resistant ceramic matrix composites based on SiC- and novel SiBNC-fibres

International Nuclear Information System (INIS)

Daenicke, Enrico

2014-01-01

Novel ceramic fibres in the quaternary system Si-B-C-N exhibit excellent high temperature stability and creep resistance. In th is work it was investigated, to what extent these outstanding properties of SiBNC-fibres can be transferred into ceramic matrix composites (CMC) in comparison to commercial silicon carbide (SiC) fibres. For the CMC development the liquid silicon infiltration (LSI) as well as the polymer infiltration and pyrolysis process (PIP) was applied. Extensive correlations between fibre properties, fibre coating (without, pyrolytic carbon, lanthanum phosphate), process parameters of the CMC manufacturing method and the mechanical and microstructural properties of the CMC before and after exposure to air could be established. Hence, the potential of novel CMCs can be assessed and application fields can be derived.

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...

Thermal Conductivity of Structural Glass/Fibre Epoxy Composite as a Function of Fibre Orientation

CERN Document Server

Cugnet, D; Kuijper, A; Parma, Vittorio; Vandoni, Giovanna

2002-01-01

The LHC, the new superconducting particle accelerator presently under construction at CERN, makes use of some 1200 dipole magnets for orbit bending and 500 quadrupole magnets for focusing/defocusing of the circulating high-energy proton beams. Two or three column-type support posts sustain each cryomagnet. The choice of a convenient material for these supports is critical, because of the required high positioning accuracy of the magnets in their cryostats and stringent thermal budget requirements imposed by the LHC cryogenic system. A glass-fibre/epoxy resin composite has been chosen for its good combination of high stiffness and low thermal conductivity over the 2-293 K temperature range. Plies of long glass-fibres are stacked optimally yielding the best mechanical behaviour. However, heat leaks from the supports are influenced by the thermal characteristics of the composite, which in turn depend on the orientation of the fibres. To study the dependence of the thermal conductivity on fibre's orientation, we ...

Water properties and structure of pork sausages as affected by high-pressure processing and addition of carrot fibre

DEFF Research Database (Denmark)

Møller, Sandie Mejer; Grossi, Alberto Blak; Christensen, Mette

2011-01-01

The effects of high-pressure processing (HPP) and addition of carrot fibre on pork sausages have been studied using NMR T(2) relaxometry and measurements of water-binding capacity (WBC) by centrifugation. Significant effects of temperature (raw, 40, 50, or 60°C), holding time (1s, 3, 6, or 9min......), and addition of carrot fibre on the distribution and mobility of water were found. However, the effect of carrot fibre could not be explained by structural changes in the sausages when examined by confocal laser scanning microscopy (CLSM). Correlations between T(2) relaxation measurements and WBC determined...... by centrifugation revealed that T(2) relaxation times were able to explain more than 90% of the variation in WBC for both non-pressure and pressure-treated sausages. However, only 49% of the variation was explained for pressure-treated sausages with carrot fibre, indicating that combining addition of fibre and high...

Energy, saturated fat and fibre intakes among Dutch children and adolescents at breakfast and implications for educational messages.

Science.gov (United States)

Raaijmakers, L G M; Bessems, K M H H; Kremers, S P J; van Assema, P

2012-10-01

The aim of this study was to assess energy, saturated fat and fibre intakes at breakfast among Dutch youngsters aged 10-19 years and the extent to which they meet nutritional value recommendations and the educational messages on food group intake by the Netherlands Nutrition Centre (NNC). A cross-sectional design was used and data were collected through an online questionnaire among 2380 students attending 71 Dutch schools for primary and secondary education. Energy intake at breakfast was, on average, 15.8% of daily recommended energy intake; mean saturated fat intake was 7.5 en% and mean fibre intake 1.0 g per 100 kcal. Of the participants, 67.2% met the saturated fat intake recommendation and 35.3% the fibre intake recommendation. In addition, 25.5% were assessed to have an adequate energy intake based on daily recommended, but not individually measured, age- and gender-specific energy intake. Most participants consumed products from the grains food group, in combination with products from one or two other food groups. Consumption from two or more food groups resulted in less favourable intake. Our study found generally inadequate fibre intake at breakfast as well as an indication of inadequate energy intake at breakfast among Dutch youngsters. The educational message of the NNC to consume at least (wholemeal) bread or another fibre-rich product (cereals) at breakfast seems realistic in terms of compliance and favourable in terms of the resulting nutritional value. The educational message to preferably eat from each of the five main food groups should be reconsidered.

Fibre Bragg Grating and Long Period Grating Sensors in Polymer Optical Fibres

DEFF Research Database (Denmark)

Bundalo, Ivan-Lazar

mechanisms in polymer fibres using a CO2 laser. One is etching and the other one is perturbation of the microstructured region. After inscription of LPGs, the concept of a biocompatible distributed medical endoscope is presented, where an all-plastic LPG based device is produced. A transducer pod is made...... of applications and pushing the limits. The first part of the work focuses on the fabrication of FBGs in polymer optical fibres. FBGs are a periodic perturbation of the refractive index of the optical fibre core which act as a wavelength specific reflector. The fibres used are made of Polymethyl methacrylate....... In this system a high power CO2 laser is used for the inscription. An LPG is also a periodic perturbation of the guided core mode in fibre, but unlike FBG which reflects the core mode, the LPG couples the core mode to a cladding mode outside the core. We have shown that the LPG grating can be formed through two...

Characterisation and potential application of pineapple pomace in an extruded product for fibre enhancement.

Science.gov (United States)

Selani, Miriam Mabel; Brazaca, Solange Guidolin Canniatti; Dos Santos Dias, Carlos Tadeu; Ratnayake, Wajira S; Flores, Rolando A; Bianchini, Andreia

2014-11-15

This study characterised pineapple pomace (PP) and evaluated its application in extrusion to enhance fibre content of the final product. The pomace had low fat (0.61%) and high dietary fibre (45.22%), showing its potential for fibre enrichment of nutritionally poor products, as some extruded snacks. Results also showed low microbiological counts, water activity, and pH indicating good microbiological quality and low risk of physicochemical deterioration. During extrusion, pomace (0%, 10.5% and 21%), moisture (14%, 15% and 16%) and temperature (140 and 160°C) were evaluated. The PP addition decreased expansion and luminosity; while increasing redness of the extrudates compared to the control (0% pomace/14% moisture/140°C). When hardness, yellowness, water absorption, and bulk density were compared to the control, there was no effect (p>0.05) of 10.5% PP addition on the extrudates, indicating that, at this level, PP could be added without affecting the properties of the final extruded product. Copyright © 2014 Elsevier Ltd. All rights reserved.

Modelling high density phenomena in hydrogen fibre Z-pinches

International Nuclear Information System (INIS)

Chittenden, J.P.

1990-09-01

The application of hydrogen fibre Z-pinches to the study of the radiative collapse phenomenon is studied computationally. Two areas of difficulty, the formation of a fully ionized pinch from a cryogenic fibre and the processes leading to collapse termination, are addressed in detail. A zero-D model based on the energy equation highlights the importance of particle end losses and changes in the Coulomb logarithm upon collapse initiation and termination. A 1-D Lagrangian resistive MHD code shows the importance of the changing radial profile shapes, particularly in delaying collapse termination. A 1-D, three fluid MHD code is developed to model the ionization of the fibre by thermal conduction from a high temperature surface corona to the cold core. Rate equations for collisional ionization, 3-body recombination and equilibration are solved in tandem with fluid equations for the electrons, ions and neutrals. Continuum lowering is found to assist ionization at the corona-core interface. The high density plasma phenomena responsible for radiative collapse termination are identified as the self-trapping of radiation and free electron degeneracy. A radiation transport model and computational analogues for the effects of degeneracy upon the equation of state, transport coefficients and opacity are implemented in the 1-D, single fluid model. As opacity increases the emergent spectrum is observed to become increasingly Planckian and a fall off in radiative cooling at small radii and low frequencies occurs giving rise to collapse termination. Electron degeneracy terminates radiative collapse by supplementing the radial pressure gradient until the electromagnetic pinch force is balanced. Collapse termination is found to be a hybrid process of opacity and degeneracy effects across a wide range of line densities with opacity dominant at large line densities but with electron degeneracy becoming increasingly important at lower line densities. (author)

From nanoparticles to fibres: effect of dispersion composition on fibre properties

Science.gov (United States)

Schirmer, Katharina S. U.; Esrafilzadeh, Dorna; Thompson, Brianna C.; Quigley, Anita F.; Kapsa, Robert M. I.; Wallace, Gordon G.

2015-06-01

A polyvinyl alcohol (PVA)-stabilized polypyrrole nanodispersion has been optimised for conductivity and processability by decreasing the quantity of PVA before and after synthesis. A reduction of PVA before synthesis leads to the formation of particles with a slight increase in dry particle diameter (51 ± 6 to 63 ± 3 nm), and conversely a reduced hydrodynamic diameter. Conductivity of the dried nanoparticle films was not measureable after a reduction of PVA prior to synthesis. Using filtration of particles after synthesis, PVA content was sufficiently reduced to achieve dried thin film conductivity of 2 S cm-1, while the electroactivity of the dispersed particles remained unchanged. The as-synthesized and PVA-reduced polypyrrole particles were successfully spun into all-nanoparticle fibres using a wet-extrusion approach without the addition of any polymer or gel matrix. Using nanoparticles as a starting material is a novel approach, which allowed the production of macro-scale fibres that consisted entirely of polypyrrole nanoparticles. Fibres made from PVA-reduced polypyrrole showed higher electroactivity compared to fibres composed of the dispersion high in PVA. The mechanical properties of the fibres were also improved by reducing the amount of PVA present, resulting in a stronger, more ductile and less brittle fibre, which could find potential application in various fields.

[Audit of artificial nutrition in an intensive care unit].

Science.gov (United States)

Blesa Malpica, A L; Salaverría Garzón, I; Prado López, L M; Simón García, M J; Reta Pérez, O; Ramos Polo, J

2001-01-01

of diet administered in that the second series saw a significant increase in the provision of hyperproteic diets, both enterally and through patenteral formulations, rising from 9-13 grammes to 18-20 grammes of nitrogen. Using the enteral route on its own, there was a discreet increase in the energy load in the second series, but this did not occur in the other types of provision. Both series revealed over-nutrition in terms of both calories and nitrogen when enteral and parenteral nutrition were used together, although there was no difference between the series. Early enteral nutrition is possible in critically-ill patients, while artificial nutrition was used most frequently and for longer in our patients. The existence of nutrition protocols allow acceptable levels of nutritional provision. Their controlled use allows the correction of deviations between real and theoretical provisions, customizing the nutrition for each patient. The use of parenteral formulas with high levels of nitrogen requires more accurate adjustment in order to avoid over-nutrition.

Compliance with nutrition support guidelines in acutely burned patients.

Science.gov (United States)

Holt, Brennen; Graves, Caran; Faraklas, Iris; Cochran, Amalia

2012-08-01

Adequate and timely provision of nutritional support is a crucial component of care of the critically ill burn patient. The goal of this study was to assess a single center's consistency with Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition (SCCM/ASPEN) guidelines for nutritional support in critically ill patients. Acutely burned patients >45kg in weight admitted to a regional burn center during a two-year period and who required 5 or more days of full enteral nutritional support were eligible for inclusion in this retrospective review. Specific outcomes evaluated include time from admission to feeding tube placement and enteral feeding initiation and percent of nutritional goal received within the first week of hospital stay. Descriptive statistics were used for all analyses. IRB approval was obtained. Thirty-seven patients were included in this retrospective review. Median age of patients was 44.9 years (IQR: 24.2-55.1), and median burn injury size was 30% (IQR: 19-47). Median time to feeding tube placement was 31.1h post admission (IQR: 23.6-50.2h), while median time to initiation of EN was 47.9h post admission (IQR: 32.4-59.9h). The median time required for patients to reach 60% of caloric goal was 3 days post-admission (IQR: 3-4.5). The median time for initiation of enteral nutrition was within the SCCM/ASPEN guidelines for initial nutrition in the critically ill patient. This project identified a 16h time lag between placement of enteral access and initiation of enteral nutrition. Development of a protocol for feeding tube placement and enteral nutrition management may optimize early nutritional support in the acutely injured burn patient. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Multicore fibre photonic lanterns for precision radial velocity Science

Science.gov (United States)

Gris-Sánchez, Itandehui; Haynes, Dionne M.; Ehrlich, Katjana; Haynes, Roger; Birks, Tim A.

2018-04-01

Incomplete fibre scrambling and fibre modal noise can degrade high-precision spectroscopic applications (typically high spectral resolution and high signal to noise). For example, it can be the dominating error source for exoplanet finding spectrographs, limiting the maximum measurement precision possible with such facilities. This limitation is exacerbated in the next generation of infra-red based systems, as the number of modes supported by the fibre scales inversely with the wavelength squared and more modes typically equates to better scrambling. Substantial effort has been made by major research groups in this area to improve the fibre link performance by employing non-circular fibres, double scramblers, fibre shakers, and fibre stretchers. We present an original design of a multicore fibre (MCF) terminated with multimode photonic lantern ports. It is designed to act as a relay fibre with the coupling efficiency of a multimode fibre (MMF), modal stability similar to a single-mode fibre and low loss in a wide range of wavelengths (380 nm to 860 nm). It provides phase and amplitude scrambling to achieve a stable near field and far-field output illumination pattern despite input coupling variations, and low modal noise for increased stability for high signal-to-noise applications such as precision radial velocity (PRV) science. Preliminary results are presented for a 511-core MCF and compared with current state of the art octagonal fibre.

Oil palm fruit fibre promotes the yield and quality of Lentinus ...

African Journals Online (AJOL)

Agricultural production and the agro-food industry furnish large volumes of solid wastes, which when unutilized could lead to environmental pollution. ... oil palm fruit fibre (OPFF) and oil palm empty fruit bunch (OPEFB) significantly influenced crop cycle time, yield, nutritional properties and market quality of the mushroom.

Direct high-frequency modulation of VCSELs and applications in fibre optic RF and microwave links

International Nuclear Information System (INIS)

Larsson, Anders; Carlsson, Christina; Gustavsson, Johan; Haglund, Asa; Modh, Peter; Bengtsson, Joergen

2004-01-01

With the rapid development of wireless communication networks there is an increasing demand for efficient and cost-effective transmission and distribution of RF signals. Fibre optic RF links, employing directly modulated semiconductor lasers, provide many of the desired characteristics for such distribution systems and in the search for cost-effective solutions, the vertical cavity surface emitting laser (VCSEL) is of interest. It has therefore been the purpose of this work to investigate whether 850 nm VCSELs fulfil basic performance requirements for fibre optic RF links operating in the low-GHz range. The performance of single- and multimode oxide confined VCSELs has been compared, in order to pin-point limitations and to find the optimum design. Fibre optic RF links using VCSELs and multimode fibres have been assembled and evaluated with respect to performance characteristics of importance for wireless communication systems. We have found that optimized single-mode VCSELs provide the highest performance and that links using such VCSELs and high-bandwidth multimode fibres satisfy the requirements in a number of applications, including cellular systems for mobile communication and wireless local area networks

Multiscale deformations lead to high toughness and circularly polarized emission in helical nacre-like fibres.

Science.gov (United States)

Zhang, Jia; Feng, Wenchun; Zhang, Huangxi; Wang, Zhenlong; Calcaterra, Heather A; Yeom, Bongjun; Hu, Ping An; Kotov, Nicholas A

2016-02-24

Nacre-like composites have been investigated typically in the form of coatings or free-standing sheets. They demonstrated remarkable mechanical properties and are used as ultrastrong materials but macroscale fibres with nacre-like organization can improve mechanical properties even further. The fiber form or nacre can, simplify manufacturing and offer new functional properties unknown yet for other forms of biomimetic materials. Here we demonstrate that nacre-like fibres can be produced by shear-induced self-assembly of nanoplatelets. The synergy between two structural motifs--nanoscale brick-and-mortar stacking of platelets and microscale twisting of the fibres--gives rise to high stretchability (>400%) and gravimetric toughness (640 J g(-1)). These unique mechanical properties originate from the multiscale deformation regime involving solid-state self-organization processes that lead to efficient energy dissipation. Incorporating luminescent CdTe nanowires into these fibres imparts the new property of mechanically tunable circularly polarized luminescence. The nacre-like fibres open a novel technological space for optomechanics of biomimetic composites, while their continuous spinning methodology makes scalable production realistic.

Development of tilted fibre Bragg gratings using highly coherent 255 ...

Indian Academy of Sciences (India)

R&D C-1 Block, Raja Ramanna Centre for Advanced Technology, Indore 452 013, India. ∗. Corresponding author. E-mail: oprakash@rrcat.gov.in. DOI: 10.1007/s12043-013-0672-7; ePublication: 6 February 2014. Abstract. This paper reports the study on development of tilted fibre Bragg gratings using highly coherent 255 ...

Quinoa (Chenopodium quinoa W.) and amaranth (Amaranthus caudatus L.) provide dietary fibres high in pectic substances and xyloglucans.

Science.gov (United States)

Lamothe, Lisa M; Srichuwong, Sathaporn; Reuhs, Bradley L; Hamaker, Bruce R

2015-01-15

Dietary fibre of quinoa and amaranth was analysed for its insoluble and soluble fibre content, composition, and structure. Total dietary fibre content was 10% for quinoa and 11% for amaranth. For both pseudocereals, 78% of its dietary fibre was insoluble. Insoluble fibre (IDF) from quinoa and amaranth was mainly composed of galacturonic acid, arabinose, galactose, xylose and glucose. Linkage analysis indicated that IDF was composed of homogalacturonans and rhamnogalacturonan-I with arabinan side-chains (∼55-60%), as well as highly branched xyloglucans (∼30%) and cellulose. For both pseudocereals, 22% of total dietary fibre was soluble; a higher proportion than that found in wheat and maize (∼15%). The soluble fibre (SDF) was composed of glucose, galacturonic acid and arabinose; for amaranth, xylose was also a major constituent. Xyloglucans made up ∼40-60% of the SDF and arabinose-rich pectic polysaccharides represented ∼34-55%. Copyright © 2014. Published by Elsevier Ltd.

Three-dimensional holographic optical manipulation through a high-numerical-aperture soft-glass multimode fibre

Science.gov (United States)

Leite, Ivo T.; Turtaev, Sergey; Jiang, Xin; Šiler, Martin; Cuschieri, Alfred; Russell, Philip St. J.; Čižmár, Tomáš

2018-01-01

Holographic optical tweezers (HOT) hold great promise for many applications in biophotonics, allowing the creation and measurement of minuscule forces on biomolecules, molecular motors and cells. Geometries used in HOT currently rely on bulk optics, and their exploitation in vivo is compromised by the optically turbid nature of tissues. We present an alternative HOT approach in which multiple three-dimensional (3D) traps are introduced through a high-numerical-aperture multimode optical fibre, thus enabling an equally versatile means of manipulation through channels having cross-section comparable to the size of a single cell. Our work demonstrates real-time manipulation of 3D arrangements of micro-objects, as well as manipulation inside otherwise inaccessible cavities. We show that the traps can be formed over fibre lengths exceeding 100 mm and positioned with nanometric resolution. The results provide the basis for holographic manipulation and other high-numerical-aperture techniques, including advanced microscopy, through single-core-fibre endoscopes deep inside living tissues and other complex environments.

Multibeam Fibre Laser Cutting

DEFF Research Database (Denmark)

Olsen, Flemming Ove

The appearance of the high power high brilliance fibre laser has opened for new possibilities in laser materials processing. In laser cutting this laser has demonstrated high cutting performance compared to the dominating cutting laser, the CO2-laser. However, quality problems in fibre......-laser cutting have until now limited its application in metal cutting. In this paper the first results of proof-of-principle studies applying a new approach (patent pending) for laser cutting with high brightness short wavelength lasers will be presented. In the approach, multi beam patterns are applied...... to control the melt flow out of the cut kerf resulting in improved cut quality in metal cutting. The beam patterns in this study are created by splitting up beams from 2 single mode fibre lasers and combining these beams into a pattern in the cut kerf. The results are obtained with a total of 550 W of single...

Calcium binding by dietary fibre

International Nuclear Information System (INIS)

James, W.P.T.; Branch, W.J.; Southgate, D.A.T.

1978-01-01

Dietary fibre from plants low in phytate bound calcium in proportion to its uronic-acid content. This binding by the non-cellulosic fraction of fibre reduces the availability of calcium for small-intestinal absorption, but the colonic microbial digestion of uronic acids liberates the calcium. Thus the ability to maintain calcium balance on high-fibre diets may depend on the adaptive capacity on the colon for calcium. (author)

[Effects of modified bazhen decoction in assistant with enteral nutrition on the growth hormone, the nutritional state, and the immune function in patients with gastric cancer after operation].

Science.gov (United States)

Wang, Hong-xing; Li, Jian-ping

2011-10-01

To observe the effects of modified Bazhen Decoction (BZD) in assistant with enteral nutrition (EN) on the growth hormone, the nutritional state, and the immune function in patients with gastric cancer after operation. The prospective, random, single-blinded, controlled clinical trial was adopted. 88 patients receiving gastric cancer operation were randomly assigned to the parenteral nutrition group (Group A, 27 cases), the EN group (Group B, 30 cases), and the comprehensive group (Group C, BZD in assistant with EN, 31 cases). Isocaloric and isonitrogenous parenteral nutritional support was given to patients in Group A from the operation day to the ninth day. Isocaloric and isonitrogenous EN was given to patients in Group B and C from the second day of operation till the ninth day. 100 mL BZD was nasal fed to patients in Group C during the second day to the ninth day after operation. The levels of the growth hormone, immune indices such as IgA, IgG, CD4+, CD8+, and CD4+/CD8+, etc., and nutritional indices such as serum albumin, prealbumin, transferrin, etc. were detected in the three groups one day before operation, on the 1st day after operation, and on the tenth day after operation. The levels of IgA, IgG, CD4+, and CD4+/CD8+, serum albumin, prealbumin, transferrin decreased more than before operation in the three groups, with statistical difference (Pnutrition state and the immune function.

Vitellaria paradoxa Wood as a Potential Source of Dietary Fibre

Directory of Open Access Journals (Sweden)

Abdullahi Alanamu ABDULRAHAMAN

2012-02-01

Full Text Available In the tropical developing countries, diseases such as diabetes, tuberculosis, cancer, obesity have been a continuous cause of mortality. In recent times, nutrition experts have come up with new ideas for food recipe, with a view to improving human health. One of these ideas is to enhance dietary fibre content to improve food digestibility and bowel movement. In this study the effect of the processed insoluble wood fibres on the blood system of albino rats was studied by feeding the rats with the processed Vitellaria paradoxa wood fibres added to the animals� normal diet for a period of 28 days across four treatments namely the control, 10%, 15% and 20% processed wood fibres.. These cellulosic materials incorporated into normal diet of the albino rats did not cause a reduction in the live weight of the experimental animals. A paired sample t- test conducted on the two sets of data indicated no significant difference (P = 0.8390 > 0.05 in the mean difference between mean initial and final haematocrit. Therefore the wood fibre supplemented diet did not have had any deleterious effects on the quality and quantity of the rats� blood. Thus there is also a possibility that the cellulosic fibres did not reduce the plasma cholesterol level concentrations of the rats. Processed wood was also used in baking bread. The addition of cellulosic fibres did not negatively affect the physical, chemical and baking properties of bread, but it prolonged the shelf-life of the bread.

Vitellaria paradoxa Wood as a Potential Source of Dietary Fibre

Directory of Open Access Journals (Sweden)

Abdullahi Alanamu ABDULRAHAMAN

2012-02-01

Full Text Available In the tropical developing countries, diseases such as diabetes, tuberculosis, cancer, obesity have been a continuous cause of mortality. In recent times, nutrition experts have come up with new ideas for food recipe, with a view to improving human health. One of these ideas is to enhance dietary fibre content to improve food digestibility and bowel movement. In this study the effect of the processed insoluble wood fibres on the blood system of albino rats was studied by feeding the rats with the processed Vitellaria paradoxa wood fibres added to the animals normal diet for a period of 28 days across four treatments namely the control, 10%, 15% and 20% processed wood fibres.. These cellulosic materials incorporated into normal diet of the albino rats did not cause a reduction in the live weight of the experimental animals. A paired sample t- test conducted on the two sets of data indicated no significant difference (P = 0.8390 > 0.05 in the mean difference between mean initial and final haematocrit. Therefore the wood fibre supplemented diet did not have had any deleterious effects on the quality and quantity of the rats blood. Thus there is also a possibility that the cellulosic fibres did not reduce the plasma cholesterol level concentrations of the rats. Processed wood was also used in baking bread. The addition of cellulosic fibres did not negatively affect the physical, chemical and baking properties of bread, but it prolonged the shelf-life of the bread.

Correlation between compressive strength and ultrasonic pulse velocity of high strength concrete incorporating chopped basalt fibre

Science.gov (United States)

Shafiq, Nasir; Fadhilnuruddin, Muhd; Elshekh, Ali Elheber Ahmed; Fathi, Ahmed

2015-07-01

Ultrasonic pulse velocity (UPV), is considered as the most important test for non-destructive techniques that are used to evaluate the mechanical characteristics of high strength concrete (HSC). The relationship between the compressive strength of HSC containing chopped basalt fibre stands (CBSF) and UPV was investigated. The concrete specimens were prepared using a different ratio of CBSF as internal strengthening materials. The compressive strength measurements were conducted at the sample ages of 3, 7, 28, 56 and 90 days; whilst, the ultrasonic pulse velocity was measured at 28 days. The result of HSC's compressive strength with the chopped basalt fibre did not show any improvement; instead, it was decreased. The UPV of the chopped basalt fibre reinforced concrete has been found to be less than that of the control mix for each addition ratio of the basalt fibre. A relationship plot is gained between the cube compressive strength for HSC and UPV with various amounts of chopped basalt fibres.

Stability Analysis of a High Fibre Yield and Low Lignin Content “Thick Stem” Mutant in Tossa Jute (Corchorus olitorius L.

Directory of Open Access Journals (Sweden)

Aninda Mandal

2014-01-01

Full Text Available A “thick stem” mutant of Corchorus olitorius L. was induced at M2 (0.50%, 4 h, EMS and the true breeding mutant is assessed across generations (M5 to M7 considering morphometric traits as well as SEM analysis of pollen grains and raw jute fibres, stem anatomy, cytogenetical attributes, and lignin content in relation to control. Furthermore, single fibre diameter and tensile strength are also analysed. The objective is to assess the stability of mutant for its effective exploration for raising a new plant type in tossa jute for commercial exploitation and efficient breeding. The mutant trait is monogenic recessive to normal. Results indicate that “thick stem” mutant is stable across generations (2n=14 with distinctive high seed and fibre yield and significantly low lignin content. Stem anatomy of the mutant shows significant enhancement in fibre zone, number of fibre pyramids and fibre bundles per pyramid, and diameter of fibre cell in relation to control. Moreover, tensile strength of mutant fibre is significantly higher than control fibre and the trait is inversely related to fibre diameter. However the mutant is associated with low germination frequency, poor seed viability, and high pollen sterility, which may be eliminated through mutational approach followed by rigorous selection and efficient breeding.

From nanoparticles to fibres: effect of dispersion composition on fibre properties

Energy Technology Data Exchange (ETDEWEB)

Schirmer, Katharina S. U.; Esrafilzadeh, Dorna; Thompson, Brianna C.; Quigley, Anita F.; Kapsa, Robert M. I.; Wallace, Gordon G., E-mail: gwallace@uow.edu.au [University of Wollongong, ARC Centre for Electromaterials Science and Intelligent Polymer Research Institute (Australia)

2015-06-15

A polyvinyl alcohol (PVA)-stabilized polypyrrole nanodispersion has been optimised for conductivity and processability by decreasing the quantity of PVA before and after synthesis. A reduction of PVA before synthesis leads to the formation of particles with a slight increase in dry particle diameter (51 ± 6 to 63 ± 3 nm), and conversely a reduced hydrodynamic diameter. Conductivity of the dried nanoparticle films was not measureable after a reduction of PVA prior to synthesis. Using filtration of particles after synthesis, PVA content was sufficiently reduced to achieve dried thin film conductivity of 2 S cm{sup −1}, while the electroactivity of the dispersed particles remained unchanged. The as-synthesized and PVA-reduced polypyrrole particles were successfully spun into all-nanoparticle fibres using a wet-extrusion approach without the addition of any polymer or gel matrix. Using nanoparticles as a starting material is a novel approach, which allowed the production of macro-scale fibres that consisted entirely of polypyrrole nanoparticles. Fibres made from PVA-reduced polypyrrole showed higher electroactivity compared to fibres composed of the dispersion high in PVA. The mechanical properties of the fibres were also improved by reducing the amount of PVA present, resulting in a stronger, more ductile and less brittle fibre, which could find potential application in various fields.

From nanoparticles to fibres: effect of dispersion composition on fibre properties

International Nuclear Information System (INIS)

Schirmer, Katharina S. U.; Esrafilzadeh, Dorna; Thompson, Brianna C.; Quigley, Anita F.; Kapsa, Robert M. I.; Wallace, Gordon G.

2015-01-01

A polyvinyl alcohol (PVA)-stabilized polypyrrole nanodispersion has been optimised for conductivity and processability by decreasing the quantity of PVA before and after synthesis. A reduction of PVA before synthesis leads to the formation of particles with a slight increase in dry particle diameter (51 ± 6 to 63 ± 3 nm), and conversely a reduced hydrodynamic diameter. Conductivity of the dried nanoparticle films was not measureable after a reduction of PVA prior to synthesis. Using filtration of particles after synthesis, PVA content was sufficiently reduced to achieve dried thin film conductivity of 2 S cm −1 , while the electroactivity of the dispersed particles remained unchanged. The as-synthesized and PVA-reduced polypyrrole particles were successfully spun into all-nanoparticle fibres using a wet-extrusion approach without the addition of any polymer or gel matrix. Using nanoparticles as a starting material is a novel approach, which allowed the production of macro-scale fibres that consisted entirely of polypyrrole nanoparticles. Fibres made from PVA-reduced polypyrrole showed higher electroactivity compared to fibres composed of the dispersion high in PVA. The mechanical properties of the fibres were also improved by reducing the amount of PVA present, resulting in a stronger, more ductile and less brittle fibre, which could find potential application in various fields

Microanalytical investigation of fibre-reinforced ceramic materials

International Nuclear Information System (INIS)

Meier, B.; Grathwohl, G.

1989-01-01

Microanalytical investigations have been made on samples of ceramic fibres (SiC fibres, (Nicalon) C fibre coated with TiN) and fibre-reinforced ceramics (SiC-and glass-matrices). High resolution Auger electron spectroscopy (HRAES), electron probe microanalysis (EPMA) and scanning electron microscopy were employed for these examinations. Analysis was best performed with HRAES on account of its lateral and depth resolution. Some of the problems involved in this technique are discussed e.g. electron beam effects. AES depth profiles of ceramic fibres are reported and compared with the surface analysis of fibres in the composites after being broken in situ. (orig.)

The effect of fibre source on the numbers of some fibre-degrading bacteria of Arabian camel's (Camelus dromedarius) foregut origin.

Science.gov (United States)

Samsudin, Anjas Asmara; Wright, André-Denis; Al Jassim, Rafat

2014-10-01

The total bacterial community of Fibrobacter succinogenes and Ruminococcus flavefaciens in fibre-enriched culture of the foregut contents of 12 adult feral camels (Camelus dromedaries) fed on native vegetation in Australia was investigated using quantitative PCR. Foregut contents were collected postmortem, pooled and filtered before divided into two fractions. One fraction was used for extraction of DNA, while the other fraction was inoculated straight away into BM 10 contained filter paper (FP), cotton thread (CT) or neutral detergent fibre (NDF) as the sole carbohydrate sources in Hungate tubes. The tubes were incubated anaerobically at 39 °C for 1 week. After a near complete degradation of the FP and CT and extensive turbidity in the NDF, media subculturing was carried out into fresh media tubes. This was repeated twice before genomic DNA was extracted and used for quantification of bacteria. Using an absolute quantification method, the numbers of cells in 1 ml of each sample ranged from 4.07 × 10(6) to 2.73 × 10(9) for total bacteria, 1.34 × 10(3) to 2.17 × 10(5) for F. succinogenes and 5.78 × 10(1) to 3.53 × 10(4) for R. flavefaciens. The mean cell number of F. succinogenes was highest in the FP enrichment medium at approximately 107-fold, whereas for the R. flavefaciens targeted primer, the NDF enrichment media had the highest mean cell number at approximately 4-fold when compared to the rumen content. The data presented here provide evidence of fibre type preference by the two main fibre-degrading bacteria and would help us understand the interaction between fibre type and fibre-degrading microorganisms, which has ramification on camel nutrition at different seasons and environments.

The nutritional management of gastrointestinal tract disorders in companion animals.

Science.gov (United States)

Guilford, W G; Matz, M E

2003-12-01

Dietary protein, carbohydrates, fats and fibre have marked influences on gastrointestinal tract function and dysfunction. This article reviews the nutritional management of common gastrointestinal disorders in companion animals and introduces some of the current areas of research including probiotics, prebiotics, protein-hydrolysate diets, immunonutrition and dietary fibre. Nutritional management of oesophageal disease revolves around varying the consistency of the diet and feeding the animal from an elevated container. Provision of bowel rest remains the mainstay of the management of acute gastroenteritis but food-based oral rehydration solutions are a useful adjunct. The recommended diet for chronic small bowel diarrhoea is a highly digestible, hypoallergenic, gluten-free, low-lactose and low-fat diet with modest amounts of fermentable fibre. The use of probiotics in the management of diarrhoea in companion animals has not yet been shown to be beneficial. It is likely that prebiotics will prove more effective than probiotics in the prevention of enteropathogenic infections. Approximately 50% of cats in New Zealand that suffer from chronic idiopathic vomiting or diarrhoea will respond to a novel-protein-elimination diet and approximately 30% meet the diagnostic criteria for food sensitivity. Growing evidence supports the use of protein-hydrolysate diets in the management of inflammatory bowel disease and further advances in immunonutrition are expected. The dietary management of colitis should include a hypoallergenic diet with a fermentable fibre source. Manipulation of the diet provides clinicians a powerful therapeutic strategy to be used alone or concurrently with drug therapy in the management of gastrointestinal disorders.

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...

Nutritional support for critically ill children.

Science.gov (United States)

Joffe, Ari; Anton, Natalie; Lequier, Laurance; Vandermeer, Ben; Tjosvold, Lisa; Larsen, Bodil; Hartling, Lisa

2016-05-27

Nutritional support in the critically ill child has not been well investigated and is a controversial topic within paediatric intensive care. There are no clear guidelines as to the best form or timing of nutrition in critically ill infants and children. This is an update of a review that was originally published in 2009. . The objective of this review was to assess the impact of enteral and parenteral nutrition given in the first week of illness on clinically important outcomes in critically ill children. There were two primary hypotheses:1. the mortality rate of critically ill children fed enterally or parenterally is different to that of children who are given no nutrition;2. the mortality rate of critically ill children fed enterally is different to that of children fed parenterally.We planned to conduct subgroup analyses, pending available data, to examine whether the treatment effect was altered by:a. age (infants less than one year versus children greater than or equal to one year old);b. type of patient (medical, where purpose of admission to intensive care unit (ICU) is for medical illness (without surgical intervention immediately prior to admission), versus surgical, where purpose of admission to ICU is for postoperative care or care after trauma).We also proposed the following secondary hypotheses (a priori), pending other clinical trials becoming available, to examine nutrition more distinctly:3. the mortality rate is different in children who are given enteral nutrition alone versus enteral and parenteral combined;4. the mortality rate is different in children who are given both enteral feeds and parenteral nutrition versus no nutrition. In this updated review we searched: the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2); Ovid MEDLINE (1966 to February 2016); Ovid EMBASE (1988 to February 2016); OVID Evidence-Based Medicine Reviews; ISI Web of Science - Science Citation Index Expanded (1965 to February 2016); Web

High-order harmonic and attosecond pulse generation for a few-cycle laser pulse in modulated hollow fibres

International Nuclear Information System (INIS)

Zhang Xiangyun; Sun Zhenrong; Wang Yufeng; Chen Guoliang; Wang Zugeng; Li Ruxin; Zeng Zhinan; Xu Zhizhan

2007-01-01

High harmonic generation from Ar and He atoms by a few-cycle laser pulse in periodic and chirped hollow fibres is investigated theoretically by a self-consistent model. Based on enhanced high harmonics in a periodic hollow fibre, a chirped hollow fibre is proposed to improve quasi-phase matching for the generated harmonics near the cutoff. The results show that the extended and enhanced harmonics near the cutoff are well phase-matched, and a single x-ray pulse with a duration of 279 as in Ar gas and 255 as in He gas can be achieved by frequency synthesizing of high harmonics in the well-selected cutoff bandwidth. The results show that this technique is a potential candidate to generate an intense isolated attosecond pulse in the 'water window' spectrum

Fibre-optic temperature sensor

International Nuclear Information System (INIS)

Zhao Jie; Liu Zhenyuan.

1993-04-01

This experiment is a kind of nonfunction fibre-optic temperature sensor. It utilizes high-sensitive bimetallic strip for element of measuring temperature. The changing of bimetallic strip alterates intensity of light through fibre-optic. This equipment is simple in structure, subtle in design, extensive in application, and so on. (author). 4 refs, 6 figs, 1 tab

Adult classical homocystinuria requiring parenteral nutrition: Pitfalls and management.

Science.gov (United States)

Tran, Christel; Bonafé, Luisa; Nuoffer, Jean-Marc; Rieger, Julie; Berger, Mette M

2017-07-25

Homocystinuria due to cystathionine beta synthase (CBS) deficiency presents with a wide clinical spectrum. Treatment by the enteral route aims at reducing homocysteine levels by using vitamin B6, possibly methionine-restricted diet, betaine and/or folate and vitamin B 12 supplementation. Currently no nutritional guidelines exist regarding parenteral nutrition (PN) under acute conditions. Exhaustive literature search was performed, in order to identify the relevant studies describing the pathogenesis and nutritional intervention of adult classical homocystinuria requiring PN. Description of an illustrative case of an adult female with CBS deficiency and intestinal perforation, who required total PN due to contraindication to enteral nutrition. Nutritional management of decompensated classical homocystinuria is complex and currently no recommendation exists regarding PN composition. Amino acid profile and monitoring of total homocysteine concentration are the main tools enabling a precise assessment of the severity of metabolic alterations. In case of contraindication to enteral nutrition, compounded PN will be required, as described in this paper, to ensure adequate low amounts of methionine and others essential amino acids and avoid potentially fatal toxic hypermethioninemia. By reviewing the literature and reporting successful nutritional management of a decompensated CBS deficiency using tailored PN with limited methionine intake and n-3 PUFA addition, we would like to underscore the fact that standard PN solutions are not adapted for CBS deficient critical ill patients: new solutions are required. High methionine levels (>800 μmol/L) being potentially neurotoxic, there is an urgent need to improve our knowledge of acute nutritional therapy. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Modelling of high-power diode-pumped erbium 3-µm fibre lasers

NARCIS (Netherlands)

Jackson, S.D.; King, T.A.; Pollnau, Markus

2000-01-01

We present theoretical calculations that relate to the cw operation of a high-power Er3+,Pr3+:ZBLAN double-clad fibre laser. Using the measured energy-transfer, energy-transfer-upconversion and cross-relaxation parameters relevant to Er3+-doped and Er3+,Pr3+-codoped ZBLAN, we compare the theoretical

Fibre tracking

International Nuclear Information System (INIS)

Gaillard, J.M.

1994-03-01

A large-size scintillating plastic fibre tracking detector was built as part of the upgrade of the UA2 central detector at the SPS proton-antiproton collider. The cylindrical fibre detector of average radius of 40 cm consisted of 60000 plastic fibres with an active length of 2.1 m. One of the main motivations was to improve the electron identification. The fibre ends were bunched to be coupled to read-out systems of image intensifier plus CCD, 32 in total. The quality and the reliability of the UA2 fibre detector performance exceeded expectations throughout its years of operation. A few examples of the use of image intensifiers and of scintillating fibres in biological instrumentation are described. (R.P.) 11 refs., 15 figs., 2 tabs

Gastroenterology – Guidelines on Parenteral Nutrition, Chapter 15

Directory of Open Access Journals (Sweden)

Schulz, R. J.

2009-11-01

Full Text Available In patients with Crohn's disease and ulcerative colitis parenteral nutrition (PN is indicated when enteral nutrition is not possible or should be avoided for medical reasons. In Crohn's patients PN is indicated when there are signs/symptoms of ileus or subileus in the small intestine, scars or intestinal fistulae. PN requires no specific compounding for chronic inflammatory bowel diseases. In both diseases it should be composed of 55–60% carbohydrates, 25–30% lipids and 10–15% amino acids. PN helps in the correction of malnutrition, particularly the intake of energy, minerals, trace elements, deficiency of calcium, vitamin D, folic acid, vitamin B12, and zinc. Enteral nutrition is clearly superior to PN in severe, acute pancreatitis. An intolerance to enteral nutrition results in an indication for total PN in complications such as pseudocysts, intestinal and pancreatic fistulae, and pancreatic abscesses or pancreatic ascites. If enteral nutrition is not possible, PN is recommended, at the earliest, 5 days after admission to the hospital. TPN should not be routinely administered in mild acute pancreatitis or nil by moth status <7 days, due to high costs and an increased risk of infection. The energy requirements are between 25 and 35 kcal/kg body weight/day. A standard solution including lipids (monitoring triglyceride levels! can be administered in acute pancreatitis. Glucose (max. 4–5 g/kg body weight/day and amino acids (about 1.2–1.5 g/kg body weight/day should be administered and the additional enrichment of TPN with glutamine should be considered in severe, progressive forms of pancreatitis.

Influence of Random Inclusion of Coconut Fibres on the Short term Strength of Highly Compressible Clay

Science.gov (United States)

Ramani Sujatha, Evangelin; SaiSree, S.; Prabalini, C.; Aysha Farsana, Z.

2017-07-01

The choice of natural fibres for soil stabilization provides an economic, safe and eco-friendly alternative to improve the properties of soil. They are an important step forward toward sustainable development. An attempt was made to study the influence of the random addition of untreated coconut fibres on the short term strength of soil, its stress-strain behavior, compaction characteristics and index properties. The soil selected for the study is a highly compressible clay sample with a liquid limit of 52.5 % and plasticity index of 38 %. The soil has no organic content. The study reveals that the compaction curves tend to shift to the right side, indicating more plastic behavior with the addition of fibres. The addition of fibres also reorient the soil structure to a more dispersed fashion. A significant increase in the unconfined compressive strength is also observed. An increase of nearly 51 % in the unconfined compressive strength is observed at 0.75 % coir inclusion. The stress-strain behavior of the soil shows a shift toward more plastic behavior. The mode of failure of the soil specimen is by cracking and with fibre inclusion, length of the failure cracks is restrained as the fibre tends to hold the cracks together, resulting in shorter cracks, with significant bulging of the specimen at failure.

Laser self-mixing interference fibre sensor

International Nuclear Information System (INIS)

Zhu Jun; Zhao Yan; Jin Guofan

2008-01-01

Fibre sensors exhibit a number of advantages over other sensors such as high sensitivity, electric insulation, corrosion resistance, interference rejection and so on. And laser self-mixing interference can accurately detect the phase difference of feedback light. In this paper, a novel laser self-mixing interference fibre sensor that combines the advantages of fibre sensors with those of laser self-mixing interference is presented. Experimental configurations are set up to study the relationship between laser power output and phase of laser feedback light when the fibre trembles or when the fibre is stretched or pressed. The theoretical analysis of pressure sensors based on laser self-mixing interference is indicated to accord with the experimental results. (classical areas of phenomenology)

Chemical Composition, Fibre Fraction and Anti-Nutritional ...

African Journals Online (AJOL)

acer

recorded for EE and Ash values for the eight browse plants. ... INTRODUCTION ... result in reduced livestock productivity in the ... nutritionally only when the plant constitutes a ... total condensed tannin was determined as ... significant difference (LSD) (Steel and Torrie,. 1980) ... requirements of livestock at maintenance level.

Winding of fibre composites; Vikling af fiberkompositter

Energy Technology Data Exchange (ETDEWEB)

Lystrup, Aage

2006-01-01

Within the project 'Storage of hydrogen in advanced high pressure vessels' under the PSO-R AND D 2005 program one of the tasks is to describe the technology, which is used for manufacturing of fibre reinforced pressure vessels. Fibre reinforced pressure vessels for high pressures are manufactured by winding structural load bearing fibres around a mandrel or an internal liner. There are two different types of cylindrical pressure vessels: 1) Cylinders with thick metal liner, where only the cylindrical part is over wrapped with hoop windings, and 2) cylinders with a thin metal or polymer liner, where both the cylindrical part and the end domes are over wrapped with more layers with different fibre orientations (helical and hoop windings). This report describes the fundamental principles for filament winding of fibre reinforced polymer composites. After a short introduction to the advanced fibre composites, their properties and semi-raw materials used for fibre composites, the focus is on the process parameters, which have influence on the material quality of filament wound components. The report is both covering winding of fibre reinforced thermo-setting polymers as well as thermoplastic polymers, and there are references to vendors of filament winding machines, accessory equipment and computer software for design and manufacturing of filament wound components. (au)

Fractionation of high Kappa number kraft pulps of the South African softwoods and sulfonating of coarse fibre enriched fraction for production of sack paper

CSIR Research Space (South Africa)

Johakimu, Jonas K

2011-03-01

Full Text Available properties except tear strength: Tensile index (54%), TEA index (104%), Burst index (65%) and sheet density (23%). A tear index decrease (30%) could be attrib- uted to a high proportion of short and fine fibres in the accept stream. The reject stream... gave pulp samples with inferior strength properties with exception of tear strength. This may be due to high proportion of coarse fibres which have limited fibre collapsibility. Poor fibre collapsibility leads to a limited fibre bond- ing ability...

Nutritional evaluation of plants of family zygophyllaceae and euphorbiaceae

International Nuclear Information System (INIS)

Dastagir, G.; Hussain, F.

2014-01-01

The study was conducted with the objective to find out the nutritional value of some selected plants of family Zygophyllaceae and Euphorbiaceae which are traditionally used in different parts of Pakistan. Fresh plants of Fagonia indica Burm. f., Peganum harmala L., Tribulus terrestris L., Chrozophora tinctoria (L.) Raf. and Ricinus communis L., were collected from Peshawar and Attock Hills during June, 2009. It was observed that the average values revealed that P. harmala excelled in high fat, carbohydrate, protein and moisture contents than other two species, therefore it can be considered a good nutritive plant followed by F. indica that contained the highest fibre. The T. terrestris had the maximum protein and gross energy. The differences found in the proximate composition of these medicinal plants might be attributed to the habitat, environment and time of harvest. Chrozophora tinctoria and R. communis revealed variation in various analysed biochemicals. The average values showed that C. tinctoria had high the moisture, ash contents, protein, fats, fibre, carbohydrate and gross energy than its counterpart R. communis. The cultivation of Ricinus communis should be encouraged on large scale for the development of biodiesel that will help people. Its seeds can be helpful for pharmaceutical, cosmetic, food and insecticidal industries. (author)

Nutrición enteral total vs. nutrición parenteral total en pacientes con pancreatitis aguda grave Total enteral nutrition vs. total parenteral nutrition in patients with severe acute pancreatitis

Directory of Open Access Journals (Sweden)

M. Casas

2007-05-01

Full Text Available Objetivo: comparar la eficacia de la instauración precoz de nutrición enteral total (NET frente a nutrición parenteral total (NPT en pacientes con pancreatitis aguda grave (PAG. Métodos: estudio prospectivo aleatorio. Se incluyeron consecutivamente 22 pacientes con PAG aplicando los criterios APACHE II, valores de PCR y graduación de Balthazar en la TC. El grupo I (n = 11 recibió NPT y el grupo II (n = 12 NET. Se valoró la respuesta inflamatoria (PCR, TNF-alfa, IL-6, las proteínas viscerales (pre-albúmina, albúmina, la tasa de complicaciones (síndrome de respuesta inflamatoria sistémica, fallo multiorgánico, infecciones, las intervenciones quirúrgicas, la estancia hospitalaria y la mortalidad. Resultados: no hubo diferencias significativas en los primeros 10 días entre los dos grupos en la evolución de los criterios APACHE II, en las concentraciones de PCR, TNF-alfa e IL-6 ni tampoco en los valores de pre-albúmina y albúmina. Siete pacientes del grupo I presentaron complicaciones graves frente a 4 del grupo II. Requirieron intervención quirúrgica 3 pacientes del grupo I. La estancia hospitalaria fue similar en los dos grupos. Dos pacientes del grupo I fallecieron. Conclusiones: se ha observado una tendencia a una mejor evolución de los pacientes con PAG que utilizaron NET frente a los que utilizaron NPT.Objective: to compare the efficacy of early total enteral nutrition (TEN vs. total parenteral nutrition (TPN in patients with severe acute pancreatitis (SAP. Methods: a total of 22 consecutive patients with SAP were randomized to receive TPN (group I or TEN (group II. SAP was defined applying APACHE II score, C-reactive protein (CRP measurements and/or Balthazar CT scan score. Acute inflammatory response (CRP, TNF-alpha, IL-6, visceral proteins (pre-albumin, albumin, complications (systemic inflammatory response syndrome, multiorgan failure, infections, surgical interventions, length of hospital stay and mortality were

Does enteral nutrition affect clinical outcome? A systematic review of the randomized trials.

Science.gov (United States)

Koretz, Ronald L; Avenell, Alison; Lipman, Timothy O; Braunschweig, Carol L; Milne, Anne C

2007-02-01

Both parenteral nutrition (PN) and enteral nutrition (EN) are widely advocated as adjunctive care in patients with various diseases. A systematic review of 82 randomized controlled trials (RCTs) of PN published in 2001 found little, if any, effect on mortality, morbidity, or duration of hospital stay; in some situations, PN increased infectious complication rates. The objective was to assess the effect of EN or volitional nutrition support (VNS) in individual disease states from available RCTs. We conducted a systematic review. RCTs comparing EN or VNS with untreated controls, or comparing EN with PN, were identified and separated according to the underlying disease state. Meta-analysis was performed when at least three RCTs provided data. The evidence from the RCTs was summarized into one of five grades. A or B, respectively, indicated the presence of strong or weak (low-quality RCTs) evidence supporting the use of the intervention. C indicated a lack of adequate evidence to make any decision about efficacy. D indicated that limited data could not support the intervention. E indicated either that strong data found no effect, or that either strong or weak data suggested that the intervention caused harm. RCTs could include either hospitalized or nonhospitalized patients. The EN or VNS had to be provided as part of a treatment plan for an underlying disease process. The RCT had to compare recipients of either EN or VNS with controls not receiving any type of artificial nutrition or had to compare recipients of EN with recipients of PN. These were mortality, morbidity (disease specific), duration of hospitalization, cost, or interventional complications. SUMMARY OF GRADING: A: No indication was identified. B: EN or VNS in the perioperative patient or in patients with chronic liver disease; EN in critically ill patients or low birth weight infants (trophic feeding); VNS in malnourished geriatric patients. (The low-quality trials found a significant difference in

A clinical audit of the nutritional status and need for nutrition support amongst head and neck cancer patients treated with radiotherapy

Directory of Open Access Journals (Sweden)

E Jeffery

2012-01-01

Full Text Available Radiotherapy is an effective treatment for head and neck cancers but patients often experience side effects which lead to weight loss. Nutrition intervention in the form of counselling or oral nutrition support (ONS is frequently needed for these patients. For some patients, tube feeding is required to minimise weight loss during treatment.MethodData was collected on 48 patients who received radiotherapy to the head and neck region over a nine-month period (June 2009–March 2010. Retrospective data collection was commenced in July 2010. Each patient’s Diet Therapy Department record was reviewed. Main outcome measures were: 1 type of nutrition support; 2 percentage weight change during treatment; and 3 Patient-Generated Subjective Global Assessment Global (PG-SGA rating.ResultsOn initial assessment 28 (77.8% patients were classified as well nourished using the PG-SGA. Mean weight loss during radiotherapy was 5.74%. Risk factors for the need for ONS and enteral nutrition support (ENS were older age, presence of nutrition impact symptoms, high-risk tumour sites, advanced disease and chemotherapy. No significant difference was shown in weight loss between ONS and ENS groups.ConclusionThis study identified the need for early dietetic intervention for high nutritional risk groups of head and neck cancer patients to prevent significant weight loss. Pre-treatment nutritional status did not influence weight loss during treatment. ONS alone cannot prevent significant weight loss in patients with multiple nutrition impact symptoms. Early enteral feeding should be considered in this group of patients.

Fibre and polyphenols of selected fruits, nuts and green leafy vegetables used in Serbian diet

Directory of Open Access Journals (Sweden)

Dodevska Margarita

2015-01-01

Full Text Available Fruits and vegetables are known as good sources of numerous bioactive compounds among which polyphenols and dietary fibre are considered essential because of their protective health effects. The aim of this study was to characterize the quality of selected plant foods of our region regarding amount of total phenols, fibres and ratio of certain fractions of fibre. Fifteen samples of plant foods (green leafy vegetables, fruits and nuts were evaluated for total antioxidant activity, total phenolic content, total, soluble and insoluble fibre and fractions of fibre: beta-glucans, arabinoxylan, cellulose and resistant starch. Generally nuts were the richest sources of fibre and total phenols. However, when serving size was taken into consideration, it appeared that raspberry and blackberry were the richest in total, soluble fibre and cellulose. At the same time, almonds and hazelnuts were particulary rich in insoluble fibre, while walnuts had the highest polyphenol content. Analyzed plant foods were poor sources of arabinoxylan and beta-glucan. Data on resistant starch presence in cashew nut is the first confirmation that resistant starch can be found in significant amount in some nuts. The results give rare insight into the quality of selected plant foods regarding dietary fibre and polyphenols from the nutritive point of view. [Projekat Ministarstva nauke Republike Srbije, br. III46001

Should early enteral nutrition be used in the trauma intensive care ...

African Journals Online (AJOL)

Critical illness, sepsis, surgery, multi-organ failure and haemo- dynamic instability are conditions that are associated with feeding inadequacies and nutritional challenges. Conversely, meeting nutritional requirements and providing optimal nutrition are associated with an improved outcome. Since these facts have been.

On the behaviour of gelled fibre suspensions in steady shear

Energy Technology Data Exchange (ETDEWEB)

Wolf, Bettina [Unilever Corporate Research, Bedford (United Kingdom); University of Nottingham, Division of Food Sciences, Loughborough (United Kingdom); White, Duncan; Melrose, John R.; Frith, William J. [Unilever Corporate Research, Bedford (United Kingdom)

2007-03-15

The shear rheological properties of suspensions of gelled agar fibres in a low viscosity Newtonian matrix fluid were investigated. Two classes of fibres, low aspect ratio fibres and high aspect ratio fibres with an aspect ratio of the order of 10 and 100 respectively were included in the investigations. For all fibre phase volumes investigated, from as low as 0.01 upwards, the flow curves are characterised by an apparent yield stress followed by shear-thinning which was independent of the fibre aspect ratio. Based on our analysis of the flow curves, we conclude that the high aspect ratio fibres behave like flexible threads in contrast to the low aspect ratio fibres whose high shear relative viscosity is successfully described by a relation for long rigid rods. These findings are supported by flow visualisation using an optical shearing stage coupled to a light microscope. (orig.)

[Nutritional support in sepsis].

Science.gov (United States)

Ortiz Leyba, C; López Martínez, J; Blesa Malpica, A L

2005-06-01

Although it is considered that metabolic and nutritional support must be part of the management of septic patients, it has not been conclusively shown that nutritional support will improve survival or complications from sepsis. Specific data on this issue are scarce since there are few studies that have investigated specialized nutritional support in septic patients. Thus, most of the recommendations are based on outcomes obtained in severely ill patients with different pathologies. It is assumed that nutritional support should be carried out through the enteral route whenever possible, as in other critically ill patients. The energetic waste in these patients is highly variable, although in general terms the hypermetabolic situation may be classified as moderate. An adjustment factor of 1.25-1.30 is recommended for the Harris-Benedict's equation to calculate the caloric intake. Septic patients should receive a hyperproteic intake. The amount of glucose administered should not exceed 70% of non-protein calories, and lipids intake should not exceed 40%. With regards to micronutrients, it is recommended to increase the supply of those with antioxidant properties (vitamin E, carotenes, vitamin C, selenium). There are data to consider that the use of diets enriched with pharmaco-nutrients (both with parenteral and enteral routes) may be beneficial in septic patients, although there is some controversy when interpreting the outcomes.

Advanced Fibre Based Energy Storage

Science.gov (United States)

Reid, Daniel Oliver

New energy storage devices are required to enable future technologies. With the rise of wearable consumer and medical devices, a suitable flexible and wearable means of storing electrical energy is required. Fibre-based devices present a possible method of achieving this aim. Fibres are inherently more flexible than their bulk counterparts, and as such can be employed to form the electrodes of flexible batteries and capacitors. They also present a facile possibility for incorporation into many fabrics and clothes, further boosting their potential for use in wearable devices. Electrically conducting fibres were produced from a dispersion of carbon nanomaterials in a room temperature ionic liquid. Coagulation of this dispersion was achieved through manual injection into aqueous solutions of xanthan gum. The limitations of this method are highlighted by very low ultimate tensile strengths of these fibres, in the order of 3 MPa, with high variation within all of the fibres. Fibres were also produced via scrolling of bi-component films containing poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) and poly(vinyl alcohol) (PVA). Chemical treatments were employed to impart water compatibility to these fibres, and their electrochemical, physical and electrical properties were analysed. Fibres were wet spun from two PEDOT:PSS sources, in several fibre diameters. The effect of chemical treatments on the fibres were investigated and compared. Short 5 min treatment times with dimethyl sulfoxide (DMSO) on 20 mum fibres produced from Clevios PH1000 were found to produce the best overall treatment. Up to a six-fold increase in electrical conductivity resulted, reaching 800 S cm-1, with up to 40 % increase in specific capacitance and no loss of mechanical strength (55 F g-1 and 150 MPa recorded). A wet spinning system to produce PEDOT:PSS fibres containing functionalised graphenes and carbon nanotubes, as well as birnessite nanotubes was subsequently developed

Nutritional quality of diet and academic performance in Chilean students

Science.gov (United States)

Correa-Burrows, Paulina; Blanco, Estela; Reyes, Marcela; Gahagan, Sheila

2016-01-01

Abstract Objective To explore associations between the nutritional quality of diet at age 16 years and academic performance in students from Santiago, Chile. Methods We assessed the nutritional quality of diet, using a validated food frequency questionnaire, in 395 students aged 16.8 ± 0.5 years. Depending on the amount of saturated fat, fibre, sugar and salt in the foods, diet was categorized as unhealthy, fair or healthy. Academic performance was assessed using high school grade-point average (GPA) and tests for college admission in language and mathematics. Academic results on or above the 75th percentile in our sample were considered good academic performance. We tested associations between nutritional quality of diet and good academic performance using logistic regression models. We considered sociodemographic, educational and body-mass index (BMI) factors as potential confounders. Findings After controlling for potential confounding factors, an unhealthy diet at age 16 years was associated with reduced academic performance. Compared to participants with healthy diets, those with unhealthy diets were significantly less likely to perform well based on language tests (odds ratio, OR: 0.42; 95% confidence interval, CI: 0.18–0.98) mathematics tests (OR: 0.35; 95% CI: 0.15–0.82) or GPA (OR: 0.22; 95% CI: 0.09–0.56). Conclusion In our sample, excessive consumption of energy-dense, low-fibre, high-fat foods at age 16 years was associated with reduced academic performance. PMID:26966329

Nutritional quality of diet and academic performance in Chilean students.

Science.gov (United States)

Correa-Burrows, Paulina; Burrows, Raquel; Blanco, Estela; Reyes, Marcela; Gahagan, Sheila

2016-03-01

To explore associations between the nutritional quality of diet at age 16 years and academic performance in students from Santiago, Chile. We assessed the nutritional quality of diet, using a validated food frequency questionnaire, in 395 students aged 16.8 ± 0.5 years. Depending on the amount of saturated fat, fibre, sugar and salt in the foods, diet was categorized as unhealthy, fair or healthy. Academic performance was assessed using high school grade-point average (GPA) and tests for college admission in language and mathematics. Academic results on or above the 75th percentile in our sample were considered good academic performance. We tested associations between nutritional quality of diet and good academic performance using logistic regression models. We considered sociodemographic, educational and body-mass index (BMI) factors as potential confounders. After controlling for potential confounding factors, an unhealthy diet at age 16 years was associated with reduced academic performance. Compared to participants with healthy diets, those with unhealthy diets were significantly less likely to perform well based on language tests (odds ratio, OR: 0.42; 95% confidence interval, CI: 0.18-0.98) mathematics tests (OR: 0.35; 95% CI: 0.15-0.82) or GPA (OR: 0.22; 95% CI: 0.09-0.56). In our sample, excessive consumption of energy-dense, low-fibre, high-fat foods at age 16 years was associated with reduced academic performance.

Challenges and opportunities of fibre-reinforced polymers in additive manufacturing with focus on industrial applications

DEFF Research Database (Denmark)

Hofstätter, Thomas; Pedersen, David Bue; Tosello, Guido

2017-01-01

Functional parts made by additive manufacturing of polymers have entered the area of industrial applications in recent years providing a wide range of materials with various mechanical, thermal, and electrical properties. These additive manufacturing processes can be combined with known fibre...

DETERMINATION OF DIETARY FIBRE – THE INFLUENCE OF MILLING FRACTION AND MIXING PROCESS

Directory of Open Access Journals (Sweden)

Blaž FERJANČIČ

2018-04-01

Full Text Available Dietary fibre is an important constituent of a healthy diet, composed of non-digestible carbohydrates and lignin. Over the last decades dietary fibre has gained importance for human nutrition, due to its beneficial effects on health. In addition to classical enzyme-gravimetric methods, new methods for the determination of total, insoluble and soluble dietary fibres in foods have recently been developed, but have not yet been fully implemented for use. For the purpose of creating food composition databases and for food labelling, the classical AOAC 985.29 and 991.43 methods are still widely used. The methods are enzyme-gravimetric and therefore sensitive to enzyme kinetics. The aim of the study was to investigate the effect of milling fraction and mixing of the sample on dietary fibre content determined with the AOAC method 991.43. The results showed that milling fraction significantly influences the content of dietary fibre, especially in unprocessed or slightly processed cereals, the mixing acts synergistically with milling. According to the results it is proposed to mill the sample between 200 and 500 μm. For accurate determination of dietary fibre content, it is necessary to prepare the sample correctly, since the AOAC 991.43 method is, despite its robustness, sensitive during the sample preparation step.

Desserts with a high nutritional value in the industry employees nutrition

Directory of Open Access Journals (Sweden)

L. Telegenko

2017-04-01

Full Text Available In the article there are considered questions of the sweet foods with a high nutritional value development. Evaluation of the organoleptic and physical-chemical properties of model jelly samples with jost and spirulina showed that the proposed formula and technology gives a product with high consumer properties. There is a theoretically substantiated expediency of a jost and spirulina jelly implementation in such restaurant enterprises as dining rooms in the industrial plants. Using the jost and spirulina nutritional supplements can expand the range of the preventive nutrition foods.

Lysine requirement of the enterally fed term infant in the first month of life

NARCIS (Netherlands)

Huang, L.; Hogewind-Schoonenboom, J.E.; de Groof, F.; Twisk, J.W.R.; Voortman, G.J.; Dorst, K.; Schierbeek, H.; Boehm, G.; Huang, Y.; Chen, C.; van Goudoever, J.B.

2011-01-01

Background: Infant nutrition has a major impact on child growth and functional development. Low and high intakes of protein or amino acids could have a detrimental effect. Objective: The objective of the study was to determine the lysine requirement of enterally fed term neonates by using the

Deaths associated with insertion of nasogastric tubes for enteral nutrition in the medical intensive care unit: Clinical and autopsy findings

Science.gov (United States)

Smith, Avery L.; Santa Ana, Carol A.; Fordtran, John S.; Guileyardo, Joseph M.

2018-01-01

ABSTRACT It is generally assumed that blind insertion of nasogastric tubes for enteral nutrition in patients admitted to medical intensive care units is safe; that is, does not result in life-threatening injury. If death occurs in temporal association with insertion of a nasogastric tube, caregivers typically attribute it to underlying diseases, with little or no consideration of iatrogenic death due to tube insertion. The clinical and autopsy results in three recent cases at Baylor University Medical Center challenge the validity of these notions. PMID:29904295

Laser Cutting of CFRP with a Fibre Guided High Power Nanosecond Laser Source - Influence of the Optical Fibre Diameter on Quality and Efficiency

Science.gov (United States)

Bluemel, S.; Bastick, S.; Staehr, R.; Jaeschke, P.; Suttmann, O.; Overmeyer, L.

For the development of a robot based laser cutting process of automotive 3D parts consisting of carbon fibre reinforced plastics (CFRP), investigations with a newly developed fibre guided nanosecond pulsed laser with an average power of PL = 1.5 kW were conducted. In order to investigate the best combination of quality and process time 2 different optical fibres were used, with diameters of df = 400 μm and df = 600 μm. The main differences between the two setups are the resulting focal diameter and the maximum available pulse energy up to EP = 80 mJ. In a first instance, a comparable investigation was performed with both fibres for a constant pulse overlap. For each fibre the minimum required line energy was investigated and cuts were performed, distributed over the complete parameter range of the laser source. The influences of the fibre diameter on the quality and efficiency of the cutting process are summarized and discussed.

The Influence of Fibre Content on the Performance of Steel Fibre ...

African Journals Online (AJOL)

The Influence of Fibre Content on the Performance of Steel Fibre Refractory Concrete. ... Little information is available on the effect of fibre content on refractory performance and in particular resistance to thermal shock. This study has examined the influence of fibre content of stainless steel melt extract fibres on the ...

Oxidation of lignin in hemp fibres by laccase: effects on mechanical properties of hemp fibres and unidirectional fibre/epoxy composites

DEFF Research Database (Denmark)

Liu, Ming; Baum, Andreas; Odermatt, Jürgen

2017-01-01

Laccase activity catalyzes oxidation and polymerization of phenols. The effect of laccase treatment on the mechanical properties of hemp fibres and hemp fibre/epoxy composites was examined. Laccase treatment on top of 0.5% EDTA + 0.2% endo-polygalacturonase (EPG) treatments increased the mechanical...... properties of hemp fibres and fibre/epoxy composites. Comparing all fibre treatments, composites with 0.5% EDTA + 0.2% EPG + 0.5% laccase treated fibres had highest stiffness of 42 GPa and highest ultimate tensile strength (UTS) of 326 MPa at a fibre volume content of 50%. The thermal resistance of hemp...... hemp fibres and their composites were due to laccase catalyzed polymerization of lignin moieties in hemp fibres....

Surgery and transplantation – Guidelines on Parenteral Nutrition, Chapter 18

Directory of Open Access Journals (Sweden)

Holland-Cunz, S.

2009-11-01

Full Text Available In surgery, indications for artificial nutrition comprise prevention and treatment of catabolism and malnutrition. Thus in general, food intake should not be interrupted postoperatively and the re-establishing of oral (e.g. after anastomosis of the colon and rectum, kidney transplantation or enteral food intake (e.g. after an anastomosis in the upper gastrointestinal tract, liver transplantation is recommended within 24 h post surgery. To avoid increased mortality an indication for an immediate postoperatively artificial nutrition (enteral or parenteral nutrition (PN also exists in patients with no signs of malnutrition, but who will not receive oral food intake for more than 7 days perioperatively or whose oral food intake does not meet their needs (e.g. less than 60–80% for more than 14 days. In cases of absolute contraindication for enteral nutrition, there is an indication for total PN (TPN such as in chronic intestinal obstruction with a relevant passage obstruction e.g. a peritoneal carcinoma. If energy and nutrient requirements cannot be met by oral and enteral intake alone, a combination of enteral and parenteral nutrition is indicated. Delaying surgery for a systematic nutrition therapy (enteral and parenteral is only indicated if severe malnutrition is present. Preoperative nutrition therapy should preferably be conducted prior to hospital admission to lower the risk of nosocomial infections. The recommendations of early postoperative re-establishing oral feeding, generally apply also to paediatric patients. Standardised operative procedures should be established in order to guarantee an effective nutrition therapy.

Nutritional composition of the African locust bean ( Parkia biglobosa ...

African Journals Online (AJOL)

Nutritional and anti-nutritional composition of the African locust bean (Parkia biglobosa) fruit pulp were determined using standard methods. Results showed a moisture content of 8.41%, protein 6.56%, fat 1.80%, crude fibre 11.75%, ash. 4.18% and carbohydrate of 67.30%. Sugar content was found to be 9.00 °Brix; total ...

Rare-Earth Doped Photonic Crystal Fibre Lasers and Amplifiers

DEFF Research Database (Denmark)

Hougaard, Kristian G.

2005-01-01

In this thesis, a theoretical and numerical study of the use of rare-earthdoped photonic crystal fibres as optical amplifiers and lasers, has been performed. Photonic crystal fibres or microstructured optical fibres is a new kind of optical fibre in which the cladding region typically consist....... Their novel properties allow for design of optical fibre amplifiers and fibre lasers with superior performance, compared to solutions based on conventional fibres. The primary applications considered are high efficiency fibre amplifiers based on index guiding photonic crystal fibres, and cladding pumped....... The thesis also presents the basic properties of optical amplification, and describes the numerical model developed to model the behaviour of lasers and amplifiers based on photonic crystal fibres. The developed numerical tools are then used to investigate specific applications of photonic crystal fibres...

Stents in patients with esophageal cancer before chemoradiotherapy: high risk of complications and no impact on the nutritional status.

Science.gov (United States)

Mão-de-Ferro, S; Serrano, M; Ferreira, S; Rosa, I; Lage, P; Alexandre, D P; Freire, J; Mirones, L; Casaca, R; Bettencourt, A; Pereira, A D

2016-03-01

Preoperative chemoradiotherapy is the standard of care for locally advanced esophageal cancer, causing persistent deterioration in the nutritional status. We performed a prospective study to evaluate the safety and efficacy of esophageal double-covered self-expandable metal stents in patients with esophageal cancer before chemoradiotherapy. The nutritional status and dysphagia were prospectively recorded. Eleven patients were included: eight were moderate and three were severely malnourished. After stent placement, dysphagia improved in all patients. With regard to complications, one patient developed an esophageal perforation that required urgent esophagectomy. Four patients presented stent migration. Three of these patients required enteral nutrition and none was submitted to surgery because of poor nutritional status. Of the other six patients, only four were operated upon. Stent placement presented a high complication rate and did not prevent weight loss or malnutrition. Other alternatives, including naso-gastric tube placement or endoscopic percutaneous gastrostomy or jejunostomy, should be considered.

A high-performance flexible fibre-shaped electrochemical capacitor based on electrochemically reduced graphene oxide.