Purpose of Review To discuss the different forms of enteral nutrition, while outlining available evidence for its use in specific conditions and how enteral nutrition composition may or may not influence relevant outcomes. Recent Findings Enteral nutrition formulas were originally conceived as a liquid form of nutrition for individuals who otherwise could not consume adequate calories through solid food. Over time, the emergence of specialty formulas marketed to benefit specific diseases or conditions has led to a broad range of potentially confusing options. While most options have theoretical benefit for their marketed conditions, the evidence demonstrating practical benefit is not consistent. Summary Overall, the certainty of evidence for specialty formulas remains low or very low. In most instances, one could begin with standard polymeric formula, except in cases where disease-specific formulas are recommended. Much research is nonetheless still needed to clarify whether some disease-specific formulas are truly beneficial or merely theoretical features.
Malignant pleural effusion (MPE) is a common complication of thoracic and extrathoracic malignancies and is associated with high mortality. Treatment is mainly palliative, with symptomatic management achieved via effusion drainage and pleurodesis. Pleurodesis may be hastened by administering a sclerosing agent through a thoracostomy tube, thoracoscopy, or an indwelling pleural catheter (IPC). Over the last decade, several randomized controlled studies shaped the current management of MPE in favor of an outpatient-based approach with a notable increase in IPC usage. Patient preferences remain essential in choosing optimal therapy, especially when the lung is expandable. In this article, we reviewed the last 10 to 15 years of MPE literature with a particular focus on the diagnosis and evolving management.
Ein maligner Pleuraerguss (MPE) ist eine häufige Komplikation von thorakalen und extrathorakalen Malignomen und geht mit einer hohen Sterblichkeit einher. Die Behandlung ist hauptsächlich palliativ, wobei die Symptome durch Ergussdrainage und Pleurodese gelindert werden. Die Pleurodese kann durch die Verabreichung eines Sklerosierungsmittels über eine Thorakostomie-Sonde, eine Thorakoskopie oder einen Pleuraverweilkatheter (IPC) beschleunigt werden. In den letzten zehn Jahren haben mehrere randomisierte, kontrollierte Studien das derzeitige Management von MPE zugunsten eines ambulanten Ansatzes geprägt, wobei der Einsatz von IPC deutlich zugenommen hat. Die Präferenzen der Patienten sind nach wie vor entscheidend für die Wahl der optimalen Therapie, insbesondere wenn die Lunge erweiterbar ist. In dieser Übersichtsarbeit haben wir die MPE-Literatur der letzten 10 bis 15 Jahre durchgesehen und uns dabei besonders auf die Diagnose und das sich entwickelnde Management konzentriert.
Sarcoidosis is a multi-organ granulomatous disorder with an undefined etiology. Genetic susceptibility is a risk factor, but several occupations and exposures have been implicated without any proven as the causative agent. Military personnel by virtue of their deployments are exposed to a variety of different agents, and thus provide a population of interest to study sarcoidosis development patterns with environmental exposures. METHODS: 20 patients with biopsy-proven sarcoidosis were identified by a retrospective chart review of veterans within the Oklahoma City Veterans Health Administration system. 16 were males and 4 were females. We were able to contact 19 to obtain detailed exposure history.
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