In adult patients with enterocutaneous fistula: (1) What factors best describe nutrition status? (2) What is the preferred route of nutrition therapy (oral diet, enteral nutrition, or parenteral nutrition)? (3) What protein and energy intake provide best clinical outcomes? (4) Is fistuloclysis associated with better outcomes than standard care? (5) Are immune-enhancing formulas associated with better outcomes than standard formulas? (6) Does the use of somatostatin or somatostatin analogue provide better outcomes than standard medical therapy? (7) When is home parenteral nutrition support indicated?
Alarmingly high rates of disease-related malnutrition have persisted in hospitals of both emerging and industrialized nations over the past 2 decades, despite marked advances in medical care over this same interval. In Latin American hospitals, the numbers are particularly striking; disease-related malnutrition has been reported in nearly 50% of adult patients in Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Peru, Puerto Rico, Venezuela, and Uruguay. The tolls of disease-related malnutrition are high in both human and financial terms—increased infectious complications, higher incidence of pressure ulcers, longer hospital stays, more frequent readmissions, greater costs of care, and increased risk of death. In an effort to draw attention to malnutrition in Latin American healthcare, a feedM.E. Latin American Study Group was formed to extend the reach and support the educational efforts of the feedM.E. Global Study Group. In this article, the feedM.E. Latin American Study Group shows that malnutrition incurs excessive costs to the healthcare systems, and the study group also presents evidence of how appropriate nutrition care can improve patients’ clinical outcomes and lower healthcare costs. To achieve the benefits of nutrition for health throughout Latin America, the article presents feedM.E.’s simple and effective Nutrition Care Pathway in English and Spanish as a way to facilitate its use.
Nutritional care in onco-hematologic patients should be part of the overall treatment of the patient. Disturbances resulting from tumor localization, especially in tumors of the digestive tract, and their treatments like chemotherapy and radiotherapy and side effects of surgery often prevent oral feeding. This can lead to malnutrition and it is of great importance detection, assessment and intervention.
The blood supply of the attachment regions of the anterior and posterior cruciate ligament is demonstrated in 14 cadaver knees by the plastination method. Our findings demonstrate the blood supply by vessels of the synovium. The direct attachment to the bone is free of vessels. Anastomoses between the synovium and the periosteum could be found. In conclusion the surgical coverage of ligament reconstruction and of ligament transplantation by synovium is recommended when ever possible to permit the ingrowth of revascularisation vessels.
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