Compared with results from 1992, the prevalence of HEN has increased dramatically, while the prevalence of HPN has declined.

MO ILE was well tolerated in this small cohort and led to improvement in the macronutrient composition of HPN while providing a trend toward improvement in liver studies. These results are promising; however, additional randomized control trials are needed to delineate the true benefit.

The results of this retrospective review support initiation of HPN in the malnourished post-bariatric surgery patient both nutritionally and as a bridge to revision surgery.

With scientific advances allowing for the safe delivery of parenteral and enteral nutrition in the home setting, challenges have risen with determining how this will be financially feasible for patients. In the United States, the government is one of the major payers for home parenteral and enteral nutrition (HPEN). Thus, it is important for nutrition providers to have an understanding of the Medicare criteria that must be met in order for these services to be covered. It can be difficult for clinicians to sift through these requirements and decipher for whom and when HPEN is covered. As our nutrition science knowledge and delivery continue to grow and evolve, potential barriers to this coverage may arise. This article provides background on those currently on HPEN in the United States, the current Medicare HPEN coverage criteria, and challenges we may face in the future.

Due to the high osmolality of PN, CVC tip location is of paramount importance. After radiology review of CXR, we noted that 7 of 17 (41%) peripherally inserted central catheter lines were in an unsatisfactory position despite ECG confirmation. With current data available, intravenous ECG confirmation should not be used as the sole source of tip confirmation in patients receiving HPN.

clusive, as defined by health services management recruitment. We recently managed to enrol 300 early 40s, so that medicine would continue to be documents4 5). It is also likely to lead to an increase patients through 40 general practitioners over five enriched by a well trained human brain at the peak in the cost of disposing of clinical waste in months for a study on seasonal allergic rhinitis. We of its performance. To bring about these changes hospitals. This should encourage a review of the provided a substantial financial benefit, but the would entail some self immolating voting by many types of waste disposed of as clinical waste to timely completion of the project was also due to members of the boards of faculty of medicine in the discourage inappropriate use of yellow bags -for intense monitoring. Our clinical research associates universities, but perhaps no more than when the example, in offices for disposing of confidential visited general practitioners each month and full time posts were first introduced all those years documents.