Compared with a fiber-free polymeric enteral diet, the daily consumption of an enteral diet supplemented with 30 g of total dietary fiber per day derived from a poorly fermentable oat fiber, a highly fermentable soy oligosaccharide fiber, or a moderately fermentable soy polysaccharide fiber has little impact, if any, on bowel function.
Objective - to determine current clinical practice of nutrition support in hospitals in the UK and to determine whether there have been any apparent changes in practices since 1988. Design - An 81 question survey about enteral and parenteral nutriton was sent to all District Dietitians registered with the British Dietetic Association. Information was collected additionally from pharmacists and clinicians. Results - 61.2% of questionnaires distributed were completed and returned. 32.5% of respondents had access to nutrition support teams, compared with 27% in 1988. The documentation of usage of nutrition support was poor, only 33% being able to accurately quantify administation of enteral nutrition, and 53% parenteral nutrition. Since 1988 the number of respondents using peripheral parenteral nutrition had doubled to 15%. Those using percutaneous gastrostomies had increased from 6% to 74%. Those using respiratory enteral diet formulations had quadrupled to 33%. There have been no other apparent major changes in nutrition support practice in the UK, in the last 3 years. Conclusions - Despite increasing awareness about the role of artificial nutrition support, and the value of Nutrition Support Teams there has been little or no progress in the provision or monitoring of support in the last 3 years. This has important implications when considering audit of such practices.
We have concluded that cut and push is a safe method of removal for Freka 15-Fr PEG tubes in ambulant patients without significant gastrointestinal history.
The aim of this study was to determine n..etller patients' toldrance of upper gastrointestinal endoscopy is related to the dose of lignocaine spray used for oropharyngeal anaesthesia and to measure plasma concentrations at these doses. Sixty consecutive patients undergoing routine upper gastrointestinal endoscopy with sedation were randomized to receive lignocaine spray 50 mg (Group A), 100 mg (Group B) or 200 mg (Group C). Patient, endoscopist and endoscopy nurse were unaware of the variation in dose used. Each patient's tolerance of the intubation and of the remainder of the gastroscopy was assessed independently by the patient, endoscopy nurse, and endoscopist using a visual analogue scale. Plasma lignocaine concentration was measured at 20, 40, 60 and 80 min after administration of the spray. Fifty (83 %) patients were unable to recaIl either the intubation, or the procedure. On the endoscopy nurse's assessment, the patients in Group B tolerated the intubation better than those in Group A, and Groups B and C tolerated
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