JPEN. Journal of parenteral and enteral nutrition
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JPEN J Parenter Enteral Nutr · Jul 2015
Case ReportsThiamin Deficiency as a Cause of Persistent Hyperlactatemia in a Parenteral Nutrition-Dependent Patient.
Despite the demonstrated dangers of inadequate supplies of injectable multivitamins, periodic shortages of these crucial pharmaceuticals continue to occur in the developed world. This case report provides a recent example of the potential danger of rationing parenteral multivitamins in chronically parenteral nutrition (PN)-dependent patients in the setting of national supply shortages. ⋯ Physicians must be vigilant for potentially life-threatening nutrition deficiencies, as illustrated in this case of thiamine insufficiency, in PN-dependent children and adults in the setting of nationwide limitations in multivitamin supply.
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Sheean PM, Peterson SJ, Gomez Perez S, et al. Response to Dr Khursheed Jeejeebhoy. ⋯ That should read: "Patricia M. Sheean is now affiliated with Loyola University Chicago."
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JPEN J Parenter Enteral Nutr · May 2015
Multicenter StudyPrevalence, risk factors, clinical consequences, and treatment of enteral feed intolerance during critical illness.
We aimed to determine the incidence of enteral feed intolerance and factors associated with intolerance and to assess the influence of intolerance on nutrition and clinical outcomes. ⋯ Intolerance occurs frequently during EN in critically ill patients and is associated with poorer nutrition and clinical outcomes.
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JPEN J Parenter Enteral Nutr · Mar 2015
Physical assessment and anthropometric measures for use in clinical research conducted in critically ill patient populations: an analytic observational study.
Accurate assessment of nutrition status is essential in identifying subpopulations of critically ill patients who are malnourished and at higher mortality risk. The aim of this analytic observational study was to assess the performance of physical assessment and anthropometric measures commonly used in clinical research. ⋯ On the basis of the results of our ICU cohort, we recommend caution when using BMI categorized according to WHO definitions. We cannot recommend collection of TSF. More research is required to understand reliability, performance, and use before our results are able to be generalized to other ICU populations.
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JPEN J Parenter Enteral Nutr · Feb 2015
Bombesin improves adaptive immunity of the salivary gland during parenteral nutrition.
The parotid and submandibular salivary glands are gut-associated lymphoid tissues (GALTs) that secrete immune compounds into the oral cavity. Parenteral nutrition (PN) without enteral stimulation decreases GALT function, including intestinal lymphocyte counts and secretory immunoglobulin A (sIgA) levels. Since the neuropeptide bombesin (BBS), a gastrin-releasing peptide analogue, stimulates intestinal function and restores GALT parameters, we hypothesized that PN + BBS would stimulate parotid and salivary gland IgA levels, T lymphocytes, and IgA plasma cell counts compared with PN alone. ⋯ Compared with chow, PN results in atrophy of the salivary glands characterized by reduced amylase, IgA, and immune cellularity. BBS has no effect on acinar cells or amylase activity compared with PN but maintains tissue IgA and plasma cells and T-lymphocyte numbers compared with chow.