Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Randomized Controlled Trial
Is supplementation with elemental diet feasible in patients undergoing pelvic radiotherapy?
Acute gastrointestinal upset occurs in approximately 80% of patients undergoing radiotherapy for pelvic cancers. Underlying changes relate to denudation of the mucosal layer which renders the small intestine vulnerable to additional damage from proteolytic enzymes and bile acids. Severe acute bowel symptoms may predispose to progressive fibrotic and ischaemic changes. Elemental diet given during treatment may reduce acute and chronic bowel symptoms induced by pelvic radiotherapy. ⋯ Different formulations of elemental diet do not influence compliance. Patients are unlikely to be able to consume more than one-third of their calorie requirements in the form of an elemental sip feed. Further investigation is warranted to determine if intervention with this volume of elemental diet is beneficial.
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Delivery of enteral nutrition (EN) in critical illness is often inadequate. This prospective observational study addresses the implementation of enteral feeding in critically ill medical patients and its relation to energy expenditure. ⋯ A high delivery-to-prescription rate could be achieved with a standardized enteral feeding protocol in critically ill medical patients. However, caloric delivery is much less than measured energy expenditure. Enteral feeding intolerance is associated with a high mortality rate.
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The aim of our study was to detect differences in weigth loss with a hypocaloric diet in obese patients depending on their glycaemic status. ⋯ Ability to lose weight on a hypocaloric diet over a 3-month time period does not vary in obese patients as a function of glycaemic status. Improvement in cardiovascular risk factors is not related with glycaemic status, too.
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An accurate energy balance is difficult to achieve in hospitalized patients. The aim of the study was to measure the daily cumulative energy balance in critically ill patients receiving mechanical ventilation using a bedside computerized information system (CIS), and to assess its impact on outcome. ⋯ Negative energy balance may be correlated with the occurrence of complications in the ICU. The bedside CIS provides accurate information on energy balance in critically ill patients and may allow for early detection and prevention of severe negative energy balance and complications.