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D A Lipschitz

Publications and source records attributed to D A Lipschitz.

93 records · Page 6Linked to original sources
PubMedDate not supplied

The role of protein in nutrition, with particular reference to the composition and use of enteral feeding formulas. A consensus report.

In its proposed classification scheme for reimbursement for enteral feeding formulas, the United States Health Care Financing Administration (HCFA) has neglected to consider the importance of making available formulas of varying protein content. In responding to HCFA's proposal, this consensus report reviews information currently available regarding different protein requirements in healthy, ill, and undernourished adults and elderly individuals. HCFA's reimbursement guidelines should reflect sound medical and nutritional practice rather than influencing it adversely, which its original proposal could do. Clinicians should have at their disposal enteral feeding formulas of varying protein/calorie ratios, especially since the following groups often have higher than average protein requirements relative to calorie requirements: the elderly, individuals with physiologic stress such as infection and injury, and patients with protein-calorie undernutrition.

Adult↗
PubMedDate not supplied

Patterns of care: an analysis of the quality of nutritional care routinely provided to elderly hospitalized veterans.

To assess the adequacy of the nutritional care provided, a prospective noninterventional study was carried out on 250 randomly selected patients aged 65 and over who were admitted to a Veterans Administration Hospital. Of this group, 97 patients (39%) were found to be at high risk of having clinically significant protein-energy malnutrition. In 43 cases (17%), an assessment of the patient's nutritional status was not possible because the available data were inadequate. No patient had a diagnosis of malnutrition recorded on the problem list. Only 13 percent of the high-risk patients received some form of nutrition support therapy; 10 (10%) received oral supplements, and four (4%) were started on enteral feedings. Patients who received enteral feedings experienced a high rate of complications resulting from use of the feeding tubes. Over all, none of the high risk study patients received optimal nutrition support therapy. These findings indicate that elderly patients hospitalized in the Veterans Administration hospital in this study are usually not screened appropriately for protein-energy malnutrition, the diagnosis is frequently missed or ignored, and nutrition support therapy is underutilized and often ineffectually managed.

Aged↗