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S Kolb

Publications and source records attributed to S Kolb.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Nutrition of ENT tumor patients treated with radiotherapy. Comparison of oral and enteral nutrition using percutaneous gastrostomy].

The nutritional state of 99 patients with head and neck malignancies was assessed before, during and up to 18 weeks after radiotherapy (DXRT) using anthropometry, immunology and blood chemistry. 73 patients were fed orally during therapy, first with a normal diet and later, when the side effects of DXRT worsened, with a supplemental liquid formula diet. During the first two weeks 26 patients were treated with a PEG (percutaneous endoscopically controlled gastrostomy) and were fed mainly enterally with formula diets. The parameters of those patients fed orally during DXRT worsened rapidly and only recovered slowly and incompletely. On the contrary, in spite of their poor initial condition, the patients with PEG improved their state of nutrition, even during DXRT. Both the objective parameters of nutrition and the subjective condition of the patients were measured with the help of the "quality of life index". During DXRT the quality of life of both groups deteriorated equally. The objective parameters of nutrition showed that the patient's strength and the capacity for work remained constant. Unexpectedly, after DXRT only the orally fed patients were found to have an improved subjective condition, probably because the PEG patients were reminded of their disease by the tube, in spite of successful completion of tumor therapy. This undoubtedly impedes the return to normal family and working life. Early and consistent enteral diet with PEG helps to stabilize the state of nutrition of patients with head and neck cancer, and is recommended, especially for patients already suffering from malnutrition before starting an aggressive multimodal tumor therapy.

Body Mass Index↗
PubMed1989

[Comparison between oral nutrition and enteral nutrition using a percutaneous endoscopically guided gastrostomy (PEG) in patients undergoing radiotherapy for head and neck tumors].

The nutritional state of 99 patients with tumors in the head and neck area was determined prior to, during and after radiotherapy by anthropometric, laboratory-chemical and immunological parameters. In 73 orally nourished patients, the nutritional parameters deteriorated very quickly during radiotherapy and recovered slowly and incompletely after radiotherapy. In 26 patients treated prospectively by percutaneous endoscopically guided gastrostomy (PEG), however, an improved nutritional state was achieved already during the irradiation in spite of a less favorable starting point. The subjective feeling of patients was questioned by means of the "quality of life" index according to Padilla et al. (1983). The preliminary results show an identical deterioration of the subjective feeling in both groups, but - as opposed to the other patients - force and working capacity did not decrease during radiotherapy in the enterally nourished patients. This corresponds to the objective nutritional parameters. However, an improvement of the subjective feeling after the end of radiotherapy was observed only in the orally nourished patients. Possible reasons are discussed. We have the opinion that an early and constant enteral nutrition by PEG can stabilize the nutritional state of patients with tumors in the head and neck area. Therefore we recommend to establish a prophylactic, pretherapeutic PEG if an aggressive multimodal therapy is planned, especially in case of apparent primary malnutrition.

Body Mass Index↗
PubMed1988

[Experiences with percutaneous endoscopy controlled gastrostomy in patients with neck and otolaryngologic tumors].

Most patients with head and neck tumours need supportive long-term nutrition. To guarantee enteral food intake we implanted a nasogastric tube percutaneously without any complications in 108 patients. The advantage of this method of feeding is that the direct percutaneous route avoids any mechanical irritation of the upper gastro-intestinal tract; this could be important, for example, during radiotherapy, because the mucous membranes are already damaged. In addition the gastric tube is invisible below the patient's clothing so that he can move about without embarrassment.

Endoscopy↗
PubMed1987

[Amino acid level in plasma--expressed as alpha-amino-nitrogen--reaction to stimulation of the exocrine pancreas: approaches to a new pancreatic function test].

We determined by the ninhydrin method the plasma amino acid (AA) levels prior to, during and following, a 1-hour i.v. infusion of 1 U/kg body weight each of secretin and pancreozymin in patients with normal (n = 74) or reduced (n = 39) exocrine pancreatic function, as assessed by the duodenal aspiration test. The results of the two tests correlated significantly with each other (p less than 0.001). A maximum AA decrease of greater than or equal to 12% was observed in all patients with a normally functioning pancreas (specificity 100%), and of less than 12% in all patients with medium to high-grade impairment of pancreatic function (sensitivity 100%). Since, however, low-grade pancreas insufficiency (20-40% of the mean normal enzyme output) is recognized in fewer than one-half of the cases, the overall sensitivity of the AA-consumption test decreases to 69%. The results can, however, be improved by: 1) Calculating the mean percentage AA decrease with a limit value of 5% (sensitivity 90%); 2) determining individual AA with pancreas-specific absorption, such as serine (sensitivity 92%); 3) dropping the lower normal value of exocrine pancreatic function to 25% of the normal mean enzyme output (sensitivity 96%). Diseases that may be associated with the most common condition that causes pancreatic insufficiency--chronic pancreatitis--and which have an influence on AA metabolism, such as cirrhosis of the liver and diabetes mellitus, have no influence on the accuracy of the AA consumption test, which, considered overall, represents a competitive alternative to other tubeless tests of pancreatic function.

Adult↗
PubMed1987

[Ambulatory parenteral nutrition in short bowel syndrome: a retrospective study].

Parenteral nutrition via an indwelling central venous catheter was undertaken at home over a total period of 24,747 days in 34 patients with the short-bowel syndrome (of various causes). In some of the patients there developed complete adaptation of the residual intestine so that parenteral nutrition could be terminated. Complications were: infection, thrombosis, pulmonary embolism and metabolic problems. But the method proved to be suitable for improving the quality of life of these patients.

Adolescent↗
PubMed1987

[Significance of percutaneous endoscopically controlled gastrostomy in the prevention and therapy of esophagotracheal fistula following long-term intubation].

An esophago-tracheal fistula, which developed during long-term artificial ventilation, is a vital threat to the life of a patient. The esophago-tracheal fistula is caused by pressure lesion of the mucosa of the posterior tracheal and anterior esophageal wall. The adverse mechanic factors are the blocked tube cuff on the one hand and the nasogastric tube being usually required for enteral nutrition on the other hand. Replacement of a nasogastric tube through a percutaneous, endoscopically controlled gastrostomy relieves the esophagus and thus prevents pressure lesion of the anterior esophageal wall. A percutaneous endoscopic gastrostomy, if performed in time, is suggested to reduce the incidence of an esophago-tracheal fistula, which develops in the course of long-term artificial ventilation.

Enteral Nutrition↗
PubMed1986

Decrease in plasma amino acid level after secretin and pancreozymin as an indicator of exocrine pancreatic function.

Total plasma amino acids were determined by the ninhydrin method in 37 controls and 30 patients with chronic pancreatitis and normal (n = 7) pancreatic enzyme output or mildly (n = 6), moderately (n = 8), and severely (n = 9) reduced pancreatic enzyme output. Intravenous injection of synthetic secretin did not change plasma amino acid levels. During a combined intravenous infusion of secretin (1 CU/kg X h) and pancreozymin (1 Ivy dog unit/kg X h), amino acid concentrations decreased maximally by 31% +/- 19% (mean +/- SD) in controls, but only by 6.3% +/- 4.7% in patients with exocrine pancreatic insufficiency (p less than 0.001 vs. controls). At a cutoff limit of less than or equal to 12% for the decrease in total amino acids, mild exocrine insufficiency (20%-40% of mean normal chymotrypsin output) was identified with a sensitivity of 67%, whereas moderately to severely impaired function was detected in every case (overall sensitivity 91%). Pancreatic function, as assessed by duodenal intubation and the tubeless amino acid test, was significantly correlated (e.g., rs = 0.73 for chymotrypsin output, p much less than 0.001). In 15 controls and 13 patients with mildly (n = 5) to severely impaired pancreatic function, individual amino acids were estimated. Plasma serine kinetics completely distinguished both groups. Kinetics of serine, valine, isoleucine, and histidine correlated even better with pancreatic function than those of total amino acids.

Adult↗