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At least 19 recordsLinked to original sources
PubMed1979

Principles of nutritional therapy.

Provision of adequate nutrition makes a major contribution toward improvement of clinical, biochemical, cellular, and psychologic status of the cancer patient in the face of the disease process and the side effects of various treatments. The principles of nutrition support include the following: 1) Malnutrition induced by cancer and its treatment adversely affects the patient and complicates further treatment of the disease. 2) Malnutrition is not an obligatory response of the host to cancer. 3) A rational nutritional therapeutic program for a patient requires analysis of the factors inducing depletion in that patient. 4) Every patient should have an early and periodic assessment of nutritional status. 5) Nutrition therapy, when indicated, should be instituted early. 6) The application and effectiveness of therapeutic programs must become part of the medical audit and general clinical procedure for inpatients and outpatients. 7) The objectives of nutritional therapy are: a) supportive, b) adjunctive, and c) definitive. 8) Nutritional status, tumor growth and anti-tumor treatment are intimately related. 9) Nutritional therapy has the potential for difficulties as well as benefits. 10) The provision of optimal nutrition care requires a multidisciplinary approach with physicians, nurses, dietitians, and pharmacists working as a team with adequate laboratory facilities and administrative and financial support.

Adult↗
PubMed1976

[Conditions for the efficacy of nutritional therapy].

This is to discuss regulatory mechanisms which enable the organism to respond optimally to special nutritive conditions. Those regulatory mechanisms are often in disorder with patients who need nutritive therapy. However, normal functions of the body are required for nutrition. Disarrangements in microcirculation, oxygen supply, water and electrolyte metabolism and acid-base metabolism are described and the way they will influence nutrition therapy. Furthermore, we try to describe special conditions of metabolism in stress and its influence to efficiency of nutritive therapy.

Acid-Base Equilibrium↗
PubMed1979

Pharmacist as team leader for total parenteral nutrition therapy.

A total parenteral nutrition program in a 635-bed private nonteaching institution which uses the pharmacist as team leader is described. To initiate TPN therapy, the attending physician writes a request for a consulation with the pharmacist. Prior to initiation of TPN therapy, the pharmacist reviews the chart, conducts a physical and nutritional assessment of the patient, orders any laboratory tests needed for further assessment of the patient and uses these results to classify the patient's nutritional status. The pharmacist then writes all TPN-related orders, including orders for laboratory tests and nursing care. Communications between the pharmacist and the attending physician concerning the progress of the patient and TPN changes are conducted orally on rounds and via chart notes. The number of patients receiving TPN therapy has increased each year--from six patients during 1976, to 19 patients during 1977 and 54 in 1978. Of the two preventable complications that developed in these 79 patients, both were quickly resolved by the pharmacist. Physicians who, in the past, opted not to place patients on TPN because of lack knowledge or lack of a TPN consultant, now rely on the pharmacist for this service.

Florida↗
PubMed1977

Nutritional therapy in children with cancer.

The special biology and behavior of the child make nutrition an even more important adjunct to cancer therapy than is true for the adult. The time has come to add nutritional therapy routinely to our other modes of therapy: surgery, radiotherapy, chemotherapy, and immunotherapy. But it should be done in the same way other modalities are added, i.e., with continued prospective and retrospective review of the data to optimize the approach to the child.

Child↗
PubMed1977

[Metabolically adapted nutrition following the concept of clinical nutrition therapy--success and prospects].

Modern dietetics abandon the traditional, mainly hypothetically based special types of nutrition. A better knowledge of the physiological and pathological metabolic reactions and the technical possibilities to produce defined, tailor-made dietetics products require a new way of thinking. It is attempted to establish a simple scheme according to the composition and use of balanced and defined diets and to outline future tendencies. In summary, it is concluded that the consequent use of modern nutritional physiology and the application of the actual technologies allow to supply patients with a metabolicly adapted nutrition even under difficult conditions.

Adaptation, Physiological↗
PubMed1979

Mass balance: a quantitative guide to clinical nutritional therapy. II. The dialyzed patient.

The concepts of mass balance are extended to the nutritional management of the patient with chronic renal failure on dialysis. The use of these concepts permits estimation of protein catabolism from calculated rates of urea generation, using measurement of blood urea levels. Protein catabolic rate will equal intake in the stable patient (zero nitrogen balance), allowing for accurate nutritional screening in a large dialysis population for whom these values are available without individual dietary surveys. This has resulted in a four-fold reduction in routine monitoring of protein nutrition in such patients, freeing the dietitian to concentrate on specific problems. These concepts also comprise a key aspect of the National Cooperative Dialysis Study which seeks to maintain BUN at different levels in four carefully controlled modes of dialysis therapy. With these methods, the monitoring and control of BUN and protein intake has made the dietitian a pivotal member of this study staff.

Blood Urea Nitrogen↗
PubMed1979

Mass balance: a quantitative guide to clinical nutritional therapy. I. The predialysis patient with renal disease.

Mass balance principles can be readily applied to the patient with chronic renal failure for the more structured management of his/her nutritional and clinical course. Urine values provide valuable information with respect to rates of protein catabolism and sodium intake; creatinine excretion rates provide a ready check on data accuracy and lean body mass; urea and creatinine clearance can be calculated, if blood levels of these solutes are known. With accurate data on creatinine generation and the ratio of urea to creatinine clearance, creatinine clearance, urea generation, and protein catabolism rates can be estimated from blood levels alone. These techniques then provide quantitative guidance for the nutritional/medical staff in its efforts to control the clinical course of the patient with severly diminished renal function.

Acute Kidney Injury↗
PubMed1979

The nutritional therapy of histidinemia.

Control of the plasma histidine level in histidinemia is possible with the use of an amino acid mixture free of histidine and a carefully monitored intake of histidine. This regimen is compatible with good physical growth and normal mental development. If further clinical experience demonstrates that widespread nutritional intervention in this disease is warranted, it should be possible to obtain good biochemical control.

Adolescent↗
PubMed1977

Nutritional therapy based on positive caloric balance in burn patients.

Oxygen consumption and caloric expenditure was 1 1/2 to 2 times normal in 15 major burn patients from the time of burn to the time of surface coverage. This hypermetabolic state was quite consistent hour-to-hour and day-to-day, and correlated best with the extent of full-thickness burn. Nutritional management and caloric intake can be intelligently planned using simple spirometry and indirect calorimetry to measure caloric requirements. Weight gain and prompt healing can be achieved by positive caloric balance. Based on daily metabolic studies, a positive caloric balance feeding protocol has been used in the treatment of 556 patients. This regimen, in combination with many other factors in physiologic and surface care, has resulted in high survival rates, short hospitalization, and rapid rehabilitation.

Adolescent↗
PubMed1978

An approach to nutritional therapy of hepatic encephalopathy by normalization of deranged amino acid patterns in serum.

A mixture with essential and nonessential amino acids high in branched chain amino acids and low in aromatic amino acids (Fischer solution), and another synthetic mixture of branched chain amino acids containing 3 amino acids associated with the urea cycle (Hep-OU) were infused to control subjects and patients with severe hepatic disease. Alterations in serum aminograms, blood ammonia levels and electroencephalograms following the infusion were studied and compared with those obtained by a commercially available amino acid mixture. Short-term or continuous infusion of a commercially available amino acid solution to cirrhotic patients caused an increase in methionine, phenylalanine and tyrosine and a decrease in branched chain amino acids. These post-infusion results were similar to the patterns seen in hepatic encephalopathy. In cirrhotic patients, infusion of Fischer solution which contains small quantities of methionine and phenylalanine produced an increase in the concentrations of these 2 amino acids, probably because of impaired utilization by the injured liver. No marked alterations in serum aminograms, however, were observed in cirrhotic patients either immediately after, or 3 h after, the end of the Hep-OU infusion. Reduction of methionine, tyrosine and phenylalanine levels and elevation of the molar ratio of (valine + leucine + isoleucine)/(phenylalanine + tyrosine) were significant. The infusion of Hep-OU to patients with liver cirrhosis or subacute hepatitis resulted in clinical and neurological improvements and the restoration of the molar ratio of branched chain amino acids/aromatic amino acids.

Amino Acids↗