Most patients are fasted for at least 12 to 24 hours following percutaneous endoscopic gastrostomy. In order to decrease the period of fasting, inadequate nutritional support, and hospitalization time, we began enteral feedings in 24 of 28 consecutive children, aged 4 weeks to 20 years, who were referred for PEG, 6 hours following the procedure. All patients received their full volume of feedings within 24 hours. Twelve of 13 outpatients were discharged in less than 24 hours. There were no complications related to early feeding and no complications that required discontinuation of feedings. Early feeding following PEG insertion is safe in children.

Adolescent↗

PubMedDate not supplied

Comparative taste evaluation of aerosolized formulations of triamcinolone acetonide, flunisolide, and flunisolide with menthol.

The taste characteristics of aerosolized formulations of triamcinolone acetonide, flunisolide, and flunisolide with menthol flavoring were compared in 102 adult asthmatic patients. During a 2-hour test period, study participants evaluated the taste of each of the three inhaled corticosteroids, one at a time, in a randomly assigned sequence. The extent to which they liked the taste of each preparation and the taste intensity (strength of taste) of each product were rated on 100-point scales. Patients also characterized the predominant taste of each inhaled corticosteroid as "no taste," "salty," "sour," "sweet," or "bitter." Assessments were made immediately after inhalation and 2 minutes after inhalation. At both assessment times, subjects liked the taste of triamcinolone acetonide significantly more than the taste of flunisolide or flunisolide with menthol, and they liked the taste of flunisolide with menthol better than that of flunisolide without menthol. The taste intensity of triamcinolone acetonide was rated significantly less than that of the two flunisolide preparations at both evaluation times. There was no significant difference in the taste-intensity ratings for flunisolide with and without menthol. Triamcinolone acetonide was most frequently described as having no taste, whereas the taste of both flunisolide and flunisolide with menthol was most frequently described as bitter. Because of the possible adverse impact of an unpleasant taste on patient compliance with prescribed therapy, differences in the taste of inhaled corticosteroids should be an important consideration in selecting and recommending an aerosolized steroidal preparation for the control of asthma.

Administration, Inhalation↗

PubMedDate not supplied

[Glycotoxicity and mediators: nitric oxide, arachidonic acid, superoxide anion].

Explore the source record for details and available documents.

Arachidonic Acid↗

PubMedDate not supplied

A model to manage capitated risk.

The impact of increasing enrollment in Medicare HMOs will require health care providers to develop new strategies in care delivery systems. Key strategies in managing risk include health risk appraisals, proactive case management, disease management, provider education, and the use of inpatient physician managers. Implementing an integrated care management system requires a team approach. The physician inpatient manager, nurse case manager, geriatric clinical nurse specialist, and social worker composed the health care team charged with implementing a care management system responsive to enrollees' needs. A quality management plan is essential for tracking patient outcomes and quality indicators across the continuum. The focus of promoting wellness and preventing illness represents a paradigm shift from the traditional model of episodic care that can yield positive financial results.

Capitation Fee↗