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At least 667 records · Page 37Linked to original sources
PubMed1991

Dietary management of malnourished children with a new enteral feeding.

Balance (nitrogen, fat, carbohydrate) and growth studies were carried out in nine children (6 to 26 months old) recovering from protein-energy malnutrition (PEM) using a concentrated (1 kcal/mL) formula designed specifically for 1- to 6-year-olds. The formula provided 12% of energy as protein (18% whey, 82% casein), 44% of energy as carbohydrate (69% corn syrup solids, 31% sucrose), and 44% of energy as fat (50% high-oleic safflower oil, 30% soy oil, 20% medium-chain triglycerides). Means +/- standard deviations of apparent nitrogen retention and absorption were 90 +/- 3% and 39 +/- 13%, respectively. Mean fecal fat excretion was 1.3 +/- 1.0 g/day. Length-age increased 3.0 +/- 0.8 months and weight-age increased 8.3 +/- 3.8 months during the 2.4 +/- 0.3 months of the study. (Length-age and weight-age were defined as the age (in months) to which the child's length or weight corresponded at the 50th percentile of the National Center for Health Statistics reference data). Thirteen additional 40- to 30-month-old children with kwashiorkor were fed the formula for 8 to 35 days as part of the initial management of PEM. The result was prompt weight gain and increases in serum proteins. Its formulation and the findings of our study indicate that this new formula offers a notable advantage over products designed for infants or adults in the enteral alimentation of young children.

Body Height↗
PubMed1998

[Development of a milk beverage based on pumpkin flakes].

Vitamin A deficiency is one of the majors public health problems in Brazilian Northeast, and among other causes may be concerned to precocious weaning. Aiming at reducing this problem, a dehydrated product based on powdered milk and pumpkin flakes was developed to act as a carotene source at weaning period. Pumpkin flakes were obtained by drum drying at a 6 atm steam pressure, 0.75 m2 contact surface and 1 rpm, and had their content of carotenoids, beta carotene, centesimal composition molds and yeast and faecal coliforms evaluated. The flakes were added to sugar and whole powdered milk according to FAO/WHO nutritional recommendation to 6-12 months old children and submitted to acceptability test by a 6 judges' panel. The results showed that the drying process had a 7% efficiency score and the flakes composition presented 4.84% moisture; 4.0% protein; 5.5% ash; 1.30% fat; 6.22% fiber; 78.14% carbohydrates; 115.08 micrograms/g total carotenois and 80.64 micrograms/g beta-carotene content. No coliforms were detected and molds and yeast content was 4.0 x 10(2) CFU/g. The powdered formulation properly diluted in water supports 45% of the RDA for children (calories, protein, carbohydrates and lipids) and 100% vitamin A and protein considering a 400 ml/day ingestion.

Animals↗
PubMedDate not supplied

Is the use of specialized nutritional formulations a cost-effective strategy? A national database evaluation.

BACKGROUND: We apply currently published clinical outcomes data to length of stay and hospital cost to determine the potential economic benefit associated with the use of specialized nutritional formulations in elective surgical, trauma, and medical patients. Although the use of immune-modulating formulations has repeatedly shown favorable clinical outcomes, including decreased complications (both infectious and noninfectious), length of stay (both ICU and total days), and ventilator days, the cost-effectiveness of nutritional modulation of the immune response in a US-based population has not previously been explored. METHODS: Data for the current study were obtained from a large national database with 126 member hospitals and data from over 1 million patients. Data extracted from the database included patient type (surgical, medical, and trauma) and subservice, whether the hospital stay was "complicated" or "uncomplicated" (as determined by diagnosis-related groups and International Classification of Diseases, Ninth Revision coding), mean length of stay, mean cost, and incremental cost per complication experienced. The clinical outcomes measures from 3 major peer-reviewed studies were then applied to the cost data in order to determine the cost savings associated with the use of specialized nutritional formulations in each of the patient populations. Additionally, cost data were segmented by region of the United States (New England, mid-Atlantic, South, Midwest, Southwest, and West) and by primary focus of the health care facility (academic, indigent care, large community) to enable more meaningful cost comparisons. RESULTS: For the medical patient population, according to the published rate of 51% decrease in risk of infectious complications and a decreased length of hospital stay of 9.7 days, net cost savings (after accounting for the increased costs of administering immune modulating formula) is $2066. The same calculations were done for surgical and trauma patients, with $688 and $308 net cost savings per patient, respectively. These figures assume a base infection rate of 5%. Expected cost savings vary markedly for deviations in base infection rate and slightly for differences in facility type or region of the country. CONCLUSIONS: This study demonstrates that specialized nutritional formulations are a cost-effective way for hospitals to improve clinical outcomes while reducing resource consumption and total cost. These benefits are observable in all patient types, all facility types, and all regions of the United States.

Cost-Benefit Analysis↗
PubMed1996

[Chronic inflammatory bowel diseases and nutrition].

The etiology of inflammatory bowel disease is still unknown. Several potential mechanisms are discussed. The etiological and therapeutic importance of nutrition is controversial. Though changes in dietary habits and incidence of inflammatory bowel disease during the last century were in parallel, no specific nutritional factor has been isolated. No dietary prophylaxis of inflammatory bowel disease is yet known; all dietary therapies in inflammatory bowel disease aim to improve nutritional support and to diminish inflammation by bowel rest. Children and adolescents gain in weight and height. Total parenteral nutrition will not substantially reduce disease activity and operation rates. Total parenteral nutrition can only be recommended in ulcerative colitis patients with severe disease in the initial phase and in Crohn's patients with severe malnutrition and intestinal complications. Enteral nutrition support is less effective in ulcerative colitis than in Crohn's disease. Reported remission rates on enteral nutrition are 25% for ulcerative colitis and up to 80% for Crohn. However, in active Crohn's disease enteral nutrition is less effective than standard therapy with methylprednisolone and sulfasalizine. It is generally believed that nutrition therapy in combination with drugs is the best treatment modality. There is no evidence to support the importance of any combination of the formula diets such as elemental, oligopeptide, or polymeric formulations. Administration of formula diets by nasogastric tubes all show similar remission rates. Whether newer diets supplemented with arginine, glutamine, omega-3-fatty acids or short chain fatty acids increase remission rates is not known. Further studies in this field are warranted.

Adolescent↗
PubMed1979

Tumor-host responses to various nutritional feeding procedures in rats.

Parenteral and enteral nutrition are being used as adjuncts to cancer therapy. A liquid diet formulation containing a 27% solution of glucose and 3.9% crystalline amino acids with electrolytes and vitamins was given continuously for a week via parenteral (iv), and via intragastric (ig) routes and also was given ad libitum via the oral or per os (po) route to groups of Buffalo rats with and without a Morris No. 7777 transplantable hepatoma to find out how these feeding procedures affect tumor-host interactions. Other groups of rats with and without the hepatoma were given solid food ad libitum. The following parameters were examined: mortality, carcass and organ weights, body and tumor growth, nitrogen balance, energy intake, fluid balance, urinalysis, hematology values, and serum protein levels. The results are considered with respect to the influence of the tumor on the host and the influence of the feeding procedure on the animal with and without a tumor. The presence of the hepatoma was associated with: higher mortality, a decrease in carcass mass, leucocytosis, anemia, a decrease in serum IgG, transferrin and albumin, and an increase in serum alpha fetoprotein. The iv and ig feeding procedures alone resulted in some mortality which was exacerbated by the presence of the tumor. Mortality was especially high in the tumorous rats on the ig feeding procedure. The degree of positive nitrogen balance and carcass mass was similar in non-tumorous rats fed the same liquid diet formula when given iv, ig, or po. Tumorous rats fed the liquid diet ad libitum showed anorexia and a significantly lower nitrogen balance. The iv and ig feeding of tumorous rats at a level which was well above those of the tumorous rats given solid or liquid diet ad libitum maintained the same degree of positive nitrogen balance as non-tumorous rats. Even though the iv feeding of tumorous rats maintained about the same degree of positive nitrogen balance as non-tumorous rats, these tumorous rats still suffered loss of carcass mass. It appears that the large rapidly growing hepatoma has priority for available nutrition over the host. It is further suggested that the rapidly growing hepatoma places an ever increasing demand on the available nutrients. Thus, a point is eventually reached where even supplemental nutritional support can no longer meet the needs of the growing hepatoma and the host.

Animals↗
PubMed1982

Interaction of diet and toxicity--the future role of purified diet in toxicological research.

There is a growing awareness of the importance of diet as a determinant of the toxicity of many compounds. This paper briefly reviews some of the ways in which diet affects toxicity, and draws some conclusions regarding the ideal diet for toxicological investigations. Then the two competing types of diet, stock and purified (including those frequently called semi-synthetic and semi-purified), are described and their characteristic strengths and weaknesses are discussed. Stock diets are very variable commodities, may be nutritionally poorly balanced, and also contain many non-nutritive components that influence toxicity. The formulation and preparation of purified diet are discussed. It is concluded that investigations of the mechanisms of toxicity, as well as studies of absorption, distribution and metabolism of toxic compounds, could benefit from the use of well-defined purified diets.

Animal Feed↗
PubMed1997

Econometric feeding and management for first cycle phase two DeKalb Delta hens.

An experiment was conducted to determine the effect of feeding method (constant vs variable) and method of formulation (lysine vs protein) on the performance and profits of first cycle, phase 2 DeKalb Delta hens from 40 to 52 wk of age as influenced by egg and feed prices. Treatments 1 to 5 were formulated based on lysine to contain 0.65 to 0.81% TSAA and fed continuously regardless of feed consumption (constant feeding). Treatments 6 to 10 and 11 to 15 were formulated based on lysine to supply 570 to 650 mg TSAA and protein to supply 580 to 660 mg TSAA per hen per d, respectively, and fed based on feed intake. Dietary TSAA level had no overall significant effect on feed consumption, egg production, egg weight, mortality, or body weight. Hens fed diets using the constant method of feeding had significantly higher egg production, egg weight, egg specific gravity, and body weight than hens fed diets formulated based on lysine or protein using the variable method of feeding. When the treatments in the two variable feeding methods were compared, feed consumption was significantly higher for hens fed diets formulated based on protein whereas egg production, egg weight, egg specific gravity, and body weight were not different. It was concluded that method of formulation (lysine vs protein) and TSAA levels required for maximum profits can vary from at least 570 to 821 mg per hen per d depending upon energy and protein cost.

Animal Feed↗
PubMedDate not supplied

Prospective sensory evaluation of preparatory methods of elemental diets.

Palatability of elemental diets has been the greatest obstacle to their successful long-term oral administration. Two elemental diet products, A and B, were evaluated in four preparatory methods for acceptability in a prospective double-blind study. The elemental diets evaluated were most acceptable when prepared in the form of Jello (57% receiving acceptable scores) followed by frozen Tang (27% receiving acceptable scores) and those prepared with Flavor Packets (18% receiving acceptable scores). The Kool-Aid method of preparation was not accepted well (6% receiving acceptable scores). Product B was more acceptable than A in palatability and overall acceptability in the methods tested. To successfully administer elemental diets when a nasogastric tube is not employed, we recommend that these diets include formulations with Jello, frozen Tang, or Flavor Packets and that they be prepared by the dietary department. It is recognized that alterations in the composition of elemental diets result from the addition of flavoring agents. The significance of these alterations should be considered for each patient.

Food Handling↗
PubMedDate not supplied

Formulation of enteral diets.

The number of enteral diets has increased from a handful in the 1970s to over 100 at present. These can be classified as polymeric, chemically defined, disease-specific, and specialized diets, as well as oral dietary supplements. The properties, indications, pros and cons for the use of these diets are outlined in an effort to assist clinicians in their selection.

Dietary Supplements↗
PubMed2004

New lipids in enteral feeding.

PURPOSE OF REVIEW: Lipid sources for enteral nutrition continue to be an exciting area of investigation. It is timely to review recent developments which have largely contributed to thrust enteral feeding into a new era. RECENT FINDINGS: Although much more research needs to be done, there is a better understanding of the competitive relationships between n-6/n-3 fatty acids in conditions of metabolic and immune stress as well as in autoimmune and degenerative diseases. Although structured lipids are more completely absorbed and cleared, other more important clinical benefits need to be documented before they can be considered cost-effective. Immune enhancing formulas are the subject of controversy and some have been shown to be more effective than others. Enteral formulations with short-chain fatty acids are promising but more experimental work on the normal, and the sick colon is needed. Finally, there are a few isolated studies suggesting that enteral feeding with liposomes and with lipolytic products may have advantages when the digestive phase needs to be circumvented. The era of nutrigenomics, in which the effect of specific lipids on genes and proteins is being explored, is with us. We can look forward to nutrigenetics when the effect of genetic variation on the interaction between diet and disease will guide our practice. SUMMARY: Clinicians already have access to lipid sources and formulations which allow them to individualize enteral feeding programs. More clinical and technological research needs to be carried out, however, before products can be tailored to produce optimal effects in specific conditions.

Digestion↗
PubMed1991

High-moisture diet for laboratory rats: nutrient analysis, growth, and organ weights.

A diet (KSC-25) to be sterilized by irradiation was formulated to contain 66% moisture and to provide the required nutrients for growing rats. Analyses of the irradiated dry diet provided data to evaluate its nutrient content. The diet was evaluated for its ability to supply all nutrients, including water, required by immature rats. Sixteen Sprague-Dawley rats were fed the high-moisture diet with or without access to a water bottle. Rats (n = 16) fed an irradiated purified diet in a meal form with access to a water bottle were the control animals. Feed efficiency, food and water consumption, and growth rate data were collected during the 28-day study. Organ weights were collected on day 28. The test diet met or exceeded the National Research Council (NRC) estimated nutritional requirements for immature laboratory rats. The 66% moisture KSC-25 diet provided all nutrients, including water, required by weanling male Sprague-Dawley rats for growth equivalent to the established purified diet.

Animal Feed↗
PubMedDate not supplied

Disease-specific amino acid infusion (F080) in hepatic encephalopathy: a prospective, randomized, double-blind, controlled trial.

Seventy-five patients with acute hepatic decompensation superimposed on chronic alcoholic cirrhosis were prospectively randomized for a blinded trial of the treatment of hepatic encephalopathy. The control group received 4 g of enteral neomycin daily along with 25% dextrose by a central venous catheter. The experimental group received a placebo resembling neomycin and isocaloric dextrose plus a modified amino acid mixture enriched with branched-chain amino acids to 36% and deficient in aromatic amino acids and methionine. Thirty patients in the F080 group and 29 in the control group completed the trial. The group receiving the modified amino acid mixture demonstrated a statistically significant improvement in encephalopathy as compared to the neomycin group, while maintaining nitrogen equilibrium. Survival and discharge from the hospital were statistically greater in the group treated with the modified amino acid solution and hypertonic dextrose. Treatment of hepatic encephalopathy in the presence of hepatic decompensation with an amino acid solution formulated for its treatment seems to produce faster, more complete recovery with improved capacity for nutritional support.

Adolescent↗
PubMed2004

Is fibre supplementation in paediatric sip feeds beneficial?

The usefulness of a paediatric fibre containing sip feeds specifically formulated for paediatrics has not been evaluated. In an open, prospective, parallel study the efficacy, safety and tolerance of a paediatric fibre-containing sip feed designed for children weighing 8-20 kg (1-6 years) was compared with a fibre-free sip feed in 60 children with chronic illness. The subjects either received a trial sip feed containing 150 kcal (100 ml)(-1) and 2.0 g (100 ml)(-1) of fibre or a fibre-free equivalent control sip feed for 12 weeks. Blood biochemistry, haematology, anthropometry, tolerance and food intake data were estimated during week 1 and 12. The fibre intake was higher (P < 0.0001) and laxative usage decreased in the fibre-containing sip feed group. The sip feed provided almost 50% of fibre intake in the trial group. There were no differences in sip feed tolerance, anthropometry, nutritional biochemistry or haematology between the two groups. Sip feeds provide an important source of fibre for sick children with normal gut function requiring nutritional support.

Anthropometry↗
PubMedDate not supplied

Pharmacokinetic evaluation of a new oral cyclosporine formulation.

STUDY OBJECTIVE: To compare the pharmacokinetics of a new oral cyclosporine preparation with those of cyclosporine solution diluted in Isocal and the intravenous formulation. DESIGN: Randomized, crossover trial. SETTING: Tertiary care referral center. PATIENTS: Seven pediatric liver transplant recipients who were receiving oral cyclosporine as part of their immunosuppressive regimen. All patients completed the study. INTERVENTIONS: Pharmacokinetic studies were performed with the intravenous and oral dosage forms. Patients received one dose of intravenous cyclosporine, and then were randomized to receive their usual oral cyclosporine dose incorporated into a chocolate wafer or mixed with Isocal. After a minimum of 3 days, the alternative preparation was administered. Serial cyclosporine blood samples were collected at predetermined intervals for 12 hours after the third dose for each regimen. Concentrations were determined by high-performance liquid chromatography. The data for the three dosage forms were fit simultaneously with a two-compartment model. MEASUREMENTS AND MAIN RESULTS: No difference was seen in F, ka, Cmax, and tmax between the two oral cyclosporine preparations (p > 0.05). No new rejection episodes occurred during the study period. CONCLUSIONS: We conclude there is no difference in the bioavailability of the oral solution and the chocolate formulation. We believe the new preparation may increase patient compliance and ensure administration of a complete dose compared with the currently marketed solution.

Administration, Oral↗
PubMedDate not supplied

[Microbial growth in parenteral nutrition. II. Effects of osmolality].

Study on the behaviour of five microorganisms in different formulations of Parenteral Nutrition (PN) different from each other with regard to osmolarity. The organisms investigated were Staphylococcus aureus (ATCC (12600), Bacillus subtilis (ATCC 6051), Pseudomonas aeruginosa (ATCC 9027), Enterobacter cloacae (ATCC 13047) y Candida albicans (LSH 3156 D). It was observed no direct relation between microbial growth and osmolarity in PN. C. albicans showed the best growth in all the formulations tested, followed by E. Cloacae. The number of the other microorganisms is reduced, and in general, except B. subtilis grow or are reduced in a lesser extension when the glucose solutions added are at 30 or 40%.

Bacteria↗
PubMed1978

Determination of phytonadione in elemental diets by TLC-spectrophotodensitometry.

The quantitative analysis of phytonadione in several elemental diet formulations at levels ranging from 90 to 150 ppb is described. After extraction with petroleum either, the sample is cleaned up by silica gel column chromatography and separated on a TLC plate; phytonadione is determined by reflectance densitometry. Recovery data show that the method is accurate (X = 97%) and has a precision (RSD) of +/- 6%.

Chromatography, Gel↗
PubMedDate not supplied

Compatibility of enteral products with commonly employed drug additives.

Although drugs are routinely administered through gavage feedings set along with enteral products, there is little scientific data available to the physician, pharmacist, nurse, and dietician concerning the physical and chemical compatibility of drugs with enteral formulations. This study assesses the compatibility of Ensure (Ross Laboratories, Columbus, OH), Ensure Plus (Ross Laboratories, Columbus, OH), Osmolite (Ross Laboratories, Columbus, OH) with antibiotics, gastrointestinal agents, antipsychotic agents, urinary antiseptics cough and cold medications, and other commonly used additives. All enteral formulations were examined immediately after mixing for phase changes, creaming, and particle growth using a contrast light and a rotation viscometer. Results are presented in a tabular format. Guidelines and recommendations concerning how the addition of troublesome drug additives can be added are also presented.

Anti-Bacterial Agents↗
PubMed1999

Forecasting the in vivo performance of four low solubility drugs from their in vitro dissolution data.

PURPOSE: To assess the usefulness of biorelevant dissolution tests in predicting food and formulation effects on the absorption of four poorly soluble, lipophilic drugs. METHODS. Dissolution was studied with USP Apparatus II in water, milk, SIFsp, FaSSIF, and FeSSIF. The in vitro dissolution data were compared on a rank order basis with existing in vivo data for the tested products under fasted and fed state conditions. RESULTS: All drugs/formulations showed more complete dissolution in bile salt/lecithin containing media and in milk than in water and SIFsp (USP 23). Comparisons of the in vitro dissolution data in biorelevant media with in vivo data showed that in all cases it was possible to forecast food effects and differences in absorption between products of the same drug with the physiologically relevant media (FaSSIF, FeSSIF and milk). Differences between products (both in vitro or in vivo) were less pronounced than differences due to media composition (in vitro) or dosing conditions (in vivo). CONCLUSIONS: Although biorelevant dissolution tests still have issues which will require further refinement, they offer a promising in vitro tool for forecasting the in vivo performance of poorly soluble drugs.

Adamantane↗