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Nutritional care in hospitalized patients with chronic liver disease

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World Journal of Gastroenterology 2015年第45期21卷 12835-12842页

作者： Dep K Huynh shane p selvanderan Hugh AJ Harley Richard H Holloway Nam Q Nguyen Discipline of Medicine University of Adelaide North Terrace Department of Gastroenterology and Hepatology Royal Adelaide Hospital North Terrace

AIM: To evaluate the practice of nutritional assessment and management of hospitalised patients with cirrhosis and the impact of malnutrition on their clinical ***: This was a retrospective cohort study on patients with liver cirrhosis consecutively admitted to the Department of Gastroenterology and Hepatology at the Royal Adelaide Hospital over 24 mo. Details were gathered related to the patients' demographics, disease severity, nutritional status and assessment, biochemistry and clinical outcomes. Nutritional status was assessed by a dietician and determined by subjective global assessment. Estimated energy and protein requirements were calculated by Simple Ratio Method. Intake was estimated from dietary history and/or food charts, and represented as a percentage of estimated daily requirements. Median duration of follow up was 14.9(0-41.4) mo. RESULTS: Of the 231 cirrhotic patients(167 male, age: 56.3 ± 0.9 years, 9% Child-pugh A, 42% Childpugh B and 49% Child-pugh C), 131(57%) had formal nutritional assessment during their admission and 74(56%) were judged to have malnutrition. In-hospitalcaloric(15.6 ± 1.2 kcal/kg vs 23.7 ± 2.3 kcal/kg, p = 0.0003) and protein intake(0.65 ± 0.06 g/kg vs 1.01 ± 0.07 g/kg, p = 0.0003) was significantly reduced in patients with malnutrition. Of the malnourished cohort, 12(16%) received enteral nutrition during hospitalisation and only 6(8%) received ongoing dietetic review and assessment following discharge from hospital. The overall mortality was 51%, and was higher in patients with malnutrition compared to those without(HR = 5.29, 95%CI: 2.31-12.1; p pitalised patients with cirrhosis and is associated with higher mortality. Formal nutritional assessment, however, is inadequate. This highlights the need for meticulous nutritional evaluation and management in these patients.

关键词： Liver cirrhosis Nutrition assessment Mortality Mal

Greenhouse gases fluxes and soil thermal properties in a pasture in central Missouri

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Journal of Environmental Sciences 2010年第7期22卷 1029-1039页

作者： Nsalambi Vakanda Nkongolo shane Johnson Kent Schmidt Frieda Eivazi Department of Agriculture and Environmental Sciences College of Agriculture and Natural Science Lincoln University Harvard Forest Faculty of Arts and Sciences Harvard University

Fluctuations of greenhouse gases emissions and soil properties occur at short spatial and temporal scales, however, results are often reported for larger scales studies. We monitored CO2, CH4, and N2O fluxes and soil temperature （T）, thermal conductivity （K）, resistivity （R） and thermal diffusivity （D） from 2004 to 2006 in a pasture. Soil air samples for determination of CO2, CH4 and N2O concentrations were collected from static and vented chambers and analyzed within two hours of collection with a gas chromatograph. T, K, R and D were measured in-situ using a KD2 probe. Soil samples were also taken for measurements of soil chemical and physical properties. The pasture acted as a sink in 2004, a source in 2005 and again a sink of CH4 in 2006. CO2 and CH4 were highest, but N2O as well as T, K and D were lowest in 2004. Only K was correlated with C02 in 2004 while T correlated with both N2O （r = 0.76, p = 0.0001） and CO2 （r = 0.88, p = 0.0001） in 2005. In 2006, all gases fluxes were significantly correlated with T, K and R when the data for the entire year were considered. However, an in-depth examination of the data revealed the existence of month-to-month shifts, lack of correlation and differing spatial structures. These results stress the need for further studies on the relationship between soil properties and gases fluxes. K and R offer a promise as potential controlling factors for greenhouse gases fluxes in this pasture.

关键词： greenhouse gases soil thermal properties fluxes

Diurnal variation in fecal concentrations of acid-detergent insoluble ash and alkaline-peroxide lignin from cattle fed bermudagrass hays of varying nutrient content

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Journal of Animal Science and Biotechnology 2015年第4期6卷 410-415页

作者： Juvenal Kanani Dirk philipp Kenneth p Coffey Elizabeth B Kegley Charles p West shane Gadberry John Jennings Ashley N Young Robert T Rhein Division of Agriculture University of Arkansas Department of plant and Soil Science Texas Tech University

Background： The effect of time of fecal sampling on the accuracy of acid-detergent insoluble ash （ADIA） and alkaline-peroxide lignin （ApL） for the prediction of fecal output （FO） in cattle was evaluated. Eight ruminally cannulated cows （594 _＋ 35.5 kg） were allocated randomly to 4 bermudagrass [Cynodon dactylon （L.） pers.] hay diets markedly different in crude protein concentration （79-164 g/kg） with 2 replicates per diet for 3 periods. Cows were offered hay individually at 20 g DM/kg of body weight daily in equal feedings at 08：00 and 16：00 h for a 10-d adaptation period followed by 5-d of total fecal collection. Fecal grab samples also were taken each day during the fecal collection period at 06：00, 12：00, 18：00, and 24：00 h either directly from the rectum or from freshly voided feces. Samples were composited within cow and time across the 5 d total fecal collection period. Additionally, forage, ort, and fecal samples were analyzed for concentrations of ApL and ADIA. Results： Fecal concentrations of ADIA and ApL were not affected by sampling time （p 〉 0.22）, even though diet affected （p 〈 0.01） fecal ADIA and ApL concentrations. There were no diet x sampling time interactions （p ≥ 0.60）. Estimates of FO and dry matter digestibility （DMD） from ADIA and ApL were not affected （p 〉 0.16） by sampling time or the diet x sampling time interaction （p 〉 0.74）. Estimates of FO and DMD from markers from different sampling times or all different combinations of sampling time were not different （p 〉 0.72） from those of total collection among internal markers. Conclusion： Little variation in concentrations of ADIA and ApL in daily fecal excretion across time increases flexibility in fecal grab sampling schedules for predicting FO and DMD.

关键词： Digestibility Fecal sampling time Internal markers Bermudagrass Cattle

Resistance risk assessment of six pyrethroids and acephate toward the resistant adult tarnished plant bug,Lygus lineolaris

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Insect Science 2024年第3期31卷 792-802页

作者： Yuzhe Du shane Scheibener Yucheng Zhu Maribel portilla Mingling Zhang USDA-ARS Southern Insect Management Research UnitStonevilleUSA USDA-ARS Pollinator Health in Southern Crop Ecosystem Research UnitStonevilleUSA

Due to rapidly developed resistance,pest management relies less on pyrethroids to control economically damaging infestations of the tarnished plant bug(TpB),Lygus lineolaris(palisot de Beauvois)in cotton fields of ***,pyrethroid resistance remains prevalent in TpB *** study assessed the resistance levels in adult TpB to six common pyrethroids and *** TBps were collected from wild host plants in late October after harvest in the Mississippi Delta region of the United *** on LCso values,the field-resistant TpBs displayed higher resistance to permethrin,esfenvalerate,and bifenthrin(approximately 30 fold)and moderate resistance toα-cyhalothrin,β-cyfluthrin,5-cypermethrin,and acephate(approximately 15 fold).Further investigations showed that the inhibitors of three detoxification enzyme,triphenyl phosphate(Tpp),diethyl maleate(DEM),and piperonyl butoxide(pBO)had synergistic effects on permethrin,γ-cyhalothrin,and bifenthrin in resistant ***,elevated esterase,GST,and p450 activities were significantly expressed in fieldresistant ***,GST and esterase were reduced after 48 h exposure to certain pyrethroids at LCso *** synergistic and biochemical assays consistently indicated that p450 and esterase were involved in pyrethroid detoxification in *** study provides valuable information for the continued use of pyrethroids and acephate in controlling TpBs in cotton fields in the Mississippi Delta region of the United States.

关键词： cytochrome p450-monooxygenases(p450) detoxification enzyme activities esterase Lygus lineolaris pyrethroids and organophosphate resistance tarnished plant bug

Comparison of acid-detergent lignin,alkaline-peroxide lignin,and acid-detergent insoluble ash as internal markers for predicting fecal output and digestibility by cattle offered bermudagrass hays of varying nutrient composition

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Journal of Animal Science and Biotechnology 2014年第3期5卷 310-317页

Background： The potential for acid-detergent insoluble ash （ADIA）, alkaline-peroxide lignin （ApL）, and acid-detergent lignin （ADL） to predict fecal output （FO） and dry matter digestibility （DMD） by cattle offered bermudagrass [Cynodon doctylon （L） pers.] hays of different qualities was evaluated. Eight ruminally cannulated cows （594 ± 35.5 kg） were allocated randomly to 4 hay diets： low （L）, medium low （ML）, medium high （MH）, and high （H） crude protein （Cp） concentration （79, 111,131, and 164 g Cp/kg on a DM basis, respectively）. Diets were offered in 3 periods with 2 diet replicates per period and were rotated across cows between periods. Cows were individually fed 20 g DM/kg of body weight in equal feedings at 08：00 and 16：00 h for a 10-d adaptation followed by a 5-d total fecal collection. Actual DM intake （DMI）, DMD, and FO were determined based on hay offered, ort, and feces excreted. These components were then analyzed for ADL, ApL, and ADIA concentration to determine marker recovery and marker-based estimates of FO and DMD. Results： Forage DMI was affected by diet （p = 0.02）, and DMI from MH and H was greater （p 〈 0.05） than from L. Apparent DMD tended （p = 0.08） to differ among diets while FO （p = 0.20） was not affected by diet treatments. Average ADL recovery （1.16） was greater （p 〈 0.05） than that of ADIA （1.03） and ApL （1.06）, but ADIA and ApL did not differ （p = 0.42）. Estimates of FO and DMD derived using ApL and ADIA were not different （p≥0.05） from total fecal collection while those using ADL differed （p 〈 0.05）. There was no diet by marker interaction （p≥ 0.22） for either FO or DMD. Conclusion： Acid-detergent insoluble ash and ApL accurately predicted FO and DMD of cattle fed bermudagrass hay of varying nutrient composition. These internal markers may facilitate studies involving large numbers of animals and forages. Results from such studies may be used to develop improved equations to predict energy values of forages based on the relationship of di

关键词： Acid-detergent insoluble ash Alkaline-peroxide lignin Bermudagrass Cattle Digestibility Marker

Allergic dermatitis after knee arthroscopy with repeated exposure to Dermabond prineo^(TM) in pediatric patients:Two case reports

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World Journal of Orthopedics 2021年第11期12卷 931-937页

作者： James Robinson Kevin p Smidt Garrett Houk Janay McKie R shane Barton patrick Massey Department of Orthopaedic Surgery Louisiana State UniversityShreveportLA 71103United States School of Medicine Louisiana State UniversityShreveportLA 71103United States Department of Orthopaedic Surgery Shriners Hospital for ChildrenShreveportLA 71103United States

BACKGROUND Allergic contact dermatitis(ACD)secondary to Dermabond prineo^(TM) is rare,but *** our knowledge,there are no described reports of this ACD reaction within the pediatric population following arthroscopic *** SUMMARY We report two cases of pediatric ACD upon second exposure to Dermabond prineo^(TM) after knee *** cases presented within two weeks of the inciting second *** cases resolved with differing described combinations of sterile cleaning,diphenhydramine,and antibiotic *** long-term sequelae were *** This case report elucidates the rare complication of allergic dermatitis secondary to Dermabond prineo^(TM) repeat exposure use in pediatric arthroscopy.

关键词： Dermabond prineo Arthroscopy Sports medicine Contact dermatitis Case report

Glucosamine supplementation during late gestation alters placental development and increases litter size

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Journal of Animal Science and Biotechnology 2018年第1期9卷 135-144页

作者： Jeffrey L.Vallet Jeremy R.Miles Bradley A.Freking shane Meyer USDA ARS U.S. Meat Animal Research Center (USMARQ P.O. Box 166 Clay Center NE Nebraska 68933 USA plymouth Ag Group Diller NE Nebraska 68342 USA

Background： During late gestation the placental epithelial interface becomes highly folded, which involves changes in stromal hyaluronan. Hyaluronan is composed of glucoronate and N-acetyl-glucosamine. We hypothesized that supplementing gestating dams with glucosamine during this time would support placental folded-epithelial-bilayer development and increase litter size. In Exp. 1, gilts were unilaterally hysterectomizedovariectomized（UHO）. UHO gilts were mated and then supplemented daily with 10 g glucosamine（n = 16） or glucose（control, n = 17） from d 85 of gestation until slaughter（d 105）. At slaughter, the number of live fetuses was recorded and each live fetus and its placenta was weighed. Uterine wall samples adjacent to the largest and smallest fetuses within each litter were processed for histology. In Exp. 2, pregnant sows in a commercial sow farm were supplemented with either 10 g glucosamine or glucose daily from d 85 of gestation to farrowing. Total piglets born and born alive were recorded for each litter. In Exp. 3, the same commercial farm and same protocol were used except that the dose of glucosamine and glucose was doubled to 20 g/***： In Exp. 1, the number of live fetuses tended to be greater in glucosamine-treated UHO gilts（p = 0.098）.placental morphometry indicated that the width of the folded bilayer was greater（p = 0.05） in glucosamine-treated gilts. In Exp. 2, litter size did not differ between glucosamine-and glucose-treated sows. However in Exp. 3, the increased dose of glucosamine resulted in a significant treatment by parity interaction（p ≤ 0.01）, in which total piglets born and born alive were greater in glucosamine treated sows of later parity（5 and 6）.Conclusions： These results indicated that glucosamine supplementation increased the width of the folds of the placental bilayer and increased litter size in later parity, intact pregnant commercial sows.

关键词： Fructose Glucosamine Hyaluronan Swine Uterine capacity

Video capsule endoscopy in left ventricular assist device recipients with obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2016年第18期22卷 4559-4566页

作者： Surachai Amornsawadwattana Michael Nassif David Raymer shane La Rue Chien-Huan Chen Department of Internal Medicine Washington University School of Medicine Division of Cardiology Washington University School of Medicine Division of Gastroenterology Washington University School of Medicine

AIM: To assess whether video capsule endoscopy (VCE) affects the outcomes of left ventricular assist devices (LVADs) recipients with gastrointestinal ***: This is a retrospective study of LVAD recipients with obscure gastrointestinal bleeding (OGIB) who underwent VCE at a tertiary medical center between 2005 and 2013. All patients were admitted and monitored with telemetry and all VCE and subsequent endoscopic procedures were performed as inpatients. A VCE study was considered positive only when p2 lesions were found and was regarded as negative if p1 or p0 were identified. All patients were followed until heart transplant, death, or the end of the ***: Between 2005 and 2013, 30 patients with LVAD underwent VCE. Completion rate of VCE was 93.3% and there was no capsule retention. No interference of VCE recording or the function of LVAD was found. VCE was positive in 40% of patients (n = 12). The most common finding was active small intestinal bleeding (50%) and small intestinal angiodysplasia (33.3%). There was no difference in the rate of recurrent bleeding between patients with positive and negative VCE study (50.0% vs 55.6%, p = 1.00) during an average of 11.6 ± 9.6 mo follow up. Among patients with positive VCE, the recurrent bleeding rate did not differ whether subsequent endoscopy was performed (50% vs 50%, p = 1.00).CONCLUSION: VCE can be safely performed in LVAD recipients with a diagnostic yield of 40%. VCE does not affect recurrent bleeding in LVAD patients regardless of findings.

关键词： Heart-assist devices Capsule endoscopy Gastrointestinal hemorrhage Heart failure Endoscopy Digestive system

Robotic-assisted versus laparoscopic repair of type II, III and IV hiatal hernias: A retrospective study comparing adverse outcomes

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Laparoscopic, Endoscopic and Robotic Surgery 2024年第1期7卷 11-15页

作者： payton Kooiker shane Monnett Stephanie Thompson Bryan Richmond West Virginia School of Osteopathic Medicine LewisburgWV24901United States Department of Surgery Charleston Area Medical CenterCharlestonWV25304United States

Objective:Robotic-assisted surgery(RAS)is continuing to expand in use in surgical specialties,including foregut *** available data on its use in large hiatal hernia(HH)repair are limited and *** study sought to determine whether there are significant differences in adverse outcomes following HH repair performed with a robotic approach vs.a laparoscopic *** study was limited to outcomes in patients with type II,III,and IV HHs,as these hernias are typically more challenging to ***:A retrospective analysis was performed from data obtained from TriNetX,a large deidentified clinical database,over a 10-year *** patients who underwent type II,III,or IV HH repair were included in the *** with robotic repair was compared to laparoscopic *** were propensity score matched for demographic information and *** ratios,risk differences(RDs)with 95%confidence intervals(CIs),and t test for each examined adverse outcome were used to estimate the effects of robotic repair *** ***:In total,20,016 patients who met the inclusion criteria were identified;1,515 patients utilized RAS,and 18,501 used *** to matching,there were significant differences in age,sex,comorbidity,and BMI between the two *** 1:1 propensity score matching,analyses of 1,514 well-matched patient pairs revealed no significant differences in demographics or *** who underwent robotic repair were more likely to experience major complications,including venous thromboembolism(RD:0.007,95%CI:0.003,0.011;p?0.002),critical care(RD:0.023,95%CI:0.007,0.039;p?0.004),urinary/renal complications(RD:0.027,95%CI:0.014,0.041;ppiratory complications(RD:0.046,95%CI:0.028,0.064;pp?0.031),although this finding indicated a reduction in the length of stay of less than 4 *** statist

关键词： Hiatal hernia Robotic-assisted surgery Laparoscopic surgery Adverse outcomes