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Patient's Body Weight (patient + body_weight)
Selected AbstractsReview of ICU nutrition support practices: implementing the nurse-led enteral feeding algorithmNURSING IN CRITICAL CARE, Issue 3 2007Kirsty Dobson Abstract Many intensive care units (ICUs) have standard feeding protocols which promote safe early initiation of enteral feeding. The use of these protocols has been shown to increase the incidence of enteral feeding and achieve greater adequacy of nutrition support. A multidisciplinary working party developed and implemented a nurse-led enteral feeding algorithm which enabled senior nursing staff to set safe and nutritionally adequate target feed volumes based upon patient body weight. The algorithm incorporated best practice-based referral criteria so that patients at nutritional risk were referred for tailored dietetic assessment. The aims were to determine compliance with the ICU nurse-led enteral feeding algorithm and to ascertain its safety and efficacy. A 3-month prospective audit was conducted by specialist ICU dietitians. Data were obtained from electronic patient records and through observing feeding practices. Data collected included prescribed feed type and infusion rate versus volume received, frequency of gastric aspiration and prokinetic usage. In all, 90% (n = 43) of referrals received by the dietitian met the referral criteria. Absolute compliance with patients receiving correct type and volumes of feed, with a correct feed prescription and an accurate documented weight was just 2% (n = 1). Despite this finding, 60% of patients were actually receiving the correct feed regimen. If the nurse-led enteral feeding algorithm is wholly adhered to, the ICU dietitian need not formally assess every ICU patient. Nursing staff require further support in assessing patient body weight alongside an ongoing intensive educational programme for the multidisciplinary team and regular reaudit. [source] Joint line elevation in revision TKA leads to increased patellofemoral contact forcesJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2010Christian König Abstract One difficulty in revision total knee arthroplasty (TKA) is the management of distal femoral bone defects in which a joint line elevation (JLE) is likely to occur. Although JLE has been associated with inferior clinical results, the effect that an elevated joint line has on knee contact forces has not been investigated. To understand the clinical observations and elaborate the potential risk associated with a JLE, we performed a virtual TKA on the musculoskeletal models of four subjects. Tibio- and patellofemoral joint contact forces (JCF) were calculated for walking and stair climbing, varying the location of the joint line. An elevation of the joint line primarily affected the patellofemoral joint with JCF increases of as much as 60% of the patient's body weight (BW) at 10-mm JLE and 90% BW at 15-mm JLE, while the largest increase in tibiofemoral JCF was only 14% BW. This data demonstrates the importance of restoring the joint line, as it plays a critical role for the magnitudes of the JCFs, particularly for the patellofemoral joint. JLE caused by managing distal femoral defects with downsizing and proximalizing the femoral component could increase the patellofemoral contact forces, and may be a contributing factor to postoperative complications such as pain, polyethylene wear, and limited function. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:1,5, 2010 [source] Different amounts of isoflavones in various commercially available soy extracts in the light of gene expression-targeted isoflavone therapyPHYTOTHERAPY RESEARCH, Issue S1 2010Ewa Piotrowska Abstract Isoflavones are plant-derived, biologically active compounds that are commonly used as natural drugs or diet supplements in the treatment of menopausal symptoms and as antioxidants. Recently, it was proposed that genistein (4,,5,7-trihydroxyisoflavone) may be used in the treatment of patients suffering from Sanfilippo disease (mucopolysaccharidosis type III), a severe genetic disorder for which no therapy is available. A pilot clinical study with this novel therapy, called ,gene expression-targeted isoflavone therapy' (GET IT), indicated that a standardized, genistin-rich soy isoflavone extract is effective in the treatment of such patients. Since various isoflavone-containing products are commercially available, the content of the main isoflavones were measured in such products. Extremely different amounts of isoflavones were determined in various products, from 0.13 to 39 mg per tablet. Only some of these products were found to be effective in inhibition of the synthesis of glycosaminoglycans (compounds whose degradation is severely impaired in mucopolysaccharidoses, including Sanfilippo disease) in cultured fibroblasts. Since in GET IT the dose of genistein is calculated per patient's body weight, the amount of this isoflavone in a tablet is crucial for this therapy. Therefore, the results presented in this report indicate that a careful choice of a proper isoflavone extract is necessary for GET IT. Copyright © 2009 John Wiley & Sons, Ltd. [source] Method for coronary angiography in morbidly obese patientsCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2005William G. Kussmaul III MD Abstract Cardiac catheterization in morbidly obese patients is difficult. In addition to problems regarding vascular access and radiographic penetration of the chest, the engineering parameters and physical limitations of the table and its supporting structures may limit these patients' ability to undergo clinically indicated coronary angiography. We describe a method for cardiac catheterization in which much of the obese patient's body weight is supported on a stretcher placed at right angles to the catheterization table, with only the thorax on the table under the image intensifier. Using this method, five consecutive successful diagnostic procedures and one coronary stent procedure have been performed without complication. Limitations of this procedure include inability to achieve the normal variety of angiographic views due to constraints on image intensifier rotation and skew. © 2005 Wiley-Liss, Inc. [source] Older patients with chronic heart failure within Swedish community health care: a record review of nursing assessments and interventionsJOURNAL OF CLINICAL NURSING, Issue 1 2004Anna Ehrenberg PhD Background., Older patients with chronic heart failure constitute a large group within community home care that is at high risk for re-hospitalization. However, hospital readmission can be prevented if early signs of deterioration are recognized and proper interventions applied. Aims and objectives., The aim of the study was to audit nursing care for older chronic heart failure patients within the Swedish community health care system. Design., The study adopted a retrospective descriptive design. Methods., In a Swedish urban municipality nursing documentation from 161 records on patients diagnosed with chronic heart failure was collected retrospectively from community nursing home care units. Patient records were reviewed for characteristics of nursing care and assessed for comprehensiveness in recording. Results., The main results showed that medical care of patients with chronic heart failure was poorly recorded, making it possible only to follow fragments of the care process. The nursing notes showed poor adherence to current clinical guidelines. Only 12% of the records contained notes on patients' body weight and only 4% noted patients' knowledge about chronic heart failure. When interventions did occur, they largely consisted of drug administration. Conclusions., The findings revealed flaws in the recording of specific assessment and interventions as well as poor adherence to current international clinical guidelines. Relevance to clinical practice., Supportive guidelines available at the point of care are needed to enhance proper community-based home health care for older patients with chronic heart failure. [source] | ||||||||||