RESUMO
OBJECTIVE: Almost half of all hospitalized patients are malnourished with low physician awareness or implementation of nutrition support. To address this problem, a 2-day immersion course in clinical nutrition for physicians was developed by the Latin American Federation of Parenteral and Enteral Nutrition (FELANPE) with support from Abbott Laboratories. The goal of Total Nutritional Therapy (TNT) is to help physicians utilize this nutrition knowledge to increase their awareness of malnutrition and implementation of nutritional therapy. Since 1997, over 8,000 physicians have completed the TNT course in 16 Latin American countries. RESEARCH METHODS & PROCEDURES: During 1999 and 2000, 675 participants responded to a survey 6 months after having completed the TNT course to determine what impact the course had on the use of nutrition assessment, nutrition support teams, or nutrition consultations in their clinical practice, and if they had participated in any nutrition association or conferences. RESULTS: The majority of physicians who completed the survey increased their use of nutrition assessment and time dedicated to nutrition therapy, and increased the number of their patients placed on nutrition therapy. CONCLUSIONS: The TNT course has been shown to be an efficient model of clinical nutrition education for general physicians. The course should be considered as part of the training of medical residents.
Assuntos
Educação de Pós-Graduação em Medicina , Apoio Nutricional , América Latina , Inquéritos e QuestionáriosAssuntos
Cateterismo/efeitos adversos , Nutrição Parenteral Total/instrumentação , Nutrição Parenteral/instrumentação , Veia Subclávia/diagnóstico por imagem , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Cintilografia , Veia Subclávia/lesõesRESUMO
Se efectuo un estudio prospectivo en 25 pacientes que recibieron nutricion parenteral total por via subclavia con el fin de detectar lesion venosa temprana. Se empleo tecnecio 99 con estudios dinamicos de la circulacion venosa a nivel subclavio, con tomas secuenciales en la camara de centelleo. El metodo permitio descubrir tempranamente las lesiones venosas que se observaron en 20 por ciento de los casos y son problablemente secundarias a la presencia del cateter en la luz vascular y reversibles en forma espontanea tras retirar el mismo
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Nutrição Parenteral Total , Artéria Subclávia , TromboflebiteRESUMO
Este articulo se basa en la revision de los resultados obtenidos en cinco pacientes que ingirieron causticos y que presentaron lesiones faringeas que motivaron tratamiento quirurgico mediante substitucion con tubo esofagico. Se describen diferentes procedimientos que tuvieron como finalidad tratar las lesiones laringofaringeas con la idea de aprovechar funcionalmente el esofago reconstruido
Assuntos
Humanos , Faringe , Estenose Traqueal , Cáusticos , Queimaduras Químicas , Procedimentos Cirúrgicos OperatóriosRESUMO
Se efectuo una revision de 76 pacientes de acalasia tratados mediante cardiomiotomia; 30 en el periodo 1975-1980, serie actual, y 46 en el periodo 1963-1973 serie previa.En todos los pacientes excepto en 8, se efectuo un procedimiento antireflujo agregado, siendo en la mayor parte funduplastia posterior. Los resultados comparativos entre las 2 series no tuvieron practicamente diferencias. La valoracion de las series combinadas mostraron fracasos en el 8.9% de los casos y resultados satisfactorios en el 91.1%. Solo 2 pacientes presentaron reflujo gastroesofagico, los cuales formaron parte del grupo en quienes se efectuo Heller sin procedimiento antireflujo. Los resultados evidencian la utilidad de la cardiomiotomia con procedimiento antireflujo agregado
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Acalasia Esofágica , Refluxo Gastroesofágico , Procedimentos Cirúrgicos OperatóriosRESUMO
Low serum levels of zinc and copper have recently been reported in association with TPN and the fasting state. A prospective study during May 1977 through November 1978 was performed in 28 patients undergoing TPN. Serum and urinary Zn and Cu levels were detected; the patient population was divided in septic and non septic groups and each was subdivided according to plasma administration. In both groups low serum Zn and Cu levels were detected. The urinary losses were greater in the group with sepsis. Three patients had clinical manifestations of Zn deficiency, in two it was reversible with the administration of diet or oral Zn. The third one died of sepsis. The low serum levels found in our patients suggested that plasma administration might be insufficient to cover the daily requirements of such elements. This requirement is augmented by the increased urinary losses seen in septic postoperative stages.