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Preparing the Malnourished Patient for Parenteral Nutrition (PN)
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
There has been a great deal of debate regarding the subject of when to intervene (Singer et al. 2009; McClave et al. 2016; Casaer et al. 2011). It is reasonable for a patient to be fasted, as for a test or a procedure. But there is a point when prolonged fasting transitions into starvation. That transition point varies from patient to patient, depending on the degree of malnutrition they started with and their level of stress metabolism.
Fasting
Published in Mehwish Iqbal, Complementary and Alternative Medicinal Approaches for Enhancing Immunity, 2023
For example, an individual with vata constitution should not continue fasting for more than three days, as fasting may enhance lightness in the body and vata (air of body) is light too. Ultimately fasting may affect the vata element. If fast persists for a longer duration of time, it will enhance anxiety, weakness, fear and nervousness. Similarly, people with pitta constitution shouldn't fast for more than four days or else it will provoke pitta, enhancing the element of fire in the body, and it will be the reason for some reactions of mind and body such as hate, anger and dizziness. Whereas individuals with kapha body may observe fast for a longer duration, and they will get maximum benefits after fasting such as enhancement of clarity, consciousness, awareness and understanding; moreover an increased feeling of lightness.
Lessons Learned from COVID-19 and Their Implementations for Future Pandemics
Published in Debmalya Barh, Kenneth Lundstrom, COVID-19, 2022
Mauricio Corredor, Debmalya Barh, Kenneth Lundstrom
Rapid identification of COVID-19 is essential for choosing the most effective treatment option. Moreover, the diagnostic method needs to be both fast and accurate. The desirable gold standard should also be able to rule out both false positives and false negatives. The classic approach was based on antigen tests, but with extraordinary technology development reverse transcriptase-polymerase chain reaction (RT-PCR) has been widely accepted, especially in the early stages of the pandemic. While some concern has been raised related to poor performance, especially in regard to its sensitivity, RT-PCR has been considered as the gold standard for COVID-19 diagnosis [67]. While continuous technology progress takes place for COVID-19 test development, it is appropriate to have several tests available in parallel to be able to exclude false positives or false negatives more efficiently [68]. As the term “gold standard” is frequently used in the context of diagnostic tests, it should be pointed out that it does not refer to a perfect test, but to the available one, which can be replaced by any test approved to demonstrated superiority. Today, there is a large spectrum of COVID-19 tests available, ranging from DNA-based technologies such as PCR, RT-PCR, and Next Generation Sequencing (NGS) as well as different immunological tests [69].
Influence of diabetes mellitus on the biochemical parameters and outcomes of multiple myeloma
Published in Hematology, 2023
Zheng-Yue Dou, Bing Xia, Chao-Yu Wang, Yan-Jie Xu, Yi-Zhuo Zhang
International Myeloma Working Group criteria were used as the diagnostic criteria [16]. The diagnosis of type 2 DM was based on its previous diagnostic record and blood glucose level at the time of first admission (Diabetes Mellitus World Health Organization Diagnostic Criteria were used as the diagnostic criteria. [17] fasting plasma glucose ≥ 7.0mmol/l (126mg/dl) or 2–h plasma glucose ≥ 11.1mmol/l (200mg/dl))or glycosylated hemoglobin > 6.5%. The diagnostic criteria for SID were: normal fasting blood glucose level before treatment, > 7.0 mmol/L fasting blood glucose after hormone treatment, and >11.11 mmol/L fasting blood glucose 2 hours after a meal, at least twice [18]. The subjects fasted for 8 hours and blood was collected to detect fasting plasma glucose, liver and kidney function, blood coagulation, fibrin degradation products, D-dimer, electrolytes, and blood calcium. Plasma total calcium content > 2.8 mmol/L was diagnosed as hypercalcemia.
The clinicopathological characteristics of gastric cancer and precancerous conditions in gastric DLBCL and MALT lymphoma patients: a multi-center retrospective study
Published in Annals of Medicine, 2023
Yun Feng, Tian-Jiao Duan, Qing Huang, Zhi-Yi Li, Ya-Ping Liu, Miao-Sha Luo, Gui-Fang Lu, Wen Shi, Zhi-Yong Zhang, Hong-Xia Li
H. pylori infection status was determined by H. pylori detection and patients’ histories of eradication therapy. For detection, we used a 13C-urea breathing test, a 14C-urea breath test, or a rapid urease test to detect H. pylori. A positive result for any of the above tests confirmed the presence of an infection with H. pylori, which we denote as ‘Hp-infected’, and negative results without previous H. pylori eradication therapy were judged to be ‘Hp-uninfected’. Negative results after H. pylori eradication therapy was denoted as ‘Hp-eradicated’. In order to avoid false negative test results, we required an interval of at least 4 weeks from antibiotics and at least 2 weeks from proton pump inhibitor and bismuth before H. pylori detection could take place. Patients were also required to fast for at least 2 h before the examination.
Does the clinical experience of a tutor influence how students learn extended focused assessment with sonography for trauma: A randomized controlled trial
Published in Medical Teacher, 2023
Cynthia Szalai, Sharaf-Eldin Shehada, Simona Iancu, Frank Herbstreit, Arjang Ruhparwar, Thorsten Brenner, Ali Haddad
Focused assessment with sonography for trauma (FAST) is a part of the resuscitation protocol of trauma patients, recommended by international panel consensus and incorporated into the advanced trauma life support (ATLS) course. Moreover, extended focused assessment with sonography for trauma (eFAST) is now an essential part of the primary survey of an emergency patient (Scalea et al. 1999; Kim et al. 2012). The purpose of FAST is to identify free fluid in acute trauma patients in three potential body spaces, namely, pericardial, pleural, and peritoneal spaces. FAST has a high sensitivity and specificity for identifying free fluid in trauma patients (Brenchley et al. 2006; Tayal et al. 2006; Hsu et al. 2007). eFAST combines ultrasound examination of the abdomen with that of the lungs and heart, to additionally rule out pneumothorax and pericardial effusion/tamponade, respectively. eFAST is a critical bedside tool for managing multiple trauma patients. It is already an integral part of many curricula and is quickly becoming a fundamental skill for all clinicians (Moore and Copel 2011; Hoppmann et al. 2015; Rempell et al. 2016). However, the discrepancy between an increasing number of medical students and the growing clinical commitments of lecturers is a significant challenge in student teaching that needs to be resolved, especially when a competency-based curriculum is being emphasized (Gruppen et al. 2012). The practice of using peers in the clinical education of medical students is a well-established tradition and commonly practiced but lacks definition in its implementation (Secomb 2008; Buscher et al. 2013).