ABSTRACT
With the aim of assessing the possible benefits of nutritional therapy, 140 patients were prospectively studied during radiotherapy of the head and neck (81) and esophageal cancer (19). Mean age was 56.0 (17-80), with 114 males and 26 females. Duration of both nutrition and radiotherapy was 78.0 +/- 45 days. Tube feeding was the primary modality in 50.7 of the population, and oral regimens in the remaining 49.3, but associations between the methods were also used. Enteral diets were supplied under the supervision of a specialized tem for home alimentation (PROSNED). Compliance to the program was 100, and a lymphocyte count diminished along this period (1933 +/- 1033 vs 1265 +/- 688, p. 0.001). A subjective improvement was reported by 84 of the population, and total calorie intake, that was below 60 of estimated needs in 100 of the cases initially, significantly improved to just 40 inadequate at the end of the observations. Radiotherapy was associated with mucositis in 21 of the patients, taste changes in 79, xerostomy in 81, anorexia in 66 and odinophagia in 59. In the individuals selected for enteral feeding, side-effects were represented by technical problems (20) and gastrointestinal disorders (13). All patients completed the nutritional support program and there was no mortality in this series. It is concluded that; 1) Early nutritional support during radiotherapy was able to maintain or improve the nutritional status; 2) Tube feeding, alone or in combination with oral diets, was indicated whenever appropriate and contributed to fulfillment of the energy requirements; 3) Reduction of total lymphocytes could not be prevented by the mentioned therapy; 4) Complications of enteral alimentation were mild and affected a small proportion of the population; 5) Troubles induced by radiotherapy were as frequent as expected, and tended to disturb the intake of food; 6) The compliance to the therapeutic plan was excellent and can be attributed to the efforts of the multidisciplinary team as well as to the help of the specialized home alimentation unit (PROSNED): Diet therapy. Cancer. Nutritional assessment. Radiotherapy. Nutritional support.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Head and Neck Neoplasms/diet therapy , Esophageal Neoplasms/diet therapy , Nutrition Disorders , Nutritional Support , Aged, 80 and over , Serum Albumin/analysis , Lymphocyte Count , Head and Neck Neoplasms/radiotherapy , Esophageal Neoplasms/radiotherapy , Nutrition Surveys , Nutritional Status , Prospective StudiesABSTRACT
A alimentacao enteral e um procedimento amplamente utilizado na reabilitacao e manutencao nutricional de pacientes pre-operatorios com afeccoes esofagicas. Numa avaliacao prospectiva de 61 enfermos, com afeccoes benigas (n=38) e malignas (n=23), administrou-se uma dieta polimetrica comercial na proporcao de 40kcal/kg/dia, no minimo, durante duas semanas. A preparacao liquida era administrada mediante tecnica em bolo pelos proprios pacientes, atraves de sonda nasogastrica (n=25) ou naso-duodenal (n=36)...
Subject(s)
Humans , Male , Female , Adult , Enteral Nutrition , Anemia, Hypochromic/therapy , Intubation, Gastrointestinal , Esophageal Diseases/therapyABSTRACT
A atuacao do nutricionista na area hospitalar e diversificada, abrangendo atividades de planejamento, producao de refeicoes, assistencia, ensino e pesquisa. Objetivando proporcionar ao nutricionista um instrumento de trabalho seguro em assistencia de nutricao, foi estabelecido o atendimento por niveis de acordo com o grau de acoes necessarios do nutricionista no atendimento de cada caso, aplicado a dieta e ao tratamento do doente. A classificacao do atendimento por niveis de assistencia, possibilita ainda a padronizacao dos procedimentos, a mensuracao do tempo dispendido neste atendimento e o estabelecimento de padroes de qualidade em assistencia de nutricao. Esta categorizacao do atendimento de nutricao mostra-se vantajosa nao so o profissional, para a equipe multidisciplinar e para o servico de nutricao como principalmente benefica para o paciente.
Subject(s)
Humans , Diet Therapy , Food Service, Hospital/organization & administration , Nutrition AssessmentABSTRACT
Atraves de uma amostra de 1346 pacientes, correspondente a 3 por cento do atendimento mensal do I.C.H.C.-PAMB no primeiro semestre de 1992, os autores aferem o grau de satisfacao da populacao assistida. O inquerito aborda o desempenho dos multiplos profissionais que atuam junto aos pacientes, assim como avalia as dependencias dos ambulatorios quanto a sinalizacao, a higiene, a organizacao geral dos servicos, etc. Os parametros mensurados, em especial no que se refere aos profissionais da saude, mostram que e muito bom seu conceito entre os usuarios do I.C.H.C-PAMB.
Subject(s)
Humans , Quality of Health Care , Surveys and Questionnaires , Patient Satisfaction/statistics & numerical data , Ambulatory Care/statistics & numerical data , Hospital AdministrationABSTRACT
Devido ao rápido crescimento de fórmulas enterais industrializadas no mercado brasileiro, tornou-se cada vez mais difícil a seleçäo da melhor fórmula para indicaçäo adequada do suporte nutricional enteral. A análise das características inerentes a cada dieta industrializada disponível e o total conhecimento destas pelos profissionais que atuam nesta área é fundamental para a escolha da fórmula enteral mais adequada. Os autores estudaram dez dietas poliméricas nutricionalmente completas, todas isentas de lactose, as quais foram avaliadas segundo diferentes parâmetros de seleçäo e de dietas: fontes de nutrientes, densidade calórica, complexidade molecular, osmolaridade, forma de apresentaçäo e via de administraçäo