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1.
Br J Nutr ; 122(11): 1271-1278, 2019 12 14.
Article in English | MEDLINE | ID: mdl-31782379

ABSTRACT

Anecdotal evidence suggests the use of bolus tube feeding is increasing in the long-term home enteral tube feed (HETF) patients. A cross-sectional survey to assess the prevalence of bolus tube feeding and to characterise these patients was undertaken. Dietitians from ten centres across the UK collected data on all adult HETF patients on the dietetic caseload receiving bolus tube feeding (n 604, 60 % male, age 58 years). Demographic data, reasons for tube and bolus feeding, tube and equipment types, feeding method and patients' complete tube feeding regimens were recorded. Over a third of patients receiving HETF used bolus feeding (37 %). Patients were long-term tube fed (4·1 years tube feeding, 3·5 years bolus tube feeding), living at home (71 %) and sedentary (70 %). The majority were head and neck cancer patients (22 %) who were significantly more active (79 %) and lived at home (97 %), while those with cerebral palsy (12 %) were typically younger (age 31 years) but sedentary (94 %). Most patients used bolus feeding as their sole feeding method (46 %), because it was quick and easy to use, as a top-up to oral diet or to mimic mealtimes. Importantly, oral nutritional supplements (ONS) were used for bolus feeding in 85 % of patients, with 51 % of these being compact-style ONS (2·4 kcal (10·0 kJ)/ml, 125 ml). This survey shows that bolus tube feeding is common among UK HETF patients, is used by a wide variety of patient groups and can be adapted to meet the needs of a variety of patients, clinical conditions, nutritional requirements and lifestyles.


Subject(s)
Enteral Nutrition/methods , Enteral Nutrition/statistics & numerical data , Home Care Services/statistics & numerical data , Surveys and Questionnaires , Adult , Aged , Aged, 80 and over , Cerebral Palsy/therapy , Cross-Sectional Studies , Female , Head and Neck Neoplasms/therapy , Humans , Male , Middle Aged , United Kingdom
2.
Med Klin (Munich) ; 103(9): 628-32, 2008 Sep 15.
Article in English | MEDLINE | ID: mdl-18813885

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia sustained and frequently occurs in patients with coronary heart disease. Thus, a large number of patients requiring percutaneous coronary intervention (PCI) also suffer from AF. An anticoagulant regimen has not been standardized for patients with AF after coronary stent implantation. PATIENTS AND METHODS: The authors investigated data from 159 patients with AF who underwent PCI in their department. Baseline variables and incidence of a combined endpoint (stroke, myocardial infarction, cardiovascular death, severe bleeding) were compared in patients receiving clopidogrel and acetylsalicylic acid (ASA; group 1) versus patients receiving the combination of clopidogrel and ASA with low-molecular-weight heparin (LMWH; group 2) versus patients receiving the combination of clopidogrel and ASA with oral anticoagulation (OAC; group 3) at discharge. RESULTS: Patients discharged with triple therapy including OAC seemed to be at higher risk: patients in group 3 had decreased left ventricular ejection fraction and increased inflammatory state as measured by plasma fibrinogen and C-reactive protein. Moreover, previous OAC treatment and strokes were found more often in this subgroup of patients. In a median follow-up of 1.4 years, two severe bleeding events (both in group 1), four myocardial infarctions (all in group 1), 13 strokes (nine in group 1, four in group 2), and nine cardiovascular deaths (three in group 1, five in group 2, one in group 3) occurred. CONCLUSION: In this analysis, no treatment regimen seemed to be clearly superior. It underlines the importance of prospective, randomized trials to investigate the optimal antithrombotic/antiplatelet treatment for patients with AF after PCI.


Subject(s)
Angioplasty, Balloon, Coronary , Anticoagulants/therapeutic use , Atrial Fibrillation/drug therapy , Aged , Aged, 80 and over , Analysis of Variance , Anticoagulants/administration & dosage , Aspirin/administration & dosage , Aspirin/therapeutic use , Atrial Fibrillation/complications , Cardiovascular Diseases/epidemiology , Chi-Square Distribution , Clopidogrel , Coronary Disease/complications , Coronary Disease/therapy , Drug Therapy, Combination , Female , Follow-Up Studies , Heparin, Low-Molecular-Weight/administration & dosage , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Incidence , Kaplan-Meier Estimate , Male , Middle Aged , Platelet Aggregation Inhibitors/administration & dosage , Platelet Aggregation Inhibitors/therapeutic use , Retrospective Studies , Risk , Stents , Ticlopidine/administration & dosage , Ticlopidine/analogs & derivatives , Ticlopidine/therapeutic use , Time Factors , Treatment Outcome
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