ABSTRACT
Nutrition status prior to surgery and nutrition rehabilitation after surgery can affect the morbidity and mortality of pediatric patients. A comprehensive approach to nutrition in pediatric surgical patients is important and includes preoperative assessment, perioperative nutrition considerations, and postoperative recovery. A thorough nutrition assessment to identify patients who are at nutrition risk prior to surgery is important so that the nutrition status can be optimized prior to the procedure to minimize suboptimal outcomes. Preoperative malnutrition is associated with increased complications and mean hospital days following surgery. Enteral and parenteral nutrition can be used in cases where food intake is inadequate to maintain and possibly improve nutrition status, especially in the 7-10 days prior to surgery. In the perioperative period, fasting should be limited to restricting solid foods and non-human milk 6 hours prior to the procedure and allowing clear liquids until 2 hours prior to the procedure. Postoperatively, early feeding has been shown to resolve postoperative ileus earlier, decrease infection rates, promote wound healing, and reduce length of hospital stay. If nutrition cannot be provided orally, then nutrition through either enteral or parenteral means should be initiated within 24-48 hours of surgery. Practitioners should identify those patients who are at the highest nutrition risk for postsurgical complications and provide guidance for optimal nutrition during the perioperative and postoperative period.
Subject(s)
Child Nutrition Disorders/therapy , Nutritional Status , Nutritional Support/methods , Perioperative Care/methods , Postoperative Complications/prevention & control , Child , Child Nutrition Disorders/complications , Child Nutrition Disorders/diagnosis , Humans , Length of Stay , Nutrition Assessment , Postoperative Complications/etiology , Postoperative Period , Surgical Procedures, OperativeABSTRACT
Duchenne muscular dystrophy (DMD) is a serious degenerative muscular disease affecting males. Diagnosis usually occurs in childhood and is confirmed through genetic testing and/or muscle biopsy. Accompanying the disease are several nutrition-related concerns: growth, body composition, energy and protein requirements, constipation, swallowing difficulties, bone health, and complementary medicine. This review article addresses the nutrition aspects of DMD.
Subject(s)
Muscular Dystrophy, Duchenne/physiopathology , Muscular Dystrophy, Duchenne/therapy , Adolescent , Adrenal Cortex Hormones/therapeutic use , Adult , Body Composition , Body Mass Index , Child , Child, Preschool , Complementary Therapies/methods , Constipation/etiology , Dietary Fiber , Dietary Proteins , Dietary Supplements , Drinking , Energy Metabolism , Enteral Nutrition/methods , Gastric Emptying , Humans , Male , Malnutrition/etiology , Muscular Dystrophy, Duchenne/complications , Overnutrition/etiology , Young AdultABSTRACT
The surprising reaction of GaCl3 or InBr3 with the di-Grignard reagent [Me2Si(C5Me4)(N-t-Bu)](MgCl)2 x THF results in salts of the bimetallic anions of composition [X3M[C5Me4(N-t-Bu)]MX2]- (M = Ga, X = Cl; M = In; X = Br) in which the MX2 moiety undergoes an eta2-interaction with one of the double bonds of the localized cyclopentadienide ring.
