By John L. Rombeau, Rolando H. Rolandelli, Ray Kersey
Here is the thoroughly revised, up to date, and elevated re-creation of the definitive reference on enteral foodstuff. It offers the clinical origin and scientific innovations wanted for potent enteral feeding within the sanatorium and at domestic. experiences of prior version: "The most suitable textual content on enteral nutrition." --Mayo health center lawsuits "An very good reference." --Journal of the yankee Dietetic organization "It has whatever for everybody within the box of nutrition...Truly a must." --Clinics in utilized food
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Extra resources for Clinical Nutrition. Enteral and Tube Feeding
LeVoyer T, Cioffi WG, Pratt L, et al: Alterations in intestinal permeability after severe thermal injury. Arch Surg 1992;127:26-29. 48. Doig CJ, Sutherland LR, Sandham 10, et al: Increased intestinal permeability is associated with the development of multiple organ dysfunction syndrome in critically ill ICU patients. Am J Respir Crit Care Med 1998;158:444-451. 49. Kollef MH, Eisenberg PR: A rapid qualitative assay to detect circulating endotoxin can predict the development of multiple organ dysfunction.
As a hormone, insulin has a variety of important functions in the regulation of carbohydrate, lipid, and protein metabolism. Yet, even though there are species differences in the amino acid sequence of this protein, insulin from one species can be given to another species and be functionally active. Obviously, the species differences in the amino acid sequence of this protein are not at locations in the insulin molecule that determine its biologic function in promoting glucose use. The deletion or substitution of a base could occur in a noncoding region of the DNA or in an area that encodes a nonactive portion of the gene product.
In fact, gut ischemia appears to be the dominant link by which splanchnic hypoperfusion is transduced from a hemodynamic event into an immunoinflammatory event via the release of biologically active factors into the mesenteric lymphatics. These studies, coupled with the facts that gut injury leads to the gut being a cytokine and proinflammatory factor-generating organ and that the intestinal vasculature can serve as a priming bed for circulating neutrophils, have led to a more complete understanding of the role of the gut in the pathogenesis of MODS (Fig.