Download Clinical Nutrition: Enteral and Tube Feeding, Fourth Edition by Rolando Rolandelli, Robin Bankhead, Joseph Boullata, PDF

By Rolando Rolandelli, Robin Bankhead, Joseph Boullata, Charlene Compher

This definitive reference offers the main finished, clinically proper assurance of nutrients in enteral and tube feeding. the recent version has been thoroughly remodeled through a multidisciplinary editorial workforce to mirror the entire newest know-how and dietary wisdom, in addition to the recent, collaborative nature of up to date scientific perform. Plus, a brand new bonus CD-ROM promises self-assessment questions and solutions, and a downloadable photo number of illustrations from the book.Delivers 21 brand-new chapters that tackle contemporary ASPEN medical directions concerning pharmacotherapeutic concerns and enteral formulations, together with fluids and electrolytes ?· genetics ?· pre-, pro-, and synbiotics ?· foodstuff defense ?· regulatory matters ?· and more.Explores the original enteral nutrients wishes of particular sufferer populations equivalent to pregnant and lactating girls ?· kids ?· kids ?· transplant applicants ?· melanoma sufferers ?· overweight sufferers ?· sufferers with kidney issues ?· and diabetic patients.Features new editorial viewpoints representing surgical procedure, nursing, pharmacy, and nutrition/dietetics, reflecting the hot, multidisciplinary nature of the field.Offers a brand new bonus CD-ROM containing overview questions and solutions and more.Presents a brand new, extra straightforward inner a great research practise device for nutrients help Certification.With seventy eight contributing specialists

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Extra info for Clinical Nutrition: Enteral and Tube Feeding, Fourth Edition

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Lastly, we will present our current hypothesis on the role of the gut and gut barrier function in multiple organ failure. THE GUT BARRIER AND PHYSIOLOGY OF GUT BARRIER FUNCTION The gut is a complex organ, the primary function of which is the digestion and absorption of nutrients. However, in addition to nutrient absorption, the gut must function as 23 24 3 • Mechanisms and Significance of Gut Barrier Function and Failure a barrier to prevent the spread of intraluminal bacteria and endotoxin to systemic organs and tissues.

The glutamic acid side chain is more ionic and thus contributes more to the solubility of the protein than the nonpolar carbon chain of valine. This change in pH decreases its solubility in water, and, of course, a change in solubility leads to increased viscosity of the blood as the red cells rupture, spilling their contents into the bloodstream. The net result of this condition is a decrease in the survival time of the sickled cells, leading to anemia and also to an aggregation of the distorted cells in capillaries.

Consequently, a major concept has evolved from these studies: Because the splanchnic circulation is sensitive to alterations in intravascular volume, injury- or stress-induced splanchnic vasoconstriction may ultimately lead to an ischemia-reperfusion injury of the intestinal mucosa and thereby result in impaired intestinal barrier function and intestinal inflammation. These preclinical experimental studies provided important information, because impairment of many of the gut barrier defense mechanisms that are associated with bacterial translocation and gut injury/inflammation in experimental models also occur in critically ill and injured patients.

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