Search

Introduction: Intestinal failure is the loss of intestinal function due to intestinal diseases, like short bowel syndrome and/or other primary intestinal defects, or to systemic conditions involving the bowel secondarily. Intestinal failure can be reversible or permanent. Patients with intestinal failure require parenteral nutrition for a variable period to survive. It is not well established which formula should be used for weaning from parenteral nutrition. The aim of this study was to assess the impact of a new amino-acid-based formula (Humana SINEALL) on nutritional status and its safety in children with in-testinal failure during 4 weeks of observation. Patients and Methods: We conducted a prospective study in a group of patients aged 2 months to 17 years, followed in our pediatrics department for intestinal failure with different etiologies from October 2007 to February 2008. Nutritional status and feeding tolerance were assessed during 4 weeks of nutritional rehabilitation from parenteral nutrition using the new amino-acid-based formula. For each child we recorded gender, age, body weight, height, body mass index, and serum levels of nutritional biochemical parameters including albumin, prealbumin, iron, ferritin, calcium, and insulin-like growth factor-1. We also tested blood xylose and urinary iodine. All parameters were recorded at the time of enrolment (TO) and after 4 weeks of dietary management (T1). Results: Twenty-two patients (11 males) with a mean age of 4.38 ± 4.63 years were enrolled. Mean z-scored body weight increased from -2.01 ± 0.31 to 0.5 ± 0.98 (p

Diathermy entails the implementation of high-frequency electrical currents to produce heat and either make incisions or induce coagulation. Monopolar cautery involves disposable cautery pencils and electrosurgical diathermy units. In typical monopolar cautery, an electrical plate is placed on the patient's skin and acts as an electrode, while the current passes between the instrument and the plate. Although monopolar diathermy can interfere with implanted metal devices and pacemaker function,1 in plastic surgery the technique is …

Inappropriate infant feeding including a lack of breastfeeding and the early introduction of cow's milk are the most common forms of infant feeding malpractice. To evaluate the hypothesis that infant feeding malpractices are associated with mothers' low level of education, questionnaires were administered to 400 mothers of infants below 12 mo of age divided into 3 groups according to their various educational levels. Items included the type of milk given at birth and at 1, 3 and 6 mo of age. To investigate the efficacy of paediatricians in orienting infant feeding, the same questionnaire was given to 30 paediatricians in primary paediatric healthcare, in hospitals or in private practices. Initiation of breastfeeding was similar in the three groups. An analysis of the data showed that an increasing number of infants born to mothers of low and intermediate educational level did not receive exclusive breastfeeding compared with those with a higher level of education, a difference that was significant as early as 1 mo of age. In infants aged 3 mo, the prevalence of exclusive breastfeeding was 37%, 40% and 65% in the three groups, respectively, in relation to progressively increasing levels of education. In infants of 6 mo, the respective prevalence rates were 13%, 15% and 48%. Early introduction of cow's milk showed a similar correlation with educational level. A greater number of infants born to mothers with a low level of education received cow's milk at 3 mo of age compared with those born to mothers with an intermediate education (12% vs 5%). A similar difference was observed between the latter group and infants born to mothers with a high educational level (0%). This pattern was supported by data for infants at 6 mo of age with prevalence rates for cow's milk feeding of 39%, 20% and 0% in the three groups in association with progressively increasing level of educational (p < 0.05). The analysis of the paediatricians' response to the questionnaire showed that while physicians know and correctly prescribe age-related infant nutrition regimens, they are unaware that a substantial number of mothers do not comply with what they prescribe. Overall, these data support the relationship between a low educational level and infant feeding malpractice and suggest that a more effective role should be played by paediatricians in supporting an adequate duration of breastfeeding and the use of formula rather than cow's milk protein.