Fluid Diets Research Articles

Self-Care of Patients Undergoing Hemodialysis in Compliance with Diet Nutrition and Fluids

Background: Hemodialysis accompanied by proper management of nutritional and fluid diet is very important, as excessive fluid intake can worsen the condition of patients with chronic kidney disease. The aim of research to know about Self Care of Patients Undergoing Hemodialysis in Compliance with Diet Nutrition and Fluids Methods: This study is a quantitative study, this type of research is descriptive that describes self-care in hemodialysis patients in adherence to nutritional and fluid diets. This study uses a cross sectional design. This design looks at the picture of self-care, nutrient and fluid diet compliance. Sampling in this study used purposive sampling. A total sample of 118 respondents. Results: Most of the patients in the category of non-compliance with hemodialysis in the diet of nutrients and fluids from all questionnaire items (asmaul husna) were 81 respondents (68.6%). Conclusion: Patients can understand the importance of self-way, nutritional diet and high-quality health to improve health pasien. It is recommended to implement comprehensive educational programs for patients on the importance of adhering to dietary and fluid restrictions, as well as self-management techniques, to enhance their overall health outcomes.

PD06-04 A DECEPTION STUDY TO AVOID RECALL BIAS FOR 3 VALIDATED QUESTIONNAIRES IN THE OFFICE OR OVER THE PHONE FOR WOMEN WITH OR WITHOUT URINARY INCONTINENCE

You have accessJournal of UrologyCME1 May 2022PD06-04 A DECEPTION STUDY TO AVOID RECALL BIAS FOR 3 VALIDATED QUESTIONNAIRES IN THE OFFICE OR OVER THE PHONE FOR WOMEN WITH OR WITHOUT URINARY INCONTINENCE Meghana Reddy, Samuel B. Kusin, Alana L. Christie, and Philippe E. Zimmern Meghana ReddyMeghana Reddy More articles by this author , Samuel B. KusinSamuel B. Kusin More articles by this author , Alana L. ChristieAlana L. Christie More articles by this author , and Philippe E. ZimmernPhilippe E. Zimmern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002525.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: With medical practices increasingly using telehealth technology as a modality for care, confirming the validity of non-office administration of questionnaires intended for office use only is increasingly important. We studied three validated questionnaires: Urinary Distress Inventory 6 – Short Form (UDI-6), International Incontinence 7- Short Form (IIQ-7), and one Quality of Life Survey (QoL) and used a deception model to avoid recall bias. METHODS: Following IRB approval, these 3 questionnaires were prospectively administered in women with and without incontinence over the telephone and then again in person at an FPMRS clinic visit about 2 weeks later. A deception protocol was followed where participants were not fully informed of the intent of the study over the phone and then were consented for the study during their office visit after both the phone and in-person questionnaire scores were obtained to minimize any potential recall biases. For incontinent patients, a urinary analysis was obtained to exclude patients with an underlying UTI. Non-English speakers, those with impaired mental competency or on fluid diets were excluded. The study was powered at 80% to enroll 85 women in order to detect a difference between responses at the 0.05 significance level. The telephone and in-person questionnaires scores were compared using a paired T-test analysis. RESULTS: From June to September 2021, 86 women, including 40 incontinent (30-85) and 46 control (30-85), with similar demographic parameters, met all study criteria. Of the 14 questions studied, only two questions, UDI6: Q1 (p = 0.033) and IIQ-7: Q6 (p = 0.036) showed significant differences in responses in patients overall. When only responses from patients with incontinence were compared, only the IIQ-7: Q6 (p = 0.012) showed a significant difference in responses. CONCLUSIONS: The three questionnaire scores were comparable when obtained over the phone or during office visit given that the total scores remained similar and there were minimal differences in responses to individual questions. Women with incontinence, who may otherwise be lost to follow-up or only reachable by telehealth calls, can benefit from the remote administration of these 3 questionnaires. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e93 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Meghana Reddy More articles by this author Samuel B. Kusin More articles by this author Alana L. Christie More articles by this author Philippe E. Zimmern More articles by this author Expand All Advertisement PDF DownloadLoading ...

Level of ERAS understanding affects practitioners\u2019 practice and perception of early postoperative resumption of oral intake: a nationwide survey

BackgroundEarly postoperative resumption of oral intake is supposed to be safe and beneficial to patients recovery. However, practitioners still have great confusion and disagreement about postoperative resumption of oral intake. This is a nationwide survey to investigate the current status of clinical practice and practitioners’ attitude toward postoperative resumption of oral intake along with their level of understanding of the ERAS guidelines.MethodsAn anonymous web-based survey questionnaire via mobile social platform was carried out in mainland China from December 11–20, 2020. The Wilcoxon signed rank test or chi-square test was used to compare the propensity of the resumption of oral intake.ResultsTotally 5370 responses were received, and 89% of them were from anesthesiology departments. The nature of the responses from clinical practitioners was highly diverse, but each of the three surgery types showed unique patterns of ERAS implementation. The respondents were more conservative regarding the commencement of both fluid and solid diets after gastrointestinal (GI) and hepato-pancreato-biliary (HPB) surgery than after non-abdominal (NA) surgery. Most respondents agreed that early oral intake is beneficial to reduce postoperative complications improve bowel recovery and overall outcome. 55% respondents considered themselves to have a better understanding of ERAS and tended to initiate oral intake early for all three surgery types (P < 0.001).ConclusionsThe postoperative resumption of oral intake is highly variable among GI, HPB and NA surgeries. A better understanding of ERAS would encourage practitioners to commence oral intake resumption much earlier.

EFFECTIVE PSYCHEDUCATION TO REDUCE ANXIETY AND INCREASE COMPLIANCE OF LIQUID DIETS IN CHRONIC KIDNEY DISEASE PATIENTS DURING HEMODIALYSIS

Background: Chronic kidney failure (chronic renal failure) is a chronic disease that causes disruption of kidney function, so it requires kidney replacement therapy with long-term hemodialysis that must comply with fluid diets and can cause anxiety. Aims: Research to assess the effect of nursing psychoeducation on reducing anxiety levels and adherence to fluid diets in chronic renal failure patients with hemodialysis. Methods: The study was conducted in April-July 2018 in three private hospitals in Tomohon and Manado. This research is a quantitative study with a quasi-experimental pre-post test design with a control group of 112 respondents (82 in the intervention group and 30 in the control). Psychoeducation interventions are given according to the education module for 4 weeks, 2 times a week for a total of 8 meetings. Anxiety was assessed using the Beck Anxiety Inventory (BAI) questionnaire and adherence was assessed by the End Stage Renal Disease-Adherence Questionnaire (ESRD-AQ) before and after the study and weight observations at each visit. Results: Wilcoxon test results showed significant differences in anxiety levels (p &lt;0.005) and fluid diet compliance (p &lt;0.005) before and after the intervention. Mann Whitney test results showed no significant difference in decreasing anxiety level (p = 0.456) and increasing levels of fluid diet compliance (p = 0.495) between the intervention and control groups. The results of the ordinal logistic regression test, psychoeducation reduced anxiety levels by an OR of 6.5 times compared to the control group. The results of the binary logistic regression test, psychoeducation increased the level of adherence to the liquid diet with an OR value of 2.4 times compared to the control group. Conclusion: Psychoeducation can help reduce the level of anxiety and adherence to the fluid diet of patients with chronic renal failure with hemodialysis.

Feasibility and safety of laparoscopic resection for gastric GISTs larger than 5 cm: Results from a prospective study.

The role of laparoscopic resection for large gastric gastrointestinal stromal tumors (GISTs), particularly those >5 cm, remains under debate due the possibility of intraoperative tumor rupture. To determine the feasibility and safety of the laparoscopic approach in the treatment of large gastric GISTs, a prospective study was performed between March 2011 and March 2014. Intraoperative tumor rupture was studied as the primary outcome. Secondary outcomes were the conversion rate, surgical duration, estimated blood loss, time to tolerate fluid and solid diets, length of post-operative hospital stay and recurrence rate at the end of the follow-up. A total of 16 patients were included in this study, with a tumor size of 7.04±1.53 cm (range, 5.2–10.8 cm). No intraoperative tumor rupture occurred. The median duration of surgery was 88.1±31.9 min, with an estimated blood loss volume of 37.1±18.7 ml. No patient required a blood transfusion. The mean time until the start of oral intake for fluid and solid diets was 1.1±0.6 and 2.5±0.9 days, respectively. The median length of post-operative hospital stay was 5.4±5.8 days. The follow-up period for all patients was 16.9±11.2 months (range, 2–38 months). No local or distant recurrence was observed. The study indicates that laparoscopic resection for large gastric GISTs is feasible and safe. Laparoscopic surgery should be considered as the standard approach in all cases, irrespective of tumor size or location.

‘Nil By Mouth’ – Are we starving our patients?

Summary Background & aims To investigate fasting practices in the gastrointestinal wards of a tertiary-referral hospital and quantify the length of time these patients spent fasting. Methods All patients admitted to the gastrointestinal wards of a tertiary-referral hospital were studied for five consecutive weeks. The amount of time on ‘Nil By Mouth’ or fluid diets, and the reasons for these orders were audited. Total amount of time spent fasting was calculated and the reasons for fasting were recorded. Results Patients admitted to the gastrointestinal wards spent a mean of 19.95% of their hospital stay on a ‘Nil By Mouth’ diet. The main reason for fasting was preparation for a medical or surgical procedure. The mean fasting time for all procedures performed within the endoscopy department was 14:23 h (SD 12:36) compared to the official requirement of 6 h. The mean fasting time after major gastrointestinal surgery was 57:48 h (SD 31:15), compared to the recommended 24 h. Patients with mild-to-moderate malnutrition spend significantly more time fasting than severely malnourished patients. Conclusions Gastrointestinal patients spend longer than necessary fasting while in hospital. It appears that efforts are made to minimise fasting time only when patients are obviously malnourished.

特別養護老人ホームにおける超高齢者の看取りケア―殊に急性期病院における入院症例との比較について―

Although the facilities for end-of-life care in the special elderly (SE) nursing home are increasing, there are no standard guidelines for end-of-life care interventions. Furthermore, in the SE nursing home, there are not enough data concerning those who have had end-of-life care and/or emergency hospital palliative therapy. Therefore, we compared the clinical outcome of end-of-life care patients and emergency palliative therapy patients. Five end-of-life care patients (99+/-10 years old) in the SE nursing home, and 48 emergency palliative therapy patients (89+/-15 years old) in the hospitals. All end-of-life care patients are still living after 300+/-70 days by standard nursing care (mainly fluid diets with small doses of vasodilators and antibiotics) with bed side music. Their average CRP values in terminal end-of-life care patients decreased from 10+/-12 mg/dl to 1.2+/-0.5 (p<0.05), serum albumin levels increased from 2.7+/-1.6 g/dl to 3.5+/-2.6 and body mass index increased from 16+/-1.6 to 18.3+/-0.75 (p<0.05). Among 48 emergency hospitalized palliative patients, 32 patients were discharged to our facility after 120+/-26 days of hospitalization, whereas 16 patients died in hospital after 100+/-36 days of hospitalization (aspiration pneumonia: 11 patients, heart failure: 3 patients and G-I causes: 2 patients). End-of-life care in the SE nursing home prolonged their life expectancy despite centenarian status. Hospital mortality rates of palliative emergency therapy were higher than usual end-of-life care. These data suggest that end-of-life care interventions, including bed side music, could provide physical satisfaction.

Impact of dietary habits on stone incidence

Changes in dietary habits and lifestyle are suggested to contribute markedly to the rise in the prevalence and incidence of urolithiasis during the past decades. Insufficient fluid intake and diets rich in animal protein are considered to be important determinants of stone formation. Overweight and associated dietary pattern additionally contribute to the increasing incidence and prevalence of stone disease. Reduction of overweight through extreme fasting or high-protein weight-loss diets, e.g. Atkins diet, also appear to affect stone formation. Although there is evidence that changes in dietary habits can reduce urinary risk factors and the risk of stone formation, further randomized controlled clinical trials are necessary to evaluate long-term effects of dietary interventions on stone disease.

Salivary proteins of aphids, a pilot study on identification, separation and immunolocalisation

Salivary proteins (SPs) of Schizaphis graminum, Acyrthosiphon pisum and Myzus persicae were studied after probing and feeding on different artificial diets. Salivary sheaths as well as apical lumps of saliva were found, presumably representing subsequently excreted saliva of different types. Phenoloxidase, pectinase and peroxidase activities were detected by staining the enzyme-converted products, thus confirming these enzyme activities found earlier by others. Proteinase and cellulase were not found. SPs in three major SDS–PAGE bands, at 154 and 66/69 kDa, were collected in fluid diets (soluble fraction) and as sheath material (solid fraction) attached to the membranes covering these diets. Proteins of both fractions presumably represented the enzymatic activities found, although this could not be proven. The lack of electrophoretic mobility of the undenaturated (isoelectrofocusing and PAGE) active proteins meant that they could not be separated, whereas the mobile denaturated (SDS–PAGE) proteins had lost their enzyme activity. Polyclonal antibodies, anti-SP154 and anti-SP66/69, both cross-reacted to most salivary proteins in Western blots. They also reacted to sheath material and to the principal salivary glands. For further studies of saliva some monoclonal antibodies were developed. The complexity of salivation and the relation of the results obtained to the behaviourally known secretion periods is discussed.

The Effect of Age on Manganese Uptake and Retention from Milk and Infant Formulas in Rats

Manganese nutrition of the neonate is poorly understood, due in part to a paucity of information on the amount and availability of manganese in infant foods. We have developed a suckling pup model to assess the uptake of manganese from fluid diets by using extrinsic labeling. Human milk, cow milk and infant formulas were fed by intubation to fasted rat pups and adults. Rats were killed after varying time periods, and tissues were removed and counted. A period of 6 h was found to be adequate to allow for stomach emptying while limiting tissue redistribution; 24 h was found to reflect pup manganese retention. From human milk, manganese retention was highest (≥80%) in pups ≤15 days of age; in older pups average retention decreased to 40%. Using d 14 pups to assess relative Mn uptake from diets, whole-body Mn uptake was highest from cow milk (∼89%); uptake from human and cow milk formula was similar (∼80%) whereas it was lower from soy formula (∼60%). These findings suggest that bioavailability of Mn from infant diets is very high during the suckling period. Since most formulas contain considerably more manganese than is found in human milk, Mn deficiency may be less of a concern than possible toxicity from formulas.

The control of radiation caries.

One of the accepted side effects of megavoltage radiotherapy to neoplasms of the mouth and pharynx is a diminution of salivary flow. This is at its greatest when two opposed fields are used for lesions of the nasopharynx and oropharynx. Secretions from both parotids and both submandibular salivary glands as well as some of the many small mucosal glands, are then grossly diminished. This effect would seem to be at its greatest in those patients treated with hyperbaric oxygen. The reduction begins at the end of the first week of treatment, when about 1,000 rads have been given. The quantity of saliva is not only reduced but its nature becomes more viscid and adhesive. Thus the normal movements of the lips and tongue, which enable food to be manipulated and masticated, are reduced. Taste is lost and almost always the patient adopts a semisolid or fluid diet to mitigate his difficulties and, in order to obtain adequate nourishment, these fluid diets are of high carbohydrate content. These factors of reduced a...

An Improved Method for Feeding Aphids on Artificial Diets1

Recent publications by the authors described a simple method for feeding the green peach aphid, Mysus persicae (Sulzer), on various fluid diets via a membrane of stretched Parafilm “M”® (Mittler and Dadd 1962, 1963a). Although the method proved satisfactory when relatively few cages were needed at any one time (Bragdon and Mittler 1963; Mittler and Dadd 1963b; Strong 1963), the initiation of routine experiments on a larger scale called for a number of improvements to be made in the system.