5 research outputs found

    Oral diet management for carcinoma at the base of tongue with radiotherapy and chemotherapy associated dysphagia: a case report

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    IntroductionTongue cancer is one of the common malignancy of the head and neck, and directly impacts chewing, swallowing, and other eating activities. Based on the evidence-based guidelines and clinical management, this paper presents nutrition management experience of a patient with tongue cancer who had a dysphagia and feeding reflux while undergoing radiotherapy and chemotherapy.MethodsNutritional risk screening and comprehensive nutritional assessment were performed based on the patient’s medical history, and personalized nutritional programs were developed under the guidance of the clinical pharmaceutical consensus of parenteral nutrition and nutritional treatment guidelines for patients with tumors during radiotherapy. For the management of oral feeding, the patient’s swallowing function was evaluated to manage oral feeding. Thickening powders were used to improve the consistency of the patient’s food, which successfully achieved oral feeding of the patient.ResultsThe patient finally ate five meals a day by mouth, and energy requirements were met using industrialized nutritional supplements, and homogenized food was added in between the meals. The energy provided by enteral nutrition can reached approximately 60–75%. The patient’s weight and albumin levels had increased significantly at the time of discharge.DiscussionThe nutritional management of patients with dysphagia should be jointly managed by clinicians, nurses, nutritionists, and family members to effectively improve the quality of life (QOL) and nutritional status of patients. To ensure adequate nutritional supply, appropriate swallowing training may delay the deterioration of the chewing function and improve the eating experience of such patients

    Carbetocin for the prevention of postpartum hemorrhage: a systematic review and meta-analysis of randomized controlled trials

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    <div><p></p><p><i>Objective</i>: To compare the efficacy and safety profile of carbetocin with other uterotonic agents in preventing postpartum hemorrhage.</p><p><i>Methods</i>: PubMed, Web of Science, Scopus and EBSCOhost were searched for relevant randomized controlled trials published until September 2013.</p><p><i>Results</i>: Carbetocin was associated with a significantly reduced need for additional uterotonic agents (RR = 0.68, 95% CI: 0.55–0.84, <i>I</i><sup>2 </sup>= 4%) compared with oxytocin in women following cesarean delivery. However, with respect to postpartum hemorrhage, severe postpartum hemorrhage, mean estimated blood loss and adverse effects, our analysis failed to detect a significant difference. Studies comparing carbetocin with syntometrine in women undergoing vaginal delivery demonstrated no statistical difference in terms of risk of postpartum hemorrhage, severe postpartum hemorrhage or the need for additional uterotonic agents, but the risk of adverse effect was significantly lower in the carbetocin group.</p><p><i>Conclusions</i>: Carbetocin has been associated with a similar low incidence of adverse effects to oxytocin and at least as effective as syntometrine and may become an alternative uterotonic agent for the prevention of postpartum hemorrhage. Further studies should be conducted to determine the safety and efficacy profile of carbetocin in women with cardiac disorders and to analyze the cost-effectiveness and minimum effective dose of carbetocin.</p></div
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