Nutrition parenterale a domicile.

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Disintegration kinetics of tablets monitored by means of a resultant-weight apparatus

The weight and/or volume variations of a sample immersed in a fluid medium can be determined with respect to time by means of a resultant-weight measuring apparatus and method. The applicability of this in vitro technique is examined herein for the monitoring of the disintegration process of tablets. Illustrative experiments obtained with different commercially-available tablets indicate that the information provided by the resultant-weight curves faithfully translates the macroscopic changes of the sample and its hydrodynamic evolution in time. Disintegration kinetics can be recorded even for instant release tablets, but the information becomes particularly interesting when the process adopts a sequence with distinct steps, such as with tablets having a composite structure (for example multi-layered modified release tablets, film-coated tablets etc). The magnitude and duration of each step can be measured exactly and it is in turn possible to assess the different parts of the tablet separately and to adjust their formulation or technological characteristics in accordance with the intended hydrodynamic behaviour.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Home parenteral nutrition in adults: The current use of an experienced method

SCOPUS: cp.jinfo:eu-repo/semantics/publishe

Indications et résultats de la nutrition artificielle à domicile chez le patient cancéreux

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Drug administration via enteral feeding tubes: To crush or not to crush?

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

L'administration des médicaments par sonde d'alimentation entérale

The oral administration of medications during enteral feeding may be associated with a lack in absorption and bioavailability as well as a quick release of the drug in case of crushing of slow-release pharmaceutical formulation. For these reasons, liquid or dispersible formulations are preferable. Their administration usually requires the interruption of enteral feeding and the flush of feeding tubes. Guidelines have been recommended by the pharmacy department of Erasme hospital in Brussels; however, a practice survey showed that errors are still frequent. © SRLF et Springer-Verlag France 2011.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Le patient acteur dans le parcours de soin: à propos de l'assistance nutritionnelle en auto-soin

In severely malnourished patients, or in patients unable to meet their nutritional needs, the continuation of the nutritional support started in the hospital is often required after discharge. However, the management of an enteral or parenteral nutrition at home or in post-hospital facilities requires a specific training and its acceptance can be impaired by several hurdles. For these reasons, standardized therapeutic training programs involving successive steps are necessary. The management of the preparatory phase of home artificial nutrition is coordinated by a multidisciplinary hospital team in charge of (1) checking the feasibility and relevance of long-term nutrition support, (2) the placement of the device required for long-term enteral or parenteral feeding, (3) the education of the patient or his relatives for handling the connection and disconnection and (4) the coordination of the post-hospital follow-up.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Implementation of a new health information technology for the management of cancer chemotherapies

Background Cancer chemotherapy drugs are classified as high-risk molecules. Safety of the cancer chemotherapy process is often achieved with the implementation of a health information technology to each step or to the entire process. However, computerisation could lead to the emergence of new unintended medication errors. The aim of the study was to evaluate the impact of new software designed for the management of anticancer chemotherapies. Method The cartography of the process and the failure modes, effects and criticality analysis were performed by a multidisciplinary team. Criticality indexes were calculated considering or not the implementation of the commercial software (CytoWeb). Quality and satisfactory indicators were measured before the implementation and during the use of the software. Results Our results demonstrated the complexity of the cancer chemotherapy process in the hospital. Risk analysis highlighted the positive impact of CytoWeb on the process safety but pointed out some steps that were not positively influenced by the software. Although a decrease of 38.6% of error rate was observed with the electronic system, new unintended medication errors emerged. These errors were due to inadequate use of the software (encoding of the wrong drug, the wrong dose, the wrong patient parameters or lab results and lack of prescriber adherence). Our satisfaction survey showed that the hospital pharmacists and doctors were less satisfied by the software than the nurses, mostly in terms of task achievement and time saving. Survey's results highlighted some weaknesses in the user training and in the collaboration between the medical staff. Conclusions Our work showed the emergence of unintended medication errors linked to computerisation that were due to an inadequate use of the software. Other issues were highlighted such as the lack of collaboration between the medical staff, the lack of prescriber implication and weaknesses in the user training or in the information related to CytoWeb.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Lessons from a 20 year experience of Home Parenteral Nutrition in adult patients

Background: Home Parenteral Nutrition (HPN) is a method commonly used in patients with Chronic Intestinal Failure (CII) related to benign or malignant diseases. We report the experience from a 20 year programme of HPN in a single academic centre. Methods: In this study, we have reviewed characteristics and outcome of a group of patients enrolled in a HPN program between 1987 and 2007. Focus was given to the prevalence and severity of cholestasis in these patients as well as on their oral food behaviour. Results: In 20 years, 125 patients were included in a HPN programme; 65 patients had benign diseases (BD) and 60 advanced cancer (AC). Short bowel was the most common indications in patients with BD. Almost 40% of patients with BD were weaned off HPN. Median survival was excellent in BD patients and extremely short in AC. Death related to HPN was very rare. Cholestasis has been observed in 84% of patients but it was mild to moderate in the majority of cases. Hyperphagia was observed in 50% of the patients with BD on long-term HPN. Conclusions: This study confirms that HPN is the first line therapy in CII due to BD. Patients with AC should be carefully selected. Cholestasis is frequent but mostly without clinical impact. Half of the patients with CII due to BD become hyperphagic allowing to reduction of parenteral intake. The role of a multi - disciplinary nutrition support team is essential for optimizing HPN. (Acta gastro enterol. belg. 2010, 73, 451-456).SCOPUS: re.jinfo:eu-repo/semantics/publishe