Medicine and Health Sciences Commons^™

The Ketogenic Diet: An Answer For Autism?, Anne Perez

BU Well

Lacking substantial evidence regarding its genetic identity, autism spectrum disorder (ASD) is a remarkably misunderstood condition with limited options for effective treatment. As the prevalence of patients with ASD increases, medical professionals continue to search for a solution. Could the ketogenic diet, a high fat, low carbohydrate nutrition plan, provide the relief that ASD patients are searching for?

A.S.P.E.N. Parenteral Nutrition Safety Consensus Recommendations, Phil Ayers, Stephen Adams, Joseph Boullata, Jane M. Gervasio, Beverly Holcombe, Michael D. Kraft, Neil Marshall, Antoinette Neal, Gordon Sacks, David S. Seres, Patricia Worthington, American Society For Parenteral And Enteral Nutrition

Scholarship and Professional Work – COPHS

Parenteral nutrition (PN) serves as an important therapeutic modality that is used in adults, children, and infants for a variety of indications. The appropriate use of this complex therapy aims to maximize clinical benefit while minimizing the potential risks for adverse events. Complications can occur as a result of the therapy and as the result of the PN process. These consensus recommendations are based on practices that are generally accepted to minimize errors with PN therapy, categorized in the areas of PN prescribing, order review and verification, compounding, and administration. These recommendations should be used in conjunction with other A.S.P.E.N. …

Compounding Vs Standardized Commercial Parenteral Nutrition Product: Pros And Cons, Jane M. Gervasio

Scholarship and Professional Work – COPHS

Standardized commercial parenteral nutrition (PN) formulations have advantages and disadvantages as compared with PN formulations compounded using an automated compounding device. These advantages and disadvantages are discussed along with the supporting available research.

Nutrition Support In Acute Kidney Injury, Jane M. Gervasio, Wesley P. Garmon, Michael Holowatyj

Scholarship and Professional Work – COPHS

Acute kidney injury is a frequent complication affecting many hospitalized patients and is associated with increased morbidity and mortality. Acute kidney injury often occurs in conjunction with critical illness, which is a hypermetabolic state presenting with hyperglycemia, insulin resistance, hypertriglyceridemia, and increased protein catabolism. In addition to addressing these changes, the clinician should evaluate the important nutrition implications of decreased kidney function. These include vitamins, electrolytes, minerals, trace elements, and the presence and type of renal replacement therapy. Optimal nutrition management in acute kidney injury includes providing adequate macronutrient support to correct underlying conditions and prevent ongoing loss, supplementing micronutrients …

Nutrition Support Therapy In Acute Kidney Injury: Distinguishing Dogma From Good Practice, Jane M. Gervasio, Ann B. Cotton

Scholarship and Professional Work – COPHS

Acute kidney injury (AKI) is a frequently observed complication in critically ill patients. Its presentation may range from the early risk of renal dysfunction to complete renal failure. Morbidity and mortality in the AKI patient increase with the decline of renal function. Appropriate nutrition therapy is essential in the medical management of the AKI patient. Assessment of nutritional requirements should take into account the patient’s underlying complication, comorbid medical conditions, and severity of the renal dysfunction. Various stages of AKI determine the direction of nutrition therapy. Additionally, understanding the macro- and micronutrient modifications and electrolyte and vitamin alterations that should …

Nutrition In The Critically Ill Patient, Jane M. Gervasio

Scholarship and Professional Work – COPHS

Critical illness presents with the classic response to stress, including hypermetabolism and increased catabolism, resulting in a negative energy and nitrogen balance. These harmful events initiate the immunological response, starting with the systemic inflammatory response syndrome, which, if not resolved, may lead to multiple organ dysfunction syndrome (MODS). Furthermore, patients who do not develop early MODS manifest a compensation anti-inflammatory response syndrome, which suppresses immunity and predisposes the patient to sepsis, thereby ­increasing the risk of late MODS and ultimately death. The use of specialized nutrition support, including enteral nutrition (EN) and parenteral nutrition (PN), has been initiated in an …

Anabolic Agents: Adjuncts To Nutrition Support, Jane M. Gervasio

Scholarship and Professional Work – COPHS

Anabolic agents as adjuncts to nutrition support therapy have been used to improve malnutrition and establish anabolism. Growth hormone, insulin-like growth factor, and anabolic steroids have been studied for their potential to reverse the catabolic process and promote anabolism. This paper reviews several anabolic agents and their possible role in nutrition support therapy.

A Comparison Of Renal Phosphorus Regulation In Thermally-Injured And Multiple Trauma Patients Receiving Specialized Nutrition Support, Roland N. Dickerson, Jane M. Gervasio, Justin J. Sherman, Kenneth A. Kudsk, William L. Hickerson, Rex O. Brown

Scholarship and Professional Work – COPHS

To compare phosphorus intake and renal phosphorus regulation between thermally injured patients and multiple trauma patients, 40 consecutive critically ill patients, 20 with thermal injury and 20 with multiple trauma, who required enteral tube feeding were evaluated. Phosphorus intakes were recorded for 14 days from the initiation of tube feeding which was started 1 to 3 days post-injury. Serum for determination of phosphorus concentrations was collected at days 1, 3, 7, and 14 of the study period. A 24-hour urine collection was obtained during the first and second weeks of nutrition support for urinary phosphorus excretion, fractional excretion of phosphorus, …

Oxandrolone In Trauma Patients, Jane M. Gervasio, Roland N. Dickerson, Jessica Swearingen, Mary E.D. Yates, Ceaminia Yuen, Timothy C. Fabian, Martin A. Croce, Rex O. Brown

Scholarship and Professional Work – COPHS

Study Objective

To determine the effect of oxandrolone administration on nutritional and clinical outcomes after multiple trauma.

Design

Prospective, randomized, double-blind, placebo-controlled study. Setting. Level 1 trauma center in a university teaching hospital.

Patients

Sixty-two patients requiring enteral nutrition, 60 of whom completed the study.

Intervention

Patients were randomized to receive either oxandrolone 10 mg or placebo twice/day for a maximum of 28 days.

Measurements and Main Results

Total urinary nitrogen, prealbumin, nitrogen balance, total body water, and body cell mass were measured on day 1 of enteral nutrition and then at day 7, day 10, and study exit. Patients …