Subject surgical patients

King RF, Macfie J, Hill G (1981) Activities of hexokinase, phosphofructokinase, fructose bisphosphatase and 2-oxoglutarate dehydrogenase in muscle of normal subjects and very ill surgical patients. Clin Sci 60 451-456... 

Because the older formulation of diclofenac for parenteral injection was approved in the UK decades ago and marketed there continuously since, with ample experience as to its safety and efficacy, the regulatory pathway for approval of the new formulation in that country as an essentially similar product was relatively straightforward. The new formulation was approved and has been marketed in the UK since late 2007 for parenteral use, 75 mg every 12 hours as needed for the treatment of acute moderate to severe pain. This dose, dosing interval, and indication are the same as for the earlier formulation. Other European submissions are planned and our new formulation of injectable diclofenac is currently under clinical development in the USA. Because no injectable diclofenac has previously been approved in the USA, the US clinical development program has been more comprehensive than that in the UK, including clinical trials that have assessed various doses and dose intervals in several pain models and in subjects ranging from healthy normal subjects to post-surgical patients, and patients with renal or hepatic insufficiency. 

Nutritional supplementation may benefit those subjects who are malnourished (BMI < 18.5-20 kg/m or BMI < 20 kg/m in surgical patients), with unintentional weight loss >5% within the previous three to six months, or even at risk of malnutrition (eaten very little for >5 days) (49). 

Haskell MJ, Handelman GJ, Peerson JM, Jones AD, Rabbi MA, Awal MA, Wahed MA, Mahalanabis D, Brown KH (1997) Assessment of vitamin A status by the deuterated-retinol-dilution technique and comparison with hepatic vitamin A concentration in Bangladeshi surgical patients. Amer J Clin Nutr 66 61-1A Haskell MJ, Islam MA, Handelman GJ, Peerson JM, Jones AD, Wahed MA, Mahalanabis D, Brown KH (1998) Plasma kinetics of an oral dose of [ H4]retinyl acetate in human subjects with estimated low or high total body stores of vitamin A. Amer J Clin Nutr 68 90-95... 

As the surgical techniques advance, the average age of the patient subjected to total joint replacement is decreasing and therefore the life expectancy of the implant is increasing. This obviously places more emphasis on the fatigue and corrosion resistant properties of the materials which are used in orthopaedic surgery. 

An ongoing assessment is one that is made at the time of each patient contact and may include the collection of objective data, subjective data, or both. The scope of an ongoing assessment depends on many factors, such as the patient s diagnosis, the severity of illness, the response to treatment, and the prescribed medical or surgical treatment. 

Goal calorie and protein requirements Perform a subjective global assessment Take into consideration the patient s current clinical status, diagnoses, medications, etc. Total daily calories -25-30 kcal/kg per day, or -1 500-1 800 kcal/day Protein -1.5-2 g/kg per day of ideal body weight (-89-11 8 g protein/day) This patient has sepsis, diffuse peritonitis, and recent surgical procedures, target -1800 kcal/day and -11 0 g protein/day... 

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