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| 1 | Nutritional support teams increase percutaneous endoscopic gastrostomy uptake in motor neuron disease显示文摘AIM:To examine factors influencing percutaneous endoscopic gastrostomy(PEG) uptake and outcomes in motor neuron disease(MND) in a tertiary care centre.METHODS:Case notes from all patients with a confirmed diagnosis of MND who had attended the clinic at the Repatriation General Hospital between January 2007 and January 2011 and who had since died,were audited.Data were extracted for demographics(age and gender),disease characteristics(date of onset,bulbar or peripheral predominance,complications),date and nature of discussion of gastrostomy insertion,nutritional status [weight measurements,body mass index(BMI)],date of gastrostomy insertion and subsequent progress(duration of survival) and quality of life(QoL) [Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised(ALSFRS-R)].In addition,the type of clinician initiating the discussion regarding gastrostomy was recorded as Nutritional Support Team(involved in providing nutrition input viz Gastroenterologist,Speech Pathologist,Dietitian) and other(involved in non-nutritional aspects of patient care).Factors affecting placement and outcomes including length of survival,change in weight and QoL were determined.RESULTS:Case records were available for all 86 patients(49 men,mean age at diagnosis 66.4 years).Thirty-eight patients had bulbar symptoms and 48 had peripheral disease as their presenting feature.Sixty-six patients reported dysphagia.Thirty-one patients had undergone gastrostomy insertion.The major indications for PEG placement were dysphagia and weight loss.Nine patients required immediate full feeding,whereas 17 patients initially used the gastrostomy to supplement oral intake,4 for medication administration and 1 for hydration.Initially the PEG regime met 73% ± 31% of the estimated total energy requirements,increasing to 87% ± 32% prior to death.There was stabilization of weight in patients undergoing gastrostomy [BMI at 3 mo(22.6 ± 2.2 kg/m 2) and 6 mo(22.5 ± 2.0 kg/m 2) after PEG placement compared to weight at the time of the procedure(22.5 ± 3.0 kg/m 2)].However,weight loss recurred in the terminal stages of the illness.There was a strong trend for longer survival from diagnosis among MND in PEG recipients with limb onset presentation compared to similar patients who did not undergo the procedure(P = 0.063).Initial discussions regarding PEG insertion occurred earlier after diagnosis when seen by nutrition support team(NST) clinicians compared to other clinicians.(5.4 ± 7.0 mo vs 11.9 ± 13.4 mo,P = 0.028).There was a significant increase in PEG uptake(56% vs 24%,P = 0.011) if PEG discussions were initiated by the NST staff compared to other clinicians.There was no change in the ALSFRS-R score in patients who underwent PEG(pre 34.1 ± 8.6 vs post 34.8 ± 7.4),although in non-PEG recipients there was a nonsignificant fall in this score(33.7 ± 7.9 vs 31.6 ± 8.8).Four patients died within one month of the procedure,4 developed bacterial site infection requiring antibiotics and 1 required endoscopic therapy for gastric bleeding.Less serious complications attributed to the procedure included persistent gastrostomy site discomfort,poor appetite,altered bowel function and bloating.CONCLUSION:Initial discussion with NST clinicians increases PEG uptake in MND.Gastrostomy stabilizes patient weight but weight loss recurs with advancing disease. | Lin Zhang Leanne Sanders Robert JL Fraser | 2012 | World Journal of Gastroenterology2012，18，44： | 6 |
| 2 | Protein kinase C involvement in intedeukin-6 production by parathyroid hormone and tumor necrosis factor-alpha in UMR-106 osteoblastic cells显示文摘 | Sanders JL Stem PH | 2000 | J Bone Miner Res2000，15，5： | 1 |
| 3 | Colocalization and fluo-rescence resonance energy transfer between cdk5and AT8suggests a close association in pre-neurofibrillary tangles and neurofibrillary tangles显示文摘 | Augustinack JC Sanders JL Tsai LH | 2002 | J Neuropathol Exp Neurol2002，61，6： | 1 |
| 4 | Celm:aliza- tion and fluorescence resonance energy transfer between cdk5 and AT8 suggests a close association in pre-neurofibrillary tangles and neurofibrillary tangles显示文摘 | AUGUSTINACK JC SANDERS JL TSA | 2002 | J Neuropathol Exp Neurol2002，6，6： | 1 |
| 5 | Piggybacking intraocular implants to correct pseudophakic refractive error显示文摘 | Gayton JL Sanders V Van der Karr M Raanan MG | 1999 | Ophthalmology1999，106，1： | 1 |
| 6 | Anatomic goals in the correction of female stress urinary incontinence显示文摘 | Mostwin JL Genadry R Sanders R | 1996 | J Endourol1996，10，3： | 1 |
| 7 | A first course in continuum mechanics 显示文摘 | Fung YC Sanders JL | 1978 | J Appl Mech1978，45，4： | 1 |
| 8 | Effect of hydrogen peroxide disinfection during incubation of chicken eggs on microbial levels and productivity显示文摘 | Sander JE Wilson JL | 1999 | avian Dis1999，43，2： | 1 |
| 9 | Structure of the Human Lung Cytochrome P450 2A13 显示文摘 | Smith BD Sanders JL Porubsky PR | 2007 | J Biol Chem2007，282，17： | 1 |
| 10 | Casting and traction treatment methods for scoliosis显示文摘 | DAstous JL Sanders JO | 2007 | Orthop Clin North Am2007，38，4： | 1 |
| 11 | Structure of the human lung eytochrome p450 2a13显示文摘 | Smith BD Sanders JL Porubsky PR | 2007 | J Biol Chem2007，282，17： | 1 |
| 12 | A bidirectional load applicator for the investigation of skin response to mechanical stress 显示文摘 | Sanders JE Garbini JL Leschen JM | 1997 | IEEE Trans Biomed Eng1997，44，4： | 1 |
| 13 | Coactivation of NMDA receptors by glutamate and D - serine induces dilation of isolated middle cerebral arteries 显示文摘 | LeMaistre JL Sandere SA Stobarl MJ | 2012 | J Cereb Blood Flow Metab2012，32，3： | 1 |
| 14 | Carcinoma in situ of the vagina 显示文摘 | Benedet JL Sanders BH | 1984 | Am J Obstet Gynecol1984，148，5： | 1 |
| 15 | Enhanced optical coherence tomography imaging by multiple scan averaging 显示文摘 | Sander B Larsen M Thrane L Hougaard JL Jorgensen TM | 2005 | Br J Ophthalmol2005，89，2： | 1 |
| 16 | Effect of hydrogen peroxide disinfection during incubation of chicken eggs on microbial levels and productivity 显示文摘 | Sander JE Wilson JL | 1999 | Avian Dis1999，43，2： | 1 |
| 17 | Combined cataract and glaucoma surgery:trabeculectomy versus endoscopic laser cycloablation显示文摘 | Gayton JL Van De Karr M Sanders V | | 0，，： | 1 |
| 18 | Anatomic goals in the correction of female stress urinary incontinence显示文摘 | Mostwin JL Genadry R Sanders R | 1996 | J Endourol1996，10，： | 1 |
| 19 | Hemodynamics of seasonal adaptation 显示文摘 | Izzo JL Jr Larrabee PS Sander E | 1990 | Am J Hypertens1990，3，5： | 1 |
| 20 | External fixation of distal radius fractures:Results and complications显示文摘 | Sander RA Keppel FL Waldrop JL | 1991 | J Hand Surg1991，16，： | 1 |
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