PERI-OPERATIVE JEJUNOSTOMY-TUBE FEEDING IN RECONSTRUCTIVE SPINAL SURGERY

Eight malnourished children with neuromuscular spinal deformity were treated with jejunostomy tubes for supplemental feeding to attain appropriate weight before reconstructive surgery. All patients had significant gastro-esophageal reflux and had failed to gain weight during an eight-month oral supplementation program. There were no complications associated with the placement or use of the jejunostomy feeding tubes and all patients gained weight in a safe and predictable fashion, had successful spinal fusion and have maintained satisfactory weight at follow-up. Jejunostomy feeding is a safe and effective method of correcting malnutrition in patients with spinal deformity which precludes gastrostomy and Nissen fundoplication.     

白色颗粒物质:毋庸小题大做

2003年1月美国的一些南方州在红细胞成分中发现了不能解释的白色颗粒物质(WPM),使得2003年成为输血医学领域颇成为有意义的一年(见本刊2003年第2期192页--编者注)。WPM最初是由美国东南部地区亚特兰大的乔治亚州红十字发现的,很快美国的其他地区也发现了这一现象。2003年     

Diet soft drink is associated with increased odds of proliferative diabetic retinopathy

Importance

While consumption of soft drink may increase the risk of cardiovascular disease, the relationship between soft drink consumption and diabetes complications is unknown.

Background

To explore the association between regular and diet soft drink consumption, and diabetic retinopathy (DR) and diabetic macular oedema (DME).

Design

Clinical, cross‐sectional study.

Participants

Adult patients with diabetes recruited from a tertiary eye hospital (Melbourne, Australia) answered a Food Frequency Questionnaire.

Methods

None, moderate and high soft drink consumption was defined as <1, 1–4 and >4 cans/bottles (375 mL) per week, respectively. Due to missing data, data were imputed using the multiple imputation chained equation procedure. Multivariable logistic regression models determined the associations between soft drink consumption, and presence and severity of DR/DME.

Main Outcome Measures

Presence and severity of DR/DME.

Results

Of the 609 participants (mean age ± standard deviation: 64.6 ± 11.6 years; males = 210), 285 (46.8%) and 190 (31.2%) consumed diet and regular soft drink, respectively. A total of 230 (37.8%), 36 (5.9%), 154 (25.3%), 28 (4.6%) and 146 (24.0%) had no DR, mild non‐proliferative DR (NPDR), moderate NPDR, severe NPDR and proliferative DR (PDR), respectively. High diet soft drink consumption was independently associated with increased likelihood of having PDR (odds ratio = 2.51, 95% confidence interval = 1.05–5.98), compared to no consumption. In contrast, regular soft drink was not associated with DR or DME.

Conclusions and Relevance

Consuming >4 cans (1.5 L)/week of diet soft drink is associated with a more than twofold risk of having PDR in patients with diabetes. Longitudinal studies are needed to further elucidate the association and its underpinning mechanisms.