By K. Hauke. Berea College.
Transitions of Care – Occur when clients are being admitted discount 600 mg myambutol overnight delivery, discharged or transferred to or from home discount myambutol 800 mg otc, another facility/practice setting or another care provider quality myambutol 400mg. Nurse – The term nurse(s) refers to all regulated members of the College and Association of Registered Nurses of Alberta including: registered nurses, graduate nurses, certified graduate nurses, nurse practitioners and graduate nurse practitioners. Pre-Pouring – The term pre-pouring is defined as preparing medications in advance and then storing them until you or others need them. Standing Order – Directions for medication administration that apply to a group or population; not a specific client. Accreditation Canada, the Canadian Institute of Health Information, the Canadian Patient Safety Institute, & the Institute for Safe Medication Practices Canada. Medication reconciliation in Canada: Raising the bar – progress to date and the course ahead. Alberta College of Pharmacists, College and Association of Registered Nurses of Alberta & the College of Physicians and Surgeons of Alberta. Ensuring safe & efficient communication of medications prescriptions in community and ambulatory settings. Canadian Nurses Association, Canadian Physiotherapy Association, Canadian Home Care Association, Canadian Pharmacists Association, Canadian Council for Practical Nurse Regulators, Registered Psychiatric Nurses of Canada, & the Canadian Psychological Association. Maximizing health human resources: Valuing healthcare team members: Working with unregulated health workers: A discussion paper. Health professions act: Standards for registered nurses in the performance of restricted activities. Standards for supervision of nursing students and undergraduate nursing employees providing client care. Complementary and/or alternative therapy and natural health products: Standards for registered nurses. College and Association of Registered Nurses of Alberta, College of Licensed Practical Nurses of Alberta and College of Registered Psychiatric Nurses of Alberta. The use of "as-needed" range orders for opioid analgesics in the management of acute pain: A consensus statement of the American Society for Pain Management Nursing and the American Pain Society. Perilous infection control practices with needles, syringes, and vials suggest stepped-up monitoring is needed. Independent double checks: Undervalued and misused: Selective use of this strategy can play an important role in medication safety. Empowering frontline nurses: A structured intervention enables nurses to improve medication administration accuracy. Current literature on medication safety highlights two potentially error prone practices: 1) The use of verbal prescriptions; and 2) The communication of prescriptions to a pharmacist through an intermediary. The use of verbal prescriptions (spoken aloud in person or by telephone) introduces a number of variables that can increase the risk of error. These variables include: Potential for misinterpretation of orders because of accent or pronunciation; Sound alike drug names; Background noise; Unfamiliar terminology; and Patients having the same or similar names. For example, numbers in the teens such as 15 and 16 may be heard and transcribed as 50 and 60. Once received, a verbal prescription must be reduced to writing which adds further complexity and risk to the prescribing process. No one except the prescriber can verify the accuracy of a verbal order against what was intended, and identification of an error in a verbal prescription by a prescriber relies on their memory of what was spoken. Medication safety literature recognizes that the more direct the communication between a prescriber and a pharmacist, the lower the risk of error. The introduction of intermediaries into the prescribing process has been identified as a prominent source of medication error. Communicating a prescription by telephone through an intermediary: Blurs accountability; Further increases the risk of miscommunication; Reduces the effectiveness of the prescription confirmation process; and Lessens the likelihood that effective communication occurs if questions arise about a prescription. Patients can and should be supported to question why they are receiving a medication, verify that it is the appropriate medication, dose, and route, and alert the health professional involved in prescribing, dispensing, or administering a medication to potential problems such as allergies or past drug-drug interactions. There is significant legal risk associated with the use of intermediaries because current legislation does not support or is silent on the role of intermediaries in the communication of medication prescriptions. Given this level of risk, we recommend that health professionals involved in the communication of medication prescriptions in 1 community and ambulatory settings apply the core principles outlined in this document. The principles provide guidance to health professionals involved in the prescribing and management of medication prescriptions in community and ambulatory practice settings. In endorsing these principles, these organizations also acknowledge that some period of transition and redesign of processes may be required. Practitioners are encouraged to work collaboratively in addressing needed changes and to consult with their professional colleges for advice as required. Core Principles for Safe Communication of Medication Prescriptions in Community and Ambulatory Settings: 1. To minimize the risk of error, medication prescriptions must be issued clearly and completely. Health professionals involved in the management of medication prescriptions have a responsibility to question any medication prescription issued by another health professional if they believe that it may not be safe or may otherwise not be in the patient’s best interest.
As mentioned before purchase 400 mg myambutol fast delivery, most men will need more information than found in this booklet to reach their decisions trusted 600 mg myambutol. You may use the questions in these charts as a guide for talking with your doctor or learning more about your choices order 800mg myambutol overnight delivery. Active n If your cancer is: Surveillance • low-risk (see page 4) • smaller or a slow-growing type of prostate cancer • in the prostate only n If you are in your 70s or older, or have serious medical problems. Terapy n If you have serious health problems that do not allow you to have surgery. Radiation n External Beam Radiation Terapy • Your doctor will fgure out the dose of the radiation to the cancer with the least damage to the normal tissue nearby. He or she will implant the seeds using hollow needles inserted through the space between the scrotum and the anus. Surveillance n Your doctor will follow you closely and you will have regular check-ups. Surgery n Te prostate cancer is removed by removing as much of the prostate as possible. Radiation n External Beam Radiation Terapy • You will not need to spend the night in the hospital. Active n You may have feelings of worry and anxiety about living Surveillance with cancer and putting of treatment. Surgery n Tere are risks with any major surgery, such as pain, bleeding, infection, heart problems, or death. Managing this problem often means wearing pads, such as Depend® pads, to catch urine. Te most common type of incontinence is passing a small amount of urine from the stress of coughing, laughing, or sneezing. A small number of men may have more serious incontinence that can last the rest of their life. Erectile dysfunction may occur if the cancer is close to the nerves that control erections. If these nerves are damaged or removed during surgery, there is a strong chance that you will have problems with erectile dysfunction after surgery. Other factors that afect erectile dysfunction are your age, medicines you take, your hormone levels, other health problems, and how strong your erections were before surgery. Half of the men who have radiation therapy will develop problems with erectile dysfunction that are like those seen with surgery. Surveillance Surgery n Surgery to remove the prostate can cause erectile dysfunction. Talk with your doctor about whether nerve- sparing surgery can be used to limit damage to the nerves that control erections. Medications and devices can help many men with erectile dysfunction (see page 20). If you want to have children in the future, you will need to bank your sperm before surgery. Radiation n You are just as likely to develop problems with erectile Terapy dysfunction as you are with surgery. But, these problems will develop 3 to 5 years after treatment, rather than right after. Your age and health can also afect problems you might have with erectile dysfunction. Active n You will have no side efects Surveillance Surgery n For erectile dysfunction • Tere are medicines you can take by mouth that can increase blood fow to the penis, leading to an erection. Tese medicines include: – Sildenafl (Viagra®) – Vardenafl (Levitra®) – Tadalafl (Cialis®) • Tere are also medicines you can give yourself with a shot into the penis. Once you give yourself the shot, it will take about 5 minutes to start working and the efect will last for 20 to 90 minutes. Other choices for managing incontinence include collection devices, biofeedback, and surgery. Te drainage tube empties into a storage bag, which can be emptied directly into a toilet. Radiation n Urinary problems Terapy • Talk with your doctor or nurse if you have urinary problems. After you have a bowel movement, clean yourself with moist wipes, instead of toilet paper. Avoid fried, greasy, and spicy foods, and those that are high in fber, such as raw fruits and vegetables. For more information about dealing with problems caused by radiation therapy, see Radiation Terapy and You: Support for People with Cancer, a booklet from the National Cancer Institute.
We must therefore conclude that it is 11 Guide to Good Prescribing probably better not to prescribe any drug at all buy generic myambutol 800 mg. If we still consider that a drug is needed discount myambutol 600mg overnight delivery, codeine remains the best choice but in as low a dosage as possible cheap myambutol 600 mg overnight delivery, and for a few days only. Then codeine can be prescribed: R/codeine 15 mg; 10 tablets; 1 tablet 3 times daily; date; signature; name, address and age of the patient, and the insurance number (if applicable). Step 5: Give information, instructions and warnings The patient should be informed that codeine will suppress the cough, that it works within 2-3 hours, that it may cause constipation, and that it will make him sleepy if he takes too much of it or drinks any alcohol. He should be advised to come back if the cough does not go within one week, or if unacceptable side effects occur. Finally he should be advised to follow the dosage schedule and warned not to take alcohol. Step 6: Monitor (stop) the treatment If the patient does not return, he is probably better. If there is no improvement and he does come back there are three possible reasons: (1) the treatment was not effective; (2) the treatment was not safe, e. For example, in chronic diseases such as hypertension, careful monitoring and improving patient adherence to the treatment may be all that you can do. Conclusion So, what at first seems just a simple consultation of only a few minutes, in fact requires a quite complex process of professional analysis. What you should not do is copy the doctor and memorize that dry cough should be treated with 15 mg codeine 3 times daily for three days - which is not always true. Instead, build your clinical practice on the core principles of choosing and giving a treatment, which have been outlined. The process is summarized below and each step is fully described in the following chapters. Step 3: Verify the suitability of your P-treatment Check effectiveness and safety Step 4: Start the treatment Step 5: Give information, instructions and warnings Step 6: Monitor (and stop? Chapter 4 provides the theoretical model with some critical considerations, and summarizes the process. Chapter 5 describes the difference between P-drug and P-treatment: not all health problems need treatment with drugs. When selecting your P-drugs you may need to revise some of the basic principles of pharmacology, which are summarized in Annex 1. How do you manage to choose the right drug for each patient in a relatively short time? P-drugs are the drugs you have chosen to prescribe regularly, and with which you have become familiar. The P-drug concept is more than just the name of a pharmacological substance, it also includes the dosage form, dosage schedule and duration of treatment. P- drugs will differ from country to country, and between doctors, because of varying availability and cost of drugs, different national formularies and essential drugs lists, medical culture, and individual interpretation of information. And, as you use your P-drugs regularly, you will get to know their effects and side effects thoroughly, with obvious benefits to the patient. In general, the list of drugs registered for use in the country and the national list of essential drugs contain many more drugs than you are likely to use regularly. It is therefore useful to make your own selection from these lists, and to make this selection in a rational way. For these reasons they are a valuable tool for rational prescribing and you should consider them very carefully when choosing your P-drugs. P-drugs and P-treatment 19 Guide to Good Prescribing There is a difference between P-drugs and P-treatment. The concept of choosing a P-treatment was already introduced in the previous chapter. The process of choosing a P-drug is very similar and will be discussed in the following chapters. How not to compile your list of P-drugs Instead of compiling your own list, one of the most popular ways to make a list of P-drugs is just to copy it from clinical teachers, or from existing national or local treatment guidelines or formularies. While you can and should draw on expert opinion and consensus guidelines, you should always think for yourself. For example, if a recommended drug is contraindicated for a particular patient, you have to prescribe another drug. If you do not agree with a particular drug choice or treatment guideline in general, prepare your case and defend your choice with the committee that prepared it. F Through developing your own set of P-drugs you will learn how to handle pharmacological concepts and data. This will enable you to discriminate between major and minor pharmacological features of a drug, making it much easier for you to determine its therapeutic value. F Through compiling your own set of P-drugs you will know the alternatives when your P-drug choice cannot be used, for example because of serious side effects or contraindications, or when your P-drug is not available. With the experience gained in choosing your P-drugs you will more easily be able to select an alternative drug.
Cases of increased serum creatinine buy myambutol 600mg amex, interstitial nephritis and renal failure myambutol 400mg amex, pancreatitis and convulsions have been reported rarely generic myambutol 800mg visa. There have been reports of colchicine toxicity with concomitant use of clarithromycin and colchicines; deaths have been reported in such patients. If any other undesirable effect occurs, which is not mentioned above, the patient should be advised to give details to his/her doctor. Use In Pregnancy and Lactating Women Klaricid should not be used during pregnancy or lactation unless the clinical benefit is considered to outweigh the risk. Clarithromycin has been found in the milk of lactating animals and in human breast milk. Recommended Dosage Intravenous therapy may be given for 2 to 5 days and should be changed to oral clarithromycin therapy when appropriate. Renal Impairment: In patients with renal impairment who have creatinine clearance less than 30 mL/min, the dosage of clarithromycin should be reduced to one half of the normal recommended dose. Recommended Administration Clarithromycin should not be given as a bolus or an intramuscular injection. May be stored from 5°C up to room Use within 6 hours (at room temperature) or temperature. However, reports indicate that the ingestion of large amounts of clarithromycin orally can be expected to produce gastrointestinal symptoms. Adverse reactions accompanying oral overdosage should be treated by gastric lavage and supportive measures. As with other macrolides, clarithromycin serum levels are not expected to be appreciably affected by haemodialysis or peritoneal dialysis. One patient who had a history of bipolar disorder ingested 8 g of clarithromycin and showed altered mental status, paranoid behaviour, hypokalaemia and hypoxaemia. The important points to note would be the dosing information, the administration information and recommended dilutents. Children: At present, there are insufficient data to recommend a dosage regime for routine use in children. Renal Impairment: In patients with renal impairment who have creatinine clearance less than 30mL/min, the dosage of clarithromycin should be reduced to one half of the normal recommended dose. Administration information Recommended Administration Clarithromycin should not be given as a bolus or an intramuscular injection. Let us see how this is calculated: Maximum concentration is 2mg/mL, which is equal to: 1 1mg in mL = 0. Other points to note • Contra-indications: hypersensitivity to clarithromycin, otherwise nothing else of note. If you get the wrong answers for any particular section, then you should go back and re-do that section, as it indicates that you have not fully understood that type of calculation. Percentage concentration 28 How much glucose (in grams) is there in a 500 mL infusion of glucose 10%? Parts per million (ppm) strengths 31 If a disinfectant solution contains 1,000 ppm of chlorine, how much chlorine (in grams) would be present in 5 litres? Therefore you have to be able to calculate the number of tablets or capsules needed. Paediatric calculations 40 The dose of morphine for a 6-month-old child (7kg) is 200mcg/kg. Millimoles are used to describe the ‘amount of substance’, and are usually the units for body electrolytes (e. Moles and millimoles 42 Approximately how many millimoles of sodium are there in a 200mL infusion of sodium bicarbonate 8. It is designed to see if you know the different drop factors for different giving sets and fluids, as well as being able to convert volumes to drops and vice versa. Calculation of drip rates 44 What is the drip rate required to give 1 litre of sodium chloride 0. Conversion of dosages to mL/hour Sometimes it may be necessary to convert a dose (mg/min) to an infusion rate (mL/hour). Conversion of mL/hour back to a dose 48 You have enoximone 100 mg in 100 mL and the rate at which the pump is running is 30 mL/hour. Question 3 Answer: 3,200 millilitres L ml 3 2 0 0 1 2 3 The decimal point goes after the final 0. Question 6 Answer: 50,000 micrograms g mg mcg 0 0 5 0 0 0 0 1 2 3 1 2 3 As we are going from grams to micrograms, this is the same as two separate conversions. As the number is divided by 10 six times, this would mean 5 zeros before the 4 (don’t forget that the decimal point is originally after the [4. Question 9 Answer: 500 micrograms digoxin in 2mL First convert milligrams to micrograms. You are going from a larger unit to a smaller unit; so you multiply by 1,000 to remove the decimal point: 0. Chapter 5 Drug strengths or concentrations 187 To find out how much is in a 2mL ampoule, multiply by 2: 50 micrograms × 2 = 100 micrograms Chapter 5 Drug strengths or concentrations Question 1 0. First, ensure units are the same – convert the amount needed to nanograms: 1 micrograms = 1,000 nanograms Each capsule contains 250 nanograms, so how many capsules contain 1,000 nanograms?
If you don’t have creditable prescription drug coverage and delay joining a Medicare drug plan myambutol 600mg visa, you may have to pay a late enrollment penalty to join later myambutol 600 mg discount. Ask your health provider or benefts coordinator if joining a plan is right for you buy myambutol 600 mg without a prescription. See your Indian Words in health provider or check with the benefts coordinator at your local red are Indian health pharmacy to get more information on how to join a defned plan. Ask your Indian health care provider for a letter stating you have creditable prescription drug coverage. Use the personal worksheets on pages 68–69 to help decide which plan meets your needs: Step 1: Prepare—Gather information about your current drug coverage and needs. Step 2: Compare—Compare Medicare drug plans based on cost, coverage, and customer service. Tip: Before considering which Medicare drug plan to join, check out how any current health coverage you have could afect your drug coverage choices. Step 1: Gather information about your current drug coverage and needs Before choosing a Medicare drug plan, you may want to gather some information. You need information about any drug coverage you may currently have, as well as a list of the drugs and doses you currently take. Also, gather any notices you get from Medicare, Social Security, or your current Medicare drug plan about changes to your plan. If you have drug coverage, you need to fnd out whether it’s creditable prescription drug coverage. Your current insurer or plan provider is required to notify you each year whether your coverage is creditable prescription drug coverage. If you haven’t heard from your insurer or plan, call the insurer, your plan, or your benefts administrator to fnd out. Request a notice about whether your coverage is creditable prescription drug coverage if you didn’t get one. Also, you may want to consider keeping your creditable prescription drug coverage rather than choosing a Medicare drug plan. Plan name: Monthly Yearly My drugs My drugs Amount Could I Is mail premium deductible that are that aren’t I’d pay for use my order $ $ covered covered each drug pharmacy? Compare the Medicare drug plans based on what’s most important to your situation and your drug needs. Step 3: Decide which plan is best for you, and join Afer you pick a plan that meets your needs, call the company ofering it and ask how to join. Te frst time you use your new Medicare drug plan, you should come to the pharmacy with as much information as possible. Te pharmacist may have to search for your plan information, and it may take extra time for them to fll your prescription. See the chart on page 34 for a list of some of the letters that confrm you qualify for Extra Help. In some rare cases, the pharmacist may not be able to confrm your plan enrollment or that you qualify for Medicaid or Extra Help. If this happens, your doctor may be able to give you a sample of your drug to help until your coverage is confrmed. You should save the receipts and work with your new Medicare drug plan to get paid back for the drugs that would normally be covered under your plan. Tese plans and people who work with Medicare aren’t allowed to: Charge you a fee to enroll in a plan. During the appointment, they can only try to sell you the products you agreed to hear about. Identity thef happens when someone uses your personal information without your permission to commit fraud or other crimes. Personal information includes things like your name, or your Social Security, Medicare, bank account, or credit card numbers. For more on pages information about identity thef or to fle a complaint online, visit 83–86. What if I need help applying for Extra Help, joining a Medicare drug plan, or requesting a coverage determination or appeal? You may have a legal representative who, by state or federal law, has the legal right (like through a Power of Attorney or a court order) to act on your behalf. You can also appoint a family member, friend, advocate, attorney, doctor, or someone else to act as your representative. A representative can help you (or act on your behalf) apply to see if you qualify for Extra Help paying for Medicare drug coverage, or fle a request for a coverage determination, complaint (also called a “grievance”), or appeal.
Whether a random level can be usefully used to ascertain compliance remains to be determined – although this is probably useful where major non-compliance is possible buy myambutol 600 mg cheap. Unfortunately buy 800 mg myambutol with mastercard, a large number of patients developed aplastic anaemia generic 800 mg myambutol, some with a fatal outcome. This re-emergence of felbamate has not been reported to be accompanied by a corresponding increase in additional cases of aplastic anaemia or hepatitis. Its mechanism of action, and therefore its reported adverse side effects, appears to be similar, but less severe, to that of topiramate. A randomised double-blind placebo-controlled trial of 139 participants aged 430 years showed significant benefit in most seizure types, particularly atonic (‘drop’) and absence 46 seizures. Many other drugs have been used in paediatric epilepsy, usually in an attempt to control multiple and refractory seizure types. Acetazolamide, a diuretic and carbonic anhydrase inhibitor, is considered by many to be a useful add-on drug (usually in combination with 47 carbamazepine) in treating focal seizures. Pyridoxine (vitamin B ) is clearly the treatment of6 48 choice in the rare inherited disorder of pyridoxine-dependent seizures , but it has also been 49 used in West syndrome (infantile spasms). If there has been no obvious or sustained response to pyridoxine, and there remains a high suspicion of pyridoxine-dependent epilepsy, the child should then receive a three- or four-week course of pyridoxal phosphate. Biotin should also be used in infants and young children with refractory seizures pending the result of a serum biotinidase level. Folinic acid should also be used for any infant with neonatal-onset seizures that have been resistant to both conventional antiepileptic medication and pyridoxine and where no cause has been found for the epilepsy. The high-fat, low-carbohydrate ketogenic diet is a historical treatment that has gained more 50 credibility as an effective management of children with drug resistant epilepsy. A randomised controlled trial has demonstrated definitive efficacy over no change in treatment. More relaxed forms of the diet have raised the possibility of it being available to use over a wide age range. Intravenous immunoglobulins have been used with varying (usually very limited), success in ,52,53 intractable epilepsies including children with both the West and Lennox-Gastaut 54,55 syndromes. There are marked variations in the frequency of courses, duration of treatment and doses of this particular therapy and there is as yet no established or universally accepted mechanism of action. Drug choice in childhood epilepsy should, wherever possible, be evidence based as in older individuals. However, there are few randomised controlled trials on which to base drug choice within the epilepsy syndromes. This in part reflects the logistical and ethical difficulties as well as the expense in conducting paediatric trials. Nevertheless, the principal should still be to try and base treatment strategies on robust evidence. They state that focal epilepsies in children older than four years of age have a similar clinical expression to focal epilepsies in adolescents and adults. In refractory focal epilepsies, the results of efficacy trials performed in adults could to some extent be extrapolated to children, provided the appropriate dose and safety data are established. For syndromes limited to childhood, sufficient experience needs to be gained in this 56 population before a new medicinal product may be registered for these indications in children ; predictably such experience is likely to be largely anecdotal unless data can be obtained from well-conducted national or international randomised controlled trials. Many studies are conducted on the basis of seizure type rather than syndrome, are limited in duration and reveal little in the way of long-term effects. Further, a recent randomised double-blind trial in the treatment of childhood absence epilepsy comparing ethosuxuimide, sodium valproate and lamotrigine showed superior efficacy of sodium valproate and 59 ethosuximide over lamotrigine, but some neuropsychological advantage to ethosuximide. There has been increasing concern about the effect of sodium valproate on the unborn child of mothers taking the medication – both an increased risk of malformations, as well as cognitive delay in later childhood. For this reason the medication is not recommended as first line in girls of child-bearing age, and when considered, the risks of taking the medication need to be weighed against the risk of the epilepsy itself in each individual. Epilepsies associated with focal seizures are slightly less common in children in contrast to adults and for these individuals carbamazepine is the usual preferred treatment. Vigabatrin is particularly effective in 12 treating infantile spasms caused by tuberous sclerosis but appears to be slightly less effective 61,62 than tetracosactide or prednisolone in treating spasms due to other aetiologies. However there are currently differences of opinion regarding the treatment of infantile spasms, in part reflecting clinicians’ concerns over drug safety and in part availability of medication. Which is used will depend on family and physician choice, weighing up the risk:benefit of the treatment involved. Although use of vigabatrin in adults and older children has been associated with 21 visual field constriction, this appears to be related to dose and duration of treatment and does not necessarily prevent or reduce the use of this drug in treating infantile spasms when weighed up against the risk of short-term high-dose steroids. In Dravet syndrome, previously called severe myoclonic epilepsy of infancy, medications of choice are sodium valproate, clobazam and topiramate. Furthermore a well-constructed randomised crossover study demonstrated stiripentol, a cytochrome P450 inhibitor, to be 63 significantly more effective than placebo when added to sodium valproate and clobazam ; however, this drug may be associated with significant somnolence as well as loss of appetite. Several studies have been conducted evaluating treatments against placebo in Lennox-Gastaut syndrome as add-on therapy.
Defnition and Diagnosis of Diabetes Mellitus review: The effect of vitamin D on falls: a systematic and Intermediate Hyperglycemia: report of a World review and meta-analysis quality myambutol 800mg. The vicious cycle of diabetes and better lower-extremity function in both active and inactive pregnancy generic 400mg myambutol with mastercard. Artifcial sweeteners--do they Anencephaly before and after folic acid mandate--United bear a carcinogenic risk? Percentage of Vitamin A 400mg myambutol otc, Vitamin K, Arsenic, Boron, Chromium, carbohydrate and glycemic response to breakfast, lunch, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, and dinner in women with gestational diabetes. Breastfeeding and fatty acids and birth outcome: some frst results of the the basal insulin requirement in type 1 diabetic women. Longitudinal changes in selected physical systematic review of outcomes of maternal weight gain capabilities: muscle strength, fexibility and body size. Total energy expenditure in extruding memory T cells as a key feature of age-depen- the elderly. Grip strength changes over 27 yr in Estimating mortality risk in preoperative patients using Japanese-American men. Anorexia and weight loss between cutaneous cellular immune responsiveness and in the elderly. Causes range from loose dentures to debili- mortality in a nursing home population. Bacterial contamination weight on the risk of developing common chronic diseases of the small intestine is an important cause of occult mal- during a 10-year period. Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco body composition based on total-body nitrogen, potas- V. Failure to thrive, sacropenia panic white population: San Luis Valley Health and Aging and functional decline in the elderly. J Gerontol A Biol Sci Med risk screening characteristics of rural older persons: rela- Sci. Anorexia of aging: physiologic and patho- globin and several serum nutritional indicators. Reversal of protein-bound vitamin B12 malabsorp- of refned carbohydrates and the epidemic of type 2 diabe- tion with antibiotics in atrophic gastritis. Nutrition nutrient intakes are common and are associated with low factors in relation to cellular and regulatory immune vari- diet variety in rural, community-dwelling elderly. Do chemosensory changes infuence food intake University of California, Los Angeles. Nutrient intakes of senior women: balancing cholecalciferol absorption in the elderly and in younger the low-fat message. Calcium for prevention of fbers (dietary portfolio) on circulating sterol levels and osteoporotic fractures in postmenopausal women. Direct com- Effect of calcium and vitamin D supplementation on bone parison of a dietary portfolio of cholesterol-lowering foods density in men and women 65 years of age or older. Whole-grain intake age and Helicobacter pylori infection on gastric acid secre- and the risk of type 2 diabetes: a prospective study in men. Carbohydrates, dietary fber, and inci- hypochlorhydria causes high duodenal bacterial counts in dent type 2 diabetes in older women. Oral protein and energy undernourished elderly people: a prospective randomized supplementation in older people: a systematic review of community trial. Energy-dense plementation therapy in depleted patients with chronic meals improve energy intake in elderly residents in a nurs- obstructive pulmonary disease. Nutritional support and quality of life in stable 24-hour nutrient intakes in older adults. Lauque S, Arnaud-Battandier F, Mansourian R, et ment of foods for the elderly on nutritional status: food al. Protein-energy oral supplementation in malnourished intake, biochemical indices, and anthropometric measures. Providing nutrition supplements to institutionalized and nutritional status of elderly nursing home residents. J seniors with probable Alzheimer’s disease is least benef- Gerontol A Biol Sci Med Sci. Enteral (oral or tube administration) nutri- affected by dietary supplements but not by exercise. Improvements in nutritional bers’ preferences for nutrition interventions to improve intake and quality of life among frail homebound older nursing home residents’ oral food and fuid intake. Meal programs improve nutritional risk: a lon- hip fracture aftercare in older people. Changes containing nutritional supplements can affect usual energy in type of foodservice and dining room environment pref- intake postsupplementation in institutionalized seniors erentially beneft institutionalized seniors with low body with probable Alzheimer’s disease. The effect of oral health on diabetes-specifc formulas for patients with diabetes: a quality of life in an underprivileged homebound and non- systematic review and meta-analysis. Vitamins for chronic disease related quality of life of an elderly institutionalized popula- prevention in adults: scientifc review.