Sometimes it is possible to differentiate whether the aspirate is gastric or pharyngeal. The kind of bacterial contamination is, however, more difficult to establish. Oral or dental disease, antibiotic therapy, systemic illness or malnutrition and reduction of salivary flow are responsible for colonization of Gram-negative bacteria in oral and pharyngeal flora in nasogastric-tube-fed patients. The use of a nasogastric feeding tube and the administration of food increase gastric pH and lead to colonization of gastric secretions. It has also been suggested that gastric bacteria could migrate upward along the tube and colonize the pharynx.
A relatively increased amount of total body water and a relative increase in extracellular water will result in an underestimation of the percentage of body fat and an overestimation of fat-free mass in the morbid obesity state. A different body build disposition (mainly in those with severe abdominal obesity) will result in an overestimation of the percentage of body fat. New equations are needed to validate bioelectrical impedance analysis in morbidly obese patients.
This study provides the first estimates of adductor pollicis muscle thickness in normal healthy individuals. The adductor pollicis muscle has a positive correlation with anthropometric variables that estimate muscle mass, but fails to correlate with parameters that estimate fat mass. This measurement is now being evaluated as an anthropometric parameter in clinical studies.
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