No abstract

Objective: Peptide -based (PB) enteral tube feeding (ETF) formulas have been shown to reduce gastrointestinal (GI) intolerance in patients receiving enteral nutrition. However, limited data exist in relation to their use in the postacute/home care setting. We sought to assess the real-world GI tolerance, healthcare utilization, and resource use costs of 100% whey-protein PB ETF in adults in a postacute care setting and describe their demographic, clinical, and treatment characteristics.Method: Using medical claims data from the United States, we analyzed GI intolerance events occurring in adults receiving 100% whey-protein PB ETF (Peptamen ® adult formulas) for one year before and after initiation of ETF. Resource use costs were subsequently estimated using a multivariate general linearized model and adjusted for age, gender, and Charlson Comorbidity Index score.

Introduction: Gastro-oesophageal reflux disease (GORD) is a common problem in the Western countries, and the interest in the minimal access surgical approaches to treat GORD is increasing. In this study, we would like to discuss the presentations and management of complications we encountered after Laparoscopic Nissen's fundoplication in our District General NHS Hospital. The aim is to recognise these complications at the earliest stage for effective management to minimise the morbidity and mortality.

Generally, laparotomy is performed for diagnosis and management in acute bowel obstruction, but with increasing expertise, laparoscopy can be equally effective with all the other advantages of minimal access approach.

The introduction of laparoscopic hernia repair into the National Health Services (NHS) gave us an opportunity to study the feasibility and practicality of carrying out this modern hernia repair technique in a district general NHS hospital. The laparoscopic tension-free transabdominal preperitoneal (TAPP) method of hernia repair, as we do it, is cost-effective and efficacious. Most patients can be treated as day cases. We discovered incidental hernias in 18.8% of patients, which were treated simultaneously. A low recurrence rate (0.17%) with low morbidity makes it an attractive method for routine treatment of groin hernias in the NHS.