Enteral nutrition during multimodality therapy in upper gastrointestinal cancer patients.

Objective: The objective of this study was to evaluate long-term enteral nutrition support in postoperative cancer patients.

Background: Multimodality therapy for surgical patients with upper gastrointestinal malignancies may improve survival, but often results in substantial malnutrition, immunosuppression, and morbidity. The benefits of combined inpatient and outpatient enteral feeding with standard diets or diets supplemented with arginine, RNA + omega-3 fatty acids are unclear.

Surgical critical care for cancer patients.

Progress in cancer surgery and changes in philosophy have resulted in greater numbers of critically ill surgical oncology patients. The effects of cancer and prior exposure to cancer therapies increase the risks for postsurgical problems. Life-threatening cardiopulmonary sequela and patients undergoing liver resections and transplantation are examples of problems that require the knowledge and skill of critical care nurses.

Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome.

The individual nutrients arginine, RNA, and omega-3 fatty acids improve immune function, but prospective trials have not demonstrated their effects on clinical outcome. Patients (n = 85) who underwent operation for upper gastrointestinal malignancies were randomized to receive the supplemental diet or a standard enteral diet after surgery. Clinical patient characteristics were similar between the two groups.

Effects of adrenalectomy and glucocorticosteroid therapy on bone marrow T cells. Effect on T cell traffic and graft-versus-host (GVH) reactivity.

The effects of bilateral adrenalectomy (Ax) and glucocorticosteroid (GCS) treatment on the migratory behavior of circulating T cells in mice were evaluated by a 51Cr lymphocyte migration assay and two graft-versus-host (GVH) assays. The major new findings were that bilaterally adrenalectomizing a mouse effects it in two interrelated ways: 1) It decreases the accumulation of adoptively transferred 51Cr-labeled T cells to the bone marrow; and 2) it reduces the GVH reactivity of bone marrow cells. We also confirmed previous studies showing increases in the accumulation of T cells and increases in T cell-mediated GVH reactivity in the marrow of GCS-treated mice.