Impact of a multidisciplinary nutritional support team on quality improvement for patients receiving home parenteral nutrition.

Introduction: Home parenteral nutrition (HPN) is essential for patients with intestinal failure requiring long-term nutritional support. The Amerita Quality Improvement Project for HPN Patients (QIP-PN) explored the effect of a physician nutrition expert (PNE)-led multidisciplinary nutritional support team (MNST) on HPN care for patients under its service.

Objective: To determine an MNST effect on adherence to protocols, outcomes and quality of life (QOL) in HPN.

Resolution of Severe Gastric Dysmotility Disorder With Acupuncture.

Background: Patients with severe gastric dysmotility disorder (SGDD) often require parenteral nutrition or jejunostomy feeding. They frequently need long-life gastrostomy drainage tubes for gastric discharge and decompression. Currently few medical options exist for postoperative management.

Micronutrient-responsive cerebral dysfunction other than Wernicke's encephalopathy after malabsorptive surgery.

Background: Micronutrient-responsive cerebral dysfunction (MRCD) is known to occur after gastric restrictive and malabsorptive weight loss surgery. Wernicke's encephalopathy (WE) is often considered the etiology, but many cases without thiamine deficiency have been reported. It is important to recognize that other micronutrient-responsive cerebral dysfunctions exist in this high-risk group.

Reversible neurologic dysfunction caused by severe vitamin deficiency after malabsorptive bariatric surgery.

Significant deficiencies of both fat- and water-soluble vitamins have been reported to occur after malabsorptive bariatric surgery. However, despite the potential for neurologic manifestations of such deficiencies, few cases of central neurologic dysfunction have been reported. Our group previously reported reversible neurologic dysfunction as an unusual manifestation of vitamin deficiency in a postjejunoileostomy patient.