Percutaneous endoscopic gastrostomy (PEG) has evolved into a common low-risk procedure in current medical practice. Clinical evidence supporting the use of tube feedings in patients with advanced dementia is clearly lacking, yet PEG procedures continue to be performed in a large number of these cases. In fact, multiple studies have shown that feeding tubes seldom are effective in improving nutrition, maintaining skin integrity by increased protein intake, preventing aspiration pneumonia, minimizing suffering, improving functional status, or extending life. The decision-making process is complicated, however, and involves the clinician considering such issues as advance directives, ethical considerations, legal/financial concerns, emotional factors, cultural background, religious beliefs, and the need for a family meeting incorporating all of these principles.
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Comparison of two in vitro methods progressed in a computer-controlled simulated digestion system to determine amino acid digestibility of feed ingredients for yellow-feathered roosters.
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The State Key Laboratory of Animal Nutrition and Feeding, Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing 100193, China. Electronic address:
This experiment compared amino acid (AA) digestibility assessed by 2 in vitro methods using a computer-controlled simulated digestion system and in vivo assay for corn, soybean meal, casein, corn gluten meal, cottonseed meal, rapeseed meal and a corn-soybean meal diet. In vitro method 1 simulated gizzard digestion at pH 2.0, followed by small intestinal digestion, and the subsequent clearance of the digested product from dialysis tubing.
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Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA; Cincinnati Center of Excellence for Intestinal Rehabilitation (CinCEIR), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address:
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