Saint Louis University

About: Saint Louis University is a education organization based out in St Louis, Missouri, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 18927 authors who have published 34895 publications receiving 1267475 citations. The organization is also known as: SLU & St. Louis University.

Tracheobronchial aspiration of gastric contents in critically ill tube-fed patients: frequency, outcomes, and risk factors.

Abstract: Tracheobronchial aspiration can be defined as the inhalation of oropharyngeal or gastric contents into the respiratory tract (1). Although aspiration from either source is important, the type of greatest concern in critically ill tube-fed patients is tracheobronchial aspiration of gastric contents. The extent to which aspiration of gastric contents occurs is difficult to determine, primarily because most clinical studies have relied on flawed detection methods (such as observing tracheal secretions for dye-stained formula or glucose) (2–7). Nonetheless, there is evidence that it is a formidable problem. For example, a recent study found that 30 of 40 critically ill patients who received enteral formula stained with yellow microscopic beads had at least one episode of aspiration (as defined by detection of a yellow color in tracheal secretions by fluorometry) (8). The mean percentage of samples containing colored beads was 22.1% (range, 0% to 94%). Aspiration of gastric contents is a recognized risk factor for ventilator-associated pneumonia in critically ill patients (9–12). However, more information is needed to determine the extent to which the frequency of tracheobronchial aspiration of gastric contents predisposes to pneumonia and other adverse outcomes. This was an analysis to determine the occurrence of aspiration as a risk factor for pneumonia and as a determinant of clinical outcomes in comparison with other factors.

Sarcopenia: A Time for Action. An SCWD Position Paper.

Abstract: The term sarcopenia was introduced in 1988. The original definition was a "muscle loss" of the appendicular muscle mass in the older people as measured by dual energy x-ray absorptiometry (DXA). In 2010, the definition was altered to be low muscle mass together with low muscle function and this was agreed upon as reported in a number of consensus papers. The Society of Sarcopenia, Cachexia and Wasting Disorders supports the recommendations of more recent consensus conferences, i.e. that rapid screening, such as with the SARC-F questionnaire, should be utilized with a formal diagnosis being made by measuring grip strength or chair stand together with DXA estimation of appendicular muscle mass (indexed for height2). Assessments of the utility of ultrasound and creatine dilution techniques are ongoing. Use of ultrasound may not be easily reproducible. Primary sarcopenia is aging associated (mediated) loss of muscle mass. Secondary sarcopenia (or disease-related sarcopenia) has predominantly focused on loss of muscle mass without the emphasis on muscle function. Diseases that can cause muscle wasting (i.e. secondary sarcopenia) include malignant cancer, COPD, heart failure, and renal failure and others. Management of sarcopenia should consist of resistance exercise in combination with a protein intake of 1 to 1.5 g/kg/day. There is insufficient evidence that vitamin D and anabolic steroids are beneficial. These recommendations apply to both primary (age-related) sarcopenia and secondary (disease related) sarcopenia. Secondary sarcopenia also needs appropriate treatment of the underlying disease. It is important that primary care health professionals become aware of and make the diagnosis of age-related and disease-related sarcopenia. It is important to address the risk factors for sarcopenia, particularly low physical activity and sedentary behavior in the general population, using a life-long approach. There is a need for more clinical research into the appropriate measurement for muscle mass and the management of sarcopenia. Accordingly, this position statement provides recommendations on the management of sarcopenia and how to progress the knowledge and recognition of sarcopenia.

Stealth Marketing: How to Reach Consumers Surreptitiously

Abstract: Stealth marketing techniques are being driven by a growing criticism of the advertising industry, and are based on the premise that word of mouth and peer group recommendation are the most effective promotional and marketing tools.This article discusses stealth marketing methods used by companies to reach consumers without their motives being obvious. The authors feel that brand managers need to consider the strengths and weaknesses of stealth marketing and traditional marketing before they decide on either.