Jomyaku Keicho Eiyo

Background: The most of dialysis patients are suffered from constipation, and constipation occurs high frequently in hemodialysispatients than in continuous ambulatory peritoneal dialysis patients. Low total dietary fiber intake may cause the high prevalence of constipation in hemodialysis patients.
Objectives: To investigate whether administration of partially hydrolyzed guar gum improves defecation and nutritional status of dialysis patients.
Methods: Thirty-three patients on maintenance dialysis (mean age, 71 he high prevalence of constipattes/non-diabetes = 13/20) ingested partially hydrolyzed guar gum (PHGG) (10 g/day) for 6 weeks. Defecation before and after PHGG intake was scored by usingConstipation Assessment Scale-Long Term (Japanese version). Nutritional status was rated according to Geriatric Nutritional Risk Index (GNRI) before and after intake of PHGG.
Results: Constipation score decreased from4.5 to 3.0 (p<0.05) and GNRI increased from 95.0 to 95.9 (p<0.05).
Conclusion: Our results indicate that consumption of PHGG improves defecation and nutritional status.

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Purpose: The purpose of this study is to examine the stability of lipid particles in a lipid emulsion administered as a secondary piggyback infusion through primary TPN infusion line.
Methods: Gross-and-micro observation was performed, and the mean droplet size and large diameter tail (over 5 μm) were evaluated in a mixture of lipid emulsion and TPN fluid (supplemented with vitamins and minerals) administered at 100 mL/h, and in a lipid emulsion given by piggyback administration (at 100, 50, 33, 25, 20, and 17 mL/h) through TPN infusion line (at 100 mL/h).
Results: In the mixture, the mean particle size was not changed, but the volume of the large diameter tail increased after 2 h and exceeded the USP reference standard that percentage lipid over 5 μm should not exceed 0.05% of the total lipid. However, piggy administration of the lipid emulsion did not cause changes in the appearance, mean particle size of droplets, and extent of large diameter tails, enabling it to be kept under the reference value.
Conclusion: The results of the study showed that piggyback administration of lipid emulsion through primary TPN infusion line did not significantly change the mean particle size or coarsen the lipid particles, suggesting that the lipid emulsion meets the proposed USP standard and can be safely administered by this method.

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Objective: The 10-item Eating Assessment Tool (EAT-10) is specifically designed to address the clinical need for a rapidly self-administered and easily-scored questionnaire to assess dysphagia symptom severity. An EAT-10 score above 3 is abnormal and indicates the presence of swallowing difficulties. We translated the EAT-10 into Japanese, and studied the reliability and validity of the Japanese version of the EAT-10.
Method: Translation of EAT-10 was implemented in iterative process including forward translation, expert panel back-translation, and pre-testing. A cross-sectional study was performed in 393 elderly aged 65 years and above with dysphagia or suspected dysphagia. Severity of dysphagia was assessed by the Dysphagia Severity Scale (DSS). For assessment of reliability, we used Cronbach' s alpha coefficient. Validity was evaluated by examining the associations between the EAT-10 score and the DSS by Spearman's rank correlation coefficient. The sensitivity and specificity of the EAT-10 for dysphagia were also assessed.
Results: A total of 237 patients (60%) responded to the EAT-10. Cronbach' s alpha coefficient was 0.946. Elderly who could not respond to the EAT-10 were likely to have dysphagia. Median EAT-10 score of 237 respondents was 1 (0, 9), and 101 respondents were more than 3. There were significant correlations between the EAT-10 score and the DSS (r=-0.530, p<0.001). The sensitivity and specificity of EAT-10 with a score 3 or above for dysphagia were 0.522 and 0.897, for dysphagia with aspiration were 0.758 and 0.749, respectively.
Conclusion: The Japanese version of the EAT-10 is a useful swallowing screening tool.

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