A Retrospective Analysis Evaluating the Outcome of Parenteral Nutrition in the Treatment of Anorexia Nervosa in Korea.

The objective of this study was to investigate the clinical efficacy of parenteral nutrition (PN) as supplemental feeding for patients with anorexia nervosa (AN). This study was conducted by reviewing the medical records of patients with AN who were hospitalized at a non-specialized ward. A total of 129 patients with AN were recruited, consisting of 67 patients received PN with oral refeeding and 62 patients received oral refeeding alone. We compared the weight gain at discharge and after discharge between the groups. As a result, at admission, the patients given supplementary PN had lower body mass indices and lower caloric intake than the patients without PN. The mean duration of PN was 8.5 days, which amounted to about a third of the average hospital stay with no difference between the groups. Both groups had similar weight gains during hospitalization, but the patients with PN had higher weight gains than the patients without PN at one and three months after discharge. In conclusion, the results suggest that supplementary PN in the early stage of refeeding might initiate weight gain in AN when nasogastric tube feeding is not possible. Randomized controlled trials are needed to be further tested of PN in treatment of AN.

Learning curves for colonoscopy: a prospective evaluation of gastroenterology fellows at a single center.

BACKGROUND/AIMS: Colonoscopy training programs and the minimal experience with colonoscopy required to be considered technically competent are not well established. The aim of this study was to determine the colonoscopy learning curves and factors associated with this difficult procedure at a single center. METHODS: A total of 3,243 colonoscopies were performed by 12 first-year gastroenterology fellows, and various clinical factors were assessed prospectively for 22 months. Acquisition of competence (success rate) was evaluated based on two objective criteria: (i) the adjusted completion rate (>90%) and (ii) cecal intubation time (<20 minutes). RESULTS: The overall success rate in reaching the cecum in less than 20 minutes was 72.8%. The cecal intubation time was 9.34+/-4.13 minutes (mean+/-SD). Trainees' skill at performing cecal intubation in <20 minutes reached the requisite standard of competence after 200 procedures. Cecal intubation time decreased significantly from 11.3 to 9.4 minutes after 100 procedures and improved continuously thereafter. Female patients and advanced patient age (over 60 years) were associated with prolonged cecal intubation time (>20 minutes). Surgery of the uterus and ovaries was significantly correlated with delayed cecal intubation time, but not after sufficient colonoscopy experience. CONCLUSIONS: The minimum number of procedures to reach technical competence was 200. The cecal intubation time was longer in female and older patients.