PAUL JAY FRIEDMAN, M.D.
FRIEDMAN PJ. Total Parenteral Nutrition in Malignancy. Ann Intern Med. 1985;102:556-557. doi: 10.7326/0003-4819-102-4-556_2
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Published: Ann Intern Med. 1985;102(4):556-557.
To the editor: Shike and associates (1) showed that when total parenteral nutrition is used unnecessarily it raises the cost of medical care and prolongs hospitalization without corresponding benefit. On what basis did the Human Experimentation Committee at the University of Toronto approve aggressive nutritional support for patients at ideal body weight with initially trivial weight loss and adequate caloric intake to maintain body weight in sedentary subjects (1806 ± 131 kcal/d in controls)? As shown in Figure 4 (1), mortality at 6, 12, and 18 months was slightly higher in the study group than in controls. The substantial cost
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