BASICS IN CLINICAL NUTRITION

NEW - 3rd EDITION!

COMMENTARY 
ON THE 3RD EDITION 

It has been a great honor and a wonderful opportunity for me to have been invited to participate in the preparation of this 3rd edition of "Basics in Clinical Nutrition" by the eminently qualified, talented and experienced Editor-in-Chief, Professor Luboš Sobotka, who has directed the production of a most appropriate, succinct, important, useful, scholarly and educational volume, espousing the principles, practices and standards which are essential for the confident understanding and competent provision of optimal clinical nutritional support. His Associate Editors not only rank among the most distinguished, accomplished, respected and finest nutritional clinician - scientists in Europe, but also in the World. Simon Allison, Peter Fürst, Rémy Meier, Marek Pertkiewicz and Peter Soeters are a veritable "Who's Who" of basic and clinical nutritional experts, who have already earned their distinction as gifted, energetic and innovative investigators, teachers, practitioners, writers, advocates and leaders in all aspects of the vital field of nutritional support. They have diligently and capably applied their innate and acquired qualities and talents throughout this comprehensive work product, together with their outstanding group of authors and co-authors, to provide a landmark manual which will undoubtedly serve the needs of the entire range of individuals interested in providing safe and competent nutritional support, from the novice students to the most experienced practitioners of the art and science of clinical nutrition. A unique aspect of this volume is that it concisely, and virtually completely, presents the key information required for a thorough understanding of the full spectrum of nutritional support from the basic fundamentals of nutritional biochemistry to the practical essentials in the successful management of the most critically ill and malnourished patients in a wide variety of conditions and situations. Thus, it can serve aptly and concurrently as both a basic reference tome and as a convenient and practical handbook.

It has been an additional honor and great privilege for me to have had the opportunity to collaborate with my good friend and respected colleague, Dr. Marek Pertkiewicz, at his most kind and generous invitation, in the final editing of his many contributions to this 3rd Edition. I look forward to continuing my cherished association with him, his co-authors, the Associate Editors and the Editor-in-Chief of "Basics in Clinical Nutrition" in the future.

It has been a source of immense satisfaction and joy for me to have lived through a most exciting era of basic discovery and efficacious clinical application of countless modalities and technological advances of nutritional and metabolic support to the rational management of a wide variety of nutritionally deficient and/or critically ill patients in all medical and surgical disciplines. Measures for reducing the morbidity and mortality associated with all major pathophysiologic conditions, and their management, by improving the nutritional status of patients have expanded vastly from the simple peripheral intravenous infusion of isotonic carbohydrate and electrolyte solutions to the complex and sophisticated parenteral and enteral provision of most or all of the nutrient requirements in myriad clinical situations during my professional lifetime of more than four decades. Today, clinical nutrition is advancing rapidly toward the provision of optimal nutrient substrates to individual cells or groups of cells, whether normal or compromised, and in reality represents the practice of clinical biochemistry. The continuing identification and classification of genetic control of all metabolic events in human beings is well on its way, and upon its completion, nutritional support will acquire an unprecedented degree of precision; and this molecular biologic revolution will transform the practice of medicine and surgery forever. A more recent genuine and heartfelt gratification for me has been the growth and development of invaluable and productive personal and professional relationships which have been spawned by the cooperation and collaboration among the nutritional clinician scientists throughout the world, but especially among those in Europe and the United States. This volume is exemplary evidence of some of the most objective and tangible success of our mutual endeavors.

Total parenteral nutrition, inaugurated successfully as a useful basic clinical nutritional technique almost forty years ago, has been instrumental in saving countless lives and has demonstrated emphatically the relevance of adequate nutritional support and nutrition status to achieving optimal clinical outcomes. These results have subsequently led to the monumental increase in the development and application of enteral feedings in patients with functioning gastrointestinal tracts, but whose oral intakes are inadequate to support normal bodily structure and functions. Furthermore, the consequent obvious need for specialized ambulatory and home parenteral and enteral nutritional support has fostered and advanced the unbridled development of home health care and home nutritional support. Future innovative techniques, together with the natural maturation and modifications of medical technology and practices that are occurring, will continue to occur are most exciting, promising, almost incomprehensible and seemingly unlimited.

This 3rd edition of "Basics in Clinical Nutrition" is the invaluable result of the conscientious, able and unselfish efforts of the many contributors to help all of us obtain proficiency in, or remain abreast of, the many advances in this rapidly changing field. The 2nd edition, which has served so admirably to fulfil this purpose in recent years, has been so popular among nutrition support aspirants, advocates, and practitioners that it is currently out of print, and additional copies have not been available for quite some time. In a most outstanding manner, this 3rd edition fills that void most effectively and provides our highly motivated colleagues with all of the tools and knowledge currently available and validated in order to fulfil our mutual dream and goal of providing optimal nutrition to all patients, under all conditions, at all times.

Stanley J. Dudrick, MD, FACS
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