bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Esophageal Anastomotic Leakages after Cancer Resection. The Role of Total Parenteral Nutrition
Authors: Riboli E. Berti , Bertoglio S. , Arnulfo G. , Terrizzi A. 
Published: May 2008

A series of 16 cases of esophageal anastomotic leakages after cancer resection observed from 1978 to 1982 is analyzed in a retrospective manner. Eight patients related to the period 1978 to 1980 (series A) were treated with emergency surgery while the remaining eight patients observed from 1980 to 1982 (series B) were treated conservatively with total parenteral nutrition (TPN) and complete fasting.Seven patients from series A eventually died postoperatively and one patient had a good recovery after emergency reintervention. In the series B six patients left the hospital with complete healing of the anastomotic leaks after 27.2 ± 13.5 days of TPN and complete fasting, while failure of the treatment was observed in two patients who died from septic mediastinitis and acute respiratory failure. Different incidence of positive clinical results in Series A and B was statistically significant (p < 0.01).The role of TPN and complete fasting will be discussed as the primary approach for the management of this severe complication, taking in consideration the suture line drainage and the control of infection. (Journal of Parenteral and Enteral Nutrition 10:82–85, 1986)
Nutritional Assessment of Pediatric Patients Admitted to an Acute‐Care Pediatric Service Utilizing Anthropometric Measurements
Authors: Leleiko Neal S. , Luder Elisabeth , Fridman Morton , Fersel Jordan , Benkov Keith 
Published: May 2008

Two hundred consecutive pediatric patients were given a nutritional assessment at the time of their admission to the hospital. A weight‐for‐height below the 5th percentile was an indication of acute depletion and a height‐for‐age below the 5th percentile a sign of chronic depletion. Measurement of weight‐for‐height and/or height‐for‐age was below the 5th percentile in 32% of those assessed. Seventy‐five percent of the acutely depleted children and 60% of the acute and chronically depleted children had midarm circumferences below the 5th percentile. Midarm muscle circumference below the 5th percentile was significantly more prevalent in all the depleted children.This paper reports the results of our study of the objective (quantitative) elements of our nutritional assessment. These measurements indicate that a significant number of patients are at nutritional risk at the time they are admitted to the hospital.An adequate nutritional assessment cannot be limited to objective considerations, however. A complete medical evaluation of the patient is required, including objective and subjective considerations. (Journal of Parenteral and Enteral Nutrition 10:166–168, 1986)
Effects of Nutrition on Plasma, Liver and Muscle Amino Acids in Scalded Rats
Authors: Karner J. , Roth E. , Funovics J. , Hanusch J. , Walzer L.R. , Berger A. , Meissl G. 
Published: May 2008

This study set out to investigate the effect of three different parenterally administered diets on the free amino acid (AA) levels in the plasma, muscle, and liver of scalded rats. Diet I consisted of AA (1.4 g/100 g weight) and a high glucose dose (6 g/100 g weight), diet II consisted of AA and a low glucose dose (1.4 g/100 g weight) and in diet III only a low glucose dose was infused. Parenteral nutrition was started on the 3rd day posttraumatically. Sampling was performed on the 7th day posttraumatically.Nitrogen balances were significantly different in all three groups, being lowest in group III. Scalded rats fed isonitrogenously, but with different amounts of glucose showed only minor changes in AA concentrations. However scalded rats fed with a nitrogen‐free diet exhibited significantly reduced total muscle and liver AA levels. These decreased AA levels were due to a drop of glycine in the muscle tissue (74%) and liver (49%). Contrary to the clinical catabolic situation in scalded and starved rats, it was not intracellular glutamine but glycine which was considerably influenced by catabolism and starvation. (Journal of Parenteral and Enteral Nutrition 10:393–398, 1986)
Energy Metabolism and Substrate Oxidation as Possible Factors for Net Protein Accretion in Growing Rats
Authors: Lindmark L. , Martins F. , Lundholm K. 
Published: May 2008

This study describes an experimental model with growing rats in which we have measured energy expenditure and substrate oxidation as possible factors for regulation of net protein synthesis in intravenously fed growing rats. Orally fed rats were used as a reference group.Rats were given intravenous nutrition for 10 days at a high (350 kcal/kg/day) and a low (270 kcal/kg/day) energy level with four different fat‐to‐carbohydrate compositions at each energy level: N (no fat), L (low fat, 6% nonprotein calories), M (medium fat, 30% nonprotein calories) and H (high fat, 60% nonprotein calories). Continuous O2‐consumption and CO2 production of the animals were measured. Whole body substrate oxidation was calculated from respiratory gas exchange and nitrogen excretion. Body composition was assessed in all animals at the end of infusions.Energy balance with zero growth was reached at 240 kcal/ kg/day. Growth rate was normal in animals receiving 350 kcal/ kg/day compared with freely eating reference animals irrespective of the glucose‐to‐fat ratio of the intravenous solutions. Animals on 270 kcal/kg/day showed retarded growth rate, but the differences in growth rate among the groups were mainly explained by carcass fat. Net protein accretion did not differ among most of the groups irrespective of intravenous or oral intake at different levels. The whole body oxidation rate of glucose was directly proportional to the infusion rate of glucose, while the net fat oxidation was inversely correlated to the infusion rate of glucose. The oxidation rate of amino acids and proteins was not directly correlated to the oxidation of glucose or fat. Oxidation of proteins was quantitatively the same in animals on 350 kcal/kg/day and freely fed reference animals, but it was elevated in rats on 270 kcal/kg/day. The energy cost for net protein accretion was higher in rats receiving mainly fat (60 energy%) as nonprotein calories at 270 kcal/kg/day.The results show that growth rate is determined by factors that are not directly related to the oxidation rate of carbohydrates and fat above energy balance. We suggest that normal growth is achieved only at a certain intake of amino acids. Below the level net protein synthesis starts to fall irrespective of the nonprotein intake. (Journal of Parenteral and Enteral Nutrition 10:463–469, 1986)
Clinical Experience with the Multiple Lumen Central Venous Catheter
Authors: Kaufman Jeffrey L. , Rodriguez Jorge L. , McFadden John A. , Brolin Robert E. 
Published: May 2008

One hundred four multiple lumen central venous catheters (MLC) were evaluated in 74 seriously ill patients. Eighty percent of the catheters were placed in an intensive care unit. Each MLC served as access for a mean of 4.5 different functions, including infusions, central venous monitoring and phlebotomy. Complications occurred with 16 MLC (15.4%), including two aberrant placements, 10 mechanical problems, and four septic catheters (3.8%). Simultaneous administration of TPN and other infusions through MLC did not affect the rate of catheter sepsis.MLC are well tolerated and cost effective. They increase the comfort of patients who require complex venous access or who lack peripheral veins. They allow safe concurrent administration of TPN, medications, and central venous monitoring. (Journal of Parenteral and Enteral Nutrition 10:487–489,1986)
Endoscopic, Radiographic, and Clinical Response to Prolonged Bowel Rest and Home Parenteral Nutrition in Crohn's Disease
Authors: Kushner Robert F. , Shapir Jonathan , Sitrin Michael D. 
Published: May 2008

Total parenteral nutrition is widely used as a therapeutic measure is patients with severe, active Crohn's disease unresponsive to conventional medical management. We have reviewed our experience with 10 patients with nonfistulous Crohn's disease treated by home parenteral nutrition (HPN) and bowel rest (nothing‐by‐mouth) assessing the nutritional, radiologic, endoscopic, and clincial responses. After a mean of 4.1 months of treatment, all patients had a marked improvement in nutritional status and resolution of gastrointestinal symptoms; 90% reduced their corticosteroid dose. Eight of nine patients had endoscopic and/or radiographic evidence of mucosal healing. Although 60% of patients were able to avoid surgery and tolerate refeeding, all six patients continue to require steroids to control symptoms.Our study suggests that HPN and bowel rest is a useful therapeutic approach to selected patients with active Crohn's disease, which permits a reduction in corticosteroid dosage and partial healing of mucosal lesions in most. Further studies are required to determine which patients should receive HPN and its optimal duration. (Journal of Parenteral and Enteral Nutrition 10:568–573, 1986)
Protein Synthesis in Skeletal Muscle in Relation to Nitrogen Balance after Abdominal Surgery: The Effect of Total Parenteral Nutrition
Authors: Wernerman Jan , Von Der Decken Alexandra , Vinnars Erik 
Published: May 2008

Protein synthesis in skeletal muscle was studied in patients after elective abdominal surgery, using the concentration and size distribution of ribosomes. The patients were given either an electrolyte solution or total parenteral nutrition postoperatively. The analyses were performed on muscle biopsy specimens taken prior to surgery and on days 1 and 3 following surgery.The percentage content of polyribosomes, total ribosome concentration and the polyribosome concentrations per milligram of tissue DNA were determined. Elective abdominal surgery caused a significant decrease (p < 0.05) in the three variables. Total parenteral nutrition did not prevent the decrease. The negative nitrogen balance was significantly improved by total parenteral nutrition, but it did not reach equilibrium. The results show that total parenteral nutrition given postoperatively did not maintain protein synthesis activity in skeletal muscle. The improvement in nitrogen balance suggests that amino acids are utilized by tissues other than skeletal muscle. (Journal of Parenteral and Enteral Nutrition 10:578–582, 1986)
Use of an Intercostal Vein for Central Venous Access in Home Parenteral Nutrition: A Case Report
Authors: Lammermeier David , Steiger Ezra , Cosgrove Delos , Zelch Margaret 
Published: May 2008

A key factor in the success of a home parenteral nutrition program is prolonged and safe access to the central venous system. There are some patients, however, in whom the cephalic, external jugular, internal jugular, subclavian, and saphenous veins cannot be used. In these patients, cannulation of an intercostal vein can be useful for central venous access. Such a patient was recently presented to our medical care facility with bilateral subclavian vein thrombosis, left external iliac vein thrombosis, and superior vena cava obstruction above the level of the azygous vein.A Broviac catheter was successfully introduced via a right intercostal vein cutdown with the catheter tip lying in the azygous arch. This is the first known description in an adult patient in the use of an intercostal vein to gain access into the central venous system. (Journal of Parenteral and Enteral Nutrition 10:659–661, 1986)
Studies on the Tolerance of Medium Chain Triglycerides in Dogs
Authors: Grancher Denis , Jean‐Blain Claude , Frey Anny , Schirardin Henri , Bach André C. 
Published: May 2008

Two groups of five conscious dogs received total parenteral nutrition (about 100 kcal/kg body weight per 24 hr) continuously for 96 hr (0.28 g triglycerides/kg body weight per hr, constituting more than 55% of the energy supply). The only difference between the two groups was the nature of the 20% lipid emulsion. In one group, this emulsion contained only long‐chain triglycerides (LCTs), and in the other it contained a mixture (vol/vol) of medium chain triglycerides (MCTs) and LCTs. MCTs thus were given in an amount of about 30% of the total energy supplied.During infusion with the MCT/LCT mixture, C8, C10, and C12 fatty acids appeared in the total plasma fatty acids. When the infusion was stopped, the medium‐chain fatty acids disappeared; those with shorter chains did so more rapidly. The plasma triglyceride clearance was faster for the MCT/LCT mixture than for the LCTs, whereas phospholipid and cholesterol clearance seemed slower for the MCT/LCT mixture. With this mixture, there was a slight increase in the plasma concentrations of ketone bodies, lactate, and pyruvate, and a slight decrease in plasma glucose. The MCT/LCT mixture was well tolerated, causing no discernible problems, and, in particular, no signs of narcosis or encephalopathy. (Journal of Parenteral and Enteral Nutrition11:280–286, 1987)
Studies on the Toxicity and Efficacy of a New Amino Acid Solution in Pediatric Parenteral Nutrition
Authors: Coran Arnold G. , Drongqwski Robert A. 
Published: May 2008

The optimum composition and concentration of crystalline amino acid solutions necessary for growth and brain maturation in critically ill infants requiring total parenteral nutrition (TPN) are unknown. Either an excess or a deficiency of amino acids could theoretically impair normal brain development in the neonate. The purpose of this study was to compare the toxicity and efficacy of two intravenous amino acid solutions, Neopham, modeled after the amino acid pattern found in human breast milk, and Aminosyn, a marketed product, designed for general usage.Sixteen infants and children requiring continuous intravenous nutrition for at least 7 days received the Neopham amino acid solution, and eight infants and children received the Aminosyn amino acid solution as part of a total parenteral nutrition regimen which included glucose, the fat emulsion Intralipid, as well as routine mineral and vitamin additives.There were no significant differences in mean gestational age, body weight, postnatal age, or mean daily nutrient intake between the patients receiving Aminosyn or Neopham. The daily nitrogen intake, excretion, and retention were similar in both groups. In addition, there were no statistically significant differences in either hematological or biochemical parameters between the two study groups.The plasma levels of three essential amino acids, isoleucine, methionine, and valine, rose significantly higher in the Aminosyn‐treated patients. The plasma levels of all the essential amino acids increased in both study groups. (Journal of Parenteral and Enteral Nutrition 11:368–377, 1987)
A Comparison of Intestinal Adaptation to Short‐Term Intravenous Versus Intragastric Diet in Adult Rats
Authors: Raul Francis , Galluser Michel , Doffoel Michel 
Published: May 2008

This study was designed to determine, on intestinal function, the comparative effects of a fat emulsion, a carbohydrate solution, and a mixture of lipids and carbohydrates given for 4 days to adult rats either intragastrically or intravenously. The rats were separated into three groups (n = 24 in each group). Each group was divided into two populations fed either intragastrically or intravenously. Each group received one of the following nutrients: a 20% Intralipid emulsion, a mixture (1:1, V/V) of Intralipid 20% and Vamine N containing 25% glucose (W/V), a solution of Vamine‐glucose supplemented with fructose to reach a final concentration of 20% (W/V). Sham‐operated rats that received laboratory chow orally were used as controls. The daily caloric intake was 0.21 to 0.22 kcal/g body weight. The studies on villus morphology and on brush border enzyme activities were performed on the proximal part of the jejunum. For all nutrients, intragastric infusion provoked an increase in the villus height. The lipids were the only nutrients to cause villus lengthening by the intravenous route. Intragastric or intravenous infusion of fat provoked a deficiency in intestinal disaccharidases: the presence of carbohydrates in the diet inhibited this effect slightly. Carbohydrates given alone, either intragastrically or intravenously, caused an elevation of lactase activity. Independent of diet composition, aminopeptidase activity was reduced after intravenous feeding.In conclusion, the disaccharidase activities are largely dependent on changes occurring in the nutrient composition given either intragastrically or intravenously, whereas aminopeptidase activity was related to the route of diet administration. (Journal of Parenteral and Enteral Nutrition 11:389–393, 1987)
Assessment of an Automated Chemiluminescence Nitrogen Analyzer for Routine Use in Clinical Nutrition
Authors: Grimble George K. , West Malcolm F.E. , Acuti Aldo B.C. , Rees Roger G. , Hunjan Manjit K. , Webster Joan D. , Frost Peter G. , Silk David B.A. 
Published: May 2008

An automated method of chemiluminescence analysis of nitrogen used routinely for 4 yr. Liquid samples (urine, enteral, and parenteral feeds) required simple dilution, whereas feces required a modified acid‐digestion procedure, before analysis.For urine samples, the coefficient of variation was within batch from 0.9–3.6%, and between batch 4.3–7.6%. At a sample injection rate of 2 μl/sec, the useful dynamic range, for urine diluted 1:200, was 0–14 g N/liter. Precision for fecal nitrogen analysis was 3.8–6.7% for samples of low to high nitrogen content. The correlation between this technique and an established Kjeldahl method for fecal analysis was studied (r = 0.96, slope = 1.30). The discrepancy between the methods was due to inefficient conversion of nitrogen to NH4 + during Kjeldahl digestion of feces, rather than systematic errors in chemiluminescence analysis.Reliability was as good as for other automated clinical analyzers and sample cost was ca. £0.22. It has proved possible to analyze approximately 80 samples in the working day.The efficiency of measuring 24‐hr urine urea‐nitrogen (UUN) and total urine nitrogen (TUN) in patients on general wards was measured. Results were obtained on 87% of TPN days, but large variations were noted in UUN/TUN from <30% to >90% (average 75.7%) in patients receiving TPN, and from <55% to 100% (average 83.8%) in patients receiving enteral nutrition. In contrast, UUN/TUN was 87.0% and 84.0% in healthy subjects, fasted or receiving iv nutrition, respectively.We therefore expect that clinical nutritionists will find increasing applications for this method of nitrogen analysis. (Journal of Parenteral and Enteral Nutrition 12:100–106, 1988)
Elimination and Metabolism of a Fat Emulsion Containing Medium Chain Triglycerides (Lipofundin MCT 10%)
Authors: Julius Ulrich , Leonhardt Wolfgang 
Published: May 2008

Medium chain triglycerides (MCT) are supposed to be advantageous on account of rapid energy supply in parental nutrition. However, data on the elimination rate of MCT‐containing emulsions during an intravenous fat‐tolerance test (IVFTT) are scarce. We performed this test (0.1 g lipid/kg body weight) in 18 young healthy volunteers (nine females and nine males) using Lipofundin MCT 10% (50% MCT; egg phospholipids as emulsifier). Our results indicate that both elimination and metabolization of the emulsion are fast: a prompt decrease of light‐scattering index and of triglyceride concentrations in serum, an immediate appearance of post‐load fatty acids and of β‐hydroxybutyrate were observed. This was in good agreement with the findings obtained during 6‐hr infusions in the same probands.Fractional elimination rates k2obtained from light‐scattering indices are 7.29 ± 2.73%/min in males and 11.59 ± 3.38%/ min in females, indicating a higher removal capacity in women. In the same subjects, the corresponding k2 values for Lipofundin S 10% (containing only long chain triglycerides) were higher, reflecting an elimination rate that is faster due to the use of soya bean phospholipids as emulsifier. In comparison, k2 values based on the course of the triglyceride concentrations are generally lower. (Journal of Parenteral and Enteral Nutrition12:116–120, 1988)
Tissue Levels of Vitamin E (α‐Tocopherol) in Response to Continuous Intravenous Multivitamin Infusion
Authors: Gutcher Gary R. 
Published: May 2008

Weanling rats were made vitamin E deficient over a 10‐week course. Vitamin E was then provided at 4 IU/ kg/day as a continuous infusion of the α‐tocopherol in Berocca PN. Tissue samples of heart, lung, liver, and perinephric fat and plasma were analyzed for vitamin E levels at 24 and 72 hr.Compared to experimental controls that received a rat chow containing 372 IU/g mixed tocopherol, normal levels were achieved in the test group within 24 hr in plasma and liver. Lung and heart muscle levels were within the normal range by 24–72 hr, although significantly below the control level; fat levels did not normalize. Continuous infusion of vitamin E as tocopherol in a multivitamin preparation results in normal tissue levels in lung and liver in a fashion similar to that achieved by previously described methods of single bolus intravenous infusion or repeated subcutaneous injection. (Journal of Parenteral and Enteral Nutrition 12:152–154, 1988)
Preoperative Parenteral Nutrition in the High Risk Surgical Patient
Authors: Bellantone R. , Doglietto G.B. , Bossola M. , Pacelli F. , Negro F. , Sofo L. , Crucitti F. 
Published: May 2008

In order to assess the significance of malnutrition in determining surgical complications and the possibility of their reduction by preoperative nutritional support (PNS), a randomized controlled trial is being performed at our institution. The results relative to 100 patients who underwent major surgery for gastrointestinal disease, are presented here.In the treatment group 49 patients received 30 kcal/kg/day and 200 mg/kg/day of nitrogen for at least 7 days in the immediate preoperative period (nine patients were excluded from this group due to early surgery—seven cases; or refusal to accept PNS—two cases. Data analysis with their inclusion or exclusion showed similar results.) Fifty‐one patients constituted the control group. The observed septic complication rate was, respectively, 30 and 35.3% (p:NS). When the analysis was restricted to the patients with abnormal instant nutritional assessment (INA), as defined by Seltzer et al (serum albumin <3.5 g/dl and/or total lymphocyte count <1500 cells/mm3), a statistically significant difference was observed in the incidence of sepsis between the two subgroups (21% vs 53.3%, p < 0.05). Analogous results were obtained from the patients who underwent gastrectomy for gastric cancer: 16.7% of septic complications in the malnourished treated patients and 100% in the malnourished control ones (p < 0.05). The occurrence of serious sepsis (sepsis score ≥ 10, according to the scoring system developed by Elebute and Stoner) in the malnourished subgroups was 5.2% and 26.7%, respectively, (p = 0.09).The postoperative mortality rate was not significantly changed by the PNS (reduction from 3.9% to 2.5%, p:NS). This result was expected since power analysis indicates a too large number of patients would be needed to show a statistically significant difference in this low mortality risk category of patients.Our study suggests that malnourished patients waiting for major gastrointestinal surgery may benefit from an adequate PNS that seems to significantly reduce septic complication rate. (Journal of Parenteral and Enteral Nutrition 12: 195–197, 1988)