bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary Excretion of 3‐Methylhistidine as an Index of Protein Nutrition in Total Parenteral Nutrition
Authors: Kim Chang‐Woong , Okada Akira , Itakura Takeo , Takagi Yoji , Nakao Kazuyasu , Kawashima Yasunaru 
Published: May 2008

In 39 healthy adult volunteers and nine patients receiving total parenteral nutrition (TPN), determinations were made of the urinary excretion of 3‐methylhistidine (3‐Mehis) to estimate the degree to which the urinary output of 3‐Mehis reflects the status of protein nutrition.In 19 males and 10 females of the former group, measurements were made of the amount of 3‐Mehis and of creatinine (Cr) in 24‐hr urine samples. The urinary output of 3‐Mehis was also measured in two subgroups of five healthy adult male subjects who were fed one of the two different diets prescribed: meat (M) and meat‐free (F) diet. Furthermore, in one of these subgroups which was fed on F diet, the urinary output of 3‐Mehis was measured both while the subject was kept at bed rest and while the subject was allowed to live a normal life.From these measurements the standard value was determined for the urine 3‐Mehis level and the 3‐Mehis/Cr ratio in 24‐hr urine in healthy adult human subjects of both sexes.In nine patients maintained on TPN these indices of nutritional status were measured before and at 4 weeks of TPN. The time course of the indices was also investigated.The results obtained suggest that both the urinary output of 3‐Mehis and the 3‐Mehis/Cr ratio can provide a sensitive index of the status of protein nutrition. (Journal of Parenteral and Enteral Nutrition 12:198–204, 1988)
Inadvertent Catheterization of the Internal Thoracic Vein Mimicking Pulmonary Embolism: A Case Report
Authors: Brandi Luigi Severino , Oleggini Marco , Frediani Massimo , Lachi Sonia , Di Trani Massimo , Ferrannini Eleuterio 
Published: May 2008

Although aberrant locations are typical complications of central venous catheterization, the right internal thoracic vein (mammary vein) is an exceptional one. A case of this unusual aberrant location occurring after right internal jugular venous cannulation for total parenteral nutrition, is described. This aberrant position caused signs and symptoms resembling pulmonary embolism.This is the first known description of the symptoms induced by the infusion of parenteral solution into the right internal thoracic vein. (Journal of Parenteral and Enteral Nutrition 12:221–222, 1988)
Economic Impact of Malnutrition: A Model System for Hospitalized Patients
Authors: Reilly James J. , Hull Sam F. , Albert Nick , Waller Alger , Bringardener Scott 
Published: May 2008

A retrospective review of 771 patients' charts in two acute care hospitals was performed to determine likelihood of malnutrition (LOM) at admission and to assess the effect of LOM on costs and charges. Using accepted criteria, LOM was present in 59 and 48% of medical and surgical patients, respectively. Patients with LOM were 2.6 or 3.4 times as likely to have a predefined minor or major complication, respectively; and 3.8 times as likely to die as patients without LOM (all p < 0.001). In every diagnosis‐related group, the mean length of stay was longer for LOM patients (range 1.1–12.8 excess days).Accountants converted charges to direct variable costs using departmental cost‐to‐charge ratios. LOM status increased excess costs and charges per patient by $1738 and $3557, respectively (p < 0.0001). When complications occurred, LOM patients incurred $2996 or $6157 excess costs and charges per patient (p < 0.01). Serum albumin was the strongest clinical predictor of cost.The hospitals' cost of providing enteral or parenteral nutrition support was $18 or $102 per day, respectively. Too few patients received early nutrition support to assess efficacy. Nonetheless, the costs associated with malnutrition warrant early detection and aggressive treatment. (Journal of Parenteral and External Nutrition 12:371–376, 1988)
Effect of Phototherapy Light, Sodium Bisulfite, and pH on Vitamin Stability in Total Parenteral Nutrition Admixtures
Authors: Smith J.L. , Canham J.E. , Wells P.A. 
Published: May 2008

The three sections of this study extend previous research into losses of vitamins A, C, E, thiamin, riboflavin, and folic acid from total parenteral nutrition (TPN) admixtures. First, phototherapy light on TPN admixtures containing one of four amino acid solutions was studied. Experimental conditions included presence or absence of Intralipid iv fat emulsion, plastic bag or glass bottle storage container, and storage time of up to 48 hrs. The second phase studied stability of the same vitamins (except vitamin E) for 48 hrs in admixtures containing the amino acid solution which has no bisulfite, in glass bottles; with or without Intralipid; and with added sodium bisulfite (final concentrations of 0, 1, 2, 3, 4, 5 and 10 mEq/liter). Third, vitamin C and thiamin levels were measured in admixtures containing the amino acid solution with no bisulfite, without Intralipid, stored in glass bottles with various bisulfite concentrations (0, 1, 2, or 3 mEq/liter) and three pH levels (5.5, 6.5, and 6.75 pH).Exposure of TPN admixtures to phototherapy light caused losses of vitamins A, C, and riboflavin. Intralipid inclusion significantly reduced losses of vitamin A and riboflavin, but did not appear to affect vitamin C levels. The smallest vitamin C losses were noted in admixtures containing amino acid solutions A or B. Phototherapy light did not affect thiamin levels. Bisulfite had no affect on vitamin C, riboflavin, or folic acid levels. Vitamin A levels were maintained with bisulfite concentrations less than 3 mEq/liter. At 3 mEq/liter bisulfite, admixtures with Intralipid showed 50% loss of vitamin A. Significant losses of thiamin were noted at bisulfite concentrations of 3 mEq/liter and higher after 24 hrs, with or without Intralipid. Vitamin C loss was more pronounced as pH increased, especially at low bisulfite concentrations. Thiamin levels decreased as bisulfite concentration increased at 5.5 pH, but at higher pH thiamin levels were unchanged. (Journal of Parenteral and Enteral Nutrition 12:394–402, 1988)
Protein‐Sparing Effect of Substrate Infusion in Surgical Patients is Governed by the Clinical State, and Not by the Individual Substrate Infused
Authors: Shaw James H.F. , Holdaway Christopher M. 
Published: May 2008

We have determined iostopically the effect of either glucose or lipid infusion on rates of glucose turnover, glucose oxidation, and net protein catabolism (NPC) in three groups of surgical patients. Kinetic measurements were performed using the primed constant infusion of 3H‐glucose, and either 14C‐glucose or “C‐urea. The three groups included patients with: (1) sepsis and/or trauma (ST); (2) upper gastrointestinal cancer (UGI); (3) lower gastrointestinal cancer (LGI). In each patient group the effect of either glucose infusion (approximately 4 mg/kg·min) or lipid infusion (20% Intralipid lipid emulsion infused to provide calories approximately iso‐caloric to the glucose infusion) was assessed.The infusion of calories as either glucose or lipid was equally effective as a means of suppressing NPC in each individual patient group, and the degree of response was governed by the clinical disease state. In the LGI and ST patients the infusion of either glucose or fat resulted in a significant suppression of NPC (p < 0.005) of approximately 15%. However, the ongoing rate of NPC that occurred despite substrate infusion was more than twice as great in the ST patients as in the LGI patients. In contrast to what was seen in the ST and LGI patients, in the UGI patients neither glucose infusion nor lipid infusion significantly decreased NPC.Glucose infusion resulted in at least a 55% suppression of endogenous glucose production in all three groups studied. In contrast, lipid infusion had only a minor effect on glucose metabolism: lipid infusion did not significantly decrease the rate of glucose oxidation in any of the patient groups, and although lipid infusion was associated with a decrease in glucose production in all groups, this effect was minor (<9% suppression).The major hormonal response following glucose infusion was a significant increase in the plasma insulin level (plasma cortisol levels did not change), although in contrast lipid infusion did not significantly alter the plasma insulin level, but serum cortisol decreased significantly.We conclude from these studies the following: (1) “calorie for calorie,” glucose and lipid are equally effective in decreasing NPC in severely ill patients; (2) following glucose infusion, the plasma insulin level increased, and serum cortisol levels did not change, whereas in response to lipid infusion plasma insulin levels did not change and the plasma cortisol level decreased. (3) In contrast to the profound effect of glucose infusion to suppress free fatty acid appearance and utilization, lipid infusion has a minor inhibitory effect on both glucose production and glucose oxidation. (Journal of Parenteral and Enteral Nutrition 12:433–440, 1988)
Cortical Blindness after Subclavian Vein Catheterization
Authors: Acalovschi Iurie , Corbaciu Dumitru , Paraianu Ion 
Published: May 2008

The occurrence of air embolism with neurologic complications during the insertion of central venous catheters is well known, but the development of a cortical blindness has not been stress.The case of a woman patient is described, who, after the puncturing of the subclavian vein, developed a state of confusion and transient left hemiplegia, followed by the loss of sight. Blindness was associated with normal pupilary light reflexes and no observable changes in the fundi, features identifying it as cortical. Possible pathogenetic mechanisms are discussed. (Journal of Parenteral and Enteral Nutrition 12:526–527 1988)
Stability and Delivery of Vancomycin Hydrochloride When Admixed in a Total Parenteral Nutrition Solution
Authors: Schilling Craig G. , Watson David M. , McCoy Harry G. , Uden Donald L. 
Published: May 2008

Vancomycin hydrochloride, 400 mg/liter was mixed in six standard pediatric parenteral nutrition solutions with and without heparin added. The solutions were stored over a period of 8 days (192 hr) under refrigeration and at room temperature. Aliquots from all six solutions were assayed in duplicate for vancomycin at time 0, 24, 96, and 192 hr. All samples were run through an Ivex 0.22‐micron filter, observed for physical incompatibilities, and frozen at —70°C until assay.Our results indicate that vancomycin was stable and was delivered with loss in concentration of less than 5% with and without storage under refrigeration.This study suggests an alternative method for delivering vancomycin when treating a catheter‐related infection. If vancomycin is delivered in this fashion, less manipulations of the line would be required. In addition, there may be a theoretical advantage of constantly bathing the catheter with vancomycin when the catheter is suspected of harboring the infecting organism. (Journal of Parenteral and Enteral Nutrition 13:63–64, 1989)
Reduction of 24‐Hour Gastric Acidity by Different Dietary Regimens: A Randomized Controlled Study in Healthy Volunteers
Authors: Hopert Rüdiger , Liehr Ralph‐Marco , Emde Carsten , Riecken Ernst‐Otto 
Published: May 2008

Evidence from animal experiments suggests that intraduodenal infusion of nutrients leads to an inhibition of gastric acid secretion via an enterogastric feedback mechanism. Detailed data are lacking, however, on the difference in circadian gastric acidity between gastric and intraduodenal alimentation in man. We conducted a randomized study in 10 healthy volunteers (5 men, 5 women, age 22–30 yr). From 8:00 am of the first study day until 4:00 pm of the next day, either a standardized normal meal or a liquid polymer diet (Fresubin) was given orally at 8:00 am, noon, and 6:00 pm. In a third experiment, a liquid hydrolysed diet (Survimed OPD) was continuously applied to the duodenum using a portable pump. Daily caloric intake and main nutrient components were comparable in all three diets. From 2:00 pm of the first day until 4:00 pm of the next day, an intragastric pH‐metry was performed with a combined glass pH‐electrode in the gastric corpus. Median pH‐values from predefined time periods (whole day, prandial, interdigestive, nocturnal) were compared between the three groups.The orally applied liquid polymer diet led to a significantly stronger increase in 24‐hr and prandial gastric pH than the normal diet. Twenty‐four‐hr, interdigestive, and nocturnal pHmedian values were significantly higher during continuous intraduodenal application of the liquid hydrolysed diet than during the normal diet. (Journal of Parenteral and Enteral Nutrition 13:292–295, 1989)
Enteral Feeding Contamination: Comparison of Diluents and Feeding Bag Usage
Authors: Perez Susan Kimura , Brandt Karen 
Published: May 2008

This quasi‐experimental study compared bacterial growth in enteral feeding solution in six Kangaroo feeding bags filled with enteral formula diluted with sterile water vs six of the same diluted with tap water. Feeding bags, which were on continuous pumps in patient‐occupied rooms, were rinsed and refilled every 8 hours, and formula cultures were obtained at 0, 24, and 48 hr. Acceptability of cultures was based on published recommended standards.Low levels of nonpathogenic staphylococci were found in sterile water bags; high levels of bacilli and Gram negative rods were found in tap water bags. No significant differences were found in the relationship between type of formula diluent and outcomes. Type of water diluent and acceptability were not related. There was a systematic relationship between length of use and outcome; with both diluents, bags used over 24 hr became unacceptably contaminated. Further study with a larger sample is needed to determine the effects of using tap water rather than sterile water as diluent. (Journal of Parenteral and Enteral Nutrition 13:306–308, 1989)
Decrease of Polyunsaturated Fatty Acids and Elevation of the Oleic/Stearic Acid Ratio in Plasma and Red Blood Cell Lipids of Malnourished Cancer Patients
Authors: Mosconi Cristina , Agradi Elisabetta , Gambetta Achille , Bozzetti Federico , Galli Claudio 
Published: May 2008

The fatty acids profiles of plasma and red blood cell lipids have been evaluated in 12 malnourished cancer patients in comparison with samples from eight healthy controls. In such patients, significantly lower levels of linoleic acid (LA) as percentage of total fatty acids were observed in plasma phospholipids (PL) and cholesterol esters (CE), and in red blood cells PL. The levels of arachidonic acid (AA) and the unsaturation index of the two lipid classes were also reduced in plasma CE but not in PL. In spite of the marked reduction of LA and, more generally, of total polyunsaturated fatty acids (PUFA), no elevation of eicosatrienoic acid (20:3 n‐9) was observed, such acid being considered a typical index of essential fatty deficiency. Moreover, no modification of the parameters indicating impairment of the fatty acid desaturation activity was shown. In addition, the levels of palmitic and oleic acids were significantly higher in both plasma PL and CE and in red blood cells PL.The reported elevation of the oleic to stearic acid ratio in lipids of red blood cells from malnourished cancer patients, already observed by other authors, was confirmed in our study. This ratio was even more markedly elevated in plasma lipids of the patients. A very good correlation was found between the reduction of linoleic acid levels, especially in plasma CE, and weight loss, suggesting enhanced utilization of this fatty acid in association with extensive depletion of lipid stores, in this pathological state. (Journal of Parenteral and Enteral Nutrition 13:501–504, 1989)
An Analysis of Factors Contributing to the Development of Total Parenteral Nutrition‐Induced Cholestasis
Authors: Drongowski Robert A. , Coran Arnold G. 
Published: May 2008

The risk of developmental of total parenteral nutrition (TPN)‐associated cholestatic jaundice in neonates receiving intravenous hyperalimentation is high. Numerous factors have been cited as contributing to TPN cholestasis; however, the exact etiology remains obscure. This retrospective study was undertaken in order to identify any factors which might contribute to this syndrome.The hospital records of 172 neonates requiring TPN for a minimum of 1 week were reviewed. In addition, a subgroup of 32 infants requiring TPN for a minimum of 7 weeks was also examined. Cholestasis was defined as a direct serum bilirubin greater than 2.0 mg/dl during the course of TPN therapy.Significant factors for the development of cholestasis in both groups (n = 172, n = 32) included: number of operations (2.56 vs. 1.08, p = 0.0000), the number of days the patients received antibiotics (40.3 vs 12.9, p = 0.0000), and delayed start of enteral feedings (33.8 vs 14.1, p = 0.0000).Fifteen of the 32 patients who received TPN for at least 7 weeks did not develop cholestasis. In this subgroup (n = 32), there were no differences in birth weight, gestational age, days from birth to the start of TPN, or respiratory distress between those who developed cholestasis and those who remained anicteric. In contrast, there were significant differences between the cholestasis and noncholestasis groups in number of operations (13 vs 6, p = 0.0407), and days until enteral feedings were started (33.1 vs 18.9, p = 0.0289).This study suggests that the factor(s) contributing to the development of TPN‐associated cholestasis are likely multifactorial. There appears to be a direct correlation between increasing severity of cholestatic jaundice and duration of TPN. This review does add a new parameter to the various causative factors suggested, namely the number of operative procedures. This new variable could be related to the stress of surgery itself or to the repeated administration of anesthetic agents. (Journal of Parenteral and Enteral Nutrition 13:586–589, 1989)
Reduced Cardiac Selenium Content in the Acquired Immunodeficiency Syndrome
Authors: Dworkin Brad M. , Antonecchia Paul P. , Smith Fred , Weiss Lisa , Davidian Marianna , Rubin Dave , Rosenthal William S. 
Published: May 2008

Selenium deficiency has been implicated in the pathogenesis of a dilated congestive cardiomyopathy in areas of China (Keshan disease) and in several patients on long‐term total parenteral nutrition. Recently a clinically and pathologically similar cardiomyopathy has been described in AIDS. Since blood selenium levels are low in AIDS, we assayed cardiac selenium status by a spectrofluorometric method in eight AIDS patients at autopsy compared to nine age‐matched, non‐AIDS autopsy controls with histologically normal hearts. We found (mean ± SD) a cardiac selenium level of 0.327 ± 0.082 μg/g dry weight in AIDS vs 0.534 ± 0.184 μg/g dry weight in controls (p<0.01; Student's t test). There were no significant differences between the groups for heart weight, serum CPK, or other laboratory parameters. No specific chest x‐ray or electrocardiographic abnormalities were present. Histologically, all AIDS hearts were abnormal; mostly with mild degrees of muscle hypertrophy or fibrosis. Foci of myocytolysis and myocyte necrosis and fibrous replacement of myocytes and monocytic infiltration were present in two AIDS cases.We conclude that heart tissue in AIDS demonstrates a significant selenium deficit. These data provide a potential link between selenium deficiency and cardiomyopathy in AIDS. (Journal of Parenteral and Enteral Nutrition 13:644–647,1989)
Evaluation of a Percutaneously Placed 27‐Gauge Central Venous Catheter in Neonates Weighing <1200 Grams
Authors: Nakamura Kenneth T. , Sato Yutaka , Erenberg Allen 
Published: May 2008

A percutaneous 27‐gauge OD central venous catheter was inserted at 4 ± 3 (SD) days of age and left in place for up to 2 weeks in 20 neonates with birth weights <1200 g and >24 h of age. Parenteral nutritional solutions and medications were administered through these catheters. Twenty neonates matched for birth weight and gestational age served as paired controls.In vitro studies demonstrate that the maximum infusion rate for parenteral nutrition solutions is about 20 ml/hr. Packed red blood cells could not be infused through these catheters. In vivo results demonstrate a significant (p < 0.05) reduction in number of peripheral iv catheters inserted during study (2 ± 1 us 7 ± 4, SD) with no difference in cost per day of iv access ($79.42 ± 113.51 vs $43.91 ± 15.99. SD). Two‐dimensional ultrasound assessment of catheter thrombosis was unsuccessful. Moreover, there was no correlation between angiographic and electron microscopic evaluation of catheter tip thrombosis. Electron microscopy of catheter tips revealed 33% with complete, partial and no occlusion, respectively, and 39% with sheath thrombosis. In summary, percutaneous insertion of a 27‐gauge OD Vialon central venous catheter is a feasible alternative in providing venous access in very low birth weight infants. (Journal of Parenteral and Enteral Nutritiun 14:295–299, 1990)
Vitamin E Suppresses Increased Lipid Peroxidation in Cigarette Smokers
Authors: Hoshino Etsuo , Shariff Riaz , Van Gossum Andre , Allard Johane P. , Pichard Claude , Kurian Regina , Jeejeebhoy Khursheed N. 
Published: May 2008

Cigarette smoke contains many xenobiotics, including oxidants and free radicals, which can increase lipid peroxidation. Recently, breath pentane output (BPO) has been recognized as a good indicator of lipid peroxidation.Vitamin E is known to be a potent free radical scavenger which can protect biological membranes against oxidative damage. We investigated the effect of vitamin E (dl‐alpha‐tocopherol) on lipid peroxidation in 13 healthy smokers. The results showed (1) smokers had increased BPO as compared with 19 healthy non‐smokers (16.3 ± 1.9 us 5.8 ± 0.5, pmol/kg body weight/min, p < 0.001) although both groups had comparable plasma vitamin E and selenium concentrations, (2) supplementation with vitamin E (800 mg/day for 2 weeks) decreased BPO in smokers, and (3) the concentration of plasma selenium‐dependent glutathione peroxidase was restored to normal in those smokers (five out of 13) in whom this was low initially.We conclude that a normal plasma concentration of vitamin E does not prevent this increase of lipid peroxidation in smokers but that substantial doses of vitamin E will significantly reduce this increased lipid peroxidation. If a major function of vitamin E is to protect lipids from peroxidation, then smokers have a conditioned insufficiency of vitamin E on a normal diet. (Journal of Parenteral and Enteral Nutrition 14:300–305, 1990)
Use of Internal Validity in the Construct of an Index of Undernutrition
Authors: Hall John C. 
Published: May 2008

An index of undernutrition (IOU) has been developed from a crosssectional study of 200 general surgical patients. The IOU was constructed using a ranking method based upon the relative values of anthropometric measurements (weight loss, mid‐arm muscle area, mid‐arm fat area) and serum protein concentrations (albumin, transferrin). The IOU was derived without reference to the incidence of adverse clinical events and took the form of a boolean cluster.A subsequent prospective longitudinal study evaluated the IOU in 367 general surgical patients at the time of admission to hospital. The results of this study supported the validity of the IOU. There was no association between gender and IOU scores. However, patients with high scores were more likely to be elderly (p < 0.02), have cancer (p < 0.001), stay in hospital longer (p < 0.001), or experience an adverse clinical event after surgery (p < 0.001). In accord with other published indices of undernutrition, the association between the extent of undernutrition and the incidence of adverse clinical events was only of moderate diagnostic potential (overall accuracy 68%). This study demonstrates that it is possible to derive an index of protein‐energy undernutrition that is independent of the incidence of adverse clinical events. (Journal of Parenteral and Enteral Nutrition 14: 582–587, 1990)