bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fat Elimination in Acute Renal Failure: Long‐Chain vs Medium‐Chain Triglycerides W. DRUML, M. FISHER, S. SERTL, ET AL American Journal of Clinical Nutrition 55:468–472, 1992
Authors: Hamaoui E. 
Published: May 2008

This study compared the metabolism of intravenously infused fat in patients with acute renal failure (ARF) vs that in healthy control subjects, using either a long‐chain triglycerides (LCT) emulsion or a 50:50 mixture of LCT and medium‐chain triglycerides (MCT). The test subjects consisted of seven medical intensive care unit patients who had developed ARF due to various causes (sepsis in two; postoperative pancreatitis, vascular surgery, acute interstitial nephritis, poststreptococcal nephritis, and drugs in one each). These patients were considered otherwise clinically stable and were all close to ideal body weight (109 ± 3% ideal body weight). Prior to this study, the patients had been on parenteral nutrition, which provided 130% of resting energy expenditure and consisted of amino acids (15%), glucose (55%), and LCT lipids (30%). The control subjects were six healthy volunteers of somewhat younger age (32 ± 7 years vs 51.9 ± 4.4 years in the study group) and similar weight (103 ± 5% ideal body weight) and had been on a mixed oral diet providing an average of 8800 kJ/d, 80 g protein, and 35% of calories as fat. Fat clearance and hydrolysis were studied using a two‐stage constant infusion of the fat emulsion, infusing 0.75 g fat per kilogram of body weight per hour for 90 minutes, then 1.25 g fat per kilogram of body weight per hour for the next 90 minutes. The emulsions compared were Intralipid 10% (Kabi‐Vitrum, Stockholm, Sweden) as the LCT product and Lipofundin‐MCT 10% (Braun, Melsungen, Germany) as the 50:50 mixture of LCT and MCT. The infusions were administered after a 12‐hour break in nutrition support and at least 20 hours after the last dialysis in the test patients, and after a 12‐hour overnight fast in the controls.Triglyceride clearance was markedly reduced in ARF (0.53 ± 0.10 vs 1.55 ± 0.30 mL per kilogram body weight per minute) during LCT infusion and showed no improvement with MCT (0.59 ± 0.12 vs 1.93 ± 0.34 mL per kilogram body weight per minute). Elimination half‐lives were accordingly prolonged more than three times in patients with ARF as compared to controls. In both groups, triglyceride hydrolysis, as reflected by the rise in plasma free fatty acids, was higher with MCT than with LCT, but the difference was blunted in patients with ARF. Plasma glucose and lactate levels were not affected by either one of the fat infusions in the controls. In contrast, patients with ARF had significantly higher baseline glucose levels, which rose further (p <.05) with both fat infusions; similarly, their plasma lactate levels started out slightly higher and rose further with both fat infusions. The authors concluded that fat clearance is reduced in ARF and that this impairment is not alleviated by use of MCT.
Early Changes of Body Composition in Human Immunodeficiency Virus‐Infected Patients: Tetrapolar Body Impedance Analysis Indicates Significant Malnutrition
Authors: Apour Christine S. , Bell Stacey , Bistrian Bruce R. , Forse R. Armour 
Published: May 2008

In this study the investigators examined alterations in body composition and the prevalence of diarrhea in HIV‐infected subjects. By using tetrapolar body impedance analysis (RJL‐Akern BIA 109:Data‐input, Frankfurt/Main, Germany), body composition was measured in 533 subjects, including 193 men aged 21 to 70 years, who had tested positive for HIV‐1 antibodies and 340 age‐ and sex‐matched control subjects. HIV‐infected patients were grouped according to the Walter Reed (WR) classification of HIV disease stages.1 Total body water, extracellular mass (ECM), body fat, body cell mass (BCM), and ECM/BCM ratio were determined. Relative to control subjects, the body weight and body mass index (BMI) of WR 3 through WR 5 (n = 85) and WR 6 (n = 83) subjects were significantly decreased (p <.29 and P <.001, respectively), whereas WR 2 (n = 26) subjects exhibited no decline in either body weight or BMI. However, all HIV‐infected subjects, including those classified as WR 2, displayed both a statistically significant decline in BCM and an increase in ECM, resulting in an increased ECM/BCM ratio. The use of tetrapolar impedance detected depletion of lean body mass in clinically asymptomatic HIV patients at the WR 2 stage who had not yet demonstrated alterations in body weight or BMI. Malnutrition can be defined as a state of decreased BCM and increased ECM. The altered ECM/BCM ratio is independent of body weight or BMI. Almost half the WR 2 patients had ECM/BCM ratios greater than those of matched control patients by 1 standard deviation. No significant depletion of fat stores was noted in any group except in the most severe WR 6 HIV patients.When patients were classified into four diarrheal states in terms of stool evacuation, consistency, duration, and frequency, only the most severe state (patients with either more than 20 diarrheal episodes of more than 3 days duration or permanent diarrhea during the last year) correlated with the degree of malnutrition.
The Effect of Dietary Protein Depletion on Hepatic 5‐Fluorouracil Metabolism L. E. DAVIS, R. E. LENKINISKI, M. A. SHINKWIN, ET AL CANCER 72:3715–3722, 1993
Authors: Christensen Michael L. 
Published: May 2008

This study investigated the mechanism of protein depletion and its effect on host toxicity to 5‐fluorouracil. The effects of protein malnutrition on the hepatic metabolism of 5‐fluorouracil were examined using 19F‐nuclear magnetic resonance spectroscopy, pharmacokinetic disposition of 5‐fluorouracil, and hepatic dihydropyrimidine dehydrogenase activity. Harlan Sprague‐Dawley rats were given 5‐fluorouracil (150 mg/kg) by intraperitoneal injection after receiving normal (21.5%) or low (2.5%) protein diets for 19 to 30 days (mean, 25 days). Toxicity was assessed by weight loss, lymphocyte count, and survival. Hepatic fluorine spectra were used to evaluate the time to achieve maximum 5‐fluorouracil concentration, apparent hepatic 5‐fluorouracil half‐life, duration of detectable 5‐fluorouracil concentrations, and time to reach peak fluoro‐β‐alanine concentration (the main 5‐fluorouracil degradation product). Parallel experiments determined the pharmacokinetic disposition of 5‐fluorouracil and the hepatic dihydropyrimidine dehydrogenase activity.In the low‐protein group, the initial detection of the degradation product fluoro‐β‐alanine and the mean duration of 5‐fluorouracil signal in the liver were significantly prolonged: time to reach peak fluoro‐β‐alanine (minutes) 62 ± 39 vs 24 ± 12 (p <.05) and apparent 5‐fluorouracil half‐life (minutes) 96 ± 63 vs 42 ± 22 (p <.001). The 5‐fluorouracil clearance and the hepatic dihydropyrimidine dehydrogenase activity were also significantly lower in the low‐protein group: 1.8 ± 0.8 L/h/kg vs 7.3 ± 2.1 Llhlkg (p <.05) and 0.29 ± 0.04 U/mg of protein vs 0.37 ± 0.04 U/mg of protein (p <.05), respectively. Compared with animals fed a normal diet, animals in the low‐protein group sustained greater weight loss (g) 36 ± 17 vs 16 ± 17 (p <.05), lower lymphocyte count (mm3) 1767 ± 993 vs 5575 ± 2239 (p <.05), and greater mortality 7 days after 5‐fluorouracil (8/9 vs 1/10) (p <.01).
TPN‐Induced Sympathetic Activation Is Related to Diet, Bacterial Translocation, and an Intravenous Line HELTON WS, ROCKWELL M, GARCIA RM, ET AL: Arch Surg 130:209–214, 1995
Authors: Sax Harry C. 
Published: May 2008

Total parenteral nutrition (TPN) has been associated with impaired immune response, breakdown in gut mucosal integrity, and the development of hepatic toxicity. Diet alone, however, may not account for increases in bacterial translocation (BT) and mucosal permeability.1,2 There is increasing recognition of the role of neural innervation of visceral organs such as the gut and the potential mediating effects of parenteral nutrition. Catecholamines, including epinephrine and norepinephrine, may be further inhibitory to immune function.3Male Sprague‐Dawley rats were randomized to one of four groups: sham operation and food feeding (C); IV line, saline, and food feeding (S); IV TPN (T); or IV line and oral TPN (O). Urine was collected for catecholamine determination. On day 7, animals were killed, and mesenteric lymph nodes were cultured to assess BT.Food‐fed animals (C) gained significantly more weight than either groups T or O despite isocaloric feeds. Animals with IV lines (S, T, and O) manifest BT at a rate of 40% to 50%, whereas animals with no lines had sterile lymph nodes. Both groups T and O had higher levels of catecholamine secretion; the presence of a central line alone minimally increased catecholamine levels.Data were pooled to examine specific factors. The provision of TPN, whether via oral or IV routes significantly increased both norepinephrine and epinephrine secretion. When catecholamine secretion was correlated with BT, a twofold increase in norepinephrine output was noted in those animals with BT (126 ± 23 vs 64 ± 14 pmol/μmol creatinine, p <.05).
New Treatment for Patients With Short‐Bowel Syndrome: Growth Hormone, Glutamine and a Modified Diet T. A. BYRNE, R. L. PERSINGER, L. S. YOUNG, ET AL Ann Surg 222.‐243–255, 1995
Authors: Sax Harry C. 
Published: May 2008

After massive enterectomy, the remnant bowel must undergo both morphologic and physiologic adaptation if the patient is to wean to volitional enteral support. Those patients who are unable to adapt require long‐term total parenteral nutrition (TPN) with its concomitant high cost and metabolic anomalies. Previously, it was believed that adaptation ceased after a period of 1 to 2 years. In 1992, Byrne et al presented the theory that further adaptation could be elicited in a group of 8 patients who had been on TPN for up to 6 years by treatment with a combination of growth hormone, free glutamine, and a diet high in fiber and low in fat.1 This paper did not delineate the specific mechanisms or present long‐term results. The current study involves 47 patients with short‐bowel syndrome dependent on TPN for an average of 6 years. Average age was 46 with a mean jejunoileal length of 50 ± 7 cm. Half of the patients had <35 cm of small bowel. Etiologies included volvulus, SMA thromboses, or adhesions in the vast majority. Eleven patients had Crohn's disease. All but four patients had at least some colon or rectum remaining in the circuit.Patients were admitted to an inpatient residential environment (the Nutritional Restart Center), where baseline studies of nutrient balance were obtained on the patient's normal intake. They were then placed on a diet high in complex carbohydrates and low in fat for the next 3 weeks. Feedings were divided into six equal parts and isotonic fluids were allowed ad libitum. Groups were also randomized to receive human growth hormone, 0.14 mg/kg/d, or enteral glutamine, 0.6 mg/ kg/d, or both. At the conclusion of the 4‐week stay, patients were discharged on only the diet and supplemental glutamine.The combination of growth hormone, glutamine, and the diet led to a near 40% improvement in daily nitrogen balance and a 33% decrease in stool weight. Sodium balance was similarly improved, although this may reflect growth hormone's effect on water retention. Twenty‐seven patients were able to eventually be weaned off TPN. There was no significant difference in small bowel length or the presence or absence of colon compared with those patients who still required TPN. Eight patients eventually required reinstitution of TPN over the long term, usually due to recurrence of previously quiescent inflammatory bowel disease or dietary noncompliance. Nonetheless, 60% of patients remained either completely free of TPN or required TPN at a lower rate.Nutritional indices were not changed. Serum albumin remained in the 3.6 to 3.8 range in all groups, both at baseline and after the period of intervention. Weight remained stable, except for the eight patients requiring continued TPN who showed an average of a 2‐kg weight loss. Cost savings even in those patients who could not be completely weaned from TPN averaged $80,000 per year. This is exclusive of the cost of the diet or supplemental growth hormone and glutamine.
Collaborative JPEN‐Clinical Nutrition Scientific Publications Role of intestinal bacteria in nutrient metabolism
Authors: Cummings J.H. , Macfarlane G.T. 
Published: May 2008

The human large intestine contains a microbiota, the components of which are generically complex and metabolically diverse. Its primary function is to salvage energy from carbohydrate not digested in the upper gut. This is achieved through fermentation and absorption of the major products, short chain fatty acids (SCFA), which represent 40–50% of the available energy of the carbohydrate. The principal SCFA, acetate, propionate and butyrate, are metabolized by the colonic epithelium (butyrate), liver (propionate) and muscle (acetate). Intestinal bacteria also have a role in the synthesis of vitamins B and K and the metabolism of bile acids, other sterols and xenobiotics.The colonic microflora are also responsive to diet. In the presence of fermentable carbohydrate substrates such as non‐starch polysaccharides, resistant starch and oligosaccharides, bacteria grow and actively synthesize protein. The amount of protein synthesis and turnover within the large intestine is difficult to determine, but around 15 g biomass is excreted in faeces each day containing 1 g bacterial‐N. Whether bacterially synthesized amino acids are ever absorbed from the colon remains unclear.Finally, individual colonic micro‐organisms such as sulphate‐reducing bacteria, bifidobacteria and clostridia, respond selectively to specific dietary components in a way that may be important to health.
Glutamine Protects Intestinal Epithelial Cells: Role of Inducible HSP70
Authors: Robinson Malcolm K. 
Published: May 2008

In this in vitro study, the authors test the premise that glutamine (Gln) protects intestinal epithelial cells under conditions of stress via induction of heat shock proteins. Gln (0–20 mM) or its non‐metabolizable analogue, 6‐diazo‐5‐oxo‐L‐norleucine (DON, 0400 μM), was added for 2 hours to IEC‐18 cells that had previously been grown for two days to near confluence in Gln‐free and serum‐free culture media (Dulbecco's modified Eagle's medium). Induction of heat shock protein 70 (HSP70) under these conditions was assessed by Western blots using the monoclonal antibody C92, which recognizes only the inducible form of HSP70. HSP70 mRNA abundance was assessed with Northern blot analysis using a cDNA probe specific for inducible HSP70. Radiolabeled cells (51Cr) treated with Gln or DON were subsequently exposed to heat (49°C for 30–240 minutes) or an oxidant, monochloramine (NH2Cl, 2 μM), and cell injury was quantitated by calculating the percent of 51Cr release. Finally, Gln or DON was added to cells cultured in quercetin, a known inhibitor of HSP70 production. The cells were then analyzed for HSP70 induction, HSP70 mRNA abundance, and cellular protection from heat and oxidation.Gln added to IEC‐18 cells induced an increase in HSP70 and HSP70 mRNA in a concentration‐dependent manner. Gln administration caused a statistically significant 50% and 65% reduction in cytolysis of cells exposed to lethal heat and oxidation, respectively. The non‐metabolizable analogue of Gln, DON, also induced an increase in HSP70 and HSP mRNA but less than that induced by Gln. DON caused a statistically significant 35% and 25% reduction in cytolysis of cells exposed to lethal heat and oxidation. This suggests that the observed effects of Gln are mediated by both metabolic and non‐metabolic mechanisms. Incubation of cells with quercetin prior to Gln and DON administration not only blocked HSP70 protein and mRNA induction but abrogated the protective effects of Gln and DON on cells exposed to lethal heat and oxidation. The authors conclude that Gln protects intestinal epithelial cells from heat and oxidation via mechanisms which are in part mediated by HSP70 induction.
Flame Retardants in Commercial Use or Development for Textiles
Authors: Weil Edward D. , Levchik Sergei V. 
Published: May 2008

Non-durable and semi-durable flame retardants based mostly on phosphate or phosphonate salts continue to be used on infrequently washed or disposable goods, and recent improvements have been made to impart better `hand' or some limited wash resistance. Backcoating with insoluble ammonium polyphosphate, usually with additives and binders to provide intumescence, has been found effective on charrable fabrics. However, the leading backcoating effective on a wider range of fabrics, including synthetics and blends, is decabromodiphenyl ether plus antimony oxide. Newer candidates in development for textile coating are polymers and copolymers of pentabromobenzyl acrylate. The leading durable finish for cellulosic fibers, in use for about 50 years, continues to be based on tetrakis(hydroxymethyl)phosphonium salts reacted with urea and cured with gaseous ammonia. Softer versions have been recently developed using chemical or process modifications, or using selected fiber blends. Somewhat less durable phosphonic ester methylolamide finishes, not requiring gaseous curing, are used on cellulosic fabrics, especially overseas. Other competitive wash-durable phosphorus-based finishes for cellulosics and blends are in development. Polyesters continue to be flame retarded using a phosphonate or hexabromocyclododecane in a `thermosol' process. Polyesters with built-in phosphinate structures are available as specialty fabrics. A dialkylphosphinate salt has been recently introduced as a melt spinning additive in polyester. A tribromoneopentyl phosphate melt spinning additive has been developed for polypropylene fiber. A number of inherently flame retardant synthetic fibers recently achieving increased usage include melamine-based fiber, viscose rayon containing silicic acid, aramides, oxidized polyacrylonitrile, and polyphenylene sulfide fibers. Some of these are used in protective clothing. The recent California and Federal mattress open-flame test standards have brought barrier fabrics into prominence. Some of these barriers use boric acid on cotton batting, others are proprietary composites and blends, both woven and nonwoven, comprising inherently flame retarded fibers combined with lower cost non-flame-retardant fibers. Upholstered furniture open-flame standards are pending.
Clinical assessment compared to laboratory screening in acutely poisoned patients
Authors: Heyerdahl F , Hovda KE , Bjornaas MA , Brørs O , Ekeberg O , Jacobsen D 
Published: May 2008

Acute poisonings may require identification of the toxic agents. It is impossible for routine laboratories to provide a full spectrum of toxicological analyses, and clinicians should know the reliability of the clinical diagnoses of toxic agents. We performed a 1-year study of hospitalized acute poisonings to determine the agreement between the clinical assessment on admission and serum laboratory tests for eight common toxic agents. Blood samples were drawn in 665 (70%) of the 947 admissions. The total number of laboratory found agents (967) exceeded the clinically suspected (871) by 11%. The agreement between the clinical assessment and laboratory analyses was good for ethanol and paracetamol ( κ = 0.70 for both), whereas only moderate or fair for other agents ( κ 0.22–0.51). Sensitivities of the clinical assessments compared to the laboratory results were better for common than rare agents, and better for higher than lower serum concentrations. The four most common agents (ethanol, benzodiazepines, paracetamol, and opiates) had overall sensitivity of 82% for higher-than-median serum concentrations, whereas the other agents had sensitivities ranging from 14% to 71% for higher-than-median concentrations. The reliability of the clinical diagnoses varied to such an extent that agents, which are important to recognize for specific treatment, should be tested for.
Influence of adenosine triphosphate and ABCB1 (MDR1) genotype on the P-glycoprotein-dependent transfer of saquinavir in the dually perfused human placenta
Authors: Rahi M , Heikkinen T , Hakkola J , Hakala K , Wallerman O , Wadelius M , Wadelius C , Laine K 
Published: May 2008

Background: The ATP-dependent drug-efflux pump, P-glycoprotein (P-gp) encoded by ABCB1 (MDR1), plays a crucial role in several tissues forming blood–tissue barriers. Absence of a normally functioning P-gp can lead to a highly increased tissue penetration of a number of clinically important drugs. Methods: We have studied the dose–response effect of exogenous ATP on the placental transfer of the well-established P-gp substrate saquinavir in 17 dually perfused human term placentas. We have also studied the influence of the ABCB1 polymorphisms 2677G>T/A and 3435C>T on placental P-gp expression ( n = 44) and the transfer ( n = 16) of saquinavir. Results: The present results indicate that the addition of exogenous ATP to the perfusion medium does not affect the function of P-gp as measured by saquinavir transfer across the human placenta. The variant allele 3435T was associated with significantly higher placental P-gp expression than the wild-type alleles. However, neither polymorphism affected placental transfer of saquinavir nor there was any correlation between P-gp expression and saquinavir transfer. Conclusions: Our results indicate that addition of exogenous ATP is not required for ATP-dependent transporter function in a dually perfused human placenta. Although the ABCB1 polymorphism 3435C>T altered the expression levels of P-gp in the human placenta, this did not have any consequences on P-gp–mediated placental transfer of saquinavir.
Pediatric poisonings in southeast of Turkey: epidemiological and clinical aspects
Authors: Ozdogan H , Davutoglu M , Bosnak M , Tutanc M , Haspolat K 
Published: May 2008

Current detailed information about the causes, management, and clinical course of acute childhood poisonings in Turkey is scarce. Therefore, we have conducted a descriptive study of children presenting with acute poisoning to the pediatric emergency department of Dicle University Hospital throughout an 8-month period. Two hundred unselected children with poisoning were evaluated in terms of clinical, epidemiological and socioeconomic aspects. The mean age of patients was 5.7 ± 4.0 years. The majority of the patients ( n = 108, 54%) were aged from 13 months to 4 years ( P < 0.05). In majority of patients (66.5%, n = 133), poisonings were accidental. Intentional poisonings accounted for 3.5% ( n = 7) and food poisoning accounted for 30% ( n = 60) of all cases. The families had more than three children in 129 (97%) of accidentally poisoned and in seven (100%) of intentionally poisoned patients, six were girls and one was a boy. The parents of most patients were uneducated. Furthermore, more than two third of families had low level of income. In all, 171 patients (85.5%) were discharged after an observation period of 24 h. Four patients died. In conclusion, factors such as low educational level of parents, presence of more than three children in the family, and low income increase the incidence of childhood poisonings. The low educational level of girls increases the incidence of intentional poisoning.