bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of pH, Temperature, Concentration, and Time on Particle Counts in Lipid‐Containing Total Parenteral Nutrition Admixtures
Authors: Soges Bettner Francoise , Stennett Douglass J. 
Published: May 2008

It has been standard practice in the United States to separate lipid emulsion from the other components of total parenteral nutrition (TPN) due to the reported instability of admixed intravenous lipid emulsions. Some clinicians, however, have combined all TPN components into one container and administered these admixtures to patients without apparent difficulties. Infusion of all nutrients from one container has many advantages. In this study standard and concentrated admixtures were aseptically prepared using generally accepted guidelines of the nutritional requirements for a 70‐kg patient. Treatments of standard and concentrated admixtures consisted of: (1) storing at 4°C without adjusting the pH; (2) increasing the pH to 6.6 and storing at 4°C; (3) increasing the pH to 6.6 and storing at room temperature. Samples were monitored for 3 weeks by means of Coulter Counter analysis, pH determinations, and visual observations.The pH of the admixtures did not change over 3 weeks. Mean counts of particles with sizes between 1.6 and 25.4 μ increased over time for each treatment group. Within treatments, concentrated admixtures had significantly greater particle counts than the corresponding standard admixtures. Within the standard and within the concentrated admixtures, the particle counts were significantly greater for group one than for group three. Particle counts in group two tended to lie between the values of group one and three. Visual signs of emulsion deterioration were greatest in those admixtures in which the pH was not adjusted and occurred earlier in concentrated admixtures. (Journal of Parenteral and Enteral Nutrition 10:375–380, 1986)
Amino Acids and Indoleamines in the Brain after Infusion of Branched‐Chain Amino Acids to Rats with Liver Ischemia
Authors: Bugge M. , Bengtsson F. , Nobin A. , Holmin T. , Jeppsson B. , Hultberg B. , Falck B. , Herlin P. 
Published: May 2008

Rats with a portacaval anastomosis and ligation of the hepatic artery 2 days later were infused for 6 hr with a 10% glucose solution (group I) or the same solution combined with 0.24 M/liter branched‐chain amino acids (BCAA, group II). Control animals with portacaval anastomosis and sham‐operation (group III) or two sham‐operations (group IV) were infused with a 10% glucose solution. The rats were killed by decapitation and indoleamines and amino acids were determined in the brain. Rats with liver ischemia were stuporous at the end of the experiment irrespective of treatment.The concentrations in the cortex of lysine, methionine, phenylalanine, threonine, alanine, glutamine, glycine, histidine, and tyrosine were significantly increased in group I compared to group IV. Infusion of BCAA to rats with liver‐ischemia (group II) resulted in significantly lower concentrations of lysine, methionine, phenylalanine, threonine, histidine and tyrosine and increased concentrations of isoleucine, leucine, valine, and arginine compared to group I.The content of serotonin in the cortex and brain stem was significantly increased in group I compared with the BCAAtreated animals (group II) and the control groups III and IV. The concentrations of 5‐hydroxyindoleacetic acid (5‐HIAA) in the cortex and brain stem were higher in group I than in group IV. Infusion of BCAA to rats with liver ischemia normalized the concentrations of 5‐HIAA in the cortex and brain stem. (Journal of Parenteral and Enteral Nutrition 10:474–478,1986)
Microbial Growth Patterns in a Total Parenteral Nutrition Formulation Containing Lipid Emulsion
Authors: Gilbert Michael , Gallagher S. Cathy , Eads Michael , Elmore Michael F. 
Published: May 2008

Microbial growth of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Candida albicans was evaluated in a standard amino acid‐dextrose‐based total parenteral nutrition (TPN) solution, 10% lipid emulsion, and a combined TPN formulation containing amino acids, dextrose, and lipid emulsion. At an initial inoculum of 104 CFU/ml, all three bacterial organisms grew well in 10% lipid emulsion, died in the standard solution and grew only minimally or died in the combined formulation. C. albicans grew in all three formulations at an initial inoculum of 104 CFU/ml; however, at an initial inoculum of 102 CFU/ml, which approximates touch contamination, growth of Candida in the standard and combined formulations was <1 log at 24 hr in contrast to the 10% lipid emulsion which showed significant growth >2 log at 24 hr.It is concluded that a 24‐hr infusion time is safe for the combined TPN formulation used in this study. This should result in significant cost savings compared to the previously recommended 12‐hr infusion time. (Journal of Parenteral and Enteral Nutrition 10:494–497, 1986)
Hormonal and Metabolic Responses to Glucose Infusion in Sepsis Studied by the Hyperglycemic Glucose Clamp Technique
Authors: White Roger H. , Frayn Keith N. , Little Roderick A. , Threlfall Cedric J. , Stoner H.B. , Irving Miles H. 
Published: May 2008

Although nutritional support is vital to treatment of severe sepsis, the septic patient does not respond normally to glucose infusion. We have used the hyperglycemic glucose clamp technique to investigate the initial hormonal and metabolic responses of the septic patient to glucose under controlled conditions. The plasma glucose concentration was raised to and maintained at 12 mmol/liter for 2 hr in 12 septic patients and 11 normal controls. Glucose utilization, assessed from the amount infused, was significantly depressed in the patients, despite similar plasma insulin concentrations in the two groups. Forearm glucose uptake was similarly impaired. Despite very similar plasma free fatty acid concentrations in the two groups, which were suppressed equally by the glucose infusion, whole‐body fat oxidation was elevated in the patients compared with the controls, and suppressed to a lesser extent in response to glucose. Glycerol and ketone body concentrations were elevated in the patients in keeping with a picture of accelerated release, clearance, and oxidation of fatty acids.Plasma cortisol, epinephrine, and norepinephrine concentrations were elevated in the septic patients in a severity‐related manner, but not to high levels compared with experimental work. Norepinephrine showed no response to the glucose infusion in either group. Plasma glucagon concentrations were not significantly elevated in the septic patients.We conclude that the hyperglycemic glucose clamp provides a useful model for studying glucose intolerance in sepsis. Impaired glucose utilization in septic patients is associated with increased fat oxidation, although the hormonal basis for these changes is still unclear. (Journal of Parenteral and Enteral Nutrition 11: 345–353, 1987)
Relation of Serum Albumin Concentration to Death Rate in Nursing Home Men
Authors: Rudman Daniel , Feller Axel G. , Nagraj Hoskote S. , Jackson Daniel L. , Rudman Inge W. , Mattson Dale E. 
Published: May 2008

Serum albumin was measured in 126 men (average age 70.6; range 40 to 96) of a Veterans Administration Nursing Home, and was correlated with other items in an extensive clinical data base, including death or survival during the year after the analysis. The reason for institutionalization was chronic neurologic disease or other disabling physical condition in 63 men (group A), and psychiatric disorder in 63 men (group B).In group A, the proportions of men with albumin <3.5, 3.5–4.0, and >4.0 g/dl were 6%, 37%, and 57%, respectively. In this group, the serum albumin level was significantly (p < 0.05) correlated with death rate, hemoglobin, hematocrit, serum cholesterol, and serum lactic dehydrogenase. The death rate in group A during the year after the albumin analysis was 25%. For the patients with albumin level <3.5, 3.5–4.0, and >4.0 g/ dl, the death rates were 50%, 43%, and 11 % respectively (p < 0.01 for comparison of the former two groups with the latter). The subgroup with albumin 3.5–4.0 g/dl represented only 37% of the men in group A, but accounted for 63% of the group's deaths.In group B, serum albumin level was not significantly correlated with any other clinical variable. Death rate during the year after the albumin analysis was only 2% in group B, and did not correlate with the albumin level.These data indicate that, in nonpsychiatric Nursing Home men, the desirable level for the serum albumin concentration is higher than 3.5 g/dl. (Journal of Parenteral and Enteral Nutrition 11:360–363, 1987)
Effects of Intermittent Electrical Stimulations on Muscle Catabolism in Intensive Care Patients
Authors: Bouletreau P. , Patricot M.C. , Saudin F. , Guiraud M. , Mathian B. 
Published: May 2008

To determine whether muscular contractions obtained by electrical stimulation in immobilized patients are able to reduce muscle catabolism, we studied 10 patients (65–79 yr old) hospitalized in the intensive care unit for postoperative ventilatory failure or cerebral infarction. Artificial nutrition was the same for each patient during the 9‐day study period. Two periods of 4 days were defined and randomized for each patient, separated by one day. During the muscular stimulation (MS) period, intermittent electrical stimulation of the muscles of the legs (external electrodes), were performed daily during 2 X 30 mn. During the other period, muscular stimulations were not performed.Urinary excretion of nitrogen (micro‐Kjeldhal digestion and Nessler procedure), creatinine (Jaffe reaction), and 3‐methyl histidine (3‐MH) (gas phase chromatography) was measured every day.a t‐test for paired data.We conclude that a significant decrease in 3‐MH and creatinine excretion is observed during the MS period. In intensive care unit patients, muscle protein breakdown may be influenced by intermittent muscular electrical stimulation. (Journal of Parenteral and Enteral Nutrition 11:552–555, 1987)
Research Activities and Interests of Dietitians
Authors: Schiller M. Rosita 
Published: May 2008

A survey was conducted to ascertain research involvement and interests of dietitians. The survey questionnaire was developed and mailed to 1200 dietitian members of The American Society of Parenteral and Enteral Nutrition (A.S.P.E.N.). Usable responses numbered 424 (35.3%); 84% were A.S.P.E.N. members 5 years or less. Currently 46% and previously 17% of respondents served on nutrition support (NS) teams. Two‐thirds of the group either completed or were enrolled in a graduate program. Only one‐half of the respondents had statistics and/or research methodology courses.Half the group spent no time in research, 10% gave 10–50 hr/week and nearly 80% wanted to spend more time in this activity. One‐fifth were principal investigators (PI), 27% were co‐investigators and 29% had collected data for others. Although 16% wrote proposals, fewer than 10% had projects approved and/or funded; co‐investigators were more successful than PIs in this regard. Several (22.2%) presented research papers or posters and 36% gave seminars, case studies, or short presentations. One‐fifth (20.8%) published research articles and 20.3% published other works.More than 80% expressed interest in collaborative research, perhaps because many felt they lacked skills needed to develop research designs, write proposals, analyze data, obtain funding, and get published. Most said research was not rewarded, of a low priority, and generally ignored by the dietetics department; 60.5% had great interest in research and 37.1% had adequate research opportunities. No significant differences were observed for those with graduate degrees or for members of NS teams but A.S.P.E.N. dietitians appeared to be more active in research than other dietitians (Journal of Parenteral and Enteral Nutrition 12:1–7, 1988)
Activity of Natural Killer Cells after Postoperative Amino Acid Infusion
Authors: Nissilä Markku , Salo Matti , Granberg Christer , Perttilä Juha , Neuvonen Pekka 
Published: May 2008

Effects of postoperative infusion of a 3% amino acid solution on natural killer (NK) cell activity were studied in 10 patients undergoing major abdominal surgery. Eight additional patients formed the control group. Preoperative NK cell activity against K562 target cells determined in a short‐term 51Cr release assay was similar in patients of both groups. After the operation, in general the patients of both groups showed a decrease in NK cell activity (p < 0.01) but without differences between the groups. There were no changes in the percentages of Leu‐7 positive cells (NK cells) between or within the two groups. However, the number of Leu‐7 positive cells in blood was lower in the amino acid than in the control group patients during the postoperative days 3–7 (p < 0.05 and 0.01).In vitro, the amino acid solution proved to be nontoxic both for effector and target cells and no depression of NK cell activity was observed. A 16‐hr preincubation of mononuclear cells with the amino acid solution did not affect NK cell activity.The results suggest that postoperative infusion of an isotonic amino acid solution does not routinely offer any advantages over glucose containing electrolyte solution as to its effects on NK cell activity. (Journal of Parenteral and Enteral Nutrition 12:346–350, 1988)
Serotonin Metabolism in the Central Nervous System in Portacaval Shunted Rats Infused with Fat Emulsion
Authors: Bengtsson Finn , Bugge Mogens , Herlin Per , Nobin Anders , Jeppsson Bengt 
Published: May 2008

Increased brain concentrations of tryptophan, and presumably thereby increased brain serotonin metabolism, have been observed following liver impairment and implicated in the etiology of portal‐systemic encephalopathy (PSE). Increased plasma‐free tryptophan (ie, not albumin‐bound) concentrations can be expected after exogenous fat administration. This might further increase the brain serotonin metabolism in liver failure and negatively influence the PSE.We treated rats 2 weeks after end‐to‐side portacaval shunt (PCS) with continous intravenous infusion of fat emulsion (Intralipid 20%) for 24 and 72 hr, respectively. The regional serotonin turnover was determined in different regions of the central nervous system (CNS) by measuring 5‐hydroxyindole concentrations after NSD 1015 decarboxylase inhibition. The results revealed no further increase of the CNS serotonin turnover after fat infusion to PCS rats, compared with PCS rats given equal amounts of glucose. Thus, continuous infusion of a fat emulsion caused no major alteration of the CNS serotonin metabolism in PCS rats. (Journal of Parenteral and Enteral Nutrition 13:65–70, 1989)
Clearing Obstructed Feeding Tubes
Authors: Marcuard Stefan P. , Stegall Karen L. , Trogdon Sidney 
Published: May 2008

This is a report of an in vitro study evaluating the ability of six solutions to dissolve clotted enteral feeding, which can cause feeding tube occlusion. The following clotted enteral feeding products were tested: Ensure Plus, Ensure Plus with added protein (Promod 20 g/liter), Osmolite, Enrich, and Pulmocare. Clot dissolution was then tested by adding Adolf's Meat Tenderizer, Viokase, Sprite, Pepsi, Coke, or Mountain Dew. Distilled water served as control. Dissolution score for each mixture was assessed blindly. Best dissolution was observed with Viokase in pH 7.9 solution (p < 0.01). Similar results were obtained when feeding tube patency was restored in eight in vitro occluded feeding tubes (Dobbhoff, French size 8) by using first Pepsi (two/eight successful) and then Viokase in pH 7.9 (six/six successful).We also report our experience in the first 10 patients with occluded feeding tubes using this Viokase solution injected through a Drum catheter into the feeding tube. In seven patients, this method proved to be successful, and the reasons for failure in three patients include a knotted tube, impacted tablet powder, and a formula clot of 24 hr duration and 45 cm in length. (Journal of Parenteral and Enteral Nutrition 13:81–83, 1989)
Attenuation of the Febrile Response in Guinea Pigs by Fish Oil Enriched Diets
Authors: Pomposelli James J. , Mascioli Edward A. , Bistrian Bruce R. , Lopes Sarah M. , Blackburn George L. 
Published: May 2008

The influence of dietary lipid manipulation on the fever response to an injection of murine recombinant Interleukin‐1 (rIL‐1) in guinea pigs was examined. The animals were fed diets identical except for the lipid source for periods of 5 and 6 wk. In vitro thromboxane B2/B3 (TxB2/B3) production in collagen‐stimulated whole blood was also measured. One diet was enriched with menhaden oil, high in the omega‐3 series of fatty acids. The other diet contained safflower oil, consisting primarily of the omega‐6 fatty acid linoleic acid (74%). Animals fed the fish oil‐enriched diet for 6 wk not 5 week had a blunted fever response after rIL‐1 injection. This was associated with a 27% increase (p < 0.05) in total omega‐3 fatty acids in plasma phospholipids between weeks 5 and 6 in fish oil‐fed animals. Safflower oil‐fed animals produced a “normal” febrile response regardless of the duration of feeding. Safflower‐fed guinea pigs demonstrated a significant increase in TxB2/B3 production in whole blood after 6 wks that was associated with a 25% increase (p < 0.05) in plasma phospholipid arachidonic acid levels between weeks 5 and 6. Despite significant reductions in phospholipid linoleic acid in animals fed fish oil, arachidonic acid levels remained unchanged.In the guinea pig model used, long‐term menhaden oil feeding can significantly blunt the febrile response induced by exogenous Interleukin‐1. Also, a high intake of linoleic acid as seen in safflower oil feeding can significantly increase thromboxane production in stimulated whole blood. Thus, the type of fatty acids available at the substrate level could affect the physiologic response to injury and/or infection. (Journal of Parenteral and Enteral Nutrition 13:136–140, 1989)
A Mortality Risk Index for Men in a Veterans Administration Extended Care Facility
Authors: Rudman Daniel , Mattson Dale E. , Feller Axel G. , Nagraj Hoskote S. 
Published: May 2008

The purpose of this study was to develop (phase I) and validate (phase II) a mortality prognostic index, based on the annual clinical data base, for the men of this Veterans Administration extended care facility.The study population during phase I consisted of 123 men who were residing in three of the seven wards of the facility in August 1984. Sixty‐six of these individuals were institutionalized because of a chronic neurologic (50) or medical (15) disorder (“nonpsychiatric group”). In 57 men, the reason for institutionalization was a chronic psychosis (schizophrenia, 53; manic depressive illness, 4) (“psychiatric group”). During August to October 1984, a comprehensive clinical data base comprising 70 attributes (including diagnoses and drugs) was collected. Deaths were recorded during the next 14 months. Death rate during the 14 months of observation was 33.3% in the nonpsychiatric group, and only 1.7% in the psychiatric group. In the nonpsychiatric men, univariate analysis yielded six attributes significantly correlated with death rate: serum cholesterol level, hematocrit, hemoglobin, midarm muscle circumference, triceps skinfold, and number of morbidity episodes. After serum cholesterol and hematocrit had been entered into a multivariate analysis model, none of the other four attributes contributed significant information about death rate. The multivariate analysis led to a mortality risk index (MRI) for nonpsychiatric patients, MRI = [hematocrit in %] + 10% [serum cholesterol in mg/dl]. As MRI varied from <50 to >65, death rate in the nonpsychiatric group varied in parallel from 86–11%. At the cut‐off level MRI = 60, sensitivity was 0.86, specificity was 0.66, positive predictive accuracy was 0.56 and correct classification was 0.73. The odds ratio for the same cut‐off level was 12.2.In phase II, the study population was 116 nonpsychiatric men residing in the remaining four wards of the Extended Care Facility in August 1984. Mortality rate during the 14 months after August 1984 was 31%. The relation of death rate to MRI was generally similar to that observed for the nonpsychiatric men in phase I of the study.When data of phases I and II were combined and cut‐off point of 60 on the MRI was chosen, the odds ratio was 6.45. (Journal of Parenteral and Enteral Nutrition 13 :189–195, 1989)
Survey of Home Nutritional Support Patients
Authors: Herfindal Eric T. , Bernstein Linda R. , Kudzia Kathryn , Wong Alvin 
Published: May 2008

Patients receiving home parenteral nutritional services from a major corporate provider were surveyed using a written questionnaire. The survey questioned the patients about use of home parenteral nutritional services and the quality of life while receiving home parenteral therapy. Patient satisfaction with home nutritional support services, and the impact home therapy has on patient medical, financial and psychosocial status were examined. Life satisfaction measures were compared with that of end stage renal disease patients and the overall United States population.Of the 1140 patients sent the written questionnaire, 347 (30.4%) returned the survey. Half the patients had been placed on home parenteral nutrition services because of short bowel syndrome. The mean length of time respondents had been receiving home parenteral nutrition services was 35 months, reporting approximately one hospitalization per year due to complications of their home parenteral nutrition. Blood infection with catheter as focus was most frequently reported as being responsible for hospitalization. The number of hospitalizations due to complications of home parenteral nutrition therapy was positively correlated with length of time on the program. Overall, respondents were satisfied with their home nutrition services, but were less satisfied with life as a whole when compared to the overall United States population and to end stage renal disease patients. (Journal of Parenteral and Enteral Nutrition 13:255–261, 1989)