Nutrition
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Randomized Controlled Trial Clinical Trial
Circulating concentrations of soluble leptin receptor: influence of menstrual cycle and diet therapy.
Concentrations of the soluble leptin receptor (sOB-R) may be related to leptin resistance in obesity. We measured sOB-R concentrations in serum in 103 non-diabetic Japanese men and women. All subjects were grouped according to body mass index (BMI; in kg/m(2)). ⋯ Serum sOB-R concentrations did not change significantly during the menstrual cycle. Our results showed that serum sOB-R concentrations decrease with increasing BMI and that sex hormones likely do not affect serum sOB-R concentrations in non-pregnant women. The reduction in serum sOB-R concentrations in overweight and obese persons may reflect downregulation of hypothalamic leptin receptor production as a result of an increase in circulating leptin and might be an important factor in leptin resistance.
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We previously reported that omega-6 fat emulsion increases cytokine production in burned rats. Effects of soybean oil emulsion on surgical stress responses and lymphocyte function according to the surgical severity have not been studied in detail. We investigated the effects of soybean oil emulsion, which contains 50% omega-6 fatty acid, on postoperative stress responses and cell-mediated immune function according to the severity of surgical stress. ⋯ Soybean oil emulsion amplifies the stress responses and possibly suppresses cell-mediated immune function induced by surgical stress in severely stressed patients, but not in moderately stressed patients.
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We respectively compared the nutritional and clinical efficacies of eucaloric and hypocaloric enteral feedings in 40 critically ill, obese patients admitted to the trauma or surgical intensive care unit. ⋯ These data suggest that hypocaloric enteral nutrition support is as least as effective as eucaloric feeding in critically ill, obese patients.
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The most basic mechanism of cellular protection involves the expression of a highly conserved family of essential proteins, known as heat shock or stress proteins (HSPs). The expression of these proteins after a sublethal insult can induce "stress tolerance" and protect against a subsequent stress that otherwise would be lethal. Experimental data have shown that preinduction of the heat stress response can provide marked protection against many forms of cellular injury, including ischemia and reperfusion, lung injury, and shock. ⋯ Further, recent data from me and my colleagues indicate that a single dose of intravenous GLN can enhance HSP expression, decrease end-organ injury, and enhance survival from septic shock in the intact rat. Thus GLN, which is beneficial in many settings of critical illness and injury, may be a clinically applicable enhancer of HSP expression. These results indicate that GLN could be used to enhance HSP expression and attenuate end-organ injury in situations when a major clinical stress is anticipated, such as before major surgical procedures (e.g., cardiac, vascular, and transplantation) or in the critically ill.
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Randomized Controlled Trial Clinical Trial
Enforced mobilization, early oral feeding, and balanced analgesia improve convalescence after colorectal surgery.
A postoperative regimen using a multimodal approach with enforced mobilization and early oral nutrition has been reported to improve convalescence but has not been compared with other postoperative regimens. ⋯ This active per- and postoperative regimen based on a multimodal approach improved ambulation time and muscle function during admission and late convalescence.