Nutrition
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Randomized Controlled Trial Clinical Trial
Influence of polymeric enteral nutrition supplemented with different doses of glutamine on gut permeability in critically ill patients.
To evaluate the effect of glutamine-supplemented polymeric enteral formulas on the recovery of gut-permeability abnormalities in critically ill patients. ⋯ Even though polymeric enteral nutrition was associated with a significant improvement in the L/M ratio, glutamine supplementation did not show a specific influence in improving recovery of gut permeability in critically ill patients.
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With the recent implementation of the folic-acid-fortification program, our objective was to estimate its benefits in adult women and account for the higher bioavailability of synthetic folic acid in fortification programs and supplements. ⋯ Based on this sample of well-educated, adult women, the current level of folic-acid fortification should improve the intakes of a large proportion of women, especially when accompanied by supplements containing folic acid. These improvements in folate intake might not be seen in groups with limited resources, however. Further, under existing standards and practices, many women will not meet current recommendations for prevention of neural-tube defects.
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Review Comparative Study
Decisions for enteral access in the intensive care unit.
When making decisions regarding nutrition support, many factors must be considered before committing a patient to receive parenteral or enteral nutrition. Parenteral nutrition (PN) is more expensive and technically more difficult to administer than enteral nutrition (EN). The charge for PN can range from US 200 dollars to 1000 dollars per day, where a standard hospital diet or enteral tube feedings might cost less than US 25 dollars/d. ⋯ If enteral therapy can be instituted, significant patient-care cost savings may be realized. This presentation will discuss decisions that must be addressed in the intensive care unit. With more physician education, protocols can be designed to provide the most advantageous use of nutrition support for the benefit of the hospitalized patient.
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Pentoxifylline interrupts early gene activation for tumor necrosis factor, interleukin-1, and interleukin-6 production and improves survival from experimental sepsis. These effects can alter nitrogen loss during critical illness. To determine the dose-dependent influence of pentoxifylline on nitrogen loss, 44 male Sprague-Dawley rats (220 to 265 g) were randomized to receive parenteral nutrition only (PN), PN plus continuous infusion of Escherichia coli 026:B6 lipopolysaccharide (LPS) at 9 mg x kg(-1) x d(-1), or PN plus LPS plus a continuous infusion of pentoxifylline at either 25 (PEN25) or 100 mg x kg(-1) x d(-1) (PEN100) for 48 h. ⋯ Pentoxifylline, given in therapeutic doses after an endotoxin challenge, modestly, but not significantly, improved nitrogen balance. Urinary 3-methylhistidine excretion was not influenced by pentoxifylline. A dose-dependent effect by pentoxifylline on these markers was not evident.