Jpen Parenter Enter
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Jpen Parenter Enter · May 1991
Case ReportsSelenium deficiency and cardiomyopathy in acquired immunodeficiency syndrome.
Selenium deficiency is common in patients with human immunodeficiency virus infection and may contribute to the development of cardiomyopathy. A 5-year-old boy with congenital human immunodeficiency virus infection developed cardiomyopathy. ⋯ Cardiac function improved on selenium supplementation. The role of selenium in cardiac dysfunction and the need for nutritional evaluation and supplementation of malnourished patients with acquired immunodeficiency syndrome is discussed.
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Jpen Parenter Enter · Mar 1991
Effect of various lipid emulsions on total parenteral nutrition-induced hepatosteatosis in rats.
The effect of various lipid emulsions on the development of fatty liver during total parenteral nutrition (TPN) was investigated in rats given TPN for 7 days. Medium-chain triglycerides (MCT), long-chain triglycerides (LCT), chemically defined triglycerides (CDT; structured lipid with a high purity of 94.3%), and a mixture of MCT and LCT (MIX) were prepared as the lipid emulsions. TPN provided 350 kcal/kg/day, with a nonprotein calorie/nitrogen ratio of 160. ⋯ Total cholesterol and phospholipids tended to be high in the MCT TPN group. The hepatic lipid content was higher in the lipid-free TPN and the MCT TPN groups, and lower in the CDT and LCT TPN groups. Histologically, the livers of the MIX, CDT, and LCT TPN groups showed less fatty change than those of the FREE and MCT groups.
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Jpen Parenter Enter · Jan 1991
Case ReportsSevere lactic acidosis related to acute thiamine deficiency.
The authors report a case of severe lactic acidosis in a 3-year-old boy, after 20 days of total parenteral nutrition without vitamin supplementation. This child with acute lymphoblastic leukemia underwent a period of severe refractory lactic acidosis (pH between 6.81 and 7.00 and a serum lactate level up to 38 mmol/liter) leading to cardiac arrest. ⋯ An associated transient pancreatic dysfunction was also noted. The patient's overall course with thiamine replacement therapy led to a complete recovery within 5 days and no sequelae were noted after 12 months.
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Jpen Parenter Enter · Sep 1990
ReviewA clinical application of exercise physiology and nutritional support for the mechanically ventilated patient.
A challenging problem facing the clinician is the management of critically ill patients in whom repeated attempts at weaning from mechanical ventilation are unsuccessful. The difficulty weaning these patients from the ventilator can be augmented in the presence of detraining of respiratory muscles, malnutrition, stress and the metabolic response to injury, and/or immobilization. An understanding of basic concepts of established tenets of exercise physiology and of nutritional support will allow their application to respiratory muscle function with the goal of facilitating the endurance and strength of respiratory muscles needed to sustain spontaneous ventilation.
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Jpen Parenter Enter · Jul 1990
ReviewEffects of glutamine-supplemented diets on immunology of the gut.
Recent research developments have identified the gastrointestinal tract as the most metabolically active organ after surgical stress. In addition to fulfilling its role as an organ of digestion and absorption, the gut must maintain immunologic function in order to protect the host from invading pathogens. ⋯ The synthesis and expression of IgA in secretions appear to be sensitive to dietary alteration and may be impaired after surgical stress. Data are presented suggesting that maintenance of gut mass and barrier function to bacteria via dietary manipulation may be essential to ensure host survival during critical illness.