摘要:

The precise molecular immunogenetics of celiac disease continues to be defined. Susceptibility to celiac disease appears to be due to a particular HLA-DQ heterodimer and the association of the condition with HLA-DP is probably due to linkage disequilibrium. The role of small intestinal lymphocytes expressing the γ/Δ T-cell receptor in celiac disease continues to be investigated; their numbers are definitely raised in the condition but such increases are not restricted to celiac disease. The controversy surrounding the potential involvement of adenovirus 12 in the etiology of celiac disease is unresolved. Investigation continues into the precise structure of the peptide within gluten that is toxic.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This review summarizes further work characterizing the nature of the Na/glucose cotransporter and the Na/H exchanger, together with studies that question the central role of Cl secretion as the main driving force for fluid secretion. The integration of the large number of hormones, neurotransmitters and peptides involved in modulating small intestinal water and electrolyte transport into a coherent model is proving to be extremely complex. Definition of the role of single factors is currently being undertaken and this review highlights recent advances in this area. The role of diet in this respect is particularly interesting and potentially important clinically. The coordinated behavior of smooth muscle and secretory processes in small intestine is still being elucidated, but it is already clear that it is a process of some sophistication and subtlety. One endpoint of a better definition of the pathophysiology of diarrhea is better clinical management. There are therefore reviews on improved oral rehydration solutions for gastroenteritis, better management of fluid and electrolyte balance in short bowel syndrome, and recent advances in the pharmacologic treatment of diarrheal disease.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In the 1990s, the most exciting and controversial areas in physiology and metabolism of nutrition are those related to weight control and obesity in relation to food composition; alcohol metabolism and its effects on nutrition; fish oils; insulin resistance and atherogenesis; and growth hormone levels and body composition in the adult.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In the past year, many studies demonstrated the reliability of nutritional indicators in predicting clinical outcome. However, use of nutritional indicators in assessing nutritional status in hospitalized patients has been questioned, because many indicators are affected by clinical events unrelated to nutrient intake and may not change despite aggressive nutritional therapy. Studies evaluating the effect of nutritional therapy on nutritional indicators and clinical outcome are reviewed. New contributions in assessing nutritional status are also presented.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The provision of enteral nutritional support has developed rapidly in the past 5 years for a number of different reasons. Advances in our understanding of the processes of nutrient absorption have led to the development of formulas that are more physiologic. Of course, without safe and effective means of access to the gastrointestinal tract, even the best diet would not be adequate if intake were limited by poor techniques of administration. The physiology of the gastrointestinal tract is better understood, particularly with respect to what happens to small and large bowel motility and fluid flows during normal eating or during continuous nasoenteral infusion in both health and disease. Thus it is now feasible to provide diets that will meet all nutrient requirements, which contain substrates thought to beneficially moderate the inflammatory response, and which can be delivered by a number of routes other than through a nasoenteral tube. This review attempts to summarize a diverse literature.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Children are not little adults. Their needs differ from those of adults because of the rapid and complex changes they undergo in metabolism and development. These changes have their basis in growth, and the rate of growth changes during childhood: It is extremely rapid during the first year of life, then it slows until adolescence, when it again accelerates. The composition of body mass accreted varies during childhood. It is mostly fat during the first year of life and during adolescence in girls. Children's nutrient needs therefore vary with their age and rate of growth. The following studies focus on the relation between early nutrition and later achievement, nutrition in premature infants, nutrition in children with cystic fibrosis, the controversy over cholesterol screening and intervention programs, and primary malnutrition.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Nutritional factors greatly affect the aging process. Modestly elevated homocysteine levels are a significant risk factor for cerebrovascular accidents and for the development of coronary artery disease and peripheral vascular disease. Several metabolic and nutritional defects lead to hyperhomocysteinemia, a condition that can be found in up to 40% of patients with vascular disease. Folate supplementation decreases homocysteine levels. Simple nutritional assessment can be used to predict the risk for morbidity and mortality in the elderly. The most useful factors are low albumin levels, significant weight loss, and extreme body mass index values. The potential for nutritional intervention lays in recognizing these markers. Osteoporosis remains a major health problem in the elderly. Optimal management of osteoporosis may require nutritional intervention with vitamin D and calcium supplementation, an exercise regimen, and pharmacologic support. Malnutrition adversely affects the immune system. Supplementation with various micronutrients in nutritionally replete elderly persons significantly increases indices of cell-mediated immunity. The clinical significance of this observation is not yet known.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Vegetable oils have been used both enterally and parenterally for many years. This experience has helped identify the various benefits and risks associated with their use. Newer lipids have been developed to substitute for the presently available ones. Among the newer generations of lipids are medium-chain triglycerides, structured triglycerides, and ω3 polyunsaturated fatty acids. These lipids are a good source of calories and play a role in modifying patients' metabolic responses to disease in a favorable manner. Medium-chain triglycerides are oxidized better than long-chain triglycerides, with very little stored as fat. Unlike long-chain triglyceride emulsions, they minimally interfere with immune function as measured by reticulo-endothelial system uptake. The ω3 polyunsaturated fatty acids, which are found in large quantities in fish oil, have shown benefit in many clinical situations. Hypotriglyceridemia, increased high-density lipoprotein levels, decreased platelet aggregability, and blood pressure control seem to be beneficial in cerebral and cardiovascular disease. Because of their ability to incorporate into cell membranes and alter eicosanoid metabolism, they seem to play a role in immunomodulation and attenuating the body's response to overwhelming sepsis.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Current investigations focus on the role of micronutrients in the development, prevention, and treatment of chronic diseases. Within the context of the literature published during the review period, this presentation concentrates on the importance of micronutrients in human nutrition. Particularly emphasized is the immune function of micronutrients as antioxidants, and their role in preventing cancer and degenerative diseases such as atherosclerosis and cataracts.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID