摘要:

The influence of dietary nucleotides on susceptibility to candidiasis in mice was studied using two criteria: animal survival and recovery of viable Candidaalbicansorganisms from the kidney and spleen. One‐month‐old mice were placed on one of five diets with varying nucleotide content. The results show that mice maintained on a nucleotide‐free diet (NF) exhibit a significantly decreased mean survival time and a significantly increased viable organism recovery in the spleen following intravenous injection of graded inocula of C. albicans compared to mice fed diets containing RNA or uracil as a nucleotide source.(Journal of Parenteral and Enteral Nutrition12:49–52, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200149

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718801200604

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Broviac catheters are commonly used to provide parenteral nutrition and access for infusion of blood products and drugs to pediatric patients. Sepsis is the most common serious complication of continued catheter use. Although removal of the catheter is generally recommended when it becomes contaminated, it may not be feasible to do so without compromising patient care. We evaluated the management of catheter‐related infections in pediatric patients with and without removal of catheter. Seventy‐seven episodes of catheter sepsis were evaluated in 61 pediatric patients; 24 were neonates and 37 were older children. The catheters were used for multiple purposes in 75% of cases. The most common microorganisms isolated wereStaphylococcus epidermidisin 26%,Klebsiella pneumoniaein 9%, andStreptococcus viridansin 8% of cases; other pathogens included group D Enterococcus,Staphylococcus aureus,andEscherichia coli. Pseudomonas aeruginosawas isolated in four older children. Thirty‐five patients were treated with antibiotics without catheter removal. Thirty patients received appropriate antibiotic therapy based on the susceptibility data. Twenty‐six of these 30 patients responded within 5 days of therapy whereas the others required 15–39 days of treatment. Lack of response was mainly associated with the presence of abscess, immunocompromised status, and organisms P.aeruginosaandCandida albicans.Based on the sensitivity and minimum inhibitory concentration data, a combined regimen of gentamicin and vancomycin would be an effective initial therapy. These findings suggest that (1) catheter sepsis can be managed with appropriate antibiotics, and (2) when continued use of Broviac catheter is desired, a trial of antibiotic therapy should be attempted before catheter removal.(Journal of Parenteral and Enteral Nutrition12:58–59, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200158

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718801200605

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Artificial lipid particles used as parenteral nutrition solution do not contain any apolipoproteins when they are infused into the circulation. Despite the absence of apolipoproteins, the metabolism of artificial lipid particles is similar to that of chylomicrons which contain various kinds of apolipoprotein. Of the known apolipoproteins, apolipoprotein C‐II (apo C‐II) is important in the hydrolysis of triglyceride‐rich lipoproteins via involvement in the activation of lipoprotein lipase. Modifications of apo C‐II associated with intravenous infusion of a lipid emulsion were investigated in eight patients. Changes in apo C‐IIs in high density lipoproteins (HDL), low density lipoproteins (LDL) and very low density lipoproteins (VLDL) together with the plasma level of triglycerides, were quantified before and for 90 min after a bolus injection of a 10% lipid emulsion (1 ml/kg of body weight). Immediately prior to the injection, 54% of the total amount of apo C‐II was present in HDL, while 27% was present in VLDL. After 5 to 10 min, the amount of apo C‐II in HDL decreased to 29% of the total, while that in VLDL increased to 62%. Subsequently, the amounts of apo C‐II in HDL and VLDL began to return to the preinjection levels. These variations in apo C‐II were closely correlated with the plasma clearance of triglyceride. The result indicates that the injected lipids are not inert particles during their short intravascular life, but that they acquire apo C‐11 from HDL. (Journal of Parenteral and Enteral Nutrition12:60–62, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200160

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718801200606

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

In seven moderately overweight noninsulindependent diabetics with slightly elevated triglyceride levels, disappearance rates of infused medium chain triglyceride/long chain triglyceride (MCT/LCT) and long chain triglyceride (LCT) emulsions were compared. Five metabolically healthy volunteers served as controls. During a 3‐hr lipid infusion, serum triglycerides reached a steady state with both emulsions in the healthy controls, whereas, in diabetic patients, steady state triglyceride levels were seen only with MCT/LCT. After the end of the lipid infusion, the longest half‐life value in the decline of triglyceride levels was found with LCT in diabetics, whereas significantly shorter and quite similar half‐life values were found with LCT in healthy controls and with MCT/LCT in diabetics. As expected, the shortest half‐life for serum triglycerides was found in healthy controls after MCT/LCT‐infusion. Virtually the same differences in serum concentrations and in half‐life times were seen with free fatty acids. According to these data, if needed, parenteral nutrition with lipids in states of disturbed glucose and lipid metabolism may preferentially be done with MCT/LCT emulsions. (Journal of Parenteral and Enteral Nutrition12:68–71, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200168

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718801200607

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Infection may elicit a clinical picture of metabolic and hemodynamic compromise that can deteriorate acutely to shock and death. Alternatively, injury or infection can lead a more indolent course, resulting in a progressive catabolic state that in time may advance to cachexia, organ failure, and death. Recent data suggest a complex array of endogenous humoral‐ and immunomodulators may orchestrate many of these detrimental responses. It has become clear that cachectin/tumor necrosis factor, a protein secreted by monocytes in response to many inflammatory, and injurious stimuli, holds a pivotal role in these host responses to injury. Circulating levels of this monokine is found in greater abundance and in higher frequency in seriously ill patients. The cellular metabolic response to cachectin/TNF simulates many of the pathophysiologic changes seen in injury and infection. Administration of cachectin/TNF to animals and man can mimic the clinical syndromes of cachexia or endotoxic shock, and neutralization of circulating activity of this protein protects experimental animals against the detrimental consequences of otherwise lethal infection. (Journal of Parenteral and Enteral Nutriton12:072S‐077S, 1988)

ISSN:0148-6071    

DOI:10.1177/014860718801200608

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718801200609

出版商:SAGE Publications    

年代:1988

数据来源: WILEY