摘要:

Does retrograde electrical pacing of a continuously perfused jejunal segment increase absorption of xylose and vitamin C? Proximal jejunal segments (75 cm) were isolated from the intestinal stream in 5 dogs, and recording and stimulating electrodes attached. A solution containing 139.9 mmol/ liter xylose, 0.57 mmol/liter vitamin C, and 79.9 mmol/liter sodium chloride was infused into the loop at a rate of 2.8 ml/ min. Effluent from the loop was collected in 5‐min aliquots during 3 consecutive periods of 30 min, and the composition of each analyzed. During the second period, when retrograde electrical pacing was performed, there was a significant decrease in water, xylose, and vitamin C output (p<0.0001).

ISSN:0148-6071    

DOI:10.1177/0148607181005002103

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Essential fatty acid (EFA) status was assessed in 48 normal Thai adults and 6 patients who required tube feeding for 2–4 wk with commercial soybean‐base formula (Sobel, Mead Johnson). Each 1000 kcal of this formula provided 40.2 g protein, 32.8 g fat, 136 g carbohydrate, 13.9 g linoleic acid, 2.9 g linolenic acid, and 0 g arachidonic acid. The linoleic acid status in these patients before receiving soybean‐base formula was inadequate, as evidenced by the significantly lower serum 18:2‐W6 percentage but higher serum 16:1‐W7 and 18:1‐W9 percentages than those in normal adults. These changes were reversed while receiving soybean‐base formula. A significant positive correlation between linoleic acid intake and its serum level was demonstrated. There was a significant decrease in serum 20:4‐W6 percentage while receiving soybean‐base formula. This could be related to the absence of this EFA in the formula and suppression of biotransformation of 18:2‐W6 to 20: 4‐W6 in the presence of a significant amount of 18:3‐W3. None of the patients had 20:3‐W9 in the serum or developed scaly dermatitis throughout the study.

ISSN:0148-6071    

DOI:10.1177/0148607181005002106

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

In 23 adult patients with pancreatic insufficiency, we evaluated the efficacy of a pancreatic enzyme delivered as pH‐sensitive enteric‐coated pancrelipase microspheres, and compared it with placebo and other available enzyme supplements. In a short‐term study, fecal fat was 23.5 ± 7 g/day with the microspheres, compared with 29.9 ± 8 with other supplements, providing fat utilization of 76 ± 7% versus 63 ± 10% (p<0.05). Microspheres reduced daily stool frequency to 1.9 movements from 4.3 on other enzymes (p<0.01). These results were obtained with an average intake of 10 microsphere capsules/day. In a year‐long study of 22 patients, an average weight gain of 4.0 ± 1.1 kg was observed associated with return of near‐normal social and work life‐style in previously housebound patients.

ISSN:0148-6071    

DOI:10.1177/0148607181005002110

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Until recently, medium chain triglycerides (MCT) have not been used in parenteral nutrition (PN) although they are considered to be ideal sources of energy on account of their biochemical properties. The tolerance and utilization of 10% fat emulsion with 75% MCT was tested on 10 healthy males after an overnight fast. During an infusion period of 6 hr the total fat supply rate was 0.12 g/kg body weight/hr. A commercial 10% fat emulsion (Lipofundin‐S‐10) served as control. The fat emulsion containing MCT was tolerated without any side effects. Compared with the commercial fat emulsion, the increase of triglycerides was markedly lower and clearing of the serum was completed earlier. By gas chromatographic analysis of the serum fatty acid pattern, medium chain fatty acids rapidly achieved a steady state. During infusion of the fat emulsion containing MCT, the production of ketone bodies was considerably higher although acidosis was not induced. The results obtained indicate that the fat solutions containing MCT bypass gluconeogenesis and are utilized quickly without side effects.

ISSN:0148-6071    

DOI:10.1177/0148607181005002115

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Four adult patients with very low plasma selenium (Se) levels (≤1.5 μg/100 ml) were given Se supplements while receiving total parenteral nutrition. A comparison was made using the compounds selenomethionine and sodium selenite given either intravenously or by mouth. Urinary excretion and Se plasma responses differed, and indicated that selenomethionine retention was greater. However, the incorporation of Se into the erythrocyte and its enzyme glutathione peroxidase was unpredictable and delayed and was not a good indicator of supplement response. No deleterious effects of supplements were observed. Se supplements are indicated especially in patients with a high risk of developing low Se levels and are best monitored by plasma Se levels.

ISSN:0148-6071    

DOI:10.1177/0148607181005002120

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

The purpose of this investigation was to determine the effects of the volume of enteral feedings and the rate at which they were administered on subject tolerance and gastric pressure changes. Fourteen normal volunteers received enteral feedings on 9 or 10 separate days. These feedings (Ensure) were administered in combinations of 3 volumes (250, 350, and 500 ml) and of 2 rates (30 and 85 ml/min). The effect on gastric motility was monitored by an open‐tipped catheter. Nine of the subjects also received 750 ml administered at 30 ml/min. Six of the 14 subjects experienced nausea and/or discomfort during the first feeding trial (250 ml at 30 ml/min); however, subsequent feedings were tolerated without this discomfort. The rate at which feedings were administered had little effect on the time following feeding until the return of regular motility or on the mean motility index when 250 ml were administered; however, when larger volumes were administered at the faster rate, longer time was taken for the return of regular motility. Feedings administered at the faster rate were associated with a greater number of subjective complaints of abdominal discomfort, nausea, fullness, and cramping. The volume of a feeding has a significant effect on both the time required for regular motility to return following feeding and on the mean motility index, with the larger feeding volumes suppressing activity progressively longer. The volume of feeding (up to 750 ml) had little effect upon symptomatic tolerance of subjects when these feedings were administered at 30 ml/min. There was no significant interaction effect of rate and volume on the time required for motility to return following feedings. The results of this study indicate that normal subjects can tolerate bolus feedings of (250–750 ml) administered at 30 ml/ min without distress. Additional studies are needed to compare bolus and continuous feedings in relation to patient tolerance, gastric emptying, and nutritional outcome.

ISSN:0148-6071    

DOI:10.1177/0148607181005002125

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

The amount of potassium (K) in proprietary enteral feeds varies considerably from 2.7–9.2 mmol K+/g N. It has been suggested that up to 7 mmol K+/g N is required by the anabolic patient. The aim of this study was to determine the effect of a proprietary feed (Triosorbon MCT), containing 6.9 mmol K+/g N, on serum and urinary K in 13 patients requiring nutritional support. Serum electrolytes in all patients and urinary electrolytes in 7 were measured both before feeding commenced and when they had achieved an intake of between 2.4 and 3.0 liter/day (102–127 mmol K+/day) of full strength feed for a period of 1 wk. The serum K rose in all patients from 4.2 ± 0.5 mmol/liter (mean ± SD) before feeding to 5.1 ± 0.5 after feeding for 1 wk (p<0.001; pair‐difference t‐test). The daily urinary K excretion rose from 37.8 ± 24.2 mmol/day to 61.8 ± 26.6 over the same period (p<0.001) The serum urea rose from 4.7 ± 2.0 mmol/liter to 6.3 ± 3.2 (p6 mmol/liter. We conclude that the recommended levels of K intake may be too high and that serum K should be carefully monitored during enteral feeding.

ISSN:0148-6071    

DOI:10.1177/0148607181005002130

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

A psychosocial survey of patients on permanent home parenteral nutrition (HPN) has been made to assess the quality of life in these patients. All patients on permanent HPN in the period August 1978 to August 1979, including 7 women and 6 men, age range 24–62 yr (median 53) were interviewed, as well as partners of 11 patients who were married or cohabiting. The duration of HPN ranged from 2–43 mon (median 24 mon). They were asked specific questions about physical symptoms, social and leisure activities, interpersonal relationships, sexuality, psychological problems, and feelings about HPN. None had an outside job, but 6 (46%) did most of the housekeeping. Some physical distress was recorded in almost all patients, but 9 (69%) considered themselves healthy or fairly healthy, whereas 4 (31%) felt diseased. Social and leisure activities were normal or only slightly impaired in most. Sexual activity had ceased completely in 5 above 55 yr, in association with onset of the disease; younger patients displayed normal and unchanged sexual activity. Psychological symptoms were recorded in 6 (46%), major symptoms in 4 (31%). Seven partners considered HPN to be a moderate or severe burden, mainly psychological changes in the patient that caused marital tension in 3 cases. Criteria for quality of life were: 1) no major physical distress, 2) no major psychological symptoms, 3) no substantial restriction of social and leisure activities, 4) ability to accept HPN, 5) overall satisfaction with conditions of life. Nine patients who fulfilled at least 3 of these criteria were considered to have a fair quality of life, 4 who complied with<3 of the criteria a poor quality of life. The interviews were repeated at intervals of 6–10 mon in 9 patients, and revealed no systematic improvement or deterioration of quality of life during HPN.

ISSN:0148-6071    

DOI:10.1177/0148607181005002132

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

Anorexia and weight loss are major physical and psychological problems for patients with cancer, and nutritional support has become an increasingly important part of cancer treatment. Reports discussing the psychological aspects of parenteral feeding have emphasized the importance of the nature of the underlying illness, but special problems surrounding the use of artificial feeding in patients with cancer have not been described. Patterns of emotional response to artificial feeding in such patients are most directly influenced by two interacting sets of variables: the diagnosis and prognosis of cancer, and personality characteristics of patients and family members involved. Typically, management problems result when demoralized patients respond to artificial feeding by becoming more passive, when independent patients struggle over artificial feeding in order to maintain a sense of control, or when anxious patients or families express fears about dying in the form of extreme preoccupation with eating and maintaining weight. An understanding of these patterns has specific implications for improving the patient's cooperation and quality of life.

ISSN:0148-6071    

DOI:10.1177/0148607181005002138

出版商:SAGE Publications    

年代:1981

数据来源: WILEY

摘要:

A case of probable adrenal insufficiency (glucocorticoid only) with hematologic changes including eosinophilia, neutropenia, and red blood cell abnormalities developed in the course of prolonged, fat‐free feeding. The coincident development of essential fatty acid deficiency was confirmed by serum fatty acid profiles indicating the presence of abnormal amounts of eicosatrienoic acid, and a triene/tetraene ratio>0.4; all these findings responded to fat repletion. The association of glucocorticoid deficiency, neutropenia, and eosinophilia with essential fatty acid deficiency has not been previously reported in humans.

ISSN:0148-6071    

DOI:10.1177/0148607181005002141

出版商:SAGE Publications    

年代:1981

数据来源: WILEY