Sterilization of solutions for parenterals products. Problem analysis
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Yanelys Montes-González
2017-09-01
Full Text Available The solutions for the formulation of parenteral products must be sterile before the aseptic formulation process. For this reason, different methods of sterilization referred in the literature are analyzed. Thermodynamic criteria that rule the sterilization are presented. Furthermore, previous experiences in the sterilization of solutions for the formulation of parental products in an autoclave are analyzed, that take large time of processing and only low volumes of solution can be handled. Using jacketed stirred tanks for the sterilization may solve the problem and, therefore, criteria for the design of the later that allow to process high volumes of solution for the formulation of parenteral products are shown.
IODINE CONTENT OF ENTERAL AND PARENTERAL NUTRITION SOLUTIONS.
Willard, Devina L; Young, Lorraine S; He, Xuemei; Braverman, Lewis E; Pearce, Elizabeth N
2017-07-01
Iodine is essential for thyroid hormone synthesis, and iodine deficiency may result in thyroid disorders including goiter and hypothyroidism. Patients on long-term enteral nutrition (EN) or parenteral nutrition (PN) may be at risk for micronutrient deficiencies. The recommended daily allowance for iodine intake is 150 μg for nonpregnant adults. However, there is no current consensus among scientific societies regarding the quantity of iodine to be added in adult EN and PN formulations. The objective of this study was to determine the iodine content of U.S. adult enteral and parenteral nutrition solutions. This study also aimed to determine whether adult patients in the United States who are receiving long-term artificial nutrition may be at risk for iodine deficiency. Ten enteral nutrition solutions and 4 parenteral nutrition solutions were evaluated. The iodine contents of these solutions were measured spectrophotometrically and compared to the labeled contents. Measured and labeled EN iodine contents were similar (range 131-176 μg/L and 106-160 μg/L, respectively). In contrast, PN formulas were found to contain small, unlabeled amounts of iodine, averaging 27 μg/L. Typical fluid requirements are 30 to 40 mL/kg/day for adults receiving either total EN (TEN) or total PN (TPN). Adults on long-term TEN likely consume enough servings to meet their daily iodine requirements. However, patients on long-term TPN would require on average 5.6 L PN/day to meet the recommended daily allowance of iodine. This volume of PN is far in excess of typical consumption. Thus, U.S. patients requiring long-term TPN may be at risk for iodine deficiency. EN = enteral nutrition; PN = parenteral nutrition; TEN = total enteral nutrition; TPN = total parenteral nutrition; UIC = urinary iodine concentration.
Home parenteral nutrition in children: the Polish experience.
Ksiazyk, J; Lyszkowska, M; Kierkus, J; Bogucki, K; Ratyńska, A; Tondys, B; Socha, J
1999-02-01
Home parenteral nutrition has become routine for management of intestinal failure in patients. In Poland the main obstacle to widespread use of home parenteral nutrition is the lack of interest of commercial companies in delivering feedings and ancillaries to patients. Twenty-five home parenteral nutrition patients aged from 4 months to more than 13 years were reviewed. The mother or both parents were trained in home parenteral nutrition techniques for 4 to 6 weeks and compounded the nutrients themselves at home. The mean duration of home parenteral nutrition was 10,117 patient days. Hospital stays of patients receiving parenteral feedings were significantly shorter than the duration of administration of home parenteral nutrition (p rate of catheter occlusion decreased within the observation period, and in 1997 not one case of occlusion was observed. In 1997 only three catheters were removed during 7.8 patient years, and the overall incidence of catheter-related complications was 0.38 per patient year. The overall occurrence of septicemia was one case in 516 days and of catheter infection was one in 459 days. In 1997 a catheter was infected on average of once every 1419 days. There was significant improvement in the z score for weight during therapy. The average monthly cost of nutrients and ancillary items was approximately $1200 (4200 Polish zlotys [PLN]). These costs are 1.6 to 3 times lower than those recorded in other studies. Home parenteral nutrition in children with nutrients mixed by caregivers in the home setting is a safe and appropriate method of treatment that can be used in countries where home parenteral nutrition solutions are not manufactured or where commercial home parenteral nutrition is not economically feasible.
Compatibility of 5-fluorouracil and total parenteral nutrition solutions.
Hardin, T C; Clibon, U; Page, C P; Cruz, A B
1982-01-01
The physicochemical stability and availability of 0.1% 5-fluorouracil solutions in D5W and a typical total parenteral nutrition solution (hypertonic dextrose and crystalline amino acids) were studied in both glass and Viaflex delivery systems. Serial samples collected over a 48-hour period were assayed for 5-fluorouracil concentration using a high performance liquid chromatographic technique. Changes in the pH as well as precipitate formation were also investigated. There was no reduction in the amount of 5-fluorouracil at 48 hours in either the glass or plastic system, regardless of whether the drug was added to D5W or to the total parenteral nutrition solution. No pH changes or precipitates were observed. These findings indicate that 5-fluorouracil is compatible with and available from total parenteral solutions of hypertonic dextrose and amino acid in both plastic and glass containers. Use of such a system would allow for (1) a reduction in vascular access in patients receiving both treatments and (2) continued administration of nutritional support without the requirement for additional fluid volume.
Delivery of vitamins E and C from parenteral alimentation solution.
Shenai, J P; Borum, P R; Duke, E A
1982-01-01
We have previously shown that substantial losses of fat-soluble (FS) vitamin A from parenteral alimentation solution occur due to adsorption in the intravenous tubing and photodegradation in the bottle. This study assessed the delivery of other vitamins, viz, FS vitamin E and water-soluble (WS) vitamin C, from parenteral alimentation solution. The solution containing 2.0 ml/L of an aqueous multivitamin infusion was infused at a constant rate of 10 ml/h using a standard intravenous administration set. Multiple aliquots of the solution from the bottle and the effluent obtained sequentially in a 24-h period were analyzed for concentrations of vitamins E and C. Both vitamins remained relatively stable in the bottle. A significant amount (12%) of vitamin E was lost in the intravenous tubing. No losses of vitamin C were incurred in the intravenous tubing. The data suggest that delivery of FS vitamin E from parenteral alimentation solutions is less than optimum because of adsorptive losses. Similar losses are not encountered with WS vitamin C.
Application of refractometry to quality assurance monitoring of parenteral nutrition solutions.
Chang, Wei-Kuo; Chao, You-Chen; Yeh, Ming-Kung
2008-01-01
Parenteral nutrition (PN) solution contains various concentrations of dextrose, amino acids, lipids, vitamins, electrolytes, and trace elements. Incorrect preparation of PN solution could lead to patient death. In this study we used the refractive index as a quality assurance tool to monitor the preparation of PN solution. Refractive indices of single nutrient components and PN solutions consisting of various concentrations of dextrose, amino acids, electrolytes, and lipids were measured. A mathematical equation and its linear plot were generated then used to predict the refractive index of the PN solution. The best-fit refractive index for PN solution (i.e., the predicted refractive index)=0.9798x(% dextrose)+1.2889x(% amino acids)+1.1017x(% lipids)+0.9440x(% sum of the electrolytes)+0.5367 (r2=0.99). This equation was validated by comparing the measured refractive indices of 500 clinical PN solutions to their predicted refractive indices. We found that 2 of the 500 prepared samples (0.4%) had less than the predicted refractive index (<95%). Refractive index can be used as a reliable quality assurance tool for monitoring PN preparation. Such information can be obtained at the bedside and used to confirm the accuracy of the PN solution composition.
Beattie, Colleen; Allard, Johane; Raman, Maitreyi
2016-04-01
Parenteral nutrition (PN) may be provided through compounded or premixed solutions. To determine the proportion of stable custom-compounded PN prescriptions that would fit within a 20% deviance of an existing premixed PN solution. A retrospective study design was used. Inpatients who received PN in non-critical care units in the preceding year were screened for eligibility. Results are reported descriptively as means (95% confidence intervals) and proportions. We reviewed 97 PN prescriptions that met inclusion criteria. Stable hospital PN prescriptions compared with the reference premixed prescription provided 1838 (1777-1898) vs 1843 (1781-1905) kcal/d, P = .43; dextrose, 266 (254-277) vs 225 (216-234) g/d, P magnesium, 5.4 (4.8-5.4) vs 7.6 (7.4-7.9) mmol/L. Calories and protein were remarkably similar, but dextrose, lipid, and electrolytes differed between hospital PN and the reference premixed prescription. We believe that there may be a role for premixed solutions in quaternary centers in stable non-critically ill patients. © 2016 American Society for Parenteral and Enteral Nutrition.
Miura, S; Tanaka, S; Yoshioka, M; Serizawa, H; Tashiro, H; Shiozaki, H; Imaeda, H; Tsuchiya, M
1992-01-01
The effect of total parenteral nutrition on nutrients absorption and glycoprotein changes of brush border membrane was examined in rat small intestine. In total parenteral nutrition rats, a marked decrease in activity of brush border enzymes was observed mainly in the proximal and middle segments of the intestine. Galactose perfusion of jejunal segment showed that hexose absorption was significantly inhibited, while intestinal absorption of glycine or dipeptide, glycylglycine was not significantly affected by total parenteral nutrition treatment. When brush border membrane glycoprotein profile was examined by [3H]-glucosamine or [3H]-fucose incorporation into jejunal loops, significant changes were observed in the glycoprotein pattern of brush border membrane especially in the high molecular weight range over 120 kDa after total parenteral nutrition treatment, suggesting strong dependency of glycoprotein synthesis on luminal substances. Molecular weight of sucrase isomaltase in brush border membrane detected by specific antibody showed no significant difference, however, in total parenteral nutrition and control rats. Also, molecular weight of specific sodium glucose cotransporter of intestinal brush border membrane detected by selective photoaffinity labelling was not altered in total parenteral nutrition rats. It may be that prolonged absence of oral food intake may produce significant biochemical changes in brush border membrane glycoprotein and absorptive capacity of small intestine, but these changes were not observed in all brush border membrane glycoproteins. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:1582592
Minimizing systemic infection during complete parenteral alimentation of small infants
Nelson, R.
1974-01-01
A regimen of parenteral alimentation for infants was designed to eliminate as many factors responsible for infection as possible. The most important features of the feeding regimen were as follows. (1) Infants were fed via indwelling silastic catheters inserted into the superior vena cava or the right atrium by a cutdown operation. (2) The parenteral feeding was fat free to simplify the administration system. Y connectors and 2- or 3-way taps were avoided. (3) Extreme care was taken of junctions within the infusion system. Only certain members of the hospital staff were allowed to break such junctions, e.g. during the changing of packs of solution or of the giving sets. These junctions were sprayed with antibacterial aerosols. (4) The hypertonic solutions of nutrients were prepared in plastic packs, which do not require ventilation. The infusion system was therefore not contaminated by the entry of unsterile outside air. (5) The infused solutions were passed through 0·22 μm millipore filters before entering the patient's blood stream. There was an infection rate of 9% which was less than the 25 to 45% infection rate previously reported during parenteral feeding through indwelling venous catheters, and is also less than that associated with ventriculoatrial shunts for hydrocephalus. There was no case of systemic candidiasis, which is the most frequent and most serious infection associated with parenteral feeding. PMID:4206445
ESPEN Guidelines on Parenteral Nutrition: gastroenterology
DEFF Research Database (Denmark)
A., Van Gossum; Cabre, E.; Hebuterne, X.
2009-01-01
. There is a lack of data supporting specific nutrients in these conditions. Parenteral nutrition is mandatory in case of intestinal failure, at least in the acute period. In patients with short bowel, specific attention should be paid to water and electrolyte supplementation. Currently, the use of growth hormone......-based recommendations for the indications, application and type of parenteral formula to be used in acute and chronic phases of illness. Parenteral nutrition is not recommended as a primary treatment in CD and UC. The use of parenteral nutrition is however reliable when oral/enteral feeding is not possible...
Parenteral nutrition in intestinal failure
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Kurkchubasche AG
2015-01-01
Full Text Available Arlet G Kurkchubasche,1 Thomas J Herron,2 Marion F Winkler31Department of Surgery and Pediatrics, 2Department of Surgery, Alpert Medical School of Brown University, 3Department of Surgery/Nutritional Support Service, Rhode Island Hospital, Providence, RI, USAAbstract: Intestinal failure is a consequence of extensive surgical resection resulting in anatomic loss and/or functional impairment in motility or absorptive capacity. The condition is clinically characterized by the inability to maintain fluid, energy, protein, electrolyte, or micronutrient balance when on a conventionally accepted, normal diet. Parenteral nutrition (PN is the cornerstone of management until intestinal adaptation returns the patient to a PN-independent state. Intestinal length, residual anatomic segments and motility determine the need for and duration of parenteral support. The goals of therapy are to provide sufficient nutrients to enable normal growth and development in children, and support a healthy functional status in adults. This review addresses indications for PN, the formulation of the PN solution, patient monitoring, and considerations for prevention of PN-associated complications. With the ultimate goal of achieving enteral autonomy, the important role of diet, pharmacologic interventions, and surgery is discussed.Keywords: intestinal failure, short-bowel syndrome, parenteral nutrition, home nutrition support, intestinal rehabilitation
Tarachai, P; Yamauchi, K
2000-11-01
The aim of this study was to clarify which of the following three factors induces villus morphological recovery best: enteral nutrient absorption, intraluminal physical stimulation, or intravenous parenteral alimentation. At 142 d, male White Leghorn chickens (Gallus gallus domesticus) were divided into eight groups of five birds each as follows: 1) access given ad libitum to a commercial layer mash diet (CP, 17.5%; ME, 2,830 kcal/kg) (control), 2) 5-d feed withdrawal (feed withdrawal), 3) 3-d feed withdrawal (3-FW), followed by refeeding the same diet as the control for 2 d (refeeding), 4) 3-FW followed by force-feeding enteral hyperalimentation (enteral), 5) 3-FW followed by force-feeding an indigestible (nonabsorbable) substance (kaolin), 6) 3-FW followed by force-feeding water for 2 d (force-fed control), 7) 3-FW followed by parenteral hyperalimentation (parenteral), and 8) 3-FW followed by no alimentation (sham control) for 2 d. In the refeeding and enteral groups, BW significantly recovered (P alimentation, but by enteral nutrient absorption.
Severe Hypothyroidism From Iodine Deficiency Associated With Parenteral Nutrition.
Golekoh, Marjorie C; Cole, Conrad R; Jones, Nana-Hawa Yayah
2016-11-01
Parenteral nutrition is crucial for supply of nutrients in children who cannot tolerate a full enteral diet. In the United States, it is not standard of care to give iodine to children dependent on parenteral nutrition, hence iodine is not routinely included in the micronutrient package. Herein, we present a case of a boy with hypothyroidism secondary to iodine deficiency after prolonged exclusive use of parenteral nutrition. Our case highlights the importance of screening for iodine deficiency and administering timely iodine supplementation in these at-risk children to prevent iatrogenic hypothyroidism. © 2015 American Society for Parenteral and Enteral Nutrition.
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Robert K. Huston
2018-02-01
Full Text Available There are no compatibility studies for neonatal parenteral nutrition solutions without cysteine containing calcium chloride or calcium gluconate using light obscuration as recommended by the United States Pharmacopeia (USP. The purpose of this study was to do compatibility testing for solutions containing calcium chloride and calcium gluconate without cysteine. Solutions of TrophAmine and Premasol (2.5% amino acids, containing calcium chloride or calcium gluconate were compounded without cysteine. Solutions were analyzed for particle counts using light obscuration. Maximum concentrations tested were 15 mmol/L of calcium and 12.5 mmol/L of phosphate. If the average particle count of three replicates exceeded USP guidelines, the solution was determined to be incompatible. This study found that 12.5 and 10 mmol/L of calcium and phosphate, respectively, are compatible in neonatal parenteral nutrition solutions compounded with 2.5% amino acids of either TrophAmine or Premasol. There did not appear to be significant differences in compatibility for solutions containing TrophAmine or Premasol when solutions were compounded with either CaCl2 or CaGlu-Pl. This study presents data in order to evaluate options for adding calcium and phosphate to neonatal parenteral nutrition solutions during shortages of calcium and cysteine.
Timing of the initiation of parenteral nutrition in critically ill children.
Jimenez, Lissette; Mehta, Nilesh M; Duggan, Christopher P
2017-05-01
To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to enteral nutrition often leads to reliance on parenteral nutrition. The timing of parenteral nutrition initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with avoiding initiation of parenteral nutrition on day 1 of admission to the pediatric ICU. Although there is no consensus on the optimal timing of parenteral nutrition initiation among critically ill children, recent literature does not support the immediate initiation of parenteral nutrition on pediatric ICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate parenteral nutrition. As with all medical interventions, the initiation of parenteral nutrition should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding.
Pharmaceutical Point of View on Parenteral Nutrition
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M. Stawny
2013-01-01
Full Text Available Parenteral nutrition—a form of administering nutrients, electrolytes, trace elements, vitamins, and water—is a widely used mode of therapy applied in many diseases, in patients of different ages both at home and in hospital. The success of nutritional therapy depends chiefly on proper determination of the patient’s energetic and electrolytic needs as well as preparation and administration of a safe nutritional mixture. As a parenterally administered drug, it is expected to be microbiologically and physicochemically stable, with all of the components compatible with each other. It is very difficult to obtain a stable nutritional mixture due to the fact that it is a complex, two-phase drug. Also, the risk of incompatibility between mixture components and packaging should be taken into consideration and possibly eliminated. Since parenteral nutrition is a part of therapy, simultaneous use of drugs may cause pharmacokinetic and pharmacodynamic interactions as well as those with the pharmaceutical phase. The aim of this paper is to discuss such aspects of parenteral nutrition as mixture stability, methodology, and methods for determining the stability of nutritional mixtures and drugs added to them.
Pharmaceutical Point of View on Parenteral Nutrition
Stawny, M.; Olijarczyk, R.; Jaroszkiewicz, E.; Jelińska, A.
2013-01-01
Parenteral nutrition—a form of administering nutrients, electrolytes, trace elements, vitamins, and water—is a widely used mode of therapy applied in many diseases, in patients of different ages both at home and in hospital. The success of nutritional therapy depends chiefly on proper determination of the patient's energetic and electrolytic needs as well as preparation and administration of a safe nutritional mixture. As a parenterally administered drug, it is expected to be microbiologically and physicochemically stable, with all of the components compatible with each other. It is very difficult to obtain a stable nutritional mixture due to the fact that it is a complex, two-phase drug. Also, the risk of incompatibility between mixture components and packaging should be taken into consideration and possibly eliminated. Since parenteral nutrition is a part of therapy, simultaneous use of drugs may cause pharmacokinetic and pharmacodynamic interactions as well as those with the pharmaceutical phase. The aim of this paper is to discuss such aspects of parenteral nutrition as mixture stability, methodology, and methods for determining the stability of nutritional mixtures and drugs added to them. PMID:24453847
Safety of parenteral nutrition in newborns: Results from a nationwide prospective cohort study.
Lapillonne, Alexandre; Berleur, Marie-Pierre; Brasseur, Yvette; Calvez, Sophie
2018-04-01
Limited or delayed availability of parenteral nutrition (PN) solutions, as well as difficulties in ordering are often identified as reasons for non-compliance with international guidelines in newborns. This study aims at assessing the modality of use and safety of premixed standardized PN solutions in a nationwide prospective cohort of newborns treated in clinical practice. Two premixed fixed formulations with respective osmolarity of 715 and 790 mOsm/L specifically designed for neonates were made available throughout the country for clinical use from birth onwards. Descriptive data and modality of use were prospectively collected in a case report form, whereas all related and unrelated adverse events were recorded on a separate adverse event form. A total of 14,167 infants were prospectively included and 16,640 parenteral nutrition periods were analyzed. Mean age was 33 weeks of gestation, and mean weight was 2086 g. The majority of infants (81%) started the parenteral nutrition the first day of life or the day after. The route of parenteral nutrition delivery was peripheral in 47% of the parenteral nutrition periods. During the whole study, a total of 72 adverse events occurring in 68 infants were reported. Of these adverse events, 59 (0.37% of the nutrition periods), among which 19 serious adverse events, were reported as related to the parenteral nutrition solutions. The events related to parenteral nutrition solutions were general disorders and administration site conditions (n = 42 including 9 cases of cutaneous necrosis), and nutrition and metabolism disorders (n = 17). There was no case of thrombophlebitis. Six of the 19 serious events related to the parenteral nutrition solutions (32%) were due to the misuse of the infusion bag. These data support the concept that ready-to-use parenteral nutrition formulations can safely provide parenteral nutrition from birth onwards. They further support that parenteral solutions with an osmolarity up to 800
Directory of Open Access Journals (Sweden)
Layara Alexandre Bessa
2013-06-01
Full Text Available Hancornia speciosa Gomes (Mangaba tree is a fruit tree belonging to the Apocynaceae family and is native to Brazil. The production of seedlings of this species is limited by a lack of technical and nutritional expertise. To address this deficiency, this study aimed to characterize the visual symptoms of micronutrient deficiency and to assess growth and leaf nutrient accumulation in H. speciosa seedlings supplied with nutrient solutions that lack individual micronutrients. H. speciosa plants were grown in nutrient solution in a greenhouse according to a randomized block design, with four replicates. The treatments consisted of a group receiving complete nutrient solution and groups treated with a nutrient solution lacking one of the following micronutrients: boron (B, copper (Cu, iron (Fe, manganese (Mn, zinc (Zn, and molybdenum (Mo. The visual symptoms of nutrient deficiency were generally easy to characterize. Dry matter production was affected by the omission of micronutrients, and the treatment lacking Fe most limited the stem length, stem diameter, root length, and number of leaves in H. speciosa seedlings as well as the dry weight of leaves, the total dry weight, and the relative growth in H. speciosa plants. The micronutrient contents of H. speciosa leaves from plants receiving the complete nutrient solution treatment were, in decreasing order, Fe>Mn>Cu>Zn>B.
Effect of organic substrates on available elemental contents in nutrient solution
Energy Technology Data Exchange (ETDEWEB)
Ao, Y.S.; Sun, M.; Li, Y.Q. [Shanghai Jiao Tong University, Shanghai (China). School for Agriculture & Biology
2008-07-15
In this paper, the changes of available elemental contents in the nutrient solution extracts of organic substrates (peat moss, charred rice husk, chicken manure, sawdust, turfgrass clipping and weathered coal) were studied and compared with that in the water extracts. Results showed that available elemental contents in the nutrient solution extracts are significantly different between organic substrates, whereas ionic concentrations are basically under steady condition after treatment for 36-108 h. Ionic contents in the nutrient solution extracts are not equal to the value of adding ionic concentrations in the supplied nutrient solution to that in the water extract. Thus, a mathematical model was proposed for adjusting the composition of supplied nutrient solution to match plant requirements in the organic soilless culture system.
Response of non-added solutes during nutrient addition experiments in streams
Rodriguez-Cardona, B.; Wymore, A.; Koenig, L.; Coble, A. A.; McDowell, W. H.
2015-12-01
Nutrient addition experiments, such as Tracer Additions for Spiraling Curve Characterization (TASCC), have become widely popular as a means to study nutrient uptake dynamics in stream ecosystems. However, the impact of these additions on ambient concentrations of non-added solutes is often overlooked. TASCC addition experiments are ideal for assessing interactions among solutes because it allows for the characterization of multiple solute concentrations across a broad range of added nutrient concentrations. TASCC additions also require the addition of a conservative tracer (NaCl) to track changes in conductivity during the experimental manipulation. Despite its use as a conservative tracer, chloride (Cl) and its associated sodium (Na) might change the concentrations of other ions and non-added nutrients through ion exchange or other processes. Similarly, additions of biologically active solutes might change the concentrations of other non-added solutes. These methodological issues in nutrient addition experiments have been poorly addressed in the literature. Here we examine the response of non-added solutes to pulse additions (i.e. TASCC) of NaCl plus nitrate (NO3-), ammonium, and phosphate across biomes including temperate and tropical forests, and arctic taiga. Preliminary results demonstrate that non-added solutes respond to changes in the concentration of these added nutrients. For example, concentrations of dissolved organic nitrogen (DON) in suburban headwater streams of New Hampshire both increase and decrease in response to NO3- additions, apparently due to biotic processes. Similarly, cations such as potassium, magnesium, and calcium also increase during TASCC experiments, likely due to cation exchange processes associated with Na addition. The response of non-added solutes to short-term pulses of added nutrients and tracers needs to be carefully assessed to ensure that nutrient uptake metrics are accurate, and to detect biotic interactions that may
Nutrient solution and substrates for ‘cedro doce’ (Pochota fendleri seedling production
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Oscar J. Smiderle
Full Text Available ABSTRACT This study assessed the effect of different substrates and addition of nutrient solution on the production of Pochota fendleri seedlings, leaf contents of macro and micronutrients and chlorophyll a and b. The experimental design was completely randomized, in a 3 x 2 factorial scheme, with four replicates. The factors were three substrates, with or without addition of nutrient solution, composing six treatments: (T1 = sand; (T2 = soil; (T3 = sand + soil (1:1; (T4 = sand + nutrient solution; (T5 = soil + nutrient solution; (T6 = sand + soil + nutrient solution. Growth characteristics (height, collar diameter, shoot dry matter, root dry matter, root/shoot ratio and total dry matter and contents of macro- and micronutrients and chlorophyll a and b were evaluated. The use of nutrient solution reduces the time to obtain seedlings of Pochota fendleri, and it is important for proper growth and quality of seedlings. The sequence of nutritional requirement presented by Pochota fendleri seedlings in three substrates with addition of nutrient solution follows the descending order: macronutrients (N > Ca > K > Mg > P > S and micronutrients (Fe > Mn > B > Zn > Cu.
Parenteral Nutrition Basics for the Clinician Caring for the Adult Patient.
Derenski, Karrie; Catlin, Jennifer; Allen, Livia
2016-10-01
Parenteral nutrition (PN) is a life-sustaining therapy providing nutrients to individuals with impaired intestinal tract function and enteral access challenges. It is one of the most complex prescriptions written routinely in the hospital and home care settings. This article is to aid the nutrition support clinician in the safe provision of PN, including selecting appropriate patients for PN, vascular access, development of a PN admixture, appropriate therapy monitoring, recognition of preparation options, and awareness of preparation and stability concerns. © 2016 American Society for Parenteral and Enteral Nutrition.
Omotani, Sachiko; Tani, Katsuji; Nagai, Katsuhito; Hatsuda, Yasutoshi; Mukai, Junji; Myotoku, Michiaki
2017-01-01
Peripheral parenteral nutrition (PPN) solutions contain amino acids, glucose, and electrolytes, with or without some water soluble vitamins. Peripheral venous catheters are one of the causes of catheter related blood stream infection (CRBSI), which requires infection control. In Japan, PPN solutions have rarely been prepared under aseptic conditions. However, in recent years, the necessity of adding vitamins to infusions has been reported. Therefore, we investigated the effects of water soluble vitamins on growth of microorganisms in PPN solutions. AMINOFLUID ® (AF), BFLUID ® (BF), PARESAFE ® (PS) and PAREPLUS ® (PP) PPN solutions were used. Water soluble vitamins contained in PP were also used. Causative microorganisms of CRBSI were used. Staphylococcus epidermidis decreased after 24 hours or 48 hours in all solutions. On the other hand, Escherichia coli , Serratia marcescens , Pseudomonas aeruginosa, Staphylococcus aureus and Candida albicans increased, especially in PP. When each water soluble vitamin was added to BF and PS, growth of S. aureus was greater in solutions that contained nicotinamide than in solutions that contained other vitamins. As for C. albicans , they grew in all test solutions. C. albicans grew especially well in solutions that contained biotin. When commercial amino acids and glucose solutions with electrolytes are administered, in particular those containing multivitamins or water soluble vitamins, efforts to control infection must be taken to prevent proliferation of microorganisms.
International Nuclear Information System (INIS)
Gil, R.A.; Cerutti, S.; Gasquez, J.A.; Olsina, R.A.; Martinez, L.D.
2005-01-01
A method for the preconcentration and speciation of chromium was developed. On-line preconcentration and determination were obtained using inductively coupled plasma optical emission spectrometry (ICP-OES) coupled with flow injection. To determinate the chromium (III) present in parenteral solutions, chromium was retained on activated carbon at pH 5.0. On the other hand, a step of reduction was necessary in order to determine total chromium content. The Cr(VI) concentration was then determined by difference between the total chromium concentration and that of Cr(III). A sensitivity enrichment factor of 70-fold was obtained with respect to the chromium determination by ICP-OES without preconcentration. The detection limit for the preconcentration of 25 ml of sample was 29 ng l -1 . The precision for the 10 replicate determinations at the 5 μg l -1 Cr level was 2.3% relative standard deviation, calculated with the peak heights. The calibration graph using the preconcentration method for chromium species was linear with a correlation coefficient of 0.9995 at levels near the detection limits up to at least 60 μg l -1 . The method can be applied to the determination and speciation of chromium in parenteral solutions
Gomes, Cláudio Luís Nina; Ribeiro Filho, José Dantas; Faleiros, Rafael Resende; Dantas, Fernanda Timbó D'el Rey; Amorim, Lincoln da Silva; Dantas, Waleska de Melo Ferreira
2014-01-01
Large volumes of different electrolytes solutions are commonly used for ingesta hydration in horses with large colon impaction, but little is known about their consequences to blood acid-base balance. To evaluate the effects of PEG 3350 or enteral and parenteral electrolyte solutions on the blood gas analysis, anion gap and strong ion difference, five adult female horses were used in a 5x5 latin square design. The animals were divided in five groups and distributed to each of the following tr...
Standardised versus Individualised Parenteral Nutrition. Further Food for Thought.
McCarthy, R; Segurado, R; Crealey, M; Twomey, A
2016-04-11
Parenteral Nutrition may be prescribed as a standard PN (SPN) formulation or as an individualised PN (IPN) formulation. SPN may have advantages in terms of rapid availability, less prescription errors, decreased risk of infection and cost savings but IPN, specifically tailored to an infants needs, may achieve better outcomes in terms of nutrient intake and weight gain. The aim of our study was to determine if VLBW infants in our NICU benefited from receiving IPN over currently available SPN solutions. Our findings were that VLBW infants prescribed IPN received significantly more amino acid (28%), glucose (6%), energy (11%) and calcium (8%) from the aqueous phase of PN than had they received a similar volume of SPN. The benefits were seen over all the days for which PN was administered. In conclusion, IPN was found to offer significant benefits to our VLBW infants. Modifications to currently available SPN would result in better SPN formulations. Our study also supported the recent recommendation to reduce the calcium:phosphate ratio in PN solutions to avoid early hypophosphataemia.
Standardised versus Individualised Parenteral Nutrition. Further Food for Thought
LENUS (Irish Health Repository)
McCarthy, R
2016-04-01
Parenteral Nutrition may be prescribed as a standard PN (SPN) formulation or as an individualised PN (IPN) formulation. SPN may have advantages in terms of rapid availability, less prescription errors, decreased risk of infection and cost savings but IPN, specifically tailored to an infant’s needs, may achieve better outcomes in terms of nutrient intake and weight gain. The aim of our study was to determine if VLBW infants in our NICU benefited from receiving IPN over currently available SPN solutions. Our findings were that VLBW infants prescribed IPN received significantly more amino acid (28%), glucose (6%), energy (11%) and calcium (8%) from the aqueous phase of PN than had they received a similar volume of SPN. The benefits were seen over all the days for which PN was administered. In conclusion, IPN was found to offer significant benefits to our VLBW infants. Modifications to currently available SPN would result in better SPN formulations. Our study also supported the recent recommendation to reduce the calcium:phosphate ratio in PN solutions to avoid early hypophosphataemia
Standardised neonatal parenteral nutrition formulations – an Australasian group consensus 2012
2014-01-01
Standardised parenteral nutrition formulations are routinely used in the neonatal intensive care units in Australia and New Zealand. In 2010, a multidisciplinary group was formed to achieve a consensus on the formulations acceptable to majority of the neonatal intensive care units. Literature review was undertaken for each nutrient and recommendations were developed in a series of meetings held between November 2010 and April 2011. Three standard and 2 optional amino acid/dextrose formulations and one lipid emulsion were agreed by majority participants in the consensus. This has a potential to standardise neonatal parenteral nutrition guidelines, reduce costs and prescription errors. PMID:24548745
Kaushal, G; Sayre, B E; Prettyman, T
2012-02-01
Oxytocin is very commonly used in clinical settings and is a nonapeptide hormone that stimulates the contraction of uterine smooth muscles. In this study the stability of extemporaneously compounded oxytocin solutions was investigated in polyolefin bags. The sterile preparations of oxytocin were compounded to the strength of 0.02 U/mL in accordance with United States Pharmacopeia (USP) standards. In order to carry out the stability testing of these parenteral products, the solutions were stored under three different temperature conditions of -20°C (frozen), 2-6°C (refrigerated), and 22-25°C (room temperature). Three solutions from each temperature were withdrawn and were assessed for stability on days 0, 7, 15, 21, and 30 as per the USP guidelines. The assay of oxytocin was examined by an HPLC method at each time point. No precipitation, cloudiness or color change was observed during this study at all temperatures. The assay content by HPLC revealed that oxytocin retains greater than at least 90% of the initial concentrations for 21 days. There was no significant change in pH and absorbance values for 21 days under all the conditions of storage. Oxytocin parenteral solutions in the final concentration of 0.02 U/mL and diluted in normal saline are stable for at least 30 days under frozen and refrigerated conditions for 30 days. At the room temperature, the oxytocin solutions were stable for at least 21 days. The stability analysis results show that the shelf-life of 21 days observed in this study was far better than their recommended expiration dates.
Vente, J. P.; Soeters, P. B.; von Meyenfeldt, M. F.; Rouflart, M. M.; van der Linden, C. J.; Gouma, D. J.
1991-01-01
The addition of branched chain amino acids (BCAA) to total parenteral nutrition (TPN) solutions of balanced aminoacid composition has been reported to result in improved nitrogen balance, preservation of plasma protein levels, and improved immune function; however, only a few large clinical studies
Parenteral nutrition in patients with renal failure – Guidelines on Parenteral Nutrition, Chapter 17
Directory of Open Access Journals (Sweden)
Druml, W.
2009-11-01
Full Text Available Partial EN (enteral nutrition should always be aimed for in patients with renal failure that require nutritional support. Nevertheless PN (parenteral nutrition may be necessary in renal failure in patient groups with acute or chronic renal failure (ARF or CRF and additional acute diseases but without extracorporeal renal replacement therapy, or in patients with ARF or CRF with additional acute diseases on extracorporeal renal replacement therapy, haemodialysis therapy (HD, peritoneal dialysis (PD or continuous renal replacement therapy (CRRT, or in patients on HD therapy with intradialytic PN. Patients with renal failure who show marked metabolic derangements and changes in nutritional requirements require the use of specifically adapted nutrient solutions. The substrate requirements of acutely ill, non-hypercatabolic patients with CRF correspond to those of patients with ARF who are not receiving any renal replacement patients therapy (utilisation of the administered nutrients has to be monitored carefully. In ARF patients and acutely ill CRF patients on renal replacement therapy, substrate requirements depend on disease severity, type and extent/frequency of extracorporeal renal replacement therapy, nutritional status, underlying disease and complications occurring during the course of the disease. Patients under HD have a higher risk of developing malnutrition. Intradialytic PN (IDPN should be used if causes of malnutrition cannot be eliminated and other interventions fail. IDPN should only be carried out when modifiable causes of malnutrition are excluded and enhanced oral (like i.e. additional energy drinks or enteral supply is unsuccessful or cannot be carried out.
2001-08-28
This final rule implements fee schedules for payment of parenteral and enteral nutrition (PEN) items and services furnished under the prosthetic device benefit, defined in section 1861(s)(8) of the Social Security Act. The authority for establishing these fee schedules is provided by the Balanced Budget Act of 1997, which amended the Social Security Act at section 1842(s). Section 1842(s) of the Social Security Act specifies that statewide or other area wide fee schedules may be implemented for the following items and services still subject to the reasonable charge payment methodology: medical supplies; home dialysis supplies and equipment; therapeutic shoes; parenteral and enteral nutrients, equipment, and supplies; electromyogram devices; salivation devices; blood products; and transfusion medicine. This final rule describes changes made to the proposed fee schedule payment methodology for these items and services and provides that the fee schedules for PEN items and services are effective for all covered items and services furnished on or after January 1, 2002. Fee schedules will not be implemented for electromyogram devices and salivation devices at this time since these items are not covered by Medicare. In addition, fee schedules will not be implemented for medical supplies, home dialysis supplies and equipment, therapeutic shoes, blood products, and transfusion medicine at this time since the data required to establish these fee schedules are inadequate.
Production of gherkin seedlings in coconut fiber fertirrigated with different nutrient solutions
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Francisco de Assis de Oliveira
Full Text Available ABSTRACT Seedling quality is a key factor to achieve success in vegetable production. The present work aimed to evaluate the production of gherkin seedlings in substrate of coconut fiber fertirrigated with different concentrations of nutrients. The experimental design was completely randomized in a 3 × 5 factorial with four replications. The treatments consisted of combinations of three cultivars of gherkin (Do Norte, Liso de Calcutá, e Liso Gibão with five concentrations of nutrients in the solution (0, 25, 50, 75, and 100%. The nutrient solution, considered standard, matches the recommended solution for melon in hydroponic systems. We evaluated the variables: chlorophyll index, shoot length, number of leaves, stem diameter, main root length, dry weight of leaves, roots, and stem, mass of total dry matter, leaf area, specific leaf area, and leaf area ratio. All variables were affected by the ionic concentration in nutrient solutions. The use of coconut fiber in the production of gherkin seedlings is more efficient with nutrient solutions in concentrations ranging from 75 to 100% of the recommended solution for melon cultivation.
Responses of Preterm Pigs to an Oral Fluid Supplement During Parenteral Nutrition
DEFF Research Database (Denmark)
Berding, Kirsten; Makarem, Patty; Hance, Brittany
2016-01-01
Background: Nutrients and electrolytes in amniotic fluid swallowed by fetuses are important for growth and development. Yet, preterm infants requiring parenteral nutrition (PN) receive minimal or no oral inputs. With the limited availability of amniotic fluid, we evaluated the responses of preterm...
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Nurşen Gürsoy
2012-08-01
Full Text Available Objective: In this study, we aimed to compare the changes in biochemical parameters and efficacy of nutrition by using parenteral nutrition solutions with different lipid content in critically ill patients. Material and Method: Fourty-five intensive care patients were randomized into three groups to receive either soy bean based (Group 1 or olive oil based (Group 2 or MCT/LCT based (Group 3 nutrition solutions. The calorie requirement was calculated using Schofield equation day. The levels of albumin, total protein, AST, ALT, LDH, GGT, ALP, glucose, triglyceride, cholesterol, LDL, HDL, aPTT, PT, INR, CRP, transferin and prealbumin were measured on days 1, 7 and 14. Results: There was no statistically significant difference between groups according to glucose, liver function tests, triglyceride, cholesterol, LDL, HDL, aPTT, PT, INR levels. CRP and prealbumin were similar within-group and between-group comparisons. In groups II and III, CRP levels decreased while prealbumin levels were increasing. Conclusion: As a conclusion, no difference was found comparing the biochemical parameters and efficacy of nutrition, in ICU patients fed with soy oil, olive oil or MCT/LCT based parenteral nutrition solutions. (Journal of the Turkish Society Intensive Care 2012; 10: 52-8
Amino acid composition in parenteral nutrition: what is the evidence?
Yarandi, Shadi S.; Zhao, Vivian M.; Hebbar, Gautam; Ziegler, Thomas R.
2011-01-01
Purpose of review Complete parenteral nutrition solutions contain mixed amino acid products providing all nine essential amino acids and a varying composition of nonessential amino acids. Relatively little rigorous comparative efficacy research on altered parenteral nutrition amino acid composition has been published in recent years. Recent findings Limited data from randomized, double-blind, adequately powered clinical trials to define optimal doses of total or individual amino acids in parenteral nutrition are available. An exception is the growing number of studies on the efficacy of glutamine supplementation of parenteral nutrition or given as a single parenteral agent. Parenteral glutamine appears to confer benefit in selected patients; however, additional data to define optimal glutamine dosing and the patient subgroups who may most benefit from this amino acid are needed. Although some promising studies have been published, little data are available in the current era of nutrition support on the clinical efficacy of altered doses of arginine, branched chain amino acids, cysteine, or taurine supplementation of parenteral nutrition. Summary Despite routine use of parenteral nutrition, surprisingly little clinical efficacy data are available to guide total or specific amino acid dosing in adult and pediatric patients requiring this therapy. This warrants increased attention by the research community and funding agencies to better define optimal amino acid administration strategies in patient subgroups requiring parenteral nutrition. PMID:21076291
Computer model of hydroponics nutrient solution pH control using ammonium.
Pitts, M; Stutte, G
1999-01-01
A computer simulation of a hydroponics-based plant growth chamber using ammonium to control pH was constructed to determine the feasibility of such a system. In nitrate-based recirculating hydroponics systems, the pH will increase as plants release hydroxide ions into the nutrient solution to maintain plant charge balance. Ammonium is an attractive alternative to traditional pH controls in an ALSS, but requires careful monitoring and control to avoid overdosing the plants with ammonium. The primary advantage of using NH4+ for pH control is that it exploits the existing plant nutrient uptake charge balance mechanisms to maintain solution pH. The simulation models growth, nitrogen uptake, and pH of a l-m2 stand of wheat. Simulation results indicated that ammonium-based control of nutrient solution pH is feasible using a proportional integral controller. Use of a 1 mmol/L buffer (Ka = 1.6 x 10(-6)) in the nutrient solution is required.
Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits
Brennan, Ann-Marie; Fenton, Sarah; Murphy, Brendan P.
2018-01-01
The optimal composition of standardized parenteral nutrition (SPN) is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN) phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL/kg/day to <40 mL/kg/day, and earlier fortification of breastmilk at 80 mL/kg/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase. PMID:29393903
TOTAL PARENTERAL NUTRITION (TPN: ROLE OF RIBOFLAVIN (VITAMIN B2 AND CYANOCOBALAMIN (VITAMIN B12
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Samina Shiekh
2015-06-01
Full Text Available Total parenteral nutrition (TPN replaces and maintains essential nutrients in patients in whom oral or tube feedings are contraindicated or inadequate. A nutritional assessment must be carried out before initiating TPN in order to determine nutritional needs and any metabolic changes due to the patient’s underlying condition, medications or concurrent therapies. In addition to carbohydrates, proteins and fats, certain amounts of micronutirents are also added to TPN solutions. These micronutrients include electrolytes, vitamins, and trace minerals. This review highlights some basic concepts regarding the use and formulation of TPNs along with their advantages and disadvantages and the importance of water soluble vitamins B2 and B12 in human nutrition.
Management of Ready-to-Use Parenteral Nutrition in Newborns: Systematic Review.
Mena, Karen Daniela Romero; Espitia, Olga Lucia Pinzón; Vergara, José Alejandro Daza
2018-04-27
Parenteral support has increased the possibility of neonatal recovery. However, complications associated with its use have been documented. One commercial method developed to decrease the complications of this type of support is the ready-to-use parenteral nutrition (PN), a 3-chamber bag that provides a complete nutrient mix. This systematic review seeks, through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, to establish the benefits in newborns. Seven databases and gray literature were used. The search was limited to publications from 2007-2017 and to articles written in English, Spanish, and Portuguese. Articles that did not meet the inclusion criteria and studies with low quality evaluated with the Scottish Intercollegiate Guidelines Network guidelines, which were without information about the study or analytical methods, were excluded. A total of 24,193 articles were obtained, which were initially evaluated by title and abstract according to the inclusion criteria. A total of 24,167 articles were discarded, obtaining 27 eligible for follow-up evaluation. After a detailed evaluation of the full text, 13 articles were selected. It was found that ready-to-use PN has the potential benefit to reduce the risks for infections, provide an adequate supply of nutrients, generate growth within the expected range, provide ease of use, decrease prescription errors, and potentially reduce costs. It is necessary to evaluate the short- and long-term impact of its use. © 2018 American Society for Parenteral and Enteral Nutrition.
New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition.
Akbulut, Gamze
2011-07-01
Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer.
A. Ayúcar Ruiz de Galarreta; F. Pita Gutiérrez; F. Mosteiro Pereira; L. Cordero Lorenzana; S. Gómez Canosa; C. Seco Vilariño
2011-01-01
Introducción: La Nutrición Parenteral Perif��rica, definida como la mezcla de macronutrientes, vitaminas y minerales con osmolaridad menor de 800 mOsm/L, permite evitar los riesgos del catéter central. Clásicamente ha sido utilizada en postoperados, pero actualmente la patología médica también puede beneficiarse de ella, bien como única fuente de nutrientes, ya que un alto porcentaje de pacientes precisan menor aporte calórico de lo que se creía, o como complementaria. Objetivo: Evaluación de...
Combined enteral and parenteral nutrition.
Wernerman, Jan
2012-03-01
To review and discuss the evidence and arguments to combine enteral nutrition and parenteral nutrition in the ICU, in particular with reference to the Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients (EPaNIC) study. The EPaNIC study shows an advantage in terms of discharges alive from the ICU when parenteral nutrition is delayed to day 8 as compared with combining enteral nutrition and parenteral nutrition from day 3 of ICU stay. The difference between the guidelines from the European Society of Enteral and Parenteral Nutrition in Europe and American Society for Parenteral and Enteral Nutrition/Society of Critical Care Medicine in North America concerning the combination of enteral nutrition and parenteral nutrition during the initial week of ICU stay was reviewed. The EPaNIC study clearly demonstrates that early parenteral nutrition in the ICU is not in the best interests of most patients. Exactly at what time point the combination of enteral nutrition and parenteral nutrition should be considered is still an open question.
Use of parenteral testosterone in hypospadias cases
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Vikram Satav
2015-01-01
Full Text Available Objectives: The aim was to evaluate the effect of parenteral testosterone on penile length, preputial hood, vascularity of dartos pedicle in patients with hypospadias. Materials and Methods: A total of 42 patients with hypospadias were included in this study. Injection aquaviron (oily solution each ml containing testosterone propionate 25 mg was given deep intramuscularly in three doses with an interval of 3 weeks before reconstructive surgery at the dose of 2 mg/kg body weight. Preoperatively penile length, transverse preputial width and diameter at the base of the penis were measured. Basal testosterone levels were obtained before the institution of therapy and on the day of operation. Results: Following parenteral testosterone administration, the mean increase in penile length, transverse preputial width and diameter at the base of penis was 1.01 ± 0.25 cm (P < 0.001, 1.250 ± 0.52 cm and 0.61 ± 0.35 cm, respectively, (P < 0.001. Serum testosterone level after injection was well within normal range for that age. Conclusion: Parenteral testosterone increased phallus size, diameter and prepuce hypertrophy without any adverse effects. However, due to lack of a control group we cannot make any inferences. Controlled studies are required to establish the benefits of parenteral testosterone.
Brinkman, Adam S.; Murali, Sangita G.; Hitt, Stacy; Solverson, Patrick M.; Holst, Jens J.
2012-01-01
Glucagon-like peptide-2 (GLP-2) is a nutrient-dependent, proglucagon-derived gut hormone that shows promise for the treatment of short bowel syndrome (SBS). Our objective was to investigate how combination GLP-2 + enteral nutrients (EN) affects intestinal adaption in a rat model that mimics severe human SBS and requires parenteral nutrition (PN). Male Sprague-Dawley rats were assigned to one of five groups and maintained with PN for 18 days: total parenteral nutrition (TPN) alone, TPN + GLP-2 (100 μg·kg−1·day−1), PN + EN + GLP-2(7 days), PN + EN + GLP-2(18 days), and a nonsurgical oral reference group. Animals underwent massive distal bowel resection followed by jejunocolic anastomosis and placement of jugular catheters. Starting on postoperative day 4, rats in the EN groups were allowed ad libitum access to EN. Groups provided PN + EN + GLP-2 had their rate of PN reduced by 0.25 ml/day starting on postoperative day 6. Groups provided PN + EN + GLP-2 demonstrated significantly greater body weight gain with similar energy intake and a safe 80% reduction in PN compared with TPN ± GLP-2. Groups provided PN + EN + GLP-2 for 7 or 18 days showed similar body weight gain, residual jejunal length, and digestive capacity. Groups provided PN + EN + GLP-2 showed increased jejunal GLP-2 receptor (GLP-2R), insulin-like growth factor-I (IGF-I), and IGF-binding protein-5 (IGFBP-5) expression. Treatment with TPN + GLP-2 demonstrated increased jejunal expression of epidermal growth factor. Cessation of GLP-2 after 7 days with continued EN sustained the majority of intestinal adaption and significantly increased expression of colonic proglucagon compared with PN + EN + GLP-2 for 18 days, and increased plasma GLP-2 concentrations compared with TPN alone. In summary, EN potentiate the intestinotrophic actions of GLP-2 by improving body weight gain allowing for a safe 80% reduction in PN with increased jejunal expression of GLP-2R, IGF-I, and IGFBP-5 following distal bowel
Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits.
LENUS (Irish Health Repository)
Brennan, Ann-Marie
2018-02-02
The optimal composition of standardized parenteral nutrition (SPN) is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN) phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation < 34 weeks) by collecting hourly macronutrient intake data as part of a prospective, observational study over 19 months. Using a nutrient modeling technique for the TN phase, various amino acid (AA) concentrations of SPN were tested within the database, whilst acknowledging the nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g\\/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL\\/kg\\/day to <40 mL\\/kg\\/day, and earlier fortification of breastmilk at 80 mL\\/kg\\/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase.
Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits
Directory of Open Access Journals (Sweden)
Ann-Marie Brennan
2018-02-01
Full Text Available The optimal composition of standardized parenteral nutrition (SPN is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation < 34 weeks by collecting hourly macronutrient intake data as part of a prospective, observational study over 19 months. Using a nutrient modeling technique for the TN phase, various amino acid (AA concentrations of SPN were tested within the database, whilst acknowledging the nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL/kg/day to <40 mL/kg/day, and earlier fortification of breastmilk at 80 mL/kg/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase.
... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...
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Cláudio Luís Nina Gomes
2014-06-01
Full Text Available Large volumes of different electrolytes solutions are commonly used for ingesta hydration in horses with large colon impaction, but little is known about their consequences to blood acid-base balance. To evaluate the effects of PEG 3350 or enteral and parenteral electrolyte solutions on the blood gas analysis, anion gap and strong ion difference, five adult female horses were used in a 5x5 latin square design. The animals were divided in five groups and distributed to each of the following treatments: NaCl (0.9% sodium chloride solution; EES (enteral electrolyte solution, EES+LR (EES plus lactated Ringer's solution; PEG (balanced solution with PEG 3350 and PEG+LR (PEG plus lactated Ringer's solution. Treatments PEG or PEG + LR did not change or promoted minimal changes, while the EES caused a slight decrease in pH, but its association with lactated Ringer's solution induced increase in AG and SID values, as well as caused hypernatremia. In turn, the treatment NaCl generated metabolic acidosis. PEG 3350 did not alter the acid-base balance. Despite it's slight acidifying effect, the enteral electrolyte solution (EES did not cause clinically relevant changes.
Inayet, N; Neild, P
2015-03-01
Over the last 50 years, parenteral nutrition has been recognised as an invaluable and potentially lifesaving tool in the physician's arsenal in the management of patients with intestinal failure or inaccessibility; however, it may also be associated with a number of potentially life-threatening complications. A recent NCEPOD report (2010) identified a number of inadequacies in the overall provision and management of parenteral nutrition and recommendations were made with the aim of improving clinical practice in the future. This paper focuses on the practical aspects relating to parenteral nutrition for adults, including important concepts, such as patient selection, as well as general management. We also explore the various pitfalls and potential complications and how these may be minimised.
Managing an outpatient parenteral antibiotic therapy team: challenges and solutions.
Halilovic, Jenana; Christensen, Cinda L; Nguyen, Hien H
2014-01-01
Outpatient parenteral antimicrobial therapy (OPAT) programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.
New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition
AKBULUT, GAMZE
2011-01-01
Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer. PMID:22977559
Choline Alleviates Parenteral Nutrition-Associated Duodenal Motility Disorder in Infant Rats.
Zhu, Jie; Wu, Yang; Guo, Yonggao; Tang, Qingya; Lu, Ting; Cai, Wei; Huang, Haiyan
2016-09-01
Parenteral nutrition (PN) has been found to influence duodenal motility in animals. Choline is an essential nutrient, and its deficiency is related to PN-associated organ diseases. Therefore, this study was aimed to investigate the role of choline supplementation in an infant rat model of PN-associated duodenal motility disorder. Three-week-old Sprague-Dawley male rats were fed chow and water (controls), PN solution (PN), or PN plus intravenous choline (600 mg/kg) (PN + choline). Rats underwent jugular vein cannulation for infusion of PN solution or 0.9% saline (controls) for 7 days. Duodenal oxidative stress status, concentrations of plasma choline, phosphocholine, and betaine and serum tumor necrosis factor (TNF)-α were assayed. The messenger RNA (mRNA) and protein expression of c-Kit proto-oncogene protein (c-Kit) and membrane-bound stem cell factor (mSCF) together with the electrophysiological features of slow waves in the duodenum were also evaluated. Rats on PN showed increased reactive oxygen species; decreased total antioxidant capacity in the duodenum; reduced plasma choline, phosphocholine, and betaine; and enhanced serum TNF-α concentrations, which were reversed by choline intervention. In addition, PN reduced mRNA and protein expression of mSCF and c-Kit, which were inversed under choline administration. Moreover, choline attenuated depolarized resting membrane potential and declined the frequency and amplitude of slow waves in duodenal smooth muscles of infant rats induced by PN, respectively. The addition of choline to PN may alleviate the progression of duodenal motor disorder through protecting smooth muscle cells from injury, promoting mSCF/c-Kit signaling, and attenuating impairment of interstitial cells of Cajal in the duodenum during PN feeding. © 2015 American Society for Parenteral and Enteral Nutrition.
The effect of pH on phosphorus availability and speciation in an aquaponics nutrient solution.
Cerozi, Brunno da Silva; Fitzsimmons, Kevin
2016-11-01
The interaction between the main ions in aquaponics nutrient solutions affects chemical composition and availability of nutrients, and nutrient uptake by plant roots. This study determined the effect of pH on phosphorus (P) speciation and availability in an aquaponics nutrient solution and used Visual MINTEQ to simulate P species and P activity. In both experimental and simulated results, P availability decreased with increase in pH of aquaponics nutrient solutions. According to simulations, P binds to several cations leaving less free phosphate ions available in solution. High pH values resulted in the formation of insoluble calcium phosphate species. The study also demonstrated the importance of organic matter and alkalinity in keeping free phosphate ions in solution at high pH ranges. It is recommended though that pH in aquaponics systems is maintained at a 5.5-7.2 range for optimal availability and uptake by plants. Copyright © 2016 Elsevier Ltd. All rights reserved.
Directory of Open Access Journals (Sweden)
Carolina Alves dos Santos
2012-12-01
Full Text Available Ceftazidime is a broad spectrum antibiotic administered mainly by the parenteral route, and it is especially effective against Pseudomonas aeruginosa. The period of time in which serum levels exceed the Minimum Inhibitory Concentration (MIC is an important pharmacodynamic parameter for its efficacy. One of the forms to extend this period is to administer the antibiotic by continuous infusion, after prior dilution in a Parenteral Solution (PS. The present work assessed the stability of ceftazidime in 5% glucose PS for 24 hours, combined or not with aminophylline, through High Performance Liquid Chromatography (HPLC. The physicochemical evaluation was accompanied by in vitro antimicrobial activity compared MIC test in the 24-hour period. Escherichia coli and Pseudomonas aeruginosa were the microorganisms chosen for the MIC comparison. The HPLC analysis confirmed ceftazidime and aminophylline individual stability on PS, while the MIC values were slightly higher than the mean described in the literature. When both drugs were associated in the same PS, the ceftazidime concentration by HPLC decreased 25% after 24 hours. Not only did the MIC values show high loss of antibiotic activity within the same period, but also altered MIC values immediately after the preparation, which was not detected by HPLC. Our results indicate that this drug combination is not compatible, even if used right away, and that PS might not be the best vehicle for ceftazidime, emphasizing the importance of the MIC evaluation for drug interactions.Ceftazidima é um antimicrobiano administrado por via parenteral, que apresenta amplo espectro de ação, principalmente contra Pseudomonas aeruginosa. O tempo em que a concentração sérica de ceftazidima permanece acima da concentração mínima inibitória (MIC é um importante parâmetro farmacodinâmico para a determinação da eficácia antimicrobiana e pode ser potencializado através da utilização de infusão contínua em
Parenteral Nutrition-Associated Liver Disease: The Role of the Gut Microbiota.
Cahova, Monika; Bratova, Miriam; Wohl, Petr
2017-09-07
Parenteral nutrition (PN) provides life-saving nutritional support in situations where caloric supply via the enteral route cannot cover the necessary needs of the organism. However, it does have serious adverse effects, including parenteral nutrition-associated liver disease (PNALD). The development of liver injury associated with PN is multifactorial, including non-specific intestine inflammation, compromised intestinal permeability, and barrier function associated with increased bacterial translocation, primary and secondary cholangitis, cholelithiasis, short bowel syndrome, disturbance of hepatobiliary circulation, lack of enteral nutrition, shortage of some nutrients (proteins, essential fatty acids, choline, glycine, taurine, carnitine, etc.), and toxicity of components within the nutrition mixture itself (glucose, phytosterols, manganese, aluminium, etc.). Recently, an increasing number of studies have provided evidence that some of these factors are directly or indirectly associated with microbial dysbiosis in the intestine. In this review, we focus on PN-induced changes in the taxonomic and functional composition of the microbiome. We also discuss immune cell and microbial crosstalk during parenteral nutrition, and the implications for the onset and progression of PNALD. Finally, we provide an overview of recent advances in the therapeutic utilisation of pro- and prebiotics for the mitigation of PN-associated liver complications.
21 CFR 201.323 - Aluminum in large and small volume parenterals used in total parenteral nutrition.
2010-04-01
... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Aluminum in large and small volume parenterals... for Specific Drug Products § 201.323 Aluminum in large and small volume parenterals used in total parenteral nutrition. (a) The aluminum content of large volume parenteral (LVP) drug products used in total...
Xuzhang Xue; Yinkun Li; Feng Li; Fang Zhang; Wenzhong Guo
2015-01-01
In this study, experiment with four levels of nutrient solution pH control upper limit was conducted to explore the optimal nutrient solution pH management scheme under hydroponics by evaluating the nutrient solution characters i.e., pH, Electric Conductivity (EC), nitrate, soluble phosphorus (soluble-P), water spinach growth and quality. The results showed that the nutrient solution pH was 8.2 and unsuitable for water spinach growth under the treatment with no pH regulation during the experi...
Managing an outpatient parenteral antibiotic therapy team: challenges and solutions
Nguyen, Hien; Halilovic,Jenana; Christensen,Cinda
2014-01-01
Jenana Halilovic,1 Cinda L Christensen,2 Hien H Nguyen31University of the Pacific Thomas J Long School of Pharmacy, Stockton, CA, USA; 2Department of Pharmaceutical Services, University of California, Davis Health System, Sacramento, CA, USA; 3Division of Infectious Diseases, Section of Hospital Medicine, University of California, Davis Health System, Sacramento, CA, USAAbstract: Outpatient parenteral antimicrobial therapy (OPAT) programs should strive to deliver safe, cost effective, and hig...
Kuwahara, Takashi; Kaneda, Shinya; Shimono, Kazuyuki
2016-01-01
We have previously demonstrated that Candida albicans requires multivitamins (MVs) or lipid to increase rapidly in parenteral nutrition (PN) solutions. In this study, in detail, the effects of vitamins on the growth of C. albicans in PN solutions without lipid were investigated. In the 1st experiment, a commercial PN solution without lipid was supplemented with water-soluble vitamins (SVs: vitamins B1, B2, B6, B12 and C, folic acid, nicotinamide, biotin and panthenol), water-insoluble vitamins (IVs: vitamins A, D, E and K) or both (MVs). In the 2nd experiment, the test solutions were prepared by supplementing the PN solution with one of each or all of the SVs. In the 3rd experiment, another commercial peripheral PN (PPN) solution without lipid was supplemented with SVs, nicotinic acid, biotin or both nicotinic acid and biotin. In each of the experiments, a specified number of C. albicans organisms was added to each test solution, and all of the test solutions were allowed to stand at room temperature (23-26ºC). The number of C. albicans was counted at 0, 24, 48 and 72 hours after the addition of the organism. In the 1st experiment, the C. albicans increased rapidly in the PN solution supplemented with the SVs, but increased slowly without the SVs, regardless of the addition of the IVs. In the 2nd experiment, the C. albicans increased rapidly in the PN solution supplemented with the SVs or biotin, but increased slowly with each of the other water-soluble vitamins. In the 3rd experiment, the C. albicans increased rapidly in the PPN solution supplemented with the SVs or biotin, but increased slowly with the addition of nicotinic acid. These results suggested that adding MVs or SVs to PN solutions without lipid promotes the growth of C. albicans, and that this effect is mostly attributable to biotin.
Nutritional intake of gut failure patients on home parenteral nutrition
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DiCecco, S.; Nelson, J.; Burnes, J.; Fleming, C.R.
1987-01-01
Nutrient intake patterns were analyzed in 23 patients with gut failure who were receiving home parenteral nutrition (HPN). All patients had stable weights without changes in intravenous calories or protein for 3 consecutive months. Our objectives were to assess oral intake of calories, carbohydrates, fat, and protein, to examine relationships between oral nutrient intakes and disease categories, and to compare oral and intravenous intakes to calculated resting energy expenditure (REE). Two patterns of oral nutrient intake were identified among the patients. Patients with short bowel syndrome, regardless of the underlying disease, consumed calories by mouth that clearly exceeded calculated resting energy expenditure (short bowel, non-Crohn's, 170% of REE; short bowel, Crohn's, 200 of REE); however, calories approximating the REE had to be given via HPN, suggesting that efficiency of absorption was at a very low level. Patients with diffuse gut diseases (radiation enteritis or pseudo-obstruction syndromes) had very low intakes of oral nutrients. The distribution of oral calories among carbohydrate, protein, and fat did not differ among the disease categories
Home parenteral nutrition in children
International Nuclear Information System (INIS)
Kalousova, J.; Rouskova, B.; Styblova, J.
2011-01-01
Parenteral nutrition delivered at home presents a major improvement in the quality of life of children dependent on long term parenteral nutrition. Indications, technical conditions, logistics, complications, prognosis of home parenteral nutrition as well as some health-care issues to be addressed by pediatric practitioner are summarized. (author)
Automated pH Control of Nutrient Solution in a Hydroponic Plant Growth System
Smith, B.; Dogan, N.; Aglan, H.; Mortley, D.; Loretan, P.
1998-01-01
Over, the years, NASA has played an important role in providing to and the development of automated nutrient delivery and monitoring, systems for growing crops hydroponically for long term space missions. One example are the systems used in the Biomass Production Chamber (BPC) at Kennedy Space Center (KSC). The current KSC monitoring system is based on an engineering workstation using standard analog/digital input/output hardware and custom written software. The monitoring system uses completely separate sensors to provide a check of control sensor accuracy and has the ability to graphically display and store data form past experiment so that they are available for data analysis [Fortson, 1992]. In many cases, growing systems have not been fitted with the kind of automated control systems as used at KSC. The Center for Food and Environmental Systems for Human Exploration of Space (CFESH) located on the campus of Tuskegee University, has effectively grown sweetpotatoes and peanuts hydroponically for the past five years. However they have adjusted the pH electrical conductivity and volume of the hydroponic nutrient solution only manually at times when the solution was to be replenished or changed out according to its protocol (e.g. one-week, two-week, or two-day cycle). But the pH of the nutrient solution flowing through the channel is neither known nor controlled between the update, change out, or replenishment period. Thus, the pH of the nutrient solution is not held at an optimum level over the span of the plant's growth cycle. To solve this dilemma, an automated system for the control and data logging of pH data relative to sweetpotato production using the nutrient film technique (NFT) has been developed, This paper discusses a microprocessor-based system, which was designed to monitor, control, and record the pH of a nutrient solution used for growing sweetpotatoes using NFT.
Total parenteral nutrition - infants
... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...
[Routine comparison of trace element deficiencies during parenteral alimentation].
du Cailar, J; Mathieu-Daudé, J C; Kienlen, J; Béssou, D; Griffe, O; Bélé-Binda
1977-01-01
In 50 patients aged between 3 and 84 years treated in a multidisciplinary Intensive Care Unit and receiving parenteral alimentation, deficiency in certain trace elements or electrolytes (Cu++, Zn++, Mn++, Co++, PO-4, Mg++) was prevented or treated by the administration of a glucose solution (MB 147 G) enriched in trace elements. The aim of the present study was to demonstrate, on the basis of assay of serum levels of the trace elements involved, with the exception of Mn and Co, the effectiveness of treatment. Reference values were determined on the one hand in healthy individuals for normal figures and secondly on subjects included in the study, already on parenteral alimentation for several days, before treatment with MB 147 G, in order to demonstrate the existence of a deficiency (patient control values). In the case of PO--4, however, the patient control values concerned at one and the same time subjects in the study before treatment with MB 147 G and other patients receiving parenteral alimentation who were not part of the trial. MB 147 G solution was presented in units of 500 ml associated with glucose of varying concentrations (15 p. 100, 30 p. 100, 50 p. 100). The average daily amount administered, over a period of 236 days, was 3 unites per 24 hours, corresponding to an intake of copper of 3.78 mg, 3.90 mg of zinc, 0.20 mg of manganese, 0.24 mg of cobalt, 363 mg of magnesium, 240 mg of calcium and 15 mEz of phosphates. The results show that levels of copper, zinc, magnesium and phosphates were low during parenteral alimentation. The administration of MB 147 G resulted in a significant increase in these values, without there being any evidence of accumulation.
Orso, Giuseppe; Mandato, Claudia; Veropalumbo, Claudio; Cecchi, Nicola; Garzi, Alfredo; Vajro, Pietro
2016-03-01
Parenteral nutrition constitutes a life-saving therapeutic tool in patients unable to ingest/absorb oral or enteral delivered nutrients. Liver function tests abnormalities are a common therapy-related complication, thus configuring the so-called Parenteral Nutrition Associated Liver Disease (PNALD) or cholestasis (PNAC). Although the damage is frequently mild, and resolves after discontinuation of parenteral nutrition, in some cases it progresses into cirrhotic changes, especially in neonates and infants. We present a literature review focusing on the pathogenetic mechanisms-driven prevention and therapies for the cases where parenteral nutrition cannot be discontinued. Ursodeoxycholic acid has been proposed in patients with cholestatic hepatopathy, but its efficacy needs to be better established. Little evidence is available on efficacy of anti-oxidants, antibiotics, probiotics and anti TNFα. Lipid emulsions based on fish oil with a high content of long-chain polyunsaturated fatty acids ω-3 appear effective both in decreasing intrahepatic inflammation and in improving biliary flow. Most recent promising variations such as soybean/MCT/olive/fish oil emulsion [third generation lipid emulsion (SMOFlipid)] are under investigation. In conclusion, we remark the emergence of a number of novel pathomechanisms underlying the severe liver impairment damage (PNALD and PNAC) in patients treated with parenteral nutrition. Only few traditional and innovative therapeutic strategies have hitherto been shown promising. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Parenteral nutrition in the critically ill.
Gunst, Jan; Van den Berghe, Greet
2017-04-01
Feeding guidelines have recommended early, full nutritional support in critically ill patients to prevent hypercatabolism and muscle weakness. Early enteral nutrition was suggested to be superior to early parenteral nutrition. When enteral nutrition fails to meet nutritional target, it was recommended to administer supplemental parenteral nutrition, albeit with a varying starting point. Sufficient amounts of amino acids were recommended, with addition of glutamine in subgroups. Recently, several large randomized controlled trials (RCTs) have yielded important new insights. This review summarizes recent evidence with regard to the indication, timing, and dosing of parenteral nutrition in critically ill patients. One large RCT revealed no difference between early enteral nutrition and early parenteral nutrition. Two large multicenter RCTs showed harm by early supplementation of insufficient enteral nutrition with parenteral nutrition, which could be explained by feeding-induced suppression of autophagy. Several RCTs found either no benefit or harm with a higher amino acid or caloric intake, as well as harm by administration of glutamine. Although unanswered questions remain, current evidence supports accepting low macronutrient intake during the acute phase of critical illness and does not support use of early parenteral nutrition. The timing when parenteral nutrition can be initiated safely and effectively is unclear.
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A. A. Popov
2012-01-01
Full Text Available Pathologic nutrients metabolism presents a severe problem in metastatic colorectal cancer patients, especially those with canceromatosis. A hypermetabolism-catabolism syndrome frequently develops in in patients with progressing canceromatosis. This leads to cachexia anorexia syndrome, which significantly impedes available treatment options. Artificial nutrition allows to improve available treatment in such patients. We present a successful case of concomitant parenteral nutrition and systemic cytotoxic therapy in metastatic colorectal cancer patient with peritoneal canceromatosis.
DEFF Research Database (Denmark)
Brinkman, Adam S; Murali, Sangita G; Hitt, Stacy
2012-01-01
human SBS and requires parenteral nutrition (PN). Male Sprague-Dawley rats were assigned to one of five groups and maintained with PN for 18 days: total parenteral nutrition (TPN) alone, TPN + GLP-2 (100 μg·kg(-1)·day(-1)), PN + EN + GLP-2(7 days), PN + EN + GLP-2(18 days), and a nonsurgical oral...
Ainsworth, S B; Clerihew, L; McGuire, W
2007-07-18
Parenteral nutrition for neonates may be delivered via a short peripheral cannula or a central venous catheter. The latter may either be inserted via the umbilicus or percutaneously. Because of the complications associated with umbilical venous catheter use, many neonatal units prefer to use percutaneously inserted catheters following the initial stabilisation period. The method of parenteral nutrition delivery may affect nutrient input and consequently growth and development. Although potentially more difficult to place, percutaneous central venous catheters may be more stable than peripheral cannulae, and need less frequent replacement. These delivery methods may also be associated with different risks of adverse events, including acquired systemic infection and extravasation injury. To determine the effect of infusion via a percutaneous central venous catheter versus a peripheral cannula on nutrient input, growth and development, and complications including systemic infection, or extravasation injuries in newborn infants who require parenteral nutrition. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2007), MEDLINE (1966 - February 2007), EMBASE (1980 - February 2007), conference proceedings, and previous reviews. Randomised controlled trials that compared the effect of delivering parenteral nutrition via a percutaneous central venous catheter versus a peripheral cannulae in neonates. Data were extracted the data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by each author, and synthesis of data using relative risk, risk difference and mean difference. Four trials eligible for inclusion were found. These trials recruited a total of 368 infants and reported a number of different outcomes. One study showed that the use of a percutaneous
Bacterial Shifts in Nutrient Solutions Flowing Through Biofilters Used in Tomato Soilless Culture.
Renault, David; Déniel, Franck; Vallance, Jessica; Bruez, Emilie; Godon, Jean-Jacques; Rey, Patrice
2017-11-25
In soilless culture, slow filtration is used to eliminate plant pathogenic microorganisms from nutrient solutions. The present study focused on the characterization and the potential functions of microbial communities colonizing the nutrient solutions recycled on slow filters during a whole cultivation season of 7 months in a tomato growing system. Bacterial microflora colonizing the solutions before and after they flew through the columns were studied. Two filters were amended with Pseudomonas putida (P-filter) or Bacillus cereus strains (B-filter), and a third filter was a control (C-filter). Biological activation of filter unit through bacterial amendment enhanced very significantly filter efficacy against plant potential pathogens Pythium spp. and Fusarium oxysporum. However, numerous bacteria (10 3 -10 4 CFU/mL) were detected in the effluent solutions. The community-level physiological profiling indicated a temporal shift of bacterial microflora, and the metabolism of nutrient solutions originally oriented towards carbohydrates progressively shifted towards degradation of amino acids and carboxylic acids over the 7-month period of experiment. Single-strand conformation polymorphism fingerprinting profiles showed that a shift between bacterial communities colonizing influent and effluent solutions of slow filters occurred. In comparison with influent, 16S rDNA sequencing revealed that phylotype diversity was low in the effluent of P- and C-filters, but no reduction was observed in the effluent of the B-filter. Suppressive potential of solutions filtered on a natural filter (C-filter), where the proportion of Proteobacteria (α- and β-) increased, whereas the proportion of uncultured candidate phyla rose in P- and B-filters, is discussed.
Stability of furosemide and aminophylline in parenteral solutions
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Carolina Alves dos Santos
2011-03-01
Full Text Available Parenteral solutions (PS are one of the most commonly used drug delivery vehicles. Interactions among the drug, components in the drug's formulation, and the PS can result in the formation of inactive complexes that limit efficacy or increase side effects. The aim of this work was to evaluate possible interactions between the drugs and PS, assess drug stability and to identify degradation products after 20 h at room temperature. Furosemide (FSM and Aminophylline (APN were added to PS containing either 20% mannitol or 0.9% NaCl at pH 6.5-7.5 and 10-11. Their behavior was studied individually and as an admixture, after 1 h oxidation with H2O2, using a spectrophotometer and HPLC. Individually, FSM and APN added to 20% mannitol and 0.9% NaCl solutions had the highest stability at pH 10-11. When FSM and APN were combined, the behavior of FSM was similar to the behavior observed for the drug individually in the same solutions. With the drugs combined in 20% mannitol pH 10-11, HPLC showed that both drugs were stable after a 20 h period yielding two distinct peaks; in oxidized samples, the elution profile showed four peaks with retention times unrelated to the untreated samples.Soluções parenterais de grande volume são frequentemente utilizadas no ambiente hospitalar para a veiculação de fármacos. No entanto, possíveis incompatibilidades entre as estruturas dos fármacos, em diferentes veículos de administração, podem gerar possíveis associações antagônicas ou sinérgicas, resultando em alterações das propriedades físico-químicas, consequentemente, dos efeitos farmacológicos e das respostas clínicas esperadas. Este artigo avaliou a estabilidade e a possível formação de produtos de degradação entre os fármacos furosemida e aminofilina quando estes foram veiculados em soluções parenterais, após o preparo e após o período de 20 h. Furosemida e aminofilina foram adicionadas às soluções de 20% manitol e 0,9% NaCl nos valores
Izquierdo, Montserrat; Martínez-Monseny, Antonio Federico; Pociello, Neus; Gonzalez, Paloma; Del Rio, Ruth; Iriondo, Martin; Iglesias-Platas, Isabel
2016-10-01
Postnatal growth restriction remains a serious problem in very low-birth-weight infants. Enhanced parenteral supply of nutrients as soon as possible after birth is one of the strategies addressed to avoid extrauterine growth restriction. We aimed to analyze changes in growth patterns and in clinical outcomes in our unit after a change in our parenteral nutrition (PN) protocol. We collected data from 2 time periods, comprising the 2 years before (period I) and the 2 years after (period II) the change of protocol. We included 142 very low-birth-weight infants ≤32 weeks of gestation with a birth weight ≤1500 g. Data regarding nutrition intakes (parenteral and enteral) in the first week of life, growth during admission, and clinical outcomes were retrieved from clinical charts. Babies in period II received a higher nutrition supply during the first week of life, but no further differences were found after this period. Weight at 14 days of life was significantly higher in period II but not at day 28 of life or discharge. In our population, an enhanced PN regimen for very low-birth-weight infants led to a better growth at 14 days of life. However, this positive effect had disappeared at day 28 of life. Strategies to improve nutrient supply once the preterm baby is stable and on full enteral feeds should be implemented and analyzed. © 2016 American Society for Parenteral and Enteral Nutrition.
Chekli, Laura
2017-03-10
This study investigated the sustainable reuse of wastewater using fertilizer drawn forward osmosis (FDFO) process through osmotic dilution of commercial nutrient solution for hydroponics, a widely used technique for growing plants without soil. Results from the bench-scale experiments showed that the commercial hydroponic nutrient solution (i.e. solution containing water and essential nutrients) exhibited similar performance (i.e., water flux and reverse salt flux) to other inorganic draw solutions when treating synthetic wastewater. The use of hydroponic solution is highly advantageous since it provides all the required macro- (i.e., N, P and K) and micronutrients (i.e., Ca, Mg, S, Mn, B, Zn and Mo) in a single balanced solution and can therefore be used directly after dilution without the need to add any elements. After long-term operation (i.e. up to 75% water recovery), different physical cleaning methods were tested and results showed that hydraulic flushing can effectively restore up to 75% of the initial water flux while osmotic backwashing was able to restore the initial water flux by more than 95%; illustrating the low-fouling potential of the FDFO process. Pilot-scale studies demonstrated that the FDFO process is able to produce the required nutrient concentration and final water quality (i.e., pH and conductivity) suitable for hydroponic applications. Coupling FDFO with pressure assisted osmosis (PAO) in the later stages could help in saving operational costs (i.e., energy and membrane replacement costs). Finally, the test application of nutrient solution produced by the pilot FDFO process to hydroponic lettuce showed similar growth pattern as the control without any signs of nutrient deficiency.
A targeted management of the nutrient solution in a soilless tomato crop according to plant needs
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Angelo eSignore
2016-03-01
Full Text Available The adoption of closed soilless systems is useful in minimizing the environmental impact of the greenhouse crops. Instead, a significant problem in closed soilless systems is represented by the accumulation of ions in the recycled nutrient solution, in particular the unabsorbed or poorly absorbed ones. To overcome such problem, we: 1 studied the effect of several values of the electrical conductivity (EC of nutrient solution in a NFT (Nutrient Film Technique system on a cherry type tomato crop, and 2 define a NS (called recovery solution, based on the concept of uptake concentration and transpiration-biomass ratio, that fits the real needs of the plant with respect to water and nutrients. Three levels of EC set point (SP, above which the NS was completely replaced (SP5, SP7.5, and SP10 for the EC limit of 5, 7.5 and 10 dS m-1, respectively, were established. The SP10 treatment yield was not different from other treatments, and it allowed a better quality of the berries (for dry matter and total soluble solids and higher environmental sustainability due to a lower discharge of total nutrients into the environment (37 and 59% with respect to SP7.5 and SP5, respectively.The recovery solution used in the second trial allowed a more punctual NS management, by adapting to the real needs of the crop. Moreover, it allowed a lesser amount of water and nutrients to be discharged into the environment and a better use of brackish water, due to a more accurate management of the EC of the NS. The targeted management, based on transpiration-biomass ratio, indicates that, in some stages of the plant cycle, the nutrient solution used can be diluted, in order to save water and nutrients. With such management a closed cycle can be realized without affecting the yield, but improving the quality of the tomato berries.
Yasui, Shinji; Seki, Satoshi; Yoshida, Ryohei; Shoji, Kazuhiro; Terazoe, Hitoshi
2016-01-01
Fusarium wilt of spinach due to F. oxysporum infection is one of the most destructive root diseases in hydroponics in factories using the nutrient film technique. We investigated new technologies for the sterilization of microconidia of F. oxysporum by using a non-thermalequilibrium plasma treatment method in nutrient solution. Specifically, we investigated the sterilization capabilities of five types of gas (air, O2, N2, He, and Ar) used for plasma generation. The highest sterilization capability was achieved by using O2 plasma. However, ozone, which causes growth inhibition, was then generated and released into the atmosphere. The sterilization capability was lower when N2 or air plasma was used in the nutrient solution. It was confirmed that sterilization can be achieved by plasma treatment using inert gases that do not generate ozone; therefore, we determined that Ar plasma is the most preferable. In addition, we investigated the sterilization capabilities of other factors associated with Ar plasma generation, without direct plasma treatment. However, none of these other factors, which included Ar bubbling, pH reduction, increased temperature, hydrogen peroxide concentration, and UV radiation, could completely reproduce the results of direct plasma treatment. We assume that radicals such as O or OH may contribute significantly to the sterilization of microconidia of F. oxysporum in a nutrient solution.
Early versus Late Parenteral Nutrition in Critically Ill Children.
Fivez, Tom; Kerklaan, Dorian; Mesotten, Dieter; Verbruggen, Sascha; Wouters, Pieter J; Vanhorebeek, Ilse; Debaveye, Yves; Vlasselaers, Dirk; Desmet, Lars; Casaer, Michael P; Garcia Guerra, Gonzalo; Hanot, Jan; Joffe, Ari; Tibboel, Dick; Joosten, Koen; Van den Berghe, Greet
2016-03-24
Recent trials have questioned the benefit of early parenteral nutrition in adults. The effect of early parenteral nutrition on clinical outcomes in critically ill children is unclear. We conducted a multicenter, randomized, controlled trial involving 1440 critically ill children to investigate whether withholding parenteral nutrition for 1 week (i.e., providing late parenteral nutrition) in the pediatric intensive care unit (ICU) is clinically superior to providing early parenteral nutrition. Fluid loading was similar in the two groups. The two primary end points were new infection acquired during the ICU stay and the adjusted duration of ICU dependency, as assessed by the number of days in the ICU and as time to discharge alive from ICU. For the 723 patients receiving early parenteral nutrition, parenteral nutrition was initiated within 24 hours after ICU admission, whereas for the 717 patients receiving late parenteral nutrition, parenteral nutrition was not provided until the morning of the 8th day in the ICU. In both groups, enteral nutrition was attempted early and intravenous micronutrients were provided. Although mortality was similar in the two groups, the percentage of patients with a new infection was 10.7% in the group receiving late parenteral nutrition, as compared with 18.5% in the group receiving early parenteral nutrition (adjusted odds ratio, 0.48; 95% confidence interval [CI], 0.35 to 0.66). The mean (±SE) duration of ICU stay was 6.5±0.4 days in the group receiving late parenteral nutrition, as compared with 9.2±0.8 days in the group receiving early parenteral nutrition; there was also a higher likelihood of an earlier live discharge from the ICU at any time in the late-parenteral-nutrition group (adjusted hazard ratio, 1.23; 95% CI, 1.11 to 1.37). Late parenteral nutrition was associated with a shorter duration of mechanical ventilatory support than was early parenteral nutrition (P=0.001), as well as a smaller proportion of patients
Surgery and transplantation – Guidelines on Parenteral Nutrition, Chapter 18
Directory of Open Access Journals (Sweden)
Holland-Cunz, S.
2009-11-01
Full Text Available In surgery, indications for artificial nutrition comprise prevention and treatment of catabolism and malnutrition. Thus in general, food intake should not be interrupted postoperatively and the re-establishing of oral (e.g. after anastomosis of the colon and rectum, kidney transplantation or enteral food intake (e.g. after an anastomosis in the upper gastrointestinal tract, liver transplantation is recommended within 24 h post surgery. To avoid increased mortality an indication for an immediate postoperatively artificial nutrition (enteral or parenteral nutrition (PN also exists in patients with no signs of malnutrition, but who will not receive oral food intake for more than 7 days perioperatively or whose oral food intake does not meet their needs (e.g. less than 60–80% for more than 14 days. In cases of absolute contraindication for enteral nutrition, there is an indication for total PN (TPN such as in chronic intestinal obstruction with a relevant passage obstruction e.g. a peritoneal carcinoma. If energy and nutrient requirements cannot be met by oral and enteral intake alone, a combination of enteral and parenteral nutrition is indicated. Delaying surgery for a systematic nutrition therapy (enteral and parenteral is only indicated if severe malnutrition is present. Preoperative nutrition therapy should preferably be conducted prior to hospital admission to lower the risk of nosocomial infections. The recommendations of early postoperative re-establishing oral feeding, generally apply also to paediatric patients. Standardised operative procedures should be established in order to guarantee an effective nutrition therapy.
Palm, Eric; Dotson, Bryan
2015-11-01
Drug shortages in the United States, including parenteral nutrition (PN) components, have been common in recent years and can adversely affect patient care. Here we report a case of copper and zinc deficiency in a patient receiving PN during a shortage of parenteral trace element products. The management of the patient's deficiencies, including the use of an imported parenteral multi-trace element product, is described. © 2014 American Society for Parenteral and Enteral Nutrition.
Iron Deficiency in Long-Term Parenteral Nutrition Therapy.
Hwa, Yi L; Rashtak, Shahrooz; Kelly, Darlene G; Murray, Joseph A
2016-08-01
Iron is not routinely added to parenteral nutrition (PN) formulations in the United States because of the risk of anaphylaxis and concerns about incompatibilities. Studies have shown that iron dextran in non-lipid-containing PN solutions is safe. Data are limited on iron status, prevalence of iron deficiency anemia (IDA), and efficacy of intravenous iron infusion in long-term home PN (HPN). We aimed to determine the incidence of IDA and to examine the effectiveness of parenteral iron replacement in patients receiving HPN. Medical records of patients receiving HPN at the Mayo Clinic from 1977 to 2010 were reviewed. Diagnoses, time to IDA development, and hemoglobin, ferritin, and mean corpuscular volume (MCV) values were extracted. Response of iron indices to intravenous iron replacement was investigated. Of 185 patients (122 women), 60 (32.4%) were iron deficient. Five patients were iron deficient, and 18 had unknown iron status before HPN. Of 93 patients who had sufficient iron storage, 37 had IDA development after a mean of 27.2 months (range, 2-149 months) of therapy. Iron was replaced by adding maintenance iron dextran to PN or by therapeutic iron infusion. Patients with both replacement methods had significant improvement in iron status. With intravenous iron replacement, mean ferritin increased from 10.9 to 107.6 mcg/L (P Parenteral and Enteral Nutrition.
Advantages of enteral nutrition over parenteral nutrition
Seres, David S.; Valcarcel, Monika; Guillaume, Alexandra
2013-01-01
It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition.
Symptoms of nutritional deficiencies in neem plants cultivated in nutrient solution
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Ronnky Chaell Braga da Silva
2011-03-01
Full Text Available The planting of forest species is an activity that, besides introducing new exotic types of plants, can lessen the environmental impacts resulting from extractivism. Nevertheless, such success depends, upon other factors, on the knowledge of the nutritional needs of the species to be used. This study intended to check the typical symptoms of nutritional deficiency of macronutrients in the culture of Neem, through the visual observation of the plants. The experiment was carried out in a greenhouse at the College of Agronomy and Veterinary Medicine (FAMEV of the Federal University of Mato Grosso (UFMT in Cuiabá/MT, and it was set up in randomized blocks, with seven treatments and three repetitions. Each experimental unit was represented by a plastic vase, two liters capacity. The treatments used were: complete nutritive solution and solution with the omission of the following nutrients: -N, -P, -K, -Ca, -Mg and -S. It was ascertained that the visual symptoms of nutrient deficiency were, as a general rule, of easy characterization except for the treatment with omission of sulphur. Therefore, the omission of macronutrients decreases the production of total dry matter of the Neem plants, except for the omission of the S nutrient.
Runia, W.T.; Dekker, A.; Houx, N.W.H.
1995-01-01
On a 1.8 ha eggplant nursery with open drainage of the excess of nutrient solution the distribution of oxamyl was measured after it had been added to the nutrient solution. When it was applied via injection at a tap of a section, the distribution was more uniform than when applied via the central
International Nuclear Information System (INIS)
Khan, Sumaira; Kazi, Tasneem G.; Baig, Jameel A.; Kolachi, Nida F.; Afridi, Hassan I.; Wadhwa, Sham Kumar; Shah, Abdul Q.; Kandhro, Ghulam A.; Shah, Faheem
2010-01-01
A cloud point extraction (CPE) method has been developed for the determination of trace quantity of vanadium ions in pharmaceutical formulations (PF), dialysate (DS) and parenteral solutions (PS). The CPE of vanadium (V) using 8-hydroxyquinoline (oxine) as complexing reagent and mediated by nonionic surfactant (Triton X-114) was investigated. The parameters that affect the extraction efficiency of CPE, such as pH of sample solution, concentration of oxine and Triton X-114, equilibration temperature and time period for shaking were investigated in detail. The validity of CPE of V was checked by standard addition method in real samples. The extracted surfactant-rich phase was diluted with nitric acid in ethanol, prior to subjecting electrothermal atomic absorption spectrometry. Under these conditions, the preconcentration of 50 mL sample solutions, allowed raising an enrichment factor of 125-fold. The lower limit of detection obtained under the optimal conditions was 42 ng/L. The proposed method has been successfully applied to the determination of trace quantity of V in various pharmaceutical preparations with satisfactory results. The concentration ranges of V in PF, DS and PS samples were found in the range of 10.5-15.2, 0.65-1.32 and 1.76-6.93 μg/L, respectively.
Excess nutrients in hydroponic solutions alter nutrient content of rice, wheat, and potato
McKeehen, J. D.; Mitchell, C. A.; Wheeler, R. M.; Bugbee, B.; Nielsen, S. S.
1996-01-01
Environment has significant effects on the nutrient content of field-grown crop plants. Little is known, however, about compositional changes caused by controlled environments in which plants receive only artificial radiation and soilless, hydroponic culture. This knowledge is essential for developing a safe, nutritious diet in a Controlled Ecological Life-Support System (CELSS). Three crops that are candidates for inclusion in a CELSS (rice, wheat, and white potato) were grown both in the field and in controlled environments where the hydroponic nutrient solution, photosynthetic photon flux (PPF), and CO2 level were manipulated to achieve rapid growth rates. Plants were harvested at maturity, separated into discrete parts, and dried prior to analysis. Plant materials were analyzed for proximate composition (protein, fat, ash, and carbohydrate), total nitrogen (N), nitrate, minerals, and amino-acid composition. The effect of environment on nutrient content varied by crop and plant part. Total N and nonprotein N (NPN) contents of plant biomass generally increased under controlled-environment conditions compared to field conditions, especially for leafy plant parts and roots. Nitrate levels were increased in hydroponically-grown vegetative tissues, but nitrate was excluded from grains and tubers. Mineral content changes in plant tissue included increased phosphorus and decreased levels of certain micronutrient elements under controlled-environment conditions. These findings suggest that cultivar selection, genetic manipulation, and environmental control could be important to obtain highly nutritious biomass in a CELSS.
Nutritional disorder of lettuce cv. Veronica in nutrient solution with suppressed macronutrients
Directory of Open Access Journals (Sweden)
Thiago Batista Firmato de Almeida
2011-06-01
Full Text Available Lettuce is the most popular of the leafy vegetables. It is known worldwide and its consumption occurs mainly in the natural form. The objective was to evaluate the effect of macronutrient omission on the growth and nutritional status of the lettuce cv. Veronica, and to describe the visual symptoms of nutritional deficiency. The treatments complete consisted of the solution and the individual omission of N, P, K, Ca, Mg and S, under a completely randomized design with three replications. Plants were grown in Hoagland & Arnon, in pots (8L. At 56 days after transplant we evaluated plant height, leaf number, leaf area, SPAD index, dry matter of shoots, roots and whole plant, levels of macronutrients in shoots and roots, and the nature of nutritional disorders. The omission of nutrients affected the growth variables. The nutrients found in lettuce plants from nutrient solution and the complete omission in the shoot were, respectively, N= 23.2 to 9.5, P= 5.4 to 1.3, K= 58,9 to 3.2, Ca= 12.1 to 3.6, Mg= 5.5 to 0.7 and S= 3.2 to 1.5g.kg-1. The omission of macronutrients caused quality losses, since it affected the nutrition of the vegetables and this resulted in morphological changes, reflected as symptoms of deficiency for each nutrient.
M. I. T. D. Correia; J. Guimarâes; L. Cirino de Mattos; K. C. Araújo Gurgel; E. B. Cabral
2004-01-01
Objective: The aim of this study was to examine and describe our experience with the use of peripheral parenteral nutrition (PPN). Methods: Patients with an indication for parenteral nutrition for less than 15 days received it via a peripheral vein via a short, 20 or 22 gauge French polyurethane catheter. Parenteral nutrition had a final osmolality of 993 mOsm/l and was administered by infusion pump. The nutritional status of patients was assessed by the Subjective Global Assessment (SGA) tec...
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Uenis Tannuri
2004-09-01
Full Text Available OBJETIVO: Em 1979 o autor utilizou, pela primeira vez no Brasil, a nutrição parenteral prolongada domiciliar em criança. O objetivo deste trabalho é o de apresentar a experiência da utilização deste método no tratamento de crianças com síndrome do intestino curto nos últimos 23 anos. MÉTODOS: Dezenove crianças com esta afecção (ressecção de mais de 75% do comprimento intestinal foram tratadas inicialmente em hospital e a seguir no próprio domicílio. Os períodos totais de terapia nutricional variaram de quatro meses a quatro anos e meio, enquanto que as crianças permaneceram em nutrição parenteral domiciliar por períodos que variaram de uma semana a quatro anos, com mediana de oito meses. As soluções nutrientes completas, contendo aminoácidos, glicose, emulsão lipídica, eletrólitos, vitaminas e micro-elementos foram administradas através de catéteres venosos centrais do tipo Broviac ou Hickman. No domicílio, as soluções foram administradas durante o período diurno ou noturno, segundo a preferência dos familiares. RESULTADOS: Em todos os casos verificou-se ganho ponderal, crescimento e desenvolvimento satisfatórios, semelhantes aos obtidos durante nutrição oral. Obstruções do cateter, alterações hepáticas e infecção devida ao cateter foram as complicações mais freqüentes. Sete crianças (37% sobreviveram e estão fora de tratamento. Doze crianças faleceram (dez com resecção total do intestino delgado, sendo 11 por complicações relacionadas à nutrição parenteral (nove por infecção sistêmica e dois por embolia pulmonar maciça e uma por complicação neurológica, dois meses após transplante duplo de intestino e fígado. CONCLUSÃO: A nutrição parenteral domiciliar em crianças com síndrome do intestino curto traz indiscutíveis benefícios, permite redução do período de internação hospitalar, tornando possível a adaptação funcional do intestino remanescente e manutenção do
Managing an outpatient parenteral antibiotic therapy team: challenges and solutions
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Halilovic J
2014-06-01
Full Text Available Jenana Halilovic,1 Cinda L Christensen,2 Hien H Nguyen31University of the Pacific Thomas J Long School of Pharmacy, Stockton, CA, USA; 2Department of Pharmaceutical Services, University of California, Davis Health System, Sacramento, CA, USA; 3Division of Infectious Diseases, Section of Hospital Medicine, University of California, Davis Health System, Sacramento, CA, USAAbstract: Outpatient parenteral antimicrobial therapy (OPAT programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.Keywords: OPAT, quality, safety, program management
Siahi Shadbad, Mohammad Reza; Ghaderi, Faranak; Hatami, Leila; Monajjemzadeh, Farnaz
2016-12-01
In this study the stability of parenteral acyclovir (ACV) when diluted in dextrose (DEX) as large volume intravenous fluid preparation (LVIF) was evaluated and the possible Maillard reaction adducts were monitored in the recommended infusion time. Different physicochemical methods were used to evaluate the Maillard reaction of dextrose with ACV to track the reaction in real infusion condition. Other large volume intravenous fluids were checked regarding the diluted drug stability profile. Differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), and mass data proved the reaction of glucose with dextrose. A Maillard-specific high performance liquid chromatography (HPLC) method was used to track the reaction in real infusion condition in vitro. The nucleophilic reaction occurred in diluted parenteral preparations of acyclovir in 5% dextrose solutions. The best diluent solution was also selected as sodium chloride and introduced based on drug stability and also its adsorption onto different infusion sets (PVC or non PVC) to provide an acceptable administration protocol in clinical practices. Although, the Maillard reaction was proved and successfully tracked in diluted solutions, and the level of drug loss when diluted in dextrose was reported to be between 0.27 up to 1.03% of the initial content. There was no drug adsorption to common infusion sets. The best diluent for parenteral acyclovir is sodium chloride large volume intravenous fluid.
Guenter, Peggi; Boullata, Joseph I; Ayers, Phil; Gervasio, Jane; Malone, Ainsley; Raymond, Erica; Holcombe, Beverly; Kraft, Michael; Sacks, Gordon; Seres, David
2015-08-01
Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized model for PN prescribing competency is proposed based on a competency framework, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines. This framework will guide institutions and agencies in developing and maintaining competency for safe PN prescription by their staff. © 2015 American Society for Parenteral and Enteral Nutrition.
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Joanna Nowak
2013-12-01
Full Text Available Effects of growing media and concentration of nutrient solution on growth, flowering, evapotranspiration and macroelement content of media and leaves of Tymophylla tenuiloba were evaluated under ebb-and-flow conditions. Two media: peat and peat + perlite (3:l, v/v, and four concentrations of nutrient solution: 1.0, 1.5, 2.0, 2.5 mS cm-1 were applied. High quality plants were produced in both media and all concentration of nutrient solution. The lowest evapotranspiration was measured at the highest concentration of nutrient solution. N concentration of leaves was high in all treatments. Concentrations of K, Ca, and Mg decreased with increasing concentration of nutrient solution. Opposite was found for P. At the end of cultivation the lowest pH was measured in the upper layer of growing media. The highest total soluble salt level was measured in the upper layers. Upper layers accumulated more N-NO3, P, Ca, and Mg. Mineral element content of both media was high in all concentrations of nutrient solution. Low concentration of nutrient solution at 1.0 mS cm-1 is recommended, although -1Tymophylla tenuiloba-1 can be also cultivated at higher concentrations of nutrient solution up to 2.5mS cm-1, if placed on the same bench with other bedding plants requiring more nutrients.
Amino acids – Guidelines on Parenteral Nutrition, Chapter 4
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Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine
2009-11-01
Full Text Available Protein catabolism should be reduced and protein synthesis promoted with parenteral nutrion (PN. Amino acid (AA solutions should always be infused with PN. Standard AA solutions are generally used, whereas specially adapted AA solutions may be required in certain conditions such as severe disorders of AA utilisation or in inborn errors of AA metabolism. An AA intake of 0.8 g/kg/day is generally recommended for adult patients with a normal metabolism, which may be increased to 1.2–1.5 g/kg/day, or to 2.0 or 2.5 g/kg/day in exceptional cases. Sufficient non-nitrogen energy sources should be added in order to assure adequate utilisation of AA. A nitrogen calorie ratio of 1:130 to 1:170 (g N/kcal or 1:21 to 1:27 (g AA/kcal is recommended under normal metabolic conditions. In critically ill patients glutamine should be administered parenterally if indicated in the form of peptides, for example 0.3–0.4 g glutamine dipeptide/kg body weight/day (=0.2–0.26 g glutamine/kg body weight/day. No recommendation can be made for glutamine supplementation in PN for patients with acute pancreatitis or after bone marrow transplantation (BMT, and in newborns. The application of arginine is currently not warranted as a supplement in PN in adults. N-acetyl AA are only of limited use as alternative AA sources. There is currently no indication for use of AA solutions with an increased content of glycine, branched-chain AAs (BCAA and ornithine-α-ketoglutarate (OKG in all patients receiving PN. AA solutions with an increased proportion of BCAA are recommended in the treatment of hepatic encephalopathy (III–IV.
DEFF Research Database (Denmark)
Thomsen, Katrine Moe; Beck-Nielsen, Signe Sparre; Lando, Ane
2015-01-01
AIM: When a new high amino acid parenteral nutrition (PN) solution was introduced to our hospital, a design error led to decreased phosphate levels. This prompted us to examine the effect of three different PN solutions on plasma phosphate, plasma calcium and weight increases on extremely preterm...
21 CFR 310.509 - Parenteral drug products in plastic containers.
2010-04-01
... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Parenteral drug products in plastic containers... Parenteral drug products in plastic containers. (a) Any parenteral drug product packaged in a plastic... parenteral drug product for intravenous use in humans that is packaged in a plastic immediate container on or...
Nutrient Management in Recirculating Hydroponic Culture
Bugbee, Bruce
2004-01-01
There is an increasing need to recirculate and reuse nutrient solutions in order to reduce environmental and economic costs. However, one of the weakest points in hydroponics is the lack of information on managing the nutrient solution. Many growers and research scientists dump out nutrient solutions and refill at weekly intervals. Other authors have recommended measuring the concentrations of individual nutrients in solution as a key to nutrient control and maintenance. Dumping and replacing solution is unnecessary. Monitoring ions in solution is not always necessary; in fact the rapid depletion of some nutrients often causes people to add toxic amounts of nutrients to the solution. Monitoring ions in solution is interesting, but it is not the key to effective maintenance.
Alteraciones hepáticas inducidas por la nutrición parenteral
J Salas Salvado; A Recaséns Garica
1993-01-01
Liver disorders induced by parenteral nutrition Alteraciones hepáticas inducidas por la nutrición parenteral Liver disorders induced by parenteral nutrition Alteraciones hepáticas inducidas por la nutrición parenteral
Hayasaka, M; Ogasawara, H; Hotta, Y; Tsukagoshi, K; Kimura, O; Kura, T; Tarumi, T; Muramatsu, H; Endo, T
2017-12-01
The δ 13 C and δ 15 N values in the scalp hair of geriatric patients in Japan who received the enteral or parenteral nutrition formula were measured to assess nutritional status. The relations among δ 13 C, δ 15 N, calorie intake, BMI, albumin concentration, total cholesterol (T-CHO) and geriatric nutritional risk index (GNRI) in the patients were investigated. Furthermore, the enrichment of δ 13 C and δ 15 N from the nutrients to the hair was investigated. The δ 13 C values in the hair of patients who received enteral nutrition decreased with decreases in the calories received, while the δ 15 N values increased, suggesting malnutrition in some patients with a low calorie intake due to a negative nitrogen balance. The distribution of patients with a low calorie intake (below 20 kcal/kg/day) when δ 13 C was plotted against δ 15 N differed from that of control subjects, but the distribution of patients with a high calorie intake (above 20 kcal/kg/day) was similar to that of control subjects. No significant differences were observed in BMI, albumin concentration, T-CHO or GNRI between the low and high calorie groups. The enrichment of δ 13 C and δ 15 N from the enteral nutrients to the hair were inversely correlated with the δ 13 C and δ 15 N in the enteral nutrients. The enrichment levels of δ 13 C and δ 15 N tended to be higher and lower, respectively, in the high calorie group. On the other hand, the δ 13 C and δ 15 N values in the hair of patients who received parenteral nutrition were higher and lower than those in the control subjects and in the patients who received enteral nutrition, respectively, reflecting the higher δ 13 C and lower δ 15 N contents of the parenteral nutrients. The δ 13 C and δ 15 N values in the hair of patients who received enteral nutrition may be effective indicators for evaluating the long-term nutritional status of geriatric patients. A calorie intake of 20 kcal/kg/day may be a cut-off value for malnutrition in
Wamser, Anderson Fernando; Cecilio Filho, Arthur Bernardes; Nowaki, Rodrigo Hiyoshi Dalmazzo; Mendoza-Cortez, Juan Waldir; Urrestarazu, Miguel
2017-01-01
The interactive effects of N (6, 9, 12 and 15 mmol L-1) and K (3, 5, 7, and 9 mmol L-1) concentrations in nutrient solutions were evaluated on bell pepper grown in a coconut-coir substrate and fertilized without drainage. An additional treatment with drainage was evaluated using N and K concentrations of 12 and 7 mmol L-1, respectively. The hybrid Eppo cultivar of yellow bell pepper was cultivated for 252 days beginning 9 November 2012. Electrical conductivity (EC), the N and K concentrations in the substrate solution, marketable fruit yield, total dry weight and macronutrient concentrations in shoots were periodically evaluated. Fruit production was lower in the system without drainage, regardless of the N and K concentrations, compared to the recommended 10-20% drainage of the volume of nutrient solution applied. Higher K concentrations in the nutrient solution did not affect plant production in the system without drainage for the substrate with an initial K concentration of 331.3 mg L-1. Fruit yield was higher without drainage at a nutrient-solution N concentration of 10.7 mmol L-1. The upper EC limit of the substrate solution in the system without drainage was exceeded 181 days after planting. Either lower nutrient concentrations in the nutrient solution or a drainage system could thus control the EC in the substrate solution.
Tolerance of physic nut plants to aluminum activity in nutrient solution
Lana, Maria do Carmo; Steiner, Fábio [UNESP; Zoz, Tiago [UNESP; Fey, Rubens; Frandoloso, Jucenei Fernando
2013-01-01
Plants have different levels of tolerance to phytotoxic effects of aluminum and the exploitation of this characteristic is of significant importance to the use of acid soils. This research aimed to evaluate the effect of aluminum activity in nutrient solution on growth of physic nut young plant. After seven days of adaptation, plants were submitted to Al concentrations of 0; 200; 400; 600; 800 and 1,000 μmol L-1, corresponding to Al3+ activity solution, of: 14.5, 21.4; 46.6; 75.6; 108.3 e 144...
Role of luminal nutrients and endogenous GLP-2 in intestinal adaptation to mid-small bowel resection
DEFF Research Database (Denmark)
Dahly, Elizabeth M; Gillingham, Melanie B; Guo, Ziwen
2003-01-01
To elucidate the role of luminal nutrients and glucagon-like peptide-2 (GLP-2) in intestinal adaptation, rats were subjected to 70% midjejunoileal resection or ileal transection and were maintained with total parenteral nutrition (TPN) or oral feeding. TPN rats showed small bowel mucosal hyperpla......To elucidate the role of luminal nutrients and glucagon-like peptide-2 (GLP-2) in intestinal adaptation, rats were subjected to 70% midjejunoileal resection or ileal transection and were maintained with total parenteral nutrition (TPN) or oral feeding. TPN rats showed small bowel mucosal...... rats was associated with a significant positive correlation between increases in plasma bioactive GLP-2 and proglucagon mRNA expression in the colon of TPN rats and ileum of orally fed rats. These data support a significant role for endogenous GLP-2 in the adaptive response to mid-small bowel resection...
Kawamura, Hiromi; Tanaka, Sarasa; Uenami, Yuri; Tani, Mariko; Ishitani, Midori; Morii, Saeko; Sakaue, Motoyoshi; Ito, Mikiko
2018-01-01
Refeeding syndrome (RFS) is characterized by the metabolic and clinical changes that occur following aggressive nutritional supplementation in malnourished patients. Hypophosphatemia is the hallmark of RFS and is key to its prevention and treatment in clinical practice. However, the mechanism of hypophosphatemia during RFS is unclear because of the lack of an animal model. In this study, we developed a rat RFS model as a first step to clarifying the molecular mechanism. After establishing the parenteral route, rats were fasted for 5 days and refeeding was started using total parenteral nutrition. The animals were infused with a high calorie solution with or without insulin administration. Results showed that plasma phosphate levels did not decrease in rats infused with the high calorie solution alone;in contrast, a 20% reduction compared to baseline was observed in rats administered insulin. In addition, rats infused with the high calorie solution containing added phosphate did not present with hypophosphatemia. Thus, we developed a rat RFS model with hypophosphatemia by tube feeding and insulin administration, and demonstrated the importance of phosphate in preventing refeeding hypophosphatemia. J. Med. Invest. 65:50-55, February, 2018.
Influence of Phosphorus and Manganese Rats in Nutrient Solution on Mn-54 Uptake by Mango Plants
International Nuclear Information System (INIS)
Sharaf, A.N.
2011-01-01
A greenhouse experiment was designed using solution culture and Mn-54 to study the effect of P and Mn rates on absorption of Mn-54, its translocation and percentage using six month old mango seedlings (Hindi Bi-Sinara cv.). Rates of P in nutrient solution were zero, half, one and two strength i.e. 0, 1, 2 and 4 m M whereas Mn rates were 1, 2 and 3 strength i.e. 2, 4 and 6 μM. The prepared nutrient solutions were labelled with carrier free Mn-54. Total absorption of Mn-54 by mango roots from nutrient solution was highly increased by increasing Mn rates, moreover, increasing P rates in media tended to enhance Mn-54 absorption. Translocation and distribution pattern of absorbed Mn-54 followed, to a great extent, the same trend of total absorption of it but with different magnitude. In this concern, more than 90% (about 94%) of total absorption of Mn-54 was retained in root system, whereas about 4% and 2% was translocated in stems and leaves, respectively. Retained Mn in mango roots is considered a good source of Mn for supplying mango plants with it for long term during growing season.
DEFF Research Database (Denmark)
Jeppesen, P B; Gilroy, R; Pertkiewicz, M
2011-01-01
Teduglutide, a GLP-2 analogue, may restore intestinal structural and functional integrity by promoting repair and growth of the mucosa and reducing gastric emptying and secretion, thereby increasing fluid and nutrient absorption in patients with short bowel syndrome (SBS). This 24-week placebo-co......-controlled study evaluated the ability of teduglutide to reduce parenteral support in patients with SBS with intestinal failure....
Directory of Open Access Journals (Sweden)
Stephan Bachlechner
2017-11-01
Full Text Available Food intake influences human cognition, olfaction, hunger, and food craving. However, little research has been done in this field to elucidate the effects of different nutrients. Thus, the goal of our study was to investigate the effects of oral ingestion of different nutrient solutions on olfactory, cognitive, metabolic and psychophysical function. Twenty healthy men participated in our study employing a double-blind, cross-over, repeated measurement design. Participants were tested on four different study days. Each day participants received, in randomized order, one of three isocaloric (protein, carbohydrate or fat 600 kcal, 1,500 mL solutions or a placebo. Olfactory and cognitive tests (monitoring only were conducted three times, i.e., 60 min before the beginning of nutrient intake, following oral ingestion of the solution and 60, and 240 min after. Psychophysical and metabolic function tests (active grehlin, desacyl ghrelin, insulin, glucagon, glucose, triglyceride, urea were performed 7 times on each examination day (observation period: −60 min, 0 = solution intake, +60, +120, +180, +240, and +300 min. Ratings of hunger and food craving significantly differed over the observation period with lowest ratings following application of the protein solution. Highest ratings of craving were found following placebo intake. We further observed a significant positive correlation of active grehlin with hunger and fat, protein and sweets craving for each nutrient solution. Active grehlin significantly correlated with carbohydrate craving for carbohydrate and fat solution and with vegetable craving for fat solution only. Hunger hormone levels, hunger and food craving ratings demonstrated that the hierarchical order that appears in satiating efficiencies of isovolumetric-isocaloric ingested macronutrients is protein > fat > carbohydrate. Our study reveals that the type of nutrient exerts a significant influence on metabolic parameters, hunger and food
Bachlechner, Stephan; Denzer-Lippmann, Melanie Y; Wielopolski, Jan; Fischer, Marie; Buettner, Andrea; Doerfler, Arndt; Schöfl, Christof; Münch, Gerald; Kornhuber, Johannes; Thürauf, Norbert
2017-01-01
Food intake influences human cognition, olfaction, hunger, and food craving. However, little research has been done in this field to elucidate the effects of different nutrients. Thus, the goal of our study was to investigate the effects of oral ingestion of different nutrient solutions on olfactory, cognitive, metabolic and psychophysical function. Twenty healthy men participated in our study employing a double-blind, cross-over, repeated measurement design. Participants were tested on four different study days. Each day participants received, in randomized order, one of three isocaloric (protein, carbohydrate or fat 600 kcal, 1,500 mL) solutions or a placebo. Olfactory and cognitive tests (monitoring only) were conducted three times, i.e., 60 min before the beginning of nutrient intake, following oral ingestion of the solution and 60, and 240 min after. Psychophysical and metabolic function tests (active grehlin, desacyl ghrelin, insulin, glucagon, glucose, triglyceride, urea) were performed 7 times on each examination day (observation period: -60 min, 0 = solution intake, +60, +120, +180, +240, and +300 min). Ratings of hunger and food craving significantly differed over the observation period with lowest ratings following application of the protein solution. Highest ratings of craving were found following placebo intake. We further observed a significant positive correlation of active grehlin with hunger and fat, protein and sweets craving for each nutrient solution. Active grehlin significantly correlated with carbohydrate craving for carbohydrate and fat solution and with vegetable craving for fat solution only. Hunger hormone levels, hunger and food craving ratings demonstrated that the hierarchical order that appears in satiating efficiencies of isovolumetric-isocaloric ingested macronutrients is protein > fat > carbohydrate. Our study reveals that the type of nutrient exerts a significant influence on metabolic parameters, hunger and food craving.
Jensen, Gordon L.; Koletzko, Berthold V.; Singer, Pierre; Wanten, Geert J. A.
2010-01-01
Background Energy deficit is a common and serious problem in intensive care units and is associated with increased rates of complications, length of stay, and mortality. Parenteral nutrition (PN), either alone or in combination with enteral nutrition, can improve nutrient delivery to critically ill patients. Lipids provide a key source of calories within PN formulations, preventing or correcting energy deficits and improving outcomes. Discussion In this article, we review the role of parenteral lipid emulsions (LEs) in the management of critically ill patients and highlight important biologic activities associated with lipids. Soybean-oil-based LEs with high contents of polyunsaturated fatty acids (PUFA) were the first widely used formulations in the intensive care setting. However, they may be associated with increased rates of infection and lipid peroxidation, which can exacerbate oxidative stress. More recently developed parenteral LEs employ partial substitution of soybean oil with oils providing medium-chain triglycerides, ω-9 monounsaturated fatty acids or ω-3 PUFA. Many of these LEs have demonstrated reduced effects on oxidative stress, immune responses, and inflammation. However, the effects of these LEs on clinical outcomes have not been extensively evaluated. Conclusions Ongoing research using adequately designed and well-controlled studies that characterize the biologic properties of LEs should assist clinicians in selecting LEs within the critical care setting. Prescription of PN containing LEs should be based on available clinical data, while considering the individual patient’s physiologic profile and therapeutic requirements. PMID:20072779
Parenteral nutrition in malnourished patients
International Nuclear Information System (INIS)
Lichvarova, I.
2011-01-01
Parenteral nutrition became a routine therapeutic option in malnourished patients, if conventional nutritional enteral support is not effective. Cachexia and malnutrition prolong the wound healing, contribute to immunosuppression, increase morbidity and the cost of treatment. Using of a malnutrition protocol as a screening tool is necessary to sort out malnourished patients. Parenteral nutrition is therefore an important part of the multimodal therapy and from the medical and the ethical point of view is a great mistake not to feed a patient. (author)
Neonatology/Paediatrics – Guidelines on Parenteral Nutrition, Chapter 13
Directory of Open Access Journals (Sweden)
Fusch, C.
2009-11-01
Full Text Available There are special challenges in implementing parenteral nutrition (PN in paediatric patients, which arises from the wide range of patients, ranging from extremely premature infants up to teenagers weighing up to and over 100 kg, and their varying substrate requirements. Age and maturity-related changes of the metabolism and fluid and nutrient requirements must be taken into consideration along with the clinical situation during which PN is applied. The indication, the procedure as well as the intake of fluid and substrates are very different to that known in PN-practice in adult patients, e.g. the fluid, nutrient and energy needs of premature infants and newborns per kg body weight are markedly higher than of older paediatric and adult patients. Premature infants <35 weeks of pregnancy and most sick term infants usually require full or partial PN. In neonates the actual amount of PN administered must be calculated (not estimated. Enteral nutrition should be gradually introduced and should replace PN as quickly as possible in order to minimise any side-effects from exposure to PN. Inadequate substrate intake in early infancy can cause long-term detrimental effects in terms of metabolic programming of the risk of illness in later life. If energy and nutrient demands in children and adolescents cannot be met through enteral nutrition, partial or total PN should be considered within 7 days or less depending on the nutritional state and clinical conditions.
Development of cyclosporine A microemulsion for parenteral delivery.
Yuan, Yue; Che, Xin; Zhao, Mingyi; Wang, Yan; Liu, Yajun; Schwendeman, Anna; Li, Sanming
2015-01-01
The goal of this study was to develop a parenteral microemulsion formulation of cyclosporine A (CyA). The CyA solubility in caprylic capric triglyceride (GTCC), ethyl oleate and soybean oil were determined. The pseudo-ternary diagrams of oil (GTCC), surfactant (Solutol® HS-15), cosurfactants (ethanol/polyethylene glycol 400 [PEG 400] mixture) and water were constructed to identify boundaries for microemulsion existence. The CyA was added at 3, 6 and 9% w/w to the optimal microemulsion composition. Microemulsion particle size, solution viscosity and conductivity were examined. The microemulsion stability and haemolytic potential were examined after dilution in 5% dextrose solution for injection to 1 mg/mL CyA. Microemulsion stability was examined after a three-month storage at 4 and 25 °C. The GTCC was selected as an oil phase for CyA microemulsion based on solubility results. The optimum CyA microemulsion formulation consisted of 2.5% CyA, 9% GTCC, 24% Solutol® HS 15, 8% PEG 400, 4% ethanol and 52.5% water based on weight percent. The average particle sizes of the optimized blank and drug-loaded microemulsions were 68.7 nm and 71.6 nm, respectively and remained unchanged upon 25-fold dextrose dilution. The results of microemulsion physical and CyA chemical were confirmed by a three-month stability study at 4 and 25 °C. In vitro haemolysis studies indicated that CyA microemulsions were well tolerated by erythrocytes. The novel microemulsion formulation of CyA was developed that is suitable for parenteral administration. This new formulation could potentially have less vehicle-associated side effects that current commercial formulation of CyA based on Cremophor® EL and ethanol solution.
Boullata, Joseph I; Holcombe, Beverly; Sacks, Gordon; Gervasio, Jane; Adams, Stephen C; Christensen, Michael; Durfee, Sharon; Ayers, Phil; Marshall, Neil; Guenter, Peggi
2016-08-01
Parenteral nutrition (PN) is a high-alert medication with a complex drug use process. Key steps in the process include the review of each PN prescription followed by the preparation of the formulation. The preparation step includes compounding the PN or activating a standardized commercially available PN product. The verification and review, as well as preparation of this complex therapy, require competency that may be determined by using a standardized process for pharmacists and for pharmacy technicians involved with PN. An American Society for Parenteral and Enteral Nutrition (ASPEN) standardized model for PN order review and PN preparation competencies is proposed based on a competency framework, the ASPEN-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines, and is intended for institutions and agencies to use with their staff. © 2016 American Society for Parenteral and Enteral Nutrition.
Temporal Trends in the Use of Parenteral Nutrition in Critically Ill Patients
Kahn, Jeremy M.; Wunsch, Hannah
2014-01-01
Background: Clinical practice guidelines recommend enteral over parenteral nutrition in critical illness and do not recommend early initiation. Few data are available on parenteral nutrition use or timing of initiation in the ICU or how this use may have changed over time. Methods: We used the Project IMPACT database to evaluate temporal trends in parenteral nutrition use (total and partial parenteral nutrition and lipid supplementation) and timing of initiation in adult ICU admissions from 2001 to 2008. We used χ2 tests and analysis of variance to examine characteristics of patients receiving parenteral nutrition and multilevel multivariate logistic regression models to assess parenteral nutrition use over time, in all patients and in specific subgroups. Results: Of 337,442 patients, 20,913 (6.2%) received parenteral nutrition. Adjusting for patient characteristics, the use of parenteral nutrition decreased modestly over time (adjusted probability, 7.2% in 2001-2002 vs 5.5% in 2007-2008, P nutrition use increased simultaneously (adjusted probability, 11.5% in 2001-2002 vs 15.3% in 2007-2008, P parenteral nutrition declined most rapidly in emergent surgical patients, patients with moderate illness severity, patients in the surgical ICU, and patients admitted to an academic facility (P ≤ .01 for all interactions with year). When used, parenteral nutrition was initiated a median of 2 days (interquartile range, 1-3), after ICU admission and > 90% of patients had parenteral nutrition initiated within 7 days; timing of initiation of parenteral nutrition did not change from 2001 to 2008. Conclusions: Use of parenteral nutrition in US ICUs declined from 2001 through 2008 in all patients and in all examined subgroups, with the majority of parenteral nutrition initiated within the first 7 days in ICU; enteral nutrition use coincidently increased over the same time period. PMID:24233390
Toxic metabolities of disulfoton: behavior in bean-seedlings, in soil, and in nutrient solution
International Nuclear Information System (INIS)
Andrea, M.M. de
1986-10-01
The absorption, translocation and degradation in bean-seedlings of three toxic metabolites of the pesticide 14 C- disulfoton from nutrient solution or three different types of Brazilian soils is studied. (M.A.C.) [pt
DEFF Research Database (Denmark)
Colding, H; Møller, S; Andersen, G E
1982-01-01
Ampicillin and gentamicin were dissolved once a day in an L-amino acid solution especially prepared for parenteral nutrition of newborn infants and infused continuously to 88 infants in whom septicaemia was suspected or had been proved. The mean dosages were 162 and 5.3 mg/kg per 24 hours...
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Jessica Nover
2016-02-01
Full Text Available In this study, feasibility of selected nutrient sequestration during hydrothermal carbonization (HTC was tested for three different HTC temperatures (180, 230, and 300 °C. To study the nutrient sequestration in solid from liquid solution, sugar and salt solutions were chosen as HTC feedstock. Glucose was used as carbohydrate source and various salts e.g., ammonium hydrophosphate, potassium chloride, potassium sulfate, and anhydrous ferric chloride were used as source of nitrogen and phosphorus, potassium, and iron, respectively. Solid hydrochar was extensively characterized by means of elemental, ICP-OES, SEM-EDX, surface area, pore volume and size, and ATR-FTIR to determine nutrients’ sequestration as well as hydrochar quality variation with HTC temperatures. The spherical mesoporous hydrochars produced during HTC have low surface area in the range of 1.0–3.5 m2 g−1. Hydrochar yield was increased about 10% with the increase of temperature from 180 °C to 300 °C. Nutrient sequestration was also increased with HTC temperature. In fact, around 71, 31, and 23 wt% nitrogen, iron, and phosphorus were sequestered at 300 °C, respectively. Potassium sequestration was very low throughout the HTC and maximum 5.2% was observed in solid during HTC.
Busch, Rebecca A; Curtis, Caitlin S; Leverson, Glen E; Kudsk, Kenneth A
2015-07-01
Parenteral nutrition (PN) is available as individualized prescriptions frequently prepared with an automated compounding device or as commercially prepared premixed solutions. Our institution exclusively used individualized PN until an amino acid shortage forced a temporary switch to premixed solutions. In general, premixed solutions contain lower electrolyte levels than individualized formulations prescribed for patients with normal organ function. We aimed to quantify supplemental intravenous piggyback (IVPB) electrolyte use in adult patients receiving individualized and premixed PN and to quantify any effect on difference in the cost of therapy. We compared use of supplemental IVPB electrolytes administered to patients receiving PN during consecutive periods prior to and during the amino acid shortage. Electrolyte IVPBs tabulated were potassium chloride, 10 and 20 mEq; magnesium sulfate, 2 g and 4 g; potassium phosphate, 7.5 and 15 mmol; and sodium phosphate, 7.5 and 15 mmol IVPB. There was no statistical difference in the number of PN formulations administered per day during each period (14.7 ± 3.9 vs 14.0 ± 2.6, individualized vs premixed, respectively). Total IVPB electrolytes prescribed per day increased significantly from the individualized PN period to the premixed PN period (7.03 ± 3.8 vs 13.8 ± 6.8; P Parenteral and Enteral Nutrition.
Hallikainen, Maarit; Huikko, Laura; Kontra, Kirsi; Nissinen, Markku; Piironen, Vieno; Miettinen, Tatu; Gylling, Helena
2008-01-01
Hepatobiliary complications are common during parenteral nutrition. Lipid moiety in commercially available solutions contains plant sterols. It is not known whether plant sterols in parenteral nutrition interfere with hepatic function in adults. We detected how different amounts of plant sterols in parenteral nutrition solution affected serum plant sterol concentrations and liver enzymes during a 1.5-year follow-up in a patient with short bowel syndrome. Serum lipid, plant sterol, and liver enzyme levels were measured regularly during the transition from Intralipid (100% soy-based intravenous fat emulsion) to ClinOleic (an olive oil-based intravenous fat emulsion with 80% olive oil, 20% soy oil and lower plant sterols); the lipid supply was also gradually increased from 20 to 35 g/d. Plant sterols in parenteral nutrition solution and serum were measured with gas-liquid chromatography. During infusion of soy-based intravenous fat emulsion (30 g/d, total plant sterols 87 mg/d), the concentrations of sitosterol, campesterol, and stigmasterol were 4361, 1387, and 378 microg/dL, respectively, and serum liver enzyme values were >or= 2.5 times above upper limit of normal. After changing to olive oil-based intravenous fat emulsion (20-35 g/d, plant sterols 37-65 mg/d), concentrations decreased to 2148 to 2251 microg/dL for sitosterol, 569-297 microg/dL for campesterol, and 95-55 microg/dL for stigmasterol. Concomitantly, liver enzyme values decreased to 1.4 to 1.8 times above upper limit of normal at the end of follow-up. The nutrition status of the patient improved. The amount of plant sterols in lipid emulsion affects serum liver enzyme levels more than the amount of lipid.
Interactions between nitrate and chloride in nutrient solutions for substrate grown tomato
Voogt, W.; Sonneveld, C.
2004-01-01
In two successive experiments tomato was grown at different Cl and NO3 concentrations in the root environment with rockwool as a sub-strate. The EC value in the nutrient solution was fairly constant, varying between 3.5 and 4.0 dS m-1 in all treatments. The NO3 concentrations in the treatments
Yunes-Zárraga, J L; de la Garza-Garza, G; Velázquez-Quintana, N
1989-04-01
A revision was made on files of newborns whom received total parenteral nutrition (TPN) in the neonatal intensive care unit of the Hospital Infantil de Tamaulipas during a two and a half years period. We try to correlate dosage and caloric intake with weight gain, survival and complications. We reviewed the principal indications that motivated the use of total parenteral nutrition. The average period of administration was 15 days and caloric intake average 75 cal. There was significance in weight gain in newborns older than 35 weeks (14.6 g/kg/day) compared with younger than 34 weeks (9.2 g/kg/day) (p less than 0.001). There was no relation between days and dosage in both groups. Only one case showed cholestatic jaundice. Hyperglycemia was present statistically more frequent in the group lesser gestational age. There were no important electrolytic disturbances. Necrotizing enterocolitis was present more frequent in the older group. Some comments are made in relation to sepsis and a discussion of possible causes that do no permit a better assimilation of nutrients in these babies.
Total parenteral nutrition - Problems in compatibility and stability
DEFF Research Database (Denmark)
Schroder, A.M.
2008-01-01
Adding calcium, trace elements and vitamins could turn parenteral nutrition into a dangerous product, which could harm the patient. This article focuses on the major pharmaceutical problems of parenteral. nutrition when adding nutritional compounds Udgivelsesdato: 2008...
Liu, Ming-Yi; Tang, Hsiu-Chih; Hu, Shu-Hui; Yang, Hui-Lan; Chang, Sue-Joan
2015-01-01
The inflammatory reactions are stronger after surgery of malnourished preoperative patients. Many studies have shown vitamin and trace element deficiencies appear to affect the functioning of immune cells. Enteral nutrition is often inadequate for malnourished patients. Therefore, total parenteral nutrition (TPN) is considered an effective method for providing preoperative nutritional support. TPN needs a central vein catheter, and there are more risks associated with TPN. However, peripheral parenteral nutrition (PPN) often does not provide enough energy or nutrients. This study investigated the inflammatory response and prognosis for patients receiving a modified form of PPN with added fat emulsion infusion, multiple vitamins (MTV), and trace elements (TE) to assess the feasibility of preoperative nutritional support. Methods. A cross-sectional design was used to compare the influence of PPN with or without adding MTV and TE on malnourished abdominal surgery patients. Both preoperative groups received equal calories and protein, but due to the lack of micronutrients, patients in preoperative Group B exhibited higher inflammation, lower serum albumin levels, and higher anastomotic leak rates and also required prolonged hospital stays. Malnourished patients who receive micronutrient supplementation preoperatively have lower postoperative inflammatory responses and better prognoses. PPN with added fat emulsion, MTV, and TE provides valid and effective preoperative nutritional support.
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Josiel Paiva Vieira
2010-10-01
Full Text Available PURPOSE: To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization. METHODS: The study was comprised of 31 patients, divided into a parenteral group (n=16 and an enteral group (n=15, who met severity criteria for abdominal tomography (Balthazar classes C, D, and E. The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression. RESULTS: There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10. Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006. There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group. CONCLUSION: Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support.OBJETIVO: Comparar o efeito do suporte nutricional parenteral versus enteral, em pancreatite aguda grave, com relação à eficácia, à segurança, à morbi-mortalidade e ao tempo de internação. MÉTODOS: Foram estudados 31 pacientes distribuídos em grupo parenteral (n=16, no período de 1995 a 1998 e grupo enteral (n=15, no período de 1999 a 2002, que preencheram os critérios de gravidade pela tomografia de abdome (Balthazar C,D,E. Os pacientes foram comparados quanto aos dados demográficos, etiologia, antibioticoprofilaxia, somatostatina, suporte nutricional, complicações e evolução. RESULTADOS
Jauch, K W; Schregel, W; Stanga, Z; Bischoff, S C; Brass, P; Hartl, W; Muehlebach, S; Pscheidl, E; Thul, P; Volk, O
2009-11-18
Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious). Long-term (>7-10 days) parenteral nutrition (PN) requires central venous access whereas for PN 3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter) should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7-10 days), a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L) or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC) can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site.
Wheat cultivar tolerance to boron deficiency and toxicity in nutrient solution
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Furlani Ângela Maria Cangiani
2003-01-01
Full Text Available Field symptoms of open spikelets in wheat were observed in specific cultivars and supposedly related to low B soils and differential B requirement among cultivars. This study aimed to evaluate the response of four wheat (Triticum aestivum L. cultivars, IAC 24, IAC 60, IAC 287 and IAC 289, to increasing B concentrations in nutrient solution. The experiment was set up in a randomized complete block design, with four replicates and five B concentrations (0.0, 0.05, 0.2, 0.8 and 2.0 mg L-1, during 1997/1998, in a greenhouse. Plants were grown to maturity and evaluated for plant height, spike number and length, open spikelet number, grains per spike, plant parts dry matter, B, P, K, Ca and Mg leaf concentrations and total nutrient contents. The visual symptoms of B deficiency consisted of open spikelets, distorted spikes without grains. 'IAC 60' and 'IAC 287' had higher B efficiency, with the highest grain yields in lower B concentrations. The 'IAC 287' and 'IAC 24' were more tolerant to the highest B concentrations. 'IAC 24' required more B for grain production as compared to the other cultivars. The critical leaf B concentration for deficiency was 25 mg kg-1 of dry matter tissue for all cultivars, and for toxicity were: 44 to 45 mg kg-1 for 'IAC 60' and 'IAC 289'; 228 and 318 mg kg-1 for 'IAC 24' and 'IAC 287', respectively. Except for the highest B level in the nutrient solution, the leaf P, K, Ca and Mg concentrations and whole plant contents were in an adequate range in the plants and did not vary among cultivars.
Nutrient management in substrate systems
Sonneveld, C.; Voogt, W.
2009-01-01
Speaking about nutrient solutions in soilless cultivation, different solutions can be discerned. Originally, in soilless culture only one nutrient solution was taken into account, being the solution in the containers in which the plants were grown. Such solutions were intensively moved by air
Voogt, W.; Sonneveld, C.
2017-01-01
In soil-less culture systems Fe is usually supplied as chelate to ensure an adequate availability of this element. As chelates have affinity for many metal ions these chelates will interact with other cation nutrients in nutrient solutions. This affects the availability of Fe and other nutrients.
International Nuclear Information System (INIS)
Jabeen, N.; Ahmad, R.
2012-01-01
The effect of salinity and foliar application of nutrient solutions on sunflower and safflower in vegetative and reproductive phases of the growth were investigated in Bio saline Research Field, University of Karachi, Pakistan. The seeds were sown in pots under non saline condition and saline water irrigation was started at three leaf stage after germination. Different concentration of saline water were made by dissolving 3g and 6g sea salt per litre of tap water, equivalent to an EC of 4.8 and 8.6 dS/m respectively. Nutrient solution (KNO/sub 3 /, H/sub 3/ BO/sub 3/, Fe-EDTA or its mixture) was sprayed thrice, i.e., 45, 75 and 95 days after planting. KNO/sub 3/ was given at the rate 250 ppm and other H/sub 3/ BO/sub 3/ and Fe-EDTA was given at the rate 5 ppm. Salinity caused a significant reduction in nutrient uptake, height, biomass and yield of both sunflower and safflower. Foliar application of macro and micro nutrients (i.e. KNO/sub 3/, H/sub 3/BO/sub 3/, Fe-EDTA and mixture of KNO/sub 3/ + H/sub 3/BO/sub 3/ + Fe-EDTA) partially minimized the salt induced deficiency and showed significant increase in height, fresh and dry biomass, number and weight of seeds, and amount of oil per sunflower and safflower plant irrespective to their growth under non saline or saline conditions. Among the nutrient solutions, mixture of KNO/sub 3/+ H/sub 3/BO/sub 3/ + Fe-EDTA seemed to be the most effective followed by H/sub 3/ BO/sub 3/ and Fe-EDTA. These results suggested that foliar application of nutrients could be used to improve plant tolerance to salinity by alleviating the adverse effects of salinity on growth and reproductive yield. (author)
Gratieri, Luiz Augusto; Cecílio Filho, Arthur Bernardes; Barbosa, José Carlos; Pavani, Luiz Carlos
2013-01-01
With the objective of evaluating the effects of N and K concentrations for melon plants, an experiment was carried out from July 1, 2011 to January 3, 2012 in Muzambinho city, Minas Gerais State, Brazil. The "Bonus no. 2" was cultivated at the spacing of 1.1 × 0.4. The experimental design was a randomized complete block with three replications in a 4 × 4 factorial scheme with four N concentrations (8, 12, 16, and 20 mmol L(-1)) and four K concentrations (4, 6, 8, and 10 mmol L(-1)). The experimental plot constituted of eight plants. It was observed that the leaf levels of N and K, of N-NO₃ and of K, and the electrical conductivity (CE) of the substrate increased with the increment of N and K in the nutrients' solution. Substratum pH, in general, was reduced with increments in N concentration and increased with increasing K concentrations in the nutrients' solution. Leaf area increased with increments in N concentration in the nutrients solution. Fertigation with solutions stronger in N (20 mmol L(-1)) and K (10 mmol L(-1)) resulted in higher masses for the first (968 g) and the second (951 g) fruits and crop yield (4,425 gm(-2)).
Phytosterols, Lipid Administration, and Liver Disease During Parenteral Nutrition.
Zaloga, Gary P
2015-09-01
Phytosterols are plant-derived sterols that are structurally and functionally analogous to cholesterol in vertebrate animals. Phytosterols are found in many foods and are part of the normal human diet. However, absorption of phytosterols from the diet is minimal. Most lipid emulsions used for parenteral nutrition are based on vegetable oils. As a result, phytosterol administration occurs during intravenous administration of lipid. Levels of phytosterols in the blood and tissues may reach high levels during parenteral lipid administration and may be toxic to cells. Phytosterols are not fully metabolized by the human body and must be excreted through the hepatobiliary system. Accumulating scientific evidence suggests that administration of high doses of intravenous lipids that are high in phytosterols contributes to the development of parenteral nutrition-associated liver disease. In this review, mechanisms by which lipids and phytosterols may cause cholestasis are discussed. Human studies of the association of phytosterols with liver disease are reviewed. In addition, clinical studies of lipid/phytosterol reduction for reversing and/or preventing parenteral nutrition associated liver disease are discussed. © 2015 American Society for Parenteral and Enteral Nutrition.
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O. A. Obukhova
2011-01-01
Full Text Available Objective: to estimate blood glucose levels during complete parenteral nutrition (CPN, by using the three-in-one system with a high glucose level. Subjects and methods. Thirty adult patients without diabetes mellitus (including 18 men were examined. Twelve and 18 patients were operated on for colonic and gastric cancers, respectively. CPN (Oliclinomel No. 7 — 1000, 1500 ml; glucose, 240 g in 1500 ml, Baxter, Belgium was carried out at the Surgery Department in the early postoperative period (3-5 postoperative days with stable hemodynamics and no organ dysfunction (acute respiratory, renal, hepatic failure. The preparation was administered at a rate of about 83 ml/h over 18 hours. Insulin was not used. Serum glucose concentrations were measured before the study and then for 24 hours at an interval of 6 hours. Results. Glucose concentrations were not found to exceed the allowable values in the majority of patients during CPN at the given rate. In 5 (16.7% patients, short-term glucose increases up to 13.3 mmol/l were corrected, by decreasing the infusion rate. There was no hypoglycemia or other complications during CPN. Conclusion. Our findings suggest that three-in-one parenteral feeding is safe and causes no metabolic disturbances if simple principles are followed, the basic ones of which are to observe the intake of an adequate total dose and the rate of administration of nutrients. Key words: parenteral feeding, hyperglycemia, metabolic disturbances.
Hypercalcemia and hypophosphatemia among preterm infants receiving aggressive parenteral nutrition.
Brener Dik, Pablo H; Galletti, María F; Bacigalupo, Leticia T; Fernández Jonusas, Silvia; L Mariani, Gonzalo
2018-06-01
Aggressive parenteral nutrition is the standard of care among very-low-birth weight preterm infants. However, in recent studies, its impact on short-term outcomes, has been evaluated. The objective was to compare the prevalence of hypercalcemia and hypophosphatemia among preterm infants receiving aggressive or standard parenteral nutrition. Observational, retrospective study comparing a group of preterm infants weighing less than 1250 grams who received aggressive parenteral nutrition with a historical control group. The prevalence of hypercalcemia was estimated and its association with aggressive parenteral nutrition was searched adjusting by confounders. The mean phosphate level was estimated for the control group by linear regression and was compared to the value in the other group. Forty patients per group were included. The prevalence of hypercalcemia was higher in the group who received aggressive parenteral nutrition (87.5% versus 35%, p= 0.001). Aggressive parenteral nutrition was associated with hypercalcemia when adjusting by birth weight, intrauterine growth restriction, amino acid, and calorie intake (adjusted odds ratio: 21.8, 95% confidence interval [CI]: 3.7-128). The mean calcium level was different between both groups (p= 0.002). Infants who received aggressive parenteral nutrition had more sepsis without reaching statistical significance and the mean phosphate level was lower than that estimated for the control group (p= 0.04). The prevalence of hypophosphatemia in this group was 90% (95% CI: 76-97%). Our data show an association between hypercalcemia/hypophosphatemia and aggressive parenteral nutrition. It is recommended to frequently monitor calcium and phosphate levels since they might be associated with adverse clinical outcomes. Sociedad Argentina de Pediatría.
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Bischoff, S. C.
2009-11-01
Full Text Available Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious. Long-term (>7–10 days parenteral nutrition (PN requires central venous access whereas for PN 3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7–10 days, a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site.
Parenteral nutrition in patients with inborn errors of metabolism - a therapeutic problem.
Kaluzny, L; Szczepanik, M; Siwinska-Mrozek, Z; Borkowska-Klos, M; Cichy, W; Walkowiak, J
2014-06-01
Parenteral nutrition is now a standard part of supportive treatment in pediatric departments. We describe four cases in which parenteral nutrition was extremely difficult due to coincidence with inborn errors of metabolism. The first two cases was fatty acid beta-oxidation disorders associated with necrotizing enterocolitis and congenital heart disease. Thus, limitations of intravenous lipid intake made it difficult to maintain a good nutritional status. The third case was phenylketonuria associated with a facial region tumour (rhabdomyosarcoma), in which parenteral nutrition was complicated because of a high phenylalanine content in the amino acid formulas for parenteral nutrition. The fourth patient was a child with late-diagnosed tyrosinemia type 1, complicated with encephalopathy - during intensive care treatment the patient needed nutritional support, including parenteral nutrition - we observed amino acid formula problems similar to those in the phenylketonuria patient. Parenteral nutrition in children with inborn errors of metabolism is a rare, but very important therapeutic problem. Total parenteral nutrition formulas are not prepared for this group of diseases.
DEFF Research Database (Denmark)
Tribler, Siri; Brandt, Christopher F.; Petersen, Anne H.
2017-01-01
Background: In patients with intestinal failure who are receiving home parenteral support (HPS), catheter-related bloodstream infections (CRBSIs) inflict health impairment and high costs.Objective: This study investigates the efficacy and safety of the antimicrobial catheter lock solution, taurol...
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Farzad Khademi
2018-02-01
Full Text Available Objective(s: Production of effective tuberculosis (TB vaccine is necessity. However, the development of new subunit vaccines is faced with concerns about their weak immunogenicity. To overcome such problems, polymers-based vaccine delivery systems have been proposed to be used via various routes. The purpose of this study was to determine the potential of polymeric particles as future vaccine delivery systems/adjuvants for parenteral and non-parenteral immunization against TB. Materials and Methods: PubMed, Scopus, Science-Direct, and the ISI web of knowledge databases were searched for related keywords. A total of 420 articles, written up to June 25, 2016, were collected on the potential of polymeric particles as TB vaccine delivery systems after parenteral and non-parenteral immunization. Thirty-one relevant articles were selected by applying inclusion and exclusion criteria. Results: It was shown that the immunogenicity of TB vaccines had been improved by using biodegradable and non-biodegradable synthetic polymers as well as natural polymers and they are better able to enhance the humoral and cellular immune responses, compared to TB vaccines alone. The present study revealed that various polymeric particles, after M. tuberculosis challenge in animal models, provide long-lasting protection against TB. PLGA (poly (lactide-co-glycolide and chitosan polymers were widely used as TB vaccine delivery systems/adjuvants. Conclusion: It seems that PLGA and chitosan polymers are well-suited particles for the parenteral and non-parenteral administration of TB vaccines, respectively. Non-biodegradable synthetic polymers in comparison with biodegradable synthetic and natural polymers have been used less frequently. Therefore, further study on this category of polymers is required.
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Myriam Bastidas
1989-03-01
Full Text Available
Between May and July 1987, we studied 36 children with second or third degree dehydration secondary to acute diarrheal disease of less than one week duration; they had no serious associated problems. Parenteral rehydration was carried out with a solution similar in composition to the one recommended by the World Health Organization for Oral Rehydration Therapy (ORT. Rehydration was achieved in 30 patients within 6 hours and In 3 more within 12 hours; there were no cases of hypernatremia or hyperkalemia. It is concluded that parenteral rehydration with a solution similar to the one employed for ORT is an adequate alternative when oral rehydration is not indicated in children with diarrheal disease.
Entre mayo y julio de 1987 se estudiaron 36 niños que ingresaron al Hospital Infantil de Medellín con deshidratación de segundo o tercer grado, secundaria a enfermedad diarreica de evolución menor de una semana y sin enfermedad grave asociada. La hidratación se llevó a cabo parenteralmente empleando una mezcla de composición similar a la que recomienda la Organización Mundial de la Salud para la Terapia de Rehidratación Oral (TRO. Se logró la hidratación en un lapso de 6 horas en 30 de los 36 pacientes y en 3 más en las siguientes 6 horas; no se produjeron casos de hipernatremia ni de hiperkalemia. Se concluye que la hidratación parenteral, con una solución de composición similar a la de la TRO, es una alternativa adecuada cuando no está indicada la hidratación oral del niño con enfermedad diarreica.
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Maria Carolina Borges
2008-03-01
Full Text Available A glutamina é o aminoácido livre mais abundante no sangue e no músculo esquelético, bem como é o principal substrato energético para células de elevado turnover, como enterócitos e leucócitos. Adicionalmente, a glutamina representa o principal aminoácido transferido para o feto pela placenta e, juntamente com o glutamato, constituem os aminoácidos mais abundantes no leite materno. Todavia, bebês nascidos prematuramente sofrem interrupção abrupta do fornecimento placentário de glutamina, o que acarreta em dependência exclusiva da síntese endógena ou do fornecimento exógeno deste aminoácido. Aliado a isso, neonatos pré-termo (PT e com baixo peso ao nascer (BPN, freqüentemente, recebem apenas nutrição parenteral total nas primeiras semanas de vida, a qual não contém glutamina. Cabe ainda destacar que esses bebês possuem pouca massa muscular e, portanto, seus estoques de glutamina são limitados. Uma vez que neonatos PT e com BPN estão sujeitos a intenso crescimento e a inúmeros estresses fisiológicos, é possível que a glutamina seja um nutriente condicionalmente essencial nessa fase da vida, fato que estimulou a realização de estudos com a finalidade de avaliar os possíveis benefícios clínicos da suplementação enteral e parenteral com glutamina em neonatos PT e com BPN.Glutamine is the most abundant amino acid found in the blood and skeletal muscle, and is the principal energetic substrate for cells with a high turnover, such as enterocytes and leucocytes. Furthermore, glutamine is the most important amino acid that is passed to the foetus via the placenta, and together with glutamate, is the most abundant amino acid in maternal milk. Preterm infants suffer an abrupt interruption in the supply of glutamine via the placenta, which leads to an exclusive dependence on the endogenous synthesis or the exogenous supply of this amino acid. Preterm neonates (PT as well as low-birth-weight neonates (LBW frequently
Impact of Early Parenteral Nutrition on Metabolism and Kidney Injury
Gunst, Jan; Vanhorebeek, Ilse; Casaer, Michaël P.; Hermans, Greet; Wouters, Pieter J.; Dubois, Jasperina; Claes, Kathleen; Schetz, Miet; Van den Berghe, Greet
2013-01-01
A poor nutritional state and a caloric deficit associate with increased morbidity and mortality, but a recent multicenter, randomized controlled trial found that early parenteral nutrition to supplement insufficient enteral nutrition increases morbidity in the intensive care unit, including prolonging the duration of renal replacement therapy, compared with withholding parenteral nutrition for 1 week. Whether early versus late parenteral nutrition impacts the incidence and recovery of AKI is ...
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Luiz Augusto Gratieri
2013-01-01
Full Text Available With the objective of evaluating the effects of N and K concentrations for melon plants, an experiment was carried out from July 1, 2011 to January 3, 2012 in Muzambinho city, Minas Gerais State, Brazil. The “Bonus no. 2” was cultivated at the spacing of 1.1 × 0.4. The experimental design was a randomized complete block with three replications in a 4 × 4 factorial scheme with four N concentrations (8, 12, 16, and 20 mmol L−1 and four K concentrations (4, 6, 8, and 10 mmol L−1. The experimental plot constituted of eight plants. It was observed that the leaf levels of N and K, of N-NO3 and of K, and the electrical conductivity (CE of the substrate increased with the increment of N and K in the nutrients' solution. Substratum pH, in general, was reduced with increments in N concentration and increased with increasing K concentrations in the nutrients' solution. Leaf area increased with increments in N concentration in the nutrients solution. Fertigation with solutions stronger in N (20 mmol L−1 and K (10 mmol L−1 resulted in higher masses for the first (968 g and the second (951 g fruits and crop yield (4,425 gm−2.
Nutrient supply of plants in aquaponic systems
Bittsánszky, András; Uzinger, Nikolett; Gyulai, Gábor; Mathis, Alex; Junge, Ranka; Villarroel, Morris; Kotzen, Benzion; Komives, Tamas
2016-01-01
In this preliminary article we present data on plant nutrient concentrations in aquaponic systems, and compare them to nutrient concentrations in “standard” hydroponic solutions. Our data shows that the nutrient concentrations supplied by the fish in aquaponic system are significantly lower for most nutrients, compared to hydroponic systems. Nevertheless, plants do thrive in solutions that have lower nutrient levels than “standard” hydroponic solutions. This is especially true for green leafy...
Early optimal parenteral nutrition and metabolic acidosis in very preterm infants.
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Francesco Bonsante
Full Text Available It is currently recognized that an optimized nutritional approach, consisting of an early and substantial supply of protein and energy by parenteral route, may be beneficial for very low birth weight infants and recent guidelines endorse this strategy. However, the impact of the enhanced parenteral nutrition (PN on acid-basic balance has never been investigated. The aim of the present study is to assess the effect of nutrient intake on acid-base homeostasis in a large population of preterm infants on PN.This observational study described the acid-base profile of very preterm infants (≤29 week's gestation receiving PN during the first week of life. For this purpose three different cohorts of infants who received increasing (group 1 to group 3 nutritional intakes were considered. Nutrition data were recorded daily and correlated to acid-base data (pH, base excess, and lactate. The outcome measure to assess metabolic acidosis was the base excess (BE.161 infants were included. 1127 daily nutritional records and 795 blood gas data were analyzed. The three groups were different with regard to nutritional intravenous intakes. Group 3 in particular had a higher mean intake of both amino acids (3.3 ± 0.8 g/kg/d and lipids (2.8 ± 1.4 g/kg/d during the first week of life. Metabolic acidosis was more severe in the group with the highest parenteral intake of amino acids and lipids: mean BE = -8.7 ± 3.4 (group 3; -6.4 ± 3.4 (group 2; -5.1 ± 3.0 (group 1]. At the multivariate analysis the significant risk factors for metabolic acidosis were: gestational age, initial base excess, amino acid and lipid intravenous intakes.Acid-base homeostasis was influenced by the nutritional intake. Earlier and higher intravenous amino acid and lipid intakes particularly increased the risk of metabolic acidosis. The nutritional tolerance was different depending on gestational age, and the smaller infants (24-26 week's gestation displayed greater acidotic disequilibrium
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José Henrique Silvah
2011-09-01
Full Text Available Hidrotórax secundário à infusão de nutrição parenteral é uma condição rara, embora se apresente cada vez mais comum. Neste relato de caso, uma paciente com síndrome do intestino curto desenvolveu instabilidade hemodinâmica e insuficiência respiratória algumas horas após o início da infusão de nutrição parenteral. Ressaltamos também as manobras para evitar e tratar tal complicação.Hydrothorax due to parenteral nutrition infusion is a rare, although increasingly common event. This report shows a short bowel patient who developed hemodynamic instability and respiratory failure few hours after parenteral nutrition infusion's start. We also emphasize the maneuvers to avoid and treat such complication.
DEFF Research Database (Denmark)
Kenneth, Ng; Stoll, Barbara; Chacko, Shaji
2016-01-01
Introduction: Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. Hypothesis: Whether modifying the phytosterol and vitamin E...... composition of soy and fish oil lipid emulsions affects development of PNALD in preterm pigs. Methods: We measured markers of PNALD in preterm pigs that received 14 days of PN that included 1 of the following: (1) Intralipid (IL, 100% soybean oil), (2) Intralipid + vitamin E (ILE, d-α-tocopherol), (3......, OV, and PS compared to IL. Hepatic cholesterol 7-hydroxylase and organic solute transporter-α expression was lower (P E1 fatty acid...
N. Najafi; M. Parsazadeh
2010-01-01
In order to study the effect of nitrogen form and pH of nutrient solution on the shoot concentration of P, nitrate, organic N + inorganic ammonium, and total N of spinach, a factorial experiment was conducted with two factors including pH of nutrient solution in three levels (4.5, 6.5 and 8.0) and nitrate to ammonium ratio of nutrient solution in five levels (100:0, 75:25, 50:50, 25:75 and 0:100). This factorial experiment was carried out in a completely randomized design with four replicatio...
International Nuclear Information System (INIS)
Victor Garcia-Gaytan, Libia Iris Trejo-Tellez; Olga Tejeda-Sartorius; Maribel Ramirez-Martinez; Julian Delgadillo-Martinez; Fernando Carlos Gomez-Merino; Soledad Garcia-Morales
2018-01-01
Chilhuacle pepper (Capsicum annuum L.) seeds were exposed to gamma radiation (GR) doses (0, 10, 80 and 120 Gy), and plants were grown in hydroponics with different osmotic potentials (OP) (- 0.036, - 0.072, - 0.092, and - 0.108 MPa) in the nutrient solution. We measured the nutrient concentrations, pH and electrical conductivity (EC) in fruits at different time points after transplanting (70, 90 and 130 dat), and found the GR, nutrient solution OP and their interactions differentially affected N, P, K, Ca, and Mg concentrations, as well as pH and EC in chilhuacle peppers. (author)
Influence of lead on atrazine uptake by rice (Oryza sativa L.) seedlings from nutrient solution.
Su, Yu-Hong; Zhu, Yong-Guan
2005-01-01
Atrazine is a widely used herbicide, and its persistence in soil and water causes environmental concerns. In the past, plant uptake processes are mainly investigated for single contaminants. However, in many cases, contaminants co-exist in environmental matrix, such as soil, and plant uptake of one contaminant may be influenced by its co-existing ones. The uptake of atrazine by rice seedlings (Oryza sativa L.) from nutrient solution through the roots was investigated in a solution culture, over an exposure period of 4 weeks. Atrazine accumulation in plant tissues was determined by gas chromatography, and lead was determined using atomic absorption spectrometry. With different ratios of atrazine and Pb2+ concentrations in solution, the observed atrazine concentrations in shoots and roots varied significantly. In atrazine-Pb2+ mixture systems, the added Pb2+ either increased or decreased the concentrations or BCFs of atrazine in seedlings (relative to those without Pb2+), depending on the atrazine-Pb2+ ratio in nutrient solution. The enhanced atrazine uptake results presumably from atrazine-Pb2+ complex formation. The reduced atrazine uptake, which occurred mainly at high atrazine concentrations, is attributed to atrazine toxicity that inhibited seedling growth and transpiration. The formation of atrazine-Pb2+ complex both in the solution and within plant tissues may affect the accumulation of both contaminants by rice plants.
Total parenteral nutrition in diabetic rats
International Nuclear Information System (INIS)
Norcross, E.D.; Stein, T.P.
1986-01-01
Parenteral Nutrition with hypertonic glucose is frequently given to diabetic patients. Large amounts of insulin can be required. The purpose of this investigation was to develop a totally parenterally nourished diabetic rat model. 200 g Female Sprague Dawley rats were made diabetic by i.v. injection of streptozotocin (50 mg/kg). Rats were then allowed to recover for at least 1 week before undergoing surgical insertion of a central venous catheter for parenteral feeding. TPN was begun 3 days after surgery. Prior to this they were allowed unlimited access to food and water. Control (non-streptozotocin treated) rats were run at the same time. Protein turnover was investigated by using 15 N glycine. Preliminary results: diabetic rats given mostly fat as a calorie source survived well in the absence of exogenous insulin whereas those that were given glucose only as their non-protein calorie source showed poor survival even with exogenous insulin. N balance and protein turnover in the lipid treated diabetic rats were comparable to the non-diabetic control rats
Vardar, Gökay; Altıkatoğlu, Melda; Ortaç, Deniz; Cemek, Mustafa; Işıldak, İbrahim
2015-01-01
Generally, the life cycle of plants depends on the uptake of essential nutrients in a balanced manner and on toxic elements being under a certain concentration. Lack of control of nutrient levels in nutrient solution can result in reduced plant growth and undesired conditions such as blossom-end rot. In this study, sensitivity and selectivity tests for various polyvinylchloride (PVC)-based ion-selective membranes were conducted to identify those suitable for measuring typical concentration ranges of macronutrients, that is, NO(3-), K(+), and Ca(2+), in hydroponic solutions. The sensitivity and selectivity of PVC-membrane-based ion-selective sensors prepared with tetradodecylammoniumnitrate for NO(3-), valinomycin for K(+), and Ca ionophore IV for Ca(2+) were found to be satisfactory for measuring NO(3-), K(+), and Ca(2+) ions in nutrient solutions over typical ranges of hydroponic concentrations. Potassium, calcium, and nitrate levels that were utilized by cucumber and tomato seedlings in the greenhouse were different. The findings show that tomato plants consumed less amounts of nitrate than cucumber plants over the first 2 months of their growth. We also found that the potassium intake was higher than other nutritional elements tested for all plants. © 2014 International Union of Biochemistry and Molecular Biology, Inc.
Parenteral nutrition in the ICU setting: need for a shift in utilization.
Oshima, Taku; Hiesmayr, Michael; Pichard, Claude
2016-03-01
The difficulties to feed the patients adequately with enteral nutrition alone have drawn the attention of the clinicians toward the use of parenteral nutrition, although recommendations by the recent guidelines are conflicting. This review focuses on the intrinsic role of parenteral nutrition, its new indication, and modalities of use for the critically ill patients. A recent trial demonstrated that selecting either parenteral nutrition or enteral nutrition for early nutrition has no impact on clinical outcomes. However, it must be acknowledged that the risk of relative overfeeding is greater when using parenteral nutrition and the risk of underfeeding is greater when using enteral nutrition because of gastrointestinal intolerance. Both overfeeding and underfeeding in the critically ill patients are associated with deleterious outcomes. Thus, early and adequate feeding according to the specific energy needs can be recommended as the optimal feeding strategy. Parenteral nutrition can be used to substitute or supplement enteral nutrition, if adequately prescribed. Testing for enteral nutrition tolerance during 2-3 days after ICU admission provides the perfect timing to start parenteral nutrition, if needed. In case of absolute contraindication for enteral nutrition, consider starting parenteral nutrition carefully to avoid overfeeding.
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Iwona Kowalska
2015-03-01
Full Text Available Effects of P level in nutrient solution and the colonization of roots by arbuscular mycorrhizal fungi (AMF on P uptake by tomato plants, their nutritional status, yield and quality of fruits were studied. Plants were grown on rockwool or coconut coir. Inoculation by a mixture of several AMF species was performed three times during the growing period. The mycorrhizal frequency in roots inoculated with AMF amounted to 35.79 – 50.82%. The highest level of mycorrhiza was found in plants receiving nutrient solution with a lower concentration of P. Among the experimental factors, only P level influenced the fruit yield, being higher from plants receiving a nutrient solution with a higher P level. A higher concentration of P in nutrient solution imposed better nutritional status of plants. Higher contents of ascorbic acid and total soluble sugars were found in fruits collected from inoculated plants, grown on rockwool.
Schwartz, Emily
2016-04-01
Inflammatory bowel disease (IBD) is a chronic inflammatory condition with numerous nutrition implications, including an increased risk of malnutrition and various nutrient deficiencies. Surgical interventions are often necessary in the treatment of IBD, and patients with IBD presenting for surgery often have multiple issues, including acute inflammatory processes, malnutrition, anemia, and infections, which may increase the likelihood of poor surgical outcomes. Thus, determining adjunctive treatments that may decrease postoperative complications is paramount. Although enteral nutrition (EN) is considered the preferred nutrition support modality when the gastrointestinal tract is accessible and functional, parenteral nutrition (PN) may provide a suitable alternative when the use of EN is not feasible. The aim of this review is to evaluate the currently available literature on the impact of perioperative PN on postoperative complications, disease severity, and nutrition status in adults with IBD. Six studies within the past 10 years investigated this topic and are analyzed here. Results indicate general trends toward improvements in postoperative outcomes, disease severity, and nutrition status associated with perioperative PN use. Although results appear promising, additional, larger studies with an emphasis on PN composition will improve our understanding of the benefits of perioperative PN in adults with IBD. © 2015 American Society for Parenteral and Enteral Nutrition.
International Nuclear Information System (INIS)
Fontes, P.C.R.; Barber, S.A.
1984-01-01
To evaluate the effects P concentrations in nutrient solution on root growth and on root physiological characteristics involved in P uptake by tomato Lycopersicon esculentum Mill plants, six seedlings were grown in nutrient solution at initial concentrations of 48.5, 97, 194 and 388 μMP until one day before harvest. They were then transferred to solutions with P at 20 μM and 30 μM, and the depletion curves and Michaelis-Menten parameters were determined. The conclusions were that as P supply increased and as the plant P contents are sufficient for maximum growth, the rate of P uptake tends to be lower. The results also indicate that total P uptake by tomato seedlings depends on the amount of root surface area exposed to P. (M.A.C.) [pt
Parenteral nutrition in radiation injuries
International Nuclear Information System (INIS)
Glants, R.M.
1985-01-01
Basing on the results of experiments on mice and rats and their clinical use in oncological patients treatment recommendations are given on use of parenteral nutrition in treatment of radiation disease
Parenteral nutrition in the elderly cancer patient.
Orrevall, Ylva
2015-04-01
Parenteral nutrition may be considered when oral intake and/or enteral nutrition are not sufficient to maintain nutritional status and the patient is likely to die sooner from starvation than from the cancer. A detailed assessment should be made prior to the decision about whether parenteral nutrition should be started. A follow up plan should be documented with objective and patient centred treatment goals as well as specific time points for evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.
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Geraldo Duarte
2005-08-01
Full Text Available OBJETIVO: analisar a efetividade e segurança da antibioticoterapia parenteral hospitalar exclusiva para tratamento da endometrite puerperal, em população de baixo nível socioeconômico. MÉTODOS: estudo clínico prospectivo, que avaliou 21 puérperas com diagnóstico de endometrite puerperal, cujas gestações foram resolvidas em hospital universitário por cesárea (52,4% ou parto normal (47,6. A amostra caracterizou-se por baixo nível socioeconômico e de escolaridade. Foram submetidas ao regime de antibioticoterapia parenteral exclusiva, apenas durante o período de internação (grupo ATP-EX. Os resultados foram comparados com aqueles obtidos de série histórica do mesmo serviço (20 casos submetidas a antibioticoterapia parenteral hospitalar, complementada por terapia via oral ambulatorial (grupo ATP+VO. As pacientes foram avaliadas clinicamente em retornos periódicos visando identificar casos de recidivas e complicações infecciosas. RESULTADOS: uma paciente do grupo ATP+VO necessitou de reinternação no 6º dia após a alta por recrudescência da endometrite. Não foi observada nenhuma complicação entre as pacientes do grupo ATP-EX. CONCLUSÃO: para o tratamento de endometrite puerperal, não foi observado benefício adicional com a adição da antibioticoterapia oral complementar após a alta. Os resultados com o uso da antibioticoterapia parenteral exclusiva durante a internação indicam que esse esquema pode ser utilizado com segurança em população de baixo nível socioeconômico.PURPOSE: to analyze the effectiveness and safety of exclusive hospital parenteral antibiotic therapy to treat puerperal endometritis in a population of low socioeconomic level. METHODS: a prospective clinical trial evaluated 21 puerperae with a diagnosis of postpartum endometritis, whose deliveries occurred at a university hospital by cesarean section (52.4% or normal delivery (47.6%. The sample was characterized by low socioeconomic and
Clinical significance of changes of serum TBA, CG, HA levels in neonate with parenteral nutrition
International Nuclear Information System (INIS)
Huang Weiliang; Zhou Jiongying; Zhang Xiaoyi; Lv Weihua; Ma Yunbao; He Qizhi
2010-01-01
Objective: To study the clinical significance of changes of serum levels of TBA, CG, HA in neonate with parenteral nutrition. Methods: Serum total bile acid (TBA, with biochemistry) and CG, HA (with RIA) contents were measured in 52 neonates (full-term 32, preterm 20) with parenteral nutrition and 28 neonates (full-term 16, preterm 12) without parenteral nutrition (as controls). Results: Before parenteral nutrition,the serum TBA, CG and HA levels in full-term neonates were not significantly different from those in the controls (P>0.05). After parenteral nutrition,serum levels were significantly higher than those before parenteral nutrition (P<0.01). The levels in pre-term neonates were significantly higher after parenteral nutrition than those in full-term neonates (P<0.05). Conclusion: Long term parenteral nutrition might be harmful to hepatic and gall bladder function in neonates especially in premature ones. (authors)
Validation of doubly labeled water for measuring energy expenditure during parenteral nutrition
International Nuclear Information System (INIS)
Schoeller, D.A.; Kushner, R.F.; Jones, P.J.
1986-01-01
The doubly labeled water method was compared with intake-balance for measuring energy expenditure in five patients receiving total parenteral nutrition (TPN). Because parenteral solutions were isotopically different from local water, patients had to be placed on TPN at least 10 days before the metabolic period. Approximately 0.1 g 2H2O and 0.25 g H2(18)O per kg total body water were given orally. We collected saliva before, 3 h, and 4 h after the dose for measurement of total body water and urine before, 1 day, and 14 days after the dose for measurement of isotope eliminations. On day 14, total body weight was remeasured and change in body energy stores was calculated, assuming constant hydration. Intake was assessed from weights of TPN fluids plus dietary record for any oral intake. Energy expenditure from doubly labeled water (+/- SD) averaged 3 +/- 6% greater than intake-balance. Doubly labeled water method is a noninvasive, nonrestrictive method for measuring energy expenditure in patients receiving TPN
Closed-Cycle Nutrient Supply For Hydroponics
Schwartzkopf, Steven H.
1991-01-01
Hydroponic system controls composition and feed rate of nutrient solution and recovers and recycles excess solution. Uses air pressure on bladders to transfer aqueous nutrient solution. Measures and adjusts composition of solution before it goes to hydroponic chamber. Eventually returns excess solution to one of tanks. Designed to operate in microgravity, also adaptable to hydroponic plant-growing systems on Earth.
Chekli, Laura; Eun Kim, Jung; El Saliby, Ibrahim; Kim, Youngjin; Phuntsho, Sherub; Li, Sheng; Ghaffour, NorEddine; Leiknes, TorOve; Kyong Shon, Ho
2017-01-01
This study investigated the sustainable reuse of wastewater using fertilizer drawn forward osmosis (FDFO) process through osmotic dilution of commercial nutrient solution for hydroponics, a widely used technique for growing plants without soil
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E. Shabani Sangtarashani
2013-06-01
Full Text Available Potassium (K has a special place in improving the quality of agricultural products. To evaluate the effect of K concentration in nutrient solution on lycopene content, vitamin C and qualitative characteristics of cherry tomato in NaCl salinity conditions, an experiment was carried out as a completely randomized design with five treatments and three replications at university of Tabriz, Tabriz, Iran, in 2010. Treatments consisted of four concentrations of K (0.2, 2, 7 and 14 mM in nutrient solution with 60 mM NaCl concentration. A nutrient solution treatment without salinity was considered as control. The experiment was conducted in greenhouse, in a hydroponic system. The results indicated that increasing of K concentration increased lycopene content in fruit. Lycopene content in control treatment showed significant difference (P<0.01 in comparison with salinity treatments. With increasing the K concentration (except at 14 mM concentration, vitamin C content was increased, but indicated no statistically significant difference. Vitamin C content in saline conditions was more than control treatment, but showed no significant difference. Adding potassium concentration in nutrient solution improved yield and enhanced quality parameters such as percentage of dry matter, soluble solids and electrical conductivity of fruit extract. Since in saline conditions, the qualitative characteristics of tomato at 7 mM concentration were in the best situation, therefore using this concentration is recommended.
Mutanen, Annika; Lohi, Jouko; Sorsa, Timo; Jalanko, Hannu; Pakarinen, Mikko P
2016-09-01
Intestinal failure is associated frequently with liver injury, which persists after weaning off parenteral nutrition. We compared features of liver remodeling in intestinal failure during and after weaning off parenteral nutrition. Liver biopsies and serum samples were obtained from 25 intestinal failure patients at a median age of 9.7 years (interquartile range: 4.6-18) and from age-matched control patients. Seven patients had been receiving parenteral nutrition for 53 months (22-160), and 18 patients had been weaned off parenteral nutrition 6.3 years (2.4-17) earlier, after having received parenteral nutrition for 10 months (3.3-34). Expression of alpha-smooth muscle actin, collagen 1, proinflammatory cytokines, growth factors, and matrix metalloproteinases (MMPs) was measured. Significant increases in immunohistochemical expression of alpha-smooth muscle actin and collagen 1 were observed predominantly in portal areas and were similar to increases seen in patients currently receiving parenteral nutrition and in patients weaned off parenteral nutrition. Gene and protein expressions of alpha-smooth muscle actin and collagen were interrelated. Gene expression of ACTA2, encoding alpha-smooth muscle actin, was increased only in patients who were receiving parenteral nutrition currently. Comparable upregulation of interleukin-1 (α and ß), epidermal growth factor, integrin-ß6, and MMP9 gene expression was observed in both patient groups, irrespective of whether they were receiving parenteral nutrition currently. Liver expression and serum levels of TIMP1 and MMP7 were increased only in the patients on parenteral nutrition currently but were not increased after weaning off parenteral nutrition. Intestinal failure is characterized by abnormal activation of hepatic myofibroblast and accumulation of collagen both during and after weaning off parenteral nutrition. Persistent transcriptional upregulation of proinflammatory and fibrogenic cytokines after weaning off
Martínez-Fernández, Domingo; Bingöl, Deniz; Komárek, Michael
2014-07-15
Two experiments were carried out to study the competition for adsorption between trace elements (TEs) and nutrients following the application of nano-maghemite (NM) (iron nano-oxide; Fe2O3) to a soil solution (the 0.01molL(-1) CaCl2 extract of a TEs-contaminated soil). In the first, the nutrients K, N, and P were added to create a set of combinations: potential availability of TEs during their interaction with NM and nutrients were studied. In the second, response surface methodology was used to develop predictive models by central composite design (CCD) for competition between TEs and the nutrients K and N for adsorption onto NM. The addition of NM to the soil solution reduced specifically the concentrations of available As and Cd, but the TE-adsorption capacity of NM decreased as the P concentration increased. The CCD provided more concise and valuable information, appropriate to estimate the behavior of NM sequestering TEs: according to the suggested models, K(+) and NH4(+) were important factors for Ca, Fe, Mg, Mn, Na, and Zn adsorption (Radj(2)=95%, except for Zn with Radj(2)=87%). The obtained information and models can be used to predict the effectiveness of NM for the stabilization of TEs, crucial during the phytoremediation of contaminated soils. Copyright © 2014 Elsevier B.V. All rights reserved.
Calcium and potassium contents in nutrient solution on Phoma leaf spot intensity in coffee seedlings
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Aricléia de Moraes Catarino
Full Text Available ABSTRACT Coffee is one of the main export commodities of Brazilian agribusiness. Phoma leaf spot [Phoma tarda (Stewart Boerema & Bollen] is one of the most important coffee fungal diseases in Brazil. Therefore, this study aimed to evaluate the intensity of Phoma leaf spot in coffee seedlings supplied with different rates of Ca+2 and K+. The study was conducted under controlled conditions in a growth chamber, at the Department of Phytopathology - UFLA, from February 2010 to December 2011. The assay was repeated twice under the same conditions. The nutrient solutions consisted of five concentrations of K+ (3, 4, 5, 6, 7 mmol L-1 and Ca+2 (2, 4, 6, 8 and 10 mmol L-1. The experiment was arranged in a randomized block design, with 25 treatments and three replicates, with two plants per plot. The areas under incidence progress curve (AUIPC and severity (AUSPC were calculated. At the lowest rate of Ca2+ (2 mmol L-1 and highest K+ (6 and 7 mmol L-1, approximately, the AUIPC was the smallest. For the AUSPC, the lowest rates of Ca+2 and K+ resulted in the lowest severities. Supply of Ca+2 and K+ in nutrient solution reduced AUIPC and AUSPC of Phoma leaf spot, and these nutrients can be recommended for the management of the disease.
Institute of Scientific and Technical Information of China (English)
Juan LI; Jianmin ZHOU
2008-01-01
A growth chamber experiment was conducted to investigate the influence of NH4+/NO3- ratio and elevated CO2 concentration on the pH in nutrient solution,growth and root vigor system of tomato seedling roots,which attempts to understand whether the elevated CO2 concentration can alleviate the harmful effects of higher NH4+-N concentration in nutrient solutions on the tomato root system.Tomato (Lycopersicon esculenturn Mill.var.Hezuo 906) was grown in pots with nutrient solutions varying in NH4+/NO3- ratio (0:1,1:3,1:1,3:1and 1:0) and the growth chambers were supplied with with the growth process and CO2 concentration increased.At both CO2 levels,pH increased when 100% NO3--N was supplied and decreased in other treatments.The pH decrease in the nutrient solution was directly correlated to the NH4+-N proportion.The pH value was more reduced in 100% NH4+-N nutrient solution than increased in the 100% NO3--N nutrient solution.CO2 enrichment increased the dry weight of shoots and roots,root vigor system,total absorbing area and active absorbing area of tomato seedlings.All the measurement indexes above were increased in the elevated CO2 concentration treatment with the NO3- proportion increase in the nutrient solutions.Thus,under the elevated CO2 concentration,the dry weights of shoots and roots,root vigor system,total root absorbing area and active absorbing area were found to be inversely correlated to NH4+/NO3- ratio,leading to about 65.8%,78.0%,18.9%,12.9% and 18.9% increase,respectively,compared with that under the ambient CO2 concentration.Our results indicated that tomato seedling roots may benefit mostly from CO2 enrichment when 100% NO3--N nutrient solutions was supplied,but the CO2 concentration elevation did not alleviate the harmful effects when 100% NHa+-N was supplied.
Luna, María C; Martínez-Sánchez, Ascensión; Selma, María V; Tudela, Juan A; Baixauli, Carlos; Gil, María I
2013-01-01
Little information is available about the impact of nutrient solution ion concentration on quality characteristics and shelf life of fresh-cut lettuce grown in soilless systems in open field. Three lettuce genotypes, lollo rosso and red oak leaf as red-leafed genotypes and butterhead as green-leafed genotype, were studied. The influence of three nutrient solutions with low, medium and high ion concentrations, which varied in the macroanion (NO₃⁻) and macrocations (K⁺, Ca²⁺ and NH₄⁺), were compared in summer and winter. The nutrient solutions evaluated in this study for the production of lettuce in a soilless system did not strongly influence the quality characteristics of the raw material. When the ion concentration of the nutrient solution was increased, fresh weight decreased, although it depended on the genotype and season. Maturity index and dry matter content varied with the season but independently of the nutrient solution. In summer, maturity index was higher and dry matter lower than in winter. Initial texture and visual quality were not influenced by the nutrient solution. Medium ion concentration provided the highest content of vitamin C and phenolic compounds. Our observations pointed out that the genotype had a strong influence on the shelf life of the fresh-cut product with minor differences among nutrient solutions. In general, red-leafed lettuces showed the highest antioxidant content, helping the maintenance of sensory characteristics throughout storage. The combination of optimal nutrient solution ion concentration and suitable cultivar is considered essential to ensure lettuce post-cutting life. Copyright © 2012 Society of Chemical Industry.
M. Parsazadeh; N. Najafi
2011-01-01
In this study, the effect of nitrate to ammonium ratio and pH of nutrient solution on the changes in pH and EC of rhizosphere during spinach growth period in perlite culture, under greenhouse conditions, was investigated. A split factorial experiment in a completely randomized design with four replications was conducted with three factors including nutrient solution’s pH in three levels (4.5, 6.5 and 8), nitrate to ammonium ratio of nutrient solution in five levels (100:0, 75:25, 50:50, 25:75...
Reconciling divergent results of the latest parenteral nutrition studies in the ICU.
Singer, Pierre; Pichard, Claude
2013-03-01
Recent studies on the optimal modalities to feed patients during the ICU stay show divergent results. The level and the timing of energy provision is a critical issue, associated with the clinical outcome. These results questioned the clinical relevance of the recent guidelines issued by American, Canadian and European academic societies. Four recent prospective randomized studies enrolled critically ill patients who received various nutritional regimens and tested the effect of nutritional support on outcome. The Tight Calorie balance Control Study (TICACOS) targeted on calorie administration according to measured energy expenditure and found increased ICU morbidity but improved hospital mortality. The large EpaNIC study compared 'early' with 'late' (parenteral nutrition) nutrition, mostly in patients after cardiac surgery, and found an increased morbidity associated with early parenteral nutrition. The supplemental parenteral nutrition (SPN) study randomized the patients after 3 days and targeted the calories administered by parenteral nutrition as a complement to unsuccessful enteral nutrition using indirect calorimetry. The SPN resulted in less nosocomial infections and shorter duration of mechanical ventilation. Finally, a recent Australian study enrolled patients unable to be early fed enterally to receive, or not, parenteral nutrition targeted at 1500 kcal. No complications were noted in the parenteral nutrition group. Lessons from all these studies are summarized and should help in designing better studies and guidelines. The critical analysis of recent prospective studies comparing various levels of calorie administration, enteral versus parenteral nutrition and enteral versus SPN confirms the recommendations to avoid underfeeding and overfeeding. Parenteral nutrition, required if enteral feeding is failing, and if adjusted up to a measured optimal level, may improve outcome. More studies on the optimal level of energy and protein administration to
Nutrient supply of plants in aquaponic systems
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Andras Bittsanszky
2016-10-01
Full Text Available In this preliminary article we present data on plant nutrient concentrations in aquaponics systems, and we compare them to nutrient concentrations in “standard” hydroponic solutions. Our data shows that the nutrient concentrations supplied by the fish in the aquaponics system are significantly lower for most nutrients compared to hydroponic systems. Nevertheless, plants do thrive in solutions that have lower nutrient levels compared to “standard” hydroponic solutions. This is especially true for green leafy vegetables that rarely need additional nutritional supplementation. It is concluded that in the highly complex system of aquaponics, special care has to be taken, via continuous monitoring of the chemical composition of the circulating water, to provide adequate concentrations and ratios of nutrients, and especially for the potentially toxic component, ammonium. If certain plants require nutrient supplementation, we consider that one based on organic substances would be most beneficial. However, protocols for the application of such nutrient amendments still need to be developed.
Karadağ, Sevinç; Görüşük, Emine M; Çetinkaya, Ebru; Deveci, Seda; Dönmez, Koray B; Uncuoğlu, Emre; Doğu, Mustafa
2018-01-25
A fully automated flow injection analysis (FIA) system was developed for determination of phosphate ion in nutrient solutions. This newly developed FIA system is a portable, rapid and sensitive measuring instrument that allows on-line analysis and monitoring of phosphate ion concentration in nutrient solutions. The molybdenum blue method, which is widely used in FIA phosphate analysis, was adapted to the developed FIA system. The method is based on the formation of ammonium Mo(VI) ion by reaction of ammonium molybdate with the phosphate ion present in the medium. The Mo(VI) ion then reacts with ascorbic acid and is reduced to the spectrometrically measurable Mo(V) ion. New software specific for flow analysis was developed in the LabVIEW development environment to control all the components of the FIA system. The important factors affecting the analytical signal were identified as reagent flow rate, injection volume and post-injection flow path length, and they were optimized using Box-Behnken experimental design and response surface methodology. The optimum point for the maximum analytical signal was calculated as 0.50 mL min -1 reagent flow rate, 100 µL sample injection volume and 60 cm post-injection flow path length. The proposed FIA system had a sampling frequency of 100 samples per hour over a linear working range of 3-100 mg L -1 (R 2 = 0.9995). The relative standard deviation (RSD) was 1.09% and the limit of detection (LOD) was 0.34 mg L -1 . Various nutrient solutions from a tomato-growing hydroponic greenhouse were analyzed with the developed FIA system and the results were found to be in good agreement with vanadomolybdate chemical method findings. © 2018 Society of Chemical Industry. © 2018 Society of Chemical Industry.
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Kaler J
2012-01-01
Full Text Available Abstract Background No clinical trials have been conducted in India on the efficacy of parenteral antibacterials to treat footrot in sheep. In addition, there are no studies worldwide on the efficacy of parenteral antibacterials to treat chronic footrot. Sixty two sheep with acute footrot and 30 sheep with chronic footrot from 7 villages in Kashmir, India were recruited into two separate trials. Sheep with acute footrot were allocated to one of three treatments using stratified random sampling: long acting parenteral oxytetracycline, long acting parenteral enrofloxacin and topical application of potassium permanganate solution (a traditional treatment used by sheep farmers in India. In a quasi pre-post intervention design, sheep with chronic footrot that had not responded to treatment with potassium permanaganate were randomly allocated to treatment with one of the two parenteral antibacterials mentioned above. Sheep with acute footrot were treated on day 0 and those with chronic footrot on days 0, 3, 6 and 9. Sheep were monitored for up to 28 days after treatment. Time to recovery from lameness and initial healing of lesions was assessed using Kaplan-Meier survival curves, nonparametric log-rank and Wilcoxon sign-rank tests. Results There was significant correlation in recovery from lameness and presence of healing lesions in sheep with acute (r = 0.94 or chronic (r = 0.98 footrot. Sheep with acute footrot which were treated with parenteral antibacterials had a significantly more rapid recovery from lameness and had healing lesions (median = 7 days compared with those treated with topical potassium permanganate solution (less than 50% recovered in 28 days. The median time to recovery in sheep with chronic footrot treated with either antibacterial was 17 days; this was significantly lower than the median of 75 days lame before treatment with antibacterials. The median time to recovery for both acute and chronic footrot increased as the severity
Parenteral Opioid Analgesics Utilization Pattern in Amir-al-Momenin Hospital, Zabol-IRAN
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Hossein Vatanpour
2016-08-01
Full Text Available Opioids are the most available medicines to get rid of any general severe pain and avoiding of any deleterious sequential that can worsen patient outcomes. Rational prescription of opioid analgesics with respect to the possibility of abuse is a big concern in the medical care costs. Zabol, where is located in eastern part of Iran and has common border with Afghanistanhas the most opioid traffic in the region. In this study the rational prescription of parenteral opioid in Amir-al-Momenin general hospital was investigated. A retrospective drug utilization review was performed on 509 in-patients who received parenteral opioids including Morphine, Pethidin, Pentazocin, Fentanyl, Alfentanil, Sufentanil and Methadone from March 21sttoSeptember 23rd, 2011. Multivariate conditional regression modeling was used to determine independent predictors for daily parenteral opioid consumption. Total daily parenteral opioid consumption was 38.63 DDDs/100bed-days for Morphine, Pethidine and Pentazocin and 84564.78 PFEQs/100bed-days for Fentanyl, Alfentanil and Sufentanil and 766 mg for Methadone. Pethidine was the most frequently prescribed parenteral opioid. Most patients who were prescribed by the intramuscular routes, ordered PRN. Daily parenteral opioid consumption was the highest in the emergency ward whereas it was considered as the lowest in the intensive care unit[ICU]. According to our findings, total daily parenteral opioid consumption was almost high in Amir-al-Momenin Hospital. Unlike to some relevant factors that can effect on the consumption of analgesic opioids like gender, age, drug-drug interaction and etc, we found no rational prescription and consumption in the mentioned hospital.
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José Geraldo Speciali
1971-09-01
Full Text Available As modificações dos quadros clínico e EEG foram estudadas em 9 pacientes com manifestações epilépticas rebeldes às medicações anticonvulsivantes habituais, quando submetidos à administração parenteral diária de diazepam (Valium e após sua interrupção. Houve diminuição do número e da duração das crises, superior a 75%, em três pacientes. Esses resultados são satisfatórios, considerando a gravidade dos quadros epilépticos e foram obtidos em pacientes com predomínio de alterações EEG lentas antes de iniciar o esquema terapêutico. Não se verificaram efeitos colaterais relevantes na época da administração parenteral. Em dois pacientes foi observado o aparecimento de crises tônicas coincidindo com o aumento de elementos EEG paroxísticos rápidos, localizados ou difusos.Changes of the clinical pictures and electroencephalographic patterns were studied in 9 patients suffering from epileptic seizures non responsive to common anticonvulsivants, when submitted to daily parenteral administration of diazepam (Valium and after its interruption. There was decrease of the number and duration of seizures, over to 75%, in 3 patients. These results can be considered as satisfatory, considering the intensity of the seizures. The best results were obtained in those patients which showed predominance of slow waves in the EEGs prior to the begin of the treatment. No side effects were observed during the treatment. Two patients developed tonic seizures coincident with the increasing of fast paroxistic EEG patterns, of localized or diffuse type.
Benefits of a new pediatric triple-chamber bag for parenteral nutrition in preterm infants.
Rigo, Jacques; Marlowe, Monica L; Bonnot, Denis; Senterre, Thibault; Lapillonne, Alexandre; Kermorvant-Duchemin, Elsa; Hascoet, Jean Michel; Desandes, Roxane; Malfilâtre, Geneviève; Pladys, Patrick; Beuchée, Alain; Colomb, Virginie
2012-02-01
The aim of this study was to evaluate the efficacy, safety, flexibility, and ease of handling and use of the Ped3CB-A 300 mL, the first ready-to-use multichamber parenteral nutrition (PN) system, with optional lipid bag activation, specially designed for administration to preterm infants. In this prospective, open-label, multicenter, noncomparative, phase III clinical trial, preterm infants were treated with Ped3CB-A for 5 to 10 consecutive days. A total of 113 preterm infants were enrolled in the study and 97 (birth weight 1382 ± 520 g; gestational age 31.2 ± 2.5 weeks; postnatal age administration 5.6 ± 6.1 days) were included in the per protocol analysis accounting for 854 perfusion days. Double-chamber bag activation was used for 32 perfusion days. Macronutrient, electrolyte, and mineral supplements were primarily administered through a Y-line or directly in the activated bag. In all, 199 additions (mainly sodium, 95%) were made to the Ped3CB-A bags on 197 infusion days (23.1%) in 43 infants (44.3%). More than 1 of these nutrients was added to the bag on only 1 perfusion day. Mean and maximum parenteral nutrient intakes were 2.8 ± 0.7 and 3.6 ± 0.8 g amino acids per kilogram per day, and 80 ± 20 and 104 ± 22 kcal · kg(-1) · day(-1). Mean weight gain represented 10.0, 21.5, and 22. 6 g · kg(-1) · day(-1) according to age at inclusion (0-3, 4-7, or >7 days of life). A visual analog scale was completed and produced positive results. No adverse events were attributable to the design of the Ped3CB-A system. Ped3CB-A provides easy-to-use, well-balanced, and safe nutritional support. Nutritional intakes and weight gain were within the recent PN recommendations in preterm infants.
Parenteral nutrition in childhood and consequences for dentition and gingivae.
Olczak-Kowalczyk, D; Danko, M; Banaś, E; Gozdowski, D; Popińska, K; Krasuska-Sławińska, E; Książyk, J
2017-03-01
Assessment of dentition in children under parenteral nutrition, risk factors for caries, and dental developmental abnormalities. The study involved 63 patients (aged 2.25-16.6 years), i.e. 32 subjects receiving parenteral nutrition for a mean period of 5.6±2.94 years, and 31 healthy control subjects. Oral hygiene (OHI-S, PL-I), gingival (GI), and dentition status (caries, DMFT/dmft, enamel defects, shape alterations), frequency of oral meals and frequency of cariogenic snacks consumption were evaluated. Medical records provided information on parenteral meals per week, age parenteral nutrition started, birth body mass, Apgar score, weight deficiency, and antibiotic therapy until aged 1 year. The Mann-Whitney test, chi-squared test, and Spearman rank correlation coefficient were used (p≤0.05). Dental developmental abnormalities occurred more often in PN subjects (71.87% vs. 25.80%). The prevalence of caries in PN (56.25% vs. 90.32%) and dmft (2.00±3.30 vs. 4.21±3.33) and DMFT (2.47±4.08 vs. 3.33±3.50) were lower. Positive caries Spearman's rank correlation coefficients: frequency of oral meals and frequency of cariogenic snacks consumption, and GI. Negative correlation coefficients: low birth body mass, antibiotic therapy, and low body mass in the first year of life. Positive dental developmental abnormality Spearman's coefficients: low birth body mass, Apgar score parenteral nutrition duration, low body mass and antibiotic therapy in the first year of life. Beta- lactam, aminoglycoside, glycopeptide and nitroimidazole treatments were related to enamel hypoplasia. Parenteral nutrition in childhood is related to the risk of dental developmental abnormalities, promoted by malnutrition and antibiotic therapy in infancy. Limiting the number of meals and cariogenic snacks, and most probably administration of antibiotics, decreases the risk of caries.
[Intrahepatic cholestasis associated with parenteral nutrition: an experimental study in rats].
Salas Martínez, J; Morán Penco, J M; Mahedero Ruiz, G; García Gamito, F; Limón Mora, M; Maciá Botejara, E; Vinagre Velasco, L M
1989-01-01
Intrahepatic cholestasis is a condition often observed in patients receiving parenteral nutrition, especially in new born babies who are underweight (taurina. This makes it impossible to achieve a correct conjugation of toxic biliary acids. The access of nutrients to the liver may have an effect on this. An experimental study on rats was performed, administering an oral diet at the expense of lipids (20% Intralipid, 60% of caloric needs) and glucose (40% of caloric needs) in one group, another group received amino acid supplements to this diet (16N) at a proteic rate of 2 gr/kg of weight and day orally, with an identical diet to the above, except that the proteic intake was intraperitoneal. Two control groups were established. We found a microvacuolization in hepatic fat with the help of an electronic microscope in the groups lacking proteins and those with oral or intraperitoneal supplements of amino acids, as well as an increase in plasmatic AST.
Plasma trace metals during total parenteral alimentation.
Solomons, N W; Layden, T J; Rosenberg, I H; Vo-Khactu, K; Sandstead, H H
1976-06-01
The plasma concentrations of the trace metals zinc and copper were studied prospectively in 13 patients with gastrointestinal diseases treated with parenteral alimentation (TPA) for periods of from 8 days to 7 1/2 weeks. Plasma copper levels fell rapidly and consistently in all patients, with an overall rate of - 11 mug per 100 ml per week. Zinc concentrations declined in 10 of 13 patients at a more gradual rate. Analysis of the standard parenteral alimentation fluids revealed zinc content equivalent to 50% of the daily requirement and a negligible content of copper. From combined analysis of plasma zinc, hair zinc, and taste acuity, there is evidence that increased utilization or redistribution within the body may effect plasma concentrations in some patients. Neither an increase in urinary excretion nor a primary decrease in plasma binding proteins appeared to be a major factor in lowering plasma trace metal concentrations. These findings indicate that a marked decrease in plasma copper is regular and a decline in plasma zinc is common during TPA using fluids unsupplemented with trace metals. Supplementation of parenteral alimentation fluids with the trace metals zinc and copper is recommended.
Aría Guerra, Eva; Cortés-Salgado, Alfonso; Mateo-Lobo, Raquel; Nattero, Lía; Riveiro, Javier; Vega-Piñero, Belén; Valbuena, Beatriz; Carabaña, Fátima; Carrero, Carmen; Grande, Enrique; Carrato, Alfredo; Botella-Carretero, José Ignacio
2015-09-01
the precise role of parenteral nutrition in the management of oncologic patients with intestinal occlusion is not well defined yet. We aimed to identify the effects of parenteral nutrition in these patients regarding prognosis. 55 patients with intestinal occlusion and peritoneal carcinomatosis were included. Parenteral nutrition aimed at 20-35 kcal/Kg/day, and 1.0 g/kg/day of amino-acids. Weight, body mass index, type of tumor, type of chemotherapy, and ECOG among others were recorded and analyzed. 69.1% of the patients had gastrointestinal tumors, 18.2% gynecologic and 12.7% others. Age was 60 ± 13y, baseline ECOG 1.5 ± 0.5 and body mass index 21.6 ± 4.3. Malnutrition was present in 85%. Survival from the start of parenteral nutrition was not significant when considering baseline ECOG (log rank = 0.593, p = 0.743), previous lines of chemotherapy (log rank = 2.117, p = 0.548), baseline BMI (log rank = 2.686, p = 0.261), or type of tumor (log rank = 2.066, p = 0.356). Survival in patients who received home parenteral nutrition after hospital discharge was higher than those who stayed in-hospital (log rank = 7.090, p = 0.008). Survival in patients who started chemotherapy during or after parenteral nutrition was higher than those who did not so (log rank = 17.316, p Parenteral nutrition in patients with advanced cancer and intestinal occlusion is safe, and in tho se who respond to chemotherapy, further administration of home parenteral nutrition together with chemotherapy may enhance prolonged survival. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Enteral and Parenteral Nutrition in the Perioperative Period: State of the Art
Abunnaja, Salim; Cuviello, Andrea; Sanchez, Juan A.
2013-01-01
Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and biochemistry, have allowed clinicians to treat malnutrition and improve surgical patient’s outcomes. We reviewed the literature for the current status of perioperative nutrition comparing parenteral nutrition with enteral nutrition. In a surgical patient with established malnutrition, nutritional support should begin at least 7–10 days prior to surgery. Those patients in whom eating is not anticipated beyond the first five days following surgery should receive the benefits of early enteral or parenteral feeding depending on whether the gut can be used. Compared to parenteral nutrition, enteral nutrition is associated with fewer complications, a decrease in the length of hospital stay, and a favorable cost-benefit analysis. In addition, many patients may benefit from newer enteral formulations such as Immunonutrition as well as disease-specific formulations. PMID:23429491
Ceramide in lipid emulsions used in parenteral nutrition: an innocent bystander?
Groener, Johanna E.; Serlie, Mireille J.; Poppema, Aldi; Mirzaian, Mina; Aerts, Johannes M.
2011-01-01
Parenteral nutrition-associated liver disease is a prevalent and severe complication of long term parenteral nutrition. We present here for the first time data on the presence of ceramide, a bioactive compound involved in a variety of metabolic processes, in different lipid emulsions used in
Bachlechner, Stephan; Denzer-Lippmann, Melanie Y.; Wielopolski, Jan; Fischer, Marie; Buettner, Andrea; Doerfler, Arndt; Schöfl, Christof; Münch, Gerald; Kornhuber, Johannes; Thürauf, Norbert
2017-01-01
Food intake influences human cognition, olfaction, hunger, and food craving. However, little research has been done in this field to elucidate the effects of different nutrients. Thus, the goal of our study was to investigate the effects of oral ingestion of different nutrient solutions on olfactory, cognitive, metabolic and psychophysical function. Twenty healthy men participated in our study employing a double-blind, cross-over, repeated measurement design. Participants were tested on four ...
Nutrición parenteral precoz en el neonato grave
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Alina González Mustelier
2004-06-01
Full Text Available Se realizó un estudio descriptivo en el Servicio de Terapia Intensiva Neonatal del Hospital Ginecoobstétrico "Ramón González Coro" de Ciudad de La Habana, desde enero del 2000 hasta enero del 2002, con el objetivo de valorar las ventajas del uso de nutrición parenteral (NP precoz en los neonatos críticamente enfermos, durante la primera semana de vida. Se compararon 2 grupos de 23 recién nacidos críticos, uno de ellos recibió alimentación parenteral (grupo I y el otro no (grupo II. Se encontró homogeneidad en ambos grupos en cuanto a peso, edad gestacional, valoración nutricional al nacer, sexo y morbilidad inicial. La nutrición parenteral se caracterizó por su uso precoz (menos de 72 horas, conjuntamente con alimentación enteral mínima. La media del aporte máximo de macronutrientes fue de 16 g/kg/d de dextrosa, 1,2 g/kg/d de lípidos y 2 g/kg/d de proteínas. El desarrollo nutricional fue más favorable en el grupo con NP, porque le disminuyó a la mitad el tanto por ciento de peso perdido en la primera semana de vida, le sostuvo mayor aporte energético durante ese período y recupó 7 días antes su peso del nacimiento en relación con el grupo II. Las complicaciones fueron similares en ambos grupos, para concluir en que estas no estuvieron relacionadas con el uso de NP.A descriptive study was conducted at the Neonatal Intensive Therapy Service of "Ramón Gonzalez Coro" Gynecoobstetric Hospital, in Havana City, from January 2000, to January 2002, aimed at assessing the advantages of the use of early parenteral nutrition in the critically ill neonates during the first week of life. 2 groups of 23 critical newborn infants each were compared. One of them recieved parenteral nutrition (group 1 and the other one did not (group II. Homogeneity was found in both groups as regards weight, gestational age, nutritional assessment at birth and initial morbidity. The parenteral nutrition was characterized by its early use (less than 72
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Daniel Baron
2013-06-01
Full Text Available "Araticum-de-terra-fria" (Annona emarginata (Schltdl. H. Rainer has been consider a good alternative in rootstock production for the main commercial Annonaceae species. Although this species develops in different soil and climate conditions, there is no understanding by the physiological responses of this species at different nutritional levels. Thus, the objective of this study was to evaluate the influence of different ionic strengths on development of vegetative species known as "Araticum-de-terra-fria". It was evaluated in seedlings grown in different ionic strengths (25% I, 50% I, 75% I and 100% I of the complete nutrient solution Hoagland and Arnon (1950 nº 2, for 140 days, the following characteristics: Gas Exchange (CO2 assimilation rate, stomatal conductance, internal CO2 concentration, transpiration rate, water use efficiency, Rubisco carboxylation efficiency; Vegetative growth characteristics (diameter, leaf number, dry matter; Physiological Indexes (leaf area ratio, specific leaf area, relative growth rate, net assimilation rate, leaf weight ratio and Ionic Accumulation (nutrients leaf analysis. Seedlings grown under 50% I showed the highest values of Leaf CO2 assimilation rate, water use efficiency, carboxylation efficiency, growth, relative growth rate, net assimilation rate and ionic accumulation in the total dry matter. So it is concluded that "Araticum-de-terra-fria" seedlings grown under intermediate nutrient concentrations of complete nutrient solution Hoagland and Arnon (1950 nº 2, explored more adequately their physiological potential that justify their adaptation in different nutritional conditions and allow reducing the amount of mineral nutrition of seedlings production.
Bizari, Letícia; da Silva Santos, Andressa Feijó; Foss, Norma Tiraboschi; Marchini, Júlio Sérgio; Suen, Vivian Marques Miguel
2016-07-01
Short bowel syndrome is a severe malabsorption disorder, and prolonged parenteral nutrition is essential for survival in some cases. Among the undesirable effects of long-term parenteral nutrition is an increase in proinflammatory cytokines. The aim of the present study was to measure the serum levels of interleukin-6, interleukin-10, tumor necrosis factor alpha, and transforming growth factor beta, in patients with short bowel syndrome on cyclic parenteral nutrition and patients who had previously received but no longer require parenteral nutrition. The study was cross-sectional and observational. Three groups were studied as follows: Parenteral nutrition group, 9 patients with short bowel syndrome that receive cyclic parenteral nutrition; Oral nutrition group, 10 patients with the same syndrome who had been weaned off parenteral nutrition for at least 1 year prior to the study; Control group, 13 healthy adults, matched for age and sex to parenteral and oral groups. The following data were collected: age, tobacco use, drug therapies, dietary intake, body weight, height, blood collection. All interleukins were significantly higher in the parenteral group compared with the control group as follows: interleukin-6: 22 ± 19 vs 1.5 ± 1.4 pg/mL, P= .0002; transforming growth factor β: 854 ± 204 vs 607 ± 280 pg/mL, P= .04; interleukin-10: 8 ± 37 vs 0.6 ± 4, P= .03; tumor necrosis factor α: 20 ± 8 vs 8 ± 4 pg/mL, Pparenteral nutrition in short bowel syndrome patients, regardless of its duration, increases serum proinflammatory cytokines. Copyright © 2016 Elsevier Inc. All rights reserved.
Intensive medicine - Guidelines on Parenteral Nutrition, Chapter 14.
Kreymann, G; Adolph, M; Druml, W; Jauch, K W
2009-11-18
In intensive care patients parenteral nutrition (PN) should not be carried out when adequate oral or enteral nutrition is possible. Critically ill patients without symptoms of malnutrition, who probably cannot be adequately nourished enterally for a period of <5 days, do not require full PN but should be given at least a basal supply of glucose. Critically ill patients should be nourished parenterally from the beginning of intensive care if they are unlikely to be adequately nourished orally or enterally even after 5-7 days. Critically ill and malnourished patients should, in addition to a possible partial enteral nutrition, be nourished parenterally. Energy supply should not be constant, but should be adapted to the stage, the disease has reached. Hyperalimentation should be avoided at an acute stage of disease in any case. Critically ill patients should be given, as PN, a mixture consisting of amino acids (between 0.8 and 1.5 g/kg/day), carbohydrates (around 60% of the non-protein energy) and fat (around 40% of the non-protein energy) as well as electrolytes and micronutrients.
Zhi, Ying-Jie; Zhang, Hui; Xie, Yan-Ming; Yang, Wei; Yang, Hu; Zhuang, Yan
2013-09-01
Hospital information system data of cerebral infaction patients who received parenterally administered Shuxuetong was analyzed. This provided frequency data regarding patients' conditions and related information in order to provide a clinical reference guide. In this study, HIS data from 18 hospitals was analyzed. Patients receiving parenterally administered Shuxuetong for the treatment of cerebral infarction were included. Information on age, gender, costsand route of administration were collated. The average age of patients was 66 years old. Days of hospitalization ranged from 15 to 28 days. The majority of patients were classified as having phlegm and blood stasis syndrome, which is inaccordance with the indications for this drug. The most commonly used drugs used in combination with parenterally administered Shuxuetong were: aspirin, insulin and heparin. Patients with cerebral infarction crowd using parenterally administered Shuxuetong were a mostly elderly population, with an average age of 66. Although generally use was in accordance with indications, dosage, and route of administration, there were however some discrepancies. Therefore, doctors need to pay close attention to guidelines and closely observe patients when using parenterally administered Shuxuetong and to consider both the clinical benefits and risks.
Accelerated in-vitro release testing methods for extended-release parenteral dosage forms.
Shen, Jie; Burgess, Diane J
2012-07-01
This review highlights current methods and strategies for accelerated in-vitro drug release testing of extended-release parenteral dosage forms such as polymeric microparticulate systems, lipid microparticulate systems, in-situ depot-forming systems and implants. Extended-release parenteral dosage forms are typically designed to maintain the effective drug concentration over periods of weeks, months or even years. Consequently, 'real-time' in-vitro release tests for these dosage forms are often run over a long time period. Accelerated in-vitro release methods can provide rapid evaluation and therefore are desirable for quality control purposes. To this end, different accelerated in-vitro release methods using United States Pharmacopeia (USP) apparatus have been developed. Different mechanisms of accelerating drug release from extended-release parenteral dosage forms, along with the accelerated in-vitro release testing methods currently employed are discussed. Accelerated in-vitro release testing methods with good discriminatory ability are critical for quality control of extended-release parenteral products. Methods that can be used in the development of in-vitro-in-vivo correlation (IVIVC) are desirable; however, for complex parenteral products this may not always be achievable. © 2012 The Authors. JPP © 2012 Royal Pharmaceutical Society.
Accelerated in vitro release testing methods for extended release parenteral dosage forms
Shen, Jie; Burgess, Diane J.
2012-01-01
Objectives This review highlights current methods and strategies for accelerated in vitro drug release testing of extended release parenteral dosage forms such as polymeric microparticulate systems, lipid microparticulate systems, in situ depot-forming systems, and implants. Key findings Extended release parenteral dosage forms are typically designed to maintain the effective drug concentration over periods of weeks, months or even years. Consequently, “real-time” in vitro release tests for these dosage forms are often run over a long time period. Accelerated in vitro release methods can provide rapid evaluation and therefore are desirable for quality control purposes. To this end, different accelerated in vitro release methods using United States Pharmacopoeia (USP) apparatus have been developed. Different mechanisms of accelerating drug release from extended release parenteral dosage forms, along with the accelerated in vitro release testing methods currently employed are discussed. Conclusions Accelerated in vitro release testing methods with good discriminatory ability are critical for quality control of extended release parenteral products. Methods that can be used in the development of in vitro-in vivo correlation (IVIVC) are desirable, however for complex parenteral products this may not always be achievable. PMID:22686344
Enteral and Parenteral Nutrition in the Perioperative Period: State of the Art
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Juan A. Sanchez
2013-02-01
Full Text Available Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and biochemistry, have allowed clinicians to treat malnutrition and improve surgical patient’s outcomes. We reviewed the literature for the current status of perioperative nutrition comparing parenteral nutrition with enteral nutrition. In a surgical patient with established malnutrition, nutritional support should begin at least 7–10 days prior to surgery. Those patients in whom eating is not anticipated beyond the first five days following surgery should receive the benefits of early enteral or parenteral feeding depending on whether the gut can be used. Compared to parenteral nutrition, enteral nutrition is associated with fewer complications, a decrease in the length of hospital stay, and a favorable cost-benefit analysis. In addition, many patients may benefit from newer enteral formulations such as Immunonutrition as well as disease-specific formulations.
Intestine, immunity, and parenteral nutrition in an era of preferred enteral feeding.
Barrett, Meredith; Demehri, Farokh R; Teitelbaum, Daniel H
2015-09-01
To review the benefits of enteral nutrition in contrast to the inflammatory consequences of administration of parenteral nutrition and enteral deprivation. To present the most recent evidence for the mechanisms of these immunologic changes and discuss potential areas for modification to decrease infectious complications of its administration. There is significant data supporting the early initiation of enteral nutrition in both medical and surgical patients unable to meet their caloric goals via oral intake alone. Despite the preference for enteral nutrition, some patients are unable to utilize their gut for nutritious gain and therefore require parenteral nutrition administration, along with its infectious complications. The mechanisms behind these complications are multifactorial and have yet to be fully elucidated. Recent study utilizing both animal and human models has provided further information regarding parenteral nutrition's deleterious effect on intestinal epithelial barrier function along with the complications associated with enterocyte deprivation. Changes associated with parenteral nutrition administration and enteral deprivation are complex with multiple potential areas for modification to allow for safer administration. Recent discovery of the mechanisms behind these changes present exciting areas for future study as to make parenteral nutrition administration in the enterally deprived patient safer.
PIPIDA scintigraphy for cholecystitis: false positives in alcoholism and total parenteral nutrition
International Nuclear Information System (INIS)
Shuman, W.P.; Gibbs, P.; Rudd, T.G.; Mack, L.A.
1982-01-01
A review of gallbladder scintigraphy in patients with potentially compromised hepatobiliary function revealed two groups in whom cholecystitis might be mistakenly diagnosed. In 200 consecutive hospitalized patients studied with technetium-99m-PIPIDA for acute cholecystitis or cholestasis, there were 41 alcoholics and 17 patients on total parenteral nutrition. In 60% of the alcoholics and 92% of those on parenteral nutrition, absent or delayed visualization of the gallbladder occurred without physical or clinical evidence of cholecystitis. A cholecystagogue, sincalide, did not prevent the false-positive features which presumably are due to altered bile flow kinetics related to alcoholism and parenteral nutrition. Four patients on parenteral nutrition undergoing cholecystectomy for suspected cholecystitis had normal gallbladders filled with jellylike viscous thick bile. A positive (nonvisualized or delayed visualized) gallbladder PIPIDA scintigram in these two populations should not be interpreted as indicating a need for cholecystectomy
Evidence for the use of parenteral nutrition in the pediatric intensive care unit.
Fivez, Tom; Kerklaan, Dorian; Mesotten, Dieter; Verbruggen, Sascha; Joosten, Koen; Van den Berghe, Greet
2017-02-01
During hospitalization in a pediatric intensive care unit (PICU), critically ill children are fed artificially. Administered via the preferred enteral route, caloric targets are often not reached. Hence, parenteral nutrition is given to this patient population. In this review we analyzed the available evidence from randomized controlled trials (RCTs) that supports the use of parenteral nutrition in children during critical illness. A search strategy in Ovid MEDLINE and Ovid EMBASE was created and trial registries were screened to identify the relevant RCTs. Studies were included if they were randomized controlled trials, involved pediatric patients admitted to PICU, and compared different dosing/compositions of parenteral nutrition. Descriptive studies and reviews were excluded. Of the 584 articles identified by the search strategy, only 114 articles were retained after title screening. Further abstract and full text screening identified 6 small RCTs that compared two dosing/composition strategies of parenteral nutrition. These trials reported differences in surrogate endpoints without an effect on hard clinical endpoints. The RCTs observed improvements in these surrogate endpoints with the use of more calories or when parenteral glutamine or fish oil was added. The few RCTs suggest that surrogate endpoints can be affected by providing parenteral nutrition to critically ill children, but the studies were not statistically powered to draw meaningful clinical conclusions. Large RCTs with clinically relevant outcome measures are urgently needed to support the current nutritional guidelines that advise the use of parenteral nutrition in the PICU. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Steroidal Compounds in Commercial Parenteral Lipid Emulsions
Xu, Zhidong; Harvey, Kevin A.; Pavlina, Thomas; Dutot, Guy; Hise, Mary; Zaloga, Gary P.; Siddiqui, Rafat A.
2012-01-01
Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn® II, Liposyn® III, Lipofundin® MCT, Lipofundin® N, Structolipid®, Intralipid®, Ivelip® and ClinOleic®. Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction. PMID:23016123
Steroidal compounds in commercial parenteral lipid emulsions.
Xu, Zhidong; Harvey, Kevin A; Pavlina, Thomas; Dutot, Guy; Hise, Mary; Zaloga, Gary P; Siddiqui, Rafat A
2012-08-01
Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn(®) II, Liposyn(®) III, Lipofundin(®) MCT, Lipofundin(®) N, Structolipid(®), Intralipid(®), Ivelip(®) and ClinOleic(®). Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction.
Directory of Open Access Journals (Sweden)
Manuel Díaz Álvarez
2006-03-01
Full Text Available Se realizó un estudio analítico, retrospectivo, en el que se conformaron dos grupos según el régimen de tratamiento antibiótico parenteral (TAP: corto y largo. Éste fue seguido de antibioticoterapia oral, lo cual generó un ciclo de tratamiento parenteral-oral secuencial al menos de 10 días de duración. Se determinó la tasa de curación de la infección del tracto urinario, las reinfecciones en los primeros 3 meses de edad y la presencia de cicatrices renales. El objetivo fue evaluar la efectividad de un régimen de tratamiento antibiótico parenteral de corta duración (3 días en recién nacidos con infección del tracto urinario alta, de evolución inicial favorable. La tasa de curación de la infección con el TAP corto fue de 93,9 % y con el largo de 97,0 % (p = 0,32. En 5 pacientes del grupo de TAP corto ocurrió reinfección dentro de los 3 meses de edad, mientras que sólo ocurrió en 3 de los que llevaron TAP largo (p = 0,49. En los casos estudiados con gammagrafía con DMSA renal, se constató la presencia de cicatrices renales en 3 de 32 (9,4 % del grupo de TAP corto y en 7 de 33 (21,2 % en los pacientes de TAP largo (p = 0,30. Ambos regímenes de TAP tuvieron similar efectividad.
Iron deficiency anaemia in pregnancy: The role of parenteral iron.
Esen, Umo I
2017-01-01
Maternal and perinatal morbidity and mortality remain major challenges in the delivery of safe maternity care worldwide. Anaemia in pregnancy is an important contributor to this dismal picture, especially where blood transfusion services are poorly developed. An early diagnosis and treatment of iron deficiency anaemia in pregnancy using the new generation dextran-free parenteral iron preparations can save lives and reduce morbidity in selected pregnancies. It is time to cast aside the fears associated with the use of the old parenteral iron preparations which were associated a high incidence of anaphylaxis, and embrace the use of new parenteral iron products which have better side effect profiles and can deliver total dose infusions without the need for test dosing. In selected women, the benefits of this treatment far outweigh any disadvantages.
Clinical relevance of trace element measurement in patients on initiation of parenteral nutrition.
Salota, Rashim; Omar, Sohail; Sherwood, Roy A; Raja, Kishor; Vincent, Royce P
2016-11-01
Background and Aims Serum zinc, copper and selenium are measured in patients prior to commencing on parenteral nutrition; however, their interpretation can be difficult due to acute phase reactions. We assessed (i) the relationship of raised C-reactive protein with trace elements and albumin (ii) benefits of measuring trace elements when C-reactive protein is raised in patients requiring short-term parenteral nutrition. Methods Samples were collected for zinc, copper, selenium and albumin at baseline and then every two weeks and correlated with C-reactive protein results in patients on parenteral nutrition. Results were categorized into four groups based on the C-reactive protein concentrations: (i) 0.05), whereas selenium and albumin were lower in the group with C-reactive protein > 40 mg/L ( P parenteral nutrition, measurement of C-reactive protein is essential when interpreting zinc and selenium but not copper results. Routine measurement of trace elements prior to commencing parenteral nutrition has to be considered on an individual basis in patients with inflammation.
Management of Hyperglycemia During Enteral and Parenteral Nutrition Therapy
Umpierrez, Guillermo E.
2013-01-01
Hyperglycemia is a frequent complication of enteral and parenteral nutrition in hospitalized patients. Extensive evidence from observational studies indicates that the development of hyperglycemia during parenteral and enteral nutrition is associated with an increased risk of death and infectious complications. There are no specific guidelines recommending glycemic targets and effective strategies for the management of hyperglycemia during specialized nutritional support. Managing hyperglycemia in these patients should include optimization of carbohydrate content and administration of intravenous or subcutaneous insulin therapy. The administration of continuous insulin infusion and insulin addition to nutrition bag are efficient approaches to control hyperglycemia during parenteral nutrition. Subcutaneous administration of long-acting insulin with scheduled or corrective doses of short-acting insulin is superior to the sliding scale insulin strategy in patients receiving enteral feedings. Randomized controlled studies are needed to evaluate safe and effective therapeutic strategies for the management of hyperglycemia in patients receiving nutritional support. PMID:23065369
Reversal of growth arrest in adolescents with Crohn's disease after parenteral alimentation.
Layden, T; Rosenberg, F; Nemchausky, G; Elson, C; Rosenberg, I
1976-06-01
Growth arrest and delayed onset of puberty often complicate childhood onset Crohn's disease of the small bowel (granulomatous enteritis). Nutritional deficits arising from inadequate dietary intake, malabsorption, and increased caloric needs may contribute to growth retardation. To assess whether a sustained high caloric and nitrogen intake could reestablish growth, 4 children with extensive Crohn's disease of the small bowel were studied before and after parenteral alimentation which was instituted for symtomatic disease control. Weight gain, positive nitrogen balance, and improved nutritional status were achieved during parenteral alimentation in each patient. In 2 patients weight gain was sustained using oral nutritional supplements, and a substantial increase in linear skeletal growth continued in the ensuing months. One patient entered puberty within 4 months of parenteral alimentation and another had the onset of menarche and the development of secondary sex characteristics 4 months after parenteral alimentation and resection of diseased bowel. Growth may be reestablished in some growth-arrested children if intake is sufficient to establish a sustained positive caloric and nitrogen balance. Nutritional requirements imposed by the demands of growth and active disease and often compounded by the catabolic effects of corticosteroids may be excessive; growth may occur only if these needs are met orally and/or parenterally.
Chemical Incompatibility of Parenteral Drug Admixtures
African Journals Online (AJOL)
1974-09-21
Sep 21, 1974 ... made of a single drug injection at a separate locus. S. Afr. Med. J., 48, 1951 ... and nursing staff with the difficulties of administering safe parenteral ... needle and infusion bottle, but this practice is not common in South Africa.
Chace, Donald H; De Jesús, Víctor R; Lim, Timothy H; Hannon, W Harry; Spitzer, Alan R
2010-11-11
The false positive rate for the newborn screening of disorders of amino acid metabolism for premature infants is higher than full term infants. This may be due to very low birth weight infants receiving high concentrations of amino acids from total parenteral nutrition (TPN) administration and/or immature metabolism. An investigation of the possible influence of TPN on screening of premature infants resulted in the detection of three unusual peaks in the tandem mass spectrometry (MS/MS) acylcarnitine profile. These markers were closely correlated with the detection of very high multiple amino acid increases in the profiles of newborns administered with TPN and who were ultimately found to be normal and free of inherited metabolic disorders. TPN solutions contain a concentrated mixture of amino acids and dextrose and other nutrients in saline. Due to its high concentration and suggestion of a carbohydrate, it was hypothesized that dextrose (D-glucose) was the contaminant and source of the markers detected. Dextrose, stable isotope-labeled 13C6-dextrose and various TPN solutions were analyzed directly or after enrichment in whole blood by multiple MS/MS acquisition modes including MS-only, product and precursor ion and neutral loss scans. Analysis of dried-blood spots (DBS) prepared from whole blood spiked with TPN solutions containing 12.5% dextrose and amino acid formulations designed to deliver 2.5 gm/kg/day of an amino acid mixture had moderate increases of all 3 dextrose markers detected at m/z 325, 399 and 473 as compared to controls. MS-only scans, product and precursor ion scans of dextrose and 13C6-dextrose in positive ion mode confirmed that these 3 peaks are derived from dextrose. Mass spectral analysis of labeled and unlabeled dextrose suggested that these peaks were dimers derived from dextrose. The identification of dextrose markers in DBS indicates that high concentrations of dextrose were present in blood and the likely source was contamination by TPN
DEFF Research Database (Denmark)
Liu, Xiaowen; Nelson, David W; Holst, Jens Juul
2006-01-01
BACKGROUND: Short bowel syndrome (SBS) can lead to intestinal failure and require total or supplemental parenteral nutrition (TPN or PN, respectively). Glucagon-like peptide 2 (GLP-2) is a nutrient-dependent, proglucagon-derived gut hormone that stimulates intestinal adaptation. OBJECTIVE: Our...... objective was to determine whether supplemental enteral nutrients (SEN) modulate the intestinotrophic response to a low dose of GLP-2 coinfused with PN in a rat model of SBS (60% jejunoileal resection plus cecectomy). DESIGN: Rats were randomly assigned to 8 treatments by using a 2 x 2 x 2 factorial design...
Sun, Dongya; Gao, Yifan; Hou, Dianxun; Zuo, Kuichang; Chen, Xi; Liang, Peng; Zhang, Xiaoyuan; Ren, Zhiyong Jason; Huang, Xia
2018-04-01
Recovery of nutrient resources from the wastewater is now an inevitable strategy to maintain the supply of both nutrient and water for our huge population. While the intensive energy consumption in conventional nutrient recovery technologies still remained as the bottleneck towards the sustainable nutrient recycle. This study proposed an enlarged microbial nutrient recovery cell (EMNRC) which was powered by the energy contained in wastewater and achieved multi-cycle nutrient recovery incorporated with in situ wastewater treatment. With the optimal recovery solution of 3 g/L NaCl and the optimal volume ratio of wastewater to recovery solution of 10:1, >89% of phosphorus and >62% of ammonium nitrogen were recovered into struvite. An extremely low water input ratio of water. It was proved the EMNRC system was a promising technology which could utilize the chemical energy contained in wastewater itself and energy-neutrally recover nutrient during the continuous wastewater purification process.
Trace Elements in Parenteral Nutrition: Considerations for the Prescribing Clinician.
Jin, Jennifer; Mulesa, Leanne; Carrilero Rouillet, Mariana
2017-04-28
Trace elements (TEs) are an essential component of parenteral nutrition (PN). Over the last few decades, there has been increased experience with PN, and with this knowledge more information about the management of trace elements has become available. There is increasing awareness of the effects of deficiencies and toxicities of certain trace elements. Despite this heightened awareness, much is still unknown in terms of trace element monitoring, the accuracy of different assays, and current TE contamination of solutions. The supplementation of TEs is a complex and important part of the PN prescription. Understanding the role of different disease states and the need for reduced or increased doses is essential. Given the heterogeneity of the PN patients, supplementation should be individualized.
Steroidal Compounds in Commercial Parenteral Lipid Emulsions
Directory of Open Access Journals (Sweden)
Rafat A. Siddiqui
2012-08-01
Full Text Available Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn® II, Liposyn® III, Lipofundin® MCT, Lipofundin® N, Structolipid®, Intralipid®, Ivelip® and ClinOleic®. Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction.
Home parenteral nutrition in treatment of severe radiation enteritis
International Nuclear Information System (INIS)
Miller, D.G.; Ivey, M.; Young, J.
1979-01-01
Ten patients with radiation enteritis unresponsive to conventional medical and surgical therapy were put on long-term parenteral nutrition at home. Six of the patients are alive at home; four patients died, two from recurrent cancer. Some of the patients have been able to resume oral intake, but none have been able to discontinue parenteral nutrition. Fistulas healed or had a marked decrease in output. Two patients in our series were given prednisone and sulfasalazine without significant benefit, in contrast to previously reported clinical improvement of radiation enteritis with this therapy
van der Poll, T.; Levi, M. [=Marcel M.; Braxton, C. C.; Coyle, S. M.; Roth, M.; ten Cate, J. W.; Lowry, S. F.
1998-01-01
Venous thrombosis and bacterial infections are common complications of parenteral nutrition. To test the hypothesis that infection facilitates activation of coagulation during parenteral nutrition, healthy subjects were intravenously injected with endotoxin (2 ng/kg) after they had received either 1
Intensive medicine – Guidelines on Parenteral Nutrition, Chapter 14
Directory of Open Access Journals (Sweden)
Kreymann, G.
2009-11-01
Full Text Available In intensive care patients parenteral nutrition (PN should not be carried out when adequate oral or enteral nutrition is possible. Critically ill patients without symptoms of malnutrition, who probably cannot be adequately nourished enterally for a period of <5 days, do not require full PN but should be given at least a basal supply of glucose. Critically ill patients should be nourished parenterally from the beginning of intensive care if they are unlikely to be adequately nourished orally or enterally even after 5–7 days. Critically ill and malnourished patients should, in addition to a possible partial enteral nutrition, be nourished parenterally. Energy supply should not be constant, but should be adapted to the stage, the disease has reached. Hyperalimentation should be avoided at an acute stage of disease in any case. Critically ill patients should be given, as PN, a mixture consisting of amino acids (between 0.8 and 1.5 g/kg/day, carbohydrates (around 60% of the non-protein energy and fat (around 40% of the non-protein energy as well as electrolytes and micronutrients.
O significado da nutrição parenteral para o cliente no contexto hospitalar
Directory of Open Access Journals (Sweden)
Consuelo Helena Aires de Freitas Lopes
1996-06-01
Full Text Available A necessidade de compreender o significado da nutrição parenteral para o cliente no contexto hospitalar surgiu das nossas inquietações diante do cuidado de enfermagem. Realizaram-se observações participantes, entrevistas e anotações de campo junto a sete clientes hospitalizados, que se encontravam sob nutrição parenteral. O sentido das investigações foi centrado na indagação: como você está se sentindo com a nutrição parenteral? Os dados foram analisados numa abordagem interacionista, mostrando as dificuldades enfrentadas pelos clientes na assistência hospitalar, como percebiam eles a nutrição parenteral e que significados eram atribuídos a essa terapêutica. O estudo revelou os sentimentos, comportamentos e atitudes relacionados aos aspectos biológico, emocional e sócio-cultural do cliente, ligados à nutrição parenteral, demonstrando, também as limitações impostas ao cliente sob esse tratamento, bem como as dificuldades na assistência de enfermagem.
Pulmonary nodules secondary to total parenteral alimentation
International Nuclear Information System (INIS)
Landry, B.A.; Melhem, R.E.
1989-01-01
A seven-year-old male, who had a retroperitoneal alveolar rhabdomyosarcoma and was on total parenteral alimentation (TPN) developed muliple pulmonary nodules, indistinguishable from metastases. These proved to be multiple lipid emboli on open biopsy. (orig.)
Parenteral nutrition in malnourished patients; Parenteralna vyziva u malnutricnych pacientov
Energy Technology Data Exchange (ETDEWEB)
Lichvarova, I. [OAIM, Narodny onkologicky ustav, Bratislava (Slovakia)
2011-07-01
Parenteral nutrition became a routine therapeutic option in malnourished patients, if conventional nutritional enteral support is not effective. Cachexia and malnutrition prolong the wound healing, contribute to immunosuppression, increase morbidity and the cost of treatment. Using of a malnutrition protocol as a screening tool is necessary to sort out malnourished patients. Parenteral nutrition is therefore an important part of the multimodal therapy and from the medical and the ethical point of view is a great mistake not to feed a patient. (author)
Prolonged parenteral nutrition after neonatal gastrointestinal surgery
DEFF Research Database (Denmark)
Estmann, Anne; Qvist, Niels; Husby, Steffen
2002-01-01
to diagnosis and clinical course. METHODOLOGY: This study reviews the clinical course of infants with gastrointestinal disease (gastroschisis, intestinal atresia, omphalocele, volvulus, Hirschsprung's disease and necrotizing enterocolitis) with a prolonged need for parenteral nutrition in the Western part...
Directory of Open Access Journals (Sweden)
José E. Aguilar-Nascimento
1997-09-01
Full Text Available The objective of this study was to investigate the effect of an elemental diet (ED on the strength and on the morphology of the small bowel. Male Wistar rats were randomized to two groups to receive during 14 days either standard laboratory rat chow (N=16 or ED (N=16 containing total parenteral nutrition (TPN solution. After this period they were killed and necropsied. The small bowel was measured and weighted with and without the contents. Bursting pressure (BP was taken from the jejunum and ileum and histological sections of these two portions was performed to register the crypt depth (CD, vilus height (VH and wall width (WW. All animals significantly gain weight. The bowel of animals fed with TPN solution had significantly less weight when compared with the controls either with (9.9 ± 1.9g x 7.8 ± 1.5g, pForam submetidos a ração padrão de laboratório 16 ratos e outros 16 receberam nutrição parenteral total (NPT por via oral, durante 14 dias. Os animais de ambos os grupos ganharam peso, sem diferença estatistica. Na necrópsia retirava-se o segmento intestinal a partir do piloro até a valva ileocecal. Não houve diferença no comprimeto do intestino delgado em ambos os grupos. Porém, o intestino dos animais alimentados com NTP apresentaram diminuiçao significante de peso comparado com o grupo controle, independentemente da presença ou não de conteúdo. A resistência intestinal era menor no grupo NTP comparado ao controle, sendo mais significante no íleo. A altura dos vilos, a profundidade das criptas e a extensão da parede eram significantemente menores no íleo no grupo NTP comparado ao controle. Este achado foi observado também no jejuno, mas sem diferença significante. Conclui-se que nos ratos alimentados com NTP o intestino delgado perde massa e torna-se menos resistente, principalmente no íleo,apesar da manutenção do estado nutricional. A perda de massa aparece não apenas na mucosa mas em toda a parede intestinal.
ESPEN Guidelines on Parenteral Nutrition: home parenteral nutrition (HPN) in adult patients
DEFF Research Database (Denmark)
Staun, M.; Pironi, L.; Bozzetti, F.
2009-01-01
Home parenteral nutrition (HPN) was introduced as a treatment modality in the early 1970s primarily for the treatment of chronic intestinal failure in patients with benign disease. The relatively low morbidity and mortality associated with HPN has encouraged its widespread use in western countries....... Thus there is huge clinical experience, but there are still few controlled clinical studies of treatment effects and management of complications. The purpose of these guidelines is to highlight areas of good practice and promote the use of standardized treatment protocols between centers...
Stability investigation of total parenteral nutrition admixture prepared in a hospital pharmacy
Directory of Open Access Journals (Sweden)
Mirković Dušica
2008-01-01
Full Text Available Background/Aim. In the cases when nutrition of patients can not be orally nor enterally performed, parenteral nutrition is a method of the therapy that provides more successful and rapid recovery. In that way, hospitalization can be significantly shorter, healing costs reduced and mortality minimized. Total parenteral nutrition (TPN admixtures are the most complex systems which contain amino acids, carbohydrates, lipid emulsion, macroelectrolytes (Na+, K+, Ca2+, Mg2+, Cl-, SO42-, PO43-, oligoelements, hydro- and liposoluble vitamines, heparin, insulin and water. Concerning the mentioned complexity, special attention should be payed to physicochemical and microbiological stability of a mixture, because of interactions among components, that can be very hard to analyze. The aim of this study was to investigate the problem of stability of TPN admixtures prepared in a hospital pharmacy. Methods. Admixture TPN was aseptically prepared in laminar air - flow environment on the basis of the specified order in supplementing components and additives to basic solutions. Solutions were kept in sterile multicompartment ethylene-vinyl-acetate bags. After preparation and slow homogenization, TPN admixtures were submitted to physicochemical and microbiological stability analyses in various period of time. The assessment of physical stability of TPN admixture was done on the basis of visual inspection, determination of pH value and measuring of particle size. The investigation of sterility and pyrogenic test were performed according to Ph. Yug. V regulations. Results. Physico-chemical and microbiological analyses were applied and no significant changes in visual sense, pH value and droplet size stability of the TPN admixture were observed during the period of 60 hours. The lipid droplets were smaller in size than 5 μm, that is the most common pharmacopoeia requirement. Conclusion. The results of our study confirmed that a TPN admixture prepared in a hospital
Solid lipid nanoparticles for parenteral drug delivery
Wissing, S.A.; Kayser, Oliver; Muller, R.H.
2004-01-01
This review describes the use of nanoparticles based on solid lipids for the parenteral application of drugs. Firstly, different types of nanoparticles based on solid lipids such as "solid lipid nanoparticles" (SLN), "nanostructured lipid carriers" (NLC) and "lipid drug conjugate" (LDC)
Microbiocidal effects of various taurolidine containing catheter lock solutions
Olthof, E.D.; Nijland, R van; Gulich, A.F.; Wanten, G.J.A.
2015-01-01
BACKGROUND & AIMS: We have recently shown that a catheter lock solution containing taurolidine dramatically decreases catheter-related bloodstream infections (CRBSI) in patients on home parenteral nutrition (HPN) when compared to heparin. Since several taurolidine formulations are commercially
Schrumpf, Marion; Axmacher, Jan C; Zech, Wolfgang; Lehmann, Johannes; Lyaruu, Herbert V C
2007-04-15
At the lower parts of the forest belt at Mt. Kilimanjaro, selective logging has led to a mosaic of mature forest, old secondary forests ( approximately 60 years), and old clearings ( approximately 10 years) covered by shrub vegetation. These variations in the vegetation are reflected by differences in nutrient leaching from the canopy and in both amount and quality of litter reaching the ground, thereby also influencing mineralization rates and the composition of seepage water in litter percolate and soil solution. The aim of this study was to investigate how above- and belowground nutrient dynamics vary between regeneration stages, and if forest regeneration at the clearings is hampered by a deterioration of abiotic site conditions. K, Mg, Ca, Na and N compounds were analysed in rainfall, throughfall, organic layer percolate and the soil solution to a depth of 1.00 m at three clearings, three secondary forest and four mature forest sites. Element fluxes via throughfall showed only small variations among regeneration stages except for K and NO(3)-N. With 57-83 kg ha(-1) a(-1)and 2.6-4.1 kg ha(-1) a(-1) respectively, K and NO(3)-N fluxes via throughfall were significantly higher at the clearings than at the mature forest sites (32-37 and 0.7-1.0 kg ha(-1) a(-1) for K and NO(3)-N). In organic layer percolate and in soil solution at 0.15-m soil depth, concentrations of K, Mg, Ca and N were highest at the clearings. In the organic layer percolate, median K concentrations were e.g. 7.4 mg l(-1) for the clearings but only 1.4 mg l(-1) for the mature forests, and for NO(3)-N, median concentrations were 3.1 mg l(-1) for the clearings but only 0.92 mg l(-1) for the mature forest sites. Still, differences in annual means between clearings and mature forests were not always significant due to a high variability within the clearings. With the exception of NO(3)-N, belowground nutrient concentrations in secondary forests ranged between concentrations in mature forests and
Salih, Muhannad R M; Bahari, Mohd Baidi; Abd, Arwa Y
2010-12-31
To conduct a systematic review for the evidence supporting or disproving the reality of parenteral nutrition- antiepileptic drugs interaction, especially with respect to the plasma protein-binding of the drug. The articles related to the topic were identified through Medline and PubMed search (1968-Feburary 2010) for English language on the interaction between parenteral nutrition and antiepileptic drugs; the search terms used were anti-epileptic drugs, parenteral nutrition, and/or interaction, and/or in vitro. The search looked for prospective randomized and nonrandomized controlled studies; prospective nonrandomized uncontrolled studies; retrospective studies; case reports; and in vitro studies. Full text of the articles were then traced from the Universiti Sains Malaysia (USM) library subscribed databases, including Wiley-Blackwell Library, Cochrane Library, EBSCOHost, OVID, ScienceDirect, SAGE Premier, Scopus, SpringerLINK, and Wiley InterScience. The articles from journals not listed by USM library were traced through inter library loan. There were interactions between parenteral nutrition and drugs, including antiepileptics. Several guidelines were designed for the management of illnesses such as traumatic brain injuries or cancer patients, involving the use of parenteral nutrition and antiepileptics. Moreover, many studies demonstrated the in vitro and in vivo parenteral nutrition -drugs interactions, especially with antiepileptics. There was no evidence supporting the existence of parenteral nutrition-antiepileptic drugs interaction. The issue has not been studied in formal researches, but several case reports and anecdotes demonstrate this drug-nutrition interaction. However, alteration in the drug-free fraction result from parenteral nutrition-drug (i.e. antiepileptics) interactions may necessitate scrupulous reassessment of drug dosages in patients receiving these therapies. This reassessment may be particularly imperative in certain clinical situations
Cost analysis of neonatal and pediatric parenteral nutrition in Europe: a multi-country study.
Walter, E; Liu, F X; Maton, P; Storme, T; Perrinet, M; von Delft, O; Puntis, J; Hartigan, D; Dragosits, A; Sondhi, S
2012-05-01
Parenteral nutrition (PN) is critical in neonatal and pediatric care for patients unable to tolerate enteral feeding. This study assessed the total costs of compounding PN therapy for neonates, infants and children. Face-to-face and telephone interviews were conducted in 12 hospitals across four European countries (Belgium, France, Germany and UK) to collect information on resources utilized to compound PN, including nutrients, staff time, equipment cost and supplies. A bottom-up cost model was constructed to assess total costs of PN therapy by assigning monetary values to the resource utilization using published list prices and interview data. A total of 49,922 PN bags per year were used to treat 4295 neonatal and pediatric patients among these hospitals. The daily total costs of one compounded PN bag for neonates in the 12 hospitals across the four countries equalled euro 55.16 (Belgium euro 53.26, France euro 46.23, Germany euro 64.05, UK Ł 37.43/\\[euro]42.86). Overall, nutrients accounted for 25% of total costs, supplies 18%, wages 54% and equipment 3%. Average costs per bag for infants France, euro 92.70 in Germany and Ł 52.63/euro 60.26 in the UK), and for children 2-18 years euro 118.02 (euro 93.85 in Belgium, euro 121.35 in France, euro 124.54 in Germany and Ł 69.49/euro 79.56 in the UK), of which 63% is attributable to nutrients and 28% to wages. The data indicated that PN costs differ among countries and a major proportion was due to staff time (Ł 1=euro 1.144959).
Home parenteral nutrition in management of patients with severe radiation enteritis
International Nuclear Information System (INIS)
Lavery, I.C.; Steiger, E.; Fazio, V.W.
1980-01-01
Five patients who would have been unable to survive because of intestinal complications of radiation therapy were able to lead an otherwise normal life with the use of parenteral nutrition administered at home. One patient died of recurrent carcinoma of the cervix after 14 months. Another patient died as the result of a totally avoidable pharmaceutical error after 2 1/2 years. The remaining three are still disease free without morbidity relating to the parenteral nutrition
Evaluation of the hepatobiliary function with 99mTc-EHIDA imaging during total parenteral nutrition
International Nuclear Information System (INIS)
Zhou Qian; Jiang Zhouming; Yang Meifang
1988-01-01
14 surgical patients with non-hepatobiliary diseases were studied with 99m Tc-EHIDA imaging to evaluate the effect of total parenteral nutrition (TPN) on the hepatobiliary function. Duration of TPN ranged from 6-56 days, 10 of the 14 patients Beijing within 10 days. The results showed that: (1) 11 of 14 patients had abnormal scintigraphic features. The most prominet findings were delayed liver excretion and prolonged blood clearance time. This fact suggests that not only the rate of excretion of the bile from the liver is decreased but the uptake ability of the hepatorcyte is also impaired. (2) The effect of TPN on liver function is reversible. It was concluded that in order to prevent irreversible damage of hepatobiliary function caused by TPN, the duration of TPN should not be too long and oral intake of nutrients should be resumed as soon as possible
Brief Parenteral Nutrition Accelerates Weight Gain, Head Growth Even in Healthy VLBWs
Morisaki, Naho; Belfort, Mandy B.; McCormick, Marie C.; Mori, Rintaro; Noma, Hisashi; Kusuda, Satoshi; Fujimura, Masanori
2014-01-01
Introduction Whether parenteral nutrition benefits growth of very low birth weight (VLBW) preterm infants in the setting of rapid enteral feeding advancement is unclear. Our aim was to examine this issue using data from Japan, where enteral feeding typically advances at a rapid rate. Methods We studied 4005 hospitalized VLBW, very preterm (23–32 weeks' gestation) infants who reached full enteral feeding (100 ml/kg/day) by day 14, from 75 institutions in the Neonatal Research Network Japan (2003–2007). Main outcomes were weight gain, head growth, and extra-uterine growth restriction (EUGR, measurement parenteral nutrition. Adjusting for maternal, infant, and institutional characteristics, infants who received parenteral nutrition had greater weight gain [0.09 standard deviation (SD), 95% CI: 0.02, 0.16] and head growth (0.16 SD, 95% CI: 0.05, 0.28); lower odds of EUGR by head circumference (OR 0.66, 95% CI: 0.49, 0.88). No statistically significant difference was seen in the proportion of infants with EUGR at discharge. SGA infants and infants who took more than a week until full feeding had larger estimates. Discussion Even in infants who are able to establish enteral nutrition within 2 weeks, deprivation of parenteral nutrition in the first weeks of life could lead to under nutrition, but infants who reached full feeding within one week benefit least. It is important to predict which infants are likely or not likely to advance on enteral feedings within a week and balance enteral and parenteral nutrition for these infants. PMID:24586323
Tindall, J.A.; Weeks, E.P.; Friedel, M.
2005-01-01
The objective of this study was to test the effectiveness of a nitrate-rich nutrient solution and hydrogen peroxide (H2O2) to enhance in-situ microbial remediation of toluene in the unsaturated zone. Three sand-filled plots were tested in three phases (each phase lasting approximately 2 weeks). During the control phase, toluene was applied uniformly via sprinkler irrigation. Passive remediation was allowed to occur during this phase. A modified Hoagland nutrient solution, concentrated in 150 L of water, was tested during the second phase. The final phase involved addition of 230 moles of H2O2 in 150 L of water to increase the available oxygen needed for aerobic biodegradation. During the first phase, measured toluene concentrations in soil gas were reduced from 120 ppm to 25 ppm in 14 days. After the addition of nutrients during the second phase, concentrations were reduced from 90 ppm to about 8 ppm within 14 days, and for the third phase (H 2O2), toluene concentrations were about 1 ppm after only 5 days. Initial results suggest that this method could be an effective means of remediating a contaminated site, directly after a BTEX spill, without the intrusiveness and high cost of other abatement technologies such as bioventing or soil-vapor extraction. However, further tests need to be completed to determine the effect of each of the BTEX components. ?? Springer 2005.
Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery
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Mohammadtaghi Rajabi Mashhadi
2015-09-01
Full Text Available Introduction: The incidence of malnutrition in hospitalized patients is reported to be high. In particular, patients with esophageal cancer are prone to malnutrition, due to preoperative digestive system dysfunctions and short-term non-oral feeding postoperatively. Selection of an appropriate method for feeding in the postoperative period is important in these patients. Materials and Methods: In this randomized clinical trial, 40 patients with esophageal cancer who had undergone esophagectomy between September 2008 and October 2009 were randomly assigned into either enteral feeding or parenteral feeding groups, with the same calorie intake in each group. The level of serum total protein, albumin, prealbumin, transferrin, C3, C4 and hs-C-reactive protein (hs-CRP, as well as the rate of surgical complications, restoration of bowel movements and cost was assessed in each group. Results: Our results showed that there was no significant difference between the groups in terms of serum albumin, prealbumin or transferrin. However, C3 and C4 levels were significantly higher in the enteral feeding group compared with the parenteral group, while hs-CRP level was significantly lower in the enteral feeding group. Bowel movements were restored sooner and costs of treatment were lower in the enteral group. Postoperative complications did not differ significantly between the groups. There was one death in the parenteral group 10 days after surgery due to myocardial infarction. Conclusion: The results of our study showed that enteral feeding can be used effectively in the first days after surgery, with few early complications and similar nutritional outcomes compared with the parenteral method. Enteral feeding was associated with reduced inflammation and was associated with an improvement in immunological responses, quicker return of bowel movements, and reduced costs in comparison with parenteral feeding.
Parenteral nutrition in very low birth weight infants in the United Kingdom and Ireland.
LENUS (Irish Health Repository)
Hopewell, J
2012-02-01
Parenteral nutrition (PN) plays an important role in providing nutrients for infants unable to tolerate enteral feeds study was to look at PN prescribing in neonatal units in the United Kingdom (U.K.) and Ireland, in particular in infants < 1.5 kg. A postal questionnaire was administered to the 235 neonatal units. The response rate was 179 (76%), of which 136 (76%) used PN. The initial amount of protein prescribed was 0.1-2 g\\/kg\\/day in 102 units (91%), >2 g\\/kg\\/day in 4 (4%) and 5 (5%) used no protein. 88 (80%) started lipids with the first PN prescription. Only 5 units (5%) started with >1 g\\/kg\\/day. The maximum dose of lipids and protein both varied from 2 - >4 g\\/kg\\/day. The initial glucose infusion rate was 4-8 mg\\/kg\\/min. Interestingly only 44% of units started PN in the first 24 hours of age. Hence results show great variation in PN prescribing.
Use of ultraviolet-disinfected nutrient solutions in greenhouses
International Nuclear Information System (INIS)
Acher, A.; Heuer, B.; Rubinskaya, E.; Fischer, E.
1997-01-01
Environmental concerns and economics require the recycling of plant nutrient solutions (PNS) used in soilless cultures in greenhouses. To avoid possible outbreaks of plant diseases, disinfection of the recycled PNS might be necessary. This paper describes a case study on the stability of Fe 3+ -chelates, present in PNS and exposed to ultraviolet radiation (UV 254 nm) for disinfection, and the effect on plant growth. Three Fe-chelates, each containing 2 mg Fe 3+ l -1 , in PNS were: i, Fe-EDDHA (Fe-ethylene-diamine-dihydroxyphenyl acetic acid); ii, Fe-Na-EDTA (Fe-ethylene-diamine-tetraacetic acid); and iii, Fe-DTPA (Fe-diethylene-triamine-pentaacetic acid). Seedlings of sorghum, corn and tomatoes were grown hydroponically for four weeks in continuously aerated PNS, which had been exposed previously for 0, 2.5 and 130 s to a UV radiation fluence of 80 mW s -1 cm -2 . The accumulation of plant fresh weight (APFW) differed from non-treated controls, depending on chelating agent and on exposure time to UV. The greatest APFW was observed in sorghum (128, 178 and 98%) at 2.5 s UV-exposure for PNS containing i, ii and iii, respectively. For corn and tomato, the respective results were: 108, 139 and 96%, and 129, 91 and 89% for tomatoes, respectively. The stability of i, ii and iii upon exposure to UV radiation is discussed. (author)
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Abd Arwa Y
2010-12-01
Full Text Available Abstract Objectives To conduct a systematic review for the evidence supporting or disproving the reality of parenteral nutrition- antiepileptic drugs interaction, especially with respect to the plasma protein-binding of the drug. Methods The articles related to the topic were identified through Medline and PubMed search (1968-Feburary 2010 for English language on the interaction between parenteral nutrition and antiepileptic drugs; the search terms used were anti-epileptic drugs, parenteral nutrition, and/or interaction, and/or in vitro. The search looked for prospective randomized and nonrandomized controlled studies; prospective nonrandomized uncontrolled studies; retrospective studies; case reports; and in vitro studies. Full text of the articles were then traced from the Universiti Sains Malaysia (USM library subscribed databases, including Wiley-Blackwell Library, Cochrane Library, EBSCOHost, OVID, ScienceDirect, SAGE Premier, Scopus, SpringerLINK, and Wiley InterScience. The articles from journals not listed by USM library were traced through inter library loan. Results There were interactions between parenteral nutrition and drugs, including antiepileptics. Several guidelines were designed for the management of illnesses such as traumatic brain injuries or cancer patients, involving the use of parenteral nutrition and antiepileptics. Moreover, many studies demonstrated the in vitro and in vivo parenteral nutrition -drugs interactions, especially with antiepileptics. Conclusions There was no evidence supporting the existence of parenteral nutrition-antiepileptic drugs interaction. The issue has not been studied in formal researches, but several case reports and anecdotes demonstrate this drug-nutrition interaction. However, alteration in the drug-free fraction result from parenteral nutrition-drug (i.e. antiepileptics interactions may necessitate scrupulous reassessment of drug dosages in patients receiving these therapies. This
MRI in children receiving total parenteral nutrition
International Nuclear Information System (INIS)
Quaghebeur, G.; Taylor, W.J.; Kingsley, D.P.E.; Fell, J.M.E.; Reynolds, A.P.; Milla, P.J.
1996-01-01
Cranial MRI was obtained in 13 of a group of 57 children receiving long-term parenteral nutrition, who were being investigated for hypermanganasaemia. Increased signal intensity on T1-weighted images has been reported in adult patients on long-term parenteral nutrition and with encephalopathy following chronic manganese exposure in arc welding. It has been postulated that these changes are due to deposition of the paramagnetic trace element manganese. In excess manganese is hepato- and neurotoxic and we present the correlation of whole blood manganese levels with imaging findings. The age range of our patients was 6 months to 10 years, and the duration of therapy 3 months to 10 years. In 7 children we found characteristic increased signal intensity on T1-weighted images, with no abnormality on T2-weighted images. All patients had elevated whole blood manganese levels, suggesting that the basis for this abnormality is indeed deposition of manganese within the tissues. (orig.). With 3 figs
Parenteral treatment of episodic tension-type headache: a systematic review.
Weinman, Danielle; Nicastro, Olivia; Akala, Olabiyi; Friedman, Benjamin W
2014-02-01
Tension-type headache is highly prevalent in the general population and is a consistent if not frequent cause of visits to acute care settings. Analgesics such as nonsteroidal anti-inflammatory drugs, acetaminophen, and salicylates are considered first-line therapy for treatment of tension-type headache. For patients who present to an acute care setting with persistent tension-type headache despite analgesic therapy, it is not clear which parenteral agent should be administered. We performed a systematic review of the medical literature to determine whether parenteral therapies other than salicylates or nonsteroidals are efficacious for acute tension-type headache. We performed a systematic review of Medline, EMBASE, CINAHL, Google scholar, and the Cochrane Central Registry of Controlled Trials from inception through August, 2012 using the search terms "tension-type headache" and "parenteral or subcutaneous or intramuscular or intravenous." Our goal was to identify randomized trials in which one parenteral treatment was compared to another active comparator or to placebo for the acute relief of tension-type headache. Parenteral was defined as intravenous, intramuscular, or subcutaneous administration. We only included studies that distinguished tension-type headache from other primary headache disorders, such as migraine. The primary outcome for this review was measures of efficacy one hour after medication administration. Data abstraction was performed by two authors. Disagreements were resolved by a third author. We assessed the internal validity of trials using the Cochrane Collaboration risk of bias tool. Because of the small number of trials identified, and the substantial heterogeneity among study design and medications, we decided that combining data and reporting summary statistics would serve no useful function. The results of individual studies are presented using Number Needed to Treat (NNT) with 95%CI when dichotomous outcomes were available and
Water, electrolytes, vitamins and trace elements – Guidelines on Parenteral Nutrition, Chapter 7
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Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine
2009-11-01
Full Text Available A close cooperation between medical teams is necessary when calculating the fluid intake of parenterally fed patients. Fluids supplied parenterally, orally and enterally, other infusions, and additional fluid losses (e.g. diarrhea must be considered. Targeted diagnostic monitoring (volume status is required in patients with disturbed water or electrolyte balance. Fluid requirements of adults with normal hydration status is approximately 30–40 ml/kg body weight/d, but fluid needs usually increase during fever. Serum electrolyte concentrations should be determined prior to PN, and patients with normal fluid and electrolyte balance should receive intakes follwing standard recommendations with PN. Additional requirements should usually be administered via separate infusion pumps. Concentrated potassium (1 mval/ml or 20% NaCl solutions should be infused via a central venous catheter. Electrolyte intake should be adjusted according to the results of regular laboratory analyses. Individual determination of electrolyte intake is required when electrolyte balance is initially altered (e.g. due to chronic diarrhea, recurring vomiting, renal insufficiency etc.. Vitamins and trace elements should be generally substituted in PN, unless there are contraindications. The supplementation of vitamins and trace elements is obligatory after a PN of >1 week. A standard dosage of vitamins and trace elements based on current dietary reference intakes for oral feeding is generally recommended unless certain clinical situations require other intakes.
Methods of preparing and using intravenous nutrient compositions
International Nuclear Information System (INIS)
Beigler, M.A.; Koury, A.J.
1983-01-01
A method for preparing a stable, dry-packaged, sterile, nutrient composition which upon addition of sterile, pyrogen-free water is suitable for intravenous administration to a mammal, including a human, is described. The method comprises providing the nutrients in a specific dry form and state of physical purity acceptable for intravenous administration, sealing the nutrients in a particular type of container adapted to receive and dispense sterile fluids and subjecting the container and its sealed contents to a sterilizing, nondestructive dose of ionizing radiation. The method results in a packaged, sterile nutrient composition which may be dissolved by the addition of sterile pyrogen-free water. The resulting aqueous intravenous solution may be safely administered to a mammal in need of nutrient therapy. The packaged nutrient compositions of the invention exhibit greatly extended storage life and provide an economical method of providing intravenous solutions which are safe and efficacious for use. (author)
Zinc: physiology, deficiency, and parenteral nutrition.
Livingstone, Callum
2015-06-01
The essential trace element zinc (Zn) has a large number of physiologic roles, in particular being required for growth and functioning of the immune system. Adaptive mechanisms enable the body to maintain normal total body Zn status over a wide range of intakes, but deficiency can occur because of reduced absorption or increased gastrointestinal losses. Deficiency impairs physiologic processes, leading to clinical consequences that include failure to thrive, skin rash, and impaired wound healing. Mild deficiency that is not clinically overt may still cause nonspecific consequences, such as susceptibility to infection and poor growth. The plasma Zn concentration has poor sensitivity and specificity as a test of deficiency. Consequently, diagnosis of deficiency requires a combination of clinical assessment and biochemical tests. Patients receiving parenteral nutrition (PN) are susceptible to Zn deficiency and its consequences. Nutrition support teams should have a strategy for assessing Zn status and optimizing this by appropriate supplementation. Nutrition guidelines recommend generous Zn provision from the start of PN. This review covers the physiology of Zn, the consequences of its deficiency, and the assessment of its status, before discussing its role in PN. © 2015 American Society for Parenteral and Enteral Nutrition.
Product quality of parenteral vancomycin products in the United States.
Nambiar, S; Madurawe, R D; Zuk, S M; Khan, S R; Ellison, C D; Faustino, P J; Mans, D J; Trehy, M L; Hadwiger, M E; Boyne, M T; Biswas, K; Cox, E M
2012-06-01
In response to concerns raised about the quality of parenteral vancomycin products, the U.S. Food and Drug Administration (FDA) is investigating the product quality of all FDA-approved parenteral vancomycin products available in the United States. Product quality was evaluated independently at two FDA Office of Testing and Research (FDA-OTR) sites. In the next phase of the investigation, being done in collaboration with the National Institute of Allergy and Infectious Diseases, the in vivo activity of these products will be evaluated in an appropriate animal model. This paper summarizes results of the FDA investigation completed thus far. One site used a validated ultrahigh-pressure liquid chromatography method (OTR-UPLC), and the second site used the high-performance liquid chromatography (HPLC) method for related substances provided in the British Pharmacopeia (BP) monograph for vancomycin intravenous infusion. Similar results were obtained by the two FDA-OTR laboratories using two different analytical methods. The products tested had 90 to 95% vancomycin B (active component of vancomycin) by the BP-HPLC method and 89 to 94% vancomycin by OTR-UPLC methods. Total impurities were 5 to 10% by BP-HPLC and 6 to 11% by OTR-UPLC methods. No single impurity was >2.0%, and the CDP-1 level was ≤ 2.0% across all products. Some variability in impurity profiles of the various products was observed. No adverse product quality issues were identified with the six U.S. vancomycin parenteral products. The quality parameters of all parenteral vancomycin products tested surpassed the United States Pharmacopeia acceptance criteria. Additional testing will characterize in vivo performance characteristics of these products.
2011-08-16
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] 2011 Parenteral Drug Association/Food and Drug Administration Joint Public Conference; Quality and...: Notice of public conference. The Food and Drug Administration (FDA), in cosponsorship with Parenteral...
Iodine Supplementation for Pediatric Patients Receiving Long-Term Parenteral Nutrition.
Santoro, Jonathan D; Nespor, Colleen; Poole, Robert L; Kerner, John A
2016-04-01
Patients dependent on parenteral nutrition (PN) are among a group at risk of developing iodine deficiency. Supplementation with iodine in this population has been debated in a number of studies, resulting in variable clinical practices. The Committee on Clinical Practice Issues of the American Society for Clinical Nutrition recommends a dose of 1 mcg/kg/d of parenteral iodine for patients receiving PN. At our institution, PN trace elements do not include iodine, although this is not the case internationally. Our study sought to assess iodine levels and thyroid function in a cohort of PN-dependent pediatric patients. A retrospective analysis studied 32 pediatric patients with a variety of medical diagnoses who received PN as a primary means of nutrition for 6 months or longer. Patients received variable proportions of their total caloric intake as PN, which ranged from 14%-100%. Iodine and thyroid function levels were obtained by serum sampling. No patient in our cohort of 32 demonstrated thyroid dysfunction or developed iodine deficiency. The length of time on PN and the percentage of total nutrition intake as PN were not associated with iodine levels (P Parenteral and Enteral Nutrition.
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Langhoff Jens D
2007-05-01
Full Text Available Abstract Background Several diseases affect bone healing and physiology. Many drugs that are commonly used in orthopaedics as "analgesics" or anti-inflammatory agents impair bone healing. Stressful conditions are associated with decreased serum osteocalcin concentration. High endorphin levels alter calcium metabolism, blocking the membrane channels by which calcium normally enters cells. The consequent decrease of intracellular calcium impairs the activities of calcium-related enzymes. Naloxone is a pure opioid antagonist. Morphine-induced osteocalcin inhibition was abolished when osteoblasts were incubated with naloxone. Naloxone restored the altered cellular and tissue physiology by removing β-endorphins from specific receptors. However, this is only possible if the circulating Ca concentration is adequate. The aim of the present study was to evaluate the efficacy of parenteral naloxone administration in inducing fast mineralization and callus remodelling in a group of sheep with a standardised bone lesion. Methods Twenty ewes were randomly assigned to 4 treatment groups. Group A acted as control, group B received a solution of calcium gluconate, group C a solution of naloxone, and group D a solution of calcium gluconate and naloxone. A transverse hole was drilled in the left metacarpus, including both cortices, then parenteral treatment was administered intramuscularly, daily for four weeks. Healing was evaluated by weekly radiographic examination for eight weeks. For quantitative evaluation, the ratio of the radiographic bone density between the drill area and the adjacent cortical bone was calculated. After eight weeks the sheep were slaughtered and a sample of bone was collected for histopathology Results Group D showed a higher radiographic ratio than the other groups. Sheep not treated with naloxone showed a persistently lower ratio in the lateral than the medial cortex (P Conclusion A low-dose parenteral regimen of naloxone enhances
Prediction of parenteral nutrition osmolarity by digital refractometry.
Chang, Wei-Kuo; Yeh, Ming-Kung
2011-05-01
Infusion of high-osmolarity parenteral nutrition (PN) formulations into a peripheral vein will damage the vessel. In this study, the authors developed a refractometric method to predict PN formulation osmolarity for patients receiving PN. Nutrients in PN formulations were prepared for Brix value and osmolality measurement. Brix value and osmolality measurement of the dextrose, amino acids, and electrolytes were used to evaluate the limiting factor of PN osmolarity prediction. A best-fit equation was generated to predict PN osmolarity (mOsm/L): 81.05 × Brix value--116.33 (R(2) > 0.99). To validate the PN osmolarity prediction by these 4 equations, a total of 500 PN admixtures were tested. The authors found strong linear relationships between the Brix values and the osmolality measurement of dextrose (R(2) = 0.97), amino acids (R(2) = 0.99), and electrolytes (R(2) > 0.96). When PN-measured osmolality was between 600 and 900 mOsm/kg, approximately 43%, 29%, 43%, and 0% of the predicted osmolarity obtained by equations 1, 2, 3, and 4 were outside the acceptable 90% to 110% confidence interval range, respectively. When measured osmolality was between 900 and 1,500 mOsm/kg, 31%, 100%, 85%, and 15% of the predicted osmolarity by equations 1, 2, 3, and 4 were outside the acceptable 90% to 110% confidence interval range, respectively. The refractive method permits accurate PN osmolarity prediction and reasonable quality assurance before PN formulation administration.
2013-01-01
Background Pediatric osteomyelitis is a bacterial infection of bones requiring prolonged antibiotic treatment using parenteral followed by enteral agents. Major complications of pediatric osteomyelitis include transition to chronic osteomyelitis, formation of subperiosteal abscesses, extension of infection into the joint, and permanent bony deformity or limb shortening. Historically, osteomyelitis has been treated with long durations of antibiotics to avoid these complications. However, with improvements in management and antibiotic treatment, standard of care is moving towards short durations of intravenous antibiotics prior to enteral antibiotics. Methods/Design The authors will perform a systematic review based on PRISMA guidelines in order to evaluate the literature, looking for evidence to support the optimal duration of parenteral and enteral therapy. The main goals are to see if literature supports shorter durations of either parenteral antibiotics and/or enteral antibiotics. Multiple databases will be investigated using a thorough search strategy. Databases include Medline, Cochrane, EMBASE, SCOPUS, Dissertation Abstracts, CINAHL, Web of Science, African Index Medicus and LILACS. Search stream will include medical subject heading for pediatric patients with osteomyelitis and antibiotic therapy. We will search for published or unpublished randomized and quasi-randomized controlled trials. Two authors will independently select articles, extract data and assess risk of bias by standard Cochrane methodologies. We will analyze comparisons between dichotomous outcomes using risk ratios and continuous outcomes using mean differences. 95% confidence intervals will be computed. Discussion One of the major dilemmas of management of this disease is the duration of parenteral therapy. Long parenteral therapy has increased risk of serious complications and the necessity for long therapy has been called into question. Our study aims to review the currently available
Rojas, Carmen L; Romera, Francisco J; Alcántara, Esteban; Pérez-Vicente, Rafael; Sariego, Cristina; Garcaí-Alonso, J Ignacio; Boned, Javier; Marti, Gabriel
2008-11-26
The FeEDDHA [iron(3+) ethylenediamine di(o-hydroxyphenylacetic) acid] is one of the most efficient iron chelates employed in the correction of iron clorosis in calcareous soils. FeEDDHA presents different positional isomers: the ortho-ortho (o,o), the ortho-para (o,p), and the para-para (p,p). Of these isomers, the p,p cannot chelate Fe in soil solution in a wide range of pH values, while both o,o and o,p can. The objective of this work was to compare the efficiency of both isomers (o,o and o,p) to provide Fe to two Strategy I plants (tomato and peach) in nutrient solution (pH approximately 6.0), as well as in calcareous soil (pH approximately 8.4; CALCIXEREPT). For this, chelates of both o,o-EDDHA and o,p-EDDHA with 57Fe (a nonradioactive isotope of Fe) were used, where the 57Fe acts as a tracer. The results obtained showed that the o,o isomer is capable of providing sufficient Fe to plants in both nutrient solution and calcareous soil. However, the o,p isomer is capable of providing sufficient Fe to plants in nutrient solution but not in calcareous soil.
The effect of enteral and parenteral feeding on secretion of orexigenic peptides in infants
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Sztefko Krystyna
2009-12-01
Full Text Available Abstract Background The feeding in the first months of the life seems to influence the risks of obesity and affinity to some diseases including atherosclerosis. The mechanisms of these relations are unknown, however, the modification of hormonal action can likely be taken into account. Therefore, in this study the levels of ghrelin and orexin A - peripheral and central peptide from the orexigenic gut-brain axis were determined. Methods Fasting and one hour after the meal plasma concentrations of ghrelin and orexin were measured in breast-fed (group I; n = 17, milk formula-fed (group II; n = 16 and highly hydrolyzed, hypoallergic formula-fed (group III; n = 14 groups, age matched infants (mean 4 months as well as in children with iv provision of nutrients (glucose - group IV; n = 15; total parenteral nutrition - group V; n = 14. Peptides were determined using EIA commercial kits. Results Despite the similar caloric intake in orally fed children the fasting ghrelin and orexin levels were significantly lower in the breast-fed children (0.37 ± 0.17 and 1.24 ± 0.29 ng/ml, respectively than in the remaining groups (0.5 ± 0.27 and 1.64 ± 0.52 ng/ml, respectively in group II and 0.77 ± 0.27 and 2.04 ± 1.1 ng/ml, respectively, in group III. The postprandial concentrations of ghrelin increased to 0.87 ± 0.29 ng/ml, p Conclusion The highly hydrolyzed diet strongly affects fasting and postprandial ghrelin and orexin plasma concentrations with possible negative effect on short- and long-time effects on development. Also total parenteral nutrition with the continuous stimulation and lack of fasting/postprandial modulation might be responsible for disturbed development in children fed this way.
[Staff accreditation in parenteral nutrition production in hospital pharmacy].
Vrignaud, S; Le Pêcheur, V; Jouan, G; Valy, S; Clerc, M-A
2016-09-01
This work aims to provide staff accreditation methodology to harmonize and secure practices for parenteral nutrition bags preparation. The methodology used in the present study is inspired from project management and quality approach. Existing training supports were used to produce accreditation procedure and evaluation supports. We first defined abilities levels, from level 1, corresponding to accredited learning agent to level 3, corresponding to expert accredited agent. Elements assessed for accreditation are: clothing assessment either by practices audit or by microbiologic test, test bags preparation and handling assessment, bag production to assess aseptic filling for both manual or automatized method, practices audit, number of days of production, and non-conformity following. At Angers Hospital, in 2014, production staff is composed of 12 agents. Staff accreditation reveals that 2 agents achieve level 3, 8 agents achieve level 2 and 2 agents are level 1. We noted that non-conformity decreased as accreditation took place from 81 in 2009 to 0 in 2014. To date, there is no incident due to parenteral bag produced by Angers hospital for neonatal resuscitation children. Such a consistent study is essential to insure a secured nutrition parenteral production. This also provides a satisfying quality care for patients. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.
Douds, D D; Schenck, N C
1990-02-01
Adjustment of pot culture nutrient solutions increased root colonization and sporulation of vesicular-arbuscular mycorrhizal (VAM) fungi. Paspalum notatum Flugge and VAM fungi were grown in a sandy soil low in N and available P. Hoagland nutrient solution without P enhanced sporulation in soil and root colonization of Acaulospora longula, Scutellospora heterogama, Gigaspora margarita, and a wide range of other VAM fungi over levels produced by a tap water control or nutrient solutions containing P. However, Glomus intraradices produced significantly more spores in plant roots in the tap water control treatment. The effect of the nutrient solutions was not due solely to N nutrition, because the addition of NH(4)NO(3) decreased both colonization and sporulation by G. margarita relative to levels produced by Hoagland solution without P.
Parenteral nutrition-associated liver disease and lipid emulsions.
Zugasti Murillo, Ana; Petrina Jáuregui, Estrella; Elizondo Armendáriz, Javier
2015-01-01
Parenteral nutrition-associated liver disease (PNALD) is a particularly important problem in patients who need this type of nutritional support for a long time. Prevalence of the condition is highly variable depending on the series, and its clinical presentation is different in adults and children. The etiology of PNALD is not well defined, and participation of several factors at the same time has been suggested. When a bilirubin level >2 mg/dl is detected for a long time, other causes of liver disease should be ruled out and risk factors should be minimized. The composition of lipid emulsions used in parenteral nutrition is one of the factors related to PNALD. This article reviews the different types of lipid emulsions and the potential benefits of emulsions enriched with omega-3 fatty acids. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.
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Guillermo García Gutiérrez
1994-03-01
Full Text Available
Pizarro's solution for parenteral rehydration has the following composition in mmol/l: sodium: 90, potassium 20, chloride 80, acetate 30 and glucose 111. Fifty dehydrated infants were parenterally rehydrated with this solution in order to confirm its safety and efficacy. Mean age was 10.3::!: 8.1 months (SEM; 31 were males and 19 females; 27 (54% were undernourished; 45 (90% had previously received oral rehydration therapy. Pizarro's solution was intravenously administered at the rate of 25 ml/kg/hour. Blood samples for determination of sodium, potassium, glucose and blood gases were drawn at the beginning of therapy and after achieving rehydration. AII infants were rehydrated uneventfully. Initial weight was 6.63 :t 2.85 kg. Average weight gain was 5.18 :t 2.59%. The volume of fluid administered was 105.8 :t 45.8 ml/kg. Time to achieve rehydration was 4.32 :t2.13 hours. Serum sodium levels were 139.32 :t 9.03 and 137.10 :t 7.62 mmol/l, serum potassium levels were 4.10 :t 1.06 and 4.22 :t 0.76 mmol/l, blood pH was 7.25 :t 0.197 and 7.34 :t 0.088, blood glucose levels were 122.18 :t 66.31 and 117.46 :t 47 mg/dl at admission and after rehydration, respectively. We concluded that Pizarro's solution is suitable and safe for intravenous rehydration of infants dehydrated by diarrheal disease when oral rehydration therapy is not feasible.
El objetivo de este estudio fue comprobar la seguridad y eficacia de la solución recomendada por Pizarro para el tratamiento parenteral de la deshidratación. Se hidrataron 50 niños con edad promedio de 10.3 :t 8.1 meses. De ellos 31 fueron hombres y 19 mujeres; 27 (54% presentaban desnutrición y 45 (90% habían recibido hidratación oral. Se programó la corrección del déficit con 25 ml/kg/hora. Se tomaron muestras de
Girke, Jutta; Seipt, Claudia; Markowski, Andrea; Luettig, Birgit; Schettler, Anika; Momma, Michael; Schneider, Andrea S
2016-10-01
Patients with end-stage cancer and advanced chronic bowel disease are often malnourished, which has a negative effect on patients' outcome, well-being, and activity. It is inconclusive whether these patients benefit from home parenteral nutrition. This prospective exploratory study investigates its influence on nutrition state, muscle strength, mobility, and quality of life. Patients ≥18 years old with an indication for home parenteral nutrition were included and followed for 2-24 months. Nutrition parameters, activity, and quality of life were assessed. Forty-eight patients participated (mean age 11.5 years), and 85% were severely malnourished (subjective global assessment score, class C). Four weeks after parenteral nutrition, patients with tumors demonstrated a deterioration in phase angle (from 3.9 to 3.4) and extracellular mass:body cell mass ratio (from 1.6 to 2.1), while patients with bowel disease improved (from 3.4 to 4.0 and 2.1 to 1.6, respectively); grip strength remained constant in both groups (difference: 1.11 and -2.11, respectively). Activity improved in patients with bowel disease but stayed the same in the tumor group (P = .02 and P = .33, respectively). When the groups were pooled, emotional and social functioning domain scores (P parenteral nutrition. Both groups seem to benefit from home parenteral nutrition without harmful side effects. If the indication is determined early, the patients' disease course could perhaps be improved. © 2016 American Society for Parenteral and Enteral Nutrition.
García de Lorenzo Mateos, A.; Bermejo Vicedo, T.; Gómez Candela, C.; Planas Vila, M.
2005-01-01
Conclusiones de la Mesa de Trabajo sobre productos listos para su uso (RTU) en nutrición parenteral. Se efectúa una aproximación a la definición y a las ventajas en comparación con otros modelos de nutrición parenteral. Destacan los aspectos relacionados con la gestión, composición de la RTU e indicaciones tanto intrahospitalarias como domiciliarias.Conclusions to the workshop on ready-to use (RTU) products for parenteral nutrition. An approximation is done to the definition and advantages in...
Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. Whether modifying the phytosterol and vitamin E composition of soy and fish oil lipi...
Bubenheim, David L.; Wignarajah, Kanapathipillai; Kliss, Mark H. (Technical Monitor)
1996-01-01
Recovery of resources from waste streams is essential for future implementation and reliance on a regenerative life support system. The major waste streams of concern are from human activities and plant wastes. Carbon, water and inorganics are the primary desired raw materials of interest. The goal of resource recovery is maintenance of product quality to insure support of reliable and predictable levels of life support function performance by the crop plant component. Further, these systems must be maintained over extended periods of time, requiring maintenance of nutrient solutions to avoid toxicity and deficiencies. Today, reagent grade nutrients are used to make nutrient solutions for hydroponic culture and these solutions are frequently changed during the life cycle or sometimes managed for only one crop life cycle. The focus of this study was to determine the suitability of the ash product following incineration of inedible biomass as a source of inorganic nutrients for hydroponic crop production. Inedible wheat biomass was incinerated and ash quality characterized. The incinerator ash was dissolved in adequate nitric acid to establish a consistent nitrogen concentration in all nutrient solution treatments. Four experimental nutrient treatments were included: control, ash only, ash supplemented to match control, and ash only quality formulated with reagent grade chemicals. When nutrient solutions are formulated using only ash following-incineration of inedible biomass, a balance in solution is established representing elemental retention following incineration and nutrient proportions present in the original biomass. The resulting solution is not identical to the control. This imbalance resulted in suppression of crop growth. When the ash is supplemented with nutrients to establish the same balance as in the control, growth is identical to the control. The ash appears to carry no phytotoxic materials. Growth in solution formulated with reagent grade chemicals
Habes, Q L M; Pickkers, P
2016-01-01
- Overfeeding of critically ill patients is associated with a higher incidence of infections and an increased length of ventilation. However, trophic nutrition or permissive underfeeding appears to have no negative effect on the patient and may even provide a survival benefit.- Initiation of enteral nutrition within 24-48 hours after Intensive Care Unit (ICU) admission may reduce the number of complications and increase the chance of survival.- Total parenteral nutrition is associated with a higher risk of infections than enteral nutrition. This seems to be related to the higher calorie intake with parenteral nutrition rather than the route of administration.- In previously well-nourished patients, in whom enteral nutrition is only partially successful, it is safe to wait for up to 8 days before initiating supplemental parenteral nutrition.- In critically ill children, it is also safe to start supplemental parenteral nutrition at a late (on the 8th day after admission) rather than an early stage (within 24 hours of admission). Late supplemental parenteral nutrition may even result in fewer infectious complications and shorter hospitalisation.
Koelfat, Kiran V K; Schaap, Frank G; Hodin, Caroline M J M; Visschers, Ruben G J; Svavarsson, Björn I; Lenicek, Martin; Shiri-Sverdlov, Ronit; Lenaerts, Kaatje; Olde Damink, Steven W M
2017-10-01
Parenteral nutrition (PN), a lifesaving therapy in patients with intestinal failure, has been associated with hepatobiliary complications including steatosis, cholestasis and fibrosis, collectively known as parenteral nutrition-associated liver disease (PNALD). To date, the pathogenesis of PNALD is poorly understood and therapeutic options are limited. Impaired bile salt homeostasis has been proposed to contribute PNALD. The objective of this study was to establish a PNALD model in rats and to evaluate the effects of continuous parenteral nutrition (PN) on bile salt homeostasis. Rats received either PN via the jugular vein or received normal diet for 3, 7 or 14 days. Serum biochemistry, hepatic triglycerides, circulating bile salts and C4, IL-6 and TNF-alpha, and lipogenic and bile salt homeostatic gene expression in liver and ileum were assessed. PN increased hepatic triglycerides already after 3 days of administration, and resulted in conjugated bilirubin elevation after 7 or more days. This indicates PN-induced steatosis and impaired canalicular secretion of bilirubin, the latter which is in line with reduced hepatic expression of Mrp2 mRNA. There was no histological evidence for liver inflammation after PN administration, and circulating levels of pro-inflammatory cytokines IL-6 and TNF-α, were comparable in all groups. Hepatic expression of Fxr mRNA was decreased after 7 days of PN, without apparent effect on expression of Fxr targets Bsep and Shp. Nonetheless, Cyp7a1 expression was reduced after 7 days of PN, indicative for lowered bile salt synthesis. Circulating levels of C4 (marker of bile salt synthesis) were also decreased after 3, 7 and 14 days of PN. Levels of circulating bile salts were not affected by PN. This study showed that PN in rats caused early mild steatosis and cholestasis, while hepatic and systemic inflammation were not present. The onset of these abnormalities was associated with alterations in bile salt synthesis and transport. This
Ross, Vicki M; Guenter, Peggi; Corrigan, Mandy L; Kovacevich, Debra; Winkler, Marion F; Resnick, Helaine E; Norris, Tina L; Robinson, Lawrence; Steiger, Ezra
2016-12-01
Home parenteral nutrition (HPN) is a high-cost, complex nutrition support therapy that requires the use of central venous catheters. Central line-associated bloodstream infections (CLABSIs) are among the most serious risks of this therapy. Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care (Sustain registry) provides the most current and comprehensive data for studying CLABSI among a national cohort of HPN patients in the United States. This is the first Sustain registry report detailing longitudinal data on CLABSI among HPN patients. To describe CLABSI rates for HPN patients followed in the Sustain registry from 2011-2014. Descriptive, χ 2 , and t tests were used to analyze data from the Sustain registry. Of the 1,046 HPN patients from 29 sites across the United States, 112 (10.7%) experienced 194 CLABSI events during 223,493 days of HPN exposure, for an overall CLABSI rate of 0.87 episodes/1,000 parenteral nutrition-days. Although the majority of patients were female (59%), adult (87%), white (75%), and with private insurance or Medicare (69%), CLABSI episodes per 1,000 parenteral nutrition-days were higher for men (0.69 vs 0.38), children (1.17 vs 0.35), blacks (0.91 vs 0.41), and Medicaid recipients (1.0 vs 0.38 or 0.39). Patients with implanted ports or double-lumen catheters also had more CLABSIs than those with peripherally inserted or central catheters or single-lumen catheters. Staphylococci were the most commonly reported pathogens. These data support findings of smaller studies about CLABSI risk for children and by catheter type and identify new potential risk factors, including gender, race, and insurance type. Additional studies are needed to determine effective interventions that will reduce HPN-associated CLABSI. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
A Review of the Parenteral Nutrition Supply Service in an Irish Neonatal Unit
LENUS (Irish Health Repository)
Smith, A
2018-06-01
Neonatal Intensive Care (NICU) patients have individual nutritional requirements often requiring Patient Specific Parenteral Nutrition (PSPN). From October 2015, the national PSPN compounding service availability changed from 7 days per week service to 5 days per week (i.e. no weekend and limited bank holiday ordering available). The aim of this study was to examine the introduction of a 5 day only PSPN supply on neonatal patient parenteral nutrition availability in a tertiary NICU.
Directory of Open Access Journals (Sweden)
Alex Humberto Calori
Full Text Available ABSTRACT The recent introduction in Brazil of production of quality seed potatoes in hydroponic systems, such as aeroponics, demands studies on the nutritional and crop management. Thus, this study evaluated the influence of electrical conductivity of the nutrient solution and plant density on the seed potato minitubers production in aeroponics system. The Agata and Asterix cultivars were produced in a greenhouse under tropical conditions (winter/spring. The experimental design was a randomized block in a split-split plot design. The plot consisted of 4 electrical conductivities of the nutrient solution (1.0; 2.0; 3.0; and 4.0 dS∙m−1; the subplot, of 4 plant densities (25; 44; 66; and 100 plants∙m−2; and the subsubplot, of the 2 potato cultivars (Ágata and Asterix, totaling 4 blocks. The 2.2 and 2.1 dS∙m−1 electrical conductivities yielded the highest productivity of seed potato minitubers, for Ágata and Asterix cultivars, respectively, regardless of plant density. For both cultivars, the highest yield was observed for the 100 plants∙m−2 density.
Garcia, Jowell; Garg, Alka; Song, Yunmei; Fotios, Ambados; Andersen, Chad; Garg, Sanjay
2018-01-01
There is increasing interest to administer ibuprofen as a continuous infusion instead of a traditional bolus for treating Patent Ductus Arteriosus (PDA). However, its compatibility data with commonly used drugs in the neonatal period, including parenteral nutrition (PN) and lipids is unavailable. The aim is to determine the compatibility of intravenous ibuprofen lysine with various ANZNN parenteral nutrition consensus group standard neonatal PN formulations and lipids. The PN and lipid solutions used in a tertiary neonatal unit were obtained. These included a Starter, Standard Preterm and low carbohydrate PN, and IV SMOF lipid admixture (SMOFLipid 20% 15 mL; Vitalipid N infant 4 mL, Soluvit N 1 mL) plus vitamin mixtures. 10% glucose was used as a control. 1:1 mixtures of different concentrations (1.25 to 5mg/mL) of ibuprofen lysine and each of the PN/glucose/lipid formulations were made. Samples were taken at hourly intervals for a total of 4 hours and tested for both physical (visual assessment, pH and microscopy) and chemical compatibility (High Performance Liquid Chromatography analysis). Zeta potential and particle diameter were measured for SMOF lipid admixture and ibuprofen combination to assess emulsion stability. 24 hour stability of ibuprofen dilution in 5 mL BD Luer-lok polypropylene syringes at 25°C was also assessed. Most PN formed opaque solutions when mixed with ibuprofen 2.5 and 5mg/mL solutions. However, ibuprofen dilution of 1.25mg/mL produced clear, colourless solutions with no microscopic particles when mixed with all PN/glucose/lipid formulations tested. Ibuprofen was chemically stable with all PN and SMOF lipid admixture, for a period of 4 hours. The zeta potential and particle diameter were within acceptable limits. Ibuprofen lysine was stable over 24 hours in Luer-lok polypropylene syringes. Ibuprofen 1.25mg/mL is physically and chemically compatible with 10% glucose, starter PN, standard preterm and low carbohydrate PN, and SMOF lipid
Iestra, J. A.; Fibbe, W. E.; Zwinderman, A. H.; Romijn, J. A.; Kromhout, D.
1999-01-01
Patients receiving intensive cytotoxic therapy are traditionally supported with parenteral nutrition (PN), although it is unclear whether all patients benefit from PN. This study aimed to identify regimen-associated differences in PN requirements, to reveal discrepancies between the number of PN
Coupled Spatio-Temporal Patterns of Solute Transport, Metabolism and Nutrient Uptake in Streams
Kurz, M. J.; Schmidt, C.
2017-12-01
Slower flow velocities and longer residence times within stream transient storage (TS) zones facilitate interaction between solutes and microbial communities, potentially increasing local rates of metabolic activity. Multiple factors, including channel morphology and substrate, variable hydrology, and seasonal changes in biological and physical parameters, result in changes in the solute transport dynamics and reactivity of TS zones over time and space. These changes would be expected to, in turn, influence rates of whole-stream ecosystem functions such as metabolism and nutrient uptake. However, the linkages between solute transport and ecosystem functioning within TS zones, and the contribution of TS zones to whole-stream functioning, are not always so straight forward. This may be due, in part, to methodological challenges. In this study we investigated the influence of stream channel hydro-morphology and substrate type on reach (103 m) and sub-reach (102 m) scale TS and ecosystem functioning. Patterns in solute transport, metabolism and nitrate uptake were tracked from April through October in two contrasting upland streams using several methods. The two streams, located in the Harz Mountains, Germany, are characterized by differing size (0.02 vs. 0.3 m3/s), dominant stream channel substrate (bedrock vs. alluvium) and sub-reach morphology (predominance of pools, riffles and glides). Solute transport parameters and respiration rates at the reach and sub-reach scale were estimated monthly from coupled pulse injections of the reactive tracer resazurin (Raz) and conservative tracers uranine and salt. Raz, a weakly fluorescent dye, irreversibly transforms to resorufin (Rru) under mildly reducing conditions, providing a proxy for aerobic respiration. Daily rates of primary productivity, respiration and nitrate retention at the reach scale were estimated using the diel cycles in dissolved oxygen and nitrate concentrations measured by in-situ sensors. Preliminary
Higher versus lower amino acid intake in parenteral nutrition for newborn infants.
Osborn, David A; Schindler, Tim; Jones, Lisa J; Sinn, John Kh; Bolisetty, Srinivas
2018-03-05
Sick newborn and preterm infants frequently are not able to be fed enterally, necessitating parenteral fluid and nutrition. Potential benefits of higher parenteral amino acid (AA) intake for improved nitrogen balance, growth, and infant health may be outweighed by the infant's ability to utilise high intake of parenteral AA, especially in the days after birth. The primary objective is to determine whether higher versus lower intake of parenteral AA is associated with improved growth and disability-free survival in newborn infants receiving parenteral nutrition.Secondary objectives include determining whether:• higher versus lower starting or initial intake of amino acids is associated with improved growth and disability-free survival without side effects;• higher versus lower intake of amino acids at maximal intake is associated with improved growth and disability-free survival without side effects; and• increased amino acid intake should replace non-protein energy intake (glucose and lipid), should be added to non-protein energy intake, or should be provided simultaneously with non-protein energy intake.We conducted subgroup analyses to look for any differences in the effects of higher versus lower intake of amino acids according to gestational age, birth weight, age at commencement, and condition of the infant, or concomitant increases in fluid intake. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (2 June 2017), MEDLINE (1966 to 2 June 2017), Embase (1980 to 2 June 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 2 June 2017). We also searched clinical trials databases, conference proceedings, and citations of articles. Randomised controlled trials of higher versus lower intake of AAs as parenteral nutrition in newborn infants. Comparisons of higher intake at commencement, at maximal intake, and at both commencement and maximal
Energy Technology Data Exchange (ETDEWEB)
Osawa, T; Ikeda, H
1977-01-01
Eight species of vegetable crops were grown in solution culture in order to investigate the effect of potassium and calcium concentration in the nutrient solution on manganese toxicities in vegetable crops. Manganese was supplied at levels of 0.5, 30, and 100 ppm. At each manganese level potassium or calcium was supplied at rates of 2, 6, and 18 me/l. The pH of the nutrient solution was adjusted to 5. Manganese excess induced interveinal chlorosis on upper leaves in bean, eggplant, pepper, and spinach, and marginal chlorosis on lower leaves in cabbage, lettuce, and celery. In Welsh onions chlorosis was induced on lower leaves. Increasing the supply of potassium and calcium reduced the severity of manganese-induced chlorosis. This beneficial effect was generally more marked with calcium than with potassium. Increasing the supply of potassium and calcium was effective in alleviating the growth reduction of vegetable crops due to manganese excess. This effect also was more marked with calcium than with potassium. With increasing manganese level in the nutrient solution the manganese concentration in leaves of vegetable crops increased. Increasing the supply of potassium and calcium inhibited excessive accumulation of manganese in leaves. The influence of calcium was stronger than that of potassium. In any of the vegetable crops tested, regardless of potassium and calcium treatments, manganese concentration in leaves was closely related to manganese toxicities; the more the accumulation of manganese in leaves increased, the more the severity of manganese-induced chlorosis and growth reduction increased.
Directory of Open Access Journals (Sweden)
Mirković Dušica
2013-01-01
Full Text Available Background/Aim. Parenteral nutrition as a specific aspect of providing nutritients still remains a permanent topic of both theoretical and experimental research. Total parenteral nutrition (TPN admixtures have complex contents making difficult to maintain their stability. The most critical parameter is the diameter of a lipid droplet, i.e. droplet size distribution. It is recommended that droplet size should not be more than 5
Plasma Aluminum Concentrations in Pediatric Patients Receiving Long-Term Parenteral Nutrition.
Courtney-Martin, Glenda; Kosar, Christina; Campbell, Alison; Avitzur, Yaron; Wales, Paul W; Steinberg, Karen; Harrison, Debra; Chambers, Kathryn
2015-07-01
Patients receiving long-term parenteral nutrition (PN) are at increased risk of aluminium (Al) toxicity because of bypass of the gastrointestinal tract during PN infusion. Complications of Al toxicity include metabolic bone disease (MBD), Al-associated encephalopathy in adults, and impaired neurological development in preterm infants. Unlike the United States, there are no regulations regarding Al content of large- and small-volume parenterals in Canada. We, therefore, aimed to present our data on plasma Al concentration and Al intake from our cohort of pediatric patients receiving long-term PN. Plasma Al concentration was retrospectively gathered from the patient charts of all 27 patients with intestinal failure (IF) receiving long-term PN at The Hospital for Sick Children, Toronto, Canada, and compared with age- and sex-matched controls recruited for comparison. In addition, Al concentration was measured in PN samples collected from 10 randomly selected patients with IF and used to determine their Al intake. The plasma Al concentration of patients with IF receiving long-term PN was significantly higher than that of control participants (1195 ± 710 vs 142 ± 63 nmol/L; P Parenteral and Enteral Nutrition.
Hué, Stéphane; Buckton, Andrew J.; Myers, Richard E.; Duiculescu, Dan; Ene, Luminita; Oprea, Cristiana; Tardei, Gratiela; Rugina, Sorin; Mardarescu, Mariana; Floch, Corinne; Notheis, Gundula; Zöhrer, Bettina; Cane, Patricia A.; Pillay, Deenan
2012-01-01
Abstract In the late 1980s an HIV-1 epidemic emerged in Romania that was dominated by subtype F1. The main route of infection is believed to be parenteral transmission in children. We sequenced partial pol coding regions of 70 subtype F1 samples from children and adolescents from the PENTA-EPPICC network of which 67 were from Romania. Phylogenetic reconstruction using the sequences and other publically available global subtype F sequences showed that 79% of Romanian F1 sequences formed a statistically robust monophyletic cluster. The monophyletic cluster was epidemiologically linked to parenteral transmission in children. Coalescent-based analysis dated the origins of the parenteral epidemic to 1983 [1981–1987; 95% HPD]. The analysis also shows that the epidemic's effective population size has remained fairly constant since the early 1990s suggesting limited onward spread of the virus within the population. Furthermore, phylogeographic analysis suggests that the root location of the parenteral epidemic was Bucharest. PMID:22251065
Douds, David D.; Schenck, N. C.
1990-01-01
Adjustment of pot culture nutrient solutions increased root colonization and sporulation of vesicular-arbuscular mycorrhizal (VAM) fungi. Paspalum notatum Flugge and VAM fungi were grown in a sandy soil low in N and available P. Hoagland nutrient solution without P enhanced sporulation in soil and root colonization of Acaulospora longula, Scutellospora heterogama, Gigaspora margarita, and a wide range of other VAM fungi over levels produced by a tap water control or nutrient solutions contain...
Jenke, Dennis; Egert, Thomas; Hendricker, Alan; Castner, James; Feinberg, Tom; Houston, Christopher; Hunt, Desmond G; Lynch, Michael; Nicholas, Kumudini; Norwood, Daniel L; Paskiet, Diane; Ruberto, Michael; Smith, Edward J; Holcomb, Frank; Markovic, Ingrid
2017-01-01
A simulating leaching (migration) study was performed on a model container-closure system relevant to parenteral and ophthalmic drug products. This container-closure system consisted of a linear low-density polyethylene bottle (primary container), a polypropylene cap and an elastomeric cap liner (closure), an adhesive label (labeling), and a foil overpouch (secondary container). The bottles were filled with simulating solvents (aqueous salt/acid mixture at pH 2.5, aqueous buffer at pH 9.5, and 1/1 v/v isopropanol/water), a label was affixed to the filled and capped bottles, the filled bottles were placed into the foil overpouch, and the filled and pouched units were stored either upright or inverted for up to 6 months at 40 °C. After storage, the leaching solutions were tested for leached substances using multiple complementary analytical techniques to address volatile, semi-volatile, and non-volatile organic and inorganic extractables as potential leachables.The leaching data generated supported several conclusions, including that (1) the extractables (leachables) profile revealed by a simulating leaching study can qualitatively be correlated with compositional information for materials of construction, (2) the chemical nature of both the extracting medium and the individual extractables (leachables) can markedly affect the resulting profile, and (3) while direct contact between a drug product and a system's material of construction may exacerbate the leaching of substances from that material by the drug product, direct contact is not a prerequisite for migration and leaching to occur. LAY ABSTRACT: The migration of container-related extractables from a model pharmaceutical container-closure system and into simulated drug product solutions was studied, focusing on circumstances relevant to parenteral and ophthalmic drug products. The model system was constructed specifically to address the migration of extractables from labels applied to the outside of the
Blok, C. de; Schilp, J.; Wagner, C.
2013-01-01
Objectives: To evaluate the implementation of a four-year national patient safety program concerning the parenteral drug administration process in the Netherlands. Methods: Structuring the preparation and administration process of parenteral drugs reduces the number of medication errors. A
DEFF Research Database (Denmark)
Pironi, Loris; Joly, Francisca; Forbes, Alastair
2011-01-01
The indications for intestinal transplantation (ITx) are still debated. Knowing survival rates and causes of death on home parenteral nutrition (HPN) will improve decisions.......The indications for intestinal transplantation (ITx) are still debated. Knowing survival rates and causes of death on home parenteral nutrition (HPN) will improve decisions....
Effect of CO2 Enrichment on the Growth and Nutrient Uptake of Tomato Seedlings
Institute of Scientific and Technical Information of China (English)
LI Juan; ZHOU Jian-Min; DUAN Zeng-Qiang; DU Chang-Wen; WANG Huo-Yan
2007-01-01
Exposing tomato seedlings to elevated CO2 concentrations may have potentially profound impacts on the tomato yield and quality. A growth chamber experiment was designed to estimate how different nutrient concentrations influenced the effect of elevated CO2 on the growth and nutrient uptake of tomato seedlings. Tomato (Hezuo 906) was grown in pots placed in controlled growth chambers and was subjected to ambient or elevated CO2 (360 or 720 μL L-1), and four nutrient solutions of different strengths (1/2-, 1/4-, 1/8-, and 1/16-strength Japan Yamazaki nutrient solutions) in a completely randomized design. The results indicated that some agricultural characteristics of the tomato seedlings such as the plant height, stem thickness, total dry and fresh weights of the leaves, stems and roots, the G value (G value = total plant dry weight/seedling age),and the seedling vigor index (seedling vigor index = stem thickness/(plant height × total plant dry weight) increased with the elevated CO2, and the increases were strongly dependent on the nutrient solution concentrations, being greater with higher nutrient solution concentrations. The elevated CO2 did not alter the ratio of root to shoot. The total N, P, K, and C absorbed from all the solutions except P in the 1/8- and 1/16-strength nutrient solutions increased in the elevated CO2 treatment. These results demonstrate that the nutrient demands of the tomato seedlings increased at elevated CO2 concentrations.
Ponta, Monica Laura; Rabbione, Laura; Borgio, Cristina; Quirico, Eliana; Patrito, Elena; Petrachi, Maria Novella; Girotto, Elisabetta; Sillano, Marisa; Geninatti, Silvio; Zanardi, Michela; Pezzana, Andrea
2018-06-01
Our aim is to assess parenteral nutrition (PN) bag prescription in hospitalized patients and evaluate clinical outcomes linked to PN therapy. We performed an observational longitudinal retrospective study on PN prescription in a General Public Hospital in Turin, Italy, on ninety-five patients receiving PN prescribed by the Nutrition Support Team (NST). We described patients' demography and assessed nutritional outcomes, as well as PN bag prescription in different wards. Medians were calculated for several clinical parameters before and after PN therapy. A z-test for proportions has been performed to better understand the impact of various conditions on clinical outcomes and to compare differences between administered nutrients and required amounts. The NST resulted responsible for only 18% of bags prescribed in the geriatrics ward and for 48% in the surgery wards. PN was not able to fulfill nutritional requirements resulting in a median lack of 3.1 calories and 0.23 g of proteins per kilogram of reference body weight per day. Despite this, PN therapy was able to improve total blood proteins and calcium blood levels in our cohort. The NST changed the prescription in 55.8% of the pre-existing PN regimens. More strict adherence to guidelines is needed in order to maximize effectiveness of PN and observe a positive impact on clinical parameters. Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
Nutritional requirements and parenteral nutrition in preterm infants ...
African Journals Online (AJOL)
Provision of appropriate nutritional requirements soon after birth is critical for normal development and growth of preterm infants. Preterm infants are often not able to tolerate volumes of oral feeds that will provide adequate daily requirements for growth within the first week or two of life, therefore parenteral nutrition is often ...
Schilp, J.; Boot, S.; Blok, C. de; Spreeuwenberg, P.; Wagner, C.
2014-01-01
Objectives: Preventable adverse drug events (ADEs) are closely related to administration processes of parenteral medication. The Dutch Patient Safety Program provided a protocol for administering parenteral medication to reduce the amount of ADEs. The execution of the protocol was evaluated and a
Reuse of hydroponic waste solution.
Kumar, Ramasamy Rajesh; Cho, Jae Young
2014-01-01
Attaining sustainable agriculture is a key goal in many parts of the world. The increased environmental awareness and the ongoing attempts to execute agricultural practices that are economically feasible and environmentally safe promote the use of hydroponic cultivation. Hydroponics is a technology for growing plants in nutrient solutions with or without the use of artificial medium to provide mechanical support. Major problems for hydroponic cultivation are higher operational cost and the causing of pollution due to discharge of waste nutrient solution. The nutrient effluent released into the environment can have negative impacts on the surrounding ecosystems as well as the potential to contaminate the groundwater utilized by humans for drinking purposes. The reuse of non-recycled, nutrient-rich hydroponic waste solution for growing plants in greenhouses is the possible way to control environmental pollution. Many researchers have successfully grown several plant species in hydroponic waste solution with high yield. Hence, this review addresses the problems associated with the release of hydroponic waste solution into the environment and possible reuse of hydroponic waste solution as an alternative resource for agriculture development and to control environmental pollution.
DEFF Research Database (Denmark)
Jeppesen, Palle B; Høy, Carl-Erik; Mortensen, Per B
1999-01-01
Background: Essential fatty acid (EFA) requirements of patients receiving home parenteral nutrition (HPN) are uncertain. Objective: The objective was to evaluate the influence of the route of administration (enteral compared with parenteral) on plasma phospholipid EFA concentrations. Design......: Intestinal absorption, parenteral supplement of EFAs, and plasma phospholipid EFA concentrations were investigated in balance studies in 4 groups (A, B, C, and D) of 10 patients with short-bowel syndrome and a fecal loss of >2000 kJ/d. Groups A (fat malabsorption 50%) did...... absorption was negligible in groups C and D. Thus, intestinal absorption of EFAs in group A. corresponded to parenteral EFA supplements in group C, whereas group D was almost totally deprived of EFAs. The median plasma phospholipid concentration of linoleic acid decreased by 21.9%, > 16.3%, >13.8%, 11...
Adverse effects of parenteral dexamethasone in the treatment of pemphigus vulgaris
Directory of Open Access Journals (Sweden)
Mohammad Jamal Uddin
2016-08-01
Full Text Available Background: Pemphigus vulgaris is associated with high morbidity as well as significant mortality rate. Today the risk of death in pemphigus from the side effect of oral prednisolone is greater than risk of death from the disease itself. Objective: To observe the adverse effects of parenteral dexamethasone compared with oral prednisolone in the treatment of pemphigus vulgaris. Methods: An interventional study was carried out in the department of Dermatology and Venereology, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total number of patients was thirty and among them fifteen patients were treated with parenteral dexamethasone (Group-A and other fifteen were treated with oral prednisolone (Group-B. Results: The study showed statistically significant differences of skin lesion as well as mucosal lesion of pemphigus after 6 weeks of therapy between of two groups (P<0.05. The most common adverse effects were increased body weight(40%, increased appetite(40%, and puffy face(40% in dexamethasone group. In prednisolone group, these side effects were 60% of the subjects. Other side effects in dexamethasone group were hyperglycemia (33.33%, hypertension (26.66%, and sleep disturbance (13.33%. In prednisolone group, other side effects were hyperglycemia(33.33%, hypertension(40%, gastritis (33.33%, nausea, vomiting (13.33% in each , reactivation of tuberculosis, herpes zoster infection, sleep disturbance, and mood change were 6.66% in each group. Conclusion: In the light of the findings of the study, we conclude that each of the treatment of dexamethasone group and prednisolone group is individually effective and safe in the treatment of pemphigus vulgaris but adverse effects are less in parenteral dexamethasone group than oral prednisolone group. So parenteral dexamethasone can be used as an alternative drug in the treatment of pemphigus vulgaris.
Introduction and methodology – Guidelines on Parenteral Nutrition, Chapter 1
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Jauch, K. W.
2009-11-01
Full Text Available Guidelines for Parenteral Nutrition were prepared by the German Society for Nutritional Medicine (http://www.dgem.de/, in collaboration with other medical associations to provide guidance for quality assurance for parenteral nutrition (PN practice, and to promoting health and quality of life of patients concerned. A coordination team proposed topics, working group leaders who along with working group members performed systematic literatur searches and drafted recommendations in a nominal group process. Recommendations were discussed and agreed upon in a structured consensus conference process, followed by a Delphi consensus. The current English version of the guidelines was written and updated during the period between the last quarter of 2007 and the first quarter of 2009. The recommendations of the guidelines should be reviewed, and if necessary updated five years after publication.
Spectral Quantitation Of Hydroponic Nutrients
Schlager, Kenneth J.; Kahle, Scott J.; Wilson, Monica A.; Boehlen, Michelle
1996-01-01
Instrument continuously monitors hydroponic solution by use of absorption and emission spectrometry to determine concentrations of principal nutrients, including nitrate, iron, potassium, calcium, magnesium, phosphorus, sodium, and others. Does not depend on extraction and processing of samples, use of such surrograte parameters as pH or electrical conductivity for control, or addition of analytical reagents to solution. Solution not chemically altered by analysis and can be returned to hydroponic process stream after analysis.
Economakis, C; Skaltsa, Helen; Demetzos, Costas; Soković, M; Thanos, Costas A
2002-10-23
The chemical composition of the essential oils obtained from the leaves and bracts of hydroponically cultivated Origanum dictamnus were analyzed by GC-MS techniques. Three different concentrations of phosphorus (5, 30, and 60 mg/L) in the nutrient solution were used for the cultivation, using the nutrient film technique (NFT). A total of 46 different compounds were identified and significant differences (qualitative and quantitative) were observed between the samples. Carvacrol and p-cymene were identified as the main compounds in all samples analyzed, whereas thymoquinone was found in higher percentage in the leaves than in bracts. The essential oils were tested for their antibacterial activity against Gram-positive and Gram-negative bacteria. The oils obtained from the bracts were found to be more active. The results obtained from GC-MS analyses were submitted to chemometric analysis.
Voogt, W.; Dijk, van P.; Douven, F.; Maas, van der M.P.
2014-01-01
Although the majority of blueberries in The Netherlands are soil grown, interest in soilless culture has increased recently. Modern cultivation with high yield and fruit quality needs maximum control of growth and crop development, which is expected to be achieved with irrigation and nutrient
Mirković, Dušica; Ibrić, Svetlana; Antunović, Mirjana
2013-01-01
Background/Aim. Parenteral nutrition as a specific aspect of providing nutritients still remains a permanent topic of both theoretical and experimental research. Total parenteral nutrition (TPN) admixtures have complex contents making difficult to maintain their stability. The most critical parameter is the diameter of a lipid droplet, i.e. droplet size distribution. It is recommended that droplet size should not be more than 5 m and that the presence of greater droplets should not exceed th...
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Luiz V. E. Villela Júnior
2004-08-01
Full Text Available Este trabalho teve como objetivo a produção hidropônica de morangos com resfriamento da solução nutritiva, em Jaboticabal - SP. O experimento foi conduzido no Setor de Plasticultura do Departamento de Engenharia Rural da FCAV/UNESP, Câmpus de Jaboticabal, em casa de vegetação coberta com filme de polietileno, sendo o transplantio realizado em 9-1-2002. Foram avaliadas duas variedades de morango: Campinas e "Sweet Charlie", cultivadas em sistema hidropônico tipo NFT, com ou sem resfriamento da solução nutritiva. A solução nutritiva resfriada foi mantida à temperatura de aproximadamente 12 ºC, por meio de um trocador de calor. A variedade "Sweet Charlie" apresentou melhores resultados para peso médio dos pseudofrutos, diâmetro médio longitudinal, diâmetro médio transversal, número médio de pseudofrutos e produtividade. O resfriamento da solução nutritiva conferiu maior número de pseudofrutos colhidos, maior produtividade e maior teor de sólidos solúveis totais aos pseudofrutos da variedade "Sweet Charlie". No entanto, o resfriamento da solução nutritiva não causou efeitos sobre a variedade Campinas.This work had as its major aim the hydroponic production of strawberries with the cooling of the nutrient solution, in Jaboticabal - SP - Brazil. The experiment was conducted in a covered greenhouse with a plastic film and seed transplantation achieved on January 9, 2002. Two varieties of strawberries were evaluated: Campinas and Sweet Charlie, both cultivated under the hydroponic system NFT type with or without cooling the nutrient solution. The cooling of the nutrient solution at about 12 °C was in a heating exchange device. The Sweet Charlie variety presented the best results for both the average weight and number of pseudofruit, longitudinal average diameter, cross average diameter, average number of pseudofruit and productivity. The cooling of the nutrient solution confered greater number of pseudofruit collected and
Gluconeogenesis continues in premature infants receiving total parenteral nutrition
To determine the contribution of total gluconeogenesis, to glucose production in preterm infants receiving total parenteral nutrition (TPN) providing glucose exceeding normal infant glucose turnover rate, eight infants (0.955 +/- 0.066 kg, 26.5 - 0.5 wks, 4-1 d) were studied while receiving routine ...
Barco, Stefano; Atema, Jasper J.; Coppens, Michiel; Serlie, Mireille J.; Middeldorp, Saskia
2017-01-01
Patients on parenteral nutrition require a central venous access and are at risk of catheter-related thrombosis, pulmonary embolism, and vena cava syndrome. Parenteral nutrition guidelines suggest anticoagulation for the primary prevention of catheter-related thrombosis during long-term parenteral
Total parenteral alimentation via indwelling umbilical catheters in the newborn period.
Hall, R T; Rhodes, P G
1976-01-01
Total parenteral alimentation (TPA) was delivered to 80 infants via indwelling umbilical artery and to 9 via indwelling umbilical venous catheters. The primary indication for catheter placement and maintenance was monitoring of arterial blood gases (umbilical venous catheter tip in left atrium) in a group of sick neonates requiring increased inspired oxygen or assisted ventilation. Results were compared with those from 23 infants who had tunnelled jugular catheters for a variety of chronic medical and surgical problems preventing gastric or intestinal feeding. A mean weight gain was achieved in both groups. Mortality and morbidity rates were similar in both groups. The most common complications were infection and thrombotic phenomena. Metabolic complications were few. It is concluded that infusing TPA solutions via indwelling umbilical catheters presents no greater risk than infusion via tunnelled jugular catheters, and provides a method for supplying adequate caloric intake for growth during the acute stage of illness. PMID:827978
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E.F.S. David
2014-03-01
Full Text Available Mentha piperita L. is an aromatic and medicinal species of the family Lamiaceae, known as mint or peppermint, and its leaves and branches produce essential oil rich in menthol. This study aimed to evaluate physiological indexes, macro- and micronutrients inthe shootsand essential oil of Mentha piperita L. grown in nutrient solution number 2 of Hoagland and Arnon (1950 with different N, P, K and Mg levels. Shoot length, dry mass of the different organs, total dry mass, leaf area, essential oil yield and composition, and macronutrient (N, P, K, Mg, Ca, S and micronutrient (Mn, Cu, Fe, Zn contents in the shoot were evaluated. Plants treated with 65%N/50%P/25%K/100%Mg had a tendency towards longer shoot, greaterroot and leaf blade dry masses, higher essential oil yield, higher menthol levels and lower menthone levels. The results showed that Mentha can be grown in nutrient solution by reducing 65% N, 50% P, 25% K and 100% Mg. This solution had better development compared to the other tested treatments. Therefore,we recommendMentha piperita L. to be grown with such nutrient levels.
Parenteral Antibiotics Reduce Bifidobacteria Colonization and Diversity in Neonates
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Séamus Hussey
2011-01-01
Full Text Available We investigated the impact of parenteral antibiotic treatment in the early neonatal period on the evolution of bifidobacteria in the newborn. Nine babies treated with intravenous ampicillin/gentamicin in the first week of life and nine controls (no antibiotic treatment were studied. Denaturing gradient gel electrophoresis was used to investigate the composition of Bifidobacterium in stool samples taken at four and eight weeks. Bifidobacteria were detected in all control infants at both four and eight weeks, while only six of nine antibiotic-treated infants had detectable bifidobacteria at four weeks and eight of nine at eight weeks. Moreover, stool samples of controls showed greater diversity of Bifidobacterium spp. compared with antibiotic-treated infants. In conclusion, short-term parenteral antibiotic treatment of neonates causes a disturbance in the expected colonization pattern of bifidobacteria in the first months of life. Further studies are required to probiotic determine if supplementation is necessary in this patient group.
Nutrient Film Technique (NFT Hydroponic Monitoring System
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Helmy Helmy
2016-10-01
Full Text Available Plant cultivation using hydroponic is very popular today. Nutrient Film Technique (NFT hydroponic system is commonly used by people. It can be applied indoor or outdoor. Plants in this systemneed nutrient solution to grow well. pH, TDS and temperature of the nutrient solution must be check to ensure plant gets sufficient nutrients. This research aims todevelop monitoring system of NFT hydroponic. Farmer will be able to monitor pH, TDS and temperature online. It will ease farmer to decide which plant is suitable to be cultivated and time to boost growth.Delay of the system will be measured to know system performance. Result shows that pH is directly proportional with TDS. Temperature value has no correlation with pH and TDS. System has highest delay during daylight and afternoon but it will decline in the night and morning. Average of delay in the morning is 11 s, 28.5 s in daylight, 32 s in the afternoon and 17.5 s in the night.
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Carlos Fernando Agudelo Ramírez
2012-01-01
Full Text Available The effect of enrofloxacin on the QT interval of the electrocardiogram was studied in 30 hospitalized dogs. The experimental group (n = 15 received enrofloxacin parenterally (subcutaneously at a dose of 5 mg/kg twice daily and amoxicillin-clavulanate intravenously at a dose of 22 mg/kg three times daily. The control group (n = 15 received only amoxicillin-clavulanate. Electrocardiography was carried out for 5 min once daily for 6 days. The QT interval was corrected by four different formulae. No differences were found between the two groups or within each group for the duration of the study. On the last day of the study the average QT interval for the control and experimental groups was 213.2 ms and 202.9 ms, respectively. Enrofloxacin did not cause prolongation of the QT or corrected QT intervals. We can conclude that the parenteral administration of enrofloxacin in non-cardiac dogs does not adversely affect the electrocardiographic indicators (no prolongation of the QT or corrected QT interval and does not induce ventricular arrhythmias. Parenteral use of enrofloxacin is thus safe and effective in non-cardiac dogs.
Nakayama, Hirokazu; Echizen, Hirotoshi; Ogawa, Ryuichi; Akabane, Atsuya; Kato, Toshiaki; Orii, Takao
2017-06-01
Phenobarbital is well tolerated and effective for controlling agitation or preventing convulsion at the end of life. No information is available concerning parenteral bioavailability of phenobarbital when induration develops at the injection or infusion site. We investigated whether induration at injection or infusion site is related to phenobarbital bioavailability via parenteral routes of continuous subcutaneous infusion and intermittent subcutaneous or intramuscular injection. A retrospective analysis was conducted on the medical data obtained from 18 patients who received chronic subcutaneous or intramuscular injections of phenobarbital for the prevention of convulsions and underwent plasma concentration monitoring of the drug. Patients whose concomitant medications were altered during the observation periods were excluded from the analysis. Comparisons were performed for concentration/dose (C/D) ratios obtained from patients with induration at injection or infusion sites (induration group, n = 6) and those without induration (noninduration group, n = 12). P phenobarbital may be reduced when induration develops at the injection or infusion site in patients treated parenterally by continuous subcutaneous infusion or intramuscular injection.
Parenteral Nutrition in Liver Resection
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Carlo Chiarla
2012-01-01
Full Text Available Albeit a very large number of experiments have assessed the impact of various substrates on liver regeneration after partial hepatectomy, a limited number of clinical studies have evaluated artificial nutrition in liver resection patients. This is a peculiar topic because many patients do not need artificial nutrition, while several patients need it because of malnutrition and/or prolonged inability to feeding caused by complications. The optimal nutritional regimen to support liver regeneration, within other postoperative problems or complications, is not yet exactly defined. This short review addresses relevant aspects and potential developments in the issue of postoperative parenteral nutrition after liver resection.
Taurolidine in Pediatric Home Parenteral Nutrition Patients.
Hulshof, Emma Claire; Hanff, Lidwien Marieke; Olieman, Joanne; de Vette, Susanna; Driessen, Gert-Jan; Meeussen, Conny; Escher, Johanna Caroline
2017-02-01
To reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients, the use of taurolidine was introduced in the Sophia Children's Hospital in 2011. This introduction led to a reduction in catheter-related bloodstream infections: 12.7/1000 catheter days before the use of taurolidine, compared with 4.3/1000 catheter days afterwards (n = 7) [relative risk = 0.36, 95% confidence interval: 0.20-0.65 (P = 0.018)].
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R Khorasani
2015-07-01
Full Text Available In order to investigate the effect of different levels of nutrient solution concentration and times and frequencies of foliar applications on dry weight, nitrogen, phosphorus and potassium concentrations of leaf and corm of saffron, a pot experiment was conducted as a completely randomized design with factorial arrangement and three replications under open door conditions in research garden of ferdowsi university, faculty of agriculture. The experimental treatments were included 4 levels of solution concentration (0, 4, 8 and 12 per 1000 and 7 levels of time and frequency of foliar applications (F1: foliar application on 3th February, F2: foliar application on 18th February, F3: foliar application on 5th March, F4: foliar applications on 3th and 18th February, F5: foliar applications on 3th February and 5th March, F6: foliar applications on 18th February and 5th March, F7: foliar applications on 3th and 18th February and 5th March. Results of variance analysis showed that fresh and dry weight of corm and leaf were not influenced by concentration, time and frequency of foliar applications. Also, comparison of nitrogen, phosphorus and potassium concentrations of leaf and corm showed that there was no significant difference between levels of foliar treatments and control. Therefore, it seems that due attention to pattern of leaf and low nutrient demand of saffron, foliar applications in different levels of nutrient solution concentrations and times and frequencies of foliar applications could not increase vegetative growth and consequently, could not improve the growth and nutritional properties of saffron corms.
Complications relating to enteral and parenteral nutrition in trauma ...
African Journals Online (AJOL)
Objectives: The aim of the study was to compare the incidence of complications in patients receiving enteral and parenteral nutrition (PN), and review how the early initiation of enteral feeding and early achievement of caloric goal would affect the incidence of complications. Design: The design was a retrospective audit of ...
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Leandro Souza da Silva
2005-10-01
Full Text Available A calagem do solo altera o pH e, conseqüentemente, influencia no processo de redução dos solos submetidos ao alagamento para o cultivo do arroz irrigado, alterando a disponibilidade de nutrientes na solução do solo. Entretanto, a recomendação de calcário para o arroz irrigado é variável, implicando em diferentes quantidades a aplicar, dependendo da situação. Assim, o objetivo deste trabalho foi avaliar a liberação de nutrientes para a solução do solo após o alagamento, em três solos de várzea com diferentes valores de pH, resultantes da aplicação de diferentes quantidades de calcário. Amostras de solos de várzea foram coletadas da camada de 0 a 20 cm em áreas de produção de arroz nos municípios de Cachoeirinha/RS (Gleissolo, Faxinal do Soturno (Planossolo 1 e Santa Maria (Planossolo 2, as quais foram misturadas com calcário para comporem os seguintes tratamentos: zero; ½ SMP e 1 SMP para pH 5,5 e 1 SMP para pH 6,0. Após 90 dias de incubação, as amostras foram acondicionadas em vasos plásticos com um dispositivo para coleta da solução do solo e alagadas. Aos 2, 8, 15, 22, 28, 42 e 56 dias de alagamento foram retiradas amostras da solução do solo e determinados os teores de Fe, Ca, Mg, K e P. Com os maiores valores de pH, diminuíram os teores de ferro na solução, aumentaram os de cálcio e magnésio e não afetaram os teores de fósforo e potássio. As concentrações dos nutrientes e as mudanças provocadas pela calagem foram diferentes nos três solos.Liming changes soil pH, reduction process and nutrient availability in flooded soils used for rice production. However, the lime requirement for rice production is variable, depending on the situation. The objective of the experiment was to evaluate the nutrient release to soil solution after flooding of three lowland soils with different pH values resulting from different lime application. Soils samples from 0 to 20 cm were collected in three places and
Carbohydrates – Guidelines on Parenteral Nutrition, Chapter 5
Bolder, U.; Ebener, C.; Hauner, H.; Jauch, K. W.; Kreymann, G.; Ockenga, J.; Traeger, K.
2009-01-01
The main role of carbohydrates in the human body is to provide energy. Carbohydrates should always be infused with PN (parenteral nutrition) in combination with amino acids and lipid emulsions to improve nitrogen balance. Glucose should be provided as a standard carbohydrate for PN, whereas the use of xylite is not generally recommended. Fructose solutions should not be used for PN. Approximately 60% of non-protein energy should be supplied as glucose with an intake of 3.0–3.5 g/kg body weight/day (2.1–2.4 mg/kg body weight/min). In patients with a high risk of hyperglycaemia (critically ill, diabetes, sepsis, or steroid therapy) an lower initial carbohydrate infusion rate of 1–2 g/kg body weight/day is recommended to achieve normoglycaemia. One should aim at reaching a blood glucose level of 80–110 mg/dL, and at least a glucose level <145 mg/dL should be achieved to reduce morbidity and mortality. Hyperglycaemia may require addition of an insulin infusion or a reduction (2.0–3.0 g/kg body weight/day) or even a temporary interruption of glucose infusion. Close monitoring of blood glucose levels is highly important. PMID:20049080
Carbohydrates – Guidelines on Parenteral Nutrition, Chapter 5
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Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine
2009-11-01
Full Text Available The main role of carbohydrates in the human body is to provide energy. Carbohydrates should always be infused with PN (parenteral nutrition in combination with amino acids and lipid emulsions to improve nitrogen balance. Glucose should be provided as a standard carbohydrate for PN, whereas the use of xylite is not generally recommended. Fructose solutions should not be used for PN. Approximately 60% of non-protein energy should be supplied as glucose with an intake of 3.0–3.5 g/kg body weight/day (2.1–2.4 mg/kg body weight/min. In patients with a high risk of hyperglycaemia (critically ill, diabetes, sepsis, or steroid therapy an lower initial carbohydrate infusion rate of 1–2 g/kg body weight/day is recommended to achieve normoglycaemia. One should aim at reaching a blood glucose level of 80–110 mg/dL, and at least a glucose level <145 mg/dL should be achieved to reduce morbidity and mortality. Hyperglycaemia may require addition of an insulin infusion or a reduction (2.0–3.0 g/kg body weight/day or even a temporary interruption of glucose infusion. Close monitoring of blood glucose levels is highly important.
Environmental farm accounting: the case of the Dutch nutrients accounting system.
Breembroek, J.A.; Koole, B.; Poppe, K.J.; Wossink, G.A.A.
1996-01-01
In the Netherlands bookkeeping of inputs and outputs at the level of individual farms has been selected as a new solution to control nutrient use and to tax nutrient surpluses in agriculture. At the same time, nutrient accounting presents important management information. This paper presents a
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Dalva Paulus
2008-03-01
,50 x 0,25 m pode ser recomendada para o cultivo hidropônico de Mentha arvensis.The mint (Mentha arvensis L. is an aromatic plant that produces essential oil with high menthol concentration. For the hydroponic cultivation of vegetables and fruits, a great number of recommended formulas exist; however, little information exists about hydroponic solutions for mint. The goal of this work was to evaluate a nutrient solution for the mint cultivation in hydroponic system. Two experiments were carried out from October to December, 2004. For the field experiment, transplants were obtained from cuttings and produced in organic mineral substrates (plantmax®. Later they were transplanted in seed beds of 5.00 m length and 1.00 m width, spacings of 0.60 x 0.30 m. For the hydroponic system NFT, seedlings were obtained from cuttings and planted in phenolic foam where they stayed during 18 days. After that, they were transplanted to a production canal. The experimental design was a 2x2 factorial (nutrient solution concentrations x spacings. The hydroponic solution with 100% concentration in transplant and 50% replacement when the electric condutivity decreased 50% of the initial value and 0.5 x 0.25 m spacings resulted in the highest concentration of essential oil (0.60 mL 100 g-1 fresh leaves, menthol (82,4% and total dry matter (45 g plant-1. In hydroponic system the yield of dry matter and content of essential oil was higher than under soil conditions 27 g planta-1 of dry matter, concentration oil 0.53 mL 100 g-1 and 64,43% of menthol. The hydroponic solution with 100% concentration in transplant and 50% replacement when the electric condutivity decreased 50% of the initial value and 0.5 x 0.25 m spacing can be recommended for the cultivation of mint in hydroponic solution.
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Juliana Deh Carvalho Machado
2009-12-01
Full Text Available OBJETIVO: Avaliar a freqüência de infecção relacionada ao cateter venoso central em pacientes submetidos a terapia nutricional parenteral. MÉTODOS: Foram analisados os cateteres venosos centrais de pacientes em terapia nutricional parenteral que tiveram a indicação de retirada do cateter venoso central por infecção, alta hospitalar, ou trombose. Os pacientes com infecção foram denominados de Grupo 1 e os demais de Grupo 2. RESULTADOS: Não houve diferença estatisticamente significante quanto ao estado nutricional dos 18 pacientes analisados. Foram analisados 28 cateteres e destes 68% estavam infectados, sendo 72% do Grupo 1 e 28% do Grupo 2 (assintomáticos. No Grupo 1, houve infecção sistêmica em 70% dos casos, já no Grupo 2 a hemocultura foi positiva em 17% dos casos. A colonização por Staphylococcus sp. ocorreu em 48% dos casos, seguida de Candida sp. (21%, Enterococcus faecalis (16%, Pseudomonas aerurginosa (10% e Proteus sp.(5%. CONCLUSÃO: A contaminação de cateter venoso central utilizado para terapia nutricional parenteral é freqüente. Mesmo pacientes assintomáticos recebendo nutrição parenteral têm uma incidência maior de infecção por Candida sp. Portanto é necessária a criação de barreiras que impeçam a colonização destes cateteres venosos centrais, a fim de diminuir a morbimortalidade de pacientes dependentes deste tipo de terapia.OBJECTIVE: The aim of this study was to evaluate the frequency of central venous catheter-related infections in hospitalized patients receiving total parenteral nutrition. METHODS: Central venous catheters were analyzed immediately after removal due to infection, hospital discharge or thrombosis. The patients with catheter-related infection were named Group 1 and the other patients were named Group 2. RESULTS: Eighteen patients were studied. There was no statistically significant difference in nutritional status between the two groups. A total of 28 catheters were analyzed
International Nuclear Information System (INIS)
Stepanov, S.A.; Yusupova, I.U.; Grozdov, S.P.
1988-01-01
Local X-irradiation of rat abdomen (13.5 Gy) caused a pronounced intestinal syndrome which was partially coped with by parenteral feeding. The results indicate (1) a satisfactory assimilation of fatty emulsions used at certain doses and with certain parenteral diet composition, (2) a favourable effect of fatty emulsions on lipid metabolism in irradiated rats, and (3) some advantages of the parenteral feeding with infusolipol over lipofundin S
Safety, cost, and clinical considerations for the use of premixed parenteral nutrition.
Hall, Jacob W
2015-06-01
Premixed parenteral nutrition (PN) can be used for PN therapy in place of traditional compounded or customized PN. Premixed PN may have a number of advantages over compounded PN such as decreased costs, decreased compounding time, reduced chance for error, and reduced incidence of bloodstream infections. However, premixed PN may not be appropriate for all patients and may have other additional costs associated with its use. This article discusses the data available with regard to the use of premixed PN, focusing on the potential advantages and disadvantages of using premixed PN, and also discusses the implementation of premixed PN in a large tertiary cancer center. © 2015 American Society for Parenteral and Enteral Nutrition.
Roots, plant production and nutrient use efficiency
Willigen, de P.; Noordwijk, van M.
1987-01-01
The role of roots in obtaining high crop production levels as well as a high nutrient use efficiency is discussed. Mathematical models of diffusion and massflow of solutes towards roots are developed for a constant daily uptake requirement. Analytical solutions are given for simple and more
[Domiciliary parenteral antibiotic therapy: a prospective analysis of the last 12 years].
Peláez Cantero, M J; Madrid Rodríguez, A; Urda Cardona, A L; Jurado Ortiz, A
2014-08-01
Parenteral antibiotic treatment has been classically developed in hospitals and is considered as a hospital procedure. The development of Hospital at Home Units (HHU) has led to an increase in outpatient parenteral antibiotic therapy (OPAT) in paediatrics patients. The objective of this study is to describe our experience, as an HHU integrated within a Paediatric Department, in home antimicrobial therapy over a period of 12 years. This prospective and descriptive study included every patient with a disease requiring parenteral antimicrobial therapy who was admitted to our HHU from January 2000 to December 2012. During the study there were 163 cases on OPAT. The mean age of the patients was 11.1 years, and the sample group was comprised of 33 males and 22 feamales. The main sources of the treated infections were respiratory tract (76%), catheter-related bloodstream (9.2%), and urinary tract infections (5.5%). Amikacin was the most widely used antibiotic. Almost all treatments (96.6%) were via an intravenous route. Catheter-associated complications were more common than drug-associated complications. Successful at-home treatment was observed in 90.2% of cases. OPAT is a good and safe alternative in many paediatric diseases. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.
Cost analysis of premixed multichamber bags versus compounded parenteral nutrition: breakeven point.
Bozat, Erkut; Korubuk, Gamze; Onar, Pelin; Abbasoglu, Osman
2014-02-01
Industrially premixed multichamber bags or hospital-manufactured compounded products can be used for parenteral nutrition. The aim of this study was to compare the cost of these 2 approaches. Costs of compounded parenteral nutrition bags in an university hospital were calculated. A total of 600 bags that were administered during 34 days between December 10, 2009 and February 17, 2010 were included in the analysis. For quality control, specific gravity evaluation of the filled bags was performed. It was calculated that the variable cost of a hospital compounded bag was $26.15. If we take the annual fixed costs into consideration, the production cost reaches $36.09 for each unit. It was estimated that the cost for the corresponding multichamber bag was $37.79. Taking the fixed and the variable costs into account, the breakeven point of the hospital compounded and the premixed multichamber bags was seen at 5,404 units per year. In specific gravity evaluation, it was observed that the mean and interval values were inside the upper and lower control margins. In this analysis, usage of hospital-compounded parenteral nutrition bags showed a cost advantage in hospitals that treat more than 15 patients per day. In small volume hospitals, premixed multichamber bags may be more beneficial.
Santarpia, Lidia; Bozzetti, Federico
2018-02-01
Since there is no information regarding quality of life of caregivers assisting patients with advanced malignancy on home parenteral nutrition, herewith we report a preliminary series of 19 patients who received total parenteral nutrition at home under the strict supervision of their relatives. The relatives of 19 incurable patients with cancer-related cachexia, discharged from the hospital with a home parenteral nutrition program, were prospectively studied. They filled out a validated questionnaire, the Family Strain Questionnaire Short Form, prior to patient discharge and after 2 weeks of home care. The questionnaire included 30 items, which explored different domains regarding the superimposed burden on caregivers in relation to the assistance given to their relatives. Our findings show that the basal level of strain was relatively high (about three quarters of positive answers) but did not increase after 2 weeks of home care. Similarly, there was no difference in the nutritional status and quality of life of the patients. Eight patients and their relatives could be also analyzed after 2 months and the results maintained unchanged. This preliminary investigation shows that home parenteral nutrition does not exacerbate the level of strain on caregivers involved in surveillance of such a supportive intervention. It is possible that the perception of an active contribution to the benefit of patients, who maintained unchanged their nutritional status and quality of life, could gratify caregivers despite the objective burden in the constant supervision of administering Parenteral Nutrition.
Vente, J. P.; von Meyenfeldt, M. F.; van Eijk, H. M.; van Berlo, C. L.; Gouma, D. J.; van der Linden, C. J.; Soeters, P. B.
1990-01-01
Total parenteral nutrition with branched chain amino-acids enriched solutions has been advocated in patients with sepsis and stress because of favourable effects on nitrogen balance, protein synthesis and immune competence. The rationale for the use of BCAA-enriched solutions is based on their
Home Parenteral Nutrition in Adult Patients With Chronic Intestinal Failure
DEFF Research Database (Denmark)
Brandt, Christopher Filtenborg; Tribler, Siri; Hvistendahl, Mark
2018-01-01
BACKGROUND/AIMS: Catheter-related complications (CRCs) cause mortality and morbidity in patients dependent on parenteral support at home (HPN) due to intestinal failure (IF). This study describes the incidences of CRCs in an adult IF cohort over 40 years. It illustrates the evolution and conseque...
Sivasubramanian, K N; Henkin, R I
1978-11-01
Two premature infants were observed to develop behavioral and dermatologic changes and low serum zinc and copper concentrations following cessation of prolonged parenteral alimentation, while being fed exclusively with human milk. Following treatment with exogenous oral zinc supplementation, prompt relief of symptoms and increases of serum zinc and copper concentrations were observed in both infants. These patients comprise about 5% of our premature infants who are treated with parenteral alimentation for more than two weeks. We recommend that premature infants on prolonged parenteral alimentation should be monitored for changes in serum zinc and copper concentrations and, if a marked fall is observed, supplementation should be considered.
Directory of Open Access Journals (Sweden)
Poliana Rocha D'Almeida Mota
2013-03-01
Full Text Available A análise de crescimento com base no acúmulo de fitomassa e na marcha de absorção de nutrientes são importantes para determinar as épocas da maior demanda nutricional, de modo a programar a fertirrigação. Assim, esta pesquisa tem como objetivo determinar o crescimento e o acúmulo de nutrientes em plantas de crisântemo desenvolvidas em diferentes níveis de condutividade elétrica (CE da solução nutritiva. Realizou-se experimento em casa de vegetação, utilizando o delineamento de blocos casualizados com cinco tratamentos e quatro repetições. Os tratamentos corresponderam aos níveis de CE da solução aplicada, com valores de 1,42; 1,65; 1,89; 2,13 e 2,36 dS m¹(fase vegetativa e 1,71; 1,97; 2,28; 2,57 e 2,85 dS m¹(fase de botão. Após o enraizamento das estacas, determinou-se a fitomassa seca da parte aérea e realizou-se a análise química dos macronutrientes e micronutrientes a cada quatorze dias. Os nutrientes tiveram a seguinte ordem de absorção: K>N>Ca>P>Mg>S (1425, 892, 184, 150, 110 e 59 mg planta¹ e Fe>Zn>B>Mn>Cu (2254, 2219, 1725, 1287,210 µg planta¹. Grande parte dos nutrientes tem seu teor aumentado com a elevação do nível da CE da solução, sem que haja efeito salino até a CE de 2,85 dS m¹The study of growth and uptake of nutrients is important to determine the times of increased demand in order to schedule the fertigation. The present research was developed with the objective of evaluating the effects of different levels of electrical conductivity on growth and accumulation of nutrients in chrysanthemum plants under greenhouse conditions. The electri- cal conductivity levels on the applied solution were 1. 42, 1. 65, 1. 89, 2. 13 and 2. 36 dS m¹(bud vegetative stage; 1. 71, 1. 97, 2. 28, 2. 57 and 2. 85 dS m¹(bud stage. The dry mass of the aerial portion of the plant and the contents of macronutrients and micronutrients were determined every 14 days. The nutrient accumulation in chrysanthemum plant
Directory of Open Access Journals (Sweden)
Poliana Rocha D'Almeida Mota
2013-01-01
Full Text Available A análise de crescimento com base no acúmulo de fitomassa e na marcha de absorção de nutrientes são importantes para determinar as épocas da maior demanda nutricional, de modo a programar a fertirrigação. Assim, esta pesquisa tem como objetivo determinar o crescimento e o acúmulo de nutrientes em plantas de crisântemo desenvolvidas em diferentes níveis de condutividade elétrica (CE da solução nutritiva. Realizou-se experimento em casa de vegetação, utilizando o delineamento de blocos casualizados com cinco tratamentos e quatro repetições. Os tratamentos corresponderam aos níveis de CE da solução aplicada, com valores de 1,42; 1,65; 1,89; 2,13 e 2,36 dS m¹(fase vegetativa e 1,71; 1,97; 2,28; 2,57 e 2,85 dS m¹(fase de botão. Após o enraizamento das estacas, determinou-se a fitomassa seca da parte aérea e realizou-se a análise química dos macronutrientes e micronutrientes a cada quatorze dias. Os nutrientes tiveram a seguinte ordem de absorção: K>N>Ca>P>Mg>S (1425, 892, 184, 150, 110 e 59 mg planta¹ e Fe>Zn>B>Mn>Cu (2254, 2219, 1725, 1287,210 µg planta¹. Grande parte dos nutrientes tem seu teor aumentado com a elevação do nível da CE da solução, sem que haja efeito salino até a CE de 2,85 dS m¹The study of growth and uptake of nutrients is important to determine the times of increased demand in order to schedule the fertigation. The present research was developed with the objective of evaluating the effects of different levels of electrical conductivity on growth and accumulation of nutrients in chrysanthemum plants under greenhouse conditions. The electri- cal conductivity levels on the applied solution were 1. 42, 1. 65, 1. 89, 2. 13 and 2. 36 dS m¹(bud vegetative stage; 1. 71, 1. 97, 2. 28, 2. 57 and 2. 85 dS m¹(bud stage. The dry mass of the aerial portion of the plant and the contents of macronutrients and micronutrients were determined every 14 days. The nutrient accumulation in chrysanthemum plant
Turkot, Maryla; Sobocki, Jacek
2017-10-31
In the world, the inflammatory bowel disease affects an increasing number of younger and younger patients, and in some of them parenteral nutrition is an alternative to high-risk surgical intervention due to advancement of the disease and malnutrition. The aim of the study was to assess the results of home parenteral nutrition in patients with severe bowel inflammatory disease, in whom surgical treatment is associated with high risk of complications. A retrospective analysis was conducted on 46 patients, who received home parenteral nutrition instead of another surgical intervention. The inclusion criteria included home parenteral nutrition and diagnosis of Crohn's disease or ulcerative colitis. Mean number of complications requiring hospital admission per patient was 1.76, the BMI increased by 4.3 on average [kg/m2]. During parenteral nutrition, the percentage of patients, in whom anti-inflammatory or immunosuppressant drugs were completely discontinued, was 17.4%. In the whole group, at least one immunosuppressive drug was discontinued in onefifth of patients. Mean albumin level increased by 2.4 g/L, lymphocyte count dropped by 474 lymphocytes/mm3, and leukocyte count increased by 747.6/mm3. The patients described their condition as good in 87%, and 7.4% of patients were able to work. Home parenteral nutrition positively affects patient's general condition by increasing BMI and normalizing biochemical test results. The results indicate the need to consider this method as an alternative to surgical intervention in severe bowel inflammatory disease with high perioperative risk, which could reduce the complication rate.
Keyany, Ala; Nielen, Johannes T H; Souverein, Patrick C.; de Vries, Frank; van den Bemt, Bart
2018-01-01
Background: Use of oral glucocorticoids (GCs) has been associated with hyperglycaemia and type 2 diabetes mellitus (T2DM). However, unlike oral GCs, there is minimal or no data on the effect of parenteral GC use on T2DM. Objective: To assess the association between use of parenteral GCs and the risk
Lipid emulsions in parenteral nutrition: does one size fits all ...
African Journals Online (AJOL)
Dietary lipids significantly contribute to preserve the efficiency of human metabolism and restore it during disease. Therefore, in the absence of absolute contraindications, it would not appear reasonable to exclude lipid emulsions when prescribing parenteral nutrition (PN). The metabolic role of lipids has been elucidated, ...
International Nuclear Information System (INIS)
Isabel-Martinez, L.; Skinner, C.; Parkin, A.; Hall, R.I.
1989-01-01
Plasma triglyceride turnover was measured during steady-state conditions in 22 postoperative patients. Nine had received nutritional support with an enteral regimen, seven had received an equivalent regimen as continuous parenteral nutrition, and six received the same parenteral regimen as a cyclical infusion. After 5 days of nutritional support, each patient received an intravenous bolus of tritiated glycerol. Plasma radiolabeled triglyceride content was measured during the subsequent 24 hours. The data were analyzed by means of a simple deterministic model of plasma triglyceride kinetics and compared with the results obtained by stochastic analysis. The rates of hepatic triglyceride secretion obtained by deterministic analysis were higher than those obtained by the stochastic approach. However, the mode of delivery of the nutritional regimen did not affect the rate of hepatic triglyceride secretion regardless of the method of analysis. The results suggest that neither complete nutritional bypass of the gastrointestinal tract nor interruption of parenteral nutrition in an attempt to mimic normal eating has any effect on hepatic triglyceride secretion. Any beneficial effect that enteral feeding or cyclical parenteral nutrition may have on liver dysfunction associated with standard parenteral nutrition appears to be unrelated to changes in hepatic triglyceride secretion
Meixner, K; Fritz, I; Daffert, C; Markl, K; Fuchs, W; Drosg, B
2016-12-20
Within the last decades, environmental pollution with persistent plastics steadily increased; therefore the production of biodegradable materials like poly-ß-hydroxybutyrate (PHB) is essential. Currently, PHB is produced with heterotrophic bacteria from crops. This leads to competition with food and feed production, which can be avoided by using photoautotrophic cyanobacteria, as Synechocystis salina, synthesizing PHB from CO 2 at nutrient limitation. This study aims to increase the economic efficiency of PHB production with cyanobacteria by using nutrients from anaerobic digestate. First, growth and PHB production of S. salina in digestate fractions (supernatant and permeate, with/without precipitating agents) and dilutions thereof and then the scale-up (photobioreactor, 200 L working volume) were evaluated. With precipitated and centrifuged digestate diluted 1/3 the highest biomass (1.55gL -1 ) and PHB concentrations (95.4mgL -1 ), being 78% of those in mineral media, were achieved. In the photobioreactor-experiments biomass (1.63gL -1 ) and PHB concentrations (88.7mgL -1 ), being 79% and 72% of those in mineral medium, were reached, but in a cultivation time 10days longer than in mineral medium. The possibility to use digestate as sustainable and low cost nutrient solution for microalgae cultivation and photoautotrophic PHB production, instead of applying it on fields or processing it to achieve discharge limits, makes this application a highly valid option. Copyright © 2016 Elsevier B.V. All rights reserved.
Nutrient depletion from rhizosphere solution by maize grown in soil with long-term compost amendment
Improved understanding of rhizosphere chemistry will enhance our ability to model nutrient dynamics and on a broader scale, to develop effective management strategies for applied plant nutrients. With a controlled-climate study, we evaluated in situ changes in macro-nutrient concentrations in the rh...
Bohrer, Denise; Viana, Carine; Barichello, Marcia M; de Moura, Juliane F; de Carvalho, Leandro M; Nascimento, Paulo C
2017-08-01
Rubber closures are the primary packaging material for sterile preparations intended for repeated use. Important features of rubber closures are achieved after additives are added to the elastomeric material that compounds the rubber. Among these additives is carbon black. Because of its origin, carbon black may contain polycyclic aromatic hydrocarbons (PAHs). The U.S. Environmental Protection Agency has identified 16 priority PAHs on the basis of concerns that they cause or might cause cancer in animals and humans. Regulatory agencies impose carbon black purity specifications based on limits for total PAHs (0.5 mg/kg) and benzo[a]pyrene (5 μg/kg) or benzo[a]pyrene only (250 μg/kg). PAHs in rubber packaging used for pharmaceutical formulations and in parenteral products stored in containers with rubber stoppers were investigated. To this end, the method proposed by the National Institute for Occupational Safety and Health-based on high-performance liquid chromatography with ultraviolet and fluorescence detection-was adapted to determine the levels of PAHs in rubber stoppers (gray and red) and in lipid emulsions and amino acid solutions stored in bottles with rubber stoppers. The rubber materials were shown to contain 12 PAHs, in concentrations ranging from 0.25-3.31 µg/g. Only 1 of 18 samples (11 amino acid solutions and 7 lipid emulsions) was uncontaminated. The most prevalent contaminants were pyrene, benzo[a]pyrene, and fluoranthene. The total PAH concentrations in the samples ranged from 0.11-5.96 µg/mL. Components of parenteral nutrition may be contaminated with PAHs, and rubber stoppers represent a potential source of these contaminants.
Hepatology – Guidelines on Parenteral Nutrition, Chapter 16
Directory of Open Access Journals (Sweden)
Plauth, M.
2009-11-01
Full Text Available Parenteral nutrition (PN is indicated in alcoholic steatohepatitis (ASH and in cirrhotic patients with moderate or severe malnutrition. PN should be started immediately when sufficientl oral or enteral feeding is not possible. ASH and cirrhosis patients who can be sufficiently fed either orally or enterally, but who have to abstain from food over a period of more than 12 hours (including nocturnal fasting should receive basal glucose infusion (2–3 g/kg/d. Total PN is required if such fasting periods last longer than 72 h. PN in patients with higher-grade hepatic encephalopathy (HE; particularly in HE IV° with malfunction of swallowing and cough reflexes, and unprotected airways. Cirrhotic patients or patients after liver transplantation should receive early postoperative PN after surgery if they cannot be sufficiently rally or enterally nourished. No recommendation can be made on donor or organ conditioning by parenteral administration of glutamine and arginine, aiming at minimising ischemia/reperfusion damage. In acute liver failure artificial nutrition should be considered irrespective of the nutritional state and should be commenced when oral nutrition cannot be restarted within 5 to 7 days. Whenever feasible, enteral nutrition should be administered via a nasoduodenal feeding tube.
Characteristics of medication errors with parenteral cytotoxic drugs
Fyhr, A; Akselsson, R
2012-01-01
Errors involving cytotoxic drugs have the potential of being fatal and should therefore be prevented. The objective of this article is to identify the characteristics of medication errors involving parenteral cytotoxic drugs in Sweden. A total of 60 cases reported to the national error reporting systems from 1996 to 2008 were reviewed. Classification was made to identify cytotoxic drugs involved, type of error, where the error occurred, error detection mechanism, and consequences for the pati...
Radpay, Rojan; Poor Zamany Nejat Kermany, Mahtab; Radpay, Badiozaman
2016-01-01
Malnutrition is very common among chronically hospitalized patients, especially those in the intensive care unit (ICU). Identifying the patients at risk and providing suitable nutritional support can prevent and/or overcome malnutrition in them. Total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) are two common routes to deliver nutrition to hospitalized patients. We conducted a multicenter, prospective double blind randomized controlled trial to evaluate the benefits and compare their adverse effects of each method. 97 patients were enrolled and divided into two groups based on the inclusion criteria. Serum protein, serum albumin, serum transferrin, and total lymphocyte count were measured on days 7 and 14. We did not find any statistically significant differences in clinical status or laboratory values between the two groups but there were significant improvements in measured lab values between days 7 and 14 (pnutritional status in each groups. This study shows that both TPN and PPN can be used safely in chronic ICU patients to provide nutritional support and prevent catabolic state among chronic critically ill patients. We need to develop precise selection criteria in order to choose the patients who would benefit the most from TPN and PPN. In addition, appropriate laboratory markers are needed to monitor the metabolic requirements of the patients and assess their progress.
An Overview of Chitosan Nanoparticles and Its Application in Non-Parenteral Drug Delivery
Directory of Open Access Journals (Sweden)
Munawar A. Mohammed
2017-11-01
Full Text Available The focus of this review is to provide an overview of the chitosan based nanoparticles for various non-parenteral applications and also to put a spotlight on current research including sustained release and mucoadhesive chitosan dosage forms. Chitosan is a biodegradable, biocompatible polymer regarded as safe for human dietary use and approved for wound dressing applications. Chitosan has been used as a carrier in polymeric nanoparticles for drug delivery through various routes of administration. Chitosan has chemical functional groups that can be modified to achieve specific goals, making it a polymer with a tremendous range of potential applications. Nanoparticles (NP prepared with chitosan and chitosan derivatives typically possess a positive surface charge and mucoadhesive properties such that can adhere to mucus membranes and release the drug payload in a sustained release manner. Chitosan-based NP have various applications in non-parenteral drug delivery for the treatment of cancer, gastrointestinal diseases, pulmonary diseases, drug delivery to the brain and ocular infections which will be exemplified in this review. Chitosan shows low toxicity both in vitro and some in vivo models. This review explores recent research on chitosan based NP for non-parenteral drug delivery, chitosan properties, modification, toxicity, pharmacokinetics and preclinical studies.
Ueda, T; Hida, S; Higasa, K; Shinomiya, S; Matsumoto, T; Fukuoka, K; Yamanaka, E; Ozaki, S; Takayama, E
2000-12-01
We are managing 8 home care patients who have a gastrostomy made using an endoscopic percutaneous technique as a route of parenteral alimentation. Based on our experience, the preconditions for an endoscopic percutaneous gastrostomy as a route of parenteral alimentation are 1. normal gastrointestinal function, 2. difficulty in swallowing, 3. possibility that the caregiver can manage the gastrostomy. When we performed an endoscopic percutaneous gastrostomy as a route of parenteral alimentation for 8 home care patients, we obtained the several advantages mentioned below. 1. Swallowing pneumonia was prevented. 2. Adequate amount of alimental liquid could be infused. 3. Patient could take a bath or shower with the gastrostomy, and good QOL was realized. 4. The home care patient with the gastrostomy could have a satisfactorily long life.
Autonomous nutrient detection for water quality monitoring
Maher, Damien; Cleary, John; Cogan, Deirdre; Diamond, Dermot
2012-01-01
The ever increasing demand for real time environmental monitoring is currently being driven by strong legislative and societal drivers. Low cost autonomous environmental monitoring systems are required to meet this demand as current monitoring solutions are insufficient. This poster presents an autonomous nutrient analyser platform for water quality monitoring. Results from a field trial of the nutrient analyser are reported along with current work to expand the range of water quality targ...
Recent developments in protein and peptide parenteral delivery approaches
Patel, Ashaben; Cholkar, Kishore; Mitra, Ashim K
2014-01-01
Discovery of insulin in the early 1900s initiated the research and development to improve the means of therapeutic protein delivery in patients. In the past decade, great emphasis has been placed on bringing protein and peptide therapeutics to market. Despite tremendous efforts, parenteral delivery still remains the major mode of administration for protein and peptide therapeutics. Other routes such as oral, nasal, pulmonary and buccal are considered more opportunistic rather than routine application. Improving biological half-life, stability and therapeutic efficacy is central to protein and peptide delivery. Several approaches have been tried in the past to improve protein and peptide in vitro/in vivo stability and performance. Approaches may be broadly categorized as chemical modification and colloidal delivery systems. In this review we have discussed various chemical approaches such as PEGylation, hyperglycosylation, mannosylation, and colloidal carriers including microparticles, nanoparticles, liposomes, carbon nanotubes and micelles for improving protein and peptide delivery. Recent developments on in situ thermosensitive gel-based protein and peptide delivery have also been described. This review summarizes recent developments on some currently existing approaches to improve stability, bioavailability and bioactivity of peptide and protein therapeutics following parenteral administration. PMID:24592957
Knodell, R G; Spector, M H; Brooks, D A; Keller, F X; Kyner, W T
1980-12-01
Recent in vitro observations suggest that the intestine, in addition to the liver, may be an important organ of first-pass drug metabolism. While a variety of changes in intestinal morphology and function in response to continuous parenteral and enteral nutrition have been documented, the effect of different routes of alimentation on intestinal drug metabolism has not been previously investigated. Objectives of this study were to assess the contribution of intestinal pentobarbital metabolism to overall in vivo pentobarbital pharmacokinetics in the rat and to determine if differences in pentobarbital pharmacokinetics were seen between parenterally and enterally nourished animals. After 7 days of continuous infusion of amino acid-glucose mixture via a gastric or jugular vein catheter, pharmacokinetic parameters were determined after 40 mg/kg of pentobarbital was given orally or into the portal or femoral vein. Reduced systemic availability of pentobarbital after oral administration as compared to portal vein injection was seen in both alimentation groups indicating that significant intestinal metabolism of pentobarbital occurred in vivo. Total area under the pentobarbital plasma concentration-time curve was significantly greater in parenterally nourished animals as compared with enterally alimented animals after oral, portal vein and systemic vein drug administration. Differences in pentobarbital, pharmacokinetics between the two alimentation groups appeared to be primarly due to effects on hepatic pentobarbital metabolism. While the mechanism producing these changes has not been defined, differences in gut hormones release and/or pancreatic secretion in response to the two routes of alimentation may be contributory. The widespread use of enteral and parenteral alimentation in clinical medicine suggests that studies to determine if nutrition route of administration similarly influences drug metabolism in humans may be indicated.
Energy Technology Data Exchange (ETDEWEB)
Wang, Hao [State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092 (China); Wang, Xuejiang, E-mail: wangxj@tongji.edu.cn [State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092 (China); Ma, Jinxing, E-mail: jinxing.ma@unsw.edu.au [School of Civil and Environmental Engineering, University of New South Wales, Sydney, NSW 2052 (Australia); Xia, Peng; Zhao, Jianfu [State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092 (China)
2017-05-05
Highlights: • Both nutrient recovery and Cd(II) removal were achieved by MAP/APT. • The nutrient recovery process was used as a novel method of modification. • Compared with raw APT, MAP/APT enhanced Cd(II) adsorption capacity. • Cd(II) adsorption mechanisms from aqueous solution were extensively investigated. - Abstract: In this study, raw attapulgite (APT) and a novel adsorbent, struvite/attapulgite (MAP/APT) obtained from nutrient-rich wastewater treated by MgO modified APT, were applied as the absorbent for Cd(II) ion removal from aqueous solution. The two adsorbents were characterized by BET, SEM-EDS, XRD, FT-IR. Raw APT and MAP/APT separately presented the maximum Cd(II) adsorption capacities of 10.38 mg/g and 121.14 mg/g at pH of 5.45. The Cd(II) adsorption on raw APT and MAP/APT could be well fitted by Freundlich isotherm and Langmuir isotherm, respectively. Pseudo-second order equation was able to properly describe the kinetics of Cd(II) adsorption by raw APT and MAP/APT. The calculated thermodynamic parameters indicated that Cd(II) adsorption onto raw APT and MAP/APT were spontaneous and endothermic. An economic evaluation revealed that the treatment costs of the adsorption process by raw APT and MPA/APT were 0.013 $ per 1000 mg Cd and 0.004 $ per 1000 mg Cd, respectively.
Adult classical homocystinuria requiring parenteral nutrition: Pitfalls and management.
Tran, Christel; Bonafé, Luisa; Nuoffer, Jean-Marc; Rieger, Julie; Berger, Mette M
2017-07-25
Homocystinuria due to cystathionine beta synthase (CBS) deficiency presents with a wide clinical spectrum. Treatment by the enteral route aims at reducing homocysteine levels by using vitamin B6, possibly methionine-restricted diet, betaine and/or folate and vitamin B 12 supplementation. Currently no nutritional guidelines exist regarding parenteral nutrition (PN) under acute conditions. Exhaustive literature search was performed, in order to identify the relevant studies describing the pathogenesis and nutritional intervention of adult classical homocystinuria requiring PN. Description of an illustrative case of an adult female with CBS deficiency and intestinal perforation, who required total PN due to contraindication to enteral nutrition. Nutritional management of decompensated classical homocystinuria is complex and currently no recommendation exists regarding PN composition. Amino acid profile and monitoring of total homocysteine concentration are the main tools enabling a precise assessment of the severity of metabolic alterations. In case of contraindication to enteral nutrition, compounded PN will be required, as described in this paper, to ensure adequate low amounts of methionine and others essential amino acids and avoid potentially fatal toxic hypermethioninemia. By reviewing the literature and reporting successful nutritional management of a decompensated CBS deficiency using tailored PN with limited methionine intake and n-3 PUFA addition, we would like to underscore the fact that standard PN solutions are not adapted for CBS deficient critical ill patients: new solutions are required. High methionine levels (>800 μmol/L) being potentially neurotoxic, there is an urgent need to improve our knowledge of acute nutritional therapy. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Directory of Open Access Journals (Sweden)
Maria do Rosário Del Lama de Unamuno
2005-04-01
Full Text Available Cateteres venosos totalmente implantados são utilizados em pacientes com síndrome do intestino curto, para realizar o suporte nutricional parenteral, o qual mantém estes pacientes vivos, pois fornece-lhes nutrientes que são absorvidos pela via digestiva. No entanto, estes cateteres não são isentos de complicações. As infecções relacionadas aos cateteres venosos são as complicações mais temidas e sua incidência varia de 3% a 20%, aumentando em pacientes mais graves. O objetivo do presente estudo é descrever as complicações infecciosas em pacientes recebendo nutrição parenteral por meio de cateteres venosos totalmente implantados. Tais cateteres são utilizados pela Divisão de Nutrição Clínica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, para realizar o suporte nutricional parenteral em pacientes submetidos a ressecções extensas de intestino delgado. Foram avaliadas as complicações infecciosas ocorridas com 21 cateteres, implantados em 16 pacientes. O tempo de permanência dos cateteres foi de 768±664,3 dias (mediana 529 dias e a taxa de infecção foi de 0,029 infecções/paciente/ano, resultados que se comparam às taxas de infecção observadas em países desenvolvidos. Concluiu-se que os cuidados observados no manuseio destes cateteres foram de fundamental importância para diminuir a incidência de infecção nestes pacientes.Long-term venous catheters are used for the total parenteral nutrition infusion, which is essential for feeding short-bowel syndrome patients. However, complications are likely to occur. The incidence of catheter related infections ranges from 3 to 20% in hospitalized patients. The Divisão de Nutrição Clínica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Brazil, has been providing nutrition support to short-bowel syndrome patients, using totally implantable venous catheters. This is a
Validation of the aseptic filling at the Parenteral Products Plant 3 in BioCen
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Marisol Álvarez-González
2016-07-01
Full Text Available As part of the continuous improvement process, a new parenterals production plant (PPP3 was constructed at the National Center for Bioproducts. The validation of the aseptic filling process is a key element to carry out before manufacturing products. Therefore, the aim of this work was to obtain documented evidence that all the operations were carried out according the regulations of Good Manufacturing Practices for liquid and lyophilized sterile products during the aseptic filling at the Parenterals Product Plant 3. The study was designed for lyophilized products connected to the manifold of the peristaltic pump and to the four rotary piston pumps. Besides, during the filling operation four interventions were planned. The validation was carried out with three consecutive batches of media fill. In the first processed lot no vial was contaminated, but in the second and third lots there was one contaminated vial. For that reason, an investigation was performed in order to know the cause of the contamination. Finally, with this wok the validated condition was obtained, following the regulations of Good Manufacturing Practices for sterile liquids and lyophilizes products during the aseptic filling process at the Parenterals Products Plant 3.
Directory of Open Access Journals (Sweden)
Fernanda Alice Antonello Londero Backes
2008-10-01
Full Text Available O diagnóstico nutricional é fundamental para determinar as exigências das plantas quanto aos nutrientes, de forma a se proceder a um manejo adequado, de acordo com a espécie. Assim, para determinar as concentrações e conteúdos nutricionais adequados à produção e qualidade de plantas de lisianto em cultivo hidropônico, instalou-se um experimento onde as plantas foram cultivadas em sistema NFT, em diferentes soluções nutritivas. O experimento foi conduzido, segundo delineamento experimental em blocos casualizados, em esquema fatorial 4x3, totalizando 12 tratamentos, com três repetições. Ostratamentos foram compostos de quatro cultivares (Echo Champagne, Mariachi Pure White, Balboa Yellow e Ávila Blue Rim e três soluções nutritivas (Teste, Steiner modificada e Barbosa. Foram avaliadas as concentrações e os conteúdos dos nutrientes nas folhas e conteúdos na parte aérea das plantas. As plantas cultivadas nas soluções Barbosa eTeste apresentaram resultados satisfatórios quanto às concentrações e aos conteúdos de nutrientes, enquanto a solução Steiner modificada produziu plantas com limitações nutricionais.The nutritional diagnosis is fundamental for determining plantnutrients, in order to correctly manage the nutritional requirements for each species. Thus, in order to determine the ideal nutrient amount and concentration for obtaining the best yield and quality of lisianthus grown hydroponically, an experiment was conducted inwhich the plants were grown under the NFT system in different nutrient solutions. The experiment was conducted according to a random block design arrangement in a 4x3 factorial scheme, totaling 12 treatments with three repetitions. The treatments werecomprised of four cultivars (Echo Champagne, Mariachi Pure White, Balboa Yellow and Ávila Blue Rim and three nutrient solutions (Test, modified Steiner and Barbosa. In the leaves, nutrient concentration and content were evaluated; in the aerial
Continuous parenteral and enteral nutrition induces metabolic dysfunction in neonatal pigs
DEFF Research Database (Denmark)
Stoll, Barbara; Puiman, Patrycja Jolanta; Cui, Liwei
2012-01-01
We previously showed that parenteral nutrition (PN) compared with formula feeding results in hepatic insulin resistance and steatosis in neonatal pigs. The current aim was to test whether the route of feeding (intravenous [IV] vs enteral) rather than other feeding modalities (diet, pattern) had...
The prognosis of incurable cachectic cancer patients on home parenteral nutrition
DEFF Research Database (Denmark)
Bozzetti, F; Santarpia, L; Pironi, L
2014-01-01
BACKGROUND: The role of home parenteral nutrition (HPN) in incurable cachectic cancer patients unable to eat is extremely controversial. The aim of this study is to analyse which factors can influence the outcome. PATIENTS AND METHODS: We studied prospectively 414 incurable cachectic (sub)obstruc...
Jara-Aguirre, Jose C; Smeets, Steven W; Wockenfus, Amy M; Karon, Brad S
2018-05-01
Evaluate the effects of blood gas sample contamination with total parenteral nutrition (TPN)/lipid emulsion and dextrose 50% (D50) solutions on blood gas and electrolyte measurement; and determine whether glucose concentration can predict blood gas sample contamination with TPN/lipid emulsion or D50. Residual lithium heparin arterial blood gas samples were spiked with TPN/lipid emulsion (0 to 15%) and D50 solutions (0 to 2.5%). Blood gas (pH, pCO2, pO2), electrolytes (Na+, K+ ionized calcium) and hemoglobin were measured with a Radiometer ABL90. Glucose concentration was measured in separated plasma by Roche Cobas c501. Chart review of neonatal blood gas results with glucose >300 mg/dL (>16.65 mmol/L) over a seven month period was performed to determine whether repeat (within 4 h) blood gas results suggested pre-analytical errors in blood gas results. Results were used to determine whether a glucose threshold could predict contamination resulting in blood gas and electrolyte results with greater than laboratory-defined allowable error. Samples spiked with 5% or more TPN/lipid emulsion solution or 1% D50 showed glucose concentration >500 mg/dL (>27.75 mmol/L) and produced blood gas (pH, pO 2 , pCO 2 ) results with greater than laboratory-defined allowable error. TPN/lipid emulsion, but not D50, produced greater than allowable error in electrolyte (Na + ,K + ,Ca ++ ,Hb) results at these concentrations. Based on chart review of 144 neonatal blood gas results with glucose >250 mg/dL received over seven months, four of ten neonatal intensive care unit (NICU) patients with glucose results >500 mg/dL and repeat blood gas results within 4 h had results highly suggestive of pre-analytical error. Only 3 of 36 NICU patients with glucose results 300-500 mg/dL and repeat blood gas results within 4 h had clear pre-analytical errors in blood gas results. Glucose concentration can be used as an indicator of significant blood sample contamination with either TPN
Shiroma, Glaucia Midori; Horie, Lilian Mika; Castro, Melina Gouveia; Martins, Juliana R; Bittencourt, Amanda F; Logullo, Luciana; Teixeira da Silva, Maria de Lourdes; Waitzberg, Dan L
2015-06-01
Nutrition quality control in parenteral nutrition therapy (PNT) allows the identification of inadequate processes in parenteral nutrition (PN). The objective of this study was to assess the quality of PNT at a hospital with an established nutrition support team (NST). This observational, longitudinal, analytical, and prospective study examined 100 hospitalized PNT adult patients under the care of an NST for 21 days or until death/hospital discharge. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) 2007 guidelines for PNT prescription were followed. PNT indications were not in accordance with the A.S.P.E.N. 2007 guidelines in 15 patients. Among the remaining 85 patients, 48 (56.5%) did not receive adequate PNT (≥80% of the total volume prescribed). Non-NST medical orders, progression to and from enteral nutrition, changes in the central venous catheter, unknown causes, and operational errors (eg, medical prescription loss, PN nondelivery, pharmacy delays, inadequate PN bag temperature) were associated with PNT inadequacy (P nutrition therapy related to estimated energy expenditure and protein requirements and glycemia levels reached the expected targets; however, the central venous catheter infection rate was higher than 6 per 1000 catheters/d and did not meet the expected targets. Despite an established NST, there was a moderate level of PNT inadequacy in indications, administration, and monitoring. It is important to establish periodic meetings among different health professionals who prescribe and deliver PNT to define responsibilities and protocols. © 2015 American Society for Parenteral and Enteral Nutrition.
Parenteral nutrition in radiation therapy and combined treatment of patients with esophageal cancer
International Nuclear Information System (INIS)
Sudzhyan, A.V.; Buzovkina, L.P.; Biletov, B.V.; Breusenko, E.Ya.; Krasnova, A.I.; Tsaryuk, V.F.
1980-01-01
Results obtained while studying 165 patients with esophageal cancer are presented. It is shown that radiation therapy and combined treatment result in the body mass loss, in the increase of katabolic processes in organism, in the negative nitrogen balance. Weaken patients, being under starvation conditions, are subjected more often to reaction changes and complications developing during the treatment. A comparison characteristics of two methods providing the organism with nutrition is given, i.e. gastrostomy and parenteral nutrition. Shown is the advantage of the adequate parenteral nutrition preventing the appearence of reaction changes and complications, improving the subjective state of patients, homeostasis indices, promoting the elimination of esophagitis phenomena, general radiation response and reaction to chemical preparations; resulting in the increase of quantity of leucocytes at leukopenia
DEFF Research Database (Denmark)
Slimani, N.; Deharveng, G.; Unwin, I.
2007-01-01
the absence of a reference European nutrient database for international nutritional epidemiology studies, the EPIC Nutrient Database (ENDB) project has been set up to standardise nutrient databases (NDBs) across 10 European countries participating in the EPIC study. This paper reports the main...... problems in harmonising NDBs experienced by end-user in the ENDB project and the solutions adopted to prevent and minimize them, which are also relevant for other large European nutritional studies. Furthermore, it provides end-user recommendations for improving the comparability of European and other NDBs...
Recent advances in polymeric microspheres for parenteral drug delivery--part 1.
Mao, Shirui; Guo, Chunqiang; Shi, Yi; Li, Luk Chiu
2012-09-01
Polymeric microspheres have been established as a valuable parenteral drug delivery system for sustained release of therapeutic agents via subcutaneous or intramuscular injection. Biodegradable polymers which are either synthetic or from natural sources are reviewed with respect to recent advances in exploring their applications for microsphere fabrications. New information on the impact of formulation variables on the properties of microspheres formed by an emulsion method was also presented. The characterization of microspheres using advanced physical analytical techniques was also reviewed and the utilization of the information in assessing in vivo performance of the product was also highlighted. The broad clinical use of microspheres for delivery of therapeutic agents in particular biologics such as proteins has not been realized commercially. The limited availability of biodegradable polymers with a long history of regulatory approval and the challenges in gaining regulatory approval of a new polymer have hindered the development of microspheres for parenteral drug delivery.
El Kasmi, Karim C.; Anderson, Aimee L.; Devereaux, Michael W.; Vue, Padade M.; Zhang, Wujuan; Setchell, Kenneth D. R.; Karpen, Saul J.; Sokol, Ronald J.
2014-01-01
Parenteral nutrition–associated liver disease (PNALD) is a serious complication of PN in infants who do not tolerate enteral feedings, especially those with acquired or congenital intestinal diseases. Yet, the mechanisms underlying PNALD are poorly understood. It has been suggested that a component of soy oil (SO) lipid emulsions in PN solutions, such as plant sterols (phytosterols), may be responsible for PNALD, and that use of fish oil (FO)–based lipid emulsions may be protective. We used a mouse model of PNALD combining PN infusion with intestinal injury to demonstrate that SO-based PN solution causes liver damage and hepatic macrophage activation and that PN solutions that are FO-based or devoid of all lipids prevent these processes. We have furthermore demonstrated that a factor in the SO lipid emulsions, stigmasterol, promotes cholestasis, liver injury, and liver macrophage activation in this model and that this effect may be mediated through suppression of canalicular bile transporter expression (Abcb11/BSEP, Abcc2/MRP2) via antagonism of the nuclear receptors Fxr and Lxr, and failure of up-regulation of the hepatic sterol exporters (Abcg5/g8/ABCG5/8). This study provides experimental evidence that plant sterols in lipid emulsions are a major factor responsible for PNALD and that the absence or reduction of plant sterols is one of the mechanisms for hepatic protection in infants receiving FO-based PN or lipid minimization PN treatment. Modification of lipid constituents in PN solutions is thus a promising strategy to reduce incidence and severity of PNALD. PMID:24107776
Ridley, Emma J; Davies, Andrew R; Parke, Rachael; Bailey, Michael; McArthur, Colin; Gillanders, Lyn; Cooper, David J; McGuinness, Shay
2015-12-24
Nutrition is one of the fundamentals of care provided to critically ill adults. The volume of enteral nutrition received, however, is often much less than prescribed due to multiple functional and process issues. To deliver the prescribed volume and correct the energy deficit associated with enteral nutrition alone, parenteral nutrition can be used in combination (termed "supplemental parenteral nutrition"), but benefits of this method have not been firmly established. A multi-centre, randomised, clinical trial is currently underway to determine if prescribed energy requirements can be provided to critically ill patients by using a supplemental parenteral nutrition strategy in the critically ill. This prospective, multi-centre, randomised, stratified, parallel-group, controlled, phase II trial aims to determine whether a supplemental parenteral nutrition strategy will reliably and safely increase energy intake when compared to usual care. The study will be conducted for 100 critically ill adults with at least one organ system failure and evidence of insufficient enteral intake from six intensive care units in Australia and New Zealand. Enrolled patients will be allocated to either a supplemental parenteral nutrition strategy for 7 days post randomisation or to usual care with enteral nutrition. The primary outcome will be the average energy amount delivered from nutrition therapy over the first 7 days of the study period. Secondary outcomes include protein delivery for 7 days post randomisation; total energy and protein delivery, antibiotic use and organ failure rates (up to 28 days); duration of ventilation, length of intensive care unit and hospital stay. At both intensive care unit and hospital discharge strength and health-related quality of life assessments will be undertaken. Study participants will be followed up for health-related quality of life, resource utilisation and survival at 90 and 180 days post randomisation (unless death occurs first). This trial
Development of a vinasse nutritive solution for hydroponics.
dos Santos, José Darcy; Lopes da Silva, André Luís; da Luz Costa, Jefferson; Scheidt, Gessiel Newton; Novak, Alessandra Cristine; Sydney, Eduardo Bittencourt; Soccol, Carlos Ricardo
2013-01-15
Vinasse is a residue that originates from the distillation of fuel alcohol. However, it contains a relative amount of nutrients. The aim of this work was to develop a nutritive solution using vinasse and to compare it with a commercial solution for the cultivation of lettuce, watercress and rocket. Vinasse obtained from juice must was decanted and filtered, followed by chemical analyses of the nutrients. A nutritive solution composed of 10% vinasse supplemented with nutrients was in agreement with the results of the chemical analyses (a similar amount of Furlani's solution). Experiments were then performed in an NFT (Nutrient film technique) system. The treatments used the vinasse solution and a commercial solution constituted from a Yara Fertilizantes(®) product. The height of the aerial part and the number of leaves of the crops were evaluated at 7, 14, 21, 28, 35 and 42 days. In most crops, the results were very similar. The vinasse solution promoted a larger number of leaves in lettuce and the highest aerial part in watercress. For the rocket, there were no significant differences between the two solutions. In conclusion, a nutritive solution was developed using vinasse, and this solution provided suitable growth, which was higher in some cases, for the crops studied herein. This study shows the great potential of this technology as a rational alternative to vinasse disposal. Copyright © 2012 Elsevier Ltd. All rights reserved.
Optimal nutrient application strategy for bioremediation of oil-polluted beaches. Volume 1
International Nuclear Information System (INIS)
Li, H.; Zhao, Q.; Boufadel, M.C.; Venosa, A.D.
2007-01-01
Offshore oil spills in coastal areas generally occur in the intertidal zone of beaches and affect the top 25 cm of soil, known as the bioremediation zone. Biostimulation by nutrient application such as nitrogen and phosphorus is a viable technology for restoring oil-contaminated beaches. The key for achieving a rapid cost-effective cleanup is to ensure maximum nutrient residence time. This study proposed a strategy that consisted of injecting nutrients through a perforated pipe at the high tide line. Beach hydraulics were numerically simulated to estimate the optimal injection flow rate of nutrient solution. It was shown that the optimal application should begin following high tide just as it drops and should last for half a tidal cycle. The flow rate ensures that the saturated wet-front of the nutrient solution on the beach surface moves seaward with the same speed of the falling tide keeping a constant distance with the tide line. The numerical results were generalized to a broad range of hydraulic and tidal properties of beaches using an innovative dimensionless formulation for water flow and solute transport in porous media. Nomographs were presented to provide the flow rate based on 4 parameters, notably the beach slope, permeability, tidal amplitude and tidal period. 29 refs., 1 tab., 5 figs
Essential fatty acid deficiency in patients receiving home parenteral nutrition 1,2
DEFF Research Database (Denmark)
Jeppesen, P. B.; Høy, Carl-Erik; Mortensen, Per B
1998-01-01
Home parenteral nutrition (HPN), initiated in patients with severe malabsorption or decreased oral intake, may exhaust stores of essential fatty acids and cause clinical manifestations, mainly dermatitis. Plasma fatty acid profiles were measured by gas-liquid chromatography in 37 healthy control...
Development of the management for parenteral nutrition traceability in a standard hospital
Directory of Open Access Journals (Sweden)
Beatriz Bernabeu Soria
2015-11-01
Full Text Available Objective: to develop the traceability control and the hazard analysis in the processes of parenteral nutrients (PN. Method: a standardized graphical notation was generated, describing in detail each of the stages in the overall process. The presence of hazards was analysed by sequencing decisions. The existence of Control Points (CP or Critical Control Points (CCP was estimated by Criticality Index (CI for each hazard taking into account the probability of occurrence and the severity of the damage. The threshold for the IC was set in 6. Results: a specific flow chart for the management and traceability of PN was obtained, defining each of the stages in CPs (validation and transcription of the prescription and administration or CCPs (preparation, storage and infusion pump –flow and filter-. Stages regarding the delivery, the recovery and the recycle of the packing material of PNs are not considered CPs and, therefore, they were not included in the dashboard. Conclusions: PN must be dealt with in the frame of a standardized management system in order to improve patient safety, clinical relevance, maximize resource efficiency and minimize procedural issues. The proposed system provides a global management model whose steps are fully defined, allowing monitoring and verification of PN. It would be convenient to make use of a software application to support the monitoring of the traceability management and to store the historical records in order to evaluate the system.
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Paulo Camara Marques Pereira
1985-10-01
Full Text Available Os Autores descrevem um caso de paracoccidioidomicose subaguda progressiva, com quadro clínico sugestivo de síndrome de má absorção, em que o doente não se beneficiara apenas com o tratamento antifúngico convencional. Ao se introduzir como medida auxiliar a nutrição parenteral houve evidente melhora clínica e laboratorial. Desta maneira os Autores propõe o uso associado da nutrição parenteral no tratamento de doentes com esta forma clínica de paracoccidioidomicose.
DEFF Research Database (Denmark)
Iyer, Kishore R; Kunecki, Marek; Boullata, Joseph I
2017-01-01
BACKGROUND: In phase III clinical studies, treatment with teduglutide was associated with clinically meaningful reductions (≥20% from baseline) in parenteral support (PS; parenteral nutrition and/or intravenous fluids) requirements in adult patients with intestinal failure associated with short...
International Nuclear Information System (INIS)
Ragon, A.; Reynier, J.P.; Guiraud, G.
1985-01-01
During total and stable parenteral nutrition, a branched chain amino acid enriched solution containing [ 15 N]leucine was infused into a patient to determine the fate of the nitrogen administered through this formulation. Measurements of 15 N isotopic enrichments were performed on the same biological samples (urinary urea, total plasma proteins and albumin) by optical emission spectrometry (OES) and mass spectrometry (MS) to determine if OES with its specific advantages (cost, handling maintenance) constituted even with low enrichments a useful alternative technique to MS considered as the reference method. The results show that OES constituted a very useful analytical technique to obtain reliable information in clinical metabolic studies when low 15 N enrichments must be determined. (Auth.)
Cost of goods sold and total cost of delivery for oral and parenteral vaccine packaging formats.
Sedita, Jeff; Perrella, Stefanie; Morio, Matt; Berbari, Michael; Hsu, Jui-Shan; Saxon, Eugene; Jarrahian, Courtney; Rein-Weston, Annie; Zehrung, Darin
2018-03-14
Despite limitations of glass packaging for vaccines, the industry has been slow to implement alternative formats. Polymer containers may address many of these limitations, such as breakage and delamination. However, the ability of polymer containers to achieve cost of goods sold (COGS) and total cost of delivery (TCOD) competitive with that of glass containers is unclear, especially for cost-sensitive low- and lower-middle-income countries. COGS and TCOD models for oral and parenteral vaccine packaging formats were developed based on information from subject matter experts, published literature, and Kenya's comprehensive multiyear plan for immunization. Rotavirus and inactivated poliovirus vaccines (IPV) were used as representative examples of oral and parenteral vaccines, respectively. Packaging technologies evaluated included glass vials, blow-fill-seal (BFS) containers, preformed polymer containers, and compact prefilled auto-disable (CPAD) devices in both BFS and preformed formats. For oral vaccine packaging, BFS multi-monodose (MMD) ampoules were the least expensive format, with a COGS of $0.12 per dose. In comparison, oral single-dose glass vials had a COGS of $0.40. BFS MMD ampoules had the lowest TCOD of oral vaccine containers at $1.19 per dose delivered, and ten-dose glass vials had a TCOD of $1.61 per dose delivered. For parenteral vaccines, the lowest COGS was achieved with ten-dose glass vials at $0.22 per dose. In contrast, preformed CPAD devices had the highest COGS at $0.60 per dose. Ten-dose glass vials achieved the lowest TCOD of the parenteral vaccine formats at $1.56 per dose delivered. Of the polymer containers for parenteral vaccines, BFS MMD ampoules achieved the lowest TCOD at $1.89 per dose delivered, whereas preformed CPAD devices remained the most expensive format, at $2.25 per dose delivered. Given their potential to address the limitations of glass and reduce COGS and TCOD, polymer containers deserve further consideration as alternative
Recovery of Nutrients from Biogas Digestate with Biochar and Clinoptilolite
DEFF Research Database (Denmark)
Kocatürk, Nazli Pelin
in recovery of nutrients whose natural reserves are being depleted such as phosphorus and potassium. In this thesis I propose the use of sorbents i.e. biochar and clinoptilolite to concentrate nutrients and subsequently the application of digestate-enriched biochar and clinoptilolite as fertiliser. Therefore...... the overall objective of this thesis is to investigate the use of clinoptilolite and biochar to recover plant nutrients from the liquid fraction of digestate resulting from anaerobic digestion of animal manure and investigate the plant-availability of the recovered form of nutrients. In Chapter 1 (General...... of nutrients on sorbent) but decreasing efficiencies of clinoptilolite to remove nutrients from the liquid fraction of digestate. In Chapter 3, I studied the chemical activation of biochar by treating the biochar with deionised water, hydrogen peroxide, sulfuric acid and sodium hydroxide solutions...
Third-Generation Fatty Emulsions as Part of Parenteral Feeding in Operated Cancer Patients
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S. V. Lomidze
2010-01-01
Full Text Available Objective: to study the efficacy of third- versus secondary-generation fatty emulsions as part of parenteral nutrition in patients operated on for gastric cancer. Subjects and methods. Envelope randomization was used to make up two groups, each comprising 10 patients, operated on for gastric cancer in the scope of gastrectomy. A control group received parenteral nutrition having the following components: Lipofundin MST/LST 20%, (500 ml daily + Nutriflex 48/150 (B. Braun (1000 ml daily, 1744 kcal/day. The study group patients were given Lipoplus 20% (500 ml daily + Nutriflex 48/150 (1000 ml daily, 1745 kcal/day. Parenteral nutrition was used on postoperative days 1 to 5. Results. Nutritional status evaluation revealed a significant increase in the concentration of total protein and albumin in the control and study group patients on postoperative day 6. The use of both second- and third-generation fatty emulsions caused a significant increase in the concentration of triglycerides on day 6 after surgery; no differences were found between the groups. On day 6 following surgery, there was a significant decrease in IL-4 in both groups (p<0.05. At the same time the Lipofundin MST/LST group showed a significantly lower concentration of IL-4 than did the study group (p<0.05. After termination of a parenteral nutrition course, the study and control groups showed a significant decrease in one of the major pro-inflammatory cytokines — IL-6. Conclusion. In the study group, the serum anti-inflammatory activity of IL-4 was more evident than that in the control group and the proinflammatory activity (IL-6 concentration decreased, which can support that as compared with the second-generation fatty emulsions, third-generation ones with a balanced omega 3 to omega-6 fatty acid ratio (1:2.7 had a normalizing effect on systemic inflammatory processes and cytokine balance with increased anti-inflammatory and reduced proinflammatory activities. Key words: third
DEFF Research Database (Denmark)
Siggers, Jayda; Sangild, Per T.; Jensen, Tim Kåre
2011-01-01
bacterial groups (Clostridium, Enterococcus, Streptococcus species) increased with time. We conclude that a switch from parenteral to enteral nutrition rapidly induces diet-dependent histopathological, functional, and proinflammatory insults to the immature intestine. Great care is required when introducing......-six preterm pigs were fed total parenteral nutrition (TPN) for 48 h followed by enteral feeding for 0, 8, 17, or 34 h with either colostrum (Colos, n = 20) or formula (Form, n = 31). Macroscopic NEC lesions were detected in Form pigs throughout the enteral feeding period (20/31, 65%), whereas most Colos pigs...... no histopathological lesions, increased maltase activity, and induced changes in gene expressions related to tissue development. Total bacterial density was high after 2 days of parenteral feeding and was not significantly affected by diet (colostrum, formula) or length of enteral feeding (8–34 h), except that a few...
Nitrogen sparing by 2-ketoisocaproate in parenterally fed rats
International Nuclear Information System (INIS)
Yagi, M.; Matthews, D.E.; Walser, M.
1990-01-01
In rats receiving total parenteral nutrition with or without sodium 2-ketoisocaproate (KIC; 2.48 g.kg-1.day-1), L-[1- 13 C]leucine and [1- 14 C]KIC were constantly infused for 6 h. CO 2 production, 14 CO 2 production, 13 CO 2 enrichment, urinary urea nitrogen (N) plus ammonia N and total urinary N were measured. Whole body protein synthesis (S) was calculated in non-KIC-infused rats and also in unfed rats infused with [1- 14 C]leucine from fractional oxidation of labeled leucine (1-F), where F is fractional utilization for protein synthesis, and urea N plus ammonia N excretion (C) as S = C x F/(1-F). Addition of KIC caused a significant reduction in N excretion and a significant improvement in N balance. Fractional oxidation of labeled KIC increased, whereas fractional utilization of labeled KIC for protein synthesis decreased, but the extent of incorporation of infused KIC into newly synthesized protein (as leucine) amounted to at least 40% of the total rate of leucine incorporation into newly synthesized whole body protein. We conclude that addition of KIC spares N in parenterally fed rats and becomes a major source of leucine for protein synthesis
Validation of cold chain during distribution of parenteral nutrition
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Federico Tuan
2015-09-01
Full Text Available Objective: this study aims to demonstrate the suitability of the process used to condition the extemporaneous mixtures of parenteral nutrition for distribution, considering the objective of preserving the cold chain during transport until it reaches the patient, necessary to ensure stability, effectiveness and safety of these mixtures. Method: concurrent validation, design and implementation of a protocol for evaluating the process of packaging and distribution of MNPE developed by a pharmaceutical laboratory. Running tests, according to predefined acceptance criteria. It is performed twice, in summer and on routes that require longer transfer time. Evaluation of conservation of temperature by monitoring the internal temperature values of each type of packaging, recorded by data loggers calibrated equipment. Results: the different tests meet the established criteria. The collected data ensure the maintenance of the cold chain for longer than the transfer time to the most distant points. Conclusions: this study establishes the suitability of the processes to maintaining the cold chain for transfer from the laboratory to the patient pharmacist. Whereas the breaking of cold chain can cause changes of compatibility and stability of parenteral nutrition and failures nutritional support, this study contributes to patient safety, one of the relevant dimensions of quality of care the health.
ROLE OF PARENTERAL AMINO ACIDS SUPPLEMENATION IN OLIGOHYDRAMNIOS & IUGR COMPLICATED PREGNANCIES
Anuradha; Malini; Sumit
2015-01-01
OBJECTIVES: To see whether parenteral nutritional supplementation of women with oligohydramnios/IUGR can improve the amount of liquor and to evaluate the role of pareneral therapy in improving maternal and perinatal outcome and to correlate between the occurrence of oligohydramnios and IUGR among women of different age, parity, education and socioe...
Modelling nutrient cycling in forest ecosystems; Modellering av naeringssyklus i skogoekosystemer
Energy Technology Data Exchange (ETDEWEB)
Kvindesland, Sheila H.S.B.
1997-12-31
Acid deposition`s threat to fresh water and forest environments became an issue in the late 1960s. Acid deposition and forest nutrient cycling then began to be researched in greater co-operation. This thesis studies nutrient cycling processes in Norway spruce forests, emphasizing the effects on soil chemical properties, soil solution chemistry and streamwater chemistry. It investigates the effects of different aged stands on nutrient cycling and sets up nutrient budgets of the base cations and nitrogen at two sites in Norway. It also selects, documents, calibrates, tests and improves nutrient cycling models for use in Norwegian forests. 84 refs., 44 figs., 46 tabs.
Directory of Open Access Journals (Sweden)
Anamaria RP Ramos
2012-06-01
mudas de melancia, em relação ao crescimento e status nutricional.The choice of substrate is one of the most important stages for the seedlings production and must take into account the nutritional requirements of cultivated species. Thus, the objective was to evaluate the substrate using coconut dust associated with nutrient solutions to produce seedlings of watermelon. The experiment was carried out at Embrapa Semi-Arid in Petrolina, Pernambuco state, Brazil, in a greenhouse in a completely randomized design with ten replications in a factorial arrangement 2 x 10 (cultivars of watermelon and substrates. The cultivars used were: Opara and Top Gun. The coconut fiber was associated with nutrient solutions as follows: T1= control treatment composed of the commercial organic substrate Plantmax® (SC, T2= coconut powder (PC, T3= coconut powder + melon solution (PC+SM, T4= coconut powder + solution of Hoagland and Arnon 12.5% (12.5% PC+HS, T5= coconut powder + solution of Hoagland and Arnon 25% (PC+HS 25%, T6= coconut powder + solution of Hoagland and Arnon 50% (PC+HS 50%, T7= coconut powder + solution of Hoagland and Arnon 75% (PC+HS 75%, T8= coconut powder + solution of Hoagland and Arnon 100% (100% PC+HS, T9= coconut powder + Aminoagro Mol (PC+AM, T10= coconut powder Aminoagro Root (PC+AR. The solutions were applied eight times, 10 mL on each application, since the fourth day after sowing date (DAS, when the evaluation of seedlings emergence began. At 24 DAS we evaluated the fresh weight of shoots and roots, root length, number of roots in the upper third and contents of macro and micronutrients in the aboveground part. The cv. Top Gun presented higher levels of nutrients, except for iron and copper. The treatments T6, T7 and T8 presented levels of nutrients in plants similar to the commercial substrate Plantmax. In general, the combinations of coconut dust associated with the nutrient solution of Hoagland and Arnon at 50, 75 and 100% and Aminoagro Root proved to be
Sauerwein, H. P.; Michels, R. P.; Cejka, V.
1985-01-01
The influence of total parenteral nutrition and stomach resection on alanine turnover rate and alanine oxidation rate was measured in ten patients after single injection of U-14 C-alanine. Sequential studies were done in three patients. During parenteral nutrition alanine turnover was significantly
Femoral venous catheters: a safe alternative for delivering parenteral alimentation.
Friedman, B; Kanter, G; Titus, D
1994-04-01
Femoral vein catheterization is an alternative method of obtaining central venous access. Placement of femoral venous catheters (FVCs) is possible in the majority of patients, suitable for most indications, and associated with a low complication rate during insertion. We wished to determine the incidence of infections or other complications resulting when parenteral nutrition was delivered through FVCs. Fifty-two patients were followed from a hospital-wide population including patients in the critical care units. Triple-lumen catheters were placed by using the sterile Seldinger technique, and sites were examined daily for inflammation. Bacteriologic surveillance was accomplished by submitting the catheter tip for semiquantitative cultures. If catheter line sepsis was suspected, blood samples for cultures were drawn through the catheter and peripherally. The rate of occurrence of colonized catheters was 9.6% (five of 52), and catheter sepsis was found in one case (1.9%). Other than inflammation at six (11.5%) of 52 catheter sites, noninfectious complications of FVCs were not found. On the basis of these findings, we consider FVC-delivered parenteral alimentation a safe and effective alternative to other forms of central venous access.
Directory of Open Access Journals (Sweden)
Marcelo Zanetti
2004-12-01
Full Text Available Com o objetivo de avaliar o efeito da presença do extrato pirolenhoso (EP na calda de pulverização sobre o teor foliar de nutrientes de limoeiro 'Cravo' (Citrus limonia Osbeck, foi desenvolvido um experimento com seis tratamentos e quatro repetições, em blocos ao acaso, em ambiente protegido. Os tratamentos constituíram da pulverização das soluções: T0 = água; T1 = solução de micronutrientes sem EP; T2 = solução de micronutrientes + EP (1cm³ dm-3; T3 = solução de micronutrientes + EP (2 cm³ dm-3; T4 = solução de micronutrientes + EP (5cm³ dm-3; T5 = solução de micronutrientes + EP (10 cm³ dm-3. A solução de micronutrientes foi preparada com sulfatos de Cu, Fe, Mn, Zn (250 mg dm-3 do elemento e ácido bórico (42,5 mg dm-3 de B. As plantas foram cultivadas em tubetes cônicos de 0,280 dm³, com substrato sem a adição de micronutrientes na formulação. As soluções foram pulverizadas uma única vez, aos 140 dias após o plantio (DAP, momento em que as plantas apresentavam aproximadamente 20 cm de altura. Ao final do experimento (160 DAP, quantificaram-se a massa seca e os teores de macro e micronutrientes da parte aérea e sistema radicular. A presença do extrato pirolenhoso na solução de micronutrientes não interferiu na concentração foliar de B, Fe e Zn em mudas de limoeiro 'Cravo'. Entretanto, na concentração de 10 cm³ dm-3, aumentou a concentração foliar de Cu e Mn. Observou-se também que as plantas pulverizadas com soluções contendo EP (1 a 10 cm³ dm-3 + micronutrientes apresentaram menor teor de Fe e maior teor de Ca no sistema radicular.This research studied the effect of pyroligneous acid (PA presence in the micronutrient solution sprayed on leaves on the foliar nutrient content of 'Rangpur lime' (Citrus limonia Osbeck0 seedlings, under screen house. An experiment in a randomized complete block design with six treatments and four replicates was set up. Treatments consisted of leaf spraying with
Subunit Rotavirus Vaccine Administered Parenterally to Rabbits Induces Active Protective Immunity
Ciarlet, Max; Crawford, Sue E.; Barone, Christopher; Bertolotti-Ciarlet, Andrea; Ramig, Robert F.; Estes, Mary K.; Conner, Margaret E.
1998-01-01
Virus-like particles (VLPs) are being evaluated as a candidate rotavirus vaccine. The immunogenicity and protective efficacy of different formulations of VLPs administered parenterally to rabbits were tested. Two doses of VLPs (2/6-, G3 2/6/7-, or P[2], G3 2/4/6/7-VLPs) or SA11 simian rotavirus in Freund’s adjuvants, QS-21 (saponin adjuvant), or aluminum phosphate (AlP) were administered. Serological and mucosal immune responses were evaluated in all vaccinated and control rabbits before and after oral challenge with 103 50% infective doses of live P[14], G3 ALA lapine rotavirus. All VLP- and SA11-vaccinated rabbits developed high levels of rotavirus-specific serum and intestinal immunoglobulin G (IgG) antibodies but not intestinal IgA antibodies. SA11 and 2/4/6/7-VLPs afforded similar but much higher mean levels of protection than 2/6/7- or 2/6-VLPs in QS-21. The presence of neutralizing antibodies to VP4 correlated (P < 0.001, r = 0.55; Pearson’s correlation coefficient) with enhanced protection rates, suggesting that these antibodies are important for protection. Although the inclusion of VP4 resulted in higher mean protection levels, high levels of protection (87 to 100%) from infection were observed in individual rabbits immunized with 2/6/7- or 2/6-VLPs in Freund’s adjuvants. Therefore, neither VP7 nor VP4 was absolutely required to achieve protection from infection in the rabbit model when Freund’s adjuvant was used. Our results show that VLPs are immunogenic when administered parenterally to rabbits and that Freund’s adjuvant is a better adjuvant than QS-21. The use of the rabbit model may help further our understanding of the critical rotavirus proteins needed to induce active protection. VLPs are a promising candidate for a parenterally administered subunit rotavirus vaccine. PMID:9765471
Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy
International Nuclear Information System (INIS)
Fietkau, R.
1998-01-01
Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [de
Mehta, Nilesh M; Skillman, Heather E; Irving, Sharon Y; Coss-Bu, Jorge A; Vermilyea, Sarah; Farrington, Elizabeth Anne; McKeever, Liam; Hall, Amber M; Goday, Praveen S; Braunschweig, Carol
2017-07-01
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and 2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance. The PubMed/MEDLINE search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search for clinical trials culled 1661 citations. In total, the search for clinical trials yielded 1107 citations, whereas the cohort search yielded 925. After careful review, 16 randomized controlled trials and 37 cohort studies appeared to answer 1 of the 8 preidentified question groups for this guideline. We used the GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluation) to adjust the evidence grade based on assessment of the quality of study design and execution. These guidelines are not intended for neonates or adult patients. The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention. There is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake. Indirect calorimetry, where feasible, and cautious use of estimating equations and increased surveillance for unintended caloric underfeeding and overfeeding are recommended. Optimal protein intake and its correlation with clinical outcomes are areas of great interest. The optimal route and timing of nutrient delivery are areas of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The
Adachi, Kyoichi; Furuta, Kenji; Aimi, Masahito; Fukazawa, Kousuke; Shimura, Shino; Ohara, Shunji; Nakata, Shuji; Inoue, Yukiko; Ryuko, Kanji; Ishine, Junichi; Katoh, Kyoko; Hirata, Toshiaki; Ohhata, Shuzo; Katoh, Setsushi; Moriyama, Mika; Sumikawa, Masuko; Sanpei, Mari; Kinoshita, Yoshikazu
2012-05-01
The aim of this study was to determine the efficacy of pectin solution, which increases the viscosity of liquid nutrient, for prevention of gastro-esophageal reflux in comparison with half-solid nutrient. The subjects were 10 elderly patients undergoing percutaneous endoscopic gastrostomy feeding. Twenty-four-hour esophageal multichannel intraluminal impedance and pH testing was performed during intake of half-solid nutrient and a combination of pectin solution and liquid nutrient. During 4 h after delivery, there was no significant difference in the total number of gastro-esophageal reflux events between the feeding of the half-solid nutrient and the combination of pectin solution and liquid nutrient (5.7 ± 1.2 vs 5.3 ± 1.0/4 h). Acidic reflux after delivery of the half-solid nutrient was significantly more frequent than that after delivery of the combination of pectin solution and liquid nutrient (80.7% vs 60.4%, p = 0.018). The incidence of gastro-esophageal reflux reaching the upper portion of the esophagus tended to be higher during delivery of the half-solid nutrient than during delivery of the combination of pectin solution and liquid nutrient (47.4% vs 34.0%, p = 0.153). In conclusion, the usage of pectin solution combined with liquid nutrient is effective for preventing acidic gastro-esophageal reflux and gastro-esophageal reflux reaching the upper portion of the esophagus.
Jones, Jesica A; Ninnis, Janet R; Hopper, Andrew O; Ibrahim, Yomna; Merritt, T Allen; Wan, Kim-Wah; Power, Gordon G; Blood, Arlin B
2014-09-01
Dietary nitrate and nitrite are sources of gastric NO, which modulates blood flow, mucus production, and microbial flora. However, the intake and importance of these anions in infants is largely unknown. Nitrate and nitrite levels were measured in breast milk of mothers of preterm and term infants, infant formulas, and parenteral nutrition. Nitrite metabolism in breast milk was measured after freeze-thawing, at different temperatures, varying oxygen tensions, and after inhibition of potential nitrite-metabolizing enzymes. Nitrite concentrations averaged 0.07 ± 0.01 μM in milk of mothers of preterm infants, less than that of term infants (0.13 ± 0.02 μM) (P milk. Concentrations in parenteral nutrition were equivalent to or lower than those of breast milk. Freeze-thawing decreased nitrite concentration ~64%, falling with a half-life of 32 minutes at 37°C. The disappearance of nitrite was oxygen-dependent and prevented by ferricyanide and 3 inhibitors of lactoperoxidase. Nitrite concentrations in breast milk decrease with storage and freeze-thawing, a decline likely mediated by lactoperoxidase. Compared to adults, infants ingest relatively little nitrite and nitrate, which may be of importance in the modulation of blood flow and the bacterial flora of the infant GI tract, especially given the protective effects of swallowed nitrite. © 2013 American Society for Parenteral and Enteral Nutrition.
[Role of parenteral cephalosporins for outpatients treatment of infections].
Esposito, S; Mazzei, T; Novelli, A
2001-12-01
OPAT (Outpatient Parenteral Antibiotic Therapy) arose in the early 1980s in the USA and later in many other countries from the primary consideration that outpatient treatment is more cost-effective than hospitalisation. Currently, several thousand patients undergo OPAT programmes all over the world and several different bacterial infections are included in the list of treatable diseases, especially those requiring long-term parenteral treatment such as osteomyelitis and soft tissue infections. All injectable antibiotics are suitable for OPAT according to their microbiological spectrum, although clearly some pharmacological properties make one antibiotic more preferable than another. Beta-lactams represent more than half of the antibiotic world market and two-thirds of them are cephalosporins. Such a widespread use of cephalosporins is certainly due to their wide antibacterial spectrum and good tolerability. Among third-generation cephalosporins, covering the majority of micro-organisms responsible for community-acquired infections, ceftriaxone is the only one with an 8-hour half-life, thereby permitting a single daily dose, which represents a great advantage when undertaking an OPAT programme. Analysis of antibiotic consumption used for OPAT therapies, based on data collected from the International OPAT Registry project, with the participation of many countries (USA, Canada, Britain, Argentina, etc.) including Italy, shows that ceftriaxone is the most widely used antibiotic for home therapy, clearly due to the above-mentioned properties.
Covino, T. P.; Bowden, W. B.; Gooseff, M. N.; Wollheim, W. M.; McGlynn, B. L.; Whittinghill, K. A.; Wlostowski, A. N.; Herstand, M. R.
2012-12-01
Understanding the relationship between solute travel time, concentration, and nutrient uptake remains a central question in watershed hydrology and biogeochemistry. Theoretical understanding predicts that nutrient uptake should increase as in-stream solute travel time lengthens and/or as concentration increases; however, results from field-based studies have been contradictory. We used a newly developed approach, Tracer Additions for Spiraling Curve Characterization (TASCC), to investigate relationships between solute travel time, nutrient concentration, and nutrient uptake across a range of stream types. This approach allows us to quantify in-stream nutrient uptake across a range of travel times and nutrient concentrations using single instantaneous injections (slugs) of conservative and non-conservative tracers. In some systems we observed counter-clockwise hysteresis loops in the relationship between nutrient uptake and concentration. Greater nutrient uptake on the falling limb of tracer breakthrough curves indicates stronger uptake for a given concentration at longer travel times. However, in other systems we did not observe hysteresis in these relationships. Lack of hysteresis indicates that nutrient uptake kinetics were not influenced by travel time travel time. Here we investigate the potential roles of travel time and in-stream flowpaths that could be responsible for hysteretic behavior.
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Martha Medina García
2006-06-01
Full Text Available Se realizó un estudio de análisis económico, del tipo de minimización de costes, con el objetivo de evaluar los costes de un régimen de tratamiento antibiótico parenteral de corta duración (3 días utilizado en recién nacidos con infección del tracto urinario alta, de evolución inicial favorable, en comparación con otro de larga duración (≥ 5 días. Se tuvo como base un estudio analítico, observacional, en el que se conformaron dos grupos según el régimen de tratamiento antibiótico parenteral (corto o largo seguido de antibioticoterapia oral, que generó un ciclo de tratamiento parenteral-oral secuencial de 10 días de duración. Se evaluaron los costes por concepto de tratamiento con antibióticos y de hospitalización. Con el tratamiento corto se habrían ahorrado 29 054,58 CU con respecto a los costes derivados del régimen de tratamiento largo, a lo que se suman otros beneficios en la esfera psico-social familiar. Con los resultados obtenidos concluimos que un régimen de tratamiento antibiótico parenteral de corta duración (3 días para el tratamiento de una infección del tracto urinario alta de evolución inicial favorable, tiene mayor eficiencia que un régimen largo (≥ 5 días, pues se logra minimizar los costes relativos al tratamiento antibiótico y a la hospitalización.
Enteral versus parenteral nutrition in cancer patients: evidences and controversies.
Cotogni, Paolo
2016-01-01
The debate over the use of enteral nutrition (EN) and parenteral nutrition (PN) is an old but evergreen and hot topic. Since many years, studies comparing EN and PN have been a pivotal 'leitmotif' in the published literature on artificial nutrition (AN). Actually, there is a background misunderstanding in this debate; specifically, that EN and PN are competitors in the choice of the route for delivering nutrition support in cancer patients. Conversely, EN and PN have specific indications and contraindications. This review has the purpose to discuss the indications and complications as well as pros and cons of EN and PN in cancer patients, the crucial role of nutrition support in oncology patients during anticancer treatments and throughout the course of disease, and, finally, the role of AN in advanced cancer patients. In summary, we have no evidence-based data able to definitively indicate the optimal method for delivering AN in cancer patients. EN and PN have to be considered equally effective in maintaining or improving nutritional status in cancer patients. Besides, this review strongly supports the recommendation that a baseline nutritional assessment should be carried out by a healthcare professional expert in AN for all cancer patients at the time of diagnosis or anticancer treatment plan, taking the nutritional status, estimated duration of AN, AN-related potential benefits and possible complications into consideration on an individual basis. Moreover, the patient symptoms, performance status, estimated life expectancy, and mainly, will or preferences have to be evaluated and incorporated into the nutrition support plan before the definitive choice of the route for delivering nutrients is decided. Finally, applying a decision-making process tailored to patient needs-regardless of whether receiving or not anticancer treatment-allows to choose reasonably the optimal nutritional support strategy.
Review of macronutrients in parenteral nutrition for neonatal intensive care population.
Johnson, Patricia J
2014-01-01
Parenteral nutrition (PN) has become essential in the management of sick and growing newborn populations in the NICU. In the past few decades, PN has become fundamental in the nutritional management of the very low birth weight infant (macronutrients in PN, including carbohydrates, protein, and fat. A subsequent article will review the micronutrients in PN, including electrolytes, minerals, and vitamins.
Energy Technology Data Exchange (ETDEWEB)
Foroughi, M.; Hoffmann, G.; Teicher, K.; Venter, F.
1975-01-01
Experiments were performed to examine concentrations at which excess symptoms could be expected, which kind of damage symptoms appear and in which amount the heavy metals are enriched in roots and leaves. The following results were revealed. Lettuce (Lactuca sativa L. var. capitata L.) can tolerate amounts of Cd below 1 ppm, of Ni below 2 ppm and of Pb below 20 ppm in the nutrient solution without any symptoms of excess. The growth of lettuce was mostly influenced by Cd, least of all by Pb. Only Ni caused specific poisoning symptoms. Heavy metals were enriched in different amounts in roots and leaves. The contents of Cd and Ni were more than twice as high as those of Pb. The heavy metals influenced the uptake and distribution of macro-elements more (nitrogen) or less (potassium) vigorously.
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Pandit Vinay
2011-01-01
Full Text Available Organophosphate (OP poisoning is common in India. Only few case reports of parenteral OP poisoning have been described. We report a case of self-injected methyl parathion poisoning, presenting after four days with seizure, altered sensorium, and respiratory distress which posed a diagnostic and therapeutic dilemma. Despite nonavailability of history of OP poisoning, he was treated based on suspicion and showed a good clinical response to treatment trial with atropine and pralidoxime, and had a successful recovery. Atypical presentations may be encountered following parenteral administration of OP poison, and even a slight suspicion of this warrants proper investigations and treatment for a favorable outcome. Persistently low plasma cholinesterase level is a useful marker for making the diagnosis.
DEFF Research Database (Denmark)
Jakobsen, Marianne Skytte; Jørgensen, Marianne Hørby; Husby, Steffen
2015-01-01
INTRODUCTION: Parenteral nutrition-associated cholestasis (PNAC) is a complication of long-term parenteral nutrition (PN). Removal of lipids may reverse PNAC but compromises the energy to ensure infant growth. The purpose of this study was to test whether a low-fat, high-carbohydrate PN regimen......, which prevents and reverses PNAC in adults, could do the same in infants. This regimen could potentially avoid the problem of diminished energy input after removing nutritional lipids. METHODS: Infants developing PNAC over a 2-year period were started on a low-fat PN regimen with calories primarily from...
Parenteral nutrition including polyamine under experimental irradiation of the abdomen
International Nuclear Information System (INIS)
Moroz, B.B.; Fedorovskij, L.L.; Lyashchenko, Yu.N.
1982-01-01
White rats-males were used in experiments. Irradiation dose of abdomen area is 13.5 Gy (1400 R). Parenteral nutrition using aminoacid preparation of polyamine affects favourably during radiation damage resulted from local irradiation of abdomen area. This was manifested in weakening of gastroenteric syndrom, reduction of 3.5 day death of animals and increase of their 30 day survival rate, intensification of recovery processes in small intestine, decrease of cell devastation in bone marrow
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Paulo Francisco Guerreiro Cardoso
2011-10-01
Full Text Available OBJETIVO: Apresentar um modelo experimental de administração de prostaglandina I2 (PGI2 por via inalatória vs. parenteral e avaliar o desempenho funcional dos pulmões em um sistema de perfusão pulmonar ex vivo. MÉTODOS: Quarenta ratos Wistar foram anestesiados, ventilados, submetidos a laparotomia com ressecção do esterno e anticoagulados. O tronco da artéria pulmonar foi canulado. Todos os animais foram submetidos a ventilação mecânica. Os animais foram randomizados em quatro grupos (10 ratos/grupo: salina nebulizada (SN; salina parenteral (SP; PGI2 nebulizada (PGI2N; e PGI2 parenteral (PGI2P. A dose de PGI2 nos grupos PGI2N e PGI2P foi de 20 e 10 µg/kg, respectivamente. Os blocos cardiopulmonares foram submetidos in situ a perfusão anterógrada com solução de baixo potássio e dextrana a 4ºC via artéria pulmonar, extraídos em bloco e armazenados a 4ºC por 6 h. Os blocos foram ventilados e perfundidos em um sistema ex vivo por 50 min, sendo obtidas medidas de mecânica ventilatória, hemodinâmica e trocas gasosas. RESULTADOS: Houve redução da pressão arterial pulmonar média após a nebulização em todos os grupos (p OBJECTIVE:To present a model of prostaglandin I2 (PGI2 administration (inhaled vs. parenteral and to assess the functional performance of the lungs in an ex vivo lung perfusion system. METHODS: Forty Wistar rats were anesthetized and placed on mechanical ventilation followed by median sterno-laparotomy and anticoagulation. The main pulmonary artery was cannulated. All animals were maintained on mechanical ventilation and were randomized into four groups (10 rats/group: inhaled saline (IS; parenteral saline (PS; inhaled PGI2 (IPGI2; and parenteral PGI2 (PPGI2. The dose of PGI2 used in the IPGI2 and PPGI2 groups was 20 and 10 µg/kg, respectively. The heart-lung blocks were submitted to antegrade perfusion with a low potassium and dextran solution via the pulmonary artery, followed by en bloc extraction and
A smart market for nutrient credit trading to incentivize wetland construction
Raffensperger, John F.; Prabodanie, R. A. Ranga; Kostel, Jill A.
2017-03-01
Nutrient trading and constructed wetlands are widely discussed solutions to reduce nutrient pollution. Nutrient markets usually include agricultural nonpoint sources and municipal and industrial point sources, but these markets rarely include investors who construct wetlands to sell nutrient reduction credits. We propose a new market design for trading nutrient credits, with both point source and non-point source traders, explicitly incorporating the option of landowners to build nutrient removal wetlands. The proposed trading program is designed as a smart market with centralized clearing, done with an optimization. The market design addresses the varying impacts of runoff over space and time, and the lumpiness of wetland investments. We simulated the market for the Big Bureau Creek watershed in north-central Illinois. We found that the proposed smart market would incentivize wetland construction by assuring reasonable payments for the ecosystem services provided. The proposed market mechanism selects wetland locations strategically taking into account both the cost and nutrient removal efficiencies. The centralized market produces locational prices that would incentivize farmers to reduce nutrients, which is voluntary. As we illustrate, wetland builders' participation in nutrient trading would enable the point sources and environmental organizations to buy low cost nutrient credits.
Hydroponic Crop Production using Recycled Nutrients from Inedible Crop Residues
Garland, Jay L.; Mackowiak, Cheryl L.; Sager, John C.
1993-01-01
The coupling of plant growth and waste recycling systems is an important step toward the development of bioregenerative life support systems. This research examined the effectiveness of two alternative methods for recycling nutrients from the inedible fraction (residue) of candidate crops in a bioregenerative system as follows: (1) extraction in water, or leaching, and (2) combustion at 550 C, with subsequent reconstitution of the ash in acid. The effectiveness of the different methods was evaluated by (1) comparing the percent recovery of nutrients, and (2) measuring short- and long-term plant growth in hydroponic solutions, based on recycled nutrients.
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El Essawy R
2013-05-01
Full Text Available Rania El Essawy,1 Rasha Essameldin Galal21Department of Ophthalmology, 2Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, EgyptBackground: The purpose of this study was to evaluate the results and complications of early surgical resection of large amblyogenic subdermal eyelid hemangiomas in infants after prior short-term parenteral administration of corticosteroids.Methods: Sixteen infants were given dexamethasone 2 mg/kg/day in two divided doses for three consecutive days prior to scheduled surgical excision of large eyelid hemangiomas. The lesions were accessed via an upper eyelid crease, subeyebrow incision, or a lower eyelid subciliary incision.Results: In all cases, surgical excision of the entire lesion was possible with no significant intraoperative or postoperative complications. The levator muscle/aponeurosis complex was involved in 31.25% of cases and was managed by reinsertion or repositioning without resection. A satisfactory lid position and contour with immediate clearing of the visual axis was achieved in all but one case (93.8%.Conclusion: Parenteral corticosteroids helped in reducing volume and blood flow from the hemangiomas, allowing for very early total excision of large subdermal infantile hemangiomas without significant intraoperative hemorrhage. This resulted in immediate elimination of any reason for occlusion amblyopia. Long-term follow-up of visual development in these patients would help to demonstrate the effectiveness of this strategy compared with more conservative measures.Keywords: large eyelid hemangiomas, early surgical resection, parenteral corticosteroids
Damgaard, Rasmus; Rasmussen, Mats; Buus, Peter; Mulhall, Brian; Guazzo, Dana Morton
2013-01-01
In Part 1 of this three-part research series, a leak test performed using high-voltage leak detection (HVLD) technology, also referred to as an electrical conductivity and capacitance leak test, was developed and validated for container-closure integrity verification of a small-volume laminate plastic bag containing an aqueous solution for injection. The sterile parenteral product is the rapid-acting insulin analogue, insulin aspart (NovoRapid®/NovoLog®, by Novo Nordisk A/S, Bagsværd, Denmark). The aseptically filled and sealed package is designed to preserve product sterility through expiry. Method development and validation work incorporated positive control packages with a single hole laser-drilled through the laminate film of each bag. A unique HVLD method characterized by specific high-voltage and potentiometer set points was established for testing bags positioned in each of three possible orientations as they are conveyed through the instrument's test zone in each of two possible directions-resulting in a total of six different test method options. Validation study results successfully demonstrated the ability of all six methods to accurately and reliably detect those packages with laser-drilled holes from 2.5-11.2 μm in nominal diameter. Part 2 of this series will further explore HVLD test results as a function of package seal and product storage variables. The final Part 3 will report the impact of HVLD exposure on product physico-chemical stability. In this Part 1 of a three-part research series, a leak test method based on electrical conductivity and capacitance, called high voltage leak detection (HVLD), was used to find leaks in small plastic bags filled with an insulin pharmaceutical solution for human injection by Novo Nordisk A/S (Bagsværd, Denmark). To perform the test, the package is electrically grounded while being conveyed past an electrode linked to a high-voltage, low-amperage transformer. The instrument measures the current that passes
The effect of structured triglycerides on the kinetic stability of total nutrient admixtures.
Balogh, Judit; Bubenik, Júlia; Dredán, Judit; Csempesz, Ferenc; Kiss, Dorottya; Zelkó, Romána
2005-10-05
The physical stability of two types of total parenteral nutrient (TPN) admixtures was studied as a function of storage time and temperature. One of them contained only structured triglycerides and the other exclusively long-chain triglycerides as lipid components. Droplet size of the mixtures was followed by photon correlation spectroscopy for 10 days. Zeta potential and dynamic surface tension measurements were carried out to evaluate the possible changes in the charge and interfacial surface tension of the emulsion droplets during the storage. pH values were monitored in order to follow the possible decomposition processes in the course of storage. Droplet size of emulsions prepared with lipids containing exclusively long-chain triglycerides showed remarkable increase after 4 days of storage in contrast with that of the mixtures containing structured lipids. The obtained results indicate that besides the advantageous metabolic effects of structured triglycerides, their application is recommended to improve the physical stability of TPN admixtures.
Zhu, Xin-Hua; Wu, Ya-Fu; Qiu, Yu-Dong; Jiang, Chun-Ping; Ding, Yi-Tao
2013-09-21
To investigate the effect of early enteral nutrition (EEN) combined with parenteral nutritional support in patients undergoing pancreaticoduodenectomy (PD). From January 2006, all patients were given EEN combined with parenteral nutrition (PN) (EEN/PN group, n = 107), while patients prior to this date were given total parenteral nutrition (TPN) (TPN group, n = 67). Venous blood samples were obtained for a nutrition-associated assessment and liver function tests on the day before surgery and 6 d after surgery. The assessment of clinical outcome was based on postoperative complications. Follow-up for infectious and noninfectious complications was carried out for 30 d after hospital discharge. Readmission within 30 d after discharge was also recorded. Compared with the TPN group, a significant decrease in prealbumin (PAB) (P = 0.023) was seen in the EEN/PN group. Total bilirubin (TB), direct bilirubin (DB) and lactate dehydrogenase (LDH) were significantly decreased on day 6 in the EEN/PN group (P = 0.006, 0.004 and 0.032, respectively). The rate of grade I complications, grade II complications and the length of postoperative hospital stay in the EEN/PN group were significantly decreased (P = 0.036, 0.028 and 0.021, respectively), and no hospital mortality was observed in our study. Compared with the TPN group (58.2%), the rate of infectious complications in the EEN/PN group (39.3%) was significantly decreased (P = 0.042). Eleven cases of delayed gastric emptying were noted in the TPN group, and 6 cases in the EEN/PN group. The rate of delayed gastric emptying and hyperglycemia was significantly reduced in the EEN/PN group (P = 0.031 and P = 0.040, respectively). Early enteral combined with PN can greatly improve liver function, reduce infectious complications and delayed gastric emptying, and shorten postoperative hospital stay in patients undergoing PD.
Prematurity and overfeeding in infants are associated with insulin resistance in childhood and may increase the risk of adult disease. Total parenteral nutrition (TPN) is a major source of infant nutrition support and may influence neonatal metabolic function. Our aim was to test the hypothesis that...
The parenteral nutritional regimen in pigs for basic studies in physiology of nutrition
International Nuclear Information System (INIS)
Matkowitz, R.; Harting, W.; Souffrant, W.B.; Junghans, P.; Boerner, P.
1983-01-01
Experimental studies concerning a parenteral nutritional regimen were performed in pigs aiming at comparative metabolic investigations to evaluate clinically relevant problems within nutritional research. By means of the 15 N tracer technique the evaluation of the postoperative protein turnover was rendered possible by this animal model
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Matteo Ghiringhelli
2015-07-01
Full Text Available Our study is focused on evaluation and use of the most effective and correct nutrients. In particular, our attention is directed to the role of certain amino acids in cachectic patients. During parenteral nutrition in humans, physician already associates in the PN-bags different formulations including amino acids, lipids and glucose solutions or essential amino acids solution alone or exclusively branched-chain amino acids (BCAA. Studies investigated the effects of dietary BCAA ingestion on different diseases and conditions such as obesity and metabolic disorders, liver disease, muscle atrophy, cancer, impaired immunity or injuries (surgery, trauma, burns, and sepsis. BCAAs have been shown to affect gene expression, protein metabolism, apoptosis and regeneration of hepatocytes, and insulin resistance. They have also been shown to inhibit the proliferation of liver cancer cells in vitro, and are essential for lymphocyte proliferation and dendritic cell maturation. Oral or parenteral administration of these three amino acids will allow us to evaluate the real efficacy of these compounds during a therapy to treat malnutrition in subjects unable to feed themselves.
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Major-Godlewska Marta
2015-09-01
Full Text Available The aim of the study presented was to experimentally analyze an effect of the nutrient type and its concentration on the variability of rheological properties of the baker’s yeast suspensions for different time periods. Aqueous suspensions of the baker’s yeast of various concentration (solution I, without nutrient and yeasts suspended in aqueous solution of sucrose or honey as nutrients with different concentration (solution II or solution III were tested. Experiments were carried out using rotational rheoviscometer of type RT10 by a company HAAKE. The measurements were conducted for different time periods (from 1 h up to 144 h at given fluid temperature. On the basis of the obtained data, rheological characteristics of the aqueous solution of baker’s yeast suspensions without and with nutrients of different sucrose or honey concentration were identified and mathematically described.
Performance test of nutrient control equipment for hydroponic plants
Rahman, Nurhaidar; Kuala, S. I.; Tribowo, R. I.; Anggara, C. E. W.; Susanti, N. D.
2017-11-01
Automatic control equipment has been made for the nutrient content in irrigation water for hydroponic plants. Automatic control equipment with CCT53200E conductivity controller to nutrient content in irrigation water for hydroponic plants, can be used to control the amount of TDS of nutrient solution in the range of TDS numbers that can be set according to the range of TDS requirements for the growth of hydroponically cultivated crops. This equipment can minimize the work time of hydroponic crop cultivators. The equipment measurement range is set between 1260 ppm up to 1610 ppm for spinach plants. Caisim plants were included in this experiment along with spinach plants with a spinach plants TDS range. The average of TDS device is 1450 ppm, while manual (conventional) is 1610 ppm. Nutrient solution in TDS controller has pH 5,5 and temperature 29,2 °C, while manual is pH 5,6 and temperature 31,3 °C. Manually treatment to hydroponic plant crop, yields in an average of 39.6 grams/plant, greater than the yield of spinach plants with TDS control equipment, which is in an average of 24.6 grams / plant. The yield of caisim plants by manual treatment is in an average of 32.3 grams/crop, less than caisim crop yields with TDS control equipment, which is in an average of 49.4 grams/plant.
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Mohammad Zahirul Islam
2018-04-01
Full Text Available ABSTRACT This study was conducted to investigate the effects of nutrient and salinity concentrations on the quality of deepflow technique hydroponic system cultivated cherry tomatoes (Lycopersicon esculentum Mill ‘Unicorn’. The conditions were: (1 control (NS-1 × nutrient Solution, Electrical Conductivity – EC: 2.5 mS∙cm–1; (2 2 × NS (2 × NS-Double NS, EC: 5 mS∙cm–1; (3 NS + 4.23 mM NaCl (NaCl-Sodium Chloride, EC: 5 mS∙cm–1; and (4 NS + 13.70 mM Sea Water – SW (EC: 7.5 mS∙cm–1. NS + 13.70 mM SW treatment showed the lowest fresh weight loss. Visual quality as well as shelf life was the longest in NS (1 × nutrient solution treated tomato fruits. The longest shelf life at 5 °C, 11 °C, and 24 °C were 21, 16, and 8 days, respectively, in NS (1 × nutrient solution treated tomato fruits. The highest firmness was recorded in NS (1 × nutrient solution treated tomato fruits, which was retained after storage. Moreover, NS + 13.70 mM SW treatment increased the cherry tomato fruit’s quality, especially soluble solids and sugar contents. These results indicate that salinity concentration has effect the soluble solids and sugar of cherry tomato fruits. In addition, nutrient concentration influenced the shelf life and firmness of cherry tomato fruits.
Meyer, H; Steinbach, G; Hartmann, H; Hauke, H; Koch, H; Stelzner, A; Linde, K; Schmerbauch, A; Kiupel, H
1977-01-01
Reported are results obtained from studies into oral and parenteral immunisation of calf. The approaches had included the use of live (Smd) or dead antigen from Salmonella (S.) dublin and a combination of the two immunisation methods. Live antigen (Smd) was superior to thermally activated dead antigen, when the oral route was used to prevent S.-dublin injection of calves. The above findings were supported by results from analogous studies in which S. typhimurium and S. dublin or live antigen (Smd) or dead antigen, made of the two, had been applied to mice. (One single subcutaneous) parenteral administration did hardly reveal any difference in favour of live vaccine (Smd). Parenteral administration of live or dead antigen proved to be less effective than repeated oral immunisation, particularly when live vaccine (Smd) was used. Immunity not less than up to six months of age against S. dublin wild strain infection can be provided for young calves by oral immunisation, with Smd vaccine (5. 1010 to 1. 1011 live germs/d) being given on ten consecutive days. Calves orally immunised with live antigen (ten repetitive applications of Smd mutants) are likely to develop an antibody titre (H-agglutinins) against S. dublin. Parenteral boostering,using live antigen, has been accompanied by sensitisation due to oral live antigen administration as well as by dose dependence, as was seen from the bactericidal values. Sensitisation was established from orally immunised calves up to three months old (typical booster reaction). Some of it was attributabale to confrontation with wild strains of Salmonella. The H-agglutinin titres of animals aged threemonths in a calf herd with salmonelloses in which all animals had been orally Smd-immunised were close to those recorded from calves in stocks with no salmonellosis occurrence. Under the conditions of oral immunisation, there had obviously been no action of the wild strain which might have triggered intensive antibody formation.
System-Wide Water Resources Program Nutrient Sub-Model (SWWRP-NSM) Version 1.1
2008-09-01
in solution Thrm by the mixing of rainwater with soil solution . A rate-limited mass transfer at the soil overland flow interface controls the...dissolved nutrient transfer from soil solution to overland flow, once formed. The mass transfer coefficient will be affected by many factors including
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Simić Dušica
2014-01-01
Full Text Available Introduction. Parenteral nutrition-associated cholestasis is well recognized phenomenon in the term and preterm infant receiving long-term parenteral nutrition. Objectives. The aim of this study was to evaluate the effect of ursodeoxycholic acid (UDCA use on cholestasis in newborns on prolonged TPN. Methods. A total of 56 infants were enrolled in this retrospective study: control group consisted of lower (1500 g birth weight infants (n=30, as well as the group of pediatric (n=11 and surgical patients (n=15 treated with UDCA. Blood chemistries were obtained two times weekly. Results. All of 56 newborns developed cholestasis but duration of parenteral nutrition (PN before onset of cholestasis was significantly longer in UDCA treated patients. Average duration of PN before the onset of cholestasis in control group of patients was 25 days in distinction from treated pediatric and surgical patients (39 and 34 days, respectively. The peak serum conjugated bilirubin (CB, AST, ALT and alkaline phosphatase (AP levels were significantly lower in the treated groups. There was no significant difference among treated pediatric and surgical patients and between lower and higher birth weight infants considering the CB, ALT, AST and AP peak. Duration of cholestasis was significantly decreased in all treated groups. There was a significant difference in time needed to achieve complete enteral intake between pediatric and surgical patient group. Conclusion. Cholestasis developed significantly later in treated groups than in the controls. UDCA appears to be very successful in reducing the symptoms of cholestasis. The difference in efficacy of UDCA treatment between lower and higher birth weight infants could not be proven.
Davidson, Eric A.; Niphong, Rachel; Ferguson, Richard B.; Palm, Cheryl; Osmond, Deanna L.; Baron, Jill S.
2016-01-01
Synthetic nitrogen (N) fertilizer has enabled modern agriculture to greatly improve human nutrition during the twentieth century, but it has also created unintended human health and environmental pollution challenges for the twenty-first century. Averaged globally, about half of the fertilizer-N applied to farms is removed with the crops, while the other half remains in the soil or is lost from farmers’ fields, resulting in water and air pollution. As human population continues to grow and food security improves in the developing world, the dual development goals of producing more nutritious food with low pollution will require both technological and socio-economic innovations in agriculture. Two case studies presented here, one in sub-Saharan Africa and the other in Midwestern United States, demonstrate how management of nutrients, water, and energy is inextricably linked in both small-scale and large-scale food production, and that science-based solutions to improve the efficiency of nutrient use can optimize food production while minimizing pollution. To achieve the needed large increases in nutrient use efficiency, however, technological developments must be accompanied by policies that recognize the complex economic and social factors affecting farmer decision-making and national policy priorities. Farmers need access to affordable nutrient supplies and support information, and the costs of improving efficiencies and avoiding pollution may need to be shared by society through innovative policies. Success will require interdisciplinary partnerships across public and private sectors, including farmers, private sector crop advisors, commodity supply chains, government agencies, university research and extension, and consumers.
Effects of different combinations of Hoagland's solution and Azolla ...
African Journals Online (AJOL)
ALAN
2013-04-17
Apr 17, 2013 ... hydroponic cultures containing different compositions of hydroponic solutions were evaluated in ... (Hoagland's solution minus N solution excluding Azolla; ..... nutrient deficiencies on photosynthesis and respiration in spinach.
Kim, Sun Hee; Krämer, Irene
2017-01-01
Centralized aseptic preparation of ready-to-administer carfilzomib containing parenteral solutions in plastic syringes and polyolefine (PO) infusion bags needs profound knowledge about the physicochemical stability in order to determine the beyond-use-date of the preparations. Therefore, the purpose of this study was to determine the physicochemical stability of carfilzomib solution marketed as Kyprolis® powder for solution for infusion. Reconstituted solutions and ready-to-administer preparations of Kyprolis® stored under refrigeration (2-8℃) or at room temperature (25℃) were analyzed at predetermined intervals over a maximum storage period of 28 days. Chemical stability of carfilzomib was planned to be determined with a stability-indicating reversed-phase high-performance liquid chromatography assay. Physicochemical stability was planned to be determined by visual inspection of clarity and color as well as pH measurement. The study results show that reconstituted carfilzomib containing parenteral solutions are stable in glass vials as well as diluted solutions in plastic syringes and PO infusion bags over a period of at least 28 days when stored light protected under refrigeration. When stored at room temperature, reconstituted and diluted carfilzomib solutions are physicochemically stable over 14 days and 10 days, respectively. The physicochemical stability of carfilzomib infusion solutions allows cost-saving pharmacy-based centralized preparation of ready-to-administer preparations.
Conjugated hyperbilirubinemia in infancy associated with parenteral alimentation.
Bernstein, J; Chang, C H; Brough, A J; Heidelberger, K P
1977-03-01
Liver biopsy was performed to exclude anatomic obstruction of the biliary tract in five prematurely born infants who had developed conjugated hyperbilirubinemia during intravenous alimentation with a protein hydrolysate. Each was being treated after having undergone a segmental intestinal resection for necrotizing enterocolitis. Bacterial and viral infections, metabolic disorders, and isoimmune hemolytic disease were excluded as possible causes of jaundice. Light microscopic and ultrastructural analysis disclosed cholestasis and hepatocellular injury without significant inflammatory reaction. Jaundice abated following permanent discontinuation of parenteral alimentation. The jaundice and cholestasis are interpreted to be hepatotoxic effects because of (1) their temporal relationship to the treatment and (2) the presence of hepatocellular damage.
Studies with a safflower oil emulsion in total parenteral nutrition.
Wong, K. H.; Deitel, M.
1981-01-01
The prevention of essential fatty acid deficiency and the provision of adequate amounts of energy are two major concerns in total parenteral nutrition. Since earlier preparations of fat emulsion used to supplement the usual regimen of hypertonic glucose and amino acids have widely varying clinical acceptability, a new product, a safflower oil emulsion available in two concentrations (Liposyn), was evaluated. In four clinical trials the emulsion was used as a supplement to total parenteral nutrition. In five surgical patients 500 ml of the 10% emulsion infused every third day prevented or corrected essential fatty acid deficiency; however, in some cases in infusion every other day may be necessary. In 40 patients in severe catabolic states the emulsion provided 30% to 50% of the energy required daily: 10 patients received the 10% emulsion for 14 to 42 days, 9 patients received each emulsion in turn for 7 days, and 21 patient received the 20% emulsion for 14 to 28 days. All the patients survived and tolerated the lipid well; no adverse clinical effects were attributable to the lipid infusions. Transient mild, apparently clinically insignificant abnormalities in the results of one or more liver function tests and eosinophilia were observed in some patients. Thus, the safflower oil emulsion, at both concentrations, was safe and effective as a source of 30% to 50% of the energy required daily by seriously ill patients. PMID:6799182
Hyperintense brain lesions on T1-weighted MRI after parenteral nutrition
International Nuclear Information System (INIS)
Saitoh, Yoshiaki; Kimura, Seiji; Nezu, Atsuo; Ohtsuki, Noriyuki; Kobayashi, Takuya; Osaka, Hitoshi; Uehara, Saori
1996-01-01
We experienced five children having T 1 -shortening lesions in basal ganglia or thalami on magnetic resonance imaging (MRI), which were supposed to be caused by manganese (Mn) overdoses. Instead of the presence of above-mentioned lesions, no neurological manifestations corresponding to them had developed in all patients. This observation suggests that MRI is useful for detecting side effects caused by overdoses of Mn in patients having parenteral nutrition. (author)
Omata, Jiro; Fukatsu, Kazuhiko; Murakoshi, Satoshi; Moriya, Tomoyuki; Ueno, Chikara; Maeshima, Yoshinori; Okamoto, Koichi; Saitoh, Daizoh; Yamamoto, Junji; Hase, Kazuo
2011-09-01
Experimental intravenous (IV) parenteral nutrition (PN) diminishes gut-associated lymphoid tissue (GALT) cell number and function. PN solution cannot maintain GALT at the same level as a normal diet, even when delivered intragastrically (IG). Previous studies demonstrated pyrroloquinoline quinone (PQQ)-deficient mice to be less immunologically responsive. Because standard (STD) PN solution lacks PQQ, PQQ supplementation may prevent PN-induced GALT changes. This study was designed to determine the influence of adding PQQ to PN on GALT. In experiment 1, mice (n = 32) were randomized to chow, IV-STD-PN, and IV-PQQ-PN groups. The chow group was fed chow with the same caloric content as PN. The IV-STD-PN group received STD-PN solution, whereas the IV-PQQ-PN group was given PQQ (3 mcg/d)-enriched PN by the IV route. After 5 days of feeding, lymphocytes were isolated from the Peyer's patch (PPs), intraepithelial space (IE), and lamina propria (LP) of the small intestine. GALT lymphocyte number and phenotype (αβTCR+, γδTCR+, CD4+, CD8+, B220+ cells) and intestinal immunoglobulin A (IgA) level were determined. In experiment 2, mice (n = 28) were randomized to IG-STD-PN or IG-PQQ-PN group. After IG nutrition supports, GALT mass and function were determined as in experiment 1. The IV-PQQ-PN group showed increased PP lymphocyte number and PP CD8+ cell number compared with the IV-STD PN group. The IG-PQQ-PN group had significantly greater PP lymphocyte number and PP CD4+ cell numbers than the IG-STD-PN group. Neither IV nor IG PQQ treatment raised IgA level. PQQ added to PN partly restores GALT mass, although its effects on GALT function remain unclear.
DEFF Research Database (Denmark)
Joly, Francisca; Baxter, Janet; Staun, Michael
2018-01-01
BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions and underl......BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions...
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Gláucio da C Genuncio
2011-12-01
Full Text Available A rúcula é uma das principais hortaliças produzidas no Brasil via hidroponia. Entretanto, além da aplicação de uma solução nutritiva adequada à cultura, torna-se imprescindível o conhecimento e o controle das variáveis intrínsecas ao manejo da solução nutritiva. Assim, o objetivo foi avaliar o acúmulo de biomassa fresca de parte aérea e raiz e a produtividade da rúcula cultivada em três vazões de solução nutritiva em hidroponia NFT, durante seis ciclos de cultivo. Os tratamentos consistiram de três vazões de solução nutritiva, sendo V1= 0,75, V2= 1,00 e V3= 1,50 L min-1. Foram avaliados seis ciclos de cultivo (de julho a dezembro. O delineamento experimental foi de blocos ao acaso com oito repetições. Realizaram-se as colheitas aos 30 dias após o transplante para os canais de hidroponia. O acúmulo de biomassa de parte aérea e de raiz foi maior nos meses de novembro e dezembro, devido a maiores temperaturas em casa de vegetação. Foi observado menor valor de biomassa de parte aérea na menor vazão do sistema. A produtividade da parte aérea e total (parte aérea + raiz foi maior nos meses mais quentes. Observou-se um incremento na produtividade com um aumento da vazão da solução nutritiva nos canais de hidroponia.The rocket is one of the main vegetable crops produced in Brazil through hydroponics. Nevertheless, besides the application of an appropriate nutrient solution for the crop, the knowledge and control of intrinsic variables for the management of the nutrient solution is essential. The accumulation of fresh biomass of the aboveground part, roots and the yield of rocket grown in three flow rates of nutrient solution during six crop cycles was studied. The treatments consisted of three flows rates of nutrient solution, V1= 0.75, V2= 1.00 and V3= 1.50 L min-1. We also evaluated six cycles of cultivation (from July to December. The experimental design was randomized blocks with eight replications. Harvest
Gastroenterology – Guidelines on Parenteral Nutrition, Chapter 15
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Schulz, R. J.
2009-11-01
Full Text Available In patients with Crohn's disease and ulcerative colitis parenteral nutrition (PN is indicated when enteral nutrition is not possible or should be avoided for medical reasons. In Crohn's patients PN is indicated when there are signs/symptoms of ileus or subileus in the small intestine, scars or intestinal fistulae. PN requires no specific compounding for chronic inflammatory bowel diseases. In both diseases it should be composed of 55–60% carbohydrates, 25–30% lipids and 10–15% amino acids. PN helps in the correction of malnutrition, particularly the intake of energy, minerals, trace elements, deficiency of calcium, vitamin D, folic acid, vitamin B12, and zinc. Enteral nutrition is clearly superior to PN in severe, acute pancreatitis. An intolerance to enteral nutrition results in an indication for total PN in complications such as pseudocysts, intestinal and pancreatic fistulae, and pancreatic abscesses or pancreatic ascites. If enteral nutrition is not possible, PN is recommended, at the earliest, 5 days after admission to the hospital. TPN should not be routinely administered in mild acute pancreatitis or nil by moth status <7 days, due to high costs and an increased risk of infection. The energy requirements are between 25 and 35 kcal/kg body weight/day. A standard solution including lipids (monitoring triglyceride levels! can be administered in acute pancreatitis. Glucose (max. 4–5 g/kg body weight/day and amino acids (about 1.2–1.5 g/kg body weight/day should be administered and the additional enrichment of TPN with glutamine should be considered in severe, progressive forms of pancreatitis.
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Geraldo Rogério Faustini Cuzzuol
2005-09-01
Full Text Available O crescimento limitado de rizóforos de Vernonia herbacea (Asteraceae em solução de Hoagland levou à necessidade de estabelecer uma solução nutritiva para o cultivo dessa planta, visando ao incremento da biomassa de seus rizóforos ricos em frutanos. Essa solução (denominada Vernonia, constituída de Ca(NO32.4H2O 2,5 mmol L-1, KNO3 2,3 mmol L-1 , KH2PO4 0,52 mmol L-1, Mg(NO32.6H2O 1,7 mmol L-1 e Na2SO4 1,3 mmol L-1, foi comparada com a de Hoagland nas forças iônicas de 50%, 100% e 200%. Foram realizadas duas avaliações para análise de crescimento e conteúdo de frutanos. As plantas não sobreviveram até os dois meses na solução de Hoagland 200%. A solução Vernonia diluída duas vezes (50% foi a mais eficiente para o incremento de massa seca dos rizóforos e produção de frutanos por planta. Maior crescimento da parte aérea foi verificado nas soluções de Hoagland e Vernonia 100%. Em comparação com a solução de Hoagland, a solução Vernonia é mais pobre em macronutrientes, confirmando a hipótese de que plantas adaptadas a solos oligotróficos são menos exigentes em nutrientes minerais.The limited growth of rhizophores of Vernonia herbacea in Hoagland solution demanded the definition of a nutrient solution for plants of V. herbacea, aiming at the increase of the rhizophore biomass and fructan production. This solution, named Vernonia, is comprised of Ca(NO32.4H2O 2.5 mmol L-1, KNO3 2.3 mmol L-1 , KH2PO4 0.52 mmol L-1, Mg(NO32.6H2O 1.7 mmol L-1 and Na2SO4 1.3 mmol L-1. Its effect on plants was compared to that of Hoagland solution, both with different ionic strengths, 50%, 100% and 200%. The effect of the solutions on plant growth and fructan content was evaluated twice in a six-month period. Plants did not survive up to two months, when cultivated in 200% Hoagland solution. The 50% Vernonia solution was the most effective for rhizophore biomass increase and fructan production per plant. Growth of aerial organs was
Jacobs, Maartje S.; Luinstra, Marianne; Moes, Jan Reindert; Chan, Tiffany C. Y.; Minovic, Isidor; Frijlink, Henderik W.; Woerdenbag, Herman J.
Objectives To determine the feasibility of preparing a long-term stable ready-to-use parenteral amiodarone formulation using cyclodextrins as dissolution enhancer. Methods A preformulation study was performed with different molar ratios of hydroxypropyl-beta-cyclodextrin (HP-BCD) or
Sauerwein, H. P.; Michels, R. P.; Cejka, V.
1981-01-01
Influence of total parenteral nutrition and operation on alanine turnover and venous alanine concentration was determined in 5 patients with stomach carcinoma using single technique of U-14C alanine. Every patient served at his own control. In the postabsorptive state alanine turnover was 1.63 +/-
ASSISTÊNCIA DE ENFERMAGEM A PACIENTES SUBMETIDOS À HIPERALIMENTAÇÃO PARENTERAL
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Maria Isabel Pedreira de Freitas Ceribelli
1975-03-01
Full Text Available RESUMO A hiperalimentação parenteral consiste no fornecimento de alta dosagem de glicose hipertónica, soluções de aminoácidos, sais minerais e vitaminas para garantir anabolismo proteico e síntese tissular em pacientes debitados. Está indicada em casos em que a via digestiva não pode ser utilizada ou não é suficiente para manter as necessidades metabólicas. Este procedimento requer conduta especializada com cuidadosa assistência de enfermagem relacionada ao preparo do paciente, do material para punção e da solução de hiperalimentação parenteral. Uma vez instalada, há necessidade de verificação sistemática quanto ao fluxo da solução, quanto às manifestações do paciente e quanto aos cuidados com o catéter de infusão. Os resultados obtidos são altamente significativos, mas o riscos a que o paciente está sujeito também são numerosos. Seu sucesso dependerá grandemente das disponibilidades econômicas locais e da especialização da equipe de saúde.
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Flávio F. Blanco
2008-02-01
Full Text Available Em geral, culturas tolerantes à salinidade geralmente apresentam maiores teores foliares de certos nutrientes, sugerindo que a adubação em culturas sensíveis poderia elevar os teores desses nutrientes nas folhas, aumentando sua tolerância aos sais. Este trabalho teve o objetivo de estudar os efeitos do N e do K na condutividade elétrica, pH e concentração de nutrientes da solução do solo e nos teores de nutrientes e prolina nas folhas do tomateiro irrigado com água salina. Os tratamentos foram compostos da combinação de três níveis de N (7,5; 15,0 e 22,5 g por planta e de K (8, 16 e 24 gK2O por planta aplicados via fertirrigação por gotejamento, no esquema fatorial 3 x 3, com cinco repetições, sendo que à água de irrigação foram adicionados os sais cloreto de sódio e cloreto de cálcio, para obtenção de condutividade elétrica da água de 9,5 dS m-1. As concentrações de NO3 e K na solução do solo e de N e K nas folhas do tomateiro aumentaram com as doses de N e K mas não promoveram redução dos teores de Cl nem de Na nas folhas das plantas. O aumento do teor de prolina com as doses de K e a redução de Cl/N com as doses de N, sugerem que o aumento na adubação potássica e nitrogenada pode ser benéfico para o tomateiro sob condições de salinidade moderada.Crops tolerant to salinity generally present higher concentrations of some nutrients in the leaves, suggesting that the fertilization of sensitive crops could increase the contents of these nutrients in the leaves to increase the crop tolerance to salts. This work had the objective of studying the effects of N and K on electrical conductivity, pH and nutrient concentrations of soil solution and on concentration of nutrients and proline in the leaves of tomatos irrigated with saline water. The treatments were composed of the combination of three levels of N (7.5, 15.0 and 22.5 g per plant and K (8, 16 and 24 g K2O per plant applied by drip fertigation, in a 3
Zhang, Binhao; Wei, Gang; Li, Rui; Wang, Yanjun; Yu, Jie; Wang, Rui; Xiao, Hua; Wu, Chao; Leng, Chao; Zhang, Bixiang; Chen, Xiao-Ping
2017-10-01
A new lipid emulsion enriched in n-3 fatty acid has been reported to prevent hepatic inflammation in patients following major surgery. However, the role of n-3 fatty acid-based parenteral nutrition for postoperative patients with cirrhosis-related liver cancer is unclear. We investigated the safety and efficacy of n-3 fatty acid-based parenteral nutrition for cirrhotic patients with liver cancer followed hepatectomy. A prospective randomized controlled clinical trial (Registered under ClinicalTrials.gov Identifier no. NCT02321202) was conducted for cirrhotic patients with liver cancer that underwent hepatectomy between March 2010 and September 2013 in our institution. We compared isonitrogenous total parenteral nutrition with 20% Structolipid and 10% n-3 fatty acid (Omegaven, Fresenius-Kabi, Germany) (treatment group) to Structolipid alone (control group) for five days postoperatively, in the absence of enteral nutrition. We enrolled 320 patients, and 312 (97.5%) were included in analysis (155 in the control group and 157 in the treatment group). There was a significant reduction of morbidity and mortality in the treatment group, when compared with the control group (total complications 78 [50.32%] vs. 46 [29.30%]; P parenteral nutrition significantly improved postoperative recovery for cirrhotic patients with liver cancer following hepatectomy, with a significant reduction in overall mortality and length of hospital stay. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Wang, Bing; Gao, Bin; Zimmerman, Andrew R; Zheng, Yulin; Lyu, Honghong
2018-03-01
Drought conditions and nutrients loss have serious impacts on soil quality as well as crop yields in agroecosystems. New techniques are needed to carry out effective soil water and nutrient conservation and fertilizer application tools. Here, calcium alginate (CA) beads impregnated with ball-milled biochar (BMB) were investigated as a new type of water/nutrients retention agent. Both CA and Ca-alginate/ball milled biochar composite (CA-BMB) beads showed high kinetic swelling ratios in KNO 3 solution and low kinetic swelling ratios in water, indicating that CA-BMB beads have the potential to retain mineral nitrogen and nutrients by ion exchange. Pseudo-second-order kinetic model well-described the swelling kinetics of both beads in KNO 3 solution. Over a range of temperatures, the characteristics of dehydration suggested that impregnation with BMB improved the water holding capacity and postponed the dehydration time of Ca-alginate. The cumulative swelling and release characteristics of water, K + , and NO 3 - indicated that CA-BMB beads have great potential as a soil amendment to improve its nutrient retention and water holding capacity. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Leandro Souza da Silva
2003-06-01
Full Text Available O alagamento e a presença de plantas alteram as propriedades biológicas e químicas do solo em relação ao ambiente anteriormente oxidado, influenciando a disponibilidade de nutrientes. Foi conduzido um experimento com o objetivo de avaliar as alterações dos teores de alguns nutrientes na solução de um Planossolo e um Gleissolo durante o ciclo do arroz. Os solos foram acondicionados em vasos (50 litros contendo dispositivos para coleta da solução em diferentes profundidades, mantidos sem ou com plantas de arroz. A solução foi coletada aos 10, 19, 44, 77 e 113 dias de alagamento e determinados os teores de P, K, Ca, Mg, Fe e Mn. A concentração dos nutrientes na solução, especialmente o K, variou com a profundidade de coleta e com a presença de plantas, demonstrando a influência desses fatores na disponibilidade dos nutrientes em solos alagados.Flooding a soil and growing plant on it can change its biological and chemistry properties, in comparison with a non-flooded environment. An experiment was conducted in order to study the nutrients dynamics in the solution of two soils (Planossolo and Gleissolo during the rice cycle. Rice plants were cultivated in 50L containers having devices to collect soil solution at several depths (2.5, 5.0, 7.5 and 31cm. In the soil solution, with and without plant, P, K, Ca, Mg, Fe and Mn, were measured at 10, 19, 44, 77, and 113 days after the flooding. Potassium was especially sensible to the rice plant and depth of sampling
Moonens, F; el Alami, S; Van Gossum, A; Struelens, M J; Serruys, E
1994-01-01
The accuracy of Gram staining of blood drawn from catheters used to administer total parenteral nutrition was compared with paired quantitative blood cultures for the diagnosis of catheter-related sepsis. Gram staining was positive in 11 of 18 episodes of catheter-related sepsis documented by quantitative culture (sensitivity, 61%) but in none of the 5 episodes of fever unrelated to catheter infection. Thus, this procedure enabled the rapid presumptive diagnosis and guidance of antimicrobial therapy for total parenteral nutrition catheter sepsis, with a positive predictive value of 100% and a negative predictive value of 42%. PMID:7521359
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Roseane Rodrigues de Souza
2010-12-01
Full Text Available O boro desempenha funções importantes em processos biológicos das plantas, como a síntese e estruturação da parede celular, lignificação, metabolismo e transporte de carboidratos, além de participar da divisão e diferenciação celular em tecidos meristemáticos. No entanto, as necessidades nutricionais para o cultivo de copo-de-leite, especialmente de boro, ainda são pouco conhecidas. Assim, objetivou-se avaliar os efeitos de diferentes doses de boro no crescimento e desenvolvimento, teor e acúmulo desse nutriente em plantas de copo-de-leite cultivadas em solução nutritiva. Mudas micropropagadas foram submetidas aos tratamentos com as doses de 0,05; 0,25; 0,50; 0,75; 1,00 e 2,00 mg L-1 de boro em solução nutritiva de Hoagland & Arnon diluída a 30% de sua força iônica. O delineamento experimental foi o inteiramente casualizado, com dez repetições. As plantas não manifestaram sintomas visuais de deficiência ou de toxidez de boro, no entanto, o sistema radicular das plantas cultivadas na dose de 0,05 mg L-1 de boro apresentou-se com o crescimento reduzido. A melhor dose para o desenvolvimento adequado de plantas de copo-de-leite em solução nutritiva é de 1,20 mg L-1 de boro.Boron has essential functions in plant biological processes such as cell wall synthesis and structuralization, lignification, carbohydrates metabolism and transport. This element also acts in cell division and differentiation in meristematic tissues. However, the nutritional needs for calla lily cultivation, and especially boron needs, are still poorly known. Thus, the objective of this work was to evaluate the effects of different boron doses on growth and development, content and accumulation of boron in calla lily plants grown in a nutrient solution. Micropropagated seedlings were submitted to treatments with the doses 0.05; 0.25; 0.50; 0.75; 1.00 and 2.00 mg L-1 boron in Hoagland & Arnon nutrient solution diluted to 30% of its ionic force. The
DEFF Research Database (Denmark)
Nauck, Michael A; Walberg, Jörg; Vethacke, Arndt
2004-01-01
It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition.......It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition....
Su, Mao-sheng; He, Lei; Liu, Zhi-wei; Ma, Huan-xian; Zhao, Qing-hua; Zhang, Wen-zhi
2012-03-27
To evaluate the effects of structured triglycerides in parenteral nutrition versus a physical medium-chain triglycerides (MCT)/long-chain triglycerides (LCT) mixture on severe hemorrhagic shock patients after resuscitation. In a randomized trial, we studied 20 critical patients with a total blood loss of over 3000 ml perioperatively and/or intraoperatively. The use of triglycerides started from Day 3 postoperation and parenteral nutrition lasted for no less than 5 days. They were allocated to receive one of two nutrition regiments: structured triglycerides in Group A (n = 10) and MCT/LCT in Group B (n = 10). There were no significant differences of general conditions in two groups. Before the start of parenteral nutrition (d0), d1 d3 and d5 after start of infusion, the following parameters were measured: hemoglobin (Hb), platelet count (Plt), alanine aminotransferase (ALT), total bilirubin (TB), direct bilirubin (DB), serum triglycerides (TG), prealbumin (PA) and transferrin (TF). And mean artery pressure (MAP), heart rate (HR) and central vein pressure (CVP) were also recorded at the same time-points. Then the post-TG changes of the above data were compared in both groups. After the use of triglycerides, there were no significant differences of MAP, HR, CVP, Hb and Plt in both groups (P > 0.05). At D3 and D5, the serum levels of TG ((2.1 ± 0.4) vs (1.6 ± 0.6) mg/L, (2.3 ± 0.7) vs (1.5 ± 0.3) mg/L) and alanine aminotransferase ((133 ± 58) vs (97 ± 26) U/L; (116 ± 48) vs (77 ± 31) U/L) were significantly higher in Group B versus those receiving structured triglycerides in Group A (P 0.05). The serum levels of such nutrition markers as PA ((195 ± 55) vs (166 ± 55) mg/L,(245 ± 53) vs (195 ± 58) mg/L) and TF ((2.6 ± 0.5) vs (2.5 ± 0.6) g/L, (3.3 ± 0.8) vs (2.9 ± 0.6) g/L)were significantly higher in Group A than those in Group B (P synthesis and hepatocyte protection, structured triglycerides in parenteral nutrition is advantageous to standard MCT
2011-05-04
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] 2011 Parenteral Drug Association/Food and Drug Administration Glass Quality Conference; Public Conference AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public conference. SUMMARY: The Food...
Xue, Miaoge; Yu, Linqi; Che, Yaojian; Lin, Haijun; Zeng, Yuanjun; Fang, Mujin; Li, Tingdong; Ge, Shengxiang; Xia, Ningshao
2015-05-21
The cell-attachment protein VP8* of rotavirus is a potential candidate parenteral vaccine. However, the yield of full-length VP8 protein (VP8*, residues 1-231) expressed in Escherichia coli was low, and a truncated VP8 protein (ΔVP8*, residues 65-231) cannot elicit efficient protective immunity in a mouse model. In this study, tow novel truncated VP8 proteins, VP8-1 (residues 26-231) and VP8-2 (residues 51-231), were expressed in E. coli and evaluated for immunogenicity and protective efficacy, compared with VP8* and ΔVP8*. As well as ΔVP8*, the protein VP8-1 and VP8-2 were successfully expressed in high yield and purified in homogeneous dimeric forms, while the protein VP8* was expressed with lower yield and prone to aggregation and degradation in solution. Although the immunogenicity of the protein VP8*, VP8-1, VP8-2 and ΔVP8* was comparable, immunization of VP8* and VP8-1 elicited significantly higher neutralizing antibody titers than that of VP8-2 and ΔVP8* in mice. Furthermore, when assessed using a mouse maternal antibody model, the efficacy of VP8-1 to protect against rotavirus-induced diarrhea in pups was comparable to that of VP8*, both were dramatically higher than that of VP8-2 and ΔVP8*. Taken together, the novel truncated protein VP8-1, with increased yield, improved homogeneity and high protective efficacy, is a viable candidate for further development of a parenterally administrated prophylactic vaccine against rotavirus infection. Copyright © 2015 Elsevier Ltd. All rights reserved.
Olthof, E.D.; Roelofs, H.M.J.; Fisk, H.L.; Calder, P.C.; Wanten, G.J.A.
2016-01-01
BACKGROUND: Home parenteral nutrition (HPN) patients depend on lipid emulsions as part of their parenteral nutrition regimen to provide essential fatty acids (EFAs). Mixed-oil sources are used in modern lipid emulsions to decrease the amount of proinflammatory EFAs, mainly linoleic acid, which is
WERF Nutrient Challenge investigates limits of nutrient removal technologies.
Neethling, J B; Clark, D; Pramanik, A; Stensel, H D; Sandino, J; Tsuchihashi, R
2010-01-01
The WERF Nutrient Challenge is a multi-year collaborative research initiative established in 2007 to develop and provide current information about wastewater treatment nutrients (specifically nitrogen and phosphorus in wastewater), their characteristics, and bioavailability in aquatic environments to help regulators make informed decisions. The Nutrient Challenge will also provide data on nutrient removal so that treatment facilities can select sustainable, cost-effective methods and technologies to meet permit limits. To meet these goals, the Nutrient Challenge has teamed with a wide array of utilities, agencies, consultants, universities and other researchers and practitioners to collaborate on projects that advance these goals. The Nutrient Challenge is focusing on a different approach to collaborating and leveraging resources (financial and intellectual) on research projects by targeting existing projects and research that correspond with its goals and funding those aspects that the Nutrient Challenge identified as a priority. Because the Nutrient Challenge is focused on collaboration, outreach is an absolutely necessary component of its effectiveness. Through workshops, webinars, a web portal and online compendium, published papers, and conference lectures, the Nutrient Challenge is both presenting important new information, and soliciting new partnerships.
Catheter-Related Bloodstream Infections in Adults Receiving Home Parenteral Nutrition
DEFF Research Database (Denmark)
Tribler, Siri; Brandt, Christopher F; Hvistendahl, Mark
2018-01-01
BACKGROUND: A common complication in patients receiving home parenteral nutrition (HPN) is catheter-related bloodstream infections (CRBSIs). The CRBSI incidence has been advocated as an outcome parameter assessing the quality of care. This study aimed to illustrate how the use of different CRBSI......) and European Society for Clinical Nutrition (ESPEN) CRBSI criteria. Employing a catheter-salvaging strategy, 40% of the CRBSI diagnoses were supported by the paired blood culture positivity criteria and only 6% by a positive catheter tip. In 53%, CRBSIs were categorized as a clinical or "probable CRBSI...
Home Parenteral Nutrition in Adult Patients with Chronic Intestinal Failure
DEFF Research Database (Denmark)
Brandt, Christopher Filtenborg; Hvistendahl, Mark; Naimi, Rahim M.
2017-01-01
in treating IF with home parenteral nutrition (HPN), this study documents the HPN evolution and describes the demographics and outcome in one of the world's largest single-center cohorts. Methods: We included patients with IF discharged with HPN from 1970-2010. Data were extracted according to European...... Society for Clinical Nutrition and Metabolism classifications from the Copenhagen IF database. Results: Over the decades, we observed an exponential increase in the number of HPN patients. The 508 patients with IF collectively received HPN for 1751 years. While receiving HPN, 211 patients with IF (42...
Kruimel, J W; Naber, T H; van der Vliet, J A; Carneheim, C; Katan, M B; Jansen, J B
2001-01-01
Most postoperative patients lose net protein mass, which reflects loss of muscle tissue and organ function. Perioperative parenteral nutrition may reduce the loss of protein, but in general, with conventional lipid emulsions a waste of protein still remains. We compared the effects on nitrogen balance of an emulsion containing structured triglycerides, a new type of synthesized triglycerides, with an emulsion of a physical mixture of medium- and long-chain triglycerides as part of parenteral feeding in moderately catabolic patients. The first 5 days after placement of an aortic prosthesis patients received total parenteral nutrition (TPN) providing 0.2 g of nitrogen per kg body weight per day; energy requirement was calculated using Harris and Benedict's equation, adding 300 kcal per day for activity. Twelve patients were treated with the structured triglyceride emulsion and 13 patients with the emulsion of the physical mixture of medium- and long-chain triglycerides. The design was a randomized, double-blind parallel study. In the patients who completed the study, the mean cumulative nitrogen balance over the first 5 postoperative days was -8+/-2 g in 10 patients on the structured triglyceride emulsion and -21+/-4 g in 9 patients on the emulsion of the physical mixture of medium- and long-chain triglycerides; the mean difference was 13 g of nitrogen (95% confidence interval 4 to 22, p = .015) in favor of the structured triglyceride emulsion. On the first postoperative day serum triglyceride and plasma medium-chain free fatty acid levels increased less during infusion of the structured triglyceride emulsion than with the physical mixture emulsion. The parenteral structured triglyceride emulsion improves the nitrogen balance and is cleared faster from the blood, compared with the emulsion of the physical mixture of medium- and long-chain triglycerides, in moderately catabolic patients.
Tuberculosis and parenteral viral hepatitides: incidence of mixed forms
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A. A. Asratyan
2014-01-01
Full Text Available Objective: to estimate the frequency of parenteral viral hepatitides (HB and HC (PVH in patients with tuberculosis in Moscow in relation to data on their incidence in the aggregate population of the capital.Materials and methods. The authors analyzed the incidence of (acute, chronic HB and HC (carriage and tuberculosis in Moscow in 2009. A total of 24,220 cards for infectious patients (No. 089/y and federal statistical follow-up forms (No. 2 were first processed to compare and search for personal data among the patients with tuberculosis and all forms of PVH and to establish the evidence of PVH and tuberculosis comorbidity.Results. The infection of tuberculosis patients with parenteral hepatitis B and C viruses was ascertained to be 5.5 to 284.9 times higher (in relation to the form of a hepatitis course than that in the aggregation population of Moscow, which suggests that PVH is of high significance for the tuberculosis patients and that it is necessary to improve a PVH prevention program among this cohort patients. Analysis of the sex-age structure shows that male tuberculosis patients in the 20-39-year-old group should be considered to be a special risk group that should attract special attention when implementing preventive measures. The tuberculosis mortality rate among mixed infected patients was 1.8-fold higher than among those who had PVH-uncomplicated tuberculosis.Conclusion. The results of the investigations are suggestive of the evidence of PVH and tuberculosis comorbidity. The mixed forms of these infections in different combinations have been established to be accompanied by their severer clinical course and high death rates.
PROTEIN NEEDS OF CRITICALLY ILL PATIENTS RECEIVING PARENTERAL NUTRITION.
Germano Borges de Oliveira Nascimento Freitas, Renata; Negrão Nogueira, Roberto José; Hessel, Gabriel
2015-07-01
assess whether the current protein intake recommendations may improve the biochemical parameters of critical patients receiving parenteral nutrition. longitudinal study with three evaluations made (during the first 72 hours, on the 7th and the 14th days of PN). The following tests were applied: albumin, C-reactive protein, prealbumin, total cholesterol, HDL, triglycerides, lymphocytes, and glutathione peroxidase. The severity was determined by SOFA. The statistical analysis included the Spearman and Mann-Whitney tests, as well as ANOVA (analysis of variance). among the 53 patients evaluated, 20 (37.74%) died. The mean calorie was 24.68 ± 9.78 kcal/kg (beginning of PN), 26.49 ± 8.89 kcal/kg (3rd to 7th days of PN), and 30.9 ± 12.19 kcal/kg (7th to 14th days of PN). The mean protein was 1.19 ± 0.44 g/kcal/kg (first 72 hours of PN), 1.29 ± 0.44 g/kcal/kg (3rd to 7th days of PN) and 1.49 ± 0.69 g/kcal/kg (7th to 14th days of PN). Prealbumin, albumin, total cholesterol and HDL were below the reference values, while the CRP levels were high. Throughout the three evaluation times, there was no a significant improvement on the levels of laboratory examinations. A strong and negative correlation was found between SOFA and prealbumin (r = -0.64, p = 0.05). the protein offer, according to the traditional recommendations, was not enough to improve the biochemical parameters of critical patients undergoing parenteral nutrition. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Neelis, E.G.; Oers, H.A. van; Escher, J.C.; Damen, G.M.; Rings, E.H.; Tabbers, M.M.
2014-01-01
Intestinal failure is characterised by inadequate absorption of food or fluids, which is caused by insufficient bowel surface area or functioning. Children with chronic intestinal failure are dependent on parenteral nutrition (PN), which can be provided at home (HPN). In the Netherlands, HPN for
Santosuosso, Michael; McCormick, Sarah; Zhang, Xizhong; Zganiacz, Anna; Xing, Zhou
2006-08-01
Parenterally administered Mycobacterium bovis BCG vaccine confers only limited immune protection from pulmonary tuberculosis in humans. There is a need for developing effective boosting vaccination strategies. We examined a heterologous prime-boost regimen utilizing BCG as a prime vaccine and our recently described adenoviral vector expressing Ag85A (AdAg85A) as a boost vaccine. Since we recently demonstrated that a single intranasal but not intramuscular immunization with AdAg85A was able to induce potent protection from pulmonary Mycobacterium tuberculosis challenge in a mouse model, we compared the protective effects of parenteral and mucosal booster immunizations following subcutaneous BCG priming. Protection by BCG prime immunization was not effectively boosted by subcutaneous BCG or intramuscular AdAg85A. In contrast, protection by BCG priming was remarkably boosted by intranasal AdAg85A. Such enhanced protection by intranasal AdAg85A was correlated to the numbers of gamma interferon-positive CD4 and CD8 T cells residing in the airway lumen of the lung. Our study demonstrates that intranasal administration of AdAg85A represents an effective way to boost immune protection by parenteral BCG vaccination.
Toward a transport-based analysis of nutrient spiraling and uptake in streams
Runkel, Robert L.
2007-01-01
Nutrient addition experiments are designed to study the cycling of nutrients in stream ecosystems where hydrologic and nonhydrologic processes determine nutrient fate. Because of the importance of hydrologic processes in stream ecosystems, a conceptual model known as nutrient spiraling is frequently employed. A central part of the nutrient spiraling approach is the determination of uptake length (SW), the average distance traveled by dissolved nutrients in the water column before uptake. Although the nutrient spiraling concept has been an invaluable tool in stream ecology, the current practice of estimating uptake length from steady-state nutrient data using linear regression (called here the "SW approach") presents a number of limitations. These limitations are identified by comparing the exponential SW equation with analytical solutions of a stream solute transport model. This comparison indicates that (1) SW, is an aggregate measure of uptake that does not distinguish between main channel and storage zone processes, (2) SW, is an integrated measure of numerous hydrologie and nonhydrologic processes-this process integration may lead to difficulties in interpretation when comparing estimates of SW, and (3) estimates of uptake velocity and areal uptake rate (Vf and U) based on S W, are not independent of system hydrology. Given these findings, a transport-based approach to nutrient spiraling is presented for steady-state and time-series data sets. The transport-based approach for time-series data sets is suggested for future research on nutrient uptake as it provides a number of benefits, including the ability to (1) separately quantify main channel and storage zone uptake, (2) quantify specific hydrologic and nonhydrologic processes using various model parameters (process separation), (3) estimate uptake velocities and areal uptake rates that are independent of hydrologic effects, and (4) use short-term, non-plateau nutrient additions such that the effects of
Monitoring TASCC Injections Using A Field-Ready Wet Chemistry Nutrient Autoanalyzer
Snyder, L. E.; Herstand, M. R.; Bowden, W. B.
2011-12-01
Quantification of nutrient cycling and transport (spiraling) in stream systems is a fundamental component of stream ecology. Additions of isotopic tracer and bulk inorganic nutrient to streams have been frequently used to evaluate nutrient transfer between ecosystem compartments and nutrient uptake estimation, respectively. The Tracer Addition for Spiraling Curve Characterization (TASCC) methodology of Covino et al. (2010) instantaneously and simultaneously adds conservative and biologically active tracers to a stream system to quantify nutrient uptake metrics. In this method, comparing the ratio of mass of nutrient and conservative solute recovered in each sample throughout a breakthrough curve to that of the injectate, a distribution of spiraling metrics is calculated across a range of nutrient concentrations. This distribution across concentrations allows for both a robust estimation of ambient spiraling parameters by regression techniques, and comparison with uptake kinetic models. We tested a unique sampling strategy for TASCC injections in which samples were taken manually throughout the nutrient breakthrough curves while, simultaneously, continuously monitoring with a field-ready wet chemistry autoanalyzer. The autoanalyzer was programmed to measure concentrations of nitrate, phosphate and ammonium at the rate of one measurement per second throughout each experiment. Utilization of an autoanalyzer in the field during the experiment results in the return of several thousand additional nutrient data points when compared with manual sampling. This technique, then, allows for a deeper understanding and more statistically robust estimation of stream nutrient spiraling parameters.
Refeeding syndrome in a small-for-dates micro-preemie receiving early parenteral nutrition.
Mizumoto, Hiroshi; Mikami, Masamitsu; Oda, Hirotsugu; Hata, Daisuke
2012-10-01
This report describes a small-for-date extremely low birth weight infant who manifested bradycardic events, respiratory failure, and hemolytic jaundice during her first week of life. These complications were attributed to severe hypophosphatemia and hypokalemia. Inadequate supply and refeeding syndrome triggered by early aggressive parenteral nutrition were responsible for electrolyte abnormalities. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.
International Nuclear Information System (INIS)
Tatar, E.; Mihucz, V.G.; Varga, G.; Zaray, G.; Cseh, E.
2000-01-01
The total reflection X-ray fluorescence (TXRF) spectrometry was used to determine the elemental composition of xylem saps of cucumber plants grown in nutrient solutions having urea, as the sole nitrogen source and artificially contaminated with nickel(II) ions in concentration of 10 μM, which proved to be toxic for the plants. The saps of uncontaminated plants - grown at the same time with the contaminated ones - were also investigated. The collection of the samples was performed for 1 hour followed by two additional 30-minute-long time periods, thus three samples resulted for each group of plants. The TXRF measurements were performed using Ga as internal standard. For excitation, Mo tube was used and the integration time was 300 s. The nutrient heavy metals determined by the TXRF spectrometry in the saps were Fe, Mn and Zn in concentration range of ng/cm 3 . Two other nutrient elements, Ca and K were also determined and they were present in the samples in concentration of μg/cm 3 . The concentration of nickel in the saps originating from the contaminated plants, was approximately 1400 ng/cm 3 . The concentration of another nutrient heavy metal, Cu was determined by the graphite furnace atomic absorption (GF-AAS) spectrometry. Applying a reversed-phased HPLC method, the organic acids of the samples, citric, malic and fumaric acids were also quantified, their concentrations being also in the μg/cm 3 concentration range. Size exclusion chromatography (SEC) measurements were also performed in order to detect possible macromolecules of the saps. Both techniques, having low sample volume demand, were suitable to perform reliable measurements of the samples whose masses were between 0,9-2,5 g. Furthermore, the absence of the matrix effects is also an important advantage of the TXRF spectrometry that permits the direct analysis of the xylem saps. These investigations form part of our work focusing on the availability, accumulation and transport of heavy metals in
Parenteral Nutrition and Intestinal Failure.
Bielawska, Barbara; Allard, Johane P
2017-05-06
Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient's home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes.
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Marie Yan
2016-01-01
Full Text Available Outpatient parenteral antimicrobial therapy (OPAT is a safe and effective alternative to hospitalization for many patients with infectious diseases. The objective of this study was to describe the OPAT experience at a Canadian tertiary academic centre in the absence of a formal OPAT program. This was achieved through a retrospective chart review of OPAT patients discharged from Sunnybrook Health Sciences Centre within a one-year period. Between June 2012 and May 2013, 104 patients (median age 63 years were discharged home with parenteral antimicrobials. The most commonly treated syndromes included surgical site infections (33%, osteoarticular infections (28%, and bacteremia (21%. The most frequently prescribed antimicrobials were ceftriaxone (21% and cefazolin (20%. Only 56% of the patients received follow-up care from an infectious diseases specialist. In the 60 days following discharge, 43% of the patients returned to the emergency department, while 26% required readmission. Forty-eight percent of the return visits were due to infection relapse or treatment failure, and 23% could be attributed to OPAT-related complications. These results suggest that many OPAT patients have unplanned health care encounters because of issues related to their infection or treatment, and the creation of a formal OPAT clinic may help improve outcomes.
Aluminum Exposure from Parenteral Nutrition: Early Bile Canaliculus Changes of the Hepatocyte
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Amanda R. Hall
2018-06-01
Full Text Available Background: Neonates on long-term parenteral nutrition (PN may develop parenteral nutrition-associated liver disease (PNALD. Aluminum (Al is a known contaminant of infant PN, and we hypothesize that it substantially contributes to PNALD. In this study, we aim to assess the impact of Al on hepatocytes in a piglet model. Methods: We conducted a randomized control trial using a Yucatan piglet PN model. Piglets, aged 3–6 days, were placed into two groups. The high Al group (n = 8 received PN with 63 µg/kg/day of Al, while the low Al group (n = 7 received PN with 24 µg/kg/day of Al. Serum samples for total bile acids (TBA were collected over two weeks, and liver tissue was obtained at the end of the experiment. Bile canaliculus morphometry were studied by transmission electron microscopy (TEM and ImageJ software analysis. Results: The canalicular space was smaller and the microvilli were shorter in the high Al group than in the low Al group. There was no difference in the TBA between the groups. Conclusions: Al causes structural changes in the hepatocytes despite unaltered serum bile acids. High Al in PN is associated with short microvilli, which could decrease the functional excretion area of the hepatocytes and impair bile flow.
Predictive modeling of transient storage and nutrient uptake: Implications for stream restoration
O'Connor, Ben L.; Hondzo, Miki; Harvey, Judson W.
2010-01-01
This study examined two key aspects of reactive transport modeling for stream restoration purposes: the accuracy of the nutrient spiraling and transient storage models for quantifying reach-scale nutrient uptake, and the ability to quantify transport parameters using measurements and scaling techniques in order to improve upon traditional conservative tracer fitting methods. Nitrate (NO3–) uptake rates inferred using the nutrient spiraling model underestimated the total NO3– mass loss by 82%, which was attributed to the exclusion of dispersion and transient storage. The transient storage model was more accurate with respect to the NO3– mass loss (±20%) and also demonstrated that uptake in the main channel was more significant than in storage zones. Conservative tracer fitting was unable to produce transport parameter estimates for a riffle-pool transition of the study reach, while forward modeling of solute transport using measured/scaled transport parameters matched conservative tracer breakthrough curves for all reaches. Additionally, solute exchange between the main channel and embayment surface storage zones was quantified using first-order theory. These results demonstrate that it is vital to account for transient storage in quantifying nutrient uptake, and the continued development of measurement/scaling techniques is needed for reactive transport modeling of streams with complex hydraulic and geomorphic conditions.
Versleijen, M.W.J.; Esterik, J.C. van; Schaap-Roelofs, H.M.J.; Emst-de Vries, S.E. van; Willems, P.H.G.M.; Wanten, G.J.A.
2009-01-01
BACKGROUND & AIMS: Lipid-induced immune modulation might contribute to the increased infection rate that is observed in patients using parenteral nutrition. We previously showed that emulsions containing medium-chain triglycerides (LCT/MCTs or pure MCTs), but not pure long-chain triglycerides
Study on optimal fat content in total parenteral nutrition in partially hepatectomized rats.
Abe, S; Sakabe, S; Hirata, M; Kamuro, H; Asahara, N; Watanabe, M
1997-04-01
In order to investigate the optimal fat content for total parenteral nutrition (TPN) solutions, male Wistar rats were subjected to 70% hepatectomy and then placed, for five days, on one of five TPN regimens in which fat represented 0%, 10%, 20%, 30% and 40%, respectively, of the total calorie content. As serum triglyceride levels in the fat-treated groups were lower than those in the non-treated normal rats, it was concluded that the administered fat was sufficiently hydrolyzed. The greater the fat content, the higher the regeneration rate of the remnant liver. Significant differences were found between the 0%-fat group and 20%-plus fat groups. Hepatic triglyceride level was significantly lower in the 20%-fat group. Hepatic protein level was significantly elevated in all fat-treated groups. Serum phospholipids and total cholesterol due to the lecithin contained in fat emulsion were significantly elevated in the 30 and 40%-fat groups, indicating that fat content of 30 and 40% was excessive. The results suggest that TPN containing fat is superior to fat-free TPN for liver regeneration after partial hepatectomy, and that optimal fat content is estimated to be about 20% of total calorie content in the case of this fat emulsion.
Contribution of fish farming to the nutrient loading of the Mediterranean
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Ioannis Karakassis
2005-06-01
Full Text Available Mediterranean fish farming has grown exponentially during the last 20 years. Although there is little evidence of the impact on the trophy status around fish farms, there are concerns that the release of solute wastes from aquaculture might affect larger scales in the ecosystem by changing the nutrient load. After combining information from various sources on waste production and on nutrient loads, it was concluded that the overall N and P waste from fish farms in the Mediterranean represents less than 5% of the total annual anthropogenic discharge, and the overall annual increase in P and N pools in the Mediterranean, under a production rate of 150000 tons, is less than 0.01%. The proportion of fish farming discharged nutrients was slightly higher in the eastern Mediterranean. A simple model was used to assess the long-term effects of nutrients released from various sources taking into account the water renewal rate in the Mediterranean. We conclude that, in the long term, fish farm waste could cause a 1% increase in nutrient concentrations in contrast to other anthropogenic activities which might double the Mediterranean nutrient pool.
The necessity of selenium substitution in total parenteral nutrition and artificial alimentation.
Gramm, H J; Kopf, A; Brätter, P
1995-03-01
For the trace element selenium, in contrast to zinc, iron, copper, chromium, manganese and iodine, there is still no clear official recommendation with regard to routine substitution in artificial nutrition. An overview of the manifestations of selenium deficiency in humans during the period 1979-1995 shows that nutritive deficiencies are exclusively TPN-induced or the result of severe malnutrition. The pathology of TPN-induced selenium deficiency and the analytic assessment of selenium status are described. Patients undergoing long-term parenteral nutrition or suffering from an increased loss of intestinal secretions have to be characterized as being especially at risk for clinical selenium deficiency. The relationship of the serum selenium kinetics in pediatric and adult patients to the depletion of body compartments during the course of short-term and prolonged TPN is discussed. Because of the importance of the selenoproteins, the regularly occurring depletion during selenium-free TPN and the borderline supply of selenium in Germany the routine substitution of selenium in TPN is strongly recommended. The pharmaceutical industry should be encouraged to develop a trace element solution that includes selenium, so that the nutritive requirement of patients on TPN can be satisfied. Adequate intravenous dosage recommendations are based on maintenance of glutathione peroxidase homeostasis. The routine supplementation dosage may not meet the selenium requirements of intensive care patients under conditions of increased metabolic demands on their anti-oxidative system.
Affordable nutrient solutions for improved food security as evidenced by crop trials.
van der Velde, Marijn; See, Linda; You, Liangzhi; Balkovič, Juraj; Fritz, Steffen; Khabarov, Nikolay; Obersteiner, Michael; Wood, Stanley
2013-01-01
The continuing depletion of nutrients from agricultural soils in Sub-Saharan African is accompanied by a lack of substantial progress in crop yield improvement. In this paper we investigate yield gaps for corn under two scenarios: a micro-dosing scenario with marginal increases in nitrogen (N) and phosphorus (P) of 10 kg ha(-1) and a larger yet still conservative scenario with proposed N and P applications of 80 and 20 kg ha(-1) respectively. The yield gaps are calculated from a database of historical FAO crop fertilizer trials at 1358 locations for Sub-Saharan Africa and South America. Our approach allows connecting experimental field scale data with continental policy recommendations. Two critical findings emerged from the analysis. The first is the degree to which P limits increases in corn yields. For example, under a micro-dosing scenario, in Africa, the addition of small amounts of N alone resulted in mean yield increases of 8% while the addition of only P increased mean yields by 26%, with implications for designing better balanced fertilizer distribution schemes. The second finding was the relatively large amount of yield increase possible for a small, yet affordable amount of fertilizer application. Using African and South American fertilizer prices we show that the level of investment needed to achieve these results is considerably less than 1% of Agricultural GDP for both a micro-dosing scenario and for the scenario involving higher yet still conservative fertilizer application rates. In the latter scenario realistic mean yield increases ranged between 28 to 85% in South America and 71 to 190% in Africa (mean plus one standard deviation). External investment in this low technology solution has the potential to kick start development and could complement other interventions such as better crop varieties and improved economic instruments to support farmers.
MacKay, Mark; Anderson, Collin; Boehme, Sabrina; Cash, Jared; Zobell, Jeffery
2016-04-01
The Institute for Safe Medication Practices has stated that parenteral nutrition (PN) is considered a high-risk medication and has the potential of causing harm. Three organizations--American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), American Society of Health-System Pharmacists, and National Advisory Group--have published guidelines for ordering, transcribing, compounding and administering PN. These national organizations have published data on compliance to the guidelines and the risk of errors. The purpose of this article is to compare total compliance with ordering, transcription, compounding, administration, and error rate with a large pediatric institution. A computerized prescriber order entry (CPOE) program was developed that incorporates dosing with soft and hard stop recommendations and simultaneously eliminating the need for paper transcription. A CPOE team prioritized and identified issues, then developed solutions and integrated innovative CPOE and automated compounding device (ACD) technologies and practice changes to minimize opportunities for medication errors in PN prescription, transcription, preparation, and administration. Thirty developmental processes were identified and integrated in the CPOE program, resulting in practices that were compliant with A.S.P.E.N. safety consensus recommendations. Data from 7 years of development and implementation were analyzed and compared with published literature comparing error, harm rates, and cost reductions to determine if our process showed lower error rates compared with national outcomes. The CPOE program developed was in total compliance with the A.S.P.E.N. guidelines for PN. The frequency of PN medication errors at our hospital over the 7 years was 230 errors/84,503 PN prescriptions, or 0.27% compared with national data that determined that 74 of 4730 (1.6%) of prescriptions over 1.5 years were associated with a medication error. Errors were categorized by steps in the PN process
Parenteral adjuvant potential of recombinant B subunit of Escherichia coli heat-labile enterotoxin
Directory of Open Access Journals (Sweden)
Carlos Eduardo Pouey da Cunha
Full Text Available BACKGROUND The B subunit of Escherichia coli heat-labile enterotoxin (LTB is a potent mucosal immune adjuvant. However, there is little information about LTB's potential as a parenteral adjuvant. OBJECTIVES We aimed at evaluating and better understanding rLTB's potential as a parenteral adjuvant using the fused R1 repeat of Mycoplasma hyopneumoniae P97 adhesin as an antigen to characterise the humoral immune response induced by this construct and comparing it to that generated when aluminium hydroxide is used as adjuvant instead. METHODS BALB/c mice were immunised intraperitoneally with either rLTBR1 or recombinant R1 adsorbed onto aluminium hydroxide. The levels of systemic anti-rR1 antibodies (total Ig, IgG1, IgG2a, and IgA were assessed by enzyme-linked immunosorbent assay (ELISA. The ratio of IgG1 and IgG2a was used to characterise a Th1, Th2, or mixed Th1/Th2 immune response. FINDINGS Western blot confirmed rR1, either alone or fused to LTB, remained antigenic; anti-cholera toxin ELISA confirmed that LTB retained its activity when expressed in a heterologous system. Mice immunised with the rLTBR1 fusion protein produced approximately twice as much anti-rR1 immunoglobulins as mice vaccinated with rR1 adsorbed onto aluminium hydroxide. Animals vaccinated with either rLTBR1 or rR1 adsorbed onto aluminium hydroxide presented a mixed Th1/Th2 immune response. We speculate this might be a result of rR1 immune modulation rather than adjuvant modulation. Mice immunised with rLTBR1 produced approximately 1.5-fold more serum IgA than animals immunised with rR1 and aluminium hydroxide. MAIN CONCLUSIONS The results suggest that rLTB is a more powerful parenteral adjuvant than aluminium hydroxide when administered intraperitoneally as it induced higher antibody titres. Therefore, we recommend that rLTB be considered an alternative adjuvant, even if different administration routes are employed.
Directory of Open Access Journals (Sweden)
Manuel Benito Novella
2008-09-01
Full Text Available The effect of the nutrient solution concentration on potato plant growth and minituber yield were determined in a sand closed hydroponic system. Minitubers and micropropagated plantlets of the cv. 'Macaca' were used. Treatments were five nutrient solution concentrations at electrical conductivities (EC of 1.0 (T1, 2.2 (T2, 3.4 (T3, 4.7 (T4 and 5.8dS m-1 (T5. The split plot randomised experimental design was used with three replications. Plants from minitubers produced higher fresh and mean weight of minitubers, shoot dry mass and leaf area index than the micropropagated ones. However, higher dry mass of minitubers was found with micropropagated plantlets compared to minitubers. The concentration of the nutrient solution did not affect minituber number. Increasing the nutrient solution concentration decreased total and minituber dry mass production of micropropagated plantlets and plant growth and minituber production of minituber-originated plants. Low concentration of nutrient solution at an EC of about 1.0dS m-1 can be used in the hydroponic production of potato minitubers of both micropropagated and minituber-originated plants.Neste trabalho foi determinado o efeito da concentração da solução nutritiva no crescimento e na produtividade de minitubérculos de batata em um sistema hidropônico fechado empregando areia como substrato. Plântulas micropropagadas e minitubérculos foram plantados em 24 de março de 2004. Os tratamentos foram cinco soluções nutritivas com condutividades elétricas (CE de 1,0 (T1, 2,2 (T2, 3,4 (T3, 4,7 (T4 e 5,8dS m-1 (T5. O experimento foi conduzido em parcelas subdivididas no delineamento inteiramente casualizado com três repetições. Plantas originadas de minitubérculos produziram mais massa fresca total e média de minitubérculos, massa seca da parte aérea e maior índice de área foliar que plantas micropropagadas. Entretanto, maior massa seca dos minitubérculos foi obtida em plantas micropropagadas
Liu, Zhi-Juan; Liu, Guo-Sheng; Chen, Yong-Ge; Zhang, Hui-Li; Wu, Xue-Fen
2015-01-01
To study the short-term response and tolerance of different doses of amino acids in parenteral nutrition among preterm infants. This study included 86 preterm infants who had a birth weight between 1 000 to 2 000 g and were admitted to the hospital within 24 hours of birth between March 2013 and June 2014. According to the early application of different doses of amino acids, they were randomized into low-dose group (n=29, 1.0 g/kg per day with an increase of 1.0 g/kg daily and a maximum of 3.5 g/kg per day), medium-dose group (n=28, 2.0 g/kg per day with an increase of 1.0 g/kg daily and a maximum of 3.7 g/kg per day), and high-dose group (n=29, 3.0 g/kg per day with an increase of 0.5-1.0 g/kg daily and a maximum of 4.0 g/kg per day). Other routine parenteral nutrition and enteral nutrition support were also applied. The maximum weight loss was lower and the growth rate of head circumference was greater in the high-dose group than in the low-dose group (Pnutrition, shorter duration of hospital stay, and less hospital cost than those in the low-dose group (P0.05). Parenteral administration of high-dose amino acids in preterm infants within 24 hours after birth can improve the short-term nutritional status of preterm infants, but there is a transient increase in BUN level.
[Should pediatric parenteral nutrition be individualized?].
Freitas, Renata Germano Borges de Oliveira Nascimento; Nogueira, Roberto José Negrão; Saron, Margareth Lopes Galvão; Lima, Alexandre Esteves Souza; Hessel, Gabriel
2014-12-01
Parenteral nutrition (PN) formulations are commonly individualized, since their standardization seem inadequate for the pediatric population. This study aimed to evaluate the nutritional state and the reasons for PN individualization in pediatric patients using PN hospitalized in a tertiary hospital in Campinas, São Paulo. This longitudinal study comprised patients using PN followed by up to 67 days. Nutritional status was classified according to the criteria established by the World Health Organization (WHO) (2006) and WHO (2007). The levels of the following elements on blood were analyzed: sodium, potassium, ionized calcium, chloride, magnesium, inorganic phosphorus and triglycerides (TGL). Among the criteria for individualization, were considered undeniable: significant reduction in blood levels of potassium (nutritional state of patients was considered critical in most cases. Thus, the individualization performed in the beginning of PN for energy protein adequacy was indispensable. In addition, the individualized PN was indispensable in at least 29.2% of PN for correction of alterations found in biochemical parameters. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
Zarnetske, J. P.; Abbott, B. W.; Bowden, W. B.; Iannucci, F.; Griffin, N.; Parker, S.; Pinay, G.; Aanderud, Z.
2017-12-01
Dissolved organic carbon (DOC), nutrients, and other solute concentrations are increasing in rivers across the Arctic. Two hypotheses have been proposed to explain these trends: 1. distributed, top-down permafrost degradation, and 2. discrete, point-source delivery of DOC and nutrients from permafrost collapse features (thermokarst). While long-term monitoring at a single station cannot discriminate between these mechanisms, synoptic sampling of multiple points in the stream network could reveal the spatial structure of solute sources. In this context, we sampled carbon and nutrient chemistry three times over two years in 119 subcatchments of three distinct Arctic catchments (North Slope, Alaska). Subcatchments ranged from 0.1 to 80 km2, and included three distinct types of Arctic landscapes - mountainous, tundra, and glacial-lake catchments. We quantified the stability of spatial patterns in synoptic water chemistry and analyzed high-frequency time series from the catchment outlets across the thaw season to identify source areas for DOC, nutrients, and major ions. We found that variance in solute concentrations between subcatchments collapsed at spatial scales between 1 to 20 km2, indicating a continuum of diffuse- and point-source dynamics, depending on solute and catchment characteristics (e.g. reactivity, topography, vegetation, surficial geology). Spatially-distributed mass balance revealed conservative transport of DOC and nitrogen, and indicates there may be strong in-stream retention of phosphorus, providing a network-scale confirmation of previous reach-scale studies in these Arctic catchments. Overall, we present new approaches to analyzing synoptic data for change detection and quantification of ecohydrological mechanisms in ecosystems in the Arctic and beyond.
Kinetics of phytosterol metabolism in neonates receiving parenteral nutrition.
Nghiem-Rao, T Hang; Tunc, Ilker; Mavis, Alisha M; Cao, Yumei; Polzin, Elizabeth M; Firary, Mary F; Wang, Xujing; Simpson, Pippa M; Patel, Shailendra B
2015-08-01
Phytosterols in soybean oil (SO) lipids likely contribute to parenteral nutrition-associated liver disease (PNALD) in infants. No characterization of phytosterol metabolism has been done in infants receiving SO lipids. In a prospective cohort study, 45 neonates (36 SO lipid vs. 9 control) underwent serial blood sample measurements of sitosterol, campesterol, and stigmasterol. Mathematical modeling was used to determine pharmacokinetic parameters of phytosterol metabolism and phytosterol exposure. Compared to controls, SO lipid-exposed infants had significantly higher levels of sitosterol and campesterol (P Phytosterols in SO lipid accumulate rapidly in neonates. Very preterm infants receiving SO lipid have higher sitosterol exposure, and may have poorly developed mechanisms of eliminating phytosterols that may contribute to their vulnerability to PNALD.
DEFF Research Database (Denmark)
Jain, Ajay Kumar; Stoll, Barbara; Burrin, Douglas G
2012-01-01
Total parenteral nutrition (TPN) is essential for patients with impaired gut function but leads to parenteral nutrition-associated liver disease (PNALD). TPN disrupts the normal enterohepatic circulation of bile acids, and we hypothesized that it would decrease intestinal expression of the newly...... described metabolic hormone fibroblast growth factor-19 (FGF19) and also glucagon-like peptides-1 and -2 (GLP-1 and GLP-2). We tested the effects of restoring bile acids by treating a neonatal piglet PNALD model with chenodeoxycholic acid (CDCA). Neonatal pigs received enteral feeding (EN), TPN, or TPN...... + CDCA for 14 days, and responses were assessed by serum markers, histology, and levels of key regulatory peptides. Cholestasis and steatosis were demonstrated in the TPN group relative to EN controls by elevated levels of serum total and direct bilirubin and also bile acids and liver triglyceride (TG...
Ng, Kenneth; Stoll, Barbara; Chacko, Shaji; de Pipaon, Miguel Saenz; Lauridsen, Charlotte; Gray, Matthew; Squires, E. James; Marini, Juan; Zamora, Irving J.; Olutoye, Oluyinka O.; Burrin, Douglas G.
2015-01-01
Introduction Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. Hypothesis Whether modifying the phytosterol and vitamin E composition of soy and fish oil lipid emulsions affects development of PNALD in preterm pigs. Methods We measured markers of PNALD in preterm pigs that received 14 days of PN that included 1 of the following: (1) Intralipid (IL, 100% soybean oil), (2) Intralipid + vitamin E (ILE, d-α-tocopherol), (3) Omegaven (OV, 100% fish oil), or (4) Omegaven + phytosterols (PS, β-sitosterol, campesterol, and stigmasterol). Results Serum levels of direct bilirubin, gamma glutamyl transferase, serum triglyceride, low-density lipoprotein, and hepatic triglyceride content were significantly lower (P phytosterols to Omegaven did not produce evidence of PNALD. PMID:25596209
Dos Santos, Quenia; Sichieri, Rosely; Darmon, Nicole; Maillot, Matthieu; Verly-Junior, Eliseu
2018-06-01
To identify optimal food choices that meet nutritional recommendations to reduce prevalence of inadequate nutrient intakes. Linear programming was used to obtain an optimized diet with sixty-eight foods with the least difference from the observed population mean dietary intake while meeting a set of nutritional goals that included reduction in the prevalence of inadequate nutrient intakes to ≤20 %. Brazil. Participants (men and women, n 25 324) aged 20 years or more from the first National Dietary Survey (NDS) 2008-2009. Feasible solution to the model was not found when all constraints were imposed; infeasible nutrients were Ca, vitamins D and E, Mg, Zn, fibre, linolenic acid, monounsaturated fat and Na. Feasible solution was obtained after relaxing the nutritional constraints for these limiting nutrients by including a deviation variable in the model. Estimated prevalence of nutrient inadequacy was reduced by 60-70 % for most nutrients, and mean saturated and trans-fat decreased in the optimized diet meeting the model constraints. Optimized diet was characterized by increases especially in fruits (+92 g), beans (+64 g), vegetables (+43 g), milk (+12 g), fish and seafood (+15 g) and whole cereals (+14 g), and reductions of sugar-sweetened beverages (-90 g), rice (-63 g), snacks (-14 g), red meat (-13 g) and processed meat (-9·7 g). Linear programming is a unique tool to identify which changes in the current diet can increase nutrient intake and place the population at lower risk of nutrient inadequacy. Reaching nutritional adequacy for all nutrients would require major dietary changes in the Brazilian diet.
Breemen, van N.
1995-01-01
This paper briefly reviews pathways by which plants can influence the nutrient cycle, and thereby the nutrient supply of themselves and of their competitors. Higher or lower internal nutrient use efficiency positively feeds back into the nutrient cycle, and helps to increase or decrease soil
CSIR Research Space (South Africa)
Mulopo, J
2015-03-01
Full Text Available + are reduced to ferrous ions Fe2+. During the industrial regeneration of Fe3+, nutrients and trace minerals usually provided in a laboratory setup are not present and this depletion of nutrients may have a negative impact on the bacteria responsible for ferrous...
Wolf, Jan; Keipert, Dieter; Motazedi, Heiko; Ernst, Michael; Nettleship, Joanne; Gooren, Louis
2017-12-01
This observational post-marketing study of parenteral testosterone undecanoate (TU) in a non-selected population aimed to: examine the effectiveness of TU as treatment of hypogonadism; record adverse drug reactions (ADR) quantitatively particularly regarding polycythemia, prostate safety and cardiovascular-related metabolic risk factors; and verify whether recommended injection intervals apply to routine clinical practice. Eight hundred and seventy subjects from 259 outpatient units scheduled to visit the clinic six times were included. Effectiveness and tolerability of TU administration were assessed on a 4-point scale. Body weight, waist girth, blood pressure, hemoglobin levels, hematocrit, prostate-specific antigen (PSA), and digital rectal prostate examination were assessed. Over 90% of subjects completed the observational duration of 52.8 ± 9.7 weeks (mean ± SD) and 56% judged effectiveness as very good, 30.8% as good. 63.1% judged tolerability as very good, and 24.4% as good. No adverse effects on indicators of cardiovascular risk were observed. Polycythemia occurred in one subject and a supranormal hematocrit in one subject. Four subjects developed supranormal PSA levels. Prostate carcinoma was found in one subject, one subject had recurrence of a previously surgically treated prostate carcinoma, and the other two showed no indication of malignancy. Parenteral TU is safe, effective, and well-tolerated in clinical practice proving a good therapeutic option for hypogonadism.
Predictive Modeling of Transient Storage and Nutrient Uptake: Implications for Stream Restoration
Energy Technology Data Exchange (ETDEWEB)
O’Connor, Ben L.; Hondzo, Miki; Harvey, Judson W.
2010-12-01
This study examined two key aspects of reactive transport modeling for stream restoration purposes: the accuracy of the nutrient spiraling and transient storage models for quantifying reach-scale nutrient uptake, and the ability to quantify transport parameters using measurements and scaling techniques in order to improve upon traditional conservative tracer fitting methods. Nitrate (NO-3)(NO3-) uptake rates inferred using the nutrient spiraling model underestimated the total NO-3NO3- mass loss by 82%, which was attributed to the exclusion of dispersion and transient storage. The transient storage model was more accurate with respect to the NO-3NO3- mass loss (±20%) and also demonstrated that uptake in the main channel was more significant than in storage zones. Conservative tracer fitting was unable to produce transport parameter estimates for a riffle-pool transition of the study reach, while forward modeling of solute transport using measured/scaled transport parameters matched conservative tracer breakthrough curves for all reaches. Additionally, solute exchange between the main channel and embayment surface storage zones was quantified using first-order theory. These results demonstrate that it is vital to account for transient storage in quantifying nutrient uptake, and the continued development of measurement/scaling techniques is needed for reactive transport modeling of streams with complex hydraulic and geomorphic conditions.
Effects of nutrient omission in Caesalpinia echinata plants
Directory of Open Access Journals (Sweden)
Sergio Valiengo Valeri
2014-03-01
Full Text Available The objective of this study was to evaluate the growth, the morphological alterations and the mineral composition of brazilwood (Caesalpinia echinata plants caused by mineral nutrients omission in a green house experiment. The experimental units were distributed in the green house according to a completely random design. The treatments, each repeated five times, were the following : check (natural soil, complete (N, P, K, Ca, Mg, S, B, Cu, Mn, and Zn and a complete solution but for the omission of one of the nutrients in parenthesis. Each plot was represented by a plant growing in a 7 dm3 vase filled with Quartzarenic Neosol. The analyzed variables were the following: visual nutritional deficiency symptoms, plant height, stem diameter, shoot dry matter, stem, branches and leaves included, and leaf nutrients level. The omission of nitrogen limited plant growth in height and shoot biomass production. The first visual deficiency symptoms were those due to N omission followed by those caused by P, Ca, Mg, S, Cu, and Mn omissions. Later on the K and B deficiency symptoms became visible. The omission of a nutrient always caused its level in the leaves to be significantly lower than that found when it was not omitted.
Lee, Ju Yeon; Rahman, Arifur; Azam, Hossain; Kim, Hyung Seok; Kwon, Man Jae
2017-01-01
A balanced nutrient supply is essential for the healthy growth of plants in hydroponic systems. However, the commonly used electrical conductivity (EC)-based nutrient control for plant cultivation can provide amounts of nutrients that are excessive or inadequate for proper plant growth. In this study, we investigated the kinetics of major and minor nutrient uptake in a nutrient solution during the growth of tomato (Solanum lycopersicum var. cerasiforme Alef.) in a closed hydroponic system. The concentrations of major and minor ions in the nutrient solution were determined by various analytical methods including inductively coupled plasma-optical emission spectroscopy (ICP-OES), ion chromatography (IC), ion specific electrodes, and/or colorimetric methods. The concentrations of the individual nutrient ions were compared with changes in the EC. The EC of the nutrient solution varied according to the different growth stages of tomato plants. Variation in the concentrations of NO3-, SO42-, Mg2+, Ca2+, and K+ was similar to the EC variation. However, in the cases of PO43-, Na+, Cl-, dissolved Fe and Mn, Cu2+, and Zn2+, variation did not correspond with that of EC. These ions were generally depleted (to 0 mg L-1) during tomato growth, suggesting that these specific ions should be monitored individually and their supply increased. Nutrient uptake rates of major ions increased gradually at different growth stages until harvest (from 15 mg L-1 d-1). Saturation indices determined by MINEQL+ simulation and a mineral precipitation experiment demonstrated the potential for amorphous calcium phosphate precipitation, which may facilitate the abiotic adsorptive removal of dissolved Fe, dissolved Mn, Cu2+, and Zn2+.
Parenteral magnesium load testing with 28Mg in weanling and young adult rats
International Nuclear Information System (INIS)
Caddell, J.L.; Calhoun, N.R.; Howard, M.P.; Patterson, K.Y.; Smith, J.C. Jr.
1981-01-01
A sound diagnostic test for Mg deficiency is needed. This is a report of the parenteral Mg load test conducted in weanling and young adult rats fed a purified basal diet containing 3 mg magnesium/100 g with 150 mg of added magnesium/100 g (control) or 0 added magnesium (deficient). Weanlings were studied at about 1 week of dietary treatment and young adults at 2 weeks. The protocol included: a) a 6-hour preload urinary collection; b) an intraperitoneal load of 15 mg of magnesium/kg (weanlings) or 12 mg/kg (young adults) with 2 microCi 28Mg given simultaneously with each load; c) a 6-hour postload urinary collection; d) chemical analysis of selected tissues and urine for Mg; and e) 28Mg counting 6 and 24 hours postload. Controls all excreted large amounts of Mg pre- and postload, retaining less than 26% of nonradioactive loads. They had high urinary 28Mg counts. In Mg-deficient animals, the concentration of Mg in bone more than halved. These animals avidly conserved Mg and retained over 85% of nonradioactive Mg loads. Their 28Mg activity in vital organs was 3--6 times greater than in controls. We concluded that the parenteral Mg load test reliably identifies severe Mg deficiency
Wen, Xiaobo; Cao, Dianjun; Jones, Ronald W; Li, Jianping; Szu, Shousun; Hoshino, Yasutaka
2012-09-21
Two currently licensed live oral rotavirus vaccines (Rotarix® and RotaTeq®) are highly efficacious against severe rotavirus diarrhea. However, the efficacy of such vaccines in selected low-income African and Asian countries is much lower than that in middle or high-income countries. Additionally, these two vaccines have recently been associated with rare case of intussusception in vaccinated infants. We developed a novel recombinant subunit parenteral rotavirus vaccine which may be more effective in low-income countries and also avert the potential problem of intussusception. Truncated recombinant VP8* (ΔVP8*) protein of human rotavirus strain Wa P[8], DS-1 P[4] or 1076 P[6] expressed in Escherichia coli was highly soluble and was generated in high yield. Guinea pigs hyperimmunized intramuscularly with each of the ΔVP8* proteins (i.e., P[8], P[4] or P[6]) developed high levels of homotypic as well as variable levels of heterotypic neutralizing antibodies. Moreover, the selected ΔVP8* proteins when administered to mice at a clinically relevant dosage, route and schedule, elicited high levels of serum anti-VP8* IgG and/or neutralizing antibodies. Our data indicated that the ΔVP8* proteins may be a plausible additional candidate as new parenteral rotavirus vaccines. Published by Elsevier Ltd.
An integrated decision support system for wastewater nutrient recovery and recycling to agriculture
Roy, E. D.; Bomeisl, L.; Cornbrooks, P.; Mo, W.
2017-12-01
Nutrient recovery and recycling has become a key research topic within the wastewater engineering and nutrient management communities. Several technologies now exist that can effectively capture nutrients from wastewater, and innovation in this area continues to be an important research pursuit. However, practical nutrient recycling solutions require more than capable nutrient capture technologies. We also need to understand the role that wastewater nutrient recovery and recycling can play within broader nutrient management schemes at the landscape level, including important interactions at the nexus of food, energy, and water. We are developing an integrated decision support system that combines wastewater treatment data, agricultural data, spatial nutrient balance modeling, life cycle assessment, stakeholder knowledge, and multi-criteria decision making. Our goals are to: (1) help guide design decisions related to the implementation of sustainable nutrient recovery technology, (2) support innovations in watershed nutrient management that operate at the interface of the built environment and agriculture, and (3) aid efforts to protect aquatic ecosystems while supporting human welfare in a circular nutrient economy. These goals will be realized partly through the assessment of plausible alternative scenarios for the future. In this presentation, we will describe the tool and focus on nutrient balance results for the New England region. These results illustrate that both centralized and decentralized wastewater nutrient recovery schemes have potential to transform nutrient flows in many New England watersheds, diverting wastewater N and P away from aquatic ecosystems and toward local or regional agricultural soils where they can offset a substantial percentage of imported fertilizer. We will also highlight feasibility criteria and next steps to integrate stakeholder knowledge, economics, and life cycle assessment into the tool.
The imprint of crop choice on global nutrient needs
International Nuclear Information System (INIS)
Jobbágy, Esteban G; Sala, Osvaldo E
2014-01-01
Solutions to meet growing food requirements in a world of limited suitable land and degrading environment focus mainly on increasing crop yields, particularly in poorly performing regions, and reducing animal product consumption. Increasing yields could alleviate land requirements, but imposing higher soil nutrient withdrawals and in most cases larger fertilizer inputs. Lowering animal product consumption favors a more efficient use of land as well as soil and fertilizer nutrients; yet actual saving may largely depend on which crops and how much fertilizer are used to feed livestock versus people. We show, with a global analysis, how the choice of cultivated plant species used to feed people and livestock influences global food production as well as soil nutrient withdrawals and fertilizer additions. The 3 to 15-fold differences in soil nutrient withdrawals per unit of energy or protein produced that we report across major crops explain how composition shifts over the last 20 years have reduced N, maintained P and increased K harvest withdrawals from soils while contributing to increasing dietary energy, protein and, particularly, vegetable fat outputs. Being highly variable across crops, global fertilization rates do not relate to actual soil nutrient withdrawals, but to monetary values of harvested products. Future changes in crop composition could contribute to achieve more sustainable food systems, optimizing land and fertilizer use. (letter)
Directory of Open Access Journals (Sweden)
Vatanpour H, Soltani M,
2016-08-01
Full Text Available Persistent pain continues to be a common problem among patients undergoing cardiac operations and the need for controlling such pain is believed to be as a prime necessity in terms of the patient’s well being, health care costs and avoiding negative consequences provoked by the pain itself. Regarding to the newly established guidelines, opioid analgesic agents are considered as the mainstay of moderate to severe acute pain. Nonetheless, the underutilization of opioids for pain relief is still a persisting huge challenge. This survey, applying as a concurrent Drug Utilization Review using ATC/DDD system provided and recommended by the DUR group of the World Health Organization, conducted on 108 inpatients who received opioid drugs by parenteral route during 9 months from February to November 2013 at the post-ICU ward of Shahid Modarres Cardiovascular Hospital, affiliated to Shahid Beheshti University of Medical Science, in Tehran. Our findings revealed that morphine was the most commonly prescribed parenteral opioid in the hospitalized patients and pethidine usage was in the lowest level for the geriatric patients, resulting in satisfaction with the analgesic procedure among most of the cases in our study. Both of the mentioned drugs were prescribed by intramuscular route, regarding PRN way of injecting as well. Comparative results of our study with the literature revealed relatively moderate and roughly rational consumption of morphine (10.282 DDD/100bed-days and pethidine (0.013 DDD/100bed-days. Applying multivariate conditional regression modeling on the question of determining independent predictors for opioid usage, disclosed a direct correlation between the patient’s weight and daily dose of parenteral opioid consumption.
Workshops sponsored by the Institute of Medicine (IOM) and the World Health Organization (WHO) suggested that incorporating systematic reviews into the process of updating nutrient reference values would enhance the transparency of the process. The IOM issues the Dietary Reference Intake values (DR...
Algal remediation of CO₂ and nutrient discharges: A review.
Judd, Simon; van den Broeke, Leo J P; Shurair, Mohamed; Kuti, Yussuf; Znad, Hussein
2015-12-15
The recent literature pertaining to the application of algal photobioreactors (PBRs) to both carbon dioxide mitigation and nutrient abatement is reviewed and the reported data analysed. The review appraises the influence of key system parameters on performance with reference to (a) the absorption and biological fixation of CO2 from gaseous effluent streams, and (b) the removal of nutrients from wastewaters. Key parameters appraised individually with reference to CO2 removal comprise algal speciation, light intensity, mass transfer, gas and hydraulic residence time, pollutant (CO2 and nutrient) loading, biochemical and chemical stoichiometry (including pH), and temperature. Nutrient removal has been assessed with reference to hydraulic residence time and reactor configuration, along with C:nutrient ratios and other factors affecting carbon fixation, and outcomes compared with those reported for classical biological nutrient removal (BNR). Outcomes of the review indicate there has been a disproportionate increase in algal PBR research outputs over the past 5-8 years, with a significant number of studies based on small, bench-scale systems. The quantitative impacts of light intensity and loading on CO2 uptake are highly dependent on the algal species, and also affected by solution chemical conditions such as temperature and pH. Calculations based on available data for biomass growth rates indicate that a reactor CO2 residence time of around 4 h is required for significant CO2 removal. Nutrient removal data indicate residence times of 2-5 days are required for significant nutrient removal, compared with PBR configuration (the high rate algal pond, HRAP) means that its footprint is at least two orders of magnitude greater than a classical BNR plant. It is concluded that the combined carbon capture/nutrient removal process relies on optimisation of a number of process parameters acting synergistically, principally microalgal strain, C:N:P load and balance, CO2 and liquid
A dual porosity model of nutrient uptake by root hairs
Zygalakis, K. C.; Kirk, G. J. D.; Jones, D. L.; Wissuwa, M.; Roose, T.
2011-01-01
Summary: • The importance of root hairs in the uptake of sparingly soluble nutrients is understood qualitatively, but not quantitatively, and this limits efforts to breed plants tolerant of nutrient-deficient soils. • Here, we develop a mathematical model of nutrient uptake by root hairs allowing for hair geometry and the details of nutrient transport through soil, including diffusion within and between soil particles. We give illustrative results for phosphate uptake. • Compared with conventional 'single porosity' models, this 'dual porosity' model predicts greater root uptake because more nutrient is available by slow release from within soil particles. Also the effect of soil moisture is less important with the dual porosity model because the effective volume available for diffusion in the soil is larger, and the predicted effects of hair length and density are different. • Consistent with experimental observations, with the dual porosity model, increases in hair length give greater increases in uptake than increases in hair density per unit main root length. The effect of hair density is less in dry soil because the minimum concentration in solution for net influx is reached more rapidly. The effect of hair length is much less sensitive to soil moisture. © 2011 The Authors. New Phytologist © 2011 New Phytologist Trust.
A dual porosity model of nutrient uptake by root hairs
Zygalakis, K. C.
2011-08-09
Summary: • The importance of root hairs in the uptake of sparingly soluble nutrients is understood qualitatively, but not quantitatively, and this limits efforts to breed plants tolerant of nutrient-deficient soils. • Here, we develop a mathematical model of nutrient uptake by root hairs allowing for hair geometry and the details of nutrient transport through soil, including diffusion within and between soil particles. We give illustrative results for phosphate uptake. • Compared with conventional \\'single porosity\\' models, this \\'dual porosity\\' model predicts greater root uptake because more nutrient is available by slow release from within soil particles. Also the effect of soil moisture is less important with the dual porosity model because the effective volume available for diffusion in the soil is larger, and the predicted effects of hair length and density are different. • Consistent with experimental observations, with the dual porosity model, increases in hair length give greater increases in uptake than increases in hair density per unit main root length. The effect of hair density is less in dry soil because the minimum concentration in solution for net influx is reached more rapidly. The effect of hair length is much less sensitive to soil moisture. © 2011 The Authors. New Phytologist © 2011 New Phytologist Trust.
Parenteral opioids for maternal pain management in labour.
Smith, Lesley A; Burns, Ethel; Cuthbert, Anna
2018-06-05
Parenteral opioids (intramuscular and intravenous drugs including patient-controlled analgesia) are used for pain relief in labour in many countries throughout the world. This review is an update of a review first published in 2010. To assess the effectiveness, safety and acceptability to women of different types, doses and modes of administration of parenteral opioid analgesia in labour. A second objective is to assess the effects of opioids in labour on the baby in terms of safety, condition at birth and early feeding. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (11 May 2017) and reference lists of retrieved studies. We included randomised controlled trials examining the use of intramuscular or intravenous opioids (including patient-controlled analgesia) for women in labour. Cluster-randomised trials were also eligible for inclusion, although none were identified. We did not include quasi-randomised trials. We looked at studies comparing an opioid with another opioid, placebo, no treatment, other non-pharmacological interventions (transcutaneous electrical nerve stimulation (TENS)) or inhaled analgesia. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We assessed the quality of each evidence synthesis using the GRADE approach. We included 70 studies that compared an opioid with placebo or no treatment, another opioid administered intramuscularly or intravenously or compared with TENS applied to the back. Sixty-one studies involving more than 8000 women contributed data to the review and these studies reported on 34 different comparisons; for many comparisons and outcomes only one study contributed data. All of the studies were conducted in hospital settings, on healthy women with uncomplicated pregnancies at 37 to 42 weeks' gestation. We excluded studies focusing on women with pre
Modelling of the Nutrient Medium for Plants Cultivation in Spaceflight
Nechitailo, Galina S.
2016-07-01
MODELLING OF THE NUTRIENT MEDIUM FOR PLANTS CULTIVATION IN SPACEFLIGHT Nechitajlo G.S.*, Rakhmetova A.A.**, Bogoslovskaja O.A.**, Ol'hovskay I.P.**, Glushchenko N.N.** *Emanuel Institute of Biochemical Physics of Russian Academy of Sciences (IBCP RAS) mail: spacemal@mail.ru **V.L. Talrose Institute for Energy Problems of Chemical Physics of Russian Academy of Science (INEPCP RAS) mail: nnglu@ mail.ru The valuable life and fruitful activity of cosmonauts and researchers in conditions of spaceflights and prolonged work at space stations are only possible with creating life area providing fresh air, natural food, comfortable psychological conditions, etc. The solution of that problem under space conditions seems impossible without use of high nano- and biotechnologies for plants growth. A priority should be given not only to choose species of growth plants in space, but also to improve conditions for their growth which includes optimal nourishing components for plants, preparation of nutrient mediums, illumination and temperature. We are deeply convinced that just manipulations with growing conditions for cultivated plants, but not genes changes, is a guarantee of success in the decision of this problem. For improving the method of plants growing on the artificial nutrient medium with balanced content of components, being necessary for growth and development of plants, we added essential metal elements: Fe, Zn, Cu - in an electroneutral state in the form of nanoparticles instead of sulfates or other easily dissolving salts. Nanoparticulated metals are known to have a number of advantages in comparison with salts: metals in an electroneutral form are characterized with the prolonged and multifunctional action, low toxicity per se and appearing to be much below the toxicity of the same metals in the ionic forms, accumulation as a reserve being used in biotic dozes, active distribution in bodies and organs of plants and stimulation of vital processes. A high reactivity
Zee, van der S.E.A.T.M.; Leijnse, A.
2013-01-01
Solute transport is of importance in view of the movement of nutrient elements, e.g. towards the plant root system, and because of a broad range of pollutants. Pollution is not necessarily man induced, but may be due to geological or geohydrological causes, e.g. in the cases of pollution with
Effect of parenteral nutrition on postradiational metabolic changes under experimental conditions
International Nuclear Information System (INIS)
Grozdov, S.P.; Moroz, B.B.; Fedorovskij, L.L.; Vasil'evskaya, V.V.; Lyrshchikova, A.V.
1978-01-01
The assimilation of carbohydrates, nitrogen compounds, fat and electrolytes during parenteral feeding (PF) of irradiated animals was studied. Rats were subjected to PF from 2nd to 5th day after total gamma irradiation at 750 R, dogs - from 8th to 11th day after irradiation at 300 R. The results are indicative of a satisfactory assimilation of carbohydrates, nitrogen compounds, fat and electrolytes by animals in the cource of PF. The negative nitrogen balance characteristic of irradiated animals was expressed to a lesser degree. A trend to a lower sodium excretion has been observed during PF period
Pedrón Giner, Consuelo; Cuervas-Mons Vendrell, Margarita; Galera Martínez, Rafael; Gómez López, Lilianne; Gomis Muñoz, Pilar; Irastorza Terradillos, Iñaki; Martínez Costa, Cecilia; Moreno Villares, José Manuel; Pérez-Portabella Maristany, Cleofé; Pozas Del Río, M ª Teresa; Redecillas Ferreiro, Susana E; Prieto Bozano, Gerardo; Grupo de Estandarización de la Senpe, Senpe
2017-06-05
Introduction:Parenteral nutrition (PN) in childhood is a treatment whose characteristics are highly variable depending on the age and pathology of the patient. Material and methods: The Standardization and Protocols Group of the Spanish Society for Parenteral and Enteral Nutrition (SENPE) is an interdisciplinary group formed by members of the SENPE, the Spanish Society of Gastroenterology, Hepatology and Pediatric Nutrition (SEGHNP) and the Spanish Society of Hospital Pharmacy (SEFH) that intends to update this issue. For this, a detailed review of the literature has been carried out, looking for the evidences that allow us to elaborate a Clinical Practice Guide following the criteria of the Oxford Center for Evidence-Based Medicine. Results: This manuscript summarizes the recommendations regarding indications, access routes, requirements, modifi cations in special situations, components of the mixtures, prescription and standardization, preparation, administration, monitoring, complications and home NP. The complete document is published as a monographic number. Conclusions: This guide is intended to support the prescription of pediatric PN. It provides the basis for rational decisions in the context of the existing evidence. No guidelines can take into account all of the often compelling individual clinical circumstances.
Patients' experiences with home parenteral nutrition: A grounded theory study.
Wong, Christina; Lucas, Beverley; Wood, Diana
2018-04-01
Parenteral nutrition (PN) provides nourishment and hydration as an intravenous infusion to patients with intestinal failure (IF). The aim of the study is to generate theory that explains the experiences of adult patients living with home parenteral nutrition (HPN) and complex medication regimens. A grounded theory methodology was used to explore the experiences of twelve patients receiving HPN. A semi-structured interview was conducted and recorded in each participant's home setting. Each interview was transcribed verbatim. The simultaneous process of data collection and analysis was followed reflecting the principles of the constant comparative approach. A total of 15 patients gave written consent, with 12 of them agreeing to be interviewed. All the participants had previously undergone surgery as a result of chronic ill health or sudden illness. Analysis revealed two core categories: stoma and HPN, and these were supported by the subcategories: maintaining stoma output, access to toilets, managing dietary changes, maintaining the HPN infusion routine, access to technical help to set up an HPN infusion, mobility with HPN equipment and general health changes. The strategy of living with loss was demonstrated by all the participants, and this was supported by the action strategies of maintaining daily activities and social interactions. This study generates new understanding and insight into the views and experiences of patients receiving HPN in the UK. The findings from these participants have been shown to resonate with the Kubler-Ross Model [1] of the five stages of grief. The theory of living with loss was generated by the use of a grounded theory methodology. This small scale exploratory study reveals opportunities for improvements in practice to be considered by the nutrition support team (NST) and other healthcare professionals involved in the patient's hospital stay prior to discharge on HPN. Copyright © 2018 European Society for Clinical Nutrition and
Savini, Sara; Correani, Alessio; Pupillo, Daniele; D'Ascenzo, Rita; Biagetti, Chiara; Pompilio, Adriana; Simonato, Manuela; Verlato, Giovanna; Cogo, Paola; Taus, Marina; Nicolai, Albano; Carnielli, Virgilio Paolo
2016-12-01
Several studies reported the association between total plasma phytosterol concentrations and the parenteral nutrition-associated cholestasis (PNAC). To date, no data are available on phytosterol esterification in animals and in humans during parenteral nutrition (PN). We measured free and esterified sterols (cholesterol, campesterol, stigmasterol, and sitosterol) plasma concentrations during PN in 16 preterm infants (500-1249 g of birth weight; Preterm-PN), in 11 term infants (Term-PN) and in 12 adults (Adult-PN). Gas chromatography-mass spectrometry was used for measurements. Plasma concentrations of free cholesterol (Free-CHO), free phytosterols (Free-PHY) and esterified phytosterols (Ester-PHY) were not different among the three PN groups. Esterified cholesterol (Ester-CHO) was statistically lower in Preterm-PN than Adult-PN. Preterm-PN had significantly higher Free-CHO/Ester-CHO and Free-PHY/Ester-PHY ratios than Adult-PN (Free-CHO/Ester-CHO: 1.1 ± 0.7 vs. 0.6 ± 0.2; Free-PHY/Ester-PHY: 4.1 ± 2.6 vs. 1.3 ± 0.8; *P phytosterol intake in Preterm-PN. Free-PHY/Ester-PHY of Preterm-PN was positively correlated with the Free-CHO/Ester-CHO and negatively correlated with gestational age and birth weight. In conclusion, PHY were esterified to a lesser extent than CHO in all study groups; the esterification was markedly decreased in Preterm-PN compared to Adult-PN. The clinical consequences of these findings warrant further investigations.
Johnsen, Jacob Clarke; Reese, Susan Anne; Mackay, Mark; Anderson, Collin R; Jackson, Daniel; Paul, Irasema Libertad
2017-08-01
Pediatric patients who are receiving parenteral nutrition (PN) unsupplemented with trace minerals can become deficient. Due to shortages in trace mineral products and the 2004 American Society for Parenteral and Enteral Nutrition report stating that individualized trace element supplementation may be warranted, a review was conducted concerning the trace minerals selenium (Se), manganese (Mn), and iodine (I). A retrospective review of pediatric patients receiving PN that contained Se and Mn was conducted to determine if a difference existed between them and patients receiving PN without Se and Mn. Statistical analysis was done to assess a difference between trace mineral levels and the time to deficiency between supplemented and unsupplemented patients. Unsupplemented I patients had urine I levels assessed to determine deficiencies in patients receiving PN. Plasma Se levels were measured at a mean of 20 days for supplemented patients (n = 131) and 19 days for nonsupplemented patients (n = 57) with no difference between groups ( P = .2973). Plasma Mn levels were measured at a mean of 28 days, showing no statistical difference ( P = .721). Of the 177 nonsupplemented I patients, 74% demonstrated I deficiencies without supplementation. Time to the development of a Se, Mn, or I deficiency is important to guide supplementation of exclusive PN in children when trace mineral products are short in supply. Our retrospective experience supports assessment of the trace minerals Se at 21 days and Mn at 30 days. It also suggests that some pediatric patients receiving PN are deficient in I.
Directory of Open Access Journals (Sweden)
Richard P. Taylor
2018-06-01
Full Text Available Brewery effluent (BE needs to be treated before it can be released into the environment, reused or used in down-stream activities. This study demonstrated that anaerobic digestion (AD followed by treatment in an integrated tertiary effluent treatment system transformed BE into a suitable solution for crop irrigation. Brewery effluent can be used to improve crop yields: Cabbage (Brassica oleracea cv. Star 3301, grew significantly larger when irrigated with post-AD, post-primary-facultative-pond (PFP effluent, compared with those irrigated with post-constructed-wetland (CW effluent or tap water only (p < 0.0001. However, cabbage yield when grown using BE was 13% lower than that irrigated with a nutrient-solution and fresh water; the electrical conductivity of BE (3019.05 ± 48.72 µs/cm2 may have been responsible for this. Post-CW and post-high-rate-algal-pond (HRAP BE was least suitable due to their higher conductivity and lower nutrient concentration. After three months, soils irrigated with post-AD and post-PFP BE had a significantly higher sodium concentration and sodium adsorption ratio (3919 ± 94.77 & 8.18 ± 0.17 mg/kg than soil irrigated with a commercial nutrient-solution (920.58 ± 27.46 & 2.20 ± 0.05 mg/kg. However, this was not accompanied by a deterioration in the soil's hydro-physical properties, nor a change in the metabolic community structure of the soil. The benefits of developing this nutrient and water resource could contribute to cost-reductions at the brewery, more efficient water, nutrient and energy management, and job creation. Future studies should investigate methods to reduce the build-up of salt in the soil when treated BE is used to irrigate crops. Keywords: Wastewater irrigation, Nutrient recovery, Agriculture, Brewery effluent
Directory of Open Access Journals (Sweden)
Na Lu
2017-05-01
Full Text Available The global demand for medicinal plants is increasing. The quality of plants grown outdoors, however, is difficult to control. Myriad environmental factors influence plant growth and directly impact biosynthetic pathways, thus affecting the secondary metabolism of bioactive compounds. Plant factories use artificial lighting to increase the quality of medicinal plants and stabilize production. Photosynthetic photon flux density (PPFD and electrical conductivity (EC of nutrient solutions are two important factors that substantially influence perilla (Perilla frutescens, Labiatae plant growth and quality. To identify suitable levels of PPFD and EC for perilla plants grown in a plant factory, the growth, photosynthesis, and accumulation of secondary metabolites in red and green perilla plants were measured at PPFD values of 100, 200, and 300 μmol m-2 s-1 in nutrient solutions with EC values of 1.0, 2.0, and 3.0 dS m-1. The results showed significant interactive effects between PPFD and EC for both the fresh and dry weights of green perilla, but not for red perilla. The fresh and dry weights of shoots and leafy areas were affected more by EC than by PPFD in green perilla, whereas they were affected more by PPFD than by EC in red perilla. Leaf net photosynthetic rates were increased as PPFD increased in both perilla varieties, regardless of EC. The perillaldehyde concentration (mg g-1 in red perilla was unaffected by the treatments, but accumulation in plants (mg per plant was significantly enhanced as the weight of dry leaves increased. Perillaldehyde concentrations in green perilla showed significant differences between combinations of the highest PPFD with the highest EC and the lowest PPFD with the lowest EC. Rosmarinic acid concentration (mg g-1 was increased in a combination of low EC and high PPFD conditions. Optimal cultivation conditions of red and green perilla in plant factory will be discussed in terms of plant growth and contents of
Directory of Open Access Journals (Sweden)
Thomas Kiran Marella
2018-05-01
Full Text Available Because of the decreasing fossil fuel supply and increasing greenhouse gas (GHG emissions, microalgae have been identified as a viable and sustainable feedstock for biofuel production. The major effect of the release of wastewater rich in organic compounds has led to the eutrophication of freshwater ecosystems. A combined approach of freshwater diatom cultivation with urban sewage water treatment is a promising solution for nutrient removal and biofuel production. In this study, urban wastewater from eutrophic Hussain Sagar Lake was used to cultivate a diatom algae consortium, and the effects of silica and trace metal enrichment on growth, nutrient removal, and lipid production were evaluated. The nano-silica-based micronutrient mixture Nualgi containing Si, Fe, and metal ions was used to optimize diatom growth. Respectively, N and P reductions of 95.1% and 88.9%, COD and BOD reductions of 91% and 51% with a biomass yield of 122.5 mg L−1 day−1 and lipid productivity of 37 mg L−1 day−1 were observed for cultures grown in waste water using Nualgi. Fatty acid profiles revealed 13 different fatty acids with slight differences in their percentage of dry cell weight (DCW depending on enrichment level. These results demonstrate the potential of diatom algae grown in wastewater to produce feedstock for renewable biodiesel production. Enhanced carbon and excess nutrient utilization makes diatoms ideal candidates for co-processes such as CO2 sequestration, biodiesel production, and wastewater phycoremediation. Keywords: Micro algae, Diatom, Biodiesel, Nualgi, Nutrient removal, Wastewater
Directory of Open Access Journals (Sweden)
Luiz Antônio Zanão Júnior
2010-10-01
Full Text Available Although silicon is not recognized as a nutrient, it may benefit rice plants and may alleviate the Mn toxicity in some plant species. The dry matter yield (root, leaf, sheaths and leaf blade and plant architecture (angle of leaf insertion and leaf arc were evaluated in rice plants grown in nutrient solutions with three Mn doses, with and without Si addition. The treatments were arranged in a 2 x 3 factorial [with and without (2 mmol L-1 Si; three Mn doses (0.5; 2.5 and 10 µmol L-1], in a randomized block design with 4 replications. The experimental unit was a 4 L plastic vase with 4 rice (Metica-1 cultivar plants. Thirty nine days after keeping the seedlings in the nutrient solution the plant dry matter yield was determined; the angle of leaf insertion in the sheath and the leaf arc were measured; and the Si and Mn concentrations in roots, sheaths and leaves were determined. The analysis of variance (F test at 5 and 1 % levels and the regression analysis (for testing plant response to Mn with the Si treatments were performed. The Si added to the nutrient solution increased the dry matter yield of roots, sheaths and leaf blades and also decreased the angle of leaf blade insertion into the sheath and the foliar arc in the rice plant. Additionally, it ameliorated the rice plant architecture which allowed an increase in the dry matter yield. Similarly, the addition of Mn to the solution improved the architecture of the rice plants with gain in dry matter yield. As Si was added to the nutrient solution, the concentration of Mn in leaves decreased and in roots increased thus alleviating the toxic effects of Mn on the plants.O silício destaca-se por exercer vários benefícios para a cultura do arroz, apesar de não ser considerado um nutriente. Um desses benefícios é que ele pode amenizar a toxidez causada por Mn em algumas espécies de plantas. Objetivou-se com este trabalho avaliar a produção de matéria seca (raízes, bainhas e limbo foliar e
Effect of nutrient calcium on the cell wall composition and ...
African Journals Online (AJOL)
The effect of calcium in the nutrient medium on kikuyu grass (Pennisetum clandestinum Hochst), grown in a solution culture, was investigated. Calcium had no effect on the lignin content of leaf material, but decreased the lignin content per unit stem cell wall. Calcium appeared to have no significant effect on either the ...
Tamaro, G; Morena, C; Uxa, F; Candusso, M; Trappan, A; de Vonderweid, U
1993-01-01
Immunoglobulins IgA, IgG and IgM and complement factors C3 and C4 have been measured in a population of premature infants to evaluate their degree of immunological maturity. All the infants were receiving complete parenteral nutrition. In parallel, the same parameters were measured in twenty two full term, healthy neonates. To explore maturation and liver function, the authors used other proteins as nutritional markers. Differences in the immunoglobulins, but not in the complement fractions were seen between the two groups. Two applications are suggested: incidence of infections and post partum maturation.
Schauer, Steven G; Cunningham, Cord W; Fisher, Andrew D; DeLorenzo, Robert A
2017-12-01
Introduction Select units in the military have improved combat medic training by integrating their functions into routine clinical care activities with measurable improvements in battlefield care. This level of integration is currently limited to special operations units. It is unknown if regular Army units and combat medics can emulate these successes. The goal of this project was to determine whether US Army combat medics can be integrated into routine emergency department (ED) clinical care, specifically medication administration. Project Design This was a quality assurance project that monitored training of combat medics to administer parenteral medications and to ensure patient safety. Combat medics were provided training that included direct supervision during medication administration. Once proficiency was demonstrated, combat medics would prepare the medications under direct supervision, followed by indirect supervision during administration. As part of the quality assurance and safety processes, combat medics were required to document all medication administrations, supervising provider, and unexpected adverse events. Additional quality assurance follow-up occurred via complete chart review by the project lead. Data During the project period, the combat medics administered the following medications: ketamine (n=13), morphine (n=8), ketorolac (n=7), fentanyl (n=5), ondansetron (n=4), and other (n=6). No adverse events or patient safety events were reported by the combat medics or discovered during the quality assurance process. In this limited case series, combat medics safely administered parenteral medications under indirect provider supervision. Future research is needed to further develop this training model for both the military and civilian setting. Schauer SG , Cunningham C W, Fisher AD , DeLorenzo RA . A pilot project demonstrating that combat medics can safely administer parenteral medications in the emergency department. Prehosp Disaster Med. 2017;32(6):679-681.
Hess, Julie; Rao, Goutham; Slavin, Joanne
2017-01-01
Background: Although Americans receive almost a quarter of their daily energy from snacks, snacking remains a poorly defined and understood eating occasion. However, there is little dietary guidance about choosing snacks. Families, clinicians, and researchers need a comprehensive approach to assessing their nutritional value. Objective: To quantify and compare the nutrient density of commonly consumed snacks by their overall nutrient profiles using the Nutrient-Rich Foods (NRF) Index 10.3. Methods: NRF Index scores were calculated for the top 3 selling products (based on 2014 market research data) in different snack categories. These NRF scores were averaged to provide an overall nutrient-density score for each category. Results: Based on NRF scores, yogurt (55.3), milk (52.5), and fruit (30.1) emerged as the most nutrient-dense snacks. Ice cream (-4.4), pies and cakes (-11.1), and carbonated soft drinks (-17.2) emerged as the most nutrient-poor snacks. Conclusions: The NRF Index is a useful tool for assessing the overall nutritional value of snacks based on nutrients to limit and nutrients to encourage.
Kruimel, J.W.; Naber, A.H.J.; Vliet, J.A. van der; Carneheim, C.; Katan, M.B.; Jansen, J.B.M.J.
2001-01-01
BACKGROUND: Most postoperative patients lose net protein mass, which reflects loss of muscle tissue and organ function. Perioperative parenteral nutrition may reduce the loss of protein, but in general, with conventional lipid emulsions a waste of protein still remains. METHODS: We compared the
Mockus, Linas N; Paul, Timothy W; Pease, Nathan A; Harper, Nancy J; Basu, Prabir K; Oslos, Elizabeth A; Sacha, Gregory A; Kuu, Wei Y; Hardwick, Lisa M; Karty, Jacquelyn J; Pikal, Michael J; Hee, Eun; Khan, Mansoor A; Nail, Steven L
2011-01-01
A case study has been developed to illustrate one way of incorporating a Quality by Design approach into formulation and process development for a small molecule, freeze-dried parenteral product. Sodium ethacrynate was chosen as the model compound. Principal degradation products of sodium ethacrynate result from hydrolysis of the unsaturated ketone in aqueous solution, and dimer formation from a Diels-Alder condensation in the freeze-dried solid state. When the drug crystallizes in a frozen solution, the eutectic melting temperature is above -5°C. Crystallization in the frozen system is affected by pH in the range of pH 6-8 and buffer concentration in the range of 5-50 mM, where higher pH and lower buffer concentration favor crystallization. Physical state of the drug is critical to solid state stability, given the relative instability of amorphous drug. Stability was shown to vary considerably over the ranges of pH and buffer concentration examined, and vial-to-vial variability in degree of crystallinity is a potential concern. The formulation design space was constructed in terms of pH and drug concentration, and assuming a constant 5 mM concentration of buffer. The process design space is constructed to take into account limitations on the process imposed by the product and by equipment capability.
Energy Technology Data Exchange (ETDEWEB)
Millikan, C R
1947-01-01
The addition of molybdenum to solutions containing an excess of either manganese, zinc, copper, nickel or cobalt respectively, resulted in decreases in the severity of iron deficiency symptoms which normally occurred when flax was grown in solutions containing the same concentrations of any of these elements, but without molybdenum. The efficacy of molybdenum in this regard increased with increasing concentration up to 25 parts per million. However, concentrations of 0.5 to 2 parts per million of molybdenum had little effect on the severity of iron deficiency symptoms at the concentrations of heavy metals used. Molybdenum 5, 10 or 25 parts per million also retarded the date of appearance and reduced the severity of lower leaf necrosis which is another characteristic symptom of the presence of excess manganese (25 to 100 parts per million) in the nutrient solution. It is concluded that an essential function of molybdenum is intimately associated with the regulation of the deleterious effect of manganese, zinc, copper, nickel or cobalt on the physiological availability of iron to the plant. 46 references, 3 figures.
Strang, Brian J; Reddix, Bruce A; Wolk, Robert A
2016-10-01
Parenteral nutrition-associated cholestasis (PNAC) and liver disease have been associated with soybean oil-based intravenous fat emulsions (IVFEs). The benefit of fish oil-based IVFEs in the reversal of parenteral nutrition (PN)-associated liver damage includes allowing for longer PN duration without immediate need for bowel or liver transplantation. The present case involves an infant born with short bowel syndrome (SBS) requiring long-term PN with development of PNAC and subsequent administration of a fish oil-based IVFE. An infant born with SBS was initiated on PN and enteral feeds. After failed enteral progression, bowel lengthening by serial transverse enteroplasty (STEP) resulted in postoperative ileus with delayed enteral feeding for 4 weeks. The administration of long-term PN led to development of PNAC, resulting in initiation of a fish oil-based IVFE. After 4 months, the cholestasis had resolved. Despite the STEP, at 16 months, the child required bowel tapering due to inability to advance enteral feeding. Fish oil-based IVFE was effectively used to reverse PNAC in a child with SBS. Despite early STEP, the patient was not able to tolerate enteral feedings and required bowel tapering. This case illustrates that early surgical intervention did not allow for improved feed tolerance. This resulted in a significant period without enteral nutrition, leading to development of cholestasis. The use of fish oil-based IVFE may permit a longer duration of PN administration without the development of cholestasis or liver disease, allowing for longer time for bowel adaptation prior to the need for surgical intervention. © 2016 American Society for Parenteral and Enteral Nutrition.
International Nuclear Information System (INIS)
Wulp, Simon A. van der; Damar, Ario; Ladwig, Norbert; Hesse, Karl-J.
2016-01-01
The present application of numerical modelling techniques provides an overview of river discharges, nutrient flux and nutrient dispersal in Jakarta Bay. A hydrological model simulated river discharges with a total of 90 to 377 m 3 s −1 entering Jakarta Bay. Daily total nitrogen and total phosphorus loads ranged from 40 to 174 tons and 14 to 60 tons, respectively. Flow model results indicate that nutrient gradients are subject to turbulent mixing by tides and advective transport through circulation driven by wind, barotropic and baroclinic pressure gradients. The bulk of nutrient loads originate from the Citarum and Cisadane rivers flowing through predominantly rural areas. Despite lower nutrient loads, river discharges from the urban area of Jakarta exhibit the highest impact of nutrient concentrations in the near shore area of Jakarta Bay and show that nutrient concentrations were not only regulated by nutrient loads but were strongly regulated by initial river concentrations and local flow characteristics. - Highlights: • Full overview of river discharges, nutrient flux and nutrient levels in Jakarta Bay • Important overview of nutrient flux from individual rivers • Simulations identify the principal drivers of water circulation and nutrient gradient. • Nutrient dispersion model includes the local effects of the Java Sea current system.
Oenema, O.; Kros, J.; Vries, de W.
2003-01-01
Nutrient budgets of agroecosystems are constructed either (i) to increase the understanding of nutrient cycling, (ii) as performance indicator and awareness raiser in nutrient management and environmental policy, or (iii) as regulating policy instrument to enforce a certain nutrient management
Directory of Open Access Journals (Sweden)
A. Butturini
2005-01-01
Full Text Available Input-output mass balances within stream reaches provide in situ estimates of stream nutrient retention/release under a wide spectrum of hydrological conditions. Providing good estimates of the mass balances for nutrients depends on precise hydrological monitoring and good chemical characterisation of stream water at the input and output ends of the stream reach. There is a need to optimise the hydrological monitoring and the frequencies of water sampling to yield precise annual mass balances, so as to avoid undue cost - high resolution monitoring and subsequent chemical analysis can be labour intensive and costly. In this paper, simulation exercises were performed using a data set created to represent the instantaneous discharge and solute dynamics at the input and output ends of a model stream reach during a one year period. At the output end, stream discharge and water chemistry were monitored continuously, while the input end was assumed to be ungauged; water sampling frequency was changed arbitrarily. Instantaneous discharge at the ungauged sampling point was estimated with an empirical power model linking the discharge to the catchment area (Hooper, 1986. The model thus substitutes for the additional gauge station. Simulations showed that 10 days was the longest chemical sampling interval which could provide reach annual mass balances of acceptable precision. Presently, the relationship between discharge and catchment area is usually assumed to be linear but simulations indicate that small departures from the linearity of this relationship could cause dramatic changes in the mass balance estimations.
[Suppression of cycling activity in sheep using parenteral progestagen treatment].
Janett, F; Camponovo, L; Lanker, U; Hässig, M; Thun, R
2004-03-01
The objective of this study was to evaluate the effect of two synthetic progestagen preparations Chlormadinone acetate (CAP, Chronosyn, Veterinaria AG Zürich) and Medroxyprogesterone acetate (MPA, Nadigest, G Streuli & Co. Uznach) on cycling activity and fertility in sheep. A flock of 28 non pregnant white alpine sheep was randomly divided into three groups, A (n = 10), B (n = 9) and C (n = 9). During a period of 4 weeks the cycling activity was confirmed by blood progesterone analysis. Thereafter, the animals of group A were treated with 50 mg CAP, those of group B with 140 mg MPA and those of group C with physiological saline solution. All injections were given intramuscularly. Suppression of endogenous progesterone secretion lasted from 28 to 49 days (mean = 39 days) in group A and from 42 to 70 days (mean = 50 days) in group B. The synchronization effect of both preparations was unsatisfactory as the occurrence of first estrus was distributed over a period of 3 weeks in group A and 4 weeks in group B. These findings could also be confirmed by the lambing period which lasted 52 days in group A and 36 days in group B. Control animals lambed within 9 days due to the synchronizing effect of the ram. The first fertile estrus was observed 36 days (group A) and 45 days (group B) after the treatment. In group A all 10 animals and in groups B and C 8 of 9 ewes each became pregnant. Parenteral progestagen application with CAP and MPA is a simple, safe and reversible method of estrus suppression in the sheep. The minimal suppressive duration of 4 (CAP) and 5 weeks (MPA) is not sufficient when a period of 3 months (alpine pasture period) is desired.
Yao, Danhua; Zheng, Lei; Wang, Jian; Guo, Mingxiao; Yin, Jianyi; Li, Yousheng
2016-04-01
A prospective, randomized, controlled study was performed to evaluate the effects of perioperative alanyl-glutamine-supplemented parenteral nutrition (PN) support on the immunologic function, intestinal permeability, and nutrition status of surgical patients with chronic radiation enteritis (CRE)-induced intestinal obstruction. Patients who received 0.4 g/kg/d alanyl-glutamine and isonitrogenous PN were assigned to an alanyl-glutamine-supplemented PN (Gln-PN) group and a control group, respectively. Serum levels of alanine aminotransferase and glutamine, body fat mass (FM), immunologic function, and intestinal permeability were measured before and after surgery. Serum glutamine levels of the Gln-PN group significantly exceeded that of the control group (P nutrition state and intestinal motility of surgical patients with CRE-induced intestinal obstruction. © 2015 American Society for Parenteral and Enteral Nutrition.
Metabolic rates of 15N-D- and 15N-L-phenylalanine in an amino acid mixture for parenteral feeding
International Nuclear Information System (INIS)
Wutzke, K.; Heine, W.; Drescher, U.
1982-01-01
15 N investigations on the metabolism of L- and D-phenylalanine under conditions of parenteral feeding with the aminoacid solution Infesol in 6 infants revealed a retention rate of 83.4 +- 3.4 per cent for the L-form and of 36.6 +- 5.2 per cent for the D-form. When the D-isomer was raised from 1:3 to 1:1 in relation to the L-Form, 32.6 per cent of the infused D-phenylalanine were still retained. After continuous 24-hour infusion of the tracers, the maximum of 15 N excretion in the urine was reached between the 24th and the 30th hour. But little incorporation of 15 N-nitrogen was found in the serum and erythrocytes because of the relatively long half-life period of these proteins. Changes in the composition of commercial DL-amino acid mixtures will only be possible after determining the utilization rates of all essential and non-essential D-amino acids being used in such mixtures. (author)
Lewis, Sharon R; Schofield-Robinson, Oliver J; Alderson, Phil; Smith, Andrew F
2018-06-08
Critically ill people are at increased risk of malnutrition. Acute and chronic illness, trauma and inflammation induce stress-related catabolism, and drug-induced adverse effects may reduce appetite or increase nausea and vomiting. In addition, patient management in the intensive care unit (ICU) may also interrupt feeding routines. Methods to deliver nutritional requirements include provision of enteral nutrition (EN), or parenteral nutrition (PN), or a combination of both (EN and PN). However, each method is problematic. This review aimed to determine the route of delivery that optimizes uptake of nutrition. To compare the effects of enteral versus parenteral methods of nutrition, and the effects of enteral versus a combination of enteral and parenteral methods of nutrition, among critically ill adults, in terms of mortality, number of ICU-free days up to day 28, and adverse events. We searched CENTRAL, MEDLINE, and Embase on 3 October 2017. We searched clinical trials registries and grey literature, and handsearched reference lists of included studies and related reviews. We included randomized controlled studies (RCTs) and quasi-randomized studies comparing EN given to adults in the ICU versus PN or versus EN and PN. We included participants that were trauma, emergency, and postsurgical patients in the ICU. Two review authors independently assessed studies for inclusion, extracted data, and assessed risk of bias. We assessed the certainty of evidence with GRADE. We included 25 studies with 8816 participants; 23 studies were RCTs and two were quasi-randomized studies. All included participants were critically ill in the ICU with a wide range of diagnoses; mechanical ventilation status between study participants varied. We identified 11 studies awaiting classification for which we were unable to assess eligibility, and two ongoing studies.Seventeen studies compared EN versus PN, six compared EN versus EN and PN, two were multi-arm studies comparing EN versus PN
Piper, S N; Röhm, K D; Boldt, J; Odermatt, B; Maleck, W H; Suttner, S W
2008-07-01
The aetiology of parenteral nutrition-associated hepatic injury remains unresolved. The aim of the study was to evaluate the effects of structured triglycerides in parenteral nutrition compared either to a physical medium-chain triglycerides (MCT)/long-chain triglcerides (LCT) mixture or to a LCT emulsion on hepatic integrity. In a randomized, double-blinded trial, we studied 45 patients undergoing abdominal surgery, who were expected to receive parenteral nutrition for 5 days. Patients were allocated to one of three nutrition regimens: Group A (n = 15) received structured triglycerides, Group B (n = 15) a MCT/LCT and Group C (n = 15) a LCT lipid emulsion. Before the start of parenteral nutrition (T0), 24 h (T1), 48 h (T2), 72 h (T3) and 120 h (T4) after start of infusion the following parameters were measured: Alpha-glutathione S-transferase (alpha-GST), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glucose and serum triglycerides. At T3 and T4, alpha-GST levels were significantly higher in Group B (T3: 9.4 +/- 9.9; T4: 14.6 +/- 19.5 microg L-1) and Group C (T3: 14.2 +/- 20.8; T4: 22.4 +/- 39.3 microg L-1) compared with the patients receiving structured triglycerides (T3: 1.9 +/- 1.8; T4: 3.2 +/- 2.7 microg L-1). Whereas the mean alpha-GST-levels in structured triglycerides group always remained in the normal range, this was not the case in both other groups at T3 and T4. There were no significant differences concerning ALT, AST and glucose levels. At T3 and T4, triglyceride levels were significantly lower in Group A than in Groups B and C. Hepatic integrity was well retained with the administration of structured triglycerides, whereas both MCT/LCT emulsion and LCT emulsion caused subclinical hepatic injury.
Modeling farm nutrient flows in the North China Plain to reduce nutrient losses
Zhao, Zhanqing; Bai, Zhaohai; Wei, Sha; Ma, Wenqi; Wang, Mengru; Kroeze, Carolien; Ma, Lin
2017-01-01
Years of poor nutrient management practices in the agriculture industry in the North China Plain have led to large losses of nutrients to the environment, causing severe ecological consequences. Analyzing farm nutrient flows is urgently needed in order to reduce nutrient losses. A farm-level
Blok, Chris; Jackson, Brian E; Guo, Xianfeng; de Visser, Pieter H B; Marcelis, Leo F M
2017-01-01
Growing on rooting media other than soils in situ -i.e., substrate-based growing- allows for higher yields than soil-based growing as transport rates of water, nutrients, and oxygen in substrate surpass those in soil. Possibly water-based growing allows for even higher yields as transport rates of water and nutrients in water surpass those in substrate, even though the transport of oxygen may be more complex. Transport rates can only limit growth when they are below a rate corresponding to maximum plant uptake. Our first objective was to compare Chrysanthemum growth performance for three water-based growing systems with different irrigation. We compared; multi-point irrigation into a pond (DeepFlow); one-point irrigation resulting in a thin film of running water (NutrientFlow) and multi-point irrigation as droplets through air (Aeroponic). Second objective was to compare press pots as propagation medium with nutrient solution as propagation medium. The comparison included DeepFlow water-rooted cuttings with either the stem 1 cm into the nutrient solution or with the stem 1 cm above the nutrient solution. Measurements included fresh weight, dry weight, length, water supply, nutrient supply, and oxygen levels. To account for differences in radiation sum received, crop performance was evaluated with Radiation Use Efficiency (RUE) expressed as dry weight over sum of Photosynthetically Active Radiation. The reference, DeepFlow with substrate-based propagation, showed the highest RUE, even while the oxygen supply provided by irrigation was potentially growth limiting. DeepFlow with water-based propagation showed 15-17% lower RUEs than the reference. NutrientFlow showed 8% lower RUE than the reference, in combination with potentially limiting irrigation supply of nutrients and oxygen. Aeroponic showed RUE levels similar to the reference and Aeroponic had non-limiting irrigation supply of water, nutrients, and oxygen. Water-based propagation affected the subsequent
Nutrient-mediated architectural plasticity of a predatory trap.
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Sean J Blamires
Full Text Available BACKGROUND: Nutrients such as protein may be actively sought by foraging animals. Many predators exhibit foraging plasticity, but how their foraging strategies are affected when faced with nutrient deprivation is largely unknown. In spiders, the assimilation of protein into silk may be in conflict with somatic processes so we predicted web building to be affected under protein depletion. METHODOLOGY/PRINCIPAL FINDINGS: To assess the influence of protein intake on foraging plasticity we fed the orb-web spiders Argiope aemula and Cyclosa mulmeinensis high, low or no protein solutions over 10 days and allowed them to build webs. We compared post-feeding web architectural components and major ampullate (MA silk amino acid compositions. We found that the number of radii in webs increased in both species when fed high protein solutions. Mesh size increased in A. aemula when fed a high protein solution. MA silk proline and alanine compositions varied in each species with contrasting variations in alanine between the two species. Glycine compositions only varied in C. mulmeinensis silk. No spiders significantly lost or gained mass on any feeding treatment, so they did not sacrifice somatic maintenance for amino acid investment in silk. CONCLUSIONS/SIGNIFICANCE: Our results show that the amount of protein taken in significantly affects the foraging decisions of trap-building predators, such as orb web spiders. Nevertheless, the subtle differences found between species in the association between protein intake, the amino acids invested in silk and web architectural plasticity show that the influence of protein deprivation on specific foraging strategies differs among different spiders.
Nutrient-mediated architectural plasticity of a predatory trap.
Blamires, Sean J; Tso, I-Min
2013-01-01
Nutrients such as protein may be actively sought by foraging animals. Many predators exhibit foraging plasticity, but how their foraging strategies are affected when faced with nutrient deprivation is largely unknown. In spiders, the assimilation of protein into silk may be in conflict with somatic processes so we predicted web building to be affected under protein depletion. To assess the influence of protein intake on foraging plasticity we fed the orb-web spiders Argiope aemula and Cyclosa mulmeinensis high, low or no protein solutions over 10 days and allowed them to build webs. We compared post-feeding web architectural components and major ampullate (MA) silk amino acid compositions. We found that the number of radii in webs increased in both species when fed high protein solutions. Mesh size increased in A. aemula when fed a high protein solution. MA silk proline and alanine compositions varied in each species with contrasting variations in alanine between the two species. Glycine compositions only varied in C. mulmeinensis silk. No spiders significantly lost or gained mass on any feeding treatment, so they did not sacrifice somatic maintenance for amino acid investment in silk. Our results show that the amount of protein taken in significantly affects the foraging decisions of trap-building predators, such as orb web spiders. Nevertheless, the subtle differences found between species in the association between protein intake, the amino acids invested in silk and web architectural plasticity show that the influence of protein deprivation on specific foraging strategies differs among different spiders.
Safety of home parenteral nutrition during pregnancy.
Theilla, Miriam; Ławiński, Michał; Cohen, Jonathan; Hadar, Eran; Kagan, Ilya; Perkewick, Marek; Singer, Pierre
2017-02-01
Few studies have examined the effect of total parenteral nutrition which is lipid-based given throughout pregnancy to patients unable to obtain adequate nutrition by the oral route. In this study we examined the use of lipid-based home parenteral nutrition (HPN) in 7 pregnant women, commenced either before or during pregnancy, and their intra-pregnant course as well as a 2-year follow-up of their offspring is described. HPN was formulated on an individual basis and protein administered in a dose of 0.8-1.1 g/kg during the three trimesters. Lipid emulsions included long chain triglycerides or olive-oil based formulae and all patients received trace elements. Data were collected during the course of pregnancy and at birth while infants were followed for a period of between 6 months and 2 years using medical records and questionnaires. In total, we studied 9 pregnancies (in 7 women). HPN was administered for a median of 9 months (range 3-9 months). The mean energy provided during the 1st, 2nd and 3rd trimester was 9297 ± 2797 kcal/week, 9148 ± 2629 kcal/week and 8564 ± 4059 kcal/week resp. The mean increase in weight during the pregnancy was 9 ± 5 Kg. The only complications noted during the pregnancy consisted of 3 episodes of catheter-related infections which were successfully treated by antibiotics. The infants were born after a mean of 38.00 ± 1.55 weeks of gestation, with a mean first minute Apgar score of 8.7 ± 1.8 which increased to 9.8 ± 0.4 after 10 min. The mean infant birth weight was 2.45 ± 0.37 kg. No complications were noted at birth apart from one infant who suffered from torticollis which resolved spontaneously. During follow up, a decrease in hemoglobin related to low iron levels was noted in 1 infant, 2 infants were noted to be allergic to pollen and one underwent a scrotal hernia reduction. No developmental problems have been observed, neither physiological nor psychomotor, over the 2-year follow-up period. The authors
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Stigzelius Shayarina
2011-07-01
Full Text Available Abstract Background Hyponatremia is the most frequent electrolyte abnormality observed in post-operative pediatric patients receiving intravenous maintenance fluid therapy. If plasma sodium concentration (p-Na+ declines to levels below 125 mmol/L in vs. restricted rate of infusion and the composition of solutions used for parenteral maintenance fluid therapy (hypotonic vs. isotonic solutions contribute to the development of hyponatremia. So far, there is no definitive pediatric data to support a particular choice of parenteral fluid for maintenance therapy in post-surgical patients. Methods/Design Our prospective randomized non-blinded study will be conducted in healthy children and adolescents aged 1 to 14 years who have been operated for acute appendicitis. Patients will be randomized either to intravenous hypotonic (0.23% or 0.40% sodium chloride in glucose, respectively or near-isotonic (0.81% sodium chloride in glucose solution given at approximately three-fourths of the average maintenance rate. The main outcome of interest from this study is to evaluate 24 h post-operatively whether differences in p-Na+ between treatment groups are large enough to be of clinical relevance. In addition, water and electrolyte balance as well as regulatory hormones will be measured. Discussion This study will provide valuable information on the efficacy of hypotonic and near-isotonic fluid therapy in preventing a significant decrease in p-Na+. Finally, by means of careful electrolyte and water balance and by measuring regulatory hormones our results will also contribute to a better understanding of the physiopathology of post-operative changes in p-Na+ in a population at risk for hyponatremia. Trial registration The protocol for this study is registered with the current controlled trials registry; registry number: ISRCTN43896775.
Venturinil, C G; Bruinsmann, A; Oliveira, C P; Contri, R V; Pohlmann, A R; Guterres, S S
2016-02-01
An innovative nanocapsule formulation for parenteral administration using selected vegetable oils (mango, jojoba, pequi, oat, annatto, calendula, and chamomile) was developed that has the potential to encapsulate various drugs. The vegetable oil-loaded nanocapsules were prepared by interfacial deposition and compared with capric/caprylic triglyceride-loaded lipid core nanocapsules. The major objective was to investigate the effect of vegetable oils on particle size distribution and physical stability and to determine the hemolytic potential of the nanocapsules, considering their applicability for intravenous administration. Taking into account the importance of accurately determining particle size for the selected route of administration, different size characterization techniques were employed, such as Laser Diffraction, Dynamic Light Scattering, Multiple Light Scattering, Nanoparticle Tracking Analysis, and Transmission Electronic Microscopy. Laser diffraction studies indicated that the mean particle size of all nanocapsules was below 300 nm. For smaller particles, the laser diffraction and multiple light scattering data were in agreement (D[3,2]-130 nm). Dynamic light scattering and nanoparticle tracking analysis, two powerful techniques that complement each other, exhibited size values between 180 and 259 nm for all nanoparticles. Stability studies demonstrated a tendency of particle creaming for jojoba-nanocapsules and sedimentation for the other nanoparticles; however, no size variation occurred over 30 days. The hemolysis test proved the hemocompatibility of all nanosystems, irrespective of the type of oil. Although all developed nanocapsules presented the potential for parenteral administration, jojoba oil-loaded nanocapsules were selected as the most promising nanoformulation due to their low average size and high particle size homogeneity.
Microbial enzyme activity, nutrient uptake and nutrient limitation in forested streams
Brian H. Hill; Frank H. McCormick; Bret C. Harvey; Sherri L. Johnson; Melvin L. Warren; Colleen M. Elonen
2010-01-01
The flow of organic matter and nutrients from catchments into the streams draining them and the biogeochemical transformations of organic matter and nutrients along flow paths are fundamental processes instreams (Hynes,1975; Fisher, Sponseller & Heffernan, 2004). Microbial biofilms are often the primary interface for organic matter and nutrient uptake and...
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Xun Yue
2012-01-01
Full Text Available Aquaporins are multifunctional membrane channels that facilitate the transmembrane transport of water and solutes. When transmembrane mineral nutrient transporters exhibit the same expression patterns as aquaporins under diverse temporal and physiological conditions, there is a greater probability that they interact. In this study, genome-wide temporal profiling of transcripts analysis and coexpression network-based approaches are used to examine the significant specificity correlation of aquaporins and transmembrane solute transporters in developing maize leaf. The results indicate that specific maize aquaporins are related to specific transmembrane solute transporters. The analysis demonstrates a systems-level correlation between aquaporins, nutrient transporters, and the homeostasis of mineral nutrients in developing maize leaf. Our results provide a resource for further studies into the physiological function of these aquaporins.
Tall, Susanna; Meyling, Nicolai V
2018-03-28
Cultivation of crops requires nutrient supplements which are costly and impact the environment. Furthermore, global demands for increased crop production call for sustainable solutions to increase yield and utilize resources such as nutrients more effectively. Some entomopathogenic fungi are able to promote plant growth, but studies over such effects have been conducted under optimal conditions where nutrients are abundantly available. We studied the effects of Beauveria bassiana (strain GHA) seed treatment on the growth of maize (Zea mays) at high and low nutrient conditions during 6 weeks in greenhouse. As expected, B. bassiana seed treatment increased plant growth, but only at high nutrient conditions. In contrast, the seed treatment did not benefit plant growth at low nutrient conditions where the fungus potentially constituted a sink and tended to reduce plant growth. The occurrence of endophytic B. bassiana in experimental plant tissues was evaluated by PCR after 6 weeks, but B. bassiana was not documented in any of the above-ground plant tissues indicating that the fungus-plant interaction was independent of endophytic establishment. Our results suggest that B. bassiana seed treatment could be used as a growth promoter of maize when nutrients are abundantly available, while the fungus does not provide any growth benefits when nutrients are scarce.
Paskiet, Diane; Jenke, Dennis; Ball, Douglas; Houston, Christopher; Norwood, Daniel L; Markovic, Ingrid
2013-01-01
The Product Quality Research Institute (PQRI) is a non-profit consortium of organizations working together to generate and share timely, relevant, and impactful information that advances drug product quality and development. The collaborative activities of PQRI participants have, in the case of orally inhaled and nasal drug products (OINDPs), resulted in comprehensive and widely-accepted recommendations for leachables assessments to help ensure patient safety with respect to this class of packaged drug products. These recommendations, which include scientifically justified safety thresholds for leachables, represent a significant milestone towards establishing standardized approaches for safety qualification of leachables in OINDP. To build on the success of the OINDP effort, PQRI's Parenteral and Ophthalmic Drug Products (PODP) Leachables and Extractables Working Group was formed to extrapolate the OINDP threshold concepts and best practice recommendations to other dosage forms with high concern for interaction with packaging/delivery systems. This article considers the general aspects of leachables and their safety assessment, introduces the PODP Work Plan and initial study Protocol, discusses the laboratory studies being conducted by the PODP Chemistry Team, outlines the strategy being developed by the PODP Toxicology Team for the safety qualification of PODP leachables, and considers the issues associated with application of the safety thresholds, particularly with respect to large-volume parenterals. Lastly, the unique leachables issues associated with biologics are described. The Product Quality Research Institute (PQRI) is a non-profit consortium involving industry organizations, academia, and regulatory agencies that together provide recommendations in support of regulatory guidance to advance drug product quality. The collaborative activities of the PQRI Orally Inhaled and Nasal Drug Products Leachables and Extractables Working Group resulted in a
Lapillonne, Alexandre; Carnielli, Virgilio Paolo; Embleton, Nicholas David; Mihatsch, Walter
2013-09-18
The level of adherence to guidelines should be explored particularly in preterm infants for whom poor nutrition has major effects on outcomes in later life. The objective was to evaluate compliance to international guidelines for parenteral nutrition (PN) in preterm infants across neonatal intensive care units (NICUs) of four European countries. Clinical practice survey by means of a questionnaire addressing routine PN protocols, awareness and implementation of guidelines. NICUs in the UK, Italy, Germany and France. One senior physician per unit; 199 units which represent 74% of the NICUs of the four countries. Adherence of unit protocol to international guidelines. Factors that influence adherence to guidelines. 80% of the respondents stated that they were aware of some PN clinical practice guidelines. For amino acid infusion (AA), 63% of the respondents aimed to initiate AA on D0, 38% aimed to administer an initial dose ≥1.5 g/kg/day and 91% aimed for a target dose of 3 or 4 g/kg/day, as recommended. For parenteral lipids, 90% of the respondents aimed to initiate parenteral lipids during the first 3 days of life, 39% aimed to use an initial dose ≥1.0 g/kg/day and 76% defined the target dose as 3-4 g/kg/day, as recommended. Significant variations in PN protocols were observed among countries, but the type of hospital or the number of admissions per year had only a marginal impact on the PN protocols. Most respondents indicated that their clinical practice was based on common guidelines. However, the initiation of PN is frequently not compliant with current recommendations, with the main differences being observed during the first days of life. Continuous education focusing on PN practice is needed, and greater efforts are required to disseminate and implement international guidelines.
Akin, M; Sarbay, H; Guler, S; Balci, Y I; Polat, A
2016-04-01
We evaluated that response to parenteral iron therapy could be helpful in distinguishing the types of iron deficiency anemia. This study analyzed responses to IV iron sucrose therapy of 15 children with unexplained refractory iron deficiency anemia (URIDA). We compared the results at diagnosis, 6 weeks and 6 months after the therapy. Results were compared with responses of 11 patients' results with iron-refractory iron deficiency anemia (IRIDA) from our previous study. Six weeks after the start of treatment, ferritin, MCV, MCH and Hb values were in normal range in 10 patients. The increase in Hb, MCH, MCV, and ferritin values ranged 2.6-3.5 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. In five patients, Hb, MCH, and MCV mean (range) values [11.2 g/dL (11-12.2), 24.5 pg (24-25.6), and 67 fL (65-70)] were nearly normal but ferritin mean (range) values [9.8 ng/mL (8-11)] were below normal. Six weeks after the start of treatment, Hb, MCH, MCV and ferritin values of patients with IRIDA were increased. The increase in Hb, MCH, MCV, and ferritin values ranged 0.8-2.7 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. IRIDA is only partially responsive to parenteral iron supplementation. In conclusion, this study demonstrated that the response to intravenous iron therapy for the URIDA cases improved blood parameters more effectively than hereditary IRIDA. Response to parenteral iron therapy would be helpful to distinguish unexplained refractory IDA from hereditary IRIDA for clinicians who do not have access to hepcidin or TMPRS6 mutation analysis. © 2016 John Wiley & Sons Ltd.
Soil nutrient enhancement by rice husk in smallholder farms of the ...
African Journals Online (AJOL)
Soil fertility management is one of the most cherished natural resource that requires being safeguard at all cost. An adequate and better solution to combat soil constraint arising from nutrient depletion has been developed; a low external input technology, amending soils with an organic base fertilizer (rice husk) as it is high ...
Rothaermel, S; Bischoff, S C; Bockenheimer-Lucius, G; Frewer, A; Wehkamp, K H; Zuercher, G
2009-11-18
Adequate nutrition is a part of medical treatment and is influenced by ethical and legal considerations. Patients, who cannot be sufficiently fed via the gastrointestinal tract, have the fundamental right to receive PN (parenteral nutrition) even so patients who are unable to give their consent. General objectives in nutrition support are to supply adequate nutrition with regards to the prevention of malnutrition and its consequences (increased morbidity and mortality), and thereby promoting improved outcome and/or quality of life for the patient considering always the patient's needs and wishes. The requests of the patient to renounce PN should be respected where a signed living will is helpful. During the course of a terminal illness the nutrition has to be adapted individually according to the needs and wishes of a patient in the corresponding phase. Capability of consent should be checked in each individual case and for each measure on an individual basis. Consent should only be accepted if the patient is capable of recognizing the nature, meaning and importance of the intervention as well as the consequences of relinquishment of such an intervention, and is capable to make a self-determined decision. If the patient is not capable of consenting, the patient's living will is the most important document when determining their assumed will and legally binding. Otherwise a guardian appointed by the patient, or the representative appointed by the court (if the patient has made no provisions) can make the decision.