Nutrition
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Albumin plasma concentrations are being used as indicators of nutritional status and hepatic function based on the assumption that plasma levels reflect the rate of albumin synthesis. However, it has been shown that albumin levels are not reliable markers of albumin synthesis under a variety of clinical conditions including inflammation, malnutrition, diabetes mellitus, liver disease, and surgical tissue trauma. To date, only a few studies have measured albumin synthesis in surgical and critically ill patients. ⋯ The results indicate that the fractional synthesis rate of albumin appears to decrease during surgery, followed by an increase during the postoperative phase. In the early postoperative phase, albumin fractional synthesis rate can be stimulated by perioperative nutrition, if enough amino acids are being provided and if nutrition is being initiated before the operation. The physiologic meaning of albumin synthesis after surgery, however, still needs to be further clarified.
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In hospitalized patients, the optimal target blood glucose concentration is controversial. Numerous studies have examined clinical use of glucose control in various patient populations. In the present review, we briefly discuss corresponding meta-analyses. ⋯ Eight meta-analyses showed that, despite the intensity of glucose control, the frequency of hypoglycemic episodes increased. The residual heterogeneity of individual studies incorporated into the various meta-analyses prevents a valid conclusion regarding potential benefits of a specific glucose target. A glucose concentration <200 mg/dL appears preferable.
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Selenium is a metalloid element with the atomic number 34. It is one of the elements that determine the normal functioning of an organism; it has antioxidant properties and protects the organism against the actions of free radicals and carcinogenic factors. Selenium is an element that fulfills an important physiologic function, but there is a fine line between the concentration that still has beneficial effects on an organism and that at which selenium begins exerting toxic effects. ⋯ Studies clearly indicate that selenium-containing yeast can be an effective, safe, and natural source of dietary selenium. In general, the selenium content of various diets can differ significantly depending on the food items and, more importantly their geographical origin and the respective soil selenium content. Thus, it seems advisable to pay attention to the use of this element in the manufacture of high-quality consumer goods, including finished protein-mineral preparations that enrich those diets that are deficient in selenium.