Nutrition
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The polyamines (PA) spermidine (SD) and spermine and their precursor putrescine (PU) play a leading role in the regulation of protein, RNA and DNA synthesis. We examined the role of PA along with other biomarkers of injury in eight victims of multiple trauma in the early post-traumatic period when they were hypermetabolic and highly catabolic. Intravenous nutritional therapy (TPN) was started 48 to 60h after trauma and continued for 6 days. ⋯ Injury stimulated ribonuclease and catecholamine levels were also enhanced by nutritional therapy, peaking on the first and fourth day of TPN, respectively. This study demonstrated for the first time elevated levels of PA in trauma patients that correlated well with the other known measures of protein metabolic response to injury and changes during nutritional therapy. Extracellular PA levels could be used as markers of both catabolic pathology in trauma and of its response to nutritional therapy.
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Comparative Study
Comparison of effects of long-chain and medium-chain triglyceride emulsions during hepatic regeneration in rats.
We examined the effect of long-chain triglyceride (LCT) and medium-chain triglyceride (MCT) emulsions on hepatic regeneration. After approximately 70% hepatectomy, Sprague-Dawley rats were maintained for 96 hours on total parenteral nutrition (TPN) (250 kcal/kg per day; nonprotein calories-nitrogen 160:1) with LCT or MCT as 30% of nonprotein calories. ⋯ Furthermore, the incorporation of 3H-orotic acid into DNA and RNA of regenerating liver cells in the LCT group was higher than in the MCT group 24 hours after hepatectomy. These observations indicate that essential fatty acids--components of the cell membrane and precursors as functional mediators--are very important to hepatic regeneration.
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The effect of peripheral parenteral nutrition (PPN) on voluntary food intake was examined in healthy male subjects. Each study (lasting 17 to 19 days) was divided into three phases: Ringer's lactate (RL); PPN administered as a combination of glucose, fat, and amino acids; and finally RL. ⋯ When PPN was infused, subjects reduced their food intake within 48 hours by approximately 80% of the infused calories (p less than 0.001) within 48 hours, whereas intake was reduced by less than 40% of the infused calories when BCPPN was infused. Use of branched-chain amino acid-enriched parenteral nutrition may minimize the reduction in food intake seen during intravenous nutrition, possibly hastening a return to normal eating.
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Randomized Controlled Trial Clinical Trial
Total parenteral nutrition in the cancer patient: the present as viewed from the past.