BACKGROUND: Whether or not the rapid reduction in serum albumin concentration in acute surgical patients without evidence of pre-existing energy deficit correlates with outcome has yet to be studied. In this study, we attempted to determine whether albumin infusion or nutritional supplementation can improve outcome for patients with hypoalbuminemia. METHODS: ...

The objective of this study was to evaluate resting energy expenditure (REE) in spontaneously breathing and artificially ventilated burn patients during the entire intensive care period. In 27 patients with 51 +/- 20% body surface area burned (BSAB) the REE was determined via indirect calorimetry. Three groups were formed according ...

The authors evaluated the nutritional status of 47 continuous ambulatory peritoneal dialysis (CAPD) patients, 26 men (age 58.9 +/- 14.6 years, duration on CAPD 27.3 +/- 18.3 months) and 21 women (age 56.2 +/- 14.9 years, duration on CAPD 34.5 +/- 23.4 months), using subjective global assessment (SGA), an established ...

According to international and national surveys, 5-15% of patients admitted to hospitals require partial or total artificial nutrition. The development or progression of malnutrition influences patients' lives significantly and also increases the costs of their treatment substantially and unnecessarily. Nutrition therapy, meaning a balanced intake of food or provision of ...

In a randomized, prospective, multicenter study with an observation period of 2.5 years, the differential prophylactic efficacy of lithium versus carbamazepine was compared in 171 patients fulfilling DSM-IV criteria for bipolar disorder. Serum drug levels were 0.6+/-0.1 mmol/L for lithium and 6.1+/-1.3 microg/mL for carbamazepine. Patients were subdivided into a ...

The published reports of dietary protein and energy intake and protein and energy requirements for maintenance hemodialysis (MHD) patients and chronic peritoneal dialysis (CPD) patients are reviewed. Evidence indicates that the dietary energy intake of patients undergoing MHD or continuous ambulatory peritoneal dialysis (CAPD) is less than normal. Dietary protein ...

In patients affected by MMC both neurological and systemic dysfunctions may cause obesity and malnutrition. The aim of this study is a nutritional survey, with anthropometric assessment and dietary evaluation, of patients affected by MMC. CLINICAL MATERIALS AND METHODS: Anthropometric assessment, dietary evaluation, and a comprehensive assessment of motor impairment ...

BACKGROUND: Reticuloendothelial system function is impaired in humans receiving lipid regimens. AIMS: To evaluate the effects of long term administration of long chain triglyceride emulsions on reticuloendothelial system function. METHODS: Splenic function and tuftsin activity were measured in 20 patients on intravenous nutrition for intestinal failure, 20 patients with Crohn's ...

The nutritional status of 75 maintenance hemodialysis (MHD) patients was evaluated according to the dietary intake analysis, anthropometric measurements, biochemical and immunological parameters in this study. Furthermore, some possible factors which would affect nutritional status of hemodialysis patients were discussed. The results showed that hemodialysis patients demonstrated a high incidence ...

OBJECTIVE: Prospectively evaluate the effect on the nutritional status of a glucose polymer as energy supplementation alone in chronic hemodialysis patients with moderate and severe malnutrition. MATERIAL AND METHODS: The nutritional status of 55 hemodialysis patients was assessed by using a score that included Iron binding capacity, albumin, cholesterol, body ...

BACKGROUND: Patients with intestinal disease are at risk of developing selenium deficiency due to impaired intestinal absorption. The aim of the present study was to evaluate selenium status and to identify predictive factors of selenium depletion in patients with gastrointestinal disease. METHODS: The concentration of selenium and the activity of ...

Two patients who were receiving home parenteral nutrition complained of vague neurological symptoms of such severity that they underwent full clinical appraisal. The only positive finding was that plasma manganese concentrations were greater than twice the upper 95% confidence interval of normal (7-27|nmol/l). In the light of this result all ...

The purpose of the study was to examine the outcome of long-term lithium treatment in consecutively admitted affective disorder patients assigned to high and low serum lithium levels. A total of 91 patients were diagnosed according to DSM-III criteria and randomly allocated to two open treatment groups in which prophylactic ...

We investigated the nutritional status of a cross-sectional sample of 47 patients with motor neurone disease (MND). Anthropometric measurements (mid-arm circumference and triceps skinfold thickness) and dietary analysis were taken by a trained observer. 21% of patients were moderately to severely malnourished. Patients with bulbar onset were no more likely ...

AIM:To understand the role of nutritional status in cirrhotic patients without clinical porto-systemic encephalopathy (PSE).METHODS:Fifty-one non-alcoholic patients with cirrhosis without PSE were studied prospectively and compared with 20 healthy volunteers. The nutritional evaluation included serum prealbumin, albumin, transferrin, body mass index (BMI), mid-arm muscle circumference (MAMC), and grip power. The ...

OBJECTIVE: To study the effect of the protease inhibitor indinavir on body weight and body composition of subjects with HIV-related wasting. DESIGN: Prospective measurement of body weight in patients who had wasting and were treated with indinavir. A subgroup of 16 representative patients also underwent a metabolic study that included ...

BACKGROUND: Infections are an important cause of morbidity and mortality in patients with multiple trauma. Studies in both animals and human beings have suggested that glutamine-enriched nutrition decreases the number of infections. METHODS: Patients with multiple trauma with an expected survival of more than 48 h, and who had an ...

Thresholds for detection of both pressure and thermal pain are elevated in patients with bulimia nervosa. The present study was aimed at determining (1) if pressure pain detection thresholds (PDT) varied dynamically with the primary disease symptoms of binge eating and vomiting and (2) if the elevation in PDT was ...

OBJECTIVES: This retrospective study was conducted to determine the incidence of cholestasis and liver failure in patients with intestinal resection in the neonatal period who subsequently become dependent on parenteral nutrition support and to assess the significance of associated clinical factors--gestational age, birth weight and length; length of bowel resected; ...

BACKGROUND: The treatment of malnutrition, frequently present in elderly dialysis patients, is important to promote better quality of life and rehabilitation. The aim of this study was to assess the impact of prolonged use of intradialysis parenteral nutrition (IDPN) as a strategy for malnutrition in elderly haemodialysis patients. METHODS: Twenty-eight ...

This study examined the effects of weight loss and nutritional status on the cognitive performance of patients with anorexia nervosa. The intellectual, memory, attentional, verbal fluency and visuospatial abilities of 34 females with anorexia were compared to that of 31 normal weight-for-height females. Group differences in anxiety and depression were ...

The metabolic derangements of the injured or stressed patient are governed by multiple factors that partially include the severity of insult, preexisting illnesses, available energy reserves, and appropriateness of intervention. The normal response to injury is further characterized by the release of proinflammatory and antiinflammatory mediators that exert potent effects ...

In this study we hypothesized that there is a correlation between serum leptin levels and body mass indices within patients with anorexia nervosa or bulimia nervosa during a twelve weeks' course of in-patient treatment. We evaluated leptin levels weekly in female in-patients with anorexia (n = 17) or bulimia nervosa ...

Lithium administration was used in a patient with a clozapine-induced neutropenia and in another with complete agranulocytosis to assess whether lithium could stimulate neutrophil production. In both cases, following lithium administration, the neutrophil count was increased to the normal range within 6 days. In the patient who had presented a ...

OBJECTIVE: Few studies have investigated perceptions of operant conditioning programs by anorexic patients. This study examined patients' perceptions of the Bed Rest (BR) component which is employed in some operant conditioning programs. METHODS: A sample of 48 anorexic inpatients was administered a survey to elicit their attitudes towards BR. RESULTS: ...

Malnutrition is common and often undiagnosed in affected patients, especially those in the hospital, and is associated with impaired organ function, increased morbidity, and prolongation of hospital stay. It should be recognized and treated appropriately, because artificial nutritional support in malnourished patients leads to improvement in nutritional status and clinical ...

BACKGROUND: The purpose of this study was to determine whether nutritional state was related to infectious complications in adult patients with acute leukemia. METHODS: During first-remission induction therapy (mean, 71 days), the duration of neutropenia, various infections, and fevers were related to changes in body weight and serum albumin concentrations ...

No systematic studies have been carried out on the association of nutritional status with the severity of mucosal villous atrophy in newly diagnosed celiac disease patients. We examined the nutritional status of 40 adult patients with newly diagnosed celiac disease classified according to the grade of villous atrophy: partial, subtotal, ...

Lithium kinetics were studied in four manic-depressive women treated with calcitonin for post-menopausal osteoporosis. During calcitonin therapy all patients showed a significant decrease of lithium blood levels, and an increase in lithium renal clearance was observed in two out of two patients. According to these data, lithium therapy needs to ...

Because lithium is difficult to use, divalproex may be an effective alternative for elderly manic patients. In this study, the authors retrospectively assessed outcome of 21 patients, age 60 to 82 years, hospitalized for a manic episode and treated with divalproex. The mean final divalproex dose was 1,405 mg/day, and ...

Early enteral nutrition improves the outcome of severely injured patients. To provide enteral nutrition, various methods are available. In a restrospective study we analysed the outcome of 24 severely traumatized patients (mean ISS = 44), in whom a percutaneous endoscopic gastrostomy (PEG) was used for enteral nutrition. All patients had ...

OBJECTIVE: In this prospective study, information was collected on all bipolar I patients who started lithium prophylaxis at a lithium clinic during more than 15 years. METHOD: Patients were evaluated bimonthly with standardized instruments for as long as they took lithium. Treatment surveillance conformed to internationally accepted guidelines. Five years ...

BACKGROUND: Hypophosphatemia is common in acutely ill patients and possibly may occur in the acute-phase response syndrome (APR), secondary to hyperglycemia and shifts of extracellular phosphorus into cells. AIM: To compare the frequency of hypophosphatemia in patients with or without APR. METHODS: All plasma phosphorus results (n = 822) corresponding ...

The efficacy of lithium carbonate in the first reported case of a female with mild mental disability who engaged in public and compulsive masturbation is described. The patient was born in 1975, and was 19 years old at first admission. A diagnosis of schizophrenia was initially suspected, therefore the patient ...

In this study the use of home parenteral and enteral nutrition (HPEN) therapy in geriatric patients and the effect of aging on the clinical outcome of HPEN therapy was assessed between 1985 and 1992. Data were obtained from Medicare (part B) parenteral and enteral nutrition workload statistics, Blue Cross and ...

The effect of nutrition therapies on wound healing is discussed. The article assumes that, in addition to biologic therapies, psychosocial factors influence wound healing. Psychosocial factors include the patient's personality, ways of coping, and family and cultural make-up. Clinicians should consider the patient's psychosocial history when planning and implementing biologic ...

We measured the level of resting energy expenditure (BEE) and its evolution in patients with multiple organ failure (MOF). We studied 30 patients requiring mechanical ventilation and sedation. REE was measured by means of a closed circuit method on days 1-5, 7, 10 and 14 after initiating the protocol. REE ...

The prevalence of malnutrition and its predictive value for the incidence of complications were determined in 155 patients hospitalized for internal or gastrointestinal diseases. At admission, 45% of the patients were malnourished according to the Subjective Global Assessment (physical examination plus questionnaire), 57% according to the Nutritional Risk Index [(1.5 ...

OBJECTIVE: To compare the results of cardiac output measurements obtained by lithium dilution and thermodilution. DESIGN: Case series, observational study. SETTING: High-dependency postoperative unit and intensive care unit of a teaching hospital. PATIENTS: Forty patients were studied. Thirty-four patients had undergoing heart surgery requiring cardiopulmonary bypass within the previous 2 ...

OBJECTIVE: To examine the rates of exclusion and inclusion in various research studies for a series of 51 treatment-seeking patients. METHOD: The inclusion and exclusion criteria employed in a sample of 41 studies were applied to a series of 51 treatment-seeking bulimia nervosa patients. RESULTS: Of the sample of 51, ...

The article briefly analyzes the concept of a person, arguing that personhood does not coincide with the actual enjoyment of certain intellectual capacities, but is coextensive with the embodiment of a human individual. Since in PVS patients we can observe a human individual functioning as a whole, we must conclude ...

1. Brain phosphorus metabolism was examined using phosphorus-31 magnetic resonance spectroscopy in 4 patients with anorexia nervosa. 2. In 4 patients examined before treatment, phosphodiester (PDE) peak area was significantly higher than that in 13 normal females. 3. In 6 data points in 4 patients, lower levels of PME were ...

Twenty-two patients affected by bipolar or schizoaffective disorder, in whom carbamazepine was added to lithium after recurrence when on maintenance with lithium alone, were followed up prospectively for 2 to 13 years. The number of episodes, hospitalizations, and cumulative affective morbidity was markedly reduced after carbamazepine augmentation. Seventeen patients presented ...

Hepatoblastoma, a malignant hepatic tumor in children, is thought to be an embryonal tumor resulting from developmental disturbances during organogenesis. Although factors that might be involved in the tumorigenesis have been suggested, an association between hepatoblastoma and the patient's birth weight has not been reported. We have accessed the data ...

We examined the hypothesis that weight loss in heart failure patients is associated with elevated daily energy expenditure. Twelve cachectic patients [age = 73 +/- 6 yr; weight loss = 15 +/- 6 kg; body mass index (BMI) = 21 +/- 5 kg/m2], 13 noncachectic patients (age = 67 +/- ...

Most of the traditional parameters for nutrition assessment have important limitations in patients with chronic liver disease. Insulin-like growth factor 1 (IGF-1) has been found to be regulated by nutrition and proposed as a nutritional marker. Its nutritional significance in patients with liver cirrhosis, however, has not been investigated. Serum ...

The beta 2-Mg (beta 2-microglobulin) and GAG (glycosaminogyclan) excretions in 107 patients with bipolar disorder who had been on lithium treatment for 1-15 years were compared with 29 matched psychiatric control patients. 24-h urine volume, urine beta 2-Mg, GAG values were significantly higher, and maximal urinary osmolality was significantly lower ...

BACKGROUND: Patients with anorexia nervosa (AN) run a high risk of becoming chronically ill and of dying. In the acute phase of their illness they present with numerous physical and laboratory abnormalities. However, little is known about the long-term prognostic value of these findings or about the medical morbidity in ...

We report on a patient who developed severe lithium-induced nephrogenic diabetes insipidus (NDI) and neurotoxicity, despite recommended serum lithium levels. Hydrochlorothiazide and indomethacin appeared effective antipolyuric drugs, which led to a normalization of serum osmolality. After re-initiating lithium therapy, with lithium levels around 0.3 mmol/l, recurrence of NDI or neurotoxicity ...

We report two new cases of hyperparathyroidism during lithium therapy. The patients were a 50-year-old male and a 48-year-old female under lithium for bipolar disease. Both developed osteoporosis without fractures and laboratory test abnormalities consistent with moderate hyperparathyroidism. Although only 30 or so cases of lithium-associated hyperparathyroidism have been reported, ...