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Three oral absorption tests have been used in patients with short bowel syndrome (SBS) to evaluate the absorption site of each substrate. In this study, three absorption tests were applied: the oral pancreatic function test using N-benzoyl-l-tyrosyl-p-aminobenzoic acid (NBT-PABA), the d-xylose tolerance test, and the oral fat tolerance test. Examinations were performed in eight patients with either...
Parenteral nutrition-associated metabolic bone disease in children is manifested primarily as osteopenia and, on occasion, fractures. The etiology is likely multifactorial, with calcium and phosphate deficiency playing a major role in the preterm infant and with the role of aluminum toxicity yet to be clearly defined in this population. Lack of normal values of bone histomorphometry in the premature...
As with energy requirements, protein requirements are relatively much greater in infants and decline progressively with age. Amino acid metabolism in pediatric patients is characterized by the following differences. The requirement for essential amino acids in neonates is larger than that in adults. Because of low activity of phenylalanine hydroxylase and cystathionase, hyperphenylalaninemia and hypermethioninemia...
Atherosclerosis in Vervet or African Green monkeys (Cercopithecus aethiops) models the morphology and cytology of the disease of humans, and it is well established that the rate of atherogenesis in Vervets is influenced by diet. Aortic intimal concentrations of lipids and phospholipids known to be major components of atheromas were determined in female Vervets fed for 4 years on either an atherogenic...
The origins of cardiovascular disease are related to genetic factors, postnatal environmental and behavioral influences, and also the environment experienced in utero. Patterns of disproportionate fetal growth consistent with maternal undernutrition appear to be predictive of later hypertension and coronary heart disease. These findings from epidemiologic studies are strongly supported by animal studies...
Central venous access for the purpose of supplying parenteral nutrition to the pediatric age group requires a careful definition of the patient’s caloric need, estimated duration of therapy, and an assessment of available sites. Peripheral vein parenteral nutrition is limited by caloric density of the nutrient fluids, while peripherally inserted central catheters (PICC) offers a new technology for...
In vivo studies of protein turnover in the fasted to fed transition have shown conflicting results. In the present study, protein turnover was investigated in primary cultures of rat hepatocytes, perfused for 48 h under conditions simulating portal vein concentrations of amino acids and hormones in the fasted or fed state. The rate of protein degradation was about 40% lower under fed than under fasted...
Nutritional status affects every pediatric patient’s response to illness. Good nutrition is important for achieving normal growth and development. Nutritional assessment therefore should be an integral part of the care for every pediatric patient. Routine screening measures for abnormalities of growth should be performed on all pediatric patients. Those patients with chronic illness and those at risk...
Total parenteral nutrition (TPN)-induced liver disease develops in 40–60% of infants who require long-term TPN for intestinal failure. The clinical spectrum includes cholestasis, cholelithiasis, hepatic fibrosis with progression to biliary cirrhosis, and the development of portal hypertension and liver failure in a significant number of children who are totally parenterally fed. The pathogenesis is...
To compare the effectiveness of four dietary preparations for stabilizing resting and exercise measurements, seven male recreational exercisers (27 ± 4 y) participated in four dietary preparations, each repeated in successive weeks: (1) 24-h random diet including an overnight fast (RAN); (2) 24-h random diet, including fast, followed by a standard meal 3 h before testing (RANM); (3) 24-h prescribed...
Long-term parenteral nutrition of infants who have had major gut resections is associated with a high incidence of cholestatic liver disease. Affected infants have high plasma concentrations of phytosterols—compounds that resemble cholesterol but have an alkylated side chain. The phytosterols that accumulate in patients receiving parenteral nutrition are derived from the soya oil and/or soya lecithin...
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