Does glutamine-enriched parenteral nutrition really affect intestinal morphology and gut permeability?

Background: Nutritional depletion has been related to low glutamine levels in plasma and gut mucosa. This study was set up to investigate the effects of glutamine-enriched total parenteral nutrition on intestinal morphology and permeability.

Methods: Twenty-three depleted patients were randomized and after stabilization baseline measurements were performed.

Assessment of whole body protein metabolism in critically ill children: can we use the [15N]glycine single oral dose method?

Background & Aims: Most stable-isotope methods to evaluate whole body protein metabolism in patients are invasive and difficult to use in children. In this study protein metabolism was evaluated with the non-invasive [15N]glycine single oral dose method in critically ill children and the value of the method is discussed.

Methods: [15N]glycine (100mg) was given orally to children (mean age 5.

Bioelectrical impedance measurements in patients with gastrointestinal disease: validation of the spectrum approach and a comparison of different methods for screening for nutritional depletion.

Background: Bioelectrical impedance spectroscopy (BIS) may be of value in identifying patients with nutritional depletion.

Objective: The primary aim of the study was to assess the validity of BIS in patients with gastrointestinal disease. The secondary aim was to compare different screening methods for identifying nutritionally depleted patients.

Lipid, nitrogen, water and energy content of a single stool sample in healthy children and children with cystic fibrosis.

Unlabelled: To evaluate the usefulness of "single stool sample" analysis in the investigation of steatorrhoea instead of 72-h stool collection, we examined 57 stool samples of patients with cystic fibrosis (CF) while on pancreatic enzyme therapy and 29 stool samples of healthy children. We compared results of fat, nitrogen, water and energy content. Fat was determined by the method of Van de Kamer et al.

Influence of fluid status on techniques used to assess body composition in peritoneal dialysis patients.

Objective: A reliable assessment of nutritional state in peritoneal dialysis (PD) patients is of great importance. Nevertheless, techniques used to assess body composition in patients on PD may be affected by abnormalities in fluid status. The primary aim of the present study was to compare different techniques used to evaluate body composition and to assess the influence of fluid status on the assessment of body composition.

Assessment of fluid status in peritoneal dialysis patients.

Objectives: To assess the influence of abnormalities in fluid status and body composition on agreement between multifrequency bioimpedance analysis (MF-BIA), segmental BIA (sigmaBIA), the Watson formula, and tracer dilution techniques.

Design: Cross-sectional.

Setting: Multicenter.

Functional relationship of alpha-glutathione S-transferase and glutathione S-transferase activity in machine-preserved non-heart-beating donor kidneys.

alpha-Glutathione S-transferase (alpha-GST) is a biochemical parameter used to estimate the amount of proximal tubule damage to a kidney. In normal clinical practice, the concentration of alpha-GST in urine is determined by a rather time-consuming immunochemical test, the enzyme-linked immunosorbent assay (ELISA). Kidneys from non-heart-beating (NHB) donors are perfused prior to transplantation.

Fluid status, blood pressure, and cardiovascular abnormalities in patients on peritoneal dialysis.

Objective: Hypertension, reduced arterial distensibility, and left ventricular hypertrophy (LVH) are risk factors for mortality in hemodialysis patients. However, few studies have focused on the relation between fluid status, blood pressure (BP), and cardiovascular abnormalities in peritoneal dialysis (PD) patients. This study was designed, first, to assess, using tracer dilution techniques, fluid status in PD patients compared to a control population of stable renal transplant (RTx) patients; second, to study the relation between fluid status, BP, and arterial wall abnormalities; third, to assess the determinants of cardiac structure; and last, to compare office and ambulatory BP measurements with respect to cardiac abnormalities.

Bio-electrical impedance spectroscopy: alternatives for the conventional hand-to-foot measurements.

Background And Aims: Bio-impedance spectroscopy (BIS) is a very attractive method for measuring body composition. The standard method measures impedance from hand to foot. However, in patients a hand or foot is not always accessible.

Comparison of near infrared reflectance analysis of fecal fat, nitrogen and water with conventional methods, and fecal energy content.

Objectives: To evaluate Near-Infrared Analysis (NIRA) method for determining fecal fat, water and nitrogen.

Design And Methods: The results of fecal fat, water and nitrogen by NIRA were compared with results of van de Kamer and Acid Steatocrit (AS), Dumas and vacuum drying methods for fat, nitrogen and water respectively. Results of fat determining methods were also compared with total fecal energy as obtained by bomb calorimeter.

Accuracy of bioelectrical impedance spectroscopy in measuring changes in body composition during severe weight loss.

Background: Bioelectrical impedance spectroscopy (BIS) is an attractive method for measuring body composition because it is noninvasive, simple, and cheap. The effect of obesity on the accuracy of impedance measurements has been recognized for some time, but no conclusive explanations or ways to correct the measurement errors have been published. We studied the effect of the composition of weight loss on the accuracy of BIS to measure changes in body fluid volumes during severe weight loss.

Multi-frequency bioimpedance measurements of children in intensive care.

Bioimpedance spectroscopy is used to monitor the condition of the tissues of children staying in intensive care for the treatment of meningitis. The results are significant, with the angular frequency at maximum reactance lying between 1500 and 6400 x 10(3) rads(-1), whereas in a control group, this value does not exceed 900 x 10(3) rads(-1). The ratio between the specific conductance at zero and that at infinite frequency (this ratio is proportional to total body volume/volume of extracellular space) remains constant at 1.

Effects of therapy with lansoprazole on intestinal permeability and inflammation in young cystic fibrosis patients.

Background: Defective pancreatic bicarbonate secretion with low intestinal pH or intestinal inflammation of any origin increase intestinal permeability in cystic fibrosis (CF).

Methods: In this open study, the authors evaluated the effect of a proton-pump inhibitor on intestinal permeability and inflammation in 14 young, pancreatic-insufficient CF patients. Permeability was measured by a three-sugar permeability test before and after 1 year of lansoprazole use, and urinary nitric oxide (NO) oxidation products were assessed before and during that year as a marker of inflammation.

Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations.

Background: Body composition evaluation by bioelectrical impedance analysis in children makes use of different group-specific population-derived equations. The present study was conducted to attempt to validate the use of population-independent physical model-derived equations in children.

Methods: The validity of bioelectrical impedance analysis for the measurement of total body water in children was evaluated by comparing results of two physical model-derived and two population-derived equations with those of deuterium dilution as reference method in a group of 38 heterogeneous children.

The value of dextran 12,000 in ischemically damaged canine kidneys during machine perfusion.

The use of non-heartbeating (NHB) donor kidneys has led to the search for new methods of viability-testing. We investigated, in a canine model, the relationship between the filtration of dextran 12, 000 into urine and a certain period of warm ischemic time (WIT) during machine perfusion. Twenty-four canine kidneys were divided into three groups, sustaining 0 min, 30 min or 60 min of WIT.

Glutamine: the pivot of our nitrogen economy?

Glutamine serves as a shuttle of useful nontoxic nitrogen, supplying nitrogen from glutamine-producing (eg, muscle) to glutamine-consuming tissues. True production rates of glutamine are difficult to measure, but probably are less than 60 to 100 g/d for a 70-kg man. During catabolic stress increased amounts of glutamine are released from muscle, consisting of protein derived glutamine, newly synthesized glutamine, and glutamine losses from the intramuscular free pool.

Body composition in renal transplant patients: bioimpedance analysis compared to isotope dilution, dual energy X-ray absorptiometry, and anthropometry.

Whether multifrequency bioelectrical impedance analysis (MF-BIA), a relatively new method for measuring body composition, is also applicable for accurate body composition measurements in renal transplant (RTx) patients is not known. Therefore, the use of MF-BIA is validated in 77 RTx patients with a stable renal function at least 2 yr posttransplantation. MF-BIA is compared to isotope dilution techniques for measurement of body water compartments, and to dual energy x-ray absorptiometry (DEXA) and anthropometry for measurement of fat and fat free mass.

Determination of total body water by multifrequency bio-electric impedance: development of several models.

Multifrequency bio-electronic impedance analysis (MF BIA) measurements are taken from a heterogeneous group of patients, varying in size between obese and slim. The measuring system uses four electrodes: two current and two potential electrodes. Three new models are developed to calculate total body water (TBW) from the BIA data, and the resulting TBW values are compared with TBW determined by D2O dilution.

Absence of glutamine isotopic steady state: implications for the assessment of whole-body glutamine production rate.

1. During infusion of [5-15N]glutamine in patients with gastrointestinal cancer we unexpectedly observed a gradual decrease in time of the appearance rate (Ra) of glutamine in plasma. Here we investigate whether the failure to achieve a plateau isotopic enrichment in plasma is, among other factors, due to incomplete equilibration of the glutamine tracer with the large intramuscular free glutamine pool.

A new method for plasma volume measurements with unlabeled dextran-70 instead of 125I-labeled albumin as an indicator.

A method has been developed to determine plasma volume with dextran-70 without the use of a fluorescent label. The results obtained are compared to those found using the 125I-labeled albumin method, which is taken as the gold standard. The CV of the method is about 5%, compared to 3% with the gold standard.

Mechanism of volume adaptation in the awake early pregnant rat.

The objective of the present study was to determine whether the increase in plasma volume (PV) during pregnancy is established by fluid retention or by a shift within the extracellular fluid volume (ECFV) from the interstitium toward the intravascular compartment. To this end, we simultaneously, measured total body water, (TBW), ECFV, and PV together with the hematocrit (Hct) and plasma osmolality 4, 8, and 12 days postsurgery in chronically instrumented pregnant (P) and nonpregnant (NP) rats. The P rats were instrumented with a catheter in the femoral artery on day 1 postconception.

Gut permeability, intestinal morphology, and nutritional depletion.

Nutritional depletion increases the risk for postoperative complications. The intestinal barrier may be important in the underlying pathophysiologic mechanism. In this study, 26 patients were evaluated to determine whether nutritional depletion was related to gut integrity and intestinal morphology.

Glutathione S-transferase as predictor of functional outcome in transplantation of machine-preserved non-heart-beating donor kidneys.

Non-heart-beating (NHB) donors are a valuable source of kidneys for transplantation. The organs, however, sustain substantial warm ischemic damage that may jeopardize the transplantability and result in nonfunction of the grafts. Quantification of warm ischemic time (WIT) and prediction of transplant outcome are essential for the use of NHB donor organs.