I review here some key developments of personal and professional interest, with special reference to total parenteral nutrition (TPN), an area in which I have been involved from 1937 until recently. As a result of basic and biomedical science advances achieved in university and industrial laboratories in numerous countries, many essential nutrients were identified, synthesized, produced, and provided to patients in safe and effective forms both enterally and parenterally. This period also saw important developments in analytic instrumentation. I have had the privilege of seeing major advances in nutrition during my lifetime, and it is my belief and my hope for the future that with the advent of bowel transplants and tissue growth from cells, TPN will be a temporary measure rather than a lifetime regimen.
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http://dx.doi.org/10.1146/annurev-nutr-072709-082241 | DOI Listing |
BMJ Nutr Prev Health
December 2024
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Background: Health policies promote optimal care, yet policies that address disease-related malnutrition (DRM) are lacking. The purpose of this study was to conduct a scoping review to identify literature on existing and planned policy to address DRM in children or adults and explore the settings, contexts and actors of DRM policy.
Methods: A search strategy comprising DRM and policy keywords was applied to eight databases on 24 February 2023.
Pediatr Nephrol
January 2025
Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, China.
This case report presents a newborn with pyruvate dehydrogenase complex deficiency who developed significant lactic acidosis and acute kidney injury after birth. Peritoneal dialysis with glucose-based peritoneal dialysis fluid was initially started, but the patient had worsening hyperglycemia and lactic acidosis, likely related to excess glucose reabsorption with shunting to lactate due to the underlying metabolic disorder. As amino acid-based dialysis solution was not available in our formulary, a dialysis fluid was manually created with Vaminolact, which was commonly used in neonatal parenteral nutrition.
View Article and Find Full Text PDFCrit Care
January 2025
Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000, Leuven, Belgium.
Background: As compared to withholding parenteral nutrition (PN) until one week after intensive care unit (ICU) admission, Early PN prolonged ICU dependency in the EPaNIC randomized controlled trial (RCT). The Refeeding RCT showed improved outcome by temporary macronutrient restriction in ICU patients developing refeeding hypophosphatemia, defined as a phosphate decrease of > 0.16 mmol/L to levels < 0.
View Article and Find Full Text PDFPediatr Nephrol
January 2025
Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 6500047, Japan.
Wernicke's encephalopathy (WE) is a severe neurological condition caused by the deficiency of thiamine, which is a vitamin B1 molecule. Herein, we present the case of a 3-year-old girl with steroid-resistant nephrotic syndrome (SRNS) who did not achieve remission despite steroid pulse therapy (MPT) and rituximab. She had frequent vomiting and decreased oral intake on the 61st day.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Nishtar Medical University, Multan, PAK.
Progressive familial intrahepatic cholestasis type 2 (PFIC2) is a rare genetic disorder characterized by severe intrahepatic cholestasis, which often manifests in infancy with progressive liver dysfunction. We present the case of a 3-month-old infant with a one-month history of jaundice, vomiting, and bloody stools, presenting a unique set of diagnostic challenges. Initial clinical and laboratory findings indicated significant liver dysfunction, prompting further imaging and genetic analysis.
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