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Biomedical subjects

F Ruiz

Publications and source records attributed to F Ruiz.

At least 37 records · Page 2Linked to original sources
PubMed2001

Phlebotomine sandflies and leishmaniasis risks in Colombian coffee plantations under two systems of cultivation.

The phlebotomine sandfly fauna of traditional (shaded) and intensified (unshaded) coffee plantations in Colombia was sampled by a variety of methods and the species composition and density under the two systems compared. Twenty species of Lutzomyia sandflies (Diptera: Psychodidae: Phlebotominae) were collected, of which eight were found only in the 'Coffee Axis' ('Eje Cafetero') of the departments of Caldas, Risaralda and Quindio, six were exclusive to the department of Norte de Santander and six occurred in both regions. Four species were collected only in traditional plantations and two exclusively in intensified ones. At least 13 species occurred in both plantation types. Fifteen species are opportunistic man-biters and eight are suspected vectors of leishmaniasis caused by Le. braziliensis, Le. panamensis or Le. mexicana. Seven species were collected inside houses and may be involved in intradomiciliary transmission of Leishmania. The dominant species in Norte de Santander was Lu. spinicrassa, which made up 93.8% of all the sandflies collected in this department. This species was absent from the Eje Cafetero and a number of others among the 15 recorded there might be responsible for Leishmania transmission in this region, including Lu. trapidoi, Lu. yuilli, Lu. gomezi, L. hartmanni and Lu. ovallesi. Sandfly population densities were significantly higher in traditional plantations than in intensified ones. Residents of traditional plantations were able to describe sandflies in significantly more detail than those of intensified plantations, based on seven basic characteristics related to the appearance and biting behaviour of the insects.

Adolescent↗
PubMed2001

Macrophage 3-hydroxy-3-methylglutaryl coenzyme a reductase activity in sitosterolemia: effects of increased cellular cholesterol and sitosterol concentrations.

Sitosterolemia is a rare, recessively inherited disease characterized clinically by accelerated atherosclerosis and xanthomas and biochemically by hyperabsorption and retention of sitosterol and other plant sterols in tissues. Decreased cholesterol biosynthesis and inhibition of 3-hydroxy-3-methylgluratyl coenzyme A (HMG-CoA) reductase and other enzymes in the biosynthetic pathway have been associated with enhanced low-density lipoprotein (LDL) receptor function. We examined the effects of cholesterol and sitosterol on sterol concentrations and composition and HMG-CoA reductase activity in monocyte-derived macrophages (MDM) from 12 control and 3 homozygous sitosterolemic subjects. The cells were cultured up to 7 days in media devoid of plant sterols, but containing increasing amounts of serum cholesterol. Before culture, MDM from the homozygous sitosterolemic subjects contained 22% more total sterols than cells from control subjects. Plant sterols and stanols represented 15.6% of MDM total sterols in sitosterolemic cells, but only 3.8% in control cells. After 7 days of culture in 10% delipidated serum (DLS) (20 microg/mL cholesterol, no sitosterol), all plant sterols were eliminated so that cells from both phenotypes contained only cholesterol. When DLS was replaced with fetal bovine serum (FBS) (300 micromL cholesterol), with and without addition of 200 microg/mL LDL, cholesterol levels in MDM from sitosterolemic subjects increased 108% (P <.05) compared with a 65% increase (P <.04) in control MDM cultured similarly. MDM HMG-CoA reductase activity from the 3 sitosterolemic subjects, which was significantly lower than controls at baseline (24 +/- 3 v 60 +/- 10 pmol/mg/min, P <.05), was not downregulated by increased cellular cholesterol levels, as observed in control cells. Control MDM were also cultured in medium that contained 10% DLS and was supplemented with 100 microg/mL cholesterol or sitosterol dissolved in ethanol or the ethanol vehicle alone. In contrast to cellular cholesterol accumulation, which significantly downregulated HMG-CoA reductase activity (-53%, P <.05), the increase in cellular sitosterol up to 25.1% of total sterols did not change MDM HMG-CoA reductase activity. Evidence of a normal HMG-CoA reductase protein in sitosterolemic cells, which was not derepressed upon removal of cellular sitosterol, and the failure of cellular sitosterol to inhibit normal HMG-CoA reductase activity argue against feedback inhibition by sitosterol as a mechanism for low reductase activity in this disease. The larger accumulation of sterols and inadequate downregulation of HMG-CoA reductase in MDM may be mechanisms for foam cell formation and explain, in part, the increased risk of atherosclerosis in sitosterolemia.

Adult↗
PubMed2001

Basal body-associated nucleation center for the centrin-based cortical cytoskeletal network in Paramecium.

The infraciliary lattice, a contractile cortical cytoskeletal network of Paramecium, is composed of a small number of polypeptides including centrins. Its overall pattern reflects a hierarchy of structural complexity, from assembly and bundling of microfilaments to formation of polygonal meshes arranged in a continuous network subtending the whole cell surface, with local differentiations in the shape and size of the meshes. To analyse how the geometry of this complex network is generated and maintained, we have taken two approaches. Firstly, using monoclonal antibodies raised against the purified network, we have shown that all the component polypeptides colocalize, in agreement with previous biochemical data indicating that the infraciliary lattice is formed of large complexes comprising all the component polypeptides. Secondly, by taking advantage of different experimental conditions leading to disassembly of the network, we have followed its reassembly. Cytological analysis of the process revealed 1) that the network regrows exclusively from specific infraciliary lattice organizing centers (ICLOC), precisely localized near each basal body and, 2) that the global organization is not precisely controlled by genetic information but by the basal body pattern. Finally, slight ultrastuctural differences between reassembled and control lattices suggest that the organization of the filament bundles is partly templated by that of the preexisting ones.

Animals↗
PubMed2001

Physical factors affecting the production of carbon monoxide from anesthetic breakdown.

BACKGROUND: Parameters determining carbon monoxide (CO) concentrations produced by anesthetic breakdown have not been adequately studied in clinical situations. The authors hypothesized that these data will identify modifiable risk factors. METHODS: Carbon monoxide concentrations were measured when partially desiccated barium hydroxide lime was reacted with isoflurane (1.5%) and desflurane (7.5%) in a Draeger Narkomed 2 anesthesia machine with a latex breathing bag substituting for a patient. Additional experiments determined the effects of carbon dioxide (0 or 350 ml/min), fresh gas flow rates (1 or 4 l/min), minute ventilation (6 or 18 l/min), or absorbent quantity (1 or 2 canisters). End-tidal anesthetic concentrations were adjusted according to a monochromatic infrared monitor. RESULTS: Desflurane produced approximately 20 times more CO than isoflurane when completely dried absorbents were used. Peak CO concentrations approached 100,000 ppm with desflurane. Traces of water remaining after a 66-h drying time (one weekend) markedly reduced the generation of CO compared with 2 weeks of drying. Reducing the quantity of desiccated absorbent by 50% reduced the total CO production by 40% in the first hour. Increasing the fresh gas flow rate from 1 to 4 l/min increased CO production by 67% in the first hour but simultaneously decreased average inspiratory concentrations by 53%. Carbon dioxide decreased CO production by 12% in completely desiccated absorbents. CONCLUSION: Anesthetic identity, fresh gas flow rates, absorbent quantity, and water content are the most important factors determining patient exposures. Minute ventilation and carbon dioxide production by the patient are relatively unimportant.

Absorption↗
PubMed2001

Mathematical modeling of carbon monoxide exposures from anesthetic breakdown: effect of subject size, hematocrit, fraction of inspired oxygen, and quantity of carbon monoxide.

BACKGROUND: Carbon monoxide (CO) is produced by reaction of isoflurane, enflurane, and desflurane in desiccated carbon dioxide absorbents. The inspiratory CO concentration depends on the dryness and identity of the absorbent and anesthetic. The adaptation of existing mathematical models to a rebreathing circuit allows identification of patient factors that predispose to more severe exposures, as identified by carboxyhemoglobin concentration. METHODS: From our companion study, the authors used quantitative in vitro CO production data for 60 min at 7.5% desflurane or 1.5% isoflurane at 1 l/min fresh gas flow. The carboxyhemoglobin concentration was calculated by iteratively solving the Coburn Forster Kane equation modified for a rebreathing system that incorporates the removal of CO by patient absorption. Demonstrating good fit of predicted carboxyhemoglobin concentrations to published data from animal and human exposures validated the model. Carboxyhemoglobin concentrations were predicted for exposures of various severity, patients of different sizes, hematocrit, and fraction of inspired oxygen. RESULTS: The calculated carboxyhemoglobin concentrations closely predicted the experimental results of other investigators, thereby validating the model. These equations indicate the severity of CO poisoning is inversely related to the hemoglobin quantity of a subject. Fraction of inspired oxygen had the greatest effect in patients of small size with low hematocrit values, where equilibrium and not the rate of uptake determined carboxyhemoglobin concentrations. CONCLUSION: This model predicts that patients with low hemoglobin quantities will have more severe CO exposures based on the attainment of a higher carboxyhemoglobin concentration. This includes patients of small size (pediatric population) and patients with anemia.

Anesthetics, Inhalation↗
PubMed2001

Evidence that systemic gentamicin suppresses premature stop mutations in patients with cystic fibrosis.

Here we report the effects of gentamicin treatment on cystic fibrosis transmembrane regulator (CFTR) production and function in CF airway cells and patients with CF with premature stop mutations. Using immunocytochemical and functional [6-methoxy-N- (3-sulfopropyl) quinolinium (SPQ)-based] techniques, ex vivo exposure of airway cells from stop mutation CF patients led to the identification of surface-localized CFTR in a dose-dependent fashion. Next, five patients with CF with stop mutations and five CF control subjects were treated with parenteral gentamicin for 1 wk, and underwent repeated in vivo measures of CFTR function (nasal potential difference [PD] measurements and sweat chloride [Cl(-)] testing). During the treatment period, the number of nasal PD readings in the direction of Cl(-) secretion was increased approximately 3-fold in the stop mutation patient group compared with controls (p < 0.001), and four of five stop mutation patients with CF had at least one reading during gentamicin treatment with a Cl(-) secretory response of more than -5 mV (hyperpolarized). A response of this magnitude was not seen in any of the CF control subjects (p < 0.05). In an independent series of experiments designed to test the ability of repeat nasal PDs to detect wild-type CFTR function, evidence of Cl(-) secretion was seen in 88% of control (non-CF) nasal PDs, and 71% were more than -5 mV hyperpolarized. Together, these results suggest that gentamicin treatment can suppress premature stop mutations in airway cells from patients with CF, and produce small increases in CFTR Cl(-) conductance (as measured by the nasal PD) in vivo.

Adolescent↗
PubMed2001

Mechanisms for cholesterol homeostasis in rat jejunal mucosa: effects of cholesterol, sitosterol, and lovastatin.

The effects of feeding cholesterol, sitosterol, and lovastatin on cholesterol absorption, biosynthesis, esterification, and LDL receptor function were examined in the rat jejunal mucosa. Cholesterol absorption was measured by the dual-isotope plasma ratio method; the rate-limiting enzyme of cholesterol biosynthesis, 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, was measured as total and expressed enzyme activities (in the absence and presence of a phosphatase inhibitor, NaF, respectively); mucosal total and esterified cholesterol concentrations were determined by gas-liquid chromatography; LDL receptor function was assayed as receptor-mediated binding of (125)I-labeled LDL to mucosal membranes. Feeding 2% sitosterol or 0.04% lovastatin for 1 week significantly (P < 0.01) decreased the amounts of cholesterol absorbed per day (-85% and -63%, respectively). In contrast, feeding 2% cholesterol for 1 week increased the amounts of absorbed cholesterol 27-fold, even though the percent absorption significantly decreased. With all three treatments, there was a coordinate regulation of total HMG-CoA reductase activity and receptor-mediated LDL binding. Cholesterol feeding downregulated both total jejunal HMG-CoA reductase activity (P < 0.05) and receptor-mediated LDL binding (P < 0.01), whereas lovastatin- and sitosterol-supplemented diets significantly upregulated both of these parameters. In the control, cholesterol-fed, and sitosterol-fed animals, about half of the total jejunal HMG-CoA reductase activity was expressed (in functional dephosphorylated form). However, in the lovastatin-treated rats with 4-fold stimulation of HMG-CoA reductase, only 23% of the total enzyme activity was expressed. Changes in total HMG-CoA reductase activity and receptor-mediated LDL binding in all tested groups occurred with no change in total concentrations of mucosal cholesterol, and only cholesterol-fed animals had increased mucosal esterified cholesterol concentrations. Thus, in response to various fluxes of dietary or newly formed cholesterol, HMG-CoA reductase and receptor-mediated LDL binding are coordinately regulated to maintain constant cellular cholesterol concentrations in the jejunum.

Animals↗
PubMed2001

Ethnicity influences morphine pharmacokinetics and pharmacodynamics.

OBJECTIVE: Our objective was to evaluate ethnic differences in response to morphine and to determine whether any detectable differences were pharmacokinetically based. METHODS: This cohort study was carried out in a teaching hospital. Sixty-six young, healthy male subjects from 3 ethnic groups (Caucasians, native Indians, and Latinos; n = 22 in each group) consented to participate. All subjects received an intravenous morphine bolus of 0.08 mg/kg followed by 0.002 mg/kg. min infused for 30 minutes. Respiratory response was evaluated with the carbon dioxide rebreathing method before and at 25, 95, 180, and 360 minutes after morphine administration. Vital signs and opioid side effects were recorded, and serial blood samples were analyzed for morphine, morphine-3-glucuronide, and morphine-6-glucuronide (M6G). RESULTS: All 3 groups had suppression of the ventilatory response to hypercapnia, but the degree of blunting of the ventilatory response differed among groups. Compared with Caucasians, native Indians had an additional 18% reduction in ventilatory response after morphine administration (95% confidence interval, -35% to -2%). The incidence of side effects was similar in all groups (P =.18). Caucasians had higher plasma levels of M6G than did native Indians or Latinos. M6G areas under 6-hour concentration-versus-time curve were as follows: Caucasians, 12,065 +/- 4354; native Indians, 8464 +/- 4809; and Latinos, 9156 +/- 3764 ng. min/mL (P =.03). CONCLUSIONS: Ethnicity influences the response to morphine. Native Indians are more susceptible to morphine depression of the ventilatory response than Caucasians, despite the higher serum M6G levels in Caucasians.

Adult↗
PubMed2000

The SM19 gene, required for duplication of basal bodies in Paramecium, encodes a novel tubulin, eta-tubulin.

The discovery of delta-tubulin, the fourth member of the tubulin superfamily, in Chlamydomonas [1] has led to the identification in the genomes of vertebrates and protozoa of putative delta homologues and of additional tubulins, epsilon and zeta [2-4]. These discoveries raise questions concerning the functions of these novel tubulins, their interactions with microtubule arrays and microtubule-organising centres, and their evolutionary status. The sm19-1 mutation of Paramecium specifically inhibits basal body duplication [5] and causes delocalisation of gamma-tubulin, which is also required for basal body duplication [6]. We have cloned the SM19 gene by functional complementation and found that it encodes another new member of the tubulin superfamily. SM19p, provisionally called eta-tubulin (eta-tubulin), shows low sequence identity with the tubulins previously identified in Paramecium, namely, alpha [7], beta [8], gamma [6], delta (this work) and epsilon (P. Dupuis-Williams, personal communication). Phylogenetic analysis indicated that SM19p is not consistently grouped with any phylogenetic entity.

Amino Acid Sequence↗
PubMed2000

Cyclosporin A targets involved in protection against glutamate excitotoxicity.

The toxicity of glutamate in neuronal cultures has been attributed in part to a mitochondrial dysfunction involving the permeability transition pore. The participation of the permeability transition pore in this process has been pharmacologically demonstrated by the use of cyclosporin A, which inhibits pore opening by interaction with mitochondrial cyclophilin and, thus, prevents cell death and upstream events. Since cyclosporin A also acts on calcineurin, we have investigated which of the targets of cyclosporin A was responsible for the inhibition of glutamate-excitotoxicity in cerebrocortical primary neuronal cultures. Reactive oxygen species production and early (30 min to 2 h) drop in ATP levels are initial events in glutamate excitotoxicity taking place before neuronal death. Cyclosporin A did not inhibit reactive oxygen species production, but reduced the drop in ATP levels and subsequent neuronal death. However, cyclosporin derivatives that do not bind to calcineurin had smaller effect on survival than cyclosporin A, (regardless of whether they were able to bind cyclophilin), indicating that cyclosporin A protects against glutamate toxicity also through calcineurin-related mechanisms. Consistent with this view, ATP loss appears to result from nitric oxide synthase (NOS) activation (including calcineurin-dependent dephosphorylation) and nitric oxide (NO)/peroxinitrite-dependent increase in poly (ADP-ribose) polymerase activity, since it was reduced by inhibitors of these activities. Collectively, these results suggest that cyclosporin A exerts its protective effects through calcineurin-dependent and independent mechanisms.

Adenine Nucleotides↗
PubMed2000

Non-heart-beating donors from the streets: an increasing donor pool source.

BACKGROUND: Non-heart-beating donors have become a source for organ donation, especially kidneys. The emergency room and the critical care unit are the two sources for this kind of donor. Three years ago, our hospital began a policy of obtaining organs and tissues successfully from subjects who died in the streets. METHODS: We consider as potential organ donors people who die out-of-hospital, are less than 50 years old, with less than 15 min of asystolia without cardiac massage, with a known etiology of death, and without general contraindications for donating. After death diagnosis, the cadaver is taken to the hospital where an emergency room doctor certifies the death. Afterward, the cadaver is transferred to the operating room where a cardiopulmonary bypass is performed to preserve the organs while the legal aspects of donation go on. RESULTS: Up to now, 111 cadavers have been taken as non-heart-beating donors; 53 of them have been actual donors. The average time before arrival to the hospital was 68+/-2.64 min, and the average interval between cardiac arrest and the beginning of cardiopulmonary bypass was 111.33+/-7.09 min. We have obtained 105 kidneys, 12 livers, 84 corneas, and 31 pancreata for islets isolation as well as 49 long bones. Seventy-two kidneys were transplanted, with a probability of survival of 83% at 36 months. CONCLUSIONS: Our experience indicates that it is possible to obtain organs for transplant from donors who die in the streets and are brought to the hospital under strict selection criteria.

Cadaver↗
PubMed2000

Effect of buck stimulus on mature and pre-pubertal norgestomet-treated goats.

Two experiments were conducted to assess the effect of buck exposure to synchronize estrus in mature and pre-pubertal norgestomet-treated crossbred (criolloxdairy breeds) goats. In experiment 1, 100 mature goats (25 per group) under range conditions were either teased at 48 or 24h before Sincromate-B (SMB; 9 days treatment of 2mg norgestomet) implant withdrawal. A third group was exposed to bucks 1 day after SMB treatment and another group was only exposed to bucks (control). Does exposed to bucks 1 day after SMB treatment tended to have a lower percentage of estrus (70% compared to 80% and 92% in other groups) and lower pregnancy rate (57.9 compared to 78.3 and 82.6 in other groups). At 156 days post-joining a significant (P<0.05) difference in cumulative kidding percentage was found between does teased 48h before implant removal (88.9%) and does teased 24h before implant removal (56.3%). Teasing without norgestomet was completely effective at stimulating estrus activity. In experiment 2, pre-pubertal does (n=36; mean 16.6kg BW) treated with SMB+PMSG+teasing tended to have a higher estrus response than SMB+PMSG treated female goat kids (91.6% vs. 66.6%; P=0.13). The results of this study indicate that, during the transitional period, the male effect was as effective as the synchronizing treatments involving SMB in inducing estrus in goats with reduced seasonal inhibition of reproduction. Also, buck exposure potentiates the effect of PMSG to induce estrus in norgestomet primed pre-pubertal does.

Journal Article↗
PubMed2000

The role of oxidative stress in the toxicity induced by amyloid beta-peptide in Alzheimer's disease.

One of the theories involved in the etiology of Alzheimer's disease (AD) is the oxidative stress hypothesis. The amyloid beta-peptide (A beta), a hallmark in the pathogenesis of AD and the main component of senile plaques, generates free radicals in a metal-catalyzed reaction inducing neuronal cell death by a reactive oxygen species mediated process which damage neuronal membrane lipids, proteins and nucleic acids. Therefore, the interest in the protective role of different antioxidants in AD such as vitamin E, melatonin and estrogens is growing up. In this review we summarize data that support the involvement of oxidative stress as an active factor in A beta-mediated neuropathology, by triggering or facilitating neurodegeneration, through a wide range of molecular events that disturb neuronal cell homeostasis.

Alzheimer Disease↗
PubMed2000

Low cleavage activity of 15,15'dioxygenase to convert beta-carotene to retinal in cattle compared with goats, is associated with the yellow pigmentation of adipose tissue.

Two experiments (one with twelve heifers and the other with 14 goats) were designed to evaluate the effect of increasing dietary beta-carotene concentration on the activity of the cleaving enzyme 15,15' beta-carotene dioxygenase and the concentration of beta-carotene and retinol in selected tissues. The experiments lasted 120 days. During the first 90 days animals were offered a beta-carotene unsupplemented diet. In the following 30 days, they were distributed to one of three treatments: 0, 5.5 or 352 mg of beta-carotene/kg of dry matter intake. All animals were slaughtered at the end. In heifers the concentration of beta-carotene in plasma, reflected the level of beta-carotene fed. Goats had detectable levels of beta-carotene only on day 10 of supplementation. In the liver, beta-carotene concentrations were highest with the 352 dose in both species. Heifers had the highest concentration of beta-carotene in the adipose tissue. In bovines, no interaction between beta-carotene treatment and intestinal sampling site was found (P > 0.2) for the activity of 15,15 dioxygenase. Across beta-carotene levels, results of the enzyme assay were: 0.19, 0.32 and 0.45 nmol retinal/(mg S-9 protein/h) (P < 0.01) for 0, 5.5 and 352 mg beta-carotene.kg dry matter intake -1.d-1, respectively; across intestinal sampling sites results of the enzyme assay were 0.45, 0.43 and 0.08 nmol retinal/(mg S-9 protein/h) (P < 0.01) for duodenum, jejunum and ileum, respectively. Caprine data showed an interaction between beta-carotene treatment and intestinal sampling site (P < 0.05) for the activity of 15,15 dioxygenase. The results for treatment 0 were: 1.4, 1.4 and 0; for treatment 5.5: 1.41, 1.42 and 0.13; and for treatment 352: 1.46, 1.99 and 0.48 nmol retinal/mg S-9 protein/h for duodenum, jejunum and ileum, respectively. The lower levels of duodenal and jejunal 15,15'dioxygenase activity in cattle compared with goats, may explain the greater pigmentation of adipose tissue in the former ruminant specie.

Adipose Tissue↗
PubMed2000

Beta,gamma-methylene ATP but not alpha,beta-methylene ATP mimics the inhibitory effect of ATP on ventricular automaticity.

The effects of alpha,beta- and beta,gamma-methylene ATP on ventricular automaticity induced by local injury in the right ventricle of rats pretreated with reserpine, were investigated and compared with the effects of ATP and adenosine. Beta,gamma-methylene ATP but not alpha,beta-methylene ATP mimicked the inhibitory effect of both ATP and adenosine on the spontaneous automaticity In low concentrations, adenosine was more effective than ATP. Alpha,beta-methylene ATP caused little or no effect on ventricular automaticity. The results suggest that the effect of ATP might depend on its hydrolysis into AMP/adenosine.

Adenosine Triphosphate↗
PubMed2000

Stochastic risk estimate for barium radiological examinations in Malaga (Spain).

The aim of this research work has been the estimation of the stochastic risk for five barium examinations. The sample was the population attending the Radiological Service of the 'Nuestra Señora de la Victoria' University Hospital, who had been treated with some barium examinations, set in five different groups: oesophagus tract, oesophagus-gastric-duodenal tract, intestinal tract, enteroclysis and double enema. To estimate the stochastic risk, it is necessary to know the organ dose. This can be calculated from the dose-area product which allows us to determine the effective dose using software. The dose-area product is the most suitable quantity to measure in these types of examination. We have evaluated the contribution that each procedure provides to the genetically significant dose, somatically significant dose, collective effective dose, annual effective dose 'per capita' and detriment, which are useful for assessing the population risk of cancer or hereditary effects after x-ray exposure. The contribution to the genetically significant dose is 6.7 microGy, to the somatically significant dose 8.82 mSv-yr, 16.07 person-Sv for the collective effective dose, 0.03 mSv for the 'per capita' annual effective dose and the annual aggregated detriment is 0.33.

Age Factors↗
PubMed2000

Transpyloric enteral nutrition reduces the complication rate and cost in the critically ill child.

BACKGROUND: Studies in adults have shown that transpyloric enteral nutrition (TEN) is useful in certain patients who cannot tolerate oral or gastric feeding. This study was conducted to compare TEN with parenteral nutrition (PN) in critically ill pediatric patients. METHODS: A retrospective descriptive study conducted in the pediatric intensive care unit of a tertiary pediatric referral center. All patients in the pediatric intensive care unit (PICU) receiving PN and/or TEN from January 1993 through December 1996 were included in the study. RESULTS: Two hundred forty patients (14.6% of all patients admitted to the PICU) received PN and/or TEN (168 exclusively PN, 21 exclusively TEN, and 51 a combined regimen). The number of patients receiving PN and duration of PN declined significantly from 1993 (65 patients, 703 days) through 1996 (48 patients, 395 days). This was mirrored by the increase in the number of patients receiving TEN and duration of TEN. The incidence of complications (hyperglycemia, hypertriglyceridemia, and cholestasis) was higher in the PN group. There was no difference in the incidence of hospital-acquired infection or mortality between the two groups. The cost of TEN was lower than that of PN, with an estimated annual saving of $5,422. CONCLUSIONS: Transpyloric enteral nutrition is a suitable method of nutritional support for critically ill pediatric patients. It has fewer complications and a lower cost than PN.

Child↗