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At least 721 records · Page 40Linked to original sources
PubMed1980

[The instant formulated parenteral solution Fresubin in the postoperative feeding of patients after maxillofacial surgery].

21 patients who underwent maxillofacial surgery received daily 6-8 packets of the instant formula diet Fresubin (2,100-2,800 kcal = 8,790-11,720 J). In 1 patient nutrition with Fresubin had to be interrupted due to vomiting. Under nutrition with Fresubin, mean body weight decreased significantly by about 3.5 kg. Serum electrolytes, blood gases, pH, base excess, serum-urea-nitrogen and creatinine, albumin content, serum transaminases, glucose content, hemoglobin and hematocrit did not show any significant change. It was evident that the sodium and potassium content of Fresubin was not high enough to guarantee normal serum values. In 8 of 21 patients potassium had to be substituted parenterally. Concentrations of lipids and triglycerids increased during nutrition with Fresubin and became elevated over normal values without statistic significance.

Adult↗
PubMed1992

Causes of non-medication-induced nasogastric tube occlusion.

In vitro simulation of nasogastric tube delivery of enteral formulas was used to study the mechanism and prevention of non-medication-induced nasogastric tube occlusion. Enteral nutrition products--Osmolite, Ensure, Vital High Nitrogen, and Vivonex T.E.N.--were placed in glass beakers and titrated with hydrochloric acid to determine the pH at which clotting would occur. Factors such as pH, protein content, viscosity, electrolyte composition, flow rate, and tube design were evaluated to determine their effects on coagulation of formula. Addition of simethicone emulsion and docusate sodium to the formulas and siliconization of the nasogastric tubes were studies for their effect on prevention of clog formation. Clumping began to occur at pH 4.6 (the isoelectric point for casein) for Ensure and Osmolite; addition of protein supplement did not change the pH at which coagulation occurred. Vital High Nitrogen and Vivonex T.E.N. formulations did not clump in the beakers. Ensure and Osmolite coagulated within 35 seconds at pH 4.6 or less and remained unchanged at pH greater than 6.0. Addition of sodium or calcium caseinate greatly increased the tendency of the formulas to coagulate. Viscosity of the formula increased markedly as pH decreased. Addition of electrolytes had no effect on precipitation or clumping. Slow or no flow rates within nasogastric tubes placed in simulated gastric juice decreased the pH and caused clumping of formulas within the tubes in a retrograde manner. Flow time or clog formation was not affected by the addition of simethicone or docusate sodium or siliconization of the nasogastric tube.(ABSTRACT TRUNCATED AT 250 WORDS)

Enteral Nutrition↗
PubMed1986

Comparison of glucose, LCT, and LCT plus MCT as calorie sources for parenterally nourished septic rats.

Protein and energy metabolism were investigated in acutely septic rats. Rats were made septic by cecal puncture and ligation. For the next 24 h they were given one of five parenteral formulations differing only in the nonprotein calorie source. The five calorie sources were 1) glucose, 2) long-chain triglycerides (LCT), 3) a 27:73 mixture of medium- and long-chain triglycerides (M/LCT), 4) a 50:50 mixture of glucose plus LCT, and 5) a 50:50 mixture of glucose plus the M/LCT mixture. The formulations also contained amino acids at a calorie:ratio of 165:1. The results were that N retention was greater with the glucose plus LCT mixture than with glucose alone. With this mixture, N retention increased as calorie intake increased, whereas with glucose, N retention plateaued. In spite of the high glucose load given to the glucose-only groups, there was a significant reduction in endogenous fat in peripheral depots. Lipid loss was least with the glucose plus LCT combination. The M/LCT mixture given alone or with glucose resulted in significantly lower survival rates.

Amino Acids↗
PubMed1993

A histomorphometric comparison of bone in young growing rats fed an elemental diet versus a chemically defined polymeric diet.

This study was designed to examine whether a synthetic elemental diet, which could be adapted for total parenteral nutrition, is capable of promoting bone growth comparable to a commercially available liquid polymeric diet. The orally fed young rat was chosen as a model of rapid bone growth. Sixteen male, Wag/Rij rats weighing 120 +/- 3 g were divided into two groups of eight rats each. One group was fed an elemental diet formulated to approximate the nutritional requirements of the rat as recommended by the National Research Council. The comparison group received a liquid polymeric diet. After 14 days there were no significant differences between groups in femur and tibia weights, cortical and medullary area, periosteal and endosteal label area, growth plate width, percent cancellous bone, bone apposition rates and osteoblasts and osteoclasts per millimeter. Both groups maintained a positive calcium and nitrogen balance. These data indicate that bone growth, structure and remodeling comparable to that seen in a polymeric-fed comparison group can be achieved in young rats when fed an oral dextrose/amino acid-based elemental solution for 2 weeks.

Animals↗
PubMedDate not supplied

[3 possible sources of microbiologic contamination in the preparation of formulations for parenteral nutrition].

It is well known that the microbiological control of "all in one" nutritional preparations is difficult. In this work we evaluated and compared the potential contaminants that may be present in the process of manufacturing in a Centralized Unit of Parenteral Nutrition. The study has been centered on the microbiological contamination that may be introduced by the technician, by the raw materials, and that existing in the work area. A microbiological contact technique was used. The results obtained showed that the main microbiological contaminants are introduced by the technician when not observing strict aseptic measures. Another source of contamination is represented by PVC bags when they are manipulated in the pre-sterile area and are not sprayed with alcohol 70 degrees. Therefore, PVC contamination arises from the hands of the technician. Significant differences in contamination between hands washed with germicidal soap and sterile gloves and between clean and sterile surgical dressing could not be demonstrated.

Food Handling↗
PubMed1996

Ileal recovery of nutrients and mucin in humans fed total enteral formulas supplemented with soy fiber.

The objective of this study was to determine whether soy fiber supplementation of total enteral nutrition formulas affected small intestinal recovery of nitrogen, amino acids, and carbohydrates or mucin output in eight human subjects (four males, four females) with ileostomies. The subjects ingested five test diets to provide 1.0-16.5 g soy fiber/L for 2 consecutive days each. The five test diets, each with a different soy fiber content were formulated by varying the relative proportion (1:0, 0.75:0.25, 0.5:0.5, 0.25:0.75, and 0:1) of two commercially available formulas. Effluent dry matter increased with soy fiber intake as a result of the quantitative recovery of soy fiber nonstarch polysaccharide. Nitrogen and amino acid digestibilities were unchanged by the ingestion of soy fiber. Nutrients from the total enteral nutrition formulas were well digested in the small intestine with true nitrogen and amino acid digestibilities in excess of 90% and starch digestibilities approaching 100%. Ileal mucin output was higher in male subjects and was unaffected by soy fiber intake. In summary, soy fiber supplementation does not compromise protein and carbohydrate absorption from the small intestine of humans.

Adult↗
PubMed2004

[A case of intraoperative hyperkalemia probably due to preoperative feeding with a liquid enteral formulation].

A 67-year-old man with no remarkable preanesthetic complications underwent esophagectomy. The patient was fed only with a liquid enteral formulation (Ensure Liquid) for 5 days immediately before the operative day. His serum potassium level before Ensure Liquid administration was 4.1 mEq x l(-1). The first blood analysis at 30 min after the initiation of the surgery revealed an increase in serum potassium level (5.9-6.1 mEq x l(-1)) without any conceivable cause during the anesthetic management. A glucose-insulin infusion treatment lowered the serum potassium level to the normal range. The serum potassium level re-increased to 6.4 mEq x l(-1) 4 days after the initiation of jejunal feeding with Ensure Liquid and then returned to the normal range after the termination of Ensure Liquid administration. The patient's perioperative course suggests that the preoperative Ensure Liquid administration is a probable cause of the intraoperative hyperkalemia in this case.

Aged↗
PubMed1999

Phytoestrogen content of purified, open- and closed-formula laboratory animal diets.

BACKGROUND AND PURPOSE: Phytoestrogens exert estrogenic effects on the central nervous system, induce estrus, and stimulate growth of the genital tract of female animals. Over 300 plants and plant products, including some used in laboratory animal diets, contain phytoestrogens. Therefore, the source and concentration of phytoestrogens in rodent diets were determined. METHODS: Twelve rodent diets and six major dietary ingredients were assayed for phytoestrogens (daidzein, genistein, formononetin, biochanin A, and coumestrol), using high-performance liquid chromatography. Three rodent diets recently formulated to reduce phytoestrogen content also were assayed. RESULTS: Formononetin, biochanin A, and coumestrol were not detected. Soybean meal was the major source of daidzein and genistein; their concentrations were directly correlated to the percentage of soybean meal in each diet. CONCLUSIONS: High, variable concentrations of daidzein and genistein are present in some rodent diets, and dietary phytoestrogens have the potential to alter results of studies of estrogenicity. Careful attention should be given to diet phytoestrogen content, and their concentration should be reported. A standardized, open-formula diet in which estrogenic substances have been reduced to levels that do not alter results of studies that are influenced by exogenous estrogens is recommended.

Animal Feed↗
PubMedDate not supplied

Liquid chromatographic determination of tocopherols and tocotrienols in vegetable oils, formulated preparations, and biscuits.

A precise and selective liquid chromatographic procedure for determining tocopherol and tocotrienol isomers in vegetable oils, formulated preparations, and biscuits was developed and validated. The proposed method quantitates vitamin E in better conditions of recoverability and reproducibility than the standard saponification procedure. Tocopherols and tocotrienols were extracted in hexane from vegetable oils, passed through a silica Sep-pak, chromatographed on a mu-Bondapak C18 column with a mobile phase of methanol-water (95 + 5, v/v), identified at 292 nm, and detected with fluorescence procedure (excitation 296 nm, and emission 330 nm). The correlation coefficient on the calibration curve was 0.9995 over the range of 0.1 to 100 microg/mL. Overall recovery of vitamin E isomers was 93%; coefficients of variation for intra- and interday precision, < 2.25%. The results obtained from extraction methods 1 (with saponification) and 2 (without saponification) were compared by ANOVA test. Significant differences appeared between vitamin E isomers (p < or = 0.05).

Bread↗
PubMedDate not supplied

[Bacteriologic control of total parenteral nutrition formulations at the Bellvitge Hospital].

Septic complications often lead to halting nutritional parenteral therapy. In general, the source of infection lies in the mixture, the connection and/or point of catheter insertion. The objective of this study is to show the need for bacteriological control throughout the parenteral nutrition process in order to assess the efficacy of the methods used, discover the source of infection and establish an in-house quality control. Different methods for bacteriological control of parenteral nutrition mixtures are studied and are compared with the method used at our hospital which is based on routine culture sampling after the mixture is prepared and before it is perfused, on repeating bacteriological control cultures and on performing bacteriological assessments of the catheter. In order to achieve this goal, 28.501 nutritional parenteral samples from 1,782 patients were studied. Only 185 (0.65%) samples were originally positive, and only 59 of them (0.21%) remained positive following a verification culture. Of the 6 culture-verified septic cases, 5 corresponded to Enterobacter cloacae and 1 to Klebsiella pneumoniae.

Bacterial Infections↗
PubMed2001

Enteral feeding in stable chronic obstructive pulmonary disease patients.

OBJECTIVE: The study aimed to compare the effectiveness of a defined formula diet with a blenderized diet on nutritional and respiratory function parameters and to determine the bacteriological load of the two formulations. METHODOLOGY: Seventeen patients, aged 50-75 years, admitted to the University of the Philippines-Philippine General Hospital for chronic bronchitis and/or emphysema, were studied. They were divided into two groups according to dietary regimens. Each group of patients received either the standardized commercial formula or the blenderized formula for 2 weeks. Evaluation of dietary intake, anthropometric measurements, laboratory examinations and lung function were assessed. Subjective evaluation (patient's and physician's assessment) was also sought. Microbiological examinations were performed on the prepared enteral formulas. RESULTS: There was a slight increase in weight and in pulmonary function in both groups but these results did not differ significantly. Possible formula contamination was confirmed. Furthermore, in the overall assessment, the physician and patients rated both formulas as comparable.

Aged↗
PubMed1983

[Formulation and nutritive value of 2 milk substitutes based on sweet lupine (Lupinus albus, var. multolupa)].

Two protein mixtures, A and B, based on sweet lupine, wheat flour and dried skim milk powder were formulated, bearing in mind the chemical and nutritional standards set by the National System of Health Services for protein mixtures used through the National Program of Complementary Feeding (PNAC) for preschool children. Both formulas contained 12% of sweet lupine flour, but they differed in their skim milk content, which was 15% in mixture A, and 10% in mixture B. Taking as reference value a content of 2% moisture, formula A contains 17.6% protein and mixture B, 16.4%, with a caloric content of 420 kcal/100 g for both of them. The amino acid score was 0.80 for both mixtures. The biological quality of the proteins of A and B, measured as protein efficiency ratio (PER), was 2.2 and 2.1, respectively. These values are not statistically different, although they are lower than the value of 2.5 obtained for casein (p less than 0.01).

Amino Acids↗
PubMed1991

Dietary plant materials and development of diabetes in the BB rat.

The present study was designed to examine further the impact of individual plant protein sources found in a diabetogenic, cereal-based, rodent laboratory diet, NIH-07 [open formula, nonpurified rat and mouse diet (positive control)], on the development of diabetes. Diabetes-prone BB rats that were pan-T(OX19+)-lymphopenic were fed a low diabetogenic diet during gestation and lactation. Progeny of these rats were fed a normal or autoclaved NIH-07 diet, or one of eight other diets based on the AIN-76A formulation, with modified protein sources as follows: hydrolyzed casein (HC), soybean meal, HC+ trypsin inhibitor (TI) in water (2 mg/mL, wheat germ, alfalfa seeds, Brewer's yeast, red lentils and a plant protein mixture. Feeding soybean meal increased the incidence of diabetes compared with the negative control, HC diet (47% vs. 12% incidence, P = 0.02). Wheat germ, alfalfa seeds and plant protein mixture resulted in an intermediate incidence of diabetes of 33%; the incidence was lower for Brewer's yeast and lentils (20% and 13%). Autoclaving (121 degrees C, 10 min) the NIH-07 diet or the presence of TI in drinking water had a minimal effect on diabetes frequency, suggesting heat-labile plant toxicants were not directly involved. Thus, certain dietary plant protein sources or associated agents may influence the development of spontaneous diabetes in the BB rat.

Age Factors↗
PubMed2006

Do meal replacement drinks have a role in diabetes management?

The poor effectiveness of conventional dietary treatment for weight loss and weight maintenance in patients with type-2 diabetes may be improved by a meal replacement strategy that provides a strong structured meal plan with reasonable opportunity for dietary variety. Typical meal replacement programs fix the intake of one or two meals per day with a calorie-controlled, nutritionally balanced commercial formulation, and allow prudent additional meals and snacks. In obese subjects, diets with meal replacements have proven to be more efficient than conventional diets. Patients on the meal replacement regimen lost 7.3 and 8.4% of initial body weight after 12 weeks and 4 years, respectively, whereas the patients on the conventional diet had lost 1.4% and 3.2% of initial body weight after 12 weeks and 4 years, respectively. The meal replacement plan has also proven to be effective in patients with type-2 diabetes. After 6 and 12 months, patients in the meal replacement group achieved on average a weight loss of 5.24 and 4.35% of their initial body weight, respectively. In contrast, after 6 and 12 months, patients on the individualized diet plan achieved on average a weight loss of 2.85 and 2.36% of their initial body weight, respectively. Meal replacements offer a promising strategy for treating obese patients with type-2 diabetes.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

Enteral nutrition: frequency of formula modification.

A retrospective study was undertaken to determine with what frequency one of the 12 standard enteral formulations routinely used by the Metabolic Support Service could not be used without modification. Forty-three percent of the 83 patients studied required modification of one or more of the 5 individual components of the enteral product being utilized (ie, carbohydrate, protein, fat, electrolytes, and vitamins). Organ dysfunction was the reason for 31% of those changes in formula, other conditions included vitamin deficiencies (30%), electrolyte imbalances (27%), and essential fatty acid deficiencies (12%). The results of the study confirm the fact that no single formula can be effective in meeting every patient's fluid and electrolyte requirements while addressing the specific nutritional aspects of their disease. It would appear that a totally modular system for enteral nutrition similar to that used in parenteral nutritional support would allow maximum flexibility in the preparation of formulae that conform to patient's needs.

Acute Kidney Injury↗
PubMed1996

[Color loss evaluation of a dietary formulation in function of temperature, storage time and packaging].

Color loss of a dietetic formulae based on pumpkin (Cucurbita maxima), rice, hen and vegetable oils was evaluated. The product was under an accelerated test at temperatures of 40, 50 and 70 degrees C for a month. The kinetic reaction of color loss (quality loss indicator) was obtained with n = 1 and Ea = 11.5 Kcal/mol. The product was also stored for sixth months at temperatures of 25, 30, 35 and 40 degrees C using glass containers, laminated and composite cans (non metallic). The color was measured by a colorimetric method and by sensory evaluation under the defined conditions of time, temperature and package. The statistical analyses of the color loss measured by instrument was performed by a randomized block design with a significance level of p < 0.05. The results obtained both by the instrument and by the sensory evaluation method, showed that the temperature and storage time has significant effect (p < 0.05) on the other hand, the package does not have a significant effect. It was concluded from this study that the product could be stored for 6 months at temperatures below 35 degrees C without changes in color.

Color↗
PubMed1997

Respiratory distress and sudden death associated with receipt of a peripheral parenteral nutrition admixture.

OBJECTIVE: To detect respiratory adverse reactions potentially related to receipt of peripheral parenteral nutrition (PPN) in hospitalized patients and to determine risk factors for their occurrence. DESIGN: Retrospective cohort study. SETTING: Federal tertiary-care hospital. PATIENTS: Medical and pharmacy records of all patients who received PPN from October 1992 to February 1994 were abstracted for demographics, diagnoses, medications received, indications for and formulation of PPN, and severity of illness as measured by Acute Physiology and Chronic Health Evaluation II scores. RESULTS: A case-patient was defined as any patient who, while receiving PPN, had unexplained chest pain, dyspnea, cardiopulmonary arrest, or new interstitial infiltrates on chest radiograph. Patients who received PPN in which FreAmine was the amino acid source were more likely than those who received PPN made with Travasol to meet the case definition (5/11 vs 0/39; relative risk, > 18; 95% confidence interval, 3.3->136; P < .001). CONCLUSIONS: A change in the amino acid source of a PPN admixture was associated with respiratory adverse events that ranged from interstitial infiltrates to sudden death. These events apparently resulted from the infusion of a calcium phosphate precipitate in an opaque admixture. Each new PPN admixture should be tested for stability before clinical use and infused into patients through an appropriate filter.

APACHE↗
PubMed1986

[Artificial nutrition in hospitals: general principles of quality control].

Sterile pharmaceutical preparations must be supplied to clinical wards; their high degree of safety is given by hospital pharmacists who are responsible for quality control of these preparations. Various considerations on the choice of protocol are suggested. Good manufacturing practice is to carry out quality controls at every stage of production of total parenteral nutrition fluids. However, these controls are made difficult by the poor equipment of hospital pharmacies and by the absence of specific pharmaceutical monographs. The selected protocol involves: preliminary controls, which determine the practicability of the suggested formulation, as well as its expiration date: amino acid determinations using liquid chromatography, electrolyte analysis and concentration, pH, evolution of particle size in fat emulsion according to storage conditions, choice of plastic container; microbiological controls: every two months and every time the pharmaceutical staff changes; moreover, a search for bacterial endotoxins using a chromogenic substrate (LAL technique) with "microstrips" is suggested; a sample from each admixture is kept under refrigeration for 15 days; controls during fabrication to check, at the end of the process, if good manufacturing practices have been realized: microbiological sampling of the working area and elaboration of a written procedure; control after fabrication of each nutrient admixture: determination of various elements such as sodium, potassium and dextrose in a 5 ml sample. These assays enable the checking of high standards of fabrication. Hospital pharmacies, despite their reduced equipment, can answer by these procedures to the physicians' needs and supply sterile TPN meeting pharmaceutical standards.

Electrolytes↗