Sustained benefit from ultrafiltration in moderate congestive heart failure.

Body fluids, particularly in the thorax, are increased in moderate congestive heart failure, even if diuretic treatment is appropriate. Ultrafiltration, differently from diuretics, removes isotonic fluid and therefore the greatest possible amount of sodium per unit of fluid withdrawn, providing a physiologic dehydration. This results in improvement in the patient's clinical condition, exercise capacity, lung function, as shown by improvement of standard pulmonary function tests, lung mechanics during exercise, and norepinephrine kinetics during exercise and orthostatic tilting.     

Complications and management after a nonsurgical rhinoplasty: A literature review

Nonsurgical rhinoplasty with injectable fillers has become an increasingly popular option in recent years. Their rise in popularity has been driven by a number of factors, including their minimally invasive nature and the cost lower than surgical option. Physicians should keep in mind that there are many possible complications, especially in the hands of a novice injector. Fortunately, most complications are minor and transient in nature, although the patient may consider them aesthetically displeasing and unacceptable. Major complications are rare; however, an inadequate treatment can produce transient to permanent damage for the patient. A review of the medical literature from 2002 was performed to gather information on main complications after nasal injections using the databases of the National Library of Medicine, Ovid MEDLINE, and Cochrane Library. Understanding the basic anatomical knowledge of the midface, especially the vascular system, is fundamental to prevent the appearance of complications. However, recognize immediately the symptoms and know the correct treatment in case of complications is the only way to minimize permanent bad outcome.     

Role of long-chain polyunsaturated fatty acids in the first year of life

The 2 most abundant long-chain polyunsaturated fatty acids (LCPUFAs) in the brain are docosahexaenoic acid (DHA) and arachidonic acid (ARA), where they have a functional and structural role in infant development. DHA is concentrated in the prefrontal cortex, which is important for association and short-term memory, and in some retinal cells. Concentrations of PUFAs in human breast milk are relatively consistent during the first year of life, and studies have shown that breast-fed infants have a greater mean weight percentage of DHA and a greater proportion of DHA in their red blood cells and brain cortex than formula-fed infants. Furthermore, cortex DHA in breast-fed infants increases with age, probably due to the length of feeding. Maternal supplementation with cod liver oil, which is rich in DHA and eicosapentaenoic acid, improved children's intelligence quotient compared with corn-oil supplementation by 4 years of age. The LCPUFA content of human breast milk is affected by a number of factors, including diet, gestational age, parity, and smoking. Supplementation of formula feed with DHA and ARA results in infant development that is similar to breast-feeding, and may have benefits on blood pressure in later childhood. The beneficial effects of LCPUFA supplementation on visual acuity continue after weaning irrespective of the type of diet. The long-term effects and duration of supplementation of breast- and formula-fed infants requires further investigation.     

Feeding preterm infants after hospital discharge: a commentary by the ESPGHAN Committee on Nutrition

Survival of small premature infants has markedly improved during the last few decades. These infants are discharged from hospital care with body weight below the usual birth weight of healthy term infants. Early nutrition support of preterm infants influences long-term health outcomes. Therefore, the ESPGHAN Committee on Nutrition has reviewed available evidence on feeding preterm infants after hospital discharge. Close monitoring of growth during hospital stay and after discharge is recommended to enable the provision of adequate nutrition support. Measurements of length and head circumference, in addition to weight, must be used to identify those preterm infants with poor growth that may need additional nutrition support. Infants with an appropriate weight for postconceptional age at discharge should be breast-fed when possible. When formula-fed, such infants should be fed regular infant formula with provision of long-chain polyunsaturated fatty acids. Infants discharged with a subnormal weight for postconceptional age are at increased risk of long-term growth failure, and the human milk they consume should be supplemented, for example, with a human milk fortifier to provide an adequate nutrient supply. If formula-fed, such infants should receive special postdischarge formula with high contents of protein, minerals and trace elements as well as an long-chain polyunsaturated fatty acid supply, at least until a postconceptional age of 40 weeks, but possibly until about 52 weeks postconceptional age. Continued growth monitoring is required to adapt feeding choices to the needs of individual infants and to avoid underfeeding or overfeeding.