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81.
Daniel H. Montes-Cortés José L. Novelo-Del Valle Ivonne M. Olivares-Corichi José V. Rosas-Barrientos Luis J. Jara María Pilar Cruz-Domínguez 《The American journal of emergency medicine》2018,36(9):1570-1576
Hyperammonemia results from hepatic inability to remove nitrogenous products generated by protein metabolism of intestinal microbiota, which leads to hepatic encephalopathy (HE) in chronic liver disease (CLD). In ammonium neurotoxicity, oxidative stress (OxS) plays a pathogenic role. Our objective was to evaluate if intestinal mannitol is as effective and safe as conventional treatment for diminishing hyperammonemia, OxS, and HE in patients with CLD.
Material and methods
We included 30 patients with HE classified by “Haven Criteria for Hepatic Encephalopathy”. They were randomized into two groups: 1) Mannitol Group (MG) with mannitol 20% administered into the intestine by an enema, 2) conventional group (CG) with lactulose 40?g enema both substances were diluted in 800?mL of double distilled solution every 6?h; all patients received neomycin. We evaluated ammonia concentration, plasma oxidative stress, HE severity, intestinal discomfort and adverse effects.Results
Hyperammonemia (171?±?104 vs 79?±?49?μmol ammonia/L, p?<?0.01), and oxidative stress (MDA 29 vs 27%, formazan 15 vs 11%, carbonyls 16 vs 9% and dityrosines 10 vs 5%) were reduced in MG and CG respectively. The HE severity decreased by two degrees compared to baseline values in both groups. Intestinal discomfort and electrolyte plasma alterations were less frequent (p?<?0.05) in MG than CG.Conclusions
Intestinal mannitol is as effective and safe as conventional treatment for reducing hyperammonemia, oxidative stress, and hepatic encephalopathy of CLD patients in the emergency room. Likewise, mannitol is better tolerated than conventional treatment. 相似文献82.
83.
Iris?Iglesia Isabelle?Guelinckx Pilar?M.?De?Miguel-Etayo Esther?M.?González-Gil Jordi?Salas-Salvadó Stavros?A.?Kavouras Joan?Gandy Homero?Martínez Saptawati?Bardosono Morteza?Abdollahi Esmat?Nasseri Agnieszka?Jarosz Guansheng?Ma Esteban?Carmuega Isabelle?Thiébaut Luis?A.?MorenoEmail author 《European journal of nutrition》2015,54(2):57-67
Purpose
To describe total fluid intake (TFI) according to socio-demographic characteristics in children and adolescents worldwide.Methods
Data of 3611 children (4–9 years) and 8109 adolescents (10–18 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, school classes were randomly recruited with stratified cluster sampling design. In the other countries, participants were randomly recruited based on a quota method. TFI (drinking water and beverages of all kinds) was obtained with a fluid-specific record over 7 consecutive days. Adequacy was assessed by comparing TFI to 80 % of adequate intake (AI) for total water intake set by European Food Safety Authority. Data on height, weight and socio-economic level were collected in most countries.Results
The mean (SD) TFI ranged from [1.32 (0.68)] to [1.35 (0.71)] L/day. Non-adherence to AIs for fluids ranged from 10 % (Uruguay) to >90 % (Belgium). Females were more likely to meet the AIs for fluids than males (4–9 years: 28 %, OR 0.72, p = 0.002; 10–18 years: 20 %, OR 0.80, p = 0.001), while adolescents were less likely to meet the AI than children (OR 1.645, p < 0.001 in males and OR 1.625, p < 0.001 in females).Conclusions
A high proportion of children and adolescents are at risk of an inadequate fluid intake. This risk is especially high in males and adolescents when compared with females or children categories. This highlights water intake among young populations as an issue of global concern.84.
Bonnefoy Pierre-Benoît Prevot Nathalie Mehdipoor Ghazaleh Sanchez Alicia Lima Jorge Font Llorenç Gil-Díaz Aída Llamas Pilar Aibar Jesús Bikdeli Behnood Bertoletti Laurent Monreal Manuel 《Journal of thrombosis and thrombolysis》2022,53(4):829-840
Journal of Thrombosis and Thrombolysis - Ventilation/perfusion (V/Q) imaging and computed tomography pulmonary angiography (CTPA) are common tools for acute pulmonary embolism (PE) diagnosis.... 相似文献
85.
de Luis D Bustamante J 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2008,28(3):333-342
Patients with kidney failure are a high nutritional risk group. Patients with acute kidney failure need and energy intake of 30-40 kcal/kg and a protein intake of 0,8-1 g/kg of ideal weight, that it is increased with glomerular filtration improvement. Potassium must be limited to 30-50 mEq/day and sodium to 20-40 mEq/day in oliguric phase, and must be replaced the losses in diuretic phase. Specific recommendations have been designed to some nutrients. A diet with 0.75-1 g/kg/day of proteins must be recommended in patients with chronic kidney failure (CDF). Low protein diets (<0.6 g/kg/day) are not justified, due to a possible malnutrition might be developed (A). In patients with haemodialysis, energy requirements are 35 Kcal/kg/day. Protein recommendations are 1.2-1.4 g/Kg/day. Water recommendations depend of residual diuresis. 500-800 ml must be added to residual diuresis. Sodium must limited to 60-100 meq/day, with a depth reduction of water and sodium in anuric patients. Potassium must be under 1 meq/kg/day. Patients with peritoneal dialysis had different dietary recommendations. Protein recommendations are higher than previous (1.5 g/Kg/day). Energy recommendations from carbohydrates must be included glucose of dialyser liquid (60% of total amount). Diet has low restrictions due to the daily sessions of peritoneal dialysis, for example potassium intakes can reach 2000-3000 mg/day. Hidrosoluble vitamin losses are lower than patients with haemodialysis. 相似文献
86.
Herrerías JM Esteban JM Caballero-Plasencia AM Valenzuela-Barranco M Motilva V Alarcón C Martín J Herrerías JM Esteban P 《Digestive diseases and sciences》2003,48(5):986-991
Cyclic GMP plays an important role in maintaining homeostasis in the gastric mucosa. NSAIDs damage the mucosa by mechanisms that may be mediated by alterations in the intragastric concentration of cyclic GMP. To test this hypothesis we studied the effects of the oral administration of acetylsalicylic acid (100, 300, and 500 mg/kg), piroxicam (5, 10, and 20 mg/kg) and sodium diclofenac (10, 25, 50, and 100 mg/kg), and of their interaction with zaprinast (5 mg/kg) and IBMX (10 mg/kg), on intragastric concentrations of cyclic GMP and the gastric erosive index in rats. All determinations were done 3 hr after the NSAID was given. All NSAIDs induced dose-dependent decreases in mucosal concentrations of cyclic GMP, which correlated inversely with the surface area showing mucosal injury. In contrast, cyclic GMP concentrations remained normal, and no intragastric damage was seen in rats given zaprinast (cyclic GMP-specific phosphodiesterase inhibitor) or IBMX (non-specific phosphodiesterase inhibitor) or in combination with NSAIDs. These findings are in line with the hypothesis that cyclic GMP is involved in the biochemical mechanisms of NSAID-induced gastric injury. 相似文献
87.
Yañez-Mó M Barreiro O Gonzalo P Batista A Megías D Genís L Sachs N Sala-Valdés M Alonso MA Montoya MC Sonnenberg A Arroyo AG Sánchez-Madrid F 《Blood》2008,112(8):3217-3226
MT1-MMP plays a key role in endothelial function, as underscored by the angiogenic defects found in MT1-MMP deficient mice. We have studied the molecular interactions that underlie the functional regulation of MT1-MMP. At lateral endothelial cell junctions, MT1-MMP colocalizes with tetraspanin CD151 (Tspan 24) and its associated partner alpha3beta1 integrin. Biochemical and FRET analyses show that MT1-MMP, through its hemopexin domain, associates tightly with CD151, thus forming alpha3beta1 integrin/CD151/MT1-MMP ternary complexes. siRNA knockdown of HUVEC CD151 expression enhanced MT1-MMP-mediated activation of MMP2, and the same activation was seen in ex vivo lung endothelial cells isolated from CD151-deficient mice. However, analysis of collagen degradation in these experimental models revealed a diminished MT1-MMP enzymatic activity in confined areas around the cell periphery. CD151 knockdown affected both MT1-MMP subcellular localization and its inclusion into detergent-resistant membrane domains, and prevented biochemical association of the metalloproteinase with the integrin alpha3beta1. These data provide evidence for a novel regulatory role of tetraspanin microdomains on the collagenolytic activity of MT1-MMP and indicate that CD151 is a key regulator of MT1-MMP in endothelial homeostasis. 相似文献
88.
Serrano D Carrión R Balsalobre P Miralles P Berenguer J Buño I Gómez-Pineda A Ribera JM Conde E Díez-Martín JL;Spanish Cooperative Groups GELTAMO GESIDA 《Experimental hematology》2005,33(4):487-494
OBJECTIVE: To evaluate feasibility, safety, and efficacy of peripheral blood stem cell collection (PBSCC) and autologous stem cell transplantation (ASCT), to treat patients diagnosed of high-risk or relapsed HIV-associated lymphoma (HIV+ Ly), responding to highly active antiretroviral therapy (HAART). METHODS: Prospective and multicentric study in patients with high-risk or relapsed chemosensitive HIV+ Ly, candidate for consolidation with ASCT. Eligibility criteria were similar to those of HIV- lymphoma. HAART was aimed to be maintained during the procedure. RESULTS: Fourteen patients were admitted. Adequate PBSCC was obtained from all patients (median CD34+ cells was 4.7 x 10(6)/kg). Three patients died before ASCT; two had disease progression and one died from VHC-liver failure. Eleven transplanted patients showed neutrophil engraftment after a median time of 16 days (range, 9-33 days), and nine patients showed platelet engraftment after a median time of 20 days (range, 11-36 days). CD4+ cell counts and HIV viral load (VL) were appropriately preserved along the procedure. No patients died from treatment-related complications. One patient died from lymphoma progression (day +19), and another died in complete remission (CR) with undetectable VL, 15 months after transplant, due to infection. One patient relapsed at 32 months after ASCT. The remaining eight patients are alive in CR with an event-free survival of 65% and a median follow-up of 30 months after ASCT (range, 7-36 months). CONCLUSIONS: These results show that feasibility, safety, and efficacy of PBSCC and ASCT in HIV+ Ly patients responding to HAART are similar to those observed in the HIV- lymphoma setting. 相似文献
89.
Milke García Mdel P 《Revista de gastroenterologia de Mexico》2005,70(4):465-474
Man ingests food to mitigate hunger (mediated by physiological and biochemical signals), satisfy appetite (subjective sensation) and because of psychosocial reasons. Satiation biomarkers (stop feeding) are gastric distention and hormones (CCK, GLP-1) and satiety biomarkers (induce feeding) are food-induced thermogenesis, body temperature, glycaemia and also hormones (insulin, leptin and ghrelin). Oxidative metabolism/body composition, tryptophan/serotonin and proinflammatory cytokines are also implicated on hunger physiology. At the present time, ghrelin is the only known circulating orexigenic with potential on hunger/body weight regulation. It is a neuropeptide (endogenous ligand for the GH secretagogue) recently isolated from the oxyntic mucosa and synthesized mainly in the stomach. Its blood concentration depends on diet, hyperglucemia and adiposity/leptin. It is secreted 1-2 hours preprandially and its concentration decreases drastically during the postprandium. Ghrelin acts on the lateral hypothalamus and theoretically inhibits proinflammatory cytokine secretion and antagonizes leptin. Ghrelin physiologically increases food intake and stimulates adipogenesis, gastrointestinal motility and gastric acid secretion, and has other hormonal and cardiovascular functions. Ghrelin blood concentration is reduced in massive obesity, non-alcoholic steatohepatitis, polycystic ovary syndrome, acromegaly, hypogonadism, ageing, short bowel syndrome and rheumatoid arthritis; and increased in primary or secondary anorexia, starvation, chronic liver disease and celiac disease. Cerebral and peritoneal ghrelin administration (rats) and systemic administration (rats and healthy volunteers, cancer patients or patients on peritoneal dialysis) promotes food consumption and increases adiposity, of utmost importance in the treatment of patients with anorexia. 相似文献
90.
Hernández del-Rey R Armario P Martín-Baranera M Sánchez P Almendros MC Coca A Pardell H 《Blood pressure》2003,12(2):89-96
BACKGROUND: Few studies have assessed the relationship between ambulatory blood pressure (BP) and cardiac damage in essential hypertensive patients with inverse white coat hypertension (IWCH). OBJECTIVES: To determine the frequency of IWCH in untreated grade 1-2 hypertension and to assess possible differences in cardiac damage among patients with IWCH, white coat hypertension (WCH) and the rest of patients with grade 1-2 hypertension. PATIENTS AND METHODS: Two hundred and eleven patients with grade 1-2 hypertension were sequentially included. A good quality 24-h ambulatory BP monitoring was obtained in 204 patients (age: 41 +/- 12 years, 56% males). IWCH was defined as a daytime systolic and/or diastolic BP higher than diagnostic office systolic and/or diastolic BP, respectively. WCH was defined as a daytime BP < 135/85 mmHg. A good quality echocardiogram was obtained in 174 patients. We considered left ventricular hypertrophy a left ventricular mass index (LVMI) > or = 125 g/m2. RESULTS: We found IWCH in 29 subjects (14%), and WCH in 68 (33%). Office BP in patients with IWCH was in an intermediate position between WCH and the rest of grade 1-2 hypertension patients. The IWCH patients showed 24-h, daytime and night-time BP higher than the other groups. Left ventricular mass was significantly greater in patients with IWCH than in the other grade 1-2 hypertension patients after adjusting for age, gender, body mass index, smoking and office BP (regression coefficient 28.14, 95%CI: 7.36-48.91). CONCLUSION: IWCH is independently associated with higher values of left ventricular mass in patients with grade 1-2 hypertension. 相似文献