Evaluación prospectiva clínica y de cambios histológicos del intestino delgado en lactantes desnutridos suplementados con glutamina Valencia 2004 / Clinical retrospective evaluation and histological changes of the small intestine in undernourished feeding age babies supplemented with glutamin Valencia 2004

Conocida la experiencia exitosa de algunos investigadores en la utilización de glutamina en pacientes cuya patología produce alteración a nivel del intestino delgado, se realizó la presente investigación, cuyo objetivo fue evaluar la mejoría clínica a través de la ganancia de peso, y cambios histológicos de la mucosa duodenal en lactantes desnutridos moderados y graves que recibieron una dieta suplementada con glutamina. Se realizó un estudio experimental, con diagnóstico de desnutrición moderada y grave en el Hospital "Dr. Jorge Lizarraga". Cada grupo estuvo conformado por 9 niños, un grupo que recibió dieta y suplementada con glutamina (Glutapack-10) y otro recibió placebo. A todos los pacientes se les tomó biopsia de la porción mas distal del duodeno, al inicio y al final de estudio. Las biopsias fueron realizadas por microscopía óptica. El análisis se realizó a través de medidas de tendencia central y dispersión, Análisis de varianza y correlación de Pearson. En ambos grupos hubo incremento en el peso, Siendo éste estadísticamente significativo. Tanto el grupo de pacientes que recibió suplementación con Glutamina como el grupo control, experimentó aumento en el tamaño de la vellosidad duodenal, la cual no fué estadísticamente significativa. Un infiltrado de células mononucleares en dievrsos en diversoso grados fue descrito en al mucosa duodenal de ambos grupos (Duodenitis crónica no específica), estos hallazgos podrán influir en el normal funcionamiento de la mucosa intestinal de estos pequeños pacientes

Amino acid losses during hemodialysis with polyacrylonitrile membranes: effect of intradialytic amino acid supplementation on plasma amino acid concentrations and nutritional variables in nondiabetic patients.

BACKGROUND: Malnutrition is highly prevalent in hemodialysis patients. Amino acid (AA) losses during the dialysis procedure may be a contributing factor. OBJECTIVES: The objectives of this study were 1) to prospectively evaluate AA losses and their effect on plasma AA concentrations during dialysis with polyacrylonitrile at baseline and after administration of AAs by intradialysis and 2) to investigate the effects of intradialytic AA supplementation on nutritional status. DESIGN: Seventeen stable patients without diabetes who were receiving hemodialysis were studied. In the first phase, AA losses were evaluated over 2 wk in 10 patients randomly assigned to receive AA supplementation. AA losses were analyzed during the first week without supplementation and during the second week with AA administration. In the second phase, the patients' nutritional status was investigated after 3 mo of AA supplementation and was compared with those in 7 patients not receiving AAs. RESULTS: Mean +/- SD) AA losses during a 4-h dialysis session were 12 +/- 2 g; there was a significant decrease in plasma AA concentrations (386 +/- 298 micromol/L for essential and 902 +/- 735 micromol/L for nonessential AAs). After administration of AAs, the losses increased to 28 +/- 4 g. However, this procedure produced a positive net balance of AAs (10.6 +/- 5.6 g for total AAs), preventing a reduction in plasma concentrations. After 3 mo of AA administration, there was a significant increase in protein catabolic rate and serum albumin and transferrin. This improvement occurred without any change in the dialysis dose, ruling out the possibility that an increase in dialysis efficiency played a role. CONCLUSIONS: Intradialysis adequately provides AA supplements, prevents reductions in plasma AA concentrations, and favorably affects the nutritional status of patients receiving hemodialysis.

[Changes of calcium-phosphorus metabolism in patients with chronic renal failure on hemodialysis treatment]. / Modificaciones del metabolismo calcio-fósforo en pacientes con insuficiencia renal crónica en régimen de hemodiálisis

Hemodialysis induced changes in calcium (Ca) and phosphorous (P) metabolism are studied in a group of ten (10) patients with chronic renal failure. There was a significant rise in total serum calcium (Ca), that was closely related to changes in serum proteins level, and a very significant decrease in serum phosphorous (P). Calcium levels of 7 to 8 mgs/100 cc in the dialyzer fluid were considered ideale.