Alexithymia as a Risk Factor for an Internet Addiction in Adolescents and Young Adults with Autism Spectrum Disorder.

The aim of the study is to investigate the association of alexithymia with Internet addiction and autism spectrum disorders among adolescents and young adults. The links between alexithymia, ASD and other mental disorders are still a largely unexplored topic in psychiatry. An intriguing question is to what extent alexithymia can be a component of the clinical picture of ASD, and to what extent it is an independent phenomenon often co-occurring with ASD. The study group consisted of young Poles aged 11 to 35 (n = 229), including women (n = 167; 73%), men (n = 53; 23%) and non-binary people (n = 9; 4%). The following questionnaires were used in the Polish validated version as screening tools and shared online: AQ (Autism Quotient), TAS-20 (Toronto Alexithymia Scale), IAT (Internet Addiction Test). Among the subjects, 15 people admitted that they had received an official diagnosis of ASD, while 26 people showed a significantly increased severity of autistic traits on the AQ questionnaire. People with ASD who also exhibit alexithymia features are certainly more prone to problematic use of the Internet. In contrast, such a risk in people with ASD without alexithymia is comparable to the general population.

Molecular Oxygen Levels and Percentages of DNA Damage in TPN Patients.

Total parenteral nutrition (TPN) is a life-saving therapy for patients with intestinal failure, but it carries the risk of complications, including an increase in liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) after long-term use. Patients receiving chronic TPN are also exposed to metabolic stress from both the underlying disease and parenteral nutrition. The aim of this study was to compare the concentration of liver transaminases AST and ALT in relation to the rate of oxygen consumption in platelet mitochondria in patients receiving long-term TPN with the degree of oxidative stress induced by lipid emulsions, and to explain their role in cellular energy metabolism and changes in the liver based on the percentage of genomic DNA damage. The study group consisted of 86 TPN patients, while the control group consisted of 86 healthy volunteers who were fed only orally. The results of the study showed that the percentage of molecular oxygen depended on the type of lipid emulsion supplied. Analyzing time on TPN as a factor, we observed a decrease in percentage genomic DNA damage and an increase in percentage molecular oxygen in cells. It remains unclear whether TPN has a direct effect on genomic DNA damage and the level of molecular oxygen in cells during the course of treatment. In conclusion, this study provides important insights into the potential effects of TPN on liver enzymes and cellular metabolism. Further research is needed to better understand the underlying mechanisms and to develop strategies to minimize the risk of complications associated with TPN.

Activity of aminotransferases as a marker of liver injury in home parenteral nutrition patients.

Aim of the study: Parenteral nutrition associated liver disease (PNALD) is a frequently reported complication of long-term parenteral nutrition. Early diagnosis and treatment of PNALD can help prevent end-stage liver disease. The aim of the study was to evaluate the activity of aminotransferases as a marker of liver dysfunction in patients receiving home parenteral nutrition under the care of a reference center. Material and methods: A comprehensive analysis of patients' medical records from a 9-year period (December 2012 - December 2021) was conducted and the following parameters were evaluated: parenteral nutrition mixture composition, total plasma bilirubin, activity of the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST), standardized time factor prothrombin (international normalized ratio [INR] factor) and serum albumin. The analysis covered 630,537 days of parenteral nutrition. The study included 251 patients (140 women and 111 men) included in the Home Parenteral Nutrition Program. Results: PNALD was diagnosed in 11 parenteral fed patients, which gives the frequency of 8.3%/9 years of treatment. Two deaths were classified as cause of death related to liver disease but not related to PNALD. None of the patients included in the analysis developed end-stage liver failure. Conclusions: The above analysis shows that individual selection of the composition of the mixture for intravenous nutrition significantly reduces the risk of PNALD and may prevent liver failure in this context.

Changes in Parenteral Nutrition Requirements and BMI in Patients with Parenteral Nutrition-Dependent Short Bowel Syndrome after Stopping Teduglutide-9 Years of Follow-Up.

Teduglutide (TED) is widely used in patients with short-bowel-syndrome-associated intestinal failure (SBS-IF) to enhance intestinal adaptation and reduce the need for parenteral support (PS). There are limited data on the effects of discontinuing TED. In this study, we describe the changes in parenteral nutrition (PN) requirements and body mass index (BMI) in a 9-year follow-up of patients receiving home parenteral nutrition after discontinuation of the TED treatment. We performed a retrospective analysis of changes in weekly PN orders and BMI in all patients with PN-dependent SBS from two Polish home parenteral nutrition (HPN) centers who received teduglutide between 2009 and 2013 and still required HPN 9 years after discontinuation of the TED treatment. Data included in the analysis were collected prospectively at mandatory visits to the HPN centers at 12, 24, 60, 84, and 108 months after drug discontinuation and compared with values before and after TED treatment. Weekly PN volume values varied significantly between all of the above time points from baseline to 9 years after TED discontinuation (χ2 = 34.860, p < 0.001). After an initial increase within the first year after treatment discontinuation (not statistically significant), the PN volume requirements remained stable for 4 years and increased 5−9 years after treatment discontinuation. The rate of patients requiring an increase in PN volume was 84.62% at 60 and 84 months and 92.30% at 108 months. At 9 years after cessation of the TED treatment, 53.85% of the study group required a 21.21% increase in PN volume compared with values before treatment. The need for PN volume in patients with PN-dependent SBS who discontinued the TED treatment increased within the first year and 4−5 years after treatment cessation, and in some cases might even exceed pretreatment values after 9 years.

Effect of Thickening Powder on Gastrointestinal Losses in Patients With High-output End Jejunostomy Syndrome - Preliminary Results.

BACKGROUND/AIM: End jejunostomy syndrome is a type of short bowel syndrome (SBS) in which the jejunum forms the end of the bowel, as a result of resection or exclusion of the ileum and colon. It is associated with a high risk of dehydration, electrolyte imbalance, and malnutrition due to excessive stomal losses. PATIENTS AND METHODS: In this retrospective study, we analyzed the medical records of sixteen adult patients with SBS and high-output end jejunostomy syndrome who received thickened fluids during their hospitalization in the home parenteral nutrition unit. The main parameter considered was daily stoma excretion volume, measured by 24-h collection. Values were compared between days when patients drank the daily amount of 600 ml of water, and days when patients ingested the same amount of water but mixed with thickening powder to achieve a mildly thick consistency. RESULTS: Median volumes of end jejunostomy output were significantly lower when patients consumed the mixture of water and thickening powder, compared with drinking water without additives (550.0 ml/d vs. 811.9 ml/d, p=0.002). CONCLUSION: These preliminary results demonstrate a potential benefit of thickening powder for the nutritional management of patients with SBS type I, and point to the need for further randomized clinical studies with larger patient groups.

Mechanical properties of the porcine pericardium extracellular matrix cross-linked with glutaraldehyde and tannic acid.

PURPOSE: The aim of this study was to determine the influence of factors such as temperature and glutaraldehyde (GA) concentration on the mechanical properties of porcine pericardia, in order to propose the recommended optimal conditions of a cross-linking process. It was also to verify whether tannic acid (TA), a natural cross-linking agent that stabilizes collagenous tissues by a different mechanism than GA, may positively influence the strength of pericardium. METHODS: The samples were incubated at various temperatures (4, 22, and 37°C) and GA concentration solutions (0.6, 1.5 and 3%) for 7 days. Three series were selected and additionally cross-linked with 0.3% TA for another 7 days. Mechanical properties of cross-linked pericardium samples, i.e., ultimate tensile strength (UTS) and elastic modulus (E) were measured in uniaxial tensile testing. The hyperelastic model for incompressible materials - isotropic by Ogden [24] and anisotropic by Fung [7] were utilized to describe the mechanical behaviour of treated pericardium. RESULTS: The temperature has an influence on cross-linking effects; the lowest values of UTS were reported for specimens cross-linked at 22 °C, while the mechanical properties of series treated at 4°C or 37°C were comparable. At a particular temperature of incubation, the GA concentrations have not affected the mechanical properties of tissues. The dependence between mechanical parameters and agent concentration was only observed for specimens treated with GA at 37 °C. CONCLUSIONS: The conditions of the cross-linking process affect the mechanical properties of the porcine pericardium. Room temperature (22 °C) and the concentration of 1.5% GA occurred to be ineffective. The mechanical properties of GA-treated pericardium were improved by an additional TA cross-linking.

2-Ethylhexanol Derivatives as Nonionic Surfactants: Synthesis and Properties.

The synthesis and basic properties of 2-ethylhexanol based innovative nonionic surfactants are described in this paper. 2-Ethylhexanol as an available and relatively inexpensive raw material was used as the hydrophobe source modified by propoxylation and followed by polyethoxylation. As the result, six series of 2-ethylhexyl alcohol polyalkoxylates (EHP m E n ) were obtained with three steps of propoxylation, each followed by polyethoxylation and two series only with polyethoxylation (EHE n ). Two different catalysts were used, a dimetalcyanide and KOH. Values of average conversion rates and chemical content of the obtained products (GC, TG and GPC techniques) were compared. The influence of the applied catalyst and polyaddition degree on the homologue distribution, reactant conversion and amount of byproducts is discussed. The basic physicochemical parameters including refractive index, solubility in polar media, foaming properties and wettability were investigated and compared. Furthermore, surface activity parameters, i.e. surface tension (γCMC) and critical micelle concentrations were determined. Results are compared to C12-14 alcohol ethoxylates (LaE n ). Accordingly, it was found that the studied 2-ethylhexyl alcohol based compounds are effective, low foaming nonionic surfactants.