scholarly journals Modern Approaches to Enteral Nutrition in Intensive Care

2021 ◽  
Vol 10 (1) ◽  
pp. 108-121
Author(s):  
M. M. Potskhveriya ◽  
Yu. S. Goldfarb ◽  
V. A. Matkevich ◽  
A. A. Ryk
Keyword(s):  
Oxidative Stress ◽  
Enteral Nutrition ◽  
Nutritional Therapy ◽  
Acute Poisoning ◽  
Critical Conditions ◽  
Results Of Treatment ◽  
Scientific Analysis ◽  
Staged Treatment ◽  
Positive Results ◽  
Instrumental Control

The analysis of the literature data allowed us to establish that today enteral nutrition (EN) is unanimously recognized by specialists as the preferred method of nutritional therapy, which significantly affects the course of critical conditions (CC). The use of EN now affects almost the entire nosology that forms the cohort of such patients. To the least extent, the scientific analysis of the possibilities of EN touched acute poisoning, where, given the special danger to life of their severe forms, there are great prospects for further research of this kind. It is especially emphasized that EN mainly in the first 24-48 hours from the onset of the disease mostly affects the achievement of positive results of treatment of CC, accompanied by an improvement in metabolic processes in organs and tissues. There is great interest in studying the pathogenesis of CC by assessing changes in homeostasis indicators using modern laboratory and instrumental control, which strengthens the scien-tific basis of EN. At the same time, it also contributes to the disclosure of his sanogenesis. Considering that, along with immunological shifts, the formation of oxidative stress and hemorheological disorders is of particular  importance in the pathogenesis of CC, being to a large extent involved in the development of endogenous intoxication and their irrevers-ibility, studies on EN in this field are promising, which, in our opinion, are still are very limited,  and in relation to hemorheology, according to the data available to us, are not represented at all. There are also no generalized up-to-date data on the economic component of EN. Further improvement of EN, as well as the  corresponding organizational measures, it seems, can bring this method to a  higher level of efficiency and, accordingly, safety, which, combined with the economic advantages of EN, will expand the possibilities of its  implementation in clinical practice.AIM OF STUDY Standardization of staged treatment of patients with severe concomitant closed abdominal trauma.

VIOLATIONS OF HOMEOSTASIS PARAMETERS IN ACUTE POISONINGS AND WAYS OF THEIR CORRECTION

2018 ◽  
pp. 18-26
Author(s):  
V. A. Matkevich ◽  
M. M. Potskhveriya ◽  
Yu. S. Goldfarb ◽  
A. Yu. Simonova
Keyword(s):  
Russian Federation ◽  
Professional Education ◽  
Acute Poisoning ◽  
Critical Conditions ◽  
Infusion Therapy ◽  
Results Of Treatment ◽  
Medical Academy ◽  
Scientific Papers ◽  
Special Solutions ◽  
Russian Medical

N.V. Sklifosovsky Research Institute for Emergency Medicine, Healthcare Department of Moscow|, 129090, Moscow, Russian Federation Research and Applied Toxicology Center of Federal Medical and Biological Agency|, 129090, Moscow, Russian Federation Russian Medical Academy of Continuous Professional Education, RF Ministry of Health|, 125993, Moscow, Russian Federation The problem of correction of disturbed homeostasis parameters in critical conditions, including acute poisoning, has revealed its increasing importance in recent years. In this respect, extracorporeal methods of detoxification (hemosorption, hemodialysis, etc.) and physio- and chemohemotherapy are quite effective. With the help of these methods positive changes in hemorheological, immune and other parameters are achieved, that increase significantly the overall results of treatment of patients. At the same time, targeted correction of disturbed homeostasis outside detoxification activities is still carried out mainly through infusion therapy. Along with this in recent years a growing number of scientific papers devoted to the correction of homeostatic disorders by enteral administration of special solutions in emergency conditions has appeared. However, this approach, although physiological and technically simple, has not yet been studied in clinical toxicology, and this fact encourages further research in this direction.

scholarly journals Nutritional Therapy Strategies in Pediatric Crohn’s Disease

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 212
Author(s):  
Charlotte M. Verburgt ◽  
Mohammed Ghiboub ◽  
Marc A. Benninga ◽  
Wouter J. de Jonge ◽  
Johan E. Van Limbergen
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Intestinal Inflammation ◽  
Management Strategies ◽  
Nutritional Therapy ◽  
Nutritional Deficiencies ◽  
Intestinal Immunity ◽  
Exclusive Enteral Nutrition ◽  
Therapy Strategies

The increase in incidences of pediatric Crohn’s Disease (CD) worldwide has been strongly linked with dietary shifts towards a Westernized diet, ultimately leading to altered gut microbiota and disturbance in intestinal immunity and the metabolome. Multiple clinical studies in children with CD have demonstrated the high efficacy of nutritional therapy with exclusive enteral nutrition (EEN) to induce remission with an excellent safety profile. However, EEN is poorly tolerated, limiting its compliance and clinical application. This has spiked an interest in the development of alternative and better-tolerated nutritional therapy strategies. Several nutritional therapies have now been designed not only to treat the nutritional deficiencies seen in children with active CD but also to correct dysbiosis and reduce intestinal inflammation. In this review, we report the most recent insights regarding nutritional strategies in children with active CD: EEN, partial enteral nutrition (PEN), Crohn’s disease exclusion diet (CDED), and CD treatment-with-eating diet (CD-TREAT). We describe their setup, efficacy, safety, and (dis)advantages as well as some of their potential mechanisms of action and perspectives. A better understanding of different nutritional therapeutic options and their mechanisms will yield better and safer management strategies for children with CD and may address the barriers and limitations of current strategies in children.

Exposure to varied cage-size habitats alters pain sensitivity and inflammation-related biomarkers

2020 ◽  
Author(s):  
Aboyeji Lukuman OYEWOLE ◽  
Kehinde Olumide OYAFEMI ◽  
Kolade Samson BADMUS ◽  
Janet Omotola OMOLEYE ◽  
Midrar Folahanmi ABUBAKAR ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Glucose Metabolism ◽  
Pain Sensitivity ◽  
False Negative ◽  
Inflammatory Conditions ◽  
Cage Size ◽  
Profile Changes ◽  
Varied Size ◽  
Cage Migration ◽  
Positive Results

Abstract Background Nature and size of rodent cages vary from one laboratory or country to another. Little is however known about the physiological implications of exposure to diverse cage sizes in animal-based experiment. Here, we exposed male Swiss mice to various cage sizes used across laboratories in Nigeria, top-rated paradigms were used to profile changes in physiological behaviours, and this was followed by evaluation of modified biochemical metrics. Results The study showed a better systemic regulation of glucose metabolism in cage migrated mice compared to cage stationed. Strikingly, peripheral oxidative stress and pain sensitivity decreased significantly in cage-to-cage migrated mice despite increased pro-inflammation mediators (IL-6 and NF-κB) which contrast the norm reported in inflammatory conditions. Interestingly, emotion-linked behaviours, neurotransmitters (serotonin, noradrenaline and GABA) and body electrolytes were not altered by cage-to-cage migration. Conclusion Taken together, these results suggest that varied size cage-to-cage migration of experimental mice could affect targeted behavioural and biomolecular parameters of pain and inflammation, thus diminishing research reproducibility, precipitating false negative/positive results and leading to poor translational outcomes.

Dietary fat source alters hepatic gene expression profile and determines the type of liver pathology in rats overfed via total enteral nutrition

2012 ◽  
Vol 44 (22) ◽  
pp. 1073-1089 ◽  
Author(s):  
M. J. J. Ronis ◽  
J. N. Baumgardner ◽  
J. C. Marecki ◽  
L. Hennings ◽  
X. Wu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Gene Expression ◽  
Fatty Acid ◽  
Enteral Nutrition ◽  
Olive Oil ◽  
Dietary Fat ◽  
Hepatic Gene Expression ◽  
Affymetrix Array ◽  
Array Analysis ◽  
Total Enteral Nutrition

To determine if dietary fat composition affects the progression of nonalcoholic fatty liver disease (NAFLD), we overfed male Sprague-Dawley rats low (5%) or high (70%) fat diets with different fat sources: olive oil (OO), corn oil (CO), or echium oil (EO), with total enteral nutrition (TEN) for 21 days. Overfeeding of the 5% CO or 5% EO diets resulted in less steatosis than 5% OO ( P < 0.05). Affymetrix array analysis revealed significant differences in hepatic gene expression signatures associated with greater fatty acid synthesis, ChREBP, and SREBP-1c signaling and increased fatty acid transport ( P < 0.05) in the 5% OO compared with 5% CO group. The OO groups had macrosteatosis, but no evidence of oxidative stress or necrosis. The 70% CO and 70% EO groups had a mixture of micro- and macrosteatosis or only microsteatosis, respectively; increased oxidative stress; and increased necrotic injury relative to their respective 5% groups ( P < 0.05). Oxidative stress and necrosis correlated with increasing peroxidizability of the accumulated triglycerides. Affymetrix array analysis comparing the 70% OO and 70% CO groups revealed increased antioxidant pathways and lower expression of genes linked to inflammation and fibrosis in the 70% OO group. A second study in which 70% OO diet was overfed for 50 days produced no evidence of progression of injury beyond simple steatosis. These data suggest that dietary fat type strongly influences the progression of NAFLD and that a Mediterranean diet high in olive oil may reduce the risk of NAFLD progressing to nonalcoholic steatohepatitis.

Stability of Results of Treatment and Therapeutic Compliance of Patients with Organic Non-psychotic Mental Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S716-S716
Author(s):  
V. Rudnitsky ◽  
V.B. Nikitina ◽  
M.M. Axenov ◽  
N.P. Garganeeva ◽  
E.D. Schastnyy
Keyword(s):  
Mental Disorders ◽  
Educational Approach ◽  
Social Approach ◽  
Results Of Treatment ◽  
Organic Mental Disorders ◽  
Cognitive Disturbances ◽  
Organic Process ◽  
Competing Interest ◽  
Unrealistic Expectations ◽  
Positive Results

IntroductionNon-psychotic mental disorders of organic register tend to have protracted progressive course, to respond poorly to treatment. Traditionally it is explained by features of cerebral-organic process. However, affective, behavioural and cognitive disturbances can be complicated by medico-social problems including treatment-related.ObjectiveTo analyse efficiency and stability of results of the therapy of organic mental disorders and propose approaches and means of their improvement.MethodsClinical-psychopathological, epidemiological, clinical-dynamic, catamnestic, experimental-psychological, medical statistics.ResultsThe most frequent causes of decompensations of organic mental disorders in patients with positive results of the therapy were analyzed. Sixty-four percent (58 patients) after 6 months showed partial recurrence of symptoms and after a year the condition practically returned to the initial one. However, only 12.22% (11 patients) passed recommended course of maintenance therapy to sufficiently full extent, 23.33% (21 persons) have discontinued it due to subjective causes during a month after discharge, about 2/3 of patients during the first two months of the therapy. Patients showed low indicators of therapeutic compliance, low level of therapeutic alliance, little familiarity with the illness and treatment and unrealistic expectations about prospects of the therapy. During insignificant difficulties in the therapy, it usually was discontinued and renewed during relapse of symptoms. A medico-social approach with support of psychotherapeutic and psycho-corrective work and information educational programs were developed.ConclusionProposed psychotherapeutic and educational approach heightens efficiency and stability of treatment and can serve a basis for further improvement of psychiatric, psychotherapeutic and medico-social assistance for patients with organic mental disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Acute oral and inhalation thallium poisonings and their remote consequences (literature review and data from our own research)

2020 ◽  
Vol 88 (1) ◽  
pp. 67-78 ◽  
Author(s):  
G.M. Balan ◽  
A.G. Bogomol ◽  
P.G. Zhminko ◽  
N.M. Bubalo ◽  
V.O. Bubalo ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Clinical Manifestations ◽  
Acute Poisoning ◽  
Toxic Effects ◽  
Analytical Determination ◽  
Biological Media ◽  
Scientific Analysis ◽  
Dermatological Disorders ◽  
Thallium Compounds

Aim of the Research. To generalize modern literature data on the toxicity of thallium compounds (Tl+), the mechanisms of their toxic effects and to analyze the prevalence of acute Tl+ poisonings in recent years abroad and in Ukraine. Compare the features of the clinical manifestations and outcome of Tl+ intoxications with the dose received and the content of Tl+ in biological media. Methods and Materials. A scientific analysis of literature data and our own observations on the prevalence, characteristics of clinical manifestations and outcomes of acute poisoning with thallium compounds was carried out. Results. An increase in the prevalence of single and group cases of acute Tl+ poisoning in recent years both abroad and in Ukraine has been revealed. It was established that among the clinical manifestations of Tl+ poisoning, neurological disorders, gastrointestinal and dermatological symptoms predominate, the severity of which in most cases depends on the content of Tl+ in biological media, mainly in urine and nails. Conclusions. Diagnosis of acute Tl+ poisoning in most cases is delayed or posthumous. When combining previous gastrointestinal and dermatological disorders with painful paresthesias and ascending sensory and motor disorders of innervation in the lower and upper extremities, it is necessary to conduct a chemical-analytical determination of Tl in the patient’s biological media to exclude or confirm intoxication. Key Words: thallium, mechanisms of toxic effects, acute poisoning, diagnostics.

scholarly journals The Current State of Renal Replacement Therapy in the Treatment of Sepsis

2021 ◽  
Vol 18 (4) ◽  
pp. 80-89
Author(s):  
T. G. Kim ◽  
M. А. Magomedov ◽  
D. N. Protsenko ◽  
M. V. Zakharov ◽  
А. V. Marukhov ◽  
...  
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Results Of Treatment ◽  
Current State ◽  
Sepsis And Septic Shock ◽  
Positive Results ◽  
Organ Dysfunctions

Of all cases of acute kidney injury (AKI), 45-70% are associated with sepsis. Lethality in sepsis-associated AKI requiring renal replacement therapy (RRT) ranges from 40 to 50%, and in AKI combined with other organ dysfunctions - 60-80%. In order to improve the results of treatment of sepsis and septic shock, various methods of extracorporeal detoxification (ECD) have been developed. The effectiveness of these methods is controversial. In the treatment of sepsis, RRT is used not only to replace the impaired detoxification function of kidneys, but also to remove excess cytokines from the systemic bloodstream. The literature describes mainly positive results of the use of dialyzers with an adsorbing membrane, however, these data do not have the necessary degree of evidence. Currently, there are no clear criteria for the initiation of RRT, its duration and doses, the choice of methodology determined by specific clinical and laboratory parameters, and staging of this therapy. All this highlights the need for further research in this field.

scholarly journals Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy

2020 ◽  
Vol 66 (9) ◽  
pp. 1241-1246
Author(s):  
Amanda Coelho Ribeiro ◽  
Diana Borges Dock-Nascimento ◽  
João Manoel Silva Jr. ◽  
Cervantes Caporossi ◽  
José Eduardo de Aguilar-Nascimento
Keyword(s):  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutritional Therapy ◽  
Tertiary Hospital ◽  
Serum Phosphorus ◽  
Refeeding Syndrome ◽  
Before And After ◽  
Phosphorus Levels

Summary OBJECTIVE: To investigate the prevalence of hypophosphatemia as a marker of refeeding syndrome (RFS) before and after the start of nutritional therapy (NT) in critically ill patients. METHODS: Retrospective cohort study including 917 adult patients admitted at the intensive care unit (ICU) of a tertiary hospital in Cuiabá-MT/Brasil. We assessed the frequency of hypophosphatemia (phosphorus <2.5mg/dl) as a risk marker for RFS. Serum phosphorus levels were measured and compared at admission (P1) and after the start of NT (P2). RESULTS: We observed a significant increase (36.3%) of hypophosphatemia and, consequently, a greater risk of RFS from P1 to P2 (25.6 vs 34.9%; p<0.001). After the start of NT, malnourished patients had a greater fall of serum phosphorus. Patients receiving NT had an approximately 1.5 times greater risk of developing RFS (OR= 1.44 95%CI 1.10-1,89; p= 0.01) when compared to those who received an oral diet. Parenteral nutrition was more associated with hypophosphatemia than either enteral nutrition (p=0,001) or parenteral nutrition supplemented with enteral nutrition (p=0,002). CONCLUSION: The frequency of critically ill patients with hypophosphatemia and at risk for RFS on admission is high and this risk increases after the start of NT, especially in malnourished patients and those receiving parenteral nutrition.

scholarly journals OSTEOSYNTHESIS OF THE SPINE AT PATHOLOGICAL FRACTURES AGAINST THE BACKGROUND OF EXTENSIVE METASTATIC SPREAD IN COMBINATION WITH RADIO- AND CHEMOTHERAPY

2010 ◽  
Vol 16 (1) ◽  
pp. 14-20
Author(s):  
R. M. Tikhilov ◽  
D. Ph. Karagodin ◽  
D. A. Ptashnikov ◽  
D. V. Usikov ◽  
Sh. Sh. Magomedov
Keyword(s):  
Metastatic Spread ◽  
Cannulated Screws ◽  
Pathological Fractures ◽  
Results Of Treatment ◽  
Syndrome Scale ◽  
Sf 36 ◽  
Life Scale ◽  
Painful Syndrome ◽  
Positive Results

The results of the stabilizing spine osteosynthesis in 82 patients with extensive metastatic spread are presented. Patients have been distributed to 3 groups: in I group the extended osteosynthesis of a spine without application cement vertebroplasty was carried out, in II group the extended spine osteosynthesis was performed, but with performance vertebroplasty through cannulated screws, in III group the limited osteosynthesis with cement vertebroplasty through cannulas screws was applied. Results of treatment were estimated considering spine support ability, elimination of a painful syndrome (scale of pain McAfee, 1989) and neurologic dysfunctions (scale ASIA/IMSOP, 1992), improvement of quality of a life (scale SF-36). The received positive results of treatment allow to conclude that tactics of treatment has been chosen correctly.

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