A case report of refractory congenital chylous ascites in infant – surgical treatment with Fibrin glue

Congenital chylous ascites is a rare disease that results from abnormal development of the intra-abdominal lymphatic system. No gold standard treatment has been described so far, however, a combination of medium–chain triglyceride based diet or total parenteral nutrition along with octreotide and abdominal paracentesis is considered as a conservative management. This treatment is often a challenge to physicians since chylous ascites is often refractory and result in malnutrition and immune deficiency because of the loss of proteins and lymphocytes. We report a four-month old boy with congenital chylous ascites who was refractory to medical treatment with prolonged bowel rest, total parenteral nutrition, octreotide and repeated paracentesis. The baby well responded to surgical treatment with application of fibrin glue on the surface area of the leak site and was discharged after 2 month of hospitalization. When following up the patient had no recurrence of the ascites and he was growing up normally.

The Effect of High Glucose Intake on Weight Gain in Very Low Birth Weight Neonates: A Randomized Controlled Trial

This study aims at evaluating the effect of high glucose intake as a component of total parenteral nutrition on birth weight (BW) regain in very low birth weight neonates. Ninety newborns with BW <1500 g were randomized to control or experimental groups. Both groups received the same total parenteral nutrition regimens except glucose intake provided by dextrose water (DW) serum: 7 to 15 g/kg/d (10% DW) in the former versus 8.75 to 18.75 g/kg/d (12.5% DW) in the latter. Body weight as the primary outcome was monitored until the BW was regained. Results revealed that neonates who received 12.5% DW regained BW significantly faster (10.98 ± 2.46 vs 13.24 ± 4.03 days, P = .024) and needed lesser duration of respiratory support (5.34 ± 2.11 vs 7.17 ± 3.19 days, P = .003). As the proposed intervention can reduce neonatal intensive care unit admission duration, it mitigates risks of health care−associated infections, while favorably affecting the health economy.

Efeitos da nutrição parenteral total associada à glutamina e da fluidoterapia enteral, associada ou não à glutamina, sobre os parâmetros hematológicos de equinos submetidos à inanição / Effects of total parenteral nutrition associated with glutamine and enteral fluid therapy, associated or not with glutamine, on the hematological parameters of horses subjected to starvation

Apetite diminuído ou incapacidade de alimentar-se são achados clínicos comuns em muitas enfermidades na espécie equina, levando rapidamente a desnutrição e comprometimento da função imune e reparação tecidual. Este estudo teve por objetivo avaliar os efeitos da nutrição parenteral total associada a glutamina ou fluidoterapia enteral, associada ou não à glutamina, sobre os parâmetros hematológicos de equinos submetidos à inanição. Foram utilizados 16 equinos adultos hígidos, sem raça definida, de ambos os sexos, quatro machos e 12 fêmeas, com idade variando entre quatro e 14 anos e peso corporal médio de 248,40 + 2,28 kg, divididos em quatro grupos, quatro animais por grupo: Grupo I (ENTGL): fluidoterapia enteral com eletrólitos associada a glutamina; Grupo II (PARGL): Nutrição parenteral total (NPT) associada a glutamina; Grupo III (ENTFL): fluidoterapia enteral com eletrólitos; Grupo IV (PARFL): fluidoterapia parenteral. Para a realização do hemograma, amostras de sangue foram colhidas por venopunção na jugular externa esquerda, em tubos a vácuo, contendo EDTA (sal dissódico do ácido etilenodiamino tetra-acético). O hemograma foi constituído do eritrograma e do leucograma. As amostras para realização da hematologia foram obtidas a cada 24 horas durante todo o período experimental, totalizando sete amostras. O delineamento experimental foi inteiramente ao acaso, em esquema fatorial 4x12 (grupos x tempo de colheita), para cada fase, e suas médias comparadas pelo teste de Duncan ao nível de 5% de significância. Não foram observadas alterações significativas para a maioria dos parâmetros avaliados.