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    Tytuł:
    Peroksydacja lipidów w mieszaninach do żywienia pozajelitowego - czynniki pro- i antyoksydacyjne oraz ich znaczenie kliniczne.
    Lipid peroxidation in parenteral nutrition admixtures - prooxidative and antioxidative factors, as well as their clinical significance
    Autorzy:
    Brniak, Witold
    Jachowicz, Renata
    Powiązania:
    https://bibliotekanauki.pl/articles/762661.pdf
    Data publikacji:
    2019-12-29
    Wydawca:
    Polskie Towarzystwo Farmaceutyczne
    Tematy:
    neonatologia
    fototerapia
    peroksydacja
    żywienia pozajelitowe
    worki wielowarstwowe
    emulsja tłuszczowa
    ochrona przed światłem
    Lipid emulsion
    phototherapy
    Neonatology
    parenteral nutrition
    peroxidation
    multilayer bags
    light protection
    Opis:
    Parenteral nutrition (PN) is a therapy used for over 50 years in a wide variety of clinical conditions in which oral or enteral feeding is impossible, insufficient or contraindicated. Due to the complex nature of the admixtures composition, they should always be prepared under the supervision of a trained pharmacist in a properly equipped parenteral nutrition unit of hospital pharmacy. PN is a high-alert medication, which means that it can place patients at risk for significant harm when used in error, and even small errors can cause serious outcomes, including death. Parenteral nutrition admixtures contain dozens of active substances and excipients, and their preparation is associated with a high risk of interactions and instabilities. Despite many years of research, the role of individual factors affecting the stability of the mixture is still not fully understood. The major risk includes precipitation of calcium phosphate, aggregation of lipid emulsion droplets, and separation of its phases. Also many chemical reactions can take place during storage and administration. They can be affected by the storage temperature and time, composition of the admixture, particularly the type of lipid emulsion, addition of trace elements, and vitamins. What is more, the exposure to oxygen and light can cause formation of peroxides and other degradation products that can be harmful for the patients, particularly neonates, because their limited antioxidant reserves. Numerous in vitro an in vivo studies described many different methods of limiting peroxidation process in parenteral nutrition admixtures, including protection from light by covering admixture bag or syringe with polymer foil, as well as using dark color tubing to deliver PN. It was showed that peroxidation process can be also limited by using multilayer bags, impermeable to oxygen. In most studies, addition of multivitamins to admixture has protective effect on lipids, due to antioxidative properties of ascorbic acid and tocopherols, but in some studies the effect was opposite. It was caused by the reaction of light-induced riboflavin with ascorbates, thus the light protection seems to have the major importance. The aim of this review is to present available data on factors stimulating and inhibiting the process of peroxidation in parenteral nutrition admixtures, their importance for the health of nutritionally treated patients, as well as to describe the current guidelines on proper methods of protection of admixtures from peroxidation process.
    Żywienie pozajelitowe jest terapią stosowaną od ponad 50 lat w wielu różnych sytuacjach klinicznych, w których podaż pokarmu drogą doustną lub dojelitowo jest niemożliwa, niewystarczająca lub przeciwskazana. Bezpieczeństwo leczenia żywieniowego zależne jest od wielu czynników, a złożoność składu mieszaniny powoduje, że powinno być zawsze sporządzane pod nadzorem wyszkolonego farmaceuty w odpowiednio wyposażonej pracowni żywienia pozajelitowego. Pomimo wieloletnich badań, rola poszczególnych czynników wpływających na stabilność mieszaniny pozostaje nadal nie do końca poznana. Najistotniejsze z nich, poza samym składem mieszaniny, to dodatek pierwiastków śladowych, witamin, temperatura i okres przechowywania, narażenie na tlen i promieniowanie świetlne. Ich rola może być szczególnie istotna w przypadku mieszanin przeznaczonych dla pacjentów neonatologicznych, bowiem wrażliwość noworodków na produkty peroksydacji jest znacznie większa niż w przypadku dorosłych. Celem pracy jest przedstawienie dostępnych danych dotyczących czynników stymulujących oraz hamujących proces peroksydacji w mieszaninach do żywienia pozajelitowego, ich znaczenia dla zdrowia pacjentów leczonych żywieniowo, a także opis aktualnych wytycznych na temat środków zabezpieczających mieszaniny przed peroksydacją.
    Źródło:
    Farmacja Polska; 2019, 75, 11; 638-647
    0014-8261
    2544-8552
    Pojawia się w:
    Farmacja Polska
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Quality of life of patients on chronic parenteral nutrition before and after gastrointestinal tract continuity restoration
    Autorzy:
    Ławiński, Michał
    Kot-Mielczarska, Edyta
    Gradowska, Aleksandra
    Powiązania:
    https://bibliotekanauki.pl/articles/1395598.pdf
    Data publikacji:
    2015-04-01
    Wydawca:
    Index Copernicus International
    Tematy:
    quality of life
    parenteral nutrition
    stoma
    Opis:
    The issue of the quality of life considering patients with a temporary or permanent intestinal stoma, as well as the necessity for chronic parenteral nutrition at home remain a poorly understood problem. Daily care of the intestinal stoma and the need to comply with sterile procedures required for parenteral nutrition require such patients to commit their time, which secondarily is associated with the broad aspects of social and personal life. The aim of the study was to analyse the quality of life considering patients with intestinal stomas subjected to chronic parenteral nutrition, before and after gastrointestinal tract continuity restoration. Material and methods. The survey was conducted between May and July, 2014 on a group of 71 patients (33 female and 38 male) who were under the care of the Department of General Surgery and Clinical Nutrition, Warsaw Medical University, operated during the period between 2007 and July, 2014 with a present stoma (32 patients - 45%), as well as after stoma closure (39 patients - 55%). The analysed questionnaire contained 31 questions, and the SF-36 questionnaire was additionally used, determining the quality of life. Results. Analysis of the study material showed differences in the quality of life, considering three most important determinants. Significantly worse assessment of the quality of life was reported by patients with a stoma and subject to intravenous nutrition (83.2±30.5), as compared to those after stoma closure subject to normal nutrition (52.3±33.8). Based on the SF-36 questionnaire differences between patients with a stoma and those without amounted to t(69)=2.84 (p=0.006) demonstrating that those with a stoma reported a lower quality of life. Analysis between younger and older patients, based on the SF-36 questionnaire (t(62.87)=2.49; p=0.016) showed that younger patients achieved lower results, considering dissatisfaction with life (61.55±27.5), as compared to the elderly (80.8±36.9). Conclusions. The group of patients without a stoma seem to be more independent- the vast majority do not use the help of family members (43.6%), or friends (64.1%). Patients with a stoma more often withdraw from social life. The factor that mostly reduces the quality of life is the presence of a stoma, which impairs daily functioning a lot more than the sterile procedures associated with parenteral nutrition. All patients after stoma closure consider that their overall functioning has significantly improved.
    Źródło:
    Polish Journal of Surgery; 2015, 87, 4; 153-159
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The Efficacy of Alcohol-Antibiotic Lock Therapy for Treatment of Catheter Related Bloodstream Infections in Patients Receiving Home Parenteral Nutrition
    Autorzy:
    ławiński, Michał
    Majewska, Krystyna
    Fołtyn, Iwona
    Gradowska, Aleksandra
    Powiązania:
    https://bibliotekanauki.pl/articles/1395998.pdf
    Data publikacji:
    2015-03-01
    Wydawca:
    Index Copernicus International
    Tematy:
    home parenteral nutrition
    alcohol-antibiotic lock therapy
    catheter related bloodstream infections
    Opis:
    In patients with chronic gastrointestinal tract failure, requiring access to the venous system, the subsequent catheter re-insertion are leading to large veins thrombosis impeding or preventing the insertion of another catheter and exposing patients to the risk of complications. Understanding the pathophysiology of catheter-related infections, enabled to use methods allowing to eradicate the source of infection without removal and replacement of central catheter with a new one. In our center, for many years we have been using an alternative method involving implementation of the alcohol-antibiotic lock in the treatment of infections. This method is based on the assumption that the destruction of biofilm with concentrated alcohol will enable antibiotic penetration and killing other microorganisms. Treatment with alcohol-antibiotic lock lasts from 8 to 10 days and involves filling the catheter with 96% alcohol followed by a solution of the antibiotic of high concentration. The aim of the study was to evaluate the efficacy of treatment of catheter-related bloodstream infections with two methods (catheter replacement with a new one and the alcohol-antibiotic lock therapy) in patients receiving home parenteral nutrition (HPN). Material and methods. 428 HPN in the period from 1 January 2005 to 31 December 2010. Among which 240 (56%) of women with an average age of 56.5±16 years and 188 (44%) of men with an average age of 54±17 years. The indications to HPN were as follows: short bowel syndrome in 298 (70%) patients, multilevel obstruction of the gastrointestinal tract in 52 (12%), postoperative gastrointestinal fistulas in 48 (11.2%), malabsorption syndrome in 17 (4%), motility disorders in 6, cachexia in 4 and radiation enteritis in 3 patients. Results. In 247 (57.5%) from 428 patients, no episode of catheter-related bloodstream infection was found, while 181 were diagnosed with 352 episodes of catheter-related bloodstream infections. In 40 (9.4%) from 428 patients, 168 (47.8%) episodes have been found - almost a half. The mean duration of treatment of patients receiving home parenteral nutrition, starting from the first episode of catheterrelated bloodstream infection, in 48 patients treated with the lock was equal to 1053+748 days, and in 133 patients treated with catheter replacement was equal to 952+709 days (t-test p = 0.62). Conclusions. The survival time of patients treated with alcohol-antibiotic lock is the same as in patients treated with the catheter removal and insertion of the new one. The use of alcohol-antibiotic lock to treat catheter-related bloodstream infections in order to eradicate selected microorganisms that colonize the lumen and cause an infection, is as effective as catheter replacement with a new one.
    Źródło:
    Polish Journal of Surgery; 2014, 86, 12; 563-568
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Evaluation of factors associated with the nutritional mixture leading to liver complications in patients treated by means of parenteral nutrition at home
    Autorzy:
    Matras, Przemysław
    Żuchowska, Katarzyna
    Banakiewicz, Katarzyna
    Bobak, Adam
    Jajko, Krzysztof
    Szypowski, Roman
    Zalewski, Grzegorz
    Zieliński, Paweł
    Rudzki, Sławomir
    Powiązania:
    https://bibliotekanauki.pl/articles/1396531.pdf
    Data publikacji:
    2013-12-01
    Wydawca:
    Index Copernicus International
    Tematy:
    hepato-billiary complications
    long-term parenteral nutrition
    Opis:
    The major problem of total parenteral treatment consists in the balancing of the source and dose of the nutritional mixture, so as to not deepen malnutrition with a positive impact on the patients’ organism. The aim of the study was to evaluate selected factors that induce hepato-billiary complications in patients treated by means of parenteral nutrition at home. Material and methods. The retrospective study comprised 70 patients with biochemistry performed every three months. Considering statistical analysis patients were allocated to four groups, depending on the period of treatment. Group A analysis results were based on the activity of aminotransferases, group B on the activity of bilirubin. Both groups A and B were additionally divided into group I where we assigned normal values of control lab results, and group II with improper results after treatment. Results. Differences between groups Ia vs IIa were presented on the basis of the daily supply of glucose: mean- 2.52 vs 3.49 g/kg (p=0.000003), glucose/lipids ratio: mean- 3.76 vs 4.90 g/kg (p=0.0001), daily non-protein energy: mean- 16.73 vs 21.06 kcal/kg (p=0.0001). Differences between groups Ib vs IIb were presented on the basis of the daily supply of glucose: mean- 2.76 vs 3.46 g/kg (p=0.0007), glucose/lipids ratio: mean- 3.98 vs 5.13 g/kg (p=0.01), daily non-protein energy: mean-17.96 vs 20.36 kcal/kg (p=0.04). Based on the above-mentioned analysis the main goal in the prevention of hepatic complications should lead to the reduction of the dose of glucose. Increased glucose supply leads to increased number of hepato-billiary complications. Conclusions. Based on obtained results we were able to conclude that in case of liver complications associated with parenteral nutrition, proper management consists in the modification of nutritional mixtures (reduction in the daily glucose supply and change in the proportions of extra-protein energy). Such management has the greatest clinical effect. When determining the composition of the nutritional mixture one should adjust the glucose supply, so as to offset both sources of extra-protein energy
    Źródło:
    Polish Journal of Surgery; 2013, 85, 12; 681-686
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Activity of alpha-fucosidase and beta-glucuronidase in serum and urine of patients administered parenteral nutrition
    Autorzy:
    Raczkowska, K.
    Szajda, S.D.
    Raczkowski, K.
    Zasadowska, W.
    Chojnowska, S.
    Kepka, A.
    Zalewska-Szajda, B.
    Waszkiewicz, N.
    Knas, M.
    Snarska, J.
    Zwierz, K.
    Ladny, J.R.
    Powiązania:
    https://bibliotekanauki.pl/articles/874170.pdf
    Data publikacji:
    2013
    Wydawca:
    Narodowy Instytut Zdrowia Publicznego. Państwowy Zakład Higieny
    Tematy:
    alpha-fucosidase
    beta-glucuronidase
    serum
    urine
    patient
    parenteral nutrition
    malnutrition
    enzyme activity
    Opis:
    Background. In hospital patients suffering from adverse clinical and biochemical symptoms of malnutrition, it is often necessary to employ parenteral nutrition to avoid the body’s tissue becoming broken down by being metabolised. Thus, the patient’s welfare and survival can be supported throughout any periods of medical crisis. Two of the enzymes responsible for metabolising glycoconjugates are a-fucosidase (FUC) and p-glucuronidase (GLU), present in lysosomes. They release fucose or glucuronic acid from the non-reducing end of oligosaccharide chains. Objective. To determine the effect of parenteral nutrition administered to ill patients, on glycoconjugate metabolism, by measuring serum and urinary activities of FUC and GLU. Material and methods. Blood samples and the daily urine collection were taken from 23 patients’ who had been undergoing parenteral nutrition for either 5 or 10 days, as well as from a baseline sample. Enzyme activities in serum and urine were determined by the method of Zwierz et al. Results. Serum FUC activities were significantly lower after 10 days compared to 5, (p< 0.0172), whereas GLU activities were significantly lower after both 5 and 10 days, (p< 0.0007 and p< 0.0208 respectively), compared to levels before starting parenteral nutrition. GLU activities were however higher after 10 days than those after 5 days, (p< 0.0023). In urine, FUC activities were significantly decreased after 10 days compared to 5 days after starting parenteral nutrition, (p< 0.0245). Urine GLU activities were unaffected by parenteral nutrition nor was any effect seen on FUC or GLU activities when calculated per 1mg creatinine. Conclusions. Serum FUC and GLU activities can be used for assessing the effect of parenteral nutrition on glycoconjugate metabolism. The significant decreases of serum GLU activity observed after 5 and 10 days, may serve to indicate that the components of parental nutrition are appropriate and that the body has become suitably adapted to this form of nutrition.
    Wprowadzenie. Kliniczne lub biochemiczne objawy niedoborów pokarmowych stwarzają konieczność wdrożenia żywienia pozajelitowego w celu ograniczenia katabolizmu własnych tkanek i stworzenia warunków umożliwiających choremu przetrwanie krytycznego okresu, a-fukozydaza (FUC) i P-glukuronidaza (GLU) są enzymami lizosomalnymi uczestniczącymi w katabolizmie glikokoniugatów. Odcinają fukozę (FUC) lub kwas glukuronowy (GLU) od nieredukującego końca łańcuchów oligosacharydowych. Cel . Celem badań było zbadanie wpływu żywienia pozajelitowego na katabolizm glikokoniugatów poprzez ocenę aktywności FUC i GLU w surowicy krwi i moczu chorych żywionych pozajelitowo. Materiał i metody. Krew z żyły łokciowej oraz mocz z dobowej zbiórki pobrano od 23 pacjentów żywionych pozajelitowo trzykrotnie: przed rozpoczęciem żywienia pozajelitowego, w piątej oraz dziesiątej dobie alimentacji dożylnej. Aktywność FUC i GLU w surowicy krwi i moczu oznaczano metodą kolorymetryczną Zwierza i wsp. Wyniki. W trakcie żywienia pozajelitowego, stężenie aktywności FUC w surowicy krwi uległo istotnemu obniżeniu w dziesiątej dobie (p<0,0172), w porównaniu do doby piątej, żywienia pozajelitowego. Stężenie aktywności GLU istotne obniżyło się (p<0,0007) w piątej oraz (p<0,0208) dziesiątej dobie, w porównaniu do aktywności przed zastosowaniem żywienia pozajelitowego. Stężenie aktywności GLU istotnie rosło (p<0,0023) w dziesiątej dobie, w porównaniu do piątej doby żywienia pozajelitowego. Stężenie aktywności FUC w moczu uległo istotnemu obniżeniu (p<0,0245) w dziesiątej dobie, w porównaniu do piątej doby żywienia pozajelitowego. Żywienie pozajelitowe nie wpływa istotnie na stężenie aktywności GLU w moczu oraz moczowe aktywności FUC i GLU przeliczane na 1 mg kreatyniny. Wnioski. Stężenia aktywności FUC i GLU w surowicy mogą być użyte do oceny wpływu żywienia pozajelitowego na katabolizm glikokoniugatów. Istotne obniżenie aktywności GLU w surowicy krwi w 5 i 10 dniu pozajelitowego żywienia, może świadczyć o prawidłowym doborze składników i adaptacji organizmu do żywienia pozajelitowego.
    Źródło:
    Roczniki Państwowego Zakładu Higieny; 2013, 64, 3
    0035-7715
    Pojawia się w:
    Roczniki Państwowego Zakładu Higieny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Results of home parenteral nutrition in patients with severe inflammatory bowel disease – an alternative for surgery of malnourished patients
    Autorzy:
    Turkot, Maryla
    Sobocki, Jacek
    Powiązania:
    https://bibliotekanauki.pl/articles/1393286.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    home parenteral nutrition
    inflammatory bowel disease
    nutrition
    Crohn’s disease
    colitis ulcerosa
    Opis:
    Introduction: In the world, the inflammatory bowel disease affects an increasing number of younger and younger patients, and in some of them parenteral nutrition is an alternative to high-risk surgical intervention due to advancement of the disease and malnutrition. Aim: The aim of the study was to assess the results of home parenteral nutrition in patients with severe bowel inflammatory disease, in whom surgical treatment is associated with high risk of complications. Materials and methods: A retrospective analysis was conducted on 46 patients, who received home parenteral nutrition instead of another surgical intervention. The inclusion criteria included home parenteral nutrition and diagnosis of Crohn’s disease or ulcerative colitis. Results: Mean number of complications requiring hospital admission per patient was 1.76, the BMI increased by 4.3 on average [kg/m2]. During parenteral nutrition, the percentage of patients, in whom anti-inflammatory or immunosuppressant drugs were completely discontinued, was 17.4%. In the whole group, at least one immunosuppressive drug was discontinued in onefifth of patients. Mean albumin level increased by 2.4 g/L, lymphocyte count dropped by 474 lymphocytes/mm3, and leukocyte count increased by 747.6/mm3. The patients described their condition as good in 87%, and 7.4% of patients were able to work. Conclusions: Home parenteral nutrition positively affects patient’s general condition by increasing BMI and normalizing biochemical test results. The results indicate the need to consider this method as an alternative to surgical intervention in severe bowel inflammatory disease with high perioperative risk, which could reduce the complication rate.
    Źródło:
    Polish Journal of Surgery; 2017, 89, 5; 23-28
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
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