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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nutritional status and its relation to respiratory function and respiratory muscle strength were assessed in patients with pulmonary emphysema. Energy metabolism was also examined in order to elucidate the mechanism of their malnutrition. BCAA/AAA ratio of plasma amino acid was positively correlated with FEV1.0%. Resting energy expenditure (REE) was negatively correlated with FEV1.0%, and REE/REEpred ratio was also negatively correlated with BCAA/AAA and PImax. These findings suggest that increased mechanical work load, associated with airway obstruction and reduced respiratory muscle efficiency, contribute to the increased energy expenditure and amino acid imbalance. Oral nutritional supplementation using BCAA enriched-elemental diet was found to be effective, as assessed by nutritional parameters, PImax, D.O.E., and QOL index, in malnourished emphysema patients.
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PMID:[Nutritional assessment and the effect of supplementary oral nutrition in patients with pulmonary emphysema]. 143 21

Resting energy expenditure (REE) was assessed and its relationship to nutritional status, pulmonary function and respiratory muscle function was studied in 25 patients with pulmonary emphysema. The mean value of REE was 1413 +/- 251 Cal and the ratio of REE/REEpred was 1.398 +/- 0.23, suggesting the existence of a hypermetabolic state in these patients. REE/REEpred ratio was inversely correlated with plasma amino acid BCAA/AAA ratio and body muscle mass; and PImax. REE was inversely correlated with FEV1.0%. REE in the patient subgroup with severe hyperinflation (%RV > or = 200) was significantly higher than that in the subgroup with moderate hyperinflation. Malnourished patients showed significantly more severe hyperinflation than well-nourished patients. These findings suggest that augmented REE contributes to malnutrition in patients with emphysema, and that the increase in REE was related to the increase in mechanical work load on the basis of airway obstruction, respiratory muscle weakness and hyperinflation.
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PMID:[Relation of airway obstruction and respiratory muscle weakness to energy metabolism in pulmonary emphysema]. 144 42

We assessed nutritional status in 30 patients with pulmonary emphysema and 60 healthy controls. The relationship between nutritional status, pulmonary function and respiratory muscle function was also studied. Anthropometric measures, visceral proteins such as PA and RPB, and the Fischer ratio (BCAA/AAA), an index of imbalance of amino acids were significantly lower in the patients. The incidence of moderately malnourished patients with less than 80% of IBW was 40%. The incidence of hyporetinol-binding protein was 40%. 48% of the patients were found to show an amino acid imbalance. These findings suggested that protein-energy malnutrition in association with amino acid imbalance occurred commonly in patients with pulmonary emphysema. FEV1% correlated significantly with some anthropometric indices and the Fischer ratio. Respiratory muscle function, assessed by P1 max, correlated significantly with some anthropometric indices and grasp strength. These results suggested that the degree of airway obstruction and respiratory muscle function was associated with malnutrition characterized by the reduction of the Fischer ratio.
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PMID:[Nutritional assessment of chronic pulmonary emphysema and the significant relation of malnutrition to pulmonary function and respiratory muscle function]. 221 86

The evaluation of nutrition in patients who are candidates for liver transplants often indicates the presence of a state of malnutrition with regard to calories and proteins, which may lead to posterior complications. The transplant reverts the metabolic alterations in cases of good evolution, and there is evidence of a correct hepatic treatment of amino acids in the studies performed. Thus, this group of patients may be treated with a similar nutritional support to that indicated in other types of critical patients. On the other hand, in patients with an unfavourable evolution of the graft, the use of nutritional formulae that take into account an increase in the BCAA/AAA ratio is indicated. However, the high level of metabolic stress in the immediate postoperative period and the need for substrata to favour hepatic regeneration seem to indicate the need for early, aggressive nutritional treatment, which should be accompanied by a correct evaluation of its effect on postoperative evolution.
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PMID:[Nutrition in the liver transplant]. 248 53

Although epidemiological studies have shown that malnutrition is associated with the reactivation and development of pulmonary tuberculosis, little is known about their nutritional status. We studied comprehensive profile of their nutritional status. We also studied the effects of malnutrition on cell-mediated immunity in tuberculosis patients. Nutritional status was assessed by anthropometric measurements and biochemical examinations, and cell-mediated immunity was evaluated by delayed-type hypersensitivity (DTH) reaction, lymphocyte transformation and natural killer (NK) activity in 47 patients with active pulmonary tuberculosis and 47 healthy controls. Cytokine production including IL-2, IL-1 was also examined. Anthropometrics and visceral proteins were significantly lower in tuberculosis patients. Fischer ratio (BCAA/AAA), an index of plasma amino acids imbalance, was significantly (p less than 0.01) lower in the patients. DTH to 2, 4-dinitrochlorobenzene and lymphocytes transformation were attenuated in the patients. NK activity was reduced in patients with severe pulmonary tuberculosis. The patient subgroup with reduced DTH was more malnourished than another one with normal DTH. The Fischer ratio correlated significantly with lymphocyte transformation response and visceral proteins and BCAA correlated with NK activity. IL-2 production was remarkably reduced in the patient subgroup whose serum albumin was less than 3.5 g/dl. IL-1 production was remarkably reduced in the patient subgroup whose serum albumin was less than 2.5 g/dl. Patient subgroup whose serum albumin level was more than 2.5 g/dl and less than 3.5 g/dl, produced remarkably more IL-1 than those whose serum albumin was more than 3.5 g/dl. These results suggested that malnutrition characterized by the reduction of the Fischer ratio was associated with impairment of cell-mediated immunity and cytokine production in pulmonary tuberculosis.
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PMID:[Relation between malnutrition and cell-mediated immunity in pulmonary tuberculosis]. 281 Oct

Our findings indicate that serum amino acid changes after OLT are complex and influenced by multiple factors including sepsis and use of parenteral hyperalimentation with exogenous amino acids. Additional factors which may influence the rate of normalization of amino acids after OLT include the presence of malnutrition (frequently observed before OLT) and the extent of pretransplant portal-systemic shunting. Our results demonstrate that the presence of septic complications and the use of CPN are important determinants of the postoperative levels of several amino acids, including the BCAA/AAA ratio. Our logistic regression model using the BCAA/AAA ratio predicted the occurrence of sepsis after OLT 77% of the time. Prospective assessment and validation of this model is under way.
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PMID:Serum amino acids following human orthotopic liver transplantation. 847 Jan 62

Nutritional assessment was conducted in 30 patients with chronic, intractable pulmonary tuberculosis. More prevalent and severer protein-energy malnutrition was found in the chronic patients compared with that in newly-diagnosed, drug-sensitive tuberculous bacilli-excreting patients. Duration of excreting bacilli in 163 newly-diagnosed patients was found to be significantly associated with ChE, hypersensitivity reaction to PPD, lymphocytes transformation response to ConA before treatment. The grade of malnutrition was significantly associated with the reduction in delayed-type hypersensitivity response, ratio of CD4/CD8, IL-2 production by peripheral blood mononuclear cells and NK cell activity. Nutritional and immunological spectrum, which was classified with the combination of serum albumin level, hypersensitivity response to DNCB and NK cell activity, was significantly associated with clinical course and manifestations in patients with chronic, intractable pulmonary tuberculosis. TNF-alpha production by peripheral blood monocytes was significantly higher in moderately to mildly-malnourished tuberculous patients than that in healthy controls. TNF-alpha production in patients with severely-malnourished patients was significantly lower than that in healthy controls. Level in TNF-alpha production was inversely related with visceral proteins and the ratio of plasma amino acid BCAA/AAA. In conclusion these findings suggested that nutritional support should be taken in consideration in combination with conventional chemotherapy in treating chronic, intractable pulmonary tuberculosis.
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PMID:[Nutritional status and support in chronic intractable pulmonary tuberculosis]. 880 70

Weight loss is common in patients with chronic obstructive pulmonary disease (COPD). Comprehensive nutritional assessment was conducted in two large groups of patients with COPD who were enrolled in the Respiratory Failure Research Program sponsored by the Japanese Ministry of Health and Welfare and the Kinki COPD Research Group. The incidences of mild malnutrition (%IBW < 90%) were 74% and 62%, respectively. The incidences of hypoalbuminemia were low: 10.0% and 6.5%, respectively. The incidence of imbalance in plasma amino acids, which was defined as an abnormally low BCAA/AAA ratio, was as high as 93% in patients with COPD and chronic respiratory failure. The %IBW was significantly related to the FEV1 and to the DLco/VA. The moderately-malnourished subpopulation was characterized by a greater degree of hyperinflation and hypercapnea: the measured resting energy expenditure (REE) was significantly higher than the values in age-matched healthy controls. REE/REEpred was significantly and inversely related to BCAA/AAA and to Pimax. REE was inversely related to FEV1%. REE in the subgroup with severe hyperinflation was significantly higher than REE in those with milder hyperinflation. Among patients with an FEV1% of less than 50%, mortality tended to be higher in those with lower body weight, and this relationship was stronger in patients with an FEV1% of more than 50%. When patients were given a BCAA-enriched enteral formula in addition to their usual diet for 3 months, there was a significant increase in body weight, transferrin level, and Pimax.
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PMID:[Clinical benefit of nutritional assessment and support in patients with chronic obstructive pulmonary disease]. 921 90

BACKGROUND: In an elderly population of surgical patients, poor mobility, poor diet and chronic disease contribute to a significant risk of malnutrition. Malnutrition is associated with muscle weakness, fatigue, poor wound healing and immunological dysfunction. The aim of the study was to establish the prevalence of malnutrition in vascular surgical patients and to compare postoperative infection rates in well nourished and malnourished patients. METHODS: A nutritional assessment was performed on 71 patients (49 men; median age 65 (range 26-85) years) attending preassessment for vascular surgical procedures. Nutritional status was measured using validated indicators of malnutrition: estimated weight changes over 3 months; body mass index; mid-arm muscle circumference (MAMC) calculated using triceps skin fold thickness (TSF) and mid-arm circumference (MAC) (MAMC = MAC - (3.14 x TSF)); and serum albumin concentration. Fifty-nine patients were followed after vascular surgery. The incidence of postoperative infections was related to preoperative nutritional status. RESULTS: Nineteen patients (27 per cent) had normal values for all nutritional indicators examined. The remaining 52 patients (73 per cent) had one (37), two (12), three (two) or four (one) nutritional indicators within the range for malnutrition. Among the 59 patients who underwent surgery there were five chest infections, seven wound infections, one urinary tract infection and one infected central line in 13 patients following six femorodistal bypasses, four abdominal aortic aneurysm repairs and three miscellaneous arterial procedures. The incidence of septic complications was zero in 14 patients with normal nutritional indicators and 41 per cent (13 of 32) in patients with indicators of malnutrition (P < 0.05, Fisher's exact test). CONCLUSION: Malnutrition is prevalent among vascular patients and may contribute to postoperative morbidity. Malnourished patients should be identified and referred to the dietician at the earliest opportunity to minimize the morbid effects of undernutrition.
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PMID:Vascular surgical society of great britain and ireland: contribution of malnutrition to postoperative morbidity in vascular surgical patients 1036 Dec 8

The portacaval anastomosis (PCA) rat model and human cirrhosis have many metabolic and nutritional abnormalities in common, such as growth retardation, hepatic and gonadal atrophy, and hyperammonemia. The severity of these abnormalities is variable and may be related to a number of factors, including portal pressure, portosystemic shunting, dietary intake, and how efficiently food is used. Therefore, this rat model was used to study these variables with the intent of gaining insights for improving the management of portal hypertension and malnutrition in human cirrhosis. A nonsuture end-to-side PCA (N = 100) or sham surgery (N = 71) was performed in 100 male rats. Four weeks after surgery, body and organ weights, food intake, serum ammonia, and serum amino acids were measured at death. In a subgroup of rats, (sham 7; PCA 34) portal venous pressure, degree of portosystemic shunting, and organ and body weights were obtained at death. Growth, liver weight, and testes weight were decreased, ammonia levels were higher, and the ratios of branched chain to aromatic amino acid (BCAA/AAA) were lower in the PCA group compared to the sham animals (P < 0.05). Since spleen weights correlated with portal pressure (P = 0.01), the PCA animals were then divided into those with preserved and those with low portal pressures based on spleen weight. The PCA group with preserved portal pressure had better growth, larger livers and testes, lower serum ammonia, and higher BCAA/AAA levels than the PCA group with low portal pressure; improvements associated with normal amounts of food intake and better food efficiency than the low pressure animals (P < 0.05 or better). Sham animals had no portosystemic shunting, while 100% shunting occurred in both PCA groups regardless of the portal pressure. In conclusion, preservation of portal pressure after portacaval anastomosis provides metabolic and nutritional benefits, which are independent of portosystemic shunting and associated with normal dietary intake and better preserved food efficiency.
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PMID:Preservation of portal pressure improves growth and metabolic profile in the male portacaval-shunted rat. 1235 33


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