597 research outputs found
Complications and Monitoring – Guidelines on Parenteral Nutrition, Chapter 11
Compared to enteral or hypocaloric oral nutrition, the use of PN (parenteral nutrition) is not associated with increased mortality, overall frequency of complications, or longer length of hospital stay (LOS). The risk of PN complications (e.g. refeeding-syndrome, hyperglycaemia, bone demineralisation, catheter infections) can be minimised by carefully monitoring patients and the use of nutrition support teams particularly during long-term PN. Occuring complications are e.g. the refeeding-syndrome in patients suffering from severe malnutrition with the initiation of refeeding or metabolic, hypertriglyceridemia, hyperglycaemia, osteomalacia and osteoporosis, and hepatic complications including fatty liver, non-alcoholic fatty liver disease, cholestasis, cholecystitis, and cholelithiasis. Efficient monitoring in all types of PN can result in reduced PN-associated complications and reduced costs. Water and electrolyte balance, blood sugar, and cardiovascular function should regularly be monitored during PN. Regular checks of serum electrolytes and triglycerides as well as additional monitoring measures are necessary in patients with altered renal function, electrolyte-free substrate intake, lipid infusions, and in intensive care patients. The metabolic monitoring of patients under long-term PN should be carried out according to standardised procedures. Monitoring metabolic determinants of bone metabolism is particularly important in patients receiving long-term PN. Markers of intermediary, electrolyte and trace element metabolism require regular checks
Carbohydrates – Guidelines on Parenteral Nutrition, Chapter 5
The main role of carbohydrates in the human body is to provide energy. Carbohydrates should always be infused with PN (parenteral nutrition) in combination with amino acids and lipid emulsions to improve nitrogen balance. Glucose should be provided as a standard carbohydrate for PN, whereas the use of xylite is not generally recommended. Fructose solutions should not be used for PN. Approximately 60% of non-protein energy should be supplied as glucose with an intake of 3.0–3.5 g/kg body weight/day (2.1–2.4 mg/kg body weight/min). In patients with a high risk of hyperglycaemia (critically ill, diabetes, sepsis, or steroid therapy) an lower initial carbohydrate infusion rate of 1–2 g/kg body weight/day is recommended to achieve normoglycaemia. One should aim at reaching a blood glucose level of 80–110 mg/dL, and at least a glucose level <145 mg/dL should be achieved to reduce morbidity and mortality. Hyperglycaemia may require addition of an insulin infusion or a reduction (2.0–3.0 g/kg body weight/day) or even a temporary interruption of glucose infusion. Close monitoring of blood glucose levels is highly important
Overexpression of melanoma inhibitory activity (MIA) enhances extravasation and metastasis of A-mel 3 melanoma cells in vivo
The secreted MIA protein is strongly expressed by advanced primary and metastatic melanomas but not in normal melanocytes. Previous studies have shown that MIA serum levels correlate with clinical tumour progression in melanoma patients. To provide direct evidence that MIA plays a role in metastasis of malignant melanomas, A-mel 3 hamster melanoma cells were transfected with sense- and antisense rhMIA cDNA and analysed subsequently for changes in their tumorigenic and metastatic potential. Enforced expression of MIA in A-mel 3 cells significantly increased their metastatic potential without affecting primary tumour growth, cell proliferation or apoptosis rate in hamsters, compared with control or antisense transfected cells. Additionally, MIA overexpressing transfectants showed a higher rate of both tumour cell invasion and extravasation. Cells transfected with MIA antisense generally exerted an opposite response. The above changes in function attributed to the expression of MIA may underlie the contribution of MIA to the malignant phenotype. © 2000 Cancer Research Campaig
The Gibbs paradox, Black hole entropy and the thermodynamics of isolated horizons
This letter presents a new, solely thermodynamical argument for considering
the states of the quantum isolated horizon of a black hole as distinguishable.
We claim that only if the states are distinguishable, the thermodynamic entropy
is an extensive quantity and can be well-defined. To show this, we make a
comparison with a classical ideal gas system whose statistical description
makes only sense if an additional 1/N!-factor is included in the state counting
in order to cure the Gibbs paradox. The case of the statistical description of
a quantum isolated horizon is elaborated, to make the claim evident.Comment: 8 pages, closest to the published version; taken from the author's
diploma thesi
Introduction and methodology – Guidelines on Parenteral Nutrition, Chapter 1
Guidelines for Parenteral Nutrition were prepared by the German Society for Nutritional Medicine (http://www.dgem.de/), in collaboration with other medical associations to provide guidance for quality assurance for parenteral nutrition (PN) practice, and to promoting health and quality of life of patients concerned. A coordination team proposed topics, working group leaders who along with working group members performed systematic literatur searches and drafted recommendations in a nominal group process. Recommendations were discussed and agreed upon in a structured consensus conference process, followed by a Delphi consensus. The current English version of the guidelines was written and updated during the period between the last quarter of 2007 and the first quarter of 2009. The recommendations of the guidelines should be reviewed, and if necessary updated five years after publication
Longitudinal fluorescence in situ hybridization reveals cytogenetic evolution in myeloma relapsing after autologous transplantation
To investigate cytogenetic evolution after upfront autologous stem cell
transplantation for newly diagnosed myeloma we retrospectively analyzed
fluorescence in situ hybridization results of 128 patients with paired bone
marrow samples from the time of primary diagnosis and at relapse. High-risk
cytogenetic abnormalities (deletion 17p and/or gain 1q21) occurred more
frequently after relapse (odds ratio: 6.33; 95% confidence interval:
1.86–33.42; P<0.001). No significant changes were observed for defined IGH
translocations [t(4;14); t(11;14); t(14;16)] or hyperdiploid karyotypes
between primary diagnosis and relapse. IGH translocations with unknown
partners occurred more frequently at relapse. New deletion 17p and/or gain
1q21 were associated with cytogenetic heterogeneity, since some de novo
lesions with different copy numbers were present only in subclones. No
distinct baseline characteristics were associated with the occurrence of new
high-risk cytogenetic abnormalities after progression. Patients who relapsed
after novel agent-based induction therapy had an increased risk of developing
high-risk aberrations (odds ratio 10.82; 95% confidence interval: 1.65–127.66;
P=0.03) compared to those who were treated with conventional chemotherapy.
Survival analysis revealed dismal outcomes regardless of whether high-risk
aberrations were present at baseline (hazard ratio, 3.53; 95% confidence
interval: 1.53–8.14; P=0.003) or developed at relapse only (hazard ratio,
3.06; 95% confidence interval: 1.09–8.59; P=0.03). Our results demonstrate
cytogenetic evolution towards high-risk disease after autologous
transplantation and underline the importance of repeated genetic testing in
relapsed myeloma (EudraCT number of the HD4 trial: 2004-000944-26)
Time delay for one-dimensional quantum systems with steplike potentials
This paper concerns time-dependent scattering theory and in particular the
concept of time delay for a class of one-dimensional anisotropic quantum
systems. These systems are described by a Schr\"{o}dinger Hamiltonian with a potential converging to different limits
and as and respectively. Due to the
anisotropy they exhibit a two-channel structure. We first establish the
existence and properties of the channel wave and scattering operators by using
the modern Mourre approach. We then use scattering theory to show the identity
of two apparently different representations of time delay. The first one is
defined in terms of sojourn times while the second one is given by the
Eisenbud-Wigner operator. The identity of these representations is well known
for systems where vanishes as (). We show
that it remains true in the anisotropic case , i.e. we prove
the existence of the time-dependent representation of time delay and its
equality with the time-independent Eisenbud-Wigner representation. Finally we
use this identity to give a time-dependent interpretation of the
Eisenbud-Wigner expression which is commonly used for time delay in the
literature.Comment: 48 pages, 1 figur
- …