Impact of enteral protein supplementation in premature infants

David M Barrus1, Joann Romano-Keeler2, Christopher Carr3, Kira Segebarth4, Betty Claxton2, William F Walsh2, Paul J Flakoll51Department of Neonatology, Saint Francis Hospital–Bartlett, Memphis, TN, 2Department of Pediatrics, Vanderbilt Medical Center, Nashville, TN, 3Department of Surgery, Naval Hospital Bremerton, Bremerton, WA, 4Pediatric and Diabetes Specialists, Carolinas Medical Center, Charlotte, NC, 5Department of Surgery, Vanderbilt Medical Center, Nashville, TN, USAObjective: The quantity of enteral protein supplementation required by premature infants to optimize growth has not been determined. This study compares the growth of premature infants fed the current standard intake of protein (3.5 g/kg/day) with the growth of those fed a higher amount (4.0 g/kg/day).Study design: Fifty-two infants <1500 g and <33 weeks gestational age participated in a blinded, single-center, prospective randomized control trial to compare growth between two groups of different protein-intake levels. Primary outcomes were average daily weight gain (g/kg/day), head-circumference (cm/kg/week) and linear growth velocity (cm/kg/week). Secondary outcomes were serum indices of protein tolerance and plasma amino acid concentrations.Results: Infants receiving higher amounts of protein had higher rates of growth for body weight (18.2 ± 0.7 versus 16.2 ± 1.0 g/kg/day; P < 0.05) and head circumference (0.87 ± 0.08 versus 0.62 ± 0.07 cm/kg/week; P < 0.05), with no differences in blood protein or plasma amino acid concentrations. Length of hospital stay was 14 days shorter for the higher-protein group (51.4 ± 4.0 versus 65.9 ± 6.3 days).Conclusion: Increasing premature infant enteral protein supplementation from a calculated intake of 3.5–4.0 g/kg/day improved growth in a safe manner.Keywords: human milk, human milk fortifier, growth, low birth weigh

Central processing of rectal pain in patients with irritable bowel syndrome: an fMRI study.

International audienceOBJECTIVES: In healthy subjects, the neural correlates of visceral pain bear much similarity with the correlates of somatic pain. In patients with irritable bowel syndrome, the central nervous system is believed to play a strong modulatory or etiological role in the pathophysiology of the disease. We hypothesize that this role must be reflected in aberrations of central functional responses to noxious visceral stimulation in these patients. To verify this hypothesis, we have induced transient rectal pain in patients and assessed the functional responses of the brain by means of functional magnetic resonance imaging. METHODS: Twelve right-handed patients (11 female) were examined. Functional imaging (1.5 T) was performed following a block paradigm, alternating epochs with and without noxious stimulation of the rectum. Rectal pain was induced by inflating a latex balloon. Whole-brain coverage was achieved by means of echo-planar magnetic resonance acquisition. RESULTS: A strong variability of the individual responses to rectal pain was found in patients with irritable bowel syndrome. Significant activations were found in only two patients, and group analysis did not reveal significant activations. In contrast, all patients exhibited significant deactivations. Group analysis revealed significant deactivations within the right insula, the right amygdala, and the right striatum. CONCLUSIONS: This study reveals aberrant functional responses to noxious rectal stimulation in patients with irritable bowel syndrome. Those results add grounds to the hypothesis that the central nervous system plays a significant role in the pathophysiology of this syndrome

Central processing of rectal pain: a functional MR imaging study.

International audienceBACKGROUND AND PURPOSE: Although the central processing of somatic pain has been dealt with in numerous brain imaging studies, the neural correlates of visceral pain have received much more limited attention. Our goal was to assess the feasibility of detecting brain activation patterns induced by rectal pain by means of functional MR imaging. We hypothesized that the cerebral processing of rectal pain would exhibit strong similarities with the central processing of somatic pain. METHODS: Functional MR imaging data were obtained from eight healthy subjects. A block paradigm was applied. Rectal pain was induced by inflating a latex balloon catheter that had been inserted into the rectum. Functional responses were established by means of cross-correlation analysis. RESULTS: Activation was detected within the anterior cingulate gyrus, the prefrontal cortex, the insular cortex, the sensory-motor cortex, the inferior parietal lobule, the posterior cingulate gyrus, and the visual cortex. CONCLUSION: Functional MR imaging of visceral pain is feasible in healthy subjects. The activation patterns observed in this study support the hypothesis that the cerebral processing of visceral pain involves multiple components, similar to the central processing of somatic pain. Our results constitute a first step toward the identification of possible aberrations in the activation patterns of patients suffering from visceral hypersensitivity

Gd-DTPA-enhanced MR imaging of spinal tumors

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Quality assessment in in vivo NMR spectroscopy: IV. A multicentre trial of test objects and protocols for performance assessment in clinical NMR spectroscopy

A multicentre trial of test objects and protocols for performance assessment in single volume and slice selective magnetic resonance spectroscopy (MRS) was conducted by the European Community Concerted Action on MRI and MRS. The trial assessed phosphorus and proton localisation techniques implemented on commercially available MR systems at ten sites in Europe. At each site, a number of parameters devised by the Concerted Action were measured using prototype test objects. Some of these parameters related to the quality of localisation and others to the overall performance of the spectrometer. Results were obtained for the ISIS, DRESS, STEAM, and PRESS sequences with a range of acquisition parameters, allowing evaluation of the assessment methodology and comparison of the efficacy of various implementations of these localisation techniques. The results of this trial have been important in the development of the Concerted Action's final recommendations for MRS performance assessment, and demonstrate that such assessment provides valuable information in the comparison of spectroscopy data from different sites and in the development of new localisation sequences, and provides a means of quality assurance in MRS