Glutaminesupplemented parenteral nutritionto prevent ventilator- associated pneumonia in the intensive care unit

Objective: Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospita stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut perme- ability in patients receiving total parenteral nutrition (TPN). We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU). Material and Methods: With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The frst group received enteral nutrition (n=20), and the second was prescribed TPN (n=20) while the third group was given glutamine-supplemented TPN (n=20). C-reactive protein (CRP), sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs. Results: No statistically signifcant difference was found among groups in terms of development of VAP (p=0.622). Conclusion: Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically signifcant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP. © Trakya University Faculty of Medicine

The classification of some plants subjected to disturbance factors (grazing and cutting) based on ecological strategies in Turkey

WOS: 000427112700010The effect of disturbance factors such as grazing and cutting were investigated in some plants in central Black Sea Region of Turkey using Grime's CSR strategies and Ellenberg's indicator values (EIVs). Grime's CSR strategies were also determined by Pierce et al.'s (Funct Ecol 27:1002-1010, 2013) scheme because there were some inconsistencies between Grime's and Pierce et al.'s schemes. Secondary strategies in the study area found to be dominant and the dominance of secondary strategies are consistent with "intermediate disturbance hypothesis". All the EIVs were found to be significantly different in grazed vs non-ungrazed and cutted vs uncutted areas. PCA diagram showed that ungrazed and cutted areas are associated with EIVR, while grazed and uncutted plots are associated with EIVL, EIVM, EIVN and EIVT.Amasya UniversityAmasya University [FMB-BAP-14-067]; Amasya University Research FundAmasya UniversityThis study is supported by Amasya University Project number (FMB-BAP-14-067). Thank you Amasya University Research Fund for their support