Realimentation syndrome

BACKGROUND: Angiopoietin-like proteins (ANGPTLs) 3 and 4 are circulating factors that participate in the regulation of lipid and glucose metabolism. SUBJECTS AND METHODS: We measured serum ANGPTL3 and 4 levels in 23 patients with obesity, 40 patients with obesity and type 2 diabetes mellitus (T2DM), 22 patients with anorexia nervosa (AN), 15 subjects undergoing 72-h fasting, and 12 patients with short bowel syndrome (SBS), and their changes after very-low-calorie diet (VLCD), bariatric surgery, partial realimentation, acute fasting, and parenteral nutrition in order to assess their possible role in metabolic regulations...

Le crush syndrome se définit comme l'ensemble des manifestations locales et générales secondaires à une rhabdomyolyse traumatique avec ischémie de grosses masses musculaires par compression prolongée, à l'origine d'un syndrome compartimental ou syndrome des loges. Rarement isolé, il peut passer inaperçu dans les 24 à 48 premières heures de la phase aiguë d'un traumatisme sévère quand les principales préoccupations médicales sont la sauvegarde des fonctions vitales...

postoperatively Seventeen females presenting rectal intussusception with a combined outlet obstruction underwent laparoscopic resection of the rectum (n = 4) or rectum and sigma (n = 13). Mean age was 61.5 +/- 9.7 years, mean duration of surgery took 117 +/- 30.4 minutes, realimentation started 3.5 +/- 1.3 days postoperatively and the mean stay in hospital lasted 11.8 +/- 2.9 days. In all patients an ano-rectal pressure-measurement and EMG were carried out. There was a significant lower resting-pressure of the anal sphincter in comparison to a normal collective of healthy patients with 67...

The primary function of the gastrointestinal system is to assist the intake and further processing of food and liquids. Besides that, it forms an anatomical barrier between the external environment and internal milieu. It is also highly important for its paracrine and endocrine function. Inflammatory bowel diseases, which frequently cause a gastrointestinal failure, form a specific group. Most frequently it is the ulcerative colitis and Crohn's disease. Impaired integrity of the gastrointestinal mucosa and failure of protective mechanisms lead to the increased permeability of the intestinal wall for antigens derived from food, saprophytic bacteria and pathogenic microorganisms...

Serum lipoproteins, triglyceride, total cholesterol as well as HDL, LDL and VLDL-cholesterol were studied in 35 children, actually well nourished, who as infants suffered from malabsorption syndrome with severe malnutrition. If at the active stage of malabsorption some risk factors of atherosclerosis had been found, at the stage of realimentation no disturbances were encountered. The results did not significantly differ from those of the control group.

Too often neglected, dosage of phosphatemia should yet be kept on mind. The role of phosphorus in bone mineralization and regulation of acid-base balance is well known. Phosphorus is also an energy purveyor during numerous biologic reactions, and deep deprivation may lead to a lot of pathologic situations, sometimes severe. Mild hypophosphatemia is not rare and occurs in various clinical or therapeutic circumstances; deep hypophosphatemia is rather uncommon, occuring chiefly during hyperalimentation or realimentation of starving patients, especially alcoholics...

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Sodium, potassium and chloride stool content was studied in 107 children aged 1 to 32 months (11 +/- 8 months) presenting with acute diarrhea related to a rotavirus infection (34 cases), to an invasive pathogen (Salmonella or Shigella 14 cases, E. coli 4 cases), or of non-identified etiology (65 cases). The therapeutic protocol was the same in all cases: rehydration for the first 24 hours, progressive realimentation from the second or third day, no drugs being given. An average of 4 stools were analysed for each child (range 2-14), the fecal samples being collected over 2 to 4 consecutive days...

This communication presents evidence from the literature and recent experiments that describe circumstances wherein arginine may be a conditional dietary essential. Previous work has established that the synthesis of orotic acid (OA), the first pyrimidine formed in the de novo pathway of nucleic acid synthesis, becomes elevated whenever the ammonia load exceeds the capacity of the urea cycle. Under these circumstances, the common intermediate, carbamyl phosphate, leaks from the mitochondria and induces OA synthesis in the cytoplasm...

Although, in many respects and from a metabolic point of view, obesity and AN are clearly two opposite pathological conditions, the available data concerning insulin sensitivity in these two syndromes are not so obviously opposite. Indeed, whereas everybody is convinced that obesity is characterized by an increased insulin resistance, the papers reporting insulin sensitivity parameters in AN contain some apparently contradictory results. The observations of simultaneously low fasting blood glucose and plasma-insulin levels in anorectic patients could suggest increased insulin sensitivity in AN...

The clinical picture of metabolic encephalopathies has no aetiological specificity. It combines disturbances in conscious level dominated by disorientation and time and space and disturbances in motor activity, in particular tremor and asterixis. For each of the aetiologies studied, the following are considered: the circumstances of onset, the clinical and laboratory picture, the physiopathology and the treatment. From a diagnostic standpoint, particular emphasis should be placed upon the circumstances of onset which alone give any indication...