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Parenteral nutrition facilitates activation of coagulation but not fibrinolysis during human endotoxemia
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van der Poll T, Levi M, Braxton CC, Coyle SM, Roth M, Ten Cate JW, Lowry SF. Parenteral nutrition facilitates activation of coagulation but not fibrinolysis during human endotoxemia. J Infect Dis 1998; 177:793-795. A comparison was made of treatment with EN or PEN during 4 days before the challenge with endotoxin. Both EN and PEN were discontinued from midnight of the study day, no fat and no fibre was used in the formulas, and no antibiotics were given. Compared with EN, PEN was associated with a selectively enhanced activation of the coagulation system during endotoxaemia. Activation of the fibrinolytic system proceeded in a similar way in the two groups.
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Van Der Poll, T.1
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Studies in blood coagulation, diet and ischaemic heart disease in two population groups in India
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Brandtzaeg P, Halstersen TS, Kett K, Krajci P, Kvale D, Rognum TO, et al. Immunobiology and immunopathology of the human gut mucosa: humoral immunity and intraepithelial lymphocytes. Gastroenterology 1989; 97:1562-1584.
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Bengmark S (Editor). Immunonutrition. Nutrition 1998; 14:563-647. A review of some immunomodulating nutrients with contributions from leading scientists from around the world.
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Does the route of feeding modify gut barrier function and clinical outcome in patients after major upper gastrointestinal surgery?
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Reynolds JV, Kanwar S, Welsh FKS, Windsor ACJ, Murchan P, Barclay GR, Guillou PJ. Does the route of feeding modify gut barrier function and clinical outcome in patients after major upper gastrointestinal surgery? J Parenter Enter Nutr 1997; 21:196-201.
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Reynolds, J.V.1
Kanwar, S.2
Welsh, F.K.S.3
Windsor, A.C.J.4
Murchan, P.5
Barclay, G.R.6
Guillou, P.J.7
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11
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0031958661
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Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis
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Windsor ACJ, Kanwar S, Li AGK, Barnes E, Guthrie JA, Spark JI, et al. Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis. Gut 1998; 42:431-435. EN was instituted within 48 h, with 36% fat, no fibre in the formula used, and no routine antibiotics. Whereas the sickness score (APACHE II) fell significantly in EN patients, it remained unchanged in patients on PEN, and whereas C-reactive protein decreased from a mean of 156 down to 84 mg/l in patients on EN, it remained unchanged in PEN patients. Furthermore, the antioxidant score increased by an average of 33% in the EN group whereas it decreased by 28% in the patients on PEN, and endotoxin antibodies expressed as IgM EndoCAb remained unchanged in the EN group but increased by 29% in the PEN group. Five out of 12 patients in the PEN group developed multiple organ failure in contrast to none among the EN patients, and two out of 12 in the PEN group but none in the EN group died.
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Gut
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Windsor, A.C.J.1
Kanwar, S.2
Li, A.G.K.3
Barnes, E.4
Guthrie, J.A.5
Spark, J.I.6
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12
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0031058110
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A comparison of parenteral hyperalimentation and early enteral feeding regarding systemic immunity and major hepatic resection - The results of a randomized prospective study
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Shirabe K, Matsumata T, Shimada M, Takenaka K, Kawahara N, Yamamoto K, et al. A comparison of parenteral hyperalimentation and early enteral feeding regarding systemic immunity and major hepatic resection - the results of a randomized prospective study. Hepato-Gastroenterology 1997; 44: 205-209. EN was administered from the second postoperative day, with 15% fat, and no fibre in the formula. The report was unclear about antibiotics. No differences were observed between EN and PEN in the nutritional parameters: retinol binding protein, transferrin, prealbumin, and 3-methylhistidine. Early enteral feeding maintained immunocompetence. Among the immunological parameters, lymphocyte numbers, natural killer cell activity and phytohemagglutinin response were significantly higher in early EN compared with the total parenteral nutrition group. One patient in each group suffered enteritis. In the total parenteral nutrition group three out of 13 suffered pneumonia, two out of 13 suffered wound infection, one out of 13 suffered intraperitoneal abscess in contrast to none in the early EN group. 'Early EN maintained immunocompetence and...reduced septic complications'.
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(1997)
Hepato-Gastroenterology
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Shirabe, K.1
Matsumata, T.2
Shimada, M.3
Takenaka, K.4
Kawahara, N.5
Yamamoto, K.6
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13
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0027956830
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Visceral protein response to enteral versus parenteral nutrition and sepsis in trauma
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Kudsk, K.A.1
Minard, G.2
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Infection and acute pancreatitis
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Isenmann R, Buchler M. Infection and acute pancreatitis. Br J Surg 1994; 81:1707-1708.
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Enteral nutrition is superior to parenteral nutrition in severe acute pancreatitis: Results of a randomized prospective trial
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Kalfarentzos F, Kehagias J, Mead N, Kokkinis K, Gogos CA. Enteral nutrition is superior to parenteral nutrition in severe acute pancreatitis: results of a randomized prospective trial. Br J Surg 1997; 84:1665-1669. EN was instituted within 48 h, with 35% fat, no fibre in the formula, and imipenim was used as the standard antibiotic. No difference was observed in mortality, mean intensive care unit stay, mean ventilator time, mean haemodialysis time or mean hospital stay, but in septic complications: total parenteral nutrition 50%, EN 28%, P<0.05.
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Br J Surg
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Kalfarentzos, F.1
Kehagias, J.2
Mead, N.3
Kokkinis, K.4
Gogos, C.A.5
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16
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0031026166
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Comparison of the safety of early enteral vs parenteral nutrition in mild acute pancreatitis
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Clave SA, Greene LM, Snider HL, et al. Comparison of the safety of early enteral vs parenteral nutrition in mild acute pancreatitis. J Parenter Enter Nutr 1997; 21:14-20. EN was instituted within 48 h, with no fibre in the diet. The report was unclear about fat and antibiotics. No difference was observed in mortality (0% in both groups), intensive care unit days, and nosocomial infections, but the cost of EN was US$761 and total parenteral nutrition was US$3294. The authors' impression was that 'EN may promote a more rapid resolution of the toxicity and stress response'.
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J Parenter Enter Nutr
, vol.21
, pp. 14-20
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Clave, S.A.1
Greene, L.M.2
Snider, H.L.3
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17
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0025788401
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Composition of fat in enteral diets can influence outcome in experimental pancreatitis
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Peck MD, Ogle CK, Alexander JW. Composition of fat in enteral diets can influence outcome in experimental pancreatitis. Ann Surg 1991; 214:74-82.
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Alexander, J.W.3
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Tumour necrosis factor-α and interleukin-6: Early indicators of bacterial infection after human orthotopic liver transplantation
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Függer, R.2
Götzinger, P.3
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0005223931
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Early enteral feeding (EEF) reduces incidence of early rejection following orthotopic liver transplantation
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Sharpe MD, Pikul J, Lowndes R, et al. Early enteral feeding (EEF) reduces incidence of early rejection following orthotopic liver transplantation [abstract]. London: Joint Congress of Liver Transplantation; 1995.
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Joint Congress of Liver Transplantation
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Sharpe, M.D.1
Pikul, J.2
Lowndes, R.3
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