Search

A neonate with transposition of the great arteries developed chylothorax following ligation of the patent ductus arteriosus. At first, multiple thoracenteses and chest drainage were employed without significant diminution of pleural fluid production. Administration of a formula containing medium chain triglycerides (MCT) was associated with a marked decrease of pleural fluid accumulation within a few days. Total lipid concentration of pleural fluid prior to the diet was 890 mg/100 ml and diminished to 40 mg/100 ml after eight days of administration of the diet. Cholesterol and cholesterol esters decreased from 101 mg/100 ml to 24 mg/100 ml and from 83 mg/100 ml to 9 mg/100 ml, respectively. Total triglyceride concentration fell from 111 mg/100 ml to 2 mg/100 ml. Only negligible amounts of fatty acids with a chain length lower than capric (C10:0) were recovered from the analyses of the samples. Thereafter, x-ray films revealed no pleural effusion and at the third-month follow-up visit the chest remained clear. The marked diminution in volume of the pleural effusion in this case is thought to be associated with MCT feedings. MCT passes directly into the portal system, bypassing the lymphatic pathways and still provides adequate caloric intake. Thus, it seems ideal for the treatment of conditions which have a compromised lymphatic drainage. Both clinical data and biochemical findings in this case strongly suggest the use of MCT diet as an important adjunct of the management of neonatal chylothorax. [ABSTRACT FROM AUTHOR]

Presents a study which examined the effects of high and low carbohydrate diet on patients with diabetes mellitus. Goals of diet therapy; Comparison of the effects of diet on diabetic control, insulin secretion and blood lipids of the patients; Assessment of the concept of carbohydrate-induced hypertriglyceridemia.

Examines available evidence that shows the rarity with which diabetics understand and follow diet prescriptions. Degree where patients follow their diet prescriptions; Causes of failure; Confusion on dietary goals, strategies and priorities.

Erythroderma is described in a 2-year-old child with coeliac disease, who died of fungal pneumonia. The skin eruption commenced the day after a gluten-free diet was instituted and proved intractable to treatment, whereas the signs of malabsorption were swiftly controlled. We could establish no connection between the cutaneous and intestinal disorders. [ABSTRACT FROM AUTHOR]

An attempt to treat a case of histidinemia using a low histidine protein hydrolysate is describe. The diet was started at the age of 7 months in a male infant with severe clinical disorder. The diagnosis was made at 24 weeks, which is the youngest recorded case. Good control of histidine metabolism was achieved. There was an initial improvement in growth rate but very little effect on development otherwise. Death from bronchopneumonia occurred in the fourth year. The brain showed cerebral maldevelopment, likely to be of prenatal origin, as well as typical postepileptic encephalopathy. The etiology of this malformation is discussed in relation to histidinemia and the family history of neurologic disorder. [ABSTRACT FROM AUTHOR]

Provides information on the management of hyperlipoproteinemia. Treatment of the disease through dietary and drug therapy; Benefits of low-cholesterol, polyunsaturated fat and cholestyramine diet; Health risk concerning coronary artery disease.

Prospective epidemiologic studies have uniformly demonstrated that a high serum cholesterol level is predictive of increased risk of myocardial infarction or sudden death, but a relationship between cholesterol level and cerebral stroke has not been consistently found. Lowering of serum cholesterol concentrations may retard atherogenesis and delay some of its complications. A controlled clinical trial of a cholesterol-lowering diet in older men has resulted in a decreased combined incidence of myocardial infarction, sudden death, and cerebral infarction; the diet was more effective if started before age 66. Even though efforts to lower plasma cholesterol by pharmacologic inhibition of cholesterol biosynthesis have yielded discouraging results, there are sound reasons to attempt a new approach by inhibition of hepatic prenyl synthetase, the enzyme that catalyzes synthesis of farnesyl pyrophosphate. [ABSTRACT FROM AUTHOR]

Focuses on the use of low protein diets in the management of patients with renal failure. Effectivity of low protein diets; Nutritional value of protein; Patient evaluation and protein restrictions in the diet.

Demonstrates that the serum iron and the percent saturation of transferrin decrease after acceleration of erythropoiesis. Information on the percent saturation of serum transferrin; Factors that suggest a diagnosis of iron deficiency; Changes that occur when megaloblastic anemia is treated with the appropriate vitamin.

Editorial. Comments on studies on the role of gluten in the pathogenesis of celiac disease. Possible induction of a clinical remission of celiac disease upon withdrawal of the cereal protein called gluten; Changes in intestinal histology and in absorptive function that result from dietotherapy.

This article presents information on galactosemia and its nutritional therapy. Galactosemia is an inherited disorder characterized by an inability to convert galactose to glucose in the normal manner. An immediate result of this disorder is an abnormal accumulation of the metabolites of galactose in the body, leading to various tissue injuries. Management of this disorder is directed toward the rigid exclusion of galactose from the diet. Despite this metabolic handicap, the child with galactosemia needs the same kinds and amounts of nutrients that any normal child needs for growth and development.

Studies the changes in intelligence of diet-treated phenylketonuric children and of their untreated and unaffected siblings, for an average of 27 months. Tendency for treated children to have significantly lower scores than their unaffected siblings; Evidence showing that those treated before two years were more intelligent than later-treated children.

A review is given of the metabolism of fructose in the mammalian organism, and its significance in medicine. Emphasis is laid upon the absorption and assimilation of fructose through pathways not identical with those of glucose. The metabolism of fructose is largely insulin-independent, although the ultimate fate of fructose carbons is determined by the presence or the absence of insulin. Clinical and experimental work has suggested that fructose may exert beneficial effects as a component of the diet for patients with mild and well-balanced diabetes. Fructose is absorbed slowly from the gut, and does not induce drastic changes in blood sugar levels. Secondly, fructose is metabolized by insulin-independent pathways in the liver, intestinal wall, kidney and adipose tissue. As a consequence of the rapid and efficient utilization of fructose, it has been used widely for intravenous feeding in medicine and surgery. However, it has been shown that the rapid infusion of large amounts of fruetose may cause accumulation of lactic acid in the extracellular fluid. The possibility of lactate acidosis, with concomitant impairment of the acid-base balance, already disturbed, constitutes a relative contraindication to the use of intravenous fructose in the treatment of diabetic ketoacidosis. Fructose is known to accelerate ethanol metabolism in the liver. No well-documented reports on the use of fructose in the treatment of ethanol intoxication have been published, although it has recently been suggested that fructose might be of value in the treatment of delirium tremens. Fructose may be less cariogenic than sucrose, at least in short-term experiments. Long-term trials are lacking, and thus the potential advantages of fructose in preventive odontology have not been determined. Fructose does not seem to have any side-effects when used in reasonable amounts. However, it has been reported that the administration of fructose in large amounts induces hyperlipidemia both in man and in experimental animals. Earlier suggestions concerned with the atherogenic properties of fructose have recently been challenged. The apparent increase in the incidence of coronary disease among sucrose users seems to be a statistical artefact, caused by the increased ingestion of coffee and soft drinks by cigarette smokers. [ABSTRACT FROM PUBLISHER]

At present there is considerable controversy over many aspects of iron nutrition, including: (1) iron needs and intake levels; (2) the bearing of iron intake on haematological levels; (3) iron deficiency anaemia and deficiency stigmata; and (4) iron therapy, prophylaxis, and the haematological and clinical benefits accruing. Differences of opinion prevail because of inadequacies of knowledge of the level of haemoglobin (or other parameter of iron status) below which unequivocal signs and symptoms of ill-health become manifest in the major proportion of those affected. Difficulties arise equally from lack of knowledge of the level of haemoglobin above which no clinical benefit, short-term or long-term, can be detected from iron supplementation. Clarification of the situation can be obtained only by carrying out the same meticulous and time-consuming procedures that have been used in respect of requirements and deficiency stigmata of other nutrients. Comprehensive iron depletion studies, real and simulated, and repletion studies, including the use of placebos, will be required. Epidemiological investigations bearing on haematological status and morbidity will also need to be undertaken, and include groups of subjects in both Western, and developing countries. [ABSTRACT FROM PUBLISHER]

Two patients are described whose clinical condition deteriorated following gastric surgery for peptic ulceration. Both were demonstrated to be suffering from gluten enteropathy with generalized malabsorption which included lactose. Following treatment with a gluten-free diet over a 2-year period the jejunal mucosa showed a marked improvement of villous architecture associated with a return of lactose absorption to normal in one patient. This supports the view that following a gastro-jejunal anastomosis the gastric secretion is not itself injurious to the jejunal mucosal structure. [ABSTRACT FROM PUBLISHER]

The article presents a study which investigates the use of the standard insulin tolerance test (ITT) on chronic schizophrenics. Under the study, 22 chronic schizophrenic and 8 non-psychotic inpatients between ages 23 and 55 were chosen and compared with one another as to a control group of non-psychotic in-patients in terms of glucose, free-fatty acids (FFA), human growth hormone responses to exogenous insulin by ITT with dietary controls. Highly significant correlations were observed between the duration of hospitalization and the glucose and FFA response to the ITT and the similarity of insulin resistance between chronic schizophrenic and severely depressed untreated inpatients is pointed out. It concluded that insensitivity to insulin may be alleviated with medication.

The presents an account on the psychiatric contribution to renal unit undertaking chronic hemodialysis and renal homotransplantation program at Queen Elizabeth Hospital in Adelaide, South Australia. Established two years ago, it has developed a program of recurrent hemodialysis and has used recurrent peritoneal dialysis for a period. The Unit staff consist of a full time director, one senior medical registrar, senior house physician, nurses and technicians. According to the author, psychiatrist is expected that he can provide important insights not only into the patient's current mental state, but also into the interactions between patient and family and between patient and staff.

Discusses some methods for treating viral hepatitis. Use of human gamma globulin as a prophylactic agent against infectious hepatitis; Ways to prevent homologous serum hepatitis; Foods that should be eaten by patients with viral hepatitis; Symptoms of viral hepatitis.

Evaluates long-term follow-up studies on patients with idiopathic steatorrhea seen at the Mount Sinai Hospital. Materials and methods used; Effect of gluten-free diet on the patients; Results of tests of absorption in patients; Clinical value of gluten-free diet.

Discusses several potential treatment for regional ileitis. High-caloric and protein diet; Psychotherapy; Antibiotics; Sulfonamides.

Describes several medical cases that illustrate the principles of dietotherapy. Dietary hazards in patients receiving diets law in salt; Case of the anorexia of undernutrition, which occurs in the chronically ill patient whose dietary intakes are inadequate for considerable periods; Symptoms presented by the malnourished visceroptotic patient; Implementation of an unorthodox mode of treatment in the management of severe intractable obesity.

Evaluates the effect of different types of spices upon the stomach and peptic ulcer disease. Problems of diet therapy in peptic ulcer; Presentation of the concept of gastric mucus barrier; Determination of the impact of spices on gastric secretion of pepsin.

Discusses the application of the principles of nutrition therapy in facilitating the treatment of diseases of the gastrointestinal tract. Influence of nutrition to the overall state of health and disease; Details on the manifestations of the generalized deterioration of the tissues produced by the state of malnutrition; Role of gastrointestinal dysfunction in the etiology of malnutrition.

Focuses on the etiology of functional hypoglycemia in patients with an altered glucose tolerance whose chief complaints or symptomatology could not be explained on the basis of organic disease. Assessment of the dietary intake of the respondents and the application of dietary therapy for the respondents with a high-protein diet; Evaluation of the trends on the abnormal variations of blood sugar; Views on the best practices in managing such kind of patients.

Focuses on studies on the use of the specific carbohydrate diet in the treatment of celiac disease. Factors involved in the diagnosis of the disease; Basic principles of the specific carbohydrate diet; Factors to be considered in prescribing such a diet; Results of the investigations of the role of gluten factor in the cause and dietary treatment of the disease.

Discusses the study "Control of Stomach Pain," by Donald C. Balfour Jr., presented before the Course in Postgraduate Gastroenterology of the National Gastroenterological Association in Los Angeles, California on October 15-17, 1953. Types of pain that may arise from the upper gastrointestinal tract; Pathways of pain from the upper gastrointestinal tract; Suggested foods that should be eaten by a patient to control pain.

Focuses on a study which discussed dietary treatment of an infant with isovaleric acidemia. Patient and methodology; Details of the recommended dietary treatment; Observations and treatment outcome; Analysis of the case.

Editorial. Discusses the challenges that confront the medical profession in clinical nutrition in the U.S. as of October 1970. Information on the status of nutrition in the country; Involvement of nutritionists in problems of human nutrition; Responses to the challenges.

Editorial. Discusses the importance of clinical nutrition in the practice of medicine. Background on mass starvation in Latin America; Information on nutrition disorders; Details on problems associated with undernutrition.

The article discusses the findings of a study which assessed the applicability of the Guthrie Inhibition Assay Test in monitoring the diet of patients suffering from phenylketonuria. The experiment was conducted at the Child Development Clinic of the State University of Iowa in collaboration with the State Hygienic Laboratory and the Metabolism Laboratory of the Department of Pediatrics. The study was designed to examine the reliability of the assay test for monitoring the phenylalanine blood levels of children with phenylketonuria receiving diet therapy. Based from the findings, it found that the Guthrie test is sufficiently reliable as a method for monitoring dietary control of children with phenylketonuria.

Discusses the factors in the successful treatment of patients with duodenal ulcer. Reason why the treatment of all ulcer patients must be individualized; Appraisal of the patient's nutritional status; Medications for hospitalized and ambulatory patients; Psychiatric appraisal of the patient.

A 57-year-old woman being treated with cholestyramine developed hypoprothrombinemic hemorrhage. Dietary supplements of fat-soluble vitamins should be used routinely in every patient given the drug on a long-term basis. [ABSTRACT FROM AUTHOR]

Presents the book "Handbook of Diet Therapy," 4th ed., by Dorothea Turner.

Presents an abstract of the article "Functional and Morphological Changes in Response to a Gluten-Free Diet and Corticosteroids in Dermatitis Herpitiformis and Adult Coelic Disease," by Paryeen J. Kumar, D. B. A. Silk, R. Marks, M. L. Clark and A. M. Dawson.