ABSTRACT
Backgrounds and aims: Total parenteral nutrition (TPN) has been traditionally used as an adjunctive therapy in severe ulcerative colitis patients. We performed a prospective study to ascertain the safety, nutritional efficiency, tolerance and costs of total enteral nutrition in this situation. Methods: After 48 hours of intensive medical treatment, severe ulcerative colitis patients initiated enteral feeding with a polymeric formula. The formula concentration and volume were increased daily. Results: 17 patients (7 women, 10 men; age 36,8ñ12,8 years) with a mean clinical activity score of 15,6ñ1,5 were included. In 14 patients (82,4percent) enteral nutrition was well tolerated, attaining in 11 of them more than 80percent of the caloric requirements by day 4. In 3 cases we observed vomiting and bloating. Prealbumin levels improved significantly from 11,1ñ3,4 mg/dl to 22,7ñ6,8 mg/dl (p= 0.002) at the end of enteral nutrition (11,8ñ4,7 days). Albumin and other nutritional parameters did not change. Conclusions: Total enteral nutrition could be considered a safe and well tolerated nutritional support in these patients. Although albumin and other nutritional parameters did not change during the study period, the increase in prealbumin levels suggests a favourable anabolic effect of total enteral nutrition
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Colitis, Ulcerative/diet therapy , Enteral Nutrition/methods , Treatment Outcome , Nutritional Support , Serum Albumin/analysis , Nutrition AssessmentABSTRACT
Background: The evolution of ulcerative colitis in pregnancy is far from clear. While some authors state that the disease aggravates during this period, others do not share this opinion. Aim: To assess the evolution of ulcerative colitis in pregnancy. Patients and methods: A paired case-control design was used in which 15 women, with diagnosed ulcerative colitis at the moment of becoming pregnant, were followed for 12 months and the activity of the disease was compared with that of the 12 months preceding the pregnancy. The activity of the disease in the period preceding the pregnancy was gathered retrospectively from the patient's charts. Results: The mean age of the first ulcerative colitis crisis was 24 years. It was moderate in 49 percent and severe in 35 percent of women. During pregnancy 55 percent of women did not have a crisis, compared with 26.7 percent during the period preceding pregnancy (relative risk of not having a crisis during pregnancy of 1.7). During both periods, seven women had digestive complications, whereas extra digestive complications were not observed in 60 percent of patients during pregnancy and 11.8 percent of patients during the preceding period. Perinatal results were similar to those of the general population. Conclusions: In our group of patients the evolution of ulcerative colitis was better during pregnancy, reflected by a lower number of crisis
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Pregnancy Complications/physiopathology , Colitis, Ulcerative/complications , Sulfasalazine , Inflammatory Bowel Diseases , Colitis, Ulcerative , Follow-Up StudiesABSTRACT
Se determinó retrospectivamente la incidencia de displasia broncopulmonar en el total de recién nacidos sometidos a ventilación artificial en una unidad de neonatología, analizándola según peso al nacer y comparándola con la observada en el subgrupo de recién nacidos ventilados sobrevivientes a los 28 días de edad. Se estudió la posible asociación entre displasia broncopulmonar, enfermedad de membrana hialina, ductus arterioso permeable y rotura alveolar. El número de pacientes ventilados fue 200, de los cuales 9,5 por cento presentaron evidencias de DBP (19/200), falleciendo 1 de ellos (letalidad 5,2 por cento). La incidencia aumentó en forma progresiva en los niños de menor PN, hasta llegar a 37,5 por cento en los de <1.000 g (p <0,001 X*). Al considerar los sobrevivientes a los 28 días en este mismo grupo de PN la incidencia fue 75 por cento (p < 0,05 (Fisher)). Se puede plantear que en la medida que aumenta la sobrevida de los RN de muy bajo peso, aumenta también la incidencia de DBP. Se encontró una asociación significativa entre DBP con DAP y RA, DAP se presentó en 33/181 vs. 10/19 (p < 0,01) y RA en 16/181 vs. 6/19 (p <0,01) en el grupo sin DBP vs. el grupo con DBP. La presencia de EMH no mostró diferencias significativas en ambos grupos