Effect of electrolytes in the presence of some trace elements on the stability of all-in-one emulsion mixtures for total parenteral nutrition.

In a previous study we showed that the 'all-in-one' emulsion mixtures investigated for total parenteral nutrition are stable for 1 month when kept in ethylene vinyl acetate polymer (EVA) bags and refrigerated at 4 degrees C. Analogous experiments were performed with the addition of two different solutions of trace-elements: one was prepared in the pharmacy while the other was commercially obtained (Addamel, Kabi Vitrum). A Coulter counter TA II with a 30 microns orifice was used for globule size measurements. Particles with diameters ranging from 0.6 up to 16 microns were measured. No significant changes in particle size were noticed during storage and the routine addition of trace elements to the 'all-in-one' mixtures was thus possible. These emulsions can be stored without stability problems for at least 8 days.

[Our experience in the treatment of imperforate anus. Anterior (Mollard's technic) versus posterior approach (Stephens' technic)]. / Onze ervaring met de behandeling van anus imperforatus. Anterieure (techniek volgens Mollard) versus posterieure toegangsweg (techniek volgens Stephens).

The present series concerns the method of treatment for anus imperforatus as it was performed at the Academic Hospital Ghent (Belgium) between 1971 and 1980. Two different technics are confronted one with the other: the anterior perineal approach according to Mollard and the posterior transsacral approach according to Stephens. In agreement with the recent literature the anterior way of acceding to the puborectalissling has undeniable advantage. Even with a very short follow-up period the number of children with supralevatoric localization of anus imperforatus treated by the technic of Mollard and showing a proven continence is now already outnumber.

[Parenteral nutrition "à la carte" in major abdominal surgery with mixtures of Totamine concentrate and Vintène. A clinical study based on nitrogen balance]. / Parenterale voeding "à la carte" in maieure abdominale heelkunde met gebruik van Totamine concentre en Vintène. En klinische studie aan de hand van de stikstofbalansen.

The authors present a series of thirty patients who underwent major abdominal surgery. Each patient received preoperative total parenteral nutrition (TPN) during bowel preparation. After the operation the TPN was continued immediately, even if reanimation was necessary. The dosages of nitrogen and calories were individually adapted in function of the daily calculated nitrogen-balances. So the authors were able to administer a TPN "à la carte" using eight solutions mixed in a single bag, containing amino-acids (varying between 6 and 20 g of nitrogen), glucose (ad 150 Kcal/gN) lipids (constituting 40% of the calorie-intake), ions, vitamins and oligoelements. With a follow-up of minimum 10 days, the study proves the possibility of creating positive nitrogen-balances in 87% of the cases and an acceptable deviation in the daily measured glycemia and plasma-ionograms.

[The use of nutritive mixtures in a surgical unit (author's transl)]. / Het gebruik van nutritieve mengsels in een chirurgische eenheid.

Fifty patients in whom different nutritive mixtures were used are presented. Eight solutions with increasing caloric and nitrogen contents were used. The purpose of the study was to improve the nutritional status of patients prepared to major surgical interventions. A daily nitrogen balance was made to find out in what measure a positive balance could be attained. The presence or absence of complication was of utmost importance in the evaluation.

[Pregnancy in obese women who have had jejuno-ileal short-circuit operations (author's transl)]. / La grossesse chez les obèses ayant subi une dérivation jéjuno-iléale.

The authors report two cases of obese women who had had intestinal short-circuit operations for obesity 18 months and 24 months previously. They review the indications for this type of operations and the effects the operation has on the body. It has been possible to find 85 other cases in the literature. In general the pregnancy proceeds well but it is important to carry out very strict supervision of the electrolyte balance, of the hypoprotinaemia and of the blood count. Mechanical complications of the short-circuit operation are rare. While abortions and premature labours are not more frequent in these than in other cases the child is often moderately small-for-dates. Congenital malformations can be raised and are of the order of 7 per cent. These fetal abnormalities, as well as maternal digestive troubles, are definitely more frequent if the interval between the operation and the pregnancy is short. It is therefore preferable to wait for two years before allowing a woman who has had a short-circuit type of operation to become pregnant.