Effect of glutamine dipeptide on hepatic regeneration in partially hepatectomized malnourished rats.

Glutamine promotes hepatic regeneration in nourished (N) rats. The aim of the present study was to evaluate the effects of glutamine-enriched total parenteral nutrition (TPN) on liver regeneration in malnourished (MN) rats.Seventy-two male Wistar rats ( congruent with 270 g) were assigned to one of two groups: N and MN. Each group was then subdivided into three groups: the first underwent partial hepatectomy (PH) and received standard TPN enriched with L-alanyl-L-glutamine (Ala-Gln); the second also underwent PH and received standard TPN, but enriched with a solution containing proline and alanine (Ala-Pro); and the third underwent no surgical procedure (control group). All experimental groups received isocaloric (188 kcal. kg(-1). d(-1)) and isonitrogenous (1.12 g of nitrogen. kg(-1). d(-1)) TPN for 96 h. All animals were injected with bromodeoxyuridine 2 h before death. The hepatic regeneration index (HRI), hepatic growth percentage (HG) and hepatic morphology were analyzed. In MN rats, HRI and HG were higher with glutamine enrichment (HRI = 81 and HG = 190) than with proline-containing TPN (HRI = 66 and HG = 154; P < 0.05) and HRI was 100 times higher in animals that underwent PH than in control animals. Morphologic analysis of hepatic tissue showed no difference among the six groups.Glutamine-enriched TPN promoted growth of the remnant liver in MN rats after PH, maintained cellular proliferation in the various experimental groups after surgery, and maintained hepatic morphology of MN rats after surgery.

Nutrição enteral como alternativa em síndrome do intestino curto / Enteral nutrition as an alternative in short bowel syndrome / Nutrición enteral como una alternativa en el síndrome de intestino corto

Este trabalho avaliou a eficácia da terapia nutricional (TN) adjuvante em portadores de síndrome do intestino curto (SIC) em regime de NPT domiciliar por 2 a 4,5 anos. A interrupção da terapia deu-se por sepse por cateter em dois pacientes, trombose venosa profunda em dois e embolia pulmonar em um. A dieta enteral foi introduzida após um a seis meses de suspensão de NPT. A via de acesso da TN enteral foi nasotenral (um paciente), gastronomia (três) e oral (um). A dieta enteral utilizada foi polimérica isomolar com fibras (três pacientes) e sem fibras (dois). A técnica de infusão foi cíclica noturna e/ou diurna em sistema fechado com bomba de infusão (50 a 83 ml/h) ou oral fracionada. Os resultados permitiram concluir que a TN enteral adjuvante nesta população permitiu prover as necessidades calóricas sem NPT, com manutenção de peso corpóreo, constituindo-se alternativa viável no manuseio nutricional de SIC.

This study evaluated the efficacy of nutritional therapy (NT) adjuvant in patients with short bowel syndrome (SBS) on a home TPN for 2 to 4.5 years. Discontinuation of therapy was given by catheter sepsis in two patients, deep vein thrombosis and pulmonary embolism in two in one. Enteral feeding was introduced after a six-month suspension of NPT. The route of enteral access was nasotenral TN (one patient), food (three) and oral (a). Enteral nutrition was used isomolar polymeric fibers (three patients) and no fiber (two). The infusion technique was cyclical and nighttime or daytime in a closed system using an infusion pump (50-83 ml / h) or divided oral doses. The results showed that NT enteral adjuvant allowed this population to provide the caloric needs without TPN, with maintenance of body weight, becoming a viable alternative in the nutritional management of SBS.

Este estudio evaluó la eficacia de la terapia nutricional (NT) adyuvante en pacientes con síndrome de intestino corto (SIC) en un TPN en casa por 2 a 4,5 años. La interrupción del tratamiento fue dado por sepsis por catéter en dos pacientes, la trombosis venosa profunda y embolismo pulmonar en dos en uno. La alimentación enteral se introdujo después de una suspensión de seis meses del TNP. La ruta de acceso enteral fue nasotenral TN (un paciente), alimentos (tres) y oral (a). La nutrición enteral se utilizó isomolar fibras poliméricas (tres pacientes) y sin fibra (dos). La técnica de infusión era cíclico y la noche o de día en un sistema cerrado mediante una bomba de infusión (50 a 83 ml / h) o divide las dosis orales. Los resultados mostraron que adyuvante NT enteral permite a esta población para cubrir las necesidades de calorías sin RPT, con el mantenimiento del peso corporal, convirtiéndose en una alternativa viable en el manejo nutricional de SBS.