Nutrient modulation of inflammatory and immune function
Article Abstract:
An overview is presented of a new area of surgical research that uses nutrients to alter the inflammatory response and immune function of the body. The administration of a nutrient is targeted to perform a specific metabolic function not normally associated with nutrition. This nutrient pharmacology is an outgrowth of research undertaken on patients with multiple organ failure following trauma or surgical systemic infection or sepsis. Metabolic responses occur after surgical injuries (major surgery, shock, infection) and inflammation, such as acute pancreatitis. Research has focused on when and how to influence the inflammatory and reparative processes and immune functioning of the body. Persistent hypermetabolism is an abnormal metabolic regulation that appears to result in persistent inflammatory response with associated immune suppression. Various research approaches are being used to understand and influence this abnormal metabolic regulation. The roles of substances such as arginine, n-3 polyunsaturated fatty acids, and RNA, which play a part in these regularly processes, are being evaluated for their ability to modulate inflammation and improve immune function. The initial results are encouraging. They suggest that the administration of the added nutrients is associated with the return to more normal responses of the immune system. Specifically, it seems that in vitro T cell proliferative responses return to levels above those of nonstressed individuals. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1991
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Monitoring of the inflammatory response in early peritonitis
Article Abstract:
All forms of peritonitis, the inflammation of the membrane lining the inside of the abdominal cavity (peritoneum), are similar. The degree of inflammation was recorded in a group of patients with different underlying diseases by examination of the affected cells and blood, and by analysis of the capacity of the blood to inhibit such inflammation. Blood testing in these patients began at the time of hospital admission when acute abdominal pain led to emergency laparotomy, a surgical incision into the abdominal cavity. Depending upon the duration of the illness and the severity of the peritonitis, levels of fibrinopeptide A and of C3a, two substances produced during blood clotting, significantly increased within a few hours of admission. Subsequently there was an increase in the level of elastase alpha-1-proteinase inhibitor complex, a substance which inhibits an enzyme necessary for protein digestion. There was a strong correlation between levels of these three substances before surgery and the course of the patient's postoperative recovery. A significant increase in the ability of a toxin produced by the body to inhibit growth of certain cells of the peritoneum was identified in the blood of patients who died. This toxin was present in trace amounts before surgery in four patients with peritonitis.
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1989
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Early experience with the automatic implantable cardioverter defibrillator in sudden death survivors
Article Abstract:
Managing life-threatening disturbances of the heartbeat (arrhythmias) of the ventricle (main pumping chambers of the heart) is difficult because of the toxicity and limited effectiveness of antiarrhythmic drugs. An automatic implantable cardioverter defibrillator, AICD (gives a corrective electric shock if arrhythmia occurs) protects against arrhythmias and lets some patients be managed without antiarrhythmic drugs. Twenty-four patients who survived either ventricular fibrillation (ventricles contract in random frenzy), or ventricular tachycardia (more than 100 beats per minute) causing instabilities in the flow of blood not associated with the kind of heart attack caused when part of the heart muscle dies from loss of its blood supply, underwent implantation of the device. Twenty-three patients had abnormal function of the left ventricle which pumped a third of the normal volume with each beat. There were no deaths from surgery, but there were three complications. Nine months after surgery, twenty-three patients were still alive. In eight patients, the device had fired one or more discharges because the heart had stopped beating. Implantation of the device is not risky, and is an effective alternative to toxic antiarrhythmic drug therapy.
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1989
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