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By J. E. Fischer M.D. (auth.), J. M. Greep, Peter B. Soeters, R. I. C. Wesdorp, C. W. R. Phaf, Josef E. Fischer M.D. (eds.)

ISBN-10: 9401010706

ISBN-13: 9789401010702

ISBN-10: 9401010722

ISBN-13: 9789401010726

J. E. Fischer, M.D. Professor Greep, women and gents. it's a nice excitement for me and the contributors to be current at this overseas assembly of Parenteral Nutri­ tion. This assembly should not have been attainable 5 years in the past. at the moment we have been nonetheless arguing approximately important vs. peripheral routes, efficacy of the tech­ nique, and nonetheless getting conversant in our skill to aid sufferers nutri­ tionally. in the final 5 years those discussions, which appear nearly futile looking back, were set aside. either thoughts, we all know how, paintings relatively good and feature their very own symptoms. Having develop into happy with the method, it really is now time to go into the second one section of parenteral foodstuff, and that's the differentiation of the procedure for the advantage of assorted sufferers. Over the subsequent days we are going to be discussing numerous difficulties which today are principal to the complete topic of parenteral nutrients. Is a fats calorie kind of like a carbo­ hydrate calorie? what's the impression on protein metabolism of the fats calorie rather than the carbohydrate calorie? Are they similar? Are'there events during which one is stronger to the opposite? probably we'll discover the next day within the panel.

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The choice of a proper carbohydrate source will be extensively discussed in section 4. c. Several vitamins Several vitamins might be essential for the utilization of the amino acid source and/or for the normal supply. Because of the differences in the quantities given by several authors (9, 27, 58,59) we will only list the names of vitamins used for this purpose (table 7). Table 7. d. Several ions For the correction of the nitrogen balance, several ions in a normal supply are indispensable. The requirements for sodium, potassium, calcium, magnesium, phosphate, chlorine and iron are well-known.

These three fundamentally different nutritional substrates exert other specific effects. As their administration proceeds, each substrate may preserve, stimulate or inhibit the activities, the release and/or the synthesis of hormones and/or enzymes through what can be called a "substrate effect", the intensity of which is proportional to the substrate level. It thus can be stated that normally these hormone and/or enzyme activities and levels are substrate-modulated and vice versa, all through complex feedback mechanisms.

So the proper rate of administration, length of treatment and daily and total quantities of the doses will have to be different for different people. - Is it possible to find and use criteria and schemes for the treatment of individual patients or at least for the management of different categories of patients? - Could such schemes be evaluated using existing preparations? If this is Metabolic imbalance 35 not be possible, cost factors have to be taken into account as well. By giving you this information and these problems we hope to have at least fluttered the dovecot.

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Current Concepts in Parenteral Nutrition by J. E. Fischer M.D. (auth.), J. M. Greep, Peter B. Soeters, R. I. C. Wesdorp, C. W. R. Phaf, Josef E. Fischer M.D. (eds.)


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