Molecular Oxygen Levels and Percentages of DNA Damage in TPN Patients

Total parenteral nutrition (TPN) is a life-saving therapy for patients with intestinal failure, but it carries the risk of complications, including an increase in liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) after long-term use. Patients receiving chronic TPN are also exposed to metabolic stress from both the underlying disease and parenteral nutrition. The aim of this study was to compare the concentration of liver transaminases AST and ALT in relation to the rate of oxygen consumption in platelet mitochondria in patients receiving long-term TPN with the degree of oxidative stress induced by lipid emulsions, and to explain their role in cellular energy metabolism and changes in the liver based on the percentage of genomic DNA damage. The study group consisted of 86 TPN patients, while the control group consisted of 86 healthy volunteers who were fed only orally. The results of the study showed that the percentage of molecular oxygen depended on the type of lipid emulsion supplied. Analyzing time on TPN as a factor, we observed a decrease in percentage genomic DNA damage and an increase in percentage molecular oxygen in cells. It remains unclear whether TPN has a direct effect on genomic DNA damage and the level of molecular oxygen in cells during the course of treatment. In conclusion, this study provides important insights into the potential effects of TPN on liver enzymes and cellular metabolism. Further research is needed to better understand the underlying mechanisms and to develop strategies to minimize the risk of complications associated with TPN.

Changes in Parenteral Nutrition Requirements and BMI in Patients with Parenteral Nutrition-Dependent Short Bowel Syndrome after Stopping Teduglutide-9 Years of Follow-Up

Teduglutide (TED) is widely used in patients with short-bowel-syndrome-associated intestinal failure (SBS-IF) to enhance intestinal adaptation and reduce the need for parenteral support (PS). There are limited data on the effects of discontinuing TED. In this study, we describe the changes in parenteral nutrition (PN) requirements and body mass index (BMI) in a 9-year follow-up of patients receiving home parenteral nutrition after discontinuation of the TED treatment. We performed a retrospective analysis of changes in weekly PN orders and BMI in all patients with PN-dependent SBS from two Polish home parenteral nutrition (HPN) centers who received teduglutide between 2009 and 2013 and still required HPN 9 years after discontinuation of the TED treatment. Data included in the analysis were collected prospectively at mandatory visits to the HPN centers at 12, 24, 60, 84, and 108 months after drug discontinuation and compared with values before and after TED treatment. Weekly PN volume values varied significantly between all of the above time points from baseline to 9 years after TED discontinuation (χ2 = 34.860, p < 0.001). After an initial increase within the first year after treatment discontinuation (not statistically significant), the PN volume requirements remained stable for 4 years and increased 5−9 years after treatment discontinuation. The rate of patients requiring an increase in PN volume was 84.62% at 60 and 84 months and 92.30% at 108 months. At 9 years after cessation of the TED treatment, 53.85% of the study group required a 21.21% increase in PN volume compared with values before treatment. The need for PN volume in patients with PN-dependent SBS who discontinued the TED treatment increased within the first year and 4−5 years after treatment cessation, and in some cases might even exceed pretreatment values after 9 years.

Effect of Thickening Powder on Gastrointestinal Losses in Patients With High-output End Jejunostomy Syndrome - Preliminary Results

BACKGROUND/AIM

End jejunostomy syndrome is a type of short bowel syndrome (SBS) in which the jejunum forms the end of the bowel, as a result of resection or exclusion of the ileum and colon. It is associated with a high risk of dehydration, electrolyte imbalance, and malnutrition due to excessive stomal losses.

PATIENTS AND METHODS

In this retrospective study, we analyzed the medical records of sixteen adult patients with SBS and high-output end jejunostomy syndrome who received thickened fluids during their hospitalization in the home parenteral nutrition unit. The main parameter considered was daily stoma excretion volume, measured by 24-h collection. Values were compared between days when patients drank the daily amount of 600 ml of water, and days when patients ingested the same amount of water but mixed with thickening powder to achieve a mildly thick consistency.

RESULTS

Median volumes of end jejunostomy output were significantly lower when patients consumed the mixture of water and thickening powder, compared with drinking water without additives (550.0 ml/d vs. 811.9 ml/d, p=0.002).

CONCLUSION

These preliminary results demonstrate a potential benefit of thickening powder for the nutritional management of patients with SBS type I, and point to the need for further randomized clinical studies with larger patient groups.

Characteristics of Block Copolymers of Methyl Oxirane and Oxirane Derivatives of 2-Ethylhexanol as Obtained with KOH and Dimetalcyanide Type Catalyst

Two series of block copolymers of methyloxirane and oxirane, derivatives of 2-ethylhexanol, were obtained with the use of KOH as a conventional homogeneous alkaline catalyst and a coordinative dimetalcyanide catalyst (DMC), respectively. The DMC type catalyst showed much higher kinetic activities and its reaction exhibited a narrower distribution of homologues, as compared with those obtained in the presence of KOH. The thermogravimetric technique was proposed for the characterization of the fractional content of products. The pluming phenomenon and VOCs content were discussed as a practical aspect of the differences in fractional compositions of the products examined.

2-Ethylhexanol Derivatives as Nonionic Surfactants: Synthesis and Properties

The synthesis and basic properties of 2-ethylhexanol based innovative nonionic surfactants are described in this paper. 2-Ethylhexanol as an available and relatively inexpensive raw material was used as the hydrophobe source modified by propoxylation and followed by polyethoxylation. As the result, six series of 2-ethylhexyl alcohol polyalkoxylates (EHP _m E _n ) were obtained with three steps of propoxylation, each followed by polyethoxylation and two series only with polyethoxylation (EHE _n ). Two different catalysts were used, a dimetalcyanide and KOH. Values of average conversion rates and chemical content of the obtained products (GC, TG and GPC techniques) were compared. The influence of the applied catalyst and polyaddition degree on the homologue distribution, reactant conversion and amount of byproducts is discussed. The basic physicochemical parameters including refractive index, solubility in polar media, foaming properties and wettability were investigated and compared. Furthermore, surface activity parameters, i.e. surface tension (γ_CMC) and critical micelle concentrations were determined. Results are compared to C_12-14 alcohol ethoxylates (LaE _n ). Accordingly, it was found that the studied 2-ethylhexyl alcohol based compounds are effective, low foaming nonionic surfactants.