Early life overfeeding in the rat can be experimentally induced by reducing litter size. This investigation assessed the consequences of this manipulation on glucose metabolism in vivo and in isolated hepatocytes in 1...Early life overfeeding in the rat can be experimentally induced by reducing litter size. This investigation assessed the consequences of this manipulation on glucose metabolism in vivo and in isolated hepatocytes in 150-day old rats. Additionally, after body growth, the effects of caloric restriction and refeeding were tested. Adult rats from control （G9） and reduced litters （G3L） did not differ in body and fat weights, glucose tolerance or insulin resistance （insulin-induced hypoglycemia）, or hepatocyte glucose release under basal or gluconeogenic conditions. Caloric restriction （G3R） reduced body and fat weights, decreased glucose decay after insulin injection and decreased hepatocyte gluconeogenic glucose release. Refeeding after caloric restriction reversed these parameters to those of the freely-fed groups （G9 and G3L）. Taken together, these results suggest that the liver glucose metabolism is not programmed by lactational overfeeding, but rather is responsive to the current nutritional condition of the animal.展开更多
Objective: To explore the objective basis of the time and characterstics of refeeding of patients with acute pancreatitis (AP). Methods: AP patients were randomly divided into routine group (n=105) and special group (...Objective: To explore the objective basis of the time and characterstics of refeeding of patients with acute pancreatitis (AP). Methods: AP patients were randomly divided into routine group (n=105) and special group (n=99). The refeeding time and characteristics of the routine group were based on their levels of blood and urine amylase, function of the gastrointestinal tract, and symptoms and signs, and those of the special group on their imaging changes of ultrasonography and CT of the pancreas. Clinical data from the groups were analyzed prospectively and statistically. Results: At the beginning of refeeding, patients of the two groups showed a high recurrence rate of ab- dominal pain (routine group, 9.1%; special group, 10.5%), but no AP relapse. Three days to 2 weeks after refeeding, the patients of the routine group had a higher recurrence rate of abdominal pain (11.1%) and a relapse rate of AP (14.1%) as compared with those of the special group (P<0. 05). Two weeks later, both rates decreased apparently. However, 3 days to 4 weeks after refeeding, the patients of the special group had no recurrence of abdominal pain and relapse of AP. Imaging changes of the pancreas and peripancreatic tissue were not consistent with the symptoms and signs of AP patients. The higher the Balthazar CT grading and APACHE-Ⅱ score, the higher the recurrence rate of abdominal pain and the relapse rate of AP after refeeding (P<0. 05). Conclusions: Symptoms and signs were usually dis- cordant to the imaging changes of the pancreas in AP patients. Imaging changes of the pancreas might serve as a basis for the best occasion of refeeding light semi-fluid or light food in AP patients.展开更多
Although the idea that pancreas rest has long been considered as a very relevant topic in acute pancreatitis (AP)therapy,the right time and type of diet to be offered to patients recovering from an acute attack are a ...Although the idea that pancreas rest has long been considered as a very relevant topic in acute pancreatitis (AP)therapy,the right time and type of diet to be offered to patients recovering from an acute attack are a great challenge to clinicians who treat this condition.Fortunately,the last decade was noted for several trials looking for the best answer to the question:"when and how to start oral refeeding in AP?"It is well known that 80%of patients present with mild disease characterized by usually uncomplicated clinical course are managed with pancreatic rest through nil per oral;while the use of specific nutritional intervention is an exception.Therefore,mild AP has been the most investigated form of AP and researchers have tried different kind of meals to offer calories and reduce costs by shortening hospitalization time.Usually in mild AP,the oral refeeding is introduced between the first 3 d and 7 d after hospitalization but,the type of diet and patients’tolerance have been scrutinized in detail with mixed results.Although 20%to 25%have pain recurrence requiring nutritional support and greater time of hospitalization,most patients seem to tolerate oral refeeding well.We propose analyzing the most recent investigations of this matter and their conclusions to develop a better understanding of the management of AP.展开更多
Takotsubo cardiomyopathy is characterized by the development of transient left ventricular regional wall motion abnormalities,in the absence of significant coronary artery obstruction. This syndrome usually occurs in ...Takotsubo cardiomyopathy is characterized by the development of transient left ventricular regional wall motion abnormalities,in the absence of significant coronary artery obstruction. This syndrome usually occurs in women and is frequently associated with an intense emotional or physical stress. It usually involves apical segments,but in the recent years atypical forms have been described. Inverted or reverse Takotsubo is a variant in which the basal and midventricular segments are hypokinetic,sparing contractile function of the apex. In this report we describe the case of a 54-year-old woman,with chronic malnutrition,initially admitted because of hypoglycemia and severe electrolyte disturbance due to a refeeding syndrome. Within the next hours she experienced acute cardiac symptoms and developed heart failure with low cardiac output. Electrocardiogram(ECG),elevation of troponin and echocardiographic findings were consistent with inverted Takotsubo cardiomyopathy. To the best of our knowledge,this is the first incidence reported of inverted Takotsubo triggered by refeeding syndrome.展开更多
The present study investigated the effect of starvation-refeeding status on cholesterol metabolism in rats fed a high-cholesterol diet or a cholesterol-free diet. Twenty male and 20 female Donryu rats (age 5 weeks) we...The present study investigated the effect of starvation-refeeding status on cholesterol metabolism in rats fed a high-cholesterol diet or a cholesterol-free diet. Twenty male and 20 female Donryu rats (age 5 weeks) were fed a cho-lesterol-free diet for 14 days. Then the male and female rats were each divided into two groups: feeding and starva-tion-refeeding groups. The feeding groups were fed the experimental diet for 3 days, and the starvation-refeeding groups fasted for 2 days followed by 3 days of feeding. Half of each of groups was fed a cholesterol-free diet and the other half was fed a high-cholesterol diet. Starvation-refeeding significantly increased the plasma free cholesterol and HDL-cholesterol concentrations in both the high-cholesterol-diet-fed rats and the cholesterol-free-diet-fed rats. In the female rats, plasma total cholesterol and cholesteryl ester concentrations were significantly higher in the high-cholesterol groups than in the cholesterol-free groups, whereas TG concentration and total cholesterol/TG ratio were not significantly different among all of the groups. Liver total cholesterol and cholesteryl ester were significantly higher in the high-cholesterol groups than in the cholesterol-free groups in both male and female rats. These results suggest that starvation-refeeding affected cholesterol metabolism at least in part. The reactivity of the cholesterol me-tabolism may be different between male and female rats.展开更多
The present study was performed to investegate the effects of high-fat diets containing different fats on cholesterol metabolism in starvation-refeeding rats. Forty female Donryu rats were divided into two groups and ...The present study was performed to investegate the effects of high-fat diets containing different fats on cholesterol metabolism in starvation-refeeding rats. Forty female Donryu rats were divided into two groups and then fed high-fat diets containing beef tallow or corn oil without cholesterol for 14 days. Then, 10 rats from each group were divided into high-cholesterol and cholesterol-free groups (Experiment 1). Another 10 rats from beef tallow and corn oil groups were divided into high-cholesterol and high-cholesterol-cholestyramine groups (Experiment 2). All rats were fasted for 2 days followed by 3 days of feeding. In Experiment 1, the high-cholesterol diet caused significant increases in plasma total cholesterol and cholesteryl ester concentrations in the beef tallow diet group. In Experiment 2, dietary cholestyramine markedly decreased plasma and liver cholesterol levels;however, these cholesterol levels were higher in the beef tallow diet group even if cholestyramine was added to the diet. These results suggested that the cholesterol- lowering effect of dietary corn oil may not be due solely to reabsorption of bile acids. This study suggested that high-fat diets containing different fats affected cholesterol metabolism under conditions of starvation-refeeding.展开更多
文摘Early life overfeeding in the rat can be experimentally induced by reducing litter size. This investigation assessed the consequences of this manipulation on glucose metabolism in vivo and in isolated hepatocytes in 150-day old rats. Additionally, after body growth, the effects of caloric restriction and refeeding were tested. Adult rats from control （G9） and reduced litters （G3L） did not differ in body and fat weights, glucose tolerance or insulin resistance （insulin-induced hypoglycemia）, or hepatocyte glucose release under basal or gluconeogenic conditions. Caloric restriction （G3R） reduced body and fat weights, decreased glucose decay after insulin injection and decreased hepatocyte gluconeogenic glucose release. Refeeding after caloric restriction reversed these parameters to those of the freely-fed groups （G9 and G3L）. Taken together, these results suggest that the liver glucose metabolism is not programmed by lactational overfeeding, but rather is responsive to the current nutritional condition of the animal.
文摘Objective: To explore the objective basis of the time and characterstics of refeeding of patients with acute pancreatitis (AP). Methods: AP patients were randomly divided into routine group (n=105) and special group (n=99). The refeeding time and characteristics of the routine group were based on their levels of blood and urine amylase, function of the gastrointestinal tract, and symptoms and signs, and those of the special group on their imaging changes of ultrasonography and CT of the pancreas. Clinical data from the groups were analyzed prospectively and statistically. Results: At the beginning of refeeding, patients of the two groups showed a high recurrence rate of ab- dominal pain (routine group, 9.1%; special group, 10.5%), but no AP relapse. Three days to 2 weeks after refeeding, the patients of the routine group had a higher recurrence rate of abdominal pain (11.1%) and a relapse rate of AP (14.1%) as compared with those of the special group (P<0. 05). Two weeks later, both rates decreased apparently. However, 3 days to 4 weeks after refeeding, the patients of the special group had no recurrence of abdominal pain and relapse of AP. Imaging changes of the pancreas and peripancreatic tissue were not consistent with the symptoms and signs of AP patients. The higher the Balthazar CT grading and APACHE-Ⅱ score, the higher the recurrence rate of abdominal pain and the relapse rate of AP after refeeding (P<0. 05). Conclusions: Symptoms and signs were usually dis- cordant to the imaging changes of the pancreas in AP patients. Imaging changes of the pancreas might serve as a basis for the best occasion of refeeding light semi-fluid or light food in AP patients.
基金Supported by A grant from CNPq,Brazil(to Julio Maria Fonseca Chebli)a clinical research fund from the CNPq and FAPE- MIG,Brazil(in part)
文摘Although the idea that pancreas rest has long been considered as a very relevant topic in acute pancreatitis (AP)therapy,the right time and type of diet to be offered to patients recovering from an acute attack are a great challenge to clinicians who treat this condition.Fortunately,the last decade was noted for several trials looking for the best answer to the question:"when and how to start oral refeeding in AP?"It is well known that 80%of patients present with mild disease characterized by usually uncomplicated clinical course are managed with pancreatic rest through nil per oral;while the use of specific nutritional intervention is an exception.Therefore,mild AP has been the most investigated form of AP and researchers have tried different kind of meals to offer calories and reduce costs by shortening hospitalization time.Usually in mild AP,the oral refeeding is introduced between the first 3 d and 7 d after hospitalization but,the type of diet and patients’tolerance have been scrutinized in detail with mixed results.Although 20%to 25%have pain recurrence requiring nutritional support and greater time of hospitalization,most patients seem to tolerate oral refeeding well.We propose analyzing the most recent investigations of this matter and their conclusions to develop a better understanding of the management of AP.
基金Supported by Hospital Universitario Fundación Alcorcón,Madrid(Spain)
文摘Takotsubo cardiomyopathy is characterized by the development of transient left ventricular regional wall motion abnormalities,in the absence of significant coronary artery obstruction. This syndrome usually occurs in women and is frequently associated with an intense emotional or physical stress. It usually involves apical segments,but in the recent years atypical forms have been described. Inverted or reverse Takotsubo is a variant in which the basal and midventricular segments are hypokinetic,sparing contractile function of the apex. In this report we describe the case of a 54-year-old woman,with chronic malnutrition,initially admitted because of hypoglycemia and severe electrolyte disturbance due to a refeeding syndrome. Within the next hours she experienced acute cardiac symptoms and developed heart failure with low cardiac output. Electrocardiogram(ECG),elevation of troponin and echocardiographic findings were consistent with inverted Takotsubo cardiomyopathy. To the best of our knowledge,this is the first incidence reported of inverted Takotsubo triggered by refeeding syndrome.
文摘The present study investigated the effect of starvation-refeeding status on cholesterol metabolism in rats fed a high-cholesterol diet or a cholesterol-free diet. Twenty male and 20 female Donryu rats (age 5 weeks) were fed a cho-lesterol-free diet for 14 days. Then the male and female rats were each divided into two groups: feeding and starva-tion-refeeding groups. The feeding groups were fed the experimental diet for 3 days, and the starvation-refeeding groups fasted for 2 days followed by 3 days of feeding. Half of each of groups was fed a cholesterol-free diet and the other half was fed a high-cholesterol diet. Starvation-refeeding significantly increased the plasma free cholesterol and HDL-cholesterol concentrations in both the high-cholesterol-diet-fed rats and the cholesterol-free-diet-fed rats. In the female rats, plasma total cholesterol and cholesteryl ester concentrations were significantly higher in the high-cholesterol groups than in the cholesterol-free groups, whereas TG concentration and total cholesterol/TG ratio were not significantly different among all of the groups. Liver total cholesterol and cholesteryl ester were significantly higher in the high-cholesterol groups than in the cholesterol-free groups in both male and female rats. These results suggest that starvation-refeeding affected cholesterol metabolism at least in part. The reactivity of the cholesterol me-tabolism may be different between male and female rats.
文摘The present study was performed to investegate the effects of high-fat diets containing different fats on cholesterol metabolism in starvation-refeeding rats. Forty female Donryu rats were divided into two groups and then fed high-fat diets containing beef tallow or corn oil without cholesterol for 14 days. Then, 10 rats from each group were divided into high-cholesterol and cholesterol-free groups (Experiment 1). Another 10 rats from beef tallow and corn oil groups were divided into high-cholesterol and high-cholesterol-cholestyramine groups (Experiment 2). All rats were fasted for 2 days followed by 3 days of feeding. In Experiment 1, the high-cholesterol diet caused significant increases in plasma total cholesterol and cholesteryl ester concentrations in the beef tallow diet group. In Experiment 2, dietary cholestyramine markedly decreased plasma and liver cholesterol levels;however, these cholesterol levels were higher in the beef tallow diet group even if cholestyramine was added to the diet. These results suggested that the cholesterol- lowering effect of dietary corn oil may not be due solely to reabsorption of bile acids. This study suggested that high-fat diets containing different fats affected cholesterol metabolism under conditions of starvation-refeeding.
