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Atrial flutter catheter ablation in adult congenital heart diseases.

Indian Pacing Electrophysiol J 2021 Jun 19. Epub 2021 Jun 19.

Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Le Plessis-Robinson, France; Department of Pediatric Cardiology and Congenital Heart Diseases, Pasteur Clinic, Toulouse, France.

The important increase in life expectancy of adult patients with congenital heart disease (ACHD) has generated new challenges, including arrhythmias that represent one of the main late complications. Reentrant atrial arrhythmias are by far the main mechanism encountered, and catheter ablation has been now presented as a first-line therapy in this patient population. The number of procedures is expected to continuously increase year after year. Read More

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Therapeutic efficacy of connectivity-directed transcranial magnetic stimulation on anticipatory anhedonia.

Depress Anxiety 2021 Jun 22. Epub 2021 Jun 22.

School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.

Background: There are currently no effective treatments specifically targeting anticipatory anhedonia, a major symptom of severe depression which is associated with poor outcomes. The present study investigated the efficacy of individualized repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (lDLPFC)-nucleus accumbens (NAcc) network on anticipatory anhedonia in depression.

Methods: This randomized, double-blind, sham-controlled clinical trial (NCT03991572) enrolled 56 depression patients with anhedonia symptoms. Read More

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Predicting motor gains with home-based telerehabilitation after stroke.

J Telemed Telecare 2021 Jun 22:1357633X211023353. Epub 2021 Jun 22.

Department of Neurology, 8783University of California Los Angeles, USA.

Introduction: Telerehabilitation (TR) may be useful for rehabilitation therapy after stroke. However, stroke is a heterogeneous condition, and not all patients can be expected to derive the same benefit from TR, underscoring the need to identify predictors of response to TR.

Methods: A prior trial provided patients with 6 weeks of intensive rehabilitation therapy targeting arm movement, randomly assigned to be provided in the home via TR (current focus) or in clinic. Read More

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Long-term survival of a patient with amyotrophic lateral sclerosis (ALS) who received autologous adipose-derived mesenchymal stem cells.

Eur Rev Med Pharmacol Sci 2021 Jun;25(11):4086-4090

Department of Neurology, Minami Kyoto Hospital, National Hospital Organization, Kyoto, Japan.

Objective: Amyotrophic lateral sclerosis (ALS) is a progressive debilitating neurodegenerative disease with a life expectancy of 3-5 years from initial symptoms. We report a case of ALS who received autologous adipose-derived mesenchymal stem cells (ADSC) and was followed up for 7 years.

Case Report: A 46-year-old man noticed weakness of his legs, difficulties on going down the stairs and coughing during eating in 2009. Read More

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Long-term survival after primary intracerebral hemorrhage: a population-based case-control study spanning a quarter of a century.

Eur J Neurol 2021 Jun 22. Epub 2021 Jun 22.

Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.

Background And Purpose: The aim of this study was to determine the differences in life expectancy and causes of death after primary intracerebral hemorrhage (ICH) relative to general population controls.

Methods: In a population-based setting, 963 patients from Northern Ostrobothnia who had their first-ever ICH between 1993 and 2008 were compared with a cohort of 2884 sex and age-matched controls in terms of dates and causes of death (COD) as extracted from the Causes of Death Register kept by Statistics Finland and valid up to the end of 2017.

Results: Out of our 963 patients, 781 died during the follow-up time (mortality 81. Read More

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Precision medicine in Fabry disease.

Nephrol Dial Transplant 2021 Jun;36(Supplement_2):14-23

Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, Interdisciplinary Fabry Center Münster, University Hospital Münster, Münster, Germany.

Fabry disease (FD) is a rare X-linked lysosomal storage disorder caused by mutations in the α-galactosidase A (GLA) gene, leading to a deficiency in α-galactosidase A. The lysosomal accumulation of glycosphingolipids, primarily globotriaosylceramide (Gb3) and its deacylated form, globotriaosylsphingosine (lyso-Gb3), results in progressive renal failure, cardiomyopathy associated with cardiac arrhythmia and recurrent cerebrovascular events, significantly limiting life expectancy in affected patients. In male patients, a definitive diagnosis of FD involves demonstrating a GLA deficiency in leucocytes. Read More

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Precision medicine in diabetic nephropathy and chronic kidney disease.

Nephrol Dial Transplant 2021 Jun;36(Supplement_2):10-13

Department of Internal Medicine I, Division of Nephrology, Würzburg University Medical Center, Würzburg, Germany.

Progressive chronic kidney disease (CKD) in individuals with type 2 diabetes mellitus is a global public health problem accompanied by substantial comorbidities and reduced life expectancy. In this respect, CKD leading to uremia can be seen as a systemic disease with a critical impact on virtually all organ systems. Thus it is of particular importance to identify patients with incipient CKD and ongoing CKD progression, but the individual course of CKD is challenging to predict. Read More

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Fibromyalgia syndrome - a risk factor for poor outcomes following orthopaedic surgery: A systematic review.

Semin Arthritis Rheum 2021 Jun 9;51(4):793-803. Epub 2021 Jun 9.

Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy. Electronic address:

Background: Fibromyalgia (FM) is a complex syndrome incorporating many features associated with poor outcome in orthopaedic surgery. Aim of the present review was to comprehensively characterize the available evidence on the consequences of pre-existent FM on the outcomes of orthopaedic surgery.

Methods: We performed a systematic search in MedLine and Web of Science (WOS) to identify studies evaluating the effect of FM on patient-centred outcomes, opioids consumption and postoperative complications. Read More

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Are patient reported outcome measures (PROMs) useful in low back pain? Experiences of physiotherapists in primary health care in Sweden.

Musculoskelet Sci Pract 2021 Jun 6;55:102414. Epub 2021 Jun 6.

Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Alfred Nobels Allé 23, 141 83 Huddinge, Sweden.

Background: Physiotherapists in primary health care are required to use patient reported outcome measures (PROMs) to manage patients with low back pain (LBP).

Objective: Our aim was to explore and describe how physiotherapists in primary care managing patients with LBP, experience the use of PROMs with a focus on facilitating and hindering factors.

Methods: We undertook a qualitative study with semi-structured interviews. Read More

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Health and economic burden estimates of snakebite management upon health facilities in three regions of southern Burkina Faso.

PLoS Negl Trop Dis 2021 Jun 21;15(6):e0009464. Epub 2021 Jun 21.

The Centre for Snakebite Research & Interventions, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.

Background: Snakebite has become better recognized as a significant cause of death and disability in Sub-Saharan Africa, but the health economic consequences to victims and health infrastructures serving them remain poorly understood. This information gap is important as it provides an evidence-base guiding national and international health policy decision making on the most cost-effective interventions to better manage snakebite. Here, we assessed hospital-based data to estimate the health economic burden of snakebite in three regions of Burkina Faso (Centre-Ouest, Hauts Bassins and Sud-Ouest). Read More

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Humanizing the ICU Patient: A Qualitative Exploration of Behaviors Experienced by Patients, Caregivers, and ICU Staff.

Crit Care Explor 2021 Jun 15;3(6):e0463. Epub 2021 Jun 15.

Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY.

Objectives: To understand how patients and family members experience dehumanizing or humanizing treatment when in the ICU.

Design: Qualitative study included web-based focus groups and open-ended surveys posted to ICU patient/family social media boards. Focus groups were audio recorded and transcribed. Read More

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Weight management counseling experiences of first year medical students before starting medical school and their self-perceived impact on treating patients with obesity.

Prev Med Rep 2021 Sep 1;23:101411. Epub 2021 Jun 1.

Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.

Physicians can play a vital role in counseling patients on overweight and obesity. This secondary analysis examined whether experiences in patient care specific to weight management before starting medical school were associated with students' intentions and confidence to provide weight management counseling (WMC) to patients who have overweight or obesity, and perceived impact as future physicians on patients' motivation to manage weight. First-year medical students (n = 1305) in the entering class of 2020 at eight medical schools nationwide completed questions relating to their prior experiences in patient care and WMC using the 5As. Read More

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September 2021

Longitudinal Data in Patients with Niemann-Pick Type C Disease Under Combined High Intrathecal and Low Intravenous Dose of 2-hydroxylpropyl-β-cyclodextrin.

Innov Clin Neurosci 2021 Jan-Mar;18(1-3):11-16. Epub 2021 Jan 1.

Drs. Bountouvi, Giorgi, Papadopoulou, Tsirouda, Fryganas, Spanou, Georgaki, Asprogeraka, and Dinopoulos are with the Third Department of Pediatrics, Athens University Medical School, at the University General Hospital "Attikon" in Athens, Greece.

Niemann-Pick Type C disease (NPC) is a rare, incurable, autosomal-recessive, lysosomal storage disorder with protean and progressive neurovisceral manifestations characterized by accumulation of intracellular unesterified cholesterol. The investigational use of 2-hydroxypropyl-beta-cyclodextrin (HP-β-CD) in the treatment of NPC has shown promising results in improving life expectancy and reducing neurological damage in this patient population. This case report describes two children with the neurological form of NPC: a 5-year-old male patient in advanced stage of the disease and an 11-year-old female patient in moderately advanced stage. Read More

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January 2021

Hematopoietic Stem Cell Therapy for Wiskott-Aldrich Syndrome: Improved Outcome and Quality of Life.

J Blood Med 2021 11;12:435-447. Epub 2021 Jun 11.

Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.

The Wiskott-Aldrich syndrome (WAS) is an X-linked disorder caused by mutations in the gene resulting in congenital thrombocytopenia, eczema, recurrent infections and an increased incidence of autoimmune diseases and malignancies. Without curative therapies, affected patients have diminished life expectancy and reduced quality of life. Since WAS protein (WASP) is constitutively expressed only in hematopoietic stem cell-derived lineages, hematopoietic stem cell transplantation (HSCT) and gene therapy (GT) are well suited to correct the hematologic and immunologic defects. Read More

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Threshold Analysis of the Cost-effectiveness of Endoscopic Ultrasound in Patients at High Risk for Pancreatic Ductal Adenocarcinoma.

Pancreas 2021 Jun 19. Epub 2021 Jun 19.

From the Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA Division of Digestive and Liver Diseases, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY Division of Gastroenterology, St Luke's University Health Network, Allentown, PA Division of Gastroenterology, University of Pittsburgh Medical Center, Pittsburgh, PA Division of Gastroenterology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH Division of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD.

Objectives: Data from the International Cancer of the Pancreas Screening Consortium studies have demonstrated that screening for pancreatic ductal adenocarcinoma can be effective and that surveillance improves survival in high-risk individuals. Endoscopic ultrasound (EUS) and cross-sectional imaging are both used, although there is some suggestion that EUS is superior. Demonstration of the cost-effectiveness of screening is important to implement screening in high-risk groups. Read More

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Establishment of a multimodal protocol combining a motivational interview, subcutaneous injection of NicoSan® and hyper-hydration for the "stopsmoking therapy": A multicentre real-life study'.

Encephale 2021 Jun 17. Epub 2021 Jun 17.

Clinique de l'Alliance, 3, Voie de l'Orchidée Sauvage, 93420 Villepinte, France.

Objectives: The StopSmoking Therapy, combins a motivational interview, a subcutaneous injection of NicoSan® and a hyperhydration protocol. The objectives were to evaluate the number of patients declaring cessation and factors related to relapse.

Methods: In the 18 months following protocol, 554 subjects who consented, responded to the study's questionnaire. Read More

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Female Sex is Associated with Improved Long-Term Survival Following Allogeneic Hematopoietic Stem Cell Transplant.

Transplant Cell Ther 2021 Jun 16. Epub 2021 Jun 16.

Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC. Electronic address:

Background: Life expectancy for long-term survivors of allogeneic hematopoietic stem cell transplant (alloHSCT), defined as those living ≥5 years post-transplant, is significantly lower compared to that of the age-matched general population despite a relatively low primary disease relapse rate >2 years post-transplant. Among several factors, patient sex is increasingly recognized as a prognostic indicator of long-term survival.

Objective: We examined the influence of patient sex and donor-recipient sex matching on overall survival in a landmark analysis of long-term survivors. Read More

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Life expectancy estimations and determinants of return to work among cancer survivors over a 7-year period.

Sci Rep 2021 Jun 18;11(1):12858. Epub 2021 Jun 18.

Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.

Due to advances in medical science and technology, the number of cancer survivors continues to increase. The workplace needs and employment difficulties cancer survivors face after treatment need to be addressed to protect these individuals' right to work and to maintain the overall labor force of the country. We conducted a retrospective cohort study with a follow-up period from 2004 to 2010. Read More

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Virtual reality and annotated radiological data as effective and motivating tools to help Social Sciences students learn neuroanatomy.

Sci Rep 2021 Jun 18;11(1):12843. Epub 2021 Jun 18.

Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.

Neuroanatomy as a subject is important to learn, because a good understanding of neuroanatomy supports the establishment of a correct diagnosis in neurological patients. However, rapid changes in curricula reduced time assigned to study (neuro)anatomy. Therefore, it is important to find alternative teaching methods to study the complex three-dimensional structure of the brain. Read More

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Prevalence of Cardiac Abnormalities in Children with Chronic Kidney Disease: A Cross-sectional Study from a Developing Country.

Saudi J Kidney Dis Transpl 2021 Jan-Feb;32(1):92-100

Department of Pediatric Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

Improved therapeutic modalities in chronic kidney diseases (CKD) children and consequent extension of life expectancy, draws more attention towards secondary complications. Cardiovascular adaptations precipitating such terminal events, begin in pre-dialysis CKD. Hence, it's imperative to identify modifiable risk factors to direct care and resources in haltering CKD progression, evade long-term dialysis and anticipate kidney transplantation to avert cardiac complications in predialysis period. Read More

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[Prognosis of in hospital nonagenarians with acute kidney injury].

An Sist Sanit Navar 2021 Jun 18;0(0). Epub 2021 Jun 18.

Servicio de Nefrología. Hospital Universitario de La Princesa. Madrid..

Background: There has been little in the way of study of nonagenarians with acute kidney injury (AKI, defined in lines with KDIGO guidelines), but the rise in their life expectancy makes further study of this population necessary. The aim of this study is to assess mortality in nonagenarians with AKI during hospitalization.

Methods: In this retrospective study, patients with AKI during hospitalization between 2013-2014 were included. Read More

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Estimating the health benefits of timely diagnosis and treatment of transthyretin amyloid cardiomyopathy.

J Comp Eff Res 2021 Jun 18. Epub 2021 Jun 18.

University of Utah, Salt Lake City, UT 84132, USA.

Delayed diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) represents a missed opportunity for intervention. This study estimates the health benefits of timely diagnosis and treatment with tafamidis. A disease simulation model was developed to predict health outcomes under scenarios of timely and delayed diagnosis and treatment. Read More

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Immunological mechanisms underlying progression of chronic wounds in recessive dystrophic epidermolysis bullosa.

Exp Dermatol 2021 Jun 17. Epub 2021 Jun 17.

Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Hereditary epidermolysis bullosa (EB) is a mechanobullous skin fragility disorder characterized by defective epithelial adhesion, leading to mechanical stress-induced skin blistering. Based on the level of tissue separation within the dermal-epidermal junction, EB is categorized into simplex (EBS), junctional (JEB), dystrophic (DEB), and Kindler syndrome. There is no cure for EB, and painful chronic cutaneous wounds are one of the major complications in recessive (RDEB) patients. Read More

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Hemodynamic Abnormalities in the Aorta of Turner Syndrome Girls.

Front Cardiovasc Med 2021 1;8:670841. Epub 2021 Jun 1.

Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom.

Congenital abnormalities in girls and women with Turner syndrome (TS), alongside an underlying predisposition to obesity and hypertension, contribute to an increased risk of cardiovascular disease and ultimately reduced life expectancy. We observe that children with TS present a greater variance in aortic arch morphology than their healthy counterparts, and hypothesize that their hemodynamics is also different. In this study, computational fluid dynamic (CFD) simulations were performed for four TS girls, and three age-matched healthy girls, using patient-specific inlet boundary conditions, obtained from phase-contrast MRI data. Read More

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Reducing Generalization of Conditioned Fear: Beneficial Impact of Fear Relevance and Feedback in Discrimination Training.

Front Psychol 2021 1;12:665711. Epub 2021 Jun 1.

Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Center of Mental Health, University of Würzburg, Würzburg, Germany.

Anxiety patients over-generalize fear, possibly because of an incapacity to discriminate threat and safety signals. Discrimination trainings are promising approaches for reducing such fear over-generalization. Here we investigated the efficacy of a fear-relevant vs. Read More

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Does Health Literacy Make a Difference? Comparing the Effect of Conventional Medicine Versus Homeopathic Prescribing on Treatment Credibility and Expectancy.

Front Psychol 2021 1;12:581255. Epub 2021 Jun 1.

Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany.

Objective: While homeopathic remedies are often used to treat non-specific complaints such as headaches, empirical evidence suggests their treatment effect is due to the placebo effect. Low health literacy seems to be connected to higher use of complementary and alternative medicine (CAM). The aim of this study was to examine what people with occasional headaches expect from conventional medicine or homeopathic remedies and if health literacy interacts with this expectation. Read More

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Health system preparedness for COVID-19 and its impacts on frontline health care workers in Nepal: a qualitative study among frontline healthcare workers and policymakers.

Disaster Med Public Health Prep 2021 Jun 18:1-29. Epub 2021 Jun 18.

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.

Background: Rapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to the health system in Nepal. The main objective of this study was to explore the health system preparedness for COVID-19 and its impacts on frontline health care workers in Nepal.

Methods: Semi-structured interviews were conducted among 32 health care workers who were involved in clinical care of COVID-19 patients and four policymakers who were responsible for COVID-19 control and management at central and provincial level. Read More

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The referral of patients to smoking cessation counselling: perceptions and experiences of healthcare providers in general practice.

BMC Health Serv Res 2021 Jun 17;21(1):583. Epub 2021 Jun 17.

The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, PO Box 725, 3500 AS, Utrecht, The Netherlands.

Background: Few European smokers receive professional counselling when attempting to quit smoking, resulting in suboptimal success rates and poor health outcomes. Healthcare providers in general practice play an important role in referring smokers to smoking cessation counselling. We chose the Netherlands as a case study to qualitatively explore which factors play a role among healthcare providers in general practice with regard to referral for smoking cessation counselling organised both inside and outside general practice. Read More

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AXL receptor tyrosine kinase: a possible therapeutic target in acute promyelocytic leukemia.

BMC Cancer 2021 Jun 17;21(1):713. Epub 2021 Jun 17.

Department of Healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, H-12, Campus, Islamabad, Pakistan.

Background: Acute promyelocytic leukemia (APL) is a subset of acute myeloid leukemia (AML) which is characterized by the fusion of promyelocytic leukemia PML and retinoic acid receptor- alpha (RAR-alpha) genes. All-trans retinoic acid (ATRA) and/or arsenic trioxide (ATO) have resulted in durable cytogenetic and molecular remissions in most APL patients and have altered the natural history of the disease. Most APL patients treated with ATRA and/or ATO are now anticipated to have a nearly normal life expectancy. Read More

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Effect of age, stress and protein supply on plasma amino acids during continuous enteral nutrition; a pragmatic study in rats.

Clin Nutr 2021 May 7;40(6):3931-3939. Epub 2021 May 7.

EA 4466 PRETRAM, Faculty of Pharmacy, Paris University, France; Clinical Chemistry Department, Cochin Hospital, AP-HP.Centre - Université de Paris, France. Electronic address:

Background & Aims: As life expectancy increases, an increasing older population may require surgery with perioperative nutritional management. While little is known about the combined effect of age and stress on amino acid metabolism during enteral nutrition, we hypothesized that blood amino acid bioavailability may be influenced not only by the characteristics of the ingested protein but also by intestinal ageing and splanchnic sequestration of amino acids. Plasma amino acid kinetics were thus evaluated in aged and adult rats receiving continuous enteral nutrition before and after standardized surgical stress. Read More

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