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Supplementation in modulating oxidative stress after major elective surgery was to evaluate these two components of patient outcome. The prospective double blind trial conducted on surgery patients between November 2002 and April 2003 was designed to treat oxidative stress in previously identified susceptible patient groups. Glutamine was chosen with the aim of increasing GSH levels thereby correcting oxidative stress, and it was clinically acceptable because previous use. Oral alanyl-glutamine was found to be a safe supplement in the immediate post-operative period. The study revealed depletion in plasma glutamine levels following surgery in all patients. Oral alanyl-glutamine was effective even at very low doses 0.3 g kg body weight ; in increasing plasma glutamine p 0.002 ; and antioxidant levels as well as in reducing strong oxidant production p 0.005 ; . The difference in plasma glutamine levels between the treatment and control groups was however limited probably due to the following possible reasons. There is increasing awareness and over the counter use of antioxidant supplements hence the higher preoperative plasma glutamine levels observed in the control group. Elective surgery is classified as mild to moderate trauma, radical production and the need to increase erythrocyte glutathione is therefore limited. The other reason for the transient increase observed could be due to the low dose used in this study. We therefore recommend increasing the dose up to 0.75g kg in clinical practice in order to maximize the benefit derived from the supplement. Glutamine supplement reduced hospital stay in noncancer and higher complexity groups but not in the cancer group. This may be because surgery is first line of cancer therapy while it is a consequence of inadequate medical treatment in non-cancer patients who usually have pre-existing medical factors and previous glutamine depletion. Despite it's limitation as a measure of economic benefit as shown by Girroti et al [301], the RIW score improved with glutamine supplementation. The intervention resulted in significant economic benefit in patients with greater disease complexity that will invariably benefit the health care system significantly. Higher doses of oral alanyl-glutamine supplementation are therefore recommended in major surgery patients both in the pre and post-operative periods to enhance improved patient outcome. The research on oxidative stress in trauma and surgery patients has provided better understanding of the mechanism of oxidative stress, a bedside method of.
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1. Franco EL, Duarte-Franco E, Ferenczy A. Cervical cancer: epidemiology, prevention and the role of human papillomavirus infection. CMAJ. 2001; 164: 10171025. Burk RD, Kelly P, Feldman J, et al. Declining prevalence of cervicovaginal human papillomavirus infection with age is independent of other risk factors. Sex Transm Dis. 1996; 23: 333341. Ho GY, Bierman R, Beardsley L, Chang CJ, Burk RD. Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med. 1998; 338: 423428. Van Ranst MA, Tachezy R, Delius H, Burk RD. Taxonomy of the human papillomaviruses. Papillomavirus Rep. 1993; 4: 61. Noorani HZ, Brown A, Skidmore B, Stuart GCE. Liquid-based cytology and human papillomavirus testing in cervical cancer screening. Ottawa, ON: Canadian Coordinating Office for Health Technology Assessment; 2003. Technology Report No. 40. 6. ACOG Committee on Practice Bulletins. ACOG Practice Bulletin: clinical management guidelines for obstetrician-gynecologists. Number 45, August 2003. Cervical cytology screening replaces committee opinion 152, March 1995 ; . Obstet Gynecol. 2003; 102: 417427. Sasieni P, Adams J, Cuzick J. Benefits of cervical screening at different ages: evidence from the UK audit of screening histories. Br J Cancer. 2003; 89: 8893. Anttila A, Ronco G, Clifford G, et al. Cervical cancer screening programmes and policies in 18 European countries. Br J Cancer. 2004; 91: 935941. Cervical Cancer Prevention Network. Programmatic Guidelines for Screening for Cancer of the Cervix in Canada. Ottawa, ON: Health Canada and the Society of Obstetricians and Gynecologists of Canada; 1998. 10. Sigurdsson K. The Icelandic and Nordic cervical screening programs: trends in incidence and mortality rates through 1995. Acta Obstet Gynecol Scand. 1999; 78: 478485. Nieminen P, Kallio M, Anttila A, Hakama M. Organised vs. spontaneous Pap-smear screening for cervical cancer: a case-control study. Int J Cancer. 1999; 83: 5558. Health Canada. Cervical Cancer Screening in Canada: 1998 Surveillance Report. Ottawa, ON: Health Canada; 2002. 13. Hawes SE, Critchlow CW, Faye Niang MA, et al. Increased risk of high-grade cervical squamous intra-epithelial lesions and invasive cervical cancer among African women with human immunodeficiency virus type 1 and 2 infections. J Infect Dis. 2003; 188: 555563. Paterson ME, Peel KR, Joslin CA. Cervical smear histories of 500 women with invasive cancer in Yorkshire. BMJ. 1984; 289: 896898. Sexually transmitted diseases treatment guidelines 2002. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2002; 51 RR-6 ; : 178. 16. Chao A, Lin CT, Hsueh S, et al. Usefulness of human papillomavirus testing in the follow-up of patients with high-grade cervical intra-epithelial neoplasia after conization. J Obstet Gynecol. 2004; 190: 10461051. Tyring SK, Arany I, Stanley MA, et al. A randomized, controlled, molecular study of condylomata acuminata clearance during treatment with imiquimod. J Infect Dis. 1998; 178: 551555. Kirby P, Dunne A, King DH, Corey L. Double-blind randomized clinical trial of self-administered podofilox solution vehicle in the treatment of genital warts. J Med. 1990; 88: 465470. Simmons PD, Langlet F, Thin RN. Cryotherapy versus electrocautery in the treatment of genital warts. Br J Vener Dis. 1981; 57: 273274. Godley MJ, Bradbeer CS, Gellan M, Thin RN. Cryotherapy compared with trichloroacetic acid in treating genital warts. Genitourin Med. 1987; 63: 390392. Abdullah AN, Walzman M, Wade A. Treatment of external genital warts comparing cryotherapy liquid nitrogen ; and trichloroacetic acid. Sex Transm Dis. 1993; 20: 344345. Gross GE, Barasso R, eds. Human Papillomavirus Infection: A Clinical Atlas. Wiesbaden: Ullstein Mosby; 1997. G.
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Trey C, Burns DG, Saunders SJ. Treatment of hepatic coma by exchange blood transfusion. N Engl J Med 1966 ; 274 : 473-81. Pugh RNH, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Brit J Surg 1973 ; 60 : 646-9. Starzl TE, Demetris AJ, Van Thiel D. Liver transplantation. N Engl J Med 1989 ; 321 : 1014-22 et 1092-9. Chapman RW, Forman D, Peto R, Smallwood R. Liver transplantation for acute hepatic failure ? Lancet 1990 ; 1 : 32-5. Caraceni P, van Thiel DH. Acute liver failure. Lancet 1995 ; 345 : 1639. Giostra E, Mentha G, Mal PJ, et al. Insuffisance hpatocellulaire IHC ; aigu et hpatite fulminante. In : Urgences Mdicales, Restellini A et al. eds. ; . Editions Mdecine et Hygine, 1997, p : 278-83. Lebrec D. Pharmacological treatment of portal hypertension : present and future. J Hepatol 1998 ; 28 : 869-907, for instance, bp!
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Authors Kaplan I. Houp JA. Montgomery RA. Leffell MS. Hart JM. Zachary AA. Institution Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. ikaplan jhmi Title A computer match program for paired and unconventional kidney exchanges.[erratum appears in J Transplant. 2005 Oct; 5 10 ; : 2597 Note: Montgomery, Robert A [added]]. Source American Journal of Transplantation. 5 9 ; : 2306-8, 2005 Sep. Abstract The number of renal transplants can be increased by implementing an exchange program involving donor-recipient pairs for whom the donors are each incompatible with their original patient but compatible with each other's patient. The number can be further increased if the exchanges are not limited to ABO incompatible pairs or combinations of two donor-recipient pairs. However, as the number of donor-recipient pairs willing to participate in such a program increases, there is a substantial increase in both the time taken to identify such matches and the potential for error. We have developed a computer program that accounts for ABO and HLA compatibility and is not limited to two-way exchanges. With our database of 60 patients and 83 donors, we have been able to identify 122 two-way and 1230 three-way exchanges with an average run time of 30 s. Publication Type Journal Article. Avoiding medications that aggravate symptoms decongestants and antihistamines.
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