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Biomedical subjects

J Bhatia

Publications and source records attributed to J Bhatia.

At least 19 recordsLinked to original sources
PubMed1992

Glutathione and tissue amino acid responses to light-exposed parenteral nutrients.

Effects of infusion of light-exposed (+L) or light-protected (-L) total parenteral nutrition solutions were investigated in rats. The parenteral infusions were carried out for 7 days through jugular cannulas in freely moving rats in metabolic cages. Plasma tyrosine and citrulline, hepatic methionine, valine, isoleucine, leucine and tyrosine, and biliary cystathionine were significantly greater in the -L than +L rats, whereas biliary arginine was significantly lower in the -L compared to +L rats. Bile flow, biliary inorganic phosphate and glucose were significantly lower, whereas biliary total glutathione (GSH+GSSG) was significantly greater in the -L compared to +L animals. These data suggest adverse effects on hepatobiliary function due to light exposure of parenteral nutrients. The endogenous markers used suggest that tight junction permeability, bile acid-independent flow, glutathione and amino acid homeostasis are altered by light exposure and that these changes can be minimized by light protection. The mechanisms involved in the induction of these changes need to be elucidated. The role of light exposure of parenteral nutrients during routine clinical use in the induction of hepatic dysfunction, a common metabolic complication of parenteral nutrition, needs to be considered.

Amino Acids↗
PubMed1992

Biliary endogenous inorganic phosphate, D-glucose, IgA and transferrin are differentially altered by hydrostatic pressure.

Our objective was to determine the effects of hydrostatic biliary pressure on excretion patterns of endogenous solutes which reflect various pathways of bile formation. A stable in vivo model was developed using anesthetized rats intraduodenally infused with taurocholate to maintain bile flow. Bile was collected during a 2-h basal period, a 4-h pressure period where elevation of the bile duct cannula decreased bile flow to 1/3 the basal rate, and a 2-h period after release of hydrostatic biliary pressure. During pressure treatment, bile salt concentration gradually increased approximately 3-fold, biliary inorganic phosphate concentrations rapidly rose approximately 5-fold, and biliary glucose concentration progressively rose approximately 17-fold. Concentrations of proteins in bile were affected differently with extreme decreases in IgA, moderate decreases in total protein and leucine aminopeptidase, and minimal change in transferrin. By 2 h after pressure release, only the alterations in biliary glucose and IgA persisted. The observed striking and persisting increases in biliary glucose are tentatively explained as an impaired reabsorption of glucose by the biliary tract.

Animals↗
PubMed1992

Hepatic function during short-term total parenteral nutrition: effect of exposure of parenteral nutrients to light.

Total parenteral nutrition (TPN) solutions either exposed to light (+L) or protected from light (-L) were infused for 5 days through jugular cannulas in freely moving rats placed in metabolic cages. At the end of the 5 day period, bile flow, biliary inorganic phosphate and biliary gamma-glutamyl transferase activity, as well as biliary concentrations of several essential and branch chain amino acids were significantly lower in the -L animals compared to +L animals. In addition, biliary glutathione was significantly lower in the +L animals. In both groups of animals, plasma tyrosine decreased significantly from pre-TPN values despite a doubling of plasma phenylalanine concentrations suggesting that tyrosine may become a conditionally essential amino acid in rats provided TPN. Our findings indicate that short-term parenteral infusion of light exposed TPN solutions alters hepatobiliary function as well as amino acid homeostasis and that the changes are minimized by light protection of the infusates. The exact mechanisms of the contribution of light exposure in the induction of hepatic dysfunction remain to elucidated.

Amino Acids↗
PubMed1991

Effect of protein/energy ratio on growth and behavior of premature infants: preliminary findings.

Premature infants weighing less than 1550 gm at birth were randomly assigned to receive one of three formulas identical in composition except for protein content (2.2, 2.7, and 3.2 gm.100 kcal-1) to determine the effects on growth, protein nutritional status, and behavior. Data collected for 2 weeks from the time of achieving an enteral energy intake of 100 kcal.kg-1.day-1 included measurements of weight, length, head circumference, and skin-fold thickness, and concentrations of plasma amino acids, serum total protein, prealbumin, retinol-binding protein, and urea nitrogen. In a subset of infants, behavior was assessed at the end of the feeding study with the Neonatal Behavior Assessment Scale. Except for the concentrations of plasma amino acids, there were no significant differences in growth or in other biochemical measurements among the three groups, but there were significant differences in the orientation, habituation, and stability clusters of the behavior assessment. Further, there were significant correlations between the plasma amino acid values and the behavioral clusters. These preliminary data suggest a relationship between protein intake in the neonatal period and behavioral outcome at the end of the feeding period in the absence of differences in growth and gross markers of protein nutritional status. The behavioral items noted to differ among the groups may indicate later cognitive outcome; detailed studies about behavioral responses to neonatal dietary intakes and later outcome seem indicated.

Amino Acids↗
PubMed1991

Feeding the premature infant after hospital discharge: growth and biochemical responses.

We conducted a double-blinded, randomized trial in premature infants after hospital discharge to test the hypotheses that growth and biochemical responses in those fed a formula with a reduced protein content (1.3 gm/dl) would be similar to those in infants fed a standard infant formula (protein 1.5 gm/dl). Twenty low birth weight infants were followed for 16 weeks from the time of hospital discharge. Growth (weight, length, and head circumference) and biochemical responses (total protein, prealbumin, retinol-binding protein, and blood urea nitrogen values) were similar in the two groups of infants. Plasma amino acids reflected the differences in protein intakes and were similar to previously reported values for premature infants fed human milk or formula. These results demonstrate similar growth and biochemical responses in preterm infants fed a standard infant formula and a formula with a protein content closer to that of human milk.

Amino Acids↗
PubMed1990

Cord blood gamma glutamyl transferase activity: effect of gestational age, gender, and perinatal events.

Gamma glutamyl transferase (GGT) activity was measured in cord blood of 125 preterm and term neonates ranging from 26 to 42 weeks of gestation. The enzyme activity was higher in cord blood of infants from 33 to 37 weeks' gestation than in those of younger or older gestation. Furthermore, GGT activity in infants of greater than 37 weeks' gestation was significantly higher in male than in female infants. There were no significant correlations between GGT and Apgar scores, regardless of gestational age. However, GGT activity in term infants with a history of perinatal events suggestive of stress (meconium passage in utero, fetal decelerations, tight nuchal cord, or difficult delivery) was significantly higher than in term infants without such perinatal history. No such association existed in infants of less than 38 weeks' gestation. Infants of 33 to 37 weeks' gestation delivered vaginally had significantly higher cord GGT activity than those delivered by cesarean section. This difference was not apparent in younger or older infants. These data suggest that GGT activity reflects gender, gestational age, route of delivery, and perinatal stress. Further investigation is required to establish the reasons for these differences and to determine the usefulness of such enzyme activity in the delineation of liver dysfunction during postnatal development.

Birth Weight↗
PubMed1989

Sucking and breathing patterns during breast- and bottle-feeding in term neonates. Effects of nutrient delivery and composition.

We attempted to determine whether differences in milk composition or flow rate are the primary determinants in altering breathing pattern during nipple-feeding. In the first phase of the study, 15 neonates were studied during breast-feeding and bottle-feeding; in the second phase, 15 were evaluated during bottle-feeding of expressed human milk and formula. A reduction in inspiratory duration was observed with all feeding regimens. Moreover, significant prolongation in expiratory duration and reduction in breathing frequency were observed during bottle-feeding of formula and expressed human milk (compared with control); these effects were greater with formula feeding. Higher sucking frequency was observed during breast-feeding compared with bottle-feeding; no difference in suckling frequency or sucking pressure was observed between bottle-feeding of expressed human milk and formula. We conclude that most of the differences in sucking and breathing patterns between breast- and bottle-feeding can be attributed to nutrient delivery rather than nutrient composition.

Bottle Feeding↗
PubMed1989

Dental caries and periodontal diseases--a hospital based study.

Two thousand children aged 3 to 12 years, attending the Pediatric Outdoor and Well Baby Clinic were examined to find the prevalence of dental caries (DC) and periodontal diseases (PD). DC was detected in 55.75% whereas PD were present in 9.35% children. Even 3 to 5 years old were found to have a significant prevalence of the diseases. Children with an urban background, irregular brushing habits and malnutrition had significantly higher prevalence of both the diseases.

Child↗
PubMed1988

Human milk supplementation. Delivery of energy, calcium, phosphorus, magnesium, copper, and zinc.

Human milk when fed to preterm infants is frequently supplemented with human milk fortifiers that provide an additional source of protein, energy, and minerals. Human milk that was provided by the mother of a preterm infant, and that was supplemented with commercially available human milk fortifiers, was assessed under simulated syringe-pump and bolus feeding circumstances for the delivery of energy, calcium, phosphorus, copper, magnesium, and zinc to an infant. In general, the nutrients were not completely delivered with syringe-pump feedings, with the greatest losses occurring in the concentrations of calcium and phosphorus. The losses were more pronounced with the use of a powdered fortifier than with the use of a liquid fortifier. Little or no change in the concentrations of the various nutrients were observed with simulated bolus feeding. We suggest that human milk fortified with supplements be fed with care to assure complete delivery of the nutrients and that infants receiving such feedings be monitored to assure adequate nutritional status.

Calcium↗
PubMed1988

Growth and total body water in premature infants fed "in-utero" or "ex-utero".

Total body water and anthropometric measurements were compared in two groups of premature infants. The first group included infants with birthweights less than 1,501 g who were fed under usual clinical circumstances and studied at a bodyweight of 1,800-2,100 g ("Ex-utero"); the second group of infants had a birthweight of 1,800 to 2,100 g and were studied within the first week of life ("In-utero"). Triceps and subscapular skinfold thicknesses were significantly greater in "Ex-utero" infants than in "In-utero" infants, whereas body length was significantly greater in the latter group compared to the former. There were no difference in total body water, abdominal skinfold thickness, or midarm circumference between the two groups. These data suggest that feeding premature infants a standard premature infant formula under established guidelines leads to differences in body and fat distribution but not total body water compared to infants nourished "in utero".

Arm↗
PubMed1986

Parenteral antibiotics and carbohydrate intolerance in term neonates.

To evaluate the effects of parenteral antibiotics on carbohydrate tolerance, fecal reducing substances, stool frequency, and dietary manipulation were monitored in two groups of term neonates. The first group (n = 25) consisted of neonates receiving parenteral ampicillin sodium and gentamicin sulfate. A second group (n = 25) of matched neonates not receiving antibiotics served as controls. Most of the neonates were fed a standard lactose-containing formula and the remainder were breast-fed. Stool frequency, presence of fecal reducing substances, and requirement for dietary manipulation were significantly greater in neonates receiving antibiotics compared with controls. Infants manifesting symptomatic carbohydrate intolerance while receiving parenteral antibiotics may benefit either from receiving lactose-free formula or from decreasing the intake of lactose for the duration of antibiotic therapy.

Age Factors↗
PubMed1986

Hexosaminidase: a marker for healing after ischemic gut injury.

Serum hexosaminidase activity (HEX) is elevated with ischemic gut injury. To determine if subsequent decreases in HEX correlate with gut healing, 97 weanling rats were subjected to laparotomy at which alternate vascular bundles were ligated along the base of the entire anterior mesenteric artery arcade. Fifteen rats served as preoperative controls. After recovery, rats were allowed ad lib food and water. Groups were then killed at intervals, blood was drawn for HEX determination, and samples of small bowel were taken for histological evaluation. Microscopically, focal ischemic necrosis began at 6 hr. Between 12 and 48 hr, cellular changes were consistent with progressive ischemic injury. Evidence of healing was apparent beginning at 5 days and these histological changes correlated with changes in HEX. Thus HEX proves useful as a marker for gut healing in this model.

Animals↗
PubMed1986

Comparative effects of dopamine, naloxone, and prostacyclin in the resuscitation of fecal-Escherichia coli peritonitis-induced septic shock in neonatal swine.

To explain the high neonatal mortality from peritonitis-induced septic shock despite current resuscitation practices, the efficacy of dopamine, naloxone, and prostacyclin was evaluated in an experimental neonatal model. Hemodynamics were monitored and survival was measured in anesthetized neonatal swine, which were subjected to fatal fecal-Escherichia coli peritonitis-induced septic shock. All the animals received fluid resuscitation, antibiotics, and bicarbonate to correct acidosis. Pharmacologic resuscitation began when cardiac output dropped below baseline in the experimental groups. Although significant differences were observed between groups in cardiac output, mean arterial and mean pulmonary arterial pressures, left ventricular stroke work, stroke volume, and pulmonary vascular resistance indices (P less than 0.02), and each animal exhibited favorable hemodynamic responses during the first several hours of dopamine and naloxone infusion, these drugs failed to prolong survival. Also, 5 of the 9 naloxone-treated pigs (56%), died with histologically proven intestinal ischemia (P less than 0.02). Thus, dopamine, naloxone, and prostacyclin (at doses commonly recommended for the treatment of septic shock) fail to positively influence the fatal course of this condition, and the use of naloxone in this model is associated with profound intestinal ischemia.

Analysis of Variance↗
PubMed1985

Resolution of pneumothorax in neonates.

The resolution time of pneumothorax in neonates requiring tube thoracotomy is not known. We found that 28%, 50%, and 83% of 54 pneumothoraces in 40 neonates resolved within 24, 96, and 168 h of tube thoracotomy, respectively. Pneumothoraces that persisted beyond 168 h were in infants requiring ventilatory assistance. Moreover, a significantly (p less than .05) greater number of preterm infants with persistent pneumothorax developed chronic lung disease compared to preterm infants in whom pneumothorax resolved by 168 h.

Birth Weight↗
PubMed1985

The study of fecal-Escherichia coli peritonitis-induced septic shock in a neonatal pig model.

Peritonitis-induced septic shock in the neonate is associated with a high mortality. Because there exists no clinically relevant model to study resuscitation of these patients, a model using the neonatal pig was developed. After arterial and central venous cannulation, and placement of a left pulmonary-artery thermodilution catheter, 12 anesthetized neonatal pigs were "resuscitated" with fluids (5% albumin in lactated Ringer's solution at 15 ml/kg/hr), antibiotics, and correction of acidemia. The pigs were divided into two groups: a control group (n = 5), which was not subjected to peritonitis and which was killed after 6 hours of monitoring, and a septic group (n = 7), which was inoculated with an intraperitoneal injection of sterile pig feces and Escherichia coli and was monitored until death (mean survival time (S.D.) 546(159) minutes). Serial measurements of hemodynamic and laboratory data were obtained. While pigs in the control group showed no significant changes in these data as measured against time, the pigs in the experimental group showed an early transient rise in cardiac index which was significant (p less than .05) and which was followed by a steady decline in cardiac index until death. These changes in cardiac index were accompanied by a continuous decline in mean arterial pressure, central venous pressure, pulmonary artery pressure, and systemic vascular resistance index, while pulmonary vascular resistance index showed a gradual continuous rise. The observed changes in hemodynamic and laboratory data mimic those anticipated in the human neonate with peritonitis-induced septic shock. This model proves reliable and reproducible, and shows promise as a tool to study the resuscitation of neonates with septic shock.

Animals↗
PubMed1985

Formula fixed.

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Humans↗