Biomedical subjects

M A DeBiasse

Publications and source records attributed to M A DeBiasse.

4 recordsLinked to original sources

PubMed1997

Management of a patient with advanced AIDS and toxic epidermal necrolysis using human growth hormone and G-CSF.

Toxic epidermal necrolysis (TEN) is a serious drug reaction that is occurring with increased frequency among those affected with HIV and AIDS. It carries a grave prognosis for those with advanced AIDS and massive skin involvement. We report a severe case of TEN treated with wound care, intravenous nutrition, human growth hormone (hgh), and granulocyte colony-stimulating factor (G-CSF).

Acquired Immunodeficiency Syndrome↗

PubMed1995

Micronutrients in critical illness.

Micronutrients play a key role in many of the metabolic processes that promote survival from critical illness. For vitamins, these processes include oxidative phosphorylation, which is altered in the patient with systemic inflammation, and protection against mediators, in particular oxidants. Trace elements are essential for direct antioxidant activity as well as functioning as cofactors for a variety of antioxidant enzymes. Wound healing and immune function also depend on adequate levels of vitamins and trace elements (Table 6). Of extreme importance is the ease with which a deficiency state can develop in the critically ill because of decreased nutrient intakes and increased requirements. Daily intakes up to or exceeding many times the RDA usually are required. The enteral route is preferred, although, if not available, most of these agents can be given by the parenteral route. In that case, however, dose recommendations are less clear. Attention to micronutrients is paramount both in optimizing the nutritional management of the critically ill and in the overall management of these patients. It also is essential in promoting positive outcomes and decreasing complications.

Avitaminosis↗

PubMed1994

What is optimal nutritional support?

Nutritional support of the seriously ill patient has evolved with time and reflects new developments in the field of critical care. Current information suggests that optimal nutritional support can be provided by supplying at least 80% of energy requirements with at least 70% of the energy given as carbohydrate and the remaining 30% or less administered as fat (with > or = 3% of energy requirements as essential fatty acids). The caloric load may be reduced to 50% of requirements if growth factors (e.g., growth hormone) are utilized and the patient has adequate fat stores. Protein should be given as 1.5 g/kg/day; more catabolic patients, such as patients with burn injury, should receive 2 g/kg/day. All protein or amino acid feeding should include glutamine. There is an increased need for vitamins (especially A, C, and E) and minerals (zinc, selenium, and magnesium). The preferred route of feeding should be enteral, followed by enteral plus supplemental parenteral nutrition. If the gastrointestinal tract cannot be used, parenteral nutrition should be given. Nutrients should be administered early in the catabolic course, especially glucose, sodium, potassium, vitamins, and minerals. Over time (approximately 7 days) amino acids should be added and approximately 50% of caloric support should be provided. Finally, full nutritional support should be provided (by 7 to 10 days) if the catabolic course is expected to continue.

Amino Acids↗

PubMedDate not supplied

Essential microminerals and their response to burn injury.

Certain microminerals, named because of their minute quantities in the body, are essential components for maintaining homeostasis involving, in particular, metabolism, immune defense, and wound healing. In general, these trace elements are characterized by having multiple roles and by demonstrating deficiency syndromes that are complex and difficult to diagnosis. The response of the microminerals to injury, especially burn injury, is not well defined. The purpose of this article is to describe the known roles of the trace elements and the effect of burn injury on circulating and tissue levels. As will be noted, much less is known regarding the impact of trace elements' changes on the injury process than the role of these elements in the normal state. In addition, the amount of trace elements needed for the stress changes after injury are, for the most part, undefined.

Animals↗