The results of plasma-ammonium determinations by an ion-exchange method and by a microdiffusion method were compared on the same specimens with each other and with ammonium determinations carried out on the corresponding whole-blood specimens by the microdiffusion method. The plasma-ammonium levels of whole-blood specimens were higher than those of the corresponding plasma specimens, but the difference was not constant. Recoveries of added NH(4) from plasma by the microdiffusion method ranged from 65 to 144%. Recoveries of NH(4) from the same specimens by the ion-exchange method ranged from 93 to 96%. Of the two, the ion-exchange method was the only one of value.

Adolescent↗

PubMed1968

Patterns of muscle activity in the leg, hip, and torso associated with anomalous fifth lumbar conditions.

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Body Height↗

PubMedDate not supplied

Pre-operative nutritional support in children with end-stage liver disease accepted for liver transplantation: an approach to management.

Pre-operative nutritional support was studied in 28 children with end-stage liver disease awaiting orthotopic liver transplantation. Nasogastric supplemental administration of a standard semi-elemental enteral nutritional formula was compared with a similar formula enriched with branched chain amino acids, and with a group receiving oral nutrition only. The duration of treatment in all groups was similar (mean 90 days). Energy intakes in the supplemented groups were 120-150% of recommended daily intakes (RDI), whereas ad libitum intakes in the oral group ranged 58-100% RDI. A significant improvement in mean Z-score for body weight (denoting catch-up) was noted only in those children who received nasogastric supplements enriched with branched-chain amino acids. The standard enterally-fed group maintained their body weight and Z-scores did not change significantly. In contrast, body weight Z-scores in those fed orally declined significantly. Nutritional supportive therapy of malnourished children with end-stage liver disease can minimize or improve nutritional status in children awaiting liver transplantation. The use of nutritional formulae rich in branched-chain amino acids may have nutritional advantages in children with chronic liver disease which require further study and evaluation.

Amino Acids, Branched-Chain↗

PubMedDate not supplied

Cytomegalovirus infection after liver transplantation in children.

Post-liver transplant cytomegalovirus (CMV) infection (seroconversion or virus isolation) and CMV disease (infection plus clinical signs and symptoms) were studied in relation to pretransplant recipient and donor serology, age, nutritional status and the effect of paediatric versus adult (reduced size) grafts. Of 70 children receiving 79 transplants, 26 (37%) had evidence of CMV infection, and eight (11.5%) had evidence of CMV disease, four of whom died. The primary infection rate (where the recipients were CMV negative) was 71% with mortality of 7% with most receiving a CMV-positive graft. The active secondary infection rate (reactivation or reinfection, where the recipients were CMV positive) was 60% with mortality of 12.5%. No significant differences in infection or disease rates were found comparing malnourished versus well-nourished patients, or between those who received whole or reduced-size grafts. The high prevalence of CMV infections supports the view that clinical signs alone are inadequate to direct investigations for CMV. Both primary and active secondary CMV infection can result in serious morbidity and mortality in children receiving liver transplants. These data do not support the strategy of providing immunoprophylaxis to seronegative recipients only, at least in paediatric liver transplantation.

Adolescent↗