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Twenty-one patients undergoing regular hemodialysis completed a trial of energy supplementation. Nine patients added the glucose polymer Polycose to their usual diet and 12 acted as control subjects. The supplemented patients were asked to incorporate 100 or 150 g polymer, equivalent to 1600 or 2400 kJ (400 or 600 kcal) into their usual diet, daily for 6 mo. This resulted in a mean increase in energy intake of 1630 kJ (p less than 0.05) and a mean weight gain of 3.1 kg (p less than 0.005). The addition of glucose polymer to the diet resulted in a mean increase in body fat of 1.8 kg and the lean body mass increased by 1.3 kg. No significant effect on plasma triglycerides, urea, or creatinine was detected. The intake of macro- and micronutrients was not adversely affected and no clinical or psychological side effects were reported. Follow-up of these patients showed that the weight gain was maintained after 6 mo. Glucose polymer was an effective energy supplement that had beneficial effects on the nutritional status of hemodialysis patients.

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We describe six patients diagnosed with serotonin syndrome after exposure to drugs with serotonergic activity Drug interactions occurred as a result of a combination of tricyclic antidepressants, selective serotonin reuptake inhibitors, selective noradrenaline reuptake inhibitors or monoamine oxidase inhibitors. Management included supportive care and the use of non‐specific serotonin antagonists (cyproheptadine, benzodiazepines and chlorpromazine). All patients made uneventful recoveries.

Genotyping for the CYP3A4-G polymorphism is unlikely to assist cyclosporin dose selection in transplant patients.

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