Cost containment through L-alanyl-L-glutamine supplemented total parenteral nutrition after major abdominal surgery: a prospective randomized double-blind controlled study

Mertes, N.; Schulzki, Carola; Goeters, Christiane; Winde, Günther; Benzing, Steffen; Kuhn, Katharina S.; Aken, Hugo Van; Stehle, Peter; Fürst, Peter

doi:10.1054/clnu.2000.0142

Cited by 70 publications

(45 citation statements)

References 45 publications

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“…Several controlled trials in specific subgroups of postsurgical and other types of patients have shown beneficial clinical or metabolic effects when GLN is added to PN. 25,[31][32][33][34][35]39,41,42 These studies have incorporated L-GLN doses in PN ranging from 0.29 to 0.57 g/kg/d, 25,[31][32][33][34][35]39 and alanyl-GLN dipeptide doses similar to the dose used in the current trial (0.40-0.50 g/kg/d or equivalent to 0.26-0.33 g of L-GLN/kg/d). However, several trials also show no benefits, possibly attributable to differences in study patient clinical characteristics and degree of GLN depletion within and between studies, as well as the dose of parenteral GLN used.…”

Section: Discussionmentioning

confidence: 99%

“…This dose of alanyl-GLN dipeptide was based on results of previous safety and efficacy studies of GLN-supplemented PN. [31][32][33][34][35] This dose of GLN dipeptide provides 23 g of L-GLN daily for a 70-kg subject (two-thirds of alanyl-GLN is the GLN moiety). The study amino acid solutions were designed to be essentially isonitrogenous; the STD-PN solution provides 2.35 g of nitrogen and the GLN-PN provides 2.45 g of nitrogen per 100 mL of amino acid solution.…”

Section: Nutrition Supportmentioning

confidence: 99%

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Efficacy of Parenteral Nutrition Supplemented With Glutamine Dipeptide to Decrease Hospital Infections in Critically Ill Surgical Patients

Estívariz

Griffith

Luo

et al. 2008

J Parenter Enteral Nutr

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Background-Nosocomial infections are an important cause of morbidity and mortality in the surgical intensive care unit (SICU). Clinical benefits of glutamine-supplemented parenteral nutrition may occur in hospitalized surgical patients, but efficacy data in different surgical subgroups are lacking. The objective was to determine whether glutamine-supplemented parenteral nutrition differentially affects nosocomial infection rates in selected subgroups of SICU patients.

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Section: Discussionmentioning

confidence: 99%

Section: Nutrition Supportmentioning

confidence: 99%

Efficacy of Parenteral Nutrition Supplemented With Glutamine Dipeptide to Decrease Hospital Infections in Critically Ill Surgical Patients

Estívariz

Griffith

Luo

et al. 2008

J Parenter Enteral Nutr

View full text Add to dashboard Cite

show abstract

“…Esses dados são compatíveis com os resultados encontrados em estudos randômicos e controlados, realizados em adultos internados em UTI, queimados e em pós--operatório. Nestes estudos, a suplementação da glutamina não promoveu redução da mortalidade em pacientes pós-cirúrgicos, mostrando apenas tendência à redução desta variável em pacientes criticamente enfermos 8,25,[29][30][31][32] .…”

Section: Exclusão Durante Estudounclassified

“…Apesar da presente revisão não evidenciar vantagens do uso da glutamina em reduzir o tempo de internação 10,11,13 , sendo detectada apenas uma tendência a essa redução no estudo de Lacey et al 12 , a literatura evidencia reduções significantes no tempo de hospitalização, nos estudos com adultos pós-cirúrgicos, com doenças hematológicas e com adultos criticamente enfermos 8,22,27,28,31,32 .…”

Section: Exclusão Durante Estudounclassified

A suplementação de glutamina é benéfica em crianças com doenças graves?

2005

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Embora haja vários estudos clínicos randômicos avaliando os benefícios da suplementação de glutamina em pacientes adultos, há pouca informação em pacientes pediátricos, particularmente naqueles com doenças graves. O objetivo deste estudo foi avaliar criticamente os estudos sobre suplementação de glutamina, para verificar os possíveis benefícios clínicos desta suplementação em crianças gravemente doentes. Levou-se a cabo uma pesquisa dos estudos publicados entre 1992 e 2003, do tipo prospectivo, randômico e controlado, conduzidos em pacientes pediátricos gravemente doentes, divididos em dois grupos: o dos que receberam suplementos de glutamina por via enteral ou parenteral, e o dos que receberam placebo. As variáveis de desfecho foram: tempo para atingir oferta plena de dieta enteral, tempo de hospitalização, complicações e mortalidade. Foram utilizadas as bases de dados Medline, LILACS e Cochrane, com as palavras-chave: glutamine, critically ill, trauma, sepsis, burned, injured, bone marrow transplantation, intensive care, mechanical ventilation. Dos 33 estudos inicialmente identificados, 7 preencheram os critérios de inclusão. A análise dos resultados mostrou que nos pacientes suplementados com glutamina, houve melhor aceitação por via enteral e redução do tempo de nutrição parenteral em recém-nascidos, não havendo efeito sobre o tempo de internação, custos hospitalares e mortalidade. Os estudos controlados na faixa etária pediátrica, não permitem que se adote o uso rotineiro da glutamina em crianças gravemente enfermas. O número reduzido de pacientes e a heterogeneidade quanto ao grupo etário, doenças e via de administração são fatores que limitam a interpretação dos resultados.

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“…To improve mental function, to control blood sugar levels and to maintain muscle mass, it is also utilized by the body. L-alanyl-L-glutamine (Ala-Gln) dipeptide which is an substantial biological active molecule has various, effective, and important biological activities such as; decreasing effect of infection, dehiscence, abcess, mortality in critically ill patients and length of stay after operation [1], preventive effect of the inhibition of migration, apoptosis [2], improving effect of replenishment of depleted glutathione stores, nitrogen balance, immune defenses, growth performance of piglets [3][4][5][6][7], increasing effect of protein synthesis, ameliorates immune function [3][4][5], protective effect of intestinal barrier permeability [3][4][5], and also shows effective properties on control of diabetes in liver transplanted patients, survival and activities of digestive enzyme, enzymatic antioxidative status [8][9]. It is also used as an immunomodulator in addition to knowing that chemotherapy side effects are diminised.…”

Section: Introductionmentioning

confidence: 99%

Molecular Mechanic Studies on the Zwitterionic and Neutral Conformation Stability of Biological Active Peptide

Kecel‐Gunduz

Çeli̇k²

2017

SDÜ Fen Bil Enst Der

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In this current work the conformational properties of the L-Alanyl-LGlutamine dipeptide which was biological active dipeptide has been investigated by theoretical conformational analysis method using program which is based on Molecular Mechanic calculations in order to determine the structure function relation. The calculations on zwitterionic and neutral form of Ala-Gln which is formed side and main chain torsion angles let us to define their preferable energetically conformers. The side and main chain status of the stable conformations of Ala-Gln were acquired based on the results of the conformational analysis. By using Ramachandran maps, the global conformation, which has the lowest energy of the dipeptide, has been determined. The goal of this work was to explain structure-activity relationship by investigating the bioactive conformation of biological active peptide. Biyolojik Aktif Peptidin Zwitterionik ve Nötr Konformasyon Kararlılığı üzerine Moleküler Mekanik Araştırmalar Anahtar KelimelerZwitteriyonik, Nötral, Ala-Gln, Konformasyon analizi, DFT Özet: Bu çalışmada, biyolojik aktif dipeptid olan L-Alanil-L-Glutamin dipeptidin konformasyonel özellikleri, yapı fonksiyonu ilişkisini belirlemek için Moleküler Mekanik hesaplamalara dayanan program kullanılarak, teorik konformasyon analizi yöntemi ile araştırılmıştır. Ala-Gln dipeptidinin zwitterionik ve nötr formda yan zincir torsiyon açılarının bir fonksiyonu olarak hesaplanması, enerjik olarak tercih edilen konformasyonlarını belirlememizi sağlar. Elde edilen konformasyonel analiz sonuçlarına bağlı olarak, dipeptide ait stabil konformasyonların yan zincir kalıntılarının göreli pozisyonları elde edilmiştir. Dipeptide ait en düşük enerji konformasyonu Ramachandran haritaları kullanılarak belirlenmiştir. Bu çalışmanın amacı biyolojik aktif dipeptidin biyoaktif konformasyonunu açıklığa kavuşturmak için yapı-aktivite ilişkisini araştırmaktır.

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Cost containment through L-alanyl-L-glutamine supplemented total parenteral nutrition after major abdominal surgery: a prospective randomized double-blind controlled study

Cited by 70 publications

References 45 publications

Efficacy of Parenteral Nutrition Supplemented With Glutamine Dipeptide to Decrease Hospital Infections in Critically Ill Surgical Patients

Efficacy of Parenteral Nutrition Supplemented With Glutamine Dipeptide to Decrease Hospital Infections in Critically Ill Surgical Patients

A suplementação de glutamina é benéfica em crianças com doenças graves?

Molecular Mechanic Studies on the Zwitterionic and Neutral Conformation Stability of Biological Active Peptide

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