Intravenous feeding to sustain pregnancy in patient with Crohn's disease.

Abstract

up to five hours in five cases, five to 12 hours in one, 12-24 hours in one, and unspecified in eight. Sixteen of the children did not have to be admitted to hospital. Eight were admitted for up to five hours, 11 for five to 12 hours, 12 for 12-24 hours, and one for over 24 hours; in one duration of admission was not specified. Twelve children were not given any treatment at all, two required only fluids, 31 were dosed with ipecacuanha (despite vomiting), four received gastric lavage, and three were given purgatives. The conclusion to be drawn from these data is that, among these children, laburnum by no means behaved viciously, no one came to serious harm, and no more than modest treatment had to be vouchsafed. Indeed, as a generalisation, overtreatment might be suspected. Comment There are few reports of the clinical picture after ingestion of laburnum, though Richards and Stephens3 described a fatal outcome in a patient with advanced schizophrenia who was found at necropsy to have ingested more than 23 pods of laburnum, from which it was confirmed by analysis that he had adsorbed a minimum of 35 mg of cytosine, with 50 mg being the more likely figure. Little published information is available on the alkaloid cytosine, which is accepted as the toxic component of laburnum. Pharmacologically it is said to resemble nicotine in its action, and the lethal dose has been estimated at about 0-5 mg/kg. The seeds are said to contain about 1% (by weight) of cytosine. If this is so 3-4 g of them might constitute a fatal quantity for an adult, with correspondingly less for achild. This would not amount to many seeds. Given the inaccuracies of anecdotal evidence, the children in our series had consumed from one to 10 seeds, though higher figures were quoted in two cases, and from one to five pods. Questions thus arise whether these children in fact.ingested far less than was asserted, or even none at all; whether the cytosine content is not as high as is averred, or varies between one specimen and another; and whether cytosine is, after all, not as toxic as it is made out to be ("probably the fastest-acting poison in common use, being as fast or faster than hydrocyanic acid and much faster than any metal cyanide"'3). In everyday practice laburnum does not behave as ferociously as a poison among children taking it accidentally as is generally thought. Summary figures from the National Poisons Information Service for years other than 1979 show the same pattern of relative innocuity.

A Historical Perspective and Review of the Safety of Lipid Emulsion in Pregnancy

“…In the remaining three cases where lipids were used, the course and type of therapy was unspecified. 13,16 Parenteral nutrition with the lipid system was initiated before conception in 3 of the entire 32 cases reported and was continued through the entire pregnancy. [19][20][21] In one pregnancy, premature contractions occurred before the initiation of parenteral nutrition and contractions stopped after 2 weeks of therapy with the lipid system.…”

Total Parenteral Nutrition With Fat Emulsions During Pregnancy— Nutritional Requirements: A Case Report

“…(3) low plasma levels of albumin and transferrin; (4) low urinary urea outputs with apparent positive nitrogen balance calculated after 1 day of TPN; (5) total lymphocyte count (TLC) superior to twice the usual values; (6) three positive skin tests with recall antigens (C.C.B., candidin, tuberculin). Plasmatic biochemical examinations essentially showed changes in the lipidic fractions with hypertriglyceridemia, hyperphospholipidemia, and a moderate hypocholesterolemia.…”