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We reviewed antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Early administration of amino acids results in positive nitrogen balance. Metabolic acidosis, elevated serum ammonia and hypoglycaemia are not a complication of early administration of amino acids. Elevated blood urea nitrogen (BUN) is consistently associated with early administration of amino acids. We included seven trials in this review. The number of study participants is small and the protocols of the studies included are not identical.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Hepatic encephalopathy is a brain dysfunction associated with liver disease. Cirrhosis, which is a condition where scar tissue (fibrosis) replaces the normal liver tissue, is the most common cause of hepatic encephalopathy. The severity of the symptoms range from minor signs to coma. The minor changes are known as minimal hepatic encephalopathy. Overt hepatic encephalopathy refers to the more severe stages with clinically apparent manifestations such as changes in the level of consciousness or neuropsychiatric abnormalities. Many people with cirrhosis lack amino acids, which are building blocks of proteins. The amino acids with a side‐chain (a branch) are known as branched‐chain amino acids (BCAA). The BCAA play an important part of the generation muscles and of the signalling chemicals in the brain. These effects may benefit people with hepatic encephalopathy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Brain injury can start a cascade of damage to brain tissue. Release into the brain of excess excitatory amino acids is thought to begin this process. Drugs which stop the release of excitatory amino acids or which block them may reduce brain damage. Studies have been done in patients with stroke as well as traumatic brain injury. The review found that the results from most drug trials with brain injured patients have not been published. There is therefore not enough evidence about the effects of excitatory amino acid inhibiting drugs for traumatic brain injury, and more published trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

We reviewed the evidence on the effects of polyunsaturated fatty acids (PUFAs), compared with placebo or no treatment, on reading, writing or mathematical abilities of children up to 18 years of age who have specific learning disorders.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Vascular dementia (VaD) is a common disorder which currently lacks definitive treatments. Cerebrolysin, a peptide preparation produced from purified pig brain proteins, seems to be a promising intervention based on animal studies and clinical trials in other conditions. We identified six trials involving 597 participants suitable for inclusion in this review. Pooled results showed improvements in cognitive function and global function in patients with VaD of mild to moderate severity, with no obvious side effects related to Cerebrolysin. However, due to the limited number of included trials, varying treatment durations and short‐term follow‐up, there is insufficient evidence to recommend Cerebrolysin as a routine treatment for patients with VaD.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

We wanted to find out about the effects that intravenous nutrients (amino acids or sugars given into the bloodstream through a tube or a catheter in a vein) have on adults having surgery. Giving intravenous nutrients increases a person's metabolism, and this may increase the body heat produced. We wanted to know if giving intravenous nutrients during a surgical procedure could keep people warm, and if intravenous nutrients can keep them from having problems caused by being cold.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Cerebrolysin, a mixture derived from pig brain tissue, is widely used in Russia, Eastern Europe, China, and other Asian and post‐Soviet countries. We assessed evidence from randomised controlled trials (RCTs) investigating cerebrolysin in people with acute ischaemic stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 21, 2017

Lubeluzole is not effective in patients with acute ischaemic stroke. After a stroke, where a part of the brain suffers from reduced blood supply, an excess of chemicals known as excitatory amino acid neurotransmitters is produced. This excess can cause some brain cells to be damaged or to die (permanent cell damage is called cerebral infarction). Drugs which block the effects of these amino acids can protect against the cerebral infarct. The review focuses on the effects of lubeluzole, an inhibitor of excitatory amino acids. The review of trials did not find any benefit of lubeluzole in humans either to prevent death after acute ischaemic stroke or to reduce disability from it. Moreover, lubeluzole may cause heart‐conduction disorders.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Maintaining nutritional balance is vital in treating patients with acute kidney injury (AKI). Nutritional therapies, including parenteral nutrition (delivered via injection) and enteric (oral) nutrition are widely used. Eight randomised controlled trials (257 participants) were included in this review. Essential L‐amino acids may shorten the overall duration of kidney dysfunction and improved survival from AKI. However, due to the small number of participants and the poor quality of some studies, we are unable to provide recommendations for the use of nutritional support for treating AKI.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

The intestine is a winding muscular tube extending from the stomach to the anus. Its main purpose is to digest food. But it also produces various substances that carry messages to other parts of the body, and it plays an important role in fighting germs and regulating the body’s water balance.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 14, 2016

We reviewed the evidence about the effects of drug and nutritional treatment for McArdle disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Too little evidence to show whether extra carnitine, solcoseryl, glucose or galactose for pregnant women benefits babies in the womb who are smaller than expected.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Achieving and maintaining optimal nutrition is considered an important adjunct in the clinical care of patients infected with HIV, as good nutrition can improve an individual's immune function, limit disease‐specific complications, and improve quality of life and survival. We sought to determine whether macronutrient interventions, either given to provide protein and/or energy or test the effect of specific macronutrients (i.e. ch as amino acids, whey protein concentrate or Spirulina), given orally, influence morbidity and mortality in adults and children living with HIV infection. Our review, based on fourteen small trials, evaluating different macronutrient supplements, found limited evidence that balanced macronutrient formulas increase protein and energy intake. However, we found no evidence that such supplementation translates into reductions in disease progression or HIV‐related complications, such as opportunistic infections or death.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

This review did not find any randomised controlled trials that looked at whether creatine, given to a mother in pregnancy, can help protect her baby's brain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Poor nutritional status is a common problem in patients waiting for liver transplantation and it is a risk factor for post‐transplant morbidity and mortality. Nutritional status can worsen rapidly in the postoperative period due to preoperative malnutrition, the stress of the surgical procedure, immunosuppressive therapy, and in some patients liver or kidney dysfunction or sepsis. Nutritional interventions for people on a waiting list for liver transplantation include nutritional supplements providing additional protein, fat, and carbohydrates as well as liver‐adapted formulas also containing branched‐chain amino acids. Nutritional interventions after liver transplantation consist of parenteral or enteral nutrition and oral nutritional supplementation during the postoperative phase.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

With burn injuries involving a large total body surface area, damage and breakdown of tissues can result in a condition similar to that seen with severe malnourishment. In addition, destruction of the effective skin barrier leads to body temperature dysregulation and increased susceptibility to infection and fluid loss. Previous studies have investigated specific naturally occurring additives to nutritional support, which may lead to an increase in immune system function and therefore a reduction in infection, hospital length of stay and chance of death. These additives are termed immunonutrients and include glutamine, arginine, branched‐chain amino acids (BCAAs) and omega‐3 fatty acids (fish oil). The authors of this review searched for randomised controlled trials assessing the effects of immunonutrients in patients with severe burn injury.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

The liver is one of the largest organs in the body. It has many important metabolic functions. For example, it converts the nutrients in our diets into substances that the body can use, stores those substances, and supplies cells with them when needed. It also takes up toxic substances and converts them into harmless substances, or makes sure they are released from the body.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 22, 2016

Sick or preterm newborn infants may require intravenous nutrition, including intravenous administration of solutions containing amino acids. Newborn infants need cysteine (an amino acid) for growth under certain conditions. Cysteine may decrease the chance of liver disease and brittle bones. This systemic review was done to analyze whether adding cysteine (or related compounds) to intravenous nutrition affects growth and other outcomes in newborn infants. Five trials studied the effects of adding cysteine to intravenous nutrition that did not contain cysteine. Addition of cysteine significantly improved the babies' ability to build body proteins (analyzed in four studies); however, it did not improve growth (analyzed in one study); no other outcomes were available. One large randomized trial studied the effect of adding another chemical, N‐acetyl‐cysteine, to intravenous nutrition that already contained cysteine. This study showed no benefit and no toxicity of this intervention. We conclude that present data are insufficient to justify routine addition of cysteine to the intravenous nutrition of newborn infants that does not contain cysteine. Available evidence does not support routine addition of N‐acetylcysteine to intravenous nutrition of newborn infants containing cysteine.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

In health, protein and amino acids remain in equilibrium however in CKD this balance is disturbed. Metabolic acidosis has been shown to have deleterious effects on protein balance, leading to a negative nitrogen balance, increased protein degradation, increased essential amino acid oxidation, reduced albumin synthesis and a lack of adaption to a low protein diet, and hence is associated with protein energy malnutrition, loss of lean body mass and muscle weakness. Metabolic acidosis is also a factor in the development of renal bone disease, as bone acts as a buffer for excess acid, with loss of mineral resulting from the increase in acid. This review found three small trials in adult haemodialysis patients (n = 117). The evidence for the benefits and risks of correcting metabolic acidosis is very limited with no RCTs in pre‐ESRD patients and none in children. These trials suggest there may be some beneficial effects on both protein and bone metabolism but the trials were underpowered to provide strong evidence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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