Enteral gln supplementation using a commercially available dipeptide supported plasma gln levels, improved gut permeability, and initially decreased plasma endotoxin levels in severely thermally injured patients. These alterations were associated with a reduction in the length of hospitalization and lower costs.

To determine the effects of low-dose recombinant human growth hormone (GH) and hypocaloric nutrition on postoperative convalescence, we performed a placebo-controlled randomized double-blind trial in 18 patients after elective gastrectomy or colectomy. The subjects received parenteral nutrition containing 20 calories/kg per day and 1 g protein/kg per day. Daily injections of drug or placebo were given during the first postoperative week. The nine control subjects lost 3.3 kg (5.9% of preoperative weight) and had a cumulative nitrogen loss of 32.6 +/- 4.2 g nitrogen at eight days. The patients receiving GH lost significantly less weight (1.3 kg) and nitrogen loss was 7.1 +/- 3.1 g at eight days (p less than 0.001). Kinetic studies demonstrated that the anabolic effects of GH were associated with increased protein synthesis, and amino acid flux studies across the forearm revealed increased uptake of amino acid nitrogen in the GH-treated patients. Body compositional analysis revealed that the patients receiving GH maintained their lean body mass despite the major surgical procedure. Analysis of hand grip force showed a 10% loss of strength in the control subjects; with GH the patients maintained their grip force throughout the postoperative period. We conclude that the postoperative catabolic response can be modified with GH and hypocaloric nutrition. These metabolic and physiologic effects should now be studied in a larger number of patients to determine if this approach can reduce morbidity, mortality, and length of hospital stay for surgical patients.

MPFF significantly reduced the extent of pain and bleeding in the selected subjects of this study with acute haemorrhoids. The tolerability was similar in patients receiving MPFF to that in patients receiving a placebo during the 7-day duration of the treatment.MPFF can be considered an effective and well-tolerated agent in the treatment of acute episodes of haemorrhoids.