Download Intestinal Failure: Diagnosis, Management and by Alan N. Langnas, Olivier Goulet, Eamonn M. M. Quigley, Kelly PDF
By Alan N. Langnas, Olivier Goulet, Eamonn M. M. Quigley, Kelly A. Tappenden
Intestinal failure is a tough, rising box that has been the topic of a lot learn and debate in recent times and has just recently develop into commonly authorized as a special scientific syndrome.This entire booklet presents an in-depth assessment of clinical idea and scientific perform with regards to intestinal failure with particular emphasis on evaluation and administration as a part of a multidisciplinary workforce. Compiled via an across the world known editorial crew, the e-book presents a pragmatic how-to advisor to the administration of grownup and pediatric sufferers with intestinal failure, targeting quality-of-life concerns which are on the center of sufferer care.World specialists from facilities of excellence proportion their scientific event and services, delivering the 1st ever authoritative source on intestinal failure All elements of sufferer administration are coated, from prognosis and scientific and surgical administration (including transplantation) to dietary attention and psychosocial features of care various illustrations, stream diagrams and precis containers supplement the textual content and emphasize very important techniques, offering an available method of this complicated fieldThis landmark e-book is vital analyzing for any gastroenterologists, surgeons, transplant groups or medical nutritionists fascinated by the care of sufferers with intestinal failure.
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Extra info for Intestinal Failure: Diagnosis, Management and Transplantation
Example text
In order for lipids to be 28 absorbed into enterocytes, they need to be partitioned into water-soluble micelles. Micelles are small (30–100 ˚ particles formed by bile salts, phospholipids, and A) cholesterol in bile and products from enzymatic digestion of lipids. Micelles are rounded structures in which the outer surface is rendered hydrophilic by the polar sides of bile salts and phospholipids whereas the inner core is hydrophobic and can assimilate nonpolar lipids. The digestion of lipids begins in the stomach.
The digestion of lipids begins in the stomach. Lingual lipase from the salivary glands and gastric lipase are both acidic lipases with activity optima in the acidic environment of the stomach. In humans, the amount of lingual lipase is small and gastric lipase is the predominant acidic lipase. The two enzymes hydrolyze TG with a preference for medium-chained TG to diacylglycerol (DG) and free fatty acids (FFA). The acidic lipases do not hydrolyze either phospholipids or cholesterol esters. Another important part of lipid digestion is the emulsification of fat that is geberated by the grinding and mixing of food in the antrum.
The chylomicrons are then transported to the basolateral membrane where they exocytose into the interstitial space and traverse the basement membrane to reach the lacteals. Very low density lipoproteins (VLDL) are also produced by the enterocytes and, during fasting, these are the only lipoproteins produced by the small intestine. After a meal, the production of chylomicrons is increased in response to the amount of lipids being absorbed. It is unclear if production of VLDL is similarly increased.