Lower Plasma Values Research Articles

The possible link between Fetuin-A Protein and Neuro-inflammation in Children with Autism Spectrum Disorder.

Objectives:To investigate the blood plasma levels of Fetuin-A protein in children with Autism Spectrum Disorder (ASD) and healthy controls that could offer novel diagnostic biomarkers of disease development in ASD. Another objective was to investigate the severity of autistic children by Childhood Autism Rating Scale (CARS) and Short Sensory Profile (SSP).Methods:This case control study was carried out at Autism Research and Treatment (ART) Center, King Saud University, Riyadh, Saudi Arabia, from October 2019 to February 2020. Plasma concentration of Fetuin-A was analyzed by enzyme-linked immunosorbent assay (ELISA) in ASD subjects (n=46) and normal controls (n=44). Correlation among Fetuin-A levels, CARS and SSP was established by Spearman’s correlation coefficient (r).Results:Overall, autistic children had significantly (p= 0.0.02) lower Fetuin-A concentration [50.76 (22.2-68.5) ng/ml] than those of healthy controls [53.7 (35.6-99.7) ng/ml] [median (interquartile range)]. Children with mild to moderate autism (n=24, 52%) also showed significantly lower Fetuin-A levels [50.0 (30.0-68.2) ng/ml], (p =0.02} than healthy controls [53.7 (35.6-99.7) ng/ml] [median (IQR)]. However, there was no significant change (p = 0.71) observed between the Fetuin-A levels of children with severe autism [51.8 (22.2-68.5)] ng/ml, mild to moderate autism [50 (30-68.2)] ng/ml [median (IQR)] and healthy controls (p=0.12). Also no significant correlations between Fetuin-A, CARS and SSP were observed (CARS, r= 0.024, p=0.88; SSP, r= -0.003, p=0.98).Conclusion:Overall the low Fetuin-A plasma values in ASD subjects, most likely show that Fetuin-A could be associated in the physiology of autism. Further studies with larger patient and control cohorts will be necessary to determine whether Fetuin-A can be used as a biomarker for ASD.

The relationship between plasma albumin, alkaline phosphatase and pyridoxal phosphate concentrations in plasma and red cells: Implications for assessing vitamin B6 status.

Plasma concentrations of most vitamins decrease as part of the systemic inflammatory response (SIR). Thus low plasma values do not necessarily indicate deficiency. Vitamin B6 status is usually assessed by measurement of pyridoxal phosphate (PLP) in plasma, although vitamin concentrations in blood cells tend to be better markers of cellular stores. In health, plasma PLP appears to be determined primarily by intake, its binding to albumin, and its hydrolysis by alkaline phosphatase (ALP). To examine, using invitro studies, the effect of albumin concentration and ALP activity on PLP concentration in plasma and red blood cells of healthy subjects (HS) and critically ill patients (CI). Heparin and EDTA (ALP inhibited) whole blood samples from HS (n=8) and CI (n=26) were incubated with PLP. Concentration of PLP in plasma and red cells was measured. Albumin and ALP levels were determined in plasma. In PLP incubated heparin samples, there was a strong direct relationship between albumin in the concentration range 10-44g/L and increase in plasma PLP concentration (rs=0.93, P<0.001) and an inverse relationship with increase in red cell PLP concentration (rs=-0.90, P<0.001). In contrast, ALP activity was inversely associated with increase in plasma PLP concentration (rs=-0.42; P=0.013) and directly associated with red cell PLP concentration (rs=0.49; P=0.003). Plasma albumin concentration and to a lesser extent ALP activity influences PLP concentration in plasma and red cells. In conditions associated with low albumin (e.g. SIR) or altered ALP activity, red cell PLP measurements are more likely to be reliable than plasma measurements in differentiating true from apparent vitamin B6 deficiency and to guide vitamin B6 supplementation.

Validation of a point-of-care instrument for bedside glutamine screening in the intensive care unit

A point-of-care instrument developed for measuring glutamine levels in cell cultures was validated for bedside use in the ICU setting and compared with a standard HPLC technique to measure plasma glutamine. The aim was to evaluate the instrument for absolute measurements and for screening purposes. Consecutive blood samples were obtained from one hundred adult ICU patients 3-5 days apart during their ICU stay. Each sample was divided into 3 aliquots, out of which two were used for analyses of plasma and whole blood glutamine by the point-of-care instrument, and one was used for analysis of plasma glutamine concentration by the gold standard HPLC technique. Comparisons were performed by Bland-Altman analyses. Comparison of the initial plasma sample of each subject (n=100), between the point of care instrument and HPLC analysis revealed a systematic bias of-221μmol/L. Comparisons between plasma and whole blood on the point-of-care instrument revealed comparable results. After pragmatic adjustments for the measured bias and hematocrit, whole blood analyses during ICU stay (n=316) compared with HPLC plasma analyses showed a line of identity of-34μmol/L and limits of agreement between 288 and -355μmol/L. When compared to the HPLC gold standard in particular, the lines of agreement indicate that the point-of-care instrument is not suitable for quantitative plasma or whole blood glutamine concentration measurements. For screening purposes the instrument may be useful in order to identify patients with hypoglutaminemia and hyperglutaminemia and the tested accuracy was high enough for safe supplementation of glutamine to patients with low plasma values measured with the device. The point-of-care instrument may also serve as a screening tool for scientific studies.

Sequential analysis of myeloperoxidase for prediction of adverse events after suspected acute coronary ischemia.

Myeloperoxidase (MPO) plasma values predict major adverse cardiac events (MACE) in cases of acute coronary syndrome. The effect of serial testing in patients who are suspected for acute coronary ischemia is unclear. We hypothesize that sequential MPO measurement may improve prediction of MACE in patients with suspected acute coronary ischemia. The present prospective observational study examined the prognostic significance of MPO in 917 patients with suspicion of acute coronary syndrome. Blood samples were taken at cardiac catheter laboratory admission and the day after coronary angiography. We recorded patients' mortality, the occurrence of cardiac ischemia, and repeated percutaneous coronary intervention through the next 6 months. Mortality among patients with increased MPO plasma levels the day after coronary angiography was increased significantly (P < 0.01). Patients with MPO values above 306.3 pmol/L had a significantly higher incidence of 6-month MACE (P < 0.0001) than patients with lower plasma values. Cox proportional hazards multivariate regression analyses revealed that MPO was an independent marker for MACE after suspected acute coronary ischemia (P = 0.048). However, MPO plasma levels at cardiac catheter laboratory admission showed no prognostic significance. In patients with suspected myocardial infarction, MPO levels above 306.3 pmol/L measured 24 hours after onset of symptoms were independent predictors of 6-month mortality and MACE.

Hemodialysis: Core Curriculum 2014

From the Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN. Received May 1, 2013. Accepted in revised form July 1, 2013. Originally published online November 21, 2013. Address correspondence to Thomas A. Golper, MD, S3303 Medical Center North, Vanderbilt University Medical Center, 21st Ave S, Nashville, TN 37232. E-mail: thomas.golper@vanderbilt. edu 2013 by the National Kidney Foundation, Inc. 0272-6386/$36.00 http://dx.doi.org/10.1053/j.ajkd.2013.07.028 PRINCIPLES OF DIALYSIS AND HOW MODALITIES DIFFER

Quantitative data on the magnitude of the systemic inflammatory response and its effect on carotenoids status based on plasma measurements

Summary Background & aim Plasma concentrations of carotenoids are decreased in association with the systemic inflammatory response and as a result do not necessarily indicates deficiency. Therefore, the aim of the present study was to examine the magnitude of systemic inflammatory response effect on plasma carotenoids concentration in a large cohort and to provide guidance on the interpretation of routine clinical results. Methods Between December 2005 and December 2010, the results (1665 blood samples from 1074 patients) of a carotenoid screen (lutein, lycopene, α-carotene and β-carotene), cholesterol and CRP concentrations, a marker of the severity of systemic inflammation, were extracted from a laboratory database. Plasma carotenoid concentrations were categorised according to an incremental increase in CRP concentrations. Result In 1074 patient samples, with the exception of α-carotene (that had median concentrations at the limit of detection), all carotenoids showed a significant trend of decreasing plasma concentrations as CRP concentrations increased. For lutein, lycopene and β-carotene, the decrease was significant when CRP concentrations were modestly elevated (between 20 and 40 mg/L). CRP concentrations of >80 mg/L were associated with the largest decrease in plasma carotenoid concentrations ( p Conclusion The clinical interpretation of plasma carotenoids requires knowledge of the magnitude of the systemic inflammatory response even after adjustment for cholesterol. A reliable clinical interpretation can be made only for plasma lutein, lycopene and β-carotene if the CRP is less than 20 mg/L. Where CRP is greater than 20 mg/L low plasma values are difficult to interpret and may be the first warning sign of carotenoid insufficiency.

Cardiorespiratory depression and haemolysis due to thioridazine overdose in the rat.

The cardiovascular and respiratory effects of an intravenous overdose of thioridazine (125 mg kg-1 h-1) were examined in either spontaneously breathing or artificially ventilated urethane-anaesthetized rats. In both groups PO2, heart rate and mean arterial pressure decreased and atrioventricular and intraventricular conduction time, as well as QT time, increased similarly. PCO2 and pH did not differ significantly except in spontaneously breathing rats where a severe acidosis occurred at the end of the experiments. Haemolysis was suspected. The same dose was administered intravenously to artificially ventilated rats. Plasma concentrations of the drug and its main metabolites, haematocrit and free plasma Hb were determined in separate groups. A severe haemolysis was observed. Thioridazine administered in the same doses intragastrically, intraduodenally or intraperitoneally resulted in lower plasma values than after intravenous administration and there was no haemolysis. Much higher oral doses produced haemolysis at 36 h, at which time plasma concentrations were not higher than those recorded after administration via the other non-intravenous routes. It is probable that the observed changes in cardiovascular and respiratory parameters are partly the result of haemolysis following thioridazine administration.

Pharmacokinetic studies on tobramycin in horses

The objective of the study was to evaluate the pharmacokinetics of tobramycin in plasma and urine in the horse (n = 7) after intravenous administration of a dose of 4 mg/kg b.w. Plasma tobramycin concentrations were assayed microbiologically and by means of HPLC analyses. Pharmacokinetic parameters, calculated on the basis of concentrations determined with the microbiological assay were not statistically different from those obtained when data from HPLC analysis were used, but the microbiological assay was more sensitive in the detection of low plasma and urine values. The values of the total body clearance (Cl(B)) were 101.4 +/- 30.1 and 130.0 +/- 49.9 mL/kg/h, respectively. The overall extraction ratio was 2.9%. The determined capacity of elimination of tobramycin in horses was similar to those for other aminoglycosides. Within 24 h after treatment, 57.6 +/- 12.2% of injected antibiotic was excreted in the urine.

Rapid analysis of fatty acid-binding proteins with immunosensors and immunotests for early monitoring of tissue injury

Fatty acid-binding protein (FABP) holds promise for early detection of tissue injury. This small protein (15kD) appears earlier in the blood than large proteins after cell damage. Combined its characteristics of high concentration tissue contents and low normal plasma values provide the possibility of a rapid rise above the respective reference values, and thus an early indication of the appearance of tissue injury. A general review was presented on the current status of different types of FABP for the detection of tissue injury in patients with myocardial injury, brain injury and also in athletes or horses with skeletal muscle injury. To take full advantage of the characteristics of the early marker FABP, rapid analysis is a crucial parameter. In this review, an overview of the development of immunoassay for the quantification of FABP in buffer, plasma or whole blood was outlined. The characteristics of different FABP immunosensors and immunotests were described. The feasibility of these immunoassays to be used in routine clinical practice and in emergency case was also discussed. Nowadays, the improved automated immunoassays (e.g. a microparticle-enhanced turbidimetric immunoassay), less time-consuming bedside immunosensors and immunotests (e.g. a one-step FABP lateral flow immunotest), are the main advance technology in point-of-care testing. With these point-of-care tests, the application of FABP as an early tissue injury marker has a great potential for many clinical purposes.

Biochemical risk factors for cardiovascular disease in an aged male population: emerging vascular pathogens.

The progressive increase of deaths and morbidity from cardiovascular disease (CVD) in most developed societies has led to the formulation of preventive strategies and application of several diagnostic guidelines. However, there is emerging evidence that most panels and algorithms are inadequate and require urgent revision and updating. Therefore, the aim of this study was the evaluation of a wide cardiovascular risk profile in elderly male patients with acute myocardial infarction (AMI) or peripheral occlusive disease (POD). The risk profile was assessed by measuring conventional serum lipid and lipoprotein levels and emerging parameters: lipoprotein(a) (Lp[a]), homocysteine (Hcy), and C-reactive protein (CRP). The concentration of triglycerides, Lp(a), Hcy and the total cholesterol/high-density lipoprotein (TC/HDL) ratio were significantly higher in both classes of patients than in a population of matched healthy controls and, similarly, patients with CVD displayed lower plasma values of HDL. No significant differences were observed for TC, low-density lipoprotein (LDL), and CRP. Patients with POD exhibited a marked atherogenic profile, as attested by substantially increased values of Hcy, Lp(a), triglycerides, and TC/HDL ratio. The frequency distributions of Lp(a) and Hcy concentrations were markedly shifted toward upper values in both classes of patients than in controls. In multivariate regression analysis, Lp(a) and Hcy were the best predictors for AMI, whereas Lp(a), Hcy, and the TC/HDL ratio were the best predictors for POD. Taken together, these data suggest that Lp(a) and Hcy excesses might exert a central role in the development of atherosclerotic disease in elderly male patients. Thereby, the inclusion of those tests, along with the TC/HDL ratio and other more conventional analyses in panels for the evaluation of the cardiovascular risk might be profitable in terms of effectual prevention.

Is there any health risk of low dietary selenium supply in PKU-children?

87 participants of the German collaboratory study for children with phenylketonuria (PKU) were investigated in order to monitor effects of a low selenium (Se) supply. The low selenium intake results from the semisynthetic “PKU-diet” which is not supplemented with selenium. The influence of the low selenium state on different clinical and biochemical parameters was evaluated. Samples of 34 healthy children of matching age and sex (on a normal diet) were analysed to achieve contemporary reference values. All PKU children presented a low selenium state (low plasma, whole blood, and hair Se values, reduced urinary selenium excretion, and decreased plasma and erythrocyte glutathione peroxidase activity (GSH-Px A)) in comparison with the healthy reference group (all figures p < 0,001). The investigated hematological and biochemical parameters were found to be within normal range (except T). The aspartate amino transferase (ASAT) was found to be negatively correlated with plasma Se (ASAT / plasma Se: p = 0,006). Plasma thyroxine (T 4) was higher in PKU children compared with the reference group. This hormone was inversely correlated with the selenium blood values of the PKU children. (T 4 /whole blood Se p = 0,001). The somatic measurements showed a negative standard deviation score (SDS) of the body height in the PKU children compared with reference values. Despite the difference in Se supply the infants did not present any specific Se deficiency symptoms.

Plasma vitamin a (Retinol) and retinol-binding protein in newborns and their mothers

Plasma vitamin A (retinol) and retinol-binding protein (RBP) were measured in 66 women at delivery and in their full-term offsprings at birth. In newborns the plasma vitamin A and RBP concentrations were 50–60% of the values found in their mothers at delivery (p<0.025). According to the guidelines recommended by the NHANES II Committee, 35% of the newborns had plasma vitamin A concentrations below 1.01 μmol/L, considered to be indicative of inadequate Vitamin A status if encountered in older infants and adults. The mean plasma molar ratio of vitamin A/RBP was found to be close to 1.0 in both newborns and mothers. This in turn is indicative of normal saturation of RBP with vitamin A. Furthermore, all of the neonates were born with normal birthweights. We suggest that the low plasma values of vitamin A and its carrier protein in the newborns may be a reflection of age rather than of a true deficiency of vitamin A. The age-specific plasma levels of these two parameters may serve as reference values which could be used to interpret plasma vitamin A and RBP levels of newborns with clinical conditions.

Arachidonic fatty acid in red blood cell membranes, lymphocytes, and cultured skin fibroblasts of dominant Charcot-Marie-Tooth syndrome

Altered proportions of long-chain unsaturated n − 6 fatty acids (FA) in plasma and myelin of the heredodegenerative peripheral neuropathy, Charcot-Marie-Tooth syndrome (CMT), may implicate FA metabolism in the pathogenesis of CMT demyelination. A significant relationship between low plasma values of the polyunsaturated n − 6 FA, arachidonic acid, and an increased amount of prostaglandin-mediated immune responses had suggested the possibility of immune system metabolic usage of these n − 6 FA rather than an inherited FA enzyme defect. This relationship between peripheral immunostimulation and altered FA was documented repeatedly in CMT patients. Increased and cyclic lymphocyte activation expressions were measured at the same time as low amounts of plasma arachidonic acid, which is the FA precursor of prostaglandin immunoregulatory agents. An autoimmune process with possible enhanced formation of the n − 6 immune prostenoid agents in CMT had also been suggested by increased class II antigen expression on CMT sural nerves. Here, normal proportions of total FA in cultured CMT skin fibroblasts diminishes a notion of hereditary defects in CMT fatty acid metabolism. In addition, a significant depletion of the key arachidonic acid in lipid stores of CMT red blood cell membranes with elevated values of this FA in functional CMT lymphocytes, compared to controls, support the concept in CMT patients of a metabolic diversion of n − 6 FA, particularly arachidonic acid, from tissue stores for immunoregulatory prostenoid agent formation.

Circulating levels and bone contents of bone γ-carboxyglutamic acid-containing protein in rat models of non-insulin-dependent diabetes mellitus

In order to investigate the pathophysiology of the diabetic osteopenia observed in non-insulin-dependent diabetes mellitus, the circulating levels and the bone contents of bone gamma-carboxyglutamic acid-containing protein (osteocalcin) were determined in rat models of non-insulin-dependent diabetes mellitus, neonatally streptozotocin-induced rats and in genetic Wistar fatty rats. In Wistar fatty rats the plasma level of osteocalcin was 8.1 +/- 0.8 nmol/l, significantly lower than the value of 17.3 +/- 0.9 nmol/l in their lean littermates (p < 0.001). Bone length, bone strength, and weight of powdered bone in Wistar fatty rats were significantly decreased compared to control rats (p < 0.001, p < 0.02 and p < 0.001, respectively). Bone content of osteocalcin per femur in Wistar fatty rats was also significantly decreased compared to controls (p < 0.001). In addition, plasma osteocalcin in neonatally streptozotocin-induced diabetic rats was 2.9 +/- 0.3 nmol/l, which was also significantly decreased compared to the value of 5.6 +/- 0.5 nmol/l in their controls (p < 0.001). Since it has been established that the plasma level of osteocalcin is well related to bone formation and turnover, the low plasma values in these animal models suggest that bone formation and turnover are decreased in non-insulin-dependent diabetes mellitus. Low bone formation and turnover are, therefore, postulated to be one of the pathophysiological characteristics of the skeletal tissue in non-insulin-dependent diabetes mellitus, and to be at least in part responsible for the occurrence of this complication.

Topical and systemic availability of 5‐amino‐salicylate: comparisons of three controlled release preparations in man

The bioavailability of three pure 5-aminosalicylic (5-ASA) preparations (Asacol, Claversal, and Pentasa) was studied in 8 ileostomy patients and 12 normal subjects after 6 days of treatment with 2000 mg 5-ASA. The local bioavailability, reflected by the 5-ASA concentration was thereby measured at two clinically relevant areas of the gut: at the entrance to, and the exit from the colon. Estimates of the systemic bioavailability were obtained from the urinary excretions and the plasma values of 5-ASA and Acetyl-5-ASA (Ac-5-ASA) during the three regimens. The three preparations studied are designed to release 5-ASA at different levels in the intestine, but there was no significant difference in the 5-ASA concentrations in the ileostomy effluents (Asacol 1.8 mmol/L, Claversal 3.4 mmol/L, Pentasa 2.0 mmol/L, median values). However, we found a smaller urinary excretion of 5-ASA and Ac-5-ASA (5.2% vs Claversal 27.9% and Pentasa 23.0%, median values of ingested daily dose) and a lower concentration of Ac-5-ASA in the ileostomy effluents after Asacol treatment (0.8 mmol/L, median value) which indicates a more distal release from this preparation compared with Claversal (2.4 mmol/L, median value) and Pentasa (5.5 mmol/L, median value). In normal subjects a higher faecal water concentration of 5-ASA was found after Asacol (9.8 mmol/L, median value) compared with Claversal (5.0 mmol/L, median value), whereas no difference between the faecal water concentrations of Ac-5-ASA was found (Asacol 21.5 mmol/L, Claversal 21.6 mmol/L, median values). This can be explained by a larger systemic absorption of 5-ASA from Claversal, and accordingly Claversal treatment resulted in the largest urinary excretion of 5-ASA and Ac-5-ASA (43.7% vs Asacol 35.6% and Pentasa 31.6%, median values of ingested daily dose). The high Ac-5-ASA concentration in the ileostomy effluents and in the faeces after Pentasa, and the low plasma values, indicate a slow 5-ASA release from this preparation throughout the small and large intestine. The results of the study indicate that Asacol is released in the distal part of the small intestine, that Pentasa is gradually released in the small and large intestine, and that Claversal shows an intermediate release pattern.

Twice-daily dosing of valproate with divalproex.

Equivalent doses of enteric-coated divalproex were substituted for valproic acid in 15 epileptic patients who were on a three- or four-times-a-day dosing schedule. After 2 wk the dosing regimen was changed to twice-daily divalproex dosing, and plasma levels were determined during the 12-hr period after the morning dose. Peak absorption was reached at 4 hr; extended plateaus were noted thereafter. The mean fluctuation between low and high plasma values for the group was 46%, with a decrease of less than 50% of peak levels in 9 of the 15 patients at a sampling time just before the second dose. Breakthrough seizures did not occur as a result of twice-daily dosing.

Use of erythrocyte copper:zinc superoxide dismutase activity and hair or fleece copper concentrations in the diagnosis of hypocuprosis in ruminants

Changes in the activity of superoxide dismutase, a copper-containing enzyme in erythrocytes (ESOD), and changes in copper in hair or fleece were compared with the changes in plasma copper during copper depletion and repletion in steers, lambs and ewes. During depletion the decline in ESOD began later than the decline in plasma copper: the lag varied from 0 to 80 days in individual steers and it was least evident when young rapidly growing lambs were subjected to severe depletion. ESOD activity eventually declined at only one-third to one-seventh of the rate shown by plasma copper, the difference being particularly marked in severely depleted lambs. Repletion of ESOD began after repletion in plasma copper and continued more slowly particularly in growing animals. Hair and fleece copper also responded relatively slowly to depletion and repletion. Low values of ESOD and hair or fleece copper may have diagnostic significance, indicating a more prolonged or intense deficiency of copper and a higher probability of clinical and production responses to copper therapy than low plasma or liver copper values.

The magnesium load test: I. A design for infants.

The purpose of this study was to design the shortest suitable magnesium load test for infants up to six months of age. A 56-hour test was used to study cation and creatinine excretion before and after an intramuscular load of 0.49 mEq of magnesium/kg of body weight. No diurnal excretion pattern for magnesium was found, and most of the magnesium rejected by the kidney was excreted by neonates within 32 hours, and by infants from one to six months of age within 24 hours. The postload urinary magnesium value usually stabilized at a slightlyhigher level than the preload level. The mean plasma magnesium level increased about 0.65 mEq/liter one hour after the load, and at the end of the test was 0.25 mEq/liter higher than the initial value; abnormally low plasma values were normalized. Renal excretion of creatinine and potassium was not affected by the magnesium load, but the 24-hour postload excretion was higher than the 24-hour preload excretion of calcium for all patients, and of sodium for some full-term neonates. Because of slow excretion of magnesium and concomitant caocium loss, special precautions are required for testing and repletion of young infants to avoid magnesium overload and calcium depletion. A suitable test would have an eight-hour preload period, a load of 0.49 mEq of magnesium (0.12 ml of 50 per cent MgSO4.7H20) per kg of body weight, and a postload collection of 32 hours for neonates and 24 hours for infants from one to six months of age.

Amino acid patterns in plasma and erythrocytes in protein malnutrition.

SummaryThe reliability of the paper chromatographic technique developed by Whitehead for evaluation of the amino pattern of serum and plasma has been studied by comparison with the results obtained by quantitative column chromatography. The results obtained with the two techniques show a satisfactory agreement.The screening technique has been used in a field study of protein malnutrition among Ethiopian pre‐school children in different areas of the country. Changes of the amino acid pattern of blood serum of the type seen in protein malnutrition have been found in 27‐52 % of the children. The highest figure of amino acid imbalance was obtained for an area, where ensete (false banana) containing only about 1 % of protein is the main staple food.The erythrocyte/plasma distribution ratios of amino acids have been determined in a group of children with advanced protein malnutrition. The erythrocyte values of amino acids are often increased in spite of low plasma values resulting in high erythrocyte/plasma distribution ratios in most of the protein malnutrition cases studied.

Influence of Catharsis and Diarrhea on Gastrointestinal Absorption of Ascorbic Acid in Infants

SummaryAscorbic acid is excreted in small amounts in the stools of the normal infant studied. Large amounts of orally administered ascorbic acid are excreted in the stools of infants following catharsis and during acute diarrhea. The increased fecal excretion of orally administered ascorbic acid during acute diarrhea in the infant points to its failure of absorption in the intestinal tract, and explains the low blood plasma values and low urinary excretion.