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Lecture 6c 10 Feb. 2014 Acute diseases Acute respiratory distress syndrome Acute glomerulonephritides Acute human immunodeficiency Acute renal failure Acute tubular necrosis Bacterial and viral infections Allergic reactions and food intolerances These topics discussed in terms of : -Pathology -nutritional intervention -nutraceuticals Acute respiratory distress syndrome -Pathology -infection e.g. pneumonia -usually caused by anorexia, fatigue, malaise Acute respiratory distress syndrome -nutritional intervention -avoid high glucose loads as this aggravates infection -nasogastic feeding but problem if misplace tube -parenteral feeding avoids misplaced tube -nutritional supplementation of antioxidant minerals important Acute respiratory distress syndrome -nutraceuticals none found Acute glomerulonephritides -Pathology -brought on by a variety of kidney diseases -inflammation of capillary loops of glomerulus -blood in urine -hypertension -temporary loss of renal function -nutritional intervention maintain good nutritional status -nutraceuticals none found Acute human immunodeficiency virus -Pathology -6-7 weeks after infection before detection -rapid replication of virus -fever, malaise, headache, sometimes rash -nutritional intervention maintain good nutritional status -nutraceuticals none found Acute renal failure Pathology sudden reduction of glomerular filtration rate -due to inadequate renal perfusion -diseases of renal parenchyma -renal obstruction Acute renal failure -nutritional intervention total parenteral nutrition since patient is usually unable to eat initially due to physiological stress protein intake must be increased Acute renal failure -nutritional intervention -preferred mix is glucose (high intake), lipids (high intake) and mixture of essential and non-essential amino acids -this reduces protein catabolism (protein sparing) and urea production -balance fluid and electrolyte intake with output -nutraceuticals none found Acute tubular necrosis -Pathology - due to renal ischemia -nutritional intervention -as in acute renal failure -nutraceuticals -none found Bacterial and viral infections -Pathology -microbial entry by respiratory or touch -elicits immune response -nutritional intervention -eating in accordance with the principles of adequacy , balance, moderation, energy control variety and nutrient density to supply sufficient nutrients to facilitate maximal immune response Bacterial and viral infections -nutraceuticals vitamin C ~ 2 g per day -said to reduce the duration and severity of symptoms of common cold -this is controversial -mechanism is not clear- interesting that vitamin C is an antioxidant yet part of immune response is to spew free radicals to suppress infection Allergic reactions and food intolerances -Pathology -allergy -food protein or other molecular entity seen as foreign to body elicts immune response -food intolerance-inability of body to digest, absorb, transport, utilise or excrete a food component Allergic reactions and food intolerances -nutritional intervention -avoid offending food component -read labels -substitute non offending agents eg sugar for phenylalanine Allergic reactions and food intolerances nutraceuticals -if solve or substitute for offending agent eg lactaid for lactose intolerance eg cyclamate or sucralose for phenylalanine