Pulmonology

Textbook in Internal medicine consists of 37 chapters. This textbook is made up of text material and enough illustrations, including clinical findings and schematic figures. The textbook is intended for English-speaking students of medical and pharmaceutical faculties of higher educational establishments of Ukraine.

Підручник з внутрішньої медицини складається з 37 розділів. Містить текстові матеріали та достатньо ілюстрацій, у тому числі клінічні матеріали та схематичні рисунки. Підручник призначений для англомовних студентів медичних та фармацевтичних факультетів вищих навчальних закладів України.

Fractional tubular reabsorption (FTR) of free and acyl carnitine was measured in 15 patients with various selective tubular transport defects and in 19 patients with more generalized tubular dysfunction (Fanconi syndrome). FTR of free carnitine was normal in all patients with a selective tubulopathy, FTR of acyl carnitine was normal in most, and plasma carnitine levels were normal without exception. In these patients, there was no evidence for the existence of a defective renal transport mechanism shared by carnitine. In the patients with Fanconi syndrome, mean FTR of free and acyl carnitine was low; their plasma carnitine levels were lowered and correlated with the FTR. In individual patients, FTR of free and acyl carnitine also correlated with the severity of the disease. In the group of Fanconi syndrome patients, FTR of free and acyl carnitine correlated linearly with that of valine. We concluded that the lowering of plasma carnitine in the patients with Fanconi syndrome was caused by excessive loss of carnitine in urine. Its pathophysiological significance remained to be established.

O n t a r i o , Canada Technetium-99m l a b e l l e d Salbutamol was administered through a tracheostomy t o v e n t i l a t e d r a b b i t s by e i t h e r an MDI (5 puffs,lOOpg/puff) aided with a s p a c e r (MV15 Aemhantber, T r u d e l l , Canada) (Groupl, n=7); o r by n e b u l i z a t i o n (10DpgIkg i n 3ml Technetium-9% l a b e l l e d 5% albumin). Nebulization was c a r r i e d o u t f o r 20 min. with a J e t (Hudson, USA) (Group 2, n = l l ) o r U l t r a s o n i c d e v i c e (Siemens, Sweden) using e i t h e r a s t a n d a r d (Group 3, n=6) o r a small (Group 4, n=7) r e s e r v o i r .

Summary: To initiate an investigation into the biochemistry and mechanism of group B [beta]-hemolytic Streptococcus virulence, bacterial cultures grown in suspension were centrifuged, and the bacteria and media were subjected to extensive fractionation. Each ...

У навчальному посібнику висвітлено сучасну інформацію про методи діагностики в клініці внутрішньої медицини з урахуванням рекомендацій провідних світових та європейських наукових товариств. Детально розглянуто питання фізикального, лабораторного та інструментального дослідження основних систем організму (серцево-судинної, дихальної, травної, опорно-рухової, сечовидільної, кровотвірної) та при алергійних захворюваннях.
Для лікарів-практиків терапевтичного профілю (лікарів загальної практики — сімейної медицини, терапевтів, кардіологів, пульмонологів, гастроентерологів, ревматологів, нефрологів, гематологів, алергологів), аспірантів, лікарів-інтернів, резидентів і студентів медичних закладів вищої освіти.

RESUMO: -Enfermidades do trato respiratório inferior são comuns na clínica de pequenos animais. Devido à vasta etiologia dessas afecções é necessário realizar um diagnóstico preciso, para que seja determinada a terapêutica adequada. O lavado broncoalveolar (LBA) é uma ferramenta diagnóstica auxiliar, quando métodos de rotina são inconclusivos. Tendo como objetivo identificar as alterações citológicas presentes no lavado broncoalveolar de cães de abrigo acometidos por pneumonia, foram utilizados 10 cães doentes e 20 (vinte) cães saudáveis, como grupo controle. O LBA foi realizado por meio da técnica endotraqueal, com os animais sob anestesia geral de curta duração. A amostra coletada foi sedimentada em câmara de Suta e recebeu coloração tipo Romanowski. Na avaliação citológica do LBA do grupo com pneumonia foi observado elevação significativa na contagem celular total e no número de neutrófilos, associada à diminuição no número de macrófagos, linfócitos, mastócitos, eosinófilos e células epiteliais. O LBA mostrou-se seguro e eficaz como diagnóstico diferencial nas doenças do trato respiratório inferior em cães, promoveu achados relevantes no grupo pneumonia como neutrofilia, presença de macrófagos multinucleados e corpúsculos de Lentz, comprovando seu mérito como ferramenta diagnóstica.

Introduction: Critically ill patients are prone to malnutrition because of their hyper metabolic condition and increased requirement of nutrition supply. The purpose of the study was to compare the complication of bolus and continuous method of enteral nutrition in critically ill patients. Methodology: A randomised control study was done in intensive care unit of Himalayan hospital Dehradun. The study included a total of 136 patients who were randomised to continuous (n=68) and bolus (n=68) method of enteral nutrition. The data regarding complication of enteral nutrition was obtained on 1 st , 2 nd and 3 rd day of enteral nutrition. Result: In the study both the finding method had shown similar effects in terms of complications. There was no incidence of tube obstruction, tube displacement, gastric aspiration and vomiting seen in both the groups, but the incidence of gastric aspiration (3.3%) was seen on 2 nd and 3 rd day and the incidence of diarrhea (6.7%) was seen on 2 nd day in bolus group. Whereas there was only 1 incidence (3.3%) of diarrhea was seen in continuous group. Conclusion: The study concluded that continuous and bolus feeding methods had similar effect in terms complication in critically ill patients admitted in ICU.

Latar belakang : Rokok elektrik adalah produk yang melepaskan aerosol berisi nikotin kepada pengguna dengan cara memanaskan cairan yang terdiri dari propylen glycol atau gliserol (glycerin), nikotin, dan zat pemberi rasa. Penelitian ini bertujuan untuk mengetahui pengaruh  perbedaan waktu paparan asap rokok elektrik terhadap gambaran histopatologi paru-paru Mencit (Mus musculus).
Metodologi : Penelitian ini merupakan penelitian  eksperimental laboratorik. Semua data diuji secara statistik menggunakan uji parametrik ANOVA. Apabila data tidak terdistribusi dengan normal maka digunakan uji alternatif nonparametrik yaitu Kruskal-Wallis. Subjek penelitian ini menggunakan 25 ekor Mencit yang dibagi menjadi 5 kelompok perlakuan yaitu kontrol, dan empat kelompok perlakuan yang dipapari waktu yang berbeda yakni dari 15 menit hingga 60 menit perhari. Perubahan diamati secara mikroskopis setelah 14 hari perlakuan dan dinilai menggunakan Skor kerusakan Paru oleh Marianti.
Hasil : Pada penelitian ini diperoleh hasil p=0,000. Kesimpulan: Terdapat pengaruh perbedaan waktu paparan asap rokok terhadap gambaran histopatologi Mencit.
Kata kunci : Rokok Elektrik, Vape, ENDS (Electronic Nicotine Delivery Systems), ENNDS (Electronic Non-Nicotine Delivery Systems.

Anamnesis: Datos de filiación, motivo de consulta, enfermedad actual, antecedentes personales, antecedentes familiares, antecedentes sociales, hábitos, revisión actual por sistemas. Checklist signos vitales, checklist piel, checklist cabeza: cráneo, ojos, oídos, nariz y senos paranasales, boca, faringe, checklist cuello, checklist respiratorio y pulmonar, checklist cardiaco.

Atypical sensory-based behaviors are a ubiquitous feature of autism spectrum disorders (ASD). In this article, we review the neural underpinnings of sensory processing in autism by reviewing the literature on neurophysiological responses to auditory, tactile, and visual stimuli in autistic individuals. We review studies of unimodal sensory processing and multi-sensory integration that use a variety of neuroimaging techniques, including: electroencephalography (EEG), magnetoencephalography (MEG), and functional Magnetic Resonance Imaging (fMRI). We then explore the impact of covert and overt attention on sensory processing. With additional characterization, neurophysiologic profiles of sensory processing in ASD may serve as valuable biomarkers for diagnosis and monitoring of therapeutic interventions for autism and reveal potential strategies and target brain regions for therapeutic interventions.

Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled ''A Global Strategy for Asthma Management and Prevention'', first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that ''it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained,'' and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.

Secara ilmiah osteoporosis adalah penyakit rapuh tulang yang ditandai dengan hilangnya kepadatan tulang sehingga tulang mudah patah serta tidak tahan dengan benturan ringan. Dampak rokok terhadap kesehatan tulang belum diketahui pasti apakah penurunan massa tulang memang disebabkan oleh rokok, atau oleh faktor resiko lain. Misalnya secara umum tubuh para perokok cenderung lebih kurus. Berat badan ringan adalah salah satu faktor resiko massa resiko massa tulang rendah. Perokok juga cenderung lebih akrab terhadap alkohol, kurang aktif dan memiliki pola makan yang kurang baik. Dan wanita perokok umumnya memiliki kadar estrogen lebih rendah, dan cenderung lebih cepat mengalami menopause. Namun, beberapa literatur menyebutkan bahwa merokok dapat mengurangi penyerapan kalsium oleh tubuh.

The purpose of this study was to assess differences in sound spectra of crying of term newborns in relation to different pain levels. Fifty-seven consecutively born neonates were evaluated during heel-prick performed with different analgesic techniques. Crying was recorded and frequency spectrograms analyzed. A pain score on the DAN (Douleur Aiguë du Nouveau-né) scale was assigned to each baby after the sampling. Three features were considered and correlated with the corresponding DAN scores: 1) whole spectral form; 2) the fundamental frequency of the first cry emitted (F 0 ); and 3) root mean square sound pressure normalized to its maximum. After emission of the first cry, babies with DAN scores Ͼ8, but not with DAN scores Յ8 (p Ͻ 0.001), showed a pattern ("siren cry") characterized by a sequence of almost identical cries with a period on the order of 1 s. A statistically significant correlation was found between root mean square (r 2 ϭ 89%, p Ͻ 0.01), F 0 (r 2 ϭ 32%, p Ͻ 0.05), siren cry (r 2 ϭ 68.2%, p ϭ 0.02), and DAN score. F 0 did not show significant correlation with DAN score in the subset of neonates with DAN scores Յ8 (r 2 ϭ 1.4%, p ϭ 0.94), and babies with a DAN score Ͼ8 had a significantly higher F 0 than those with lower DAN scores (p ϭ 0.016). An alarm threshold exists between high (Ͼ8) and low (Յ8) DAN scores: crying has different features in these two groups. When pain exceeds a DAN score of 8, usually a first cry at a high pitch is emitted, followed by the siren cry, with a sound level maintained near its maximum. Abbreviations RMS, root mean square F 0 , fundamental sound frequency DAN, Douleur Aiguë du Nouveau-Né SS, sensorial saturation

Allergy is one of the most common conditions that affect mankind with diverse manifestations. Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis and food allergy afflict up to 20% of the human population in most countries. Allergies have become big problem around the world. The prevalence of allergic diseases like Asthma has risen in the recent years despite an improvement in the general health of the population. It is roughly estimated that one in three people have an active allergy at any given time and at least three in four people develop an allergic reaction at least once in their lives. The drugs used for allergy in allopathy are steroids, Anti histamine, decongestants, Mast cell stabilizer and leukotriene receptor antagonists. Anti histamine drugs can have undesirable side effects, most notably drowsiness, dry mouth etc. The use of medicinal plants becomes more popular due to the adverse effects of such allopathic drugs. In recent years, a safe and effective management of diseases through plant resources has received much attention. Many herbs are used for their anti histamine and anti inflammatory properties. Siddha, an Indian system of medicine has better remedies for the treatment and management of all type of allergic diseases. This article reviews the anti allergic properties of the most commonly used herbs in Siddha system of medicines.

Dengan semakin meningkatnya teknologi dan industri di negara kita terutama kendaraan bermotor serta peningkatan kriminalitas, maka akan meningkat pula angka kejadian dari trauma toraks. Di Amerika Serikat, penderita trauma secara keseluruhan mendekati 70 juta jiwa setiap tahunnya dengan menghabiskan dana kira-kira 100 milyar dolar setahun, dan kematian oleh trauma disebabkan oleh truma toraks.

Reč „astma“ je grčkog porekla i znači dahtanje ili teško disanje. Simptomi astme su opisani još prvih godina nove ere. Laenecc je u prvoj polovini XIX veka otkrio strukturna oštećenja disajnih puteva i uveo termin „bronhijalna astma“ („ asthma bronchiale“). Poslednjih decenija su činjeni brojni pokušaji preciznog definisanja astme. Najnovija definicija je postavljena na osnovu rezultata multidisciplinarnog, odnosno patohistološkog, imunološkog, patofiziološkog, biohemijskog, molekularno biološkog i kliničkog pristupa proučavanjima promena disajnih puteva obolelih od astme. Ona glasi: „Astma je oboljenje sa hroničnom inflamacijom disajnih puteva, u kojoj su značajne mnoge ćelije, uključujući mast ćelije, eozinofilne leukocite i T-limfocite. Ova inflamacija izaziva kod osetljivih osoba ponavljanje epizoda šištanja, gušenja, tegobe u grudima i kašalj, posebno noću ili rano ujutru. Ovi simptomi su povezani sa rasprostranjenom, ali promenljivom opstrukcijom protoka vazduha kroz disajne puteve, koja je bar delom reverzibilna, bilo spontano ili pod dejstvom lekova.“ Astma je česta bolest, široko rasprostranjena u svim područjima sveta, u svim uzrastima i podjednako u oba pola, sa konstantnom tendencijom porasta poslednjih decenija.

Traumatic asphyxia is a clinical syndrome related to cervicofascial cyanosis, petechiae, subconjunctival
haemorrhages and neurological symptoms. This syndrome occurs after a transient, severe and compressive
blunt thoracic trauma. Here, we presented two cases of traumatic asphyxia. They both had prominent petechiae
on upper parts of their bodies. The prognosis was excellent in the boy. Contrary, second case was dead in
emergency department due to subarachnoid haemorrhage and intracerebral petechial haemorrhages. Traumatic
asphyxia alone does not predict morbidity and mortality. It is the concomitant cardiovascular, pulmonary
and neurologic injuries that affect the outcome. (Hong Kong j.emerg.med. 2011;18:339-342)

Ο πιο σημαντικός παράγοντας για την πρόγνωση των ασθενών με καρκίνο του πνεύμονα (ΚΠ) είναι το στάδιο της νόσου κατά τη διάγνωση. Μια μεγάλη καθυστέρηση στη διάγνωση μπορεί να αποβεί μοιραία. Σε 181 ασθενείς που έχουν διαγνωστεί με ΚΠ μεταξύ 2010-2014 στην Πνευμονολογική Κλινική του Γενικού Νοσοκομείου Κέρκυρας, προσδιορίσαμε το προφίλ των συμπτωμάτων, το διάστημα από την έναρξη των συμπτωμάτων στη διάγνωση και τη σχέση τους με την πρόγνωση. Επίσης μελετήθηκαν δημογραφικοί παράγοντες( καπνιστική συνήθεια , ηλικία , φύλο), το στάδιο και ο τύπος του ΚΠ αλλά και η παρουσία συννοσηρότητας και καρκινικών δεικτών. Οι περισσότεροι ασθενείς με ΚΠ ήταν συμπτωματικοί και διαγνώστηκαν με προχωρημένη νόσο, σταδία ΙΙΙ και IV. Φάνηκε ότι τα συστηματικά συμπτώματα σχετίζονται με αυξημένη καθυστέρηση στη διάγνωση και με κακή πρόγνωση ενώ αντίθετα μια τυχαία διάγνωση (όπως μια λοίμωξη του αναπνευστικού) σχετίζεται με μικρότερη καθυστέρηση και καλύτερη πρόγνωση. Η μέση καθυστέρηση ήταν 2,2 μήνες, αρκετά μικρότερη από σχετικές μελέτες, χωρίς ωστόσο να αποτελεί προγνωστικό δείκτη της νόσου. Η ηλικία, το φύλο και η συννοσηρότητα του ασθενούς δεν επηρέασαν τις μετρήσεις μας, ενώ οι ενεργοί καπνιστές και οι ασθενείς με αυξημένες τιμές του δείκτη Ca125 παρουσίαζαν χειρότερη πρόγνωση.Μελέτες έχουν αποδώσει σε μεγάλο βαθμό το πρόβλημα, στην καθυστερημένη παραπομπή των ασθενών από το πρωτοβάθμιο επίπεδο στον ειδικό γιατρό . Επίσης, έχουν προταθεί πολλές κοινωνικές και συμπεριφοριακές αιτίες για να εξηγηθεί το περίπλοκο θέμα της καθυστερημένης διάγνωσης στα διάφορα είδη καρκίνου. Παράλληλα με τις εξελίξεις στον τομέα της μοριακής ανίχνευσης, στον προσυμπτωματκό έλεγχο, και στην αντικαπνιστική εκστρατεία, οφείλουμε να ερευνήσουμε προσεκτικότερα το συγκεκριμένο πρόβλημα.


In lung cancer (LC), the most important factor for survival is the stage of disease at diagnosis. A long delay in diagnosis can be fatal. In 181 patients diagnosed between 2010-2014 in Pulmonary Clinic of the General Hospital of Corfu, we determined the profile of symptoms, time from onset of symptoms to diagnosis and their relationship with prognosis. We also studied demographic factors (smoking habits, age, gender), stage and type of the disease and the presence of comorbidity and tumor markers. Most patients were symptomatic and diagnosed with advanced disease, stages III and IV. It seemed that the systemic symptoms associated with increased delay in diagnosis and poor prognosis whereas a random diagnosis (such as a respiratory infection) is associated with less delay and better prognosis. The average delay was 2.2 months, well below relevant studies, though it was not a predictor of disease. The age, sex and comorbidity of the patient did not affect our measurements, while current smokers and patients with elevated serum Ca 125 showed worse prognosis. Studies have yielded largely the problem in late referral of patients from primary health services to expert. They suggested many social, behavioral and other causes to explain the complex issue of late diagnosis in various types of cancer. In parallel with developments in molecular detection, screening methods, and anti-smoking campaign, we need to investigate more closely the specific problem.

We investigated pubertal development of 4019 boys and 3562 girls Ͼ8 y of age participating in a cross-sectional survey in The Netherlands and compared the results with those of two previous surveys. Reference curves for all pubertal stages were constructed. The 50th percentile of Tanner breast stage 2 was 10.7 y, and 50% of the boys had reached a testicular volume of 4 mL at 11.5 y of age. Median age at menarche was 13.15 y. The median age at which the various stages of pubertal development were observed has stabilized since 1980. The increase of the age at stage G2 between 1965 and 1997 is probably owing to different interpretations of its definition. The current age limits for the definition of precocious are close to the third percentile of these references. A high agreement was found between the pubic hair stages and stages of pubertal (genital and breast) development, but slightly more in boys than in girls. Menarcheal age was dependent on height, weight, and body mass index. At a given age tall or heavy girls have a higher probability of having menarche compared with short or thin girls. A body weight exceeding 60 kg (ϩ1 SDS), or a body mass index of Ͼ20 (ϩ1 SDS), has no or little effect on the chance of having menarche, whereas for height such a ceiling effect was not observed. In conclusion, in The Netherlands the age at onset of puberty or menarche has stabilized since 1980. Height, weight, and body mass index have a strong influence on the chance of menarche. Abbreviations BMI, body mass index P 50 , 50th percentile P 3 , 3rd percentile P 97 , 97th percentile SDS, SD score

The significance of minor myocardial inflammatory infiltrates and viral detection in SIDS is controversial. We retrospectively compared the demographic profiles, myocardial inflammation, cardiomyocyte necrosis, and myocardial virus detection in infants who died of SIDS in a safe sleep environment, accidental suffocation, or myocarditis. Formalin-fixed, paraffin-embedded myocardial sections were semiquantitatively assessed for CD3 lymphocytes and CD68 macrophages using immunohistochemistry and for cardiomyocyte cell death in H&E-stained sections. Enteroviruses and adenoviruses were searched for using PCR technology. The means of lymphocytes, macrophages, and necrotic cardiomyocytes were not statistically different in SIDS and suffocation cases. Enterovirus, not otherwise specified, was detected in one suffocation case and was the only virus detected in the three groups. Very mild myocardial lymphocyte and macrophage infiltration and scattered necrotic cardiomyocytes in SIDS are not pathologic, but may occur after the developing heart is exposed to environmental pathogens, including viruses.

Дефицит альфа-1-антитрипсина (А1АТ) -генетически детерминированное заболевание, вызванное недостаточностью А1АТ в сыворотке крови, возникающее вследствие различных мутаций в гене Pi и проявляющееся в виде хронической обструктивной болезни легких (ХОБЛ), эмфиземы легких, идиопатическим фиброзом, бронхоэктазами, развитием рака легкого, поражением печени и сосудов. Точная распространенность дефицита А1АТ в большинстве популяций не известна и у многих лиц он остается не диагностированным. Например, в США из 70 000 -100 000 пациентов с признаками дефицита А1АТ идентифицированы только 10% (1), а в Европе из 125 000 индивидуумов лишь приблизительно 5 000 человек включены в Международный Регистр Альфа1 (The Alpha One International Registry) (2). ) (2). В многочисленных исследо-ваниях было показано, что срок установления диагноза составляет от 5,6 до 7,2 года с момента первого обращенияк врачу. Это связано с тем, что у некоторых людей с очень низким уровнем этого белка не отмечаются клинические признаки заболевания, а симп-томы у разных индивидуумов различны или полностью отсутствуют. Кроме того, на про-явление заболевания влияет не только генетическая предрасположенность, но и факторы окружающей среды. Распространенность дефицита А1АТ в мире не превышает 0,5-1% (наибольшее в странах Скандинавии -1,8%). Дефицит альфа-1-антитрипсина в огранизме человека является недооцененным заболеванием. Физиологическая роль альфа-1-антитрипсина. Альфа-1-антитрипсин имеет альтернативное название ингибитор альфа-1-протеиназы или SERPINA1 (SERine Proteinase INhibitor), является членом суперсемейства ингибиторов сериновых протеаз (серпинов), которое состоит из альфа-1-химотрипсина, ингибитора С1, антитромбина, нейросерпина и др. (3,4). А1АТ считается основной анти-эластазой нижних дыхательных путей в основе действия которого лежит способность ингибировать сериновую протеазу и нейтрофильную эластазу (5,6). Кроме анти-протеазной активности А1АТ обладает другими биологическими эффектами, состоящими в модулировании воспаления, обладает антиоксидантным и антимикробным действием, участвует в локальном иммунном ответе, препятствует апоптозу (7,8). Мутантные формы А1АТ играют важную роль в патогенезе заболеваний. Это связано с неправильным сворачиванием белка, аккумулировании этих форм в полимеры, что приводит к уменьшению секреции функциональных мономеров. История открытия А1АТ. В 1963 г. учеными Laurell C-B и Eriksson S. из университета Лунд в Швеции было сделано замечательное открытие (9,10). Оказалось, что при электрофорезе белков сыворотки у лиц с панацинарной эмфиземой не было полосы для альфа-1 глобулина (Рис.1).

La prise de glutamine (Gln) sur 5 h inhibe la dégradation protéique dans la dystrophie de Duchenne de Boulogne (DDB) mais le bénéfice clinique restait à évaluer. Nous avons testé dans la DDB, si l'inhibition de la dégradation protéique persistait après 10 j, et étudié les mécanismes de cette inhibition, et l'impact clinique de la prise orale de Gln au long cours.

We previously showed that, in prematurely born infants, an anabolic state without metabolic acidosis can be achieved upon intravenous amino acid (AA) administration in the immediate postnatal phase, despite a low energy intake. We hypothesized that the anabolic state resulted from an increased protein synthesis and not a decreased proteolysis. Furthermore, we hypothesized that the energy needed for the higher protein synthesis rate would be derived from an increased glucose oxidation. To test our hypotheses, 32 ventilated premature infants (Ͻ1500 g) received intravenously either solely glucose or glucose and 2.4 g AA/kg/d immediately postnatally. On postnatal d 2, each group received primed continuous infusions of either [1-13 C]leucine or [U-13 C 6 ]glucose. 13 CO 2 enrichments in expiratory air and plasma [1-13 C]␣-KICA (as an intracellular leucine precursor) and [U-13 C 6 ]glucose enrichments were measured by mass spectrometry techniques. The AA administration resulted in an increased incorporation of leucine into body protein and a higher leucine oxidation rate, whereas leucine release from proteolysis was not affected. Glucose oxidation rate did not increase upon AA administration. In conclusion, the anabolic state resulting from AA administration in the immediate postnatal period resulted from increased protein synthesis and not decreased proteolysis. The energy needed for the additional protein synthesis was not derived from an increased glucose oxidation.