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Introduction: Aluminum (Al) is a toxic element which may contaminate pharmaceutical products used as individual components to prepare total parenteral nutrition mixtures (TPN)., Objectives: 1) to determine Al levels in the individual components used to prepare TPN mixtures; 2) to compare detected Al levels with those imposed by international regulations (FDA); 3) to calculate the total amount of Al administered to adult and children receiving those typical TPN mixtures., Methods: Al was determined by Inductively Coupled Plasma- Atomic Emission Spectrometry (ICP-OES) (Perkin Elmer OPTIMA 5100 DV) in 44 individual products, from different labs and lots, belonging to 16 components available in Argentina: dextrose and amino acids for adult formulas and for pediatric formulas: lípids; potassium chloride; sodium chloride, magnesium sulfate; sodium phosphate; calcium gluconate; sodium glycerophosphate, zinc sulfate; multitrace elements; steril water (ampoules and great volume presentations)., Results: Al levels were detected in 43 of the 44 the studied components, except sterile water. The components of large volume presented between 249 y 1,580 μg Al/ L, between 4 and 180 times FDA established levels (25 μg Al/ L). Small volume components presented Al levels between 85 y 4,909 g/ L, not declared in labels., Conclusions: The highest amounts of Al were detected in calcium gluconate, sodium phosphate and multitrace elements. 2) Usually prescribed TPN mixtures would have higher Al levels than those accepted by FDA regulation; 3) The highest aluminum concentration was provided by dextrose, amino acids and lipids in adult TPN mixtures. In neonate TPN mixtures, Al highest amounts were provided by dextrose and calcium gluconate. The calculated concentration of Al in TPN mixtures was higher than those stipulated by international regulation (5 μg Al/kg (body weight)/ d). It would be advisable for manufacturers to declare the content of aluminum in the label, with the aim of avoiding toxicities which would compromise the critical patients' evolution., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Objectives: 1) to determine zinc and copper levels of contamination in the individual component solutions used to prepare the pediatric total parenteral nutrition mixtures in Argentina; 2) to compare zinc and copper amounts prescribed by the physician with the true amount given to a neonate weighing 1.2 kg and to a child weighing 10 kg, who would receive total parenteral nutrition formulas prepared with those component solutions., Materials and Methods: Zn and Cu were determined by atomic absorption spectrophotometry in 59 individual solutions belonging to 14 components chosen between the commercial products available in Argentina., Results: zinc and copper, as contaminants, were found neither in the sterile water, nor in the potassium chloride or in the vitamin solutions. Zinc, but no copper, was detected in sodium chloride, manganese sulfate, chromium chloride and seleniose acid solutions. Zinc and copper were detected in dextrose, amino acids, calcium gluconate and lipid solutions at variable levels. Zinc sulfate solutions contained between 90.4% and 140% of the declared content and a variable contamination with copper. Copper sulfate solutions presented between 4% and 18% less the declared copper concentration and a variable contamination with zinc. Dextrose and lipid solutions presented the highest amount of zinc and copper. Therefore, the total parenteral mixtures prepared with the analyzed solutions must have had an excess of zinc and copper in relation to the prescription: ranging between 103% and 161% and between 7%-426% higher than the Zn and Cu amounts prescribed for neonates, respectively; the excess in the total parenteral nutrition for a child weighing 10 kg would ranged between 105% and 189% and between 7%-365% higher than the prescribed for Zn and Cu, respectively., Conclusions: 1) Nine components presented Zn and five Cu, both of them not declared in the label; 2) the usually prescribed total parenteral nutrition mixtures must have had a zinc and copper amount higher than the prescribed one according to international recommendations; 3) those figures would be safe in patients without complications, but it would be harmful in renal failure, hepatic compromise or colestasis mainly in pediatric patients; 4) It would be advisable to declare in the label the true content of zinc and copper, with the aim to avoid deficiencies and excess which would compromise the evolution of pediatric patients.

Orange juice may be a nutrient vehicle that helps to improve diet quality. The addition of whey allows the incorporation of high quality proteins. However, a good acceptability is necessary. The aims of the present study were: a) to assess the acceptability of a beverage prepared with orange juice (J) and whey powder (WP) at 7 g/100 g (J+WP7) or at 13 g/100 g (J+WP13); b) to measure available lysine content and ascorbic acid retention of the more accepted formulation, comparing the effect of HIPEF treatment (29 kV/cm, t(acum): 59 micros) with a conventional heat treatment at 75 degrees C, for 15 minutes (HT). The beverages were subjected to sensory evaluation (Friedman test). Available lysine was assessed by the Carpenter method, modified by Booth, and vitamin C by HPLC; minerals Na and K, by flame photometry; Ca, Mg and Zn by atomic absorption spectrometry. There were no significant differences between the acceptance of J and J+WP7. J+WP13 was significantly less accepted (p < 0.01), so it was discarded. Available lysine (mg/g protein) in untreated J+WP7 was 60.2 +/- 0.15; after treatments: 50.0 +/- 2.8 (HT) and 51.0 +/- 3.4 (HIPEF). The HIPEF treated J and (J+WP7) retained 100% and 98% of their vitamin C initial content and the HT treated, 91% and 88%, respectively. The amount of whey powder added to the orange juice conditioned the acceptability. The juice containing 7% of whey powder was well accepted, and after treatment by HIPEF, it retained a good nutritional quality, regarding available lysine, vitamin C retention and provision of mineral nutrients.

Objectives: To study in severe patients that required parenteral nutrition the relationship between Zn and Cu amounts present in formulas, the clinical course and changes in some biochemical parameters (plasmatic and erythrocytic Zn and Cu levels) during the parenteral nutrition therapy., Patients and Methodology: Five adult severe patients were studied, submitted to major abdominal surgery, and that required parenteral nutrition. Determinations were done for: 1) Zinc and copper in parenteral formulas; 2) in patients, at the beginning (T0) and at the end (Tf) of treatment, in erythrocytes: zinc (Zn-E) and cupper (Cu-E); in plasma, zinc (Zn-Pl) and in serum, cupper (Cu-S). Zinc and cupper were determined by means of atomic absorbance spectrometry., Results: mean +/- standard deviation values and ranges (between brackets) were: parenteral formulas (microg/g): zinc: 0.6 +/- 1.1 (2.2 - 7.0); Cupper: 2.4 +/- 0.7 (0.5-3.7). Biochemical parameters: at T0 (n = 5): Zn-E (microg/mL): 21.6 +/- 10.0 (13.6-36.1); Zn-Pl (microg/dL): 88 +/- 72 (29-205); Cu-E (microg/dL): 113 +/- 22 (60-102); Cu-E (microg/dL): 139 +/- 29 (106 +/- 156); Cu-S (microg/dL): 172 +/- 20 (158-195). Individual values compared to reference ones (normal individual from Buenos Aires with adequate nutrition) indicated that the three patients with favorable course normalized Zn-Pl and Zn-E levels. However, Cu-S increased in the three cases and Cu-E in two of them., Conclusions: These results make clear that in the studied patients Zinc levels in parenteral formulas would be adequate to prevent deficiency while Copper levels could be too high.