Shriners Hospitals for Children - Galveston

About: Shriners Hospitals for Children - Galveston is a healthcare organization based out in Galveston, Texas, United States. It is known for research contribution in the topics: Burn injury & Lean body mass. The organization has 249 authors who have published 420 publications receiving 15311 citations.

Effect of an amino acid, protein, and carbohydrate mixture on net muscle protein balance after resistance exercise

Abstract: This study tests the hypotheses that (a) a mixture of whey protein, amino acids (AA), and carbohydrates (CHO) stimulates net muscle protein synthesis to a greater extent than isoenergetic CHO alone after resistance exercise; and (b) that the stimulatory effect of a protein, AA, and CHO mixture will last beyond the 1st hour after intake. Eight subjects participated in 2 trials. In one (PAAC), they ingested 77.4 g CHO, 17.5 g whey protein, and 4.9 g AA 1 hr after resistance exercise. In the other (CON), 100 g CHO was ingested instead. They received a primed constant infusion of L-[2H5]-phenylalanine, and samples from femoral artery and vein, and biopsies from vastus lateralis were obtained. The area under the curve for net uptake of phenylalanine into muscle above pre-drink value was 128+/- 42 mg x leg(- 1) (PAAC) versus 32+/- 10 mg x leg (-1) (CON) for the 3 hr after the drink (p =.04). The net protein balance response to the mixture consisted of two components, one rapid immediate response, and a smaller delayed response about 90 min after drink, whereas in CON only a small delayed response was seen. We conclude that after resistance exercise, a mixture of whey protein, AA, and CHO stimulated muscle protein synthesis to a greater extent than isoenergetic CHO alone. Further, compared to previously reported findings, the addition of protein to an AA+ CHO mixture seems to extend the anabolic effect.

Attenuation of posttraumatic muscle catabolism and osteopenia by long-term growth hormone therapy.

Abstract: The hypermetabolic response to severe trauma is associated with increased systemic energy expenditure, peripheral insulin resistance, immunodeficiency, and marked whole body catabolism. These systemic derangements are most profound after severe burn. Classically, hypermetabolism associated with injury was thought to recede with closure of wounds and healing of bone and soft tissue injury. 1,2 In our long-term follow-up of severely burned children, however, we found that hypermetabolism did not abate after full healing of burn wounds; in fact, we found that children burned over 40% total body surface area (TBSA) undergo muscle protein catabolism for at least 9 months 3 and growth arrest for at least 2 years after injury. 4 The clinical result of this persistent pathology is wasting of musculature at a time when strength reserves would be of benefit to assist with recovery, rehabilitation, and reintegration into society. Growth hormone is known to be a potent anabolic agent and salutary modulator of posttraumatic metabolic responses. 5 After severe burn, it has been shown to decrease whole body catabolism, 6 improve muscle protein synthesis, 7 accelerate wound healing, 8,9 attenuate prolonged hyperactivity of the hepatic acute-phase response, 10,11 and promote linear growth. Its side effects when used in burned children are well characterized, and it has been shown to be a safe pharmacotherapeutic adjunct to standard excisional therapy after severe burn. 12,13 The purpose of this study was to determine whether the effects of growth hormone after severe burn persist throughout the prolonged hypermetabolic and hypercatabolic response to severe burn. Specifically, our hypothesis was that low-dose growth hormone increases accretion of muscle mass and attenuates bone mineral wasting when given daily during outpatient convalescence, from hospital discharge through 1 year after severe burn.

Potential Ergogenic Effects of Arginine and Creatine Supplementation

Abstract: The rationale for the use of nutritional supplements to enhance exercise capacity is based on the assumption that they will confer an ergogenic effect above and beyond that afforded by regular food ingestion alone. The proposed or advertised ergogenic effect of many supplements is based on a presumptive metabolic pathway and may not necessarily translate to quantifiable changes in a variable as broadly defined as exercise performance. L-arginine is a conditionally essential amino acid that has received considerable attention due to potential effects on growth hormone secretion and nitric oxide production. In some clinical circumstances (e.g., burn injury, sepsis) in which the demand for arginine cannot be fully met by de novo synthesis and normal dietary intake, exogenous arginine has been shown to facilitate the maintenance of lean body mass and functional capacity. However, the evidence that supplemental arginine may also confer an ergogenic effect in normal healthy individuals is less compelling. In contrast to arginine, numerous studies have reported that supplementation with the arginine metabolite creatine facilitates an increase in anaerobic work capacity and muscle mass when accompanied by resistance training programs in both normal and patient populations. Whereas improvement in the rate of phosphocreatine resynthesis is largely responsible for improvements in acute work capacity, the direct effect of creatine supplementation on skeletal muscle protein synthesis is less clear. The purpose of this review is to summarize the role of arginine and its metabolite creatine in the context of a nutrition supplement for use in conjunction with an exercise stimulus in both healthy and patient populations.

Nutrition in Burns Galveston Contributions

Abstract: Aggressive nutrition support is recommended following severe burn injury. Initially, such injury results in a prolonged and persistent hypermetabolic response mediated by a 10- to 20-fold elevation in plasma catecholamines, cortisol, and inflammatory mediators. This response leads to twice-normal metabolic rates, whole-body catabolism, muscle wasting, and severe cachexia. Thus, it is relevant to review the literature on nutrition in burns to adjust/update treatment. Failure to meet the increased substrate requirements may result in impaired wound healing, multiorgan dysfunction, increased susceptibility to infection, and death. Therefore, aggressive nutrition support is essential to ensure adequate burn care, attenuate the hypermetabolic response, optimize wound healing, minimize devastating catabolism, and reduce morbidity and mortality. Here, the authors provide nutrition recommendations gained from prospective trials, retrospective analyses, and expert opinions based on the authors' practices in Galveston, Texas, and Vienna, Austria.