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  1. Article ; Online: Crisis hipercalcémica como causa de pancreatitis aguda.

    Scarlatto, Bruno / Manzanares, William

    Revista medica de Chile

    2023  Volume 150, Issue 7, Page(s) 970–974

    Abstract: Severe hypercalcemia may cause acute pancreatitis. We report a 75-yearold male presenting with abdominal pain and confusion. The initial laboratory showed elevated amylase levels and a serum calcium of 19.0 mg/dl with highly elevated parathormone levels. ...

    Title translation Hypercalcemia as a cause of acute pancreatitis. Report of one case.
    Abstract Severe hypercalcemia may cause acute pancreatitis. We report a 75-yearold male presenting with abdominal pain and confusion. The initial laboratory showed elevated amylase levels and a serum calcium of 19.0 mg/dl with highly elevated parathormone levels. An abdominal CT scan disclosed pancreatitis. A neck CT scan showed a parathyroid tumor, which was successfully excised. The pathology of the surgical piece showed a parathyroid adenoma.
    MeSH term(s) Humans ; Male ; Aged ; Hypercalcemia/complications ; Acute Disease ; Pancreatitis/complications ; Pancreatitis/diagnostic imaging ; Parathyroid Neoplasms ; Abdominal Pain
    Language Spanish
    Publishing date 2023-10-25
    Publishing country Chile
    Document type Case Reports ; English Abstract ; Journal Article
    ZDB-ID 732136-3
    ISSN 0717-6163 ; 0034-9887
    ISSN (online) 0717-6163
    ISSN 0034-9887
    DOI 10.4067/s0034-98872022000700970
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    Zs.B 402: Show issues Location:
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  2. Article ; Online: Diagnóstico y tratamiento del traumatismo de páncreas.

    García Reyes, Valentina / Scarlatto, Bruno / Manzanares, William

    Medicina clinica

    2023  Volume 160, Issue 10, Page(s) 450–455

    Abstract: Pancreatic trauma is a rare but potentially lethal entity which requires a high level of clinical suspicion. Early diagnosis and assessment of the integrity of the pancreatic duct are essential since ductal injury is a crucial predictor of morbimortality. ...

    Title translation Diagnosis and treatment of pancreatic trauma.
    Abstract Pancreatic trauma is a rare but potentially lethal entity which requires a high level of clinical suspicion. Early diagnosis and assessment of the integrity of the pancreatic duct are essential since ductal injury is a crucial predictor of morbimortality. Overall mortality is 19%, which can rise to 30% in cases of ductal injury. The diagnostic and therapeutic approach is multidisciplinary and guided by a surgeon, imaging specialist and ICU physician. Laboratory analysis shows that pancreatic enzymes are frequently elevated, which is a low specificity finding. In hemodynamically stable patients, the posttraumatic condition of the pancreas is firstly evaluated by the multidetector computed tomography. Moreover, in case of suspicion of ductal injury, more sensitive studies such as Endoscopic Retrograde Cholangiopancreatography or cholangioresonance are needed. This narrative review aims to analyze the etiopathogenesis and pathophysiology of pancreatic trauma and discuss its diagnosis and treatment. Also, the most clinically relevant complications will be summarized.
    MeSH term(s) Humans ; Pancreas/diagnostic imaging ; Pancreas/injuries ; Pancreas/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Pancreatic Ducts/injuries ; Pancreatic Diseases/complications ; Abdominal Injuries/complications ; Abdominal Injuries/pathology ; Abdominal Injuries/surgery
    Language Spanish
    Publishing date 2023-03-31
    Publishing country Spain
    Document type Journal Article ; Review
    ZDB-ID 411607-0
    ISSN 1578-8989 ; 0025-7753
    ISSN (online) 1578-8989
    ISSN 0025-7753
    DOI 10.1016/j.medcli.2023.03.002
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  3. Article ; Online: Thiamine pharmaconutrition in sepsis: Monotherapy, combined therapy, or neither? Current evidence on safety and efficacy.

    Novoa, Juan / Hardy, Gil / Manzanares, William

    Nutrition (Burbank, Los Angeles County, Calif.)

    2023  Volume 109, Page(s) 112000

    Abstract: Sepsis is a life-threatening condition characterized by multiorgan dysfunction due to an exaggerated host response to infection associated with a homeostatic failure. In sepsis, different interventions, aimed at improving clinical outcomes, have been ... ...

    Abstract Sepsis is a life-threatening condition characterized by multiorgan dysfunction due to an exaggerated host response to infection associated with a homeostatic failure. In sepsis, different interventions, aimed at improving clinical outcomes, have been tested over the past decades. Among these most recent strategies, intravenous high-dose micronutrients (vitamins and/or trace elements) have been investigated. According to current knowledge, sepsis is characterized by low thiamine levels, which are associated with illness severity, hyperlactatemia, and poor clinical outcomes. However, caution is needed about the clinical interpretation of thiamine blood concentration in critically ill patients, and the inflammatory status, based on C-reactive protein levels, should always be measured. In sepsis, parenteral thiamine has been administered as monotherapy or in combination with vitamin C and corticosteroids. Nevertheless, most of those trials failed to report clinical benefits with high-dose thiamine. The purpose of this review is to summarize the biological properties of thiamine and to examine current knowledge regarding the safety and efficacy of high-dose thiamine as pharmaconutrition strategy when administering singly or in combination with other micronutrients in critically ill adult patients with sepsis or septic shock. Our examination of the most up-to-date evidence concludes that Recommended Daily Allowance supplementation is relatively safe for thiamine-deficient patients. However, current evidence does not support pharmaconutrition with high-dose thiamine as a single therapy or as combination therapy aimed at improving clinical outcomes in critically ill septic patients. The best nutrient combination still needs to be determined, based on the antioxidant micronutrient network and the multiple interactions among different vitamins and trace elements. In addition, a better understanding of the pharmacokinetic and pharmacodynamic profiles of intravenous thiamine is needed. Future well-designed and powered clinical trials are urgently warranted before any specific recommendations can be made regarding supplementation in the critical care setting.
    MeSH term(s) Adult ; Humans ; Thiamine/therapeutic use ; Trace Elements/therapeutic use ; Critical Illness/therapy ; Sepsis/complications ; Sepsis/drug therapy ; Sepsis/diagnosis ; Vitamins/therapeutic use ; Ascorbic Acid/therapeutic use ; Shock, Septic ; Micronutrients/therapeutic use
    Chemical Substances Thiamine (X66NSO3N35) ; Trace Elements ; Vitamins ; Ascorbic Acid (PQ6CK8PD0R) ; Micronutrients
    Language English
    Publishing date 2023-02-23
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 639259-3
    ISSN 1873-1244 ; 0899-9007
    ISSN (online) 1873-1244
    ISSN 0899-9007
    DOI 10.1016/j.nut.2023.112000
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Micronutrients early in critical illness, selective or generous, enteral or intravenous?

    Berger, Mette M / Manzanares, William

    Current opinion in clinical nutrition and metabolic care

    2020  Volume 24, Issue 2, Page(s) 165–175

    Abstract: Purpose of review: Micronutrients have essential antioxidant and immune functions, while low blood concentrations are frequently observed in critically ill patients. This has led to the concepts of complementation, repletion, or even pharmacological ... ...

    Abstract Purpose of review: Micronutrients have essential antioxidant and immune functions, while low blood concentrations are frequently observed in critically ill patients. This has led to the concepts of complementation, repletion, or even pharmacological supplementation. Over the last three decades, many clinical studies have tested the latter strategy, with controversial or negative results. Therefore, this review aims at evaluating micronutrient-related interventions that are mandatory or need to be assessed in future trials or clinical registries in all or specific critically ill patients.
    Recent findings: In the critically ill, low plasma/serum micronutrient levels not always reflect a true deficiency in the absence of demonstrable losses. Current practices of micronutrient provision and monitoring in critical care, vary substantially across the world. Also, recent clinical trials testing high dose as monotherapy (selenium, thiamine, vitamin C, vitamin D) or in combination have failed to demonstrate clinical benefits in sepsis. However, these studies have not applied a physiological integrative approach of micronutrient action.
    Summary: Micronutrients are essential in nutrition but their administration and monitoring are difficult. So far, different well designed RCTs on intravenous and oral high dose micronutrient supplementation have been conducted. Nevertheless, very high-dose single micronutrients cannot be advocated at this stage in sepsis, or any other critical condition. By contrast, studies using combination of moderate doses of micronutrients in specific diseases, such as burns and trauma have been associated with improved outcomes. Intravenous administration seems to be the most efficient route. Future clinical trials need to integrate the physiology underlying the interconnected micronutrient activity, and choose more specific primary and secondary endpoints.
    MeSH term(s) Administration, Intravenous ; Critical Illness ; Dietary Supplements ; Humans ; Micronutrients ; Vitamin D ; Vitamins
    Chemical Substances Micronutrients ; Vitamins ; Vitamin D (1406-16-2)
    Language English
    Publishing date 2020-12-17
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1460178-3
    ISSN 1473-6519 ; 1363-1950
    ISSN (online) 1473-6519
    ISSN 1363-1950
    DOI 10.1097/MCO.0000000000000724
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  5. Article: Commentary.

    Manzanares, William

    Journal of neurosciences in rural practice

    2013  Volume 4, Issue 1, Page(s) 43–44

    Language English
    Publishing date 2013-04-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2601242-X
    ISSN 0976-3155 ; 0976-3147
    ISSN (online) 0976-3155
    ISSN 0976-3147
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  6. Article ; Online: Authors' response to comment on "Omega-3 polyunsaturated fatty acids in critically ill patients with acute respiratory distress syndrome: a systematic review and meta-analysis".

    Manzanares, William / Hardy, Gil / Langlois, Pascal L

    Nutrition (Burbank, Los Angeles County, Calif.)

    2021  Volume 90, Page(s) 111432

    MeSH term(s) Critical Illness ; Fatty Acids, Omega-3 ; Humans ; Respiratory Distress Syndrome
    Chemical Substances Fatty Acids, Omega-3
    Language English
    Publishing date 2021-07-25
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 639259-3
    ISSN 1873-1244 ; 0899-9007
    ISSN (online) 1873-1244
    ISSN 0899-9007
    DOI 10.1016/j.nut.2021.111432
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  7. Article: Pharmaconutrition revisited for critically ill patients with coronavirus disease 2019 (COVID-19): Does selenium have a place?

    Manzanares, William / Moreira, Eduardo / Hardy, Gil

    Nutrition. 2021 Jan., v. 81

    2021  

    Abstract: Coronavirus disease 2019 (COVID-19) is a global pandemic causing one of the biggest challenges for critical care medicine. Mortality from COVID-19 is much greater in elderly men, many of whom succumb to acute respiratory distress syndrome (ARDS) ... ...

    Abstract Coronavirus disease 2019 (COVID-19) is a global pandemic causing one of the biggest challenges for critical care medicine. Mortality from COVID-19 is much greater in elderly men, many of whom succumb to acute respiratory distress syndrome (ARDS) triggered by the viral infection. Because there is no specific antiviral treatment against COVID-19, new strategies are urgently needed. Selenium is an essential trace element with antioxidant and immunomodulatory effects. Poor nutritional status increases the pathogenicity of viruses and low selenium in particular can be a determinant of viral virulence. In the past decade, selenium pharmaconutrition studies have demonstrated some reduction in overall mortality, including how reduced incidence of ventilator-associated pneumonia and infectious complications such as ARDS in the critically ill. Consequently, we postulate that intravenous selenium therapy, could be part of the therapeutic fight against COVID-19 in intensive care unit patients with ARDS and that outcomes could be affected by age, sex, and body weight. Our working hypothesis addresses the question: Could high-dose selenite pharmaconutrition, as an early pharmacologic intervention, be effective at reducing the incidence and the progression from type 1 respiratory failure (non-ARDS) to severe ARDS, multiorgan failure, and new infectious complications in patients with COVID-19 patients?
    Keywords COVID-19 infection ; acute respiratory distress syndrome ; antioxidants ; body weight ; elderly ; intravenous injection ; medicine ; mortality ; nutritional status ; pandemic ; pneumonia ; selenites ; selenium ; virulence
    Language English
    Dates of publication 2021-01
    Publishing place Elsevier Inc.
    Document type Article
    Note NAL-AP-2-clean
    ZDB-ID 639259-3
    ISSN 1873-1244 ; 0899-9007
    ISSN (online) 1873-1244
    ISSN 0899-9007
    DOI 10.1016/j.nut.2020.110989
    Database NAL-Catalogue (AGRICOLA)

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    Z 4802: Show issues

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  8. Article ; Online: Nutrition in the ICU: Foreword from the Editors.

    Manzanares, William / Singer, Pierre

    Nutrition (Burbank, Los Angeles County, Calif.)

    2018  Volume 62, Page(s) 61–62

    MeSH term(s) Critical Care/methods ; Critical Illness ; Humans ; Intensive Care Units ; Nutritional Status ; Nutritional Support/methods
    Language English
    Publishing date 2018-12-26
    Publishing country United States
    Document type Editorial
    ZDB-ID 639259-3
    ISSN 1873-1244 ; 0899-9007
    ISSN (online) 1873-1244
    ISSN 0899-9007
    DOI 10.1016/j.nut.2018.12.010
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  9. Article ; Online: Pharmaconutrition revisited for critically ill patients with coronavirus disease 2019 (COVID-19): Does selenium have a place?

    Manzanares, William / Moreira, Eduardo / Hardy, Gil

    Nutrition (Burbank, Los Angeles County, Calif.)

    2020  Volume 81, Page(s) 110989

    Abstract: Coronavirus disease 2019 (COVID-19) is a global pandemic causing one of the biggest challenges for critical care medicine. Mortality from COVID-19 is much greater in elderly men, many of whom succumb to acute respiratory distress syndrome (ARDS) ... ...

    Abstract Coronavirus disease 2019 (COVID-19) is a global pandemic causing one of the biggest challenges for critical care medicine. Mortality from COVID-19 is much greater in elderly men, many of whom succumb to acute respiratory distress syndrome (ARDS) triggered by the viral infection. Because there is no specific antiviral treatment against COVID-19, new strategies are urgently needed. Selenium is an essential trace element with antioxidant and immunomodulatory effects. Poor nutritional status increases the pathogenicity of viruses and low selenium in particular can be a determinant of viral virulence. In the past decade, selenium pharmaconutrition studies have demonstrated some reduction in overall mortality, including how reduced incidence of ventilator-associated pneumonia and infectious complications such as ARDS in the critically ill. Consequently, we postulate that intravenous selenium therapy, could be part of the therapeutic fight against COVID-19 in intensive care unit patients with ARDS and that outcomes could be affected by age, sex, and body weight. Our working hypothesis addresses the question: Could high-dose selenite pharmaconutrition, as an early pharmacologic intervention, be effective at reducing the incidence and the progression from type 1 respiratory failure (non-ARDS) to severe ARDS, multiorgan failure, and new infectious complications in patients with COVID-19 patients?
    MeSH term(s) COVID-19/complications ; COVID-19/diet therapy ; COVID-19/epidemiology ; Critical Illness ; Female ; Host Microbial Interactions ; Humans ; Inflammation/etiology ; Male ; Micronutrients/administration & dosage ; Micronutrients/pharmacokinetics ; Micronutrients/therapeutic use ; Models, Biological ; Nutritional Physiological Phenomena ; Obesity/complications ; Pandemics ; Practice Guidelines as Topic ; SARS-CoV-2/pathogenicity ; Selenium/administration & dosage ; Selenium/pharmacokinetics ; Selenium/therapeutic use
    Chemical Substances Micronutrients ; Selenium (H6241UJ22B)
    Keywords covid19
    Language English
    Publishing date 2020-08-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639259-3
    ISSN 1873-1244 ; 0899-9007
    ISSN (online) 1873-1244
    ISSN 0899-9007
    DOI 10.1016/j.nut.2020.110989
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Commentary

    William Manzanares

    Journal of Neurosciences in Rural Practice, Vol 4, Iss 1, Pp 43-

    2013  Volume 44

    Keywords Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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