human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In order to determine the intravenous energy and nitrogen intakes required to achieve intrauterine rates of nitrogen accretion and growth , 30 studies were completed in 22 premature infants who were provided with various intakes of amino acids and energy ( glucose + /- lipid ) by peripheral vein infusion .  At constant nitrogen intake , increasing energy intake ( as lipid ) from 50 to 80 nonprotein kcal/kg/day result ed in significant increases in nitrogen retention and weight gain . Increasing nitrogen intake from 494 to 655 mg/kg/day at constant low energy intake ( mean = 53 kcal/kg/day ) had no effect on nitrogen retention or weight change ; however , at higher energy intakes ( mean = 81 kcal/kg/day ) increasing nitrogen intake correlated significantly with increasing nitrogen retention . At energy intakes greater than 70 kcal/kg/day the major determinant of nitrogen retention was nitrogen intake . When energy intake was greater than 70 kcal/kg/day , the infusion of nitrogen providing 430 to 560 mg/kg/day ( 2.7 to 3.5 gm protein/kg/day ) result ed in the duplication of intrauterine nitrogen accretion rates OBJECTIVE : Morbidity and mortality of premature infants have decreased considerably over the last decades , therefore , adequate nutrition of the premature is a major concern . Enteral feeding is the route of choice , but when it is not possible the parenteral route , which contains glucose as one of its main components , is used . Glucose infusions are not devoid of risk as they facilitate the development of hyperglycemia leading to intracranial hemorrhage , glucosuria and dehydration . The aim of this paper is to relate hyperglycemia and glucosuria to birth weight , gestational age and glucose infusion rate . METHODS : The study was developed at the Nursery of Santa Catarina Hospital ( São Paulo ) . The authors developed a prospect i ve study ; 511 concurrent determinations of glycemia and qualitative glucosuria were performed in 40 preterm newborn infants receiving parenteral glucose ( mean of 12.8 dosages per newborn ) . RESULTS : Fifty-nine ( 11.5 % ) episodes of hyperglycemia were detected , and their frequency was higher at lower gestational ages ( < /=34 weeks ) , lower birth weights ( < 1500 g ) and higher glucose infusion rates ( > /= 6 mg/kg/min ) . Thirty-one ( 6.1 % ) episodes of glucosuria were detected , and were more frequent in lower gestational ages ( < /= 34 weeks ) , lower birth weights ( < 1500 g ) and higher glucose infusion rates ( > /= 6 mg/kg/min ) . CONCLUSIONS : The frequency of hyperglycemia and glucosuria in preterm newborn infants receiving glucose infusion was higher in lower gestational ages , lower birth weights and higher glucose infusion rates . In preterm newborn infants it is necessary to observe the glucose infusion rate and its respective glycemia , in order to avoid the complications of hyperglycemia ABSTRACT : Small substrate stores and immature enzyme systems make preterm infants prone to develop hypoglycemia . Hy-perglycemia may also occur , particularly when these infants are given i.v . glucose . To evaluate the capacity for regulation of glucose production in response to glucose infusion , 10 newborn infants , born after 25–30 wk of gestation , were studied . Their glucose production rates ( GPR ) were calculated and the concentrations of glucose , insulin , and glucagon in plasma were measured during infusion of glucose at a rate of first 1.7 ± 0.2 and then 6.5 ± 0.3 mg·kg−1·min−1 ( 9.4 ± 1.1 and 36.1 ± 1.7 μmol·kg−1·min−1 ) ( mean ± SD ) . GPR was determined by use of D-6,6–2H2 glucose . When the rate of infusion of glucose was increased , GPR decreased from 4.3 ± 1.3 to 1.4 ± 1.1 mg-kg−1·min−1 ( 23.9 ± 7.2 to 7.8 ± 6.1 μmol·kg−l·min−1 ) ( mean ± SD ) ( p = 0.00006 ) . In addition , the plasma insulin concentration increased from 6±2 to 11±4 μU·mL ' ( p = 0.006 ) and the plasma glucose concentration from 3.6 ± 1.1 to 6.1 ± 1.3 mM ( mean ± SD ) ( p = 0.0002 ) , whereas the glucagon concentration remained unchanged . only the insulin concentration in plasma was significantly related to GPR . The results show that very immature newborn infants have an incomplete and varying capacity to respond to glucose infusion with suppression of glucose production . Insulin seems to be more important than plasma glucose in the regulation of glucose homeostasis in these infants OBJECTIVE Many extremely preterm infants develop hyperglycemia in the first week of life during continuous glucose infusion . The objective of this study was to determine whether defective insulin secretion or resistance to insulin was the primary factor involved in transient hyperglycemia of extremely preterm infants . METHODS A prospect i ve comparative study was conducted in appropriate-for-gestational-age preterm infants < 30 weeks of gestational age with the aim specifically to evaluate the serum levels of proinsulin , insulin , and C-peptide secreted during transient hyperglycemia by specific immunoassays . Three groups of infants were investigated hyperglycemic ( n = 15 ) and normoglycemic preterm neonates ( n = 12 ) and normal , term neonates ( n = 21 ) . In addition , the changes in beta-cell peptide levels were analyzed during and after intravenous insulin infusion in the hyperglycemic group . Data were analyzed using analysis of variance and analysis of variance for repeated measures . RESULTS At inclusion , insulin and C-peptide levels did not differ in hyperglycemic subjects and in preterm controls . Proinsulin concentration was significantly higher in the hyperglycemic group ( 36.5 + /- 3.9 vs 23.2 + /- 0.9 pmol/L ) . Compared with term neonates , proinsulin and C-peptide levels were higher in normoglycemic preterm infants ( 23.2 + /- 0.9 vs 18.9 + /- 2.71 pmol/L and 1.67 + /- 0.3 vs 0.62 + /- 0.12 nmol/L , respectively ) . During and after insulin infusion in hyperglycemic neonates , plasma glucose concentration fell and proinsulin and C-peptide levels were lowered ( 18.4 + /- 7.6 and 20.7 + /- 4.5 pmol/L , respectively ) . CONCLUSION These data suggest that 1 ) preterm neonates are sensitive to changes in plasma glucose concentration , but proinsulin processing to insulin is partially defective in hyperglycemic preterm neonates ; 2 ) hyperglycemic neonates are relatively resistant to insulin because higher insulin levels are needed to achieve euglycemia in this group compared with normoglycemic neonates . These results also show that insulin infusion is beneficial in extremely preterm infants with transient hyperglycemia Abstract Serum-insulin was investigated in eighteen premature infants during their first 24 hours of life .  Glucose infusions that produced blood-sugar levels over 250 mg . per 100 ml . result ed in only a slight elevation of the serum-insulin . Infusion of a mixture of essential aminoacids was associated with a striking increase in serum-insulin , with a mean peak of 153 μU per ml Greater protein intakes are required than have been commonly used to achieve fetal in utero protein accretion rates in preterm neonates . To study the efficacy and safety of more aggressive amino acid intake , we performed a prospect i ve r and omized study in 28 infants [ mean wt , 946 ± 40 g ( SEM ) ] of 1 ( low amino acid intake , LAA ) versus 3 g·kg−1·d−1 ( high amino acid intake , HAA ) at 52.0 ± 3.0 h of life . After a minimum of 12 h of parenteral nutrition , efficacy was determined by protein balance and was significantly lower in the LAA versus HAA groups by both nitrogen balance ( −0.26 ± 0.11 versus 1.16 ± 0.15 g·kg−1·d−1 , p < 0.00005 ) and leucine stable isotope ( 0.184 ± 0.17 versus 1.63 ± 0.20 g·kg−1·d−1 , p < 0.0005 ) methods . Leucine flux and oxidation and nonoxidative leucine disposal rates were all significantly higher in the HAA versus LAA groups ( 249 ± 13 versus 164 ± 8 , 69 ± 5 versus 32 ± 3 , and 180 ± 10 versus 132 ± 8 μmol·kg−1·h−1 , respectively , p < 0.005 ) , but leucine appearance from protein breakdown was not ( 140 ± 15 in HAA versus 128 ± 8 μmol·kg−1·h−1 ) . In terms of possible toxicity with HAA , there were no significant differences between groups in the amount of sodium bicarbonate administered , degree of acidosis as determined by base deficit , or blood urea nitrogen concentration . Parenteral HAA versus LAA intake result ed in increased protein accretion , primarily by increasing protein synthesis versus suppressing protein breakdown , and appeared to be well tolerated by very preterm infants in the first days of life 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In order to determine the intravenous energy and nitrogen intakes required to achieve intrauterine rates of nitrogen accretion and growth , 30 studies were completed in 22 premature infants who were provided with various intakes of amino acids and energy ( glucose + /- lipid ) by peripheral vein infusion .  At constant nitrogen intake , increasing energy intake ( as lipid ) from 50 to 80 nonprotein kcal/kg/day result ed in significant increases in nitrogen retention and weight gain . Increasing nitrogen intake from 494 to 655 mg/kg/day at constant low energy intake ( mean = 53 kcal/kg/day ) had no effect on nitrogen retention or weight change ; however , at higher energy intakes ( mean = 81 kcal/kg/day ) increasing nitrogen intake correlated significantly with increasing nitrogen retention . At energy intakes greater than 70 kcal/kg/day the major determinant of nitrogen retention was nitrogen intake . When energy intake was greater than 70 kcal/kg/day , the infusion of nitrogen providing 430 to 560 mg/kg/day ( 2.7 to 3.5 gm protein/kg/day ) result ed in the duplication of intrauterine nitrogen accretion rates OBJECTIVE : Morbidity and mortality of premature infants have decreased considerably over the last decades , therefore , adequate nutrition of the premature is a major concern . Enteral feeding is the route of choice , but when it is not possible the parenteral route , which contains glucose as one of its main components , is used . Glucose infusions are not devoid of risk as they facilitate the development of hyperglycemia leading to intracranial hemorrhage , glucosuria and dehydration . The aim of this paper is to relate hyperglycemia and glucosuria to birth weight , gestational age and glucose infusion rate . METHODS : The study was developed at the Nursery of Santa Catarina Hospital ( São Paulo ) . The authors developed a prospect i ve study ; 511 concurrent determinations of glycemia and qualitative glucosuria were performed in 40 preterm newborn infants receiving parenteral glucose ( mean of 12.8 dosages per newborn ) . RESULTS : Fifty-nine ( 11.5 % ) episodes of hyperglycemia were detected , and their frequency was higher at lower gestational ages ( < /=34 weeks ) , lower birth weights ( < 1500 g ) and higher glucose infusion rates ( > /= 6 mg/kg/min ) . Thirty-one ( 6.1 % ) episodes of glucosuria were detected , and were more frequent in lower gestational ages ( < /= 34 weeks ) , lower birth weights ( < 1500 g ) and higher glucose infusion rates ( > /= 6 mg/kg/min ) . CONCLUSIONS : The frequency of hyperglycemia and glucosuria in preterm newborn infants receiving glucose infusion was higher in lower gestational ages , lower birth weights and higher glucose infusion rates . In preterm newborn infants it is necessary to observe the glucose infusion rate and its respective glycemia , in order to avoid the complications of hyperglycemia ABSTRACT : Small substrate stores and immature enzyme systems make preterm infants prone to develop hypoglycemia . Hy-perglycemia may also occur , particularly when these infants are given i.v . glucose . To evaluate the capacity for regulation of glucose production in response to glucose infusion , 10 newborn infants , born after 25–30 wk of gestation , were studied . Their glucose production rates ( GPR ) were calculated and the concentrations of glucose , insulin , and glucagon in plasma were measured during infusion of glucose at a rate of first 1.7 ± 0.2 and then 6.5 ± 0.3 mg·kg−1·min−1 ( 9.4 ± 1.1 and 36.1 ± 1.7 μmol·kg−1·min−1 ) ( mean ± SD ) . GPR was determined by use of D-6,6–2H2 glucose . When the rate of infusion of glucose was increased , GPR decreased from 4.3 ± 1.3 to 1.4 ± 1.1 mg-kg−1·min−1 ( 23.9 ± 7.2 to 7.8 ± 6.1 μmol·kg−l·min−1 ) ( mean ± SD ) ( p = 0.00006 ) . In addition , the plasma insulin concentration increased from 6±2 to 11±4 μU·mL ' ( p = 0.006 ) and the plasma glucose concentration from 3.6 ± 1.1 to 6.1 ± 1.3 mM ( mean ± SD ) ( p = 0.0002 ) , whereas the glucagon concentration remained unchanged . only the insulin concentration in plasma was significantly related to GPR . The results show that very immature newborn infants have an incomplete and varying capacity to respond to glucose infusion with suppression of glucose production . Insulin seems to be more important than plasma glucose in the regulation of glucose homeostasis in these infants OBJECTIVE Many extremely preterm infants develop hyperglycemia in the first week of life during continuous glucose infusion . The objective of this study was to determine whether defective insulin secretion or resistance to insulin was the primary factor involved in transient hyperglycemia of extremely preterm infants . METHODS A prospect i ve comparative study was conducted in appropriate-for-gestational-age preterm infants < 30 weeks of gestational age with the aim specifically to evaluate the serum levels of proinsulin , insulin , and C-peptide secreted during transient hyperglycemia by specific immunoassays . Three groups of infants were investigated hyperglycemic ( n = 15 ) and normoglycemic preterm neonates ( n = 12 ) and normal , term neonates ( n = 21 ) . In addition , the changes in beta-cell peptide levels were analyzed during and after intravenous insulin infusion in the hyperglycemic group . Data were analyzed using analysis of variance and analysis of variance for repeated measures . RESULTS At inclusion , insulin and C-peptide levels did not differ in hyperglycemic subjects and in preterm controls . Proinsulin concentration was significantly higher in the hyperglycemic group ( 36.5 + /- 3.9 vs 23.2 + /- 0.9 pmol/L ) . Compared with term neonates , proinsulin and C-peptide levels were higher in normoglycemic preterm infants ( 23.2 + /- 0.9 vs 18.9 + /- 2.71 pmol/L and 1.67 + /- 0.3 vs 0.62 + /- 0.12 nmol/L , respectively ) . During and after insulin infusion in hyperglycemic neonates , plasma glucose concentration fell and proinsulin and C-peptide levels were lowered ( 18.4 + /- 7.6 and 20.7 + /- 4.5 pmol/L , respectively ) . CONCLUSION These data suggest that 1 ) preterm neonates are sensitive to changes in plasma glucose concentration , but proinsulin processing to insulin is partially defective in hyperglycemic preterm neonates ; 2 ) hyperglycemic neonates are relatively resistant to insulin because higher insulin levels are needed to achieve euglycemia in this group compared with normoglycemic neonates . These results also show that insulin infusion is beneficial in extremely preterm infants with transient hyperglycemia Abstract Serum-insulin was investigated in eighteen premature infants during their first 24 hours of life .  Glucose infusions that produced blood-sugar levels over 250 mg . per 100 ml . result ed in only a slight elevation of the serum-insulin . Infusion of a mixture of essential aminoacids was associated with a striking increase in serum-insulin , with a mean peak of 153 μU per ml Greater protein intakes are required than have been commonly used to achieve fetal in utero protein accretion rates in preterm neonates . To study the efficacy and safety of more aggressive amino acid intake , we performed a prospect i ve r and omized study in 28 infants [ mean wt , 946 ± 40 g ( SEM ) ] of 1 ( low amino acid intake , LAA ) versus 3 g·kg−1·d−1 ( high amino acid intake , HAA ) at 52.0 ± 3.0 h of life . After a minimum of 12 h of parenteral nutrition , efficacy was determined by protein balance and was significantly lower in the LAA versus HAA groups by both nitrogen balance ( −0.26 ± 0.11 versus 1.16 ± 0.15 g·kg−1·d−1 , p < 0.00005 ) and leucine stable isotope ( 0.184 ± 0.17 versus 1.63 ± 0.20 g·kg−1·d−1 , p < 0.0005 ) methods . Leucine flux and oxidation and nonoxidative leucine disposal rates were all significantly higher in the HAA versus LAA groups ( 249 ± 13 versus 164 ± 8 , 69 ± 5 versus 32 ± 3 , and 180 ± 10 versus 132 ± 8 μmol·kg−1·h−1 , respectively , p < 0.005 ) , but leucine appearance from protein breakdown was not ( 140 ± 15 in HAA versus 128 ± 8 μmol·kg−1·h−1 ) . In terms of possible toxicity with HAA , there were no significant differences between groups in the amount of sodium bicarbonate administered , degree of acidosis as determined by base deficit , or blood urea nitrogen concentration . Parenteral HAA versus LAA intake result ed in increased protein accretion , primarily by increasing protein synthesis versus suppressing protein breakdown , and appeared to be well tolerated by very preterm infants in the first days of life 
    Output:
    