Preoperative immune nutrition for 5 days (Impact, Nestle) Preoperative fasting of 2h with a drink containing 12% maltodextrine No intravenous fluids postoperatively

No immune nutrition Preoperative fasting of 6-8 h Crystalloid intravenous fluids until PO day 1

Arthroplasty, Hip Replacement

Perioperative Care

Nutritional Support

600 ml of Impact, Nestle for 5 days prior to surgery

Impact

Gastroclinica

Immunonutrition in Total Hip Arthroplasty

A Protocol Of Perioperative Care Plus Immunonutrition Enhances Recovery After Total Hip Arthroplasty. A Randomized Pilot Study

days of postoperative stay until discharge up to 30 days

Blood samples collected at anesthesia induction and again at PO day 2 to C-reactive protein assay

Jose Eduardo de Aguilar-Nascimento

Chair Professor, MD, PhD

Federal University of Mato Grosso

Polyunsaturated fatty acid will consist of purified EPA:DHA (360 mg EPA and 240 mg DHA) 6 gelcaps-3 capsules by mouth 2x per day x 48 weeks

Gelcaps containing corn oil as placebo 6 capsules 3 capsules by mouth 2 x per day for 48 weeks

Purified EPA:DHA (360 mg EPA and 240 mg DHA) 6 gelcaps 3 capsules by mouth 2x per day x 48 weeks

PUFA

Placebo

Total

Sex: Female, Male

The non-alcoholic fatty liver disease (NAFLD) activity score (NAS) is a score based on the liver biopsy. It represents the sum of scores for steatosis, lobular inflammation, and ballooning, and ranges from 0-8, with high scores indicating more activity.

Number of Participants With Improvement of >= 2 Points in NAFLD Activity Score (NAS)

Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) measures insulin resistance, calculated by fasting insulin (μU/mL) multiplied by fasting glucose (mg/dL), and divided by a constant (405). A higher score indicates higher insulin resistance.

Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) Values

Aspartate amino transferase (IU/dL) at 48 weeks

Aspartate Amino Transferase (AST) Levels

Alanine amino transferase (IU/dL) ay 48 weeks

Alanine Amino Transferase (ALT) Levels

Blood Glucose Levels

HbA1C Levels

Overall Study

Srinivasan Dasarathy MD

Fatty Liver

Active experimental arm to patients with diabetes mellitus and non alcoholic steatohepatitis: Eicosapentaenoic acid (EPA):Docosahexaenoic acid (DHA)[360 mg EPA and 240 DHA in each capsule] 6 capsules-3 capsules by mouth 2 x per day x 48 weeks

Polyunsaturated fatty acid (Opti-EPA)

Placebo gelcaps containing corn oil identical to the PUFA gelcaps 6 capsules-3 capsules by mouth 2x per day x 48 weeks

Nonalcoholic Steatohepatitis Clinical Research Network

fibrosis/ذرة

Immunonutrition in Total Hip Arthroplasty

Polyunsaturated Fatty Acids (PUFA) in Diabetic Fatty Liver

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