Calories In Chicken Chow Mein And Curry Sauce

Write to the HSM of 21 December 2005

Hessian Ministry of Social Affairs
The Social Security
PO Box 3140
65 021 WIESBADEN

AZ V 7 A - 181 02 13

ban initiative on oil emulsions for intravenous infusion

here: Your letter of 22 November 2005

Dear Mrs Lautenschläger

outset, I thank you for the detailed replies to my letter of 27 October 2005 and for Your search for information about the approval procedure of the lipid infusion solutions including in the drug database, AMIS.

based in fact, as you noted correctly, my objections to the declaration of the oil emulsions as a "culture media" in scientific publications from 1950 to 1962. The detailed investigations of the mechanisms of lipid metabolism in human blood were then partially on the occasion of the deaths of hospital patients after intravenous administration of fat emulsions published. The investigation focused particularly on the products and LIPOMUL ABBOLIPID the North American pharmaceutical manufacturers UPJOHN and ABBOTT.

Between 1962 and 1976, aspects of the theme "Parenteral Nutrition" at numerous congresses of the International Society for Parenteral Nutrition ISPN and the European Society for Parenteral and Enteral Nutrition ESPEN in medical circles. As a topic repeatedly used most German Medical Association in particular the German Society for Nutritional Medicine DGEM for comments would be responsible for these products.

to illustrate to you my stance on the issue of existence and application of oil-containing infusion solutions, I would tell them also that to my letter dated in my 27th belong in October alleged objections to these products to less possible side effects of this agent as to the aspects of

1. basic incompatibility oily infusion solutions with added surface tension-reducing emulsifiers for the human blood and the
   

2. risk of misuse of these substances and the risk of application failures in connection with the administration of the substances to patients.

to already in my first written statement addressed fundamental incompatibility I want them using the following causal chain in a simplified form the main argumentation against the state on the market are oil-containing infusion media:

1. main component of blood is water

2. oil does not mix with water

3. The metabolism of autologous blood came into the transport medium fat is there in microscopic components of more than 1 diameter before Mykrometer

4. To reduce the size of the emulsion droplets of intravenously administered oil are the lipid infusion means oberflächenspannungsverringernde substances (emulsifiers) mixed

5. This oberflächenspannungsverringernden substances develop a similar oberflächenspannungsverringernde effect in human blood

6. This leads to damage of the blood plasma, the blood cells and clotting of the blood which can lead to so-called blood embolism

This , examined in the above-mentioned scientific publications effect of lipid infusion on human blood LIPOMUL is described as having "the blood plasma is transformed into a white, milky, creamy substance in the blood cells lose all coagulation ability. The human blood would thus be its main function as a transport medium for oxygen supply to the organs deprived.

The addition of smaller amounts of oil-containing infusion solutions by regulated, slow dropping of the substances from the blood infusion bottles in the human body could therefore have a certain Period to be absorbed. Fatal damage to the human body would be expected with this dosage form only after a certain period if they would not have the blood of biodegradable oil or the vehicle in the Kapillarendigungen the blood vessels of the supplied organs (especially in brain, lung, liver) accumulated and there would cause a disturbance of oxygen supply, which could lead to pulmonary or cerebral embolism.

latter is particularly associated with the technical information you mentioned is important that monitoring of patients particularly recommended in the initial phase of the lipid infusion . Similarly, the question of the non-degradable infusion Kapillarakkumulation shares for the above-mentioned clinical trials will play an important role, some of the subjects studied by taking blood and vital signs measurement only in the first 4 days after infusion administration. Neither blood nor vital signs were measured but the risk of onset of organ embolism by substance accumulation in the Kapillarendigungen show the blood vessel system. remain

to the above under 2 possible danger of abuse or misuse of substances to make the following comments:

During the search of my office CID research on the issue of lipid infusions, I was, according to informed by medical treatment personnel that cases known to his, which removes the infusion solution in the sterile dropper bottles and syringes had been transferred to administer the substance to patients by injection directly into the vein. That method are then made by the nursing staff as "at once" , "May in the clinic staff often overworked and be the nurse or nurses do not spend hours sat next to a patient in order to allow slow the oil-containing infusion solution according to the instructions for use for several hours to drip into the vein" . This administration takes shape, however, as stated above, blood embolism and immediately following the death of the patient .

If this is false, since, contrary to the manufacturer's instructions implemented application for lack of medical knowledge and intent, a potentially compromised patients "to be quickly send food" , then spoke a sometimes occurring application error of this kind does constitute a labeling requirement with appropriate warnings, as I they ask in my first letter to the BifAmMp.

If this misuse abuse, having regard to the products' impact and with deliberate intent to kill, it would actually also pose a risk to declare the "broth" as " Toxic or "not sufficient protection for hospital patients so treated.

would Expanding and finally, in this context to mention, that using the Level of West German nurses may well expect that the application of the risks of the oil-containing infusion solutions are known. However, can the total number of 20 different products indicate that the total volume produced in Germany, "oil-containing parenteral nutrient substance" not only hospital patients in the Federal Republic can be fed. That is, obviously, part of the manufactured products is exported to other countries or continents.

Not least for television news is the dramatic situation of refugees, particularly from African hunger crisis regions known. I believe it is important to make as a production country of so problematic and hazardous substance such as oil-based infusion nutrient solutions to proactively think about the possible errors that the unwitting because of poorly trained health workers were made, could occur misapplication. It would be only a matter of time before victims from these countries claim from the Federal Republic of Germany would comply.

Ultimately, there is also to countries in which the question of medical ethics is not considered high as here in Germany, which ultimately means that the improper application of the oil-containing infusate such as against political refugees, minorities, unpopular people, socially disadvantaged and marginalized by the production of the substance in Germany, responsible parties can not be excluded. I therefore consider a ban on production of lipid infusion solutions required.

It is left for me just to give you a very Merry Christmas and a Happy New Year.

Sincerely

Biol Peter Zanger
Research Director CID / CID-Verlag
Weilmünster, Wednesday, 21 December 2005