Causas da desnutrição pós-gastrectomia

Racional A retirada total ou parcial do estômago resulta em conseqüências nutricionais, agudas ou crônicas, perfeitamente prognosticáveis, mas nem sempre ponderadas na terapia pós-operatória. Objetivo - Rever as participações mecânicas e químicas do estômago no aproveitamento do nutriente dietético, e as conseqüências nutricionais da gastrectomia. Resultados - A deficiência energética, com conseqüente perda de peso, acompanha inversamente o volume gástrico remanescente e o tempo pós-operatório; tem a anorexia e diarréia (má absorção) como principais causas, sendo a primeira decorrente de fatores emocionais ou de mediadores químicos de ação hipotalâmica. A diarréia pode ser decorrente da maior motilidade ou do supercrescimento bacteriano intestinais, com o agravante da insuficiência pancreática exócrina e maior esvaziamento da vesícula biliar. A má absorção traz conseqüências não apenas energética-protéica com a perda fecal de gordura e nitrogênio, como também vitamínico-mineral pelo menor aproveitamento da vitamina D e cálcio dietéticos. A anemia verificada no gastrectomizado é conseqüente à diminuição da produção de HCl (e menor solubilização do ferro) e do fator intrínseco (com menor absorção da vitamina B12). Conclusão - Perda de peso e anemia são os sinais de desnutrição mais comumente observados nestes pacientes, em intensidade e duração variáveis dependentes do tipo de cirurgia e do tempo e tratamento nutricional pós-operatório, sendo recomendável o tratamento dietético supervisionado.

Morphological deformities in the osseous structure in spotted sorubim Pseudoplatystoma coruscans (agassiz & spix, 1829) with vitamin c deficiency

A vitamina C é essencial para dietas de peixe porque muitas espécies não conseguem sintetizá-la. Esta vitamina é necessária par a formação de cartilagem e matriz óssea. Além disso, age como antioxidante e melhora as resposta do sistema imunológico. O presente trabalho investigou os efeitos da suplementação de vitamina C em dietas para alevinos de pintado (Pseudoplatystoma corruscans) pela incidência de deformidades na estrutura óssea e cartilaginosa. O ascorbil polifosfato (AP) foi utilizado como fonte de vitamina C em dietas para alevinos de pintado durante o período de três meses. Seis dietas foram formuladas: uma dieta controle (0 mg de vitamina C / kg) e cinco dietas 500, 1.000, 1.500, 2.000 e 2.500 mg de AP / kg. Os peixes alimentados sem suplementação de vitamina C apresentaram deformidades óssea na cabeça e mandíbula e fragilidade de nadadeiras. Assim, a dieta de 500 mg de AP/kg foi suficiente para prevenir a ocorrência de deformidades, e a ausência desta vitamina prejudica o desenvolvimento ósseo de juvenis de pintados.

Ischemia and reperfusion in skin flaps: effects of mannitol and vitamin C in reducing necrosis area in a rat experimental model

OBJETIVO: Neste trabalho foi padronizado modelo experimental de isquemia e reperfusão em retalho cutâneo em ratos no qual estudou-se possibilidade de uma solução antioxidante, composta por Ringer lactato, vitamina C e manitol de reduzir a área de necrose. MÉTODOS: O modelo consistiu de levantamento de retalho cutâneo axial de 6,0 x 3,0cm, submetido à isquemia de 8 horas e reperfusão de 7 dias. Os animais foram divididos em quatro grupos: grupos S1, S2 (10 animais cada), C e T (14 animais cada). Nos grupos S1 e S2 todos os procedimentos dos demais grupos foram efetuados, exceto a isquemia e reperfusão: S1 recebeu apenas Ringer lactato e S2 a solução antioxidante. Os grupos C e T foram submetidos à isquemia. O grupo C recebeu somente Ringer lactato e o grupo T a solução antioxidante. No 7(0) dia de pós-operatório as áreas de necrose e pele viável do retalho foram delineadas em decalque de acetato, os quais foram por sua vez analisados em sistema computadorizado KS-300 (Carl Zeiss). RESULTADOS: A análise estatística mostrou que não houve diferenças significativas entre o grupo tratado e controle quanto à área de necrose. CONCLUSÃO: Concluiu-se que o modelo experimental é consistente, determinando área de necrose limitada e uniforme nos animais não tratados e que as drogas usadas, nessa posologia e modo de aplicação, não foram efetivas em diminuir a área de necrose no modelo experimental em questão.

Performance, carcass traits, meat quality and economic analysis of feedlot of young bulls fed oilseeds with and without supplementation of vitamin E

The objective of this research was to evaluate average daily gain (ADG), carcass traits, meat tenderness and profitability of keeping cattle fed different oilseeds and vitamin E in feedlot. A total of 40 Red Norte young bulls with initial average body weight of 339±15 kg were utilized. The experimental design was completely randomized in a 2 × 2 factorial arrangement. The experiment lasted 84 days and experimental diets presented soybeans or cottonseeds as lipid sources associated or not to daily supplementation of 2,500 UI vitamin E per animal. The concentrate:roughage ratio was 60:40. Diets had the same amount of nitrogen (13% CP) and ether extract (6.5%). The data were analyzed by means of statistical software SAS 9.1. Neither vitamin supplementation nor lipid source affected ADG. There was no interaction between lipid source and vitamin supplementation for the variables studied. The inclusion of cottonseed reduced the carcass yield. There was no effect of diets on hot and cold carcass weights or prime cuts. The inclusion of cottonseed reduced the backfat thickness. No effect of experimental diets on the rib-eye area was observed. There was no effect of lipid source or vitamin supplementation on meat tenderness, which was affected, however, by ageing time. Diets with soybeans presented higher cost per animal. The utilization of soybean implied reduction of the gross margin (R$ 59.17 and R$ 60.51 for diets based on soy with and without supplemental vitamin, respectively, vs. R$ 176.42 and R$ 131.79 for diets based on cottonseed). The utilization of cottonseed enables improvement of profitability of feedlot fattening, in spite of negatively affecting some carcass characteristics.

INFLUENCE OF ENTERAL PARASITES ON THE BLOOD VITAMIN-A LEVELS IN PRESCHOOL-CHILDREN ORALLY SUPPLEMENTED WITH RETINOL AND OR ZINC

A sample of 471 pre-school children who frequented schools and creches in a poor district of Manaus (Amazonas), Brazil, were randomly submitted to faecal parasitological tests. Two-hundred-and-forty children from both sexes between the ages of 3 and 7 years with Ascaris lumbricoides and/or Giardia lamblia were selected. The objective of the study was to determine the possible influence of these two intestinal parasites and vitamin A and/or zinc supplementation on the serum retinol levels of primary school children. The children were submitted to clinical and anthropometric examinations, dietary interviews and biochemical examinations of retinol and carotene in the serum and of zinc in the hair. The parasitic incidence was 85.0% and about 54% of the children were polyparasitic. During the pretreatment phase, the retinol and carotene serum levels were 36% and 57%, respectively, below the normal levels. Using the Waterlow classification, the anthropometric analyses revealed that 88% of the children showed normal growth. A significant effect was observed of the anti-parasitic medicine on the serum retinol levels.

Activity of pectinmethylesterase, pectin content and vitamin C in acerola fruit at various stages of fruit development

In order to know which stage of fruit development is better for acerola industrialization, we studied the PME specific activity, pectin content and vitamin C at various stages of development. The acerola fruits were classified according to colour and weight in five stages: immature green (2.62-3.21 g), green (4.04-4.83 g), mature green/yellow (5.03-5.88 g), pale-red (6.16-6.77 g) and ripe mature (6.92-8.37 g). The results showed that the highest content of pectin and vitamin C occurred at the immature green stage, 4.51 +/- 0.1% yield, 2424 mg/100 g of pulp and decreased as fruit ripened, 2.99 +/- 0.03% yield, 957 +/- 0.0 mg/100 g of pulp, respectively. However, at the same stages, the values of PME specific activity were lowest, 0.61 +/- 0.01 and 0.55 +/- 0.0 units g(-1)/g of pulp, respectively. The highest value of PME activity was 2.08 +/- 0.01 units g(-1)/g of pulp in the green stage. (C) 2001 Elsevier B.V. Ltd. All rights reserved.

Interaction between vitamin K nutriture and bacterial overgrowth in hypochlorhydria induced by omeprazole

Subjects taking a hydrogen pump blocking agent (omeprazole) develop bacterial overgrowth of the small intestine. We tested the hypothesis that this bacterial overgrowth produces menaquinones, which would meet the Vitamin requirement in situations of vitamin K deficiency. In a crossover-type design, 13 healthy Volunteers eating a phylloquinone-restricted diet for 35 d were randomly assigned to take omeprazole during the first period of study or starting on day 15 until the end of the study. Coagulation times, serum osteocalcin [total osteocalcin and undercarboxylated osteocalcin (ucOC)], plasma phylloquinone, urinary gamma-carboxyglutamic acid, and plasma undercarboxylated prothrombin (PIVKA-II) were measured. Plasma phylloquinone concentrations declined 82% with dietary phylloquinone restriction (P < 0.05) and were not significantly different in the period when the diet was combined with omeprazole treatment (P > 0.05), the mean value for PIVKA-II during the phylloquinone-restricted diet significantly increased 5.7-fold from baseline (P < 0.05); however, the combination of omeprazole treatment and the phylloquinone-restricted diet significantly reduced PIVKA-II values by 21% (P < 0.05) compared with the diet period alone. There were no alterations in total or percentage ucOC concentrations during the phylloquinone-restricted diet or during the period of diet plus omeprazole treatment. Our data support the hypothesis that bacterial overgrowth results in the synthesis and absorption of menaquinones. These menaquinones contribute to vitamin K nutriture during dietary phylloquinone restriction, but not enough to restore normal vitamin K status.

Physiological responses of Nile tilapia, Oreochromis niloticus, fed vitamin C- and lipid-supplemented diets and submitted to low-temperature stress

Water temperature alterations can determine harmful physiological modifications in fish, which should be prepared to cope with this, and nutrition strategies seem to be essential. This study evaluated the effects of different levels of vitamin C and lipids on physiological responses of Nile tilapia, Oreochromis niloticus, submitted to temperature stress. There were two phases: Phase I - preparing fish to store vitamin C and lipid at appropriate temperature, and Phase II - evaluating the contributions these reserves make to fish physiology under low-temperature stress. The experiment used a 3 x 2 factorial design with three vitamin C levels (300, 600, and 1200 mg/kg diet) and two lipid levels (8.0 and 12.0%), plus absence of nutrient test and a diet of 6.0% lipids and 125.0 mg/kg vitamin C. In Phase I, 192 fish were kept at 26.0 +/- 1.0 C for 112 d, and in Phase II, 48 fish were kept at 18.0 +/- 0.5 C for 32 d and at 15.0 +/- 0.5 C for 11 d. Fish fed C0L0 diet showed lower erythrocytes values in both phases; higher vitamin C supplement determined higher red blood cell (RBC) number and higher hematocrit (Htc) (Phase II); Htc was significantly lower in Phase II; after temperature stress, fish fed C0L0 diet had higher mean corpuscular volume, lower hemoglobin corpuscular concentration, and significantly lower vitamin C concentration in the liver; and higher supplementation determined a higher concentration in the liver (Phases I and II). Higher plasmatic cortisol concentration was seen in fish fed C0L0 diet. In conclusion, our results show that the absence of vitamin C in diets impairs RBC formation and does not enable fish to cope with stress; excess vitamin C is efficient in mitigating stress and 600 mg/kg diet is economic and physiologically sufficient to prepare fish for coping with low-temperature stress. Lipid supplementation does not determine alterations in stress biochemical parameters.

Amperometric differential determination of ascorbic acid in beverages and vitamin C tablets using a flow cell containing an array of gold microelectrodes modified with palladium

A simple and attractive method for quantification of ascorbic acid (AA) in beers, soda, natural juices and commercial vitamin C tablets was achieved by combining Bow injection analysis and amperometric detection. An array of gold microelectrodes electrochemically modified by deposition of palladium was employed as working electrode which was almost unaffected by fouling effects. Ascorbic acid was quantified in beverages and vitamin tablets using amperometric differential measurements. This method is based on three steps involving the flow injection of: 1) the sample plus a standard addition of AA, 2) the pure sample, and 3) the enzymatically-treated sample. The enzymatic treatment was carried out with Cucumis sativus tissue, which is a rich source of ascorbate oxidase, at pH 7. The calibration plots for freshly prepared ascorbic acid standards were very linear in the concentration range of 0.18-1.8 mg L-1 with a relative standard deviation (RSD) < 1%, while for real samples the deviations were between 2.7% to 8.9%.

Oral clefts and vitamin supplementation

Objectives: the evidence linking low levels of folic acid and orofacial clefting (OFC) is presently equivocal, There is stronger evidence for the role of folic acid supplementation in protection against the occurrence and recurrence of neural tube defects. The present investigation tested the hypotheses that cleft lip, cleft palate, or both are inversely associated with maternal intake of dietary and supplemental vitamins during the periconceptional period and first 4 months of pregnancy in a Brazilian population.Design: A population-based, case-control study of cleft lip with or without cleft palate (CL(P)) and isolated cleft palate (CP) in a Brazilian population. in structured interviews, case histories were taken from the mothers of a consecutive sample of 450 infants born with nonsyndromic OFC,Results: Mothers who had children with CL(P) were less likely to have been supplemented during the periconceptional period. The statistical significance of the difference in prevalence of the use of supplements between mothers of patients and of controls was greater for the CL(P) group: p < .05 for CP and p < .001 for CL(P). Multivariate analysis confirmed this finding of a protective effect for both types of orofacial cleft,Conclusions: the use of vitamin supplements in the first 4 months of pregnancy was suggestive of a protective effect against the occurrence of CP and CL(P) in this population, the significance of an association between multivitamin supplementation and OFC and the possible role of gene/environment interaction are discussed.