Preliminary Study of the Gastric Acidity in Thoroughbred Horses at Rest after Enteral Administration of Esomeprazole Magnesium (Nexium)

The regulation of gastric secretion is of crucial importance to the equilibrium of the gastroenteric system. Despite the large number of factors involved in the causes of peptic illnesses, pH = 4 is considered the threshold between physiologic and deleterious effects of stomach acid secretion. With the aim of maintaining pH greater than 4, proton-pump inhibitors, such as esomeprazole magnesium (NEXIUM), have shown excellent results in the control of acid secretion. Aimed at examining the action of this drug in the control of pH levels of gastric secretion in thoroughbreds, a single dose of 40 or 80 mg of esomeprazole magnesium was administered daily, and pH was determined serially for 5 consecutive days. The results obtained corroborated the efficacy of esomeprazole magnesium in the control of gastric pH at both doses tested, with 100% of the mean pH being greater than 5. Moreover, no statistical difference was noted between the two doses tested.

Avaliação do estado nutricional precedente ao uso de nutrição enteral

CONTEXTO: O adequado diagnóstico do estado nutricional é de vital importância para a prescrição da terapia nutricional enteral no ambiente hospitalar. OBJETIVO: Avaliar indicadores do estado nutricional em pacientes ingressantes na terapia nutricional enteral em uma unidade hospitalar. MÉTODOS: Estudo transversal com 100 pacientes adultos, sendo analisado o estado nutricional de ingresso à terapia nutricional enteral, por meio do índice de massa corporal obtido do peso e estatura estimados a partir de fórmulas de predição, e de indicadores laboratoriais do estado metabólico e nutricional. RESULTADOS: do total, 29% dos pacientes foram classificados como desnutridos pelo índice de massa corporal, enquanto 80% dos mesmos apresentaram albumina abaixo do valor de referência (<3,2 g/dL). Não houve diferença na distribuição das causas de base da internação entre os grupos classificados quanto ao estado nutricional pelo índice de massa corporal, prevalecendo as doenças cardiovasculares e pulmonares entre as principais causas. As concentrações abaixo dos valores de referência de albumina não foram diferentes entre os grupos classificados pelo índice de massa corporal e pelo diagnóstico de internação. CONCLUSÃO: O índice de massa corporal estimado foi indicador específico do estado nutricional, porém pouco sensível, enquanto a albumina mostrou-se mais sensível, o que reafirma a necessidade da combinação de vários indicadores para obtenção de um adequado diagnóstico nutricional.

Hiperalimentação enteral em traumatismos crânio-encefálicos agudos reposição ou dietoterapia?

Os autores apresentam revisão geral sobre a fisiopatogenia do trauma, ressaltando os estados de hipereatabolismo e hipermetabolismo, suas consequências nutricionais, com as particularidades do trauma encefálico. São feitas, também, considerações sobre as vias, composição e volumes das dietas enterais a serem administradas a pacientes com trauma agudo encefálico, assim como são apontadas questões a serem melhor elucidadas.

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.

Comparação entre as necessidades energéticas prescritas e administradas a pacientes em terapia nutricional enteral

Objective: evaluating the adequacy, prescription and energy supply of enteral nutrition therapy in hospitalized patients. Methods: was performed a retrospective survey of the evolution of TNE protocol of 59 patients hospitalized in a general hospital in Marília / SP / BR. Data collected included gender, age, clinical diagnosis, anthropometric and dietary data related to the prescribed dietary formula, route and method of administration of the enteral nutrition, the daily volume prescribed and administered, the daily amount of energy required and offered in the diet, as well as possible complications. Body mass index (BMI), triceps skinfold (TSF) and arm muscle circumference (AMC) were used to establish the nutritional status of the patients. The adequacy of ENT was done according to the daily energy requirement compared to the average energy received during the daily use of ENT. Results: The average found to the BMI was 21.4 kg/m 2, and no differences were found comparing male and female. The data for TSF and AMC were different between genders (p<0.05) and suggest a more severe muscle mass in relation to adipose tissue. The averaged to the energy requirements was 1642 kcal/day but the average of energy prescribed was 1045 kcal/day and the amount offered was 1035 kcal/day. There was a significant difference between the necessity and the supplied energy offered through enteral nutrition (p=0.00) as well between the energy required and prescribed (p =0.00), both were shorter than the necessity. There was no significant difference (p>0.05) in energy supply, volume of enteral nutrition prescribed and administered among eutrophic, underweight or overweight patients. Conclusion: The results of this study indicate that the prescription and energy supply were not based on the needs of these patients, causing a significant energy deficit, which can lead to worsening of the nutritional status of the same. In hospitalized patients in use of ENT, the energy requirement must be made by a qualified professional within the multidisciplinary team, based on the needs of each patient.

Fistulização temporária do ceco em equinos: estudo experimental da técnica cirúrgica e da viabilidade desta via para a administração de fluído enteral

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Saúde bucal de pacientes com desordens neurológicas e nutrição enteral: análise microbiológica, bioquímica e protocolo de prevenção

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Enteral nutrition feeding alters antioxidant activity in unstimulated whole saliva composition of patients with neurological disorders

Patients with neurological disorders have an increased risk of oral and systemic diseases due to compromised oral hygiene. If patients lose the ability to swallow and chew food as a result of their disorder, enteral nutrition is often utilized. However, this type of feeding may modify salivary antioxidant defenses, resulting in increased oxidative damage and the emergence of various diseases. The aim of this study was to evaluate the effects of enteral nutrition on biochemical parameters in the unstimulated whole saliva composition of patients with neurological disorders. For this, enzymatic (superoxide dismutase - SOD; glutathione peroxidase - GPx) and non-enzymatic (uric acid; ferric ion reducing antioxidant power - FRAP) antioxidant activity, as well as a marker for oxidative damage (thiobarbituric acid reactive substances - TBARS) were analyzed. Unstimulated whole saliva was collected from 12 patients with neurological disorders and tube-feeding (tube-fed group - TFG), 15 patients with neurological disorders and normal feeding via the mouth (non-tube-fed group - NTFG), and 12 volunteers without neurological disorders (control group - CG). The daily oral hygiene procedures of TFG and NTFG patients were similar and dental care was provided monthly by the same institution's dentist. All patients exhibited adequate oral health conditions. The salivary levels of FRAP, uric acid, SOD, GPx, TBARS, and total protein were compared between studied groups. FRAP was increased (p < 0.05) in the NTFG (4651 +/- 192.5 mmol/mL) and the TFG (4743 +/- 116.7 mmol/mL) when compared with the CG (1844 +/- 343.8 mmol/mL). GPx values were lower (p < 0.05) in the NTGF (8.24 +/- 1.09 mmol/min/mg) and the TFG (8.37 +/- 1.60 mmol/min/mg) than in the CG (15.30 +/- 2.61 mmol/min/mg). Uric acid in the TFG (1.57 +/- 0.23 mg/dL) was significantly lower than in the NTFG (2.34 +/- 0.20 mg/dL) and the CG (3.49 +/- 0.21 mg/dL). Protein was significantly lower in the TFG (5.35 +/- 0.27 g/dL) than in the NTFG (7.22 +/- 0.57 g/dL) and the CG (7.86 +/- 0.54 g/dL). There was no difference in the salivary flow rate and SOD between groups. Enteral nutrition in patients with neurological disorders was associated with lower oxidative damage, resulting in increased salivary. antioxidant capacity. These results emphasize the importance of oral care for this population to prevent oral and systemic diseases. (C) 2014 Elsevier Ltd. All rights reserved.

Desperdício de dieta enteral em UTI: análise de modo de falhas e efeitos de danos ao paciente grave

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Effects of nutritional support on hospital outcome in dogs and cats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Evaluation of chemopreventive activity of glutamine by the comet and the micronucleus assay in mice's peripheral blood

This research has evaluated the effects of enteral supplementation of glutamine in clastogens and genotoxic damages caused by the acute administration of cisplatin. For this. it was utilized Swiss mice distributed in eight experimental groups: control, cisplatin, glutamine, in three different doses and the combination of these with cisplatin. The results show that the glutamine was present in neither genotoxic nor mutagenic activity. When in association with glutamine and cisplatin, in simultaneous treatment, it was verified the frequency decreased of micronuclei and comets. The damage reduction percentages to the micronucleus ranged from 95.4 to 91.8% after 24 h of administration of these compounds and 76.7 to 56.8% after 48 h. In the same time the damage reduction percentages to the comet test ranged from 117.0 to 115.0%. The results suggest that glutamine is capable of preventing genotoxic and mutagenic damage according to the experimental design proposed. (C) 2009 Elsevier B.V. All rights reserved.

O uso da gastrostomia percutânea endoscópica

A gastrostomia percutânea endoscópica foi introduzida na prática clínica como via alternativa de alimentação enteral. É procedimento que não necessita de anestesia ou laparotomia, como a gastrostomia cirúrgica. A gastrostomia percutânea endoscópica tem como objetivos a manutenção do aporte nutricional e a melhoria da qualidade de vida e sobrevida dos pacientes. É indicada quando o paciente necessita de dieta enteral por período superior a um mês. A freqüência de complicações varia de 1,0% a 10,0% e a mortalidade de 0,3% a 1,0%. É propósito deste trabalho abordar aspectos relevantes desse método de alimentação enteral, aprimorar seu manejo, bem como facilitar o manejo pelos pacientes que dele se utilizam. Para isso, vamos comentar as indicações e contra-indicações da gastrostomia percutânea endoscópica, técnica de colocação, material das sondas, antibiótico profilático, início de utilização, custo do procedimento, além de suas complicações, aspectos legais e éticos.

Serum Vitamins in Adult Patients With Short Bowel Syndrome Receiving Intermittent Parenteral Nutrition

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Nutritional management and weight changes during hospitalization of Brazilian infants with diarrhoea: Primary reliance on oral feeding or continuous nasogastric drip with locally made, modulated minced chicken formula

The nutritional management of infants admitted with diarrhoea to the University Hospital of Botucatu includes a change from bolus feeding of a modulated minced-chicken formula to a continuous nasogastric drip (NGD) feeding, whenever the required calorie intake is not achieved or the diarrhoea does not subside. To evaluate this approach, the clinical course and weight changes of 63 children, aged 1-20 months, were reviewed; most (81 per cent) were below the third percentile for weight at admission and 76 per cent had a total duration of diarrhoea ≥10 days. Associated infections, mainly systemic, were present at or after admission in 70 per cent of them. Twenty-five survivors needed nutritional support (NS), predominantly NGD, for a median duration of 30 per cent of their admission time, and were compared to 31 survivors managed without NS. Those who necessitated NS lost weight for a significantly longer median time (12x4 days, p<0.005), but their total weight loss was similar (5x4 per cent) as well as diarrhoea's duration (8x7 days). There was a tendency for a longer hospitalization (21x16 days 0.05

Minerals in the nutrition of extremely low birth weight infants

Objective: To review the literature on the role of calcium, phosphorus and trace elements in the nutrition of extremely low birth weight infants, considering their importance for metabolism, bone mineralization and as dietary components. Sources of data: MEDLINE, the Cochrane Database of Systematic Reviews and books on nutrition were searched between 1994 and 2004. Original research studies and reviews were selected. Summary of the findings: Extremely preterm infants are frequently growth-restricted at hospital discharge as a consequence of difficulties in the provision of adequate nutrition. The long-term effects of this growth restriction need to be determined. There is a paucity of studies about the role of minerals, especially micronutrients, in the nutrition of extremely preterm infants. The principal focus of this review was on calcium and phosphorus metabolism, bone mineralization and parenteral and enteral supplementation. A critical evaluation of post-discharge nutrition and its influence upon growth and bone mineralization was presented. Selenium and zinc requirements and the role of selenium as an antioxidant with possible effects on free radical diseases of the preterm infant were discussed. Conclusions: Extremely preterm infants have low mineral reserves and, as a consequence, may have deficiencies in the postnatal period if they do not receive parenteral or enteral supplementation. More studies are needed to elucidate the actual requirements and the appropriate supplementation of micronutrients. There are controversies about the outcome and the influence of post-discharge nutrition on bone disease of prematurity. Copyright © 2005 by Sociedade Brasileira de Pediatria.