Nutritional follow-up of critically ill infants receiving short term parenteral nutrition

Few studies have tried to characterize the efficacy of parenteral support of critically ill infants during short period of intensive care. We studied seventeen infants during five days of total parenteral hyperalimentation. Subsequently, according to the clinical conditions, the patients received nutritional support by parenteral, enteral route or both up to the 10th day. Evaluations were performed on the 1st, 5th, and 10th days. These included: clinical data (food intake and anthropometric measurements), haematological data (lymphocyte count), biochemical tests (albumin, transferrin, fibronectin, prealbumin, retinol-binding protein) and hormone assays (cortisol, insulin, glucagon). Anthropometric measurements revealed no significant difference between the first and second evaluations. Serum albumin and transferrin did not change significantly, but mean values of fibronectin (8.9 to 16 mg/dL), prealbumin (7.7 to 18 mg/dL), and retinol-binding protein (2.4 to 3.7 mg/dL) increased significantly (p < 0.05) from the 1st to the 10th day. The hormonal study showed no difference for insulin, glucagon, and cortisol when the three evaluations were compared. The mean value of the glucose/insulin ratio was of 25.7 in the 1st day and 15.5 in the 5th day, revealing a transitory supression of this hormone. Cortisol showed values above normal in the beginning of the study. We conclude that the anthropometric parameters were not useful due to the short time of the study; serum proteins, fibronectin, prealbumin, and retinol-binding protein were very sensitive indicators of nutritional status, and an elevated glucose/insulin ratio, associated with a slight tendency for increased cortisol levels suggest hypercatabolic state. The critically ill patient can benefit from an early metabolic support.

Isokinetic dynamometry of knee flexors and extensors: comparative study among non-athletes, jumper athletes and runner athletes

Participation in intensive sports activities leads to muscular specializations that may generate alterations in involved articular forces and cause static (posture) and dynamic changes (alterations of articular stability, coordination, etc.). Prevention of injury requires specific functional muscular evaluation in all athletes and for any kind of sport. OBJECTIVE: To dynamically evaluate, through isokinetic tests, the peak torque, total work, and average power of the knee flexor and extensor muscles of jumper and runner athletes and compare them to those of a non-athletic population, evaluating dominance and balance between agonistic and antagonistic muscle groups. RESULTS: In the non-athlete group, we noted a higher asymmetry between the dominant and nondominant members. The jumpers had the highest values of the evaluated parameters of all groups, whereas parameters for the runners were intermediate between non-athletes and jumpers.

Effects of continuous versus bolus infusion of enteral nutrition in critical patients

PURPOSE: Enteral alimentation is the preferred modality of support in critical patients who have acceptable digestive function and are unable to eat orally, but the advantages of continuous versus intermittent administration are surrounded by controversy. With the purpose of identifying the benefits and complications of each technique, a prospective controlled study with matched subjects was conducted. PATIENTS AND METHODS: Twenty-eight consecutive candidates for enteral feeding were divided into 2 groups (n = 14 each) that were matched for diagnosis and APACHE II score. A commercial immune-stimulating polymeric diet was administered via nasogastric tube by electronic pump in the proportion of 25 kcal/kg/day, either as a 1-hour bolus every 3 hours (Group I), or continuously for 24 hours (Group II), over a 3-day period. Anthropometrics, biochemical measurements, recording of administered drugs and other therapies, thorax X-ray, measurement of abdominal circumference, monitoring of gastric residue, and clinical and nutritional assessments were performed at least once daily. The principal measured outcomes of this protocol were frequency of abdominal distention and pulmonary aspiration, and efficacy in supplying the desired amount of nutrients. RESULTS: Nearly half of the total population (46.4%) exhibited high gastric residues on at least 1 occasion, but only 1 confirmed episode of pulmonary aspiration occurred (3.6%). Both groups displayed a moderate number of complications, without differences. Food input during the first day was greater in Group II (approximately 20% difference), but by the third day, both groups displayed similarly small deficits in total furnished volume of about 10%, when compared with the prescribed diet. CONCLUSIONS: Both administration modalities permitted practical and effective administration of the diet with frequent registered abnormalities but few clinically significant problems. The two groups were similar in this regard, without statistical differences, probably because of meticulous technique, careful monitoring, strict patient matching, and conservative amounts of diet employed in both situations. Further studies with additional populations, diagnostic groups, and dietetic prescriptions should be performed in order to elucidate the differences between these commonly used feeding modalities.

Eating habits and psychopathology: translation, adaptation, reliability of the Nutrition Behavior Inventory to Portuguese and relation to psychopathology

Objective: The Nutrition-Behavior Inventory (NBI) is a self-administered instrument that allows eating habits to be correlated with psychopathological symptoms. The objective was to translate and adapt the NBI to Portuguese, and test the Portuguese NBI’s reliability. The second aim was to verify its sensitivity for identification of risk factors in terms of behavior/eating habits in children and adolescents. Methods: The NBI was translated, adapted, and back-translated. The Portuguese version of the NBI was then applied (N = 96; 9-12 years). In order to verify the internal consistency, Cronbach’s alpha was used. The psychopathological indicators of the participants were accessed using the Child Behavior Checklist (CBCL). The mean CBCL scores were analyzed in relation to the NBI data (cutoff point: ≥ 30 with indicators, and < 30 without). Results: Internal consistency was high (Cronbach’s alpha = 0.89) for the NBI. The CBCL scores correlated significantly with NBI (> 30) on the following: anxiety and depression (p = 0.041), social difficulties (p = 0.028), attention problems (p = 0.001), aggressive behavior (p = 0.015); ADHD (p < 0.001), and conduct problems (p = 0.032). Conclusion: The present results indicate that the NBI is a reliable instrument. The NBI can be useful for evaluating psychopathological symptoms related to the eating habits and behaviors of children and adolescents.

Lipid profile of nutrition students and its association with cardiovascular disease risk factors

OBJECTIVE: To describe the lipid profile and to verify its relationship with cardiovascular disease risk factors in students at a public university in São Paulo. METHODS: After obtaining clinical, anthropomorphic, and lipid profile data from 118 students, variables of the lipid profile were related to other risk factors. RESULTS: The mean age of the students was 20.3 years (SD=1.5). The risk of cardiovascular disease was characterized by a positive family history of ischemic heart disease in 38.9%; sedentariness in 35.6%; limiting and increased total and LDL-C cholesterol levels in 17.7% and 10.2%, respectively; decreased HDL-C levels in 11.1%; increased triglyceride levels in 11.1%; body mass index >25 in 8.5%, and smoking in 6.7% of the subjects. Students' diet was found to be inadequate regarding protein, total fat, saturated fat, sodium, and fiber contents. A statistically significant association between cholesterol and contraceptive use, between HDL-C and contraceptive use, age and percent body fat, and triglycerides and percent lean weight was observed. CONCLUSION: A high prevalence of some risk factors of cardiovascular disease as well as the association between these factors with altered lipid profiles was observed in the young population studied.

Studies on the mineral nutrition and fertilization of the passion fruit plant (Passiflora edulis f. flavicarpa): II - placement of fertilizer phosphorus

A localização do superfosfato (marcado com P32) no maracujá em produção foi estudada em condições de plantação comercial. Verificou-se que as aplicações em sulcos circulares ou faixas superficiais ao redor da planta tem eficiência equivalente sendo esses métodos três vezes superiores à localização do adubo em furos no solo. A pulverização foliar, por sua vez, mostrou-se 20 vezes mais eficiente que a aplicação no solo de acordo com os dois primeiros métodos.

Studies on the mineral nutrition and fertilization of the passion fruit plant (Passiflora edulis F. flavicarpa): II. placement of fertilizer phosphorus

1. Tagged superphosphate was applied to 2.5 year old passion fruit plants from a commercial plantation established in a sandy loam. 2. 100 grams of the fertilizer were distributed in the following ways: in a circular furrow 20 cm around the plant 40 cm from the stems; in a circular strip 10 cm wide, 40 cm from the stems; in six holes around the plants, 40 cm from the stems 20 cm deep, 2.5 cm in diameter. 3. 10 grams of the fertilizer in 11 of water were sprayed to the leaves. 4. Three weeks after the treatments were made, leaf samples were taken for analysis. 5. Determinations of specific activities both in the leaves and in the fertilizer used have shown that R in the plant was derived from the superphosphate in the following relative proportions (by making the first treatment equal to 100): circular furrow = 100; circular strip = 120; holes = 30; foliar spray = 230.

Juvenile hormone III and nutrition effects on spermatogenesis in the 4th instar nymphs of Panstrongylus megistus (Hemiptera: Reduviidae)

When 4th instar nymphs of Panstrongylus megistus are fed with a saturant blood meal, there is an intense proliferation of the spermatogonia. At the end of the intermoult, the older spermatogonial cysts differentiate into 1st primary spermatocyte cysts. In the nymphs deprived of the blood meal this evolution is not observed, but a small growth of the testicular follicles occurs, due to a few mitotic divisions. This growth is observed at least, until 25 days after ecdysis. Since day 15, an autolytic process starts in the older spermatogonial cysts. The presence of exogenous juvenile hormone III (JH III) does not promote the development of the germ cells in the fasting insects. There is only a small growth of the testicular follicles and the autolytic process is also observed. In the precocious adults obtained by allatectomy or precocene II treatment, germ cells are observed in all development stages, except packed and elongated spermatozoa bundels.

Aspects of gastrointestinal immunology and nutrition in human immunodeficiency virus-1 infection in Brazil

Mucosal surfaces have a fundamental participation in many aspects of the human immunodeficiency virus (HIV) infection pathogenesis. In Brazilian HIV-1 infected subjects, loss of weight and appetite are among the most debilitating symptoms. In this review we describe a defined mucosal immunogen that has profound but transient effects on HIV viral load, and we suggest that gut associated lymphoid tissue under constant immunostimulation is likely to provide a major contribution to the total levels of HIV. We also show that hypermetabolism appears to play a role in the wasting process in Brazilian patients coinfected with HIV and tuberculosis.

Hepatitis C among former athletes: association with the use of injectable stimulants in the past

This study was performed with the purpose of testing the hypothesis that the high prevalence of hepatitis C among former athletes is associated with their past use of injectable stimulants. The study involved the participation of 208 former professional and amateur soccer and basketball players from the region of Ribeirão Preto, Brazil, who answered a questionnaire regarding their exposure to risk factors, including the use of injectable stimulants in the time they were engaged in sporting activities. ELISA tests were used to detect infection by the hepatitis C virus, and confirmed with PCR and genotyping for the positive cases. It was observed that the former use of injectable stimulants was a practice disseminated among the participants (24.5%), reaching 50.8% in the professionals. The overall prevalence for hepatitis C was 7.2%, with values of 11% among professionals and 5.5% among amateurs. In both categories, the presence of infection was markedly higher among those who admitted past use of injectable stimulants when compared to those who denied such practice (36% and 0.8% among amateurs; 21.9% and 0% among professionals, respectively). Multivariate analysis showed that the use of those substances was the only variable associated with the risk of hepatitis C. This confirms previous observations, performed with reduced sample sizes and without comparison groups, which indicated that the use of injectable vitamins was a risk factor of hepatitis C among former athletes.

Effect of 15n-labeled hairy vetch and nitrogen fertilization on maize nutrition and yield under no-tillage¹

This study evaluated the effect of hairy vetch (Vicia villosa Roth) as cover crop on maize nutrition and yield under no tillage using isotope techniques. For this purpose, three experiments were carried out: 1) quantification of biological nitrogen fixation (BNF) in hairy vetch; 2) estimation of the N release rate from hairy vetch residues on the soil surface; 3) quantification of 15N recovery by maize from labeled hairy vetch under three rates of mineral N fertilization. This two-year field experiment was conducted on a sandy Acrisol (FAO soil classification) or Argissolo Vermelho distrófico arênico (Brazilian Soil Classification), at a mean annual temperature of 18 ºC and mean annual rainfall of 1686 mm. The experiment was arranged in a double split-plot factorial design with three replications. Two levels of hairy vetch residue (50 and 100 % of the aboveground biomass production) were distributed on the surface of the main plots (5 x 12 m). Maize in the sub-plots (5 x 4 m) was fertilized with three N rates (0, 60, and 120 kg ha-1 N), with urea as N source. The hairy vetch-derived N recovered by maize was evaluated in microplots (1.8 x 2.2 m). The BFN of hairy vetch was on average 72.4 %, which represents an annual input of 130 kg ha-1 of atmospheric N. The N release from hairy vetch residues was fast, with a release of about 90 % of total N within the first four weeks after cover crop management and soil residue application. The recovery of hairy vetch 15N by maize was low, with an average of 12.3 % at harvest. Although hairy vetch was not directly the main source of maize N nutrition, the crop yield reached 8.2 Mg ha-1, without mineral fertilization. There was an apparent synergism between hairy vetch residue application and the mineral N fertilization rate of 60 kg ha-1, confirming the benefits of the combination of organic and inorganic N sources for maize under no tillage.

Nutrition, dry matter accumulation and partitioning and phosphorus use efficiency of potato grown at different phosphorus levels in nutrient solution

High rates of phosphate fertilizers are applied to potato (Solanum tuberosum L.), which may cause antagonistic interactions with other nutrients and limit crop yields when over-supplied. The purpose of this study was to evaluate the influence of phosphorus (P) levels in nutrient solution on P use efficiency, nutritional status and dry matter (DM) accumulation and partitioning of potato plants cv. Ágata. The experiment was carried out in a greenhouse, arranged in a completely randomized block design with four replications. Treatments consisted of seven P levels in nutrient solution (0, 2, 4, 8, 16, 31, and 48 mg L-1). Plants were harvested after 28 days of growth in nutrient solution, and separated in roots, stems and leaves for evaluations. The treatment effects were analyzed by regression analysis. Phosphorus levels of up to 8 mg L-1 increased the root and shoot DM accumulation, but drastically decreased the root/shoot ratio of potato cv. Ágata. Higher P availability increased P concentration, accumulation and absorption efficiency, but decreased P use efficiency. Higher P levels increased the N, P, Mg, Fe, and Mn concentrations in roots considerably and decreased K, S, Cu, and Zn concentrations. In shoot biomass, N, P, K, and Ca concentrations were significantly increased by P applied in solution, unlike Mg and Cu concentrations. Although higher P levels (> 8 mg L-1) in nutrient solution increased P concentration, accumulation and absorption efficiency, the DM accumulation and partitioning of potato cv. Ágata were not affected.

Effect of fertilization at sowing on nutrition and yield of crambe in second season

The interest in crambe (Crambe abyssinica ) cultivation in Brazil is on the rise, whereas information on the nutrient requirements for this crop is scarce. The objective of this work was to evaluate the effect of nitrogen-phosphorus-potassium (N-P2O5-K2O formula 8:28:16) fertilization (0, 150, and 300 kg ha-1) on crambe shoot biomass production, grain and oil yields, and nutrient extraction and exportation in the second growing season after soybean. The experiment with a Haplorthox (Dystroferric Red Latosol) was carried out for two years in Botucatu, São Paulo State, Brazil. A randomized complete block design with eight replications was used. Fertilization with NPK at sowing increased the shoot biomass production, grain yield, grain oil content, as well as nutrient extraction and exportation at harvest. In the fertilized treatments, the average amounts of nutrients extracted per hectare were 91 kg K, 71 kg N, 52 kg Ca, 9.4 kg P, 9.4 kg Mg, 7.9 kg S, 2,348 g Fe, 289 g Zn, 135 g Mn, and 18.2 g Cu; while the average values of nutrient exportation per hectare were 54 kg N, 20 kg K, 12.3 kg Ca, 10 kg P, 6.6 kg S, 3.2 kg Mg, 365 g Zn, 60 g Fe, 50 g Mn, and 7.3 g Cu, with NPK fertilizer application.

Effect of potassium sources and rates on arabica coffee yield, nutrition, and macronutrient export

The use of potassium (K) rock powder can be an alternative for K supply of crops. Thus, to reduce K fertilizer imports from abroad, possibilities of extracting this nutrient from Brazilian rocks are being studied. The objective was to evaluate the effect of phonolite rock powder (F2) as K source (Ekosil®) on the air-dried fruit yield, nutrition and macronutrient export of Arabica coffee. The experiment was carried out on a dystroferric Red Latosol (Typic Haplorthox), in Piraju, São Paulo State, Brazil, in the 2008/09 and 2009/10 growing seasons. The experimental design was a randomized complete block, in a factorial 2 × 3 + 1 arrangement, with four replications. The treatments consisted of two K sources (KCl - 58 % of K2O and F2 - 8.42 % K2O) and three rates ½-, 1-, and 2-fold the K2O rate recommended for coffee, i.e., 75, 150, and 300 kg ha-1 of K2O), plus a control (without K application). Potassium supply increased coffee yield, regardless of the source. Application of source F2 increased coffee yield similarly to KCl at the recommended K rate for coffee (150 kg ha-1 K2O), proving efficient as K supply for coffee. Potassium application increased macronutrient export in coffee, especially in the growing season with higher yield.

Soil fertility, nutrition and yield of maize and barley with gypsum application on soil surface in no-till

Annual crop yield and nutrition have shown differentiated responses to modifications in soil chemical properties brought about by gypsum application. The aim of this study was to evaluate the effect of gypsum application rates on the chemical properties of a Latossolo Bruno (Clayey Oxisol), as well as on the nutrition and yield of a maize-barley succession under no-till. The experiment was set up in November 2009 in Guarapuava, Parana, Brazil, applying gypsum rates of 0.0, 1.5, 3.0, 4.5, and 6.0 Mg ha-1 to the soil surface upon sowing maize, with crop succession of barley. Gypsum application decreased the levels of Al3+ and Mg2+ in the 0.0-0.1 m layer and increased soil pH in the layers from 0.2-0.6 m depth. Gypsum application has increased the levels of Ca2+ in all soil layers up to 0.6 m, and the levels of S-SO4(2-) up to 0.8 m. In both crops, the leaf concentrations of Ca and S were increased while Mg concentrations have decreased as a function of gypsum rates. There was also an effect of gypsum rates on grain yield, with a quadratic response of maize and a linear increase for barley. Yield increases were up to 11 and 12 % in relation to control for the maximum technical efficiency (MTE) rates of 3.8 and 6.0 Mg ha-1 of gypsum, respectively. Gypsum application improved soil fertility in the profile, especially in the subsurface, as well as plant nutrition, increasing the yields of maize and barley.