996 resultados para Alimentação parenteral


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Duas espécies de piranhas ocorrem no rio Ibicuí, um dos principais afluentes do rio Uruguai. Com o objetivo de analisar a distribuição e a alimentação destas espécies, foram realizadas coletas de dezembro de 1999 a janeiro de 2002, utilizando-se diferentes artes de pesca em três pontos do rio, sendo que cada ponto foi amostrado em dois ambientes (lêntico e lótico). Foram capturados 203 indivíduos de Serrasalmus maculatus Kner, 1858 e 86 de Pygocentrus nattereri Kner, 1858, sendo que a maior captura de ambas as espécies ocorreu no ambiente lêntico e próximo ao rio Uruguai, onde P. nattereri parece estar mais concentrada. O número de exemplares capturados por horário não apresentou variações significativas em P. nattereri enquanto que S. maculatus apresentou a maior captura na revisão da meia-noite. Juvenis de S. maculatus (2-4 cm de comprimento padrão) consumiram preferencialmente nadadeiras e insetos. Nas demais classes de tamanho de ambas as espécies, restos de peixes foi o alimento predominante, havendo sobreposição alimentar intra e interespecífica nas maiores classes (8-16 cm e >16 cm de comprimento padrão). Não foram constatadas diferenças no índice de repleção entre os horários e os ambientes para as duas espécies.

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No presente trabalho, comparamos a morfologia e o hábito alimentar de 18 espécies de peixes do alto rio Tocantins a fim de verificar se os padrões morfológicos obtidos para o conjunto das espécies estudadas corroboram os padrões tróficos e, portanto, se podem ser usados como caracteres preditivos da estrutura trófica da comunidade. A análise da dieta revelou ampla variedade de itens consumidos e distinção de três grandes grupos tróficos: espécies carnívoras/insetívoras/piscívoras, onívoras e herbívoras. A Análise dos Componentes Principais, baseada nos índices morfológicos, determinou a ordenação das espécies de acordo com tamanho da cabeça, diâmetro do olho, posição da boca e altura do corpo e permitiu a distinção de dois grandes grupos de espécies. Os grupos obtidos a partir dos índices morfológicos corroboram o padrão obtido a partir da análise da dieta das espécies. A análise ecomorfológica revelou-se uma ferramenta adequada na descrição de aspectos ecológicos das espécies estudadas, refletindo preferências alimentares e de uso do hábitat e pode ser usada como método preditivo da estrutura trófica da comunidade estudada.

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A biota aquática da bacia do rio Paraná tem sido impactada por várias barragens. Este estudo teve como objetivo caracterizar e comparar sazonalmente a alimentação dos peixes do rio Grande, à jusante da usina de Itutinga. Neste trecho de rio é esperada a redução do efeito sazonal devido à regulação do fluxo. A coleta foi realizada em janeiro e julho de 2010, com redes de emalhar e de arrasto. Os peixes foram fixados em formol e conservados em álcool para a análise dos conteúdos estomacais. A dieta foi caracterizada pelo índice alimentar (IA) e a guilda a que cada espécie pertence foi determinado pelo teste de χ². A alimentação de cada espécie e a ocorrência dos itens alimentares foram comparadas nos períodos de seca e chuva utilizando-se as análises de nMDS e SIMPER. Foram analisados 809 estômagos de 32 espécies de peixes categorizadas nas guildas piscívora, herbívora, iliófaga/detritívora, algívora, frugívora, invertívora e generalista, sendo esta a guilda de maior riqueza de espécies. O nMDS indicou menor diversificação na dieta em julho, quando foi observado um aumento na ocorrência de vegetal, invertebrados e sedimento. Este estudo ampliou o conhecimento dos hábitos alimentares dos peixes e o efeito do barramento local sobre a dieta das espécies em virtude da regularização do fluxo.

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Os AA. realizaram um trabalho com a finalidade de aumentar a população de Macaca mulatta na ilha do Pinheiro, RJ, através do conhecimento de dados comportamentais desta colônia. Neste estudo inicial são empregadas técnicas etológicas de observação direta visando a esclarecer aspectos da organização social, determinar a quantidade de animais discriminada por sexo e levantar as condições de alimentação. A população é constituída de 91 animais distribuídos em três grupos sociais, havendo 22 machos, 40 fêmeas e 29 filhotes.

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Objetivando ampliar o conhecimento da biologia de flebótomos em cativeiro, que propicie condições para mantê-los regularmente, estabelecemos colônias autônomas de Lutzomyia intermedia e Lutzomyia longipalpis, apresentando aqui dados referentes às observações sobre a alimentaçãodas larvas e adultos. A ração comercializada para peixes é bem aceita pelas larvas das duas espécies, em todos os estádios; é de fácil aquisição e de baixo custo, não favorecendo a proliferação de fungos. As larvas de L. intermedia e de L. longipalpis, em todos os estádios, aceitam rações alimentares de origem vegetal e de origem mista; porém as de 1º e 2º estádios de L. intermedia têm certa preferência pela ração de base vegetal, enquanto que as de 3º e 4º estádios de L. longipalpis ainda que discretamente, preferem ração de origem mista. A prévia alimentação com solução açucarada não é fator indispensável ao hematofagismo nas duas espécies. Ambas se alimentam bem em homem, cão, pinto ou hamster, mas a fonte de alimento sanguíneo mais adequada é o hamster, analisando-se aceitação da isca, desova, duração do ciclo e produtividade a partir do número de ovos postos. As fêmeas de L. longipalpis mostraram maior resistência ao jejum de sangue que as l. intermedia, embora ambas possam resistir, em mais de 70% até o 7º dia, apenas com alimentação de solução açucarada.

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Critically ill patients depend on artificial nutrition for the maintenance of their metabolic functions and lean body mass, as well as for limiting underfeeding-related complications. Current guidelines recommend enteral nutrition (EN), possibly within the first 48 hours, as the best way to provide the nutrients and prevent infections. EN may be difficult to realize or may be contraindicated in some patients, such as those presenting anatomic intestinal continuity problems or splanchnic ischemia. A series of contradictory trials regarding the best route and timing for feeding have left the medical community with great uncertainty regarding the place of parenteral nutrition (PN) in critically ill patients. Many of the deleterious effects attributed to PN result from inadequate indications, or from overfeeding. The latter is due firstly to the easier delivery of nutrients by PN compared with EN increasing the risk of overfeeding, and secondly to the use of approximate energy targets, generally based on predictive equations: these equations are static and inaccurate in about 70% of patients. Such high uncertainty about requirements compromises attempts at conducting nutrition trials without indirect calorimetry support because the results cannot be trusted; indeed, both underfeeding and overfeeding are equally deleterious. An individualized therapy is required. A pragmatic approach to feeding is proposed: at first to attempt EN whenever and as early as possible, then to use indirect calorimetry if available, and to monitor delivery and response to feeding, and finally to consider the option of combining EN with PN in case of insufficient EN from day 4 onwards.

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Continuous respiratory exchange measurements were performed on 10 healthy young women for 1 h before, 3 h during, and 3 h after either parenteral (iv) or intragastric (ig) administration of a nutrient mixture (52% glucose, 18% amino acid, and 30% lipid energy) infused at twice the postabsorptive resting energy expenditure (REE). REE rose from 0.98 +/- 0.02 (iv) and 0.99 +/- 0.02 kcal/min (ig) postabsorptively to 1.13 +/- 0.03 (iv) and 1.13 +/- 0.02 kcal/min (ig), resulting in nutrient-induced thermogenesis of 10 +/- 0.6 and 9.3 +/- 0.9%, respectively, when related to the metabolizable energy. The respiratory quotient rose from preinfusion values of 0.81 +/- 0.02 (iv) and 0.80 +/- 0.01 (ig) to 0.86 +/- 0.01 (iv) and 0.85 +/- 0.01 (ig). After nutrient administration the respiratory quotient fell significantly to below the preinfusion values. Plasma glucose and insulin concentrations rose during nutrient administration but were higher during the intravenous route. It is concluded that, although the response time to intragastric administration was delayed, the thermic effects and overall substrate oxidations were comparable during intravenous or intragastric administration, albeit, at lower plasma glucose and insulin concentrations via the intragastric route.

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BACKGROUND & AIMS: n-3 fatty acids are expected to downregulate the inflammatory responses, and hence may decrease insulin resistance. On the other hand, n-3 fatty acid supplementation has been reported to increase glycemia in type 2 diabetes. We therefore assessed the effect of n-3 fatty acids delivered with parenteral nutrition on glucose metabolism in surgical intensive care patients. METHODS: Twenty-four surgical intensive care patients were randomized to receive parenteral nutrition providing 1.25 times their fasting energy expenditure, with 0.25 g of either an n-3 fatty acid enriched-or a soy bean-lipid emulsion. Energy metabolism, glucose production, gluconeogenesis and hepatic de novo lipogenesis were evaluated after 4 days. RESULTS: Total energy expenditure was significantly lower in patients receiving n-3 fatty acids (0.015+/-0.001 vs. 0.019+/-0.001 kcal/kg/min with soy bean lipids (P<0.05)). Glucose oxidation, lipid oxidation, glucose production, gluconeogenesis, hepatic de novo lipogenesis, plasma glucose, insulin and glucagon concentrations did not differ (all P>0.05) in the 2 groups. CONCLUSIONS: n-3 fatty acids were well tolerated in this group of severely ill patients. They decreased total energy expenditure without adverse metabolic effects.

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A new, investigational, parenteral form of sparfloxacin was compared with ceftriaxone in the treatment of experimental endocarditis caused by either of three penicillin-susceptible streptococci or one penicillin-resistant streptococcus. Both drugs have prolonged half-lives in serum, allowing single daily administration to humans. Sparfloxacin had relatively low MICs (0.25 to 0.5 mg/liter) for all four organisms and was also greater than or equal to eight times more effective than the other quinolones against 21 additional streptococcal isolates recovered from patients with bacteremia. Ceftriaxone MICs were 0.032 to 0.064 mg/liter for the penicillin-susceptible strains and 2 mg/liter for the resistant isolate. Both antibiotics resulted in moderate bacterial killing in vitro. Rats with catheter-induced aortic vegetations were inoculated with 10(7) CFU of the test organisms. Antibiotic treatment was started 48 h later and lasted either 3 or 5 days. The drugs were injected at doses which mimicked the kinetics in human serum produced by one intravenous injection of 400 mg of sparfloxacin (i.e., the daily dose expected to be given to human adults) and 2 g of ceftriaxone. Both antibiotics significantly decreased the bacterial densities in the vegetations. However, sparfloxacin was slower than ceftriaxone in its ability to eradicate valvular infection caused by penicillin-susceptible bacteria. While this difference was quite marked after 3 days of therapy, it tended to vanish when treatment was prolonged to 5 days. In contrast, sparfloxacin was very effective against the penicillin-resistant isolate, an organism against which ceftriaxone therapy failed in vivo. No sparfloxacin-resistant mutant was selected during therapy. Thus, in the present experimental setting, this new, investigational, parenteral form of sparfloxacin was effective against severe infections caused by both penicillin-susceptible and penicillin-resistant streptococci.

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Undernutrition is a widespread problem in intensive care unit and is associated with a worse clinical outcome. A state of negative energy balance increases stress catabolism and is associated with increased morbidity and mortality in ICU patients. Undernutrition-related increased morbidity is correlated with an increase in the length of hospital stay and health care costs. Enteral nutrition is the recommended feeding route in critically ill patients, but it is often insufficient to cover the nutritional needs. The initiation of supplemental parenteral nutrition, when enteral nutrition is insufficient, could optimize the nutritional therapy by preventing the onset of early energy deficiency, and thus, could allow to reduce morbidity, length of stay and costs, shorten recovery period and, finally, improve quality of life. (C) 2009 Elsevier Masson SAS. All rights reserved.

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Patients with intestinal failure who receive HPN are at high risk of developing MBD. The origin of this bone alteration is multifactorial and depends greatly on the underlying disease for which the nutritional support is required. Data on the prevalence of this disease in our environment is lacking, so NADYA-SEMPE group has sponsored this transversal study with the aim of knowing the actual MBD prevalence. MATERIAL AND METHODS: Retrospective data from 51 patients from 13 hospitals were collected. The questionnaire included demographic data as well as the most clinically relevant for MBD data. Laboratory data (calciuria, PTH, 25 -OH -vitamin D) and the results from the first and last bone densitometry were also registered. RESULTS: Bone mineral density had only been assessed by densitometry in 21 patients at the moment HPN was started. Bone quality is already altered before HPN in a significant percentage of cases (52%). After a mean follow up of 6 years, this percentage increases up to 81%. Due to retrospective nature of the study and the low number of subjects included it has not been possible to determine the role that HPN plays in MBD etiology. Only 35% of patients have vitamin D levels above the recommended limits and the majority of them is not on specific supplementation. CONCLUSIONS: HPN is associated with very high risk of MBD, therefore, management protocols that can lead to early detection of the problem as well as guiding for follow up and treatment of these patients are needed.

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This document summarizes the issues raised in a think-tank meeting held by professionals with expertise in pediatric Home Parenteral Nutrition. This nutritional technology enables patients to return home to their family and social environment, improves their quality of life and decreases health-care costs; however, it is complex and requires an experienced nutritional support team. Patient selection is normally made according to their underlying disease, the estimated duration of support and family and social characteristics. The patient''s family must agree to take on caregiver's responsibilities and should be able to perform treatment safely and effectively after receiving proper training from the nutritional support team. Close monitoring must be carried out to ensure tolerance and effectiveness of nutritional support, thereby avoiding complications. This nutritional treatment achieves, in most cases, recovery and intestinal adaptation in varying periods of time. In certain diseases, and when home parenteral nutrition becomes complicated, intestinal transplant may be recommendable, so referral to rehabilitation units and Intestinal Transplantation should be made early on.

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Los datos existentes sobre el progresivo incremento de la infección con el virus de inmunodeficiencia humana (VIH) entre los adictos a las drogas por via parenteral (ADVP) y sus parejas e hijos, plantean la necesidad urgente de elaborar programas preventivos con el mayor grado de eficacia posible. En el presente trabajo nos proponemos tres objetivos: 1) Poner de manifiesto algunas insuficiencias observadas en los modelos deprevención que se aplican al caso del SIDA. 2) Conferir un énfasis especial a la influencia sobre los comportamientos preventivos frente al SIDA, de ciertos factores que, en general, no se tienen 10 bastante en cuenta en los modelos actuales como son: la magnitud del reforzamiento contingente a un determinado comportamiento y la demora con la que éste se recibe. 3) Exponer los resultados de una investigación realizada con drogadictos por via parenteral (Planes, 1991), cuyos objetivos eran conocer las relacionesexistentes entre la magnitud y la demora del reforzamiento contingente a los comportamientos sexuales preventivos y la frecuencia de dichos comportamientos

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INTRODUCTION In the critically ill patient, there is a continuous production of reactive oxygen species (ROS) that need to be neutralized to prevent oxidative stress (OS). Quantitatively speaking, the glutathione system (GSH) is the most important anti-oxidant endogenous defense. To increase it, glutamine supplementation has been shown to be effective by protecting against the oxidative damage and reducing the morbimortality. OBJECTIVE To assess the effect of adding an alanylglutamine dipeptide to PN on lipid peroxidation lipidica and glutathione metabolism, as well as its relationship with morbidity in critically ill patients. METHODS Determination through spectrophotometry techniques of glutathione peroxidase, glutathione reductase, total glutathione, and maloniladdehyde at admission adn after seven days of hospitalization at the Intensive Care Unit (ICU) in 20 patients older than 18 years on parenteral nutrition therapy. RESULTS The group of patients receiving parenteral nutrition with glutamine supplementation had significant increases in total glutathione (42.35+/-13 vs 55.29+/-12 micromol/l; p<0.05) and the enzymatic activity of glutathione peroxidasa (470+/-195 vs 705+/-214 micromol/l; p<0.05) within one week of nutritional therapy, whereas the group on conventional parenteral nutrition did not show significant changes of any of the parameters studied (p>0.05). However, both mortality and ICU stay were not different between the study group, whereas the severity (assessed by the SOFA score) was lower in the group of patients receiving glutamine (SOFA 5+/-2 vs 8+/-1.8; p<0.05). CONCLUSIONS Glutamine intake in critically ill patients improves the antioxidant defenses, which leads to lower lipid peroxidation and lower morbidity during admission at the ICU.

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Hemodialysis patients present an increase in plasma homocysteine (Hcy) due to methylation impairment caused by uremia and the deficiency of the co-factors needed (vitamin B, folic acid). This correlates with a more common development of premature vascular disease. There is no consensus on the therapy, with a poor response to oral administration of conventional doses of folic acid. In this work, we assessed the response of hyperhomocysteinemia in 73 regular hemodialysis patients after the administration of 50 mg of parenteral folinic acid for 18 months. Plasma homocysteine of the patients at the time of the study beginning presented mean values of 22.67 (micromol/L). During the first year of supplementation the mean value was kept at 20 micromol/L. From the first year to the end of the 18-months observation period the mean homocysteine levels were 19.58 micromol/L. Although we found a clear trend towards a decrease in plasma homocysteine levels during the treatment period, there were no significant differences. Homocysteine levels did not come back to normal in none of the patients treated.