548 resultados para Alimentació enteral
Resumo:
Aquest projecte de dos anys de durada, ha tingut com a objectius: el disseny i la creació de recursos multimèdia, així com, l’optimització de metodologies d'aplicació de sistemes telemàtics interactius per a la millora de la docència universitària. Com a entorn telemàtic s’ha utilitzat la plataforma de treball cooperatiu BSCW (Basic Support for Cooperative Work). S'ha dissenyat i produït un recurs multimèdia enfocat a l'alumnat de l'assignatura troncal Ciències naturals i la seva didàctica de la diplomatura de Mestre d'Educació Primària, que porta per títol 'Alimentació i nutrició humanes i la seva didàctica’ i es pot consultar a: http://www.ub.edu/didactica_ciencies/mqd06/. Aquest material està format per dues unitats: a) Alimentació i nutrició; b) L'ensenyament-aprenentatge de la digestió humana des d'una perspectiva constructivista. Les unitats s'han orientat a la millora de la formació inicial dels futurs mestres i tenen un enfocament de clar caire constructivista, amb exercicis interactius de detecció de concepcions alternatives, així com organitzadors previs, posteriors nodes expositius i d'obtenció d'informació, exercicis interactius destinats al canvi conceptual i una interactivitat d'avaluació final amb un cert caràcter sumatiu. Cada unitat es tanca amb un mapa conceptual dels continguts tractats. La metodologia emprada en la seva elaboració és una evolució de la que l'equip de la Universitat Pompeu Fabra va encetar en la web ‘Aracné. Ciència en xarxa’: http://www.edu365.com/aulanet/aracne/ (usuari i contrasenya: guest100), i va perfeccionar a 'Idees i vincles en el segle XX. La ciència': http://www.xtec.es/aulanet/seglexx/ (cal permetre que s'obrin finestres emergents), en ambdós casos hi ha col·laborat professorat del nostre grup d'innovació docent de la UB.
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Tradicionalment, els peixos marins s'han alimentat amb dietes altes en lípids amb ingredients d'origen marí, que contenen els àcids grassos essencials per a aquestes espècies. El subministrament dels olis i les farines de peix s'han vist afectats per l'augment de la ramaderia intensiva incloent l'aqüicultura i els fenòmens naturals que afecten la producció del mar. En diversos estudis s'ha observat que les dietes poden afectar la salut dels peixos cultivats. La quantitat i qualitat dels macronutrients, així com les vitamines i minerals essencials, poden afectar tant la incidència com la gravetat de determinades malalties infeccioses dels peixos. Alguns canvis en les dietes, encara que siguin molt subtils, poden influir greument en la capacitat de l'organisme de resistir els patògens oportunistes. Aquestes malalties microbianes causen grans pèrdues a l'aqüicultura intensiva i necessiten ser controlades per millorar el benestar dels animals i el benefici econòmic. Hi ha diferents tipus de substàncies conegudes per actuar com a immunoestimulants, però només unes poques són aptes per a la seva utilització en l'aqüicultura. Aquests immunoestimulants són extractes biològics i substàncies químiques sintètiques que estimulen la resposta immune mitjançant la promoció de la funció de cèl•lules fagocítiques.
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The objective was to evaluate the effect of ZnO-Functionalised-Sepiolite (ZnO-Sepiolite) to fulfil Zn requirements and health status of weaning piglets. Pre-starter Basal Diet (BD, corn– soybean based, from weaning till 14 days on trial) was calculated to provide 27 mg Zn/kg feed from raw materials and had no added ZnO and no antibiotics or organic acids. Treatments during pre-starter period were: 1) BD+90% of NRC Zn requirements completed with ZnO (ZnO90); 2) BD+90% of NRC Zn requirements completed with ZnO-Sepiolite (ZnOS90); 3) BD+3000 mg ZnO/kg of diet (ZnO3000); 4) BD+150 mg added Zn/kg diet from ZnO-Sepiolite (ZnOS150). The starter feed (corn–soybean based, from 14 till 31 days on trial) was common for all piglets, and met 90% NRC Zn requirements by adding ZnO. Diarrhea affected more than 50% of the animals of ZnO90, ZnOS90 and ZnOS150, and 33% of the ZnO3000 animals. Animals from ZnOS90 tended (Pb0.10) to improve Gain to Feed ratio (G:F) compared to animals from ZnO90 (0.830 kg/kg vs. 0.811 kg/kg for G:F). Performance of animals from ZnO3000 was not significantly different from the other treatments, and was numerically similar to animals from ZnOS90. The inclusion of ZnO at 3000 mg/kg of feed in the pre-starter period numerically decreased P in serum at the end of this period, with no effect on Ca level; normal levels were restored after 2 weeks of feeding the same levels of Zn than other animals. Animals fed ZnOSepiolite diets had numerically higher serum Ca than ZnO90 and ZnO3000 at 12 days and higher than ZnO90 at 28 days. Serum Zn levels were significantly higher for ZnO3000 than the other treatments.
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Two experiments were performed to determine the best strategy of use of the product TRACTcare® 4P (ITPSA) (TC, specific immunoglobulin-rich egg yolk powder within an energetic fatty acid matrix) in piglets from weaning and for 6 weeks, in diets without or with inclusion of antibiotics. Each trial was performed with 144 piglets in 24 pens, in a completely randomized design blocked by initial body weight. Feeds were formulated according to animal requirements in two periods. In the first trial no antibiotics were included in the feeds and no room disinfection from previous trial was performed; treatments were: 1) Negative control (NC); 2) NC+TC on top of the feed within the hopper for the first 3 days on trial (30 g/pig×day), and eventually if diarrhea appeared (TCOT); 3) NC+TC ad libitum provided in an extra hopper within the pen (TCAL); and 4) NC+TC at 5 g/kg added to the feed in the mixer (TC5). In the second trial, treatments were: 1) Positive control: basal diet that included 250 mg/kg amoxiciline (BD)+100 mg/kg colistine (AC); 2) BD+2 g/kg TC (TC2A); 3) BD+5 g/kg TC (TC5A); and 4) BD+8 g/kg TC (TC8A). In diets without antibiotics, the product TC at 5 g/kg in the feed numerically improved BW by 8% compared to Control animals, while G:F was almost identical between both groups. When antibiotics were used in the feed, replacement of colistin at 100 mg/kg for TC at 2 g/kg in feed numerically improved the performance compared to Positive control animals (for the whole trial period ADG 8% better: 390 g vs. 361 g; G:F 1% better: 0.748 kg/kg vs. 0.742 kg/kg), possibly due to the stimulation of feed consumption at weaning. In both trials, the lower number of dead and culled animals from TC5 and TC2A together with higher BW represented an advantage over Control treatments of 6% to 10% animals more and 15% to 17% total BW more at the end of the trial.
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Near infrared spectroscopy (NIRS) is a non-invasive method of estimating the haemoglobin concentration changes in certain tissues. It is frequently used to monitor oxygenation of the brain in neonates. At present it is not clear whether near infrared spectroscopy of other organs (e.g. the liver as a corresponding site in the splanchnic region, which reacts very sensitively to haemodynamic instability) provides reliable values on their tissue oxygenation. The aim of the study was to test near infrared spectroscopy by measuring known physiologic changes in tissue oxygenation of the liver in newborn infants during and after feeding via a naso-gastric tube. The test-retest variability of such measurements was also determined. On 28 occasions in 25 infants we measured the tissue oxygenation index (TOI) of the liver and the brain continuously before, during and 30 minutes after feeding via a gastric tube. Simultaneously we measured arterial oxygen saturation (SaO2), heart rate (HR) and mean arterial blood pressure (MAP). In 10 other newborn infants we performed a test-retest analysis of the liver tissue oxygenation index to estimate the variability in repeated intra-individual measurements. The tissue oxygenation index of the liver increased significantly from 56.7 +/- 7.5% before to 60.3 +/- 5.6% after feeding (p < 0.005), and remained unchanged for the next 30 minutes. The tissue oxygenation index of the brain (62.1 +/- 9.7%), SaO2 (94.4 +/- 7.1%), heart rate (145 +/- 17.3 min-1) and mean arterial blood pressure (52.8 +/- 10.2 mm Hg) did not change significantly. The test-retest variability for intra-individual measurements was 2.7 +/- 2.1%. After bolus feeding the tissue oxygenation index of the liver increased as expected. This indicates that near infrared spectroscopy is suitable for monitoring changes in tissue oxygenation of the liver in newborn infants.
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Análisis de la alteración de la permeabilidad intestinal (P.I.) en pacientes críticos afectos de insuficiencia cardiaca aguda o crónica descompensada empleando la prueba de lactulosa/manitol administrada por vía enteral con recogida de la diuresis siguiente para calcular su ratio. Conclusiones: Existe una alteración funcional aunque no se ha podido relacionar con la gravedad del paciente, una relación entre la alteración y la hipoperfusión sistémica, una asociación entre la mejora de la función intestinal y la supervivencia y una relación entre la elevación de procalcitonina y la alteración de la permeabilidad que explicaría la traslocación bacteriana como fuente de los signos de infección que suelen presentar.
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To study energy and protein balances in elderly patients after surgery, spontaneous energy and protein intake and resting energy expenditure (REE) were measured in 20 elderly female patients with a femoral neck fracture (mean age 81 +/- 4, SD, range 74-87 years; weight 53 +/- 8, range 42-68 kg) during a 5-6 day period following surgery. REE, measured over 20-40 min by indirect calorimetry using a ventilated canopy, averaged 0.98 +/- 0.15 kcal/min on day 3 and decreased to 0.93 +/- 0.15 kcal/min on day 8-9 postsurgery (p less than 0.02). REE was positively correlated with body weight (r = 0.69, p less than 0.005). Mean REE extrapolated to 24 hr (24-REE) was 1283 +/- 194 kcal/day. Mean daily food energy intake measured over the 5-day follow-up period was 1097 +/- 333 kcal/day and was positively correlated with 24-REE (r = 0.50, p less than 0.05). Daily energy balance was -235 +/- 351 kcal/day on day 3 (p less than 0.01 vs zero) and -13 +/- 392 kcal/day on day 8-9 postsurgery (NS vs zero) with a mean over the study period of -185 +/- 289 kcal/day (p less than 0.01 vs zero). When an extra 100 kcal/day was allowed for the energy cost of physical activity, mean daily energy balance over the 5-day study period was calculated to be -285 +/- 289 kcal/day (p less than 0.01 vs zero). Measurements of total 24-hr urinary nitrogen (N) excretion were obtained in a subgroup of 14 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Estudio sobre el estado nutricional de los pacientes ingresados en el servicio de Medicina digestiva
Resumo:
La malnutrició està present en el 30% dels pacients hospitalitzats. Aquest estat patològic causa una major aparició de complicacions intrahospitalàries, prolongació de l'estada hospitalària, i augment de la mortalitat. El nostre objectiu va ser avaluar el maneig de l'estat nutricional en el nostre servei (Medicina digestiva, de l'hospital La Fe). Per aconseguir-ho, es va realitzar un estudi observacional d'una cohort de pacients ingressats en el nostre servei, amb posterior anàlisi de les dades necessàries per a avaluar l'estat nutricional a nivell hospitalari (valors antropomètrics, valors analítics, proves de cribatge de risc malnutricional). S'han trobat dades que indiquen falta de conscienciació sobre la malnutrició per part del personal sanitari, i la influència negativa de la malnutrició sobre el pacient ingressat, encara que aquesta relació no aconsegueix nivells de significació estadística, sent necessari un augment de la grandària de la mostra per a obtindre dades significatives.
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En este trabajo se realiza un estudio de usabilidad para la elaboración óptima de una Web de un supermercado de alimentación online. Para tal fin, se sigue la filosofía del Diseño Centrado en el Usuario. En primer lugar, se presenta un análisis del problema de cara a identificar los requisitos básicos de usabilidad que necesita una Web de esta tipología: se estudia la literatura previa sobre el tema, se consulta a los usuarios y se realiza un análisis comparativo de las principales Webs de supermercados online de ámbito nacional. En segundo lugar, se procede a la elaboración de un prototipo basado en la información recogida en la fase de análisis, y teniendo en cuenta la estructura mental de los usuarios en cuanto a la organización de los productos, obtenida mediante la técnica del card sorting. Finalmente, se procede a evaluar la calidad del prototipo elaborado con una evaluación heurística llevada a cabo por expertos. De todo ello se obtienen una serie de recomendaciones que todo sitio Web de comercio electrónico (en especial supermercados de alimentación) debería cumplir si quiere ofrecer una Web adaptada a las necesidades del usuario.
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BACKGROUND AND AIMS: Critically ill patients with complicated evolution are frequently hypermetabolic, catabolic, and at risk of underfeeding. The study aimed at assessing the relationship between energy balance and outcome in critically ill patients. METHODS: Prospective observational study conducted in consecutive patients staying > or = 5 days in the surgical ICU of a University hospital. Demographic data, time to feeding, route, energy delivery, and outcome were recorded. Energy balance was calculated as energy delivery minus target. Data in means+/-SD, linear regressions between energy balance and outcome variables. RESULTS: Forty eight patients aged 57+/-16 years were investigated; complete data are available in 669 days. Mechanical ventilation lasted 11+/-8 days, ICU stay 15+/-9 was days, and 30-days mortality was 38%. Time to feeding was 3.1+/-2.2 days. Enteral nutrition was the most frequent route with 433 days. Mean daily energy delivery was 1090+/-930 kcal. Combining enteral and parenteral nutrition achieved highest energy delivery. Cumulated energy balance was between -12,600+/-10,520 kcal, and correlated with complications (P < 0.001), already after 1 week. CONCLUSION: Negative energy balances were correlated with increasing number of complications, particularly infections. Energy debt appears as a promising tool for nutritional follow-up, which should be further tested. Delaying initiation of nutritional support exposes the patients to energy deficits that cannot be compensated later on.
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Aquest treball consisteix en el disseny d'una ontologia universal sobre el domini de l'alimentació. L'ontologia es definirà utilitzant les eines necessàries proposades pel W3C per a la construcció de la web semàntica.
Resumo:
Introduction. Preoperative malnutrition is a major risk factor for increased postoperative morbidity and mortality. Definition and diagnosis of malnutrition and its treatment is still subject for controversy. Furthermore, practical implementation of nutrition-related guidelines is unknown. Methods. A review of the available literature and of current guidelines on perioperative nutrition was conducted. We focused on nutritional screening and perioperative nutrition in patients undergoing digestive surgery, and we assessed translation of recent guidelines in clinical practice. Results and Conclusions. Malnutrition is a well-recognized risk factor for poor postoperative outcome. The prevalence of malnutrition depends largely on its definition; about 40% of patients undergoing major surgery fulfil current diagnostic criteria of being at nutritional risk. The Nutritional Risk Score is a pragmatic and validated tool to identify patients who should benefit from nutritional support. Adequate nutritional intervention entails reduced (infectious) complications, hospital stay, and costs. Preoperative oral supplementation of a minimum of five days is preferable; depending on the patient and the type of surgery, immune-enhancing formulas are recommended. However, surgeons' compliance with evidence-based guidelines remains poor and efforts are necessary to implement routine nutritional screening and nutritional support.