Avaliação do efeito da megadose de vitamina A no colostro humano

The mothers supplementation of vitamin A in the postpartum comes being a measure of intervention sufficiently used in the combat to the vitamin deficiency. The objective of this work was to evaluate the effect of the mother megadose of vitamin A under the levels of retinol in colostrum of postpartum mothers receiving care at the Januário Cicco Maternity School (MEJC), Natal, RN, as well as analyzing the influence of the maternal nutritional status in the reply to this supplementation. The study it was transversal type, with participation of 91 women in labor divided in group had participated of the study have controlled (44 women) and supplemented group (47 women). In the period of the morning blood and milk had been collected (milk 0h). After that a capsule of retinil palmitate of (200 000 UI or 60 mg) was supplied to the supplemented group. Another aliquot of colostro was after gotten 24h of the first collection (milk 24h). Retinol in milk and serum was quantified through the High Pressure Liquid Chromatography. The vitamin ingestion was evaluated by the questionnaire of frequency of alimentary consumption. The levels of serum retinol were 40.6 ± 10.6 and 35.9 ± 10.9 µg/dL in the groups controlled and supplemented, respectively. The women had presented a satisfactory average ingestion of vitamin (1492,4 µgRAE/dia), however with high prevalence of inadequate consumption (23%). Average values of retinol in milk 0h had been found and 24h of 93.5 ± 50.3 µg/dL and 99.1 ± 49.3 µg/dL has the group controlled group, respectively (p>0.05). After the supplementation had a significant increase in the levels of retinol of the supplemented group, being found values of 102.0 ± 56.0 µg/dL and 196.1 ± 74.0 µg/dL for milk 0h and 24h, respectively (p<0.0001). The women in labor presented different answers to the supplementation influenced for the basal levels of retinol in colostrum. It was possible to verify that women with deficient levels of retinol in milk had transferred more retinol to milk 24h than ones with adjusted levels, showing a percentage of reply equivalent to 326.1% and 86.5% of increase, respectively (p< 0.0001). Although the apparent normality found in the serum, the studied women are considered of risk to the development of the vitamin deficiency, and megadose was efficient in first 24h after the supplementation and wakes up with the mechanisms considered for transference of vitamin A to the milk

Interventions for dysphagia in acute stroke (Review)

Background It is unclear how dysphagic patients should be fed and treated after acute stroke. Objectives The objective of this review was to assess the effect of different management strategies for dysphagic stroke patients, in particular how and when to feed, whether to supplement nutritional intake, and how and whether to treat dysphagia. Search strategy We searched the Cochrane Stroke Group trials register, Medline, Embase, ISI, and existing review articles.We contacted researchers in the field and equipment manufacturers. Date of the most recent searches: March 1999. Selection criteria Unconfounded truly or quasi randomised controlled trials in dysphagic patients with acute/subacute (within 3 months) stroke. Data collection and analysis Three reviewers independently applied the trial inclusion criteria. Two reviewers assessed trial quality and extracted the data. Main results Percutaneous endoscopic gastrostomy (PEG) versus nasogastric tube (NGT) feeding: two trials (49 patients) suggest that PEG reduces end-of-trial case fatality (Peto Odds Ratio, OR 0.28, 95% CI 0.09 to 0.89) and treatment failures (OR 0.10, 95% CI 0.02 to 0.52), and improves nutritional status, assessed as weight (Weighted Men Difference, WMD +4.1 kg, 95% CI -4.3 to +12.5), mid-arm circumference (WMD +2.2 cm, 95% CI -0.5 to +4.9) or serum albumin (WMD + 7.0 g/l, 95% CI +4.9 to +9.1) as compared with NGT feeding; two larger studies are ongoing. Timing of feeding: no completed trials; one large study is ongoing. Swallowing therapy for dysphagia: two trials (85 patients) suggest that formal swallowing therapy does not significantly reduce end-of-trial dysphagia rates (OR 0.55, 95%CI 0.18 to 1.66). Drug therapy for dysphagia: one trial (17 patients); nifedipine did not alter end-of-trial case fatality or the frequency of dysphagia. Nutritional supplementation: one trial (42 patients) found a non-significant trend to a lower case fatality, and significantly increased energy and protein intake; one large trial is ongoing and data is awaited from two other studies. Fluid supplementation: one trial (20 patients) found that supplementation did not alter the time to resolution of dysphagia. Authors’ conclusions Too few studies have been performed, and these have involved too few patients. PEG feeding may improve outcome and nutrition as compared with NGT feeding. Further research is required to assess how and when patients are fed, and the effect of swallowing or drug therapy on dysphagia.

Variação sazonal da concentração de nutrientes em folhas de bananeiras, no Vale do Ribeira-SP

The Vale do Ribeira, SP, main agricultural activity is the banana crop, which accounts for most of this fruit production in the State of São Paulo. The nutritional balance of the plant is one of the most important factors for the banana plant can complete the cycle and achieve high productivity. Aiming to evaluate the seasonal variation of leaf nutrient concentration in banana plants in Vale do Ribeira-SP, we used the results of 252 chemical analyses of plant tissue, collected from August 2009 to September 2010, in the 18 representative properties for the region, ten cultivated with subgroup Cavendish banana plant and eight of subgroup Prata banana plant. The largest variation between the macronutrient occurred for K and S, and among the micronutrients, especially for Fe and B. In some dates of evaluation, there was a higher leaf concentration of P, K, Ca and Zn, in subgroup Cavendish banana plants, while the subgroup Prata banana plants showed higher leaf concentration, especially of Mn, B and N. Climatic conditions, especially rain, influenced the leaf nutrient content, especially for K, N, S, B and Fe.

Factors associated with obesity in Brazilian children enrolled in the School Health Program: a case-control study

Case-control studies evaluating the factors associated with childhood obesity are scarce in Brazil. We aimed to analyze the factors associated with obesity in Brazilian schoolchildren enrolled in the School Health Program.A case-control study was conducted on 80 schoolchildren aged 7 to 9 years, 40 of them obese and 40 of normal weight according to the cut-off points established by the World Health Organization (2007). Weight, height and waist circumference were obtained. Socioeconomic, demographic, health, eating behavior and lifestyle data were collected by applying a questionnaire to the person responsible and by determining his/her nutritional status. A binary unconditional logistic regression model (univariate and multivariate) was used for data analysis. The prevalence of obesity was 7.21%. The final model showed that duration of breast-feeding ≥6 months of age (OR 5.3; 95% CI: 1.3-22.1), excess weight of the person responsible (OR 7.1; 95% CI: 1.2-40.2), a sedentary level of physical activity (OR 4.1; 95% CI: 1.115.5), and fast chewing (OR 7.4; 95% CI: 2.1-26.9) were significantly associated with childhood obesity. The factors associated with obesity in schoolchildren were duration of breast-feeding ≥6 months, persons responsible with excess weight, and sedentary children who chew fast. The present study contributes information to be used for the health actions planned by the School Health Program.

Association between ferritin, high sensitivity c-reactive protein (hsCRP) and relative abundance of Hepcidin mRNA with the risk of type 2 diabetes in obese subjects

Obesity and Type 2 diabetes mellitus share a strong pro-inflammatory profile. It has been observed that iron is a risk factor in the development of type 2 diabetes. The aim of this study was to evaluate the relationship between iron nutritional status and inflammation with the risk of type 2 diabetes development in obese subjects. We studied 30 obese men with type 2 diabetes (OBDM); 30 obese subjects without diabetes (OB) and 30 healthy subjects (Cn). We isolated peripheral mononuclear cells (PMCs) and challenged them with high Fe concentrations. Total mRNA was isolated and relative abundance of TNF-αIL-6 and hepcidin were determined by qPCR. Iron status, biochemical, inflammatory and oxidative stress parameters were also characterized. OBDM and OB patients showed increased hsCRP levels compared to the Cn group. OBDM subjects showed higher levels of ferritin than the Cn group. TNF-α and IL-6 mRNA relative abundances were increased in OBDM PMCs treated with high/Fe. Hepcidin mRNA was increased with basal and high iron concentration. We found that the highest quartile of ferritin was associated with an increased risk of type 2 diabetes when it was adjusted to BMI and HOMA-IR; this association was independent of the inflammatory status. The highest level of hepcidin gene expression also showed a trend of increased risk of diabetes, however it was not significant. Levels of hsCRP over 2 mg/L showed a significant trend of increasing the risk of diabetes. In conclusion, iron may stimulate the expression of pro-inflammatory genes (TNF-α and IL-6), and both hepcidin and ferritin gene expression levels could be a risk factor for the development of type 2 diabetes. Subjects that have an increased cardiovascular risk also have a major risk to develop type 2 diabetes, which is independent of the BMI and insulin resistance state.

Estado nutricional, hábitos saludables, calidad de vida y somnolencia diurna en personal de ocio nocturno de Córdoba

Premio extraordinario de Trabajo Fin de Máster curso 2013-2014

The influence of the initial state of nutrition on the lifespan of patients with amyotrophic lateral sclerosis (ALS) during home enteral nutrition

Aim: Amyotrophic lateral sclerosis (ALS) is a chronic, neurodegenerative disease, which leads to development of malnutrition. The main purpose of this research was to analyze the impact of malnutrition on the course of the disease and long-term survival. Material and methods: A retrospective analysis has been performed on 48 patients (22 F [45,83%] and 26 M [54,17%], the average age of patients: 66,2 [43-83]) in 2008-2014.The analysis of the initial state of nutrition was measured by body mass index (BMI), nutritional status according to NRS 2002, SGA and concentration of albumin in blood serum. Patients were divided into two groups, depending on the state of nutrition: well-nourished and malnourished. The groups were created separately for each of these, which allowed an additional comparative analysis of techniques used for the assessment of nutritional status. Results: Proper state of nutrition was interrelated with longer survival (SGA: 456 vs. 679 days, NRS: 312 vs. 659 vs. 835 days, BMI: respectively, 411, 541, 631 days, results were statistically significant for NRS and BMI). Concentration of albumin was not a prognostic factor, but longer survival was observed when level of albumin was increased during nutritional therapy. Conclusions: The initial nutrition state and positive response to enteral feeding is associated with better survival among patients with ALS. For this reason, nutritional therapy should be introduced as soon as possible.

Prevalencia de anemia con sus factores asociados en niños/as de 12 a 59 meses de edad y capacitación a los padres de familia en el Centro de Desarrollo Infantil de la Universidad de Cuenca. Cuenca, diciembre 2015 - mayo 2016

OBJETIVO: Determinar la prevalencia de anemia en niños y niñas de 12 a 59 meses de edad con sus factores asociados, y capacitación a padres de familia en el Centro de Desarrollo Infantil de la Universidad de Cuenca (CEDIUC), METODOLOGÍA: Esta investigación se basó en un estudio descriptivo – transversal de prevalencia, se efectuó mediante la obtención de pruebas de hemoglobina a 90 niños/as de 12 a 59 meses de edad y cuestionarios a los padres sobre factores de riesgo; a los mismos se les aplicó encuestas validadas para visualizar el grado de conocimientos, actitudes y prácticas sobre la alimentación y nutrición respecto a la deficiencia de hierro. Se manejó frecuencias y porcentajes, y para las variables numéricas media, mediana y moda en programas estadísticos. RESULTADOS: La prevalencia de anemia fue en total del 43,3%, el 30% de los niños/as presentó anemia leve y un 13,3% padeció de anemia moderada. La afección tuvo un asocio importante con respecto a la edad, género, lugar de residencia, condición socioeconómica, factores perinatales y estado nutricional actual. Sobre los conocimientos y prácticas en relación a la alimentación, se pudo señalar que gracias a las capacitaciones se mejoró del 31,4% a un 89,9% al finalizar el estudio. CONCLUSIÓN: Se logró evidenciar ciertas relaciones importantes entre anemia e indicadores de riesgo a pesar del número reducido de participantes. Brindar charlas y talleres de manera periódica a los padres y personal del CEDIUC para mejorar sus conocimientos y prevenir complicaciones a futuro se considera oportuno, necesario y preventivo.

Relación de la imagen corporal percibida con el índice de masa corporal real en estudiantes de la Escuela de Tecnología Médica de la Universidad de Cuenca. Cuenca octubre 2015 – marzo 2016

OBJETIVO: Determinar la relación de la imagen corporal percibida con el índice de masa corporal real en estudiantes de la Escuela de Tecnología Médica de la Universidad de Cuenca. MATERIALES Y METODOS: Estudio transversal efectuado en estudiantes de la Escuela de Tecnología Médica, con una muestra probabilística aleatoria de 250 alumnos. Previo consentimiento informado, se encuestó a los estudiantes a través del “Cuestionario de la forma corporal” elaborado por: Cooper, Taylor y Fairburn; posteriormente se les presentó a los estudiantes el test de fotografías corporales de los autores Harris y Col., en el cual eligieron una de las figuras con las que se sentían mejor identificados; consecutivamente se procedió a la toma de las medidas antropométricas para la obtención del estado nutricional; finalmente se comparó la imagen corporal percibida con el estado nutricional de cada estudiante. La información fue analizada en el programa SPSS V22 y Excel 2013. RESULTADOS: Del total de la muestra de 251 estudiantes, el 69.7% presentaron un estado nutricional normal; el 4.4% bajo peso; el 20.7% sobrepeso y el 5.2% presentó obesidad. El 67.3% de los estudiantes presentó una adeudada percepción de su imagen corporal, el 6.8% sobrestima su peso y el 25.9% de la muestra lo subestimó. CONCLUSIONES: La mayor parte de los estudiantes universitarios presentaron una correcta percepción de su imagen corporal, al compararla con el IMC real; se evidenció un mínimo porcentaje de distorsión, donde se presentó una tendencia a la subestimación, condición que aumenta el riesgo de padecer enfermedades relacionadas con la alimentación.

Valores hematológicos y bioquímicos, y su asociación con el estado nutricional, en escolares urbanos. Cuenca

Objetivo: Determinar los valores hematológicos y bioquímicos y su asociación con el estado nutricional, en escolares urbanos de Cuenca. Materiales y métodos: Estudio transversal analítico, muestra aleatorizada por conglomerados, de 585 escolares entre 5 y 12 años de las escuelas urbanas de Cuenca, periodo 2012-2013. Se determinó el estado nutricional usando curvas de crecimiento para niños yadolescentes (z-score), índice de masa corporal por edad y sexo, según las recomendaciones de la Organización Mundial de la Salud; con los valores de los análisis hematológicos y bioquímicos practicados, se relacionaron los resultados de laboratorio con el estado nutricional. Resultados: La media de edad en la población fue de 8.87±1.9 años; promedio en valores hematológicos: glóbulos rojos 4.82±0.31 x 106/ml; glóbulos blancos 7.15±1.86 x 103/ ml; hemoglobina 13.66±1.34 g/dL; hematocrito 40.59±3.92%; volumen corpuscular medio (VCM) 83.64±4.03fl; hemoglobina corpuscular media (HCM) 38.31±1.27pg. Promedio de valores bioquímicos: proteína total 6.92±1.04g/ dL, albúmina sérica 4.37±0.7g/dL, hierro sérico 87.40±35.31μg/dL. El 19.3% presentó malnutrición (desnutrición 1.2%, sobrepeso 12.8% y obesidad 5.3%), existiendo asociación estadísticamente significativa (p<0.05) con glóbulos rojos. Existieron diferencias estadísticamente significativas, entre niños y niñas, en valores de hierro, VCM y HCM; y respecto de malnutrición, en hierro sérico, glóbulos rojos, glóbulos blancos, hematocrito y VCM. Conclusiones: Se encontró asociación entre el estado nutricional y los valores hematológicos y bioquímicos. Se determinó prevalencia alta de sobrepeso y obesidad en población escolar urbana de Cuenca, similar a la reportada en otros estudios.

Food consumption and risk of malnutrition in community-dwelling very old Spanish adults (≥ 80 years)

Introduction: There are few studies assessing overall diet and food patterns of the oldest population. Objectives: To examine food groups consumption (grams and servings) and their compliance with the dietary guidelines in community-dwelling very old Spanish adults. The relationship with the risk of malnutrition was also studied. Methods: Within the cross-sectional health study of elderly people of Villanueva de la Cañada (Madrid, Spain), in 98 non-institutionalized elders aged ≥ 80 years (66% women) food consumption was calculated from a 24-hour dietary recall and nutritional risk was assessed by Mini Nutritional Assessment (MNA). Statistical significance was evaluated at 95% confidence level (p < 0.05). Results: Men consumed significantly higher amounts of snacks/pickles and alcoholic beverages. The consumption of cereals/grain products (2 servings/day), vegetables (1.5 servings/day) and meat, fish, eggs (1.4 servings/day), was below desirable levels. As nutritional status got worse, fruit consumption was significantly smaller (p = 0.039). Relatively weak but highly significant correlations were found between MNA and oils/fats, fruits and alcoholic beverages. After adjustment for energy intake, oils and fats and fruits associations disappeared whereas a negative association between milk/dairy products and MNA was found. Conclusions: Dietary patterns of the elderly population of Villanueva are departing from the traditional Mediterranean diet and though adequate consumption of fruits, milk/dairy products, oils/fats and sugar/confectionery has been achieved, cereals/grain products, vegetables and the meat,fish,eggs group consumption was below the desirable levels. Deterioration of the nutritional status coincided with a reduction in the consumption of all food groups except for ready meals and milk/dairy products whose consumption increased. Further research on the influence of fruit, milk/dairy products, wine and olive oil consumption on nutritional status is required.

Alimentos fortificados con hierro en niños entre 6 a 23 meses del Hospital Vicente Corral Moscoso en la ciudad de Cuenca-Ecuador 2015

ANTECEDENTES: Los niños de 6 a 23 meses son vulnerables a déficit por micronutrientes por esto la OMS recomienda la fortificación con hierro. En Ecuador el 62% de niños de 6 a 11 meses y el 32,4% de niños de 12 a 23 meses, presentan anemia por déficit de hierro OBJETIVO GENERAL: Describir la fortificación con hierro de los alimentos de los niños y niñas de 6 a 23 meses de edad, en su hogares, previo a su ingreso en el Hospital Vicente Corral Moscoso en un periodo de 5 meses en el año 2015 METODOLOGÍA: Estudio descriptivo en 171 niños de 6 a 23 meses ingresados en el Hospital Vicente Corral Moscoso de Cuenca en el 2015. Se recolectaron los datos demográficos acerca de la alimentación fortificada con hierro. RESULTADOS: El 50,8% de los niños estuvieron entre 6 y 12 meses de edad, el 64,1% tuvo estado nutricional normal, el 42,1% fueron hospitalizados por neumonía, el 58,5% viven en zonas urbanas, el 53,85% tiene familias nucleares, el 56,1% con nivel de instrucción básica, el 64,3% de las cuidadoras se dedicaba a quehaceres domésticos. El 52% de niños recibió alimentos fortificados con hierro. Podemos decir que no se encontró relación estadística entre la ingesta de alimentos fortificados y las variables demográficas. CONCLUSIONES: El porcentaje de niños que reciben alimentos fortificados con hierro fue del 52%, por lo tanto es importante promover la ingesta de alimentos fortificados con hierro, para obtener un crecimiento y desarrollo óptimo en los niños

Desvendando a resposta dos eosinófilos, dos neutrófilos e dos monócitos nas parasitoses intestinais, na asma e na associação de ambas em crianças

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Medicina, Pós-graduação em Medicina Tropical, 2015.

Frecuencia de hipertensión arterial en los adultos mayores de las parroquias urbanas de Cuenca-Ecuador, 2015

Introducción: A nivel mundial la población de adultos mayores se incrementa, Ecuador no se queda fuera de esta transición demográfica y así aumentan también todas las enfermedades asociadas con la edad, principalmente la hipertensión arterial. Objetivo: Determinar la frecuencia de hipertensión arterial en adultos mayores de las parroquias urbanas de la ciudad de Cuenca, 2015. Metodología: Se realizó un estudio descriptivo en una muestra de 378 adultos mayores. Fueron hipertensos aquellos pacientes que tengan dos tomas de presión arterial separadas como mínimo una semana en las cuales la presión arterial sistólica sea >o= a 140 mmHg y presión arterial diastólica >o= a 90 mmHg. Se clasificó según parámetros sociodemográficos, antecedentes familiares, estado nutricional y actividad física. El muestreo fue de las zonas censales de cada parroquia, se usó un muestreo aleatorio simple. Los datos fueron analizados en el programa SPSS versión 15.0, utilizando distribución de frecuencias, medidas de tendencia central: media y medidas de dispersión: desvió estándar. Resultados: la frecuencia de hipertensión arterial fue 52,5%. El 65,1% de hipertensos fueron mujeres y el 34.9% hombres. El 57,6% de hipertensos fueron estuvieron entre los 65 y 74 años. El 41,2% tenía instrucción primaria completa. El 76,4% no tenía una ocupación laboral. El 51,2% no tenía antecedentes familiares de HTA. El 40% realizaba actividad física moderada. El 41,9% presentó obesidad. Conclusión: la frecuencia de hipertensión arterial en los adultos mayores de las parroquias urbanas de la ciudad de Cuenca fue del 52,5%

Adubação de capim-elefante com composto orgânico produzido com resíduos animais.

Resumo: A utilização do composto orgânico proveniente de resíduos da criação e abate de pequenos ruminantes pode elevar a produção de matéria seca do capim-elefante, tendo em vista o teor de nutrientes contidos nesse fertilizante orgânico, diminuindo os impactos da produção animal sobre o ambiente e reduzindo os custos de produção na área de capineira de capim-elefante. Dada à escassez de informações na literatura e a importância do manejo adequado da adubação orgânica na agropecuária, objetivou-se avaliar os atributos químicos e físicos do solo, o estado nutricional e a produção do capim-elefante submetido à aplicação de doses do composto orgânico proveniente de resíduos da produção e abate de pequenos ruminantes. O delineamento experimental adotado foi em parcelas subdivididas, com medidas repetidas no tempo, sendo as parcelas as doses (0; 13,3; 26,6; 39,9; 52,3; 79,8 t ha-1 ) de composto orgânico e um tratamento adicional com adubos minerais e as subparcelas os ciclos (1, 2, 3 e 4) com 4 blocos, totalizando 28 parcelas. As variáveis mensuradas foram atributos físicos e químicos do solo, a diagnose foliar e a produtividade de capim-elefante. Para o fator ciclo, a adubação orgânica incrementou a umidade gravimétrica e umidade volumétrica e ainda houve diminuição da densidade de partículas em função dos ciclos. Com as doses do fertilizante orgânico houve aumento nas concentrações da matéria orgânica, amônio, nitrato, amônio + nitrato, fósforo e saturação por base; houve redução do valor da acidez potencial, além da elevação dos teores de nitrogênio e fósforo nas plantas. As doses de composto orgânico aumentaram a biomassa de forragem total de capim elefante. A adubação mineral proporcionou maior incremento da produção do capim em relação à adubação orgânica no decorrer dos ciclos. Abstract: The use of organic compost from residues of production and slaughter of small ruminants can increase dry matter production of elephant grass, in due function of quantity nutrients in this compost, thus reducing the animal production impacts in the environment and production costs in elephant grass fields. Due to the Lack of information in literature and the importance regarding organic fertilization in agriculture, the aim of this work was evaluate chemical and physical soil attributes, nutritional status in plants and production of elephant grass in function of doses of organic compound of residues of production and slaughter of small ruminants. The experimental design was in split-plot, with the main treatment the doses (0; 13,3; 26,6; 39,9; 52,3; 79,8 t ha-1 ) of organic compost and one additional treatment with mineral fertilization and secondary treatments was the cycles (1, 2, 3 and 4) with 4 blocks, and 28 plots. The measured variables were physical and chemical attributes in the soil, nutritional diagnosis in plants and production of elephant grass. For cycle factor the organic fertilization increased gravimetric and volumetric humidity, yet, occurred decrease of density in function of cycles. With the doses of organic compost increased organic matter, ammonium, nitrate, ammonium + nitrate, phosphor and base saturation; and decreased the value of potential acidity; and increased content of N and P in plants. The doses of organic compost increased the elephant grass production. The mineral fertilization increased the elephant grass production in relation of organic fertilization over the cycles.