A randomised clinical trial to assess the effect of total enteral and total parenteral nutritional support on metabolic, inflammatory and oxidative markers in patients with predicted severe acute pancreatitis (APACHE II >= 66)

Background: Total enteral nutrition (TEN) within 48 h of admission has recently been shown to be safe and efficacious as part of the management of severe acute pancreatitis. Our aim was to ascertain the safety of immediate TEN in these patients and the effect of TEN on systemic inflammation, psychological state, oxidative stress, plasma glutamine levels and endotoxaemia. Methods: Patients admitted with predicted severe acute pancreatitis (APACHE II score 15) were randomised to total enteral (TEN; n = 8) or total parenteral nutrition (TPN; n = 9). Measurements of systemic inflammation (C-reactive protein), fatigue ( visual analogue scale), oxidative stress ( plasma thiobarbituric acid- reactive substances), plasma glutamine and anti-endotoxin IgG and IgM antibody concentrations were made on admission and repeated on days 3 and 7 thereafter. Clinical progress was monitored using APACHE II score. Organ failure and complications were recorded. Results: All patients tolerated the feeding regime well with few nutrition-related complications. Fatigue improved in both groups but more rapidly in the TEN group. Oxidative stress was high on admission and rose by similar amounts in both groups. Plasma glutamine concentrations did not change significantly in either group. In the TPN group, 3 patients developed respiratory failure and 3 developed non-respiratory single organ failure. There were no such complications in the TEN group. Hospital stay was shorter in the TEN group [ 7 (4-14) vs. 10 (7-26) days; p = 0.05] as was time to passing flatus and time to opening bowels [1 (0-2) vs. 2 (1-5) days; p = 0.01]. The cost of TEN was considerably less than of TPN. Conclusion: Immediate institution of nutritional support in the form of TEN is safe in predicted severe acute pancreatitis. It is as safe and as efficacious as TPN and may be beneficial in the clinical course of this disease. Copyright (C) 2003 S. Karger AG, Basel and IAP.

Changes in biomass, chemical composition and nutritive value of Spartina alterniflora due to organic pollution in the Itanhaém River Basin (SP, Brazil)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Opinion of hepatic transplant waiting list patients regarding split liver transplantation

Background. Split liver transplantation (SLT) increases organ supply for hepatic transplantation. Long-term patient survival and complication rates seem to be equivalent between orthotopic liver transplantation (OLT) and SLT. There are controversies among transplant physicians due to an ethical dilemma between benefiting individual needs or those of society. Barshes and Goss (Am J Transplant 5:2047, 2005) demonstrated that the majority of adult liver transplant candidates are favorable to SLT. The aim of our study was to evaluate the opinions of patients at a Brazilian university hospital regarding SLT.Materials and Methods. A questionnaire with 14 questions was applied to 50 patients included in a hepatic transplant waiting list regarding SLT.Results. The overall attitudes of 66% of the participants were classified as utilitarian, 31% were classified as self-preserving, and 3% were undecided. Ninety-one percent of patients would be willing to share even if their expected survival after SLT was shorter than that with OLT. For 77% of patients, children must have priority over adults. However, 83% were unaware of the donors for pediatric transplantations.Conclusions. SLT is a consistent solution for organ demand despite controversies among transplant physicians. The present study demonstrated that most patients were favorable to SLT. In conclusion, attitudes toward graft sharing are not barriers to SLT.

Dacriocistorrinostomia externa em crianças

OBJETIVO: Avaliar a eficácia da dacriocistorrinostomia (DCR) externa realizada em crianças. MÉTODOS: O estudo foi retrospectivo, avaliando-se 16 crianças com idade inferior a 10 anos, portadoras de obstrução da via lacrimal e submetidas a DCR externa, no período de 1986 até 2001. Foram avaliadas as características dos portadores, as queixas apresentadas, o exame e o tipo de cirurgia efetuada, assim como o resultado do tratamento. RESULTADO: A amostra estudada não diferiu quanto ao sexo e faixa etária. A cirurgia mais realizada foi DCR sem o uso de entubação de vias lacrimais (87,5%). 62,5% tiveram resolução da epífora com um único procedimento e 81,0%, com dois. CONCLUSÃO: O resultado da DCR externa, quando realizada em crianças, é semelhante ao observado em adultos.

Nutrient Digestibility of Cereal Grain Products and By-products in Extruded Diets for Nile Tilapia

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Reação de cultivares de soja a isolado de Curtobacterium flaccumfaciens pv. flaccumfaciens, proveniente de feijoeiro

O objetivo deste trabalho foi avaliar a reação das cultivares de soja Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) 46, Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) 47, Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) 48, Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) 58, Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) 59, Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) 60, Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) 61, Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) 62, BRS 66, BRS 132, BRS 133, BRS 134, BRS 135, BRS 136, BRS 155, BRS 156, BRS 157, IAC/BR-21, MG/BR-46 (Conquista) e MG/BR-48 (Garimpo RCH) a um isolado de Curtobacterium flaccumfaciens pv. flaccumfaciens, proveniente de feijoeiro, usando dois métodos de inoculação, em casa de vegetação. Foram observados baixos níveis de severidade da doença nas cultivares de soja, independentemente do método de inoculação utilizado.

Validity and reliability of the Portuguese version of Mandibular Function Impairment Questionnaire

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

La política económica de Colombia en el período 1950-66 = The economic policy of Colombia in 1950-66

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