Biochemical and nutritional evaluation of patients with visceral leishmaniasis before and after treatment with leishmanicidal drugs

Introduction Visceral leishmaniasis (VL) is caused by the intracellular protozoan Leishmania donovani complex. VL may be asymptomatic or progressive and is characterized by fever, anemia, weight loss and the enlargement of the spleen and liver. The nutritional status of the patients with VL is a major determinant of the progression, severity and mortality of the disease, as it affects the clinical progression of the disease. Changes in lipoproteins and plasma proteins may have major impacts in the host during infection. Thus, our goal was evaluate the serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, glucose, albumin, globulin and total protein levels, as well as the body composition, of VL patients before and after treatment. Methods Nutritional evaluation was performed using the bioelectrical impedance analysis (BIA) to assess body composition. Biochemical data on the serum total cholesterol, HDL, LDL, triglycerides, glucose, albumin, globulin and total protein were collected from the medical charts of the patients. Results BIA indicated that both pre-treatment and post-treatment patients exhibited decreased phase angles compared to the controls, which is indicative of disease. Prior to treatment, the patients exhibited lower levels of total body water compared to the controls. Regarding the biochemical evaluation, patients with active VL exhibited lower levels of total cholesterol, HDL, LDL and albumin and higher triglyceride levels compared to patients after treatment and the controls. Treatment increased the levels of albumin and lipoproteins and decreased the triglyceride levels. Conclusions Our results suggest that patients with active VL present biochemical and nutritional changes that are reversed by treatment.

Chemical and nutritional evaluation of kernels of bocaiuva, Acrocomia aculeata (Jacq.) Lodd.

Protein characterization and results of proximate composition and mineral analyses of fruit kernels of bocaiuva, Acrocomia aculeata (Jacq.) Lodd., are reported. The kernels presented high contents of oil (51.7%), protein (17.6%) and fiber (15.8%). The seeds´ soluble proteins were isolated according to their solubility. The main separated proteins were globulins (53.5%) and glutelins (40.0%). Moreover, the presence of low molecular mass proteases in these two fractions was shown by the SDS-PAGE method. The assays of protease-inhibitory and hemagglutinating activities showed that bocaiuva´s protein fractions were not resistant to trypsin or chymotrypsin activities and that both had low lectin content. The globulin in vitro digestibility assay resembled a casein standard. Neither globulin nor glutelin enzymatic hydrolyses increased significantly (p < 0.05) after heat treatment. Threonine and lysine are the most limiting amino acids, respectively from two major protein fractions of the bocaiuva kernel, globulin (47.1% amino acid score) and glutelin (49.5% amino acid score), in terms of the theoretical profiles for children in the age range of 2 to 5 years recommended by the FAO/WHO. Bocaiuva kernels are found to be rich in calcium, phosphorus and manganese compared to some fruit nuts such as cashew and coconut.

Comparative analysis of vitamin A and iron content in food according to different food composition tables and nutritional evaluation software programs

The objective of this study was to analyze retinol equivalent and iron content in different food composition tables and nutritional evaluation software programs. A literature search was conduct to identify tables and software available in Brazil containing information about retinol equivalent and iron content that are currently used by nutritionists. Ten tables and five software programs were selected for this study. The methodology used to present the retinol equivalent and iron content was evaluated and no pattern to obtain such content was found in the tables and software programs analyzed. Only one of the tables had enough information for the calculation of retinol equivalents; this table is recommended to all Latin America As for the iron content, three of the tables analyzed stand out and therefore should be used; two of them are based on national foods and the other is recommended for use in all Latin America countries. None of the software programs evaluated use the conversion factors suggested by IVACG to assess the vitamin A content in foods. Special attention should be given to the content of iron provided in the software programs since they use tables as international sources and fortified foods.

Studies on Synthesis And Nutritional Evaluation of Prawn Feeds

Chemical Oceanography Division, School of Marine Sciences, Cochin University of Science and Technology

Nutritional evaluation of stage 5 chronic kidney disease patients on dialysis

CONTEXTO E OBJETIVO: Portadores de insuficiência renal crônica em diálise apresentam alta prevalência de desnutrição proteico-energética. Não existe ainda um método uniforme para avaliar o estado nutricional desses pacientes. Recomenda-se a aplicação de um conjunto de métodos subjetivos e objetivos para se chegar aos diagnósticos nutricionais adequados. O objetivo deste estudo é traçar o perfil nutricional de pacientes submetidos a hemodiálise. TIPO DE ESTUDO E LOCAL: Estudo transversal descritivo realizado na Unidade de Tratamento Dialítico de Araraquara, São Paulo, Brasil, em 2008. MÉTODOS: 48 pacientes tiveram seus indicadores antropométricos e bioquímicos caracterizados, sendo também submetidos ao questionário Avaliação Global Subjetiva modificada (SGAm), verificando-se possíveis correlações entre esses indicadores. RESULTADOS: A frequência de desnutrição moderada e grave variou de 22% a 54%, de acordo com o parâmetro utilizado. Com relação à adequação do peso ideal, 29% da amostra estavam com porcentagem de adequação abaixo do percentil 75, classificados como portadores de desnutrição moderada e grave. As correlações mais significativas foram observadas entre índice de massa corporal (IMC) e adequações de prega triciptal (PCT), circunferência do braço (CB) e circunferência muscular do braço (CMB); e entre o SGAm e adequações de CB e CMB. CONCLUSÃO: A desnutrição apresentou grande variabilidade de frequência entre os pacientes de acordo com o critério escolhido para avaliação. O acompanhamento nutricional de rotina e a validação de métodos que avaliem a composição corporal desses pacientes são de extrema importância para diagnosticar precocemente a desnutrição e assim prevenir complicações e reduzir as taxas de morbimortalidade nesta população.

Preoperative and Postoperative Nutritional Evaluation in Patients with Non-advanced Megaesophagus

Megaesophagus, an affection characterized by aperistalses of the esophageal body and deficient relaxation of lower esophageal sphincter, has disphagia as main symptom. The aim of this study was to evaluate the nutritional status of patients with non advanced megaesophagus in pre and post-operative periods of cardiomyotomy. Ten patients were evaluated at 5 moments (pre-operative - M 1 and post-operative - 1, 3, 6 ant 12 months after surgery). The anthropometric, hematimetric and biochemical parameters were studied in the 5 moments. Conclusions: 1. Most 017 the patients with non-advanced megaesophagus are eutrophic; 2. Surgical treatment determines an improvement in nutritional status and an increase in HDL cholesterol values.

Nutritional evaluation of elephant-grass silages with byproduct of annato

Objetivou-se avaliar o valor nutritivo de silagens de capim-elefante contendo subproduto do processamento do urucum. Vinte ovinos machos, não-castrados, foram distribuídos em delineamento inteiramente casualizado com cinco dietas (0; 4; 8; 12 e 16% de subproduto de urucum na silagem) e quatro repetições, e utilizados para estimar o consumo, a digestibilidade aparente de nutrientes, o teor de nutrientes digestíveis totais e o balanço de nitrogênio. A adição de subproduto de urucum elevou os consumos de matéria seca (MS), matéria orgânica (MO), proteína bruta (PB), fibra em detergente neutro (FDN), fibra em detergente ácido (FDA), extrato etéreo (EE), carboidratos não-fibrosos (CNF), carboidratos totais e nutrientes digestíveis totais (NDT), tanto em relação ao peso vivo (%PV) quanto em relação ao peso metabólico (g kg-1PV0,75). As digestibilidades de MS (55,95%), MO (58,19%), PB (45,34%), FDN (52,79%), FDA (45,79%), EE (34,96%) e CNF (99,86%) não foram influenciadas pela adição de subproduto de urucum. A inclusão de subproduto de urucum na silagem de capim-elefante promoveu aumento na digestibilidade dos carboidratos totais, no teor de NDT e no balanço de nitrogênio. A adição de subproduto de urucum em níveis de até 16% da matéria natural na ensilagem de capim-elefante melhora o consumo de nutrientes e o balanço de nitrogênio.

Nutritional evaluation of soy yoghurt in comparison to soymilk and commercial milk yoghurt. Effect of fermentation on soy protein

Soymilk was fermented using Lactobacillus delbrueckii ssp. bulgaricus and Streptococcus thermophilus. The soy yoghurt produced was evaluated in comparison to soymilk and commercial milk yoghurt by biological evaluation, rat growth, nitrogen balance assays and microbiological methods. Trypsin inhibitor activity and chemical composition were also determined for all samples. For the soy yoghurt, the growth and nitrogen balance values were not different from the control diet, but the nitrogen balance values were higher than for the soymilk, without significant difference in terms of growth assays. Compared to the commercial yoghurt, Net Protein Ratio and Nitrogen Utilization values were lower, but the Protein Efficiency Ratio, Biological Value and Net Protein Utilization values were equivalent, and for digestibility assays the best results were obtained with the soy yoghurt. The results indicated that soy yoghurt represents a good protein alternative to milk yoghurt and casein. The protein quality of soymilk evidently increased during the fermentation process using Lactobacillus delbrueckii ssp. bulgaricus and Streptococcus thermophilus, including a reduction in trypsin inhibitor levels of about 30%.

Biochemical and nutritional evaluation of patients with visceral leishmaniasis before and after treatment with leishmanicidal drugs

Introduction Visceral leishmaniasis (VL) is caused by the intracellular protozoan Leishmania donovani complex. VL may be asymptomatic or progressive and is characterized by fever, anemia, weight loss and the enlargement of the spleen and liver. The nutritional status of the patients with VL is a major determinant of the progression, severity and mortality of the disease, as it affects the clinical progression of the disease. Changes in lipoproteins and plasma proteins may have major impacts in the host during infection. Thus, our goal was evaluate the serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, glucose, albumin, globulin and total protein levels, as well as the body composition, of VL patients before and after treatment. Methods Nutritional evaluation was performed using the bioelectrical impedance analysis (BIA) to assess body composition. Biochemical data on the serum total cholesterol, HDL, LDL, triglycerides, glucose, albumin, globulin and total protein were collected from the medical charts of the patients. Results BIA indicated that both pre-treatment and post-treatment patients exhibited decreased phase angles compared to the controls, which is indicative of disease. Prior to treatment, the patients exhibited lower levels of total body water compared to the controls. Regarding the biochemical evaluation, patients with active VL exhibited lower levels of total cholesterol, HDL, LDL and albumin and higher triglyceride levels compared to patients after treatment and the controls. Treatment increased the levels of albumin and lipoproteins and decreased the triglyceride levels. Conclusions Our results suggest that patients with active VL present biochemical and nutritional changes that are reversed by treatment.

Fibula free flap reconstruction of the mandible in cancer patients: Evaluation of a combined surgical and prosthodontic treatment concept

The final goal of mandibular reconstruction following ablative surgery for oral cancer is often considered to be dental implant-supported oral rehabilitation, for which bone grafts should ideally be placed in a suitable position taking subsequent prosthetic restoration into account. The aim of this study was to evaluate the efficacy of a standardized treatment strategy for mandibular reconstruction according to the size of the bony defect and planned subsequent dental prosthetic rehabilitation. Data of 56 patients, who had undergone such a systematic mandibular fibula free flap reconstruction, were retrospectively analyzed. Early complications were observed in 41.5% of the patients but only in those who had been irradiated. Late complications were found in 38.2%. Dental implant survival rate was 92%, and dental prosthetic treatment has been completed in all classes of bony defects with an overall success rate of 42.9%. The main reasons for failure of the complete dental reconstruction were patients' poor cooperation (30.4%) and tumour recurrence (14.3%) followed by surgery-related factors (10.8%) such as implant failure and an unfavourable intermaxillary relationship between the maxilla and the mandible. A comparison of our results with the literature findings revealed no marked differences in the complication rates and implant survival rates. However, a systematic concept for the reconstructive treatment like the method presented here, plays an important role in the successful completion of dental reconstruction. The success rate could still be improved by some technical progress in implant and bone graft positioning.

Estado nutricional e níveis plasmáticos de trauma e seus precursores em pacientes portadores de neoplasias malignas de esôfago

Pós-graduação em Bases Gerais da Cirurgia - FMB

Evaluation of nutritional status in patients with endemic pemphigus foliaceus

Sixteen patients with endemic pemphigus foliaceus were submitted to nutritional evaluation. Ten had the localized form of the disease (Group G1) and six the disseminated form (Group G2). The patients were submitted to anthropometric measurements (weight, height, Quetelét index, tricipital skin fold, subscapular skin fold, arm circumference, arm muscle circumference, arm area, arm muscle area, and arm adipose area) and to laboratory evaluation by protein electrophoresis. Arm circumference, arm area and arm muscle area showed lower values in G2 than in G1. Weight and arm muscle circumference tended to the lower in G2 than in G1. Protein electrophoresis showed decreased albumin levels in both groups, with lower values in G2. Overall analysis of the results permits us to conclude that patients with endemic pemphigus foliaceus present signs and symptoms of protein, but not calorie, malnutrition and that this malnutrition is more marked in patients with disseminated pemphigus foliaceus.

Evaluation of nutritional status in patients with endemic pemphigus foliaceus

A avaliação nutricional foi realizada em dezesseis doentes portadores de pênfigo foliáceo endêmico, sendo dez portadores da forma localizada da doença (Grupo G1) e seis portadores da forma disseminada da mesma (Grupo G2). Foram realizadas avaliações antropométricas (peso, altura, índice de Quetelét, prega cutânea tricipital, prega cutânea subescapular, circunferência braquial, circunferência muscular do braço, área do braço, área muscular do braço, área adiposa do braço) e laboratorial (eletroforese de proteínas séricas). Quanto aos parâmetros antropométricos, observaram-se as seguintes alterações: a circunferência do braço, área do braço, e área muscular do braço mostraram valores mais baixos nos doentes do grupo G2 que nos do grupo G1. O peso e a circunferência muscular do braço, por sua vez, mostraram tendência a valores mais baixos nos doentes do grupo G2 que nos do grupo G1. A eletroforese de proteínas revelou valores de albumina diminuídos em ambos os grupos, e menores nos doentes do grupo G2. Quanto às demais frações, com exceção das beta globulinas, não foram evidenciadas alterações. A análise global dos resultados permite concluir que os doentes com pênfigo foliáceo endêmico apresentam um quadro de desnutrição proteica, mas não calórica. Esta desnutrição mostrou-se mais acentuada no pênfigo foliáceo disseminado.