RESUMEN
Sheep production systems in Brazilian caatinga rangelands require supplementation adapted to changes in floristic and chemical composition as dry seasons progress. Meeting sheep nutritional needs in extensive semiarid systems is challenging because of sheep dietary preferences and habits. The objective of this trial was to evaluate the substitutive effect of concentrate supplementation on grazing sheep in the Brazilian caatinga rangeland and its consequences on performance in different seasons. The trial was conducted from March to August 2013 at Embrapa Goat and Sheep in Sobral, Ceará State, Brazil. Thirty-two Brazilian Somali multiparous ewes were submitted to estrus synchronization and controlled breeding. At the start of the trial, ewes averaged 30.45 + 2.60 kg body weight (BW). Ewes were divided into four groups and individually offered 0, 200, 350, or 500 g supplement head-1 day-1. Intake prediction and digestibility trials were evaluated at three periods: rainy season (April), transition rainy-dry (June), and dry season (August). Sheep weights were taken every 14 days to measure their performance from late gestation until weaning. Ewe BW and body condition score changes were determined too. Lamb BW changes were also measured every 14 days from birth through weaning. A completely randomized design with split plot arrangement using eight replications was used for intake and digestibility measurements. The differences between supplement offered (0, 200, 350, and 500 g sheep-1) and season (rainy, transition rainy-dry, and dry) were submitted to analyses of variance and multiple means were separated, where differences were detected, using the Tukey's test. During lactation up through weaning, ewes supplemented at 500 g day-1 had greater BW than ewes without supplement. Ewes supplemented with 200 g concentrate head-1 day-1 had 9.1% greater (P ≤ 0.05) BW at weaning and their lambs had 19.7% greater birth and 16.6% heavier wean BW despite lower dry matter intake compared to unsupplemented animals. Supplementation with 200 g concentrate increased carrying capacity by 28.8% during the dry season and by 20.5% during the rainy season. This study confirmed that in the dry season, when quality of rangeland forages decreases, supplementation contributes to greater DMI, improves postpartum and lactation BW recovery of ewes, and contributes to greater lamb birth and wean weights. Moreover, supplementation leads to feed substitution effects that may increase rangeland resilience by mitigating overgrazing. Supplementation with 200 g concentrate can also prevent negative energy balance for grazing animals, improving longer postnatal recovery, longer intervals between parturitions, fewer double and is necessary to ensure a better BW at birth to lambs.
Asunto(s)
Digestión , Ingestión de Alimentos , Preñez , Oveja Doméstica/fisiología , Alimentación Animal/análisis , Crianza de Animales Domésticos , Fenómenos Fisiológicos Nutricionales de los Animales/efectos de los fármacos , Animales , Brasil , Dieta/veterinaria , Suplementos Dietéticos/análisis , Digestión/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Ingestión de Alimentos/efectos de los fármacos , Ecosistema , Femenino , Embarazo , Preñez/efectos de los fármacos , Distribución Aleatoria , Estaciones del Año , DesteteRESUMEN
Malnutrition constitutes a major public health concern worldwide and serves as an indicator of hospitalized patients’ prognosis. Although various methods with which to conduct nutritional assessments exist, large hospitals seldom employ them to diagnose malnutrition. The aim of this study was to understand the prevalence of child malnutrition at the University Hospital of the Ribeirão Preto Medical School, University of São, Brazil. A cross-sectional descriptive study was conducted to compare the nutritional status of 292 hospitalized children with that of a healthy control group (n=234). Information regarding patients’ weight, height, and bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained, and the phase angle was calculated. Using the World Health Organization (WHO) criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10% had undernutrition and 19.17% were overweight. Classification according to the bioelectrical impedance results of nutritional status was more sensitive than the WHO criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited undernutrition and 4.20% were overweight. After applying the WHO criteria in the unpaired control group (n=234), we observed that 100.00% of the subjects were eutrophic; however, 23.34% of the controls were malnourished according to impedance analysis. The phase angle was significantly lower in the hospitalized group than in the control group (P<0.05). Therefore, this study suggests that a protocol to obtain patients’ weight and height must be followed, and bioimpedance data must be examined upon hospital admission of all children.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Adulto Joven , Composición Corporal , Trastornos de la Nutrición del Niño/epidemiología , Impedancia Eléctrica , Índice de Masa Corporal , Brasil/epidemiología , Trastornos de la Nutrición del Niño/fisiopatología , Estudios Transversales , Pruebas Diagnósticas de Rutina/métodos , Hospitalización/estadística & datos numéricos , Hospitales Universitarios/estadística & datos numéricos , Evaluación en Enfermería , Evaluación Nutricional , Estado Nutricional/fisiología , PrevalenciaRESUMEN
Malnutrition constitutes a major public health concern worldwide and serves as an indicator of hospitalized patients' prognosis. Although various methods with which to conduct nutritional assessments exist, large hospitals seldom employ them to diagnose malnutrition. The aim of this study was to understand the prevalence of child malnutrition at the University Hospital of the Ribeirão Preto Medical School, University of São, Brazil. A cross-sectional descriptive study was conducted to compare the nutritional status of 292 hospitalized children with that of a healthy control group (n=234). Information regarding patients' weight, height, and bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained, and the phase angle was calculated. Using the World Health Organization (WHO) criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10% had undernutrition and 19.17% were overweight. Classification according to the bioelectrical impedance results of nutritional status was more sensitive than the WHO criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited undernutrition and 4.20% were overweight. After applying the WHO criteria in the unpaired control group (n=234), we observed that 100.00% of the subjects were eutrophic; however, 23.34% of the controls were malnourished according to impedance analysis. The phase angle was significantly lower in the hospitalized group than in the control group (P<0.05). Therefore, this study suggests that a protocol to obtain patients' weight and height must be followed, and bioimpedance data must be examined upon hospital admission of all children.
Asunto(s)
Composición Corporal , Trastornos de la Nutrición del Niño/epidemiología , Impedancia Eléctrica , Adolescente , Índice de Masa Corporal , Brasil/epidemiología , Niño , Trastornos de la Nutrición del Niño/fisiopatología , Preescolar , Estudios Transversales , Pruebas Diagnósticas de Rutina/métodos , Femenino , Hospitalización/estadística & datos numéricos , Hospitales Universitarios/estadística & datos numéricos , Humanos , Lactante , Masculino , Evaluación en Enfermería , Evaluación Nutricional , Estado Nutricional/fisiología , Prevalencia , Adulto JovenRESUMEN
The participation of regulatory T (Treg) cells in B cell-induced T cell tolerance has been claimed in different models. In skin grafts, naive B cells were shown to induce graft tolerance. However, neither the contribution of Treg cells to B cell-induced skin tolerance nor their contribution to the histopathological diagnosis of graft acceptance has been addressed. Here, using male C57BL/6 naive B cells to tolerize female animals, we show that skin graft tolerance is dependent on CD25+ Treg cell activity and independent of B cell-derived IL-10. In fact, B cells from IL-10-deficient mice were able to induce skin graft tolerance while Treg depletion of the host inhibited 100% graft survival. We questioned how Treg cell-mediated tolerance would impact on histopathology. B cell-tolerized skin grafts showed pathological scores as high as a rejected skin from naive, non-tolerized mice due to loss of skin appendages, reduced keratinization and mononuclear cell infiltrate. However, in tolerized mice, 40% of graft infiltrating CD4+ cells were FoxP3+ Treg cells with a high Treg:Teff (effector T cell) ratio (6:1) as compared to non-tolerized mice where Tregs comprise less than 8% of total infiltrating CD4 cells with a Treg:Teff ratio below 1:1. These results render Treg cells an obligatory target for histopathological studies on tissue rejection that may help to diagnose and predict the outcome of a transplanted organ.
Asunto(s)
Linfocitos B/inmunología , Supervivencia de Injerto/inmunología , Trasplante de Piel , Linfocitos T Reguladores/inmunología , Tolerancia al Trasplante/inmunología , Animales , Femenino , Citometría de Flujo , Factores de Transcripción Forkhead/inmunología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Factores de TiempoRESUMEN
The objectives of the present study were to describe and compare the body composition variables determined by bioelectrical impedance (BIA) and the deuterium dilution method (DDM), to identify possible correlations and agreement between the two methods, and to construct a linear regression model including anthropometric measures. Obese adolescents were evaluated by anthropometric measures, and body composition was assessed by BIA and DDM. Forty obese adolescents were included in the study. Comparison of the mean values for the following variables: fat body mass (FM; kg), fat-free mass (FFM; kg), and total body water (TBW; %) determined by DDM and by BIA revealed significant differences. BIA overestimated FFM and TBW and underestimated FM. When compared with data provided by DDM, the BIA data presented a significant correlation with FFM (r = 0.89; P < 0.001), FM (r = 0.93; P < 0.001) and TBW (r = 0.62; P < 0.001). The Bland-Altman plot showed no agreement for FFM, FM or TBW between data provided by BIA and DDM. The linear regression models proposed in our study with respect to FFM, FM, and TBW were well adjusted. FFM obtained by DDM = 0.842 x FFM obtained by BIA. FM obtained by DDM = 0.855 x FM obtained by BIA + 0.152 x weight (kg). TBW obtained by DDM = 0.813 x TBW obtained by BIA. The body composition results of obese adolescents determined by DDM can be predicted by using the measures provided by BIA through a regression equation.
Asunto(s)
Composición Corporal/fisiología , Óxido de Deuterio , Obesidad/fisiopatología , Adolescente , Niño , Impedancia Eléctrica , Femenino , Humanos , Técnicas de Dilución del Indicador/estadística & datos numéricos , Modelos Lineales , Masculino , Adulto JovenRESUMEN
The objectives of the present study were to describe and compare the body composition variables determined by bioelectrical impedance (BIA) and the deuterium dilution method (DDM), to identify possible correlations and agreement between the two methods, and to construct a linear regression model including anthropometric measures. Obese adolescents were evaluated by anthropometric measures, and body composition was assessed by BIA and DDM. Forty obese adolescents were included in the study. Comparison of the mean values for the following variables: fat body mass (FM; kg), fat-free mass (FFM; kg), and total body water (TBW; percent) determined by DDM and by BIA revealed significant differences. BIA overestimated FFM and TBW and underestimated FM. When compared with data provided by DDM, the BIA data presented a significant correlation with FFM (r = 0.89; P < 0.001), FM (r = 0.93; P < 0.001) and TBW (r = 0.62; P < 0.001). The Bland-Altman plot showed no agreement for FFM, FM or TBW between data provided by BIA and DDM. The linear regression models proposed in our study with respect to FFM, FM, and TBW were well adjusted. FFM obtained by DDM = 0.842 x FFM obtained by BIA. FM obtained by DDM = 0.855 x FM obtained by BIA + 0.152 x weight (kg). TBW obtained by DDM = 0.813 x TBW obtained by BIA. The body composition results of obese adolescents determined by DDM can be predicted by using the measures provided by BIA through a regression equation.
Asunto(s)
Adolescente , Niño , Femenino , Humanos , Masculino , Adulto Joven , Composición Corporal/fisiología , Óxido de Deuterio , Obesidad/fisiopatología , Impedancia Eléctrica , Técnicas de Dilución del Indicador/estadística & datos numéricos , Modelos LinealesRESUMEN
Plasma amino acid levels have never been studied in the placental intervillous space of preterm gestations. Our objective was to determine the possible relationship between plasma amino acids of maternal venous blood (M), of the placental intervillous space (PIVS) and of the umbilical vein (UV) of preterm newborn infants. Plasma amino acid levels were analyzed by ion-exchange chromatography in M from 14 parturients and in the PIVS and UV of their preterm newborn infants. Mean gestational age was 34 +/- 2 weeks, weight = 1827 +/- 510 g, and all newborns were considered adequate for gestational age. The mean Apgar score was 8 and 9 at the first and fifth minutes. Plasma amino acid values were significantly lower in M than in PIVS (166%), except for aminobutyric acid. On average, plasma amino acid levels were significantly higher in UV than in M (107%) and were closer to PIVS than to M values, except for cystine and aminobutyric acid (P < 0.05). Comparison of the mean plasma amino acid concentrations in the UV of preterm to those of term newborn infants previously studied by our group showed no significant difference, except for proline (P < 0.05), preterm > term. These data suggest that the mechanisms of active amino acid transport are centralized in the syncytiotrophoblast, with their passage to the fetus being an active bidirectional process with asymmetric efflux. PIVS could be a reserve amino acid space for the protection of the fetal compartment from inadequate maternal amino acid variations.
Asunto(s)
Aminoácidos/sangre , Vellosidades Coriónicas/química , Recien Nacido Prematuro/sangre , Venas Umbilicales/química , Adulto , Cromatografía por Intercambio Iónico , Femenino , Edad Gestacional , Humanos , Recién Nacido , Masculino , Intercambio Materno-Fetal , EmbarazoRESUMEN
Plasma amino acid levels have never been studied in the placental intervillous space of preterm gestations. Our objective was to determine the possible relationship between plasma amino acids of maternal venous blood (M), of the placental intervillous space (PIVS) and of the umbilical vein (UV) of preterm newborn infants. Plasma amino acid levels were analyzed by ion-exchange chromatography in M from 14 parturients and in the PIVS and UV of their preterm newborn infants. Mean gestational age was 34 ± 2 weeks, weight = 1827 ± 510 g, and all newborns were considered adequate for gestational age. The mean Apgar score was 8 and 9 at the first and fifth minutes. Plasma amino acid values were significantly lower in M than in PIVS (166 percent), except for aminobutyric acid. On average, plasma amino acid levels were significantly higher in UV than in M (107 percent) and were closer to PIVS than to M values, except for cystine and aminobutyric acid (P < 0.05). Comparison of the mean plasma amino acid concentrations in the UV of preterm to those of term newborn infants previously studied by our group showed no significant difference, except for proline (P < 0.05), preterm > term. These data suggest that the mechanisms of active amino acid transport are centralized in the syncytiotrophoblast, with their passage to the fetus being an active bidirectional process with asymmetric efflux. PIVS could be a reserve amino acid space for the protection of the fetal compartment from inadequate maternal amino acid variations.
Asunto(s)
Adulto , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Aminoácidos/sangre , Vellosidades Coriónicas/química , Recien Nacido Prematuro/sangre , Venas Umbilicales/química , Cromatografía por Intercambio Iónico , Edad Gestacional , Intercambio Materno-FetalRESUMEN
Two different levels of control for bone marrow hematopoiesis are believed to exist. On the one hand, normal blood cell distribution is believed to be maintained in healthy subjects by an "innate" hematopoietic activity, i.e., a basal intrinsic bone marrow activity. On the other hand, an "adaptive" hematopoietic state develops in response to stress-induced stimulation. This adaptive hematopoiesis targets specific lineage amplification depending on the nature of the stimuli. Unexpectedly, recent data have shown that what we call "normal hematopoiesis" is a stress-induced state maintained by activated bone marrow CD4+ T cells. This T cell population includes a large number of recently stimulated cells in normal mice whose priming requires the presence of the cognate antigens. In the absence of CD4+ T cells or their cognate antigens, hematopoiesis is maintained at low levels. In this review, we summarize current knowledge on T cell biology, which could explain how CD4+ T cells can help hematopoiesis, how they are primed in mice that were not intentionally immunized, and what maintains them activated in the bone marrow.
Asunto(s)
Animales , Humanos , Células de la Médula Ósea/citología , /inmunología , Hematopoyesis/inmunología , Memoria Inmunológica/inmunología , Células de la Médula Ósea/inmunología , /fisiología , Inmunidad Celular/fisiología , Inmunidad Innata/fisiología , Memoria Inmunológica/fisiologíaRESUMEN
Two different levels of control for bone marrow hematopoiesis are believed to exist. On the one hand, normal blood cell distribution is believed to be maintained in healthy subjects by an "innate" hematopoietic activity, i.e., a basal intrinsic bone marrow activity. On the other hand, an "adaptive" hematopoietic state develops in response to stress-induced stimulation. This adaptive hematopoiesis targets specific lineage amplification depending on the nature of the stimuli. Unexpectedly, recent data have shown that what we call "normal hematopoiesis" is a stress-induced state maintained by activated bone marrow CD4+ T cells. This T cell population includes a large number of recently stimulated cells in normal mice whose priming requires the presence of the cognate antigens. In the absence of CD4+ T cells or their cognate antigens, hematopoiesis is maintained at low levels. In this review, we summarize current knowledge on T cell biology, which could explain how CD4+ T cells can help hematopoiesis, how they are primed in mice that were not intentionally immunized, and what maintains them activated in the bone marrow.
Asunto(s)
Células de la Médula Ósea/citología , Linfocitos T CD4-Positivos/inmunología , Hematopoyesis/inmunología , Memoria Inmunológica/inmunología , Animales , Células de la Médula Ósea/inmunología , Linfocitos T CD4-Positivos/fisiología , Humanos , Inmunidad Celular/fisiología , Inmunidad Innata/fisiología , Memoria Inmunológica/fisiologíaRESUMEN
The objective of this study was to compare growth retardation frequency, and 24-h food intake data of children with or without positive Montenegro (leishmanin) test, examined in Porteirinha town, Brazil. Daily nutrient intake was determined by 24-h food intake recall and the anthropometric data were compared to the standard values from WHO. Montenegro-positive (n = 9) and Montenegro-negative (n = 17) groups showed similar age (5.5 +/- 1.9 vs 6.7 +/- 2.3y), and energy (1,456.8 +/- 314.8 vs 1,316.2 +/- 223.8kcal) and protein (50.4 +/- 16.7 vs 49.9 +/- 13.9g) daily consumption, respectively. Montenegro-positive children had higher percentage of stunting than their Montenegro-negative counterparts (44.4 vs 5.9), suggesting that previous Leishmania sp infection had negative impact on children's nutritional status.
Asunto(s)
Insuficiencia de Crecimiento/etiología , Leishmaniasis Visceral/complicaciones , Niño , Preescolar , Ingestión de Alimentos , Femenino , Humanos , Leishmaniasis Visceral/diagnóstico , Masculino , Pruebas CutáneasRESUMEN
The objective of this study was to compare growth retardation frequency, and 24-h food intake data of children with or without positive Montenegro (leishmanin) test, examined in Porteirinha town, Brazil. Daily nutrient intake was determined by 24-h food intake recall and the anthropometric data were compared to the standard values from WHO. Montenegro-positive (n = 9) and Montenegro-negative (n = 17) groups showed similar age (5.5 +/- 1.9 vs 6.7 +/- 2.3y), and energy (1,456.8 +/- 314.8 vs 1,316.2 +/- 223.8kcal) and protein (50.4 +/- 16.7 vs 49.9 +/- 13.9g) daily consumption, respectively. Montenegro-positive children had higher percentage of stunting than their Montenegro-negative counterparts (44.4 vs 5.9), suggesting that previous Leishmania sp infection had negative impact on children's nutritional status.
O objetivo deste trabalho foi comparar a ingestão alimentar habitual e a freqüência de retardo do crescimento de crianças com reação intradérmica positiva para leishmaniose (Montenegro-positivas), com um grupo Montenegro-negativo. A ingestão alimentar habitual foi avaliada pelo recordatório de 24 horas e o retardo do crescimento definido segundo critérios da OMS. Crianças Montenegro-positivo (n = 9) e Montenegro-negativo (n = 17) ingeriam, respectivamente, quantidades similares de energia (1456,8 ± 314,8 vs 1316,2 ± 223,8kcal/dia) e proteínas (50,4 ± 16,7 vs 49,9 ± 13,9g/dia). Déficit de altura foi mais comum em crianças Montenegro-positivas (44,4 vs 5,9). Estes dados sugerem que a infecção prévia pela Leishmania sp afeta desfavoravelmente o estado nutricional de crianças vivendo em área endêmica.
Asunto(s)
Niño , Preescolar , Femenino , Humanos , Masculino , Insuficiencia de Crecimiento/etiología , Leishmaniasis Visceral/complicaciones , Ingestión de Alimentos , Leishmaniasis Visceral/diagnóstico , Pruebas CutáneasRESUMEN
Nutritional status and some iron metabolism parameters of acute phase response (APR) positive and APR-negative AIDS patients were studied. Twenty-nine AIDS patients were submitted to 24h food intake recall, anthropometry, and albumin, C-reactive protein (CRP), hemoglobin, ferritin, and total iron binding capacity (TIBC) measurements. Infection plus serum CRP > 7 mg/dl were criteria for APR presence. Protein-energy malnutrition (PEM) was ascertained by body mass index (BMI) lower than 18.5 kg/m2 and height-creatinine index (HCI < 70%). PEM (77.8 vs 40%) and pulmonary tuberculosis (44. 4 vs 9.5%) were more frequent in APR-positive patients, which also had lower serum albumin (3.7 +/- 0.9 vs 4.3 +/- 0.9 g/dl), TIBC (165. 8 +/- 110.7 vs 265.9 +/- 74.6 mg/dl) and blood hemoglobin (10.5 +/- 1. 8 vs 12.6 +/- 2.3g/dl). Iron intake was similar between groups; however, serum ferritin levels (median, range) were higher among APR-positive (568, 45.3-1814 vs 246, 18.4-1577 ng/ml) patients. HIV-positive adults with systemic response to invading pathogens showed worse nutritional status than those APR-negative. In APR-positive AIDS patients, anemia appears to be unrelated to recent iron intake.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Reacción de Fase Aguda/complicaciones , Hierro/sangre , Desnutrición Proteico-Calórica/complicaciones , Síndrome de Inmunodeficiencia Adquirida/sangre , Reacción de Fase Aguda/sangre , Adulto , Femenino , Humanos , Masculino , Desnutrición Proteico-Calórica/sangreRESUMEN
BACKGROUND: Owing to high diarrhoea and protein malnutrition frequencies in pellagra, we hypothesised that pellagra patients would have higher electrolyte disturbances than non-pellagra alcoholics. OBJECTIVE: To compare serum electrolytes of hospitalised alcoholics with or without pellagra. DESIGN: Retrospective and descriptive case-control study. SETTING: Internal Medicine wards at a University Hospital, Medical School of Uberaba, Brazil. SUBJECTS: Medical records were reviewed to obtain relevant clinical details, main diagnosis and laboratory data, including serum electrolytes on hospital admission of pellagra patients (n=33) and a randomly chosen control group of alcoholics (n=37), matched in age, gender and socio-economic status. Anaemia was ascertained by haemoglobin <12.5 g/dl (men) and 1.5 g/dl (women), and hypoalbuminemia by serum albumin <3.3 g/dl. RESULTS: Pellagra and controls showed similar age (39.4+/-13.1 vs 45.0+/-11.4 years) and a male predominance of gender (69.7 vs 78.4%), and similar associated diagnoses, including high blood pressure (21.2 vs 16.2%), peripheral neuropathy (12.1 vs 13. 5%), and pneumonia (9.1 vs 13.5%). Despite displaying similar serum sodium (136.6+/-6.1 vs 137.8+/-5.7 mEq/I), magnesium (1.72+/-0.74 vs 1.62+/-0.34 mg/dl), phosphorus (3.79+/-0.87 vs 3.87+/-0.78 mEq/1) than controls,in addition to higher hypoalbuminemia (76.2 vs 33%) and anaemia (60.6 vs 35.1%) frequencies. CONCLUSIONS: Higher anaemia and hypoalbuminemia frequencies associated with lower serum potassium levels suggest increased protein malnutrition prevalence among pellagrins.
Asunto(s)
Alcoholismo/sangre , Alcoholismo/complicaciones , Electrólitos/sangre , Pelagra/sangre , Pelagra/complicaciones , Adulto , Anemia/complicaciones , Estudios de Casos y Controles , Femenino , Hospitalización , Humanos , Hipertensión/complicaciones , Magnesio/sangre , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso Periférico/complicaciones , Fósforo/sangre , Neumonía/complicaciones , Potasio/sangre , Estudios Retrospectivos , Albúmina Sérica/deficiencia , Sodio/sangreRESUMEN
Our objective was to compare food intake and nutritional status of Pemphigus Foliaceus patients (PG) on long term glucocorticoid therapy to a Control Group (CG). Fourteen PG female inpatients receiving prednisone (0.33 +/- 0.22mg/kg) for at least 12 months and twelve CG subjects were submitted to nutritional evaluation, including anthropometry, urinary creatinine determination and serum biochemical measurements, besides 48-h-based food intake records. Groups were compared by Chi-square, Mann-Whitney and "t" tests. PG patients and CG were paired, respectively, in relation to age (24.7 +/- 14.1 vs. 22.0 +/- 12.0 years), body mass index (25.8 +/- 6.4 vs. 24.0 +/- 5.6kg/m2), daily protein intake (132.9 +/- 49.8 vs. 95.2 +/- 58.9g), and serum albumin (median; range) (3.8; 3.5-4.1 vs. 3.8; 3.6-5.0g/dl). However, PG patients had lower height-creatinine index (64.8 +/- 17.6 vs. 90.1 +/- 33.4%), and higher daily energy (3080 +/- 1099 vs. 2187 +/- 702kcal) and carbohydrate (376.8 +/- 135.8 vs. 242.0 +/- 80.7g) intakes. Despite high food, protein and energy consumption, PG patients on long term glucocorticoid therapy had lower body muscle mass than controls, while showing high body fat stores. These findings are possibly related to combined metabolic effects of long term corticotherapy and inflammatory disease plus corticosteroid-induced increased appetite.
Asunto(s)
Glucocorticoides/uso terapéutico , Estado Nutricional , Pénfigo/tratamiento farmacológico , Prednisona/uso terapéutico , Adulto , Antropometría , Apetito/efectos de los fármacos , Índice de Masa Corporal , Estudios de Casos y Controles , Creatinina/orina , Ingestión de Alimentos , Ingestión de Energía , Femenino , Humanos , Pénfigo/sangre , Pénfigo/orina , Albúmina Sérica/análisis , Factores de TiempoRESUMEN
AIM: To verify whether malnourished inpatients receiving a typical Brazilian diet meet their food requirements. METHODS: Thirty-five consecutive surgical and medical hospitalized adults, able to feed themselves, received rice and beans based diets for 3 consecutive days. All served food was weighed before and after the meals. Nutrient intake was determined and results compared to American Recommended Dietary Allowances (RDA). Malnutrition was defined by the presence of at least one of these criteria: body mass index &lE 18.5 kg/m(2); height-creatinine index << 70%; or albumin level << 3. 5 g/dl. RESULTS: Malnourished and non-malnourished patients were paired in relation to age, gender, diagnoses and clinical parameters. Despite showing distinct anthropometric parameters and laboratory data, malnourished patients ingested enough quantities of food and met or exceeded RDA for energy and other nutrients. CONCLUSIONS: Clinically-stable malnourished inpatients, supplied with rice- and beans based diets have adequate energy and nutrient intake, the same occurring for non-malnourished ones.
Asunto(s)
Dieta , Ingestión de Alimentos , Hospitalización , Trastornos Nutricionales/dietoterapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antropometría , Brasil , Estudios de Casos y Controles , Ingestión de Energía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Política Nutricional , Estudios ProspectivosRESUMEN
The aim of this study was to compare the frequency of headache between Chagasic and Non-chagasic women. The cross-sectional study comprised 647 female > or = 40 years old, Chagasic (n = 362) and Controls (n = 285) at a Brazilian University Hospital. Chagasic were classified as Cardiac (n = 179), Megas (n = 58) or Indeterminate (n = 125) clinical forms. Headache was ascertained according to Headache International Society diagnostic criteria. The age (57.0 +/- 11.3 versus 57.3 +/- 10.4 years), and the percentage of white women (75.8% versus 77.1%) were similar between Chagasic and Controls, respectively. Headache was more prevalent among Chagasic (32.9%) than Controls (16.1%), mainly in Cardiac form (odds ratio, 2.41; 95% confidence interval, 1.38-4.23), phenomenon possibly related to parasympathetic denervation and cerebral vessels changes.
Asunto(s)
Enfermedad de Chagas/complicaciones , Cefalea/etiología , Adulto , Brasil/epidemiología , Intervalos de Confianza , Femenino , Cefalea/epidemiología , Humanos , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Estudios RetrospectivosRESUMEN
A case of postoperative left chylothorax in a 43-year-old black woman with hairy cell leukemia is reported. First submitted to pleural drainage, she was successfully treated with a combination of chemotherapy and elemental enteral diet enriched with medium-chain triglycerides.
Asunto(s)
Quilotórax/etiología , Leucemia de Células Pilosas/cirugía , Complicaciones Posoperatorias , Adulto , Quilotórax/tratamiento farmacológico , Drenaje , Quimioterapia Combinada , Femenino , Humanos , Derrame Pleural/cirugíaRESUMEN
Medical records of > or = 40 years old female seen at University Hospital from June/93 to July/95 were submitted to a cross-sectional study. According to Chagas' disease tests, patients were divided into chagasic (n = 362) and controls (n = 285). Diabetes mellitus was defined on the basis of two fasting blood glucose levels > or = 140 mg/dl and hyperglycemia as fasting blood glucose > 110 mg/dl. Chagasic patients were divided into groups with the cardiac form of the disease (n = 179), with megas (n = 58), and asymptomatic (n = 125). Groups were compared by the chi 2 test, analysis of variance, Student's "t" test, and Kruskal-Wallis and Mann-Whitney tests. A significant difference was assumed when p < 0.05. Chagasic and control groups were matched for age, white color and body mass index. Diabetes mellitus was more prevalent in patients with the cardiac form of Chagas' disease than in controls, or patients with the megas or the asymptomatic form (15.1%, 7.4%, 7.4%, and 5.6%, respectively); the same was observed for hyperglycemia (37.4%, 26.7%, 25.9%, 27.2%), in agreement with the hypothesis that the reduced parasympathetic activity caused by Trypanosoma cruzi leads to relative sympathetic hyperactivity.
Asunto(s)
Enfermedad de Chagas/complicaciones , Complicaciones de la Diabetes , Diabetes Mellitus/epidemiología , Hiperglucemia/complicaciones , Hiperglucemia/epidemiología , Adulto , Femenino , Humanos , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
The aim of this study was to compare the frequency of pancreas morphologic and morphometric changes in chagasic women (n = 6) aged > or = 40 years, with non-chagasic controls (n = 4), paired concerning to age (59.8 +/- 11.5 versus 59.0 +/- 6.3 years), white color (33.3% versus 50.0%) and body mass index (22.3 +/- 7.0 versus 18.8 +/- 2.1 kg/m2). There were no pancreatic morphometric differences between necropsied chagasic and control groups. However, there was a smaller intrapancreatic neuronal population and a higher frequency of leukocyte perineural infiltrate in the pancreas of chagasic women. This possible intrapancreatic denervation could be associated with changes in carbohydrate metabolism, including hyperglycemia and diabetes mellitus, in some chronic chagasic women.