RESUMEN
Os parâmetros de permeabilidade e solubilidade são fundamentais à absorção oral de fármacos e a partir dessas características, foi criado o Sistema de Classificação Biofarmacêutica, através do qual os fármacos são divididos em quatro classes. Atualmente, para a determinação da solubilidade de um fármaco, existem diversos métodos padronizados por agências regulatórias, no entanto, para a determinação da permeabilidade, os ensaios são passíveis de diversas variações em sua execução, diminuindo a confiabilidade dos resultados obtidos e impossibilitando a comparação dos mesmos quando realizados com técnicas diferentes umas das outras. O objetivo do presente trabalho é avaliar as variáveis experimentais do modelo do saco intestinal que podem influenciar nos resultados de permeabilidade aparente de fármacos e na viabilidade do tecido. O presente estudo foi aprovado pelo Comitê de Ética no Uso de Animais da FCF-USP (109.2018-P574). Foram utilizados 33 Rattus norvegicus da linhagem Wistar, machos, jovens adultos, com peso entre 200 g e 300 g. Para realização do procedimento, cada animal permaneceu em jejum por cerca de quatro horas e após adequada anestesia a porção do jejuno do intestino delgado foi retirada e dividida em seis segmentos de aproximadamente 8,5cm cada. Foram realizados experimentos com e sem inversão do saco intestinal, submetidos a diferentes tempos de banho de gelo após sua ressecção, na presença ou ausência de inibidor da glicoproteína-P (verapamil). Os fármacos naproxeno e famotidina foram empregados como marcadores de alta e baixa permeabilidade, respectivamente. A losartana foi utilizada como substrato da glicoproteína P. Cada um dos sacos intestinais foi colocado em um tubo de ensaio contendo tampão Krebs, a 37°C, saturado com gás carbogênio. Para avaliação da integridade e viabilidade dos segmentos intestinais, observou-se a presença de movimentos peristálticos e coletaram-se amostras do meio de incubação nos tempos 0, 30, 45, 60, 90 e 120 minutos para quantificação dos fármacos e de glicose, uma vez que esta é ativamente transportada para a serosa do intestino delgado. Determinou-se a permeabilidade aparente de cada fármaco e as concentrações de glicose nas diferentes condições experimentais, realizou-se planejamento fatorial multinível e os resultados foram analisados por análise variância (ANOVA), seguida de pós-teste de Tukey. Observou-se que as variáveis experimentais interferiram de forma significativa na viabilidade tecidual e na permeabilidade aparente dos fármacos. Não foram observadas diferenças significativas da permeabilidade de fármacos nos diferentes segmentos do jejuno. A glicose mostrou-se um bom marcador de viabilidade tecidual e foi constatado que a presença ou ausência de movimentos peristálticos não está relacionada diretamente com a viabilidade do tecido. Uma vez que foram constatadas tantas interferências nos resultados, é imprescindível que os procedimentos experimentais sejam padronizados, para que os resultados apresentem menor variabilidade e possam ser comparados entre si
The permeability and solubility parameters are fundamental to the oral absorption of drugs and from these characteristics, the Biopharmaceutical Classification System was created, through which drugs are divided into four classes. Currently, for the determination of the solubility of a drug, there are several methods standardized by regulatory agencies, however, for the determination of permeability, the tests are subject to several variations in their execution, reducing the reliability of the results obtained and making it impossible to compare the results obtained. same when performed with different techniques. The aim of this study is to evaluate if different experimental conditions can influence the results of apparent drug permeability and tissue viability on gut sac model. The present study was approved by the Ethics Committee for the Use of Animals of FCF-USP (109.2018-P574). Thirty-three male, young adult Rattus norvegicus were used, weighing between 200 g and 300 g. To perform the procedure, each animal fasted for about four hours and after adequate anesthesia, the portion of the jejunum of the small intestine was removed and divided into six segments of approximately 8.5 cm each. Experiments were performed with and without inversion of the gut sac, submitted to different times of ice bath after its resection, in the presence or absence of a P-glycoprotein inhibitor (verapamil). The drugs naproxen and famotidine were used as markers of high and low permeability, respectively. Losartan was used as a substrate for P-glycoprotein. Each of the gut sacs was placed in a test tube containing Krebs buffer, at 37°C, saturated with carbogen gas. To evaluate the integrity and viability of the intestinal segments, the presence of peristaltic movements was observed and samples of the incubation medium were collected at 0, 30, 45, 60, 90 and 120 minutes for quantification of drugs and glucose, as it is actively transported to the serosa of the small intestine. The apparent permeability of each drug and the glucose concentrations were determined under different experimental conditions, multilevel factorial design was performed and the results were analyzed by analysis of variance (ANOVA), followed by Tukey's post-test. It was observed that the experimental variables significantly interfered in the tissue viability and in the apparent permeability of the drugs. No significant differences in drug permeability were observed in the different segments of the jejunum. Glucose proved to be a good marker of tissue viability and it was found that the presence or absence of peristaltic movements is not directly related to tissue viability. Since so many interferences were found in the results, it is essential that the experimental procedures be standardized, so that the results show less variability and can be compared between different authors
Asunto(s)
Animales , Masculino , Ratas , Permeabilidad , Solubilidad , Biofarmacia/instrumentación , Preparaciones Farmacéuticas/análisis , Intestino Delgado/metabolismo , Métodos , Estándares de Referencia , Análisis de Varianza , Ayuno/efectos adversos , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/efectos adversos , Absorción , Yeyuno/anomalíasRESUMEN
Objetivo: identificar os principais diagnósticos de enfermagem e suas respectivas intervenções em uma população de pacientes oncológicos submetidos a jejum prolongado no pós-operatório. Método: estudo descritivo, documental e transversal. O cenário do estudo foi um hospital federal de ensino no Rio de Janeiro, caracterizado como UNACON. Os dados foram coletados durante 60 dias em prontuários referentes aos anos de 2016 a 2018. Foram analisados 61 prontuários que atendiam aos critérios de inclusão e 208 complicações foram apresentadas pelos pacientes oncológicos. Resultados: Foram definidos oito diagnósticos de enfermagem, entre os quais os mais evidentes foram: Nutrição desequilibrada: menor que as necessidades corporais e Risco de glicemia instável. Onze intervenções de enfermagem foram definidas em consonância com a Taxonomia de NANDA-I e buscaram ser de fácil aplicação na prática assistencial de enfermagem. Conclusão: foi evidenciada uma ampla gama de diagnósticos e intervenções de enfermagem a qual se recomenda sua adoção no processo de enfermagem.
Objective: to identify the main nursing diagnoses and respective interventions in a population of cancer patients undergoing prolonged postoperative fasting. Method: descriptive, cross-sectional, documentary study. The study scenario was a federal teaching hospital in Rio de Janeiro, characterized as a high-complexity oncological facility. Data were collected for 60 days from medical records for the years 2016 to 2018. In the 61 medical records that met the inclusion criteria and were analyzed, cancer patients presented 208 complications. Results: eight diagnoses were established, the most in evidence being: nutrition imbalance: less than body requirements; and risk of unstable blood glucose level. Eleven nursing interventions, designed to be easily applied in nursing care practice, were specified in line with the NANDA-I Taxonomy. Conclusion: the wide range of nursing diagnoses and interventions evidenced are recommended for adoption in the nursing process.
Objetivo: identificar los principales diagnósticos de enfermería y sus respectivas intervenciones en una población de pacientes oncológicos sometidos a ayuno postoperatorio prolongado. Método: estudio descriptivo, transversal, documental. El escenario de estudio fue un hospital universitario federal en Río de Janeiro, caracterizado como una instalación oncológica de alta complejidad. Se recolectaron datos durante 60 días de las historias clínicas de los años 2016 a 2018. En las 61 historias clínicas que cumplieron con los criterios de inclusión y fueron analizadas, los pacientes con cáncer presentaron 208 complicaciones. Resultados: se establecieron ocho diagnósticos, siendo los más evidentes: desequilibrio nutricional: menor que los requerimientos corporales; y riesgo de niveles inestables de glucosa en sangre. Once intervenciones de enfermería, diseñadas para ser fácilmente aplicadas en la práctica del cuidado de enfermería, fueron especificadas de acuerdo con la Taxonomía NANDA-I. Conclusión: la amplia gama de diagnósticos e intervenciones de enfermería evidenciados se recomiendan para su adopción en el proceso de enfermería.
Asunto(s)
Humanos , Masculino , Femenino , Cuidados Posoperatorios/enfermería , Instituciones Oncológicas , Ayuno/efectos adversos , Enfermería Posanestésica , Hospitales de Enseñanza , Proceso de Enfermería , Dolor Postoperatorio/enfermería , Diagnóstico de Enfermería/clasificación , Brasil , Estudios Transversales , Terminología Normalizada de Enfermería , Hipoglucemia/enfermería , Trastornos Nutricionales/enfermeríaRESUMEN
BACKGROUND: During a surgical procedure, patients are often subjected to fasting for times that are more prolonged than the ideal, which may lead to complications. OBJECTIVE: To evaluate the duration of perioperative fasting and its association with postoperative complications, length of hospital stay (LOS) and mortality among gastric and colorectal cancer patients. DESIGN AND SETTING: Cohort study developed in a surgical oncology hospital in the city of Natal (Rio Grande do Norte, Brazil). METHODS: Patients aged over 18 years were included. The Clavien-Dindo surgical complication scale was used to evaluate occurrences of postoperative complications. LOS was defined as the number of days for which patients stayed in the hospital after surgery, or until the day of death. RESULTS: Seventy-seven patients participated (59.8 ± 11.8 years; 54.5% females; 70.1% with bowel tumor). The incidences of postoperative complications and death were 59.7% and 3.9%, respectively. The duration of perioperative fasting was 59.0 ± 21.4 hours, and it was higher among non-survivors and among patients with prolonged hospital stay (≥ 6 days). For each one-hour increase in the durations of perioperative and postoperative fasting, the odds of prolonged hospitalization increased by 12% (odds ratio, OR = 1.12; 95% confidence interval, CI 1.04-1.20) and 5% (OR = 1.05; 95% CI 1.02-1.08), respectively. CONCLUSION: Prolonged perioperative fasting, especially in the postoperative period, was observed in a sample of patients with gastric and colorectal cancer, and this was an independent predictor of LOS.
Asunto(s)
Neoplasias Colorrectales , Ayuno , Tiempo de Internación , Periodo Perioperatorio , Complicaciones Posoperatorias , Neoplasias Gástricas , Adulto , Anciano , Brasil/epidemiología , Estudios de Cohortes , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/cirugía , Ayuno/efectos adversos , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugíaRESUMEN
ABSTRACT BACKGROUND: During a surgical procedure, patients are often subjected to fasting for times that are more prolonged than the ideal, which may lead to complications. OBJECTIVE: To evaluate the duration of perioperative fasting and its association with postoperative complications, length of hospital stay (LOS) and mortality among gastric and colorectal cancer patients. DESIGN AND SETTING: Cohort study developed in a surgical oncology hospital in the city of Natal (Rio Grande do Norte, Brazil). METHODS: Patients aged over 18 years were included. The Clavien-Dindo surgical complication scale was used to evaluate occurrences of postoperative complications. LOS was defined as the number of days for which patients stayed in the hospital after surgery, or until the day of death. RESULTS: Seventy-seven patients participated (59.8 ± 11.8 years; 54.5% females; 70.1% with bowel tumor). The incidences of postoperative complications and death were 59.7% and 3.9%, respectively. The duration of perioperative fasting was 59.0 ± 21.4 hours, and it was higher among non-survivors and among patients with prolonged hospital stay (≥ 6 days). For each one-hour increase in the durations of perioperative and postoperative fasting, the odds of prolonged hospitalization increased by 12% (odds ratio, OR = 1.12; 95% confidence interval, CI 1.04-1.20) and 5% (OR = 1.05; 95% CI 1.02-1.08), respectively. CONCLUSION: Prolonged perioperative fasting, especially in the postoperative period, was observed in a sample of patients with gastric and colorectal cancer, and this was an independent predictor of LOS.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Complicaciones Posoperatorias/epidemiología , Neoplasias Colorrectales/cirugía , Neoplasias Colorrectales/mortalidad , Ayuno/efectos adversos , Periodo Perioperatorio , Tiempo de Internación/estadística & datos numéricos , Neoplasias Gástricas/cirugía , Neoplasias Gástricas/mortalidad , Brasil/epidemiología , Estudios de CohortesAsunto(s)
Peso Corporal/fisiología , Ayuno/efectos adversos , Glucemia , Índice de Masa Corporal , Ayuno/fisiología , Humanos , Obesidad , SobrepesoRESUMEN
Fasting is known to cause physiological changes in the endocrine pancreas, including decreased insulin secretion and increased reactive oxygen species (ROS) production. However, there is no consensus about the long-term effects of intermittent fasting (IF), which can involve up to 24 hours of fasting interspersed with normal feeding days. In the present study, we analyzed the effects of alternate-day IF for 12 weeks in a developing and healthy organism. Female 30-day-old Wistar rats were randomly divided into two groups: control, with free access to standard rodent chow; and IF, subjected to 24-hour fasts intercalated with 24-hours of free access to the same chow. Alternate-day IF decreased weight gain and food intake. Surprisingly, IF also elevated plasma insulin concentrations, both at baseline and after glucose administration collected during oGTT. After 12 weeks of dietary intervention, pancreatic islets displayed increased ROS production and apoptosis. Despite their lower body weight, IF animals had increased fat reserves and decreased muscle mass. Taken together, these findings suggest that alternate-day IF promote ß -cell dysfunction, especially in developing animals. More long-term research is necessary to define the best IF protocol to reduce side effects.
Asunto(s)
Tejido Adiposo/metabolismo , Ingestión de Alimentos , Ayuno/efectos adversos , Islotes Pancreáticos/metabolismo , Islotes Pancreáticos/patología , Pérdida de Peso , Tejido Adiposo/patología , Animales , Apoptosis , Ayuno/fisiología , Femenino , Insulina/sangre , Secreción de Insulina , Músculos/metabolismo , Músculos/patología , Ratas Wistar , Especies Reactivas de Oxígeno/metabolismo , Factores de TiempoAsunto(s)
Humanos , Peso Corporal/fisiología , Ayuno/efectos adversos , Glucemia , Índice de Masa Corporal , Ayuno/fisiología , Sobrepeso , ObesidadRESUMEN
This study was carried out in order to compare the relative bioavailability of two different formulations containing 400 mg of acetaminophen + 4 mg of phenylephrine hydrochloride + 4 mg of chlorpheniramine maleate, Test formulation (Cimegripe®) and Reference formulation (Resfenol®) in 84 healthy volunteers of both sexes under fasting conditions. The study was conducted in a single dose, randomized, open-label, crossover 3-way and partially replicated. The tolerability was evaluated by the monitoring of adverse events and vital signs, results of clinical and laboratory tests. Plasma concentrations were quantified by validated bioanalytical methods using the ultra-performance liquid chromatography coupled to tandem mass spectrometry. The Cmax, Tmax, AUC0-t, AUC0-inf, T1/2 and Kel pharmacokinetic parameters were calculated from these obtained concentrations. The 90% confidence intervals were constructed for the ratio reference/test from the geometric average of the Cmax and AUC parameters which were comprised between 80% and 125%. Only the Cmax parameter of the phenylephrine was applied the scaled average bioequivalence due to the intraindividual coefficient of variation > 30% obtained, thus extending the acceptance limits of the interval. It can be concluded that the two formulations were bioequivalent in terms of rate and absorption extent and thus interchangeable
Asunto(s)
Humanos , Masculino , Femenino , Fenilefrina/análisis , Cápsulas/clasificación , Disponibilidad Biológica , Clorfeniramina/análisis , Acetaminofén/análisis , Espectrometría de Masas/métodos , Dosis Única , Ayuno/efectos adversos , Estudios Cruzados , Absorción/efectos de los fármacos , Espectrometría de Masas en Tándem/métodos , Voluntarios Sanos/clasificaciónRESUMEN
El ayuno intermitente es una estrategia nutricional de creciente interés para el control del peso y mejora de la salud metabólica. El objetivo del presente estudio fue evaluar el efecto de un protocolo de ayuno intermitente sobre la composición corporal, perfil lipídico y los biomarcadores de riesgo cardiovascular en estudiantes universitarios. En este estudio experimental participaron 30 sujetos varones y fueron divididos aleatoriamente en dos grupos, 15 sujetos constituían el grupo experimental (GE) (edad: 20,83±0,98 años) y 15 el grupo control (GC) (edad: 23,71±5,55 años). El GE realizó un protocolo de ayuno 16/8, dieciséis horas de ayuno y ocho horas de ingesta calórica sin limitaciones, dos días consecutivos a la semana durante cinco semanas. Se evaluó la composición corporal, la ingesta calórica, el perfil lipídico y los biomarcadores del riesgo cardiovascular al inicio, mitad y final del protocolo. Se observaron descensos significativos en el GE en pliegues cutáneos, perímetro cintura, porcentaje de grasa, perfil lipídico y biomarcadores del riesgo cardiovascular en comparación con GC (p<0,05). Se encontraron incrementos significativos en la ingesta de colesterol y ácidos grasos poliinsaturados en el GE al final del estudio (p<0,05). Se observaron descensos en el colesterol total, triglicéridos, lipoproteínas de baja densidad y biomarcadores del riesgo cardiovascular a lo largo del protocolo en el GE (p<0,05). Un protocolo de ayuno intermitente 16/8, dos días consecutivos por semana, durante cinco semanas, parece efectivo para mejorar parámetros de composición corporal y perfil lipídico, así como para mejorar los biomarcadores relacionados con el riesgo cardiovascular(AU)
Intermittent fasting is a nutritional strategy of high interest in weight control and improvement of metabolic health. The objective of this study was to evaluate the effect of an intermittent fasting protocol on body composition, lipid profile and biomarkers of cardiovascular risk in university students. In this experimental study thirty male subjects participated and were randomly divided into two groups; fifteen subjects constituted the experimental group (GE) (age: 20.83 ± 0.98 years) and fifteen the control group (GC) (age: 23.71 ± 5.55 years). The GE performed a fasting protocol 16/8, sixteen hours of fasting and eight hours of caloric intake without limitations, two consecutive days per week for five weeks. Body composition, calorie intake, lipid profile and biomarkers of cardiovascular risk were evaluated at the beginning, middle and at the end of the protocol. Significant decreases were found in GE in skinfolds, waist perimeter, % fat, lipid profile and biomarkers of cardiovascular risk as compared to GC (p <0.05). There were significant increases in the intake of cholesterol and polyunsaturated fatty acids in the GE at the end of the study (p <0.05). There were decreases in total cholesterol, triglycerides, low-density lipoproteins, and biomarkers of cardiovascular risk throughout the study in GE (p<0.05). An intermittent fasting protocol 16/8, two consecutive days per week, for five weeks, seems effective to improve parameters of body composition and lipid profile, as well as to improving biomarkers related to cardiovascular risk(AU)
Asunto(s)
Humanos , Masculino , Adulto , Ayuno/efectos adversos , Conducta Alimentaria , Lípidos/análisis , Composición Corporal , Estado Nutricional , Composición de AlimentosRESUMEN
PURPOSE: To measure the preoperative fasting durations with respect to time of the day and its effect on vital parameters and electrocardiogram in elderly patients undergoing surgery under spinal anesthesia. METHODS: This study investigated 211 patients older than 60 years undergoing elective surgery under spinal anesthesia. Patients scheduled for surgery in morning hours (AM) and afternoon hours (PM) were compared. Patients fasting hours and repeated measurements of mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (Sp02) and the type and number of ischemic electrocardiogram (ECG) signs were recorded and compared [preoperative, zeroth, 2nd,5th,15th,30th minutes following spinal anesthesia(SA)]. RESULTS: Mean fasting durations were 12±2.8 and 9.5±2.1 hours in AM group and 15.5±3.4 12.7±4.4 hours in PM group for foods and liquids respectively. ECG changes were significantly more frequent in PM group and body temperatures were significantly higher in AM group patients. CONCLUSION: Our study has shown that fasting times in our population is far longer than recommended and fasting prolonged>15 hours is related to a transiently increased cardiac stress and mild hypothermia.
Asunto(s)
Anestesia Raquidea , Presión Arterial/fisiología , Procedimientos Quirúrgicos Electivos , Ayuno/fisiología , Frecuencia Cardíaca/fisiología , Anciano , Electrocardiografía , Ayuno/efectos adversos , Femenino , Humanos , Masculino , Consumo de Oxígeno , Estudios Prospectivos , Factores de TiempoRESUMEN
Abstract Purpose: To measure the preoperative fasting durations with respect to time of the day and its effect on vital parameters and electrocardiogram in elderly patients undergoing surgery under spinal anesthesia. Methods: This study investigated 211 patients older than 60 years undergoing elective surgery under spinal anesthesia. Patients scheduled for surgery in morning hours (AM) and afternoon hours (PM) were compared. Patients fasting hours and repeated measurements of mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (Sp02) and the type and number of ischemic electrocardiogram (ECG) signs were recorded and compared [preoperative, zeroth, 2nd,5th,15th,30th minutes following spinal anesthesia(SA)]. Results: Mean fasting durations were 12±2.8 and 9.5±2.1 hours in AM group and 15.5±3.4 12.7±4.4 hours in PM group for foods and liquids respectively. ECG changes were significantly more frequent in PM group and body temperatures were significantly higher in AM group patients. Conclusion: Our study has shown that fasting times in our population is far longer than recommended and fasting prolonged>15 hours is related to a transiently increased cardiac stress and mild hypothermia.
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Ayuno/fisiología , Procedimientos Quirúrgicos Electivos , Presión Arterial/fisiología , Frecuencia Cardíaca/fisiología , Anestesia Raquidea , Consumo de Oxígeno , Factores de Tiempo , Estudios Prospectivos , Ayuno/efectos adversos , ElectrocardiografíaRESUMEN
OBJECTIVE: We investigated the effect of intermittent food restriction (IFR) cycles on hypothalamic expression of lipogenic proteins and induction of overeating. METHODS: Female Wistar rats were distributed in three groups: free access to feed (control, C), 2 d feed restriction at 50% of C intake followed by 3 d (restricted 3, R3) or 5 d (restricted 5, R5) ad libitum feeding. After 6 wk, the rats were submitted to euthanasia and collected the hypothalamus and blood. The deposits of retroperitoneal, mesenteric, and gonadal fat were weighed. The expression of the mRNA for sterol regulatory element binding protein (SREBP) 1c and 2 and acetyl-CoA carboxylase in the hypothalamus were determined by real-time polymerase chain reaction, and glucose and triacylglycerol were evaluated by a commercial kit. Body mass and food intake were measured daily. RESULTS: IFR promoted increased expression of SREBP-2 in both treated groups and, in R5, increased expression of SREBP-1c. The serum triacylglycerol, mesenteric deposit, and total fat content were higher in R3. Neither of the treatment intervals altered the expression of the mRNA of acetyl-CoA carboxylase enzyme but induced hyperglycemia and higher food intake immediately after food restriction. CONCLUSION: IFR affected the expression of SREBP-1c in R5 and SREBP-2 in the hypothalamus and caused overeating immediately after fasting in both groups. We suggest that hypothalamic and peripheral alterations, coupled with compulsive eating behavior in the ad libitum period, indicate risks for diabetes mellitus and recovery of body mass after interruption of IFR.
Asunto(s)
Restricción Calórica/efectos adversos , Ingestión de Alimentos/genética , Ayuno/efectos adversos , Hiperfagia/metabolismo , Proteínas de Unión a los Elementos Reguladores de Esteroles/metabolismo , Acetil-CoA Carboxilasa/metabolismo , Animales , Femenino , Hiperfagia/etiología , Hipotálamo/metabolismo , ARN Mensajero/metabolismo , Ratas , Ratas WistarRESUMEN
Devido à precocidade e a grande capacidade de ganho de peso dos frangos de corte, a qualidade do pintinho se tornou um parâmetro fundamental. Pintos de baixa qualidade (refugos) tendem a ganhar menos peso e obter pior conversão alimentar, gerando prejuízo aos avicultores. Dentre os vários fatores que impactam na qualidade de pintos de corte, o jejum pós-eclosão é responsável por significativas perdas iniciais de desempenho, sendo essas, muitas vezes, não compensadas futuramente. Durante a vida embrionária, os pintos de corte já possuem enzimas digestivas ativas, assim como mecanismos de absorção de nutrientes no intestino; mas, tanto as enzimas, quanto a capacidade intestinal não se encontram no seu ápice de funcionamento. Após a eclosão, devido à falta de alimento, uma escassez de carboidratos de origem alimentar, leva ao pintinho necessitar prover glicose via gliconeogênese de origem proteica, processo esse que pode levar o pintainho à cetose e também redução da disponibilidade de água metabólica; sendo todo esse quadro agravado, quanto maior for o tempo em que a ave ficar em jejum, após o nascimento. O jejum pré-alojamento pode gerar inúmeros impactos negativos no desempenho da ave: no desenvolvimento muscular, no crescimento visceral e na microbiota intestinal. O fornecimento de uma ração logo após a eclosão, durante o trajeto incubatório-granja, se mostra uma alternativa para reduzir os malefícios ocorridos devido ao jejum pós-eclosão; no entanto, é necessário antes um estudo econômico, visto que dependendo do tempo de jejum entre o nascimento e o alojamento das aves essa prática pode não ser viável.
Due to the earliness and the large weight gain capacity of broiler chick quality has become a very important parameter. Low quality chicks (scrap) tend to gain less weight and get worse feed conversion, generating damage to poultry farmers. Among the many factors that impact the quality of broiler chicks, the post-hatching fasting is responsible for significant initial losses of performance, and these often not compensated in the future. During embryonic life, the broilers already have their active digestive enzymes, as well as nutrient uptake mechanisms in the gut, but both enzymes as the intestinal ability are not in their working apex. After hatching, due to lack of food, shortage of food-borne carbohydrates leads to chick need to provide glucose via protein source gluconeogenesis, a process that can take the chick to ketosis and also reducing the availability of metabolic water and all that table exacerbated the longer the time that the bird to fast after birth. The pre-accommodation fasting can generate numerous negative impacts on bird performance: in muscle development, visceral growth and intestinal microbiota. Providing a feed immediately after hatching in the hatchery-farm path shown an alternative to reduce the harm occurred because the post-hatching fasting, however is required before an economic study, since depending on the time of fasting between birth and the housing of birds this practice may not be feasible.
Asunto(s)
Animales , Animales Recién Nacidos , Pollos/fisiología , Ayuno/efectos adversos , Alimentación Animal , Tracto Gastrointestinal/crecimiento & desarrollo , Fenómenos Fisiológicos Nutricionales de los AnimalesRESUMEN
Devido à precocidade e a grande capacidade de ganho de peso dos frangos de corte, a qualidade do pintinho se tornou um parâmetro fundamental. Pintos de baixa qualidade (refugos) tendem a ganhar menos peso e obter pior conversão alimentar, gerando prejuízo aos avicultores. Dentre os vários fatores que impactam na qualidade de pintos de corte, o jejum pós-eclosão é responsável por significativas perdas iniciais de desempenho, sendo essas, muitas vezes, não compensadas futuramente. Durante a vida embrionária, os pintos de corte já possuem enzimas digestivas ativas, assim como mecanismos de absorção de nutrientes no intestino; mas, tanto as enzimas, quanto a capacidade intestinal não se encontram no seu ápice de funcionamento. Após a eclosão, devido à falta de alimento, uma escassez de carboidratos de origem alimentar, leva ao pintinho necessitar prover glicose via gliconeogênese de origem proteica, processo esse que pode levar o pintainho à cetose e também redução da disponibilidade de água metabólica; sendo todo esse quadro agravado, quanto maior for o tempo em que a ave ficar em jejum, após o nascimento. O jejum pré-alojamento pode gerar inúmeros impactos negativos no desempenho da ave: no desenvolvimento muscular, no crescimento visceral e na microbiota intestinal. O fornecimento de uma ração logo após a eclosão, durante o trajeto incubatório-granja, se mostra uma alternativa para reduzir os malefícios ocorridos devido ao jejum pós-eclosão; no entanto, é necessário antes um estudo econômico, visto que dependendo do tempo de jejum entre o nascimento e o alojamento das aves essa prática pode não ser viável.(AU)
Due to the earliness and the large weight gain capacity of broiler chick quality has become a very important parameter. Low quality chicks (scrap) tend to gain less weight and get worse feed conversion, generating damage to poultry farmers. Among the many factors that impact the quality of broiler chicks, the post-hatching fasting is responsible for significant initial losses of performance, and these often not compensated in the future. During embryonic life, the broilers already have their active digestive enzymes, as well as nutrient uptake mechanisms in the gut, but both enzymes as the intestinal ability are not in their working apex. After hatching, due to lack of food, shortage of food-borne carbohydrates leads to chick need to provide glucose via protein source gluconeogenesis, a process that can take the chick to ketosis and also reducing the availability of metabolic water and all that table exacerbated the longer the time that the bird to fast after birth. The pre-accommodation fasting can generate numerous negative impacts on bird performance: in muscle development, visceral growth and intestinal microbiota. Providing a feed immediately after hatching in the hatchery-farm path shown an alternative to reduce the harm occurred because the post-hatching fasting, however is required before an economic study, since depending on the time of fasting between birth and the housing of birds this practice may not be feasible.(AU)
Asunto(s)
Animales , Pollos/fisiología , Animales Recién Nacidos , Tracto Gastrointestinal/crecimiento & desarrollo , Ayuno/efectos adversos , Alimentación Animal , Fenómenos Fisiológicos Nutricionales de los AnimalesRESUMEN
An investigation was made into the effects of different lairage times and the position of chicken crates during transport to the slaughterhouse on the biochemical and hematological profile and physical parameters of broilers, such as color and pH of their breast meat. The treatments were defined by the animals slaughtered after 0, 2, 4 and 6 hours of lairage time at the slaughterhouse, transported in crates located in the top and bottom layers of the truck. It was found that increasing the lairage time at the slaughterhouse to over two hours reduced the number of lymphocytes and increased the heterophil/lymphocyte (H/L) ratio and the basophil count in the hemogram. In addition, lactate dehydrogenase (LDH) activity and cholesterol levels increased and plasma triglyceride and glucose levels decreased. The position of the crates in the truck altered the creatine kinase (CK) activity, and the highest enzyme activity was found in birds transported in the top layer of crates in the truck. Furthermore, the long lairage time in the slaughterhouse increased the pH and the value of a* (redness value) and decreased the lightness value of breast fillets. The interaction significant between 4 and 6 hours of lairage time and the position of the crate in the top layer of the truck favored the development of dark, firm, dry (DFD) meat.(AU)
Este trabalho objetivou a avaliação dos efeitos dos diferentes tempos de espera e da posição das caixas de transporte no caminhão sobre perfil bioquímico e hematológico, além de parâmetros físicos da carne, como cor e pH do peito, de frangos de corte. Os tratamentos foram definidos pelos animais abatidos com zero, duas, quatro e seis horas de espera no abatedouro, posicionados nas partes superior e inferior do caminhão. Como resultado, verificou-se que o aumento do tempo de espera no abatedouro, acima de duas horas, resultou em redução no número de linfócitos, elevação da razão heterófilos/ linfócitos (H/L) e de basófilos no hemograma. Houve aumento da atividade de lactato desidrogenase (LDH), dos níveis de colesterol e redução de triglicerídeos e glicose no plasma. O posicionamento das caixas na parte superior da carroceria do caminhão elevou a enzima creatina quinase (CK) sanguínea. Além disso, o tempo prolongado na área de espera aumentou o pH final e o valor de a* (teor de vermelho) e diminuiu a luminosidade dos filés. A interação significante dos fatores tempo de espera de quatro e seis horas e a posição superior das caixas de transporte propiciaram o desenvolvimento de carnes duras, firmes e escuras (DFD) em frangos de corte.(AU)
Asunto(s)
Animales , Pollos/metabolismo , Carne/análisis , Mataderos , Ayuno/efectos adversos , Bienestar del AnimalRESUMEN
An investigation was made into the effects of different lairage times and the position of chicken crates during transport to the slaughterhouse on the biochemical and hematological profile and physical parameters of broilers, such as color and pH of their breast meat. The treatments were defined by the animals slaughtered after 0, 2, 4 and 6 hours of lairage time at the slaughterhouse, transported in crates located in the top and bottom layers of the truck. It was found that increasing the lairage time at the slaughterhouse to over two hours reduced the number of lymphocytes and increased the heterophil/lymphocyte (H/L) ratio and the basophil count in the hemogram. In addition, lactate dehydrogenase (LDH) activity and cholesterol levels increased and plasma triglyceride and glucose levels decreased. The position of the crates in the truck altered the creatine kinase (CK) activity, and the highest enzyme activity was found in birds transported in the top layer of crates in the truck. Furthermore, the long lairage time in the slaughterhouse increased the pH and the value of a* (redness value) and decreased the lightness value of breast fillets. The interaction significant between 4 and 6 hours of lairage time and the position of the crate in the top layer of the truck favored the development of dark, firm, dry (DFD) meat.(AU)
Este trabalho objetivou a avaliação dos efeitos dos diferentes tempos de espera e da posição das caixas de transporte no caminhão sobre perfil bioquímico e hematológico, além de parâmetros físicos da carne, como cor e pH do peito, de frangos de corte. Os tratamentos foram definidos pelos animais abatidos com zero, duas, quatro e seis horas de espera no abatedouro, posicionados nas partes superior e inferior do caminhão. Como resultado, verificou-se que o aumento do tempo de espera no abatedouro, acima de duas horas, resultou em redução no número de linfócitos, elevação da razão heterófilos/ linfócitos (H/L) e de basófilos no hemograma. Houve aumento da atividade de lactato desidrogenase (LDH), dos níveis de colesterol e redução de triglicerídeos e glicose no plasma. O posicionamento das caixas na parte superior da carroceria do caminhão elevou a enzima creatina quinase (CK) sanguínea. Além disso, o tempo prolongado na área de espera aumentou o pH final e o valor de a* (teor de vermelho) e diminuiu a luminosidade dos filés. A interação significante dos fatores tempo de espera de quatro e seis horas e a posição superior das caixas de transporte propiciaram o desenvolvimento de carnes duras, firmes e escuras (DFD) em frangos de corte.(AU)
Asunto(s)
Animales , Mataderos , Pollos/metabolismo , Ayuno/efectos adversos , Carne/análisis , Bienestar del AnimalRESUMEN
Abstract OBJECTIVE To identify the length of perioperative fasting among patients submitted to gastrointestinal cancer surgeries. METHOD Retrospective cohort study, developed by consulting the medical records of 128 patients submitted to gastrointestinal cancer surgeries. RESULTS The mean of total length of fasting was 107.6 hours. The total length of fasting was significantly associated with the number of symptoms presented before (p=0.000) and after the surgery (p=0.007), the length of hospital stay (p=0.000), blood transfusion (p=0.013), nasogastric tube (p=0.001) and nasojejunal tube (p=0,003), postoperative admission at ICU (p=0.002), postoperative death (p=0.000) and length of preoperative fasting (p=0.000). CONCLUSION The length of fasting is associated with complications that affect the quality of the patients’ postoperative recovery and nurses’ work. The nursing team should be alert to this aspect and being responsible for overseeing the patients’ interest, should not permit the unnecessary extension of fasting.
Resumo OBJETIVO Identificar o tempo de jejum perioperatório e sua associação a variáveis pós-operatórias entre pacientes submetidos a cirurgias oncológicas do trato digestório. MÉTODO Estudo de coorte retrospectiva, realizado por meio da consulta a 128 prontuários de pacientes adultos, submetidos a cirurgias oncológicas gastrointestinais. RESULTADOS O tempo total de jejum durante a internação foi em média 107,6 horas. O tempo total de jejum foi associado de forma estatisticamente significante ao número de sintomas pré-operatórios (p=0,000) e pós-operatórios (p=0,007), ao período de internação (p=0,000), à transfusão sanguínea (p=0,013), ao uso de cateter nasogástrico (p=0,001) e nasoentérico (p=0,003), à admissão pós-operatória em terapia intensiva (p=0,002), à morte pós-operatória (p=0,000) e à duração do jejum pré-operatório (p=0,000). CONCLUSÃO A duração do jejum é associada a complicações que afetam a qualidade da recuperação do paciente e o trabalho da enfermagem. A equipe de enfermagem deve estar atenta a esse aspecto, uma vez que, como responsável pela vigilância dos interesses dos pacientes, não deve permitir o prolongamento desnecessário do período de jejum.
Resumen OBJETIVO Identificar la duración del ayuno perioperatorio entre los pacientes sometidos a cirugías de cáncer gastrointestinal. MÉTODO Estudio de cohorte retrospectivo, por consulta de los registros médicos de 128 pacientes sometidos a cirugías de cáncer gastrointestinal. RESULTADOS La media de la duración total del ayuno fue de 107,6 horas. La duración total del ayuno se asoció significativamente con el número de síntomas presentados antes (p=0,000) y después de la cirugía (p=0,007), la duración de la estancia hospitalaria (p=0,000), transfusión de sangre (p=0,013),tubo nasogástrico (P=0,003), ingreso postoperatorio en la UCI (p=0,002), muerte postoperatoria (p=0,000) y duración del ayuno preoperatorio (p=0,000). CONCLUSIÓN La duración del ayuno se asocia con complicaciones que afectan la calidad de la recuperación postoperatoria de los pacientes y el trabajo de enfermería. El equipo de enfermería debe estar alerta en relación a este aspecto y ser responsable de supervisar el interés de los pacientes, no permitiendo la extensión innecesaria del ayuno.
Asunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo , Ayuno/efectos adversos , Neoplasias del Sistema Digestivo , Enfermería Oncológica , Enfermería Perioperatoria , Estudios Retrospectivos , Estudios de CohortesRESUMEN
OBJECTIVE: To evaluate the change in respiratory function and functional capacity according to the type of preoperative fasting. METHODS: Randomized prospective clinical trial, with 92 female patients undergoing cholecystectomy by laparotomy with conventional or 2 hours shortened fasting. The variables measured were the peak expiratory flow, forced expiratory volume in the first second, forced vital capacity, dominant handgrip strength, and non-dominant handgrip strength. Evaluations were performed 2 hours before induction of anesthesia and 24 hours after the operation. RESULTS: The two groups were similar in preoperative evaluations regarding demographic and clinical characteristics, as well as for all variables. However, postoperatively the group with shortened fasting had higher values than the group with conventional fasting for lung function tests peak expiratory flow (128.7±62.5 versus 115.7±59.9; p=0.040), forced expiratory volume in the first second (1.5±0.6 versus 1.2±0.5; p=0.040), forced vital capacity (2.3±1.1 versus 1.8±0.9; p=0.021), and for muscle function tests dominant handgrip strength (24.9±6.8 versus 18.4±7.7; p=0.001) and non-dominant handgrip strength (22.9±6.3 versus 17.0±7.8; p=0.0002). In the intragroup evaluation, there was a decrease in preoperative compared with postoperative values, except for dominant handgrip strength (25.2±6.7 versus 24.9±6.8; p=0.692), in the shortened fasting group. CONCLUSION: Abbreviation of preoperative fasting time with ingestion of maltodextrin solution is beneficial to pulmonary function and preserves dominant handgrip strength.
Asunto(s)
Ayuno/metabolismo , Capacidad Residual Funcional/efectos de los fármacos , Fuerza Muscular/efectos de los fármacos , Polisacáridos/farmacología , Capacidad Vital/efectos de los fármacos , Adulto , Colecistectomía/efectos adversos , Colecistolitiasis/cirugía , Ayuno/efectos adversos , Femenino , Volumen Espiratorio Forzado/efectos de los fármacos , Fuerza de la Mano/fisiología , Humanos , Persona de Mediana Edad , Polisacáridos/metabolismo , Periodo Posoperatorio , Cuidados Preoperatorios , Estudios Prospectivos , Espirometría , Factores de TiempoRESUMEN
BACKGROUND AND OBJECTIVES: Patient's satisfaction is a standard indicator of care quality. The aim of this study was to evaluate whether a preoperative oral ingestion of 200 mL of a carbohydrate drink can improve comfort and satisfaction with anesthesia in elderly patients with hip fracture. METHOD: Prospective randomized clinical trial conducted in a Brazilian public hospital, with patients ASA I-III undergoing surgery for hip fracture. The control group (NPO) received nothing by mouth after 9:00 p.m. the night before, while patients in the experimental group (CHO) received 200 mL of a carbohydrate drink 2-4 h before the operation. Patients' characteristics, subjective perceptions, thirst and hunger and satisfaction were determined in four steps. Mann-Whitney U-test and Fisher exact test were used for comparison of control and experimental groups. A p-value <0.05 was considered significant. RESULTS: A total of 100 patients were included in one of the two regimens of preoperative fasting. Fasting time decreased significantly in the study group. Patients drank 200 mL 2:59 h before surgery and showed no hunger (p < 0.00) and thirst on arrival to OR (p < 0.00), resulting in increased satisfaction with the perioperative anesthesia care (p < 0.00). CONCLUSIONS: The satisfaction questionnaire for surgical patient could become a useful tool in assessing the quality of care. In conclusion, CHO significantly reduces preoperative discomfort and increases satisfaction with anesthesia care. .
JUSTIFICATIVA E OBJETIVOS: A satisfação do paciente é indicador padrão da qualidade da assistência prestada. O objetivo deste estudo foi avaliar se a ingestão de 200 mL oral pré-operatória de uma bebida de carboidratos pode melhorar o conforto e a satisfação com a anestesia no paciente idoso com fratura de quadril. MÉTODO: Ensaio clínico prospectivo e randomizado realizado em hospital público de saúde brasileiro, pacientes estado físico ASA I-III submetidos à cirurgia de fratura de quadril. O grupo controle (NPO) não recebeu nada pela boca, após as 21 horas da noite anterior, enquanto que os pacientes no grupo experimental (CHO) recebeu 200 mL de uma bebida de carbohidratos de 2 a 4 horas antes da operação. Características dos pacientes, percepções subjetivas, presença de sede e fome e satisfação dos pacientes foi apurado em quatro etapas. Teste de Mann-Whitney U-test e exato de Fisher foram utilizados entre o grupo controle e o grupo experimental. Valor de p < 0,05 foi considerado significativo. RESULTADOS: Um total de 100 pacientes foram incluídos em um dos dois regimes de jejum pré-operatório. Tempo de jejum diminuiu significativamente no grupo de estudo. Pacientes beberam 200 mL 2:59 h antes da cirurgia e não apresentaram fome (p < 0,00) e sede na chegada à SO (p < 0,00), resultando em aumento da satisfação com o cuidado perioperatório anestesia (p < 0,00). CONCLUSÕES: O questionário de satisfação do paciente cirúrgico poderia tornar-se um instrumento útil na avaliação da qualidade de atendimento. Em conclusão, CHO reduz significativamente o desconforto pré-operatório e satisfação com os cuidados da anestesia. .
JUSTIFICACIÓN Y OBJETIVOS: La satisfacción del paciente es un indicador estándar de la calidad de la asistencia prestada. El objetivo de este estudio fue evaluar si la ingestión oral preoperatoria de 200 ml de una bebida de hidratos de carbono puede mejorar el bienestar y la satisfacción con la anestesia en el paciente anciano con fractura de cadera. MÉTODO: Ensayo clínico prospectivo y aleatorizado realizado en un hospital público brasileño, en pacientes estado físico ASA I-III sometidos a cirugía de fractura de cadera. El grupo control no recibió nada por la boca, después de las 21 h de la noche anterior, mientras que los pacientes en el grupo experimental recibieron 200 ml de una bebida de hidratos de carbono 2-4 h antes de la operación. Se investigaron características de los pacientes, percepciones subjetivas, presencia de sed y hambre, y satisfacción de los pacientes en 4 etapas. El test U de Mann-Whitney y el exacto de Fisher fueron utilizados en el grupo control y el grupo experimental. Un valor de p < 0,05 fue considerado significativo. RESULTADOS: Un total de 100 pacientes fueron incluidos en uno de los 2 regímenes de ayuno preoperatorio. El tiempo de ayuno disminuyó significativamente en el grupo de estudio. Los pacientes bebieron 200 ml 2:59 h antes de la cirugía y no sintieron hambre (p < 0,00) ni sed a su llegada al quirófano (p < 0,00), lo que trajo un aumento de la satisfacción con el cuidado perioperatorio anestésico (p < 0,00). CONCLUSIONES: El cuestionario de satisfacción del paciente quirúrgico podría convertirse en un instrumento útil para la evaluación de la calidad de la atención. Como conclusión, podemos decir que los hidratos de carbono reducen significativamente el malestar preoperatorio y aumentan la satisfacción con los cuidados de la anestesia. .
Asunto(s)
Humanos , Satisfacción Personal , Carbohidratos/administración & dosificación , Ayuno/efectos adversos , Fracturas de Cadera/cirugía , Anestesia Raquidea/instrumentaciónRESUMEN
Different regimens of food restriction have been associated with protection against obesity, diabetes and CVD. In the present study, we hypothesised that food restriction would bring benefits to atherosclerosis- and diabetes-prone hypercholesterolaemic LDL-receptor knockout mice. For this purpose, 2-month-old mice were submitted to an intermittent fasting (IF) regimen (fasting every other day) over a 3-month period, which resulted in an overall 20 % reduction in food intake. Contrary to our expectation, epididymal and carcass fat depots and adipocyte size were significantly enlarged by 15, 72 and 68 %, respectively, in the IF mice compared with the ad libitum-fed mice. Accordingly, plasma levels of leptin were 50 % higher in the IF mice than in the ad libitum-fed mice. In addition, the IF mice showed increased plasma levels of total cholesterol (37 %), VLDL-cholesterol (195 %) and LDL-cholesterol (50 %). As expected, in wild-type mice, the IF regimen decreased plasma cholesterol levels and epididymal fat mass. Glucose homeostasis was also disturbed by the IF regimen in LDL-receptor knockout mice. Elevated levels of glycaemia (40 %), insulinaemia (50 %), glucose intolerance and insulin resistance were observed in the IF mice. Systemic inflammatory markers, TNF-α and C-reactive protein, were significantly increased and spontaneous atherosclerosis development were markedly increased (3-fold) in the IF mice. In conclusion, the IF regimen induced obesity and diabetes and worsened the development of spontaneous atherosclerosis in LDL-receptor knockout mice. Although being efficient in a wild-type background, this type of food restriction is not beneficial in the context of genetic hypercholesterolaemia.