RESUMO
Objetivo: evaluar la efectividad de la técnica de conteo de grasas y ajuste de enzimas pancreáticas en un grupo de pacientes con insuficiencia pancreática secundaria a fibrosis quística (FQ). Materiales y métodos: En un grupo de pacientes con FQ, sin otra patología asociada, mayores de 1 año, con >10 000 UKD (unidades por kilo por día) de lipasa; se realizó educación y aplicación de técnica de conteo de grasas con ajuste enzimático, solicitando Van de Kamer y registro alimentario de 5 días durante la recolección de la muestra con un intervalo de 3 meses entre ambas determinaciones. Se evaluó la efectividad de la misma y las dosis de enzimas utilizadas mediante el porcentaje de excreción grasa (PEG), así como las variaciones en la cantidad de enzimas utilizadas y la ganancia de peso. Los datos se registraron en RED Cap (Research Electronic Data Capture) y se analizaron mediante Stata 12. Resultados: De un total de 21 pacientes, 16 completaron la intervención. El 50% presentó un índice de masa corporal (IMC) mayor del Plo 25 antes y después, un 87% alcanzó adecuación calórica mayor del 120% de la ingestas diarias recomendadas (RDA) al final, logrando un aumento promedio de z score de peso de 0,28 con una media inicial de 17 kg y final de 18,2 kg. En cuanto a la media del requerimiento enzimático fue de 14 800 UKD antes y 10 145 UKD después (z=0,002), asimismo el porcentaje de excreción grasa (PEG) tuvo una disminución del 38% (p=0,1705). Conclusiones: La implementación de la técnica de conteo de grasas y ajuste enzimático, podría ser una estrategia válida para aquellos pacientes con FQ que tienen dosis altas de enzimas e inadecuada ganancia de peso (AU)
Objective: To evaluate the effectiveness of the fat counting technique and pancreatic enzyme adjustment in a group of patients with pancreatic insufficiency secondary to cystic fibrosis (CF). Materials and methods: A group of patients with CF without other associated diseases, older than 1 year of age, lipase dose >10 000 UKD (units per kilo per day), received education on the fat counting technique with enzyme adjustment followed by its implementation of the intervention. Van de Kamer was requested and a 5-day food record was kept during the sample collection with an interval of 3 months between both measurements. The effectiveness of the technique and the enzyme doses used were evaluated based on the percentage of fat excretion (PFE), as well as the variations in the amount of enzymes used and weight gain. Data were recorded in RED Cap (Research Electronic Data Capture) and analyzed using Stata 12. Results: Of a total of 21 patients, 16 completed the intervention. Fifty percent had a body mass index (BMI) greater than Plo 25 before and after the intervention; 87% had achieved a caloric increase greater than 120% of the recommended daily intake (RDA) at the end of the study and an average increase in weight z score of 0.28 with an initial mean of 17 kg and a final mean of 18.2 kg. Mean enzyme requirement was 14 800 UKD before and 10 145 UKD after the intervention (z=0.002). PFE decreased by 38% (p=0.1705). Conclusions: The implementation of the technique of fat counting and enzyme adjustment may be a valid strategy for CF patients with high enzyme doses and inadequate weight gain. (AU)
Assuntos
Lactente , Pré-Escolar , Criança , Adolescente , Pâncreas/enzimologia , Insuficiência Pancreática Exócrina , Gorduras na Dieta/administração & dosagem , Fibrose Cística/dietoterapia , Glândulas Exócrinas/anormalidades , Terapia de Reposição de EnzimasRESUMO
The objective was to evaluate the performance, relative organ weight, morphometry, intestinal length and pancreatic enzyme activity of broilers receiving neonatal supplementation. A total of 900 Cobb 500 broiler chicks was housed in 30 boxes of 2.5 m². The treatments were divided in a completely randomized design with six replications, and consisted of five inclusion levels (0.0, 2.5, 5.0, 7.5and 10 grams per bird). The supplement used was based of amino acids, vitamins and minerals, which wasprovided on the ration on the first day in the housing. Statistical analysis was performed using SAS (2008) and when significant broken down using a polynomial regression. Due to the inclusion of the neonatal supplement in the period from one to seven and one to 21 days of age, the feed intake presented a linear effect and the weight gain, a quadratic effect. The relative weights of the gizzard and liver showed a quadratic effect, and the inclusions of 4.18 and 3.41 grams/bird provided the lowest weights, respectively. The jejunum villi height decreased with supplementation as well as the activity of pancreatic lipase. It can be concluded that neonatal supplementation benefited the performance of birds up to 21 days of age.(AU)
O objetivo foi avaliar o desempenho, peso relativo de órgãos, morfometria, comprimento intestinal e atividade de enzimas pancreáticas de frangos de corte recebendo suplemento neonatal. Foramutilizados 900 pintos de corte da linhagem Cobb 500, alojados em 30 boxes de 2,5 m². Os tratamentosforam divididos em delineamento inteiramente casualizado, com seis repetições, e consistiram em cinconíveis de inclusão (0,0; 2,5; 5,0; 7,5 e 10 gramas por ave). O suplemento utilizado foi à base de aminoácidos,vitaminas e minerais, o qual foi fornecido no primeiro dia de alojamento sobre a ração. A análise estatísticafoi realizada utilizando o SAS (2008) e quando significativos desdobrados em regressão polinomial. Em função da inclusão do suplemento neonatal no período de um a sete e de um a 21 dias de idade o consumode ração apresentou efeito linear e o ganho de peso efeito quadrático. Os pesos relativos da moela e dofígado apresentaram efeito quadrático, e as inclusões de 4,18 e 3,41 gramas/ave proporcionaram os menores pesos respectivamente. A altura das vilosidades do jejuno diminuiu com a suplementação assim como aatividade da lipase pancreática. Conclui-se que a suplementação neonatal beneficiou o desempenho das avesaté os 21 dias de idade.(AU)
Assuntos
Animais , Aves Domésticas/anatomia & histologia , Aves Domésticas/metabolismo , Ativação Enzimática , Suplementos Nutricionais/análise , Suplementos NutricionaisRESUMO
The objective was to evaluate the performance, relative organ weight, morphometry, intestinal length and pancreatic enzyme activity of broilers receiving neonatal supplementation. A total of 900 Cobb 500 broiler chicks was housed in 30 boxes of 2.5 m². The treatments were divided in a completely randomized design with six replications, and consisted of five inclusion levels (0.0, 2.5, 5.0, 7.5and 10 grams per bird). The supplement used was based of amino acids, vitamins and minerals, which wasprovided on the ration on the first day in the housing. Statistical analysis was performed using SAS (2008) and when significant broken down using a polynomial regression. Due to the inclusion of the neonatal supplement in the period from one to seven and one to 21 days of age, the feed intake presented a linear effect and the weight gain, a quadratic effect. The relative weights of the gizzard and liver showed a quadratic effect, and the inclusions of 4.18 and 3.41 grams/bird provided the lowest weights, respectively. The jejunum villi height decreased with supplementation as well as the activity of pancreatic lipase. It can be concluded that neonatal supplementation benefited the performance of birds up to 21 days of age.
O objetivo foi avaliar o desempenho, peso relativo de órgãos, morfometria, comprimento intestinal e atividade de enzimas pancreáticas de frangos de corte recebendo suplemento neonatal. Foramutilizados 900 pintos de corte da linhagem Cobb 500, alojados em 30 boxes de 2,5 m². Os tratamentosforam divididos em delineamento inteiramente casualizado, com seis repetições, e consistiram em cinconíveis de inclusão (0,0; 2,5; 5,0; 7,5 e 10 gramas por ave). O suplemento utilizado foi à base de aminoácidos,vitaminas e minerais, o qual foi fornecido no primeiro dia de alojamento sobre a ração. A análise estatísticafoi realizada utilizando o SAS (2008) e quando significativos desdobrados em regressão polinomial. Em função da inclusão do suplemento neonatal no período de um a sete e de um a 21 dias de idade o consumode ração apresentou efeito linear e o ganho de peso efeito quadrático. Os pesos relativos da moela e dofígado apresentaram efeito quadrático, e as inclusões de 4,18 e 3,41 gramas/ave proporcionaram os menores pesos respectivamente. A altura das vilosidades do jejuno diminuiu com a suplementação assim como aatividade da lipase pancreática. Conclui-se que a suplementação neonatal beneficiou o desempenho das avesaté os 21 dias de idade.
Assuntos
Animais , Ativação Enzimática , Aves Domésticas/anatomia & histologia , Aves Domésticas/metabolismo , Suplementos Nutricionais , Suplementos Nutricionais/análiseRESUMO
BACKGROUND: Puncture biopsy and fine needle aspiration guided by endoscopic ultrasound has been used as an effective technique and is quickly becoming the procedure of choice for diagnosis and staging in patients suspected of having pancreatic cancer. This procedure has replaced retrograde cholangiopancreatography and brush cytology due to its higher sensitivity for diagnosis, and lower risk of complications. OBJECTIVE: To assess the levels of pancreatic enzymes amylase and lipase, after the puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions and the frequency of post-puncture acute pancreatitis. MATERIAL AND METHODS: A longitudinal and descriptive study of consecutive cases was performed on outpatients submitted to puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions. Levels of pancreatic enzymes such as amylase and lipase were measured before and after the pancreatic puncture. Finally we documented post-puncture pancreatitis cases. RESULTS: A total of 100 patients who had been diagnosed with solid and cystic lesions were included in the study. Significant elevation was found at twice the reference value for lipase in 5 cases (5%) and for amylase in 2 cases (2%), none had clinical symptoms of acute pancreatitis. Eight (8%) of patients presented with mild nonspecific pain with no enzyme elevation compatible with pancreatitis. CONCLUSION: Pancreatic biopsy needle aspiration guided by endoscopic ultrasound was associated with a low rate of elevated pancreatic enzymes and there were no cases of post-puncture pancreatitis.
Assuntos
Amilases/sangue , Biópsia/métodos , Lipase/sangue , Pancreatopatias/patologia , Pancreatite/enzimologia , Ultrassonografia de Intervenção , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia/efeitos adversos , Biópsia por Agulha Fina/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/lesões , Pâncreas/patologia , Pancreatopatias/diagnóstico por imagem , Pancreatite/etiologia , Estudos Prospectivos , Sensibilidade e Especificidade , Adulto JovemRESUMO
Exocrine pancreatic insufficiency (EPI), a common disease indogs, is mainly caused by pancreatic acinar atrophy, followedby chronic pancreatitis and pancreatic duct obstruction, withconsequent inadequate secretion of pancreatic enzymes.The present paper is a case report observed in a male eightyear-old dog that had the diagnosis of EPI suggested by thefecal proteolytic activity test (X-ray film proof). To date, thetreatment given with pancreatic enzyme supplementation andadequate diet has been able to promote the resolution of theclinical condition.(AU)
A insuficiência pancreática exócrina (IPE), doença comum principalmenteem cães, é causada, usualmente, pela atrofia acinar dopâncreas, seguida de pancreatite crônica e obstrução do ductopancreático, com consequente secreção inadequada de enzimaspancreáticas. O caso clínico descrito foi observado em um cão,macho, de oito anos de idade, em que o diagnóstico de IPE foilevantado pelo resultado do teste da atividade proteolítica fecal(prova do filme de raio-x). Até o presente momento, o tratamentoinstituído com suplementação de enzimas pancreáticas eadequação da dieta propiciou a resolução do quadro clínico.(AU)
Assuntos
Animais , Cães , /classificação , Insuficiência Pancreática Exócrina/diagnóstico , Insuficiência Pancreática Exócrina/veterinária , Estudos Clínicos como Assunto , Tripsina/análiseRESUMO
Exocrine pancreatic insufficiency (EPI), a common disease indogs, is mainly caused by pancreatic acinar atrophy, followedby chronic pancreatitis and pancreatic duct obstruction, withconsequent inadequate secretion of pancreatic enzymes.The present paper is a case report observed in a male eightyear-old dog that had the diagnosis of EPI suggested by thefecal proteolytic activity test (X-ray film proof). To date, thetreatment given with pancreatic enzyme supplementation andadequate diet has been able to promote the resolution of theclinical condition.
A insuficiência pancreática exócrina (IPE), doença comum principalmenteem cães, é causada, usualmente, pela atrofia acinar dopâncreas, seguida de pancreatite crônica e obstrução do ductopancreático, com consequente secreção inadequada de enzimaspancreáticas. O caso clínico descrito foi observado em um cão,macho, de oito anos de idade, em que o diagnóstico de IPE foilevantado pelo resultado do teste da atividade proteolítica fecal(prova do filme de raio-x). Até o presente momento, o tratamentoinstituído com suplementação de enzimas pancreáticas eadequação da dieta propiciou a resolução do quadro clínico.
Assuntos
Animais , Cães , Insuficiência Pancreática Exócrina/diagnóstico , Insuficiência Pancreática Exócrina/veterinária , Estudos Clínicos como Assunto , Tripsina/análiseRESUMO
En los pacientes con fibrosis quística (FQ) el íleo meconial, el síndrome de obstrucción distal y la constipación conforman un grupo de manifestaciones gastrointestinales con una gravedad variable como consecuencia del incremento en la viscosidad del moco y el tiempo prolongado del tránsito intestinal. El grupo de trabajo de fibrosis quística de la Sociedad Europea de Gastroenterología, Hepatología y Nutrición Pediátrica realizó un consenso en 2010 y definió el síndrome de obstrucción intestinal distal (DIOS) como un cuadro agudo de obstrucción intestinal que puede ser completo o incompleto. El DIOS completo se define como un cuadro de vómito bilioso y/o niveles hidroaéreos en el intestino delgado observados en la radiografía de abdomen, masa fecal a nivel ileocecal, y dolor y/o distensión abdominal; el incompleto se define como el cuadro de dolor abdominal y/o distensión y masa fecal a nivel ileocecal, pero sin los otros signos de obstrucción completa. La frecuencia de presentación de esta entidad en pacientes con FQ es variable y depende de las definiciones utilizadas; se ha considerado que la prevalencia va del 7% a 8% en niños y en adultos puede ser tan alta como de 23,3 episodios por 1000 pacientes/año, con una prevalencia que varía entre el 14% y el 16%. Dadas las dificultades que se presentan en estos pacientes para definir y establecer el diagnóstico, quisimos ilustrar este síndrome con 2 niños que consultaron a nuestra institución; además, se realizó una revisión del tema para generar sensibilización sobre el diagnóstico temprano y su manejo.
Patients with cystic fibrosis (CF) have greater than normal mucosal viscosity and prolonged intestinal transit times which can result in meconium ileus, distal intestinal obstruction syndrome (DIOS) and constipation of varying severity. The cystic fibrosis working group of the European Society of Gastroenterology, Hepatology and Pediatric Nutrition produced a consensus in 2010 that defined distal intestinal obstruction syndrome (DIOS) as acute intestinal obstruction which may be complete or incomplete. Fully developed DIOS is defined as bilious vomiting and/or sufficient amounts of fluid and air in the small intestine to be observed in an abdominal X-ray, a fecal mass in the ileocecal area, pain and/or bloating. Incomplete DIOS is defined as abdominal pain and/or bloating and fecal mass in the ileocecal area, but without the other signs of complete obstruction. The incidence of this condition in cystic fibrosis patients varies. Depending on the definition used, the prevalence of DIOS has been measured between 7% and 8% in children with cystic fibrosis, but has been reported to be as high as 23.3 episodes per 1,000 patients per year for adult cystic fibrosis patients with a prevalence ranging between 14% and 16%. Given the difficulties of establishing this diagnosis in these patients, we wanted to illustrate this syndrome with two children who were treated in our institution and to review this subject in order to generate awareness about early diagnosis and management.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Constipação Intestinal , Fibrose Cística , Enzimas , Hepatopatia Veno-OclusivaRESUMO
The present study aimed to evaluate the effect of different levels of an ethanolic extract of propolis (EEP) on broiler performance, carcass characteristics, weight of gastrointestinal organs, intestinal morphometry and digestive enzyme activity. 1020 male broiler chicks were assigned in a completely randomised experimental design to six treatments (EEP supplement levels of 0, 1000, 2000, 3000, 4000 and 5000 ppm) and five replications, and 34 birds per experimental unit. The experimental diets were administered from 1 to 21 days of age, and the birds were subsequently provided a ration based on corn and soybean meal. EEP supplementation from 1 to 7 days negatively affected (p < 0.05) the weight gain and feed intake. The proventriculus weight at 7 days exhibited a quadratic response (p < 0.05), which predicted a lower weight at a dose of 2865 ppm of the EEP. For the duodenum at 21 days of age, the response pattern (p < 0.05) predicted that birds that were fed 2943 and 3047 ppm of the EEP would exhibit an improved crypt depth and villus-to-crypt ratio respectively. The villus height, crypt depth and villus-to-crypt ratio in the jejunum and the ileum were not affected (p > 0.05). With increased EEP doses, the duodenal sucrase activity linearly decreased at 7 days of age and linearly increased in the jejunum at 21 days of age (p < 0.05), while pancreatic enzyme activity was unaffected (p > 0.05). Although the carcass and cut yields did not improve, the percentage of abdominal fat decreased (p < 0.05). The supplementation of the broiler pre-starter diet with 1000-5000 ppm of the EEP impaired performance at this stage, most likely due to the decreased sucrase activity. However, the EEP supplementation from 3000 ppm improved intestinal morphophysiology at 21 days of age and did not affect the performance or carcass yield at 42 days of age.
Assuntos
Galinhas/metabolismo , Suplementos Nutricionais , Etanol/química , Trato Gastrointestinal/enzimologia , Intestinos/anatomia & histologia , Própole/farmacologia , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Galinhas/anatomia & histologia , Dieta/veterinária , Intestinos/efeitos dos fármacos , Masculino , Própole/químicaRESUMO
Foi avaliado o efeito da adição de glutamina, ácidos graxos poliinsaturados ou parede celular de levedura à dieta de leitões desmamados sobre a atividade das enzimas pancreáticas (lipase, amilase e tripsina) e da mucosa intestinal (dipeptidase, sacarase e maltase) e sobre o desempenho. Foram utilizados 45 leitões desmamados e distribuídos em delineamento em blocos casualizados, em esquema fatorial, com quatro dietas (T1 - dieta basal (DB); T2 - DB + 1% de glutamina; T3 - DB + 0,2% de parede celular de levedura; T4 - DB + 5% de óleo de peixe) e duas idades de abate (sete e 14 dias pós-desmame). O desempenho foi medido nas duas primeiras semanas pós-desmame. A adição de 1% de glutamina na dieta dos leitões aumentou a atividade específica e total da amilase, e atividade total da tripsina na segunda semana pós-desmame. Os demais aditivos não alteraram a atividade das enzimas digestivas nos leitões. Também foi observado aumento na atividade total da lipase, e atividade específica da tripsina e maltase em função da idade pós desmame. De modo geral, as atividades das enzimas digestivas estiveram correlacionadas positivamente, com exceção da dipeptidase que não se correlacionou com nenhuma outra enzima. Foi observada correlação positiva entre ganho de peso e atividades da lipase e da amilase. Os aditivos incluídos na dieta não influenciam o desempenho dos leitões no pós-desmame.
It was evaluated the effect of the addition of glutamine, polyunsaturated fatty acids or cellular wall of yeast to the diet of weaned pigs on the activity of the pancreatic enzymes (lipase, amylase and trypsin) and the intestinal mucous membrane (dipeptidase, sucrase and maltase) and on the performance. Forty-five weaned pigs were used and distributed in a randomized block design, in factorial outline, with four diets (T1 - basal diet (BD); T2 - BR + 1% glutamine; T3 - BD + 0,2% cellular wall of yeast; T4 - BD + 5% fish oil) and two slaughter ages (seven and 14 days post weaning). The performance was measured in the first two weeks post-weaning. The addition of 1% glutamine in the diet of pigs increased the specific and total activity of the amylase, and total activity of the trypsin in the second week post weaning. The others supplements not change the activity of the digestive enzymes in the pigs. Also an increase was observed in the total activity of the lipase, and specific activity of the trypsin and maltase in function of the age post-weaning. In general, the activities of the digestive enzymes were correlated positively, except for the dipeptidase that was not correlated with any other enzyme. Positive correlation was observed between weight gain and activity of the lipase and of the amylase. The supplements included in the diet not influence the performance of weaned pigs.
Assuntos
Animais , Dieta , Enzimas , Suínos/classificação , Glutamina/biossíntese , Prebióticos/efeitos adversosRESUMO
Foi avaliado o efeito da adição de glutamina, ácidos graxos poliinsaturados ou parede celular de levedura à dieta de leitões desmamados sobre a atividade das enzimas pancreáticas (lipase, amilase e tripsina) e da mucosa intestinal (dipeptidase, sacarase e maltase) e sobre o desempenho. Foram utilizados 45 leitões desmamados e distribuídos em delineamento em blocos casualizados, em esquema fatorial, com quatro dietas (T1 - dieta basal (DB); T2 - DB + 1% de glutamina; T3 - DB + 0,2% de parede celular de levedura; T4 - DB + 5% de óleo de peixe) e duas idades de abate (sete e 14 dias pós-desmame). O desempenho foi medido nas duas primeiras semanas pós-desmame. A adição de 1% de glutamina na dieta dos leitões aumentou a atividade específica e total da amilase, e atividade total da tripsina na segunda semana pós-desmame. Os demais aditivos não alteraram a atividade das enzimas digestivas nos leitões. Também foi observado aumento na atividade total da lipase, e atividade específica da tripsina e maltase em função da idade pós desmame. De modo geral, as atividades das enzimas digestivas estiveram correlacionadas positivamente, com exceção da dipeptidase que não se correlacionou com nenhuma outra enzima. Foi observada correlação positiva entre ganho de peso e atividades da lipase e da amilase. Os aditivos incluídos na dieta não influenciam o desempenho dos leitões no pós-desmame.(AU)
It was evaluated the effect of the addition of glutamine, polyunsaturated fatty acids or cellular wall of yeast to the diet of weaned pigs on the activity of the pancreatic enzymes (lipase, amylase and trypsin) and the intestinal mucous membrane (dipeptidase, sucrase and maltase) and on the performance. Forty-five weaned pigs were used and distributed in a randomized block design, in factorial outline, with four diets (T1 - basal diet (BD); T2 - BR + 1% glutamine; T3 - BD + 0,2% cellular wall of yeast; T4 - BD + 5% fish oil) and two slaughter ages (seven and 14 days post weaning). The performance was measured in the first two weeks post-weaning. The addition of 1% glutamine in the diet of pigs increased the specific and total activity of the amylase, and total activity of the trypsin in the second week post weaning. The others supplements not change the activity of the digestive enzymes in the pigs. Also an increase was observed in the total activity of the lipase, and specific activity of the trypsin and maltase in function of the age post-weaning. In general, the activities of the digestive enzymes were correlated positively, except for the dipeptidase that was not correlated with any other enzyme. Positive correlation was observed between weight gain and activity of the lipase and of the amylase. The supplements included in the diet not influence the performance of weaned pigs.(AU)