Prevalencia y factores relacionados con desnutrición en la primera infancia. Colombia año 2018 a 2020

La desnutrición como enfermedad de origen social es la expresión última de la situación de inseguridad alimentaria y nutricional de una población, al afectar principalmente a los niños. El objetivo fue analizar la prevalencia y factores relacionados con la desnutrición en la primera infancia en Colombia durante los años 2018 a 2020, mediante un estudio cuantitativo descriptivo de tipo ecológico - exploratorio, con recolección de datos retrospectivos a partir de reportes obtenidos del Sistema Integrado de Información de la Protección Social. El total de casos corresponde a 43.823 reportes, la prevalencia para los tres años fue de 1,13% principalmente en los departamentos de Guajira (n: 3.488; 3,17%) y Boyacá (n: 1.277; 1,39%), mayor número de casos presentados en el sexo masculino (n: 23.804; 54,3%), en edad entre 0 y 1 año (n: 17.099; 39,0%), pertenecientes al régimen subsidiado (n: 28.814; 65,75%) y ubicados en la cabecera municipal (n: 28.114; 64,15%). Con relación a la pertenencia étnica la mayor frecuencia se evidencia en "otras etnias" (n: 33.050; 75,42%), seguido de la etnia indígena (n: 8.348; 19,05%) y el estrato socioeconómico más representativo es el "bajo-bajo" (n: 17.620; 40,21%). Además, existe relación entre el sexo masculino y la desnutrición, comportándose como un factor de riesgo, y el vivir en centro poblado disminuye la probabilidad de presentar desnutrición. Se evidenció una frecuencia significativa de características asociadas a los determinantes sociales en salud y variables específicas relacionadas con la desnutrición.

Malnutrition as a disease of social origin is the ultimate expression of the situation of food and nutritional insecurity of a population, mainly affecting children. The objective was to analyze the prevalence and factors related to malnutrition in early childhood in Colombia during the years 2018 to 2020, through a descriptive quantitative study of an ecological-exploratory type, with retrospective data collection from reports obtained from the Integrated System of Social Protection Information. The total number of cases corresponds to 43,823 reports, the prevalence for the three years was 1.13%, mainly in the departments of Guajira (n: 3,488; 3.17%) and Boyacá (n: 1,277; 1.39%). greater number of cases presented in males (n: 23,804; 54.3%), aged between 0 and 1 year (n: 17,099; 39.0%), belonging to the subsidized regime (n: 28,814; 65.75%) and located in the municipal seat (n: 28,114; 64.15%). In relation to ethnicity, the highest frequency is evidenced in "other ethnic groups" (n: 33,050; 75.42%), followed by the indigenous ethnic group (n: 8,348; 19.05%), and the most representative socioeconomic stratum is the "low-low" (n: 17,620; 40.21%). In addition, there is a relationship between the male sex and malnutrition, behaving as a risk factor, and living in a populated center decreases the probability of presenting malnutrition. A significant frequency of characteristics associated with the social determinants of health and specific variables related to malnutrition was evidenced.

Aerobic Exercise Increases the Damage to the Femoral Properties of Growing Rats with Protein-Based Malnutrition

Abstract The present study investigated the effects of aerobic physical training on the femoral morphological, densitometric and biomechanical properties in growing male rats subjected to protein-based malnutrition. Four-week-old male Wistar rats were randomized into groups of 10 animals: Control Sedentary (CS), Control Trained (CT), Malnourished Sedentary (MS) and Malnourished Trained (MT). Control and malnourished animals received diets with 12% protein and 6% protein, respectively. The trained groups were submitted to a treadmill running program for 8 weeks. Total proteins and albumin were analyzed in the animals' blood plasma. Histological, densitometric and biomechanical analyzes were performed on the animals' femur. Body mass gain, physical performance, biochemical markers and the femoral morphological, densitometric and biomechanical properties were determined. Exercise tolerance increased in trained groups. Malnourished animals exhibited lower serum protein and albumin levels than controls. Porosity and trabecular bone density were not different between groups. The femoral maximum load, maximum load until fracture, resilience, stiffness, tenacity and densitometric properties were reduced by malnutrition. Physical training associated with malnutrition exacerbated the impairment in the femoral maximum load, maximum load until fracture, bone mineral content and density. Aerobic physical training worsens the damages induced by protein-based malnutrition in the femoral biomechanical and densitometric properties of growing male rats.

Protein malnutrition effects of perivascular bone marrow microenvironment on the regulation of hematopoiesis / Efeitos da desnutrição proteica sobre o microambiente perivascular medular na regulação da hematopoese

Protein malnutrition (PM) causes anemia and leukopenia by reduction of hematopoietic precursors and impaired production of mediators that induce hematopoiesis, as well as structural and ultrastructural changes in the bone marrow (BM) extracellular matrix. Hematopoiesis occurs in the bone marrow (BM) in distinct regions called niches, which modulate the processes of differentiation, proliferation and self-renewal of the hematopoietic stem cell (HSC). The perivascular niche, composed mainly by mesenchymal stem cells (MSC) and endothelial cells (EC), is the major modulator of HSC and its function extends to the migration of mature hematopoietic cells into the peripheral blood through the production of cytokines and growth factors. Thus, our hypothesis is that PM changes the perivascular niche and our objective is to evaluate whether PM affects the modulatory capacity of MSC and EC on hematopoiesis. C57BL/6 male mice were divided into Control and Malnourished groups, which received for 5 weeks, respectively, a normal protein diet (12% casein) and a low protein diet (2% casein). After this period, animals were euthanized, nutritional and hematological evaluations were performed, featuring the PM. We performed leukemic myelo-monoblasts cells transplantation and observed that these cells have a lower proliferation rate and are rather in the cell cycle G0/G1 phases in malnourished mice, indicating that the BM microenvironment is compromised in PM. MSC were isolated, characterized and differentiated in vitro into EC cells, which were evidenced by CD31 and CD144 markers. We performed the quantification of HSC and hematopoietic progenitors, as well as some regulators of proliferation and differentiation, ex vivo and after cultures with MSC or EC. We observed that PM reduces HSC and hematopoietic progenitors ex vivo. In PM, MSC promote increase in HSC and suppress hematopoietic differentiation, whereas ECs induce cell cycle arrest. Additionally, we verified that PM affects granulopoesis by decreasing the expression of G-CSFr in granule-monocytic progenitors. Thus, we conclude that PD compromises hematopoiesis due to intrinsic alterations in HSC, as well as alterations in the medullary perivascular niche

A desnutrição proteica (DP) provoca anemia e leucopenia decorrente da redução de precursores hematopoéticos e comprometimento da produção de mediadores indutores da hematopoese. A hematopoese ocorre na medula óssea (MO) em regiões distintas chamadas de nichos, que modulam os processos de diferenciação, proliferação e auto renovação da célula tronco hematopoiética (CTH). O microambiente perivascular, composto principalmente por células tronco mesenquimais (CTM) e células endoteliais (CE), é o principal modulador das CTH e sua função se estende até a migração das células hematopoiéticas maduras para o sangue periférico, através da produção de citocinas e fatores de crescimento. Dessa forma, nossa hipótese é que a DP altera o microambiente perivascular e objetivamos avaliar se a DP afeta a capacidade modulatória das CTM e CE sobre a hematopoese. Utilizamos camundongos C57BL/6 machos, divididos em grupos Controle e Desnutrido, sendo que o grupo Controle recebeu ração normoproteica (12% caseína) e o grupo Desnutrido recebeu ração hipoproteica (2% caseína), ambos durante 5 semanas. Após este período, os animais foram eutanasiados, foi realizada a avaliação nutricional e hematológica, caracterizando a DP. Realizamos transplantes de mielomonoblastos leucêmicos e observamos que estas células apresentam menor taxa de proliferação e se encontram em maior quantidade nas fases G0/G1 do ciclo celular em camundongos desnutridos, indicando que o microambiente medular está comprometido. Isolamos CTM, que foram caracterizadas e diferenciadas in vitro em CE, o que foi evidenciado pelos marcadores CD31 e CD144. Quantificamos CTH e progenitores hematopoéticos, bem como reguladores de proliferação e diferenciação, ex vivo e após culturas com CTM ou CE. Observamos que a DP reduz CTH e progenitores hematopoéticos ex vivo. Na DP, as CTM promovem incremento de CTH e suprimem a diferenciação hematopoética, enquanto que as CE induzem parada no ciclo celular. Adicionalmente, observamos que a DP afeta a granulopoese por diminuição da expressão de G-CSFr nos progenitores grânulo-monocíticos. Dessa forma, concluímos que a DP compromete a hematopoese por alterações intrínsecas na CTH, como também por alterações ocasionadas no microambiente perivascular medular

The effect of ileocecal valve removal in a model of short bowel syndrome / Efeito da remoção da válvula ileocecal em modelo de síndrome do intestino curto

ABSTRACT Background : Short bowel syndrome is a harmful condition that needs experimental research. Aim: To assess the impact of the ileocecal valve removal in a model of short bowel syndrome, in order to investigate the evolution of the colon under this circumstance. Method: Fifteen Wistar rats were equitable divided into: Control (Sham), Group I (70% enterectomy preserving ileocecal valve) and Group II (70% enterectomy excluding ileocecal valve). After enterectomy was performed jejunoileal or jejunocecal anastomosis and sacrificed the animals on 30th postoperative day for histomorphometric study of the colon. During this period, was observed the clinical evolution of the animals weekly including body weight measurement. Results: Group I and II presented progressive loss of weight. In Group I was observed diarrhea, perineal hyperemia and purple color of the colon during autopsy. Histomorphometry assay showed hypertrophy and hyperplasia of colon mucosa in Group I. In Group II the colon wall was thicker due to hypertrophy and muscular hyperplasia, and in mucosa vascular proliferation and inflammatory infiltrate were intense. Conclusion : This short bowel syndrome model is relevant and achieve 100% of survival. Animal's weight loss was not altered by the presence or exclusion of the ileocecal valve. Animals with 70% of small bowel removal and presence of the ileocecal valve attained a better clinical evolution and histological colon adaptation than those without ileocecal valve.

RESUMO Racional: Síndrome do intestino curto é condição clínica crítica e que precisa de pesquisa experimental. Objetivo: Avaliar o impacto da remoção da válvula ileocecal em um modelo de síndrome do intestino curto para investigar o comportamento do cólon nesta circunstância. Método: Quinze ratos Wistar foram divididos em três grupos de cinco: Controle (Sham), grupo I (enterectomia de 70% com preservação da válvula ileocecal), e grupo II (70% enterectomia de 70% excluindo a válvula ileocecal). Após a enterectomia foi restabelecido o trânsito com anastomose jejunoileal no grupo I e jejunocecal no grupo II. Os animais foram sacrificados no 30º dia do pós-operatório para histomorfometria do cólon. Durante este período, observou-se a evolução clínica semanal, incluindo a medição do peso corporal. Resultados: Grupos I e II apresentaram perda progressiva de peso. No grupo I houve diarreia, períneo hiperemiado e cor violácea do cólon durante a autópsia. A histomorfometria mostrou hipertrofia e hiperplasia da mucosa do cólon no grupo I. No grupo II a parede do cólon estava mais espessa devido à hipertrofia e hiperplasia das camadas muscular e mucosa onde a proliferação vascular e infiltração inflamatória foi intensa. Conclusão: Este modelo é factível e atingiu 100% de sobrevida. A perda de peso não foi alterada pela presença ou exclusão da válvula ileocecal. Animais com remoção de 70% do intestino delgado e presença da válvula ileocecal apresentaram melhor evolução clínica e adaptação histológica do cólon que os sem válvula ileocecal.

Influence of protein malnutrition on cutaneous wound healing in rats / Impacto da desnutrição proteica na cicatrização de feridas cutâneas em ratos

ABSTRACT Objective Investigate histological changes related to inflammatory response and collagen expression during wound healing in rats with protein malnutrition. Methods Twenty male Wistar rats underwent cutaneous surgery and were divided into two experimental groups: Malnourished (8% casein diet); Nourished (17% casein diet). Animals were euthanized after 5th and 10th days, descriptive and quantitative analyses were performed on sections stained with hematoxylin-eosin and sirius red, respectively. Statistical analysis of data using nonparametric Fisher's exact test with p<0.05 was carried out. Results At five days, increased fibroblast proliferation (p<0.01) and collagen expression (p<0.05) was observed in N5 group. After ten days, N10 and MN10 animals showed higher amount of granulation tissue and edema/inflammatory infiltrate independent of nutritional status (p>0.05), only N10 group showed fibroblast proliferation (p<0.01) and increased collagen expression (p<0.01). Conclusion Protein malnutrition seems not to influence inflammatory phase of healing, whereas it negatively effects fibroblast proliferation and collagen synthesis.

RESUMO Objetivo Investigar as alterações histológicas relacionadas à resposta inflamatória e à expressão de colágeno durante a cicatrização em ratos com desnutrição protéica. Métodos Vinte ratos Wistar machos foram submetidos à cirurgia cutânea e divididos em dois grupos experimentais: Desnutridos (dieta com caseína a 8%); Nutridos (17% de dieta com caseína). Animais foram eutanasiados após 5 e 10 dias, análises descritivas e quantitativas foram realizadas em cortes corados com hematoxilina-eosina e sirius vermelho, respectivamente. Análise estatística dos dados utilizando teste exato não paramétrico de Fisher com p<0,05 foi realizada. Resultados Aos cinco dias, observou-se aumento da proliferação fibroblástica (p<0,01) e expressão de colágeno (p<0,05) no grupo N5. Após 10 dias, animais N10 e MN10 apresentaram maior quantidade de tecido de granulação e edema/infiltrado inflamatório independente do estado nutricional (p>0,05), apenas grupo N10 apresentou proliferação fibroblástica (p<0,01) e aumento da expressão de colágeno (p<0,01). Conclusão A desnutrição protéica parece não influenciar na fase inflamatória da cicatrização, porém afeta negativamente a proliferação de fibroblastos e a síntese de colágeno.

Comportamento social em ratos recuperados após desnutrição proteica: análise comparativa entre machos e fêmeas / Social behavior in rats recovered from protein malnutrition: comparative analysis between males and females

A maturação do sistema nervoso central depende, entre outros fatores, da ingestão adequada de nutrientes. Períodos de desnutrição podem afetar seu desenvolvimento, comprometendo a capacidade cognitiva. O objetivo do trabalho foi avaliar o comportamento social de ratos e ratas Wistar alimentados com dieta hipoproteica e posteriormente recuperados com dieta normoproteica. Foram utilizados ratos Wistar (machos e fêmeas) divididos em dois grupos: Controle (C), alimentado com dieta normoproteica (AIN 14% de proteína) durante 12 semanas e Recuperado (R), desnutrido com dieta hipoproteica (AIN 6% de proteína) por 6 semanas e posteriormente alimentado com dieta normoproteica da 7ª a 12ª semanas. A massa corporal foi verificada semanalmente e após o período experimental os animais foram submetidos aos testes de labirinto em cruz elevado e reconhecimento social. Foram avaliados os parâmetros sensoriais utilizados pelos ratos no reconhecimento de seus pares no lócus de convívio. Utilizou-se o paradigma intruso-residente na análise, sendo observado que a dieta hipoproteica comprometeu o ganho de massa corporal em machos e fêmeas, como também foi verificado redução na capacidade de reconhecer seus pares, após exposição consecutiva de curta duração, e ainda, houve uma intensa manifestação de agressividade nos machos do grupo recuperado, fato que não foi observado pelas fêmeas indicando que a intensidade de comprometimento no sistema nervoso central, gerado pela desnutrição pode ter relação com o dimorfismo sexual. (AU)

The maturation of the central nervous system depends, among other factors, proper intake of nutrients. Periods of malnutrition can affect your development, undermining the cognitive ability. The objective of this work was to evaluate the social behavior of mice and Wistar rats fed with hipoproteica diet and later recovered with present diet. Wistar rats were used (males and females) divided into two groups: control (C), fed up with the present diet (AIN 14% protein) for 12 weeks and recovered (R), malnourished with diet hipoproteica (AIN 6% protein) for 6 weeks and subsequently fed with the present diet of 7th to 12th weeks. Body mass was checked weekly and after the trial period the animals were subjected to the tests of high cross maze and social recognition. We evaluated the sensory parameters used by rats in the recognition of his peers in locus. The intruder-resident paradigm in the analysis, being observed that diet hipoproteica undertook the weight gain in males and females and verified reduction in ability to recognize their peers, after successive exposure of short duration, and yet, there was an intense manifestation of aggression in males of the group recovered, a fact that was not observed for females, indicating that the intensity of commitment in the central nervous system, generated by malnutrition may be related to sexual dimorphism. (AU)

Hemopoese em desnutrição proteica: caracterização do estroma medular e avaliação da participação do cálcio / Hematopoiesis in protein malnutrition: characterization of bone marrow stroma and evaluation of calcium participation

A desnutrição proteica continua sendo um dos principais problemas nutricionais do mundo. Trabalhos de nosso laboratório e de outros autores evidenciam que entre as alterações presentes na desnutrição proteica, está a alteração do tecido hemopoético, com modificações em componentes da matriz extracelular, alterações no ciclo celular da célula tronco/progenitora hemopoética, redução da produção de precursores hemopoéticos, tanto na série eritrocitária como na série leucocitária, levando a anemia e leucopenia. Os mecanismos de participação do Ca2+ nas células da medula óssea são pouco conhecidos, porém, sabe-se que ele atua no processo de hemopoese. Têm sido descrito que elevações da concentração de Ca2+ citoplasmático induzem a proliferação e diferenciação de células mielóides. A ação dessa via em indivíduos desnutridos também é pouco conhecida. Este estudo tem como objetivo avaliar o estabelecimento da celularidade medular in vitro, bem como investigar mecanismos moleculares envolvidos na proliferação e diferenciação dessa celularidade, além de avaliar a ação do cálcio na presença da interleucina-3 em células-tronco hemopoéticas murinas e sua modulação para avaliar alterações na via das MAPKs. Camundongos C57BL/6, machos e adultos foram submetidos à desnutrição proteica e, após a perda de aproximadamente 20% de seu peso corporal, as células da medula óssea foram colhidas. Essas células foram imunofenotipadas, além de reagirem com anticorpos específicos para caracterização da célula-tronco hemopoética e proteínas da via de sinalização de cálcio intracelular. Observamos que a celularidade do estroma medular em cultura de longa duração de animais desnutridos é alterada, principalmente em células de origem mesenquimal, que aparecem em maior número em desnutridos ao longo dos dias de cultura. Além disso, as ondas de cálcio intracelular estavam diminuídas em animais desnutridos, bem como as proteínas p-PKC, p-PLCy, CAMKII, p-AKT e p-STAT5 não respondem ao estímulo de IL-3, levando a uma deficiência da expressão das MAPK: ERK 1/2, JNK e p38. A desnutrição proteica pode causar alterações na celularidade estromal da medula óssea e na diferenciação das células tronco hemopoéticas pela via das MAPKs estimulada por IL-3

Protein malnutrition remains one of the world's major nutritional problems. Studies from our laboratory and others shown that alterations in protein malnutrition include hemopoietic tissue alterations, changes in extracellular matrix components, changes in the hemopoietic stem/progenitor cell tissue, reduction in the production of hemopoietic precursors, in the erythroid series as in the mieloyd series, leading to anemia and leukopenia. Mechanisms of Ca2+ participation in bone marrow cells are poorly understood, but no hemopoiesis has been developed. Elevations of cytoplasmic Ca2+ concentration in proliferation and differentiation of myeloid cells were included. Such an action through malnourished animals is also a little known. This study aims to evaluate the establishment of cellularity in vitro as well as investigate the molecular involvement in cell proliferation and differentiation, as well as to evaluate the action of calcium in the presence of IL-3 in hemopoietic stem cells and its modulation by analytical evaluations in the MAPKs pathway. C57BL/6, male adult mices were subjected to protein restriction and, after loss of approximately 20% of their body weight, bone marrow cells were harvested. These were immunophenotyped in addition to specific activation terms for the hemopoietic stem cell and intracellular signaling pathway proteins. We observed that the bone marrow cells in long-term culture of malnourished animals is altered, mainly in cells of mesenchymal origin, which appears in greater numbers in undernourished throughout the days of culture. In addition, as intracellular calcium waves decreased in malnourished animals, as well as the p-PKC, p-PLC, CAMKII, p-AKT and p-STAT5 proteins did not respond to IL-3, sugesting expression of the expression of MAPK: ERK 1/2, JNK and p38. Protein malnutrition may have changes in bone marrow capacity and differentiation of hemopoietic stem cells through IL-3-stimulated MAPKs

Sindrome de Cotard: Monicete, el haitiano / Cotard's syndrome: Monicete, the Haitian

Paciente NN de sexo masculino, de edad media, es traído por carabineros al Servicio de Urgencia del Instituto, luego de haber realizado intento suicida por ahorcamiento. El paciente no aporta mayor información respecto de sus datos demográficos ni cuenta con identificación. Existe falta de cooperación y aparentes dificultades con el manejo del idioma. Paciente de raza negra, muy enflaquecido, de unos 40 a 50 años de edad, desaseado. Lúcido y orientado. Juicio de realidad alterado. Hipótesis Diagnóstica: Síndrome Suicidal. Psicosis Lúcida. Desnutrición Calórico-Proteica. Social: Situación de identidad y documentación. Red de apoyo. No se ha logrado contactar familiares. Debido a la situación de indocumentación, se dificulta el realizar varios estudios médicos. Idioma criollo haitiano (creol). Migración: Es conocido el aumento de la población migrante en nuestro país. El desafío de la competencia cultural.

NN male patient, middle age, is brought by police to the Institute's Emergency Department, after having committed a suicide attempt by hanging. The patient does not provide more information regarding his / her demographic data or has identification. There is a lack of cooperation and apparent difficulties with language management. Black patient, very emaciated, about 40 to 50 years of age, dirty. Lucid and oriented. Altered judgment of reality. Diagnostic Hypothesis: Suicidal Syndrome. Lucid Psychosis. Caloric-Protein Malnutrition. Social: Status of identity and documentation. Supporting net. Family members could not be reached. Due to the undocumented situation, it is difficult to perform several medical studies. Haitian Creole language. Migration: It is known the increase of the migrant population in our country. The challenge of cultural competence.

Nutritional profile of hemodialysis patients concerning treatment time / Análise do perfil nutricional de pacientes renais crônicos em hemodiálise em relação ao tempo de tratamento

Abstract Introduction: The mortality of the population with chronic kidney disease (CKD) on hemodialysis (HD) is very high and the protein-energy malnutrition stands out as one of the most common consequences in relation to this condition. Objective: To evaluate the association between time of hemodialysis and nutritional parameters of patients. Methods: It is a cross-sectional study with secondary data, developed of the University Hospital of the Federal University of Juiz de Fora (HU/UFJF). This study was approved by the Research Ethics Committee (Nº 1.233.142), a total of 36 patients. The medical records and collected data were analyzed for anthropometric markers, biochemical and diet, considering two groups: HD time less than three and greater than or equal to three years. Results: There was reduction of mass of somatic protein with increased duration of HD. In relation to food intake was observed that in patients with increased duration of dialysis, an increase in average consumption of protein / kg of weight, calories, phosphorus and potassium, with a significant difference from the mean protein intake / kg (p = 0.04) and phosphorus (p = 0.045). Increasing HD time has altered body composition of patients, indicating a decline in the nutritional status of these individuals. Conclusion: HD patients are a risk group for protein-energy malnutrition, where HD time interferes with the nutritional status and food profile of the patient. The group HD time greater than or equal to 3 years presented worsening nutritional status.

Resumo Introdução: Pacientes com doença renal crônica em hemodiálise (HD) apresentam risco elevado para mortalidade, sendo que a desnutrição protéico-energética se destaca como uma das causa mais comuns em relação a essa condição. Objetivo: Avaliar a associação entre o tempo de hemodiálise e parâmetros nutricionais dos pacientes. Métodos: É um estudo transversal com dados secundários, desenvolvido no Hospital Universitário Federal Universidade de Juiz de Fora (HU / UFJF). Este estudo foi aprovado pela pesquisa Comitê de Ética (nº 1.233.142), um Total de 36 pacientes. Os dados foram coletados por meio dos prontuários médicos, os quais foram analisados marcadores antropométricos, bioquímicos e dieta, considerando dois grupos: tempo HD menor do que três anos e tempo de HD maior ou igual atrês anos. Resultados: Houve redução de massa de proteína somática com aumento do tempo em HD. Em relação à avaliação alimentar, observou-se que em pacientes com maior tempo em diálise houve aumento no consumo médio de proteína/kg de peso, calorias, fósforo e Potássio, com diferença significativa da ingestão média de proteína/kg (p = 0,04) e fósforo (p = 0,045). O tempo em HD alterou a composição corporal dos pacientes, indicando um declínio doestado nutricional desses indivíduos. Conclusão: Pacientes com HD são um grupo de risco para desnutrição protéico-energética, onde o tempo em HD interfere no perfil antropométrico e alimentar do paciente.O grupo com tempo de HD superior ou igual a 3 anos apresentou piora do estado nutricional.

Evaluation of skeletal muscle regeneration in experimental model after malnutrition / Avaliação da regeneração do músculo esquelético em modelo experimental após desnutrição

Abstract The aim of this study was to analyze muscle regeneration after cryoinjury in the tibialis anterior muscle of young rats that were malnourished and then recovered. Forty Wistar rats were divided into a nourished group that received a normal protein diet (14% casein) for 90 days and a malnourished and recovered rats group (MR) that was submitted to 45 days of malnutrition with a hypoproteic diet (6% casein) followed by 45 days of a normal protein diet (14% casein). After the recovery period, all of the animals underwent cryoinjury in the right tibialis anterior muscle and euthanasia after 7, 14 and 21 days. The amount of connective tissue and the inflammation area was higher in the malnutrition recovered injury MR group (MRI) at 14 days post-injury (p < 0.05). Additionally, the cross-sectional area (CSA) of the regenerated fibers was decreased in the MRI (p < 0.05). The MyoD and myogenin protein levels were higher in the nourished injury group. Similar levels of TGF-β1 were found between groups. The proposed malnutrition protocol was effective in showing delayed changes in the regeneration process of the tibialis anterior muscle of young rats. Furthermore, we observed a delay in muscle repair even after nutritional recovery.

Resumo O objetivo do presente estudo foi analisar a regeneração muscular após criolesão no músculo tibial anterior de ratos jovens desnutridos e recuperados. Foram utilizados 40 ratos da linhagem Wistar, divididos em 2 grupos: ratos nutridos receberam dieta normoproteica (14% de caseína) por 90 dias; e ratos desnutridos e recuperado submetidos a duas fases nutricionais pós-desmame, correspondendo a 45 dias de desnutrição com dieta hipoproteica (6% caseína), seguida por 45 dias de dieta normoproteica (14% caseína). Ao completar a fase de recuperação, todos os animais foram submetidos à criolesão no músculo tibial anterior direito e a eutanasia ocorreu 7, 14 e 21 dias após a lesão. A quantidade de tecido conjuntivo e a área de inflamação 14 dias pós-lesão foi maior no grupo desnutrido, recuperado e lesado (MRI – malnourished, recovered and injured group) (p < 0,05). A área de secção transversa (AST) das fibras regeneradas do grupo MRI foi menor (p < 0,05). O conteúdo das proteínas MyoD e Miogenina foi maior no grupo nutridos e lesados. A citocina TGF-β1 não apresentou diferença entre os grupos. O protocolo proposto foi eficaz para demonstrar alterações no processo de regeneração do músculo tibial anterior de ratos jovens, atrasando o reparo muscular mesmo após a recuperação nutricional.

The influence of protein malnutrition on the production of GM-CSF and M-CSF by macrophages

ABSTRACT It is well established that protein malnutrition (PM) impairs immune defenses and increases susceptibility to infection. Macrophages are cells that play a central role in innate immunity, constituting one of the first barriers against infections. Macrophages produce several soluble factors, including cytokines and growth factors, important to the immune response. Among those growth factors, granulocyte-macrophage colony-stimulating factor (GM-CSF) and macrophage colony-stimulating factor (M-CSF). GM-CSF and M-CSF are important to monocyte and macrophage development and stimulation of the immune response process. Knowing the importance of GM-CSF and M-CSF, we sought to investigate the influence of PM on macrophage production of these growth factors. Two-month-old male BALB/c mice were subjected to PM with a low-protein diet (2%) and compared to a control diet (12%) mouse group. Nutritional status, hemogram and the number of peritoneal cells were evaluated. Additionally, peritoneal macrophages were cultured and the production of GM-CSF and M-CSF and mRNA expression were evaluated. To determine if PM altered macrophage production of GM-CSF and M-CSF, they were stimulated with TNF-α. The PM animals had anemia, leukopenia and a reduced number of peritoneal cells. The production of M-CSF was not different between groups; however, cells from PM animals, stimulated with or without TNF-α, presented reduced capability to produce GM-CSF. These data imply that PM interferes with the production of GM-CSF, and consequently would affect the production and maturation of hematopoietic cells and the immune response.

Joint immobilization: effects on muscular tissue of obese and malnourished mice / Imobilização articular: efeitos sobre o tecido muscular de camundongos obesos e desnutridos

Abstract Although it is a widely used resource for the treatment of musculoskeletal injuries, immobilization causes deleterious effects in muscle tissue after a short period of time. This study aimed to evaluate the gastrocnemius and tibialis anterior muscles of obese and protein malnourished animals under joint immobilization condition. Overall, 28 adult male mice were used (C57 / BL6), being divided into four groups (N = 7): Control Group (CG), Immobilized Control Group (ICG), Immobilized Obese Group (IOG) and Immobilized Malnourished Group (IMG). The immobilization protocol was performed by the use of adhesive tape and plaster. The conditions and obesity and protein malnutrition have been developed through the ingestion of diets specific for each group of animals. The histomorphometric analysis of muscles evaluated area and the diameter of muscle fibers. All immobilized groups showed reduction in the area and diameter of muscle fibers when compared to GC. Comparisons among immobilized groups showed that the area and diameter of muscle fibers of IOG and IMG were lower than ICG. The immobilization protocol caused reduction in muscle trophism in animals, and obese and malnourished animals suffered high losses under condition of muscle atrophy.

Resumo Embora seja um recurso muito utilizado para tratamento de lesões musculoesqueléticas, a imobilização causa efeitos deletérios no tecido muscular após curto período de tempo. O presente estudo teve como objetivo avaliar os músculos gastrocnêmio e tibial anterior de animais obesos e desnutridos proteicamente sob a condição de imobilização articular. Foram utilizados 28 camundongos (C57/BL6) machos adultos, distribuídos em quatro grupos (N=7): Grupo controle (GC), Grupo Controle Imobilizado (GCI), Grupo Obeso imobilizado (GOI) e Grupo Desnutrido Imobilizado (GDI). O protocolo de imobilização foi realizado por meio da utilização de tiras de esparadrapo e faixa gessada. As condições de obesidade e desnutrição proteica foram desenvolvidas por meio da ingestão de dietas específicas para cada grupo de animais. A análise histomorfométrica dos músculos avaliou a área e o diâmetro das fibras musculares. Todos os grupos imobilizados apresentaram redução na área e no diâmetro das fibras musculares quando comparados ao GC. As comparações entre os grupos imobilizados mostraram que os valores do diâmetro e área de fibras dos grupos GOI e GDI foram menores do que o GCI. O protocolo de imobilização provocou redução do trofismo muscular nos animais estudados e os animais obesos e desnutridos sofreram prejuízo elevado na condição de atrofia muscular.

Assessment of Fatty Acid Profile, Protein, and Micronutrient Bioavailability of Winged Termites (Marcrotermes bellicosus) Using Albino Rats

Introduction: The need for alternative protein and essential micronutrients sources for adequate complementary foods is urgent. Dried Marcrotermes bellicosus was reported to be a good source of dietary protein, fat, and micronutrients. This study investigated the fatty acid profile, protein, and essential micronutrient bioavailability in M. bellicosus using albino rats. Methods: M. bellicosus was collected around the Alegongo area, Akobo, Ibadan, Nigeria during their swarming flights, roasted at 105 °C for fifteen min, dewinged, and winnowed. The roasted sample was analysed for proximate, minerals, and antinutrients using standard methods of the AOAC International. Fatty acid profile was determined using a gas-liquid chromatographic method, whilst protein and essential minerals bioavailability were determined using weanling albino rats. Results: Roasted M. bellicosus contained 31.8 g protein, 16.4 g fat, 1.3 g ash, 46.5 g carbohydrates, 361.13 mg potassium, 227.50 mg calcium, 361.30 mg phosphorus, 15.03 mg zinc, 52.30% linolenic acid, 24.91% linoleic acid, 5.97% oleic acid and yielded 460.8 kcal gross energy/100g sample. The mean weight gain in the experimental diet group (+23.17±6.71) was significantly higher than that of the control diet group (+16.83±6.71) and the basal diet group (-19.50±9.03). The basal diet group had the least value for all serum micronutrient levels whilst the experimental diet group had the highest. Conclusion: M. bellicosus protein supported rat growth at a 15% inclusion level. The calcium, iron, zinc and vitamin A in M. bellicosus were bioavailable in rats. M. Bellicosus could be a potential novel food for humans.

Silymarin Supplementation Attenuation of the Lipopolysaccharide-Induced Metabolic Changes in Protein Malnourished Rats

Introduction: Protein malnutrition increases the sensitivity to septic shock by impairing antioxidation and immune response. Based on the potent antioxidant effects of silymarin, the putative protective role of silymarin against sepsis-induced oxidative damage in protein malnourished rats was investigated. Methods: Adult male Wistar rats were subjected to protein malnutrition via a low-protein diet (8% protein), with and without silymarin supplementation (30 mg/kg/day) for four weeks, and compared to a control group on a 18% protein diet At end of the experiment, the animals received intraperitoneal injections (i.p.) of 0.1 mg/ kg lipopolysaccharide (LPS) derived from Esdieridtia coil, and decapitation 24 h later. Albumin, C-reactive protein (CRP), total protein (TP), alkaline phosphates (A/CP ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), tumor necrosis factor-a (TNF-a), interleultine-lp (IL-1p) and interleukine-6 (IL-6) levels were measured in serum. In the lungs and liver, thiobarbituric acid reactive substances (TBARS) and glutathione (GSH) concentrations, superoxide dismutase (SOD), catalase (CAT), and glutathione-s-transferase (GST) activities were measured. Results: oxidative and inflammatory processes were significantly increased by the LPS injection and these changes were to a greater extent in the low-protein dietary group compared to control group. Silymarin supplementation in both dietary groups showed marked inhibition in these activities, although the affect was more prominent in the control group compared to the rats fed a low-protein diet. Conclusions: The study showed that silymarin protected against the impairment of antioxidation and immune response in protein malnourished rats, particularly in septic shock conditions.

Assessment of Fatty Acid Profile, Protein, and Micronutrient Bioavailability of Winged Termites (Marcrotermes bellicosus) Using Albino Rats

The need for alternative protein and essential micronutrients sources for adequate complementary foods is urgent. Dried Marcrotermes bellicosus was reported to be a good source of dietary protein, fat, and micronutrients. This study investigated the fatty acid profile, protein, and essential micronutrient bioavailability in M. bellicosus using albino rats. Methods: M. bellicosus was collected around the Alegongo area, Akobo, Ibadan, Nigeria during their swarming flights, roasted at 105 °C for fifteen min, dewinged, and winnowed. The roasted sample was analysed for proximate, minerals, and antinutrients using standard methods of the AOAC International. Fatty acid profile was determined using a gas-liquid chromatographic method, whilst protein and essential minerals bioavailability were determined using weanling albino rats. Results: Roasted M. bellicosus contained 31.8 g protein, 16.4 g fat, 1.3 g ash, 46.5 g carbohydrates, 361.13 mg potassium, 227.50 mg calcium, 361.30 mg phosphorus, 15.03 mg zinc, 52.30% linolenic acid, 24.91% linoleic acid, 5.97% oleic acid and yielded 460.8 kcal gross energy/100g sample. The mean weight gain in the experimental diet group (+23.17±6.71) was significantly higher than that of the control diet group (+16.83±6.71) and the basal diet group (-19.50±9.03). The basal diet group had the least value for all serum micronutrient levels whilst the experimental diet group had the highest. Conclusion: M. bellicosus protein supported rat growth at a 15% inclusion level. The calcium, iron, zinc and vitamin A in M. bellicosus were bioavailable in rats. M. Bellicosus could be a potential novel food for humans.

Silymarin Supplementation Attenuation of the Lipopolysaccharide-Induced Metabolic Changes in Protein Malnourished Rats

Protein malnutrition increases the sensitivity to septic shock by impairing antioxidation and immune response. Based on the potent antioxidant effects of silymarin, the putative protective role of silymarin against sepsis-induced oxidative damage in protein malnourished rats was investigated. Methods: Adult male Wistar rats were subjected to protein malnutrition via a low-protein diet (8% protein), with and without silymarin supplementation (30 mg/kg/day) for four weeks, and compared to a control group on a 18% protein diet At end of the experiment, the animals received intraperitoneal injections (i.p.) of 0.1 mg/ kg lipopolysaccharide (LPS) derived from Esdieridtia coil, and decapitation 24 h later. Albumin, C-reactive protein (CRP), total protein (TP), alkaline phosphates (A/CP ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), tumor necrosis factor-a (TNF-a), interleultine-lp (IL-1p) and interleukine-6 (IL-6) levels were measured in serum. In the lungs and liver, thiobarbituric acid reactive substances (TBARS) and glutathione (GSH) concentrations, superoxide dismutase (SOD), catalase (CAT), and glutathione-s-transferase (GST) activities were measured. Results: oxidative and inflammatory processes were significantly increased by the LPS injection and these changes were to a greater extent in the low-protein dietary group compared to control group. Silymarin supplementation in both dietary groups showed marked inhibition in these activities, although the affect was more prominent in the control group compared to the rats fed a low-protein diet. Conclusions: The study showed that silymarin protected against the impairment of antioxidation and immune response in protein malnourished rats, particularly in septic shock conditions.

Evaluation of protein undernourishment on the condylar process of the Wistar rat mandible correlation with insulin receptor expression

The mandible condylar process cartilage (CP) of Wistar rats is a secondary cartilage and acts as a mandibular growth site. This phenomenon depends on adequate proteins intake and hormone actions, including insulin. Objectives The present study evaluated the morphological aspects and the expression of the insulin receptor (IR) in the cartilage of the condylar process (CP) of rats subjected to protein undernourishment. Material and Methods The nourished group received a 20% casein diet, while the undernourished group (U) received a 5% casein diet. The re-nourished groups, R and RR, were used to assess the effects of re-nutrition during puberty and adulthood, respectively. CPs were processed and stained with picro-sirius red, safranin-O and azocarmine. Scanning electron microscopy and immunohistochemistry were also performed. Results The area of the CP cartilage and the number of cells in the chondroblastic layer decreased in the U group, as did the thickness of the CP layer in the joint and hypertrophic layer. Renourishment during the pubertal stage, but not during the adult phase, restored these parameters. The cell number was restored when re-nutrition occurred in the pubertal stage, but not in the adult phase. The extracellular matrix also decreased in the U group, but was restored by re-nutrition during the pubertal stage and further increased in the adult phase. IR expression was observed in all CPs, being higher in the chondroblastic and hypertrophic cartilage layers. The lowest expression was found in the U and RR groups. Conclusions Protein malnutrition altered the cellularity, the area, and the fibrous cartilage complex, as well as the expression of the IRs. .

Effects of acute stress on learning and memory processes of malnourished rats / Efeitos do estresse agudo em processos de aprendizagem e memória de ratos desnutridos

The aim of the study was to investigate the effects of acute stress on the processes of learning and memory in malnourished rats tested in the Morris water maze. The animals were divided into eight groups according to nutritional status (malnourished or well nourished) and stress (stressed or unstressed). In Experiment I the animals were subjected to immobilization stress procedure before the learning session and in Experiment II after the learning sessions. The test consisted of two daily sessions, and a memory test after four weeks. There was loss of learning and memory in malnourished rats. In Experiment I the malnourished group was positively affected by acute stress, with significant improvement of performance. No effects of stress on the animals' performance in Experiment II were observed. In the memory test, the malnourished rats showed deficits in consolidation and recall, regardless of the occurrence of stress. The stress imposed 24 hours before the learning task improved performance of malnourished animals with a protective effect of stress. However there was no improvement in the processes of retention or recall from memory (previously learned information) assessed four weeks later, during the memory retention test. (AU)

O objetivo do estudo foi investigar os efeitos do estresse agudo sobre os processos de aprendizagem e memória em ratos desnutridos testados no labirinto aquático de Morris. Os animais foram divididos em oito grupos de acordo com a condição nutricional (desnutridos ou bem nutridos) e estresse (não estressados ou estressados). No Experimento I os animais foram submetidos ao procedimento de estresse por imobilização antes da sessão de aprendizagem e no Experimento II após as sessões de aprendizagem. O teste consistiu de duas sessões diárias e um teste de memória após quatro semanas. Houve prejuízos de aprendizagem e memória em ratos desnutridos. No Experimento I o grupo desnutrido foi positivamente afetado pelo estresse agudo, apresentando melhora significativa de desempenho. Não foram observados efeitos do estresse sobre o desempenho dos animais no Experimento II. No teste de memória os ratos desnutridos apresentaram déficits de consolidação e evocação, independentemente da ocorrência de estresse. O estresse imposto 24 horas antes da tarefa de aprendizagem melhorou o desempenho de animais desnutridos com um efeito protetor do estresse. Entretanto não houve melhora nos processos de retenção ou evocação da memória (informações previamente aprendidas), avaliados quatro semanas mais tarde, durante o teste de retenção de memória. (AU)

Possible Protective Effects of Garlic, Grinkobiloba and Silymarin on Cisplatin Hepatotoxicity in Protein-Malnourished Rats.

Background: Protein malnutrition (PM) is one of the major public health problems in developing countries. Cisplatin (CDDP) is an effective anticancer drug that elicits many hepatotoxicity. CDDP hepatotoxicity restricts its clinical use under long term treatment. Objectives: The study was carried out to determine the possible protective effects of fresh garlic homogenate (FGH), Ginkobiloba extract (GBE) or silymarin (Sly) on cisplatin hepatotoxicity in protein malnourished rats. Methods: Sprague-Dawley rats were divided into NF set and PM set. Each set divided into control group and seven treated groups received cisplatn and FGH, GBE or Sly and its combinations with cisplatin. Biochemical changes, reactive oxygen species (ROS) and superoxide dismutase (SOD), Malondialdehyde (MDA) and glutathione (GSH) parameters were evaluated. Liver samples were examined for histopathological changes Results: Cisplatin increased ALT and AST, as well as liver body weight ratio. ROS parameters showed a significant increase in MDA and nitric oxide (NO) and decrease in glutathione and SOD. PM potentiates cisplatin side effects. FGH, GBE or Sly attenuate cisplatin toxicity and liver histopathological changes. Conclusion: PM potentiates cisplatin toxicity. FGH, GBE or Sly has partial protective effects against the cisplatin- induced toxicity induced in NF and PM rats.

Phototherapy promotes healing of cutaneous wounds in undernourished rats

BACKGROUND: Various studies have shown that phototherapy promotes the healing of cutaneous wounds. OBJECTIVE: To investigate the effect of phototherapy on healing of cutaneous wounds in nourished and undernourished rats. METHODS: Forty rats, 20 nourished plus 20 others rendered marasmus with undernourishment, were assigned to four equal groups: nourished sham, nourished Light Emitting Diode treated, undernourished sham and undernourished Light Emitting Diode treated. In the two treated groups, two 8-mm punch wounds made on the dorsum of each rat were irradiated three times per week with 3 J/cm2 sq cm of combined 660 and 890nm light; wounds in the other groups were not irradiated. Wounds were evaluated with digital photography and image analysis, either on day 7 or day 14, with biopsies obtained on day 14 for histological studies. RESULTS: Undernourishment retarded the mean healing rate of the undernourished sham wounds (p < 0.01), but not the undernourished Light emission diode treated wounds, which healed significantly faster (p < 0.001) and as fast as the two nourished groups. Histological analysis showed a smaller percentage of collagen in the undernourished sham group compared with the three other groups, thus confirming our photographic image analysis data. CONCLUSION: Phototherapy reverses the adverse healing effects of undernourishment. Similar beneficial effects may be achieved in patients with poor nutritional status. .