Residual gastric volume evaluation with ultrasonography after ingestion of carbohydrate- or carbohydrate plus glutamine-enriched beverages: a randomized, crossover clinical trial with healthy volunteers / Avaliação do volume residual gástrico em voluntários saudáveis usando a ultrassonografia, após ingestão de solução líquida enriquecida com carboidrato e glutamina. Estudo clínico, randomizado, duplo cego e cruzado

ABSTRACT BACKGROUND Abbreviation of preoperative fasting to 2 hours with maltodextrin (CHO)-enriched beverage is a safe procedure and may enhance postoperative recovery. Addition of glutamine (GLN) to CHO beverages may include potential benefits to the metabolism. However, by adding a nitrogenous source to CHO beverages, gastric emptying may be delayed and increase the risk of bronchoaspiration during anesthesia. OBJECTIVE In this study of safety, we aimed at investigating the residual gastric volume (RGV) 2 hours after the intake of either CHO beverage alone or CHO beverage combined with GLN. METHODS We performed a randomized, crossover clinical trial. We assessed RGV by means of abdominal ultrasonography (US) in 20 healthy volunteers (10 males and 10 females) after an overnight fast of 8 hours. Then, they were randomized to receive 600 mL (400 mL immediately after US followed by another 200 mL 2 hours afterwards) of either CHO (12.5% maltodextrin) or CHO-GLN (12.5% maltodextrin plus 15 g GLN). Two sequential US evaluations were done at 120 and 180 minutes after ingestion of the second dose. The interval of time between ingestion of the two types of beverages was 2 weeks. RESULTS The mean (SD) RGV observed after 8 hours fasting (13.56±13.25 mL) did not statistically differ (P>0.05) from the RGV observed after ingesting CHO beverage at both 120 (16.32±11.78 mL) and 180 minutes (14.60±10.39 mL). The RGV obtained at 120 (15.63±18.83 mL) and 180 (13.65±10.27 mL) minutes after CHO-GLN beverage also was not significantly different from the fasting condition. CONCLUSION The RGV at 120 and 180 minutes after ingestion of CHO beverage combined with GLN is similar to that observed after an overnight fast.

RESUMO CONTEXTO A abreviação do jejum pré-operatório com solução enriquecida com maltodextrina é segura, recomendada por sociedades de anestesiologia e acelera a recuperação pós-operatória. A associação de glutamina à maltodextrina resultaria em benefícios metabólicos, porém, esta associação pode alterar o volume do resíduo gástrico e consequentemente risco de broncoaspiração. OBJETIVO Avaliaremos, usando a ultrassonografia, o volume residual gástrico em jejum de 8 horas e após 120 e 180 minutos da ingestão de solução de maltodextrina isolada ou associada a 15 g de glutamina. MÉTODOS Estudo clínico, randomizado, duplo cego e cruzado. Vinte voluntários saudáveis, sendo 10 do sexo masculino e 10 do sexo feminino, foram submetidos a seguinte sequência de avaliação, independente da solução usada. Os voluntários foram avaliados em jejum de 8 horas, 120 e 180 minutos após a ingestão da solução de maltodextrina 12,5% e 120 e 180 após a ingestão da solução de maltodextrina 12,5% mais 15 g de glutamina. RESULTADOS Não houve diferença estatisticamente significativa entre os volumes obtidos após jejum de 8 horas (13,56 mL) e os obtidos após 120 (16,32 mL) e 180 minutos (14,60 mL) da ingestão da solução de maltodextrina 12,5% (P>0,05). Para a solução enriquecida com glutamina, os volumes obtidos após 120 minutos (15,63 mL) e 180 minutos (13,65 mL) também não demostraram diferença estatisticamente significativa quando comparados ao jejum (P>0,05). CONCLUSÃO O volume residual gástrico após 120 e 180 minutos da ingestão das soluções de maltodextrina a 12,5% isolada ou associada a 15 g de glutamina é semelhante ao observado em jejum.

Morphological and molecular identification of ticks infesting Boa constrictor (Squamata, Boidae) in Manaus (Central Brazilian Amazon) / Identificação morfológica e molecular de carrapatos coletados de jiboias (Boa constrictor) (Squamata, Boidae) da zona urbana de Manaus

The Boa constrictor is one of the world's largest vertebrate carnivores and is often found in urban areas in the city of Manaus, Brazil. The morphological identification of ticks collected from 27 snakes indicated the occurrence of Amblyomma dissimile Koch 1844 on all individuals sampled. In contrast, Amblyomma rotundatum Koch was found on only two snakes. An analysis of the 16S rRNA molecular marker confirmed the morphological identification of these ectoparasites.

A jiboia (Boa constrictor), vertebrado carnívoro, tem sido encontrada em abundância na área urbana de Manaus. A identificação morfológica dos carrapatos coletados em 27 dessas serpentes verificou a ocorrência de Amblyomma dissimile Koch 1844, em todos os exemplares avaliados e a presença de Amblyomma rotundatum Koch 1844, em duas dessas serpentes. A análise do marcador 16S rRNA confirma a identificação morfológica das espécies A. rotundatum e A. dissimile e apresenta novas sequências destes organismos.

Transport of glutamine, alanine and glucose by rabbit intestinal membrane

Malnutrition and dehydration are the immediated consequences of diarrheal diseases. To investigate the biological significance ofglutamine, alanine and glucose in the intestinal mucosa, we have used Ussing chambers to determine electrolyte transport by measuring short-circuit current (Isc), potential difference (PD) and tissue resistance (TR) in rabbit intestinal mucosa. Increasing doses (10-5 M to 10-1 M)of glutamine,alanine and glucose cause a significant increase in intestinal cation cotransport. Although glucose had a slightly earlier effect, 30mM glutamine and 0.1 M alanine had a maximal effect which was more than two times that caused by 30 nM glucose. The pD2 values for glucose, glutamine and alanine were 3.0, 2.5, and 2.0, respectively. The dose-response curves of these substrates suggest that the intestinal cotransport kinetics for glutamine is differentfrom that of glucose and alanine. Our results demonstrated that all three substrates cause a significant increase in Isc or PD, suggesting an increase in the intestinal mucosa cation cotransport. Glutamine has a larger effect on cation cotransport than alanine and glucose. These combinations should be studied further for the development of an oral rehydrating solution for diarrhea treatment which could prevent the resulting malnutrition, especially in those cases of prolonged diarrheal diseases