Educación alimentaria en pacientes en dialisis / Nutritional education in dialysis patients

La enfermedad renal crónica terminal aumenta el riesgo cardiovascular y puede ocasionar defectos en la mineralización ósea. Para prevenir esto, se debe mantener el fósforo plasmático normal, que depende de la diálisis, los quelantes y la ingesta de fósforo, principalmente de origen inorgánico, incorporado mediante aditivos alimentarios. Las intervenciones nutricionales son pilares en el tratamiento de estos pacientes. El objetivo es facilitar estrategias alimentarias a un grupo de pacientes pediátricos en diálisis, mediante educación alimentaria nutricional, para aumentar el consumo de alimentos naturales, disminuyendo la ingesta de fósforo inorgánico especialmente de los productos cárnicos procesados. Materiales y métodos: se estudió una población pediátrica en diálisis. Se preparó un programa educativo con atención personalizada, instrucción alimentaria y seguimiento mensual, seguido de un taller. Resultados: n: 17 pacientes, edad decimal media de 12,3, 53% sexo masculino, 88% en hemodiálisis. Previo a la intervención el 64,7% consumía productos cárnicos procesados. Luego del taller el 58,8% disminuyó su consumo, el 41,2% aumentó la ingesta de preparaciones caseras, el 53% incorporó nuevos condimentos, de los cuales el 89% presentó al incorporarlos, mejor aceptación a las preparaciones. Conclusiones: la hiperfosfatemia está presente en alrededor del 50% de los pacientes en diálisis asociándose a un incremento entre 20% al 40% del riesgo de mortalidad. La presencia de fósforo oculto en los alimentos y la falta de adherencia hacen prioritario trabajar en programas educativos que favorezcan el aprendizaje colaborativo, centralizados en prácticas culinarias, para brindar herramientas que faciliten una alimentación natural, disminuyendo el consumo de ultraprocesados (AU)

Chronic end-stage renal disease increases the risk of cardiovascular disease and may lead to defects in bone mineralization. In order to prevent these risks, normal plasma phosphorus levels should be maintained. Achieving this goal depends on dialysis, chelators, and phosphorus intake, mainly of inorganic origin, incorporated through food supplements. Nutritional interventions are crucial in the treatment of these patients. The objective is to facilitate nutritional strategies to a group of pediatric dialysis patients, through food education, to increase the consumption of natural foods, decreasing the intake of inorganic phosphorus, especially from processed meat products. Materials and methods: a pediatric population undergoing dialysis was studied. An educational program was prepared with personalized care, nutritional instruction, and monthly follow-up visits, followed by a workshop. Results: n: 17 patients, mean age 12.3 years, 53% male, 88% on hemodialysis. Prior to the intervention, 64.7% consumed processed meat products. After the workshop, 58.8% decreased their consumption, 41.2% increased the intake of homemade food, 53% incorporated new seasonings, of whom 89% reported better acceptance of the preparations when they were incorporated. Conclusions: hyperphosphatemia is observed in around 50% of patients undergoing dialysis and is associated with a 20% to 40% increased risk of mortality. The presence of hidden phosphorus in food and the lack of adherence point to the need for the development of educational programs that promote collaborative learning, focusing on food-preparation practices. These programs should provide tools that facilitate a natural diet, reducing the consumption of ultra-processed food (AU)

Biodisponibilidad de fósforo en alimentos y su efecto en la enfermedad renal crónica / Bioavailability of phosphorus in food and its effect in chronic kidney disease

Resumen Introducción: el objetivo del presente trabajo se centra en reconocer la importancia de las investigaciones que relacionan la biodisponibilidad de fósforo en diferentes grupos de alimentos de origen animal, vegetal e industrial y su efecto en la progresión de la enfermedad renal crónica (ERC). Metodología: la revisión se sustentó en la búsqueda literaria en páginas web como PUBMED, Redalyc, SciELO, SCIHUB y Google Academic. Se seleccionó cada estudio, descartando aquellos que no fueran cuantitativos u originales, estuvieran incompletos, sin metodología clara, realizados en mamíferos o si los resultados no se especificaban en porcentajes. La lectura puso especial énfasis en el índice de biodisponibilidad de fósforo derivado del consumo de distintos productos alimenticios. Se elaboraron tres matrices de acuerdo con el origen del comestible y la biodisponibilidad de fósforo que absorbe el organismo. Resultados: se encontró que los alimentos industrializados y los aditivos muestran una biodisponibilidad de fósforo del 90 % al 100 %, los de origen animal del 40 % al 80 % y los de origen vegetal del 30 %. Conclusiones: los aditivos de los alimentos industrializados promueven la hiperfosfatemia y, con ello, aceleran la progresión de la enfermedad renal crónica, a diferencia de los de origen animal y vegetal, menos perjudiciales para la salud. Esto da pauta a la formación del sector salud para ampliar su conocimiento sobre el tratamiento nutricional del paciente.

Abstract Introduction: to know the importance of the investigations that relate the bioavailability of phosphorus in different groups of foods of animal, vegetable and industrialized origin and its effect on the progression in patients with Chronic Kidney Disease (CKD). Methodology: the review is based on a literary search that was carried out on web pages such as: PUBMED, Redalyc, SciELO, SCIHUB and Google Academic. Each of the studies was selected discarding those that were not quantitative, original, complete, with clear methodology, carried out in mammals, and that in their results specified the bioavailability of phosphorus in percentages. All the studies were read, placing main emphasis and interest on the percentage of phosphorus bioavailability when consuming different food groups. Three matrices were made according to the origin of the food and the bioavailability of phosphorus that is absorbed in the body; grouping them into foods of animal, vegetable and industrialized origin and additives. Results: it was found that industrialized foods and additives show a phosphorus bioavailability of 90-100%, those of animal origin 40-80%, those of plant origin 30%. Conclusions: The additives used in industrialized foods promote hyperphosphatemia and thus accelerate the progression of chronic kidney disease, unlike foods of animal and vegetable origin that are less harmful to health. This guides the training of the health sector, expanding its knowledge in the nutritional treatment of the patient.

Organic phosphorus fractions in soil chronosequence of cane sugar in burnt savannah goiano / Frações do fósforo orgânico no solo em cronossequência de cana-de-açúcar queimada no cerrado goiano

Phosphorus (P) is an important macronutrient for plant development. The distribution of its forms in the soil depends on geochemical, biological and anthropogenic processes. The characterization of these compartments favors the understanding of this nutrient cycle. The objective of this work was to evaluate the total P contents and organic P fractions of Red Latosol samples in areas with different management systems in the State of Goiás, Brazil. The study was conducted in sugarcane areas in which the sugarcane harvest was performed with previous straw burning for 1 (CN1), 5 (CN5), 10 (CN10) and 20 (CN20) years, plus an area with native vegetation (NV) of the Cerrado biome, and an area with pasture (PA). Quantification of P fractions was performed by extraction with NaHCO3, H2SO4 and NaOH. The CN20 area had the highest total P values up to 0.40 m deep compared with the others, while the CN5 area had values in the layer 0.40-0.60 m similar to those found for CN20. Regarding the inorganic labile P fraction, the largest contents were also found in the area CN20 up to 0.30 m deep. The P fraction extracted by NaOH had the highest proportions among the systems evaluated, although this fraction is considered little labile, it is quite dynamical in tropical soils.

O fósforo (P) é um importante macronutriente para o desenvolvimento vegetal. A distribuição de suas formas no solo está condicionada por processos geoquímicos, biológicos e ações antrópicas. A caracterização desses compartimentos favorece o entendimento do ciclo desse nutriente. O objetivo desse trabalho foi avaliar o teor de P total e das frações de P orgânico de amostras de Latossolo Vermelho em áreas com diferentes sistemas de manejo ao estado de Goiás. O estudo foi realizado em áreas de cana-de-açúcar, de 1 (CN1), 5 (CN5), 10 (CN10), 20 (CN20) anos, onde a colheita da cana é feita com a prática da queima prévia da palhada antes da colheita e adicionalmente uma área de cerrado (VN) e pastagem (PA). A quantificação das frações de P foram obtidas empregando-se extrações com NaHCO3, H2SO4 e NaOH. A área CN20 apresentou os maiores valores de Pt quando comparadas as demais até 0,40 m de profundidade, já para a camada de 0,40-0,60 m a área CN5 apresentou valores semelhantes aos verificados para CN20. Para a fração lábil inorgânica os maiores teores de P também foram observados na área CN20 até 0,30 m de profundidade. A fração extraída com NaOH apresentou as maiores proporções de P entre os sistemas avaliados, apesar dessa fração ser considerada pouco lábil, em solos de regiões tropicais se apresenta como forma bastante dinâmica.

Phenotypic and Genotypic Characterization of Phosphate Solubilizing Bacteria Isolated from the Errachidia Province, Morocco.

Aims: The aim of this study was to characterize phenotypically and genotypically bacterial isolated from the soils of the Errachidia province in order to select the ones having the potential to solubilize the inorganic phosphate. Study Design: Rhizosphere soil samples for different legumes in sixteen sites from Errachidia province were collected for the assessment. Place and Duration of Study: Department of Biology (Soil & Environment Microbiology Unit) Faculty of Sciences, Moulay Ismail University and Technical Support Unit for Scientific Research, CNRST in Rabat; between September 2012 and January 2013. Methodology: The samples were collected from 16 different sites belonging to Errachidia province in order to select bacterial strains able to solubilize inorganic phosphate. Morphological, cultural and phenotypic parameters of the isolated strains were evaluated. Phenotypic characteristics include the use of carbohydrates, tolerance to temperature, salt and pH. The genotypic diversity between the selected isolates was investigated throught 16S rDNA gene sequencing. Results: 19,4% from the 62strains isolated were selected as PSBs; They showed phenotypic heterogeneity confirmed by the genetic one. Their effectiveness on the solid growth medium was greater which was confirmed by the significant index of solubilization of each strain. Although that on the broth medium the concentration of the solubilized phosphorus differs from one strain to another, a negative correlation moderately strong between the final pH of the growth medium and the concentration of the solubilized phosphorus was deduced. Also a lack of correlation between the index of solubilization and concentration was concluded (r = -0.08). Conclusion: The importance of the phosphorus soluble forms for the agricultural production and taking in consideration the environmental concerns and sustainable developments compromise the use of cheapest and natural techniques to protect the environment.

Métodos de incorporação da enzima fitase em rações para poedeiras / Methods of incorporation of the enzyme phytase in diets for laying hens

Objetivou-se com o estudo avaliar duas metodologias de incorporação da enzima fitase comparando-as a uma dieta basal e ao método de aumentar a suplementação de Fósforo inorgânico na dieta, em busca de uma forma mais eficaz de atenuar o fator antinutricional ácido fítico. Foram observadas características de desempenho de poedeiras Isa Brown, durante 63 dias de período experimental. O delineamento experimental foi inteiramente casualizado com quatro tratamentos e cinco repetições de seis aves. As aves foram submetidas aos tratamentos (dietas): dieta basal (DB), dieta com farelo de arroz desengordurado tratado com fitase (FADFI), método tradicional de incorporação de fitase na dieta sem tratamento prévio do farelo de arroz desengordurado com fitase (MTFI) e dieta com farelo de arroz desengordurado e sem fitase (SEMFI). Os métodos de incorporação da fitase nas rações não influenciaram significativamente (P>0,05) o desempenho das aves, ambos equivalendo-se à dieta basal. O tratamento prévio do farelo de arroz desengordurado com fitase a nível de 300 FTU kg-1 é eficiente, ou seja, tratar somente um ingrediente da dieta com fitase permite incoporar uma quantidade menor de fitase, mantendo bom desempenho. Portanto, os métodos que envolveram fitase, independentemente da metodologia de incorporação, são indicados na alimentação de poedeiras.

The objective of the study to evaluate two methods of incorporation of the enzyme phytase by comparing them to a basal diet and the method of increasing the supplementation of inorganic phosphorus in the diet, in search of a more effective way to mitigate the anti-nutritional factor phytic acid. Were observed performance characteristics of Isa Brown hens for 63 days trial period. The experimental design was completely randomized design with four treatments and five replicates of six birds. The birds received the treatments (diets): basal diet (BD), diet with defatted rice bran treated with phytase (DRBF), the traditional method of incorporation of dietary phytase untreated defatted rice bran phytase (MTF) and diet with defatted rice bran and without phytase (DRB). The methods of incorporating phytase in the diets did not significantly (P>0.05) broiler performance, both equivalent to the basal diet. The treatment of DRBF with phytase at 300 FTU kg-1 is effective, ie, treating only one ingredient of the diet with phytase onboard allows a smaller amount of phytase, while maintaining good performance. Therefore, methods involving phytase, regardless of method of incorporation, are indicated in the diet of laying hens.

Intoxicación pediátrica por fósforo blanco (saltapericos): supervivencia a ingesta de dosis potencialmente letal / Pediatric poisoning with white phosphorus (saltapericos): survival after potentially lethal ingestion

El saltapericos es un juego pirotécnico a base de fósforo inorgánico, cuyo uso está prohibido porque causa daño hepático agudo. Se reporta un caso de intoxicación severa en una niña sobreviviente, quien ingirió una dosis potencialmente letal y recibió asistencia médica tardía. El protocolo terapéutico que se siguió en el presente caso clínico, permitió el logro de una evolución satisfactoria; este tratamiento consistió en descontaminación interna con agua oxigenada y aceite mineral, exsanguinotransfusión y fármacos hipoamonemizantes.

Saltapericos is a pyrotechnic firework containing inorganic phosphorus whose use is banned since causes acute liver damage. A case of severe poisoning is reported in a girl, who consumed a potentially lethal dose and received late medical care. The therapeutic protocol followed in the present clinical case led to a positive outcome; this treatment consisted of internal decontamination with hydrogen peroxide and mineral oil, exchange transfusion and hypoammonemic drugs.

A study of calcium and inorganic phosphorus levels in maternal and cord blood

No abstract available.

Study on Serum and Urinary Levels of Calcium, Inorganic Phosphorus and Uric Acid in Patients with Urinary Stone and Immobilized State / 대한비뇨기과학회지

The serum concentration and urinary excretion of calcium, inorganic phosphorus and uric acid in 75 stone-former and 33 immobilized patients, comparing to those in 45 controls . The following results were obtained. 1. Serum calcium levels of stone-formers were significantly higher than those of controls in total, male and female. 2. Urinary calcium levels of stone-formers were significantly higher than those of controls in total and female, but not in male. 3. Serum and urinary levels of inorganic phosphorus did not show significant difference between stoneformers and controls. 4. Serum and urinary levels of uric acid in stone-formers were significantly higher than those of controls in total, male and female. 5. Serum and urinary levels of calcium in immobilized patients were higher than those of controls, but did not show significant difference between both groups. 6. Serum and urinary levels of inorganic phosphorus in immobilized patients were slight higher than those of controls, but did not show significant difference between both groups. 7. Serum and urinary uric acid levels of immobilized patients were lower than those of controls, but showed significant difference between both groups only in urinary uric acid levels. These results suggest the possibility that increased calcium and uric acid level may play some role in the genesis of urinary stone. Urinary uric acid level significantly decrease in immobilized state.