Randomized clinical trial to evaluate the effect on postprandial glycemia of Nutren Control®, a glycemia-targeted specialized supplement, compared to standardized breakfast in patients with type-2 diabetes: the CONTROL DIABETES study / Ensayo clínico aleatorizado para evaluar el efecto sobre la glucemia posprandial de Nutren Control®, un suplemento especializado dirigido a la glucemia, en comparación con el desayuno estandarizado en pacientes con diabetes de tipo 2: el estudio CONTROL DIABETES

Objective: to evaluate the effects of a new glycemia targeted specialized supplement (GTSS) compared to a standard breakfast on postprandial blood glucose (PPG). Methods: patients with type 2 diabetes (T2D) and suboptimal control (A1C between 6.5 and 8.5 %) in monotherapy with metformin were included to this prospective, randomized, crossover trial. The standardized breakfast was isoenergetic compared to the GTSS, differing on macronutrients distribution. Both interventions were used once a day in the morning, each replacing breakfast for 7 consecutive days (14 days of observation). Intermittent scanning continuous glucose monitoring system (isCGM) determined the difference between the interventions regarding the incremental area under the curve (iAUC) of the PPG (3 hours after intervention), as a primary endpoint; secondary endpoints were the difference between the interventions regarding the glycemic peak, postprandial glucose excursion (PPGE), mean blood glucose (MBG) and time in range (TIR). Results: thirty-one T2D patients with ages between 39 and 69 years-old were enrolled. GTSS group had significantly lower iAUC of the PPG compared to standardized breakfast (33.3 [15.0 to 54.0] vs 46.8 [27.3 to 75.1] mg/dL), while also presenting a significantly lower PPG excursion (26.4 ± 17.2 vs 44.8 ± 24.4 mg/dL). There was no difference between the intervention periods regarding MBG, TIR and hypoglycemic events. Conclusion: The new GTSS, as a meal replacement in the breakfast, produced a 25 % reduction in the iAUC of the PPG, as accessed by isCGM, in comparison with an isocaloric-standardized meal. (AU)

Objetivo: evaluar los efectos de un suplemento especializado en el control de la glucosa (GTSS) frente a un desayuno estándar sobre la glucemia posprandial (PPG). Metodología: es un estudio cruzado, prospectivo, aleatorizado en el que se incluyeron a pacientes con diabetes tipo 2 (T2D) con control subóptimo de la glucemia (HbA1c entre 6,5 y 8,5 %) utilizando monoterapia con metformina. El desayuno estandarizado fue isocalórico en comparación con el GTSS y solamente la distribución calórica fue diferente. Ambas intervenciones se utilizaron una vez al día por la mañana, reemplazando cada una el desayuno durante 7 días consecutivos (14 días de observación). Se utilizó el sistema de monitoreo continuo de glucosa (isCGM) para determinar las diferencias entre las intervenciones con respecto al área bajo la curva (iAUC) de glucosa postprandial (PPG) (3 horas después de la intervención) como variable principal o primaria; las variables secundarias fueron la diferencia entre las intervenciones con respecto al pico glicémico, la excursión de glucosa posprandial (PPGE), la glucosa media en sangre (MBG) y el rango de tiempo (TIR). Resultado: se incluyeron treinta y un pacientes con T2D con edades entre 39 y 69 años. El grupo del GTSS tuvo un área bajo la curva (iAUC) significativamente más baja de la PPG en comparación con el grupo del desayuno estandarizado (33,3 [15,0 a 54,0] frente a 46,8 [27,3 a 75,1] mg/dL), mientras que también presentó una PPG significativamente más baja (26,4 + 17,2 vs. 44,8 + 24,4 mg/dL). No hubo diferencia entre los períodos de intervención con respecto a la MBG, el TIR y eventos hipoglucémicos. Conclusión: el nuevo GTSS, como sustituto del desayuno, produjo una reducción de la iAUC de la PPG del 25 %, según el isCGM, en comparación con un desayuno isocalórico normalizado. (AU)

Randomized clinical trial to evaluate the effect on postprandial glycemia of Nutren Control®, a glycemia-targeted specialized supplement, compared to standardized breakfast in patients with type-2 diabetes: the CONTROL DIABETES study.

Introduction: Objective: to evaluate the effects of a new glycemia targeted specialized supplement (GTSS) compared to a standard breakfast on postprandial blood glucose (PPG). Methods: patients with type 2 diabetes (T2D) and suboptimal control (A1C between 6.5 and 8.5 %) in monotherapy with metformin were included to this prospective, randomized, crossover trial. The standardized breakfast was isoenergetic compared to the GTSS, differing on macronutrients distribution. Both interventions were used once a day in the morning, each replacing breakfast for 7 consecutive days (14 days of observation). Intermittent scanning continuous glucose monitoring system (isCGM) determined the difference between the interventions regarding the incremental area under the curve (iAUC) of the PPG (3 hours after intervention), as a primary endpoint; secondary endpoints were the difference between the interventions regarding the glycemic peak, postprandial glucose excursion (PPGE), mean blood glucose (MBG) and time in range (TIR). Results: thirty-one T2D patients with ages between 39 and 69 years-old were enrolled. GTSS group had significantly lower iAUC of the PPG compared to standardized breakfast (33.3 [15.0 to 54.0] vs 46.8 [27.3 to 75.1] mg/dL), while also presenting a significantly lower PPG excursion (26.4 ± 17.2 vs 44.8 ± 24.4 mg/dL). There was no difference between the intervention periods regarding MBG, TIR and hypoglycemic events. Conclusion: The new GTSS, as a meal replacement in the breakfast, produced a 25 % reduction in the iAUC of the PPG, as accessed by isCGM, in comparison with an isocaloric-standardized meal.

Introducción: Objetivo: evaluar los efectos de un suplemento especializado en el control de la glucosa (GTSS) frente a un desayuno estándar sobre la glucemia posprandial (PPG). Metodología: es un estudio cruzado, prospectivo, aleatorizado en el que se incluyeron a pacientes con diabetes tipo 2 (T2D) con control subóptimo de la glucemia (HbA1c entre 6,5 y 8,5 %) utilizando monoterapia con metformina. El desayuno estandarizado fue isocalórico en comparación con el GTSS y solamente la distribución calórica fue diferente. Ambas intervenciones se utilizaron una vez al día por la mañana, reemplazando cada una el desayuno durante 7 días consecutivos (14 días de observación). Se utilizó el sistema de monitoreo continuo de glucosa (isCGM) para determinar las diferencias entre las intervenciones con respecto al área bajo la curva (iAUC) de glucosa postprandial (PPG) (3 horas después de la intervención) como variable principal o primaria; las variables secundarias fueron la diferencia entre las intervenciones con respecto al pico glicémico, la excursión de glucosa posprandial (PPGE), la glucosa media en sangre (MBG) y el rango de tiempo (TIR). Resultado: se incluyeron treinta y un pacientes con T2D con edades entre 39 y 69 años. El grupo del GTSS tuvo un área bajo la curva (iAUC) significativamente más baja de la PPG en comparación con el grupo del desayuno estandarizado (33,3 [15,0 a 54,0] frente a 46,8 [27,3 a 75,1] mg/dL), mientras que también presentó una PPG significativamente más baja (26,4 + 17,2 vs. 44,8 + 24,4 mg/dL). No hubo diferencia entre los períodos de intervención con respecto a la MBG, el TIR y eventos hipoglucémicos. Conclusión: el nuevo GTSS, como sustituto del desayuno, produjo una reducción de la iAUC de la PPG del 25 %, según el isCGM, en comparación con un desayuno isocalórico normalizado.

Effects of oral probiotics administration on the expression of transforming growth factor ß and the proinflammatory cytokines interleukin 6, interleukin 17, and tumor necrosis factor α in skin wounds in rats.

BACKGROUND: Cytokines and growth factors play key roles during the tissue repair process. We aim to evaluate the effect of perioperative oral of probiotics, on the healing process in skin wound in rats, by histological aspects, and by the expression of TGF-ß, and the pro-inflammatory cytokines IL6, IL7, and TNF-α. METHODS: 72 adult male Wistar rats were split into two groups control (n = 36) and probiotic group (n = 36). Each group was subdivided into three subgroups with 12 animals each according to euthanasia day: 3rd, 7th, and 10th postoperative(PO) day. RESULTS: Wound contraction was faster with the use of probiotics (p = .013). Also fibrosis was significantly higher in the Probiotic group in the 7th PO day (p = .028). In the probiotic group, there was a reduction of TNF-α at 3th PO day (p = .023); and a reduction of IL6 in 7th PO day (p = .030). There was also a reduction of the expression of IL-17 in 3rd PO day (p = .039) and 7rd PO day (P = .024). In contrast, TGF-ß was lower in the 10th PO day (p = .031) in the probiotic group as compared to controls, indicating that the increase of the fibrosis caused negative feedback with the TGF-ß. CONCLUSION: Probiotics are associated with a shorter inflammatory phase by attenuating the expression of cytokines IL-6 and TNF-α and accelerating the reduction of IL-17 and TGF-ß, leading to faster and improved cutaneous healing in rats.

Consensus on the standard terminology used in the nutrition care of adult patients with chronic kidney disease / Consenso sobre a terminologia padronizada do processo de cuidado em nutrição para pacientes adultos com doença renal crônica

Abstract This nutrition consensus document is the first to coordinate the efforts of three professional organizations - the Brazilian Association of Nutrition (Asbran), the Brazilian Society of Nephrology (SBN), and the Brazilian Society of Parenteral and Enteral Nutrition (Braspen/SBNPE) - to select terminology and international standardized tools used in nutrition care. Its purpose is to improve the training delivered to nutritionists working with adult patients with chronic kidney disease (CKD). Eleven questions were developed concerning patient screening, care, and nutrition outcome management. The recommendations set out in this document were developed based on international guidelines and papers published in electronic databases such as PubMed, EMBASE(tm), CINHAL, Web of Science, and Cochrane. From a list of internationally standardized terms, twenty nutritionists selected the ones they deemed relevant in clinical practice involving outpatients with CKD. The content validity index (CVI) was calculated with 80% agreement in the answers. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to assess the strength of evidence and recommendations. A total of 107 terms related to Nutrition Assessment and Reassessment, 28 to Diagnosis, nine to Intervention, and 94 to Monitoring and Evaluation were selected. The list of selected terms and identified tools will be used in the development of training programs and the implementation of standardized nutrition terminology for nutritionists working with patients with chronic kidney disease in Brazil.

Resumo Este consenso representa a primeira colaboração entre três organizações profissionais com foco em nutrição: Associação Brasileira de Nutrição (Asbran), Sociedade Brasileira de Nefrologia (SBN) e Sociedade Brasileira de Nutrição Parenteral e Enteral (Braspen/SBNPE), com o objetivo de identificar a terminologia e instrumentos padronizados internacionalmente para o processo de cuidado em nutrição. O foco é facilitar a condução de treinamentos de nutricionistas que trabalham com pacientes adultos com doenças renais crônicas (DRC). Foram levantadas onze questões relacionadas à triagem, ao processo de cuidado e à gestão de resultados em nutrição. As recomendações foram baseadas em diretrizes internacionais e em bancos de dados eletrônicos, como PubMed, EMBASE(tm), CINHAL, Web of Science e Cochrane. A partir do envio de listas de termos padronizados internacionalmente, vinte nutricionistas especialistas selecionaram aqueles que consideraram muito claros e relevantes para a prática clínica com pacientes ambulatoriais com DRC. Foi calculado o Índice de Validade de Conteúdo (IVC), com 80% de concordância nas respostas. O Grading of Recommendations, Assessment, Development and Evaluation (GRADE) foi usado para atribuir força de evidência às recomendações. Foram selecionados 107 termos de Avaliação e Reavaliação, 28 de Diagnóstico, 9 de Intervenção e 94 de Monitoramento e Aferição em Nutrição. A lista de termos selecionados e identificação de instrumentos auxiliará no planejamento de treinamentos e na implementação de terminologia padronizada em nutrição no Brasil, para nutricionistas que trabalham com pacientes renais crônicos.

Consensus on the standard terminology used in the nutrition care of adult patients with chronic kidney disease.

This nutrition consensus document is the first to coordinate the efforts of three professional organizations - the Brazilian Association of Nutrition (Asbran), the Brazilian Society of Nephrology (SBN), and the Brazilian Society of Parenteral and Enteral Nutrition (Braspen/SBNPE) - to select terminology and international standardized tools used in nutrition care. Its purpose is to improve the training delivered to nutritionists working with adult patients with chronic kidney disease (CKD). Eleven questions were developed concerning patient screening, care, and nutrition outcome management. The recommendations set out in this document were developed based on international guidelines and papers published in electronic databases such as PubMed, EMBASE(tm), CINHAL, Web of Science, and Cochrane. From a list of internationally standardized terms, twenty nutritionists selected the ones they deemed relevant in clinical practice involving outpatients with CKD. The content validity index (CVI) was calculated with 80% agreement in the answers. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to assess the strength of evidence and recommendations. A total of 107 terms related to Nutrition Assessment and Reassessment, 28 to Diagnosis, nine to Intervention, and 94 to Monitoring and Evaluation were selected. The list of selected terms and identified tools will be used in the development of training programs and the implementation of standardized nutrition terminology for nutritionists working with patients with chronic kidney disease in Brazil.

EFFECTS OF PROBIOTICS SUPPLEMENTATION ON SKIN WOUND HEALING IN DIABETIC RATS.

BACKGROUND: Example of wound contraction area at: A) day of surgery in the control group; B) 7PO in the control group; C) day of surgery in the probiotic group; D) 7PO in probiotic group. Chronic wounds in patients with Diabetes Mellitus often become incurable due to prolonged and excessive production of inflammatory cytokines. The use of probiotics modifies the intestinal microbiota and modulates inflammatory reactions. AIM: To evaluate the influence of perioperative supplementation with probiotics in the cutaneous healing process in diabetic rats. METHODS: Forty-six rats were divided into four groups (C3, P3, C10, P10) according to the treatment (P=probiotic or C=control, both orally administered) and day of euthanasia, 3rd or 10th postoperative days. All rats were induced to Diabetes Mellitus 72 h before starting the experiment with alloxan. Supplementation was initiated five days before the incision and maintained until euthanasia. Scalpel incision was guided by a 2x2 cm mold and the wounds were left to heal per second-intention. The wounds were digitally measured. Collagen densitometry was done with Picrosirius Red staining. Histological parameters were analyzed by staining by H&E. RESULTS: The contraction of the wound was faster in the P10 group which resulted in a smaller scar area (p=0.011). There was an increase in type I collagen deposition from the 3rd to the 10th postoperative day in the probiotic groups (p=0.016), which did not occur in the control group (p=0.487). The histological analysis showed a better degree of healing in the P10 group (p=0.005), with fewer polymorphonuclear (p<0.001) and more neovessels (p=0.001). CONCLUSIONS: Perioperative supplementation of probiotics stimulates skin wound healing in diabetic rats, possibly due to attenuation of the inflammatory response and increased neovascularization and type I collagen deposition.

Effects of probiotics supplementation on skin wound healing in diabetic rats / Suplementação perioperatória com probióticos na cicatrização de feridas cutâneas em ratos diabéticos

ABSTRACT Background: Chronic wounds in patients with Diabetes Mellitus often become incurable due to prolonged and excessive production of inflammatory cytokines. The use of probiotics modifies the intestinal microbiota and modulates inflammatory reactions. Aim: To evaluate the influence of perioperative supplementation with probiotics in the cutaneous healing process in diabetic rats. Methods: Forty-six rats were divided into four groups (C3, P3, C10, P10) according to the treatment (P=probiotic or C=control, both orally administered) and day of euthanasia, 3rd or 10th postoperative days. All rats were induced to Diabetes Mellitus 72 h before starting the experiment with alloxan. Supplementation was initiated five days before the incision and maintained until euthanasia. Scalpel incision was guided by a 2x2 cm mold and the wounds were left to heal per second-intention. The wounds were digitally measured. Collagen densitometry was done with Picrosirius Red staining. Histological parameters were analyzed by staining by H&E. Results: The contraction of the wound was faster in the P10 group which resulted in a smaller scar area (p=0.011). There was an increase in type I collagen deposition from the 3rd to the 10th postoperative day in the probiotic groups (p=0.016), which did not occur in the control group (p=0.487). The histological analysis showed a better degree of healing in the P10 group (p=0.005), with fewer polymorphonuclear (p<0.001) and more neovessels (p=0.001). Conclusions: Perioperative supplementation of probiotics stimulates skin wound healing in diabetic rats, possibly due to attenuation of the inflammatory response and increased neovascularization and type I collagen deposition.

RESUMO Racional: Feridas crônicas em pacientes diabéticos muitas vezes se tornam incuráveis devido à produção prolongada e excessiva de citocinas inflamatórias. A utilização de probióticos modifica a microbiota intestinal e modula reações inflamatórias. Objetivo: Avaliar a influência da suplementação perioperatória com probióticos no processo de cicatrização cutânea em ratos diabéticos. Método: Quarenta e seis ratos foram divididos em quatro grupos (C3, P3, C10, P10) conforme tratamento (P=probiótico ou C=controle, via oral) e dia de eutanásia: 3o ou 10o dia de pós-operatório. Todos os ratos foram induzidos ao diabete melito 72 h antes de iniciar o experimento com aloxana. A suplementação foi iniciada cinco dias antes da operação e mantida até a eutanásia. Foi realizada incisão com bisturi guiada por molde de 2x2 cm e a ferida foi deixada para cicatrizar por segunda intenção. As feridas foram medidas digitalmente. A densitometria de colágeno foi determinada com coloração picrosirius red. A histologia foi avaliada por coloração com H&E. Resultados: A contração da ferida foi maior no grupo P10, o que resultou em menor área cruenta (p=0,011). Houve aumento do colágeno tipo I do 3o para o 10o dia de pós-operatório no grupo P10 (p=0,016), o que não ocorreu no grupo controle (p=0,487). A análise histológica mostrou melhor grau de cicatrização no grupo P10 (p=0,005), com menos polimorfonucleares (p<0,001) e mais neovasos (p=0,001). Conclusões: A suplementação perioperatória de probióticos promove aceleração da cicatrização cutânea em ratos diabéticos, possivelmente por atenuar a resposta inflamatória e aumentar a neovascularização e a deposição de colágeno tipo I.

EFFECT OF PROBIOTIC ORAL ADMINISTRATION ON SKIN WOUND HEALING IN RATS.

BACKGROUND: Manipulating intestinal microbiota with probiotics might stimulate skin response. Understanding all stages of the healing process, as well as the gut-skin-healing response can improve the skin healing process. AIM: To evaluate the effect of perioperative oral administration of probiotics on the healing of skin wounds in rats. METHODS: Seventy-two Wistar male adult rats were weighed and divided into two groups with 36 each, one control group (supplemented with oral maltodextrin 250 mg/day) and one probiotic group (supplemented with Lactobacillus paracasei LPC-37, Bifidobacterium lactis HN0019, Lactobacillus rhamnosus HN001, Lactobacillus acidophilus NCFM® at a dose of 250 mg/day), both given orally daily for 15 days. The two groups were subsequently divided into three subgroups according to the moment of euthanasia: in the 3rd, 7th and 10th postoperative days. RESULTS: There were no significant changes in weight in both groups. Wound contraction was faster in probiotic group when compared to the controls, resulting in smaller wound area in the 7th postoperative day. As for histological aspects, the overall H&E score was lower in the probiotic group. The probiotic group showed increased fibrosis from 3rd to the 7th postoperative day. The type I collagen production was higher in the probiotic group at the 10th postoperative day, and the type III collagen increased in the 7th. CONCLUSION: The perioperative use of orally administrated probiotic was associated with a faster reduction of the wound area in rats probably by reducing the inflammatory phase, accelerating the fibrosis process and the deposition of collagen.

Campanha "Diga não à desnutrição": 11 passos importantes para combater a desnutrição hospitalar / Campaign "Say no to malnutrition": 11 important steps to fight hospital malnutrition

A desnutrição é frequentemente encontrada no ambiente hospitalar. Muitas vezes negligenciada, apesar de afetar desfavoravelmente a saúde da população, a desnutrição apresenta como principais complicações: pior resposta imunológica, atraso no processo de cicatrização, risco elevado de complicações cirúrgicas e infecciosas, maior probabilidade de desenvolvimento de lesões por pressão, aumento no tempo de internação e do risco de mortalidade. Fora isso, acarreta considerável aumento dos custos hospitalares. A taxa de desnutrição varia entre 20 e 50% em adultos hospitalizados e durante a hospitalização esta condição piora progressivamente principalmente em idosos e pacientes críticos. Em 1998, o inquérito brasileiro, conhecido como IBRANUTRI, avaliou 4 mil pacientes internados na rede pública hospitalar de vários estados brasileiros, confirmando a prevalência da desnutrição em 48,1% dos pacientes. Há 20 anos, estes dados foram publicados e o cenário permanece imutável até os dias atuais, pois, em 2016, outro estudo (com aproximadamente 30.000 pacientes) corroborou a manutenção da alta prevalência de desnutrição em pacientes hospitalizados. A identificação precoce da desnutrição, bem como o manejo, por meio de ferramentas recomendadas, possibilita estabelecer a conduta nutricional mais apropriada e melhora do desfecho nestes pacientes.O objetivo desta campanha é reduzir as taxas de desnutrição por meio de uma série de ações que incluem a triagem, o diagnóstico, o manejo e o tratamento da desnutrição. Para facilitar a maneira de difundir este conhecimento, foi desenvolvido um método mnemônico com a palavra "DESNUTRIÇÃO", abordando cada letra inicial de forma simples, desde o conceito até o tratamento da desnutrição. Desta forma, o método garante uma integração interdisciplinar, além de averiguar os principais aspectos do cuidado geral do paciente desnutrido.

Glycemic response to Carob (Ceratonia siliqua L) in healthy subjects and with the in vitro hydrolysis index / Respuesta glucémica de algarrobo (Ceratonia siliqua L) en sujetos sanos y con el índice de hidrólisis in vitro

The purpose of this study was to determine the in vivo glycemic index of carob tablets with healthy subjects and to determine the in vitro glycemic index of carob tablets and carob flour by the hydrolysis index. Seven healthy volunteers consumed portions of carob tablets containing 26g of available carbohydrate. Their capillary blood was taken at intervals after carob or glucose consumption. The glycemic hydrolysis index by an in vitro technique was based in the release of glucose after enzymatic treatment of carob tablets and carob flour. The determination of the fiber content was performed using the enzymatic- gravimetric method. By the in vivo determination, the estimated glycemic index of carob tablets could be considered low (≤ 55). By the in vitro determination, the estimated glycemic index ranged from 40.1+0.02 of carob tablets to 40.6+0.05 of carob flour. The total fiber values obtained for carob flour samples were from 42.6% ± 0.49 to 42.9% ± 0.68 with no statistical significant differences between samples. Carob tablets and carob flour could be classified as low glycemic index food and low glycemic load food. Carob flour is a high fiber food, containing mainly high levels of insoluble fiber (AU)

El presente estudio tuvo como objetivos determinar el índice glucémico in vivo de barras de algarroba en individuos saludables y determinar el índice glucémico in vitro de barras de algarroba y harina de algarroba, utilizando el índice de hidrólisis. Siete voluntarios saludables consumieron porciones de barras de algarroba conteniendo 26 g de carbohidratos. Se han recolectado muestras de sangre capilar tras la ingestión de barras de algarroba y de glucosa. El índice de glucosa in vitro se basó en la liberación de glucosa tras el tratamiento enzimático de barras de harina de algarroba. La determinación de fibras se realizó por el método enzimático-gravimétrico. Por la determinación in vitro, el índice glicémico estimado puede ser considerado bajo (≤ 55). Por la determinación in vitro, el índice glicémico varió entre 40.1±0.02 (barras) y 40.6±0.05 (harina). El tenor de fibra alimentaria encontrado fue del 42.6% ± 0.49 a 42.9% ± 0.68, sin diferencias estadísticas entre las uestras. Las barras de harina de algarroba pueden ser clasificadas como alimentos de bajo índice glicémico y de baja carga glucémica. La harina de algarroba presenta alto tenor de fibras alimentarias, sobre todo fibras insolubles (AU)

Efeitos do aditivo do leite materno com ferro sobre as propriedades bacteriostáticas do leite materno / Effects of human milk fortifier with iron on the bacteriostatic properties of breast milk

OBJETIVO: Comparar o crescimento bacteriano em colostro puro e colostro com aditivo do leite materno contendo ferro. MÉTODOS: Foram comparadas 78 amostras de colostro puro ou colostro com adição de aditivo do leite materno contendo ferro para avaliar o crescimento de Escherichia coli, Staphylococcus aureus e Pseudomonas aeruginosa. Para a análise qualitativa, discos de papel-filtro foram imersos em amostras de cada grupo e incubados por 48 horas com 10¹ Unidades Formadoras de Colônias/mL de cada cepa. Para a avaliação quantitativa, 1 mL de cada cepa contendo 10(7) Unidades Formadoras de Colônias/mL foi homogeneizado com 1 mL, tanto de colostro puro quanto de colostro com aditivo do leite materno, espalhado em placa de Petri e incubado a 37ºC. O número de Unidades Formadoras de Colônias foi contado 24 horas depois. RESULTADOS: A análise qualitativa não mostrou nenhuma diferença no crescimento bacteriano. Na avaliação quantitativa, o crescimento de Escherichia coli (EC) no grupo C foi de 29,4±9,7 x 10(6) CFU/mL, enquanto no grupo FM85 foi de 31,2±10,8 x 10(6) CFU/mL. A diferença entre o crescimento médio foi de 1,9±4,9 x 10(6) CFU/mL (p = 0,001). Não houve diferenças no crescimento de Staphylococcus aureus e Pseudomonas aeruginosa. CONCLUSÃO: A adição de ferro a essa concentração reduz a ação bacteriostática do leite materno contra Escherichia coli.

OBJECTIVE: To compare bacterial growth in pure colostrum versus colostrum with human milk fortifier (HMF) containing iron. METHODS: The growth of Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa in 78 samples of pure colostrum or colostrum with added iron-containing HMF was compared. For qualitative analysis, filter paper discs were immersed in samples from each group and incubated for 48 hours with 10¹ colony forming units (CFUs)/mL of each strain. For quantitative assessment, 1 mL of each strain containing 10(7) CFUs/mL was homogenized with 1 mL of either colostrum or colostrum with human milk fortifier, seeded into a Petri dish, and incubated at 37ºC. Twenty-four hours later, the number of CFUs was counted. RESULTS: The qualitative analysis showed no difference in bacterial growth. In the quantitative evaluation, E. coli growth in the control group was 29.4±9.7 x 10(6) CFU/ mL, while in the HMF group it was 31.2±10.8 x 10(6) CFU/mL. The difference between the average growth was 1.9±4.9 x 10(6) CFU/mL (p = 0.001). There were no differences in S. aureus and P. aeruginosa growth. CONCLUSION: Addition of iron at this concentration reduces breast milk bacteriostatic action against E. coli.

Effects of human milk fortifier with iron on the bacteriostatic properties of breast milk.

OBJECTIVE: To compare bacterial growth in pure colostrum versus colostrum with human milk fortifier (HMF) containing iron. METHODS: The growth of Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa in 78 samples of pure colostrum or colostrum with added iron-containing HMF was compared. For qualitative analysis, filter paper discs were immersed in samples from each group and incubated for 48 hours with 10(1) colony forming units (CFUs)/mL of each strain. For quantitative assessment, 1 mL of each strain containing 10(7) CFUs/mL was homogenized with 1 mL of either colostrum or colostrum with human milk fortifier, seeded into a Petri dish, and incubated at 37°C. Twenty-four hours later, the number of CFUs was counted. RESULTS: The qualitative analysis showed no difference in bacterial growth. In the quantitative evaluation, E. coli growth in the control group was 29.4±9.7×10(6)CFU/mL, while in the HMF group it was 31.2±10.8×10(6)CFU/mL. The difference between the average growth was 1.9±4.9×10(6)CFU/mL (p=0.001). There were no differences in S. aureus and P. aeruginosa growth. CONCLUSION: Addition of iron at this concentration reduces breast milk bacteriostatic action against E. coli.