Association of PCSK1 and PPARG1 Allelic Variants with Obesity and Metabolic Syndrome in Mexican Adults.

Metabolic diseases, including obesity, diabetes, and metabolic syndrome, are among the most important public health challenges worldwide. Metabolic diseases are classified as multifactorial diseases in which genetic variants such as single-nucleotide polymorphisms (SNPs) may play an important role. The present study aimed to identify associations linking allelic variants of the PCSK1, TMEM18, GPX5, ZPR1, ZBTB16, and PPARG1 genes with anthropometric and biochemical traits and metabolic diseases (obesity or metabolic syndrome) in an adult population from northwestern Mexico. METHODS: Blood samples were collected from 523 subjects, including 247 with normal weight, 276 with obesity, and 147 with metabolic syndrome. Anthropometric and biochemical characteristics were recorded, and single-nucleotide polymorphisms (SNPs) were genotyped by real-time PCR. RESULTS: PCSK1 was significantly (p < 0.05) associated with BMI, weight, and waist-to-hip ratio; TMEM18 was significantly associated with systolic blood pressure and triglyceride levels; GPX5 was significantly associated with HDL cholesterol levels. In addition, PCSK1 was associated with obesity (p = 1.0 × 10-4) and metabolic syndrome (p = 3.0 × 10-3), whereas PPARG1 was associated with obesity (p = 0.044). CONCLUSIONS: The associations found in this study, mainly between allelic variants of PCSK1 and metabolic traits, obesity, and metabolic syndrome, may represent a risk for developing metabolic diseases in adult subjects from northwestern Mexico.

Influence of keeping the calyces during fermentation on physicochemical and sensory properties of Hibiscus sabdariffa wines.

Hibiscus (Hibiscus sabdariffa) wines are usually made through the fermentation of its calyces extracts. However, the exhausted calyces could still contain a considerable amount of extractable bioactive compounds. This work analyzed the effect of keeping the hibiscus calyces during fermentation on the physicochemical and sensory characteristics and acceptance of its wines. Hibiscus wines Filtered-Ch and Filtered-C were generated by fermentation of filtered musts of China and Colima varieties, respectively, while Unfiltered-Ch and Unfiltered-C were obtained by fermentation of musts from calyces that were kept for 120 days. Unfiltered-C and Unfiltered-Ch wines had higher contents of total monomeric anthocyanins (32.5 mg/L in Unfiltered-C and 48.5 mg/L in Unfiltered-Ch), condensed tannins (around 200 mgCE/L), total phenolic compounds (800 mgGAE/L), and antioxidant activity (8.4-8.8 mMTE/L), as well as a higher concentration of tartaric, citric and malic acids (0.26, 0.32 and 2.25 g/L, respectively) than Filtered-C and Filtered-Ch wines (P < 0.05). Moreover, Unfiltered-C and Unfiltered-Ch wines had darker red colors, evidenced by lower lightness, chroma and hue values, than those observed in Filtered-C and Filtered-Ch wines (P < 0.01). Furthermore, Unfiltered-Ch and Unfiltered-C wines were more appreciated, having a more intense taste and smell according to the descriptions obtained from consumers by applying the Check-All-That-Apply technique. Sensory attributes observed in hibiscus wines were statistically correlated with the physicochemical characteristics. Keeping hibiscus calyces during fermentation allows for the production of wines with acceptable sensory characteristics and a higher concentration of bioactive compounds than producing wines from filtered musts.

The impact of a low-calorie, low-glycemic diet on systemic lupus erythematosus: a systematic review.

BACKGROUND: Diet plays a critical role in Systemic Lupus Erythematosus (SLE) patients, impacting on the microbiota composition and, consequently, on the immune response. The objective was to analyze and verify the diet effect on SLE patients. METHODS: This is a systematic review performed at the Evidences-based Health Lab, Escola Superior em Ciências da Saúde, Brasília (DF), Brazil. In March, 2021, five databases, and grey literature, through JSTOR, Open Grey, and Google Scholar were searched. Randomized Clinical Trials in which SLE patients with calorie restricted, low glycemic index or other diet involving the joint adequacy of these aspects, compared with placebo or different types of diet, were included. RESULTS: It was identified in the databases 758 articles; 132 were duplicated; 616 references were screened, and 604 were excluded. After reading the title and abstract, 12 articles were included for full-text reading. After the full-text reading, three studies were included for quantitative analysis. The diet improved the quality of life at 6 (MD 16.30; 5.91;26.69) and 12 weeks (MD 14.60; 0.88;28.32). The GRADE was used to evaluate the quality of evidence. CONCLUSION: There is low evidence that the diet has a positive impact on the quality of life of SLE patients. Trial registration PROSPERO-CRD4202012208.

Evidence for the efficacy of Tai Chi for treating rheumatoid arthritis: an overview of systematic reviews

ABSTRACT BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with higher prevalence among women aged between 30 and 50 years and general prevalence of 1% worldwide. Interventions promoting improvement of quality of life for individuals with RA are required. Tai Chi appears to be a low-cost alternative, with studies showing positive results from this technique. However, regarding aspects of RA such as pain and sensitivity, studies remain inconclusive. OBJECTIVES: To compare the effectiveness of the Tai Chi method for treating patients diagnosed with rheumatoid arthritis, among systematic reviews. DESIGN AND SETTING: Overview of systematic reviews with Cochrane and non-Cochrane methodology. METHODS: Systematic reviews involving quasi-randomized and randomized clinical trials (RCTs) on use of Tai Chi, with no restrictions regarding the date and language of publication, were included. RESULTS: Three systematic reviews were included. The effects of Tai Chi associated with education and stretching exercises versus education and stretching were evaluated in these reviews. They showed that improvements in the variables of mood, depression and functional index were associated with use of Tai Chi. CONCLUSIONS: The findings suggest that clinical improvement was achieved, although not statistically significant with regard to pain and disease pattern, as assessed using the ACR20 measurement. Improvements relating to disability and quality of life were also seen. There was a low level of evidence and therefore caution in data analysis is recommended. The three studies included showed poor reliability for providing an accurate and complete summary of use of Tai Chi among people diagnosed with rheumatoid arthritis. PROSPERO: CRD42019125501.

Evidence for the efficacy of Tai Chi for treating rheumatoid arthritis: an overview of systematic reviews.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with higher prevalence among women aged between 30 and 50 years and general prevalence of 1% worldwide. Interventions promoting improvement of quality of life for individuals with RA are required. Tai Chi appears to be a low-cost alternative, with studies showing positive results from this technique. However, regarding aspects of RA such as pain and sensitivity, studies remain inconclusive. OBJECTIVES: To compare the effectiveness of the Tai Chi method for treating patients diagnosed with rheumatoid arthritis, among systematic reviews. DESIGN AND SETTING: Overview of systematic reviews with Cochrane and non-Cochrane methodology. METHODS: Systematic reviews involving quasi-randomized and randomized clinical trials (RCTs) on use of Tai Chi, with no restrictions regarding the date and language of publication, were included. RESULTS: Three systematic reviews were included. The effects of Tai Chi associated with education and stretching exercises versus education and stretching were evaluated in these reviews. They showed that improvements in the variables of mood, depression and functional index were associated with use of Tai Chi. CONCLUSIONS: The findings suggest that clinical improvement was achieved, although not statistically significant with regard to pain and disease pattern, as assessed using the ACR20 measurement. Improvements relating to disability and quality of life were also seen. There was a low level of evidence and therefore caution in data analysis is recommended. The three studies included showed poor reliability for providing an accurate and complete summary of use of Tai Chi among people diagnosed with rheumatoid arthritis. PROSPERO: CRD42019125501.

Efeitos da Educação Alimentar e Nutricional sobre qualidade da dieta e comportamento alimentar de idosos / Effects of Food and Nutrition Education on diet quality and feeding behavior of elderly

Objetivo: investigar os efeitos de intervenção do tipo Educação Alimentar e Nutricional baseada no Modelo Transteórico. Métodos: ensaio clínico aberto com 70 idosos. Avaliou­se qualidade da dieta, por meio de Recordatórios Alimentares e Índice de Qualidade da Dieta, e o comportamento alimentar, com análise comparativa do tipo pré­pós onde o grupo de comparação ou controle foi o próprio grupo selecionado para a intervenção. Resultados: melhora da dieta, com aumento do consumo de frutas, vegetais e hortaliças e do comportamento alimentar (evolução dos estágios de pré­contemplação para ação). Conclusão: mudança nos hábitos de idosos é difícil, considera­se que a intervenção foi efetiva.

Objective: to investigate the effects of intervention of the type of Food and Nutrition Education based on the Transtheoretical Model.Methods: open clinical trial with 70 elderly people. Diet quality was assessed through Food Recalls and Diet Quality Index and eating beha­vior was evaluated with comparative analysis of the pre­post type where the comparison or control group was the group selected for the intervention. Results: improved diet, with increased consumption of fruits and vegetables, and eating behavior (evolution from pre­contemplation stages to action). Conclusion: changing habits of the elderly is difficult, it is considered that the intervention was effective.

Influence of expectations on the level of liking of a local coffee in Mexico.

BACKGROUND: In Mexico, coffee activity is mainly carried out in indigenous zones, involving almost one million people. However, local national coffee consumption is low. This article focuses on the analysis of the effect of consumers' expectations as well as some sociodemographic characteristics on the level of liking of Mexican local coffee. Four coffees from three indigenous zones of Hidalgo, Mexico were evaluated using a nine-point hedonic scale. The samples were evaluated under three conditions: (i) blind, no information given to the consumer; (ii) expected, only information given to the consumer; and (iii) informed, giving information and product to the consumer. RESULTS: The difference observed between expected and blind condition was significant (P < 0.005) for the three local coffees evaluated, indicating a negative disconfirmation. The local coffees were less appreciated than expected, since the information about the samples created high hedonic expectations among the consumers. The level of education and the place of residence of consumers had a significant influence on their level of liking. Based on demographic characteristics, three segments were found presenting a different pattern of liking. CONCLUSIONS: Consumers had positive expectations towards the local coffee. The sociodemographic characteristics and aspects related to consumption, particularly the experience with the product, are decisive in the expectations concerning the local product. This investigation can be useful to generate marketing strategies according to the demands and needs of the market, making local products to be valued. © 2020 Society of Chemical Industry.

Concentration of roselle (Hibiscus sabdariffa L) and sucrose in beverages: Effects on physicochemical characteristics and acceptance.

The calyces of roselle (Hibiscus sabdariffa L.) are used to make a refreshing drink with high content of anthocyanins and other phenolic compounds, although the process for obtaining the beverage is not standardized. In this research it was determined physicochemical characteristics, total soluble polyphenols content, antioxidant activity and acceptance for beverages prepared by decoction at four concentrations of calyces in water (1.0, 2.5, 5.0 and 10.0%) and two concentrations of sucrose (11 and 16%). Color parameters in beverages permitted to describe them as red, which turned darker as the content of hibiscus increased. Total soluble polyphenols content and antioxidant activity were directly correlated with content of calyces in beverages and inversely correlated with pH, which means that beverages with higher content of calyces could be perceived as more acidic and more intense in characteristics associated with hibiscus presence, such as acid, astringent and the presence of intense dark red color, although the higher concentration of sucrose might have contributed to mask slightly the sourness and astringency. Acceptance for hibiscus beverages allowed to observe two segments of consumers, high-intensity and low-intensity likers but both confluence in overall liking values for beverages prepared with 2.5% calyces and 16% sucrose.

The impact of a low-calorie, low-glycemic diet on systemic lupus erythematosus: a systematic review

Abstract Background: Diet plays a critical role in Systemic Lupus Erythematosus (SLE) patients, impacting on the microbiota composition and, consequently, on the immune response. The objective was to analyze and verify the diet effect on SLE patients. Methods: This is a systematic review performed at the Evidences-based Health Lab, Escola Superior em Ciências da Saúde, Brasília (DF), Brazil. In March, 2021, five databases, and grey literature, through JSTOR, Open Grey, and Google Scholar were searched. Randomized Clinical Trials in which SLE patients with calorie restricted, low glycemic index or other diet involving the joint adequacy of these aspects, compared with placebo or different types of diet, were included. Results: It was identified in the databases 758 articles; 132 were duplicated; 616 references were screened, and 604 were excluded. After reading the title and abstract, 12 articles were included for full-text reading. After the full-text reading, three studies were included for quantitative analysis. The diet improved the quality of life at 6 (MD 16.30; 5.91;26.69) and 12 weeks (MD 14.60; 0.88;28.32). The GRADE was used to evaluate the quality of evidence. Conclusion: There is low evidence that the diet has a positive impact on the quality of life of SLE patients. Trial registration PROSPERO—CRD4202012208.

Aplicação da avaliação geriátrica ampla em idosa hospitalizada em um hospital público do DF: um relato de caso / Application of the broad geriatric evaluation in hospitalized elderly women in a public hospital in the Federal District: a case report

Conclusão: A AGA é fundamental para identificação da fragilidade (muitas vezes de forma precoce) - permite intervenções individualizadas que tem como objetivo de mudar/prevenir ou amenizar desfechos clínicos adversos e negativos. Serve de guia para a escolha de medidas que visam restaurar e preservar a saúde (farmacoterapia, fisioterapia, terapia ocupacional, psicoterapia, nutrição), sendo assim uma importante ferramenta de saúde pública, visto que atua na prevenção e na promoção da saúde do idoso. A implementação da AGA na prática clínica dos serviços da SES-DF será de grande importância para uma melhor avaliação e acompanhamento da pessoa idosa.

Características dos serviços de atenção domiciliar / Characteristics of home care services

Objetivos: identificar características dos serviços de atenção domiciliar brasileiros. Método: revisão integrativa, que buscou artigos científicos publicados entre janeiro de 2012 a maio de 2017, nas bases de BDENF, LILACS e na biblioteca virtual SciELO. A avaliação dos estudos foi feita pela leitura dos resumos dos artigos que respondessem como é o cenário da assistência domiciliar no Brasil e os resultados foram apresentados em forma de tabela e sínteses. Resultados: a amostra foi composta por nove artigos dos quais foram possíveis identificar três categorias temáticas ­ "os grupos populacionais prevalentes na assistência domiciliar", "o perfil dos profissionais e dos cuidadores familiares inseridos nesse contexto" e "características do serviço de atenção domiciliar". Conclusão: a atenção domiciliar é um eficaz meio de desospitalização e redução de custo e humanização do cuidado, porém, de acesso escasso aos usuários da rede pública de saúde.(AU)

Situación socio-demográficas y de salud de niños de 0 a 5 años de muertes maternas ocurridas en el Hospital Regional "Dr. Ramón Carrillo. Santiago del Estero, año 2008

Fundamentación. La población santiagueña presentó obstáculos geográficos, económicos,sociales, comunicacionales y culturales que dificultaron a las mujeres en proceso reproductivorecibir atención de salud adecuada y oportuna; muriendo arbitrariamente, dejando hijos huérfanosy familias cuidadoras, muchas veces en situaciones adversas y muy desfavorables.Diseño. Estudio descriptivo-prospectivo, transversal y observacional.Población y muestra. Se incluyeron los registros del total (16) de las muertes maternas ocurridasen el hospital de referencia, año 2008; 7 huérfanos sobrevivientes menores de 5 años que semantenían en el núcleo familiar. Controles: 14 madres vivas; 14 menores de 5 años, mediantemuestreo aleatorio estratificado.Material y Métodos. Se evaluó el estado de salud de los menores involucrados de ambos grupos.El crecimiento, según criterios de OMS/SAP-OPS/MSN, estado nutricional y enfermedadesprevalentes de la infancia. Se administró Prueba Nacional de Pesquisa (PRUNAPE) para captar eldesarrollo social-personal, funcionamiento cognitivo, habilidades motoras gruesas y finas, habla ylenguaje. Se aplicó entrevistas semi-estructuradas a las familias involucradas en la muestra yobservación en terreno con el objeto de valorar la situación socio-familiar.Resultados. Las mujeres fallecidas eran jóvenes (EM 26 años); el 87,5% residían en el interior,Los departamentos más afectados fueron General Taboada (25%) Banda (18,75%), Salavina(12.5%) y capital (12,5%); el resto 6,25 se distribuyó en Choya, Juan Felipe Ibarra, Moreno, SanMartín y Alberdi El 25% de las fallecidas eran adolescentes solteras, entre 14 y 17 años. Laprincipal causa de muerte fue abortos sépticos (43,75%); seguido de hemorragias post-parto conun 31,25%...

Foundation: The population Santiago del Estero presented obstacles geographical, economic,social, communicational and cultural that hindered to them women in process reproductive receiveattention of health adequate and timely; dying arbitrarily, leaving children orphaned and familiescaregivers, many times in situations adverse and very unfavorable.Design: Descriptive prospective, transversal and observational.Population and sample: Total (16) records included maternal deaths that occurred at the hospitalof reference year 2008; 7 surviving orphans under age 5 who are kept in the family. Controls: 14mothers living; 14 children under 5 years, through stratified random sampling.Material and methods: We evaluated the State of health of both groups involved minors. Thegrowth, according to criteria of WHO/SAP-OPS/MSN, nutritional status and management ofchildhood diseases. Given National screening test (PRUNAPE) to capture the social-personaldevelopment, cognitive performance, gross and fine motor skills, speech and language. Appliedsemi-structured interviews to the families involved in the sample and on-site observation in order toassess the socio-familial situation.Results: Las deceased women were young (Ms 26); 87.5% resided in the interior, the mostaffected departments were General Taboada (25%) band (18.75%), Salavina (12.5%) and capital(12.5%); the rest 6.25 was distributed in Choya, Juan Felipe Ibarra, Moreno, San Martín and Alberdi25% of the deceased were young single women, between 14 and 17 years. The main cause ofdeath was septic abortions (43.75%); followed by bleeding postpartum with 31.25%...

Situación social - familiar y de salud de los huérfanos de muertes maternas en trance obstétrico. Hospital regional "Dr. Ramón Carrillo". Santiago del Estero 2008 / Situação-familiar social e de saúde dos órfãos demortes maternas em estágio obstétrico. Hospitalregional “Dr. Ramon Carrillo”. Santiago del Estero.2008 / Health, social and family situation of orphans due to maternal deaths in obstetric situations regional hospital “Dr. Ramon Carrillo”, Santiago del Estero - 2008

Investigación cuanti-cualitativa. Se evaluó estado de salud(crecimiento y desarrollo) con normas de OMS/SAP, PruebaNacional de Pesquisa y situación social- familiar; de huérfanosmenores de 5 años, de madres fallecidas en trance obstétrico2008, mediante visitas domiciliarias, entrevistas semiestructuradas.Se identificaron 16 muertes maternas, 12 con hijosprevios, que dejaron 51 huérfanos, 7 menores de 5 años.En crecimiento: 57% eutróficos; 29% desnutridos crónicos,14% sobrepeso. En desarrollo: Área personal-social (100%);motricidad fina y gruesa (86%), lenguaje (42%) acordes aedadLa situación social-familiar frágil; 87% pobres, 13%indigentes; 100% sin cobertura de salud, con serviciosbásicos carecientes, insuficientes o inadecuados. Resolvíanproblemas de salud con remedios caseros y/o curanderos.Escasa protección social.Conclusión: Estado de salud de los huérfanos, satisfactorio.En desarrollo algunos con retrasos en motricidad y lenguaje. En las familias cuidadoras aumentó la precariedad y vulverabilidad. Mostraron fuertes lazosde protección y amparo, hacia los huérfanos.

Quanti-qualitative research. Health condition (growth and development) was evaluatedusing WHO/SAP standars, PESQUISA NATIONAL TEST*; and the social family situationof motherless children under 5, from mothers who died in obstetric situations in 2008 wasassessed through home visits and semi-structured surveys. In growth: 57% eutrophic; 29%chronic undernurished; 14% over-weight. In development: Personal-social area (100%);fine and gross motor skills (86%), language (42%) according to age. Fragile social familysituation; 87% poor; 13% indigents, 100% with no medical coverage and absense, shortageor inadequacy of basic services. They solved health problems with homemade medicineor healers. Poor social protection.Conclusion: Health condition of motherless children, satisfactory. In deveplomentsome presented delays in language and motor skills. Precariousness and vulnerabilityhave increased in carer families. They showed strong bonds of protection towards thesemotherless children.

Planificación funcional de unidad de nutrición enteral para atención domiciliaria en un hospital de Brasil / The functional planning of a enteral nutrition unit for home care at a hospital in Brazil

Introduction: In order to warrant the quality of the products offered to their clients at home, hospitalar units need to adequate their physical structures to develop their specialized activities on enteral nutrition. Objective. The present article aims to provide a functional planning and tools for the reorganization of the physical space of an enteral nutrition preparation unit describing its features and function. Methods. A descriptive, prospective and documental study was undertaken, providing the tools for the functional planning and quality management at a unit of enteral nutrition preparation in a public hospital in the Federal District, Brazil. Data were collected in the period from 2000 to 2010. Results. Through the establishment of a Home Enteral Nutrition Program in the Public Health Department of the Federal District and as determined by the publication of national legislation, a District Plan of High Complexity in Enteral Nutrition was conducted, according to the demographic and epidemiological profile of the population.This plan consisted of the proposal for implementation of the high complexity in nutritional therapy, according to the Health Ministry legislation. The number of patients assisted by this therapeutical modality has increased, which indicates the need to ensure the quality of dispensed formulas through the planning of functional spaces. Conclusion.The functional planning of an Enteral Nutrition Laboratory ensures assistance for the needs of the population enrolled at the hospital and at home, allowing the proper training of caregivers aiming at the adequacy of necessary precautions in manipulating enteral formulas (AU)

Introducción: Con el objeto de garantizar la calidad del producto ofrecido a los clientes en sus domicilios, las unidades hospitalarias necesitan adecuar sus áreas físicas para poder desarrollar todas las actividades especializadas que conlleva la nutrición enteral. Objetivo: Proporcionar una planificación funcional y las herramientas para la reorganización del espacio físico de una unidad de nutrición enteral, describiendo el proceso de preparación, la descripción de sus características y funciones laborales. Métodos. Estudio descriptivo, retrospectivo y documental, proporcionando las herramientas para la planificación funcional y de gestión de calidad en una unidad de preparación de la nutrición enteral en un hospital público del Distrito Federal, Brasil. Los datos fueron recolectados en el período comprendido entre los años 2000 y 2010. Resultados. A través de la creación de un programa de nutrición enteral en el Departamento de Salud Pública del Distrito Federal y según lo dispuesto por la legislación nacional, se efectuó un plan de alta complejidad respecto de la nutrición enteral en atención al perfil demográfico y epidemiológico de la población. Este trabajo consiste en una propuesta de implementación de terapia nutricional dentro de un plan de alta complejidad, y de acuerdo a lo prescrito por la legislación del Ministerio de Salud Brasileño. El número de pacientes atendidos por esta modalidad terapéutica se ha ido incrementando, por consiguiente se hace necesario garantizar la calidad del servicio, por medio de la organización de los espacios funcionales. Conclusión. Por medio de la planificación funcional de un Laboratorio de Nutrición Enteral, se puede garantizar la asistencia nutricional especializada y de calidad, a la población hospitalaria o domiciliaria, tomando las precauciones necesarias en la manipulación de las fórmulas enterales (AU)

Suplementação com aminoácidos de cadeia ramificadae estado clínico-nutricional de pacientes cirróticos: série de casos / Supplementation with branched chain amino acids and clinical andnutritional status of cirrhotic patients: a case series

Introdução: a doença hepática, na forma aguda ou crônica, provocagrandes alterações no estado nutricional e no metabolismo denutrientes do doente, principalmente na utilização de aminoácidos.Mudanças no metabolismo de aminoácidos, com reduções nosníveis dos de cadeia ramificada (BCAA) e elevações nos níveis deaminoácidos aromáticos, tem função importante no aparecimentodas complicações da cirrose hepática (CH). A suplementação oralcom BCAA pode corrigir tanto transformações metabólicas quantomelhorar a desnutrição associada à cirrose.Objetivo: avaliar os efeitos da administração de suplemento deBCAA sobre o estado clínico - nutricional de pacientes com CH.Método: estudo em série de casos com pacientes cirróticos internadosno Hospital Regional da Asa Norte (HRAN), entre novembro de2012 e agosto de 2013. Foram aferidas medidas antropométricas eanalisados os resultados de exames bioquímicos antes e após 7 diasde suplementação com BCAA oral.Resultados: seis pacientes participaram do estudo, não houvemelhora da albumina.Conclusão: existe uma elevada prevalência de pacientes comdesnutrição, os valores de albumina não refletiram os efeitosda suplementação na doença hepática e sim o estado clíniconutricionaldos pacientes. Em curto prazo, o BCAA oral não foieficaz em evitar o agravo do estado nutricional nem de melhorar oquadro de desnutrição.

Introduction: Liver disease in its acute or chronic forms, causesmajor changes in nutritional status and nutrient metabolism of thepatient, especially in the use of amino acids. Changes in amino acidmetabolism, with reductions in levels of branched chain (BCAA)and elevated levels of aromatic amino acids, plays an important rolein the onset of complications of liver cirrhosis (LC). Oral supplementationwith BCAA can correct both metabolic transformationsand improve malnutrition associated with cirrhosis.Objective: To evaluate the effects of administration of BCAAsupplementation on clinical and nutritional status of patients withCH.Method: this is a series of cases study with cirrhotic patients conductedat Hospital Regional da Asa Norte (HRAN), between November2012 and August 2013. Anthropometric measurements were takenand the results of biochemical tests of albumin were analyzedbefore and after 7 days of oral supplementation with BCAA.Results: six patients participated in the study, there was no improvementin albumin.Conclusion: there is a high prevalence of malnutrition, albuminvalues did not reflect the effects of supplementation on liver diseasebut the clinical and nutritional status of patients. In the shortterm, oral BCAA was not effective in preventing the worsening ofthe nutritional status and improvement of malnutrition.

[The functional planning of a enteral nutrition unit for home care at a hospital in Brazil]. / Planificación funcional de unidad de nutrición enteral para atención domiciliaria en un hospital de Brasil.

INTRODUCTION: In order to warrant the quality of the products offered to their clients at home, hospitalar units need to adequate their physical structures to develop their specialized activities on enteral nutrition. OBJECTIVE: The present article aims to provide a functional planning and tools for the reorganization of the physical space of an enteral nutrition preparation unit describing its features and function. METHODS: A descriptive, prospective and documental study was undertaken, providing the tools for the functional planning and quality management at a unit of enteral nutrition preparation in a public hospital in the Federal District, Brazil. Data were collected in the period from 2000 to 2010. RESULTS: Through the establishment of a Home Enteral Nutrition Program in the Public Health Department of the Federal District and as determined by the publication of national legislation, a District Plan of High Complexity in Enteral Nutrition was conducted, according to the demographic and epidemiological profile of the population.This plan consisted of the proposal for implementation of the high complexity in nutritional therapy, according to the Health Ministry legislation. The number of patients assisted by this therapeutical modality has increased, which indicates the need to ensure the quality of dispensed formulas through the planning of functional spaces. CONCLUSION: The functional planning of an Enteral Nutrition Laboratory ensures assistance for the needs of the population enrolled at the hospital and at home, allowing the proper training of caregivers aiming at the adequacy of necessary precautions in manipulating enteral formulas.

Introducción: Con el objeto de garantizar la calidad del producto ofrecido a los clientes en sus domicilios, las unidades hospitalarias necesitan adecuar sus áreas físicas para poder desarrollar todas las actividades especializadas que conlleva la nutrición enteral. Objetivo: Proporcionar una planificación funcional y las herramientas para la reorganización del espacio físico de una unidad de nutrición enteral, describiendo el proceso de preparación, la descripción de sus características y funciones laborales. Métodos. Estudio descriptivo, retrospectivo y documental, proporcionando las herramientas para la planificación funcional y de gestión de calidad en una unidad de preparación de la nutrición enteral en un hospital público del Distrito Federal, Brasil. Los datos fueron recolectados en el período comprendido entre los años 2000 y 2010. Resultados. A través de la creación de un programa de nutrición enteral en el Departamento de Salud Pública del Distrito Federal y según lo dispuesto por la legislación nacional, se efectuó un plan de alta complejidad respecto de la nutrición enteral en atención al perfil demográfico y epidemiológico de la población. Este trabajo consiste en una propuesta de implementación de terapia nutricional dentro de un plan de alta complejidad, y de acuerdo a lo prescrito por la legislación del Ministerio de Salud Brasileño. El número de pacientes atendidos por esta modalidad terapéutica se ha ido incrementando, por consiguiente se hace necesario garantizar la calidad del servicio, por medio de la organización de los espacios funcionales. Conclusión. Por medio de la planificación funcional de un Laboratorio de Nutrición Enteral, se puede garantizar la asistencia nutricional especializada y de calidad, a la población hospitalaria o domiciliaria, tomando las precauciones necesarias en la manipulación de las fórmulas enterales.

Resposta inflamatória de pacientes com doença renal crônica em fase pré-dialítica e sua relação com a ingestão proteica / Inflammatory response in chronic kidney disease patients in pre-dialysisand its relation to protein intake

Introdução: a maioria dos distúrbios metabólicos presentes na Doença Renal Crônica (DRC) resulta, principalmente, do acúmulo de produtos do metabolismo do nitrogênio presentes nos alimentos ricos em proteínas. A dietoterapia tem um papel importante no tratamento da DRC, consistindo, principalmente, naadequação da oferta diária de proteínas.Objetivo: discutir a resposta inflamatória e terapia nutricional empregada no tratamento conservador e as vantagens do emprego de dieta normoproteica à base de soja.Métodos: realizada revisão da literatura por meio de busca de artigos científicos indexados em bases de dados online, publicados preferencialmente nos últimos dez anos, além de livros técnicos e outras formas de publicações.Resultados: as complicações metabólicas estabelecem consequênciasimportantes na DRC e podem comprometer o estado nutricional do indivíduo. Ainda são poucas as referências ao uso de dieta normoproteica à base de soja, sendo destacados apenas alguns benefícios em curto prazo, com pouca ênfase às metodologias usadas para a terapia nutricional.Considerações Finais: a evolução do tratamento depende de sua qualidade e das estratégias que serão adotadas durante sua implementação. A dietoterapia é importante no tratamento da DRC, consistindo, principalmente, na redução de oferta diária de proteínas. A presença da inflamação influencia negativamente o estado nutricional e a evolução da função renal do indivíduo.Mais estudos com dieta à base de soja são necessários.

Introduction: Most metabolic disorders present in Chronic Kidney Disease (CKD) results mainly from the accumulation of products of nitrogen metabolism in foods rich in protein. The diet therapy plays an important role in the treatment of CKD, consisting mainly, on the matching of supply daily protein.Objective: discuss the inflammatory response and nutritional therapyused in the conservative treatment and the advantages of using a normalprotein diet based on soy.Methods: literature review was conducted by searching scientific articlesindexed in online databases, preferably published in the last ten years, and technical books and others publications.Results: Metabolic complications establish important consequences in CKD and may compromise the nutritional status of the individual.Although, there are few references to the use of a normal protein dietbased on soy, and posted just a few short-term benefits, with little emphasison the methodologies used for nutritional therapy.Final Remarks: The evolution of treatment depends on the quality and the strategies to be adopted during its implementation. The diet therapy plays an important role in the treatment of CRF, consisting mainly inthe reduction of daily supply of proteins. The presence of inflammation adversely affects the nutritional status of renal function and evolution of the individual. More studies with soy-based diet are needed.

Tumor engraftment in nude mice and enrichment in stroma- related gene pathways predict poor survival and resistance to gemcitabine in patients with pancreatic cancer.

PURPOSE: The goal of this study was to evaluate prospectively the engraftment rate, factors influencing engraftment, and predictability of clinical outcome of low-passage xenografts from patients with resectable pancreatic ductal adenocarcinoma (PDA) and to establish a bank of PDA xenografts. EXPERIMENTAL DESIGN: Patients with resectable PDA scheduled for resection at the Johns Hopkins Hospital were eligible. Representative pieces of tumor were implanted in nude mice. The status of the SMAD4 gene and content of tumor-generating cells were determined by immunohistochemistry. Gene expression was carried out by using a U133 Plus 2.0 array. Patients were followed for progression and survival. RESULTS: A total of 94 patients with PDA were resected, 69 tumors implanted in nude mice, and 42 (61%) engrafted. Engrafted carcinomas were more often SMAD4 mutant, and had a metastatic gene expression signature and worse prognosis. Tumors from patients resistant to gemcitabine were enriched in stroma-related gene pathways. Tumors sensitive to gemcitabine were enriched in cell cycle and pyrimidine gene pathways. The time to progression for patients who received treatment with gemcitabine for metastatic disease (n = 7) was double in patients with xenografts sensitive to gemcitabine. CONCLUSION: A successful xenograft was generated in 61% of patients attempted, generating a pool of 42 PDA xenografts with significant biological information and annotated clinical data. Patients with PDA and SMAD4 inactivation have a better engraftment rate. Engraftment is a poor prognosis factor, and engrafted tumors have a metastatic gene expression signature. Tumors from gemcitabine-resistant patients were enriched in stromal pathways.

Demographic, epidemiological and nutritional profile of elders in home enteral nutricional therapy in Distrito Federal, Brazil

According to statistical projections of the World Health Organization, during the period between 1950 and 2025, the group of elderly in Brazil will have increased 15 times. Chronic-degenerative diseases are the illnesses that most affect the elderly population, directly related to the growing demand for Enteral Nutrition Therapy. The objective of this study was to analyze the demographic, epidemiological and nutritional profile of elderly patients assisted at the public hospitals in the Home Enteral Nutrition Therapy Program, of the State Health Department of Distrito Federal. This is a retroprospective, cross-sectional and analytical study, based on primary data, which enrolled 141 elderly patients who were prescribed home enteral nutrition. The collected variables corresponded to age, gender, clinical diagnosis, enteral route and nutritional status at the beginning of Home Enteral Nutrition Therapy. The association between variables was analyzed through the t-Student and chi-square tests, with a significance level of 0.05 and a Confidence Interval (CI) of 95%. There was a higher number of female patients (53.9%) when compared to male (46.1%), average age 75.82 years old for both groups. The most prevalent diseases were cerebro-vascular accident sequels and cancer (42.6% and 22.7% respectively). It was observed a prevalence of malnutrition equal to 69.7%, independent of age and gender. The most used enteral route was the nasal. Though Brazilian policies concerning assistance to the elderly have advanced during the last few years, the need for public policies for nutritional recovery of such patients persists, to promote a better quality of life for them.

De acuerdo con estimados de la Organización Mundial de la Salud, en el período de 1950 y 2025, el número de personas ancianas aumentó cerca de 15 veces en Brazil. Las enfermedades crónico-degenerativas que más afectan la población anciana, demandan la terapia nutricional enteral. El objetivo de este estudio fue analizar el perfil demográfico, epidemiológico y nutricional de enfermos ancianos asistidos en el Programa de Terapia Nutricional Enteral en los hospitales públicos de la Secretaria de la Salud del Distrito Federal (SES/DF). Este estudio fue retroprospectivo, transversal, analítico, con base en los datos primarios de 141 ancianos que recibieron nutrición enteral a domicilio. Los datos fueron edad, diagnóstico clínico, via enteral de la administración y perfil nutricional. La asociación entre las variables fue analizada con los tests Student y chi-Cuadrado, con un nivel de significancia de 0,05 y con un intervalo de confianza de 95%. Fue observado un mayor número de ancianas (53,9%) que ancianos (46,1%), con una edad media de 75,82 años para ambos grupos. Las enfermedades con mayor prevalencia fueron secuelas de accidentes cerebro-vasculares y cáncer (42,6% y 22,7%, respectivamente). La prevalencia de desnutrición fue de 69,7%, independientemente de la edad y el género. La ruta más usada en la administración fue la nasal. Las políticas de salud brasileñas en la asistencia a ancianos han mejorado en los últimos años; sin embargo, persiste la necesidad de políticas públicas para la asistencia nutricional a este grupo con el propósito de promover una mejor calidad de vida.

Proyecto de redes secundarias y conexiones domiciliarias : subsistema cloacal Rawson. San Juan - Argentina

El documento describe las características regionales propias de la provincia de San Juan y señala que el cultivo de la zona se basa en el riego artificial compuesto por acequias, canales, drenes a lo largo de la urbanización. La empresa Obras Sanitarias Sociedad del Estado (O.S.S.E) cuenta desde hace mucho tiempo con un Plan Directo de Cloacas para el Gran San Juan que se compone de colectores principales y planta depuradora para tres subsistemas: Chimbas, Centro y Rawson