Elimination of Giardia duodenalis BIV in vivo using natural extracts in microbiome and dietary supplements.

In this study, a combination therapy of several natural products was evaluated in vivo in the Giardia duodenalis infection model. G. duodenalis infected mice were treated as follows: distilled water (infected control C+), BIOintestil® (BIO; natural products of Cymbopogon martinii and Zingiber officinale), MicrobiomeX® (MBX; extract of Citrus sinensis and Citrus paradisi), MBX + BIO, Camellia sinensis tea (CPR; black tea). These natural compounds were administered in a dose of 100 mg/day and were compared to G. duodenalis-infected mice treated with albendazole (ALB; 50 mg/Kg/day) and metronidazole (MET; 500 mg/Kg/day), the conventional therapies used to this day. One group remained un-infected and untreated as our control group (C-). Treatment started 8 days after infection, and after 5 days of treatment (7 days for MET), all animals were followed for 15 days. We continuously checked for the presence of G. duodenalis by Faust method, in association with detection of the parasite by PCR from feces, as well for the presence of trophozoites in the intestinal mucosa after sacrifice. Animals treated with MBX, BIO and MBX + BIO presented an undetectable parasitic load until the 15th day of monitoring, while animals treated with CPR, MET and ALB continued to release cysts. Animals in the MBX, MBX + BIO, ALB groups consumed lower feed, MBX, CPR, MET had greater weight and MBX, MBX + BIO, BIO, CPR, C- consumed more water when compared to infected-group control. MBX and BIO alone or associated eliminated G. duodenalis without apparent adverse effects and animals of these groups showed better clinical performance in relation to those with high parasitic load. MET, ALB and CPR only decreased the number of cysts, indicating limitations and therapeutic failure.

Nutritional profile of cancer patients treated at an outpatient oncology center in the south region of Brazil

To evaluate the nutritional profile of cancer patients treated at an oncology center in South Brazil.This is a descriptive, exploratory and sectional study that was developed in a process that involved 100 patients aged between 18 and 75 years old, suffering from cancer.The anthropometric variables studied were weight, height, Body Mass Index (BMI), arm circumference (AC), arm muscle circumference (AMC),triceps skinfold (TSF) and corrected arm muscle area (cAMA). For subjective nutritional assessment, we used the Patient-Generated Subjective Global Assessment (PG-SGA). Nearly half of the patients evaluated had a critical need for nutritional intervention. There was a statistically significant association between cAMA and marital status, age and gender; between AC and age, gender and staging; between AMC and staging; between BMI and marital status and age; and between TSF and marital status. Patients diagnosed with IV stage had the lowest values for nutritional variables. There was no significant association between nutritional status of patients obtained by the PG-SGA instrument and sociodemographic characteristics. Malnutrition should be diagnosed as soon as possible,aiming at early intervention and improving survival and quality of life. Therefore, early nutritional assessment in cancer patients is required, combining subjective and objective methods.

The Correlation between Hand Grip Strength and Nutritional Variables in Ambulatory Cancer Patients.

Among the methods used in the nutritional assessment of cancer patients, handgrip strength (HGS), an important indicator of malnutrition, was chosen in this study. An observational cross-sectional study with the prospective collection. We analyzed 100 patients from the Oncology Department of Santa Rita Hospital, in Maringá city, Paraná, Brazil. To determine the clinical-pathological staging was used the Cancer Staging Manual. In the objective nutritional assessment, data to calculate Body Mass Index (BMI), arm muscle circumference (AMC), corrected arm muscle area (cAMA) and measurement of HGS were measured. In connection with the subjective method used, a Patient-Generated Subjective Global Assessment (PG-SGA) has been selected. Arm Circumference (AC) presents a significant association with the left hand HGS classification. The right hand HGS does not show a significant correlation with the analyzed variables. However, the results showed that patients with higher left hand HGS tend to present lower PG-SGA and higher AMC. HGS, as a predictor of nutritional vulnerability, has proved superiority for predicting clinical results in cancer patients. However, it requires more studies that investigate other nutritional variables to determine the nutritional risk in this population.

β-ecdysone content and antioxidant capacity in different organs of Brazilian ginseng / Teor de β-ecdisona e capacidade antioxidante em diferentes órgãos de ginseng brasileiro

ABSTRACT: Plants that contain antioxidant compounds have attracted increasing interest for their vital role in the attenuation of oxidative damage caused by free radicals and in the treatment of various diseases. The present study investigated the β-ecdysone content and the antioxidant activity of Brazilian ginseng (Pfaffia glomerata) extracts obtained from inflorescences, stems, and roots. The P. glomerata extracts were tested for antioxidant activity using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging method, β-carotene bleaching test, and phosphomolybdenum method. The β-ecdysone content of P. glomerata extracts was measured by high-performance liquid chromatography (HPLC). The P. glomerata inflorescences showed the strongest DPPH radical scavenging activity and the strongest antioxidant activity in the β-carotene bleaching assay and phosphomolybdenum test. The roots showed the lowest antioxidant capacity in all of the assays. The concentration of β-ecdysone in the plant organs followed the following decreasing order: inflorescences > stems > roots. The present study showed that P. glomerata inflorescence extract had high antioxidant capacity that could be attributed to the presence of β-ecdysone.

RESUMO: Plantas que contêm compostos antioxidantes têm atraído interesse crescente por seu papel fundamental na atenuação de danos oxidativos causados pelos radicais livres e no tratamento de várias doenças. O presente estudo investigou o conteúdo de β-ecdysone e a atividade antioxidante de extratos de ginseng brasileiro (Pfaffia glomerata) obtidos a partir das inflorescências, caules e raízes. Os extratos de Pfaffia glomerata foram testados para atividade antioxidante usando o método sequestrante do radical 2,2-difenil-1-picrilhidrazil (DPPH), sistema modelo β-caroteno-linoleato e método de fosfomolibdênio. O conteúdo de β-ecdisona dos extratos de P. glomerata foi medido por cromatografia líquida de alta eficência (CLAE). As inflorescências de P. glomerata mostraram a maior atividade sequestrante de radical DPPH e a maior atividade antioxidante no ensaio β-caroteno-linoleato e no teste de fosfomolibdênio. As raízes mostraram a menor capacidade antioxidante em todos os ensaios. A concentração de β-ecdisona nos órgãos da planta seguiu a seguinte ordem decrescente: inflorescências > caules > raízes. Os resultados indicaram uma correlação positiva entre conteúdo de β-ecdisona e atividade sequestrante de radical DPPH. O presente estudo mostrou que o extrato das inflorescências de P. glomerata teve alta atividade antioxidante que poderia ser atribuída à presença de β-ecdisona.

Group Nutrition Counseling or Individualized Prescription for Women With Obesity? A Clinical Trial.

Background: This study investigates the effects of group counseling vs. individual dietary prescription on physical, nutritional, and mental health in overweight or obese women. Methods: Seventy-four women aged 40-59 years with body mass index ≥ 25 kg/m2 were randomized into 2 intervention arms: group nutrition counseling (GNC) or individualized nutrition prescription (INP). Twenty-seven women completed the 12-week intervention protocol. The GNC received counseling once a week and the INP received an individualized prescription once a month. All participants attended physical exercise sessions 3 times a week following the same protocol. Body mass, body mass index, fat mass, body fat percentage, lean mass, lipid profile, hemoglobin A1c, insulin and liver transaminases were measured pre- and post-intervention in both arms. A 3 day food record was applied to calculate the intake of calories, carbohydrates, proteins, and lipids. Body image dissatisfaction, level of anxiety, self-esteem measure and pathological eating attitudes were measured. Results: Both dietary interventions decreased body mass, body mass index, fat mass, body fat percentage, total caloric intake, carbohydrates, proteins, lipids, body dissatisfaction, anxiety, and saturated and polyunsaturated fats (p < 0.05). Lean mass, metabolic variables, self-esteem and pathological eating attitudes remained unchanged (p > 0.05). Conclusion: Both nutritional interventions combined with concurrent exercise were effective to improve anthropometrics, body composition, food intake, and some mental health parameters. We suggest that the choice of nutritional intervention (GNC or INP) could be based on the participants preference, considering the adherence and satisfaction, to promote health and quality of life.

Association of Folate and Vitamins Involved in the 1-Carbon Cycle with Polymorphisms in the Methylenetetrahydrofolate Reductase Gene (MTHFR) and Global DNA Methylation in Patients with Colorectal Cancer.

Folate, vitamin B2, vitamin B6, vitamin B12, choline, and betaine are nutrients involved in the 1-carbon cycle that can alter the levels of DNA methylation and influence genesis and/or tumor progression. Thus, the objective of this study was to evaluate the association of folate and vitamins involved in the 1-carbon cycle and MTHFR polymorphisms in global DNA methylation in patients with colorectal cancer gene. The study included 189 patients with colorectal adenocarcinoma answering a clinical evaluation questionnaire and the Food Frequency Questionnaire (FFQ) validated for patients with colon and rectal cancer. Blood samples were collected for evaluation of MTHFR gene polymorphisms in global DNA methylation in blood and in tumor. The values for serum folate were positively correlated with the equivalent total dietary folate (total DFE) (rho = 0.51, p = 0.03) and global DNA methylation (rho = 0.20, p = 0.03). Individuals aged over 61 years (p = 0.01) in clinicopathological staging III and IV (p = 0.01) and with + heterozygous mutated homozygous genotypes for the MTHFR A1298C gene had higher levels of global DNA methylation (p = 0.04). The association between dietary intake of folate, serum folate, and tumor stage were predictive of global DNA methylation in patients' blood. The levels of serum folate, the dietary folate and the status of DNA methylation can influence clinicopathological staging.

Folate and nutrients involved in the 1-carbon cycle in the pretreatment of patients for colorectal cancer.

To assess the ingestion of folate and nutrients involved in the 1-carbon cycle in non-treated patients with colorectal adenocarcinoma in a reference center for oncology in southeastern Brazil. In total, 195 new cases with colorectal adenocarcinoma completed a clinical evaluation questionnaire and a Food Frequency Questionnaire (FFQ). Blood samples from 161 patients were drawn for the assessment of serum folate. A moderate correlation was found between serum concentrations of folate, folate intake and the dietary folate equivalent (DFE) of synthetic supplements. Mulatto or black male patients with a primary educational level had a higher intake of dietary folate. Of patients obtaining folate from the diet alone or from dietary supplements, 11.00% and 0.10%, respectively, had intake below the recommended level. Of the patients using dietary supplements, 35% to 50% showed high levels of folic acid intake. There was a prevalence of inadequacy for vitamins B2, B6 and B12, ranging from 12.10% to 20.18%, while 13.76% to 22.55% of patients were likely to have adequate choline intake. The considerable percentage of patients with folate intake above the recommended levels deserves attention because of the harmful effects that this nutrient may have in the presence of established neoplastic lesions.

Associação do folato e vitaminas envolvidas no ciclo docarbono-1 com polimorfismos no gene metilenotetrahidrofolatoredutase (MTHFR) e metilação global do DNA em pacientes com câncercolorretal / Association of folate and vitamins involved in the one-carbon cycle with polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene and global DNA methylation in patients with colorectal cancer

Introdução: Folato, vitamina B2, vitamina B6, vitamina B12, colina e betaína são nutrientes envolvidos no ciclo do carbono-1 que podem alterar os níveis de metilação do DNA e influenciar na gênese e/ou progressão tumoral. Objetivo: Avaliar a associação de folato e vitaminas envolvidas no ciclo do carbono-1 com polimorfismos no gene MTHFR e metilação global do DNA em pacientes com câncer colorretal. Material e Métodos: 189 pacientes casos novos com adenocarcinoma colorretal responderem a um questionário de avaliação clínica e um Questionário de Frequência Alimentar (QFA) validado para pacientes com câncer de cólon e reto. Foram coletadas amostras de sangue para a avaliação dos polimorfismos no gene MTHFR da metilação global do DNA no sangue e no tumor. Resultados: Os valores de folato sérico foram correlacionados positivamente com o equivalente dietético de folato total (DFE total) (rho= 0,51 e p= 0.03) e com a metilação global do DNA (rho= 0,20 e p= 0.03). Indivíduos com idade igual ou superior a 61 anos (p= 0.01), em estadiamento clínico-patológico III e IV (p= 0.01) e com genótipos homozigotos mutados + heterozigotos para o gene MTHFR A1298C apresentaram maiores níveis de metilação global do DNA (p= 0.04). A associação entre a ingestão dietética de folato, folato sérico e estadiamento do tumor foram preditoras da metilação global do DNA no sangue dos pacientes. Conclusão: Os níveis de folato sérico e dietético, além do estadiamento clínico-patológico podem influenciar no status de metilação do DNA.

Introduction: Folate, vitamin B2, vitamin B6, vitamin B12, choline and betaine are nutrients involved in the one-carbon cycle that can alter the levels of DNA methylation and influence the genesis and/or tumor progression. Objective: Evaluate the association of folate and vitamins involved in the one-carbon cycle and MTHFR polymorphisms in global DNA methylation in patients with colorectal cancer gene. Material and Methods: 189 new cases with colorectal adenocarcinoma answering a clinical evaluation questionnaire and the Food Frequency Questionnaire (FFQ) validated for patients with colon and rectal cancer. Blood samples were collected for evaluation of MTHFR gene polymorphisms in the global DNA methylation in blood and in tumor. Results: The values for serum folate were positively correlated with the equivalent total dietary folate (total DFE) (rho = 0.51, p = 0:03) and the global DNA methylation (rho = 0.20, p = 0:03). Individuals aged over 61 years (p = 0.01) in staging clinicopathological III and IV (P = 0.01) and with + heterozygous mutated homozygous genotypes for the MTHFR A1298C gene had higher levels of global DNA methylation (p = 0:04). The association between dietary intake of folate, serum folate, and tumor stage were predictive of global DNA methylation in patients' blood. Conclusion: The levels of serum and dietary folate, the clinical-pathological staging can influence the status of DNA methylation.

Evolução da mucosite oral após intervenção nutricional em pacientes oncológicos no serviço de cuidados paliativos / Oral mucositis evolution after nutritional intervention in cancer patients under palliative care

JUSTIFICATIVA E OBJETIVOS: A sintomatologia da mucosite oral traz graves consequências para a qualidade de vida dos pacientes, podendo exigir interrupção parcial ou completa do tratamento antineoplásico. O objetivo deste estudo foi avaliar a evolução da mucosite oral em pacientes oncológicos atendidos pelo serviço de cuidados paliativos, após a intervenção e orientação médica e nutricional, além de analisar de que forma a mucosite interfere na ingestão alimentar dos pacientes. MÉTODO: Foram avaliados 23 pacientes em cuidados paliativos, que responderam a questionários compostos por questões relacionadas ao número de refeições/dia, consistência das refeições, medicamentos em uso, queixas orais e hábitos de vida. As entrevistas foram realizadas no primeiro atendimento e após 15 dias. Os atendimentos foram realizados pela nutricionista e médica, de maneira individualizada, considerando o diagnóstico da doença e sintomas apresentados. RESULTADOS: 65,2% dos pacientes apresentaram mucosite grau I e 46,6% destes consumiam alimentos de consistência sólida. 4,3% dos pacientes apresentaram mucosite grau IV com 100% destes deglutindo alimentos de consistência líquida. No retorno dos pacientes 73,9% não apresentaram mucosite e destes 64,7% referiram não ter restrições à consistência da dieta. Xerostomia foi que apresentou maior incidência no primeiro atendimento, 86,9% reduzindo para 34,7% no final do tratamento. A candidíase diagnosticada em 43,4% dos pacientes reduziu para 13% após a intervenção. CONCLUSÃO: A mucosite oral é intercorrência muito comum nos pacientes em tratamento oncológico e a atuação multiprofissional é fundamental para o manejo eficiente dos pacientes em cuidados paliativos, respeitando sua autonomia e qualidade de vida.

BACKGROUND AND OBJECTIVES: Oral mucositis symptoms bring severe consequences to patients' quality of life and may require partial or complete interruption of cancer treatment. This study aimed at evaluating oral mucositis evolution in cancer patients under palliative care after medical and nutritional intervention and orientation, in addition to analyzing how mucositis interferes with patients' food ingestion. METHOD: Participated in this study 23 patients under palliative care who answered questionnaires with questions regarding number of meals/day, meals consistency, drugs used, oral complaints and life habits. Patients were individually interviewed in the first visit and 15 days after by the physician and the nutritionist considering disease diagnosis and symptoms. RESULTS: 65.2% of patients had mucositis grade I and 46.6% of them consumed solid food. 4.3% of patients had mucositis grade IV and all of them consumed liquid food. At return, 73.9% of patients had no mucositis and from them, 64.7% reported no restriction with regard to diet consistency. Xerostomia had the highest incidence at first visit (86.9%) being decreased to 34.7% at treatment completion. Candidiasis, diagnosed in 43.4% of patients was decreased to 13% after the intervention. CONCLUSION: Oral mucositis is very common among cancer patients and the multiprofessional approach is critical for the efficient management of patients under palliative care, respecting their autonomy and quality of life.