Concepts of indirect calorimetry on metabolic disorders: a narrative review

Introdução: A calorimetria indireta continua sendo um padrão ouro na avaliação do gasto energético de repouso no campo clínico. Por meio de suas medições, é possível oferecer as necessidades energéticas de um paciente para maximizar os benefícios da terapia nutricional. No entanto, os conceitos e as bases metodológicas dos dados coletados podem ser dificultosos para serem interpretados pelos usuários na prática clínica. Objetivo: abordar os conceitos de gasto energético diário total e seus componentes, e, apresentar os aspectos metodológicos da calorimetria indireta que podem servir como guia no campo clínico. Método: Revisão bibliográfica narrativa, realizada pelas bases de dados eletrônicas Pubmed (US National Library of Medicine), SCOPUS e Scientific Electronic Library Online (SciELO). A pesquisa foi realizada no período entre 1905-2019, utilizando os seguintes identificadores em Descritores em Ciências da Saúde: Metabolismo Basal, Metabolismo Energético e Calorimetria Indireta. Foram selecionadas 55 pesquisas publicadas que apresentaram conteúdos relacionados aos objetivos deste estudo. Resultado: O gasto energético total diário (GETD) é composto por três componentes principais, tais como: atividade física (AF), efeito térmico dos alimentos (TEF) e taxa metabólica basal (TMB) e / ou gasto energético de repouso (GER). O GER é geralmente avaliado por calorimetria indireta, que também fornece informações sobre o coeficiente respiratório (CR) e oxidação de substratos, que pode variar de acordo com o metabolismo do paciente, como algum distúrbio metabólico, obesidade ou desnutrição. Portanto, o manejo adequado dos aspectos metodológicos da calorimetria indireta e sua posterior interpretação nos distúrbios metabólicos é fundamental para garantir a qualidade dos resultados. Conclusão: Os conceitos de gasto energético e as bases metodológicas da calorimetria indireta são relevantes para fornecer uma atenção individualizada aos pacientes com distúrbios metabólicos. As descrições desta revisão podem ser utilizadas como um guia prático, auxiliando a compreensão da aplicação correta da técnica de calorimetria indireta, em estudos relacionados ao gasto energético com ênfase nos distúrbios metabólicos.Introduction: Indirect calorimetry remains a gold standard in measuring resting energy expenditure in the clinical field. Through its measurements, it is possible to offers a patient’s energy needs to maximize nutritional therapy benefits. However, the concepts and methodological basis of collected data can be difficult to be interpreted by users in clinical practice. Objective: To address the concepts of total daily energy expenditure and its components and present the methodological aspects of indirect calorimetry that can guide the clinical field. Method: Narrative bibliographic review using the electronic Pubmed (US National Library of Medicine), SCOPUS, and Scientific Electronic Library Online (SCIELO) databases. The research was carried out in the period between 1905-2019, using the following identifiers in Health Sciences Descriptors: Basal Metabolism, Energy Metabolism and Indirect Calorimetry. We selected 55 researches published that presented contents related to the objectives of this study. Result: The total daily energy expenditure (TDEE) is comprised of three main components, such as physical activity (PA), thermic effect of food (TEF) and basal metabolic rate (BMR) and/or resting energy expenditure (REE). The REE is generally evaluated by indirect calorimetry, which also provides information on the respiratory coefficient (RQ) or oxidation of substrates. Its result varies depending on the existence of some metabolic disorders such as obesity or malnutrition. Therefore, the proper management of the methodological aspects of indirect calorimetry and its subsequent interpretation in metabolic disorders is essential to guarantee the results’ quality. Conclusion: Energy expenditure concepts and the methodological basis of indirect calorimetry are relevant to providing individualized attention to patients with metabolic disorders. This review can be used as a practical guide, helping to understand the correct application of the indirect calorimetry technique in studies related to energy expenditure with an emphasis on metabolic disorders

COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy?

Background: Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. Aims: To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for “respiratory diseases” within the current frame of the COVID-19 pandemic as an adjuvant treatment. Method: The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified as positive, promising, negative, and unknown. Results: A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, and Sambucus nigra), promising in 12 cases (Allium sativum, Andrographis paniculata, Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulus essential oil, Justicia pectoralis, Magnolia officinalis, Mikania glomerata, Pelargonium sidoides, Pimpinella anisum, Salix sp, Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. Conclusions: Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches

Transtorno bipolar em crianças: análise de relato de caso 2018-2023

O transtorno bipolar em crianças é uma realidade clínica que demanda atenção especializada. A compreensão dos sintomas, fatores de risco, prevalência e desafios diagnósticos é fundamental para proporcionar intervenções precoces e adequadas, visando melhorar a qualidade de vida desses jovens e reduzir o impacto a longo prazo dessa condição psiquiátrica. Trata-se de um estudo cujo objetivo foi objetivo revisar relatos de caso publicados entre 2018 e 2023 sobre transtorno bipolar em crianças, identificando o estado da arte desses estudos. Para isso, se realizou uma revisão sistemática de literatura utilizando as bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SCIELO). Com a análise e interpretação qualitativa dos resultados, a principal conclusão deste estudo é que o transtorno bipolar na infância é uma condição complexa, manifestando-se com comportamentos consistentes com o Transtorno de Conduta e sendo influenciado por fatores ambientais, familiares e genéticos. O tratamento eficaz requer uma abordagem multidisciplinar, integrando intervenções farmacológicas e não farmacológicas, personalizadas conforme as necessidades individuais. A supervisão familiar é crucial para a adesão ao tratamento, mas reconhece-se a necessidade contínua de pesquisa para aprimorar as estratégias terapêuticas diante da diversidade de casos

Meroplankton community structure across oceanographic fronts along the South Brazil Shelf

The influence of oceanographic fronts on the abundance and community composition of invertebrate larvae, mostly of benthic species, along nearly 2000 km of the southwestern Atlantic shelf (21–34°S) was investigated. Meroplankton was sampled through vertical hauls at 89 stations, distributed along 14 cross-shelf transects, during late spring 2010 and early summer 2011. Salinity and temperature were registered with a CTD/rosette system, which provided seawater for chlorophyll-a and nutrient concentrations estimations. Vertical profiles of temperature, salinity, chlorophyll-a and nutrients were used as proxies of the fronts. In addition, high-resolution thermosalinograph data were used to detect surface frontal features. Meroplankton abundance peaks were found at several fronts intersected by the ship, including upwelling zones, estuarine and plume fronts, a shelf-break front, and two cyclonic eddies. Furthermore, meroplankton abundance was also relatively higher at small-scale thermal and/or saline surface fronts observed along the shelf. Such increases in meroplankton abundance are likely to be ascribed to high nutrient input and primary production. Distinct taxa of invertebrate larvae occurred at different types of fronts, besides the coastal realm, which was virtually dominated by decapod, cirripede and bivalve larvae. Small-scale shelf fronts presented high abundances of decapod and gastropod larvae, for instance, while larvae of polychaetes were the most frequent in the estuarine front of Patos Lagoon section.

First record of Grapsus grapsus (Linnaeus, 1758) (Brachyura: Decapoda: Grapsidae) in freshwater habitat

The sally lightfoot crab, Grapsus grapsus (Linnaeus, 1758), has been recorded from the oceanic islands off Brazil, as well as from the Caribbean, in coastal rocky shores in the Eastern Pacific, and in Galapagos. We report the first observation of G. grapsus in freshwater habitat, registered in a stream at Trindade Island, Brazil

Control descentralizado de una formación lider-seguidor con compensación de la dinámica

Dit werk presenteert de ontwikkeling van een adaptieve controller voor dynamische compensatie van mobiele robots van het eenwieler-type en hun gebruik in een gedecentraliseerde aansturing van een leider-volgsysteem. In dit controlesysteem zijn er geen uitwisselingen van informatie nodig tussen de robots en de tracker

The meaning of the paralympic judo: a case study

Na busca pela compreensão do significado do judô paralímpico e do impacto desta modalidade na vida do atleta, foi desenvolvido um estudo de caso, de natureza qualitativa, com a participação de um atleta paralímpico da seleção brasileira de judô, que obteve resultados importantes no cenário internacional. A Abordagem História Oral de Vida fundamentou a realização da entrevista, salientou o fenômeno da vida do atleta e privilegiou uma visão contextualizada da situação e dos processos de interação deste atleta com descrição de eventos de sua vida antes e durante a trajetória esportiva, e a expressão de sua luta e estratégias de superação das adversidades. Também foi possível conhecer a trajetória esportiva, o processo de aceitação da deficiência e a aderência ao esporte adaptado. O esporte significou a possibilidade de exercer sua autonomia e, ao mesmo tempo, desempenhar seu papel social e representou o espaço para mostrar sua competência e obter reconhecimento social, a partir do bom desempenho obtido e das vitórias. Assim, pode-se concluir que a ocorrência de um determinado fenômeno (no caso a cegueira) foi ao mesmo tempo um produto e um produtor da mudança evolutiva do atleta.RESUMEN: En la búsqueda por la comprensión del significado del judo paralímpico y del impacto de esta modalidad en la vida del atleta, se desarrolló un estudio de caso, de naturaleza cualitativa, con la participación de un atleta paralímpico de la selección brasileña de judo, que obtuvo resultados importantes en el escenario internacional. El Enfoque Historia Oral de Vida fundamentó la realización de la entrevista, subrayó el fenómeno de la vida del atleta y privilegió una visión contextualizada de la situación y de los procesos de interacción de este atleta con descripción de eventos de su vida antes y durante la trayectoria deportiva, y la expresión de su lucha y estrategias de superación de las adversidades. También fue posible conocer la trayectoria deportiva, el proceso de aceptación de la discapacidad y la adherencia al deporte adaptado. El deporte significó la posibilidad de ejercer su autonomía y, al mismo tiempo, desempeñar su papel social y representó el espacio para mostrar su competencia y obtener reconocimiento social, a partir del buen desempeño obtenido y de las victorias. Así, se puede concluir que la ocurrencia de un determinado fenómeno (en el caso de la ceguera) fue al mismo tiempo un producto y un productor del cambio evolutivo del atleta.ABSTRACT: In the search for an understanding of the meaning of Paralympic judo and the impact of this modality on the athlete's life, a case study of a qualitative nature was developed with the participation of a Paralympic athlete of the Brazilian judo team, who obtained important results in the international scenario. The Oral History of Life Approach based the interview, emphasized the phenomenon of the athlete's life and privileged a contextualized view of the situation and the interaction processes of this athlete with a description of events of his life before and during the sporting trajectory, and the expression of their struggle and strategies to overcome adversities. It was also possible to know the sporting trajectory, the process of acceptance of the disability and the adherence to the adapted sport. The sport meant the possibility of exercising its autonomy and, at the same time, playing its social role and represented the space to show its competence and obtain social recognition, from the good performance obtained and the victories. Thus, it can be concluded that the occurrence of a certain phenomenon (in this case blindness) was at the same time a product and a producer of the evolutionary change of the athlete