Deficiência de tiamina em paciente com Síndrome do Intestino Curto: um relato de caso

This is a case report of patient OG 70, which looked for assistance at the Hospital de Clinicas de Porto Alegre (HCPA) by fatigue, dyspnea, vomiting and diarrhea. Patient had undergone intestinal resection 5 years ago by strangulated abdominal hernia, came up with gastrointestinal symptoms and progressive weight loss. On admission, showed malnutrition and clinical and echocardiographic signs suggestive of heart failure (HF), with probable diagnosis of IC by thiamine deficiency. Thiamine replacement was initiated 300mg, EV, per day. The patient was also managed with replacement of electrolytes, antibiotics for bacterial overgrowth, antiparasitic, and oral diet with low osmolarity, lactose free, low in sucrose. Replacement of zinc and B vitamins were also accomplished. The patient was discharged after 30 days of hospitalization with clinical improvement and without clinical signs of HF. Conclusion: Deficiency of vitamin B1 should be investigated in patients with malnutrition and Short Bowell Syndrome, especially those with cardiac and neurological expressions characteristic of beriberi. The treatment of thiamine deficiency is relatively simple and leads to rapid improvement of symptoms

Manejo nutrológico no pós-operatório de cirurgia bariátrica

Obesity is one of the largest epidemics of this century and is associated with several comorbidities, leading to poor quality of life and longevity. Obesity is related to genetic and environmental factors and is characterized by change in body composition, where there is more supply than energy expenditure, allowing the accumulation of body fat. The Bariatric Surgery (BC) is an effective method for sustained weight loss in obese patients, where the gastric bypass surgery Roux-Y (RYGB) is the most common technique in Brazil. BC is set by a procedure, which changes the gastrointestinal tract leading to reduced food intake and reduced absorption. Patients who undergo BC at risk for nutritional deficiencies in the postoperative period and obesity by itself is related to some deficiencies. Nutritional deficiencies in the postoperative period can be attributed to several factors such as the preoperative deficiency, reduced food intake, inadequate supplementation, malabsorption of nutrients and inadequate nutrological support, such as lack of monitoring or absence of postoperative follow-up. The most common deficiencies are iron, protein, calcium, folate, thiamine, zinc, copper and vitamins D, B12, A, C and K. The proper guidance, monitoring and follow-up postoperatively are the essential actions in identifying and/or prevention of these deficiencies

Adequação de medicamentos prescritos em pacientes em uso de sonda enteral em um hospital público no sul do Brasil

Patients receiving enteral nutritional therapy are fed via enteral feeding tubes, which are also routes of medical administration. Nutrients and drugs interact with each other and with the gastrointestinal tract; care is needed to ensure that this therapy is properly performed in order to avoid adverse effects related to enteral nutritional therapy. The professionals involved in prescribing, dispensing and administrating drugs by feeding tubes should have the technical ability and skills that ensure the adequacy of the drug treatment in patients who use this type of therapy. There are few clinical protocols that refer to drug use in solid pharmaceutical form via enteral catheter. This study aimed to verify the inadequacy of the prescription of the solid pharmaceutical form through enteral feeding tube in patients hospitalized in a clinical unit in a public hospital in the south of Brazil. This is an observational, cross-sectional study whose data were analyzed from medical prescriptions of patients using enteral tubes. Among the drugs with pharmaceutical form of oral use prescribed via enteral feeding tubes, 94% (604) were prescribed in a solid dosage form, of which 42% (253) were inadequately prescribed. The high prevalence of inadequately prescribed drugs for tube administration demonstrates the importance of the pharmaceutical activity among the multidisciplinary team who assists patients with enteral nutritional therapy