Gengibre (Zingiber officinale) no Manejo de Náuseas e Vômitos Induzidos por Quimioterapia em Pacientes com Câncer: Revisão Integrativa da Literatura

Introdução: Náuseas e vômitos induzidos por quimioterapia (NVIQ) são importantes efeitos colaterais dos tratamentos antineoplásicos. Algumas plantas medicinais vêm sendo estudadas no manejo desses efeitos, como o gengibre (Zingiber officinale). Objetivo: Realizar uma revisão acerca do uso via oral do gengibre no manejo de NVIQ em pacientes com câncer. Método: Revisão integrativa da literatura realizada na base de dados MEDLINE, em setembro de 2022, adotando a combinação das palavras-chave “Zingiber officinale” e “Cancer”. Foram também aplicados filtros na seleção para incluir ensaios clínicos aleatórios publicados entre 2012 e 2022. Resultados: Ao todo, foram analisados nove estudos. O gengibre apresenta potencial de reduzir NVIQ em pacientes com câncer, refletindo positivamente na qualidade de vida e na melhora do apetite e da fadiga. Os estudos não observaram efeitos adversos da administração do gengibre. Conclusão: O uso por via oral do gengibre demonstra ser uma estratégia segura para o manejo de NVIQ em pacientes com câncer, na dose de 1 g/dia do gengibre em pó, podendo ser utilizado como terapia complementar juntamente com regimes antieméticos padrões

Changes in the Gut Microbiota after the Use of Herbal Medicines in Overweight and Obese Individuals: A Systematic Review

Background: Herbal medicine is a low-cost treatment and has been increasingly applied in obesity treatment. Gut microbiota (GM) is strongly associated with obesity pathogenesis. Methods: We conducted a systematic review guided by the question: “Does the use of herbal medicine change the GM composition in obese individuals?” Randomized clinical trials with obese individuals assessing the effects of herbal medicine intervention in GM were retrieved from the Medline, Embase, Scopus, Web of Science, and Cochrane Library databases, including the Cochrane Controlled Trials Register. Two reviewers independently extracted data using standardized piloted data extraction forms and assessed the study-level risk of bias using an Excel template of the Cochrane “Risk of bias” tool 2—RoB 2. Results: We identified 1094 articles in the databases. After removing duplicates and reading the title and abstract, 14 publications were fully evaluated, of which seven publications from six studies were considered eligible. The herbs analyzed were Moringa oleifera, Punica granatum, Scutellaria baicalensis, Schisandra chinensis, W-LHIT and WCBE. The analysis showed that Schisandra chinensis and Scutellaria baicalensis had significant effects on weight loss herbal intervention therapy composed by five Chinese herbal medicines Ganoderma lucidum, Coptis chinensis, Astragalus membranaceus, Nelumbo nucifera gaertn, and Fructus aurantii (W-LHIT) and white common bean extract (WCBE) on GM, but no significant changes in anthropometry and laboratory biomarkers. Conclusions: Herbal medicine modulates GM and is associated with increased genera in obese individuals

Serum Hepcidin Concentration in Individuals with Sickle Cell Anemia: Basis for the Dietary Recommendation of Iron

Dietary iron requirements in patients with sickle cell disease (SCD) remain unclear. SCD is a neglected hemoglobinopathy characterized by intense erythropoietic activity and anemia. Hepcidin is the hormone mainly responsible for iron homeostasis and intestinal absorption. Intense erythropoietic activity and anemia may reduce hepcidin transcription. By contrast, iron overload and inflammation may induce it. Studies on SCD have not evaluated the role of hepcidin in the presence and absence of iron overload. We aimed to compare serum hepcidin concentrations among individuals with sickle cell anemia, with or without iron overload, and those without the disease. Markers of iron metabolism and erythropoietic activity such as hepcidin, ferritin, and growth differentiation factor 15 were evaluated. Three groups participated in the study: the control group, comprised of individuals without SCD (C); those with the disease but without iron overload (SCDw); and those with the disease and iron overload (SCDio). Results showed that hepcidin concentration was higher in the SCDio > C > SCDw group. These data suggest that the dietary iron intake of the SCDio group should not be reduced as higher hepcidin concentrations may reduce the intestinal absorption of iron

Correction: Nutritional Supplementation Is a Necessary Complement to Dietary Counseling among Tuberculosis and Tuberculosis-HIV Patients.

The Brazilian Ministry of Health and the World Health Organization recommend dietary counseling for patients with malnutrition during tuberculosis treatment. Patients under tuberculosis therapy (infected and not infected with HIV) were followed-up to evaluate the effectiveness of dietary counseling.describe the nutritional status of patients with tuberculosis.an observational follow-up study over a 180-day period of tuberculosis therapy in adults was conducted. Subjects were assessed for body composition (using BMI, TSF and MUAC parameters), serum biomarkers and offered dietary counseling. The data obtained at each visit (D15, D30, D60, D90, D120, D150, and D180) were analyzed, showing trajectories over time and central tendencies each time.at baseline, the mean age was 41.1 (± 13.4) years; they were predominantly male, with income lower than a local minimum wage and at least six years of schooling. Patients showed predominantly pulmonary tuberculosis. At baseline, all patients suffered from malnutrition. The overall energy malnutrition prevalence was of 70.6%. Anemia at baseline was observed in both groups (63.2%), however, it was significantly more pronounced in the HIV+. At the end, energy malnutrition was reduced to 57.1% (42.9% of HIV- and 71.4% of the HIV+). Micronutrients malnutrition was evident in 71.4% of the HIV- patients and 85.7% of HIV+ patients at the end of tuberculosis therapy. Using BMI (≤ 18.5 kg/m2cutoff) as an index of malnutrition, it was detected in 23.9% of the HIV- and 27.3% of the HIV+ patients at baseline, with no evident improvement over time; using TSF (≤ 11.4mm as cutoff) or MUAC (≤ 28.5cm as cutoff), malnutrition was detected in 70.1% and 85.3% of all patients, respectively. Nevertheless, combining all biomarkers, at the end of follow-up, all patients suffered from malnutrition.Although with a limited number of patients, the evidence does not support that dietary counseling is effective to recover from malnutrition in our population

Measurements of body composition and biomarkers of all patients throughout tuberculosis treatment.

<p>1 = mean (SD)</p><p>2 = kilogram (Kg)</p><p>3 = kilogram per square meter (Kg/m²)</p><p>4 = centimeters (cm)</p><p>5 = millimeters (mm)</p><p>6 = grams per deciliter (g/dl)</p><p>7 = percentage (%)</p><p>8 = micrograms per deciliter (mcg/dl)</p><p>9 = milligrams per deciliter (mg/dl)</p><p>10 = milligrams per liter (mg/l)</p><p>11 = micrograms per liter (mcg/l)</p><p>BMI = body mass index; MUAC = mid–upper-arm circumference; MAMC = mid arm muscle circumference; TSF = triceps skinfold thickness; TIBIC = iron fixation capacity; RV = reference values.</p><p>Measurements of body composition and biomarkers of all patients throughout tuberculosis treatment.</p

Biochemical and hematological assessment of HIV-infected and non-infected patients at the beginning of the follow-up.

<p>¹ = n (%)</p><p>Anemia = hemoglobin < 12g/dl; severe anemia = hemoglobin< 8g/dl; energy malnutrition = verified by BMI, MUAC and TSF; micronutrient malnutrition = verified by retinol, tocopherol, zinc, selenium and iron; protein malnutrition = verified by MAMC, albumin, TIBC; global malnutrition = verified by all the available nutritional parameters.</p><p>Biochemical and hematological assessment of HIV-infected and non-infected patients at the beginning of the follow-up.</p