Nutritional therapy and infectious diseases: a two-edged sword

The benefits and risks of nutritional therapies in the prevention and management of infectious diseases in the developed world are reviewed. There is strong evidence that early enteral feeding of patients prevents infections in a variety of traumatic and surgical illnesses. There is, however, little support for similar early feeding in medical illnesses. Parenteral nutrition increases the risk of infection when compared to enteral feeding or delayed nutrition. The use of gastric feedings appears to be as safe and effective as small bowel feedings. Dietary supplementation with glutamine appears to lower the risk of post-surgical infections and the ingestion of cranberry products has value in preventing urinary tract infections in women

O perfil do idoso de baixa renda no Município de São Carlos, São Paulo, Brasil: um estudo epidemiológico Low-income senior citizens in the Municipality of São Carlos, São Paulo State, Brazil: an epidemiological survey

O presente estudo delineou o perfil de saúde de uma população idosa, residente em São Carlos, São Paulo, Brasil, no ano de 2003. A população do estudo (n = 523) foi constituída pelo universo de pessoas com sessenta anos e mais, cadastradas no Programa Saúde da Família e no Cartão Nacional de Saúde. A prevalência de incapacidades, doenças crônicas e estado cognitivo foi estimada por ponto e por intervalos, construídos com 95% de confiança. Os resultados do estudo mostraram um predomínio de mulheres com baixa escolaridade; 24,8% referiram não receber aposentadoria ou pensão; 43,6% relataram não participar de atividades de integração social; 46,7% necessitavam de ajuda para realizar de uma a três atividades da vida diária. Com relação à morbidade, 74,9% eram portadores de 1 a 5 doenças crônicas não transmissíveis e 56,2% alcançaram escores abaixo de 24 no teste cognitivo, 87% procuraram por serviços de saúde e 22,4% necessitaram de algum tipo de internação. Conclui-se pela necessidade de maior adequação dos profissionais e serviços de saúde para uma efetiva implementação de políticas públicas de atenção adequada aos idosos.<br>This study focuses on the health profile of the elderly population in São Carlos, São Paulo State, Brazil, in 2003. The study population consisted of a sample over 60 years of age (n = 523) registered with the Family Health Program and the Unified National Health System. Point and interval prevalence of disabilities and chronic non-communicable diseases and cognitive status were estimated (95%CI). The study population was predominantly female with low education; 24.8% lacked any kind of retirement pension; 43.6% presented a low level of social integration; 46.7% required some form of help for 1 to 3 routine activities; 74.9% presented 1 to 5 chronic non-communicable diseases; and 56.2% scored under 24 on a cognitive test. Some 87.0% had sought health care and 22.4% required some kind of inpatient care. The results confirmed the need for improved professional training, adequacy of health services, and effective public policy to provide qualified health care for the elderly population

Parental allergic status influences the risk of developing allergic sensitization and an asthmatic-like phenotype in canine offspring

Increasing evidence suggests that parental allergic status, especially that of the mother, may play a unique and important role in influencing the development of fetal infant immune responses to inhaled allergens, independently of genetic predisposition. We have developed an experimental model in dogs where the offspring from allergic parents, when exposed to inhaled allergen, develop allergic sensitization and an asthmatic phenotype, whereas the offspring from non-allergic parents do not. Offspring from ragweed-sensitized (two litters, n = 10) or non-sensitized (two litters, n = 11) Beagle dogs were exposed repeatedly, by inhalation, to ragweed or filtered air (negative control) beginning within 1 week after birth. Serum levels of total immunoglobulin (Ig)E, and ragweed-specific IgE and IgG, were measured at specific time-points up to 40 weeks after birth. Cell differentials in the bronchoalveolar lavage were determined on days 1 and 4 following ragweed instillation into the offspring's lungs at 26 weeks of age. Changes in pulmonary resistance following challenge with histamine and ragweed (five breaths) were measured at 40 weeks after birth. Offspring from sensitized parents exposed to ragweed developed elevated serum total IgE and ragweed-specific IgE and IgG, and showed an increased pulmonary resistance to histamine and ragweed, and increased numbers of eosinophils in bronchoalveolar lavage. In contrast, offspring from non-sensitized parents did not exhibit this immune response. These results suggest that parental allergic sensitivity is important in the development of allergic sensitization and an asthmatic phenotype in the offspring

Development and evaluation of Cetirizine HCl taste-masked oral disintegrating tablets

The purpose of the current study was to mask the taste of cetirizine HCl and to incorporate the granules produced in oral disintegrating tablets (ODT). The bitter, active substance was coated by fluidized bed coating using Eudragit® RL30-D at levels between 15% and 40% w/w. The ODTs were developed by varying the ratio of superdisintegrants such as sodium croscarmellose, crospovidone grades and low substituted hydroxypropyl cellulose (L-HPC). A direct compression process was used to compress the ODTs under various compaction forces to optimize tablet robustness. The properties of the compressed tablets including porosity, hardness, friability and dissolution profiles were further investigated. The in vitro and in vivo evaluation of the tablet disintegration times showed almost identical rapid disintegration below 10 s at the optimal levels of each superdisintegrant. Finally, the taste and sensory evaluation in human volunteers demonstrated excellence in masking the bitter active and tablet palatability