Atualização sobre o manejo nutricional da insuficiência pancreática exócrina: revisão da literatura

Exocrine pancreatic insufficiency (EPI) results in maldigestion and malabsorption, with a negative impact on the patient’s nutritional status. If not treated adequately, it leads to a progressive loss of weight and potential nutritional deficiencies, increasing morbidity and mortality, hospital readmissions and healthcare costs. Detection and appropriate treatment of EPI has a positive effect on disease prognosis. Nutritional care as a continuous process has to be part of the comprehensive approach to the patient and, therefore, an inherent component of care. Early detection of patients at risk of malnutrition or already malnourished allows for early nutritional intervention and mitigation of the nutritional impact of EPI. The objective of this review is to offer scientific evidence on EPI and to provide a practical approach to nutritional management and clinical treatment of this condition.La insuficiencia pancreática exocrina (IPE) produce mala digestión y malabsorción de nutrientes, lo que impacta negativamente en el estado nutricional. Si no se trata adecuadamente, esta conduce a una pérdida de peso progresiva y posibles deficiencias nutricionales, lo que aumenta la morbimortalidad de los pacientes, las reinternaciones y los costos sanitarios. La detección y el tratamiento oportuno de la IPE afectan positivamente el pronóstico de la enfermedad. El cuidado nutricional, el cual consta de un proceso continuo, tiene que formar parte de la atención integral del paciente, por tanto, debe ser un componente inherente a su cuidado. La detección temprana de pacientes en riesgo de desnutrición, o desnutridos, permite una intervención nutricional precoz, con el propósito de atenuar el impacto nutricional de la IPE. El objetivo de esta revisión es proporcionar evidencia científica acerca de la IPE y brindar un enfoque práctico para el manejo nutricional y el tratamiento clínico de la misma, importante por su impacto en la morbimortalidad y la calidad de vida.A insuficiência pancreática exócrina (IPE) produz má digestão e má absorção de nutrientes, impactando negativamente no estado nutricional. Quando não è tratada adequadamente, leva à perda progressiva de peso e possíveis deficiências nutricionais, aumentando a morbimortalidade dos pacientes, as re-hospitalizações e os custos em saúde. A detecção e o tratamento precoce da IPE afetam positivamente o prognóstico da doença. O cuidado nutricional, que consiste num processo contínuo, deve fazer parte da atenção integral do paciente e, portanto, deve ser um componente inerente ao seu cuidado. A detecção precoce de pacientes em risco de desnutrição ou desnutridos, permite uma intervenção nutricional antecipada, com o objetivo de atenuar o impacto nutricional da IPE. O objetivo desta revisão é proporcionar evidências científicas sobre a IPE e fornecer uma abordagem prática para o manejo nutricional e o tratamento clínico da doença, importante por seu impacto na morbimortalidade e na qualidade de vida

Recomendaciones para el diagnóstico y tratamiento del adenocarcinoma ductal de páncreas

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Microplastics and hydrocarbons in soils: Quantification as an anthropic carbon source

The literature on the presence of microplastics (MPs) and their potential impact on terrestrial ecosystems is still scarce. Interestingly, soil MPs are detected as organic carbon (SOC) using traditional quantification methods (e.g., loss on ignition [LOI]), although its dynamics in the environment will be different. The objective of this study was to quantify the carbon (C) contribution of MPs to the SOC in superficial soil samples from a coastal urban wetland (Avellaneda, Buenos Aires, Argentina) with the features of a humid subtropical forest and compare with hydrocarbon contribution. Soil samples were split for analysis of moisture content; texture (sieve and pipet method); organic matter as a LOI (8 h at 450 °C); total hydrocarbons (THCs; gravimetry of solvent extractable matter); n-alkanes (solvent extraction and gas chromatography-flame ionization detection analysis); and extraction of MPs (floatation in NaClaq, filtration, H2O2 digestion, and visual sorting under a stereomicroscope). The superficial soil was a sandy clay loam with a large organic matter content (19%–30%). The THC averaged 2.5 ± 1.9 g kg and the marked predominance of odd-numbered carbon n-alkanes maximizing at C29 and C31 show the contribution of the terrestrial plant waxes. The average number of MPs was 587 ± 277 items kg of dry soil, predominantly fibers. Taking account of the C content, THCs and MPs add to the soil 1.23 ± 1.10 ton C ha and 0.10–0.97 ton C ha, respectively. Therefore, in this system with humid forest characteristics, the MPs represent between 0.12% and 1.25% of soil estimated carbon, in a magnitude similar to the C contribution of THCs (0.6%–4.2%). This preliminary study shows the relevance of discriminating MPs from other carbon sources and presents a description of their impact on soils to advance future research or tools for decision-makers.Fil: Aquino, Victor Nahuel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Avellaneda; ArgentinaFil: Plaul, Florencia Eva. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Avellaneda; ArgentinaFil: Sanchez, Anabel Danila. Universidad Nacional de Avellaneda; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Villagra, Sebastian. Universidad Nacional de Avellaneda; ArgentinaFil: Cappelletti, Natalia Elsa. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Avellaneda; Argentin