Leveduras probióticas no processo de translocação bacteriana em modelo experimental de obstrução intestinal em camundongos

Exportado OPUSMade available in DSpace on 2019-08-11T20:20:12Z (GMT). No. of bitstreams: 1 tesedoutoradosimone.pdf: 1291723 bytes, checksum: e204c64797e6ef01dbb3eb1bef52cec8 (MD5) Previous issue date: 10Existem evidências dos efeitos benéficos dos probióticos na proteção da barreira intestinal e modulação da função imunológica, reduzindo a translocação bacteriana (TB). O objetivo deste estudo foi avaliar os efeitos das células viáveis e não viáveis dos probióticos, Saccharomyces boulardii (Sb) e Saccharomyces cerevisiae UFMG 905 (Sc) na TB induzida em modelo murino de obstrução intestinal (OI), assim como os mecanismos de ação. Foram utilizados 6 grupos de animais. Grupo I: Sham; Grupo II: OI; Grupo III: OI + Sb; Grupo IV: OI + Sb não viável, Grupo V: OI + Sc ; Grupo VI: OI + Sc não viável. Os animais receberam durante 10 dias por gavagem solução salina (grupos I e II) ou tratamento com células viáveis ou não viáveis dos respectivos probióticos os (III a VI). No décimo dia, todos os camundongos foram submetidos a OI, exceto o grupo I. A TB que foi determinada por meio da captação de 99mTc-Escherichia coli no sangue, linfonodos mesentéricos, fígado, baço e pulmões e foi significativamente maior no grupo II em relação ao grupo I. Os tratamentos com ambas as leveduras, com células viáveis e não viáveis, reduziram a TB para o sangue e todos os órgãos investigados, além de inibirem o aumento da permeabilidade intestinal, conforme determinado pela captação no sangue do 99mTc-DTPA. Esses dados foram coerentes com o exame histológico intestinal que mostrou lesões mais graves no grupo II quando comparado aos grupos I e tratados com probióticos. Além disso, os tratamentos com probióticos foram capazes de aumentar significativamente (p < 0,05) os níveis de IL-10, e tiveram o mesmo efeito sobre os níveis de sIgA quando comparados com os animais do grupo II. O grupo VI foi o único a não apresentar aumento significativo nos níveis de sIgA. Concluindo, os tratamentos com os dois probióticos viáveis ou não foram capazes de impedir a TB, provavelmente por imunomodulação e pela manutenção da integridade da barreira intestinal. No caso da levedura S. cerevisiae UFMG 905 alguns de seus efeitos, como estímulo à produção de sIgA, parecem depender de sua viabilidade.There is evidence of the beneficial effects of probiotics in the intestinal mucosa protection and modulation of immune function, reducing bacterial translocation (BT). The aim of this study was to evaluate the effects of viable cells and nonviable probiotics, S. boulardii and S. cerevisiae (UFMG 905) in BT as well as its means of action in model intestinal obstruction (IO) in mice. We used 6 groups. Group I: Sham operated, Group II: intestinal obstruction (IO), Group III: IO+Sb and Group IV: IO+not viable Sb, Group V: IO+Sc, Group VI: IO+ not viable Sc. Animals in groups I and II were given for 10 days, gavage saline, and the animals in other groups received their treatments by gavage with probiotics. In 10 day all mice underwent the operation for the promotion of IO, except the Sham group. BT was determined by uptake of 99mTc-E.coli in the blood, lymph nodes, liver, spleen and lungs was significantly higher in group HI than in group Sham. Treatment with both yeasts, with both viable and non viable cells, reduced BT in the blood and all organs investigated, in addition to inhibiting the increase in intestinal permeability, as determined by uptake in the blood of 99mTc-DTPA. These data were confirmed by histology as intestinal histopathological lesions were more severe in the IO group compared to Sham and treated groups. Furthermore, treatments with probiotic were able to significantly increase the levels of IL-10 (p<0.05) and had the same effect on the levels of sIgA compared with the animals in group IO. The group IO+not viable Sc, was an exception since they were not observed significant increases in the levels of sIgA. In conclusion, treatments with both probiotics were able to prevent BT probably through immunomodulation and maintaining the integrity of the intestinal barrier. In the case of the yeast S. cerevisiae UFMG 905 some of its effects as stimulating the production of sIgA seem to depend on their viability

Associação do ângulo de fase padronizado com estado nutricional e desfechos clínicos em pacientes cirúrgicos oncológicos

Exportado OPUSMade available in DSpace on 2019-08-14T00:35:58Z (GMT). No. of bitstreams: 1 dissertacao_af____finalizada_com_ficha.pdf: 782730 bytes, checksum: 5a0350c9943069b290f5c51e03d972cc (MD5) Previous issue date: 18O Ângulo de Fase Padronizado (AFP) é medida derivada da Bioimpedância Elétrica (BIA) ajustado por sexo e idade. O AFP é capaz de avaliar a integridade das membranas celulares e tem sido estudado recentemente como possível indicador do estado nutricional (EN) e fator prognóstico em pacientes com câncer. Entretanto, poucos trabalhos avaliaram o comportamento do AFP como indicador do estado nutricional e desfechos clínicos adversos em pacientes oncológicos. Objetivo: Avaliar a associação entre o AFP com as variáveis do estado nutricional no pré-operatório e desfechos clínicos em pacientes cirúrgicos oncológicos. Métodos: Estudo longitudinal-prospectivo realizado com pacientes cirúrgicos oncológicos, admitidos no Instituto Alfa de Gastroenterologia, do Hospital das Clínicas de Belo Horizonte, Minas Gerais. A avaliação do estado nutricional dos pacientes foi realizada antes da cirurgia (pré-operatório) e os desfechos clínicos foram avaliados nos momentos pós-operatório até a alta hospitalar. Os dados sobre o estado nutricional (EN) foram obtidos no pré-operatório imediato, por meio da Avaliação Global Subjetiva (AGS), circunferência do braço (CB), dobra cutânea tricipital (DCT), área muscular do braço (AMB), percentual de perda de peso (PPP) e a funcionalidade, pela dinamometria. O AFP foi obtido por meio da BIA e calculado segundo a seguinte equação: AFP=AF medido - AF médio (para idade e sexo)/desvio-padrão da população, segundo idade e sexo. Dados sobre os desfechos clínicos e glicemia capilar foram coletados em prontuário médico e corridas de leito. Foram realizadas análises descritivas e bivariadas; concordância entre métodos por meio do coeficiente kappa e modelos de regressão logística simples foram utilizados para avaliar a associação entre o AFP, estado nutricional e desfechos clínicos nessa população. Para comparar as médias da glicemia capilar, segundo a categorização do AFP, utilizou-se o Teste Ancova. Para todas as análises foi adotado um nível de significância de 5%; (p0,05). Conclusão: Nossos achados sugerem que o AFP pode ser considerado instrumento útil e mais precoce que parâmetros tradicionais, capaz de auxiliar na avaliação e classificação do estado nutricional de pacientes oncológicos, no ambiente hospitalar. Este também mostrou-se bom indicador prognóstico, capaz de predizer complicações infecciosas e apresentou uma tendência significativa de associação, em relação à hiperglicemia hospitalar avaliada. Futuros estudos poderão confirmar esses achados e se o AFP, utilizado em combinação com outras ferramentas de diagnóstico nutricional nesses pacientes, aumentaria a sensibilidade em detectar estados nutricionais mais debilitados.The Standardized Phase Angle (AFP) is measured derived from electrical bioimpedance (BIA) adjusted for sex and age. AFP is able to assess the integrity of cell membranes and has recently been studied as a possible indicator of nutritional status (NS) and a prognostic factor in patients with cancer. However, few studies have evaluated the AFP's behavior as an indicator of nutritional status and adverse clinical outcomes in cancer patients. Objective: To evaluate the association between the AFP and the variables of the nutritional status preoperatively and clinical outcomes in cancer surgical patients. Methods: A longitudinal-prospective study of cancer surgical patients admitted to the Alfa Institute of Gastroenterology, Hospital das Clinicas in Belo Horizonte, Minas Gerais. The evaluation of the nutritional status of patients was performed before surgery (pre-operative) and clinical outcomes were evaluated postoperatively times until hospital discharge. The data on the nutritional status (NS) were obtained immediately preoperatively through the Subjective Global Assessment (SGA), arm circumference (AC), triceps skinfold (TSF), arm muscle area (AMA), percentage of weight loss (PPP) and functionality, the grip strength. The AFP was obtained by BIA and calculated according to the following equation: measured AFP = AF - AF average (for age and sex) / standard deviation of the population by age and sex. Data on clinical outcomes and blood glucose were collected from medical records and bed races. Descriptive and bivariate analyzes were performed; agreement between methods using the kappa coefficient and simple logistic regression models were used to evaluate the association between AFP, nutritional status and clinical outcomes in this population. To compare the mean blood glucose of the second categorization AFP, we used the ANCOVA. For all analyzes it was adopted a significance level of 5%; (p 0.05). Conclusion: Our findings suggest that the AFP can be considered useful and earlier than traditional parameters, able to assist in the evaluation and classification of the nutritional status of cancer patients in the hospital. This also proved to be good prognostic indicator, capable of predicting infectious complications and showed a significant association tendency in relation to hyperglycaemia evaluated hospital. Future studies will confirm these findings and AFP, used in combination with other diagnostic tools in these patients nutritional, increase the sensitivity to detect more impaired nutritional status

Osmolality and pH in handmade enteral diets used in domiciliary enteral nutritional therapy

Abstract Patients who need prolonged domiciliary enteral nutritional therapy may benefit from handmade diets. However, the preparation of such diets might cause insecurity with regard to their nutritional composition and physical-chemical properties. Current study analyzes the osmolality and Hydrogen-Ion concentration (pH) on handmade enteral diets. To this purpose, six formulas and two juices, prescribed on discharge from hospital, were analyzed physically and chemically. Osmolality and pH were respectively determined by cryoscopy and potentiometry. Most formulations were classified as isosmolar (with less than 400 mOsm/kg solvent), and only one was classified as slightly hyperosmolar, with rates ranging from 356.7 to 403.5 mOsm/kg solvent. On average, the standard formula presented higher osmolality than similar ones prepared for hyperglycemia. Among the juices, only one registered hyperosmolar concentration of 595.54 mOsm/kg solvent. All formulas presented pH rates classified as low acidity, ranging between 6.1 and 6.6, while the two juices had the lowest results, 4.73 and 4.66 each. The blend of ingredients used in handmade formulas and juices studied presented acceptable osmolality and pH rates for a safe administration and absence of gastrointestinal complications. Data showed here are consistent with an appropriate and healthy diet and contributed towards success in domiciliary enteral nutritional therapy

Osmolality and pH in handmade enteral diets used in domiciliary enteral nutritional therapy

<div><p>Abstract Patients who need prolonged domiciliary enteral nutritional therapy may benefit from handmade diets. However, the preparation of such diets might cause insecurity with regard to their nutritional composition and physical-chemical properties. Current study analyzes the osmolality and Hydrogen-Ion concentration (pH) on handmade enteral diets. To this purpose, six formulas and two juices, prescribed on discharge from hospital, were analyzed physically and chemically. Osmolality and pH were respectively determined by cryoscopy and potentiometry. Most formulations were classified as isosmolar (with less than 400 mOsm/kg solvent), and only one was classified as slightly hyperosmolar, with rates ranging from 356.7 to 403.5 mOsm/kg solvent. On average, the standard formula presented higher osmolality than similar ones prepared for hyperglycemia. Among the juices, only one registered hyperosmolar concentration of 595.54 mOsm/kg solvent. All formulas presented pH rates classified as low acidity, ranging between 6.1 and 6.6, while the two juices had the lowest results, 4.73 and 4.66 each. The blend of ingredients used in handmade formulas and juices studied presented acceptable osmolality and pH rates for a safe administration and absence of gastrointestinal complications. Data showed here are consistent with an appropriate and healthy diet and contributed towards success in domiciliary enteral nutritional therapy.</p></div