Prospective study of consecutive patch testing in patients with contact dermatitis using an adapted Latin American baseline series.

Summary: Background. Contact dermatitis is characterized by pruritic skin lesions with high prevalence rates. Our objective is to describe the clinical and epidemiological characteristics of a population with suspected contact dermatitis who underwent to a patch testing using an adapted Latin American baseline series.Methods. Observational, descriptive, analytical clinical study with prospective data collection was performed. 208 participants who underwent patch testing using an adapted Latin American baseline series containing 40 allergens were analyzed. The prevalence of contact allergies was compared with data from the literature. Pearson's chi-square test was used for qualitative variables. Quantitative variables were compared using the Mann-Whitney U test. The significance of the regression parameters was tested using the Wald statistical test. Results. A total of 69.7% had one or more positive tests. Among those, 82.8% were women (OR 1.371; p = 0.398). The hands were the most commonly affected site at 43%. An occupational history was detected in 19.2%. The most common allergens were nickel sulfate (32.2%), sodium tetrachloropalladate (19.7%), fragrance mix I (15.4%), and methylisothiazolinone (13.5%). In multivariate logistic regression models, nickel was significantly related to female sex, as well as palladium. Fragrance mix I was related to a family history of allergy (p less than 0.05). Methylisothiazolinone was statistically significantly related to face and hand lesions. Conclusions. This study demonstrated a detailed profile of a population with suspected allergic contact dermatitis. Our patch test results, using an adapted Latin American baseline series, represent a significant update of this important diagnostic tool.

Outcomes of enteral nutrition for patients with advanced dementia: a systematic review.

The present article aims to evaluate the outcomes of enteral nutrition for people with advanced dementia. A systematic review was conducted by searching The Cochrane Library, MEDLINE, EMBASE, PROQUEST and LILACS for articles that were published from 2008 to 2013. Prospective and retrospective studies involving a control group were searched. Data were independently extracted and assessed by one reviewer and checked by a second. Searched outcomes included survival, clinical and nutritional parameters and complications. In total, nine controlled studies were identified from several parts of the world: Israel, Italy, Japan, the United States and Brazil. Most of the studies did not report any outcome of harm with enteral nutrition use in dementia patients compared with patients without dementia. A study with a higher follow-up period demonstrated improvements in albumin, weight and chronic inflammation parameters. It is not possible to affirm that tube feeding is harmful for dementia patients. Thus, an adequate follow-up by a multidisciplinary team may lower complications associated with this therapy and thus improve survival.

Multidisciplinary care in cystic fibrosis: a clinical-nutrition review.

The multidisciplinary care, at different referral centers of cystic fibrosis, is aimed at monitoring and treating cystic fibrosis patients. Mortality attributed to this hereditary disease is high, since it affects the exocrine glands, involving multiple organs, and evolves in a chronic, progressive way. However, systemized care and the improved, shared understanding of gastroenterologists, nutritionists and pulmonologists, contribute to prolonged survival and abated morbimortality. The aim of this study is to describe the main aspects of clinical and nutritional intervention in cystic fibrosis patients so that monitoring by a multidisciplinary team is optimized and performed as early as possible. The review was carried out on articles indexed in the Medline, Lilacs, SciELO, Current Contents and Cochrane databases, finding 189 articles in Portuguese, English and Spanish, with emphasis on articles published between 2000 and 2011. Due to the scientific relevant contribution, some publications before 2000 were included totalized 77 related to the multidisciplinary care. The reviewed studies suggest that multidisciplinary care is essential for knowledge integration in order to impose permanent update of scientific information, thereby contributing to the development of intervention strategies that enhance survival and motivate the development of skills to cope with the complex treatment regimen that is necessary for cystic fibrosis treatment and prevention of related complications.

Poisonous mushrooms: a review of the most common intoxications.

Mushrooms have been used as components of human diet and many ancient documents written in oriental countries have already described the medicinal properties of fungal species. Some mushrooms are known because of their nutritional and therapeutical properties and all over the world some species are known because of their toxicity that causes fatal accidents every year mainly due to misidentification. Many different substances belonging to poisonous mushrooms were already identified and are related with different symptoms and signs. Carcinogenicity, alterations in respiratory and cardiac rates, renal failure, rhabidomyolisis and other effects were observed in toxicity studies with various species including edible and therapeutic ones. Proper identification is important to avoid accidents and toxicity studies are necessary to assure the safe use of mushrooms as food and for medicinal purposes.

Nutritional value of Agaricus sylvaticus: mushroom grown in Brazil.

The bromatological characterization of the Agaricus sylvaticus species (A. sylvaticus), known as the Sun Mushroom and cultivated in Brazil, is necessary to determine substances with pharmacological and nutritional potential, in view its safe use in food and in human medicine. The purpose of the present study was to determine the chemical composition of the A. sylvaticus mushroom grown in Brazil. Mushrooms were obtained in dehydrated form from a producer in Minas Gerais State. Through this study it was able to observe the fungus' rich chemical composition, highlighting the variety and quantity of minerals as well as its high protein content. There are many components of this mushroom that have medicinal properties, which are recognized as excellent antioxidants. Results also proved that the composition of A. sylvaticus presented differences when compared to the chemical composition of other Agaricaceae fungi.

Albendazole versus metronidazole in the treatment of adult giardiasis: a randomized, double-blind, clinical trial.

BACKGROUND: Albendazole (ABZ) is a benzimidazole carbamate compound currently in use for human medical practice against enterobiasis and soil-transmitted helminthiasis (STH); However, its spectrum of activity is broad and goes beyond these infections. OBJECTIVE: This study compares the efficacy and safety of ABZ versus metronidazole (MTZ) in human giardiasis. RESEARCH DESIGN AND METHODS: A randomized, double-blind, clinical trial was carried out at the Centre of Hygiene, Epidemiology and Microbiology in Matanzas City, Cuba. Adult patients with confirmed symptomatic G. duodenalis mono-infection were randomly assigned to receive either ABZ [400 mg daily (n = 75)] or MTZ [250 mg t.i.d. (n = 75)], both for 5 days. Follow-up fecal samples were obtained at 3, 5, 7 days after treatment end. RESULTS: The efficacy was similar for both treatment groups: ABZ (82.6%) and MTZ (85.3%); p > 0.05. Side-effects including bitter taste, headache, vomiting and dizziness were significantly higher in the MTZ group. Abdominal pain was significantly higher in ABZ group. CONCLUSION: ABZ was found as effective as MTZ in the treatment of G. duodenalis infections in adult patients from Cuba and could be a useful drug in areas where co-infection with STH infections is common.

The effects of Agaricus sylvaticus fungi dietary supplementation on the metabolism and blood pressure of patients with colorectal cancer during post surgical phase.

INTRODUCTION: Metabolic, biochemical and enzymatic alterations are common in patients with cancer. Medicinal fungi has been used as adjuvants in cancer therapy due to its immunomodulatory and nutritional effects. OBJECTIVE: The objective of this study was to evaluate the metabolic and blood pressure effects on patients with colorectal cancer after dietary supplementation with Agaricus sylvaticus. METHODS: The methodology used was a randomized, double-blind, placebo-controlled clinical trial conducted at the Base Hospital of the Federal District-Brazil. Samples of 56 patients with colorectal cancer, divided into two groups: Agaricus sylvaticus (30 mg/kg/day) and placebo. Three serum evaluations were conducted throughout the treatment: glucose, total cholesterol, triglycerides, uric acid, urea, creatinine, alkaline phosphatase; total, direct and indirect bilirubin; aspartate aminotransferase and alanine aminotransferase; immunoglobulins A (IgA), G (IgG) and M (IgM); total proteins and protein fractions; blood pressure levels were measured as well. The results were analyzed by Microsoft Excel 2003 and SPSS 14.0 programs, Student's t test, F statistical test, with p < 0.05. RESULTS: The Agaricus sylvaticus group presented a significant reduction of fasting plasma glucose (p = 0.02), total cholesterol (p = 0.01), creatinine (p = 0.05), aspartate aminotransferase (p = 0.05), alanine aminotransferase (p = 0.04), IgA (p = 0.0001), IgM (p = 0.02), systolic blood pressure (p = 0.0001) and diastolic blood pressure (p = 0.0001). These alterations were not observed in the placebo group. CONCLUSIONS: Results suggest that dietary supplementation with Agaricus sylvaticus is capable of providing metabolic benefits to the biochemical, enzymatic and blood pressure parameters of patients with colorectal cancer in the postsurgical phase.

Life quality of postsurgical patients with colorectal cancer after supplemented diet with agaricus sylvaticus fungus.

INTRODUCTION: Therapeutical alternatives, directed to improve life quality and reduce adverse effects of cancer treatment, have been the purpose of studies that try to prove the immunomodulator efficacy of medicinal fungi as coadjuvant for conventional therapies. OBJECTIVE: The objective of this study was to evaluate the impact on the life quality of post-surgical patients with colorectal cancer after supplemented diet with Agaricus sylvaticus fungus cultivated in Brazil. METHODS: Randomized, double-blind, placebo-controlled clinical trial carried out at the Federal District Base Hospital-Brazil, for six months. Samples of 56 enrolled patients (24 men and 32 women), stadium phases I, II and III, separated as placebo and Agaricus sylvaticus (30 mg/kg/day) supplemented groups. Form-standard and direct anamnesis-standard were used to evaluate indicators for life quality. The method of analysis was qualitative and descriptive, processed with Microsoft Excel 2003 and Epi Info 2004 programs. The protocol was approved by the Ethics Research Committee-Health Department-Federal District. RESULTS: After six months of treatment, the supplemented group had increased adhesion to physical activity; improved disposition and good mood; reduced complaints of pains and alterations of sleep such as insomnia and restless sleep; presenting more appetite, reduced constipation, diarrhea, alternate diarrhea/constipation, flatulence, flatus retention, pyrosis, postprandial fullness, nausea, abdominal distention and abdominal pain, facts not observed in the placebo group. CONCLUSIONS: The results suggest that a dietary supplement with Agaricus sylvaticus fungus is capable of improving the life quality of patients with colorectal cancer in post-surgical phase.

Effects of dietary supplementation with medicinal fungus in fasting glycemia levels of patients with colorectal cancer: a randomized, double-blind, placebo-controlled clinical study.

OBJECTIVE: The objective of this study was to evaluate the effects of dietary supplementation with Agaricus sylvaticus medicinal fungus in fasting glycemia of post-surgery patients with colorectal cancer. SCOPE: Proctology Ambulatory of Federal District Base Hospital-Brazil. SUBJECTS: Fifty-six colorectal cancer patients in postsurgery phase, stadiums phase I, II and II, which followed specific criteria of inclusion and exclusion. INTERVENTIONS: All patients were randomized in two groups: supplemented with Agaricus sylvaticus fungus (30 mg/kg/day) and placebo, and were followed up for six months. Subjects were divided later on according to BMI--Body Mass Index, sex and stage. Three fasting glycemia evaluations were carried out throughout the treatment. RESULTS: Subjects presented BMI medium = 24.65 kg/m2 (57.1% women and 42.9% men). The placebo group (average age 59.14 +/- 12.95 years) had initial glycemia levels of 94.36 +/- 15.34 mg/dL, after three months 98.12 +/- 15.54 mg/dL (p = 0.03) and in the sixth month 98.52 +/- 9.03 mg/dL (p = 0.01). The supplemented group (average age of 56.34 +/- 15.53 years) had initial glycemia levels of 95.92 +/- 11.64 mg/dL, after three months 94.88 +/- 12.24 mg/dL (p = 0.65) and, in the sixth month, a significant reduction to 92.86 +/- 6.82 mg/dL (p = 0.01). CONCLUSION: The results suggest that the dietary supplementation with Agaricus sylvaticus medicinal fungus can significantly reduce fasting glycemia levels of colorectal cancer patients in post-surgery phase.

Metabolic and hematological effects of dietary supplementation with arginine on rats bearing ascitic Walker 256 tumor.

The notion of using supplementary quantities of arginine for nutritional support in patients with cancer has been evaluated not only as supplement intake of nitrogen substrate but also for its immunopharmacological effects capable of improving the patient's prognosis. The aim of the present study is to evaluate the effects of dietary supplementation with arginine on metastatic dissemination, amino acid metabolism, hematological functions of rats with Walker 256 ascitic tumor. Animals were inoculated intraperitoneally with approximately 4 million cells. Nutritional solutions containing 4 or 6% arginine or just a control diet without added arginine, were administered to the animals via esophagic gavages. The rate of metastasis was lower in animals supplemented with arginine at 4 and 6%. Amino acid metabolism was stimulated in tumor-bearing animals after receiving 4 or 6% arginine, demonstrated by significant increase of arginine, ornithine, citrulline, proline and histidine levels in the blood (p < or = 0.001) when compared to the control diet group. Anemia was less severe in tumor-bearing animals that received arginine supplementation. The findings suggest that arginine supplementation at 6% may have a beneficial effect on to the host, besides its pharmacological action.

Maillard's reaction in parenteral solutions supplemented with arginine

Arginine, as a basic amino acid, can alter the pH of a parenteral solution and consequently to interfere in the stability of other amino acids. The objective of this study was to analyze the chemical stability of amino acids in solutions for parenteral nutrition with arginine supplementation. Amino acids concentrations were determined using an amino acid analyzer in intervals of 12, 36, 72 hours, 7 and 28 days. Storage temperatures were -20 degrees C, 5 degrees C and 25 degrees C. A decrease was observed (p < 0.05) in the concentrations of threonine, methionine, isoleucine, leucine, proline and lysine on the 28th day of study, in the solutions kept at 25 degrees C. The side chains of threonine, methionine, isoleucine, leucine, proline and lysine have hydrophobic groups, which renders them less soluble in water when compared to amino acids that have polar side chains. The degradation of lysine was significant in the sample of parenteral nutrition supplemented with arginine, possibly due to the fact that the solution's pH was between 7.5 and 7.6, therefore facilitating the Maillard reaction between lysine and glucose.

Maillard's reaction in parenteral solutions supplemented with arginine.

Arginine, as a basic amino acid, can alter the pH of a parenteral solution and consequently to interfere in the stability of other amino acids. The objective of this study was to analyze the chemical stability of amino acids in solutions for parenteral nutrition with arginine supplementation. Amino acids concentrations were determined using an amino acid analyzer in intervals of 12, 36, 72 hours, 7 and 28 days. Storage temperatures were -20 degrees C, 5 degrees C and 25 degrees C. A decrease was observed (p < 0.05) in the concentrations of threonine, methionine, isoleucine, leucine, proline and lysine on the 28th day of study, in the solutions kept at 25 degrees C. The side chains of threonine, methionine, isoleucine, leucine, proline and lysine have hydrophobic groups, which renders them less soluble in water when compared to amino acids that have polar side chains. The degradation of lysine was significant in the sample of parenteral nutrition supplemented with arginine, possibly due to the fact that the solution's pH was between 7.5 and 7.6, therefore facilitating the Maillard reaction between lysine and glucose.

Efeitos farmacológicos da suplementaçao dietética com arginina em ratos com tumor sólido de walker 256 / Pharmacological effects of arginine supplementation in rats walker 256 solid tumor

Os efeitos da suplementaçao com arginina na dieta de portadores de cancer sao controversos. O objetivo deste trabalho é avaliar os efeitos da suplementacao dietética com arginina no crescimento tumoral, disseminaçao metastática, metabolismo de aminóacidos, alteraçoes hematológicas, tempo de sobrevida e peso corporal de ratos Wistar com tumor sólido de Walker 256. Foram administradas soluçoes por via gástrica, contendo arginina nas concentraçoes de 4 por cento, 6 por cento e dieta padrao (controle). A suplementacao com arginina inibiu a desseminaçao de células tumorais no modelo experimental, embora crescimento tumoral nao tenha sido afectado significantemente. O tempo de sobrevida dos animais com tumor sólido nao foi afetado de forma significativa. Foi observado disminuiçao significativa de peso corpóreo após a administraçao da arginina a 6 por cento (p<0.05). O metabolismo dos aminóacidos foi estimulado após ingestao de suplementos com arginina, evidenciado pelos aumentos significativos dos níveis sanguíneos de arginina, ornitina, citrulina, prolina e histidina quando comparados ao grupo controle (p<0.001). O grau de anemia no tumor sólido foi menos severo nos grupos que receberam suplementaçao com arginina, evidenciado através do hemograma (p<0.001) e da análise citológica. Os resultados sugerem que a suplementaçao dietética com arginina a 6 por cento apresentou algum efeito benéfico no tumor sólido de Walker 256 que ultrapassa o efeito nutricional

[Pharmacological effects of arginine supplementation in rats with Walker 256 solid tumor]. / Efeitos farmacológicos da suplementação dietética com arginina em ratos com tumor sólido de Walker 256.

The effects of diet arginine supplementation for those with cancer are controversial. We evaluate the effects of dietetic supplementation with arginine over body weight, growth of tumor, metastatic dissemination, surviving time, amino acid metabolism, haematological changes of the rats with Walker 256 solid tumor. Intragastrical solutions with arginine at 4% and 6%, a standard diet (control) were administered to the animals. The supplementation with arginine was associated with a lower weight gain during the study period (p < 0.05). Surviving time of the rats with solid tumor did not vary significantly between the groups. The rate of metastase was lower in animals with Walker 256 solid tumor supplemented with arginine. The amino acid metabolism was estimulate in the animals after arginine supplementation at 4% and 6%, demonstrated by significant increases in blood levels of arginine, ornitine, citruline, proline and histidine when compared to the control group. Anaemia was less severe in the rats with Walker 256 solid tumor that received arginine supplementation. The results suggest that arginine 6% supplementation may have pharmacologic effect in rats with Walker 256 solid beyond the nutritional one.

[Effects of dietetic supplementation with L-arginine in cancer patients. A review of the literature]. / Efeitos da suplementação dietética com L-arginina no paciente oncológico. Uma revisão de literatura.

It has been suggested that the administration of certain nutrients may improve the immune response of patients with cancer. Experimental studies have shown that deficiencies in specific amino acids have a worse effect on humoral immunity than they do on cell-mediated immunity because they impair antibody synthesis. Here, arginine plays a particularly important role, and research with several experimental and human tumor models to determine the therapeutic utility of this amino acid is under way. In this paper, we review current literature on the use of arginine as pharmacologic nutritional support for cancer patients. Dietary supplementation with arginine has been shown to benefit these patients by reducing the growth of transplantable tumors, the incidence of metastases, and the tumor-producing potential of carcinogens. However, results observed in humans have given rise to controversy regarding the optimal dosage of arginine supplementation and the types of cancer best treated with amino acids. Further prospective and randomized studies will be necessary in order to determine the proper utilization and the therapeutic benefits of such dietary supplementation.