Effect of Agaricus sylvaticus supplementation on nutritional status and adverse events of chemotherapy of breast cancer: a randomized, placebo-controlled, double-blind clinical trial.

BACKGROUND: Breast cancer (BC) represents the highest incidence of malignancy in women throughout the world. Medicinal fungi can stimulate the body, reduce side-effects associated with chemotherapy and improve the quality of life in patients with cancer. AIM: To evaluate the effects of dietary supplementation of Agaricus sylvaticus on clinical and nutritional parameters in BC patients undergoing chemotherapy. MATERIALS AND METHODS: A randomized, placebo-controlled, double-blind, clinical trial was carried out at the Oncology Clinic, Hospital of the Federal District-Brazil from September 2007 to July 2009. Forty six patients with BC, Stage II and III, were randomly assigned to receive either nutritional supplement with A. sylvaticus (2.1 g/day) or placebo. Patients were evaluated during treatment period. RESULTS: Patient supplemented with A. sylvaticus improved in clinical parameters and gastrointestinal functions. Poor appetite decreased by 20% with no changes in bowel functions (92.8%), nausea and vomiting (80%). CONCLUSION: Dietary supplementation with A. sylvaticus improved nutritional status and reduced abnormal bowel functions, nausea, vomiting, and anorexia in patients with BC receiving chemotherapy.

Home enteral nutrition in children: a one-year experience with 184 patients in Distrito Federal, Brazil.

There is little published evidence concerning home enteral nutrition therapy in children. The present work attempts to analyze the profile of pediatric patients undergoing this therapy in the Federal District, Brazil. This is a retrospective study of data of all patients younger than 18 y old enrolled in the Home Enteral Nutrition Therapy Program of the Brazilian Public Health Department, Federal District, from January to December 2005. The study covered 184 children and adolescents. The patients' median age at the beginning of treatment was 2.00 y (Q1-Q3: 1.00-7.00). Pathologies leading to home enteral nutrition therapy were digestive disorders (54.9%), neuromuscular disorders (21.2%), epidermolysis bullosa congenital (7.1%), congenital malformation (5.0%), cardiac disorders (4.3%), malignancies (0.5%) and miscellaneous causes (7.0%). The prevalence of the therapy was 81.23. The oral route was used in 70.7% of cases. Enteral feeding comprised mainly industrial pediatric formulas (44.9%) and hydrolyzed-protein formulas (20%). This study supports the fact that home enteral nutrition is necessary in special pediatric conditions, favoring a precocious hospital discharge and then lowering the risk of infectious processes, and stimulating the reinsertion of children in their homes, their safe environment. The need for further studies still remain, especially ones in national basis, so as to reinforce the importance of a national regulation which would benefit all Brazilian pediatric patients in need of such therapy.

Demographic, epidemiological and nutritional profile of elders using home enteral nutritional therapy in Distrito Federal, Brazil.

According to statistical projections of the World Health Organization, during the period between 1950 and 2025, the group of elderly in Brazil will have increased 15 times. Chronic-degenerative diseases are the illnesses that most affect the elderly population, directly related to the growing demand for Enteral Nutrition Therapy. The objective of this study was to analyze the demographic, epidemiological and nutritional profile of elderly patients assisted at the public hospitals in the Home Enteral Nutrition Therapy Program, of the State Health Department of Distrito Federal. This is a retroprospective, cross-sectional and analytical study, based on primary data, which enrolled 141 elderly patients who were prescribed home enteral nutrition. The collected variables corresponded to age, gender, clinical diagnosis, enteral route and nutritional status at the beginning of Home Enteral Nutrition Therapy. The association between variables was analyzed through the t-Student and chi-square tests, with a significance level of 0.05 and a Confidence Interval (CI) of 95%. There was a higher number of female patients (53.9%) when compared to male (46.1%), average age 75.82 years old for both groups. The most prevalent diseases were cerebro-vascular accident sequels and cancer (42.6% and 22.7% respectively). It was observed a prevalence of malnutrition equal to 69.7%, independent of age and gender. The most used enteral route was the nasal. Though Brazilian policies concerning assistance to the elderly have advanced during the last few years, the need for public policies for nutritional recovery of such patients persists, to promote a better quality of life for them.

Inserção dos temas de humanidades e ética em curriculo médico integrado em escola pública no distrito federal, Brasil / Ethic and humanities themes insertion in medical integrate curriculum at public school of medicine in federal district of Brazil / Inserción de temas de humanidades y ética en currículo médico integrado de escuela pública en el distrito federal, Brasil

Objetivo: Realizar uma análise da inserção da ética e humanidades no currículo do Curso de Medicina da Escola Superior em Ciências da Saúde - ESCS, escola pública do Distrito Federal, Brasil, de forma a contribuir com o processo de gestão curricular. Metodologia: O Estudo é de coorte e documental. Foram pesquisados 37 termos relacionados à ética e 36 referentes à humanização nos objetivos educacionais e conteúdo dos módulos temáticos, habilidades e atitudes e interação ensino-serviço-comunidade, de 1a a 4a série e no programa do internato no currículo (ano 2006) e no projeto pedagógico do Curso de Medicina (2001). Resultados: Maior inserção da humanização, ética e bioética na 1a e 2a série, quando comparado à inserção na 3a e 4a série e no internato, (IC95 por cento-a=0,034, pvalue=0,007). Unidade de habilidades e atitudes: freqüência das 3 temáticas no currículo da 1a a 4a séries (IC95 por cento-a=0,026, pvalue=0,013). Quando comparada a inserção entre o internato e as quatro primeiras séries, observa-se que nestas a inserção da temática humanização é superior (IC95 por cento-a=0,042, pvalue=0,029). Conclusão: O currículo desenvolvido no ano de 2006 na ESCS apresentou correlação com o projeto pedagógico do curso e contemplou a temática de forma abrangente, em todas as séries e internato.

Objetivo: Realizar un análisis de la inserción de la ética y de las humanidades en el currículo del Curso de Medicina de la Escuela Superior en Ciencias de la Salud-ESCS, escuela pública del Distrito Federal, Brasil, para contribuir con el proceso de gestión curricular. Metodología: El estudio es de cohorte y documental. Se investigaron 37 términos relacionados con la ética y 36 referidos a la humanización en los objetivos educacionales y en el contenido de los módulos temáticos, habilidades, actitudes e interacción enseñanza-servicio-comunidad, de 1a a 4a serie, en el programa del internado del currículo (año 2006) y en el proyecto pedagógico del Curso de Medicina (2001). Resultados: Mayor inserción de la humanización, ética y bioética en la 1a y 2a serie, comparada con la inserción en la 3¬ y 4¬ serie y con el internado, (IC95 por ciento-#945; =0,034, pvalue=0,007). Unidad de habilidades y actitudes: frecuencia de las 3 temáticas en el currículo de 1a a 4a series (IC95 por ciento-#945; =0,026, pvalue=0,013). Cuando se compara la inserción entre el internado y las cuatro primeras series, se observa que en éstas la inserción de la temática humanización es superior (IC95 por ciento-#945; =0,042, pvalue=0,029). Conclusión: El currículo desarrollado en 2006 en ESCS presentó correlación con el proyecto pedagógico del curso y contempló la temática de forma abarcadora, en todas las series e internado.

Objective: To establish a diagnosis of the insertion of bioethics, ethics and humanistic values and attitudes to the program of the Medical School of ESCS - Escola Superior em Ciências da Saúde, public school of medicine, Distrito Federal, Brazil, in order to contribute to the process of curricular management. Methodology: The study is cohorte and documental. Thirty-two indicators to the thematic on ethics and twenty-four related to humanization were utilized. The educational purpose and contents of activities in modules such as thematic, abilities, interaction and attitude towards the community for teaching and services, from first to senior years as well as in boarding schools programs were all analyzed in the Medical School curriculum of ESCS (2006) and about the pedagogic project of the Course (2001). Results: It was observed a greater insertion of thematic related to ethics and bioethics in the initial levels of the course, Freshman and Sophomore including boarded students, when compared to the insertion in Junior and Senior clerkship years (IC95 percent-a=0,034, pvalue=0,007). The unit on abilities and attitudes was the axle which presented greater recurrence of the thematic on humanization in programs of 1a and 4a years (IC95 percent-a=0,026, pvalue=0,013). It was observed an increase in the recurrence of the thematic on humanization developed in thematic modules and interaction community-teaching/service in the 2a year and decline in the subsequent ones. The results were very low in the 3a and 4a years. When compared with the clerkship it was observed that the first four series had greater insertion of such thematic (IC95 percent-a=0,042, pvalue=0,029). Conclusion: The academic program developed in the year of 2006 at ESCS presented improvements when compared to the pedagogical project of the course.