Brazilian Guidelines for Nutrition in Cystic Fibrosis.

OBJECTIVE: To develop a scientific consensus on nutrition in cystic fibrosis. METHODS: Sixteen coordinators elaborated relevant questions on nutritional therapy in cystic fibrosis, which were divided into six sections: nutritional assessment, nutritional recommendations, nutritional intervention, dietary counseling, special situations and enzyme replacement, and gastrointestinal manifestations. Two to three specialists in the field were responsible for each section and obtaining answers formulated based on standardized bibliographic searches. The available literature was searched in the PubMed®/MEDLINE database, after training and standardization of search strategies, to write the best level of evidence for the questions elaborated. Issues related to disagreement were discussed until a consensus was reached among specialists, based on the current scientific literature. RESULTS: Forty-two questions were prepared and objectively answered, resulting in a consensus of nutritional therapy in cystic fibrosis. CONCLUSION: This work enabled establishing a scientific consensus for nutritional treatment of cystic fibrosis patients.

Brazilian Guidelines for Nutrition in Cystic Fibrosis

ABSTRACT Objective To develop a scientific consensus on nutrition in cystic fibrosis. Methods Sixteen coordinators elaborated relevant questions on nutritional therapy in cystic fibrosis, which were divided into six sections: nutritional assessment, nutritional recommendations, nutritional intervention, dietary counseling, special situations and enzyme replacement, and gastrointestinal manifestations. Two to three specialists in the field were responsible for each section and obtaining answers formulated based on standardized bibliographic searches. The available literature was searched in the PubMed®/MEDLINE database, after training and standardization of search strategies, to write the best level of evidence for the questions elaborated. Issues related to disagreement were discussed until a consensus was reached among specialists, based on the current scientific literature. Results Forty-two questions were prepared and objectively answered, resulting in a consensus of nutritional therapy in cystic fibrosis. Conclusion This work enabled establishing a scientific consensus for nutritional treatment of cystic fibrosis patients.

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: children and adolescents.

The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Children and Adolescents was developed by dietitians, physicians, and pediatric hematologists from 10 Brazilian reference centers in hematopoietic stem cell transplantation. The aim was to emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to patient´s nutritional assessment. This consensus is intended to improve and standardize nutrition therapy during hematopoietic stem cell transplantation. The consensus was approved by the Brazilian Society of Bone Marrow Transplantation.

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: children and adolescents / Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: crianças e adolescentes

ABSTRACT The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Children and Adolescents was developed by dietitians, physicians, and pediatric hematologists from 10 Brazilian reference centers in hematopoietic stem cell transplantation. The aim was to emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to patient´s nutritional assessment. This consensus is intended to improve and standardize nutrition therapy during hematopoietic stem cell transplantation. The consensus was approved by the Brazilian Society of Bone Marrow Transplantation.

RESUMO O Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: crianças e adolescentes foi elaborado com a participação de nutricionistas, médicos nutrólogos e médicos hematologistas pediátricos de 10 centros brasileiros que são referência em transplante de células-tronco hematopoiéticas. O objetivo foi salientar a importância do estado nutricional e da composição corporal durante o tratamento, bem como as principais características relacionadas à avaliação nutricional do paciente. As intenções, ao se estabelecer o consenso, foram aprimorar e padronizar a terapia nutricional durante o transplante de células-tronco hematopoiéticas. O consenso foi aprovado pela Sociedade Brasileira de Transplante de Médula Óssea.

Hepatic and thymic alterations in newborn offspring of malnourished rat dams.

BACKGROUND: Protein-energy malnutrition encompasses a group of conditions resulting from a lack of both protein and calories. It affects immune function and the gastrointestinal tract. Animal model studies of the effect of malnutrition during pregnancy and lactation have shown changes in the body weight of dams, with consequences for the pups. METHODS: Sixty healthy adult Wistar rats were mated for breeding. Pregnant dams (n = 19) were separated and randomly divided into 2 groups: normally nourished (NG; n = 10) and malnourished (MG; n = 9). The authors measured the average amount of feed eaten by the dams in the NG group in 24 hours and offered half this amount to the MG dams until delivery, after which both groups had an adequate amount of feed. Offspring were killed after birth and after lactation. Morphometric liver parameters were measured, and the tissue microarray method was performed manually to carry out histopathological and immunohistochemical analysis of thymuses from the offspring. RESULTS: Body weight, body length, and intestine length measured after birth were statistically lower (P < .05) in the MG group offspring than in the NG group offspring but recovered after lactation. Histological comparison of pups' livers revealed minimal differences. However, morphometric evaluation showed significant differences. Slides exposed to antivimentin and anti-CD45 RO stained positively in both groups, but the samples from the NG group were more heavily stained. CONCLUSIONS: Malnutrition in dams causes alterations in the liver, thymus, and other internal organs of newborn offspring. Significant changes in thymuses were found using human monoclonal antibodies that cross-react with rat proteins, a novel finding in the literature.

Desnutricão intra-uterina e suas alteracões no intestino delgado de ratos Wistar ao nascimento e após a lactacão / In-uterus malnutrition and its changes in the small bowel of Wistar rats at birth and after lactation

INTRODUÇAO: Os efeitos da desnutricão intra-uterina dependem da fase de desenvolvimento em que está o feto ou o órgão, sendo tanto mais intensos e permanentes quanto mais precocemente ocorrer e mais tarde se iniciar a recuperacão nutricional. OBJETIVOS: Avaliar alteracões no intestino delgado diante da desnutricão intra-uterina e após a lactacão em filhotes de ratas Wistar submetidas à restricão dietética na gestacão e comparar com o grupo controle. MATERIAL E MÉTODOS: As ratas prenhes foram divididas em dois grupos; o grupo controle recebeu dieta ad libitum enquanto o grupo com restricão alimentar recebeu 50 por cento dessa dieta. Ao nascimento as ninhadas foram avaliadas quanto ao número de filhotes e ao peso. Os filhotes foram sacrificados em até 24 horas após o nascimento e avaliados individualmente. Na morfometria do intestino delgado estudou-se: altura total da mucosa, altura da vilosidade, espessura da vilosidade e altura do enterócito. Após a lactacão as mesmas medidas foram realizadas e comparadas entre os grupos. RESULTADOS: Ao nascimento, o peso individual, o comprimento do corpo e o do intestino foram menores no grupo com restricão alimentar. Tais resultados mantiveram-se após a lactacão, exceto o comprimento do corpo, que se mostrou semelhante nos dois grupos. A morfometria observou-se, após o nascimento, que todas as variáveis estudadas foram significativamente menores no grupo de filhotes de mães com restricão alimentar. Após a lactacão houve recuperacão da espessura da vilosidade, porém as demais variáveis permaneceram menores. DISCUSSAO E CONCLUSÕES: A restricão de 50 por cento da dieta materna durante a gestacão leva a baixo ganho de peso e produz conceptos menores, com menor comprimento do intestino em relacão a grupo controle e morfometria microscópica revelando medidas menores estatisticamente significativas. A maioria dessas alteracões se mantém após a lactacão e apresenta uma correlacão positiva com o peso dos animais.

In utero malnutrition influences wound healing of newborn rats as measured by tensile strength and collagen deposition.

BACKGROUND: Studies have investigated the consequences of intrauterine malnutrition on birth weight and overall survival but not on wound healing. This study aims to assess the influence of in utero malnutrition on wound healing of newborn rats. METHODS: Pregnant Wistar rats were divided into 2 groups. Study rats were given 50% of the food intake of controls throughout pregnancy in a pair-fed manner. The body weight and length of the newborns were measured. Newborns were breast-fed until day 21, when a laparotomy was performed. The effect of the laparotomy was assessed by measure of the wound strength and collagen deposition at postoperative day (POD) 7 (n = 15) and POD 21 (n = 15). RESULTS: The body weight and length of newborns of malnourished mothers were significantly smaller at birth compared with controls (respectively, 4.5 +/- 0.1 g vs 5.8 +/- 0.1 g, p = .0003 and 4.6 +/- 0.1 cm vs 5.2 +/- 0.1 cm, p = .0003). Maximum, rupture, and tensile strength of malnourished newborns were smaller than controls on POD 7 (0.281 +/- 0.031 vs 0.470 +/- 0.031, p = .0061, 0.112 +/- 0.06 kgf vs 0.173 +/- 0.08 kgf, p = .0495 and 0.019 +/- 0.002 kgf/mm2 vs 0.024 +/- 0.003 kgf/mm2, p = .050, respectively). On POD 21, only tensile strength remained lower (0.044 +/- 0.003 kgf/mm2 vs 0.058 +/- 0.003 kgf/mm2, p = .0477). Type I collagen deposition of malnourished newborns was similar to controls on POD 7 (57.69 +/- 10.06 vs 48.34 +/- 15.65, p = .3187) and on POD 21 (75.6 +/- 7.21 vs 80.0 +/- 9.92, p = .4212). CONCLUSIONS: In utero malnutrition decreases the abdominal wound strength of newborn rats but not the collagen deposition, suggesting that breast-feeding nutrition is effective in recovering the collagen deposition but not overall wound strength.