Evaluación del soporte nutricional intensivo en pacientes con neumonía grave por COVID-19

RESUMEN Introducción: En los pacientes críticos con COVID-19 ocurren una serie de alteraciones metabólicas, las cuales afectan directamente el estado nutricional del paciente. Para mejorar la sobrevida de los pacientes con COVID-19, se hace relevante el tratamiento nutricional oportuno, idealmente dentro de las primeras 24-48 horas de la admisión a la UCI. El objetivo de este estudio fue reportar la evolución, desde el ingreso hasta el egreso, del balance nitrogenado, diversos parámetros bioquímicos y el estado nutricional de los pacientes con neumonía por COVID-19. Método: Estudio observacional retrospectivo de temporalidad longitudinal, se realizó en la UCI del Hospital Las Higueras de Talcahuano, Chile. Se incluyeron a 33 pacientes al ingreso y al egreso de la UCI. Resultados: Se reportó un incremento significativo del balance nitrogenado al egreso de los pacientes de UCI, sin embargo, no se registraron cambios en la media de talla, peso, IMC, prevalencia de desnutrición durante la estancia en la UCI. La prevalencia de desnutrición moderada y severa fue de un 14,0%, valor inferior al 45,0% informado en pacientes con COVID-19. Conclusión: En este estudio se reportó que la implementación del protocolo y la terapia nutricionales durante la pandemia de COVID-19 se asoció a un aumento del balance nitrogenado y un mejor control glicémico en los pacientes que egresan de la UCI por neumonía de COVID-19.

ABSTRACT Introduction: In critically ill patients with COVID-19, a series of metabolic alterations occur, which directly affect the patient's nutritional status. To improve the survival of patients with COVID-19, timely nutritional treatment is relevant, ideally within the first 24-48 hours of admission to the ICU. The objective of this study was to report the evolution, from admission to discharge, of the nitrogen balance, various biochemical parameters and the nutritional status of patients with COVID-19 pneumonia. Method: We conducted a retrospective observational study in the ICU of Las Higueras Hospital in Talcahuano, Chile. Thirty-three patients were included at admission and discharge from the ICU. Results: A significant increase in nitrogen balance was reported at ICU patient discharge, however, no changes were recorded in mean height, weight, BMI, or prevalence of malnutrition during ICU stay. The prevalence of moderate and severe malnutrition was 14.0%, a value lower than the 45.0% reported in patients with COVID-19. Discussion: In this study we reported that the implementation of the nutritional protocol and therapy during the COVID-19 pandemic was associated with an increase in nitrogen balance and better glycemic control in patients discharged from the ICU due to COVID-19 pneumonia.

Preservation of sugarcane silage with urea and calcium oxide: performance and metabolic efficiency of dairy cows / Conservación del ensilaje de caña de azúcar con urea y óxido de calcio: rendimiento y eficiencia metabólica en vacas lecheras / Preservação da silagem de cana-de-açúcar com ureia e óxido de cálcio: desempenho e eficiência metabólica de vacas leiteiras

Abstract Background: Inclusion of urea and calcium oxide (CaO) during sugarcane ensilage has been hypothesized to improve dairy cow performance. Objective: To evaluate the use of urea and calcium oxide as additives to preserve sugarcane silage quality and determine whether they improve dairy cow performance and metabolic efficiency. Methods: Four diets were used: sugarcane silage without additive (SS), sugarcane silage with 10 g/kg urea (SU), sugarcane silage with 5 g/kg urea + 5 g/kg CaO (SUC), and sugarcane silage with 10 g/kg CaO (SC). Eight crossbred cows at approximately 100 days of lactation were distributed in two 4x4 Latin squares, and their diets were formulated to reach an average milk production of 15 kg/day. Results: Dry matter, non-fibrous carbohydrates, organic matter, total carbohydrates, and total digestible nutrient intake were the highest (p<0.05) for the cows fed SC. Urinary excretion of nitrogen was higher (p<0.05) for cows fed diets based on SUC than those fed diets with SC. Milk urea nitrogen content was the highest (p<0.05) in animals fed SU diets. Nitrogen balance was positive in all treatments; however, the microbial protein synthesis was low for all diets. Conclusions: The diet with SU showed the highest nitrogen loss through the milk. Among the evaluated silages, those with SC and SUC are recommended to promote a high intake of nutritional components.

Resumen Antecedentes: La hipótesis fue que una dieta con combinación de urea y óxido de calcio (CaO) para el ensilaje de caña de azúcar, puede mejorar la producción de vacas lecheras cruzadas. Objetivo: Evaluar la urea y el óxido de calcio como aditivos para preservar la calidad del ensilaje de caña de azúcar y determinar si mejoran el rendimento y la eficiencia metabólica de vacas lecheras. Métodos: Cuatro dietas fueron utilizadas: ensilaje de caña de azúcar sin aditivo (SS), ensilaje de caña de azúcar con 10 g/kg de urea (SU), ensilaje de caña de azúcar con 5 g/kg de urea + 5 g/kg de CaO (SUC) y ensilaje de caña de azúcar con 10 g/kg de CaO (SC). Ocho vacas cruzadas fueron evaluadas con una producción media de leche de 15 kg/día y aproximadamente 100 días de lactación, distribuidas en dos cuadrados latinos 4x4. Resultados: El consumo de materia seca, carbohidratos no fibrosos, materia orgánica, carbohidratos totales y nutrientes digestibles totales fue mayor (p<0,05) cuando las vacas fueron alimentadas con dietas conteniendo SC. La excreción de nitrógeno en la orina fue mayor (p<0,05) cuando las vacas fueron alimentadas con dietas basadas en SUC que las alimentadas con dietas SC. El nitrógeno ureico de la leche fue mayor (p<0,05) en animales alimentados con dietas con SU. El balance de nitrógeno fue positivo en todos los tratamientos, sin embargo, la síntesis de proteína microbiana fue baja para todas las dietas. Conclusión: La dieta con SU presentó la mayor pérdida de nitrógeno por medio de la leche. Entre los ensilajes evaluados, aquellos con SC y SUC son recomendados por promover un mayor consumo de componentes nutricionales.

Resumo Antecedentes: A hipótese foi que uma dieta com a mistura de ureia e óxido de cálcio (CaO) para a ensilagem de cana de açúcar, poderia melhorar a produção de vacas leiteiras mestiças. Objetivo: Avaliar ureia e óxido de cálcio como aditivos para preservar a qualidade da silagem de cana de açúcar: melhoria da produção e eficiência metabólica de vacas leiteiras. Métodos: Quatro dietas foram utilizadas: silagem de cana de açúcar sem aditivo (SS), silagem de cana de açúcar com 10 g/kg de ureia (SU), silagem de cana de açúcar com 5 g/kg de ureia + 5 g/kg de CaO (SUC) e silagem de cana de açúcar com 10 g/kg de CaO (SC). Oito vacas mestiças foram avaliadas com uma produção media de 15 kg/dia e aproximadamente 100 dias de lactação, distribuídas em dois quadrados latinos 4x4. Resultados: O consumo de matéria seca, carboidratos não fibrosos, matéria orgânica, carboidratos totais e nutrientes digestíveis totais foi maior (p<0,05) quando as vacas foram alimentadas com dietas contendo SC. A excreção de nitrogênio na urina foi maior (p<0,05) quando as vacas foram alimentadas com dietas baseadas em SUC do que aqueles animais alimentados com dietas SC. O nitrogênio ureico do leite foi maior (p<0,05) em animais alimentados com dietas com SU. O balanço de nitrogênio foi positivo em todos os tratamentos, no entanto, a síntese de proteína microbiana foi baixa para todas as dietas. Conclusão: A dieta com SU apresentou maior perda de nitrogênio por meio do leite. Entre as silagens avaliadas, aquelas com SC e SUC são recomendadas por promover maior consumo de componentes nutricionais.

Nutritional, behavioral and performance parameters of F1 Holstein x Zebu cows at different lactation stages / [Parâmetros nutricionais, comportamento ingestivo e desempenho de vacas F1 Holandês x Zebu em diferentes estádios da lactação]

The objective of this study was to evaluate the different lactation stages of F1 Holstein x Zebu cows on intake and digestibility of nutrients, nitrogen use efficiency, feeding behavior and performance. Thirty-six F1 Holstein × Zebu cows with initial body weight (BW) of 482±43kg were used. The early, mid and late lactation stages were characterized after 50±13, 111.5±11.75 and 183.0±17.5 days in milk, respectively. A completely randomized design with three lactation stages and 12 cows in each treatment group was used. Dry matter intake (P=0.01) was higher in late lactation. Milk yield (P<0.01) was 24.17% higher in early lactation than in other stages. Body weight was lowest in mid-lactation cows (465.63kg; P<0.01). The feed efficiency was 23.36% higher in early lactation than in other stages (0.82kg of milk/kg of DM). F1 Holstein x Zebu cows have increased dry matter intake in late lactation. Milk yield and feed efficiency in early lactation were benefited by changes in feeding behavior, such as increased rumination time.(AU)

O objetivo deste estudo foi avaliar os diferentes estágios de lactação de vacas F1 Holandês x Zebu quanto ao consumo e à digestibilidade de nutrientes, à eficiência no uso de nitrogênio, ao comportamento ingestivo e ao desempenho. Trinta e seis vacas F1 Holandês × Zebu, com peso corporal inicial (PC) de 482±43kg, foram utilizadas. Os estágios inicial, médio e final da lactação foram caracterizados após 50±13, 111,5±11,75 e 183,0±17,5 dias de lactação, respectivamente. O arranjo experimental adotado foi o delineamento inteiramente ao acaso, com três fases de lactação e 12 vacas em cada grupo de tratamento. O consumo de matéria seca (P=0,01) foi maior no período final da lactação. Na fase inicial da lactação, a produção de leite (P<0,01) foi maior em 24,17% em comparação às demais fases. Na fase intermediária da lactação, as vacas apresentaram menor peso corporal (465,63kg; P<0,01) em relação às demais fases. A eficiência alimentar foi maior em 23,36% na fase inicial da lactação (0,82kg de leite/kg de MS). Vacas F1 Holandês x Zebu aumentam o consumo de matéria seca no período final da lactação. A produção de leite e a eficiência alimentar no início da lactação foram favorecidas por mudanças no comportamento ingestivo, como o aumento do tempo de ruminação.(AU)

Intake, nitrogen balance and microbial protein synthesis of steers fed with or without lipid addition / Consumo, balanço de nitrogênio e síntese de proteína microbiana de novilhos alimentados com ou sem adição de lipídios

This study investigated the influence of energy supplementation with or without the addition of lipids on microbial production, microbial synthesis efficiency and nitrogen balance. Eight fistulated steers were used with accessible rumens and kept in individual stalls. Their diets consisted of corn silage; corn silage + concentrate; corn silage + concentrate with addition of lipids in the form of soybean oil; and corn silage + concentrate with addition of lipids in the form of soybean grains. Estimates of microbial protein synthesis were obtained based on the urinary excretion of purine derivatives. The concentrations of ammonia in the rumen were determined immediately at 2, 4, 6 and 8 hours after feeding. The diets with concentrate increased (P<0.05) the microbial protein synthesis and the efficiency of the synthesis and nitrogen balance without a difference between the lipid sources (P>0.05). Concentrated diets presented higher concentrations of urea nitrogen in the serum and urinary urea excretion (P<0.05), but there was no difference between the lipid sources (P>0.05). Energy supplementation, with or without lipid addition, can be used as a strategy to increase the synthesis of the microbial protein in the cattle fed corn silage.

Este estudo investigou a influência da suplementação energética com ou sem adição de lipídios na produção microbiana, eficiência de síntese microbiana e balanço de nitrogênio. Oito novilhos fistulados foram utilizados com rúmen acessível e mantidos em baias individuais. Suas dietas consistiram de silagem de milho; silagem de milho + concentrado; silagem de milho + concentrado com adição de lipídios na forma de óleo de soja; e silagem de milho + concentrado com adição de lipídios na forma de grãos de soja. Estimativas de síntese de proteína microbiana foram obtidas com base na excreção urinária de derivados de purina. As concentrações de amônia no rúmen foram determinadas imediatamente às 2, 4, 6 e 8 horas após a alimentação. As dietas com concentrado aumentaram (P<0,05) a síntese de proteína microbiana e a eficiência da síntese e o balanço de nitrogênio sem diferença entre as fontes lipídicas (P>0,05). As dietas concentradas apresentaram maiores concentrações de nitrogênio uréico no soro e excreção urinária de uréia (P <0,05), mas não houve diferença entre as fontes lipídicas (P>0,05). A suplementação energética, com ou sem adição de lipídios, pode ser utilizada como estratégia para aumentar a síntese da proteína microbiana em bovinos alimentados com silagem de milho.

Resultados de la implementación de un protocolo de soporte nutricional en grandes quemados pediátricos internados en la Unidad de Cuidados Intensivos / Results of the implementation of a nutritional support protocol for major burn pediatric patients hospitalized in the Intensive Care Unit

Introducción: "Gran quemado" es quien sufre lesiones por daño térmico que afectan más del 30% de su superficie corporal (SC). El hipercatabolismo secundario causa pérdida de masa magra y retraso de la cicatrización de heridas. Objetivo: Describir y analizar los resultados de la implementación de un protocolo de soporte nutricional en niños quemados graves internados en una Unidad de Cuidados Intensivos durante las primeras 6 semanas evolutivas. Población y métodos: Diseño analítico, prospectivo, observacional y longitudinal. Se midieron peso, talla, porcentaje de SC quemada, días de internación en la Unidad de Cuidados Intensivos y mortalidad. Se analizaron tasa metabólica basal por calorimetría indirecta y fórmula de Schofield, cobertura de aporte energético y proteico, prealbúmina, proteína C reactiva, vitaminas A, D, E, cobre y zinc semanales. Resultados: Se incluyeron 18 pacientes (media: 3,9 años, 49% de SC quemada). Se alcanzó la media de objetivo energético en la segunda semana y el requerimiento proteico en la semana 6. Doce pacientes requirieron nutrición parenteral complementaria sin complicaciones. Se hallaron parámetros de hipermetabolismo, que se normalizaron a las 4-6 semanas del ingreso, excepto la proteína C reactiva. Las vitaminas A y E y elementos traza (zinc y cobre) estaban descendidos al ingreso con mejoría posterior. La vitamina D persistió en valores bajos. Un paciente falleció. Conclusiones: La implementación del protocolo permitió lograr el aporte de la totalidad del requerimiento energético; la cobertura del requerimiento proteico se postergó hasta la semana 6. Es necesario hacer hincapié en resolver las limitaciones para alcanzar este último.

Introduction. "Major burn" is used to describe a person who suffers thermal damage affecting more than 30% of his/her total body surface area (TBSA). The secondary hypercatabolism causes lean body mass loss and delayed wound healing. Objective. To describe and analyze the results of implementing a nutritional support protocol for pediatric burn patients hospitalized in the intensive care unit in the first 6 weeks. Population an d methods. Analytical, prospective, observational, and longitudinal design. Weight, height, %TBSA, length of stay in the intensive care unit, and mortality were measured. The basal metabolic rate was measured by indirect calorimetry and the Schofield equation, and protein and energy intake, prealbumin, C-reactive protein, vitamins A, D, E, copper, and zinc levels were analyzed every week. Results. Eighteen patients were included (mean: 3.9 years old, 49%TBSA). The mean energy target was achieved by week 2 and protein requirements were met by week 6. Twelve patients required complementary parenteral nutrition and there were no complications. Hypermetabolism parameters were observed, which returned to normal 4-6 weeks after hospitalization, except for C-reactive protein. Vitamins A and E and trace elements (zinc and copper) were reduced at the time of admission and showed a subsequent improvement. Vitamin D remained low. One patient died. Conclusions. Implementing the protocol was useful to cover the total energy requirement; the coverage of protein requirements was delayed until week 6. It is necessary to focus on solving limitations to achieve the latter.

Effect of stanozolol on the nitrogen balance,grip strength and clinical outcomes of critical patients with high nutrition risk / 重庆医学

Objective To investigate the effect of stanozolol on nitrogen balance ,grip strength and clinical outcomes of criti‐cal patients with high nutrition risk .Methods We enrolled patients who were admitted to the ICU of Guizhou provincial Hospital during the time period from January 2014 to June 2014 and ,as patients with high nutrition risk .Patients ,who received same base nutritional support program ,were divided into two groups .Treatment group who were treated with stanozolol administrated with gastric or jejunal tube for 7 days by 4 mg Tid .The control group whose members underwent placebo simultaneously with the treat‐ment group .The nitrogen balance ,grip strength of both groups was measured when at admitted and 4th as well as 7th day .Prealbu‐min ,total bilirubin ,alanine aminotransferase ,and aspartate aminotransferase were measured when at the same time and before leave hospital .The duration of the mechanical ventilation ,ICU stays ,hospital stays and mortality within 28 days were recorded .Results There was no statistical significance in the differences between all the indicators of the two groups at admission(P>0 .05) .The du‐ration of mechanical ventilation ,ICU stays ,hospital stays were decreased significantly in the treatment group (P0 .05) .Nitrogen bal‐ance ,prealbumin ,grip strength and liver function parameters in the treatment group were significantly higher than they were been at admitted and control group at 4th and 7th day (all P<0 .05) .Liver function parameters of treatment group gradually decreased to the normal range before discharge .Conclusion In critically ill patients treated with anabolic steroid stanozolol ,can promote protein synthesis ,reduce muscle and other lean tissue decomposition ,improve clinical symptoms ,short the length of hospital stay and ICU stay .But we should pay more attention on liver function in critically ill patients who treated with stanozolol .

Effect of compound amino acid 15-peptide 2 injection on levels of tumor markers in serum of postoperative patients with liver cancer surgery / 中国生化药物杂志

Objective To analysis effect of compound amino acid 15 peptide 2 on levels of tumor markers in serum of postoperative patients with liver cancer.Methods 42 postoperative patients who were diagnosed with liver cancer were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.The two groups of patients were given the corresponding parenteral nutrition therapy, after treatment, the serum tumor markers, T lymphocytes, liver function and nitrogen balance related indicators in all patients were detected.Results After treatment, compared with control group, the serum alpha fetal protein(AFP),carbohydrate antigen 19-9(CA19-9) and carcino embryonie antigen(CEA) levels were lower in the experimental group (P<0.05); the serum CD3 +T cells, CD4 +T cells and CD4 +/CD8 + ratio levels were lower in the experimental group (P<0.05); the serum alanine amino transferase (ALT), aspartate aminotransferase (AST) and total bilirubin(TBIL) levels were lower in the experimental group (P<0.05); the patients in the experimental group changed to positive nitrogen balance(P<0.05).Conclusion The diluted compound amino acid 15-2 injection for intravenous injection,can significantly reduce the level of serum tumor markers in patients with liver cancer, improve the immune function of patients, correct negative nitrogen balance, protect liver function.

Changes of the nitrogen balance in premature infants with extrauterine growth restriction / 中华临床营养杂志

Objective To observe changes of the nitrogen balance in premature infants with extrauterine growth restriction (EUGR) during hospitalization.Methods We selected a total of 64 very preterm (VP) infants admitted to Neonatal Medical Center of Huai'an Maternity and Child Healthcare Hospital affiliated to School of Medicine, Yangzhou University within 24 hours after birth and with gestational age ＜ 32 weeks from May to October 2014, and divided them into EUGR group (n =18) and non-EUGR group (n =46) according to the diagnostic criteria of EUGR.All of the infants' urea nitrogen levels were detected by Kjeldahl method on the 1st, 7th, 14th, and 28th days after birth, and nitrogen balance scores were calculated and compared between the EUGR and non-EUGR groups.Results Nitrogen balance scores of the two groups were all negative on the 1 st, 7th, 14th, and 28th days after birth, with a tendency rising with days.A significant difference was showed in the intra-group comparison in EUGR group on the 1st, 7th, 14th, and 28th days after birth (-492.66 ±204.39,-290.79 ± 173.78,-205.96 ± 180.59, and-145.14 ± 140.15, respectively, F =53.086, P =0.000), so was in the non-EUGR group (-383.41 ± 130.57,-278.91 ±225.80,-182.00 ± 144.70, and-61.08 ±49.71, respectively, F =41.745, P =0.000).At each observation time point after death, the nitrogen balance score in the EUGR group was lower than in the non-EUGR group, and the differences on the 1st and 28th days were statistically significant (both P ＜ 0.05);while those on the other time points were not statistically significant (both P ＞ 0.05).Conclusion The VP infants are at a negative nitrogen balance during hospitalization, among whom the EUGR premature infants may be more serious.

Nutritional parameters are associated with mortality in acute kidney injury

OBJECTIVE: The objective of this study was to perform a nutritional assessment of acute kidney injury patients and to identify the relationship between nutritional markers and outcomes. METHOD: This was a prospective and observational study. Patients who were hospitalized at the Hospital of Botucatu School of Medicine were evaluated between January 2009 and December 2011. We evaluated a total of 133 patients with a clinical diagnosis of acute kidney injury and a clinical presentation suggestive of acute tubular necrosis. We explored the associations between clinical, laboratory and nutritional markers and in-hospital mortality. Multivariable logistic regression was used to adjust for confounding and selection bias. RESULTS: Non-survivor patients were older (67±14 vs. 59±16 years) and exhibited a higher prevalence of sepsis (57.1 vs. 21.4%) and higher Acute Tubular Necrosis-Individual Severity Scores (0.60±0.22 vs. 0.41±0.21) than did survivor patients. Based on the multivariable analysis, laboratorial parameters such as blood urea nitrogen and C-reactive protein were associated with a higher risk of death (OR: 1.013, p = 0.0052; OR: 1.050, p = 0.01, respectively), and nutritional parameters such as low calorie intake, higher levels of edema, lower resistance based on bioelectrical impedance analysis and a more negative nitrogen balance were significantly associated with a higher risk of death (OR: 0.950, p = 0.01; OR: 1.138, p = 0.03; OR: 0.995, p = 0.03; OR: 0.934, p = 0.04, respectively). CONCLUSIONS: In acute kidney injury patients, a nutritional assessment seems to identify nutritional markers that are associated with outcome. In this study, a low caloric intake, higher C-reactive protein levels, the presence of edema, a lower resistance measured during a bioelectrical impedance analysis and a lower nitrogen balance were significantly associated ...

Descrição do potencial de retenção de nitrogênio em frangas de postura por diferentes metodologias: mínima retenção / Description of the potential for nitrogen retention in pullets by different methodologies: minimum retention

Objetivou-se com esta pesquisa descrever o potencial de retenção de nitrogênio por duas técnicas: abate comparativo e balanço de nitrogênio. Também se objetivou comparar os modelos ajustados para cada técnica e estimar as exigências de mantença para frangas de postura. Os ensaios foram realizados no período de 14 a 28, 56 a 70 e 98 a 112 dias de idade, utilizando 168 frangas. Os ensaios tiveram sete tratamentos e oito repetições. Os tratamentos consistiram de níveis de proteína variando de 75 a 435gkg-1 de matéria seca. As variáveis coletadas pelo abate comparativo foram nitrogênio ingerido e depositado e, pela técnica do balanço de nitrogênio, ingestão e excreção de nitrogênio. O intercepto da relação exponencial entre nitrogênio excretado e ingerido foi considerado a exigência de mantença. Os modelos ajustados foram comparados pelo teste da razão de máxima verossimilhança. As técnicas comparadas descreveram de forma diferente a exigência de mantença de nitrogênio. Para o abate comparativo, a exigência de mantença foi estimada em 342, 372 e 543mg/kgPC0,67 e para o balanço de nitrogênio foi de 342, 225 e 284mg/kgPC0,67, para os período de 14 a 28, 56 a 70 e 98 a 112 dias de idade, respectivamente.

The objectives of this study were to describe the potential for nitrogen retention by two techniques: comparative slaughter and nitrogen balance; compare the adjusted models for each technique and estimate the maintenance requirement for pullets. Assays were performed during 14 to 28, 56-70 and 98 to 112 days of age, using 168 pullets. The design was completely randomized with seven treatments and eight replications. Treatments consisted of protein levels ranging from 75 to 435gkg-1 of dry matter. The variables were collected by comparative slaughter and nitrogen ingested and deposited in nitrogen balance technique intake and nitrogen excretion. The intercept of the exponential relationship between ingested and excreted nitrogen was considered a requirement for maintenance. The adjusted models were compared by using the maximum likelihood ratio. The techniques described differently compared the requirement for maintenance of nitrogen. For comparative slaughter requiring maintenance was estimated at 342, 372 and 543mg/kgPC0,67 and for nitrogen balance was 342, 225 and 284mg/kgPC0,67 for the period of 14 to 28, 56-70 and 98 to 112 days of age, respectively.

Influence of early rapidly increased amino acid dosaging on nitrogen balance and growth in preterm infants / 中华临床营养杂志

Objective To explore the influence of early rapidly increased amino acid dosaging on the nitrogen balance and growth in preterm infants.Methods A total of 37 prematures admitted to our NICU within 24 hours after birth and with birth weight of 1 000 g to 1 800 g from November 2011 to January 2013 were randomly divided into study group (n =18) and control group (n =19).Parenteral nutrition (PE) was provided in both groups within 24 hours after birth.The starting amino acid dose was 1.5g/kg per day,then rose by 1 g/kg per day in study group and by 0.5 g/kg per day in control group,until to maximum of 3.5 g/kg per day.The dosage of lipids,glucose,and electrolytes in parenteral nutrition was provided routinely.The trial was double-blinded.Results In the first 5 days of PE,the nitrogen balance had no significant difference between these two groups (F =0.025,P =0.652) ; however,the time of regaining birth weight was significantly shorter in study group [(7.23±2.48) d] than in control group [(9.42±2.03) d] (t=-2.090,P=0.044).There were no differences between these two groups in trems of completely feeding time,weight gain rate,head circumference growth rate,length of hospital stay,and hospital costs (all P ＞ 0.05).Meanwhile,the rates of neonatal necrotizing enterocolitis,sepsis,mechanical ventilation administration,and damage of hepatic and renal function were also not significantly different.The administration of different dosages of amino acids did not affect the energy intake in both groups (F =1.893,P =0.218).Conclusions Prematures need early amino acid administration,with a starting dosage of more than 1.5 g/(kg · d).Rapid increase of amino acid dosing will not affect early nitrogen balance in premature infants; meanwhile,it contributes to weight gain without increasing the complications and hospitalization costs.

Protein requirements in healthy adults: a meta-analysis of nitrogen balance studies / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The goal of this study was to analyze protein requirements in healthy adults through a meta-analysis of nitrogen balance studies.</p><p><b>METHODS</b>A comprehensive search for nitrogen balance studies of healthy adults published up to October 2012 was performed, each study were reviewed, and data were abstracted. The studies were first evaluated for heterogeneity. The average protein requirements were analyzed by using the individual data of each included studies. Study site climate, age, sex, and dietary protein source were compared.</p><p><b>RESULTS</b>Data for 348 subjects were gathered from 28 nitrogen balance studies. The natural logarithm of requirement for 348 individuals had a normal distribution with a mean of 4.66. The estimated average requirement was the exponentiation of the mean of the log requirement, 105.64 mg N/kg•d. No significant differences between adult age, source of dietary protein were observed. But there was significant difference between sex and the climate of the study site (P<0.05).</p><p><b>CONCLUSION</b>The estimated average requirement and recommended nutrient intake of the healthy adult population was 105.64 mg N/kg•d (0.66 g high quality protein/kg•d) and 132.05 mg N/kg•d (0.83 g high quality protein/kg•d), respectively.</p>

Effect of sorghum tannins in sheep fed with high-concentrate diets / Efeito do tanino do sorgo em dietas de ovinos com alto concentrado

The aim of this study was to evaluate the nutritional value of three sorghum cultivars with different concentrations of condensed tannins in sheep diets. Six adult sheep (LW=56kg) with rumen and duodenal fistulas were assigned to experimental groups using two 3x3 Latin Square designs. The diets were formulated using three sorghum cultivars: LTC (low-tannin cultivar), MTC (medium-tannin cultivar) and HTC (high-tannin cultivar). Microbial nitrogen (MN) concentration in the duodenum was measured using a 15N trace technique. LTC, MTC and HTC diets presented values of 788, 722 and 747 (SE=20.6) g kg-1 for dry matter digestibility and 633, 535 and 530 (SE=35.8) g/kg for crude protein digestibility. The LTC diet was significantly different from the other diets (P<0.05). The nitrogen balance was 145.5, 94.8 and 83.8g kg-1 (SE=13.0) for LTC, MTC and HTC, respectively, with LTC showing greater nitrogen retention (P<0.05). Values obtained for MN in the digesta were 301, 364 and 469 (SE=30.6) g kg-1 for LTC, MTC and HTC, respectively, and there was no statistical difference (P>0.05) between the diets. The presence of condensed tannins in the sorghum interfered with the sheep's nitrogen retention; however, the microbial protein supply to the duodenum of the animals was not inhibited.

O objetivo do presente estudo foi avaliar o valor nutricional de três cultivares de sorgo com diferentes concentrações de tanino condensado em dietas de ovinos. Seis carneiros machos, adultos, castrados, canulados no rúmen e duodeno foram divididos em três grupos experimentais, em um delineamento em quadrado latino 3x3. Os tratamentos foram representados por três dietas experimentais contendo diferentes cultivares de grão de sorgo: LTC (cultivar com baixa concentração de tanino), MTC (cultivar com concentração média de tanino) e HTC (cultivar com concentração alta de tanino). As concentrações de nitrogênio de origem microbiana no duodeno (MN) foram mensuradas pela técnica de marcador isótopo estável 15N. As dietas LTC, MTC e HTC apresentaram valores de 788, 722 e 747g.kg-1 (EP=20,6) para a digestibilidade aparente da matéria seca e 633, 535 e 530g.kg-1 (EP=35,8) para a digestibilidade aparente da proteína bruta. A dieta LTC apresentou diferença significativa quando comparada às demais dietas para as avaliações de digestibilidade (P<0,05). Os valores encontrados para o balanço de nitrogênio foram de 145,5; 94,8 e 83,8g.kg-1 (EP=13,0) para LTC, MCT e LTC, respectivamente, sendo a dieta LTC a que apresentou maior retenção de nitrogênio (P<0,05). Os valores obtidos para MN na digesta foram de 301, 364 e 469 para LTC, MTC e HTC, respectivamente, e não apresentaram diferenças estatísticas (P>0,05). As diferentes concentrações de taninos condensados nos cultivares de sorgo resultaram em melhorias na digestibilidade e retenção de nitrogênio das dietas, entretanto o fluxo de proteína microbiana não foi inibido.

Descrição do potencial de retenção de nitrogênio em frangas de postura por diferentes metodologias: máxima deposição e estimativas da ingestão de metionina+cistina / Description of the potential for nitrogen retention in pullets by different methodologies: maximum deposition and estimates of intake of methionine+cystine

Objetivou-se descrever o máximo potencial de deposição de nitrogênio e estimar a ingestão de metionina+cistina pela técnica do balanço de nitrogênio e abate comparativo. Foram realizados ensaios no período de 14 a 28, 56 a 70 e 98 a 112 dias de idade, utilizando 168 frangas Dekalb White, distribuídas em sete tratamentos e oito repetições. Os tratamentos consistiram de níveis de proteína na dieta, variando de 75 a 435 g kg-1 de matéria seca, em que a metionina+cistina foi o primeiro aminoácido limitante. As variáveis coletadas pelo abate comparativo foram nitrogênio ingerido e depositado e, nos ensaios de balanço de nitrogênio, coletaram-se ingestão e excreção de nitrogênio. Por meio da relação exponencial entre ingestão e deposição de nitrogênio, determinou-se a máxima deposição de nitrogênio. As técnicas foram comparadas pelo teste da razão de máxima verossimilhança. As técnicas descrevem de forma diferente o máximo potencial de deposição pela ave, mas são similares na estimativa da exigência de metionina+cistina. Com base em 60% do máximo potencial, as ingestões de metionina+cistina digestível foram estimadas em 163, 243 e 343 mg dia-1 para os período de 14 a 28, 56 a 70 e 98 a 112 dias de idade, respectivamente.

This study aimed to describe the maximum potential of nitrogen deposition and to estimate the intake of methionine+cystine by nitrogen balance and comparative slaughter. Assays were performed in the periodsof 14 to 28, 56 to 70 and 98 to 112 days of age, using 168 Dekalb White pullets, distributed in seven treatments and eight replications. Treatments consisted of protein levels in the diets ranging from 75 to 435 g kg-1 dry matter in which methionine+cystine was the first limiting amino acid. The variables collected by comparative slaughter were nitrogen intake and deposition and, in nitrogen balance trials were collected nitrogen intake and excretion. With the exponential relationship between nitrogen intake and deposition was determined the maximum nitrogen deposition. The techniques were compared by the test of maximum likelihood ratio. The techniques described differently the maximum potential for deposition by the bird, but were similar in the estimation of methionine+cystine. Based on 60% of the maximum potential the intakes of digestible methionine+cystine were estimated at 163, 243 and 343mg day-1 for the period of 14 to 28, 56 to70 and 98 to 112 days of age, respectively.

Exigência de treonina digestível para codornas de corte no período de 15 a 35 dias de idade / Digestible threonine requirements for quail meat from 15 to 35 days of age

Estimou-se a exigência de treonina digestível (ThrD) para codornas de corte (Coturnix coturnix sp.) em fase de crescimento no período de 15 a 35 dias de idade. Foram utilizadas 1020 codornas com 15 dias de idade, não sexadas, distribuídas em um delineamento experimental inteiramente ao acaso, com seis porcentagens de adição de treonina digestível - 0,93; 1,00; 1,07; 1,14; 1,21 e 1,28% na dieta - , cinco repetições e 34 codornas por unidade experimental. Não houve efeito sobre o desempenho, o rendimento e a composição química da carcaça e sobre o balanço de nitrogênio com o aumento da porcentagem de treonina digestível na dieta. Houve aumento linear no consumo de treonina e no custo da ração por quilograma de peso vivo ganho com o aumento da porcentagem de treonina digestível. Concluiu-se que o melhor nível de treonina digestível avaliado foi suficiente para atender as exigências de codornas de corte, no período de 15 a 35 dias de idade.

The digestible threonine (DThr) requirements for meat quails (Coturnix coturnix sp) during growing phase from 15 to 35 days of age were estimated, using 1,020 quails with 15 days of age, of both sexes, distributed in a completely randomized design, with six levels of digestible threonine - 0.93; 1.00; 1.07; 1.14; 1.21 and 1.28% in diet, five replications and 34 quails per experimental unit. There was no effect on performance variables, carcass yield and chemical composition and nitrogen balance with the studied increase in digestible threonine levels. There was a linear increase in threonine intake andfeed cost per kilogram of body weight gain with increasing levels of digestible threonine. It was concluded that the best level of threonine evaluated was sufficient to meet the requirements of meat quails, in the period from 15 to 35.

Nitrogen mass balance in the Brazilian Amazon: an update / Balanço de massa do nitrogênio na Amazônia Brasileira: uma atualização

The main purpose of this study is to perform a nitrogen budget survey for the entire Brazilian Amazon region. The main inputs of nitrogen to the region are biological nitrogen fixation occurring in tropical forests (7.7 Tg.yr-1), and biological nitrogen fixation in agricultural lands mainly due to the cultivation of a large area with soybean, which is an important nitrogen-fixing crop (1.68 Tg.yr-1). The input due to the use of N fertilizers (0.48 Tg.yr-1) is still incipient compared to the other two inputs mentioned above. The major output flux is the riverine flux, equal to 2.80 Tg.yr-1 and export related to foodstuff, mainly the transport of soybean and beef to other parts of the country. The continuous population growth and high rate of urbanization may pose new threats to the nitrogen cycle of the region through the burning of fossil fuel and dumping of raw domestic sewage in rivers and streams of the region.

O principal objetivo deste estudo é realizar um balanço do nitrogênio em toda a Região Amazônica Brasileira. As principais entradas de nitrogênio na região foram a fixação biológica do nitrogênio que ocorre nas florestas tropicais (7,7 Tg.ano-1) e a fixação biológica do nitrogênio em terras agrícolas, que ocorre principalmente devido à existência de grandes áreas de cultivo de soja, uma importante cultura de fixação de nitrogênio (1,68 Tg.ano-1). A entrada em razão do uso de fertilizantes nitrogenados (0,48 Tg.ano-1) ainda é incipiente em comparação com aquelas duas outras entradas mencionadas. Os maiores fluxos de saída foram o fluxo fluvial, que foi igual a 2,80 Tg.ano-1, e a exportação relacionada aos gêneros alimentícios, principalmente a transferência de soja e carne para outras regiões do País. O contínuo crescimento populacional e as elevadas taxas de urbanização podem representar novas ameaças sobre o ciclo do nitrogênio da região por meio da queima de combustíveis fósseis e do despejo de esgoto doméstico nos rios e córregos da região.

Nitrogen mass balance in the Brazilian Amazon: an update

The main purpose of this study is to perform a nitrogen budget survey for the entire Brazilian Amazon region. The main inputs of nitrogen to the region are biological nitrogen fixation occurring in tropical forests (7.7 Tg.yr-1), and biological nitrogen fixation in agricultural lands mainly due to the cultivation of a large area with soybean, which is an important nitrogen-fixing crop (1.68 Tg.yr-1). The input due to the use of N fertilizers (0.48 Tg.yr-1) is still incipient compared to the other two inputs mentioned above. The major output flux is the riverine flux, equal to 2.80 Tg.yr-1 and export related to foodstuff, mainly the transport of soybean and beef to other parts of the country. The continuous population growth and high rate of urbanization may pose new threats to the nitrogen cycle of the region through the burning of fossil fuel and dumping of raw domestic sewage in rivers and streams of the region.

O principal objetivo deste estudo é realizar um balanço do nitrogênio em toda a Região Amazônica Brasileira. As principais entradas de nitrogênio na região foram a fixação biológica do nitrogênio que ocorre nas florestas tropicais (7,7 Tg.ano-1) e a fixação biológica do nitrogênio em terras agrícolas, que ocorre principalmente devido à existência de grandes áreas de cultivo de soja, uma importante cultura de fixação de nitrogênio (1,68 Tg.ano-1). A entrada em razão do uso de fertilizantes nitrogenados (0,48 Tg.ano-1) ainda é incipiente em comparação com aquelas duas outras entradas mencionadas. Os maiores fluxos de saída foram o fluxo fluvial, que foi igual a 2,80 Tg.ano-1, e a exportação relacionada aos gêneros alimentícios, principalmente a transferência de soja e carne para outras regiões do País. O contínuo crescimento populacional e as elevadas taxas de urbanização podem representar novas ameaças sobre o ciclo do nitrogênio da região por meio da queima de combustíveis fósseis e do despejo de esgoto doméstico nos rios e córregos da região.

Efeito da temperatura ambiente e da idade do frango sobre o valor energético do farelo de soja / Effects of environmental temperature and age of broilers on energy value of soybean meal

Foram utilizados 288 pintos de corte Cobb, distribuídos em delineamento experimental inteiramente ao acaso, em esquema de parcelas subdivididas no tempo, sendo as três temperaturas de criação - fria, termoneutra e quente - as parcelas, e as três fases de avaliação - inicial, crescimento e final - as subparcelas, com seis repetições de seis aves cada. A dieta-teste foi obtida pela substituição de parte da ração basal pelo alimento-teste: 40 por cento do farelo de soja + 60 por cento da ração basal. Foram calculados os coeficientes de metabolizabilidade aparente e verdadeiro da matéria seca, do nitrogênio, do extrato etéreo da dieta-teste e os valores de energia metabolizável aparente e verdadeira (EMA e EMV), e corrigidas pelo balanço de nitrogênio do farelo de soja (EMAn e EMVn). Foram encontrados valores médios de EMAn do farelo de soja para aves criadas em temperatura fria, termoneutra e quente de 2110, 2016 e 2022kcal/kg, respectivamente, e para as fases de criação inicial, crescimento e final de 1840, 2052 e 2256kcal/kg, respectivamente. O valor de energia metabolizável do farelo de soja, os balanços e os coeficientes de metabolizabilidade dos nutrientes da dieta-teste aumentaram com a idade do frango de corte, porém não são afetados pela temperatura ambiente.

Two hundred and eighty-eight Cobb chicks were distributed in a completely randomized design with a split-plot arrangement with six replication of six chicks each, the main plots were in three temperatures (cold, thermo neutral and hot) and the secondary plot were by phase (initial, growing and final). The test diet was produced by replacing the basal diet with test food: 40 percent soybean meal+60 percent basal diet. The coefficient of apparent and true metabolizability of dry matter, nitrogen, ether extract of the test diet and apparent and true metabolizable energies (AME and TME) of soybean meal were calculated and energy values were corrected for nitrogen balance (AMEn and TMEn) of soybean meal, in kcal/kg, as fed basis. The mean values of AMEn observed for broiler chicks in cold, thermo neutral and hot temperature were 2110, 2016 and 2022kcal/kg, respectively, and the initial, growing and final phases were 1840, 2052 and 2256kcal/kg, respectively. The metabolizable energy values of soybean meal, the balance and coefficients of metabolizability of the nutrients of the test diet increased with the age of broiler; however, they were not affected by environmental temperature.

Efeito da relação de calorias glicídicas/lipídicas da dieta sobre o balanço nitrogenado e composição corpórea de praticantes de musculação em treinamento / Effect of the dietary glycid/lipid calorie ratio on the nitrogen balance and body composition of bodybuilders

The aim of this study was to determine the effect of the carbohydrate/fat ratio on body composition, body weight, muscle mass and nitrogen retention in young bodybuilders. This was a prospective, randomized cross-over study with eleven voluntary males undergoing bodybuilding training. The volunteers were randomly divided in two groups; one receiving a dietary carbohydrate/fat ratio of 4.0 (D1) and the other one receiving a dietary carbohydrate/fat ratio of 8.0 (D2); both groups receiving a high-protein diet (1.5g protein/kg/d). Muscle mass, fat mass, nitrogen retention and biochemical analyses were assessed. Both diets promoted weight and fat mass gain and positive nitrogen retention. However, D2 showed a higher muscle mass gain. Thus,the higher carbohydrate/fat ratio resulted in a greater muscle mass gain.

El objetivo del estudio fue comparar los efectos dedos dietas isoproteicas e isocalóricas, con diversas proporciones de carbohidratos y lípidos, sobre la composición corporal y retención de nitrógeno en jóvenes practicantes de entrenamiento de fuerza. El estudio fue prospectivo, randomizado cruzado, con 11 culturistas jóvenes del sexo masculino. Fueron formados dos grupos diferenciados por recibir relación calorías glúcidos/lípidos de valor 4,0 (D1) o 8,0 (D2), ambos con dieta hiperproteica (1,5g/kg/d). Se evaluaron masa muscular, masa gorda, retención de nitrógeno y análisis bioquímico. Ambas dietas promovieron aumento de peso y de masa adiposa y el balance nitrogenado positivo, sin embargo, la dieta D2 provocó mayor aumento de masa muscular. Se concluye que la mayor relación calórica glúcidos/lípidos promovió un mayor aumento de masa muscular.

O objetivo do estudo foi comparar os efeitos de duas dietas isoproteica-isocalóricas diversificadas na proporção carboidratose lipídios sobre a composição corporal e retenção nitrogenada de jovens praticantes de treinamento de força. O estudo foi prospectivo, randomizado cruzado, com 11 culturistas jovens do sexo masculino. Foram formados dois grupos diferenciados por receberem relação calorias glicídicas/lipídicas de valor 4,0 (D1) ou 8,0 (D2), ambos com dieta hiperproteica (1,5g/kg/d). Massa muscular, massa gorda, retenção nitrogenada e análise bioquímica foram avaliadas. Ambas as dietas promoveram ganho de peso e massa adiposa e positivação do balanço nitrogenado, no entanto, a dieta D2 resultou em maior ganho de massa muscular. Conclui-se que a maior relação calórica glicídica/lipídica promoveu maior ganho de massa muscular.

Resposta de vacas leiteiras à substituição parcial de farelo de soja por ureia encapsulada / Response of lactating cows to the partial replacement of soybean meal by encapsulated urea

Avaliou-se a substituição parcial de farelo de soja na dieta-controle por ureia encapsulada ou por ureia, ambos acrescidos de polpa cítrica. Dezoito vacas foram alocadas a uma sequência de três tratamentos, em seis quadrados latinos 3x3, com períodos de 21 dias. O teor de proteína bruta nas dietas foi 15,5 por cento, cerca de 1,5 por cento oriundo de nitrogênio não proteico (NNP). O uso de NNP reduziu o consumo diário de matéria seca em 0,8kg (P=0,04), sem influenciar a produção de leite (31,5kg, P=0,98). A conversão do alimento em leite foi menor na dieta-controle (P<0,09). As fontes de NNP aumentaram o teor de N-ureico no plasma (NUP) duas horas após a alimentação da manhã (P=0,06). A frequência de NUP acima de 22,0mg/dL foi maior com ureia (P<0,01), similarmente ao observado para o teor e a secreção diária de N-ureico no leite (P<0,01). A substituição de farelo de soja por NNP e polpa cítrica melhorou a eficiência alimentar, sem afetar o balanço de nitrogênio.

The partial replacement of the soybean meal in the control diet for encapsulated urea or urea, both with added citrus pulp was evaluated. Eighteen Holstein cows were allocated to a sequence of the three treatments, in six 3x3 latin squares, with 21-day periods. The dietary level of crude protein was 15.5 percent, around 1.5 percent from non-protein nitrogen (NPN). The use of NPN reduced 0.8kg of daily dry matter intake (P=0.04), without affecting milk yield (31.5kg, P=0.98). The conversion of feed into milk decreased for the control diet (P<0.09). The NPN sources increased plasma urea-N (PUN) two hours after the morning feeding (P=0.06). The frequency of PUN above 22.0mg/dL was increased by urea (P<0.01), similarly to the observed for milk urea-N content and daily secretion (P<0.01). The replacement of soybean meal for NPN and citrus pulp improved feed efficiency, without affecting the nitrogen balance.