Remote nutrition care during the first wave of COVID-19 pandemic: Did it impact nutrition therapy goals?

BACKGROUND AND AIMS: Nutrition societies recommended remote hospital nutrition care during the coronavirus disease 2019 (COVID-19) pandemic. However, the pandemic's impact on nutrition care quality is unknown. We aimed to evaluate the association between remote nutrition care during the first COVID-19 wave and the time to start and achieve the nutrition therapy (NT) goals of critically ill patients. METHODS: A cohort study was conducted in an intensive care unit (ICU) that assisted patients with COVID-19 between May 2020 and April 2021. The remote nutrition care lasted approximately 6 months, and dietitians prescribed the nutrition care based on medical records and daily telephone contact with nurses who were in direct contact with patients. Data were retrospectively collected, patients were grouped according to the nutrition care delivered (remote or in person), and we compared the time to start NT and achieve the nutrition goals. RESULTS: One hundred fifty-eight patients (61.5 ± 14.8 years, 57% male) were evaluated, and 54.4% received remote nutrition care. The median time to start NT was 1 (1-3) day and to achieve the nutrition goals was 4 (3-6) days for both groups. The percentage of energy and protein prescribed on day 7 of the ICU stay concerning the requirements did not differ between patients with remote and patients with in-person nutrition care [95.5% ± 20.4% × 92.1% ± 26.4% (energy) and 92.9% ± 21.9% × 86.9% ± 29.2% (protein); P > 0.05 for both analyses]. CONCLUSION: Remote nutrition care in patients critically ill with COVID-19 did not impact the time to start and achieve the NT goals.

Morphoanatomy, Histochemistry, and Phytochemistry of Stem and Leaves of Crateva tapia L.

Crateva tapia L. occurs only in Brazil and belongs to the family Capparaceae. This study aimed to characterize the morphoanatomy and histochemistry of stem and leaves, and phytochemical tests of the leaf of C. tapia. Macroscopic characterization was performed with the aid of a pachymeter and a stereomicroscope. Cross-sections of the stem, petiole, petiolule, and leaf blade, as well as paradermal sections of the leaf blade were mounted on microscope slides. Analyzes were carried out with optical microscopy. For histochemical analysis, different reagents were useda ccording to the targeted metabolite. Phytochemical tests of the methanolic extracts of the leaves were performed using thin layer chromatography. Crateva tapia has a stem with a circular cross-section and smooth bark. The leaves are alternate spirally, compound 3-foliolate. The leaf blade is elliptical and has a reticulate dictiodromous nerve. Through anatomical characterization, it was possible to identify a hypostomatic leaf blade with anisocytic, tetracytic, and anomocytic stomata and the presence of secretory canals. Through histochemistry and phytochemical tests, it was possible to observe the presence of different metabolites. Thus, the results obtained in this study contribute to the quality control of C. tapia, a species only found in Brazil, increasing the taxonomic knowledge of the family Capparaceae.

Semiochemical delivery systems based on natural polymers to attract sand flies (Diptera: Psychodidae).

BACKGROUND: The successful use of semiochemicals to attract insects to traps is based on research on the most suitable compounds and their release profiles over time. Based on the group's promising results, matrices with a more adequate release profile and more eco-friendly properties for the release of 1-hexanol were developed. To use a more suitable prototype in the field, the most promising systems were added to a capsule and evaluated in a wind tunnel. Behavioral experiments were performed using the sand fly species, Lutzomyia longipalpis, to evaluate the efficacy of the proposed system. METHODS: Different delivery systems were developed by varying the polymer (gellan gum and pectin) ratio, crosslinker (aluminum chloride) concentration, and glutaraldehyde removal.The delivery systems were loaded with 1-hexanol, and their release profiles were evaluated using gravimetric analysis under ambient and high-humidity conditions. When the matrix system was placed inside a plastic container, modulations in the active release profile were observed and the system could be reused. Actid attraction behaviors of the sand fly species, Lu. longipalpis, were evaluated in a wind tunnel when exposed to 1-hexanol-loaded release systems at different times. RESULTS: Among the four formulations evaluated, System 2 (gellan gum and pectin in a 1:1 ratio with 5% aluminum chloride) exhibited the most promising release profile, with greater uniformity and longer compound release time. The maximum 1-hexanol release uniformity was achieved over a longer time, mainly every 24 h, under both ambient and high-humidity conditions. System 2 can be reused at least once with the same structure. The wind tunnel trials exhibited efficient activation and attraction of Lu. longipalpis to 1-hexanol after 24, 48, and 72 h in System 2 placed inside the capsules. CONCLUSIONS: The polymeric matrix supplemented with 1-hexanol and introduced in plastic capsules showed promising results in attracting sand flies. This system can be used as a solution for other attractive compounds as well as in other applications where their release needs to be controlled or prolonged.

Does vitamin blends supplementation affect the animal performance, carcass traits, and nutrient digestibility of young Nellore finishing bulls?

OBJECTIVE: This study was realized to evaluate the effects of supplementation with blends of water and fat-soluble vitamins on animal performance and carcass traits of young Nellore bulls. METHODS: Forty-three Nellore bulls, with an initial weight of 261±27.3 kg and a mean age of 8±1.0 months, were used. Five animals were slaughtered at the beginning of the experiment (reference group), to determine the initial empty body weight of the bulls that remained in the experiment. The remaining 38 bulls were fed ad libitum and distributed in a completely randomized design in a 2×2 factorial scheme, with or without supplementation of water-soluble (B-blend+ or B-blend-) and fat-soluble (ADE+ or ADE-) vitamin blends. Diets were isonitrogenous (120 g of crude protein/kg dry matter [DM] of total mixed ration) and consisted of a roughage:concentrate rate of 30:70 based on total DM of diet. The experiment lasted 170 days, with 30 days of adaptation and 140 days for data collection. At the beginning and end of the experimental period, the bulls were weighed to determine the average daily gain. To estimate the apparent digestibility of nutrients and microbial efficiency, spot collections of feces and urine were performed for five consecutive days. RESULTS: DM, ashes, organic matter, crude protein, ethereal extract, neutral detergent fiber corrected for residual ash and residual nitrogenous, and N intake and apparent digestibility were not influenced by vitamin supplementation, but total digestible nutrients intake and non-fibrous carbohydrates digestibility were influenced by B complex vitamin supplementation. Nitrogen balance, microbial efficiency, and performance data were not influenced (p>0.05) by vitamin supplementation. CONCLUSION: Vitamin supplementation (a blend of water-soluble and fat-soluble vitamins or their combinations) does not influence the animal performance and carcass traits of young Nellore bulls.

Maternal dietary zinc status alters offspring female mammary gland development and response to acute 7,12-dimethylbenzanthracene insult.

We evaluated the effects of prenatal and postnatal dietary zinc (Zn) deficiency or supplementation on mammary gland morphology and on acute response to 7,12-dimethylbenzanthracene (DMBA) in pubertal female rats. On gestational day 10 (GD 10), rat dams were allocated randomly into three experimental groups of 10: a Zn-adequate diet group (ZnA) fed 35 mg Zn/kg chow, a Zn-deficient diet group (ZnD) fed 3 mg ZN/kg chow and a Zn-supplemented diet group (ZnS) fed 180 mg Zn/kg chow. After weaning, female offspring were fed the same diet as their dams until postnatal day 53 (PND 53). All animals received a single 50 mg/kg dose of DMBA on PND 51 and were euthanized on PND 53. Female ZnD offspring exhibited significantly less weight gain compared to the ZnA group and reduced mammary gland development compared to the ZnD and ZnA groups. By PND 53, the Ki-67 labeling index in mammary gland epithelial cells was significantly greater for the ZnS group than for the ZnA and ZnD groups. Apoptosis and ER-α indices did not differ among groups. The ZnD group exhibited significantly increased lipid hydroperoxide (LOOH) levels and decreased catalase and glutathione peroxidase (GSH-Px) activity compared to the ZnA and ZnS groups. The ZnS group exhibited significantly reduced superoxide dismutase (SOD) activity compared to the ZnA and ZnS groups. We observed atypical ductal hyperplasia in the mammary gland of female ZnS group offspring compared to the ZnA and ZnD groups and decreased expression of the Api5 and Ercc1 genes related to apoptosis inhibition and DNA damage repair, respectively. Both the Zn-deficient and Zn-supplemented diet exerted adverse effects on offspring mammary gland morphology and acute response to DMBA.

Effects of the addition of fatty acid from soybean oil sludge in recycled asphalt mixtures.

Recycling agents provide better additions of reclaimed asphalt pavement (RAP) in the production of new asphalt mixtures. Alternative and residual materials that have the potential as asphalt binder viscosity reducers have gained visibility in the field of paving due to the perspective of circular economy in recycled mixtures. Soybean oil sludge fatty acid is a material produced from soybean oil sludge, a waste generated in the soybean oil refining step. Thus, this paper investigated the physical, chemical, and rheological effects of the asphalt binder PG 64-XX modified by the fatty acid of soybean oil sludge in the contents of 6% and 7% by weight of the binder. The modified binder samples were submitted to penetration tests, softening point, rotational viscosity, performance grade (PG), before and after short-term aging (RTFO), and multiple stress creep and recovery (MSCR). A control asphalt mixture and recycled asphalt mixtures produced with 40% RAP and fatty acid-modified binders were subjected to tensile strength, induced moisture damage, resilient modulus, and fatigue life. A Student's t statistical test verified the significance of the data, as well as the estimation of production costs of these asphalt mixtures. The use of the fatty acid significantly reduced the stiffness and viscosity of the control asphalt binder, decreasing the mixing temperatures at 14 °C and 17 °C to 6% and 7%, respectively. Using higher fatty acid contents from soybean oil sludge significantly improved the performance of recycled mixtures in tensile strength, moisture damage, and fatigue life. The production cost of recycled asphalt mixtures was lower than that of the control mixture.

Quality appraisal of clinical nutrition practice guidelines for critically ill adult patients: a systematic review using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE-II) and AGREE-Recommendation Excellence (AGREE-REX).

Nutritional therapy should follow evidence-based practice, thus several societies regarding nutrition and critical care have developed specific Clinical Practice Guidelines (CPG). However, to be regarded as trustworthy, the quality of the CPG for critically ill patients and its recommendations need to be high. This systematic review aimed to appraise the methodology and recommendations of nutrition CPG for critically ill patients. We performed a systematic review (protocol number CRD42020184199) with literature search conducted on PubMed, Embase, Cochrane Library and other four specific databases of guidelines up to October 2021. Two reviewers, independently, assessed titles and abstracts and potentially eligible full-text reports to determine eligibility and subsequently four reviewers appraised the guidelines quality using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE-II) and AGREE-Recommendation Excellence (AGREE-REX). Ten CPG for nutrition in critically ill patients were identified. Only Academy of Nutrition and Dietetics and European Society of Intensive Care Medicine had a total acceptable quality and were recommended for daily practice according AGREE-II. None of the CPG recommendations had an overall quality score above 70 %, thus being classified as moderate quality according AGREE-REX. The methodological evaluation of the critically ill adult patient CPG revealed significant discrepancies and showed a need for improvement in its development and/or reporting. In addition, recommendations about nutrition care process presented a moderate quality.

Antimicrobial Activity of Silver and Gold Nanoparticles Prepared by Photoreduction Process with Leaves and Fruit Extracts of Plinia cauliflora and Punica granatum.

The increased number of resistant microbes generates a search for new antibiotic methods. Metallic nanoparticles have emerged as a new platform against several microorganisms. The nanoparticles can damage the bacteria membrane and DNA by oxidative stress. The photoreduction process is a clean and low-cost method for obtaining silver and gold nanoparticles. This work describes two original insights: (1) the use of extracts of leaves and fruits from a Brazilian plant Plinia cauliflora, compared with a well know plant Punica granatum, and (2) the use of phytochemicals as stabilizing agents in the photoreduction process. The prepared nanoparticles were characterized by UV-vis, FTIR, transmission electron microscopy, and Zeta potential. The antimicrobial activity of nanoparticles was obtained with Gram-negative and Gram-positive bacteria, particularly the pathogens Staphylococcus aureus ATCC 25923; Bacillus subtilis ATCC 6633; clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus faecalis; Escherichia coli ATCC 25922; Escherichia coli O44:H18 EAEC042 (clinical isolate); Klebsiella pneumoniae ATCC 700603, Salmonella Thiphymurium ATCC 10231; Pseudomonas aeruginosa ATCC 27853; and Candida albicans ATCC 10231. Excellent synthesis results were obtained. The AgNPs exhibited antimicrobial activities against Gram-negative and Gram-positive bacteria and yeast (80-100%), better than AuNPs (0-87.92%), and may have the potential to be used as antimicrobial agents.

Behavioral responses of sand fly Nyssomyia neivai (Psychodidae: Phlebotominae) to 1-hexanol and light.

BACKGROUND: The search for attractive baits that may facilitate the capture of haematophagous insects has been epidemiologically relevant. Sand flies use chemical cues in different phases of their life cycles to find carbohydrate meals, mates, blood meals and oviposition sites. Few studies have related the behaviours of sand flies with volatile compounds that can influence their life cycles. Previous studies in our laboratory have shown that 1-hexanol released on filter paper is a good attractant for the sand fly Nyssomyia neivai, which is suspected in the transmission of the aetiologic agent of American cutaneous leishmaniasis. METHODS: In this study, we developed two release systems to modulated 1-hexanol release: system 1 contained gellan gum and pectin (4:1 ratio), 3% aluminium chloride and 1% glutaraldehyde; system 2 contained: gellan gum and pectin (4:1 ratio) and 3% aluminium chloride. After addition of 1-hexanol to each release system, trials were performed in a wind tunnel with Ny. neivai males and females (unfed, blood-fed and gravid) to evaluate activation and attraction responses. RESULTS: Males and unfed females showed the same response pattern to the systems. For both systems, the males and unfed females of the sand flies showed an activation response up to 24 h. The number of responsive gravid females was lower than unfed females for both systems. The blood-fed females showed no responses in any of the release systems. CONCLUSIONS: Our findings indicate that the state of the females (unfed, fed and gravid) can interfere with the sand fly responses to volatile compounds. Additionally, both systems evaluated with the compound showed effectiveness for sand fly attraction.

Adaptability and stability of Coffea canephora to dynamic environments using the Bayesian approach.

The objective of this work was to use the Bayesian approach, modeling the interaction of coffee genotypes with the environment, using a bisegmented regression to identify stable and adapted genotypes. A group of 43 promising genotypes of Coffea canephora was chosen. The genotypes were arranged in a randomized block design with three replications of seven plants each. The experimental plot was harvested four years in the study period, according to the maturation cycle of each genotype. The proposed Bayesian methodology was implemented in the free program R using rstanarm and coda packages. It was possible to use previous information on coffee genotypes as prior information on parameter distributions of an Adaptability and Stability model, which allowed obtaining shorter credibility intervals and good evidence of low bias in the model by the determination coefficient. After fine adjustments in the approach, it was possible to make inferences about the significant GxE interaction and to discriminate the coffee genotypes regarding production, adaptability, and stability. This is still a new approach for perennials, and since it allows more accurate estimates it can be advantageous when planning breeding programs. The Z21 genotype is recommended to compose part of selected genetic material for highly technical farmers, as it responds very well to the favorable environment, being one of the most productive and with excellent stability.

Efficacy of Acupuncture on Quality of Life, Functional Performance, Dyspnea, and Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease: Protocol for a Randomized Clinical Trial.

Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by the presence of chronic airflow obstruction. Previous studies have evaluated the effect of acupuncture treatment (AT) in patients with COPD. Nevertheless, these studies show a great deal of heterogeneity in treatment protocols, having sample sizes that are too small to estimate and clarify effect size and heterogeneity in patients' baseline. The aim of this study is to evaluate the effectiveness of acupuncture on quality of life, functional performance, dyspnea, and pulmonary function in patients with COPD. As such, patients will go through the following three phases: Phase I-pretreatment: period of subject selection and inclusion in the protocol, with an interview and performance of exams and tests as follows: Mini-Cog, dual-energy X-ray absorptiometry, spirometry, the Patient-Generated Index, Saint George's Respiratory Questionnaire, the six-minute walk test, the London Chest Activity of Daily Living, and the COPD Assessment Test. Phase II-8 weeks of treatment, with AT 3 times a week, with two parallel groups: Group I-with 50 subjects-AT according to the recommended technical standards; Group II-with 50 subjects-Control, without acupuncture. Phase III-Continuation of AT for 8 weeks, maintaining the subjects in the previously allocated groups and following the same methodology.

Heteropterys tomentosa and Interactions with the Musculoskeletal System: Systematic Review / Heteropterys tomentosa e Interações com o Sistema Musculoesquelético: Revisão Sistemática

Abstract Although Brazil is a country with the greatest plant biodiversity, there are still shortcomings regarding phytotherapy studies and their practical application. In Brazil alone there are 65 plants with psychoactive principles, and Heteropterys tomentosa, from the ethnobotanical point of view, is one of the most famous plants in the Midwest region, it is known for its aphrodisiac, physical and mental invigorating and depurative properties. The objective of this review was to point out the number of scientific articles published about the benefits of using the plant H. aphrodisiac in interactions with the musculoskeletal system. A consultation was performed in 10 databases: Embase, Scopus, Pubmed, Livivo, Science Direct, Web of science, Cochrane, Koreamed, Lilacs and Clinical trials for the elaboration of a systematic review, for this there was no limitation of time, language or type of study. Results: the search described found 111 articles, all primary studies; of these only 5 original studies (4.5%) were included in the review. Positive adaptations were observed in bones, tendons, muscles and hormone release, which resulted in improvements in exercise time and load, delaying fatigue and increasing functional capacity. However, the scarcity of studies, pointed out several gaps, opening space for other works. (AU)

Resumo Embora o Brasil seja um país com a maior biodiversidade vegetal, ainda existem carências com relação a estudos fitoterápicos e sua aplicação prática. Só no Brasil existem 65 plantas com princípios psicoativos, e a Heteropterys tomentosa, no ponto de vista etnobotânico, é uma das plantas mais famosas da região Centro-Oeste, ela é conhecida por propriedades afrodisíacas, de revigorante físico e mental, e depurativa. O objetivo desta revisão foi apontar a quantidade de artigos científicos publicados sobre os benefícios da utilização da planta H. aphrodisiaca em interações com o sistema musculoesquelético. Foi realizada uma consulta em 10 bases de dados, sendo elas: Embase, Scopus, Pubmed, Livivo, Science Direct, Web of science, Cochrane, Koreamed, Lilacs e Clinical trials para a elaboração de uma revisão sistemática, para isso não houve limitação de tempo, de língua ou tipo de estudo. A busca descrita encontrou 111 artigos, sendo todos estudos primários; destes apenas 5 estudos originais (4,5%) foram incluídos na revisão. Foram observadas adaptações positivas em ossos, tendões, músculos e liberação hormonal, que acarretaram melhorias no tempo e carga de exercício, retardando a fadiga e aumentando a capacidade funcional. Contudo, a escassez de estudos, apontou diversas lacunas, abrindo espaço para outros trabalhos. (AU)

Estratégias para promoção da saúde e seus impactos na qualidade de vida de adultos hipertensos: revisão integrativa / Strategies for health promotion and their impact on the quality of life of hypertensive adults: integrative review

Resumo Introdução A promoção da saúde é uma prática que qualifica o cuidado e impacta positivamente a qualidade de vida, especialmente em indivíduos com hipertensão que requerem acompanhamento por toda a vida. Objetivo O presente estudo objetivou investigar as estratégias desenvolvidas para a promoção da saúde e seus impactos na qualidade de vida de adultos hipertensos. Método Foi realizada uma revisão integrativa por meio de consulta às bases de dados Lilacs, Medline, SciELO, Scopus e Web of Science. Foram incluídos artigos originais sobre práticas de promoção da saúde realizadas com adultos hipertensos, publicados nos últimos cinco anos, nos idiomas português, inglês ou espanhol e disponíveis na íntegra. Foram excluídas as pesquisas realizadas com grávidas, adolescentes e crianças hipertensas. Resultados Foram incluídos 12 artigos na revisão. As principais estratégias consistiram em práticas grupais, que consideraram o usuário como protagonista do cuidado. As atividades desenvolvidas se mostraram eficazes, pois promoveram a redução de níveis pressóricos, a adesão ao tratamento, a mudança no estilo de vida, a melhor percepção da qualidade de vida e o empoderamento dos adultos hipertensos. Conclusão As estratégias para a promoção da saúde são fundamentais para possibilitar aos adultos hipertensos a capacidade de analisar seu estado de saúde e tomar decisões para o planejamento e a manutenção do autocuidado.

Abstract Background Health promotion is a practice that qualifies care and positively impacts the quality of life, especially in individuals with hypertension who need lifelong monitoring. Objective This study aimed to investigate the strategies developed for health promotion and their impacts on the quality of life of hypertensive adults. Method An integrative review was carried out by consulting Lilacs, Medline, SciELO, Scopus and Web of Science databases. Original articles on health promotion practices conducted with hypertensive adults, published in the last five years, in Portuguese, English or Spanish, and available in full, were included. Researches with hypertensive pregnant women, adolescents and children were excluded. Results Twelve articles were included in the review. The main strategies consisted of group community interventions, which considered the user as protagonist of care. Activities developed proved to be effective, as they promoted the reduction of blood pressure levels, as well as adherence to treatment, change in lifestyle, better perception of quality of life and empowerment of hypertensive adults. Conclusion Strategies for health promotion are essential to enable hypertensive adults to analyze their health status and make decisions for planning and maintaining self-care.

Percepção de médica(o)s e enfermeira(o)s da Saúde da Família sobre o uso da auriculoterapia em problemas de Saúde Mental / Family Health doctors' and nurses' perceptions of the use of auriculotherapy for Mental Health problems / Percepción de médicos y enfermeros de la Salud de la Familia sobre el uso de auriculoterapia en problemas de Salud Mental

Técnicas não farmacológicas são consideradas cada vez mais importantes no cuidado aos Problemas de Saúde Mental (PSM). Exploramos a percepção de médicas(os) e enfermeiras(os) da Atenção Primária à Saúde (APS) do Distrito Sanitário Norte de Florianópolis/SC sobre o uso da auriculoterapia em PSM, via questionário on-line autoadministrado, qualiquantitativo. Os dados qualitativos receberam análise temática. Responderam aos questionários 44 profissionais (57% do total convidado). Das(os) respondentes, 57% das(os) enfermeiras(os) e 43% das(os) médicas(os) tinham formação em auriculoterapia e 93% a utilizavam e/ou indicavam para PSM. Foram referidos bons resultados clínicos com auriculoterapia em PSM comuns, sobretudo relacionados aos sintomas depressivos e ansiosos, incluindo insônia e dores associadas; além de contribuições positivas para o acolhimento, a humanização, a ampliação do cuidado e do autocuidado, e a redução de psicofármacos/medicalização. Na percepção das(os) participantes, a auriculoterapia é eficaz e útil no cuidado a PSM comuns na APS.(AU)

Non-pharmacological interventions are considered increasingly important in care for mental health problems (MHP). We explored the perceptions of primary care doctors and nurses working in the Norte de Florianópolis/SC health district regarding the use of auriculotherapy for MHP using a self-administered on-line qualitative and quantitative questionnaire. Thematic analysis was used to analyze the qualitative data. Forty-four professionals (57 per cent of the total number invited to participate) responded the questionnaire. Fifty-seven per cent of the nurses who responded the questionnaire and 43 per cent of the doctors had training in auriculotherapy and 93 per cent used and/or recommended the technique for MHP. The respondents reported good clinical results from the use of auriculotherapy for common MHP, especially those related to symptoms of depression and anxiety, including insomnia and associate pain; as well as positive contributions with regard to welcoming, humanization, expansion of care and self-care, and a reduction in the use of psychotropics/medicalization. According to the participants, auriculotherapy is an effective and useful technique in care for common MHP in primary health care.(AU)

Las técnicas no farmacológicas se consideran cada vez más importantes en el cuidado de los problemas de salud mental (PSM). Exploramos la percepción de médicas y médicos, así como de enfermeras y enfermeros de la Atención Primaria de la Salud (APS) del Distrito Sanitario Norte de Florianópolis (Estado de Santa Catarina) sobre el uso de la auriculoterapia en PSM, vía cuestionario on-line autoadministrado, cualicuantitativo. Los datos cualitativos pasaron por análisis temático. Respondieron 44 profesionales (el 57% del total invitado). De los respondedores, el 57% de las enfermeras o enfermeros y el 43% de las médicas o médicos tenían formación en auriculoterapia y el 93% la utilizaba o recomendaba para PSM. Se refirieron buenos resultados clínicos con auriculoterapia en PSM comunes, sobre todo relacionados a los síntomas depresivos y ansiosos, incluyendo insomnio y dolores relacionados, además de contribuciones positivas con relación a la acogida, humanización, ampliación del cuidado y autocuidado y reducción de psicofármacos/medicalización. Conforme la percepción de los participantes, la auriculoterapia es eficaz y útil en el cuidado de las PSM comunes en la APS.(AU)

Feed intake, nutrient digestibility, and selected rumen parameters in feedlot bulls fed diets with different feed additives.

An experiment was conducted to evaluate the feed intake, nutrient digestibility and selected rumen parameters in feedlot bulls fed diets containing different feed additives. Six rumen-cannulated Nellore bulls (age = 8 ± 1.0 months; initial BW = 225 ± 13.2 kg) were distributed in a 6 × 6 Latin square design. Six experimental diets based on 30% corn silage and 70% concentrate on a dry matter (DM) basis were evaluated. Diets differed in feed additive on a DM basis, as follows: 1.4% bicarbonate and magnesium oxide in 3:1 ratio (BOX); 36 ppm lasalocid sodium (LAS); 30 ppm monensin sodium (MON); 25 ppm virginiamycin (VIR); 30 ppm monensin sodium plus 25 ppm virginiamycin (MV); and 3.15% commercial mineral supplement containing D-limonene and exogenous α-amylase (EOA). The experiment lasted 144 d, with six periods of 24 d. Each period consisted of 14 d for dietary adaptation, 3 d for feces and urine collection, and 7 d for omasal and ruminal digesta collection. Bulls fed the BOX diet showed greater (P < 0.05) intake of DM, organic matter (OM), neutral detergent fiber (apNDF), crude protein (CP), and starch compared to the other diets. Diets with LAS, MON, VIR, MV, or EOA did not influence (P > 0.05) the DM, OM, apNDF, CP, or starch intake of feedlot bulls. Bulls fed the EOA diet showed greater (trend; P = 0.09) ruminal digestibility of starch compared to the other diets. The feed additives did not affect (P > 0.05) the intestinal or total tract digestibility of starch, rumen pH, microbial efficiency, total rumen fluid, dilution rate, rate of intake, rate of degradation, or passage rate of the DM, OM, apNDF, and starch. In conclusion, LAS, MON, VIR, MV, and EOA diets reduced nutrient intake compared to BOX. Although all feed additives presented similar effects on rumen pH, temperature, and kinetics the presence of exogenous α-amylase in the EOA diet may increase ruminal starch digestibility and apparent total tract digestibility of DM and OM.

Chemical composition and antiproliferative, antioxidant and trypanocidal activities of the fruits from Campomanesia xanthocarpa (Mart.) O. Berg (Myrtaceae).

Chemical investigation of the extracts of the fruits from Campomanesia xanthocarpa resulted in the isolation of six known compounds identified by NMR and comparison with literature data (2',4'-dihydroxy-5'-methyl-6'-methoxychalcone (1), 2',4'-dihydroxy-3',5'-dimethyl-6'-methoxychalcone (2), 2'-hydroxy-3'-methyl-4',6'-dimethoxychalcone (3), 2',6'-dihydroxy-3'-methyl-4'-methoxychalcone (4), 5-hydroxy-7-methoxy-8-methylflavanone (5) and 7-hydroxy-5-methoxy-6-methylflavanone (6)). The considerable antioxidant capacity of the extracts was demonstrated by ORAC-FL and DPPH tests. The antiproliferative assay of the extracts and 5 was done in vitro, against many different cancer cell lines besides a healthy one. The extracts presented low cytotoxicity and the substance demonstrated promising results against all the cancer cell lines tested, with IC50 values ranging from 4.75 to 45.81 µmol L-1. The in vitro trypanocidal activity was evaluated against the epimastigote form of the Y strain of Trypanosoma cruzi and an improvement in the activity of the substances 2 (221.81 µmol L-1) and 5 (61.87 µmol L-1) was observed regarding the values obtained for the extracts.

Decline of nutritional status in the first week of hospitalisation predicts longer length of stay and hospital readmission during 6-month follow-up.

Nutritional status (NS) monitoring is an essential step of the nutrition care process. To assess changes in NS throughout hospitalisation and its ability to predict clinical outcomes, a prospective cohort study with patients over 18 years of age was conducted. The Subjective Global Assessment (SGA) was performed within 48 h of admission and 7 d later. For each patient, decline in NS was assessed by two different methods: changes in SGA category and severe weight loss alone (≥2 % during the first week of hospitalisation). Patients were followed up until discharge to assess length of hospital stay (LOS) and in-hospital mortality and contacted 6 months post-discharge to assess hospital readmission and death. Out of the 601 patients assessed at admission, 299 remained hospitalised for at least 7 d; of those, 16·1 % had a decline in SGA category and 22·8 % had severe weight loss alone. In multivariable analysis, decline in SGA category was associated with 2-fold (95 % CI 1·06, 4·21) increased odds of prolonged LOS and 3·6 (95 % CI 1·05, 12·26) increased odds of hospital readmission at 6 months. Severe weight loss alone was associated with 2·5-increased odds (95 % CI 1·40, 4·64) of prolonged LOS. In conclusion, deterioration of NS was more often identified by severe weight loss than by decline in SGA category. While both methods were associated with prolonged LOS, only changes in the SGA predicted hospital readmission. These findings reinforce the importance of nutritional monitoring and provide guidance for further research to prevent short-term NS deterioration from being left undetected.

Calorie and protein delivery in critically ill surgical and non-surgical patients receiving enteral nutrition therapy

ABSTRACT Providing enteral nutritional therapy to critically ill patients is a challenge, especially during the first days after starting intensive care. These challenges appear to be greater in critically ill surgical patients. Objectives: Describe and compare enteral nutrition practices in critically ill surgical and non-surgical patients. Methods: We conducted a prospective cohort study of surgical and non-surgical patients receiving exclusive enteral nutritional therapy. The values for calorie and protein delivery during the first week after admission to the intensive care unit were recorded. Results: 103 patients were enrolled (54.4% male, mean age: 63.9 years, 26.2% surgical). The median time of initiation of enteral nutritional therapy was the third day in non-surgical and the fourth day in surgical patients. Surgical patients had a lower calorie and protein delivery than non-surgical patients on the second to fourth days after admission. At the end of the first week, 20.2% of the patients had not received any diet, and there was no significant difference in nutrient delivery between the groups. Of the surgical and non-surgical patients, 42.9% and 39.3% were receiving ≥20 kcal/kg/day, and 28.6% and 34.4% were receiving ≥1.2 g/kg of protein per day, respectively. Conclusion: There was a delay in starting patients on enteral nutritional therapy and calorie and protein delivery was low, especially among surgical patients. By the end of the first week, calorie and protein delivery was similar in both groups.

RESUMEN Proporcionar terapia nutricional enteral a pacientes críticos es un desafío, especialmente durante los primeros días después de comenzar los cuidados intensivos. Estos desafíos parecen ser mayores en pacientes quirúrgicos críticos. El propósito del estudio fue describir y comparar las prácticas de nutrición enteral en pacientes críticos quirúrgicos y no quirúrgicos. Se realizó un estudio de cohorte prospectivo de pacientes quirúrgicos y no quirúrgicos que recibieron terapia nutricional enteral exclusiva. Se registraron los datos de entrega de calorías y proteínas durante la primera semana después de la admisión a la unidad de cuidados intensivos. Se estudiaron 103 pacientes (54,4% hombres, edad media: 63,9 años, 26,2% quirúrgicos). La mediana de tiempo de inicio de la terapia nutricional enteral fue el tercer día en pacientes no quirúrgicos y el cuarto día en pacientes quirúrgicos. Los pacientes quirúrgicos tuvieron una entrega de calorías y proteínas más baja que los pacientes no quirúrgicos en el segundo a cuarto día después del ingreso. Al final de la primera semana, el 20,2% de los pacientes no habían recibido ningún aporte nutricional, y no hubo diferencias significativas en el suministro de nutrientes entre los grupos. De los pacientes quirúrgicos y no quirúrgicos, 42,9% y 39,3% estaban recibiendo ≥20 kcal/kg/día, y 28,6% y 34,4% estaban recibiendo ≥1,2 g/kg de proteína por día, respectivamente. Conclusiones: Hubo un retraso en el inicio de los pacientes en terapia nutricional enteral y la entrega de calorías y proteínas fue baja, especialmente entre los pacientes quirúrgicos. Al final de la primera semana, la entrega de calorías y proteínas fue similar en ambos grupos.

Dietary interventions and cognition of Alzheimer's disease patients: a systematic review of randomized controlled trial.

It is estimated that by 2030 there will be 82 million people in the world with dementia. OBJECTIVE: To evaluate the effect of dietary interventions on the cognitive performance of individuals with Alzheimer's disease (AD). METHODS: A systematic review of randomized controlled trials (RCT) was conducted in the Scopus, PubMed, and Cochrane databases. Thirty-two RCT were included. RESULTS: Omega-3 fatty acid showed positive effects at different doses. Fortasyn Connect seemed to be effective in the early stages of the disease. Probiotic, Ginseng, Inositol and specialized nutritional formulas seemed to have a positive effect on cognition. Most of the primary studies presented poor methodological quality, included patients with mild AD, small samples, and did not obtain significative results for all the cognitive outcomes. CONCLUSIONS: The effect of most dietary interventions on cognition in AD patients remains inconclusive, however, several nutrients, isolated or not, show potential to improve cognitive function in AD, especially in its early stages.

Estima-se que até 2030 haverá 82 milhões de pessoas no mundo com demência. OBJETIVO: Avaliar o efeito de intervenções dietéticas no desempenho cognitivo de indivíduos com DA. MÉTODOS: Foi realizada uma revisão sistemática de ensaios clínicos randomizados (ECR) nas bases de dados Scopus, PubMed e Cochrane. Trinta e dois ECRs foram incluídos. RESULTADOS: Ácidos graxos ômega-3 apresentaram efeitos positivos em diferentes doses. O Fortasyn Connect mostrou-se efetivo em estágios iniciais. Probióticos, Ginseng, Inositol e fórmulas nutricionais especializadas também demonstraram efeito positivo sobre a cognição. A maioria dos estudos primários apresentou baixa qualidade metodológica, incluiu pacientes com DA leve e amostras pequenas e não obteve resultados significativos para todos os desfechos cognitivos. CONCLUSÕES: O efeito da maioria das intervenções dietéticas em pacientes com DA permanece inconclusivo; entretanto, vários nutrientes, isolados ou não, apresentam potencial para melhorar a função cognitiva na DA, principalmente em seu estágio inicial.

Dietary interventions and cognition of Alzheimers disease patients: a systematic review of randomized controlled trial / Intervenções dietéticas e cognição em portadores de doença de Alzheimer: uma revisão sistemática de ensaios clínicos randomizados

ABSTRACT. It is estimated that by 2030 there will be 82 million people in the world with dementia. Objective: To evaluate the effect of dietary interventions on the cognitive performance of individuals with Alzheimer's disease (AD). Methods: A systematic review of randomized controlled trials (RCT) was conducted in the Scopus, PubMed, and Cochrane databases. Thirty-two RCT were included. Results: Omega-3 fatty acid showed positive effects at different doses. Fortasyn Connect seemed to be effective in the early stages of the disease. Probiotic, Ginseng, Inositol and specialized nutritional formulas seemed to have a positive effect on cognition. Most of the primary studies presented poor methodological quality, included patients with mild AD, small samples, and did not obtain significative results for all the cognitive outcomes. Conclusions: The effect of most dietary interventions on cognition in AD patients remains inconclusive, however, several nutrients, isolated or not, show potential to improve cognitive function in AD, especially in its early stages.

RESUMO. Estima-se que até 2030 haverá 82 milhões de pessoas no mundo com demência. Objetivo: Avaliar o efeito de intervenções dietéticas no desempenho cognitivo de indivíduos com DA. Métodos: Foi realizada uma revisão sistemática de ensaios clínicos randomizados (ECR) nas bases de dados Scopus, PubMed e Cochrane. Trinta e dois ECRs foram incluídos. Resultados: Ácidos graxos ômega-3 apresentaram efeitos positivos em diferentes doses. O Fortasyn Connect mostrou-se efetivo em estágios iniciais. Probióticos, Ginseng, Inositol e fórmulas nutricionais especializadas também demonstraram efeito positivo sobre a cognição. A maioria dos estudos primários apresentou baixa qualidade metodológica, incluiu pacientes com DA leve e amostras pequenas e não obteve resultados significativos para todos os desfechos cognitivos. Conclusões: O efeito da maioria das intervenções dietéticas em pacientes com DA permanece inconclusivo; entretanto, vários nutrientes, isolados ou não, apresentam potencial para melhorar a função cognitiva na DA, principalmente em seu estágio inicial.