Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention.

Phyllanthus niruri (P.niruri) or stone breaker is a plant commonly used to reduce stone risk, however, clinical studies on this issue are lacking. OBJECTIVE: To prospectively evaluate the effect of P. niruri on the urinary metabolic parameters of patients with urinary lithiasis. MATERIALS AND METHODS: We studied 56 patients with kidney stones <10mm. Clinical, metabolic, and ultrasonography assessment was conducted before (baseline) the use of P. niruri infusion for 12-weeks (P. niruri) and after a 12-week (wash out) Statistical analysis included ANOVA for repeated measures and Tukey's/McNemar´s test for categorical variables. Significance was set at 5%. RESULTS: Mean age was 44±9.2 and BMI was 27.2±4.4kg/m2. Thirty-six patients (64%) were women. There were no significant changes in all periods for anthropometric and several serum measurements, including total blood count, creatinine, uric acid, sodium, potassium, calcium, urine volume and pH; a significant increase in urinary potassium from 50.5±20.4 to 56.2±21.8 mg/24-hour (p=0.017); magnesium/creatinine ratio 58±22.5 to 69.1±28.6mg/ gCr24-hour (p=0.013) and potassium/creatinine ratio 39.3±15.1 to 51.3±34.7mg/gCr24- hour (p=0.008) from baseline to wash out. The kidney stones decreased from 3.2±2 to 2.0±2per patient (p<0.001). In hyperoxaluria patients, urinary oxalate reduced from 59.0±11.7 to 28.8±16.0mg/24-hour (p=0.0002), and in hyperuricosuria there was a decrease in urinary uric acid from 0.77±0.22 to 0.54±0.07mg/24-hour (p=0.0057). CONCLUSIONS: P.niruri intake is safe and does not cause significant adverse effects on serum metabolic parameters. It increases urinary excretion of magnesium and potassium caused a significant decrease in urinary oxalate and uric acid in patients with hyperoxaluria and hyperuricosuria. The consumption of P.niruri contributed to the elimination of urinary calculi.

Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention

ABSTRACT Phyllanthus niruri (P.niruri) or stone breaker is a plant commonly used to reduce stone risk, however, clinical studies on this issue are lacking. Objective: To prospectively evaluate the effect of P. niruri on the urinary metabolic parameters of patients with urinary lithiasis. Materials and Methods: We studied 56 patients with kidney stones <10mm. Clinical, metabolic, and ultrasonography assessment was conducted before (baseline) the use of P. niruri infusion for 12-weeks (P. niruri) and after a 12-week (wash out) Statistical analysis included ANOVA for repeated measures and Tukey's/McNemar's test for categorical variables. Significance was set at 5%. Results: Mean age was 44±9.2 and BMI was 27.2±4.4kg/m2. Thirty-six patients (64%) were women. There were no significant changes in all periods for anthropometric and several serum measurements, including total blood count, creatinine, uric acid, sodium, potassium, calcium, urine volume and pH; a significant increase in urinary potassium from 50.5±20.4 to 56.2±21.8 mg/24-hour (p=0.017); magnesium/creatinine ratio 58±22.5 to 69.1±28.6mg/gCr24-hour (p=0.013) and potassium/creatinine ratio 39.3±15.1 to 51.3±34.7mg/gCr24-hour (p=0.008) from baseline to wash out. The kidney stones decreased from 3.2±2 to 2.0±2per patient (p<0.001). In hyperoxaluria patients, urinary oxalate reduced from 59.0±11.7 to 28.8±16.0mg/24-hour (p=0.0002), and in hyperuricosuria there was a decrease in urinary uric acid from 0.77±0.22 to 0.54±0.07mg/24-hour (p=0.0057). Conclusions: P.niruri intake is safe and does not cause significant adverse effects on serum metabolic parameters. It increases urinary excretion of magnesium and potassium caused a significant decrease in urinary oxalate and uric acid in patients with hyperoxaluria and hyperuricosuria. The consumption of P.niruri contributed to the elimination of urinary calculi.

Informática na gestão de indicadores de assistência nutricional / Data management indicators in nutrition assistance / La informática en la gestión de los indicadores de asistencia nutricional

Objetivo: O estudo objetiva relatar a experiência da implantação de sistema informatizado na gestão da assistência nutricional. Metodologia: Descrever a criação do repositório de dados e construção dos indicadores de assistência nutricional e listar as melhorias alcançadas pela informatização. Resultados: A parametrização do sistema envolveu a criação do banco de dados da classificação do atendimento por níveis de assistência nutricional e critérios de visita de acompanhamento dos pacientes. Para análise crítica dos indicadores o sistema gera relatórios cujos dados são comparados às metas. As melhorias alcançadas foram: banco de dados livre de erros de operacionalização; garantia da autoria dos dados; análises por períodos e especialidades médicas; agilidade no processo de auditoria; facilidade e rapidez de acesso e manuseio de dados e economia com armazenamento físico. Conclusão: O relato revela como a informatização otimizou a análise, o controle e as decisões para a qualidade da assistência nutricional preconizada...

Objective: This study aims to report the implementation experience of a computerized system for a nutritional assistance management. Methods: We describe the criation of a data bank, developed a nutritional assistance indicators and listed the gains obtained by the computerization of the system. Results: The system parameterization involved the data bank creation for the service classification by levels of nutritional assistance and visiting criteria for patients attendance. For a critical analysis of the indicators, the system generates reports which data are compared with the goals. The improvements achieved were: a data bank free of operational errors; the guarantee of the authorship of data; analysis by period and medical specialties; auditing process readiness; ease and speed of access in data handling and decrease of physical space for data storage. Conclusion: this report reveals how the computerization optimized the analysis, control and decision making process of the quality of the preconized nutritional assistance...

Objetivo: Relatar la implementación de un sistema informatizado de gestión de asistencia nutricional. Metodología: Describir la creación del almacenaje de datos y la construcción de los indicadores de asistencia nutricional. Registrar las mejoras logradas con la informatización. Resultados: La parametrización del sistema abarcó la creación de base de datos para la clasificación de los niveles de asistencia nutricional y de los criterios de visita de seguimiento de pacientes. El sistema genera informes para análisis de los indicadores y compara los datos con las metas. Mejoras logradas: base de datos sin errores de operación; garantía de la autoría de los datos; análisis de resultados por períodos y especialidades médicas; agilidad en la auditoría; facilidad y rapidez de acceso y manejo de datos, ahorro en el almacenaje. Conclusión: Este informe muestra cómo la informatización optimizó el análisis, el control y las decisiones para asegurar una atención nutricional de calidad...

Repercussöes da atuaçäo profissional junto a gestantes de alto risco no período de internaçäo: um estudo exploratório / Multiprofessional repercussions of pregnants work with hight risk during hospitalization time: an explorated study

O objetivo deste trabalho foi o de avaliar as repercussöes da atuaçäo multiprofissional junto a gestantes de alto risco durante o período de internaçäo. Foram entrevistadas 27 pacientes internadas da Divisäo de Clínica Obstetrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo que participaram de grupos terapeuticos coordenados por enfermeira, nutricionista e psicóloga. Os dados obtidos apontam a importância do grupo para as pacientes tanto no que se refere ao aspecto informativo como emocional. Os temas abordados favorecem a compreensäo e o esclarecimento de informaçöes e a elaboraçäo de conflitos associados a situaçäo de internaçäo, o que propicia a assitencia integral e integrada a paciente