Chagasic megacolon and proximal jejunum microbiota.

BACKGROUND: Among other factors, control of jejunal microflora depends on intestinal emptiness, and it can be impaired by Chagas disease. This study was developed to identify the microecology of the proximal jejunum in chagasic megacolon. Our objective was to characterize both the jejunal microbial stasis before surgery and the microflora after surgical treatment in patients with chagasic megacolon. METHODS: The intestinal fluids were collected, and the proximal jejunum microflora was analyzed. RESULTS: Preoperative microflora had shown an increase in bacteria compatible with bacterial overgrowth syndrome, mainly facultative and strict anaerobes microorganisms and fungi. The microflora had changed in the postoperative period in 83% of these patients, with significant decrease in the number of transient microorganisms. CONCLUSIONS: Chagasic megacolon was related to an increase in jejunal microflora. By removing the impairment of the colon there was a transient decrease in the proximal jejunum microflora.

[Enteral feeding of hospitalized neurologic patients: analysis of complications and nutritional results]. / Dieta enteral em pacientes neurológicos hospitalizados: análise das complicações e dos resultados nutricionais.

Patients with severe neurologic diseases submitted to enteral tube feeding were analyzed for four weeks. Initial and weekly assessment was done by laboratory and anthropometric data. Caloric requirements were calculated by the Harris-Benedict equation corrected for stress factors. The diet used provided 151 calories per gram of nitrogen, consisting of egg albumin, soy protein, maltodextrin, soy oil, medium-chain triglycerides, vitamin supplement, and mineral salts. Starting on the second week, there was a statistically significant correlation between caloric intake and caloric needs. In the same period, maintenance of lab parameters, worsening of the arm muscle circumference, and a trend to a positive nitrogen balance were observed. Diarrhea occurred in 14.5% of the patients. Enteral nutrition support for neurologic patients can be considered effective in the maintenance of the nutritional status. Careful daily monitoring is mandatory.