ABSTRACT
Resumen Introducción: las dificultades en la comprensión de las indicaciones sobre las dietas de textura modificada según la severidad de la disfagia por parte de pacientes y sus cuidadores, influyen negativamente en la adherencia y aumentan la morbimortalidad de los pacientes. La explicación escrita o verbal, no sería suficiente requiriendo recursos adicionales basados en imágenes y/o la realización de demostraciones prácticas. Por lo mencionado, se diseñó el instrumento audiovisual NutriDis®. Objetivos: determinar la validez aparente, de contenido y la factibilidad de un instrumento audiovisual basado en los descriptores de la "International Dysphagia Diet Standardisation Initiative" (IDDSI). Materiales y método: se utilizó la técnica Delphi por juicio de expertos, incluyendo a nutricionistas, kinesiólogos y fonoaudiólogos. En la primera ronda participaron 19 expertos y 9 en la segunda. Se determinó el grado de acuerdo entre éstos, a través del coeficiente V de Aiken para cada nivel de IDDSI y a nivel global. Resultados: el instrumento resultó presentar validez de contenido y el grado de acuerdo global aumentó entre la primera y la segunda ronda desde 90,8 a 94,1%, clasificándose como adecuado. El nivel IDDSI 4 presentó el máximo acuerdo e IDDSI 1 el menor. Conclusiones: según la opinión de expertos en el área, la herramienta audiovisual NutriDis®, presentó una validez de contenido adecuada en promedio y calificado globalmente como excelente por la mayoría. Se destaca que el instrumento es inédito, representando un gran desafío su desarrollo.
Abstract Introduction: patients and caregivers find it difficult to understand the indications of modified texture diets following dysphagia severity, and this negatively influences adherence and increases patient morbidity and mortality. The written or verbal explanation would not be enough, and additional resources based on images and / or the realization of practical demonstrations are required. As a result, the NutriDis® audiovisual tool was designed. Objectives: to determine the apparent and content validity and feasibility of an audiovisual tool based on the descriptors of the "International Dysphagia Diet Standardization Initiative" (IDDSI). Materials and method: the Delphi technique was used following experts judgment, including nutritionists, speech therapists and kinesiologists. 19 experts participated in the first round and 9 in the second. The degree of agreement among them was determined through Aiken's V coefficient for each level of IDDSI and also at global level. Results: the tool turned out to be valid and the degree of global agreement increased between the first and second rounds from 90, 8 % to 94,1%, classifying as adequate. Level IDDSI 4 presented the highest agreement and IDDSI 1 the lowest. Conclusions: according to the opinion of experts in the area, the NutriDis® audiovisual tool presented an adequate content validity on average and was globally rated as excellent by the majority. It is highlighted that the tool is unprecedented and its development represented a great challenge.
Subject(s)
Deglutition Disorders , DietABSTRACT
The increase of industrial discharges is the first cause of the contamination of water bodies. The bacterial survival strategies contribute to the equilibrium restoration of ecosystems being useful tools for the development of innovative environmental biotechnologies. The aim of this work was to study the Cu(II) and Cd(II) biosensing, removal and recovery, mediated by whole cells, exopolymeric substances (EPS) and biosurfactants of the indigenous and non-pathogenic Pseudomonas veronii 2E to be applied in the development of wastewater biotreatments. An electrochemical biosensor was developed using P. veronii 2E biosorption mechanism mediated by the cell surface associated to bound exopolymeric substances. A Carbon Paste Electrode modified with P. veronii 2E (CPEM) was built using mineral oil, pre-washed graphite power and 24 h-dried cells. For Cd(II) quantification the CPEM was immersed in Cd(II) (1-25 µM), detected by Square Wave Voltammetry. A similar procedure was used for 1-50 µM Cu(II). Regarding Cd(II), removal mediated by immobilized EPS was tested in a 50 ml bioreactor with 0.13 mM Cd(II), pH 7.5. A 54% metal retention by EPS was achieved after 7 h of continuous operation, while a 40% was removed by a control resin. In addition, surfactants produced by P. veronii 2E were studied for recovery of Cd(II) adsorbed on diatomite, obtaining a 36% desorption efficiency at pH 6.5. Cu(II) adsorption from a 1 mM solution was tested using P. veronii 2E purified soluble EPS in 50 mL- batch reactors (pH = 5.5, 32°C). An 80% of the initial Cu(II) was retained using 1.04 g immobilized EPS. Focusing on metal recovery, Cu nanoparticles (NPs) biosynthesis by P. veronii 2E was carried out in Cu(II)-PYG Broth at 25°C for 5 days. Extracellular CuNPs were characterized by UV-Vis spectral analysis while both extracellular and intracellular NPs were analyzed by SEM and TEM techniques. Responses of P. veronii 2E and its products as biosurfactants, bound and soluble EPS allowed Cu(II) and Cd(II) removal, recovery and biosensing resulting in a multiple and versatile tool for sustainable wastewater biotreatments.
ABSTRACT
γ-Aminobutyric acid (GABA) inhibits insulin secretion through GABA(B) receptors in pancreatic ß-cells. We investigated whether GABA(B) receptors participated in the regulation of glucose homeostasis in vivo. BALB/c mice acutely pre-injected with the GABA(B) receptor agonist baclofen (7.5mg/kg, i.p.) presented glucose intolerance and diminished insulin secretion during a glucose tolerance test (GTT, 2g/kg body weight, i.p.). The GABA(B) receptor antagonist 2-hydroxysaclofen (15 mg/kg, i.p.) improved the GTT and reversed the baclofen effect. Also a slight increase in insulin secretion was observed with 2-hydroxysaclofen. In incubated islets 1.10(-5)M baclofen inhibited 20mM glucose-induced insulin secretion and this effect was reversed by coincubation with 1.10(-5)M 2-hydroxysaclofen. In chronically-treated animals (18 days) both the receptor agonist (5mg/kg/day i.p.) and the receptor antagonist (10mg/kg/day i.p.) induced impaired GTTs; the receptor antagonist, but not the agonist, also induced a decrease in insulin secretion. No alterations in insulin tolerance tests, body weight and food intake were observed with the treatments. In addition glucagon, insulin-like growth factor I, prolactin, corticosterone and growth hormone, other hormones involved in glucose metabolism regulation, were not affected by chronic baclofen or 2-hydroxysaclofen. In islets obtained from chronically injected animals with baclofen, 2-hydroxysaclofen or saline (as above), GABA(B2) mRNA expression was not altered. Results demonstrate that GABA(B) receptors are involved in the regulation of glucose homeostasis in vivo. Treatment with receptor agonists or antagonists, given acutely or chronically, altered glucose homeostasis and insulin secretion alerting to the need to evaluate glucose metabolism during the clinical use of these drugs.