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1.
Food Chem ; 456: 140038, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38876069

RESUMO

Food-packaging-processing interactions define packaging materials' performance properties and product quality. This study evaluated the effect of ohmic heating (OH) processing and different food simulants on the properties of four multilayer flexible packaging materials (PETmet/PE, PETmet/PP, PET/Al/PE, and PET/Al/PA/PP). OH treatment was applied to the sealed packages containing the food simulants using a voltage gradient of 3.7 V/cm at a frequency of 20 kHz, resulting in a thermal process of at 80 °C for 1 min. The structure and performance of the different packages were then evaluated. The materials did not show changes in chemical groups nor thermal properties. However, the simulant-packaging-processing interaction resulted in changes in crystallinity, morphology, mechanical and barrier properties (water and oxygen), especially for metallized films in contact with acidic food simulants. The results indicate that although OH resulted in changes in packaging materials, these materials can be used under the conditions applied in this study.

2.
Cells ; 13(9)2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38727306

RESUMO

Parkinson's disease (PD) is recognized as the second most prevalent primary chronic neurodegenerative disorder of the central nervous system. Clinically, PD is characterized as a movement disorder, exhibiting an incidence and mortality rate that is increasing faster than any other neurological condition. In recent years, there has been a growing interest concerning the role of the gut microbiota in the etiology and pathophysiology of PD. The establishment of a brain-gut microbiota axis is now real, with evidence denoting a bidirectional communication between the brain and the gut microbiota through metabolic, immune, neuronal, and endocrine mechanisms and pathways. Among these, the vagus nerve represents the most direct form of communication between the brain and the gut. Given the potential interactions between bacteria and drugs, it has been observed that the therapies for PD can have an impact on the composition of the microbiota. Therefore, in the scope of the present review, we will discuss the current understanding of gut microbiota on PD and whether this may be a new paradigm for treating this devastating disease.


Assuntos
Eixo Encéfalo-Intestino , Encéfalo , Microbioma Gastrointestinal , Doença de Parkinson , Humanos , Doença de Parkinson/microbiologia , Doença de Parkinson/terapia , Encéfalo/microbiologia , Encéfalo/patologia , Eixo Encéfalo-Intestino/fisiologia , Animais
3.
J Anim Physiol Anim Nutr (Berl) ; 108 Suppl 1: 36-41, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38613489

RESUMO

Obesity is a highly prevalent disease in dogs and is characterized by the excessive accumulation of adipose tissue that results in metabolic changes. Its treatment is based on a negative energy balance focusing on energy restriction. However, there are few studies in dogs that assessed the energy intake needed for adequate weight loss and to weight maintenance afterward. The aim of this study was to evaluate data about the treatment of canine obesity, with emphasis on energy restriction to induce weight loss and to maintain body weight (BW) and ideal body condition after weight loss. This was a retrospective study in which records of obese dogs from a veterinary teaching hospital were assessed between 2014 and 2020. Sixteen dogs were considered in the study according to inclusion and exclusion criteria and 10 of these participated in the maintenance phase after weight loss. The animals lost a mean of 23.2% their initial weight in a mean of 422 days. The mean weekly weight loss rate was 0.58% of BW, and the mean daily energy intake for weight loss was 59 kcal/kg current BW0.75. When the target BW was considered, which was defined as the current weight minus 10% for every point in the body condition score scale above 5, the mean energy for weight loss was 71 kcal/kg target BW0.75. In the maintenance phase, the animals were assessed for a mean of 134 days. The mean energy intake to maintenance BW was 70 kcal/kg BW0.75. The lower energy requirement of obese dogs during and after weight loss can work as an alert for the formulations of therapeutic weight loss diets to contain a high nutrient density focusing on the wellbeing, health, and quality of life of obese dogs, not just for the weight loss phase, but a diet for the weight maintenance phase.


Assuntos
Doenças do Cão , Ingestão de Energia , Obesidade , Redução de Peso , Animais , Cães , Estudos Retrospectivos , Doenças do Cão/dietoterapia , Obesidade/veterinária , Obesidade/dietoterapia , Masculino , Feminino , Fenômenos Fisiológicos da Nutrição Animal , Metabolismo Energético , Programas de Redução de Peso , Dieta/veterinária
4.
Crohns Colitis 360 ; 6(2): otae023, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38681979

RESUMO

Background: Real-world data on the effectiveness and safety of ustekinumab (UST) in ulcerative colitis (UC) are lacking in Latin America. In this study, we aimed to describe the effectiveness and safety of UST in a real-world multicenter cohort of Brazilian patients with UC. Methods: We conducted a multicenter retrospective observational cohort study, including patients with moderate-to-severe UC (total Mayo score 6-12, with an endoscopic subscore of 2 or 3) who received UST. The co-primary endpoints were clinical remission, defined as a total Mayo score ≤2 at 1 year, with a combined rectal bleeding and stool frequency subscore of ≤1, and endoscopic remission (endoscopic Mayo subscore of 0) within 1 year from baseline. Secondary endpoints included clinical response between weeks 12 and 16, endoscopic response within 1 year of starting UST, steroid-free clinical remission at week 52, and biochemical remission at week 52. We also evaluated UST treatment persistence and safety. Results: A total of 50 patients were included (female, n = 36, 72.0%), with a median disease duration of 9.2 years (1-27). Most patients had extensive colitis (n = 38, 76.0%), and 43 (86.0%) were steroid dependent at baseline. Forty patients (80.0%) were previously exposed to biologics (anti-TNF drugs, n = 31; vedolizumab [VDZ], n = 27). The co-primary endpoints of clinical remission at 1 year and endoscopic remission within 1 year were achieved by 50.0% and 36.0% of patients, respectively. Clinical response at weeks 12-16 was 56.0%, and endoscopic response, steroid-free clinical remission, and biochemical remission at week 52 were 68.0%, 46.5%, and 50.0%, respectively. The UST treatment persistence rate at 24 months was 73.7%. During the follow-up, 10 patients (20.0%) were hospitalized, mostly due to disease progression, and 3 patients required colectomy. Nine patients (18.0%) discontinued the drug mainly due to a lack of effectiveness. Twenty-seven adverse events (AEs) were reported, 16 of which were considered as serious AEs. Conclusions: In this real-world cohort of difficult-to-treat UC patients, UST was associated with improvements in clinical, biochemical, and endoscopic outcomes. The safety profile was favorable, consistent with the known profile of UST.

5.
Mol Psychiatry ; 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454085

RESUMO

Adult cytogenesis, the continuous generation of newly-born neurons (neurogenesis) and glial cells (gliogenesis) throughout life, is highly impaired in several neuropsychiatric disorders, such as Major Depressive Disorder (MDD), impacting negatively on cognitive and emotional domains. Despite playing a critical role in brain homeostasis, the importance of gliogenesis has been overlooked, both in healthy and diseased states. To examine the role of newly formed glia, we transplanted Glial Restricted Precursors (GRPs) into the adult hippocampal dentate gyrus (DG), or injected their secreted factors (secretome), into a previously validated transgenic GFAP-tk rat line, in which cytogenesis is transiently compromised. We explored the long-term effects of both treatments on physiological and behavioral outcomes. Grafted GRPs reversed anxiety-like deficits and demonstrated an antidepressant-like effect, while the secretome promoted recovery of only anxiety-like behavior. Furthermore, GRPs elicited a recovery of neurogenic and gliogenic levels in the ventral DG, highlighting the unique involvement of these cells in the regulation of brain cytogenesis. Both GRPs and their secretome induced significant alterations in the DG proteome, directly influencing proteins and pathways related to cytogenesis, regulation of neural plasticity and neuronal development. With this work, we demonstrate a valuable and specific contribution of glial progenitors to normalizing gliogenic levels, rescuing neurogenesis and, importantly, promoting recovery of emotional deficits characteristic of disorders such as MDD.

6.
Trop Anim Health Prod ; 55(5): 322, 2023 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-37749415

RESUMO

Our hypothesis is that the total replacement of ground corn grain (GCG) by cactus pear (CP) in association with 70% of leucaena hay (LH) increases dry matter (DM) intake and digestibility and nitrogen metabolism and maintains the feeding behavior of cattle. The objective was to evaluate the effects of inclusion of these feeds on the nutritional parameters and nitrogen metabolism of cattle. Eight steers, average age of 12 months, weight of 267.5 ± 15 kg, were distributed into two simultaneous 4 × 4 Latin squares according to a 2 × 2 factorial scheme, in which the first factor evaluated was different proportions of inclusion of LH (50 or 70% DM basis), and the second factor was the total replacement of GCG with CP. There was lower DM intake in animals fed with 70% LH. There was an interaction between the factors for DM digestibility, in which the animals fed CP did not differ regardless of the inclusion of LH, but for animals without CP, the greater inclusion of LH decreases DM digestibility. The inclusion of CP decreased free water intake. There was an interaction for total water intake (WI), in which the animals fed without CP presented similarity for this, while in the inclusion of CP, the animals fed 70% of LH presented higher WI. Also, lower values of chewing were observed for animals fed with CP. The replacement of GCG with CP improves the efficiency of nitrogen utilization in the rumen. The inclusion of 70% LH depresses intake.

7.
PLoS One ; 18(7): e0287797, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37410738

RESUMO

A high-protein hypercaloric diet enriched with glutamine and omega-3 polyunsaturated fatty acids was called an onco-diet. The goal was to verify the modulation of the inflammatory response and body composition of female dogs with mammary tumor after mastectomy, during onco-diet consumption, using a randomized, double-blinded, clinical trial. Six bitches (average age of 8.6 years) were allocated into Control Group-diet without glutamine, EPA and DHA supplementation; and six bitches (10.0 years) were allocated into Test-diet enriched with glutamine and omega-3. Serum measurements of TNF-α, IL-6, IL-10, IGF-1, C-reactive protein and determination of body composition were performed at pre- and post-surgical times. Statistical tests were used to compare the nutrient intake and dietary effects on inflammatory variables between the diets. No differences in concentrations of different cytokines (p>0.05) and C-reactive protein (CRP) (p = 0.51) were observed between the groups. The test group had a higher concentration of IGF-1 (p<0.05), higher percentage of muscle mass (p<0.01) and lower body fat (p<0.01), but the difference was present from initial and throughout the study. Onco-diet, enriched with glutamine and omega-3, in the amounts evaluated in this study, was not sufficient to modulate the inflammation and body composition of female dogs with mammary tumors submitted to unilateral mastectomy.


Assuntos
Ácidos Graxos Ômega-3 , Neoplasias , Animais , Cães , Feminino , Composição Corporal , Proteína C-Reativa/metabolismo , Dieta/veterinária , Ácidos Docosa-Hexaenoicos , Ácidos Graxos Ômega-3/metabolismo , Glutamina/metabolismo , Fator de Crescimento Insulin-Like I/metabolismo , Mastectomia , Projetos Piloto
8.
Antioxidants (Basel) ; 12(6)2023 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-37371987

RESUMO

Preventing degeneration and the loss of dopaminergic neurons (DAn) in the brain while mitigating motor symptoms remains a challenge in Parkinson's Disease (PD) treatment development. In light of this, developing or repositioning potential disease-modifying approaches is imperative to achieve meaningful translational gains in PD research. Under this concept, N-acetylcysteine (NAC) has revealed promising perspectives in preserving the dopaminergic system capability and modulating PD mechanisms. Although NAC has been shown to act as an antioxidant and (neuro)protector of the brain, it has yet to be acknowledged how this repurposed drug can improve motor symptomatology and provide disease-modifying properties in PD. Therefore, in the present work, we assessed the impact of NAC on motor and histological deficits in a striatal 6-hydroxydopamine (6-OHDA) rat model of PD. The results revealed that NAC enhanced DAn viability, as we found that it could restore dopamine transporter (DAT) levels compared to the untreated 6-OHDA group. Such findings were positively correlated with a significant amelioration in the motor outcomes of the 6-OHDA-treated animals, demonstrating that NAC may, somehow, be a modulator of PD degenerative mechanisms. Overall, we postulated a proof-of-concept milestone concerning the therapeutic application of NAC. Nevertheless, it is extremely important to understand the complexity of this drug and how its therapeutical properties interact with the cellular and molecular PD mechanisms.

9.
Res Sq ; 2023 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-37034743

RESUMO

Adult cytogenesis, the continuous generation of newly-born neurons (neurogenesis) and glial cells (gliogenesis) throughout life, is highly impaired in several neuropsychiatric disorders, such as Major Depressive Disorder (MDD), impacting negatively on cognitive and emotional domains. Despite playing a critical role in brain homeostasis, the importance of gliogenesis has been overlooked, both in healthy and diseased states. To examine the role of newly formed glia, we transplanted Glial Restricted Precursors (GRPs) into the adult hippocampal dentate gyrus (DG), or injected their secreted factors (secretome), into a previously validated transgenic GFAP-tk rat line, in which cytogenesis is transiently compromised. We explored the long-term effects of both treatments on physiological and behavioral outcomes. Grafted GRPs reversed anxiety-like and depressive-like deficits, while the secretome promoted recovery of only anxiety-like behavior. Furthermore, GRPs elicited a recovery of neurogenic and gliogenic levels in the ventral DG, highlighting the unique involvement of these cells in the regulation of brain cytogenesis. Both GRPs and their secretome induced significant alterations in the DG proteome, directly influencing proteins and pathways related to cytogenesis, regulation of neural plasticity and neuronal development. With this work, we demonstrate a valuable and specific contribution of glial progenitors to normalizing gliogenic levels, rescueing neurogenesis and, importantly, promoting recovery of emotional deficits characteristic of disorders such as MDD.

10.
Pharmaceutics ; 15(2)2023 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-36839908

RESUMO

Despite some variability in ideal serum Adalimumab (ADA) concentrations, there is increasing evidence that higher concentrations of anti-TNF-α agents can be associated with sustained efficacy, and low or undetectable levels may lead to loss of response. This study aims to correlate serum ADA concentrations with clinical and endoscopic activity in patients with Crohn's disease (CD). A cross-sectional and multicentric study was performed with patients with CD, who used ADA for at least 24 weeks. Patients were allocated into groups according to the presence of clinical or endoscopic disease activity. Serum ADA concentrations were measured and compared between groups. Overall, 89 patients were included. A total of 27 patients had clinically active CD and 62 were in clinical remission. Forty patients had endoscopic disease activity and 49 were in endoscopic remission. The mean serum ADA concentration was 10.2 µg/mL in patients with clinically active CD and 14.3 µg/mL in patients in clinical remission (p = 0.395). The mean serum ADA concentration in patients with endoscopic activity was 11.3 µg/mL as compared to 14.5 µg/mL in those with endoscopic remission (p = 0.566). There was no difference between serum ADA concentrations regarding clinical or endoscopic activity in CD, as compared to patients in remission.

11.
Crohns Colitis 360 ; 5(1): otac050, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36777366

RESUMO

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease which affects the colorectal mucosa with a relapsing-remitting pattern. The therapeutic options currently available for the medical management of UC include many options. Tofacitinib is an oral small molecule, Janus kinase (JAK) inhibitor, more selective for JAK1 and JAK3, which reduces the inflammatory process involved in the pathogenesis of UC. Methods: Retrospective observational multicentric study of patients with UC who used tofacitinib in any phase of their treatment. Clinical remission and response (according to Mayo score), mucosal healing, primary and secondary loss of response, discontinuation of the drug with possible causes, and the need for dose optimization or switching to biologicals, need for surgery and adverse events were evaluated. Results: From a total of 56 included patients, clinical remission was observed in 43.6% at week 12, 54.5% at week 26, 57.9% at week 52, and 40% at the last follow-up visit. Clinical response was observed in 71.4%, 81.8%, 89.5%, and 61.8% at the same time periods, respectively. Mucosal healing rates were 50% and 17.8% needed colectomy. Conclusions: Tofacitinib was effective in induction and maintenance of clinical response and remission rates, compatible to other international real-word studies and meta-analyses.

12.
Food Res Int ; 163: 112217, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36596146

RESUMO

In this study, the effect of ultrasound processing on the properties of two packages widely used in food products was evaluated: polyamide (PA) and polyethylene (PE) multilayer packaging. Packages composed of PE/PA/PE (Film A) and PE/PA/PE/PA/PE (Film B) were filled with aqueous and fatty food simulants and treated in an ultrasound water bath (frequency 25 kHz, volumetric power of 9.74 W/L, temperature of 25 °C, and time of 30 and 60 min). Materials were evaluated in term of structure and performance properties. Ultrasound did not or induced small changes in chemical groups, crystallinity, melting temperature, and tensile strength of the films. Film A showed a reduction in heat sealing tensile strength of 25% in the machine direction and 22% in the transverse direction. Film B showed a 20% increase of water vapor transmission rate after ultrasound processing. Although ultrasound had little impact on the properties of the evaluated materials, these modifications do not compromise the use of these packages for applications in ultrasound-processed foods. Therefore, the results indicate that ultrasound can be used as a food processing technology in multilayer PA and PE packaging.


Assuntos
Embalagem de Alimentos , Nylons , Embalagem de Alimentos/métodos , Polietileno/química , Manipulação de Alimentos , Resistência à Tração
13.
Toxins (Basel) ; 14(12)2022 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-36548762

RESUMO

The aim was to evaluate the effect of feeding a low-phosphorus and maintenance protein diet in healthy cats and cats with chronic kidney disease (CKD) with IRIS stages 1 (CKD-1) and 2 (CKD-2). Cats were initially fed a senior diet (30 days) followed by the renal diet (60 days). Body composition, body weight (BW), muscle mass score (MMS), and body condition score (BCS) were assessed before (T30) and after renal diet intake (T60). General mixed linear models were used to assess the effects of fixed groups and moments (T30 × T60), as well as their interaction, in addition to the random effects of animals within each group. Unlike healthy cats and cats with CKD-1, cats with CKD-2 had a loss of BW, lower BCS (p < 0.005), and lower MMS (p = 0.0008) after 60 days of consuming the renal diet. The fat mass and lean body mass (LBM), determined by the deuterium isotopes method, did not change in all cats between T0 and T60. In healthy cats and cats with CKD-1, the renal diet resulted in maintenance of BW, BCS and MMS; but cats with CKD-2 presented lower BCS and did not reduce phosphatemia after consumption.


Assuntos
Fósforo , Insuficiência Renal Crônica , Gatos , Animais , Dieta/veterinária , Peso Corporal , Insuficiência Renal Crônica/veterinária , Composição Corporal
14.
Sci Rep ; 12(1): 18510, 2022 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-36396966

RESUMO

Food production is responsible for almost one-quarter of the environmental impact and, therefore, its importance regarding sustainability should not be overlooked. The companion animal population is increasing, and an important part of pet food is composed of ingredients that have a high environmental impact. This study aimed to evaluate the impact of dry, wet, and homemade pet diets on greenhouse gas emission, land use, acidifying emission, eutrophying emissions, freshwater withdrawals, and stress-weighted water use. The wet diets were responsible for the highest impact, and dry diets were the type of diet that least impacted the environment, with a positive correlation between the metabolizable energy provided by animal ingredients and the environmental impact. It is necessary to consider the environmental impact of pet food since it is significant, and the population of pets tends to increase.


Assuntos
Dieta , Animais , Gatos , Cães , Doenças do Gato , Dieta/veterinária , Doenças do Cão , Meio Ambiente , Alimentos
15.
Biomedicines ; 10(11)2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36359265

RESUMO

The gut microbiota refers to bacteria lodges in the gastrointestinal tract (GIT) that interact through various complex mechanisms. The disturbance of this ecosystem has been correlated with several diseases, such as neurologic, respiratory, cardiovascular, and metabolic diseases and cancer. Therefore, the modulation of the gut microbiota has emerged as a potential therapeutic tool; of the various forms of gut microbiota modulation, fecal microbiota transplantation (FMT) is the most approached. This recent technique involves introducing fecal material from a healthy donor into the patient's gastrointestinal tract, aiming to restore the gut microbiota and lead to the resolution of symptoms. This procedure implies a careful donor choice, fine collection and handling of fecal material, and a balanced preparation of the recipient and consequent administration of the prepared content. Although FMT is considered a biological therapy with promising effects, side effects such as diarrhea and abdominal pain have also been claimed, making this a significant challenge in the application of FMT. Bearing this in mind, the present review aims to summarize the recent advances in understanding FMT mechanisms, their impact across different pathological conditions, and the associated side effects, emphasizing the most recent published data.

16.
Cells ; 11(18)2022 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-36139483

RESUMO

Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder worldwide. Clinically, it is characterized by a progressive degeneration of dopaminergic neurons (DAn), resulting in severe motor complications. Preclinical and clinical studies have indicated that neuroinflammation can play a role in PD pathophysiology, being associated with its onset and progression. Nevertheless, several key points concerning the neuroinflammatory process in PD remain to be answered. Bearing this in mind, in the present review, we cover the impact of neuroinflammation on PD by exploring the role of inflammatory cells (i.e., microglia and astrocytes) and the interconnections between the brain and the peripheral system. Furthermore, we discuss both the innate and adaptive immune responses regarding PD pathology and explore the gut-brain axis communication and its influence on the progression of the disease.


Assuntos
Doenças Neurodegenerativas , Doença de Parkinson , Neurônios Dopaminérgicos/patologia , Humanos , Microglia/patologia , Doenças Neurodegenerativas/patologia , Doenças Neuroinflamatórias , Doença de Parkinson/etiologia
17.
Gastroenterol. hepatol. (Ed. impr.) ; 45(7): 499-506, Ago - Sep 2022. tab
Artigo em Inglês | IBECS | ID: ibc-206908

RESUMO

Background: In the last decade, new therapies with different mechanisms of action have been approved for the treatment of moderate to severe Crohn's disease (CD) and ulcerative colitis (UC). Due to the lack of comparative head-to-head trials, the ideal positioning of agents as the most appropriate first- or second-line therapies remains to be defined. Objective: This survey aimed to evaluate the perception and decisions of Brazilian Inflammatory Bowel Diseases (IBD) specialists in positioning of new therapies (vedolizumab [VEDO], ustekinumab [UST] and tofacitinib [TOFA]) in the management of IBD in different clinical scenarios. Methodology: An anonymous national web-based questionnaire was used to determine the positioning of treatment options in different clinical scenarios (using Google Forms platform), which involved different age ranges, phenotypes, clinical situations and previous exposure to anti-TNF agents (14 scenarios for CD and 10 scenarios for UC). In CD, physicians could choose between UST or VEDO, whilst in UC, between UST, VEDO or TOFA. Six reasons for the specific choice were proposed, such as mechanism of action, safety, method of administration or onset of action. Statistical analysis was carried out with chi-square and t-tests. Results: A total of 150 out of 672 GEDIIB IBD specialists (22.32%) responded to the survey. In CD scenarios, UST was the most dominant choice (11/14 scenarios), with VEDO dominating only 3 clinical situations. In UC scenarios, VEDO was the dominant choice (8/10), with UST being chosen for scenarios that included extraintestinal manifestations. Among the reasons for specific choices, the most commonly chosen were the higher efficacy due to the intrinsic mechanism of action and safety profile.(AU)


Antecedentes: En la última década se han aprobado nuevas terapias con diferentes mecanismos de acción para el tratamiento de la enfermedad de Crohn (EC) y de la colitis ulcerosa (CU) de moderada a grave. Debido a la falta de ensayos comparativos cara a cara, aún no se ha definido el posicionamiento ideal de los agentes como terapias de primera o segunda línea más adecuadas. Objetivo: El objetivo de esta encuesta fue evaluar la percepción y las decisiones de los especialistas brasileños en enfermedades inflamatorias intestinales (EII) en el posicionamiento de las nuevas terapias (vedolizumab [VEDO], ustekinumab [UST] y tofacitinib [TOFA]) en el manejo de la EII en diferentes escenarios clínicos. Metodología: Se utilizó un cuestionario nacional anónimo basado en la web para determinar el posicionamiento de las opciones de tratamiento en diferentes escenarios clínicos (utilizando la plataforma Google Forms), que implicaban diferentes rangos de edad, fenotipos, situaciones clínicas y exposición previa a agentes anti-TNF (14 escenarios para la EC y 10 escenarios para la CU). En la EC, los médicos podían elegir entre UST o VEDO, mientras que, en la CU, entre UST, VEDO o TOFA. Se propusieron 6 razones para la elección específica, como el mecanismo de acción, la seguridad, el método de administración o el inicio de acción. El análisis estadístico se llevó a cabo con las pruebas de Chi-cuadrado y la t de Student. Resultados: Un total de 150 de los 672 especialistas en EII del Grupo de Estudios Brasileño de Enfermedades Inflamatorias (GEDIIB) (22,32%) respondieron a la encuesta. En los escenarios de la EC, la UST fue la opción más dominante (11/14 escenarios), y la VEDO solo dominó 3 situaciones clínicas. En los escenarios de la CU, la VEDO fue la elección dominante (8/10), siendo la UST la elegida para los escenarios que incluían manifestaciones extraintestinales.(AU)


Assuntos
Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Doença de Crohn/diagnóstico , Doença de Crohn/terapia , Colite Ulcerativa , Ustekinumab , Integrinas , Janus Quinases , Produtos Biológicos , Inquéritos e Questionários , Brasil , Gastroenterologia , Gastroenterologistas
18.
BMC Gastroenterol ; 22(1): 268, 2022 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-35644668

RESUMO

BACKGROUND: Anti-TNF therapy represented a landmark in medical treatment of ulcerative colitis (UC). There is lack of data on the efficacy and safety of these agents in Brazilian patients. The present study aimed to analyze rates of clinical and endoscopic remission comparatively, between adalimumab (ADA) and infliximab (IFX), in Brazilian patients with UC, and evaluate factors associated with clinical and endoscopic remission after 1 year of treatment. METHODS: A national retrospective multicenter study (24 centers) was performed including patients with UC treated with anti-TNF therapy. Outcomes as clinical response and remission, endoscopic remission and secondary loss of response were measured in different time points of the follow-up. Baseline predictive factors of clinical and endoscopic remission at week 52 were evaluated using logistic regression model. Indirect comparisons among groups (ADA and IFX) were performed using Student's t, Pearson χ2 or Fisher's exact test when appropriated, and Kaplan Meier analysis. RESULTS: Overall, 393 patients were included (ADA, n = 111; IFX, n = 282). The mean age was 41.86 ± 13.60 years, 61.58% were female, most patients had extensive colitis (62.40%) and 19.39% had previous exposure to a biological agent. Overall, clinical remission rate was 66.78%, 71.62% and 82.82% at weeks 8, 26 and 52, respectively. Remission rates were higher in the IFX group at weeks 26 (75.12% vs. 62.65%, p < 0.0001) and 52 (65.24% vs. 51.35%, p < 0.0001) when compared to ADA. According to Kaplan-Meier survival curve loss of response was less frequent in the Infliximab compared to Adalimumab group (p = 0.001). Overall, endoscopic remission was observed in 50% of patients at week 26 and in 65.98% at week 52, with no difference between the groups (p = 0.114). Colectomy was performed in 23 patients (5.99%). Age, non-prior exposure to biological therapy, use of IFX and endoscopic remission at week 26 were associated with clinical remission after 52 weeks. Variables associated with endoscopic remission were non-prior exposure to biological therapy, and clinical and endoscopic remission at week 26. CONCLUSIONS: IFX was associated with higher rates of clinical remission after 1 year in comparison to ADA. Non-prior exposure to biological therapy and early response to anti-TNF treatment were associated with higher rates of clinical and endoscopic remission.


Assuntos
Colite Ulcerativa , Adalimumab/uso terapêutico , Adulto , Brasil , Colite Ulcerativa/induzido quimicamente , Colite Ulcerativa/tratamento farmacológico , Feminino , Humanos , Infliximab/efeitos adversos , Infliximab/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inibidores do Fator de Necrose Tumoral/uso terapêutico
19.
J Pers Med ; 12(5)2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35629159

RESUMO

Chronic diseases are commonly defined as conditions that last one year or more and require ongoing medical attention, limit activities of daily living, or both [...].

20.
J Anim Physiol Anim Nutr (Berl) ; 106(2): 355-367, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35112401

RESUMO

During a weight loss program, energy restriction is performed, which can result in nutrient intake below the minimum recommendations if a proper diet is not offered. A common recommendation for dogs undergoing energy restriction is to use a veterinary diet formulated for the management of obesity to potentially reduce the likelihood of nutritional deficiencies. The objective of this study was to perform bromatological and essential mineral analysis in veterinary diets for the management of canine obesity available in the Brazilian market and to analyse whether these diets provide the recommended amount of nutrients per kg of metabolic body weight (kg BW0.75 ) for animals undergoing energy restriction. Samples of all veterinary diets for the management of canine obesity available in the Brazilian pet food market were analysed (n = 8). The nutrient supply per kg BW0.75 was calculated and compared with the NRC recommended allowance and FEDIAF recommendations by descriptive statistics. For this purpose, the weight loss energy requirement equations of 70 kcal/target body weight0.75 and 63 kcal/target body weight0.75 were used, in which target body weight corresponds to 10%-40% of the initial body weight according to the body condition score. The manufacturers' intake recommendations were also evaluated and compared to the NRC and FEDIAF recommendations. Almost all of the diets (n = 7/8) had at least one nutrient below the NRC and FEDIAF recommendations when target weight of minus 10%, 20% or 30% was considered, and all diets had at least one nutrient deficiency when the target weight was minus 40%. When the energy intake was restricted a further 10%, all diets had at least one nutrient below recommendations at the minus 30% target weight. The nutrients for which the recommendations were not met were as follows: calcium, magnesium, potassium, selenium, sodium, protein and fat. When compared to the manufacturers' recommendations, nutrient deficiencies were observed in all of the diets when compared to the NRC and in 7/8 when compared to FEDIAF, and all diets had at least one deficiency when compared to both NRC and FEDIAF after an extra 10% calorie restriction. It was concluded that the majority of veterinary diets formulated for weight loss/obesity management in Brazil did not meet all the recommendations of the analysed nutrients, which reinforces that diets for weight loss should be used according to veterinary prescription and should ideally be prescribed by nutrition specialists that can better understand the limitations of the diet's composition.


Assuntos
Doenças do Cão , Programas de Redução de Peso , Ração Animal/análise , Animais , Brasil , Dieta/veterinária , Cães , Ingestão de Energia , Nutrientes , Obesidade/veterinária
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