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1.
Rev Gaucha Enferm ; 40: e20180200, 2019 Jun 19.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31241655

RESUMO

OBJECTIVE: Verifying the clinical-surgical profile and the results of patients monitored in an surgical wound ambulatory after a cardiac surgeries. METHODS: This is a historical cohort research with patients submitted to cardiac surgery and monitored for a year in an outpatient surgical wound clinic from a hospital specialized in cardiology. The study analyzed the prevalent microorganisms in infections, the products used in the dressings, the time of follow-up, and the type of therapy established in the dressings. RESULTS: Among the 150 patients, most were sexagenarians (61.7 ± 11.4 years), hypertensive patients (75%), and diabetic (44.7%). There were 12 patients with mediastinitis (8%) and 44 with surgical site infection (29.3%). Fatty acids (80%) and calcium alginate (19%) were used for wound healing. The mean follow-up time was 35 ± 71 days. CONCLUSION: Sexagenary, hypertensive, diabetic and revascularized patients constituted the population monitored in the wounds outpatient clinic. The SSI and mediastinitis rates found were acceptable and similar to those in literature.


Assuntos
Bandagens , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Infecção da Ferida Cirúrgica/microbiologia , Infecção da Ferida Cirúrgica/terapia , Idoso , Alginatos/uso terapêutico , Instituições de Assistência Ambulatorial , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Ácidos Graxos Essenciais/uso terapêutico , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Masculino , Mediastinite/epidemiologia , Pessoa de Meia-Idade , Veia Safena/cirurgia , Esternotomia/efeitos adversos , Infecção da Ferida Cirúrgica/epidemiologia , Cicatrização
2.
Vet Dermatol ; 29(6): 465-e158, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30251442

RESUMO

BACKGROUND: The pathogenesis and treatment of cutaneous malodour in dogs have not been investigated previously. Staphylococcus and Corynebacterium spp. are associated with human axillary malodour. HYPOTHESIS: Staphylococcus and Corynebacterium spp. are associated with cutaneous malodour in dogs, and treatment with a topical essential oil-based product will improve malodour and reduce the abundance of odour-causing bacteria. ANIMALS: Twenty seven bloodhound dogs from a south Texas boarding facility were enrolled in this study. METHODS AND MATERIALS: Skin swabs were taken from the axilla and dorsum of 27 dogs at initiation of the study. Mean malodour scores were used to assign dogs to control or malodour groups. The malodourous dogs were randomly assigned to a treatment or placebo group, received four weekly topical applications of the spot-on or placebo, and samples were recollected. Next-generation sequencing (NGS) and real-time quantitative PCR (qPCR) were performed on all swabs. RESULTS: Psychrobacter and Pseudomonas spp. were significantly more abundant (P < 0.001, P = 0.006; respectively), and overall bacterial diversity was reduced (P = 0.0384) on the skin of malodourous dogs. Staphylococcus and Corynebacterium spp. were not associated with malodour. The topical essential oil-based product significantly (P = 0.0078) improved malodour in the treatment group and shifted their bacterial community structure. CONCLUSIONS AND CLINICAL IMPORTANCE: A novel association of bacterial genera with malodour in bloodhound dogs, identified by NGS, highlights future targets for odour control. The topical treatment significantly reduced malodour. The interaction between the topical treatment and cutaneous microbiota should be further investigated and may be useful in other dermatological conditions involving microbiota.


Assuntos
Doenças do Cão/microbiologia , Ácidos Graxos Essenciais/uso terapêutico , Infecções por Moraxellaceae/veterinária , Odorantes , Óleos Voláteis/uso terapêutico , Infecções por Pseudomonas/veterinária , Pseudomonas , Psychrobacter , Dermatopatias Bacterianas/veterinária , Administração Cutânea , Animais , Doenças do Cão/tratamento farmacológico , Cães , Ácidos Graxos Essenciais/administração & dosagem , Feminino , Sequenciamento de Nucleotídeos em Larga Escala/veterinária , Masculino , Infecções por Moraxellaceae/complicações , Infecções por Moraxellaceae/tratamento farmacológico , Óleos Voláteis/administração & dosagem , Pseudomonas/genética , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/tratamento farmacológico , Psychrobacter/genética , Reação em Cadeia da Polimerase em Tempo Real , Dermatopatias Bacterianas/complicações , Dermatopatias Bacterianas/tratamento farmacológico
3.
Vet Dermatol ; 29(2): 134-e53, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29076573

RESUMO

BACKGROUND: Nasal hyperkeratosis may cause discomfort in dogs by predisposing them to fissures and secondary bacterial infection. Approaches to treatment have been described anecdotally; the effectiveness of such therapies remains unproven. HYPOTHESIS/OBJECTIVES: To investigate the efficacy of a balm containing essential oils and essential fatty acids in dogs with idiopathic nasal hyperkeratosis. ANIMALS: Client-owned dogs with noncomplicated nasal hyperkeratosis. METHODS: The study was conducted as a randomized, double-blind, placebo-controlled clinical trial with parallel group design and two month follow-up period. Dogs received daily topical application of a commercial balm product (group DBB) or placebo (aqueous gelling agent with preservatives, group PB). The main outcome variables were lichenification, dryness, suppleness and extent of lesions. Subjective owner satisfaction index score was a secondary variable. Evaluation was performed on days (D)0, 30 and 60. Response to treatment was assessed as the change from baseline to each examination day for each criterion. RESULTS: Forty eight dogs, principally French (26 of 48) and English (seven of 48) bulldogs, were included and 39 completed the study. No major adverse events were reported. On D60, changes from baseline for lichenification, lesion extent, suppleness and total score were -31.2%, -18.3%, -72.8% and -36.8% in group DBB (23 dogs) and -11.9%, 2.3%, -42.1% and -14% in group PB (16 dogs), respectively. The total score was significantly improved on D60 in group DBB compared to PB (Wilcoxon-Mann-Whitney U-test, P = 0.0016). CONCLUSIONS AND CLINICAL IMPORTANCE: The balm proved safe and helpful in managing canine idiopathic noncomplicated nasal hyperkeratosis.


Assuntos
Ácidos Graxos Essenciais/uso terapêutico , Ceratose/veterinária , Nariz/patologia , Óleos Voláteis/uso terapêutico , Animais , Dermatite Atópica/veterinária , Cães , Método Duplo-Cego , Ácidos Graxos Essenciais/administração & dosagem , Ácidos Graxos Essenciais/efeitos adversos , Feminino , Ceratose/tratamento farmacológico , Masculino , Nariz/efeitos dos fármacos , Óleos Voláteis/administração & dosagem , Óleos Voláteis/efeitos adversos , Prurido/veterinária
4.
Vet Dermatol ; 28(6): 569-e138, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28736909

RESUMO

BACKGROUND: Zinc is important for skin health and proper immune system function. HYPOTHESIS/OBJECTIVES: A zinc methionine, essential fatty acids (EFA) and biotin product (Zn supplement) was compared to an EFA and biotin product (control) in canine atopic dermatitis (CAD). ANIMALS: Twenty seven client-owned dogs with chronic CAD receiving ciclosporin or glucocorticoids. METHODS: A 24 week, randomized, double-blinded, controlled study with crossover at week 12 and 4 week period of allergy medication reduction at weeks 8 and 20. Evaluations included Canine Atopic Dermatitis Lesion Index (CADLI), pruritus Visual Analog Scale (VAS) and cytology sampling. RESULTS: In dogs receiving the zinc supplement and ciclosporin for eight weeks, 44% (n = 7) had significantly decreased CADLI from 11.9 to 6.0 (P = 0.0002) with no significant change in pruritus VAS (P = 1.0). In dogs receiving the zinc supplement and glucocorticoids for eight weeks, 55% (n = 6) had significantly decreased CADLI from 10.9 to 5.0 (P = 0.0043) and pruritus VAS from 7.4 to 3.2 (P = 0.0166). For dogs receiving either steroids or ciclosporin there was a reduction in use of such medications, for at least four weeks, in 63% of dogs receiving the zinc supplement and 37% of dogs receiving the control. This difference was not significant (P = 0.1027). Seventy eight percent of dogs were diagnosed and treated for superficial skin infections during the study. CONCLUSIONS AND CLINICAL IMPORTANCE: This study supports a potential benefit of adjunctive zinc methionine supplementation in CAD. Dogs receiving glucocorticoids may be more likely to benefit. Further studies are needed to substantiate these initial results.


Assuntos
Dermatite Atópica/veterinária , Fármacos Dermatológicos/uso terapêutico , Doenças do Cão/tratamento farmacológico , Metionina/análogos & derivados , Compostos Organometálicos/uso terapêutico , Animais , Biotina/uso terapêutico , Estudos Cross-Over , Ciclosporina/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Suplementos Nutricionais , Cães , Método Duplo-Cego , Quimioterapia Combinada , Ácidos Graxos Essenciais/uso terapêutico , Feminino , Masculino , Metionina/administração & dosagem , Metionina/uso terapêutico , Compostos Organometálicos/administração & dosagem
5.
Vet Dermatol ; 28(6): 577-e140, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28736984

RESUMO

BACKGROUND: Lipid-based emulsions can be useful for the management of canine atopic dermatitis (cAD). 18-beta glycyrrhetinic acid (GRA), a component of liquorice root, has anti-inflammatory and anti-pruritic effects. HYPOTHESIS/OBJECTIVES: To evaluate the effects of a topical lipid emulsion containing ceramides, fatty acids and GRA on clinical signs of cAD and skin barrier in a randomized, double-blinded, placebo-controlled trial. METHODS: Client owned (n = 45) dogs with nonseasonal, mild/moderate AD, received either treatment or placebo for three months. Skin lesions, pruritus, transepidermal water loss (TEWL) and global assessment (GA) were evaluated. RESULTS: Fourteen dogs receiving treatment and 14 receiving the placebo completed the study. After one month ≥50% reduction in pruritus was seen in seven of 14 dogs (50%) in the Treatment group, and in two of 14 dogs (14.3%) in the Control group (P = 0.047). After two and three months, significant reduction in pruritus was not seen. For Canine Atopic Dermatitis Extent and Severity Index (CADESI), TEWL and GA, there were no significant findings over time or between groups. CONCLUSIONS AND CLINICAL RELEVANCE: The emulsion had some transient beneficial clinical effects. However, it was not effective in controlling pruritus as a monotherapy. Further studies should examine whether owner compliance was a factor in the steady decline of effect on pruritus scores. Further studies evaluating its role as an adjunctive therapy are indicated.


Assuntos
Ceramidas/uso terapêutico , Dermatite Atópica/veterinária , Doenças do Cão/tratamento farmacológico , Ácidos Graxos Essenciais/uso terapêutico , Ácido Glicirretínico/análogos & derivados , Ácido gama-Linolênico/uso terapêutico , Administração Cutânea , Animais , Ceramidas/administração & dosagem , Dermatite Atópica/tratamento farmacológico , Cães , Método Duplo-Cego , Emulsões/uso terapêutico , Ácidos Graxos Essenciais/administração & dosagem , Feminino , Ácido Glicirretínico/administração & dosagem , Ácido Glicirretínico/uso terapêutico , Masculino , Projetos Piloto , Pele/efeitos dos fármacos , Pele/metabolismo , Ácido gama-Linolênico/administração & dosagem
6.
Prog Retin Eye Res ; 61: 23-34, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28532687

RESUMO

Dry eye is a prevalent condition and one of the main reasons for patients to seek ophthalmic medical care. A low systemic level of omega fatty acids is a risk factor for dry eye disease (DED). There are two groups of essential fatty acids (EFAs): the omega-6 (n-6) family and the omega-3 (n-3) family. Humans evolved on a diet in which the n-6:n-3 ratio was approximately 1:1, however the current Western diet tends to be deficient in n-3 EFAs and this ratio is typically much higher (approaching 17:1). The metabolism of EFAs generates four new families of local acting mediators: lipoxins, resolvins, protectins, and maresins. These molecules have anti-inflammatory and pro-resolution properties. We present a critical overview of animal model studies and human clinical trials that have shown that dietary modification and oral supplementation could be complementary therapeutic strategies for the treatment of dry eye. Furthermore, we discuss preliminary results of the topical application of n-3 and n-6 EFAs because these molecules may act as natural anti-inflammatory agents with positive changes of the entire ocular surface system.


Assuntos
Gorduras na Dieta/uso terapêutico , Síndromes do Olho Seco/tratamento farmacológico , Ácidos Graxos Essenciais/uso terapêutico , Animais , Anti-Inflamatórios/uso terapêutico , Modelos Animais de Doenças , Síndromes do Olho Seco/metabolismo , Humanos
7.
Crit Rev Food Sci Nutr ; 57(1): 212-223, 2017 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-25830700

RESUMO

Depression is a common, recurrent, and debilitating illness that has become more prevalent over the past 100 years. This report reviews the etiology and pathophysiology of depression, and explores the role of omega 3 polyunsaturated fatty acids (n-3 PUFA) as a possible treatment. In seeking to understand depression, genetic factors and environmental influences have been extensively investigated. Research has led to several hypotheses for the pathophysiological basis of depression but a definitive pathogenic mechanism, or group thereof, has hitherto remained equivocal. To date, treatment has been based on the monoamine hypothesis and hence, selective serotonin reuptake inhibitors have been the most widely used class of medication. In the last decade, there has been considerable interest in n-3 PUFAs and their role in depression. These fatty acids are critical for development and function of the central nervous system. Increasing evidence from epidemiological, laboratory, and randomized placebo-controlled trials suggests deficiency of dietary n-3 PUFAs may contribute to development of mood disorders, and supplementation with n-3 PUFAs may provide a new treatment option. Conclusions based on systematic reviews and meta-analyses of published trials to date vary. Research into the effects of n-3 PUFAs on depressed mood is limited. Furthermore, results from such have led to conflicting conclusions regarding the efficacy of n-3 PUFAs in affecting reduction in symptoms of depression. PUFAs are generally well tolerated by adults and children although mild gastrointestinal effects are reported. There is mounting evidence to suggest that n-3 PUFAs play a role in depression and deserve greater research efforts.


Assuntos
Deficiências Nutricionais/dietoterapia , Depressão/prevenção & controle , Transtorno Depressivo Maior/prevenção & controle , Suplementos Nutricionais , Medicina Baseada em Evidências , Ácidos Graxos Essenciais/deficiência , Ácidos Graxos Ômega-3/uso terapêutico , Animais , Antidepressivos/uso terapêutico , Deficiências Nutricionais/metabolismo , Deficiências Nutricionais/fisiopatologia , Deficiências Nutricionais/psicologia , Depressão/tratamento farmacológico , Depressão/etiologia , Depressão/genética , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/etiologia , Transtorno Depressivo Maior/genética , Dieta Ocidental/efeitos adversos , Dieta Ocidental/psicologia , Suplementos Nutricionais/efeitos adversos , Ácidos Graxos Essenciais/efeitos adversos , Ácidos Graxos Essenciais/uso terapêutico , Ácidos Graxos Ômega-3/efeitos adversos , Feminino , Óleos de Peixe/efeitos adversos , Óleos de Peixe/uso terapêutico , Predisposição Genética para Doença , Humanos , Masculino , Fatores Sexuais
8.
Actas esp. psiquiatr ; 45(supl.1): 48-63, 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-172029

RESUMO

Los tratamientos de la medicina complementaria y alternativa, incluyendo los tratamientos con suplementos nutricionales, son muy populares en los países desarrollados y su uso continúa creciendo. La facilidad de uso, su accesibilidad y posibilidad de autoadministración y la percepción como seguros y carentes de efectos secundarios han conducido a un incremento de su consumo. Sin embargo, la evidencia de la efectividad y seguridad de estos tratamientos es limitada a causa de los problemas metodológicos. En el caso de la psiquiatría del niño y del adolescente, el nivel de evidencia científica es particularmente escaso y débil. El propósito de este artículo es dar una visión general actualizada de los tratamientos nutricionales en psiquiatría del niño y del adolescente. Realizamos una breve introducción que expone cuestiones generales sobre este tema, incluyendo aspectos legales. Proponemos recomendaciones generales prácticas para un manejo adecuado de las familias que escogen estos tratamientos. Nos centramos en la revisión del estado actual de la investigación de los tratamientos nutricionales en varios trastornos psiquiátricos infanto-juveniles, y describimos la evidencia actual de tratamientos específicos. El objetivo último de este artículo es proporcionar a los profesionales implicados en la atención de niños y adolescentes la información sobre el nivel de la evidencia actual de los tratamientos nutricionales para que puedan orientar, ayudar y educar a las familias sobre su uso y procurar de esta manera el mayor beneficio de los pacientes (AU)


Complementary and alternative treatments, including dietary supplements, are very popular and increasingly used in developed countries. Some features such as accessibility, ease of use, the possibility of self-administration and the belief they are safe without side effects, have led to an increase in their consumption. However, there is limited evidence of the effectiveness and safety of these treatments because of methodological issues. The level of scientific evidence is particularly low and weak in the field of child and adolescent Psychiatry. The purpose of this article is to give an updated overview of dietary treatments in this area. We make a brief introduction about general questions, including legal aspects, and propose general practical recommendations for a proper management by the families that choose these treatments. We focus on reviewing the current state of research into dietary treatments in some childhood and juvenile psychiatric disorders, highlighting current evidence of specific treatments. The final purpose of this article is to describe the level of current evidence on dietary treatments and to provide professionals involved in the care of children and adolescents with a useful tool to help, guide and educate families about their use in order to achieve the greatest benefit to patients (AU)


Assuntos
Humanos , Criança , Adolescente , Transtornos do Neurodesenvolvimento/dietoterapia , Transtornos Mentais/dietoterapia , Suplementos Nutricionais , Transtorno do Deficit de Atenção com Hiperatividade/dietoterapia , Transtorno do Espectro Autista/dietoterapia , Alimentação Alternativa , Micronutrientes/uso terapêutico , Ácidos Graxos Essenciais/uso terapêutico , Corantes de Alimentos , Conservantes de Alimentos
9.
Nutr Clin Pract ; 31(5): 596-609, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27533942

RESUMO

Intravenous fat emulsions (IVFEs) provide essential fatty acids (EFAs) and are a dense source of energy in parenteral nutrition (PN). Parenterally administered lipid was introduced in the 17th century but plagued with side effects. The formulation of IVFEs later on made it a relatively safe component for administration to patients. Many ingredients are common to all IVFEs, yet the oil source(s) and its (their) percentage(s) makes them different from each other. The oil used dictates how IVFEs are metabolized and cleared from the body. The fatty acids (FAs) present in each type of oil provide unique beneficial and detrimental properties. This review provides an overview of IVFEs and discusses factors that would help clinicians choose the optimal product for their patients.


Assuntos
Emulsões Gordurosas Intravenosas/uso terapêutico , Nutrição Parenteral/métodos , Adulto , Criança , Ácidos Graxos Essenciais/uso terapêutico , Óleos de Peixe/uso terapêutico , Humanos , Azeite de Oliva/uso terapêutico , Óleos Vegetais/uso terapêutico , Óleo de Soja/uso terapêutico
10.
Adv Nutr ; 7(2): 279-86, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26980811

RESUMO

Many studies have reported that olive oil-based lipid emulsion (LE) formulas of soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOF) may be a viable alternative for parenteral nutrition. However, some randomized controlled clinical trials (RCTs) have raised concerns regarding the nutritional benefits and safety of SMOFs. We searched principally the MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Scopus, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to March 2014 for the relevant literature and conducted a meta-analysis of 15 selected RCTs that 1) compared either olive oil- or SMOF-based LEs with soybean oil-based LEs and 2) reported plasma concentrations of α-tocopherol, oleic acid, and ω-6 (n-6) and ω-3 (n-3) long-chain polyunsaturated fatty acids (PUFAs) and liver concentrations of total bilirubin and the enzymes alanine transaminase, aspartate transaminase, alkaline phosphatase, and γ-glutamyl transferase. The meta-analysis suggested that SMOF-based LEs were associated with higher plasma concentrations of plasma α-tocopherol, oleic acid, and the ω-3 PUFAs eicosapentaenoic and docosahexaenoic acid. Olive oil- and SMOF-based LEs correlated with lower plasma concentrations of long-chain ω-6 PUFAs and were similar to soybean oil-based LEs with regard to their effects on liver function indicators. In summary, olive oil- and SMOF-based LEs have nutritional advantages over soybean oil-based LEs and are similarly safe. However, their performance in clinical settings requires further investigation.


Assuntos
Deficiências Nutricionais/prevenção & controle , Medicina Baseada em Evidências , Emulsões Gordurosas Intravenosas/uso terapêutico , Ácidos Graxos Essenciais/uso terapêutico , Azeite de Oliva/uso terapêutico , Nutrição Parenteral/métodos , Óleo de Soja/uso terapêutico , Deficiências Nutricionais/sangue , Emulsões Gordurosas Intravenosas/efeitos adversos , Ácidos Graxos Essenciais/efeitos adversos , Ácidos Graxos Essenciais/sangue , Ácidos Graxos Essenciais/deficiência , Óleos de Peixe/efeitos adversos , Óleos de Peixe/uso terapêutico , Humanos , Azeite de Oliva/efeitos adversos , Nutrição Parenteral/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Óleo de Soja/efeitos adversos
11.
Clin Dermatol ; 34(2): 276-85, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26903189

RESUMO

Visual impairment is a global epidemic. In developing countries, nutritional deficiency and cataracts continue to be the leading cause of blindness, whereas age-related macular degeneration (AMD) and cataracts are the leading causes in developed nations. The World Health Organization has instituted VISION 2020: "The Right to Sight" as a global mission to put an end to worldwide blindness. In industrialized societies, patients, physicians, researchers, nutritionists, and biochemists have been looking toward vitamins and nutrients to prevent AMD, cataracts, and dry eye syndrome (DES). Nutrients from the AREDS2 study (lutein, zeaxanthin, vitamin C, vitamin E, zinc, copper, eicosapentanoic acid [EPA], and docosahexanoic acid [DHA]) set forth by the National Institutes of Health remain the most proven nutritional therapy for reducing the rate of advanced AMD. Omega-3 fatty acids, especially DHA, have been found to improve DES in randomized clinical trials. Conflicting results have been seen with regard to multivitamin supplementation on the prevention of cataract.


Assuntos
Antioxidantes/uso terapêutico , Catarata/prevenção & controle , Síndromes do Olho Seco/tratamento farmacológico , Ácidos Graxos Essenciais/uso terapêutico , Degeneração Macular/tratamento farmacológico , Vitaminas/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Ácido Ascórbico/uso terapêutico , Suplementos Nutricionais , Ácidos Docosa-Hexaenoicos/uso terapêutico , Quimioterapia Combinada , Ácido Eicosapentaenoico/uso terapêutico , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Luteína/uso terapêutico , Degeneração Macular/prevenção & controle , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitamina E/uso terapêutico , Zeaxantinas/uso terapêutico , Zinco/uso terapêutico , beta Caroteno/uso terapêutico
12.
Am J Clin Nutr ; 103(2): 606S-15S, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26791188

RESUMO

The vast majority of infant formulas in the United States contain the long-chain polyunsaturated fatty acids (PUFAs) docosahexaenoic acid (22:6n-3) and arachidonic acid (20:4n-6), which were first permitted by the US Food and Drug Administration in 2001. As a scientific case study, preclinical animal studies of these nutrients definitively influenced the design and interpretation of human clinical studies. Early studies were tied to the availability of test substances, and in hindsight suggest re-evaluation of the essential fatty acid concept in light of the totality of available evidence. Research in the 1950s established the essentiality of n-6 PUFAs for skin integrity; however, widespread recognition of the essentiality of n-3 PUFAs came decades later despite compelling evidence of their significance. Barriers to an understanding of the essentiality of n-3 PUFAs were as follows: 1) their role is in neural function, which is measured only with difficulty compared with skin lesions and growth faltering that are apparent for n-6 PUFAs; 2) the experimental use of vegetable oils as PUFA sources that contain the inefficiently used C18 PUFAs rather than the operative C20 and C22 PUFAs; 3) the shift from reliance on high-quality animal studies to define mechanisms that established the required nutrients in the first part of the 20th century to inherently challenging human studies. Advances in nutrition of premature infants require the best practices and opinions available, taking into account the totality of preclinical and clinical evidence.


Assuntos
Desenvolvimento Infantil , Medicina Baseada em Evidências , Ácidos Graxos Ômega-3/uso terapêutico , Ácidos Graxos Ômega-6/uso terapêutico , Fenômenos Fisiológicos da Nutrição do Lactente , Nascimento Prematuro/dietoterapia , Animais , Congressos como Assunto , Ácidos Graxos Essenciais/deficiência , Ácidos Graxos Essenciais/metabolismo , Ácidos Graxos Essenciais/uso terapêutico , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-3/metabolismo , Ácidos Graxos Ômega-6/administração & dosagem , Ácidos Graxos Ômega-6/metabolismo , Humanos , Fórmulas Infantis/química , Fórmulas Infantis/normas , Recém-Nascido , Neurogênese , Necessidades Nutricionais , Guias de Prática Clínica como Assunto , Estados Unidos , United States Food and Drug Administration
13.
Nutr Neurosci ; 19(4): 145-55, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-24915543

RESUMO

OBJECTIVE: To use proton magnetic resonance spectroscopy ((1)H MRS) to investigate the effects of fish oil (FO) supplementation on cortical metabolite concentrations in adolescents with major depressive disorder (MDD). METHODS: Metabolite concentrations were determined by (1)H MRS in the anterior cingulate cortex and bilateral dorsolateral prefrontal cortex (DLPFC) of adolescents with MDD before and following 10-week open-label supplementation with low (2.4 g/day, n = 7) or high (16.2 g/day, n = 7) dose FO. Depressive symptom severity scores and erythrocyte fatty acid levels were also determined. RESULTS: Baseline erythrocyte eicosapentaenoic acid (EPA) composition was positively correlated, and arachidonic acid (AA) and the AA/EPA ratio were inversely correlated, with choline (Cho) concentrations in the right DLPFC. Docosahexaenoic acid (DHA) composition was inversely correlated with myo-inositol (mI) concentrations in the left DLPFC. Erythrocyte EPA and DHA composition increased, and AA decreased, significantly following low-dose and high-dose FO supplementation. In the intent-to-treat sample, depressive symptom severity scores decreased significantly in the high-dose group (-40%, P < 0.0001) and there was a trend in the low-dose group (-20%, P = 0.06). There were no significant baseline-endpoint changes in metabolite levels in each voxel. In the low-dose group there were changes with large effect sizes, including a decrease in mI in the left DLPFC (-12%, P = 0.18, d = 0.8) and increases in glutamate + glutamine (Glx) (+12%, P = 0.19, d = 0.8) and Cho (+15%, P = 0.08, d = 1.2) in the right DLPFC. In the high-dose group, there was a trend for increases in Cho in the right DLPFC (+10%, P = 0.09, d = 1.2). DISCUSSION: These preliminary data suggest that increasing the LCn-3 fatty acid status of adolescent MDD patients is associated with subtle changes in Glx, mI, and Cho concentrations in the DLPFC that warrant further evaluation in a larger controlled trial.


Assuntos
Fenômenos Fisiológicos da Nutrição do Adolescente , Deficiências Nutricionais/dietoterapia , Transtorno Depressivo Maior/prevenção & controle , Suplementos Nutricionais , Ácidos Graxos Essenciais/uso terapêutico , Óleos de Peixe/uso terapêutico , Adolescente , Adulto , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Deficiências Nutricionais/metabolismo , Deficiências Nutricionais/fisiopatologia , Deficiências Nutricionais/psicologia , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/etiologia , Transtorno Depressivo Maior/metabolismo , Manual Diagnóstico e Estatístico de Transtornos Mentais , Ácidos Graxos Essenciais/deficiência , Ácidos Graxos Essenciais/metabolismo , Feminino , Óleos de Peixe/administração & dosagem , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/metabolismo , Humanos , Análise de Intenção de Tratamento , Perda de Seguimento , Imagem por Ressonância Magnética , Masculino , Neuroimagem , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/metabolismo , Escalas de Graduação Psiquiátrica , Adulto Jovem
15.
Nutr Neurosci ; 19(4): 156-61, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-25056532

RESUMO

OBJECTIVES: Previously, oxidative damage has been associated with severity of clinical symptoms and supplementation with antioxidants and essential polyunsaturated fatty acids (EPUFAs) was proposed to have beneficial effects in schizophrenia. We evaluated the effects of supplementation with EPUFAs and vitamin E in patients treated with haloperidol depot injection. DESIGN: This was a double-blind randomized placebo-controlled study with four arms (Placebo, vitamin E, EPUFAs, and vitamin E + EPUFAs). Biomarkers of oxidative stress, neurochemistry, psychopathology, and extrapyramidal symptoms were assessed at baseline and after 4 months. RESULTS: In EPUFAs group of patients, reduced glutathione concentration was increased compared to placebo. Concentration of oxidized glutathione was decreased in patients receiving vitamin E. In addition, compared to placebo a non-significant trend of increased activity of catalase and superoxide dismutase was observed in all three treatment groups. Patients receiving vitamin E experienced less motor retardation. No difference in extrapyramidal symptoms was found. DISCUSSION: Our study indicates that supplementation with vitamin E and EPUFAs may improve the antioxidative defense, especially glutathione system, while there is no major effect on symptoms severity. Supplemental treatment with EPUFAs and vitamin E in schizophrenia patients treated with haloperidol is potentially beneficial and a larger independent study appears warranted.


Assuntos
Antioxidantes/uso terapêutico , Suplementos Nutricionais , Ácidos Graxos Ômega-3/uso terapêutico , Haloperidol/análogos & derivados , Estresse Oxidativo , Esquizofrenia/dietoterapia , Vitamina E/uso terapêutico , Administração Oral , Adulto , Antipsicóticos/administração & dosagem , Antipsicóticos/uso terapêutico , Biomarcadores/sangue , Terapia Combinada , Preparações de Ação Retardada , Manual Diagnóstico e Estatístico de Transtornos Mentais , Método Duplo-Cego , Ácidos Graxos Essenciais/uso terapêutico , Haloperidol/administração & dosagem , Haloperidol/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Ácido Oleico/uso terapêutico , Projetos Piloto , Escalas de Graduação Psiquiátrica , Esquizofrenia/sangue , Esquizofrenia/tratamento farmacológico , Esquizofrenia/etiologia
16.
Nutr Neurosci ; 19(10): 447-460, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25138699

RESUMO

OBJECTIVES: We previously demonstrated that a mild pre-natal/early post-natal iron-deficient anaemic (IDA) diet devoid of long-chain polyunsaturated fatty acids (LC-PUFA) affected development, neurophysiology, and cerebral lipid biochemistry of the guinea pigs' progeny. Impacts of dietary LC-PUFA on altered cerebral development resulting from pre-natal IDA are unknown. To address this health issue, impacts of mild gestational IDA in the presence of dietary LC-PUFA on the offsprings' neural maturation were studied in guinea pigs using auditory brainstem responses (ABRs) and assessments of brain fatty acids (FAs). METHODS: Female guinea pigs (n = 10/group) were fed an iron sufficient (IS) or IDA diet (146 and 12.7 mg iron/kg, respectively) with physiological amounts of LC-PUFA, during the gestation and lactation periods. From post-natal day (PNd) 9 onwards, the IS + PUFA diet was given to both groups of weaned offspring. Cerebral tissue and offsprings' ABR were collected on PNd24. RESULTS: There was no difference in peripheral and brainstem transmission times (BTTs) between IS + PUFA and IDA + PUFA siblings (n = 10/group); the neural synchrony was also similar in both groups. Despite the absence of differences in auditory thresholds, IDA + PUFA siblings demonstrated a sensorineural hearing loss in the extreme range of frequencies (32, 4, and 2 kHz), as well as modified brain FA profiles compared to the IS + PUFA siblings. DISCUSSION: The present study reveals that siblings born from dams exposed to a moderate IDA diet including balanced physiological LC-PUFA levels during pregnancy and lactation demonstrate minor impairments of ABR compared to the control siblings, particularly on the auditory acuity, but not on neural synchrony, auditory nerve velocity and BTT.


Assuntos
Anemia Ferropriva/fisiopatologia , Córtex Auditivo/fisiopatologia , Tronco Encefálico/fisiopatologia , Ácidos Graxos Essenciais/uso terapêutico , Lactação , Fenômenos Fisiológicos da Nutrição Materna , Neurogênese , Anemia Ferropriva/prevenção & controle , Animais , Córtex Auditivo/metabolismo , Limiar Auditivo , Tronco Encefálico/metabolismo , Ácidos Graxos Essenciais/metabolismo , Ácidos Graxos Ômega-3/metabolismo , Ácidos Graxos Ômega-3/uso terapêutico , Ácidos Graxos Ômega-6/metabolismo , Ácidos Graxos Ômega-6/uso terapêutico , Feminino , Desenvolvimento Fetal , Cobaias , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/metabolismo , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Neurossensorial/prevenção & controle , Ferro na Dieta/uso terapêutico , Masculino , Neurônios , Gravidez , Distribuição Aleatória , Transmissão Sináptica , Desmame
18.
Public Health Nutr ; 18(18): 3420-8, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25805397

RESUMO

OBJECTIVE: Supply of essential n-3 PUFA is limited worldwide. While fish-oil supplementation effectively improves n-3 PUFA status, it may not be a sustainable intervention. The use of α-linolenic acid (ALA)-rich cooking oils in the household may be a suitable alternative but its effect on PUFA status is unclear. We aimed to compare the effect of providing families with soyabean oil, an ALA-rich cooking oil, v. sunflower oil on whole-blood PUFA levels of children aged 11-18 years. DESIGN: In a randomized, masked, parallel trial, we assigned families to receive a one-month supply of either soyabean or sunflower oil. Fatty acid concentrations were quantified in whole-blood samples obtained from the children before and at the end of the intervention. Changes in fatty acids were compared between treatment arms with use of linear regression for repeated measures. SUBJECTS: Sixty low- and middle-income families. SETTING: Bogotá, Colombia. RESULTS: Soyabean oil significantly increased ALA concentrations by 0.05 percentage points of total serum fatty acids whereas sunflower oil decreased them by 0.12 percentage points (soyabean v. sunflower oil effect=0.17; 95% CI 0.11, 0.24). Concentrations of both n-3 and n-6 very-long-chain PUFA, including docosapentaenoic acid, DHA, dihomo-γ-linolenic acid and arachidonic acid, increased significantly in both intervention arms. Levels of oleic acid and palmitic acid decreased, irrespective of oil assignment. Total energy or energy intake from saturated fat did not change. CONCLUSIONS: Replacing cooking oils at the household level is an effective intervention to improve essential PUFA status of children.


Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Culinária , Deficiências Nutricionais/prevenção & controle , Ácidos Graxos Essenciais/uso terapêutico , Óleo de Soja/uso terapêutico , Ácido alfa-Linoleico/sangue , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Criança , Deficiências Nutricionais/sangue , Características da Família , Ácidos Graxos Essenciais/sangue , Ácidos Graxos Essenciais/deficiência , Ácidos Graxos Ômega-3/efeitos adversos , Ácidos Graxos Ômega-3/metabolismo , Ácidos Graxos Ômega-3/uso terapêutico , Ácidos Graxos Ômega-6/efeitos adversos , Ácidos Graxos Ômega-6/metabolismo , Ácidos Graxos Ômega-6/uso terapêutico , Feminino , Humanos , Estudos Longitudinais , Masculino , Inquéritos Nutricionais , Estado Nutricional , Óleos Vegetais/efeitos adversos , Óleos Vegetais/metabolismo , Óleos Vegetais/uso terapêutico , Método Simples-Cego , Óleo de Soja/efeitos adversos , Óleo de Soja/metabolismo , Óleo de Girassol , Ácido alfa-Linoleico/metabolismo
19.
Metabolism ; 64(2): 274-82, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25458829

RESUMO

OBJECTIVE: Parenteral nutrition associated liver disease (PNALD) is a deadly complication of long term parenteral nutrition (PN) use in infants. Fish oil-based lipid emulsion has been shown in recent years to effectively treat PNALD. Alternative fat sources free of essential fatty acids have recently been investigated for health benefits related to decreased inflammatory response. We hypothesized that the addition of medium-chain triglycerides (MCT) to a purified fish oil-based diet would decrease the response to inflammatory challenge in mice, while allowing for sufficient growth and development. MATERIALS/METHODS: Six groups of ten adult male C57/Bl6 mice were pair-fed different dietary treatments for a period of twelve weeks, varying only in fat source (percent calories by weight): 10.84% soybean oil (SOY), 10% coconut oil (HCO), 10% medium-chain triglycerides (MCT), 3% purified fish oil (PFO), 3% purified fish oil with 3% medium-chain triglycerides (50:50 MCT:PFO) and 3% purified fish oil with 7.59% medium-chain triglycerides (70:30 MCT:PFO). An endotoxin challenge was administered to half of the animals in each group at the completion of dietary treatment. RESULTS: All groups demonstrated normal growth throughout the study period. Groups fed MCT and HCO diets demonstrated biochemical essential fatty acid deficiency and decreased IL-6 and TNF-α response to endotoxin challenge. Groups containing PFO had increased inflammatory response to endotoxin challenge, and the addition of MCT to PFO mitigated this inflammatory response. CONCLUSION: These results suggest that the addition of MCT to PFO formulations may decrease the host response to inflammatory challenge, which may pose potential for optimized PN formulations. Inclusion of MCT in lipid emulsions given with PN formulations may be of use in therapeutic interventions for disease states resulting from chronic inflammation.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Gorduras Insaturadas na Dieta/uso terapêutico , Suplementos Nutricionais , Modelos Animais de Doenças , Óleos de Peixe/uso terapêutico , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Triglicerídeos/uso terapêutico , Animais , Anti-Inflamatórios não Esteroides/efeitos adversos , Anti-Inflamatórios não Esteroides/química , Deficiências Nutricionais/etiologia , Deficiências Nutricionais/prevenção & controle , Gorduras Insaturadas na Dieta/administração & dosagem , Gorduras Insaturadas na Dieta/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Emulsões , Ácidos Graxos Essenciais/efeitos adversos , Ácidos Graxos Essenciais/deficiência , Ácidos Graxos Essenciais/uso terapêutico , Óleos de Peixe/efeitos adversos , Óleos de Peixe/química , Lipopolissacarídeos , Fígado/imunologia , Fígado/metabolismo , Fígado/patologia , Masculino , Camundongos Endogâmicos C57BL , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/patologia , Nutrição Parenteral Total/efeitos adversos , Triglicerídeos/administração & dosagem , Triglicerídeos/efeitos adversos , Triglicerídeos/química , Ganho de Peso
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