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2.
Nutr. hosp ; 38(1): 11-15, ene.-feb. 2021. graf
Artigo em Espanhol | IBECS | ID: ibc-198834

RESUMO

INTRODUCCIÓN: la instauración de nutrición parenteral al prematuro ha supuesto un importante avance en su pronóstico. Los últimos años han sido muy fructíferos en cuanto a la publicación de guías en este ámbito. OBJETIVOS: conocer los procedimientos de formulación y elaboración de las nutriciones parenterales neonatales (NPN) en los hospitales españoles. MÉTODOS: se llevó a cabo una encuesta multicéntrica dirigida a los servicios de farmacia sobre los procesos anteriormente citados. RESULTADOS: 55 hospitales cumplieron criterios de inclusión. El 51 % disponía de sistemas informáticos de prescripción, y el 65,5 % formulaba siempre de forma individualizada, mientras que el 34,4 % disponía de fórmulas prediseñadas. Los preparados tricamerales eran utilizados por el 13,0 %. En el 52,7 % de los casos se preparaban las nutriciones de primer día bajo demanda, y ésta se iniciaba antes de las 8 horas de vida en un 88,1 % de los casos. El fosfato inorgánico era la primera opción en un 10,4 %. Se añadían diariamente vitaminas, oligoelementos y zinc en el 92,7 %, 90,9 % y 70,9 % de los casos, respectivamente. El 45,4 % de los hospitales elaboraba siempre las NPPN incluyendo los lípidos en la misma bolsa, frente al 34,5 % en los que estos se administraban por separado en todos los casos. El 50,9 % de los hospitales nunca añadía heparina a sus nutriciones. Las bolsas fotoprotectoras eran utilizadas por un 89,1 %. La estabilidad de las nutriciones variaba desde 24 horas a 15 días. CONCLUSIONES: la elaboración de la NPN en España está sujeta a gran variabilidad. Existe controversia respecto al uso de heparina y mezclas ternarias, reflejada en la variabilidad de la práctica clínica


INTRODUCTION: the introduction of parenteral nutrition in preterm infants has meant a major advance in their prognosis, being the last few years very fruitful in terms of publication of guidelines in this area. OBJECTIVES: to know the formulation and preparation procedures of neonatal parenteral nutrition (NPN) in Spanish hospitals. METHODS: a multi-centre survey was conducted in Pharmacy Services on the aforementioned processes. RESULTS: fifty-five hospitals met inclusion criteria. Electronic prescription systems were use by 51 %, 65.5 % always formulated individually, while 34.4 % had predesigned formulas. Tricameral preparations were used by 13.0 %. In 52.7 % of cases, first day nutrition was prepared on demand, starting before 8 hours of life in 88.1 % of cases. Inorganic phosphate was the first option in 10.4 %, vitamins, trace elements and zinc were added daily in 92.7 %, 90.9 % and 70.9 % of cases, respectively. NPN including lipids in the same bag was formulated by 45.4 % of the hospitals, compared to 34.5 % where it was administered separately in all cases. In 50.9 % of hospitals they never added heparin to their NPN. The 89.1 % used photoprotected bags. The stability of the admixture varied from 24 hours to 15 days. CONCLUSION: the elaboration of the PPN in Spain is subject to great variability. There is controversy regarding the use of heparin and ternary mixtures, which is reflected in the variability of clinical practice


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Alimentos Formulados , Nutrição Parenteral/métodos , Nutrição Parenteral/normas , Inquéritos e Questionários , Assistência Farmacêutica/estatística & dados numéricos , Estudos Transversais
3.
Methods Mol Biol ; 2223: 79-86, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33226588

RESUMO

Atopic dermatitis (AD) is a common skin disease characterized by chronic inflammation and itchiness. Although skin barrier dysfunction and immune abnormalities are thought to contribute to the development of AD, the precise pathogenic mechanism remains to be elucidated. We have developed a unique, diet-induced AD mouse model based on the findings that deficiencies of certain polyunsaturated fatty acids and starches cause AD-like symptoms in hairless mice. Here, we present a protocol and tips for establishing an AD mouse model using a custom diet modified from a widely used standard diet (AIN-76A Rodent Diet). We also describe methods for evaluating skin barrier dysfunction and analyzing itch-related scratching behavior. This model can be used not only to investigate the complex pathogenic mechanism of human AD but also to study the puzzling relationship between nutrition and AD development.


Assuntos
Dermatite Atópica/imunologia , Modelos Animais de Doenças , Ácidos Graxos Insaturados/química , Alimentos Formulados , Prurido/imunologia , Amido/química , Animais , Comportamento Animal , Óleo de Milho/química , Dermatite Atópica/etiologia , Dermatite Atópica/fisiopatologia , Etanol/química , Ácidos Graxos Insaturados/deficiência , Ácidos Graxos Insaturados/imunologia , Feminino , Humanos , Camundongos , Camundongos Pelados , Permeabilidade , Prurido/etiologia , Prurido/fisiopatologia , Pele/efeitos dos fármacos , Pele/imunologia , Pele/patologia , Amido/deficiência , Amido/imunologia
4.
Medicine (Baltimore) ; 99(50): e22867, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327227

RESUMO

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has emerged as a major health problem worldwide; according to statistics, 10% to 25% of patients with NAFLD can progress to nonalcoholic steatohepatitis (NASH). A link between the composition and metabolites of intestinal microbiota and the development of NAFLD is becoming clearer. It is believed that microbiota factors are driving forces of hepatic steatosis and inflammation. The formulated food that contains prebiotics and dietary fiber may improve NAFLD by altering the intestinal flora and its metabolites. METHODS: The study plan to recruit adult patients (18-75 years, n = 120) with NAFLD, range of alanine aminotransferase is 1.5 to 5 times upper limit of normal (ULN) or liver biopsy is confirmed as NASH. Participants will be randomly allocated into 2 groups: formulated food (n = 80) and a placebo group (n = 40) for 24 weeks. Both groups will receive lifestyle and nutritional advice. The primary endpoint is a decrease in MRS-PDFF by more than 30% from baseline at 24 weeks. The secondary endpoints include the change of anthropometric, liver function, glycolipid metabolism, and systemic inflammation at 4, 12, and 24 weeks. In addition, we consider the changes in intestinal microbiota as an exploration to assess the abundance and diversity at 24 weeks. Weeks 24 to 36 are the follow-up period of drug withdrawal. DISCUSSION: This clinical trial will provide evidence of efficacy and safety of formulated food as a potential new therapeutic agent for NAFLD patients. TRIAL REGISTRATION: The trial is registered in the China Clinical Trial Center (ChiCTR1800016178).


Assuntos
Alimentos Formulados/efeitos adversos , Microbioma Gastrointestinal/fisiologia , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Adulto , Idoso , Alanina Transaminase/análise , Bactérias/metabolismo , Estudos de Casos e Controles , China/epidemiologia , Fígado Gorduroso/dietoterapia , Fígado Gorduroso/microbiologia , Feminino , Seguimentos , Alimentos Formulados/microbiologia , Alimentos Formulados/provisão & distribução , Humanos , Inflamação/dietoterapia , Inflamação/microbiologia , Metabolismo dos Lipídeos/fisiologia , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/dietoterapia , Hepatopatia Gordurosa não Alcoólica/patologia , Segurança , Resultado do Tratamento
5.
Artigo em Inglês | MEDLINE | ID: mdl-33371227

RESUMO

The use of blenderised enteral nutrition formula (ENF) is on the increase globally. However, concerns remain regarding the microbial quality and safety of blenderised ENF compared with standard recommendations and commercial ENF. AIM: This was a systematic review which sought to compare the microbial quality of blenderised ENF and commercial ENF and to evaluate the effect of storage time on blenderised ENF. METHOD: Four databases (Pubmed, EMBASE, PSYCInfo and Google scholar) were searched for relevant articles based on the Population, Intervention, Comparator, Outcomes framework. RESULTS: Eleven studies which met the criteria were included in the systematic review. Two major areas were identified; Microbial Quality of Blenderised ENF versus Commercial ENF; and The Effect of Storage Time on Microbial Quality of Blenderised ENF. Overall, 72.7% of the studies showed microbial contamination in blenderised ENF compared with 57.1% of commercial ENF, and the storage time was another important factor in the rates of contamination. The extent of handling or manipulation of the enteral formula was critical in determining the level of contamination. CONCLUSION: Preparation techniques for blenderised ENF need to be established and caregivers taught how to prepare and administer it appropriately in order to reduce contamination. Further, well-designed studies are required, which compare the microbial quality of blenderised ENF using adequate handling techniques and commercial ENF.


Assuntos
Nutrição Enteral , Staphylococcus aureus , Estudos Transversais , Escherichia coli , Alimentos Formulados , Humanos
6.
PLoS One ; 15(7): e0236644, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32730360

RESUMO

BACKGROUND: Gastrostomy tubes (G-tubes) are typically used when people cannot eat food by mouth. The connector section that allows G-tubes to connect to other devices, such as feeding sets or syringes, has been modified on some of the devices to reduce misconnections in hospital settings. The narrow internal diameter of the new connector, standardized under ISO 80369-3, has caused some users to express concern about a reduced flow rate. Previous studies performed on commercial devices determined that it was not conclusive how much the ISO 80369-3 connector contributed towards the reduced flow rate, because when manufacturers designed these new connector-based devices, they often changed other geometric variables (such as distal tube diameter, or length) at the same time. Thus, it became difficult isolating the effect of the connector from other geometric variables. METHOD: The key objective of this study was to investigate how different design variables impacted the flow rate through the G-tubes. 3D-printed devices were used to assess the geometric parameters in a systematic manner. Commercial diets and Newtonian analog fluids with matched viscosities were used for testing. RESULTS: The flow path length of the "transition section" encompassing the standardized ISO 80369-3 connector in the new devices was found to cause reduced flow. Additionally, results showed that a shortened (≤ 10 mm) transition section, along with a 10% increase in the distal inner diameter of large bore devices (e.g., 24 Fr), can restore flow rates to levels consistent with the previous devices prior to the connector standardization. CONCLUSIONS: The strategy for restoring flow rates to previous levels may help alleviate concerns raised by multiple stakeholders such as health care professionals, patients, caregivers and device manufacturers. In addition, the approach proposed here can be used as a tool for designing future G-tube devices.


Assuntos
Nutrição Enteral/instrumentação , Nutrição Enteral/métodos , Nutrição Enteral/normas , Planejamento Ambiental , Alimentos Formulados , Gastrostomia , Humanos , Impressão Tridimensional , Viscosidade
7.
Public Health ; 185: 290-297, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32712460

RESUMO

OBJECTIVES: Malnutrition is one of the leading causes of death among children younger than five years. In this study, we aimed to formulate a ready-to-use supplementary food (RUSF), based on local food products, and investigate its efficacy on growth indicators in children with mild to moderate malnutrition. STUDY DESIGN: This is a randomized controlled clinical trial. METHODS: This study was performed in six health centers in Shahr-e-Rey, Tehran, Iran, between April and October 2017. One hundred children, aged 24-59 months, with mild to moderate malnutrition (weight-for-height Z-score [WHZ] between -3 and -1) were randomly assigned to two groups to receive either 1-3 sachets of RUSF or normal diet for 8 weeks. All mothers and caregivers received nutrition education. Growth indicators including weight and height, WHZ, and body mass index (BMI), along with clinical outcomes, were assessed. RESULTS: Children who received RUSF had a significant increase in weight (1.44 ± 0.38 vs 0.7 ± 0.32 kg, respectively, P < 0.001), and BMI (1.2 ± 0.47 vs 0.35 ± 0.33 kg/m2, respectively, P < 0.001) compared with the control group. There was a greater daily weight gain during the first 4 weeks (P < 0.001) and throughout the study (P = 0.013) in the RUSF group. Daily height gain was considerably higher in the RUSF group during the first 4 weeks (P = 0.027). Children in the RUSF group had more improvement in WHZ (1.18 ± 0.41 vs 0.41 ± 0.31, P < 0.001) after supplementation. Besides, 92% of the RUSF and 12% of the control group reached to WHZ > -1 at the end of the study (P < 0.001). There was lower prevalence of diarrhea (12% vs 28.6%, respectively, P = 0.01) and marginally lower fever (16% vs 36.7%, respectively, P = 0.05) in the intervention than in the control group. CONCLUSIONS: A newly developed RUSF improved growth indicators and clinical outcomes in children with mild to moderate malnutrition. CLINICAL TRIAL REGISTRY NUMBER: IRCT2017021315536N6 (registered at www.irct.ir).


Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Suplementos Nutricionais , Alimentos Formulados , Desnutrição/dietoterapia , Índice de Massa Corporal , Peso Corporal , Desenvolvimento Infantil , Pré-Escolar , Dieta , Feminino , Humanos , Irã (Geográfico) , Masculino , Ganho de Peso
8.
Gan To Kagaku Ryoho ; 47(6): 1001-1003, 2020 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-32541184

RESUMO

White solids were observed in the esophagus of a patient with multiple system atrophy. The patient was receiving enteral nutrition with a polymeric formula and cranberry juice via nasogastric feeding. To test the assumption that the precipitates were formed from a reaction between the juice and the formula, a verification experiment was conducted usingformulae of differinging redients, pH and protein content. The results indicated that a precipitate was formed when formulae with lower pH values and higher protein content were used. Mixing a pH neutral enteral formula with cranberry juice, vinegar or their 2- fold diluted solutions may result in the formation of precipitates in the stomach and esophagus.


Assuntos
Vaccinium macrocarpon , Nutrição Enteral , Alimentos Formulados , Humanos , Intubação Gastrointestinal , Estômago
9.
Arch. latinoam. nutr ; 70(2): 134-143, jun. 2020. tab, graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1140344

RESUMO

El consumo excesivo de sodio es causa importante de enfermedades no transmisibles incluyendo hipertensión. En esta investigación se evaluó una metodología sensorial para reducir el contenido de sodio en salsas de tomate y mayonesas, productos altamente consumidos en Costa Rica. Se caracterizaron, por triplicado, 16 salsas y 7 mayonesas comerciales para determinar los ingredientes más comunes y sus características físicoquímicas. Se comparó el contenido de sodio reportado en la etiqueta contra el valor determinado experimentalmente. Se formularon prototipos de ambos productos y se determinó el umbral de diferencia apenas perceptible (DAP) para el gusto salado utilizando el método de estímulo constante con 40 panelistas no entrenados (d'= 1, significancia de 0,05 y potencia de prueba de 0,95). Se contruyeron las curvas psicofísicas con concentraciones de sal entre 0,67% y 2,5% para salsa de tomate y 0,13% y 4,16% para mayonesa; obteniéndose DAPs de 0,51% y 0,26% respectivamente; equivalentes a 28,3% y 14,4% menos de sal en cada producto. Para la validación del umbral, se aplicó una prueba de discriminación 2-AFC con 40 panelistas comparando la formulación regular con la reducida en sodio. Los panelistas no detectaron diferencias significativas entre mayonesas (P>0,05) pero sí entre salsas (P<0,05), por lo que se aplicó una prueba de agrado con 112 consumidores y se determinó que la salsa reducida en sodio resultó de mayor o igual agrado que la contraparte. Estos resultados guiarían a la industria alimentaria regional hacia el mejoramiento del perfil nutricional de estos productos(AU)


The excessive consumption of sodium is an important cause of noncommunicable diseases including hypertension. This research aimed, using a sensorial methodology, to reduce sodium content in tomato sauces and mayonnaise, highly consumed products in Costa Rica. A total of 16 commercial sauces and 7 mayonnaises were characterized to determine their most common ingredients and physicochemical properties. The sodium content reported in the labed was compared against values obtained experimentally. Prototypes for both products were developed and the threshold for the just noticiable difference (JND) for salty flavor was determined using the constant stimulus method with 40 panelists (d'= 1, 0.05 significance and a test power of 0,95). Psychophysical curves were built with salt concentrations between 0.67% and 2.5% for tomato sauce and 0.13% and 4.16% for mayonnaise; obtaining JNDs of 0.51% and 0.26% respectively; equivalent to 28.3% and 14.4% less salt in tomato and mayonnaise. To validate the threshold, a discriminatory 2-AFC test with 40 panelists was performed to compare the regular formulations against those reduced in sodium. Panelists did not detect significant differences among mayonnaises (P>0.05) but they did found differences between sauces (P<0.05). Thus, for tomato sauce a consumer liking test with 112 consumers was performed and it was found that sodium reduced tomato sauce was equally or more liked than its counterpart. These results guide the regional food industry towards the improval of the nutritional profile of both products(AU)


Assuntos
Humanos , Masculino , Feminino , Sódio , Lycopersicon esculentum , Manipulação de Alimentos , Doenças Cardiovasculares , Alimentos Formulados , Consumo de Alimentos
10.
Nutr. hosp ; 37(3): 432-435, mayo-jun. 2020.
Artigo em Inglês | IBECS | ID: ibc-193847

RESUMO

BACKGROUND: the planning of nutritional therapy depends on restrictions defined by the prescriber, in a way that nutrients and calories levels are placed at appropriate intervals. Since industrialized formulas (IF) have fixed compositions of macro and micronutrients, there is a high risk of not meeting the set of restrictions in a given clinical scenario, i.e., attendance of the caloric, but not of the protein target. OBJECTIVE: the objective of this study is to identify under what conditions it is possible an industrialized formula to meet the clinical restrictions of calories, macro and micronutrients. METHODS: we deduced a mathematical relationship that must be met in order to satisfy such constraints. Using as variables: a) the necessary volume of an FI to meet the energy goal; b) the energy density of the FI; c) upper limit of calorie or nutrient; and d) the lower limit of calorie or nutrient. RESULTS: a first degree inequality was developed that if attended allows to discriminate if a prescribed volume V of an IF meets the set of restrictions placed by the prescriber, in order to previously select viable formulas among a portfolio. Clinical vignettes are presented. CONCLUSION: the viability condition of an industrialized formula for the attendance of a system of constraints can be identified with the aid of a mathematical formula of the first-degree inequality type


INTRODUCCIÓN: la planificación de la terapia nutricional depende de las restricciones definidas por el prescriptor, de manera que los niveles de nutrientes y calorías se coloquen a intervalos apropiados. Como las fórmulas industrializadas (IF) tienen composiciones fijas tanto de macronutrientes como de micronutrientes, existe un alto riesgo de no cumplir con el conjunto de restricciones en un escenario clínico dado; es decir, la consecución del objetivo calórico, pero no del objetivo proteico. OBJETIVO: el objetivo de este estudio es identificar bajo qué condiciones una fórmula industrializada puede cumplir con las restricciones clínicas de calorías, macronutrientes y micronutrientes. MÉTODOS: dedujimos una relación matemática que debe cumplirse para satisfacer tales restricciones. Usando como variables: a) el volumen necesario de un FI para alcanzar la meta de energía; b) la densidad de energía del FI; c) el límite superior de calorías o nutrientes; y d) el límite inferior de calorías o nutrientes. RESULTADOS: se desarrolló una desigualdad de primer grado que, si se atiende, permite discriminar si un volumen prescrito V de un IF cumple con el conjunto de restricciones impuestas por el prescriptor para seleccionar previamente fórmulas disponibles dentro de una cartera. Se presentan viñetas clínicas. CONCLUSIÓN: la condición de viabilidad de una fórmula industrializada para el cumplimiento de un sistema de restricciones puede identificarse con la ayuda de una fórmula matemática del tipo de desigualdad de primer grado


Assuntos
Humanos , Modelos Teóricos , Alimentos Formulados , Terapia Nutricional/métodos , Nutrientes , Micronutrientes
11.
J Dairy Sci ; 103(7): 6299-6310, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32418688

RESUMO

Single-step genomic BLUP (ssGBLUP) is a powerful approach for breeding value prediction in populations with a limited number of genotyped animals. However, conflicting genomic (G) and pedigree (A22) relationship matrices complicate the implementation of ssGBLUP into practice. The metafounder (MF) approach is a recently proposed solution for this problem and has been successfully used on simulated and real multi-breed pig data. Advantages of the method are easily seen across breed evaluations, where pedigrees are traced to several pure breeds, which are thereafter used as MF. Application of the MF method to ruminants is complicated due to multi-breed pedigree structures and the inability to transmit existing unknown parent groups (UPG) to MF. In this study, we apply the MF approach for ssGBLUP evaluation of Finnish Red Dairy cattle treated as a single breed. Relationships among MF were accounted for by a (co)variance matrix (Γ) computed using estimated base population allele frequencies. The attained Γ was used to calculate a relationship matrix A22Γ for the genotyped animals. We tested the influence of SNP selection on the Γ matrix by applying a minor allele frequency (MAF) threshold (ΓMAF) where accepted markers had an MAF ≥0.05. Elements in the ΓMAF matrix were slightly lower than in the Γ matrix. Correlation between diagonal elements of the genomic and pedigree relationship matrices increased from 0.53 (A22) to 0.76 ( A22Γ and [Formula: see text] ). Average diagonal elements of A22Γ and [Formula: see text] matrices increased to the same level as in the G matrix. The ssGBLUP breeding values (GEBV) were solved using either the original 236 or redefined 8 UPG, or 8 MF computed with or without the MAF threshold. For bulls, the GEBV validation test results for the 8 UPG and 8 MF gave the same validation reliability (R2; 0.31) and over-dispersion (0.73, measured by regression coefficient b1). No significant R2 increase was observed in cows. Thus, the MF greatly influenced the pedigree relationship matrices but not the GEBV. Selection of SNP according to MAF had a notable effect on the Γ matrix and made the A22 and G matrices more similar.


Assuntos
Bovinos/genética , Genômica , Seleção Artificial , Animais , Feminino , Alimentos Formulados , Frequência do Gene , Genoma , Genômica/métodos , Genótipo , Masculino , Modelos Genéticos , Linhagem , Reprodutibilidade dos Testes
12.
Environ Entomol ; 49(4): 777-788, 2020 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-32406911

RESUMO

The golden twin-spot moth or tomato looper, Chrysodeixis chalcites (Esper), is a polyphagous and worldwide pest that causes important aesthetic damages to banana fruits in the Canary Islands. The life history parameters of C. chalcites were determined under laboratory conditions in base on the age-stage, two-sex life table at 15, 20, 25, 30, and 35°C, 65% relative humidity (RH), and a photoperiod of 16:8 (L:D) h, when it was reared on a semi-synthetic diet. The results show that C. chalcites was able to develop and survive from 15 to 30°C, but no development occurred at 35°C. Developmental threshold temperatures of the egg, larval, pupal, and total preoviposition stages were 10.42, 11.73, 11.22, and 9.42°C, respectively, and their effective accumulated temperatures were 58.31, 265.96, 118.57, and 562.39 degree-days, respectively. The adult longevity was reduced with increasing temperature, which ranged between 16.27 and 34.85 d for females and between 14.27 and 35.21 d for males. The highest values of net reproductive rate (R0) and fecundity were observed at 25°C, with 232.70 offspring and 1,224.74 eggs, respectively. Both the intrinsic rate of increase (r) and finite rate of increase (λ) increased significantly and mean generation time (T) decreased significantly with increasing temperature. These results provide useful information that will allow predicting the impact of climate change on the distribution and population dynamics of C. chalcites and developing successful integrated management programs.


Assuntos
Mariposas , Óvulo , Animais , Feminino , Alimentos Formulados , Tábuas de Vida , Masculino , Espanha , Temperatura
13.
Gastroenterology ; 158(6): 1789-1810.e15, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32359563

RESUMO

Eosinophilic esophagitis (EoE) is a chronic inflammatory condition of the esophagus. Many new studies have been reported recently that describe EoE management. An expert panel was convened by the American Gastroenterological Association Institute and the Joint Task Force on Allergy-Immunology Practice Parameters to provide a technical review to be used as the basis for an updated clinical guideline. This technical review was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Eighteen focused EoE management questions were considered, with 15 answered using the GRADE framework and 3 with a narrative summary. There is moderate certainty in the evidence that topical glucocorticosteroids effectively reduce esophageal eosinophil counts to <15 per high-power field over a short-term treatment period of 4-12 weeks, but very low certainty about the effects of using topical glucocorticosteroids as maintenance therapy. Multiple dietary strategies may be effective in reducing esophageal eosinophil counts to <15 per high-power field over a short-term treatment period, with moderate certainty for elemental diets, low certainty for empiric 2-, 4-, and 6-food elimination diets, and very low certainty that allergy-based testing dietary eliminations have a higher failure rate compared to empiric diet elimination. There is very low certainty for the effect of proton pump inhibitors in patients with esophageal eosinophilia. Although esophageal dilation appears to be relatively safe, there is no evidence that it reduces esophageal eosinophil counts. There is very low certainty in the effects of multiple other medical treatments for EoE: anti-interleukin-5 therapy, anti-interleukin-13 therapy, anti-IgE therapy, montelukast, cromolyn, and anti-TNF therapy.


Assuntos
Esofagite Eosinofílica/terapia , Medicina Baseada em Evidências/normas , Hipersensibilidade Alimentar/diagnóstico , Administração Tópica , Adulto , Comitês Consultivos/normas , Fatores Etários , Alergia e Imunologia/organização & administração , Alergia e Imunologia/normas , Criança , Dilatação/efeitos adversos , Dilatação/normas , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/imunologia , Eosinófilos/efeitos dos fármacos , Eosinófilos/imunologia , Esofagoscopia/efeitos adversos , Esofagoscopia/normas , Medicina Baseada em Evidências/métodos , Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/imunologia , Alimentos Formulados , Gastroenterologia/métodos , Gastroenterologia/organização & administração , Gastroenterologia/normas , Glucocorticoides/administração & dosagem , Humanos , Inibidores da Bomba de Prótons/uso terapêutico , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Resultado do Tratamento , Estados Unidos
14.
PLoS One ; 15(5): e0225871, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32369478

RESUMO

The potential of probiotics to manipulate the intestinal microbial ecosystem toward commensal bacteria growth offers great opportunity for enhancing health and performance in poultry. This study aimed to evaluate the efficacy of five probiotic-based formulations in modulating cecal microbiota in broilers at 21 and 42 days of age. Probiotics investigated included a synbiotic (SYNBIO), a yeast (YEAST), and three single-strain formulations of Bacillus amyloliquefaciens (SINGLE1), B. subtilis (SINGLE2) and B. licheniformis (SINGLE3). Alpha-diversity analyses showed that cecal microbiota of SINGLE1, SINGLE2, and YEAST had low diversity compared to the control diet with no feed additive (CON) at 21d. At the same age, weighted Unifrac distance measure showed significant differences between samples from SYNBIO and CON (P = 0.02). However, by analyzing principal coordinates analysis (PCoA) with unweighted Unifrac, there was no evidence of clustering between CON and probiotic treatments. By 42d, there were no differences in alpha or beta-diversity in the microbiota of probiotic treatments compared to CON. Similarly, taxonomic microbial profiling did not show major changes in cecal microbial taxa. In conclusion, not all probiotic-based formulations tested had a core benefit on the modulation of microbiota. However, based on the quantitative beta diversity results, SYNBIO greatly influenced the cecal microbial community structure attributable to transient variations in relative taxon abundance.


Assuntos
Ceco/microbiologia , Galinhas/microbiologia , Alimentos Formulados , Microbioma Gastrointestinal , Probióticos , Animais
15.
PLoS One ; 15(5): e0233797, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32470042

RESUMO

The incidence of metabolic diseases, such as type 2 diabetes, has increased steadily worldwide. Diet, beverages, and food texture can all markedly influence these metabolic disorders. However, the combined effects of food texture and beverages on energy metabolism remains unclear. In the present study, we examined the effect of food texture on energy metabolism in mice administered high-fructose corn syrup (HFCS). Mice were fed a soft or hard diet along with 4.2% HFCS or tap water. Body weight and total caloric intake were not affected by food texture irrespective of HFCS consumption. However, caloric intake from HFCS (i.e., drinking volume) and diet were higher and lower, respectively, in the hard food group than in the soft food group. The hard food group's preference for HFCS was absent in case of mice treated with the µ-opioid receptor antagonist naltrexone. Despite increased HFCS consumption, blood glucose levels were lower in the hard-diet group than in the soft-diet group. In HFCS-fed mice, insulin levels after glucose stimulation and insulin content in the pancreas were higher in the hard food group than the soft food group, whereas insulin tolerance did not differ between the groups. These food texture-induced differences in glucose tolerance were not observed in mice fed tap water. Thus, food texture appears to affect glucose tolerance by influencing pancreatic ß-cell function in HFCS-fed mice. These data shed light on the combined effects of eating habits and food texture on human health.


Assuntos
Glicemia/efeitos dos fármacos , Alimentos Formulados , Xarope de Milho Rico em Frutose/efeitos adversos , Células Secretoras de Insulina/efeitos dos fármacos , Insulina/sangue , Doenças Metabólicas/induzido quimicamente , Animais , Peso Corporal/efeitos dos fármacos , Ingestão de Energia/efeitos dos fármacos , Metabolismo Energético/efeitos dos fármacos , Preferências Alimentares/efeitos dos fármacos , Células Secretoras de Insulina/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL
16.
J Food Sci ; 85(4): 1265-1273, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32249412

RESUMO

Ready-to-use therapeutic foods (RUTFs) are special foods used to encourage rapid weight gain in 5-year-old malnourished children, avoiding hospitalization. The factors affecting sensory characteristics and acceptability of RUTFs have been not adequately described. The aim of this work was to evaluate both the sensory properties and volatile compounds of four alternative RUTFs, varying in soy and sorghum, icing sugar, and oil content. Nine nonoral sensory attributes were evaluated by nine selected and trained assessors. The perceived intensity of five oral sensory attributes and the overall liking were assessed by 100 adult consumers. The volatile compounds were extracted and concentrated by solid phase microextraction and analyzed by gas chromatography/mass spectrometry. RUTF formulations significantly differed for graininess between fingers (size of granules) (P = 0.007), viscosity (P = 0.013), adhesiveness to the spoon (P < 0.044), and meltability (P = 0.005), but in consumers' opinion, they differed only for difficulty in swallowing, intensity of global odor, flavor, and sweetness. A positive correlation between overall liking and sweetness was found. Volatile compounds arising from lipid oxidation (hexanal and octanoic acid) were positively correlated with global odor and flavor. These attributes negatively affected the overall liking and were mainly contained in one out of the four formulations. Sensory and instrumental characterization identified key attributes for this kind of food, such as difficulty in swallowing, global odor, and sweetness, suggesting how to formulate an alternative RUTF to be used for a future clinical trial on malnourished children. PRACTICAL APPLICATION: Starting from the world's need to fight child malnutrition, the present study tried to characterize alternative ready-to-use therapeutic foods (RUTFs), special foods used to encourage rapid weight gain in 5-year-old malnourished children, from several points of view, such as acceptability, stability, technological, and overall quality. Results obtained will be an aid to setup the technological conditions and scale-up parameters for local productions of RUTFs to be tested in real trials on malnourished children. Indeed, key sensory attributes that drive consumer acceptance for this special food, such as sweetness and difficulty in swallowing, came out from the present study.


Assuntos
Transtornos da Nutrição Infantil/dietoterapia , Fast Foods , Alimentos Formulados , Paladar , Adulto , Criança , Pré-Escolar , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Microextração em Fase Sólida
17.
ScientificWorldJournal ; 2020: 9872185, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32292296

RESUMO

The present work aims to elaborate many juice formulas (F1 to F8) from two dried fruits (jujubes: Ziziphus lotus L. and dates: Phoenix dactylifera L.). Physicochemical and biochemical characterization of the formula juices shows that juices rich in dates fruits (F1, F3, F5, and F7) are loaded, on average, in total sugars (129.5 g/l), proteins (3.02 g/l), lipids (1.08 g/l), and carotenoid (0.02 mg/l), while juices rich in jujube fruits (F2, F4, F6, and F8) are overloaded, on average, in phenolic compounds (697 mg/l), flavonoids (6.32 mg/l), condensed tannins (2.1 mg/l), hydrolysable tannins (359.5 mg/l), and viscosity (1.062 mm 10-3 s). All formulations developed have a pH that rotates between 5.12 and 5.20. Total antioxidant capacity (CAT) reveals that formulations F1, F3, F5, and F7 show a strong activity compared to the other formulas. The DPPH test shows that all formulated juices have the same antioxidant profile with IC50 values lower than the template (BHT and Vit C). The FRAP test reveals that F2, F4, F6, and F8 formulas have a strong reducing power. Organoleptic evaluation by a jury shows that F4 formula is the best in terms of odor, aroma, and aftertaste agreeability.


Assuntos
Alimentos Formulados/análise , Sucos de Frutas e Vegetais/análise , Nutrientes/análise , Phoeniceae/química , Extratos Vegetais/química , Ziziphus/química , Antioxidantes/química , Antioxidantes/farmacologia , Fenômenos Químicos , Relação Dose-Resposta a Droga , Micronutrientes
20.
Aliment Pharmacol Ther ; 51(10): 935-947, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32249975

RESUMO

BACKGROUND: Exclusive enteral nutrition (EEN) is an effective treatment for Crohn's disease. AIMS: To investigate the hypothesis that ingredients of EEN formulas are unlikely to initiate a disease flare and that their dietary elimination is not essential for disease amelioration. METHODS: We performed compositional analysis of EEN formulas with evidence of efficacy in management of active Crohn's disease. Macronutrient content was compared against the dietary reference values (DRV), the UK National Diet and Nutrition Survey (NDNS) and intake of Crohn's disease children. Food additives were cross-referenced against the FAO/WHO database. RESULTS: Sixty-one formulas were identified with variable composition (carbohydrates [22.8%-89.3%], protein [7.8%-30.1%], fat [0%-52.5%]). Maltodextrin, milk protein and vegetable/plant oils were the commonest macronutrient sources. Their n-6:n-3 fatty acid ratio varied from 0.25 to 46.5. 56 food additives were identified (median per formula: 11). All formulas were lactose-free, gluten-free, and 82% lacked fibre. The commonest food additives were emulsifiers, stabilisers, antioxidants, acidity regulators and thickeners. Food additives, implicated in Crohn's disease aetiology, were present in formulas (modified starches [100%], carrageenan [22%], carboxymethyl cellulose [13%] and polysorbate 80 [5%]). Remission rates did not differ between EEN formulas with and without those food additives. Analysis including only formulas from randomised controlled trials (RCTs) retained in the latest Cochrane meta-analysis produced similar findings. EEN formulas contained less energy from saturated fat than NDNS intake. CONCLUSION: We have identified food ingredients which are present in EEN formulas that are effective in Crohn's disease and challenge perceptions that these ingredients might be harmful.


Assuntos
Doença de Crohn/terapia , Nutrição Enteral , Alimentos Formulados/análise , Adolescente , Criança , Pré-Escolar , Humanos , Inquéritos Nutricionais , Resultado do Tratamento
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