International Journal of Nutrology
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The Time for Parenteral Nutrition is Now: 12 Months Caring for Patients with Severe COVID-19
Get PDFThe coronavirus disease 2019 (COVID-19) pandemic has brought new challenges to adequate nutrition, especially in critically ill patients. Physicians caring for these patients face great difficulties, including a different pathophysiology compared with other diseases, inadequately trained personnel, pressure from the media and family members, logistical and economic obstacles, and lack of robust medical evidence. Although the literature on COVID-19 is still limited, evidence demonstrates the need to reevaluate the use of effective nutritional support in this unprecedented, challenging clinical context. Supplemental parenteral nutrition must be considered due to the energy expenditure from COVID-19, the difficulty in achieving protein and energy goals in patients under enteral nutrition in prone position, and the worsened gastroparesis related to high doses of sedative/neuromuscular blocking agents
Evaluation of Nutritional Risk and Prevalence of Obesity in Patients with Covid-19 in A Reference Hospital in Salvador, Bahia, Brazil: A Cross-Sectional Study
Get PDFIntroduction: The Coronavirus has spread to almost every country in the world, causing the coronavirus disease (COVID-19). The coronavirus stands out among the other infections especially by it's high contagious power and important effects on the respiratory system. The COVID-19 has differents ways of presentation and these are influenced by the patient's previous nutricional status, correlated with the patient's lifestyle and comorbities. Objective: this survey seeks to analyze the nutritional status and the prevalence of obesity in patients hospitalized with SARS-CoV-2. Methods: this is a descriptive, prospective and cross-sectional study type, which 41 patients affected by COVID-19 were interviewed. Patient's weight and height were used to assess the BMI, and nutritional risk assessment was performed using the Nutritional Risk Screening tool (NRS 2002). For the analysis, Absolute (AF) and Relative Frequency (RF), the mean and the standard deviation were calculated. Results: It was observerd that 78% of the participants had a high nutritional risk, while only 22% had a low nutritional risk. Besides that, 34% showed overweight and 41.4% showed obesity. Conclusion: the existence of a high prevalence of increased nutritional risk was evidenced, in addition to the high frequency of overweight in patients affected by SARS-CoV-2
Applications of Fecal Microbiota Transplantation: Emphasis on Clostridioides difficile Infections
Get PDFObjective: This study aimed to perform a comprehensive review of clinical trials using fecal microbiota transplantation in cases of Clostridioides difficile infection. Methods: This manuscript reviews clinical studies published from 2003 to 2020 at the Scientific Electronic Library Online (SciELO Brazil), Latin American and Caribbean Health Sciences Literature (LILACS) and US National Library of Medicine (MedLine/PubMed) databases using the descriptors antibiotic/antimicrobial, Clostridium difficile/Clostridioides difficile, intestinal microbiota/intestinal microbiome and fecal transplantation. Results: Interventions on microbiota include the use of probiotics, prebiotics, and fecal microbiota transplantation as therapeutic methods. Results show that fecal microbiota transplantation is an excellent alternative for the treatment of recurrent C. difficile infections
Idiopathic achalasia primarily diagnosed as bulimia nervosa: the importance of the nutrologyst
Get PDFIdiopathic achalasia is a primary esophageal motor disorder characterized by esophageal aperistalsis and abnormal lower esophageal sphincter relaxation in response to deglutition. Bulimia nervosa is an eating disorder, which amongst other symptoms presents with self-induced vomiting after repetitive episodes of binge eating in order to prevent weight gain. The present study reports the case of a female patient initially diagnosed with bulimia nervosa, after ruling out an etiology of organic cause through lab tests and endoscopy. The patient was referred to a nutrologyst for treating the eating disorder, and after nutritional evaluation, she received nutritional supplementation due to severe dysphagia, regurgitation and weight loss. As diagnostic criteria of bulimia nervosa were not met, a further investigation was conducted, which eventually confirmed idiopathic achalasia through two specific tests: digital esophagogastroduodenal seriography, and esophageal manometry. Chagas disease, the major cause of idiopathic achalasia in Brazil, was ruled out by specific lab test. In view of the severity of the disease, the patient underwent urgent cardiomyotomy and fundoplication. Later, balloon dilators were also used in two occasions. After sixteen months of medical and nutrology follow-up, the patient now is in good nutritional status and was able to go back to her daily activities and healthy lifestyle
Urinary calcium excretion in short bowel syndrome patients receiving cyclic parenteral nutrition: Case report
Get PDFTotal parenteral nutrition is essential for the survival of short bowel syndrome patients. However, in the long term it is associated with complications such as metabolic bone disease. This complication has been attributed, among other causes, to an increased urinary calcium loss, which might be related to the amount of aminoacids, glucose and calcium present in the parenteral nutrition solution. Two case reports are here presented showing normal calciuria in short bowel syndrome adults, receiving parenteral nutrition for up to 5 years after extensive bowel resection
Perfil nutricional, glicêmico, insulínico e de resistência Insulínica de crianças e adolescentes do “Projeto Equilíbrio Alimentar” em Santa Maria - RS
Get PDFThe study aimed to evaluate the nutritional, glycemic and insulin profile and insulin resistance from children and adolescents "Balance Food Project" in Santa Maria - RS. Eighty seven participants between 5 and 16 years, of both sexes were evaluated. The data obtained were: anthropometric measures (weight and height), the input and output or the last evaluation, blood glucose and fasting insulin and BMI was calculated. We conducted the nutritional classification, the evolution of BMI, insulin and glucose profile, the evaluation of the criterion of 100mg/dl glucose and insulin as criteria> 15 μUI / ml, we calculated the HOMA IR and the relation between glucose / insulin, compared to four parameters of peripheral insulin resistance: HOMA IR, fasting insulin, glucose ratio / Point insulin and fasting insulin cut by De Almeida (2008). There was predominance of females (56.3%), the age group between 9 and 10 years (39.1%), and obese (86.2%) reduction in BMI (65.5%) of glucose normal fasting (98.8%), blood glucose values between 80 and 89 mg / dl (48.3%) and above 25 μUI insulin / ml for 31% of the participants. Insulin resistance was positive: HOMA IR (46%), fasting insulin <15μUI/ml (57.5%), Glucose-insulin ratio (69%), and cutoffs for fasting insulin De Almeida (2008) (78%). The project was effective in controlling weight. Childhood obesity is already producing comorbidities. It is necessary to spread the Food Balance Project in Santa Maria, RS
Prevalência de diabetes e intolerância a glicose em pacientes com dor crônica
Get PDFJustificativa e objetivos: A diabetes é associada ao aumento de prevalência de dor crônica, porém faltam estudos que associem dor crônica como um sintoma precoce de intolerância a glicose ou diabetes. O objetivo deste estudo foi avaliar na população adulta a prevalência de diabetes e intolerância a glicose em pacientes com dor crônica comparado com pacientes sem dor crônica em um ambulatório privado especializado em nutrologia. Método: Foram incluídos 60 pacientes, 30 pacientes com dor crônica com duração de pelo menos 3 meses e 30 pacientes sem queixa de dor crônica. Todos os pacientes foram estudados prospectivamente para o diagnóstico de diabetes ou intolerância a glicose por meio do teste de tolerância oral com medição glico-insulinica basal a após 2 horas, após estímulo de 75 gramas de glicose. Resultados: Dos 30 indivíduos com dor crônica, 6 pacientes (20%) tinham diabetes, 3 pacientes (10%) tinham intolerância a glicose, totalizando 9 pacientes (30%) com alteração dos níveis glicêmicos (pré-diabético ou diabético). Dos 30 indivíduos sem dor crônica, 1 paciente (3,3%) foi diagnosticado como diabético, 3 pacientes (10%) com intolerância a glicose, totalizando 4 pacientes (13,3%) com alteração dos níveis glicêmicos (pré-diabético ou diabético). Conclusão: Houve significância estatística na prevalência de alteração do nível glicêmico em pacientes com dor crônica em comparação com pacientes sem queixa de dor crônica
Constipação Intestinal: Abordagem Medicamentosa e não Medicamentosa
Get PDFConstipation is a prevalent condition in both adults and children. The clinical criteria for treatment are well established, and different non-drug approaches (fiber, hydration, physical activity, regular bowel habits, biofeedback, botulinum toxin injection, surgery) and medication (laxatives and purgatives) have been proposed to intervene in problem. However, supported by the media, in purely commercial character and sometimes improperly sustained medical advice, even with little demonstrated efficacy and safety in controlled studies, the use of laxatives persists as a treatment of constipation. Laxatives and purgatives may be needed within a pre - operative preparation for radiological and endoscopic procedures, among other reasons, and exceptionally, under medical supervision, as initial adjuvant in the treatment of constipation
Retinolemia em escolares eutróficos e com sobrepeso
Get PDFObjectives: To determine the frequency of normal weight and overweight schoolchildren who have deficiency of vitamin A and to study the relationship between serum retinol concentrations and body mass index (BMI), body fat percentage and waist circumference of normal weight and overweight children. Methods: Cross-sectional, descriptive and analytical study carried out with schoolchildren aged 8 to 10 years old from public schools in Uberaba (MG). The sample consisted of eighty students matched for age and sex, being forty eutrophic schoolchildren and forty with overweight. Results: It was observed that 25% of students were overweight and 20% of normal weight children presented serum retinol disabled. There was no significant difference between the mean serum retinol concentrations in the eutrophic schoolchildren group and overweight group. No significant correlations were observed between serum concentrations and BMI, waist circumference and body fat percentage measured by bioelectrical impedance in both groups. Conclusion: The results show a high prevalence of deficient serum retinol, which are not related to body fat percentage and waist circumference measurement, in two groups of healthy schoolchildren, an eutrophic and another group, overweight