International Journal of Nutrology
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Management of severe diarrhea in an AIDS patient with inflammatory bowel disease with Short Bowel Syndrome
Get PDFIntroduction: The human immunodeficiency virus (HIV) can lead to a loss of lymphoid tissue through the intestinal mucosa, making the intestine susceptible to infections and inflammation. As a result, the patient may present with Crohn's Disease (CD), a chronic inflammatory bowel disease (IBD). Short Bowel Syndrome (SBS) results from loss of bowel absorption capacity after extensive bowel resection and is associated with several complications. Objective: To report the case of a patient presenting with acute chronic diarrhea, of probable multifactorial etiology, secondary to HIV, CD, and SBS. Methods: The information contained in this report was obtained through a review of the medical record and a review of the literature. Case Report: This is the report of E. F. C, male, 49 years old, who was admitted to the ICU of Hospital Ernesto Dornelles, in Porto Alegre, from 12/04/2020 to 01/07/2021, with HIV, CD, and SBS. The patient was admitted complaining of diarrhea that had started 15 days ago, which had worsened in the last 7 days, with loss of appetite, vomiting episodes, and mental confusion. Using empirical Lamivudine, Zidovudine, Tenofovir, Ciprofloxacin and Metronidazole, Methotrexate and Prednisone. On physical examination, he was sleepy, afebrile, with a normotensive abdomen, severe dehydration, and edema 3+/4+. From anthropometry, the measured weight of 50 kg, reported height of 1.70 m, and BMI of 17 kg/m2. On laboratory tests, he had severe pancytopenia and electrolyte disturbances. Although the cause of diarrhea was not clarified, bowel rest and the use of glutamine and enteral symbiotic were chosen, while treating HIV and CD, to improve enterocyte nutrition and reduce bacterial translocation capable of causing septic conditions. Despite this, diarrhea was untreatable, mean greater than 1,000 ml/day, with indication, but without the possibility of total parenteral nutrition, due to thrombocytopenia. On 12/06, E. F. C was in poor general condition, anasarca, tachycardic, hypotensive, treating septicemia caused by Candida tropicalis. On 12/07, he presented no spontaneous breathing, absence of central pulses and pupillary reflexes, opted not to institute invasive measures, and died. Final Considerations: The report highlights the need to cover IBD and opportunistic infections in the differential diagnosis of diarrhea in AIDS patients with CD and SBS. It also demonstrates the challenge of nurturing the patient who does not have conditions for enteral and/or parenteral nutrition, with a high risk of malnutrition due to the catabolism of such pathologies
A case report on the septic arthritis in a newborn: therapeutic approaches and major considerations
Get PDFIntroduction: The prevalence of septic arthritis (SA) is higher in underdeveloped countries than in developed countries, and the number of hospitalizations of children for this cause is decreasing and the most prevalent age group is between 0 and 4 years of age. Clinical history and detailed physical examination are essential to make an accurate diagnosis, but the neonatal period has certain limitations. Objective: To report a case of septic arthritis that occurred in a newborn admitted to the Neonatal Intensive Care Unit (ICU) due to its serious condition, morbidity, and unusual evolution of the pathology in the pediatric population, scarcity of epidemiological data on the subject, still aiming address aspects of the treatment of the disease. Case report: Male patient, born on 09/11/2020 at Santa Casa de Tupã, Sao Paulo, with a gestational age of 36 weeks and 6 days, through cesarean delivery and without complications, obtaining APGAR 9 and 10, and maintained in a room with the mother. The morning after birth, the newborn (NB) began to groan and have mild respiratory distress. The patient evolved with worsening of the breathing pattern and oxygen was concentrated at 6L/min in Hood's Halo, presenting hyperthermia, hyperemia, and edema in the right elbow. Laboratory tests showed an increase in C-Reactive Protein and worsened hematimetric indices of the blood count, and antibiotic therapy was then started with oxacillin 50 mg/kg/dose and amikacin 15 mg/kg/day. The ultrasound of the right elbow showed skin thickening, absence of collections, and no changes in vasculature, being suggestive of cellulite. A new ultrasound of the right elbow showed bulging, intra-articular collection, and discreet collection with extra-articular communication in the medial region, being suggestive of septic arthritis. Blood culture collection resulted in the growth of gram-positive cocci (Staphylococcus aureus) in a pair of samples. The patient received intravenous treatment with Vancomycin for 14 days with clinical and laboratory improvement of the infection and was discharged with the use of oral Clindamycin for another 14 days and physical therapy follow-up for rehabilitation of movement of the affected limb. Final considerations: Due to the unusual evolution of SA in the neonatal period, and the scarcity of literature on the pathology in this age group, the importance of further studies on the subject, and greater surveillance for neonatal diagnosis, in addition to early treatment to reduce of complications
O que podemos fazer para evitar as doenças inflamatórias intestinais? A importância da microbiota
Get PDFInflammatory bowel disease (IBD) are characterized by chronic,recurrent and idiopathic inflammation, which result from an inappropriate immune response in genetically susceptible individuals. Essentially IBD comprises two forms of presentation: ulcerative colitis (UC) and Crohn’s disease (CD). The UCaffects the mucosa of colon and rectum and, classically, has symmetrical distribution, ascendingand continuous. The DC is characterized by a chronic transmural inflammation of the digestivetract, which can affect the mouth to the anus segmentally or sauteed, with frequent involvementof the ileal or ileocecal region. The disease pathogenesis is not fully understood, it appear to be triggered by the mutual interaction of environmental, immune, genes and microbiota. In recent years several studies were published on the changes of microbiota in these patients demonstrating the importance of this factor. The knowledgement of environmental risk factors supports international planning to the use resources for health, scientific researches and may be a potential therapeutic target, as was stated in the last ESPGHAN 2016
Consumo de alimentos ultraprocessados em crianças atendidas pelo serviço de Atenção Básica na região Sul do Brasil
Get PDFObjective: To investigate the consumption of ultraprocessed foods by children between 2 and 9 years old living in the South region of Brazil. Methodology: Cross-sectional study, in which public data of the System of Food and Nutritional Supervision reports were used. The nutritional consumption data of children in the range of 2 to 9 years old of the years from 2015 to 2016 were utilized. The data utilized for the analysis were: the consumption of cookies and snacks, sweetened drinks, instant noodles, crisps and crackers, and hamburgers and/or sausages. Results: Data from 22,761 children were analyzed. Of these, 55.8% were aged between 2 and 4 years, and 44.1% between 5 and 9 years. The group sweetened beverages (70.45%), followed by the category instant noodles, snacks and crackers (63.25%) had the highest average consumption between the two age groups. When compared with the prevalence of Brazil, the consumption of ultraprocessed foods was significantly higher in the South region. In relation to the age group, it was verified that the consumption of ultraprocessed foods by children from 5 to 9 years old was higher when compared with that of children from 2 to 4 years old (p < 0.002). Conclusions: Therefore, there is a necessity of implementing effective health and education actions that can decrease the prevalence of the consumption of ultraprocessed foods in Brazil, especially in the South region
Errata – Consenso da Associação Brasileira de Nutrologia Sobre Recomendações do Uso de Probióticos
Get PDFCorrection to:
Brazilian Association of Nutrology Consensus Recommendations for the Use of ProbioticsInternational Journal of Nutrology 2019; 12(02): 051-051DOI: 10.1055/s-0039-3402021
Rio de Janeiro, 13 de Abril de2020
Caros leitores,
No artigo Consenso da Associação Brasileira de Nutrologia Sobre Recomendações do Uso de Probióticos (Int J Nutrol 2019;12(2):50. DOI: https://doi.org/10.1055/s-0039-3402021.), publicado online e impresso na International Journal of Nutrology em Dezembro de 2019:
Onde se lê:
No tratamento dietético, os prebióticos da dieta, especialmente as bifidobactérias, visam modificar a composição do ecossistema intestinal por meio de mudanças nutricionais.
Leia-se:
No tratamento dietético, os prebióticos da dieta, ou seja, substâncias fermentáveis, não digeríveis, que promovem o desenvolvimento seletivo e ativam o metabolismo de bactérias benéficas no trato intestinal, especialmente as bifidobactérias, visam modificar a composição do ecossistema intestinal por meio de mudanças nutricionais.4, 1
Good News!
Get PDFThe International Journal of Nutrology (IJN) brings good news!
Connected with the exponential advancement of knowledge in the areas of Health and seeking to contribute to the dissemination of this knowledge, starting with this issue, IJN will publish its articles entirely in English.
It is already well known that articles published in the English language are significantly more likely to be read and cited by other authors, thus expanding the web of communications.
This possibility is advantageous for IJN since one focus on obtaining insertion among the most prominent indexing bases.
With this new and vital step, we hope to be taking another action to contribute to our future indexations and improve IJN to the top of best international journals, benefits our authors, readers, and collaborators.
Good reading!
The Editor
Smartphone-based photo analysis for the evaluation of anemia, jaundice and COVID-19
Get PDFAnemia and jaundice are common health conditions that affect millions of children, adults, and the elderly worldwide. Recently, the pandemic caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), the virus that leads to COVID-19, has generated an extreme worldwide concern and a huge impact on public health, education, and economy, reaching all spheres of society. The development of techniques for non-invasive diagnosis and the use of mobile health (mHealth) is reaching more and more space. The analysis of a simple photograph by smartphone can allow an assessment of a person's health status. Image analysis techniques have advanced a lot in a short time. Analyses that were previously done manually, can now be done automatically by methods involving artificial intelligence. The use of smartphones, combined with machine learning techniques for image analysis (preprocessing, extraction of characteristics, classification, or regression), capable of providing predictions with high sensitivity and specificity, seems to be a trend. We presented in this review some highlights of the evaluation of anemia, jaundice, and COVID-19 by photo analysis, emphasizing the importance of using the smartphone, machine learning algorithms, and applications that are emerging rapidly. Soon, this will certainly be a reality. Also, these innovative methods will encourage the incorporation of mHealth technologies in telemedicine and the expansion of people's access to health services and early diagnosis
Major approaches to melatonin and nutrients regulation in the bone regeneration process with exosomes and microRNAs: a systematic review
Get PDFIntroduction: Bone diseases comprise a large group of common diseases, including fractures, osteoporosis, and osteoarthritis that affect a large number of individuals. Without intervention, the prevalence of osteopenia is projected to increase to 64.3 million Americans and that of osteoporosis to 11.9 million by the year 2030. Melatonin exerts numerous physiological effects, including the induction of anti-inflammatory and antioxidants, resetting circadian rhythms, and promoting wound healing and tissue regeneration, participating in the maintenance and regenerative processes of bones and cartilage. Objective: A systematic review was carried out to present the state of the art of melatonin regulation, mesenchymal stem cells, exosomes, microRNAs, and nutrients in the bone regeneration process. Methods: The systematic review rules (PRISMA) were followed. The search was carried out from July to September 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using scientific articles from 2019 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 126 articles were found. A total of 59 articles were fully evaluated and 46 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 9 studies at high risk of bias and 24 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with I2 =97.8%>50%. The symmetrical funnel plot does not suggest a risk of bias between small sample-size studies. Based on the results, melatonin has important functions in regulating the regenerative activities of mesenchymal stem cells that modulate, together with nutrients, the activities of exosomes and microRNAs in the bone regeneration process
A qualidade da alimentação para suprir as necessidades de energia de crianças, jovens e adultos
Get PDFThe article discusses the importance of energy in ensuring a healthy diet. It covers issues relating to the distribution of daily energy needs, the main sources and energy balance in humans.
O artigo discute sobre a importância da energia na garantia de uma alimentação saudável. São abordadas questões relativas à distribuição da necessidade energética diária, as principais fontes e o balanço energético no ser humano
Why we need to eat milk products?
Get PDFIntroduction: The World Health Organization (WHO) defines osteoporosis as a systemic metabolic bone disease, characterized by the reduction of bone mass and deterioration of the micro architecture of the bone tissue. The mineral bone density in adults, an important component of bone resistance, depends on the peak of bone mass acquired and accumulated by 11 to 14-year-old girls and by 13 and 17-year-old boys. Sources: MEDLINE, LILACS, Scielo and PUBmed were searched for relevant Portuguese, English and spanish- language article. Objectives: This article revises the properties of calcium, the risk factors for osteoporosis as well as the various physiological and nutritional factors that may intervene in the bioavailability of calcium. Results: As a result, patients should be oriented about food rich in calcium and their daily needs. Agood bone formation is considered one of the most efficient ways to prevent osteoporosis in old age