RESUMO
INTRODUCTION: Prebiotics positively affect gut microbiota composition, thus improving gut function. These properties may be useful for the treatment of constipation. OBJECTIVES: This study assessed the tolerance and effectiveness of a prebiotic inulin/partially hydrolyzed guar gum mixture (I-PHGG) for the treatment of constipation in females, as well as its influence on the composition of intestinal microbiota and production of short chain fatty acids. METHODS: Our study enrolled 60 constipated female health worker volunteers. Participants reported less than 3 bowel movements per week. Volunteers were randomized to treatment with prebiotic or placebo. Treatment consisted of 3 weeks supplementation with 15 g/d IPHGG (fiber group) or maltodextrin (placebo group). Abdominal discomfort, flatulence, stool consistency, and bowel movements were evaluated by a recorded daily questionnaire and a weekly interview. Changes in fecal bacterial population and short chain fatty acids were assessed by real-time PCR and gas chromatography, respectively. RESULTS: There was an increased frequency of weekly bowel movements and patient satisfaction in both the fiber and placebo groups with no significant differences. Total Clostridium sp significantly decreased in the fiber group (p = 0.046) and increased in the placebo group (p = 0.047). There were no changes in fecal short chain fatty acid profile. CONCLUSIONS: Consumption of I-PHGG produced clinical results comparable to placebo in constipated females, but had additional protective effects on gut microbiota by decreasing the amount of pathological bacteria of the Clostridium genera.
Assuntos
Constipação Intestinal/tratamento farmacológico , Galactanos/uso terapêutico , Inulina/uso terapêutico , Mananas/uso terapêutico , Metagenoma/fisiologia , Gomas Vegetais/uso terapêutico , Prebióticos , Adolescente , Adulto , Idoso , Constipação Intestinal/microbiologia , Suplementos Nutricionais , Método Duplo-Cego , Ácidos Graxos/metabolismo , Fezes/química , Fezes/microbiologia , Feminino , Galactanos/efeitos adversos , Humanos , Intestinos/microbiologia , Inulina/efeitos adversos , Mananas/efeitos adversos , Pessoa de Meia-Idade , Gomas Vegetais/efeitos adversos , Prebióticos/efeitos adversos , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: No study so far has tested a beverage containing glutamine 2 h before anesthesia in patients undergoing surgery. OBJECTIVES: The aim of the study was to investigate: 1) the safety of the abbreviation of preoperative fasting to 2 h with a carbohydrate-L-glutamine-rich drink; and 2) the residual gastric volume (RGV) measured after the induction of anesthesia for laparoscopic cholecystectomies. METHODS: Randomized controlled trial with 56 women (42 (17-65) years-old) submitted to elective laparoscopic cholecystectomy. Patients were randomized to receive either conventional preoperative fasting of 8 hours (fasted group, n = 12) or one of three different beverages drunk in the evening before surgery (400 mL) and 2 hours before the initiation of anesthesia (200 mL). The beverages were water (placebo group, n = 12), 12.5% (240 mOsm/L) maltodextrine (carbohydrate group, n = 12) or the latter in addition to 50 g (40 g in the evening drink and 10 g in the morning drink) of L-glutamine (glutamine group, n = 14). A 20 F nasogastric tube was inserted immediately after the induction of general anesthesia to aspirate and measure the RGV. RESULTS: Fifty patients completed the study. None of the patients had either regurgitation during the induction of anesthesia or postoperative complications. The median (range) of RGV was 6 (0-80) mL. The RGV was similar (p = 0.29) between glutamine group (4.5 [0-15] mL), carbohydrate group (7.0 [0-80] mL), placebo group (8.5 [0-50] mL), and fasted group (5.0 [0-50] mL). CONCLUSION: The abbreviation of preoperative fasting to 2 h with carbohydrate and L-glutamine is safe and does not increase the RGV during induction of anesthesia.
Assuntos
Jejum/fisiologia , Glutamina/efeitos adversos , Período Pré-Operatório , Adolescente , Adulto , Idoso , Anestesia , Colecistectomia Laparoscópica , Carboidratos da Dieta/uso terapêutico , Método Duplo-Cego , Feminino , Glutamina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho da Amostra , Estômago/anatomia & histologia , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Parenteral nutrition (PN) is used to control the nutritional state after severe intestinal resections. Whenever possible, enteral nutrition (EN) is used to promote intestinal rehabilitation and reduce PN dependency. Our aim is to verify whether EN + oral intake (OI) in severe short bowel syndrome (SBS) surgical adult patients can maintain adequate nutritional status in the long term. METHODS: This longitudinal retrospective study included 10 patients followed for 7 post-operative years. Body mass index (BMI), percentage of involuntary loss of usual body weight (UWL), free fat mass (FFM), and fat mass (FM) composition assessed by bioelectric impedance, and laboratory tests were evaluated at 6, 12, 24, 36, 48, 60, 72, and 84 months after surgery. Energy and protein offered in HPN and at long term by HEN+ oral intake (OI), was evaluated at the same periods. The statistical model of generalized estimating equations with p < 0,05 was used. RESULTS: With long term EN + OI there was a progressive increase in the UWL, a decrease in BMI, FFM, and FM (p < 0,05). PN weaning was possible in eight patients. Infection due to central venous catheter (CVC) contamination was the most common complication (1.2 episodes CVC/patient/year). There was an increase in energy and protein intake supply provided by HEN+OI (p < 0.05). All patients survived for at least 2 years, seven for 5 years and six for 7 years of follow-up. CONCLUSIONS: In the long term SBS surgical adult patients fed with HEN+OI couldn't maintain adequate nutritional status with loss of FM and FFM.
Assuntos
Avaliação Nutricional , Nutrição Parenteral no Domicílio/métodos , Síndrome do Intestino Curto/terapia , Adolescente , Adulto , Idoso , Composição Corporal , Distribuição da Gordura Corporal , Índice de Massa Corporal , Peso Corporal/fisiologia , Infecções Relacionadas a Cateter/etiologia , Impedância Elétrica , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Nutrição Parenteral no Domicílio/efeitos adversos , Estudos Retrospectivos , Síndrome do Intestino Curto/mortalidade , Síndrome do Intestino Curto/fisiopatologia , Sobrevida , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND & AIM: To compare the effect of fish oil-based (FO) lipid emulsions (LE) for parenteral administration with standard LE and a new FO containing LE composed of four different oils on the antigen presentation and inflammatory variables. METHODS: Phytohemagglutinin (PHA) activated human mononuclear leukocytes were cultured with different LE - Control: without LE; SO: soybean oil; SO/FO: soybean and FO (4:1); MCT/SO: medium chain triglycerides and SO (1:1); MCT/SO/FO: MCT/SO and FO (4:1) and SMOF: a new LE containing FO. Cytokine production was evaluated by ELISA, the expression of antigen-presenting and co-stimulatory surface molecules were analyzed by flow cytometry and lymphocyte proliferation was assessed by H(3)-Thymidine incorporation, after tetanus toxoid-induced activation. RESULTS: All LE decreased the HLA-DR and increased CD28 and CD152 expression on monocytes/macrophages and lymphocytes surface (p < 0.05). SO/FO and MCT/SO/FO decreased lymphocyte proliferation (p<0.05). All LE decreased IL-2 production, but this effect was enhanced with MCT/SO/FO and SMOF (p < 0.05). MCT/SO/FO decreased IL-6 and increased IL-10, whereas SO had the opposite effect (p < 0.05). CONCLUSION: FO LE inhibited lymphocyte proliferation and had an anti-inflammatory effect. These effects seem to be enhanced when FO is mixed with MCT/SO. SMOF had a neutral impact on lymphocyte proliferation and IL-6 and IL-10 production.