RESUMO
OBJETIVO: Comparar os níveis séricos de retinol em crianças pré-escolares durante um episódio de pneumonia e 45 dias após a resolução da infecção. MÉTODOS: O estudo foi conduzido com crianças pré-escolares sem infecção (grupo controle, n = 9) ou com pneumonia (n = 12), após a hospitalização (fase 1) e 45 dias após a alta (fase 2). A avaliação nutricional incluiu antropometria, questionário alimentar e exames laboratoriais, incluindo os níveis urinários e séricos de retinol. Aplicou-se o teste pareado de Student ou de Mann-Whitney. RESULTADOS: Não houve diferença na ingestão alimentar. Documentaram-se menores valores de hemoglobina sanguínea e dos níveis séricos de sódio e albumina durante a fase 1, além de maiores valores da proteína C reativa. Não houve mudança no retinol urinário, enquanto os níveis séricos aumentaram após a recuperação da pneumonia. CONCLUSÕES: Durante a pneumonia, as crianças apresentam redução transitória nos níveis séricos de vitamina A, um epifenômeno da resposta de fase aguda.
OBJECTIVE: To compare serum retinol levels in preschool children during an episode of pneumonia and 45 days after the resolution of the infection. METHODS: The study was conducted with preschool children without any infection (control group, n = 9) or children hospitalized for pneumonia (n = 12), who were evaluated soon after hospitalization (phase 1) and 45 days later (phase 2). Nutritional assessment included anthropometric measurements, a food questionnaire, and laboratory blood routine examination, including urinary and serum retinol levels. Paired Student t or Mann-Whitney tests were used as required. RESULTS: Food intake was similar between groups. Blood hemoglobin and serum sodium and albumin decreased during phase 1, while there were higher C-reactive protein serum values. Urinary retinol levels remained unchanged whereas serum retinol increased significantly after pneumonia recovery. CONCLUSIONS: During the course of pneumonia, children had transient decrease in serum levels of vitamin A, an epiphenomenon of the acute phase response.
Assuntos
Pré-Escolar , Feminino , Humanos , Masculino , Reação de Fase Aguda/sangue , Pneumonia/sangue , Recuperação de Função Fisiológica/fisiologia , Deficiência de Vitamina A/etiologia , Vitamina A/sangue , Estudos de Casos e Controles , Estado Nutricional/fisiologia , Estatísticas não Paramétricas , Vitamina A/urinaRESUMO
OBJECTIVE: To compare serum retinol levels in preschool children during an episode of pneumonia and 45 days after the resolution of the infection. METHODS: The study was conducted with preschool children without any infection (control group, n = 9) or children hospitalized for pneumonia (n = 12), who were evaluated soon after hospitalization (phase 1) and 45 days later (phase 2). Nutritional assessment included anthropometric measurements, a food questionnaire, and laboratory blood routine examination, including urinary and serum retinol levels. Paired Student t or Mann-Whitney tests were used as required. RESULTS: Food intake was similar between groups. Blood hemoglobin and serum sodium and albumin decreased during phase 1, while there were higher C-reactive protein serum values. Urinary retinol levels remained unchanged whereas serum retinol increased significantly after pneumonia recovery. CONCLUSIONS: During the course of pneumonia, children had transient decrease in serum levels of vitamin A, an epiphenomenon of the acute phase response.
Assuntos
Reação de Fase Aguda/sangue , Pneumonia/sangue , Recuperação de Função Fisiológica/fisiologia , Deficiência de Vitamina A/etiologia , Vitamina A/sangue , Estudos de Casos e Controles , Pré-Escolar , Feminino , Humanos , Masculino , Estado Nutricional/fisiologia , Estatísticas não Paramétricas , Vitamina A/urinaRESUMO
OBJECTIVE: Retinol deficiency is quite frequent in the population of human immunodeficiency virus (HIV)-infected individuals. Serum retinol levels of less than 1.05 micromol/L determine a 3.5 to five times higher death risk. However, studies evaluating the efficacy of retinol supplementation in HIV-seropositive individuals have reported conflicting results. The World Health Organization recommends the treatment of vitamin A deficiency in seropositive individuals in the same manner as for seronegative individuals, but clinical studies proving the efficacy of this scheme are lacking. The proposal of the present study was to assess the efficacy of supplementation with high retinol doses in HIV-infected patients with vitamin A deficiency. METHODS: Twenty-five adult HIV-seropositive individuals were monitored over a period of 9 months, with determination of serum and urinary retinol every 3 months. The subjects received retinol palmitate doses ranging from 300,000 IU to 600,000 IU. Patients whose retinol levels were higher than 1.60 micromol/L were only observed. RESULTS: Eighteen patients received supplementation during clinical monitoring. The dose of 600,000 IU induced a significant mean increase in serum levels of 0.47 micromol/L (P = 0.049) within a period of three months. Those who received 300,000 IU presented a mean increase of 0.29 micromol/L. In contrast, the patients who did not receive replacement therapy presented a significant decrease (P = 0.017) in serum retinol levels, with initial and final values of 1.77 micromol/L and 1.55 micromol/L. The individuals with the worst response to supplementation presented a higher urinary loss of retinol at the beginning of the study. Even with a mean retinol supplementation of 771,428 IU during the study period, six patients had marginal serum retinol levels at the end of the study. CONCLUSION: We conclude that, in view of the high urinary loss of this nutrient, there is the need to redefine the ideal dose for the treatment of HIV-infected individuals.
Assuntos
Síndrome da Imunodeficiência Adquirida/sangue , Infecções por HIV/sangue , Necessidades Nutricionais , Deficiência de Vitamina A/tratamento farmacológico , Vitamina A/metabolismo , Vitamina A/uso terapêutico , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/metabolismo , Adulto , Contagem de Linfócito CD4 , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Feminino , Infecções por HIV/complicações , Infecções por HIV/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Resultado do Tratamento , Carga Viral , Vitamina A/sangue , Vitamina A/urina , Deficiência de Vitamina A/etiologia , Vitaminas/sangue , Vitaminas/metabolismo , Vitaminas/uso terapêutico , Vitaminas/urinaRESUMO
Studies using a model of non-infectious diarrhea, have shown that increasing fecal mass by using laxatives resulted in greater fecal losses of nutrients and lower intestinal absorption. In the present study we used a diuretic to determine if increasing urine volume could result in greater urinary losses of essential nutrients. This is a relevant question because diuretics are widely and successfully used in the treatment of diseases associated with water retention and hypertension. They are known to increase potassium losses. However, there is less information on the effect of diuretics on the urinary losses of essential nutrients. Accordingly, urinary nitrogen, phosphorous, sodium, potassium, magnesium, zinc and retinol were measured in young rats consuming increasing concentrations of furosemide (0, 0.5, 1.0, 1.5 mg/g diet) in the diet over 15 days. The results showed that dietary furosemide caused a dose-dependent polyuria. In addition it reduced food intake and feed efficiency and leaded to poor growth and greater urinary losses of all the measured nutrients and electrolytes. These losses were proportional to urine volume and represented an important fraction of the rats daily intake. The losses were negatively associated with the body and liver content of the same electrolytes and nutrients. In general, this study showed that the diuretic furosemide caused malnutrition in a short period of time by reducing food intake as well as the capacity of retaining macro and micronutrients including the liposoluble vitamin A in a relatively short period of time. This study, together with our previous studies on diarrhea, indicate that proper nutrient utilization requires both an adequate intestinal and renal function.
Assuntos
Diuréticos/farmacologia , Eletrólitos/urina , Furosemida/farmacologia , Micronutrientes/urina , Vitamina A/urina , Absorção/efeitos dos fármacos , Animais , Composição Corporal/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Ingestão de Alimentos/efeitos dos fármacos , Eletrólitos/farmacocinética , Feminino , Micronutrientes/farmacocinética , Ratos , Ratos Sprague-Dawley , Vitamina A/farmacocinéticaRESUMO
In the present investigation 28 serologically positive HIV-1 patients, 16 patients with AIDS (< 200/mm3 CD4+ T lymphocytes) and 12 with HIV-1 (200 to 500/mm3 CD4+ T lymphocytes) were studied. The Control Group consisted of 11 healthy individuals. The occurrence of alterations in the anthropometric parameters were higher in AIDS patients, compared to HIV-1 and controls patients, indicating a greater level of malnutrition. All individuals in present study showed normal plasma vitamin A levels. Contrasting, urinary excretion of vitamin A were higher in the AIDS Group (0.23 +/- 0.20 mumol/l) than in the HIV Group (0.19 +/- 0.12 mumol/l) and considerably higher than in the Control Group (0.06 +/- 0.05 mumol/l). Urinary excretion of TBARS also were higher in AIDS Group (3.34 +/- 2.65 mumol/l) compared to HIV (1.71 +/- 0.74 mumol/l) and Control Group (1.70 +/- 0.75 mumol/l). These results demonstrate a greater level of malnutrition and elevate excretion of vitamin A and SRATB in urine of AIDS patients. Therefore, monitoring of nutritional status, especially in relation to vitamin A is recommended for patients with HIV and AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/urina , Infecções por HIV/urina , HIV-1 , Estado Nutricional , Substâncias Reativas com Ácido Tiobarbitúrico/análise , Vitamina A/urina , Síndrome da Imunodeficiência Adquirida/sangue , Adulto , Análise de Variância , Antropometria , Infecções por HIV/sangue , Humanos , Contagem de Linfócitos , Vitamina A/sangueRESUMO
Foram estudados 28 pacientes com sorologia positiva para HIV-1, sendo 16 classificados como aideticos (linfocitos-T CD4+ < 200/mm3) e 12 portadores do HIV-1 (linfocitos-T CD4+ entre 200 e 500/mm3), o grupo controle foi composto por 11 individuos saudaveis. A ocorrencia de alteracoes de parametros antropometricos foi alta nos pacientes com AIDS, quando comparados com pacientes com HIV-1 e controles, indicando um grau acentuado de desnutricao nestes pacientes. Todos os individuos estudados apresentaram niveis normais de vitamina A plasmatica. Verificou-se uma maior excrecao urinaria no grupo com AIDS (0,23 + ou - 0,20 umol/l) em relacao ao grupo HIV (0,19 + ou - 0,12 umol/l) e muito maior que o controle (0,06 + ou - 0,05 umol/l)...