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Prescription and Delivery of Enteral Nutrition for ICU Patients: A Case Study of a Hospital in the Interior of Brazil

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Food and Nutrition Sciences 2023年第10期14卷 880-896页

作者： Valtemir paula de Oliveira Junior Daiane costa dos Santos Sibele Santos fernandes Mariana Buranelo Egea Campus Rio Verde Goiano Federal Institute of Education Science and Technology Rio Verde Brazil Institute of Tropical Pathology and Public Health Goiás Federal University (UFG) IPTSP-UFG Goiania Brazil School of Chemistry and Food Federal University of Rio Grande Rio Grande Brazil

Background: The objective of the present study was to evaluate during one year the total delivery of volume, calories, and proteins and compare them with the total prescribed to ICU patients using ENT (Enteral Nutrition Therapy) exclusively. Methods: Data on the prescribed or infused volume, calories, and protein, as well as their respective needs for each individual, were collected. Anthropometric parameters and age data were also collected from the medical records of 41 patients admitted to the intensive care unit. Results: Prescribed versus infused enteral diet volume was presented in 5 weeks which corresponds to the maximum duration of ICU treatment. Regarding sampling, the majority corresponded to elderly people (>64 years old) and males (63.4%). The total average prescribed was 719.2 mL of enteral diet on an average of 649.7 mL delivered. In addition, there was no significant difference between the prescribed and delivered volume, caloric value, and protein content of the diet only in the last week of hospitalization, which corresponded to the range of 29 - 36 days. Several factors make it difficult to reach the patient’s caloric and protein recommendations. Most of the reasons are not recorded, corresponding to 57.1%, indicating the difficulty of assessing the inadequacy of the prescribed and delivered volume. Conclusion: To our knowledge, this is the first time that a prescription vs. delivery assessment has been carried out for patients in the Brazilian Midwest. In addition, although our research is a difficulty reported worldwide (in most hospitals), we also provide opportunities for how the problem was solved in our case, which may contribute to other cases.

关键词： Caloric-Protein Diet Enteral Formula Nutritional Needs Daily Intake Patients Ill

Evaluation of Physicochemical,Microbiological and Sensory Stability of Frozen Stored Vacuum-Packed Lamb Meat

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Journal of Integrative Agriculture 2013年第11期12卷 1946-1952页

作者： Rafaella de paula Paseto fernandes Maria Teresa de Alvarenga Freire Celso da costa Carrer Marco Antonio Trindade Department of Food Engeneering College of Animal Science and Food Engineering of UniversitySo Paulo(FZEA/USP)Avenida Duque of Caxias Norte225Jardim ElitePirassunungaSo Paulo 13.635-900Brazil Department of Food Engineering FZEA/USPPirassunungaSo Paulo 13.635-900Brazil Department of Animal Science FZEA/USPPirassunungaSo Paulo 13.635-900Brazil

Nowadays, lamb meat represents only 7% of all meat produced in the world. In recent years the demand for standardized lamb meat cuts has been considered of great importance and the marketing occurs predominantly in the form of frozen cuts. Herewith, the main of this work was to evaluate the stability and safety of lamb meat during frozen storage. Meats were vacuum packed in high barrier multilayer plastic iflms and stored during 12 mon at （-18±1）℃. The meat stability was assessed by physical and chemical （lipid oxidation, objective color, pH value, cooking losses and instrumental texture）, microbiological （total count of psychrotrophic, coliform count at 45℃, coagulase-positive staphylococci and the presence of Salmonella） and sensory analysis （acceptance test and visual evaluation）. The vacuum packed lamb meat remained stable as to most physical and chemical indexes. Microbiological indexes showed good stability throughout the storage period according to Brazilian legislation standards to pathogenic microorganisms. Although a signiifcant reduction in tenderness （shear force increase from 3 to 8 kg）, it showed a good sensorial acceptance for all attributes tested, including texture, with scores of around 7 （like moderately） during the 12 mon of storage. Therefore, it can be concluded that, under the conditions applied in this study, lamb meat presents a shelf life of at least 12 mon when stored at-18℃.

关键词： acceptance test Longissimus dorsi shelf life

Contraception Knowledge, Attitudes and Practices of Adolescents at Risk of Pregnancy in Northeastern Brazil

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Open Journal of Obstetrics and Gynecology 2014年第6期4卷 300-308页

作者： Gilka Paiva Oliveira costa Giulia Paiva Oliveira costa Monica de paula Farias Ana Cristina Pinheiro fernandes de Araújo Federal University of Paraíba Joao Pessoa(PB)Brazil Federal University of Rio Grande do Norte Joao Pessoa(PB)Brazil

Background: Contraceptive methods (CM) are important resources in the prevention of adolescent pregnancy. This study aimed to investigate adolescent knowledge, attitudes and practices related to contraception. Study Design: A cross-sectional and exploratory study was conducted with 7th to 9th grade adolescents in northeastern Brazil. Their knowledge, attitudes, and contraceptive method use were analysed by gender, age and sexual initiation groups. Results: A sexual debut had been experienced by 21% (n = 120) of all respondents (n = 570). The majority of the respondents who had experienced a sexual debut were male (73.3%, n = 88), their mean age was 15 years (SD = 1.46), and 49.3% (n = 59) never used any CM. The participants displayed low knowledge and unfavourable and ambivalent attitudes concerning contraception. Conclusion: Adolescents initiate sexual intercourse with knowledge and attitudes that limit the use of CM, which makes them more at risk of pregnancy. Further research that will be representative of the specific population in need of interventions is necessary.

关键词： Adolescent Contraception Pregnancy Attitudes

The Contribution of Waves in Mixing Processes of the Patos Lagoon Plume

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International Journal of Geosciences 2012年第5期3卷 1019-1026页

作者： Eduardo de paula Kirinus Wiliam Correa Marques Julliet Correa da costa Elisa Helena Leao fernandes Instituto de Matematica Estatistica e Fisica Universidade Federal do Rio GrandeRio Grande do SulBrazil Instituto de Oceanografia Universidade Federal do Rio GrandeRio Grande do SulBrazil

The analysis of wave effects above salinity is important in order to define mixing processes and their potential to change density gradients, since action in the region of the Patos Lagoon plume is highly dynamic. This paper aims to evaluate the influence of waves on the mixing pattern of the adjacent continental shelf. Constantly marked by tides and circulation variations, changing from flood to ebb tide, salinity stands as a major parameter for analysis. The study is based on hydrodynamic numerical modeling experiments using the TELEMAC3D model and waves generated by the wind using the TOMAWAC coupled model. The comparison between the situations considering the waves generated by the wind and without waves was made through time series analysis, stratification series, transversal cross sections, longitudinal cross sections, salinity mean fields and diagrams by Richardson and Brünt-V?is?l?s frequency parameters. With the cross sections analysis, the mixing effect generated by the waves was observed, demonstrating clearly that the waves were capable of raising the superficial salinity in regions far from the Patos Lagoon entrance, while at the entrance, the wave effects enhanced the mixing on the deepest layers, decreasing the saline intrusion and expanding the plume more radially on the surface. The space-temporal diagrams were effective to demonstrate the modulation effect of the waves over the salt mixing of saline waters, revealing that wave effects decrease the stratification as well as the Brünt-V?is?l?s frequency and increase the period of buoyancy, due to the mixing increase.

关键词： Vertical Mixing Tridimensional Numerical Modeling Stratification

Infections Following Kidney Transplant in Children: A Single-Center Study

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Open Journal of Nephrology 2014年第3期4卷 117-124页

作者： Alexandre fernandes Liliana Rocha Teresa costa paula Matos Maria Sameiro Faria Laura Marques Conceicao Mota Antonio Castro Henriques Pediatric Infectious Diseases and Immunodeficiency Department Centro Hospitalar do PortoOportoPortugal Pediatric Nephrology Department Centro Hospitalar do PortoOportoPortugal Kidney Transplant Department Centro Hospitalar do PortoOportoPortugal

Introduction: Infections are a major cause of morbidity and mortality in pediatric patients undergoing kidney transplantation (KT). Aim and Methods: To determine the patterns of infectious complications during the first 6 months post transplantation, we report our single center experience with data from pediatric kidney recipients transplanted between 2006 and 2011. Results: Thirty-two children (20 males) were submitted to KT. The most common cause of end-stage renal disease (ESRD) was congenital anomalies of the kidney and urinary tract (CAKUT) accounting for 62%. Over the first 6 months post-transplant period, twenty-eight (87.5%) children developed a total of 77 infections, mainly urinary tract infections (UTI) (64.9%). CAKUT etiology of ESRD and UTI before KT increased the risk to develop more than one episode of UTI [71.4% vs. 14.3% and 81.8% vs. 18.2%, respectively;p < 0.05]. Twenty-three (29.9%) viral infections occurred. Cytomegalovirus (CMV) was the most common opportunistic pathogen, occurred in 11 patients and was more frequently in those with a donor (D)+/recipient (R)- CMV sero-status [74.5% vs. 25.5% (p < 0.05)]. A polyomaviruses (BKV) disease with nephropathy and meningitis was registered. The majority of infectious episodes had mild or moderate severity. No deaths occurred. Conclusion: A significant number of patients presented infectious complications during the first 6 months post transplantation. UTI are the most common type of infection, followed by viral infections, particularly CMV. Recognition, prevention and early treatment of infections are of major importance.

关键词： CMV Infection Immunosuppression Kidney Transplantation Urinary Tract Infections

Dengue in renal transplant recipients: Clinical course and impact on renal function

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World Journal of Transplantation 2017年第1期7卷 57-63页

作者： paula Frassinetti Castelo Branco Camur?a fernandes Reed AndréSiqueira Evelyne Santana Gir?o Rainne AndréSiqueira Márcia Uchoa Mota Leyla Castelo Branco fernandes Marques Silvana Cristina Albuquerque Andrade Wilson Mendes Barroso S?nia Leite Silva Bruno Gomes Rodrigues dos Santos Claúdia Maria costa de Oliveira Kidney Transplant Unit Hospital Universitário Walter Cantídio Universidade Federal do Ceará Department of Nephrology of Universidade Estadual do Ceará Universidade Estadual do Ceará

AIM To present clinical characteristics from renal transplant recipients with dengue fever and its impact on graft *** We retrospectively evaluated 11 renal transplant recipients(RTR) with dengue infection confirmed by laboratory test, between January 2007 and July 2012, transplanted in the Renal Transplant Center of Walter Cantídio University Hospital from Federal University of Ceará. RESULTS Positive dengue serology(IgM) was found in all patients. The mean time between transplant and dengue infection was 43 mo. Fever was presented in all patients. Nine patients presented with classical dengue and two(18%) with dengue hemorrhagic fever. All cases had satisfactory evolution with complete recovery of the symptoms. The time for symptom resolution varied from 2 to 20 d, with an average of 9 d. An increase of creatinine after the infection was observed in three(27.2%) patients with no clinically impact on the kidney graft function. CONCLUSION RTR with dengue infection seems to have a clinical presentation and evolution similar to those seen in the general population, with no long-term damage to patient and to the graft.

关键词： Kidney Renal Transplant Dengue Clinical Brazil

Motor Development as a Potential Marker to Monitor Infantile Pompe Disease on Enzyme Replacement Therapy

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Open Journal of Clinical Diagnostics 2017年第1期7卷 8-19页

作者： paula de Almeida Thomazinho Fernanda Bertao Scalco Maria Lucia costa de Oliveira Dafne Dain Gandelman Horovitz Juan Clinton Llerena Jr Fisioterapia Motora Instituto Nacional de Saude da Mulherda Crianca e do Adolescente Fernandes Figueira/FIOCRUZRio de JaneiroBrasil Departamento de Bioquimica Universidade Federal do Rio de JaneiroRio de JaneiroBrasil Area de Centro de Genetica Medica Instituto Nacional de Saude da Mulherda Crianca e do Adolescente Fernandes Figueira/FIOCRUZRio de JaneiroBrasil

After Enzyme Replacement Therapy (ERT) using recombinant human acid alpha-glucosidase (rhGAA), survival of Infantile Pompe Disease (IPD) patients through the first 18 months of age has been documented and acquisitions of motor development are an important outcome, but description of its course is scarce. Objective: To describe the motor development in an IPD patient and its correlation with clinical conditions during the first 18 months on ERT with rhGAA. Methods: By longitudinal observational study of an IPD case at early stage. Clinical and biochemical characteristics were obtained from patient records. Echocardiogram assessed cardiac indexes and the urinary biomarker—glucose tetrasaccharide (Glc4)—was obtained by HPLC/UV, following sample derivatization with butyl 4-amino benzoate and analysis on a C18 stationary phase column. Motor skills were evaluated with Alberta Infant of Motor Scale (AIMS) and motor delay was considered as motor percentile (p) below 10. Descriptive statistical analysis was carried out and t-test was used to calculate the differences among means, with significance level defined as p value < 0.05. Results: After ERT beginning amelioration of the cardiomyopathy with reduced left ventricle mass index (LVMI) from the 2nd month onwards was observed, but above the upper normal limit for healthy children and CRIM-positive IPD patients. Although GAA antibodies level remained above the recommended titers and fluctuating elevation of Glc4 quantified, motor development analysis showed an ascendant curve expected for age within achievement of independent ambulation. Motor delay after pneumonia and maintenance of hypotonia were noted. Variation of Glc4 appeared long after a transitory intercurrence. Conclusion: In an IPD case, motor development can have normal evolution despite hypotonia. Motor analysis seems to be sensitive to follow-up clinical intercurrences. To elucidate the interaction among prognostic factors and outcomes, further clinical studies

关键词： Infantile Pompe Disease Motor Development Enzyme Replacement Therapy Glc4 Biomarker

Pressure Ulcers in Institutionalized Elderly People:Association of Sociodemographic and Clinical Characteristics and Risk Factors

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Open Journal of Nursing 2017年第1期7卷 111-122页

作者： Suellen Duarte de Oliveira Matos Iraktania Vitorino Diniz Adriana Lira Rufino de Lucena Smalyanna Sgren da costa Andrade Karen Krystine Goncalves de Brito Elizabeth Souza Silva de Aguiar Emanuelle Malzac Freire de Santana Mailson Marques de Sousa Ana paula Marques Andrade de Souza Hemílio fernandes Campos Coelho Mirian Alves da Silva Marta Miriam Lopes costa Maria Julia Guimaraes Oliveira Soares Simone Helena dos Santos Oliveira Graduate Program in Nursing Universidade Federal da ParaíbaJoao PessoaBrazil Departament of Statistics Universidade Federal da ParaíbaParaíbaBrazil

Objective: To evaluate the association of socio-demographic and clinical characteristics, and risk factors with occurrence of pressure ulcers in institutionalized elderly people. Method: This cross-sectional, analytical study, in quantitative approach, performed from the database analysis linked to the project “Pressure Ulcer in institutionalized elderly people: Association of incidence with the risk factors to functional and nutritional assessment” developed in six long-stay institutions for the elderly people in João Pessoa. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Associations were made through chi square test and Odds Ratio. Results: The clinical conditions of significant associations with the occurrence of pressure ulcers were the variables neurological disorders (p = 0.011) and visual impairment (p = 0.005). As for risk factors, the most important was fecal incontinence (p Conclusion: The analysis of the associations pointed out problems that require intervention in order to prevent health implications of the elderly people and to minimize the risk and occurrence of this injury.

关键词： Elderly People Institutions for the Elderly People Pressure Ulcer Health Profile Risk Factors

Punica granatum Leaf Lipophilic Fraction Favours Mortality by Attenuating Inflammation in Mice with Polymicrobial Sepsis

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Journal of Pharmacy and Pharmacology 2019年第7期7卷 355-367页

作者： Nagila Caroline Fialho Sousa Isabella fernandes da Silva Figueiredo Mizael Calacio de Araujo Elaine Pereira de Andrade Thais costa Alves Bruna Letícia Rosa da Silva Domingos Magno Santos Pereira Saulo JoseFigueiredo Mendes Joao Francisco Silva Rodrigues Jaqueline Pessoa Pontes Simone Aparecida Teixeira AndreAlvares Marques Vale Marcus Vinicius Dias-Souza Lidio Goncalves Lima-Neto Vera Lucia dos Santos Ana paula Azevedo-Santos Marcelo Nicolas Muscara Valerio Monteiro-Neto Andrea de Souza Monteiro Luis Claudio Nascimento da Silva Elizabeth Soares fernandes Programa de Pos-graduacao Universidade CEUMARua JosueMontellon°1RenascencaSao LuisMA 65075-120Brazil Departamento de Farmacologia Universidade de Sao PauloAv.Prof.Lineu Prestesn°1524Sala 326ButantanSao PauloSP 05508-900Brazil Programa de Pos-graduacao em Ciências em Saude Universidade Federal do MaranhaoAvenida dos Portuguesesn°1966BacangaSao LuisMA 65080-805Brazil Departamento de Microbiologia Universidade Federal de Minas GeraisAv.Antonio Carlosn°6627PampulhaBelo HorizonteMG 31270-901Brazil Departamento de Patologia Universidade Federal do MaranhaoAvenida dos Portuguesesn°1966BacangaSao LuísMA 65080-805Brazil

Punica granatum *** known antimicrobial and anti-inflammatory *** of different parts of this plant have been commonly used in the folk medicine to prevent and treat infections;and studies have supported the use of *** extracts for this ***,little is known of the effects of ***-derived fractions in severe infectious diseases such as ***,we investigated the actions of the hexane fraction(HF),rich in lipophilic compounds,obtained from the leaves of this plant,in a murine model of polymicrobial *** pre-treatment with HF increased mortality in septic *** same animals presented with lower levels of interleukin-6,nitric oxide and hydrogen peroxide in their peritoneal lavage samples than vehicle *** also increased polymorphonuclear cell accumulation in to the peritoneum of mice with ***-derived nitric oxide upon lipopolysaccharide stimuli was markedly reduced by incubation with ***,triterpenes,phytosterols,vitamin E and ascorbyl palmitate were detected in the *** results indicate that *** leaf lipophilic fractions may worsen sepsis *** effect may be associated with its bioactive compounds which act synergistically or not,increasing sepsis mortality in vivo.

关键词： P.granatum infection inflammation