Biomedical subjects

D L Waitzberg

Publications and source records attributed to D L Waitzberg.

60 records · Page 4Linked to original sources

PubMedDate not supplied

[Nutritional assistance to patients during radiotherapy].

With the aim of assessing the possible benefits of nutritional therapy, 140 patients were prospectively studied during radiotherapy of the head and neck (81%) and esophageal cancer (19%). Mean age was 56.0 (17-80), with 114 males and 26 females. Duration of both nutrition and radiotherapy was 78.0 +/- 45 days. Tube feeding was the primary modality in 50.7% of the population, and oral regimens in the remaining 49.3%, but associations between the methods were also used. Enteral diets were supplied under the supervision of a specialized tem for home alimentation (PROSNED). Compliance to the program was 100%, and a lymphocyte count diminished along this period (1933 +/- 1033 vs 1265 +/- 688, p. 0.001). A subjective improvement was reported by 84% of the population, and total calorie intake, that was below 60% of estimated needs in 100% of the cases initially, significantly improved to just 40% inadequate at the end of the observations. Radiotherapy was associated with mucositis in 21% of the patients, taste changes in 79%, xerostomy in 81%, anorexia in 66% and odinophagia in 59%. In the individuals selected for enteral feeding, side-effects were represented by technical problems (20%) and gastrointestinal disorders (13%). All patients completed the nutritional support program and there was no mortality in this series. It is concluded that; 1) Early nutritional support during radiotherapy was able to maintain or improve the nutritional status; 2) Tube feeding, alone or in combination with oral diets, was indicated whenever appropriate and contributed to fulfillment of the energy requirements; 3) Reduction of total lymphocytes could not be prevented by the mentioned therapy; 4) Complications of enteral alimentation were mild and affected a small proportion of the population; 5) Troubles induced by radiotherapy were as frequent as expected, and tended to disturb the intake of food; 6) The compliance to the therapeutic plan was excellent and can be attributed to the efforts of the multidisciplinary team as well as to the help of the specialized home alimentation unit (PROSNED): Diet therapy. Cancer. Nutritional assessment. Radiotherapy. Nutritional support.

Adolescent↗

PubMedDate not supplied

[The role of glutamine in nutrition in clinical practice].

Nutritional therapy using nutrients with pharmacological properties has been intensively discussed in the recent literature. Among these nutrients, glutamine has gained special attention. Glutamine is the most abundant amino acid in the blood stream of the mammals and, besides it has been considered a non-essential amino acid, glutamine is a non-dispensable nutrient in catabolic states. In this situation, there are alterations in its inter-organic flux, leading to lower plasmatic concentrations. Glutamine is the main fuel to enterocytes and it has an important role in the maintenance of intestinal structure and functions. Moreover, supplementation with glutamine has proved to be beneficial to the immunological system functions, improves nitrogen balance and nutritional parameters in the post-operative period and lessens protein loss in severe catabolic states. For these reasons, glutamine enriched-diets must be considered in the nutritional support of many diseases; new controlled, prospective and randomized studies will help to define what group of patients can really benefit from glutamine supplementation.

Enteral Nutrition↗

PubMedDate not supplied

[Biological activity of fish oil].

Omega-3 fatty acids (n-3) found specially on fish oil are represented by the acid alfa-linolenic, eicosapeniaenoic and docosahexaenoic. After 72 hours of n-3 fatty acids intake there are changes on membrane composition and decrease of synthesis of prostaglandin (PG), leucotriens (LT) and thromboxanes (TX) of the 2 and 4 series production and substitution for prostaglandin, thromboxanes and leucotriens of 3 and 5 series respectively. These alterations can modulate the inflammatory response in some diseases. N-3 fatty acid have been used in cardiology on hypercholesterolemy and hypertension control and on immunologic diseases as psoriasis, rheumatoid arthritis and Crohn disease. Experimentally the n-3 fatty acid inhibit tumor growth and metastasis. The authors consider the biophysiological actions of n-3 fatty acids and discuss the results of its use on clinical results.

Animals↗

PubMedDate not supplied

[Technical and histological standardization of experimental colitis with trinitrobenzenosulfonic acid (TNBS)].

Attempts to reproduce inflammatory colitis have created many experimental models. Since the pioneer work of Morris et al. (1989), trinitrobenzenosulfonic (TNBS) solutions have been used with different dosages. The aims of this work were standardize the induction of colitis, evaluate the clinical and intestinal effects of different doses and verify the reproducibility of the intestinal inflammatory process. Wistar rats were inoculated endo rectally with 2.5 ml solutions of different concentrations of TNBS and ethanol, and the rats were sacrificed after 14 days. According to the solution concentrations of TNBS (mg) and ethanol (%), six groups of animals were established: Control (saline), 30 mg/30%, 30 mg/40%, 30 mg/50%, 50 mg/10% and 50 mg/30%. Statistical analysis of food ingestion showed no differences between groups (p = 0.247). The 30/50 group presented greater weight loss when compared to 50/10 and 50/30 groups (p = 0.012). Groups 30/50 and 30/40 showed greater degrees of macroscopic lesion than control and 50/10 group (p < 0.05). Histologic lesion was not uniform to all rats regardless of the solution employed. Group 50/10 presented the less severe histologic alterations; on the other hand, 30/40 and 30/50 groups had important changes on mucosal thickness, on vascularization and ulceration. The authors conclude that experimental colitis with TNBS 1) cause intestinal lesions that are not uniform to all animals, although they may be reproduced in many of them; 2) with the same doses of TNBS, the increase in ethanol concentrations leads to a greater inflammatory process, intestinal thickness, vascularization, abscess formation and intestinal ulceration; 3) 50/10 and 50/30 solutions make less severe lesions when compared to 30/40 and 30/50 solutions; 4) 30/50 solution was the best one, as it produces inflammation 90% of the animals, increases in wall thickness in 50%, abscess in 70% and ulceration in 38%.

Analysis of Variance↗

PubMedDate not supplied

[Effect of glucidic and fat total parenteral nutrition on macrophage phagocytosis in rats].

Fat lipid emulsions in Total Parenteral Nutrition (TPN) have been associated to Mononuclear Phagocytary System (MPS) changes. Intravenous lipid emulsions may alter macrophage membrane composition but there are controversies about their effects on MPS function. The aim of the present investigation was to assess the influence of fat free TPN and fat emulsions TPN on the macrophage phagocytosis. Wistar rats (70) with external jugular vein canulation were divided in seven groups. The rats received, intravenously (i.v.) different isocaloric (1.16 kcal/mL), isonitrogenous (1.5 g/mL), and isolipidic (30 to 32% of non-proteic caloric value) TPN regimens or oral diet: 1) Group OS: oral diet with i.v. infusion of saline; 2) Group GLU: fat-free TPN; 3) Group LCT: TPN with 10% long chain triglecide emulsion (TCL); 6) Group MCT: TPN with 10% lipid emulsion with medium chain triglycerides (TCM-50%) and TCL (50%). After 96 hours of TPN or saline infusion, colloidal carbon was i.v. injected at 1.0 mL/kg body weight. The rats were sacrificed after three hours. Liver, spleen and lung were weighted and studied by immunohistochemistry by the avidine-biotine method. Under light microscopy the total macrophage number (MT) and colloidal carbon phagocytic macrophages number (MF) were established. Phagocytic index was MT/MF x 100. The results were statistically analysed (p < 0.05). The group under oral diet (OS) was the only one to gain weight. There were no differences in organ weight in any group. There were changes in MT, MF and phagocytic index in all TPN groups. Fat free TPN inhibited liver, spleen and lung macrophage phagocytosis. Fat TPN with TCL inhibited liver and lung macrophage phagocytosis. At conclusion fat free TPN or with long chain tryglicerides may inhibit MPS phagocytosis. Further studies are necessary to estabilish the effect of TPN on other MPS function.

Animals↗

PubMedDate not supplied

Significance of bacterial translocation in nutrition.

Considerable progress has been made during the last decade in the understanding of the pathophysiology of sepsis and multiple organ dysfunction syndrome. Gut-derived sepsis has been recognized as an important etiology of multiple organ dysfunction syndrome. Bacterial translocation of indigenous intestinal flora to the systemic circulation has been postulated as an important etiology of gut-derived sepsis. In this paper, we review the fundamental aspects of bacterial translocation as mechanism of disease, and the influence of nutritional support. Critical animal and human data are presented and discussed, and emphasis is given to its potential clinical applications.

Animals↗