Submitted by Aline Batista (alinehb.ufpel@gmail.com) on 2018-05-16T13:55:58Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Cíntia_Valente_Gonçalves.pdf: 944490 bytes, checksum: cc70fe882bcf06d57d873236f6a036ae (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2018-05-16T20:21:38Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Cíntia_Valente_Gonçalves.pdf: 944490 bytes, checksum: cc70fe882bcf06d57d873236f6a036ae (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2018-05-16T20:21:55Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Cíntia_Valente_Gonçalves.pdf: 944490 bytes, checksum: cc70fe882bcf06d57d873236f6a036ae (MD5) / Made available in DSpace on 2018-05-16T20:21:55Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Cíntia_Valente_Gonçalves.pdf: 944490 bytes, checksum: cc70fe882bcf06d57d873236f6a036ae (MD5) Previous issue date: 2015-03-12 / Sem bolsa / A desnutrição do paciente em tratamento intensivo tem sido evidenciada em inúmeros estudos e o suporte nutricional inadequado é fator determinante para o surgimento de complicações, podendo contribuir para a maior mortalidade. O presente estudo consistiu em determinar a adequação da terapia nutricional enteral em pacientes críticos internados na Unidade de Terapia intensiva do Hospital Universitário Dr. Miguel Riet Correa Júnior da Universidade Federal do Rio Grande – FURG, identificar os fatores limitantes na administração da dieta e avaliar a adequação energética e proteica perante a evolução clínica do paciente até o fim da internação na unidade. Foram incluídos todos os pacientes de ambos os sexos que receberam terapia nutricional enteral por um período superior a 72 horas entre maio e novembro de 2014. O estado nutricional foi avaliado através da Avaliação Subjetiva Global na admissão do paciente na UTI e reaplicada semanalmente. O cálculo das necessidades energéticas e proteicas foi realizado de acordo com as recomendações para paciente crítico. Os dados foram coletados diariamente através dos registros dos prontuários do paciente. A adequação energética e proteica foi determinada através da razão entre os valores administrados e prescritos, sendo considerados adequados valores iguais ou maiores a 70% do prescrito. Essa adequação foi relacionada com o tempo de internação, tempo de ventilação mecânica e mortalidade. Foram avaliados 32 pacientes, com idade média de 56,4 ± 17,4 anos, sendo 59,4% do gênero masculino. Somente 21 (65,6%) atingiram percentuais superiores ou iguais a 70% de calorias prescritas, enquanto que para a oferta proteica 19 (59,4%) pacientes atingiram valores iguais ou superiores a 70%. A média de adequação calórica foi de 72,3% e a média de adequação proteica foi de 70,2%. A média de adequação volume de dieta infundido foi de 72,6% perante o prescrito. Foram identificadas 213 interrupções da nutrição enteral, 81,3% dos pacientes tiveram a dieta suspensa em razão de pausas para procedimentos e exames, 56,3% apresentaram piora clínica, 53,1% apresentaram intolerâncias do trato gastrointestinal, 50,0% tiveram erros na administração da dieta e 31,3% apresentaram problemas com a sonda. Não houve relação entre a adequação energética e proteica igual ou superior a 70,0% em pacientes recebendo TNE exclusiva em relação ao tempo de internação, tempo de ventilação mecânica e mortalidade. Mais estudos são necessários para determinar o valor seguro de adequação calórica e proteica, visando à melhora da saúde do paciente em UTI e minimizando intercorrências relacionadas à TNE. / Malnutrition in intensive care has been demonstrated in studies and inadequate nutrition is a determining factor for the complications and may contribute to the higher mortality. This study aimed to evaluate the adequacy of enteral nutrition therapy in critically ill patients admitted to the Intensive Care Unit of the Hospital Dr. Miguel Riet Correa Junior of the Federal University of Rio Grande - FURG and its association to the clinical evolution. Was included all patients who received enteral nutrition therapy for more than 72 hours between May and November 2014. Nutritional status was assessed by the Subjective Global Assessment on admission to the ICU and reapplied weekly. The energy and protein requirements were calculated using the recommendations for critical patients. Data were collected to patient's records. Energy and protein adequacy was determined by the ratio between administered and prescribed. Up to 70% of the prescribed was considered adequate. The adequacy was associated to the length of stay, duration of mechanical ventilation and mortality. 32 patients were included (mean age was 56.4 ± 17.4 years, 59.4% were man). Only 21 (65.6%) patients achieved up to 70% of calories requirement and 19 (59.4%) patients achieved up to 70% of protein requirement. The means of adequacy were 72.3% for calories, 70.2% for protein and 72.6% for diet volume. 213 interruptions of enteral nutrition were identified, 81.3% of patients had suspended diet due to break for procedures and tests, 56.3% had clinical worsening, 53.1% showed gastrointestinal symptoms, 50.0% had wrong administration in the enteral nutrition and 31.3% had problems with the enteral tube. There was no association between energy and protein intake with the length of stay, duration of mechanical ventilation and mortality in critically ill patients. More studies are needed to determine the value of caloric and protein adequacy, aimed at improving patient health in ICU and minimizing complications related to enteral nutrition.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Vitamin A is a fat soluble compound occurring in three chemical forms in animal tissues: alcohol (retinol), aldehyde (retinal) and acid (retinoic acid). It is an essential nutrient for fish, required in small quantities, important for the health, growth and reproduction. In this study, the objective was to determine the nutritional requirement and the response in growth, hematological disorders and oxidative parameters of juvenile catfish (Rhamdia quelen) fed diets with vitamin A. We conducted an experiment lasting 70 days, with 500 silver catfish (initial weight = 23.00 ± 4.27 g), distributed in 20 tanks (25 fish per tank), with four replications. The semi-purified diets were formulated to meet the protein and energy requirements of the species (37% CP and 3.400 kcal/kg DE). Five vitamin A levels were tested: 0; 1500; 3000; 4500; 6000 IU kg-1. Fish were fed three times a day (8, 12 and 18 hours), at 3% PV. Three sampling was performed at the beginning, the middle and the end of the experiment. The following parameters were measured: average weight (g), total length and standard length (cm). Fish used to collect tissue samples were killed by benzocaine overdose (dose: 35 mg L-). Liver, gills and muscle samples were collected to determine oxidative stress parameters (tissue protein, TBARS non-protein thiols, catalase, superoxide dismutase, glutathione-S-transferase). Hematological analyzes of fish were made by analyzing the total number of red blood cells, hematocrit, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration. Analysis of body composition (crude protein, fat, dry matter and mineral matter) of silver catfish to whole fish and fillet samples were also carried out. It has been found that providing diets with levels greater than 3500 IU of vitamin A kg- is ideal for better growth, animals increased proportionally to the increase of vitamin A in the diet. There were no effects on hematological and biochemical parameters of plasma. Considering the fillet quality parameters the level of 4500 IU kg- of vitamin A in the diet showed better results, there were a higher amount of protein and less fat in the fillet. To oxidative protection the level of 4500 IU kg- of vitamin A in the diet showed better results too, was observed lower activity of enzymes that act as an antioxidant, proving that retinoids and carotenoids act by donating electrons to reactive oxygen species, saving the enzymatic protection. / A vitamina A é lipossolúvel e ocorre de três formas químicas no tecido animal: álcool (retinol), aldeído (retinal) e ácido carboxílico (ácido retinóico). É um nutriente essencial para os peixes, exigido em pequenas quantidades, importante para a saúde, crescimento e reprodução. Neste estudo, o objetivo foi determinar a exigência nutricional e a resposta em crescimento, alterações hematológicas e parâmetros oxidativos de juvenis de jundiá (Rhamdia quelen) alimentados com dietas contendo níveis de vitamina A. Para isso, foi realizado um experimento com duração de 70 dias, com 500 jundiás (peso médio inicial = 23,00 ± 4,27 g), distribuídos em 20 tanques (25 peixes por tanque), com quatro repetições por tratamento. As dietas utilizadas foram semi-purificadas e formuladas para atender às exigências proteicas e energéticas da espécie (37% proteína bruta e 3.400 kcal/kg de energia digestível). Foram testados cinco níveis de vitamina A: 0; 1500; 3000; 4500; 6000 UI/kg na dieta. Os peixes foram alimentados três vezes ao dia (8, 12 e 18 horas), 3% do peso vivo, em três refeições. Foram realizadas três biometrias para coleta de dados: no dia 0, aos 35 e aos 70 dias (final do experimento). Foram mensurados os seguintes parâmetros: peso médio (g), comprimento total e comprimento padrão (cm). Os peixes utilizados para coleta de amostras de tecidos foram eutanasiados por meio de overdose de benzocaína (dose: 250mg/L). Foi realizada coleta de amostras de fígado, brânquias e músculo para a determinação de parâmetros oxidativos (proteína tecidual, TBARS, tióis não proteicos, catalase, superóxido dismutase, glutationa-S-transferase). Foram realizadas análises hematológicas dos peixes, quantificando número total de eritrócitos, hematócrito, taxa de hemoglobina, volume corpuscular médio, hemoglobina corpuscular média e concentração de hemoglobina corpuscular média. Também foram realizadas análises de composição corporal (proteína bruta, gordura, matéria seca e matéria mineral) dos jundiás utilizando amostras de peixe inteiro e amostras de filé. Constatou-se que fornecer dietas com níveis acima de 3500 UI de vitamina A/kg é ideal para melhor crescimento, animais cresceram proporcionalmente ao aumento de quantidade de vitamina A na dieta. Não ocorreu efeitos nos parâmetros hematológicos e bioquímicos de plasma. Considerando os parâmetros de qualidade de filé e proteção oxidativa o nível de 4500 UI/kg de vitamina A na dieta apresentou melhores resultados. No filé, houve maior quantidade de proteína e menor quantidade de gordura e quanto ao estresse oxidativo, foi observado menor atividade de enzimas que atuam como antioxidante, provando que retinóides e carotenoides agem doando elétrons para espécies reativas ao oxigênio, poupando a proteção enzimática.

Detritus is an important energy source of stream food webs. Being a mix of allochthonous and autochthonous sources, it is often unknown, which components contribute to the growth of stream organisms. This study focussed on the comparison of two different detritus types (riparian detritus and stream detritus) with respect to food quality and effects on growth as a fitness parameter of juvenile freshwater pearl mussels (FPM). We performed feeding experiments with juvenile FPM under laboratory conditions using the two detritus types from four different natural sources each. Food quality was determined by analysing the fatty acid composition. Stream detritus (conditioned to stream environment including autochthonous microbes) resulted in significantly higher growth rates of juvenile FPM than predominately terrestrial-based riparian detritus indicating higher food quality. Significantly positive correlations were found between mussel growth and different groups of polyunsaturated fatty acids (PUFA). This suggests that especially trace substances such as long-chained n-3 PUFAs and a high ratio of n-3 to n-6 PUFAs enhance the food quality of stream detritus for juvenile FPM. These results highlight the importance of instream conditioning of detritus for the food mix in headwater streams and the importance of PUFAs for the development of juvenile FPM.

Background Due to small iron stores and rapid growth during the first months of life, infants with low birth weight (LBW) are at risk of iron deficiency (ID). ID in infancy is associated with irreversible impaired neurodevelopment. Preventive iron supplementation may reduce the risk of ID and benefit neurodevelopment, but there is also a possible risk of adverse effects. More than 50% of all LBW infants are born with marginally LBW (MLBW, 2000-2500g), and it is not known if they benefit from iron supplementation. Methods We randomized 285 healthy, Swedish, MLBW infants to receive 3 different doses of oral iron supplements; 0 (Placebo), 1, and 2 mg/kg/day from six weeks to six months of age. Iron status, during and after the intervention was assessed and so was the prevalence of ID and ID anemia (IDA), growth, morbidity and the interplay with iron and the erythropoetic hormones hepcidin and erythropoietin (EPO). As a proxy for conduction speed in the developing brain, auditory brainstem response (ABR) was analyzed at six months. In a follow up at 3.5 years of age, the children were assessed with a cognitive test (WPPSI-III) and a validated parental checklist of behavioral problems (CBCL), and compared to a matched reference group of 95 children born with normal birth weight. Results At six months of age, the prevalence of ID and IDA was significantly higher in the placebo group compared to the iron supplemented infants. 36% had ID in the placebo group, compared to 8% and 4 % in the 1 and 2mg/kg/day-groups, respectively. The prevalence of IDA was 10%, 3% and 0%, respectively. ABR-latencies did not correlate with the iron intake and was not increased in infants with ID or IDA. ABR wave V latencies were similar in all three groups. Hepcidin correlated to ferritin and increased in supplemented infants while EPO, which was negatively correlated to iron status indicators, decreased. At follow up there were no differences in cognitive scores between the groups but the prevalence of behavioral problems was significantly higher in the placebo group compared to those supplemented and to controls. The relative risk increase of CBCL-scores above a validated cutoff was 4.5 (1.4 – 14.2) in the placebo-group compared to supplemented children. There was no detected difference in growth or morbidity at any age. Conclusion MLBW infants are at risk of ID in infancy and behavioral problems at 3 years of age. Iron supplementation at a dose of 1-2 mg/kg/day from six weeks to six months of age reduces the risks with no adverse effects, suggesting both short and long term benefit. MLBW infants should be included in general iron supplementation programs during their first six months of life.