Evidence synthesis is considered a corner stone of modern health care and clinical practice. Systematic reviews of randomised trials, when undertaken with meta-analysis provide summary estimates on the effectiveness of interventions. However, the findings of meta-analysis are often limited by the selective reporting of primary studies, and the variations in population, intervention and outcomes. Furthermore, difficulties in disentangling the study and individual level associations in meta-analysis make them susceptible to ecological fallacy, and may lead to incorrect conclusions. Meta-analysis using Individual Participant Data (IPD) has the potential to overcome many of the above limitations, by using raw trial data. Access to IPD minimises problems from incomplete or incorrect reporting of trial outcomes, by verifying reported results, and by standardising the definition of outcomes where possible. Importantly, this allows detecting any variation in the effects of interventions according to characteristics of the participants. Amalgamated individual datasets assembled to address the effectiveness question, can be further used to explore secondary objectives such as the relationship between surrogate and clinical outcomes. This maximises the use of available clinical data, and addresses the problem of research waste. In this thesis, I evaluated the effects of diet and physical activity based interventions in pregnancy on maternal and offspring outcomes using both study-level and IPD meta-analyses, and assessed the differential effects of interventions on outcomes according to mother's BMI pre or in early pregnancy. I reviewed the variation in outcomes reported in this field, and developed composite outcomes for IPD meta-analysis. I also evaluated the relationship between weight gain in pregnancy and clinical outcomes in pregnancy using the IPD meta-analysis methodology. Aims The aim of this thesis was to evaluate the effects of diet and physical activity based interventions in pregnancy on clinical outcomes using standard and advance methods of evidence synthesis; assess the variation in outcomes and their clinical importance in a trial with those interventions and examine the relationship between gestational weight gain and important clinical outcomes. Methods Delphi methodology, systematic reviews of literature, and meta-analyses using study-level and individual participant data of randomised controlled trials (RCTs). Results Composite outcomes Developed composite outcomes comprise of four maternal (gestational diabetes, hypertensive disorders in pregnancy, preterm birth, caesarean section) and four offspring outcomes (stillbirth, small for gestational age, large for gestational age, and admission to neonatal intensive care unit). The components to assess maternal composite outcome were available in two-thirds (66.7%, 24/36) and for offspring composite in half (50%, 18/36) of the studies in the IPD meta-analysis. The effect of interventions was not statistically significant neither on the maternal nor on the offspring composite - Odds Ratio (OR) 0.90 (95% CI 0.79, 1.03) and OR 0.94 (95% CI 0.83, 1.08), respectively. The direction of the pooled effect was consistent between the composite and its components for the maternal composite and variable for the offspring outcomes. 6 Effects of diet and physical activity based interventions The IPD meta-analysis of 36 RCTs (>12 500 women) showed a significant effect of diet and physical activity based interventions in pregnancy in reducing gestational weight gain (Mean Difference -0.70 kg, 95% CI -0.92, -0.48) and chance of caesarean section delivery (OR 0.91, 95% CI 0.83, 0.99) in comparison to routine antenatal care. There was no effect of the interventions on any of the offspring complications. Incorporation of outcome data unavailable on study-level returned more modest magnitude of the summary estimates in comparison to effects obtained using study-level data of trials that shared IPD. The addition of study-level data from non-IPD trials changed the magnitude and the statistical significance of the summary effects on GDM - from OR 0.89 with only IPD (95% CI 0.72, 1.10; 27 studies, 9 427 women) to OR 0.76 (95% CI 0.65, 0.89; 59 studies, 16 885 women). It has also changed the funnel plot structure in the meta-analysis for gestational weight gain (Egger's test p = 0.04 with only IPD to p= 0.61). The IPD meta-analysis shows that the effects of diet and physical activity based interventions on the maternal and the offspring outcomes did not differ by women's BMI status. While the study-level meta-regression indicated that the interventions might reduce gestational weight gain stronger for the obese women - coefficient -0.22 (95% CI -0.33, -0.11) for each 10% change in the proportion of women in the obese class. Outcomes in trials with diet and physical activity based interventions 66 primary publications from trials with diet and physical activity based interventions in pregnancy reported 142 outcomes. Half of those outcomes appeared in the publications once (72/142). 'Critically important' outcomes are reported less often in comparison to 'non-critical' ones (15.5%, 22/142 vs 68.3%, 97/142). The overall quality of outcome reporting varied between trials with the least frequently provided information on the methods to improve the quality of outcome measures (33.3%, 22/66 publications). 7 Gestational weight gain and pregnancy outcomes IPD from 4 429 pregnant women randomised to the control arms of RCTs with diet and physical activity based interventions were available for the analysis. Women who most often exceeded the IOM recommendation belonged to the overweight (51.5%, 641/ 1 245 women) and the obese groups (44.5%, 695/ 1 562 women) while women with normal BMI most often gained below the recommended amounts (40%, 649/1 622 women). Each kilogram of gestational weight gain within the IOM ranges was not link with a change in the chances of preterm birth, caesarean section, or birth of LGA and SGA infant. Not achieving of the recommended weight was associated with the decreasing chance of giving birth to LGA infant with each kilogram below the lower limit among the obese women (OR 0.80, 95% CI 0.65, 0.99). Each kilogram of weight gain above the upper limit was associated with an increase in the chance of caesarean section (adjusted 1.04, 95% CI 1.01, 1.08) and delivering LGA infant (adjusted 1.08, 95% CI 1.05, 1.12) regardless on women's BMI status. Conclusions Diet and physical activity based interventions in pregnancy moderately reduced gestational weight gain and decrease the odds of caesarean delivery. Overall, IPD meta-analysis improved the robustness of the evidence synthesis of RCTs with diet and physical activity based interventions. However, more attention is needed for the data-related issues in IPD meta-analysis as the purported benefits of the method are not always practically realised. The use of the composite outcomes was hampered by the variable availability of important clinical outcomes. The introduction of minimal core outcome set would facilitate the comparison of the wide range of the evaluated interventions and improve implementation of the composite outcomes. Gestational weight gain was found to be associated with the odds of delivering LGA infant and caesarean section. Future research should aim to collect and report a minimal set of outcomes, and ensure better reporting of study conduct and its findings.

O chá verde (Camellia sinensis L) apresenta potencial de uso em dietas dos animais domésticos devido à grande quantidade de polifenóis presentes em suas folhas. Pesquisas desenvolvidas com animais, realizadas primeiramente com cobaias, mostram resultados positivos na nutrição e comportamento animal. O objetivo deste estudo foi avaliar o efeito da adição de extrato de chá verde à dieta de novilhas leiteiras sobre o comportamento, consumo de concentrado e desenvolvimento corporal. Foram utilizadas no experimento 32 novilhas não gestantes. O delineamento experimental utilizado foi o de blocos completos casualizados, com medidas repetidas no tempo e quatro tratamentos. As variáveis avaliadas foram: consumo de concentrado e matéria seca, ganho de peso, medidas corporais, comportamento ingestivo junto ao cocho e medidas fisiológicas. O consumo de concentrado foi maior (P<0,05) nas doses zero e 3g que nas doses de 1 e 2g de extrato de chá verde. O ganho de peso dos animais que receberam 2 e 3g/d de extrato de chá verde tendeu a ser maior (P<0,10) que o dos animais que receberam 1g ou o controle (zero). A inclusão de extrato de chá verde na dieta de novilhas não influenciou o consumo de matéria seca total, eficiência alimentar, as medidas corporais, comportamentais e fisiológicas, mas influenciou o consumo de concentrado e tendeu a influenciar o ganho de peso diário. / Green tea (Camellia sinensis L) is potentially useful as a dietary additive for domestic animals due to the polyphenols found in the leaves. The aim of this study was to evaluate the addition of green tea extract into the concentrate of dairy heifers on behavior, concentrate intake and body development. Thirty-two Holstein and Jersey dairy heifers not pregnant were selected. The experimental design was a randomized complete block design with repeated measures and four treatments: zero, 1, 2 and 3 grams of green tea extract added into the concentrate. Variants used: concentrated intake and dry matter, weight gain, body measurements, ingestion behavior along with trough and physiological dimension. The concentrated intake is higher (P<0,05) in doses zero and 3g than in doses with 1 and 2 g of green tea extract. The weight gain of the subjects that received 2 and 3 g/d of green tea extract tended to be higher (P<- 0,10) than those that received 1 g or the control sample (zero). The inclusion of green tea extract in the diet of heifers didn’t affect the ingestion of total dry matter, nurture efficiency nor the bodily, behavioural and the physiological measurements, but it did influence the concentrated intake and trended to sway the daily weight gain.

Orientador: Ricardo Velludo Gomes de Soutello / Resumo: Atualmente na pecuária de corte as infecções causadas por parasitos gastrintestinais são um importante problema encontrado, associado ao estresse do desmame pode acarretar prejuízos devido ao menor desempenho e a maior susceptibilidade dos bezerros às doenças e parasitoses nesta fase de vida. O objetivo do trabalho foi avaliar os efeitos do tratamento anti-helmíntico e da suplementação em bezerros da raça Nelore no período pós-desmame, pelo grau de verminose, análises hematológicas e seu desempenho, bem como avaliar a viabilidade financeira. Foram utilizados 100 bezerros contemporâneos da raça Nelore, com peso médio de 173,9 kg, divididos em quatro grupos de 25 animais cada, sendo 13 machos e 12 fêmeas. Os grupos receberam os tratamentos: G1) Ração e anti-helmíntico; G2) Ração; G3) Suplementação proteica e anti-helmíntico; G4) Suplementação proteica. Foram realizadas: análise coprológica (ovos por grama de fezes, coprocultura), análise sanguínea observação dos padrões hematológicos (volume globular, proteína plasmática total e eosinófilos) e desempenho produtivo por meio do ganho de peso. Também foi realizada análise de custo conforme os gastos obtidos, calculando a viabilidade financeira dos diferentes grupos. Os dados foram analisados com o auxilio do software Minitab - Versão 17. Os resultados mostram que as fêmeas e os machos que receberam ração com tratamento anti-helmíntico apresentaram maior ganho de peso. Nas fêmeas, foi observada diferença significativa na contagem d... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Currently in beef cattle infections caused by gastrointestinal parasites are an important problem found, associated to stress weaning, can result in losses due to the lower performance and higher susceptibility of calves to diseases and parasitic infections in this life phase. The objective was to evaluate the effects of the anthelmintic treatment and supplementation in Nellore calves post-weaning period, by the degree of worms, hematological analysis and performance, and assess the financial viability. Were used 100 contemporary calves of the Nellore breed, weighing approximately 173.9 kg, divided into four groups of 25 animals each, 13 males and 12 females. The groups received treatments where: G1) ration and anthelmintic; G2) Ration; G3) protein supplementation and anthelmintic; G4) Protein supplementation. The evaluated variables were: coprologic analysis (eggs per gram of faeces and coproculture), blood analysis to normal patterns (packed cell volume, total plasma protein and eosinophils), productive performance through weight gain. The cost analysis was calculated according to obtained expenditures. The data were analyzed with the Minitab software - version 17. The results show that females and males that received ration with anthelmintic treatment showed greater weight gain. In females, there was significant difference in counts of eggs per gram of feces only between groups 2 and 3, as in males was observed difference in the animals that received anthelmintic treatment... (Complete abstract click electronic access below) / Mestre

Orientador: Cristiana Andrighetto / Resumo: O objetivo deste trabalho foi avaliar a produção, valor nutritivo e capacidade de suporte do capim Marandu, desempenho produtivo e comportamento ingestivo de novilhas meio sangue Angus x Nelore. O experimento foi conduzido na APTA – Andradina, SP em Sistemas Silvipastoris, sendo: SSP-1 com 187 árvores/ha, SSP-2 com 446 árvores/ha, associado ao Eucalyptus urograndis, clone I-224 (17 e 18,7m de altura respectivamente) e Sistema Convencional (SC), ambos em pastagens de Urochloa brizantha cv. Marandu. Para as avaliações da forragem, foram realizadas: massa seca total, análise bromatológica, desempenho animal e taxa de lotação nas estações inverno e verão. Para o comportamento ingestivo, realizou-se quatro coletas: uma no início e outra no final das estações inverno e verão. Foram observados os seguintes comportamentos: pastejo, ruminação (em pé e deitado), ócio (em pé e deitado), outras atividades, que incluem: interação com outros animais, ida ao bebedouro e ao cocho, urinar e defecar e deslocamento. Concomitantemente, foram avaliados as seguintes variáveis microclimáticas: temperatura de globo negro, temperatura ambiente, umidade relativa do ar e velocidade do vento. A partir destes dados, foram calculados os seguintes índices de conforto térmico: índice de temperatura e umidade (ITU), índice de temperatura de globo e umidade (ITGU) e carga térmica radiante (CTR). O delineamento experimental foi em blocos completos com 3 tratamentos e 4 repetições. Os dados foram submetidos às ... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

Made available in DSpace on 2014-06-11T19:22:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-03-27Bitstream added on 2014-06-13T20:48:48Z : No. of bitstreams: 1 massago_h_me_jabo.pdf: 505723 bytes, checksum: 1b1f4ab5136c45685bc1851b627e27fc (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Este trabalho teve como objetivo verificar o desempenho inicial de quatro linhagens comerciais de Oreochromis niloticus denominadas Bouaké, GIFT, Supreme e Chitralada, com ênfase no ganho em peso e sobrevivência. Utilizou-se os alevinos revertidos com o peso médio de um grama. O experimento foi conduzido em sistema fechado durante 112 dias, com biometrias realizadas a cada 28 dias. Inicialmente eram mantidos 38 peixes por 120 L em cada caixa e, após 84 dias, 13 peixes por 180 L. A qualidade da água foi avaliada através dos seguintes parâmetros: temperatura, oxigênio dissolvido (OD) e Potencial Hidrogeniônico (pH). Forneceu-se inicialmente a ração em pó com 45% de proteína bruta e, depois, a ração extrusada contendo 40% do mesmo nutriente. Os pesos médios finais das linhagens Bouaké, GIFT, Supreme e Chitralada foram 98,83 g, 121,46 g, 133,20 g e 112,89 g, respectivamente. As linhagens Supreme e GIFT apresentaram melhor desempenho, sendo que o desempenho da linhagem GIFT foi semelhante ao da Chitralada. O desempenho da linhagem Bouaké não diferiu da Chitralada (p<0,05). A taxa de sobrevivência (acima de 80%, com exceção da Bouaké) pode ser considerada normal. / This work aimed to verify the initial performance of four commercial Oreochromis niloticus strains named Bouaké, GIFT, Supreme and Chitralada, with special attention on the weight gain and survival rates. Tilapia fingerlings, post reversion with mean weight of one gram were used. The experiment was carried out in a closed system of Tilapia laboratory of CAUNESP, during 112 days, and biometries for performance evaluation have been done every 28 days. Water quality was evaluated through the following parameters: temperature, dissolved oxygen and pH value. Feeding was initially with powdered ration with 45 % crude protein, and after three weeks, with extruded ration with 40% crude protein. The final mean weight of the Bouaké, GIFT, Supreme and Chitralada strains were 98.83g, 121.46 g, 133.20 g and 112.89 g, respectively. Supreme and GIFT strains presented better performance, and the GIFT and Chitralada strains were similar too (p<0.05). Survival rate was considered normal (above 80%), with the exception of Bouaké strain.

A olanzapina é um fármaco antipsicótico atípico utilizado no tratamento da esquizofrenia. Como efeitos adversos relacionados ao seu uso, encontram-se obesidade, hiperlipidemia, Diabetes Mellitus tipo II, entre outros. O presente trabalho avaliou os efeitos adversos passíveis de desenvolvimento em pacientes esquizofrênicos que fazem uso deste medicamento, avaliando o indivíduo antes de começar o tratamento, 30 e 60 dias após o início (T0, T1 e T2) através de dosagens antropométricas (peso, IMC, circunferência abdominal e porcentagens de tecido adiposo no organismo), hemodinâmicas (pressão arterial, frequência cardíaca), perfil lipídico (colesterol total, LDL-col, HDL-col e triglicérides), glicêmico (resistência à insulina HOMA-R, QUICKI e razão G/I; glicemia de jejum) e bioquímico (avaliação da função renal, hepática e dosagem de homocisteína, um marcador de risco cardiovascular). A olanzapina plasmática foi dosada nos mesmos tempos com intenção de se buscar uma correlação de dose-resposta (efeito adverso). A análise estatística foi realizada com auxílio dos \"softwares\" Graphpad Instat e Statgraphics, para o estudo e análise das médias (ANOVA), e análise de comparação múltipla entre os grupos (Tukey-Kramer). O nível de significância foi fixado em p<0,05. Para os grupos sem diferença estatística relevante, foram utilizadas técnicas de estatística descritiva para se observar diferenças mais sutis ou com relevância clínica. As altas concentrações plasmáticas encontradas não foram concordantes com os estudos prévios de outros autores, já que não foram mais propensos a desenvolver ganho de peso. Este efeito adverso foi encontrado no nosso grupo, porém sem apresentar uma correlação direta com a concentração plasmática. / The olanzapine is an atypical antipsychotic drug used to treat schizophrenia. The adverse effects related to its use are obesity, hyperlipidemia, diabetes mellitus type II and others. This study evaluated the adverse effects likely to develop in schizophrenia patients who use this drug, assessing the individual before starting treatment, 30 and 60 days after the start (T0, T1 and T2) by anthropometric measurements (weight, BMI , waist circumference and percentage of fat in the body), hemodynamic (blood pressure, heart rate), lipid profile (total cholesterol, LDL-col, col-HDL and triglycerides), glucose (insulin resistance - HOMA-R, QUICKI, G/I ratio and fasting plasma glucose) and biochemical (measurement of renal function, liver and determination of homocysteine, a marker of cardiovascular risk). The olanzapine plasma was measured at the same time looking for a dose-response (effect) correlation. Statistical analysis was performed using the \"software\" Statgraphics and GraphPad Instat for the study and analysis of means (ANOVA) and analysis of variance between groups (Tukey-Kramer). The significance level was set at p <0.05. For groups without statistical significant difference were used descriptive statistical techniques to observe more subtle differences or clinical relevance. The high plasma concentrations found were not consistent with previous studies of other authors, since there were more likely to develop weight gain. This adverse effect was found in our group, but without a direct correlation with plasma concentration.

Este estudo foi realizado na Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, com cento e oitenta e sete gestantes sem comorbidades, para conhecer o perfil nutricional de gestantes que receberam orientação dietética e avaliar o ganho ponderal materno total, o tipo de parto e os resultados perinatais. Foi realizada pesquisa retrospectiva e descritiva, por meio de consulta dos formulários de anamnese alimentar, dos bancos de dados clínicos e prontuários das pacientes. As gestantes foram classificadas de acordo com o IMC prégestacional: 23 (12,2%) eram de baixo peso (IMC < 19,8 kg/m2); 84 (45%), eutróficas (IMC de 19,8 a 26,0 kg/m2); 37 (19,8%), sobrepeso (IMC de 26,1 a 29,0 kg/m2) e 43 (23%), obesas (IMC > 29,0 kg/m2). No consumo energético, não se constatou diferença entre os grupos. A média de porcentagem de carboidratos, proteínas e lipídeos ingerida foi semelhante entre os grupos. Sobre o perfil da ingestão de micronutrientes, a de cálcio, vitamina A e vitamina C foi semelhante entre os grupos; a de ferro foi maior nas gestantes eutróficas quando comparadas às com sobrepeso e com obesidade (p<0,001); a de folatos foi maior nas gestantes eutróficas quando comparadas às obesas (p=0,002); a de fibras foi menor nas gestantes de baixo peso quando comparadas às eutróficas (p=0,042). O ganho de peso excessivo (acima do recomendado) foi significativamente maior (p=0,009) nas gestantes com sobrepeso e obesidade, porém o ganho ponderal materno médio foi significativamente menor nas obesas (p<0,001). Não foi observada diferença entre os grupos quanto à idade gestacional no parto e o tipo de parto. O peso dos recém-nascidos das gestantes de baixo peso apresentou média significativamente menor (p=0,005) que dos demais grupos. As gestantes com sobrepeso apresentaram maior porcentagem de recém-nascidos com mais de 4000g (p=0,037) que os demais grupos. A proporção de recém-nascidos grandes para a idade gestacional foi significativamente maior (p=0,006) nas gestantes com sobrepeso e com obesidade quando comparadas aos demais grupos. Os índices de Apgar não apresentaram diferença significativa entre os grupos. A indicação de cesárea por vício pélvico foi significativamente mais frequente em gestantes com baixo peso (p = 0,006) quando comparadas aos outros grupos / This study was carried out at Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, with one hundred eighty-seven pregnant women without comorbidities. This study aimed to know the nutrition profile of pregnant women who received dietary counseling and to evaluate the maternal total weight gain, type of delivery and perinatal outcome. A retrospective and descriptive research was carried out through consultation of forms of dietary anamnesis, the clinical databases and medical records. The women were classified according to pre-gestational body mass index (BMI): 23 (12.2%) were underweight (BMI < 19.8 kg/m2), 84 (45%) normal weight (BMI 19.8 to 26.0 kg/m2), 37 (19.8%) overweight (BMI 26.1 to 29.0 kg/m2) and 43 (% 23) obese (BMI > 29.0 kg/m2). No difference was observed in energy consumption between the groups. The averages percentage of carbohydrates, protein and lipid intake were similar between groups. Regarding the profile of micronutrient intake, calcium intake, vitamin A and vitamin C was similar between groups; iron intake was higher in normal weight pregnant women compared to overweight and obese (p<0.001); folate intake was higher in normal weight pregnant women compared to obese (p=0.002); fiber intake was lower in underweight pregnant women compared to normal weight (p=0.042). Excessive weight gain (above the recommended) was significantly higher (p=0.009) in pregnant women with overweight and obesity, however the mean of total maternal weight gain was significantly lower in obese women (p<0.001). No difference was observed between the groups regarding gestational age at delivery and mode of delivery. The weight of newborns of underweight pregnant women had a mean significantly lower (p=0.005) compared to other groups. The overweight pregnant women had a higher percentage of newborns with more than 4000g (p=0.037) compared to other groups. The proportion of newborns large for gestational age was significantly higher (p=0.006) in pregnant women with overweight and obesity compared to other groups. The Apgar scores did not differ significantly between groups. Indication of cesarean for contracted pelvis was significantly more frequent in underweight pregnant women (p=0.006) when compared to other groups

Dois ensaios experimentais foram conduzidos com o objetivo de determinar o efeito dietético da suplementação de acidificantes sobre o desempenho, incidência de diarréia (ensaio 1) e na digestibilidade aparente de nutrientes (ensaio 2). No ensaio 1, com duração de 42 dias, 120 leitões desmamados aos 21 dias foram distribuídos em 8 blocos experimentais com três leitões por baia,foram aplicados cinco tratamentos. Os tratamentos foram: ração sem acidificante, com 1,0% de diformiato de potássio, com 1,0% de ácido fumárico, com 1,0% de ácido cítrico ou com 1,0% de ácido benzóico. No ensaio 2, 10 leitões com peso médio inicial de 16,4 kg foram distribuídos em dois blocos experimentais, cada um com cinco repetições, sob dois tratamentos (ração sem acidificante ou com 1,0% de ácido fumárico). No estudo de desempenho, a adição de ácido fumárico nas rações determinou aumentos (P<0,05) no consumo de ração nos períodos de 0 aos 15 dias, 0 aos 32 dias e ganho de peso de 0 aos 42 dias, quando comparado ao tratamento controle. Não foi observada a ocorrência de diarréia nos leitões nos primeiros 14 dias pós-desmame. No ensaio 2, a adição de 1,0% de ácido fumárico na ração não alterou (P>0,05) os coeficientes de digestibilidade aparente da matéria seca, proteína bruta e fibra bruta, os valores de energia digestível e metabolizável das rações e a taxa de absorção e retenção de nitrogênio. A ausência de diferenças nos coeficientes de digestibilidade aparente dos nutrientes dietéticos com a inclusão do acidificante, provavelmente, deveu-se ao curto período de avaliação. A inclusão de ácido fumárico nas rações de leitões desmamados favoreceu o desempenho dos leitões. / Two experimental assays were conducted in order to evaluate the effect of supplementation of acidifiers in the diets both on performance traits and incidence of diarrhea (assay 1) and on nutrient digestibility (assay 2). In assay 1, which lasted for 42 d, it was used 120 21-days old weaned piglets, distributed in 8 blocks of 3 pigs per pen. There were five evaluated treatments, which consisted of: ration without acidifier, with 1,0% of K-diformate, 1,0% of fumaric acid, 1,0% of citric acid or 1,0% of benzoic acid. In assay 2, 10 pigs with an average weight of 16,4 kg were allocated in two treatments (ration without acidifier or supplemented with 1,0% of fumaric acid) with five replicates each; experimental design was ramdomized complete blocks. In comparison with the control treatment, the addition of fumaric acid in the ration led to an increase in the following parameters: daily feed intake from day 0 to 15 (P< 0,05); daily feed intake and body weight gain from day 0 to 32 (P< 0,05) and from day 0 to 42 d (P< 0,05). There was not treatment effect (P> 0,05) upon feed conversion over the experimental period, and it was not observed the occurrence of diarrhea over the first 14 days after weaning. In assay 2, the addition of 1,0% of fumaric acid in the ration did not modify (P>0,05) the coefficients of apparent fecal digestibility of dry matter, crude protein and crude fiber, the values of digestible and metabolizable energy of the rations and the rates of nitrogen absorption and retention. The absence of differences in the coefficients of the dietary nutrient s apparent digestibilidade with the inclusion of the acidifier, probably, was due to the short evaluation period. The inclusion of fumaric acid in the rations of weaned pigs improved performance of piglets; however, it did not modify the coefficients of apparent fecal digestibility of the nutrients.

Introdução: O ganho de peso interdialítico (GPID), aquele ganho entre sessões de diálise, pode ser considerado um preditor da qualidade de vida e da mortalidade em pacientes de hemodiálise (HD). Fatores nutricionais podem estar envolvidos na preservação ou piora destes parâmetros e estas relações não estão investigadas detalhadamente. Objetivo: Este estudo objetivou avaliar o estado nutricional e composição corporal de pacientes em hemodiálise, em relação ao GPID. Métodos: Foi um estudo transversal, com 102 pacientes em HD, de ambos os sexos, com idade entre 18 e 80 anos e sem quadros agudos de infecção e/ou inflamação, foi realizado em dois centros de diálise, no Hospital das Clínicas e no Serviço de Nefrologia ambos na cidade de Ribeirão Preto - São Paulo. Após o tratamento dialítico, foi avaliado o estado nutricional por meio de dados antropométricos (índice de massa corporal, circunferência da cintura, circunferência do quadril, dobras cutâneas e dinamometria manual) além do uso da análise subjetiva global de 7 pontos, de dados de ingestão alimentar avaliados por registro alimentar de 24 horas e de dados bioquímicos e a composição corporal foi avaliada utilizando a bioimpedância unifrequencial - BIA, a análise de bioimpedância vetorial - BIVA e a bioimpedância multifrequencial por espectroscopia - BIS. Resultados: Pacientes com maior ganho de peso interdialítico apresentaram significativamente maior índice de massa corporal (24,5±4,1 vs 28,8±5,5kg/m²), excesso de gordura corporal (22,7±9,5 vs 31,7±14,4kg), sendo evidenciada uma predominância da gordura na região abdominal (91,3±10,8 vs 101,5±15,1cm), de água corporal total (33,4±7,7 vs 40,1±8,6L) e água extracelular (15,1±3,4 vs 18,1±4,2L) além do maior consumo de sódio (2278±755 vs 2906±650mg) e de gorduras (59,8±17,6 vs 71,8±23g). A BIA superestimou a quantidade de água corporal nos pacientes em HD e, consequentemente as massas corporais hidratadas. Ao comparar os valores de BIVA vs BIS foi evidenciada apenas uma fraca concordância (kappa = 0,34). Conclusão: Pacientes com maior GPID além de mais água extracelular apresentam maior gordura corporal e consumo de alimentos ricos em gordura e sódio. A BIS pode ser um método que melhor avalia pacientes em HD com sobrecarga hídrica e desta forma, poderia auxiliar no manejo do GPID, individualizando o cuidado nutricional destes pacientes e propiciando maior qualidade de vida. / Introduction The interdialytic weight gain (IDWG), that gain between dialysis sessions, may be considered a predictor of quality of life and mortality in hemodialysis (HD) patients. Nutritional factors may be involved in preserving or worsening of these parameters and these relations are not investigated in detail. Objective: This study aimed to evaluate the nutritional status and body composition in hemodialysis patients, in relation to the IDWG. Methods: It was a cross-sectional study of 102 HD patients, of both sexes, 18 and 80 years old and without acute episodes of infection and / or inflammation, was conducted in two dialysis centers, at the Hospital and the Service Nephrology both in the city of Ribeirão Preto - São Paulo. After dialysis, it evaluated the nutritional status through anthropometric data (body mass index, waist circumference, hip circumference, skinfold thickness and handgrip strength) and the use of subjective global analysis of 7 points, food intake data assessed by food record 24 hours and biochemical data and body composition was assessed using bioimpedance unifrequencial - BIA, the bioimpedance vector analysis - BIVA and multifrequency bioimpedance spectroscopy - BIS. Results: Patients with higher interdialytic weight gain had significantly higher body mass index (24.5±4.1 vs 28.8±5.5kg/m²), excess body fat (22.7±9.5 vs 31.7±14,4kg), evidencing a predominance of fat in the abdominal region (91.3±10.8 vs 101.5±15,1cm), total body water (33.4±7.7 vs 40.1±8,6L) and water extracellular (15.1±3.4 vs 18.1±4,2L) in addition to the increased consumption of sodium (2278 ± 755 vs. 2906 ± 650mg) and fat (59.8±17.6 vs 71.8±23g). The BIA overestimated the amount of body water in HD patients and consequently the body hydrated masses. When comparing the values of BIVA vs BIS was evidenced only a weak agreement (kappa = 0.34). Conclusion: Patients with higher IDWG as well as more extracellular water have higher body fat and consumption of foods high in fat and sodium. The BIS may be a method that better evaluates HD patients with fluid overload and thus, could help in the management of IDWG, individualizing the nutritional care of these patients and providing better quality of life.

Inappropriate weight gain during pregnancy is a widespread problem associated with adverse maternal and newborn outcomes. This study’s objective was to examine the impact of gestational weight gain (GWG) above and below the Institute of Medicine (IOM) guidelines on pregnancy, delivery, and newborn outcomes in a rural population. Women were recruited at the first prenatal visit, and data was collected through research interviews and examination of prenatal and delivery medical records. Prepregnancy weight and weight at delivery were obtained, and the final sample (n=913) was restricted to women with singleton pregnancies. Participants were categorized by prepregnancy body mass index (BMI) and GWG above, within, or below IOM guidelines based on gestational length. After controlling for pregnancy smoking, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to identify significant outcomes associated with high or low weight gain, with normal GWG as the control. Of the 913 participants, 208 (22.8%) had inadequate GWG, 255 (27.9%) gained within the recommended range, and 450 (49.3%) gained more than recommended. Inadequate GWG was associated with delivery before 39 weeks, oxygen administration to the infant, admission to the neonatal intensive care unit (NICU), and a hospital stay longer than seven days. Excess GWG was associated with preeclampsia, pregnancy-induced hypertension (PIH), gestational diabetes mellitus, cesarean delivery, labor longer than 12 hours, macrosomia, and large-for-gestational-age (LGA) infants. GWG outside IOM guidelines was prevalent in the sample and associated with numerous adverse outcomes, suggesting a need for increased awareness and improved management of GWG in this population.