RONALDO SOUSA OLIVEIRA FILHO
Projetos de Pesquisa
Unidades Organizacionais
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
8 resultados
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- Is There an Advantage in Enriching Parenteral Lipid Emulsions Containing Fatty Acids From Fish Oil With Medium-Chain Triglycerides? A Study on Body Pool Concentrations of omega-3 Fatty Acids in Lewis Rats(2021) TESSER, Alweyd; TORRINHAS, Raquel S. M. M.; GARLA, Priscila C.; OLIVEIRA-FILHO, Ronaldo S.; APROBATO, Felipe G. G.; TAMANAHA, Erika M.; ANTUNES, Marcia S.; SAMPAIO, Geni R.; TORRES, Elizabeth; CALDER, Philip C.; WAITZBERG, Dan LinetzkyBackground The addition of medium-chain triglycerides (MCTs) into parenteral lipid emulsions rich in fatty acids from fish oil (FOLEs) has been shown to improve their clearance and extrahepatic uptake. We assessed whether this effect could favor the leukocyte uptake of omega-3 polyunsaturated fatty acids (PUFAs) for immunomodulatory purposes Methods Following 5-day adaptation in metabolic cages, 42 male Lewis rats fed with AIN-93M chow were killed (baseline control group [BC]) or submitted to central venous catheterization and distributed into (1) surgical control group without parenteral infusion (chow group), (2) test emulsion (MCT/LCT/FO) group with the parenteral infusion of a FOLE containing 40% MCT, and (3) control emulsion group (LCT/FO) with the parenteral infusion of an FOLE without MCT. The 2 FOLEs had similar omega-3 PUFA contents and omega-6/omega-3 PUFA ratios and were infused during 48 and 72 hours. Concentrations of omega-3 and omega-6 PUFAs in plasma, liver, and blood mononuclear and polymorphonuclear leukocytes were assessed by gas chromatography Results In both FOLE groups, leukocyte concentrations of omega-3 PUFAs peaked after 48 hours' infusion (vs BC). At this time point, plasma concentrations of omega-3 PUFAs were higher in MCT/LCT/FO group than in LCT/FO group and the opposite was found in the liver (P<.05), but no differences in PUFA concentrations were observed between these groups in leukocytes (P>.05) Conclusion The omega-3 PUFAs provided by FOLEs rich in MCT were less incorporated by liver and remained more available for extrahepatic cell delivery, but this did not result in a clear benefit in increasing their incorporation by peripheral leukocytes.
- Quality control of enteral nutrition therapy in cancer patients at nutritional risk(2017) LEE, Ariana; OLIVEIRA FILHO, Ronald Sousa; CARDENAS, Thais de Campos; OZORIO, Gislaine Aparecida; GROPP, Juliana Pereira Lima; WAITZBERG, Dan LinetzkyIntroduction: Quality indicators in nutritional therapy (QINTs) allow for the practical assessment of quality in the management of enteral nutrition therapy (ENT) among hospitalized patients. Objective: To control ENT quality in cancer patients at nutritional risk. Methods: A prospective, observational study was performed with cancer patients over 19 years of age who had undergone exclusive ENT for at least 72 h. Nutritional Risk Screening was used to assess nutritional risk; in the presence of nutritional risk, the Subjective Global Assessment (SGA) was used. Six QINTs were applied. Results: Our study included 211 patients (mean age: 59 +/- 10 years, 67.3% men). Most common cancer diagnoses were head and neck (68.2%) and gastrointestinal (18%). Nutritional risk was identified in 93.3% (n = 197) of patients; SGA identified malnutrition in 84.2% of patients (n = 166). ENT was used for 9.7 +/- 7 days, presenting a daily deficit of-243.1 +/- 141 ml of dietary volume,-363.3 +/- 214.1 kcal, and-14.2 +/- 8.41 g of protein. Three of the six QINTs were in accordance with the proposed goal: frequency of SGA application, calculations of nutritional needs, and frequency of diarrhea. Three of the six QINTs were in disagreement with the proposed goal: ENT infused volume exceeding 70% of prescribed volume, frequency of digestive fasting exceeding 24 h, and frequency of constipation. Prescriptions for anticholinergic drugs (p = 0.023) and diuretics (p = 0.007) were associated with diarrhea. Conclusion: Nutritional risk and malnutrition are frequent among ENT cancer patients. Quality control in ENT was moderately impaired by episodes of fasting and intestinal motility disorders.
- Quality indicators for enteral and parenteral nutrition therapy: application in critically ill patients ""at nutritional risk""(2016) OLIVEIRA-FILHO, Ronaldo Sousa; RIBEIRO, Lia Mara Kauchi; CARUSO, Lucia; LIMA, Patricia Azevedo de; DAMASCENO, Nagila Raquel Teixeira; SORIANO, Francisco GarciaIntroduction: Quality Indicators for Nutritional Therapy (QINT) allow a practical assessment of nutritional therapy (NT) quality. Objective: To apply and monitor QINT for critically ill patients at nutritional risk. Methods: Cross sectional study including critically ill patients > 18 years old, at nutritional risk, on exclusive enteral (ENT) or parenteral nutritional therapy (PNT) for > 72 hours. After three consecutive years, 9 QINT were applied and monitored. Statistical analysis was performed with SPSS version 17.0. Results: A total of 145 patients were included, 93 patients were receiving ENT, among then 65% were male and the mean age was 55.7 years (+/- 17.4); 52 patients were receiving PNT, 67% were male and the mean age was 58.1 years (+/- 17.4). All patients (ENT and PM) were nutritionally screened at admission and their energy and protein needs were individually estimated. Only ENT was early initiated, more than 70% of the prescribed ENT volume was infused and there was a reduced withdrawal of enteral feeding tube. The frequency of diarrhea episodes and digestive fasting were not adequate in ENT patients. The proper supply of energy was contemplated only for PNT patients and there was an expressive rate of oral intake recovery in ENT patients. Conclusion: After three years of research, the percentage of QINT adequacy varied between 55%-77% for ENT and 60%-80% for PNT. The results were only made possible by the efforts of a multidisciplinary team and the continuous re-evaluation of the procedures in order to maintain the nutritional assistance for patients at nutritional risk.
- Infusion time for fish oil-containing parenteral emulsions in surgery: A study on omega-3 fatty acid dynamics in rats(2021) ANTUNES, Marcia S.; WAITZBERG, Dan L.; TESSER, Alweyd; GUTIERRES, Felipe A.; TAMANAHA, Erika M.; OLIVEIRA, Ronaldo; SAMPAIO, Geni; TORRES, Elizabeth A.; GARLA, Priscilla C.; CALDER, Phillip C.; TORRINHAS, Raquel S.Objectives: The aim of this study was to contribute to the design of specialized parenteral nutrition protocols in surgery by evaluating the dynamics of polyunsaturated fatty acid (PUFA) concentrations in different body pools after the infusion of fish oil-containing lipid emulsion (FOLE) in rats that had undergone surgical central venous catheterization (CVC). Methods: After 5-d adaptation in metabolic cages, 78 male Lewis rats (300-450 g) fed a standard diet were sacrificed (baseline control) or had only CVC (surgical control) or also received a 72-h infusion of a parenteral lipid emulsion with or without fish oil. The catheterized animals were sacrificed 0 (T0), 2 (T2), 6 (T6), and 12 h (T12) after the infusion ended. Gas chromatography was used to determine the concentrations of eicosapentaenoic (EPA), docosahexaenoic (DHA), and arachidonic (ARA) acids and the omega-3 to omega-6 ratio in plasma, liver, and blood leukocytes. Kruskal-Wallis and Wilcoxon tests were applied to plasma and liver data and descriptive analysis to leukocyte data. Results: Plasma, liver, and leukocytes exhibited almost undetectable EPA and DHA and detectable ARA concentrations at baseline. Immediately after FOLE infusion (T0), these PUFAs changed in all pools, resulting in a higher ratio of omega-3 to omega-6 compared with rats with no FOLE infusion (P < 0.05). All these changes decreased over time, with residual effects remaining until T6 in plasma, T12 in liver, and only until T2 in leukocytes. Conclusion: Data from this study suggest that omega-3 PUFAs are cleared early after the end of FOLE infusion, mainly in leukocytes. This should be considered when FOLEs are applied for immunomodulatory purposes in surgery.
- Effect of a parenteral fish-oil-containing lipid emulsion on liver lipid perioxidation and antioxidative defenses in Lewis rats(2023) OLIVEIRA-FILHO, Ronaldo Sousa; TORRINHAS, Raquel Susana; TESSER, Alweyd; SAMPAIO, Geni R.; TORRES, Elizabeth; GARLA, Priscila Casarin; WAITZBERG, Dan LinetzkyBackgroundEicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), naturally abundant in fish oil (FO), are known for their anti-inflammatory and potential antioxidant properties. The aim in this article is to evaluate the effect of the infusion of a parenteral FO-containing lipid emulsion on markers of liver lipid peroxidation and oxidative stress in rats undergoing central venous catheterization (CVC). MethodsAfter 5-day acclimatization, adult Lewis rats (n = 42) receiving a 20-g/day AIN-93M oral diet were randomly subdivided into four groups: (1) basal control (BC) (n = 6), without CVC or LE infusion; (2) SHAM (n = 12), with CVC but without LE infusion; (3) soybean oil (SO)/medium-chain triglyceride (MCT) (n = 12), with CVC and receiving LE without FO (4.3 g/kg fat); and (4) SO/MCT/FO (n = 12), with CVC and receiving LE containing 10% FO (4.3 g/kg fat). Animals from the BC group were euthanized immediately after acclimatization. The remaining groups of animals were euthanized after 48 or 72 h of surgical follow-up to assess profiles of liver and plasma fatty acids by gas chromatography, liver gene transcription factor Nrf2, F2-isoprostane lipid peroxidation biomarker, and the antioxidant enzymes glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) by enzyme-linked immunosorbent assay. R program (version 3.2.2) was utilized for data analysis. ResultsCompared with the other groups, liver EPA and DHA levels were higher in the SO/MCT/FO group, which also showed the highest liver Nrf2, GPx, SOD, and CAT levels and lower liver F2-isoprostane (P < 0.05). ConclusionExperimental delivery of FO via EPA and DHA sources in a parenteral LE was associated with a liver antioxidant effect.
article 1 Citação(ões) na Scopus Dietary intake of AIN-93 standard diet induces fatty liver with altered hepatic fatty acid profile in Wistar rats(2015) GARLA, Priscila; TORRINHAS, Raquel Susana; TESSER, Alweyd; APROBATO, Felipe; OLIVEIRA FILHO, Ronaldo; ANTUNES, Marcia; WAITZBERG, Dan Linetzky- Comment on: ""Influence of an omega 3-fatty acid-enriched enteral diet with and without added glutamine on the metabolic response to injury in a rat model of prolonged acute catabolism""(2018) OLIVEIRA FILHO, Ronaldo Sousa; GARLA, Priscila Casarin; TORRINHAS, Raquel Susana; GARIB, Ricardo Alexandre; TESSER, Alweyd; APROBATO, Felipe Garcia Gutierres; TAMANAHA, Erika Midori; ANTUNES, Marcia de Souza; WAITZBERG, Dan Linetzky
- Adequação dos balanços energético e proteico na nutrição por via enteral em terapia intensiva: quais são os fatores limitantes?(2014) RIBEIRO, Lia Mara Kauchi; OLIVEIRA FILHO, Ronaldo Sousa; CARUSO, Lucia; LIMA, Patricia Azevedo; DAMASCENO, Nágila Raquel Teixeira; SORIANO, Francisco GarciaObjective: To determine the factors that influence the adequacy of enteral nutritional therapy in an intensive care unit. Methods: This prospective observational study was conducted in an intensive care unit between 2010 and 2012. Patients >18 years of age underwent exclusive enteral nutritional therapy for ≥72 hours. The energy and protein requirements were calculated according to the ICU protocols. The data regarding enteral nutrition, the causes of non-compliance, and the biochemical test results were collected daily. Results: Ninety-three patients admitted to the intensive care unit were evaluated. Among these patients, 82% underwent early enteral nutritional therapy, and 80% reached the nutritional goal in <36 hours. In addition, 81.6%±15.4% of the enteral nutrition volume was infused, with an adequacy of 82.2%±16.0% for calories, 82.2%±15.9% for proteins, and a mean energy balance of -289.9±277.1kcal/day. A negative correlation of C-reactive protein with the volume infused and the energy and protein balance was observed. In contrast, a positive correlation was found between C-reactive protein and the time required to reach nutritional goals. Extubation was the main cause for interrupting the enteral nutritional therapy (29.9% of the interruption hours), and the patients >60 years of age exhibited a lower percentage of recovery of the oral route compared with the younger patients (p=0.014). Conclusion: Early enteral nutritional therapy and the adequacy for both energy and protein of the nutritional volume infused were in accordance with the established guidelines. Possible inadequacies of energy and protein balance appeared to be associated with an acute inflammatory response, which was characterized by elevated C-reactive protein levels. The main cause of interruption of the enteral nutritional therapy was the time spent in extubation.