Background: The development of nutrition care programs for patients undergoing hematopoietic stem cell transplantation is necessity in view of the rapid and aggressive consequences frequently seen with this procedure. Patients require constant care to reduce complications and to contribute to the success of therapy. Methods: In an attempt to ascertain the impact of systematic nutritional care on patients submitted to allogeneic hematopoietic stem cell transplantation, the present study assessed the nutritional and clinical status, use of parenteral nutrition, and complication and mortality rates in two groups of patients, who were submitted to transplantation between April 2003 and December 2004 (Non-intervention Group - NIG; n = 57) and between March 2006 and January 2008 (Intervention Group - IG; n = 34). Results: There were no significant differences between groups in terms of clinical or nutritional profiles. Additionally, the length of hospital stay and complication and mortality rates were similar for both groups. However, time on parenteral nutrition during treatment was shorter for the IG [median 6.5 days (range: 1-28) for related donor recipients and 11 days (range: 1-21) for unrelated donor recipients] than for the NIG [median 20.5 days (range, 4-73) for patients submitted to myeloablative conditioning and 18.5 days (range: 11-59 days) for those submitted to nonablative conditioning]. Conclusion: The implementation of a nutritional follow-up and therapy protocol for adult patients submitted to hematopoietic stem cell transplantation shortens the duration of parenteral nutrition. It certainly has an impact on hospitalization costs and, potentially, on the rate of complications, even though this was not demonstrated in this study.

The influence of the initial state of nutrition on the lifespan of patients with amyotrophic lateral sclerosis (ALS) during home enteral nutrition

Severe dietary restriction, catabolic states and even short-term caloric deprivation impair fertility in mammals. Likewise, obesity is associated with anovulation and lower pregnancy rates. The nutritional imbalance may adversely reflect on humoral and cellular immune function. The inadequacy between nutritional needs and energy balance would explain the irregularity of ovulation found in the most of environmental disturbances of menstrual pattern. The availability of metabolic sources produced by body stocks can affect gonadotrophins secretion by means of acting on central nervous system. The brain receives information about energy metabolism through peripheral signals such as insulin, insulin-like growth factor-1, leptin and insulin receptor substrate-2. It is proposed an attentive valuation about food intake and energy expenditure (physical activity) like first step to investigate possible etiological factors involved in ovulatory disturbs responsible for infertility, since hypothalamo-pituitary-gonadal axis is sensitive a relatively small calorie intake restriction that culminates to a negative energy balance.