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ABSTRACT BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with higher prevalence among women aged between 30 and 50 years and general prevalence of 1% worldwide. Interventions promoting improvement of quality of life for individuals with RA are required. Tai Chi appears to be a low-cost alternative, with studies showing positive results from this technique. However, regarding aspects of RA such as pain and sensitivity, studies remain inconclusive. OBJECTIVES: To compare the effectiveness of the Tai Chi method for treating patients diagnosed with rheumatoid arthritis, among systematic reviews. DESIGN AND SETTING: Overview of systematic reviews with Cochrane and non-Cochrane methodology. METHODS: Systematic reviews involving quasi-randomized and randomized clinical trials (RCTs) on use of Tai Chi, with no restrictions regarding the date and language of publication, were included. RESULTS: Three systematic reviews were included. The effects of Tai Chi associated with education and stretching exercises versus education and stretching were evaluated in these reviews. They showed that improvements in the variables of mood, depression and functional index were associated with use of Tai Chi. CONCLUSIONS: The findings suggest that clinical improvement was achieved, although not statistically significant with regard to pain and disease pattern, as assessed using the ACR20 measurement. Improvements relating to disability and quality of life were also seen. There was a low level of evidence and therefore caution in data analysis is recommended. The three studies included showed poor reliability for providing an accurate and complete summary of use of Tai Chi among people diagnosed with rheumatoid arthritis. PROSPERO: CRD42019125501.
Subject(s)
Humans , Female , Adult , Middle Aged , Arthritis, Rheumatoid/therapy , Tai Ji , Quality of Life , Exercise Therapy , Systematic Reviews as TopicABSTRACT
Objetivo: investigar os efeitos de intervenção do tipo Educação Alimentar e Nutricional baseada no Modelo Transteórico. Métodos: ensaio clínico aberto com 70 idosos. Avaliouse qualidade da dieta, por meio de Recordatórios Alimentares e Índice de Qualidade da Dieta, e o comportamento alimentar, com análise comparativa do tipo prépós onde o grupo de comparação ou controle foi o próprio grupo selecionado para a intervenção. Resultados: melhora da dieta, com aumento do consumo de frutas, vegetais e hortaliças e do comportamento alimentar (evolução dos estágios de précontemplação para ação). Conclusão: mudança nos hábitos de idosos é difícil, considerase que a intervenção foi efetiva.
Objective: to investigate the effects of intervention of the type of Food and Nutrition Education based on the Transtheoretical Model.Methods: open clinical trial with 70 elderly people. Diet quality was assessed through Food Recalls and Diet Quality Index and eating behavior was evaluated with comparative analysis of the prepost type where the comparison or control group was the group selected for the intervention. Results: improved diet, with increased consumption of fruits and vegetables, and eating behavior (evolution from precontemplation stages to action). Conclusion: changing habits of the elderly is difficult, it is considered that the intervention was effective.
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Abstract Background: Diet plays a critical role in Systemic Lupus Erythematosus (SLE) patients, impacting on the microbiota composition and, consequently, on the immune response. The objective was to analyze and verify the diet effect on SLE patients. Methods: This is a systematic review performed at the Evidences-based Health Lab, Escola Superior em Ciências da Saúde, Brasília (DF), Brazil. In March, 2021, five databases, and grey literature, through JSTOR, Open Grey, and Google Scholar were searched. Randomized Clinical Trials in which SLE patients with calorie restricted, low glycemic index or other diet involving the joint adequacy of these aspects, compared with placebo or different types of diet, were included. Results: It was identified in the databases 758 articles; 132 were duplicated; 616 references were screened, and 604 were excluded. After reading the title and abstract, 12 articles were included for full-text reading. After the full-text reading, three studies were included for quantitative analysis. The diet improved the quality of life at 6 (MD 16.30; 5.91;26.69) and 12 weeks (MD 14.60; 0.88;28.32). The GRADE was used to evaluate the quality of evidence. Conclusion: There is low evidence that the diet has a positive impact on the quality of life of SLE patients. Trial registration PROSPERO—CRD4202012208.
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Conclusão: A AGA é fundamental para identificação da fragilidade (muitas vezes de forma precoce) - permite intervenções individualizadas que tem como objetivo de mudar/prevenir ou amenizar desfechos clínicos adversos e negativos. Serve de guia para a escolha de medidas que visam restaurar e preservar a saúde (farmacoterapia, fisioterapia, terapia ocupacional, psicoterapia, nutrição), sendo assim uma importante ferramenta de saúde pública, visto que atua na prevenção e na promoção da saúde do idoso. A implementação da AGA na prática clínica dos serviços da SES-DF será de grande importância para uma melhor avaliação e acompanhamento da pessoa idosa.
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Humans , Male , Female , Aged , Aged, 80 and over , Case Reports , Geriatric Assessment/methods , Health Services for the AgedABSTRACT
Introdução: a doença hepática, na forma aguda ou crônica, provocagrandes alterações no estado nutricional e no metabolismo denutrientes do doente, principalmente na utilização de aminoácidos.Mudanças no metabolismo de aminoácidos, com reduções nosníveis dos de cadeia ramificada (BCAA) e elevações nos níveis deaminoácidos aromáticos, tem função importante no aparecimentodas complicações da cirrose hepática (CH). A suplementação oralcom BCAA pode corrigir tanto transformações metabólicas quantomelhorar a desnutrição associada à cirrose.Objetivo: avaliar os efeitos da administração de suplemento deBCAA sobre o estado clínico - nutricional de pacientes com CH.Método: estudo em série de casos com pacientes cirróticos internadosno Hospital Regional da Asa Norte (HRAN), entre novembro de2012 e agosto de 2013. Foram aferidas medidas antropométricas eanalisados os resultados de exames bioquímicos antes e após 7 diasde suplementação com BCAA oral.Resultados: seis pacientes participaram do estudo, não houvemelhora da albumina.Conclusão: existe uma elevada prevalência de pacientes comdesnutrição, os valores de albumina não refletiram os efeitosda suplementação na doença hepática e sim o estado clíniconutricionaldos pacientes. Em curto prazo, o BCAA oral não foieficaz em evitar o agravo do estado nutricional nem de melhorar oquadro de desnutrição.
Introduction: Liver disease in its acute or chronic forms, causesmajor changes in nutritional status and nutrient metabolism of thepatient, especially in the use of amino acids. Changes in amino acidmetabolism, with reductions in levels of branched chain (BCAA)and elevated levels of aromatic amino acids, plays an important rolein the onset of complications of liver cirrhosis (LC). Oral supplementationwith BCAA can correct both metabolic transformationsand improve malnutrition associated with cirrhosis.Objective: To evaluate the effects of administration of BCAAsupplementation on clinical and nutritional status of patients withCH.Method: this is a series of cases study with cirrhotic patients conductedat Hospital Regional da Asa Norte (HRAN), between November2012 and August 2013. Anthropometric measurements were takenand the results of biochemical tests of albumin were analyzedbefore and after 7 days of oral supplementation with BCAA.Results: six patients participated in the study, there was no improvementin albumin.Conclusion: there is a high prevalence of malnutrition, albuminvalues did not reflect the effects of supplementation on liver diseasebut the clinical and nutritional status of patients. In the shortterm, oral BCAA was not effective in preventing the worsening ofthe nutritional status and improvement of malnutrition.
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Humans , Male , Female , Amino Acids, Branched-Chain , Liver Cirrhosis , Liver DiseasesABSTRACT
Introdução: a maioria dos distúrbios metabólicos presentes na Doença Renal Crônica (DRC) resulta, principalmente, do acúmulo de produtos do metabolismo do nitrogênio presentes nos alimentos ricos em proteínas. A dietoterapia tem um papel importante no tratamento da DRC, consistindo, principalmente, naadequação da oferta diária de proteínas.Objetivo: discutir a resposta inflamatória e terapia nutricional empregada no tratamento conservador e as vantagens do emprego de dieta normoproteica à base de soja.Métodos: realizada revisão da literatura por meio de busca de artigos científicos indexados em bases de dados online, publicados preferencialmente nos últimos dez anos, além de livros técnicos e outras formas de publicações.Resultados: as complicações metabólicas estabelecem consequênciasimportantes na DRC e podem comprometer o estado nutricional do indivíduo. Ainda são poucas as referências ao uso de dieta normoproteica à base de soja, sendo destacados apenas alguns benefícios em curto prazo, com pouca ênfase às metodologias usadas para a terapia nutricional.Considerações Finais: a evolução do tratamento depende de sua qualidade e das estratégias que serão adotadas durante sua implementação. A dietoterapia é importante no tratamento da DRC, consistindo, principalmente, na redução de oferta diária de proteínas. A presença da inflamação influencia negativamente o estado nutricional e a evolução da função renal do indivíduo.Mais estudos com dieta à base de soja são necessários.
Introduction: Most metabolic disorders present in Chronic Kidney Disease (CKD) results mainly from the accumulation of products of nitrogen metabolism in foods rich in protein. The diet therapy plays an important role in the treatment of CKD, consisting mainly, on the matching of supply daily protein.Objective: discuss the inflammatory response and nutritional therapyused in the conservative treatment and the advantages of using a normalprotein diet based on soy.Methods: literature review was conducted by searching scientific articlesindexed in online databases, preferably published in the last ten years, and technical books and others publications.Results: Metabolic complications establish important consequences in CKD and may compromise the nutritional status of the individual.Although, there are few references to the use of a normal protein dietbased on soy, and posted just a few short-term benefits, with little emphasison the methodologies used for nutritional therapy.Final Remarks: The evolution of treatment depends on the quality and the strategies to be adopted during its implementation. The diet therapy plays an important role in the treatment of CRF, consisting mainly inthe reduction of daily supply of proteins. The presence of inflammation adversely affects the nutritional status of renal function and evolution of the individual. More studies with soy-based diet are needed.
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Humans , Diet Therapy , Kidney , Diet, Protein-Restricted , Diet , Inflammation , Soy FoodsABSTRACT
According to statistical projections of the World Health Organization, during the period between 1950 and 2025, the group of elderly in Brazil will have increased 15 times. Chronic-degenerative diseases are the illnesses that most affect the elderly population, directly related to the growing demand for Enteral Nutrition Therapy. The objective of this study was to analyze the demographic, epidemiological and nutritional profile of elderly patients assisted at the public hospitals in the Home Enteral Nutrition Therapy Program, of the State Health Department of Distrito Federal. This is a retroprospective, cross-sectional and analytical study, based on primary data, which enrolled 141 elderly patients who were prescribed home enteral nutrition. The collected variables corresponded to age, gender, clinical diagnosis, enteral route and nutritional status at the beginning of Home Enteral Nutrition Therapy. The association between variables was analyzed through the t-Student and chi-square tests, with a significance level of 0.05 and a Confidence Interval (CI) of 95%. There was a higher number of female patients (53.9%) when compared to male (46.1%), average age 75.82 years old for both groups. The most prevalent diseases were cerebro-vascular accident sequels and cancer (42.6% and 22.7% respectively). It was observed a prevalence of malnutrition equal to 69.7%, independent of age and gender. The most used enteral route was the nasal. Though Brazilian policies concerning assistance to the elderly have advanced during the last few years, the need for public policies for nutritional recovery of such patients persists, to promote a better quality of life for them.
De acuerdo con estimados de la Organización Mundial de la Salud, en el período de 1950 y 2025, el número de personas ancianas aumentó cerca de 15 veces en Brazil. Las enfermedades crónico-degenerativas que más afectan la población anciana, demandan la terapia nutricional enteral. El objetivo de este estudio fue analizar el perfil demográfico, epidemiológico y nutricional de enfermos ancianos asistidos en el Programa de Terapia Nutricional Enteral en los hospitales públicos de la Secretaria de la Salud del Distrito Federal (SES/DF). Este estudio fue retroprospectivo, transversal, analítico, con base en los datos primarios de 141 ancianos que recibieron nutrición enteral a domicilio. Los datos fueron edad, diagnóstico clínico, via enteral de la administración y perfil nutricional. La asociación entre las variables fue analizada con los tests Student y chi-Cuadrado, con un nivel de significancia de 0,05 y con un intervalo de confianza de 95%. Fue observado un mayor número de ancianas (53,9%) que ancianos (46,1%), con una edad media de 75,82 años para ambos grupos. Las enfermedades con mayor prevalencia fueron secuelas de accidentes cerebro-vasculares y cáncer (42,6% y 22,7%, respectivamente). La prevalencia de desnutrición fue de 69,7%, independientemente de la edad y el género. La ruta más usada en la administración fue la nasal. Las políticas de salud brasileñas en la asistencia a ancianos han mejorado en los últimos años; sin embargo, persiste la necesidad de políticas públicas para la asistencia nutricional a este grupo con el propósito de promover una mejor calidad de vida.