ABSTRACT
Resumen: Introducción: Los cuidados paliativos en México son contemplados como una necesidad en todos los niveles de atención. La nutrición e hidratación en estos enfermos hacia sus últimos días de vida es controversial. Objetivo: Identificar las recomendaciones basadas en la evidencia sobre la nutrición e hidratación en los últimos días de vida. Material y métodos: Se realizó una búsqueda documental sobre la nutrición e hidratación hacia el final de la vida tomando como marco temporal las últimas horas y/o los últimos días de vida del enfermo en el contexto hospitalario. Resultados: Con los criterios de búsqueda seleccionados se identificaron 83 documentos. No se encontraron metaanálisis. Existen dos revisiones sistematizadas de la literatura, un ensayo clínico, cuatro guías de práctica clínica, cuatro reportes de caso y 17 revisiones. Se desglosan los resultados relevantes de lo seleccionado. Conclusiones: Se identifica que existen controversias de fondo sobre la alimentación al final de la vida. Sobre la hidratación existe cierto consenso. Es indispensable contar con un nutriólogo dentro de los servicios de cuidados paliativos de la Nación.
Abstract: Introduction: Palliative care in Mexico is considered a necessity at all levels of care. Nutrition and hydration in these patients towards the last days of life is controversial. Objective: To identify evidence-based recommendations on nutrition and hydration in the last days of life. Material and methods: A documentary search on nutrition and hydration towards the end of life was carried out taking as a time frame the last hours and/or the last days of life of the patient in the hospital context. Results: With the selected search criteria, 83 documents were identified. No meta-analyses were found. There are two systematized literature reviews, one clinical trial, four clinical practice guidelines, four case reports and 17 reviews. The relevant results of the selected documents are broken down. Conclusions: It is identified that there are fundamental controversies about feeding at the end of life. On hydration there is some consensus. It is essential to have a nutritionist within the palliative care services of the Nation.
ABSTRACT
RESUMEN: El confinamiento por pandemia por SARS-CoV-2 ha agravado la condición física y nutricional de los deportistas de élite, modificando la rutina de los entrenamientos. La bioimpedancia (BIA) estudia la composición corporal y es utilizada para valorar la evolución de las intervenciones médicas, deportivas y nutricionales. El objetivo del estudio fue observar si una intervención nutricional y una prescripción de actividad física específicas pudieron atenuar los cambios hídricos, de composición corporal, y ángulo de fase (PhA) tras el confinamiento por la pandemia SARS-CoV-2 en una población de futbolistas de élite. En un grupo de 22 futbolistas profesionales (Serie A, Calcio, Italia) se evaluó la BIA antes (febrero 2020) y después (mayo 2020) del confinamiento por la pandemia SARS-CoV-2. Durante el periodo de confinamiento se aplicó una intervención nutricional y prescripción de actividad física específicas. Las medidas de los participantes se realizaron de forma protocolizada, usando material antropométrico y un impedanciómetro multifrecuencia, octopolar y segmental de la marca Tanita modelo MC-780MA. Se aplicó la prueba t de Student para muestras relacionadas. No se observaron diferencias significativas antes y después del periodo de intervención, en el grado de hidratación y composición corporal (masa muscular y masa grasa). Por el contrario, se evidenció un cambio significativo en el PhA. Estos datos nos permiten poder tener una referencia de que intervenciones nutricionales y de actividad física pueden minimizar o disminuir el impacto de un confinamiento en la composición corporal. No obstante, este tipo intervención no fue capaz de atenuar los efectos del confinamiento sobre el PhA, considerado un indicador de la salud celular. Así mismo, aportamos una gráfica vectorial de referencia, mediante SpecificBIVA, de esta población.
SUMMARY: The confinement due to a SARS-CoV-2 pandemic has aggravated the physical and nutritional condition of elite athletes, modifying their training routine. Bioimpedance (BIA) studies body composition and is used to assess the evolution of medical, sports and nutritional interventions. The objective of the study was to observe if a specific nutritional intervention and prescription of physical activity could attenuate the changes in water, body composition, and phase angle (PhA) after confinement due to the SARS-CoV-2 pandemic in a population of professional soccer players. In a group of (22 professional soccer players (Serie A, Calcio, Italy) the BIA was evaluated before (February 2020) and after (May 2020) the confinement due to the SARS-CoV-2 pandemic. During the confinement period, a specific nutritional intervention and prescription of physical activity was applied. The measurements of the participants were carried out in a standardized way, using anthropometric material and a multifrequency, octopolar and segmental impedance measurer of the "Tanita" brand model MC-780MA. Student's T test was applied for related samples. No significant differences were observed before and after the intervention period, in the degree of hydration and body composition (muscle mass and fat mass). On the contrary, a significant change in PhA was evidenced. These data allow us to hav a reference for nutritional and physical activity interventions that can minimize or reduce the impact of confinement on body composition. However, this type of intervention was not able to attenuate the effects of confinement on PhA, considered an indicator of cellular health. Likewise, we provide a reference vector graph, using Specific BIVA, of this population.
Subject(s)
Humans , Male , Adolescent , Adult , Young Adult , Soccer , Body Composition , Quarantine , COVID-19 , Electric Impedance , SARS-CoV-2ABSTRACT
Objetivo: Avaliar a correlação entre as diferentes concentrações e o efeito hidratante da ureia. Material e Método: Cada indivíduo recebeu aplicações de emulsões com 3%, 5% e 10% de ureia e uma emulsão controle. Realizaram-se avaliações clínicas, subjetivas e corneométricas em 1, 4 e 6 horas. Resultados: Todas as emulsões, incluindo a do controle, obtiveram efeito hidratante na primeira avaliação (p < 0,05). A ureia a 10% foi signifi cativamente superior às outras concentrações na avaliação de 4 horas comparada à ureia a 3% e na avaliação de 6 horas, às concentrações de 3 e 5%. Formigamento e ardência foram mencionados para a ureia a 10% na avaliação de 1 hora. Conclusão: A duração das propriedades higroscópicas da ureia está positivamente relacionada com a concentração. Sintomas adversos, como ardência, foram observados apenas em maiores concentrações.
Objective: To evaluate the correlation from different concentrations and hydration effect of urea. Material and Method: A double blind, randomized, placebo-controlled clinical trial, with dry skin individuals submitted to one application of three different urea emulsion concentrations: 3%, 5% and 10%, and a control emulsion. Corneometry measures, clinical evaluation and a questionnaire at 1, 4, and 6 hours were developed. Results: All the emulsions, including the control, had a signifi cant moisturizing effect in the fi rst evaluation (p < 0,05); 10% urea is superior to other concentrations, which was observed at 4 hour evaluation against 3% urea, and at 6 hour evaluation against 5% and 3%. Itching and stinging were mentioned for 10% urea at 1 hour evaluation. Conclusion: The duration of urea hygroscopic properties is positively related with the concentration; adverse symptoms like stinging are observed only in higher concentrations.