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1.
Arch. pediatr. Urug ; 92(2): e211, dic. 2021. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1278304

ABSTRACT

Introducción: las cardiopatías congénitas (CC) son patologías frecuentes en pediatría. Son causa de importante morbimortalidad en la infancia. Son pacientes complejos, que requieren abordaje integral, en equipo interdisciplinario. Objetivos: describir las características epidemiológicas, clínicas y evolutivas de niños portadores de CC asistidos en la Unidad de Cardiología del HP-CHPR durante el año 2015, así como su estado nutricional y los factores que pudieran influir en este. Material y método: estudio descriptivo, retrospectivo, a través de la revisión de historias clínicas de pacientes portadores de CC, hospitalizados en la Unidad de Cardiología del HP-CHPR en 2015. Se describieron características epidemiológicas y clínicas de los pacientes. Resultados: en el período evaluado egresaron 63 pacientes, que representaron una tasa de 6,58/1.000 egresos hospitalarios. Tenían un promedio de edad de 23,8 meses. Un total de 8 pacientes fueron diagnosticados en el período prenatal, 54 presentaban CC no cianóticas. Habían sido sometidos a tratamiento quirúrgico 24 niños, 13 con cirugía correctiva. Se diagnosticó desnutrición en 43%. Esta fue más prevalente en portadores de CC cianótica, de defectos complejos, y de cromosomopatías u otras malformaciones. Conclusión: los niños con CC representaron un pequeño porcentaje de quienes requirieron hospitalización en el HP-CHPR. El porcentaje de desnutrición fue elevado. Este estudio confirma la importante morbimortalidad de los niños pequeños portadores de CC. Es importante reconocer el mayor riesgo de estos pacientes y actuar en forma individualizada y oportuna.


Introduction: congenital heart disease (CHD) is a frequent pathology among children. It may cause significant morbidity and mortality during childhood. These are complex patients, who require a comprehensive approach and an interdisciplinary team. Objective: to describe the epidemiological, clinical and evolutionary characteristics of children with CHD assisted in the Cardiology Department of the Children Hospital-CHPR in 2015. Material and Methods: descriptive, retrospective study, review of clinical records of patients with CHD, hospitalized in the Cardiology Department of the Children's Hospital PRHC in 2015. Epidemiological and clinical characteristics of patients were described. Results: 63 patients were hospitalized during the evaluated period, a total rate of 6.58/1.000 discharges. They had an average age of 23.8 months. Eight patients were diagnosed in the prenatal period, 54 presented non-cyanotic CHD. Twenty-four children had undergone surgical treatment, 13 had had corrective surgery. Malnutrition was diagnosed in 43% and it was more prevalent in cyanotic CHD carriers, complex defects, and chromosomopathies or other malformations. Conclusion: CHD represented a small percentage of the children who required hospitalization at the PH-PRHC. The percentage of malnutrition was high. The study confirmed the significant morbidity and mortality of these patients. It is important to recognize the highest risk of these patients and act in a customized and timely fashion.


Introdução: as cardiopatias congênitas (CC) são patologias comuns em pediatria. Elas são uma causa significativa de morbidade e mortalidade na infância. Os pacientes são complexos e requerem uma abordagem integral e uma equipe interdisciplinar. Objetivos: descrever as características epidemiológicas, clínicas e evolutivas de crianças com CC atendidas na Unidade de Cardiologia do Hospital Pediátrico PHPR durante o ano de 2015, descrever seu estado nutricional e os fatores que poderiam influenciá-lo. Material e métodos: estudo descritivo, retrospectivo, feito por meio da revisão de prontuários de pacientes com CC, internados na Unidade de Cardiologia do HP-CHPR em 2015. Foram descritas as características epidemiológicas e clínicas dos pacientes. Resultados: no período avaliado, 63 pacientes receberam alta hospitalar, representando uma taxa de 6,5/1.000 altas hospitalares. Eles tinham uma idade média de 23,8 meses. Oito pacientes foram diagnosticados no período pré-natal, 54 apresentavam CC não cianótica. 24 crianças tinham sido submetidas a tratamento cirúrgico, 13 tinham recebido cirurgia corretiva. 43% foram diagnosticadas com desnutrição, a qual foi mais prevalente em portadores de CC cianótica, defeitos complexos e malformações cromossômicas ou outras. Conclusão: os CCs representaram um pequeno percentual de crianças que necessitaram de internação no HP-CHPR. O percentual de desnutrição foi alto. Este estudo confirma a morbidade e mortalidade significativas de crianças pequenas com CC. É importante reconhecer o risco aumentado desses pacientes e agir de forma individualizada e oportuna.


Subject(s)
Humans , Male , Female , Pregnancy , Infant , Child, Preschool , Child , Adolescent , Malnutrition/complications , Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/epidemiology , Hospitalization , Prenatal Diagnosis , Epidemiology, Descriptive , Retrospective Studies , Malnutrition/diagnosis , Malnutrition/epidemiology , Heart Defects, Congenital/surgery , Heart Defects, Congenital/classification
2.
Medicina (B.Aires) ; 80(6): 622-632, dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1250284

ABSTRACT

Resumen El índice PROFUND es una de las puntuaciones pronósticas sugeridas en pacientes pluripatológicos (PP). A pesar del valor pronóstico de la desnutrición y su prevalencia en esta población, el mismo no incluye una variable que estime el estado nutricional. La valoración global subjetiva (VGS) es una herramienta ampliamente validada para tal fin. Se evaluó mediante un estudio prospectivo y observacional, la capacidad pronóstica de mortalidad a 12 meses del índice PROFUND y VGS en PP internados en clínica médica. Ingresaron al estudio 111 pacientes. Edad 75.8 (± 9.3) años. Índice PROFUND 7.6 (± 4.7) puntos. El 60.1% presentaba desnutrición moderada-severa por VGS. Fallecieron 66 dentro del año. En el modelo de Cox, la VGS y el índice PROFUND se asocian con mortalidad a los 12 meses (p < 0.0001 y p 0.0026 respectivamente). En los desnutridos severos, el riesgo es aproximadamente 6 veces mayor en comparación a los normonutridos (HR: 6.514, IC95% 2.826-15.016) y para un mismo nivel de VGS, el riesgo es un 10% mayor por cada punto que aumenta el índice PROFUND (HR: 1.106, IC95% 1.036-1.181). El AUC para predecir mortalidad a 12 meses del índice PROFUND y VGS fue: 0.747 (IC95%: 0.656-0.838); 0.733 (IC95%: 0.651-0.816) y al combinar las dos variables: 0.788 (IC95%: 0.703-0.872, p 0.048). Como conclusión el índice PROFUND y la VGS se asocian con mortalidad y tienen un valor pronóstico similar. La combinación de ambas herramientas permitiría establecer mejor el pronóstico y el manejo en esta compleja población


Abstract The PROFUND index is one of the suggested prognostic scores in pluripathological patients (PP). Despite the prognostic value of malnutrition and its prevalence in this population, it does not include a variable that estimates nutritional status. Subjective global assessment (SGA) is a widely validated tool for this purpose. The prognostic capacity of 12-month mortality of PROFUND index and SGA in PP admitted to a medical clinic was evaluated by a prospective and observational study. 111 patients entered the study. Age 75.8 (± 9.3) years. PROFUND index 7.6 (± 4.7) points. 60.1% had moderate-severe malnutrition due to VGS. 66 died within the year. In the Cox model, SGA and PROFUND index are associated with mortality at 12 months (p <0.0001 and p 0.0026 respectively). In severe malnutrition, the risk is approximately 6 times higher compared to normonutrition (HR: 6.514, 95% CI 2.826-15.016) and for the same level of SGA, the risk is 10% higher for each point that the PROFUND index increases (HR: 1.106, 95% CI 1.036-1.181). The AUC for predicting 12-month mortality from PROFUND index and SGA was: 0.747 (95% CI: 0.656-0.838); 0.733 (95% CI: 0.651-0.816) and when combining the two variables: 0.788 (95% CI: 0.703-0.872, p 0.048). In conclusion, PROFUND index and SGA are associated with mortality and have a similar prognostic value. The combination of both tools would allow better prognosis and management in this complex population.


Subject(s)
Humans , Malnutrition/diagnosis , Malnutrition/epidemiology , Hospitalization , Prognosis , Nutrition Assessment , Nutritional Status , Prospective Studies
3.
Buenos Aires; s.n; oct. 2020. 19 p. tab, graf, mapas.
Non-conventional in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1284008

ABSTRACT

La malnutrición por exceso es uno de los problemas de salud más prevalentes en niños y niñas en edad escolar, etapa en la que se observa un marcado incremento en el sobrepeso y la obesidad. Se describe el estado nutricional de una cohorte de niños y niñas que concurrieron a escuelas de gestión estatal de CABA, evaluados/as en 1º y 6º grado, se comparan las prevalencias de sobrepeso / obesidad y su asociación con sexo, zona de la ciudad, tipo de jornada escolar y realización de intervenciones educativas por parte del Programa Mi Escuela Saludable, y se analiza la incidencia del exceso de peso y, en particular, de la obesidad y su asociación con las variables mencionadas.


Subject(s)
Humans , Male , Female , Child , School Health Services , Health Programs and Plans , Food and Nutrition Education , Malnutrition/diagnosis , Malnutrition/etiology , Malnutrition/prevention & control , Malnutrition/epidemiology , Overweight/diagnosis , Overweight/epidemiology , Pediatric Obesity/diagnosis , Pediatric Obesity/prevention & control , Pediatric Obesity/epidemiology
4.
Einstein (Säo Paulo) ; 18: eAO5309, 2020. tab
Article in English | LILACS | ID: biblio-1133765

ABSTRACT

ABSTRACT Objective: To investigate the discriminative power of Nutritional Risk Screening 2002. Methods: A cross sectional study involving one hundred participants aged ≥60 years. The original and adapted versions of Nutritional Risk Screening 2002 and the Mini Nutritional Assessment were used. Nutritional Risk Screening 2002 adaptation consisted of a lower age cutoff (60 years or older) for addition of one extra point to the final score. Results: Screening using Nutritional Risk Screening 2002 revealed higher nutritional risk among patients aged ≥70 years (p=0.009), whereas screening using the adapted version of Nutritional Risk Screening 2002 revealed similar nutritional risk in both age groups (60-69 years and ≥70 years; p=0.117). Frequency of nutritional risk was highest when the Mini Nutritional Assessment was administered (52.7%), followed by the adapted and original versions of Nutritional Risk Screening 2002 (35.5% and 29.1%, respectively). Conclusion: The adapted version of Nutritional Risk Screening 2002 was more effective than the original version. However, further studies are needed to confirm these findings.


RESUMO Objetivo: Avaliar o poder de discriminação diagnóstica da ferramenta Nutritional Risk Screening 2002. Métodos: Estudo transversal com cem participantes com idade ≥60 anos. Foram aplicados o Nutritional Risk Screening 2002 original, o Nutritional Risk Screening 2002 adaptado e o Mini Nutritional Assessment. A adaptação do Nutritional Risk Screening 2002 consistiu em diminuir o critério de idade, incluindo pontuação adicional para 60 anos de idade ou mais. Resultados: Maior risco nutricional ocorreu nos ≥70 anos quando aplicado o Nutritional Risk Screening 2002 original (p=0,009), enquanto o Nutritional Risk Screening 2002 adaptado apresentou risco nutricional semelhante em ambos os grupos (60-69 anos e ≥70 anos; p=0,117). A frequência de risco nutricional foi maior no Mini Nutritional Assessment (52,7%), seguido do Nutritional Risk Screening 2002 adaptado (35,5%) e do Nutritional Risk Screening 2002 original (29,1%). Conclusão: A adaptação do Nutritional Risk Screening 2002 mostrou-se descritivamente mais eficaz do que a original, porém mais estudos devem ser realizados para confirmar os achados.


Subject(s)
Humans , Aged , Nutrition Assessment , Malnutrition/diagnosis , Malnutrition/epidemiology , Brazil , Geriatric Assessment , Nutritional Status , Cross-Sectional Studies , Risk Assessment , Middle Aged
5.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(4): 435-441, Oct.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1041361

ABSTRACT

ABSTRACT Objective: To determine the prevalence of hepatic steatosis (HS) in children and adolescents with cystic fibrosis (CF) and associate it with nutritional status. Methods: Cross-sectional study with children and adolescents with CF diagnosis. Weight and height were used to calculate the body mass index (BMI) and subsequent classification of the nutritional status. The midarm circumference (MAC), triceps skinfold thickness (TSF) and midarm muscle circumference (MAMC) were used to evaluate body composition. Abdominal ultrasonography was performed for diagnosis of HS. The statistical tests used were Student's t test, Mann-Whitney test and chi-square test with significance level of 5%. Results: 50 patients with CF were evaluated, 18 (36%) were diagnosed with HS (Group A) and 32 (64%) without HS (Group B). The mean age of Group A was 13,2±4,9 years old and Group B 11,7±4,9; for BMI, the value for Group A was 18,0±4,1 and Group B was 15,7±3,8; the TSF of Group A was 8,4±3,5 mm and Group B was 7,0±2,5 mm. For these variables, there was no significant difference between the groups. The mean of MAC and MAMC differed significantly between the groups, being higher in the HS group, with p values of 0,047 and 0,043. Conclusions: The frequency of HS in patients with CF is high and it is not related to malnutrition, according to the parameters of BMI, TSF and MAMC. The values of MAC and MAMC indicated a greater reserve of muscle mass in patients with HS.


RESUMO Objetivo: Determinar a prevalência de esteatose hepática (EH) em crianças e adolescentes com fibrose cística (FC) e associá-la com o estado nutricional. Métodos: Estudo transversal com crianças e adolescentes com diagnóstico de FC. Foram aferidos o peso e a altura para o cálculo do índice de massa corpórea (IMC) e classificação do estado nutricional. A circunferência do braço (CB), a dobra cutânea tricipital (DCT) e a circunferência muscular do braço (CMB) foram empregadas para avaliação da composição corporal. A ultrassonografia abdominal foi realizada para o diagnóstico de EH. Os testes estatísticos empregados foram o teste t de Student, o teste de Mann-Whitney e o teste do qui-quadrado, com nível de significância de 5%. Resultados: Dos 50 pacientes avaliados, 18 (36%) apresentaram EH (Grupo A) e 32 (64%) não (Grupo B). Para as médias de idade (Grupo A: 13,3±5,0 anos; e Grupo B: 11,7±5,0 anos), IMC (Grupo A: 18,0±4,1; e Grupo B: 15,7±3,8) e DCT (Grupo A: 8,4±3,5 mm; e Grupo B: 7,0±2,5 mm), não houve diferença significativa entre os grupos. A média da CB e da CMB diferiram significativamente entre os grupos, sendo mais elevada no grupo com EH, com valores p respectivos de 0,047 e 0,043. Conclusões: É alta a frequência de EH em pacientes com FC e ela não está relacionada com a desnutrição, segundo os parâmetros de IMC, DCT e CMB. Os valores de CB e CMB indicaram maior reserva de massa muscular nos pacientes com EH.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Young Adult , Nutritional Status , Cystic Fibrosis/complications , Malnutrition/complications , Non-alcoholic Fatty Liver Disease/ethnology , Risk Management , Prevalence , Cross-Sectional Studies , Cystic Fibrosis/physiopathology , Malnutrition/diagnosis , Malnutrition/physiopathology , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/epidemiology
6.
Arq. gastroenterol ; 56(4): 447-450, Oct.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1055162

ABSTRACT

ABSTRACT BACKGROUND: Malnutrition is associated with clinical factors, including longer hospital stay, increased morbidity and mortality and hospital costs. OBJECTIVE: To investigate the prevalence of malnutrition using different nutritional indicators and to identify factors that contribute to malnutrition in hospitalized patients. METHODS: We investigated anthropometric, laboratory standards, nutritional risk screening (NRS), subjective global assessment (SGA), mini nutritional assessment and habitual energy consumption (HEC). Chi-square, Fisher's exact test, Mann-Whitney test and univariate and multiple Cox regression analysis were used, at 5% significance level. RESULTS: It was found 21.01% of malnourished individuals by ASG; a total of 34.78% with nutritional risk according to NRS and 11.59% with low weight (BMI). There was no statistically significant difference in the prevalence of malnutrition by ASG (P=0.3344) and nutritional risk by NRS (P=0.2286), among the types of disorders. Patients with nutritional risk were of higher median age (64.5 vs 58.0 years; P=0.0246) and had lower median values of HEC (1362.1 kcal vs 1525 kcal, P=0.0030), of calf circumference (32.0 cm vs 33.5 cm, P=0.0405) of lymphocyte count (1176.5 cell/mm3 vs 1760.5 cell/ mm3, P=0.0095); and higher percentage of low body weight according to the BMI (22.9% vs 5.6%; P=0.0096). Lymphocyte count was associated with nutritional risk (P=0.0414; HR= 1.000; IC95%= 0.999; 1.000). CONCLUSION: NRS was more sensitive than other indicators in the diagnosis of malnutrition. Patients at risk were older and had lower HEC values, calf circumference, BMI and lymphocyte count. Low lymphocyte count was considered a factor associated with nutritional risk by the NRS.


RESUMO CONTEXTO: A desnutrição está associada a fatores clínicos, incluindo maior tempo de internação, aumento da morbimortalidade e custos hospitalares. OBJETIVO: Investigar a prevalência de desnutrição por diferentes indicadores nutricionais e identificar fatores que contribuem para a desnutrição em pacientes hospitalizados. MÉTODOS: Investigou-se indicadores antropométricos, laboratoriais, nutritional risk screening, avaliação subjetiva global (ASG), mini avaliação nutricional e consumo energético habitual (CEH). Utilizou-se os testes qui-quadrado, exato de Fisher, Mann-Whitney e análise de regressão de Cox univariada e múltipla, com nível de significância de 5%. RESULTADOS: Verificou-se 21,01% de desnutridos pela ASG; 34,78% com risco nutricional pelo NRS e 11,59% com baixo peso pelo índice de massa corporal (IMC). Não houve diferença estatisticamente signi­ficante da prevalência de desnutrição pela ASG (P=0,3344) e de risco nutricional pelo NRS (P=0,2286), entre os tipos de doenças. Os pacientes com risco nutricional apresentaram maior mediana de idade (64,5 vs 58,0 anos; P=0,0246) e menores valores medianos no CEH (1362,1 kcal vs 1525 kcal, P=0,0030); na circunferência de panturrilha (CP) (32,0 cm vs 33,5 cm, P=0,0405); na contagem de linfócitos (CL) (1176,5 cel/mm3 vs 1760,5 cel/mm3, P=0,0095); e maior percentual de baixo peso pelo IMC (22,9% vs 5,6%; P=0,0096). A CL foi associada ao risco nutricional (P=0,0414; HR=1,000; IC95%= 0,999; 1,000). CONCLUSÃO: O NRS foi mais sensível que outros indicadores no diagnóstico de desnutrição. Pacientes com risco apresentaram mais idade e valores menores de CEH, CP, IMC e CL. A baixa CL foi considerada fator associado ao risco nutricional pelo NRS.


Subject(s)
Humans , Young Adult , Malnutrition/diagnosis , Hospitalization , Prevalence , Cross-Sectional Studies , Risk Factors , Malnutrition/epidemiology
7.
Rev. medica electron ; 41(5): 1166-1177, sept.-oct. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1094120

ABSTRACT

RESUMEN Introducción: la nutrición tiene importancia capital en la evolución de los pacientes ingresados. La prevalencia de malnutrición oscila entre 30% y 60% de los enfermos hospitalizados. Objetivo: evaluar impacto en la mortalidad y complicaciones a corto plazo de una intervención nutricional precoz. Material y método: se realizó un estudio caso control con todos los pacientes que ingresaron en la Unidad de Cuidados intensivos emergentes con el diagnóstico de neumonía adquirida en la comunidad asociada a desnutrición en Hospital Militar Dr. Carlos J. Finlay, de noviembre de 2017 hasta mayo del 2018. Resultados: la media de la edad del estudio fue de 80,73 ± 9,01 años. El 46 % fueron mujeres. La mortalidad global estuvo en el 26 %. El 69 % de los pacientes presento alguna complicación. Existió una mayor sobrevida en el grupo de estudio (7 fallecidos y 29 vivos), que en el grupo de control donde hubo 12 fallecidos y 24 vivos x2 = 0,18. En la tabla 2 se evidencia que existe diferencia entre los grupos según las complicaciones aparecidas. Fue marcada la diferencia entre los grupos en relación a la cantidad de pacientes con diarreas. La incidencia fue mayor tanto en el subgrupo de vivos(8) como en el de fallecidos(3) del grupo control. Por otro lado la hiperglucemia fue mucho mayor en el grupo de estudio(11) y sin embargo, no hubo impacto en la mortalidad x2 = 0,03. En la tabla 3 se evidencia una fuerte evidencia que relaciona al estado nutricional deficiente con una peor evolución. Entre los fallecidos solo 1 tenía un estado nutricional catalogado como desnutrido ligero, sin embargo entre los 22 fallecidos 14 presentaron desnutrición severa. Conclusiones: el estado nutricional al ingreso impacta negativamente en la mortalidad a corto plazo y la estrategia nutricional mixta precoz no reduce ese aspecto sin embargo si reduce el número de complicaciones aunque se asoció a mayor incidencia de hiperglucemia sin impactar en la mortalidad (AU).


SUMMARY Introduction: nutrition has a capital importance in the evolution of in-patients. Malnutrition prevalence ranges from 30 % to 60 % of the admitted patients. Objective: to evaluate the impact on mortality and the short time complications of the precocious nutritional intervention. Material and Method: a case control study was carried out with all patients who entered the Emergency Intensive Care Unit with the diagnosis of community-acquired pneumonia associated to malnutrition in the Military Hospital "Dr, Carlos J. Finlay" from November 2017 to May 2018. Results: the average age was 80.73 ± 9.01 years. 46 % were female patients. Global mortality was 26 %. 69 % of patients had complications. The group of study showed a higher survival (7 deads and 29 survivors) than the control one where there were 12 deads and 24 survivors (2=0.18). Table 2 shows that there are differences between groups according to the complications found. The difference between groups was remarkable in relation to the quantity of patients with diarrhea. The incidence was higher both in the group of survivors(8) and in the group of dead peoples(3) of the control group. On the other hand, hyperglycemia was much higher in the group of study(11) but without striking on mortality (2= 0.03). Table 3 shows strong evidence relating deficient nutritional status to a worth evolution. Among the deceased patients only 1 had a nutritional status classified as slightly malnutrition, but among the 22 deceased, 14 had severe malnutrition. Conclusions: the nutritional status at admission negatively strikes on short term mortality, and mixed precocious nutritional strategy does not reduce that aspect. However it does reduce the number of complications, though it was associated to a higher incidence of hyperglycemia without striking on mortality (AU).


Subject(s)
Humans , Aged , Pneumonia/complications , Malnutrition/diagnosis , Early Medical Intervention , Pneumonia/mortality , Nutrition Programs , Malnutrition/etiology , Malnutrition/mortality , Malnutrition/therapy
8.
Buenos Aires; s.n; ago. 2019. 24 p. tab, graf, mapas.
Non-conventional in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1284048

ABSTRACT

Se presenta información referida a la situación nutricional de la población menor de 19 años, adultos/as y embarazadas atendidas en los Centros de Salud Nivel 1 (CESACs) durante el período 2019. El propósito de este Informe es facilitar el acceso a datos consolidados sobre la situación nutricional de la población atendida en el primer nivel de atención, de manera que los equipos de salud puedan disponer y compartir información correspondiente a sus áreas de trabajo y al conjunto de la Ciudad, y planificar acciones acordes al perfil epidemiológico-nutricional. (AU)


Subject(s)
Humans , Male , Female , Pregnancy , Child , Adolescent , Adult , Nutrition Programs , Nutritional Surveillance , Health Centers , Malnutrition/diagnosis , Malnutrition/epidemiology , Overweight/diagnosis , Overweight/epidemiology , Nutritional Sciences , Anemia/diagnosis , Obesity/epidemiology
9.
Int. j. cardiovasc. sci. (Impr.) ; 32(2): 143-151, mar.-abr. 2019. tab
Article in English | LILACS | ID: biblio-988184

ABSTRACT

Background: Anabolic/catabolic disorder in heart failure (HF) favors cardiac cachexia, implying a reduction in HF survival. Objectives: To assess the accuracy and concordance of the diagnosis of protein malnutrition and excess fat among the anthropometric and body composition methods in individuals with HF. Method: A study of accuracy that included 60 individuals with HF. Body mass index (BMI), arm circumference (AC), triceps skinfold thickness (TST), adductor pollicis muscle thickness (APMT), arm muscle circumference (AMC) and corrected arm muscle area (cAMA). Fat free mass index (FFMI) and body fat percentage (BF%), obtained by electrical bioimpedance (EBI), were used to compare the diagnosis of protein malnutrition and excess fat. Accuracy was assessed by calculating sensitivity, specificity, positive and negative predictive value. The concordance of the EBI diagnosis and other methods was performed by the chi-square test and kappa (k) statistic, where p<0.05 was considered significant.Results: Higher frequencies of protein malnutrition were identified by cAMA and AMC, and excess fat by BF%. BMI presented low sensitivity (43%) and accuracy (38.5%), with moderate concordance (0.50). AMC sensitivity was 86%, accuracy 66.4%, and acceptable concordance (0.36) compared to FFMI. Similar percentages of moderate sensitivity and low accuracy were observed for TST and BMI.Conclusion: AMC may be useful to identify protein malnutrition and TST has not been adequate to diagnose adiposity. BMI was not sensitive to assess muscle and adipose reserve. EBI was more accurate


Subject(s)
Humans , Male , Female , Middle Aged , Body Mass Index , Nutrition Assessment , Anthropometry/methods , Heart Failure , Stroke Volume , Cachexia , Adipose Tissue , Statistical Analysis , Malnutrition/diagnosis , Dyslipidemias/diagnosis , Heart Ventricles , Obesity/complications
10.
Arq. gastroenterol ; 55(4): 397-402, Oct.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-983840

ABSTRACT

ABSTRACT BACKGROUND: Malnutrition is a frequent condition among hospitalized patients and a factor of increased risk of postoperative complication. OBJECTIVE: This study aimed to evaluate the impact of malnutrition on phase angle (PA), body water distribution and clinical outcomes in surgical patients with colorectal disease. METHODS: This retrospective study was performed in a tertiary hospital with 40 patients admitted electively. In the preoperative evaluation, global subjective assessment and bioelectrical impedance analysis were performed to determine nutritional status, PA, extracellular water (ECW), intracellular water (ICW) and total body water (TBW). In postoperative evaluation, the length of hospital stay and severe complications, according to Clavien-Dindo classification, were determined. The optimal PA cutoff for malnutrition screening was determined by ROC curve analysis. RESULTS: Seventeen (42.5%) patients were diagnosed as malnourished and 23 (57.5%) as well-nourished according to global subjective assessment. Twelve (30.0%) patients developed severe complications. The malnourished group presented lower values of serum albumin (P=0.012), hematocrit (P=0.026) and PA (P=0.002); meanwhile, ECW/ICW (P=0.019) and ECW/TBW (P=0.047) were higher. Furthermore, 58.8% of malnourished patients developed severe postoperative complications compared to 8.7% of well-nourished. Malnutrition was independent predictor of severe postoperative complications (OR=15.00, IC: 2.63-85.68, P=0.002). The optimal PA cutoff obtained was 6.0º (AUC=0.82, P=0.001), yielding sensitivity, specificity, positive predictive value and negative predictive value of 76.5%, 87.0%, 81.3% and 83.4%, respectively. CONCLUSION: Malnutrition was an independent predictive factor for severe complications in patients underwent to elective major coloproctological surgery. Besides that, malnutrition was associated with lower PA values and greater ratio of ECW. The PA provided great accuracy in nutritional screening, implying a useful marker of malnutrition.


RESUMO CONTEXTO: A desnutrição é uma condição frequente entre pacientes hospitalizados e é um fator de risco para complicações pós-operatórias. OBJETIVO: Este estudo tem como objetivo avaliar o impacto da desnutrição sobre o ângulo de fase (AF), a distribuição de água corporal e complicações clínicas em pacientes cirúrgicos com doença colorretal. MÉTODOS: Trata-se de um estudo retrospectivo realizado em um hospital universitário terciário com 40 pacientes admitidos eletivamente. Na avaliação pré-operatória, foram realizadas a avaliação subjetiva global e análise de bioimpedância elétrica com a finalidade de determinarem o estado nutricional, AF, água extracelular (AEC), água intracelular (AIC) e água corporal total (ACT). Na avaliação pós-operatória, o tempo de internação hospitalar e a presença de complicações graves, segundo a classificação de Clavien-Dindo, foram determinados. O melhor ponto de corte do AF para o rastreamento de desnutrição foi obtido a partir da análise da curva ROC. RESULTADOS: Dezessete (42,5%) pacientes foram diagnosticados como desnutridos e 23 (57,5%), como bem nutridos de acordo com a avaliação subjetiva global. Doze (30,0%) pacientes desenvolveram complicações pós-operatórias graves. O grupo desnutrido apresentou menores valores de albumina sérica (P=0,012), hematócrito (P=0,026) e AF (P=0,002); enquanto que as relações de AEC/AIC (P=0,019) e AEC/ACT (P=0,047) estiveram elevadas. Além disso, 58,8% dos pacientes desnutridos desenvolveram complicações pós-operatórias graves em comparação a 8,7% dos pacientes bem nutridos. A desnutrição foi fator preditivo independente para o desenvolvimento de complicações pós-operatórias graves (OR=15,00, IC: 2,63-85,68; P=0,002). O melhor ponto de corte do AF obtido foi 6.0º (AUC=0,82; P=0,001) com sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo de 76,5%, 87,0%, 81,3% e 83,4%, respectivamente. CONCLUSÃO: A desnutrição foi fator preditivo para o desenvolvimento de complicações graves em pacientes submetidos à cirurgia eletiva coloproctológica de grande porte. Além disso, a desnutrição foi associada a menores valores de AF e maior proporção de AEC. O AF forneceu boa acurácia no rastreamento da desnutrição, sugerindo seu uso como potencial marcador de desnutrição.


Subject(s)
Humans , Male , Female , Adolescent , Aged, 80 and over , Postoperative Complications/etiology , Colorectal Neoplasms/surgery , Malnutrition/complications , Severity of Illness Index , Body Water , Colorectal Neoplasms/complications , Nutrition Assessment , Nutritional Status , Cross-Sectional Studies , Predictive Value of Tests , Retrospective Studies , ROC Curve , Sensitivity and Specificity , Malnutrition/diagnosis , Gastrointestinal Diseases/surgery , Gastrointestinal Diseases/classification , Gastrointestinal Diseases/complications , Middle Aged
11.
J. pediatr. (Rio J.) ; 94(6): 602-608, Nov.-Dec. 2018. tab
Article in English | LILACS | ID: biblio-976005

ABSTRACT

Abstract Objective: To assess the agreement between the results of the Subjective Global Nutritional Assessment questionnaire, adapted for children and adolescents of the Brazilian population, and the nutritional status assessment method through growth curves and the classification of the World Health Organization in a pediatric hospital service. Methods: This was an analytical, quantitative, cross-sectional study. During the data collection period, the nutritional status of all patients from 0 to 12 years of age, admitted to the pediatric unit of a university hospital, was concomitantly assessed according to the Subjective Global Nutritional Assessment and World Health Organization curves. To determine the assessment and agreement between these methods, the Kappa and Kendall coefficients were used, respectively, considering a significance level of 5%. Results: Sixty-one children participated, with a predominance of males. It was observed that the highest frequency of equivalent results occurred among the group classified as well nourished, and that only the height/age variable showed a close agreement between the methods. Additionally, there was a good correlation only for the weight/height variable between the assessment tools used. Conclusion: Due to the low agreement between the methods, the combination of both may be beneficial for the nutritional assessment of pediatric patients, collaborating with the early diagnosis of nutritional alterations and facilitating the use of adequate dietary therapy.


Resumo Objetivo: Avaliar a concordância entre os resultados do questionário da Avaliação Nutricional Subjetiva Global adaptado para crianças e adolescentes da população brasileira e do método de avaliação do estado nutricional por meio de curvas de crescimento e a classificação da Organização Mundial da Saúde em um serviço pediátrico hospitalar. Métodos: Trata-se de um estudo analítico, quantitativo, de caráter transversal. Durante o período de coleta de dados, foi avaliado o estado nutricional de todos os pacientes até 12 anos admitidos na Enfermaria de Pediatria de um hospital universitário segundo a Avaliação Nutricional Subjetiva Global e as curvas da Organização Mundial da Saúde, concomitantemente. Para determinar a avaliação e a concordância entre esses métodos, os coeficientes de Kappa e de Kendall foram usados, respectivamente, considerou-se nível de significância de 5%. Resultados: Participaram do trabalho 61 crianças, com predominância do sexo masculino. Observou-se que a maior frequência de resultados iguais ocorreu entre o grupo classificado como bem nutrido e que somente a variável altura/idade demonstrou íntima concordância entre os métodos. Além disso, verificou-se uma boa correlação somente para a variável peso/altura entre os instrumentos usados. Conclusão: Devido à baixa concordância entre os métodos, a combinação de ambos pode ser benéfica para a avaliação nutricional dos pacientes pediátricos e colaborar com o diagnóstico precoce de alterações nutricionais, facilitar a aplicação do tratamento dietoterápico adequado.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , World Health Organization , Nutrition Assessment , Nutritional Status/physiology , Surveys and Questionnaires/standards , Malnutrition/diagnosis , Severity of Illness Index , Brazil , Child Development/physiology , Anthropometry/methods , Cross-Sectional Studies , Reproducibility of Results , Risk Factors , Age Factors , Statistics, Nonparametric , Malnutrition/complications , Hospitals, Pediatric , Length of Stay
12.
Rev. salud pública ; 20(1): 60-66, ene.-feb. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-962093

ABSTRACT

RESUMEN Objetivo Estimar el estado nutricional de dos cohortes (C) de niños concurrentes a escuelas de barrios con diferentes Necesidades Básicas Insatisfechas (NBI) de Puerto Madryn, Argentina. Métodos Investigación transversal. Se midieron peso y talla de niños de seis a 11 años asistentes a escuelas ubicadas en siete barrios. La C1 (n=2 040) fue relevada entre 2001-2006 y C2 (n=1 696) entre 2014-2016. Se calculó el Índice de Masa Corporal y se emplearon los puntos de corte de la OMS para determinar el estado nutricional. Para estimar la pobreza estructural se extrajeron, para 2001 y 2010, los porcentajes de NBI censales de cada barrio. Las prevalencias de estado nutricional entre cohortes y categorías de NBI se compararon mediante Chi2. Resultados En los siete barrios analizados, las NBI fueron: 0%-10% (n=3), 10%-25% (n=2) y 25%-50% (n=1), sin variación entre 2001-2010. En otro barrio, las NBI aumentaron de 25%-50% a >50%. Al evaluar el estado nutricional de los niños de cada escuela hubo diferencias para obesidad en la mayoría de ellas y para baja talla/edad y sobrepeso solo en una. La comparación C1-C2 indicó diferencias para obesidad. Conclusiones Los barrios de Puerto Madryn conservan, en gran parte, sus niveles de pobreza estructural. No ocurre lo mismo con el estado nutricional de los niños: mientras las prevalencias de desnutrición crónica se mantienen o descienden, las de obesidad aumentan en todos los barrios. El análisis efectuado permite evaluar transformaciones del contexto de residencia de la población e identificar grupos vulnerables.(AU)


ABSTRACT Objective To assess nutritional condition in two cohorts (C) of children from households with different Unsatisfied Basic Needs (UBN) attending neighborhood schools in Puerto Madryn, Argentina. Methods A cross-sectional study on six to 11 year-old children attending seven neighborhood schools surveyed in the periods 2001-2006 (C1, n=2 040) and 2014-2016 (C2, n=1 696) was performed. Weight, height and body mass index were measured using the World Health Organization cut-off values for nutritional condition. Neighborhood structural poverty was determined with percent UBN from the 2001 and 2010 census. Chi2 was used to compare the prevalence of nutritional condition between C and UBN categories. Results In the seven neighborhoods analyzed, percent UBN was 0%-10% (n=3), 10%-25% (n=2) and 25%-50% (n=1), without changes in the period 2001-2010. In the remaining neighborhood, UBN increased from 25%-50% to >50%. The nutritional evaluation of children showed significant differences in the prevalence of obesity in most schools, while low height-for-age and overweight prevalence was significant only in one school. Comparison of C1 and C2 only showed significant differences in the prevalence of obesity. Conclusions Structural poverty rates in Puerto Madryn neighborhoods were mostly unchanged; however, the nutritional condition of children was different: while the prevalence of chronic malnutrition did not change or decreased, the prevalence of obesity increased in all neighborhoods. Our findings could help to determine changes in the context of resident population and identify vulnerable groups.(AU)


Subject(s)
Humans , Child, Preschool , Child , Poverty , Nutritional Status , Malnutrition/diagnosis , Overweight/diagnosis , Argentina , Cross-Sectional Studies/instrumentation , Cohort Studies
13.
Rev. bras. cancerol ; 64(4): 479-487, 2018.
Article in Portuguese | LILACS | ID: biblio-1025798

ABSTRACT

Introdução: O acompanhamento nutricional nos cuidados paliativos é de extrema importância, já que os níveis de mortalidade, desnutrição e perda de peso não intencional ocorre na maioria dos pacientes oncológicos. Dessa maneira, é possível prevenir carências nutricionais e perdas de peso, o que leva a uma piora do estado nutricional. Objetivo: O objetivo do estudo foi avaliar a associação entre a classificação do estado nutricional obtido pela avaliação subjetiva global produzida pelo próprio paciente (ASG-PPP), a força de preensão manual (FPM) e a espessura do músculo adutor do polegar (EMAP) em pacientes oncológicos em cuidados paliativos exclusivos. Método: Foram avaliados 70 pacientes oncológicos cadastrados no Programa de Cuidados Paliativos. Para a avaliação do estado nutricional, foi utilizada a ASG-PPP. Para avaliar a associação do estado nutricional com outras medidas preditoras, foram realizadas as medidas da FPM com um dinamômetro e a EMAP com um adipômetro. Foram utilizadas estatísticas descritivas e a análise de regressão linear para avaliar a capacidade dessas medidas de predizer o estado nutricional. Resultados: Dos 70 pacientes, com idade entre 31 e 101 anos, 58,6% eram do sexo masculino e foi encontrada frequência de desnutrição (B+C) em 87,2% (n=61) de acordo com a ASG-PPP. O valor da EMAP estava alterado em 72,9% (n=51) pacientes e 42,9% (n=30) na FPM. A FPM foi associada ao ASG-PPP (b=-0,273; p=0,04) e o EMAP não (b=-0,124; p=0,546); portanto, somente o FPM foi um bom preditor do estado nutricional neste estudo. Conclusão: Sugere-se a utilização da FPM para avaliação do estado nutricional em pacientes oncológicos paliativos.


Introduction: Nutritional monitoring in palliative care is extremely important, since levels of mortality, malnutrition and unintentional weight loss occur in the majority of cancer patients. In this way, it is possible to prevent nutritional deficiencies and weight loss, which leads to a worsening nutritional status. Objective: The aim of the study was to evaluate the association between the classification of nutritional status obtained by the patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and adductor pollicis muscle (APM) in cancer patients palliative. Method: We evaluated 70 cancer patients enrolled in the exclusive palliative care program. The PG-SGA was used to assess the nutritional status. To evaluate the association of nutritional status with other predictive measures, HGS measurements were performed with a dynamometer and APM with an adipometer. Descriptive statistics and linear regression analysis were used to evaluate the ability of these measures to predict nutritional status. Results: Of the 70 patients, aged between 31 and 101 years, in which 58.6% were male and malnutrition (B+C) was found in 87.2% (n=61) according to PG-SGA. The value of APM was altered in 72.9% (n=51) patients and 42.9% (n=30) in HGS. HGS was associated with PG-SGA (b=-0.273, p=0.04) and APM didn't (b=-0,124; p=0.546); therefore, only HGS was a good predictor of nutritional status in this study. Conclusion: It's suggested the use of HGS to evaluate nutritional status in palliative cancer patients.


Introducción: El seguimiento nutricional en los cuidados paliativos es de extrema importancia, ya que los niveles de mortalidad, desnutrición y pérdida de peso no intencional ocurre en la mayoría de los pacientes oncológicos. De esta manera, es posible prevenir carencias nutricionales y pérdidas de peso, lo que lleva a un empeoramiento del estado nutricional. Objetivo: El objetivo del estudio fue evaluar la asociación entre la clasificación del estado nutricional obtenido por la valoración subjetiva global generada por el Paciente (GP-VSG), la fuerza de asimiento manual (FAM) y el espesor del músculo aductor del pollicis (EMAP) en pacientes oncológicos paliativos exclusivos. Método: Se evaluaron 70 pacientes oncológicos registrados en el Programa de Cuidados Paliativos. Para la evaluación del estado nutricional se utilizó la GP-VSG.Para evaluar la asociación del estado nutricional con otras medidas preditoras, se realizaron las medidas de la FAM con un dinamómetro y EMAP con un adipómetro. Se utilizaron estadísticas descriptivas y análisis de regresión lineal para evaluar la capacidad de esas medidas de predecir el estado nutricional. Resultados: De los 70 pacientes, con edad entre 31 y 101 años, en que 58,6% eran del sexo masculino y se encontró frecuencia de desnutrición (B+C) en el 87,2% (n=61) de acuerdo con la GP-VSG. El valor del EMAP estaba alterada en el 72,9% (n=51) pacientes y el 42,9% (n=30) en la FAM. La FAM fue asociada al GP-VSG (b=-0,273, p=0,04) y el EMAP no (b=-0,124, p=0,546), por lo tanto, sólo el FAM fue un buen predictor del estado nutricional en este estudio. Conclusión: Se sugiere la utilización de la FAM para evaluación del estado nutricional en pacientes oncológicos paliativos.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Palliative Care , Nutritional Status , Hand Strength , Malnutrition/diagnosis , Muscle Strength , Neoplasms/complications
14.
Einstein (Säo Paulo) ; 16(2): eAO4189, 2018. tab
Article in English | LILACS | ID: biblio-953149

ABSTRACT

ABSTRACT Objective: To determine frequency of dysphagia risk and associated factors in hospitalized patients as well as to evaluate nutritional status by using different methods and correlate the status with scores of the Eating Assessment Tool (EAT-10). Methods: This was a cross-sectional study including 909 inpatients of a philanthropic hospital. For the diagnosis of dysphagia we used an adapted and validated Brazilian version of the Eating Assessment Tool (EAT-10). The nutritional status was evaluated through the subjective global assessment, and anthropometric measurements included weight, calf and arm circumference, and knee height. The Mann-Whitney test, associations using the Pearson's χ2 and Spearman's correlation were used to verify differences between the groups. Results: The prevalence of dysphagia risk was 10.5%, and aging was the associated factor with this condition. Patients at risk presented lower values of arm and calf circumference, variables that correlated inversely with the Eating Assessment Tool (EAT-10) score. Malnutrition was observed in 13.2% of patients based on the subjective global assessment and in 15.2% based on the Body Mass Index. Conclusion: Screening for dysphagia and malnutrition should be introduced in hospitals routine to avoid or minimize damages caused by dysphagia or malnutrition, especially among older people.


RESUMO Objetivo: Verificar a prevalência do risco de disfagia e seus fatores associados em pacientes hospitalizados, bem como avaliar o estado nutricional por diferentes métodos e correlacioná-los à pontuação do Eating Assessment Tool (EAT-10). Métodos: Estudo de delineamento transversal, realizado com 909 pacientes internados em um hospital filantrópico. Para o rastreamento de disfagia, foi aplicado o Eating Assessment Tool (EAT-10) em sua versão adaptada para o Brasil. O diagnóstico nutricional foi realizado por meio da avaliação global subjetiva e pela aferição de medidas antropométicas. A diferença entre os grupos foi verificada pelo teste de Mann-Whitney e as associações, pelo χ2 de Pearson e correlação de Spearman. Resultados: A prevalência do risco de disfagia foi de 10,5%, sendo a faixa etária idosa um fator associado a esta condição. Pacientes em risco apresentaram valores inferiores de perímetro do braço e panturrilha, variáveis que se correlacionaram de forma inversa à pontuação do Eating Assessment Tool (EAT-10). A desnutrição foi identificada em 13,2% dos avaliados, segundo a avaliação global subjetiva, e em 15,2%, quando utilizado o índice de massa corporal. Conclusão: O rastreamento da disfagia e da desnutrição devem ser incorporados à rotina hospitalar, com o objetivo de evitar ou minimizar os prejuízos provocados por estas condições, especialmente nos idosos.


Subject(s)
Humans , Male , Female , Adult , Aged , Deglutition Disorders/epidemiology , Nutrition Assessment , Mass Screening , Nutritional Status , Hospitalization/statistics & numerical data , Brazil/epidemiology , Deglutition Disorders/diagnosis , Deglutition Disorders/etiology , Body Mass Index , Prevalence , Cross-Sectional Studies , Risk Factors , Malnutrition/diagnosis , Malnutrition/epidemiology , Middle Aged
15.
J. bras. pneumol ; 43(5): 337-343, Sept.-Oct. 2017. tab
Article in English | LILACS | ID: biblio-893867

ABSTRACT

ABSTRACT Objective: To determine the prevalence of malnutrition in patients attending an adult cystic fibrosis (CF) program and to investigate the associations of malnutrition with the clinical characteristics of those patients. Methods: This was a cross-sectional study involving patients with clinically stable CF patients (16 years of age or older). The patients underwent clinical assessment, nutritional assessments, pulmonary function tests, and pancreatic function assessment. They also completed a questionnaire regarding diet compliance. On the basis of their nutritional status, the patients were classified divided into three groups: adequate nutrition; at nutritional risk; and malnutrition. Results: The study has included 73 patients (mean age, 25.6 ± 7.3 years), 40 of whom (54.8%) were female. The mean body mass index was 21.0 ± 3.0 kg/m2 and the mean FEV1 was 59.7 ± 30.6% of predicted. In this sample of patients, 32 (43.8%), 23 (31.5%), and 18 (24.7%) of the patients were allocated to the adequate nutrition, nutritional risk, and malnutrition groups, respectively. The logistic regression analysis identified three independent factors associated with the risk of malnutrition: Shwachman-Kulczycki score, percent predicted FEV1; and age. Conclusions: Malnutrition remains a common complication in adolescents and adults with CF, despite dietary advice. Malnutrition is associated with age, clinical severity, and lung function impairment.


RESUMO Objetivo: Determinar a prevalência de desnutrição em pacientes de um programa para adultos com fibrose cística (FC) e investigar a relação da desnutrição com as características clínicas desses pacientes. Métodos: Trata-se de um estudo transversal com pacientes com FC clinicamente estáveis (com 16 anos de idade ou mais). Os pacientes foram submetidos a avaliação clínica, avaliação nutricional, testes de função pulmonar e avaliação da função pancreática. Eles também preencheram um questionário sobre sua adesão à dieta proposta. Os pacientes foram divididos em três grupos, de acordo com seu estado nutricional: nutrição adequada, risco nutricional e desnutrição. Resultados: O estudo incluiu 73 pacientes (média de idade: 25,6 ± 7,3 anos), dos quais 40 (54,8%) eram do sexo feminino. A média do índice de massa corporal foi de 21,0 ± 3,0 kg/m2, e a média do VEF1 foi de 59,7 ± 30,6% do previsto. Nessa amostra de pacientes, 32 (43,8%) ficaram no grupo com nutrição adequada, 23 (31,5%) ficaram no grupo com risco nutricional e 18 (24,7%) ficaram no grupo com desnutrição. A análise de regressão logística identificou três fatores independentes relacionados com o risco de desnutrição: escore de Shwachman-Kulczycki, VEF1 em % do previsto e idade. Conclusões: A desnutrição ainda é uma complicação comum em adolescentes e adultos com FC, não obstante o aconselhamento dietético. A desnutrição está relacionada com a idade, a gravidade clínica e o comprometimento da função pulmonar.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Cystic Fibrosis/complications , Malnutrition/epidemiology , Body Mass Index , Cross-Sectional Studies , Malnutrition/diagnosis , Malnutrition/etiology , National Health Programs , Nutritional Status , Predictive Value of Tests , Prevalence , Respiratory Function Tests , Sensitivity and Specificity , Spirometry
16.
Rev. méd. Chile ; 145(4): 449-457, abr. 2017. graf, tab
Article in Spanish | LILACS | ID: biblio-902498

ABSTRACT

Background: On admission, 30 to 50% of hospitalized patients have some degree of malnutrition, which is associated with longer length of stay, higher rates of complications, mortality and greater costs. Aim: To determine the frequency of screening for risk of malnutrition in medical records and assess the usefulness of the Malnutrition Screening Tool (MST). Material and Methods: In a cross-sectional study, we searched for malnutrition screening in medical records, and we applied the MST tool to hospitalized patients at the Internal Medicine Wards of San Ignacio University Hospital. Results: Of 295 patients included, none had been screened for malnutrition since hospital admission. Sixty one percent were at nutritional risk, with a higher prevalence among patients with HIV (85.7%), cancer (77.5%) and pneumonia. A positive MST result was associated with a 3.2 days increase in length of hospital stay (p = 0.024). Conclusions: The prevalence of malnutrition risk in hospitalized patients is high, but its screening is inadequate and it is underdiagnosed. The MST tool is simple, fast, low-cost, and has a good diagnostic performance.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Nutrition Assessment , Malnutrition/diagnosis , Prevalence , Cross-Sectional Studies , Risk Factors , Colombia/epidemiology , Malnutrition/etiology , Malnutrition/epidemiology , Hospitals, University
17.
Braspen J ; 32(1): 20-24, jan.-mar. 2017.
Article in Portuguese | LILACS | ID: biblio-847914

ABSTRACT

Introdução: O estado nutricional do paciente hospitalizado é um fator de extrema importância, sendo a desnutrição o prejuízo nutricional mais frequente, pois alguns pacientes já são admitidos nesta condição e outros a desenvolvem no ambiente hospitalar. Neste contexto, a triagem de risco nutricional surge como uma alternativa que antecede à avaliação e permite, a partir daí, selecionar indivíduos que necessitam precocemente de uma análise nutricional mais completa. Assim, objetivou-se aplicar e comparar diferentes tipos de ferramentas de triagem nutricional e, então, propor um padrão de triagem para a unidade hospitalar avaliada. Método: Estudo quantitativo, transversal e analítico, com adultos de ambos os sexos, submetidos à aplicação de três instrumentos validados de triagem nutricional: MUST, NRS-2002 e URS, além da realização de avaliação antropométrica. Resultados: Houve predomínio de pacientes do sexo masculino, a média de idade foi de 37,64±12,79 anos (21 a 59 anos). A NRS-2002 foi a ferramenta que detectou o percentual mais elevado de indivíduos com risco nutricional (55,71%). Tal resultado foi o que mais se aproximou dos valores de desnutrição detectados pela avaliação nutricional, sobretudo pela medida antropométrica da circunferência braquial (54,28%). Conclusões: Nesta pesquisa, evidenciou-se concordância entre os resultados obtidos com a avaliação antropométrica, com destaque para a circunferência braquial no que diz respeito ao diagnóstico de desnutrição, e a detecção do risco nutricional com o uso da ferramenta de triagem NRS-2002.(AU)


Introduction: The nutritional state of patients is an extremely important factor, malnutrition being the most common nutritional loss, since some patients are already admitted this condition and others to develop in hospitals. In this context the nutritional risk is an alternative screening prior to the assessment and allows thereafter, selecting subjects who prematurely require a more complete nutritional analysis. So, if aimed apply and compare different types of nutritional screening tools and, as appropriate, propose a standard screening for hospital under study. Methods: A quantitative, cross-sectional and analytical study, with adults of both sexes, submitted to application of three validated instruments of nutritional screening MUST, NRS-2002 and URS, in addition to performing anthropometric. Results: There was a predominance of male patients, the mean age was 37.64±12.79 years (21 to 59 years). The NRS-2002 has been the tool that has detected the highest percentage of individuals with nutritional risk (55.71%). This result was the one closest to the malnutrition of values detected by nutritional assessment, especially for anthropometric measure the circumference brachial (54.28%). Conclusions: In this research, it became clear the agreement between the results obtained from the anthropometric assessment, highlighting the brachial circumference with regard to the diagnosis of malnutrition, and the detection of nutritional risk by NRS-2002 screening tool.(AU)


Subject(s)
Humans , Nutrition Assessment , Triage/methods , Malnutrition/diagnosis , Anthropometry/instrumentation , Cross-Sectional Studies/instrumentation
18.
Braspen J ; 31(4): 305-310, out.-dez. 2016.
Article in Portuguese | LILACS | ID: biblio-847233

ABSTRACT

Introdução: A desnutrição atualmente é definida como qualquer alteração na fisiologia, composição ou na função de um organismo atribuível a uma dieta ou estado de doença que afeta negativamente o estado nutricional. O propósito da realização da avaliação nutricional não é apenas o diagnóstico da desnutrição, mas também uma maneira de identificar pacientes que apresentam maior risco de sofrer complicações associadas ao estado nutricional durante sua internação. Objetivo: Realizar uma análise comparativa entre os diagnósticos nutricionais obtidos por meio da avaliação subjetiva global (ASG), considerado padrão-ouro, e o método de avaliação proposto pela Sociedade Americana de Nutrição Enteral e Parenteral (American Society for Parenteral and Enteral Nutrition ­ ASPEN) em pacientes internados na clínica cirúr em pacientes internados na clínica cirúrgica. Método: Estudo transversal, analítico, de acurácia e reprodutibilidade de instrumentos de avaliação do estado nutricional. Resultados: De uma amostra de 40 pacientes avaliados, 18 (45%) representam o gênero masculino, e 22 (55%) o feminino; a faixa de idade de 18 a 59 anos teve maior frequência: 26 (65%). Para a desnutrição, a sensibilidade da ASPEN foi de 70% e a especificidade de 100%. Foi encontrada correlação considerada substancial (Kappa=0,78) entre os dois métodos. Conclusão: Foi observada maior prevalência de pacientes não desnutridos. O método proposto pela ASPEN apresentou boa sensibilidade e especificidade quando comparado ao método considerado padrão ouro, a ASG e, portanto, mostrou ser uma boa ferramenta para avaliação do estado nutricional dos pacientes, confiável e que transmite segurança, podendo ser utilizado na prática clínica em pacientes cirúrgicos.(AU)


Introduction: Malnutrition is currently defined as any change in physiology, composition or function of an organism attributable to a diet or disease state that adversely affect nutritional status. The purpose of carrying out the nutritional assessment would be not only the diagnosis of malnutrition, but also a way to identify patients who are at increased risk of complications associated with nutritional status during their stay. Objective: Conduct a comparative analysis of the nutritional diagnoses obtained by subjective global assessment (ASG), considered the gold standard, and the evaluation method proposed by the American Society for Parenteral and Enteral Nutrition (ASPEN) in patients admitted to the surgical clinic. Methods: Cross-sectional study, analytical accuracy and reproducibility of assessment tools of nutritional status. Results: From a sample of 40 patients, 18 (45%) were male, and 22 (55%) female; the age group 18-59 years had a higher frequency: 26 (65%). For malnutrition ASPEN sensitivity was 70% and specificity of 100%. considered a substantial correlation was found (Kappa=0.78) between the two methods. Conclusion: We found a higher prevalence of patients not malnourished. And the method proposed by ASPEN showed good sensitivity and specificity when compared to the method considered the gold standard, ASG, and therefore proved to be a good tool for assessing the nutritional status of patients, reliable and transmits security. It can be used in clinical practice in surgical patients.(AU)


Subject(s)
Humans , Surgical Procedures, Operative/methods , Nutrition Assessment , Malnutrition/diagnosis , Cross-Sectional Studies/instrumentation , Inpatients
19.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 14(2): 25-34, ago. 2016. tab
Article in Spanish | LILACS, BDNPAR | ID: biblio-869091

ABSTRACT

Los menores de cinco años de edad se afectan por la falta de alimentos adecuados mucho más rápido que a edades superiores por las demandas del crecimiento. El objetivo fue evaluar la situación nutricional de niños menores de cinco años de comunidades rurales, indígenas y no indígenas. Previo consentimiento informado de los padres o tutores, fueron evaluados 226 niños menores de cinco años de ambos sexos, 117 indígenas y 109 no indígenas según indicadores antropométricos de malnutrición por defecto y por exceso. Se aplicó una encuesta para obtener información de las características sociodemográficas y hábitos alimentarios. En niños indígenas y no indígenas la prevalencia de desnutrición global fue de 2,4 % y 2,6 %, riesgo de desnutrición 22% y 5,1%, desnutrición crónica 35,9% y 12,8%, sobrepeso 28,9% y 12,9%, respectivamente. Se observó un consumo frecuente de frutas en ambas poblaciones, seguida del consumo de proteína vegetal en población indígena y de proteína animal en los no indígenas. El 69,2% de los niños indígenas y el 3,7% de los niños no indígenas vivían en la pobreza extrema. Los principales problemas nutricionales encontrados fueron la desnutrición crónica, el riesgo de desnutrición y el sobrepeso. Los niños más fuertemente afectados son los indígenas, que sobreviven en difíciles condiciones socioeconómicas.


Children under five years of age are affected by the lack of adequate food faster thanolder individuals due to growth demands. The objective was to evaluate the nutritional situation of indigenous and non-indigenous children under five years living in rural communities. After obtaining the informed consent of their parents, 226 boys and girls under five years, 117 indigenous and 109 non-indigenous children, were evaluated using nutritional indicators of malnutrition by defect and excess. A questionnaire was applied toobtain information about social-demographic characteristics and dietary habits. Inindigenous and non-indigenous children, the prevalences of global malnutrition were 2.4% and 2.6%, malnutrition risk 22% and 5.1%, chronic malnutrition 35.9% and 12.8%,overweight 28.9% and 12.9%. Frequent consumption of fruits was observed in both populations, followed by consumption of vegetable protein in indigenous population and animal protein in non-indigenous. 69.2% of indigenous children and 3.7% of non-indigenous children living in extreme poverty. The main nutritional problems found were chronic malnutrition, malnutrition risk and overweight. The most strongly affected children were theindigenous, who survive in difficult socio-economic conditions.


Subject(s)
Humans , Child, Preschool , Malnutrition/complications , Malnutrition/diagnosis , Nutrition Disorders , Infant Nutrition Disorders , Public Health
20.
J. pediatr. (Rio J.) ; 92(4): 343-352, July-Aug. 2016. tab, graf
Article in English | LILACS | ID: lil-792578

ABSTRACT

Abstract Objective: This systematic review aimed to verify the available scientific evidence on the clinical performance and diagnostic accuracy of nutritional screening tools in hospitalized pediatric patients. Data source: A search was performed in the Medline (National Library of Medicine United States), LILACS (Latin American and Caribbean Health Sciences), PubMed (US National Library of Medicine National Institutes of Health), in the SCIELO (Scientific Electronic Library Online), through CAPES portal (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), bases Scopus e Web of Science. The descriptors used in accordance with the Descriptors in Health Sciences (DeCS)/Medical Subject Headings (MeSH) list were “malnutrition”, “screening”, and “pediatrics”, as well as the equivalent words in Portuguese. Summary of the findings: The authors identified 270 articles published between 2004 and 2014. After applying the selection criteria, 35 were analyzed in full and eight articles were included in the systematic review. We evaluated the methodological quality of the studies using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Five nutritional screening tools in pediatrics were identified. Among these, the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) showed high sensitivity, almost perfect inter-rater agreement and between the screening and the reference standard; the Screening Tool Risk on Nutritional Status and Growth (STRONGkids) showed high sensitivity, lower percentage of specificity, substantial intra-rater agreement, and ease of use in clinical practice. Conclusions: The studies included in this systematic review showed good performance of the nutritional screening tools in pediatrics, especially STRONGkids and STAMP. The authors emphasize the need to perform for more studies in this area. Only one tool was translated and adapted to the Brazilian pediatric population, and it is essential to carry out studies of tool adaptation and validation for this population.


Resumo Objetivo: Esta revisão sistemática tem por objetivo verificar as evidências científicas disponíveis sobre o desempenho clínico e acurácia diagnóstica dos instrumentos de triagem nutricional em pacientes pediátricos hospitalizados. Fonte de dados: Realizou-se busca nas bases de dados Medline (National Library of Medicine United States), LILACS (Latin American and Caribbean Health Sciences), PubMed (US National Library of Medicine National Institutes of Health), na biblioteca eletrônica SCIELO (Scientific Electronic Library Online), através do portal de periódicos da CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), bases Scopus e Web of Science. Os descritores utilizados conforme lista do DeCS (Descritores em Ciências da Saúde)/MeSH (Medical Subject Headings) foram “desnutrição”, “triagem” e “pediatria”, bem como, “malnutrition”, “screening” e “pediatrics”, respectivamente. Síntese dos dados: Identificou-se 270 artigos, publicados entre 2004 e 2014. Após aplicação dos critérios de seleção, 35 foram analisados na íntegra, sendo incluídos 8 artigos na revisão sistemática. Avaliou-se a qualidade metodológica dos estudos utilizando-se o QUADAS (Quality Assessment of Diagnostic Accuracy Studies). Verificou-se 05 instrumentos de triagem nutricional em pediatria. Dentre estes, o STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics) apresentou sensibilidade elevada, concordância quase perfeita inter-avaliador e entre a triagem e padrão de referência; o STRONGkids (Screening Tool Risk on Nutritional Status and Growth) evidenciou sensibilidade elevada, menor percentual de especificidade, concordância intra-avaliador substancial e facilidade de uso na prática clínica. Conclusões: Os estudos incluídos nesta revisão sistemática demonstraram um bom desempenho dos instrumentos de triagem nutricional em pediatria, principalmente STRONGkids e STAMP. Evidencia-se a necessidade de mais pesquisas nessa área. Apenas um instrumento foi traduzido e adaptado para a população pediátrica brasileira, sendo imprescindível a realização de estudos de adaptação e validação de instrumentos para essa população.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Child, Hospitalized , Nutrition Surveys/methods , Risk Assessment/methods , Malnutrition/diagnosis , Nutritional Status , Reproducibility of Results , Risk Factors , Sensitivity and Specificity
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