Dietitians' practices in dialysis units in Brazil: nutritional assessment and intervention / Práticas de nutricionistas em unidades de diálise no Brasil: avaliação e intervenção nutricionais

ABSTRACT Introduction: The importance of dietitians in dialysis units is indisputable and mandatory in Brazil, but little is known about the practices adopted by these professionals. Objective: To know practices adopted in routine nutritional care, focusing on nutritional assessment tools and treatment strategies for people at risk or diagnosed with malnutrition. Methodology: Electronic questionnaire disseminated on social media and messaging applications. It included questions that covered dietitians' demographic and occupational profile characteristics and of the dialysis unit, use and frequency of nutritional assessment tools, nutritional intervention strategies in cases of risk or diagnosis of malnutrition, prescription and access to oral supplements. Results: Twenty four percent of the Brazilian dialysis units (n = 207) responded electronically. The most used nutritional assessment tools with or without a pre-established frequency were dietary surveys (96%) and Subjective Global Assessment (83%). The strategies in cases of risk or presence of malnutrition used most frequently (almost always/always) were instructions to increase energy and protein intake from foods (97%), and increasing the frequency of visits (88%). The frequency of prescribing commercial supplements with standard and specialized formulas was quite similar. The availability of dietary supplements by the public healthcare system to patients varied between regions. Conclusion: Most dietitians use various nutritional assessment tools and intervention strategies in cases of risk or malnutrition; however, the frequency of use of such tools and strategies varied substantially.

Resumo Introdução: A importância da atuação do nutricionista em unidades de diálise é indiscutível e obrigatória no Brasil, porém pouco sabemos sobre as práticas adotadas por esses profissionais. Objetivo: Conhecer práticas adotadas na rotina dos atendimentos nutricionais, com foco nas ferramentas de avaliação nutricional e nas estratégias de tratamento das pessoas com risco ou diagnóstico de desnutrição. Metodologia: Questionário eletrônico divulgado em mídias sociais e aplicativos de mensagens. Incluiu questões que abrangiam características do perfil demográfico e ocupacional do profissional e da unidade de diálise, utilização e frequência de ferramentas de avaliação nutricional, estratégias de intervenção nutricional em casos de risco ou diagnóstico de desnutrição e prescrição e acesso a suplementos alimentares orais. Resultados: Foram recebidos eletronicamente o equivalente a 24% das unidades de diálise brasileiras (n = 207). As ferramentas de avaliação nutricional mais utilizadas com ou sem frequência pré-estabelecida foram inquéritos dietéticos (96%) e Avaliação Global Subjetiva (83%). As estratégias em casos de risco ou presença de desnutrição utilizadas com mais frequência (quase sempre/sempre) foram a orientação de incremento energético e proteico por meio de alimentos (97%) e o aumento da periodicidade das visitas (88%). A frequência de prescrição de suplemento industrializado de fórmula padrão e especializada foi bastante semelhante. A disponibilização de suplementos alimentares pelo Sistema Único de Saúde aos pacientes variou entre as regiões. Conclusão: A maior parte dos nutricionistas utiliza diversas ferramentas de avaliação nutricional e estratégias de intervenção em casos de risco ou desnutrição, porém a frequência de utilização de tais ferramentas e estratégias foi bastante variada.

Percepção do peso corporal e dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos / Perception of body weight and difficulties encounteredby people with visual impairment in acquiring, preparing and consuming food

Objetivo: investigar a percepção do peso corporal e as dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos. Metodologia: estudo observacional transversal, com adultos e idosos com deficiência visual em Pelotas/RS, realizado no período de abril a maio de 2023. Foi utilizado um questionário composto de 42 itens. Os dados coletados foram analisados por análise descritiva e analítica, e apresentados como média ± desvio padrão ou percentual. Resultados: a amostra contou com 20 pessoas, predominantemente do sexo feminino e idosas. Em relação ao consumo alimentar, 50% dos participantes consomem feijão, 75% frutas e hortaliças, 50% bebidas adoçadas, biscoitos recheados e doces. Referente à percepção do peso corporal, percebeu-se que a maior parte do grupo sente que está acima do peso adequado e se sentem "insatisfeitos(as)". Sobre as dificuldades encontradas, 85% dos participantes relataram dificuldade extrema para identificar a validade dos alimentos, 70% para comprar alimentos frescos e perecíveis e 40% para usar a faca para cortar e descascar os alimentos. Conclusão: verificou-se que a maior parte do grupo sente que está acima do peso adequado e estão "insatisfeitos(as)" em relação ao peso corporal. Além disso, dependem de outra pessoa para escolher os alimentos a serem comprados, saber o prazo de validade, preparar alimentos que precisam ser porcionados, servir refeições no prato, cortar carnes, descascar vegetais e frutas, utilizar faca, entre outros. Esta dependência pode influenciar diretamente no seu consumo alimentar quando essas pessoas se encontram sozinhas, optando por consumir alimentos industrializados de fácil preparo ou prontos.

Objective: to investigate the perception of body weight and the difficulties encountered by people with visual impairments in acquiring, preparing and consuming food. Methodology: cross-sectional observational study, with adults and elderly people with visual impairment in Pelotas/RS, carried out from April to May 2023. A questionnaire composed of 42 items was used. The collected data were analyzed using descriptive and analytical analysis, and presented as mean ± standard deviation or percentage. Results: the sample included 20 people, predominantly female and elderly. Regarding food consumption, 50% of participants consume beans, 75% fruits and vegetables, 50% sweetened drinks, stuffed cookies and sweets. Regarding the perception of body weight, it was noticed that the majority of the group feels that they are overweight and feel "dissatisfied". Regarding the difficulties encountered, 85% of participants reported extreme difficulty in identifying the expiration date of food, 70% in purchasing fresh and perishable foods and 40% in using a knife to cut and peel food. Conclusion: it was found that the majority of the group feels that they are overweight and are "dissatisfied" with their body weight. Furthermore, they depend on someone else to choose the food to be purchased, know the expiration date, prepare food that needs to be portioned, serve meals on the plate, cut meat, peel vegetables and fruits, use a knife, among others. This dependence can directly influence their food consumption when these people are alone, choosing to consume easily prepared or ready-made processed foods.

Estado nutricional y practicas alimentarias en lactantes con labio leporino y/o paladar hendido pre y post quirúrgico. Operación Sonrisa Paraguay 2020-2021

Introducción: El labio y paladar hendido (LPH) son una alteración cráneo facial de etiología multifactorial. La alimentación de los niños con LPH puede llegar a ser deficiente, comprometiendo el crecimiento y el desarrollo. Objetivo: Determinar la evolución del estado nutricional pre y post quirúrgico y las prácticas alimentarias en lactantes de 6 a 24 meses de edad, con labio y/o paladar hendido que acudieron a la Clínica de la Fundación Operación Sonrisa durante el periodo de setiembre 2020 a mayo del 2021. Materiales y métodos: Estudio observacional, prospectivo con componente analítico. Se incluyó a 50 niños con diagnóstico de LPH de 6 a 24 meses de edad. Se evaluó el estado nutricional según estándares del MSP y BS. Resultados: Fueron evaluados 50 lactantes de 6 a 24 meses, el 60 % entre 6 -11 meses, el 64 % fueron varones, el 54 % provenía del interior del país y fueron sometidos a cierre primario de labios el 86 % y el 12 % a reconstrucción de paladar hendido. El 88 % de los niños recibieron lactancia materna. El estado nutricional pre quirúrgico fue adecuado (94 %) por indicador peso para la edad. Post quirúrgico hubo una diferencia significativa de 0,927Kg para el peso para la talla (p< 0,001), lo mismo para el peso para la edad(p<0,001). Para la talla para la edad se encontró una diferencia de 0,8cm(p=ns). Conclusiones: El estado nutricional de los niños con labio o paladar hendido, mejora a los 4 meses post cirugía reconstructiva para los indicadores peso para la edad y peso para la talla.

Introduction: Cleft lip and palate (CLP) is a craniofacial alteration of multifactorial etiology. The diet of children with CLP can become deficient, compromising growth and development. Objective: To determine the evolution of the pre- and post-surgical nutritional status and feeding practices in infants between 6 and 24 months of age, with cleft lip and/or palate who attended the "Operation Smile" Foundation Clinic from September 2020 to May 2021. Materials and methods: This was an observational and prospective study with an analytical component. 50 children with a diagnosis of CLP from 6 to 24 months of age were included. Nutritional status was evaluated according to National Health Ministry standards. Results: 50 infants from 6 to 24 months were evaluated, 60% were between 6 -11 months, 64% were males, 54% came from the rural areas. 86% underwent primary lip closure and 12% cleft palate reconstruction. 88% of the children were breastfed. The pre-surgical nutritional status was adequate (94%) by weight for age indicator. Post surgery there was a significant difference of 0.927 kg for weight for height (p < 0.001), the same for weight for age (p < 0.001). For height for age, a difference of 0.8 cm was found (p=ns). Conclusions: The nutritional status of children with cleft lip or palate improves 4 months after reconstructive surgery for the indicators weight for age and weight for height.

Estado nutricional, composición corporal y conducta alimentaria de estudiantes de primer año de la Escuela de Grumetes "Alejandro Navarrete Cisterna" de Talcahuano, Chile

Introducción: El estado nutricional, la composición corporal y los hábitos alimentarios son relevantes para la elegibilidad, entrenamiento y progresión de la carrera naval, por la influencia que tienen estos factores sobre la salud física, mental y rendimiento deportivo de los reclutas. Objetivo: Describir y evaluar el estado nutricional, la composición corporal y la conducta alimentaria de estudiantes de primer año de la Escuela de Grumetes "Alejandro Navarrete Cisterna" de Talcahuano. Métodos: Estudio no experimental de corte transversal a 781 grumetes. Se realizó evaluación antropométrica y de composición corporal por nutricionistas entrenadas, y se aplicó la Encuesta sobre Hábitos Alimentarios de autorreporte. Resultados: Edad 19,2 ± 1,47 años, 35,7% mujeres. Según el estado nutricional, se observó un mayor porcentaje de sobrepeso y obesidad en mujeres comparado con los hombres. El IMC se relacionó directamente con la composición corporal; las mujeres presentaron una media de IMC de sobrepeso con mayor porcentaje de grasa corporal y menor porcentaje de masa muscular. La conducta alimentaria se relacionó con estado nutricional significativamente, siendo los cumplimientos de: consumo de lácteos, consumo de legumbres, cena diariamente y no consumo de bebidas alcohólicas más altos en reclutas normopeso que en aquellos con sobrepeso y obesidad. Conclusión: Los grumetes presentaron mayor normopeso, menor obesidad y mejor conducta alimentaria que la población general, debido posiblemente a la preparación física y nutricional en el periodo inicial de la instrucción naval.

Introduction: Nutritional status, body composition and eating habits are relevant for eligibility, training, and naval career progression, due to the influence of these factors have on the physical and mental health and sports performance of recruits. Objective: To describe and evaluate the nutritional status, body composition and eating behavior of first-year students of the "Alejandro Navarrete Cisterna" Naval School in Talcahuano. Methods: Non-experimental cross-sectional study of 781 recruits. Anthropometric and body composition evaluation was carried out by trained nutritionists, and the self-report Eating Habits Survey was applied. Results: Age 19.2 ± 1.47 years, 35.7% women. According to nutritional status, a higher percentage of overweight and obesity was observed in women compared to men. BMI was related to body composition; women had a mean BMI of overweight with a higher percentage of body fat and a lower percentage of muscle mass. Eating behavior was significantly related to nutritional status, with compliance of: dairy consumption, legume consumption, daily dinner and non-consumption of alcoholic beverages being higher in normal weight recruits than in those with overweight and obesity. Conclusion: The naval recruits had a higher normal weight, less obesity and better eating behavior than the general population, possibly due to the physical and nutritional preparation in the initial period of naval training.

Fatores associados à deficiência de vitamina D em mulheres gestantes e lactantes / Factores asociados a la deficiencia de vitamina D en mujeres embarazadas y lactantes / Factors associated with vitamin d deficiency in pregnant and lactatingwomen

Introdução: A deficiência de vitamina D durante a gestação e a lactação pode repercutir negativamente no desenvolvimento fetal e infantil, devido seu papel fundamental nos sistemas imunológico, cardíaco, ósseo, muscular e neural. Objetivo: Realizar uma revisão de literatura para integrar estudos que evidenciam a deficiência de vitamina D em gestantes e lactantes, e os fatores de risco associados a essa carência. Metodologia: Foi realizado um levantamento bibliográfico entre agosto e outubro de 2021, com atualização entre outubro e novembro de 2022 através de pesquisas às bases Pubmed e Scielo, bem como às listas de referências dos artigos selecionados. Foram empregados os descritores consumo alimentar, vitamina D, deficiência de vitamina D, gestantes e lactantes, usando-se o operador booleano AND para a associação entre eles. Como critérios de inclusão foram adotados o tipo de estudo (epidemiológicos, ensaios clínicos e revisões integrativa e sistemática), o idioma (espanhol, inglês e português) e o período de publicação (2010 a 2022). Resultados: Evidenciou-se que existem vários fatores de riscos para a inadequação do status de vitamina D em gestantes e lactantes como a baixa exposição da pele à luz solar e fatores relacionados (uso excessivo de protetor solar, menor tempo de atividades ao ar livre, clima, religião e hábitos culturais, maior escolaridade);a pigmentação mais escura da pele; o baixo consumo alimentar de vitamina D e variáveis associadas; a menor idade materna; o primeiro trimestre gestacional; a primiparidade e o excesso de tecido adiposo. Conclusões: Em gestantes e lactantes, a carência de vitamina D associa-se a distintos fatores, com destaque principalmente para a baixa exposição à luz solar, a pigmentação mais escura da pele e o excesso de tecido adiposo, sendo de extrema importância que sejam abordados com cautela, visando ações voltadas a variáveis modificáveis, de modo a auxiliar na redução da hipovitaminose D nestes grupos (AU).

Introduction: Vitamin D deficiency during pregnancy and breastfeeding can have a negative impact on fetal and infant development due to its fundamental role in the immune, cardiac, bone, muscular and neural systems. Objective: To conduct a literature review to integrate studies which show the Vitamin D deficiency in pregnant andlactating women, and the risk factors associated with this deficiency. Methodology: A bibliographic survey was carried out between August and October 2021, with an update between October and November 2022 through searches in the Pubmed and Scielo databases, as well as the reference lists of the selected articles. The descriptors food consumption, vitamin D, vitamin D deficiency, pregnant and lactating women were used, using the Boolean operator AND for the association between them. The type of study (epidemiological, clinical trials and integrative and systematic reviews), language (Spanish, English and Portuguese) and publication period (2010 to 2022) was adopted as inclusion criteria.Results:It was shown that there are several risk factors for inadequate vitamin D status in pregnant and lactating women, such as low skin exposure to sunlight and related factors (excessive use of sunscreen, less time spent outdoors, climate, religion and cultural habits, higher education); darker skin pigmentation; low dietary intake of vitamin D and associated variables; the lowest maternal age; the first gestational trimester; primiparity and excess adipose tissue.Conclusions: Vitamin D deficiency in pregnant and lactating women is associated with different factors, witha main emphasis on low exposure to sunlight, darker skin pigmentation and excess adipose tissue. Furthermore, it is extremely important that these factors are approached with caution, implementing actions aimed at modifiable variables in order to help reduce hypovitaminosis D in these groups (AU).

Introducción: La deficiencia de vitamina D durante el embarazo y la lactancia puede tener un impacto negativo en el desarrollo fetal e infantil, por su papel fundamental en los sistemas inmunológico, cardíaco, óseo, muscular y neural. Objetivo: Realizar una revisión bibliográfica para integrar estudios que evidencien la deficiencia de vitamina D en mujeres embarazadas y lactantes, y los factores de riesgo asociados. Metodología:Se realizó un levantamiento bibliográfico entre agosto y octubre de 2021, con actualizaciones entre octubre y noviembre de 2022 mediante búsquedas en las bases de datos Pubmed y Scielo, así como en las listas de referencias de los artículos seleccionados. Se utilizaron los descriptores consumo de alimentos, vitamina D, deficiencia de vitamina D, gestantes y lactantes, utilizándose el operador booleano AND para la asociación entre ellos. Se adoptaron como criterios de inclusión el tipo de estudio (epidemiológicos, clínicos, revisiones integradoras y sistemáticas), idioma (español, inglés y portugués) y período de publicación (2010 a 2022).Resultados: Existen varios factores de riesgo para un estado inadecuado de vitamina D en mujeres embarazadas y lactantes, como la baja exposición de la piel a la luz solar y factores relacionados (uso excesivo de protector solar, menor tiempo al aire libre, clima, religión y hábitos culturales, educación más alta); pigmentación de la piel más oscura; baja ingesta dietética de vitamina D y variables asociadas; la edad materna más baja; el primer trimestre gestacional; Primiparidad y exceso de tejido adiposo. Conclusiones:En mujeres embarazadas y lactantes, el déficit de vitamina D se asocia a diferentes factores, especialmente la baja exposición solar, la pigmentación de la piel más oscura y el exceso de tejido adiposo, y es de suma importancia abordarlos con precaución, apuntando a acciones dirigidas a variables modificables, con el fin de ayudar a reducir la hipovitaminosis D en estos grupos (AU).

Estado nutricional de crianças com microcefalia congênita transmitida pelo vírus Zika / Nutritional status of children with congenital microcephaly transmitted by Zika Virus / Estado nutricional de niños con microcefalia congénita transmitida por el Virus Zika

A microcefalia é uma condição sem tratamento causa alterações de cunho sensorial, cognitivo, motor, auditivo e visual, podendo ser adquirida por meio da infecção congênita pelo vírus Zika. O objetivo desta pesquisa foi avaliar o estado nutricional, o consumo alimentar e os fatores socioeconômicos que implicam na alimentação das crianças com microcefalia oriunda da infecção pelo Zika Vírus. Este estudo é uma pesquisa de campo descritiva, de delineamento transversal, que foi realizada com dez crianças na faixa etária de 2 a 3 anos. O estado nutricional foi avaliado utilizando balança digital e fita métrica, e os questionários sobre o consumo alimentar e condições socioeconômicas foram respondidos pelos cuidadores das crianças. Os resultados encontrados apresentaram inadequações das seguintes maneiras: 60% na estatura por idade, 50% no peso por idade e 40% no peso por estatura. Sobre a alimentação, 70% tinham uma alimentação inadequada e 60% apresentavam condições socioeconômicas de risco. Perante os achados, é possível interligar os fatores pesquisados com um retardo no desenvolvimento infantil. Portanto, ressalta-se que a microcefalia associada à alimentação inadequada e baixa condição social é capaz de agravar o estado nutricional.

Microcephaly is an untreated condition that leads to sensory, cognitive, motor, auditory and visual changes and can be acquired through congenital infection by the Zika Virus. Hence, this study evaluates the nutritional status, food consumption and socioeconomic factors that affect the nutrition of children with microcephaly transmitted by Zika Virus infection. A descriptive, cross-sectional field research was conducted with ten children aged 2 to 3 years. Nutritional status was assessed using a digital scale and measuring tape. Questionnaires on food consumption and socioeconomic conditions were answered by the children's caregivers. The results found presented the following inadequacies: 60% in height for age, 50% in weight for age, and 40% in weight for height. Regarding nutrition, 70% of the children had inadequate nutrition and 60% lived under risky socioeconomic conditions. Given these findings, the factors researched can be linked with a delay in child development. Therefore, microcephaly associated with inadequate nutrition and low social status can worsen nutritional status.

La microcefalia es una afección no tratada que conlleva cambios sensoriales, cognitivos, motores, auditivos y visuales, y puede adquirirse a través de una infección congénita por el virus Zika. El objetivo de este estudio fue evaluar el estado nutricional, el consumo de alimentos y los factores socioeconómicos que afectan la nutrición de niños con microcefalia provocada por la infección por el virus Zika. Se trata de un estudio descriptivo, de enfoque transversal, que se realizó con 10 niños de entre 2 y 3 años. El estado nutricional se evaluó mediante una balanza digital y una cinta métrica, y los cuidadores de los niños respondieron cuestionarios sobre consumo de alimentos y condiciones socioeconómicas. Los resultados encontrados presentaron insuficiencias en los siguientes aspectos: 60% en talla para la edad, 50% en peso para la edad y 40% en peso para la talla. En cuanto a la nutrición, el 70% tenía una nutrición inadecuada y el 60% tenía condiciones socioeconómicas de riesgo. Teniendo en cuenta los hallazgos, es posible relacionar los factores investigados con un retraso en el desarrollo infantil. Por tanto, cabe destacar que la microcefalia asociada a una nutrición inadecuada y un bajo estatus social es capaz de empeorar el estado nutricional.

Consumo de alimentos ultraprocesados en niños entre 6 y 23 meses según la Segunda Encuesta Nacional de Nutrición y Salud de Argentina / Consumption of ultra-processed foods among children aged 6 to 23 months as per the Second National Survey on Nutrition and Health of Argentina

Introducción. Contar con los datos del consumo de alimentos ultraprocesados en los niños resulta importante para planificar políticas públicas. Objetivos. Describir la prevalencia de consumo de alimentos ultraprocesados en menores de 2 años e identificar factores asociados. Describir la proporción que los alimentos ultraprocesados representan del número total de los alimentos consumidos en el día. Métodos. Análisis secundario de los datos de niños entre 6 y 23 meses de edad con al menos un recordatorio de 24 horas de consumo de alimentos de la Segunda Encuesta Nacional de Nutrición y Salud de Argentina del año 2018. Se estudiaron como variables principales: "consumo de alimentos ultraprocesados" (según el sistema NOVA) categorizada en sí/no y la "proporción de ultraprocesados del total de alimentos consumidos". Los factores asociados explorados fueron lactancia materna, sexo, edad y el número de alimentos no ultraprocesados consumidos. Se realizó un modelo de regresión logística multivariable y se aplicó un factor de expansión para ponderar los datos. Resultados. Se incluyeron 4224 niños (ponderado 908 104). La prevalencia de consumo de ultraprocesados fue del 90,8 % (IC95%: 89,5-92) y fue asociado con mayor edad (OR 3,21; IC95% 2,28-4,52) y con el número de alimentos no ultraprocesados consumidos (OR 1,17; IC95% 1,13-1,23). Los ultraprocesados representaron una mediana del 20 % (RIC: 12,5-28,6 %) del total de alimentos consumidos en el día. Conclusiones. Este estudio señala la alta penetración de los alimentos ultraprocesados en la alimentación complementaria.

Introduction. The availability of data on the consumption of ultra-processed foods among children is important for planning public policies. Objectives. To describe the prevalence of consumption of ultra-processed foods in children under 2 years of age and identify associated factors. To describe the proportion that ultra-processed foods represent out of the total number of foods consumed in a day. Methods. Secondary analysis of data from children aged 6­23 months with at least a 24-hour recall of food consumption based on the Second National Survey on Nutrition and Health of Argentina (2018). The following primary variables were studied: "consumption of ultra-processed foods" (according to the NOVA system) categorized into yes/no and "proportion of ultra-processed out of total foods consumed." The following associated factors were studied: breastfeeding, sex, age, and number of non-ultra-processed foods consumed. A multivariate logistic regression model was developed and an expansion factor was applied to weight the data. Results. A total of 4224 children were included (weighed: 908 104). The prevalence of ultra-processed food consumption was 90.8% (95% CI: 89.5­92) and was associated with an older age (OR: 3.21, 95% CI: 2.28­4.52) and the number of non-ultra-processed foods consumed (OR: 1.17, 95% CI: 1.13­1.23). Ultra-processed foods accounted for a median 20% (IQR: 12.5­28.6%) of all foods consumed in a day. Conclusions. This study highlights the high penetration of ultra-processed foods in complementary feeding.

Fístula enterocutánea: un enfoque desde las generalidades y el estado nutricional / Enterocutaneous fistula: An approach based on generalities and nutritional status

Introducción. Una fístula es una conexión anormal entre dos superficies epitelizadas. Cerca del 80 % de las fístulas entero-cutáneas son de origen iatrogénico secundarias a cirugía, y un menor porcentaje se relacionan con traumatismos, malignidad, enfermedad inflamatoria intestinal o isquemia. La morbilidad y las complicaciones asociadas pueden ser significativas, como la desnutrición, en la que intervienen múltiples factores. Métodos. Se realizó una búsqueda de la literatura en las bases de datos de PubMed, Google Scholar y SciELO, utilizando las palabras claves descritas y se seleccionaron los artículos más relevantes de los últimos años. Resultados. La clasificación de las fístulas se basa en su anatomía, su gasto o secreción diaria y su localización. Existe una tríada clásica de las complicaciones: sepsis, desnutrición y anomalías electrolíticas. El control del gasto de la fístula, el drenaje adecuado de las colecciones y la terapia antibiótica son claves en el manejo precoz de estos pacientes. Los estudios recientes hacen hincapié en que la sepsis asociada con la desnutrición son las principales causas de mortalidad. Conclusiones. Esta condición representa una de las complicaciones de más difícil y prolongado tratamiento en cirugía abdominal y colorrectal, y se relaciona con importantes tasas de morbilidad, mortalidad y altos costos para el sistema de salud. Es necesario un tratamiento multidisciplinario basado en la reanimación con líquidos, el control de la sepsis, el soporte nutricional y el cuidado de la herida, entre otros factores.

Introduction. A fistula is an abnormal connection between two epithelialized surfaces. About 80% of enterocutaneous fistulas are of iatrogenic origin secondary to surgery, and a smaller percentage are related to trauma, malignancy, inflammatory bowel disease or ischemia. The associated morbidity and complications can be significant, such as malnutrition, in which multiple factors intervene. Methods. A literature search was carried out in the PubMed, Google Scholar and SciELO databases using the keywords described and the most relevant articles from recent years were selected. Results. The classification of fistulas is based on their anatomy, their daily secretion output, and their location. There is a classic triad of complications: sepsis, malnutrition and electrolyte abnormalities. Control of fistula output, adequate drainage of the collections and antibiotic therapy are key to the early management of these patients. Recent studies emphasize that sepsis associated with malnutrition are the main causes of mortality. Conclusions. This condition represents one of the most difficult and prolonged complications to treat in abdominal and colorectal surgery, and is related to significant rates of morbidity, mortality and high costs for the health system. Multidisciplinary treatment based on fluid resuscitation, sepsis control, nutritional support, and wound care, among other factors, is necessary.

Seguridad alimentaria y nutricional de niños menores de 5 años: de la dimensión alimentaria a la nutricional / Food and Nutrition Security of Children under 5 Years: From Food to Nutritional Dimension / Segurança alimentar e nutricional de crianças menores de 5 anos: da dimensão alimentar à nutricional

Objetivo: analizar la asociación de características biológicas y sociales con la seguridad alimentaria y nutricional (san) de niños menores de 5 años con base en indicadores de percepción del hambre y antro-pométricos.Materiales y métodos: estudio transversal realizado en municipios brasileños que fueron priorizados para el desarrollo de acciones de prevención de la obesidad infantil en 2017/2018. La san se midió usando la Escala Brasileña de Inseguridad Alimentaria y se utilizaron los índices antropométricos Talla/Edad (T/E), Peso/Edad (P/E) y Peso/Talla (P/T). Las asociaciones se testaron por regresión de Poisson con varianza robusta.Resultados: de los 868 niños, el 24.3 % vivía en familias con inseguridad alimenta-ria y nutricional moderada-severa (ianm-s), el 7.0 % tenía T/E baja; el 7.8 % P/E alto, y el 14.4 %, P/T alto. Si bien la ianm-s se asoció con una amplia gama de factores negativos del contexto social, las prevalencias de las desviaciones antropométricas fueron mayores en menores de 2 años y cuando las madres tenían el mismo diagnóstico nutricional que el niño.Conclusión: a pesar de las prevalencias expresivas de ianm-sy desviaciones antropométricas, la ianm-s fue más pronunciada, especialmente en contextos sociales des-favorables. La san mostró un comportamiento diferente en sus dimensiones alimentaria y nutricional, tanto en términos de frecuencia como de determinación

Objective: To analyze the association between biological and social characteristics with the food and nutritional security (fns) of children aged <5 years based on hunger perception and anthropometric indicators. Materials and methods: This cross-sectional study was performed at Brazilian municipali-ties that have been prioritized for the development of actions aimed at preventing childhood obesity in 2017­2018. The fns aspect was analyzed with reference to the Brazilian Food Insecurity Scale and the anthropometric indices Height/Age (H/A), Weight/Age (P/A), and Weight/Height (P/H) were used. The associations were tested by the Poisson Regression with robust variance. Results: Of the 868 children, 24.3 % lived in families with moderate­severe food and nutritional insecurity, 7.0 % had low H/A, 7.8 % had high P/A, and 14.4% had high P/E. The moderate­severe food and nutritional insecurity was associ-ated with a wide range of negative factors in the social context, but the prevalence of anthropometric deviations was higher in children <2 years and when their mothers had the same nutritional diagno-sis. Conclusion: Despite the expressive prevalence of moderate­severe food and nutritional insecurity and anthropometric deviations, the former was more pronounced, especially under unfavorable social contexts. san displayed different behaviors in its food and nutritional dimensions, both in the terms of frequency and determination.

Objetivo: analisar a associação de características biológicas e sociais com a Segurança Alimentar e Nutricional (san) de crianças menores de 5 anos com base em indicadores de percepção da fome e antropométricos. Materiais e métodos: estudo transversal realizado em municípios brasileiros que foram priorizados para o desenvolvimento de ações de prevenção da obesidade infantil em 2017/2018. A san foi medida usando a Escala Brasileira de Insegurança Alimentar e utilizaram-se os índices antropométricos Estatura/Idade (E/I), Peso/Idade (P/I) e Peso/Estatura (P/E). As associações se testaram por Regressão de Poisson com variância robusta. Resultados: das 868 crianças, 24.3 % residiam em famílias com Insegurança Alimentar e Nutricional Moderada-Grave (ianm-g), 7.0 % tinham E/I baixa, 7.8 % P/I elevado e 14.4 % P/E elevado. Enquanto a ianm-gassociou-se a uma ampla gama de fatores negativos do contexto social, as prevalências dos desvios antropo-métricos foram maiores em menores de 2 anos e quando as mães tiveram o mesmo diagnóstico nutricional que a criança. Conclusão: apesar das prevalências expressivas de ianm-g e de desvios antropométricos, a ianm-gfoi mais acentuada, sobretudo em contextos sociais desfavoráveis. A san manifestou comportamento dife-rente nas suas dimensões alimentar e nutricional, tanto em termos de frequência quanto de determinação.

Factores que influyen en la adherencia al tratamiento nutricional en pacientes hipertensos, Paraguay 2021 / Factors that influence adherence to nutritional treatment in hypertensive patients, Paraguay 2021

Introducción: el tratamiento nutricional está afectado por la conducta de los sujetos para generar adherencia. Objetivo: determinar factores que influyen en la no adherencia al tratamiento nutricional en pacientes hipertensos que acuden al Hospital Regional de Coronel Oviedo, 2021. Metodología: estudio descriptivo transversal. La población estuvo comprendida por pacientes registrados en el Programa de hipertensión arterial/Departamento cardiovascular del Hospital Regional de Coronel Oviedo. Se estudiaron los datos sociodemográficos, los factores de tratamiento nutricional y el grado de adherencia al tratamiento nutricional. Resultados: participaron del estudio 206 sujetos, el 53,4 % poseía 55 años o menos y el 81,1 % fue del sexo femenino. Se pudo hallar que solo el 3,8 % de los pacientes se adhieren al tratamiento. La no adherencia al factor conocimiento estuvo relacionado con el bajo nivel educativo (p=0,032), al factor equipo de salud con provenir del área rural y tener un bajo nivel educativo (p=0,006, p=0,002), al factor paciente con provenir del área rural (p=0.002), ser de bajo nivel educativo (p=0,008) y poseer obesidad grado II y III (p=0,036). La no adherencia global estuvo relacionada a estar casado (p=0.001) y realizar trabajos domésticos (p=0,009). Conclusiones: la adherencia al tratamiento es baja en la población de estudio.

Introduction: nutritional treatment is affected by the behavior of the subjects to generate adherence. This study was carried out to determine factors that influence non-adherence to nutritional treatment in hypertensive patients who attend the Coronel Oviedo Regional Hospital, 2021. Methodology: this was a cross-sectional descriptive observational study. The population was comprised of patients registered in the hypertension department of the Coronel Oviedo Regional Hospital. Sociodemographic data, nutritional treatment factors and the degree of adherence to nutritional treatment were studied. Results: 206 subjects participated in the study, 53.4 % were 55 years old or younger and 81.1 % were female. We found that only 3.8 % of patients adhere to treatment. Non-adherence due to the knowledge factor was related to low educational level (p=0.032), to the health team factor with coming from a rural area and having a low educational level (p=0.006, p=0.002), to the patient factor with coming from a rural area (p=0.002), to have a low educational level (p=0.008) and to have obesity grade II and III (p=0.036). Global non-adherence was related to being married (p=0.001) and doing housework (p=0.009). Conclusions: adherence to treatment is low in the study population.

Application value of nutritional intervention in children with acute lymphoblastic leukemia during maintenance treatment / 公共卫生与预防医学

Objective To observe the application value of nutritional intervention in children with acute lymphoblastic leukemia (ALL) during maintenance treatment. Methods A total of 75 children with ALL admitted to Hematology and Oncology Department of Children's Hospital Affiliated to Nanjing Medical University from January 2020 and January 2022 were enrolled as the research subjects. According to different intervention methods, the patients were divided into routine intervention group (n=35) and nutritional intervention group (n=40). The routine intervention group was given routine interventions and diet guidance, while the nutritional intervention group was additionally given continuous nutritional intervention. The nutritional status, anthropometry indicators [weight, upper arm circumference, triceps skin fold thickness (TSFT)], biochemical indicators (prealbumin, albumin) and incidence of complications were compared between the two groups. Results After intervention, the nutritional risk rate in the nutritional intervention group was lower than that in the routine intervention group (47.50% vs 71.43% , P<0.05), while the values of weight, upper arm circumference and TSFT were higher than those in the routine intervention group (P<0.05), the serum albumin level was higher than that in the routine intervention group (P<0.05), and the incidence of complications was lower than that in the routine intervention group (25.00% vs 48.57%, P<0.05). Conclusion Nutritional intervention is beneficial to maintain stable nutritional status, promote growth and development, and reduce the incidence of related complications in ALL children during maintenance treatment.

Association between Self-Esteem and Dietary Changes among Cancer Patients: A Cross-Sectional Study

@#Introduction: Cancer diagnosis may shift an individual’s food choices as well as self-esteem mainly due to the side effects of treatment, which will influence their nutritional status and perception about themselves. The aim of this study was to explore the association between dietary changes and self-esteem among cancer patients. Methods: A cross-sectional study was conducted among 113 cancer patients in Hospital Universiti Sains Malaysia. Among the data collected were socio-demographic background, clinical characteristics, Karnofsky Performance Status Scale, dietary changes questionnaire before and after cancer diagnosis, self-esteem. Spearman correlation was employed for determining the relationship between dietary changes and self-esteem. Results: Out of 113 subjects, 98 subjects (86.7%) made changes in their dietary intake after being diagnosed with cancer. A total of 58.4% and 45.1% of the subjects reported a decrease in their intake of sugar and condensed milk, while 52.2% stopped consuming red meat. The mean self-esteem score was reported to be average (29.33 ± 3.52). However, no statistically significant association was found between socio-demographic, clinical parameters, and self-esteem with dietary changes. Conclusion:The findings of this study demonstrated that cancer patients had made drastic dietary changes following cancer diagnosis especially consumption of red meat and food high in sugar. Most cancer patients had average self-esteem level. Although no association had been found between dietary changes and self-esteem level, it is suggested for more studies should be carried out to provide clear understanding of the factors affecting dietary changes among cancer patients.

Nutritional status and its related factors among primary and secondary school students in Beijing City / 中国学校卫生

Objective@#To assess the nutritional status of primary and secondary school students in Beijing City and to analyze the related factors, so as to provide a scientific basis for improving the nutritional status of primary and secondary school students in a targeted manner.@*Methods@#Based on the 2021 Beijing Student Common Diseases and Health Influencing Factors Surveillance Project, a stratified random cluster sampling method was used to conduct a physical examination and questionnaire survey on 25 487 primary and secondary school students from September to November 2021. The Chi square test was used for comparison of nutritional status detection rates, and disordered multi classification Logistic regression analysis was used to explore the factors associated with students nutritional status.@*Results@#The detection rates of malnutrition, overweight and obesity among primary and secondary school students in Beijing City were 4.7%, 18.0% and 23.8% respectively. The detection rates of malnutrition, overweight and obesity were higher among male students (5.1%, 20.4%, 29.7%) than female students (4.2%, 15.5%, 17.4%) ( χ 2= 12.23, 101.71, 526.99, P <0.01). The detection rate of obesity was higher in the suburbs than urban areas(26.6%, 19.8%), and the detection rate of malnutrition was lower in the suburbs than urban areas (4.2%,5.5%)( χ 2=157.25, 23.61, P <0.01). The results of disordered multi classification Logistic regression showed that the related factors for malnutrition, overweight and obesity were gender, residence, moderate to vigorous exercise ≥60 min per day and lack of sleep( OR =1.70, 1.88,2.48; 1.14, 0.87, 0.67; 0.85, 0.92, 0.81 ; 0.83, 1.08, 1.07); frequency of fried food intake daily was a related factor for overweight ( OR =0.70); whether eating breakfast daily or not was a related factor for overweight and obesity ( OR =0.91, 0.84); academic level (middle and high school) was a related factor for malnutrition and obesity ( OR =1.38, 1.37; 0.77, 1.40)( P <0.05).@*Conclusions@#The problem of overweight and obesity among primary and secondary school students in Beijing City continues to be serious, especially among boys and suburban areas. It is recommended that society, schools, families and individuals should work together to improve the nutritional status of primary and secondary school students by adopting a graded and classified approach.

Clinical Efficacy of Modified Banxia Xiexintang Combined with Vedolizumab in Treatment of Crohn's Disease with Syndrome of Cold and Heat in Complexity / 中国实验方剂学杂志

ObjectiveTo evaluate the clinical efficacy of modified Banxia Xiexintang combined with vedolizumab （VDZ） in the treatment of active moderate to severe Crohn's disease （CD） with the syndrome of cold and heat in complexity and the effect of the therapy on intestinal flora. MethodEighty patients were randomized based on the random number table method into a control group （40 cases） and an observation group （40 cases）. The control group was treated with VDZ， and the observation group was treated with modified Banxia Xiexintang （1 bag per day） combined with VDZ. The treatment in both groups lasted for 14 weeks and the follow-up lasted until the 52th weeks. The CD activity index （CDAI）， CD simplified endoscopic score （SES-CD）， inflammatory bowel disease questionnaire （IBDQ） score， and syndrome score of cold and heat in complexity were assessed before treatment， after treatment， and at the end of follow-up. The levels of hemoglobin （HGB）， hematocrit （HCT）， albumin （ALB）， C-reactive protein （CRP）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， interleukin-17 （IL-17）， and fecal calprotectin （FC） were measured before and after treatment. Intestinal flora was examined before and after treatment. The safety of the therapy was evaluated. ResultCompared with those before treatment， the scores of CDAI， SES-CD， and the syndrome of cold and heat in complexity decreased （P<0.05） and the IBDQ score increased after treatment （P<0.05）. Compared with those before treatment， the scores of CDAI， SES-CD， and the syndrome of cold and heat in complexity increased （P<0.05） and the IBDQ score decreased （P<0.05） at the end of follow-up. After treatment and at the end of follow-up， the observation group had lower scores of CDAI， SES-CD， and syndrome of cold and heat （P<0.05） and higher IBDQ score （P<0.05） than the control group. Moreover， the observation group had higher clinical remission rate（χ2=4.381，3.962） and response rate（χ2=5.541，4.306） and lower non-response rate（χ2=6.646，4.306） than the control group at the two time points （P<0.05）. The endoscopic remission rate（χ2=4.072，3.985） and response rate（χ2=4.528，5.161） in the observation group were higher than those in the control group （P<0.05）. After treatment， the HGB， HCT， and ALB levels in both groups elevated， and the observation group had higher levels than the control group （P<0.05）. The treatment in both groups lowered the levels of CRP， IL-6， TNF-α， IL-17， and FC （P<0.05）， and the observation group had lower levels of CRP， IL-6， TNF-α， IL-17， and FC than the control group after treatment （P<0.05）. The relative abundance of Bifidobacterium， Lactobacillus， and Prevotella increased （P<0.05）， while that of Proteus， Klebsiella， and Enterococcus decreased （P<0.05） in the two groups after treatment. Moreover， the changes in the relative abundance of these bacteria in the observation group were more obvious than those in the control group （P<0.05）. No adverse reactions related to the modified Modified Banxia Xiexintang were observed during the study period. ConclusionModified Banxia Xiexintang combined with VDZ can play a synergistic role and has good short-term and long-term efficacy. This therapy can improve the nutritional status， regulate intestinal flora， and reduce inflammatory injury in the treatment of moderate to severe active CD patients with the syndrome of cold and heat in complexity without causing severe adverse reactions.

Physiological responses of tambaqui (Colossoma macropomum) fed diets supplemented with silage from fish and vegetables residues / Respostas fisiológicas de tambaqui (Colossoma macropomum) alimentado com dietas suplementadas com silagem de resíduos de pescado e vegetais

The demand for products to replace high-cost raw materials, such oil and fish meal, in the manufacture of feed for use in aquaculture, while also guaranteeing the nutritional quality of the diets, is increasing. Silage produced with fish and vegetables residues is a low-cost and efficient protein source. The objective of the present study was to evaluate the physiological and biochemical responses of tambaqui fingerlings fed four different levels of silage included in commercial feed with 28% crude protein, over two periods: 45 and 90 days. Each treatment was carried out over three replications, with 10 tambaqui in each 100 L experimental tank. At the end of each established period, blood samples were collected from five animals from each repetition to determine the hematological and biochemical variables. Body weight and total length, hepatosomatic and liposomal indices and hematocrit of specimens fed with diets supplemented with silage did not exhibit significant changes in both assessment period. After 45 days of feeding, the hemoglobin concentration increased when tambaqui were fed a diet including 20% silage. The red blood cell count, mean corpuscular volume and mean corpuscular hemoglobin did not change between treatments in either period. The total protein concentrations increased significantly in the plasma of tambaqui fed with diets with the inclusion of 5 and 10% of silage, evaluated after feeding for 45 days. It was found that the groups which had silage included in their diet did not exhibit significant alterations in the evaluated parameters, and the diet was therefore not consider harmful to the health of tambaqui. Therefore, the use of silage as a feed supplement during tambaqui farming is a sustainable alternative for producers, as it leads to a reduction of impacts of fish and vegetables waste disposal.

A procura por insumos que substituam produtos de alto custo, como óleo e farinha de peixe, na fabricação de rações para uso na aquicultura é crescente, sendo necessário garantir a qualidade nutricional das dietas. A silagem produzida a partir de resíduos de pescado e de vegetais apresenta-se como uma alternativa de baixo custo e eficiente fonte proteica. O objetivo do presente estudo foi avaliar as respostas fisiológicas e bioquímicas de alevinos de tambaqui alimentados com quatro níveis de inclusão de silagem em ração comercial com 28% de proteína bruta, em dois períodos: 45 e 90 dias. Cada tratamento foi realizado em três repetições, com 10 tambaquis em cada caixa experimental de 100 L. Ao término de cada período estabelecido, amostras sanguíneas foram coletadas de cinco animais de cada repetição para determinação das variáveis hematológicas e bioquímicas. Peso, comprimento total e índices hepatossomático e lipossomático de espécimes alimentados com silagem não mostraram alterações significativas em ambos os períodos de avaliação, bem como os valores de hematócrito. A concentração de hemoglobina de tambaqui após 45 dias de alimentação aumentou quando foi fornecida dieta com inclusão de 20% de silagem. A contagem de eritrócitos, volume corpuscular médio e hemoglobina corpuscular média não apresentaram alterações entre os tratamentos, em ambos os períodos. As proteínas totais aumentaram significativamente no plasma de tambaquis que receberam dietas com inclusão de 5 e 10% de silagem, avaliados após 45 dias de alimentação. Evidenciou-se que os grupos com inclusão de silagem na dieta não apresentaram alterações significativas nos parâmetros avaliados, assim não sendo prejudiciais à higidez do tambaqui. Portanto, o uso da silagem como suplemento alimentar durante o cultivo do tambaqui é uma alternativa sustentável para produtores, por promover a redução do descarte de resíduos de pescado e da agricultura.

Physiological responses of tambaqui (Colossoma macropomum) fed diets supplemented with silage from fish and vegetables residues

Abstract The demand for products to replace high-cost raw materials, such oil and fish meal, in the manufacture of feed for use in aquaculture, while also guaranteeing the nutritional quality of the diets, is increasing. Silage produced with fish and vegetables residues is a low-cost and efficient protein source. The objective of the present study was to evaluate the physiological and biochemical responses of tambaqui fingerlings fed four different levels of silage included in commercial feed with 28% crude protein, over two periods: 45 and 90 days. Each treatment was carried out over three replications, with 10 tambaqui in each 100 L experimental tank. At the end of each established period, blood samples were collected from five animals from each repetition to determine the hematological and biochemical variables. Body weight and total length, hepatosomatic and liposomal indices and hematocrit of specimens fed with diets supplemented with silage did not exhibit significant changes in both assessment period. After 45 days of feeding, the hemoglobin concentration increased when tambaqui were fed a diet including 20% silage. The red blood cell count, mean corpuscular volume and mean corpuscular hemoglobin did not change between treatments in either period. The total protein concentrations increased significantly in the plasma of tambaqui fed with diets with the inclusion of 5 and 10% of silage, evaluated after feeding for 45 days. It was found that the groups which had silage included in their diet did not exhibit significant alterations in the evaluated parameters, and the diet was therefore not consider harmful to the health of tambaqui. Therefore, the use of silage as a feed supplement during tambaqui farming is a sustainable alternative for producers, as it leads to a reduction of impacts of fish and vegetables waste disposal.

Resumo A procura por insumos que substituam produtos de alto custo, como óleo e farinha de peixe, na fabricação de rações para uso na aquicultura é crescente, sendo necessário garantir a qualidade nutricional das dietas. A silagem produzida a partir de resíduos de pescado e de vegetais apresenta-se como uma alternativa de baixo custo e eficiente fonte proteica. O objetivo do presente estudo foi avaliar as respostas fisiológicas e bioquímicas de alevinos de tambaqui alimentados com quatro níveis de inclusão de silagem em ração comercial com 28% de proteína bruta, em dois períodos: 45 e 90 dias. Cada tratamento foi realizado em três repetições, com 10 tambaquis em cada caixa experimental de 100 L. Ao término de cada período estabelecido, amostras sanguíneas foram coletadas de cinco animais de cada repetição para determinação das variáveis hematológicas e bioquímicas. Peso, comprimento total e índices hepatossomático e lipossomático de espécimes alimentados com silagem não mostraram alterações significativas em ambos os períodos de avaliação, bem como os valores de hematócrito. A concentração de hemoglobina de tambaqui após 45 dias de alimentação aumentou quando foi fornecida dieta com inclusão de 20% de silagem. A contagem de eritrócitos, volume corpuscular médio e hemoglobina corpuscular média não apresentaram alterações entre os tratamentos, em ambos os períodos. As proteínas totais aumentaram significativamente no plasma de tambaquis que receberam dietas com inclusão de 5 e 10% de silagem, avaliados após 45 dias de alimentação. Evidenciou-se que os grupos com inclusão de silagem na dieta não apresentaram alterações significativas nos parâmetros avaliados, assim não sendo prejudiciais à higidez do tambaqui. Portanto, o uso da silagem como suplemento alimentar durante o cultivo do tambaqui é uma alternativa sustentável para produtores, por promover a redução do descarte de resíduos de pescado e da agricultura.

Imagem corporal e fatores associados em estudantes da rede municipal de ensino em uma cidade no sul do Brasil / Body image and associated factors among students from the municipal school network in a city in southern Brazil

Resumo A percepção negativa da imagem corporal está relacionada à piora da saúde física e mental. Estudo transversal objetivou descrever a relação entre imagem corporal e fatores demográficos, socioeconômicos e comportamentais nos estudantes do nono ano de 25 escolas municipais de ensino fundamental em Pelotas, Rio Grande do Sul. Participaram 810 estudantes (85% dos elegíveis), de 13 a 22 anos (média de 14,9 anos). Dados foram coletados mediante questionário padronizado e pré-codificado e a relação entre o desfecho (estar satisfeito, indiferente ou insatisfeito em relação à imagem corporal), e variáveis independentes, foi analisada por Regressão Logística Multinomial. Prevalência de insatisfação corporal de 31%, maior entre as meninas que experimentaram fumo ou álcool, sofreram bullying, se percebiam como gordas ou magras e tentavam perder ou ganhar peso. Maior indiferença nas que atribuíram pouca ou nenhuma importância à imagem. Nos meninos, mais chances de insatisfação entre os que experimentaram fumo, sofreram bullying, atribuíram pouca ou nenhuma importância à imagem, se percebiam gordos e tentavam ganhar peso. Maior indiferença nos meninos que atribuíram pouca importância à imagem e estavam obesos. Cerca de um terço da amostra apresentou insatisfação, que esteve associada a alguns fatores comportamentais.

Abstract A negative perception of body image is related to worsening of physical and mental health. This cross-sectional study sought to describe the relationship between body image and demographic, socioeconomic and behavioral factors in ninth grade students from 25 municipal elementary schools in Pelotas, Rio Grande do Sul. A total of 810 students participated (85% of those eligible), aged 13 to 22 years (mean age 14.9 years). Data were collected through a standardized and pre-coded questionnaire and the relationship between the outcome (satisfied/indifferent or dissatisfied with body image), and independent variables were analyzed using Multinomial Logistic Regression. The prevalence of body dissatisfaction of 31%, higher among girls who tried smoking or alcohol, suffered bullying, perceived themselves as fat/thin and tried to lose/gain weight. There was greater indifference among those who attributed little or no importance to image. In boys, there was a higher incidence of dissatisfaction among those who tried smoking, suffered bullying, gave little/no importance to image, saw themselves as fat and tried to gain weight. There was greater indifference in boys who attributed little importance to image and were obese. A third of the sample were dissatisfied, which was associated with various behavioral factors.

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management: Preoperative Phase - Preoperative management of the patient's anemia

Abstract Managing anemia before surgery is extremely important as it is a clinical condition that can significantly increase surgical risk and affect patient outcomes. Anemia is characterized by a reduction in the number of red blood cells or hemoglobin levels leading to a lower oxygen-carrying capacity of the blood. Proper treatment requires a multifaceted approach to ensure patients are in the best possible condition for surgery and to minimize potential complications. The challenge is recognizing anemia early and implementing a timely intervention to correct it. Anemic patients are more susceptible to surgical complications such as increased infection rates, slower wound healing and increased risk of cardiovascular events during and after surgery. Additionally, anemia can exacerbate existing medical conditions, causing greater strain on organs and organ systems. To correct anemia and optimize patient outcomes, several essential measures must be taken with the most common being identifying and correcting iron deficiency.

Sociodemographic and nutritional situation of children under six years of age in the Nasa Indigenous Reservation, Iquira, Colombia / Situación sociodemográfica y nutricional de menores de seis años del Resguardo Indígena Nasa, Iquira, Colombia

Abstract Objectives: identify the sociodemographic conditions of the community and determine the prevalence of the nutritional status of children under six years of age in the Nasa Paéz Indigenous Reserve, Rionegro-Huila, Colombia. Methods: cross-sectional descriptive study whose data was obtained from two databases, one of sociodemographic conditions and other anthropometric measurements of children under six years of age. The sample corresponded to the total population of less than six years. The data was analyzed using descriptive statistics using the R Studio 3.4 software. Results: 98.6% of the population is enrolled in the health system. Water consumption comes from 71.6% of non-potable sources. 25.5% of the population has access to wastewater disposal systems. Regarding nutritional status, the prevalence of delay in growth and risk of delay in growth is 43.3% in the population under six months and 69.4% in those aged between six months and six years. Furthermore, 34.3% of children under six months of age are at risk of being overweight. Conclusions: sociodemographic conditions are determined by different inequities, low education levels, inadequate housing, drinking water consumption, as well as a high prevalence of child malnutrition.

Resumen Objetivos: identificar las condiciones sociodemográficas de la comunidad y determinar la prevalencia del estado nutricional de niños menores de seis años en el Resguardo Indígena Nasa Paéz, Rionegro-Huila, Colombia. Métodos: estudio descriptivo transversal cuyos datos se obtuvieron de dos bases de datos, una de las condiciones sociodemográficas y otra de medidas antropométricas de niños menores de seis años. La muestra correspondió a la totalidad población menor seis años. Los datos se analizaron mediante estadística descriptiva utilizando el software R Studio 3.4. Resultados: el 98,6% de la población está inscrito en el sistema de salud. El consumo de agua proviene en un 71,6% de fuentes no potables. El 25,5% de la población tiene acceso a sistemas de eliminación de aguas residuales. En cuanto al estado nutricional, la prevalencia de retraso en el crecimiento y riesgo de retraso en el crecimiento es del 43,3% en la población menor de seis meses y del 69,4% en edad entre los seis meses a seis años. Además, el 34,3% de los niños menores de seis meses estaban en riesgo de tener sobrepeso. Conclusiones: las condiciones sociodemográficas están determinadas por diferentes inequidades, bajos niveles de educación, vivienda inadecuada, consumo de agua no potable, así como por una alta prevalencia de malnutrición infantil.