Desnutrição e desfechos clínicos e nutricionais de pacientes oncológicos atendidos em um ambulatório de nutrição: um estudo transversal / Malnutrition and clinical and nutritional outcomes in patients with cancer treated at an outpatient nutrition clinic: a cross-sectional study

Introdução: O câncer causa alterações metabólicas e disfunções imunológicas e nutricionais significativas que podem acarretar desnutrição e síndrome de anorexia-caquexia. O objetivo do presente estudo foi avaliar a associação entre a Avaliação Subjetiva Global produzida pelo paciente e os desfechos clínicos e nutricionais.Métodos: Foi realizado um estudo transversal, com coletas de dados retrospectivos, de pacientes atendidos em Ambulatório de Nutrição e Oncologia de um hospital público no Rio Grande do Sul, entre Janeiro de 2018 a Janeiro de 2020. Foram incluídos adultos com diagnóstico de câncer hematológico ou tumor sólido. Os dados demográficos e clínicos foram coletados a partir de prontuário eletrônico e os dados nutricionais e sintomas coletados através da ficha de anamnese. A relação entre variáveis categóricas foi avaliada pelos testes do qui-quadrado ou exato de Fischer, e de variáveis contínuas através dos testes de Pearson ou correlação de Spearman. O nível de significância utilizado foi de 5%.Resultados: Foram avaliados 260 pacientes, sendo 51,5% do sexo feminino, a maioria de raça branca (84,2%), com idade média de 59 anos. Em relação ao diagnóstico nutricional, observou-se que 41,5% dos pacientes eram bem nutridos, 39,6% apresentavam suspeita de desnutrição ou desnutrição moderada e 18,8% eram desnutridos graves. Observou-se associação significativa entre pacientes com desnutrição (ASGPPP B e/ou C) e os seguintes desfechos: idade, óbito, tipo de câncer, em especial, esôfago, pulmão e cólon, presença de diabetes melito, tipo de tratamento clínico e via alimentar. Também foi observada associação significativa com os sintomas de disfagia, odinofagia, saciedade precoce, alteração do paladar, xerostomia e inapetência quando comparado os pacientes desnutridos com os classificados como bem nutrido.Conclusão: Observou-se associação entre os pacientes com algum grau de desnutrição e diversos sintomas que influenciam negativamente no consumo alimentar. Além disso, foi associada à localização do câncer e seu tratamento.

Introduction: Cancer causes metabolic changes and relevant immune and nutritional disorders, which can lead to malnutrition and anorexia-cachexia syndrome. The aim of the present study was to evaluate the association between the Patient-Generated Subjective Global Assessment and clinical and nutritional outcomes.Methods: This was a cross-sectional, retrospective study of patients treated at the Outpatient Nutrition and Oncology Clinic of a public hospital in Rio Grande do Sul, Brazil, between January 2018 and January 2020. Adults with a diagnosis of hematologic cancer or solid tumor were included. Demographic and clinical data were collected from electronic medical records, and nutritional data and symptoms were collected using a medical history form. The relationship between categorical variables was assessed using the chi-square test or Fischer's exact test, and continuous variables were assessed using Pearson's or Spearman's correlation. The significance level was set at 5%.Results: A total of 260 patients were evaluated, 51.5% of whom were women, mostly white (84.2%), with a mean age of 59 years. In relation to the nutritional diagnosis, 41.5% of patients were well nourished, 39.6% had suspected malnutrition or moderate malnutrition, and 18.8% were severely malnourished. There was a significant association between patients with malnutrition and the following outcomes: age, death, type of cancer (especially esophageal, lung, and colon), presence of diabetes, type of clinical treatment, and diet. Patients with malnutrition were also significantly associated with symptoms of dysphagia, odynophagia, early satiety, altered taste, dry mouth, and lack of appetite.Conclusion: Patients with some degree of malnutrition were associated with several symptoms that negatively affect food consumption, as well as with cancer site and cancer treatment.

Dietary patterns of adults with asthma treated at a referral center for asthma

Introduction: Consumption of foods with anti-inflammatory and antioxidant components could contribute to a better control of the asthma. The aim of this study was to assess the association between dietary patterns, nutritional status, and asthma control in patients treated at an asthma referral center in Porto Alegre, Brazil. Methods: This is a cross-sectional study with 198 adult asthma patients. Participants completed a 24-hour food recall and a questionnaire on disease history, degree of control, and severity, as well as pulmonary and anthropometric assessments. We used exploratory factor analysis and principal component analysis as an extraction method to derive the dietary patterns. Results: The mean body mass index was 29.6 (SD, 5.7) kg/m2, and 41.9% were classified as obese. Regarding disease severity, 72.7% were classified as having severe persistent asthma, and concerning the degree of control, 59.6% of the patients had uncontrolled asthma. Three dietary patterns were identified: "Sugars", "Healthy", and "Fats and Alcohol". It was observed that the Fats and Alcohol pattern was significantly associated with men. However, no associations were observed between the other variables and dietary patterns. Conclusion: This was the first study to identify the dietary patterns in asthmatics in Brazil. Patterns found in the present study were "Sugars", "Healthy" and "Fats and Alcohol". However, there was no significant association between the 3 patterns and nutritional status or disease control. (AU)

Intestinal microbiota changes after solid organ transplantation: a systematic review

Introduction: The intestinal microbiota may undergo changes after solid organ transplantation. The purpose of this systematic review was to characterize the intestinal microbiota of patients undergoing solid organ transplantation. Methods: MEDLINE, EMBASE and Cochrane Library databases were searched from inception to July 21, 2017. Studies of patients undergoing solid organ transplantation that evaluated changes in intestinal microbiota composition and one of the following outcomes were included: post-transplant weight, new-onset diabetes after transplantation, delayed graft function, acute rejection, graft and patient survival, and post-transplant infections. Results: Out of 765 studies found in this search, two studies (86 patients) fulfilled inclusion criteria. Both studies assessed kidney transplantation recipients, and a reduction in bacterial species diversity after transplantation was observed. Changes in intestinal microbiota were associated with acute rejection in both studies. One study reported diarrhea and urinary infections, while the other one reported urinary and respiratory infections. None of them reported other outcomes of interest. Conclusion: Changes in intestinal microbiota were observed after kidney transplantation, and they were associated with higher incidence of acute rejection and infections in transplant recipients. However, data are still scarce and more studies are needed to evaluate if microbiota changes have an impact on post-transplant outcomes. (AU)

Relação entre a retenção de peso nos primeiros três meses pós-parto com ganho de peso e ingestão alimentar durante a gestação / The relation between weight retention in the first three months post-partum and weight gain and diet during gestation

Estudar a retenção de peso em mulheres nos primeiros três meses pós-parto e sua correlação com ganho de peso gestacional (GPG) e consumo alimentar.Métodos:estudo de coorte com 61 mulheres. Aplicou-se: Questionário de Frequência Alimentar (QFA), Questionário Internacional de Atividade Física (IPAQ) e questionário referente à amamentação e dados antropométricos. Realizaram-se avaliações entre 24 e 48 horas pós-parto, 7, 15, 30 e 90 dias. A retenção de peso deu-se pela subtração entre peso aos três meses pós-parto e peso pré-gestacional. Os testes estatísticos usados foram: correlações de Pearson e Spearman, teste t de Student, de comparação múltipla com ajuste de Bonferroni e regressão linear.Resultados:a média de idade foi 28±7,0 anos, com medianas: de consumo alimentar diário na gestação de 3.670,3 kcal, GPG de 12,0 kg e retenção de peso nos primeiros três meses de 3,2 Kg. Observou-se associação significativa entre retenção de peso nos primeiros três meses pós-parto e o GPG (p<0,001) e a paridade (p<0,05). Para cada quilo ganho durante a gestação 0,8 kg foi retido nos primeiros três meses.Conclusões:a retenção de peso três meses pós-parto mostrou-se maior quanto maior o GPG durante a gestação e a paridade...

To study weight retention in women in the first three months post-partum and its correlation with gestational weight gain (GWG) and diet.Methods:a cohort study of 61 women was conducted. The Food Intake Frequency Questionnaire (FIFQ), International PhysicalActivity Questionnaire (IPAQ) and a questionnaire on breastfeeding and anthropometric data were applied. Evaluations were conducted between 24 and 48 hours post-partum, and after 7, 15, 30 and 90 days. Weight retention was calculated by subtractingpre-gestational weight from weight three months post-partum. The statistical tests used were the Pearson and Spearman correlations, Student’s t test, multiple comparisons with Bonferroni’s adjustment, and linear regression.Results:the mean age was 28±7.0 years, with median daily food intake duringpregnancy of3,670.3 kcal, GWG of 12.0 kg and weight retention in the first three months of 3.2 Kg. A significant association was found between weight retention in the first three months post-partum and GWG (p<0.001) andparity (p<0.05). For each kilo gained during pregnancy, 0.8 kg was retained in the first three months.Conclusions:Conclusions: weight retention three months post-partum was found to be greater the greater the GWG and the number of previous births...