Nutritional status and appetite-regulating hormones in early treatment of acute lymphoblastic leukemia among children and adolescents: a cohort study

ABSTRACT BACKGROUND: Children with acute lymphoblastic leukemia are at risk of malnutrition, but few studies have described the changes in nutritional status during the different phases of chemotherapy. OBJECTIVE: To evaluate changes in nutritional status, food intake and appetite-regulating hormones among children and adolescents with acute lymphoblastic leukemia in the first phase of chemotherapy. DESIGN AND SETTING: Cohort study developed in the pediatric oncology departments of two hospitals in the city of Natal, Rio Grande do Norte, Brazil. METHODS: Fourteen children/adolescents (mean age of 7 years; 50% female) with acute lymphoblastic leukemia were monitored over the 28 days of an induction chemotherapy cycle. Anthropometric measurements, 24-hours food weight records and appetite-regulating hormone levels (ghrelin, leptin, insulin and cortisol) were obtained at three different times (before, in the middle and at the end of the induction phase). RESULTS: Most of the patients (85.7%) had normal weight at the beginning of the treatment, and this did not change significantly during the 28 days. Energy and nutrient intakes improved from the start of the treatment to the midpoint, according to the ghrelin levels (from 511.1 ± 8.3 to 519.3 ± 6.6 pg/ml; P = 0.027). Other appetite-regulating hormones did not present changes. CONCLUSION: Food consumption improves during the first phase of treatment, without alterations in anthropometric nutritional status.

Effects of myocardial infarction and an intensive exercise bout on kinetic of lactate, and LDH-B levels in spontaneously hypertensive rats

Aims: This study aimed to evaluate the kinetics of lactate and lactate dehydrogenase B (LDH-B) protein levels as well as the maximum effort capacity of spontaneously hypertensive rats (SHRs) with experimental acute myocardial infarction (AMI). Methods: thirty-two SHRs were divided into (n=8/group): S (sham), SE (sham+exercise), I (AMI), and IE (AMI+exercise). A maximum exercise test (treadmill) was evaluated before AMI or sham surgery. Echocardiography was performed 48h after the surgery. Lactacidemia was assessed at rest and during an intense exercise bout (48h after echocardiography). A two-way ANOVA followed by the post-hoc (Bonferroni) test was used, p<0.05. Results: In the end, the heart was removed for analysis of LDH-B. AMI resulted in lower cardiac output (S vs I: ∆51.3%, p<0.001), ejection fraction (S vs I: ∆60.5%, p<0.001) and shortening fraction (S vs I: ∆72.4%, p<0.001). The IE showed a reduction in exercise capacity when compared with pre-AMI values (1.50±0.1 vs 1.38±0.2 km/h; p=0.030) but not when compared with SE (1.41±0.3 vs 1.38±0.2 km/h; p=0.208). During the exhaustion exercise session, IE group showed lower lactacidemia at 12 min (∆9.7%, p=0.042) and 18 min (∆8.3%, p=0.038). No differences were observed in the protein level of LDH-B among the groups (p=0.573). However, when the AMI factor was considered alone, LDH-B expression was lower (sham vs AMI rats, p=0.040). Conclusion: LDH-B protein levels in cardiac tissue appear to be associated with AMI only. Furthermore, AMI induced a reduction in exercise capacity but did not affect lactacidemia during the intense exercise bout.(AU)

Variations in the Prevalence of Risk Factors for Coronary Artery Disease in Rio Grande do Sul-Brazil: A Comparative Analysis between 2002 and 2014 / Variações na Prevalência dos Fatores de Risco para Doença Arterial Coronariana no Rio Grande do Sul: Uma Análise Comparativa entre 2002-2014

Abstract Background: Due to the importance of coronary artery disease (CAD), continuous investigation of the risk factors (RFs) is needed. Objective: To evaluate the prevalence of RFs for CAD in cities in Rio Grande do Sul State, and compare it with that reported in a similar study conducted in the same cities in 2002. Methods: Cross-sectional study on 1,056 healthy adults, investigating the prevalence and absolute and relative frequencies of the following RFs for CAD: obesity, systemic arterial hypertension (SAH), dyslipidemias, smoking, sedentary lifestyle, diabetes mellitus, and family history, as well as age and sex. Data was collected in 19 cities, host of the Offices of the Regional Coordinators of Health, as in the 2002 study. Results: Twenty-six percent of the sample consisted of older adults and 57% were women. The prevalence of sedentary lifestyle was 44%, history family 50%, smoking 23%, overweight/obesity 68%, dyslipidemia (high cholesterol levels) 43%, SAH 40%, and diabetes 11%. When compared to the 2002 study, the prevalence of active smoking and sedentary behavior decreased, whereas the prevalence of hypertension, dyslipidemia and obesity increased. Obesity is the most prevalent RF in women, and SAH the most prevalent in men. Conclusions: The prevalence of RFs for CAD in Rio Grande do Sul State remains high. Hypertension, obesity and dyslipidemia are still prevalent and require major prevention programs. Smoking and physical inactivity have decreased in the state, suggesting the efficacy of related campaigns.

Resumo Fundamento: Diante da importância da doença arterial coronariana (DAC), é necessário pesquisar continuamente seus fatores de risco (FR). Objetivo: Conhecer a prevalência dos FR da DAC em cidades do Estado do Rio Grande do Sul (RS), e compará-la com a encontrada em pesquisa semelhante realizada nas mesmas cidades em 2002. Métodos: Estudo transversal de uma amostra de 1056 indivíduos adultos, em que se pesquisou a prevalência e frequências absolutas e relativas dos seguintes FR para a DAC: obesidade, hipertensão arterial sistêmica (HAS), dislipidemias, tabagismo, sedentarismo, diabetes mellitus, e antecedentes familiares de cardiopatia isquêmica, além de idade e gênero. A coleta de dados foi realizada em 19 cidades sede das Coordenadorias Regionais de Saúde do RS, como feito em 2002. Resultados: A amostra foi constituída de 26% de idosos e 57% de mulheres. As prevalências dos FR foram de 44% de sedentarismo, 50% de antecedentes familiares, 23% de tabagismo, 68% de sobrepeso/obesidade, 43% de dislipidemia (colesterol elevado), 40% de HAS, e 11% de diabetes. Quando comparado ao estudo de 2002, verificou-se que a população de fumantes ativos e sedentários diminuiu, e a de hipertensos, dislipidêmicos e obesos aumentou. A obesidade é o FR mais prevalente em mulheres, e a HAS o mais prevalente em homens. Conclusão: A prevalência dos FR da DAC no RS continua alta. Fatores como hipertensão, obesidade, dislipidemia continuam elevados e demandam maiores programas de prevenção. O hábito de fumar e a inatividade física têm diminuído no estado, sugerindo a eficácia das campanhas relacionadas.