ABSTRACT
O mieloma múltiplo é uma neoplasia maligna caracterizada pela proliferação clonal de plasmócitos na medula óssea. O objetivo deste trabalho foi avaliar as possíveis associações entre o estado nutricional, força muscular e capacidade funcional de pacientes ambulatoriais portadores de mieloma múltiplo. Trata-se de estudo transversal realizado em amostra não probabilística de pacientes com mieloma múltiplo atendidos no Hospital das Clínicas, em Goiânia. Os dados foram coletados entre agosto e dezembro de 2015, utilizando-se de entrevistas e informações dos prontuários. O estado nutricional foi avaliado aplicando-se a Avaliação Subjetiva Global Produzida pelo Próprio Paciente; a força muscular medida por meio da Força do Aperto de Mão e a capacidade funcional, pela Escala de Performance de Karnofsky. O estudo foi aprovado pelo Comitê de Ética e Pesquisa do referido hospital. Foram avaliados 52 pacientes, em que 48,1% estavam desnutridos, 30,8% apresentavam baixa força muscular e 73,1%, comprometimento da capacidade funcional. A força muscular e a capacidade funcional foram menores nos desnutridos. Observou-se que aqueles que utilizavam corticoides apresentaram 18% menos chance de se tornarem desnutridos (OR=0,18; IC=0,05-0,62; p=0,011) porém, é importante considerar as possíveis causas de viés; por outro lado, os pacientes com baixa força muscular ou faziam quimioterapia apresentaram, aproximadamente, quatro vezes mais chances de desnutrição, respectivamente (OR=3,46; IC=0,99-12,08; p=0,047) (OR=3,64; IC=1,13-11,69; p=0,027). Concluiu-se que a desnutrição é comum nos pacientes portadores de mieloma múltiplo, indicando a necessidade premente de intervenção nutricional apropriada e precoce.
Multiple myeloma is a malignant neoplasm characterized by the clonal proliferation of plasma cells in the bone marrow. The objective of this study was to evaluate possible associations between nutritional status, muscle strength and functional capacity of outpatients with multiple myeloma. This is a cross-sectional study carried out on a non-probabilistic sample of patients with multiple myeloma treated at Hospital das Clínicas, in Goiânia. Data were collected between August and December 2015, using interviews and information from medical records. Nutritional status was assessed using the Patient Generated Subjective Global Assessment; muscular strength measured using Hand Grip Strength and functional capacity, using the Karnofsky Performance Scale. The study was approved by the Ethics and Research Committee of that hospital. 52 patients were evaluated, of which 48.1% were malnourished, 30.8% had low muscle strength and 73.1% had impaired functional capacity. Muscle strength and functional capacity were lower in malnourished individuals. It was observed that those who used corticosteroids were 18% less likely to become malnourished (OR=0.18; CI=0.05-0.62; p=0.011), however, it is important to consider the possible causes of bias; on the other hand, patients with low muscle strength or undergoing chemotherapy were approximately four times more likely to be malnourished, respectively (OR=3.46; CI=0.99-12.08; p=0.047) (OR=3.64; CI=1.13-11.69; p=0.027). It was concluded that malnutrition is common in patients with multiple myeloma, indicating the pressing need for appropriate and early nutritional intervention.
ABSTRACT
BACKGROUND: Nut consumption has been related to improvements on cardiometabolic parameters and reduction in the severity of atherosclerosis mainly in primary cardiovascular prevention. The objective of this trial is to evaluate the effects of the Brazilian Cardioprotective Diet (DIeta CArdioprotetora Brasileira, DICA Br) based on consumption of inexpensive locally accessible foods supplemented or not with mixed nuts on cardiometabolic features in patients with previous myocardial infarction (MI). METHODS: DICA-NUTS study is a national, multicenter, randomized 16-week follow-up clinical trial. Patients over 40 years old with diagnosis of previous MI in the last 2 to 6 months will be recruited (n = 388). A standardized questionnaire will be applied to data collection and blood samples will be obtained. Patients will be allocated in two groups: Group 1: DICA Br supplemented with 30 g/day of mixed nuts (10 g of peanuts, 10 g of cashew, 10 g of Brazil nuts); and Group 2: only DICA Br. The primary outcome will consist of LDL cholesterol means (in mg/dL) after 16 weeks of intervention. Secondary outcomes will consist of other markers of lipid profile, glycemic profile, and anthropometric data. DISCUSSION: It is expected that DICA Br supplemented with mixed nuts have superior beneficial effects on cardiometabolic parameters in patients after a MI, when compared to DICA Br. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT03728127 . First register: November 1, 2018; Last update: June 16, 2021. World Health Organization Universal Trial Number (WHO-UTN): U1111-1259-8105.
Subject(s)
Diet , Myocardial Infarction , Adult , Biomarkers , Blood Glucose , Cholesterol, LDL , Humans , Multicenter Studies as Topic , Myocardial Infarction/diagnosis , Myocardial Infarction/prevention & control , Randomized Controlled Trials as TopicABSTRACT
Fortification with multiple micronutrient powder has been proposed as a public health intervention able to reduce micronutrient deficiencies in children. Our objective was to compare the effectiveness of fortification with multiple micronutrient powder with drug supplementation in the prevention and treatment of iron deficiency and anaemia. This was a cluster trial with anemic and non-anaemic children between six and 42 months old, in randomization data. Non anaemic children received fortification with multiple micronutrient powder or standard drug supplementation of ferrous sulfate associated with folic acid in a prevention dose. Anaemic children who were randomized to receive multiple micronutrient powder also received the recommended iron complementation for anaemia treatment. A total of 162 children were evaluated. The prevalence of anaemia decreased from 13.58 to 1.85%. Iron deficiency decreased from 21.74% to 7.89% (by serum ferritin) and iron deficiency decreased from 66.81 to 38.27% (by soluble transferrin receptor). No difference was identified between interventions for hemoglobin (p = 0.142), serum ferritin (p = 0.288), and soluble transferrin receptor (p = 0.156). Fortification with multiple micronutrient powder was effective in preventing iron deficiency and anaemia in children aged six to 48 months. In anaemic children; it was necessary to supplement the dose of multiple micronutrient powder with ferrous sulfate.
Subject(s)
Anemia, Iron-Deficiency/prevention & control , Anemia, Iron-Deficiency/therapy , Food, Fortified , Micronutrients/pharmacology , Anemia, Iron-Deficiency/epidemiology , Brazil/epidemiology , Child, Preschool , Female , Ferritins/blood , Food, Fortified/adverse effects , Hemoglobins/metabolism , Humans , Infant , Male , Micronutrients/adverse effects , Powders , PrevalenceABSTRACT
Introdução: O câncer é uma enfermidade caracterizada pelo crescimento desordenado de células anormais cujo tratamento pode desencadear imunossupressão. Pacientes imunossuprimidos são mais susceptíveis a micro-organismos oportunistas, que em contato com o organismo, podem levar a quadros infecciosos graves. Assim, a dieta para imunossuprimidos é utilizada com a finalidade de diminuir o risco de doenças transmitidas por alimentos, através da restrição de alimentos como vegetais crus e as frutas com casca fina. Objetivo: Verificar a qualidade microbiológica da dieta livre e a viabilidade de sua oferta para pacientes imunossuprimidos Métodos: Pesquisou-se nos meses de abril a maio de 2016, 120 amostras de componentes da dieta livre (arroz, feijão, prato proteico, guarnição, salada e fruta). As amostras foram submetidas à análise microbiológica de acordo com a legislação vigente para quantificação de Coliformes a 45ºC, Staphylococcus coagulase positiva, Bacillus cereus, Clostridium sulfito redutor e análise de presença de Salmonella sp, seguindo metodologia preconizada pela American Public Health Association. Resultados: Todas as amostras analisadas estavam em conformidade com a legislação vigente. Discussão: Estudos demonstram que a relação entre dieta para imunossuprimidos e diminuição do risco de contaminantes alimentares e infecção permanece contraditória. A prevalência de complicações ou desfechos clínicos desfavoráveis são maiores entre pacientes que ingerem a dieta neutropênica ou aparecem neutras, quando comparadas a dieta livre. Em contrapartida, a aceitação alimentar pela dieta neutropênica é reduzida e visível a piora do estado nutricional do paciente. Conclusão: Foi considerada viável a oferta de dieta livre aos pacientes imunossuprimidos
Introduction: Cancer is a disorder characterized by the disordered growth of abnormal cells whose treatment can trigger immunosuppression. Immunosuppressed patients are more susceptible to opportunistic microorganisms, which in contact with the organism, can lead to serious infectious conditions. Thus, the immunosuppressed diet is used to reduce the risk of foodborne illness by restricting foods such as raw vegetables and fruits with thin bark. Objective: Verify the microbiological quality of the geral diet and the viability of its offer for immunosuppressed patients.Methods: From April to May 2016, 120 samples of free diet components (rice, beans, protein plate, garnish, salad and fruit) were investigated. The samples were submitted to microbiological analysis according to the current legislation for the quantification of Coliforms at 45ºC, Staphylococcus coagulase positive, Bacillus cereus, Clostridium sulfite reducer and analysis of the presence of Salmonella sp, following a methodology recommended by the American Public Health Association. Results: All samples analyzed were in compliance with current legislation. Discussion: Studies have shown that the relationship between diet for immunosuppressed and decreased risk of food contaminants and infection remains contradictory. The prevalence of unfavorable complications or clinical outcomes is greater among patients who ingest the neutropenic diet or appear neutral when compared to the geral diet. On the other hand, the food acceptance by the neutropenic diet is reduced and the deterioration of the nutritional status of the patient is visible. Conclusion: The availability of geral diet to immunosuppressed patients was considered feasible
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