Advancements in nutritional diagnosis and support strategies during the perioperative period for patients with liver cancer.

Liver cancer represents a grave hepatic condition and constitutes a significant global health concern. Surgical resection remains the principal therapeutic modality for liver cancer. Nevertheless, perioperative malnutrition exerts a notable impact on patients with liver cancer, emerging as an independent risk factor for disease mortality and adverse outcomes. Hence, precise nutritional diagnosis and timely nutritional support hold the potential to enhance therapeutic efficacy and quality of life for liver cancer patients. This study represents a meticulous foray into the literature, extracting data from PubMed, Web of Science, and EMBASE databases, with a focus on the past 5 years. It scrutinizes the impact of malnutrition on patients undergoing liver cancer surgery, the etiological underpinnings of malnutrition within this patient cohort, the critical assessment of perioperative nutritional status, and the strategic approaches to nutritional support. Utilizing rigorous inclusion and exclusion criteria, the amassed scholarly works are meticulously synthesized, methodically organized, and categorically elaborated upon. Ultimately, the authors propose the incorporation of a multidisciplinary nutrition management team during the perioperative period, comprising nutritionists, pharmacists, physicians, nurses, psychologists, and rehabilitation therapists, among other specialized professionals. Together, they collaborate to devise and implement personalized nutritional support plans, monitor patients' nutritional status, and make necessary adjustments as required. Through comprehensive management and intervention, improvements in the nutritional status of liver cancer patients can be achieved, thereby enhancing surgical success rates and facilitating postoperative recovery. It is believed that this manuscript will offer valuable insights to advance the nutritional management during the perioperative phase of liver cancer, aiding in ameliorating patients' nutritional status and treatment outcomes.

Optimizing nutrition in hepatic cirrhosis: A comprehensive assessment and care approach.

Cirrhosis is considered a growing cause of morbidity and mortality, which represents a significant public health problem. Currently, there is no effective treatment to reverse cirrhosis. Treatment primarily centers on addressing the underlying liver condition, monitoring, and managing portal hypertension-related complications, and evaluating the potential for liver transplantation in cases of decompensated cirrhosis, marked by rapid progression and the emergence of complications like variceal bleeding, hepatic encephalopathy, ascites, malnutrition, and more. Malnutrition, a prevalent complication across all disease stages, is often underdiagnosed in cirrhosis due to the complexities of nutritional assessment in patients with fluid retention and/or obesity, despite its crucial impact on prognosis. Increasing emphasis has been placed on the collaboration of nutritionists within hepatology and Liver transplant teams to deliver comprehensive care, a practice that has shown to improve outcomes. This review covers appropriate screening and assessment methods for evaluating the nutritional status of this population, diagnostic approaches for malnutrition, and context-specific nutrition treatments. It also discusses evidence-based recommendations for supplementation and physical exercise, both essential elements of the standard care provided to cirrhotic patients.

Comparación de ambos criterios diagnósticos de malnutrición ESPEN y GLIM en pacientes institucionalizados / Comparison of both ESPEN and GLIM diagnostic criteria for malnutrition in institutionalized patients

Introducción: La malnutrición relacionada con la enfermedad es un problema de alta prevalencia que continúa provocando graves repercusiones clínicas sobre los pacientes institucionalizados. La falta de un acuerdo mundial sobre los criterios de diagnóstico nutricional que deben aplicarse en el entorno clínico compromete la detección y el abordaje nutricional. En este estudio se pretende evaluar el índice de malnutrición en la institución hospitalaria, definir la validez de los criterios GLIM y ESPEN y determinar el criterio de referencia para el diagnóstico nutricional en la práctica clínica. Metodología: Estudio transversal, descriptivo desarrollado en un hospital de larga estancia en una muestra de 314 pacientes. Se analizó el diagnóstico nutricional mediante los criterios ESPEN y GLIM. Se evaluó la sensibilidad, especificidad y concordancia entre ambos criterios para determinar la validez de su uso en la práctica clínica. Resultados: La prevalencia de malnutrición fue del 58% según ESPEN y 78% en base a GLIM, siendo severa en el 24% de los pacientes y moderada en el 76%. La concordancia entre ESPEN y GLIM fue moderada (I. kappa: 0,325). Los criterios GLIM mostraron una sensibilidad buena (93,75%) y una especificad deficiente (38,32%). Por el contrario, los criterios ESPEN definieron una sensibilidad regular (61,4%) y una buena especificidad (85,4%). Conclusiones: Ambos criterios diagnósticos ESPEN y GLIM serían adecuados para la evaluación del diagnóstico nutricional en la práctica clínica. Sin embargo, los criterios GLIM resultan de mayor validez al identificar precozmente individuos en proceso de malnutrición. (AU)

Introduction: Disease-related malnutrition is a problem of high prevalence that continues to cause serious clinical repercussions on institutionalized patients. The lack of global agreement on the nutritional diagnostic criteria to be applied in the clinical setting compromises the detection and nutritional approach. This study intends to evaluate the malnutrition index in the hospital institution, define the validity of the GLIM and ESPEN criteria and determine the reference criterion for nutritional diagnosis in clinical practice. Methods: Cross-sectional, descriptive study conducted in a long-stay hospital in a sample of 314 patients. Nutritional diagnosis was analyzed using ESPEN and GLIM criteria. The sensitivity, specificity and concordance between both criteria were evaluated to determine the validity of their use in clinical practice. Key results: The prevalence of malnutrition was 58% according to ESPEN and 78% based on GLIM, being severe in 24% of patients and moderate in 76%. The agreement between ESPEN and GLIM was moderate (I. kappa: 0.325). The GLIM criteria showed good sensitivity (93.75%) and poor specificity (38.32%). In contrast, the ESPEN criteria defined regular sensitivity (61.4%) and good specificity (85.4%). Conclusions: Both ESPEN and GLIM diagnostic criteria would be suitable for the evaluation of nutritional diagnosis in clinical practice. However, the GLIM criteria are more valid when identifying individuals in the process of malnutrition early. (AU)

Comparison of the performance of the GLIM criteria, PG-SGA and mPG-SGA in diagnosing malnutrition and predicting survival among lung cancer patients: A multicenter study.

BACKGROUND & AIMS: The present study aimed to compare the ability of the GLIM criteria, PG-SGA and mPG-SGA to diagnose malnutrition and predict survival among Chinese lung cancer (LC) patients. METHODS: This was a secondary analysis of a multicenter, prospective, nationwide cohort study, 6697 LC inpatients were enrolled between July 2013 and June 2020. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the curve (AUC), and quadratic weighted Kappa coefficients were calculated to compare the ability to diagnose malnutrition. There were 754 patients who underwent follow-up for a median duration of 4.5 years. The associations between the nutritional status and survival were analyzed by the Kaplan-Meier method and multivariable Cox proportional hazard regression models. RESULTS: The median age of LC patients was 60 (53, 66), and 4456 (66.5%) were male. There were 617 (9.2%), 752 (11.2%), 1866 (27.9%), and 3462 (51.7%) patients with clinical stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ LC, respectively. Malnutrition was present in 36.1%-54.2% (as evaluated using different tools). Compared with the PG-SGA (used as the diagnostic reference), the sensitivity of the mPG-SGA and GLIM was 93.7% and 48.3%; the specificity was 99.8% and 78.4%; and the AUC was 0.989 and 0.633 (P < 0.001). The weighted Kappa coefficients were 0.41 for the PG-SGA vs. GLIM, 0.44 for the mPG-SGA vs. GLIM, and 0.94 for the mPG-SGA vs PG-SGA in patients with stage Ⅰ-Ⅱ LC. These values were respectively 0.38, 0.39, and 0.93 in patients with stage Ⅲ-Ⅳ of LC. In a multivariable Cox analysis, the mPG-SGA (HR = 1.661, 95%CI = 1.348-2.046, P < 0.001), PG-SGA (HR = 1.701, 95%CI = 1.379-2.097, P < 0.001) and GLIM (HR = 1.657, 95%CI = 1.347-2.038, P < 0.001) showed similar death hazard ratios. CONCLUSIONS: The mPG-SGA provides nearly equivalent power to predict the survival of LC patients as the PG-SGA and the GLIM, indicating that all three tools are applicable for LC patients. The mPG-SGA has the potential to be an alternative replacement for quick nutritional assessment among LC patients.

Consensus of nutritional management for survivors of malignant tumor (2023) / 中华临床营养杂志

Reasonable nutrition management is important in the long-term care of cancer survivors. It can contribute to reducing the risk of metabolic complications, improving patients' understanding, beliefs, and behavior as regards healthy lifestyles, promoting lifestyle and dietary changes, and positively impacting disease treatment and long-term prognosis. To improve the long-term management of Chinese cancer survivors, reduce medical costs, and maximize clinical benefits and patient outcomes, the Cancer Nutrition Branch of the Chinese Nutrition Society has developed this consensus based on the current cancer patient management and nutritional therapy in China, evidence-based medicine from domestic and foreign publications, as well as expert opinions and experiences in clinical and nutritional fields. Following the Oxford Centre for Evidence-based Medicine (OCEBM) grading system, this consensus provides recommendations for nutritional risk screening, assessment (diagnosis), enteral and parenteral nutrition support, and medical nutrition therapy for cancer survivors, aiming to inform and support the standardized nutritional management of cancer survivors.

Leaf concentration of macronutrients in oil palm plants fertilized with phosphorus, potassium and magnesium in the Eastern Amazon

The concentrations of nutrients in the leaves allow a better understanding of the nutritional status of oil palm plants, making it a tool for diagnosing the origins of nutritional problems and assisting in fertilizer recommendations. In this sense, the objective of the current research was to evaluate the leaf concentrations of N, P, K, Ca, Mg and S in the oil palm under fertilization with phosphate, potassium and magnesium in edaphoclimatic conditions of Eastern Amazon. The experiment was conducted at the AGROPALMA® Company in the municipality of Tailândia, state of Pará, Brazil. The experimental design used was randomized blocks in a factorial scheme 4 x 2 x 3 x 2, with four levels of phosphorus, two sources of phosphorus (natural phosphate and triple superphosphate), three levels of potassium and two levels of magnesium. Phosphorus fertilization increased the leaf concentrations of N, P, Ca and Mg, providing higher levels when triple superphosphate was applied. However, in adult oil palm plants (12 years old), there was different on leaf concentrations of N, P, K and S between phosphorus sources aphid. Potassium and magnesium fertilization only increased the leaf concentrations of K and Mg, respectively. Fertilization with P, K and Mg promotes adequate leaf concentrations of K, Ca, Mg e S in oil palm plants grown in the Eastern Amazon.

Obesidade e sobrepeso em colaboradores de um Centro Universitário em Fortaleza ­ Ceará - Brasil: há diferença entre os sexos? / Obesity and overweight in collaborators of a University Center in Fortaleza ­ Ceará ­ Brazil: is there a difference between the sexes?

Objetivo: avaliar a prevalência de sobrepeso e obesidade de acordo com o sexo entre os colaboradores de um centro universitário. Métodos: trata-se de um estudo transversal realizado com funcionários de um centro universitário particular, localizado na cidade de Fortaleza ­ Ceará ­ Brasil. Foram coletados, em entrevista presencial, os seguintes dados: pessoais, socioeconômicos e demográficos, além de ter sido realizadas por equipe treinada, medidas antropométricas, tais como, peso, altura, circunferência do pescoço (CP) e circunferência da cintura (CC). Resultados: foram entrevistados 80 funcionários, a maioria do sexo feminino 65% e 40% na faixa etária entre 20 a 29 anos, 40,0% com ensino médio incompleto e 31,3% com renda de até um salário-mínimo mensal. De acordo com a classificação do estado nutricional segundo valores de Índice de Massa Corporal (IMC), 68,7% dos participantes apresentavam excesso de peso, considerando os colaboradores com sobrepeso e obesidade e 78,8% das mulheres apresentaram CC de risco moderado e alto para o desenvolvimento de doenças cardiovasculares (DCV). Os dados de CP mostraram que há uma prevalência elevada 77,5% de sobrepeso e obesidade em ambos os sexos. Do total, 75% das mulheres apresentaram risco nutricional antropométrico para desenvolver DCV, enquanto 60,7 % dos homens apresentaram parâmetros de risco, sem diferença estatística (p = 0,184). Conclusão: foi possível identificar que a maioria da população estudada apresenta excesso de peso segundo o IMC e CP, além de apresentar risco para o desenvolvimento de DCV analisados por meio da CC e RCE, sem diferença significativa entre os sexos. Ressalta, assim, a importância do atendimento nutricional para o diagnóstico precoce de sobrepeso/obesidade, com a finalidade de reduzir a prevalência de excesso de peso no ambiente de trabalho e no setor produtivo, com a realização de ações de conscientização da importância da alimentação e hábitos saudáveis na promoção da saúde e na prevenção de doenças crônicas não transmissíveis, como a obesidade

Objective: To assess the prevalence of overweight and obesity according to sex among employees of a university center. Methods: This is a cross-sectional study carried out with employees of a private university center located in the city of Fortaleza ­ Ceará ­ Brazil. Personal, socioeconomic, and demographic data were collected in a face-to-face interview, in addition to anthropometric measurements such as weight, height, neck circumference (NC), and waist circumference (WC) by a trained team. Results: 80 employees were interviewed, most of them 65% female and 40% aged between 20 and 29 years, 40.0% with incomplete high school education, and 31.3% with an income of up to one minimum monthly wage. According to the classification of nutritional status according to Body Mass Index (BMI) values, 68.7% of the participants were overweight, considering the overweight and obese employees, and 78.8% of the women had moderate-risk WC and high for the development of cardiovascular disease (CVD). The PC data showed that there is a high 77.5% prevalence of overweight and obesity in both sexes. Of the total, 75% of women had an anthropometric nutritional risk for developing CVD, while 60.7% of men had risk parameters, with no statistical difference (p = 0.184). Conclusion: It was possible to identify that the majority of the studied population is overweight according to BMI and LC, in addition to being at risk for the development of CVD analyzed through WC and WHtR, with no significant difference between genders. Thus, it emphasizes the importance of nutritional care for the early diagnosis of overweight/obesity to reduce the prevalence of excess weight in the work environment and the productive sector by carrying out actions to raise awareness of the importance of food and healthy habits in promoting health and preventing chronic non-communicable diseases such as obesity.

Obesidad y características de personalidad en adolescentes de Argentina y España: Un estudio transcultural / Obesity and personality characteristics in adolescents from Argentina and Spain: A cross-cultural study

Resumen Los objetivos de este estudio fueron: 1. Comparar la presencia de sobrepeso y obesidad en adolescentes de Argentina vs. España, 2. Comparar la personalidad según diagnóstico nutricional (DN) y lugar de residencia (LR), y 3. Identificar la presencia de riesgo psicopatológico (RP). Participaron 272 adolescentes, hombres y mujeres, de 11-16 años de edad, quienes completaron el Cuestionario de Personalidad para Niños de Eysenck (EPQ-J) y, para calcular el índice de masa corporal, fueron recabadas medidas de talla y peso. Presentaron sobrepeso u obesidad 39% de los adolescentes españoles y 43% de los argentinos, con quienes se conformaron dos grupos clínicos, uno por país; mientras que ambos grupos control estuvieron constituidos por los participantes normopeso. La combinación de las variables DN y LR no arrojó diferencias significativas en cuanto a las dimensiones de personalidad. Sin embargo, ambos grupos clínicos presentaron mayor neuroticismo (NE) que sus pares control. Respecto al LR, los adolescentes argentinos registraron mayor NE y dureza emocional (4% de alto riesgo) vs.3% de alto riesgo por NE en los españoles. Los datos obtenidos no permitieron establecer un perfil psicopatológico del adolescente con sobrepeso u obesidad, dado que prevaleció la influencia del país de procedencia.

Abstract The objectives of this study were: 1. To compare the presence of overweight and obesity in adolescents from Argentina vs. Spain, 2. To compare personality according to nutritional diagnosis (ND) and place of residence (PR), and 3. To identify the presence of psychopathological risk (PR). A total of 272 adolescents, men and women from 11 to 16 years completed the Personality Questionnaire for Children of Eysenck (EPQ-J) and body mass index was calculated through height and weight measures. The 39% of the Spanish adolescents and 43% of the Argentinians presented overweight or obesity, two clinical groups were formed, one per country and both control groups were constituted by the normal weight participants. The combination of the variables ND and PR did not show significant differences in terms of personality dimensions. However, both clinical groups presented greater neuroticism (NE) than their control peers. Regarding the PR, the Argentine adolescents registered higher NE and emotional hardness (4% of high risk) than 3% of high risk of NE in the Spanish. The data obtained did not allow to establish a psychopathological profile of the overweight or obese adolescent, this is because the influence of the country of origin prevailed.

Are our rural adolescents eating healthy?: Implications for redesigning school health interventions - A cross sectional study in rural Coimbatore.

BACKGROUND: Adolescence is a period of transition where independence in thinking and behavior is established and food choices that are made are followed for several years, and this can influence their health in adulthood. Hence, understanding the eating habits are necessary to plan effective nutritional interventions in adolescents. OBJECTIVES: The main objective of the study is to find out the extent of malnutrition among rural adolescents as well as evaluate their eating habits against recommended dietary food groups and to compare eating habits across gender and age groups. METHODS: A cross-sectional study was done among 1425 adolescents from 13 rural schools from 2014 to 2015, and the variables considered in this study were age, sex, body mass index (BMI), and the eating habits of the adolescents. RESULTS: Undernutrition was seen among 23% and overweight/obesity among 8% of adolescents. The habit of taking milk and milk products, fruits, and green leafy vegetables were very poor among the adolescents. Significant association was found between eating habits and BMI. Furthermore, late adolescents had better eating habits, and significant gender difference was seen in certain eating habits. CONCLUSIONS: The study shows that it is possible to understand the gaps in eating habits of adolescents, and this can be used to plan tailor-made nutritional interventions to adolescent groups as their eating habits are different and have long-term nutritional and health implications.

Variables socio-epidemiológicas de las enteroparásitosis en escolares de la Escuela Bolivariana "Manuel Molina Hernández", Boca de Tocuyo. Estado Falcón, Venezuela / Socioepidemiological variables of intestinal parasites in students of the Bolivarian School "Manuel Molina Hernández"; Boca del Tocuyo. Falcón, States, Venezuela

Los enteroparásitos constituyen un problema de Salud Pública en los países sub-desarrollados; su identificación mediante el coproanálisis es esencial para el manejo global del escolar. Con el objetivo de caracterizar las enteroparásitosis en escolares de la primera etapa de la Escuela Bolivariana "Manuel Molina Hernández", Boca de Tocuyo-Municipio Monseñor Iturriza durante los meses de Mayo y Junio, 2011, se realizó un estudio descriptivo de corte transversal en una muestra de 36 escolares, cuyos representantes, previo consentimiento informado, autorizaron la toma de muestras de heces para el diagnóstico de enteroparasitosis. Los datos fueron analizados mediante estadística univariada y bivariada. Los Resultados obtenidos reflejaron que la presencia de parasitosis predominó en los escolares de sexo masculino (47,2%); y las edades en que prevaleció la parasitosis fue en 8años 27,8%, 7años 19,4% y 6 años 16,7%. En 58,3% de los escolares se les diagnosticó 2 y3 tipos de parasitosis. Las especies parasitarias más frecuentes fueron: Blastocystis hominis 43,3%, Endolimax nana 20%, Entamoeba histolytica 10%, Entamoeba coli 8,3% y Giardia lamblia con 6,7%. Se asoció estadísticamente el sexo con los quistes parasitarios, pero no se encontró significancia. La caracterización de la condición social aplicando el Modelo de Graffar Modificado por Méndez Castellanos, reporto que 58,3% de los escolares se ubicaron en el estrato V de Graffar. Se concluye que la parasitosis más frecuente fue B. hominis en todas las edades, seguida de E. nana, predominando la B. hominis en el sexo masculino, los escolares de 6 a 8 años fueron los más afectados que se ubican en el estrato social V.

The intestinal parasites are a public health problem in underdeveloped countries, its identification by coproanalisis is essential for the overall management of the school. The objetive was to determine the presence of intestinal parasitosis and nutritional diagnosis in schoolchildren of the first stage of the Bolivarian School "Manuel Molina Hernandez," Boca de Tocuyo-City Iturriza Municipality from May to June of 2011. A descriptive cross-sectional sample of 36 schools at the Bolivarian School "Manuel Molina Hernandez." The data collection was through a card, stool samples were taken diagnosing intestinal parasites or not and the type, display the results in absolute and relative frequency. The results observed, the most common parasites: Blastocystis hominis 27 (75%), Endolimax nanny with 12 (33.3%) and Entamoeba coli with 6 (16.6%). Entamoeba histolytica less frequent with 5 (13.8%) and Giardia lamblia with 4 (11.1%). The distribution of parasitized schoolchildren by age group, the group from 7 to 8 years had higher parasite, with 17 (47.2%) schoolchildren. The rate of parasitism by age group, the group of 5-6 and 7-8 years Blastocystis hominis with 7 predominated (63.6%) and 16 (76.19%) pupils respectively. The classification of schools by level of layer prevailed Graffar V. The nutritional diagnosis in 23 parasitized group (79.3%) was normal. The predominant parasite was B. hominis in all ages, followed by E. nana, prevailing B. hominis in men, schoolchildren 6 to 8 years were affected and in the social stratum V.

Potencial de resposta à adubação para N, P, K, Ca e Mg em cupuaçueiros avaliados por diferentes normas DRIS / Response potential to fertilization response for N, P, K, Ca and Mg in cupuaçueiros evaluated by different DRIS standards

O potencial de resposta à adubação é uma ferramenta utilizada para a interpretação dos valores dos índices DRIS, de forma que pode ser útil para verificar se diferentes grupos de normas resultam em diagnósticos distintos ou semelhantes entre si. Neste sentido, objetivou-se avaliar o comportamento do diagnóstico nutricional, submetidos a cinco grupos de normas DRIS. Para isto, amostras foliares de cupuaçueiros foram coletadas de pomares comerciais, cuja idade das plantas variou de 5 a 18 anos, sob monocultivo e sistemas agroflorestais (SAF's), obtendo-se para cada relação nutricional entre os nutrientes N, P, K, Ca, Mg, as normas DRIS bivariadas, as quais foram obtidas para o conjunto das populações monitoradas e para subpopulações específicas. As diferentes normas DRIS resultaram em diagnósticos semelhantes para N, P e Ca, enquanto que para K e Mg os diagnósticos produzidos distinguiram-se entre as normas resultando em desvios nutricionais.

The response of potential fertilization is a tool used to interpret the values of DRIS indices, so that it may be useful to see if different groups of rules might result in different or similar diagnosis among themselves. In this sense, it we aimed to evaluate the performance of the nutritional diagnosis, submitted to five groups of DRIS norms. For this, leaf samples were collected from commercial cupuaçueiro orchards, whose plant ages ranged from 5 to 18, with cropping or agroforestry (SAF). For each relationship among the nutrition nutrients N, P, K, Ca and Mg, we obtained bivariate DRIS standards for all populations and monitored for specific subpopulations. The different standards resulted in DRIS diagnoses similar for N, P and Ca and distinct for Mg and K the produced diagnoses stood out among the norms resulting in nutritional deviations.

Relações nutricionais log-transformadas para avaliação nutricional de cupuaçueiros comerciais / Log-transformed nutrient ratio for evaluation nutritional of cultivated cupuaçu trees

A transformação logarítmica das relações bivariadas no cálculo das normas e dos índices do sistema integrado de diagnose e recomendação de nutrientes (DRIS) tem sido sugerida como uma forma de melhorar a acurácia do sistema, principalmente por diminuir a inconsistência na distribuição de freqüência entre as formas de expressão direta e inversa de uma mesma relação. Neste sentido, o objetivo deste trabalho foi avaliar o uso de relações log-transformadas entre diferentes populações de referência. Amostras foliares de cupuaçu foram coletadas de 153 pomares comerciais, cuja idade das plantas variou de 5 a 18 anos, cultivados em monocultivo ou sistemas agroflorestais, obtendo-se para cada relação nutricional entre os nutrientes N, P, K, Ca, Mg, Fe, Cu, Zn, e Mn as normas DRIS bivariadas log-transformadas e não transformadas, obtidas para o conjunto da população e para condições específicas. Os resultados mostraram que as relações log-transformadas contribuem para uma maior consistência dos resultados entre as formas direta e inversa entre diferentes normas DRIS.

The logarithmic transformation of the bivariate relationships in the calculation of integrated system of diagnosis and recommendation indices (DRIS) has been suggested as a way to improve the accuracy of the system, mainly by reducing the inconsistency between the frequency distribution of the forms expression of direct and inverse of the same relationship. Accordingly, the objective of this study was to evaluate the use of log-transformed relationship between different populations of reference. Cupuaçu leaf samples were collected at 153 commercial orchards; trees were part of either monoculture or agroforestry systems and ranged from 5 to 18 years old. For each individual, the nutritional relationship was calculated for the nutrients: N, P, K, Ca, Mg, Fe, Cu, Zn and Mn. Log-transformed and no- transformed nutrient ratio were obtained for the entire population and specific conditions.The results showed that the log-transformed relationship contributes to greater consistency of results between the direct and inverse forms between DRIS norms.

Evaluación global subjetiva y antropométrica para el diagnóstico nutricional de pacientes con enfermedad hepática crónica

La enfermedad hepática crónica es una entidad frecuente y el diagnostico nutricional, es de gran utilidad para influir en la historia natural de la enfermedad; por ello esta investigación tuvo como objetivo comparar la Evaluación Global Subjetiva con la evaluación Antropométrica para el diagnostico nutricional de pacientes con Enfermedad Hepática Crónica. Se evaluaron, previo consentimiento por el Comité de Ética del Hospital Universitario de Maracaibo, 30 individuos (11 mujeres y 19 hombres) con enfermedad hepática crónica (EHC) CHILD A. Se aplicaron ambos métodos por diferentes evaluadores de acuerdo a las normas establecidas. Se aplicó el coeficiente de correlación de Pearson, a través del programa SPSS 12. (P >0,05). En el diagnostico nutricional de la evaluación antropométrica se encontró un total de 22 individuos (73.3%) se encontraban en normal, sobrepeso y obesidad; y 8 individuos (26.7%) con desnutrición proteico calórica; mientras que con la evaluación global subjetiva 22 individuos (73.3%) estaban bien nutridos, 8 (26.7%) moderadamente mal nutrido o riesgo de desnutrición (r=0,775), Se concluye que tanto la VGS como la Antropometría son aplicables para medir riesgo de desnutrición, pero la VGS no es aplicable para medir malnutrición por exceso dentro la evaluación nutricional del paciente ambulatorio con enfermedad hepática crónica.

Chronic liver disease is a common diagnosis and the nutritional diagnosis is very useful in influencing the natural history of the disease, that´s why this study objective was to compare the Subjective Global Assessment with the Anthropometric assessment for the nutritional diagnosis of patients with chronic liver disease. We assessed 30 individuals (11 women and 19 men) with chronic liver disease (EHC) CHILD A. Both methods were applied by different evaluators in accordance with established standards. It applied the Pearson correlation coefficient, through the program SPSS 12 (P> 0.05). In the anthropometrical assessment nutritional diagnosis a total of 22 individuals (73.3%) were normal, overweight and obesity, and 8 individuals (26.7%) with protein calorie malnutrition, while the 22 individuals subjective global assessment ( 73.3%) were well nourished, 8 (26.7%) moderately malnourished or at risk of malnutrition (r = 0775); was concluded that both the VGS as Anthropometrics are applicable to measure risk of malnutrition, but the VGS is not applicable to measure Malnutrition excess into the nutritional assessment in the ambulatory patient with chronic liver disease.

Diagnóstico nutricional: comparação entre os instrumentos de avaliação nutrition risk screening (nrs-2002) e avaliação nutricional do hospital de clínicas de Porto Alegre (AN-HCPA) / Nutritional diagnosis: comparison between nutrition risk screening (nrs-2002) protocol and the nutrition assessment system of hospital de clínicas de Porto Alegre (AN-HCPA)

Introdução: A desnutrição hospitalar é altamente prevalente e continua pouco identificada. Ainda não há concordância sobre qual método melhor reflete a realidade dos pacientes hospitalizados. Objetivos: Identificar o nível de concordância entre o diagnóstico nutricional para eutrofia e desnutrição quando os pacientes são avaliados pelos protocolos Nutrition Risk Screening (NRS-2002) e o utilizado no Hospital de Clínicas de Porto Alegre (AN-HCPA). Métodos: Estudo transversal em pacientes hospitalizados. As avaliações foram realizadas em momentos distintos, por pesquisadores diferentes. Resultados: Participaram 247 pacientes com idade de 50,7 ± 15,5 anos, e IMC de 21,31 ± 2,1 kg/m². O NRS-2002 encontrou 43% dos pacientes eutróficos e 57% desnutridos. O AN-HCPA identificou 50% dos pacientes com eutrofia e 50% com desnutrição. Dos 247 pacientes avaliados houve concordância em 93 pacientes no diagnóstico de eutrofia e em 110 pacientes no diagnóstico de desnutrição, com um coeficiente Kappa de 0,64 (IC 95% 0,55-0,74), p < 0,001. O AN-HCPA teve sensibilidade de 78,6% e especificidade de 86,9%, valor preditivo positivo de 88,7% e valor preditivo negativo de 75,6%. Conclusão: Os resultados demonstram que o protocolo AN-HCPA apresenta boa concordância com o método de referência NRS-2002, não considerando a gravidade da doença. Este protocolo é uma ferramenta rápida e de fácil utilização podendo ser recomendada como um instrumento sensível para caracterizar o estado nutricional de eutrofia e desnutrição dos pacientes hospitalizados.

Background: Malnutrition during hospitalization is highly prevalent and remains poorly identified. There is no agreement on the best method to assess the nutritional status of hospitalized patients. Objectives: To identify the agreement level of the eutrophy and malnutrition nutritional diagnosis when patients are evaluated using Nutrition Risk Screening (NRS-2002) protocol and the one used at Hospital de Clínicas de Porto Alegre (ANHCPA). Methods: Cross-sectional study of hospitalized patients. The evaluations were performed at distinct moments, by different researchers. Results: The study involved 247 patients of 50.7 ± 15.5 years and BMI of 21.31 ± 2.1 kg/m2. NRS-2002 classified 43% of patients with eutrophy and 57% with malnutrition. AN-HCPA identified 50% of patients with eutrophy and 50% with malnutrition. Among the 247 evaluated patients both systems agreed in 93 cases for eutrophy diagnosis and in 110 cases for malnutrition diagnosis, with Kappa coefficient of 0.64 (95% CI 0.55-0.74) p < 0.001. AN-HCPA presented a sensitivity of 78.6% and a specificity of 86.9%, positive predictive value of 88.7% and negative predictive value of 75.6%. Conclusion: The results showed that AN-HCPA has a good level of agreement with the reference method, but did not consider illness severity. This protocol is a fast and easy-to-use tool that can be recommended as a sensitive instrument to identify eutrophy and malnutrition nutritional status of hospitalized patients.

A Study on the Nutritional Knowledge, Nutritional Attitude, Eating Practice and Food Intake of Womans University Students / 예방의학회지

This study was conducted to analyze the relations among nutritional knowledge, nutritional attitude eating practice and total nutritional diagnosis and also to find the influencing factors of them. The survey was done during the period from April 1990 to June 1990 and the target population were Ewha Woman's University students (freshmen and senior) of whom 1,354 peoples were surveyed. The summarized results are as follows ; 1. For the learning environment, the percentage of completion on nutritional knowledge course was 28.6% and among them the department of foods and nutrition had the highest score(100.0%) and the next was dept. of medicine(53.4%). 2. To find the relation which the nutritional knowledge, nutritional attitude, eating practice and the total nutritional diagnosis influence on one another, the multiple correlation analysis was done. The attitude the practice were highly correlated with total nutritional diagnosis, but the correlation between nutritional knowledge and total nutritional diagnosis was not significant. The correlation between the practice and nutritional knowledge which were positively and significantly correlated with attitude respectively was positive but not significant. 3. The difference which were analyzed by department, grade and completion on knowledge course on the nutritional knowledge, attitude, eating practice were significant (p<0.01) by ANOVA. 4. The significant variables on nutritional diagnosis are the eating practice points, the grade, the knowledge course, the breakfast and the attitude (r2=10.3%) by multiple regression analysis. This study has the limitation that it did not consider the environmental factors of dietary life such as dietary culture, family environment, cultural habit. Therefore important points of these dietary studies are to extend to the practical nutritional education and dietary improvement for the national health not restricted to the local area or local population.