Power of mortality prediction in patients awaiting liver transplantation according to the Global Leadership Initiative on Malnutrition criteria and Subjective Global Assessment and Royal Free Hospital Global Assessment scores.

OBJECTIVES: This study aimed to analyze the performance of the Global Leadership Initiative on Malnutrition (GLIM) criteria and Subjective Global Assessment (SGA) and Royal Free Hospital Global Assessment (RFH-GA) scores in predicting 12-mo mortality in patients awaiting liver transplantation. METHODS: This is a longitudinal observational study, carried out between March 2019 and November 2021. Clinical data were collected and nutritional assessment was performed through anthropometry and application of validated instruments, such as the SGA, GLIM criteria, and RFH-GA. A Cox regression model was carried out, in which the dependent variable was mortality in 1 y, and the independent variables were the classifications of nutritional status by the different methods. RESULTS: The sample consisted of 126 patients, most of them male (56.35%). Malnutrition was diagnosed in 85.71% of the patients according to the RFH-GA, 62.70% according to the SGA, and 56.31% according to the GLIM criteria. Malnutrition assessed by GLIM was related to a 3.79-fold increase in the chance of mortality over time in patients awaiting liver transplantation. Moreover, the GLIM criteria had good discriminatory power in identifying mortality in patients awaiting liver transplantation, compared with the initial and final SGA and RFH-GA scores and the Model for End-stage Liver Disease-Sodium (MELD-Na) index. CONCLUSIONS: The GLIM criteria were a good predictor of increased risk of mortality in malnourished patients with chronic liver disease awaiting liver transplantation, compared with the SGA and RFH-GA scores and the MELD-Na index.

Unbalance of Se and nutritional status in male infertility.

OBJECTIVE: To evaluate the selenium status and oxidative stress in male infertility cases selected from a private human reproduction center in the state of Ceará, Brazil. METHODS: The present study had a cross-sectional quantitative approach, carried out between January and October 2013 at a Human Reproduction Center. The studied population was composed of 49 male individuals seen at the clinic, aged between 18 and 60 years. Blood samples were collected to measure serum selenium concentrations, erythrocyte activity and glutathione peroxidase. After medical diagnosis, the participants were divided into fertile and infertile groups. Blood samples were collected for establishing Se concentrations in plasma and erythrocytes, and measurements of the enzymatic activity of glutathione peroxidase in the erythrocytes. RESULT: it resulted in 53.1% of fertile men and 46.9% of infertile men. The average age of the fertile group was 34.1 years and the infertile group was 37.3 years. Regarding the assessment of nutritional status, the scatter diagram of the infertility group showed a higher body mass index and waist circumference, showing that this group has a higher risk of global and abdominal obesity compared to the fertile group (p<0.0001, respectively). There were similarities between the groups regarding caloric intake, macronutrient and selenium intake. CONCLUSION: We can conclude that the serum values of selenium, in excess and in deficiency, can be harmful to male fertility.

Estado nutricional e qualidade de vida de pacientes em tratamento crônico de hemodiálise em lista de espera de um centro de transplante renal em Fortaleza, Ceará / Nutritional status and quality of life in patients under chronic hemodialysis on a waiting list from a kidney transplantation center in Fortaleza, Ceará, Brazil

Objetivo: Investigar a associação entre o estado nutricional e a qualidade de vida de pacientes dialíticos em lista de espera para Transplante Renal (TxR) de um centro de transplante em Fortaleza, Ceará. Métodos: Estudo caráter transversal analítico, realizado entre agosto a outubro de 2018, no qual foram avaliados o estado nutricional (EN) e a qualidade de vida (QV), utilizando a versão brasileira do questionário SF-36, em 52 pacientes de um centro de TxR de um hospital universitário da rede pública de saúde. Resultados: Observou-se que a maioria dos pacientes eram eutróficos de acordo com os parâmetros índice de massa corporal (59,6%), circunferência do braço (48,1%) e circunferência muscular do braço (75,0%); no entanto, de acordo com prega cutânea triciptal, 59,6% da amostra encontrava-se desnutrida. Com relação às dimensões de QV, verificou-se que os "Aspectos Físicos" e "Estado Geral de Saúde" tiveram os piores escores, mas apresentaram associação significativa com o sexo feminino (p=0,046) e com o IMC (p=0,010), respectivamente. Já a dimensão "Capacidade Funcional" apresentou associação significativa com a população masculina (p=0,045). Conclusão: Observou-se comprometimento em algumas das dimensões de QV, as quais sugeriram guardar relação com o sexo e o EN. Assim, ressalta-se a importância da realização periódica do diagnóstico nutricional e da avaliação da QV, visto que os pacientes renais dialíticos listados merecem atenção especial, pois apresentam diversas fragilidades físicas, sociais e emocionais, que podem comprometer aspectos importantes no EN e na QV durante o cuidado antes e após o TXR e impactar no tratamento da doença. (AU)

Objective: To investigate the association between nutritional status and quality of life in patients under hemodialysis from a kidney transplantation center in Fortaleza, Ceará waiting for kidney transplantation. Methods: Cross-sectional analytical study carried out from August to October 2018, in which the patients' nutritional status and quality of life were evaluated using the Brazilian version of the SF-36 questionnaire. A total of 52 patients from a kidney transplantation center belonging to a public university hospital participated. Results: It was observed that most patients were eutrophic according to the body mass index (59.6%), arm circumference (48.1%), and arm muscle circumference (75.0%) parameters; however, based on the tricipital skin-fold measurement, 59.6% of the sample was malnourished. Regarding the quality of life dimensions, the "physical role functioning" and "general health perceptions" had the worst scores, but a significant association with female gender (p = 0.046) and body mass index (p=0.010), respectively. The "physical functioning" dimension, on the other hand, was significantly associated with male gender (p=0.045). Conclusion: Compromise was observed in some quality of life dimensions, and the findings suggest a relationship between quality of life and sex and nutritional status. Patients under hemodialysis deserve special attention as they present several physical, social, and emotional weaknesses that can compromise important nutritional aspects and quality of life before and after transplantation, affecting the treatment of the disease. Thus, the importance of periodic nutritional diagnosis and quality of life assessment is emphasized. (AU)

Correlation between nutritional assessment and oxidative stress in candidates for liver transplant.

OBJECTIVE: To evaluate the oxidative profile, nutritional status and food intake (caloric value; macronutrients; vitamins A, E and C; and zinc), and to correlate oxidative stress with nutritional status in patients who were candidates for liver transplant. METHODS: This is a cross-sectional, analytical, and descriptive study with 51 candidates for liver transplant. Sociodemographic and clinical data, anthropometric parameters, food consumption, and a 10mL blood sample were collected from each patient. Oxidative stress was analyzed by the thiobarbituric acid method. The consumption of macronutrients, caloric value and micronutrients (zinc, vitamins A, E and C) were qualitatively analyzed, and zinc was also quantitatively analyzed. RESULTS: The mean age was 49.17±8.17 years. The highest percentage of malnutrition was according to arm muscle circumference (56.86%), followed by arm circumference (52.94%), triceps skin fold (50.98%), and body mass index (1.96%). The mean malondialdehyde level was 14.80±8.72µM/L, presenting a negative correlation with the body mass index for patients with liver cirrhosis according to IMC-Campillo values (p=0.001; r=-0.430). Low energy, carbohydrate, protein, vitamin A and E consumption were observed in more than 50% of subjects. CONCLUSION: This study showed an association of nutritional status through body mass index for patients with liver cirrhosis according to IMC-Campillo, with oxidative stress in patients with liver cirrhosis on a liver transplant waiting list.

Correlation between nutritional assessment and oxidative stress in candidates for liver transplant / Correlação entre avaliação nutricional e estresse oxidativo em candidatos ao transplante hepático

ABSTRACT Objective To evaluate the oxidative profile, nutritional status and food intake (caloric value; macronutrients; vitamins A, E and C; and zinc), and to correlate oxidative stress with nutritional status in patients who were candidates for liver transplant. Methods This is a cross-sectional, analytical, and descriptive study with 51 candidates for liver transplant. Sociodemographic and clinical data, anthropometric parameters, food consumption, and a 10mL blood sample were collected from each patient. Oxidative stress was analyzed by the thiobarbituric acid method. The consumption of macronutrients, caloric value and micronutrients (zinc, vitamins A, E and C) were qualitatively analyzed, and zinc was also quantitatively analyzed. Results The mean age was 49.17±8.17 years. The highest percentage of malnutrition was according to arm muscle circumference (56.86%), followed by arm circumference (52.94%), triceps skin fold (50.98%), and body mass index (1.96%). The mean malondialdehyde level was 14.80±8.72μM/L, presenting a negative correlation with the body mass index for patients with liver cirrhosis according to IMC-Campillo values (p=0.001; r=-0.430). Low energy, carbohydrate, protein, vitamin A and E consumption were observed in more than 50% of subjects. Conclusion This study showed an association of nutritional status through body mass index for patients with liver cirrhosis according to IMC-Campillo, with oxidative stress in patients with liver cirrhosis on a liver transplant waiting list.

RESUMO Objetivo Avaliar o perfil oxidativo, o estado nutricional e o consumo alimentar (valor calórico; macronutrientes; vitaminas A, E e C; e zinco), e correlacionar o estresse oxidativo com o estado nutricional em pacientes candidatos ao transplante hepático. Métodos Trata-se de estudo transversal, analítico e descritivo com 51 pacientes candidatos ao transplante hepático. Coletaram-se dados sociodemográficos e clínicos, parâmetros antropométricos, consumo alimentar e amostra de 10mL de sangue de cada paciente. O estresse oxidativo foi analisado por método do ácido tiobarbitúrico. O consumo de macronutrientes, do valor calórico e dos micronutrientes (zinco, vitaminas A, E e C) foi analisado qualitativamente, e o zinco também foi analisado quantitativamente. Resultados A média de idade foi de 49,17±8,17 anos. Maior percentual de desnutrição esteve de acordo com circunferência muscular do braço (56,86%), seguida de circunferência do braço (52,94%), dobra cutânea triciptal (50,98%) e índice de massa corporal (1,96%). A média do malondialdeído foi de 14,80±8,72µM/L, apresentando correlação negativa com os valores do índice de massa corporal para pacientes com cirrose hepática segundo IMC-Campillo (p=0,001; r=-0,430). Observou-se baixo consumo de energia, carboidrato, proteína, e vitaminas A e E em mais de 50% dos indivíduos. Conclusão Este estudo mostrou associação do estado nutricional, por meio do índice de massa corporal para pacientes com cirrose hepática segundo IMC-Campillo, com o estresse oxidativo em paciente com cirrose hepática em lista de transplante de fígado.

Risco nutricional e desnutrição em pacientes portadores de doença hepática crônica de um hospital universitário / Nutritional risk and malnutrition in patients with liver cirrhosis in a university hospital

INTRODUÇÃO: a doença hepática crônica leva a diversas alterações orgânicas e funcionais que impactam sobre o estado nutricional. OBJETIVO: avaliar o risco e o estado nutricional de pacientes portadores de Doença Hepática Crônica de um Hospital Universitário. MÉTODOS: estudo transversal, composta por 100 pacientes maiores de 18 anos. Foram coletados dados sóciodemográficos, antropométricos e funcionais. Os parâmetros antropométricos utilizados foram Índice de Massa Corporal, circunferência corporal, dobras cutâneas e Força do Aperto de Mão. Utilizaram-se as seguintes triagens: Avaliação Subjetiva Global, Royal Free Hospital - Global Assessment e Royal Free Hospital Nutritional Prioritizing Tool. Foram utilizados o teste Qui-quadrado de Pearson e correlação de Spearman, considerando nível de significância de 5%. RESULTADOS: observou-se predomínio de homens (57,0%), com idade de média de 51,9±11,69 anos. Houve predomínio de alto risco nutricional (55%) e de desnutrição. Dentre os métodos subjetivos, detectou-se desnutrição principalmente pela Royal Free Hospital - Global Assessment. Considerando-se todos os parâmetros, a desnutrição foi detectada principalmente pela força do aperto de mão, que se correlacionou positivamente com índice de massa corporal (r=0,207; p < 0,039), circunferência muscular do braço (r=0,232; p = 0,020), espessura de músculo adutor do polegar (r=0,206; p = 0,040) e área muscular do braço corrigida (r=0,160; p = 0,113). DISCUSSÃO: estudos mostram que os pacientes com doença hepática têm risco nutricional elevado e alta prevalência de desnutrição. CONCLUSÃO: a população estudada encontrou-se em alto risco nutricional e com desnutrição, sobretudo pela menor força do aperto de mão

INTRODUCTION: liver cirrhosis leads to several organic and functional changes that impact on nutritional status. OBJECTIVE: To assess the risk and nutritional status of patients with liver cirrhosis at a university hospital METHODS: cross-sectional study, comprising 100 patients over 18 years of age. Sociodemographic, anthropometric and functional data were collected. The anthropometric parameters used were body mass index, body cir cum ference, skinfolds and handgrip strength. The following screenings were used: Subjective Global Assessment, Royal Free Hospital - Global Assessment and Royal Free Hospital Nutritional Prioritizing Tool. Pearson's Chi-square test and Spearman's correlation were used, considering a signi ficance level of 5%. RESULTS: There was a predominance of men (57.0%), with a mean age of 51.9 ± 11.69 years. There was a predo minance of high nutritional risk (55%) and malnutrition. Among the subjective methods, malnutrition was detected mainly by the Royal Free Hospital - Global Assessment. Considering all parameters, malnutrition was detected mainly by the handgrip strength, which was positively correlated with body mass index (r = 0.207; p <0.039), arm muscle circumference (r = 0.232; p = 0.020), adductor pollicis muscle thickness (r = 0.206; p = 0.040) and corrected arm muscle area (r = 0.160; p = 0.113). DISCUSSION: studies show that patients with liver disease have a high nutritional risk and a high prevalence of malnutrition. CONCLUSION: The studied population was found to be at high nutritional risk and malnourished, mainly due to the lower handgrip strength

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Fatores nutricionais associados ao ângulo de fase empacientes pré-transplante de células-tronco hematopoiéticas / Nutritional factors associated with phase angle in hematopoietic stem cellpre-transplant patients

INTRODUÇÃO: O ângulo de fase tem sido utilizado como parâmetro de avaliação nutricional em diversas condições clínicas, inclusive em pacientes oncológicos. OBJETIVO: Avaliar a prevalência de baixo ângulo de fase e a relação com o perfil clínico e nutricional em pacientes pré-transplante de células-tronco hematopoiéticas. MÉTODOS: Estudo transversal realizado no período de maio a dezembro de 2018 em um hospital universitário no Nordeste brasileiro, envolvendo 80 pacientes admitidos para realização do transplante de células-tronco hematopoiéticas, com idade acima de 18 anos. O estado nutricional foi avaliado através de índice de massa corporal, circunferências, dobras cutâneas, força de preensão manual, índice de massa muscular esquelética. O ângulo de fase foi determinado por meio da bioimpedância elétrica, considerando baixo ângulo valor inferior a 5° para ambos os sexos. RESULTADOS: A média de idade foi de 47,5±15,2 anos e 51,2% eram do sexo masculino, sendo o transplante autólogo o de maior indicação (71,3%). Constatou-se que 8,8% dos pacientes apresentaram desnutrição pelo índice de massa corporal e 65% pela espessura de músculo adutor do polegar. Foi observada uma prevalência de 27,7% de baixo ângulo de fase. Houve associação significativa entre o baixo ângulo de fase e idade acima de 60 anos (p = 0,002), transplante autólogo (p = 0,04) e baixo índice de massa muscular esquelética (p = 0,01). DISCUSSÃO: Estudos mostram que o baixo ângulo de fase está associado ao risco nutricional ou desnutrição. Porém, ainda são necessários mais estudos na temática em pacientes com indicação ao transplante de células-tronco hematopoiéticas. CONCLUSÃO: O estudo revelou que houve prevalência considerável de pacientes com baixo ângulo de fase. Este indicador mostrou associação com índice de massa muscular esquelética

INTRODUCTION: The phase angle has been used as a nutritional assessment parameter in several clinical con ditions, including cancer patients. OBJECTIVE: To evaluate the prevalence of low phase angle and the relationship with the clinical and nutritional profile in pre-transplant for hematopoietic stem cell patients. METHODS: A cross-sectional study was conducted from may to december 2018 at a universitary hospital in brazilian Northeast. Eighty patients admitted for hematopoietic stem cell transplantation, aged above 18 years was evaluated. Nutritional status was assessed by body mass index, body circumferences, skinfolds, handgrip strength, skeletal muscle mass index. The phase angle was determined by bioelectrical impedance, considering low phase angle below 5 ° for both genders. RESULTS: The mean age was 47.5 ± 15.2 years and 51.2% were male, with autologous transplantation being the most indicated (71.3%). It was found that 8.8% of patients had malnutrition by body mass index and 65% by adductor pollicis muscle thickness. A prevalence of 27.7% of low phase angle was observed. There was a significant association between low phase angle and age over 60 years (p = 0.002), autologous transplantation (p = 0.04) and low skeletal muscle mass index (p = 0.01). DISCUSSION: Studies have shown that low phase angle is associated with nutritional risk or malnutrition. However, further studies on the subject are needed in patients with indication for hematopoietic stem cell transplantation. CONCLUSION: In this study, there was a considerable prevalence of patients with low phase angle. This indicator was associated with skeletal muscle mass index

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Avaliação do Risco Nutricional em Pacientes Onco-Hematológicos Hospitalizados / Evaluation of Nutritional Risk in Hospitalized Oncohematologic Patients / Evaluación del Riesgo Nutricional en Pacientes Onco-Hematológicos Hospitalizados

Introdução: O diagnóstico precoce do risco nutricional pode melhorar o prognóstico dos pacientes onco-hematológicos. Objetivo:Descrever o estado nutricional nos pacientes onco-hematológicos e avaliar os fatores associados ao risco nutricional nos pacientes onco-hematológicos de um hospital universitário terciário de Fortaleza - Ceará. Método: Estudo transversal que incluiu 127 pacientes adultos internados. Os dados de diagnóstico clínico e demográficos foram coletados por meio da análise de prontuários. O estado nutricional foi avaliado pelo índice de massa corporal (IMC), circunferência braquial (CB) e pela aplicação da ferramenta de triagem de risco nutricional - NRS-2002. Resultados: Pelos diferentes parâmetros, houve divergências no estado nutricional. A maioria da amostra apresentava risco nutricional de acordo com a avaliação da NRS-2002 (70,1%; n=89), seguida pela CB (33,9%; n=43) e pelo IMC (8,7%; n=11). Houve correlação positiva significativa entre IMC e idade [r=0,313, p<0,001] e CB [r=0,846, p<0,001], e associação significativa entre NRS-2002≥3 e IMC<18,5 kg/m² (p=0,023); NRS-2002 ≥3 e CB classificada como desnutrição (p=0,001); IMC<18,5kg/m² e CB classificada como desnutrição; e residir em zona urbana e apresentar CB adequada (p=0,023). Conclusão: Este estudo revelou alta prevalência de risco nutricional, bem como uma associação significativa entre risco nutricional e baixos valores de IMC e CB, e residir em zona rural. Assim, há a necessidade de utilizar uma combinação de indicadores, a fim de diagnosticar, de forma mais precisa e precoce, o estado nutricional desses pacientes.

Introduction: Early diagnosis of nutritional risk may improve the prognosis of oncohaematological patients. Objective: To describe the nutritional status and to evaluate the nutritional risk factors in oncohaematological patients of a tertiary university hospital in Fortaleza, Ceará. Method: This cross-sectional study included 127 patients hospitalized. Clinical and demographic diagnostic data were selected through chart analysis. The nutritional status was elaborated by body mass index (BMI), arm circumference (AC) and by the application of the nutritional risk screening (NRS-2002). Results:Due to the different parameters, there were differences in nutritional status. The majority of the presentation criteria were NRS-2002 70.1% (n=89), followed by the AC 33.9% (n=43) and the BMI 8.7% (n=11). There was a significant positive correlation between BMI and age [r=0.313, p<0.001] and AC [r=0.846, p<0.001]. There was a significant association between NRS-2002≥3 and BMI<18.5 kg/m² (p=0.023); NRS-2002≥3 and AC classified as malnutrition (p=0.001); BMI<18.5 kg/m² and AC classified as malnutrition; and reside in urban areas and present adequate AC (p=0.023). Conclusion: This study revealed a high prevalence of nutritional risk, as well as a significant association between nutritional risk and low BMI, AC and to reside in rural areas. Thus, there is a need to use a combination of indicators to diagnose the nutritional status of these patients in a more precise and early manner.

Introducción: El diagnóstico precoz del riesgo nutricional puede mejorar el pronóstico de los pacientes onco-hematológicos. Objetivo: Describir el estado nutricional en los pacientes onco-hematológicos y evaluar los factores asociados al riesgo nutricional en los pacientes onco-hematológicos de un Hospital Universitario Terciario de Fortaleza - Ceará. Método: Estudio transversal que incluyó a 127 pacientes adultos internados. Los datos de diagnóstico clínico y demográfico fueron recolectados a través de análisis de prontuarios. El estado nutricional fue evaluado por el índice de masa corporal (IMC), circunferencia braquial (CB) y por la aplicación de la herramienta de clasificación de riesgo nutricional - NRS-2002. Resultados: Diferentes parámetros, hubo divergencias en el estado nutricional. La mayoría de la muestra presentaba riesgo nutricional de acuerdo con la evaluación de la NRS-2002 70,1% (n=89), seguida por la CB 33,9% (n=43) y por IMC 8,7% (n=11). Se observó una correlación positiva significativa entre el IMC y la edad [r=0,313, p<0,001] y CB [r=0,846, p<0,001]. Se observó una asociación significativa NRS-2002≥3, e IMC<18,5 kg/m² (p=0,023) y CB desnutrida (p=0,001). Hubo asociación significativa entre IMC<18,5kg/m² y CB desnutrida (p=0,001), y entre residir en zona urbana y presentar CB adecuado (p=0,023). Conclusión: Alta prevalencia de riesgo nutricional, así como una asociación significativa entre riesgo nutricional y bajos valores de IMC y CB, y residir en zonas rurales. Hay la necesidad de utilizar una combinación de indicadores para diagnosticar de forma más precisa y precoz el estado nutricional de estos pacientes.

Cardiovascular risk and use of conicity index in patients submitted to autologous hematopoietic stem cell transplantation.

OBJECTIVE: To analyze the prevalence of overweight and the use of conicity index for cardiovascular risk assessment in individuals submitted to autologous hematopoietic stem cell transplantation. METHODS: The sample comprised 91 patients of both sexes, who underwent autologous hematopoietic stem cell transplantation from September 2008 to December 2013, aged 18 years or over. To determine the nutritional profile, we collected anthropometric data on weight, height, waist circumference upon hospital admission. The body mass index and the conicity index were calculated. RESULTS: A total of 91 patients diagnosed with multiple myeloma, Hodgkin's lymphoma, non-Hodgkin's lymphoma and other conditions were evaluated. The mean age was 43.5 (14.2) years, 63.7% were male. We verified that according to the body mass index, 63.7% were overweight and, according to waist circumference, 74.7% had a higher risk for cardiovascular diseases. According to the calculation of the conicity index, 92.3% of patients presented increased cardiovascular risk. Patients with multiple myeloma had a higher conicity index when compared to other patients (p<0.01). CONCLUSION: This study revealed a high prevalence of overweight and cardiovascular risk. It should be noted that the conicity index was a good method to evaluate cardiovascular risk and that new studies using this index should be performed.

Cardiovascular risk and use of conicity index in patients submitted to autologous hematopoietic stem cell transplantation / Risco cardiovascular e uso do índice de conicidade em pacientes submetidos ao transplante autólogo de células-tronco hematopoiéticas

ABSTRACT Objective To analyze the prevalence of overweight and the use of conicity index for cardiovascular risk assessment in individuals submitted to autologous hematopoietic stem cell transplantation. Methods The sample comprised 91 patients of both sexes, who underwent autologous hematopoietic stem cell transplantation from September 2008 to December 2013, aged 18 years or over. To determine the nutritional profile, we collected anthropometric data on weight, height, waist circumference upon hospital admission. The body mass index and the conicity index were calculated. Results A total of 91 patients diagnosed with multiple myeloma, Hodgkin's lymphoma, non-Hodgkin's lymphoma and other conditions were evaluated. The mean age was 43.5 (14.2) years, 63.7% were male. We verified that according to the body mass index, 63.7% were overweight and, according to waist circumference, 74.7% had a higher risk for cardiovascular diseases. According to the calculation of the conicity index, 92.3% of patients presented increased cardiovascular risk. Patients with multiple myeloma had a higher conicity index when compared to other patients (p<0.01). Conclusion This study revealed a high prevalence of overweight and cardiovascular risk. It should be noted that the conicity index was a good method to evaluate cardiovascular risk and that new studies using this index should be performed.

RESUMO Objetivo Analisar a prevalência de excesso de peso e a utilização do índice de conicidade para a avaliação do risco cardiovascular em indivíduos submetidos ao transplante autólogo de células-tronco hematopoiéticas. Métodos A amostra foi composta por 91 pacientes, de ambos os sexos, submetidos ao transplante autólogo de células-tronco hematopoiéticas, de setembro de 2008 a dezembro de 2013, com idade igual ou superior a 18 anos. Para traçar o perfil nutricional, foram coletados dados antropométricos, como peso, altura e circunferência da cintura, na admissão hospitalar. Calcularam-se o índice de massa corporal e o índice de conicidade. Resultados Foram avaliados 91 pacientes, diagnosticados com mieloma múltiplo, linfoma de Hodgkin, linfoma não Hodgkin e outras patologias. A média de idade foi de 43,5 (14,2) anos, e 63,7% eram do sexo masculino. Verificou-se que, de acordo com o índice de massa corporal, 63,7% apresentavam excesso de peso e, segundo a circunferência da cintura, 74,7% possuíam maior risco para doenças cardiovasculares. De acordo com o cálculo do índice de conicidade, constatou-se que 92,3% dos pacientes apresentavam risco cardiovascular aumentado. Os pacientes com mieloma múltiplo apresentaram índice de conicidade mais elevado, se comparado aos outros pacientes (p<0,01). Conclusão Este estudo revelou alta prevalência de excesso de peso e de risco cardiovascular. Salienta-se que o índice de conicidade se mostrou um bom método para avaliação do risco cardiovascular e que novos estudos utilizando este índice devem ser realizados.

Estado Nutricional e indicadores de qualidade em terapia nutricional de pacientes hematológicos internados em Hospital Público Universitário do Brasil / Nutritional status ans quality indicators in nutritional therapy of hematological patients hospitalized in Public University Hospital of Brazil

Objetivo: Avaliar o estado nutricional e a prevalência de adequação dos indicadores de qualidade em terapia nutricional (IQTNs) de pacientes hospitalizados na unidade de hematologia. Métodos: Estudo de caráter transversal, retrospectivo e descritivo, realizado no período fevereiro a maio de 2017, no qual foi avaliado o estado nutricional e os IQTNs (1- realização de triagem nutricional até 48 horas de internação, 2- medida de Índice de Massa Corporal (IMC), 3- catabolismo proteico pela circunferência do braço) de 133 pacientes internados na unidade de hematologia do Hospital Universitário da rede pública de saúde em Fortaleza, por meio de informações contidas no banco de dados dos serviços de nutrição. Resultados: A amostra predominante era do sexo feminino (60,9%). A idade média geral foi em torno de 45±16,0 anos. Observou-se que a maioria dos pacientes avaliados foram classificados como eutróficos pelo IMC (41,6%) e circunferência do braço (43,6%); no entanto, de acordo com a triagem nutricional, a maioria dos pacientes internados encontrava- se em risco nutricional (55,3%). Com relação aos IQTNs, observou-se conformidade no indicador 1 e não conformidade nos indicadores 2 e 3. Conclusão: Conclui-se que a maioria dos pacientes eram eutróficos; no entanto, apresentavam risco nutricional. Além disso, O IMC foi o único indicador de qualidade que atingiu a meta proposta. Sendo assim, ressalta-se a importância da avaliação periódica dos outros IQTNs do serviço de nutrição, visto que os pacientes hematológicos merecem atenção especial por apresentarem elevado risco nutricional e necessitarem de cuidados rigorosos

Objective: To evaluate the nutritional status and the adequacy prevalence of quality indicators for nutrition therapy (QINTs) of hospitalized patients in the hematology unit. Methods: A cross-sectional, retrospective and descriptive study was carried out between February and May 2017, in which nutritional status and QINTs were evaluated (1- nutritional screening up to 48 hours of hospitalization, 2- body mass index (BMI), 3- protein catabolism by arm circumference) of 133 patients hospitalized at the University Hospital of the public health service in Fortaleza, through information contained in the database of the nutrition services. Results: The predominant sample was female (60.9%). Overall mean age was around 45 ± 16.0 years. It was observed that the majority of the evaluated patients were classified as eutrophic based on BMI (41.6%) and arm circumference (43.6%); however, according to nutritional screening, most hospitalized patients were at nutritional risk (55.3%). With regard to QINTs, compliance with indicator 1 and nonconformity in indicators 2 and 3 were observed. Conclusions: It is concluded that the majority of patients were eutrophic; however, presented nutritional risk. The BMI was the only quality indicator that met the proposed goal. Therefore, the importance of periodic evaluation of other indicators of quality of nutrition service is emphasized, since hematological patients deserve special attention because they present high nutritional risk and require rigorous care

Objetivo: Evaluar el estado nutricional y la prevalencia de adecuación de los indicadores de calidad en terapia nutricional (IQTNs) de pacientes hospitalizados en la unidad de hematología. Método: El estudio de carácter transversal, retrospectivo y descriptivo, realizado en el período febrero a mayo de 2017, en el cual se evaluó el estado nutricional y los IQTNs (1- realización de clasificación nutricional hasta 48 horas de internación, 2- medida de Índice de Masa Corporal (IMC), 3- catabolismo proteico por la circunferencia del brazo) de 133 pacientes internados en la unidad de hematología del Hospital Universitario de la red pública de salud en Fortaleza, por medio de informaciones contenidas en el banco de datos de los servicios de nutrición. Resultados: La muestra predominante era del sexo femenino (60,9%). La edad media general fue de alrededor de 45 ± 16,0 años. Se observó que la mayoría de los pacientes evaluados fueron clasificados como eutróficos por el IMC (41,6%) y circunferencia del brazo (43,6%); sin embargo, de acuerdo con la clasificación nutricional, la mayoría de los pacientes internados se encontraba en riesgo nutricional (55,3%). Con respecto a los IQTNs, se observó conformidad en el indicador 1 y no conformidad en los indicadores 2 y 3. Conclusiones: Se concluye que la mayoría de los pacientes eran eutróficos; sin embargo, presentaban riesgo nutricional. Además, el IMC fue el único indicador de calidad que alcanzó la meta propuesta. Por lo tanto, se resalta la importancia de la evaluación periódica de los otros IQTNs del servicio de nutrición, ya que los pacientes hematológicos merecen atención especial por presentar un alto riesgo nutricional y necesitan cuidados rigurosos