RESUMO
OBJECTIVE: Protein-energetic malnutrition (PEM) affects prognosis and mortality in elderly patients as an inadequate nutritional status is a risk factor for the development and worsening of pressure sores (PS). We aimed to evaluate the incidence of PEM in outpatients with PS and to study the impact of nutritional support on the stage of PS. PATIENTS AND METHODS: PS patients, divided in a group treated with artificial nutrition (group A) and those fed orally (group B) at home, were consecutively enrolled in the Integrated Home Care program of Ascoli Piceno between June and September 2015. At T0 the patients underwent medical history, nutritional, anthropometric/biochemical parameters assessment, and the staging of the PS. The same assessments and staging of the pressure lesions were performed three months later (T1). RESULTS: Group A (n=25) started from a better nutritional status vs. group B (n=25) at T0, according to MNA assessment. Group A showed a significant improvement of nutritional status correlating with detailed control of nutrients intake and improvement of PS stage (T0 vs. T1, p<0.05). On the other hand, group B showed a significant difference between nutrients intake and nutritional needs that correlated with both malnutrition state increase and worsening of the PS staging (T0 vs. T1, p<0.05). CONCLUSIONS: The present study shows that PEM has a significant prevalence in the elder, in general, and in older people with PS, in particular. A targeted nutritional intake can prevent and help the healing of PS.
Assuntos
Continuidade da Assistência ao Paciente , Nutrição Enteral/métodos , Desnutrição/terapia , Avaliação Nutricional , Estado Nutricional/fisiologia , Úlcera por Pressão/terapia , Idoso , Idoso de 80 Anos ou mais , Continuidade da Assistência ao Paciente/tendências , Ingestão de Energia/fisiologia , Nutrição Enteral/tendências , Feminino , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Projetos Piloto , Úlcera por Pressão/diagnóstico , Úlcera por Pressão/epidemiologia , Estudos ProspectivosRESUMO
OBJECTIVE: Surgery is a major stress factor that activates several inflammatory and catabolic pathways in man. An appropriate nutritional status allows the body to react properly to this stressor and recover in a faster and more efficient manner. On the other hand, malnutrition is related to a worse surgery outcome and to a higher prevalence of comorbidities and mortality. The aims of this study were to evaluate the nutritional status of patients undergoing major surgery and investigate the potential correlation between malnutrition and surgical outcomes. PATIENTS AND METHODS: Mini Nutritional Assessment (MNA) and global clinical examination (including biochemical parameters and comorbidities existence) were undertaken in 50 consecutive patients undergoing major surgery. Patients' clinical conditions were re-evaluated at 3 and 6 days after surgery, recording biochemical parameters and systemic and/or wound-related complications. RESULTS: A compromised nutritional status was present in more than half (54%) of patients (malnutrition in 10% and risk of malnutrition in 44% of patients, respectively). Females were slightly more at risk of malnutrition (48% vs. 41%, p=NS, females vs. males) and clearly malnourished (14% vs. 7%, p<0.05, females vs. males). Age was an independent risk factor for malnutrition and within the elders' group (> 80 years old) 16.70% of patients was diagnosed with malnutrition and 58.3% was at risk of malnutrition. Systemic complications were registered in all patients both at 3 and 6 days after surgery. However, well-nourished and at-risk of malnutrition patients had earlier complications that only partially resolved within six days after the operation. Malnourished patients showed fewer complications at the 3rd post-surgery follow-up day but had a worse outcome six days after surgery. CONCLUSIONS: Older age and but not female sex are independent risk factors for malnutrition development in patients undergoing major surgery. More interestingly, more than half of patients with an impaired nutritional status presented a less appropriated stress response to surgery. These data suggest that nutritional status assessment may be important to recognize patients at potential risk of surgical complications and that early nutritional interventions must be promptly arranged.
Assuntos
Estado Nutricional , Procedimentos Cirúrgicos Operatórios , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Prevalência , Fatores de Risco , Fatores SexuaisRESUMO
Synopsis A new method is described for studying the in vivo formation of oxygen reactive species (free radicals) in humans after exposure to UV radiation. The procedure is based on the quantitative determination in urine of (i) metabolic products of pentane, a hydrocarbon formed during lipid peroxidation, and (ii) thymine hydroxylated bases and deoxyribonucleosides as indices of DNA repair that has taken place. Creams containing UV filters protect the organism against free radical formation. Subjects using such cosmetic preparations during complete body tanning sessions do, in fact, have reduced urinary excretion of 2-pentanol and hydroxythmine derivatives.