Food insecurity and malnutrition in older adults from the Family Health Strategy in the Northeast of Brazil / Inseguridad alimentaria y desnutrición en adultos mayores de la Estrategia Salud de la Familia del nordeste brasileño

Introduction: Food insecurity (FI) is a state characterized by instability and irregularity of access to food. This condition has negative impacts on dietary intake, affecting nutritional status and health condition. Objective: To evaluate the association between malnutrition and FI among communitydwelling older adults attended to under the Family Health Strategy (FHS). Materials and methods: This is a cross-sectional study conducted using communitydwelling older adults attended to under the FHS in the municipality of Barreiras, in Bahia, Brazil. Between 2017 e 2018, we collected demographic, social, economic, health condition, lifestyle, anthropometric, and food consumption data. We evaluated nutritional status using the Mini Nutritional Assessment (MNA) and we assessed FI with the Brazilian Food Insecurity Scale (EBIA). Besides the chi-squared test, we carried out a binary logistic regression to verify the association between malnutrition and FI, adjusted for possible confounding factors. The significance level was p<0.05. Results: We evaluated 307 older adults with a mean age of 70.4 (±7.5 years). The prevalence of malnutrition/risk of malnutrition was 35.2% and that of FI was 63.5%. Households with older adults in moderate/severe FI presented almost three times more chance (OR 2.97; CI95% 1.37-6.44) of having malnutrition compared with those in food security. Conclusions: The study indicates that there is an association between household FI and malnutrition/risk of malnutrition among older adults from the FHS, especially among those in severe FI. This result attributes to FI the status of determinant of malnutrition in older adults within the context investigated(AU)

Introducción: La inseguridad alimentaria (IA) es un estado caracterizado por la inestabilidad e irregularidad en el acceso a los alimentos. Esta condición tiene impactos negativos en la ingesta de alimentos, afectando el estado nutricional y la condición de salud. Objetivo: Evaluar la asociación entre desnutrición e IA en adultos mayores comunitarios atendidos en la Estrategia Salud de la Familia (ESF). Materiales y métodos: Estudio transversal realizado con ancianos de comunidad atendidos en la ESF del municipio Barreiras, Bahía, Brasil. Entre 2017 y 2018, se recolectaron datos demográficos, sociales, económicos, condición de salud, estilo de vida, antropométricos y de consumo de alimentos. El estado nutricional se evaluó por la Mini Evaluación Nutricional (MEN) y la IA con la Escala Brasilera de Inseguridad Alimentaria (EBIA). Además de la prueba de chi-cuadrado, se realizó una regresión logística binaria para verificar la asociación entre desnutrición e IA, ajustada para posibles factores de confusión. El nivel de significancia fue p<0,05. Resultados: Fueron evaluados 307 ancianos, con una edad media de 70,4 (±7,5 años). La prevalencia de desnutrición/riesgo de desnutrición fue de 35,2% y la de IA de 63,5%. Los hogares con adultos mayores en IA moderada/grave presentaron casi tres veces más chance (OR 2,97; IC95% 1,37-6,44) de tener desnutrición en comparación con aquellos en Seguridad Alimentaria y Nutricional. Conclusiones: El estudio apunta que existe asociación entre la IA domiciliaria y desnutrición/ riesgo de desnutrición entre los ancianos de la ESF, especialmente entre aquellos con IA severa. Este resultado atribuye a la IA un estatus de determinante de la desnutrición en ancianos en el contexto investigado(AU)

Análise descritiva da mini avaliação nutricional em idosos da universidade aberta à terceira idade ­ UATI / Descriptive analysis of the mini nutritional assessment in the elderly at the open university for the third age ­ UATI

Introdução: o envelhecimento populacional é um fenômeno universal devido ao processo de transição demográfica característico de diversos países. Nesse processo, observam-se alterações fisiológicas e nutricionais nos indivíduos, acompanhadas do declínio das atividades funcionais cotidianas. A Mini Avaliação Nutricional foi desenvolvida para detectar a desnutrição ou o risco nutricional. Trata ­ se de uma ferramenta simples, de fácil aplicação, efetiva e validada, para utilização em pacientes idosos. Objetivo: avaliar o estado nutricional através da aplicação da Mini Avaliação Nutricional (MAN) e fatores associados em idosos frequentadores da Universidade Aberta à Terceira Idade (UATI), situada em Salvador, Bahia. Metodologia: trata-se de um estudo observacional, analítico e de corte transversal, em que foram avaliados 52 idosos a partir de 60 anos, de ambos os sexos, admitidos entre os meses de fevereiro e junho de 2021. Na avaliação do estado nutricional, utilizou ­ se a MAN e, para a análise estatística, foi aplicado o programa Statistical Package for Social Science 20.0. A amostra foi categorizada em três grupos: adequado, risco de desnutrição e desnutrição. Utilizou-se o teste de qui quadrado, considerando p<0,05. Conclusão: os Resultados encontrados neste estudo mostram que há prevalência e um elevado risco de desnutrição nos pacientes idosos da UATI. Os grupos estudados se caracterizam por maior frequência do sexo feminino, faixa etária entre 60 e 69 anos, sem ocupação e com hipossuficiência financeira. A aplicação desse método de avaliação nutricional em idosos é de baixo custo e de fácil reprodutividade e tem demonstrado eficácia no rastreio da desnutrição de forma precoce, proporcionando intervenções nutricionais mais rápidas e efetivas, especialmente no contexto da saúde pública.

Introduction: population aging is a universal phenomenon due to the demographic transition process characteristic of several countries. In this process, physiological and nutritional changes are observed in individuals, accompanied by a decline in daily functional activities. The mini nutritional assessment was developed to detect malnutrition or nutritional risk. It is a simple, easy-to-apply, effective and validated tool for use in elderly patients. Objective: to evaluate the nutritional status through the application of the mini nutritional assessment (man) and associated factors in elderly people attending the universidade aberta à terceira idade (uati) [open university for the third age ­ elderly], located in salvador, bahia. Methods: this is an observational, analytical and cross-sectional study, in which 52 elderly people aged 60 years and over, of both sexes, admitted between february and june 2021, were evaluated. In the assessment of nutritional status, man was used and, for statistical analysis, the statistical package for social science 20.0 program was applied. The sample was categorized into three groups: adequate, risk of undernutrition and malnutrition. The chi-square test was used, considering p<0.05. Conclusion: the Results found in this study show that there is a prevalence and a high risk of malnutrition in elderly patients at the uati. The groups studied are characterized by a higher frequency of females, aged between 60 and 69 years, without occupation and with financial deficiency. The application of this method of nutritional assessment in the elderly is low-cost and easily reproducible and has been shown to be effective in screening for malnutrition at an early stage, providing faster and more effective nutritional interventions, especially in the context of public health.

Malnutrición por exceso, alteraciones de salud mental y autoconcepto en población infanto-juvenil: revisión integrativa / Malnutrition due to excess, mental health disorders and self-concept in children and adolescents: an integrative review / Desnutrição por excesso, transtornos mentais e autoconceito em crianças e adolescentes: uma revisão integrativa

Introducción: Tanto la malnutrición por exceso como enfermedades de salud mental han afectado a los jóvenes y se ha buscado conocer cómo repercuten entre sí. El objetivo de esta revisión fue determinar si la malnutrición por exceso afecta la salud mental y/o el autoconcepto de la población infanto-juvenil. Material y método: Se realizó una revisión integrativa de la literatura en el período comprendido entre los años 2016 a 2021 a través de las bases de datos: PubMed, LILACS y EBSCO. Se identificaron 3.985 artículos de forma inicial, en donde sólo 9 cumplían criterios de inclusión y exclusión, dentro de los cuales destaca la disponibilidad del texto completo de forma gratuita o mediante las bases de datos de la Universidad Nacional Andrés Bello. Resultados: Los niños/adolescentes diagnosticados con problemas de malnutrición por exceso experimentan dificultades psicosociales por su autopercepción, dependiendo no sólo de su condición física, sino también de factores socioeconómicos, familiares y sociales, estableciéndose una relación directa bidireccional. Discusión: A partir de la primera infancia se adquieren ciertas pautas de comportamiento y aprendizajes que guían las conductas de cada individuo, dentro de estas pautas se encuentran los estereotipos de género, estándares de belleza implantados por la sociedad y medios de comunicación, estos se encuentran directamente relacionados con los problemas de autopercepción y autoestima presentes en la población infanto-juvenil, afectando en mayor porcentaje al género femenino. Conclusión: Los profesionales de Enfermería deben intervenir desde temprana edad en la promoción y prevención de la salud física y mental en la población infanto-juvenil.

Introduction: Both malnutrition due to excess and mental health diseases have affected young people and it has been sought to know how they affect each other. The objective of this review was to determine if malnutrition due to excess affects the mental health and/or self-concept of the child and adolescent population. Material and method: An integrative review of the literature was carried out in the period between 2016 and 2021 through the databases: PubMed, LILACS and EBSCO. Initially, 3,985 articles were identified, where only 9 met inclusion and exclusion criteria, among which the availability of the full text for free or through the databases of the Universidad Nacional Andrés Bello stands out. Results: Children/adolescents diagnosed with problems of malnutrition due to excess experience psychosocial difficulties due to their self-perception, depending not only on their physical condition, but also on socioeconomic, family and social factors, establishing a direct bidirectional relationship. Discussion: From early childhood certain patterns of behavior and learning are acquired that guide the behavior of each individual, within these guidelines are gender stereotypes, beauty standards implemented by society and the media, these are directly related to the problems of self-perception and self-esteem present in the child-juvenile population, affecting the female gender in a greater percentage. Conclusion: Nursing professionals should intervene from an early age in the promotion and prevention of physical and mental health in the child and adolescent population.

Introdução: Tanto a desnutrição por excesso quanto as doenças de saúde mental têm afetado os jovens e tem-se procurado saber como elas afetam umas às outras. O objetivo desta revisão foi de-terminar se a desnutrição por excesso afeta a saúde mental e/ou autoconceito da população infantil e adolescente. Material e método: Foi realizada uma revisão integrativa da literatura no período entre 2016 e 2021 por meio das bases de dados: PubMed, LILACS e EBSCO. Inicialmente, foram identificados 3.985 artigos, onde apenas 9 atenderam aos critérios de inclusão e exclusão, dentre os quais se destaca a disponibilização do texto completo gratuitamente ou por meio das bases de dados da Universidade Nacional Andrés Bello. Resultados: As crianças/adolescentes diagnostica-das com problemas de desnutrição por excesso vivenciam dificuldades psicossociais devido à sua autopercepção, dependendo não apenas de sua condição física, mas também de fatores socioeconômicos, familiares e sociais, estabelecendo uma relação direta bidirecional. Discussão: Desde a primeira infância são adquiridos determinados padrões de comportamento e aprendizagem que orientam o comportamento de cada indivíduo, dentro dessas diretrizes estão os estereótipos de gênero, padrões de beleza implementados pela sociedade e pela mídia, estes estão diretamente relacionados aos problemas de autopercepção e autoconhecimento presente na população infanto-juvenil, afetando em maior percentual o gênero feminino. Conclusão: Os profissionais de enfermagem devem intervir desde cedo na promoção e prevenção da saúde física e mental da população infanto-juvenil.

Lineamientos técnicos para la atención nutricional y manejo ambulatorio de las personas con malnutrición en el ciclo de vida / Technical guidelines for nutritional care and outpatient management of people with malnutrition in the life cycle

Para contribuir a reducir o mejorar la problemática, se hace necesario fortalecer la atención nutricional, la cual tiene presencia en los diferentes niveles de atención en salud, sin embargo, no se cuenta con una normativa que determine como llevar a cabo el proceso; así como el manejo integral de la malnutrición. Sumado a ello se encuentra la brecha de cobertura con nutricionistas en los establecimientos de salud que aborden y desarrollen este tipo de atención; dicha situación da lugar a que los profesionales en nutrición empleen técnicas de manejo para la malnutrición no estandarizadas en el nivel nacional, a nivel público y privado. El presente documento, "Lineamientos Técnicos para la atención nutricional y manejo ambulatorio de las personas con malnutrición en el ciclo de vida", contiene las disposiciones técnicas del proceso de atención nutricional, manejo integral de la malnutrición; y referencia, interconsulta y retorno

To help reduce or improve the problem, it is necessary to strengthen nutritional care, which is present at different levels of health care, however, there are no regulations that determine how to carry out the process; as well as the comprehensive management of malnutrition. Added to this is the coverage gap with nutritionists in health establishments that address and develop this type of care; This situation leads nutrition professionals to use management techniques for malnutrition that are not standardized at the national, public, and private levels. This document, "Technical Guidelines for nutritional care and outpatient management of people with malnutrition in the life cycle", contains the technical provisions of the nutritional care process, comprehensive management of malnutrition; and reference, interconsultation and return

La desnutrición, factor de riesgo para complicaciones en pacientes con tuberculosis en Bogotá / Malnutrition, a risk factor for complications in patients with tuberculosis in Bogotá

En la Revista Colombiana de Neumología, número dos, volumen 34 del año 2022, está publicado el artículo original de los doctores Daniel Adolfo Suárez, Andrea Carolina Córdoba y Oscar Alberto Sáenz titulado "Factores de riesgo para complicaciones en pacientes con tuberculosis en una institución de tercer nivel de la ciudad de Bogotá". Es un estudio observacional retrospectivo de la cohorte de 130 pacientes con tuberculosis pulmonar diagnosticados entre los años 2017 y 2018, cuyo objetivo fue el de identificar posibles factores de riesgo asociados al desarrollo de complicaciones por la tuberculosis. Los autores presentan la revisión de la literatura con relación a las complicaciones de la tuberculosis. En general, las complicaciones de la tuberculosis se han dividido según el sitio anatómico comprometido, esto es, pulmonar o respiratorio, neurológico, cardiovascular, gastrointestinal u otros y han sido atribuidas al efecto patológico de la micobacteria o al efecto inflamatorio desencadenado por la respuesta inmune del huésped.

In the Colombian Journal of Pneumology, number two, volume 34 of the year 2022, the original article by doctors Daniel Adolfo Suárez, Andrea Carolina Córdoba and Oscar Alberto Sáenz entitled "Risk factors for complications in patients with tuberculosis in a hospital third level of the city of Bogotá". It is a retrospective observational study of the cohort of 130 patients with pulmonary tuberculosis diagnosed between 2017 and 2018, whose objective was to identify possible risk factors associated with the development of complications from tuberculosis. The authors present a review of the literature regarding the complications of tuberculosis. In general, the complications of tuberculosis have been divided according to the anatomical site involved, that is, pulmonary or respiratory, neurological, cardiovascular, gastrointestinal or others, and have been attributed to the pathological effect of the mycobacteria or to the inflammatory effect triggered by the immune response. of the host.

Factores de riesgo para complicaciones en pacientes con tuberculosis en una institución de tercer nivel de la ciudad de Bogotá / Risk factors for complications in tuberculosis patients in a third-level institution in Bogotá city

Introducción: la tuberculosis es considerada como un problema de salud pública a nivel mundial, siendo la decimotercera causa de muerte y la enfermedad infecciosa más mortífera detrás del COVID-19 y por encima de la infección por VIH, llegando a un total de 1.5 millones de muertes en el 2020. Colombia es el quinto país de la región con mayor carga de casos de tuberculosis, reportándose en el Programa Nacional de Tuberculosis un total de 13.037 casos preliminares en el 2020, representando una importante carga para el Sistema General de Seguridad Social en Salud. Material y métodos: se realizó un estudio observacional de corte retrospectivo con una población de 130 pacientes con diagnóstico de tuberculosis en una institución de tercer nivel en la ciudad de Bogotá, con el fin de identificar posibles factores de riesgo asociados al desarrollo de complicaciones en estos pacientes. Resultados y discusión: en el grupo total encontramos que la presencia de desnutrición es un factor de riesgo independiente para presentar complicaciones asociadas a la infección por tuberculosis; mediante análisis de regresión condicionada por método exacto se identifica un HR de 2.53 [1.008;6.378] (p 0.002) y HR ajustado de 1.47 [0.400-2.556] (p 0.007). El resto de condiciones no presentaron asociación estadísticamente significativa con el desarrollo de complicaciones en pacientes con diagnóstico de tuberculosis. Conclusiones: en los pacientes con diagnóstico de tuberculosis que asistieron al hospital Santa Clara entre 2017 y 2018, encontramos que un estado nutricional inadecuado tuvo una asociación significativa a la presencia de complicaciones relacionadas con infección por tuberculosis. Otros factores como el nivel de educación, estrato socioeconómico o la presencia de comorbilidades no demostraron una influencia significativa en el objetivo del estudio.

Introduction: Tuberculosis is considered a public health problem worldwide, being the thirteenth cause of death and the deadliest infectious disease behind COVID-19 and above HIV infection, reaching a total of 1, 5 million deaths in 2020. Colombia is the fifth country in the region with the highest burden of tuberculosis cases, reporting a total of 13,037 preliminary cases in 2020 in the National Tuberculosis Program, representing a significant burden for the General System of Social Security in Health. Materials and methods: A retrospective observational study was carried out with a population of 130 patients diagnosed with tuberculosis in a third level institution at Bogotá city, to identify factors associated with the development of complications in tuberculosis patients. Results and discussion: In the total group, the presence of malnutrition is found to be an independent risk factor for tuberculosis complications by means of a conditioned regression analysis using the exact method we found an OR of 2.53 [1.008;6.378] (p 0.00202) and adjusted OR of 1.47 [0.400-2.556] (p 0.007), neither of the other conditions can't be associated with the presence of complications in patients diagnosed with tuberculosis. Conclusions: In patients diagnosed with tuberculosis who attended the Santa Clara hospital between 2017 and 2018, we found that an inadequate nutritional status is associated with the presence of major complications. Other factors such as level of education, socioeconomic status or the presence of comorbidities do not show a significant influence on the objective of the study.

Risco nutricional e fatores associados em pacientes hospitalizados pelo sistema único de saúde: comparação entre os sexos / Nutricional risk and associated factors in hospitalized patients: comparison between genders

Introdução: a desnutrição representa um problema clínico-nutricional frequente em pacientes hospitalizados, sendo que a detecção precoce do risco nutricional torna-se fundamental, pois possibilita à equipe multidisciplinar o início imediato de uma conduta dietética adequada, minimizando o sinergismo entre a desnutrição e os demais fatores clínicos. Objetivo: determinar o risco nutricional, associando com o estado nutricional, estilo de vida e variáveis clínicas de hospitalização de pacientes internados pelo SUS, comparando tais condições entre os sexos. Metodologia: trata-se de estudo transversal. Para avaliação do risco nutricional dos pacientes hospitalizados foi utilizado o protocolo de triagem nutricional Nutricional Risk Screening (NRS) 2002, além disso foram coletados dados antropométricos, clínicos, sociodemográficos e dietéticos para comparação com o risco nutricional. Resultados: a amostra foi composta por 100 pacientes, sendo 50% adultos e 50% idosos, com média de idade de 56,11±19 anos, sendo a maioria do sexo masculino (51%). O risco nutricional esteve presente em 34% dos pacientes avaliados, sendo 58,8% no sexo feminino e 41,2% no sexo masculino. Não houve diferença das demais variáveis quando comparadas entre os sexos (p>0,05). A maior prevalência de risco observada foi em idosos (27%). Conclusão: o risco nutricional obteve maior prevalência nos pacientes idosos, porém não houve diferença entre os sexos. Sabe-se que a presença de comorbidades e uma inadequada aceitação da dieta por parte dos mesmos pode levar a uma piora significativa do estado nutricional.

Malnutrition is a frequent clinical and nutritional problem in hospitalized patients, and early detection of nutritional risk is essential, as it allows the multidisciplinary team to immediately start an adequate dietary approach, minimizing the synergism between malnutrition and other clinical factors. Objective: to determine the nutritional risk, associating it with the nutritional status, lifestyle and clinical variables of hospitalization of patients hospitalized by the SUS, comparing such conditions between the sexes. Methodology: this are a cross-sectional study. To assess the nutritional risk of hospitalized patients, the Nutritional Risk Screening (NRS) 2002 protocol was used. In addition, anthropometric, clinical, sociodemographic and dietary data were collected for comparison with nutritional risk. Results: the sample consisted of 100 patients, 50% adults and 50% elderly, with a mean age of 56.11±19 years, the majority being male (51%). Nutritional risk was present in 34% of the patients evaluated, being 58.8% female and 41.2% male. There was no difference in the other variables when compared between the sexes (p>0.05). The highest prevalence of risk observed was in the elderly (27%). Conclusion: nutritional risk was more prevalent in elderly patients, but there was no difference between the sexes. It is known that the presence of comorbidities and an inadequate acceptance of the diet by them can lead to a significant worsening of the nutritional status.

Llamado a la implementación de la Ley 2120 de 2021 contra la comida chatarra en los tiempos del COVID-19 en Colombia / A call for implementation of the Law 2120 against junk food during pandemic times in Colombia

Durante dos años y medio, tanto en Colombia como en el resto del mundo, hemos enfrentado la pandemia generada por el SARS-CoV-2, agudizando los múltiples problemas de salud pública que venían cursando a manera de sindemias. Tal es el caso de las enfermedades crónicas no transmisibles asociadas, entre otros factores, a los malos hábitos alimenticios, especialmente por el gran consumo de alimentos ultraprocesados y bebidas azucaradas. En julio del 2021, se aprobó la Ley 2120, por medio de la cual se adoptaron medidas para fomentar entornos alimentarios saludables. Entre estas medidas, también se promueve que los alimentos empacados, procesados y que afectan negativamente la salud humana, tengan un sello que identifique sus componentes y valor nutricional para informar a los consumidores sobre el producto que están comprando o consumiendo. Entre las enfermedades más prevalentes en Colombia que afectan la salud bucal, se encuentran las caries y las periodontitis, ambas con factores de riesgo comunes con las enfermedades crónicas no transmisibles. Dados sus costos y prevalencia, dichas enfermedades crónicas no transmisibles resultan primordiales desde un enfoque de gestión del riesgo en salud pública, siendo, quizá, su gravedad mayor durante la pandemia generada por el SARS CoV-2. Asimismo, se especula que la población confinada pudo llegar a consumir más comida chatarra durante la pandemia del COVID-19 en comparación con otros períodos, además, porque en aquellos con enfermedades crónicas no transmisibles, el confinamiento obligado se asocia con mayor sedentarismo y con un menor número de controles médicos regulares, asuntos que se han reportado previamente. La promulgación de la ley de comida chatarra no va a cambiar los hábitos de alimentación de los colombianos "de la noche a la mañana" y, por esto, se necesita con urgencia implementar procesos de educación y sensibilización frente a los efectos adversos de los alimentos procesados y ultraprocesados en la salud.

For more than one year and a half, Colombia and the world have been facing the effects caused by the pandemics of SARS CoV-2 with concomitant and aggravating deterioration of multiple public health problems such as noncommunicable diseases. Noncommunicable diseases are frequently associated with poor eating habits and regular consumption of processed and ultra-processed foods, among other important risk factors related to culture, genetics, and sedentarism. In July, 2021, Colombia ratified the Law 2120 that promotes healthy food habits and recreational environments, by forcing food producers to include nutritional advertisement seals on processed food packages, with explanatory guidelines for consumers about calories and nutritional value. This editorial note highlights the importance in Odontology of promoting and implementing this Law through education and sensitization of populations, in order to cope with some of the adverse risk factors of the hypercaloric diet.

Relación de la caries dental y el índice de masa corporal en población infantil / Relationship between dental caries and body mass index in children

La nutrición y salud bucal son temas de interés en salud pública por su alto impacto en el bienestar y desarrollo de las personas. Existe una alta prevalencia e incidencia de caries y malnutrición en los primeros años de vida. Determinar la relación entre el índice de caries en dentición primaria y permanente e índice de masa corporal en niños de 5 a 11 años en las unidades de salud de San Miguel Tepezontes y Panchimalco en el año 2019. Investigación cuantitativa con una muestra de 265 niños de 5 a 11 años. Se evaluó el índice de masa corporal y el índice de caries; se hizo un análisis estadístico descriptivo e inferencial, realizando la prueba estadística de correlación de Spearman. Se encontró que el índice de caries es de 2,11 en dentición permanente con una prevalencia de 70,5 % y el índice de caries de 7,02 en dentición primaria con una prevalencia de un 94,98 %. El coeficiente de correlación de Spearman entre índice de masa corporal e índice de caries en dentición permanente fue de 0,226, que indica una correlación positiva baja y el índice de masa corporal e índice de caries en dentición primaria fue - 0,158, que indica una correlación negativa muy baja. Existe relación entre el índice de caries en ambas denticiones y el índice de masa corporal

Nutrition and oral health are topics of interest in public health due to their high impact on the well-being and development of people. There is a high prevalence and incidence of caries and malnutrition in the first years of life. To determine the relationship between the caries index in primary and permanent dentition and body mass index in children aged 5 to 11 years in the health units of San Miguel Tepezontes and Panchimalco in the year 2019. Quantitative research with a sample of 265 children from 5 to 11 years. Body mass index and caries index were evaluated; A descriptive and inferential statistical analysis was performed, performing the Spearman correlation statistical test. It was found that the caries index is 2.11 in permanent dentition with a prevalence of 70.5% and the caries index is 7.02 in primary dentition with a prevalence of 94.98%. Spearman's correlation coefficient between body mass index and caries index in permanent dentition was 0.226, indicating a low positive correlation, and body mass index and caries index in primary dentition was -0.158, indicating a negative correlation. very low. There is a relationship between the caries index in both dentitions and the body mass index

Prognostic nutritional index and mortality in children and adolescents underwent cardiac surgery / Índice nutricional prognóstico e mortalidade entre crianças e adolescentes submetidos à cirurgia cardíaca

Abstract Objectives: to analyze the prognostic nutritional index and factors associated with mortality in children and adolescents with heart disease who underwent cardiac surgery. Methods: this is a longitudinal, retrospective study that included 98 children and adolescents with heart disease from 0 to 14 years old, and assessed the prognostic nutritional index and nutritional status, through the body mass index for age, weight for height, weight for age and height for age. Multiple logistic regression analysis was performed. Results: malnutrition was present in 27 patients, 68 were categorized as having a low prognostic nutritional index and 16 died. In the adjusted analysis, malnutrition (OR=4.11; CI95%=1.26-13.40; p=0.019), the low body mass index for age (OR=4.14; CI95%=1.26-13.61; p=0.019), low weight for height (OR=4.15; CI95%=1.29-13.35; p=0.017) and low weight for age (OR=5.20; CI95%=1.39-19.43; p=0.014) were associated with mortality. Conclusions: malnutrition, low body mass index for age, weight for height and weight for age had shown a significant association with mortality. Despite being an easily applicable indicator of nutritional status, the findings suggest no association between the prognostic nutritional index and mortality in patients with congenital heart disease after cardiac surgery.

Resumo Objetivos: analisar o índice nutricional prognóstico e os fatores associados a mortalidade em crianças e adolescentescardiopatas submetidas à cirurgia cardíaca. Métodos: estudo longitudinal, retrospectivo, que incluiu 98 crianças e adolescentes cardiopatas entre zero a 14 anos e avaliou o índice nutricional prognóstico e o estado nutricional, através dos indicadores índice de massa corporal para idade, peso para estatura, peso para idade e estatura para idade. Foi realizada análise de regressão logística múltipla. Resultados: a desnutrição esteve presente em 27 pacientes, 68 foram categorizados como baixo índice nutricional prognóstico e 16 foram a óbito. Na análise ajustada, a desnutrição (OR=4,11; IC95%=1,26-13,40; p=0,019), o baixo índice de massa corporal para idade (OR=4,14; IC95%=1,26-13,61; p=0,019), o baixo peso para estatura (OR=4,15; IC95%=1,29-13,35; p=0,017) e baixo peso para idade (OR=5,20; IC95%=1,39-19,43; p=0,014) apresentaram associação com a mortalidade. Conclusão: desnutrição, baixo índice de massa corporal para idade, peso para estatura e peso para idade mostraram associação significativa com a mortalidade. Apesar de ser um indicador do estado nutricional de fácil aplicação não foi observada associação do índice nutricional prognóstico com a mortalidade em pacientes com cardiopatias congênitas após cirurgia cardíaca.

Perfil epidemiológico nutricional dos pacientes em hemodiálise / Nutritional epidemiological profile of patients in hemodialysis

A insuficiência renal crônica compromete as funções fisiológicas dos rins, e leva o paciente à diálise como terapia; contudo, essa condição gera suscetibilidade àdesnutrição. O objetivo deste estudo foi descrever o perfil epidemiológico e nutricional dos pacientes em hemodiálise e compará-los em relação à doença renal de base. Éestudo retrospectivo, descritivo e transversal. Foram coletados dados demográficos, clínicos, antropométricos e laboratoriais de pacientes que estiveram em diálise. Foram incluídos pacientes com insuficiência renal crônica e excluídos menores de 18 anos, com dados insuficientes ou com comorbidades que alterassem processo nutricional. Em conclusão, observaram-se 4 principais causas para doença renal crônica: hipertensão arterial crônica, doença renal policística, doença renal terminal e nefropatia diabética, que foi a mais prevalente, com pouca evidência de desnutrição

Chronic renal failure compromises the physiological functions of the kidneys and leads the patient to dialysis as a therapy; however, this condition generates susceptibility to malnutrition. The aim of this study was to describe the epidemiological and nutritional profile of patients on hemodialysis and to compare them in relation to the underlying renal disease. It is a retrospective, descriptive and cross-sectional study. Demographic, clinical, anthropometric and laboratory data were collected from patients who were on dialysis. Patients with chronic renal failure were included and those under 18 years of age, with insufficient data or with comorbidities that altered the nutritional process, were excluded. In conclusion, 4 main causes of chronic kidney disease were observed: chronic arterial hypertension, polycystic kidney disease, end-stage renal disease and diabetic nephropathy, which was the most prevalent, with little evidence of malnutrition.

Perfil epidemiológico nutricional dos pacientes em hemodiálise / Nutritional epidemiological profile of hemodialysis patients

A insuficiência renal crônica compromete as funções fisiológicas dos rins, e leva o paciente à diálise como terapia; contudo, essa condição gera suscetibilidade à desnutrição. O objetivo deste estudo foi descrever o perfil epidemiológico e nutricional dos pacientes em hemodiálise e compará-los em relação à doença renal de base. É estudo retrospectivo, descritivo e transversal. Foram coletados dados demográficos, clínicos, antropométricos e laboratoriais de pacientes que estiveram em diálise. Foram incluídos pacientes com insuficiência renal crônica e excluídos menores de 18 anos, com dados insuficientes ou com comorbidades que alterassem processo nutricional. Em conclusão, observaram-se 4 principais causas para doença renal crônica: hipertensão arterial crônica, doença renal policística, doença renal terminal e nefropatia diabética, que foi a mais prevalente, com pouca evidência de desnutrição

Chronic renal failure compromises the physiological functions of the kidneys and leads the patient to dialysis as a therapy; however, this condition generates susceptibility to malnutrition. The aim of this study was to describe the epidemiological and nutritional profile of patients on hemodialysis and to compare them in relation to the underlying renal disease. It is a retrospective, descriptive and cross-sectional study. Demographic, clinical, anthropometric and laboratory data were collected from patients who were on dialysis. Patients with chronic renal failure were included and those under 18 years of age, with insufficient data or with comorbidities that altered the nutritional process, were excluded. In conclusion, 4 main causes of chronic kidney disease were observed: chronic arterial hypertension, polycystic kidney disease, end-stage renal disease and diabetic nephropathy, which was the most prevalent, with little evidence of malnutrition

Incidencia de desnutrición en el departamento de ambulatorios con algunos factores asociados, del Hospital Universitario de Kerbala / Incidence of Malnutrition in Outpatient Department of Kerbala Teaching Hospital with some Associated Factors

Objetivos: evaluar la incidencia de la desnutrición global en el Departamento de externos del Hospital de Enseñanza de Kerbala y los factores asociados que incluyen el sexo de los pacientes, el empleo paterno y el tipo de alimentación. Métodos: mediante el uso de M.U.A.C, que es una prueba antropométrica de detección simple para la desnutrición. El estudio transversal aleatorizado de 1000 niños entre los 6-59 meses había tomado en el estudio. Del Departamento de Outpatiente del Hospital de Enseñanza de Kerbala. Datos registrados con respecto al género de pacientes, empleo paternal y tipo de alimentación en aquellos menos de 2 años. Pacientes viejos. Resultados: La incidencia general de desnutrición global fue del 6,9% en el Departamento de Overpatismo del Hospital de Enseñanza de Kerbala. Existe una fuerte asociación entre la desnutrición y el tipo de alimentación durante los primeros 2 años y hubo alguna asociación entre el empleo de padres y la desnutrición.

Objectives: To evaluate the incidence of global malnutrition in outpatient department of Kerbala teaching hospital and the associated factors which include sex of patients, paternal employment and type of feeding. Methods: By using M.U.A.C which is simple screening anthropometric test for malnutrition. Randomized Cross sectional study of 1000 child between the age of 6-59 months had taken in the study. From outpatient department of Kerbala teaching hospital. Data recorded regarding gender of patients, paternal employment and type of feeding in those less than 2 yrs. old patients. Results: Overall incidence of global malnutrition was 6.9% in outpatient department of Kerbala teaching hospital. There is strong association between malnutrition and type of feeding during first 2 years and there was some association between employment of parents and malnutrition.

Nutrición clínica o clínica de la nutrición / Clinical Nutrition or Nutrition Clinic

Introducción: El diagnóstico de la desnutrición ha tenido un complejo proceso histórico y su concepto ha transitado por numerosas tentativas para definirla. La palabra desnutrición y especialmente el término malnutrición crean bastante confusión entre los estudiosos del tema. En la última década han surgido consensos variados para clasificar la desnutrición asociada a las enfermedades unida a la carga que representan el sobrepeso y obesidad en la presencia de enfermedades crónicas y agudas. Objetivo: Conocer cómo las nuevas tecnologías mejoran el conocimiento de los trastornos nutricionales mediante la descripción e integración de sus compartimentos corporales, pero no están al alcance de los equipos de salud ni de los pacientes en los diversos escenarios de trabajo. Desarrollo: La nutrición constituye una ciencia integrada por un conjunto de disciplinas científicas que transitan desde las ciencias exactas, hasta las ciencias políticas. La aplicación del método clínico como una modalidad del método científico obliga a considerar a la nutrición también con esta visión y no como la última opción del médico en una intervención diagnóstica o terapéutica, contaminada por mitos, tabúes y prejuicios culturales. La medicina clínica proporciona competencias duras adquiridas en forma de conocimientos y habilidades a lo largo de la formación preprofesional y de postgrado, que unidas a la competencias blandas garantizarán una labor exitosa incluidos los entornos culturales hostiles, tóxicos y /o caóticos. Conclusiones: Existen tendencias a seguir patrones y guías de sociedades de países con grandes recursos financieros y tecnológicos para la investigación, que no siempre en están en consonancia con nuestras realidades. La aparición de la pandemia COVID-19, ha planteado nuevos desafíos y serias amenazas tanto para las personas, como a los sistemas de salud de forma global que afectó de manera importante a los pacientes ancianos, con cáncer y enfermedades crónicas junto al choque de la pandemia de la obesidad con la del Coronavirus(AU)

Introduction: The diagnosis of malnutrition has had a difficult historical process and its concept has gone through numerous attempts to define it. The word undernourishment and especially the term malnutrition creates a lot of confusion among scholars of the subject. In the last decade, various consensuses have emerged to classify malnutrition associated with diseases together with the burden represented by overweight and obesity in the presence of chronic and acute diseases. Objective: To identify how new technologies improve knowledge of nutritional disorders through the description and integration of their body compartments, but they are not available to health teams or patients in various work settings. Findings: Nutrition is a science made up of a set of scientific disciplines that range from exact sciences to political sciences. The application of the clinical method as a modality of the scientific method makes it necessary to consider nutrition also with this vision and not as the last option of the doctor in a diagnostic or therapeutic intervention, contaminated by myths, taboos and cultural prejudices. Clinical medicine provides hard skills acquired in the form of knowledge and skills throughout pre-professional and postgraduate training, which together with soft skills will guarantee successful work, including hostile, toxic and/or chaotic cultural environments. Conclusions: There are tendencies to follow patterns and guides of societies in countries with great financial and technological resources for research, which are not always in line with our realities. The appearance of the COVID-19 pandemic has posed new challenges and serious threats to both people and health systems globally, significantly affecting elderly patients, those with cancer and chronic diseases, along with the shock of the COVID-19 pandemic, obesity with that of the Coronavirus(AU)

Protein-Energy Supplementation in Early-Life Decreases the Odds of Mental Distress in Later Adulthood in Guatemala

The prevalence of mental health concerns is growing worldwide, along with lack of access to and receipt of needed treatment. Current gaps in treatment provision have led to exploring alternative methods of prevention, with research linking nutrition and mental health, of particular relevance in low- and middle-income countries, with a high prevalence of undernutrition. To examine whether exposure to a protein-energy nutritional supplement during the first 1000 d of life decreased odds of mental distress in adulthood among men and women in Guatemala compared with receiving a low energy-no protein supplement or supplementation outside the 1000-d window. Data from participants (n = 1249) in a longitudinal cohort protein-energy supplementation trial (early-life, supplementation data from 1969 to 1977, ages 0­7 y; life course, outcome data from 2017­2018 follow-up, ages 40­57 y) were analyzed for associations between nutrition in the first 1000 d and mental distress in adulthood (WHO Self- Reporting Questionnaire 20 [SRQ-20]), controlling for early-life variables and current life stress; life course variables (e.g. education) were examined as potential mediators of this relation. Generalized linear mixed models and zero-inflated Poisson generalized linear mixed models were utilized. Both partial and full supplementation with Atole during the first 1000 d were associated with 63% (95% CI: 0.16, 0.87) and 56% (95% CI: 0.19, 1.03) lower odds, respectively, of experiencing mental distress in adulthood. Did not differ by sex. These inverse relations remained relatively unchanged (partial OR = 0.34 [95% CI: 0.14, 0.83]; full OR = 0.38 [95% CI: 0.16, 0.92]) after controlling for early-life and life course variables, including life stress. Protein-energy supplementation during the first 1000 d of life in Guatemala, where undernutrition is prevalent, may reduce the prevalence of later mental distress in adulthood. This effect appears to occur directly, rather than indirectly, through pathways of life course variables such as education, wealth, and marital status. Keywords: early childhood nutrition, protein-energy

Manual autoformativo para el coordinador de visita domiciliaria en el marco de la meta 4: "Acciones de municipios para promover la adecuada alimentación, la prevención y reducción de la anemia" / Self-training manual for the home visit coordinator in the framework of goal 4: "Actions of municipalities to promote adequate nutrition, prevention and reduction of anemia"

El manual autoformativo permite comprender la importancia del trabajo que realiza los coordinadores de visita domiciliaria, la problemática de la anemia, el rol de gestor y articulador para los procesos que involucra el cumplimiento de la Meta 4, a fin de contribuir de manera efectiva en la reducción sostenida de la anemia en el país

Manual de autoaprendizaje para el actor social "Acciones de municipios para promover la adecuada alimentación, la prevención y reducción de la anemia / Self-learning manual for the social actor "Actions of municipalities to promote adequate nutrition, prevention and reduction of anemia

El manual contiene el desarrollo breve de las sesiones de aprendizaje, que deberás leer y aprender cada una de ellas, logrando motivar y persuadir a la madre, padre o cuidador de las niñas y niños menores de 1 año al cuidado de su salud

Riesgo nutricional asociado a mortalidad de pacientes oncológicos ingresados a una unidad de cuidados intensivos: Un estudio descriptivo de centro único / Nutritional risk associated with mortality in cancer patients admitted to an intensive care unit: A descriptive study of a single center

Introducción: Los pacientes críticos con enfermedades oncológicas desarrollan una respuesta metabólica severa frente a la agresión con un alto grado de hipermetabolismo, lo que constituye un riesgo asociado e incide en la mortalidad de estos pacientes. El objetivo del presente estudio fue medir el estado nutricional de un grupo de pacientes oncológicos ingresados en terapia intensiva y establecer una asociación con la mortalidad. Metodología: El presente estudio observacional retrospectivo se realizó en la unidad de cuidados intensivos del Instituto Oncológico Nacional "Dr. Juan Tanca Marengo" - Guayaquil en el período septiembre - 2017 /agosto -2018. La muestra fue no probabilística, de pacientes con diagnóstico oncológico. Las variables fueron edad, sexo, mortalidad, NUTRIC score, condición de ingreso, tipo de tumores, escalas fisiológicas APACHE y SOFA, días de hospitalización y número de comorbilidades. Se utilizó análisis de curvas ROC, Rho de Spearman y Chi2 para establecer la asociación. Resultados: Se incluyeron 176 casos, con edad de 57 años (RI 43-67). 113/176 mujeres (64.2%). La media de puntuación de APACHE fue de 18 ±7.3 y la mediana de SOFA fue de 4.0 (RI 1.0 ­ 6.0). El tipo de cáncer más frecuente fue el ginecológico con un 25% (44/176) de los casos. La mortalidad fue del 19.9% (35/176). Los puntajes de NUTRIC fueron mayores en los pacientes fallecidos (Me 6.00 (RI 5-9) vs Me 3.00 (RI 1-4); P <0.0001). La presencia de puntaje NUTRIC >4 tiene una sensibilidad del 74.3% (IC 95% 56.7 ­ 87.5), especificidad del 80.9% (IC 95% 73.4 ­ 87.0), valor predictivo positivo del 49.1% (IC 95% 39.4 ­ 58.7) y un valor predictivo negativo 92.7% (IC 95% 87.8 ­ 95.7) para el desenlace de mortalidad. Conclusión: En este estudio las puntuaciones altas de NUTRIC score modificado se encuentran fuertemente asociadas a mortalidad en pacientes oncológicos críticos. Las puntuaciones altas del test NUTRIC score modificado se correlaciona con peor condición clínica al momento de la admisión y mayor estancia en la unidad de cuidados intensivos.

Introduction: Critically ill patients with oncological diseases develop a severe metabolic response to aggression with a high degree of hypermetabolism, which constitutes an associated risk and affects the mortality of these patients. The objective of the present study was to measure the nutrition-al status of a group of cancer patients admitted to intensive care and establish an association with mortality. Methodology: This retrospective observational study was conducted in the intensive care unit of the National Oncology Institute "Dr. Juan Tanca Marengo" - Guayaquil in September - 2017 / August -2018. The sample was nonprobabilistic of patients with a cancer diagnosis. The variables were age, sex, mortality, NUTRIC score, admission condition, type of tumor, APACHE and SOFA physiological scales, days of hospitalization, and some comorbidities. ROC curve, Spearman's Rho, and Chi2 analyses were used to establish the association. Results: A total of 176 cases were included, aged 57 years (IR 43-67). 113/176 women (64.2%). The mean APACHE score was 18 ±7.3, and the median SOFA score was 4.0 (IR 1.0 ­ 6.0). The most fre-quent type of cancer was gynecological, with 25% (44/176) of cases. Mortality was 19.9% (35/176). NUTRIC scores were higher in deceased patients (Me 6.00 (IR 5-9) vs Me 3.00 (IR 1-4); P<0.0001). The presence of a NUTRIC score >4 has a sensitivity of 74.3% (95% CI 56.7 ­ 87.5), a specificity of 80.9% (95% CI 73.4 ­ 87.0), a positive predictive value of 49.1% (95% CI 39.4 ­ 58.7) and a negative predic-tive value of 92.7% (95% CI 87.8 ­ 95.7) for the outcome of mortality. Conclusion: In this study, high modified NUTRIC score scores were strongly associated with mor-tality in critical cancer patients. High scores on the modified NUTRIC score test correlate with worse clinical condition at admission and more extended stay in the intensive care unit.

Calf circumference is an independent predictor of postoperative complications in the surgical treatment of head and neck cancer

INTRODUCTION: The prevalence of malnutrition is high among head and neck cancer (HNC) patients and negatively impacts their quality of life, treatment, and survival rates. OBJECTIVE: To identify preoperative nutritional variables capable of predicting postoperative complications in surgically treated HNC patients. METHODS: This was a prospective cohort study of HNC patients referred for surgery as initial treatment. RESULTS: Sixty patients were included in the study; they had a median age of 65.5 years, were mostly me n (85%), and most had low education levels (90%) and low household income (78.3%). The incidence rate of severe postoperative complications (grades II, III, IV, and V according to the Clavien-Dindo grading system) was found to be 50%. The nutritional variables under investigation, namely calf circumference (CC), triceps skinfold, body mass index, and adductor pollicis muscle thickness were shown to predict postoperative complications in HNC patients, especially CC, which was found to be an independent predictor of complications (OR=0.8; 95%CI: 0.65­0.96). Each 1-cm increase in calf circumference was associated with a 20% decrease in the risk of postoperative complications. CONCLUSION: Our findings show the nutritional variables studied are useful in the prognostic assessment of HNC surgery.

Mapa de Evidências sobre o manejo e tratamento da má nutrição no contexto da atenção primária: informe executivo / Evidence Map on the management and treatment of malnutrition in the context of primary care: executive report

O Mapa de Evidências sobre o manejo e tratamento da má nutrição no contexto da atenção primária é um produto do projeto de cooperação técnica estabelecido entre o Ministério da Saúde do Brasil, por meio da Coordenação Geral de Alimentação e Nutrição (CGAN/DEPROS/SAPS/MS), e a Organização Pan-Americana da Saúde, por meio do Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BIREME/OPAS/OMS). Este informe executivo consolida as evidências analisadas nos estudos incluídos no Mapa de Evidências sobre as intervenções da atenção primária para desfechos decorrentes do manejo e tratamento da má nutrição. O Mapa está publicado e disponível na Plataforma Tableau Public BIREME em: https://public.tableau.com/app/profile/bireme/viz/ma-nutricao-aps-pt/evidence-map