Phase angle, muscle mass, and functionality in patients with Parkinson's disease.

OBJECTIVE: To evaluate the association of phase angle (PA) with clinical and nutritional aspects in patients with Parkinson's disease (PD) treated in an outpatient clinic in northeastern Brazil. METHODS: This is a case series study involving adults and the elderly with PD of both genders. We collected data such as stage, severity, and time of diagnosis of the disease, muscle strength, gait speed, and level of physical activity. We evaluated the nutritional status using body mass index, calf circumference, skeletal appendicular muscle mass index, and the presence of sarcopenia. We obtained the PA through the analysis by electrical bioimpedance. After obtaining the result of the division between reactance and resistance, with later transformation into degrees, we multiplied the result by 180/π. RESULTS: We evaluated 77 individuals with a mean age of 65.4 ± 8.9 years. 63.6% of them had reduced PA values and 19.7% of them had sarcopenia. Age (rho = - 0.423; p = < 0.001) was inversely correlated with PA. Skeletal appendicular muscle mass index (rho = 0.251; p = 0.028), pressure force (rho = 0.240; p = 0.035), and gait speed (rho = 0.323; p = 0.005) showed a direct correlation with age. When adjusted for confounding factors, only age remained associated with PA (p = 0.012). CONCLUSION: Most individuals had reduced PA, and only age was associated with this result. Aging is a risk factor for reducing muscle mass and physical disability in PD. Although this study indicates a relationship between PA, age, muscle mass, and functionality, further prospective studies are needed to confirm these findings.

Adiposity, inflammation and fat-soluble vitamins in adolescents / Adiposidade, inflamação e vitaminas lipossolúveis em adolescentes

Abstract Objective: Evaluate the association between inflammatory process, adiposity, and vitamins A, D, and E in adolescents, according to gender. Methods: Cross-sectional study with adolescents aged 12-19 years old of both genders attending public schools in Recife. A questionnaire was used to collect data on socioeconomic level, lifestyle, and food intake of adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of α-1-acid glycoprotein, retinol, β-carotene, α-tocopherol, and 25-hydroxy-vitamin D. Results: The levels of α-1-acid glycoprotein were higher for abdominal obesity in both genders. Male adolescents with insufficient serum α-tocopherol levels had low levels of α-1-acid glycoprotein (p = 0.03) and an increased risk of 25-hydroxy-vitamin D and β-carotene deficiency in relation to total and abdominal fat; female adolescents had an increased risk of insufficient β-carotene with abdominal obesity (PR: 1.33; 95% CI: 1.2-1.5). Conclusion: Abdominal adiposity implies a higher risk of inflammation and causes different changes to the levels of fat-soluble vitamins according to gender.

Resumo: Objetivo: Avaliar a associação entre processo inflamatório, adiposidade e as vitaminas A, D e E em adolescentes, segundo o sexo. Métodos: Estudo transversal com adolescentes de 12 a 19 anos de ambos os sexos de escolas públicas de Recife. Foi utilizado um questionário para coleta de dados socioeconômicos, de estilo de vida e de consumo alimentar dos adolescentes. Em seguida, realizou-se a avalição antropométrica e coleta de sangue para análise das concentrações séricas de α-1-glicoproteína ácida, retinol, β-caroteno, α-tocoferol e 25-hidroxivitamina D. Resultados: Os níveis de α-1-glicoproteína ácida foram maiores na obesidade abdominal de ambos os sexos. Os meninos com níveis séricos insuficientes de α-tocoferol expressaram níveis reduzidos de α-1-glicoproteína ácida (p = 0,03) e apresentaram um maior risco de deficiência de 25-hidroxivitamina D e β-caroteno na adiposidade total e abdominal, enquanto as meninas mostraram maior risco de insuficiência de β-caroteno com a obesidade abdominal (RP 1,33; IC 95% 1,2-1,5). Conclusão: A adiposidade abdominal reflete maior risco de inflamação e causa alterações distintas nas concentrações das vitaminas lipossolúveis, de acordo com o sexo.

Adiposity, inflammation and fat-soluble vitamins in adolescents.

OBJECTIVE: Evaluate the association between inflammatory process, adiposity, and vitamins A, D, and E in adolescents, according to gender. METHODS: Cross-sectional study with adolescents aged 12-19 years old of both genders attending public schools in Recife. A questionnaire was used to collect data on socioeconomic level, lifestyle, and food intake of adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of α-1-acid glycoprotein, retinol, ß-carotene, α-tocopherol, and 25-hydroxy-vitamin D. RESULTS: The levels of α-1-acid glycoprotein were higher for abdominal obesity in both genders. Male adolescents with insufficient serum α-tocopherol levels had low levels of α-1-acid glycoprotein (p=0.03) and an increased risk of 25-hydroxy-vitamin D and ß-carotene deficiency in relation to total and abdominal fat; female adolescents had an increased risk of insufficient ß-carotene with abdominal obesity (PR: 1.33; 95% CI: 1.2-1.5). CONCLUSION: Abdominal adiposity implies a higher risk of inflammation and causes different changes to the levels of fat-soluble vitamins according to gender.

Prevalence and factors associated with fat-soluble vitamin deficiency in adolescents.

BACKGROUND: fat-soluble vitamin deficiency may be a health problem not recognized in children and adolescents. OBJECTIVE: to estimate the prevalence and factors associated with the deficiency of vitamins A, D and E among adolescent students from Northeastern Brazil. METHODS: transversal study with adolescents aged 12 to 19 of both genders. A questionnaire to collect socioeconomic and lifestyle data and food intake was applied to adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of retinol, ß-carotene, α-tocopherol and 25-hydroxy vitamin D (25[OH]D). RESULTS: the intake of vitamins A (50.3%), E (94.0%) and D (99.8%), as well as α-tocopherol (88.1%), ß-carotene (74.1%), 25(OH)D (50.9%) and retinol (46.6%) serum levels were mostly deficient/insufficient. An increased risk of α-tocopherol deficiency was observed in girls (PR = 1.11) and an increased risk of 25(OH)D deficiency was observed in boys (PR = 1.41). An increased likelihood of ß-carotene (PR = 1.14) and 25(OH) D (PR = 1.38) insufficiency was observed in overweight individuals. CONCLUSIONS: the adolescents had a deficit in the intake and in serum levels of fat-soluble vitamins. The greatest risk of inadequacy was associated with gender and weight excess. However, the behavior of fat-soluble vitamins in adolescents needs further research.

Prevalence and factors associated with fat-soluble vitamin deficiency in adolescents / Prevalencia y factores asociados a la deficiencia de vitaminas liposolubles en adolescentes

Background: fat-soluble vitamin deficiency may be a health problem not recognized in children and adolescents. Objective: to estimate the prevalence and factors associated with the deficiency of vitamins A, D and E among adolescent students from Northeastern Brazil. Methods: transversal study with adolescents aged 12 to 19 of both genders. A questionnaire to collect socioeconomic and lifestyle data and food intake was applied to adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of retinol, beta-carotene, alfa-tocopherol and 25-hydroxy vitamin D (25[OH]D).Results: the intake of vitamins A (50.3%), E (94.0%) and D (99.8%), as well as alfa-tocopherol (88.1%), beta-carotene (74.1%), 25(OH)D (50.9%) and retinol (46.6%) serum levels were mostly deficient/insufficient. An increased risk of α-tocopherol deficiency was observed in girls (PR = 1.11) and an increased risk of 25(OH)D deficiency was observed in boys (PR = 1.41). An increased likelihood of β-carotene (PR = 1.14) and 25(OH) D (PR = 1.38) insufficiency was observed in overweight individuals. Conclusions: the adolescents had a deficit in the intake and in serum levels of fat-soluble vitamins. The greatest risk of inadequacy was associated with gender and weight excess. However, the behavior of fat-soluble vitamins in adolescents needs further research

Introducción: la deficiencia de vitaminas liposolubles puede ser un problema de salud no reconocido en niños y adolescentes. Objetivo: estimar la prevalencia y los factores asociados a la deficiencia de las vitaminas A, D y E entre adolescentes escolares del nordeste de Brasil. Métodos: estudio transversal con adolescentes de 12 a 19 años de ambos sexos. Se utilizó un cuestionario para la recolección de datos socioeconómicos, de estilo de vida y de consumo alimentario de los adolescentes. A continuación, se realizó la evaluación antropométrica y la recolección de sangre para el análisis de las concentraciones séricas de retinol, beta-caroteno, alfa-tocoferol y 25-hidroxivitamina D (25[OH]D). Resultados: la ingesta de vitaminas A (50,3%), E (94,0%) y D (99,8%), así como los niveles séricos del alfa-tocoferol (88,1%), (R)-caroteno (74,1%), 25(OH)D (50,9%) y retinol (46,6%) se presentaron en su mayoría deficientes/insuficientes. Se observó un mayor riesgo de deficiencia del alfa-tocoferol en las niñas (RP = 1,11), y mayor riesgo de insuficiencia de 25(OH)D en los niños (RP = 1,41), así como mayor probabilidad de insuficiencia del (R)-caroteno (RP = 1,14) y 25(OH)D (RP = 1,38) en el exceso de peso. Conclusiones: los adolescentes presentaron déficit en el consumo y en los niveles séricos de las vitaminas liposolubles. El mayor riesgo de inadecuación estuvo asociado al sexo y el exceso de peso, sin embargo el comportamiento de las vitaminas hiposolubles en los adolescentes necesita una mayor investigación

Frequência do Transtorno de Compulsão Alimentar Periódica em pacientes obesos e naqueles submetidos à cirurgia bariátrica / Frequency of Periodic Binge Eating Disorder in obese patients and in those who underwent bariatric surgery

Introdução: O Transtorno de Compulsão Alimentar Periódica é caracterizado pela ingestão de uma grande quantidade de alimentos, em um curto período de tempo, e ocorre com frequência em pacientes obesos e principalmente naqueles submetidos à cirurgia bariátrica. Obesos com compulsão alimentar apresentam mais sintomas psicopatológicos, que interferem na adesão ao tratamento quando não diagnosticados adequadamente. Objetivo: Avaliar a frequência do transtorno de compulsão periódica em pacientes obesos e naqueles submetidos à cirurgia bariátrica. Métodos: Participaram do estudo indivíduos de ambos os sexos, atendidos numa clínica particular de cirurgia bariátrica, em Caruaru, Pernambuco. Foi avaliado a presença desse transtorno nos pacientes obesos candidatos ou submetidos a cirurgia, através da Escala de Compulsão Alimentar Periódica, um questionário autoaplicável, que tem como finalidade discriminar indivíduos obesos de acordo com a gravidade da compulsão alimentar. Além disso, também foi avaliado o estilo de vida (tabagismo, etilismo e prática de atividade física) dos pacientes. Resultados: A amostra foi composta por 45 pacientes, sendo 82,2% mulheres, 73,3% pacientes pós-cirúrgico e 26,7% pré-cirúrgicos. Verificou-se que 43,2% dos pacientes apresentavam compulsão alimentar, sendo observado uma frequência maior entre os candidatos à cirurgia bariátrica (75%). Conclusão: A frequência do transtorno foi superior nos pacientes pré-cirúrgicos, quando comparados naqueles que realizaram a cirurgia bariátrica. Diante do exposto torna-se essencial investigar a presença desse transtorno em obesos candidatos ou não a cirurgia bariátrica, tendo em vista a maior efetividade e adesão do tratamento adequado destes pacientes

Introduction: Binge Eating Disorder is characterize by the ingestion of alarge amount of food in a short period and occurs with frequency in obese patients, mainly in those undergoing bariatric surgery. Obese with eating disorder present such psychopathological symptoms that interferes on the adhesion to treatment when undiagnosed properly. Objective: Evaluate the frequency of Binge Eating Disorder in obese patients and those undergoing bariatric surgery. Methods: Individuals of both genders participated in the study attended on a particular clinic of bariatric surgery, in Caruaru, Pernambuco. It was evaluated the presence of this disorder on obese patients candidates or submitted to surgery, ath wart the Binge-Eating Scale (BES), a self-administered questionnaire whose purpose is to discriminate obese individuals according to the severity of Binge Eating. Furthermore was also evaluated the lifestyle (Smoking, alcoholism and physical activity practice) of the patients. Results: The sample was composed by 45 patients, being 82,2% women, 73,3% post -surgical patient and 26,7% presurgical patients. It was verified that 43,2% of the patients have Binge Eating, being observed alarge frequency between the candidates for bariatric surgery (75 %). Conclusion: The frequency of Binge Eating was superior in pre-surgical patients, when compared in those who performed the bariatric surgery. In the view of the above, it is essential to investigate the presence of this disorder in obese, candidates or not to the bariatric surgery, with a view to greater effectiveness and adherence of the adequate treatment of these patients

Introducción: El trastorno de la compulsión alimentaria periódica se caracteriza por la ingestión de una gran cantidad de alimentos en un corto período de tiempo, y ocurre con frecuencia en pacientes obesos y principalmente en aquellos sometidos a la cirugía bariátrica. Obesos con compulsión alimentaria presentan más síntomas psicopatológicos, que interfieren en la adhesión al tratamiento cuando no se diagnostica adecuadamente. Objetivo: Evaluar la frecuencia del trastorno de compulsión periódica en pacientes obesos y en aquellos sometidos a la cirugía bariátrica. Métodos: Participaron del estudio individuos de ambos sexos, atendidos en una clínica privada de cirugía bariátrica, en la ciudad de Caruaru, Pernambuco. Se evaluó la presencia de este trastorno en los pacientes obesos candidatos o sometidos a la cirugía a través de la Escala de Compulsión Alimentaria Periódica, un cuestionario auto aplicable, que tiene como finalidad discriminar individuos obesos de acuerdo con la gravedad de la compulsión alimentaria. Además, también se evaluó el estilo de vida (tabaquismo, etilismo y práctica de actividad física) de los pacientes. Resultados: La muestra fue compuesta por 45 pacientes, siendo 82,2% mujeres, 73,3% pacientes postoperatorio y 26,7% preoperatorios. Se verificó que el 43,2% de los pacientes presentaban compulsión alimentaria, siendo observado una frecuencia mayor entre los candidatos a la cirugía bariátrica (75%). Conclusión: La frecuencia del trastorno fue superior en los pacientes preoperatorios cuando comparados en aquellos que realizaron la cirugía bariátrica. Ante lo expuesto se hace esencial investigar la presencia de ese trastorno en obesos candidatos o no la cirugía bariátrica, teniendo en vista la mayor efectividad y adhesión del tratamiento adecuado de estos pacientes

Immune response of severe malnutrition children treated according to the protocol of the World Health Organization / Respuesta inmune de niños con desnutrición grave tratada según el protocolo de la organización mundial de la salud

The aim of the study was to compare the innate immune system of severely malnourished children admitted to the Instituto de Medicina Integral Professor Fernando Figueira and treated according to the protocol of the World Health Organization (WHO) at admission and discharge. An experimental study was conducted with 20 children under two years of age. Ten of them had severe malnutrition and ten were a control group. The malnourished group consisted of hospitalized infants and it was submitted to WHO’s protocol. Children with HIV and re-admitted during the study period were excluded. A blood sample was taken at admission and at discharge. Later, an analysis of blood leukocytes, adherence index, phagocytic capacity, production of free radicals superoxide and nitric oxide was performed. Patients with severe malnutrition at hospital discharge showed improved phagocytic function, release of oxygen radicals and reduction of the number of lymphocytes when compared to the time of admission. When compared to the control group, patients at hospital discharge had lower lymphocyte values and lower production of free radicals. Thus, it can be concluded that the duration of hospitalization was insufficient to restore cell-mediated immunity and microbicide activity (AU)

El objetivo del estudio fue comparar el sistema inmune innato de niños con malnutrición grave ingresados en el Instituto de Medicina Integral Professor Fernando Figueira, tratados de acuerdo con el protocolo de la Organización Mundial de la Salud (OMS), al ingreso y al alta hospitalaria. Se llevó a cabo un estudio experimental con 20 niños menores de dos años de edad, 10 con malnutrición grave y 10 niños del grupo de control. El grupo de malnutridos se compuso de lactantes hospitalizados y sometidos al protocolo de la OMS. Se excluyeron los niños afectados por el HIV y los readmitidos durante el período del estudio. Se recogió una muestra de sangre al ingreso y otra al alta, y posterioriormente se realizó el análisis del perfil leucocitario, y el índice de adherencia, la capacidad fagocítica y la producción de los radicales libres superóxido y óxido nítrico. Los pacientes con malnutrición grave en el alta hospitalaria mostraron mejoría de la función fagocítica, la liberación de radicales oxidantes y la reducción del número de linfocitos en comparación con el ingreso hospitalario. En comparación con el grupo de control, los pacientes en el alta hospitalario presentaron valores más bajos de linfocitos y de producción de radicales libres. Por lo tanto, se puede concluir que el tiempo de hospitalización fue insuficiente para restablecer la inmunidad mediada por células, así como para restaurar la actividad microbicida (AU)