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1.
Emerg Med Australas ; 2024 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-39129651

RESUMEN

OBJECTIVE: Testicular torsion is an uncommon but time-critical condition in EDs. If the diagnosis is missed or delayed, there are significant medicolegal and patient fertility implications. Scoring tools are advocated for use in children but have limited validation in adults. The aim of the present study was to explore the predictive accuracy of the testicular torsion scoring tools, Testicular Workup for Ischemia and Suspected Torsion (TWIST) and Boettcher Alert Score (BALS), in adult patients with a final ED diagnosis of torsion. METHODS: All patients with an ED working diagnosis of testicular torsion were identified retrospectively. Data collected from digital medical records included demographics, processes of care and clinical information. The outcome of interest was the predictive performance of the scores for a confirmed diagnosis of testicular torsion as adjudicated by an urologist or a surgeon. RESULTS: Fifty-four patients had complete clinical data, of whom 13 had confirmed torsion. The TWIST score had a high area under the receiver operating characteristics curve (AUROC) of 0.89 (95% confidence interval [CI] = 0.78-0.999) with a score of 6-7 corresponding to a positive predictive value (PPV) of 80% (95% CI = 38-96%). The BAL score had an AUROC of 0.79 (95% CI = 0.69-0.92). PPV for a score ≥2 was 38% (95% CI = 22-56%). CONCLUSION: A high TWIST score correlates to a high likelihood of torsion and can inform surgical decision-making in the absence of US.

2.
Emerg Med Australas ; 2024 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-39086015

RESUMEN

OBJECTIVE: Falls are a leading cause for ED presentations among older adults. Existing secondary falls prevention interventions have not been shown to decrease fall-related ED re-presentation, indicating a need to better understand contributing factors. Our aim was to evaluate risk factors for fall re-presentations among the older patient population presenting to the ED. METHODS: This is a single-centre case-control study. Cases were patients aged ≥65 years with two falls-related ED presentations within 6 months. Age- and sex-matched controls had a corresponding index, but no subsequent ED fall presentation. Data collected included falls risk factors and clinical features of the index presentation. Univariate and multivariate analyses were conducted to assess the relationship between potential exposures and fall re-presentation. RESULTS: A total of 300 patients (mean age 83.8 years) were studied. On univariate analysis, factors significantly associated with ED fall re-presentation included increasing multimorbidity (P < 0.0001), increasing number of medications (P < 0.0001) and residing in residential aged care facility (RACF) (odds ratio [OR] 3.06, P < 0.001). No factors remained significant on multivariate analysis. Post-hoc analyses for the RACF subgroup showed that psychotropic medication use (OR 1.65, P = 0.04) and prior fall within 12 months (OR 2.68, P < 0.001) were significantly associated with re-presentation. Initial presentation with serious musculoskeletal injury was a significant protective factor (OR 0.21, P = 0.02). CONCLUSION: The present study failed to identify factors independently associated with ED fall re-presentation, suggesting that the factors are complex and inter-related. Two high-risk populations were identified - those from RACF and those initially presenting with falls not resulting in serious injury.

3.
Expert Rev Respir Med ; 18(7): 553-559, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38973767

RESUMEN

BACKGROUND: Several methods exist to reduce the number of arterial blood gases (ABGs). One method, Roche v-TAC, has been evaluated in different patient groups. This paper aggregates data from these studies, in different patient categories using common analysis criteria. RESEARCH DESIGN AND METHODS: We included studies evaluating v-TAC based on paired arterial and peripheral venous blood samples. Bland-Altman analysis compared measured and calculated arterial values of pH, PCO2, and PO2. Subgroup analyses were performed for normal, chronic hypercapnia and chronic base excess, acute hyper- and hypocapnia, and acute and chronic base deficits. RESULTS: 811 samples from 12 studies were included. Bias and limits of agreement for measured and calculated values: pH 0.001 (-0.029 to 0.031), PCO2 -0.08 (-0.65 to 0.49) kPa, and PO2 0.04 (-1.71 to 1.78) kPa, with similar values for all sub-group analyses. CONCLUSION: These data suggest that v-TAC analysis may have a role in replacing ABGs, avoiding arterial puncture. Substantial data exist in patients with chronic hypercapnia and chronic base excess, acute hyper- and hypocapnia, and in patients with relatively normal acid-base status, with similar bias and precision across groups and across study data. Limited data exist for patients with acute and chronic base deficits.


Asunto(s)
Arterias , Análisis de los Gases de la Sangre , Oxígeno , Venas , Humanos , Análisis de los Gases de la Sangre/métodos , Oxígeno/sangre , Arterias/fisiopatología , Concentración de Iones de Hidrógeno , Dióxido de Carbono/sangre , Equilibrio Ácido-Base , Hipercapnia/sangre , Hipercapnia/fisiopatología , Hipercapnia/diagnóstico , Desequilibrio Ácido-Base/sangre , Desequilibrio Ácido-Base/diagnóstico , Desequilibrio Ácido-Base/fisiopatología , Valor Predictivo de las Pruebas
4.
Br J Nurs ; 33(12): 538-544, 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38900669

RESUMEN

In modern society, people engage in social interactions and activities outside their own home. When in public settings people may need to eliminate bodily waste, so public toilets are required. Accessibility, availability and adaptability are essential principles for safe, private, and purposeful visits to public toilets. A diverse range of individuals use public toilets: various age profiles, all gender groups, vulnerable individuals and people with additional needs. Public toilets essentially need to be a place of privacy, safety and cleanliness to facilitate elimination of urine, evacuation of faeces, management of menstruation, and changing/disposing of continence wear products in a secure environment.


Asunto(s)
Cuartos de Baño , Humanos
5.
Lett Appl Microbiol ; 77(7)2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38925640

RESUMEN

Faecal contamination of surface waters has the potential to spread not only pathogenic organisms but also antimicrobial resistant organisms. During the bathing season of 2021, weekly water samples, from six selected coastal bathing locations (n = 93) and their freshwater tributaries (n = 93), in Northern Ireland (UK), were examined for concentrations of faecal indicator bacteria Escherichia coli and intestinal enterococci. Microbial source tracking involved detection of genetic markers from the genus Bacteroides using PCR assays for the general AllBac marker, the human HF8 marker and the ruminant BacR marker for the detection of human, and ruminant sources of faecal contamination. The presence of beta-lactamase genes blaOXA-48, blaKPC, and blaNDM-1 was determined using PCR assays for the investigation of antimicrobial resistance genes that are responsible for lack of efficacy in major broad-spectrum antibiotics. The beta-lactamase gene blaOXA-48 was found in freshwater tributary samples at all six locations. blaOXA-48 was detected in 83% of samples that tested positive for the human marker and 69% of samples that tested positive for the ruminant marker over all six locations. This study suggests a risk of human exposure to antimicrobial resistant bacteria where bathing waters receive at least episodically substantial transfers from such tributaries.


Asunto(s)
Proteínas Bacterianas , Escherichia coli , Heces , Agua Dulce , beta-Lactamasas , beta-Lactamasas/genética , Irlanda del Norte , Agua Dulce/microbiología , Proteínas Bacterianas/genética , Escherichia coli/genética , Escherichia coli/aislamiento & purificación , Escherichia coli/efectos de los fármacos , Humanos , Heces/microbiología , Microbiología del Agua , Enterococcus/genética , Enterococcus/aislamiento & purificación , Enterococcus/enzimología , Enterococcus/efectos de los fármacos , Antibacterianos/farmacología , Animales
6.
Br J Nurs ; 33(9): S16-S28, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38722011

RESUMEN

Incontinence-associated dermatitis (IAD) is a skin inflammation caused by contact with urine or faeces or both. It has a negative effect on the patient's quality of life and is indicative of the care provided. However, globally there is a lack of empirical data on the prevalence of IAD. AIM: To identify, for the first time, the proportion of older adults in extended care settings in Ireland affected by IAD. DESIGN: Cross-sectional, multisite, point prevalence survey, across three community extended care settings for older people in Ireland. METHODS: Two clinical nurse specialists, using the Scottish Excoriation and Moisture Related Skin Damage Tool, identified the presence of IAD through clinical observation and visual skin inspection. IAD prevalence was calculated for the total population and incontinent population sets using percentages and confidence intervals (CI). RESULTS: The prevalence of incontinence was 86.4% (n=165), a significantly higher proportion were female (P=0.003). The point prevalence of IAD across the total population and incontinent population was 11.5% (22/191; 95% CI, 7.4-19.9%) and 13.3% (22/164; 95% CI, 8.5-19.5%), respectively. Being incontinent was associated with being female, more dependent (Barthel), having possible cognitive impairment, poorer mobility (Braden and Waterlow) and a high risk of pressure ulcers (Waterlow). A logistic regression analysis found no predictor variables for IAD among the variables that met the cut-off point for this analysis. CONCLUSIONS: The study provides the first point prevalence empirical data on the occurrence of IAD in Ireland. It can inform decision-making on future planning and budgeting of new quality improvement projects and act as a benchmark for ongoing auditing of IAD.


Asunto(s)
Incontinencia Fecal , Incontinencia Urinaria , Humanos , Femenino , Estudios Transversales , Masculino , Irlanda/epidemiología , Prevalencia , Anciano , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/complicaciones , Incontinencia Fecal/epidemiología , Incontinencia Fecal/complicaciones , Anciano de 80 o más Años , Dermatitis/epidemiología , Dermatitis/etiología
7.
Br J Community Nurs ; 29(Sup5): S52-S58, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38728160

RESUMEN

The fundamental principles of why specific people become homeless, can be grounded in a simple rationale or founded within sophisticated reasoning. For instance, people who suffer from substance abuse, addiction, alcohol, gambling, have mental health concerns or financial difficulties may be susceptible to homelessness. It is also identified that persons who experienced violence in their childhood or abuse by a partner are at a higher risk of becoming homeless. Homelessness knows no ethnic, cultural, religious or gender boundaries, and can impact all individuals' health and well-being. A health problem and worldwide phenomenon that affects all cohorts of the population, including the homeless, is urinary incontinence. The aim of this article is to increase the awareness of incontinence and highlight the impact it has on the lives of people that experience homelessness.


Asunto(s)
Personas con Mala Vivienda , Incontinencia Urinaria , Humanos , Femenino , Masculino
8.
Cancer ; 130(16): 2746-2762, 2024 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-38752572

RESUMEN

BACKGROUND: Breast cancer (BC) in women aged ≤40 years carrying germline pathogenetic variants (PVs) in BRCA1/2 genes is infrequent but often associated with aggressive features. Human epidermal growth factor receptor 2 (HER2)-low-expressing BC has recently emerged as a novel therapeutic target but has not been characterized in this rare patient subset. METHODS: Women aged ≤40 years with newly diagnosed early-stage HER2-negative BC (HER2-0 and HER2-low) and germline BRCA1/2 PVs from 78 health care centers worldwide were retrospectively included. Chi-square test and Student t-test were used to describe variable distribution between HER2-0 and HER2-low. Associations with HER2-low status were assessed with logistic regression. Kaplan-Meier method and Cox regression analysis were used to assess disease-free survival (DFS) and overall survival. Statistical significance was considered for p ≤ .05. RESULTS: Of 3547 included patients, 32.3% had HER2-low BC, representing 46.3% of hormone receptor-positive and 21.3% of triple-negative (TN) tumors. HER2-low vs. HER2-0 BC were more often of grade 1/2 (p < .001), hormone receptor-positive (p < .001), and node-positive (p = .003). BRCA2 PVs were more often associated with HER2-low than BRCA1 PVs (p < .001). HER2-low versus HER2-0 showed better DFS (hazard ratio [HR], 0.86; 95% CI, 0.76-0.97) in the overall population and more favorable DFS (HR, 0.78; 95% CI, 0.64-0.95) and overall survival (HR, 0.65; 95% CI, 0.46-0.93) in the TN subgroup. Luminal A-like tumors in HER2-low (p = .014) and TN and luminal A-like in HER2-0 (p = .019) showed the worst DFS. CONCLUSIONS: In young patients with HER2-negative BC and germline BRCA1/2 PVs, HER2-low disease was less frequent than expected and more frequently linked to BRCA2 PVs and associated with luminal-like disease. HER2-low status was associated with a modestly improved prognosis.


Asunto(s)
Proteína BRCA1 , Proteína BRCA2 , Neoplasias de la Mama , Mutación de Línea Germinal , Receptor ErbB-2 , Humanos , Femenino , Receptor ErbB-2/genética , Receptor ErbB-2/metabolismo , Estudios Retrospectivos , Adulto , Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Neoplasias de la Mama/mortalidad , Proteína BRCA1/genética , Proteína BRCA2/genética , Adulto Joven , Supervivencia sin Enfermedad , Pronóstico
10.
Emerg Med J ; 41(6): 368-375, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38658053

RESUMEN

OBJECTIVES: Only a small proportion of patients presenting to an ED with headache have a serious cause. The SNNOOP10 criteria, which incorporates red and orange flags for serious causes, has been proposed but not well studied. This project aims to compare the proportion of patients with 10 commonly accepted red flag criteria (singly and in combination) between patients with and without a diagnosis of serious secondary headache in a large, multinational cohort of ED patients presenting with headache. METHODS: Secondary analysis of data obtained in the HEAD and HEAD-Colombia studies. The outcome of interest was serious secondary headache. The predictive performance of 10 red flag criteria from the SNNOOP10 criteria list was estimated individually and in combination. RESULTS: 5293 patients were included, of whom 6.1% (95% CI 5.5% to 6.8%) had a defined serious cause identified. New neurological deficit, history of neoplasm, older age (>50 years) and recent head trauma (2-7 days prior) were independent predictors of a serious secondary headache diagnosis. After adjusting for other predictors, sudden onset, onset during exertion, pregnancy and immune suppression were not associated with a serious headache diagnosis. The combined sensitivity of the red flag criteria overall was 96.5% (95% CI 93.2% to 98.3%) but specificity was low, 5.1% (95% CI 4.3% to 6.0%). Positive predictive value was 9.3% (95% CI 8.2% to 10.5%) with negative predictive value of 93.5% (95% CI 87.6% to 96.8%). CONCLUSION: The sensitivity and specificity of the red flag criteria in this study were lower than previously reported. Regarding clinical practice, this suggests that red flag criteria may be useful to identify patients at higher risk of a serious secondary headache cause, but their low specificity could result in increased rates of CT scanning. TRIAL REGISTRATION NUMBER: ANZCTR376695.


Asunto(s)
Servicio de Urgencia en Hospital , Cefalea , Valor Predictivo de las Pruebas , Humanos , Femenino , Servicio de Urgencia en Hospital/organización & administración , Masculino , Persona de Mediana Edad , Adulto , Cefalea/etiología , Cefalea/diagnóstico , Sensibilidad y Especificidad , Anciano
11.
Emerg Med Australas ; 36(3): 336-339, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38627201

RESUMEN

Patients leave ED for a variety of reasons and at all stages of care. In Australian law, clinicians and health services owe a duty of care to people presenting to the ED for care, even if they have not yet entered a treatment space. There is also a positive duty to warn patients of material risks associated with their condition, proposed treatment(s), reasonable alternative treatment options and the likely effect of their healthcare decisions, including refusing treatment. This extends to a decision to leave the ED before care is completed. The form of that warning may vary based on what is known about the patient's condition and the associated risks at the time. Specific documentation of warnings given is essential.


Asunto(s)
Deber de Advertencia , Servicio de Urgencia en Hospital , Humanos , Servicio de Urgencia en Hospital/legislación & jurisprudencia , Australia , Deber de Advertencia/legislación & jurisprudencia
13.
Haemophilia ; 30(2): 306-319, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38239180

RESUMEN

AIM: For people with haemophilia A (PwHA), bleeding in the joints leads to joint damage and haemophilia-related arthropathy, impacting range of motion and life expectancy. Existing guidelines for managing haemophilia A support healthcare professionals (HCPs) and PwHA in their efforts to preserve joint health. However, such guidance should be reviewed, considering emerging evidence and consensus as presented in this manuscript. METHODS: Fifteen HCPs experienced in the management of PwHA in the UK participated in a three-round Delphi panel. Consensus was defined at ≥70% of panellists agreeing or disagreeing for Likert-scale questions, and ≥70% selecting the same option for multiple- or single-choice questions. Questions not reaching consensus were revised for the next round. RESULTS: 26.8% (11/41), 44.8% (13/29) and 93.3% (14/15) of statements reached consensus in Rounds 1, 2 and 3, respectively. HCPs agreed that prophylaxis should be offered to patients with a baseline factor VIII (FVIII) level of ≤5 IU/dL and that, where there is no treatment burden, the aim of prophylaxis should be to achieve a trough FVIII level ≥15 IU/dL and maintain a longer period with FVIII levels of ≥20-30 IU/dL to provide better bleed protection. The aspirational goal for PwHA is to prevent all joint bleeds, which may be achieved by maintaining normalised (50-150 IU/dL) FVIII levels. CONCLUSION: The panel of experts were largely aligned on approaches to preserving joint health in PwHA, and this consensus may help guide HCPs.


Asunto(s)
Hemofilia A , Humanos , Hemofilia A/tratamiento farmacológico , Factor VIII/uso terapéutico , Consenso , Hemartrosis/prevención & control , Hemorragia/prevención & control , Reino Unido
14.
PLoS One ; 19(1): e0288577, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38266007

RESUMEN

BACKGROUND: Chronic hepatitis B (CHB) is endemic in the Aboriginal and Torres Strait Islander population of Australia's Northern Territory. Progression to liver disease can be prevented if holistic care is provided. Low health literacy amongst health professionals is a known barrier to caring for people living with CHB. We co-designed and delivered a culturally safe "Managing hepatitis B" training course for the Aboriginal health workforce. Here, we present an evaluation of the course. OBJECTIVES: 1. To improve course participants CHB-related knowledge, attitudes, and clinical practice. 2. To evaluate the "Managing hepatitis B" training course. 3. To enable participants to have the skills and confidence to be part of the care team. METHODS: We used participatory action research and culturally safe principles. We used purpose-built quantitative and qualitative evaluation tools to evaluate our "Managing hepatitis B" training course. We integrated the two forms of data, deductively analysing codes, grouped into categories, and assessed pedagogical outcomes against Kirkpatrick's training evaluation framework. RESULTS: Eight courses were delivered between 2019 and 2023, with 130 participants from 32 communities. Pre- and post-course questionnaires demonstrated statistically significant improvements in all domains, p<0.001 on 93 matched pairs. Thematic network analysis demonstrated high levels of course acceptability and significant knowledge acquisition. Other themes identified include cultural safety, shame, previous misinformation, and misconceptions about transmission. Observations demonstrate improvements in post-course engagement, a deep understanding of CHB as well as increased participation in clinical care teams. CONCLUSIONS: The "Managing hepatitis B" training course led to a sustained improvement in the knowledge and attitudes of the Aboriginal health workforce, resulting in improved care and treatment uptake for people living with CHB. Important non-clinical outcomes included strengthening teaching and leadership skills, and empowerment.


Asunto(s)
Educación Médica Continua , Servicios de Salud del Indígena , Hepatitis B Crónica , Humanos , Fuerza Laboral en Salud , Northern Territory , Aborigenas Australianos e Isleños del Estrecho de Torres
15.
Rev. Headache Med. (Online) ; 14(1): 43-48, 2023.
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1531774

RESUMEN

Introduction:Headache is a common reason for presentation to emergency departments (ED) around the world. In many countries, ED are not speciality-focussed, however, in Colombia and some other countries, specialist neurological hospitals have ED with a strong neurological focus. For patients presenting with headache, these ED may have different epidemiology, investigation strategies and treatment patterns from general ED. Objective:The objective of this study was to describe the epidemiology of headache presenting to the ED of Instituto Neurológico de Colombia in Medellin, Colombia ­ an ED which is a referral centre for neurological and neurosurgical diseases. Methods:This was an observational study by chart review of adults (aged ≥18) with a main presenting compliant of headache. Demographic, clinical, imaging, diagnoses and outcome data were collected. The primary outcome of interest was the rate of serious secondary intracranial headache cause. Analysis was descriptive. Results:757 patients were studied ­ female 76%, median age 39. Most headache were of gradual onset (85%) and new neurological signs were uncommon (4%). CT was performed in 50% of cases and MRI in 20%. A wide variety of headache causes were identified. Serious secondary intracranial headache was identified in 8.9% (95% CI 7.1-11.1%) of cases. Most patients (89%) were discharged home from ED. Conclusion:Diagnosis of headache in ED is challenging with a very wide range of possible causes. A small proportion of patients (approx. 9%) have a serious cause for their symptoms ­ a proportion similar to that reported in other international emergency department cohorts.


Introdução: A cefaleia é um motivo comum de apresentação aos departamentos de emergência (DE) em todo o mundo. Em muitos países, os PS não são focados em especialidades, no entanto, na Colômbia e em alguns outros países, os hospitais neurológicos especializados têm PS com um forte foco neurológico. Para pacientes que apresentam cefaleia, esses DE podem ter epidemiologia, estratégias de investigação e padrões de tratamento diferentes dos DE geral. Objetivo: O objetivo deste estudo foi descrever a epidemiologia da dor de cabeça apresentada ao pronto-socorro do Instituto Neurológico de Colômbia em Medellín, Colômbia ­ um pronto-socorro que é um centro de referência para doenças neurológicas e neurocirúrgicas. Métodos: Este foi um estudo observacional por meio de revisão de prontuários de adultos (idade ≥18) com apresentação principal complacente de cefaleia. Dados demográficos, clínicos, de imagem, diagnósticos e resultados foram coletados. O desfecho primário de interesse foi a taxa de causa grave de dor de cabeça intracraniana secundária. A análise foi descritiva. Resultados: Foram estudados 757 pacientes ­ 76% do sexo feminino, idade mediana de 39 anos. A maioria das cefaleias foi de início gradual (85%) e os novos sinais neurológicos foram incomuns (4%). A tomografia computadorizada foi realizada em 50% dos casos e a ressonância magnética em 20%. Uma grande variedade de causas de dor de cabeça foi identificada. Cefaleia intracraniana secundária grave foi identificada em 8,9% (IC 95% 7,1-11,1%) dos casos. A maioria dos pacientes (89%) recebeu alta do pronto-socorro. Conclusão: O diagnóstico de cefaleia no DE é desafiador, com uma ampla gama de causas possíveis. Uma pequena proporção de pacientes (aproximadamente 9%) tem uma causa grave para os seus sintomas ­ uma proporção semelhante à relatada em outras coortes internacionais de serviços de emergência.

16.
Br. j. haematol ; 190: 684-695, 20200510.
Artículo en Inglés | BIGG - guías GRADE | ID: biblio-1292053

RESUMEN

The writing group produced the draft guideline, which was subsequently revised by consensus. Review of the manuscript was performed by the BSH Guidelines Committee Haemostasis and Thrombosis Taskforce, the BSH Guidelines Committee and the Haemostasis and Thrombosis sounding board of the BSH. It was also on the members section of the BSH website for comment. It has also been reviewed by members of the United Kingdom Haemophilia Centre Doctors' Organisation (UKHCDO) Advisory Board, Haemophilia Nurses Association (HNA), Haemophilia Chartered Physiotherapists Association (HCPA); these organisations do not necessarily approve or endorse the contents.


Asunto(s)
Humanos , Preescolar , Niño , Adolescente , Adulto , Hemartrosis/prevención & control , Trastornos Hemorrágicos/tratamiento farmacológico , Hemostáticos/uso terapéutico , Trastornos Hemorrágicos/diagnóstico
17.
Nutr. clín. diet. hosp ; 35(2): 16-25, 2015. tab
Artículo en Portugués | IBECS | ID: ibc-139267

RESUMEN

Introdução: A ingestão de bebidas alcoólicas vem se elevando continuamente no mundo e pode trazer malefícios à saúde. Se as bebidas alcoólicas forem consumidas em demasia, pode ocorrer dependência, desequilíbrio e carências nutricionais. Objetivo: Avaliar o estado nutricional e o consumo alimentar de alcoolistas em reabilitação, a fim de identificar possíveis intervenções pertinentes a uma equipe multidisciplinar e ressaltar a importância do estabelecimento de uma alimentação adequada por parte dos alcoolistas em reabilitação com o propósito de promover a saúde dos indivíduos. Métodos: Foi realizado um estudo transversal, de caráter descritivo, em um centro de reabilitação de alcoolistas, denominado de Alcoólicos Anônimos (AA), situado na cidade Caruaru, no Agreste de Pernambuco. O estudo contou com a participação de 43 alcoolistas em reabilitação com idade igual ou superior a 20 anos e inferior a 60 anos de ambos os sexos. Foram obtidos dados socioeconômicos e foi realizada uma avaliação nutricional dos indivíduos através da ficha de avaliação socioeconômica e nutricional. O consumo alimentar dos participantes foi analisado através do Questionário de Frequência Alimentar (QFA) adaptado. Resultados: Dentre os indivíduos, observou-se uma frequência elevada de alcoolistas em reabilitação do sexo masculino (88,4%). A média do índice de massa corporal (IMC) da população avaliada foi de 26,9 (+/- 5,1) kg/m²; de acordo com este parâmetro 60% das mulheres apresentaram estado nutricional eutrófico e 40% apresentaram obesidade. A média da circunferência da cintura (CC) na população feminina foi de 91(+/-5,4) cm. Entre os participantes do sexo masculino, considerando o IMC, 28,9% apresentaram eutrofia, 34,2% sobrepeso e 36,7% obesidade. A mé- dia da CC no sexo masculino foi 97,3 (+/-8,9) cm. Desta forma, nesta pesquisa, 32,5% dos indivíduos avaliados encontrava-se em estado nutricional eutró- fico e 67,4% dos reabilitandos apresentavam sobrepeso ou obesidade. O consumo alimentar entre os alcoolistas em reabilitação foi considerado inadequado em relação ao consumo de diversos alimentos como consumo raro de peixes, consumo habitual de pães e consumo não habitual, contudo semanal (variando de 1 a 2 ou 3 vezes por semana), de embutidos, biscoitos, bolos e macarrão, assim como doces/balas, chocolates e refrigerantes. O consumo de hortaliças e frutas também foi considerado não habitual. Discussão: Historicamente os homens sempre estiveram mais relacionados ao consumo do álcool. A idade média dos participantes da pesquisa destaca a frequência elevada de adultos jovens entre os indivíduos em reabilitação pelo uso abusivo de álcool. Observou-se um percentual elevado de indivíduos com baixa renda financeira e escolaridade. Nas classes econômicas consideradas menos favorecidas e em grupos populacionais que possuem menor grau de escolaridade no Brasil, a incidência do alcoolismo é maior, ratificando afirmação de diversos autores de que aspectos psicológicos, sociais e econômicos favorecerem o uso abusivo de álcool e a sua dependência. O consumo alimentar, considerado inadequado em relação ao consumo de diversos grupos alimentares, entre os alcoolistas em reabilitação, pode ser responsável pela elevada frequência de sobrepeso e obesidade observada entre os indivíduos. Conclusão: No período de reabilitação do alcoolista, torna-se imprescindível o acompanhamento e orientação dos mesmos por profissionais da área de nutrição para que o objetivo do tratamento seja alcançado, bem como demais ajudas multiprofissionais. Este fato ratifica a importância da nutrição no processo reabilitatório e a necessidade de uma atuação multiprofissional em busca da promoção da saúde e bem estar dos indivíduos (AU)


Introduction: alcohol consumption has increased over the years in the world and can be harmful to health. If alcoholic beverages are consumed in excess, it can promote dependence, imbalance and nutritional deficiencies. Objective: To evaluate the nutritional status and food consumption of alcoholics in rehabilitation, in order to identify possible interventions relevant to a multidisciplinary group and to emphasize the importance of establishing adequate nutrition for alcoholics in rehabilitation to promote the health of individuals. Methods: We conducted a descriptive cross-sectional study, in an alcoholic rehabilitation center, recognized as Alcoholics Anonymous (AA), located in Caruaru city, Pernambuco state. The study was conducted with 43 alcoholics in rehabilitation, aged above 20 years and below 60 years of both sexes. Socioeconomic data and the nutritional state of individuals were analysed by using a socioeconomic and nutritional evaluation form. The dietary consumption of participants was analyzed by the Food Frequency Questionnaire (FFQ) adapted. Results: Among individuals, there was a high frequency of alcoholism rehabilitation in male population (88.4%). The mean body mass index (BMI) of the studied population was 26.9 (+/- 5.1) kg/m2; according to this parameter, 60% of women exhibited eutrophic nutritional status and 40% were obese. The average of waist circumference (WC) in the female population was 91 (+/- 5.4) cm. Among the male participants, using BMI, 28.9% were eutrophic, 34.2% overweight and 36.7% obese. The average of WC in male individuals was 97.3 (+/- 8.9) cm. Thus, in this study, 32.5% of the individuals presented an eutrophic nutritional status and 67.4% of participants were overweight or obese. Food consumption among alcoholics in rehabilitation was considered inadequate in relation to the consumption of several foods, as rare fish consumption, habitual consumption of bread and no habitual consumption, however weekly (ranging from 1 to 2 or 3 times a week), of embedded, cookies, cakes and pasta, as well as sweets/candy, chocolate and soft drinks. The consumption of fruit and vegetables were also considered unusual. Discussion: Historically, men have always been more related to alcohol consumption. The average age of respondents highlights the high frequency of young adults between individuals in rehabilitation for alcohol abuse. There was a high percentage of individuals with low financial income and education. In economic classes considered disadvantaged and in population groups having lower education in Brazil, the incidence of alcoholism is higher, confirming statement of several authors that psychological, social and economic aspects have the potential to promote the abuse of alcohol and its dependence. Food consumption considered inappropriate in relation to consumption of various food groups, among alcoholics in rehabilitation, may be responsible for the high rates of overweight and obesity observed among individuals. Conclusion: In the alcoholic rehabilitation period, it is essential monitoring and guidance the individuals by nutrition professionals to achieve the treatment objectives. In addition, a multi-professional support is also needed. This fact confirms the importance of nutrition in reabilitatorio process and the need of a multidisciplinary performance for promoting health and well being of individuals (AU)


Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Alcoholismo/diagnóstico , Alcoholismo/rehabilitación , Alcoholismo/terapia , Estado Nutricional/fisiología , Desnutrición Proteico-Calórica/complicaciones , Desnutrición/complicaciones , Desnutrición/dietoterapia , Promoción de la Salud/métodos , Alcoholismo/dietoterapia , Estado Nutricional , Estudios Transversales/métodos , Estudios Transversales/tendencias , Encuestas y Cuestionarios , Promoción de la Salud/normas , Promoción de la Salud
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