Changes in body composition of burn patients during the phases of response to trauma.

OBJECTIVE: To assess the changes in body composition of burn patients through electrical bioimpedance in the phases of response to trauma. METHODS: a longitudinal observational study, carried out from October 2019 to March 2020. Sociodemographic, clinical, epidemiological, anthropometric and body composition data were collected. Statistical analysis was performed with SPSS, considering a significance of 5%. The comparison between variables was performed using the paired Student's t test. RESULTS: the sample consisted of 58 adult burn patients, with a mean age of 38.2±12.5 years. The mean body surface area (BSA) with burns was 10.8±7.3%. Nutritional assessment demonstrated a depletion of body weight, Body Mass Index, fat-free mass and muscle mass in the phases of response to trauma (p<0.005). CONCLUSION: metabolic alterations in the different phases of the metabolic response to trauma led to a depletion of the nutritional status of burn patients of both sexes during hospitalization.

Changes in body composition of burn patients during the phases of response to trauma / Alterações na composição corporal de pacientes queimados durante as fases de resposta ao trauma / Cambios en la composición corporal de pacientes quemados durante las fases de respuesta al trauma

ABSTRACT Objective: To assess the changes in body composition of burn patients through electrical bioimpedance in the phases of response to trauma. Methods: a longitudinal observational study, carried out from October 2019 to March 2020. Sociodemographic, clinical, epidemiological, anthropometric and body composition data were collected. Statistical analysis was performed with SPSS, considering a significance of 5%. The comparison between variables was performed using the paired Student's t test. Results: the sample consisted of 58 adult burn patients, with a mean age of 38.2±12.5 years. The mean body surface area (BSA) with burns was 10.8±7.3%. Nutritional assessment demonstrated a depletion of body weight, Body Mass Index, fat-free mass and muscle mass in the phases of response to trauma (p<0.005). Conclusion: metabolic alterations in the different phases of the metabolic response to trauma led to a depletion of the nutritional status of burn patients of both sexes during hospitalization.

RESUMO Objetivo: avaliar as alterações na composição corporal de pacientes queimados por meio da bioimpedância elétrica nas fases de resposta ao trauma. Métodos: estudo observacional longitudinal, realizado de outubro de 2019 a março de 2020. Foram coletados dados sociodemográficos, clínicos, epidemiológicos, antropométricos e de composição corporal. A análise estatística foi realizada com o SPSS, considerando significância de 5%. Comparação entre as variáveis foi realizada por meio do teste t de Student pareado. Resultados: a amostra foi composta por 58 pacientes adultos queimados, com média de 38,2±12,5 anos. A média da área de superfície corporal (ASC) com queimaduras foi de 10,8±7,3%. A avaliação nutricional demonstrou depleção do peso corporal, índice de massa corporal, massa magra e massa muscular nas fases de resposta ao trauma (p<0,005). Conclusão: alterações metabólicas nas diferentes fases da resposta metabólica ao trauma levaram a depleção do estado nutricional de pacientes queimados de ambos os sexos durante a internação.

RESUMEN Objetivo: evaluar alteraciones en la composición corporal de pacientes quemados mediante bioimpedancia eléctrica en las fases de respuesta al trauma. Métodos: estudio observacional longitudinal, realizado de octubre de 2019 a marzo de 2020. Se recogieron datos sociodemográficos, clínicos, epidemiológicos, antropométricos y de composición corporal. El análisis estadístico se realizó mediante SPSS, considerando una significancia del 5%. La comparación entre variables se realizó mediante la prueba de la t de Student pareada. Resultados: la muestra estuvo compuesta por 58 pacientes adultos quemados, con una edad media de 38,2±12,5 años. El área de superficie corporal media (ASC) con quemaduras fue de 10,8±7,3%. La evaluación nutricional mostró disminución del peso corporal, índice de masa corporal, masa magra y masa muscular en las fases de respuesta al trauma (p<0,005). Conclusión: los cambios metabólicos en las diferentes fases de la respuesta metabólica al trauma llevaron a la disminución del estado nutricional de los pacientes quemados de ambos sexos durante la hospitalización.

Association between being underweight and excess body weight before SARS coronavirus type 2 infection and clinical outcomes of coronavirus disease 2019: Multicenter study.

OBJECTIVES: The present study aimed to identify associations between extremes in body weight status (underweight and excess body weight) before a COVID-19 diagnosis and clinical outcomes in patients infected with SARS coronavirus type 2. METHODS: A multicenter cohort study was conducted in eight different states in northeastern Brazil. Demographic, clinical (previous diagnosis of comorbidities), and anthropometric (self-reported weight and height) data about individuals who tested positive for COVID-19 were collected. Outcomes included hospitalization, mechanical ventilation, and death. Multivariable logistic regression models, adjusted based on age, sex and previous comorbidities, were used to assess the effects of extremes in body weight status on clinical outcomes. RESULTS: A total of 1308 individuals were assessed (33.6% were elderly individuals). The univariable analyses showed that only hospitalization was more often observed among underweight (3.2% versus 1.2%) and overweight (68.1% versus 63.3%) individuals. In turn, cardiovascular diseases were more often observed in all clinical outcomes (hospitalization: 19.7% versus 4.8%; mechanical ventilation: 19.9% versus 13.5%; death: 21.8% versus 14.1%). Based on the multivariable analysis, body weight status was not associated with risk of hospitalization (underweight: odds ratio [OR]: 1.10; 95% confidence interval [CI] 95%, 0.50-2.41 and excess body weight: OR: 0.81; 95 CI, 0.57-1.14), mechanical ventilation (underweight: OR: 0.92; 95% CI, 0.52-1.62 and excess weight: OR: 0.90; 95% CI, 0.67-1.19), and death (underweight: OR: 0.61; 95% CI, 0.31-1.20 and excess body weight: OR 0.88; 95% CI, 0.63-1.23). CONCLUSIONS: Being underweight and excess body weight were not independently associated with clinical outcomes in patients with COVID-19 in the herein analyzed cohort. This finding indicates that the association between these variables may be confounded by both age and comorbidities.

Clinical and nutritional predictors of hospital readmission within 30 days.

BACKGROUND/OBJECTIVES: Identify clinical, sociodemographic, and nutritional predictors of hospital readmission within 30 days. SUBJECTS/METHODS: A longitudinal study was conducted with patients hospitalised at a public institution in Recife, Brazil. Sociodemographic (age, sex, race, and place of residence), clinical (diagnosis, comorbidities, medications, polypharmacy, hospital outcome, hospital stay, and occurrence of readmission within 30 days), and nutritional (% of weight loss, body mass index, arm circumference [AC], and calf circumference [CC]) characteristics were collected from the nutritional assessment files and patient charts. Nutritional risk was determined using the 2002 Nutritional Risk Screening tool and the diagnosis of malnutrition was based on the GLIM criteria. RESULTS: The sample was composed of 252 patients, 58 (23.0%; CI95%: 17.2-28.8%) of whom were readmitted within 30 days after discharge from hospital, 135 (53.5%; CI95%: 46.7-60.5%) were at nutritional risk and 107 (42.4%; CI95%: 35.6-49.3%) were malnourished. In the bivariate analysis, polypharmacy, nutritional risk, malnutrition, low AC, and low CC were associated with readmission. In the multivariate analysis, low CC was considered an independent risk factor, increasing the likelihood of hospital readmission nearly fourfold. In contrast, the absence of polypharmacy was a protective favour, reducing the likelihood of readmission by 81%. CONCLUSIONS: The use of six medications or more and low calf circumference are risk factors for hospital readmission within 30 days after discharge.

Nutritional assessment of hospitalized patients: Comparison of real and estimated anthropometric measures

ABSTRACT The assessment of the nutritional status of hospitalized patients is fundamental to the establishment of the diagnosis. For bedridden patients, however, it is not possible to determine simple measures, such as weight and height, which are the most widely used variables for nutritional assessments. Objective: Compare real and estimated anthropometric measures in hospitalized patients. Methods: A cross-sectional study was conducted with adult (>18 years of age) and senior patients (>60 years of age) admitted for clinical or surgical treatment in the general surgery infirmary of Governador Paulo Guerra Restauração Hospital. Data (sex, age, clinical diagnosis, real weight, real height, body mass index, knee height and arm circumference) were collected using nutritional follow-up charts and tabulated using Excel 2016. Statistical analyses were performed in SPSS® version 21.0. Results: One hundred and twenty patients participated in the study (median age: 55 years). Most were adults (73.3%) and women (53.3%). The mean differences in weight between the estimated and real measures were statistically significant (p=0.000), with an overestimation of this variable. Regarding height, the estimated values differed significantly from the real values in both men and women (p<0.000) and the difference was larger among the seniors (mean: -0.072). No significant difference was found between the real and estimated body mass index (p= 0.44). Conclusion: In the comparison of methods for estimating weight and height to real measures, a tendency was found to overestimate these body measures.

RESUMEN La evaluación del estado nutricional de los pacientes hospitalizados es esencial para establecer su diagnóstico. Sin embargo, para los pacientes postrados en cama, no se pueden realizar medidas sencillas como el peso y la altura, que son las más utilizadas para el diagnóstico nutricional. Objetivo: Comparar mediciones antropométricas reales y estimadas en pacientes hospitalizados. Metodología: Estudio transversal, que incluye pacientes adultos (>18 años) y personas mayores de 60 años, ingresados para tratamiento clínico o quirúrgico en la sala de cirugía general del Hospital da Restauração Governador Paulo Guerra. Los datos (sexo, edad, diagnóstico clínico, peso real, altura real, índice de masa corporal, altura de la rodilla y circunferencia del brazo) se recopilaron mediante los formularios de monitoreo nutricional y se tabularon en el software Excel 2016. Los análisis estadísticos se realizaron con SPSS®, versión 21.0. Resultados: 120 pacientes con mediana de 55 años, en su mayoría adultos (73,3%) y mujeres (53,3%). Las diferencias promedio entre las mediciones estimadas y reales fueron estadísticamente significativas, con sobreestimación del peso (p<0,0001). Con respecto a la altura, fue posible identificar que las medidas estimadas diferían significativamente (p<0,0001) de las reales para hombres y mujeres, y que esta variación era aún mayor entre los ancianos (media: -0,072). No hubo diferencias estadísticamente significativas entre el índice de masa corporal real y el estimado (p= 0,44). Conclusión: Al comparar las metodologías para estimar el peso y la altura con las mediciones reales, fue posible observar una tendencia de los métodos a sobreestimar estas mediciones corporales.

Imunomodulação em paciente queimado fasciotomizado: Relato de caso / Immunomodulation in a burned fasciotomized patient: A case report

OBJETIVO: Descrever a evolução clínica e nutricional de paciente queimado fasciotomizado com uso de terapia nutricional imunomoduladora. RELATO DO CASO: Estudo do tipo relato de caso, realizado durante 52 dias na Unidade de Tratamento de Queimados do Hospital da Restauração Governador Paulo Guerra, em Recife-PE. Paciente do sexo masculino, adulto, 27 anos, proveniente do interior de Pernambuco, sem comorbidades, queimado por eletricidade de alta voltagem após acidente de trabalho, evoluindo com síndrome compartimental do membro superior esquerdo e submetido a fasciotomia. Prescrita dieta por via oral associada à suplementação imunomoduladora de característica hipercalórica, hiperproteica, contendo arginina e alto teor de oligoelementos e micronutrientes. Durante o internamento, o paciente apresentou manutenção do estado nutricional, com adesão de novos hábitos alimentares que contribuíram para a cicatrização do membro afetado. CONCLUSÃO: A terapia nutricional imunomoduladora individualizada beneficiou a reparação tecidual, cicatrização e redução do risco de amputação em paciente queimado fasciotomizado.

OBJECTIVE: To describe the clinical and nutritional evolution of a burn patient submitted to fasciotomy and immunomodulating nutritional therapy. CASE REPORT: A case-report study was conducted over a 52-day period at the Burn Treatment Unit of Governador Paulo Guerra Restauração Hospital in the city of Recife, Brazil. A 27-year-old male patient, brown skin color, from the instate region of the state of Pernambuco, without comorbidities, suffered a high-voltage electrical burn after a work accident, developing compartment syndrome of the left upper limb, and was submitted to fasciotomy. An orally diet was prescribed associated with immunomodulatory supplementation with a hypercaloric, hyper protein character, with arginine and high content of trace elements and micronutrients. During hospitalization, the patient's nutritional status was maintained with the adherence to new dietary habits, which contributed to the healing of the affected limb. CONCLUSIONS: Individualized immunomodulating nutritional therapy benefits the tissue repair and healing processes, reducing the risk of amputation in burn patients submitted to fasciotomy.

Discriminative power of an adapted version of Nutritional Risk Screening 2002 applied to Brazilian older adults.

OBJECTIVE: To investigate the discriminative power of Nutritional Risk Screening 2002. METHODS: A cross sectional study involving one hundred participants aged ≥60 years. The original and adapted versions of Nutritional Risk Screening 2002 and the Mini Nutritional Assessment were used. Nutritional Risk Screening 2002 adaptation consisted of a lower age cutoff (60 years or older) for addition of one extra point to the final score. RESULTS: Screening using Nutritional Risk Screening 2002 revealed higher nutritional risk among patients aged ≥70 years (p=0.009), whereas screening using the adapted version of Nutritional Risk Screening 2002 revealed similar nutritional risk in both age groups (60-69 years and ≥70 years; p=0.117). Frequency of nutritional risk was highest when the Mini Nutritional Assessment was administered (52.7%), followed by the adapted and original versions of Nutritional Risk Screening 2002 (35.5% and 29.1%, respectively). CONCLUSION: The adapted version of Nutritional Risk Screening 2002 was more effective than the original version. However, further studies are needed to confirm these findings.

Requerimento energético de pacientes queimados pediátricos: comparação de diferentes fórmulas preditivas / Energy requirements of pediatric burn patients: comparison of different predictive equations

INTRODUÇÃO: Crianças são mais vulneráveis a queimaduras devido as habilidades físicas e motoras em desenvolvimento. Na prática clínica são utilizadas equações preditivas para a determinação do gasto energético total. OBJETIVO: Comparar os requerimentos energéticos obtidos por diferentes equações preditivas em pacientes pediátricos queimados de uma Unidade de Referência em Recife-PE. MÉTODOS: Estudo transversal realizado com pacientes divididos em três grupos: 0 a 5 anos, 5 a 10 anos e 10 a 18 anos, internados de março a outubro/2019 na Unidade de Tratamento de Queimados do Hospital da Restauração Governador Paulo Guerra. Foram coletados dados em prontuário e ficha de avaliação nutricional. As necessidades energéticas foram estimadas utilizando diferentes fórmulas preditivas. RESULTADOS: Dos 117 pacientes, 53,8% eram do sexo masculino. A mediana de idade e tempo de internamento foi de 2,6 (1,4-6,7) anos e 7 (5,0-10,5) dias, respectivamente. Todos os pacientes apresentaram lesões de 2º grau com mediana de 6% de superfície corporal queimada. No grupo 1, o valor energético obtido por Schofield utilizando fator estresse mínimo e médio, mostrou-se semelhante ao de Davies & Liljedahl e Mayes, respectivamente. No grupo 2, o valor energético obtido por Schofield utilizando os três fatores de estresse foi diferente das demais. No grupo 3, o valor energético obtido por Schofield utilizando fator estresse mínimo, foi semelhante ao de Harris Benedict modificado por Long e Curreri. DISCUSSÃO: Estudo pioneiro que compara as diferentes fórmulas preditivas com a equação mais recomendada pela literatura. A maioria das equações preditivas estudadas não concordam com a recomendada, talvez por apresentarem apenas o peso corporal como variável comum. CONCLUSÃO: A maioria dos valores energéticos obtidos pelas fórmulas foram diferentes entre si, o que pode ser explicado pelos distintos fatores que compõem essas equações

INTRODUCTION: Children are vulnerable to burns due to the fact that their physical and motor skills are in the process of development. In clinical practice, predictive equations are used for the determination of total energy expenditure. OBJECTIVE: Compare energy requirements obtained from different predictive equations in pediatric burn patients at a reference service of Recife, Brazil. 10 Nutr. clín. diet. hosp. 2020; 40(2):10-16 Nutr. clín. diet. hosp. 2020; 40(2):10-16 DOI: 10.12873/402andressa Artículo Original Requerimento energético de pacientes queimados pediátricos: comparação de diferentes fórmulas preditivas Energy requirements of pediatric burn patients: comparison of different predictive equations. METHODS: A cross-sectional study was conducted with patients divided into groups (0-5 years, 5-10 years and 10- 18 years) hospitalized at the Burn Treatment Unit of the Restauração Hospital. Data were collected from the patient charts and nutritional assessment. Energy requirements were estimated using different equations. RESULTS: Among the 117 patients, 53.8% were males. Median age and hospital stay were 2.6(1.4-6.7) years and seven (5.0-10.5) days, respectively. All patients had seconddegree burns, with a median of 6% of the body surface affected. In Group 1, the energy value obtained using Schofield's formula considering minimum and mean stress factors was similar to that obtained using the Davies & Liljedahl and Mayes equations, respectively. In Group 2, the energy value obtained using Schofield's formula with three stress factors differed from that of the other equations. In Group 3, the energy value obtained using Schofield's factors with a minimum stress factor was similar to that obtained using the Harris-Benedict equation modified by Long and Curreri. DISCUSSION: This is a pioneering study that compared different formulas with the most recommended equation in the literature. CONCLUSION: Most energy values obtained by the equations differed from each other, which may be explained by the different factors that compose these equations

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Discriminative power of an adapted version of Nutritional Risk Screening 2002 applied to Brazilian older adults / Poder diagnóstico discriminativo da versão adaptada do Nutritional Risk Screening 2002 administrada em idosos brasileiros

ABSTRACT Objective: To investigate the discriminative power of Nutritional Risk Screening 2002. Methods: A cross sectional study involving one hundred participants aged ≥60 years. The original and adapted versions of Nutritional Risk Screening 2002 and the Mini Nutritional Assessment were used. Nutritional Risk Screening 2002 adaptation consisted of a lower age cutoff (60 years or older) for addition of one extra point to the final score. Results: Screening using Nutritional Risk Screening 2002 revealed higher nutritional risk among patients aged ≥70 years (p=0.009), whereas screening using the adapted version of Nutritional Risk Screening 2002 revealed similar nutritional risk in both age groups (60-69 years and ≥70 years; p=0.117). Frequency of nutritional risk was highest when the Mini Nutritional Assessment was administered (52.7%), followed by the adapted and original versions of Nutritional Risk Screening 2002 (35.5% and 29.1%, respectively). Conclusion: The adapted version of Nutritional Risk Screening 2002 was more effective than the original version. However, further studies are needed to confirm these findings.

RESUMO Objetivo: Avaliar o poder de discriminação diagnóstica da ferramenta Nutritional Risk Screening 2002. Métodos: Estudo transversal com cem participantes com idade ≥60 anos. Foram aplicados o Nutritional Risk Screening 2002 original, o Nutritional Risk Screening 2002 adaptado e o Mini Nutritional Assessment. A adaptação do Nutritional Risk Screening 2002 consistiu em diminuir o critério de idade, incluindo pontuação adicional para 60 anos de idade ou mais. Resultados: Maior risco nutricional ocorreu nos ≥70 anos quando aplicado o Nutritional Risk Screening 2002 original (p=0,009), enquanto o Nutritional Risk Screening 2002 adaptado apresentou risco nutricional semelhante em ambos os grupos (60-69 anos e ≥70 anos; p=0,117). A frequência de risco nutricional foi maior no Mini Nutritional Assessment (52,7%), seguido do Nutritional Risk Screening 2002 adaptado (35,5%) e do Nutritional Risk Screening 2002 original (29,1%). Conclusão: A adaptação do Nutritional Risk Screening 2002 mostrou-se descritivamente mais eficaz do que a original, porém mais estudos devem ser realizados para confirmar os achados.

Terapia nutricional em ginecologia e obstetrícia em Hospital Público Universitário do Brasil / Nutrition therapy in gynecology and obstetrics in Hospital Public University of Brazil

Introdução: Terapia nutricional (TN) é definida como a provisão de nutrientes por via oral, enteral ou parenteral com intenção terapêutica. Métodos: Estudo retrospectivo transversal no período de 2009 a 2013, no qual foi avaliada a TN (oral, enteral, parenteral) de 183 pacientes internadas no Hospital das Clínicas da Universidade Federal de Pernambuco, por meio de informações contidas no banco de dados dos serviços de nutrição/farmácia. Para as análises estatísticas, foram aplicados os testes t de Student, χ2 e ANOVA. Resultados: A clínica predominante foi a ginecologia (82%). A idade média geral foi de 49,0 ±17,1 anos. O tipo de TN mais freqüente foi oral (67,2%). Na ginecologia, a patologia mais encontrada foi a neoplasia de colo de útero (27,1%), na obstetrícia 56,3% eram gestantes de alto risco. A anorexia foi a indicação mais frequente independente da clínica. A maioria das pacientes recebeu terapia nutricional oral (TNO) normocalórica, com maior percentual das fórmulas poliméricas. Quanto às fibras, 79,3% das fórmulas da terapia nutricional enteral (TNE) continham fibras, diferindo da TNO (p=0,0023). Na TN parenteral houve predominância de neoplasias ginecológicas (85,7%). Pode-se perceber que a TNE possuiu teor calórico maior do que a TNO (p < 0,0001). O tempo médio de administração foi de 10,3±10,9 dias (1-83 dias), sem diferença entre as clínicas estudadas (p = 0,6). Conclusões: A TNO polimérica normocalórica, normoprotéica, normoglicídica e normolipídica predominou no grupo estudado, sendo as pacientes de ginecologia as que mais fizeram uso da terapêutica (AU)

Introduction: Nutritional therapy (TN) is defined as the supply of nutrients orally, enterally or parenterally with therapeutic intent. Methods: Retrospective study from 2009 to 2013, where NT (oral, enteral, parenteral) was evaluated in 183 patients admitted to the Hospital of the Federal University of Pernambuco, through information contained in the database of nutrition/pharmacy services. To perform the statistical analysis, were applied the Student t, χ2 and ANOVA tests. Results: The predominant clinical was the gynecology (82%). The overall mean age was 49.0 ± 17.1 years. The most frequent type of NT was oral (67.2%). In gynecology, the most frequent pathology was neoplasm of the cervix (27.1%), obstetrics 56.3% were high-risk pregnants. Anorexia was the most frequent indication independent of the clinic. Most patients received oral NT normocaloric, with the highest percentage of polymeric formulas. As for fiber, 79.3% of EN (enteral nutrition) formulas contained fibers, differing from oral NT (p = 0.0023). Parenteral nutrition predominated gynecological patients (85.7%). One can see that the EN owned calorie greater than the oral NT (p <0.0001). The time of administration mean was 10.3 ± 10.9 days (1-83 days), with no difference between the studied clinics (p = 0.6). Conclusions: polymer, normocaloric, normoproteic, normoglicidic and normolipidic oral NT predominated in the study group, and the gynecology patients the ones that took the therapy (AU)

Triagem nutricional pelo Malnutrition Universal Screening Tool (MUST) no paciente oncológico em quimioterapia / Nutritional risk by Malnutrition Universal Screening Tool (MUST) in patients undergoing chemotherapy

Introdução: A quimioterapia contribui para a redução da ingestão alimentar e maior perda de peso, devido ao aparecimento de sintomas gastrointestinais, o que, consequentemente, pode levar à desnutrição. Objetivo: Identificar o risco nutricional, pelo Ferramenta Universal de Triagem para Desnutrição - Malnutrition Universal Screening Tool (MUST), em pacientes com câncer submetidos à quimioterapia. Método: Estudo do tipo transversal envolvendo pacientes ambulatoriais do serviço de quimioterapia do Hospital de Câncer de Pernambuco, de outubro de 2014 a maio de 2015. Foram avaliadas características sociodemográficas, estilo de vida (fumo, álcool e atividade física), variáveis antropométricas (peso e índice de massa corporal-IMC), comorbidades (hipertensão e diabetes), tipo de neoplasia, tempo de diagnóstico e de tratamento. O risco nutricional foi avaliado utilizando-se a Ferramenta Universal de Triagem para Desnutrição (MUST), que classifica o paciente em baixo, médio e alto risco nutricional. Resultados: Foram estudados 150 pacientes, sendo a maioria mulheres (81,3%), adultos (64,7%), e com faixa etária de 40-59 anos (49,3%). A neoplasia mais frequente foi o câncer de mama (52%). O risco nutricional foi verificado em 42% da amostra, sendo 28% de alto risco. Foi significativamente maior nos idosos (54,7%), com predominância do alto risco, enquanto nos adultos o risco foi verificado em 35% dos pacientes. Conclusões: Muitos pacientes em quimioterapia foram identificados em risco nutricional por meio da triagem MUST. Sugere-se a comparação da MUST com a Avaliação Subjetiva Global Produzida pelo Próprio Paciente (ASG-PPP), para identificar o método que melhor traduz o risco nutricional nesta população.(AU)

Introduction: Chemotherapy contributes to the reduction of food intake and increased weight loss due to the appearance of gastrointestinal symptoms, which consequently leads to malnutrition. Objective: To identify nutritional risk through the Malnutrition Universal Screening Tool (MUST), in patients with cancer submitted to chemotherapy. Methods: Cross-sectional study conducted between October 2014 and May 2015 with outpatients of the chemotherapy service at the Pernambuco Cancer Hospital (Brazil). Socio-demographic characteristics, lifestyle (tobacco, alcohol and physical activity), anthropometric variables (habitual weight, current weight and body mass index), comorbidities (hypertension and diabetes), type of neoplasm, time since diagnosis and duration of treatment were evaluated. Nutritional risk was evaluated using the MUST, which classifies patients as having low, moderate or high nutritional risk. Results: One hundred fifty patients were studied. Most were women (81.3%), adults (64.7%) and in the 40-to-59-year-old age group (49.3%). The most common neoplasm was breast cancer (52%). Nutritional risk was found in 42% of the sample, with 28% at high risk. Risk was significantly higher among older adults (54.7%), with a predominance of high risk, whereas the prevalence of risk among adults was 35%. Conclusions: Many patients in chemotherapy were identified as being at nutritional risk using the MUST. It is suggested that the MUST and the Patient-Generated Subjective Global Assessment be used to identify the method that better translates nutritional risk in this population.(AU)

Triagem nutricional por meio do MUST no paciente oncológico em radioterapia / Nutrition screening by MUST on the oncological patient in radiotherapy / Triage nutricional por médio de MUST para pacientes oncológicos en radioterapia

Introdução: a radioterapia contribui para a redução da ingestão alimentar e maior perda de peso, devido ao aparecimento de sintomas gastrointestinais, o que consequentemente leva à desnutrição. Objetivo: i dentificar o risco nutricional, por meio do Malnutrition Universal Screening Tool (Must ), em pacientes com câncer submetidos à radioterapia. Método: estudo transversal, realizado com pacientes ambulatoriais do s erviço de radioterapia do Hospital de câncer de Pernambuco, durante outubro/2014 a maio/2015. Foram avaliadas as características socioeconômicas, demográficas, estilo de vida (fumo, álcool e atividade física), variáveis antropométricas (peso habitual, atual e iMc), comorbidades (hipertensão e diabetes), tipos de neoplasias, tempo de diagnóstico e tratamento. o risco nutricional foi identificado utilizando-se o Must , que classifica o paciente com risco ou sem risco, e em baixo, médio e alto risco nutricional. Resultados: Foram estudados 150 pacientes com média de idade de 47,3 anos, a maioria mulheres (72%) e proporções semelhantes de adultos e idosos. observou-se que a maioria do grupo era procedente do interior do estado, inativos/aposentados e recebiam 1-3 salários mínimos. o risco nutricional foi significantemente maior nos idosos (62,9%), em que predominou o alto risco (45,7%), enquanto nos adultos a maioria evidenciou sem risco (61,2%). as neoplasias mais frequentes foram as ginecológicas (59,4%) com ganho de peso de 33,3%; em seguida, os tumores de cabeça e pescoço com elevada perda ponderal (p=0,007). Conclusão: o Must detectou risco nutricional em 50% dos pacientes estudados, com predominância nos idosos, a maioria com alto risco. n a neoplasia de cabeça e pescoço, predominou a perda ponderal; enquanto, no ginecológico, o ganho de peso. r essalta-se a importância da realização de triagem ambulatorial para instituir precocemente uma terapia nutricional especializada.

Introduction: radiotherapy contributes to the reduction of food intake and increased weight loss due to the appearance of gastrointestinal symptoms, which consequently leads to malnutrition. Objective: i dentify nutritional risk through the Malnutrition universal screening tool (Must ), in patients submitted to radiotherapy for the treatment of cancer. Method: c ross-sectional study with outpatients at the radiotherapy service of the cancer Hospital of Pernambuco, during o ctober 2014 until May 2015. s ocio-demographic characteristics, lifestyle (smoking, alcohol use and physical activity), anthropometric variables (habitual weight, current weight and body mass index), comorbidities (hypertension and diabetes), tumor type, time since diagnosis and duration of treatment were evaluated. n utritional risk was assessed using the Must , which classifies patients as being at low, medium or high nutritional risk. Results: 150 patients were studied with an average age of 47.3 years, with a predominance of women (72%) and similar proportions of adults and elderly individuals. The sample mainly comprised individuals from in-state regions and inactive/retired individuals who received one to three times the minimum salary. nutritional risk was significantly higher among elderly individuals (62.9%), among whom high risk predominated (45.7%), whereas most adults had no risk (61.2%). The most frequent tumors were gynecological (59.4%) with weight gain (33.3%), followed by tumors of the head and neck region with a high degree of weight loss (p = 0.007). Conclusion: The use of Must led to the detection of nutritional risk in 50% of the studied patients, with a predominance of elderly individuals, the majority of whom were at high risk. tumors of the head and neck led to weight loss, whereas gynecological tumors led to weight gain. out-patient nutritional screening is important for the early establishment of specialized nutritional counselin

Introducción: la radioterapia contribuye a la reducción de la ingesta de alimentos y el aumento de la pérdida de peso debido a la aparición de los síntomas gastrointestinales, que en consecuencia lleva a la desnutrición. Objetivo: identificar el riesgo nutricional, a través del Malnutrition Universal Screening Tool (Must ), en pacientes con cáncer sometidos a radioterapia. Método: estudio transversal con pacientes ambulatorios en el servicio de radioterapia del Hospital de cáncer de Pernambuco, realizado desde octubre/2014 hasta mayo/2015. s e evaluaron características sociodemográficas, estilo de vida (tabaco, alcohol y actividad física), variables antropométricas (peso habitual, actual e icM), comorbideces (hipertensión y diabetes), tipos de neoplasias, tiempo de diagnóstico y tratamiento. el riesgo nutricional se evaluó utilizándose el Must que clasifica al paciente en bajo, medio y alto riesgo nutricional. Resultados: se estudiaron 150 pacientes con promedio de edad de 47,3 años, en su mayoría mujeres (el 72%) y proporciones semejantes de adultos y ancianos. s e observó que la mayoría del grupo era procedente del interior del estado, inactivos/jubilados y recibían 1-3 sueldos mínimos. e l riesgo nutricional significante fue mayor en los ancianos (el 62,9%) en el que predominó el alto riesgo (el 45,7%), mientras en los ancianos la mayoría evidenció sin riesgo (el 61,2%). las neoplasias más frecuentes fueron las ginecológicas (el 59,4%) con aumento de peso del 33,3%; en seguida, los tumores de cabeza y cuello con elevada pérdida ponderal (p=0,007). Conclusión: e l Must detectó riesgo nutricional en el 50% de los pacientes estudiados, con predominancia en los ancianos, la mayoría con alto riesgo. e n la neoplasia de cabeza y cuello predominó la pérdida ponderal, mientras que en el ginecológico el aumento de peso. s e resalta la importancia de la realización de selección ambulatorio para instituir precozmente una terapia nutricional especializad

Clinical-nutritional evolution of older women submitted to Roux-en-Y gastric bypass / Evolución clínico-nutricional de mujeres mayores sometidas a bypass gástrico en Y de Roux

The aim of the present study was to describe the clinical-nutritional evolution of older women submitted to Roux-en-Y gastric bypass surgery. A concurrent, retrospective study was conducted involving a sample of16 older women with morbid obesity submitted to Rouxen-Ygastric bypass surgery between 1997 and 2010. Weight, body mass index (BMI), percentage of weight loss(%WL) and percentage of excess weight loss (%EWL)were evaluated three, six and 12 months after surgery. Preoperative comorbidities, postoperative clinical-nutritional manifestations and peri-operative mortality were also investigated. Mean age was 62.02 ± 2.02 years. A progressive reduction was found in mean body weight(116.04 ± 22.99 to 80.96 ± 21.43 Kg) and BMI (47.13 ±8.19 to 33.42 ± 9.31 Kg/m2), with a consequent %WL of28.60 ± 8.59% and %EWL of 64.79 ± 3.99% throughout the one-year follow-up period (p < 0.05). All patients has diseases associated with obesity, the most frequent of which were arterial hypertension (n = 16), arthropathy(n = 11), dyslipidemia (n = 9) and diabetes (n = 7). The following clinical-nutritional symptoms were reported: alopecia (n = 9), nausea/vomiting (n = 7), constipation (n= 5) and food intolerance (n = 4). One patient was diagnosed with malnutrition one year after surgery. No deaths occurred within 30 days after surgery. At the one-year evaluation, surgical success was evidenced by the significant reductions in mean weight and BMI and the more than 50% loss of excess weight (AU)

El objetivo de este estudio fue la descripción de la evolución clinico-nutricional de mujeres mayores sometidas a cirugía de bypass gástrico en Y de Roux. Se desarrolló un estudio concurrente, retrospectivo, que incluyó una muestra de 16 mujeres mayores con obesidad mórbida sometidas a bypass gástrico en Y de Roux entre 1997 y 2010. Se evaluó el peso, índice de masa corporal (IMC), porcentaje de pérdida de peso (%WL) y porcentaje de pérdida de peso excesivo (%EWL) tres, seis y doce meses después de la cirugía. También se investigó las comorbilidades preoperatorias, manifestaciones clínico-nutricionales postoperatorias y mortalidad perioperatoria. La edad media fue 62,02 ± 2,02 años. Se detectó una reducción progresiva en el peso medio corporal (116,04 ± 22,99 a 80,96 ± 21,43 Kg) e IMC (47,13 ± 8,19 a 33,42 ± 9,31 Kg/ m2), con un consecuente porcentaje de pérdida de peso (%WL) de 28,60 ± 8,59% y %EWL de 64,79 ± 3,99% a lo largo del periodo de seguimiento de un año (p < 0,05). Todas las pacientes tenían enfermedades relacionadas con obesidad, siendo la más frecuente hipertensión arterial (n = 16), artropatía (n = 11), dislipidemia (n = 9) y diabetes (n = 7). Se comunicaron los siguientes síntomas clínico-nutricionales: alopecia (n = 9), nausea/vómitos (n = 7), estreñimiento (n = 5) e intolerancia a la comida (n = 4). Una paciente fue diagnosticada de malnutrición un año después de la cirugía. No se registraron muertes tras 30 días de la cirugía. En la evaluación a un año, el éxito quirúrgico quedó constatado por las reducciones significativas en peso medio e IMC, además de más de un 50% de pérdida de peso excesivo (AU)