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1.
Artículo en Inglés | MEDLINE | ID: mdl-33818806

RESUMEN

BACKGROUND: Early identification of patients in the Pediatric Intensive Care Unit (PICU) at risk of nutritional status (NS) deterioration and poor outcomes is desirable. AIM: To identify factors associated with NS deterioration and prolonged PICU stay. METHODS: In a prospective cohort study in eight Brazilian PICUs, we enrolled children <18 years with PICU stay >72h. We used multivariable logistic regression to identify the clinical, laboratory, and nutritional variables at admission that were associated with outcomes. NS deterioration was defined as the reduction in weight-for-age, body mass index-for-age or mid-upper arm circumference-for-age z-score ≥1 during PICU stay. Prolonged PICU stay was defined as ≥13 days. RESULTS: We enrolled 363 eligible patients, median age 11.3 months (IQR:3.1-45.6) and 46% had at least one Complex Chronic Condition (CCC). NS deterioration was observed in 23% and was associated with CCC (OR:2.71, 95%CI:1.44-5.09), after adjusting for severity risk score, leukocyte count, obesity, and PICU site. Prolonged PICU stay (33% of the cohort) was associated with age <2 years (OR:1.95, 95%CI:1.03-3.66), fluid overload (>10%) over first 72 hours (OR:2.66, 95%CI:1.50-4.73) and hypoalbuminemia (<3.0 g/dL) (OR:2.05, 95%CI:1.12-3.76), after adjusting for CCC, severity risk score, undernutrition, early nutrition therapy, and PICU site. CONCLUSIONS: CCC at admission was associated with NS deterioration. Age <2 years, fluid overload, and hypoalbuminemia at PICU admission were associated with prolonged PICU stay. These factors must be further evaluated as part of an admission nutritional screening tool for critically ill children. This article is protected by copyright. All rights reserved.

2.
J Acad Nutr Diet ; 120(2): 219-229, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31522971

RESUMEN

BACKGROUND: There are few studies that assess the role of different nutritional assessment variables at pediatric intensive care unit (PICU) admission in predicting clinical outcomes. OBJECTIVE: To identify nutritional variables in the first 4 days of PICU stay that predict 60-day mortality and time to discharge alive from the PICU. DESIGN: Single-center prospective study in Southern Brazil, conducted between July 2013 and February 2016. At PICU admission, children with z scores <-2 for body mass index (BMI)-for-age, mid-upper arm circumference (MUAC)-for-age, and triceps skinfold thickness (TSF)-for-age were considered as undernourished. PARTICIPANTS/SETTING: There were 199 patients, aged <15 years, with PICU stay >48 hours. MAIN OUTCOME MEASURES: Sixty-day mortality and time to discharge alive from the PICU. STATISTICAL ANALYSIS PERFORMED: Cox regression model was applied to determine predictors of 60-day mortality and time to discharge alive from the PICU. RESULTS: Median age was 23.1 months (interquartile range=3.9 to 89.1), and 63% were male, with 18% prevalence of undernutrition at admission by BMI-for-age. Median PICU stay was 7 days (interquartile range=4 to 12), and 60-day mortality was 12%. After adjusting for sex, age, Pediatric Index of Mortality 2, and presence of complex chronic conditions, undernutrition based on BMI-for-age (hazard ratio [HR]=3.75; 95% CI=1.41 to 9.95; P=0.008), MUAC-for-age (HR=7.62; 95% CI=2.42 to 23.97; P=0.001), and TSF-for-age (HR=4.01; 95% CI=1.14 to 14.15; P=0.031) was associated with higher risk of 60-day mortality. Based on MUAC-for-age with the same adjustment model, undernourished children had longer time to discharge alive from the PICU (HR=0.45; 95% CI=0.21 to 0.98; P=0.045). CONCLUSIONS: Undernutrition at PICU admission based on different anthropometric variables was predictive of 60-day mortality and longer time to discharge alive from the PICU.


Asunto(s)
Trastornos de la Nutrición del Niño/mortalidad , Enfermedad Crítica/mortalidad , Unidades de Cuidado Intensivo Pediátrico/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Admisión del Paciente/estadística & datos numéricos , Adolescente , Antropometría , Índice de Masa Corporal , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Alta del Paciente/estadística & datos numéricos , Valor Predictivo de las Pruebas , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Análisis de Regresión , Factores de Tiempo
3.
Clin Nutr ESPEN ; 28: 12-20, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30390867

RESUMEN

BACKGROUND AND AIMS: Fluid retention is a risk factor for mortality in several medical conditions. However, the accurate and fast assessment of hydration status remains a challenge in the clinical practice. Bioelectrical impedance analysis (BIA) could be an alternative to assess volume status. This systematic review aimed to evaluate the use of BIA to identify hydration status in patients with different medical conditions and to verify the association of hyperhydration, assessed by BIA, with mortality. METHODS: This systematic review and meta-analyses included 29 studies conducted from 2002 to 2017 among different medical conditions in adults. Eligible studies were randomized and non-randomized clinical trials, prospective and retrospective observational studies. For quality assessment of studies, Effective Public Health Practice Project (EPHPP) was used. RESULTS: Twelve studies provided data eligible for meta-analyses. A direct association between hyperhydration and mortality was observed (Odds Ratio [OR] 4.38; Confidence interval 95% [95% CI] 2.76-6.94), even when stratified for medical condition (OR 4.37; 95% CI 1.15-6.92) and BIA device (OR 4.37; 95% CI 2.75-6.92). CONCLUSION: Hyperhydration, evaluated by BIA, was positive associated with mortality. Therefore, the prognostic impact of hyperhydration may be properly assessed by a bedside tool such as BIA.


Asunto(s)
Enfermedad Crítica/mortalidad , Impedancia Eléctrica , Fluidoterapia , Equilibrio Hidroelectrolítico , Enfermedad Crítica/terapia , Humanos
4.
Nutr Clin Pract ; 33(6): 831-842, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29786896

RESUMEN

BACKGROUND: In the absence of a gold standard technique for assessing nutrition status in patients receiving hemodialysis (HD), we aimed to determine the diagnostic accuracy of single-frequency (50 kHz) bioelectrical impedance analysis parameters, resistance/height (R/H), reactance/height (Xc/H), and impedance/height (Z/H), and their cutoff points for malnutrition. METHODS: The reference standards, Subjective Global Assessment (SGA), Malnutrition Inflammation Score, and Nutritional Risk Screening 2002, were performed at baseline and then once a year for 2 years. At least 2 assessments for each reference standard were performed during the monitoring period, and those patients who were assessed as malnourished on at least 2 consecutive occasions were classified as malnourished. RESULTS: A total 101 patients receiving HD were evaluated. R/H and Z/H demonstrated low to moderate accuracy to diagnose malnutrition in men and low accuracy in women, whereas the accuracy of Xc/H was uncertain. The cutoff points of bioelectrical impedance vector analysis (BIVA) parameters, determined based on the SGA to maximize sensitivity and specificity simultaneously, were: R/H ≥330.05 and ≥420.92 ohms/m for men and women, respectively; Z/H ≥332.71 and ≥423.19 ohms/m for men and women, respectively. In men, sensitivity based on the cutoff points of R/H and Z/H together ranged from 73% to 89% and specificity ranged from 49% to 50%. In women, sensitivity ranged from 58% to 80% and specificity from 48% to 55%. CONCLUSION: BIVA parameters demonstrated low to moderate accuracy in men and low accuracy in women for the diagnosis of malnutrition.


Asunto(s)
Impedancia Eléctrica , Fallo Renal Crónico/complicaciones , Desnutrición/diagnóstico , Evaluación Nutricional , Estado Nutricional , Diálisis Renal , Adulto , Anciano , Composición Corporal , Femenino , Humanos , Masculino , Desnutrición/etiología , Tamizaje Masivo , Persona de Mediana Edad , Valores de Referencia , Sensibilidad y Especificidad , Factores Sexuales
5.
Cien Saude Colet ; 23(4): 1019-1031, 2018 Apr.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-29694574

RESUMEN

The scope of this study was to identify the characteristics of sexual abuse against children including the profiles of the victims and the perpetrators, and associated factors notified in a health service of reference with the database of the Brazilian Case Registry Database, in a city in the south of Brazil. Categorical variables are presented in prevalence with 95% confidence intervals. There were 489 notifications from 2008 to 2014 of confirmed or suspected child sexual abuse. The majority was related to female victims, but the repeated abuse was reported mainly with male victims. In most cases, the abuse took place at the victims' or perpetrators' homes and the main perpetrators of abuse were male and acquainted with the victims. Twelve victims have contracted sexually transmitted infections; pregnancies were six, five of them legally terminated. This study highlights that the child sexual abuse profiles were similar in almost all of Brazilian regions, showing that it is possible to have a coordinated national action to prevent this offence.


Asunto(s)
Abuso Sexual Infantil/estadística & datos numéricos , Víctimas de Crimen/estadística & datos numéricos , Criminales/estadística & datos numéricos , Aborto Inducido/estadística & datos numéricos , Adolescente , Distribución por Edad , Brasil , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Embarazo , Prevalencia , Distribución por Sexo , Enfermedades de Transmisión Sexual/epidemiología
6.
Ciênc. Saúde Colet ; 23(4): 1019-1031, abr. 2018. tab, graf
Artículo en Portugués | LILACS | ID: biblio-952624

RESUMEN

Resumo O objetivo deste estudo foi identificar características do abuso sexual contra crianças, como perfil da vítima, do autor da agressão e fatores associados, notificadas em um serviço de referência, utilizando o Sistema de Informação de Agravos de Notificação, em todos os casos suspeitos ou confirmados de abuso sexual infantil, de 2008 a 2014, em Florianópolis/SC. As variáveis foram: características da vítima, do agressor, da ocorrência, tipologia da violência, consequências, encaminhamentos e procedimentos realizados. Variáveis categóricas são apresentadas em prevalências e intervalos de confiança de 95%. Houve 489 notificações, predominando vítimas do sexo feminino, maior recorrência no masculino e ocorrendo em residências. Estupro foi duas vezes mais frequente no sexo feminino e em mais da metade dos casos o autor era homem conhecido da vítima. Doze vítimas contraíram infecções sexualmente transmissíveis, houve seis gestações, cinco delas interrompidas legalmente. Mesmo sendo inédito para a região estudada, se observou características semelhantes às encontradas em outros estudos brasileiros, mostrando ser possível ações coordenadas nacionalmente para prevenir esse agravo.


Abstract The scope of this study was to identify the characteristics of sexual abuse against children including the profiles of the victims and the perpetrators, and associated factors notified in a health service of reference with the database of the Brazilian Case Registry Database, in a city in the south of Brazil. Categorical variables are presented in prevalence with 95% confidence intervals. There were 489 notifications from 2008 to 2014 of confirmed or suspected child sexual abuse. The majority was related to female victims, but the repeated abuse was reported mainly with male victims. In most cases, the abuse took place at the victims' or perpetrators' homes and the main perpetrators of abuse were male and acquainted with the victims. Twelve victims have contracted sexually transmitted infections; pregnancies were six, five of them legally terminated. This study highlights that the child sexual abuse profiles were similar in almost all of Brazilian regions, showing that it is possible to have a coordinated national action to prevent this offence.


Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Lactante , Preescolar , Niño , Adolescente , Abuso Sexual Infantil/estadística & datos numéricos , Víctimas de Crimen/estadística & datos numéricos , Criminales/estadística & datos numéricos , Brasil , Enfermedades de Transmisión Sexual/epidemiología , Prevalencia , Estudios Transversales , Aborto Inducido/estadística & datos numéricos , Distribución por Sexo , Distribución por Edad
7.
Rev. paul. pediatr ; 36(1): 31-38, jan.-mar. 2018. tab, graf
Artículo en Portugués | LILACS | ID: biblio-902893

RESUMEN

RESUMO Objetivo: Avaliar a associação entre estado nutricional, função pulmonar e morbidade em coorte de 36 meses de crianças e adolescentes com fibrose cística (FC). Métodos: Coorte prospectiva de 36 meses, com crianças e adolescentes com FC e idade entre 1 e 15 anos. No tempo inicial, o estado nutricional foi determinado a partir dos indicadores: peso-para-estatura e índice de massa corporal-para-idade, para crianças <2 anos e ≥2 anos, respectivamente, e classificado em: falência nutricional, risco nutricional e estado nutricional aceitável; também foi determinado por meio do percentil 50°, de acordo com a curva de crescimento da World Health Organization (WHO). A função pulmonar foi avaliada pelo volume expiratório forçado no primeiro segundo (VEF1). A morbidade foi determinada pela presença de infecção e hospitalização por exacerbação pulmonar. Foi calculado risco relativo (RR) e intervalo de confiança (IC95%), considerando significante p<0,05. Resultados: Foram avaliadas 38 crianças e adolescentes (mediana de idade 3,8 anos). Os pacientes classificados em falência nutricional no início do estudo mostraram um RR de 5,00 (IC95% 1,49; 16,76) para o comprometimento da função pulmonar após 36 meses. Aqueles classificados abaixo do percentil 50° apresentaram RR de 4,61 (IC95% 0,89; 23,81) para o desfecho. O estado nutricional não foi fator de risco para morbidade. Conclusões: O déficit nutricional esteve associado ao comprometimento da função pulmonar, mas não com a morbidade em crianças e adolescentes com FC.


ABSTRACT Objective: To evaluate the association between nutritional status, lung function and morbidity in a 36-month cohort in children and adolescents with cystic fibrosis. Methods: Prospective cohort of children and adolescents with cystic fibrosis aged 1-15 years. At the baseline, the nutritional status was determined by weight-for-height and body mass index-for-age for children <2 years and ≥2 years, respectively, and classified as: nutritional failure, nutritional risk and acceptable; and by the 50th percentile, according to the World Health Organization (WHO) growth charts. Lung function was assessed by forced expiratory volume in one second (FEV1). Morbidity was determined by the presence of infection and hospitalization by pulmonary exacerbation. Risk ratio and 95% confidence interval (95%CI) were calculated, being significant when p<0.05. Results: We evaluated 38 children and adolescents (median age 3.8 years). Patients that were classified as having nutritional failure at baseline had a RR of 5.00 (95%CI 1.49; 16.76) to present impaired lung function after 36 months. Those classified bellow the 50th percentile had a RR of 4.61 (95%CI 0.89; 23.81) to present the same outcome. Nutritional status was not a risk factor for morbidity in this cohort. Conclusions: Nutritional deficit was associated with impaired lung function, but not with morbidity in children and adolescents with cystic fibrosis.


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Preescolar , Niño , Adolescente , Estado Nutricional , Fibrosis Quística/complicaciones , Fibrosis Quística/fisiopatología , Pulmón/fisiopatología , Factores de Tiempo , Volumen Espiratorio Forzado , Estudios de Cohortes
8.
Rev Paul Pediatr ; 36(1): 8, 2018.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-29412427

RESUMEN

OBJECTIVE: To evaluate the association between nutritional status, lung function and morbidity in a 36-month cohort in children and adolescents with cystic fibrosis. METHODS: Prospective cohort of children and adolescents with cystic fibrosis aged 1-15 years. At the baseline, the nutritional status was determined by weight-for-height and body mass index-for-age for children <2 years and ≥2 years, respectively, and classified as: nutritional failure, nutritional risk and acceptable; and by the 50th percentile, according to the World Health Organization (WHO) growth charts. Lung function was assessed by forced expiratory volume in one second (FEV1). Morbidity was determined by the presence of infection and hospitalization by pulmonary exacerbation. Risk ratio and 95% confidence interval (95%CI) were calculated, being significant when p<0.05. RESULTS: We evaluated 38 children and adolescents (median age 3.8 years). Patients that were classified as having nutritional failure at baseline had a RR of 5.00 (95%CI 1.49; 16.76) to present impaired lung function after 36 months. Those classified bellow the 50th percentile had a RR of 4.61 (95%CI 0.89; 23.81) to present the same outcome. Nutritional status was not a risk factor for morbidity in this cohort. CONCLUSIONS: Nutritional deficit was associated with impaired lung function, but not with morbidity in children and adolescents with cystic fibrosis.


Asunto(s)
Fibrosis Quística/complicaciones , Fibrosis Quística/fisiopatología , Pulmón/fisiopatología , Estado Nutricional , Adolescente , Niño , Preescolar , Estudios de Cohortes , Femenino , Volumen Espiratorio Forzado , Humanos , Lactante , Masculino , Factores de Tiempo
9.
Säo Paulo med. j ; 136(1): 29-36, Jan.-Feb. 2018. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-904131

RESUMEN

ABSTRACT BACKGROUND: Chronic lung infections, inflammation and depletion of nutritional status are considered to be prognostic indicators of morbidity in patients with cystic fibrosis. The aim of this study was to investigate the association between inflammatory markers and lung function, nutritional status and morbidity among children/adolescents with cystic fibrosis. DESIGN AND SETTINGS: Prospective three-year longitudinal study conducted in an outpatient clinic in southern Brazil. METHODS: Children/adolescents aged 1-15 years with cystic fibrosis were enrolled. Nutritional status was determined from weight-to-length and body mass index-to-age z-scores and was classified as acceptable, at risk or nutritional failure. Tumor necrosis factor-α, interleukin-1β, myeloperoxidase, C-reactive protein and C-reactive protein/albumin ratio were analyzed. Lung function was evaluated based on the forced expiratory volume in the first second and morbidity according to the number of hospitalizations for pulmonary exacerbation and infections by Pseudomonas aeruginosa. Lung function, nutritional status and morbidity were the outcomes. Odds ratios and 95% confidence intervals were to evaluate the effect of baseline inflammatory markers on the clinical outcomes after three years of follow-up and p-values < 0.05 were considered significant. RESULTS: We evaluated 38 children/adolescents with cystic fibrosis: 55% female; median age (with interquartile range), 3.75 years (2.71-7.00). Children/adolescents with high C-reactive protein/albumin ratio at baseline had odds of 18 (P = 0.018) of presenting forced expiratory volume in the first second ≤ 70% after three years. The other inflammatory markers were not associated with the outcomes. CONCLUSION: C-reactive protein/albumin ratio was associated with forced expiratory volume in the first second ≤ 70% after three years.

10.
Sao Paulo Med J ; 136(1): 29-36, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29267535

RESUMEN

BACKGROUND: Chronic lung infections, inflammation and depletion of nutritional status are considered to be prognostic indicators of morbidity in patients with cystic fibrosis. The aim of this study was to investigate the association between inflammatory markers and lung function, nutritional status and morbidity among children/adolescents with cystic fibrosis. DESIGN AND SETTINGS: Prospective three-year longitudinal study conducted in an outpatient clinic in southern Brazil. METHODS: Children/adolescents aged 1-15 years with cystic fibrosis were enrolled. Nutritional status was determined from weight-to-length and body mass index-to-age z-scores and was classified as acceptable, at risk or nutritional failure. Tumor necrosis factor-α, interleukin-1ß, myeloperoxidase, C-reactive protein and C-reactive protein/albumin ratio were analyzed. Lung function was evaluated based on the forced expiratory volume in the first second and morbidity according to the number of hospitalizations for pulmonary exacerbation and infections by Pseudomonas aeruginosa. Lung function, nutritional status and morbidity were the outcomes. Odds ratios and 95% confidence intervals were to evaluate the effect of baseline inflammatory markers on the clinical outcomes after three years of follow-up and p-values < 0.05 were considered significant. RESULTS: We evaluated 38 children/adolescents with cystic fibrosis: 55% female; median age (with interquartile range), 3.75 years (2.71-7.00). Children/adolescents with high C-reactive protein/albumin ratio at baseline had odds of 18 (P = 0.018) of presenting forced expiratory volume in the first second ≤ 70% after three years. The other inflammatory markers were not associated with the outcomes. CONCLUSION: C-reactive protein/albumin ratio was associated with forced expiratory volume in the first second ≤ 70% after three years.


Asunto(s)
Proteína C-Reactiva/análisis , Fibrosis Quística/sangre , Mediadores de Inflamación/sangre , Interleucina-1beta/sangre , Peroxidasa/sangre , Albúmina Sérica/análisis , Factor de Necrosis Tumoral alfa/sangre , Adolescente , Biomarcadores/sangre , Niño , Fibrosis Quística/fisiopatología , Femenino , Humanos , Estudios Longitudinales , Masculino , Estado Nutricional , Estudios Prospectivos , Pruebas de Función Respiratoria
11.
Nutr Clin Pract ; 31(3): 378-86, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26920645

RESUMEN

BACKGROUND: (1) To compare nutrition and hydration status between a group of children/adolescents with cystic fibrosis (CFG; n = 46; median age, 8.5 years) and a control group without cystic fibrosis (CG). (2) To examine the association of nutrition and hydration status with lung function in the CFG. MATERIAL AND METHODS: A cross-sectional study. Nutrition screening, anthropometric parameters, and bioelectrical impedance analysis (BIA) were assessed. The z scores for body mass index for age, height for age, mid upper arm circumference, triceps and subscapular skinfold thickness, mid upper arm muscle area, resistance/height, and reactance/height were calculated. Bioelectrical impedance vector analysis was conducted. Forced expiratory volume in 1 second <80% was considered lung function impairment. An adjusted logistic regression was applied (P < .05). RESULTS: In the CFG, lung function impairment was observed in 51.1%. All anthropometric parameters were lower, and the mean z-resistance/height and z-reactance/height were higher in the CFG (P < .05) compared with the CG. In the CFG, 43% were severely/mildly dehydrated, while none were in the CG (P = .007). In the CFG, there was an association between high nutrition risk-via nutrition screening (odds ratio [OR], 22.28; P < .05), lower values of anthropometric parameters, higher z-resistance/height (OR, 2.23; P < .05) and z-reactance/height (OR, 1.81; P < .05), and dehydration (OR, 4.94; P < .05)-and lung function impairment. CONCLUSIONS: The CFG exhibited a compromised nutrition status assessed by anthropometric and BIA parameters. Nutrition screening, anthropometric and BIA parameters, and hydration status were associated with lung function.


Asunto(s)
Composición Corporal/fisiología , Agua Corporal/fisiología , Fibrosis Quística/fisiopatología , Impedancia Eléctrica , Pulmón/fisiopatología , Estado Nutricional/fisiología , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Masculino
12.
J Ren Nutr ; 24(6): 417-22, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25091136

RESUMEN

OBJECTIVES: Modifiable risk factors for kidney stones, such as diet and nutritional status, are targets in the treatment and prevention of nephrolithiasis. The aim of the present study was to assess the nutritional state and energy and nutrient adequacy of patients with nephrolithiasis via anthropometric evaluation, dietary inquiry, and urine biochemistry. DESIGN: The present observational cross-sectional study. SETTING: An outpatient, nephrolithiasis clinic of a tertiary care, university hospital. SUBJECTS: A total of 31 patients with nephrolithiasis and 25 controls were assessed. INTERVENTIONS: All patients were subjected to nutritional evaluation, including dietary inquiry and chemical tests of blood and 24-hour urine samples. MAIN OUTCOME MEASURE: Nutritional state and nutrient ingestion adequacy. RESULTS: The group of patients with nephrolithiasis exhibited high body mass index, abdominal circumference, and body fat percentage values. The protein, sodium, calcium, potassium, and oxalate intakes differed significantly from the recommended values in both the nephrolithiasis and control groups. The nephrolithiasis and control groups differed only in terms of oxalate intake (159 ± 119.27 vs. 112 ± 47.9, respectively, P = .042). Regarding urine biochemistry, 30% of the patients with nephrolithiasis exhibited hypercalciuria, versus 12% of the control group. CONCLUSIONS: The prevalence of individuals with overweight/obesity was high in both the nephrolithiasis and control groups. This finding indicates that in addition to orientation regarding nonlithogenic dietary habits, continuous education by a multidisciplinary staff must also address the prevention and treatment of obesity.


Asunto(s)
Dieta , Nefrolitiasis/fisiopatología , Estado Nutricional , Adulto , Índice de Masa Corporal , Calcio en la Dieta/administración & dosificación , Estudios Transversales , Proteínas en la Dieta/administración & dosificación , Impedancia Eléctrica , Ingestión de Energía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nefrolitiasis/epidemiología , Evaluación Nutricional , Necesidades Nutricionales , Obesidad/epidemiología , Sobrepeso/epidemiología , Fósforo Dietético/administración & dosificación , Potasio en la Dieta/administración & dosificación , Factores de Riesgo , Sodio en la Dieta/administración & dosificación
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