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1.
Hosp Pract (1995) ; 48(sup1): 17-25, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32046544

RESUMEN

Cancer occurs most frequently in patients aged 65 and older. With the increasing age of the world's population, there will be a significant increase in cancer diagnoses in older adults. Aging imposes a wide variety of physiological responses, comorbidities, and ailments, but older patients are less represented in clinical studies. Specific needs of older patients with cancer often go under-recognized and consequently unmet. In this review, common diagnoses that can affect the outcomes of this population, including frailty, malnutrition, and delirium, are discussed. Areas that need further research to improve the care of geriatric cancer patients, particularly in the hospital settings, are also identified.


Asunto(s)
Delirio/epidemiología , Fragilidad/epidemiología , Evaluación Geriátrica/métodos , Desnutrición/epidemiología , Neoplasias/epidemiología , Neoplasias/terapia , Anciano , Anciano de 80 o más Años , Envejecimiento , Comorbilidad , Delirio/diagnóstico , Delirio/terapia , Anciano Frágil , Fragilidad/diagnóstico , Fragilidad/terapia , Humanos , Desnutrición/diagnóstico , Desnutrición/terapia , Obesidad/epidemiología , Factores de Riesgo
2.
Nutr. hosp ; 37(1): 80-85, ene.-feb. 2020. tab
Artículo en Español | IBECS | ID: ibc-187577

RESUMEN

Antecedentes: las técnicas de cribado e intervención nutricional en pacientes hospitalizados son una medida coste-efectiva. En la práctica clínica, el problema radica en cómo aplicarlas. Objetivo: evaluar la aplicación de un protocolo de cribado nutricional en pacientes hospitalizados en la Planta de Medicina (M). Material y métodos: estudio unicéntrico, prospectivo y observacional realizado a pacientes que ingresan en M. Los criterios de exclusión fueron: pacientes oncológicos en fase terminal, ingresos inferiores a 72 h y reingresos de pacientes previamente incluidos. Se seleccionaron 1 de cada 2 ingresos. Se evaluaron: si Enfermería había realizado el test de cribado, el Short Nutritional Assessment Questionnaire (SNAQ); la puntuación obtenida; las interconsultas a dietistas (ICD); el soporte nutricional prescrito, y el diagnóstico de desnutrición en el informe de alta. Los dietistas volvieron a administrar el SNAQ a 1 de cada 3 pacientes incluidos. Resultados: durante el periodo de estudio ingresaron 726 pacientes, se seleccionaron 377 y se incluyeron 315. Enfermería administró el SNAQ al 93,6% de los pacientes; presentaban desnutrición el 19%. La determinación realizada por los dietistas detectó un 37,8% de desnutrición. En el 41,9% de los que presentaban desnutrición severa se realizaron ICD; al 40% de ellos no se les realizó ninguna intervención nutricional, y el diagnóstico de desnutrición constaba en el informe de alta del 42,1% de los pacientes. Conclusión: existe un buen cumplimiento en la realización del test de cribado, pero existe también discordancia con la valoración de los dietistas. En la mayoría de los pacientes con desnutrición no se realizan ICD, no se prescribe soporte nutricional y no se hace constar el diagnóstico en el informe de alta


Background: the techniques for screening and nutritional intervention in hospitalized patients are a cost-effective measure. In clinical practice the problem lies in their administration. Objective: to evaluate the implementation of a nutritional screening tool in patients admitted to our Medicine Ward (M). Material and methods: a single-center, prospective, observational study in patients admitted to M. Exclusion criteria: end-stage cancer patients, inpatient stay less than 72 h, and hospital readmission of previously included patients. One out of every 2 hospital admissions was selected. We assessed the following: whether nurses performed the screening test, the Short Nutritional Assessment Questionnaire (SNAQ); the score obtained; consultations with dieticians (ICD); prescribed nutritional support; and coding of malnutrition in the discharge report. Dieticians repeated the SNAQ for one in every 3 patients. Results: during the study period 726 patients were admitted, 377 were selected, and 315 were included. The nursing staff administered the SNAQ to 93.6 % of patients and malnutrition was present in 19 %. Dieticians detected malnutrition in 37.8 %. In 41.9 % of patients with severe malnutrition an ICD was performed, whereas in 40 % of them no nutritional intervention was implemented. The diagnosis of malnutrition was recorded in the discharge report of 42.1 % of our cases. Conclusion: Compliance with screening test administration was good, but there is disagreement with the assessment made by dieticians. For most malnourished patients nutritional support fals to be prescribed, no ICDs are performed, and a malnutrition diagnosis is not included in the discharge report


Asunto(s)
Humanos , Tamizaje Masivo/métodos , Desnutrición/diagnóstico , Hospitalización/economía , Estudios Prospectivos , Encuestas y Cuestionarios , Derivación y Consulta
3.
Nutr. hosp ; 37(1): 223-227, ene.-feb. 2020. tab
Artículo en Español | IBECS | ID: ibc-187592

RESUMEN

Introducción: presentamos el caso de un paciente con antecedentes de polineuropatía amiloidótica familiar por transtiretina (TTR-FAP) diagnosticado de hipocupremia severa. Caso clínico: varón de 79 años afecto de TTR-FAP. Visto en consulta de nutrición por desnutrición severa. En el estudio analítico presenta cifras de cobre (Cu) sérico y ceruloplasmina bajas, con Cu en orina también bajo. No tiene clínica digestiva ni antecedentes de cirugía gastrointestinal. Las pruebas de función hepática, la ferrocinética, las cifras de Hb y leucocitos y los niveles de zinc (Zn) no presentan alteraciones relevantes. Discusión: el Cu es un oligoelemento que participa como componente de las cuproenzimas en múltiples funciones fisiológicas. Los niveles séricos bajos pueden relacionarse con causas genéticas o adquiridas, como la baja ingesta, la cirugía bariátrica, el aumento de las pérdidas, etc. Las principales manifestaciones clínicas son hematológicas (anemia, leucopenia) o neurológicas (mielopatía, neuropatía periférica). El tratamiento tiene base empírica. En los casos severos puede iniciarse con administración intravenosa, seguido de mantenimiento por vía oral


Introduction: we report a patient with transthyretin familial amyloid polyneuropathy (TTR-FAP) and severe hypocupremia. Case report: a 79-year-old male with TTR-FAP and severe malnutrition. Laboratory tests showed low serum copper (Cu) and ceruloplasmin levels, as well as low urinary Cu levels. The patient reported neither digestive symptoms nor previous gastrointestinal surgery. Liver function tests, iron metabolism, hemoglobin, leukocytes and zinc were normal. Discussion: Cu is a trace element. It is part of the cuproenzymes involved in several physiological functions. Hypocupremia can be related to genetic or acquired etiologies, including low intake, bariatric surgery, increased losses, etc. Primary clinical manifestations include hematological (anemia and leukopenia) and neurological (myelopathy, peripheral neuropathy) features. Treatment is empirical. In severe cases it may be initiated with endovenose administration, followed by oral supplementation


Asunto(s)
Humanos , Masculino , Anciano , Desnutrición/diagnóstico , Ceruloplasmina/orina , Cobre/orina , Síndrome del Pelo Ensortijado/complicaciones , Síndrome del Pelo Ensortijado/dietoterapia , Nutrición Parenteral Total
4.
PLoS One ; 15(2): e0229396, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32092109

RESUMEN

OBJECTIVE: This study is aimed at determining the preoperative nutritional status of patients with hepatic alveolar echinococcosis (HAE), and subsequently establish a concise and reasonable nutritional evaluation indicator. The established evaluation method could be used for clinical preoperative risk assessment and prediction of post-operation recovery. METHODS: The basic patient information on height, body weight, BMI and hepatic encephalopathy of 93 HAE patients were examined. Subsequently, abdominal ultrasonography, blood coagulation and liver function tests were done on the patients. Liver function was assessed using the Child-Pugh improved grading method while nutritional status was evaluated using the European Nutrition Risk Screening 2002 (NRS 2002) method. Additional parameters including hospitalization time, the hemoglobin (HGB) level on the 3rd day after the operation, and the number of postoperative complications of HAE patients were also recorded. RESULTS: The NRS 2002 score was negatively correlated with body weight, body mass index (BMI)and albumin (ALB) (P<0.01), and positively correlated with the transverse and longitudinal diameters of the lesions (P<0.01). A worse grading of liver function was associated with a low ALB and a high NRS 2002 score (P<0.01). Results of the NRS 2002 score indicate that the hospitalization time of the normal nutrition group was significantly shorter than that of the malnourished group (P < 0.05). The HGB level of the control group on the 3rd day after the operation was significantly higher than that of the malnourished group (P < 0.05), and the number of postoperative complications was lower than that of malnutrition group (P < 0.05). CONCLUSION: Malnutrition is common in HAE patients. The nutritional status of HAE patients is related to many clinical factors, such as Child-Pugh classification of liver function, size of the lesion, and ALB among others. Although both BMI and ALB can be used as primary screening indicators for malnutrition in HAE patients, NRS 2002 is more reliable and prudent in judging malnutrition in HAE patients. Therefore, BMI and ALB are more suitable for preoperative risk assessment and prediction of postoperative recovery.


Asunto(s)
Equinococosis Hepática/diagnóstico , Equinococosis Hepática/cirugía , Evaluación Nutricional , Estado Nutricional , Complicaciones Posoperatorias/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Equinococosis Hepática/complicaciones , Equinococosis Hepática/dietoterapia , Femenino , Hepatectomía/efectos adversos , Hepatectomía/rehabilitación , Humanos , Pruebas de Función Hepática , Masculino , Desnutrición/diagnóstico , Desnutrición/dietoterapia , Desnutrición/etiología , Desnutrición/cirugía , Persona de Mediana Edad , Terapia Nutricional , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Cuidados Preoperatorios/métodos , Periodo Preoperatorio , Pronóstico , Recuperación de la Función , Medición de Riesgo , Adulto Joven
5.
PLoS One ; 15(2): e0228738, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32053672

RESUMEN

BACKGROUND: Premorbid undernutrition has been proven to have an adverse effect on the prognosis of stroke patients. The evaluation of nutritional status is important, but there is no universally accepted screen methodology. PURPOSE: We aimed to use the geriatric nutritional risk index (GNRI) for evaluating the effect of premorbid undernutrition on short-term outcomes in patients with acute ischemic stroke. METHODS: A total of 1,906 patients were included for analysis. Baseline characteristics were collected. We evaluated the nutritional status of the patients using the GNRI and body mass index(BMI). The GNRI was calculated as {1.519×serum albumin(g/dL) + 41.7×present weight (kg)/ideal body weight (kg)}. All patients were categorized into four groups on the basis of the GNRI score. RESULTS: Among the included patients, 546 patients had an unfavorable outcomes. The proportion of patients with moderate and severe risk, assessed in GNRI, was significantly higher in the unfavorable outcome group compared to the favorable outcome group (33.3% vs 15.0%). The increased risk of premorbid undernutrition was associated with an increased risk of unfavorable outcome in a dose-response manner after adjusting for covariates. CONCLUSIONS: This study demonstrated that GNRI was associated with poor prognosis in patients with acute ischemic stroke. GNRI may be used to screen patients at high risk for unfavorable outcome.


Asunto(s)
Evaluación Geriátrica , Desnutrición/diagnóstico , Estado Nutricional , Accidente Cerebrovascular/patología , Enfermedad Aguda , Anciano , Área Bajo la Curva , Automatización , Índice de Masa Corporal , Peso Corporal , Femenino , Humanos , Masculino , Desnutrición/complicaciones , Persona de Mediana Edad , Pronóstico , Curva ROC , Riesgo , Factores de Riesgo , Albúmina Sérica/análisis , Accidente Cerebrovascular/complicaciones
6.
PLoS One ; 15(2): e0228592, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32012187

RESUMEN

BACKGROUND: The coexistence of undernutrition (thinness) and overnutrition (overweight/obesity) among children and adolescents is a public health concern in low-middle-income countries. Accurate prevalence estimates of thinness and overweight/obesity among children and adolescents are unavailable in many low-middle-income countries due to lack of data. Here we describe the prevalences and examine correlates of objectively measured weight status among urban and rural schoolchildren in Mozambique. METHODS: A cross-sectional study design was applied to recruit 9-11-year-old schoolchildren (n = 683) from 17 urban and rural primary schools in Mozambique. Body mass index (BMI) was computed from objectively measured height and weight and participants' weight categories were determined using the World Health Organization cut-points. Actigraph GT3X + accelerometers were worn 24 hours per day for 7 days to assess movement behaviours. Multilevel multivariable modelling was conducted to estimate odds ratios and confidence intervals. RESULTS: Combined prevalence of overweight/obesity (11.4%) was significantly higher among urban participants compared to rural participants (5.7%; χ2 = 7.1; p = 0.008). Conversely, thinness was more prevalent among rural (6.3%) compared to urban (4.2%) participants. Passive school commute, not meeting daily moderate- to vigorous-intensity physical activity (MVPA) guidelines, and maternal BMI >25 kg/m2 were associated with overweight/obesity while possessing one or more functional cars at home, maternal BMI >25 kg/m2 and being an older participant were associated with thinness in the present sample. The proportion of total variance in the prevalences of obesity and/or thinness occurring at the school level was 8.7% and 8.3%, respectively. CONCLUSION: Prevalences of thinness, overweight/obesity and other key variables differ between urban and rural schoolchildren in Mozambique. MVPA, active transport and mother's BMI are important modifiable correlates of weight status among Mozambican schoolchildren. Results from this study demonstrate important differences between urban and rural schoolchildren that should not be ignored when designing interventions to manage malnutrition, formulating public health strategies, and interpreting findings.


Asunto(s)
Desnutrición/epidemiología , Delgadez/epidemiología , Niño , Femenino , Humanos , Masculino , Desnutrición/diagnóstico , Mozambique , Prevalencia , Población Rural/estadística & datos numéricos , Instituciones Académicas/estadística & datos numéricos , Delgadez/diagnóstico , Población Urbana/estadística & datos numéricos
8.
Klin Padiatr ; 232(1): 20-28, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31569262

RESUMEN

OBJECTIVE: The prevalence and follow-up of the clinical real-world data focussing on existing or risk of malnutrition in a tertiary hospital general paediatric ward including 4 months of follow-up was assessed. METHODS: Measurements included anthropometric measurements, a nutrition interview and an extended version of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP). R Studio 3.4.2 was used for statistical analysis and diagnosing malnutrition by calculating height-for-age (HfAz)-, weight-for-age (WfAz)- weight-for-height (WfHz)-, body mass index-for-age (BMIz) and mid-upper-arm circumference (MUACz)-z-scores with the childsds package with KIGGS and WHO for reference. RESULTS: The median age of the 68 participants was 8.00 (4.00-13.00) years. The main reasons for hospitalisation in the tertiary centre were gastrointestinal diseases, diabetes mellitus and rheumatic diseases. At admission 39.71%, at the second examination 36.00% and at the third examination 45.90% were malnourished. 68% of inpatients lost weight during their clinical stay, of which 35.29% lost more than 3% of their initial weight. However, changes were not significantly different. CONCLUSION: A significant share of patients was diagnosed to be malnourished at admission, the majority of patients lost weight during their hospital stay and the 4 months after admission. Due to the far reaching consequences for patients, doctors, health insurance and politics, the early diagnosis and treatment of malnutrition should take greater account in the future.


Asunto(s)
Desnutrición/diagnóstico , Tamizaje Masivo/métodos , Hipernutrición/diagnóstico , Pediatría , Adolescente , Índice de Masa Corporal , Peso Corporal , Niño , Estudios de Seguimiento , Humanos , Desnutrición/epidemiología , Hipernutrición/epidemiología , Prevalencia
10.
Orv Hetil ; 161(1): 11-16, 2020 Jan.
Artículo en Húngaro | MEDLINE | ID: mdl-31884812

RESUMEN

Introduction: There are no satisfying data about the difficulties of nutritional therapy during rehabilitation, but malnutrition and secondary sarcopenia increase the number of complications. Aim: The aim of this cross-sectional study was measuring of patients' malnutrition risk in the National Institute for Medical Rehabilitation of Hungary. Method: Malnutrition Universal Screening Tool was used in this study. Results: 44% of the patients had a risk of malnutrition (n = 331; average age: 59 years), 19% of the patients presented moderate risk and 25% had high risk of malnutrition. The sample consisted of 176 males and 155 females (53%/47%). The interquartile range of body mass index of patients was between 22-29.9 kg/m2 (s = 6.36). Comparison of units showed that the Brain Injury Rehabilitation Unit has the most malnutrition-risked patients (62.5%, 25 patients). Conclusions: Malnutrition screening tools are not sensitive enough in the case of special patient groups of rehabilitation, therefore a combined screening method is needed. Orv Hetil. 2020; 161(1): 11-16.


Asunto(s)
Pacientes Internos , Desnutrición/diagnóstico , Tamizaje Masivo/métodos , Sarcopenia , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Hungría , Masculino , Desnutrición/prevención & control , Persona de Mediana Edad , Evaluación Nutricional , Estado Nutricional
12.
Rev Fac Cien Med Univ Nac Cordoba ; 76(4): 233-237, 2019 12 03.
Artículo en Español | MEDLINE | ID: mdl-31833747

RESUMEN

Background: Malnutrition at admission of paediatric hospitalization is a risk factor for negative evolution and is associated with increased morbidity and mortality. The main objective was to learn about the frequency of malnutrition and undernourishment as well as the nutritional risk at hospital admission, through a sample of paediatric patients. Material and Methods: A descriptive cross-sectional was taken, chosen from long term patients in Hospital Dr. Humberto Notti. A nutritional screening (Strong Kids) was applied, assessing nutritional risk within 48 hours. of hospital admission and nutritional diagnosis was obtained with the corresponding anthropometric data. For the statistical analysis, Fisher Test and Student test were used. Results: 134 patients were admitted (59% women), 4 years of age, (1 to 9 years) (medium sized and IQR), and hospitalization lasted 4 days (3 to 7 days). At the ingress, 17% presented acute malnutrition, and 60% presented moderate nutritional risk. Those who suffered from high nutritional risk, went through more frequent pain, change of weight, less eating, diarrhea, and signs of undernourishment, than those who suffered from moderated nutritional risk. (Fisher < 0, 0001). Conclusion: Malnutrition or undernourishment at hospital admission affects about the 20% of patients and more than half presents moderated nutritional risk. These two observations justify the systematic carrying out of an evaluation of the nutritional status


Asunto(s)
Hospitalización/estadística & datos numéricos , Desnutrición/diagnóstico , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Tiempo de Internación , Masculino , Desnutrición/epidemiología , Evaluación Nutricional , Proyectos Piloto , Factores de Riesgo
13.
BMC Gastroenterol ; 19(1): 223, 2019 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-31864303

RESUMEN

BACKGROUND: Malnutrition is a common problem among children with chronic liver diseases (CLD). We aimed to assess the nutritional status of children with CLD and to correlate the anthropometric indices with the severity of liver disease, liver function tests, insulin growth factor-1 (IGF-1) and 25-hydroxy vitamin D (25- OH D). METHODS: A total of 69 patients with CLD and 50 healthy controls (6 months - 6 years) were included in the study. Nutritional status was assessed by anthropometric indices expressed in standard deviation score (Z score), biochemical, hematological and clinical parameters. RESULTS: We found 52.2% of CLD patients underweight by weight for age (W/A); 50.2% were stunted by height for age/ length for age (HAZ or LAZ); and 39% exhibited wasting by weight/height or (length) for age (W/HZ or W/LZ) z scores analysis. The mean values of z scores for all anthropometric parameters were significantly correlated with unconjugated and conjugated bilirubin and INR (p < 0.05), except HAZ or LAZ. Also, a significant correlation to albumin was found, except for W/HZ or (W/LZ) (p = 0.157). The z scores < - 2 SD based on W/ H versus arm indicators showed significant differences in MUAC, UAA and AMA (p < 0.001). We found no correlation between anthropometric z-scores and the mean IGF-1 and (25- OH D) values (p > 0.05). Malnutrition was directly correlated with the severity of hepatic dysfunction, particularly, Child-Pugh C cases. The mean IGF-1 and (25- OH D) values were significantly correlated with the severity of liver disease (p < 0.001). CONCLUSIONS: Our results identified anthropometric arm indicators and MUAC/A measurements as an effective applied methods for assessing nutritional status in CLD children. Moreover, Integrating comprehensive clinical assessment, anthropometric measurements and objective biochemical analyses is essential for evaluation, follow-up and management of CLD children with variable degree of malnutrition.


Asunto(s)
Hepatopatías/complicaciones , Desnutrición/diagnóstico , Evaluación Nutricional , Factores de Edad , Brazo/anatomía & histología , Estatura , Peso Corporal , Proteínas Portadoras/sangre , Estudios de Casos y Controles , Niño , Preescolar , Enfermedad Crónica , Estudios Transversales , Egipto , Femenino , Trastornos del Crecimiento/sangre , Trastornos del Crecimiento/diagnóstico , Cabeza/anatomía & histología , Humanos , Lactante , Factor I del Crecimiento Similar a la Insulina/análisis , Hepatopatías/sangre , Pruebas de Función Hepática , Masculino , Desnutrición/sangre , Desnutrición/etiología , Albúmina Sérica/análisis , Índice de Severidad de la Enfermedad , Grosor de los Pliegues Cutáneos , Delgadez/sangre , Delgadez/diagnóstico , Vitamina D/análogos & derivados , Vitamina D/sangre , Síndrome Debilitante/sangre , Síndrome Debilitante/diagnóstico
14.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(4): 435-441, Oct.-Dec. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1041361

RESUMEN

ABSTRACT Objective: To determine the prevalence of hepatic steatosis (HS) in children and adolescents with cystic fibrosis (CF) and associate it with nutritional status. Methods: Cross-sectional study with children and adolescents with CF diagnosis. Weight and height were used to calculate the body mass index (BMI) and subsequent classification of the nutritional status. The midarm circumference (MAC), triceps skinfold thickness (TSF) and midarm muscle circumference (MAMC) were used to evaluate body composition. Abdominal ultrasonography was performed for diagnosis of HS. The statistical tests used were Student's t test, Mann-Whitney test and chi-square test with significance level of 5%. Results: 50 patients with CF were evaluated, 18 (36%) were diagnosed with HS (Group A) and 32 (64%) without HS (Group B). The mean age of Group A was 13,2±4,9 years old and Group B 11,7±4,9; for BMI, the value for Group A was 18,0±4,1 and Group B was 15,7±3,8; the TSF of Group A was 8,4±3,5 mm and Group B was 7,0±2,5 mm. For these variables, there was no significant difference between the groups. The mean of MAC and MAMC differed significantly between the groups, being higher in the HS group, with p values of 0,047 and 0,043. Conclusions: The frequency of HS in patients with CF is high and it is not related to malnutrition, according to the parameters of BMI, TSF and MAMC. The values of MAC and MAMC indicated a greater reserve of muscle mass in patients with HS.


RESUMO Objetivo: Determinar a prevalência de esteatose hepática (EH) em crianças e adolescentes com fibrose cística (FC) e associá-la com o estado nutricional. Métodos: Estudo transversal com crianças e adolescentes com diagnóstico de FC. Foram aferidos o peso e a altura para o cálculo do índice de massa corpórea (IMC) e classificação do estado nutricional. A circunferência do braço (CB), a dobra cutânea tricipital (DCT) e a circunferência muscular do braço (CMB) foram empregadas para avaliação da composição corporal. A ultrassonografia abdominal foi realizada para o diagnóstico de EH. Os testes estatísticos empregados foram o teste t de Student, o teste de Mann-Whitney e o teste do qui-quadrado, com nível de significância de 5%. Resultados: Dos 50 pacientes avaliados, 18 (36%) apresentaram EH (Grupo A) e 32 (64%) não (Grupo B). Para as médias de idade (Grupo A: 13,3±5,0 anos; e Grupo B: 11,7±5,0 anos), IMC (Grupo A: 18,0±4,1; e Grupo B: 15,7±3,8) e DCT (Grupo A: 8,4±3,5 mm; e Grupo B: 7,0±2,5 mm), não houve diferença significativa entre os grupos. A média da CB e da CMB diferiram significativamente entre os grupos, sendo mais elevada no grupo com EH, com valores p respectivos de 0,047 e 0,043. Conclusões: É alta a frequência de EH em pacientes com FC e ela não está relacionada com a desnutrição, segundo os parâmetros de IMC, DCT e CMB. Os valores de CB e CMB indicaram maior reserva de massa muscular nos pacientes com EH.


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto Joven , Estado Nutricional , Fibrosis Quística/complicaciones , Desnutrición/complicaciones , Enfermedad del Hígado Graso no Alcohólico/etnología , Gestión de Riesgos , Prevalencia , Estudios Transversales , Fibrosis Quística/fisiopatología , Desnutrición/diagnóstico , Desnutrición/fisiopatología , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Enfermedad del Hígado Graso no Alcohólico/epidemiología
15.
Rev Med Suisse ; 15(670): 2046-2051, 2019 Nov 06.
Artículo en Francés | MEDLINE | ID: mdl-31696680

RESUMEN

Stroke is the most common acute neurological disease in the world. Approximately 16 000 strokes occur each year in Switzerland. In the older population, the stroke outcomes are related to high risk of malnutrition due to neurological deficits impacting oral feeding. Therefore, systematic screening of malnutrition is required upon admission to hospital. Then, assessment of the nutritional status by a specialist should be initiated before deciding on individualised nutritional strategy. Rehabilitation is complex and must be done in multidisciplinary team to provide optimal care to the patients.


Asunto(s)
Desnutrición/etiología , Desnutrición/terapia , Evaluación Nutricional , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/complicaciones , Anciano , Hospitalización , Humanos , Desnutrición/diagnóstico , Estado Nutricional , Accidente Cerebrovascular/epidemiología , Suiza/epidemiología
16.
PLoS Negl Trop Dis ; 13(11): e0007851, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31730639

RESUMEN

Environmental enteric dysfunction (EED) is associated with chronic undernutrition. Efforts to identify minimally invasive biomarkers of EED reveal an expanding number of candidate analytes. An analytic strategy is reported to select among candidate biomarkers and systematically express the strength of each marker's association with linear growth in infancy and early childhood. 180 analytes were quantified in fecal, urine and plasma samples taken at 7, 15 and 24 months of age from 258 subjects in a birth cohort in Peru. Treating the subjects' length-for-age Z-score (LAZ-score) over a 2-month lag as the outcome, penalized linear regression models with different shrinkage methods were fitted to determine the best-fitting subset. These were then included with covariates in linear regression models to obtain estimates of each biomarker's adjusted effect on growth. Transferrin had the largest and most statistically significant adjusted effect on short-term linear growth as measured by LAZ-score-a coefficient value of 0.50 (0.24, 0.75) for each log2 increase in plasma transferrin concentration. Other biomarkers with large effect size estimates included adiponectin, arginine, growth hormone, proline and serum amyloid P-component. The selected subset explained up to 23.0% of the variability in LAZ-score. Penalized regression modeling approaches can be used to select subsets from large panels of candidate biomarkers of EED. There is a need to systematically express the strength of association of biomarkers with linear growth or other outcomes to compare results across studies.


Asunto(s)
Biomarcadores/sangre , Discapacidades del Desarrollo/diagnóstico , Discapacidades del Desarrollo/patología , Enfermedades Ambientales/diagnóstico , Enfermedades Ambientales/patología , Desnutrición/diagnóstico , Desnutrición/patología , Bioestadística , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Perú
17.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(9): 555-562, nov. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-184378

RESUMEN

Introducción: La prevalencia de la desnutrición relacionada con la enfermedad en el hospital varía del 20 al 50%. La utilización de herramientas de cribado debe ser el primer paso en la prevención y el tratamiento de los pacientes en riesgo de desnutrición o desnutridos. Objetivos: Implantar un método de cribado nutricional al ingreso en el ámbito de un hospital terciario. Métodos: La Unidad de Nutrición elaboró un protocolo de detección precoz del riesgo nutricional y eligió el NRS 2002 como herramienta de cribado. El protocolo fue aprobado por la Comisión de Protocolos y Procedimientos del hospital y difundido en la intranet. El NRS 2002 se incluyó en el programa de prescripción de dietas para su realización por parte del personal de enfermería de las unidades de hospitalización y como sistema de comunicación directo con la Unidad de Nutrición. Se diseñaron 3 fases para la implantación: fase de pilotaje, fase de implantación y fase de consolidación. Resultados: En la fase de pilotaje se implantó el NRS 2002 en 2 unidades de hospitalización para monitorizar el software. La fase de implantación se realizó en las mismas unidades y se verificaron todos los protocolos de actuación relacionados con el mismo. La fase de consolidación consistió en ir ampliando sucesivamente las unidades de hospitalización con el protocolo implantado. Conclusiones: La implantación de un cribado nutricional al ingreso hospitalario es un proceso largo y complejo, con la implicación de muchos estamentos. El programa informático ha posibilitado que la realización del mismo sea rápido, sencillo y automatizado, y que el resultado del cribado llegue inmediatamente al personal de enfermería de la unidad de Nutrición y se activen los protocolos de actuación de la misma


Introduction: Prevalence of disease-related malnutrition in hospitals ranges from 20%-50%. Use of nutritional screening tools should be the first step in the prevention and treatment of patients at risk of malnutrition and/or undernourished. Aims: To implement a nutritional screening tool at admission to a tertiary hospital. Methods: The nutrition unit prepared a protocol for early detection of nutritional risk and selected the NRS 2002 as screening tool. The protocol was approved by the hospital committee of protocols and procedures and disseminated through the intranet. NRS 2002 was included in the diet prescription software to be implemented by the nursing staff of the hospital wards and as a direct communication system with the nutrition unit. Three phases were designed: pilot phase, implementation phase, and consolidation phase. Results: The pilot phase, NRS 2002 was implemented in 2 hospital units to monitor software. The implementation phase was carried out in the same units, and all action protocols related to it were verified. The consolidation phase consisted of sequential extension of the protocol to the other hospital units. Conclusions: Implementation of nutritional screening at hospital admission is a long and complex process that requires involvement of many stakeholders. Computer software has allowed for a rapid, simple, and automatic process, so that the results of the screening are immediately available to the nursing staff of the nutrition unit and activate the nutritional protocols when required


Asunto(s)
Humanos , Anciano , Desnutrición/prevención & control , Desnutrición/terapia , Diagnóstico Precoz , Hospitales Universitarios , Desnutrición/diagnóstico , Programas de Detección Diagnóstica/normas , Indicadores de Morbimortalidad , Tiempo de Internación
18.
J Stroke Cerebrovasc Dis ; 28(12): 104405, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31570264

RESUMEN

BACKGROUND: Malnutrition in patients hospitalized with a stroke have been assessed using different nutritional screening methods but there is a paucity of data linking risk of malnutrition to clinical outcomes using a validated tool. AIMS: To identify the prevalence of malnutrition risk in patients after a stroke and assess the predictive value of the Malnutrition Universal Screening Tool (MUST) on clinical outcomes. PATIENTS AND METHODS: Using data from electronic records and the Sentinel Stroke National Audit Programme (January 2013 and March 2016), patients aged more than 18 years with confirmed stroke admitted to a tertiary care stroke unit were assessed for risk of malnutrition. The association between malnutrition risk and clinical outcomes was investigated and adjusted for confounding variables. RESULTS: Of 1101 patients, 66% were screened at admission. Most patients (n = 571, 78.5%) were identified as being at low risk, 4.1% (n = 30) at medium risk, and 17.4% (n = 126) at high risk of malnutrition. Compared with low risk, patients with medium or high risk of malnutrition were more likely to have a longer hospital stay (IRR 1.30, 95% confidence interval [CI] 1.07, 1.58), and had greater risk of mortality (10.9% versus 3.5%, 95% CI .03, .13). CONCLUSIONS: Prevalence of malnutrition assessed by MUST in patients after a stroke was relatively low, but nearly a third of patients were not screened. Patients classified as being at medium or high risk of malnutrition were more likely to experience negative outcomes. Early identification of this population may improve outcome if appropriate care is provided.


Asunto(s)
Desnutrición/diagnóstico , Evaluación Nutricional , Estado Nutricional , Accidente Cerebrovascular/diagnóstico , Anciano , Anciano de 80 o más Años , Diagnóstico Precoz , Registros Electrónicos de Salud , Femenino , Humanos , Tiempo de Internación , Masculino , Desnutrición/mortalidad , Desnutrición/fisiopatología , Desnutrición/terapia , Auditoría Médica , Persona de Mediana Edad , Admisión del Paciente , Valor Predictivo de las Pruebas , Pronóstico , Sistema de Registros , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/terapia , Factores de Tiempo , Reino Unido/epidemiología
19.
Arq Gastroenterol ; 56(4): 447-450, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31618398

RESUMEN

BACKGROUND: Malnutrition is associated with clinical factors, including longer hospital stay, increased morbidity and mortality and hospital costs. OBJECTIVE: To investigate the prevalence of malnutrition using different nutritional indicators and to identify factors that contribute to malnutrition in hospitalized patients. METHODS: We investigated anthropometric, laboratory standards, nutritional risk screening (NRS), subjective global assessment (SGA), mini nutritional assessment and habitual energy consumption (HEC). Chi-square, Fisher's exact test, Mann-Whitney test and univariate and multiple Cox regression analysis were used, at 5% significance level. RESULTS: It was found 21.01% of malnourished individuals by ASG; a total of 34.78% with nutritional risk according to NRS and 11.59% with low weight (BMI). There was no statistically significant difference in the prevalence of malnutrition by ASG (P=0.3344) and nutritional risk by NRS (P=0.2286), among the types of disorders. Patients with nutritional risk were of higher median age (64.5 vs 58.0 years; P=0.0246) and had lower median values of HEC (1362.1 kcal vs 1525 kcal, P=0.0030), of calf circumference (32.0 cm vs 33.5 cm, P=0.0405) of lymphocyte count (1176.5 cell/mm3 vs 1760.5 cell/ mm3, P=0.0095); and higher percentage of low body weight according to the BMI (22.9% vs 5.6%; P=0.0096). Lymphocyte count was associated with nutritional risk (P=0.0414; HR= 1.000; IC95%= 0.999; 1.000). CONCLUSION: NRS was more sensitive than other indicators in the diagnosis of malnutrition. Patients at risk were older and had lower HEC values, calf circumference, BMI and lymphocyte count. Low lymphocyte count was considered a factor associated with nutritional risk by the NRS.


Asunto(s)
Hospitalización , Desnutrición/diagnóstico , Estudios Transversales , Humanos , Desnutrición/epidemiología , Prevalencia , Factores de Riesgo , Adulto Joven
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