Body fat predicts urinary tract infection in kidney transplant recipients: a prospective cohort study.

BACKGROUND: The association between obesity and infectious diseases is increasingly reported in the literature. There are scarce studies on the association between obesity and urinary tract infection after kidney transplantation (KTx). These studies defined obesity based on body mass index, and their results were conflicting. The present study aimed to evaluate this association using bioelectrical impedance analysis for body composition evaluation, and obesity definition. METHODS: A single-center cohort study was conducted. Demographic, clinical, anthropometric, and laboratory data were collected at KTx admission, and bioelectrical impedance analysis was performed to measure the visceral fat area, waist circumference, and total fat mass. The occurrence of urinary tract infection (symptomatic bacteriuria and/or histological evidence of pyelonephritis) was evaluated within three months after KTx. RESULTS: Seventy-seven patients were included in the cohort, and 67 were included in the final analysis. Urinary tract infection was diagnosed in 23.9% of the transplanted patients. Waist circumference (HR: 1.053; 95% CI 1.005-1.104; p = 0.032), visceral fat area (HR: 1.015; 95% CI 1.003-1.027; p = 0.014), and total fat mass (HR: 1.075; 95% CI 1.008-1.146; p = 0.028) were associated with urinary tract infection occurrence after KTx, using Cox regression models. Patients with high waist circumference (above 102 cm for men and above 88 cm for women) had a 4.7 times higher risk of a urinary tract infection than those with normal waist circumference (HR: 4.726; 95% CI 1.267-17.630; p = 0.021). Kaplan-Meier curves showed that patients with high waist circumference, high visceral fat area, and high total fat mass had more urinary tract infections (Log-rank test p = 0.014, p = 0.020, and p = 0.018, respectively). Body mass index was not able to predict urinary tract infection in the study sample. CONCLUSIONS: Waist circumference, visceral fat area, and total fat mass, assessed by bioelectrical impedance analysis, were predictors of urinary tract infection risk within the first three months after KTx.

Construção e validação de instrumento para avaliação do cuidado a prisioneiros que vivem com HIV/Aids / Construction and validation of an instrument to assess the care for prisoners living with HIV/AIDS

RESUMO Este artigo objetivou construir e validar indicadores para o cuidado à saúde dos privados de liberdade com HIV/Aids, sendo um estudo de desenvolvimento metodológico realizado em duas etapas. Na primeira, houve a construção dos indicadores por meio de revisão da literatura nas bases de dados nacionais e internacionais. Na segunda, realizaram-se a validação do conteúdo e a aparência utilizando o método da técnica Delphi; dez juízes especialistas no cuidado à pessoa que vive com HIV/Aids e atuação prática no ambiente prisional participaram dessa etapa, sendo a maioria enfermeiros atuando em unidades prisionais. Após, foi realizada a análise de consistência interna, desta feita, o instrumento foi aplicado a dez gestores de saúde de unidades prisionais e calculado do coeficiente alfa de Cronbach; a escolha dos gestores versou por meio de sorteio. O instrumento resultou em cinco dimensões: Estrutura Física; Recursos Humanos; Organização do Processo de Trabalho; Prontuários de Saúde; e Adesão ao Tratamento. O instrumento obteve 80% de concordância dos juízes com relação ao conteúdo e a aparência. O alfa de Cronbach geral foi de 0,90. O instrumento foi validado em aparência, conteúdo e consistência para avaliação do cuidado ao privado de liberdade com HIV/Aids.

ABSTRACT This study aimed to build and validate indicators for the health care of those deprived of freedom living with HIV/AIDS, being a methodological development study carried out in two stages. In the first stage, there was the construction of indicators through a literature review in national and international databases. In the second stage, the content and appearance validation were performed using the Delphi technique method; ten judges specialized in the care of the person living with HIV/AIDS and practical performance in the prison environment participated in this stage, most of them being nurses working in prison units. After that, the internal consistency analysis was performed, and the instrument was applied to 10 health managers of prison units, and the Cronbach's alpha coefficient was calculated. The instrument resulted in five dimensions: Physical Structure; Human Resources; Work Process Organization; Health Records; and Adherence to Treatment. The instrument obtained 80% of agreement from the judges regarding content and appearance. The overall Cronbach's alpha was 0.90. The instrument was validated in appearance, content, and consistency for the evaluation of care to those deprived of freedom living with HIV/AIDS.

Relationship Between Lipodystrophy, Body Composition, Metabolic Profile, and Serum Levels of Adipocytokines.

Background: Despite the benefits in improving the clinical state of people living with HIV/aids (PLWHA), some side effects associated with the use of antiretroviral therapy (ART) are reported. Redistribution of body fat has been associated with treatment and is characterized by morphological changes, also known as lipodystrophy. The complications of metabolic and morphological changes in these individuals seem to increase the risk of cardiovascular disease. Adipocytokines are proteins that have essential functions in biological processes, in which the levels of these proteins are related to the pathogenesis of metabolic syndrome (MS) and cardiovascular disease. Recent studies have shown that such levels are generally modified in PLWHA, regardless of whether the treatment is established or not. An application of methods for body fat estimation in patients with fat redistribution, as in the case of aids, especially those that quantify body fat by segments, appears to clarify these alterations and plays an important role in the development of multiprofessional treatment. Objectives: This investigation was carried out to compare and correlate body composition, biochemical metabolic parameters, and levels of adipocytokines and cytokines of PLWHA, with and without lipodystrophy, with individuals with negative HIV serology and stratified by sex. Material and Methods: This is a cross-sectional study in which body composition, metabolic and anthropometric changes, and levels of adipocytokines of 110 individuals were assessed. These individuals were paired in sex, age, and body mass index (BMI) and subdivided into three groups: PLWHA with and without a clinical diagnosis of lipodystrophy associated with HIV, and a group control. Results: Collinearity was identified both in the general sample and for genders of the waist-to-height ratio (WHtR) with all anthropometric parameters, except for muscle mass. The results show strong association between IFN-γ and TNF-α both in the general sample and for genders and moderate correlation between leptin and fasting glucose for women; worsening of the triglyceride profile in both women with lipodystrophy compared with the control group and men without lipodystrophy compared with the control group; higher serum TNF-α values among men without lipodystrophy compared to those with HIV-associated lipodystrophy (HALS). Conclusions: The results of this study underline that, considering the manifestations of the syndrome, these patients have a high-risk endocrine metabolic profile for cardiovascular events.

Dez competências para ensino-aprendizagem da consulta de enfermagem e integralidade em saúde: uma revisão integrativa / Ten competences for teaching-learning in nursing consultation and integrality of care: an integrative review

Objetivo: Identificar competências para o fortalecimento do ensino-aprendizagem da consulta de enfermagem considerando o cuidado integral. Método: Revisão integrativa de artigos publicados em português, inglês ou espanhol, nos últimos dez anos, nas bases: LILACS, MEDLINE, BDENF, PubMed, Web of Science, SCOPUS, EMBASE e CINHAL, utilizando a seguinte questão norteadora: Quais competências permeiam o ensino-aprendizagem da consulta de enfermagem, considerando a integralidade do cuidado? Resultados: A busca resultou em 95 estudos, após a aplicação dos critérios de inclusão e exclusão foram selecionados e analisados 10 artigos. Foram elencadas e discutidas as seguintes competências: comprometimento do educador na busca de conhecimento, aproximação teórico-prática, estímulo à reflexão, prioridade à prática, incentivo à pesquisa, apropriação da situação apresentada pelo usuário, ética e humanização, execução do ouvir, envolver o paciente no planejamento do cuidado e, apropriação da sistematização da assistência de enfermagem. Conclusões: Esta revisão integrativa elencou dez competências para o fortalecimento da consulta de enfermagem, enfatizando o processo de formação do enfermeiro para a prática do cuidado integral na atenção primária à saúde. Ressalta-se a necessidade de mais estudos voltados para a formação do enfermeiro nesta temática. (AU)

Objective: To identify competencies to strengthen the teaching of nursing consultation considering integral care. Method: Integrative review of articles published in Portuguese, English or Spanish, in the last ten years, based on: LILACS, MEDLINE, BDENF, PubMed, Web of Science, SCOPUS, EMBASE and CINHAL, using the following guiding question: Which competencies permeate the teaching-learning of nursing consultation, considering the integrality of care? Results: The search resulted in 95 studies, after applying the inclusion and exclusion criteria 10 articles were selected and analyzed. The following competences were listed and discussed: the educator's commitment in the search for knowledge, theoretical-practical approach, encouragement to reflection, priority to practice, incentive to research, appropriation of the situation presented by the user, ethics and humanization, execution of listening, involving the in planning care and appropriating the systematization of nursing care. Conclusions: This integrative review listed ten competencies for strengthening nursing consultation, emphasizing the process of training nurses to practice comprehensive care in primary health care. It is emphasized the need for more studies focused on the training of nurses in this theme. (AU)

Objetivo: identificar competencias para fortalecer la enseñanza de la consulta de enfermería considerando la atención integral. Método: Revisión integral de artículos publicados en portugués, inglés o español, en los últimos diez años, basados en: LILACS, MEDLINE, BDENF, PubMed, Web of Science, SCOPUS, EMBASE y CINHAL, utilizando la siguiente pregunta orientadora: ¿Qué competencias impregnan el enseñanza-aprendizaje de la consulta de enfermería, considerando la integralidad de la atención? Resultados: La búsqueda resultó en 95 estudios, luego de aplicar los criterios de inclusión y exclusión, se seleccionaron y analizaron 10 artículos. Se enumeraron y discutieron las siguientes competencias: el compromiso del educador en la búsqueda de conocimiento, enfoque teórico-práctico, estímulo a la reflexión, prioridad a la práctica, incentivo a la investigación, apropiación de la situación presentada por el usuario, ética y humanización, ejecución de la escucha, involucrando el en la planificación de la atención y la apropiación de la sistematización de la atención de enfermería. Conclusiones: Esta revisión integradora enumeró diez competencias para fortalecer la consulta de enfermería, enfatizando el proceso de capacitación de enfermeras para practicar la atención integral en atención primaria de salud. Se enfatiza la necesidad de más estudios enfocados en la capacitación de enfermeras en este tema. (AU)

Satisfação e sobrecarga na atuação de profissionais em saúde mental / Satisfacción y sobrecarga en el desempeño de los profesionales de salud mental / Satisfaction and burden in mental health professionals' performance

Resumo Objetivo analisar a sobrecarga sobre a satisfação profissional em trabalhadores dos Centros de Atenção Psicossocial (CAPS) de um município do interior paulista. Método estudo transversal. Utilizou-se como instrumento a Escala de Avaliação da Satisfação de Profissionais em Serviços de Saúde Mental e a Escala de Avaliação da Sobrecarga de Profissionais em Serviços de Saúde Mental, que foram aplicadas às equipes do CAPS de um município do interior Paulista. Resultados foram avaliados 49 trabalhadores, com predomínio do sexo feminino, idade entre 30 e 39 anos, com pós-graduação completa, trabalhando como estatutário, 30h semanais e sem trabalho complementar. Os profissionais apresentavam satisfação no trabalho e baixa sobrecarga de trabalho. Apontaram necessidade de melhorias na estrutura física, nos recursos humanos e na aquisição de materiais. Conclusão e implicações para a prática os profissionais atuantes em saúde mental se sentem satisfeitos na sua atuação, mas foi ressaltada a insatisfação na faltada continuidade do cuidado prestado e a necessidade de melhoria na estrutura física para melhor prestação de serviço. A carga horária de 30h semanais e o vínculo estatutário parecem favorecer a satisfação em relação ao trabalho e diminuir a sobrecarga.

Resumen Objetivo analizar la carga sobre la satisfacción laboral de los trabajadores de los Centros de Atención Psicosocial (CAPS) de una ciudad del interior de São Paulo. Método estudio transversal. La Escala de Evaluación de la Satisfacción de Profesionales en los Servicios de Salud Mental y la Escala de Evaluación de la Carga de Profesionales en los Servicios de Salud Mental se utilizaron como un instrumento, que se aplicaron a los equipos de CAPS en una ciudad en el interior de São Paulo. Resultados se evaluaron 49 trabajadores, con predominio de mujeres, con edades comprendidas entre 30 y 39 años, con posgrado completo, trabajando con un vínculo legal, 30 horas a la semana y sin trabajo complementario. Los profesionales tienen satisfacción laboral y baja sobrecarga de trabajo. Señalaron la necesidad de mejoras en la estructura física, los recursos humanos y la adquisición de materiales. Conclusión e implicaciones para la práctica los profesionales que trabajan en salud mental se sienten satisfechos con su desempeño, pero la insatisfacción se destacó por la falta de continuidad de la atención brindada y la necesidad de mejorar la estructura física para una mejor prestación del servicio. La carga de trabajo de 30 horas a la semana y el vínculo legal parecen favorecer la satisfacción laboral y reducir la sobrecarga.

Abstract Objective to analyze the burden on professional satisfaction in workers of Psychosocial Care Centers (CAPS - Centros de Atenção Psicossocial) in a municipality in the countryside of São Paulo state. Method this is a cross-sectional study. The Scale for Assessing the Satisfaction of Professionals in Mental Health Services and the Scale for Assessing the Burden of Professionals in Mental Health Services were used as an instrument, which were applied to CAPS teams in a city in the countryside of São Paulo. Results we assessed 49 workers, with predominance of females, aged between 30 and 39 years, with complete graduate studies, working as statutory, 30 hours per week and without complementary work. Professionals had job satisfaction and low work burden. They pointed out the need for improvements in physical structure, human resources and material acquisition. Conclusion and Implications for practice mental health professionals feel satisfied in their performance, but dissatisfaction with the lack of continuity of care provided and the need for improvement in physical structure for better service delivery was emphasized. The 30-hour weekly workload and statutory bond seems to favor satisfaction with work and reduce the burden.

Impacto da Pandemia (COVID-19) no comportamento alimentar e rotina de atividade física, no Brasil: um inquérito baseado na internet / Impact of the pandemic (COVID-19) on eating behavior and physical activity routine in Brazil: an internet-based survey

Redução da mobilidade e de contato interpessoal foram recomendados à população para controle da pandemia (COVID-19). O objetivo foi dimensionar os principais efeitos quanto ao hábito alimentar, atividade física e alteração do peso de brasileiros. Estudo transversal, a partir de dados coletados de inquérito na Internet. Foram representadas prevalências nas alterações de ingesta alimentar e de atividade física; padrões dietéticos revelados por análise de cluster e os fatores associados à variação do peso por modelo linear generalizado. Foram avaliados 2.907 participantes, 75% mulheres, idade média de 42 anos. A comparação do peso antes da pandemia, mostrou que 11% dos eutróficos tornaram-se sobrepeso, 23% evoluíram para obesidade e 40% dos que eram ativos, tornaram-se sedentários. Aumentou o consumo de pães, doces, chocolate e vinho. O ganho de peso foi associado à maior faixa etária, sedentarismo, exercício de baixa intensidade, menor escolaridade, dieta ocidental e carboidrato simples. Os principais fatores emocionais relatados foram: ansiedade, medo, estresse, depressão, indisposição, dificuldade para dormir, inatividade física, compulsão alimentar e alteração de humor. Os resultados apontam mudanças no estilo de vida decorrentes da restrição social que implicam em risco para saúde: aumento de peso, sedentarismo, consumo de álcool e dieta com alta densidade energética.

Reduced mobility and interpersonal contacts were recommended to the entire population for the control of the COVID-19 pandemic. The objective of this study was to measure the main effects of this social restriction in terms of eating habits, physical activity, and weight change, of Brazilians. This is a cross-sectional study, based on data collected from an Internet survey. The prevalence of changes in food intake and physical activity was represented. Dietary patterns were revealed using hierarchical cluster analysis. The factors associated with the variation in body weight were explored using a generalized linear model. 2,907 participants were evaluated, 75% of whom were female, and the mean age (sd) was 42 (14) years. As for body weight compared to before the pandemic, 11% of eutrophic people became overweight; and 23% of those who were already overweight, progressed to obesity. As for the practice of physical activity, 40% of those who were active, became sedentary. The foods with the greatest increase in consumption were bread (40%), sweets (39%), chocolate (30%) and wine (27%). Body weight gain was associated with a higher age group, physical inactivity, low-intensity physical activities, less education, adherence to Western standard diets, and simple carbohydrates (p≤0.01). Factors related to lifestyle changes in the pandemic have been reported, such as: anxiety, fear, stress, depression, malaise, change in family and work routine, difficulty sleeping, physical inactivity, binge eating, insecurity, increased work and change in mood. The results point to changes in lifestyle resulting from social restriction that imply health risk: weight gain, physical inactivity, alcohol consumption, and high energy density diet.

Use of structural equation models to evaluate the relationship between eating patterns and obesity for elderly people / Uso de modelos de ecuaciones estructurales para evaluar la relación entre los patrones de alimentación y la obesidad en personas mayores

INTRODUCTION: in the Brazilian population it is noted that obesity is increasing in all ages, particularly in the elderly, due to changes in habits and the consumption of foods with high energy density. The objective of this study was to reanalyze the data from a Food Frequency Questionnaire (FFQ) in order to obtain new food patterns from the elderly population. METHODS: sociodemographic data, morbidities, and Food Frequency Questionnaire (FFQ) results were collected from a representative sample of 355 elderly in the city of Botucatu, São Paulo, Brazil, and stratified by Basic Health Unit in the municipality. The data from the FFQ were transformed into daily consumption, and only foods with an intake of at least 40 % were included in the analysis. Eating patterns were obtained by means of an exploratory and confirmatory factor analysis using the principal component method, associating them with obesity and demographic variables obtained via structural equation models (SEMs). RESULTS: with the data from the FFQ, four eating patterns were obtained using the exploratory and confirmatory factor analysis: healthy, traditional, snacks and weekend meals, and mild diet. Using SEMs and considering general obesity as measured by the body mass index (BMI), being female, younger, hypertensive, diabetic, and having lower adherence to the traditional pattern increases BMI. Additionally, using SEMs and considering central obesity as measured by waist circumference (WC), being hypertensive or diabetic, and having a lower adherence to the traditional pattern increases WC. CONCLUSION: removing excess zeroes from FFQ data it was possible to obtain well-defined eating patterns using the exploratory and confirmatory analysis, and to associate them with obesity through SEMs

INTRODUCCIÓN: en la población brasileña se observa que la obesidad ha aumentado en todas las edades, incluidas las personas mayores, debido a los cambios en los hábitos y el consumo de alimentos con alta densidad energética. El objetivo de este estudio fue volver a analizar los datos de un cuestionario de frecuencia alimentaria (FFQ) con el fin de obtener los nuevos patrones dietéticos de la población de edad avanzada. MÉTODOS: se recogieron datos sociodemográficos y de morbilidad, y los resultados de un cuestionario de frecuencia alimentaria (FFQ) de una muestra representativa de 355 personas mayores de la ciudad de Botucatu, São Paulo, Brasil, y se estratificaron por Unidad Básica de Salud del municipio. Los datos del FFQ se transformaron en consumo diario y solo se incluyeron en el análisis alimentos con al menos un 40 % de consumo. Los patrones dietéticos se obtuvieron mediante el análisis factorial exploratorio y confirmatório con el método del componente principal, asociándolos con la obesidad y las variables demográficas mediante modelos de ecuaciones estructurales (SEM). RESULTADOS: con los datos del FFQ se obtuvieron cuatro patrones dietéticos mediante el análisis exploratorio y confirmatorio: saludable, tradicional, tapas y comidas de fin de semana, y dieta ligera. Con los SEM y considerando la obesidad general medida por el índice de masa corporal (IMC), ser mujer, más joven, hipertensa, diabética y con menos adherencia al patrón tradicional aumenta el IMC. Además, con los SEM y considerando la obesidad central medida por la circunferencia de la cintura (WC), ser hipertenso, diabético y tener una menor adherencia al patrón tradicional aumenta los valores de WC. CONCLUSIONES: el análisis factorial exploratorio y confirmatorio reveló los patrones dietéticos y los modelos de ecuaciones estructurales resultaron útiles para obtener las relaciones existentes entre los resultados de interés

Use of structural equation models to evaluate the relationship between eating patterns and obesity for elderly people.

INTRODUCTION: Introduction: in the Brazilian population it is noted that obesity is increasing in all ages, particularly in the elderly, due to changes in habits and the consumption of foods with high energy density. The objective of this study was to reanalyze the data from a Food Frequency Questionnaire (FFQ) in order to obtain new food patterns from the elderly population. Methods: sociodemographic data, morbidities, and Food Frequency Questionnaire (FFQ) results were collected from a representative sample of 355 elderly in the city of Botucatu, São Paulo, Brazil, and stratified by Basic Health Unit in the municipality. The data from the FFQ were transformed into daily consumption, and only foods with an intake of at least 40 % were included in the analysis. Eating patterns were obtained by means of an exploratory and confirmatory factor analysis using the principal component method, associating them with obesity and demographic variables obtained via structural equation models (SEMs). Results: with the data from the FFQ, four eating patterns were obtained using the exploratory and confirmatory factor analysis: healthy, traditional, snacks and weekend meals, and mild diet. Using SEMs and considering general obesity as measured by the body mass index (BMI), being female, younger, hypertensive, diabetic, and having lower adherence to the traditional pattern increases BMI. Additionally, using SEMs and considering central obesity as measured by waist circumference (WC), being hypertensive or diabetic, and having a lower adherence to the traditional pattern increases WC. Conclusion: removing excess zeroes from FFQ data it was possible to obtain well-defined eating patterns using the exploratory and confirmatory analysis, and to associate them with obesity through SEMs.

INTRODUCCIÓN: Introducción: en la población brasileña se observa que la obesidad ha aumentado en todas las edades, incluidas las personas mayores, debido a los cambios en los hábitos y el consumo de alimentos con alta densidad energética. El objetivo de este estudio fue volver a analizar los datos de un cuestionario de frecuencia alimentaria (FFQ) con el fin de obtener los nuevos patrones dietéticos de la población de edad avanzada. Métodos: se recogieron datos sociodemográficos y de morbilidad, y los resultados de un cuestionario de frecuencia alimentaria (FFQ) de una muestra representativa de 355 personas mayores de la ciudad de Botucatu, São Paulo, Brasil, y se estratificaron por Unidad Básica de Salud del municipio. Los datos del FFQ se transformaron en consumo diario y solo se incluyeron en el análisis alimentos con al menos un 40 % de consumo. Los patrones dietéticos se obtuvieron mediante el análisis factorial exploratorio y confirmatório con el método del componente principal, asociándolos con la obesidad y las variables demográficas mediante modelos de ecuaciones estructurales (SEM). Resultados: con los datos del FFQ se obtuvieron cuatro patrones dietéticos mediante el análisis exploratorio y confirmatorio: saludable, tradicional, tapas y comidas de fin de semana, y dieta ligera. Con los SEM y considerando la obesidad general medida por el índice de masa corporal (IMC), ser mujer, más joven, hipertensa, diabética y con menos adherencia al patrón tradicional aumenta el IMC. Además, con los SEM y considerando la obesidad central medida por la circunferencia de la cintura (WC), ser hipertenso, diabético y tener una menor adherencia al patrón tradicional aumenta los valores de WC. Conclusiones: el análisis factorial exploratorio y confirmatorio reveló los patrones dietéticos y los modelos de ecuaciones estructurales resultaron útiles para obtener las relaciones existentes entre los resultados de interés.

Oat bran in cardiovascular risk control in mental disorder.

OBJECTIVE: To evaluate the effect of oat bran supplementation on cardiovascular risk components of patients with mental disorders. METHOD: A before-and-after study, no control group. Cardiovascular risk indicators were assessed at baseline (M0), 90 (M1), 180 days (M2) and 180 days after supplementation (M3). RESULTS: Of the 45 patients admitted to a psychiatric institution using antipsychotics, more than two thirds had high cardiovascular risk assessed by abdominal obesity. Forty-six point seven percent were overweight and 31.1% metabolic syndrome. Oat bran was effective in reducing serum cholesterol (M0-M1), HDL-cholesterol (M1-M2), triglycerides (M1-M2), (M2-M3) and (M1-M3). In M3, there was a statistical difference for all indicators evaluated. CONCLUSION: Oat bran supplementation was effective in improving triglyceride, total cholesterol and HDL-cholesterol levels, suggesting that it is a therapeutic option for cardiovascular risk control in patients with psychiatric disorders.

Dietary patterns of patients with psoriasis at a public healthcare institution in Brazil.

BACKGROUND: Psoriasis is a chronic inflammatory disease with systemic repercussions and an association with comorbidities such as metabolic syndrome, cardiovascular diseases, and obesity. Psoriasis patients have a higher prevalence of obesity compared to the general population. Diet is a relevant environmental factor, since malnutrition, inadequate body weight, and metabolic diseases, in addition to the direct health risk, impair the treatment of psoriasis. OBJECTIVES: To evaluate food intake patterns, anthropometric, and metabolic syndrome-related aspects in psoriasis patients. METHODS: Cross-sectional study through anthropometric assessment and food frequency questionnaire. Food frequency questionnaire items were evaluated by exploratory factor analysis and identified dietary patterns were analyzed by multivariate methods. RESULTS: This study evaluated 94 patients, 57% female, with a mean age of 54.9 years; the prevalence of obesity was 48% and of metabolic syndrome, 50%. Factor analysis of the food frequency questionnaire identified two dietary patterns: Pattern 1 - predominance of processed foods; Pattern 2 - predominance of fresh foods. Multivariate analysis revealed that Patterns 1 and 2 showed inverse behaviors, and greater adherence to Pattern 2 was associated with females, eutrophic individuals, absence of lipid and blood pressure alterations, and lower waist-to-hip ratio and skin disease activity. STUDY LIMITATIONS: Monocentric study conducted at a public institution, dependent on dietary memory. CONCLUSION: Two dietary patterns were identified in a Brazilian sample of psoriasis patients. The prevalence of obesity and metabolic syndrome were greater than in the adult Brazilian population. The fresh diet was associated with lower indicators of metabolic syndrome in this sample.

Frailty predicts surgical complications after kidney transplantation. A propensity score matched study.

BACKGROUND AND OBJECTIVE: Surgical complications after kidney transplantation can lead to catastrophic outcomes. Frailty has been associated with important kidney transplantation outcomes; however, there are no studies assessing this measure of physiological reserve as a specific predictor of surgical complications in this population. Such an assessment was, therefore, the objective of the present study. METHODS: A total of 87 individuals aged ≥ 18 years who underwent kidney transplantation between March 2017 and March 2018 were included. At the time of admission for kidney transplantation, demographic, clinical, and kidney transplantation data were collected, and the frailty score was calculated according to Fried et al., which comprises five components: shrinking, weakness, exhaustion, low activity, and slowed walking speed. Urological, vascular, and general surgical complications were assessed three months later, or until graft loss or death. The propensity score was used to achieve a better homogeneity of the sample, and new analyses were performed in this new, balanced sample. RESULTS: Of the 87 individuals included, 30 (34.5%) had surgical complications. After propensity score matching, the risk of surgical complications was significantly higher among the frail individuals (RR 2.14; 95% CI 1.01-4.54; p = 0.035); specifically, the risk of noninfectious surgical complications was significantly higher among these individuals (RR 2.50; 95% CI 1.11-5.62; p = 0.017). CONCLUSION: The results showed that individuals with some degree of frailty before kidney transplantation were more subject to surgical complications. The calculation of the frailty score for transplant candidates and the implementations of measures to increase the physiological reserve of these patients at the time of kidney transplantation may possibly reduce the occurrence of surgical complications.

Oat bran in cardiovascular risk control in mental disorder / Salvado de avena en el control del riesgo cardiovascular en el trastorno mental / Farelo de aveia no controle de risco cardiovascular em transtorno mental

ABSTRACT Objective: To evaluate the effect of oat bran supplementation on cardiovascular risk components of patients with mental disorders. Method: A before-and-after study, no control group. Cardiovascular risk indicators were assessed at baseline (M0), 90 (M1), 180 days (M2) and 180 days after supplementation (M3). Results: Of the 45 patients admitted to a psychiatric institution using antipsychotics, more than two thirds had high cardiovascular risk assessed by abdominal obesity. Forty-six point seven percent were overweight and 31.1% metabolic syndrome. Oat bran was effective in reducing serum cholesterol (M0-M1), HDL-cholesterol (M1-M2), triglycerides (M1-M2), (M2-M3) and (M1-M3). In M3, there was a statistical difference for all indicators evaluated. Conclusion: Oat bran supplementation was effective in improving triglyceride, total cholesterol and HDL-cholesterol levels, suggesting that it is a therapeutic option for cardiovascular risk control in patients with psychiatric disorders.

RESUMEN Objetivo: Evaluar el efecto de la suplementación con salvado de avena en los componentes de riesgo cardiovascular de pacientes con trastornos mentales. Método: Un estudio antes y después, sin grupo control. Los indicadores de riesgo cardiovascular se evaluaron al inicio del estudio (M0), 90 (M1), 180 días (M2) y 180 días después de la suplementación (M3). Resultados: De los 45 pacientes ingresados en una institución psiquiátrica que usan antipsicóticos, más de dos tercios tenían un alto riesgo cardiovascular evaluado por obesidad abdominal. 46.7% tenían sobrepeso y 31.1% síndrome metabólico. El salvado de avena fue eficaz para reducir el colesterol sérico (M0-M1), el colesterol HDL (M1-M2), los triglicéridos (M1-M2), (M2-M3) y (M1-M3). En M3 hubo una diferencia estadística para todos los indicadores evaluados. Conclusión: La suplementación con salvado de avena fue efectiva para mejorarlos niveles de triglicéridos, colesterol total y colesterol HDL, lo que sugiere que es una opción terapéutica para el control del riesgo cardiovascular en pacientes con trastornos psiquiátricos.

RESUMO Objetivo: Avaliar o efeito da suplementação de farelo de aveia sobre os componentes de risco cardiovascular de pacientes com transtornos mentais. Método: Estudo antes e depois, sem grupo controle. Foram avaliados os indicadores de risco cardiovascular no início (M0), 90 (M1), 180 dias (M2) e 180 dias após a suplementação (M3). Resultados: Dos 45 pacientes internados em uma instituição psiquiátrica em uso de antipsicóticos, mais de dois terços apresentaram risco cardiovascular elevado avaliado pela obesidade abdominal. 46,7% apresentou excesso de peso e 31,1% síndrome metabólica. O farelo de aveia mostrou-se eficaz na redução do colesterol sérico (M0-M1), HDL-colesterol (M1-M2), triglicerídeos (M1-M2), (M2-M3) e (M1-M3). Em M3 houve diferença estatística para todos os indicadores avaliados. Conclusão: A suplementação do farelo de aveia foi eficaz para melhora dos níveis de triglicérides, colesterol total e HDL-colesterol, sugerindo ser uma opção terapêutica para controle dos riscos cardiovasculares de pacientes com transtornos psiquiátricos.

Adherence to dietary patterns during pregnancy and association with maternal characteristics in pregnant Brazilian women.

OBJECTIVES: The aim of this study was to investigate food consumption during pregnancy by determining dietary patterns, associations with maternal characteristics, and possible changes in adherence to patterns throughout pregnancy. METHODS: We prospectively followed two groups of pregnant women (N = 353) and collected, in each gestational trimester, two 24-h dietary recalls: one in person and another by telephone, with one of these recalls performed on a weekend or holiday. To determine the women's dietary patterns, principal component analysis was conducted using the combined data of groups and trimesters. The association between adherence to patterns and maternal characteristics was investigated using a logistic regression model, including covariates as potential confounders. Changes in adherence throughout the trimesters by the means difference test also were examined. RESULTS: Three dietary patterns were identified: traditional Brazilian; predominantly ultra-processed and beef; and whole grains, fruits, vegetables, low-fat milk, and dairy. Associations were found between adherence to patterns and not working outside the home, not being white, being younger, not living with a partner, drinking alcohol before pregnancy, years of formal education, and socioeconomic classification. Adherence to the traditional Brazilian pattern increased as gestational trimesters advanced, whereas the pattern that included whole grains, fruits, vegetables, low-fat milk, and milk derivatives decreased from the first to the second gestational trimester. CONCLUSION: We found associations between maternal sociodemographic characteristics and adherence to different dietary patterns, as well as changes in adherence during pregnancy. This knowledge is relevant to creating specific and feasible guidelines for different population strata associated with the patterns.

Incident analysis occurrence related to potentially dangerous medicines distributed in teaching hospital. / Análise das ocorrências de incidentes relacionados aos medicamentos potencialmente perigosos dispensados em hospital de ensino.

OBJECTIVE: To analyze the reports of incidents related to potentially hazardous medications distributed at a teaching hospital in the interior of São Paulo. METHODS: A descriptive, retrospective study with a quantitative approach of data from the analysis of pharmacovigilance notifications that occurred between January 2009 and December 2014, from tables and graphs, showing the absolute/relative frequencies. RESULTS: From 786 reports of pharmacovigilance, 188 were related to potentially hazardous medicines, 36.7% of which were ineffective, 32.44% were technical complaints, 15.95% were adverse reactions, 7.44% were phlebitis, 5.13% were extravasation , 1.06% dispensing error, 0.53% administration error and 0.53% medication error. The professionals who most notified were nurses. The most commonly reported pharmacological groups were drugs with action on the nervous system (35.63%). CONCLUSION: The analysis showed that there were a significant number of reports and the need to adopt strategies to ensure greater patient safety.

Análise das ocorrências de incidentes relacionados aos medicamentos potencialmente perigosos dispensados em hospital de ensino / Análisis de las ocurrencias de incidentes relacionados a los medicamentos potencialmente peligrosos suministrados en hospital de enseñanza / Incident analysis occurrence related to potentially dangerous medicines distributed in teaching hospital

Resumo OBJETIVO Analisar as notificações de incidentes relacionados aos medicamentos potencialmente perigosos dispensados em um hospital de ensino do interior de São Paulo. MÉTODOS Estudo descritivo, retrospectivo com abordagem quantitativa dos dados provenientes da análise das notificações em farmacovigilância que ocorreram no período de janeiro de 2009 a dezembro de 2014, a partir de tabelas e gráficos, apresentando as frequências absolutas/relativas. RESULTADOS Das 786 notificações de farmacovigilância, 188 foram relacionadas aos medicamentos potencialmente perigosos, sendo 36,7% de ineficácia terapêutica, 32,44% queixa técnica, 15,95% reação adversa, 7,44% flebite, 5,13% extravasamento, 1,06% erro de dispensação, 0,53% erro de administração e 0,53% erro de medicação. Os profissionais que mais notificaram foram enfermeiros. Os grupos farmacológicos de maior notificação foram drogas com ação sobre sistema nervoso (35,63%). CONCLUSÃO A análise demonstrou que houve um número de notificações expressivo e necessidade de adoção de estratégias a fim de garantir maior segurança do paciente.

Resumen OBJETIVO Analizar las notificaciones de incidentes relacionados a medicamentos potencialmente peligrosos suministrados ​​en un hospital de enseñanza del interior de San Pablo. MÉTODOS Estudio descriptivo, retrospectivo, con abordaje cuantitativo de los datos provenientes del análisis de las notificaciones en farmacovigilancia que ocurrieron en el período de enero de 2009 a diciembre de 2014, a partir de tablas y gráficos, presentando las frecuencias absolutas/relativas. RESULTADOS De las 786 notificaciones de farmacovigilancia, 188 fueron relacionadas a los medicamentos potencialmente peligrosos, siendo 36,7% de ineficacia terapéutica, 32,44% queja técnica, 15,95% reacción adversa, 7,44% flebitis, 5,13% extravasación, 1,06% error de dispensación, 0,53% error de administración, y 0,53% error de medicación. Los profesionales que más notificaron fueron enfermeros. Los grupos farmacológicos de mayor notificación fueron drogas con acción sobre el sistema nervioso (35,63%). CONCLUSIÓN El análisis demostró que hubo un número de notificaciones expresivas y necesidad de adopción de estrategias a fin de garantizar mayor seguridad al paciente.

Abstract OBJECTIVE To analyze the reports of incidents related to potentially hazardous medications distributed at a teaching hospital in the interior of São Paulo. METHODS A descriptive, retrospective study with a quantitative approach of data from the analysis of pharmacovigilance notifications that occurred between January 2009 and December 2014, from tables and graphs, showing the absolute/relative frequencies. RESULTS From 786 reports of pharmacovigilance, 188 were related to potentially hazardous medicines, 36.7% of which were ineffective, 32.44% were technical complaints, 15.95% were adverse reactions, 7.44% were phlebitis, 5.13% were extravasation , 1.06% dispensing error, 0.53% administration error and 0.53% medication error. The professionals who most notified were nurses. The most commonly reported pharmacological groups were drugs with action on the nervous system (35.63%). CONCLUSION The analysis showed that there were a significant number of reports and the need to adopt strategies to ensure greater patient safety.

Eating patterns and nutrient intake for older people: analysis with different methodological approaches. / Padrões alimentares e ingestão de nutrientes em idosos: análise com diferentes abordagens metodológicas.

This study aims to analyse the eating patterns and nutrient intake in different eating patterns of elderly persons. This is a cross-sectional study with elderly people from Botucatu, São Paulo state, Brazil. The mean daily nutrient intake of individuals with high adherence to the eating patterns identified by factor analysis was analysed, comparing the intake by analysis of variance. Individuals with high adherence to the Healthy eating pattern had the highest mean intake of retinol, vitamin A and vitamin E. Individuals with high adherence to the eating pattern Snacks and weekend meal presented lower means of vitamin B12, vitamin C, phosphorus, and retinol intake and the highest means of iron, manganese and magnesium intake. Individuals with high adherence to Fruits had the lowest mean fibre intake. Individuals with high adherence to Light and whole foods had the highest means of vitamin C intake. Individuals with high adherence to Soft diet showed lower protein intake and increased added sugar intake. Individuals with high adherence to the Traditional eating pattern presented high means of nutrient intake. In general, a better characterization of the eating behaviour of elderly people who adhere to each of these eating patterns was possible.

Este estudo objetivou analisar os padrões alimentares e a ingestão de nutrientes em cada padrão alimentar de idosos. Trata-se de um estudo transversal, com idosos de Botucatu, São Paulo. Foram analisadas as médias de ingestão diária de nutrientes de indivíduos com alta adesão a padrões alimentares identificados por análise fatorial, comparando a ingestão através de análise de variância. Indivíduos com alta adesão ao padrão "Saudável" apresentaram a maior média de ingestão de retinol, vitamina A e vitamina E. Indivíduos com alta adesão ao padrão "Lanches e refeição de final de semana" apresentaram médias de consumo menores de vitamina B12, vitamina C, fósforo e retinol; e as maiores médias de consumo de ferro, manganês e magnésio. Indivíduos com alta adesão ao padrão "frutas" apresentaram as menores médias de ingestão de fibras. Indivíduos com alta adesão ao padrão "Light e integral" apresentaram as maiores médias de ingestão de vitamina C. Indivíduos com alta adesão ao padrão "Dieta branda" apresentaram menor consumo de proteína e mais de açúcar de adição. Indivíduos com alta adesão ao padrão "Tradicional" apresentaram médias elevadas de ingestão de nutrientes. Foi possível uma melhor caracterização do comportamento alimentar dos idosos que aderem a cada um desses padrões alimentares.

Padrões alimentares e ingestão de nutrientes em idosos: análise com diferentes abordagens metodológicas / Eating patterns and nutrient intake for older people: analysis with different methodological approaches

Resumo Este estudo objetivou analisar os padrões alimentares e a ingestão de nutrientes em cada padrão alimentar de idosos. Trata-se de um estudo transversal, com idosos de Botucatu, São Paulo. Foram analisadas as médias de ingestão diária de nutrientes de indivíduos com alta adesão a padrões alimentares identificados por análise fatorial, comparando a ingestão através de análise de variância. Indivíduos com alta adesão ao padrão "Saudável" apresentaram a maior média de ingestão de retinol, vitamina A e vitamina E. Indivíduos com alta adesão ao padrão "Lanches e refeição de final de semana" apresentaram médias de consumo menores de vitamina B12, vitamina C, fósforo e retinol; e as maiores médias de consumo de ferro, manganês e magnésio. Indivíduos com alta adesão ao padrão "frutas" apresentaram as menores médias de ingestão de fibras. Indivíduos com alta adesão ao padrão "Light e integral" apresentaram as maiores médias de ingestão de vitamina C. Indivíduos com alta adesão ao padrão "Dieta branda" apresentaram menor consumo de proteína e mais de açúcar de adição. Indivíduos com alta adesão ao padrão "Tradicional" apresentaram médias elevadas de ingestão de nutrientes. Foi possível uma melhor caracterização do comportamento alimentar dos idosos que aderem a cada um desses padrões alimentares.

Abstract This study aims to analyse the eating patterns and nutrient intake in different eating patterns of elderly persons. This is a cross-sectional study with elderly people from Botucatu, São Paulo state, Brazil. The mean daily nutrient intake of individuals with high adherence to the eating patterns identified by factor analysis was analysed, comparing the intake by analysis of variance. Individuals with high adherence to the Healthy eating pattern had the highest mean intake of retinol, vitamin A and vitamin E. Individuals with high adherence to the eating pattern Snacks and weekend meal presented lower means of vitamin B12, vitamin C, phosphorus, and retinol intake and the highest means of iron, manganese and magnesium intake. Individuals with high adherence to Fruits had the lowest mean fibre intake. Individuals with high adherence to Light and whole foods had the highest means of vitamin C intake. Individuals with high adherence to Soft diet showed lower protein intake and increased added sugar intake. Individuals with high adherence to the Traditional eating pattern presented high means of nutrient intake. In general, a better characterization of the eating behaviour of elderly people who adhere to each of these eating patterns was possible.

Homemade diet versusdiet industrialized for patients using alternative feeding tube at home - An integrative review.

BACKGROUND: Enteral nutrition therapy can be provided using comercialized products (chemically defined formulas) or blenderized home-made preparations. OBJECTIVE: To perform an integrative review of the literature comparing the use of both type of formulation. METHODS: In this descriptive study papers published in English, Spanish or Portuguese Brazil, in journals indexed in the databases PubMed, EMBASE, Scopus, Web of Science and Bireme without the period 2010 to 2015 were reviewed The terms "enteral nutrition, foods, formulated, diet, homemade diet industrial and artisanal diet" according to the MeSH were used for the search. RESULTS: Twelve articles were selected. Most studies showed a level 4 of evidence and were published in journal in the higher Qualis index. Four aspects were evaluated: comparison between groups studying the clinical effects; comparison of the chemical composition of home-made products; physical-chemical and microbiological analysis of the enteral diets comes; articles on epidemiological Data on home enteral nutrition. CONCLUSION: Industrialized diet is more suitable for patients using alternative feeding supply at home. But it has a higher cost.

Homemade diet versus diet industrialized for patients using alternative feeding tube at home: an integrative review / La dieta artesanal versus la dieta industrializada en pacientes con nutrición enteral domiciliaria: una revisión integradora

Background: Enteral nutrition therapy can be provided using comercialized products (chemically defined formulas) or blenderized home-made preparations. Objective: To perform an integrative review of the literature comparing the use of both type of formulation. Methods: In this descriptive study papers published in English, Spanish or Portuguese Brazil, in journals indexed in the databases PubMed, EMBASE, Scopus, Web of Science and Bireme without the period 2010 to 2015 were reviewed The terms «enteral nutrition, foods, formulated, diet, homemade diet industrial and artisanal diet» according to the MeSH were used for the search. Results: Twelve articles were selected. Most studies showed a level 4 of evidence and were published in journal in the higher Qualis index. Four aspects were evaluated: comparison between groups studying the clinical effects; comparison of the chemical composition of home-made products; physical-chemical and microbiological analysis of the enteral diets comes; articles on epidemiological Data on home enteral nutrition Conclusion: Industrialized diet is more suitable for patients using alternative feeding supply at home. But it has a higher cost (AU)

Introducción: en la terapia nutricional enteral pueden administrarse productos comerciales con fórmulas químicamente definidas o preparados artesanales compuestas por alimentos naturales y/o procesados. Objetivo: realizar una revisión integradora de la literatura sobre el uso de la dieta artesanal versus industrializada, en pacientes con nutrición enteral. Métodos: estudio descriptivo de los artículos originales que comparaban el uso de fórmulas enterales comerciales con preparados caseros. Se consideraron elegibles los artículos publicados en inglés, español o portugués, en revistas indexadas en las bases de datos: PubMed, Scopus, EMBASE, Web of Science y Bireme en el periodo de 2010 a 2015, a partir de los descriptores: «enteral nutrition, food, formulated, industrialized diet, homemade diet, handmade diet». Para el análisis de los estudios fue utilizado un instrumento específico para evaluación de artículos. Resultados: finalmente se analizaron 12 artículos. La mayoría de los estudios presentó un nivel de evidencia 4 y fueron publicados en revistas de elevado índice Qualis. Los artículos fueron separados en 4 grupos: comparación del uso de las dietas y el efecto en los pacientes que las recibían; evaluación de la composición química de la alimentación enteral artesanal por medio de tablas de composición de alimentos; análisis físico-químico y microbiológico de las dietas enterales artesanales; y artículos que presentaron la situación epidemiológica de la terapia nutricional enteral domiciliaria. Conclusión: la dieta industrializada es la más indicada para pacientes que nutrición enteral en el domicilio, mientras, que los costos generados pueden volverse grandes obstáculos para quien la elija (AU)

Body Composition and Metabolic Syndrome Components on Lipodystrophy Different Subtypes Associated with HIV.

HIV-associated lipodystrophy syndrome (HALS) is characterized by body fat redistribution as a consequence of the antiretroviral therapy (ART) introduction, associated with an increased risk of cardiovascular disease development. Subjective diagnosis, classified between three subtypes according to the body region on which fat is lost and/or accumulated, named lipoatrophy, lipohypertrophy, and mixed lipodystrophy, is possibly accompanied with metabolic alterations. Forty people living with HIV/AIDS (PLHA), with clinical diagnosis of HALS and from both genders, were assessed. They performed ambulatorial follow-up and used ART regularly. The main findings were greater lipid profile alterations among women, while no metabolic profile differences were found between the HALS subtypes. The lipohypertrophy group showed major alterations, with higher values for total body fat percent, visceral fat area (VFA), body mass index (BMI), and abdominal and neck circumferences when compared to the other groups. Lean body mass was superior only compared to the mixed lipodystrophy group, and fat mass only compared to the lipoatrophy group. BMI showed strong correlation with the VFA. In conclusion, despite anthropometric alterations related to HALS these individuals present, those are not accompanied with metabolic alterations. Strategies, as behavioral changes and disorders prevention, are important to decrease the risk of cardiovascular disease development.