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1.
Enferm. nefrol ; 23(3): 244-251, jul.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193707

RESUMO

La prevalencia de malnutrición en paciente con Enfermedad Renal Crónica es elevada, aumentando en pacientes con infección por SARS-CoV-2. La relación existente entre inflamación y nutrición es conocida en la enfermedad renal, por lo que la presencia previa de cuadros de malnutrición empeora el pronóstico de la infección. El objetivo del presente artículo es la creación de recomendaciones dietéticas específicas para pacientes con enfermedad renal crónica e infección o post-infección por SARS-CoV-2, adaptadas al estadio de enfermedad y a la etapa del proceso de infección. El abordaje nutricional comienza por la valoración del estado nutricional, para lo que se recomiendan minimizar el contacto físico mediante la utilización de los criterios Global Leadership Initiative on Malnutrition (GLIM), y el cuestionario rápido de sarcopenia (SARC-F). Las recomendaciones dietéticas deben considerar el estadio de enfermedad renal crónica, la etapa de infección por SARS-CoV-2 y las complicaciones surgidas que comprometan la ingesta oral, entre las más comunes se encuentran: anorexia, ageusia, disfagia y diarrea. En el presente documento se han elaborado tablas de raciones de ingestas diarias adaptadas a las diferentes situaciones. En aquellos pacientes que no cubran los requerimientos nutricionales se recomienda comenzar con la suplementación nutricional de manera precoz, considerando las consecuencias de la infección descrita. Debido al elevado riesgo de malnutrición en pacientes con enfermedad renal cónica e infección por SARS-CoV-2, se recomienda la adaptación de la valoración del estado nutricional y su tratamiento, así como realizar una monitorización tras la fase de infección activa


The prevalence of malnutrition in patients with Chronic Kidney Disease is high, increasing in patients with SARS-CoV-2 infection. The relationship between inflammation and nutrition in kidney disease is known, so the previous presence of malnutrition conditions worsens the prognosis of infection. The objective of this article is the creation of specific dietary recommendations for patients with chronic kidney disease and infection or post-infection by the SARS-CoV-2 virus, adapted to the stage of the disease and the stage of the infection process. The nutritional approach begins with the assessment of nutritional status, recommending minimizing physical contact through the use of the Global Leadership Initiative on Malnutrition (GLIM) criteria and the rapid sarcopenia questionnaire (SARC-F). The dietary recommendations should consider the stage of chronic kidney disease, the stage of infection by SARS-CoV-2 and the complications arising that compromise oral intake, among the most common are: anorexia, ageusia, dysphagia and diarrhea. In this document, tables of daily intakes have been prepared adapted to different situations. In those patients who do not meet the nutritional requirements, it is recommended to start with an early nutritional supplementation, considering the consequences of the infection described. Due to the high risk of malnutrition in patients with chronic kidney disease and SARS-CoV-2 infection, it is recommended to adapt the assessment of nutritional status and treatment, as well as to carry out monitoring after the active infection phase


Assuntos
Humanos , Infecções por Coronavirus/dietoterapia , Insuficiência Renal Crônica/dietoterapia , Desnutrição/dietoterapia , Diálise Renal/estatística & dados numéricos , Infecções por Coronavirus/complicações , Insuficiência Renal Crônica/complicações , Desnutrição/epidemiologia , Avaliação Nutricional , Estado Nutricional , Pandemias/estatística & dados numéricos
2.
Medicine (Baltimore) ; 99(33): e21647, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872028

RESUMO

Prevalence of postpartum depression (PD) in Chinese women is rising and its associated factors are not well known. In this study we aim to explore the associations between nutritional factors in pregnancy and the risk of PD in Chinese women.A case-control study was performed in our hospital during January 2016 to June 2019. A food frequency questionnaire was designed to collect food consumption before the childbirth preceding month. Nutrition related biochemical indicators including fasting blood-glucose (GLU), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), and uric acid in the third trimester of pregnancy were detected. Logistic regression model was applied to compute odds ratio (OR) and its corresponding 95% confidence interval (CI).There were 565 participants in this study, which comprised 182 individuals with PD and 383 individuals without. Patients with PD had higher odds of increased GLU (OR=2.62, 95%CI = 1.67-4.11), TC (OR = 1.73 95%CI = 1.22-2.46), TG (OR = 2.43, 95%CI = 1.55-3.81), and LDL (OR = 3.41, 95%CI = 2.09-5.57), but decreased HDL (OR = 3.41, 95%CI = 2.09-5.57) during pregnancy. With respect to uric acid, there was lack of no statistical association (OR = 2.23, 95%CI = 0.82-6.26). Food frequency questionnaire indicated a higher meat intake, but a lower vegetable, fruit, fish, and poultry intake in patients with PD during pregnancy.Increased GLU, TC, TG, and LDL, but decreased HDL in later stages of pregnancy might be associated with PD.


Assuntos
Depressão Pós-Parto/etiologia , Avaliação Nutricional , Adulto , Biomarcadores/sangue , Glicemia/análise , Estudos de Casos e Controles , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Humanos , Gravidez , Terceiro Trimestre da Gravidez , Fatores de Risco , Triglicerídeos/sangue
3.
Nutrients ; 12(10)2020 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-32992538

RESUMO

Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in older people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants' ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the MNA-short form (MNA-sf), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Index (NRI), the Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in older adults with COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Avaliação Geriátrica , Desnutrição/diagnóstico , Avaliação Nutricional , Pneumonia Viral/complicações , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Desnutrição/virologia , Pessoa de Meia-Idade , Estado Nutricional , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Reprodutibilidade dos Testes , Medição de Risco , Sensibilidade e Especificidade
4.
BMJ ; 370: m3173, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938660

RESUMO

OBJECTIVE: To determine if the Food Standards Agency nutrient profiling system (FSAm-NPS), which grades the nutritional quality of food products and is used to derive the Nutri-Score front-of-packet label to guide consumers towards healthier food choices, is associated with mortality. DESIGN: Population based cohort study. SETTING: European Prospective Investigation into Cancer and Nutrition (EPIC) cohort from 23 centres in 10 European countries. PARTICIPANTS: 521 324 adults; at recruitment, country specific and validated dietary questionnaires were used to assess their usual dietary intakes. A FSAm-NPS score was calculated for each food item per 100 g content of energy, sugars, saturated fatty acids, sodium, fibre, and protein, and of fruit, vegetables, legumes, and nuts. The FSAm-NPS dietary index was calculated for each participant as an energy weighted mean of the FSAm-NPS score of all foods consumed. The higher the score the lower the overall nutritional quality of the diet. MAIN OUTCOME MEASURE: Associations between the FSAm-NPS dietary index score and mortality, assessed using multivariable adjusted Cox proportional hazards regression models. RESULTS: After exclusions, 501 594 adults (median follow-up 17.2 years, 8 162 730 person years) were included in the analyses. Those with a higher FSAm-NPS dietary index score (highest versus lowest fifth) showed an increased risk of all cause mortality (n=53 112 events from non-external causes; hazard ratio 1.07, 95% confidence interval 1.03 to 1.10, P<0.001 for trend) and mortality from cancer (1.08, 1.03 to 1.13, P<0.001 for trend) and diseases of the circulatory (1.04, 0.98 to 1.11, P=0.06 for trend), respiratory (1.39, 1.22 to 1.59, P<0.001), and digestive (1.22, 1.02 to 1.45, P=0.03 for trend) systems. The age standardised absolute rates for all cause mortality per 10 000 persons over 10 years were 760 (men=1237; women=563) for those in the highest fifth of the FSAm-NPS dietary index score and 661 (men=1008; women=518) for those in the lowest fifth. CONCLUSIONS: In this large multinational European cohort, consuming foods with a higher FSAm-NPS score (lower nutritional quality) was associated with a higher mortality for all causes and for cancer and diseases of the circulatory, respiratory, and digestive systems, supporting the relevance of FSAm-NPS to characterise healthier food choices in the context of public health policies (eg, the Nutri-Score) for European populations. This is important considering ongoing discussions about the potential implementation of a unique nutrition labelling system at the European Union level.


Assuntos
Rotulagem de Alimentos , Mortalidade , Valor Nutritivo , Adulto , Estudos de Coortes , Europa (Continente) , Feminino , Preferências Alimentares , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Modelos de Riscos Proporcionais , Inquéritos e Questionários
5.
Georgian Med News ; (304-305): 62-69, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965251

RESUMO

Congestive heart failure (CHF) is a significant healthcare problem, and is associated with high levels of morbidity and mortality. The majority of patients have poor quality of life in spite of the modern evidence-based treatment. Malnutrition is more common in patients with HF, especially at the severe stage of HF, and is associated with the risk of complications and mortality. Consequently, evaluation of malnutrition in patients with HF, monitoring of patients in this regard, and identifying the right assessment tools are the basis for developing of an effective nutritional strategy that can have a significant impact on the treatment and management of such patients.; Our aim was to study the prevalence of different markers of malnutrition, their association with nutrient indices, and their correlation with CHF in Georgian population.; The total of 96 patients relevant to the research objective (43 female and 53 male with average age 69.85) were enrolled in the study. Nutritional screening was performed using the GNRI, which was calculated as follows: GNRI=14.89× serum albumin (g/dL) +41.7*body weight÷ideal body weight. Ideal body weight=22* square of height in meters and PNI was calculated as follows: PNI=10* serum albumin (g/dL) +0.005*total lymphocyte (count per mm3) and The Controlling Nutritional Status (CONUT) score was calculated by serum albumin score plus total cholesterol score and total lymphocyte score. Peripheral venous blood was tested for acute phase reactant (hsCRP, Interleukin-6, fibrinogen, acid glycoprotein) and for protein-energy malnutrition (prealbumin, albumin, lymphocytes, lipid profile and transferrin).; By examining the correlation between the CONUT, GNRI and PNI indices, a significant negative correlation was found between CONUT and PNI. We quantitatively compared results obtained using CONUT, GNRI and PNI scale risk groups, as the primary picture suggested it in our study group (ambulatory, quite compensated CHF). CONUT and PNI represent best option.; Prealbumin, lipid profile data, transferrin decreases with increasing risk for CONUT and PNI, with Interleukin-6 increasing on both calculators. Changes in other data are not correlated.


Assuntos
Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/epidemiologia , Estado Nutricional , Idoso , Feminino , Humanos , Masculino , Avaliação Nutricional , Prognóstico , Qualidade de Vida , Estudos Retrospectivos
6.
Washington, D.C.; PAHO; 2020-09-03.
em Inglês | PAHO-IRIS | ID: phr-52637

RESUMO

Recommended dietary allowances (RDAs) for the Caribbean were first published in 1978 and then revised in 1994. Since then, ongoing research relating to the health consequences of nutrient intakes, particularly with regard to diet-related noncommunicable diseases (NCDs), has provided new evidence on the inter-relationships between diet and health. The initiative to revise the existing RDAs began with a review of the most current available information as well as the recent approaches taken by other countries and agencies in updating RDAs. The review was carried out within the context of changes in the regional food and nutrition situation. These changes included a reassessment of food availability patterns, dietary and other lifestyle practices, a growing awareness of the need for nutrition standards and dietary guidelines, and the inclusion of food and nutrition-related policy actions in regional strategies addressing rising rates of obesity and NCDs and the strengthening of food and nutrition security. A review was done of various terminologies relating to nutrient requirements, including recommended dietary allowance (RDA), recommended nutrient intake (RNI), average reference intake (ARI), estimated average requirement (EAR), and upper tolerable limit, and recommendations were then made for RNIs for the Caribbean. This report takes into account expert feedback and updates on energy and nutrient requirements from the Food and Agriculture Organization/World Health Organization (FAO/WHO), Canada, the United Kingdom, and the United States of America. A major focus has been placed on global FAO/WHO recommendations, which are based on extensive review of the available evidence. This publication provides current scientific guidance on the intake of a range of nutrients, as well as the nutrient recommendations for the Caribbean. The publication also includes the population nutrient intake goals (PNIGs) meant to promote healthy dietary consumption patterns that satisfy the nutritional needs of the population while helping to reduce the risk of diet-related NCDs. These serve as a useful adjunct to the RNIs in providing food and nutrition guidance at the population level for macronutrients and food groups in healthy, well-nourished populations.


Assuntos
Fatores de Risco , Nutrientes , Avaliação Nutricional , Região do Caribe
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1145-1150, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741185

RESUMO

Minimizing the burden on study subjects and assessing the general dietary nutritional status as accurately as possible are the basis of a nutritional epidemiological cohort study in the general population. While introducing the main dietary nutrition assessment methods, this paper manly describes the basic contents and principles for the development of food frequency questionnaire, and briefly illustrates the problems and solutions for the development of area specific food frequency questionnaires by taking the example of Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study. Finally, discusses preliminarily the necessity and possibility of developing a national food frequency questionnaire.


Assuntos
Inquéritos sobre Dietas/métodos , Avaliação Nutricional , China/epidemiologia , Estudos de Coortes , Projetos de Pesquisa Epidemiológica , Humanos
8.
J Transl Med ; 18(1): 299, 2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746930

RESUMO

BACKGROUND: Obesity and steatosis are associated with COVID-19 severe pneumonia. Elevated levels of pro-inflammatory cytokines and reduced immune response are typical of these patients. In particular, adipose tissue is the organ playing the crucial role. So, it is necessary to evaluate fat mass and not simpler body mass index (BMI), because BMI leaves a portion of the obese population unrecognized. The aim is to evaluate the relationship between Percentage of Fat Mass (FM%) and immune-inflammatory response, after 10 days in Intensive Care Unit (ICU). METHODS: Prospective observational study of 22 adult patients, affected by COVID-19 pneumonia and admitted to the ICU and classified in two sets: (10) lean and (12) obese, according to FM% and age (De Lorenzo classification). Patients were analyzed at admission in ICU and at 10th day. RESULTS: Obese have steatosis, impaired hepatic function, compromise immune response and higher inflammation. In addition, they have a reduced prognostic nutritional index (PNI), nutritional survival index for ICU patients. CONCLUSION: This is the first study evaluating FM% in COVID-19 patient. We underlined obese characteristic with likely poorly prognosis and an important misclassification of obesity. A not negligible number of patients with normal BMI could actually have an excess of adipose tissue and therefore have an unfavorable outcome such as an obese. Is fundamental personalized patients nutrition basing on disease phases.


Assuntos
Adiposidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Cuidados Críticos/métodos , Estado Nutricional , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Tecido Adiposo/patologia , Tecido Adiposo/fisiopatologia , Adulto , Betacoronavirus , Índice de Massa Corporal , Feminino , Humanos , Inflamação , Unidades de Terapia Intensiva , Masculino , Avaliação Nutricional , Obesidade/complicações , Pandemias , Prognóstico , Estudos Prospectivos
9.
PLoS One ; 15(8): e0235503, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760083

RESUMO

PURPOSE: We evaluated the outcomes of decitabine as first-line treatment in older patients with acute myeloid leukemia (AML) and investigated the predictors, including a baseline mini nutritional assessment short form (MNA-SF) score, of response and survival. PATIENTS AND METHODS: Between 2010 and 2018, 96 AML patients aged 65 and above who received decitabine treatment at 6 centers in Korea were retrospectively evaluated. Response rates, hematologic improvements (HI), progression-free survival (PFS), and overall survival (OS) were analyzed. RESULTS: The median age at diagnosis was 73.9 years, and the median number of decitabine treatments administered to the patients was 4 (range, 1-29). Of 85 patients, 15 patients (17.6%) achieved complete remission (CR) or CR with incomplete blood count recovery. Twelve patients (14.1%) showed partial remission (PR), and 18 (21.2%) demonstrated HI without an objective response. The median PFS and OS were 7.0 (95% confidence interval [CI], 4.9-9.0) and 10.6 (95% CI, 7.7-13.5%) months, respectively. In multivariate analyses, MNA-SF score ≥ 8 and the absence of peripheral blood (PB) blasts were significant predictors for improved PFS and OS. CONCLUSIONS: For older patients with newly diagnosed AML, a high MNA-SF score and the absence of PB blasts were independently associated with improved survival.


Assuntos
Antimetabólitos Antineoplásicos/administração & dosagem , Decitabina/administração & dosagem , Leucemia Mieloide Aguda/tratamento farmacológico , Indução de Remissão/métodos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Antimetabólitos Antineoplásicos/efeitos adversos , Contagem de Células Sanguíneas , Medula Óssea/patologia , Decitabina/efeitos adversos , Esquema de Medicação , Feminino , Humanos , Leucemia Mieloide Aguda/sangue , Leucemia Mieloide Aguda/mortalidade , Leucemia Mieloide Aguda/patologia , Masculino , Avaliação Nutricional , Intervalo Livre de Progressão , República da Coreia/epidemiologia , Estudos Retrospectivos , Perda de Peso
10.
Am J Kidney Dis ; 76(3 Suppl 1): S1-S107, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32829751

RESUMO

The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for nutrition in kidney diseases since 1999. Since the publication of the first KDOQI nutrition guideline, there has been a great accumulation of new evidence regarding the management of nutritional aspects of kidney disease and sophistication in the guidelines process. The 2020 update to the KDOQI Clinical Practice Guideline for Nutrition in CKD was developed as a joint effort with the Academy of Nutrition and Dietetics (Academy). It provides comprehensive up-to-date information on the understanding and care of patients with chronic kidney disease (CKD), especially in terms of their metabolic and nutritional milieu for the practicing clinician and allied health care workers. The guideline was expanded to include not only patients with end-stage kidney disease or advanced CKD, but also patients with stages 1-5 CKD who are not receiving dialysis and patients with a functional kidney transplant. The updated guideline statements focus on 6 primary areas: nutritional assessment, medical nutrition therapy (MNT), dietary protein and energy intake, nutritional supplementation, micronutrients, and electrolytes. The guidelines primarily cover dietary management rather than all possible nutritional interventions. The evidence data and guideline statements were evaluated using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. As applicable, each guideline statement is accompanied by rationale/background information, a detailed justification, monitoring and evaluation guidance, implementation considerations, special discussions, and recommendations for future research.


Assuntos
Terapia Nutricional/normas , Insuficiência Renal Crônica/terapia , Dieta com Restrição de Proteínas , Gorduras na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Suplementos Nutricionais , Eletrólitos/administração & dosagem , Ingestão de Energia , Medicina Baseada em Evidências , Ácidos Graxos Ômega-3/administração & dosagem , Humanos , Micronutrientes/administração & dosagem , Avaliação Nutricional , Apoio Nutricional/métodos , Insuficiência Renal Crônica/dietoterapia , Vitaminas/administração & dosagem
11.
Niger J Clin Pract ; 23(8): 1079-1086, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788485

RESUMO

Background: Poor growth and nutritional status are common features of sickle cell anemia (SCA) in children. The rising trend of obesity in children in developing countries has been reported despite a huge burden of undernutrition in these settings. In SCA, overweight/obesity is being increasingly reported. Aims: To evaluate the nutritional status and its determinants in children with SCA and to compare the same with hemoglobin AA (HbAA) controls of similar age, gender, and socioeconomic status. Methods: The study was a cross-sectional analytical study involving 175 subjects and controls aged 1-18 years who met the inclusion criteria. Weight and height were measured and body mass index (BMI) was calculated. Z scores were computed for the anthropometric measurements using the World Health Organization (WHO) standard reference. Hemoglobin concentration was determined using HemoCue Hb201+ Analyzer. Results: Subjects had significantly lower Z- scores for weight, height, and BMI compared with controls. Stunting, wasting, and overweight/obesity were observed in 10.9%, 24.6%, and 5.1% of subjects compared with 2.3%, 5.7%, and 9.7% respectively in controls. Wasting, stunting and overweight/obesity in SCA were significantly associated with age while overweight/obesity was significantly associated with upper social class (P = 0.001). Conclusions: Poor growth and nutritional status are still prevalent while overweight and obesity are emerging comorbidities among children with SCA in our environment. Regular nutritional assessment of children with SCA should be encouraged while those at risk of under/over-nutrition should receive adequate nutritional rehabilitation to prevent possible complications.


Assuntos
Anemia Falciforme/complicações , Anemia Falciforme/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Obesidade Pediátrica/epidemiologia , Adolescente , Índice de Massa Corporal , Peso Corporal , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Feminino , Transtornos do Crescimento/complicações , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Avaliação Nutricional , Sobrepeso/complicações , Sobrepeso/epidemiologia , Obesidade Pediátrica/complicações , Prevalência , Classe Social , Fatores Socioeconômicos
12.
Crit Care ; 24(1): 447, 2020 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-32684170

RESUMO

Five to 10% of the coronavirus SARS-CoV-2-infected patients, i.e., with new coronavirus disease 2019 (COVID-19), are presenting with an acute respiratory distress syndrome (ARDS) requiring urgent respiratory and hemodynamic support in the intensive care unit (ICU). However, nutrition is an important element of care. The nutritional assessment and the early nutritional care management of COVID-19 patients must be integrated into the overall therapeutic strategy. The international recommendations on nutrition in the ICU should be followed. Some specific issues about the nutrition of the COVID-19 patients in the ICU should be emphasized. We propose a flow chart and ten key issues for optimizing the nutrition management of COVID-19 patients in the ICU.


Assuntos
Infecções por Coronavirus/terapia , Unidades de Terapia Intensiva , Terapia Nutricional , Pneumonia Viral/terapia , Humanos , Avaliação Nutricional , Pandemias , Guias de Prática Clínica como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Medicine (Baltimore) ; 99(27): e20927, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629692

RESUMO

BACKGROUND: The serum albumin, albumin-to-globulin ratio (AGR), and prognostic nutritional index (PNI) have been recommended to represent the nutritional and inflammatory status. Thus, they may be potential prognostic biomarkers for cancer. However, contradictory results were reported in different studies on glioma. The goal of this study was to perform a meta-analysis to re-evaluate their prognostic potential for glioma. METHODS: Databases of PubMed, EMBASE, and Cochrane Library were systematically searched to enroll all the studies investigating the prognostic significance of albumin, AGR, and PNI for glioma. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using STATA 13.0 software to indicate the intensity of association. RESULTS: Eleven studies with 2928 cases were included. Overall meta-analysis showed that the prognostic values of albumin, AGR, and PNI were limited for glioma (P > .05). However, subgroup analysis demonstrated a high preoperative serum albumin was significantly related with excellent OS of patients with GBM (HR = 0.95, 95% CI: 0.91-0.99, P = .018), while high PNI (HR = 0.56, 95% CI: 0.43-0.73, P < .001) and AGR (HR = 0.57, 95% CI: 0.34-0.96, P = .034) may be a protective factor of favorable OS for patients with high-grade gliomas. Furthermore, integration of all studies with multivariate analysis and clear cut-off also proved reduced preoperative serum albumin, AGR, and PNI were predictors of poor prognosis for patients with gliomas. CONCLUSION: Preoperative serum albumin, AGR, and PNI may represent promising biomarkers to predict the prognosis in patients with glioma, especially for high-grade.


Assuntos
Neoplasias do Sistema Nervoso Central/sangue , Glioma/sangue , Globulinas/metabolismo , Avaliação Nutricional , Albumina Sérica/metabolismo , Feminino , Humanos , Masculino , Prognóstico
14.
Anticancer Res ; 40(7): 4165-4171, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620666

RESUMO

BACKGROUND/AIM: The Geriatric Nutritional Risk Index (GNRI) is a prognostic indicator for several cancers; however, the association between the GNRI and colorectal liver metastasis (CRLM) remains unknown. PATIENTS AND METHODS: Eighty patients who underwent hepatectomy for synchronous CRLM were divided into two groups based on the GNRI. RESULTS: The preoperative CA19-9 levels were significantly higher in the low (GNRI ≤98; n=30) than the normal GNRI group (GNRI >98; n=50). Patients in the low GNRI group had poorer outcomes than those in the normal GNRI group. A low GNRI was an independent prognostic factor for recurrence-free survival and overall survival. Among 50 patients who experienced recurrence, only 16 of 22 patients (72.7%) in the low GNRI group could receive intensive treatment and 27 of 28 patients (96.4%) in the normal GNRI group. CONCLUSION: The GNRI is a simplified prognostic factor for patients with CRLM.


Assuntos
Neoplasias Colorretais , Neoplasias Hepáticas , Estado Nutricional , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Feminino , Avaliação Geriátrica , Hepatectomia , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Prognóstico , Modelos de Riscos Proporcionais , Fatores de Risco
15.
PLoS One ; 15(7): e0234770, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645004

RESUMO

BACKGROUND: Zinc (Zn) deficiency is one of the most common micronutrient deficiencies worldwide. Accurate estimates of Zn intake would facilitate the design and implementation of effective nutritional interventions. OBJECTIVE: We sought to improve estimates of dietary Zn intake by evaluating staple crop Zn content and dietary Zn consumption by children under the age of 5 in 9 rural districts of Uganda. METHODS: We measured the Zn content of 581 crop samples from household farms and 167 crop samples from nearby markets, and administered food frequency questionnaires to the primary caretakers of 237 children. We estimated Zn consumption using 3 sources of crop Zn content: (i) the HarvestPlus food composition table (FCT) for Uganda, (ii) measurements from household crops, and (iii) measurements from market crops. RESULTS: The Zn content of staple crops varied widely, resulting in significantly different estimates of dietary Zn intake. 41% of children appeared to be at risk when estimates were based on market-sampled crops, 23% appeared at risk when estimates were based on the HarvestPlus FCT, and 16% appeared at risk when estimates were based on samples from household farms. CONCLUSION: The use of FCTs to calculate Zn intake overestimated the risk of dietary inadequacy for children who primarily consumed staple crops that were produced on household farms, but underestimated the risk for children who primarily consumed staple crops that were purchased at market. More information on the Zn content of staple crops in developing countries could lead to more accurate estimates of dietary intake and associated deficiencies.


Assuntos
Produtos Agrícolas/química , Zinco/análise , Zinco/deficiência , Pré-Escolar , Dieta , Feminino , Humanos , Lactente , Masculino , Micronutrientes/deficiência , Minerais , Avaliação Nutricional , Estado Nutricional , Valor Nutritivo , Uganda , Zinco/metabolismo
16.
BMC Public Health ; 20(1): 1187, 2020 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-32727437

RESUMO

BACKGROUND: Undernourished people have an increased risk of premature mortality from both infectious and non-communicable diseases. Aside from screening purposes, assessment of nutritional status is a useful tool in management and evaluation of various chronic diseases. Body-Mass-Index (BMI) is today the most commonly used marker of nutritional status however, this method presents a challenge in many low resource settings and immobile patients. Mid-upper arm circumference (MUAC) is another anthropometric measure that requires minimal equipment and little training. So far, MUAC cutoffs for undernutrition are well established in children < 5 years but there is still no consensus for a specific cutoff in adults. The objective of this study was to compare MUAC with BMI and suggest a MUAC cut-off corresponding to a BMI of 18.5 kg/m2 to identify underweight in adults. METHODS: A cross-sectional study was conducted at two urban public hospitals in Nepal. The following variables where collected: MUAC, weight, height, sex, age and self-reported medical history. EXCLUSION CRITERIA: < 19 years of age, pregnancy and oedema. Sensitivity and specificity for a MUAC value corresponding to BMI < 18.5 was calculated. ROC analysis was performed for male and female as well as Pearson's correlation of MUAC and BMI. RESULTS: A total of 302 people between 18 and 86 years of age, 197 women and 105 men, were included. Of these, 90 people suffered from rheumatic heart disease. MUAC was highly correlated with BMI in both women r = 0.889 and men r = 0.846. Best statistically derived MUAC cutoff corresponding to a BMI < 18.5 kg/m2 was 24.5 cm (Youdens Index = 0.75; sensitivity 92.86; specificity 82.48), with high predictive value (AUROCC> 0.9). The setting based optimal MUAC cutoff was also 24.5 cm. No considerable variation was found in sex- and disease specific subgroups. CONCLUSION: MUAC is strongly correlated with BMI in adults in Nepal. For simplicity, a MUAC of 24.5 cm is the optimal statistically and setting based cutoff in both women and men to identify underweight (BMI < 18.5 kg/m2).


Assuntos
Braço , Índice de Massa Corporal , Pesos e Medidas Corporais , Avaliação Nutricional , Estado Nutricional , Magreza/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria/métodos , Peso Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Nepal , Curva ROC , Valores de Referência , Sensibilidade e Especificidade , Adulto Jovem
17.
Nutr Hosp ; 34(3): 622-630, 2020 Jul 13.
Artigo em Espanhol | MEDLINE | ID: mdl-32603180

RESUMO

Introduction: The current COVID-19 pandemic mainly affects older people, those with obesity or other coexisting chronic diseases such as type-2 diabetes and high blood pressure. It has been observed that about 20 % of patients will require hospitalization, and some of them will need the support of invasive mechanical ventilation in intensive care units. Nutritional status appears to be a relevant factor influencing the clinical outcome of critically ill patients with COVID-19. Several international guidelines have provided recommendations to ensure energy and protein intake in people with COVID-19, with safety measures to reduce the risk of infection in healthcare personnel. The purpose of this review is to analyze the main recommendations related to adequate nutritional management for critically ill patients with COVID-19 in order to improve their prognosis and clinical outcomes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/dietoterapia , Cuidados Críticos/métodos , Estado Terminal , Desnutrição/dietoterapia , Pandemias , Pneumonia Viral/dietoterapia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Proteínas na Dieta/administração & dosagem , Nutrição Enteral/efeitos adversos , Nutrição Enteral/métodos , Gastroenteropatias/complicações , Humanos , Inflamação/epidemiologia , Inflamação/fisiopatologia , Desnutrição/diagnóstico , Desnutrição/etiologia , Desnutrição/prevenção & controle , Metanálise como Assunto , Micronutrientes/administração & dosagem , Avaliação Nutricional , Necessidades Nutricionais , Apoio Nutricional , Obesidade/epidemiologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Síndrome da Realimentação/prevenção & controle , Respiração Artificial , Sarcopenia/epidemiologia
19.
Neuropsychopharmacol Hung ; 22(2): 56-59, 2020 Jun.
Artigo em Húngaro | MEDLINE | ID: mdl-32683329

RESUMO

Nowadays the role of nutrition is increasingly appreciated in the development of the various mental disorders as well as in employing effi cacious therapies. Realizing this development and following international professional examples we have established the Hungarian Psychiatric Association's Nutritional Science Section in 2018. Our present paper reports on the connection between mental disorders and nutrition, reviewing the relevant literature from two directions. On the one hand, insuffi cient consumption of essential micronutrients, trace elements, (pro) vitamins cause defi ciencies leading to disrupted production and function of essential enzymes and neurotransmitters and consequentially to emergence of psychopathological symptoms as well as impeding the development of eff ect of adequately administered psychopharmacons and the effi ciency and success of pharmacotherapy. On the other hand, our paper also reviews potentially dangerous pharmacokinetic and pharmacodynamic interactions of nutraceuticals and dietary supplements used for health prevention purposes in parallel to pharmacotherapies which may infl uence or decrease eff ectiveness of medications.


Assuntos
Avaliação Nutricional , Suplementos Nutricionais , Humanos , Transtornos Mentais , Micronutrientes , Oligoelementos , Vitaminas
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