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1.
Orv Hetil ; 161(1): 11-16, 2020 Jan.
Artigo em Húngaro | MEDLINE | ID: mdl-31884812

RESUMO

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


Assuntos
Pacientes Internados , Desnutrição/diagnóstico , Programas de Rastreamento/métodos , Sarcopenia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Hungria , Masculino , Desnutrição/prevenção & controle , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional
2.
Anticancer Res ; 39(11): 6347-6353, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704866

RESUMO

BACKGROUND/AIM: The aim of this study was to determine the significance of immunonutritional and physical index in the assessment of risk associated with pancreaticoduodenectomy (PD) in the elderly. PATIENTS AND METHODS: This study enrolled 92 patients who underwent PD. They were divided into 2 groups: Group A included patients 79 years and younger (n=79) and Group B patients 80 years and older (n=13). Among 37 patients, physical function and body composition were also evaluated. RESULTS: Significantly higher neutrophil-lymphocyte ratio, lower prognostic nutritional index (PNI), and controlling nutritional score were observed in Group B. Muscle strength and walking ability were significantly impaired in Group B, although there was no significant difference in body composition. Age was not correlated with the incidence of postoperative complications, overall survival or recurrence-free survival by univariate and multivariate analysis. CONCLUSION: PD is justified for the elderly, with acceptable morbidity and prognosis. However, immunonutritional status and physical function are significantly impaired; thus, appropriate case selection and active nutritional support are required for the elderly.


Assuntos
Limitação da Mobilidade , Força Muscular , Estado Nutricional , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Neoplasias dos Ductos Biliares/cirurgia , Composição Corporal , Comorbidade , Neoplasias Duodenais/cirurgia , Feminino , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos/citologia , Avaliação Nutricional , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia/mortalidade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Medição de Risco , Albumina Sérica/análise
3.
Rev Med Suisse ; 15(670): 2046-2051, 2019 Nov 06.
Artigo em Francês | MEDLINE | ID: mdl-31696680

RESUMO

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


Assuntos
Desnutrição/etiologia , Desnutrição/terapia , Avaliação Nutricional , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/complicações , Idoso , Hospitalização , Humanos , Desnutrição/diagnóstico , Estado Nutricional , Acidente Vascular Cerebral/epidemiologia , Suíça/epidemiologia
4.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(11): 1034-1040, 2019 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-31770834

RESUMO

Objective: To investigate the safety and efficacy of surgical treatment for chronic radiation intestinal injury. Methods: A descriptive cohort study was performed. Clinical data of 73 patients with definite radiation history and diagnosed clinically as chronic radiation intestinal injury, undergoing operation at Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University from January 1, 2012 to February 28, 2019, were reviewed and analyzed retrospectively. Patients did not undergo operation or only received adhesiolysis were excluded. All the patients had preoperative examination and overall evaluation of the disease. According to severity of intestinal obstruction and patients' diet, corresponding nutritional support and conservative treatment were given. Surgical methods: The one-stage bowel resection and anastomosis was the first choice for surgical treatment of chronic radiation intestinal injury. Patients with poor nutritional condition were given enterostomy and postoperative enteral nutrition and second-stage stoma closure and intestinal anastomosis if nutritional condition improved. For those who were unable to perform stoma closure, a permanent stoma should be performed. Patients with severe abdominal adhesion which was difficult to separate, enterostomy or bypass surgery after adhesiolysis would be the surgical choice. For patients with tumor metastasis or recurrence, enterostomy or bypass surgery should be selected. Observation parameters: the overall and major (Clavien-Dindo grades III to V) postoperative complication within 30 days after surgery or during hospitalization; mortality within postoperative 30 days; postoperative hospital stay; time to postoperative recovery of enteral nutrition; time to removal of drainage tube. Results: Of the 73 patients who had been enrolled in this study, 10 were male and 63 were female with median age of 54 (range, 34-80) years. Preoperative evaluation showed that 61 patients had intestinal stenosis, 63 had intestinal obstruction, 11 had intestinal perforation, 20 had intestinal fistula, 3 had intestinal bleeding, and 6 had abdominal abscess, of whom 64(87.7%) patients had multiple complications. Tumor recurrence or metastasis was found in 15 patients. A total of 65(89.0%) patients received preoperative nutritional support, of whom 35 received total parenteral nutrition and 30 received partial parenteral nutrition. The median preoperative nutritional support duration was 8.5 (range, 6.0-16.2) days. The rate of one-stage intestine resection was 69.9% (51/73), and one-stage enterostomy was 23.3% (17/73). In the 51 patients undergoing bowel resection, the average length of resected bowel was (50.3±49.1) cm. Among the 45 patients with intestinal anastomosis, 4 underwent manual anastomosis and 41 underwent stapled anastomosis; 36 underwent side-to-side anastomosis, 5 underwent end-to-side anastomosis, and 4 underwent end-to-end anastomosis. Eighty postoperative complications occurred in 39 patients and the overall postoperative complication rate was 53.4% (39/73), including 39 moderate to severe complications (Clavien-Dindo grade III-V) in 20 patients (27.4%, 20/73) and postoperative anastomotic leakage in 2 patients (2.7%, 2/73). The mortality within postoperative 30 days was 2.7% (2/73); both patients died of abdominal infection, septic shock, and multiple organ failure caused by anastomotic leakage. The median postoperative hospital stay was 13 (11, 23) days, the postoperative enteral nutrition time was (7.2±6.9) days and the postoperative drainage tube removal time was (6.3±4.2) days. Conclusions: Surgical treatment, especially one-stage anastomosis, is safe and feasible for chronic radiation intestine injury. Defining the extent of bowel resection, rational selection of the anatomic position of the anastomosis and perioperative nutritional support treatment are the key to reduce postoperative complications.


Assuntos
Enteropatias/cirurgia , Lesões por Radiação/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica/efeitos adversos , Fístula Anastomótica/etiologia , Doença Crônica , Enterostomia , Feminino , Humanos , Enteropatias/etiologia , Intestinos/efeitos da radiação , Intestinos/cirurgia , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional , Lesões por Radiação/complicações , Estudos Retrospectivos , Resultado do Tratamento
5.
Gan To Kagaku Ryoho ; 46(10): 1671-1674, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31631171

RESUMO

INTRODUCTION: Some studies reported that the decrease in skeletal muscle mass worsens the immune and nutritional status and related to the poor prognosis in colorectal cancer. We examined the relationship of skeletal muscle mass, immune and nutritional index, and outcome in patients with colorectal cancer at our hospital. SUBJECTS AND METHODS: We retrospectively analyzed 196 patients of cStageⅡ andⅢ colorectal cancer who underwent curative surgery in our institution between 2007 and 2013. The cross-sectional area of the psoas muscle at the level of the third lumbar vertebra on preoperative computed tomography was assessed to calculate the psoas muscle index(PMI). Patients are divided into high PMIgroup(H-group)and low PMIgroup (L-group)with cut off value(6.36 cm / / 2/m2 for males and 3.92 cm2/m2 for females). Patient background, tumor factor, overall survival(OS), recurrence free survival(RFS)were examined retrospectively. RESULTS: There were 119 cases in H-group and 77 cases in L-group. Significant differences were recognized in gender, age, Alb value, BMI, and adjuvant chemotherapy between 2 groups. The 5-year survival rate was significantly different from 82.8% in H-group and 70.3% in L-group(p<0.01). The 5-year recurrence-free survival rate was 74.0%in the H-group, and 68.3%in the L-group (p=0.46). Univariate and multivariate analysis showed that age(OR: 1.90, p<0.01), high CEA(OR: 0.012, p<0.05), depth of invasion(OR: 2.19, p<0.05), lymph node metastasis(OR: 2.21, p<0.01), and preoperative low PMI(OR: 2.05, p<0.01), were significantly related to decrease of OS. CONCLUSION: Preoperative PMIsuggested to become prognostic factors in Stage Ⅱ and Ⅲ colorectal cancer.


Assuntos
Neoplasias Colorretais , Feminino , Humanos , Masculino , Músculo Esquelético , Avaliação Nutricional , Prognóstico , Estudos Retrospectivos
6.
Praxis (Bern 1994) ; 108(13): 863-868, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31571539

RESUMO

Nutritional Therapy in the Elderly - What Do We Know Today? Abstract. Malnutrition in the elderly has a high prevalence and is a strong and independent risk factor for complications and high mortality. Early diagnosis and therapeutic intervention have demonstrated positive effects on the risk for complications and morbidity/mortality. The nutritional therapy should be individually tailored to meet patients' needs and nutritional goals. Associated factors and diseases need to be taken into account while deciding on the nutritional therapy and nutritional targets. A big interprofessional effort is needed to address this specific problem. However, the latest EFFORT study showed: The expenditure is worthwhile!


Assuntos
Avaliação Nutricional , Apoio Nutricional , Idoso , Humanos , Prevalência , Fatores de Risco
7.
Medicine (Baltimore) ; 98(40): e17127, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577703

RESUMO

To investigate the functional connectome alterations in cerebral small-vessel disease (CSVD) patients with thalamus lacunes and its relation to cognitive impairment.This case-control study was approved by the local research ethics committee, and all participants provided informed consent. There were 14 CSVD patients with thalamus lacunes (CSVDw.), 27 without (CSVDwo.), and 34 healthy controls (HC) recruited matched for age, sex, and education to undergo a 3T resting-state functional MR examination. The whole-brain functional connectome was constructed by thresholding the Pearson correlation matrices of 90 brain regions, and the topologic properties were analyzed by using graph theory approaches. Networks were compared between CSVD patients and HC, and associations between network measures and cognitive function were tested.Compared with HC, the functional connectome in CSVDw. patients showed abnormalities at the global level and at the nodal level (P < .05, false discovery rate corrected). The network-based statistics method identified a significantly altered network consisting 6 nodes and 13 connections. Among all the 13 connections, only two connections had significant correlation with episodic memory (EM) and processing speed (PS) respectively (P < .05). The CSVDwo. patients showed no significant network alterations relative to controls (P > .05).The configurations of brain functional connectome in CSVDw. patients were perturbed but not obvious for those without, and correlated with the mild cognitive impairment, especially for EM and PS. This study suggested that lacunes on thalamus played a vital role in mediating the neural functional changes of CSVD patients.


Assuntos
Doenças de Pequenos Vasos Cerebrais/patologia , Disfunção Cognitiva/patologia , Conectoma , Leucoencefalopatias/patologia , Tálamo/patologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Doenças de Pequenos Vasos Cerebrais/complicações , Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Estudos Transversais , Escolaridade , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Leucoencefalopatias/complicações , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Índice de Gravidade de Doença , Fatores Sexuais , Tálamo/diagnóstico por imagem
8.
Nutr. hosp ; 36(5): 1049-1054, sept.-oct. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184625

RESUMO

Introduction: anthropometric indicators (AIs) such as waist circumference (WC), body mass index (BMI), waist/hip index (WHpI), waist/height index (WHtI) and body fat percentage (BFP) are useful tools for the diagnosis of nutritional status (NS) in adolescents. Each of these parameters has advantages and disadvantages. The purpose of the present study was to analyze the association of these AIs (WC, BMI, WHpI, WHtI, and BFP) to evaluate nutritional status and estimate the cardiometabolic risk (CMR) in Mexican adolescents. Material and method: in a cross-sectional descriptive study, the NS was analyzed through various AIs and CMR with the WHtI criteria. Nine hundred and seventeen adolescents between 15 and 17 years old participated in the study, of whom 488 (52.9%) were female and 429 (47.1%) male, all students of middle school in Tuxtla Gutiérrez, Chiapas, Mexico. Results and conclusion: women presented a higher prevalence of obesity according to most indicators. The WHtI was the parameter that detected the highest prevalence of obesity (31%), correlating with the BMI and the BFP. Moreover, there was evidence of a significant relation between NS (assessed by all the anthropometric indicators) and CMR. The WHtI could be considered as an adequate tool for the diagnosis of obesity associated with CMR in adolescents


Introducción: los indicadores antropométricos (IA) como la circunferencia de cintura (CC), el índice de masa corporal (IMC), el índice cintura/ cadera (ICC), el índice cintura/talla (ICT) y el porcentaje de grasa corporal (PGC) son herramientas útiles para el diagnóstico del estado nutricional (EN) en los adolescentes. Sin embargo, cada uno de estos IA presentan ventajas y desventajas. El propósito del presente estudio fue analizar la asociación de los IA (IMC, CC, ICC, ICT y PGC) para evaluar el EN y estimar el riesgo cardiometabólico (RCM) en adolescentes mexicanos. Material y método: el diseño del estudio fue descriptivo transversal. Se analizó el EN a través de diversos IA y el RCM bajo los criterios de ICT. Este estudio fue conducido en 917 adolescentes de entre 15 y 17 años, de los cuales 488 (52,9%) eran mujeres y 429 (47,1%) varones, todos estudiantes de nivel medio superior de Tuxtla Gutiérrez, Chiapas, México. Resultados y conclusión: las mujeres presentaron mayor prevalencia de obesidad con la mayoría de los IA utilizados. El ICT fue el IA que detectó mayor prevalencia de obesidad (31%), correlacionándose con el IMC y el PGC. Además, se evidenció una asociación significativa entre el EN valorado por todos los IA y el RCM. El ICT podría ser considerado como una herramienta adecuada para el diagnóstico de obesidad asociada a RCM en adolescentes


Assuntos
Humanos , Masculino , Feminino , Adolescente , Antropometria/métodos , Avaliação Nutricional , Estado Nutricional , Doenças Cardiovasculares/diagnóstico , Obesidade/epidemiologia , Fatores de Risco , Doenças Cardiovasculares/prevenção & controle , Relação Cintura-Quadril/métodos , Peso-Estatura , Estudos Transversais , México/epidemiologia
9.
Nutr. hosp ; 36(5): 1139-1149, sept.-oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184638

RESUMO

Introducción: la leche materna es el primer alimento fundamental de los neonatos y proporciona todas las fuentes de energía, nutrientes y protección inmunológica que necesitan durante sus primeros meses de vida. Lamentablemente, existen circunstancias específicas que implican que la madre no pueda alimentar correctamente a su bebé, ya que las necesidades nutricionales de la madre difieren en cierta medida durante los diversos periodos de la vida, especialmente en la lactancia, ya que se aumentan las necesidades nutricionales debido a la pérdida de nutrientes, primero por el calostro y luego a través de la leche materna. Objetivo: demostrar la influencia de la dieta de mujeres mexicanas sobre la calidad nutricional y la presencia de microorganismos benéficos en la leche humana. Métodos: se llevaron a cabo 70 encuestas descriptivas de nutrición y toma de muestras de leche a mujeres en estado lactante. Las leches fueron sometidas a diversos análisis bromatológicos y microbiológicos para evaluar su calidad nutricional y posible actividad probiótica. Resultados: se demostró que la ingesta de alimentos de la madre influye en la calidad nutricional de la leche. Asimismo, afecta el desarrollo y crecimiento de las bacterias lácticas. Se aislaron e identificaron diversas cepas en leche humana del género Lactobacillus, además de bacterias patógenas como el caso de Lodderomyces elongisporus, entre otros. Conclusiones: la alimentación de las madres se refleja directamente en la calidad nutricional de la leche. Se observó que la cantidad de nutrientes esenciales de la leche, como son los hidratos de carbono, lípidos y proteínas, varían conforme a la alimentación y el ritmo de vida de las madres, así como la disminución significativa de bacterias lácticas con potencial probiótico


Introduction: breast milk is the first fundamental food of newborns and it provides all the sources of energy, nutrients and the immunological protection they need during their first months of life. Unfortunately, there are specific circumstances that imply that the mother cannot feed her baby correctly, since the mother's nutritional needs differ to a certain extent during different periods of life. Especially in breastfeeding, since nutritional needs are increased, due to the loss of nutrients, first by colostrum and then by breast milk. Objective: to demonstrate the influence of the diet of Mexican women on the nutritional quality and the presence of beneficial microorganisms in human milk. Methods: seventy descriptive surveys of nutrition and sampling of milk to women in nursing state were carried out. The milks were subjected to various bromatological and microbiological analyzes to evaluate their nutritional quality and possible probiotic activity. Results: it was shown that the mother's food intake influences the nutritional quality of the milk. Likewise, it affects the development and growth of lactic acid bacteria. Several strains were isolated and identified in human milk of the genus Lactobacillus, as well as pathogenic bacteria such as Lodderomyces elongisporus among others. Conclusions: the mothers' nutrition is directly reflected in the nutritional quality of the milk. It was observed that the amount of essential nutrients of milk such as carbohydrates, lipids and proteins vary according to the diet and life rhythm of the mothers, as well as the significant decrease of lactic bacteria with probiotic potential


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Dieta , Leite Humano/microbiologia , Avaliação Nutricional , Qualidade dos Alimentos , Nutrientes , Qualidade da Assistência à Saúde , Inquéritos Nutricionais , Epidemiologia Descritiva , Análise de Alimentos/métodos , Carboidratos , Proteínas
10.
Nutr. hosp ; 36(5): 1196-1204, sept.-oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184645

RESUMO

Introducción: la práctica de actividad física y el seguimiento de una dieta cetogénica pueden suponer un doble efecto con mejores resultados en los procesos de pérdida de peso y mejora de la composición corporal y perfil lipídico. Objetivo: el objetivo de esta revisión fue investigar los trabajos realizados con pacientes obesos que siguen una dieta cetogénica y un programa de ejercicio físico, así como calcular el tamaño del efecto en cuanto a las mejoras en la masa grasa, a través de un metaaanálisis. Métodos: la selección de estudios se basó en los siguientes criterios: estudios experimentales; a) estudios experimentales (diseños controlados aleatorizados) y cuasi-experimentales (por ejemplo: pre-test/post-test); b) estudios con dieta baja en carbohidratos (< 30%) o muy baja en carbohidratos (5-10%) (< 50 g Ch) y/o alta en grasas (> 35%); c) se admitieron estudios exclusivamente con sujetos que padecieran sobrepeso u obesidad (IMC > 25 y/o enfermedad metabólica relacionada; y d) con mediciones de composición corporal y/o perfil lipídico al principio y al final de la intervención. Resultados: se analizaron 7 artículos y 3 revisiones. Comparando los diferentes tipos de ejercicio se podría afirmar que destaca la disminución de masa muscular en aquellos en los que las intervenciones son con ejercicio aeróbico, manteniéndose e incluso aumentando, en los estudios donde se realizó un ejercicio de fuerza. El metaanálisis nos muestra una reducción significativa de la masa grasa con una heterogeneidad media, por lo tanto, habrá mayor reducción de masa grasa en grupos que realizan dieta baja en carbohidratos y ejercicio que en los que no realizan dieta o tan solo realizan ejercicio. Conclusiones: la combinación de dieta cetogénica y ejercicio físico puede reducir la masa grasa en comparación con realizar solo dieta o solo ejercicio físico


Introduction: practice of physical activity and the ketogenic diet monitoring can have a double effect in helping in processes of weight loss and improvement of body composition and lipid profile. Objective: the objective of this review was to investigate the work done with obese patients who undertook a ketogenic diet and a physical exercise program, as well as to calculate the overall effect size in terms of improvements in fat mass, through a meta-analysis. Methods: the selection of studies was based on the following criteria: experimental studies; a) experimental studies (randomized controlled designs) and quasi-experimental (e.g. pre-test/post-test); b) studies with low-carbohydrate diet (< 30%) or very low in carbohydrates (5-10%) (< 50 g Ch) and/or high in fats (> 35%); c) studies were admitted exclusively with subjects that facility overweight or obesity (BMI > 25; and d) with measurements of body composition and/or Lipid profile at the beginning and end of the intervention. Results: for the methodological review, 7 articles and 3 reviews were analyzed. All studies, whether by establishing aerobic or strength training and show significant weight loss in all outcomes. Conclusions: comparing different types of exercise, we could say that interventions based on endurance exercise reported a decrease in muscle mass, however there was a maintenance, and even an increase, in studies with resistance exercises. Meta-analysis showed significant results at the global level with a medium heterogeneity, therefore, there will be greater reduction of fat mass in groups that realize diets with low carbohydrates and exercise that in those who do not undertake this type of diet, and those only perform exercise


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Perda de Peso , Composição Corporal , Dieta Cetogênica/métodos , Atividade Motora , Obesidade/dietoterapia , Dieta com Restrição de Carboidratos , Corpos Cetônicos/administração & dosagem , Avaliação Nutricional , Exercício/fisiologia , Gorduras na Dieta
11.
Zhonghua Yi Xue Za Zhi ; 99(33): 2581-2585, 2019 Sep 03.
Artigo em Chinês | MEDLINE | ID: mdl-31510716

RESUMO

Objective: To explore clinical application value of prognostic nutrition index(PNI) and apparent diffusion coefficient(ADC) in treating hepatic arterial chemoembolization (TACE) of patients with hepatic cell carcinoma (HCC). Methods: A total of 77 patients with HHC of BCLC B were retrospectively analyzed in Dalian Medical University Affiliated Second Hospital who were diagnosed for the first time and received TACE treatment from October 2017 to December 2018, of whom 64 Males, 13 females, mean age was 54±13 years.At 1 month after surgery, TACE efficacy was evaluated according to revised solid tumor evaluation criteria (mRECIST), the enrolled patients were divided into TACE effective group (41 cases, 53.2%) and TACE ineffective group (36 cases, 46.8%) to compare ability of PNI and ability of ADC alone or in combination in evaluating efficacy of TACE and the relationship between these two groups. Results: Overall postoperative PNI of enrolled patients was decreased compared with preoperative PNI, 47.7±6.6 vs 48.3±5.9 (P<0.05), preoperative and postoperative PNI of TACE effective group were all higher than that of TACE ineffective group (49.9±6.0 vs 46.6±5.3, 50.6±5.4 vs 44.4±5.1,all P<0.05), there was no significant difference in PNI between the treatment groups (P>0.05). The value of ADC in postoperative tumor region increased compared with that in preoperative tumor region ((1.43±0.15) ×10(-3) vs (1.28±0.08) ×10(-3) mm(2)/s, P<0.05), the difference between postoperative tumor region ADC value and postoperative normal liver parenchyma had no statistical significance(P>0.05). Overall postoperative PNI and tumor region ADC value of enrolled patients had linear correlation (P<0.05).Threshold value of PNI and ADC value in preoperative prediction were 51.05 and 1.32×10(-3) mm(2)/s; postoperative evaluation threshold value were 50.11 and 1.41×10(-3) mm(2)/s.Postoperative combination of PNI and ADC had the highest value in evaluating TACE efficacy. Conclusions: TACE postoperative PNI and tumor region ADC are related. PNI and tumor region ADC could be used in predicting and evaluating TACE efficacy in HCC patients, combination of these two could further increase the efficiency.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Adulto , Idoso , Carcinoma Hepatocelular/terapia , Feminino , Humanos , Neoplasias Hepáticas/terapia , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Prognóstico , Estudos Retrospectivos
13.
J Int Soc Sports Nutr ; 16(1): 42, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533743

RESUMO

BACKGROUND: The purpose of this study was to examine relationships among biomarkers of iron status, athletic performance, growth and development, and dietary intakes in pre-adolescent and adolescent male and female athletes. METHODS: Two-hundred and forty-nine male (n = 179) (mean ± standard deviation for age = 12.0 ± 2.1 years, height = 156.3 ± 13.9 cm, and weight = 49.1 ± 16.5 kg) and female (n = 70) (12.0 ± 2.2 years, 152.4 ± 12.3 cm, 45.3 ± 14.5 kg) athletes volunteered for capillary blood sample, anthropometric, athletic performance, and dietary intake assessments. Outcomes included maturity offset from peak height velocity, percent body fat, estimated muscle cross-sectional areas, vertical jump height (VJ), broad jump distance (BJ), pro-agility time (PA), L-cone time, 20-yard dash time (20YD), power push up (PPU) force, dietary intakes, and ferritin, soluble transferrin receptor (sTfR), and hemoglobin (Hb) concentrations. RESULTS: Athletic performance was consistently correlated with Hb in males (r = .237-.375, p < 0.001-0.05) and with sTfR (r = .521-.649, p < 0.001-0.004) and iron intake (r = .397-.568, p = 0.001-0.027) in females. There were no relationships between dietary intakes and ferritin, sTfR, or Hb (p > 0.05). After partialing out age and height, VJ, PA, LC, and 20YD remained correlated with Hb in males (|rHb,y.Age| = .208-.322, p = 0.001-0.041; |rHb,y.Height| = .211-.321, p = 0.001-0.038). After partialing out iron intake, PA and LC remained correlated with sTfR in females (|rsTfR,y.ironintake| = .516-.569, p = 0.014-0.028). CONCLUSIONS: Iron status biomarkers demonstrated sex-specific relationships with anaerobic exercise performance in youth athletes, which may be more dependent on maturity status and dietary intake than age. Moderate relationships between sTfR and athletic performance in adolescent female athletes emphasizes the importance of iron intake in this demographic.


Assuntos
Desempenho Atlético , Ferro/sangue , Adolescente , Antropometria , Atletas , Biomarcadores/sangue , Criança , Estudos Transversais , Feminino , Ferritinas/sangue , Hemoglobinas/análise , Humanos , Masculino , Avaliação Nutricional , Fatores Sexuais , Fenômenos Fisiológicos da Nutrição Esportiva
14.
Eur J Epidemiol ; 34(9): 853-861, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31399939

RESUMO

Intake of individual antioxidants has been related to a lower risk of type 2 diabetes. However, the overall diet may contain many antioxidants with additive or synergistic effects. Therefore, we aimed to determine associations between total dietary antioxidant capacity and risk of type 2 diabetes, prediabetes and insulin resistance. We estimated the dietary antioxidant capacity for 5796 participants of the Rotterdam Study using a ferric reducing ability of plasma (FRAP) score. Of these participants, 4957 had normoglycaemia and 839 had prediabetes at baseline. We used covariate-adjusted proportional hazards models to estimate associations between FRAP and risk of type 2 diabetes, risk of type 2 diabetes among participants with prediabetes, and risk of prediabetes. We used linear regression models to determine the association between FRAP score and insulin resistance (HOMA-IR). We observed 532 cases of incident type 2 diabetes, of which 259 among participants with prediabetes, and 794 cases of incident prediabetes during up to 15 years of follow-up. A higher FRAP score was associated with a lower risk of type 2 diabetes among the total population (HR per SD FRAP 0.84, 95% CI 0.75; 0.95) and among participants with prediabetes (HR 0.85, 95% CI 0.73; 0.99), but was not associated with risk of prediabetes. Dietary FRAP was also inversely associated with HOMA-IR (ß - 0.04, 95% CI - 0.06; - 0.03). Effect estimates were generally similar between sexes. The findings of this population-based study emphasize the putative beneficial effects of a diet rich in antioxidants on insulin resistance and risk of type 2 diabetes.


Assuntos
Antioxidantes/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Dieta , Resistência à Insulina , Avaliação Nutricional , Estado Pré-Diabético/metabolismo , Adulto , Idoso , Antioxidantes/administração & dosagem , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Frutas , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/fisiologia , Estado Pré-Diabético/sangue , Estado Pré-Diabético/epidemiologia , Fatores de Risco
15.
Diabetes Res Clin Pract ; 155: 107819, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31425770

RESUMO

AIMS: We aimed to screen the nutritional status of older adults with diabetes mellitus, seeking to outline the needs of this population group considering their socioeconomic status. METHODS: Cross-sectional study of 246 diabetic people aged 65-94 years in Northeastern Brazil. Semi-structured questionnaires were used to collect sociodemographic, general health and lifestyle data. The Mini Nutritional Assessment was used to screen nutritional status. RESULTS: Participants' mean age was 73 ±â€¯6.4 years, and there was a predominance of women (56.5%). The mean duration of diabetes was 14.1 years (±9.6 years). Patients aged 80 years or older presented a 3.7-fold higher risk of malnutrition (p < 0.001), and those who were uneducated exhibited a 5.8-fold higher risk of malnutrition (p = 0.040). Patients with BMI of 18.6-24.9 km/m2 presented a 2.2-fold higher risk of malnutrition than overweight or obese patients (p < 0.001). Nutritional status was significantly associated with coronary artery disease (p = 0.010) and stroke (p < 0.001). Malnourished patients exhibited a 2.2-fold higher occurrence of infection in the past 6 months (p = 0.017) and 2-fold higher occurrence of foot injuries (p = 0.028) than their well-nourished peers. CONCLUSION: Malnutrition in older diabetic patients exacerbates underlying diseases and contributes to unfavorable prognosis, particularly in the oldest old and in individuals with low levels of education.


Assuntos
Diabetes Mellitus/dietoterapia , Estado Nutricional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Avaliação Nutricional
16.
BMC Public Health ; 19(1): 1045, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382936

RESUMO

BACKGROUND: Undernutrition is a serious health problem and highly prevalent in developing countries. There is no as such confirmatory test to measure undernutrition. The objective of the present study is to determine a new Composite Score using anthropometric measurements. Composite Score was then compared with other methods like body mass index (BMI) and mid-upper arm circumference (MUAC) classification, to test the significance of the method. METHODS: Anthropometric data were collected from 780 adult Oraon (Male = 387, Female = 393) labourers of Alipurduar district of West Bengal, India, following standard instruments, and protocols. Nutritional status of the study participants were assessed by conventional methods, BMI and MUAC. Confirmatory factor analysis was carried out to reduce 12 anthropometric variables into a single Composite Score (C) and classification of nutritional status was done on the basis of the score. Furthermore, all the methods (BMI, MUAC and C) were compared and discriminant function analysis was adopted to find out the percentage of correctly classified individuals by each of the three methods. RESULT: The frequency of undernutrition was 45.9% according to BMI category, 56.7% according to MUAC category and 51.8% according to newly computed Composite Score. Further analysis showed that Composite Score has a higher strength of correct classification (98.7%), compared to BMI (95.9%) and MUAC (96.2%). CONCLUSION: Therefore, anthropometric measurements can be used to identify nutritional status in the population more correctly by calculating Composite Score of the measurements and it is a non-invasive and relatively correct way of identification.


Assuntos
Antropometria/métodos , Desnutrição/diagnóstico , Avaliação Nutricional , Adulto , Braço/anatomia & histologia , Índice de Massa Corporal , Feminino , Humanos , Índia/epidemiologia , Masculino , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Reprodutibilidade dos Testes
17.
Rev Assoc Med Bras (1992) ; 65(7): 952-958, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31389504

RESUMO

PURPOSE: In this prospective observational study, we aimed to investigate the role of the maximum compressed (MC) and uncompressed (UC) thickness of the quadriceps femoris muscle (QFMT) measured by ultrasonography (USG) in the detection of nutritional risk in intensive care patients (ICPs) with different volume status. METHODS: 55 patients were included. Right, left, and total ucQFMT and mcQFMT measurements were obtained by a standard USG device within the first 48 hours after ICU admission. Clinical examination and the USG device were used to determine the volume status of the patients. SOFA, APACHE II, modified NUTRIC scores, and demographic data were collected. RESULTS: There was a significant difference between the nutritional risk of patients in terms of left, right, and total mcQFMT measurements (p=0.025, p=0.039; p=0.028, respectively), mechanical ventilation requirement (p=0.014), presence of infection (p=0.019), and sepsis (p=0.006). There was no significant difference between different volume statuses in terms of mcQFMT measurements. In the multi-variance analysis, mcQFMT measurements were found to be independently associated with high nutritional risk (p=0.019, Exp(B)=0.256, 95%CI=0.082-0.800 for modified NUTRIC score ≥ 5), and higher nutritional risk (p=0.009, Exp(B)=0.144, 95%CI=0.033-0.620 for modified NUTRIC score ≥ 6). a Total mcQFMT value below 1.36 cm was a predictor for higher nutritional risk with 79% sensitivity and 70% specificity (AUC=0.749, p=0.002, likelihood ratio=2.04). CONCLUSION: Ultrasonographic measurement of total mcQFMT can be used as a novel nutritional risk assessment parameter in medical ICPs with different volume statuses. Thus, patients who could benefit from aggressive nutritional therapy can be easily identified in these patient groups.


Assuntos
Estado Nutricional/fisiologia , Músculo Quadríceps/diagnóstico por imagem , Músculo Quadríceps/patologia , Ultrassonografia/métodos , APACHE , Idoso , Idoso de 80 Anos ou mais , Estado Terminal , Feminino , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Modelos Logísticos , Masculino , Desnutrição/diagnóstico por imagem , Desnutrição/patologia , Desnutrição/fisiopatologia , Pessoa de Meia-Idade , Avaliação Nutricional , Terapia Nutricional/métodos , Estudos Prospectivos , Músculo Quadríceps/fisiopatologia , Valores de Referência , Respiração Artificial/efeitos adversos , Medição de Risco , Sensibilidade e Especificidade
18.
Neoplasma ; 66(6): 971-977, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31390870

RESUMO

Prognostic nutritional index (PNI) is a parameter reflecting prognosis for various cancers, including resected lung cancer. However, there were few reports to study the relationship between the PNI and overall survival (OS) in patients with advanced (stage IIIB/IV) non-small lung cancer (NSCLC). In this study, we collected the clinical data of 315 patients with advanced (stage IIIB/IV) NSCLC who had received chemotherapy or epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) between January 2010 and June 2011. Survival curves were plotted using the Kaplan-Meier method. Multivariate analyses were used to evaluate prognostic significance of PNI in patients with advanced (stage IIIB/IV) NSCLC. In our analysis, we found that PNI (p=0.001) was significantly associated with OS in patients with advanced (stage IIIB/IV) NSCLC, so was smoking (p<0.001) and disease stage (p=0.005). We demonstrated that PNI could be utilized to predict survival outcomes in patients with advanced (stage IIIB/IV) NSCLC. Patients with a lower PNI may have worse prognosis.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Avaliação Nutricional , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Humanos , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/tratamento farmacológico , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos
19.
Georgian Med News ; (291): 67-73, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31418734

RESUMO

The aim of the research was: evaluation of nutritional status and malnutrition risks of Georgian healthy elderly, to use modern assessment methods according to our research goal, development and adaptation of adequate approach considering specificity of Georgian population. Our research is the first study of nutritional status in Georgian elderly. Study group ≥ 60 y (n=75): men (n=14), women (n=61); Subgroup <75 y (n=64): men (n=9), women (n=55); Subgroup 75+ y (n=11): men (n=5), women (n=6). We first time used the standard and alternative anthropometric measurements, SF-BIA and validated equations for FFM (Kyle et al.) and TBW (Vache et al.); clinical, laboratory and dietary (adapted questionnaire) assessment. Estimated energy requirement (EER) was calculated using validated equation, research group was divided into 4 subgroups based on the diet energy intake to EER ratio (over 100%, >75 and ≤100%, >50 and ≤ 75%, ≤ 50%.). The findings of our study have shown the number of research participants with malnutrition according to different indicators: BMI - 0; MUAC - 0; AMA - 4; FFMI - 1; Albumin - 12; TLC - 38. Independet samples T test and ANOVA, Multiple Comparisons, Bonferroni, Paired Samples T test were used to compare variables. The difference between four subgroups was not revealed, except for nutrients and energy consumption indicators. Although there is the undernutrition of protein and energy in certain groups of participants, neither malnutrition screening tool (MNA-SF score 12-14) nor BMI and FFMI as the highest trustworthy diagnostic criteria do not reflect real condition. Predictively significant malnutrition can be left unattended, overlooked and undiagnosed without of energy intake assessment in practically healthy elderly. Therefore, he comparison of recent energy intake and estimated energy requirement is the best criterion for defining malnutrition.


Assuntos
Desnutrição/diagnóstico , Avaliação Nutricional , Estado Nutricional , Idoso , Dieta , Ingestão de Energia , Feminino , República da Geórgia , Humanos , Masculino , Medição de Risco
20.
Medicine (Baltimore) ; 98(34): e16713, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441844

RESUMO

To evaluate the nutritional status of children with chronic kidney disease (CKD) before dialysis via a series of indexes, and investigate the prognostic impact of nutritional status in these patients assessed by the Prognostic Nutritional Index (PNI).Fifty-four children with CKD before dialysis were enrolled in this study. The nutritional status was evaluated by different indexes, including dietary intake, anthropometry data and biochemical parameters. Additionally, PNI is calculated as 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (/mm). Glomerular filtration rate (GFR) of patients with different PNI scores was followed up.Thirty-four patients (63.0%) experienced unreasonable dietary intake, and the patients with CKD stage 4 were characterized by lower energy intake. The height was the most affected anthropometry parameter. Additionally, 46 patients (85.2%) suffered from anemia. The serum albumin of 42 patients (77.8%) was <35 g/L, while 34 cases (63.0%) had increased cholesterol and triglyceride. According to the PNI scores, the patients were divided into 3 groups: high-PNI (PNI ≥ 38), middle-PNI (35 ≤ PNI < 38), and low-PNI (PNI < 35). Of the 54 patients, the PNI was <35 in 29 (53.7%) and ≥38 in 13 (24.1%). The patients with CKD stage 4 were belonged to the low-PNI group. At follow-up, GFR decreased significantly in patients with low-PNI scores compared with the high-PNI group (P < .05).Malnutrition, as a common complication of CKD, has a prognostic impact in children with CKD before dialysis, as assessed by the PNI score.


Assuntos
Avaliação Nutricional , Estado Nutricional/fisiologia , Insuficiência Renal Crônica/fisiopatologia , Pesos e Medidas Corporais , Criança , Ingestão de Energia , Feminino , Taxa de Filtração Glomerular , Hemoglobinas/análise , Humanos , Estimativa de Kaplan-Meier , Lipídeos/sangue , Masculino , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Albumina Sérica/análise
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