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Enferm Clin ; 31 Suppl 2: S82-S85, 2021 04.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33849236


The objective of study is to provide an overview of the influence of nursing-based knowledge on the energy conservation model in dealing with nutritional problems in children with cancer. A case study with five pediatric patients and the nursing care approach is used. The assessment was performed using Levine's Conservation Model based on the domain of energy conservation, structural integrity, personal integrity, and social integrity. The nutritional problem of children with cancer was improved, as characterized by decreased nutritional score. Nutritional disorders greatly influence the quality of life of children with cancer, and therefore, it requires treatment so that patients can adapt to changes that occur in their internal and external environments. Levine's Conservation Model can be applied to pediatric patients with cancer who experience nutritional disorders and serve as a guide for nurses to conduct studies, decide on diagnoses, and arrange interventions to improve the quality of nursing care.

Neoplasias , Transtornos Nutricionais , Adaptação Fisiológica , Criança , Humanos , Modelos de Enfermagem , Neoplasias/complicações , Qualidade de Vida
Ned Tijdschr Geneeskd ; 1652021 03 11.
Artigo em Holandês | MEDLINE | ID: mdl-33720560


A 57-year-old man, known with severe malnutrition, vitamin E deficiency and peripheral neuropathies, presented with vomiting and abdominal tenderness. There was a suspicion of ileus and small bowel obstruction. During the exploratory laparotomy a complete brown colored bowel without peristalsis was seen.

Deficiência de Vitaminas/diagnóstico , Síndromes de Malabsorção/complicações , Transtornos Nutricionais/complicações , Deficiência de Vitamina E/complicações , Dor Abdominal/etiologia , Deficiência de Vitaminas/complicações , Humanos , Obstrução Intestinal/etiologia , Intestino Delgado , Síndromes de Malabsorção/diagnóstico , Masculino , Pessoa de Meia-Idade , Transtornos Nutricionais/diagnóstico , Deficiência de Vitamina E/diagnóstico , Vômito/etiologia
Obes Surg ; 31(6): 2503-2510, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33625656


PURPOSE: Risk of nutritional disorders (NDs) in bariatric surgical patients has led to guideline recommendations for pre- and post-operative nutrient deficiency screening. The aim of this study was to identify baseline factors associated with incident NDs and, in addition, to explore possible differences in health care spending and use between patients with and without incident NDs following bariatric surgery. MATERIALS AND METHODS: Using data linked with a state-wide bariatric surgical registry and a state-wide claims database, subjects who underwent bariatric surgery between July 1, 2013, and December 31, 2015, were identified. Incident NDs and health care cost and use outcomes following 1 year from surgery were extracted from the claims data. Logistic regression was used to identify baseline factors associated with incident NDs. Zero-inflated negative binomial regression and generalized linear regression were used to estimate health care cost and use outcomes. RESULTS: A total of 3535 patients who underwent bariatric surgery were identified. Of these patients, those without continuous health insurance enrollment (n=1880), having prevalent (pre-surgery) NDs (n=461), and missing baseline BMI (n=41) were excluded. Of patients analyzed (n=1153), about 30% had incident NDs, with a mean (SD) age and BMI at surgery of 46 (12) years and 48 (9.2) kg/m2, respectively. Patients with one incident ND had higher total health care spending (coefficient=$41118, p-value<0.01) and ED visits (IRR=1.86, p-value<0.01). CONCLUSION: Those without pre-operative NDs may have a higher chance of having NDs post-operatively. Taking multivitamins and continues monitoring are necessary to prevent any negative outcomes related to post-operative NDs.

Cirurgia Bariátrica , Transtornos Nutricionais , Obesidade Mórbida , Cirurgia Bariátrica/efeitos adversos , Custos de Cuidados de Saúde , Humanos , Obesidade Mórbida/cirurgia , Período Pós-Operatório , Estudos Retrospectivos
Soc Work Public Health ; 36(2): 98-117, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33380283


Utilizing the biopsychosocial model and the ecological systems theory, this disquisition explores on the risk factors associated with the COVID-19 pandemic. The discourse shows the interconnectedness of biological, psychological, and social domains in expatiating on the COVID-19 pandemic. It calls for the need to strengthen the resilience of the global community in the face of health outbreaks such as COVID-19. It emphasizes on the perspectives that pandemics are managed before they emerge through building systems that are resilient. Thus, it appreciates the need for a therapeutic milieu as a building block to resilience. The article calls for the adoption of a developmental stance to analyzing health outbreaks and clinical issues. The adumbration shows the reciprocity effects of the health outbreak [macrocosms] and individual factors [microcosms]. To its end, the paper implies that COVID-19 is a call for integration toward effective health planning between social policy formulators, urban and rural planners, epidemiologists, development practitioners, clinicians, researchers to mention but a few. Ultimately, the paper calls for social workers to consider a developmental-clinical social work approach which helps foster "health in all policies" so as to build resilience against the morbus and limit the proliferation of diseases.

COVID-19/psicologia , Modelos Biopsicossociais , Serviço Social , Teoria de Sistemas , Ansiedade , Comorbidade , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Transtornos Nutricionais , Pandemias , Fatores de Risco , SARS-CoV-2 , Fatores Sexuais , Classe Social , Ideação Suicida
Rev. enferm. UERJ ; 28: e50567, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1146586


Objetivo: identificar os principais diagnósticos de enfermagem e suas respectivas intervenções em uma população de pacientes oncológicos submetidos a jejum prolongado no pós-operatório. Método: estudo descritivo, documental e transversal. O cenário do estudo foi um hospital federal de ensino no Rio de Janeiro, caracterizado como UNACON. Os dados foram coletados durante 60 dias em prontuários referentes aos anos de 2016 a 2018. Foram analisados 61 prontuários que atendiam aos critérios de inclusão e 208 complicações foram apresentadas pelos pacientes oncológicos. Resultados: Foram definidos oito diagnósticos de enfermagem, entre os quais os mais evidentes foram: Nutrição desequilibrada: menor que as necessidades corporais e Risco de glicemia instável. Onze intervenções de enfermagem foram definidas em consonância com a Taxonomia de NANDA-I e buscaram ser de fácil aplicação na prática assistencial de enfermagem. Conclusão: foi evidenciada uma ampla gama de diagnósticos e intervenções de enfermagem a qual se recomenda sua adoção no processo de enfermagem.

Objective: to identify the main nursing diagnoses and respective interventions in a population of cancer patients undergoing prolonged postoperative fasting. Method: descriptive, cross-sectional, documentary study. The study scenario was a federal teaching hospital in Rio de Janeiro, characterized as a high-complexity oncological facility. Data were collected for 60 days from medical records for the years 2016 to 2018. In the 61 medical records that met the inclusion criteria and were analyzed, cancer patients presented 208 complications. Results: eight diagnoses were established, the most in evidence being: nutrition imbalance: less than body requirements; and risk of unstable blood glucose level. Eleven nursing interventions, designed to be easily applied in nursing care practice, were specified in line with the NANDA-I Taxonomy. Conclusion: the wide range of nursing diagnoses and interventions evidenced are recommended for adoption in the nursing process.

Objetivo: identificar los principales diagnósticos de enfermería y sus respectivas intervenciones en una población de pacientes oncológicos sometidos a ayuno postoperatorio prolongado. Método: estudio descriptivo, transversal, documental. El escenario de estudio fue un hospital universitario federal en Río de Janeiro, caracterizado como una instalación oncológica de alta complejidad. Se recolectaron datos durante 60 días de las historias clínicas de los años 2016 a 2018. En las 61 historias clínicas que cumplieron con los criterios de inclusión y fueron analizadas, los pacientes con cáncer presentaron 208 complicaciones. Resultados: se establecieron ocho diagnósticos, siendo los más evidentes: desequilibrio nutricional: menor que los requerimientos corporales; y riesgo de niveles inestables de glucosa en sangre. Once intervenciones de enfermería, diseñadas para ser fácilmente aplicadas en la práctica del cuidado de enfermería, fueron especificadas de acuerdo con la Taxonomía NANDA-I. Conclusión: la amplia gama de diagnósticos e intervenciones de enfermería evidenciados se recomiendan para su adopción en el proceso de enfermería.

Humanos , Masculino , Feminino , Cuidados Pós-Operatórios/enfermagem , Institutos de Câncer , Jejum/efeitos adversos , Enfermagem em Pós-Anestésico , Hospitais de Ensino , Processo de Enfermagem , Dor Pós-Operatória/enfermagem , Diagnóstico de Enfermagem/classificação , Brasil , Estudos Transversais , Terminologia Padronizada em Enfermagem , Hipoglicemia/enfermagem , Transtornos Nutricionais/enfermagem
Rev. esp. nutr. comunitaria ; 26(3): 0-0, jul.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-200757


FUNDAMENTOS: Los adultos mayores requieren de evaluaciones periódicas para determinar su estado de salud. El objetivo fue evaluar el estado ponderal y riesgo nutricional de adultos mayores que se encontraban en centros gerontológicos de Guayaquil, Ecuador, en febrero de 2018. MÉTODOS: El análisis de riesgo nutricional se realizó a 479 personas a quienes se les aplicó la herramienta Nutrition Screening Initiative Checklist, mientras que el análisis de estado ponderal incluyó a 465 personas a través de la medición del índice de masa corporal (IMC). Las pruebas se realizaron en 3 centros gerontológicos. RESULTADOS: Un total de 77% hombres y 81% mujeres se encontraban en un estado de riesgo nutricional grave por sus hábitos alimenticios, y un 61% de hombres y 45% de mujeres presentaron un estado ponderal normal. CONCLUSIONES: Los adultos mayores de la ciudad de Guayaquil requieren más atención por parte de los distintos gestores encargados de su salud para reducir el estado de riesgo grave en el que se encuentran actualmente, esto también tendrá incidencia para mejorar el estado nutricional que, si bien se encuentra controlado, no deja de ser un posible problema en el futuro

BACKGROUND: Older adults require periodic evaluations to determine their health status. The objectives were to evaluate the weight status and nutritional risk of elderly people in gerontological centers located in Guayaquil, Ecuador, in February 2018. METHODS: For the nutritional risk analysis 479 people were used to whom the Nutrition Screening Initiative Checklist tool was applied, while for the weight status analysis 465 people were used through the measurement of body mass index (BMI), the tests They were carried out in 3 centers. RESULTS: A total of 77% men and 81% women are in serious risk from their eating habits, and 61% men and 45% women have a normal weight status. CONCLUSIONS: Elderly people in Guayaquil require more attention from different managers in charge of their health, to reduce the serious risk that they're currently facing, this will also have an incidence improving the weight status that, even though is controlled, it's a possible problem in the future

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Saúde do Idoso Institucionalizado , Pesos e Medidas Corporais/estatística & dados numéricos , Transtornos Nutricionais/epidemiologia , Avaliação Nutricional , Estado Nutricional , Obesidade/epidemiologia , Desnutrição/epidemiologia , Fatores de Risco , Equador/epidemiologia , Comportamento Alimentar/classificação , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Índice de Massa Corporal , Inquéritos Nutricionais/estatística & dados numéricos
Rev. cuba. med. mil ; 49(3): e604, jul.-set. 2020. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1144479


Introducción: La diabetes mellitus es una enfermedad crónica que genera un gran número de complicaciones sistémicas, principalmente en la población geriátrica. El control metabólico resulta vital para controlar la enfermedad. Mantener un adecuado balance nutricional es fundamental. Objetivo: Identificar el efecto de una intervención de educación nutricional sobre el control glucémico en adultos mayores con diagnóstico de diabetes mellitus tipo 2. Métodos: Investigación aplicada con un diseño cuasiexperimental y enfoque mixto, que incluyó a 73 adultos mayores con diagnóstico de diabetes mellitus tipo 2. Se identificó el estado nutricional de los adultos mayores y se aplicó una intervención educativa. Se determinó el nivel glucémico previo a la intervención y posterior a su aplicación. Se aplicó la prueba de McNemar para identificar la significación de los cambios en el control glucémico de los pacientes. Resultados: Promedio de edad de 67,38 años; predominaron los pacientes entre 60 y 69 años (47,94 por ciento), del sexo femenino (73,97 por ciento) y con presencia de comorbilidades (83,56 por ciento). El 36,99 por ciento de los pacientes se encontraba con control glucémico inadecuado al inicio de la investigación. El 49,32 por ciento de los casos presentaba trastornos nutricionales por exceso y el 67,75 por ciento de ellos presentaba un nivel de conocimiento bajo. Conclusiones: La intervención nutricional aplicada favoreció el control glucémico en los adultos mayores con diagnóstico de diabetes mellitus tipo 2 incluidos en la investigación. Mejoró el por ciento de pacientes con alteraciones nutricionales por exceso y aumentó el nivel de conocimiento de los pacientes investigados(AU)

Introduction: Diabetes mellitus is a chronic disease that generates a large number of systemic complications, mainly in the geriatric population. Metabolic control is vital to control the disease. Maintaining an adequate nutritional balance is essential. Objective: To identify the effect of a nutritional education intervention on glycemic control in older adults diagnosed with type 2 diabetes mellitus. Methods: Applied research with a quasi-experimental design and mixed approach, which included 73 older adults with a diagnosis of type 2 diabetes mellitus. The nutritional status of older adults was identified and an educational intervention was applied. The glycemic level was determined before the intervention and after its application. The McNemar test was applied to identify the significance of the changes in the glycemic control of the patients. Results: Average age was 67.38 years; patients were between 60 and 69 years (47.94 percent), female (73.97 percent) and with the presence of comorbidities (83.56 percent) predominated. 36.99 percent of the patients had inadequate glycemic control at the beginning of the investigation. 49.32 percent had excess nutritional disorders and 67.75 percent of them had a low level of knowledge. Conclusions: The applied nutritional intervention favored glycemic control in older adults with a diagnosis of type 2 diabetes mellitus included in the research. Likewise, the percentage of patients with nutritional alterations due to excess improved and the level of knowledge of the investigated patients increased(AU)

Humanos , Masculino , Feminino , Idoso , Educação Alimentar e Nutricional , Diabetes Mellitus Tipo 2/complicações , Transtornos Nutricionais/complicações
Clin Nucl Med ; 45(10): 781-783, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32796238


A 7-year-old boy presented with diffuse bone pain. FDG PET/CT was performed to find the possible underlying malignant cause of hypercalcemia. The images demonstrated multiple foci of abnormal FDG activity at the sites of periosteal reaction. In addition, calcium deposit was noted in the basal ganglia, stomach, and the colon. History taking revealed that the patient had routinely taken an over-the-counter "supplement" that contains a high dose of vitamin D. One week after calcitonin therapy and stopping the supplement, the patient became symptom free. This case suggests that hypervitaminosis D might cause hypermetabolic periosteal reaction on FDG PET/CT imaging.

Fluordesoxiglucose F18/metabolismo , Transtornos Nutricionais/diagnóstico por imagem , Transtornos Nutricionais/fisiopatologia , Osteogênese , Periósteo/fisiopatologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Artefatos , Transporte Biológico , Criança , Humanos , Masculino , Transtornos Nutricionais/metabolismo , Osteogênese/efeitos dos fármacos , Periósteo/efeitos dos fármacos , Vitamina D/farmacologia
Rev. habanera cienc. méd ; 19(4): e2854, tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139175


RESUMEN Introducción: Se desconoce qué marcadores de riesgo nutricional estratifican mejor el riesgo en pacientes críticos. Objetivo: Evaluar el riesgo nutricional en pacientes críticos mediante dos escalas. Material y métodos: Estudio descriptivo, prospectivo, transversal, con 222 pacientes ingresados en la Terapia 8B del Hospital "Hermanos Ameijeiras" (septiembre 2017 / mayo 2018). Se utilizaron el Control Nutricional (CONUT) y el Nutrition Risk in the Critically ill modificado (mNutric). Resultados: Según CONUT el 96,4 por ciento estaba desnutrido; según mNutric el 27,5 por ciento eran pacientes en alto riesgo nutricional. Hubo asociación entre las escalas (Kappa = 0,102). El 78.3 por ciento de los sobrevivientes eran bajo riesgo por mNutric (p=0,013). Hubo asociación entre la sepsis y la desnutrición por mNutric (p=0,013), no así entre la ventilación mecánica artificial (VMA) y la desnutrición estimada por dicha escala (p=0,116). No se encontraron diferencias entre la sepsis y la desnutrición según CONUT (p=0,126). Hubo diferencias entre la VMA en relación con la desnutrición según CONUT (p=0,027). La frecuencia de fallecidos se incrementó paralelo al grado de desnutrición según CONUT (p=0,004). La variable que más influyó sobre la mortalidad fue la VMA (OR= 8,5). Conclusiones: Según el CONUT, la mayoría de los pacientes estaban desnutridos, y según el mNutric, predominaron los pacientes en bajo riesgo nutricional. Se demostró el valor predictivo de muerte de la presencia de VMA. La desnutrición ligera y moderada y la variable no desnutrido de la escala CONUT, se consideraron categorías de menor riesgo de muerte con respecto a la desnutrición grave(AU)

Introduction: Nutritional status markers that better stratify risk in critically ill patients have yet to be established. Objective: To assess nutritional risk in critically ill patients through the use of two assessment scales. Material and Methods: A prospective descriptive cross-sectional study was conducted in 222 patients admitted to the Intensive Care Unit (8B) at the "Hermanos Ameijeiras" Hospital from September, 2017 to May, 2018. The Controlling Nutritional Status (CONUT) and the modified Nutrition Risk in the Critically ill (mNutric) were used. Results: According to CONUT, 96.4 percent of patients were alnourished; according to mNutric, 27.5 percent of patients were categorized as high nutritional risk. There was an association between the scales (Kappa = 0.102). Among survivors, 78.3 percent of patients were at low risk according to mNutric score (p=0,013). There was an association between sepsis and malnutrition due to mNutric (p = 0.013) versus artificial mechanical ventilation (AMV) and malnutrition estimated by this scale (p = 0.116). No differences were found between sepsis and malnutrition according to CONUT (p = 0.126). There were differences between the AMV in relation to malnutrition according to CONUT score (p = 0.027). The frequency of deaths increased in parallel to the degree of malnutrition according to CONUT (p = 0.004). AMV was the variable that most influenced mortality (OR = 8,5). Conclusions: According to CONUT, most of the patients were malnourished; according to mNutric, patients at low nutritional risk predominated. The predictive value of death in patients receiving AMV was demonstrated. The light and moderate malnutrition and the variable related with the not malnourished group (CONUT scale) were considered as categories associated with lower risk of death with regard to severe malnutrition(AU)

Humanos , Avaliação Nutricional , Programas de Rastreamento/métodos , Cuidados Críticos , Transtornos Nutricionais/diagnóstico , Epidemiologia Descritiva , Estudos Transversais , Estudos Prospectivos , Estado Terminal
Am J Clin Nutr ; 112(3): 721-769, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32687145


BACKGROUND: The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain. OBJECTIVES: Our aim was to provide an objective, informative summary of 1) the mounting diet-related health burdens facing our nation and corresponding economic, health equity, national security, and sustainability implications; 2) the current federal nutrition research landscape and existing mechanisms for its coordination; 3) the opportunities for and potential impact of new fundamental, clinical, public health, food and agricultural, and translational scientific discoveries; and 4) the various options for further strengthening and coordinating federal nutrition research, including corresponding advantages, disadvantages, and potential executive and legislative considerations. METHODS: We reviewed government and other published documents on federal nutrition research; held various discussions with expert groups, advocacy organizations, and scientific societies; and held in-person or phone meetings with >50 federal staff in executive and legislative roles, as well as with a variety of other stakeholders in academic, industry, and nongovernment organizations. RESULTS: Stark national nutrition challenges were identified. More Americans are sick than are healthy, largely from rising diet-related illnesses. These conditions create tremendous strains on productivity, health care costs, health disparities, government budgets, US economic competitiveness, and military readiness. The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system. More than 10 federal departments and agencies currently invest in critical nutrition research, yet with relatively flat investments over several decades. Coordination also remains suboptimal, documented by multiple governmental reports over 50 years. Greater harmonization and expansion of federal investment in nutrition science, not a silo-ing or rearrangement of existing investments, has tremendous potential to generate new discoveries to improve and sustain the health of all Americans. Two identified key strategies to achieve this were as follows: 1) a new authority for robust cross-governmental coordination of nutrition research and other nutrition-related policy and 2) strengthened authority, investment, and coordination for nutrition research within the NIH. These strategies were found to be complementary, together catalyzing important new science, partnerships, coordination, and returns on investment. Additional complementary actions to accelerate federal nutrition research were identified at the USDA. CONCLUSIONS: The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.

Infecções por Coronavirus/complicações , Transtornos Nutricionais/complicações , Fenômenos Fisiológicos da Nutrição , Pneumonia Viral/complicações , Pesquisa/normas , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Disparidades em Assistência à Saúde/economia , Humanos , Militares , National Institutes of Health (U.S.)/economia , Transtornos Nutricionais/economia , Transtornos Nutricionais/epidemiologia , Pandemias , Estados Unidos/epidemiologia , United States Department of Agriculture/economia , United States Dept. of Health and Human Services/economia
Surg Clin North Am ; 100(4): 695-705, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32681870


Wound healing is affected by several factors. Preexisting diagnoses may significantly alter, delay, or inhibit normal wound healing. This is most commonly seen with chronic disorders, such as diabetes and renal failure, but also occurs secondary to aging and substance abuse. Less commonly, genetic or inflammatory disorders are the cause of delayed wound healing. In some cases, it is not the illness, but the treatment that can inhibit wound healing. This is seen in patients getting chemotherapy, radiation, steroids, methotrexate, and a host of other medications. Understanding these processes may help treat or avoid wound healing problems.

Falência Renal Crônica/fisiopatologia , Cicatrização/fisiologia , Ferimentos e Lesões/fisiopatologia , Fatores Etários , Antineoplásicos/efeitos adversos , Doenças Autoimunes/complicações , Doenças Autoimunes/fisiopatologia , Doença Crônica , Doenças Genéticas Inatas/complicações , Doenças Genéticas Inatas/fisiopatologia , Humanos , Infecções/complicações , Infecções/fisiopatologia , Falência Renal Crônica/complicações , Transtornos Nutricionais/complicações , Transtornos Nutricionais/fisiopatologia , Lesões por Radiação/complicações , Lesões por Radiação/fisiopatologia , Pele/efeitos da radiação , Dermatopatias/complicações , Dermatopatias/fisiopatologia , Fumar/efeitos adversos , Fumar/fisiopatologia , Ferimentos e Lesões/complicações
Curr Opin Clin Nutr Metab Care ; 23(4): 288-293, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32487876


PURPOSE OF REVIEW: The Covid-19 pandemic has daunted the world with its enormous impact on healthcare, economic recession, and psychological distress. Nutrition is an integral part of every person life care, and should also be mandatorily integrated to patient care under the Covid-19 pandemic. It is crucial to understand how the Covid-19 does develop and which risk factors are associated with negative outcomes and death. Therefore, it is of utmost importance to have studies that respect the basic tenets of the scientific method in order to be trusted. The goal of this review is to discuss the deluge of scientific data and how it might influence clinical reasoning and practice. RECENT FINDINGS: A large number of scientific manuscripts are daily published worldwide, and the Covid-19 makes no exception. Up to now, data on Covid-19 have come from countries initially affected by the disease and mostly pertain either epidemiological observations or opinion papers. Many of them do not fulfil the essential principles characterizing the adequate scientific method. SUMMARY: It is crucial to be able to critical appraise the scientific literature, in order to provide adequate nutrition therapy to patients, and in particular, to Covid-19 infected individuals.

Infecções por Coronavirus , Transtornos Nutricionais , Terapia Nutricional/normas , Fenômenos Fisiológicos da Nutrição , Pandemias , Pneumonia Viral , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Humanos , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/etiologia , Transtornos Nutricionais/terapia , Terapia Nutricional/métodos , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Fatores de Risco
Nefrología (Madrid) ; 40(2): 120-125, mar.-abr. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-199099


Las alteraciones en el sentido del olfato (disosmia, anosmia, hiposmia) son frecuentes en los pacientes con enfermedad renal crónica; sin embargo, hasta el momento actual las causas, consecuencias y tratamiento de estas alteraciones han sido poco abordadas. Los pacientes con enfermedad renal crónica sin tratamiento de diálisis muestran disminución en la percepción olfativa y existe controversia sobre si estas alteraciones se corrigen con la diálisis. El grado de percepción olfativa es similar cuando se compara la población en diálisis peritoneal y en hemodiálisis. El trasplante renal corrige estos déficits olfativos. Una de las probables consecuencias de esta afección es el impacto en el estado nutricional del paciente

Alterations in the sense of smell (dysosmia, anosmia, hyposmia) are frequently experienced by patients with chronic kidney disease. However, currently, the aetiology and consequences are poorly understood, with no effective treatments available to address such impairment. In general, the capacity of olfactory perception is affected in patients with chronic kidney disease (even in those who have not undergone dialysis therapy), and whether these alterations improve after dialysis is disputed. Patients in peritoneal dialysis and haemodialysis have the same olfactory perception defects. Kidney transplantation improves olfactory perception, and one important consequence of such impairment is the potential impact on the patient's nutritional status

Humanos , Masculino , Feminino , Transplante de Rim , Transtornos do Olfato/etiologia , Diálise Renal , Insuficiência Renal Crônica/complicações , Olfato , Rim/química , Transtornos Nutricionais/etiologia , Transtornos do Olfato/terapia , Receptores Odorantes/fisiologia , Diálise Renal/efeitos adversos , Insuficiência Renal Crônica/terapia , Olfato/fisiologia
J Zoo Wildl Med ; 51(1): 245-248, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32212572


Hypervitaminosis D was diagnosed in a giant anteater (Myromecophaga tridactyla) and a large hairy armadillo (Chaetophractus villosus) being fed a commercial insectivore diet. Clinical findings included weight loss, reduced appetite, vomiting, and suspected abdominal discomfort. Hypercalcemia (3.68 and 2.04 mmol/L total and ionized calcium, respectively) was detected in the anteater, and plasma 25(OH)D levels were measured and found to be 808.7 and 379.4 nmol/L for the anteater and armadillo, respectively. Dietary change resulted in a reduction of 25(OH)D levels in both animals and resolution of hypercalcemia in the giant anteater. Dietary analysis of the commercial insectivore food revealed levels of vitamin D3 higher than the data-sheet values. This case report demonstrates that hypervitaminosis D in Xenarthra can be associated with significant clinical signs.

25-Hidroxivitamina D 2/sangue , Cingulados , Transtornos Nutricionais/veterinária , Vitamina D/sangue , Animais , Tatus , Dieta/efeitos adversos , Dieta/veterinária , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Hipercalcemia/veterinária , Masculino , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/etiologia
Artigo em Inglês | MEDLINE | ID: mdl-32168832


BACKGROUND: Multimorbidity not only affects the quality of patients' lives, but can also bring a heavy economic burden to individuals, families and society. The purpose of this study was to reveal the connections between diseases, especially the important role each disease played in the entire multimorbidity network. METHODS: A total of 1,155,734 inpatients were enrolled through multistage stratified random sampling in Jilin Province in 2017. Categorical variables were compared using the Rao-Scott-χ2 test. Weighted networks were adopted to present the complex relationships of multimorbidity. RESULTS: The distributions of the number of diseases differed significantly by gender, age and health insurance scheme (P < 0.001). Diseases of the respiratory system had the highest weight in multimorbidity in young people. Endocrine, nutritional and metabolic diseases and circulatory system diseases were often associated with other systemic diseases in middle aged and old people. CONCLUSIONS: Multimorbidity with respiratory system diseases in young people should not be overlooked. Additionally, effective prevention efforts that target endocrine, nutritional and metabolic diseases and circulatory system diseases are needed in middle aged and old people.

Multimorbidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Doença Crônica , Comorbidade , Estudos Transversais , Doenças do Sistema Endócrino/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Doenças Metabólicas/epidemiologia , Pessoa de Meia-Idade , Transtornos Nutricionais/epidemiologia , Gravidez , Prevalência , Adulto Jovem
Clin Dermatol ; 38(1): 79-85, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32197751


Recognizing the skin manifestations of metabolic and endocrine disorders, many of which may have potentially lethal complications, is important for dermatologists and other clinicians. The skin can be a window into a patient's internal health, and cutaneous manifestations can facilitate early diagnosis and intervention of potentially life-altering systemic disorders with associated morbidity and mortality. This contribution provides an overview of the diverse rashes associated with potentially lethal, acquired metabolic and endocrine disorders of the pituitary, thyroid, parathyroid, pancreas, adrenals, and blood, as well as neuroendocrine and nutritional disease.

Doenças do Sistema Endócrino/complicações , Exantema/etiologia , Exantema/patologia , Doenças Metabólicas/complicações , Pele/patologia , Humanos , Transtornos Nutricionais/complicações
J. negat. no posit. results ; 5(2): 189-201, feb. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194008


FUNDAMENTO: El cribado de riesgo nutricional permite detectar el riesgo de desnutrición desde su inicio y antes de su manifestación clínica. OBJETIVO: Evidenciar la utilidad del CONUT en el cribado nutricional al ingreso en un hospital de media-larga estancia. MÉTODOS: Se realizaron dos estudios longitudinales (2014n=121-2018n=155), utilizando CONUT para detectar precozmente el riesgo de desnutrición y evaluar la eficacia de la intervención nutricional. Las variables respuesta fueron el tipo y grado de desnutrición al ingreso y al alta. RESULTADOS: La prevalencia de desnutrición/riesgo nutricional detectada con CONUT al ingreso fue de 85,9%. Con la Valoración Nutricional Completa (VNC), la prevalencia de desnutrición al ingreso fue del 81,0% (5% desnutrición calórica, 17,4% mixta y 58,7% proteica). Un 5% de los pacientes en riesgo detectados mediante CONUT, todavía no podían ser diagnosticados mediante la VNC. Los valores al alta fueron 5% desnutrición calórica, 7,7% mixta y 36,4% proteica. CONUT permitió identificar y seguir la evolución del paciente desnutrido con mayor sensibilidad que los parámetros antropométricos. La intervención nutricional redujo la prevalencia y severidad de la desnutrición, mejorando fundamentalmente a expensas de corregir la desnutrición proteica. Los pacientes desnutridos presentaron mayor número de categorías diagnósticas. Se observaron diferencias significativas entre los perfiles nutricionales de las patologías más prevalentes. CONCLUSIONES: CONUT permitió automatizar eficientemente el cribado nutricional. La aplicación de un protocolo estructurado para la detección, monitorización y tratamiento de la desnutrición permitió identificar pacientes subsidiarios de beneficiarse del soporte nutricional, lo que se reflejó en una mejora del estado nutricional al alta

BACKGROUND: Nutritional risk screening enables the risk of malnutrition to be detected from its beginning and before its clinical expression. OBJECTIVE: To demonstrate the usefulness of CONUT in nutritional screening at admission to a medium-to-long stay hospital. METHODS: Two longitudinal studies (2014n=121-2018n=155) were conducted using CONUT for the early detection of the risk of malnutrition and to evaluate the efficacy of the nutritional intervention. The response variables were the type and degree of malnutrition at admission and discharge. RESULTS: The prevalence of malnutrition/nutritional risk detected with CONUT at admission was 85.9%. With the Comprehensive Nutritional Assessment (CNA), the prevalence of malnutrition at admission was 81.0% (caloric malnutrition 5%, mixed malnutrition 17.4%, and protein malnutrition 58.7%). 5% of the patients at risk detected by CONUT still could not be diagnosed by the CNA. The values at discharge were caloric malnutrition 5%, mixed malnutrition 7.7%, and protein malnutrition 36.4%. CONUT enabled the evolution of the malnourished patient to be identified and followed up with greater sensitivity when compared to the anthropometric parameters. Nutritional intervention reduced the prevalence and severity of malnutrition, essentially improving it upon protein malnutrition correction. Malnourished patients showed a greater number of diagnostic categories. Significant differences were observed among the nutritional profiles of the most prevalent diseases. CONCLUSIONS: CONUT enabled nutritional screening to be efficiently automated. The application of a structured protocol for the detection, monitoring and treatment of malnutrition made it possible to identify subsidiary patients to benefit from nutritional support, which was reflected in an improvement in nutritional status at discharge

Humanos , Avaliação Nutricional , Estado Nutricional/fisiologia , Transtornos Nutricionais/diagnóstico , Desnutrição/diagnóstico , Testes Diagnósticos de Rotina/métodos , Transtornos Nutricionais/epidemiologia , Desnutrição/epidemiologia , Fatores de Risco , Hospitalização/estatística & dados numéricos , Serviço Hospitalar de Admissão de Pacientes/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos