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1.
Rev. habanera cienc. méd ; 19(4): e2854, tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139175

RESUMO

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)


Assuntos
Humanos , Avaliação Nutricional , Programas de Rastreamento/métodos , Cuidados Críticos , Transtornos Nutricionais/diagnóstico , Epidemiologia Descritiva , Estudos Transversais , Estudos Prospectivos , Estado Terminal
2.
J Zoo Wildl Med ; 51(1): 245-248, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32212572

RESUMO

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.


Assuntos
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
3.
J. negat. no posit. results ; 5(2): 189-201, feb. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194008

RESUMO

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


Assuntos
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
5.
Nutrients ; 11(12)2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31842257

RESUMO

Diet assessment tools provide valuable nutrition information in research and clinical settings. With growing evidence supporting dietary modification to delay development and progression of age-related macular degeneration (AMD), an AMD-specific diet assessment tool could encourage eye-care practitioners to refer patients in need of further dietary behavioural support to a dietitian and/or support network. Therefore, the aim of this study was to evaluate clinical use of a novel, short dietary questionnaire (SDQ-AMD) to screen for inadequate food intake in AMD patients by comparing it against a validated food frequency questionnaire (FFQ). Recruitment sources included Sydney-based private eye clinics and research databases (N = 155; 57% female; 78 ± 8 years). Scoring criteria based on the Australian Dietary Guidelines and dietary recommendations for AMD in literature were developed and applied to dietary data from the FFQ and SDQ-AMD. Bland-Altman plot of difference suggests agreement between the FFQ and SDQ-AMD as most mean difference scores were within the 95% CI (6.91, -9.94), and no significant bias between the scores as the mean score increased ((regression equation: y = 0.11x - 2.60) (95% CI: -0.058, 0.275, p-value = 0.20)). Scores were also significantly correlated (0.57, p ≤ 0.0001). The SDQ-AMD shows potential as a diet screening tool for clinical use, however, additional studies are warranted to validate the SDQ-AMD.


Assuntos
Inquéritos sobre Dietas/métodos , Dieta Saudável/estatística & dados numéricos , Degeneração Macular/dietoterapia , Programas de Rastreamento/métodos , Transtornos Nutricionais/diagnóstico , Idoso , Austrália , Dieta/efeitos adversos , Feminino , Humanos , Degeneração Macular/etiologia , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Transtornos Nutricionais/etiologia , Reprodutibilidade dos Testes
7.
Nutr. hosp ; 36(6): 1241-1247, nov.-dic. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-191140

RESUMO

Introduction: neurologically impaired children frequently experience nutritional disorders and bone health complications. Our aim was firstly to analyze a method to interpret bone mineral density (BMD) accurately in neurologically impaired children. Secondly, to determine its relationship with the nutritional status and micronutrient levels in order to identify which factors are associated with low BMD. Methods: a observational multicenter study was conducted in children with moderate-to-severe neurological impairment. Data collected included: medical records, anthropometric measures, hematologic and biochemical evaluation. BMD was measured with Dual-energy X-ray absorptiometry and z-scores were calculated adjusting for sex and chronological age. Secondly, BMD z-scores were calculated applying height age (age at which the child's height would be in 2nd percentile) instead of chronological age. Results: fifty-two children were included (aged 4-16 years). Seventeen patients (32.7%) received feeding by gastrostomy tube. Height and BMI z-score were below 2SD in 64% and 31% of patients respectively, with normal mid upper arm circumference and skinfold thickness measurements. Low vitamin-D levels were found in 42% of cases. 50% of patients evidenced low BMD when calculated for chronological age, whereas only 34.5% showed BMD z-score <-2 when calculated for height age. No correlation was observed between BMD and vitamin-D levels, weight and height z-scores or age when BMD was calculated applying height age. Conclusions: the prevalence of low BMD is high in neurologically impaired children, and it is probably multifactorial. In these children, we suggest adjusting BMD for height age, in order not to over diagnose low BMD


Introducción: los niños con afectación neurológica con frecuencia presentan trastornos nutricionales y complicaciones óseas. Nuestro objetivo fue, en primer lugar, analizar un método para interpretar la densidad mineral ósea (DMO) de forma adecuada en estos pacientes. En segundo lugar, determinar la relación de la DMO con el estado nutricional y los niveles de micronutrientes, para determinar qué factores se asocian con baja DMO. Métodos: estudio observacional multicéntrico, se incluyeron niños con afectación neurológica moderada-severa. Se recogieron datos clínicos, medidas antropométricas y una evaluación hematológica y bioquímica. La DMO fue evaluada mediante densitometría, y se calcularon los z-scores según la edad y sexo. En segundo lugar, se recalcularon los z-scores de DMO para la edad talla (edad en la cual la talla del niño se encontraría en el percentil 2) en vez de la edad cronológica. Resultados: se incluyeron 52 niños (4-16 años). Diecisiete pacientes (32,7%) recibían alimentación por gastrostomía. Los z-scores de peso y talla estaban por debajo de 2 desviaciones estándar (DE) en el 64% y 31% de los pacientes respectivamente, con normalidad de las mediciones de perímetro braquial y pliegues tricipital y subescapular. Los niveles de vitamina D estaban bajos en el 42% de los casos. La mitad de los pacientes tenían baja DMO cuando se calculó para la edad cronológica, mientras que solo el 34,5% presentaron DMO por debajo de 2 DE cuando se calculó para la edad talla. No observamos correlación entre z-scores de DMO calculados para la edad talla y los niveles de vitamina D, la edad o los z-scores de peso y talla. Conclusiones: la prevalencia de baja DMO es alta en niños con discapacidad neurológica, y probablemente es multifactorial. En estos niños, sugerimos ajustar DMO para la edad talla, para evitar sobrediagnosticar baja DMO


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Doenças Ósseas Metabólicas/diagnóstico , Doenças Ósseas Metabólicas/etiologia , Doenças do Sistema Nervoso/complicações , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/etiologia , Estado Nutricional
8.
Curr Neurol Neurosci Rep ; 19(12): 101, 2019 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-31773293

RESUMO

PURPOSE OF REVIEW: The goal of this chapter is to educate clinicians on the neurologic manifestations of certain nutritional deficiencies in order to promptly identify and appropriately treat these patients. RECENT FINDINGS: Many vitamin and nutritional deficiencies have been described dating back to the early days of neurology and medicine. Some are very rare and thus, there are no randomized controlled studies to assess supplementation or dosage; however, there are reviews of case reports that can assist clinicians in choosing treatments. While endemic vitamin and nutritional deficiencies may be rarely encountered in many countries, vulnerable populations continue to be at risk for developing neurologic complications. These populations include those with diseases causing malabsorption, the elderly, chronic alcohol users, as well as pregnant mothers with hyperemesis gravidarum to name a few. It is important to recognize syndromes associated with these nutritional deficiencies, as prompt identification and treatment may prevent permanent neurologic damage.


Assuntos
Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/epidemiologia , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/epidemiologia , Deficiência de Vitaminas/diagnóstico , Deficiência de Vitaminas/epidemiologia , Deficiência de Vitaminas/terapia , Humanos , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/terapia , Doenças do Sistema Nervoso/terapia , Neurologia , Transtornos Nutricionais/terapia
10.
Nutr Hosp ; 36(6): 1241-1247, 2019 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-31545064

RESUMO

Introduction: Introduction: neurologically impaired children frequently experience nutritional disorders and bone health complications. Our aim was firstly to analyze a method to interpret bone mineral density (BMD) accurately in neurologically impaired children. Secondly, to determine its relationship with the nutritional status and micronutrient levels in order to identify which factors are associated with low BMD. Methods: a observational multicenter study was conducted in children with moderate-to-severe neurological impairment. Data collected included: medical records, anthropometric measures, hematologic and biochemical evaluation. BMD was measured with Dual-energy X-ray absorptiometry and z-scores were calculated adjusting for sex and chronological age. Secondly, BMD z-scores were calculated applying height age (age at which the child's height would be in 2nd percentile) instead of chronological age. Results: fifty-two children were included (aged 4-16 years). Seventeen patients (32.7%) received feeding by gastrostomy tube. Height and BMI z-score were below 2SD in 64% and 31% of patients respectively, with normal mid upper arm circumference and skinfold thickness measurements. Low vitamin-D levels were found in 42% of cases. 50% of patients evidenced low BMD when calculated for chronological age, whereas only 34.5% showed BMD z-score <-2 when calculated for height age. No correlation was observed between BMD and vitamin-D levels, weight and height z-scores or age when BMD was calculated applying height age. Conclusions: the prevalence of low BMD is high in neurologically impaired children, and it is probably multifactorial. In these children, we suggest adjusting BMD for height age, in order not to over diagnose low BMD.


Assuntos
Doenças Ósseas Metabólicas/diagnóstico , Doenças Ósseas Metabólicas/etiologia , Doenças do Sistema Nervoso/complicações , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/etiologia , Estado Nutricional , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino
11.
Nutr. hosp ; 36(extr.3): 49-52, jul. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184435

RESUMO

Introducción: la fragilidad y la sarcopenia son dos condiciones altamente prevalentes en el adulto mayor que se solapan en diferentes vertientes del diagnóstico y del tratamiento. Objetivos: analizar la problemática nutricional relacionada con la fragilidad y la sarcopenia en personas de edad avanzada. Métodos: se ha realizado una revisión bibliográfica de las particularidades de la fragilidad y de la sarcopenia, así como del diagnóstico y del tratamiento nutricional. Resultados: la fragilidad es un síndrome geriátrico que puede identificarse si se tienen al menos tres de los siguientes criterios: pérdida de peso, fuerza de presión de la mano disminuida, velocidad de la marcha lenta, actividad física reducida y agotamiento. La sarcopenia es una enfermedad muscular que se caracteriza por una masa muscular baja y una fuerza muscular reducida como determinantes principales. Ambas condiciones pueden verse beneficiadas por un consumo adecuado de proteínas (1-1,5 g/kg/día) y una actividad física de resistencia regular. Conclusión: la identificación, prevención, seguimiento y tratamiento nutricional de la fragilidad y la sarcopenia en adultos mayores es de vital importancia dada su elevada prevalencia. El objetivo es mantener la integridad y minimizar la pérdida muscular en los adultos mayores. Un envejecimiento saludable incluye la realización de actividad física regular y el cumplimiento de los requerimientos proteicos de esta población


Introduction: frailty and sarcopenia are prevalent conditions in older adults which diagnosis and treatment often overlap. Objective: to analyze the nutritional problematic related to frailty and sarcopenia in older adults. Methods: a literature review, about particularities of frailty and sarcopenia, diagnosis and nutritional treatment, has been carried out. Results: frailty is a geriatric syndrome that can be identified by at least three of the following criteria: weight loss, exhaustion, reduced physical activity, increased walk time, low grip strength. Sarcopenia is a muscular disease characterized by low muscle mass and reduced muscle strength as the main determinant. Both conditions can benefit from adequate protein intake (1-1.5 g/kg/day) and regular physical activity. Conclusion: identification, prevention, monitoring and nutritional treatment of frailty and sarcopenia in older adults is important because of its high prevalence. The main goal is to maintain the muscular integrity and minimize muscle loss in older adults. A healthy aging includes regular physical activity and the fulfillment of the protein requirements of this population


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Idoso Fragilizado , Sarcopenia/dietoterapia , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/terapia , Proteínas/administração & dosagem , Sarcopenia/diagnóstico , Sarcopenia/terapia , Atividade Motora , Suplementos Nutricionais
12.
Clin Nutr ESPEN ; 32: 125-134, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31221277

RESUMO

BACKGROUND & AIMS: Although up-to-date definitions for nutrition assessment integrate behavioural components, it is not clear what behavioural components are to be assessed. Since behavioural modification is linked to effective therapeutic dietetic interventions, assessing behaviour and factors influencing behaviour might be beneficial to improve personalized dietetic outcome. The aim of the following report is to emphasize the role of behavioural components and factors affecting behaviour at baseline nutrition assessment in personalized dietetic intervention. METHODS: The present work is part of the EU-funded project IMPECD ("Improvement of Education and Competences in Dietetics", www.impecd.eu). The project aims to improve the clarity and consistency of national dietetic process models to unify education and training of future dietitians. Experts from five European Universities of Applied Sciences (UAS) in Antwerp (BE), Fulda (DE), Groningen (NL), Neubrandenburg (DE) and St. Pölten (AT) developed a Massive Open Online Course (MOOC) consisting of several clinical cases. It warranted a detailed evaluation of all dietetic care process steps, starting with nutrition assessment. RESULTS: Results for motivation assessed during nutrition assessment are not consistently positively associated with outcome and the added value of assessing them at baseline is still unclear. However, depressive symptoms, emotional distress, and anxiety negatively affect eating and physical activity and therefore limit the efficacy of the dietetic intervention. Assessing behavioural components including nutrition literacy is an important precondition for influence on behavioural modification. CONCLUSION: Indisputably, baseline assessment of behavioural components and factors influencing behaviour are important to increase the therapeutic efficacy of personalized dietetic interventions.


Assuntos
Dietética/educação , Comportamento Alimentar , Avaliação Nutricional , Transtornos Nutricionais/diagnóstico , Prática Profissional , Europa (Continente) , Humanos , Transtornos Nutricionais/dietoterapia
13.
Rev. derecho genoma hum ; (50): 205-231, ene.-jun. 2019.
Artigo em Espanhol | IBECS | ID: ibc-191223

RESUMO

El presente trabajo comenta la sentencia 317/2018 del Tribunal Superior de Justicia del País Vasco, que desestima la solicitud de un farmacéutico diplomado en Nutrición de publicitar un asesoramiento nutricional individualizado mediante la realización de un test nutrigenético. El fallo del Tribunal y las alegaciones tanto del solicitante como del Departamento de Salud del Gobierno Vasco dan paso a un debate sobre cuál es la utilidad real de este método para la personalización de dietas, novedad hoy día de fácil acceso a la población general, y si ésta es suficientemente autónoma cuando toma la decisión de usarla. Finalmente analizamos a qué nivel debe enmarcarse el empleo de esta prueba


The present work comments sentence 317/2018 of the Superior Court of Justice of the Basque Country, which dismisses the request of a pharmacist qualified in Nutrition to publicize an individualized nutritional advice by performing a nutrigenetic test. The ruling of the Court and the allegations of both the applicant and the Health Department of the Basque Government give way to a debate on what is the real use of this method for personalizing diets, a novelty nowadays easily accessible to the general population, and if it is sufficiently autonomous when it makes the decision to use it. Finally, we analyze at what level the use of this test should be framed


Assuntos
Humanos , Nutrigenômica/legislação & jurisprudência , Jurisprudência , Prescrições/classificação , Publicidade Direta ao Consumidor/legislação & jurisprudência , Dietoterapia/ética , Ciências da Nutrição/legislação & jurisprudência , Privacidade Genética/legislação & jurisprudência , Testes Genéticos/legislação & jurisprudência , Transtornos Nutricionais/diagnóstico
14.
Int J Mol Sci ; 20(9)2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035445

RESUMO

Zinc is one of the most important essential trace elements. It is involved in more than 300 enzyme systems and is an indispensable participant in many biochemical processes. Zinc deficiency causes a number of disorders in the human body, the main ones being the delay of growth and puberty, immune disorders, and cognitive dysfunctions. There are over two billion people in the world suffering from zinc deficiency conditions. Acyzol, a zinc-containing medicine, developed as an antidote against carbon monoxide poisoning, demonstrates a wide range of pharmacological activities: Anti-inflammatory, reparative, detoxifying, immunomodulatory, bacteriostatic, hepatoprotective, adaptogenic, antioxidant, antihypoxic, and cardioprotective. The presence of zinc in the composition of Acyzol suggests the potential of the drug in the treatment and prevention of zinc deficiency conditions, such as Prasad's disease, immune system pathology, alopecia, allergodermatoses, prostate dysfunction, psoriasis, stomatitis, periodontitis, and delayed mental and physical development in children. Currently, the efficiency of Acyzol in the cases of zinc deficiency is shown in a large number of experimental studies. So, Acyzol can be used as a highly effective drug for pharmacologic therapy of a wide range of diseases and conditions and it opens up new perspectives in the treatment and prevention of zinc deficiency conditions.


Assuntos
Transtornos Nutricionais/tratamento farmacológico , Transtornos Nutricionais/etiologia , Oligoelementos/deficiência , Acetato de Zinco/uso terapêutico , Zinco/deficiência , Animais , Estudos Clínicos como Assunto , Avaliação Pré-Clínica de Medicamentos , Humanos , Imidazóis/química , Camundongos , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/prevenção & controle , Resultado do Tratamento , Acetato de Zinco/química , Acetato de Zinco/farmacologia
15.
Medicine (Baltimore) ; 98(19): e15568, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083227

RESUMO

The aim of the present study was to identify risk factors for intestinal failure (IF) in infants who received surgery for necrotizing enterocolitis (NEC).A retrospective multicenter case-series study was conducted in a sample of 91 infants admitted to Children's Hospital of Chongqing Medical University between January 2010 and December 2017. The occurrence of IF was defined as the dependence on parenteral nutrition for ≥90 days. Logistic regression was used to investigate the predictors of IF.Of 179 patients reviewed, excluding those with intestinal malformation and inadequate information, 91 were included in the study, and of these cases, 32 (35.2%) developed IF. Controlling for other factors, multivariate analysis showed that birth weight (OR = 0.999; 95% CI, 0.998-1.000; P = .010), the length of the bowel resected (OR = 1.109; 95% CI, 1.048-1.173; P = .000), and the percentage of small bowel resected (OR = 1.305; 95% CI, 1.133-1.504; P = .000) were factors that increased the chances of IF occurrence.Our data demonstrated that variables characteristic of severe NEC, including lower birth weight, greater extent of bowel resection, and larger percentage of small bowel resection were associated with the incidence of IF.


Assuntos
Enterocolite Necrosante/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Peso ao Nascer , Enterocolite Necrosante/diagnóstico , Enterocolite Necrosante/epidemiologia , Feminino , Humanos , Incidência , Recém-Nascido , Intestinos/cirurgia , Masculino , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/etiologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Resultado do Tratamento
16.
J Cachexia Sarcopenia Muscle ; 10(4): 782-793, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30932365

RESUMO

BACKGROUND: An international consensus proposed in 2011 a definition and classification system for cachexia (CAX), mainly based on weight loss, sarcopenia [skeletal muscle mass (SMM) loss], inflammation, and anorexia. The aim of this study was to stage CAX in non-small-cell lung cancer (NSCLC) patients by using a classification based on the Fearon criteria and supported by quantifiable parameters. METHODS: This was a cross-sectional and non-interventional multicentre study. SMM was assessed by analysing L3 computed tomography-scan images. Patients completed the anorexia/CAX subscale of the Functional Assessment of Anorexia/Cachexia Therapy, EORTC QLQ-C30 quality of life (QoL) and International Physical Activity Questionnaire (IPAQ). RESULTS: Patients were recruited in 56 sites. The analysis population comprised 531 patients, and SMM was assessed in 312 patients. Male patients were 66.5%, with a mean (SD) age of 65.2 (10.0) years, 79.9% were PS 0-1, and the tumour stage was mainly IIIB-IV (87.3%). Overall, 38.7% of patients had CAX, 33.8% pre-CAX, and 0.9% refractory CAX. Molecular tumour profiles were significantly associated with the presence of CAX: 23.9% in EGFR, ALK, ROS1, BRAF, or HER2+ patients, 41.4% in K-RAS+, and 43.2% in patients with no molecular abnormality (P = 0.003). The more advanced the CAX stage, the poorer the scores of functional items of the QoL (P < 0.001) and International Physical Activity Questionnaire (P < 0.001). Sarcopenia was present in 66.7% of CAX and 68.5% of pre-CAX patients. Overall, 43.8% of pre-CAX patients had only sarcopenia with limited weight loss (≤2%) and no anorexia. CONCLUSIONS: This is the first study to show the distribution of CAX in a population of NSCLC patients and an association between molecular abnormality in NSCLC and CAX. The original Fearon classification for CAX stages was supported by the associated functional QoL scores and physical activity levels, resulting in a clinically relevant system for detection of early stages of CAX.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/complicações , Neoplasias Pulmonares/complicações , Músculo Esquelético/patologia , Transtornos Nutricionais/diagnóstico , Idoso , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Estadiamento de Neoplasias
17.
J Med Syst ; 43(5): 135, 2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30949846

RESUMO

This study conducts a mapping study to survey the landscape of health chatbots along three research questions: What illnesses are chatbots tackling? What patient competences are chatbots aimed at? Which chatbot technical enablers are of most interest in the health domain? We identify 30 articles related to health chatbots from 2014 to 2018. We analyze the selected articles qualitatively and extract a triplet for each of them. This data serves to provide a first overview of chatbot-mediated behavior change on the health domain. Main insights include: nutritional disorders and neurological disorders as the main illness areas being tackled; "affect" as the human competence most pursued by chatbots to attain change behavior; and "personalization" and "consumability" as the most appreciated technical enablers. On the other hand, main limitations include lack of adherence to good practices to case-study reporting, and a deeper look at the broader sociological implications brought by this technology.


Assuntos
Comportamentos Relacionados com a Saúde , Aprendizado de Máquina , Telemedicina/métodos , Envio de Mensagens de Texto , Interface Usuário-Computador , Comportamento Aditivo/diagnóstico , Comportamento Aditivo/terapia , Comunicação , Nível de Saúde , Humanos , Internet , Saúde Mental , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/terapia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/terapia , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/terapia
19.
Artigo em Inglês | MEDLINE | ID: mdl-30217770

RESUMO

BACKGROUND: Intent-to-treat analyses from a randomized controlled trial showed significant between-group differences favouring micronutrient treatment on the Clinical Global Impression-Improvement, but no group differences on clinician, parent and teacher ratings of overall ADHD symptoms. There was an advantage of micronutrients over placebo in improving overall function, emotional regulation, aggression, and reducing impairment as well as improving inattention based on clinician but not parent observation. No group differences were observed on hyperactive-impulsive symptoms. We investigated predictors of response defined by pre-treatment variables. METHOD: We conducted analyses of data from a clinical trial of children (7-12 years) with ADHD, whereby participants were randomized to receive micronutrients or placebo for 10 weeks followed by a 10 week open-label (OL) phase. We included only children who had been exposed to micronutrients for a full 10 week period and demonstrated satisfactory adherence, either in RCT phase (n = 40) or OL phase (those who received placebo during RCT phase; n = 31). Seven outcomes were examined: change in ADHD symptoms (clinician/parent), ADHD responder, overall responder, change in mood, change in functioning, and change in aggression. Demographic, developmental variables, current clinical and physical characteristics, MTHFR genotype at two common variants, and pre-treatment serum/plasma levels (vitamin D, B12, folate, zinc, copper, iron, ferritin, potassium, calcium, magnesium, and homocysteine) were all considered as putative predictors. RESULTS: Substantial nutrient deficiencies pre-treatment were observed only for vitamin D (13%) and copper (15%), otherwise most children entered the trial with nutrient levels falling within expected ranges. Regression analyses showed varying predictors across outcomes with no one predictor being consistently identified across different variables. Lower pre-treatment folate and B12 levels, being female, greater severity of symptoms and co-occurring disorders pre-treatment, more pregnancy complications and fewer birth problems were identified as possible predictors of greater improvement for some but not all outcome measures although predictive values were weak. Lower IQ and higher BMI predicted greater improvement in aggression. CONCLUSIONS: This study replicates Rucklidge et al. (2014b) showing the limited value of using serum nutrient levels to predict treatment response although we cannot rule out that other non-assayed nutrient levels may be more valuable. Additionally, no specific demographic or clinical characteristics, including MTHFR genetic status, were identified that would preclude children with ADHD from trying this treatment approach.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Suplementos Nutricionais , Micronutrientes/uso terapêutico , Vitaminas/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/sangue , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/genética , Biomarcadores/sangue , Índice de Massa Corporal , Criança , Feminino , Humanos , Inteligência , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Transtornos Nutricionais/sangue , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/genética , Transtornos Nutricionais/terapia , Polimorfismo de Nucleotídeo Único , Prognóstico , Índice de Gravidade de Doença
20.
J Perinat Med ; 47(2): 183-189, 2019 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-30231012

RESUMO

Background As breastfeeding awareness and social acceptance are increased, maternal nutritional deficiency requires more investigation. Methods A prospective cohort study was conducted to determine if vitamin A deficiency is more common in pregnant, lactating post-bariatric surgery women in an inner city population. Antepartum, women after bariatric surgery and controls with no history of malabsorption were recruited. Third trimester, postpartum maternal blood and cord blood were collected as well as three breast milk samples: colostrum, transitional and mature milk. A nutritional survey of diet was completed. Each serum sample was analyzed for total retinol and ß-carotene; breast milk samples were analyzed for retinol and retinyl esters, total retinol and ß-carotene. Results Fifty-three women after bariatric surgery and 66 controls were recruited. Postpartum serum retinol was significantly higher in women after bariatric surgery in the univariate analysis (P<0.0001) and confirmed in the multiple linear mixed model (P=0.0001). Breast milk colostrum retinol and transitional milk total retinol were significantly greater in the bariatric surgery group in the univariate analysis (P=0.03 and P=0.02, respectively), but not after adjusting for confounders. Serum ß-carotene in the third trimester and postpartum were lower (P<0.0001 and P=0.003, respectively) in the bariatric surgery group but not after adjusting for confounders. Vitamin A deficiency was high in both groups in serum and breast milk samples. Conclusion Nutritional deficiencies in breastfeeding women after bariatric surgeries may in fact be less common than in control women in an inner city.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Aleitamento Materno/estatística & dados numéricos , Leite Humano/química , Deficiência de Vitamina A , Vitamina A , beta Caroteno , Adulto , Cirurgia Bariátrica/métodos , Feminino , Humanos , Lactação/fisiologia , Avaliação Nutricional , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/etiologia , Obesidade/cirurgia , Assistência Perinatal/métodos , Assistência Perinatal/estatística & dados numéricos , Gravidez , Terceiro Trimestre da Gravidez/sangue , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos , Vitamina A/análise , Vitamina A/sangue , Deficiência de Vitamina A/diagnóstico , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina A/etiologia , beta Caroteno/análise , beta Caroteno/sangue
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