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1.
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
2.
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
3.
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
4.
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 , Mensagem 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
6.
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
7.
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
8.
Rev Assoc Med Bras (1992) ; 64(11): 1032-1037, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30570057

RESUMO

OBJECTIVE: to assess the progression of pediatric cystic fibrosis (CF) patients' nutritional status during the first 12 months after diagnosis and to establish its association with neonatal screening and clinical variables. Patients were recruited from two reference centers in Southern Brazil. METHODS: Retrospective cohort study was carried out with all the patients diagnosed between 2009 and 2014. Anthropometric, clinic and neonatal screening were collected from medical files. Analysis of anthropometric markers over time was performed by generalized estimating equations. A multivariate regression analysis model to predict the Δ percentile body mass index (BMI) (BMI percentile difference between one year after the treatment and BMI percentile at diagnosis) was done. RESULTS: Forty-seven patients were included in the study. Analysis of nutritional data over the period between six months and one year after diagnosis showed significant improvement of BMI, weight/age and weight/height percentiles and Z scores. The neonatal screening was associated with a significant increase of 31.2 points in ΔBMI percentile at the one-year evaluation (p<0.05). On the other hand, a one-point increase of initial BMI percentile was associated with a reduction of 0.6 points in ΔBMI percentile. CONCLUSION: This study demonstrated the role of neonatal screening in the nutritional status of patients diagnosed with CF in the first year after diagnosis. Early diagnosis can significantly contribute to the achievement of appropriate anthropometric indicators and important nutritional recovery of CF patients.


Assuntos
Fibrose Cística/diagnóstico , Triagem Neonatal/métodos , Transtornos Nutricionais/diagnóstico , Estado Nutricional , Antropometria , Estatura , Índice de Massa Corporal , Peso Corporal , Brasil , Pré-Escolar , Fibrose Cística/complicações , Feminino , Humanos , Recém-Nascido , Masculino , Transtornos Nutricionais/etiologia , Transtornos Nutricionais/prevenção & controle , Estudos Retrospectivos
9.
Cien Saude Colet ; 23(9): 3031-3040, 2018 Sep.
Artigo em Português | MEDLINE | ID: mdl-30281740

RESUMO

The objective of this research was to analyze the factors associated with the Food and Nutrition Surveillance System (Sisvan Web) coverage for children under five years of age in the municipalities of the Regional Health Inspectorate of Belo Horizonte (HRS-BH). Sisvan Web coverage data were collected from September to October 2012. Simultaneously, a "semi-structured questionnaire about the Sisvan operation" was sent to identify the technical references of municipalities studied. The coverage was calculated by dividing the number of under five-year-old children covered by Sisvan by the total number of similarly under five-year-old children obtained from the 2010 IBGE census. The Median Sisvan Web coverage of children in the HRS-BH municipalities was 5.59%, with coverage values ranging from 0.55% to 35.8%. Among the variables studied, the only one that revealed significant statistical association (p < 0.05) with Sisvan Web coverage was the lack of professionals to collect data. The results revealed the need for greater awareness of health managers and public health professionals about the importance of the nutritional diagnosis situation of the population through Sisvan Web.


Assuntos
Avaliação Nutricional , Transtornos Nutricionais/diagnóstico , Estado Nutricional , Vigilância da População/métodos , Brasil , Pré-Escolar , Cidades , Humanos , Inquéritos Nutricionais , Saúde Pública
10.
Ann Hematol ; 97(9): 1527-1534, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29959467

RESUMO

Copper is a crucial micronutrient needed by animals and humans for proper organ function and metabolic processes such as hemoglobin synthesis, as a neurotransmitter, for iron oxidation, cellular respiration, and antioxidant defense peptide amidation, and in the formation of pigments and connective tissue. Multiple factors, either hereditary or acquired, contribute to the increase in copper deficiency seen clinically over the past decades. The uptake of dietary copper into intestinal cells is via the Ctr1 transporter, located at the apical membrane aspect of intestinal cells and in most tissues. Copper is excreted from enterocytes into the blood via the Cu-ATPase, ATP7A, by trafficking the transporter towards the basolateral membrane. Zinc is another important micronutrient in animals and humans. Although zinc absorption may occur by direct interaction with the Ctr1 transporter, its absorption is slightly different. Copper deficiency affects physiologic systems such as bone marrow hematopoiesis, optic nerve function, and the nervous system in general. Detailed pathophysiology and its related diseases are explained in this manuscript. Diagnosis is made by measuring serum copper, serum ceruloplasmin, and 24-h urine copper levels. Copper deficiency anemia is treated with oral or intravenous copper replacement in the form of copper gluconate, copper sulfate, or copper chloride. Hematological manifestations are fully reversible with copper supplementation over a 4- to 12-week period. However, neurological manifestations are only partially reversible with copper supplementation.


Assuntos
Anemia/etiologia , Cobre/deficiência , Transtornos Nutricionais/complicações , Adenosina Trifosfatases/metabolismo , Anemia/diagnóstico , Animais , Transporte Biológico , Doença Celíaca/complicações , Doença Celíaca/diagnóstico , Doença Celíaca/metabolismo , Cobre/metabolismo , Cobre/urina , Derivação Gástrica/efeitos adversos , Humanos , Transtornos Nutricionais/diagnóstico , Terapia Nutricional/efeitos adversos , Terapia Nutricional/métodos , Zinco/sangue
12.
Nutr Hosp ; 35(Spec No1): 1-9, 2018 03 07.
Artigo em Espanhol | MEDLINE | ID: mdl-29565627

RESUMO

Eating disorders (ED) are characterized by persistent changes in eating habits that negatively affect a person's health and psychosocial abilities. They are considered psychiatric disorders, highly variable in their presentation and severity, with a huge impact on nutrition, which conditions various therapeutic approaches within a key multidisciplinary context. A group of experts in nutrition, we decided to set up a task force adscribed to the "Sociedad Española de Nutrición Parenteral y Enteral" (SENPE), which has stated as one of its goals the development of a consensus document to generate a protocol based on the best scientific evidence and professional experience available in order to improve health care in this field.


Assuntos
Avaliação Nutricional , Transtornos Nutricionais/terapia , Consenso , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Humanos , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/epidemiologia , Terapia Nutricional , Apoio Nutricional , Educação de Pacientes como Assunto
13.
Nutrients ; 10(1)2018 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-29304025

RESUMO

Surveys in high-income countries show that inadequacies and deficiencies can be common for some nutrients, particularly in vulnerable subgroups of the population. Inadequate intakes, high requirements for rapid growth and development, or age- or disease-related impairments in nutrient intake, digestion, absorption, or increased nutrient losses can lead to micronutrient deficiencies. The consequent subclinical conditions are difficult to recognize if not screened for and often go unnoticed. Nutrient deficiencies can be persistent despite primary nutrition interventions that are aimed at improving dietary intakes. Secondary prevention that targets groups at high risk of inadequacy or deficiency, such as in the primary care setting, can be a useful complementary approach to address persistent nutritional gaps. However, this strategy is often underestimated and overlooked as potentially cost-effective means to prevent future health care costs and to improve the health and quality of life of individuals. In this paper, the authors discuss key appraisal criteria to consider when evaluating the benefits and disadvantages of a secondary prevention of nutrient deficiencies through screening.


Assuntos
Deficiências Nutricionais/economia , Deficiências Nutricionais/prevenção & controle , Países Desenvolvidos/economia , Renda , Programas de Rastreamento/economia , Transtornos Nutricionais/economia , Transtornos Nutricionais/prevenção & controle , Estado Nutricional , Prevenção Secundária/economia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Redução de Custos , Análise Custo-Benefício , Deficiências Nutricionais/diagnóstico , Deficiências Nutricionais/fisiopatologia , Feminino , Custos de Cuidados de Saúde , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/fisiopatologia , Gravidez , Medição de Risco , Fatores de Risco , Prevenção Secundária/métodos , Resultado do Tratamento , Adulto Jovem
14.
Adv Exp Med Biol ; 1010: 281-293, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29098678
15.
Clin Dermatol ; 35(5): 441-452, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28916025

RESUMO

Nutritional deficiencies occur when body metabolic requirements are not matched by intake and absorption. Reasons for this discrepancy are numerous, but often social, economic, medical, and even psychiatric factors may play a role. Vitamins and minerals are required for appropriate rapid cell turnover of the oral mucosa. The oral cavity is a unique anatomic environment that may manifest early signs of nutritional disorders as well as other indicators of systemic disease. Knowledge of these oral manifestations and associated findings will allow a practitioner to consider a nutritional disorder when evaluating oral changes and, in turn, initiate appropriate therapy. A systematic approach to examination of the mouth and perioral skin is suggested. A detailed medical and social history complements the physical examination in identifying patients at risk for nutritional disorders and heightening the clinical suspicion to warrant additional nutritional screening. The rising prevalence of anorexia and bulimia, as well as fad diets, add to the population of patients at risk for vitamin and mineral deficiencies that a clinician must now consider.


Assuntos
Doenças da Boca/etiologia , Transtornos Nutricionais/complicações , Deficiência de Vitaminas/complicações , Humanos , Minerais/administração & dosagem , Mucosa Bucal/fisiologia , Transtornos Nutricionais/diagnóstico , Vitaminas/administração & dosagem
16.
Arch. latinoam. nutr ; 67(3): 169-177, sept. 2017.
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1021741

RESUMO

La caquexia, un síndrome multifactorial caracterizado por la pérdida de masa muscular con o sin pérdida de tejido adiposo que no puede ser revertido con soporte nutricional convencional, es frecuente en pacientes con enfermedades crónicas como cáncer, en quienes empeora notablemente su estado de salud. El objetivo de esta revisión fue estudiar el impacto que tienen los suplementos nutricionales en la morbimortalidad de los pacientes con caquexia secundaria a cáncer. Se realizó una búsqueda de literatura en las bases de datos Embase y Medline (Pubmed), sobre los suplementos y desenlaces clínicos en pacientes con caquexia secundaria a cáncer. Se excluyeron revisiones de literatura no sistemáticas, y aquellos que se centraran en otros desenlaces. Se seleccionaron 42 artículos, y se revisó su versión en texto completo. Se encontró que los ácidos grasos poliinsaturados aumentan el peso corporal; los antioxidantes podrían reducir la progresión del cáncer; selenio, zinc, hierro y cobre mejorarían el sistema inmunológico; y las proteínas y suplementos calóricos podrían reducir la lipólisis y proteólisis. Dentro de las limitaciones del estudio se encuentra la referencia a múltiples tipos de cáncer, con diferencias significativas en el tratamiento y el pronóstico de los pacientes. Se concluye que el soporte con suplementos nutricionales que contengan ácidos grasos poliinsaturados (EPA y DHA), micronutrientes (Fe, Cu, Zn, Se, vitamina E y C) y aminoácidos (l-arginina, l-glutamina, y b hidrometilbutirato), puede mejorar la morbimortalidad y por lo tanto la calidad de vida en pacientes con caquexia secundaria a cáncer(AU)


Cachexia, a multifactorial syndrome characterized by the loss of skeletal muscle mass with or without loss of fat mass that cannot be reversed by conventional nutrition support, is frequently present in patients with chronic diseases such as cancer, in whom the health status deteriorates markedly. The objective of this review was to study the impact of nutritional supplements on morbidity and mortality of patients with cachexia secondary to cancer. A literature search was conducted (Embase and Medline-Pubmed) looking for references that described associations between supplements and morbidity or mortality in patients with cachexia secondary to cancer. Non-systematic literature reviews, or studies with other non-clinical outcomes were excluded. A total of 42 articles were selected, and their full text version reviewed. We found that polyunsaturated fatty acids increase body weight; antioxidants reduce cancer progression; selenium, zinc, iron and copper improve the immune system and proteins and caloric supplements prevent lipolysis and proteolysis. Within the limitations of the study is the reference to multiple types of cancer, which in themselves present significant differences in treatment and prognosis of patients. As a conclusion, nutritional support with nutritional supplements containing polyunsaturated fatty acids (EPA-DHA), micronutrients (Zn, Se, Cu, Fe, vitamins C and E) and amino acids (l-arginine, l-glutamine and b hidroxymethylbutyrate), can improve morbimortality and therefore quality of life in patients with cachexia secondary to cancer(AU)


Assuntos
Humanos , Masculino , Feminino , Vitaminas/administração & dosagem , Caquexia/fisiopatologia , Deficiências Nutricionais , Minerais/administração & dosagem , Transtornos Nutricionais/diagnóstico , Suplementos Nutricionais
18.
J Nutr ; 147(8): 1483-1486, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28701388

RESUMO

We discuss whether dietary vitamin A intake should be restricted or maintained at balance when retinol isotope dilution equations are applied to estimate an individual's vitamin A total body stores (TBS) after oral administration of a labeled dose of vitamin A. Although, at first glance, restriction makes sense as a way to prevent dilution of tracer in plasma, further investigation of the assumptions underlying the widely used isotope dilution equation presented by Olson's laboratory in 1989, as well as the compartmental modeling results presented in this article, indicate that, in fact, restriction leads to an incorrect prediction of TBS if steady state retinol isotope dilution equations are applied at the traditional time (21 d). Our results show that newly ingested vitamin A is a minor contributor to total plasma retinol turnover and that restriction of vitamin A intake leads to a higher plasma retinol specific activity than the value obtained when vitamin A input equals output (balance). When that higher specific activity is used in the traditional retinol isotope dilution equation, it results in a small but notable underestimation of vitamin A TBS. We conclude that, especially if blood is sampled at the traditional time, the most accurate results will be obtained when vitamin A balance is maintained. If sampling is done soon after dosing (e.g., 4 d), dietary intake has less effect on plasma retinol specific activity and thus on predictions of vitamin A status. Vitamin A status can also be estimated if intake is completely restricted and a different (non-steady state) equation is applied at an appropriate time after isotopic equilibrium has been reached.


Assuntos
Dieta , Comportamento Alimentar , Conceitos Matemáticos , Avaliação Nutricional , Estado Nutricional , Vitamina A/administração & dosagem , Vitamina A/sangue , Administração Oral , Adulto , Criança , Homeostase , Humanos , Técnicas de Diluição do Indicador , Isótopos , Modelos Biológicos , Transtornos Nutricionais/sangue , Transtornos Nutricionais/diagnóstico
19.
J Pediatr Gastroenterol Nutr ; 65(2): 242-264, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28737572

RESUMO

OBJECTIVES: Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment. METHODS: Thirty-one clinical questions addressing the diagnosis, treatment, and prognosis of common gastrointestinal and nutritional problems in neurological impaired children were formulated. Questions aimed to assess the nutritional management including nutritional status, identifying undernutrition, monitoring nutritional status, and defining nutritional requirements; to classify gastrointestinal issues including oropharyngeal dysfunctions, motor and sensory function, gastroesophageal reflux disease, and constipation; to evaluate the indications for nutritional rehabilitation including enteral feeding and percutaneous gastrostomy/jejunostomy; to define indications for surgical interventions (eg, Nissen Fundoplication, esophagogastric disconnection); and finally to consider ethical issues related to digestive and nutritional problems in the severely neurologically impaired children. A systematic literature search was performed from 1980 to October 2015 using MEDLINE. The approach of the Grading of Recommendations Assessment, Development, and Evaluation was applied to evaluate the outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation using the nominal voting technique. Expert opinion was applied to support the recommendations where no randomized controlled trials were available.


Assuntos
Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Doenças do Sistema Nervoso/complicações , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/terapia , Composição Corporal , Pesos e Medidas Corporais , Criança , Dietoterapia/métodos , Nutrição Enteral/métodos , Gastroenteropatias/etiologia , Humanos , Terapia Miofuncional , Doenças do Sistema Nervoso/terapia , Avaliação Nutricional , Transtornos Nutricionais/etiologia , Política Nutricional , Necessidades Nutricionais , Prognóstico
20.
J Pediatr Gastroenterol Nutr ; 65(5): 569-573, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28657924

RESUMO

BACKGROUND: Recently the United States has experienced an increase in refugees. Pediatric refugees are at risk for health and nutrition problems. Literature on longitudinal change in nutritional status of resettled pediatric refugees is scant. OBJECTIVE: The present study reports the health and nutritional status of pediatric refugees and tracks changes in nutritional status. METHODS: Data were extracted retrospectively from the records of a community health center in Buffalo, NY. Two cohorts of refugees (0-18 years) were selected. Cohort A was followed during 5 years and consisted of 225 subjects whose initial visit occurred between January 1, 2007 and December 31, 2009. The 199 subjects in cohort B had an initial visit between January 1, 2013 and December 31, 2013 and were followed for 1 year. Cohort B was chosen because vitamin levels were available only for this group. Descriptive and anthropometric data, infectious disease status, and initial vitamin and hemoglobin levels were recorded. Height-for-age (HFA) z scores and body mass index (BMI) z scores were computed. Longitudinal changes were analyzed. RESULTS: The cohorts A and B differed in country of origin and infectious disease burden. On arrival, both cohorts exhibited HFA z scores reflecting short stature. BMI z scores were normal. HFA and BMI z scores increased during 5 years and 1 year for cohorts A and B, respectively. Anemia, vitamin D deficiency, and lead toxicity were identified. CONCLUSIONS: Resettled pediatric refugees were short. Some were stunted. Catch-up growth, however, occurred. There were increases in HFA and BMI z scores. Vitamin D deficiency, anemia, and lead toxicity were documented.


Assuntos
Estatura , Índice de Massa Corporal , Nível de Saúde , Refugiados , Adolescente , Criança , Pré-Escolar , Feminino , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Recém-Nascido , /epidemiologia , Intoxicação por Chumbo/diagnóstico , Intoxicação por Chumbo/epidemiologia , Estudos Longitudinais , Masculino , New York/epidemiologia , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/epidemiologia , Estado Nutricional , Estudos Retrospectivos
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