Nutritional risk and anthropometric evaluation in pediatric liver transplantation

OBJECTIVE: To analyze the nutritional status of pediatric patients after orthotopic liver transplantation and the relationship with short-term clinical outcome. METHOD: Anthropometric evaluations of 60 children and adolescents after orthotopic liver transplantation, during the first 24 hours in a tertiary pediatric intensive care unit. Nutritional status was determined from the Z score for the following indices: weight/age, height/age or length/age, weight/height or weight/length, body mass index/age, arm circumference/age and triceps skinfold/age. The severity of liver disease was evaluated using one of the two models which was adequated to the patients' age: 1. Pediatric End-stage Liver Disease, 2. Model for End-Stage Liver Disease. RESULTS: We found 50.0% undernutrition by height/age; 27.3% by weight/age; 11.1% by weight/height or weight/length; 10.0% by body mass index/age; 61.6% by arm circumference/age and 51.0% by triceps skinfold/age. There was no correlation between nutritional status and Pediatric End-stage Liver Disease or mortality. We found a negative correlation between arm circumference/age and length of hospitalization. CONCLUSION: Children with chronic liver diseases experience a significant degree of undernutrition, which makes nutritional support an important aspect of therapy. Despite the difficulties in assessment, anthropometric evaluation of the upper limbs is useful to evaluate nutritional status of children before or after liver transplantation.

A 'Relação' de Jacinto de Carvalho (1719), um texto inédito de etnografia amazônica

Depois de trabalhar por treze anos nas missões da Amazônia, o jesuíta português Jacinto de Carvalho (1677-1744) enviou ao superior da ordem uma relação descritiva do país e de alguns costumes da população indígena. Essa é a principal fonte etno-histórica da Amazônia na primeira metade do século XVIII, mas é conhecida somente por meio de uma tradução italiana coeva, até hoje inédita. Os trechos de interesse etnográfico foram aqui vertidos à língua portuguesa, precedidos de estudo.