Histopathology, serology and cultures in the diagnosis of cryptococcosis

Cryptococcosis is one of the most common opportunistic fungal infections in patients with acquired immunodeficiency syndrome (AIDS). We report 13 cases of cryptococcal infection based on histopathology, serology and cultures. Epidemiological analysis, histochemical techniques of hematoxilin and eosin (HE) and Grocot's silver (GMS), as well special histochemical techniques such as Mayer's mucicarmine (MM) and Fontana-Masson (FM), cryptococcal antigen test (CrAg) and isolation on fungal media: Sabouraud's (SAB), brain-heart infusion agar (BHI) and canavanine-glycine-bromothymol blue (CGB) agar were analyzed. Unsatisfactory staining results by MM stain associated to negative titers by CrAg test, which FM stain confirmed that capsule-deficient Cryptococcus infections were observed in four cases. Eight isolated cases were identified as follows: six cases were infection with Cryptococcus neoformans and two cases were Cryptococcus gattii.

N170 Asymmetry as an Index of Inferior Occipital Dysfunction in Patients With Symptomatic Occipital Lobe Epilepsy

Objective: Localizing epileptic foci in posterior brain epilepsy remains a difficult exercise in surgery for epilepsy evaluation. Neither clinical manifestations, neurological, EEG nor neuropsychological evaluations provide strong information about the area of onset, and fast spread of paroxysms often produces mixed features of occipital, temporal and parietal symptoms. We investigated the usefulness of the N170 event-related potential to map epileptic activity in these patients. Methods: A group of seven patients with symptomatic posterior cortex epilepsy were submitted to a high-resolution EEG (78 electrodes), with recordings of interictal spikes and face-evoked N170. Generators of spikes and N170 were localized by source analysis. Range of normal N170 asymmetry was determined in 30 healthy volunteers. Results: In 3 out of 7 patients the N170 inter-hemispheric asymmetry was outside control values. Those were the patients whose spike sources were nearest (within 3 cm) to the fusiform gyrus, while foci further away did not affect the N170 ratio. Conclusions: N170 event-related potential provides useful information about focal cortical dysfunction produced by epileptic foci located in the close neighborhood of the fusiform gyrus, but are unaffected by foci further away. Significance: The N170 evoked by faces can improve the epileptic foci localization in posterior brain epilepsy.

Perinatal Outcome and Change in Body Mass Index in Mothers of Dichorionic Twins: a Longitudinal Cohort Study

We used a prospective cohort to analyze the effect of change in BMI rather than change in weight, in mothers carrying dichorionic twins from a population that did not receive any dietary intervention. A total of 269 mothers (150 nulliparas and 119 multiparas) were evaluated. The average change (%) from the pre-gravid BMI was 7.2+/-6.1, 17.4+/-8.2, and 28.7+/-10.8, at 12-14, 22-25, and 30-34 weeks, respectively, without difference between nulliparas and multiparas. The comparison between maternities below or above the average change from the pregravid BMI failed to demonstrate an advantage (in terms of total twin birthweight and gestational age) of an above average change from the pregravid BMI, even when the lower versus upper quartiles were compared. Our observations reached different conclusions regarding the recommended universal dietary intervention in twin gestations. A cautious approach is advocated towards seemingly harmless excess weight gain, as normal weight women may turn overweight, or even obese, by the end of pregnancy, and be exposed to the untoward effects of obesity on future health and body image.

Proposta de modelo para obtenção do Work Index das rochas

Este trabalho pretende estabelecer uma relação entre o Work Index e algumas propriedades das rochas. Através da pesquisa bibliográfica foram identificadas varias propriedades com possível influência no valor do Work Index, das quais foram seleccionadas a massa volúmica aparente, a resistência à carga pontual, a composição química, a composição mineralógica e a abrasividade. Adicionalmente a porosidade aberta e resistência à compressão também foram analisadas. Assim foram analisadas 10 amostras de rocha, quatro de granitos, uma de quartzodiorito, uma de ardósia, uma de serpentinito, uma de calcário, uma de mármore e uma de sienito nefelínico, sobre as quais já eram conhecidos os valores de cinco das propriedades referidas previamente, tendo sido determinados os valores das ainda desconhecidas, resistência à carga pontual e a abrasividade que está representada através do resultado do ensaio capon. Devido à dificuldade de execução do ensaio de determinação do Work Index de Bond foram recolhidos dados bibliográficos de valores do Work Index para as amostras de rocha seleccionadas e adoptado o valor médio para cada uma. Os dados obtidos foram tratados estatisticamente através do método de análise de componentes principais assim como através de regressões lineares simples e múltiplas. A análise de componentes principais permitiu identificar várias propriedades da rocha com possível influência sobre o Work Index de entre as analisadas. Foi possível estabelecer uma relação entre o Work Index e quatro das propriedades seleccionadas, designadamente a porosidade aberta, a resistência à compressão, a resistência à carga pontual e a abrasividade.

Spatial and temporal analysis of recent drought using vegetation temperature condition index: case of Somali regional state of Ethiopia

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

DISCORDANCE BETWEEN BODY MASS INDEX AND ANTHROPOMETRIC MEASUREMENTS AMONG HIV-1-INFECTED PATIENTS ON ANTIRETROVIRAL THERAPY AND WITH LIPOATROPHY/LIPOHYPERTROPHY SYNDROME

Introduction: Highly Active Antiretroviral Therapy (HAART) has improved and extended the lives of thousands of people living with HIV/AIDS around the world. However, this treatment can lead to the development of adverse reactions such as lipoatrophy/lipohypertrophy syndrome (LLS) and its associated risks. Objective: This study was designed to assess the prevalence of self-reported lipodystrophy and nutritional status by anthropometric measurements in patients with HIV/AIDS. Methods: An observational study of 227 adult patients in the Secondary Immunodeficiencies Outpatient Department of Dermatology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo (3002 ADEE-HCFMUSP). The sample was divided into three groups; Group 1 = 92 patients on HAART and with self-reported lipodystrophy, Group 2 = 70 patients on HAART without self-reported lipodystrophy and Group 3 = 65 patients not taking HAART. The nutritional status of individuals in the study sample was determined by body mass index (BMI) and percentage of body fat (% BF). The cardiovascular risk and diseases associated with abdominal obesity were determined by waist/hip ratio (WHR) and waist circumference (WC). Results: The prevalence of self-reported lipoatrophy/lipohypertrophy syndrome was 33% among women and 59% among men. Anthropometry showed depletion of fat mass in the evaluation of the triceps (TSF) in the treatment groups with HAART and was statistically independent of gender; for men p = 0.001, and for women p = 0.007. Similar results were found in the measurement of skin folds of the upper and lower body (p = 0.001 and p = 0.003 respectively). In assessing the nutritional status of groups by BMI and % BF, excess weight and body fat were more prevalent among women compared to men (p = 0.726). The WHR and WC revealed risks for cardiovascular and other diseases associated with abdominal obesity for women on HAART and with self-reported LLS (p = 0.005) and (p = 0.011). Conclusions: Anthropometric measurements were useful in the confirmation of the prevalence of LLS. BMI alone does not appear to be a good parameter for assessing the nutritional status of HIV-infected patients on HAART and with LLS. Other anthropometric measurements are needed to evaluate patients with the lipoatrophy/lipohypertrophy syndrome.

Optimal Cut-Off Value for Homeostasis Model Assessment (HOMA) Index of Insulin-Resistance in a Population of Patients Admitted Electively in a Portuguese Cardiology Ward

INTRODUCTION: Insulin resistance is the pathophysiological key to explain metabolic syndrome. Although clearly useful, the Homeostasis Model Assessment index (an insulin resistance measurement) hasn't been systematically applied in clinical practice. One of the main reasons is the discrepancy in cut-off values reported in different populations. We sought to evaluate in a Portuguese population the ideal cut-off for Homeostasis Model Assessment index and assess its relationship with metabolic syndrome. MATERIAL AND METHODS: We selected a cohort of individuals admitted electively in a Cardiology ward with a BMI < 25 Kg/m2 and no abnormalities in glucose metabolism (fasting plasma glucose < 100 mg/dL and no diabetes). The 90th percentile of the Homeostasis Model Assessment index distribution was used to obtain the ideal cut-off for insulin resistance. We also selected a validation cohort of 300 individuals (no exclusion criteria applied). RESULTS: From 7 000 individuals, and after the exclusion criteria, there were left 1 784 individuals. The 90th percentile for Homeostasis Model Assessment index was 2.33. In the validation cohort, applying that cut-off, we have 49.3% of individuals with insulin resistance. However, only 69.9% of the metabolic syndrome patients had insulin resistance according to that cut-off. By ROC curve analysis, the ideal cut-off for metabolic syndrome is 2.41. Homeostasis Model Assessment index correlated with BMI (r = 0.371, p < 0.001) and is an independent predictor of the presence of metabolic syndrome (OR 19.4, 95% CI 6.6 - 57.2, p < 0.001). DISCUSSION: Our study showed that in a Portuguese population of patients admitted electively in a Cardiology ward, 2.33 is the Homeostasis Model Assessment index cut-off for insulin resistance and 2.41 for metabolic syndrome. CONCLUSION: Homeostasis Model Assessment index is directly correlated with BMI and is an independent predictor of metabolic syndrome.

Invasive Assessment of the Coronary Microcirculation Using the Index of Microcirculatory Resistance: Description and Validation of an Animal Model

INTRODUCTION: The index of microcirculatory resistance (IMR) enables/provides quantitative, invasive, and real-time assessment of coronary microcirculation status. AIMS: The primary aim of this study was to validate the assessment of IMR in a large animal model, and the secondary aim was to compare two doses of intracoronary papaverine, 5 and 10 mg, for induction of maximal hyperemia and its evolution over time. METHODS: Measurements of IMR were performed in eight pigs. Mean distal pressure (Pd) and mean transit time (Tmn) were measured at rest and at maximal hyperemia induced with intracoronary papaverine, 5 and 10 mg, and after 2, 5, 8 and 10 minutes. Disruption of the microcirculation was achieved by selective injection of 40-μm microspheres via a microcatheter in the left anterior descending artery. RESULTS: In each animal 14 IMR measurements were made. There were no differences between the two doses of papaverine regarding Pd response and IMR values - 11 ± 4.5 U with 5 mg and 10.6 ± 3 U with 10 mg (p=0.612). The evolution of IMR over time was also similar with the two doses, with significant differences from resting values disappearing after five minutes of intracoronary papaverine administration. IMR increased with disrupted microcirculation in all animals (41 ± 16 U, p=0.001). CONCLUSIONS: IMR provides invasive and real-time assessment of coronary microcirculation. Disruption of the microvascular bed is associated with a significant increase in IMR. A 5-mg dose of intracoronary papaverine is as effective as a 10-mg dose in inducing maximal hyperemia. After five minutes of papaverine administration there is no significant difference from resting hemodynamic status.

Contribuição para a adaptação cultural do Neck Disability Index e caraterização da prática de fisioterapia em pacientes com dor crónica cervical

RESUMO: Objetivo: Este trabalho teve como objetivo contribuir para o processo de adaptação cultural do Neck Disability Index (NDI), através da análise da sua unidimensionalidade e do estudo da sua fiabilidade (consistência interna e fiabilidade teste-reteste), validade de constructo e poder de resposta. De igual forma pretendeu-se caraterizar a intervenção realizada pela fisioterapia e os resultados obtidos em pacientes com Dor Cervical Crónica (DCC). Introdução: A dor cervical é um problema cada vez mais comum nos países industrializados, constituindo uma das três condições mais frequentemente reportadas por queixas de origem músculo-esquelética. A sua incidência é um fenómeno em crescimento, com custos implicados para a sociedade. Desta forma reconhece-se a importância de um instrumento que monitorize a evolução da incapacidade funcional associada à DCC. O NDI é atualmente o instrumento de avaliação mais recomendado para avaliar a incapacidade funcional associada à dor cervical. Foi traduzido e adaptado à língua portuguesa, mas à data não foi realizada nenhuma avaliação das suas propriedades psicométricas. Por outro lado, apesar de a literatura referir que os serviços de Fisioterapia são extremamente procurados por indivíduos com DCC, em Portugal, a informação sobre a sua prática nesta condição clínica é escassa ou mesmo inexistente. Assim, e sendo a incapacidade nas atividades funcionais uma das variáveis de maior impacto da DCC e ao mesmo tempo um dos resultados principais da intervenção da Fisioterapia, importa por um lado possuir instrumentos capazes de avaliar o nível de incapacidade funcional e a sua mudança, e por outro, aferir qual a intervenção realizada pela Fisioterapia e quais os resultados obtidos. Metodologia: Realizou-se um estudo de coorte prospetivo com uma amostra de conveniência, do tipo não probabilístico, constituída por 88 pacientes com DCC de origem músculo-esquelética e causa não traumática referenciados para 6 serviços de fisioterapia / medicina física e de reabilitação de clínicas e centros de reabilitação, sendo elegíveis todos os pacientes que cumprissem os critérios de inclusão e exclusão estabelecidos. Os pacientes foram avaliados em três momentos pré-definidos: antes do início das sessões de fisioterapia ou na 1ª semana de tratamento; 4 a 7 dias após a 1ª avaliação; e 7 semanas após o início da fisioterapia. Para verificação da unidimensionalidade do NDI, procedeu-se a uma Análise Fatorial Exploratória. As propriedades psicométricas do NDI avaliadas foram a Fiabilidade (consistência interna e fiabilidade teste-reteste), a Validade de Constructo e o Poder de Resposta. Posteriormente procedeu-se à caraterização da prática da fisioterapia quanto às modalidades utilizadas, número de sessões de tratamento e duração do episódio de cuidados. Adicionalmente descreveu-se os resultados obtidos após a intervenção da fisioterapia ao nível da dor e incapacidade. Resultados: os resultados obtidos foram positivos e significativos, com a confirmação da unidimensionalidade do NDI, sendo que em todos os critérios seguidos o fator mínimo retido foi de um. Na avaliação da consistência interna o valor obtido foi acima do mínimo aceitável (α Cronbach = 0,77), enquanto o valor de fiabilidade teste-reteste foi elevado (CCI =0,95). De igual forma, os resultados foram positivos para a validade de constructo, obtendo-se uma associação positiva do NDI com a Escala Numérica da dor (END). O valores de poder de resposta reportaram uma Área Abaixo da Curva de 0,63 (IC 95%=0,51-0,75), com valor de Diferença Mínima Clinicamente importante de 5,5 pontos (sensibilidade = 69,6%; especificidade = 43,6%). Relativamente á intervenção de fisioterapia em casos de DCC verificou-se que as características da prática da fisioterapia reportadas neste relatório são de difícil comparação ou análise dada a escassez ou inexistência de trabalhos publicados sobre este assunto em pacientes com DCC. No entanto, neste estudo, encontraram-se reduções significativas na intensidade da dor e incapacidade funcional após a intervenção de fisioterapia (z= -7,16; p<0,001 e t= 10,412, p<0,05, respetivamente). Conclusão: Os resultados do presente estudo revelam que o NDI-VP possui uma boa Fiabilidade, Validade de Constructo e Poder de Resposta. Revela ainda que a intervenção da fisioterapia em casos de DCC, apesar da escassez de trabalhos publicados, proporciona uma redução significativa dos níveis de dor e incapacidade em pacientes com DCC.--------------- ABSTRACT:Objective: the aim of this study was to contribute for the process of cultural adaption of the Neck Disability Index (NDI), through the analysis of his unidimensionality and the study of his reliability (internal consistency and test-retest reliability), construct validity and responsiveness. At the same time it pretends to characterize the intervention performed by physical therapy and the results in patients with Chronic Neck Pain (CNP). Introduction: neck pain is a common problem in the industrialized countries, since is one of the three most reported conditions by complaints with musculoskeletal origin. His incidence is a growth phenomena that implicate great costs to society. Therefore the importance of an instrument that monitories the evolution of the functional disability associated to CNP is recognized. Nowadays, NDI is the instrument most recommended to evaluate functional disability associated to neck pain. It has been translated and adapted to portuguese but, till now, no evaluation of his psychometric proprieties has been completed. In the other hand, despite literature refers that physical therapy services are extremely searched by patients with neck pain, in Portugal, the information about practice in this clinical condition is very few or inexistent. Therefore, and since disability in the functional activities is one of the variables with most impact of CNP and, at the same time, one of the main results of physical therapy interventions, it’s important to have instruments capable of evaluate the level of functional disability and his change, and also calculate which intervention of physical therapy is most appropriate and his results. Methodology: it was used a prospective cohort study with a convenience sample, non-probabilistic, consisting of 88 patients with CNP of musculoskeletal origin and non-traumatic cause, referred to 6 physical therapy services of clinics and rehabilitation centers, and fulfilled the inclusion and exclusion criteria established. Patients were evaluated in three pre-defined moments: before the beginning of physical therapy or during the first week of treatment; 4 to 7 days after the first evaluation; and 7 weeks after beginning of physical therapy. To verify NDI unidimensionality, we run an Exploratory Factorial Analysis. NDI psychometric proprieties evaluated were reliability (internal consistency and test-retest reliability), construct validity and responsiveness. Subsequently, it was proceeded the characterization the practice of physical therapy regarding to the modalities used, the number of treatment sessions and duration of the episode of care. Additionally it was described the results obtained after the intervention of the physical therapy, the level of pain and the disability. Results: results were positive and significant, with the confirmation of the NDI unidimensionality, since in every followed criteria the minimal retained factor was one. In the evaluation of internal consistency the value was above the minimal accepted (α Cronbach = 0,77), and the test-retest reliability value was high (CCI =0,95). Results were positive to construct validity, with an positive association of the NDI with Numeric Rating Scale (NRS). Responsiveness values reported an Area Under Curve (AUC) of 0,63 (IC 95%=0,51-0,75) with a Minimal Important Detectable Change (MIDC) of 5,5 points (sensitivity = 69,9%; specificity = 43,6%). Regarding physical therapy interventions in CNP, it was verified that the physical therapy characteristics reported are difficult to compare or analyze since there are very few published studies about this topic. However, in this study, significant reductions were founded in pain intensity and functional disability after intervention(z= -7,16; p<0,001 and t= 10,412, p<0,05, respectively).Conclusion: present study results reveals that NDI has an good reliability, construct validity and responsiveness. It also reveals that physical therapy intervention in CNP, beside few studies published, result in a significant reduction of pain and disability levels in patients with CNP.

Recent droughts and the impact of North Atlantic Oscillation in Iberia; a spatiotemporal analysis based on vegetation temperature condition Index (VTCI)

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

The effects Ishares IBovespa index fund creation on the liquidity of underlying stocks

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Finance from the NOVA – School of Business and Economics

A happiness index of human development

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics

Active ageing index and quality of life

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics

Malnutrição em idosos na admissão hospital actuação perante a sua elevado prevalência

RESUMO: Ao longo das últimas décadas a redistribuição etária da população mundial tem vindo a apresentar um aumento do número de pessoas com 65 ou mais anos, integrando um grupo populacional comummente designado por população idosa. Importa aprofundar mecanismos fisiológicos que conduzem ao envelhecimento e de que forma podem condicionar não só aspetos clínicos, como também nutricionais, entre outros, com a perspetiva da sua origem no aparecimento de doenças crónicas. Com esse enfoque, a desnutrição na pessoa idosa é hoje considerada pela European Nutrition for Health Alliance(ENHA) um problema de saúde pública. Está descrito que a sua prevalência ronda os 60% a nível de instituições hospitalares, 40% em unidades residenciais e 5 a 10% na pessoa idosa a residir em domicílio próprio ou de familiares, e na sua maioria permanece por diagnosticar e tratar. Assim, foi objetivo deste estudo caracterizar e estimar a prevalência da desnutrição e do risco de desnutrição na pessoa idosa, nas primeiras 72 horas de admissão hospitalar. Aplicou-se um estudo observacional, analítico, transversal, quantitativo e correlacional, cujos dados foram recolhidos por entrevista ao próprio e por observação. O estudo desenvolveu-se em duas vertentes de investigação, uma focada na caracterização da desnutrição em pessoas idosas institucionalizadas em hospitais portugueses da zona centro e sul do Continente e Madeira, nos períodos de julho/agosto de 2009, abril/junho de 2010, maio/julho de 2011, através do MNA®. A outra, uma avaliação nutricional detalhada, efetuada no Centro Hospitalar de Lisboa Central – Hospital de Santa Marta, EPE, entre o início de janeiro de 2009 e o fim de janeiro de 2010, sendo a amostra recrutada de entre os idosos de ambos os sexos, internados. Foram estudados dados sociodemográficos, de saúde e feita uma avaliação nutricional extensa. A avaliação nutricional constou de colheita de parâmetros laboratoriais (hematológicos e bioquímicos) e antropométricos (índice de massa corporal (IMC), prega cutânea tricipital(PCT), prega cutânea subescapular (PCSE), perímetro braquial (PB), adequação do perímetro braquial (APB), área muscular braquial (AMB) e perímetro Geminal (PG), análise da composição corporal (Massa Gorda Corporal (MGC), Massa Isenta de Gordura (MIG)),caracterização de um dia alimentar tipo e questionário Mini Nutritional Assessment Long Form®– MNA LF®. Dos dados obtidos em hospitais portugueses, destaca-se que dos 402 idosos avaliados, 53% eram do sexo masculino, tinham uma idade média de 75,8 + 6,52 (65 – 100) e segundo o MNA® 57,5% encontravam-se Desnutridos ou em Risco de Desnutrição.Na amostra, dos dados obtidos, a nível sociodemográfico salienta-se que 50% dos doentes eram do sexo masculino, a idade média rondava os 75,5 + 7,22 (65 – 100) anos, 55% eram naturais de Lisboa e 80% residiam em Lisboa e Vale do Tejo, 38% não tiveram estudos formais e 43% fizeram-no apenas até ao 4º ano de escolaridade. Em relação aos dados de saúde, a maioria dos doentes foi admitida através do Serviço de Urgência do Centro Hospitalar de Lisboa Central – Hospital de São José e foram internados no Serviço de Medicina (38%) e no Serviço de Cardiologia (30%), por patologia médica (38%) e patologia do sistema circulatório (56%). Nos hábitos de vida, quanto à mobilidade, um terço dos doentes estavam acamados e os restantes deambulavam ou tinham uma mobilidade normal, 74% não apresentaram hábitos etanólicos regulares, 19% apresentavam um consumo elevado (> 30g de etanol/dia); 95% dos doentes não apresentavam hábitos tabágicos. Relativamente à caracterização nutricional, os valores médios encontrados em relação aos parâmetros laboratoriais revelaram-se inferiores aos valores padrão para a idade e sexo e eram inferiores no sexo feminino. Na caracterização antropométrica verificaram-se os seguintes achados: o cálculo do IMC mostrou-se pouco sensível na identificação de doentes desnutridos; a PCT e a PCSE revelaram valores de massa gorda dentro do intervalo considerado normal;segundo o PB, 88% não apresentavam valor indicativo de desnutrição e 8% estavam desnutridos; a APB identificou 50% de doentes desnutridos; a AMB, revelou que 97% dos homens e 95% das mulheres apresentavam deficit da massa magra e segundo o PG, 18% apresentavam um valor inferior a 31cm descritor de desnutrição. Na análise da composição corporal verificou-se que ambos os sexos apresentavam uma percentagem de MGC classificada como demasiado alta e que esta era superior nas mulheres em relação aos homens. Ao analisar a ingestão nutricional verificou-se que esta era inferior às Dietary Reference Intakes (DRIs) para a ingestão hídrica (p=0,00), energética (p=0,00), proteica (p=0,00), lipídica (p=0,01), MUFA (p=0,00), PUFA (p=0,00), e glícidos (p=0,00), fibra (p=0,02), potássio (p=0,00), cálcio (p=0,00), magnésio (p=0,00), fósforo (p=0,00), zinco (p=0,00), vitamina D (p=0,00), vitamina E (p=0,00) e folato (p=0,00). No que diz respeito ao MNA®, a sua aplicação permitiu identificar 62% de situações de risco nutricional ou de desnutrição já instalada. Valores de MNA® indicativos de desnutrição ou risco estavam associados a níveis de escolaridade mais baixos (r=0,32; p=0,00). Verificou-se correlação entre o MNA® e a PCT (r=0,30;p=0,00), PCSE (r=0,19;p=0,03) e PG (r=0,27;p=0,00). Na análise da amostra por sexo e escalão etário, apenas se distinguiram as mulheres mais velhas, que apresentaram situação de IMC indicador de risco de desnutrição (IMC <23,5 + 2,9, (r=0,42;p=0,02)), e de valores médios de PB de 25,6+3,84cm (r=0,42;p=0,01), em situações de menor mobilidade caraterizados pelo MNA®. Os homens maisvelhos apresentaram correlação entre o MNA® e PCSE (r=0,41;p=0,02), APMB (r=0,57;p=0,00)e PG (r=0,55;p=0,00), e as mulheres mais velhas apenas com a PCT (r=0,39;p=0,02). A análise multivariada do MNA® em função do sexo e do escalão etário, revelou que estes são independentes. Os homens apresentaram valores médios de MNA® superiores às mulheres e à medida que a idade aumenta, os valores de MNA® em ambos os sexos diminuem, sendo indicativos de risco de desnutrição. Consideramos que, tendo em conta a natureza e objetivos do presente estudo, foi possível caracterizar e estimar a prevalência da desnutrição e do risco de desnutrição em pessoas idosas nas primeiras 72 horas de admissão hospitalar. Os resultados obtidos sinalizam a sua elevada prevalência e alertam para a necessidade de procedimentos protocolados de avaliação e intervenção nutricional da população idosa na admissão hospitalar. Para este efeito a aplicação do MNA® provou a sua aplicabilidade, assim como a medição e cálculo da AMB, que poderão ser muito precocemente aplicados e contribuir para potenciar melhorias do estado de saúde e diminuir o tempo de internamento, nomeadamente de pessoas idosas. Em relação ao padrão alimentar, este estudo contribuiu para uma chamada de atenção dos profissionais de saúde que a população idosa pode apresentar carências nutricionais na admissão, e que estas se não forem devidamente sinalizadas e colmatadas tendem a agravar-se durante o internamento podendo contribuir para o aumento da morbilidade.-------------ABSTRACT:Over the last decades the age redistribution group of the population worldwide has been presenting an increasing number of people aged 65 years or more, incorporating a population group commonly referred to as the elderly population. It´s important to further analyze the physiological mechanisms that lead to aging and how they might influence not only clinical aspects, but also nutritional, among others, with the perspective of their origin in the onset of chronic diseases. With this approach, malnutrition in the elderly is now considered by the European Nutrition for Health Alliance (ENHA) a public health problem. It is reported that its prevalence is around 60% at the level of hospital units, 40% in residential units and 5 to 10% in the elderly living in their own home or family's, and mostly remains to diagnose and treat. The aim of this study was to characterize and estimate the prevalence of malnutrition and risk of malnutrition in the elderly, in the first 72 hours of hospital admission. We applied an observational, analytical, cross-sectional and correlacional quantitative type of study and data were collected by interview and observation itself. The study was developed in two lines of research: one focused on the characterization of malnutrition in elderly institutionalized in Portuguese hospitals, in the central and southern mainland and Madeira, in the periods between July - August 2009, April - June 2010, May - July 2011, through the MNA®; and the other: a detailed nutritional assessment, conducted in Hospital Lisbon Center - Hospital de Santa Marta, EPE, between early January 2009 and late January 2010, and the sample was recruited from among the elderly of both sexes at hospital admission. We studied intensively sociodemographic, health and nutritional assessment done extensive. Nutritional evaluation consisted of harvesting different parameters: hematological, biochemical and anthropometric (body mass index (BMI), triceps skinfold (TSF), sub-scapular skinfold (SSF), arm circumference (AC), arm muscle area (AMA), geminal perimeter (GP), analysis of body composition (Fat Mass (FM), Fat Free Mass (FFM)), characterization of a daily food type and Mini Nutritional Assessment Long Form® questionnaire - MNA LF®. Form the data obtained in Portuguese hospitals, it is noteworthy that of the 402 patients included, 53% were male, had a mean age of 75,8 + 6,52 (65 - 100) and, according to the MNA®, 57,5% were malnourished or at risk of malnutrition. In the sample, from the sociodemographic data obtained, we saw that 50% of patients were male, the average age was around 75,5 + 7,22 years (65-100), 55% were from Lisbon and 80 %lived in Lisbon, 38% had no formal education and 43% did so only until the 4th grade. Regarding health data, the majorities of patients were admitted through the ER of Hospital Lisbon Center - S. José Hospital - and were admitted to the Medicine Unit (38%) and to the Cardiology Unit (30%), by medical pathology (38%) and circulatory system disease (56%). In regard to lifestyle, and considering mobility, one third of patients were bedridden and the rest were ambulating or had a normal mobility. 74% had no regular ethanol habits, 19% had a high intake (> 30 g ethanol / day); 95% of the patients had no smoking habits. Regarding nutritional assessment, the mean values for laboratory parameters proved inferior to standard values for age and sex and were lower in females. In anthropometric assessment these were the findings: BMI calculation showed to be scarcely sensitive in the identification of undernourished patients; the TSF and SSF revealed values of fat mass within the normal range; in AC, 88% did not have an indicative value of malnutrition and 8% were malnourished; in AMA, 97% of men and 95% women had a deficit of lean mass and in GP, 18% had a value of less than the 31cm malnutrition descriptor. In body composition analysis found that both sexes showed a percentage of FM ranked too high and this was higher in women compared to men. By analyzing the nutritional intake was found that this was less than the Dietary Reference Intakes (DRIs) for water intake (p=0,00), energy (p=0,00), protein (p=0,00), lipid (p=0,01), MUFA (p=0,00), PUFA (p=0,00), carbohydrates (p=0,00), fiber (p=0,02), potassium (p=0,00), calcium (p=0,00), magnesium (p=0,00), phosphorus (p=0,00), zinc (p=0,00), vitamin D (p=0,00), vitamin E (p=0,00) and folate (p=0,00). Regarding MNA®, its application identified 62% of cases of nutritional risk or malnutrition already installed. MNA® values indicative of malnutrition or risk were associated with lower levels of education (r=0,32; p=0,00). There was a correlation between the MNA ® and TSF (r =0,30, p = 0,00), SFF (r = 0,19, p = 0,03) and GP (r=0,27, p = 0,00). In the analysis of the sample by gender and age group, the highlight was in older women who had BMI status indicator of malnutrition risk (BMI <23,5 + 2,9 (r=0,42;p=0,02)) and mean values of AC 25,6 +3,84cm (r=0,42; p=0,01), in situations characterized by low mobility MNA®. Older men showed a correlation between the MNA® and SFF (r = 0,41; p = 0,02), AMA (r = 0,57; p = 0,00) and GP (r=0,55;p=0,00), and in older women only TSF showed a correlation(r = 0,39; p =0,02). Multivariate analysis of the MNA® by gender and age group, revealed that they are independent. The men had MNA® mean superior to women, and as the age increases, the values of MNA® in both sexes declined, being indicative of risk of malnutrition. We believe that, given the nature and objectives of the present study, it allowed us to characterize and estimate the prevalence of risk of malnutrition and malnutrition in older people during the first 72 hours of hospital admission. The results indicate a high prevalence and point to the need for protocol procedures of nutritional assessment and intervention in the elderly population at hospital admission. For this purpose the application of MNA® has proved its applicability, as well as measuring and calculating AMA, which may be applied in early stages thus contributing to enhance health state improvements and to shorten the time of hospitalization, particularly in elderly people. In relation to dietary pattern, this study contributed to call of attention from health professionals that the elderly may have nutritional deficiencies on admission, and that these are not properly marked and addressed tend to worsen during hospitalization may contribute to increased morbidity.