863 resultados para Maternal nutritional status


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Rationale: Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. Objectives: To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. Materials and methods: The Ecuadorian Hospital Malnutrition Study was conducted between November 2011 and June 2012 with 5,355 patients (Women. 37.5%; Ages ≥ 60 years. 35.1%; Length of stay ≤ 15 days. 91.2%) admitted to 36 public hospitals located in the prominent cities of 22 out of the 24 provinces of the country. Malnutrition frequency was estimated by means of the Subjective Global Assessment survey. Results: Malnutrition affected 37.1% of the surveyed patients. Malnutrition was dependent upon patient's age and education level; as well as the presence of cancer, sepsis, and chronic organic failure. Hospital areas showed different frequencies of hospital malnutrition. Health condition leading to hospital admission influenced negatively upon nutritional status. Malnutrition frequency increased as length of stay prolonged. Conclusions: Malnutrition currently affects an important proportion of patients hospitalized in public health institutions of Ecuador. Policies and actions are urgently required in order to successfully deal with this health problem and thus to ameliorate its negative impact upon quality of medical care

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This work aimed to evaluate how aging could influence patients' perception of health quality of life (HRQOL), as well as, the effect of aging on dialysis adequacy and in hematological, iron status, inflammatory and nutritional markers. In this transversal study were enrolled 305 ESRD patients under online-hemodiafiltration (OL-HDF) (59.67% males; 64.9 ± 14.3 years old). Data about comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patient's records. Moreover, HRQOL score, by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF), was assessed. Analyzing the results according to quartiles of age, significant differences were found for some parameters evaluated by the KDQOL-SF instrument, namely for work status, physical functioning and role-physical, which decreased with increasing age. We also found a higher proportion of diabetic patients, a decrease in creatinine, iron, albumin serum levels, transferrin saturation and nPCR, with increasing age. Moreover, significant negative correlations were found between age and mean cell hemoglobin concentration, iron, transferrin saturation, albumin, nPCR, work status, physical functioning and role-physical. In conclusion, our results showed that aging is associated with a decreased work status, physical functioning and role-physical, with a decreased dialysis adequacy, iron availability and nutritional status, and with an increased proportion of diabetic patients and of patients using central venous catheter, as the vascular access. The knowledge of these changes associated with aging, which have impact in the quality of life of the patients, could be useful in their management.

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Growth-curves are an important tool for evaluating the anthropometric development in pediatrics. The different growth-curves available are based in different populations, what leads to different cut-offs. Pediatric obesity tracks into adulthood and is associated with increased cardiovascular risk. The accurate assessment of a child nutritional status using growth-curves can indicate individuals that are either obese or in risk of becoming obese, allowing an early intervention. Moreover, the association between the data obtained from growth-curves with specific metabolic risk factors further highlights the importance of these charts. This study aimed to evaluate the associations between body mass index z-score (BMIzsc), determined using the growth-curves from the Centre for Disease Control and Prevention (CDC) and from the World Health Organization (WHO), with cardiovascular risk factors, represented here by metabolic syndrome (MS) and insulin resistance (IR) related parameters. The study involved 246 obese adolescents (10-18 years, 122 females). MS was defined according to the International Diabetes Federation. IR was considered for HOMA-IR greater than 2.5.

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Objetivo: Associar fatores de risco para doenças crônicas não transmissíveis (DCNT) com variáveis sociodemográficas de servidores de uma instituição pública de ensino superior. Métodos: Estudo transversal, realizado no período de 2012 a 2013. Utilizou-se um questionário com variáveis sociodemográficas, fatores de risco para DCNT e aferição de peso e estatura. Classificou-se o estado nutricional de acordo com o índice de massa corporal. Analisaram-se os dados pelos programas Epi-Info 3.2.1 e Bioestat 5.0. As associações foram verificadas pelos testes qui-quadrado de Yates, de tendência e exato de Fisher (p≤0,05). Resultados: Participaram 225 servidores, maioria de mulheres (64,4%), na faixa etária entre 45-54 anos (37,3%) e escolaridade superior a 12 anos de estudo (85,8%). O sexo associou-se ao excesso de peso (p=0,034), consumo diário de leite integral (p=0,023), consumo insuficiente de frutas, legumes e verduras - FLV (p=0,020) e consumo insuficiente de feijão (p=0,000), sendo mais frequentes entre mulheres. Entre os homens, foi mais frequente o consumo excessivo de bebida alcoólica (p=0,000). O excesso de peso associou-se à faixa etária (p=0,008). O hábito de fumar (p=0,004) e o consumo diário de leite integral (p=0,016) apresentaram associação com a escolaridade. Conclusão: Encontrou-se elevada prevalência de fatores de risco para doenças crônicas não transmissíveis na amostra estudada, com associação para sexo, faixa etária e escolaridade. O excesso de peso apresentou maior ocorrência nas mulheres e nas idades acima de 45 anos, hábitos alimentares inadequados no sexo feminino, maior ingestão de bebida alcoólica no masculino e hábito de fumar nos indivíduos com maior escolaridade.

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Para o sucesso de um processo de revegetação, além de melhorar as condições edáficas da área, deve-se dispor de mudas de boa qualidade, o que pode ser avaliado pelo estado nutricional. Neste trabalho, avaliaramse os teores foliares de N, P, K, Ca, Mg, S, B, Cu, Fe, Mn e Zn de mudas de Dipteryx alata produzidas a pleno sol ou em cultivo protegido (30% de sombreamento), utilizando como substrato solo degradado, condicionado ou não com resíduo orgânico (32 t ha-1 macrófitas) e com diferentes doses de fósforo (0, 100, 200 e 300 mg dm-3 P2O5), comparativamente à mudas e parte aérea de plantas adultas, coletadas em campo. A cada coleta de folhas em campo, o solo foi coletado e analisado para P, MO, pH, K, Ca, Mg, H+Al, SB e CTC. A mesma análise foi realizada nas unidades experimentais, ao final do experimento. Os resultados mostram que o Dipteryx alata é pouco exigente em P, que os teores foliares, nas mudas de campo, são superiores às plantas adultas em N, P, K e S e inferiores para Ca e que o estádio de desenvolvimento da planta não influenciou os teores foliares de Mg, B, Cu, Fe, Mn e Zn. O resíduo orgânico não foi suficiente para fornecer o N necessário às mudas produzidas. O cultivo a pleno sol propiciou maiores teores foliares de N, P, Ca, Mg, B, Cu, Fe e Mn. Teores foliares de N, P, K, Ca, B, Fe e Zn foram superiores na presença de resíduo orgânico.

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Introdução – A frequência de dislipidemia em crianças e adolescentes tem vindo a aumentar rapidamente nos últimos anos, estando o seu aparecimento associado a fatores genéticos e ambientais. Este indicador, associado a outras doenças como a obesidade, constituem a síndrome metabólica e são considerados fatores de risco para doença cardiovascular e diabetes, que quando presentes na infância podem conduzir precocemente ao aparecimento destas doenças. Objetivos – Avaliar o perfil de indicadores de saúde de crianças no início de um Programa de Educação Contínua; Verificar os efeitos do Programa de Educação Contínua aplicado durante 36 meses (ginástica funcional, brincadeiras de rua e das aulas de natação), sobre os resultados dos exames iniciais de colesterol, triglicerídeos e do IMC. Métodos - Estudo quantitativo, exploratório e descritivo de corte transversal, realizado entre 2012 e 2015 numa amostra não probabilística por conveniência de 165 crianças, 70,0% da população-alvo. As crianças tinham entre 7 a 12 anos de idade, 40,59% entre 11 e 12 anos e 54% eram do sexo feminino. Eram beneficiárias de um plano de saúde que integrava um programa de intervenção (educação contínua e atividade física), designado Crescendo com Saúde e foram selecionadas através de critérios, como: dislipidemia (colesterol total e/ou triglicerídeos elevados), sobrepeso e/ou obesidade, e história familiar de HAS e DM. Os dados clínicos foram obtidos na consulta de enfermagem, utilizando-se a recolha de sangue para dosemanento do perfil lipídico no início do programa e a cada 6 meses e avaliação do IMC na fase inicial do programa e semanalmente. Para classificação do estado nutricional foram utilizados os pontos de corte da OMS (2007). Resultados – no início do programa 69% das crianças apresentavam hipercolesterolémia, 32% aumento do colesterol, 45% tinham excesso de peso (sobrepeso e obesidade) e 12% risco de sobrepeso. Após o programa de intervenção, das 53% crianças que participaram de forma regular, 29% apresentaram redução do colesterol, 16% dos triglicerídeos e o excesso de peso reduziu em 9%, aumentando contudo o risco de sobrepeso para 22%. Das que participaram de forma irregular, apenas 3% reduziram o perfil lipídico e 1% o estado nutricional. Conclusões – O programa de intervenção permitiu uma redução dos fatores de risco de doença metabólica e permitiu melhorar os hábitos das crianças estudadas e suas famílias. Estes resultados comprovam a eficácia a curto e médio prazo dos programas de intervenção na comunidade, e realçam o papel das intervenções preventivas de educação contínua e de atividade física regular, para o processo de redução dos indicadores de risco metabólico desde a infância. Palavra-chave: Crianças; Perfil lipídico; Obesidade; Programa de intervenção .

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Nutritional status is an important determinant to the response against Leishmania infection, although few studies have characterized the molecular basis for the association found between malnutrition and the disease. Vitamin A supplementation has long been used in developing countries to prevent mortality by diarrheal and respiratory diseases, but there are no studies on the role of vitamin A in Leishmania infection, although we and others have found vitamin A deficiency in visceral Leishmaniasis (VL). Regulatory T cells are induced in vitro by vitamin A metabolites and are considered important cells implicated T CD4+ cell suppression in human VL. This work aimed to examine the correlation of nutritional status and the effect of vitamin A in the response against Leishmania infantum infection. A total of 179 children were studied: 31 had active VL, 33 VL history, 44 were DTH+ and 71 were DTH- and had negative antibody to Leishmania (DTH-/Ac-). Peripheral blood monuclear cells were isolated in a subgroup of 10 active VL and 16 DTH-/Ac- children and cultivated for 20h under 5 different conditions: 1) Medium, 2) Soluble promastigote L. infantum antigens (SLA), 3) All-trans retinoic acid (ATRA), 4) SLA + ATRA and 5) Concanavalin A. T CD4+CD25highFoxp3+, T CD4+CD25-Foxp3- and CD14+ monocytes were stained and studied by flow cytometry for IL-10, TGF-β and IL-17 production. Nutritional status was compromised in VL children, which presented lower BMI/Age and retinol concentrations when compared to healthy controls. We found a negative correlation between nutritional status (measured by BMI/Age and serum retinol) and anti-Leishmania antibodies and acute phase proteins. There was no correlation between nutritional status and parasite load. ATRA presented a dual effect in Treg cells and monocytes: In healthy children (DTH-/Ac-), it induced a regulatory response, increasing IL-10 and TGF-β production; in VL children it modulated the immune response, preventing increased IL-10 production after SLA stimulation. Furthermore, we found a positive correlation between BMI/Age and IL-17 production and negative correlation between serum retinol and IL-10 and TGF-β production in T CD4+CD25highFoxp3+ cells after SLA stimulus. Our results show a potential dual role of vitamin A in the immune system: improvement of regulatory profile during homeostasis and down modulation of IL-10 in Treg cells and monocytes during symptomatic VL. Therefore, the use of vitamin A concomitant to VL therapy might improve recovery from disease status in Leishmania infantum infection

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Obesity is increasing, reaching epidemic levels in many regions of the world. Studies have shown that consumption of peanuts influences on weight control and this influence may be due to the action of trypsin inhibitors sacietogênica that condition increased plasma colescistocinina (CCK). Moreover, the peanut has other health benefits, and these assignments are guaranteed to increase their production and consumption of several of its products, including the paçoca peanut. The aim of this study was to identify the presence of a trypsin inhibitor in paçoca peanut and evaluate its effect on food intake, weight gain and histomorphological changes in swiss mice (n = 8) and Wistar rats (n = 6). Experimental diets were prepared based on the AIN-93G and supplemented with tack or peanut trypsin inhibitor partially purified paçoca peanut (AHTI). After each treatment, the animals were anesthetized and euthanized, their bloods were collected by cardiac puncture for the determination of CCK and other biochemical parameters (glucose, triglycerides, total cholesterol, high density lipoprotein, low density lipoprotein, glutamic-pyruvic transaminase, glutamic oxaloacetic transaminase and albumin) and their pancreas removed for histologic and morphometric analysis. The supplementation with paçoca peanut and the AHTI showed a decrease of body weight gain and food intake in both mice and rats, due to the satiety, since the animals showed no evidence of impairment of nutritional status conditioned by consumption the AHTI. There were also observed biochemical or morphological important when compared with controls. However, AHTI led to increased secretion of CCK, a peptide sacietogênico. Thus, these results indicate that AHTI present in paçoca peanut, is able to enhance the secretion of plasma CCK and thereby reduce the weight gain associated with lower food intake of experimenta animals

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OBJETIVO Identificar el efecto de la educación nutricional y actividad física sobre los parámetros antropométricos en el personal de contrato colectivo con sobrepeso y obesidad del Hospital Homero Castanier Crespo METODOLOGÍA: Estudio descriptivo con un componente de intervención – acción. Para determinar el grupo de estudio se realizó una evaluación del estado nutricional a todo el personal. Al final la muestra fue de 67 personas con sobrepeso y obesidad que firmaron el consentimiento informado. Se aplicaron encuestas de conocimientos, actitudes y prácticas alimentarias y de actividad física al inicio y al final del estudio. Posteriormente se realizó un programa de educación nutricional a través de charlas y talleres semanales. Se incluyeron sesiones de actividad física mediante bailoterapias, pausas activas y ejercicios aeróbicos dos veces por semana. Al concluir el estudio se realizó una evaluación antropométrica final. RESULTADOS: Al final del estudio la población intervenida mostró una reducción en el promedio de las variables: peso, Índice de Masa Corporal (IMC) e índice de cintura /cadera, observándose un descenso significativo del peso inicial (70,7kg) en comparación con peso final (68,6kg). Además se destaca la reducción del IMC (29,67kg/m2) en comparación con el IMC final (28,7kg/m2). En cuanto al índice de cintura/cadera el promedio se redujo de 0,93 a 0,92cm. CONCLUSIÓN: La educación nutricional sumada la actividad física tiene efecto positivo sobre la reducción de medidas antropométricas, además de cambios favorables en los conocimientos, actitudes y prácticas alimentarias

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Antecedentes: La diabetes e hipertensión, son enfermedades crónicas y dos de los principales factores de riesgo cardiovascular. Miles de personas en el mundo mueren cada día por problemas asociados a estas enfermedades. En nuestro país, ellas se encuentran dentro de las principales causas de muerte, y la prevención se ha convertido en una notable forma de salvar vidas, a través de una buena organización de vida implementando o adoptando estilos de vida saludables. Por esta razón, se vuelve imprescindible llevar un programa educativo, pues el conocimiento es la herramienta que evitará complicaciones de salud. Objetivo General: Desarrollar un programa educativo para Diabéticos e Hipertensos del Club Luz y Vida del Subcentro de Salud El Cebollar, Cuenca 2014-2015. Metodología: Se realizó una investigación - acción participativa, mediante un programa educativo nutricional para Diabéticos e Hipertensos del Club Luz y Vida del Subcentro de Salud El Cebollar. Se aplicaron encuestas validadas para determinar el nivel de conocimiento del grupo (precaps), y luego de la implementación del programa (postcaps), y así verificar la efectividad del mismo. Resultados: Se observó un cambio en la salud de los participantes, mejorando su Estado Nutricional, disminución del sobrepeso en 15 puntos porcentuales. La obesidad se mantuvo, pero con el pasar del tiempo, se obtendrán resultados debido a que los participantes tendrán que continuar con dichas indicaciones combinadas con los ejercicios diarios de 30 minutos que recomienda la Organización Mundial de la Salud

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Dada a escassez de informações na literatura e a importância do manejo adequado de resíduos orgânicos na agricultura, objetivou-se avaliar os efeitos da aplicação do resíduo da indústria processadora de goiabas em um Argissolo Vermelho-Amarelo, determinando-se as alterações provocadas na química do solo, no estado nutricional de goiabeiras e na produção de frutos. As doses de resíduo aplicadas no pomar foram estabelecidas em função dos teores de N no resíduo. O delineamento empregado foi o de blocos casualizados, com cinco tratamentos e quatro repetições, sendo as doses do resíduo (moído) de 0, 9, 18, 27 e 36 t ha-1 (peso do material seco). Foram feitas três aplicações do resíduo: em 2006, 2007 e 2008. O resíduo da indústria processadora de goiabas promoveu aumento nos teores de P no solo; as goiabeiras apresentaram aumento dos teores de N, Ca, Mg e Mn; a produção de frutos foi alterada positiva e significativamente no terceiro ano do experimento.

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El confinamiento estratégico de los bovinos Argentina es una herramienta muy útil para lograr la terminación de animales destinados al consumo interno y a la exportación. La utilidad de estos encierres consiste permitir un mejor aprovechamiento del forraje y reduciendo la edad a la faena. Para su aplicación es necesario considerar los factores que afectan su resultado económico tales como la característica de las dietas utilizadas, los niveles de consumo y la eficiencia de conversión. Esto interactúa a su vez con el tipo de animal a encerrar. Son dos los sistemas de confinamiento estratégico que van a ser considerados en esta presentación: los corrales de engorde o terminación y los de recría o engorde de los terneros posdete. La actividad del engorde a corral durante los últimos años, ha estado ligada a variaciones operadas en el precio del grano y del tipo de producto logrado. Hay variaciones atribuidas al cambio en las preferencias del consumidor y también al efecto de la concentración de las ventas de carne en determinadas bocas de expendio que exigen uniformidad en la entrega de animales y del tamaño de los cortes. Se comentan entonces algunos aspectos relevantes del engorde a corral americano y de los engordes a corral en Argentina, además de algunos factores que pueden afectar el resultado económico de la actividad. En cuanto al corral de recría, tiene como objetivo la mejora de la ganancia de peso durante esta etapa frente a condiciones de recría a pasto donde pueden existir limitantes en la cantidad y calidad del forraje producido. En esta presentación se hace el comentario y el análisis de los factores a tener en cuenta en los dos tipos de manejo de los animales a corral: los de terminación o engorde final y los de recría o engorde de terneros después del destete. En el primer caso, los efectos del sexo, la edad, la eficiencia de conversión, la raza, el estado nutricional previo, así como factores de la dieta en si mismo. En el segundo caso se analizan sobre todo los distintos tipos de terneros que pueden incorporar al sistema, así como el uso de diferentes dietas. El desarrollo de los encierres de terneros permitió diseñar nuevos sistemas de producción basados en un aumento de la carga, de la ganancia de peso, la modificación del peso final y los posibles cambios en el momento de terminación. En el caso de los corrales de terminación, han sido una herramienta muy útil para lograr la terminación de animales destinados al consumo interno como exportación.

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Background It is unclear how dysphagic patients should be fed and treated after acute stroke. Objectives The objective of this review was to assess the effect of different management strategies for dysphagic stroke patients, in particular how and when to feed, whether to supplement nutritional intake, and how and whether to treat dysphagia. Search strategy We searched the Cochrane Stroke Group trials register, Medline, Embase, ISI, and existing review articles.We contacted researchers in the field and equipment manufacturers. Date of the most recent searches: March 1999. Selection criteria Unconfounded truly or quasi randomised controlled trials in dysphagic patients with acute/subacute (within 3 months) stroke. Data collection and analysis Three reviewers independently applied the trial inclusion criteria. Two reviewers assessed trial quality and extracted the data. Main results Percutaneous endoscopic gastrostomy (PEG) versus nasogastric tube (NGT) feeding: two trials (49 patients) suggest that PEG reduces end-of-trial case fatality (Peto Odds Ratio, OR 0.28, 95% CI 0.09 to 0.89) and treatment failures (OR 0.10, 95% CI 0.02 to 0.52), and improves nutritional status, assessed as weight (Weighted Men Difference, WMD +4.1 kg, 95% CI -4.3 to +12.5), mid-arm circumference (WMD +2.2 cm, 95% CI -0.5 to +4.9) or serum albumin (WMD + 7.0 g/l, 95% CI +4.9 to +9.1) as compared with NGT feeding; two larger studies are ongoing. Timing of feeding: no completed trials; one large study is ongoing. Swallowing therapy for dysphagia: two trials (85 patients) suggest that formal swallowing therapy does not significantly reduce end-of-trial dysphagia rates (OR 0.55, 95%CI 0.18 to 1.66). Drug therapy for dysphagia: one trial (17 patients); nifedipine did not alter end-of-trial case fatality or the frequency of dysphagia. Nutritional supplementation: one trial (42 patients) found a non-significant trend to a lower case fatality, and significantly increased energy and protein intake; one large trial is ongoing and data is awaited from two other studies. Fluid supplementation: one trial (20 patients) found that supplementation did not alter the time to resolution of dysphagia. Authors’ conclusions Too few studies have been performed, and these have involved too few patients. PEG feeding may improve outcome and nutrition as compared with NGT feeding. Further research is required to assess how and when patients are fed, and the effect of swallowing or drug therapy on dysphagia.

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The Vale do Ribeira, SP, main agricultural activity is the banana crop, which accounts for most of this fruit production in the State of São Paulo. The nutritional balance of the plant is one of the most important factors for the banana plant can complete the cycle and achieve high productivity. Aiming to evaluate the seasonal variation of leaf nutrient concentration in banana plants in Vale do Ribeira-SP, we used the results of 252 chemical analyses of plant tissue, collected from August 2009 to September 2010, in the 18 representative properties for the region, ten cultivated with subgroup Cavendish banana plant and eight of subgroup Prata banana plant. The largest variation between the macronutrient occurred for K and S, and among the micronutrients, especially for Fe and B. In some dates of evaluation, there was a higher leaf concentration of P, K, Ca and Zn, in subgroup Cavendish banana plants, while the subgroup Prata banana plants showed higher leaf concentration, especially of Mn, B and N. Climatic conditions, especially rain, influenced the leaf nutrient content, especially for K, N, S, B and Fe.

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Case-control studies evaluating the factors associated with childhood obesity are scarce in Brazil. We aimed to analyze the factors associated with obesity in Brazilian schoolchildren enrolled in the School Health Program.A case-control study was conducted on 80 schoolchildren aged 7 to 9 years, 40 of them obese and 40 of normal weight according to the cut-off points established by the World Health Organization (2007). Weight, height and waist circumference were obtained. Socioeconomic, demographic, health, eating behavior and lifestyle data were collected by applying a questionnaire to the person responsible and by determining his/her nutritional status. A binary unconditional logistic regression model (univariate and multivariate) was used for data analysis. The prevalence of obesity was 7.21%. The final model showed that duration of breast-feeding ≥6 months of age (OR 5.3; 95% CI: 1.3-22.1), excess weight of the person responsible (OR 7.1; 95% CI: 1.2-40.2), a sedentary level of physical activity (OR 4.1; 95% CI: 1.115.5), and fast chewing (OR 7.4; 95% CI: 2.1-26.9) were significantly associated with childhood obesity. The factors associated with obesity in schoolchildren were duration of breast-feeding ≥6 months, persons responsible with excess weight, and sedentary children who chew fast. The present study contributes information to be used for the health actions planned by the School Health Program.