O objetivo deste estudo foi caracterizar o estado nutricional relativo ao selênio (Se) de praticantes de capoeira. O presente estudo foi composto por 44 indivíduos jovens, praticantes de capoeira (CAP) com idade média de 22 ± 3,3 e 20 ± 2,5 anos para o sexo masculino e feminino respectivamente, e de 11 jovens que compuseram o grupo controle (CO), com a mesma faixa etária. A dieta ingerida por ambos os sexos e grupos CAP e CO, apresentou níveis baixos de Se em relação a recomendação da RDA (1989). A dieta ingerida apresentou-se adequada em energia para os grupos CAP e CO para ambos os sexos, porém encontramos um percentual elevado quanto à fração protéica. Foi realizada uma coleta de sangue venoso (25mL) e de unhas dos pés dos participantes da pesquisa. A análise de Se no material biológico foi determinada por método fluorimétrico (WATKINSON, 1966). As concentrações médias de Se nas unhas do pés foram de 599,27 ± 207,36 &#181;g/kg para o grupo CAP de ambos os sexos, e de 682,27 ± 146,42 &#181;g/kg para o CO de ambos os sexos. Os resultados de Se encontrados no plasma e eritrócito para o grupo CAP de ambos os sexos, foram de 78,14 ± 12,10 e de 123,46 ± 37,54 &#181;g/L, respectivamente, e para o grupo CO foram de 73,45 ± 2,01 &#181;g/L e de 115,63 ± 25,59 &#181;g/L, respectivamente. Não houve diferença significativa entre os grupos CAP e CO, bem como, entre os sexos. A atividade enzimática da GPx no plasma do grupo CAP foi de 97,06 ± 28,22 &#181;mol NADPH oxi/ min/mL e para o grupo CO foi de 69,99 ± 23,98 &#181;mol NADPH oxi/ min/mL, e no eritrócito para o grupo CAP foi de 26,87 ± 7,15 &#181;mol NADPH oxi/ min/mL, e para o grupo CO foi de 19,07 ± 5,27 &#181;mol NADPH oxi/ min/mL. Estes resultados apresentaram diferença estatítica significativa (p<0,05) entre os grupos CAP e CO, mas não entre os sexos. Portanto, pode-se concluir que a atividade física exerce efeito sobre a atividade da GPx, e que a população estudada apresenta baixa ingestão de Se na dieta, porém sem evidências de deficiência clinicamente demonstrável. / The aim of this study was to determine selenium nutritional status in capoeira (a genuine Brazilian play or fight of slave origin) fighters. The current study was carried out with 44 young capoeira fighters (CAP group), whose average age was 22 ± 3.3, for men, and 20 ± 2.5 for women. A control group (CO) was made up of 11 young individuals of the same age. The diet consumed by both groups, CAP and CO, had lower levels of selenium compared to the RDA recommendations (1989). On the contrary, the diet rendered appropriated to energy requirements for both groups and sex, while a high percentage level of protein fractions was determined. Venous blood (25ml) and toenail samples were collected from all the individuals of both groups. Selenium (Se) was quantified in biological material by fluorometric method (WATKINSON, 1966). The average concentrations of selenium in the toenails were 599.27 ± 207.36 &#181;g/kg for CAP group, both sex, and 682.27 ± 146.42 &#181;g/kg for group CO, both sexo The amount of Se for group CAP, both sex, was 78.14 ± 12.10 &#181;g/L and 123.46 ± 37.54 &#181;g/L, for plasma and erythrocyte. For group CO, both sex, it was 73.45 ± 2.01 &#181;gIL for plasma and 115.63 ± 25.59 &#181;g/L for erythrocyte. No significant difference between groups CAP and CO was found, for the same analyses. The enzyme activity of GPx in plasma of group CAP was 97.06 ± 28.22 &#181;mol of NADPH oxy/min/mL and 69.99 ± 23.98 &#181;mol of NADPH oxy/min/mL. In the erythrocyte, for groups CAP and CO, respectively, the activities ofthe enzyme were 26.87 ± 7.15 and 19.07 ± 5.27 &#181;mol of NADPH oxy/min/mL. These results show a significant statistic difference (p<0.05) between groups CAP and CO. but not in relation to sexo Therefore, we can infer that physical activity exerts an effect on GPx activity and that the population under study has a low diet selenium intake, although no clinical deficiency could be detected.

Este trabalho teve por objetivo avaliar, em seres humanos, se a exposição ao mercúrio acarreta alterações no estado nutricional relativo ao selênio que possam interferir na ativação do hormônio tireoidiano T3. Estas alterações poderiam ocorrer pela redução da disponibilidade do selênio, uma vez que este mineral é considerado um fator protetor contra a intoxicação pelo mercúrio, realizando ligações com o metal e desta forma, inibindo sua absorção; e portanto, a conversão do hormônio tiroidiano T4 em T3 poderia ser prejudicada, tendo em vista que é dependente de selenoproteínas. Alguns estudos têm avaliado a relação entre mercúrio e selênio na população brasileira, no entanto, não têm observado qual o efeito desta interação nos hormônios tiroidianos. A importância deste estudo está em detectar se existem estas alterações, e se elas forem observadas, sugerir formas de melhorar o estado nutricional relativo ao selênio, para minimizar a contaminação por mercúrio e os problemas acarretados pela redução dos níveis circulantes do hormônio tiroidiano ativo. Nesta pesquisa foram formados três grupos, um em Cubatão, um em Novo Airão na região amazônica e, como grupo controle, um em São Paulo. Foi observado que os grupos de Cubatão e São Paulo não se encontram em risco de intoxicação por mercúrio. Já o grupo formado em Novo Airão apresentou teores altos do metal. A ingestão de selênio em todos os grupos apresentou índices de inadequação de consumo acima dos 30%, no entanto, todos se apresentaram adequados em relação aos parâmetros bioquímicos do mineral, e também em relação às concentrações dos hormônios tireoidianos. Nesta pesquisa foi observado que na região amazônica, apesar dos valores elevados de mercúrio, este não provocou efeito no estado nutricional relativo ao selênio e no metabolismo normal dos hormônios tireoidianos. Mais estudos são necessários para que a dinâmica entre selênio e mercúrio seja completamente elucidada, principalmente em regiões onde possa ocorrer exposição aguda ao metal, onde se acredita que as consequências dessa exposição seriam deletérias sobre o status do mineral e suas funções. / The aim of this work was to assess, in human beings, if mercury exposure may lead to changes in selenium status that may interfere with the conversion of active thyroid hormone T3. Changes in selenium status could occur for a reduction in its bioavailability, once the mineral is considered as a protection factor against mercury intoxication, by bounding to the metal and inhibiting its absorption, and so disturbing the conversion of T4 to T3, witch is dependent on selenoproteins. Some researches have assessed the relationship between mercury and selenium in Brazilian population, but these studies did not observed the effects of this interaction in the thyroid hormones concentrations. This research is important because it might detect if there is such interaction, and if it is observed, may suggest viable ways to ameliorate selenium status, reduce mercury contamination risk and the problems that might occur due to reduction on active thyroid hormones concentration. For this research three groups were formed, one in the city of Cubatão, one in Novo Airão in the amazon region, and, as a control group, one in São Paulo city. Is has been observed that the groups of Cubatão and São Paulo are not in risk for mercury intoxication. However, in Novo Airão, the levels of Mercury found were high. Analysis of selenium intake in all groups show that in all of than inadequate rate intake was over 30%, however, in every group biomarkers for selenium were adequate, as well as the thyroid hormone levels. Hence, this study observed that in Amazon region, in spite of high mercury levels, there is no effect in selenium status and in the thyroid hormone. Further investigations are needed to fully elucidate mercury and selenium interaction, especially in regions were an acute exposure to the metal might happen, when the consequences of this mey be deleterious to selenium status and its functions.

Introdução: Aproximadamente 25 a 30% dos pacientes com DC iniciam a doença antes da idade dos 20 anos. O déficit de crescimento é a complicação mais específica da DII pediátrica, causada pela combinação de ingestão calórica inadequada, aumento das perdas calóricas e inflamação ativa persistente da mucosa intestinal. Pacientes com DII comumente sofrem de desnutrição protéico-energética no diagnóstico e com flutuações durante todo o curso da doença. A perda de peso é uma característica comum no paciente com DII recém diagnosticada, particularmente na DC, e acompanha quase todas as recaídas. Aproximadamente 60% das crianças com DC apresentam perda de peso recente no momento do diagnóstico. Objetivos: verificar o estado nutricional de pacientes portadores de DC na adolescência, através da avaliação da composição corporal, dosagem de macro e micronutrientes e consumo alimentar. Casuística e Métodos: vinte e dois pacientes com DC em atividade (leve ou moderada), vinte e nove com DC em remissão e 35 parentes de 1º grau desses pacientes de mesma faixa etária (grupo controle) foram selecionados para participar prospectivamente. Antropometria (peso, estatura e índice de massa corporal (IMC) expressos em z escore, bioimpedância e estágio de Tanner), níveis séricos e a ingestão de macro e micronutrientes foram avaliados. Resultados: os adolescentes com DC em atividade seguidos pelo DC em remissão tiveram menor valor de escore z da estatura/idade e IMC para a idade, da massa magra e do estágio pubertário (p<0,05) do que o grupo controle. Os pacientes com DC apresentaram alterações significativas da qualidade da ingestão alimentar, principalmente calorias, proteínas, fibras e micronutrientes, refletindo nas dosagens séricas principalmente das vitaminas A e E (p<0,05). Conclusão: Adolescentes com DC, mesmo quando na fase de atividade da doença leve e inativa, apresentam riscos nutricionais, reforçando a importância da avaliação nutricional / Introduction: About 25 to 30% of patients with Crohns disease begin before age 20 years. The growth deficit is the most specific complication of pediatric CD, caused by a combination of inadequate energy intake, increased loss of calories and persistent active inflammation of the mucosa intestinal. Patients with IBD often suffer from protein-energy malnutrition in the diagnosis and fluctuations throughout the course of the disease. Weight loss is a common feature in patients with newly diagnosed IBD, particularly in CD, and accompanies almost all relapses. Approximately 60% of children with CD have a recent weight loss at diagnosis Objectives: We aimed to determine the nutritional status of patients with CD in adolescence, through the assessment of body composition, levels of macro and micronutrients and food consumption. Methods: Twenty-two patients with CD activity (mild or moderate), twenty-nine with CD in remission and 35 relatives of a degree of these patients the same age range (control group) were selected to enrolled prospectively . Anthropometry (weight, height and body mass index (BMI) expressed as z score, Tanner stage, and bioimpedance), blood levels and intake of macro and micronutrients were evaluated. Results: Adolescents with CD in activity followed by CD in remission had a lower value of z-score height / age and BMI for age, lean body mass and pubertal stage (p <0.05) than the control group. CD patients showed significant changes in the quality of food intake, especially calories, protein, fiber and micronutrients, mainly reflected in serum levels of vitamins A and E (p <0.05). Conclusion: Adolescents with CD, even when the stage of mild activity and inactive, have nutritional risks, reinforcing the importance of nutritional assessment

Foi desenvolvido um estudo observacional de corte transversal, com o objetivo de avaliar o status em Mg de pacientes com diabetes mellitus tipo 2. A amostra foi composta por 51 indivíduos de ambos os gêneros, com idade média de 53,6 ± 10,5 anos, os quais foram selecionados no Ambulatório de Endocrinologia do Hospital Universitário Onofre Lopes (HUOL) Natal/RN. O projeto foi aprovado pelos Comitês de Ética em Pesquisa do HUOL e da Faculdade de Ciências Farmacêuticas da USP. Os pacientes foram submetidos à avaliação antropométrica, dietética, do controle glicêmico, função renal, perfil lipídico, Mg plasmático, eritrocitário, urinário e dietético. Foi observada ingestão adequada de macronutrientes, contudo baixo consumo dietético de Mg e de fibras. Identificou-se, ainda, controle glicêmico e perfil lipídico insatisfatórios e função renal sem alterações significativas. Quanto ao status de Mg, 70,6 % da amostra apresentaram algum dos parâmetros bioquímicos relativos a este mineral abaixo dos valores de referência, sendo estes menores nos indivíduos que tinham mais complicações metabólicas e presença de microalbuminúria. Foram observadas correlações inversas entre o Mg plasmático com a glicemia de jejum (r = -0,281, p = 0,046) e a pós-prandial (r = -0,322, p = 0,021), e correlações positivas entre o Mg urinário com a glicemia de jejum (r = 0,291, p = 0,038), a circunferência abdominal (r = 0,288, p = 0,041) e o IMC (r = 0,282, p = 0,045). Deste modo, foram diagnosticadas alterações no status de Mg, as quais foram mais evidentes nos pacientes que tinham mais complicações, demonstrando a associação dos fatores relacionados com essa doença e o Mg. / A cross-sectional study was carried out to evaluate Mg status in patients with type 2 diabetes mellitus. The sample comprehended 51 individuals, both male and female, aged 53.6 ± 10.5 years, selected from the Endocrinology Clinic of the University Hospital Onofre Lopes (HUOL) in Natal/RN, Brazil. The project was approved by the Commission on Ethics in Research of the HUOL and Faculty of Pharmaceutical Sciences of the University of São Paulo. The patients were assessed concerning anthropometry, diet, blood-glucose control, kidney functioning and lipid profile, besides plasma, erythrocyte, urinary and dietary Mg. An adequate intake of macronutrients and a low consumption of dietary Mg and fibers were observed. Unsatisfactory blood-glucose control and lipid profiles, besides kidney functioning without significant alterations, were also observed. Concerning Mg status, 70.6% of the sample presented biochemical parameters for this mineral below the reference values, and such parameters were lower in individuals with more extensive metabolic complications and microalbuminury. Inverse correlations between plasma Mg with fasting (r = -0.281, p = 0.046) and postprandial plasma glucose (r = -0.322, p = 0.021), and a positive correlation between urinary Mg with fasting plasma glucose (r = 0.291, p = 0.038), waist circumference (r = 0.288, p = 0.041) and body weight index (r = 0.282, p = 0.045) were observed. Therefore, alterations in Mg status were detected in the studied population. Such alterations were more evident in patients with more extensive complications, thus demonstrating the association of factors related to this disease and Mg.

Orientadores: Elza Cotrim Soares, Sarah Monte Alegre / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T22:40:52Z (GMT). No. of bitstreams: 1 Fioravante_Milena_M.pdf: 3241616 bytes, checksum: 06a63b1444ac4ae94958e122343557c9 (MD5) Previous issue date: 2011 / Resumo: Os objetivos deste estudo foram avaliar a perda de peso, a composição corporal e o gasto energético de repouso de pacientes durante o tratamento da hepatite crônica C com Interferon peguilado (PEG IFN) e ribavirina, comparando com os resultados obtidos antes do tratamento. Após seleção de 56 indivíduos, com o diagnóstico de hepatite crônica C, encaminhados para o ambulatório de hepatites virais no Gastrocentro da Unicamp, o presente estudo avaliou, prospectivamente, 42 pacientes que preencheram os critérios previamente estabelecidos. O estudo foi realizado em dois tempos diferentes: o primeiro, antes de iniciar o tratamento, e o segundo na 12ª semana de tratamento que consistia no uso semanal de injeções de PEG IFN alfa-2a (180 ?g) ou PEG IFN alfa-2b (1,5 ?g/kg) e ribavirina (1000 ou 1250 mg/dia). A avaliação do estado nutricional incluiu avaliação antropométrica de peso e altura para cálculo do índice de massa corporal (IMC), circunferência do braço, dobra cutânea tricipital, circunferência muscular do braço e circunferência abdominal. A composição corporal foi analisada por bioimpedância elétrica (BIA), sendo estimados os valores de massa magra em kilogramas e porcentagem de gordura corporal. O gasto energético de repouso de cada indivíduo foi obtido pelo método da calorimetria indireta e o consumo alimentar avaliado por recordatório de 24 horas e questionário de freqüência alimentar. Os exames laboratoriais foram aproveitados do prontuário médico. A amostra de indivíduos, com média de idade igual a 46,3 anos, foi composta por 30 (71,4%) homens e 12 (28,6%) mulheres. No momento basal do estudo, 40,5% dos pacientes eram eutróficos, 33,3% tinham sobrepeso e 26,2% apresentavam algum grau de obesidade. Os indivíduos apresentaram perda de peso significativa durante o tratamento (79,1 ± 15,6 vs. 75,7 ± 15 kg; p<0,001) com conseqüente redução de IMC (27,5 ± 5,2 vs. 26,3 ± 5 kg/m²; p<0,001), circunferência do braço (32,6 ± 3,8 vs. 31,3 ± 3,7 cm; p<0,001), dobra cutânea tricipital (18 ± 8,1 vs. 15,6 ± 7 mm; p<0,001), circunferência muscular do braço (27 ± 2,9 vs. 26,5 ± 2,8; p=0,008) e circunferência abdominal (97,8 ± 14,3 vs. 95,5 ± 14,1 cm; p<0,001). A perda de peso deu-se com redução significativa de gordura corporal (29 ± 8,2 vs. 26,7 ± 7,8%; p<0,001), sem redução de massa magra (55,6 ± 10 vs. 55 ± 10,2 kg; p=0,210). Houve redução significativa no consumo alimentar (2131 ± 890 vs. 1834 ± 699 kcal; p=0,012), avaliado pelo recordatório de 24 horas. Porém, não houve alteração no gasto energético de repouso (1168,2 ± 303 vs. 1151,3 ± 249 kcal; p=0,670) e no gasto energético de repouso corrigido pela massa magra (20,9 ± 3,7 vs. 21,1 ± 3,7 kcal/kg; p=0,864). Em conclusão, os pacientes com hepatite crônica C submetidos ao tratamento com interferon e ribavirina apresentaram importante perda de peso, observando-se redução significativa do consumo calórico, porém sem alteração do gasto energético de repouso. Mais estudos podem ser necessários para tentar elucidar as verdadeiras causas de perda de peso nesses pacientes / Abstract: The aim of this study was to evaluate weight loss, body composition and resting energy expenditure (REE) in patients during treatment of chronic hepatitis C with pegylated interferon (PEG IFN) and ribavirin, compared with the results obtained before treatment. After selection of 56 individuals with chronic hepatitis C, this study evaluated prospectively 42 patients who met the established criteria. The study was conducted at two different times: the first, before starting treatment, and the second at 12 weeks of treatment, which consisted in using weekly injections of PEG IFN alfa-2a (180 ?g) or PEG IFN alfa-2b (1,5 ?g/kg) and ribavirin (1000 or 1250 mg/d). The assessment of nutritional status included anthropometric measurements of body height and weight to calculate body mass index (BMI), arm circumference, triceps skinfoldthickness, arm muscle circumference and waist circumference. Body composition was determined by bioelectrical impedance analysis (BIA) and estimated values of fat free mass (FFM) in kilograms and percentage of body fat. The REE of each individual was obtained by indirect calorimetry and food intake assessed by 24- hour recall and food frequency questionnaire. Laboratory tests were drawn from medical records. The sample of individuals consisted of 30 (71.4%) men and 12 (28.6%) women. At baseline, 40.5% were eutrophic, 33.3% were overweight and 26.2% had some degree of obesity. Subjects had significant weight loss during treatment(79.1 ± 15.6 vs. 75.7 ± 15 kg, p <0.001) with consequent decrease in BMI (27.5 ± 5.2 vs. ± 26.3 5 kg / m², p <0.001), arm circumference (32.6 ± 3.8 vs. 31.3 ± 3.7 cm, p <0.001), triceps skinfold thickness (18 ± 8.1 vs. 15, 6 ± 7 mm, p <0.001), arm muscle circumference (27 ± 2.9 vs. 26.5 ± 2.8, p = 0.008) and waist circumference (97.8 ± 14.3 vs. 95.5 ± 14.1 cm, p <0.001). This weight decrease was accompanied by significant decrease in body fat (29 ± 8.2 vs. 26.7 ± 7.8%, p <0.001) and there was no decrease in FFM (55.6 ± 10 vs. ± 55 10.2 kg, p = 0.210). There was significant decrease in energy intake (2131 ± 890 vs. 1834 ± 699 kcal, p = 0.012) assessed by 24-hour recall. However, there was no change in REE (1168.2 ± 303 vs. 1151.3 ± 249 kcal; p=0.670) and REE corrected for FFM (20.9 ± 3.7 vs. 21.1 ± 3.7 kcal/kg; p=0.864). Our study of individuals with hepatitis C treatment showed that these patients had a significant weight loss and this was not associated with changes in energy expenditure. However, we observed a significant reduction in energy intake, pointing to a possible need for intervention measures to reduce damage / Mestrado / Ciencias Basicas / Mestre em Clinica Medica

Orientadores: Luiz Roberto Lopes, Nelson Adami Andreollo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T04:23:57Z (GMT). No. of bitstreams: 1 Pereira_MaricildaRegina_D.pdf: 5651954 bytes, checksum: 24a42e9163bce75ebfbe2412960e9f8f (MD5) Previous issue date: 2012 / Resumo: O adenocarcinoma (Adenoca) possui etiologia diferente do carcinoma de células escamosas (CEC) e nenhum trabalho investigou se existe diferença na qualidade de vida (QV) e no estado nutricional no pós-operatório de doentes submetidos à esofagectomia por câncer ao comparar estes dois tipos histológicos. Os Objetivos deste estudo foram: 1) Avaliar e comparar a QV entre os doentes submetidos à esofagectomia por Adenoca e por CEC; 2) Avaliar e comparar o estado nutricional destes doentes e correlacionar com os resultados referentes à QV. Métodos: 24 doentes submetidos à esofagectomia, 10 por Adenoca e 14 devido ao CEC, no período de setembro de 2004 a agosto de 2008, foram avaliados com no mínimo cinco meses de pós-operatório por meio de questionário SF-36, da Avaliação Subjetiva Global (ASG), do Índice de Massa Corporal (IMC), da porcentagem de adequação do peso atual/habitual, do questionário de frequência alimentar qualitativo e de medidas bioquímicas. Também foi investigada a presença dos sintomas de disfagia, anorexia, dificuldade de mastigação, náuseas, vômitos, diarréia e constipação. Resultados: As avaliações aconteceram em média a 2 anos, 4 meses e 26 dias de pós-operatório, com a maioria do sexo masculino (91,6%), caucasiano (70,8%), casado (83,3%), média de idade de 58,79 anos (DP=10,3) e com média de estudo de 4,94 anos. O IMC médio para o grupo Adenoca foi 21,5 (DP=2,7) e para o CEC 21,0 (DP=2,8). Na avaliação do questionário SF- 36, a capacidade funcional destes doentes mostrou diferença significativa com um melhor resultado para o grupo Adenoca e nos demais domínios houve igualdade entre os grupos. Houve correlação entre a variável "saúde mental" e "limitação por aspectos emocionais" e entre "dor" e "limitação por aspectos físicos", em ambos os grupos. Estes doentes sofrem com sintomas clínicos de disfagia, anorexia, dificuldade de mastigação, náuseas, vômitos, diarréia e constipação, que não se relacionaram com a QV. Não houve diferença significativa entre o estado nutricional dos doentes ao se comparar os dados de IMC (p=0,6602), da ASG (p=0,9493), porcentagem de adequação do peso atual em relação ao habitual (p=0,1505) e presença de sintomas clínicos (p->0,05). No grupo Adenoca e no CEC, o estado nutricional segundo os aspectos dietéticos, a presença de sintomas clínicos e a contagem de linfócitos totais, mostrou-se comprometido. Houve associação significativa entre a ASG e o sintoma de disfagia (p=0,0232) e entre o IMC e o escore de dor (p=0,0361). Conclusão: O escore mais alto para capacidade funcional indicou que o doente com Adenoca foi capaz em um nível maior que o doente com CEC de realizar todo tipo de atividade física, incluindo as mais vigorosas. A disfagia mostrou-se como um importante sintoma clínico no pós-operatório e embora o estado nutricional destes doentes seja de eutrofia antropométrica, há risco nutricional em ambos os grupos / Abstract: Adenocarcinoma (AdenoCa) has different etiology when compared to squamous cell carcinoma (SCC), but no studies were found in the literature comparing these two histologic types of Ca regarding differences in quality of life (QOL) and nutritional status during the postoperative period of patients with esophagectomy for cancer. The Objectives of this study were twofold: 1) to evaluate and compare QOL among patients with esophagectomy for Adenoca and for SCC; and 2) to evaluate and compare patient's nutritional status against the results of their quality of life (QOL). Methods: 24 patients with esophagectomy, 10 for Adenoca and 14 for SCC, from September 2004 to August 2008 were evaluated after at least five months postoperatively using SF-36 Questionnaire, the Subjective Global Assessment (SGA), the Body Mass Index (BMI), percentage of adequacy between current and usual weight, the qualitative Food Frequency Questionnaire (FFQ) and biochemical test results. Also investigated were the presence of symptoms such as dysphagia, anorexia, difficulty chewing, nausea, vomiting, diarrhea and constipation. Results: The assessments took place at an average of 2 years, 4 months and 26 days postoperatively, being the patients mostly males (91.6%), Caucasian (70.8%), married (83.3%) and mean age of 58.79 years (SD=10.3), with an average of 4.94 years of study. The mean BMI for the Adenoca group was 21.5 (SD=2.7) and for SCC 21.0 (SD=2.8). The SF-36 results showed a significant difference in the "Functional Capacity" of these patients, with a better outcome for the Adenoca group while all other areas were equal for both groups. There was a correlation between the variables "Mental Health" and "Limitation on Emotional Aspects", as well as between "Pain" and "Limitation on Physical Aspects" in both groups. These patients suffered from clinical symptoms of dysphagia, anorexia, difficulty chewing, nausea, vomiting, diarrhea and constipation, which did not correlate with QOL. There was no significant difference between the nutritional status of patients when compared to the data for BMI (p=0.6602), the SGA (p=0.9493), percentage of adequacy between their current weight in relation to their usual weight (p=0.1505) and the presence of clinical symptoms (p>0.05). In both the Adenoca and SCC groups, nutritional status according to the nutritional value was compromised, as indicated by the total lymphocyte count and the presence of clinical symptoms. There was a significant correlation between SGA and dysphagia symptom (p=0.0232), as well as between BMI and the "Pain" score (p=0.0361). Conclusion: The higher score for "Functional Capacity" indicated that patients with Adenoca were able to perfom at a higher level all kinds of physical activity, including the most vigorous activities. Dysphagia appeared as an important clinical symptom in the postoperative period and, although the nutritional status of these patients is eutrophic anthropometric, there are nutritional risks for both groups / Doutorado / Fisiopatologia Cirúrgica / Doutor em Ciências

Submitted by Aline Batista (alinehb.ufpel@gmail.com) on 2018-05-18T21:47:06Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Paula_Piske.pdf: 961983 bytes, checksum: ae57fbc1bcc7c05e47d9a5a563096ccd (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2018-05-18T22:43:34Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Paula_Piske.pdf: 961983 bytes, checksum: ae57fbc1bcc7c05e47d9a5a563096ccd (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2018-05-18T22:43:42Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Paula_Piske.pdf: 961983 bytes, checksum: ae57fbc1bcc7c05e47d9a5a563096ccd (MD5) / Made available in DSpace on 2018-05-18T22:43:42Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Paula_Piske.pdf: 961983 bytes, checksum: ae57fbc1bcc7c05e47d9a5a563096ccd (MD5) Previous issue date: 2018-01-18 / Sem bolsa / A doença grave ou crítica refere-se à amplitude de condições clínicas ou cirúrgicas que apresentam risco à vida e que, na maior parte das vezes, exigem internação em Unidade de Terapia Intensiva (UTI). Após uma agressão, ocorrem várias alterações metabólicas e hormonais com o objetivo de manutenção da homeostase do organismo. Esse quadro geralmente provoca, dentre outros efeitos, resistência à insulina e catabolismo proteico, colocando o paciente em risco nutricional significativo. Nutrition Risk Screening – 2002 (NRS -2002) e o Nutrition Risk in Critically ill (escore NUTRIC) são ferramentas de triagem nutricional indicadas pela ASPEN (2016) para avaliarem parâmetros de risco nutricional. O NUTRIC é a primeira ferramenta desenvolvida para avaliar pacientes de UTI. Entretanto, a triagem nutricional detecta apenas a presença de risco de desnutrição. A literatura sugere então, a utilização da Avaliação Subjetiva Global (ASG), ainda um método considerado padrão-ouro para realização desse tipo de avaliação no ambiente hospitalar. A partir disso, o presente estudo teve como objetivo comparar o poder prognóstico em pacientes críticos, a partir da observação do risco de morte após 28 dias da admissão na UTI, do NUTRIC e ASG de forma isolada e combinada. / Severe or critical illness refers to the range of life-threatening clinical or surgical conditions that most often require hospitalization in an Intensive Care Unit (ICU). After an aggression, several metabolic and hormonal changes occur in order to maintain the body's homeostasis. This condition usually causes, among other effects, insulin resistance and protein catabolism, placing the patient at significant nutritional risk. Nutrition Risk Screening - 2002 (NRS -2002) and Nutrition Risk in Critical Ill (NUTRIC score) are nutritional screening tools indicated by ASPEN (2016) to evaluate nutritional risk parameters, being the first tool developed to evaluate ICU patients. However, nutritional screening only detects the presence of risk of malnutrition. The literature suggests, therefore, the use of the Global Subjective Assessment (SGA), still in a gold standard method to perform this type of evaluation in the hospital environment. From this, the present study had as objective to compare the prognostic power in critically ill patients, from the observation of the risk of death after 28 days of admission to the ICU, of NUTRIC and ASG in an isolated and combined way

Background Risk factors for chronic non-communicable diseases have been shown to track from childhood into adulthood. Cost-effective intervention starts with valid screening. The aim of this research was development and comparative validation of a dietary fat screener in grade six learners. Methods A pictorial, quantitative food frequency questionnaire type, scored dietary fat screener (test method), consisting of ten food categories associated with high fat intakes, was developed and subjected to developmental evaluations in the target group. Subsequently the test method was administered to learners of an urban middle-class school (Pretoria, South Africa). Test-retest reproducibility was checked in a random sub-sample. Two reference methods were used for comparison: Parental completion of the screener and a three-day food record by the children. Reliability testing of the test method involved measuring internal consistency and test-retest reproducibility. Credibility of energy intakes in the food record was checked. Mean cholesterol intake and percentage fat and saturated fat energy were determined. Comparative validation was based on correlations, mean differences and the Bland Altman method for continuous variables. Percentage agreement, kappa statistics and the McNemar tests were determined for categorical data, as were sensitivity, specificity and predictive values. Receiver operating characteristic curves were plotted. Results Sample: Out of 108 children, 39 (100%) were re-tested, 93 (86%) provided usable food records and 78 (72%) parents responded. Mean age was 148±4.4 months. Reliability: The test method was internally consistent. Test-retest reproducibility of portion size and frequency of intake estimates depended on the food category. No systematic error between administrations was noted as mean category and final score differences between the two administrations did not differ significantly from zero. A significant (r=0.36, P=0.02) correlation existed between administrations, but boys were characterised by random error and a lack of reproducibility (r=0.26, P=0.29), whilst for girls reproducibility could be established (r=0.58, P=0.01). Comparison to screener by parents: Children and parents did not agree in respect of reported portion size and frequency of intake. Parents had lower values for all scores. Correlation between children’s and parents’ final scores was 0.23 (P=0.04) (boys: r=0.13, P=0.46; girls: r=0.33, P=0.04), but the mean difference in final scores differed significantly from zero (P=0.0001). Classification was identical in 74% of cases, but when corrected for chance this agreement was also poor. Comparison to food record: The food record appeared to be a plausible reflection of energy intakes during the recording period. For girls a significant (P<0.05) correlation between test method final score versus cholesterol intake and energy from total and saturated fat was found. The sensitivity of the test method was very high (over 90%). Chance corrected agreement between test method classification and measures of fat intake from the food record was poor. Changing the cut-off of the test method final score could not achieve high sensitivity and high specificity simultaneously. Conclusion The dietary fat screener cannot yet be used as sole indicator of high fat intake in grade six learners. Until the discriminatory abilities have been improved, its value lies in creating awareness of high fat intakes and providing a food-based starting point for anticipatory guidance. / Thesis (PhD (Human Nutrition))--University of Pretoria, 2006. / Human Nutrition / unrestricted

Background: Malnutrition occurs in almost one-fifth of the elderly in nursing homes. Malnutrition may contribute to problems such as impaired immune system, impaired healing, decreased lung and muscle function, as well as prolonged care in hospitals and increased mortality. Energy and protein dense dietary is prescribed to prevent and treat malnutrition. Objective: To investigate how many of the elderly in nursing homes were malnourished or at risk of malnutrition and how many of them were prescribed energy and protein dense dietary. Method: The design of this study was retrospective descriptive, with quantitative approach. Data from completed Mini Nutritional Assessments and existing diet certificates were collected and reviewed using a review template. Results: According to the Mini Nutritional Assessments, 144 (70%) elderly were screened for malnutrition. Of these 14 (10%) were assessed to be malnourished and 66 (46%) were at risk of malnutrition. Energy and protein dense dietary was prescribed in 12 (86%) of those who were malnourished, while 21 (32%) elderly at risk of malnutrition were prescribed energy and protein dense dietary. The difference between the groups was significant (p= .000). Conclusion: A majority was screened with Mini Nutritional Assessment. Nutritional status showed a small proportion of malnourished, and the majority were at risk of malnutrition. Most of the malnourished were prescribed energy and protein dense dietary, while the recommendation to prescribe this diet at risk of malnutrition had low compliance.

Antecedentes: En los últimos años, la prevalencia de sobrepeso y obesidad en niños ha aumentado considerablemente en el mundo. Nuestro país no es ajeno a esta problemática, ya que las cifras de niños ≤ de 5 años diagnosticados con sobrepeso y obesidad sigue en aumento. Las causas que pueden desarrollar sobrepeso y obesidad son múltiples, estas son: alteraciones endocrinas, síndromes genéticos, factores psicológicos, factores ambientales, etc. Una de las alteraciones que puede predisponer a la ganancia de peso excesiva es el Síndrome de Down o la llamada también Trisomía 21. Metodología: Se evaluó por antropometría a 33 niños ≤ de 5 años diagnosticados con Síndrome de Down con indicadores talla/edad (T/E), peso/edad (PESO/EDAD), peso/talla (PESO/TALLA) y índice de masa corporal/edad (IMC/EDAD). Además, se evaluó conocimientos, actitudes y prácticas de diversos temas a 40 padres de familia de los niños, 8 profesores y 2 personal de servicio de la Guardería privada. Resultados: Según el indicador talla/edad, 76% de los niños evaluados presentaron diagnostico normal, mientras que el 21% presentaron retardo de crecimiento leve. Asimismo, según el indicador, IMC/EDAD se diagnosticaron 50% de los niños diagnóstico de sobrepeso, el 25% presento riesgo de sobrepeso y el 25% restante presentó diagnóstico de obesidad. Conclusiones: Se evaluó el estado nutricional antropométrico y bioquímico de los niños; además, se evaluó la calidad nutricional de las loncheras enviadas a los niños de aulas: Guardería y Pre-escolaridad. También, se evaluó evaluar el sistema actual del Servicio de Alimentación de la guardería, aportes nutricionales de refrigerios y almuerzos de la Guardería privada. / Background: In recent years, the prevalence of overweight and obesity in children has increased considerably in the world. Our country is no stranger to this problem, since the numbers of children under 5 years diagnosed with overweight and obesity continue to rise. The causes that can develop overweight and obesity are multiple, these are: endocrine alterations, genetic syndromes, psychological factors, environmental factors, etc. One of the alterations that may predispose to excessive weight gain is Down Syndrome or also called Trisomy 21. Methodology: We evaluated by anthropometry 33 children under 5 years diagnosed with Down Syndrome with indicators height / age (SIZE / AGE), weight / age (WEIGHT / AGE), weight / height (WEIGHT / SIZE) and body mass index / Age (BMI / AGE). In addition, knowledge, attitudes and practices of various subjects were evaluated to 40 parents of children, 8 teachers and 2 service personnel of the Nursery House Belén de Osma. Results: According to the size / age indicator, 76% of the children evaluated had a normal diagnosis, while 21% had mild growth retardation. Also, according to the indicator, BMI / AGE was diagnosed 50% of the children evaluated diagnosed of being overweight, 25% were at risk of being overweight and the remaining 25% presented a diagnosis of obesity. Conclusions: The anthropometric and biochemical nutritional status of the children was evaluated; In addition, the nutritional quality of lunchboxes sent to classroom children was evaluated: Nursery and Pre-school. Also, it was evaluated to evaluate the current system of the Nursery Food Service, nutritional contributions of snacks and lunches of the private Nursery. / Trabajo de investigación