International Journal of Nutrology
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Síndrome de Realimentação
Get PDFThe feeding of malnourished patients should be surrounded with special caution. The refeeding syndrome characterized by neurological, respiratory symptoms, arrhythmias and heart failure, a few days after refeeding. It occurs as a result of nutritional support (oral, enteral or parenteral) in patients severely malnourished. The monitoring of the metabolic parameters and electrolyte levels before the beginning of nutritional support and periodically during the supply must be based on protocols, the state of the underlying disease and duration of therapy. Multidisciplinary team of nutritional therapy can guide and educate other health professionals in the prevention, diagnosis and treatment of this syndrome.
A alimentação de pacientes subnutridos deve ser cercada de cautela especial. A síndrome de realimentação caracteriza-se por alterações neurológicas, sintomas respiratórios, arritmias e falência cardíacas, poucos dias após a realimentação. Ocorre em consequência do suporte nutricional (oral, enteral ou parenteral) em pacientes severamente desnutridos. O acompanhamento de parâmetros metabólicos e de níveis de eletrólitos antes do início do suporte nutricional e periodicamente durante a alimentação deve ser baseado em protocolos, no estado da doença subjacente e na duração da terapia. Equipe multidisciplinar de terapia nutricional pode orientar e educar outros profissionais de saúde na prevenção, diagnóstico e tratamento dessa síndrome
A cirurgia bariátrica e a perda óssea
Get PDFIn the last few years, a significant increase has happened in the prevalence of obesity, which is considered a chronic disease. Purpose: a literature review to be held between bariatric surgery and bone loss. Method: descriptive, qualitative research with literature review. The data were surveyed from articles and dissertations related to the bariatric surgery. Conclusion: it was observed that the bariatric surgery is associated to the alterations in the bone metabolism, bone loss and to a possible increase of fractures. Thus, it is important to hold a nutritional intervention joined to the regular supplementation of D vitamin and calcium, besides a healthy life
Avaliação do estado nutricional de pacientes atendidos em ambulatório de neuropsiquiatria infantil
Get PDFObjective: This study set out to identify the prevalence of nutritional disorders in patients treated at a children’s neuropsychiatric day clinic, based on data from medical records in April 2013 - July 2015. Methods: A cross-sectional descriptive study of prevalence. Research project approved by the Research Ethics Committee. Data obtained for age, gender, weight and height, diagnosis and current medication. Body mass index (BMI = weight/height2) calculated by World Health Organization references. Results: The study analysed medical records of 381 patients, aged between 3 and 19 years (mean = 11), X males and Y females. The prevailing nutritional status was thinness, especially among patients with attention deficit hyperactivity disorder (ADH). Overweight and obesity were more prevalent in mentally retarded patients. The most prevalent diagnoses were ADHD (n = 180; 47.49%). ADHD was the most prevalent in males (n= 147; 54,8 %) and in females (n= 34; 30,6%). 0,5% of patients were preschoolers, 26,3% were students and 73,2% adolescents. In terms of medication, 21.2% (n = 81) were taking Methylphenidate while 11.8% (n = 45) were taking Risperidone. Conclusion: In this population, thinness is most prevalent, while overweight and obesity prevail in the healthy population of this same age group. It suggested that further studies on the nutritional status of children and adolescents with psychiatric disorders be carried out with a view to drafting multidisciplinary care strategies encompassing nutritional aspects to provide effective and comprehensive care to these patients
Uso abusivo de aditivos alimentares e transtornos de comportamento: há uma relação?
Get PDFIntroduction: Food additive is any ingredient added without the purpose of nurturing, employed during any stage of food production to modify physical, chemical, biological or sensory features. The earliest record of its use was in ancient Egyptian’s papyri, about 1500 BC. Spices were used to turn meals more attractive. The consumption of these elements has intensified considerably - in the last 50 years it increased 500% - and, therefore, doubts about their safety have emerged. There is contradiction between studies and their pathological effects, but those who demonstrate pathological effects highlight the behavioral disorders as the most relevant. Objective: To identify if there is any risk in the use of food additives relative to behavior disorders. Methods: A systematic review of literature between 2000 and 2015, using the databases SciELO, PubMed, Lilacs, MedLine was performed. The methodological evaluation of the articles was implemented using the Critical Appraisal Skills Programme (CASP). A total of 13 articles were included in this review. Results: Attention deficit hyperactivity disorder was the most prevalent behavioral disorder. Children appear as a vulnerable group because of the potential consumption of food containing additives, especially dyes, and also because of the immaturity of their immune and digestive systems. Discussion: Many studies not only correlate food additives to behavioral disorders but also consider their removal from the diet as a prophylactic and therapeutic treatment of hyperactive behavior. Conclusion: In Brazil, the relationship between food additives and behavioral disorders was not yet investigated. Besides, there seem to be a negative influence of existing research results, often distorted by the industry, which masks the amount of additives used. However, the effects on the consumption of these ingredients can no longer be ignored, and this study should provide data for the design of food and nutrition strategies, to protect the population and to promote public health
A importância do magnésio na doença cardiovascular
Get PDFThis paper is a literature review that aimed at describing the importance of magnesium in cardiovascular disease. Bibliographic compilations about original scientific articles and literature reviews on indexed journals were carried out. The work has described that magnesium ion is involved in over 300 enzymatic reactions with anti-inflammatory, anti-oxidant and cell growth modulating properties in order to reduce oxidative stress. Magnesium deficiency is associated to metabolic syndrome, hypertension, congestive heart failure, diabetes mellitus and arrhythmias. It has been concluded that magnesium, because of its role of relaxing the smooth muscles of cardiac vessels, dilates the coronary arteries improving myocardial contractility, reducing the risks of coronary spasms and inhibiting platelet aggregation by increasing the relationship between prostacyclin/ thromboxane. Due to its dilating effect, it reduces blood pressure and is responsible for stabilizing the cardiac rhythm. Therefore, it plays an important role in cardiovascular diseases’
Descrição do Tempo de Jejum Pré-Procedimentos em um Serviço de Oncologia Pediátrica
Get PDFIntroduction: Shortening the duration of preoperative fasting is one of the current nutritional cares related to surgical patients. The metabolic response to surgical trauma may be enhanced by fasting. The description of the actual time of pre-procedure fasting allows us to review old paradigms. Therefore, the aim of this study was to describe the practices in relation to the pre-procedure fasting time in a Pediatric Oncology Unit. Methods: Retrospective descriptive study, consultation of medical records, including patients aged between zero and 18 years who were admitted to the Pediatric Oncology Unit, diagnosed with cancer, who started fasting for tests or elective surgical procedures between July and September of 2014. Results: A total of 30 patients, 57% female, with an average age of 9 years (± 5 years) were included. The most common diagnoses were leukemia (40%), lymphoma (13%) and osteosarcoma (13%) and neuroblastoma (13%). The most common procedures performed were: placement of totally implantable catheter, bone marrow biopsy and intrathecal chemotherapy. All patients had a preprocedure fasting time greater than or equal to 6 hours; 66% of these patients fasted for 10h or more hours, and 23% had to fast for 12 hours or more. Conclusion: No patient had their pre-procedure fasting according to current guidelines. Our expectation is that abbreviation of preoperative fasting be considered and that it reduce physical symptoms and metabolic changes
Nutritional Profile of Patients in Hemodialysis of the Hospital Universitário Ciências Médicas - Minas Gerais
Get PDFObjectives: To evaluate the nutritional status of hemodialysis (HD) patients. Methods: A cross-sectional study was performed in all patients on HD at a single center. Results: We studied 72 patients, male (57%) and 45.8% between 45 and 64 years old. The most frequent etiology was systemic arterial hypertension (50.0%) and diabetes (20.8%). KT/V > 1.2 was found in 88.8% of the patients, and phosphorus level > 5.5 mg/dL in 25%. The malnourished patients classified by body mass index (BMI) < 25 kg/m2 (66.67%), arm muscle circumference (WBC) index (84.72%) and albumin (≤ 4.0 g/dL) (28,8%), and 22,22% use a specific oral nutritional supplement for hypercaloric hyperproteic dialytic patients, provided by the hemodialysis service. The mean interdialytic weight gain (GPIDm) was < 2.5kg in 58.3% and the relative interdialytic weight gain (GPIDr) was < 4.5% in 75.0% of the patients. There was a significant association between GPIDm and CMB, patients with lower GPIDm (≤ 2.5 kg) tended to have more mild or moderate malnutrition (p = 0.003). No differences were observed by time in hemodialysis in relation to age, interdialytic weight gain, laboratory and anthropometric measurements. Conclusion: The nutritional assessment by BMI was in agreement with the Brazilian literature. By CMB, most were classified as malnourished, which differs from albumin, in that only ∼ 30% were malnourished. The results show the importance of supplementation for this population. We have seen that > 75% of the patients are within the ideal GPIDr (< 4.5% of the dry weight). The dialysis time did not affect the nutritional evaluation parameters
A Nutrologia brasileira perde um de seus maiores expoentes: Faleceu o Professor Doutor Domingo Marcolino Braile
Get PDFNutrir é, de acordo com o vernáculo, “prover de alimento, de substâncias ou elementos nutritivos, alimentar”. O Nutrólogo “avalia os benefícios e malefícios causados pela ingestão dos nutrientes, de modo a auxiliar na manutenção da saúde e na redução de riscos de doenças”. E já dizia Platão que: “o conhecimento é o alimento da alma”.
Prezados leitores, unamos estes três conceitos e chegaremos, sem dificuldade, à conclusão de que o Prof. Dr. Domingo Marcolino Braile foi, de fato, um grande expoente na área da Nutrologia.
Com seu dinamismo e liderança, sempre estimulou em todos a busca do conhecimento. Atento aos avanços tecnológicos, foi pioneiro na aplicação da ciência no desenvolvimento humano. Cuidar do corpo e alimentar a alma foi um de seus lemas principais.
Deixa um currículo invejável tendo passado com brilhantismo por várias áreas. Foi um autor prolífico, um colaborador incansável, um professor amoroso, um mestre da cirurgia. Repartiu o pão do conhecimento com todos os que tiveram o privilégio de compartilhar da sua presença. Deu também inestimáveis contribuições para a reativação de nossa Revista, tendo sido um dos Editores Assistentes.
Infelizmente, em decorrência de um comprometimento crônico e progressivo de seu estado de saúde, veio a falecer em março de 2020, deixando uma enorme lacuna que dificilmente será preenchida.
Fica aqui nossa sincera homenagem àquele que nutriu a todos nós com um dos melhores alimentos: o Conhecimento
Epidemiological and Clinical Characteristics of Pediatric and Adolescent Obesity Enrolled in a Tertiary Referral Center
Get PDFObjective: To describe some demographic, clinical and laboratory characteristics of obese children and adolescents admitted in an obesity ambulatory of a referral center located in the southeastern region of Brazil. Methods: This is a cross-sectional and observational study and the data (age, gender, type of delivery, birthweight, age of birth, breastfeeding, laboratory tests and maternal body mass index [BMI]) were collected from medical records. Results: The study included 89 patients, of which 45 (50.6%) were male. The mean age was 68.9 months, 50 (55.6%) were first-born, 51 (57.3%) were exclusively breastfed during the 1st 6 months of life, and 18 (20.1%) did not receive breast milk. The mean age of the mothers was 29 years old, 87 (98%) did prenatal assistance, and 69 (77.6%) had a BMI > 25 kg/m2. The results also showed that cesarean delivery (42.6%), low birthweight (6.7%), prematurity (8.7%) and early introduction of artificial food (20.1%) was not predominant among the patients. A total of 25 (28%) subjects had total cholesterol > 170 mg/dL, 35 (39.3%) with LDL-cholesterol > 110 mg/dL, 34 (38.2%) had HDL-cholesterol < 40 mg/dL, and 6 (6.7%) with triglycerides > 130 mg/dL. All of the patients had at least one altered biochemical test. Conclusion: Healthy lifestyle promotion should be included in every pediatric primary care program, and all children should receive counseling about healthy nutrition and physical activity since birth. Reducing childhood obesity is a major public health priority and primary prevention programs are a critical part to address the problem