4 research outputs found
Nutritional diagnosis : comparison between nutrition risk screening (NRS-2002) protocol and the nutrition assessment system of Hospital de ClÃnicas de Porto Alegre (AN-HCPA)
Introdução: A desnutrição hospitalar é altamente prevalente e continua pouco identificada. Ainda não há concordância sobre qual método melhor reflete a realidade dos pacientes hospitalizados. Objetivos: Identificar o nÃvel de concordância entre o diagnóstico nutricional para eutrofia e desnutrição quando os pacientes são avaliados pelos protocolos Nutrition Risk Screening (NRS-2002) e o utilizado no Hospital de ClÃnicas de Porto Alegre (AN-HCPA). Métodos: Estudo transversal em pacientes hospitalizados. As avaliações foram realizadas em momentos distintos, por pesquisadores diferentes. Resultados: Participaram 247 pacientes com idade de 50,7 ± 15,5 anos, e IMC de 21,31 ± 2,1 kg/m². O NRS-2002 encontrou 43% dos pacientes eutróficos e 57% desnutridos. O AN-HCPA identificou 50% dos pacientes com eutrofia e 50% com desnutrição. Dos 247 pacientes avaliados houve concordância em 93 pacientes no diagnóstico de eutrofia e em 110 pacientes no diagnóstico de desnutrição, com um coeficiente Kappa de 0,64 (IC 95% 0,55-0,74), p < 0,001. O AN-HCPA teve sensibilidade de 78,6% e especificidade de 86,9%, valor preditivo positivo de 88,7% e valor preditivo negativo de 75,6%. Conclusão: Os resultados demonstram que o protocolo AN-HCPA apresenta boa concordância com o método de referência NRS-2002, não considerando a gravidade da doença. Este protocolo é uma ferramenta rápida e de fácil utilização podendo ser recomendada como um instrumento sensÃvel para caracterizar o estado nutricional de eutrofia e desnutrição dos pacientes hospitalizados.Background: Malnutrition during hospitalization is highly prevalent and remains poorly identified. There is no agreement on the best method to assess the nutritional status of hospitalized patients. Objectives: To identify the agreement level of the eutrophy and malnutrition nutritional diagnosis when patients are evaluated using Nutrition Risk Screening (NRS-2002) protocol and the one used at Hospital de ClÃnicas de Porto Alegre (ANHCPA). Methods: Cross-sectional study of hospitalized patients. The evaluations were performed at distinct moments, by different researchers. Results: The study involved 247 patients of 50.7 ± 15.5 years and BMI of 21.31 ± 2.1 kg/m2. NRS-2002 classified 43% of patients with eutrophy and 57% with malnutrition. AN-HCPA identified 50% of patients with eutrophy and 50% with malnutrition. Among the 247 evaluated patients both systems agreed in 93 cases for eutrophy diagnosis and in 110 cases for malnutrition diagnosis, with Kappa coefficient of 0.64 (95% CI 0.55-0.74) p < 0.001. AN-HCPA presented a sensitivity of 78.6% and a specificity of 86.9%, positive predictive value of 88.7% and negative predictive value of 75.6%. Conclusion: The results showed that AN-HCPA has a good level of agreement with the reference method, but did not consider illness severity. This protocol is a fast and easy-to-use tool that can be recommended as a sensitive instrument to identify eutrophy and malnutrition nutritional status of hospitalized patients
Diagnóstico Nutricional: Comparação Entre os Instrumentos de Avaliação Nutrition Risk Screening (NRS-2002) e Avaliação Nutricional do Hospital de ClÃnicas de Porto Alegre (AN-HCPA)
Introduction: Malnutrition during hospitalization is highly prevalent and remains poorly identified. There is no agreement on the best method to assess the nutritional status of hospitalized patients. Objectives: To identify the agreement level of the nutritional diagnosis when patients are evaluated using Nutrition Risk Screening (NRS-2002) protocol and the one used at Hospital de ClÃnicas de Porto Alegre (AN-HCPA). Methods: Cross-sectional study of patients with malnutrition and eutrophy diagnoses. The evaluations were performed at distinct moments, by different researchers. Results: The study involved 247 patients of 50.7 ± 15.5 years and BMI of 21.31 ± 2.1 kg/m2. NRS-2002 classified 43% of patients with eutrophy and 57% with malnutrition. AN-HCPA identified 50% of patients with eutrophy and 50% with malnutrition. Both systems agreed in 93 cases (38%) for eutrophy diagnosis and in 110 cases (45%) for malnutrition diagnosis, with Kappa coefficient of 0.64 (95% CI 0.55-0.74) p < 0.001. AN-HCPA presented a sensitivity of 78.6% and a specificity of 86.9%, positive predictive value of 88.7% and negative predictive value of 75.6%. Conclusion: The results showed that AN-HCPA has a good level of agreement with the reference method and is a fast and easy-to-use tool that can be recommended as a sensitive instrument to identify the nutritional status of hospitalized patients.Introdução: A desnutrição hospitalar é altamente prevalente e continua pouco identificada. Ainda não há concordância sobre qual método melhor reflete a realidade dos pacientes hospitalizados. Objetivos: Identificar o nÃvel de concordância entre o diagnóstico nutricional para eutrofia e desnutrição quando os pacientes são avaliados pelos protocolos Nutrition Risk Screening (NRS-2002) e o utilizado no Hospital de ClÃnicas de Porto Alegre (AN-HCPA). Métodos: Estudo transversal em pacientes hospitalizados. As avaliações foram realizadas em momentos distintos, por pesquisadores diferentes. Resultados: Participaram 247 pacientes com idade de 50,7 ± 15,5 anos, e IMC de 21,31 ± 2,1 kg/m². O NRS-2002 encontrou 43% dos pacientes eutróficos e 57% desnutridos. O AN-HCPA identificou 50% dos pacientes com eutrofia e 50% com desnutrição. Dos 247 pacientes avaliados houve concordância em 93 pacientes no diagnóstico de eutrofia e em 110 pacientes no diagnóstico de desnutrição, com um coeficiente Kappa de 0,64 (IC 95% 0,55-0,74), p < 0,001. O AN-HCPA teve sensibilidade de 78,6% e especificidade de 86,9%, valor preditivo positivo de 88,7% e valor preditivo negativo de 75,6%. Conclusão: Os resultados demonstram que o protocolo AN-HCPA apresenta boa concordância com o método de referência NRS-2002, não considerando a gravidade da doença. Este protocolo é uma ferramenta rápida e de fácil utilização podendo ser recomendada como um instrumento sensÃvel para caracterizar o estado nutricional de eutrofia e desnutrição dos pacientes hospitalizados
Nutritional diagnosis : comparison between nutrition risk screening (NRS-2002) protocol and the nutrition assessment system of Hospital de ClÃnicas de Porto Alegre (AN-HCPA)
Introdução: A desnutrição hospitalar é altamente prevalente e continua pouco identificada. Ainda não há concordância sobre qual método melhor reflete a realidade dos pacientes hospitalizados. Objetivos: Identificar o nÃvel de concordância entre o diagnóstico nutricional para eutrofia e desnutrição quando os pacientes são avaliados pelos protocolos Nutrition Risk Screening (NRS-2002) e o utilizado no Hospital de ClÃnicas de Porto Alegre (AN-HCPA). Métodos: Estudo transversal em pacientes hospitalizados. As avaliações foram realizadas em momentos distintos, por pesquisadores diferentes. Resultados: Participaram 247 pacientes com idade de 50,7 ± 15,5 anos, e IMC de 21,31 ± 2,1 kg/m². O NRS-2002 encontrou 43% dos pacientes eutróficos e 57% desnutridos. O AN-HCPA identificou 50% dos pacientes com eutrofia e 50% com desnutrição. Dos 247 pacientes avaliados houve concordância em 93 pacientes no diagnóstico de eutrofia e em 110 pacientes no diagnóstico de desnutrição, com um coeficiente Kappa de 0,64 (IC 95% 0,55-0,74), p < 0,001. O AN-HCPA teve sensibilidade de 78,6% e especificidade de 86,9%, valor preditivo positivo de 88,7% e valor preditivo negativo de 75,6%. Conclusão: Os resultados demonstram que o protocolo AN-HCPA apresenta boa concordância com o método de referência NRS-2002, não considerando a gravidade da doença. Este protocolo é uma ferramenta rápida e de fácil utilização podendo ser recomendada como um instrumento sensÃvel para caracterizar o estado nutricional de eutrofia e desnutrição dos pacientes hospitalizados.Background: Malnutrition during hospitalization is highly prevalent and remains poorly identified. There is no agreement on the best method to assess the nutritional status of hospitalized patients. Objectives: To identify the agreement level of the eutrophy and malnutrition nutritional diagnosis when patients are evaluated using Nutrition Risk Screening (NRS-2002) protocol and the one used at Hospital de ClÃnicas de Porto Alegre (ANHCPA). Methods: Cross-sectional study of hospitalized patients. The evaluations were performed at distinct moments, by different researchers. Results: The study involved 247 patients of 50.7 ± 15.5 years and BMI of 21.31 ± 2.1 kg/m2. NRS-2002 classified 43% of patients with eutrophy and 57% with malnutrition. AN-HCPA identified 50% of patients with eutrophy and 50% with malnutrition. Among the 247 evaluated patients both systems agreed in 93 cases for eutrophy diagnosis and in 110 cases for malnutrition diagnosis, with Kappa coefficient of 0.64 (95% CI 0.55-0.74) p < 0.001. AN-HCPA presented a sensitivity of 78.6% and a specificity of 86.9%, positive predictive value of 88.7% and negative predictive value of 75.6%. Conclusion: The results showed that AN-HCPA has a good level of agreement with the reference method, but did not consider illness severity. This protocol is a fast and easy-to-use tool that can be recommended as a sensitive instrument to identify eutrophy and malnutrition nutritional status of hospitalized patients
Mechanistic insights into light-driven allosteric control of GPCR biological activity
International audienceG protein-coupled receptors (GPCR), including the metabotrobic glutamate 5 receptor (mGlu5), are important therapeutic targets and the development of allosteric ligands for targeting GPCRs has become a desirable approach toward modulating receptor activity. Traditional pharmacological approaches toward modulating GPCR activity are still limited since precise spatiotemporal control of a ligand is lost as soon as it is administered. Photopharmacology proposes the use of photoswitchable ligands to overcome this limitation, since their activity can be reversibly controlled by light with high precision. As this is still a growing field, our understanding of the molecular mechanisms underlying the light-induced changes of different photoswitchable ligand pharmacology is suboptimal. For this reason, we have studied the mechanisms of action of alloswitch-1 and MCS0331; two freely diffusible, mGlu5 phenylazopyridine photoswitchable negative allosteric modulators. We combined photochemical, cell-based, and in vivo photopharmacological approaches to investigate the effects of trans–cis azobenzene photoisomerization on the functional activity and binding ability of these ligands to the mGlu5 allosteric pocket. From these results, we conclude that photoisomerization can take place inside and outside the ligand binding pocket, and this leads to a reversible loss in affinity, in part, due to changes in dissociation rates from the receptor. Ligand activity for both photoswitchable ligands deviates from high-affinity mGlu5 negative allosteric modulation (in the trans configuration) to reduced affinity for the mGlu5 in their cis configuration. Importantly, this mechanism translates to dynamic and reversible control over pain following local injection and illumination of negative allosteric modulators into a brain region implicated in pain control