Suplementação nutricional de creatina e saúde gastrintestinal: um estudo de revisão

Nos últimos anos, os pesquisadores têm investigado o potencial papel terapêutico da suplementação de creatina como adjuvante no tratamento ou na prevenção de doenças. Tem sido sugerido que a suplementação de creatina pode ser valiosa em doenças inflamatórias intestinais devido à sua capacidade postulada de modular a resposta imune e reduzir a dor induzida por inflamação. O trabalho foi realizado objetivando a análise da suplementação com creatina aprovada na literatura científica e que pode ser utilizada visando melhoria na inflamação e doenças inflamatórias intestinais. Uma pesquisa nos sites Tripdatabase, Google Schol, LILACS, Pubmed e Scielo foi conduzida para identificar artigos relevantes sobre a o uso terapêutico da suplementação nutricional da creatina, avaliando os possíveis benefícios por indivíduos, em doenças gastrintestinais. A suplementação com monohidrato de creatina demonstrou ser segura e muito eficiente para saúde gastrintestinal, tendo em vista a creatina pode diminuir os marcadores de inflamação e reduzir à sensibilidade à dor, associada à inflamação, modulando a formação de barreira epitelial do intestino

Diretrizes que norteiam a prática clínica do nutricionista

Os documentos técnicos, chamados de Diretrizes, Consensos ou Posicionamentos são um norte para prática clínica de profissionais da área da saúde. A diretriz clínica está constituída por afirmações sistematicamente desenvolvidas para auxiliar profissionais de saúde e pacientes na tomada de decisão sobre a forma mais adequada de cuidado com a saúde em condições específicas, incluindo a Nutrição. O objetivo da pesquisa foi mapear os documentos técnicos das especialidades e áreas de atuação médica que descrevem sobre o tratamento não medicamentoso que envolve a nutrição como dietoterapia, intervenções nutricionais de interesse para a prática clínica do nutricionista. A pesquisa destes documentos foi realizada nos sites do Conselho Federal de Medicina e nas respectivas sociedades de especialidades e áreas de atuação médicas, segundo a lista da Resolução CFM nº 2.221/2018. Após localizar o documento (diretriz, consenso ou posicionamento) por especialidade ou área de atuação, foi realizada uma busca minuciosa de termos relacionados à nutrição que foram previamente definidos, tais como: nutrientes, desnutrição, enteral, parenteral, alimento, alimentação, peso, dieta, IMC, refeição, obesidade, padrão de dieta, recomendações nutricionais de macronutrientes e micronutrientes, compostos bioativos e suplementos. Do total de 114 sites de entidades representativas das especialidades (n= 55) e áreas de atuação médica (n= 59), foram encontrados apenas 41 documentos técnicos (36%) que se relacionam diretamente à nutrição. Destes 41 documentos selecionados, 28 são diretrizes (68,29%), 09 consensos (21,95%) e 04 posicionamentos (9,75%).  Assim, percebe-se que menos da metade (41 | 36%) dos sites mapeados abordam a nutrição e não são totalmente completos em recomendações nutricionais, abordagem terapêutica dietoterápica, o que demonstra ser insuficiente para uma prática clínica mais assertiva e com embasamento científico. Por meio deste mapeamento das diretrizes, consensos e posicionamentos disponíveis, conclui-se que, embora o estado nutricional, a alimentação adequada e o tratamento não medicamentoso por meio da nutrição exerce papel fundamental para a saúde da população, as recomendações ainda não são suficientemente profundas para o direcionamento da prática clínica do nutricionista, sendo esta pesquisa de suma importância para que os profissionais da área de Nutrição questionem a necessidade de elaboração de documentos técnicos específicos para a Nutrição, podendo ser amplamente consultados para embasamento da prática clínica

Os malefícios da utilização de telas eletrônicas na infância: uma revisão integrativa da literatura

Introduction: The incorporation of technology into children's routine originated the so-called cyber-childhood, bringing with it advantages, as well as harms that must be debated, thus, questions arise about adequate screen time and the consequences of exacerbated use. Objective: To analyze the scientific literature on the harmful effects of using electronic screens in childhood. Methodology: This is an integrative literature review, where the Health Sciences Descriptors (DeCS/MeSH) were used: screen time; child and child development combined with the Boolean AND operator. The research was carried out in July 2023, in the databases: Medical Literature Analysis and Retrievel System Online (MEDLINE) Latin American Literature of Health Sciences (LILACS) and PubMed, in the period from 2018 to 2023. Results: The final selection had 17 articles that met the inclusion and exclusion criteria determined and were categorized into: year of publication; journal title; article title; language and main results. Discussion: The analysis of the selected articles showed that the repercussions caused by exposure to screens are presented in different ways, paying attention to: language development, cognition, socio-emotional aspects, attention, eating habits, sleep, school performance, Body Mass Index, among others. It also brings co-visualization as an interactive means of exposure to the screen. Final considerations: The study revealed an association between screen use time and consequent harm that clearly affects the neuropsychomotor development of these children, relating to sedentary lifestyle, introversion, poor sleep quality and the manifestation of diseases such as obesity, depression and anxiety.Introdução: A incorporação da tecnologia na rotina das crianças originou a chamada cyber-infância, trazendo consigo vantagens, bem como malefícios que devem ser debatidos, assim, surgem questionamentos sobre o tempo de tela adequado e as consequências do uso exacerbado. Objetivo: Analisar a literatura científica sobre os malefícios do uso de telas eletrônicas na infância. Metodologia: Se trata de uma revisão integrativa da literatura, onde utilizou-se os Descritores de Ciências da Saúde (DeCS/MeSH): screen time; child e child development combinados com o operador booleano AND. A pesquisa foi realizada em Julho de 2023, nas bases de dados: Medical Literature Analysis and Retrievel System Online(MEDLINE) Literatura Latino-Americana de Ciências da Saúde (LILACS) e PubMed, no período de 2018 a 2023. Resultados: A seleção final contou com 17 artigos que atenderam aos critérios de inclusão e exclusão determinados e foram categorizados em: ano de publicação; título do periódico; título do artigo; idioma e principais resultados. Discussão: A análise dos artigos selecionados demonstrou que as repercussões causadas por exposição a telas se apresentam de diferentes formas, atentando: o desenvolvimento da linguagem, cognição, aspectos socioemocionais, atenção, hábitos alimentares, sono, rendimento escolar, Índice de Massa Corporal, entre outros. Ainda traz a covisualização como um meio interativo de exposição à tela. Considerações finais: O estudo revelou associação entre o tempo de uso de telas e consequentes malefícios que afetam de forma clara o desenvolvimento neuropsicomotor dessas crianças, relacionando-se com sedentarismo, introversão, má qualidade de sono e a manifestação de doenças tais como obesidade, depressão e ansiedade

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Qualidade de vida de indivíduos com HIV: revisão integrativa / Quality of living of individuals with HIV integration review

 A qualidade de  vida de pacientes vivendo com HIV/AIDS é essencial, tendo em vista o caso específico dos adolescentes é ainda mais importante porque o jovem além de lidar com a resistência e a aceitação da doença, deve também enfrentar os conflitos da puberdade.O presente trabalho tem como objetivo realizar uma revisão integrativa em relação a qualidade de vida dos pacientes com HIV. Trata-se de um estudo de revisão integrativa realizado no período de 2016 a 2017, utilizando-se o banco de dados Medline e Lilacs. Apesar do impacto da infecção pelo HIV/AIDS na saúde psicológica e nas relações sociais dos indivíduos infectados, assim como no domínio físico, o uso da TARV provocou consequências positivas na saúde psicológica, proporcionando a desconstrução da ideia de morte advinda ao diagnóstico de portador do HIV/AIDS e a construção de melhores perspectivas de vida. A adesão ao tratamento em HIV/AIDS está relacionada a um aumento da sobrevida e de sua qualidade. Porém deve-se respeitar a posição pessoal do portador para fazer ou não o tratamento

Tuberculose pulmonar: perfil epidemiológico do sertão Pernambucano, Brasil / Pulmonary tuberculosis: epidemiological profile of sertão Pernambucano, Brazil

Atualmente, observa-se que a tuberculose pulmonar constitui um importante problema de Saúde Pública no mundo, uma vez que esse agravo apresentou, em 2015, 10,4 milhões de casos, dos quais, mais de um milhão de pessoas vieram a óbito. Sob essa perspectiva, o presente artigo tem como objetivo traçar um perfil epidemiológico dos casos de Tuberculose Pulmonar notificados no município de Serra Talhada, entre os anos de 2007 a 2017. Foi realizado um estudo de série histórica observacional do tipo transversal, no intervalo de tempo de 2007 a 2017.  No período investigado o número de casos de tuberculose pulmonar foi de 246 casos, o local que teve a maior prevalência foi Serra Talhada, 287 por 100 mil habitantes. Diante dos dados apresentados, é imprescindível concluir, portanto, que esse estudo corrobora o perfil epidemiológico brasileiro para a Tuberculose Pulmonar, o qual indica variabilidade nos índices de acometimento durante o período analisado

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier