Curcumin supplementation in the treatment of patients with cancer: a systematic review

Feeding with high levels of phytochemicals, including curcumin, may be a therapeutic option for diseases such as cancer which is a public health problem. The aim of this study was to systematically review the results of clinical trials investigating the effect of oral curcumin supplementation on anti-inflammatory and antioxidant profiles, reduction of PSA levels and degree of dermatitis in radiotherapy treatment in cancer patients. The review was carried out based on the items of the PRISMA Statement. A bias risk assessment was performed according to Cochrane Collaboration criteria. Six studies met the eligibility criteria and were included in the systematic review. The results of this study are based on those obtained in the literature on the effect of curcumin on the anti-inflammatory profile, on reducing dermatitis, on PSA alteration and on anti-oxidant profile for a total of 450 individuals, comprising 259 in the intervention group and 191 in the control group. Some studies have reported improvement in biochemical and clinical indicators, with limited adverse effects and good tolerance. It was not possible to determine, with the desired degree of evidence, the effect of curcumin supplementation in the treatment of cancer patients. It is important to consider the great heterogeneity and methodological weaknesses of the studies, and that it was not possible to perform a meta-analysis of the data available in the literature

Metabolic syndrome in patients with chronic hepatitis C virus genotype 1 infection who do not have obesity or type 2 diabetes

OBJECTIVE: The individual components of metabolic syndrome may be independent predictors of mortality in patients with liver disease. We aimed to evaluate the prevalence of metabolic syndrome and its related components in hepatitis C virus-infected patients who are not obese and do not have type 2 diabetes. METHODS: This cross-sectional study included 125 patients infected with hepatitis C virus genotype 1. Metabolic syndrome was defined according to the International Diabetes Federation. Anthropometric data were measured according to standardized procedures. Bioimpedance analysis was performed on all patients. RESULTS: Metabolic syndrome was diagnosed in 21.6&#37; of patients. Of the subjects with metabolic syndrome, 59.3&#37; had hypertension, 77.8&#37; had insulin resistance, 85.2&#37; were overweight, 48.1&#37; had a high waist circumference, 85.2&#37; had an increased body fat percentage, and 92.3&#37; had an elevated waist:hip ratio. In the bivariate analysis, female sex (OR 2.58; 95&#37; CI: 1.09-6.25), elevated gamma-glutamyl transferase (&#947;GT) (OR 2.63; 95&#37; CI: 1.04-7.29), elevated fasting glucose (OR 8.05; 95&#37; CI: 3.17-21.32), low HDL cholesterol (OR 2.80; 95&#37; CI: 1.07-7.16), hypertriglyceridemia (OR 7.91; 95&#37; CI: 2.88-22.71), elevated waist circumference (OR 10.33; 95&#37; CI: 3.72-30.67), overweight (OR 11.33; 95&#37; CI: 3.97-41.07), and increased body fat percentage (OR 8.34; 95&#37; CI: 2.94-30.08) were independent determinants of metabolic syndrome. Using the final multivariate regression model, similar results were observed for abdominal fat (OR 9.98; 95&#37; CI: 2.63-44.41) and total body fat percentage (OR 8.73; 95&#37; CI: 2.33-42.34). However, metabolic syndrome risk was also high for those with blood glucose >5.55 mmol/L or HDL cholesterol <0.9 mmol/L (OR 16.69; 95&#37; CI: 4.64-76.35; OR 7.23; 95&#37; CI: 1.86-32.63, respectively). CONCLUSION: Metabolic syndrome is highly prevalent among hepatitis C virus-infected patients without type 2 diabetes or obesity. Metabolic syndrome was significantly associated with hypertension, insulin resistance, increased abdominal fat, and overweight

Aspectos metodológicos e desafios da Coorte On-line Comportamento Alimentar e Saúde Mental (COCASa) de docentes e discentes universitários durante a pandemia da COVID-19

O distanciamento social adotado para controle da COVID-19 obrigou Instituições de Ensino Superior (IES) a aderirem a novas estratégias para realização das atividades acadêmicas e muitas pesquisas passaram a ser realizadas em ambientes virtuais. O objetivo deste artigo é descrever os aspectos metodológicos e principais desafios enfrentados para a execução do projeto COCASa, um estudo de coorte on-line sobre comportamento alimentar e saúde mental de docentes e discentes de IES do Brasil. O estudo foi iniciado em julho de 2020 e acompanhará os participantes por dois anos. Adotou-se amostragem não probabilística estratificada proporcional com a utilização de escalas, de inquérito alimentar e de questões estruturadas elaboradas pela equipe do projeto. Entre os participantes do baseline, 4.074 discentes e 2.210 docentes iniciaram o questionário e, respectivamente, 76,8% e 85,1% finalizaram o preenchimento. Em ambos os grupos, a maior participação foi de mulheres (docentes: 66,7% e discentes: 76,2%) e residentes nas regiões Nordeste (docentes: 37% e discentes: 50,9%) e Sul (docentes: 27,1% e discentes: 22,5%) do Brasil. A pesquisa on-line amplia a possibilidade de recrutamento de participantes e alcança limites territoriais com menor demanda por financiamento. Durante a pandemia da COVID-19, o uso do ambiente virtual tornou-se uma estratégia viável e acessível para a manutenção das atividades de pesquisa, configurando-se como uma provável tendência a ser adotada pela comunidade científica

Desigualdade, pobreza e condições de saúde e nutrição na infância no Nordeste brasileiro

Estudo transversal, envolvendo 2.001 crianças das áreas rural e urbana de dez municípios da Bahia, Brasil. Avalia-se a relação entre os gradientes da desigualdade e os fatores do ambiente familiar, de saúde e nutrição, utilizando-se a regressão logística multinomial multivariada. As crianças do tercil intermediário das condições de vida e aquelas do tercil mais pobre têm chances significantes e crescentes de viverem na área rural, em domicílio chefiado pela mulher, ter o pai desempregado, mãe com baixa escolaridade, de dormir com mais de uma pessoa na mesma cama, déficit linear grave e consumir retinol abaixo da mediana. A existência de mais de uma criança no domicílio, ser portadora de déficit ponderal e ter o consumo de lipídeo abaixo da mediana foram eventos também significantes para as crianças mais pobres. A anemia foi identificada entre as crianças do tercil intermediário. A desigualdade expõe as crianças a chances crescentes de inadequado estado de saúde e nutrição. Políticas de saúde podem implementar medidas emergenciais no sentido de minimizar os males impostos pela desigualdade à saúde e nutrição na infância

Two distinct nutritional assessment tools have dissimilar outcomes in a sample of older adult patients with cancer

Introduction: Malnutrition is strongly associated with negative outcomes in aged populations with cancer. Several studies have compared outcomes of nutritional screening tools, but knowledge covering older adult’s patients with cancer specifically remains limited. The aim of this study was to compare the outcomes of two tools, the Patient-Generated Subjective Global Assessment (PG-SGA) versus the Mini Nutritional Assessment (MNA) for this population. Methodology: Cross-sectional study with 432 participants who consented to participate and were enrolled at the admission to medical and surgical wards at a tertiary referral hospital. The participant's nutritional statuses were simultaneously assessed using the PG-SGA and the MNA, and the outcomes compared using the kappa statistical test. The Receiver Operating Characteristic Curve (ROC) was employed to calculate the MNA sensitivity, specificity, positive and negative predictive values, compared with PG-SGA. Results: Prevalence of well-nourishment was observed in 62.5% and 61.1% of the participants detected by PG-SGA and MNA, respectively. Both tools concurred moderately (kappa=0.453). Importantly, there were significant differences in the diagnosis of malnutrition (7.6% vs. 4.6%, p=0.000). The MNA showed sensitivity of 72.2% and specificity of 75.9% in detecting well-nourishment for the population investigated. Conclusion: The MNA may not present greater sensitivity possibly due to lack of coverage of gastrointestinal symptoms. It is a quick and efficient tool for nutritional assessment of older adult patients with cancer, but as it is more specific than sensitive, caution is recommended when identifying borderline or early malnourished individuals of this population