Educomunicação nutricional para pacientes com doenças neurodegenerativas: uma revisão de escopo

Trata-se de scoping review (ScR) guiada pelas recomendações do JBI Institute Reviewer’s Manual (JBI, 2020), segundo quadro teórico proposto por Arksey e O’Malley (2005). Tem como objetivo, identificar e mapear as ações/estratégias de educomunicação nutricional para pacientes com doenças neurodegenerativas

Concordance between pediatric nutritional screening tools in individuals with nefrotic syndrome

AIMS: To evaluate the concordance between three validated nutritional screening tools for pediatrics among themselves and the correlation with the anthropometric parameters of patients hospitalized with nephrotic syndrome.METHOD: Cross-sectional study with children and adolescents of both sexes hospitalized in the pediatric ward of a university hospital and diagnosed with nephrotic syndrome. Three nutritional screening instruments were applied: Screening of Risk for Nutritional Status and Growth (STRONGkids), Paediatric Yorkhill Malnutrition Score (PYMS) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP). Data on weight, height and upper arm perimeter was collected, and three nutritional screening tools were applied: The estimate of relative agreement between the instruments was evaluated with the weighted Kappa test and the correlations with anthropometric parameters were assessed with the Spearman’s Correlation Test.RESULTS: We evaluated 11 patients, with a minimum age of 2 years and a maximum of 10 years. Screening tools detected prevalence of medium and high nutritional risk. Moderate agreement (k=0.47) was observed between PYMS and STAMP and there was no correlation between the screening tools’ result and the anthropometric data. Regarding the anthropometric parameters, 100% of the participants had adequate weight for age, 63.6% of the participants were diagnosed with normal weight by the BMI/Age index and 81.8% had adequate height for age according to the index Height/Age. After analysis of the upper arm perimeter, 27.3% were at risk of malnutrition.CONCLUSIONS: Despite the fact that are no recommendations for use of pediatric nutritional screening tools specific to each clinical situation, two of the three screening tools analyzed in this study demonstrated moderate agreement between them. However, the tested tools did not reflect the anthropometric nutritional status of the evaluated population.OBJETIVO: Avaliar a concordância entre três ferramentas de triagem nutricional validadas para pediatria entre si e a correlação com os parâmetros antropométricos de pacientes hospitalizados com síndrome nefrótica.MÉTODOS: Estudo transversal com crianças e adolescentes de ambos os sexos internados na enfermaria pediátrica de um hospital universitário, com diagnóstico de síndrome nefrótica. Foram aplicados três instrumentos de triagens nutricionais: triagem de risco para estado nutricional e crescimento (STRONGkids), pontuação pediátrica de desnutrição de Yorkhill (PYMS) e ferramenta de rastreio para a avaliação da desnutrição em pediatria (STAMP). Foram coletados dados de peso, altura e perímetro do braço. A estimativa de concordância relativa entre os instrumentos foi analisada com o teste de Kappa ponderado e as correlações com os parâmetros antropométricos foram avaliadas com o teste de correlação de Spearman.RESULTADOS: Foram avaliados 11 pacientes, com idade mínima de 2 anos e máxima de 10 anos. As ferramentas de triagem detectaram prevalência de risco nutricional moderado e elevado. Foi observada concordância moderada (k=0,47) entre a PYMS e a STAMP e não houve correlação entre as triagens e os dados antropométricos. Com relação aos parâmetros antropométricos, 100% dos participantes tinham peso adequado para idade, 63,6% dos participantes foram diagnosticados com eutrofia pelo indicador IMC/idade e 81,8% tinham estatura adequada para idade de acordo com o indicador estatura/idade. Após a análise do perímetro do braço, 27,3% estavam em risco de desnutrição.CONCLUSÕES: A despeito de não haver recomendações para uso de triagens nutricionais pediátricas específicas para cada situação clínica, duas das três triagens analisadas neste estudo apresentaram moderada concordância entre elas. Contudo, as triagens testadas não refletiram o estado nutricional antropométrico da população avaliada

Avaliação do risco e prognóstico nutricional com relação ao desfecho clínico de pacientes críticos

Introdução: A avaliação do estado nutricional de pacientes críticos é um desafio, mas faz parte da rotina da nutrição clínica hospitalar. Objetivo: Avaliar o risco e o prognóstico nutricional, e suas relações, em pacientes críticos admitidos na unidade de terapia intensiva (UTI) de um hospital universitário em Natal, Brasil. Métodos: Estudo transversal, desenvolvido com pacientes adultos e idosos entre fevereiro de 2017 e fevereiro de 2020. O risco nutricional foi detectado pelo Nutrition Risk in Critically ill score modificado (mNUTRIC-score). O prognóstico nutricional foi avaliado mediante o ângulo de fase (AF). O teste de Mann-Whitney foi usado para verificar a associação do mNUTRIC-score e do AF com os desfechos (alta da UTI ou óbito). A correlação de Spearman foi usada para verificar a correlação entre o mNUTRIC-score e o AF. Resultados: Ao total, 55 indivíduos foram incluídos no estudo. O valor médio do mNUTRIC-score foi de 3,13 ± 2,35 e do AF foi de 4,19 ± 1,21. A maioria dos pacientes apresentaram baixo risco nutricional (76,4%) e tiveram alta da UTI (81,8%). Tanto o mNUTRIC-score (p<0,0001) como o AF (p=0,04) estiveram associados com o desfecho clínico. Esses dois parâmetros se correlacionaram negativamente (r= -0,3804; p=0,0059). Conclusão: A maioria dos pacientes críticos estudados apresentaram baixo risco nutricional determinado pelo mNUTRIC-score. Aqueles com alto risco nutricional tiveram pior desfecho (óbito). Observou-se correlação negativa entre o mNUTRIC-score e o AF, demostrando que quanto maior o risco nutricional, pior o prognóstico clínico e nutricional em pacientes críticos

Cross-validation of prediction equations for estimating body composition in ballet dancers.

INTRODUCTION:In sports related to low body weight, such as classical ballet, the assessment of body composition is important for monitoring performance and health status. This study aimed to cross-validate anthropometry and bioelectrical impedance (BIA) predictive equations for estimating body composition of non-professional classical ballet dancers, using dual-energy-X-ray absorptiometry (DXA) as a reference method. MATERIALS AND METHODS:Thirty-seven female non-professional classical dancers (median age of 19 years), at intermediate/advanced level, were evaluated in a cross-sectional study. Body composition was evaluated by DXA, anthropometry and tetrapolar BIA. Twenty different predictive equations of anthropometry (n = 8) and BIA (n = 12) were used to estimate Body Fat (BF) and Fat-Free Mass (FFM), testing their validity against DXA using the Bland-Altman statistics. RESULTS:For BF estimated by anthropometry equations, just one equation showed agreement with DXA (r = 0.852, p < 0.0005; p = 0.600 for one sample T-test). According to the Bland-Altman analysis, this equation also showed validity, with the absence of proportional bias. Regarding the predictive BIA equations tested, none were valid for our study group. CONCLUSION:Only one of the anthropometric equations, the one proposed by Durnin and Womerley (1974), but none of the BIA equations analyzed, was valid for the evaluation of body composition of the studied classical dancers. Our results emphasize the importance of previous cross-validation of existing equations or the development of specific equations for body composition assessment in specific populations

Phase Angle and Bioelectrical Impedance Vector Analysis (BIVA) in Amyotrophic Lateral Sclerosis (ALS) Patients

Phase angle (PhA) and bioelectrical impedance vector analysis (BIVA) have emerged as valuable tools for assessing nutritional status and prognosis in various patient populations, but there is a lack of studies in rare neurodegenerative diseases. The purpose of this cross-sectional study was to investigate these bioelectrical parameters in patients with amyotrophic lateral sclerosis (ALS), compared with healthy peers. The tetrapolar impedance method was applied and bioimpedance analysis (BIA) was performed. Bioelectrical parameters were obtained (Resistance—R; Reactance—Xc) or calculated (PhA; BIVA). For BIVA, bivariate vectors and confidence ellipses were graphically represented. In addition, R and Xc were used to determine body composition (BC) (Fat Mass—FM; Fat-Free Mass—FFM; and Total Body Water—TBW). In this study, 40 participants were divided into two groups: case group (n = 20, ALS patients) and control group (n = 20, healthy subjects. Our main results showed that ALS patients presented low levels of BMI, FFM, R, and Xc adjusted by height (R/H, Xc/H), hydration, and cellularity, compared to the healthy subjects. Our findings highlight BC and bioelectrical parameters, including PhA and BIVA, as valuable indicators of nutrition status, which should be implemented in the nutrition care process of ALS patients during the disease course

Gender-specific bioelectrical impedance reference values in healthy children

Summary: Background &amp; Aims: Bioimpedance parameters are important for assessing children's body composition and health status. However, interpreting these parameters is still challenging, especially without reference data and cut-off points.This study aimed to describe gender-specific reference phase angle (PhA) values and bioelectrical impedance vector analysis (BIVA) plots for healthy Brazilian children. Methods: Children aged 6–9 years were recruited from four public schools in Natal, Brazil. Anthropometric measurements and bioelectrical impedance (BIA) were performed. The values of age, weight (kg), height (cm), resistance (Ω), and reactance (Ω) were measured. Only eutrophic children were included according to body mass index (BMI)-for-age Z-score. BIVA 2002 software was used for the construction of BIVA plots. A P-value < 0.05 was accepted as statistically significant. Results: The sample size was 108 children (boys, n= 49; girls, n= 59) with average age of 8.4 ± 0.77. The girls showed significantly higher values of resistance and resistance normalized by height (R/H) (P < 0.05) compared to the boys. Considering the 95% confidence ellipses for mean impedance vectors, there was no difference between boys and girls. Mean gender-specific reference values for PhA in our sample were traced. The 75th tertil for PhA were 5.79° and 5.40° for boys and girls, respectively. When comparing our sample with other ethnic groups was observed that we had higher values of R/H (582.4–620.7 versus 552.5–589.5) and lower values of Xc/H (53.8–54,7 versus 61.7–64,7) and PhA (5.3–5.1 versus 5.5–6.3) for boys and girls, respectively. Conclusions: The PhA values and the new tolerance ellipses provided by our data reflect the normal growth and development of the prepubertal children studied. These reference values have significant clinical utility since they can point out altered body composition in other children due to pathophysiological conditions. Verifying changes in nutritional prognosis and hydration status allow early clinical and nutritional interventions

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data