Factors associated with packed red blood cell transfusions in premature infants in an intensive care unit

This study analyzed the factors that are associated with the need for packed red blood cell transfusions in premature infants in a neonatal intensive care unit. This study is a cross-sectional study of secondary data from premature infants who were admitted to a neonatal intensive care unit between 2008 and 2010. Premature infants with low birth weight were included. Packed red blood cell transfusion was the dependent variable. Pearson's Chi-square or Fisher's exact tests were used for data analysis, and the median, minimum, and maximum values were calculated. Prevalence ratios were calculated using the Poisson regression and Pearson correlation coefficient. Linear regression analyses were performed. P 32 weeks of gestation, and 191% more prevalent in infants who exhibited late-onset neonatal sepsis. The number of transfusions per patient was negatively correlated with gestational age and positively correlated with late-onset neonatal sepsis. A gestational age <32 weeks and late-onset neonatal sepsis explained 45% of the transfusions (p<0.0001). Premature infants with a gestational age <32 weeks and who developed late-onset neonatal sepsis exhibited a greater need for packed red blood cell transfusions

Growth in non-anemic infants supplemented with different prophylactic iron doses

OBJECTIVE: To compare the effects of different prophylactic iron doses on the growth and nutritional status of non-anemic infants. METHODS: Prospective randomized study. Infants aged 5.0 to 6.9 months who met the inclusion criteria and showed capillary hemoglobin ≥ 11 g/dL were randomly allocated into three groups who received the following prophylactic doses of iron supplement (ferrous sulfate): 1 mg/kg/day (n = 39); 2 mg/kg/day (n = 36); and 25 mg/week (n = 39). This supplementation was given during 16 weeks. Both weight and length were measured. The nutritional status was evaluated by comparing z scores for weight/age, length/age and weight/length based on the World Health Organization (2006) references. Morbidity information was collected during monthly visits. RESULTS: The groups showed similar nutritional status before supplementation. There were no differences in daily nutrient intake among groups. During the study, weight and length gain, and increments in anthropometric indices did not differ statistically among supplemented groups either. The occurrence and duration of morbidity episodes did not differ statistically among groups. In general, improvements were observed in both weight/age and weight/length indices in the population under study, whereas length/age showed no differences before and after supplementation. CONCLUSION: Different prophylactic iron doses had no different effects on the growth and nutritional status of non-anemic infants.OBJETIVO: Comparar os efeitos de diferentes doses profiláticas de ferro sobre o crescimento e estado nutricional de lactentes não-anêmicos. MÉTODOS: Estudo do tipo prospectivo e randomizado. Lactentes de 5,0 a 6,9 meses de vida que atenderam aos critérios de inclusão e apresentaram hemoglobina capilar ≥ 11 g/dL foram alocados randomicamente em três grupos com doses profiláticas de suplemento de ferro (sulfato ferroso) de 1 mg/kg/dia (n = 39), 2 mg/kg/dia (n = 36) e 25 mg/semana (n = 39). A suplementação durou 16 semanas. Foram avaliados peso e comprimento. O estado nutricional foi avaliado por meio dos escores z do peso/idade, comprimento/idade e peso/comprimento com base na referência da Organização Mundial da Saúde (2006). Os dados de morbidade foram obtidos durante as visitas mensais. RESULTADOS: Antes da suplementação, os grupos apresentaram similar estado nutricional. Não houve diferença entre os grupos na ingestão diária de nutrientes. Durante o estudo, o ganho de peso, o ganho de comprimento e os incrementos nos índices antropométricos não diferiram estatisticamente entre os grupos suplementados. A ocorrência e duração dos episódios de morbidade não diferiram estatisticamente entre os grupos. De modo geral, observaram-se melhorias nos índices peso/idade e peso/comprimento na população estudada, porém o comprimento/idade não apresentou diferenças antes e após a suplementação. CONCLUSÃO: As diferentes doses profiláticas de ferro não exerceram efeito diferenciado sobre o crescimento e estado nutricional dos lactentes não-anêmicos.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Programa de Pós-Graduação em NutriçãoUniversidade Federal de Viçosa Departamento de Nutrição e Saúde Programa de Pós-Graduação em Ciência da NutriçãoUNIFESP, EPM, Programa de Pós-Graduação em NutriçãoSciEL

Marcadores inflamatórios na avaliação nutricional: relação com parâmetros antropométricos, composição corporal e níveis de atividade física.

Objetivo: realizar um estudo de revisão sistemática referente ao uso dos marcadores inflamatórios como fator de risco de doença cardiovascular e sua relação com parâmetros antropométricos, bioquímicos, composição corporal e a influência do nível de atividade física. Métodos: Foi realizada uma revisão sistemática de literatura nas bases de dados eletrônicas: PUBMED, SciELO e Conchrane Collection. Utilizaram-se os termos associados “inflammation, cardiovascular diseases” e “nutritional status”, “inflammation, cardiovascular diseases” e “body composition” e “inflammation, cardiovascular diseases” e “physical activity”. Resultados: Encontraram-se 866 artigos entre os anos de 1998 e 2013, sendo 332 (38,3%) publicados entre os anos de 2009 e 2013. A associação entre os termos indexados que mais selecionou artigos originais foi “cardiovascular diseases, inflammation and physical activity”, com 526 artigos (60,74%). A obesidade foi o fator mais relacionado com os marcadores, e a prática de atividade física a principal medida não farmacológica para o controle do sobrepeso e processo de inflamação. Conclusão: As pesquisas avaliaram os marcadores inflamatórios nas doenças cardiovasculares relacionados com avaliação da composição corporal, do estado nutricional e da influência da atividade física. A atividade física e a dieta balanceada foram as medidas necessárias no controle da incidência ou prevalência dos marcadores inflamatórios. Estudos com delineamento longitudinal e de intervenção são necessários para avaliar precisamente como a composição corporal, o estado nutricional e a atividade física podem interferir na manifestação dos marcadores inflamatórios.Objective: To conduct a systematic review regarding the use of inflammatory markers as a risk factor of cardiovascular disease and its connection with anthropometric, biochemical parameters, body composition and the influence of physical activity. Methods: A systematic literature review was conducted in the electronic databases PUBMED, SciELO e Conchrane Collection. The associated terms “inflammation, cardiovascular diseases” and “nutritional status”, “inflammation, cardiovascular disease” and “body composition” and “inflammation, cardiovascular diseases” and “physical activity were used. Results: 866 articles between the years 1998-2013, 332 (38.3%) having been published between the years 2009-2013, were found. The association that selected more original items among the indexed terms was "cardiovascular diseases, inflammation and physical activity", with 526 articles (60.74%). Obesity was the factor the most associated with inflammatory markers, and physical activity was the main nonpharmacological measure used against overweight and inflammation process. Conclusion: The research evaluated inflammatory markers in cardiovascular diseases related to the assessment of body composition, nutritional status and the influence of physical activity. Physical activity and a balanced diet are the measures necessary to control the incidence or prevalence of inflammatory markers. Intervention longitudinal studies are needed to assess precisely how body composition, nutritional status and physical activity can interfere in the manifestation of inflammatory markers

Los primeros determinantes del sobrepeso y la obesidad a los 5 años de edad en preescolares del interior de Minas Gerais, Brasil

Introduction: Brazil is experiencing a nutritional transition characterized by a reduction in the prevalence of nutritional deficits and an increase in overweight and obesity, not only in adults but also in children and adolescents.Objectives: This study was designed to evaluate the factors associated with overweight and obesity in Brazilian 5-year-old preschoolers.Methods: A cross-sectional study of a cohort of 232 preschoolers born in Diamantina/Minas Gerais, Brazil, was undertaken. the data, including socioeconomic status, anthropometry, diet, previous history of the preschoolers and family history, were collected between July of 2009 and July of 2010. To identify the factors associated with overweight and obesity, a logistic regression and a hierarchical model were undertaken.Results: Overweight and obesity occurred in 17.2% of the preschoolers. After adjusting for mother's obesity, per capita income, protective food intake, weight gain at age 0-4 months and time spent playing, the factors associated with overweight and obesity that reached statistical significance were mother's obesity [OR = 3.12 (95% CI 1.41-6.91), P = 0.01], weight gain of more than 0.85 kg/month in the first four months of life [OR = 2.16 (95% CI 1.01-4.64), P = 0.041 and lower per capita income [OR = 0.32 (95 %CI 0.13-0.79), P = 0.01].Conclusion: the results show that more weight gain during the first four months of life and being born of mothers with obesity increased the odds of overweight/obesity in the preschoolers, while lower per capita income was a protective factor.Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)Fed Univ Vales Jequitinhonha & Mucuri, Dept Nutr, BR-39100000 Diamantina, MG, BrazilUniv Fed Minas Gerais, Dept Med, Belo Horizonte, MG, BrazilUniversidade Federal de São Paulo, Dept Nutr, São Paulo, BrazilFederal Univ Sao Joao Del Rei, Dept Med, Divinopolis, MG, BrazilUniv Fed Vicosa, Dept Nutr, Vicosa, MG, BrazilUniversidade Federal de São Paulo, Dept Nutr, São Paulo, BrazilFAPEMIG: APQ-00428-08Web of Scienc

Stature estimation using the knee height measurement amongst Brazilian elderly

Stature is an important variable in several indices of nutritional status that are applicable to elderly persons. However, stature is difficult or impossible to measure in elderly because they are often unable to maintain the standing position. A alternative is the use of estimated height from measurements of knee height measure. This study aimed to evaluate the accuracy of the formula proposed by Chumlea et al. (1985) based on the knee of a Caucasian population to estimate the height and its application in calculation of body mass index in community- dwelling older people residents in Viçosa, Minas Gerais, Brazil. The sample included 621 elderly aged 60 years old and older, living in the community. Measures of weight, height and knee height (KH) were taken and Body Mass Index (BMI) was calculated with the measured weight and estimated. The Student`s t-test was used for comparison of measurements of height between the genders. For the comparison of estimated and measured values it was used paired t-test and also the methodology proposed by Bland and Altman to compare the difference between measurements. To evaluate the agreement between the classifications for BMI was used Cohen's Kappa. The average values obtained from KH were higher than those measured in the whole sample and women. There underestimation of BMI in females and also in the whole. The present results suggest that the equation Chumlea was not adequate to estimate the height of the sample in question, especially for women.La estatura es una variable importante en varios índices del estado nutricional que son aplicables a las personas mayores. Sin embargo, la estatura es difícil o imposible de medir en la edad avanzada, ya que a menudo son incapaces de mantener la posición de pie. Una alternativa es el uso de altura estimada a partir de mediciones de medida de altura de la rodilla. Este estudio tuvo como objetivo evaluar la exactitud de la fórmula propuesta por Chumlea et al. (1985), basado en la altura de la rodilla de una población caucásica para estimar la altura y su aplicación en el cálculo del índice de masa corporal en las personas mayores residentes en la comunidad de Viçosa, Minas Gerais, Brasil. La muestra incluyó a 621 adultos mayores de 60 anos y más, que viven en la comunidad. Se tomaron medidas de peso, talla y altura de la rodilla (AR) y el Índice de Masa Corporal (IMC) se calculó con el peso medido y estimado. Se utilize la prueba T del estudiante para la comparación de las mediciones de altura entre los géneros. Para la comparación de los valores estimados y medidos se utilizó la prueba T pareada y también la metodología propuesta por Bland y Altman para comparar la diferencia entre las mediciones. Para evaluar el acuerdo entre las clasificaciones para el IMC se utilizó el Kappa de Cohen. Los valores medios obtenidos a partir de AR fueron más altos que los medidos en la muestra completa y mujeres. Hay subestimación de IMC en mujeres y también en el conjunto. Los resultados sugieren que la ecuación Chumlea no era adecuado para estimar la altura de la muestra en cuestión, especialmente para las mujeres

Prevalência de síndrome metabólica em idosos: uma revisão sistemática

Objetivo: O objetivo desse trabalho foi revisar a literatura científica acerca da prevalência da Síndrome Metabólica (SM) em idosos com 60 anos ou mais. Métodos: Pelo método de revisão sistemática, realizou-se busca nas bases eletrônicas MEDLINE e LILACS por artigos originais que utilizaram para classificação da SM os critérios da Organização Mundial de Saúde (OMS), do National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATP III) e da International Diabetes Federation (IDF). Resultados: Encontraram-se 435 resumos, sendo selecionados 21 artigos por preencherem os critérios de inclusão. A prevalência de SM entre os estudos variou de 22,3% a 67,9%, sendo que a maioria dos estudos apresentou maiores prevalências entre as mulheres e entre os idosos mais velhos. Dentre os componentes da síndrome, a pressão arterial elevada apresentou maior prevalência, com valores entre 27,5% e 92,9%, e a glicose elevada apresentou as menores prevalências. Conclusão: Conclui-se que a ocorrência da síndrome metabólica entre idosos é um problema de saúde com alta prevalência em diferentes países. Embora não haja consenso quanto à definição da SM nessa faixa etária, a presença isolada de seus componentes também é muito prevalente, com destaque para a hipertensão arterial. Objective: The aim of this study was to review the scientific literature on the prevalence of metabolic syndrome (MS) in elderly patients aged 60 years or older. Methods: We have used the systematic review method to search on the electronic databases MEDLINE and LILACS for original articles that were used for MS classification criteria of World Health Organization (WHO), National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF). Results: We have found 435 abstracts and selected 21 articles that fulfilled the inclusion criteria. The prevalence of MS among the studies ranged from 22.3% to 67.9%, most studies showing higher prevalence among women and among elder elderly. Among the components of the syndrome, high blood pressure was more prevalent, ranging from 27.5% to 92.9%, and high glucose had the lowest prevalence. Conclusions: We conclude that the occurrence of metabolic syndrome among the elderly is a health problem with high prevalence in different countries. Although there is no unanimity in the definition of metabolic syndrome in this age group, the isolated presence of components is also very prevalent, especially in the case of arterial hypertension

Risk factors for low birth weight among low-income pregnant women

This paper assessed 77 pregnant women undergoing the last three months of gestation, in order to analyze their exposure to risk factors for low birth weight. They lived in slums in the region of Vila Mariana, a district in the city of São Paulo, and were followed up by the Projeto Favela, developed by the Federal University of São Paulo/School of Medicine. The maternal variables which most influenced birth weight were the mother's number of pregnancies and height. Primiparous women gave birth to newborns with lower birthweight, presenting an average difference of -264g when compared with infants born to multiparous mothers. Women whose height did not exceed 150cm also delivered infants with lower birth weight, demonstrating an average difference of -287g when compared with neonates born to taller mothers. Only 2.6% of the infants presented low birth weight, despite the high exposure of the studied population to risk factors.Foram analisadas, quanto à exposição a fatores de risco para o baixo peso ao nascer, 77 gestantes no último trimestre da gestação, residentes em favelas da região de Vila Mariana, município de São Paulo, acompanhadas pelo Projeto Favela, desenvolvido pela Universidade Federal de São Paulo (UNIFESP)/Escola Paulista de Medicina. As variáveis maternas de maior impacto sobre o peso ao nascer foram paridade e estatura. Primíparas geraram crianças com diferença média de peso ao nascer de -264g em relação aos recém-nascidos das multíparas. Mulheres com estaturas abaixo de 150cm tiveram crianças com diferença média de peso ao nascer de -287g em comparação com os neonatos de mães com estaturas maiores. Apenas 2,6% das crianças nasceram com baixo peso, apesar da alta exposição da população estudada aos fatores de risco.Universidade Federal de Viçosa Departamento de Nutrição e SaúdeUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL