Undernutrition and associated factors among hospitalized patients

Background & aims: The identification of modifiable risk factors associated with disease-related undernutrition at hospital admission will contribute to the development of integrated intervention and control strategies for a timely primary prevention. This study aim was to quantify the association between functional autonomy and undernutrition. Methods: A multicentric cross-sectional study was developed in six public hospitals in Portugal. Undernutrition risk was assessed using Nutritional Risk Screening 2002, undernutrition status was classified from anthropometry and functional autonomy was evaluated using the Katz Index. Results: In this sample of 1144 patients, 36% were at undernutrition risk and 9.7% undernourished. In logistic regression analysis, dependent patients were at an increased risk of undernutrition (OR ¼ 1.69, 95% confidence interval (CI) ¼ 1.20e2.39). The following parameters: illiteracy (OR ¼ 2.45, CI ¼ 1.52e3.96), age (one year increment) (OR ¼ 1.03, CI ¼ 1.02e1.04), male (OR ¼ 1.61, CI ¼ 1.19e2.16), single/divorced/widowed (OR ¼ 1.83, CI ¼ 1.34e2.51) and smoker (OR ¼ 1.55, CI ¼ 1.02e2.35) also increased the undernutrition risk. The impaired functional status, being single, divorced or widowed and be a smoker were also associated with anthropometric undernutrition. Conclusions: Functional impairment is related with undernutrition risk and with anthropometrical undernutrition at hospital admission. We also conclude that little extra information is gained by using anthropometrical indices compared to NRS 2002 when assessing the factors associated with undernutrition.info:eu-repo/semantics/publishedVersio

Improving antibiotic use through educational interventions

The growing rates of antimicrobial resistances demand the improvement of antibiotic use worldwide. The antibiotic misprescription by physicians, the antibiotic dispense without prescription by pharmacists, and the misuse by patients, are some of the most important factors underlying the increasing rates of antimicrobial resistances. Accordingly, it is of major importance to develop educational interventions targeting the different actors in the chain of antibiotic resistance, aiming to increase knowledge, understand attitudes and improve antibiotic use. In this chapter, readers can find a proposed design model which aims to improve the effectiveness of the educational interventions, presenting and developing each step that should be considered when implementing an educational intervention

Discrimination of three bacteria species using a potentiometric electronic tongue

[Excerpt] The detection, monitoring and/or prevention of microorganism growing is of utmost relevance in several research fields, from food to environmental areas, being an important topic either from an academic or an industrial point of view. Conventional methods like plating techniques are the most widely used, being needed novel and faster screening methodologies like electronic noses, electronic tongues (E-tongues) and impedance based methods. In the present work, a potentiometric E-tongue (Fig. 1), comprising 40 lipid polymeric sensor membranes with cross-sensitivity, was used to identify and discriminate three bacteria (Enterococcus faecalis ATCC29212; Staphylococcus aureus ATCC653 and Escherichia coli ATCC29998) at two concentration levels (low and high). [...]info:eu-repo/semantics/publishedVersio

Heat inactivation of Listeria innocua in broth and food products under non-isothermal conditions

The objective of this work was to study the effect of three linear temperature profiles (heating rates of 1.5, 1.8 and 2.6 °C/min, from 20 to 65 °C) on Listeria innocua inactivation in liquid medium. The inactivation was also analyzed in artificially contaminated parsley (heating rate of 1.8 °C/min) and throughout a frying process, using a pre-cooked frozen food as case study. Inactivation showed a sigmoidal behaviour and all data was fitted with a Gompertz-inspired model. Results demonstrated that, in liquid media, Listeria inactivation is influenced by the temperature profile used. As heating rate increases, the shoulder decreases and the tail effect disappears. If Listeria was in parsley, its heat resistance increased (for identical experimental conditions in broth). Besides model adequacy was proven in all studied situations, the heating rate affected parameters’ precision.info:eu-repo/semantics/acceptedVersio

In Vitro Hepatotoxic and Neurotoxic Effects of Titanium and Cerium Dioxide Nanoparticles, Arsenic and Mercury Co-Exposure

This article belongs to the Special Issue Toxicity of Nanomaterials and Legacy Contaminants: Risks to the Environment and Human Health.Considering the increasing emergence of new contaminants, such as nanomaterials, mixing with legacy contaminants, including metal(loid)s, it becomes imperative to understand the toxic profile resulting from these interactions. This work aimed at assessing and comparing the individual and combined hepatotoxic and neurotoxic potential of titanium dioxide nanoparticles (TiO2NPs 0.75-75 mg/L), cerium oxide nanoparticles (CeO2NPs 0.075-10 μg/L), arsenic (As 0.01-2.5 mg/L), and mercury (Hg 0.5-100 mg/L) on human hepatoma (HepG2) and neuroblastoma (SH-SY5Y) cells. Viability was assessed through WST-1 (24 h) and clonogenic (7 days) assays and it was affected in a dose-, time- and cell-dependent manner. Higher concentrations caused greater toxicity, while prolonged exposure caused inhibition of cell proliferation, even at low concentrations, for both cell lines. Cell cycle progression, explored by flow cytometry 24 h post-exposure, revealed that TiO2NPs, As and Hg but not CeO2NPs, changed the profiles of SH-SY5Y and HepG2 cells in a dose-dependent manner, and that the cell cycle was, overall, more affected by exposure to mixtures. Exposure to binary mixtures revealed either potentiation or antagonistic effects depending on the composition, cell type and time of exposure. These findings prove that joint toxicity of contaminants cannot be disregarded and must be further explored.This research was funded by FEDER—Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020—Operacional Programme for Competitiveness and Internationalisation (POCI), and by Portuguese funds through FCT—Fundação para a Ciência e a Tecnologia in the framework of the project POCI-01-0145-FEDER-029651. This work was also financed by national funds through FCT—Fundação para a Ciência e a Tecnologia, I.P., in the scope of projects UIDB/04750/2020 and LA/P/0064/2020. This work was also developed within the scope of the project CICECO- Aveiro Institute of Materials, UIDB/50011/2020, UIDP/50011/2020 & LA/P/0006/2020, financed by national funds through the FCT/MEC (PIDDAC). A.T. Reis thanks the financial support of FCT through individual Grant SFRH/BPD/122112/2016. C.B. Lopes and A.C. Estrada acknowledge their research position funded by national funds (OE), through FCT—Fundação para a Ciência e a Tecnologia, I.P., in the scope of the framework contract foreseen in the numbers 4, 5 and 6 of the article 23, of the Decree-Law 57/2016, of August 29, changed by Law 57/2017, of July 19.info:eu-repo/semantics/publishedVersio

Menções sobre o estado nutricional nos rewgistos clínicos de doentes hospitalizados .

Está descrito que a frequência de desnutrição associada à doença (DAD) afecta cerca de 30 a 60% dos doentes no momento da admissão hospitalar e cerca de 10% dos indivíduos na comunidade. A DAD tem vindo a ser associada a graves consequências, como ao maior risco de infecções e de disfunção de órgãos e a um aumento significativo, não só da morbilidade e mortalidade, como da frequência e dos custos com os cuidados de saúde. A falta do reconhecimento e da monitorização dos aspectos relacionados com o estado nutricional, têm sido apontados como factores que contribuem para o aumento da frequência de DAD, durante o internamento hospitalar. Foi objectivo deste estudo avaliar a relevância que é dada a aspectos relacionados com o estado nutricional dos doentes (peso, ingestão alimentar) e saber se os doentes em risco nutricional ou desnutridos serão alvo de maior atenção por parte dos profissionais de saúde. Foi recolhida uma amostra sistemática de seis hospitais portugueses, correspondente a 42-50% do total de camas de cada serviço de internamento. Foram critérios de exclusão a doença crítica, a gravidez, a idade inferior a 18 anos, a incapacidade de aplicação do protocolo de rastreio nutricional e o tempo de internamento inferior a 24h.Recolheram- se dados sócio-demográficos, antropométricos, sobre as menções dos processos clínicos respeitantes ao peso, cuidados alimentares/nutricionais prestados e ingestão alimentar/nutricional dos doentes e aplicou-se uma ferramenta de rastreio nutricional (Nutritional Risk Screening 2002). Em 1152 doentes estudados, a frequência de risco nutricional variou entre os 28,5% e 47,3%, enquanto que a frequência de desnutrição antropométrica oscilou entre 6,3% e 14,9%. Dois em cada três doentes tinha menções acerca de cuidados alimentares/ nutricionais prestados nos processos clínicos, mas apenas um em cada três tinha o seu peso medido e registado. Os doentes desnutridos foram pesados com menor frequência mas a sua alimentação e problemas a ela associados foram monitorizados com maior regularidade. A frequência de DAD, no momento de admissão hospitalar, é muito elevada, enquanto que a de menções relevantes para o estado nutricional é muito escassa. A presente investigação reforça a necessidade de investir na sensibilização dos profissionais de saúde, sobre a importância do rastreio e da prescrição/monitorização da alimentação e do peso dos doentes, na admissão e durante todo o internamento hospitalar.NUTRITIONAL STATUS RECORDING in Hospitalized Patient Notes The prevalence of disease-related malnutrition (DRM) is described to be of 30-60% on admission to hospital, and of 10% in the community. It has been associated with worse clinical outcomes, namely higher morbidity and mortality as well as higher frequency of health care and its associated costs. The lack of screening and monitoring of nutritional status have been said to be risk factors for the increased prevalence of DRM during hospital stay. The aims of this study were to evaluate the importance given by health care professionals to certain aspects related with nutritional status (weight, food intake) of hospital patients and to see if there were any diferences between the under and non undernourished ones. A systematic sample of patients from six hospitals was collected. Pregnancy, paediatric age and critical illness were exclusion criteria as well as incapacity to fulfil nutritional risk screening protocol and length-of-stay less than 24h. Socio-demographic, anthropometric data and clinical notes (e.g. weight, food/nutrient intake) from medical records were collected and Nutritional Risk Screening 2002 protocol was applied. A total of 1152 patients were included in this study.The revalence of nutritional risk varied between 28.5% and 47.3% while undernutrition classified by anthropometrical parameters was considerably lower (6.3% to 14.9%). Two thirds of the patients had their food intake monitored and registered in medical records but only one third were weighted. Undernourished patients had their food intake more frequently monitored but their weight was less frequently measured, than the well-nourished ones. DRM prevalence amongst hospital patients on admission is significantly high. Clinical notes regarding nutritional status is rather infrequent on medical records. This study showed that urges the need to empower health care providers of the importance of the screening and monitoring of weight and food intake, on admission and during hospital stay.info:eu-repo/semantics/publishedVersio

Predictors of Psychological Well-Being during Behavioral Obesity Treatment in Women

This study examined the association of autonomy-related variables, including exercise motivation, with psychological well-being and quality of life, during obesity treatment. Middle-aged overweight/obese women (n = 239) participated in a 1-year behavioral program and completed questionnaires measuring need support, general self-determination, and exercise and treatment motivation. General and obesity-specific health-related quality of life (HRQOL), self-esteem, depression, and anxiety were also assessed. Results showed positive correlations of self-determination and perceived need support with HRQOL and self-esteem, and negative associations with depression and anxiety (P < .001). Treatment autonomous motivation correlated positively with physical (P = .004) and weight-related HRQOL (P < .001), and negatively with depression (P = .025) and anxiety (P = .001). Exercise autonomous motivation was positively correlated with physical HRQOL (P < .001), mental HRQOL (P = .003), weight-related HRQOL (P < .001), and self-esteem (P = .003), and negatively with anxiety (P = .016). Findings confirm that self-determination theory's predictions apply to this population and setting, showing that self-determination, perceived need support, and autonomous self-regulation positively predict HRQOL and psychological well-being