ODS/02 - Fome zero e agricultura sustentável
URI Permanente desta comunidade
Objetivo: Acabar com a fome, alcançar a segurança alimentar e melhoria da nutrição e
promover a agricultura sustentável.
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- ODS/02 - Fome zero e agricultura sustentável
- ODS/02 - Fome zero e agricultura sustentável
- ODS/02 - Fome zero e agricultura sustentável
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Quality of life and socio-demographic factors associated with nutritional risk in Brazilian community-dwelling individuals aged 80 and over: cluster analysis and ensemble methods
(2024) BRECH, Guilherme Carlos; SILVA, Vanderlei Carneiro da; ALONSO, Angelica Castilho; MACHADO-LIMA, Adriana; SILVA, Daiane Fuga da; MICILLO, Glaucia Pegorari; BASTOS, Marta Ferreira; AQUINO, Rita de Cassia de
IntroductionThe aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over.MethodsThis cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD).ResultsThe K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD.ConclusionHandgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.
Higher urea-to-albumin ratio is associated with mortality risk in critically ill COVID-19 patients
(2023) RODRIGUES, Hellen Christina Neves; SILVA, Mikaelly Luiz; MANTOVANI, Milena dos Santos; SILVA, Juliana Medeiros da; DOMINGUES, Marielle Fernanda Panelli; TANNI, Suzana Erico; AZEVEDO, Paula Schmidt; MINICUCCI, Marcos Ferreira; BUFFARAH, Marina Nogueira Berbel; PEREIRA, Amanda Gomes; COSTA, Nara Aline
Background: This study aimed to evaluate the ability of the urea-to-albumin ratio (UAR) to predict mortality in critically ill coronavirus disease 2019 (COVID-19) patients. Methods: This retrospective study included adult patients admitted with COVID-19 at two intensive care units (ICUs) at the University Hospital. Serum urea and albumin concentrations at ICU admission were used to calculate the UAR. All patients were followed up during hospitalization, and the ICU mortality rate was recorded. Results: Two hundred and eleven patients were evaluated. The mean age was 57.8 +/- 15.5 years, and 54% were male. Approximately 84.4% of patients were considered to be at nutritional risk by the NRS 2002, and the median UAR was 18.3 (10.5-34.8). The length of stay in the ICU was 10 (6-16) days, 38.4% of the patients required dialysis, and 64.9% died. Age, male sex, need of hemodialysis, lactate level, and in-flammatory parameters were associated with higher mortality. Patients non-survivors had a higher UAR (23.7 [13.6-41.8] vs. 10.9 [8.5-16.8]; p < 0.001). The cutoff point with the best performance of UAR in the ROC curve for predicting mortality was >= 12.17 (AUC: 0.7201; CI 95%: 0.656-0.784). Additionally, the risk of mortality was 2.00-fold in the group of patients with UAR >= 12.17 (HR: 2.00 CI: 1.274-3.149; p = 0.003) and remained significant after adjusted analyzes (models 1 and 2). Conclusion: Our data suggest that a UAR >= 12.17 increased the risk of mortality by 2.00-fold in critically ill COVID-19 patients.
Anthropometric Characterization of Impaired Fetal Growth Risk Factors for and Prognosis of Newborns With Stunting or Wzisting
(2015) VICTORA, Cesar G.; VILLAR, Jose; BARROS, Fernando C.; ISMAIL, Leila Cheikh; CHUMLEA, Cameron; PAPAGEORGHIOU, Aris T.; BERTINO, Enrico; OHUMA, Eric O.; LAMBERT, Ann; CARVALHO, Maria; JAFFER, Yasmin A.; ALTMAN, Douglas G.; NOBLE, Julia A.; GRAVETT, Michael G.; PURWAR, Manorama; FREDERICK, Ihunnaya O.; PANG, Ruyan; BHUTTA, Zulfiqar A.; KENNEDY, Stephen H.
IMPORTANCE Stunting (short length for age) and wasting (low body mass index [BMI] for age) are widely used to assess child nutrition. In contrast, newborns tend to be assessed solely based on their weight. OBJECTIVE WE To use recent international standards for newborn size by gestational age to assess how stunted and wasted newborns differ in terms of risk factors and prognoses. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study with follow-up until hospital discharge was conducted at urban sites in Brazil, China, India, Italy, Kenya, Oman, England, and the United States that are participating in the INTERGROWTH-21' Project. The study was conducted from April 27, 2009, to March 2, 2014, and the final dataset for analyses was locked on March 19, 2014. EXPOSURES Sociodemographic and behavioral maternal risk factors, previous pregnancy history, and maternal and fetal conditions during pregnancy were investigated as risk factors for stunting and wasting. Anthropometry at birth was used to predict for neonatal prognosis. MAIN OUTCOMES AND MEASURES Newborn stunting and wasting were defined as birth length and BlVlItor gestational age below the third centiles of the INTERGROWTH-21' standards. Prognosis was assessed through mortality before hospital discharge, admission to neonatal intensive care units, and newborn complications. RESULTS From the 60 206 singleton live births during the study period, we selected all newborns between 33 weeks' and 42 weeks 6 days' gestation at birth (51200 [85%]) with reliable ultrasound dating. Stunting affected 3.8% and wasting 3.4% of all newborns; both conditions were present in 0.7% of the sample. Of the 26 conditions studied, five were more strongly associated with stunting than with wasting (reported as odds ratios [OR]; 95% CO: short maternal height (6.7; 5.1-9.0), younger maternal age (0.7; 0.5-0.9), smoking (2.8; 2.3-3.3), illicit drug use (2.3; 1.5-3.6), and clinically suspected intrauterine growth restriction (5.2; 4.5-6.0). Wasting was more strongly related than stunting with 4 newborn outcomes (neonatal intensive care stay, 6.7 [5.5-8.1]; respiratory distress syndrome, 4.0 [3.3-4.9]; transient tachypnea, 2.1[1.5-2.9]; and no oral feeding for >24 hours, 5.0 [3.9-6.5]). Maternal gestational diabetes mellitus was protective against wasting (0.6; 0.5-0.8) but not against stunting (0.9; 0.7-1.1). CONCLUSIONS AND RELEVANCE Although newborn stunting and wasting share some common determinants, they are distinct phenotypes with their own risk factors and neonatal prognoses. To be consistent with the literature on infant and child nutrition, newborns should be classified using the 2 phenotypes of stunting and wasting. The distinction will help to prioritize preventive interventions and focus the management of fetal undernutrition.
Effects of nutritional supplementation stabilizing muscle mass loss in older patients on hemodiafiltration
(2023) SILVA, Luana Cristina A. de; CORREIA, Marilia A. de; GOUVEIA, Renata Daniel; SOUZA, Mayara S.; JR, Carlos P. Isaac; PARRILLO, Fernando; MOYSES, Rosa M. A.; DALBONI, Maria Aparecida; ELIAS, Rosilene M.
Background & aims: Malnutrition is common in older individuals with end-stage renal disease on maintenance dialysis. Whether nutritional supplementation may improve skeletal muscle mass (SMM) and survival rate in this population is uncertain. We aimed to analyze the effect of a year of nutritional supplementation on muscle mass and survival rate in older patients on hemodiafiltration.Methods: In this observational study, older patient (>= 65 years old) on maintenance hemodiafiltration were selected to receive nutritional counselling + nutritional supplementation (N = 85, Supp+) or nutritional counselling alone (N = 47, Supp-) and followed for 1 year. The outcomes were a change in SMM and sarcopenia diagnosis. The secondary outcome was 1-year mortality rate. Nutritional parameters included calf circumference, body mass index, anthropometric measurements, subjective global assessment, and handgrip strength (HGS). Data were evaluated using GLM for repeated measures with adjustment for covariates (age and diabetes).Results: Malnutrition was found in 50.8% of patients. At baseline, patients from the Supp+ group were older and had worse nutritional parameters including hand grip strength, calf circumference, anthro-pometric findings and sarcopenia (all p values < 0.05). During the follow-up, there was no significant change in sarcopenia (from 50.8% to 58.3%, p = 0.108), and there was a more pronounced decrease in the SMM index in the Supp-group (p = 0.049), with a significant intervention interaction (p = 0.030). Twenty deaths occurred, 7 (35%) in the Supp-and 13 (65%) in the Supp+ group (p = 0.540). SMM index (relative risk 0.90, p = 0.030) and age (relative risk 1.07, p = 0.046) were independently associated with higher mortality rates. Conclusion: Nutritional supplementation in older and malnourished individuals undergoing hemodia-filtration mitigates the loss of the SMM index and benefits survival rate.(c) 2023 European Society for Clinical Nutrition and Metabolism.
Malnutrition in mother-child dyads in the Brazilian National Survey on Child Nutrition (ENANI-2019)
(2023) FARIAS, Dayana Rodrigues; ANJOS, Luiz Antonio dos; FREITAS, Maiara Brusco de; BERTI, Talita Lelis; ANDRADE, Pedro Gomes; ALVES-SANTOS, Nadya Helena; LEITE, Maria Alvim; RAYMUNDO, Carlos Eduardo; LACERDA, Elisa Maria de Aquino; BOCCOLINI, Cristiano Siqueira; CASTRO, Ines Rugani Ribeiro de; KAC, Gilberto
Malnutrition affects billions of individuals worldwide and represents a global health challenge. This study aimed to determine the prevalence of malnutri-tion (undernutrition or overweight) among mother-child dyads in children under 5 years old in Brazil in 2019 and to estimate changes in this preva-lence from 2006 to 2019. Individual-level data from the Brazilian National Survey on Child Nutrition (ENANI-2019) and the Brazilian National Survey of Demography and Health of Women and Children carried out in 2006 (PNDS 2006) were analyzed. Malnutrition outcomes in mother-child dyads included overweight mother and child, undernourished mother and child, and the double burden of malnutrition, i.e., overweight mother and child having any form of undernourishment (stunting, wasting, or underweight). Prevalence and 95% confidence intervals (95%CI) were estimated. Most women (58.2%) and 9.7% of the children were overweight, 6.9% were stunted, and 3.1% of mothers and 2.9% of the children were underweight. The preva-lence of overweight in the mother-child dyad was 7.8% and was statistically higher in Southern Brazil (9.7%; 95%CI: 7.5; 11.9) than in the Central-West (5.4%; 95%CI: 4.3; 6.6). The prevalence of overweight mother and stunted child was 3.5%, with statistically significant difference between the extremes of the mother's education [0-7 vs. >= 12 years, 4.8% (95%CI: 3.2; 6.5) and 2.1%, (95%CI: 1.2; 3.0), respectively]. Overweight in the dyad increased from 5.2% to 7.8%, and the double burden of malnutrition increased from 2.7% to 5.2% since 2006. Malnutrition in Brazilian mother-child dyads seems to be a grow-ing problem, and dyads with lower formal education, higher maternal age, and from the South Region of Brazil were more vulnerable.
Maternal malnutrition during pregnancy among women with sickle cell disease
(2023) PAIVA, Leticia Vieira; IGAI, Ana Maria Kondo; NOMURA, Roseli Mieko Yamamoto
OBJECTIVE: The objective of this study was to compare the nutritional status and dietary intake of pregnant women with sickle cell disease (SS hemoglobinopathy and SC hemoglobinopathy) to healthy controls and report the maternal and perinatal outcomes.METHODS: This is a prospective, longitudinal cohort study. Pregnant women with a diagnosis of sickle cell disease and control group were recruited in an outpatient clinic of a tertiary care hospital in Sao Paulo, Brazil. Maternal anthropometric data and dietary intake data were collected at the second and third trimesters.RESULTS: A total of 49 pregnancies complicated by sickle cell disease were included. Prepregnancy body mass index was significantly lower in the SS hemoglobinopathy group (n=26, median 20.3 kg/m(2)) than the SC hemoglobinopathy group (n=23, 22.7 kg/m(2)) or control group (n=33, 23.2 kg/ m(2), p<0.05). The prepregnancy nutritional status revealed significantly more women classified as underweight in the SS hemoglobinopathy group (15.4%) than in the SC hemoglobinopathy group (4.4%) and control group (1.6%, p=0.009). In the second trimester, maternal protein intake was significantly lower in SS hemoglobinopathy (73.2 g/day) and SC hemoglobinopathy (68.8 g/day) than in the control group (95.7 g/day, p=0.004). In the third trimester, only SS hemoglobinopathy mothers showed dietary intake of protein significantly lower than that of the controls (67.5 g/day vs. 92.8 g/day, p=0.02). Vitamin A and E consumption was also reduced in the third trimester in the SS hemoglobinopathy group (p<0.05).CONCLUSION: The nutritional status of pregnant women with SS hemoglobinopathy is characterized by a state of undernutrition. The lower protein intake in the second and third trimesters of pregnant women with SS hemoglobinopathy may contribute to this condition. Undernourishment is a serious complication of sickle cell disease, primarily during pregnancy, and it should be addressed during the prenatal period.
Exploring the use of the GLIM criteria to diagnose malnutrition in cancer inpatients
(2023) OZORIO, Gislaine Aparecida; RIBEIRO, Lia Mara Kauchi; SANTOS, Barbara Chaves; BRUZACA, Wannia Ferreira de Sousa; ROCHA, Gabriela Del Gallo Vieira da; MARCHI, Luani Maria da Fonseca; SANTOS, Fernando Magri; ALMEIDA, Maria Manuela Ferreira Alves de; KULCSAR, Marco Aurelio Vamondes; RIBEIRO, Ulysses; CORREIA, Maria Isabel Toulson Davisson; WAITZBERG, Dan Linetzky
Objectives: The Global Leadership Initiative on Malnutrition (GLIM) criteria establish a diagnosis of malnutrition based on the presence of at least one phenotypic and one etiologic criterion. This study aimed to assess the concurrent and predictive validity of the GLIM criteria in hospitalized cancer patients.Methods: This is an observational retrospective study, including 885 cancer patients, ages >18 y, admitted to a medical oncology inpatient unit between 2019 and 2020. All patients at risk for malnutrition according to the Nutritional Risk Screening 2002 score were assessed by the subjective global assessment (SGA) and 14 different combinations of the GLIM criteria. The SGA was considered the gold standard for assessing the con-current validity of the GLIM combinations. For a subsample of patients with data available on inflammatory markers (n = 198), the serum albumin and C-reactive protein were included in the combinations as etiologic criteria. The predictive validity of the different combinations was tested using the occurrence of surgical complications as the clinical outcome. The sensitivity and specificity values were calculated to assess the con-current validity, univariate and multivariate logistic regression models were used to test predictive validity. Adequate concurrent and predictive validity were determined as sensitivity and specificity values >80% and odds ratio values >2.0, respectively.Results: The median age of the patients was 61.0 y (interquartile range = 51.0-70.0). Head and neck cancer was the prevailing diagnosis and 375 patients were at nutritional risk. According to the SGA, 173 (26.1%) patients were malnourished (SGA categories B or C) and the prevalence of malnutrition ranged from 3.9% to 30.0%, according to the GLIM combinations. None of the tested combinations reached adequate concurrent validity; however, the presence of malnutrition according to four combinations independently predicted surgical complications.Conclusions: The predictive validity of the GLIM was satisfactory in surgical cancer patients.
Hypertension in the Developing World
(2023) KOCH, V. H.
Hypertension is a major global chronic noncommunicable disease (NCD). Despite continued efforts to establish public policies to ensure surveillance and monitoring, the absolute numbers of patients affected by hypertension in low- and middle-income countries are likely to grow, as economic improvement favors longer life expectancy. Increasing longevity provides longer periods of exposure to the risk factors of cardiovascular disease (CVD), resulting in a greater probability of clinical manifestation of CVD events, especially because of the lack of awareness and insufficient treatment of the affected individuals. The survivors of an economic transition period are more likely to present the phenotype of lower birth weight coupled with either stunting or a higher body mass index in childhood or adulthood, which appears to be associated with the highest risks of morbid cardiovascular, renal, and metabolic outcomes into adulthood. The combination of population-wide and individual interventions may save millions of lives and considerably reduce human suffering from NCDs. © Springer Nature Switzerland AG 2023.
Medicine of Giant Armadillos (Priodontes maximus)
(2022) KLUYBER, D.; DESBIEZ, A. L. J.
The giant armadillo is vulnerable to extinction and this solitary, rare, nocturnal species can locally disappear without people even knowing it exists. Anthropogenic impacts such as habitat loss, deforestation, fire, and roadkill are the main threats for this species. Recently, wildlife diseases have been identified as an important threat. In the 21st century, the world´s biggest still lacks basic scientific knowledge on its natural history, biology, and health. Giant armadillos occur at low density, and are rarely seen in the wild, and are very challenging to study. Additionally, there are few individuals in zoos, and little is known about the husbandry and nutritional needs for this species in captivity. Most of the information presented in this chapter is the results from a few studies on ecology and medicine, of wild giant armadillos in Brazil and Colombia. © 2023 Elsevier Inc. All rights reserved.
Prevalence and genetic diversity of avian haemosporidian parasites in islands within a mega hydroelectric dam in the Brazilian Amazon
(2023) ANJOS, Carolina C.; BICUDO, Thiago; FECCHIO, Alan; ANCIAES, Marina; MATHIAS, Bruno S.; CHAGAS, Carolina R. F.; BELL, Jeffrey A.; GUIMARAES, Lilian O.; MONTEIRO, Eliana F.; KIRCHGATTER, Karin
The Brazilian Amazon supports an extremely diverse avifauna and serves as the diversification center for avian malaria parasites in South America. Construction of hydroelectric dams can drive biodiversity loss by creating islands incapable of sustaining the bird communities found in intact forest sites. Besides anthropogenic actions, the presence of parasites can also influence the dynamics and structure of bird communities. Avian malaria (Plasmodium) and related haemosporidian parasites (Haemoproteus and Leucocytozoon) are a globally distributed group of protozoan parasites recovered from all major bird groups. However, no study to date has analyzed the presence of avian haemosporidian parasites in fragmented areas such as land bridge islands formed during artificial flooding following the construction of hydroelectric dams. The aim of this study is to assess the prevalence and molecular diversity of haemosporidians in bird communities inhabiting artificial islands in the area of the Balbina Hydroelectric Dam. The reservoir area covers 443,700 ha with 3546 islands on the left bank of the Uatuma River known to contain more than 400 bird species. We surveyed haemosporidian infections in blood samples collected from 445 understory birds, belonging to 53 species, 24 families, and 8 orders. Passeriformes represented 95.5% of all analyzed samples. We found a low overall Plasmodium prevalence (2.9%), with 13 positive samples (two Plasmodium elongatum and 11 Plasmodium sp.) belonging to eight lineages. Six of these lineages were previously recorded in the Amazon, whereas two of them are new. Hypocnemis cantator, the Guianan Warbling Antbird, represented 38.5% of all infected individuals, even though it represents only 5.6% of the sampled individuals. Since comparison with Plasmodium prevalence data prior to construction of Balbina is not possible, other studies in artificially flooded areas are imperative to test if anthropogenic flooding may disrupt vector-parasite relationships leading to low Plasmodium prevalence.