BACKGROUND: Patients in end-stage renal disease often suffer from poor appetite, various comorbidities, and dietary restrictions. Despite regular hemodialysis, nutritional imbalances are frequently reported. Aiming to correlate nutritional status with food ingestion, a prospective study was done in an outpatient group. METHODS: Stable patients undergoing chronic hemodialysis for at least 3 months (n = 44) were investigated by dietary recall and standard anthropometric, biochemical, and bioimpedance determinations, including subjective and objective global assessment. The mean age of the group was 47.0 ± 16.9 years, and 63.6% were men. Body mass index was 22.2 ± 3.9 kg/m 2 (mean ± SD), calorie intake was 1471 ± 601 kcal/day (20.7 ± 6.7 kcal/kg/day), and protein ingestion was 74.3 ± 16.6 g protein/day (1.2 g/kg/day). Dietary and clinical findings were correlated with nutritional indices by linear regression analysis. RESULTS: Malnutrition estimated by subjective global assessment was very common (>90%), despite the fact that body mass index and serum albumin were within an acceptable range in the majority of the population. Objective global assessment yelded roughly comparable numerical findings, with 6.8% being well nourished, 61.4% at nutritional risk or lightly undernourished, 29.6% moderately malnourished, and 2.3% severely malnourished. Total calorie intake was devoid of associations, but protein, carbohydrate, and lipid input positively correlated with triceps skinfold (P=.02). Lipid ingestion was the only marker directly associated with arm circumference, and it correlated with body mass index, as well as with total body fat (bioimpedance analysis) (P <.001). CONCLUSIONS: 1) Bioimpedance analysis was useful and was correlated with clinical findings; 2) Lipid intake was the best dietary index in this experience, surpassing protein or total energy; 3) Despite its shortcomings, dietary recall was useful in the assessment of hemodialysis patients.

O objetivo deste estudo foi descrever a prevalência de sífilis e HIV em parturientes atendidas nas maternidades públicas, Vitória, ES. No período de janeiro a maio 2007, elas responderam a entrevista contendo dados sócio-demográficos, comportamentais e clínicos e realizaram teste rápido, ELISA e imunofluorescência indireta para HIV; e teste rápido, VDRL e MHA-TP para sífilis. Um total de 1.380 parturientes foi incluído. A média de idade foi 24,2 (DP 6,1) anos e escolaridade 8,5 (DP 2,6) anos. A prevalência de HIV foi 0,6% (IC95% 0,2%-1,1%) e sífilis 0,4% (IC95% 0,2%-0,9%). O teste rápido para HIV foi concordante com o ELISA e a imunofluorescência indireta em todos os casos. O teste rápido para sífilis foi positivo em seis parturientes, sendo que dois resultados não foram confirmados pelo VDRL e MHA-TP. Entre 71 (5,1%) parturientes que não realizaram pré-natal, o teste rápido para sífilis foi positivo em uma e o HIV em duas delas. Os resultados indicam a importância do teste rápido para o diagnóstico de sífilis e HIV, pois há parturientes que não realizam pré-natal ou que não tem acesso ao resultado ou ao tratamento durante o pré-natal.

(1) Malnutrition profile was rather unique, with relatively favorable objective findings (body mass index, serum albumin) and more deranged SGA; (2) Bioimpedance analysis suggested that phase angle could be used as an indicator of nutritional status; (3) Creactive protein was negatively associated with plasma proteins; (4) Infected subjects, although few and displaying moderate clinical troubles, were responsible for most C-reactive protein determinations above 8 mg/L; (5) Investigation of occult infectious foci is advised in these circumstances.

Adequate prenatal care provides an opportunity for counseling and reducing the complications associated with pregnancy and delivery. Our objective was to describe the demographic, behavioral, and clinical profile of the pregnant women hospitalized at public maternity hospitals and to identify factors associated with six or more prenatal consultations in Vitória, Brazil. A cross-sectional study of 1,380 women was conducted in public maternity hospitals in Vitória, Brazil. Sixty-seven percent of participants had >or=6 prenatal consultations. Reasons for hospitalization were vaginal delivery (55.7%), cesarean section (32.9%), clinical treatment (7.7%), and abortion/miscarriage (3.7%). Having >or=9 years of schooling (odds ratio, OR = 1.8; 95% confidence interval, CI: 1.1-3.1), being married (OR = 1.9; 95% CI: 1.2-2.9) and delivering at term (OR = 3.6; 95% CI: 1.6-8.2) were significantly independently associated with having >or=6 prenatal consultations. Although higher education, being married, and delivering at term were associated with >or=6 prenatal consultations in this population, the high rate of Cesarean sections demonstrates the need for ongoing educative strategies among health professionals.

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