Restricted food intake after bariatric surgery can be an important factor both in the long-term control of body weight and in the onset of nutritional deficiencies. The objective of this study was to assess the adequacy of food intake in women two or more years after bariatric surgery according to the excess weight lost. A group of 141 women who underwent banded Roux-en-Y gastric bypass (RYGB) was divided according to the percentage of excess weight they lost (%EWL)<50; 50┤75; = 75. The habitual energy and nutrient intakes were determined by a 24-hour recall over two days and the probability of adequate intake was based on the Dietary Reference Intake. The mean total estimated energy requirement (EER) as well as energy, macronutrient and cholesterol intakes did not differ among the groups. Only the %EWL<50 group had an intake equal to their EER, but they presented a higher number of inadequacies, such as low levels of magnesium, folic acid and vitamins C and E. Calcium and dietary fiber intakes were extremely low in all three groups. In conclusion, weight loss after surgery is associated with food habits that favor energy intake over micronutrient intake.
-Context -Undernutrition is a well known underlying cause in both disease onset and outcome. Objective -To associate disease severity with pre surgical nutritional status, the main postsurgical complications, and mortality in esophagus cancer patients. Method -Retrospective data from 100 patients (38-81 years old, 85% males) who had undergone esophagectomy (G1/n = 25) or gastro/jejunostomy (G2/n = 75) between 1995 and 2004. Data included clinical, endoscopic, histological (TNM-UICC), dietary, anthropometric, blood chemistry, and postsurgical (>30 days) complications and mortality. Surgical groups were compared by Student's test and existing associations between variables by either c 2 or Fisher exact tests with P = 0.05. Results -The studied sample was predominantly male (85%), white (80%), smokers and alcoholics (95%), dysphagics (95%) mostly presenting body weight loss before cancer diagnosis (78%). TNM III and IV predominated over I and II, associated (P≤0.005) with higher body mass index and hypoalbuminemia (<3.5 mg/dL) frequency. Esophagic obstructions (n = 77) were associated (P = 0.002) with lower body mass index (kg/m 2 ). Postsurgical complications were more common in G1 (69.2%) than G2, predominantly with infections in G2 (80%) and pleura-pulmonary in G1 (61%). Body mass index and lower lymphocyte counts were associated with early infections and postsurgical complications in G2. Plasma albumin levels were lower in this group than G1, and were associated with postsurgical complications and mortality whereas lower lymphocyte counts was associated with mortality in G1. Conclusions -Disease severity (or late diagnosis) is associated with poor nutritional status and palliative surgery which lead to more complicated postsurgery outcome and mortality. Early diagnosis and nutritional intervention are the recommended actions.
Rev. Nutr., Campinas, 16 (4) R E S U M O IntroduçãoA alergia ao látex tornou-se um risco crescente aos indivíduos expostos, como os profissionais da área da saúde, tendo como agravo a associação com hipersensibilidade a vários alimentos, especialmente frutas. ObjetivoAvaliar a freqüência de sensibilização ao látex e a frutas em profissionais da área da saúde. MétodosForam avaliados 53 profissionais da saúde, 81,9% do sexo feminino, aplicando-se questionário alergológico e testes cutâneos por puntura para alérgenos inaláveis, do látex e de frutas (mamão papaia, kiwi, abacate, banana, figo, tomate, noz). Resultados ConclusãoEstes achados demonstram a existência da alergia látex-fruta, como descrito na literatura, sendo de suma importância uma avaliação in vivo em profissionais da área de saúde, caracterizados como potencial grupo de risco.Termos de indexação: hipersensibilidade ao látex, reatividade cruzada, profissionais de saúde.
Introdução: Sintomas de impacto nutricional (SIN) são comuns em pacientes hospitalizados e estes podem ser agravados na presença da desnutrição. Objetivo: Verificar a presença de SIN e sua associação com as variáveis sociodemográficas, clínicas, fenótipo de sarcopenia e estado nutricional de indivíduos hospitalizados. Métodos: Trata-se de estudo transversal com pacientes internados, de ambos os sexos e idade ≥ 50 anos. Realizou-se Avaliação Subjetiva Global produzida pelo Paciente (ASG-PPP), força de preensão palmar (FPP), velocidade de caminhada (VC) e medidas antropométricas até 48 horas da admissão. Os SIN foram obtidos por meio da ASG-PPP e compilados em <3 ou ≥3 sintomas. Realizou-se o teste de qui-quadrado (χ2). Adotou-se nível de significância de 5%. Resultados: Um total de 90 pacientes (65,4±9,67 anos), sendo a maioria homem (56,7%), idoso (70,0%), casado (68,9%), classe econômica baixa (72,2%), sem atividade de trabalho (70,5%), com uma a duas doenças pregressas (60,0%), excesso de peso ao índice de massa corporal (46,7%) e adequada espessura do músculo adutor do polegar (83,3%). Os SIN “boca seca”, “anorexia” e “cheiros enjoam” foram os mais prevalentes, respectivamente 31,1%, 30,0% e 16,7%. Houve associação dos SIN com as variáveis que compõem o fenótipo de sarcopenia: o escore SARC-F (p=0,002) e FPP (p=0,016), status de sarcopenia (p=0,020), ASG-PPP (p<0,001) e classe econômica (p=0,020). Conclusão: A identificação de SIN é comum, podendo inferir negativamente no estado nutricional e desempenho funcional dos pacientes. Considerar o uso de protocolos para identificação dos SIN durante a hospitalização a fim de minimizar a repercussão negativa no estado nutricional.
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