A sarcopenia repercute de maneira importante no estado nutricional do paciente idoso, levando à diminuição da massa corporal magra, das funções orgânicas, da capacidade funcional e ao pior prognóstico clínico, aumentando assim o tempo de internamento e custos hospitalares. O objetivo do estudo foi verificar a associação do diagnóstico de sarcopenia com o diagnóstico clínico, estilo de vida, comorbidades, estado nutricional e risco de sarcopenia dos idosos hospitalizados. Tratou-se de um estudo transversal conduzido na clínica médica de um hospital de grande porte localizado em Pernambuco. Foram realizadas avaliações antropométricas, triagem de risco nutricional, risco e diagnóstico para sarcopenia. A amostra foi constituída por 70 pacientes idosos, onde o risco de sarcopenia ocorreu em 64,25 % dos pacientes, no entanto, 57,10% foram diagnosticados e destes, 97,50% foram considerados graves e 72,9% dos pacientes foram classificados com risco nutricional. Os grupos diferiram quanto ao sexo, profissão, estado nutricional e risco de sarcopenia. O elevado percentual de risco e diagnóstico de sarcopenia reforçam a importância da identificação precoce por apresentarem associação com pior risco e diagnóstico nutricional.
RESUMO Em pacientes cirúrgicos, a desnutrição figura como destaque devido a sua influência no valor prognóstico e no risco de complicações do pós-operatório. Assim sendo, este estudo transversal foi realizado como o objetivo de avaliar a frequência de desnutrição hospitalar em pacientes no préoperatório de cirurgias do trato gastrointestinal. Os pacientes internados em uma clínica cirúrgica de um hospital público em Pernambuco foram submetidos a avaliação nutricional através da antropometria e de parâmetros bioquímicos como: hematócrito, hemoglobina e contagem total de linfócitos. Foram avaliados 70 pacientes, onde 17,1% e 7,1% apresentaram desnutrição moderada e leve, respectivamente, segundo a medida da circunferência do braço. A dobra cutânea tricipital, observou que 24,2% dos pacientes se encontravam desnutridos, sendo 7,1% com desnutrição grave e o mesmo percentual para desnutrição moderada. Já a circunferência muscular do braço detectou 21,4% de pacientes desnutridos, dos quais, 5,7% apresentavam desnutrição moderada e grave. Para o índice de massa corporal, a desnutrição verificada foi de 4,3% da amostra. A contagem total de linfócitos identificou 98,4% com depleção leve. A desnutrição é um achado frequente em pacientes que serão submetidos às cirurgias do trato gastrointestinal, sendo assim, se torna relevante identificar precocemente o indivíduo em desnutrição, através da utilização de diferentes parâmetros, a fim de melhorar o desfecho clínico e nutricional deste paciente.
Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Fundação para a Ciência e Tecnologia (FCT) and Fundo Social Europeu (FSE) Introduction Atypical work schedules encompass more than 20% of the European workforce. The link between shift work and cardiovascular disease (CVD) has been extensively studied being lifestyle behaviours, sleep disruption and circadian misalignment the key mechanisms involved. Social Jetlag (SJL) has been proposed as a proxy for circadian misalignment in epidemiological studies, once it takes into account individual’s chronotype and working schedules. Therefore we hypothesize that, among workers under fixed atypical work schedules, those with a greater SJL have a higher CVD risk. Methods A cross-sectional observational study was conducted among blue-collar workers of one retail company. Fixed working schedules were early morning, late evening, and night work. Sociodemographic, occupational, lifestyle and sleep data were collected through questionnaire. SJL was quantified by the difference for mid-sleep points on work- and free-days. Even though SJL is a continuous variable, 3 categories have been used (≤2h; 2-4h; ≥4h). Blood pressure (BP) and the total cholesterol (TC) were assessed. The CVD risk was estimated according to the relative risk SCORE chart. A relative risk≥3 was considered "high CVD risk". Descriptive statistics and bivariate analysis according to the CVD risk (high vs other) was performed. The relationship between SJL and high CVD risk was analysed through logistic binary regression using generalized linear models adjusted for age, sex, education, Body Mass Index, consumptions, sleep duration and quality plus work schedule and seniority. Results Of the 301 workers, 56.1% were male with a mean age of 33.0 ± 9.4years. Average SJL was 1:57 ± 1:38hours with the majority of workers experiencing ≤2h (59.4%) and 8% (n = 24) more than 4h. Less than a half had hypercholesterolemia (48.8%), overweight (37.9%)or hypertensive values (10.6%), however 50.5% were currently smokers. We found a significant trend for hypertension (p = 0.006) and smoking prevalence (p = 0.043) among ordinal SJL categories. A relative "high CVD risk" was found in 20.3% of the sample (n = 61). These workers were significantly older (p < 0.001), less educated (p = 0.003) and slept less hours on workdays (p = 0.021). In the multiple regression analysis, SJL was an independent risk factor for a "high CVD risk" (p = 0.029).The odds of having a "high CVD risk" increased almost thirty per cent per each additional hour of SJL (OR = 1.29; 95% CI:1.03-1.63), even after adjusting for sociodemographic, lifestyle, sleep and working features. Conclusions We found compelling evidence that a greater SJL was associated with a bigger chance of high CVD risk. From this innovative perspective, the focus is not just on the working schedule itself but also on the worker’s chronotype. These findings suggest that interventions aimed to reduce Social Jetlag, especially in extreme chronotypes and working schedules, poses a great opportunity to minimize the cardiovascular health impact of shift work.
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