scholarly journals WHICH PATIENTS SURGICALLY TREATED FOR UROLITHIASIS NEED NUTRITIONAL CARE?

Author(s):  
V. Aparecida Leandro-Merhi ◽  
J.L. Braga de Aquino ◽  
R. Marmiroli ◽  
L. Oliveira Reis

Introduction: The present study is justified by the interest of investigating the impact of nutritional status on urology patients. Objective: To investigate the nutritional status of urology patients and identify the risk factors associated with type of kidney stone. Method: This cross-sectional study assessed the nutritional status and energy and nutrient intakes of 175 hospitalized adult urology patients stratified as follows: patients submitted to percutaneous nephrolithotripsy (PN), patients submitted to endoscopic ureterolithotripsy (EU), and patients without kidney stones. All study variables were investigated as possible predictors of urologic diseases. Multinomial logistic regression analysis and the proportional odds model identified the factors associated with kidney stones. The significance level was set at 5%. Results: Kidney stones were more common in females (p<0.0001), EU patients without nutritional risk according to the Nutritional Risk Screening (NRS) (p=0.0061), patients with normal triceps skinfold thickness (p=0.015), and younger patients (p=0.0001). Patients hospitalized for longer periods (p=0.0038) and older patients (p=0.0001) did not have kidney stones. In EU patients kidney stones were associated with being female (p<0.0001; OR: 3.699; CI: 2.001; 6.838), having mid-upper arm muscle circumference between the 10th and 90th percentiles (p=0.0477; OR: 3.164; CI: 1.012; 9.895), not being at nutritional risk according to the NRS (p=0.0308; OR: 3.265; IC: 1.116; 9.557), and being younger (p=0.0008; OR: 0.966; CI: 2.001; 6.838). Conclusion: PN patients seem to need nutritional assessment and follow-up, while patients with kidney stones smaller than one centimeter do not seem to need routine nutritional assessment.

2014 ◽  
Vol 17 (1) ◽  
pp. 45-58 ◽  
Author(s):  
Daniele Marano ◽  
Silvana Granado Nogueira da Gama ◽  
Rosa Maria Soares Madeira Domingues ◽  
Paulo Roberto Borges de Souza Junior

OBJECTIVE: To assess the prevalence and potential factors associated with pre-pregnancy nutritional status of women. METHODS: This is a cross-sectional study carried out between December 2007 and November 2008 with 1,535 women in the first trimester of pregnancy and randomly selected in health units of the Brazilian public health system (SUS) in the municipalities of Queimados and Petrópolis in the State of Rio de Janeiro. The diagnosis of nutritional deviations was based on the Body Mass Index, according to the classification of the Institute of Medicine, and the following categories were obtained: underweight, normal weight, overweight and obesity. In the statistical analysis, the multinomial logistic regression model was used and an odds ratio and confidence interval of 95% were estimated. RESULTS: The sample included women between 13 and 45 years. The prevalence of underweight, overweight and obesity were 10, 18 and 11%, respectively. Women living in Queimados, adolescents, women who did not live with a partner and smokers had a higher proportion of low pre-pregnancy weight. There was an association between hypertension, overweight and obesity. Adolescents presented lower chance to overweight and obesity. Living in Queimados reduced the odds of overweight. CONCLUSION: The proportion of pre-pregnancy nutritional deviations was high, and recognizing factors that lead to them is very important for an early identification of women at nutritional risk, with view to interventions to reduce the adverse effects of malnutrition on maternal and child health.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ana Paula Rocha Trotte ◽  
Rosana Oliveira Macedo ◽  
Thaiza Fragoso Nunes ◽  
Danielly Rodrigues Wassita da Rocha ◽  
Maria Eliza De Gouvêa Marti Ferrão

Abstract Objectives To identify the nutritional profile of adult and elderly patients with colorectal cancer admitted to a Proctology ward for large elective surgeries. Methods A cross-sectional and retrospective study was performed with 31 patients of both genders, aged 39 to 77 years with colorectal cancer. The nutritional screening parameters used were the percentage of weight loss and Nutrition Risck Screening (NRS 2002). The data (percentage of weight loss and NRS 2002) were collected through a nutritional assessment form completed in the care routine, applied within 72 hours after the patient's hospitalization. Results The study included 13 adults (41.9%) and 18 elderly (58.1%). The evaluation of the percentage of weight loss showed that 7 patients (22.5%) had weight loss greater than 15% in a period of less than or equal to 6 months. In the nutritional risk assessment based on the NRS 2002, we observed that 9 patients (29%) scored 2, while 22 patients (71%) achieved a score equal to or greater than 3. Conclusions The nutritional profile of the evaluated patients showed a considerable prevalence of malnutrition, considering a weight loss of more than 15% in a period of 6 months, which is associated to a decrease in survival in patients with cancer, and is a very relevant data to help in the classification of nutritional status. The classification by the NRS 2002, showed a high prevalence of patients at nutritional or malnourished risk. Variation in the classification of nutritional status using several parameters reinforces the need for them to be used in a complementary way. Funding Sources Hospital Federal dos Servidores do Estado, Ministerio da Saude.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
B. T. Mkhize ◽  
M. H. L. Mabaso ◽  
S. Madurai ◽  
Z. L. Mkhize-Kwitshana

Serum prealbumin is considered to be as important as albumin in the nutritional status assessment. However, there is relatively little evidence of its advantage over the commonly used albumin. This study investigated the use of prealbumin compared to albumin as a marker of nutritional status in adults singly and dually infected with human immunodeficiency virus (HIV) and intestinal helminths, with or without inflammatory conditions, in different body mass index (BMI) categories. This cross-sectional study was conducted in a periurban setting in KwaZulu-Natal, South Africa. Multivariate multinomial logistic regression models were fitted to investigate the effect of prealbumin and albumin in nutritional assessment among HIV and helminth individuals with or without inflammation, indicated by elevated and normal C-reactive protein (CRP) levels. In normal CRP, albumin was significantly lower in unadjusted BMI [RRR = 0.8, p = 0.001] and in normal weight [RRR = 0.7, p = 0.003] and overweight [RRR = 0.5, p = 0.001] participants. In elevated CRP, albumin was significantly lower [RRR = 0.8, p = 0.050] and prealbumin was significantly higher in unadjusted BMI [RRR = 1.2, p = 0.034] and overweight [RRR = 1.4, p = 0.052] individuals. The current study found that prealbumin can differentiate between inflammation-induced reduction of albumin and true malnutrition in adults singly or coinfected with HIV and intestinal helminths in the presence or absence of inflammation in various BMI categories.


Author(s):  
Thalita Morgana Guimarães SILVEIRA ◽  
Juliana Barbosa de SOUSA ◽  
Maria Luiza Ferreira STRINGHINI ◽  
Ana Tereza Vaz de Souza FREITAS ◽  
Paulla Guimarães MELO

BACKGROUND: The assessment of nutritional status in clinical practice must be done with simple, reliable, low cost and easy performance methods. The power of handshake is recognized as a useful tool to evaluate muscle strength, and therefore, it is suggested that can detect malnutrition. AIM: To evaluate the nutritional status by subjective global assessment and power of handshake preoperatively in patients going to gastrointestinal surgeries and to compare the diagnosis obtained by subjective global assessment with traditional anthropometric methods and power of handshake. METHODS: A cross-sectional study was conducted with patients for surgery in the gastrointestinal tract and related organs. Socioeconomic and anthropometric data, applied to subjective global assessment and checked the power of handshake, were collected. The force was obtained by the average of three measurements of the dominant and non-dominant hand and thus compared with reference values of the population by sex and age, for the classification of nutritional risk. RESULTS: The sample consisted of 40 patients, 24-83 years, and most women (52.5%) housewives (37,5%) and diagnosed with cancer (45%). According to subjective global assessment, 37.5% were classified as moderately malnourished; 15% were underweight by BMI measurements; 25% had arm circumference at risk for malnutrition (<percentil 5); 60% reported recent weight loss; and 37.5% low clamping force in power of handshake on non-dominant hand (left). CONCLUSION: A significant association was observed for the diagnosis of nutritional subjective assessment with anthropometric methods and strength of the handshake only at the non-dominant limb.


2020 ◽  
Vol 2 (35) ◽  
pp. 160-165
Author(s):  
Ludiane Alves do Nascimento ◽  
Grasiela K. P. Andrade ◽  
Juliana Bonfleur Carvalho ◽  
Ana Lucia Chalhoub Chediac Rodrigues ◽  
Ariane Nadólskis Severine

Introduction: In 2050, we estimate that the population of individuals who are 90 years of age or older will be five times higher than that in 2010. Among elderly people, the disease process can contribute to a worsening nutritional status. This article aims to examine the associations among nutritional status and initial diagnoses, muscle mass, routes of feeding, and clinical outcomes. Despite the progressive increase in this population and their particularities, few studies have been conducted among nonagenarians. Methods: This was a cross-sectional study that included patients over 90 years old admitted to Hospital Sírio Libanês. The following parameters were assessed: calf circumference (CC), body mass index (BMI), routes of feeding and medical diagnosis. Nutritional screening was performed using the Mini Nutritional Assessment (MNA). Results: A total of 79 patients were assessed, and they had a median age of 92 years, a median BMI of 22.6 kg/m2 and median hospital stay of 13 days. A total of 59.5% of the patients (n=47) were female. The frequency of malnutrition (as assessed by the BMI) was 54.4%. There was a positive relationship (71.4%) between CC <31 cm and underweight (as assessed by the BMI) (p=0.032). Malnutrition (classified using the MNA) was significantly associated with dysphagia (77.4%) (p=0,003), the use of supplements (p=0.002) and enteral nutrition therapy (p=0.005). Mortality (25.8%) was also significantly related to malnutrition, showing that nutritional status contributed to poor clinical outcomes in patients (p=0.042). Conclusion: Dysphagia had a positive relationship with malnutrition because it is a condition that affects food intake. The use of supplements and a higher indication for enteral nutritional therapy both had a positive relationship with malnutrition because they are conducts indicated to improve nutritional status, showing that specific nutrition assistance strategies for this age group can contribute to improved nutritional status in nonagenarians.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Tesfaye Assefa ◽  
Omer Seid ◽  
Fentaw Tadese ◽  
Tsegaye Gebremedhin

Background. Psychiatric illnesses involve alterations in the brain or nervous system function and result in altered perception, responses to the environment, and daily functioning, which ultimately diminish the capacity to cope with the regular demands of life, including nutritional intake. Little is known about nutritional status in psychiatric patients in our setup, particularly in northeast Ethiopia. Thus, this study is aimed at assessing the nutritional status and associated factors among adult psychiatric patients in Dessie referral hospital, northeast Ethiopia. Methods. A facility-based cross-sectional study was employed among 530 psychiatric patients using an interviewer-administered structured questionnaire, and anthropometric measurements were taken from April 10 to June 20, 2018. Multinomial logistic regression analysis was used to identify the associated factors with the nutritional status of adult psychiatric patients. Results. The study revealed that the proportion of undernutrition and overnutrition was 20.0% (95% CI: 16.80-23.60) and 23.4% (95% CI: 19.80-27.00), respectively. Being male (AOR: 2.39, 95% CI: 1.28-4.47), private employed (AOR: 0.08, 95% CI: 0.02-0.31), and not consuming alcohol (AOR: 0.20, 95% CI: 0.56-0.74) were factors associated with undernutrition. Whereas not involved in physical activity (AOR: 2.98, 95% CI: 1.37-6.49), being newly diagnosed patient (AOR: 1.86, 95% CI: 1.01-3.42), and not chewing Khat (AOR: 3.92, 95% CI: 1.63-9.42) were factors associated with overnutrition of adult psychiatric patients. Conclusion. The proportion of both undernutrition and overnutrition was above the national average. Notably, nutrition significantly affects the production and use of neurotransmitters, and this may result in significant effects on physical, mental, or emotional processes. This undoubtedly affects the stabilization processes of neuropsychiatric patients. Therefore, healthcare managers, supervisors, and policymakers identify those vulnerable groups early and thereby design effective nutritional strategies to intervene in malnutrition among adult patients with a psychiatric disorder.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoning Liu ◽  
Jing Cao ◽  
Zheng Zhu ◽  
Xia Zhao ◽  
Jing Zhou ◽  
...  

Abstract Background Nutrition is a crucial factor that can impact morbidity and mortality in older people living with HIV (PLWH). Studies on nutritional risk and nutritional status in all age groups in PLWH have been conducted. However, few studies have focused on nutritional risk in older PLWH. This study aimed to describe the nutritional risk and nutritional status in older PLWH, and explore factors associated with nutritional risk and undernutrition status. Methods We conducted a cross-sectional study. We recruited participants aged 50 years or older from the Third People’s Hospital of Shenzhen from January 2016 to May 2019. Nutritional risk and nutritional status were evaluated by the Nutritional Risk Screening 2002 (NRS 2002) tool, body mass index (BMI), albumin level, and prealbumin level on the first day of admission. Logistic regression models were used to identify the factors associated with undernutrition based on the BMI, albumin, and prealbumin criteria. Results A total of 196 older PLWH were included in the analysis. We found that 36% of hospitalized older PLWH had nutritional risk, and 12–56% of them had undernutrition based on the BMI, albumin, and prealbumin criteria. An increased nutritional risk score was associated with older age (β = 0.265 CI [0.021, 0.096], P = 0.002), a higher viral load (β = − 0.186 CI [− 0.620, − 0.037], P = 0.028), a lower BMI (β = − 0.287 CI [− 0.217, − 0.058], P = 0.001), and a lower albumin level (β = − 0.324 CI [− 8.896, − 1.230], P = 0.010). The CD4 count was associated with the prevalence of undernutrition based on the albumin criterion (OR = 15.637 CI [2.742, 89.178], P = 0.002). Conclusion Our study indicated that nutritional screening, assessment, and management should be routinely performed in hospitalized older PLWH. HIV-specific measures should be used to assess nutritional risk, and albumin, BMI, and other assessments should be used in combination to identify undernutrition in older PLWH.


Author(s):  
Simon Eyongabane Ako ◽  
Bimabam Josiah ◽  
Oscar Sakwe ◽  
Tembong Nerville ◽  
Vicky Tankeu Ndassi

Introduction: Anemia in pregnancy represents a life-threatening but preventable reason for maternal and childhood morbidity and mortality. Although intervention measures are practiced in most affected countries like Cameroon, the impact of anemia on pregnant women is still apparent in most local communities. The relative contribution of sociodemographic related to anemia throughout gestation varies greatly and warrants investigation in urban and rural communities in developing countries, where the condition is most apparent. Methods: A cross-sectional study design was carried out from February to July 2019 at six sites, Regional Hospital Buea, Bokwango Integrated Health Center (IHC), Buea - Road IHC, Buea town IHC, Molyko IHC, and Great Soppo IHC. A total of 408 pregnant women were enrolled in the study. The sociodemographic characteristics identified through questionnaires filled by the participants included age, marital status, educational status, occupation, gravida status, alcohol intake, iron folate intake, knowledge on anemia and crave for non-food substance. The clinical factors of participants gathered included previous records of diarrhea within the last 6 months, diagnosis for worm infection for the last 6 months, diagnosis for Malaria for the last 6 months. A blood sample was collected and analyzed with a haemoglobinometer ( HemoCue  201+ system, Sweden). SPSS version 22 statistical package software was used to perform the data analysis. Factors related to anemia among participants unadjusted and adjusted odds ratios with their 95%CI were calculated using logistic regression models. Results: The prevalence of anemia was 50 %. Among the anemic study participants 0.74 %, 11.76 %, and 37.50 % recorded severe, moderate, and mild levels of anemia respectively. The majority of the anemic participants 195 (95.6%) and 126 (61.8) had recently been diagnosed for Malaria and worm infections respectively. Craving for non-food substances (Calabar clay) and poor adherence to iron folate intake had a prevalence of 120 (58.8%) and 117 (57.4%) respectively. Multinomial logistic regression analysis showed that, irregular adherence to iron folate intake and reduce intake of iron folate frequency 2-3 times/week was statistically significantly associated with anemia (p=0.0001 and p= 0.0001 respectively). We equally observed a statistically significant association of alcohol drink consumption and craving for non-food substances (Calabar clay) with anemia (p=0.004 and p=0.0001 respectively). Cases of worm infection for the last 6 months were statistically significantly related to anemia (p = 0.004). Conclusion: Anemia is high among pregnant women in the Buea health district. Factors associated with persistent anemia despite intervention measures in the community hospitals include malaria; no intake or reduced intake of iron folate; alcohol drinks consumption; craving for non-food substances (Calabar clay) and previously diagnosed worm infection within the last 6 months.


Author(s):  
R. Zelig ◽  
L. Byham-Gray ◽  
S.R. Singer ◽  
E.R. Hoskin ◽  
A. Fleisch Marcus ◽  
...  

Background and Objective: Older adults are at risk for both impaired oral health and suboptimal nutritional status. The objective of this study was to explore the relationships between malnutrition risk and missing teeth in community-dwelling older adults. Design: This was a retrospective cross-sectional analysis of data obtained from the electronic health records of 107 patients aged 65 and older who attended an urban northeast US dental school clinic between June 1, 2015 and July 15, 2016. Odontograms and radiographs were used to identify teeth numbers and locations; malnutrition risk was calculated using the Self-Mini Nutritional Assessment (Self-MNA). Relationships between numbers of teeth and malnutrition risk were assessed using bivariate logistic regression. Results: Participants (N=107) were 72.6 years (SD=5.6) of age; 50.5% were female. Mean Self-MNA score was 12.3 (SD=2.0) reflective of normal nutrition status; 20.6% were at risk for malnutrition, 4.7% were malnourished. Greater than 87% were partially or completely edentulous. Those with 10-19 teeth had lower Self-MNA scores (mean=11.6, SD=2.5) than those with 0-9 teeth (mean=12.7, SD=1.3) or 20 or more teeth (mean=12.6, SD=1.8) and had an increased risk for malnutrition (OR=2.5, p=0.076). Conclusion: The majority of this sample of older adults were partially edentulous and of normal nutritional status. Those with 10-19 teeth were more likely to be at risk for malnutrition. Further studies are needed to examine relationships between tooth loss and malnutrition risk and the impact of impaired dentition on the eating experience in a larger sample and to inform clinical practice.


2012 ◽  
Vol 49 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Vânia Aparecida Leandro-Merhi ◽  
José Luiz Braga de Aquino

CONTEXT: The investigation of risk factors associated with nutritional status could contribute for better knowledge of the malnutrition. OBJECTIVE: To investigate the incidence of malnutrition and its possible association with many parameters that assess nutritional status and to identify the associated risk factors. METHODS: The nutritional status was assessed in 235 hospitalized patients. Malnutrition was defined as present when the patient presented at least two anthropometric criteria below the normal range and habitual energy intake below 75% of the energy requirement (HEI/ER<75%). Gender, age, type of disease, recent weight change and dental problems were investigated as possible associated risk factors. The chi-square and Mann-Whitney tests were used to compare the data and univariate and multiple logistic regressions were used to identify the factors associated with malnutrition. The odds ratio (OR) and confidence interval (CI) of 95% were calculated with the significance level set at 5% (P<0.05). RESULTS: One-fifth (20%) of the patients were malnourished on admission to the hospital and 27.5% reported recent weight loss. Malnutrition (P<0.0001) was greater in patients with malignant diseases. The only variables significantly associated with malnutrition according to univariate logistic regression were recent weight loss (P = 0.0058; OR = 2.909; IC95% = 1.362; 6.212) and malignant disease (P = 0.0001; OR = 3.847; IC95% = 1.948; 7.597). When multiple regression was used in the model which included type of disease, malignant disease was shown to increase the chance of malnutrition fourfold (P = 0.0002; OR = 3.855; IC95% = 1.914; 7.766). When disease was excluded, recent weight loss also increased malnutrition fourfold (P = 0.0012; OR = 3.716; IC95% = 1.677; 8.236). CONCLUSION: Patients with a history of recent weight loss and those with malignant diseases are more susceptible to malnutrition.


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