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INTRODUCTION: Sepsis is one of the main causes of mortality in patients in Intensive Care Units. As a result of the systemic inflammatory response and of the decrease of the aerobic metabolism in sepsis, the oxidative stress occurs. Vitamin A is recognized by the favorable effect that it exerts on the immune response to infections and antioxidant action. OBJECTIVE: To bring new elements for reviewing of the nutritional support addressed to critically ill patients with sepsis, with emphasis to vitamin A. METHODS: Critically ill patients with sepsis had circulating concentrations of retinol, beta-carotene, thiobarbituric acid-reactive substances (TBARS) and C-reactive protein (CRP) measured in Medicosurgical Intensive Care Unit in the city of Rio de Janeiro, Brazil. The patients were divided into two groups: patients who were receiving nutritional support and those without support. At the act of the patient's admission, APACHE II score was calculated. RESULTS: 46 patients were studied (with diet n = 24 and without diet n = 22). Reduced levels of retinol and beta-carotene were found in 65.2% and 73.9% of the patients, respectively. Among the patients who presented lower concentrations of CRP it was found higher beta-carotene inadequacy (64.8%) and 50% of retinol inadequacy. There was no significant difference as regards retinol, TBARS and APACHE II levels among the patients with and without nutritional support. However, higher levels of CRP (p = 0.001) and lower levels of serum beta-carotene (p = 0.047) were found in patients without nutritional support. CONCLUSIONS: Septic patients presented an important inadequacy of retinol and beta-carotene. The present study bring elements to the elaboration/review of the nutritional protocol directed to the group studied, especially as regards vitamin A intake.

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OBJECTIVES: This study aims to identify birth weight variation according to maternal characteristics and gestational weight gain. METHODS: It is a cross-sectional descriptive study with 433 puerperal women (> or = 20 years old) who attended a public maternity hospital in Rio de Janeiro. The data were collected through interviews with the women and access to their medical records. Several models were tested using linear regression, using the stepwise method to identify the predictive variables of birth weight. RESULTS: The mean maternal age and gestational age at the end of pregnancy were 27 years old (+/- 5.09 years) and 39 weeks (+ 1.68 weeks), respectively. The data shows that the mean number of prenatal and nutritional prenatal care appointments were 8.24 (+/- 2.98) and 2.26 (+/- 2.33), respectively. Among the predictor variables of birth weight, total gestational weight gain (beta = 25.29; p = 0.000), pre-gestational BMI (beta =13.02; p = 0.037), and the number of pre-natal care appointments (beta = 28.21; p = 0.007) were highlighted. The association of weight gain in the three trimesters was also verified. CONCLUSIONS: This study confirms the interface between adequacy of the pre-gestational and gestational nutritional status and some maternal characteristics with birth weight. Nutritional care should be recognised as part of the actions during pre-natal assistance.

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Introduction: Sepsis is one of the main causes of mortality in patients in Intensive Care Units. As a result of the systemic inflammatory response and of the decrease of the aerobic metabolism in sepsis, the oxidative stress occurs. Vitamin A is recognized by the favorable effect that it exerts on the immune response to infections and antioxidant action. Objetive: To bring new elements for reviewing of the nutritional support addressed to critically ill patients with sepsis, with emphasis to vitamin A. Methods: Critically ill patients with sepsis had circulating concentrations of retinol, β-carotene, thiobarbituric acid-reactive substances (TBARS) and C-reactive protein (CRP) measured in Medicosurgical Intensive Care Unit in the city of Rio de Janeiro, Brazil. The patients were divided into two groups: patients who were receiving nutritional support and those without support. At the act of the patient's admission, APACHE II score was calculated. Results: 46 patients were studied (with diet n = 24 and without diet n = 22). Reduced levels of retinol and β-carotene were found in 65.2% and 73.9% of the patients, respectively. Among the patients who presented lower concentrations of CRP it was found higher β-carotene inadequacy (64.8%) and 50% of retinol inadequacy. There was no significant difference as regards retinol, TBARS and APACHE II levels among the patients with and without nutritional support. However, higher levels of CRP (p = 0.001) and lower levels of serum β-carotene (p = 0.047) were found in patients without nutritional support. Conclusions: Septic patients presented an important inadequacy of retinol and β-carotene. The present study bring elements to the elaboration/review of the nutritional protocol directed to the group studied, especially as regards vitamin A intake (AU)

Introducción: La sepsis es una de las principales causas de mortalidad en pacientes en las Unidades de Cuidados Intensivos. Como consecuencia de la respuesta inflamatoria sistémica y de la disminución del metabolismo aeróbico en la sepsis se produce estrés oxidativo. La vitamina A es reconocida por el efecto favorable que ejerce sobre la respuesta inmunitaria a las infecciones y por su acción antioxidante. Objetivo: Aportar nuevos elementos a la hora de revisar el soporte nutricional de los pacientes críticos con sepsis, con un énfasis sobre la vitamina A. Métodos: Se midieron las concentraciones circulantes de retinol, β-caroteno, ácido tiobarbitúrico-sustancias reactivas (ATBSR) y proteína C reactiva (PCR) de pacientes críticos con sepsis en la Unidad de Cuidados Intensivos Medicoquirúrgica de la ciudad de Río de Janeiro, Brasil. Se dividió a los pacientes en dos grupos: pacientes que recibían soporte nutricional y aquellos que no. Se calculó la puntuación APACHE en el momento de su ingreso. Resultados: Se estudiaron 46 pacientes (con dieta n = 24 y sin dieta n = 22). Se hallaron concentraciones disminuidas de retinol y β-caroteno en el 65,2% y 73,9% de los pacientes, respectivamente. De entre los pacientes que presentaron las menores concentraciones de PCR, se halló una mayor inadecuación de β-caroteno (64,8%) y un 50% de inadecuación de retinol. No hubo diferencias significativas con respecto al retinol, ATBSR y las puntuaciones APACHE II entre los pacientes con y sin soporte nutricional. Sin embargo, se hallaron mayores concentraciones de PCR (p = 0,001) y menores concentraciones séricas de β-caroteno (p = 0,047) en los pacientes sin soporte nutricional. Conclusiones: Los pacientes sépticos presentaron una inadecuación importante de retinol y β-caroteno. El presente estudio aporta elementos a la elaboración/revisión del protocolo nutricional dirigido al grupo estudiado, especialmente con respecto de la toma de vitamina A (AU)

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Objective: This study aims to identify birth weight variation according to maternal characteristics and gestational weight gain. Methods: It is a cross-sectional descriptive study with 433 puerperal women (beta 20 years old) who attended a public maternity hospital in Rio de Janeiro. The data were collected through interviews with the women and access to their medical records. Several models were tested using linear regression, using the stepwise method to identify the predictive variables of birth weight. Results: The mean maternal age and gestational age at the end of pregnancy were 27 years old (± 5.09 years) and39 weeks (+ 1.68 weeks), respectively. The data shows that the mean number of prenatal and nutritional prenatal care appointments were 8.24 (± 2.98) and 2.26 (± 2.33), respectively. Among the predictor variables of birthweight, total gestational weight gain (beta= 25.29; p = 0.000), pre-gestational BMI (beta=13.02; p = 0.037), and the number of pre-natal care appointments (beta= 28.21; p = 0.007)were highlighted. The association of weight gain in the three trimesters was also verified. Conclusions: This study confirms the interface between adequacy of the pre-gestational and gestational nutritional status and some maternal characteristics with birth weight. Nutritional care should be recognised as part of the actions during pre-natal assistance (AU)

Objetivo: Este estudio tiene por objeto identificar la variación de peso al nacimiento en función de las características maternas y la ganancia de peso gestacional. Métodos: Se trata de un estudio transversal y descriptivo con 433 mujeres puérperas (beta 20 años de edad) que acudieron a un hospital maternal de Río de Janeiro. Se recogieron los datos mediante entrevistas con las mujeres y acceso a sus historiales clínicos. Se ensayaron diversos modelos utilizando la regresión linear y el método por pasos para identificar las variables predictivas del peso al nacimiento. Resultados: La edad media materna y la edad gestacional al final del embarazo fueron 27 años (± 5,09 años) y 39semanas (± 1,68 semanas), respectivamente. Los datos muestran que el número medio de visitas prenatales y de educación nutricional prenatal fue de 8,24 (± 2,98) y 2,26 (± 2,33), respectivamente. Entre las variables predictivas del peso al nacimiento, destacaban la ganancia total de peso gestacional (beta= 25,29; p = 0.000), el IMC pre-gestacional(beta= 13,02; p = 0,037) y el número de visitas prenatales (beta= 28,21; p = 0,007). También se verificó la asociación de ganancia de peso en los tres trimestres del embarazo. Conclusiones: Este estudio confirma la interrelación entre un estado nutricional pre-gestacional y gestacional adecuado y algunas características maternas con el peso al nacimiento. Debería reconocerse la atención nutricional como parte de las acciones de la asistencia prenatal (AU)

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One hundred and ninety-eight 24 h-recall questionnaires from pregnant attendees of the public health services in Rio de Janeiro, Brazil, were analyzed, using 5 different Food Composition Tables. The differences in calculated intakes were as high as 88% (793 to 1494 micrograms RE). The differences were significant at the 5% level using Fishers test. The INCAP table was considered more adequate because it gives more attention to the different conversion factors for carotenoids. However, the INCAP Table does not include several foods frequently consumed in Brazil, neither does it show values for culinary preparations and industrialized foods. This study shows that there is a need to improve the tools to evaluate vitamin A intake if we wish to assess nutritional risk in populations.

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