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O objetivo do trabalho foi avaliar a efetividade da dieta isenta de glúten em pacientes portadores de doenças autoimunes. Estudo retrospectivo com abordagem quantitativa e descritiva. Coleta de dados foi realizada a partir de prontuários de pacientes de uma clínica de nutrologia e de um consultório nutricional da região de Curitiba-PR. A amostra foi composta por 24 mulheres, portadoras de doenças autoimunes, orientadas a excluir o glúten da dieta. Obtendo-se como resultados média de idade de 57 anos, média de tempo de acompanhamento médico e/ou nutricional de 27,2 meses (±22,3), principais morbidades referidas Artrite Reumatoide e Tireoidite de Hashimoto. O estado nutricional prevalente a partir do IMC foi eutrofia com predomínio do quadro sintomatológico de dores no corpo, constipação e cansaço. Constatou se melhora no quadro sintomatológico após a adoção de dieta isenta de glúten em 76% dos pacientes. Logo, essa terapia dietética pode contribuir com uma melhor evolução clínica. (AU)

This study evaluated the effectiveness of a gluten-free diet in patients with autoimmune diseases. Retrospective study white a quantitative and descriptive approach. Data collection was carriedfrom medical records of patients from a nutrition clinic and a nutritional office in the region of Curitiba-Pr. The sample consisted of 24 women, with autoimmune diseases, oriented to exclude gluten from their diet. Obtaining as results mean age of 57 years, mean time of medical and/or nutritional follow-up of 27.2 months (±22.3), main morbidities referred to Rheumatoid Arthritis and Hashimoto's Thyroiditis. The prevalent nutritional status based on the BMI was eutrophic, with a predominance of the symptoms of body aches, constipation and tiredness. An improvement in the symptoms was found after the adoption of a gluten-free diet in 76% of patients. Therefore, this dietary therapy can contribute to a better clinical evolution. (AU)

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BACKGROUND: The bioelectrical impedance (BI) phase angle (PA), analyzed directly through BI analysis (BIA), is determined by tissue cellularity, representing a direct measure of cellular stability and, for this reason, has been studied and considered as an indicator of prognosis and nutrition status in adults and children. OBJECTIVE: We aimed to determine if PA can be an indicator of mortality and prognosis in newborns admitted to the neonatal intensive care unit (NICU). METHODS: Transversal study conducted at a public NICU in Curitiba, Paraná, Brazil. All newborns, preterm and term, were considered eligible for the study if admission to the NICU occurred by the first hour of life. The Score for Neonatal Acute Physiology II, as well as the Perinatal Extension version, were developed to assess the risk of mortality for all newborns, measured within 12 hours of admission. BIA measurements were conducted using the tetrapolar BioScan Maltron 916, with single-frequency (50 kHz) tetrapolar BI. PA was calculated as the arc tangent: (Xc/R) x 180°/π. RESULTS: BIA was measured during the first 24 hours of admission for all newborns (n = 93), repeated between 24 and 48 hours (n = 79) and again after 7 days (n = 55), always when possible. PA measurements decreased in the first 48 hours in premature newborns, particularly among those who died. The premature newborns also showed a significant decrease from the first to the last PA measurement (P = .001). In addition, whereas full-term newborns showed an increase of PA at 1 week of life, preterm infants continued to have a decrease in values. For preterm newborns, PA measurements decreased and more sharply so for those who died. This result should be viewed with caution given the small number of deaths, but it should be investigated to understand the role of PA in the prognosis of NICU newborns. CONCLUSIONS: The absolute value of PA during the first 24 hours of life was not a good marker for severity or mortality. However, the decrease of PA between different moments of evaluation was a good marker of severity. The decrease of PA in the first 48 hours in premature newborns, and that when the decrease is more pronounced, may be indicative of mortality. The difference in PA values between these newborns is probably a significant variable for mortality and prognosis and not a cutoff value.

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Introdução: A avaliação do estado nutricional de crianças e adolescentes com câncer é fundamental para a elaboração do plano de cuidados nutricionais adequado, entretanto as alterações da própria doença e do tratamento podem dificultar essa avaliação. Objetivo: Descrever quais são os métodos antropométricos mais utilizados na avaliação do estado nutricional de crianças e adolescentes com câncer. Método: Realizou-se revisão sistemática da literatura de publicações referentes à avaliação nutricional de crianças e adolescentes com câncer, dos últimos dez anos nas bases de dados MEDLINE, PubMed, Web of Science e LILACS . Resultados: Foram incluídos nove artigos, nos quais foram destacados a amostra, o objetivo e os métodos de avaliação nutricional utilizados. A avaliação de dados isolados da antropometria como peso e estatura de crianças e adolescentes com câncer não é suficiente, uma vez que essa população apresenta alteração da composição corporal. Conclusão: Na prática clínica, a utilização da circunferência do braço, circunferência muscular do braço e dobra cutânea tricipital é indicada para avaliação e acompanhamento da evolução do estado nutricional.

Introduction: The evaluation of nutritional status of children and adolescents with cancer is fundamental to the elaboration of adequate planning for nutritional monitoring, however alterations caused by the disease and/or the treatment may hamper this evaluation. Objective: Describing anthropometric methods mostly used at the evaluation of nutritional status of children and adolescents with cancer. Method: Systematic review of the literature of publications produced within the last ten years referring to nutritional evaluation of children and teenagers with cancer took place based on data from MEDLINE, PubMed, Web of Science and LILACS . Results: Nine articles were studied from which samples were highlighted, objectives and methods for nutritional evaluation were also used. The evaluation of isolated anthropometric data such as weight and height of children and teenagers with cancer is not sufficient once this specific population presents alteration on body composition. Conclusion: The utilization of arm muscle circumference, arm muscle area and triceps skinfold thickness measurements are proposed in order to evaluate and monitor nutritional status in practical clinics.

Introducción: La evaluación del estado nutricional de niños y adolescentes con cáncer es fundamental para la elaboración de un plan de cuidados nutricionales adecuados, sin embargo las alteraciones de la propia enfermedad y del tratamiento pueden dificultar esta evaluación. Objetivo: Describir cuales son los métodos antropométricos más utilizados en la evaluación del estado nutricional de niños y adolescentes con cáncer. Método: Se realizó revisión sistemática de la literatura y de publicaciones referentes a la evaluación nutricional de niños y adolescentes con cáncer, de los últimos diez años en las bases de datos MEDLINE, PubMed, Web of Science y LILACS . Resultados: Se incluyeron nueve artículos, en los cuales fueron destacados la muestra, objetivo y métodos de evaluación nutricional utilizados. La evaluación de datos aislados de la antropometría como peso y estatura de niños y adolescentes con cáncer no es suficiente, una vez que esta población presenta alteración de la composición corporal. Conclusión: En la práctica clínica, la utilización de la circunferencia del brazo, circunferencia muscular y dobla cutánea tricípite es indicada para evaluación y acompañamiento de la evolución del estado nutricional.

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A doença de Gaucher é um erro do metabolismo enzimático que leva ao acúmulo de glicocerebrosídeo nas células, o que caracteriza os sinais e sintomas da doença. No momento do diagnóstico, além de outros sinais e sintomas, é observado retardo no crescimento em crianças e adolescentes. O tratamento é realizado por meio de reposição enzimática, que pode ocasionar ganho de peso no paciente pela diminuição do metabolismo energético. Descrição: dois irmãos com diagnóstico de doença de Gaucher tipo I foram avaliados antes de iniciarem a reposição enzimática e depois a cada 2 meses de tratamento, por um período de 6 meses. A composição corporal foi avaliada por impedância bioelétrica, que avaliou a quantidade de massa livre de gordura e massa de gordura; o consumo energético e a relação de macronutrientes foram avaliados por registro alimentar de 3 dias. Discussão: os dois pacientes apresentavam baixa estatura para idade ao diagnóstico e tiveram aumento de massa de gordura durante o tratamento, sendo que um paciente também apresentou aumento da massa livre de gordura. O consumo energético e a relação de macronutrientes mantiveram-se semelhantes durante todo o período de acompanhamento para ambos os pacientes...

Gaucher’s disease is flaw in enzyme metabolism that leads to the accumulation of glycocerebrosides in cells that characterizes the signs and symptoms of the condition. At the time of diagnosis, retarded growth, among other signs and symptoms, is observed in children and adolescents. The disease is treated by enzyme replacement, which may lead to weight gain in the patient, owing to the reduction in energy metabolism. Description: two brothers diagnosed with type I Gaucher’s disease were evaluated prior to commencing enzyme replacement therapy and subsequently after every two months of treatment, for a period of six months. Body composition was assessed using bioelectrical impedance, which measures the quantity of fat-free and fat mass; energy consumption and macronutrients were evaluated using a three-day food diary. Discussion: the two patients were of low height for age on diagnosis and had experienced an increase in fat mass during treatment, with one patient also presenting with an increase in fat free mass. Energy consumption and macronutrients remained fairly constant during the follow-up period in both patients...

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