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AIM: To examine the influence of body mass index, bioimpedance, and skin folds on the distribution of body interface pressure in regions with the potential to develop pressure ulcers in contact with support surfaces. DESIGN: This was a descriptive and analytical study. METHODS: Twenty healthy volunteer adults were investigated in April 2017. Body mass index, skin folds, waist circumference, bioimpedance, and interface pressure on bony prominences were investigated. Descriptive statistics and correlations were analysed. RESULTS: Peak pressures in the subscapular region presented moderate and significant correlations with body mass index, waist circumference, total and extracellular body water, fat-free mass, and lean mass per body segment. The peak pressure on the right heel showed a moderate correlation with total and extracellular body water, fat-free mass, and lean mass per segment. CONCLUSION: The need for multicenter research was evident, focusing on bioimpedance assessment as a risk factor for the development of pressure ulcers.

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BACKGROUND: The subjective global assessment (SGA) is a powerful tool for nutrition status assessment. Our aim was to compare vitamin C serum levels among patients classified as A, B, or C in the SGA. METHODS: One hundred-and-fifty adults in the wards of the University Hospital participated in this study. Besides SGA, all cases were submitted to anthropometry, bioelectrical impedance analysis (BIA), and 24-hour dietary recall. Laboratory data included blood hemoglobin, serum ferritin, serum albumin, transferrin, C-reactive protein (CRP), and vitamin C. Acute phase response was defined by serum CRP > 0.5 mg/dL; low serum vitamin C was defined by serum levels < 0.4 mg/dL. Analysis of variance and χ2 tests were used to compare groups; P < 0.05 was considered significant. RESULTS: Patients were diagnosed as SGA A (n = 76), B (n = 38), or C (n = 36) and showed different anthropometry and BIA. The same occurred, respectively, with vitamin C (median; range, in mg/day) intake (55.0; 4.7-140.6 vs 34.0; 10.3-244.2 vs 15.8; 2.3-124.0) and high (%) CRP (88.3 vs 65.8 vs 48.7) and low (%) vitamin C serum levels (21.1 vs 34.2 vs 63.9). CONCLUSION: Patients with worst nutrition parameters (SGA C) showed lower ascorbic acid serum levels than those classified as SGA A or B. These results are in accordance with reduced vitamin C intake and the presence of acute phase response.

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BACKGROUND The current common practice when using urine as a biomarker for vitamin excretion is to use a 24-hour sample for analysis. Due to the difficulty involved in this process, we attempted to find an alternative solution through the use of a single first morning void. The aim of our study was to investigate if there is a correlation between the first morning single void and the 24-hour collections of urines for the urine metabolite of niacin, N-1-methylnicotinamide (N1MN), and to test the reliability of utilizing a method using first morning single void collections corrected with the concentration of urine creatinine. MATERIAL AND METHODS All urine samples were collected from 30 healthy adult volunteers over the age of 18 years: 20 females and 10 males. Samples were collected after discarding the first morning urine and collecting every other urine voided during the next 24 hours including the first morning urine of the day after in 2 separate vessels. We analyzed the concentration of N1MN by high performance liquid chromatography and the concentration of creatinine by a commercial kit by spectrophotometry. The B3 excretion was expressed as the ratio of N1MN to creatinine. RESULTS We found a significant correlation between the ratios of first morning single void and 24-hour urines. When comparing males and females, the ratio demonstrated a significant correlation as well. CONCLUSIONS Our results demonstrated that it is possible to substitute a 24-hour collection with a first morning single void urine for the estimation of N1MN excretion.

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Although myocardial rupture occurs in only 2% to 4% of cases of acute myocardial infarction (AMI), there is a high mortality rate due to acute cardiogenic shock. We present the anatomopathological findings of three cases of myocardial rupture in autopsied hearts in the last 30 years, with a diagnosis of cardiac rupture in acute myocardial infarction. In these 30 years the percentage of AMI with myocardial rupture was 0.2%. Risk factors for post-AMI myocardial rupture include older age, atherosclerosis, diabetes mellitus and systemic arterial hypertension.

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Summary Although myocardial rupture occurs in only 2% to 4% of cases of acute myocardial infarction (AMI), there is a high mortality rate due to acute cardiogenic shock. We present the anatomopathological findings of three cases of myocardial rupture in autopsied hearts in the last 30 years, with a diagnosis of cardiac rupture in acute myocardial infarction. In these 30 years the percentage of AMI with myocardial rupture was 0.2%. Risk factors for post-AMI myocardial rupture include older age, atherosclerosis, diabetes mellitus and systemic arterial hypertension.

Resumo Embora a ruptura do miocárdio ocorra em apenas 2 a 4% dos casos de infarto agudo do miocárdio (IAM), está associada a alta mortalidade, principalmente em decorrência do estado de choque cardiogênico agudo. São apresentados os achados anatomopatológicos de três casos de ruptura do miocárdio de pacientes autopsiados nos últimos 30 anos, com diagnóstico de ruptura cardíaca em decorrência de IAM. Nesse período, a porcentagem de IAM com ruptura do miocárdio foi de 0,2%. Os fatores de risco para ruptura do miocárdio pós-IAM incluem idade avançada, arteriosclerose, diabetes mellitus e hipertensão arterial sistêmica.

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O objetivo deste artigo é relatar a experiência exitosa da Rede de Teleassistência de Minas Gerais (RTMG), um serviço público de telessaúde em larga escala. A RTMG foi constituída pela parceria entre seis universidades públicas do estado de Minas Gerais (MG). Recursos públicos e de agências de pesquisa financiaram suas atividades. A telecardiologia foi o foco inicial da Rede com realização de eletrocardiograma (ECG) e plantões de cardiologia, posteriormente, um sistema de teleconsultoria em especialidades foi incorporado. A RTMG atualmente abrange 780 municípios com 1.000 pontos de telessaúde em MG. De junho de 2006 a março de 2016, 2,538,592 ECGs e 75,866 teleconsultorias foram realizados e mais de 8.000 profissionais foram treinados. As atividades da RTMG possibilitam o acesso de pacientes de municípios remotos ao cuidado especializado, qualifica os encaminhamentos e contribui para a melhoria do cuidado. Atualmente, os serviços de telessaúde foram integrados ao sistema de saúde em MG. (AU)

The purpose of this article is to report the successful experience of The Telehealth Network of Minas Gerais (TNMG), a public service of telehealth on a large scale. The TNMG was formed through a partnership among six public universities at the Minas Gerais (MG) state. Public funding and research agencies support their activities. The telecardiology was the initial focus providing tele-electrocardiography, later teleconsulting in specialties was incorporated. The TNMG currently covers 780 municipalities in MG with 1,000 points in telehealth. From June 2006 to March 2016, a total of 2,538,592 and 75.866 teleconsultation were done and more than 8,000 professionals were trained. The activities of TNMG allow access of patients from remote municipalities to specialized healthcare, qualify referrals and contribute to the improvement of care. Currently, telehealth services were integrated into to the health system in MG. (AU)

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Foram objetivos avaliar a intensidade da dor nos pacientes em pós-operatório, identificar associações entre alterações fisiológicas e presença de dor, descrever a analgesia utilizada. Estudo quantitativo, longitudinal, realizado em um hospital público de ensino através da avaliação da dor, alterações fisiológicas e esquemas analgésicos de 351 pacientes em três tempos de pós-operatório de cirurgias de médio porte. Realizou-se análise descritiva das frequências absolutas e percentuais, e o teste Qui-quadrado e Bonferroni para verificar as associações e variâncias. Houve redução da ocorrência da dor ao longo dos tempos de pós-operatório. A dor leve predominou. As alterações fisiológicas declinaram e associaram-se com a dor em todos os tempos. Em relação à analgesia, o esquema de horário fixo com a combinação de anti-inflamatórios não-esteróides, analgésicos simples e opiáceos foram mais utilizados. Conclui-se que este tipo de analgesia auxilia no controle da dor e que esta associa-se com a presença de alterações fisiológicas

The objectives of this study were to evaluate pain intensity in postoperative patients, identify associations between physiol ogical alterations and the presence of pain, and describe the analgesia used. This qualitative, longitudinal study was performed in a public teaching hospital by evaluating pain, physiological alterations and analgesic scheme of 351 patients in three postoperative moments following medium-sized surgeries. Descriptive analysis of the absolute and percentile frequencies was performed. The Chi-squared and Bonferroni's tests were used to verify associations and variances. The occurrence of pain reduced with time in the postoperative period. Mild pain prevailed. The physiological alterations declined and were associated with pain in every moment of the studied period. Regarding analgesia, the fixed time scheme combined with the use of non-steroidal anti-inflammatory drugs, simple analgesics and opioids were the most used. In conclusion, this type of analgesia helps to manage pain, which is a ssociated with the presence of physiological alterations.

Se objetivó evaluar la intensidad del dolor en pacientes en postoperatorio, identificar asociaciones entre alteraciones fisiol ógicas y presencia de dolor, describir la analgesia utilizada. Estudio cuantitativo, longitudinal, realizado en hospital público de enseñanza mediante evaluación del dolor, alteraciones fisiológicas y esquemas analgésicos de 351 pacientes en tres momentos del postoperatorio de cirugías de mediana complejidad. Se realizó análisis descriptivo de frecuencias absolutas y porcentuales, test de Chi-cuadrado y Bonferroni para verificación de asociaciones y varianzas. Hubo reducción del dolor a lo largo de los momentos postoperatorios. Predominó el dolor leve. Las alteraciones fisiológicas declinaron y se asociaron en todos los momentos al dolor. Respecto a la analgesia, el esquema de horario fijo con combinación de antiinflamatorios no esteroides, analgésicos simples y opiáceos fue el más utilizado. Se concluye en que este tipo de analgesia ayuda al control del dolor y que éste se asocia a la presencia de alteraciones fisiológicas

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OBJECTIVE: To investigate the influence of the reprocessing technique of enzymatic bath with ultrasonic cleaning and ethylene oxide sterilization on the chemical properties and morphological structure of polymeric coatings of guide wire for regular guiding catheter. METHODS: These techniques simulated the routine of guide wire reprocessing in many hemodynamic services in Brazil and other countries. Samples from three different manufacturers were verified by scanning electron microscopy and X-ray photoelectron spectroscopy. RESULTS: A single or double sterilization of the catheters with ethylene oxide was not associated with morphological or chemical changes. However, scanning electron microscopy images showed that the washing method was associated with rough morphological changes, including superficial holes and bubbles, in addition to chemical changes of external atomic layers of polymeric coating surfaces, as detected by the X-ray photoelectron spectroscopy method, which is compatible with extended chemical changes on catheter surfaces. CONCLUSION: The reprocessing of the catheters with ethylene oxide was not associated with morphological or chemical changes, and it seemed appropriate to maintain guide wire coating integrity. However, the method combining chemical cleaning with mechanical vibration resulted in rough anatomical and chemical surface deterioration, suggesting that this reprocessing method should be discouraged.

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OBJECTIVE: To investigate the influence of the reprocessing technique of enzymatic bath with ultrasonic cleaning and ethylene oxide sterilization on the chemical properties and morphological structure of polymeric coatings of guide wire for regular guiding catheter. METHODS: These techniques simulated the routine of guide wire reprocessing in many hemodynamic services in Brazil and other countries. Samples from three different manufacturers were verified by scanning electron microscopy and X-ray photoelectron spectroscopy. RESULTS: A single or double sterilization of the catheters with ethylene oxide was not associated with morphological or chemical changes. However, scanning electron microscopy images showed that the washing method was associated with rough morphological changes, including superficial holes and bubbles, in addition to chemical changes of external atomic layers of polymeric coating surfaces, as detected by the X-ray photoelectron spectroscopy method, which is compatible with extended chemical changes on catheter surfaces. CONCLUSION: The reprocessing of the catheters with ethylene oxide was not associated with morphological or chemical changes, and it seemed appropriate to maintain guide wire coating integrity. However, the method combining chemical cleaning with mechanical vibration resulted in rough anatomical and chemical surface deterioration, suggesting that this reprocessing method should be discouraged.

OBJETIVO: Investigar a influência das técnicas de reprocessamento de banho enzimático com limpeza ultrassônica e a esterilização com óxido de etileno nas propriedades químicas e estruturas morfológicas de revestimentos poliméricos de fios-guia usados como guias em cateteres regulares. MÉTODOS: Estas técnicas simulam a rotina de processamento de fios-guia em muitos serviços de hemodinâmica do Brasil e de outros países. Amostras de três diferentes fabricantes foram verificadas por microscopia eletrônica de varredura e espectroscopia de fotoelétrons de raios-X. RESULTADOS: Uma única ou dupla esterilização dos cateteres com óxido de etileno não foi associada a mudanças químicas ou morfológicas. Contudo, imagens de microscopia eletrônica de varredura mostraram que o método de lavagem foi associado a intensas modificações morfológicas, incluindo bolhas e buracos superficiais, assim como mudanças nas ligações químicas das camadas atômicas externas do revestimento polimérico, conforme demonstrado por resultados de espectroscopia de fotoelétrons de raios-X, compatível com extensas modificações químicas induzidas por esse processo de lavagem. CONCLUSÃO: O reprocessamento dos fios-guia de cateteres com óxido de etileno não está associado a mudanças químicas e morfológicas dos mesmos e pode ser considerado adequado para manter a integridade destes materiais. Entretanto, o método que combina lavagem química com vibração mecânica resulta em intensas deteriorações anatômicas e químicas, sugerindo que esse método de processamento deve ser desencorajado.

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PROBLEM: The Brazilian population lacks equitable access to specialized health care and diagnostic tests, especially in remote municipalities, where health professionals often feel isolated and staff turnover is high. Telehealth has the potential to improve patients' access to specialized health care, but little is known about it in terms of cost-effectiveness, access to services or user satisfaction. APPROACH: In 2005, the State Government of Minas Gerais, Brazil, funded the establishment of the Telehealth Network, intended to connect university hospitals with the state's remote municipal health departments; support professionals in providing tele-assistance; and perform tele-electrocardiography and teleconsultations. The network uses low-cost equipment and has employed various strategies to overcome the barriers to telehealth use. LOCAL SETTING: The Telehealth Network connects specialists in state university hospitals with primary health-care professionals in 608 municipalities of the large state of Minas Gerais, many of them in remote areas. RELEVANT CHANGES: From June 2006 to October 2011, 782,773 electrocardiograms and 30 883 teleconsultations were performed through the network, and 6000 health professionals were trained in its use. Most of these professionals (97%) were satisfied with the system, which was cost-effective, economically viable and averted 81% of potential case referrals to distant centres. LESSONS LEARNT: To succeed, a telehealth service must be part of a collaborative network, meet the real needs of local health professionals, use simple technology and have at least some face-to-face components. If applied to health problems for which care is in high demand, this type of service can be economically viable and can help to improve patient access to specialized health care.

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BACKGROUND: Atrophy of the papillae, mucosa, and dorsum of the tongue are considered classical signs of nutritional deficiencies. OBJECTIVE: To assess the nutritional status of hospitalized alcoholics with or without papillary atrophy of the tongue. METHODS: This study was performed with 21 hospitalized alcoholics divided into Atrophic Glossitis Group (n=13) and Normal Tongue Group (n=8). Healthy, non-alcoholic volunteers composed the Control Group (n=8). Anthropometry and bioelectric impedance were performed, and serum vitamins A, E, and B12 were determined. RESULTS: There were no statistical differences in relation to age (46.7 ± 8.7 vs. 46.8 ± 15.8 years) or gender (92.3% vs. 87.5% male), respectively. Control Group volunteers were also paired in relation to age (47.5 ± 3.1 years) and male predominance (62.5%). In relation to hospitalized alcoholics without atrophic lesions of the tongue and Control Group, patients with papillary atrophy showed lower BMI (18.6 ± 2,5 vs 23.8 ± 3.5 vs 26.7 ± 3,6 kg/m(2)) and body fat content 7.6 ± 3.5 vs 13.3 ± 6.5 vs 19.5 ± 4,9 kg). When compared with the Control Group, alcoholic patients with or without papillary atrophy of the tongue showed lower values of red blood cells (10.8 ± 2.2 vs 11.8 ± 2.2 vs 14.5 ± 1,6g/dL) and albumin (3.6 ± 0.9 vs 3.6 ± 0.8 vs 4.4 ± 0.2g/dL). The seric levels of vitamins A, E, and B12 were similar amongst the groups. CONCLUSION: Hospitalized alcoholics with papillary atrophy of the tongue had lower BMI and fat body stores than controls, without associated hypovitaminosis.

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Objetiva-se com esta pesquisa avaliar a dor e caracterizar os idosos institucionalizados segundo as variáveissociodemográficas e clínicas. Trata-se de estudo descritivo realizado com 124 idosos residentes nas Instituiçõesde Longa Permanência para Idosos de Minas Gerais. Para a obtenção dos dados, realizou-se entrevista, bem comoavaliação clínica. Utilizou-se estatística descritiva com análise univariada dos dados. Verificou-se a predominânciado sexo feminino, com hipertensão arterial sistêmica referida, solteiros e com filhos, média de idade 76,2 anos eIMC médio 23,1 kg/m². A dor crônica, a adoção de tratamento medicamentoso e a não realização de atividade físicaregular foram referidas pela maioria dos idosos. Os principais fatores de melhora e piora referidos foram o repouso ea movimentação física, respectivamente. A dor crônica e a não realização de atividade física regular são vivenciadaspela maioria dos idosos institucionalizados. Espera-se que novas medidas de monitoramento, prevenção e controleda dor sejam implementadas nessas instituições.

This study objective was to evaluate the pain in institutionalized elderly as well as characterize this group accordingto socio-demographic and clinical variables. It is a descriptive study with 124 elderly people living in long-term carefacilities (LTCF) in the state of Minas Gerais, Brazil. Data were obtained via interview and clinical assessment. Descriptivestatistics with univariate data were used. There was predominance of women with systemic arterial hypertension, singleand with children. The mean age was 76.2 years, and the median BMI was 23.1 kg / m². Chronic pain, the medicationtreatment and the lack of physical activity were reported. Key fators for improvement and worsening of health were thephysical rest and physical activity, respectively. Results indicated that chronic pain and lack of regular physical activityare experienced by most of the institutionalized elderly. New measures for monitoring, preventing and controlling thepain should be implemented in these institutions.

El objetivo del presente estudio fue evaluar el dolor y caracterizar ancianos institucionalizados en función de variablesdemográficas y clínicas. Se trata de un estudio descriptivo de 124 ancianos hospedados en establecimientos delarga permanencia de Minas Gerais. Llevamos a cabo entrevistas y evaluación clínica para obtener datos. Se utilizóestadística descriptiva con los datos de una variable. Los resultados indican que hay predominio de individuos delsexo femenino, hipertensos, solteros y con hijos. Edad promedio de 76,2 años y promedio de IMC de 23,1 kg / m².Dolor crónico, tratamiento con fármacos y falta de actividad física regular fueron mencionados por la mayoría de losancianos. Principales fatores de mejora y empeoramiento fueron reposo y actividad física, respectivamente. Llegamosa la conclusión que la mayoría de los ancianos vive con dolor crónico y falta de actividad física regular. Se espera quesean implementadas nuevas medidas de control, prevención y control del dolor en estas instituciones.

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BACKGROUND: Atrophy of the papillae, mucosa, and dorsum of the tongue are considered classical signs of nutritional deficiencies. OBJECTIVE: To assess the nutritional status of hospitalized alcoholics with or without papillary atrophy of the tongue. METHODS: This study was performed with 21 hospitalized alcoholics divided into Atrophic Glossitis Group (n=13) and Normal Tongue Group (n=8). Healthy, non-alcoholic volunteers composed the Control Group (n=8). Anthropometry and bioelectric impedance were performed, and serum vitamins A, E, and B12 were determined. RESULTS: There were no statistical differences in relation to age (46.7±8.7 vs. 46.8±15.8 years) or gender (92.3% vs. 87.5% male), respectively. Control Group volunteers were also paired in relation to age (47.5±3.1 years) and male predominance (62.5%). In relation to hospitalized alcoholics without atrophic lesions of the tongue and Control Group, patients with papillary atrophy showed lower BMI (18.6 ± 2,5 vs 23.8 ± 3.5 vs 26.7 ± 3,6 kg/m² ) and body fat content 7.6 ± 3.5 vs 13.3 ± 6.5 vs 19.5 ± 4,9 kg). When compared with the Control Group, alcoholic patients with or without papillary atrophy of the tongue showed lower values of red blood cells (10.8 ± 2.2 vs 11.8 ± 2.2 vs 14.5 ± 1,6g/dL) and albumin (3.6 ± 0.9 vs 3.6 ± 0.8 vs 4.4 ± 0.2g/dL). The seric levels of vitamins A, E, and B12 were similar amongst the groups. CONCLUSION: Hospitalized alcoholics with papillary atrophy of the tongue had lower BMI and fat body stores than controls, without associated hypovitaminosis.

FUNDAMENTOS: A deficiência crônica de nutrientes pode levar à hipotrofia das papilas e da mucosa e do dorso da língua, considerada um sinal clássico de subnutrição protéico-energética. OBJETIVO: O objetivo do presente estudo é comparar o estado nutricional, incluindo as dosagens dos níveis séricos de vitaminas A, E e B12 em pacientes alcoolistas com ou sem alterações tróficas das papilas linguais. MÉTODOS: O estudo caso-controle incluiu 21 pacientes adultos alcoolistas internados em um hospital universitário. Utilizando-se de um sistema de fotografia da cavidade oral, dois clínicos independentes classificaram os indivíduos alcoolistas de acordo com a presença ou não de alterações tróficas na língua. Foram registrados os dados antropométricos, a composição corporal pela impedância bioelétrica e os exames laboratoriais para avaliação clínica e nutricional, incluindo dosagens das vitaminas A, E e B12. O estudo incluiu ainda voluntários saudáveis, não alcoolistas como Grupo Controle (n=8). A comparação entre os grupos foi feita por ANOYA-F ou pelo teste de Kruskal-Wallis, de acordo com a curva de normalidade dos resultados. Foram considerados significativos diferenças com p < 0,05. RESULTADOS: De acordo com a presença de alterações tróficas nas papilas linguais, os pacientes alcoolistas foram alocados no Grupo Língua Despapilada (n=13) e Grupo Língua Normal (n=8), sem diferença estatística quanto à idade (46,7 ± 8,7 vs 46,8 ± 15,8 anos) e gênero masculino (92,3 vs 87,5%). Os voluntários do Grupo Controle apresentaram 47,5 ±3,1 anos, sendo 62,5% do gênero masculino. Os pacientes alcoolistas com hipotrofia papilar apresentaram menor IMC (18,6 ± 2,5 vs 23,8 ± 3,5 vs 26,7 ± 3,6 kg/m2) e gordura corporal (7,6 ± 3,5 vs 13,3 ± 6,5 vs 19,5 ± 4,9 kg), quando comparados com os demais grupos. Em relação ao Grupo Controle, os alcoolistas apresentaram menores valores de hemoglobina (10,8 ± 2,2 vs 11,8 ± 2,2 vs 14,5 ± 1,6 g/dL) e albumina sérica (3,6 ± 0,9 vs 3,6 ± 0,8 vs 4,4 ± 0,2 g/dL). Os níveis plasmáticos de vitaminas A, E e B12 foram similares entres os grupos. CONCLUSÃO: Os pacientes alcoolistas com achados físicos de hipotrofia de papilas linguais apresentam menores valores em medidas antropométricas, de hemoglobina e albumina séricas que os grupos Controle ou de alcoolistas sem língua despapilada. Não houve evidências de hipovitaminoses associadas.

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OBJETIVOS: Verificar adequação do consumo de vitamina C em crianças e adolescentes infectados pelo vírus da imunodeficiência humana (HIV), avaliar níveis séricos da vitamina e indicadores de estresse oxidativo, comparar ao grupo não infectado, correlacionar a vitamina sérica ao estresse oxidativo e associá-los segundo os valores de referência. MÉTODOS: Estudo seccional transversal comparativo. Dois grupos com 27 crianças e adolescentes cada, de 3 a 19 anos, sendo G1 infectados pelo HIV por transmissão vertical atendidos em ambulatório regional e G2 indivíduos convidados sem histórico de infecção pelo HIV. Foram pareados por sexo, idade e condição socioeconômica. Avaliou-se: antropometria (índice de massa corporal para idade), ingestão e consumo do micronutriente, análise sérica da vitamina C, proteína C reativa e albumina. RESULTADOS: Idade média encontrada de 12 anos, prevalência do sexo feminino (17 - 63%) e da classe econômica C (27 - 50%). Diagnóstico nutricional prevalente foi eutrofia em 20 (74,1%) em G1 e 21 (77,8%) em G2. O consumo de vitamina C foi significativamente maior em G1 (p = 0,006; t = 2,987) pelo método recordatório 24 horas. Houve diferença significativa da dosagem sérica de vitamina C, sendo menor em G1 (p = 0,000; t = -7,309). Em relação ao estresse oxidativo, os valores da proteína C reativa em G1 foram significativamente maiores (p = 0,007; t = 2,958). Não houve relação entre deficiência da vitamina, proteína C reativa e albumina. CONCLUSÃO: Os resultados encontrados mostram que indivíduos infectados pelo HIV apresentam baixos valores da vitamina C, não relacionados à alimentação, uma vez que o consumo desse micronutriente foi superior ao grupo comparativo, que não apresentou essa depleção. Existem peculiaridades nos indivíduos infectados que aumentam o estresse oxidativo, evidenciado pelo aumento da proteína C reativa.

OBJECTIVES: To assess adequacy of vitamin C intake in HIV-infected children and adolescents; to evaluate serum levels of vitamin C and indicators of oxidative stress; to compare with the uninfected group; to correlate serum vitamin C with oxidative stress and associate them according to the reference values. METHODS: Comparative cross-sectional study. Two groups of 27 children and adolescents each, aged between 3 to 19 years. Group 1 (G1) comprised individuals vertically infected with HIV seen at a regional outpatient clinic. Group 2 (G2) comprised invited individuals without history of HIV infection. The groups were matched for age, sex, and socioeconomic status. The following variables were analyzed: body mass index for age; micronutrient intake and consumption; and serum vitamin C, C-reactive protein (CRP), and albumin. RESULTS: The mean age was 12 years old. Most subjects were female (17, 63%), and there was prevalence of the economic class C (27, 50%). The most prevalent nutritional status was normal weight in 20 individuals (74.1%) in G1 and 21 (77.8%) in G2. The intake of vitamin C was significantly higher in G1 (p = 0.006; t = 2.987) according to the 24-hour dietary recall method. There were significant differences in serum vitamin C concentration between the groups, with a lower level in G1 (p = 0.000; t = -7.309). In relation to oxidative stress, values of CRP in G1 were significantly higher (p = 0.007; t = 2.958). There was no association between deficiency of vitamin, CRP, and albumin. CONCLUSION: Our findings show that HIV-infected individuals have low levels of vitamin C; however, this deficiency is not related to eating habits, since the intake of this nutrient was higher in this group than in the control group. HIV-infected individuals have specific characteristics that increase their oxidative stress, which is evidenced by increased CRP.

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OBJECTIVES: To assess adequacy of vitamin C intake in HIV-infected children and adolescents; to evaluate serum levels of vitamin C and indicators of oxidative stress; to compare with the uninfected group; to correlate serum vitamin C with oxidative stress and associate them according to the reference values. METHODS: Comparative cross-sectional study. Two groups of 27 children and adolescents each, aged between 3 to 19 years. Group 1 (G1) comprised individuals vertically infected with HIV seen at a regional outpatient clinic. Group 2 (G2) comprised invited individuals without history of HIV infection. The groups were matched for age, sex, and socioeconomic status. The following variables were analyzed: body mass index for age; micronutrient intake and consumption; and serum vitamin C, C-reactive protein (CRP), and albumin. RESULTS: The mean age was 12 years old. Most subjects were female (17, 63%), and there was prevalence of the economic class C (27, 50%). The most prevalent nutritional status was normal weight in 20 individuals (74.1%) in G1 and 21 (77.8%) in G2. The intake of vitamin C was significantly higher in G1 (p = 0.006; t = 2.987) according to the 24-hour dietary recall method. There were significant differences in serum vitamin C concentration between the groups, with a lower level in G1 (p = 0.000; t = -7.309). In relation to oxidative stress, values of CRP in G1 were significantly higher (p = 0.007; t = 2.958). There was no association between deficiency of vitamin, CRP, and albumin. CONCLUSION: Our findings show that HIV-infected individuals have low levels of vitamin C; however, this deficiency is not related to eating habits, since the intake of this nutrient was higher in this group than in the control group. HIV-infected individuals have specific characteristics that increase their oxidative stress, which is evidenced by increased CRP.

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INTRODUCTION: Metabolic syndrome (MetS), a risk factor for atherosclerosis and coronary heart disease, is related to an inadequate food intake pattern. Its incidence is increasing among Brazilian adults, including those living in rural areas. Our aim was not only to describe the frequency of MetS in adults with or without MetS but also to compare their food intake pattern as assessed by the healthy eating index (HEI) and serum albumin and C reactive protein (CRP) levels. METHODS: Men and women (n = 246) living in a small village in Brazil were included. MetS was characterized according to the adult treatment panel (ATP III) criteria. Groups were compared by chi-square, student t or Mann-Whitney tests. RESULTS: MetS was diagnosed in 15.4% of the cases. The MetS group showed higher CRP (1.8±1.2 vs. 1.0±0.9 mg/dl) and lower albumin (4.3±0.3 vs. 4.4±0.3 g/dl) serum levels compared to the control group. Additionally, the MetS group showed lower scores (median[range]) in the HEI compared to the control group (53.5[31.2-78.1] vs 58[29.7-89.5], respectively). The MetS group also had decreased scores for total fat and daily variety of food intake. CONCLUSIONS: The results suggest that adults with MetS displayed chronic mild inflammation and a poorer food intake pattern than the control group.

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INTRODUCTION: Metabolic syndrome (MetS), a risk factor for atherosclerosis and coronary heart disease, is related to an inadequate food intake pattern. Its incidence is increasing among Brazilian adults, including those living in rural areas. Our aim was not only to describe the frequency of MetS in adults with or without MetS but also to compare their food intake pattern as assessed by the healthy eating index (HEI) and serum albumin and C reactive protein (CRP) levels. METHODS: Men and women (n = 246) living in a small village in Brazil were included. MetS was characterized according to the adult treatment panel (ATP III) criteria. Groups were compared by chi-square, student t or Mann-Whitney tests. RESULTS: MetS was diagnosed in 15.4% of the cases. The MetS group showed higher CRP (1.8±1.2 vs. 1.0±0.9 mg/dl) and lower albumin (4.3±0.3 vs. 4.4±0.3 g/dl) serum levels compared to the control group. Additionally, the MetS group showed lower scores (median[range]) in the HEI compared to the control group (53.5[31.2-78.1] vs 58[29.7-89.5], respectively). The MetS group also had decreased scores for total fat and daily variety of food intake. CONCLUSIONS: The results suggest that adults with MetS displayed chronic mild inflammation and a poorer food intake pattern than the control group.

INTRODUÇÃO: A síndrome metabólica (SM), fator de risco para aterosclerose e cardiopatia isquêmica, está relacionada a uma alimentação inadequada, e sua incidência está aumentando no Brasil, incluindo entre populações rurais. O objetivo deste estudo foi descrever a frequência de síndrome metabólica, e comparar o padrão de ingestão alimentar, avaliado pelo índice de alimentação saudável (healthy eating index - HEI), e níveis séricos de albumina e proteina C reativa (PCR) entre adultos com ou sem SM. MÉTODOS: Homens e mulheres (n = 246) morando em Inhaumas, pequeno vilarejo do interior da Bahia foram incluídos. SM foi caracterizada de acordo com os critérios do adult treatment panel (ATP III). Os grupos foram comparados pelos testes qui-quadrado, teste t de student ou Mann-Whitney. RESULTADOS: SM foi diagnosticada em 15,4% dos casos. O grupo SM mostrou maiores níveis séricos de PCR (1.8±1.2 vs. 1.0±0.9mg/dl) e menores valores de albumina (4.3±0.3 vs. 4.4±0.3g/dl). O grupo SM apresentou menores notas (mediana [faixa de variação]) do HEI (53.5[31.2-78.1] vs 58[29.7-89.5]), com menores notas para a ingestão de gordura total e variedade de alimentos ingeridos. CONCLUSÕES: Adultos com SM mostraram resultados compatíveis com diagnóstico de inflamação crônica, e um padrão de ingestão alimentar inadequado em relação ao controle.

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We report the case of a 35-year-old homeless alcoholic and illicit drug user, with AIDS, who was admitted to the emergency unit complaining of asthenia and a weight loss of 30 kg over the preceding three months. Clinical and laboratory data confirmed a diagnosis of marasmus, bacterial pneumonia, chorioretinitis caused by Toxoplasma gondii and oral Candida infection. The patient also presented loss of tongue papillae, gingival hypertrophy, perifollicular hyperkeratosis and hemorrhage, coiled, corkscrew-like hair, anemia, hypoalbuminemia, increased C-reactive protein levels and low serum vitamin C levels. The patient developed severe gastric hemorrhage, with hemodynamic instability and terminal disseminated intravascular coagulopathy.

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