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BACKGROUND: Previous studies have shown a relationship between calf circumference (CC) and outcomes in hospitalized patients. AIMS: To investigate the relationship between CC and clinical and nutritional outcomes in older in-patients (OiP) in a surgery ward. METHODS: This was a cross-sectional study with 417 OiP in a surgery ward. Clinical variables, anthropometry, and nutritional screening instruments such as subjective global assessment (SGA), mini nutritional assessment (MNA), and nutritional risk screening (NRS) were used in the investigation. The tests Pearson's chi-square, Mann-Whitney, Kruskal-Wallis, and Spearman's coefficient, and multiple linear regression analyses were used to review the factors associated with CC. RESULTS: Lower CC values were found in the age group 80 years and over (p<0.0001), presence of complications (p=0.0269), NRS (p<0.0001), SGA (p<0.0001), and MNA (p<0.0001). Gender (p=0.0011; partial R2=0.01151), age (p=0.0002; partial R2=0.06032), body mass index (p≤0.0001; partial R2=0.40820), and arm circumference (p≤0.0001; partial R2=0.11890) are variables that together were associated with CC. There was also a relationship between SGA (p=0.0166; partial R2=0.00605) and absence of complications during hospitalization (p=0.0047; R2=0.01154) with CC. CONCLUSIONS: Gender, age, body mass index, and arm circumference were jointly associated with CC, in addition to SGA and absence of complications. The CC is a relevant indicator for OiP in the clinical practice.

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BACKGROUND: The perception of family support in chronic disease can be relevant. OBJECTIVE: To assess the perception of family support in adult patients with epilepsy (PWEs) and relate it to quality of life (QoL) and clinical aspects. METHODS: Data from the Perceived Family Support Inventory (IPFS) of 130 PWEs were related to the clinical variables, QOLIE-31 scores, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) with statistical tests, with p < 0.05. RESULTS: The mean age was 49.9 ± 17.2 years, and the duration of epilepsy was 20.8 ± 15.4 years. The presence of depression (scores ≥ 15) was associated with lower family support. Being married and non-occurrence of depression were the variables associated with a higher IPFS score (R = 0.2112), in the multiple linear regression. CONCLUSION: The perception of greater family support was associated with demographic aspects, the absence of depression, and better QoL. Family relationships may play an essential role in health adjustment behaviors and QoL in epilepsy.

ANTECEDENTES: A percepção do suporte familiar nas doenças crônicas pode ser relevante. OBJETIVO: Avaliar em pacientes adultos com epilepsia (PCE) a percepção do suporte familiar e relacioná-la com os aspectos clínicos e com a qualidade de vida (QV). MéTODOS: Os dados do Inventário de Percepção de Suporte Familiar (IPSF) de 130 PCE foram relacionados com as variáveis clínicas, os escores do QOLIE-31 e com o Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), com testes estatísticos, com p < 0.05. RESULTADOS: A idade média foi 49.9 ± 17.2 anos e o tempo de epilepsia foi de 20.8 ± 15.4 anos. Escores ≥ 15 no NDDI-E (presença de depressão) associaram-se a menor suporte familiar. Ser casado e não ter depressão são as variáveis associadas a maiores escores no IPSF (R = 0.2112), na regressão linear múltipla. CONCLUSãO: A percepção de maior suporte familiar associou-se à aspectos demográficos, a ausência de depressão e a melhor QV. As relações familiares podem ter papel essencial nos comportamentos de ajustamento na saúde e na QV na epilepsia.

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Abstract Background The perception of family support in chronic disease can be relevant. Objective To assess the perception of family support in adult patients with epilepsy (PWEs) and relate it to quality of life (QoL) and clinical aspects. Methods Data from the Perceived Family Support Inventory (IPFS) of 130 PWEs were related to the clinical variables, QOLIE-31 scores, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) with statistical tests, with p < 0.05. Results The mean age was 49.9 ± 17.2 years, and the duration of epilepsy was 20.8 ± 15.4 years. The presence of depression (scores ≥ 15) was associated with lower family support. Being married and non-occurrence of depression were the variables associated with a higher IPFS score (R = 0.2112), in the multiple linear regression. Conclusion The perception of greater family support was associated with demographic aspects, the absence of depression, and better QoL. Family relationships may play an essential role in health adjustment behaviors and QoL in epilepsy.

Resumo Antecedentes A percepção do suporte familiar nas doenças crônicas pode ser relevante. Objetivo Avaliar em pacientes adultos com epilepsia (PCE) a percepção do suporte familiar e relacioná-la com os aspectos clínicos e com a qualidade de vida (QV). Métodos Os dados do Inventário de Percepção de Suporte Familiar (IPSF) de 130 PCE foram relacionados com as variáveis clínicas, os escores do QOLIE-31 e com o Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), com testes estatísticos, com p < 0.05. Resultados A idade média foi 49.9 ± 17.2 anos e o tempo de epilepsia foi de 20.8 ± 15.4 anos. Escores ≥ 15 no NDDI-E (presença de depressão) associaram-se a menor suporte familiar. Ser casado e não ter depressão são as variáveis associadas a maiores escores no IPSF (R = 0.2112), na regressão linear múltipla. Conclusão A percepção de maior suporte familiar associou-se à aspectos demográficos, a ausência de depressão e a melhor QV. As relações familiares podem ter papel essencial nos comportamentos de ajustamento na saúde e na QV na epilepsia.

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Objective: This study investigated the nutritional status, 25-hydroxyvitamin D (25OHD), albumin and risk factors associated with complications in patients with foot and ankle fragility fractures. Subjects and methods: Prospective study, developed with patients who suffered fractures due to fragility of the foot and ankle (n = 108); the type of fractured bone, fracture mechanisms and classification were studied and also pseudoarthrosis, treatment, surgical dehiscence, anthropometry, 25OHD and albumin. The Chi-square or Fisher's exact test, Mann-Whitney and Kruskal-Wallis tests were used in the statistical analysis and the multiple logistic regression analysis was used to identify the risk factors associated with complications. Results: The factors that, together, were associated with treatment complications were the level of 25OHD (p = 0.0055; OR = 0.868 [1,152]; 95% CI = 0.786; 0.959 [1.043;1.272]) and diabetes (p = 0.0034; OR = 30,181; 95% CI = 3.087; 295.036). The factors that, together, were associated with the presence of any complication, were age (p = 0.0139; OR = 1.058; 95% CI = 1.011; 1,106) and 25OHD level (p = 0.0198; OR = 0.917; 95% CI = 0.852; 0.986). There was a complication probability above 0.40 associated with lower 25OHD levels (values below 20 ng/mL) and older age (over 50 years). Conclusion: Lower or abnormal levels of 25OHD were associated with pseudoarthrosis, and age and 25OHD were both risk factors for treatment complications in patients with foot and ankle fractures.

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There are several factors associated with lower participation in regular physical activity (PA) in adult patients with epilepsy (PWEs). Objective: To assess the relationship between the regular practice of PA with clinical and cognitive variables and quality of life (QoL) in PWEs. Methods: Habitual Physical Activity Questionnaire (HPAQ) was related to clinical variables, scores on the Mini-Mental State Examination (MMSE), on the Brief Cognitive Battery-Edu (BCB-Edu), on the Satisfaction Scale for Physical Activity (SSPA), and on the Quality of Life in Epilepsy Inventory (QOLIE)-31 in 60 PWEs, with a significance level of p<0.05. Results: The PWEs had a mean age of 42.4±13.6 years, 50% of whom were female. Longer length of epilepsy correlated with lower PA in leisure time (Pearson correlation [r]= -0.276; p-value [p]=0.036). The occupational physical activity scores of the HPAQ correlated positively with perception (r=0.300; p=0.021), memory (r=0.381; p=0.003), semantic verbal fluency test (SVF) (r=0.427; p=0.001), and with the total score in the MMSE (r=0.327; p=0.012). The total HPAQ score correlated with the SVF (r=0.336; p=0.009) and with the MMSE (r=0.254; p=0.049). There was no correlation among the QOLIE-31, the HPAQ, and the SSPA. Conclusions: Longer duration of epilepsy was associated with the lower practice of PA. Physical activity was associated with better performance in aspects of cognition. There was no relationship between QoL and practice and satisfaction with PA, suggesting different psychosocial aspects involved.

Existem vários fatores associados à menor participação em atividade física regular (AF) em pacientes adultos com epilepsia (PCE). Objetivo: Avaliar em PCEs a relação entre a prática regular de AF com as variáveis clínicas e cognitivas e com a qualidade de vida (QV). Métodos: Foi relacionado o Habitual Physical Activity Questionnaire (HPAQ) com as variáveis clínicas, escores no Mini-Mental State Examination (MMSE), no Brief Cognitive Battery-Edu (BCB-Edu), Satisfaction Scale for Physical Activity (SSPA) e no Quality of Life in Epilepsy Inventory (QOLIE­31) de 60 PCE, com nível de significância p<0,05. Resultados: Idade média 42,4±13,6 anos, 50% do sexo feminino. O maior tempo de epilepsia correlacionou-se com a menor prática de AF no lazer (Correlação de Person, r= -0,276; p=0,036). Escores da AF ocupacional do HPAQ correlacionaram-se positivamente com a percepção (r=0,300; p=0,021) e a memória (r=0,381; p=0,003) no teste de fluência verbal (SVF); (r=0,427; p=0,001) e com o escore total no MMSE (r=0,327; p=0,012). O escore total do HPAQ correlacionou-se com o SVF (r=0,336; p=0,009) e com o MMSE (r=0,254; p=0,049). Não houve correlação entre o QOLIE­31 com o HPAQ e a SSPA. Conclusão: A maior duração da epilepsia associou-se com a menor prática de AF. A AF associou-se com o melhor desempenho em aspectos da cognição. Não houve relação entre QV com a prática e a satisfação e a AF, sugerindo diferentes aspectos psicossociais envolvidos.

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Previous studies show changes in lipid metabolism in epilepsy. The aim of this study was to investigate the association between lipid profile and clinical variables in adult patients with epilepsy (APE). Seventy-two APE participated in this pilot study at an outpatient neurology service. The lipid profile (total cholesterol, low-density lipoprotein (LDL) cholesterol, very-low-density lipoproteins (VLDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides), age at disease onset, disease duration, seizures frequency, and the number of antiseizure medications (ASM) used were investigated. Data were analyzed using the Chi-square, Fisher, Mann-Whitney, Spearman coefficient, and logistic regression tests. There were significant differences in HDL (p = 0.0023) and total cholesterol (p = 0.0452) levels in connection with the number of ASM used. There was a significant difference in seizure control among the different numbers of ASM used (p = 0.0382). Higher HDL values were found in females (p = 0.0170). The logistic regression showed that only the number of ASM used was associated with seizure control (p = 0.0408; OR = 2.800; 95% CI = 1.044; 7.509). The number of ASM taken and not the lipid profile was associated with seizure control in APE.

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•Body weight and BMI decrease in both the EG and CG groups during the period of caloric restriction. •For both the EG and CG groups, fat-free mass decreases during food restriction. •Subjects on a high-fiber diet have reduced fasting glucose and basal insulin as well as improved insulin resistance, as attested by the lower HOMA-IR index. •Obese women on a high-fiber diet have suppressed postprandial (after 60 min) acylated ghrelin, confirming that the diet composition influences ghrelin levels from the first day. •In the present study, it was possible to verify that fasting leptin concentration diminishes in obese women on a high-fiber diet. Background - Several mechanisms, including excessive hunger, account for patients' difficulties in maintaining weight loss and dietary changes after caloric restriction. Objective - To evaluate the effect of short-term high-fiber calorie-restricted diet in appetite-regulating hormones, and hunger and satiety sensations in women with obesity. In a randomized controlled trial study, thirty women with body mass index (BMI) higher than 30 kg/m2, and aged from 20 to 50 years were hospitalized following a calorie-restricted diet (1000 kcal/day) for three days. The experimental group (n=15) received high-fiber diet and the control group (n=15), conventional diet. Results - Body weight, BMI, resting energy expenditure (REE), acylated and total ghrelin, leptin, insulin and glucose, and hunger and satiety sensations were evaluated. Linear regression models with mixed effects (fixed and random effects) helped to assess the variables between the two groups and within the groups. Body weight and BMI decreased in both the experimental and control groups (P<0.001). After the high-fiber diet, postprandial acylated ghrelin (P=0.04), glucose (P<0.001), insulin (P=0.04), and leptin (P=0.03) levels as well as the HOMA-IR index (P=0.01) decreased, whereas satiety improved (P=0.02). Obese women that followed the conventional diet had increased body fat percentage (P=0.04) and lower REE (P=0.02). The two diets did not differ in terms of hunger sensation. Conclusion - A short-term high-fiber diet improves satiety sensations and metabolic parameters while suppressing postprandial acylated ghrelin (60 minutes) and maintaining the resting energy expenditure.

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Objective: This study investigated the factors associated with satisfactory early postoperative wound conditions. Method: A prospective study was conducted with patients (n=179) submitted to osteosynthesis in general, in a hospital orthopedics service. In the preoperative period, patients underwent laboratory exams and the surgical indications were based on the type of fracture and the patient's clinical conditions. In the postoperative period, patients were evaluated based on the presence of complications and considering their surgical wounds. Chi-square, Fisher, Mann-Whitney, and Kruskal-Wallis tests were used in the analysis. To identify the factors associated with wound condition, univariate and multiple logistic regression analysis was used. Results: In the univariate analysis, each transferring unit reduction increased the chance of satisfactory outcome by 1.1% (p=0.0306; OR= 0.989 (1.011); 95%CI= 0.978;0.999; 1.001;1.023). The presence of SAH increased 2.7 fold the chance of satisfactory outcome (p=0.0424; OR= 2,667; 95%CI= 1,034;6,877). Hip fracture increased 2.6 fold the chance of satisfactory outcome (p=0.0272; OR=2.593; IC95%=1.113; 6.039). And the absence of a compound fracture increased 5.5 fold the chance of satisfactory wound outcome (p=0.0004; OR=5,493; 95%CI=2,132;14,149). In the multiple analysis, patients with non compound fractures were 9.7 times more likely to experience a satisfactory outcome when compared to patients with compound fractures (p=0.0014; OR=9,687; 95%CI= 2,399; 39,125). Conclusion: There was an inverse relationship between plasma proteins levels and satisfactory surgical wounds outcome. Only exposure remained associated with wound conditions. Level Of Evidence: II, Prospective Study.

Objetivo: Este estudo investigou os fatores associados à condição satisfatória de ferida pós-operatória precoce. Método: Foi desenvolvido um estudo prospectivo com pacientes (n=179) submetidos a osteossínteses em geral, em um serviço de ortopedia hospitalar. No período pré-operatório os pacientes foram submetidos a exames laboratoriais e as indicações cirúrgicas foram baseadas no tipo de fratura e condições clínicas. No período pós-operatório, os pacientes foram avaliados conforme a presença de complicações e feridas operatórias. Foram utilizados na análise os testes Qui-quadrado, Fisher, Mann-Whitney, Kruskal-Wallis. Para identificar os fatores associados à condição da ferida, foi utilizada a análise de regressão logística univariada e múltipla. Resultados: Na análise univariada, cada unidade a menos de transferrina, aumentou a chance de condição satisfatória em 1.1% (p= 0.0306; OR= 0.989 (1.011); IC95%= 0.978;0.999; 1.001;1.023). A presença de HAS aumentou a chance de condição satisfatória em 2.7 vezes (p=0.0424; OR= 2.667; IC95%= 1.034;6.877). Fratura de quadril aumentou a chance de condição satisfatória em 2.6 vezes (p=0.0272; OR=2.593; IC95%=1.113;6.039). E não apresentar fratura exposta, aumentou a chance de condição satisfatória da ferida em 5.5 vezes (p=0.0004; OR=5.493; IC95%=2.132;14.149). Na análise múltipla, fraturas sem exposição, apresentaram chance 9.7 vezes maior de apresentar condição satisfatória do que insatisfatória; quando comparadas às que apresentaram exposição (p=0.0014; OR=9.687; IC95%= 2,399; 39.125). Conclusão: Houve uma relação inversa entre proteínas plasmáticas e presença de feridas operatórias satisfatórias. Apenas a exposição se manteve associada à condição da ferida. Nível de Evidência: II; Estudo Prospectivo.

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ABSTRACT Background: Several mechanisms, including excessive hunger, account for patients' difficulties in maintaining weight loss and dietary changes after caloric restriction. Objective: To evaluate the effect of short-term high-fiber calorie-restricted diet in appetite-regulating hormones, and hunger and satiety sensations in women with obesity. Methds: In a randomized controlled trial study, thirty women with body mass index (BMI) higher than 30 kg/m2, and aged from 20 to 50 years were hospitalized following a calorie-restricted diet (1000 kcal/day) for three days. The experimental group (n=15) received high-fiber diet and the control group (n=15), conventional diet. Body weight, BMI, resting energy expenditure (REE), acylated and total ghrelin, leptin, insulin and glucose, and hunger and satiety sensations were evaluated. Linear regression models with mixed effects (fixed and random effects) helped to assess the variables between the two groups and within the groups. Results: Body weight and BMI decreased in both the experimental and control groups (P<0.001). After the high-fiber diet, postprandial acylated ghrelin (P=0.04), glucose (P<0.001), insulin (P=0.04), and leptin (P=0.03) levels as well as the HOMA-IR index (P=0.01) decreased, whereas satiety improved (P=0.02). Obese women that followed the conventional diet had increased body fat percentage (P=0.04) and lower REE (P=0.02). The two diets did not differ in terms of hunger sensation. Conclusion: A short-term high-fiber diet improves satiety sensations and metabolic parameters while suppressing postprandial acylated ghrelin (60 minutes) and maintaining the resting energy expenditure.

RESUMO Contexto: Vários mecanismos, incluindo a fome excessiva, são responsáveis pelas dificuldades dos pacientes em manter a perda de peso e mudanças na dieta após a restrição calórica. Objetivo: Avaliar o efeito da dieta de curta duração rica em fibras e com restrição calórica nos hormônios reguladores do apetite e nas sensações de fome e saciedade em mulheres com obesidade. Métodos: Em um estudo randomizado controlado, 30 mulheres com índice de massa corporal (IMC) superior a 30 kg/m2 e com idade entre 20 e 50 anos foram hospitalizadas seguindo dieta com restrição calórica (1000 kcal/dia) por 3 dias. O grupo experimental (n=15) recebeu dieta rica em fibras e o grupo controle (n=15), dieta convencional. Foram avaliados peso corporal, IMC, gasto energético de repouso (GER), grelina acilada e total, leptina, insulina e glicose e sensações de fome e saciedade. Modelos de regressão linear com efeitos mistos (efeitos fixos e aleatórios) ajudaram a avaliar as variáveis entre os dois grupos e dentro dos grupos. Resultados: O peso corporal e o IMC diminuíram tanto no grupo experimental quanto no controle (P<0,001). Após a dieta rica em fibras, os níveis de grelina acilada pós-prandial (P=0,04), glicose (P<0,001), insulina (P=0,04) e leptina (P=0,03), bem como o índice HOMA-IR (P=0,01) diminuiu, enquanto a saciedade melhorou (P=0,02). Mulheres obesas que seguiram a dieta convencional apresentaram aumento do percentual de gordura corporal (P=0,04) e menor GER (P=0,02). As duas dietas não diferiram em termos de sensação de fome. Conclusão: Uma dieta rica em fibras de curto prazo melhora as sensações de saciedade e os parâmetros metabólicos, suprimindo a grelina acilada pós-prandial (60 minutos) e mantendo o gasto energético de repouso.

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ABSTRACT Objective This study investigated the factors associated with satisfactory early postoperative wound conditions. Method A prospective study was conducted with patients (n=179) submitted to osteosynthesis in general, in a hospital orthopedics service. In the preoperative period, patients underwent laboratory exams and the surgical indications were based on the type of fracture and the patient's clinical conditions. In the postoperative period, patients were evaluated based on the presence of complications and considering their surgical wounds. Chi-square, Fisher, Mann-Whitney, and Kruskal-Wallis tests were used in the analysis. To identify the factors associated with wound condition, univariate and multiple logistic regression analysis was used. Results In the univariate analysis, each transferring unit reduction increased the chance of satisfactory outcome by 1.1% (p=0.0306; OR= 0.989 (1.011); 95%CI= 0.978;0.999; 1.001;1.023). The presence of SAH increased 2.7 fold the chance of satisfactory outcome (p=0.0424; OR= 2,667; 95%CI= 1,034;6,877). Hip fracture increased 2.6 fold the chance of satisfactory outcome (p=0.0272; OR=2.593; IC95%=1.113; 6.039). And the absence of a compound fracture increased 5.5 fold the chance of satisfactory wound outcome (p=0.0004; OR=5,493; 95%CI=2,132;14,149). In the multiple analysis, patients with non compound fractures were 9.7 times more likely to experience a satisfactory outcome when compared to patients with compound fractures (p=0.0014; OR=9,687; 95%CI= 2,399; 39,125). Conclusion There was an inverse relationship between plasma proteins levels and satisfactory surgical wounds outcome. Only exposure remained associated with wound conditions. Level Of Evidence: II, Prospective Study.

RESUMO Objetivo Este estudo investigou os fatores associados à condição satisfatória de ferida pós-operatória precoce. Método Foi desenvolvido um estudo prospectivo com pacientes (n=179) submetidos a osteossínteses em geral, em um serviço de ortopedia hospitalar. No período pré-operatório os pacientes foram submetidos a exames laboratoriais e as indicações cirúrgicas foram baseadas no tipo de fratura e condições clínicas. No período pós-operatório, os pacientes foram avaliados conforme a presença de complicações e feridas operatórias. Foram utilizados na análise os testes Qui-quadrado, Fisher, Mann-Whitney, Kruskal-Wallis. Para identificar os fatores associados à condição da ferida, foi utilizada a análise de regressão logística univariada e múltipla. Resultados Na análise univariada, cada unidade a menos de transferrina, aumentou a chance de condição satisfatória em 1.1% (p= 0.0306; OR= 0.989 (1.011); IC95%= 0.978;0.999; 1.001;1.023). A presença de HAS aumentou a chance de condição satisfatória em 2.7 vezes (p=0.0424; OR= 2.667; IC95%= 1.034;6.877). Fratura de quadril aumentou a chance de condição satisfatória em 2.6 vezes (p=0.0272; OR=2.593; IC95%=1.113;6.039). E não apresentar fratura exposta, aumentou a chance de condição satisfatória da ferida em 5.5 vezes (p=0.0004; OR=5.493; IC95%=2.132;14.149). Na análise múltipla, fraturas sem exposição, apresentaram chance 9.7 vezes maior de apresentar condição satisfatória do que insatisfatória; quando comparadas às que apresentaram exposição (p=0.0014; OR=9.687; IC95%= 2,399; 39.125). Conclusão Houve uma relação inversa entre proteínas plasmáticas e presença de feridas operatórias satisfatórias. Apenas a exposição se manteve associada à condição da ferida. Nível de Evidência: II; Estudo Prospectivo.

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ABSTRACT There are several factors associated with lower participation in regular physical activity (PA) in adult patients with epilepsy (PWEs). Objective: To assess the relationship between the regular practice of PA with clinical and cognitive variables and quality of life (QoL) in PWEs. Methods: Habitual Physical Activity Questionnaire (HPAQ) was related to clinical variables, scores on the Mini-Mental State Examination (MMSE), on the Brief Cognitive Battery-Edu (BCB-Edu), on the Satisfaction Scale for Physical Activity (SSPA), and on the Quality of Life in Epilepsy Inventory (QOLIE)-31 in 60 PWEs, with a significance level of p<0.05. Results: The PWEs had a mean age of 42.4±13.6 years, 50% of whom were female. Longer length of epilepsy correlated with lower PA in leisure time (Pearson correlation [r]= -0.276; p-value [p]=0.036). The occupational physical activity scores of the HPAQ correlated positively with perception (r=0.300; p=0.021), memory (r=0.381; p=0.003), semantic verbal fluency test (SVF) (r=0.427; p=0.001), and with the total score in the MMSE (r=0.327; p=0.012). The total HPAQ score correlated with the SVF (r=0.336; p=0.009) and with the MMSE (r=0.254; p=0.049). There was no correlation among the QOLIE-31, the HPAQ, and the SSPA. Conclusions: Longer duration of epilepsy was associated with the lower practice of PA. Physical activity was associated with better performance in aspects of cognition. There was no relationship between QoL and practice and satisfaction with PA, suggesting different psychosocial aspects involved.

RESUMO Existem vários fatores associados à menor participação em atividade física regular (AF) em pacientes adultos com epilepsia (PCE). Objetivo: Avaliar em PCEs a relação entre a prática regular de AF com as variáveis clínicas e cognitivas e com a qualidade de vida (QV). Métodos: Foi relacionado o Habitual Physical Activity Questionnaire (HPAQ) com as variáveis clínicas, escores no Mini-Mental State Examination (MMSE), no Brief Cognitive Battery-Edu (BCB-Edu), Satisfaction Scale for Physical Activity (SSPA) e no Quality of Life in Epilepsy Inventory (QOLIE-31) de 60 PCE, com nível de significância p<0,05. Resultados: Idade média 42,4±13,6 anos, 50% do sexo feminino. O maior tempo de epilepsia correlacionou-se com a menor prática de AF no lazer (Correlação de Person, r= -0,276; p=0,036). Escores da AF ocupacional do HPAQ correlacionaram-se positivamente com a percepção (r=0,300; p=0,021) e a memória (r=0,381; p=0,003) no teste de fluência verbal (SVF); (r=0,427; p=0,001) e com o escore total no MMSE (r=0,327; p=0,012). O escore total do HPAQ correlacionou-se com o SVF (r=0,336; p=0,009) e com o MMSE (r=0,254; p=0,049). Não houve correlação entre o QOLIE-31 com o HPAQ e a SSPA. Conclusão: A maior duração da epilepsia associou-se com a menor prática de AF. A AF associou-se com o melhor desempenho em aspectos da cognição. Não houve relação entre QV com a prática e a satisfação e a AF, sugerindo diferentes aspectos psicossociais envolvidos.

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ABSTRACT Objective: This study investigated the nutritional status, 25-hydroxyvitamin D (25OHD), albumin and risk factors associated with complications in patients with foot and ankle fragility fractures. Subjects and methods: Prospective study, developed with patients who suffered fractures due to fragility of the foot and ankle (n = 108); the type of fractured bone, fracture mechanisms and classification were studied and also pseudoarthrosis, treatment, surgical dehiscence, anthropometry, 25OHD and albumin. The Chi-square or Fisher's exact test, Mann-Whitney and Kruskal-Wallis tests were used in the statistical analysis and the multiple logistic regression analysis was used to identify the risk factors associated with complications. Results: The factors that, together, were associated with treatment complications were the level of 25OHD (p = 0.0055; OR = 0.868 [1,152]; 95% CI = 0.786; 0.959 [1.043;1.272]) and diabetes (p = 0.0034; OR = 30,181; 95% CI = 3.087; 295.036). The factors that, together, were associated with the presence of any complication, were age (p = 0.0139; OR = 1.058; 95% CI = 1.011; 1,106) and 25OHD level (p = 0.0198; OR = 0.917; 95% CI = 0.852; 0.986). There was a complication probability above 0.40 associated with lower 25OHD levels (values below 20 ng/mL) and older age (over 50 years). Conclusion: Lower or abnormal levels of 25OHD were associated with pseudoarthrosis, and age and 25OHD were both risk factors for treatment complications in patients with foot and ankle fractures.

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ABSTRACT BACKGROUND: Previous studies have shown a relationship between calf circumference (CC) and outcomes in hospitalized patients. AIMS: To investigate the relationship between CC and clinical and nutritional outcomes in older in-patients (OiP) in a surgery ward. METHODS: This was a cross-sectional study with 417 OiP in a surgery ward. Clinical variables, anthropometry, and nutritional screening instruments such as subjective global assessment (SGA), mini nutritional assessment (MNA), and nutritional risk screening (NRS) were used in the investigation. The tests Pearson's chi-square, Mann-Whitney, Kruskal-Wallis, and Spearman's coefficient, and multiple linear regression analyses were used to review the factors associated with CC. RESULTS: Lower CC values were found in the age group 80 years and over (p<0.0001), presence of complications (p=0.0269), NRS (p<0.0001), SGA (p<0.0001), and MNA (p<0.0001). Gender (p=0.0011; partial R2=0.01151), age (p=0.0002; partial R2=0.06032), body mass index (p≤0.0001; partial R2=0.40820), and arm circumference (p≤0.0001; partial R2=0.11890) are variables that together were associated with CC. There was also a relationship between SGA (p=0.0166; partial R2=0.00605) and absence of complications during hospitalization (p=0.0047; R2=0.01154) with CC. CONCLUSIONS: Gender, age, body mass index, and arm circumference were jointly associated with CC, in addition to SGA and absence of complications. The CC is a relevant indicator for OiP in the clinical practice.

RESUMO RACIONAL: Estudos anteriores mostraram uma relação entre a circunferência da panturrilha (CP) e desfechos em pacientes hospitalizados. OBJETIVOS: Investigar a relação entre CP e desfecho clínico e nutricional em pacientes idosos hospitalizados (PIH) em uma enfermaria cirúrgica. MÉTODOS: Este foi um estudo transversal com 417 PIH em uma enfermaria de cirurgia. Variáveis clínicas, antropometria e instrumentos de triagem nutricional como avaliação subjetiva global (ASG), mini avaliação nutricional (MAN) e triagem de risco nutricional (NRS) foram utilizados na investigação. Qui-quadrado, Mann-Whitney, Kruskal-Wallis, coeficiente de Spearman e análise de regressão linear múltipla foram usados para analisar os fatores associados a CP. RESULTADOS: Menores valores de CP foram encontrados na faixa etária de 80 anos (p<0,0001), complicações (p=0,0269), risco nutricional pelo NRS (p<0,0001), ASG (p<0,0001) e MAN (p<0,0001). Sexo (p=0,0011; R2 parcial=0,01151), idade (p=0,0002; R2 parcial=0,06032), IMC (p≤0,0001; R2 parcial=0,40820) e circunferência do braço (CB) (p≤0,0001; R2 parcial=0,11890) foram variáveis que juntas estiveram associadas com a CP. Também houve relação entre ASG (p=0,0166; R2 parcial=0,00605) e ausência de complicações durante a internação (p=0,0047; R2= 0,01154) com a CP. CONCLUSÕES: Sexo, idade, IMC e CB associaram-se conjuntamente com CP, ASG e ausência de complicações. CP é um indicador relevante em PIH na prática clínica.

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BACKGROUND: The prevalence of hospitalized elderly patients has grown substantially and has impacted the hospital health services. Thus, it is believed that an investigation of the nutritional status associated with different clinical situations in elderly patients could contribute to multidisciplinary hospital intervention and nutritional care actions suitable for this population. OBJECTIVE: To investigate the relationship between two nutritional screening instruments in hospitalized older patients and to compare clinical variables between these two instruments. METHODS: Retrospective study with hospitalized older patients (n=277), investigating the agreement between two nutritional screening instruments. The data were analyzed using the McNemar, chi-square, Fisher, Mann-Whitney tests and the kappa coefficient for the agreement assessment. RESULTS: There was a significant difference (P=0.0002) between the nutritional risk classifications of the two nutritional screening instruments and moderate agreement (k=0.5430) between them. The association between nutritional risk screening and age (P=0.0255), length of hospital stay (P<0.0001), gender (P=0.0365) and illness (P=0.0001) were assessed. There was an association between Mini Nutritional Assessment and length of stay (P<0.0001), illness (P=0.0001) and body weight evolution (P=0.0479). CONCLUSION: The nutritional risk screening and Mini Nutritional Assessment showed moderate agreement in the assessment of elderly patients.

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BACKGROUND: Although effective, the impact of bariatric surgery on weight loss is variable, and little is known about the influence of single-nucleotide polymorphisms (SNPs). The present study investigated the association of eleven SNPs related to obesity with weight loss 1 year after Roux-Y gastric bypass (RYGB) surgery in female patients. METHODS: This prospective study included 351 women with obesity. The genotypes for eleven SNPs (GHRL-rs26802; GHSR-rs572169; LEP-rs7799039; LEPR-rs1137101; 5HT2C-rs3813929; UCP2-rs659366; UCP3-rs1800849; SH2B1-rs7498665; TAS1R2-rs35874116; TAS1R2-rs9701796; FTO-rs9939609) were determined using a real-time polymerase chain reaction and TaqMan assays. Anthropometric measurements were performed before and 1 year after RYGB surgery. To evaluate the factors that influenced the proportion of weight loss 1 year after surgery, beta regression analysis was used. The models were estimated using the GLIMMIX procedure in SAS statistical software. p < 0.05 was considered statistically significant. RESULTS: The mean ± SD percentage of total body weight loss in 1 year was 64.4 ± 5.8% and the median was 65.0%. When assessing the proportion of weight loss in 1 year after surgery, using univariate analysis (beta regression), no SNPs influenced weight loss. Furthermore, in the multiple analysis, with stepwise process of variable selection, no variable was significant to compose the multiple model. CONCLUSIONS: The 11 SNPs investigated did not influence weight loss 1 year after RYGB surgery in female patients. This result indicates that individual behaviours and other factors might better contribute to the magnitude of loss weight loss in a short period after bariatric surgery.

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ABSTRACT Background The prevalence of hospitalized elderly patients has grown substantially and has impacted the hospital health services. Thus, it is believed that an investigation of the nutritional status associated with different clinical situations in elderly patients could contribute to multidisciplinary hospital intervention and nutritional care actions suitable for this population. Objective To investigate the relationship between two nutritional screening instruments in hospitalized older patients and to compare clinical variables between these two instruments. Methods Retrospective study with hospitalized older patients (n=277), investigating the agreement between two nutritional screening instruments. The data were analyzed using the McNemar, chi-square, Fisher, Mann-Whitney tests and the kappa coefficient for the agreement assessment. Results There was a significant difference (P=0.0002) between the nutritional risk classifications of the two nutritional screening instruments and moderate agreement (k=0.5430) between them. The association between nutritional risk screening and age (P=0.0255), length of hospital stay (P<0.0001), gender (P=0.0365) and illness (P=0.0001) were assessed. There was an association between Mini Nutritional Assessment and length of stay (P<0.0001), illness (P=0.0001) and body weight evolution (P=0.0479). Conclusion The nutritional risk screening and Mini Nutritional Assessment showed moderate agreement in the assessment of elderly patients.

RESUMO Contexto A prevalência de pacientes idosos hospitalizados tem crescido substancialmente e impactado os serviços de saúde hospitalar. Desta forma, acredita-se que uma investigação do estado nutricional, associado a situações clínicas variadas em pacientes idosos, poderia contribuir para ações de intervenção hospitalar multidisciplinares e de cuidado nutricional adequadas para esta população. Objetivo Investigar a relação entre dois instrumentos de triagem nutricional em pacientes idosos hospitalizados e comparar variáveis clínicas entre estes dois instrumentos. Métodos Estudo retrospectivo com pacientes idosos hospitalizados (n=277), sendo investigado a concordância entre dois instrumentos de triagem nutricional. Os dados foram analisados pelos testes McNemar, qui-quadrado, Fisher, Mann-Whitney e o coeficiente kappa para a avaliação de concordância. Resultados Houve diferença significativa (P=0,0002) entre as classificações de risco nutricional pelos dois instrumentos de triagem nutricional e concordância moderada (k=0,5430) entre eles. Verificou-se associação entre triagem de risco nutricional e idade (P=0,0255), tempo de internação (P<,0001), sexo (P=0,0365) e doenças (P=0,0001). Houve associação entre a Mini Avaliação Nutricional e tempo de internação (P<0,0001), doenças (P=0,0001) e evolução do peso corporal (P=0,0479). Conclusão Triagem de risco nutricional e a Mini Avaliação Nutricional apresentam concordância moderada para a avaliação de pacientes idosos.

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BACKGROUND: The prevalence of malnutrition in hospitalized elderly patients (HEP) is high. OBJECTIVE: To investigate the behavior of several nutritional indicators and predictors of unfavorable clinical outcome. METHODS: Retrospective study with hospitalized elderly patients (N = 322). Nutritional instruments, indicators and outcome were investigated. Chi-square, Fisher and Mann-Whitney tests and univariate and multiple logistic regression analysis were used. RESULTS: The variables that, jointly, were associated with hospital stay longer than 7 days, include: the presence of complications (p = 0.0328; OR 1.946; IC95% 1.056; 3.585) and nutritional risk according to the NRS-2002 (p = 0.0016; OR 2.080; IC95% 1.322; 3.275). The variable that remained associated with complications in the multiple model was the nutritional risk according to the NRS-2002 (p = 0.0018; OR 2.587; IC95% 1.423; 4.703). CONCLUSION: Nutritional risk using the NRS-2002 is a predictor of clinical outcome in hospitalized elderly patients.

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BACKGROUND: The present study aimed to investigate the influence of food intake on body weight loss (WL) and the association of gene polymorphisms, 1 year after Roux-en-Y gastric bypass (RYGB) surgery. METHODS: In total, 95 obese women (age ranged 20-50 years) in a Brazilian cohort underwent RYGB surgery and completed the study. Anthropometric measurements and food intake were assessed before and 1 year after surgery. Twelve gene polymorphisms (GHRL rs26802; GHSR rs572169; LEP rs7799039; LEPR rs1137101; 5-HT2C rs3813929; UCP2 rs659366; UCP2 rs660339; UCP3 rs1800849; SH2B1 rs7498665; TAS1R2 rs35874116; TAS1R2 rs9701796; and FTO rs9939609) were determined using a real-time polymerase chain reaction and a TaqMan assay. The subjects were divided into quartiles regarding percentage of excess weight loss (%EWL). The effect of genetic variants on energy and macronutrient intake was evaluated by simple logistic regression, followed by multiple logistic regression. RESULTS: Subjects in the first and second quartiles showed a higher initial body mass index. Energy and macronutrient intake before and 1 year after RYGB surgery did not differ between the %EWL quartiles. None of gene polymorphisms investigated showed an association with the estimated energy intake 1 year after surgery. CONCLUSIONS: In conclusion, the estimate energy and food intake did not predict a greater body WL 1 year after RYGB surgery. In addition, the 12 gene polymorphism investigated did not affect the energy intake among female patients.

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