Nutricion hospitalaria最新文献

Introduction: Introduction: disordered eating behaviors (DEBs) and eating disorders (Eds) mainly occur in adolescence, but they currently already occur at an early age between the ages of five and twelve. Although there are instruments for EDs, it is necessary to have a self-applicable instrument for evaluating DEBs in children. Objective: to determine the reliability and exploratory and confirmatory factorial validity of the Brief Questionnaire for Measuring Disordered Eating Behaviors (BQDEB) in children ages eight to twelve years. Material and methods: the sample comprised 386 Mexican children with an average age of 10.2 years. The BQDEB was adapted for this population, with questions being reduced from ten to seven and answer choices from four to three. Frequency and percentage, reliability, and exploratory and confirmatory validity analyses were undertaken. Results: concern over gaining weight was the most frequent DEB. The exploratory factorial analysis yielded seven items grouped into two factors: 1) compensatory/restrictive behaviors; and 2) binge eating, with a total ordinal alpha reliability of 0.95. Confirmatory factor analysis showed that the model fits the data well. Conclusions: since the psychometric properties of the BQDEB for children were adequate, it constitutes a useful instrument for identifying DEBs in children.

Introduction: Background: the prevalence of obesity is reaching a pandemic status. The SCALE trials showed that liraglutide 3 mg among people with obesity (PwO) was effective to reduce bodyweight and related complications. The fact that almost two-thirds of patients did not achieve the desired weight loss with the maximum dose of liraglutide made almost mandatory the development of other pharmacological options. The STEP 1-5 trials showed the effectiveness of semaglutide in reducing bodyweight in a dose-dependent manner. Moreover, the STEP 8 trial proved the superiority of semaglutide 2,4 mg/week versus liraglutide 3 mg/daily. We aimed to assess the effects of subcutaneous (s.c.) semaglutide 0.5 mg/weekly compared with s.c. liraglutide 3 mg/daily in PwO on anthropometric parameters in a real world-scenario for 3 months. Methods: we retrospectively evaluated 179 PwO (91.9 % ♀, 45.7 ± 10 years, and 33.3 ± 7 kg/m2) who received treatment with aGLP-1 as add-on therapy to lifestyle interventions. Patients were evaluated at baseline and after 3 months. Ninety-nine patients were prescribed s.c. semaglutide 0.5 mg/weekly with an off-label indication for weight reduction. These patients were compared with 80 patients treated with s.c. liraglutide 3 mg/daily. The main reason for prescribing of s.c. semaglutide was economic. Body composition was evaluated using a bioimpedance device (Tanita MC 580M®). Results: baseline weight was significantly greater with semaglutide compared to liraglutide (97.19 ± 21.09 vs. 90.73 ± 21.88 kg; p < 0.01) as was fat mass (42.43 ± 15.04 vs. 34.84 ± 16.07 kg; p < 0.01), whereas baseline lean mass was lesser among subjects treated with semaglutide (31.62 ± 7.56 vs 45.69 ± 15.51 kg; p < 0.01). PwO experienced a significant reduction in weight using s.c. semaglutide 0.5 mg/weekly (96.67 ± 20.83 vs. 91.44 ± 19.6 kg; p < 0.01) or s.c. liraglutide 3 mg/daily (90.73 ± 21.88 vs. 80.13 ± 18.38 kg; p < 0.01) No significant differences were seen between the amount of weight lost (5.28 ± 4.22 vs 5.72 ± 1.62 kg; p = 0.5) in the two groups. Furthermore, both groups were comparable in fat mass (2.69 ± 5.34 vs 0.96 ± 4.22 kg; p = 0.3) and fat-free mass (0.86 ± 1.63 vs 1.03 ± 0.94 kg; p = 0.07) after 3 months of treatment with both aGLP1. Side effects were gastrointestinal and transient/comparable between groups Conclusions: subcutaneous semaglutide 0.5 mg and subcutaneous liraglutide 3 mg are effective treatments for reducing weight safely among PwO in a real-world scenario at short term and without a negative impact on fat-free mass. Moreover, low doses of semaglutide were similar to liraglutide 3 mg in reducing bodyweight at short term.

Introduction: Background: the Naples Prognostic Score is a novel scoring system designed to provide a comprehensive assessment of patients' inflammation and nutritional status. Aim: our aim was to investigate the correlation between the Naples Prognostic Score and arterial stiffness, a factor known to be linked with heart failure and acute coronary syndrome. Materials and methods: this prospective study included 142 consecutive patients without a history of cardiovascular disease, inflammatory disease, immunological disease, malignancy, or comorbid conditions other than hypertension. Patients were categorized into two groups based on their Naples Prognostic Scores: Group 1 (score of 0-2) and Group 2 (score of 3 or 4). Arterial stiffness was assessed using the Cardio-Ankle Vascular Index (CAVI) measured with the VaSera VS-1000 device. CAVI values were compared between the groups. Results: the mean age of the patients was 54 ± 9 years. Group 1 comprised 114 (80.3 %) patients, while Group 2 comprised 28 (19.7 %) patients. There were no significant differences in demographic data between the groups (p > 0.005). Additionally, there were no statistically significant differences between Group 1 and Group 2 regarding left CAVI (7.92 ± 1.45 vs. 8.72 ± 1.85; p = 0.295), right CAVI (7.89 ± 1.52 vs. 8.67 ± 1.34; p = 0.332), or left or right ankle brachial index (p > 0.005). Conclusions: despite previous studies indicating a significant association between the Naples Prognostic Score and heart failure or acute coronary syndrome, our study did not observe a significant correlation between this score and arterial stiffness assessed by CAVI.

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Introduction: Introduction: given the problematic battle against cardio-metabolic diseases and the increase in computational power, different applications are being developed to help estimate overweight and obesity in the population. Objectives: to evaluate the body mass index (BMI) formula (kg/m2), taking body fat measured by bioimpedance as a reference and comparing it with variations of the same form obtained by applying algebraic transformation rules using an artificial intelligence heuristic search method. Material and methods: an artificial intelligence heuristic method was applied to search for the formula that most accurately calculates people's body fat percentage. The formula was generated from body mass and stature, variables used to estimate BMI. Thousands of formulas involving body mass and stature were generated from BMI using transformation rules with algebraic variations and increased and decreased constants. Results: body mass, stature, and body fat percentage data set from 142 female and 150 male participants were used. Body mass and stature were used to classify participants into two classes based on body fat percentage (excessive or adequate, with cutoff points of 30 % for women and 15 % for men). The Youden index guided the search algorithm by evaluating candidate formulas to generate new ones. Among the formulas with the maximum value of the Youden index, Body mass1.1 / Stature2.9, is proposed as the best candidate as an alternative formula to apply instead of the BMI conventional formula. Conclusions: although BMI showed a high Youden index, the AI algorithm found that the W1.1 / H2.9 formula is even more efficient in assessing body fat in men and women.

Introduction: Introduction: we aimed to investigate the associations of body mass index (BMI) and oxygen saturation with chronic obstructive pulmonary disease (COPD) grade in COPD patients. Materials and methods: the clinical data of 105 COPD patients admitted to and treated in our hospital during January 2021 and January 2022 were acquired for a retrospective analysis, and grade 1 group [n = 15, subjects presenting forced expiratory volume in one second (FEV1) ≥ 80 % of the predicted value], grade 2 group (n = 32, those with FEV1 ≥ 50 % and < 80 % of the predicted value), grade 3 group (n = 34, those with FEV1 ≥ 30 % and < 50 % of the predicted value), and grade 4 group (n = 24, those with FEV1 < 30 % of the predicted value or with FEV1 < 50 % of the predicted value and concomitant respiratory failure) were set up based on COPD grade. Results and conclusion: the BMI of the 105 patients was 20.39 ± 3.31 kg/m² on average, and it showed differences of statistical significance regarding the subjects with varying COPD grades (p < 0.05). The oxygen saturation was 89.98 ± 4.04 on average in the 105 patients, and it also displayed statistically significant differences among patients with different grades of COPD (p < 0.05). According to pairwise comparison, grade 1 group exhibited the highest oxygen saturation, followed by grade 2, 3, and 4 groups in turn (p < 0.05). Both BMI and oxygen saturation had negative correlations with COPD grade (p < 0.05). In COPD patients, COPD grade is negatively correlated with BMI and oxygen saturation.

Introduction: Objective: to investigate the clinical value of vitamin K testing in children with vitamin D deficiency rickets. Methods: fifty children with vitamin D deficiency rickets admitted to our hospital from March 2021 to March 2022 were recruited as the case group using convenience sampling; and an additional 50 children without bone health diseases during the same period of health checkup were selected as the control group. The relevant indexes between the two groups were compared. Results: there were statistically significant differences between the two groups in the level of 25 hydroxyvitamin D3 [25-(OH)D3], the proportion of breastfeeding, and the proportion of preterm birth (p < 0.001). The levels of vitamin K1 and K2 were lower in the case group than in the control group, and the proportion of those with vitamin K1 deficiency and vitamin K2 deficiency were higher than the control group (p < 0.001) . Positive correlations were found between vitamins K1 and K2 and 25-(OH)D3, blood calcium, and blood phosphorus (p < 0.05); artificial feeding, preterm birth, vitamin K1 deficiency, and vitamin K2 deficiency were risk factors for the development of vitamin D deficiency rickets, and the highest AUC of the combination of each index in predicting the occurrence of vitamin D deficiency rickets was 0.951 (95 % CI: 0.910-0.991). Conclusion: preterm birth, artificial feeding, and vitamin K1 and K2 deficiency are independent risk factors for bone metabolism in children with vitamin D-deficiency rickets. And these risk factors have predictive and diagnostic value in the diagnosis and management of vitamin D deficiency rickets.

Introduction: Background and objective: identifying patients at high risk of avoidable readmission remains a challenge for healthcare professionals. Despite the recent interest in Machine Learning in this topic, studies are scarce and commonly using only black box algorithms. The aim of our study was to develop and validate in silico an interpretable predictive model using a decision tree inference to identify pediatric patients at risk of 30-day potentially avoidable readmissions. Methods: a retrospective cohort study was conducted with all patients under 18 years admitted to a tertiary university hospital. Demographic, clinical and nutritional data were collected from electronic databases. The outcome was the potentially avoidable 30-day readmissions. The J48 algorithm was used to develop the best-fit trees capable of classifying the outcome efficiently. Leave-one-out cross-validation was applied and we computed the area under the receiver operating curve (AUC). Results: the most important attributes of the model were C-reactive protein, hemoglobin and sodium levels, besides nutritional monitoring. We obtained an AUC of 0.65 and accuracy of 63.3 % for the full training and leave-one-out cross-validation. Conclusion: our model allows the identification of 30-day potentially avoidable readmissions through practical indicators facilitating timely interventions by the medical team, and might contribute to reduce this outcome.

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