ABSTRACT Objective The aim of this study was to compare the Global Leadership Initiative on Malnutrition and Subjective Global Assessment methods produced by the patient in the nutritional assessment of cancer in-patients. Methods Cross-sectional study with a prospective variable, conducted with patients admitted to a public hospital in Pernambuco, Brazil. The application of these tools and the diagnosis of malnutrition were performed within the first 48 hours of admission. Sociodemographic, clinical and laboratory data were obtained from the medical records and weight, height, arm circumference, triceps skinfold and handgrip strength data were collected. Results The 82 patients evaluated included mostly men aged ≥ 60 years with less than 8 years education. Malnutrition frequency was 93.7% according to the Subjective Global Assessment and including 23.2% severe malnutrition while, according to the Global Leadership Initiative on Malnutrition, 50% of the patients were considered severely malnourished. Malnutrition by the Global Leadership Initiative on Malnutrition showed a sensitivity of 82.9% and when associated with handgrip strength sensitivity was 90.8%, considering the Subjective global assessment produced by the patient as a reference; on the other hand, the specificity was 16.7% independently of adding handgrip strength. None of the anthropometric variables was associated with the reference tool. Conclusion The Global Leadership Initiative on Malnutrition proved to be a very sensitive tool for diagnosing malnutrition when compared to the gold standard, particularly for severe malnutrition, but with little specificity. The need for a comprehensive nutritional assessment in the clinical practice was confirmed, using the parameters available and not interpreting them separately.

RESUMO Objetivo O objetivo deste estudo foi comparar os métodos Global Leadership Initiativeon Malnutrition e Avaliação Subjetiva Global Produzida pelo Próprio Paciente na avaliação nutricional de pacientes oncológicos hospitalizados. Métodos Estudo transversal com uma variável prospectiva, realizado com pacientes internados em um hospital público de Pernambuco. A aplicação dessas ferramentas e o diagnóstico de desnutrição foram realizados nas primeiras 48 horas de admissão. Dados sociodemográficos, clínicos e laboratoriais foram obtidos do prontuário, e dados com peso, altura, circunferência do braço, prega cutânea tricipital e força de preensão palmar foram coletados. Resultados Dos 82 pacientes avaliados, a maioria eram homens com idade ≥60 anos com menos de 8 anos de estudo. A frequência de desnutrição foi de 93,7% pela Avaliação Subjetiva Global; destes, 23,2% com desnutrição grave. Já pela Global Leadership Initiative on Malnutrition, 50% dos pacientes foram considerados desnutridos graves. A desnutrição pela Global Leadership Initiative on Malnutrition apresentou uma sensibilidade de 82,9% e de 90,8% quando associada à força de preensão palmar considerando a Avaliação Subjetiva Global Produzida pelo Próprio Paciente como referência. Por sua vez, a especificidade foi de 16,7% independentemente de adicionar a força de preensão palmar. Nenhuma das variáveis antropométricas apresentou associação com a ferramenta de referência. Conclusão A Global Leadership Initiative on Malnutrition mostrou-se uma ferramenta bastante sensível para diagnosticar desnutrição quando comparada ao padrão ouro, principalmente para desnutrição grave, porém pouco específica. Ratificou-se a necessidade de uma avaliação nutricional ampla na prática clínica, utilizando os parâmetros disponíveis e não os interpretando de forma isolada.

ABSTRACT Objective To evaluate the relationship between nutritional parameters and clinical factors and the outcome of patients diagnosed with COVID-19. Methods This is a prospective longitudinal study involving patients with COVID-19 infection admitted to a University Hospital in Pernambuco. The sample consisted of individuals aged ≥20 years who tested positive for COVID-19 infection. Nutritional risk was assessed using the recommended screening procedure for this group and the nutritional status using the Body Mass Index. Demographic and clinical variables were transcribed from the medical records. Result There was a predominance of adult inpatients between 20 and 59 years of age (95% CI: 64.6-76.0); nutritional risk was observed in 91.6% of patients and overweight in 58.9% of patients. Age ≥60 years (p=0.03), presence of malignancies and inadequate nutrition (p<0.001) were independent risk factors for in-hospital death. It was also observed that only arterial hypertension (OR 2.34, 95% CI 1.32-4.13, p=0.003) and overweight (OR 1.84, 95% CI 1.05-3.21, p=0.032) were considered independent risk factors for admission of the patients in the Intensive Care Unit. Conclusion Although overweight is a risk factor for admission in the Intensive Care Unit, it was not possible to observe it as a factor for mortality, requiring further studies to determine the mechanisms that interfere in the association between obesity and mortality in those patients.

RESUMO Objetivo Avaliar a relação dos parâmetros nutricionais e fatores clínicos com o desfecho dos pacientes diagnosticados com COVID-19. Métodos Trata-se de um estudo longitudinal prospectivo envolvendo pacientes com infecção por COVID-19 internados em um Hospital Universitário de Pernambuco. A amostra foi constituída por indivíduos com idade ≥20 anos que tiveram resultado positivo para infecção por COVID-19. O risco nutricional foi avaliado por meio de triagem recomendada para este grupo e o estado nutricional por meio do Índice de Massa Corpórea. As variáveis demográficas e clínicas foram transcritas dos prontuários. Resultados Houve predomínio de pacientes adultos entre 20 e 59 anos (95% IC: 64,6-76,0) internados, o risco nutricional foi observado em 91,6% e o excesso de peso em 58,9% dos pacientes. A idade >60 anos (p=0,03), a presença de câncer e aporte nutricional inadequado (p<0,001) foram fatores de risco independente para morte hospitalar. Observou-se também que apenas a hipertensão arterial (OR 2,34, 95% IC 1,32-4,13, p=0,003) e o excesso de peso (OR 1,84, 95% IC 1,05-3,21, p=0,032) foram considerados fatores de risco independentes para a internação do paciente na Unidade de Terapia Intensiva. Conclusão Embora o excesso de peso seja um fator de risco para admissão na Unidade de Terapia Intensiva, não foi possível observá-la como um fator para mortalidade, se fazendo necessários estudos para determinar os mecanismos que interferem na associação entre a obesidade e letalidade desses pacientes.

The aim of the study was to compare the innate immune system of severely malnourished children admitted to the Instituto de Medicina Integral Professor Fernando Figueira and treated according to the protocol of the World Health Organization (WHO) at admission and discharge. An experimental study was conducted with 20 children under two years of age. Ten of them had severe malnutrition and ten were a control group. The malnourished group consisted of hospitalized infants and it was submitted to WHO's protocol. Children with HIV and re-admitted during the study period were excluded. A blood sample was taken at admission and at discharge. Later, an analysis of blood leukocytes, adherence index, phagocytic capacity, production of free radicals superoxide and nitric oxide was performed. Patients with severe malnutrition at hospital discharge showed improved phagocytic function, release of oxygen radicals and reduction of the number of lymphocytes when compared to the time of admission. When compared to the control group, patients at hospital discharge had lower lymphocyte values and lower production of free radicals. Thus, it can be concluded that the duration of hospitalization was insufficient to restore cell-mediated immunity and microbicide activity.

El objetivo del estudio fue comparar el sistema inmune innato de niños con malnutrición grave ingresados en el Instituto de Medicina Integral Professor Fernando Figueira, tratados de acuerdo con el protocolo de la Organización Mundial de la Salud (OMS), al ingreso y al alta hospitalaria. Se llevó a cabo un estudio experimental con 20 niños menores de dos años de edad, 10 con malnutrición grave y 10 niños del grupo de control. El grupo de malnutridos se compuso de lactantes hospitalizados y sometidos al protocolo de la OMS. Se excluyeron los niños afectados por el HIV y los readmitidos durante el período del estudio. Se recogió una muestra de sangre al ingreso y otra al alta, y posterioriormente se realizó el análisis del perfil leucocitario, y el índice de adherencia, la capacidad fagocítica y la producción de los radicales libres superóxido y óxido nítrico. Los pacientes con malnutrición grave en el alta hospitalaria mostraron mejoría de la función fagocítica, la liberación de radicales oxidantes y la reducción del número de linfocitos en comparación con el ingreso hospitalario. En comparación con el grupo de control, los pacientes en el alta hospitalario presentaron valores más bajos de linfocitos y de producción de radicales libres. Por lo tanto, se puede concluir que el tiempo de hospitalización fue insuficiente para restablecer la inmunidad mediada por células, así como para restaurar la actividad microbicida.

Background: despite the decline in its incidence and mortality rate, gastric cancer continues to be the 4th most common tumor and the 2nd cause of death in the world. Objective(s): to analyze the factors associated with gastric cancer in hospitalized patients. Method: Transversal study of case series type made at Recife hospitals. The data were obtained from a questionnaire adapted from a previously validated model, which consists of socioeconomic factors, eating habits, lifestyle, family history of cancer, infection by H. pylori and anthropometric data. Results: among 33 patients, there was a slight prevalence of women aged ≥ 60, from rural areas, with low education and income levels. According to IMC, 57.6% were eutrophics and 69.7% at nutritional risk when used % PP. It was found that 42.4% did not undergo any examination for H. pylori, 48.5% had a genetic predisposition, 75.8% were sedentary, 60.6% smokers and former smokers, 51.5% addicted to alcohol and 36.4% were overweight patients. There was frequent consumption of salty foods, fried foods, and low intake of fruits, foods containing nitrates / nitrites and inadequate food storage. Conclusion: low socioeconomic status, physical inactivity and inappropriate diet patterns were prevalent factors for gastric cancer in the treated group.

Introducción: a pesar de la disminución de la incidencia y la mortalidad, el cáncer gástrico sigue siendo el cuarto tumor más frecuente y la segunda causa de muerte por cáncer en el mundo. Objetivos: analizar los factores asociados con el cáncer gástrico en pacientes hospitalizados. Método: estudio de corte serie de casos, realizado en hospitales de Recife. Los datos fueron obtenidos a partir de cuestionarios adaptados de un modelo previamente validado, que contenían los problemas socioeconómicos, los hábitos alimentarios, el estilo de vida, los antecedentes familiares de cáncer, la infección por H. pylori y los datos antropométricos. Resultados: de los 33 pacientes, tuvieron un ligero predominio las mujeres con edades ≥ 60 años, de zonas rurales, con bajos niveles de educacion e ingresos. De acuerdo con el IMC, el 57,6% fueron normales y el 69,7% en riesgo nutricional cuando se utiliza% PP. Se encontro que el 42,4% no se sometio a examen para H. pylori, el 48,5% tenian una predisposicion genetica, el 75,8% eran sedentarios, el 60,6% eran fumadores y ex fumadores, el 51,5% eran adictos al alcohol y el 36,4% tenian sobrepeso. Hubo consumo frecuente de alimentos salados, alimentos fritos, baja ingesta de frutas, alimentos que contienen nitratos/ nitritos, asi como una inadecuada conservacion de los alimentos. Conclusión: el bajo nivel socioeconómico, la inactividad física y los hábitos alimentarios inadecuados fueron factores predominantes para el cáncer gástrico en el grupo analizado.