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The food pyramid is a pre-established nutritional education tool. The integration between the intestinal microbiome, food groups, and SCFA-producing bacteria, which benefit from the ingestion of these foods, has the potential to further improve and innovate healthy eating. The diet-microbiome interaction needs to be incorporated into nutrition science, and the food pyramid might assist in this interaction and nutritional learning. Against this context, this brief communication proposes through the food pyramid, the interactions between the intestinal microbiota, food groups, and SCFAs-producing bacteria.

Phase angle through electrical bioimpedance as a predictor of cellularity in inflammatory bowel disease

Introdução: A cárie dental é uma doença crônica multifatorial que apesar do seu declínio nos últimos anos, considera-se um problema de saúde pública. Objetivo: Analisar os hábitos alimentares e a relação com a saúde bucal em escolares. Metodologia: Trata-se de um estudo transversal, realizado no período de outubro a novembro de 2017, em uma cidade da Região Meio Oeste de Santa Catarina. Os dados foram obtidos através de um questionário semiestruturado e prontuário eletrônico. A análise estatística foi realizada através do GraphPad Prism 6®. Resultados: A amostra constitui-se por 51 crianças, idade média 10,4 anos, prevalência do sexo feminino (66,7%). Os maiores índices de escolares com diagnóstico de cárie dental (25,5%) residiam na zona rural, menor renda mensal, menor escolaridade dos pais e maior frequência de consumo de alimentos cariogênicos. Conclusão: Hábitos alimentares associados às características sociodemográficas possuem relação direta refletindo na saúde bucal dos escolares, tornando-se evidente a importância da educação em saúde como medida preventiva. Palavras chave: Educação em saúde. Alimentos cariogênicos. Alimentos cariostáticos. Cárie dental. Saúde bucal.

Introdução: os pacientes submetidos à cirurgia bariátrica e metabólica apresentam melhoras clínicas significativas, porém, podem desenvolver intolerâncias alimentares e problemas emocionais, como distúrbios da imagem corporal, alterações no sistema gastrointestinal, e consequentemente a rápida perda de peso, que acarretam mudanças importantes na vida destes pacientes. Objetivo: identificar a tolerância alimentar e a percepção da imagem corporal de pacientes submetidos à cirurgia bariátrica e metabólica. Método: trata-se de um estudo prospectivo transversal de abordagem quantitativa, realizado com 36 pacientes que realizam acompanhamento no Programa de Cirurgia Bariátrica e Metabólica do Hospital de Clínicas de Itajubá, Minas Gerais (MG). Os dados clínicos e antropométricos foram obtidos em prontuários; a tolerância alimentar avaliada por meio do questionário de avaliação da qualidade da alimentação e tolerância alimentar, (14) a imagem corporal da escala de silhuetas corporais (18) e Body Shape Questionnaire-34, al, (15) nas consultas de pós operatório de acordo com o protocolo do serviço. A análise dos dados foi realizada através do Software Bioestat® v5.0, por meio da estatística descritiva (média ± desvio padrão e porcentagem). Resultados: 36 pacientes foram avaliados, sendo 75% do sexo feminino 75%, 97,2% apresentaram intolerância alimentar, sendo os alimentos menos tolerados massas (50,0%), carne vermelha (35,3%), pão (27,3%) e arroz (22,2%). Quanto à percepção da imagem corporal, 56% de participantes apresentaram algum nível de distorção da imagem corporal e 83,3% destas desejavam diminuir a silhueta. Conclusão: identificou-se elevada frequência de intolerâncias à alimentos específicos após à cirurgia bariátrica e metabólica, uma distorção importante da imagem corporal e avaliação negativa da autoimagem

Introduction: Anorectal physiology tests are indicated for patients who have refractory symptoms of constipation, but the best sequence of investigation remains controversial. Objective: To evaluate the influence of colonic transit time and anorectal manometry in the diagnosis of chronic constipation in adults. Method: This was a study of adult patients with constipation at a private clinic in a city in southern Brazil, from January 1, 2009 to December 31, 2018. Those who showed warning signs were referred for colonoscopy and those with any anatomical alterations were excluded. The patients received 10 g of psyllium and those who remained symptomatic after three weeks were referred for functional assessment with colonic transit time (CTT). Those who presented outlet obstruction in the colonic transit time were referred to anorectal manometry. Results: Of the 889 adult patients surveyed, 227 were included. Of the 216 who completed the study, 167 responded to primary treatment. Forty-nine underwent CTT. In these, 16 had normal colonic transit time and 33 were altered. In those with altered colonic transit time, eight had a pattern of colonic inertia and 25 had an obstruction pattern. The 25 patients with an outlet obstruction pattern underwent anorectal manometry. Eighteen had signs of paradoxical contracture of the puborectal muscle (PPRC) and seven did not. Conclusion: This study concluded that anorectal physiology exams contribute to the diagnosis of constipation, often changing the behavior. These exams should be performed whenever the patient does not respond to hygienic changes and fiber replacement. Resumo Introdução: Os exames de fisiologia anorretal estão indicados nos pacientes que mantém sintomas refratários de constipação, porém uma sequência desejada de investigação permanece contraditória. Objetivo: Avaliar a influência do tempo de trânsito colônico e da manometria anorretal no diagnóstico da constipação crônica de adultos. Método: Estudamos os pacientes adultos de uma clínica privada em uma cidade do sul do Brasil, no período de 01 de Janeiro de 2009 a 31 de Dezembro de 2018 apresentando constipação. Aqueles que apresentassem sinais de alerta, eram encaminhados a colonoscopia e com qualquer alteração anatômica eram excluídos. Foram prescritos 10 g de Psyllium e aqueles que permaneceram sintomáticos após três semanas foram encaminhados à avaliação funcional com tempo de trânsito colônico (TTC). Os que apresentavam obstrução de saída ao tempo de trânsito colônico foram encaminhados a manometria anorretal. Resultados: Dos 889 pacientes adultos levantados, 227 foram incluídos. Dos 216 que concluíram o estudo, 167 responderam ao tratamento primário. Quarenta e nove realizaram TTC. Nestes, 16 tiveram tempo de trânsito colônico normal e 33 alterado. Naqueles com tempo de trânsito colônico alterado: oito tinham padrão de inércia colônica e 25, padrão de obstrução de saída. Os 25 pacientes com padrão de obstrução de saída foram submetidos à manometria anorretal. Dezoito tinham sinais de Contratura Paradoxal do músculo Puborretal (CPPR) e sete não. Conclusão: Concluímos que os exames de fisiologia anorretal contribuem para o diagnóstico da constipação, muitas vezes alterando a conduta. Estes exames devem ser realizados sempre que o paciente não responder as alterações higienodietéticas e a reposição de fibras.

This study aimed to describe nutritional and lifestyle parameters following one-anastomosis gastric bypass (OAGB). A multicenter study among OAGB patients across Israel (n = 277) and Portugal (n = 111) was performed. Patients were approached according to the time elapsed since surgery. An online survey with information regarding demographics, anthropometrics, and nutritional and lifestyle aspects was administered in both countries simultaneously. Respondents from Israel (pre-surgery age of 41.6 ± 11.0 years, 75.8% females) and Portugal (pre-surgery age of 45.6 ± 12.3 years, 79.3% females) reported changes in their appetite (≤94.0% and ≤94.6%), changes in their taste (≤51.0 and ≤51.4%), and intolerance to specific foods (i.e., red meat, pasta, bread, and rice). Bariatric surgery-related eating recommendations were generally followed well, but a trend toward lower adherence was evident in groups with longer time elapsed since surgery in both countries. Most respondents from Israel and Portugal reported participation in follow-up meetings with a surgeon (≤94.0% and 100%) and a dietitian (≤92.6% and ≤100%), while far fewer reported participation in any follow-up meeting with a psychologist/social worker (≤37.9% and ≤56.1%). Patients following OAGB might experience changes in appetite, taste, and intolerance to specific foods. Adherence to bariatric surgery-related eating recommendations is not always satisfying, especially in the longer term post-surgery.

The discussion and scientific production on preventable infant deaths has attracted attention due to the intrinsicassociation with the quality of health services and social determinants. Its analysis, within the scope of SUS, supportsthe management and planning of health promotion and prevention interventions aimed at children. Thus, the presentstudy aimed to analyze the occurrence of infant deaths from preventable causes in the Health Region of the Far West ofSanta Catarina. Data collection was carried out between the months of July and December 2019, in secondary sources,in the death certificates, live birth certificates, and infant death investigation forms for the period from 01/01/2018to 12/31/2018. The information obtained was analyzed using descriptive statistics. The instrument for the analysis ofpreventability was the Brazilian List of causes of preventable deaths by interventions of the Unified Health System. Froma total of 3,046 births, verified in the analyzed period, there were 62 deaths, among which were 25 fetal deaths (40.32%) and 37 infant deaths (59.67%). With an Infant Mortality Rate estimated at 12.14%, there was a predominance of fetal(40.32%) and early neonatal (29.03%) deaths. As for preventability, 40 (64%) deaths were classified as preventable, 14(23%) were not preventable, and 8 (13%) had ill-defined causes. The causes that can be reduced by adequate care forwomen during pregnancy stood out as the main component in infant mortality. Our results demonstrate that there isa compromise in the quality of prenatal and neonatal care and demonstrate the importance of directing attention andinvestments to improve this care.

At the end of 2019, a new disease with pandemic potential appeared in China. It was a novel coronavirus called coronavirus disease 2019 (COVID-19). Later, in the first quarter of 2020, the World Health Organization declared the outbreak of this disease a pandemic. Elderly people, people with comorbidities, and health care professionals are more vulnerable to COVID-19. Obesity has been growing exponentially worldwide, affecting several age groups. It is a morbidity that is associated with genetic, epigenetic, environment factors and/or interaction between them. Obesity is associated with the development of several diseases including diabetes mellitus, mainly type 2. Diabetes affects a significant portion of the global population. Obesity and diabetes are among the main risk factors for the development of severe symptoms of COVID-19, and individuals with these conditions constitute a risk group. Based on a literature review on obesity in people with diabetes in the framework of the COVID-19 pandemic, this study presents updated important considerations and care to be taken with this population.

BACKGROUND Obesity is a condition that increases the risk of developing several health problems, resulting in high health care costs worldwide. Therefore, it is important to investigate several avenues for the control of this condition. This study aimed to identify a dermatoglyphical condition that distinguishes obesity individuals from those of appropriate weight. METHODS The sample comprised 2,172 children and teenagers between the ages of 10 and 19 years, female and male, from public and private schools of the municipality of Joacaba, Santa Catarina, Brazil. RESULTS In a comparison of qualitative variables, i.e., patterns, significant differences were observed between groups, including a higher frequency of ulnar loops (LU) on the index and middle fingers (MET2 and MET3) in the appropriate weight group. In the obesity group, a greater frequency of whorls (W) on fingers MET2 and MET3 was observed in males. In females, there were statistically significant correlations between the presence of radial loops (LR) on MET3 in the appropriate weight group and arches (A) in the obesity group. CONCLUSIONS The study uncovered dermatoglyphical marks characteristic of obesity individuals.

This study aims to understand the prevalent practices on the nutritional aspects of the enhanced recovery after surgery (ERAS) protocol based on the knowledge and practice of surgeons, nutritionists, and anesthesiologists who work in the bariatric and metabolic surgery (BMS) units worldwide. This cross-sectional study enrolled BMS unit professionals from five continents-Africa, America, Asia, Europe, and Oceania. An electronic questionnaire developed by the researchers was provided to evaluate practices about the three nutritional aspects of ERAS protocol in BMS (Thorel et al. 2016): preoperative fasting, carbohydrate loading, and early postoperative nutrition. Only surgeons, nutritionists, and anesthesiologists were invited to participate. One hundred twenty-five professionals answered the questionnaires: 50.4% from America and 39.2% from Europe. The profile of participating professionals was bariatric surgeons 70.2%, nutritionists 26.4%, and anesthesiologists 3.3%. Approximately 47.9% of professionals work in private services, for about 11 to 20 years (48.7%). In all continents, a large majority were aware of the protocol. Professionals from the African continent reported having implemented the ERAS bariatric protocol 4.0 ± 0 years ago. It is worth mentioning that professionals from the five continents implemented the ERAS protocol based on the published literature (p = 0.012). About preoperative fasting abbreviation protocol, a significant difference was found between continents and consequently between services (p = 0.000). There is no uniformity in the conduct of shortening of fasting in the preoperative period and the immediate postoperative period. Early postoperative (PO) period protein supplementation is not performed in a standard fashion in all units globally. ERAS principles and practices are partial and insufficiently implemented on the five continents despite the prevalent knowledge of professionals based on evidence. Moreover, there is no uniformity in fasting, immediate postoperative diet, and early protein supplementation practices globally. info:eu-repo/semantics/publishedVersion

Introdução: o câncer de mama é a neoplasia mais comum em mulheres no mundo, sendo que a morbidade e mortalidade resultantes dessa condição tornaram-se um problema de saúde. Uma das complicações decorrentes do tratamento do câncer de mama é o linfedema, condição que traz limitações funcionais e diminuição da qualidade de vida (QV) das pacientes. O tratamento fisioterápico é uma das abordagens mais utilizadas para prevenção e tratamento do linfedema. Objetivo: avaliar o impacto do linfedema e do tratamento fisioterápico em pacientes com câncer de mama. Métodos: foi avaliada a QV de mulheres diagnosticadas com câncer de mama na região Meio-Oeste de Santa Catarina através do instrumento genérico WHOQOL-Bref e do EORTC QLQ-BR23, questionário específico para câncer de mama. Com o objetivo de identificar fatores que interfiram na QV, foi analisada a presença ou ausência de linfedema e se essas pacientes realizaram fisioterapia para prevenir ou tratar possíveis complicações do tratamento. Resultados: das 135 pacientes avaliadas, 33,3% delas apresentavam linfedema no membro superior homolateral à cirurgia no momento da coleta, porém a presença de linfedema não afetou negativamente a QV das pacientes. Apenas 34% das pacientes realizaram fisioterapia em algum momento do tratamento, sendo que a realização desta não foi determinante para melhorar a QV. Conclusão: diante dos resultados encontrados, conclui-se que o diagnóstico de linfedema parece não afetar negativamente a QV geral das mulheres com câncer de mama avaliadas neste estudo, e que o tratamento fisioterápico não influenciou positivamente na qualidade de vida dessas pacientes. Ressalta-se a necessidade de novos estudos que permitam um melhor entendimento das causas do baixo número de encaminhamento das pacientes com câncer de mama para o tratamento fisioterápico, bem como para uma melhor avaliação da importância e a eficácia desse tipo de tratamento na funcionalidade e QV dessas pacientes.Palavras-chave: Câncer de mama; Linfedema; Fisioterapia; Oncofuncional; Qualidade de vida

O Manganes (Mn) e um metal essencial para o organismo. E distribuido no ambiente e utilizado em processos industriais. Apesar de essencial, e neurotoxico a exposicoes cumulativas, causando uma desordem neurologica, o Manganismo. O estudo avaliou o efeito da administracao subaguda de Mn sob a forma de cloreto e acetato de Mn, sobre a funcao mitocondrial e parâmetros oxidativos no encefalo, bem como o acumulo deste metal no encefalo e tecidos perifericos de ratos adultos. Os ratos receberam 6 mg/kg de Mn i.p. na forma de cloreto ou acetato de Mn, 5 dias/semana por 4 semanas. O grupo controle recebeu solucao salina 0,9% pela mesma via de administracao e mesmo periodo. Foi mensurada a concentracao de substâncias reativas ao acido tiobarbiturico (TBARS) e grupamentos NPSH, a atividade dos complexos I e II da cadeia respiratoria no encefalo e/ou estruturas cerebrais, bem como o peso corporal e a concentracao de Mn e Fe no soro, encefalo, tecido renal e hepatico. Foi observada uma diminuicao no ganho de peso corporal dos animais que receberam o Mn, um aumento na concentracao/deposito de Mn no soro, encefalo e tecido renal, tanto na forma de cloreto e acetato de Mn, quando comparados com o grupo controle. Alem disso, houve um aumento significativo no conteudo de NPSH no encefalo e, embora nao significativo, uma tendencia de aumento da concentracao de TBARS, no grupo que recebeu cloreto de Mn. Ainda, foi verificada uma inibicao na atividade do complexo I no estriado dos animais expostos ao cloreto de Mn. Nao houve diferenca entre os grupos nas atividades do complexo I e II no encefalo e hipocampo. Em conjunto, os dados indicam que a exposicao ao Mn em baixas doses contribui para o desenvolvimento de estresse oxidativo e disfuncao mitocondrial no SNC, com aparente predilecao de dano ao estriado. Palavras-chave : Manganes. Exposicao subaguda. Parâmetros oxidativos. Funcao mitocondrial. MANGANESE SUBACUTE INTOXICATION IN ADULT WISTAR RATS: EVALUATION OF OXIDATIVE PARAMETERS IN CNS AND METAL DEPOSITION IN DIFFERENT TISSUES ABSTRACT: Mn is an essential metal to the organism. It is distributed in the environment and used in industrial processes. Although essential, it is neurotoxic to cumulative exposures, and can cause a neurological disorder, called Manganism. This study evaluated the effect of subacute Mn as chloride and acetate of Mn administration on mitochondrial function and oxidative parameters in adult rat brain, as well as the accumulation of this metal in the brain and peripheral tissues. The rats received 6 mg/kg of Mn i.p., as Mn chloride or Mn acetate, 5 days/week for 4 weeks. The control group received 0.9% of saline solution in the same way of administration and in the same period. It was measured the concentration of thiobarbituric acid reactive substances (TBARS) and NPSH groups, the activity of mitochondrial complex I and II in brain and/or in the brain structures, as well as the body weight and the concentration of Mn and Fe accumulation. It was observed a decrease on body weight gain in animals exposed to Mn and an increase of concentration/deposit of Mn in serum, brain and kidney, in the both Mn chloride and acetate form when compared to the control group. In addition, there was a significant increase in brain NPSH content and, although it was not significant, a trend of increasing on TBARS concentration in the group that received Mn. Besides that, a significant inhibition of complex I activity was observed in the striatum of the animals exposed to Mn. There was not difference between groups on complex I and II in the brain and hippocampus. Together, these data indicate that exposure to Mn at low doses contributes to the development of oxidative stress and mitochondrial dysfunction in the CNS, with apparent predilection of striatum damage. Keywords: Manganese. Subacute exposure. Oxidative parameters. Mitochondrial function.

Resumo Objetivo: socializar as estratégias desenvolvidas pela Comissão Intersetorial de Saúde do Trabalhador e da Trabalhadora (CISTT) do município de Joaçaba/SC, Brasil, entre os anos de 2012 e 2017. Métodos: relato de experiência com base em levantamento e análise documental de atas e relatórios da CISTT, matérias jornalísticas e sites de instituições públicas e de sindicatos. Resultados: diálogos e interação com a comunidade a respeito do tema de saúde do trabalhador (ST) por meio de promoção de seminários temáticos sobre trabalho e saúde, concurso e exposição de fotografias, concurso de redação e desenhos, publicação de livro, criação de lei municipal, implantação do sistema de Vigilância em Saúde do Trabalhador e discussão, proposição e acompanhamento de políticas públicas na área de ST. Conclusão: apesar das dificuldades e facilidades institucionais características de um município de pequeno porte, as atividades adotadas na implementação da CISTT se configuram como uma estratégia importante para a promoção da saúde no campo da ST. Abstract Objective: to socialize the strategies developed by the Intersectoral Commission on Worker’s Health (CISTT) of the municipality of Joaçaba/SC, Brazil, from 2012 to 2017. Methods: experience report based on documentary survey and analysis of CISTT’s minutes and reports, newspaper articles and websites of public institutions and trade unions. Results: dialogues and interaction with the community through the promotion of thematic seminars on work and health; photo contest and exhibition; writing and drawing contest; book publishing; municipal law proposal and approval; implementation of the Occupational Health Surveillance System; discussion, proposition and monitoring of occupational health policies. Conclusion: despite the institutional difficulties and simplicities that are characteristic of small municipalities in Brazil, the activities adopted in CISTT implementation constitute an important strategy for worker´s health promotion.

Cancer treatment is considered a huge challenge to the science. Cancer cells frequently present resistance to chemotherapy and have fast proliferation. In this sense, several functional foods have been studied for anticancer purposes since they present a chemical matrix rich in bioactive molecules. Some of these molecules show important antitumor proprieties by increasing chemotherapy response and decreasing cancer cell proliferation. However, bioactive molecules stability and tissue-specific delivery are still challenging in the natural product field. In this context, there are many investigations looking forward to develop methods to increase bioavailability and/or to avoid degradation. Some of these researches propose nanoformulations as delivery cargoes of food bioactive molecules and nutraceuticals that could achieve these objectives. Polymeric nanoparticles have been especially used in oncology to easily transport and deliver antitumor agents. Therefore polymeric nanoparticles as delivery cargoes of food bioactives and nutraceuticals are great alternatives to reveal potent anticancer agents that could be able to improve chemotherapy treatment, decrease cancer cells resistance, and reduce side effects.

Propose the systematization of nutritional care in the endoscopic treatment of obesity. This is a bibliographical review, since the initial proposal was a systematic review. This method became unfeasible due to the inexistence of studies that address this theme. Thus, a bibliographic survey was carried out, considering the endoscopic treatment as a restrictive treatment, as well as the information referring to case reports and multicentric studies. Nutrition participation involves nutritional assessment and diagnosis, dietary planning pertinent to the adequate evolution of food consistency, as well as the use of food supplements compatible with the Gastric Sleeve due to food restriction. The Bariatric Plate Model (BPM) can be useful in the nutritional education of the patient after gastric endosuture, associated with water consumption and the performance of scheduled physical exercise, as well as periodic monitoring with the multiprofessional team. Specialized nutritional care is necessary, through a protocol of nutritional assistance defined after gastric endosuture, in order to achieve long-term weight loss and maintenance goals. The BPM can be an excellent form of nutritional education, observing protein intake as a macronutrient base.

Although the mortality rate of oropharyngeal squamous cell carcinoma (OPSCC) has been decreasing over the last 30 years, there has been a significant increase in the frequency of diagnosis of this type of cancer in several countries. Beyond the classic prognostic factors, such as TNM stage, there is a lack of predictive factors for recurrence and treatment response. A retrospective analysis of patients with OPSCC treated at the Oncology Department of the Santa Terezinha University Hospital between 2007 and 2012 was performed, with the aim of identifying new prognostic factors. In addition to the significance of clinical stage as a prognostic factor for recurrence, OPSCC patients with advanced TNM stage and those treated with radiotherapy, chemoradiation or palliative measures, had a worse prognosis. Patients with moderate or severe weight loss (>5%) at diagnosis had a higher tumor recurrence rate compared with those with mild or no weight loss (P=0.007). Furthermore, 76.9% of patients with moderate or severe weight loss, as opposed to 13.3% of patients with mild or no weight loss, eventually succumbed to the disease (P=0.0001). These data suggest that moderate and severe weight loss at diagnosis is a prognostic factor for OPSCC and it is associated with disease recurrence.

The objective of this study was to analyze the factors associated with change in body mass index (BMI) and with percentage of excess weight loss (%EWL) in patients undergoing Roux-en-Y gastric bypass (RYGB). The following factors were analyzed: sex, age, surgical access (laparotomy vs. laparoscopy), preoperative BMI, waist circumference (WC), type 2 diabetes mellitus (T2DM), high blood pressure, and dyslipidemia.Retrospective cohort study using a convenience sample of 2070 patients of both sexes, aged 18 to 65 years, undergoing RYGB between 2000 and 2013. The outcomes of interest were BMI and %EWL at 0, 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months after RYGB.After 36, 48, and 60 months, approximately 50 % of patients had BMI30 kg/m(2). As for %EWL, 60-month results were poor for 17 % of patients (%EWL50 %), good for 40 % of patients (%EWL 50-75 %), very good for 24 % of patients (%EWL from75-90 %), and excellent for 19 % of patients (%EWL90 %). The four most significant predictors of BMI change 60 months after RYGB (in descending order of magnitude) were preoperative BMI, preoperative WC, surgical access, and age; and of %EWL, surgical access, preoperative BMI, preoperative WC, and age.After 60 months of follow-up, the most relevant predictors of weight loss after RYGB were lower preoperative BMI and WC, videolaparoscopy as surgical access, and younger age. Further studies must be carried out to elucidate the impact of these factors on RYGB outcomes.

Objetivou-se analisar o aspecto nutricional de pacientes oncológicos em atendimento ambulatorial, em Joaçaba-SC. Estudo transversal, que utilizou a avaliação subjetiva global produzida pelo paciente e questionário de consumo alimentar, do Ministério da Saúde. Participaram 70 pacientes, idade média 60,3±13,9 anos, 38 (54,3%) homens, 57 (81,4%) sem acompanhamento nutricional, 48 (68,6%) com alimentação regular, 16 (22,9%) alimentação adequada e seis (8,6%) boa alimentação. O fumo teve associação com câncer de pulmão e orofaringe e o consumo de carne com câncer de intestino. A redução de peso foi elevada, 36 (52,2%) reduziram mais de 5% do peso corporal. Pessoas bem nutridas reduziram menos o peso comparado às desnutridas, tiveram melhor aceitação da dieta e menos queixas alimentares. Desnutridos totalizaram 58 indivíduos (83%), todos em estágio avançado da doença. A desnutrição teve elevada prevalência neste estudo, devendo ser implantadas estratégias de acompanhamento eficazes com equipe multiprofissional para melhorar o tratamento nutricional desta população. La finalidad fue analizar el aspecto nutricional de pacientes oncológicos en atención ambulatoria en Joaçaba-SC. Estudio transversal, que utilizó la evaluación subjetiva global producida por el paciente y cuestionario de consumo alimentario del Ministerio de la Salud brasileño. Participaron 70 pacientes, promedio de edad 60,3±13,9 años, 38 (54,3%) hombres, 57 (81,4%) sin seguimiento nutricional, 48 (68,6%) con alimentación regular, 16 (22,9%) alimentación adecuada y seis (8,6%) buena alimentación. El humo estaba asociado al cáncer de pulmón y faringe inferior y el consumo de carne con cáncer intestinal. La reducción de peso fue alta, 36 (52,2%) redujeron más del 5% del peso corporal. Personas bien nutridas redujeron menos el peso comparado a las desnutridas, aceptaron mejor la dieta y tuvieron menos quejas alimentarias. Desnutridos totalizaron 58 individuos (83%), todos en estado avanzado de la enfermedad. La prevalencia de la desnutrición fue alta en este estudio. Deben ser implantadas estrategias de seguimiento eficaces con equipo multiprofesional para mejorar el tratamiento nutricional de esta población.

BACKGROUND: Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy. AIM: 1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures. METHODS: A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed. RESULTS: From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy. CONCLUSION: 1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy. RACIONAL: Nos últimos anos, apesar do Sistema Único de Saúde Brasileiro - SUS - apresentar avanços relacionados à organização e ampliação das ações voltadas à prevenção e ao tratamento da obesidade, existe demanda reprimida de operações no país. Mesmo com evidências favoráveis à operação por via laparoscópica, o SUS só permite o procedimento por via laparotômica. OBJETIVOS: 1) Estimar se os cirurgiões bariátricos apoiariam eventual incorporação da operação por via laparoscópica no SUS; 2) se haveria incremento no número total de operações caso houvesse esta nova opção de via de acesso; e 3) como seria a redistribuição da oferta de operações pelas duas vias. MÉTODOS: Com o método Delphi, foi construído um painel de especialistas, em que cirurgiões bariátricos responderam um questionário estruturado previamente desenvolvido para esse fim. Foram realizadas duas rodadas, no intuito de melhor consenso. RESULTADOS: Dos 45 cirurgiões que estiveram presentes no evento nacional, 30 (66,7%) participaram do questionário Delphi, o que correspondeu à primeira rodada do estudo. Na segunda, e última rodada, dos 30 respondentes da primeira etapa, 22 (48,9%) cirurgiões responderam. Mediante a possibilidade de incorporação da via laparoscópica no SUS, aproximadamente 95% dos cirurgiões manifestaram interesse em realizá-la. Caso a operação por laparoscopia fosse incorporada no SUS, haveria incremento médio no número de operações na ordem de 25%; nesta nova configuração, a oferta de procedimentos cirúrgicos estaria distribuída da seguinte forma: 62,5% por laparoscopia e 37,5% por laparotomia. CONCLUSÃO: 1) Houve preferência pela via laparoscópica; 2) haveria incremento no número de operações comparado ao modelo atual em que apenas a via laparotômica está disponível aos usuários do sistema público; e 3) a distribuição em relação ao tipo de procedimento seria de 62,5% por laparoscopia e 37,5% por laparotomia.

Recentemente, vem-se atribuindo uma influência benéfica dos antimaláricos no perfil lipídico de pacientes com lúpus eritematoso sistêmico (LES). Neste estudo transversal, avaliamos o efeito da cloroquina nos níveis de colesterol de uma população brasileira com LES. O estudo avaliou 60 pacientes, 95% dos quais, mulheres, sendo a idade média 48,7 anos (DP 13,3 anos). Em 27 casos (45%), sobrepeso ou obesidade estava presente. Trinta e quatro pacientes (56,6%) usavam cloroquina em uma dosagem padrão, enquanto 33 (55%) usavam corticosteroides. Hipercolesterolemia foi detectada em 26 pacientes (43,3%), e baixos níveis de colesterol HDL em 18 (30%). Colesterolemia normal foi observada igualmente em usuários e não usuários de antimaláricos (P > 0,20). Após ajuste para a ingestão de estatina e corticosteroide através de análise multivariada, os níveis de colesterol total e colesterol HDL não diferiram significativamente em usuários e não usuários de cloroquina (P > 0,05). A ingestão de cloroquina não se associou a um baixo índice de massa corporal (P = 0,314). Nossos achados sugerem que a ingestão de antimaláricos por si não distingue perfis lipídicos em pacientes com LES. A benefi cial influence of antimalarials on lipid profile of systemic lupus erythematosus (SLE) patients has been recently claimed. In this cross-sectional study, we evaluated the effect of chloroquine on cholesterol levels of a Brazilian population with SLE. Sixty patients were studied, 95% females. Mean age was 48.7 years (SD 13.3 years). Overweight or obesity was documented in 27 cases (45%). Thirty-four patients (56.6%) were using chloroquine in standard dosage, while 33 (55%) were on corticosteroids. Hypercholesterolemia was present in 26 patients (43.3%), while low HDLcholesterol levels were seen in 18 cases (30%). Normal cholesterolemia was documented equally in users and non-users of antimalarials (P > 0.20). After adjustment for statin and corticosteroid intake by multivariate analysis, cholesterol and HDL-cholesterol levels did not significantly differ in users or non-users of chloroquine (P > 0.05). There was no association of chloroquine intake with low body mass index (P = 0.314). Our findings suggest that antimalarial intake by itself does not distinguish cholesterol profiles in SLE patients.

A beneficial influence of antimalarials on lipid profile of systemic lupus erythematosus (SLE) patients has been recently claimed. In this cross-sectional study, we evaluated the effect of chloroquine on cholesterol levels of a Brazilian population with SLE. Sixty patients were studied, 95% females. Mean age was 48.7 years (SD 13.3 years). Overweight or obesity was documented in 27 cases (45%). Thirty-four patients (56.6%) were using chloroquine in standard dosage, while 33 (55%) were on corticosteroids. Hypercholesterolemia was present in 26 patients (43.3%), while low HDL cholesterol levels were seen in 18 cases (30%). Normal cholesterolemia was documented equally in users and non-users of antimalarials (P0.20). After adjustment for statin and corticosteroid intake by multivariate analysis, cholesterol and HDL-cholesterol levels did not significantly differ in users or non-users of chloroquine (P0.05). There was no association of chloroquine intake with low body mass index (P = 0.314). Our findings suggest that antimalarial intake by itself does not distinguish cholesterol profiles in SLE patients.