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Background: The use of antiretrovirals has increased the survival of People Living with HIV/AIDS (PLWHA), resulting in an aging population and a rise in the incidence of sarcopenia. The lack of uniformity among the prevalences found in studies may be associated with the use of different diagnostic criteria, highlighting the need for local studies to determine the prevalence of sarcopenia., Methods: Cross-sectional study to estimate the prevalence and associated factors of sarcopenia using the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). This study included PLWHA of both sexes, aged 40 years or older, who were treated at the infectious disease outpatient clinic of a tertiary hospital from 2019 to 2021. Muscle mass was quantified through electrical bioimpedance, using resistance and reactance to calculate appendicular lean mass (ALM) in kg/m². Muscle strength, measured in kg, was assessed using a manual dynamometer, and muscle function was evaluated using the gait speed test (m/s). Numerical variables were analyzed using measures of central tendency and dispersion. The chi-square test was used to assess associations in categorical variables. Odds ratios (OR) and 95% Confidence Intervals (CI) were calculated to evaluate the strength of associations., Results: Among the 218 PLWHA, the prevalence of sarcopenia was 8.7% (95% CI: 5.6 to 13.3). The mean age of the study population was 51.8 ± 8.3 years; 53.7% were male, 72.9% were brown/Black, 97.7% reported not using illicit drugs, and 24.8% were classified as obese. Multivariate analysis showed that the time since HIV diagnosis (P = 0.022) and the use of illicit drugs were associated with the diagnosis of sarcopenia., Conclusion: The prevalence of sarcopenia using the EWGSOP2 criteria was low. People with a longer duration of HIV infection and those using illicit drugs were more likely to develop sarcopenia., (© 2024. The Author(s).)

Objective: To describe the feeding characteristics and growth of children with prenatal exposure to Zika virus (ZIKV) from birth to 48 months., Design: Using data from the prospective Microcephaly Epidemic Research Group Pediatric Cohort (MERG-PC), children without microcephaly born to mothers with evidence of ZIKV infection during pregnancy (ZIKV-exposed children without microcephaly) and children with Zika-related microcephaly were compared using repeated cross-sectional analyses within the following age strata: birth; 1 to 12; 13 to 24; 25 to 36; and 37 to 48 months. The groups were compared in relation to prematurity, birth weight, breastfeeding, alternative feeding routes, dysphagia and anthropometric profiles based on the World Health Organization Anthro z-scores (weight-length/height, weight-age, length/height-age and BMI-age)., Results: The first assessment included 248 children, 77 (31.05%) with microcephaly and 171 (68.95%) without microcephaly. The final assessment was performed on 86 children. Prematurity was 2.35 times higher and low birth weight was 3.49 times higher in children with microcephaly. The frequency of breastfeeding was high (> 80%) in both groups. On discharge from the maternity hospital, the frequency of children requiring alternative feeding route in both groups was less than 5%. After 12 months of age, children with microcephaly required alternative feeding route more often than children without microcephaly. In children with microcephaly, the z-score of all growth indicators was lower than in children without microcephaly., Conclusions: Children with Zika-related microcephaly were more frequently premature and low birth weight and remained with nutritional parameters, i.e., weight-for-age, weight-for-length/height and length/height-for-age below those of the children without microcephaly., (© 2024. The Author(s).)

Introduction: Antiretroviral Therapy (ART) gives people living with HIV/AIDS (PLWHA) a new perspective of life, although some develop changes in impaired body composition. This study aimed to assess the factors associated with changes in body composition in PLWHA using ART, depending food consumption., Material and Methods: It was a cross-sectional study and took place through interviews with patients treated at an University Hospital. Secondary data: CD4+ T cells, ART time and age. The level of physical activity and smoking were self-reported. For the assessment of body composition, electrical bioimpedance and measurements of weight, height and waist circumference were used., Results: The highest percentages of fat mass and fat-free mass, in treatment for more than 5 years, were in the female group ( p <0.01), aged> 50 years ( p  = 0.02) and in the male group ( p <0.01), young adult ( p <0.01), respectively. The final linear regression model for both free fat mass and fat mass had sex, age, smoking and nutritional diagnosis as relevant factors. The frequency of food consumption was inadequate for calories, carbohydrates, proteins and lipids was high, however it did not significantly influence body composition., Conclusions: Gender, age, smoking and nutritional diagnosis by BMI significantly influence body composition.

Studies investigating the association between the phase angle (PA) and frailty are scarce. The PA is considered a practical, low-cost, noninvasive measure for the early identification of this clinical condition. To investigate the association between PA and frailty/pre-frailty, nutritional and clinical aspects in older people. A cross-sectional study was conducted with 51 older people (≥ 60 years). PA was determined using bioelectrical impedance analysis. Frailty profile was determined using the criteria of unintentional weight loss, self-reported fatigue, slow gait speed, low grip strength and insufficient physical activity. Nutritional status was evaluated based on the body mass index and appendicular skeletal muscle mass index (ASMMI). Sarcopenia and sarcopenic obesity were also investigated. Sociodemographic data were collected through interviews. Prevalence of frailty/pre-frailty was 84.3%, with no difference between the sexes. The first tercile of the sample had a PA lower than 6º, which was considered low. No significant difference in PA was found between older people with or without frailty/pre-frailty. In the multiple linear regression analysis, age and ASMMI were shown to be potential independent predictors for PA. Age showed an inverse correlation with PA, while ASMMI showed a direct correlation. No association was found between PA and frailty or pre-frailty., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: Evaluate the differences between surgical techniques in the modifications of body composition and the interference in skeletal muscle health, risk of sarcopenia, and reduced physical performance., Materials and Methods: This is a cross-sectional prospective study. A total of 71 patients, who underwent sleeve gastrectomy (SG) or underwent Roux-en-Y gastric bypass (RYGB). Both groups underwent anthropometric, laboratory analysis, body composition assessment, presence of sarcopenia, and physical performance tests., Results: The study found a higher percentage of weight loss and lower BMI in RYGB compared to SG. The other assessments of sarcopenia and physical performance showed similarity between the surgical models. Baumgartner index (7.9 kg/m 2 vs. 7.3 kg/m 2 ), FNIH (9.0 vs. 3.0), handgrip strength (27.3 kg vs. 25.2 kg), and SPPB (9.5 vs. 9.3). Leptin in the general SG group was higher than in RYGB (14.2 ng/ml vs. 8.0 ng/ml)., Conclusion: RYGB and SG have a similar presence of sarcopenia and physical performance. However, SG allows greater preservation of bone and muscle mass and is associated with higher values of leptin, which may represent protection from long-term postoperative complications., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: The objective of this study was to identify an association between serum levels of 25(OH) D, inflammation and cardiovascular disease risk in older adults., Methods: This was a cross-sectional study, with older adults of both sexes, investigating variables on lifestyle, anthropometric assessments (weight, height, waist circumference, BMI), and systemic arterial hypertension (systolic blood pressure, SBP, and diastolic blood pressure DBP), serum levels of 25(OH)D, serum high-sensitive C-reactive protein (hs-CRP), serum lipid profile and fasting blood glucose. Cardiovascular disease risk was assessed using the global risk score for cardiovascular events, the Framingham criteria., Results: The sample consisted of 124 participants, 50.8% of whom were at high risk for cardiovascular events. Older adults with 25(OH)D insufficiency presented higher levels of blood sugar (p < 0.01), LDL-c (p = 0.03) SBP (p < 0.01) and hs-CRP (p < 0.01). When grouped by serum concentrations hs-CRP, it was observed that higher hs-CRP levels were associated with higher blood glucose (p = 0.02), SBP (p = 0.04) and lower HDL-c concentrations (p = 0.02). It was also observed that 25(OH)D insufficiency increased the chance of a high risk for cardiovascular events by 2.8 times (OR = 2.80; p = 0.01), which with high hs-CRP concentrations increased to 4.75 times (OR = 4.75; p < 0.01)., Conclusion: Low concentrations of 25(OH)D and the presence of inflammation in older adults are associated with a high risk for cardiovascular diseases., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Limb amputation can be defined as a procedure that consists of separating a limb or a segment of a limb from the body., Objectives: To describe the profile of limb amputation procedures performed at a large hospital run by the state of Pernambuco (Brazil)., Methods: Cross-sectional descriptive and retrospective study conducted at a large hospital in the city of Recife, PE. Data were collected from the records of patients who underwent amputations during 2017. Records from patients who had had a limb amputation during 2017 were included, unless data were illegible or missing., Results: A total of 328 procedures were performed on 274 patients, the majority of whom were male (57.7%). There was a predominance of lower limb amputations (64.2%), of non-traumatic causes (86.5%), and urgent treatment (96.4%). The majority of patients who underwent amputations remained in hospital for 11 to 25 days (32.1%). The study found that the majority of amputees were discharged (69.7%), although a proportion died. Deaths of lower limb amputees were primarily among elderly women in the age range of 60 to 90 years (76%), females (55%), and patients subjected to a single amputation (91%)., Conclusions: The data observed in this study are alarming, particularly considering that many of these amputations could have been avoided, since they were caused by complications of diseases that can be prevented and controlled at healthcare services of a lower level of complexity and at a relatively low cost., Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Background: The intensity of the inflammatory response and hemodynamic repercussion in acute myocardial infarction causing the presence in the peripheral circulation of nucleated red blood cells (NRBCs), increases in mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR) are associated with a poorer prognosis. The aim of this study was to assess the role of these hematological biomarkers as predictors of all causes of mortality during the hospitalization of patients with acute myocardial infarction., Methods: Nucleated red blood cells, mean platelet volume and neutrophil to lymphocyte ratio were measured daily during the hospitalization of the patients with acute myocardial infarction. We excluded patients younger than 18 years, on glucocorticoid therapy, with cancer or hematological diseases and those that were readmitted after hospital discharge. We performed a multiple logistic analysis to identify independent predictors of mortality., Results: We included 466 patients (mean age 64.2 ± 12.8 years, 61.6% male). The prevalence of NRBCs in the sample was 9.1% (42 patients), with levels > 200/μL in 27 patients (5.8%). The mean MPV value was 10.9 ±0,9 and the mean NLR value was 3.71 (2,38; 5,72). In a multivariate analysis of serum NRBCs (HR 2.42, 95% CI: 1.35-4.36, p = 0.003), MPV (HR 2.97, 95% CI: 1.15-7.67, p = 0.024) and NLR (HR 5.02, 95% CI: 1.68-15.0, p = 0.004). The presence in the peripheral blood of NRBCs, increased in mean platelet volume and neutrophil to lymphocyte ratio were associated with higher mortality., Conclusions: Nucleated red blood cells, mean platelet volume and neutrophil to lymphocyte ratio are independent predictors of intrahospital mortality. Therefore, an important tool in intrahospital clinical surveillance.

Background: This study aimed to analyze the effect of a behavior change program, called Vida Ativa Melhorando a Saúde (VAMOS), on physical activity, eating habits, and quality of life in patients with hypertension., Methods: A randomized controlled trial was carried out in 90 patients with hypertension (57.8 ± 9.9 y). They were randomly assigned to 2 groups: VAMOS group (n = 45) and control group (n = 45). The VAMOS group participated in a behavioral change program aimed at motivating changes in physical activity and nutrition behavior for 12 weeks. Physical activity, eating habits, quality of life, self-efficacy, and social support were evaluated at preintervention and postintervention., Results: The control group increased sedentary time (407 ± 87 vs 303 ± 100 min/d; P < .05) and sedentary bouts (434 ± 86 vs 336 ± 98 min/d; P < .05) and reduced total physical activity (553 ± 87 vs 526 ± 86 min/d; P < .05). The VAMOS group improved the general healthy eating habits score (36.9 ± 6.6 vs 43.4 ± 5.8; P < .05) and quality of life (44% vs 92%; P < .05)., Conclusion: The VAMOS program was effective in improving eating habits and quality of life in patients with hypertension.