Browsing by Author "Lemos, A"
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- Care causing diagnosis, comorbidities and nutritional status of patients in continuous long term care unitPublication . Marques, M; Gonçalves, V; Vieira, A; Magalhães, F; Godinho, J; Lemos, A; Costa, V; Faria, AnaIntroduction: Poor nutritional status has negative implications on prognosis, cost of care, morbidity and mortality. However, when nutritional assessment is not implemented, malnutrition can go untreated. Objectives: The aim of this study was to establish a relationship between care causing diagnosis, existing comorbidities and nutritional status of patients admitted to a long-term care unit. Methods: In the context of Nutrition Day audit, from 2016 to 2018, nutritional status was assessed using Mini Nutritional Assessment. Sociodemographic and anthropometric data, as well as medical history were collected. Results: Sixty-two individuals were included (51.6% male), with a mean age of 7711 years. Mean BMI was 22.94.3kg/m2. Most of the patients were bedridden or in wheelchair (51.6%). A great part of the sample was at risk of malnutrition (40.3%) and 27.4% was malnourished. The majority of the sample showed dementia (75.8%) and 66.2% had depression. A correlation was found between nutritional status and cognitive status(r = 0.445; p = 0.000); and between nutritional status and functional capacity(r = 0.284; p = 0.025). Care causing diagnosis for most of the patients was central nervous system disease (66.1%), followed by heart disease (59.7%), skeletal muscle disease (30.6%) and cancer (17.7%). An association was found between heart disease and malnutrition (p = 0.023). Almost all of the sample was polymedicated (91.9%) and most was taking antypsychotics and/or neuroleptics (71.0%). Conclusions: In this long-term care unit, malnutrition presented a significant prevalence. Cognitive status decline and low functional capacity seem to be correlated with a worse nutritional status. Also, heart disease was associated with malnutrition, meaning that these are significant risk factors for the development of malnutrition. Nutrition Day audit brings awareness to the importance of nutritional care, as well as the need for development of nutritional screening and assessment protocols.
- Food Intake in Pregnant Women with Gestational Diabetes MellitusPublication . Lemos, A; Lopes, AR; Bernardo, J; Furtado, T; Sousa, CRationale: The aim of the present study was to verify the fulfillment of the nutritional requirements of macronutrients of pregnant women diagnosed with Gestational Diabetes Mellitus (GDM) at Lusíadas Lisboa Hospital. Inadequate glycemic control in GDM increases the risk of maternal, fetal and neonatal consequences, in this sense, nutritional therapy is essential during the follow-up of these pregnant women. Methods: Cross-sectional observational study. The study sample included 20 pregnant women diagnosed with GDM. Participants were asked to answer a questionnaire that included relevant data and to complete a three-day food record, for which they gave consent. A statistical analysis was performed with IBM® SPSS® 25. Results: The mean age measured was 35±4 years and 75% of the sample were in the 3º trimester. In the pre-gestational period, the sample had a Body Mass Index (BMI) of 26,2±5,3kg/m2 . The mean fasting capillary blood glucose was 89±9mg/dL and the postprandial was 119±19mg/dL. 75% reached the fasting glycemic objective and 95% the postprandial. It was also found that pregnant women who didn´t meet the goal set for fasting blood glucose, had higher pre-gestational BMI. In terms of macronutrients, it was found that 75% of the sample didn´t reach Total Energy Requirements (TER), 50% didn´t reach protein (1,1g/kg of current weight/day and 15-20% TER), 10% lipid (30% TER) and all carbohydrates (50-55% TER), with only 35% reaching the daily minimum of carbohydrates (175g). It was also found that sample didn´t reach 28g/day of fiber. Conclusions: The present study demonstrated the importance of an individualized nutritional intervention by a nutritionist with pregnant women diagnosed with GDM. The importance of this intervention is based on adherence to an adequate dietary pattern that prevents nutritional deficits, enhances clinical outcomes and contributes to the prevention of the incidence of GDM.
- Nutrition Day in nursing homes – risk factors for malnutritionPublication . Marques, M; Damas, M; Costa, E; Brás, M; Lemos, A; Costa, V; Faria, AnaIntroduction: Malnutrition in institutionalized older adults has a significant prevalence, and is associated with cognitive decline, higher morbidity and mortality rates. Objectives: The aim of this study was to assess risk factors for malnutrition in nursing home residents. Methods: Through Nutrition Day audit (2016–2018), demographic and anthropometric data was collected, as well as medical history and nutritional status according to Mini Nutritional Assessment. Results: Sixty-three individuals were included (57.1% male), with a mean age of 849 years. Mean Body Mass Index was 21.55.1 kg/m2. Malnutrition was identified in 47.6% of the patients and nutritional risk in 28.6%. Most of the sample (61.9%) was bedridden or in wheelchair. Most of the individuals showed dementia (82.5%) and depression (79.3%). A positive moderate significant correlation was found between nutritional status and cognitive status (r = 0.407;p=0.001); and between nutritional status and functional capacity (r = 0.474;p=0.000). Considering the diagnosis which caused institutionalization, brain pathologies were the most prevalent (79.4%), followed by cardiovascular diseases (49.2%) and skeletal muscle diseases (27.0%). Mean number of medications taken daily was 74 and 74.6% of the residents were polymedicated. The majority (61.9%) was taking antipsychotics and/or neuroleptics and 28.6% were taking antidepressives. Conclusions: In this sample, individuals are essentially older adults with a high prevalence of malnutrition. The high level of dependence and the presence of dementia are significant risk factors for the development of this condition. Disturbed emotional status and the use of multiple drugs associated with impaired appetite, although without statistically significant associations with nutritional status, are highly prevalent in this sample. Nutritional screening in this population is essential and timely necessary, aiming to prevent deterioration or improve nutritional status.
- The reality of an Obesity Surgical Treatment Center in PortugalPublication . Lopes, AR; Bernardo, J; Furtado, T; Sousa, C; Lemos, AIntroduction: Obesity surgery is used as the most effective treatment for morbid obesity, with better cost-benefit, less morbidity and mortality. The present study aimed to analyze the results of a surgical center for obesity treatment and integrate them with the most recent scientific evidence. Methods: Retrospective cross-sectional observational study involving 270 patients aged 18 years or older, who underwent bariatric surgery between July 2008 and February 2020 in a private hospital in Portugal. Results: The sample presented an average age of 44 ± 12 years, being mostly female (83.7%). The average pre-surgery Body Mass Index was 41.1 ± 4.9 kg/m2 . The most performed surgery was Gastric Bypass (80.4%), followed by Gastric Banding (14.8%) and Gastric Sleeve (4.8%). One month after surgery, there was a percentage of excess weight lost (% EWL) of 25.2 ± 9.6%. After 6 months, there was an average % EWL of 67.2 ± 23.2%. One year after surgery, the average % EWL was 75.7 ± 25.7%, the average Body Mass Index was 29.3 ± 4.6 kg/m2 and the average weight loss percentage was 29.5 ± 9.4%. Conclusion: Gastric Bypass is the mostly performed surgery, because it is the Gold Standard method for surgical treatment of obesity in this center. On average, all surgeries performed have extremely positive results of excess weight lost. After 1 year, patients maintained an average weight loss percentage of 29.5 ± 9.4%, in line with data presented in a study that estimated an average recorded weight loss percentage of 28.9%. Data like those presented by the American Society for Nutrition (ASN), the Obesity Action Coalition (OAC), the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), the International Society for the Perioperative Care of the Obese Patient (ISPCOP) and the American Society for Parenteral and Enteral Nutrition (ASPEN) (2019), indicate a target weight loss percentage between 20 and 45%.