The aim of this study is to describe and relate nutritional and inflammatory status and prognostic indexes with postoperative complications and clinical outcome of patients with gastrointestinal malignancies. Twenty-nine patients were evaluated; nutritional assessment was carried out by subjective and objective parameters; albumin, pre-albumin, C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP) were determined. To assess prognosis, the Glasgow scale, the Prognostic Inflammatory Nutritional Index (PINI), and CRP/albumin ratio were used; the clinical outcomes considered were hospital discharge and death. A high Subjective Global Assessment (SGA) score was associated with the occurrence of postoperative complications: 73% of the patients with postoperative complications had the highest SGA score, but only 6% of those without postoperative complications had the highest SGA score (P < 0.001). Greater occurrence of death was observed in patients with a high SGA score, low serum albumin, increased CRP, PINI > 1, and Glasgow score 2. There was a positive correlation between weight loss percentage with serum CRP levels (P = 0.002), CRP/albumin (P = 0.002), PINI (P = 0.002), and Glasgow score (P = 0.000). This study provides evidence that the assessment of the nutritional status and the use of prognostic indexes are good tools for predicting postoperative complications and clinical outcome in patients with gastrointestinal neoplasia.

Background: Despite the positive effects of high-intensity training on weight management and health-related outcomes, it is postulated that high-intensity training may also induce oxidative stress, increasing hepatic damage. Aim: The aim of this study was to compare the effects of low versus high-intensity training on biomarkers related to non-alcoholic fatty liver disease (NAFLD) in adolescents with obesity. Methods: For this study 107 adolescents (15 ± 1 years) with obesity (BMI = 34.7 ± 4.1 kg/m²) were randomized into High-Intensity Training (HIT, n = 31), Low-Intensity Training (LIT, n = 31) or Control Group (CG, n = 45). Adolescents from HIT and LIT received nutritional, psychological and clinical counseling. Blood lipids, Castelli risk index, glucose, insulin and hepatic enzymes were measured at baseline and after 12 weeks. Results: Castelli risk index 1 was reduced in all groups ( p < 0.001) with moderate effect size ( d) for HIT ( d = 0.62) and LIT ( d = 0.66). Castelli risk index 2 also decreased ( p < 0.001 for all groups; HIT d = 0.65; LIT d = 0.79). High-density lipoprotein increased in all groups ( d = 0.25 and d = 0.18 in HIT and LIT), while alanine aminotransferase tended to reduce ( p = 0.062) in HIT ( d = 0.34) and LIT ( d = 0.73) and aspartate aminotransferase decreased ( p = 0.024) in both HIT ( d = 0.24) and LIT ( d = 0.45). There were no changes in glucose, insulin and insulin resistance. Conclusion: Both high and low-intensity training improved biomarkers related to NAFLD. Thus, high-intensity training can be a safe and effective alternative to prevent and treat NAFLD in adolescents with obesity.

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. 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. 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. 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.

Purpose To identify an association between bone mineral density (BMD) and nutritional status, body composition and bone metabolism in older patients. Methods Cross-sectional study, involving older adults, with osteopenia/osteoporosis and with normal BMD. The mineral density of the lumbar spine from L1 to L4 and the proximal region of the femur was assessed using dual energy X-ray absorptiometry. Biochemical analyzes were performed of 25(OH)-D, calcium and parathormone. Weight, knee height, and abdominal (AC), mid-upper arm (MUAC) and calf (CC) circumferences were measured. The percentage of body fat (%BF) and Fat-Free Mass (FFM) were quantified by electrical bioimpedance analysis. The Body Mass Index (BMI) was calculated. The statistical analysis used bivariate and multivariate, parametric and/or non-parametric tests, and was considered significant when p <0.05. Results Of the total 51 older adults assessed, 30 of them (58.8%) were diagnosed with osteopenia/osteoporosis. Body weight (p = 0.001), BMI (p = 0.001), % BF (p = 0.030) and serum concentrations of 25(OH)-D (p = 0.003) were higher in the group without changes in BMD. BMI and serum levels of 25(OH)-D demonstrated a positive correlation with the BMD of all bone compartments and the AC displayed a positive correlation with the lumbar vertebrae. In the logistic regression models, adjusted for sex and age, the BMI and the serum concentration of 25(OH)-D were presented as a protective factor against osteopenia/osteoporosis. Conclusions Higher body weight, BMI, AC and %BF, and sufficient serum levels of vitamin D, were shown to be promoters of BMD.

Severe brain damage associated with Zika-related microcephaly (ZRM) have been reported to result in oropharyngeal dysphagia (OPD); however, it is unknown if OPD presents in children with prenatal Zika virus (ZIKV) exposure but only mild or undetectable abnormalities. The aims of this study were: to compare the frequency and characteristics of OPD in children with ZRM and in children without microcephaly born to mothers who tested polymerase chain reaction positive (PCR+) for ZIKV during pregnancy; and to investigate the concordance of caregiver reports of OPD with the diagnosis from the clinical swallowing assessment (CSA). Between Mar/2017 and May/2018, we evaluated 116 children (n = 58 with microcephaly, n = 58 children without microcephaly born to ZIKV PCR + mothers) participating in the Microcephaly Epidemic Research Group (MERG) cohort of children born during the 2015–2016 ZIKV epidemic in Pernambuco, Brazil. To assess OPD we used: a CSA; a clinical assessment of the stomatognathic system; and a questionnaire administered to caregivers. The frequency of OPD was markedly higher in children with ZRM (79.3%) than in the exposed but normocephalic group (8.6%). The children with microcephaly also presented more frequently with anatomic and functional abnormalities in the stomatognathic system. There was a high degree of agreement between the caregiver reports of OPD and the CSA (κ = 0.92). In conclusion, our findings confirm that OPD is a feature of Congenital Zika Syndrome that primarily occurs in children with microcephaly and provide support for policies in which children are referred for rehabilitation with an OPD diagnosis based on caregiver report.