Browsing by Author "Mendes, Diana"
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- Abordagem nutricional e dietética na prevenção e tratamento da hipertensão arterialPublication . Mendes, Diana; Silva, Pedro Marques daDe natureza multifatorial, a elevação da pressão arterial resulta da combinação intrincada de fatores genéticos, fisiológicos e ambientais. Diversos estudos epidemiológicos, meta-análises e estudos experimentais confirmam o papel de certos padrões alimentares (DASH e dieta mediterrânica) e de vários nutrientes e fatores dietéticos no desenvolvimento da hipertensão arterial (ou na sua modulação favorável ou desfavorável). As alterações nutricionais podem diminuir a pressão arterial e prevenir o desenvolvimento de hipertensão arterial, com implicações potenciais na morbilidade e mortalidade cardiovascular. Pretende-se sumariar alguns dos fatores dietéticos e nutricionais mais importantes relacionados com a síndrome hipertensiva.
- DeSaFIo-ME: desnutrição, sarcopénia, fragilidade e medicação na pessoa idosaPublication . Cebola, Marisa; Tomás, Maria Teresa; Costa-Veiga, Ana; Rico, Miguel Toscano; Coelho, André; Mendes, Diana; Duque, Sofia; Galán-Mercant, Alejandro; Mendes, Lino; Marinho, Aníbal; Guerreiro, AntónioO envelhecimento ativo é definido pela Organização Mundial da Saúde (OMS) como o "processo de desenvolver e manter a capacidade funcional que promove o bem-estar da população idosa". No processo de envelhecimento são frequentes algumas alterações a nível físico, como alterações na composição corporal, diminuição na força muscular, flexibilidade, maior sensação de fadiga, que estão muitas vezes associadas a situações de doença. Ao associar ao processo de envelhecimento uma situação de doença, como obesidade, diabetes mellitus, dislipidemia, doença cardiovascular e alterações músculo-esqueléticas como a osteoartrite, osteoporose, entre outras, é previsível encontrar frequentemente diminuição da força muscular, flexibilidade e maior sensação de fadiga. Estas situações surgem mais cedo (por vezes a partir dos 30 anos e com maior intensidade a partir dos 50 anos), mas só mais tarde é que surgem os sinais e sintomas. Mas não tem que ser assim! As situações não são todas iguais! Há pessoas idosas que mantiveram estilos de vida saudáveis ao longo da sua vida e neste momento têm uma vida ativa e há outras em que as alterações fisiológicas são mais marcadas. A abordagem deve ser multidisciplinar para que todas as dimensões do envelhecimento sejam avaliadas e sejam preconizadas medidas que previnam/retardem o aparecimento/agravamento de situações mais específicas, nomeadamente desnutrição, sarcopénia e fragilidade. Com esta leitura pretende-se dar indicações para que se possa ter um estado nutricional adequado e manter hábitos de prática de atividade física.
- Intervenção nutricional no doente com COVID-19Publication . Mendes, Lino; Cebola, Marisa; Mendes, Diana; Marinho, Anibal; Guerreiro, António SousaA nutrição é uma determinante chave da saúde tanto mais que é parte integrante do tratamento das doenças agudas e crónicas. A atual pandemia de SARS-CoV-2 (COVID-19) que está a devastar o mundo veio lançar novos desafios e ameaças sem precedentes, quer para os doentes quer para os profissionais de saúde. A intervenção e a terapia nutricionais devem ser consideradas como parte integrante da abordagem dos doentes com COVID-19 nos diferentes ambientes. Com base na literatura disponível são identificados métodos de avaliação e suporte nutricional que, sistematizados numa proposta de algoritmo, permitem uma intervenção integrada nos doentes infetados com SARS-CoV-2.
- Malnutrition and body composition in elderly populationPublication . Cebola, Marisa; Mendes, Diana; Costa-Veiga, Ana; Tomás, Maria Teresa; Coelho, André; Mendes, Lino; Rico, Miguel Toscano; Guerreiro, António SousaIntroduction: Ageing leads to an increase in chronic disease’s prevalence, change in body composition: increased fat mass and decreased lean mass that can lead to malnutrition. Objectives: The aim was relating malnutrition with depletion of lean mass and alteration of fat mass. Materials and methods: Cross-sectional study, developed in the district of Lisbon, in the period from January 1, 2019, to June 30, 2019. Elderly people (≥ 65 years) admitted to the Internal Medicine Unit of a central hospital (up to 72 hours) were eligible for the study. The elderly participants had to present the capacity to make their informed consent, without the intervention of any element of coercion, with enough knowledge and understanding of the objectives of the study that allowed free and informed decision making. The nutritional assessment was performed through the MNA-LF® and the analysis of the body composition through the measurement of the calf circumference and triceps skinfold. Results: n=38 patients, with a mean age of 78.8 + 5.8 years (70-91), 50% (n=19) males and 73.6%. At hospital admission 7.9% (n=3) were malnourished, 39.5% (n=15) presented nutritional risk, 34.2% (n=13) presented depletion of lean mass and 31.6% (n=12) depletion of fat mass. When we reported the presence of malnutrition with the calf circumference and tricipital skin fold, there was a statistically significant correlation (4=0,04; r=0,05). Malnourished patients presented the depletion of lean mass and fat mass. Discussion/Conclusion: The nutritional assessment using the body composition analysis presents extreme importance in the hospital admission, which allows better performance of the nutritional support adapted to each elderly and better nutritional goals. Signaling the patients who need intervention alert all the clinical team to the importance of nutritional intervention also in the community.
- Malnutrition in elderly population: hospital versus communityPublication . Cebola, Marisa; Mendes, Diana; Costa-Veiga, Ana; Tomás, Maria Teresa; Coelho, André; Mendes, Lino; Rico, Miguel; Guerreiro, AntónioIntroduction: There are many factors that lead to malnutrition in the elderly. Prevention of malnutrition is important, and screening and assessment are necessary. Objectives: The aim was relating malnutrition in the elderly population at hospital admission and in the community. Materials and methods: Multicentric quasi-experimental, correlational, longitudinal, developed in the district of Lisbon. Elderly people (≥ 65 years) admitted to the Internal Medicine Unit of a central hospital (up to 72 hours) and in the community were eligible. The elderly participants had to present the capacity to make their informed consent, without the intervention of any element of coercion, with enough knowledge and understanding of the objectives of the study that allowed free and informed decision making. The nutritional assessment was performed through the MNA-LF® and the analysis of the body composition through the measurement of the calf circumference and triceps skinfold. Results: n= 56 patients, with a mean age of 79.8 + 6.3 years (70-94), 60.3% (n=35) males, 5.2% (n=3) were malnourished, 38,2% (n=19) presented nutritional risk, 24.1% (n=14) presented depletion of lean mass and 30,4% (n=17) depletion of fat mass. When we reported the presence of malnutrition with the calf circumference and tricipital skin fold, there was a statistically significant correlation (4=0,000; r=0,009). Malnourished patients presented the depletion of lean mass and fat mass. At hospital admission 7.9% were malnourished, 39.5% presented a nutritional risk, 34.2% presented depletion of lean mass and 31.6% depletion of fat mass. In community 22.2% presented a nutritional risk, 5.6% presented depletion of lean mass and 27.8% depletion of fat mass. No statistically significant differences were found between nutritional status and depletion of lean and fat mass. Discussion/Conclusion: Screening and nutritional assessment are important in the elderly population. It was verified that nutritional status and depletion of lean mass and fat mass is a reality in situations of acute illness.
- Malnutrition, sarcopenia and current medical use in elderly populationPublication . Cebola, Marisa; Mendes, Diana; Costa-Veiga, Ana; Tomás, Maria Teresa; Coelho, André; Mendes, Lino; Rico, Miguel; Guerreiro, AntónioIntroduction: Ageing leads to an increase in chronic disease’s prevalence, progressive loss of muscle mass, muscle weakness, and polypharmacy, contributing to the establishment of malnutrition and sarcopenia. Objectives: The aim was: 1. Characterize the prevalence of malnutrition, sarcopenia, and current medication use; 2. Relate malnutrition to sarcopenia and current medication use. Materials and methods: Cross-sectional study, developed in the district of Lisbon, in the period from January 1, 2019, to June 30, 2019. Elderly people (≥ 65 years) admitted to the Internal Medicine Unit of a hospital institution (up to 72 hours) were admitted to the study. Participants in this study were the elderly with the capacity to make their informed consent, without the intervention of any element of coercion, with enough knowledge and understanding of the objectives of the study that allowed free and informed decision making. Nutritional assessment was assessed through MNA® and sarcopenia through the SARC-F® Questionnaire. The medication was counted through the number of drugs. Results: n=38 patients, with a mean age of 78.8 + 5.8 years (70-91), born in Lisbon, living in their own home, 50% (n=19) males and 73.6% (n=28) with the first cycle of basic education. At hospital admission 7.9% (n=3) were malnourished, 39.5 (n=15) presented a nutritional risk, 47.4% (n=18) presented a risk of sarcopenia and 60.5% had a prescription of more than three drugs. There was a statistically significant correlation between polypharmacy and malnutrition, (r=0,046). Discussion/Conclusion: The nutritional assessment, presence of sarcopenia and current medication use are extremely relevant at hospital admission. This assessment allows patients to be signaled that they need early nutritional intervention to prevent deteriorating during hospitalization.
- Movement and mobility: a series of case studies in very old womenPublication . Tomás, Maria Teresa; Cebola, Marisa; Mendes, Diana; Costa-Veiga, Ana; Coelho, André; Mendes, LinoIntroduction: Normal aging implies different physiological and functional changes. One of the most affected components is mobility whose decrease implies an increased risk of morbidity and mortality. Objectives: To verify in a series of cases the effects of a movement program on the mobility of very elderly individuals using daycare centers. Materials and methods: A quasi-experimental study was developed in a day-care center for elderly people in the district of Lisbon. A small sample of older adults had participated in an 8 weeks exercise training program aiming to develop general mobility. Before and after the exercise program delivered twice a week, participants were assessed relating to mobility with the Timed-up-go test (TUG), a simple and rapid test to assess mobility, agility and fall risk. Participants in this study gave their informed consent, without intervention of any element of coercion, with enough knowledge and understanding of the objectives of the study that allowed free and informed decision making. Results: Four older (81,5 ± 6,8 yr) and overweight women (28,6 ± 6,0 kg/m2) performed both assessment moments and participated in more than 75% of all the sessions. TUG time has decreased in all the participants (26,0 ±15,9%). Discussion/Conclusion: Although very older adults had difficulty and lack of motivation to participate in exercise sessions this small sample shows that even a small amount of movement delivered twice a week is beneficial for her mobility. This study should be done in a higher sample in order to verify the significance of results and allow translate interventions and results to very older populations.
- Sarcopenia and malnutrition in elderly admitted to hospitalPublication . Dias, Ana; Monteiro, Catarina; Mendes, Diana; Cebola, Marisa; Carolino, Elisabete; Mendes, Lino; Rico, Miguel; Guerreiro, AntónioIntroduction: Sarcopenia is a progressive and generalized skeletal muscle disorder. The sarcopenia phenotype is also associated with malnutrition, regardless of whether the malnourished condition is rooted in low dietary intake, reduced nutrient bioavailability or high nutrient requirements. Aims: Relating sarcopenia with malnutrition. Materials and Methods: Cross-sectional study, developed at a central hospital, between April and July 2019. Elderly people (≥ 70 years) admitted to internal medicine service with the capacity to make their informed consent, without the intervention of any element of coercion were admitted to the study. Sarcopenia was assessed through the European Working Group on Sarcopenia criteria in Older People (EWGSOP), which include the evaluation of the grip strength (GS), appendicular skeletal muscle mass (ASM) predicted by bioelectrical impedance analysis and physical performance (gait speed). The risk of malnutrition was assessed according to the Mini Nutrition Assessment - MNA® Elderly. Results: n=32 patients, with a mean age of 79.7 + 5.9 years (70-91). At hospital admission 93.8% (n=30) were sarcopenic, 100% (n=30) presented low GS, 75% (n=24) had low ASMM and 3.1% (n=1) had normal gait speed. According to the MNA® short form, 59% (n=19) had a nutritional risk and of that group, 68% (n=13) were at risk of malnutrition and 16% (n=3) were malnourish after completing the MNA® long-form, both also had a diagnostic of sarcopenia. However, there were no significant correlations between the MNA® and the sarcopenia evaluation criteria. Discussion/Conclusion: In a population of geriatric inpatients, subjects with malnutrition risk and sarcopenia are at increased risk of long-term all-cause mortality compared to subjects with either malnutrition/malnutrition risk or sarcopenia. Therefore, the malnutrition-sarcopenia syndrome may serve as an important prognostic factor in the management of hospitalized older patients.
- Sarcopenia and risk of fall in elderly admitted to hospitalPublication . Monteiro, Catarina; Mendes, Diana; Cebola, Marisa; Carolino, Elisabete; Mendes, Lino; Rico, Miguel Toscano; Guerreiro, AntónioIntroduction: Sarcopenia, a progressive and widespread disease of the skeletal muscle, has been a topic of interest. This age-related disease is known to be highly associated with disability, functional decline, frailty and falls. Aims: Relating sarcopenia with the risk of falls. Materials and Methods: Cross-sectional study, developed in Lisbon, in the period from April 22 to July 5, 2019. Elderly people (≥ 70 years) admitted to a hospital institution (up to 72 hours) with the capacity to make their informed consent, without the intervention of any element of coercion, with enough knowledge of the aims of the study that allowed free and informed decision making were admitted to the study. Sarcopenia was assessed through the European Working Group on Sarcopenia criteria in Older People 2 (EWGSOP2), which include the evaluation of the grip strength (GS), appendicular skeletal muscle mass (ASMM) predicted by bioelectrical impedance analysis and physical performance (gait speed). The risk of falls was assessed according to the Morse Scale. Results: n=32 patients, with a mean age of 79.7 + 5.9 years (70-91). At hospital admission 93.8% (n=30) were sarcopenic, 100% (n=30) presented low GS, 75% (n=24) had low ASMM and 3.1% (n=1) had normal gait speed. There was no significant correlation between the Morse Scale and the GS (r=-0.471; p=0,056) and the ASMM (r=0,017; p=0,948). There was a significant correlation between the gait speed test and the Morse Scale (r =-0.689; p=0.002). Patients with gait difficulties are at increased risk of falling. Discussion/Conclusion: The sarcopenia and risk of fall assessment are extremely relevant at hospital admission. It demonstrates the need to establish protocols to evaluate the mentioned parameters of the algorithm and to intervene in this population since the factors that constitute the algorithm proposed by EWGSOP2 tend to worsen during hospitalization.