Navegando por Autor "Evangelista, Karine Cavalcanti Mauricio Sena"
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Artigo Acuracy and concordance of anthropometric indicators and body composition in heart failure(International Journal of Cardiovascular Sciences, 2018) Lyra, Clélia de Oliveira; Rocha, Daniela de Oliveira; Dantas, Raquel Costa Silva; Andrade, Fernanda Lambert de; Avelino, Regina Ranielly dos Santos; Diniz, Rosiane Viana Zuza; Lira, Niethia Regina Dantas de; Evangelista, Karine Cavalcanti Mauricio SenaBackground: Anabolic/catabolic disorder in heart failure (HF) favors cardiac cachexia, implying a reduction in HF survival. Objectives: To assess the accuracy and concordance of the diagnosis of protein malnutrition and excess fat among the anthropometric and body composition methods in individuals with HF. Method: A study of accuracy that included 60 individuals with HF. Body mass index (BMI), arm circumference (AC), triceps skinfold thickness (TST), adductor pollicis muscle thickness (APMT), arm muscle circumference (AMC) and corrected arm muscle area (cAMA). Fat free mass index (FFMI) and body fat percentage (BF%), obtained by electrical bioimpedance (EBI), were used to compare the diagnosis of protein malnutrition and excess fat. Accuracy was assessed by calculating sensitivity, specificity, positive and negative predictive value. The concordance of the EBI diagnosis and other methods was performed by the chi-square test and kappa (k) statistic, where p<0.05 was considered significant. Results: Higher frequencies of protein malnutrition were identified by cAMA and AMC, and excess fat by BF%. BMI presented low sensitivity (43%) and accuracy (38.5%), with moderate concordance (0.50). AMC sensitivity was 86%, accuracy 66.4%, and acceptable concordance (0.36) compared to FFMI. Similar percentages of moderate sensitivity and low accuracy were observed for TST and BMI. Conclusion: AMC may be useful to identify protein malnutrition and TST has not been adequate to diagnose adiposity. BMI was not sensitive to assess muscle and adipose reserve. EBI was more accurate. (Int J Cardiovasc Sci. 2019;32(2)143-151)Artigo Biomarkers of zinc and copper status and associated factors in outpatients with ischemic and non-ischemic heart failure(Journal of the american college of nutrition, 2022) Lima, Severina Carla Vieira Cunha; Freire, Fernanda Lambert de Andrade; Komatsu, Raquel Costa Silva Dantas; Lira, Niethia Regina Dantas de; Diniz, Rosiane Viana Zuza; Barbosa Junior, Fernando; Pedrosa, Lucia Fatima Campos; Evangelista, Karine Cavalcanti Mauricio Sena; https://orcid.org/0000-0001-8268-1986Background: Few studies have explored the impact of ischemic and non-ischemic etiologies of heart failure and other factors associated with heart failure on zinc and copper status. This study examined zinc and copper status in 80 outpatients with ischemic (n ¼ 36) and non-ischemic (n ¼ 44) heart failure and associations with biodemographic, clinical, biochemical, and nutri- tional parameters. Materials: Biomarkers of plasma zinc and copper, copper-zinc ratio, 24-h urinary zinc excretion, ceruloplasmin, and dietary intake of zinc and copper were assessed. Plasma zinc and copper and urinary zinc were measured by inductively coupled plasma mass spectrometry (ICP-MS). Results: Patients with ischemic heart failure showed lower dietary zinc intake and higher dietary copper intake (both p ¼ 0.02). Zinc and copper in plasma, copper-zinc ratio, ceruloplasmin, and 24-h urinary zinc excretion showed no statistical differences between the groups (all p 0.05). An inverse association was found between age (b ¼ 0.001; p ¼ 0.005) and the use of diuretics (b ¼ -0.047; p ¼ 0.013) and plasma zinc. Copper levels in plasma (b = 0.001; p < 0.001), and albumin (b ¼ 0.090; p<0.001) were directly associated with plasma zinc. A positive association was found between ceruloplasmin (b ¼ 0.011; p < 0.001), gamma-glutamyl transferase (b ¼ 0.001; p < 0.001), albumin (b ¼ 0.077; p ¼ 0.001), and high-sensitivity c-reactive protein (b ¼ 0.001; p ¼ 0.024) and plasma copper. Conclusion: Zinc and copper biomarkers in clinically stable patients with heart failure did not seem to be responsive to the differences in zinc and copper intake observed in this study, regard- less of heart failure etiology. The predictors of plasma zinc and copper levels related to oxidative stress and inflammation should be monitored in heart failure clinical practice.Artigo Effects of an individualized nutritional intervention on kidney function, body composition, and quality of life in kidney transplant recipients: study protocol for a randomized clinical trial(Plos One, 2022) Almeida, Jose Bruno de; Morais, Tassia Louise Sousa Augusto de; Souza, Karla Simone Costa de; Lima, Mabelle Alves Ferreira de; Pereira, Maurıcio Galvão; Oliveira, Antonio Manuel Gouveia de; Evangelista, Karine Cavalcanti Mauricio Sena; Rezende, Adriana Augusto deBackground: Proteinuria after kidney transplantation (KTx) has been a frequent problem due to several factors, high protein intake being one of them. Individualized nutritional intervention in the late post-KTx period can promote the improvement or the reduction of risks associated with the parameters of evaluation of kidney function, body composition, and quality of life in individuals submitted to KTx. Methods: This is a single-center, randomized and stratified clinical trial. The study will be conducted in a university hospital in northeastern Brazil with 174 individuals aged ≥19 years submitted to KTx and followed up for 12 months. Assessments will take place at 3-month intervals (T0, T3, T6, T9, and T12). The patients will be allocated to intervention and control groups by random allocation. The intervention group will receive individualized nutritional interventions with normoproteic diets (1.0 g/kg) after 60 days of KTx whereas the controls will receive the standard nutritional guidance for the post-KTx period. The primary efficacy variable is the change from baseline in log proteinuria assessed with the urinary albumin/creatinine ratio. Secondary efficacy variables include body composition, anthropometry, quality of life assessment and physical activity, lipid profile and glycemic control. Ninety-two subjects per group will afford 70% power to detect a difference of 25% between groups in log proteinuria. Primary efficacy analysis will be on the modified intention-to-treat population with between-groups comparison of the change from baseline in log proteinuria by analysis of covariance. Discussion: The study will assess the effects of an individualized nutritional intervention on proteinuria 12 months after KTxTCC Estimativa de risco cardiovascular e consumo dietético de pacientes com síndrome metabólica(Universidade Federal do Rio Grande do Norte, 2016-11-16) Cassemiro, Mirna Gabrielle Gomes; Evangelista, Karine Cavalcanti Maurício de Sena; Erika Paula Silva Freitas; Evangelista, Karine Cavalcanti Mauricio Sena; Freitas, Érika Paula Silva; Vale, Sancha Helena de LimaA síndrome metabólica (SM) agrupa em um mesmo indivíduo um conjunto de anormalidades metabólicas com impacto no desenvolvimento das doenças cardiovasculares (DCVs). O objetivo deste trabalho foi identificar o risco cardiovascular (RCV), com base em diferentes escores e o consumo dietético de pacientes com SM. Foi realizado um estudo transversal com 85 indivíduos adultos e idosos de ambos os sexos portadores de SM, segundo critérios do National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), atendidos no Ambulatório de Endocrinologia do Hospital Onofre Lopes. Foi realizada aferição da pressão arterial, análises bioquímicas de perfil lipídico e glicêmico, assim como a avaliação antropométrica e hábitos de vida. O RCV foi avaliado por meio dos escore de risco de Framingham (ERF), escore de risco global (ERG) e risco pelo tempo de vida (RTV). Foi avaliado o consumo de energia, macronutrientes e fibra, a partir dos dados coletados pelo recordatório 24h. Os resultados demonstraram que a idade dos pacientes variou de 20-76 anos, aproximadamente, com média de 48(10) para o sexo masculino e 51(12) para o sexo feminino, sem diferença significativa entre os sexos (p>0,05). Observou-se que a maioria dos pacientes eram do sexo feminino (72%), não fumantes (62,5% masculino e 73,8% feminino), identificando-se diferença estatística significativa para o consumo de álcool entre os sexos (p<0,001), com maior frequência de uso de álcool no sexo masculino. A maioria dos pacientes com SM foram considerados ativos (37,5% do sexo masculino e 55,7% do sexo feminino). Na avaliação pelos ER, tanto no ERF quanto no RCG, existiu diferença estatisticamente significativa entre os sexos (ambos p<0,001). Pelo ERF, verificou-se 88,5% das pacientes do sexo feminino classificadas em baixo risco, enquanto que no sexo masculino foi identificado 16,7% com alto risco. Pelo RTV não houve diferença estatística significativa entre os sexos, porém foi observado que o sexo feminino apresentou percentual de risco elevado de 45,9%, e o sexo masculino 41,7% de risco não alto. O consumo alimentar mostrou que as dietas, em média, foram caracterizadas como hiperproteica, normoglicídica e normolipídica com baixo consumo de fibras. Houve diferenças significativas para o consumo de gordura total, assim como de AGPI, AGMI (p>0,005) maiores no sexo masculino e colesterol maior que o recomendado (<300mg/dia). Em conclusão, o sexo feminino mostrou estar em maior parte no grupo de risco, principalmente acima de 45 anos, comprovando o aumento do RCV com o avançar da idade. O consumo inadequado de ácidos graxos e a baixa ingestão de fibra podem ser fatores que potencializam o RCV. Os resultados obtidos reiteram a importância da avaliação do RCV, para diminuição de suas complicações, assim como o impacto sobre a mortalidade.Artigo Frequency of metabolic syndrome and associated factors in institutionalized elderly individuals(Clinical Interventions in Aging, 2018) Lima, Severina Carla Vieira Cunha; Sales, Marcia Cristina; Oliveira, Larissa Praça; Liberalino, Laura Camila Pereira; Cunha, Aline Tuane Oliveira; Lemos, Telma Maria Araujo Moura; Lima, Kenio Costa; Evangelista, Karine Cavalcanti Mauricio Sena; Pedrosa, Lucia Fatima Campos; Sousa, Sara estefani soares; https://orcid.org/0000-0001-8268-1986Introduction: Population aging generally accompanies an increase in chronic noncommunicable diseases, such as metabolic syndrome (MS). Nursing homes have provided a solution for the decreased ability of elderly individuals for self-care and familial difficulties in meeting the health care needs of elderly individuals. Purpose: The aim of the present study was to determine the frequency of MS and its associated factors in elderly individuals living in nursing homes. Patients and methods: This cross-sectional study was conducted with 202 institutionalized elderly individuals. MS was diagnosed according to the National Cholesterol Education Program – Adult Treatment Panel III criteria. Sociodemographic, clinical, and lifestyle factors were assessed to verify their association with MS by logistic regression. Results: The MS frequency was 29.2%. The most frequent MS components were low high-density lipoprotein cholesterol level (63.9%) and abdominal obesity (42.7%). Factors associ-ated with MS were female sex (prevalence ratio [PR]=2.16; 95% CI, 1.04–4.49), age-adjusted institutionalization time .50% (PR=2.38, 95% CI, 1.46–3.88), and high concentrations of interleukin-6 (PR=2.01; 95% CI, 1.21–3.32) and tumor necrosis factor-α (PR=1.70; 95% CI, 1.05–2.77). Moreover, it was verified that the likelihood of having MS was 1.85-fold higher (95% CI, 1.11–3.10) in the group with a diet characterized by very high energy, very low fat, and high dietary fiber. Conclusion: The occurrence of MS in institutionalized elderly individuals was higher in females, and individuals with longer age-adjusted institutionalization time, higher concentrations of immunologic biomarkers, and a dietary intake consisting of higher energy and fiber and lower total fat. The results of the study are useful for guiding health care programs aimed at institutionalized elderly individuals.Artigo Nutritional risk screening tools for older adults with COVID-19: a systematic review(Nutrients, 2020) Lima, Severina Carla Vieira Cunha Lima; Silva, David Franciole Oliveira Silva; Evangelista, Karine Cavalcanti Mauricio Sena; Marchioni, Dirce Maria; Cobucci, Ricardo Ney; Andrade, Fábia Barbosa de; https://orcid.org/0000-0001-8268-1986Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in older people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the MNA-short form (MNA-sf), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Index (NRI), the Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in older adults with COVID-19.Artigo Plasma zinc in institutionalized elderly individuals: relation with immune and cardiometabolic biomarkers(Journal of Trace Elements in Medicine and Biology, 2018-12) Lyra, Clélia de Oliveira; Sales, Márcia Cristina; Oliveira, Larissa Praça de; Cabral, Natalia Louise de Araújo; Sousa, Sara Estéfani Soares de; Almeida, Maria das Graças; Lemos, Telma Maria Araújo Moura; Lima, Kenio Costa de; Evangelista, Karine Cavalcanti Mauricio Sena; Pedrosa, Lucia de Fatima CamposChanges in zinc metabolism caused by aging and the institutionalization process may contribute to zinc deficiency in elderly individuals. Hypozincemia results in changes in glycemic, lipid, and inflammatory profiles. The aim of this study was to evaluate plasma zinc concentrations and their relationships with sociodemographic, dietary, inflammatory, and cardiometabolic biomarkers in institutionalized elderly individuals. A cross-sectional study was carried out including 255 elderly adults living in nursing homes. The associations between plasma zinc and dietary zinc intake, sociodemographic indicators, and glycemic, lipid, and inflammatory biomarkers were evaluated. Independent variables were analyzed according to quartiles of plasma zinc concentrations (Q1: <71.1 μg/dL; Q2: 71.1–83.3 μg/dL; Q3: <83.3–93.7 μg/dL; Q4: >93.7 μg/dL). The relationship between plasma zinc concentrations and predictor variables was also tested. In Q1, higher concentrations of the following variables were observed, compared with those in other quartiles: total cholesterol and low-density lipoprotein cholesterol (LDL-c; Q1 > Q2, Q3, Q4; all p <0.001); triglycerides (Q1 > Q3, Q4; all p < 0.001); interleukin (IL)-6 (Q1 > Q3, Q4; p = 0.024 and p = 0.010, respectively); tumor necrosis factor (TNF)-α (Q1 > Q3, p = 0.003). A significant reduction in plasma zinc concentrations was observed with increasing age-adjusted institutionalization time (Δ = − 0.10; 95% confidence interval [CI]: −0.18 to −0.01). The concentrations of total cholesterol (Δ = − 0.19; 95% CI: −0.23 to −0.15), LDL-c (Δ = − 0.19; 95% CI: −0.23 to −0.15), triglycerides (Δ = − 0.11; 95% CI: −0.16 to −0.06), IL-6 (Δ = − 1.41; 95% CI: −2.64 to −0.18), and TNF-α (Δ = − 1.04; 95% CI: −1.71 to −0.36) were also significantly increased. In conclusion, decreased plasma zinc concentrations were associated with longer institutionalization time and worse lipid and inflammatory profiles in elderly institutionalized individuals