Navegando por Autor "Lira, Niethia Regina Dantas de"
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TCC Abreviação de jejum em indivíduos submetidos à cirurgia cardíaca: uma revisão integrativa(Universidade Federal do Rio Grande do Norte, 2024-03-01) Gomes, Larissa Benevides Serejo; Sena-Evangelista, Karine Cavalcanti Maurício; Lira, Niethia Regina Dantas de; http://lattes.cnpq.br/6955533388715615; Reis, Bruza Zavarize; Silva, Sandy Yasmine Bezerra eRESUMO Introdução: As cirurgias cardíacas são uma das alternativas terapêuticas voltadas ao tratamento das doenças cardiovasculares, sendo o tempo de jejum pré-operatório um dos fatores associados aos prejuízos metabólicos e clínicos relacionados aos desfechos pós-operatórios desfavoráveis. Objetivo: identificar as evidências disponíveis na literatura sobre as estratégias de abreviação de jejum em indivíduos submetidos à cirurgia cardíaca e principais desfechos clínicos associados. Metodologia: trata-se de uma revisão integrativa, realizada utilizando-se as fontes de dados: Medical Literature Analysis and Retrieval System Online Excerpta Medica DataBASE, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Google Scholar. Considerou-se a seguinte questão norteadora “Quais as estratégias de abreviação de jejum pré-operatório mais utilizadas, bem como os principais desfechos clínicos associados em indivíduos submetidos à cirurgia cardíaca?”. Chaves de buscas foram definidas para cada base, considerando as principais palavras-chaves: “Operative Procedures”, “Procedure, Cardiac Surgical”, “preoperative fasting” e “carbohydrate”. A ferramenta Rayyan® foi utilizada para a triagem e seleção dos artigos. Resultados: Foram incluídos 07 estudos, contemplando um número total de 937 indivíduos, sendo a maioria do sexo masculino. A revascularização do miocárdio ou troca valvar foram os procedimentos cardíacos mais predominantes. Dentre os estudos avaliados, 57,1% indicaram um tempo de jejum em torno de 2 a 3 horas antes das cirurgias cardíacas. Evidenciou-se que em 42,8% dos estudos foi utilizada a solução oral de carboidratos - maltodextrina 12,5%. Três ensaios clínicos randomizados associaram o carboidrato a outros nutrientes (proteínas, emulsões lipídicas, ômega 3 e vitamina E). Os principais desfechos clínicos identificados foram melhor controle glicêmico, redução da quantidade de insulina no período pós-operatório imediato, do tempo de internação na unidade de terapia intensiva, uso de droga inotrópica, secura bucal e fome. Conclusão: As estratégias abordadas baseadas na oferta de solução oral de carboidrato maltodextrina 12,5% foram predominantes entre os estudos e podem ser consideradas seguras quanto aos desfechos clínicos, auxiliando na recuperação otimizada dos indivíduos no pós-operatório de cirurgias cardíacas.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 Adequação de energia e proteína para pacientes críticos em terapia nutricional enteral(Braspen Journal, 2019-10-08) Lopes, Márcia Marília Gomes Dantas; Jesus, Karla Mendonça Gonçalves de; Santos, Letícia Sabino; Vermeulen, Karina Marques; Oliveira, Marcia Regina Dantas de Araújo; Leite-Lais, Lúcia; Lira, Niethia Regina Dantas de; Vale, Sancha Helena de Lima; https://orcid.org/0000-0002-0011-576X; https://orcid.org/0000-0002-8061-7048; https://orcid.org/0000-0002-0972-1678Introdução: A terapia nutricional enteral para pacientes críticos é considerada um tratamento coadjuvante, que fornece energia e nutrientes importantes para função imunológica e manutenção da massa magra, minimizando o risco de complicações metabólicas. Este estudo avaliou a adequação de energia e proteína da terapia nutricional enteral prescrita para pacientes críticos internados na unidade de terapia intensiva (UTI) de um hospital universitário. Método: Estudo prospectivo, no qual as necessidades e a oferta de energia e proteínas foram avaliadas, fornecendo informações sobre os percentuais de adequação, o tempo médio para atingir a meta nutricional e as intercorrências relacionadas à terapia. Resultados: Foram avaliados 31 pacientes, com idade média de 53,8 ± 16,0 anos, sendo 58,1% do sexo feminino. Os diagnósticos clínicos mais frequentes foram relacionados ao sistema neurológico e sistema digestório, abrangendo 45,2% da amostra. O tempo de permanência na UTI foi de 20,4 ± 16,4 dias. O tempo necessário para atingir a meta de energia e proteína foi de 6,7 dias (160,0 ± 74h) e 7,3 dias (175,2 ± 76,8h), respectivamente. Dentre as intercorrências, as complicações gastrointestinais foram os principais motivos para retardar o início da dieta ou limitar sua progressão. Conclusão: O período de 72h para a oferta de pelo menos 80% das necessidades energéticas e proteicas não foi suficiente para a adequação nutricional da população avaliada. Dentre as intercorrências observadas destacam-se as alterações das funções gastrointestinais e as situações de instabilidade hemodinâmica, denotando a necessidade de criação de protocolos para o manejo das complicações relacionadas à terapia nutricional enteralArtigo Biomarkers of zinc and copper status and associated factors in outpatients with ischemic and non-ischemic heart failure(Journal of the American Nutrition Association, 2022-02) Evangelista, Karine Cavalcanti Maurício de Sena; Freire, Fernanda Lambert de Andrade; Komatsu, Raquel Costa Silva Dantas; Lira, Niethia Regina Dantas de; Diniz, Rosiane Viana Zuza; Lima, Severina Carla Vieira Cunha; Barbosa, Fernando; Pedrosa, Lucia Fatima CamposBackground: 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 nutritional 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 ¼0.001; 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, regardless 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 practiceArtigo 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 Lack of association between inadequate micronutrient intake and prognosis in outpatients with heart failure(Nutrients, 2022) Lima, Severina Carla Vieira Cunha; Torres, Núbia Rafaella Soares Moreira; Freire, Fernanda Lambert de Andrade; Komatsu, Raquel Costa Silva Dantas; Silva, Eduardo Paixão da; Queiroz, Salomão Israel Monteiro Lourenço; Lira, Niethia Regina Dantas de; Diniz, Rosiane Viana Zuza; Pedrosa, Lucia Fatima Campos; Lopes, Márcia Marília Gomes Dantas; Evangelista, Karine Cavalcanti Maurício Sena; https://orcid.org/0000-0001-8268-1986Inadequate nutrient intake can lead to worse outcomes in patients with heart failure (HF). This prospective cohort study aimed to assess the prevalence of inadequate micronutrient intake and their association with prognosis in 121 adult and elderly outpatients with HF. Habitual micronutrient intake was evaluated using 24-h dietary recalls (minimum 2 and maximum 6). Participants were grouped into moderate (n = 67) and high (n = 54) micronutrient deficiency groups, according to the individual assessment of each micronutrient intake. Patients’ sociodemographic, clinical, and anthropometric data and clinical outcomes (hospitalization and mortality) within 24 months were collected. Overall and event-free survival rates were calculated using Kaplan–Meier estimates, and curves were compared using the log-rank test. The death risk rate (hazard ratio (HR)) was calculated using Cox’s univariate model. The rate of inadequate intake was 100% for vitamins B1 and D and above 80% for vitamins B2, B9, and E, calcium, magnesium, and copper. No differences in overall survival and event-free survival were observed between groups of HF outpatients with moderate and high micronutrient deficiencies (HR = 0.94 (CI = 0.36–2.48), p = 0.91, and HR = 1.63 (CI = 0.68–3.92), p = 0.26, respectively), as well as when the inadequacy of each micronutrient intake was evaluated alone (all p > 0.05). In conclusion, a high prevalence of inadequate micronutrient intake was observed in outpatients with HF. Inadequate micronutrient intake was not associated with hospitalization and mortality in this group of patients.Artigo Lack of association between inadequate micronutrient Intake and prognosis in outpatients with heart failure(Nutrients, 2022) Lopes, Márcia Marília Gomes Dantas; Torres, Núbia Rafaella Soares Moreira; Freire, Fernanda Lambert de Andrade; Komatsu, Raquel Costa Silva Dantas; Silva, Eduardo Paixão da; Queiroz, Salomão Israel Monteiro Lourenço; Lira, Niethia Regina Dantas de; Diniz, Rosiane Viana Zuza; Lima, Severina Carla Vieira Cunha; Pedrosa, Lucia Fatima Campos; Evangelista, Karine Cavalcanti Maurício Sena; https://orcid.org/0000-0002-0011-576XInadequate nutrient intake can lead to worse outcomes in patients with heart failure (HF). This prospective cohort study aimed to assess the prevalence of inadequate micronutrient intake and their association with prognosis in 121 adult and elderly outpatients with HF. Habitual micronutrient intake was evaluated using 24-h dietary recalls (minimum 2 and maximum 6). Participants were grouped into moderate (n = 67) and high (n = 54) micronutrient deficiency groups, according to the individual assessment of each micronutrient intake. Patients’ sociodemographic, clinical, and anthropometric data and clinical outcomes (hospitalization and mortality) within 24 months were collected. Overall and event-free survival rates were calculated using Kaplan–Meier estimates, and curves were compared using the log-rank test. The death risk rate (hazard ratio (HR)) was calculated using Cox’s univariate model. The rate of inadequate intake was 100% for vitamins B1 and D and above 80% for vitamins B2, B9, and E, calcium, magnesium, and copper. No differences in overall survival and event-free survival were observed between groups of HF outpatients with moderate and high micronutrient deficiencies (HR = 0.94 (CI = 0.36–2.48), p = 0.91, and HR = 1.63 (CI = 0.68–3.92), p = 0.26, respectively), as well as when the inadequacy of each micronutrient intake was evaluated alone (all p > 0.05). In conclusion, a high prevalence of inadequate micronutrient intake was observed in outpatients with HF. Inadequate micronutrient intake was not associated with hospitalization and mortality in this group of patients.Artigo Vitamin D status and predictors of 25-hydroxyvitamin D levels in patients with heart failure living in a sunny region(Nutrición Hospitalaria, 2021) Evangelista, Karine Cavalcanti Maurício de Sena; Komatsu, Raquel Costa Silva Dantas; Freire, Fernanda Lambert de Andrade; Lira, Niethia Regina Dantas de; Diniz, Rosiane Viana Zuza; Lima, Severina Carla Vieira Cunha; Pedrosa, Lucia Fatima CamposAims: hypovitaminosis D has frequently been identified in patients with heart failure (HF). However, few studies have been conducted in regions with high solar incidence. Therefore, this study aimed to evaluate vitamin D status and predictors of 25-hydroxyvitamin D (25(OH)D) levels in patients with HF living in a sunny region (5 °- 6 °S). Methods: this cross-sectional study enrolled 70 patients with HF. Biodemographic, clinical, biochemical, dietary, and sun exposure data were collected, and 25(OH)D levels were measured. Results: the mean 25(OH)D level was 40.1 (12.4) ng/mL, and 24.3 % (95 % CI: 14.2-33.8) of patients with HF had hypovitaminosis D (25(OH) D < 30 ng/mL). Female patients (p = 0.001), those with ischemic etiology (p = 0.03) and those with high parathyroid hormone levels (> 67 pg/ mL) (p = 0.034) were more likely to present hypovitaminosis D. Higher 25(OH)D levels were observed in men than in women (β = 7.78, p = 0.005) and in patients with HF in New York Heart Association (NHYA) functional class I when compared to those in class III/IV (β = 8.23, p = 0.032). Conclusions: the majority of patients with HF had sufficient 25(OH)D levels. Sex and functional classification were identified as independent predictors of 25(OH)D levels. These results highlight the need for increased monitoring of vitamin D status among female patients with heart failure and those with more severe symptomsArtigo Vitamin D status and predictors of 25-hydroxyvitamin D levels in patients with heart failure living in a sunny region(Nutricion Hospitalaria, 2021) Lima, Severina Carla Vieira Cunha; Komatsu, Raquel Costa Silva Dantas; Freire, Fernanda Lambert de Andrade; Lira, Niethia Regina Dantas de; Diniz, Rosiane Viana Zuza; Pedrosa, Lucia Fatima Campos; Evangelista, Karine Cavalcanti Maurício Sena; https://orcid.org/0000-0001-8268-1986Aims: hypovitaminosis D has frequently been identified in patients with heart failure (HF). However, few studies have been conducted in regions with high solar incidence. Therefore, this study aimed to evaluate vitamin D status and predictors of 25-hydroxyvitamin D (25(OH)D) levels in patients with HF living in a sunny region (5 °- 6 °S). Methods: this cross-sectional study enrolled 70 patients with HF. Biodemographic, clinical, biochemical, dietary, and sun exposure data were collected, and 25(OH)D levels were measured. Results: the mean 25(OH)D level was 40.1 (12.4) ng/mL, and 24.3 % (95 % CI: 14.2-33.8) of patients with HF had hypovitaminosis D (25(OH) D < 30 ng/mL). Female patients (p = 0.001), those with ischemic etiology (p = 0.03) and those with high parathyroid hormone levels (> 67 pg/mL) (p = 0.034) were more likely to present hypovitaminosis D. Higher 25(OH)D levels were observed in men than in women (β = 7.78, p = 0.005) and in patients with HF in New York Heart Association (NHYA) functional class I when compared to those in class III/IV (β = 8.23, p = 0.032). Conclusions: the majority of patients with HF had sufficient 25(OH)D levels. Sex and functional classification were identified as independent predictors of 25(OH)D levels. These results highlight the need for increased monitoring of vitamin D status among female patients with heart failure and those with more severe symptoms.