RESUMO -Racional -A gastrectomia traz conseqüências nutricionais inevitáveis mas atenuáveis, dependendo da dietoterapia pós-operatória. Embora observada, essa desnutrição protéico-energética é pouco dimensionada, provavelmente, pela falta de consenso metodológico. Objetivo -Avaliar o grau de desnutrição protéico-energética do paciente gastrectomizado, utilizandose de indicadores isolados ou combinados. Pacientes e Métodos -Foram estudados 71 pacientes com gastrectomia parcial (n = 53) ou total (n =18) em pós-operatório de 6 a 24 meses e 24-60 meses. Os dados dietéticos, composição corporal e bioquímicos foram analisados de acordo com o tipo de gastrectomia e tempo pós-operatório. Resultados -A cirurgia foi conseqüência de complicações de úlcera péptica (68%) ou a câncer gástrico (32%). A perda de peso foi referida por 70% dos pacientes, sendo maior no grupo gastrectomia total (16 ± 5 kg) do que no grupo gastrectomia parcial (10 ± 6 kg). Em geral, os pacientes apresentaram déficit antropométrico, albuminemia normal e baixa ingestão calórica, sugerindo deficiência energética crônica. A redução de hemoglobina, hematócrito e ferro ocorreu em maior intensidade e mais precocemente no grupo gastrectomia total. Assim, quando se associou hemoglobina aos indicadores albumina, linfócitos circunferência do braço e prega cutânea subescapular, a prevalência de desnutrição protéico-energética foi maior e em maior intensidade do que na ausência da hemoglobina. Conclusão -A gastrectomia resultou em desnutrição protéico-energética do tipo marasmática, acompanhada de anemia, mais intensa e precoce na gastrectomia total e gradativa na gastrectomia parcial, assemelhando-se à gastrectomia total no pós-operatório tardio. DESCRITORES - INTRODUÇÃOA indicação de intervenção cirúrgica diminuiu com o avanço da terapia medicamentosa e seu sucesso no tratamento das úlceras pépticas. Entretanto, nos casos de complicações de úlceras (perfurações, estenoses, hemorragias não controladas) e nos pacientes com câncer gástrico, os procedimentos cirúrgicos continuam sendo o único tratamento (17,19) . A gastrectomia consiste na retirada de parte ou de todo o estômago, refazendo o trânsito gastrointestinal através da anastomose com o duodeno (Billroth I -BI) ou jejuno (Billroth II -BII).A perda de peso é a expressão direta do déficit energético (13) , podendo se estabilizar alguns meses da cirurgia e ficar, muitas vezes, situada definitivamente abaixo do peso no pré-operatório (19) , o que pode estar relacionado diretamente à redução da ingestão alimentar e à má absorção de nutrientes, assim como ser conseqüência da doença de base. A anemia é manifestação comum em pacientes gastrectomizados, podendo ser ferropriva e/ou megaloblástica (19,27) .

The alterations found had no association with the severity of lesions, indicating the need for more effective nutritional intervention.

Funding Acknowledgements Type of funding sources: None. OnBehalf Portuguese Registry of Acute Coronary Syndromes Background Cardiovascular risk factors (CVRF) are a growing health problem in developed countries, being directly associated with acute coronary syndrome (ACS) occurrence and atrial fibrillation (AF). Nevertheless, new onset of AF in context of ACS is a clinical problem with prognostic and therapeutic implications. Objective Evaluate the impact of the CVRF in new onset AF during the hospitalization for ACS. Methods Multicenter retrospective study, based on the Portuguese Registry of ACS between 1/10/2010-4/09/2019. Patients were divided in two groups: A – without new onset of AF during the hospitalization for ACS and B – with new onset of AF during the hospitalization for ACS. CVFR was defined by body mass index, diabetes, arterial hypertension, smoking, coronary artery disease, neoplasia, dyslipidemia, chronic kidney disease and peripheral arterial disease. Logistic regression was performed to assess predictors of new onset AF in these patients. Results 14037 patients were included, 637 in group B (4.8%). Both groups were similar regarding diabetes mellitus (p = 0.116), coronary artery disease (p = 0.264) and neoplasia (p = 0.327). Curiously the group A exhibited higher body mass index (27.5 ± 4.3 vs 27.2 ± 4.4, p < 0.001), smokers (28.1 vs 18.5%, p < 0.001) and dyslipidemia (62.8 vs 56.7%, p < 0.001). On the other hand, group B presented more females (26.4 vs 35.0%, p < 0.001), arterial hypertension (70.0 vs 74.9%, p = 0.002), peripheral arterial disease (5.4 vs 8.4%, p < 0.001) and chronic kidney disease (6.7 vs 9.5%, p < 0.001). Logistic regression revealed that body mass index, smoker status, diabetes, dyslipidemia, coronary artery disease, neoplasia, chronic kidney disease and peripheral arterial disease were not predictors of AF during the hospitalization for ACS. Nonetheless, female gender (odds ratio (OR) 1.23, p = 0.025, confidence interval (CI) 1.03-1.47), obesity (OR 1.39, p = 0.004, CI 1.11-1.74) and arterial hypertension (OR 1.22, p = 0.049, CI 1.01-1.50) were predictors of new onset of AF during hospitalization for ACS. Conclusions: Female gender, obesity and arterial hypertension were predictors of new onset of AF in during hospitalization for ACS.

e menor incorporação de Cys em GSH foram resolvidos dando-se Met, NAC e Gln aos pacientes, ainda permanecendo a desvantagem do aumento da Hcy com Met ou suplementação de NAC. Palavras-chave: pacientes HIV+, GSH, aminoácidos sulfurados, suplementação de NAC, suplementação de glutamina. AlSSTRACT BACKGROUNO: Methionine (Met), cysteine (Cys), homocysteine (Hcy), and , taurine (Tau) are the 4 sulfur-containing amino acids (SAA), but only Met and Cys are incorporated into proteins. The 3 major products of SAA, glutathione (GSH), Hcy and Tau influence, mainly, inflammatory and of immune responses. Tau and GSH ameliorate inflammation whereas Hcy has the opposite effect. HIV+ patients present low leveis of GSH and other antioxidants nutrients, showing a direct relationship between Cys (and GSH) with CD/ cells. How changes in SAA intake influence this phenomenon is unknown and the relationships among Hcy, inflammatory diseases, and in vitro alterations in immune cell behavior create a cautionary note about supplementation of diets with SAA. OBJECTIVE: To investigate SAA pathways in HIV+ patients on fast and Met-overload (Met-DL) states after taken diet habitual without (HD) or with supplements of Cys (NAC) or glutamine (Gln). METHOOS: 12 HIV+ (6M and 6F, 25-36 yrs old) patients under HAART without secondary infections and 20 healthy (10M and 10F, 23-28 yrs old) controls were randomly assigned to either NAC (N-acetylcysteine, 1g/d) or Gln (20g/d) diets, in a 7-day diet crossover design, separated by a 7-day washout (with HD) period. Blood samples were drawn after overnight fast before (MO) and after each dietary treatments (M1) for the resting measurements. Immediately after blood sampling ali subjects started the Met-DL by ingesting at once 100 mg MeUkg BW and having the blood draw after 2 and 4 hours for the area under the curve (AUC) determination. At MO both groups were assessed for anthropometry (BMI, kg/m 2), glomerular (plasma urea and creatinina) and hepatocellular (plasma y-GT aetivity) funetions, nutritional (albumin, ealeium, folie aeid and vitamin 812) and antioxidant (urie aeid, GSH, GSSG, Hey) states, glueose, lipids (triglyeerides and eholesterol fractions) and SAA, serine (Ser), glyeine (Gly), glutamate (Glu) and Gln. The HIV+ group was eharaeterized also by viral load, CD 4 + and CD a + eounts. The statistieal eomparisons between groups and among diets showed group homogeneity for 8MI, albumin, ealeium, vitamin 812, Hey, HDL-eholesterol, urea and ereatinine. The patients presented higher values of glueose, triglyeerides, y-GT, LDL-eholesterol, and GSSG along with lower eoneentrations of urie aeid, GSH and ali but Hey amino aeids. The Met-OL equalized (6 values) the groups for Met, Hey, Tau and Gln. NAC and Gln diets led the HIV+ group to a higher coneentrations of GSH (NAC > Gln) by aeting differently on its precursors: Gly (Gln > NAC) and Cys (NAC > Gln), resulting similar eonsumption of Ser and produetion of Tau. 80th diets redueed GSSG/GSH (NAC > Gln) and only NAC inereased (6 x) Hey. The later was wors...