Objectives The Kangaroo method helps promote maternal breastfeeding and adequate growth of low birthweight preterm infants. The objective of this study was to analyze the association between weight-gain velocity during use of the Kangaroo method and maternal and infant variables. Methods A nested cross-sectional study in a cohort of newborn infants managed using the Kangaroo method was carried out at a reference center for the method in Brazil. Data on low birthweight and preterm infants managed using the Kangaroo Method (n = 78) and on their respective mothers (n = 70) was collected between January and July 2014. Maternal and infant variables were associated and correlated with weight-gain velocity (g/kg/day) at each phase of the method (p < 0.05). Results Mean weight-gain velocity increased from 0.12 ± 11.11 g/kg/day in the first phase to 13.47 ± 4.84 g/kg/day in the third phase (p < 0.001), and percentage of adequate weight increased at phase 3 (p < 0.001). Birthweight was inversely correlated with weight-gain velocity at phases 1 and 2 of the Kangaroo method. Birthweight of under 1500 g was associated with a lower likelihood of inadequate weight-gain velocity of the newborn at phase 1 (OR = 0.1; 95 % CI 0.01-0.78; p = 0.012). In phase 3, maternal age was directly correlated with weight-gain velocity. Conclusions Weight-gain velocity was associated with maternal (age) and infant (gestational age at birth, birthweight, weight for gestational age at birth, length of hospital stay and five-minute Apgar score) variables. Knowledge of the factors influencing weight-gain velocity and its behavior at each phase of the method can help guide conduct toward potentializing factors that promote adequate weight-gain.
Objectives: to compare the intrauterine and postnatal growth of preterm infants according to the Intergrowth-21st and Fenton curves. Methods: study carried out in a maternity hospital, reference in high-risk pregnancy, with preterm infants born in 2018 who were hospitalized in the neonatal units of the institution. Preterm newborns weighed at least twice after birth were included in the sample and those that were syndromic, malformed or presented fluid retention were excluded. Proportions and means were compared using Pearson’s chi-square and Student’s t tests for paired samples, respectively. The McNemar test was used to compare categorical variables and the Kappa test to verify the degree of agreement between birth weight classifications obtained by the curves. Results: one hundred and fifty three infants with a median gestational age of 34.4 weeks were included. The incidences of the categories of nutritional status at birth did not differ between the curves. There was perfect agreement between the curves, except when newborns born under 33 weeks of gestational age were evaluated, in which case the agreement was substantial. About 21% of the babies classified as small for gestational age (SGA) by Intergrowth-21st were adequate for gestational age (AGA) according to Fenton and, on average, 20% of cases that had postnatal growth restriction (PNGR) according to Fenton standards were categorized as adequate weight by Intergrowth-21st. Postnatal weight classifications obtained by the evaluated curves had perfect agreement. Conclusions: the differences in theclassifications found between the charts reveal the importance of choosing the growth curve for monitoring preterm infants since behaviors based on their diagnoses can impact the life of this population.
Weight loss and malnutrition in patients with Alzheimer disease in Fortaleza -CE RESUMOObjetivo: Investigar o estado nutricional e as alterações de peso corporal em pacientes com a doença de Alzheimer atendidos em ambulatório especializado em Fortaleza -CE, Brasil. Métodos: Trata-se de um estudo do tipo transversal comparativo, com abordagem quantitativa, cuja amostra envolveu idosos com e sem a doença de Alzheimer, que frequentaram ambulatório especializado durante o mês de março de 2009. Para avaliar o estado nutricional, utilizou-se o questionário Mini Avaliação Nutricional (MAN) e a classificação do Índice de Massa Corpórea (IMC) proposta por Lipschitz, enquanto que a alteração de peso foi investigada a partir de formulário pré-estabelecido. Resultados: Analisou-se 58 idosos de ambos os sexos, sendo 29 com Alzheimer (grupo 1) e 29 sem a doença (grupo 2). A perda de peso corporal foi a alteração mais frequente relatada pelos dois grupos, sendo que o percentual foi maior no grupo 1 (62,1%, n = 18) do que no grupo 2 (44,8%, n=13). O grupo 1 apresentou maior prevalência de risco de desnutrição, de acordo com a MAN (55,2%, n=16), e a totalidade dos pacientes classificados como desnutridos pelo IMC (20,7%, n=6). Conclusão: Observa-se, portanto, que a perda de peso e a desnutrição estão presentes na realidade em questão, evidenciando a importância do acompanhamento nutricional precoce na doença de Alzheimer.
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