Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study

BACKGROUND

Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness.

OBJECTIVE

Estimate the prevalence of Metabolic Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil.

METHOD

Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described.

RESULTS

MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35-2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05-1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18-1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13-2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48-4.46) were associated with MS.

CONCLUSION

The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.

Interaction between Work and Metabolic Syndrome: A Population-Based Cross-Sectional Study

Metabolic syndrome (MS) is a clinical condition and a relevant risk factor in the development of cardiovascular diseases; it occurs as a result of lifestyle factors, e.g., work. The aim of this research was to estimate the interaction between work and MS among primary health care (PHC) nursing professionals in the state of Bahia, Brazil. A sectional multicentered study carried out in 43 municipalities in Bahia, whose study population consisted of nursing professionals. The exposure variables were occupation, professional exhaustion, and working time, and the outcome variable was MS. Interaction measures based on the additivity criteria were verified by calculating the excess risks due to the interactions and according to the proportion of cases attributed to the interactions and the synergy index. The global MS prevalence is 24.4%. There was a greater magnitude in the exposure group regarding the three investigated factors (average level occupation, professional exhaustion, and working time in PHC for more than 5 years), reaching an occurrence of 44.9% when compared to the prevalence of 13.1% in the non-exposure group (academic education, without professional burnout, and working time in PHC for up to 5 years). The study’s findings showed a synergistic interaction of work aspects for MS occurrence among PHC nursing professionals.

Acute nephrotoxicity and neurotoxicity associated with concentrated star fruit juice consumption

Star fruit toxicity has been hugely described in patients with chronic kidney disease, either on conservative or renal replacement therapy. This is a case report of a man, without prior kidney or neurological dysfunction, who appeared to develop nephrotoxicity and neurotoxicity less than 12 hours after drinking concentrated star fruit juice (approximately 20 units of the fruit). He received timely renal replacement therapy and renal function fully recovered after discharge.

Red meat snacks for chronic hemodialysis patients: effect on inflammatory activity (a pilot study)

RATIONAL

Among the alternatives to reverse chronic hemodialysis protein-energy malnutrition is the enhancement of intradialytic oral nutritional therapy. Although foods of animal origin are a source of nutrients and represent a feasible diet, there is uncertainty about their health consequences.

OBJECTIVES

We assessed the relationship of intradialytic high-protein red meat snack supplementation with patient inflammatory status and protein losses (nitrogen) during this supplementation. Fourteen patients submitted to low-flux chronic hemodialysis for one month were divided into two groups receiving 2 g (group 1) and 29 g (group 2) of oral intradialytic protein during the initial phase, respectively. In the subsequent phase, group 1 was supplemented with 27 g protein (a red meat snack) for a total of 29 g per dialysis. Group 2 continued to receive 29 g protein. Nutritional status, total nitrogen losses through the dialysate and acute inflammatory phase protein (CRP) were assessed before and after dialysis. Reuse of the dialyzer was also determined on each occasion.

MAIN FINDINGS

Red meat supplementation did not interfere with CRP, nitrogen loss through the dialysate (18 ± 7 to 19 ± 4 g in group 1, ns, and 20 ± 7 to 21 ± 4 g in group 2, ns) or with nutritional status. However, the data showed a positive correlation between pre- and post-hemodialysis CRP values (r = 0.84, p < 0.01) in both groups, suggesting an increase of the values after ultrafiltration. Reuse of the dialyzer was not correlated with CRP values.

PRINCIPLE CONCLUSIONS

The results suggest that snacks were not acutely correlated with increased inflammatory levels and indicated that a protein-rich red meat snack may be beneficial for chronic hemodialysis patients.

Total Nitrogen and Free Amino Acid Losses and Protein Calorie Malnutrition of Hemodialysis Patients: Do They Really Matter?’

BACKGROUND/AIMS

Protein calorie malnutrition (PCM) in patients on hemodialysis (HD) is multifactorial; however, HD per se induces nutrient losses. The aim of the present study was to characterize the losses of total nitrogen (TN) and free amino acids (FAs) through the dialysate and to determine the relationship between this loss and PCM, food ingestion, and the characteristics of the hemodialyzer in patients on HD.

METHODS

In a prospective study, 21 patients submitted to low-flux HD 3 times a week were evaluated within a period of 6 months regarding nutritional status, dietary calorie and protein intake, and losses through the dialysate of TN, FA, and urea nitrogen (UN). The type, surface area and reuses (up to 12) of the dialysis membrane were determined on each occasion, and the adequacy of dialysis was estimated by Kt/V.

RESULTS

50% of the patients were considered malnourished, although the mean protein and energy intakes were similar for the malnourished and nourished patients. Mean TN losses through the dialysate were 16 g/session (60% UN). FA losses varied from 3.8 to 4.2 g/total volume. TN and FA in the dialysate did not differ significantly between malnourished and nourished patients. There was a positive correlation between membrane (polysulfone) area and TN (p <0.05) and ultrafiltrate volume and TN (p < 0.05), and a nonsignificant correlation between reuse of the dialysis membrane and TN.

CONCLUSIONS

TN and FA losses through the dialysate were similar for malnourished and non-malnourished patients on chronic HD, thus they do not act as indicators of nutritional status impairment.