Gastrocirurgia de Brasília

Clinical practice recommendations for macronutrient intake in Metabolic and Bariatric Surgery (MBS) are insufficiently grounded in the research, possibly due to a paucity of research in key areas necessary to support macronutrient recommendations. An initial scoping review, prior to any systematic review, was determined to be vital. To identify topical areas in macronutrients and MBS with a sufficient evidence base to guide nutrition recommendations. PubMed, Cochrane, Ovid Medline, and Embase were initially searched in January 2019 (updated November 1, 2023) with terms encompassing current bariatric surgeries and macronutrients. Out of 757 records identified, 98 were included. A template was created. Five types of outcomes were identified for extraction: dietary intake, anthropometrics, adverse symptoms, health, and metabolic outcomes. All stages of screening and extraction were conducted independently by at least two authors and disagreements were resolved via team discussion. Macronutrient-related dietary treatments were classified as either innovative or standard of care. Descriptions of dietary arms were extracted in detail for a qualitatively generated typology of dietary or nutritional treatments. Heatmaps (treatments by outcomes) were produced to identify promising topics for further systematic analyses. We identified protein supplementation and "food-focused" (e.g., portion-controlled meals, particular foods in the diet, etc.) topical areas in MBS nutrition care with potentially sufficient evidence to create specific MBS Macronutrients guidelines and identified topical areas with little research. Clinical practice regarding macronutrient intake remains guided by consensus and indirect evidence. We detail ways that leadership at the profession level may remedy this.

Introduction: Intrauterine Growth Restriction is defined as the inability of the fetus to reach its growth potential and can be caused by maternal, placental and fetal factors. Objective: The study aims to make a major social contribution, in order to help the health sectors develop actions aimed at improving the quality of life of pregnant women, promoting changes in behaviors that are harmful to the fetus and thus contributing to reducing infant morbidity and mortality. Methodology: A bibliographic survey was carried out in the Scielo, PubMed and VHL databases, between 2010-2020, with the descriptors and their combinations in Portuguese and English, using the Boolean operators: "fetal growth retardation" OR "intrauterine growth retardation" OR "intrauterine growth restriction" AND "risk factors" AND "intrauterine growth restriction" AND "Brazil". After applying inclusion and exclusion criteria, 10 articles were selected. Results: Analysis of the articles showed that Intrauterine Growth Restriction is strictly related to five themes: evolution in prenatal treatment; socioeconomic factor; low birth weight; fetal mortality and serum leptin concentration, eclampsia and HIV. Conclusion: The analyses available on the main categories related to IUGR showed that lack of prenatal care, poor socioeconomic situation, low leptin concentration during pregnancy, pre-eclampsia and viral infections such as HIV are risk factors for IUGR in Brazil.

Clinical treatment of vascular disease holds several pathologies and their risk factors. The most important are arterial obstructive disease, aortic aneurysm, and acute aortic syndrome.

In bariatric surgery patients, weight loss and long-term weight maintenance are related to food intake and eating patterns. To improve the diet orientation in the bariatric surgery postoperative period, we assessed the postoperative eating patterns and related them to weight loss. This was a transversal, analytical, and descriptive study that assessed body mass index (BMI) values and percentage of excess weight loss (%EWL) in patients who had undergone Roux-en-Y gastric bypass (RYGBP) surgery. The eating pattern and energy intake were investigated based on data collected through a 4-day food intake record. From these records, we assessed the number of daily meals, the quantity of food per meal, and calorie value of snacks between main meals. Based on these records, patients were classified under sweet-eating, snack-eating, or normal-eating patterns. Seventy-five patients met our inclusion criteria. The normal-eating pattern group was the one with the greatest weight loss with an average %EWL of 71.4 +/- 21%, followed by the sweet-eating pattern with 69.9 +/- 16.8%, and the snack-eating pattern with 56.4 +/- 16.7%. This difference was significant only between the first and the third group (p = 0.04). The snack-eating patients had the highest caloric intake and highest number of daily meals (p < 0.01). Postoperative eating pattern influenced postbariatric surgery weight loss. In the present study, the snack-eating pattern was associated with the worst weight loss outcome, followed by the sweet-eating and normal-eating patterns. A screening and a differential approach to patients according to their eating patterns may lead to better results of weight loss.