Navegando por Palavras-chave "Pancreatite Crônica"
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- ItemSomente MetadadadosAspectos da endoscopia digestiva aplicados às doenças pancreáticas(Universidade Federal de São Paulo (UNIFESP), 2006) Ferrari, Angelo Paulo [UNIFESP]
- ItemSomente MetadadadosAvaliação da qualidade de vida e do estado nutricional em pacientes com Pancreatite Crônica Alcoólica.(Universidade Federal de São Paulo (UNIFESP), 2013) Beninca, Simone Carla [UNIFESP]; Libera Júnior, Ermelindo Della [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introdução: A pancreatite cronica alcoolica leva a alteracoes no estado nutricional e diminuicao da qualidade de vida. Objetivos: Avaliar a qualidade de vida dos pacientes com pancreatite cronica alcoolica comparando com um Grupo Controle sem doencas relatadas. Secundariamente avaliar o estado nutricional e composicao corporal dos pacientes, bem como comparar os escores de qualidade de vida dos pacientes com e sem diabetes e ainda correlacionar fatores clinicos, sociodemograficos e nutricionais com os escores de qualidade de vida dos pacientes com pancreatite cronica. Pacientes e metodos: Estudo prospectivo, transversal, realizado no periodo de janeiro de 2011 a maio de 2012. A avaliacao da qualidade de vida foi realizada por meio do questionario Short Form-36, versao brasileira. O estado nutricional foi avaliado por meio da antropometria e da composicao corporal. Para o Grupo Controle somente foi realizado o questionario de qualidade de vida e indagou-se sobre informacoes sociodemograficas para posterior comparacao ao Grupo Caso (pacientes). Para cada variavel estudada foi aplicado o teste estatistico pertinente. Resultados: Nao houve diferenca entre os Grupos em relacao a idade, genero e dados sociodemograficos. A qualidade de vida mostrou-se diminuida nos pacientes com pancreatite cronica quando comparada ao Grupo Controle (p<0,000). Ao avaliar o estado nutricional dos pacientes por diferentes metodos foi encontrado divergencias em relacao ao diagnostico, principalmente quando estes eram desnutridos ou eutroficos. Ja quanto a composicao corporal, ha um grande numero de pacientes com porcentagem de gordura corporal acima do ideal. Quando comparados os subgrupos de pacientes com pancreatite cronica com e sem diabetes verificou-se diferenca em relacao a tempo medio em anos de doenca, presenca de doencas associadas, uso e tempo em meses de enzimas pancreaticas e presenca de diarreia naqueles com diabetes associado. Ja ao comparar os dominios de qualidade de vida dos pacientes do Grupo Caso com e sem diabetes associado, somente o quesito capacidade funcional apresentou diferenca. Quando foi aplicada a correlacao entre os fatores clinicos, sociodemograficos e nutricionais aos oito dominios de qualidade de vida encontrou-se que o tempo de tabagismo, a quantidade de etanol em gramas e o tempo de cirurgia incidiram de maneira negativa na qualidade de vida dos pacientes com pancreatite cronica alcoolica. Ja a idade avancada, as pregas cutaneas e a porcentagem de gordura corporal se correlacionaram positivamente para a qualidade de vida. Conclusao: A qualidade de vida esta diminuida nos pacientes com pancreatite cronica alcoolica, sendo que o tempo de tabagismo, a quantidade de etanol em gramas e o tempo de cirurgia influenciaram negativamente, ja a idade mais avancada, as dobras cutaneas e a porcentagem de gordura corporal apresentaram influencia positiva. E os pacientes com diabetes associado apresentaram qualidade de vida diminuida no quesito capacidade funcional. E ainda a maioria dos pacientes encontrava-se eutroficos ou com algum grau de desnutricao dependendo do metodo de avaliacao utilizado, dessa maneira, a associacao de diferentes metodos favorece um diagnostico nutricional mais fidedigno, direcionando para a conduta nutricional mais adequada
- ItemSomente MetadadadosEvolução E Fatores Associados Ao Ângulo De Fase Em Pacientes Com Pancreatite Crônica Alcoólica(Universidade Federal de São Paulo (UNIFESP), 2017-08-31) Freitas, Angelica Rocha De [UNIFESP]; Libera, Ermelindo Della [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: Measure the values of phase angle (PA) and standardized phase angle (SPA) of patients with chronic alcoholic pancreatitis (CAP); compare the PA and SPA values of CAP patients with the PA values of control subjects; and to analyze the evolution and factors associated with the PA values of patients with PCA during the two-year follow-up period. Patients and methods: A case-control study was conducted to verify the values of phase angle (PA) and standardized phase angle (SPA) in patients with CAP, comparing these values with those of control individuals. In a second moment, a 2-year follow-up study was performed with only patients with CAP to check the progression of PA and SPA. Fifty-four male patients from the Pancreas and Biliary Pathology Outpatient Clinic of the Universidade Federal de São Paulo (UNIFESP) – Escola Paulista de Medicina (EPM), with diagnosis of chronic pancreatitis of alcoholic etiology (CAP). A total of 54 male subjects with no diagnosis of chronic diseases were included as control of the study. The patients were interviewed through a specific form to collect data related to the disease, gastrointestinal alterations, alimentary alterations, eating habits, smoking habits and / or alcoholism, nutritional status prior to the disease, and anthropometric and body composition evaluation. In relation to the evaluation of the nutritional status, the current weight (kg) was evaluated and its stature measured in meters. With the data of weight and height, the Body Mass Index (BMI) was calculated. The evaluation of patients with chronic alcoholic pancreatitis (CAP) was performed in 3 moments. The evaluation of control subjects was unique, in a transversal way. The evaluation of the body composition in patients and controls was done by means of an electric bioimpedance apparatus (BIA), of the brand Biodynamics® model 450. For the interpretation of the value of the phase angle (AF) obtained by the BIA examination, the standardized phase angle (SPA) was used. The analysis of the data was descriptive and with inferential tests, using the SPSS (IBM) Statistical Program 22.0, considering the significance level of 5%. Results: The median PA value was 6.2º in the CAP group and 7.3º in the control group. Lower PA value was found in the CAP group [6.09º (1.10) x 7.27º (0.85), p <0.001]. This result was also observed for the mean SPA value [-1.57 (1.22) x -0.12 (0.83), p <0.001]. When the mean values of PA and standardized phase angle (SPA) were observed in all the evaluations performed with the patients, there was stability in the values throughout the follow-up (p = 0.196). Such stability also occurred for normal and reduced scores for SPA values (p=0.766). When the groups were divided according to the median value of PA (less than the median and greater than or equal to the median), it was observed in the first evaluation that the mean age (years) was higher in the group with PA less than 6,2º [53.5 (9.51) x 46.89 (9.31), p=0.013]. Also, a higher prevalence of associated diabetes (AD) was observed in the group with PA less than 6.2º [69.2% (18) x 28.6% (8), p=0.003]. In the second evaluation, there was in the group with PA lower than 6.45º [53.45 (9.24) x 46.77 (8.29), p = 0.016]. There was also a higher prevalence of AD [68.2% (15) x 27.3% (6), p = 0.007], a higher prevalence of pancreatic enzyme use in the group with AF <6.45º, 9% (20) x 45.5% (10), p=0.001], and a higher prevalence of clinical history of diarrhea [50% (11) x 18.2% (4), p=0.026]. When comparing the groups in relation to the SPA classification, in the first evaluation, the highest prevalence of current smoking was observed in the group of patients withreduced SPA (77.8% (14) x 50% (18), x 19.4% (7), p=0.050], AD [72.2% (13) x 36.1% (13), p=0.012], clinical history of diarrhea 0.007] and clinical history of steatorrhea [38.9% (7) x 11.1% (4), p=0.017]. Still, the group with reduced SPA values presented a higher mean number of bowel movements per day compared to the group with normal SPA values [4.0 (4.96) x 2.0 (1.1), p=0.014]. In the second evaluation, higher prevalences were observed in the group with reduced values for SPA, of current smoking [91.7% (11) x 48.5% (16), p=0.009], use of the pancreatic enzyme [7% (11) x 60.6% (20), p=0.047], clinical history of diarrhea [66.7% (8) x 21.2% (7), p=0.004], and clinical history of steatorrhea [50% (6) x 9.1% (3), p=0.002]. In the third evaluation, higher prevalences of clinical history of diarrhea were found for the group with reduced values for SPA [66.7% (8) x 20.7% (6), p=0.005], and clinical history of steatorrhea [50% (6) x 6.9% (2), p=0.002]. Also, for this same group, a higher mean of daily bowel movements [3.50 (2.43) x 1.83 (1.04), p=0.039]. Conclusion: Patients with CAP had a median value of 6.2º to 6.45º degrees for PA and a mean value of 6.09º to 6.1º. For SPA, they presented values of -1.57 to -1.02 standard deviations from the reference values for healthy men. Mean PA and SPA values were significantly lower in patients with CAP compared to control subjects. The PA and SPA of patients with CAP remained stable during the two-year follow-up period. Age (years), smoking, presence of diabetes mellitus, use of pancreatic enzymes as replacement therapy, presence of diarrhea, presence of steatorrhea and number of bowel movements per day were clinical and nutritional factors associated with PA and SPA in patients with CAP.