Le HAART as part of the National STD/AIDS Program and

Le HAART as part of the National STD/AIDS Program and is recognized worldwide for operating at the forefront on AIDS [8]. HAART sustainably suppresses viral replication, allowing recovery of the immune system. As a consequence, AIDS-associated mortality and morbidity declined after the widespread introduction of HAART [9] andMalnutrition in Patients Hospitalized with AIDSmortality rates for HIV-infected individuals with high CD4 cell counts and HAART use are similar to the general population [10]. Most of the nutritional concerns in AIDS care in countries where HAART is widely available are now related to metabolic alterations associated with HAART, which predispose patients to cardiovascular [11] and other chronic complications [12,13]. However, even in the HAART era, weight loss and malnutrition remain common problems for certain HIV infected subgroups, such as those diagnosed late in the course of the infection and those with failed or non-adherent antiretroviral regimens [14]. To draw attention to the importance of proper nutritional care for such vulnerable patients, we aimed to quantify the prevalence of malnutrition in patients with AIDS consecutively admitted at the reference hospital for infectious diseases in Salvador, Brazil and to investigate patient characteristics associated with malnutrition at hospital admission.Nutritional EvaluationPrior to study initiation, the study team was trained to standardize the anthropometric exam. We evaluated nutritional status during the first week of hospitalization. For patients that were not restricted to bed, we directly measured weight in kilograms using a calibrated portable digital balance (Filizola; Sao Paulo, Brazil) with capacity up to 150 kg and precision of 100 g and we directly measured height 18055761 in centimeters using a 205 cm stadiometer (Seca Leicester; Hamburg, Germany). We also measured mid-upper arm circumference and tricipital skinfold of the non-dominant arm, JSI-124 site according to the procedures described by Lohman et al. [18]. For bed-restricted patients, we obtained knee height, calf circumference, and non-dominant subscapular skinfold and mid-upper arm circumference measurements as previously described [19,20] and we MedChemExpress ZK-36374 estimated weight and height using the formulas of Chumlea et al. [20,21]. In addition, we measured tricipital skinfold of the non-dominant arm, according to previously described procedures [19]. To measure circumferences, skinfold thickness and knee height, we used an inelastic measuring tape of 1 mm precision, adipometer skinfold calipers (Lange Beta Technology Inc.; Santa Cruz, CA, USA) and an anthropometer (Fami Ita Products; Sao ? Caetano do Sul, Brazil), respectively. We measured skinfold thickness in duplicate from which we calculated a mean skinfold thickness. When the difference between the observed skinfold thickness was greater than 1 mm, we performed a third measurement and calculated the mean between the two closest measurements. We calculated body mass index (BMI) by dividing patient weight in kilograms by the square of patient height in meters and we applied the World Health Organization criteria of BMI ,18.5 kg/m2 to classify patients as malnourished [22]. We estimated the percentage of body weight loss based on the weight at hospital admission and the patient’s self-reported weight of six months prior to this hospitalization. The mid-upper arm circumference and the tricipital skinfold thickness were used to calculate the mid-upper arm muscle area wi.Le HAART as part of the National STD/AIDS Program and is recognized worldwide for operating at the forefront on AIDS [8]. HAART sustainably suppresses viral replication, allowing recovery of the immune system. As a consequence, AIDS-associated mortality and morbidity declined after the widespread introduction of HAART [9] andMalnutrition in Patients Hospitalized with AIDSmortality rates for HIV-infected individuals with high CD4 cell counts and HAART use are similar to the general population [10]. Most of the nutritional concerns in AIDS care in countries where HAART is widely available are now related to metabolic alterations associated with HAART, which predispose patients to cardiovascular [11] and other chronic complications [12,13]. However, even in the HAART era, weight loss and malnutrition remain common problems for certain HIV infected subgroups, such as those diagnosed late in the course of the infection and those with failed or non-adherent antiretroviral regimens [14]. To draw attention to the importance of proper nutritional care for such vulnerable patients, we aimed to quantify the prevalence of malnutrition in patients with AIDS consecutively admitted at the reference hospital for infectious diseases in Salvador, Brazil and to investigate patient characteristics associated with malnutrition at hospital admission.Nutritional EvaluationPrior to study initiation, the study team was trained to standardize the anthropometric exam. We evaluated nutritional status during the first week of hospitalization. For patients that were not restricted to bed, we directly measured weight in kilograms using a calibrated portable digital balance (Filizola; Sao Paulo, Brazil) with capacity up to 150 kg and precision of 100 g and we directly measured height 18055761 in centimeters using a 205 cm stadiometer (Seca Leicester; Hamburg, Germany). We also measured mid-upper arm circumference and tricipital skinfold of the non-dominant arm, according to the procedures described by Lohman et al. [18]. For bed-restricted patients, we obtained knee height, calf circumference, and non-dominant subscapular skinfold and mid-upper arm circumference measurements as previously described [19,20] and we estimated weight and height using the formulas of Chumlea et al. [20,21]. In addition, we measured tricipital skinfold of the non-dominant arm, according to previously described procedures [19]. To measure circumferences, skinfold thickness and knee height, we used an inelastic measuring tape of 1 mm precision, adipometer skinfold calipers (Lange Beta Technology Inc.; Santa Cruz, CA, USA) and an anthropometer (Fami Ita Products; Sao ? Caetano do Sul, Brazil), respectively. We measured skinfold thickness in duplicate from which we calculated a mean skinfold thickness. When the difference between the observed skinfold thickness was greater than 1 mm, we performed a third measurement and calculated the mean between the two closest measurements. We calculated body mass index (BMI) by dividing patient weight in kilograms by the square of patient height in meters and we applied the World Health Organization criteria of BMI ,18.5 kg/m2 to classify patients as malnourished [22]. We estimated the percentage of body weight loss based on the weight at hospital admission and the patient’s self-reported weight of six months prior to this hospitalization. The mid-upper arm circumference and the tricipital skinfold thickness were used to calculate the mid-upper arm muscle area wi.

Leave a Reply