Hugo da Costa Ribeiro - Academia.edu (original) (raw)

Papers by Hugo da Costa Ribeiro

Nutrition Research Reviews

The NOVA classification of food items has become increasingly popular and is being used in severa... more The NOVA classification of food items has become increasingly popular and is being used in several observational studies as well as in nutritional guidelines and recommendations. We propose that there is a need for this classification and its use in the formulation of public health policies to be critically discussed and re-appraised. The terms ‘processing’ and ‘ultra-processing’, which are crucial to the NOVA classification, are ill-defined, as no scientific, measurable or precise reference parameters exist for them. Likewise, the theoretical grounds of the NOVA classification are unclear and inaccurate. Overall, the NOVA classification conflicts with the classic, evidence-based evaluation of foods based on composition and portion size because NOVA postulates that the food itself (or how much of it is eaten) is unimportant, but rather that dietary effects are due to how the food is produced. We contend that the NOVA system suffers from a lack of biological plausibility so the asser...

Nutrition journal, Jan 9, 2005

In order to assess the effects of juice feedings during acute diarrhea a double-blind, randomized... more In order to assess the effects of juice feedings during acute diarrhea a double-blind, randomized study was performed in 90 children, mean age of 10 +/- 4.28 months. Thirty patients with acute diarrhea were fed twice-daily 15 ml/kg of Apple Juice (AJ), 30 received White Grape Juice (WGJ), and 30 were given colored and flavored water (WA) as part of their age appropriate dietary intake. The duration and severity of diarrhea were the main endpoint variables of the study performed in a metabolic unit. The patients were similar among the 3 groups, had diarrhea for 50-64 hours prior to admission, and were dehydrated when admitted to the unit for study. Half of the patients in each group were well nourished and the others had mild to moderate degrees of malnutrition. Rotavirus infection was the agent causing the illness in 63% of the patients. The infants fed juice ingested 14-17% more calories than those given WA, (those receiving AJ and WGJ ingested 95 and 98 Calories/Kg/d respectively)...

Revista Paulista de Pediatria, 2007

The Journal of Pediatrics, 1991

Twenty male infants less than I year of age with acute diarrhea and dehydration were randomly ass... more Twenty male infants less than I year of age with acute diarrhea and dehydration were randomly assigned to a study group and studied in blind fashion in a metabolic unit to assess the efficacy of the addition of 30 mmol/L alanine to the standard World Health Organization (WHO) oral rehydration solution (ORS). Patients were exclusively rehydrated with one of two types of ORS during the first 24 hours of treatment. On the second day, oral feedings were started with a lactose-free formula, and ORS was given to replace stool losses. Body weight, ORS, food intake, vomitus, stool, and urine output were recorded at 6-hour intervals. Blood was drawn at the time of admission, after rehydration, and at 24 and 48 hours of hospitalization to monitor blood gases and electrolytes. Rehydration was satisfactory in both groups of patients. ORS that contained alanine did not reduce the purging rates of the infants compared with those who received standard ORS. Clinically no adverse effect of the alanlne-based ORS was observed during hospitalization. None of the patients had significant hypernatremia or hyponatremia, and serum amino acid levels were not altered. These data show that the addition of 30 mmol/L alanine to the standard WHO-ORS produces no further improvement in the outcome of the infants with acute diarrhea compared with those fed the standard WHO-ORS.

Journal of Pediatric Gastroenterology and Nutrition, 2003

Background: Recent studies have shown that probiotics, most commonly Lactobacillus GG, may be use... more Background: Recent studies have shown that probiotics, most commonly Lactobacillus GG, may be useful in treating acute gastroenteritis. However, beneficial effects appear to be limited to a modest decrease in the duration of diarrhea. No studies have evaluated this therapy in moderate to severe dehydrating diarrhea in a metabolic facility. Methods: Male children less than 2 years of age were admitted to a metabolic unit of the Department of Pediatrics at the Federal University of Bahia, Brazil, with moderate dehydration and were randomized in a double-blind, placebo-controlled fashion. Oral rehydration solution (ORS) was administered per protocol and either placebo or Lactobacillus GG was given in combination with the ORS. Output of urine, stool, and vomitus was recorded along with stool weight, nude body weight, and standard laboratory assessments for hydration. Results: There was no significant reduction in diarrhea duration and stool output in the Lactobacillus GG group. However, Kaplan-Meier survival analysis demonstrated that, even in moderate to severe diarrhea, resolution of the illness occurred so rapidly, that statistically significant benefits of probiotic therapy could not be demonstrated. Conclusion: Our data implies that colonization must occur before benefits of probiotics can be realized. Probiotics are, therefore, likely to be of limited benefit in treating diarrheal illnesses of short duration such as viral enteritis. The beneficial effects of probiotics may be limited to prophylactic usage in high-risk populations.

Journal of Pediatric Gastroenterology and Nutrition, 2004

International Journal of Epidemiology, 2008

Objective To identify factors associated with diarrhoea occurrence in children in a city in a mid... more Objective To identify factors associated with diarrhoea occurrence in children in a city in a middle-income country, with high access to water and sanitation. Methods A case-control study in the city of Salvador, northeastern Brazil was conducted from November 2002 to August 2004. The study population consisted of children presenting at a health facility. A total of 1688 cases of diarrhoea and 1676 controls were selected. Data collection was by a questionnaire and structured observation during home visits. The explanatory variables were grouped according to a conceptual model defined previously. Analysis was done using a hierarchical approach, to provide a more dynamic view of the transmission characteristics of childhood diarrhoea. Nonconditional logistic regression was used, and odds ratio and population-attributable fractions were estimated. Results Socioeconomic factors contributed most to determining diarrhoea occurrence, followed by interpersonal contact, while factors related to food preparation, the environment and water and sanitation made a smaller contribution. Conclusion The findings indicate that the transmission of diarrhoea is influenced by factors from all hierarchical levels, with interpersonal transmission playing a relatively higher role than previously thought. This is compatible with a predominance of viruses and other agents spread by interpersonal routes including Shigella, Giardia and Cryptosporidium. Diarrhoea control strategies in similar settings (middle-income countries in which a large proportion of the population has access to water and sanitation) must give greater emphasis to policies geared towards reducing person-toperson transmission for the prevention of diarrhoea.

Gastroenterology, 1987

Jejunal volume (@cm) 45 e 30 64 2 3 Small intestine length [cm) 50 * 30 66 2 3 PEM, protein-energ... more Jejunal volume (@cm) 45 e 30 64 2 3 Small intestine length [cm) 50 * 30 66 2 3 PEM, protein-energy malnutrition; WN, well-nourished. n = 4 rats/group. Values are mean f SEM. ' p < 0.05 by unpaired t-test vs. well-nourished rats. b p < 0.01 by unpaired t-test vs. wellnourished rats.

Human parechoviruses (HPeVs) were detected by reverse transcription–PCR in 16.1 % of 335 stool sa... more Human parechoviruses (HPeVs) were detected by reverse transcription–PCR in 16.1 % of 335 stool samples from children <6 years of age with enteritis in Salvador, Brazil. Whole genome sequencing of 1 sample showed a novel HPeV that has been designated as HPeV8. The human parechovirus (HPeV) species are small, nonenveloped RNA viruses that belong to the highly diversified family Picornaviridae (1). HPeV types 1 and 2 had been known as echoviruses 22 and 23 within the genus Enterovirus but were recognized in the early 1990s as an independent genus (2). Recognition of clinical relevance is increasing after 4 novel types were more recently described (3–7). Seroprevalence studies from different countries indicate that almost the entire human adult population is infected. Predominantly in infants, HPeVs can cause a variety of clinical symptoms, including diarrhea, and respiratory infection (8,9). Recent data point toward substantial involvement in severe conditions, such as meningitis an...

Annals of Laboratory Medicine, 2020

Background: Giardia duodenalis is conventionally diagnosed in fecal samples using parasitological... more Background: Giardia duodenalis is conventionally diagnosed in fecal samples using parasitological methods. However, sensitivity is poor when only a single sample is analyzed, due to intermittent excretion of cysts in feces. Alternatively, the serum antibodies to G. duodenalis can be used for parasite diagnosis and epidemiological studies to determine previous exposure. We compared the rate of G. duodenalis infection between serum anti-Giardia IgG and IgA antibodies and fecal examination in Brazilian children. Methods: Fecal and serum samples were tested from 287 children at a clinical laboratory and from 187 children at daycare centers. Fecal samples were processed using conventional parasitological methods and coproantigen detection for Giardia diagnosis. Serum samples were tested using an in-house ELISA for detection of anti-Giardia IgG and IgA. Results: G. duodenalis was found in 8.2% (N = 39) of the 474 children analyzed. The sensitivity and specificity of ELISA were 80.0% and 90.0% for IgG and 80.0% and 83.3% for IgA, respectively. The total positivity rate of anti-Giardia IgG and IgA in the sera was 13.9% (N = 66) and 23.6% (N = 112). The agreement between the positivity of specific antibodies and the detection of G. duodenalis in feces was moderate for ELISA-IgG, kappa index (95% CI) = 0.543 (0.422-0.664), and mild for ELISA-IgA, kappa index (95% CI) = 0.283 (0.162-0.404). Among the children infected with other enteroparasites, 11.6% (N = 10) and 24.4% (N = 21) showed reactivity to anti-Giardia IgG and to IgA, respectively. This cross-reactivity was more frequent in samples from children infected with Endolimax nana and Entamoeba coli. Conclusions: The higher frequency of specific antibody reactivity compared with G. duodenalis diagnosis in feces could reflect continuous exposure of children to G. duodenalis infection, resulting in long-lasting immunological memory and/or cross-reactivity with other intestinal amoebas.

Biomédica, 2016

Introducción. El diagnóstico de infecciones parasitarias intestinales depende de la carga de pará... more Introducción. El diagnóstico de infecciones parasitarias intestinales depende de la carga de parásitos, la densidad de la gravedad específica de los huevos, ooquistes o quistes de parásitos, y de la densidad y viscosidad de los reactivos de flotación o sedimentación usados para procesar las heces.Objetivo. Evaluar la concordancia entre el método de flotación de sulfato de zinc y la sedimentación por centrifugación en la recuperación de parásitos en muestras fecales de niños.Materiales y métodos. Se evaluaron las muestras fecales de 330 niños de guarderías mediante las técnicas de flotación con sulfato de zinc y de sedimentación por centrifugación. Se determinó la frecuencia de detección de parásitos con cada método y se evaluó la concordancia entre las técnicas de diagnóstico mediante el índice kappa, con intervalos de confianza del 95 %.Resultados. Mediante la flotación fecal con sulfato de zinc, se diagnosticó un número significativamente mayor de casos de infección por Trichuris ...

Revista Acreditacao, Jan 11, 2013

RESUMO: Trata-se de um estudo de caso para descrever os resultados tangíveis e intangíveis, desde... more RESUMO: Trata-se de um estudo de caso para descrever os resultados tangíveis e intangíveis, desde o início do processo da acreditação hospitalar pela Joint Commission International (JCI), em um Hospital de Ensino da cidade de Salvador, Bahia. A instituição é pública, de ensino, caracterizada por serviços de alta complexidade e vem atuando com o processo de acreditação, desde agosto de 2009, em parceria com o Hospital Alemão Oswaldo Cruz. Os resultados apresentados indicam aspectos objetivos e subjetivos do processo. A instituição, ainda, não apresenta dados, de maneira uniforme, da influência do processo da Acreditação. Entretanto é "visível o movimento", a motivação dos agentes, profissionais, professores e estudantes, frente ao processo. Vale ressaltar que os aspectos intangíveis trazem mudanças de hábitos, valores e de comportamentos, impondo ritmos de trabalho diferentes pautados em ferramentas de qualidade e no cumprimento de padrões.

Revista Acreditacao, Nov 27, 2013

O presente trabalho propoe-se acaracterizar a qualidade em assistencia nutricional de um hospital... more O presente trabalho propoe-se acaracterizar a qualidade em assistencia nutricional de um hospitaluniversitario, atraves da descricao de indicadores de qualidade. Trata-se deuma coorte retrospectiva. A amostra foi composta por adultos e idososhospitalizados em um hospital universitario, entre marco e agosto de 2012.Foram utilizados dados secundarios. Foi elaborado um questionariosemiestruturado para a coleta de dados sobre a assistencia nutricional ecalculados indicadores de qualidade (Frequencias de: realizacao de triagemnutricional, orientacao nutricional na alta hospitalar, episodios de diarreia etempo de jejum inadequado). Realizou-se analise descritiva atraves defrequencias para as variaveis categoricas, e mediana com intervalo interquartilpara as variaveis continuas. Observou-se que 65,1% dos pacientes estavam emrisco nutricional (n=1001). Na parcela de pacientes em uso de nutricao enteral(n=77), 57,2% tinham algum grau de desnutricao. Embora os indicadores dequalidade descritos nao tenham alcancado suas metas, a maioria ficou proximadessas. A desnutricao hospitalar permanece como um problema a ser enfrentado nopais. Os indicadores de qualidade descritos evidenciam que o servico avaliadoesta proximo das metas estabelecidas pela literatura, contribuindo na identificacaoprecoce e melhor assistencia aos individuos em risco nutricional.

Revista Baiana Saúde Pública, 2015

Introduction: In a hospital organization, especially in university hospitals, health professional... more Introduction: In a hospital organization, especially in university hospitals, health professionals provide education for patients and families, guiding them to participate more effectively care and make informed decisions. The objective of this study was to describe the implementation of a program of education of patients and families in a public hospital in the city of Salvador Bahia. Initially we created a multidisciplinary group and the innovative work of the instrument was printed multidisciplinary education of patients and family. Method: Reporting of experience. Results: We used regular meetings, conducting pilot tests, audits, itinerant training, campaigns, educational lectures, preparation and distribution of brochures, film screenings and theater performances with information about the patient safety process. Conclusion: The change in organizational culture in the public health service, for the importance of educational activities, provides less risk and greater safety, guided by the best interaction of the multidisciplinary team with the patient and their family, making them active participants in the care process.

Nutrire, 2015

Objective: To discuss the newborns risk factors according to the gestational age emphasizing the ... more Objective: To discuss the newborns risk factors according to the gestational age emphasizing the maternal and prenatal characteristics. Data Source: We conducted a critical literature review using Medline, Lilacs, Scielo and national and international health committee; the articles were published between 1992 and 2012. The following descriptors were used as search criteria: risk factors, low birth weight, maternal age, and prenatal care. We included publications in Portuguese and English with primary data performed in patients hospitalized or treated in outpatient clinics. The literature search, according to the established strategy, resulted in 50 articles, 10 in MEDLINE, 10 in Lilacs and 30 in Scielo base. However, some were excluded: repeated studies in different databases (08) and those not found in its entirety (05). In Total, 37 articles, 03 textbooks, 01 dissertation and 10 publications were selected by the national and international health committee for this review. Data Synthesis: The influence of risk factors on newborns mortality such as low birth weight and the presence of complications during pregnancy and childbirth, is widely described in the literature. However, there is a complex network involving these factors, combining maternal and newborn characteristics. Conclusion: The findings of this study indicated as major factors, cesarean delivery, prenatal care frequency, maternal education, maternal age, newborn female gender and newborn black ethnicity.

Journal of the American College of Nutrition, 2015

This study identifies the risk factors for extreme weight-control behaviors among adolescents in ... more This study identifies the risk factors for extreme weight-control behaviors among adolescents in public school in Salvador, northeastern Brazil. A case-control study nested to a cross-sectional study, including 252 adolescents of both sexes, age between 11 to 17 years, with 84 cases and 168 age-matched controls was conducted. The variable outcome is represented by extreme weight-control behaviors, integrated by following the variables: self-induced vomiting and the use of laxatives, diuretics, or diet pills. Covariables included body image dissatisfaction, dieting, prolonged fasting, and self-perception of body weight. The study also investigated the demographic and anthropometric variables and economic conditions of the students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; families. Conditional logistic regression was used to identify risk factors for the adoption of extreme weight-control behaviors among adolescents. Among the adolescents investigated, the conditional logistic regression explained 22% the occurrence of extreme weight-control behaviors and showed that these behaviors were positively associated to overweight (odds ratio [OR] = 3.61; 95% confidence interval [CI], 1.42-9.17), body image dissatisfaction (OR = 3.87; 95% CI, 1.75-8.54), and the adoption of a restrictive diet (OR = 2.83; 95% CI, 1.16-6.91). The results of this study suggest that among adolescents, overweight, body image dissatisfaction, and restrictive diet are important risk factors to adoption of extreme weight-control behaviors.

Clinical Medicine Insights: Pediatrics, 2015

Objective The aim of the current study was to evaluate the safety of a new reduced protein (2.1 g... more Objective The aim of the current study was to evaluate the safety of a new reduced protein (2.1 g/100 kcal) infant formula containing 4 g/L of 90% galacto-oligosaccharides (GOS) and 10% fructo-oligosaccharides (FOS). Methods Healthy term infants from Brazil were enrolled. Those born to human immunodeficiency virus (HIV)-positive mothers were randomized to a test ( n = 65) or control ( n = 63) formula group. Infants born to HIV-negative mothers were either exclusively breast-fed ( n = 79) or received a mixed diet (breast milk and test formula, n = 65). Between 2 weeks and 4 months of age, infants were exclusively fed according to their assigned group. Anthropometric measurements were taken at baseline, 1, 2, 3, 4, 6, 8, 10, and 12 months. Digestive tolerance was evaluated during the first 4 months. The primary outcome was mean daily weight gain between 2 weeks and 4 months in the test formula and breast-fed groups. Results Data from all infants ( N = 272) were used in the intention-t...

Jornal Brasileiro de Pneumologia, 2014

OBJECTIVE: To describe lung function findings in overweight children and adolescents without resp... more OBJECTIVE: To describe lung function findings in overweight children and adolescents without respiratory disease. METHODS: This was a cross-sectional study involving male and female overweight children and adolescents in the 8-18 year age bracket, without respiratory disease. All of the participants underwent anthropometric assessment, chest X-ray, pulse oximetry, spirometry, and lung volume measurements. Individuals with respiratory disease were excluded, as were those who were smokers, those with abnormal chest X-rays, and those with an SpO2 = 92%. Waist circumference was measured in centimeters. The body mass index-for-age Z score for boys and girls was used in order to classify the individuals as overweight, obese, or severely obese. Lung function variables were expressed in percentage of the predicted value and were correlated with the anthropometric indices. RESULTS: We included 59 individuals (30 males and 29 females). The mean age was 11.7 ± 2.7 years. Lung function was norm...

Nutrición hospitalaria

To identify the prevalence of body image dissatisfaction and associated factors among students in... more To identify the prevalence of body image dissatisfaction and associated factors among students in Salvador, Brazil. A cross-sectional study involving a random sample of 1,494 (852 girls and 642 boys) adolescents between 11 and 17 years of age who were students in the public schools in Salvador, Brazil. Participants completed the Body Shape Questionnaire and the Eating Attitudes Test-26. Body image was characterized as satisfactory or unsatisfactory. We obtained demographic, anthropometric and economic information and information regarding the stage of maturation, self-perception of body weight, and consumption of sweetened beverages and diet soft drinks. To identify associated factors we used Poisson regression analysis. Body image dissatisfaction was present in 19.5% of the adolescents, with a prevalence of 26.6% among the girls and 10% among the boys. Independent of sex, the prevalence of body image dissatisfaction was higher among adolescents who were overweight or obese (girls, ...