Navegando por Autor "Medeiros, Galtieri Otávio Cunha de"
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Artigo Agreement between software programmes of body composition analyses on abdominal computed tomography scans of obese adults(Endocrinology and Metabolism, 2020) Fayh, Ana Paula Trussardi; Barbalho, Erica Roberta; Rocha, Ilanna Marques Gomes da; Medeiros, Galtieri Otávio Cunha de; Friedman, RogerioObjective: A large number of studies have used abdominal computed tomography (CT) to quantify body composition, and different software programmes have been used to perform these analyses. Thus, this comparison is important to enable researchers to know the performance of more accessible software. Subjects and methods: Fifty-four abdominal CT scans of obese (BMI 30 to 39.9 kg/m²), sedentary adults (24-41 years) patients from a Brazilian single center were selected. Two software programs were compared: Slice-O-Matic (Tomovision, Canada) version 5.0 and OsiriX version 5.8.5. The body composition analysis were segmented using standard Hounsfield unit (HU) (adipose tissue: -190 to +30 and skeletal muscle: -29 to +150) and measured at the mid third lumbar vertebra (L3) level on a slice showing both transversal processes. Bland-Altman limits of agreement analyses were used to assess the level of agreement between Slice-O-Matic and OsiriX. Results: A total of fifty four participants were evaluated, with majority women (69%), mean of age 31.3 (SD 6.5) years and obesity grade I most prevalent (74.1%). The agreement, in Bland-Altman analysis, between Slice O-Matic and OsiriX analisys for the muscle mass tissue, visceral adipose tissue and subcutaneous adipose tissue were excellent (≥ 0.954) with P-values < 0.001. Conclusion: These findings show that Slice-O-Matic and OsiriX softwares agreement in measurements of skeletal muscle and adipose tissue and sarcopenia diagnosis in obese patients, suggesting good applicability in studies with body composition in this population and clinical practiceDissertação Avaliação das características musculares por imagem de tomografia computadorizada: comparação entre sítios anatômicos(Universidade Federal do Rio Grande do Norte, 2022-04-18) Medeiros, Galtieri Otávio Cunha de; Fayh, Ana Paula Trussardi; https://orcid.org/0000-0002-9130-9630; http://lattes.cnpq.br/0049770583345803; https://orcid.org/0000-0002-8672-0126; http://lattes.cnpq.br/3222483691715896; Chagas Neto, Francisco Abaete das; https://orcid.org/0000-0002-6987-2072; http://lattes.cnpq.br/2190318238622076; Carvalheira, José Barreto CampelloEstudos que avaliam a baixa massa muscular (ou sarcopenia) por imagens de tomografia computadorizada (TC) frequentemente avaliam a terceira vértebra lombar (L3). No entanto, os músculos apendiculares dos membros inferiores estão mais envolvidos no equilíbrio, função física, locomoção e atividades diárias. Este estudo teve como objetivo comparar a avaliação da área muscular esquelética (AME em cm²), índice muscular esquelético (IME em cm²/m²) e a densidade muscular esquelética (DME em UH) entre os marcos da terceira vértebra lombar (L3) e da coxa, e a concordância no diagnóstico de baixa massa muscular e baixa DME (L3 como método de referência). Este foi um estudo transversal multicêntrico, incluindo indivíduos saudáveis (≥ 18 anos) de ambos os sexos, que fizeram o exame de tomografia eletiva, incluindo regiões abdominais e pélvicas. Foram analisadas imagens de tomografia computadorizada para avaliação de AME, IME e DME. Anormalidades musculares (baixo AME, IME e DME) foram definidas como valores abaixo do 5º percentil de uma subamostra de jovens saudáveis (n=111; 18-39 anos; 55,9% do sexo feminino). Coeficientes de correlação, gráficos Bland-Altman e curvas ROC (receiver operating characteristic) foram calculados para a amostra total e estratificados por sexo e idade. Foram avaliados 268 indivíduos (44,3 ± 15,2 anos) (53% do sexo feminino). Foram observadas correlações significativas (p <0,001 para todas as análises) e fortes correlações entre AME (rho = 0,896), IME (rho = 0,853) e DME (rho = 0,864) em relação à L3 e aos marcos das coxas. Para as curvas ROC, foram obtidos valores similares de AUC para homens (0,981), feminino (0,895), mais jovens (0,902) e idosos (0,894). As características musculares entre os marcos L3 e a coxa têm uma forte correlação. Isso sugere que imagens da coxa podem ser usadas para caracterizar características musculares. A aquisição e análise de imagem da região da coxa é mais simples, com menor exposição à radiação e, consequentemente, mais adequada para análise longitudinal.Artigo Comparative assessment of abdominal and thigh muscle characteristics using CT-derived images(Nutrition, 2022-07) Fayh, Ana Paula Trussardi; Medeiros, Galtieri Otávio Cunha de; Sousa, Iasmin Matias de; Chaves, Gabriela Villaça; Gonzalez, Maria Cristina; Prado, Carla M.Objectives: The aim of this study was to compare the assessment of skeletal muscle area (SMA in cm2 ), skeletal muscle index (SMI in cm2 /m2 ), and skeletal muscle density (SMD in HU) between third lumbar vertebra (L3) and thigh landmarks, and the agreement in diagnosing low muscle mass and low SMD (L3 as the reference method). Methods: This was a multicenter, cross-sectional study including healthy individuals (18 y of age) of both sexes, who had an elective computed tomography exam including abdominal and pelvic regions. Computed tomography images were analyzed to evaluate SMA, SMI, and SMD. Muscle abnormalities (low SMA, SMI, and SMD) were defined as values below the fifth percentile from a subsample of healthy young individuals (n = 111; 1839 y of age; 55.9% women). Correlation coefficients, BlandAltman graphs, and receiver operating characteristic (ROC) curves were calculated for the total sample and stratified by sex and age. Results: In all, 268 individuals (44.3 § 15.2 y of age) were evaluated (53% women). Significant (P < 0.001 for all analysis) and strong correlations between SMA (r = 0.896), SMI (r= 0.853), and SMD (r= 0.864) compared with L3 and thigh landmarks were observed. For the ROC curves, similar areas under the curve values were obtained for men (0.981), women (0.895), younger (0.902), and older adults (0.894). Conclusions: Muscle characteristics between L3and thigh landmarks have a strong correlation. This suggests that images of the thigh can be used to characterize muscle characteristics. Image acquisition and analysis of thigh region is simpler, with less radiation exposure, and consequently more appropriate for longitudinal analysisTCC Frequência de síndrome metabólica em pacientes com infarto agudo do miocárdio(Universidade Federal do Rio Grande do Norte, 2022-12-07) Oliveira, Carlos Diego Ramos; Fayh, Ana Paula Trussardi; Medeiros, Galtieri Otávio Cunha de; http://lattes.cnpq.br/0049770583345803; Fayh, Ana Paula Trussardi; http://lattes.cnpq.br/0049770583345803; Medeiros, Galtieri Otávio Cunha de; Queiroz, Sandra AzevedoIntrodução: A Sociedade Brasileira de Cardiologia afirma que as doenças cardiovasculares (DCV) são a principal causa de mortes no Brasil e consistem em um grupo de alterações que envolvem distúrbios no coração e nos vasos sanguíneos e a cardiopatia isquêmica é responsável pela maioria das mortes devido às DCV. As alterações metabólicas que são fatores de risco para DCV, como obesidade central, HAS e DM são também critérios de diagnóstico da Síndrome Metabólica (SM), reforçando a importância de estudar a frequência da SM em pessoas que tiveram o IAM. Objetivos: Avaliar a frequência da SM e a associação com o tempo de internação hospitalar em pacientes hospitalizados devido a um infarto agudo do miocárdio. Metodologia: Trata-se de um estudo longitudinal, que analisou dados de pacientes adultos e idosos, de ambos os sexos, até alta hospitalar no período entre julho de 2019 e março de 2020, todos admitidos no Hospital Universitário Onofre Lopes em Natal/RN, com diagnóstico de IAM. Foram coletadas variáveis sociodemográficas, histórico pregresso de doenças crônicas não transmissíveis, histórico familiar e pessoal de infarto agudo do miocárdio e variáveis antropométricas (peso, altura e CA). Resultados: Foram avaliados um total de 146 indivíduos, 28,5% do sexo feminino. As mulheres apresentaram maior frequência de obesidade central que os homens (92,7% vs 35,2%) e de todos os outros fatores relacionados com a SM. Quando considerado o tempo de internação, a maior parte (60,2%) dos pacientes com SM tiveram maior tempo de internação, mas sem associação estatística. Conclusão: Foi encontrada alta frequência de SM nos pacientes avaliados e sexo feminino apresentou frequência de obesidade central, SM e DM consideravelmente maiores que o sexo masculino e o tempo de internação prolongado e histórico de IAM não apresentou diferenças significativas entre o grupo de pacientes com ou sem SM.Artigo Is cachexia associated with chemotherapy toxicities in gastrointestinal cancer patients? a prospective study(Journal of Cachexia, Sarcopenia and Muscle, 2019-03) Fayh, Ana Paula Trussardi; Rocha, Ilanna Marques Gomes da; Marcadenti, Aline; Medeiros, Galtieri Otávio Cunha de; Bezerra, Ricardo Andrade; Rego, Juliana Florinda de Mendonça; Gonzalez, Maria CristinaBackgroundChemotherapy is an effective treatment with good clinical response in patients with cancer. However, it cancause exacerbated toxicities in patients and consequently change the course of treatment. Some factors may interfere withthis toxicity such as body composition, especially in gastrointestinal cancer. The aim of this study was to evaluate the effectsof body composition, nutritional status, and functional capacity scale in predicting the occurrence of toxicities in gastrointes-tinal cancer patients during chemotherapy treatment.MethodsThis is a prospective study with gastrointestinal cancer patients at the beginning of chemotherapy treatment.Sarcopenia and muscle attenuation were assessed using the skeletal muscle index from computerized tomography by measur-ing cross-sectional areas of the L3tissue (cm2/m2). Cachexia was graded according to involuntary weight loss associated withsarcopenia. Nutritional status was assessed by using anthropometric evaluation and Patient-Generated Subjective Global As-sessment. Functional capacity was evaluated by handgrip strength and Eastern Cooperative Oncology Group (ECOG) Perfor-mance Status scale. Haematological gastrointestinal and dose-limiting toxicities (DLTs) were defined according to NationalCancer Institute Common Toxicity Criteria. The associations among sarcopenia, cachexia, nutritional status, and functional ca-pacity with DLT were assessed by univariate and multivariate Cox regression model.ResultsA total of60patients were evaluated (55% male,60.9±14.0years) and followed up for a mean of55days. Mostpatients had normal weight (44.2%) and good ECOG Performance Status (≤1) at baseline (78%). During the chemotherapy pe-riod, the most prevalent toxicities were diarrhoea, nausea, and anorexia, but the presence of DLT was similar between cycles(P>0.05). Cachexia was associated with a higher toxicity manifested by diarrhoea (P=0.02), nausea (P=0.02), and anorexia(P<0.01andP=0.03at Cycles1and2, respectively). Sarcopenic and cachetic individuals experienced more toxicities and DLTduring chemotherapy. The only factors associated with DLT in the multivariate Cox regression analyses including the presenceof metastasis and the chemotherapy protocol were cachexia and the ECOG scale (P<0.001for both).ConclusionsCachexia and ECOG score may identify patients with an increased risk for developing severe toxicity events dur-ing chemotherapy treatment for gastrointestinal cancerArtigo Is skeletal muscle radiodensity able to indicate physical function impairment in older adults with gastrointestinal cancer?(Experimental Gerontology, 2019-10) Fayh, Ana Paula Trussardi; Barbalho, Erica Roberta; Gonzalez, Maria Cristina; Bielemann, Renata Moraes; Rocha, Ilanna Marques Gomes da; Sousa, Iasmin Matias de; Bezerra, Ricardo Andrade; Medeiros, Galtieri Otávio Cunha deBackground: Worsening nutritional status in older adult cancer patients can lead to sarcopenia, a condition that occurs with low quantity or quality of muscle mass associated with low physical function. However, most of the studies with cancer patients have only analyzed the quantity of muscle mass for diagnostic of sarcopenia, without exploring muscle characteristics and physical function. The purpose of the present study is to explore the associations between muscle mass characteristics and physical function in older adult patients with cancer. Methods: Gastric older cancer patients were enrolled in a cross-sectional study. Computed tomography images of the abdominal region evaluated skeletal muscle mass using the Slice-O-Matic version 5.0 Software program (Tomovision, Montreal, Canada) to determine the parameters of skeletal muscle index (SMI, muscle quantity) and skeletal muscle radiodensity (SMD). The physical function was evaluated through handgrip strength and gait speed test. Four musculature phenotypes were identified: normal SMI and SMD, only low SMI, only low SMD, and low SMI and SMD. Linear regression analyses adjusted by age and tumor stage verified the associations between SMI, SMD and physical function. A One-Way Covariance Analysis with Bonferroni post hoc test was used to compare the physical function variables among the four different phenotypes. Results: In total, 167 patients were evaluated (58.1% males; mean age 69.17 ± 7.97 years). The results showed that muscle mass characteristics explains, at least partially, the variability in handgrip strength and gait speed in a direct relationship. The phenotypes with low muscular SMI and/or SMD presented worse performances in handgrip strength and gait speed tests. When stratified for sexes, the significant difference occurs only in males. Conclusions: Low SMD has negatively impacted physical function in older adults with gastrointestinal cancer, especially in malesArtigo Is there a difference in the parameters of the bioelectrical impedance obtained from devices from different manufacturers? a cross-sectional study in hospitalized cancer patients(Clinical Nutrition Espen, 2023-08) Fayh, Ana Paula Trussardi; Guedes, Francisco Felipe de Oliveira; Sousa, Iasmin Matias de; Medeiros, Galtieri Otávio Cunha de; Gonzalez, Maria CristinaBackground: Cancer is a disease with high and increasing incidence rates in the world and its course tends to harm the body composition. Monitoring these body changes is very important. Therefore, it is essential to have reliable, accessible, and practical methods for evaluating body compartments. This study aims to evaluate the correlation and agreement of results for the bioelectrical impedance analysis (BIA) obtained from devices from different manufacturers. Methods: This is a single-center cross-sectional study including hospitalized patients with cancer. Two devices from different brands used for obtaining the BIA were used; both with a tetrapolar model and a single frequency (50 kHz). The results were evaluated for resistance (R) and reactance (Xc) and used to calculate the phase angle (PhA) and fat-free mass (FFM) indicators. Pearson and Spearman correlation tests and BlandeAltman plots were performed, with results expressed as bias and limits of agreement at 95% confidence intervals (95%CI). Results: We have included 116 patients, with a mean age of 60.8 ± 14.8, 51.7% were women. We have found very strong correlations between the measurements of R (rho ¼ 0.971) and FFM (r ¼ 0.979), and strong correlations for Xc (rho ¼ 0.784) and PhA (rho ¼ 0.768). However, the measurements did not agree between the methods. Conclusions: Commercial brands of devices used for the BIA influence the results generated, a factor that must be considered when choosing the most appropriate method for this analysisArtigo Low calf circumference is an independent predictor of mortality in cancer patients: a prospective cohort study(Nutrition, 2020-11) Fayh, Ana Paula Trussardi; Sousa, Iasmin Matias; Bielemann, Renata Moraes; Gonzalez, Maria Cristina; Rocha, Ilanna Marques Gomes da; Barbalho, Erica Roberta; Carvalho, Ana Lúcia Miranda de; Dantas, Maria Amélia Marques; Medeiros, Galtieri Otávio Cunha de; Silva, Flavia MoraesObjective: Loss of muscle mass is associated with worse outcomes in patients with cancer. The objective of this study was to evaluate the prognostic value of calf circumference (CC) and skeletal muscle index from computed tomography (CT) to predict mortality in patients with cancer. Methods: A single-center prospective study was conducted with patients aged 20 y attending a reference center of oncology and who had recent abdominal CT images. Data were collected through a semistructured form and patients’ records and included sociodemographic data (sex, age and ethnicity), clinical data (primary site and staging of tumor and treatments performed), anthropometric variables (body mass index and CC), and outcome (death). Low CC for men was considered to be 34 cm and for women 33 cm. Muscle mass was assessed by CT images at the level of L3. The Cox proportional hazard model adjusted for age, sex, and staging of disease was used. Results: A total of 250 patients were evaluated, 52.8% female, with a median age of 63 y (interquartile ratio: 5573). Normal body mass index was identified in 44.4%; 29.2% had low skeletal muscle index, and 46.4% had low CC. Death by any cause occurred in 16%, and only low CC was a significant predictor of mortality (hazard ratio = 3.01; confidence interval 1.525.98; P = 0.002). Conclusions: Low CC can predict risk of mortality in this cohort of patients. The findings suggest the use of CC as a simple, easy, cost-effective anthropometric measurement to quickly screen patients at risk of death who could benefit from targeted care to improve their prognosis