MARIA MANUELA FERREIRA ALVES DE ALMEIDA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
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- Comment on accuracy of predictive equations versus indirect calorimetry for the evaluation of energy expenditure in cancer patients with solid tumors - An integrative systematic review study(2021) SOUZA, Micheline Tereza Pires de; SINGER, Pierre; OZORIO, Gislaine Aparecida; ALVES-ALMEIDA, Maria Manuela Ferreira; WAITZBERG, Dan L.
- Appetite Assessment of Hospitalized Cancer Patients in Brazil - A Validation Study(2019) OZORIO, Gislaine Aparecida; ALMEIDA, Maria Manuela Ferreira Alves de; FARIA, Sheilla de Oliveira; CARDENAS, Thais de Campos; WAITZBERG, Dan LinetzkyOBJECTIVES: Appetite loss, a common symptom in cancer patients, contributes to worsened nutritional status. A validated specific tool to assess appetite is clinically useful for diagnosing and identifying symptoms and signs that could be reversed with nutritional and pharmacological therapies. The aim of this study is to produce a Brazilian Portuguese version of the Hill and Blundell visual analog scale (VAS) for appetite and investigate its validity among hospitalized cancer patients. METHODS: The original English VAS version was translated into Brazilian Portuguese in full accordance with the guidelines in the literature and adapted to the Brazilian context by conducting interviews and meetings with an expert committee until the final version was reached. Afterwards, the version was validated in hospitalized cancer patients in a cross-sectional study at Sao Paulo Cancer Institute (ICESP), where the relationships between breakfast intake (rest-ingestion index) and VAS were compared. The Spearman test was used to verify the correlation between the rest-ingestion index and the VAS ratings. RESULTS: Sixty-four patients with a mean age of 56.1 (+/- 12.3) years answered the Portuguese VAS version, and their breakfast intake was evaluated. The mean rest-ingestion index was 18.8%. The correlations between the rest-ingestion index (food acceptance) and three questions of the Portuguese visual analog scale version were inverse and significant: first question (rho -0.3028 p=0.0046), second question (rho -0.2317 p=0.0319) and third question (rho -0.3049 p=0.0043). CONCLUSION: The ""Appetite Assessment Scale of Brazilian Oncology Patients"" is a valid instrument to assess appetite in hospitalized cancer patients in Brazil.
- Comment on ""Accuracy of Resting Energy Expenditure Predictive Equations in Patients With Cancer""(2019) SOUZA, Micheline Tereza Pires de; SINGER, Pierre; OZORIO, Gislaine Aparecida; ALVES-ALMEIDA, Maria Manuela Ferreira; WAITZBERG, Dan L.
bookPart Atividades de Treinamento, Ensino e Pesquisa(2019) CARDOSO, Elisabeth; OZóRIO, Gislaine Aparecida; ALMEIDA, Maria Manuela F. Alves de; HABIRO, Renata Sayuri; ALMEIDA, Sylvia- Resting energy expenditure and body composition in patients with head and neck cancer: An observational study leading to a new predictive equation(2018) SOUZA, Micheline Tereza Pires; SINGER, Pierre; OZORIO, Gislaine Aparecida; ROSA, Vitor Modesto; ALVES, Maria Manuela Ferreira; LOPEZ, Rossana Veronica Mendoza; WAITZBERG, Dan L.Objectives: Patients with head and neck cancer have changes in body composition and resting energy expenditure (REE) related to significant inflammatory processes. We investigated REE and body composition in a population of patients with head and neck cancer, comparing the measured REE with predicted energy expenditure and deriving an equation of anthropometric values and body composition. Methods: This retrospective, observational, descriptive study of a single center included patients with head and neck cancer. We evaluated nutritional status by body mass index (BMI) and Patient Generated Subjective Global Assessment (PG-SGA), body composition by electric bioimpedance, and REE by indirect calorimetry (IC). Results: We included 140 patients, most of whom were men (80.7%), 60 y or older (58.6%), and had advanced disease (77.9%). Most were malnourished by BMI standards (77.9%) and severely malnourished according to the PG-SGA (49.3%), with a fat-free mass below the ideal values (82.9%) associated with sarcopenia (92.1%). Hypermetabolism was 57%. When comparing REE with the Harris-Benedict formula, we found the agreement limits from -546 613 to 240 708, the mean difference was -152 953 (95% confidence interval [CI], -185 844 to -120 062) and Pitman's variance test was r = -0.294 (P = 0.001). When we included the activity factor and the thermogenesis factor in REE and compared with Harris-Benedict, we found the agreement limits from -764.423 to 337.087, a mean difference of -213.668 (95% CI -259.684 to -167.652), and the Pitman's variance text at r = -0.292 (P = 0.001). Conclusion: Predictive equations, generally recommended by guidelines, are imprecise when compared with IC measures. Therefore, we suggest a new predictive equation.
bookPart Indicadores de Nutrição Clínica(2015) GANDOLFO, Adriana Servilha; SILVA, Ana Cláudia da; VALADARES, Andressa Tamasco; TEIXEIRA, Cláudia de Fátima Gomes; BASSINELLO, Giordanna Luiggia Budroni; LOPES, Helen Cristina Bittencourt; COSTA, Helenice Moreira da; SILVA, Jéssica Helena da; VIEIRA, Lis Proença; ALMEIDA, Maria Manuela Ferreira Alves de; SATO, Olga Miyuki; ZAMBERLAM, Patrícia; TRECCO, Sonia Maria Lopes de Souza Sanches; CARDENAS, Thais de Campos; SCHIESARI, Thaís Manoel Bispo; OLIVEIRA, Vanessa da Cunha; ROSA, Vitor Modesto- Applied nutritional investigation Effect of age on resting energy expenditure in patients with cancer(2022) SOUZA, Micheline Tereza Pires de; OZORIO, Gislaine Aparecida; OLIVEIRA, Giovanna Nunes de; LOPEZ, Rossana Veronica Mendoza; ALVES-ALMEIDA, Maria Manuela Ferreira; KULCSAR, Marco Aurelio Vamondes; RIBEIRO JR., Ulysses; SINGER, Pierre; WAITZBERG, Dan L.Objective: Because older patients with cancer are at high risk for developing malnutrition, it is critical to understand their energy needs and to feed them appropriately. The aim of this study was to determine whether there are differences in resting energy expenditure between younger and older adults with cancer and in various age groups of older patients. Methods: This retrospective, observational, and descriptive study from a single center included adult ( 60 y) and older ( 0.001). The REE of older patients (1263.3 [234.1] kcal/d) was lower than that of patients 60 y, an REE greater than those for individuals 60 to 69 y, 70 to 79 y, and 0.001). REE in patients 60 to 69 y was greater than for those 0.001). When compared with the Harris-Benedict formula, the REE intraclass correlation coefficient for all older patients was 0.514 (95% confidence interval [CI], 0.064-0.736); for ages 60 to 69 y it was 0.527 (95% CI, 0.126-0.733), and for ages 70 y, it was 0.466 (95% CI,-0.080 to-0.756). Conclusion: Measured REE in patients with cancer decreases with age. This finding is critical for appropriate caloric provision for older patients with cancer. ?? 2022 Elsevier Inc. All rights reserved.
- Validation and improvement of the predictive equation for resting energy expenditure in advanced gastrointestinal cancer(2020) OZORIO, Gislaine Aparecida; SOUZA, Micheline Tereza Pires de; SINGER, Pierre; LOPEZ, Rossana Veronica Mendoza; ALVES-ALMEIDA, Maria Manuela Ferreira; RIBEIRO-JUNIOR, Ulysses; WAITZBERG, Dan LinetzkyObjectives: The usual predictive equations for estimating resting energy expenditure (REE) seem to be associated with significant inaccuracy in patients with advanced cancer. Recently, our group developed a predictive equation for patients with advanced head and neck cancer, showing a better accuracy when compared with indirect calorimetry. The aim of this study was to validate this predictive equation and, if necessary, to elaborate a new predictive equation for patients with advanced gastrointestinal (GI) cancer. Methods: This was a retrospective, unicentric observational study. Data regarding the characteristics of the study were collected using an electronic medical record from June 2016 to January 2018. The nutritional status was calculated by the body mass index (BMI). Patients with nutritional risk, by the Nutritional Risk Screening 2002, were subjectively evaluated in relation to the nutritional status by the Patient-Generated Subjective Global Assessment (PG-SGA). Sarcopenia was defined as fat-free mass index <= 17.4 kg/m(2) for men and <= 15 kg/m(2) for women. Body composition and phase angle values were evaluated by electrical bioimpedance. REE was measured by indirect calorimetry. Results: The study included 109 patients with advanced GI tract cancer. Most were male (72.5%), >= 60 y of age (61.5%), and had cancer in the esophagus region (62.4%). Most patients had not undergone any treatment at the time of the examination. Regarding nutritional characteristics, the majority of the patients were malnourished by BMI (71.6%), with a deficit of lean mass (79.8%), sarcopenia (83.5%), and a phase angle below the fifth percentile for age, sex, and BMI, showing in addition to a poor nutritional condition, an impaired cellular integrity. Most of the patients were hypermetabolic (56.9%) and their caloric intake in the preceding 3 d was insufficient in 43.1%. Through the intraclass correlation coefficient (ICC), it was possible to observe the satisfactory agreement between the REE measured by the gold standard (calorimetry) versus the Souza-Singer's formula (ICC, 0.730; 95% confidence interval, 0.659-0.789; P < 0.001). When we did the multiple linear regression model, we figured that in this group of patients with GI cancer, only lean mass, phase angle, and sex were the age-adjusted independent variables that influenced REE, which was different from the Souza-Singer formula. This way a new prediction formula for this population has been created and needs to be validated. Conclusion: A new equation considering phase angle and body composition can improve the accuracy of the predictive equation.
- Exploring the use of the GLIM criteria to diagnose malnutrition in cancer inpatients(2023) OZORIO, Gislaine Aparecida; RIBEIRO, Lia Mara Kauchi; SANTOS, Barbara Chaves; BRUZACA, Wannia Ferreira de Sousa; ROCHA, Gabriela Del Gallo Vieira da; MARCHI, Luani Maria da Fonseca; SANTOS, Fernando Magri; ALMEIDA, Maria Manuela Ferreira Alves de; KULCSAR, Marco Aurelio Vamondes; RIBEIRO, Ulysses; CORREIA, Maria Isabel Toulson Davisson; WAITZBERG, Dan LinetzkyObjectives: The Global Leadership Initiative on Malnutrition (GLIM) criteria establish a diagnosis of malnutrition based on the presence of at least one phenotypic and one etiologic criterion. This study aimed to assess the concurrent and predictive validity of the GLIM criteria in hospitalized cancer patients.Methods: This is an observational retrospective study, including 885 cancer patients, ages >18 y, admitted to a medical oncology inpatient unit between 2019 and 2020. All patients at risk for malnutrition according to the Nutritional Risk Screening 2002 score were assessed by the subjective global assessment (SGA) and 14 different combinations of the GLIM criteria. The SGA was considered the gold standard for assessing the con-current validity of the GLIM combinations. For a subsample of patients with data available on inflammatory markers (n = 198), the serum albumin and C-reactive protein were included in the combinations as etiologic criteria. The predictive validity of the different combinations was tested using the occurrence of surgical complications as the clinical outcome. The sensitivity and specificity values were calculated to assess the con-current validity, univariate and multivariate logistic regression models were used to test predictive validity. Adequate concurrent and predictive validity were determined as sensitivity and specificity values >80% and odds ratio values >2.0, respectively.Results: The median age of the patients was 61.0 y (interquartile range = 51.0-70.0). Head and neck cancer was the prevailing diagnosis and 375 patients were at nutritional risk. According to the SGA, 173 (26.1%) patients were malnourished (SGA categories B or C) and the prevalence of malnutrition ranged from 3.9% to 30.0%, according to the GLIM combinations. None of the tested combinations reached adequate concurrent validity; however, the presence of malnutrition according to four combinations independently predicted surgical complications.Conclusions: The predictive validity of the GLIM was satisfactory in surgical cancer patients.
bookPart Protocolo de tratamento da fadiga oncológica(2014) VELAR, Camila Molina; BRITO, Christina May Moran de; REIS, Fabiana; ANDRADE, Lydia Caldeira Tavares de Oliveira; ALMEIDA, Maria Manuela Ferreira Alves de; SANTOS, Patricia Cunha