KARINA HELENA CANTON VIANI

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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina

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  • article 8 Citação(ões) na Scopus
    Nutritional status at diagnosis among children with cancer referred to a nutritional service in Brazil
    (2021) VIANI, Karina; BARR, Ronald D.; FILHO, Vicente Odone; LADAS, Elena J.
    Introduction: Children and adolescents with cancer are particularly vulnerable to malnutrition and require special attention on nutritional assessment. An adequate nutritional status during treatment is essential in reducing morbidity and mortality, being a modifiable risk factor for clinical outcomes. This study aims to determine the nutritional status of pediatric patients with cancer assessed by the nutrition team at diagnosis and evaluate its association with the overall survival. Method: This is a retrospective cross-sectional study of patients at the time of cancer diagnosis who had nutritional assessments when hospitalized or referred to the nutrition outpatient clinic. Nutritional status was classified by the mid-upper arm circumference (MUAC) and body mass index for age z-score (zBMI/A). The Cox regression analysis was used to determine the association between the nutritional status and overall survival, adjusting for gender, tumor group and age. Results: The study included 366 patients. The prevalence of undernutrition varied from 8 to 23% and overweight, from 5 to 20%. The MUAC identified more children as undernourished than the zBMI/A in patients with solid and hematological tumors. There was no significant difference in the overall survival by malnutrition classified by the zBMI/A (p = 0.1507) or MUAC (p = 0.8135). When adjusted for gender, tumor group and age, the nutritional status classification by the zBMI/A (hazard ratio [HR], 1.27; 95% confidence interval [CI], 0.88-1.83; p = 0.209) and MUAC (HR, 0.94; 95% CI, 0.61-1.44; p = 0.773) did not impact overall survival. Conclusion: The nutritional status at diagnosis did not significantly impact the overall survival, which suggests there may have been a protective effect by successful nutritional intervention during the subsequent care. (C) 2020 Associacao Brasileira de Hematologia, Hemoterapia e Terapia Celular.
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  • article 12 Citação(ões) na Scopus
    The importance of enteral nutrition to prevent or treat undernutrition in children undergoing treatment for cancer
    (2020) TREHAN, Amita; VIANI, Karina; CRUZ, Luciane Beitler da; SAGASTIZADO, Stephany Zelaya; LADAS, Elena J.
    Nutrition therapy is a therapeutic approach to treating medical conditions and symptoms via diet, which can be done by oral, enteral or parenteral routes. It is desirable to include nutritional interventions as a standard of care in pediatric cancer units (PCUs) at all levels of care. The interventions are dependent on available resources and personnel across all clinical settings. Enteral nutrition is easy, inexpensive, uses the gastrointestinal tract, maintains gut mucosal integrity, and allows for individualized nutritional strategies. This narrative review describes enteral nutritional interventions for children undergoing cancer treatment and is aimed at PCUs of all levels of care located in a low- and middle-income country.
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    BRAZILIAN NUTRITIONAL REGISTRY OF CHILDREN WITH CANCER
    (2022) VIANI, Karina; FILHO, Vicente Odone; MURRA, Mariana; OLIVEIRA JR., Wilson De; FERNANDES, Carolina; FERMAN, Sima; ALVES, Jullyana Da Rocha; MENDES, Mecneide; PORTO, Renata Nunes; GRUEZO, Nadia Dias; MAGALHAES, Isis; LIMA, Bruna; FIORI, Carmem Maria Costa; ALVARENGA, Mayara; AGUIRRE-NETO, Joaquim De; FONSECA, Teresa Cardoso; BARR, Ronald; LADAS, Elena
  • article 1 Citação(ões) na Scopus
    Partnership of the Sociedade Brasileira de Oncologia Pediátrica and International Society of Pediatric Oncology to improve nutritional care for children with cancer in Brazil
    (2017) VIANI, Karina; ODONE FILHO, Vicente; FERMAN, Sima; FONSECA, Teresa Cristina Cardoso; OLIVEIRA, Vanessa da Cunha; LEMOS, Priscila dos Santos Maia; BARR, Ronald D.; LADAS, Elena J.
    Abstract The authors present a proposal of a partnership between the Sociedade Brasileira de Oncologia Pediátrica (SOBOPE) and the International Society of Pediatric Oncology (SIOP) to promote the standardization and improvement of nutritional care of kids under cancer treatment in Brazil. The results of the first meeting in Brazil as well as plans for future meetings are described.
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    Height Deficit in Brazilian Children and Adolescents with Acute Lymphoblastic Leukaemia at Diagnosis: Impact on Overall Survival
    (2019) VIANI, K.; MANZOLI, B.; BOUCHABKI, G.; NETO, M.; OLIVEIRA, V.; CRISTOFANI, L.; ODONE FILHO, V.
  • article 5 Citação(ões) na Scopus
    Can calf circumference be a viable option for nutritional assessment in the PICU?
    (2021) VIEIRA, Rafaela Rodrigues; CAMPOS, Marina Morgado Simoes de; ZAMBERLAN, Patricia; VIANI, Karina
    Background: Children admitted to paediatric intensive care units (PICUs) often need specialised nutri-tional intervention. Nutritional assessments provide specific data to support such interventions. Body composition measures, such as mid-upper arm circumference (MUAC), can complement nutritional assessment. However, MUAC has limitations. Calf circumference (CC) is an easy and common measure of muscle loss in the elderly; however, there are still very few studies on CC in children. Aims: To evaluate the viability of using CC for nutritional monitoring of children under intensive care, compared with MUAC and weight. Methods: Patients aged 2-10 years admitted to the PICU between December 2018 and August 2019 were included in the study. Two MUAC, CC, and weight measurements were performed: one in the first 24 h after PICU admission and another after 7 days. As there are no reference values for CC in children, this measure was used solely to observe the patient's individual progress. The nutritional status, both ac-cording to body mass index and MUAC, was used to characterise samples. Percentage changes in these measures were compared using the Wilcoxon signed-rank test for comparison between medians and Spearman's correlation test. Information from medical records regarding hospitalisation was also collected and analysed. Results: Thirty patients were included in the study. During hospitalisation week 1, CC decreased significantly (p = 0.001), whereas MUAC (p = 0.427) and weight (p = 0.315) did not change significantly. Percentage changes in CC and MUAC were statistically different (p = 0.0449), with a positive correlation between the changes in both measures (p = 0.0333; r = 0.3896); conversely, although the percentage changes in CC and weight significantly differed (p = 0.0066), no correlation was found between them (p = 0.9382; r = 0.0148). The percentage changes in MUAC and weight were not different (p = 0.1880) or correlated (p = 0.1691; r = 0.2577). No statistically significant relationship was found between per-centage changes in CC and clinical outcomes (length of stay, fasting time, and mechanical ventilation time). Conclusions: CC appears to be a viable measure for use in PICUs. Although positively correlated with MUAC, a measure proven useful in critically ill children, CC decreased significantly in the first week of intensive care, whereas MUAC remained unchanged, indicating that CC may show signs of depletion earlier than MUAC in these patients. Our study reinforces the importance of alternative measures for anthropometric assessment of critically ill children.
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    Changes in Body Composition of Children with Cancer Admitted to A Paediatric Intensive Care Unit in Brazil
    (2016) VIANI, K.; RAFAEL, M. Neto; BOUCHABKI, G.; OLIVEIRA, A. C.; MANZOLI, B. Stachissini; OLIVEIRA, V.
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    A COLLABORATIVE EDUCATION MODEL FOR ADVANCING NUTRITIONAL CARE IN AFRICA
    (2022) SCHOEMAN, Judith; SALIFU, Nihad; OFOSUHENE, Doris; LADAS, Elena; WALTERS, Michelle; VIANI, Karina; DAMASCO-AVILA, Erika; KRUGER, Mariana; ADONGA, Emmanuel; FRECCERO, Piera; FREGOLENT, Roberta; ASAGBA, Eugene; BRUCE, Saviour; RENNER, Lorna
  • article 3 Citação(ões) na Scopus
    Increased nutrition risk at admission is associated with longer hospitalization in children and adolescents with COVID-19
    (2022) ZAMBERLAN, Patricia; CARLOTTI, Ana Paula de Carvalho Panzeri; VIANI, Karina Helena Canton; RODRIGUEZ, Isadora Souza; SIMAS, Josiane de Carvalho; SILVERIO, Ariadne Beatriz; VOLPON, Leila Costa; CARVALHO, Werther Brunow de; DELGADO, Artur Figueiredo
    Background We investigated the association of nutritional risk and inflammatory marker level with length of stay (LOS) in children and adolescents hospitalized for COVID-19 infection in two pediatric teaching hospitals in a developing country. Methods This was a cross-sectional analytical retrospective study performed in two pediatric hospitals. We included the data from all children and adolescents who were hospitalized with a SARS-CoV-2 infection between March and December 2020. Demographic, anthropometric, clinical, and laboratory data were extracted from electronic medical records. Nutritional risk was assessed according to the STRONGkids tool within 24 hours of admission and was categorized into two levels: >= 4 (high risk) and <4 (moderate or low risk). Means or medians were compared between nutritional risk groups using the t test and Mann-Whitney U test, respectively. The association of nutritional risk and inflammatory markers with LOS was estimated using the Kaplan-Meier method and log-rank test. Cox proportional-hazard and linear regression models were performed, and adjusted for sex, age, and respiratory symptoms. Results From a total of 73 patients, 20 (27.4%) had a STRONGkids score >= 4 at admission, which was associated with a longer LOS even after adjusting (beta = 12.30; 1.74-22.9 95% CI; P = 0.023). The same association was observed between LOS and all laboratory markers except for D-dimer. Conclusion Among children and adolescents with COVID-19, a STRONGkids score >= 4 at admission, lower values of albumin, lymphocytes, and hemoglobin, and higher CRP values were associated with longer LOS.