Repositório RCAAP

Alterations in sleep and wakefulness affect negatively on mood, memory and psychomotor performance of individuals. Instruments for scaling the quality of these factors should be available for clinical evaluation. The aim of this study was to translate and to culturally adapt the PROMIS® Domains of Sleep Disturbances‟ and Wake Disturbances‟ into the Portuguese language. The process of translation and cultural adaptation followed the guidelines of the FACIT organization. This methodology includes: translation, reconciliation, back translation, review by the developers of PROMIS®, review by independent reviewers, pre-test version, pre-test, incorporation of the results of the pre-test in the translation process. The pre-test verifies the comprehension of the translated version of the instrument, while the retrospective interview aims to analyze the pre-test version of the instrument items, through a cognitive interview, ie, participants are asked about the comprehension and about the existence of irrelevant items in the instrument. In the translation process of Sleep Disturbances‟ and Wake Disturbances‟ items there were some inconsistencies between the translations and between the back translation and the original items. The pre-test version was applied in a convenience sample of 10 individuals aged 18 to 55 years who had no history of sleep and wake problems, mostly female, single, with educational level varying from 1st grade to college. All the translated items were well understood by participants in the pre-test. None of the participants needed assistance for explanations or had difficulty in interpreting the items of the two banks, whose translation into Portuguese language was approved by the administrators of PROMIS® and thus considered equivalent to the English version. The Portuguese version has a semantic, idiomatic, cultural and conceptual equivalence with the items in the source language.

Breastfeeding plays an important role in reducing neonatal and infant mortality. Women s knowledge and attitudes have an impact on several aspects of breastfeeding, such as its establishment and duration. The present study aimed to evaluate the knowledge and factors interfering the establishment of breastfeeding among postpartum women of the Hospital of the Federal University of Uberlandia (Hospital das Clínicas da Universidade Federal de Uberlandia [HC-UFU]). This is a quantitative study of cross-sectional conducted at Hospital of the Federal University of Uberlandia. The study included all women staying in rooming from July 1 to December 31, 2010 who agreed to participate and had no contraindication to breastfeed. An interview was used to obtain data on breastfeeding. We assessed sociodemographic variables, obstetric profile and information on breastfeeding from interviewed women. During the study period, 958 women remained in rooming during hospitalization and 907 were interviewed. The study revealed that the majority of the puerperal women were young, with stable union, good schooling, realized prenatal in public service, decided to breastfeed before pregnancy and intend to breastfeed their infants for 12 months. Prenatal was mentioned as the main source of information about breastfeeding and nursing professionals were indicated as the main professional category responsible for guidance and assistance on establishment of breastfeeding. The results obtained in this study suggest that the training of health professionals, particularly nursing staff, could change the practice of breastfeeding.

With the technological improvement and neonatal care, there was an increasing on both survival rates of extremely premature newborns (EPN), as on the prevalence of chronic morbidity and disability in survivors. The objectives of this paper are the critical description of the ethics/ bioethics principles that are often evoked to justify the decisions on resuscitation and/or continued treatment of EPN at the limit of viability, the considerations on the difficult choices involving the premature infant, his family and health care professionals, and the consideration of guidelines in several countries. A non-systematic review was made in databases (Medline, LILACS and SciELO), 2000-2013, and on literature about bioethics issues involving EPN. In a reality of decreasing limit of viability, followed by the increase survival rates of EPN and more frequent morbidities, the main discussion is about the gray zone, which is around 23 and 24 gestational age, presently, with uncertain prognosis and high risk of serious disabilities. In that, the ethical issues are evaluated based on contemporary theories, such as personalism, utilitarianism and principlism that guide bioethics evaluations. On the decision making process for the EPN, the moral status, the best interest, the quality of life, the futility and parental participation are the points considered. Guidelines and clinical protocols arise in several countries to guide decision-making at the NICU and are developed based on bioethical questions are reflections involved in decision-making about EPN. It should be brought in mind an individualized conduct for each mother/EPN in decision making at the limit of viability, based on medical and technological knowledge and involved bioethical principles, valuing life and avoiding therapeutic obstinacy.

Introduction: Tuberculosis is an infectious disease that affects more than 9 million people each year worldwide . For tuberculosis control methods for the study of more accurate diagnostic and monitoring treatment , make it essential . Objectives: To identify biomarkers by Phage display technique and evaluate the immunoreactivity of the IG\'s clones selected sera from patients with tuberculosis to monitor treatment . Methods: Blood samples were collected from 61 individuals over 18 years , both sexes , and performed the tuberculin test ( PPD ) as a control . The samples were subjected to the process of selection of clones, the biopanning using a library of random 12 amino acid region of the protein expressed on the phage pIII . After selecting the ELISA assay was performed to analyze the immunoreactivity of selected clones . Results: after the in silico analysis , it was found that the sequence of clone F10 ( VYKTPNSTANRW ) has similarity to the membrane protein MPT64 low molecular weight , 28 to 32 kDa, immunogenicity of the M. tuberculosis complex. In ELISA clone F10 showed reactivity significant ( p < 0.05 ) and monitoring of individuals in treatment (P < 0.005). Conclusion : the reactivity of clone F10 demonstrated that it can be used for monitoring the treatment of tuberculosis , contributing to its control.

This work describes and analyzes epidemiological, clinical and microbiological aspects of Staphylococcus aureus infections in children hospitalized in a pediatric ICU (PICU). We review of medical records of patients aged 29 days to 12 years admitted to the PICU with invasive staphylococcal disease in the period from 13 August 1989 to 13 August 2009. We analyzed the records of 83 patients (1.8% of 4597 admissions) with invasive disease caused by S. aureus. The age ranged from 1m to 12.4 years (mean 4 years) and 47 (56.6%) patients were male. There were predominance of the community-acquired infections (61 cases, 73.5%) and the most frequent diagnoses were pneumonia (especially in children under five years) and osteo-arthritis (in the oldest) with or without sepsis. Most patients showed no comorbidity at admission and when present they were the postoperative condition, presence of central venous catheter, skin lesions and immunodeficiencies. The main indications for admission to the PICU were respiratory failure and cardiovascular. The most common sources of agent isolation were blood, pleural fluid and osteo-articular secretion. The most frequently used antibiotics were oxacillin, vancomycin and ceftriaxone, with or without aminoglycosides. The overall death rate of 27.7% was lower than that of hospital infections (45.5%) and those caused by MRSA (66.6%).The disagreement between the employed and antibiotic susceptibility testing resulted in no significant difference in mortality (p = .25). Despite the low frequency of the invasive staphylococcal disease, the mortality is high. The study of the clinical-epidemiological aspects of the disease and in vitro resistance of the agent contributes to the early diagnosis and the initial empirical antibiotic therapy.

Universidade Federal de Uberlândia

The intravascular administration of iodine-based contrast media is a common cause of acute kidney injury (AKI). This study investigated whether changes in the urinary concentration of neutrophil gelatinase-associated lipocalin (uNGAL) before and after coronary angiography they are able to predict the development of AKI independently of previously established absolute cut-off values. A total of 125 outpatients undergoing elective coronary angiography were enrolled and divided into 2 subgroups: G1 (n = 103), patients with changes in their serum creatinine after coronary angiography of < 0.3 mg/dL, and G2 (n = 22), patients with changes in their serum creatinine after coronary angiography &#8805; 0.3 mg/dL. The primary study endpoint was AKI defined as AKI network stages 1. uNGAL was measured before coronary arteriography and 2 and 4 hours afterwards. To determine the sensitivity and specificity for the absolute and relative variations of uNGAL, a receiver operator characteristic (ROC) curve analysis was performed. Based on the ROC curve for the relative difference in uNGAL before and after coronary angiography, a 50% increase in the uNGAL value over baseline was 60% sensitive and 81% specific for AKI. The area under the curve for relative differences 2 hours after coronary angiography was 0.82. The percentage variations in the concentration of uNGAL detected the early stages of AKI regardless of the absolute cut-off established.

To determine whether the antral follicle count (AFC), assessed by transvaginal ultrasound on day 3 of the menstrual cycle, can predict the number of retrieved oocytes in patients undergoing ovarian hyperstimulation cycles for in vitro fertilization (IVF) and to correlate it with the maternal age and pregnancy rate. METHODS: This was a retrospective observational study based on a review of medical records from 193 patients who underwent assisted reproduction techniques between September 2010 and September 2012 at the Clinic for Human Reproduction Fecunda (Clínica de Reprodução Humana Fecunda) in Uberlandia, Minas Gerais State, Brazil. The study included women indicated for IVF who had follicle-stimulating hormone (FSH) levels below 10 mIU/ml on day 3 of the menstrual cycle. Oocyte recipients were excluded. The women were divided into 3 groups according to AFC (up to 10 follicles, 11 22 follicles, and 23 or more follicles). To compare the AFC groups with the group of patients who became pregnant, patients who had not developed oocytes and had not undergone embryo transfer were also excluded from the study. All patients were submitted to ovarian hyperstimulation treatments and transvaginal ultrasonographic evaluations for the AFC. Subsequently, oocyte retrievals and embryo transfers were performed. Spearman s correlation coefficient (sc) was used to measure the level of association between the numerical variables, and the chi-square test was used to compare pregnancy rates with the AFC. To assess the likelihood of pregnancy, we used a multivariate logistic regression that considered the AFC and age as independent variables; a 5% (p<0.05) significance level was adopted. RESULTS: Overall, 179 patients with a median age of 34 years were analyzed. When AFC was considered as the main variable, a positive correlation with the number of retrieved oocytes (sc = 0.48; p < 0.05) and a negative correlation with age (sc = -0.51; p < 0.05) were observed. There was no significant difference (p = 0.162) when the AFC groups were compared with the positive pregnancy test group; however, in the multivariate analysis, a cutoff of 27 antral follicles was observed, after which the probability of successful gestation tended to remain constant. CONCLUSIONS: There were greater numbers of retrieved oocytes with a higher AFC and fewer numbers of follicles and oocytes with increased age. The AFC can predict the likelihood of successful IVF.

The fast increase in the proportion of elders in the world and Brazilian population opens a discussion about unabling events in this age, in which the occurence of falls stands out. This study aimed to evaluate epidemical and clinical aspects related to accidents caused by falls among the elders attended at Hospital de Clínicas de Uberlândia (HCU). For the data assessment, from September 01, 2003 to August 31, 2004, one day of the week was drafted to start the investigation and, in sequence, every six days, during twenty four hours, the elders victims of falls attended in the emergency hospital of HCU were interviewed. We also daily visited the nurses to interview every elder in internment because of falls. For such interviews, we used a questionnaire made specificaly to obtain data related to patients personal informations, health conditions before the fall, residence conditions, necessity and level of care they needed, causes and circumstances of the fall. In the period studied, 485 patients were attended at the hospital victims of falls, and the sample studied was composed of 177 of these patients who lived and fell in Uberlândia and were interviewed. The mean of the patients ages were 76, and 108 (61.o%) were female; prevailing the married or widowed (147; 83%) retired or pensioner (121; 68.3%); 76 (42.9%) had monthly income between 2 and 4 minimum wages. The kind of residence prevailing was house (135; 76.3%), with rugs (135; 76.8%), unlevellings (109; 61.0%) and stairs (69; 39.0%) These facts , associated with problems such as the kind of floor and luminosity, were the main difficulties reported by the elders to move in their houses. The prevailing deseases were hypertension (81; 45.8%), diabetes (57; 32.2%) and osteoporosis (24; 13.6%). Most of the patients reported daily use of medicines antihypertensives (47.5%), Hypoglycemic (32.2%) and benzodiazepinic (27.1%). Seventy five patients (42.3%) practised physical activities, being walking (62.0%) and hydrogymnastic (24.15) the most common. Ninety four (53.1%) had a leisure activity, mainly dance (36.7%) and sightseeing (29.2%). The falls presented little variation related to the months of the year, but were more common between 6 and 10 in the morning. The site of major occurence was in their own houses (135; 76.3%), mainly in the bathroom (51; 28.8%) and bedroom (28; 15.8%). The main causes were slippings (60; 37.8%) and stumbles (33; 20.8%). The major consequence was fracture (121;68.4%), mainly of femur (81; 45.8%) and radius (23; 13.0%). Fifty nine patients (33.3%) confirmed having fallen before, in the last twelve months, in their own houses (46; 78.0%), because of slipping (18; 32.1%); unbalance (11; 21.4%); 119 (67.2%) reported never have received any preventing oriantation against falls. Letality was of 3.5%. We can conclude that, in relation to elders falls attended in Hospital das Clínicas de Uberlândia that: they occur in a with little variability during the months of the year, but prevail between 6 and 10 in the morning; the frequency increases in the ages 70 to 74, is higher among women, retired and pensioners; about half of the victims had no stable union at the time of the fall; most of the residences were houses, with five to seven rooms, in which lived from 2 to 4 people; the bathrooms used by the elders were about 3.5 metres from their bedroom; the patients consider distance, lack of luminosity and the presence of rugs as the most common difficulties to reach the toilet; pre-existing health problems were mainly hypertension and diabetes; the most comons physical activities were walking and hydrogymnastics, and leisure activities were dance and sightseeing; most of the times the fall is due to slippings or stumbles; as a consequence, TCE is diagnosed for about 10% of the patients and fracture for more then half, being femur the most commonly broken bone; the great majority of the victims is helped in a few minutes after the fall; most of them consider not having received any information about avoiding falls; the percentage of deaths due to falls is less than 5%.

Objective: To analyze whether the patients with severe infections, admitted in the Pediatric Intensive Care Unit of the Hospital de Clínicas of the Universidade Federal de Uberlândia, underwent the active screening for primary immunodeficiencies (PID). Methods: Retrospective study that assessed the data records of patients with any severe infections admitted in the Pediatric Intensive Care Unit, covering a period from January 2011 to January 2012, in order to confirm if they performed an initial investigation for PID with blood count and immunoglobulin dosage. Results: In the studied period, 53 children were hospitalized with severe infections in the Pediatric Intensive Care Unit, and only in seven (13.2%) the initial investigation of PID was performed. Among these patients, 3/7 (42.8%) showed quantitative alterations in immunoglobulin G (IgG) levels, 1/7 (14.3%) had the diagnosis of cyclic neutropenia, and 1/7 (14.3%) presented thrombocytopenia and a final diagnosis of Wiskott-Aldrich syndrome. Therefore, the PID diagnosis was confirmed in 5/7 (71.4%) of the patients. Conclusions: The investigation of PID in patients with severe infections has not been routinely performed in the Pediatric Intensive Care Unit. Our findings confirm the necessity of performing PID investigation in this group of patients.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Background: The deterioration of renal function is related to the intensity of injury of the tubules and glomeruli, and the expected reduction in glomerular filtration rate, is belatedly diagnosed through late changes in serum creatinine concentrations. In general, physicians are often faced with the question whether to use drugs and potentially nephrotoxic agents in patients with reduced renal function in cineangiographic procedures. Typically, doctors are faced with the question whether to use drugs and radiographic contrast agents in patients with reduced GFR. Usually, the decision will depend of these situations, and no other additional examination is usually done for the assessment of renal function. Then, the patients are discharged soon after the coronary angiography. However, when the patient returns to medical care, on some occasions, is discovered, too late, worsening renal function. In this situation, an early marker of renal damage would be clinically more useful if it were correlated with posterior serum creatinine concentrations. Objectives: Compare the urinary NGAL concentrations (uNGAL) of patients with and without decreasing in the estimated glomerular filtration rate (eGFR) before and after infusion of radiological contrast used during the cinecoronariography (CINE). We also analyzed the possible correlations between uNGAL and the serum creatinine values measured before and two days after the contrast infusion in patients underwent to the CINE. Methods: Ninety-six patients were studied and, according to the estimated glomerular filtration (eGFR), were formed two groups: group R (n=24) with eGFR below 60 ml/min/1.73 m² and group C (n=72) with eGFR above 60 ml/min/1.73 m². The uNGAL and serum creatinine (sCr) levels were measured before and after infusion of the contrast agent. Results: The NGALu concentration before and after contrast infusion was significantly higher in the group R compared to the controls (P < 0.0001). Moreover, the uNGAL and sCr levels before coronary angiography were significantly and positively correlated (r: 0.66; P < 0.0001). Similarly, the NGALu values determined 2 h after angiography were also correlated with the sCr levels measured 2 days after the CINE (r: 0.59; P < 0.0001). Conclusions: The NGALu values were higher in patients with reduced glomerular filtration when compared to controls, and thus, can be considered as a biomarker of GFR in individuals with stable renal function. Moreover, the NGALu concentrations correlated with serum creatinine values obtained 48 hours after hospital discharge, suggesting that it may reflect further evolution of serum creatinine. Therefore, the dosage of NGALu has the expectation to be confirmed as a marker in real-time of GFR. This is especially important in patients with prior reduction of GFR needing to undergo to procedures with potential risk of worsening kidney function, such as coronary angiography, which requires the use of intravascular radiological contrast, potentially nephrotoxic.

The coronary atherosclerosis may reflect the state of major arterial vessels and may be associated with different central and peripheral blood arterial pressures. Systolic (SP) and pulse pressure (PP) of patients with different coronary lesion degrees were assessed during coronary angiography. Cardiovascular events (CV) and hospital admissions were monitored for 12 months. Participants were classified as: without coronary lesion (G-I, n = 54); with mild and moderate coronary lesion (G-II, n = 42); and severe coronary lesions (G-III, n = 95). Both pressures did not differ among the groups (p > 0.05). Central pressures exceeded brachial pressures in all groups (p < 0.05). The G-III status was associated with more hospital admissions than G-I and G-II (p < 0.05). The systolic pressure and pulse pressure were not significantly correlated with the number of admissions. In this older population, for different coronary lesion degrees we found similar central and brachial pressures. The main determinant of hospital admissions and Cardiovascular events was severity of coronary stenosis.

The survival of newborn preterm and very low birth weight (VLBW) infants has increased in recent decades and preterm delivery has been touted as a stressor in relation to maternal emotional balance. Mothers of VLBW have higher incidence of anxiety and depressive symptoms, as well as poorer perception of well-being than mothers of full-term newborns. This study examined the intensity of depressive symptoms in mothers of VLBW infants during the initial 12 months after childbirth and the association of these symptoms with sociodemographic characteristics, maternal quality of life and infants clinical characteristics. Mothers of VLBW infants (gestational age &#8804; 34 weeks; birth weight < 1.500 g) admitted to a neonatal intensive care unit (NICU) were invited to participate in a longitudinal study. Mothers responded to the Beck Depression Inventory (BDI) and WHOQOL-BREF four times over 12 months to assess the presence and intensity of depressive symptoms and quality of life, respectively. At mother s discharge, 83 mothers participated, and then, 60, 56 and 40 mothers were interviewed after three, six and 12 months post-delivery, respectively. The BDI (median; P25-P75) scores were higher at discharge (9.0; 6-19) compared to those obtained three (6.0; 3.0-12.0) (p = 0.02), six (6.0; 2.0-10.0) (p < 0.01) and 12 months (5.0; 3.7-11.2) (p < 0.01) post-delivery (p < 0.05). An association was observed between the BDI scores and the absence of a stable marital status, many previous fetal or postnatal losses, a lower total WHOQOL-BREF score, a longer infants length of hospital stay and the presence of bronchopulmonary dysplasia (BPD). Mothers of VLBW infants, particularly single women, had more intense depressive symptoms at the time of their discharge and were more vulnerable to negative effects on their quality of life.

Purpose:To evaluate pain and stress in the face of vibrocompression (VC) and secretion aspiration (SA) in babies. Methods:A clinical transversal, exploratory, controlled, prospective and randomized study with twenty babies having respiratory infection. The variables relating to heart rate (HR), respiratory frequency (f), Peripheral Oxygen Saturation (SpO2) and Neonatal Pain Scale - NIPS were evaluated before, during and after the techniques. Alpha - Amylase (AA) and Salivary Cortisol (CS) were carried out at rest, at 5\', at 20\' and at 40\'. Results:The FC (heart rate) rose during SA (p=0.0057); f did not change (p=0.8212); SpO2 reduced during SA (p=0.0001); NIPS represented pain during SA (p=0,0142), AA showed no difference; SC increased during SA (p=0.0001), with higher averages after 20\' and 40\'. At VC these variables did not change. Conclusion:SA changed HR, SpO2, NIPS, and SC, proving itself to be painful, while VC did not produce pain or stress in babies.

Introduction: Cerebral palsy patients often have dysfunction of the gastrointestinal tract and eosinophilic esophagitis can be present. Objective: The aim of this study is to describe medical records of pediatric patients with cerebral palsy related to eosinophilic esophagitis. Methods: Cross-sectional, retrospective and descriptive study that evaluates the medical records data of pediatric patients with diagnosis of cerebral palsy and eosinophilic esophagitis in a tertiary center of Pediatric Gastroenterology between August 2005 and August 2013. Results: A hundred and thirty-one patients with cerebral palsy were followed in Ambulatório de Gastroenterologia Pediátrica da Universidade Federal de Uberlândia. Seven had eosinophilic esophagitis associated. The age ranged from 70 to 156 months with a mean average of 104.7 months. The age of detection of esophageal eosinophilia ranged from 23 to 112 months, with a mean of 52.3 months. Five of seven patients filled the criteria for eosinophilic esophagitis. Conclusion: Gastrointestinal disorders are the major chronic problem in most of children with cerebral palsy. The investigation of eosinophilic esophagitis should be done regularly in those patients, once this entity could overlap other gastrointestinal diseases.

Purpose: To evaluate and characterize the heart rate variability (HRV) during a six-minute walk test (6MWT) in chronic heart failure patients (CHF) on beta-blocker treatment and analyze their quality of life (QOL) through appropriate questionnaires. Methods: Seventeen volunteers were divided into two groups: CHF group (CHFG, n=7, 47±14.9 years old) and control group (CG, n=10, 55±12.9 years old). The participants performed two 6MWT with a 20 minute interval and the RR interval was recorded, beat to beat, for HRV analysis by linear and nonlinear methods. Were assessed the 36-item Short-Form Health Survey (SF-36) in both groups and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in CHFG. The Mann-Whitney test, Spearman correlation and covariance analysis were used in the statistical analysis. Results: During the 6MWT, the CHFG showed greater complexity of HRV (p<0.03) compared to CG. In the assessment of QoL by SF-36 no statistical significance was found between the groups. Conclusions: The CHFG showed greater complexity of HRV during the 6MWT and a similar performance to the CG during submaximal exercise. Registration clinicaltrials.gov: NCT01736137

Introduction: between physical wounds caused by accidents and violence, the fractures take an evident place as they are common injuries, requiring long rehabilitation time for the victims to return to their daily activities and demanding an specialized hospital attend. Aim: to know epidemiological and clinical features of patients with fractures motivated by external causes in Uberlândia, MG. Material and method: it was done by collecting data from medical records from 1600 patients having fractures by external causes (accidents and violence), attended at Hospital de Clínicas de Uberlândia from January to December of 2003. Results: major of victims (1146; 71.6%) was attended at 09:00 a.m. to 09:00 p.m. period with quite homogeneity in the distribution of days of the week and months of the year, predominating the male ones (1090; 68.1%); 781 (48.8%) patients were at the range of 20 to 49 years old. From the whole, 1475 (92.2%) patients were victims of accidents, being falls (721; 48.9%) the most common, mainly the same level (484; 67.1%), and traffic accidents (553; 37.5%), mainly by motorcycle (279; 50.5%). On violence cases (125; 7.8%), predominated aggressions (113; 90.4%), mainly that using body strength (41; 36.3%). From the total of 2.063 episodes of bones/bones groups fractures, the most attained anatomical structures on accident cases (1910; 92.6%) were upper (841; 44.0%) and lower (686; 35.9%) limbs mainly with radius (309; 16.2%), femur (204; 10.7%) and tibia (177; 9.3%) fractures; on violence cases (153; 7.4%) were upper limbs (59; 38.6%) and cranium (58; 37.9%) mainly involving mandible (20; 13.1%), metacarpi(us) (18; 11.8%), nasal and ulna (14; 9.2% each). On majority of the 1600 cases (1166; 72.9%), only one bone was fractured. It was necessary 845 (52.8%) hospitalizations from which 610 (72.2%) patients stayed at the hospital until seven days. Among the 82 complication episodes directly related to fractures, verified in 79 (4.9%) patients, the most common were that related to synthesis material (40; 48.8%); 23 (1.4%) sequel cases occurred, with 14 (60.9%) amputations, and 35 (2.2%) obits, 26 (74.3%) of them occurred after 24 hours from injury, specially caused by falls (15; 57.7%). Conclusions: the people most attained by accidents and violence have between 20 and 39 years old and are male. They receive care most frequently from 09:00 a.m. to 03:00 p.m. of all days of the week and all months of the year. The accidents that most causes fractures are falls, especially that from the same level, and traffic accidents, mainly by motorcycle; between violence, the most common is aggression using body strength. Majority of cases, only one bone is fractured; between the accidents victims, the fractures occur mainly in upper and lower limbs involving especially radius and femur; among the violence victims, they occur in upper limbs and cranium, especially in mandible and metacarpi(us). Major of patients needs hospitalization and to stay at the hospital during a period of until a week. The complications are generally post-operative ones and related to synthesis materials. The most common sequels are amputations. The lethality is higher between fall victims.

The high prevalence of hospital protein-energy malnutrition is associated with several factors, including implemented dietary conducts. Most hospitalized patients receive oral diets as their only source of nutrition. Study objectives were to evaluate the consumption of oral diets, the presence of reasons for not ingesting or incomplete food intake, and the evolution of the nutritional status of adult patients admitted to the Hospital de Clínicas, Universidade Federal de Uberlândia (HC-UFU). It was also objective of the study, analyze the general oral diet (GOD) served to inpatients in HC-UFU. The study was prospective, observational and descriptive for the inpatients, and prospective, descriptive, with semi-quantitative/qualitative approach for the food of the hospital GOD. Patients were included in the first 48 hours of hospitalization and maintained in follow-up throughout the period of hospital stay in the internal medicine ward. The supply, intake, minimum and adjusted energy needs (MEN; AEN) and minimum and adjusted protein needs (MPN; APN), and the reasons for not ingesting or incomplete food intake were assessed daily using the 24h Food Record form. The nutritional status of patients was assessed by anthropometric measurements (weight, height, body mass index) and Subjective Global Assessment (SGA). GOD was evaluated during 28 consecutive days, it was performed the weighing of each food served in the styrofoam lunch boxes of the lunch (n=3/day) and dinner (n=3/day) of the four implemented menus. The food options served in snacks (breakfast, afternoon snack and dinner) were not heavy because the portions are standard and known. Tables of nutritional composition were used to calculate the total energy value (TEV) and the energy distribution of macronutrients (percentage) of the food meals served daily, as well as to quantify the portions of foods from different food groups. Twenty-three patients who did not have a classification of malnutrition in the first 48 hours of hospitalization (SGA A) were included in the study, it corresponded to 204 days of follow-up. The supplied oral diets were sufficient to meet the AEN in 148 days (72.5%) and the APN in 80 days (39.2%). Dietary intake was insufficient to meet the AEN in 100 days (49%) and the APN in 156 days (76%). The mean intake of energy and/or protein was lower than the MEN and MPN for 7 patients (30.4%) and smaller than the AEN and APN for 21 patients (91.3%). A large number of reasons for not ingesting or incomplete food intake (n=1193) were reported, of which 1119 (93.8%) was present in food records of days in which food intake was below that adjusted need. The most common reasons were \"fasting\" (27.1%), \"lack of appetite\" (18.1%), \"satiety\" (13.4%) and \"sensory characteristics of food\" (9.1%). At the end of the follow-up period, one patient changed the classification of nutritional status of AGS A to AGS B, and 16 patients (69.6%) showed loss of body weight (-1.4±1.2kg). Negative associations were observed for \"difference between total energy intake and AEN\" and the number of \"reasons for not ingesting or incomplete food intake\" ( &#61554; =-0.7268; p-value<0.0000), and \"difference between the total amount of protein intake and APN\" and the number of \"reasons for not ingesting or incomplete food intake\" ( &#61554; =-0.8381; pvalue< 0.0000). And positive associations for \"difference between total energy intake and AEN\" and \"weight difference\" ( &#61554; =0.5034; p-value=0.0143), and \"difference between the total amount of protein intake and NPA\" and the number of \"weight difference\" ( &#61554; =0.6441; p-value=0.0009). In assessing the GOD, which presented TEV of the average offer of 2396.53±152.55 kcal/day, the mean energy distribution was adequate for protein (13.47%), carbohydrates (65.08%) and lipids (22%). Variable energy supply (percentage of TEV) was identified at breakfast (15.57%-20.61%), lunch (26.19%-36.59%), dinner (22.21%-31.06%), afternoon snack and supper (8.41%-15.50%). The period of overnight fasting was up to 13h. Regarding food groups, the supply was excessive for beans, meat/eggs, oils/fats/oilseed and sugar/sweets, and deficient for fruit/juices, legumes/vegetables, milk/derivatives. The supply of oral diets and the food intake of energy and protein were insufficient to meet the needs adjusted of considerable proportion of patients. The reasons that interfere the adequate food intake should be investigated and implemented measures to reduce them. It is essential to characterize the quantitative/qualitative aspects of GOD served to inpatients. Reducing the period of overnight fasting, as well as adjustments in the supply of food groups and in the food fractionation can contribute to better meet the nutritional needs and preventing the onset/worsening of nutritional deficiencies.