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BACKGROUND: Social networks have emerged as powerful tools in education, offering new opportunities for interactive learning. TikTok has gained popularity among young people and has potential for use as a teaching tool in health disciplines. OBJECTIVE: To evaluate the effectiveness of an educational program based on a multimodal intervention using the TikTok platform to improve theoretical-practical knowledge about diabetic debut and vaccination schedules and satisfaction in nursing students. DESIGN: A quasi-experimental study design. SETTINGS: Faculty of Nursing, University of Cadiz, Spain. PARTICIPANTS: 74 third-year undergraduate university nursing students. METHODS: According to Kolb's experiential learning model, a multimodal educational intervention was carried out during the academic year 2022/2023, with 12 h of training. In these sessions, theoretical content on the vaccination calendar and diabetic debut was developed with written case studies. In the last session, 19 working groups were formed and each group was given a practical case study to solve through role-playing and creating a video in TikTok. A questionnaire to measure individual knowledge and a rubric questionnaire were used to evaluate the simulations in TikTok platform. RESULTS: A significant improvement (z = 6.843, p < 0.001) was observed in the mean scores (9.93 ± 1.65) of the posttest of the knowledge questionnaire, used to evaluate abstract conceptualisation abilities. Additionally, a mean score of 10.42 (SD = 1.42) of the items on the rubric questionnaire, designed to assess active experimentation and reflective observation abilities, were correctly performed. It stands out that 97.1 % of the students positively valued the elements of teaching innovation implemented, while 82.9 % showed a high level of satisfaction with their activity. CONCLUSION: A multimodal educational intervention using TikTok platform proved to be effective in improving the acquisition of theoretical-practical knowledge in the university students included in the study. Therefore, this type of experiential training is recommended for the training of future health professionals.
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Fatigue and musculoskeletal pain are also frequent in patients with psoriasis (PsO) without arthritis (PsA). The current study aimed to assess the impact of an intervention program based on aerobic training to reduce fatigue and musculoskeletal pain in patients with PsO without PsA. A total of 118 male patients with PsO volunteered in the current interventional study and were randomly allocated to the experimental (n = 59) or control group (n = 59). The intervention consisted of a 16-week aerobic training program on a treadmill, three sessions per week, consisting of a warm-up, 35-50 min treadmill exercise (increasing 5 min/4 weeks) at a work intensity of 50-65% of peak heart-rate (increasing 5%/4 weeks), and cooling-down. The functional assessment of chronic illness therapy fatigue scale (FACIT-Fatigue), health assessment questionnaire disability index (HAQ-DI), and visual analog scale (VAS) were compared pre and post intervention. Nutritional intake, maximal aerobic power, lipid profile, serum markers of muscle damage, and body composition were also assessed. When compared to baseline, FACIT-Fatigue, HAQ-DI, and VAS scores were significantly improved without increasing markers of muscle damage. Fat mass percentage, lipid profile, and maximal oxygen consumption were also improved. In conclusion, a 16-week aerobic training program at moderate intensity was safe, well tolerated, and effective in psoriatic patients without PsA. Long-term follow-up studies are required to examine whether these promising results may improve clinical outcomes.
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Artrite Psoriásica , Dor Musculoesquelética , Psoríase , Humanos , Masculino , Adulto Jovem , Artrite Psoriásica/terapia , Artrite Psoriásica/tratamento farmacológico , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/terapia , Qualidade de Vida , Psoríase/complicações , Psoríase/terapia , Fadiga/etiologia , Fadiga/terapia , Exercício Físico , LipídeosRESUMO
The use of electronic cigarettes (e-cig) or personal vaporizers (PV) has increased in recent years, especially among adolescents and adults, increasing risk factors for their health or being a starting point for other risk behaviours. The aim of our study is to learn the knowledge, attitudes and behaviours of the adolescent and young adult population on the use of e-cigarettes or PVs. A cross-sectional descriptive study was carried out among 375 subjects. The use of e-cigs or PVs was measured using a self-administered questionnaire. Overall, 13.33% of the respondents used e-cigarettes or PVs. A correlation could be established between vape use and age, with 14-18-year-olds being the highest users (25.9%). Additionally, 90.13% of the respondents answered that e-cig or PV use was harmful to health. Other behaviours, such as consumption of energy drinks (ED), increases the probability of vaping by 3.08 times (CI = 1.55-6.29; p = 0.001). Subjects aged 23-26 years and 27-34 years are less likely to vape than subjects aged 14-18 years (OR = 0.31: CI = 0.09-0.96; p = 0.044; OR = 0.07: CI = 0.00-0.63; p = 0.037). The same applies to subjects with secondary education (OR = 0.17: CI = 0.04-0.66; p = 0.011) and postgraduate education (OR = 0.07: CI = 0.06-1.19; p = 0.043), than subjects with primary education. The use of e-cigs and PVs starts at an early age, despite the known harmful effects of e-cigs and PVs. Their use may occur mainly in recreational situations and in association with other substances such as ED.
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AIM: To describe the development of a mobile health application -mICardiApp- designed by a multidisciplinary professional team and patients with heart failure and to evaluate its content validity. METHODS: Critical reviews of the literature, semi-structured interviews with patients, and user stories guided the development of the content of the mobile application. These contents were refined and validated through a modified Delphi process. An expert panel of healthcare and social care professionals together with patients and academics evaluated the content through two content validity indicators, relevance, and adequacy, and provided narrative feedback. The content validity of the app and each screen was determined by calculating the Content Validity Index (CVI). Similarly, the Adequacy Index (AI) was analyzed. RESULTS: The developed app is composed by 8 topics: (1) available resources, (2) cardiac rehabilitation, (3) control of signs and symptoms, (4) emotional support, (5) learning and having fun, (6) medication, (7) nutrition, and (8) physical activity. The results demonstrated high CVI of the screens and the full app. 57 of the 59 screens in the app reached an excellent CVI ≥ 0.70 for both relevance and adequacy, except for 2 screens. The CVI Average Method of the app was 0.851. CONCLUSIONS: mICardiApp is presented as an application to improve health literacy and self-management of patients with multimorbidity and heart failure, with proven validation.
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Insuficiência Cardíaca , Aplicativos Móveis , Autogestão , Telemedicina , Humanos , Insuficiência Cardíaca/terapia , Exercício Físico , Instalações de SaúdeRESUMO
BACKGROUND/OBJECTIVES: Malnutrition is a prevalent problem in patients with cancer and is associated with poor prognosis. The European Society for Clinical Nutrition and Metabolism (ESPEN) recommends the provision of nutritional support and evaluation. This study aims to describe the nutritional management of patients with cancer, including assessment of adherence, from the perspective of both patients and healthcare professionals (HCPs). SUBJECTS/METHODS: A cross-sectional descriptive observational study was carried out through two surveys addressed to patients and HCPs. RESULTS: A total of 230 cancer patients and 461 HCPs completed the questionnaire. The survey found 55.0% of patients experienced eating problems during treatment and 64.0% reported sequelae affecting nourishment. However, 60.1% of patients and 42.6% of HCPs indicated that nutritional status is not generally assessed. While 86.6% of HCPs stated that nutritional information is provided to patients, only 33.5% of patients reported having received it. Regarding nutritional adherence, 87.4% of HCPs stated that it is assessed whereas only 49.2% of patients receiving nutritional supplements confirmed this. General discomfort or gastrointestinal problems were the main issues hampering correct adherence perceived by both patients (41.8%) and HCPs (95.4%). CONCLUSIONS: Our study demonstrate that different perceptions exist between patients and HCPs about nutritional management in cancer and suggests that in Spain nutritional approach is suboptimal in terms of screening/assessment of malnutrition, nutritional information provided to the patient, nutritional intervention and assessment of adherence to nutritional support. Therefore, measure should be taken to foster the adoption of ESPEN recommendations in clinical practice and to promote nutritional education of HCPs.
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Desnutrição , Neoplasias , Humanos , Estudos Transversais , Espanha , Pessoal de Saúde , Neoplasias/complicações , Neoplasias/terapia , Desnutrição/etiologia , Desnutrição/terapiaRESUMO
Introduction: Objectives: an inadequate approach to prevent malnutrition in cancer patients may worsen their quality of life and reduce their response to treatment. This study aims to describe the nutritional management of cancer patients in clinical practice, as well as the opinions of the healthcare professionals (HCPs) involved. Methods: this was an observational, descriptive, cross-sectional study addressed to HCPs in the Spanish healthcare setting. The online questionnaire was designed based on a literature review, one focus group of patients (n = 6), and the experience of the multidisciplinary scientific committee (n = 5), and was distributed by the scientific societies endorsing the study. Results: a total of 461 HCPs answered the survey. Most of them considered that a nutrition expert (95.0 %) is essential for the nutritional management of patients. However, 22.8 % of HCPs did not have access to this expert, and only 49.0 % had received training. Nutritional screening or patient referral for screening was performed by 58.4 % of HCPs. Of the total of HCPs, 86.6 % stated that nutritional information is provided to patients and considered them moderately satisfied with the information received. In malnourished patients or in those at risk of malnutrition, a complete nutritional assessment was performed by HCPs (73.1 %). Most HCPs (87.4 %) reported prescribing or recommending nutritional support if needed, and assessing adherence (86.8 %). Conclusions: despite malnutrition being a common problem in cancer patients, almost half of professionals do not perform any nutritional screening. In addition, patient information and assessment of nutritional adherence appear to be suboptimal.
Introducción: Objetivos: un abordaje inadecuado de la desnutrición en el paciente con cáncer puede conducir a un empeoramiento de su calidad de vida y una respuesta deficiente al tratamiento. El estudio ONA (Oncología, Nutrición y Adherencia) tiene como objetivo describir el manejo nutricional del paciente con cáncer en la práctica clínica, así como las opiniones de los profesionales sanitarios involucrados en el mismo. Métodos: estudio observacional, descriptivo y transversal dirigido a profesionales sanitarios españoles. El cuestionario online fue diseñado a partir de una revisión bibliográfica, un grupo focal de pacientes (n = 6) y un comité científico multidisciplinar (n = 5), y distribuido por las sociedades científicas que avalan el estudio. Resultados: de los 461 profesionales sanitarios participantes, el 95,0 % consideraron fundamental la figura del profesional sanitario con formación específica en nutrición, pero el 22,8 % no tenían acceso a ella y solo el 49,0 % habían recibido formación. El 58,4 % afirmaron realizar el cribado nutricional o derivar al paciente para este fin. El 86,6 % de los participantes indicaron que se informa al paciente sobre aspectos nutricionales y consideraron que este estaba moderadamente satisfecho con la información recibida. En caso de detectarse desnutrición o riesgo de desnutrición, los profesionales afirmaron realizar una evaluación nutricional completa (73,1 %) y, de necesitarse soporte nutricional, este se prescribiría/recomendaría (87,4 %), evaluándose la adherencia al mismo (86,8 %). Conclusiones: a pesar de que la desnutrición es un problema común en el paciente con cáncer, casi la mitad de los profesionales no realizan un cribado nutricional. Además, el proceso de información y evaluación de la adherencia nutricional es subóptimo.
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Desnutrição , Neoplasias , Estudos Transversais , Atenção à Saúde , Pessoal de Saúde , Humanos , Desnutrição/diagnóstico , Desnutrição/etiologia , Desnutrição/terapia , Neoplasias/complicações , Neoplasias/terapia , Avaliação Nutricional , Estado Nutricional , Estudos Observacionais como Assunto , Qualidade de VidaRESUMO
BACKGROUND: Probiotic supplements contain different strains of living microorganisms that promote the health of the host. These dietary supplements are increasingly being used by athletes to improve different aspects such as athletic performance, upper respiratory tract infections (URTIs), the immune system, oxidative stress, gastrointestinal (GI) problems, etc. This study aimed to identify the current evidence on the management of probiotics in endurance athletes and their relationship with sports performance. METHODS: A systematic review of the last five years was carried out in PubMed, Scopus, Web of science, Sportdiscus and Embase databases. RESULTS: Nine articles met the quality criteria. Of these, three reported direct benefits on sports performance. The remaining six articles found improvements in the reduction of oxidative stress, increased immune response and decreased incidence of URTIs. There is little scientific evidence on the direct relationship between the administration of probiotics in endurance athletes and sports performance. CONCLUSIONS: Benefits were found that probiotics could indirectly influence sports performance by improving other parameters such as the immune system, response to URTIs and decreased oxidative stress, as well as the monitoring of scheduled workouts.
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Desempenho Atlético , Gastroenteropatias , Probióticos , Atletas , Suplementos Nutricionais , HumanosRESUMO
Pandemics impose an immense psychological burden on healthcare workers due to a combination of workplace stressors and personal fears. Nurses and auxiliary nursing care technicians (ANCTs) are on the front line of this pandemic and form the largest group in healthcare practice. The aim of this study is to determine the symptoms of depression and/or anxiety among nurses and ANCTs during the periods known as the first wave (March-June) and second wave (September-November) of theCOVID-19 pandemic in Spain. An observational cross-sectional study was carried out using an anonymous, self-administered questionnaire among nurses and ANCTs practising in Spain. During the first period, 68.3% and 49.6% of the subjects presented anxiety and depression, respectively, decreasing in the second period (49.5% for anxiety and 35.1% for depression). There were statistically significant differences between the different categories and periods (p < 0.001). The COVID-19 pandemic has negatively influenced mental health in nurses and ANCTs. Mental health should be monitored and coping strategies promoted to improve the health, productivity and efficiency of these professionals.
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COVID-19 , Saúde Mental , Enfermeiras e Enfermeiros , Assistentes de Enfermagem/psicologia , Ansiedade/epidemiologia , COVID-19/psicologia , Estudos Transversais , Depressão/epidemiologia , Pessoal de Saúde , Humanos , Enfermeiras e Enfermeiros/psicologia , Pandemias , Inquéritos e QuestionáriosRESUMO
The COVID-19 pandemic has impacted the mental health of people worldwide. An increase in perceived stress can lead to unhealthy behaviors such as increased food consumption. The aim of this study was to find the level of perceived stress and its relationship with increased food consumption during the "third wave" of the COVID-19 pandemic in Spain. This was a cross-sectional study that employed anonline self-reported frequency of consumption questionnaire and the Perceived Stress Scale-10. A total of 637 subjects participated and 83.6% of respondents had moderate or high stress-more prevalent in the female and young respondents. Moreover, 36.1% of respondents reported that they had increased the frequency of consumption of some foods, mainly nuts, snacks, and jellybeans, along with coffee, tea, cocoa, and soft drinks. Eating between meals was more pronounced in those with high stress (65.1%) than in those with moderate stress (40.4%) and low stress (20.2%). Furthermore, the respondents with high stress reported greater weight gain. Thus, the results show that the level of perceived stress during the 'third wave' of this pandemic increased food consumption.
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COVID-19/psicologia , Ingestão de Alimentos/psicologia , Hiperfagia/epidemiologia , Estresse Psicológico/etiologia , Adulto , Idoso , COVID-19/epidemiologia , Estudos Transversais , Humanos , Hiperfagia/etiologia , Pessoa de Meia-Idade , Espanha/epidemiologia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Aumento de Peso , Redução de Peso , Adulto JovemRESUMO
Recently, there has been an increase in the use of over-the-counter (OTC) drugs. The consumption of these medicines can be unsafe, as incorrect self-diagnosis or the ingestion of inappropriate doses can lead to side effects and the occurrence of adverse reactions and drug-drug interactions. A cross-sectional descriptive observational study was carried out, targeting the entire Spanish population by using an online questionnaire. The results showed that 78.9% of the subjects had previously taken or were currently taking OTC drugs. This consumption decreased as the age of the subjects increased, with a prevalence of 36.4% of subjects aged ≥ 71 taking OTC drugs. Analgesics were the most consumed OTC drugs (49.1%) especially in women, youngsters with non-formal educational qualifications, and individuals of a low-medium socioeconomic level residing in urban areas. Measures should be implemented to optimize the safe use of OTC drugs in order to avoid the occurrence of secondary events associated with the lack of knowledge related to their the usage.
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Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Medicamentos sem Prescrição , Analgésicos/uso terapêutico , Estudos Transversais , Feminino , Humanos , Prevalência , AutomedicaçãoRESUMO
Nutritional management of patients under palliative care can lead to ethical issues, especially when Enteral Nutrition (EN) is prescribed by nasogastric tube (NGT). The aim of this review is to know the current status in the management of EN by NG tube in patients under palliative care, and its effect in their wellbeing and quality of life. The following databases were used: PubMed, Web of Science (WOS), Scopus, Scielo, Embase and Medline. After inclusion and exclusion criteria were applied, as well as different qualities screening, a total of three entries were used, published between 2015 and 2020. In total, 403 articles were identified initially, from which three were selected for this review. The use of NGT caused fewer diarrhea episodes and more restrictions than the group that did not use NG tubes. Furthermore, the use of tubes increased attendances to the emergency department, although there was no contrast between NGT and PEG devices. No statistical difference was found between use of tubes (NGT and PEG) or no use, with respect to the treatment of symptoms, level of comfort, and satisfaction at the end of life. Nevertheless, it improved hospital survival compared with other procedures, and differences were found in hospital stays in relation to the use of other probes or devices. Finally, there are not enough quality studies to provide evidence on improving the health status and quality of life of the use of EN through NGT in patients receiving palliative care. For this reason, decision making in this field must be carried out individually, weighing the benefits and damages that they can cause in the quality of life of the patients.
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Nutrição Enteral/instrumentação , Intubação Gastrointestinal/estatística & dados numéricos , Cuidados Paliativos/estatística & dados numéricos , Adulto , Nutrição Enteral/ética , Nutrição Enteral/métodos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Cuidados Paliativos/ética , Cuidados Paliativos/métodos , Qualidade de Vida , Resultado do TratamentoRESUMO
The aim of this study was to determine healthcare providers' knowledge and practices about dysphagia. A descriptive cross-sectional study was carried out based on a self-administered and anonymous questionnaire addressed to healthcare providers in Spain. A total of 396 healthcare providers participated in the study. Of these, 62.3% knew the definition of dysphagia as a swallowing disorder. In addition, up to 39.2% of the participants reported that they did not know whether the EatingAssessmentTool (EAT-10) dysphagia screening test was usedin their own clinical settings. Similarly, up to 49.1% of them did not know the ClinicalExaminationVolume-Viscosity (MECV-V) method. Nearly all participants (98.8%) reported that thickeners must be used forall liquids administered to patients. A higher percentage of respondents based the choice of texture on patient's tolerance (78.2%) rather than on the MECV-V result (17.3%). In addition,76.4% of the professionals had witnessed a bronchoaspiration; after it, 44.4% (n = 175) of them reported the appearance of pneumonia, and 14.5% (n = 57) the death of the patient (p = 0.005). The participants revealeda moderate/low knowledge ofthe definition, diagnosis, and clinical management of liquid dysphagia, which indicates some room for improvements.
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Transtornos de Deglutição , Estudos Transversais , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/terapia , Pessoal de Saúde , Humanos , Espanha , ViscosidadeRESUMO
It is widely accepted that nursing staff play a key role in palliative care (PC). The use of Nasogastric tubes (NG tubes) for Enteral Nutrition (EN) administration is still controversial in patients who receive PC. The aim of this study was to describe nurses' and nursing students´ opinions and perceptions about EN using NG tubes in adult patients in palliative care. To achieve this goal, a cross-sectional descriptive study was carried out. A self-administered, semi-structured questionnaire intended for nurses and nursing students was used. Data was descriptively and inferentially analyzed using a chi-square test to determine the differential frequency of responses. In addition, a multivariate logistic regression model was also conducted. A total of 511 participants completed the questionnaire. Among them, nursing staff represented 74.9% (n = 383) whereas nursing students were 25.1% (n = 128). When life expectancy was above six months, 90.0% (n = 460) reported that EN using NG should be implemented. In contrast, when life expectancy is less than a month, 57.5% (n = 294) discouraged it. Significant differences within groups were found when life expectancy was <1 month (p = 0.044). It was also found that 491 participants (96.1%) reported that patient´s autonomy must be carefully respected for deciding whether continuing EN by NG tube or not. Finally, it was concluded for both nurses and nursing students that life expectancy should be the mean reason for implementing and withdrawing EN by NG tube. Major differences were found regarding when it should be ceased, suggesting perceptions may change as nurses graduate and move into their professional roles.
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Nutrição Enteral , Intubação Gastrointestinal , Cuidados Paliativos , Estudantes de Enfermagem , Adulto , Estudos Transversais , Feminino , Humanos , Expectativa de Vida , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Percepção , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Due to the pandemic situation caused by the COVID-19 infection, some governments have implemented house confinement measures. The objective of our study is to learn the dietary patterns, consumption, and physical activity of the Spanish population before and during the period of confinement by COVID-19. A cross-sectional descriptive study based on a questionnaire during May 2020, coinciding with the period of confinement and the step forward into Phase 1, is carried out. During confinement, the adherence to the Mediterranean Diet increases (8.0% versus 4.7%; p < 0.001). No socio-demographic variables show statistical significance (p < 0.05) regarding good adherence to the Mediterranean Diet (MD) before and during confinement. During confinement, consumption of homemade baking shows a higher increase (0.28% versus 4.60%; p = 0.004). During confinement, the number of subjects that practice exercise decreases (29.4% versus 28.8%; p = 0.004), as well as the time spent exercising (more than an hour, 26.6% versus 14.7%, p = 0.001). Mediterranean Diet adherence slightly increases during confinement, although consumption of 'unhealthy' food also increases. Moreover, the number of subjects that practice physical activity, as well as the time spent on it weekly, decreases.
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Infecções por Coronavirus , Dieta , Exercício Físico , Comportamento Alimentar , Estilo de Vida , Pandemias , Pneumonia Viral , Isolamento Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , COVID-19 , Culinária , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Estudos Transversais , Dieta Mediterrânea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Quarentena , SARS-CoV-2 , Espanha/epidemiologia , Inquéritos e Questionários , Adulto JovemRESUMO
The combination of hydrodynamic and electrophoretic experiments and computer simulations is a powerful approach to study the interaction between proteins. In this work, we present hydrodynamic and electrophoretic experiments in an aqueous solution along with molecular dynamics and hydrodynamic modeling to monitor and compute biophysical properties of the interactions between the extracellular domain of the HER2 protein (eHER2) and the monoclonal antibody trastuzumab (TZM). The importance of this system relies on the fact that the overexpression of HER2 protein is related with the poor prognosis breast cancers (HER2++ positives), while the TZM is a monoclonal antibody for the treatment of this cancer. We have found and characterized two different complexes between the TZM and eHER2 proteins (1:1 and 1:2 TZM:eHER2 complexes). The conformational features of these complexes regulate their hydrodynamic and electrostatic properties. Thus, the results indicate a high degree of molecular flexibility in the systems that ultimately leads to higher values of the intrinsic viscosity, as well as lower values of diffusion coefficient than those expected for simple globular proteins. A highly asymmetric charge distribution is detected for the monovalent complex (1:1 complex), which has strong implications in correlations between the experimental electrophoretic mobility and the modeled net charge. In order to understand the dynamics of these systems and the role of the specific domains involved, it is essential to find biophysical correlations between dynamics, macroscopic transport and electrostatic properties. The results should be of general interest for researchers working in this area.
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Antineoplásicos Imunológicos/química , Simulação de Acoplamento Molecular , Receptor ErbB-2/química , Trastuzumab/química , Antineoplásicos Imunológicos/farmacologia , Sítios de Ligação , Humanos , Hidrodinâmica , Ligação Proteica , Receptor ErbB-2/metabolismo , Eletricidade Estática , Trastuzumab/farmacologiaRESUMO
BACKGROUND: malnutrition is one of the complications that appears most frequently in oncological patients and causes serious consequences such as loss of lean mass. OBJECTIVE: to know which nutritional screening method is most useful in predicting the loss of lean mass in cancer patients. METHODS: a descriptive study was carried out evaluating three methods of nutritional screening, Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002), in oncological patients undergoing radiotherapy treatment. Each method was analyzed by ROC curves with AUC calculation. RESULTS: loss of lean mass is present in 48.73% of the patients. Of them, 29.44% present a loss of lean mass between 0-2%; 10.66% of patients, between 2-5%; and 8.13% of patients present a loss of lean mass > 5%. The results show that when taking a loss of lean mass > 5% as a cut-off point, the MST method has a higher AUC than the one presented by the MUST and the NRS-2002 (0.596, CI: 0.444-0.747), with significant statistics (p = 0.041). In addition, it presents high sensitivity and positive and negative predictive value. CONCLUSIONS: MST is a more valid nutritional screening method than MUST and NRS-2002 to predict the loss of lean mass > 5% in oncological patients undergoing radiotherapy treatment. Its routine use is recommended in patients under radiotherapy treatment.
INTRODUCCIÓN: la desnutrición es una de las complicaciones que aparecen con mayor frecuencia en el paciente oncológico y provoca graves consecuencias como la pérdida de masa magra. OBJETIVO: conocer qué método de cribado nutricional es más útil en la predicción de la pérdida de masa magra en pacientes oncológicos. MÉTODOS: se ha realizado un estudio descriptivo prospectivo en el que se evalúan el método de cribado nutricional Malnutrition Screening Tool (MST), el Malnutrition Universal Screening (MUST) y el Nutritional Risk Screening (NRS-2002) en pacientes oncológicos sometidos a tratamiento de radioterapia. Se analizó cada método mediante curvas ROC con cálculo AUC. RESULTADOS: el 48,73% de los pacientes presentan pérdida de masa magra. De ellos, el 29,44% presenta una pérdida de masa magra entre 0-2%; el 10,66%, entre el 2-5%; y el 8,13% presenta una pérdida de masa magra > 5%. Los resultados muestran que cuando se toma como punto de corte la pérdida de masa magra > 5%, el método MST presenta un AUC superior al presentado por el MUST y el NRS-2002 (0,596; IC: 0,444-0,747) y con significación estadística (p = 0,041). Además, presenta una alta sensibilidad y valor predictivo positivo y negativo. CONCLUSIONES: el MST es un método de cribado nutricional más válido que el MUST y el NRS-2002 para predecir la pérdida de masa magra > 5% en pacientes oncológicos sometidos a tratamiento radioterápico. Se recomienda su uso rutinario en todos los pacientes que acuden a tratamiento de radioterapia.
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Desnutrição/diagnóstico , Programas de Rastreamento/métodos , Neoplasias/complicações , Avaliação Nutricional , Idoso , Peso Corporal , Feminino , Humanos , Masculino , Desnutrição/complicações , Pessoa de Meia-Idade , Neoplasias/radioterapia , Estado Nutricional , Curva ROC , Fatores de Risco , MagrezaRESUMO
INTRODUCTION: Cases of radiation recall may be experienced by radiotherapy patients, which are named as radiodermitis. To gradate it the RTOG (Radiation Therapy Oncology Group) scale is the most used. Due to the complexity on the management of radiotherapy, a protocol based on the evidence is stablished to prevent and treat it. MATERIAL AND METHODS: Bibliographic revision of main data bases from last six years. RESULTS: 14 different studies which have the criteria for their inclusion are selected. These studies will gather, with different levels of evidence, several prevention and treatment methods and products for radiodermitis. DISCUSSION: To prevent it from happening, it is a must to clean and dry the skin appropriately. Urea, hyaluronic acid and Tex-OE based creams have shown their effectiveness on grades 0-1. Regarding treatment, the use of medium-high corticoids, the barrier creams, silver sulfadiazine, hyaluronic acid and no sting barrier film can reduce the gravity of the wounds. The use of the healing in humid environments is also recommended on the treatment of radiodermitis. Some products like hydrocolloids, silver dressings and hydrogel also improve the scarring. CONCLUSION: Managing radiodermitis is a complex matter. Therefore the action protocol based on evidence is the ideal tool to improve the efficiency and effectiveness of the cares, giving an increase on the tolerance to treatment and a reduction on the public health cost and a higher quality of life fo rpatients.
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Protocolos Clínicos , Radiodermite/enfermagem , HumanosRESUMO
INTRODUCTION: cancer is an important illness in the sanitary field due to phisic and functional consequences involved in it. Among these consequences there is the malnutrition which can cause a loss of lean mass and with it a decrease in the Quality of Life, an increase in hospital stays, social and health costs and so on. The aim of this research is to know which factors can influence in the loss of the lean mass. MATERIAL AND METHODS: it is a cross-sectional study in a sample of 72 patients who receive a radiotherapy with curative intent during a period from February 07th and May 14th, 2014. RESULTS: from this pattern Of the total 64 patients were studied, of which 43.7% of the patients presented loss of lean mass, with 21.8% the percentage of patients losing < 2%, 4.7% those with a loss between 2-5% and > 5%, 17.2% of patients. Among the factors studied that can influence the loss of lean mass, only the presence of digestive symptoms have statistical significance (OR = 3.3 or 6.6, as we take as a reference the percentage loss). CONCLUSIONS: the aim of the health staff who are working with these patients is to avoid the consequences that accompanies the loss of lean mass. For all this, it is very important to act before the digestive symptoms, by anticipating to them, or early implementation of an individualized nutritional intervention.
Introducción: el cáncer es una enfermedad de gran importancia sanitaria debido a las consecuencias físicas y funcionales que conlleva. Entre estas consecuencias está la desnutrición, que puede provocar una pérdida de masa magra y con ello una disminución de la calidad de vida, aumento de las estancias hospitalarias, costes sanitarios, etc. El objetivo de este estudio es conocer qué factores influyen en la pérdida de masa magra. Material y métodos: se trata de un estudio transversal en una muestra de 72 pacientes que reciben tratamiento radioterápico con finalidad curativa en un período comprendido entre el 7 de febrero y el 14 de mayo de 2014. Resultados: del total de pacientes se estudiaron 64, de los cuales el 43,7% presentan pérdida de masa magra, siendo el porcentaje de 21,8% los pacientes que pierden < 2%, el 4,7% los que presentan una pérdida entre el 2-5% y > 5%, el 17,2% de los pacientes. De entre los factores estudiados que pueden influir en la pérdida de masa magra, solo la presencia de síntomas digestivos poseen significación estadísitca (OR = 3,3 o 6,6, según tomemos como referencia el porcentaje de pérdida). Conclusiones: el objetivo del personal sanitario que trabaja con estos pacientes de evitar las consecuencias que acompañan a la pérdida de masa magra. Por todo esto, es importante actuar antes de la aparición de síntomas digestivos, mediante la prevención de los mismos, o la aplicación precoz de una intervención nutricional individualizada.