ABSTRACT
BACKGROUND: Malnutrition is a frequent medical problem of cancer patients that negatively impacts their quality of life. METHODS: A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Nutrition convened to discuss the management of the nutritional support in cancer patients. RESULTS: Of the 18 questions addressed, 9 focused on nutritional support, 5 were related to parenteral nutrition (PN) and 4 about home PN (HPN). The panel of experts recommends using nutritional screening routinely, at diagnosis and throughout the disease course, for detecting the risk of malnutrition and, if it is positive, to perform a complete nutritional assessment, to diagnose malnutrition. Currently, there are different screening tools and methods that allow us to detect nutritional risk. Based on the evidence and experience, the panel stated that PN is indicated mainly when it is not possible to use the digestive tract and/or oral feeding and/or enteral nutrition is not sufficient or possible. The nutritional needs of the cancer patients, except in those cases where individualized measures are required, should be considered similar to healthy individuals (25-30 kcal/kg/day). The panel considers that the nutritional monitoring of the cancer patient should be multidisciplinary and adapted to the characteristics of each center. Additionally, the objective of the HPN is to improve or maintain the nutritional status of a patient at home. CONCLUSIONS: This document seeks to lay down a set of recommendations and to identify key issues that may be useful for the nutritional management of cancer patients.
Subject(s)
Malnutrition/etiology , Malnutrition/therapy , Neoplasms/complications , Nutritional Support/methods , HumansABSTRACT
OBJECTIVE: Several studies have shown the importance of health care professionals as predictors of the use of cervical cancer screening (CCS). MATERIAL AND METHODS: A cross-sectional study of 520 health care professionals in the State of Morelos during 1998, in order to evaluate and quantify their level of knowledge on the impact, etiology, screening, diagnosis and treatment of cervical cancer. A 1 to 10 scale questionnaire was given, and the sample included family medicine specialists, general practitioners, specialist and general nurses, and social workers. Statistical analysis included analysis of variance and 95% confidence intervals. RESULTS: A knowledge mean of 4.74 (95% CI 4.57-4.88) was observed for a scale of 10; specialist physicians scored higher (mean 5.21, 95% CI 4.81-5.60) than social workers (mean 3.07, 95% CI 2.31-3.82). Periodicity of the Pap test in most cases was less than 1 year and there was poor consensus about the age period during which the Pap test should be obtained. The knowledge level was lower when trying to identify etiologic aspects and treatment perspectives. CONCLUSIONS: The results of this study show that, besides the improvement of undergraduate academic programs, it is necessary to improve educational interventions for health care professionals through the updating, recycling, training, health education, and continuing medical education, among others, to promote professional competence and thus improve the quality of medical care.