Regular Exercise Improved Fatigue and Musculoskeletal Pain in Young Adult Psoriatic Patients without Psoriatic Arthritis.

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.

Knowledge, Attitudes and Behaviours of Adolescents and Young Adult Population on the Use of E-Cigarettes or Personal Vaporizer.

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.

Self-management in heart failure using mHealth: A content validation.

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.

Nutritional management of cancer patients in clinical practice in Spain: patients' and multidisciplinary health care professionals' perceptions.

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.

[Opinions and experiences of healthcare professionals in the nutritional management of oncology patients: the ONA study]. / Opiniones y experiencias de profesionales sanitarios en el manejo nutricional del paciente oncológico: estudio ONA.

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.

Impact of Probiotics on the Performance of Endurance Athletes: A Systematic Review.

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.

Perceived Stress and Increased Food Consumption during the 'Third Wave' of the COVID-19 Pandemic in Spain.

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.

Impact of the COVID-19 Pandemic on the Mental Health of Nurses and Auxiliary Nursing Care Technicians-A Voluntary Online Survey.

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.

Enteral Nutrition by Nasogastric Tube in Adult Patients under Palliative Care: A Systematic Review.

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.

Consumption of over-the-Counter Drugs: Prevalence and Type of Drugs.

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.

Knowledge and Practice of Health Professionals in the Management of Dysphagia.

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.

Nurse and Nursing Students´ Opinions and Perceptions of Enteral Nutrition by Nasogastric Tube in Palliative Care.

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.

Eating Habits and Physical Activity of the Spanish Population during the COVID-19 Pandemic Period.

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.

Mutilación genital femenina: conocimientos del profesional sanitario y estudiantado de Enfermería / Female Genital Mutilation: Awareness by Healthcare Professionals and Nursing Students

Objetivo: identificar los conocimientos, experiencias y necesidades formativas percibidas sobre la mutilación genital femenina (MGF) en el estudiantado de Enfermería y los profesionales de la salud, así como las posibles diferencias entre ambos grupos poblacionales. Método: estudio descriptivo transversal en profesionales sanitarios y estudiantes de Enfermería de cualquier ámbito de la salud en el territorio español. Se utilizó un cuestionario autoadministrado y semiestructurado que recogía variables sociodemográficas y de conocimientos, experiencias y necesidades formativas entorno a la MGF. Se administró entre marzo y junio de 2018. Se aplicó estadística descriptiva y Chi cuadrado. Se calcularon intervalos de confianza al 95% de seguridad (IC95%). Resultados: se incluyeron 434 participantes. El 1,6% de la muestra ha presenciado algún caso de MGF durante su ejercicio profesional, existiendo diferencias estadísticamente significativas entre grupos (p< 0,01), siendo otros profesionales sanitarios el grupo con valores más altos (14,8%, n= 4). En todos los grupos, más del 80% de los sujetos afirmó tener conocimientos sobre la MGF, aunque este porcentaje disminuyó cuando se preguntó por las diferentes prácticas que engloba, siendo a veces definida solo como el procedimiento de escisión de clítoris. Más del 80% de los participantes negaron conocer la existencia de protocolos y afirmaron tener pocos conocimientos sobre el tema (> 90%). No existen diferencias entre los diferentes grupos. Conclusiones: la formación y experiencias del estudiantado de Enfermería y diferentes profesionales sanitarios sobre la MGF son mínimas, y demandan más información/formación sobre este tema

Objective: to identify the awareness, experiences and training needs perceived about female genital mutilation (FGM) among Nursing students and healthcare professionals, as well as any potential differences between both population groups. Method: a cross-sectional descriptive study among healthcare professionals and Nursing students in any healthcare setting in the Spanish territory. A self-administered and semi-structured questionnaire was used, collecting sociodemographical variables, as well as awareness, experiences and training needs around FGM. This questionnaire was applied between March and June, 2018; descriptive statistics and Square chi were used. Confidence intervals were estimated at 95% (CI95%). Results: the study included 434 participants; 1.6% of the sample had witnessed some case of FGM during their professional activity, and there were statistically significant differences between groups (p< 0.01): other healthcare professionals were the group with the highest values (14.8%, n= 4). In all groups, >80% of participants stated that they had knowledge about FGM, though this proportion was reduced when asked about the different practices included, and it was sometimes defined only as the clitoris excision procedure. Over 80% of participants said that they were not aware of any existing protocols, and had limited knowledge about the matter (> 90%). There were no differences between the different groups. Conclusions: nursing students and different healthcare professionals have minimal training and experiences around FGM, and they demand more information / training on this matter

Hydrodynamic and Electrophoretic Properties of Trastuzumab/HER2 Extracellular Domain Complexes as Revealed by Experimental Techniques and Computational Simulations.

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.

Análisis predictivo que evalúa la pérdida de masa magra en pacientes oncológicos expuestos a tratamiento de radioterapia / Predictive analytics assessing the lean mass loss in oncologic patients exposed to radiotherapy treatment

ANTECEDENTES: la pérdida de masa magra en el paciente oncológico produce graves consecuencias, tales como: la disminución de la calidad de vida, la peor tolerancia a los tratamientos y el aumento de los costos de la asistencia social. OBJETIVO: El objetivo del presente estudio fue establecer y desarrollar un análisis predictivo que evalúe la pérdida de masa magra experimentada en pacientes oncológicos en tratamiento de radioterapia. MÉTODOS: Se realizó un análisis prospectivo, tomando una muestra de 231 pacientes oncológicos que han sido expuestos a radioterapia. Las mediciones antropométricas se han registrado a través del instrumento TANITA TBF-300. El método hacia atrás se ha utilizado para determinar la ecuación que se desarrolla a partir de un modelo de regresión completo que incluye varias variables independientes. RESULTADOS: solo se estudiaron 197 pacientes que conformaron la muestra. La variable más representativa que contribuyó a la pérdida de masa magra se ha tomado como una variable de referencia. Esta es el tratamiento de quimioterapia (p = 0.02, IC = 95%), y a través del análisis estadístico, se ha obtenido la siguiente ecuación: % de pérdida de masa magra = -0.453 + 0.167% de contenido de agua inicial - 0.065% de masa magra + 0.246% de peso pérdida (R2 = 0.264, F = 5.375, p <0.01). CONCLUSIÓN: La ecuación obtenida para predecir el% de pérdida de masa magra, en cualquier punto o etapa durante el curso del tratamiento, es efectiva y confiable

BACKGROUND: The loss of lean mass in the oncological patient produces serious consequences such as: the decrease in the quality of life, in tolerance to treatments and increase in social healthcare costs. OBJECTIVE: The aim of the present study was to establish and develop a predictive analytics which assesses for the lean mass loss experienced in oncologic patients under radiotherapy treatment. METHODS: A prospective analysis has been undertaken, taking a sample of 231 oncologic patients which have been exposed to radiotherapy treatment. Anthropometric measurements have been recorded via TANITA TBF-300 instrument. Backward method has been used to determine the equation which develops from a complete regression model including several independent variables. RESULTS: Only 197 patients that conformed the sample were studied. The most representative variable that contributed to the lean mass loss has been taken as a reference variable. This is the chemotherapy treatment (p = 0.02, IC = 95%), and through statistical analysis, the following equation has been obtained:% lean mass loss = -0.453 + 0.167 % initial water content - 0.065 % lean mass + 0.246 % weight loss (R2 = 0.264, F = 5.375, p < 0.01). CONCLUSION: The equation obtained to predict the % lean mass loss, at any point or stage during the treatment course, is effective and reliable

[Analysis of three methods of nutritional screening in oncologic patients]. / Cribado nutricional en pacientes oncológicos: análisis de tres métodos.

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.

Cribado nutricional en pacientes oncológicos: análisis de tres métodos / Analysis of three methods of nutritional screening in oncologic patients

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

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

Ingesta dietética y seguimiento de la Dieta Mediterránea en pacientes oncológicos / Dietary intake and follow-up of the Mediterranean Diet in cancer patients

Introducción: Las investigaciones sobre la relación de la dieta y el cáncer se han centrado en la prevención del cáncer mediante la ingesta de algún tipo de nutriente y/o la presencia de desnutrición, pero es necesario conocer la ingesta de estos pacientes y valorar si cubren sus requerimientos nutricionales. Además, esta ingesta debe adaptarse a una dieta saludable, como la dieta mediterránea (DM) Objetivo: Conocer la ingesta dietética y el cumplimiento de las ingestas recomendadas, en estos pacientes, así como la adherencia a la DM. Material y métodos: Estudio observacional prospectivo en pacientes oncológicos que van a ser sometidos a radioterapia. Se evalúa la ingesta dietética mediante registro dietético de 3 días y adherencia a la DM mediante el cuestionario utilizado por el grupo de Prevención con Dieta Mediterránea (PREDIMED). Resultados: Se estudian un total de 84 pacientes, observándose una ingesta energética, de hidratos de carbono y ácidos grasos poliinsaturados por debajo del 5% de las IR y de proteínas, grasas y ácidos grasos monoinsaturatos superior al 5%. La ingesta de colesterol es superior para ambos sexos, especialmente en mujeres, y la de fibra inferior. El 65,48% de la muestra presenta baja adherencia a la DM y el 34,52% alta adherencia. Las mujeres presentan mejor adherencia que los hombres (37,21% frente al 31,71%), pero esta diferencia no es estadísticamente significativa (p>0,05). Conclusiones: Los resultados obtenidos muestran que los pacientes no ingieren una dieta equilibrada y adaptada a su estado de salud. Además, se deben proporcionar pautas para conseguir una mejor adherencia a la DM

Introduction: Research on the relationship between diet and cancer has focused on the prevention of cancer through the ingestion of some type of nutrient and / or the presence of malnutrition, but it is necessary to know the intake of these patients and to evaluate if they cover Their nutritional requirements. In addition, this intake should be adapted to a healthy diet, such as the Mediterranean diet (DM). Objective: To know the dietary intake and the compliance of the recommended intakes, in these patients, as well as the adherence to the DM. Material and methods: Prospective observational study in oncology patients who will undergo radiotherapy. The dietary intake is evaluated through 3-day dietary registration and adherence to DM through the questionnaire used by the Mediterranean Diet Prevention Group (PREDIMED). Results: A total of 84 patients were studied, with an energy intake of carbohydrates and polyunsaturated fatty acids below 5% of IR and protein, fat and monounsaturated fatty acids higher than 5%. Cholesterol intake is higher for both sexes, especially in women, and lower fiber intake. 65.48% of the sample shows low adherence to DM and 34.52% high adherence. Women presented better adherence than men (37.21% vs. 31.71%), but this difference is not statistically significant (p> 0.05). Conclusions: The results show that patients do not eat a balanced diet and adapted to their health status. In addition, guidelines should be provided to achieve a better adherence to DM

Correlation between loss of lean mass and quality of life in cancer patients / Relación entre la pérdida de masa magra y la calidad de vida en pacientes con cánce

Introduction: Weight loss and especially the loss of lean mass, can lead into losing own self-esteem, due to body changes suffered in the event of malnutrition and the progressive dependence of relatives and/or carers, making the oncological patient to perceive their health state in a negative way. Objective: The aim of this study was to identify the relationship or association between the loss of lean mass and the quality of life in patients with cancer. Methods: A longitudinal and prospective study was performed in 231 oncologic patients undergoing radiotherapy treatment. Sociodemographic, clinical, anthropometric and life-quality variables where measured, evaluated and collected by means of the Health-Related Quaility of Life (EORTC-QLQ c30) questionnaire. Results: Of the total sample only 197 ends with the study. The results revealed that there was a positive correlation in pre- and post-treatment, although this was not significant in most cases (rho <0.63). In addition, the results were obtained through the application of Chi-square approach, did not identify the relationship between mass loss and its effect on the quality of life of the patient, in addition to the differentiation between the categories in which the problem was subdivided P <0.05). Conclusions: The loss of lean mass, without considering other health conditions or effects, did not prove to be detrimental to the quality of life of the patient. HRQoL is a multidimensional concept

Introducción: El cáncer y sus tratamientos pueden dar lugar a la desnutrición, produciendo cambios metabólicos que pueden dar lugar a una disminución de la calidad de vida. Dentro de estos cambios se encuentra la pérdida de masa magra, que puede originar aumento de las comorbilidades, dependencia y cambios corporales. Objetivo: Evaluar si la pérdida de masa magra influye en la calidad de vida en pacientes con cáncer. Métodos: Se ha realizado un estudio longitudinal y prospectivo, en una muestra de 231 pacientes que acudieron a tratamiento de radioterapia. Se recogen variables sociodemográficas, clínicas, antropométricas y de calidad de vida mediante el cuestionario Health-Related Quaility of Life (EORTCQLQ c30) antes de inciar el tratamiento y una vez finalizado el mismo. Resultados: Del total de pacientes que se seleccionaron, se analizan 197 de ellos (33 pérdidas y 1 exitus). Los resultados pre y postratamiento muestran que existe correlación positiva entre los dos momentos de corte, aunque esta no sea alta en la mayoría de las categorías (rho < 0,63). Además el resultado obtenido mediante el test Chi-cuadrado, no refleja relación existente entre la pérdida de masa magra y la disminución de la calidad de vida, así como en las diferentes categorías en las que se divide el cuestionario de manera significativamente estadística (p>0,05). Conclusiones: La relación entre la pérdida de masa magra y la calidad de vida (CVRS) es un concepto multidimensional que no solo depende de un factor. Por ello, la pérdida de masa magra de forma aislada sin efectos derivados de la misma (aumento de las UPP, disminución de la dependencia, etc.) no conduce a una disminución de la percepción de calidad de vida