Sarcopenia and Skeletal Muscle Quality as Predictors of Postoperative Complication and Early Mortality in Gynecologic Cancer.

OBJECTIVE: This study aimed to evaluate the influence of sarcopenia and the indicators of skeletal muscle (SM) quality on surgical outcomes in women with ovarian and endometrial cancer who underwent oncologic surgery. METHODS: Endometrial and ovarian cancer patients admitted between 2008 and 2015 and who had computerized tomography images available within 45 days before surgery were enrolled in a retrospective cohort (n = 250). Computerized tomography images at the third lumbar vertebra were used to assess SM. Skeletal muscle index (SMI) was calculated in the range from -29 to +150 Hounsfield Units; reduced muscle attenuation (range, -29 to +29 HU) was classified as low-radiodensity skeletal muscle index (LRSMI). By subtracting the LRSMI area from total SMI, high-radiodensity skeletal muscle index (HRSMI) was created. Sarcopenia was defined when SMI was less than 38.9 cm/m. Multiple logistic regression evaluated predictors of surgical complications. RESULTS: Patients in lower HRSMI quartiles and in the highest quartiles of LRSMI had more postoperative surgical complication and had prolonged hospital stay. Both sarcopenia and the quality indicators of SM were predictors of increased risk of surgical complication, HRSMI being the strongest predictor. However, in a combined adjustment with sarcopenia, only HRSMI remained in the model as an independent predictor for surgical complication. In addition, HRSMI was the only indicator associated with early mortality (<30 days). CONCLUSIONS: The indicators of SM quality were the most significant predictors of surgical complications. Classifying muscle quality in terms of low-radiodensity or high-radiodensity area is a promising strategy to understand the impact of SM quality on unfavorable surgical outcomes in cancer patients.

Characterization of cereal bars enriched with dietary fiber and omega 3 / Caracterizacao de barras de cereal enriquecidas com fibra dietética e omega 3

The aim of the present work was to characterize cereal bars with high levels of fiber and w-3 using functional ingredients. Formulations were developed containing 0%, 5%, 10% and20% of linseed. Proximate chemical, w-linolenic and linoleic acids and acceptability analyses were carried out. The carbohydrate concentrations of the cereal bars with linseed were lower than those of the control (p<0.004); while the protein content did not differ among the formulations (p>0.05). The bar containing 20% of linseed presented higher lipid content (p<0.001). The formulations with 5% and 10% of linseed were considered sources of dietary fiber, while the formulation with 20% was considered a good source. Regarding -3, the formulations containing linseed were classified as excellent sources. The calorie value of the cereal bars was around 100 kcal/portion. The formulations containing linseed presented higher acceptability, and that with 20% of linseed was found to be the formulation with the best chemical and sensory characteristics. Therefore, the addition of linseed in cereal bars is a good option to develop a functional product, which may contribute to a healthy diet and to the reduction of several non-communicable diseases.

Objetivou-se caracterizar barras de cereais enriquecidas com fibra alimentar e ômega-3, utilizando ingredientes funcionais. Foram desenvolvidas formulações, contendo 0%, 5%, 10% e 20% de linhaça, realizadas análises químicas centesimal, de ácidos α-linolênico e linoléico e aceitabilidade. As concentrações de carboidratos das barras de cereais com linhaça foram menores que o controle (p<0,004) e o teor de proteína não diferiu entre as formulações (p>0,05). A barra de cereais contendo 20% de linhaça apresentou maior teor de lipídio (p<0,001). As formulações com 5% e 10% de linhaça são consideradas fontes de fibra alimentar e a formulação com 20%, boa fonte. Com relação ao ω-3, as formulações contendo linhaça foram classificadas como excelentes fontes. O valor calórico das barras de cereais foi em torno de 100 kcal/ porção. As formulações adicionadas de linhaça apresentaram maior aceitabilidade, e a de 20% de linhaça apresentou melhor formulação em relação às características químicas e sensoriais. Portanto, a adição de linhaça às barras de cereais é uma boa opção para desenvolver um produto funcional, que pode contribuir para uma dieta saudável e reduzir várias doenças crônicas não-transmissíveis.