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1.
Nutrients ; 13(4)2021 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-33919840

RESUMEN

The novel severe acute respiratory syndrome coronavirus (COVID-19) has hit older adults harder due to a combination of age-related immunological and metabolic alterations. The aim of this review was to analyze the COVID-19 literature with respect to nutritional status and nutrition management in older adults. No studies only on people aged 65+ years were found, and documentation on those 80+ was rare. Age was found to be strongly associated with worse outcomes, and with poor nutritional status. Prevalence of malnutrition was high among severely and critically ill patients. The studies found a need for nutrition screening and management, and for nutrition support as part of follow-up after a hospital stay. Most tested screening tools showed high sensitivity in identifying nutritional risk, but none were recognized as best for screening older adults with COVID-19. For diagnosing malnutrition, the Global Leadership Initiative on Malnutrition (GLIM) criteria are recommended but were not used in the studies found. Documentation of olfactory and gustatory dysfunction in relation to nutritional status is missing in older adults. Other COVID-19-associated factors with a possible impact on nutritional status are poor appetite and gastrointestinal symptoms. Vitamin D is the nutrient that has attracted the most interest. However, evidence for supplementation of COVID-19 patients is still limited and inconclusive.


Asunto(s)
Envejecimiento , Evaluación Nutricional , Terapia Nutricional/métodos , Estado Nutricional , Factores de Edad , Anciano , Anciano de 80 o más Años , Agnosia/epidemiología , Síndrome de Liberación de Citoquinas/epidemiología , Femenino , Enfermedades Gastrointestinales/epidemiología , Hospitalización , Humanos , Masculino , Desnutrición/epidemiología , Persona de Mediana Edad , Trastornos del Olfato/epidemiología , Prevalencia , Factores de Riesgo , Sarcopenia/epidemiología , Vitamina D/uso terapéutico
2.
Artículo en Inglés | MEDLINE | ID: mdl-33808072

RESUMEN

The aim of this study was to test validity and reliability of the adapted version of the Nutrition Literacy Assessment Instrument (NLit) for Italian people (NLit-IT). An observational cross-sectional study was conducted, involving a convenience sample of adults (n = 74). To explore the validity of the tool, we considered both diet quality as an outcome of NL, and health literacy (HL) as a construct that presents similarities and differences with NL. Diet quality was measured by adherence to the Mediterranean Diet (Med diet) through the validated Mediterranean Diet Literature-based adherence score (MEDI-Lite). The relationship between NL level and adherence to Med diet was assessed by linear regression analysis and computing correlations between NLit-IT and MEDI-Lite scores (Spearman's Rho). Additionally, we evaluated the correlation between NLit-IT score and the level of HL (Spearman's Rho). Internal consistency and reliability were measured by Cronbach's alpha and intraclass correlation coefficient (ICC) respectively. Internal consistency (ρT = 0.78; 95% CI, 0.69-0.84) and reliability (ICC = 0.68, 95% CI, 0.46-0.85) were confirmed. In addition, NLit-IT total score was correlated with MEDI-Lite score (Rho = 0.25; p-value = 0.031) and multivariate regression analysis confirmed that NL significantly contributed to MEDI-Lite score (R2 = 0.13; ß = 0.13; p-value = 0.008). There was no significant association between the level of HL and NL. In conclusion, NLit-IT showed validity and reliability as a measure of NL for Italian people.


Asunto(s)
Alfabetización en Salud , Evaluación Nutricional , Adulto , Estudios Transversales , Humanos , Italia , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
3.
BMC Geriatr ; 21(1): 256, 2021 04 17.
Artículo en Inglés | MEDLINE | ID: mdl-33865312

RESUMEN

BACKGROUND: Readmission is related to high cost, high burden, and high risk for mortality in geriatric patients. A scoring system can be developed to predict the readmission of older inpatients to perform earlier interventions and prevent readmission. METHODS: We followed prospectively inpatients aged 60 years and older for 30 days, with initial comprehensive geriatric assessment (CGA) on admission in a tertiary referral centre. Patients were assessed with CGA tools consisting of FRAIL scale (fatigue, resistance, ambulation, illness, loss of weight), the 15-item Geriatric Depression Scale, Mini Nutritional Assessment short-form (MNA-SF), the Barthel index for activities of daily living (ADL), Charlson Comorbidity Index (CCI), caregiver burden based on 4-item Zarit Burden Index (ZBI), and cognitive problem with Abbreviated Mental Test (AMT). Demographic data, malignancy diagnosis, and number of drugs were also recorded. We excluded data of deceased patients and patients transferred to other hospitals. We conducted stepwise multivariate regression analysis to develop the scoring system. RESULTS: Thirty-day unplanned readmission rate was 37.6 %. Among 266 patients, 64.7 % of them were malnourished, and 46.5 % of them were readmitted. About 24 % were at risk for depression or having depressed mood, and 53.1 % of them were readmitted. In multivariate analysis, nutritional status (OR 2.152, 95 %CI 1.151-4.024), depression status (OR 1.884, 95 %CI 1.071-3.314), malignancy (OR 1.863 95 %CI 1.005-3.451), and functional status (OR 1.584, 95 %CI 0.885-2.835) were included in derivation of 7 score system. The scoring system had maximum score of 7 and incorporated malnutrition (2 points), depression (2 points), malignancy (2 points), and dependent functional status (1 point). A score of 3 or higher suggested 82 % probability of readmission within 30 days following discharge. Area under the curve (AUC) was 0.694 (p = 0.001). CONCLUSIONS: Malnutrition, depression, malignancy and functional problem are predictors for 30-day readmission. A practical CGA-based 7 scoring system had moderate accuracy and strong calibration in predicting 30-day unplanned readmission for older patients.


Asunto(s)
Desnutrición , Readmisión del Paciente , Actividades Cotidianas , Anciano , Depresión/diagnóstico , Depresión/epidemiología , Evaluación Geriátrica , Humanos , Desnutrición/diagnóstico , Desnutrición/epidemiología , Persona de Mediana Edad , Evaluación Nutricional , Estado Nutricional , Estudios Prospectivos , Factores de Riesgo
4.
Cent Eur J Public Health ; 29(1): 68-75, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33831289

RESUMEN

OBJECTIVES: Measuring malnutrition is difficult in all settings and confused with the signs of aging. Mini nutritional assessment is an effective tool designed to identify older adults who have a risk of developing malnutrition. METHODS: Three hundred and one free-living elderly who lived with their family or alone were included in the study. Nutritional screening was performed with mini nutritional assessment and mini nutritional assessment short form. Dietary intake was assessed by a 3-days weighted food record. RESULTS: According to mini nutritional assessment in the 65-74 years young-old group, malnutrition, risk of malnutrition, and normal nutrition was 2.4%, 39.5%, 58.2%, respectively, and in the 75-84 years old-old group it was 10.2%, 48.7%, 41.0%, respectively, and in the older than 85 years oldest-old group 92.3%, 7.7%, 0%, respectively. The lowest nutritional intake by recommended dietary allowance was zinc and the highest intake was sodium. Neither young-old group nor old-old group nor oldest-old group met the B12 and zinc requirements. CONCLUSIONS: The free-living elderly at an age of 85 years and above are, accompanied by the existence of factors which may mask their weight losses, under a severe risk of malnutrition unless they receive adequate medical care and attention.


Asunto(s)
Desnutrición , Estado Nutricional , Anciano , Anciano de 80 o más Años , Envejecimiento , Evaluación Geriátrica , Humanos , Desnutrición/epidemiología , Evaluación Nutricional
5.
BMC Cancer ; 21(1): 435, 2021 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-33879101

RESUMEN

BACKGROUND: Local recurrence is common after curative resections for rectal cancer. Surgical intervention is among the best treatment choices. However, achieving a negative resection margin often requires extensive pelvic organ resections; thus, the postoperative complication rate is quite high. Recent studies have reported that the inflammatory index could predict postoperative complications. This study aimed to validate the correlation between clinical factors, including inflammatory markers, and severe complications after surgery for local recurrent rectal cancer. METHODS: This retrospective study included 99 patients that underwent radical resections for local recurrences of rectal cancer. Postoperative complications were graded according to the Clavien-Dindo classification. Grades ≥3 were defined as severe complications. Risk factors for severe complications were identified with univariate and multivariate logistic regression models and assessed with receiver-operating characteristic curves. RESULTS: Severe postoperative complications occurred in 38 patients (38.4%). Analyses of correlations between inflammatory markers and severe postoperative complications revealed that the strongest correlation was found between the prognostic nutrition index and severe postoperative complications. The receiver-operating characteristic analysis showed that the optimal prognostic nutrition index cut-off value was 42.2 (sensitivity: 0.790, specificity: 0.508). In univariate and multivariate analyses, a prognostic nutrition index ≤44.2 (Odds ratio: 3.007, 95%CI:1.171-8.255, p = 0.02) and a blood loss ≥2850 mL (Odds ratio: 2.545, 95%CI: 1.044-6.367, p = 0.04) were associated with a significantly higher incidence of severe postoperative complications. CONCLUSIONS: We found that a low preoperative prognostic nutrition index and excessive intraoperative blood loss were risk factors for severe complications after surgery for local recurrent rectal cancer.


Asunto(s)
Estado Nutricional , Complicaciones Posoperatorias/etiología , Neoplasias del Recto/complicaciones , Neoplasias del Recto/diagnóstico , Anciano , Biomarcadores , Terapia Combinada , Femenino , Humanos , Mediadores de Inflamación , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Evaluación Nutricional , Oportunidad Relativa , Complicaciones Posoperatorias/diagnóstico , Periodo Preoperatorio , Pronóstico , Curva ROC , Neoplasias del Recto/metabolismo , Neoplasias del Recto/cirugía , Estudios Retrospectivos , Factores de Riesgo , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad
6.
J Vis Exp ; (169)2021 03 19.
Artículo en Inglés | MEDLINE | ID: mdl-33818566

RESUMEN

To collect dietary intake data in a fast and reliable manner, a flexible and innovative smartphone application (app) called Traqq was developed (iOS/Android). This app can be used as a food record and 24-h recall (or shorter recall periods). Different sampling schemes can be created on either prespecified or random days/times within a predetermined period for both methods, with push notifications to urge the participants to register their food intake. In case of non-response, notifications are automatically rescheduled to ensure complete data collection. For use as a food record, respondents can access the app and log their food intake throughout the day. Food records close automatically at the end of the day; recalls close after submission of the consumed items. The recall as well as the food record module provide access to an extensive food list based on the Dutch food composition database (FCDB), which can be accustomed to fit different research purposes. When selecting a food item, respondents are simultaneously prompted to insert portion size, i.e., in household measures (e.g., cups, spoons, glasses), standard portion sizes (e.g., small, medium, large), or weight in grams, and eating occasion/time of consumption. Portion size options can be adjusted, e.g., only entry in grams in case of a weighed food record or time of consumption instead of eating occasion). The app also includes a My Dishes function, which allows the respondent to create their own recipes or product combinations (e.g., a daily breakfast) and only report the total quantity consumed. Subsequently, the app accounts for yield and retention factors. The data are stored on a secure server. If desired, additional questions, i.e., in general or those related to specific food items or eating occasions can be incorporated. This paper describes the development of the system (app and backend), including expert evaluations and usability testing.


Asunto(s)
Dieta/métodos , Evaluación Nutricional , Teléfono Inteligente/instrumentación , Telemedicina/métodos , Humanos
7.
Artículo en Inglés | MEDLINE | ID: mdl-33803339

RESUMEN

Malnutrition is common among severe patients with coronavirus disease 2019 (COVID-19), mainly elderly adults and patients with comorbidities. It is also associated with atypical presentation of the disease. Despite the possible contribution of malnutrition to the acquisition and severity of COVID-19, it is not clear which nutritional screening measures may best diagnose malnutrition in these patients at early stages. This is of crucial importance given the urgency and rapid progression of the disease in vulnerable groups. Accordingly, this review examines the available literature for different nutritional screening approaches implemented among COVID-19 patients, with a special focus on elderly adults. After a literature search, we selected and scrutinized 14 studies assessing malnutrition among COVID-19 patients. The Nutrition Risk Screening 2002 (NRS-2002) has demonstrated superior sensitivity to other traditional screening measures. The controlling nutritional status (CONUT) score, which comprises serum albumin level, cholesterol level, and lymphocytes count, as well as a combined CONUT-lactate dehydrogenase-C-reactive protein score expressed a predictive capacity even superior to that of NRS-2002 (0.81% and 0.92% vs. 0.79%) in midlife and elder COVID-19 patients. Therefore, simple measures based on routinely conducted laboratory investigations such as the CONUT score may be timely, cheap, and valuable alternatives for identifying COVID-19 patients with high nutritional risk. Mini Nutritional Assessment (MNA) was the only measure used to detect residual malnutrition and high malnutrition risk in remitting patients-MNA scores correlated with hypoalbuminemia, hypercytokinemia, and weight loss. Older males with severe inflammation, gastrointestinal symptoms, and pre-existing comorbidities (diabetes, obesity, or hypertension) are more prone to malnutrition and subsequently poor COVID-19 prognosis both during the acute phase and during convalescence. Thus, they are in need of frequent nutritional monitoring and support while detecting and treating malnutrition in the general public might be necessary to increase resilience against COVID-19.


Asunto(s)
Desnutrición , Adulto , Anciano , Evaluación Geriátrica , Humanos , Masculino , Desnutrición/diagnóstico , Desnutrición/epidemiología , Evaluación Nutricional , Estado Nutricional , Medición de Riesgo
8.
Kardiologiia ; 61(1): 59-65, 2021 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-33706688

RESUMEN

Objective The importance of nutritional status in non-ST segment elevated acute coronary syndrome (NSTE-ACS) is not clear. In this study, the importance of prognostic nutritional index (PNI) in terms of in-hospital mortality in patients with NSTE-ACS and its relationship with the Global Record of Acute Coronary Events (GRACE) risk score were investigated.Material and methods A total of 498 consecutive NSTE-ACS patients were recorded retrospectively. PNI for nutritional status assessment of patients with NSTE-ACS. PNI was calculated as 10 × serum albumin (g / dL) + 0.005 × total lymphocyte count (per mm3). The association between PNI and GRACE risk score was assessed.Results Patients were classified as low-risk group (≤108 points, n=222), medium-risk group (109-140 points, n=161) and high-risk group (>140 points, n=115) according to the GRACE score. The mean PNI value was found to be the lowest in the high-risk group compared to other risk groups. There was a significant negative correlation between GRACE risk score and PNI (p<0.001). In multivariate analysis, PNI resulted as a predictor of in-hospital mortality independent of GRACE risk score (OR=0.909; 95 % CI: 0.842-0.981; p=0.01). PNI value in the high risk group for in-hospital mortality was determined to have significant predictive ability (AUC=0.710; 95 % CI: 0.61-0.80; p<0001).Conclusions PNI evaluation is a useful and easy method to evaluate the nutritional status of patients with NSTE-ACS. Our study suggests that the PNI is significantly associated with in-hospital mortality, and GRACE risk score in patients with NSTE-ACS. This study is the basis for new studies to investigate whether PNI contributes additional prognostic to the GRACE risk score.


Asunto(s)
Síndrome Coronario Agudo , Evaluación Nutricional , Síndrome Coronario Agudo/diagnóstico , Humanos , Pronóstico , Estudios Retrospectivos , Medición de Riesgo
9.
Nutr Clin Pract ; 36(2): 275-281, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33734477

RESUMEN

Iatrogenic malnutrition and underfeeding are ubiquitous in intensive care units (ICUs) worldwide for prolonged periods after ICU admission. A major driver leading to the lack of emphasis on timely ICU nutrition delivery is lack of objective data to guide nutrition care. If we are to ultimately overcome current fundamental challenges to effective ICU nutrition delivery, we must all adopt routine objective, longitudinal measurement of energy targets via indirect calorimetry (IC). Key evidence supporting the routine use of IC in the ICU includes (1) universal societal ICU nutrition guidelines recommending IC to determine energy requirements; (2) data showing predictive equations or body weight calculations that are consistently inaccurate and correlate poorly with measured energy expenditure, ultimately leading to routine overfeeding and underfeeding, which are both associated with poor ICU outcomes; (3) recent development and worldwide availability of a new validated, accurate, easy-to-use IC device; and (4) recent data in ICU patients with coronavirus disease 2019 (COVID-19) showing progressive hypermetabolism throughout ICU stay, emphasizing the inaccuracy of predictive equations and marked day-to-day variability in nutrition needs. Thus, given the availability of a new validated IC device, these findings emphasize that routine longitudinal IC measures should be considered the new standard of care for ICU and post-ICU nutrition delivery. As we would not deliver vasopressors without accurate blood pressure measurements, the ICU community is only likely to embrace an increased focus on the importance of early nutrition delivery when we can consistently provide objective IC measures to ensure personalized nutrition care delivers the right nutrition dose, in the right patient, at the right time to optimize clinical outcomes.


Asunto(s)
/complicaciones , Calorimetría Indirecta/normas , Cuidados Críticos/normas , Desnutrición/diagnóstico , Evaluación Nutricional , /fisiopatología , Calorimetría Indirecta/métodos , Cuidados Críticos/métodos , Resultados de Cuidados Críticos , Enfermedad Crítica/terapia , Metabolismo Energético , Humanos , Unidades de Cuidados Intensivos , Desnutrición/prevención & control , Desnutrición/virología , Terapia Nutricional/métodos , Terapia Nutricional/normas , Necesidades Nutricionales , Estado Nutricional
10.
Nutr Clin Pract ; 36(2): 268-274, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33769598

RESUMEN

Clinicians have widely recognized that indirect calorimetry (IC) is the "gold standard" for measuring energy expenditure (EE) and thus would intuitively anticipate that its use would be needed to provide optimal nutrition support in critical illness. Recent studies in the literature as well as dramatic changes in clinical practice over the past decade, though, would suggest that such a precise measure by IC to set energy goals is not required to maximize clinical benefit from early feeding in the intensive care unit (ICU). Results from randomized controlled trials evaluating permissive underfeeding, use of supplemental parenteral nutrition to achieve tight calorie control, and caloric density of formulas to increase energy delivery have provided an important perspective on 3 pertinent issues. First, a simple weight-based predictive equation (25 kcal/kg/day) provides a clinically useful approximation of EE. Second, a precise measure of EE by IC does not appear to improve outcomes compared with use of this less accurate estimation of energy requirements. And third, providing some percentage of requirements (50%-80%), achieves similar clinical benefit to full feeding (100%) in the early phases of critical illness. The value from IC use lies in the determination of caloric requirements in conditions for which weight-based equations are rendered inaccurate (anasarca, amputation, severe obesity) or the clinical state is markedly altered (such as the prolonged hyperinflammatory state of coronavirus disease 2019 [COVID-19]). In most other circumstances, routine use of IC would not be expected to change clinical outcomes from early nutrition therapy in the ICU.


Asunto(s)
/terapia , Reglas de Decisión Clínica , Evaluación Nutricional , Apoyo Nutricional/métodos , Peso Corporal , Calorimetría Indirecta , Enfermedad Crítica/terapia , Metabolismo Energético , Humanos , Unidades de Cuidados Intensivos , Necesidades Nutricionales , Estado Nutricional
12.
BMC Geriatr ; 21(1): 161, 2021 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-33673811

RESUMEN

BACKGROUND: Globally, older population (aged ≥60 years) comprise 11% of the total population, and 23% of them are malnourished. Lack of knowledge and education, adverse dietary habits, depression or psychological disorders, poor oral and dental health, disability, and diseases are the reported factors responsible for malnutrition among them. Geriatric people comprise 7.5% of the total population of Bangladesh, and almost a quarter are malnourished. But there is scarce data on the factors associated with the nutritional status of the older population in Bangladesh. METHODS: A cross-sectional study was conducted among 125 older individuals (male 59, female 66) living in three villages of Uttarkhan, Dhaka, Bangladesh, to identify the factors associated with their nutritional status. The Mini Nutritional Assessment scale, Geriatric Depression Scale-Short Form, and Geriatric Oral Health Assessment Index were used for assessing the nutritional status, mental health status, and oral health quality of the respondents, respectively. Information on socio-demographic characteristics, comorbidities and dietary factors, and food behaviors were gathered by a pretested semi-structured questionnaire. Ethical approval was obtained from the Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. RESULTS: The participants' mean age was 67.9 ± 7.1 years. Most of them (53.6%) had no formal education. Among the respondents, 22.0% male and 28.8% female were malnourished. The proportion of malnourished and at risk of malnutrition among the respondents living without a partner were 28.6 and 65.3%, respectively. A significantly (p < 0.05) higher odds of having depression (OR 15.6; 95% CI 3.1-78.1), poor oral health (OR 7.3; 95% CI 1.3-41.8), and no formal education (OR 6.5; 95% CI 1.3-32.1) was observed among the malnourished respondents. Though it was not statistically significant, among the malnourished, 31.3, 25.0 and 25.0% avoided highly oily food, beef/mutton, and sugary food, respectively. CONCLUSIONS: More than two-thirds of the older population were malnourished or at risk of malnutrition, where the female respondents were more vulnerable. Depression, inadequate oral health, and lack of education were negatively associated with the nutritional status of the older population.


Asunto(s)
Desnutrición , Estado Nutricional , Anciano , Bangladesh/epidemiología , Estudios Transversales , Femenino , Evaluación Geriátrica , Humanos , Masculino , Desnutrición/diagnóstico , Desnutrición/epidemiología , Evaluación Nutricional
13.
Clinics (Sao Paulo) ; 76: e2258, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33787674

RESUMEN

OBJECTIVES: Geriatric nutritional risk index (GNRI) might predict the all-cause mortality in patients with heart failure (HF). We performed a meta-analysis to evaluate the correlation between GNRI and all-cause mortality in patients with HF. METHODS: We searched the PubMed, Medline, Cochrane Library, and Embase databases for clinical trials investigating the association between GNRI and all-cause mortality in patients with HF, having the primary endpoint as all-cause mortality. RESULTS: In total, nine studies involving 7,659 subjects were included in the systematic review and meta-analysis. The results indicated that major risk and moderate risk GNRI (GNRI<92) was associated with an increased risk of all-cause mortality in elderly patients with HF (hazard ratios [HR] 1.59, 95% confidence intervals [CI] 1.37-1.85). Low risk GNRI (GNRI<98) group predicted all-cause mortality in elderly HF patients (HR 1.56, 95%CI 1.12-2.18) when compared with the high GNRI value group. A subgroup analysis indicated that the relationship between GNRI and HF might differ based on the subtype of heart failure. CONCLUSIONS: GNRI is a simple and well-established nutritional assessment tool to predict all-cause mortality in patients with HF.


Asunto(s)
Insuficiencia Cardíaca , Desnutrición , Anciano , Evaluación Geriátrica , Humanos , Evaluación Nutricional , Estado Nutricional , Modelos de Riesgos Proporcionales , Factores de Riesgo
14.
Food Chem ; 354: 129529, 2021 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-33761334

RESUMEN

Approximately two-thirds of US infants receive infant formula (IF) as a primary or sole nutritional source during the first six months of life. IF is available in a variety of commercial presentations; from a manufacturing standpoint, they can be categorized as powder- (PIF) or liquid- (LIF) based formulations. Thirty commercial IFs were analyzed in their oxidative and non-oxidative lipid profiles. We identified 7-ketocholesterol - a major end-product of cholesterol oxidation - as a potential biomarker of IF manufacturing. The statistical analysis allowed a re-classification of IF based on their metabolomic fingerprint, resulting in three groups assigned with low-to-high oxidative status. Finally, we modeled the dietary intake of cholesterol, sterols, and 7-ketocholesterol in the first year of life. The database provided in this study will be instrumental for scientists interested in infant nutrition, to establish bases for epidemiological studies aimed to find connections between nutrition and diet-associated diseases, such as sitosterolemia.


Asunto(s)
Fórmulas Infantiles/química , Cetocolesteroles/química , Lípidos/química , Dieta , Evaluación Nutricional , Oxidación-Reducción
15.
Nutrients ; 13(3)2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33652581

RESUMEN

The aim of this study was to evaluate the association between handgrip strength, nutritional status and vitamin D deficiency in Mexican community-dwelling older women. A cross sectional study in women ≥ 60 years-old was performed. Plasma 25-hydroxyvitamin D (25(OH)D) concentrations were measured by a quantitative immunoassay technique. Handgrip strength was assessed using a dynamometer, while nutritional status was assessed through the Full Mini Nutritional Assessment (Full-MNA). A total of 116 women participated in the study, their mean age was 70.3 ± 5.8 years; 49.1% of the study group had plasma 25(OH)D levels lower than 40 nmol/L [16 ng/mL]. Meanwhile, 28.45% of participants had low handgrip strength (<16 kg), and 23.1% were identified at risk of malnutrition/malnourished according with Full-MNA score. Women with 25(OH)D deficiency (<40 nmol/L [16 ng/mL]) were more likely to have low handgrip strength (OR = 2.64, p = 0.025) compared with those with higher 25(OH)D values. Additionally, being malnourished or at risk of malnutrition (OR = 2.53, p = 0.045) or having type 2 diabetes mellitus (T2DM) (OR = 2.92, p = 0.044) was also associated with low 25(OH)D. The prevalence of low plasma 25(OH)D concentrations was high among Mexican active older women. Low handgrip strength, being at risk of malnutrition/malnourished, or diagnosed with T2DM was also associated with Vitamin D deficiency.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Fuerza de la Mano , Vida Independiente/estadística & datos numéricos , Estado Nutricional , Deficiencia de Vitamina D/epidemiología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/etnología , Femenino , Humanos , México/epidemiología , Persona de Mediana Edad , Evaluación Nutricional , Prevalencia , Vitamina D/análogos & derivados , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/etnología
16.
Nutrients ; 13(3)2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33652812

RESUMEN

The recent publication of the revised Consensus on definition and diagnosis of sarcopenia (EWGSOP2) and the Global Leadership Initiative on Malnutrition (GLIM) criteria changed the approach to research on sarcopenia and malnutrition. Whilst sarcopenia is a nutrition-related disease, malnutrition and cachexia are nutritional disorders sharing the common feature of low fat-free mass. However, they have differential characteristics and etiologies, as well as specific therapeutic approaches. Applying the current definitions in clinical practice is still a challenge for health professionals and the potential for misdiagnosis is high. This is of special concern in the subgroup of older people with cancer, in which sarcopenia, malnutrition, and cancer cachexia are highly prevalent and can overlap or occur separately. The purpose of this review is to provide an updated overview of the latest research and consensus definitions of sarcopenia, malnutrition, and cachexia and to discuss their implications for clinical practice in older patients with cancer. The overall aim is to improve the quality of nutritional care in light of the latest findings.


Asunto(s)
Caquexia/diagnóstico , Desnutrición/diagnóstico , Neoplasias/complicaciones , Sarcopenia/diagnóstico , Terminología como Asunto , Anciano , Anciano de 80 o más Años , Caquexia/etiología , Consenso , Fenómenos Fisiológicos Nutricionales del Anciano , Femenino , Humanos , Masculino , Desnutrición/etiología , Evaluación Nutricional , Estado Nutricional , Sarcopenia/etiología
17.
Anticancer Res ; 41(3): 1607-1614, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33788756

RESUMEN

BACKGROUND/AIM: We investigated the prognostic nutritional index (PNI), comprised of lymphocytes and albumin, as a potential prognosticator of metastatic urothelial carcinoma (mUC) patients receiving pembrolizumab. PATIENTS AND METHODS: Sixty-five patients were retrospectively enrolled and classified as low (<40) and high (≥40) based on pretreatment PNI. Progression-free survival (PFS), overall survival (OS) and response rates were evaluated. RESULTS: In the low PNI group, significantly shorter PFS and OS were observed. PNI was shown to be an independent predictor of PFS and OS in the multivariate analysis. C-index for both PFS and OS improved with the addition of PNI to the model described in the KEYNOTE-045 study. Significantly more patients experienced initial disease progression in the low PNI group. CONCLUSION: PNI is a useful predictor of prognosis and disease progression in mUC patients receiving pembrolizumab.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Evaluación Nutricional , Neoplasias Urológicas/tratamiento farmacológico , Urotelio/patología , Anciano , Carcinoma de Células Transicionales/tratamiento farmacológico , Carcinoma de Células Transicionales/metabolismo , Carcinoma de Células Transicionales/mortalidad , Carcinoma de Células Transicionales/patología , Resistencia a Antineoplásicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Estudios Retrospectivos , Neoplasias Urológicas/metabolismo , Neoplasias Urológicas/mortalidad , Neoplasias Urológicas/patología
18.
J Vis Exp ; (169)2021 03 13.
Artículo en Inglés | MEDLINE | ID: mdl-33779595

RESUMEN

Due to the issues and costs associated with manual dietary assessment approaches, automated solutions are required to ease and speed up the work and increase its quality. Today, automated solutions are able to record a person's dietary intake in a much simpler way, such as by taking an image with a smartphone camera. In this article, we will focus on such image-based approaches to dietary assessment. For the food image recognition problem, deep neural networks have achieved the state of the art in recent years, and we present our work in this field. In particular, we first describe the method for food and beverage image recognition using a deep neural network architecture, called NutriNet. This method, like most research done in the early days of deep learning-based food image recognition, is limited to one output per image, and therefore unsuitable for images with multiple food or beverage items. That is why approaches that perform food image segmentation are considerably more robust, as they are able to identify any number of food or beverage items in the image. We therefore also present two methods for food image segmentation - one is based on fully convolutional networks (FCNs), and the other on deep residual networks (ResNet).


Asunto(s)
Bebidas/análisis , Análisis de los Alimentos/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Redes Neurales de la Computación , Evaluación Nutricional , Teléfono Inteligente/estadística & datos numéricos , Humanos
19.
Minerva Surg ; 76(1): 57-61, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33754590

RESUMEN

BACKGROUND: Obesity represents a risk factor for COVID-19 infection. Therefore, in order to reduce COVID-19 related comorbidities in obese population a continuation of obesity treatment is needed. However, bariatric procedures were postponed because of COVID-19 restrictions, delaying treatment for obese patients seeking for surgery. This study aimed to test the feasibility of a telematics pre-operative psychological and nutritional assessment as an alternative tool during COVID-19 outbreak. METHODS: Twenty-six patients were contacted. The pre-operative assessment consisted in 3-weekly one-to-one online sessions and a final in-person multidisciplinary session. The protocol feasibility has been evaluated on the following outcome: rejection rate (%), dropout rate (%), compliance and satisfaction's degree. RESULTS: Eighteen participants completed the whole protocol and 10% dropped-out. Seventy-two percent of participants obtained an excess weight loss ≥5%. All participants were satisfied of the telematics assessment. CONCLUSIONS: COVID-19 emergency has changed standard hospital procedures and this study could represent a landmark for an online pre-operative assessment method to adopt in case of new restrictions.


Asunto(s)
Cirugía Bariátrica , Evaluación Nutricional , Cuidados Preoperatorios/métodos , Pruebas Psicológicas , Medios de Comunicación Sociales , Adulto , Estudios de Factibilidad , Femenino , Humanos , Intervención basada en la Internet , Masculino , Cooperación del Paciente/estadística & datos numéricos , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Proyectos Piloto , Estudios Prospectivos , Pérdida de Peso
20.
Medicine (Baltimore) ; 100(10): e25127, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725913

RESUMEN

ABSTRACT: Prognostic nutritional index (PNI) could reflect the nutrition and inflammation status in cancer patients. This study aims to identify the prognostic significance of PNI in patients with renal cell carcinoma (RCC).A total of 694 RCC patients from our institution were included in this study. The prognostic correlation between PNI and overall survival (OS) and recurrence-free survival (RFS) was analyzed respectively using Kaplan-Meier method and univariate and multivariate Cox model. Studies about the association between pretreatment or preoperative PNI and prognosis of RCC were systemically reviewed and a meta-analysis method was performed to further evaluate the pooled prognostic value of PNI in RCC.267 (38.47%) RCC patients had low PNI according to the cut off value (49.08). Low PNI was associated with poor OS (P < .001) and RFS (P < .001), respectively. In the multivariate Cox analysis, PNI was identified to be an independent prognostic factor for OS (hazard ratio [HR] = 2.13, 95%CI: 1.25-3.62, P = .005). Compared to other nutritional indexes, this risk correlation of PNI is better than that of geriatric nutritional risk index (GNRI; HR = 1.19; P = .531), while is no better than that of neutrophil-lymphocyte ratio (NLR; 1/HR = 2.56; P < .001) and platelet-lymphocyte ratio (PLR; 1/HR = 2.85; P < .001) respectively. Meanwhile, additional 4785 patients from 6 studies were included into pooled analysis. For RCC patients who underwent surgery, low preoperative PNI was significantly associated with worse OS (pooled HR = 1.57, 95%CI: 1.37-1.80, P < .001) and worse RFS (pooled HR = 1.69, 95%CI: 1.45-1.96, P < .001). Furthermore, low PNI (<41-51) was also significantly associated with poor OS (HR = 1.78, 95%CI: 1.26-2.53 P < .05) and poor RFS (HR = 2.03, 95%CI: 1.40-2.95, P < .05) in advanced cases treated with targeted therapies.The present evidences show that PNI is an independent prognostic factor in RCC. Low PNI is significant associated with poor prognosis of RCC patients.


Asunto(s)
Carcinoma de Células Renales/mortalidad , Inflamación/diagnóstico , Neoplasias Renales/mortalidad , Recurrencia Local de Neoplasia/epidemiología , Evaluación Nutricional , Adulto , Carcinoma de Células Renales/complicaciones , Carcinoma de Células Renales/inmunología , Carcinoma de Células Renales/cirugía , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Inflamación/inmunología , Neoplasias Renales/complicaciones , Neoplasias Renales/inmunología , Neoplasias Renales/cirugía , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/inmunología , Nefrectomía , Estado Nutricional/inmunología , Periodo Preoperatorio , Pronóstico , Valores de Referencia , Estudios Retrospectivos , Medición de Riesgo/métodos , Adulto Joven
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