Prevalence of Malnutrition in Older Hospitalized Cancer Patients: A Multicenter and Multiregional Study.

BACKGROUND: Malnutrition is frequent in older cancer patients, with a prevalence that ranges from 25% to 85%. The aging process is associated with several physiological changes, which may have implications for nutritional status. Screening tools can be useful for identifying malnutrition status among older patients with cancer. METHODS: A hospital-based multicenter cohort study that included 44 institutions in Brazil. The Mini Nutritional Assessment-Short Form (MNA-SF) was administered to 3061 older hospitalized cancer patients within 48 hoursof admission. The Kolmogorov-Smirnov test was used to test the sample distribution, considering sex, age range, calf circumference, body mass index, and MNA-SF score and classification. The categorical data were expressed by frequencies (n) and percentages (%)and compared using the chi-square test or Tukey test. RESULTS: According to the results of the MNA-SF, 33.4% of the patients were malnourished, 39.3% were at risk of malnutrition, and 27.3% were classified as having normal nutritional status. Length of hospital stay (in days) was found to be longer for those patients with a poorer nutritional status (malnourished: 7.07±7.58; at risk of malnutrition: 5.45±10.73; normal status: 3.9±5,84; p <0.001). CONCLUSIONS: The prevalence of malnutrition and nutritional risk is high in older hospitalized cancer patients in all the regions of Brazil and a worse nutritional status is associated with a longer hospital stay. Using a low-cost, effective nutritional screening tool for older cancer patients will enable specialized nutritional interventions and avoid inequities in the quality of cancer care worldwide.

Malnutrition associated with nutrition impact symptoms and localization of the disease: Results of a multicentric research on oncological nutrition.

BACKGROUND & AIMS: Malnutrition in cancer is an independent factor associated with negative clinical outcomes. The aim was to evaluate the prevalence and independent risk factors for malnutrition in hospitalized cancer patients using the Patient-Generated Subjective Global Assessment (PG-SGA). METHODS: We evaluated 4783 cancer patients, aged ≥20 years, in a hospital-based, multicenter, cross-sectional study. Patients were classified as well-nourished (PG-SGA Stage A), moderate/suspected malnutrition (PG-SGA Stage B), or severely malnourished (PG-SGA Stage C), and provided a score to define required nutritional interventions. Multivariate analysis was composed of the odds ratio (OR) estimated by ordinal polytomous logistic regression. RESULTS: 45.3% were classified as Stage B and 11.8% as Stage C. Moreover, 45.3% of the patients presented a need for nutritional intervention. The variables that presented the highest ORs for Stage B or Stage C were: problems with swallowing (OR 2.8, 95% confidence interval (CI) 2.2-3.4, p < 0.001), loss of appetite (OR 1.9, 95% CI 1.6-2.3, p < 0.001), vomiting (OR 1.8, 95% CI 1.5-2.3, p < 0.001), presence of more than 3 nutrition impact symptoms (OR 8.3, 95% CI 5.8-12, p < 0.001), and cancer site: lung (OR 4.6, 95% CI 3.2-6.6, p < 0.001), upper digestive cancer (OR 3.7, 95% CI 2.7-5.2, p < 0.001), and head and neck cancer (OR 3.7, 95% CI 2.7-5.2, p < 0.001). The score for Worksheet 4 on the PG-SGA had a higher association with malnutrition (OR 7.3, 95% CI 6.6-8.2, p < 0.001). CONCLUSIONS: Malnutrition is highly prevalent in cancer patients in Brazil, and is associated with nutritional impact symptoms, cancer site and age ≥65 years.

[Hookworm-related folliculitis in a woman performing skin bleaching in Benin]. / Folliculite ankylostomienne compliquant une dépigmentation cutanée volontaire au Bénin.

Hookworm-related cutaneous larva migrans is caused by the subcutaneous migration of hookworm larvae. The characteristic sign is a serpiginous cutaneous track. Folliculitis is an uncommon clinical manifestation. We report a case of hookworm-related folliculitis in a woman performing skin bleaching. A 33-year-old woman presented with a widespread cutaneous eruption made of erythematous and itchy follicular papulo-nodules, with erythematous serpiginous tracks, about 5-10cm long and numerous streaks of scratching, located on the limbs, buttocks and trunk. The cutaneous lesions occurred two days after contact with the floor of a warehouse contamined by faeces of cats. The lesions have been evolving for a week and have been treated with antibiotics without success. Clinical examination found cutaneous atrophy, purple stretch marks and hyperpigmentation of dorsal parts of fingers joints. The patient reported having been using bleaching cosmetics containing topical steroids and hydroquinone for twelve years. She was cured within 4 weeks with oral albendazole 400mg per day during 7 consecutive days.

La folliculite ankylostomienne est une forme folliculaire de larva migrans cutanée ankylostomienne rarement observée. Nous en rapportons un cas chez une patiente de 33 ans, se dépigmentant depuis 12 ans. Elle a consulté pour une éruption évoluant depuis une semaine, diffuse, très prurigineuse, apparue deux jours après le contact avec le sol d'un entrepôt souillé par des déjections de chats. L'examen physique retrouvait de nombreuses lésions de folliculites, érythémateuses coexistant avec des cordons serpigineux de dermatite rampante sur les zones d'extension des membres, le dos, les fesses et l'abdomen, typiques de folliculite ankylostomienne. Un traitement à base d'albendazole 400 mg par jour pendant 7 jours a permis d'obtenir la guérison.

[Epidemiological and clinical characteristics of anogenital dermatoses in the department of dermatology-venereology in Cotonou, Benin]. / Profil épidémioclinique des dermatoses anogénitales dans un service de dermatologie à Cotonou (Bénin).

OBJECTIVE: The aim of this study was to document the epidemiological and clinical characteristics of anogenital dermatoses (AGDs) in Cotonou, Benin. METHOD: This retrospective, descriptive study, conducted in the Department of Dermatology-Venereology at the National University Hospital of Cotonou, examined medical records of admissions and outpatient consultations for the 5-year period 2005-2009 and included the records of all patients with a clinical diagnosis of AGD. RESULTS: The prevalence of AGD in our series was 2.6% and the prevalence of sexually transmitted AGDs (STIs) was 1.3%. The sex ratio (M:F) was 2.5, and the patients' average age was 31.1 years. AGDs were classified as infectious (77%), inflammatory (12.6%), non-infectious tumors (3.7%), physiological (2.1%), psychodermatoses (2.1%), non-infectious ulcers (1.6%), and dyschromia (1%). STIs accounted for 44% of the AGDs: condyloma (65.5%), genital herpes (19%), urethritis (8.3%), and chancroids (4.8%). The primary sites in men were the foreskin, the groin, the scrotum, and the glans, and in women, the labia majora, the groin, the labia minora, and the anal cleft. CONCLUSION: AGDs were relatively rare in hospital consultations in Cotonou. They were mainly infectious (viral or fungal), and nearly half were STIs.

[Profile of HIV-infected children at the National University Hospital of Cotonou (CNHU)]. / Profil des enfants infectes par le vih suivis au centre National Hospitalier et Universitaire (CNHU) de Cotonou.

OBJECTIVE: To describe the profile of HIV-infected children. METHODS: This was a cross-sectional, descriptive and analytic study involving 317 infected children, monitored from January 1st, 2002 to July 31st, 2010 at CNHU of Cotonou. RESULTS: The average age was 89.1 months with a sex ratio of 0.91. Orphans of at least one parent represented 31.3% of cases. Vertical transmission was predominant (86.1%). Only 9.5% of patients benefited from PMTCT. They were all infected with HIV 1. According to the WHO classification, 52% were at stage 3 or 4 and 56% had advanced to severe immunodeficiency. 61% had suffered from opportunistic infections, and 53% had benefited from antiretroviral therapy. Following the study, 54% of participants had continued follow-up visits, 23% lost contact with the CNHU, 18% died and 5% were referred to another site. Factors associated with outcome were antiretroviral therapy (p < 0.0001), clinical (p < 0.0001) and immunological stage (p = 0.0042) on admission. CONCLUSION: Our findings suggest strengthening the PMTCT program, screening and early management of an HIV infection.

OBJECTIF: Décrire le profil des enfants infectés par le VIH. PATIENTS ET MÉTHODES: Etude transversale, descriptive et analytique portant sur 317 enfants infectés, suivis de Janvier 2002 à Juillet 2010. RÉSULTATS: L'âge moyen des enfants était de 89,1 mois ; le sex ratio de 0,91. Ils étaient orphelins d'au moins un parent dans 31,3% des cas. La transmission était essentiellement verticale (86,1%). Seulement 9,5% avaient bénéficié d'une prophylaxie antirétrovirale pour la PTME. Ils étaient tous infectés par le VIH 1. Selon la classification de l'OMS, 52% étaient à un stade clinique 3 ou 4 et 56% avaient un déficit immunitaire important ou sévère. 61% avaient souffert d'infections opportunistes, et 53% avaient bénéficié du traitement antirétroviral. Quant à leur devenir, 54% avaient continué le suivi, 23% étaient perdus de vue, 18% étaient décédés et 5% transférés sur un autre site de prise en charge. Les facteurs associés au devenir étaient le traitement antirétroviral (p < 0,0001), les stades clinique (p < 0,0001) et immunologique (p = 0,0042) à l'admission. CONCLUSION: Ce profil suggère le renforcement du programme de la PTME, un dépistage et une prise en charge précoces.

Profil des enfants infectes par le VIH suivis au centre national hospitalier et Universitaire (CNHU) de Cotonou

Objectif : Decrire le profil des enfants infectes par le VIH Patients et methodes : Etude transversale; descriptive et analytique portant sur 317 enfants infectes; suivis de Janvier 2002 a Juillet 2010. Resultats : L'age moyen des enfants etait de 89;1 mois ; le sex ratio de 0;91. Ils etaient orphelins d'au moins un parent dans 31;3 des cas. La transmission etait essentiellement verticale (86;1). avaient beneficie d'une prophylaxie antiretrovirale pour la PTME. Ils etaient tous infectes par le VIH 1. Selon la classification de l'OMS; 52 Seulement 9;5 etaient a un stade clinique 3 ou 4 et 56 avaient un deficit immunitaire important ou severe. 61 avaient souffert d'infections opportunistes; et 53 avaient beneficie du traitement antiretroviral. Quant a leur devenir; 54 avaient continue le suivi; 23 etaient perdus de vue; 18 etaient decedes et 5 transferes sur un autre site de prise en charge. Les facteurs associes au devenir etaient le traitement antiretroviral (p 0;0001); les stades clinique (p 0;0001) et immunologique (p

[The role of Hühner's direct post-coital test in the evaluation of conjugal sterility in the African environment in Senegal. (Apropos of 2593 post-coital tests performed by the clinical cytology, cytogenetic and reproduction biology laboratory at the University Hospital Center in Dakar, Senegal) 1983-1993]. / Place du test post-coïtal direct de Hühner dans le bilan de la stérilité conjugale en milieu africain au Sénégal. (A propos de 2593 tests post-coïtaux réalisés par le laboratoire de cytologie clinique, cyto-génétique et biologie de la reproduction du CHU de Dakar, Sénégal) 1983-1993.

About 2593 post-coïtal tests (PCT) or Hühner direct tests were realised in the laboratory of clinical cytology, cytogenetics and reproductive biology of the University medical Centre of Dakar, Senegal from 1983 to 1993. Analysing the results, the authors showed the importance of the infectious factor in women and also the role of male deficiency in conjugal sterility in black African environment. These realities have been confirmed cytospermiologic test deficient results. These sperm exams have shown among other things, the prevailing number of azoospermia (25%) and of oligo-asthénotératozoospermia (44%) in husbands of sterile women in the black African environment of Senegal. Pap's Tests have been jointly realised at the same time as 1902 PCT. The results have enabled us to track down 120 cervix with precancerous and cancerous cell alterations; 81 condylomas (HPV), 25 CIN1, 11 CIN2 and 3 CIN3 (CIN: cervical intra-epithelial Neoplasia). These facts suggest a cautious technics, and a prudent interpretation of the results and taking into account the competence and the subjectivity of the practitioner. We have learnt from the study that we must give as much as possible to biologists of Reproduction in southern countries, where conjugal sterility and cervix precancerous and cancerous cell alterations are high, a polyvalent training so that they can practise jointly the post-coïtal or Hühner direct test (PCT) and the Papanicolaou Colpocytologic Test (TP), provided that one owes a microscope.