Nutritional Risk in Oculopharyngeal Muscular Dystrophy: Beyond Dysphagia

Author(s):  
Catherine Forgues ◽  
Julie Fortin ◽  
Cynthia Gagnon ◽  
Jean-Denis Brisson ◽  
Jean Mathieu ◽  
...  

Purpose: To document the nutritional risk in adults with oculopharyngeal muscular dystrophy (OPMD) and its association with oropharyngeal dysphagia. Methods: In this cross-sectional study, 33 adults with molecular confirmation of OPMD between 50 and 75 years old were recruited from the registry of a university-affiliated neuromuscular clinic. Nutritional risk was assessed with the French version of Seniors in the Community: Risk Evaluation for Eating and Nutrition II (SCREEN II), whereas the severity of dysphagia was assessed using the French-Canadian version of the Sydney Swallow Questionnaire. Anthropometric measurements were performed with standardized procedures. Results: SCREEN II scores showed high nutritional risk for 81.8% of OPMD participants with 6 factors contributing to nutritional risk in at least 50% of the sample. Pearson’s correlational analysis showed a significant moderate relationship between dysphagia and nutritional risk (r = −0.470; P = 0.006). Conclusion: To our knowledge, this study is the first to investigate the nutritional risk of adults with OPMD. Our results indicate that individuals with OPMD may be at high nutritional risk mostly associated with swallowing difficulty, in the absence of a low body mass index. The present study highlights the need for dietary counseling in OPMD.

2021 ◽  
Vol 14 (01) ◽  
pp. 011-015
Author(s):  
Rodrigo Fernandes Weyll Pimentel ◽  
Gilson Cruz de Moraes ◽  
Shalla Gomes Cavalcanti Barcelos ◽  
Pedro Carlos Muniz de Figueiredo ◽  
Magno Conceição Das Merces

Abstract Introduction The Coronavirus has spread to almost every country in the world, causing the coronavirus disease (COVID-19). The coronavirus stands out among the other infections especially by it's high contagious power and important effects on the respiratory system. The COVID-19 has differents ways of presentation and these are influenced by the patient's previous nutricional status, correlated with the patient's lifestyle and comorbities. Objective this survey seeks to analyze the nutritional status and the prevalence of obesity in patients hospitalized with SARS-CoV-2. Methods: this is a descriptive, prospective and cross-sectional study type, which 41 patients affected by COVID-19 were interviewed. Patient's weight and height were used to assess the BMI, and nutritional risk assessment was performed using the Nutritional Risk Screening tool (NRS 2002). For the analysis, Absolute (AF) and Relative Frequency (RF), the mean and the standard deviation were calculated. Results It was observerd that 78% of the participants had a high nutritional risk, while only 22% had a low nutritional risk. Besides that, 34% showed overweight and 41.4% showed obesity. Conclusion the existence of a high prevalence of increased nutritional risk was evidenced, in addition to the high frequency of overweight in patients affected by SARS-CoV-2.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jéssika M Siqueira ◽  
Jéssika D P Soares ◽  
Thaís C Borges ◽  
Tatyanne L N Gomes ◽  
Gustavo D Pimentel

AbstractCancer patients possess metabolic and pathophysiological changes and an inflammatory environment that leads to malnutrition. This study aimed to (i) determine whether there is an association between neutrophil-to-lymphocyte ratio (NLR) and nutritional risk, and (ii) identify the cut-off value of NLR that best predicts malnutrition by screening for nutritional risk (NRS 2002). This cross-sectional study included 119 patients with unselected cancer undergoing chemotherapy and/or surgery. The NRS 2002 was applied within 24 h of hospitalisation to determine the nutritional risk. Systemic inflammation was assessed by blood collection, and data on C-reactive protein (CRP), neutrophils, and lymphocytes were collected for later calculation of NLR. A receiver operating characteristic (ROC) curve was used to identify the best cut-point for NLR value that predicted nutritional risk. Differences between the groups were tested using the Student’s t-, Mann–Whitney U and Chi-Square tests. Logistic regression analyses were performed to assess the association between NLR and nutritional risk. The ROC curve showed the best cut-point for predicting nutritional risk was NLR > 5.0 (sensitivity, 60.9%; specificity, 76.4%). The NLR ≥ 5.0 group had a higher prevalence of nutritional risk than the NLR < 5.0 group (NLR ≥ 5.0: 73.6% vs. NLR < 5.0: 37.9%, p = 0.001). The NLR group ≥ 5.0 showed higher values of CRP and NLR than the NLR < 5.0 group. In addition, patients with NLR ≥ 5.0 also had higher NRS 2002 values when compared to the NLR < 5.0 group (NLR ≥ 5.0: 3.0 ± 1.1 vs. NLR < 5.0: 2.3 ± 1.2, p = 0.0004). Logistic regression revealed an association between NRS and NLR values. In hospitalised unselected cancer patients, systemic inflammation measured by NLR was associated with nutritional risk. Therefore, we highlight the importance of measuring the NLR in clinical practice, with the aim to detect nutritional risk.


2021 ◽  
Vol 79 (9) ◽  
pp. 766-773
Author(s):  
Mariana Viana Rodrigues ◽  
Mileide Cristina Stoco-Oliveira ◽  
Talita Dias da Silva ◽  
Celso Ferreira ◽  
Heloisa Balotari Valente ◽  
...  

ABSTRACT Background: Analysis of autonomic modulation after postural change may inform the prognosis and guide treatment in different populations. However, this has been insufficiently explored among adolescents with Duchenne muscular dystrophy (DMD). Objective: To investigate autonomic modulation at rest and in response to an active sitting test (AST) among adolescents with DMD. Methods: Fifty-nine adolescents were included in the study and divided into two groups: 1) DMD group: adolescents diagnosed with DMD; 2) control group (CG): healthy adolescents. Participants’ weight and height were assessed. Lower limb function, motor limitations and functional abilities of the participants in the DMD group were classified using the Vignos scale, Egen classification and motor function measurement, respectively. The following variables were assessed before, during and after AST: systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (f), oxygen saturation and heart rate (HR). To analyze the autonomic modulation, the HR was recorded beat-by-beat. Heart rate variability (HRV) indices were calculated in the time and frequency domains. Results: Differences in relation to groups were observed for all HRV indices, except LF/HF, oxygen saturation, HR and f (p < 0.05). Differences in relation to time and the interaction effect between group and time were observed for RMSSD, SD1, SD2, SD1/SD2, LFms2 and LFnu, HFun, SBP and DBP (p < 0.05). Differences in relation to time were also observed for the indice SDNN, FC and f (p < 0.05). Conclusions: Performing the AST promoted reduced autonomic modulation and increased SBP, DBP and HR in adolescents with DMD.


Author(s):  
Miraç Vural Keskinler ◽  
Güneş Feyizoğlu ◽  
Kübra Yıldız ◽  
Aytekin Oğuz

Objective: Obesity is one of the most common comorbidities of diabetes mellitus (DM) whose frequency is rapidly increasing nowadays. Although obesity caused by excessive and unbalanced nutrition often accompanies diabetes; malnutrition is another complication of diabetes. This study was conducted to investigate the frequency of malnutrition in individuals with diabetes. Method: This study is a cross-sectional study. The patients with type 2 diabetes followed up in the diabetes outpatient clinic of a university hospital between February and March 2018 were included in the study. Anthropometric measurements of the patients and “Nutritional Risk Screening-2002” (NRS-2002) scores were recorded. Results: A total of 222 (F: 132 59.4%) patients were included in the study. When two groups with higher NRS (≥3) and lower NRS (<3) scores less than 3 were compared, any significant difference was not detected between two groups in terms of age, waist circumference and HbA1c values. Only BMI was found to be lower in the group with malnutrition risk (p: 0.030). When the patients were evaluated in terms of diabetes treatments and risk of malnutrition, any significant intergroup difference was not found (p: 0.847). Conclusion: It was found that there is a risk of malnutrition in one of every seven diabetics with a high body mass index who were being followed up in the diabetes outpatient clinic.


2021 ◽  
Vol 10 (11) ◽  
pp. e407101119859
Author(s):  
Francisca Maria da Silva ◽  
Francisca Isabelle da Silva e Sousa ◽  
Alexandre Danton Viana Pinheiro ◽  
Ribanna Aparecida Marques Braga ◽  
Maria Luisa Pereira de Melo ◽  
...  

Objective: In this study, we aim to evaluate whether the presence of malnutrition in children and adolescents with infectious diseases is associated with high nutritional risk obtained by the STRONGkids instrument. Methods: A cross-sectional study comprising 237 hospitalized patients aged between 30 days and 18 years. Identification and diagnosis data, weight and height were collected. STRONGkids determined nutritional risk. Acute malnutrition was classified by BMI/age Z score < - 2 and chronic by Height/age Z score < - 2. Associations between categorical variables were verified using Pearson's chi-square test. A logistic regression analysis was performed to assess the association between anthropometric parameters of malnutrition and nutritional risk. It was considered significant p< 0,05. Results: In multiple analysis, it was observed that having malnutrition as of BMI/age increases the chance by 5.68 of having high nutritional risk by the STRONGKids instrument, regardless of age, sex and the presence of poverty-related infectious diseases (OR: 5.68; 95% CI: 1.54-20.93; p=0.009). Conclusion: In summary, for patients with infectious diseases, acute malnutrition (BMI/age) is associated directly with the diagnosis of high nutritional risk by STRONGkids.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Wei Chen ◽  
Shengnan Zhou

Abstract Objectives This study investigated the use of standardized phase angle (SPA), determined by bioelectrical impedance analysis (BIA), as a nutrition status tool and prognostic factor for complications associated with pancreaticoduodenectomy (PD) in pancreatic cancer patients. Methods A cross-sectional study was conducted with 49 participants. All participants were assessed for nutritional risk and nutritional status using Nutritional Risk Screening 2002 (NRS-2002), Subjective Global Assessment (SGA) tools, Global Leadership Initiative on Malnutrition (GLIM) tool and BIA. The Clavien-Dindo classification method for surgical complications was used to identify and classify postoperative complications. Independent-samples T-tests, chi-square tests and Spearman correlation analyses were used to evaluate the association between SPA, nutrition and postoperative complications. Results A total of 49 patients were enrolled, and 20 patients (40%) had postoperative complications. The SPA value for the nourished group was significantly higher than the SPA value for the malnourished group (P = 0.021, 0.019, 0.023). Patients who were below the SPA cut-off values (−1.015, −1.065, and −0.69) were more likely to have postoperative complications (P = 0.009), whereas NRS-2002, SGA, and GLIM scores were not associated with postoperative complications. The SPA value of the group with complications was significantly lower than that of the group without complications (P = 0.004). The SPA threshold value for predicting postoperative complications in pancreatic cancer was −1.095 (AUC 0.737; 95% CI, 0.59, 0.88; P = 0.005). Conclusions The SPA is a prognostic indicator of postoperative complications in pancreatic cancer patients undergoing PD and is an effective tool for assessing nutritional status in pancreatic cancer patients. Funding Sources none. Supporting Tables, Images and/or Graphs


2020 ◽  
pp. 1-8
Author(s):  
Lhais de Paula Barbosa Medina ◽  
Marilisa Berti de Azevedo Barros ◽  
Regina Mara Fisberg ◽  
Daniela de Assumpção ◽  
Antônio de Azevedo Barros Filho

Abstract Objective: To evaluate associations between selected dietary concerns and eating practices and determine the association of these concerns/practices with demographic and socio-economic characteristics in a population from a large Brazilian city. Design: Population-based cross-sectional study. We investigated concerns regarding salt intake, the use of highly processed seasoning and the custom of reading the Na content on food labels. We also analysed concerns regarding the use of pesticides on food products and the practice of consuming organic foods. These variables were analysed according to sex, age group, schooling and income. Multivariate Poisson regression analysis was performed for the estimation of prevalence ratios. Setting: Campinas, state of São Paulo, Brazil. Participants: The representative sample consisted of 1710 adults and seniors. Results: A total 62·3 % of the population were concerned with salt intake, 34·7 % did not use highly processed seasoning and 10·6 % checked the Na content on food labels; 27·5 % were concerned with pesticides and 26·5 % consumed organic foods. The practices analysed were associated with the respective concerns. Women and seniors had a better profile, except for reading Na content in both groups and the consumption of organic foods among seniors. The frequency of checking the Na content and consuming organic foods increased with the level of schooling. The higher income group had a better profile, except for concern with salt intake. Conclusions: Considerable social differences were found regarding the dietary practices, and the practices were associated with concerns. The present findings underscore the need for different dietary counseling strategies targeting specific groups.


Author(s):  
Jos W. Borkent ◽  
Elke Naumann ◽  
Emmelyne Vasse ◽  
Ellen van der Heijden ◽  
Marian A. E. de van der Schueren

To stimulate undernutrition screening among Dutch community-dwelling adults, a website was developed with general information on healthy eating for healthy aging and self-tests. Based on cross-sectional data obtained from the self-tests, we studied nutritional risk factors (early determinants) as well as risk of undernutrition (late symptoms). SCREEN II (n = 2470) was used to asses nutritional risk factors. This tool consists of 16 items regarding nutritional intake, perception of body weight, appetite, oral health and meal preparation. An adjusted SNAQ65+ (n = 687) was used to assess risk of undernutrition. This four-item tool contains questions on weight loss, appetite, walking stairs and body mass index. Differences between age-groups (65–74, 75–84, ≥85) were tested by logistic regression. Overall prevalence of nutritional risk factors was 84.1%, and increased risk of undernutrition was 56.8%. Participants aged ≥85 scored worst on almost all items of the SCREEN II and the SNAQ65+. In conclusion: A large proportion of older adults reported early determinants for increased nutrition risk, while a smaller, yet remarkable proportion scored positive on undernutrition risk. Internet screening may be a useful, contemporary, and easy, accessible way to reach older adults who are at nutritional risk and may thus contribute to early identification and prevention of undernutrition.


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