Nutritional Profile of Oncology Patients from an Outpatient Nutritional Service in Brazil

Objective To characterize the nutritional variables of patients referred to an outpatient oncology nutrition service. Methods The electronic medical records of patients diagnosed with malignant neoplasms were analyzed for several parameters: weight loss, body mass index (BMI), hand-grip strength (HGS), fat-free mass index (FFMI) and serum C-reactive protein (CRP). Statistical methods included Pearson’s correlation (significance was set at P ≤ 0.05). Results There was a high prevalence of malnutrition (44%, n = 28) and sarcopenia (61%, n = 23) and a relatively low prevalence of cachexia (13%, n = 6). Moderate positive correlations were observed between the tumor site and CRP level, correlation r = 0.328 (P = 0.026); the tumor site and BMI (r = 0, P = 0.001); FFMI and BMI (r = 0.606, P = 4.334056e-005) and CRP and weight loss (r = 0.355, P = 0.024). There were negative correlations between the tumor staging and BMI r = -0.409, P = 0.001) and weight loss and FFMI (r = -0.467, P = 3,228325e-004). Conclusion These preliminary findings may help institutions implement nutritional approaches, such as the adoption of a line-ofcare focused on nutrition in the department of oncology.

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Sarcopenia, severe anxiety and increased C-reactive protein are associated with severe fatigue in patients with inflammatory bowel diseases

Scientific Reports ◽

10.1038/s41598-021-94685-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Laura Tasson ◽

Fabiana Zingone ◽

Brigida Barberio ◽

Romina Valentini ◽

Pamela Ballotta ◽

...

Keyword(s):

Fecal Calprotectin ◽

Healthy Population ◽

C Reactive Protein ◽

Reactive Protein ◽

Severe Fatigue ◽

High Prevalence ◽

Bowel Diseases ◽

Moderate Fatigue ◽

Inflammatory Bowel ◽

Severe Anxiety

AbstractPatients with inflammatory bowel disease (IBD) report fatigue more frequently than healthy population, but the precise mechanisms underlying its presence are unknown. This study aimed to evaluate the prevalence of fatigue in IBD and its relation with potential causative factors. A survey on fatigue, depression, anxiety, sleep disorders, and the presence of sarcopenia and malnutrition, was sent by email to 244 IBD outpatients of the Gastroenterology Unit of Academic Hospital of Padua. Demographics and clinical data, including the levels of fecal calprotectin (FC) and C-reactive protein (CRP), and current pharmacological treatments were obtained from patients’ medical records. Ninety-nine (40.5%) subjects answered the survey. Ninety-two (92.9%) patients reported fatigue, with sixty-six having mild to moderate fatigue and twenty-six severe fatigue. Multivariate analysis showed that abnormal values of CRP (OR 5.1), severe anxiety (OR 3.7) and sarcopenia (OR 4.4) were the factors independently associated with severe fatigue. Fatigue has a high prevalence in subject affected by IBD. Subjects with altered CRP, sarcopenia and severe anxiety appear more at risk of severe fatigue.

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Malnutrition and cancer, diagnosis and treatment

memo - Magazine of European Medical Oncology ◽

10.1007/s12254-020-00672-3 ◽

2021 ◽

Author(s):

Angelika Beirer

Keyword(s):

Weight Loss ◽

Cancer Patients ◽

Cancer Cachexia ◽

Screening Tool ◽

Psychological Treatment ◽

Early Stage ◽

Nutritional Therapy ◽

German Society ◽

Fat Free Mass ◽

Nutritional Risk

Summary Background The prevalence of malnutrition in cancer patients ranges from about 20% to more than 70%. However, 10–20% of cancer patients’ deaths are related to malnutrition, not the malignancy itself. To reverse the pattern of weight loss, improve the patients’ quality of life, reduce the treatment toxicity, the psychological stress and the risk of mortality, the diagnosis of malnutrition should be made as early as possible to facilitate the best possible treatment. Methods A systematic literature search was conducted following guidelines of ESPEN (European Society for Clinical Nutrition), DGEM (German Society for Nutritional Medicine) and ASPEN (American Society for Parenteral and Enteral Nutrition). Results and conclusion To assess the risk of malnutrition, all cancer patients should be screened regularly with a valid screening tool (e.g., MUST [Malnutrition Universal Screening Tool], NRS [Nutritional Risk Screening] or PG-SGA [Scored Patient-Generated Subjective Global Assessment]). If risk of malnutrition is present, adequate nutritional therapy is recommended to stop involuntary weight loss. Patients should engage in exercise to maintain and improve muscle mass, strength and function. They should be offered regular dietetic counselling, and their muscle depletion should be monitored by determining fat-free mass. As cachectic patients in particular are at risk, the presence of cachexia should also be recognized at an early stage. Three consensus-based definitions are widely accepted: Fearon et al. and the EPCRC (European Palliative Care Research Collaborative) propose definitions specifically for cancer cachexia, while Evans et al. put forward a definition for cachexia associated with all types of underlying chronic diseases. However, if there is a cancer cachexia diagnosis, additional pharmacological and psychological treatment should be considered.

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Associations between Pre-Bariatric High-Sensitivity C-Reactive Protein and Post-Surgery Outcomes

Diagnostics ◽

10.3390/diagnostics11040721 ◽

2021 ◽

Vol 11 (4) ◽

pp. 721

Author(s):

Tannaz Jamialahmadi ◽

Mohsen Nematy ◽

Simona Bo ◽

Valentina Ponzo ◽

Ali Jangjoo ◽

...

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Weight Loss ◽

Success Rate ◽

Liver Stiffness ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Post Surgery ◽

Hs Crp

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.

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Assessment of Protein Intake in the First Three Months after Sleeve Gastrectomy in Patients with Severe Obesity

Nutrients ◽

10.3390/nu13030771 ◽

2021 ◽

Vol 13 (3) ◽

pp. 771

Author(s):

Lucrezia Bertoni ◽

Romina Valentini ◽

Alessandra Zattarin ◽

Anna Belligoli ◽

Silvia Bettini ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Protein Intake ◽

Severe Obesity ◽

Protein Supplementation ◽

Fat Free Mass ◽

The Third ◽

Total Protein Intake ◽

Dietary Record ◽

Protein Rich

An adequate protein intake prevents the loss of fat-free mass during weight loss. Laparoscopic sleeve gastrectomy (SG) jeopardizes protein intake due to post-operative dietary restriction and intolerance to protein-rich foods. The purpose of this study is to evaluate protein intake in the first three months after SG. We evaluated, 1 month and 3 months after surgery, 47 consecutive patients treated with SG. Protein intake, both from foods and from protein supplementation, was assessed through a weekly dietary record. Patients consumed 30.0 ± 10.2 g of protein/day on average from foods in the first month, with a significant increase to 34.9 ± 4.8 g of protein/day in the third month (p = 0.003). The use of protein supplementation significantly increased total protein intake to 42.3 ± 15.9 g protein/day (p < 0.001) in the first month and to 39.6 ± 14.2 g of protein/day (p = 0.002) in the third one. Compliance with supplement consumption was 63.8% in the first month and only 21.3% in the third month. In conclusion, both one and three months after SG, protein intake from foods was not sufficient. The use of modular supplements seems to have a significant impact on protein intake, but nevertheless it remains lower than recommended.

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Changes in contraception use among Brazilian women after childbirth, 2006-2013

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.981 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Felisbino-Mendes ◽

B Barrozo Siqueira

Keyword(s):

Health System ◽

Secondary Data ◽

Reproductive Age ◽

Cross Sectional ◽

Regional Inequalities ◽

Unified Health System ◽

Contraception Use ◽

High Prevalence ◽

Modern Methods ◽

Low Prevalence

Abstract Introduction There are gaps in knowledge regarding the neglected and vulnerable subgroups of FP actions in Brazil, such as postpartum women and women in general, regardless of their marital status. Objective To assess changes in the prevalence of use and in the contraceptive pattern of Brazilian women up to two years after pregnancy, between 2006 and 2013. Methods Cross-sectional, descriptive and analytical study which used secondary data from national surveys. We studied Brazilian women with up to 2 years postpartum, of reproductive age, sexually active, non-pregnant and menstruating, and compared them with all the other women. We estimated the prevalence of use, contraception pattern of contraception and ranking of modern methods. Percentual change in indicators between the years was evaluated by calculating the difference between estimates. Results 85% of Brazilian women used CM, remaining stable in 2006 and 2013, with a high prevalence of modern methods use. An increase in the use of CM was observed among those with up to six months postpartum (71.0% to 89.0%). Pills and condoms accounted for about 60% of modern methods used in the postpartum period in both surveys. There was an increase in dual protection (2.9% to 10.1%) and contraceptive insecurity (1.6% to 5.7%) and a reduction in sterilization (16.2% to 13.4%) and traditional methods (2.1% to 1.4%). Conclusions Even with the maintenance of a high prevalence of use of CM and with the increase in contraception among women with up to six months postpartum, regional inequalities in access to CM and low prevalence of the use of other methods made available by the Unified Health System (SUS) persist, pointing out the maintenance of the insufficient care, failures in the means to regulate fertility and that public policies still hinder to guarantee the sexual and reproductive rights of the most vulnerable population. Key messages Regional inequalities in access to contraceptive methods and low prevalence of other methods made available by the Unified Health System (SUS) persist. There was an increase in contraception use among women with up to six months postpartum in Brazil.

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Low Prevalence of Pneumocystis pneumonia (PCP) but High Prevalence of Pneumocystis dihydropteroate synthase (dhps) Gene Mutations in HIV-Infected Persons in Uganda

PLoS ONE ◽

10.1371/journal.pone.0049991 ◽

2012 ◽

Vol 7 (11) ◽

pp. e49991 ◽

Cited By ~ 14

Author(s):

Steve M. Taylor ◽

Steven R. Meshnick ◽

William Worodria ◽

Alfred Andama ◽

Adithya Cattamanchi ◽

...

Keyword(s):

Gene Mutations ◽

Pneumocystis Pneumonia ◽

Dihydropteroate Synthase ◽

High Prevalence ◽

Dhps Gene ◽

Low Prevalence

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Prevalence of ColE1-Like Plasmids and Colicin K Production among Uropathogenic Escherichia coli Strains and Quantification of Inhibitory Activity of Colicin K

Applied and Environmental Microbiology ◽

10.1128/aem.01780-06 ◽

2006 ◽

Vol 73 (3) ◽

pp. 1029-1032 ◽

Cited By ~ 15

Author(s):

Matija Rijavec ◽

Maruška Budič ◽

Peter Mrak ◽

Manica Mï¿½ller-Premru ◽

Zdravko Podlesek ◽

...

Keyword(s):

Escherichia Coli ◽

Inhibitory Activity ◽

Insertion Sequence ◽

Uropathogenic Escherichia Coli ◽

Mosaic Structure ◽

High Prevalence ◽

Low Prevalence

ABSTRACT Colicin K exhibited pronounced inhibitory activity against uropathogenic Escherichia coli (UPEC) strains. Low prevalence of colicin K production and a relatively high prevalence of ColE1-like plasmids were determined among 215 UPEC strains from Slovenia. Sequencing of the colicin K-encoding pColK-K235 revealed a mosaic structure and the presence of the insertion sequence IS2.

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Abstract P410: Alternate Day Fasting with a High Fat Diet: Impact on Body Weight, Body Composition, and Coronary Heart Disease Risk Profile in Obese Adults

Circulation ◽

10.1161/circ.127.suppl_12.ap410 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Monica C Klempel ◽

Cynthia M Kroeger ◽

Krista A Varady

Keyword(s):

Coronary Heart Disease ◽

Weight Loss ◽

Body Weight ◽

Heart Disease ◽

Disease Risk ◽

Fat Free Mass ◽

High Fat ◽

Ldl Particles ◽

Chd Risk ◽

Alternate Day Fasting

Background: Alternate day fasting (ADF) with a low-fat (LF) diet is effective for weight loss and cardio-protection. However, the applicability of these findings is questionable as most Americans consume a high-fat (HF) diet. This study examined if these beneficial changes in weight and coronary heart disease (CHD) risk can be reproduced if a HF diet is used in place of a LF diet during ADF. Methods: Thirty-two obese subjects were randomized to an ADF-HF (45% fat) or ADF-LF diet (25% fat), which consisted of two phases: 1) a 2-week baseline weight maintenance period, and 2) an 8-week ADF weight loss period. All food was provided to subjects. Results: Body weight was reduced (P < 0.0001) by ADF-HF (5 ± 1%) and by ADF-LF (4 ± 1%). Fat mass decreased (P < 0.0001) by ADF-HF (5 ± 1 kg) and ADF-LF (4 ± 1 kg). Fat free mass remained unchanged. Waist circumference decreased (P < 0.001) by ADF-HF (7 ± 1 cm) and ADF-LF (7 ± 1 cm). LDL cholesterol and triacylglycerol concentrations were reduced (P < 0.01) by both interventions (ADF-HF: 18 ± 5%, 14 ± 5%; ADF-LF: 24 ± 3%, 14 ± 4%). The proportion of small LDL particles decreased (P < 0.05) in the ADF-HF and ADF-LF groups by 8 ± 3% and 10 ± 4%. Conclusion: Thus, an ADF-HF diet produces similar reductions in weight and CHD risk as an ADF-LF diet. These findings are important in terms of diet tolerability and long-term adherence to ADF diets.

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Resistive training increases fat-free mass and maintains RMR despite weight loss in postmenopausal women

Journal of Applied Physiology ◽

10.1152/jappl.1995.79.3.818 ◽

1995 ◽

Vol 79 (3) ◽

pp. 818-823 ◽

Cited By ~ 100

Author(s):

A. S. Ryan ◽

R. E. Pratley ◽

D. Elahi ◽

A. P. Goldberg

Keyword(s):

Weight Loss ◽

Body Weight ◽

Postmenopausal Women ◽

Body Fat ◽

Fat Mass ◽

Management Program ◽

Fat Free Mass ◽

Percent Body Fat ◽

Plasma Norepinephrine ◽

Resistive Training

Percent body fat increases with age and is often accompanied by a loss in muscle mass, strength, and energy expenditure. The effects of 16 wk of resistive training (RT) alone or with weight loss (RTWL) on strength (isokinetic dynamometer), body composition (dual-energy X-ray absorptiometry), resting metabolic rate (RMR) (indirect calorimetry), and sympathetic nervous system activity (catecholamines) were examined in 15 postmenopausal women (50–69 yr). RT resulted in significant improvements in upper and lower body strength in both groups (P < 0.01). The nonobese women in the RT group (n = 8) did not change their body weight or fat mass with training. In the obese RTWL group (n = 7), body weight, fat mass, and percent body fat were significantly decreased (P < 0.001). Fat-free mass and RMR significantly increased with training in both groups combined (P < 0.05). There were no significant changes in resting arterialized plasma norepinephrine or epinephrine levels in either group with training. RT increases strength with and without weight loss. Furthermore, RT and RTWL increase fat-free mass and RMR and decrease percent fat in postmenopausal women. Thus, RT may be a valuable component of an integrated weight management program in postmenopausal women.

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