Body Mass Index and Doses at Organs at Risk in a Mediterranean Population Treated with Postoperative Vaginal Cuff Brachytherapy

Objective: Delineation of organs at risk is a time-consuming task. This study evaluates the benefits of using single-subject atlas-based automatic segmentation of organs at risk in patients with breast cancer treated in prone position, with 2 different criteria for choosing the atlas subject. Together with laterality (left/right), the criteria used were either (1) breast volume or (2) body mass index and breast cup size. Methods: An atlas supporting different selection criteria for automatic segmentation was generated from contours drawn by a senior radiation oncologist (RO_A). Atlas organs at risk included heart, left anterior descending artery, and right coronary artery. Manual contours drawn by RO_A and automatic segmentation contours of organs at risk and breast clinical target volume were created for 27 nonatlas patients. A second radiation oncologist (RO_B) manually contoured (M_B) the breast clinical target volume and the heart. Contouring times were recorded and the reliability of the automatic segmentation was assessed in the context of 3-D planning. Results: Accounting for body mass index and breast cup size improved automatic segmentation results compared to breast volume-based sampling, especially for the heart (mean similarity indexes >0.9 for automatic segmentation organs at risk and clinical target volume after RO_A editing). Mean similarity indexes for the left anterior descending artery and the right coronary artery edited by RO_A expanded by 1 cm were ≥0.8. Using automatic segmentation reduced contouring time by 40%. For each parameter analyzed (eg, D2%), the difference in dose, averaged over all patients, between automatic segmentation structures edited by RO_A and the same structure manually drawn by RO_A was <1.5% of the prescribed dose. The mean heart dose was reliable for the unedited heart segmentation, and for right-sided treatments, automatic segmentation was adequate for treatment planning with 3-D conformal tangential fields. Conclusions: Automatic segmentation for prone breast radiotherapy stratified by body mass index and breast cup size improved segmentation accuracy for the heart and coronary vessels compared to breast volume sampling. A significant reduction in contouring time can be achieved by using automatic segmentation.

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The Impact of Nutritional Status and Body Mass Index on Rehabilitation Outcomes in Patients Receiving Home-Based Medical Care

World Nutrition Journal ◽

10.25220/wnj.v03.i2.0003 ◽

2020 ◽

Vol 3 (2) ◽

pp. 15

Author(s):

Kanako Eiwa ◽

Naomi Nakayama ◽

Yumi Takami ◽

Shuko Iwasaki ◽

Yoshinori Hino ◽

...

Keyword(s):

Body Mass Index ◽

At Risk ◽

Nutritional Status ◽

Medical Care ◽

Body Mass ◽

Functional Independence ◽

The Body ◽

Rehabilitation Outcomes ◽

Home Based ◽

The Impact

Background: Home-based medical care is expanding rapidly in Japan.Objectives: We aimed to identify the factors associated with outcomes of therapy in patients receiving home-visit rehabilitation.Methods: One hundred twenty-one patients receiving home-based rehabilitation were investigated. Nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF). The Functional Independence Measure (FIM) was employed to assess the activities of daily living (ADL). The body mass index (BMI), medical history, and orthopedic disease-related pain were also recorded. The primary outcome was the improvement in FIM scores in one year.Results: A total of 19 (17%) patients were malnourished and 58 (48%) were at risk of malnutrition. Malnourished patients had a lower FIM score at initiation than those at risk of malnutrition or with normal nutritional status. Only changes in patients’ BMI and MNA-SF scores over one year were significantly associated with improved FIM scores (p = 0.0079 and p = 0.0049, respectively). No association was noted with the other factors.Conclusions: This is the first report to demonstrate that changes in MNA-SF scores and BMI are significantly associated with rehabilitation outcomes in home-based care. Nutritional management is essential along with rehabilitation to improve ADL in the long-term home care setting.

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Artificial nutrition support

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0224 ◽

2020 ◽

pp. 1914-1926

Author(s):

Jeremy Woodward

Keyword(s):

Body Mass Index ◽

At Risk ◽

Weight Loss ◽

Nutritional Status ◽

Body Mass ◽

Oral Intake ◽

Nutrition Support ◽

Artificial Nutrition ◽

Nutrition Screening ◽

Disease States

The prevalence and relevance of undernutrition in affluent societies is often unrecognized, but nutritional status significantly impacts outcomes in all disease states. Nutrition screening identifies patients at risk of undernutrition and should be carried out in hospitals and community: its components comprise past weight loss, current body mass index, and likely foreseeable nutritional challenges. A body mass index less than 18.5 kg/m2; weight loss of more than 10% over 6 months; or BMI of less than 20 kg/m2 with weight loss of more than 5% over 6 months, are all indicative of undernutrition. Nutrition support is indicated for malnourished patients or those at risk of undernutrition in view of inadequate oral intake or malabsorption. Timing of the intervention depends on the pre-existing nutritional status and the likelihood of restoring adequate intake.

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Variation by body mass index and age in waist-to-hip ratio associations with glycemic status in an aboriginal population at risk for type 2 diabetes in British Columbia, Canada

American Journal of Clinical Nutrition ◽

10.1093/ajcn/69.3.455 ◽

1999 ◽

Vol 69 (3) ◽

pp. 455-460 ◽

Cited By ~ 24

Author(s):

Mark Daniel ◽

Stephen A Marion ◽

Samuel B Sheps ◽

Clyde Hertzman ◽

Diane Gamble

Keyword(s):

Type 2 Diabetes ◽

Body Mass Index ◽

At Risk ◽

British Columbia ◽

Body Mass ◽

Glycemic Status ◽

Waist To Hip Ratio ◽

Aboriginal Population ◽

Population At Risk

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Body mass index is associated with smaller medial temporal lobe volume in those at risk for Alzheimer's disease

NeuroImage Clinical ◽

10.1016/j.nicl.2019.102156 ◽

2020 ◽

Vol 25 ◽

pp. 102156

Author(s):

Jasmeet P. Hayes ◽

Jena N. Moody ◽

Juan Guzmán Roca ◽

Scott M. Hayes

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Body Mass Index ◽

At Risk ◽

Body Mass ◽

Temporal Lobe ◽

Medial Temporal Lobe

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P2607Quick nutritional assessment and prognosis in outpatients with heart failure with mid-range ejection fraction

European Heart Journal ◽

10.1093/eurheartj/ehz748.0931 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

E Zamora ◽

B Gonzalez ◽

C Rivas ◽

V Diaz ◽

P Velayos ◽

...

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

At Risk ◽

Ejection Fraction ◽

Nutritional Status ◽

Body Mass ◽

Screening Tool ◽

Nutritional Assessment ◽

Functional Class ◽

Nyha Functional Class

Abstract Background Nutritional status is an important prognostic factor in patients with heart failure (HF) beyond body mass index, although its prognostic value in patients with mid-range left ventricular ejection fraction (HFmrEF) is not completely elucidated. In a pilot study we observed that the Mini Nutritional Assessment Short Form (MNA-SF) was the best approach for the screening of nutritional status in HF outpatients over others screening tools. Purpose To assess the prognostic role of malnutrition or risk of malnutrition in HFmrEF outpatients after the implementation of the MNA-SF screening tool in a routine way in a multidisciplinary HF. Methods The MNA-SF screening tool was administered during the global nurse evaluation of patients. The scoring ranges from 0 to 14, being 0 to7 as malnutrition status, 8 to 11 as at risk of malnutrition and 12 to 14 as normal nutritional status. For the present study those patients with malnutrition and at risk of malnutrition were merged and considered abnormal nutritional status. All-cause death was the primary end-point. Univariate and multivariate (backward conditional stepwise) Cox regression analyses were performed. Results Since October 2016 to November 2017, 153 HFmrEF patients were studied (mean age 68.8±11.7 years, 72.5% men, body mass index 28.4±4.4, LVEF 44% ± 3, NYHA class I 5.9%, II 86.3%, and III 7.8%). According to the MNA-SF 25 patients were (16.3%) fulfilled criteria of malnutrition (4) or where at risk of malnutrition (21). During a mean follow-up of 17.4±6.1 months, 23 patients died (15%). In the univariate analysis, nutritional abnormal status was significantly associated with all-cause death (HR 2.93 [1.23–7], p=0.02). In the multivariate analysis which included age, sex, NYHA functional class, body mass index, ischemic aetiology of HF and years of duration of HF, abnormal nutritional status remained significantly associated with all-cause mortality (HR 3.64 [1.39–9.54], p=0.009), together with NYHA functional class (HR 7.93 [2.69–23.4], p<0.001) and years of HF duration (HR 1.10 [1.04–1.16], p=0.001). Conclusions Nutritional status assessed with the screening MNA-SF was an independent predictor of all-cause death in ambulatory patients with HFmrEF – beyond BMI – together with NYHA functional class and HF duration.

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The relationship between sleep quality and nutrition of medical school students in a city of Turkey

European Journal of Public Health ◽

10.1093/eurpub/ckz186.437 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

E Pehlivan ◽

E Yalcin ◽

B Firinci

Keyword(s):

Body Mass Index ◽

At Risk ◽

Social Media ◽

Sleep Quality ◽

Body Mass ◽

Eating Attitudes ◽

Eating Attitude ◽

Normal Body Mass Index ◽

Normal Body ◽

The Difference

Abstract Background Students need quality sleep and regular feeding during an intensive training proces. The aim of this study was to determine the sleep quality of Faculty of Medicine students and whether there is a relationship between sleep quality and eating attitudes and habits. Methods In this cross-sectional study; a face-to-face questionnaire was administered to 352 students who attending Inonu University Medical Faculty between January and March of 2019. The sample group is stratified according to class sizes (total 1665 students. The sleep quality and eating behaviors of students were questioned. For purpose, Pittsburgh Sleep Quality Index (PUKI, developed by Buysse et al,1989), and Eating Attitude Test (EAT,developed by Garner et al 1982) was used to assess quality and disorders. Kolmogorov Smirnov normal distribution test, Mann Whitney U and Kruskal Wallis test were used in analysis of the data. Results The mean age of the students was 21.5 ± 2.5 and 54.3% were female and 45.7% were male and 25.0% smoked cigarette. 64.4% of the study group had normal body mass index. The median value of the PUKI (cut of point is 5.0 and under 5 is good) score by gender is similar with 6.0 (1.0-15.0). The median value of the PUKI score was 6.0 (1.0-16.0) in social media / internet users and 5.0 (1.0-13.0) in non-users. According to Internet / social media users before going to sleep, the difference is significant (p: 0.016). The difference between cigarette smoking and median value of PUKI was significant (p: 0.029). there was a difference between classes in favor of upper classes in terms of EAT values (p = 0,046). 12.2% of the students are at risk of Blumia and 10.8% are at risk of Anorexia. There was no significant but positive correlation between the PUKI and EAT (p = 0.074, r = 0.096). Conclusions In general, the students’ sleep quality and eating attitudes and habits were found close to the cut-off points accepted by the tests. But blumia and anorexia is significant. This study was supported by the Research Fund of the Inonu University (No. 1792) Key messages Social media / internet usage of students before going to sleep affects sleep quality significantly. Although 64.4% of the students have normal body mass index, eating disorders (bulumia and anorexia) risk are noteable.

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