Standardized phase angle: relationship with functionality, muscle mass and postoperative outcomes in surgical cancer patients.

To evaluate the association of standardized phase angle (SPA) with nutritional status, functional parameters, and postoperative outcomes in surgical cancer patients. This prospective study includes 59 cancer patients from Pelotas (Brazil) admitted for elective cancer surgery. We obtained the phase angle through Bioelectrical Impedance Analysis (BIA) and standardized it according to the population's reference values. We estimated the muscle mass using BIA for later calculation of the Skeletal Muscle Index (SMI) and performed handgrip strength (HGS) and gait speed (GS) tests. We used the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutritional status. Postoperative complications and duration of hospital stay were evaluated as the outcomes. The prevalence of malnutrition in the sample was 28.8%, according to ASG-PPP. SPA was statistically lower in patients with malnutrition, with lower HGS and reduced GS. For postoperative outcomes, patients with severe complications and those with prolonged hospitalization also had lower SPA values. The greater the number of functional alterations in patients, the lower the SPA value, mainly when associated with reduced muscle mass assessed by BIA, suggesting that muscle mass reduction plays an important role in the association between functional alterations and phase angle in patients with cancer. According to the parameters used in this study, low SPA value was associated with impaired nutritional and functional status and negative outcomes in the analyzed sample.

Juvenile Violent Victimization and Adult Criminal Outcomes: The Role of Military Service as a Turning Point in Young Adulthood.

Previous research has consistently shown that juvenile violent victimization is associated with an increased risk of future criminal involvement, a phenomenon commonly known as victim-offender overlap. Despite a growing interest in the factors underlying this overlap, potential roles of major life transitions and turning points that may interrupt and reshape the nature of this developmental association have garnered less academic attention. Analyzing nationally representative data from waves I, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (Add Health; n = 10,205), this study investigates the association between juvenile violent victimization and adult criminal outcomes (i.e., violent offending, non-violent offending, arrest, and incarceration) and whether this association is moderated by military service with and without combat experience in young adulthood. Employing a series of logistic regression analyses and adjusting for a host of covariates, measures of selection, and criminogenic traits, we found that juvenile violent victimization was significantly associated with greater odds of violent offending, arrest, and incarceration in adulthood. Among individuals with violent victimization histories, military service with no combat experience was associated with a 16% decrease in the odds of incarceration in adulthood. Combat experience, however, was associated with over seven times greater odds of violent offending in adulthood for these individuals. These findings have important implications for theory, research, and practice, and highlight the relevance of life transitions and turning points in general, and military service in particular, in mitigating or perpetuating the criminogenic impacts of violent victimization in the life course.

Phase angle, physical quality of life and functionality in cancer patients undergoing chemotherapy.

INTRODUCTION: Nutritional deficiency, especially malnutrition, is frequent in cancer patients and is associated with changes in body composition, such as low muscle mass. Phase angle (PhA) has been used as a prognostic indicator and may be related to nutritional status, functionality, and quality of life in these patients. The objectives of this study were to assess the effect of chemotherapy treatment on PhA values, comparing the PhA variation before and after treatment, and to evaluate the PhA correlation, as a muscle mass surrogate, with the physical domain of quality of life, functionality, and nutritional risk in a sample of patients with cancer. METHODS: A longitudinal study was conducted in patients with cancer undergoing chemotherapy for the first time. All patients aged 18 years or older, newly diagnosed, and undergoing chemotherapy for the first time were included. To analyze the difference in the PhA means according to the different classification variables, the t-test - or ANOVA - was used. The variation of the final and initial PhA was evaluated through the linear regression test. RESULTS: A total of 175 patients were analyzed, of which 66.3% were female. The mean PhA of the initial assessment was significantly higher when compared to the final assessment of the patients PhA (p = 0.018). In both the initial and final assessments, PhA was correlated with the physical domain (r = 0.29; p < 0.001 and r = 0.19; p = 0.021) and with the functionality score (r = - 0.32; p < 0.001 and r = - 0.30; p < 0.001) and total PG-SGA (r = - 0.31; p < 0.001 and r = - 0.23; p = 0.006). CONCLUSION: PhA can be considered a predictor of physical quality of life and functionality in cancer patients receiving chemotherapy treatment.

Nutritional status and nutritional therapy in pediatric and adolescent patients submitted to autologous hematopoietic stem cell transplantation

Introduction: To assess the use of nutritional support in children and adolescents submitted to autologous hematopoietic stem cell transplantation (HSCT), and analyze changes in nutritional status at hospital discharge after HSCT. Methods: A retrospective observational study was conducted on pediatric oncology patients hospitalized for autologous HSCT between 2010 and 2017. Nutritional therapy was evaluated based on the duration of enteral tube feeding (ETF) and parenteral nutrition (PN), either alone or in combination. The length of hospital stay was measured in days. Nutritional status was assessed at admission and discharge, and classified according to World Health Organization criteria. Results: The sample consisted of 68 patients, 54.4% of whom were boys. Most participants (89.7%) had solid tumors. Nutritional therapy was required in over half (52.9%) of cases, with PN being the most common indication. There was a reduction in the percentage of overweight patients and an increase in the percentage of underweight patients at discharge relative to admission. Conclusions: The use of nutritional therapy is highly prevalent in this population, and HSCT has a negative impact on nutritional status at discharge. (AU)

Nutritional and functional factors as prognostic of surgical cancer patients.

PURPOSE: We evaluated phase angle, sarcopenia, and handgrip strength as prognostic factors of postoperative morbimortality in patients with cancer. METHODOLOGY: We conducted a prospective study with 60 oncology patients admitted for elective surgery between November 2015 and May 2016. We calculated the standardized phase angle (SPA) and the skeletal mass index of the subjects based on their bioelectrical impedance tests. Handgrip strength (HGS) was measured using a hydraulic dynamometer. Diagnosis of sarcopenia followed the criteria of the European Working Group on Sarcopenia in Older People. The nutritional status of each subject was evaluated through the Patient-Generated Subjective Global Assessment. Evaluation of postoperative complications followed the Clavien-Dindo classification. We also evaluated the duration of hospital stay. Outcomes were postoperative complications and duration of hospital stay. RESULTS: The prevalence of malnutrition was 28.3%, and the prevalence of sarcopenia was 18.6%. The SPA was significantly lower among those who had severe postoperative complications or long hospital stays, while HGS and sarcopenia showed no relationship with these outcomes. Malnutrition was also related to postoperative outcomes. CONCLUSION: SPA can be considered a prognostic factor in postoperative morbimortality for patients with cancer.