ABSTRACT
Breast cancer is the most common tumor among women, representing the second cause of cancer deaths in women. Treatment with chemotherapy negatively interferes with nutritional status. The intake of vitamins before, during and after treatment in a pilot cohort of women with non-invasive breast cancer (type I, II) treated at the Valencian Institute of Oncology (IVO) is evaluated. A 3-day anthropometric and nutritional assessment was performed using the DIAL program. Nutritional intake is compared with the values of Estimated Average Requirements (EAR) and Dietary Reference Intake (DRI) provided by the United States Department of Agriculture (USDA) and the European Food Safety Authority (EFSA). There is an overall decrease in vitamin intake during treatment which worsens at the end of said treatment. The decrease is significant in the case of vitamins B2 (p = 0.006), B3 (p = 0.042), B5 (p = 0.001), and B8 (p = 0.021). The relative risk during and after treatment increases with respect to the reference timeframe, before treatment. Deficit risks are statistically significant in the case of vitamins B5 (p = 0.001), B8 (p = 0.001) and B12 (p = 0.001). Decreased vitamin intake during treatment suggests a negative change in the patients' dietary behaviors during this time. Nutritional intervention and support may be beneficial to optimize overall dietary intake and maintain compliance with EAR and DRI for patients during a time in which adequate nutrition is important.
Subject(s)
Breast Neoplasms , Diet , Vitamins/administration & dosage , Adult , Breast Neoplasms/drug therapy , Cohort Studies , Female , Humans , Middle Aged , Nutritional Status , Pilot Projects , Spain , United StatesABSTRACT
El objetivo de este estudio consiste en determinar el estado nutricional de los 83 residentes de un centro sociosanitario y evaluar su evolución tras la aplicación del protocolo de valoración nutricional diseñado a tal efecto desde la Consejería de Bienestar Social de la Comunidad Valenciana. La muestra se clasificó según los hallazgos de índice de masa corporal (IMC), hipoalbuminemia y la aplicación del índice de riesgo nutricional geriátrico. Las intervenciones nutricionales consistieron en efectuar recomendaciones generales y seguimiento en caso de ausencia de desnutrición, la adecuación de dietas adaptadas trituradas en residentes con problemas de masticación-deglución y riesgo de broncoaspiración, la adecuación de nutrición enteral completa en residentes con catéter de alimentación nasogástrica y la instauración de suplementos nutricionales en casos de desnutrición severa. Transcurridos 3 meses se obtuvo un incremento del IMC medio, aunque no de manera significativa (p = 0,168), y se redujo el porcentaje de residentes con desnutrición del 29 al 23%. Además, disminuyó el número de residentes que recibían suplementos nutricionales sin indicación, con un ahorro mensual estimado de 965 euros. La participación activa del equipo multidisciplinario en el seguimiento nutricional de los residentes, de forma coordinada y continua, contribuye a la consecución de un adecuado estado nutricional, mejorando el uso racional de la nutrición artificial en el entorno sociosanitario (AU)
The aim of this study was to determine nutritional status in 83 residents of a nursing home and to evaluate outcomes after the application of a nutritional assessment protocol designed by the Department of Social Welfare of the autonomous community of Valencia (Spain). The sample was classified according to body mass index (BMI), hypoalbuminemia and application of the geriatric nutritional risk index. Nutritional interventions consisted of applying general recommendations and follow-up in residents without malnutrition, providing adequate powdered diets in residents with chewing and swallowing disorders and risk of bronchoaspiration, adjusting total enteral nutrition in residents with nasogastric feeding tubes and initiating vitamin supplementation in residents with severe malnutrition. After 3 months, the mean BMI showed a nonsignificant increase (P=.168), reducing the number of residents with malnutrition from 29% to 23%. The number of residents who received nutritional supplements without indication also decreased, resulting in an estimated saving of 965 euros. Active participation of the multidisciplinary team in the coordinated and continuous follow-up of nutritional status in residents contributed to achieving adequate nutritional status and improved the rational use of artificial nutrition in the nursing home (AU)
Subject(s)
Humans , Aged , Aged, 80 and over , Nutrition Assessment , Nutritional Status/physiology , Elderly Nutrition , Nutrition Disorders/epidemiology , Geriatric Assessment/methods , /trends , Health of Institutionalized Elderly , Enteral Nutrition/statistics & numerical dataSubject(s)
Analgesics, Non-Narcotic/adverse effects , Analgesics, Non-Narcotic/pharmacokinetics , Anticonvulsants/adverse effects , Anticonvulsants/pharmacokinetics , Ibuprofen/adverse effects , Ibuprofen/pharmacokinetics , Neurotoxicity Syndromes/etiology , Phenytoin/adverse effects , Phenytoin/pharmacokinetics , Aged , Drug Interactions , Female , HumansABSTRACT
No disponible
Subject(s)
Female , Aged , Humans , Neurotoxicity Syndromes/diagnosis , Phenytoin/adverse effects , Ibuprofen/adverse effects , Drug Interactions , Epilepsy/drug therapyABSTRACT
BACKGROUND: The objective of this study was two fold: to identify gynecological characteristics that distinguish women diagnosed with early-stage breast cancer from those at more advanced stages; to identify distinguishing characteristics between premenopausal and postmenopausal women diagnosed with the same stage. POPULATION AND METHOD: 186 incident cases diagnosed with breast cancer were identified out of the 685 patients who were seen to in 2000-2001. The variables to be studied were obtained by means of a specific questionnaire which collected data concerning reproductive characteristics and contraceptive types. RESULTS: Significant differences in the mean age were found, since the early-stage group was younger (57.01+/-12.82 vs. 65.06+/-15.11). Characteristic factors found in pre-menopausal women were: early menopause, they either had no children or a single child, no breastfeeding practice and a more extensive use of contraceptives. Postmenopausal women presented more advanced stages, more pregnancies and less abortions. CONCLUSIONS: By taking the obtained results into consideration, it would be recommendable to bring forward the age at which women are to be included in early detection programmes, and to conduct a follow-up of those women who present such factors to favour an earlier diagnosis of the disease.
Subject(s)
Breast Neoplasms/epidemiology , Postmenopause , Premenopause , Reproductive History , Abortion, Induced/statistics & numerical data , Adult , Aged , Breast Feeding , Breast Neoplasms/pathology , Cohort Studies , Contraceptives, Oral, Hormonal , Drug Utilization , Female , Humans , Menarche , Middle Aged , Neoplasm Staging , Parity , Pregnancy , Risk Factors , Spain/epidemiologyABSTRACT
No disponible
Background. The objective of this study was twofold: to identify gynecological characteristics thatdistinguish women diagnosed with early-stagebreast cancer from those at more advanced stages;to identify distinguishing characteristics betweenpremenopasual and postmenopausal women diagnosedwith the same stage.Population and method. 186 incident cases diagnosedwith breast cancer were identified out of the685 patients who were seen to in 2000-2001. Thevariables to be studied were obtained by means of aspecific questionnaire which collected data concerningreproductive characteristics and contraceptivetypes.Results. Significant differences in the mean age werefound, since the early-stage group was younger(57.01 ± 12.82 vs. 65.06 ± 15.11). Characteristical factorsfound in pre-menopausal women were: earlymenopause, they either had no children or a singlechild, no breastfeeding practice and a more extensiveuse of contraceptives. Postmenopausal womenpresented more advanced stages, more pregnanciesand less abortions.Conclusions. By taking the obtained results intoconsideration, it would be recommendable to bringforward the age at which women are to be includedin early detection programmes, and to conduct afollow-up of those women who present such factorsto favour an earlier diagnosis of the disease
Subject(s)
Female , Humans , Risk Adjustment/methods , Breast Neoplasms/epidemiology , Risk Factors , Epidemiologic Studies , Age Factors , Menopause , Reproductive HistoryABSTRACT
BACKGROUND: The objective of this study was to verify whether the method defined by Gail is applicable and predictive in a population of women in Valencia (Spain). POPULATION AND METHODS: Of the 685 patients diagnosed with breast cancer and attended-to in 2000-2001, 186 incident cases were identified. The variables studied were obtained from a specific questionnaire which included characteristics of reproductive history, number of biopsies and contraceptive pill consumption prior to the diagnosis. Using the model of the National Surgical Adjuvant Breast and Bowel Project (NSABP), an adaptation of the Gail model, the risk of developing breast cancer at 5 years was estimated. RESULTS: Only 40% of those women diagnosed as having breast cancer would have been identified as a high-risk patient by the Gail method. With our population group, the method detected the elderly women with a medical history of breast cancer who developed advanced stage disease. CONCLUSIONS: The Gail method does not adapt well to the study population of Valencia. It would be necessary to add other risk-factors to the Gail method so as to identify more patients in our area.
Subject(s)
Breast Neoplasms/epidemiology , Risk Assessment/methods , Adult , Aged , Humans , Male , Middle Aged , Predictive Value of Tests , Spain/epidemiologyABSTRACT
Objetivos. El objetivo del estudio es comprobar si el método definido por Gail es aplicable y predictivo en la población de mujeres valencianas. Material y métodos. Se identificaron 186 casos incidentes de las 685 pacientes atendidas de cáncer de mama durante el periodo 2000-2001. Las variables estudiadas se obtuvieron mediante un cuestionario específico que incluía características reproductivas, número de biopsias y consumo de anticonceptivos antes del diagnóstico. Se ha estimado el riesgo a los 5 años de desarrollar cáncer de mama mediante el modelo National Surgical Adjuvant Breast and Bowel Project Adaptation (NSABP), adaptación del modelo de Gail. Resultados. Únicamente el 40% de las mujeres diagnosticadas de cáncer de mama habrían sido identificadas como de alto riesgo mediante este método. En nuestra población sería útil para mujeres de edades avanzadas con antecedentes de cáncer de mama que desarrollaran enfermedad en estadios avanzados. Conclusiones. Se ha de concluir que el método de Gail no parece adaptarse a la población valenciana. Las mujeres jóvenes quedan fuera de la identificación y por lo tanto de la prevención. Sería necesario utilizar y añadir otros factores de riesgo al método de Gail para que pudiera detectar más pacientes de nuestro ámbito
Background. The objective of this study was to verify whether the method defined by Gail is applicable and predictive in a population of women in Valencia (Spain). Population and methods. Of the 685 patients diagnosed with breast cancer and attended-to in 2000-2001, 186 incident cases were identified. The variables studied were obtained from a specific questionnaire which included characteristics of reproductive history, number of biopsies and contraceptive pill consumption prior to the diagnosis. Using the model of the National Surgical Adjuvant Breast and Bowel Project (NSABP), an adaptation of the Gail model, the risk of developing breast cancer at 5 years was estimated. Results. Only 40% of those women diagnosed as having breast cancer would have been identified as a high-risk patient by the Gail method. With our population group, the method detected the elderly women with a medical history of breast cancer who developed advanced stage disease. Conclusions. The Gail method does not adapt well to the study population of Valencia. It would be necessary to add other risk-factors to the Gail method so as to identify more patients in our area
