Characterization and monitoring of nutritional risk and nutritional status in oncological patients admitted to an oncological surgery unit: A longitudinal study.

BACKGROUND AND AIMS: malnutrition is a common phenomenon in people with cancer and can occur at all stages of the disease trajectory. Prevention, early identification of patients at risk of malnutrition, nutritional diagnosis, and personalized intervention, monitoring and follow-up are essential measures to minimize the occurrence of malnutrition and its consequences. This study aims to evaluate if current institutional practices regarding nutritional intervention guarantees nutritional/dietary care for cancer patients. METHODS: adescriptive, analytical and longitudinal study was carried out, lasting five months, in a hospital inpatient surgical oncology unit. All patients admitted to the unit in the period between 1 March and 31 July 2022, who underwent nutritional screening at the time of admission to the service, were included. During hospitalization, they were subjected to periodic assessments of weight, body mass index and nutritional screening every 7 days until discharge. RESULTS: a total of 659 patients were admitted to the inpatient unit. The highest prevalence of malnutrition was observed in Head and Neck (37.6%), Genitourinary (30.8%) and Digestive (27.7%) cancers. Weight loss was especially significant in digestive, skin and sarcoma cancers, as well as genitourinary cancers, but not in breast cancer patients. During the hospitalization period, 14.0% of the hospitalized patients received nutrition-related nursing intervention, and 21.5% were referred for clinical dietetic intervention (by a registered dietitian). CONCLUSION: this work reinforces the high prevalence of malnutrition in oncological patients and the need to systematically track cancer patients throughout their disease/treatment trajectory, from admission to the hospital, to the day of admission to inpatient unit, and subsequent follow-up. We also propose expedited referrals to different specialized centres in nutritional support for cancer patients from the first day of hospitalization. Assessment of patients should always be accompanied by active referral capacity to a specialized and duly trained nutritional care team that is quick, proactive, and responsive.

Neoadjuvant Gastric Cancer Treatment and Associated Nutritional Critical Domains for the Optimization of Care Pathways: A Systematic Review.

(1) Background: Gastric cancer patients are known to be at a high risk of malnutrition, sarcopenia, and cachexia, and the latter impairs the patient's nutritional status during their clinical course and also treatment response. A clearer identification of nutrition-related critical points during neoadjuvant treatment for gastric cancer is relevant to managing patient care and predicting clinical outcomes. The aim of this systematic review was to identify and describe nutrition-related critical domains associated with clinical outcomes. (2) Methods: We performed a systematic review (PROSPERO ID:CRD42021266760); (3) Results: This review included 14 studies compiled into three critical domains: patient-related, clinical-related (disease and treatment), and healthcare-related. Body composition changes during neoadjuvant chemotherapy (NAC) accounted for the early termination of chemotherapy and reduced overall survival. Sarcopenia was confirmed to have an independent prognostic value. The role of nutritional interventions during NAC has not been fully explored. (4) Conclusions: Understanding critical domain exposures affecting nutritional status will enable better clinical approaches to optimize care plans. It may also provide an opportunity for the mitigation of poor nutritional status and sarcopenia and their deleterious clinical consequences.

Epidemiological survey of hepatitis C in a region considered to have high prevalence: the state of Minas Gerais, Brazil.

INTRODUCTION: The prevalence of hepatitis C virus (HCV) infection is affected by demographic, virological, clinical, and lifestyle-related factors and varies in different regions in Brazil or worldwide. The present study aimed to clarify the epidemiological patterns of HCV infection in the interior region of Brazil. METHODS: This study was conducted in the Southern Triangle Macro-region of the state of Minas Gerais, Brazil, according to the guidelines of the National Program for the Prevention and Control of Viral Hepatitis. The participants answered a structured questionnaire on social and epidemiological factors. Immunochromatographic rapid tests were used for the qualitative detection of antibodies against HCV in whole blood (Alere HCV® Code 02FK10) in adult subjects by a free-standing method. RESULTS: Of 24,085 tested individuals, 184 (0.76%) were anti-HCV positive. The majority of anti-HCV-positive individuals were born between 1951 and 1980 (n=146 [79.3%]), with 68 women and 116 men. Identified risk factors included syringe and/or needle sharing (p = 0.003), being in prison (p = 0.004), and having tattoos or piercings (p = 0.005) and were significantly associated with the decade of birth. CONCLUSIONS: The study shows the importance of testing populations at risk for HCV infection, including incarcerated individuals, those with tattoos or piercings, those who share or have shared syringes or needles, and those in high-risk birth cohorts (1950s, 1960s, and 1970s) in the Southern Triangle Macro-region.

Epidemiological survey of hepatitis C in a region considered to have high prevalence: the state of Minas Gerais, Brazil

Abstract INTRODUCTION: The prevalence of hepatitis C virus (HCV) infection is affected by demographic, virological, clinical, and lifestyle-related factors and varies in different regions in Brazil or worldwide. The present study aimed to clarify the epidemiological patterns of HCV infection in the interior region of Brazil. METHODS: This study was conducted in the Southern Triangle Macro-region of the state of Minas Gerais, Brazil, according to the guidelines of the National Program for the Prevention and Control of Viral Hepatitis. The participants answered a structured questionnaire on social and epidemiological factors. Immunochromatographic rapid tests were used for the qualitative detection of antibodies against HCV in whole blood (Alere HCV® Code 02FK10) in adult subjects by a free-standing method. RESULTS: Of 24,085 tested individuals, 184 (0.76%) were anti-HCV positive. The majority of anti-HCV-positive individuals were born between 1951 and 1980 (n=146 [79.3%]), with 68 women and 116 men. Identified risk factors included syringe and/or needle sharing (p = 0.003), being in prison (p = 0.004), and having tattoos or piercings (p = 0.005) and were significantly associated with the decade of birth. CONCLUSIONS: The study shows the importance of testing populations at risk for HCV infection, including incarcerated individuals, those with tattoos or piercings, those who share or have shared syringes or needles, and those in high-risk birth cohorts (1950s, 1960s, and 1970s) in the Southern Triangle Macro-region.

Cirrose por HCV genótipo 1a, tratada com 7 semanas de interferon peguilado/ribavirina, transplantada por hepatocarcinoma, em RVS / Cirrhosis by HCV genotype 1a, treated with 7 weeks of pegylated interferon/ribavirin, transplanted for hepatocellular carcinoma, on SVR

A hepatopatia crônica causada pelo vírus da hepatite C (HCV) é a indicação mais comum de transplante hepático no mundo. A recorrência da hepatite C após o transplante hepático é elevada e em grande parte dos pacientes pode evoluir com cirrose e perda do enxerto de forma acelerada. Relatamos caso de portadora de cirrose por hepatite C genótipo 1a, tratada durante sete semanas com Interferon Peguilado e Ribavirina, em Resposta Viral Sustentada (RVS), mesmo após transplante hepático por hepatocarcinoma.

Chronic liver disease caused by hepatitis C virus (HCV) is the most common indication for liver transplantation in the world. The recurrence of hepatitis C after liver transplantation is high and most patients can develop cirrhosis and graft loss in an accelerated manner. A case of a patient with cirrhosis due to hepatitis C genotype 1a, treated for seven weeks with pegylated interferon and Ribavirin in Sustained Viral Response (SVR), even after liver transplantation for hepatocellular carcinoma.

Bladder cancer-induced skeletal muscle wasting: disclosing the role of mitochondria plasticity.

Loss of skeletal muscle is a serious consequence of cancer as it leads to weakness and increased risk of death. To better understand the interplay between urothelial carcinoma and skeletal muscle wasting, cancer-induced catabolic profile and its relationship with muscle mitochondria dynamics were evaluated using a rat model of chemically induced urothelial carcinogenesis by the administration of N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN). The histologic signs of non-muscle-invasive bladder tumors observed in BBN animals were related to 17% loss of body weight and high serum levels of IL-1ß, TNF-α, TWEAK, C-reactive protein, myostatin and lactate and high urinary MMPs activities, suggesting a catabolic phenotype underlying urothelial carcinoma. The 12% loss of gastrocnemius mass was related to mitochondrial dysfunction, manifested by decreased activity of respiratory chain complexes due to, at least partially, the impairment of protein quality control (PQC) systems involving the mitochondrial proteases paraplegin and Lon. This was paralleled by the accumulation of oxidatively modified mitochondrial proteins. In overall, our data emphasize the relevance of studying the regulation of PQC systems in cancer cachexia aiming to identify therapeutic targets to counteract muscle wasting.

Identificação de necessidades e planeamento de respostas para as pessoas idosas / Identifying needs and planning responses for older people

O envelhecimento da população tem gerado a necessidade de se encontrar estratégias de intervenção que possam colmatar as necessidades da população idosa. Na ilha de Santa Maria, o envelhecimento populacional não é excepção. Desta forma, o presente estudo pretende identificar as necessidades dos idosos da referida ilha com o intuito de apresentar propostas de intervenção. Num universo de 676 idosos que residem na ilha, participaram no estudo 430 indivíduos. O instrumento de recolha de dados utilizado, para avaliar as necessidades da pessoa idosa, foi o EASY Care, tendo-se elaborado um algoritmo de decisão no âmbito do planeamento de respostas sociais às necessidades identificadas. Dos resultados do estudo evidencia-se que em termos de necessidades a incapacidade física afecta 87,7% dos idosos; a incapacidade funcional está associada ao sexo masculino e ao aumento da idade e a incapacidade total tem uma preponderância reduzida (24,2%). Porém, ao aumento da dependência está associado o aumento da idade. Verifica-se também que 60,9% dos idosos apresentam sinais/sintomas de depressão estando a sintomatologia depressiva principalmente associada ao sexo feminino, e que 39,8% dos idosos apresentam diminuição moderada a grave na função cognitiva, estando a diminuição cognitiva associada ao aumento da idade. No âmbito do planeamento de respostas sociais constata-se que 24 idosos poderão ter as suas necessidades satisfeitas com a resposta social lar, 16 idosos com a residência, 150 idosos com o centro de dia, 209 idosos com o serviço de apoio ao domicílio e 27 idosos apresentam necessidades que poderão ser colmatadas na resposta de centro de convívio. Constata-se, pois, a necessidade de se planear intervenções direccionadas para a continuidade do idoso no seu domicílio e inserido na comunidade, privilegiando-se as respostas sociais de serviço de apoio ao domicílio, centro de convívio, e centro de dia, asseguradas pelo estado e os recursos disponíveis na comunidade.

The aging of the population has led the need to find intervention strategies that can bridge the needs of the elderly population. In the Island of Santa Maria, populational aging is not an exception. Therefore, the present study aims to identify the needs of the elderly in said Island, with the purpose of presenting intervention proposals. In a universe of 676 elderly residing in the Island, 430 individuals participated in the study. The instrument used to gather the data to evaluate the needs of the elderly person was EASY Care, and an algorithm of decision was elaborated in the ambit of planning for social answers to the identified needs. From the results of the study it is evident that in terms of needs, physical incapacity affects 87, 7% of the elderly; functional incapacity is associated to the male gender and increase in age and total disability have a reduced preponderance (24,2%). However, the increase in dependence is associated with the increase in age. It is also established that 60, 9% of the elderly demonstrate signs/symptoms of depression, being that the depressive symptomatology is mainly associated to the female gender, and that 39, 8% of the elderly present a moderate to severe decrease in the cognitive function, being the cognitive decrease associated with the increase in age. In the ambit of planning for social answers, it is acknowledged that 24 elderly may have their needs met by the social response nursing home, 16 elderly with assisted living facilities, 150 elderly with a day care center, 209 elderly with the home care services and 27 elderly demonstrate needs that may be filled in the social center response. It is therefore established, the need to plan for directed interventions toward the continuity of the elderly in their home and inserted into the community, privileging the social responses of home care services, social centers and day care centers, assured by the State and the available resources in the community.