Low calf circumference is an independent predictor of mortality in cancer patients: A prospective cohort study.

OBJECTIVE: Loss of muscle mass is associated with worse outcomes in patients with cancer. The objective of this study was to evaluate the prognostic value of calf circumference (CC) and skeletal muscle index from computed tomography (CT) to predict mortality in patients with cancer. METHODS: A single-center prospective study was conducted with patients aged ≥20 y attending a reference center of oncology and who had recent abdominal CT images. Data were collected through a semistructured form and patients' records and included sociodemographic data (sex, age and ethnicity), clinical data (primary site and staging of tumor and treatments performed), anthropometric variables (body mass index and CC), and outcome (death). Low CC for men was considered to be ≤ 34 cm and for women ≤ 33 cm. Muscle mass was assessed by CT images at the level of L3. The Cox proportional hazard model adjusted for age, sex, and staging of disease was used. RESULTS: A total of 250 patients were evaluated, 52.8% female, with a median age of 63 y (interquartile ratio: 55-73). Normal body mass index was identified in 44.4%; 29.2% had low skeletal muscle index, and 46.4% had low CC. Death by any cause occurred in 16%, and only low CC was a significant predictor of mortality (hazard ratio = 3.01; confidence interval 1.52-5.98; P = 0.002). CONCLUSIONS: Low CC can predict risk of mortality in this cohort of patients. The findings suggest the use of CC as a simple, easy, cost-effective anthropometric measurement to quickly screen patients at risk of death who could benefit from targeted care to improve their prognosis.

[Microbiologic evaluation of enteral diets handled in a hospital]. / Avaliação microbiológica de dietas enterais manipuladas em um hospital.

PURPOSE: To evaluate the microbiological quality of open enteral feeding system manipulated in a specialized hospital in oncology in the city of Natal-RN. METHODS: 20 samples of industrialized enteral feeding in open system had been analyzed. The searched microrganisms had been: Bacillus cereus, total coliforms, Escherichia coli, Salmonella sp, Clostridium sulfite reducer, mesophilic aerobic bacteria and coagulase positive Staphylococci. The methodology used for accomplishment of the microbiological analyses was the praised one for the Food and Drug Administration--FDA. RESULTS: It was evidenced total coliforms, Escherichia coli and mesophilic aerobic bacteria contamination in 25%, 10% and 20% of the analyzed samples, respectively. It was not identified the presence of Bacillus cereus, Salmonella sp, Clostridium sulfite reducer, and coagulase positive Staphylococci in none of the analyzed samples. CONCLUSION: The gotten results show that the enteral feedings are in unsatisfactory hygienic-sanitary conditions, evidencing the necessity of a bigger control in the manipulation of the same ones.

Avaliação microbiológica de dietas enterais manipuladas em um hospital / Microbiologic evaluation of enteral diets done in hospital

OBJETIVO: Avaliar a qualidade microbiológica de dietas enterais em sistema aberto manipuladas em um hospital especializado em oncologia na cidade de Natal-RN. MÉTODOS: Foram analisadas 20 amostras de dietas enterais industrializadas em sistema aberto. Os microrganismos pesquisados foram: Bacillus cereus, coliformes totais, Escherichia coli, Salmonella sp, Clostridium sulfito redutor, bactérias mesófilas aeróbias e Staphylococcus coagulase positiva. A metodologia empregada para realização das análises microbiológicas foi a preconizada pelo Food and Drug Administration - FDA. RESULTADOS: Foi evidenciada a contaminação por coliformes totais, Escherichia coli e bactérias mesófilas aeróbias em 25 por cento, 10 por cento e 20 por cento das amostras analisadas, respectivamente. Não foi identificada a presença de Bacillus cereus, Salmonella sp, Clostridium sulfito redutor, e Staphylococcus coagulase positiva em nenhuma das amostras analisadas. Conclusão: Os resultados obtidos mostram que as dietas enterais encontram-se em condições higiênico-sanitárias insatisfatórias, evidenciando a necessidade de um maior controle na manipulação das mesmas.