Nutritional Status Of Patients Research Articles

Observation of Nutritional Status Changes in Patients with Acute Leukemia During Chemotherapy

To assess changes of nutritional status by comprehensive nutrition assessment including nutritional risk screening, dietary assessment, blood biochemical index, and body composition in acute leukemia patients who had undergone chemotherapy. A total of 169 patients with acute leukemia treated at The First Affiliated Hospital of Soochow University from June 2018 to August 2019 were recruited for this study. Before and after chemotherapy, the NRS-2002 and PG-SGA scales, dietary intake, blood biochemical index and body composition were evaluated to compare the changes of nutritional status. NRS-2002 score and PG-SGA score after chemotherapy were significantly increased than those before chemotherapy (P<0.001). Many patients had insufficient nutritional intake during chemotherapy, and the dietary intake score of patients with induction chemotherapy was significantly lower than that of patients with consolidation chemotherapy (P=0.043). The results of multivariate analysis showed that induction chemotherapy was the independent risk factor for the increase of PG-SGA scores and the decrease of dietary intake (all P<0.05). After chemotherapy, the white blood cell count, hemoglobin, and platelet count were significantly decreased (P<0.001), the prealbumin was significantly increased (P<0.001), and the blood glucose was increased (P=0.04), but albumin was not significantly changed. The weight, body mass index, fat-free mass, skeletal muscle mass and intracellular water were all significantly decreased (P<0.001), and visceral fat area was increased significantly after chemotherapy (P<0.05), especially in newly-diagnosed acute lymphoblastic leukemia patients after the induction of chemotherapy. The nutritional status of patients with acute leukemia has undergone significant changes after chemotherapy. A single indicator has limited significance for nutritional status assessment. Comprehensive assessment of nutritional status by multiple tools is worthy of clinical application.

Association between malnutrition and leucopenia in patients with osteosarcoma.

Background and aimLeucopenia (LP) greatly limits the efficacy of chemotherapy in osteosarcoma patients. This study aimed to evaluate the nutritional status of osteosarcoma patients before chemotherapy, assess the risk of LP during the perichemotherapy period, and explore the association between malnutrition and LP.Materials and methodsThis study retrospectively analyzed osteosarcoma patients treated in the Tianjin Medical University Cancer Institute and Hospital, China, between January 2009 and December 2020 according to the inclusion and exclusion criteria. Malnutrition in adolescents (5 to 19 years old) and adults (≥20 years old) was diagnosed using WHO AnthroPlus software (version 1.0.4) and Global Leadership initiative on Malnutrition (GLIM), respectively. According to the diagnostic criteria of LP in CTCAE 5.0, patients were divided into the LP group and the non-LP group.ResultsA total of 245 osteosarcoma patients were included. The incidence of malnutrition was 49.0%, and the incidence of LP was 51.8%. The incidence of malnutrition in adolescent patients was 53.1%, and their incidence of LP was 55.2%; the incidence of malnutrition in adult patients was 43.1%, and their incidence of LP was 47.1%. Logistic regression analysis showed that malnutrition before chemotherapy was an independent risk factor for the occurrence of LP after chemotherapy (OR = 6.85, 95% CI = 2.16-25.43; and OR = 35.03, 95% CI = 6.98-238.46 in mildly and severely malnourished young patients; OR = 6.06; 95% CI = 1.43-30.16; and OR = 38.09, 95% CI = 7.23-285.78 in mildly and severely malnourished adult patients, respectively). The results showed that age and nutritional status had a joint effect on the occurrence of LP.ConclusionThe nutrition status of osteosarcoma patients before chemotherapy is significantly correlated with the occurrence and severity of LP during peri-chemotherapy period. During osteosarcoma chemotherapy, necessary nutritional support should be given to patients of different ages to correct their malnutrition status in a timely manner, ultimately improving the efficacy of chemotherapy and the prognosis of patients.

Intradialytic parenteral nutrition for patients on hemodialysis: when, how and to whom?

Hemodialysis is associated with high morbidity and mortality rates as well as low quality of life. Altered nutritional status and protein-energy wasting are important indicators of these risks. Maintaining optimal nutritional status in patients with hemodialysis is a critical but sometimes overlooked aspect of care. Nutritional support strategies usually begin with dietary counseling and oral nutritional supplements. Patients may not comply with this advice or oral nutritional supplements, however , or compliance may be affected by other complications of progressive chronic kidney disease. Intradialytic parenteral nutrition (IDPN) may be a possibility in these cases, but lack of knowledge on practical aspects of IDPN delivery are seldom discussed and may represent a barrier. In this review, we, as a consensus panel of clinicians experienced with IDPN, survey existing literature and summarize our views on when to use IDPN, which patients may be best suited for IDPN, and how to effectively deliver and monitor this strategy for nutritional support.

Nutritional status in patients with hepatocellular carcinoma: Potential relevance for clinical outcome

BackgroundImpaired nutritional status is a risk factor for unfavorable outcome in cirrhosis. MethodsIn this prospective cohort study in hepatocellular carcinoma patients referred for tumor-specific therapy, nutritional status was assessed before and 3 months post-treatment using 4 complementary tools: hand-grip strength (HGS), Liver Frailty Index (LFI), Patient-Generated Subjective Global Assessment (PG-SGA) and skeletal muscle index (L3-SMI). Uni- and multivariable analyses were performed using Kaplan Meier curves and Cox's regression analyses with correction for Barcelona Clinic Liver Cancer (BCLC) stage, alpha-fetoprotein and age. Results56 patients were evaluated at baseline and 38 patients 3 months post-treatment. Baseline BCLC stage was 0 in 14%, A in 27%, B in 36%, C in 21%, and D in 2%. HGS, LFI, PG-SGA and L3-SMI were impaired in 13%, 95%, 21% and 71% respectively. Of all patients, 52% died after (median, range) 373 (32–962) days. Of the nutritional assessment tools, only HGS was independently associated with complication-free survival (HR 0.304, 95%CI 0.10–0.88: p = 0.028) and, approaching significance, with overall survival (HR 0.323, 95%CI 0.103–1.008: p = 0.052). Tumor-specific therapy was administered in 50 patients (20% radiofrequency / microwave ablation, 4% resection, 74% transarterial radio- or chemoembolization, 2% sorafenib). Three months post-treatment, complete response occurred in 44%, partial response in 20%, stable disease in 20% and progressive disease in 16%. Child-Pugh scores deteriorated and such deterioration was independently associated with reduced overall and complication-free survival. Conclusionsreduced baseline HGS and deteriorated post-treatment Child-Pugh score are associated with reduced overall and complication-free survival in HCC.

Changes in nutritional status of patients with jaw deformities due to orthognathic surgery

In orthognathic surgery, it is important to carefully manage peri-operative nutrition because maxillomandibular fixation and problems such as swelling and pain after surgery may make it difficult to eat normally and may prevent adequate nutrition. This study investigated the changes in nutritional status of patients with jaw deformities due to orthognathic surgery. The subjects were 155 jaw deformity patients, who underwent orthognathic surgery. The nutritional status was evaluated using anthropometry immediately before and 10 days after surgery and clinical laboratory results and the controlling nutritional status (CONUT) score before surgery and immediately, 1 week and >6 months after surgery. We investigated the relationship among the nutritional status, surgical procedures, and dietary intake in patients who underwent orthognathic surgery. The surgical procedure time and amount of bleeding were significantly greater as the surgical procedure became more complex. All of the laboratory values and CONUT scores were significantly decreased immediately after surgery and then increased over time, recovering to the same level as before surgery except for serum albumin at >6 months after surgery. Nutritional management is considered as one of the key factors for the better and faster recovery after the orthognathic surgery.

Exploration on the Effect of Dietary Care Intervention on the Nutritional Status of Patients during Chemotherapy for Digestive Tract Tumors

Exploration on the Effect of Dietary Care Intervention on the Nutritional Status of Patients during Chemotherapy for Digestive Tract Tumors

Salivary Dysfunctions and Consequences After Radioiodine Treatment for Thyroid Cancer: Protocol for a Self-Controlled Study (START Study).

BackgroundFollowing radioiodine (131I) therapy of differentiated thyroid cancer, the salivary glands may become inflamed, leading to dysfunctions and decreases in patients’ nutritional status and quality of life. The incidence of these dysfunctions after 131I-therapy is poorly known, and no clinical or genetic factors have been identified to date to define at-risk patients, which would allow the delivered activity to be adapted to the expected risk of salivary dysfunctions.ObjectiveThe aims of this study are to estimate the incidence of salivary dysfunctions, and consequences on the quality of life and nutritional status for patients after 131I-therapy; to characterize at-risk patients of developing posttreatment dysfunctions using clinical, biomolecular, and biochemical factors; and to validate a dosimetric method to calculate the dose received at the salivary gland level for analyzing the dose-response relationship between absorbed doses to salivary glands and salivary dysfunctions.MethodsThis prospective study aims to include patients for whom 131I-therapy is indicated as part of the treatment for differentiated thyroid cancer in a Paris hospital (40 and 80 patients in the 1.1 GBq and 3.7 GBq groups, respectively). The follow-up is based on three scheduled visits: at inclusion (T0, immediately before 131I-therapy), and at 6 months (T6) and 18 months (T18) posttreatment. For each visit, questionnaires on salivary dysfunctions (validated French tool), quality of life (Hospital Anxiety and Depression scale, Medical Outcomes Study 36-Item Short Form Survey), and nutritional status (visual analog scale) are administered by a trained clinical research associate. At T0 and T6, saliva samples and individual measurements of the salivary flow, without and with salivary glands stimulation, are performed. External thermoluminescent dosimeters are positioned on the skin opposite the salivary glands and at the sternal fork immediately before 131I administration and removed after 5 days. From the doses recorded by the dosimeters, an estimation of the dose received at the salivary glands will be carried out using physical and computational phantoms. Genetic and epigenetic analyses will be performed to search for potential biomarkers of the predisposition to develop salivary dysfunctions after 131I-therapy.ResultsA total of 139 patients (99 women, 71.2%; mean age 47.4, SD 14.3 years) were enrolled in the study between September 2020 and April 2021 (45 and 94 patients in the 1.1 GBq and 3.7G Bq groups, respectively). T6 follow-up is complete and T18 follow-up is currently underway. Statistical analyses will assess the links between salivary dysfunctions and absorbed doses to the salivary glands, accounting for associated factors. Moreover, impacts on the patients’ quality of life will be analyzed.ConclusionsTo our knowledge, this study is the first to investigate the risk of salivary dysfunctions (using both objective and subjective indicators) in relation to organ (salivary glands) doses, based on individual dosimeter records and dose reconstructions. The results will allow the identification of patients at risk of salivary dysfunctions and will permit clinicians to propose a more adapted follow-up and/or countermeasures to adverse effects.Trial RegistrationClinicalTrials.gov NCT04876287; https://clinicaltrials.gov/ct2/show/NCT04876287International Registered Report Identifier (IRRID)DERR1-10.2196/35565

Anti-inflammatory and nutritional improvement effects of dietary supplementation combined with fish oil in patients with epithelial cancer.

The present study investigated the effects of dietary supplementation combined with fish oil containing relatively low levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on the inflammatory and nutritional status of patients with epithelial cancer. Fish oil capsules (498 mg EPA and 213 mg DHA) and dietary supplements (100 kcal and 5 g protein) were administered for 8 weeks to 20 patients with cancer and inflammation [C-reactive protein (CRP) ≥0.30 mg/dl]. Blood EPA levels increased significantly after 4 and 8 weeks, while no significant differences were observed in log-transformed (log) CRP levels, which were the major inflammatory indices in these patients. A declining trend was observed at 8 weeks after excluding 2 patients with suspected infection (P=0.06). A significant increase was observed from week 0 to week 8 for log interleukin-6 (IL-6) levels. After excluding the 2 patients with suspected infection, no significant difference was observed when comparing week 0 to week 8 for log IL-6. No deterioration in albumin or pre-albumin levels was observed. These results suggest that although suppression of acute inflammation associated with infection is difficult, intake of relatively low EPA and DHA supplements may be effective for mild chronic inflammation in patients with epithelial cancer without infection. Large-scale randomized clinical trials are required to make the final decision regarding efficacy. The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; 06/07/2018, UMIN000033309).

A 6-Month clinical practice pilot study of sucroferric oxyhydroxide on nutritional status in patients on peritoneal dialysis

BackgroundHyperphosphatemia is common in patients on peritoneal dialysis (PD). Restricting dietary phosphorus often leads to a decrease in protein intake, which may result in hypoalbuminemia. The high pill burden of phosphate binders may also contribute to compromised appetite and dietary intake. Hypoalbuminemia is associated with an increased risk of morbidity and mortality in PD patients. The goal of this study was to determine if sucroferric oxyhydroxide improves albumin and self-reported measures of appetite in PD patients.MethodsWe performed a prospective, open-label, 6-month, pilot study of 17 adult PD patients from the Denver Metro Area. Patients had to use automated peritoneal dialysis for ≥ 3 months, have a serum albumin ≤ 3.8 g/dL, and have serum phosphate ≥ 5.5 mg/dL or ≤ 5.5 mg/dL on a binder other than SO. SO was titrated to a goal serum phosphate of < 5.5 mg/dL. The primary outcome was change in serum phosphate, albumin, and phosphorus-attuned albumin (defined as albumin divided by phosphorus) over 6 months.ResultsThe mean (SD) age and dialysis vintage was 55 ± 13 years and 3.8 ± 2.7 years, respectively. Participants’ serum phosphate significantly decreased with fewer phosphate binder pills/day after switching to SO. There was no change in serum albumin, appetite, or dietary intake. However, participants had significant improvements in phosphorus-attuned albumin.ConclusionThe transition to SO improved phosphorus control, phosphorus-attuned albumin, and pill burden. There were no significant changes in self-reported appetite or dietary intake during the study. These findings suggest that PD patients maintained nutritional status with SO therapy.Trial registrationFirst registered at ClinicalTrials.gov (NCT04046263) on 06/08/2019.

Soluble ST2 and nutritional status in patients hospitalized with heart failure with reduced ejection fraction - pilot study

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Student Scientific Society Background Chronic heart failure with reduced ejection fraction (HFrEF) is very often accompanied by malnutrition, which seems to be a marker for poor prognosis. With still high prevalence of HFrEF new aspects of malnourishment should be assessed in order to plan a more individualized management and to achieve better prognosis. In addition to that the multimarker approach to evaluating HFrEF is gaining importance. One of the most promising new markers seems to be the soluble receptor for interleukin-33 (IL-33) - sST2 peptide. Purpose The aim of the study was to find relationship between serum sST2 level and malnourishment indicators in patients with HFrEF. Methods 33 consecutive patients hospitalized in the Department of Cardiology. The sST2 level was assessed using the rapid ST2 test. We assessed nutritional status with the Mini Nutritional Assessment (MNA) questionnaire and collected the chosen clinical and biochemical parameters related to nutrition. It was tested if sST2 level could predict risk of malnutrition defined as MNA score below or equal to 23.5 using ROC curve analysis. Then to further evaluate the relation between nutritional status and sST2 level appropriate correlations were tested. Results The studied group consisted of 9.1% women, mean age was 55.3 ± 10.0 years, left ventricular ejection fraction - 24.8 ± 8.7%, sST2 level - 49.84 ± 37.02 ng/ml. Using ROC curve analysis we found that sST2 levels can predict the risk of malnutrition with both considerable sensitivity – 0.786, specificity – 0.737 and an area under the curve (AUC) 0.726 (95%CI 0.548-0.903; p=0.013). The optimal cutoff point - 35 ng/ml was derived and according to this value patients were divided into two groups. MNA score was 22.4 ± 2.3 in group with high ST2 (&amp;gt;35 ng/ml) and 24.4 ± 2.4 in group with low ST2 (&amp;lt;35 ng/ml); the difference was statistically significant (p=0.026). Using Spearman’s Rank-Order Correlation we found that sST2 level correlated significantly with total protein level (p=0.0349, R=-0.46), albumin level (p&amp;lt;0.001, R=-0.80) and total cholesterol level (p=0.002, R=-0.52), while no relevant relation to BMI nor triglycerides was found. Conclusions The study revealed a potential value of sST2 level in predicting impaired nutritional status defined with MNA and its correlation with serum protein, albumin and total cholesterol. More research needs to be conducted in order to verify these relations and to study its usefulness.

O15-2 HGCSG1902: Multicenter, prospective, observational study for patients with dysgeusia caused by chemotherapy

Dysgeusia is the one of important adverse events in patients treated with chemotherapy because it could reduce oral intake and worsen patient's nutritional status. Although some retrospective studies showed zinc administration improved dysgeusia, there is no prospective study. Therefore, we planned this study to clarify the effect of zinc therapy on dysgeusia in patients with gastrointestinal cancer.

The correlation between iodine nutrition and autoimmunity among hyperthyroid goiter patients in tertiary care hospital of Tamil Nadu

Background: Iodine is a trace element that is essential for the formation of thyroid hormones. It is essential for the human life’s growth and development. The thyroid gland size and functions affected by deficient or excessive intake of iodine. Iodine excess intake was found to associating with iodine-induced hyperthyroidism (IIH) and autoimmune thyroiditis. Aims and Objectives: The present study was to find the hyperthyroid goiter patient nutritional status by urinary iodine excretion (UIE) measurement and correlate them with thyroid hormone and thyroid autoantibodies. Materials and Methods: In this study, 100 adult hyperthyroid goiter ssubjects and 100 apparently normal adult subjects were conveniently recruited in this study.Urinary iodine estimation and serum TSH, fT4, fT3, AMA, and ATG were estimated,which were estimated for case and control groups. Results: The hyperthyroid goiter patient mean UIE concentration was 278.98 μg/L and 68% of excess UIE which was found. There was significant difference in the UIE between the hyperthyroid goiter patient and control (P&lt;0.001). The following types of goiter, based on palpation, were identified among the 100 hyperthyroid patients: Grade I – 4 %, Grade II – 63%, and Grade III – 33%. There were elevated serum AMA levelswith positive correlation of excess iodine for hyperthyroid goiter patient. Conclusion: In this study, there were excess UIEs among patients; hence, these associated complications, namely, benign goiter (14%), thyroiditis (43%), cancer of thyroid (4%), and thyrotoxicosis (39%) were observed.

Lipid-Enriched Parenteral Nutrition and Bloodstream Infections in Hospitalized Patients: Is It a Real Concern?

Today, few clinicians are still convinced that lipids are sepsis risk factors in patients receiving parenteral nutrition. This dogma is principally based on old literature. This review deals with the most recent literature search that provided up-to-date data over the past ten years. Systematic research was performed on Pubmed, MEDLINE, and Web of Science. The recent evidence does not justify the exclusion of lipid emulsions in patients receiving parenteral nutrition for fear of bloodstream infection risk. Moreover, lipids represent a substantial proportion of the energy source providing essential fatty acids, potentially improving clinical outcomes in patients often malnourished. Understanding the actual risk factors of sepsis during parenteral nutrition is necessary to optimize patient nutritional status and care and avoid essential fatty acid deficiency. There is an urgent need to make updated nutrition training available at all levels of medical education.

Efektivitas Intervensi Edukasi Nutrisi pada Ostomate Paska Operasi Digestif

This study aims to investigate and describe the types and formats of nutrition education interventions in colon cancer patients with a postoperative stoma and to examine the effect of nutrition education interventions on ostomate nutritional status. The method used is a systematic review through article searches on the Google Scholar, ScienceDirect and Proquest databases. The results showed that there was a significant improvement in the nutritional status of the patients. The ostomates can maintain fluid and electrolyte balance and albumin levels in the blood while suppressing the incidence of sepsis. One article showed a decrease in ostomate re-admission due to malnutrition (10.3%). In conclusion, the effectiveness of nutrition education intervention can improve the nutritional status of colorectal cancer patients with a stoma.&#x0D; Keywords: Diet Education, Nutrition Education, Ileostomy, Colostomy, Ostomate, Ostomy, Postoperative Follow-up

Mistakes in assessing the nutrition of patients with chronic liver disease and practical recommendations on how to avoid them: essentials of the United European Gastroenterological Week (2021)

Malnutrition is common for patients with chronic liver disease (CLD), it significantly aggravates prognosis for their quality of life and overall survival. Liver cirrhosis (LC) is one of the most severe CLD manifestations. The main causes of malnutrition at CL include insufficient food intake (deficiency of nutrients, especially proteins), malabsorption, metabolic disorders (predominance of gluconeogenesis rather than glycogenolysis) and changes in substrate metabolism (hypermetabolism). Sarcopenia, which is defined by loss of muscle mass and function, is a major component of malnutrition in patients with cirrhosis. It is important to note that sarcopenia adversely affects the number and severity of complications, quality of life, the outcome of liver transplantation and the overall survival rate of patients with advanced liver disease.Physicians of different specialties should be aware of the clinical and prognostic relevance of nutritional status, how to promptly recognize malnutrition and sarcopenia in patients with liver cirrhosis and how to appropriately manage these conditions.This paper elucidates methods of assessment of the nutritional status of patients and screening for sarcopenia, the main pathogenetic links in sarcopenia development, dietary recommendations (including diet in case of hepatic encephalopathy development), tactics of curation of patients with eating disorders. Particular attention is paid to assessing the presence of eating disorders in the process of selection of patients for transplantation and for TIPS. Recommendations are given for educating the caregivers for patients with chronic liver disease and informing patients about the risks of developing sarcopenia/sarcopenic obesity.This article discusses some of the most common errors in assessing the diet of patients with chronic liver disease, as well as current practical recommendations based on evidence that will allow physicians to avoid possible future errors in the care of such patients.

Hospital nutrition: dietary intake characteristics among adults with NCDs (Algeria, 2020)

Introduction: Hospital malnutrition is a common problem among non-communicable diseases' (NCDs) inpatients, and it is related to food intake characteristics. The aim of this study was to determine the current dietary intake characteristics of hospitalized adults with NCDs in Algeria. Methods: The study sample consisted of 105 inpatients. The dietary intake was evaluated using the 24 hours recall method, CIQUAL Table, 2016 was used for nutritional values and Subjective global assessment (SGA) for the nutritional status assessment. Results: The study design responds to a descriptive cross-sectional study carried out on a sample of 105 inpatients. The malnutrition percentage was 44.76% (B/C on SGA). Most consumed food was self-provided (78.09%) and 3.81% of food was hospital-provided. Energy intakes were low with a median of 4805 kJ/day; 24.76% of participants met 100% of their energy requirements while 13.33% met ≥75% of their protein requirements with no significant difference between well-nourished and malnourished patients. Dietary sugar was higher than 10% of total energy, and alpha-linolenic acid was at 0.06% of total energy with severe deficient of vitamins and minerals. Conclusions: Current food supply including non-regulated sources in hospital was not able to meet the dietary requirements of inpatients. Improving hospital nutritional services, supporting patients at mealtimes and nutritional education among patients’ families are solutions to improve patient nutritional status.

Nutritional Status and Related Factors in Patients with Gastric Cancer after Gastrectomy: A Cross-Sectional Study.

Patients after gastrectomy for gastric cancer are at risk of malnutrition, and poor nutritional status negatively affects patients’ clinical outcomes. Knowledge of the factors influencing patients’ nutritional status can inform interventions for improving patients’ nutrition. A cross-sectional study was conducted to describe nutritional status and related factors in gastric cancer patients after gastrectomy. A convenience sample of gastric cancer patients with gastrectomy was recruited from general surgery or oncology clinics of a medical center in northern Taiwan. Data were collected with self-reported questionnaires, including the Functional Assessment Cancer Therapy—Gastric Module version 4, the Concerns in Meal Preparation scale, the Center for Epidemiologic Studies Depression Scale, and the Mini Nutrition Assessment. One hundred and one gastric cancer patients participated in the study. There were 81 cases of subtotal gastrectomy and 20 cases of total gastrectomy. Most patients (52.5%) were malnourished or at risk. Linear regression showed that symptom severity (β = −0.43), employment status (β = 0.19), and difficulty in diet preparation (β = −0.21) were significant predictors of nutritional status. Together, these three variables explained 35.8% of the variance in patient nutritional status (F = 20.3, p < 0.001). More than 50% of our participants were malnourished or at risk for malnutrition, indicating a need for continued monitoring and support after discharge from hospitals. Special attention should be given to patients with severe symptoms, unemployment, and difficulties in diet preparation.

Prognostic prediction of preoperative nutritional status in low-grade appendiceal mucinous neoplasms

To describe the preoperative nutritional status of Low-grade Appendiceal Mucinous Neoplasms (LAMNs) and identify prognostic factors for survival. Medical records from 165 patients with LAMNs who attended the Aerospace Center Hospital, Beijing, China between January 2017, and December 2018 were retrospectively reviewed. Survival analysis was performed with the Kaplan–Meier method, the log-rank test, and a Cox proportional hazards model. Among 165 patients, 59 (36%) were male and 106 (64%) were female. Patient’s median age was 58 years (range 20 to 78 years). Univariate analysis indicated that gender, weight loss, prior surgical score (PSS), red blood cell, albumin, peritoneal cancer index (PCI), completeness of cytoreduction (CCR), and hyperthermic intraperitoneal chemotherapy (HIPEC) were related to prognosis. Multivariate analysis showed that PSS, CCR and HIPEC were independent predictors of prognosis. The preoperative nutritional status of patients plays an important role in predicting prognosis. Patients can benefit from a complete cytoreductive surgery (CCRS) and HIPEC in an experienced institution for the first medical treatment.

Malnutrition Is Associated With Worse Outcomes of Inpatient Endoscopic Retrograde Cholangiopancreatography.

ObjectivesEndoscopic retrograde cholangiopancreatography (ERCP) is frequently used to manage pancreaticobiliary disorders in an inpatient setting. Malnutrition is prevalent among hospitalized patients, and it is generally associated with poor clinical outcomes. However, there is a lack of studies on how malnutrition affects the outcomes of inpatient ERCP. Thus, we investigated the outcomes of inpatient ERCP among patients with malnutrition.MethodsAdult patients who underwent ERCP from the 2014 National Inpatient Sample database were selected to conduct retrospective analysis. Patient demographics and outcomes of ERCP were compared between the groups with and without malnutrition. The outcomes of interest were inpatient mortality, length of stay, total hospital charge, and ERCP complications, including pancreatitis, cholecystitis, cholangitis, sepsis, hemorrhage, and intestinal perforation.ResultsPatients with malnutrition had longer length of stay (15.5 days vs. 6.7 days, p < 0.05) and higher total hospital charge ($149,699 vs. $71,723, p < 0.05). Malnutrition was an independent risk factor for inpatient mortality (adjusted odds ratio (aOR) 2.54, 95% confidence interval (CI): 1.70-3.82, p < 0.05), sepsis (aOR 2.20, 95% CI: 1.82-2.65, p < 0.05), hemorrhage (aOR 1.64, 95% CI: 1.05-2.56, p < 0.05), and intestinal perforation (aOR 4.29, 95% Cl:1.61-11.46, p < 0.05).ConclusionsOur study indicates that patients with malnutrition are more likely to have worse outcomes, such as increased inpatient mortality, sepsis, hemorrhage, and intestinal perforation. Understanding the nutrition status of patients undergoing ERCP can be a useful approach for risk stratification and determining if closer surveillance of the complications is warranted.

The Impact of Dietary Counselling on Achieving or Maintaining Normal Nutritional Status in Patients with Early and Locally Advanced Breast Cancer Undergoing Perioperative Chemotherapy.

Background: Obesity is an independent prognostic factor and is associated with poorer response to oncological treatment of breast cancer. Obesity is associated with shorter overall survival and shorter time to recurrence. Material and methods: The study included 104 breast cancer patients qualified for neoadjuvant chemotherapy. The control group consisted of 40 patients who refused to participate in the study. Consultation before chemotherapy included: author’s diet questionnaire, body composition analysis, nutrition education. After chemotherapy, the effects of the first dietary advice were evaluated. Results: More than half of all women had a BMI above normal before treatment. Analysis of the effects of nutrition education showed a significant improvement in body composition. After education, a slight increase in body weight and a significant decrease in fat mass and fat percentage were observed. In women who did not participate in education, a statistically significantly greater increase in body weight after chemotherapy was noted. Nutrition education of the study group did not prevent adverse changes in lipid profile resulting from chemotherapy. Conclusions: Dietary counselling prior to neoadjuvant chemotherapy may limit weight gain and may also influence fat mass reduction. Implementation of dietary recommendations does not guarantee maintenance of normal lipid parameters during chemotherapy.