Nutrition
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Malnutrition is frequent in patients with cancer and is associated with a higher rate of morbidity and mortality. However, a significant number of patients at nutritional risk remain undetected due to the lack of a routine screening procedure during diagnosis. Costa del Sol Hospital in Marbella (Málaga), Spain has implemented a protocol for outpatients with cancer aimed at identifying and treating malnutrition at an early stage. The aim of this study was to determine the prevalence of nutritional risk and the rate of malnutrition when cancer is diagnosed. ⋯ The high rate of malnutrition observed and the identification of cachexia at an early stage highlight the importance of obtaining early identification of patients at risk to improve the efficacy of nutritional interventions.
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Body weight and height measurements are essential in children for assessing growth and nutrition, for the calculation of medication doses, and for the effectiveness of medical interventions. When direct measurements cannot be made, segmental measures can be used to estimate weight and height. The equations available to estimate height and weight, however, are limited. The aim of this study was to use segmental measures to develop equations for use in pediatric clinical practice. ⋯ MAC and KH can be used for estimation equations for weight and height with a very good predictive power. Sex and age were significant covariates in estimating weight. To predict height, only sex was needed to fit the model.
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The aim of this study was to assess whether the nutritional status of children with cancer is influenced by variations in cytokine concentrations observed during chemotherapy. We also evaluated whether this relationship could be modified by nutritional status at diagnosis and type of cancer. ⋯ These results suggest that the cytokine responses during chemotherapy are related to nutritional status at the end of 6 mo of treatment regardless of the initial nutritional status and the type of cancer.
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Observational Study
Development of a bedside-applicable ultrasound protocol to estimate fat mass index derived from whole body dual-energy x-ray absorptiometry scans.
Precise measures of adiposity are difficult to obtain in clinical settings due to a lack of access to accurate and reliable techniques. The aim of this study was to develop and internally validate a bedside-applicable ultrasound protocol to estimate fat mass index. ⋯ This optimized protocol developed can be applied bedside and provide accurate assessments of fat mass index.
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Case Reports
Potential cause-effect relationship between insulin autoimmune syndrome and alpha lipoic acid: Two case reports.
Insulin autoimmune syndrome (IAS) or Hirata disease is a rare cause of autoimmune hypoglycemia with apparent high insulin levels and anti-insulin autoantibodies and was first described by Hirata in Japan in 1970. IAS cases are usually related to exposure to sulfhydryl-containing drugs, which stimulate the production of insulin autoantibodies. Among sulfhydryl-containing compounds, alpha lipoic acid (ALA) has recently emerged as a cause of IAS. After the first observations of ALA-induced IAS were reported in Japan in 2006, an increasing number of cases related to ALA administration have been described. An Italian group recently reported on six cases of IAS of which one was associated with HLA-DRB1*04:06 and the remaining five with HLA-DRB1*04:03. This suggests that the latter is potentially involved in the genetic susceptibility of people of European descent to IAS. ⋯ Case reports of ALA-induced hypoglycemic episodes highlight the need for greater care in prescribing ALA supplementation as well as the identification of specific and personalized therapeutic targets.