Αρχειοθήκη ιστολογίου

Παρασκευή 24 Ιουνίου 2022

Nutritional problems of patients with COVID‐19 receiving dietetic treatment in primary care

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Abstract

Background

The nutritional problems of patients who are hospitalised for COVID-19 are becoming increasingly clear. However, a large group of patients have never been hospitalised and also seem to experience persistent nutritional problems. The present study describes the nutritional status, risk of sarcopenia and nutrition-related complaints of patients recovering from COVID-19 receiving dietetic treatment in primary care.

Methods

In this retrospective observational study, data were collected during dietetic treatment by a primary care dietitian between April and December 2020. Both patients who had and had not been admitted to the hospital were included at their first visit to a primary care dietitian. Data on nutritional status, risk of sarcopenia and nutrition-related complaints were collected longitudinally.

Results

Data from 246 patients with COVID-19 were collected. Mean age was 57 ± 16 years and 61% of the patient population was female. At first consultation, two thirds of patients were classified as overweight or obese (BMI >25 kg/m2). The majority had experienced unintentional weight loss due to COVID-19. Additionally, 55% of hospitalised and 34% of non-hospitalised patients had a high risk of sarcopenia. Most commonly reported nutrition-related complaints were: decreased appetite, shortness of breath, changed or loss of taste, and feeling of being full. Nutrition-related complaints decreased after the first consultation, but remained present over time.

Conclusions

In conclusion, weight changes, risk of sarcopenia and nutrition-related complaints were prevalent in patients with COVID-19, treated by a primary care dietitian. Nutrition-related complaints improved over time, but remained prevalent until several months after infection.

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Tone Enhancement Electro‐Fiberscope Combined with Strobe Light Source and Re‐analysis Past Images‐Tone Enhancement Dynamic Stroboscope

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Tone Enhancement Electro-Fiberscope Combined with Strobe Light Source and Re-analysis Past Images-Tone Enhancement Dynamic Stroboscope

Tone enhancement electro fiberscope combined with strobe light source is benefit for dynamic observation of vocal fold vibration, mucosal waves and voice, it also may be effective for early detection of cases of glottal cancer rather than ordinate stroboscopic examination or simple NBI observation. Laryngoscope, 2022


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Risk Stratification of Acute Invasive Fungal Rhinosinusitis in Patients With Hematologic Pathology

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Risk Stratification of Acute Invasive Fungal Rhinosinusitis in Patients With Hematologic Pathology

This study sought to identify objective perioperative diagnostic factors for acute invasive fungal rhinosinusitis (AIFS) to develop a diagnostic scoring system. A retrospective case-control study was developed identifying patients with underlying hematologic malignancy with concerns for AIFS. Patients with hematologic malignancy-related AIFS have measurable differences in lab values and standard imaging, which were utilized to develop a novel scoring system.


Objective

The purpose of this study is to identify objective perioperative diagnostic factors for acute invasive fungal rhinosinusitis (AIFS) to create a diagnostic scoring system using objective criteria.

Methods

Retrospective case–control study performed at an academic, tertiary care center. Biopsy-proven cases of AIFS identified from pathology records (2015–2019) were compared to patients the otolaryngology service was consulted to "Rule out AIFS" in the year 2019, only including those with underlying hematologic malignancy. Eighteen patients with AIFS and 20 patients without were included. One and two tailed T-tests were used for p-values. Receiver operating characteristic curves were generated for the significant data, and Youden's J-statistic was used to create the ideal cutoff values for each. Likelihood ratios were used to give a power for the scoring system.

Results

Compared to patients with non-hematologic malignancy-related AIFS, patients with hematologic malignancy-related AIFS have significantly elevated C-reactive protein (CRP) and blood glucose; while albumin, hematocrit, platelet count, and absolute neutrophil count (ANC) were found to be significantly lower. In addition, Lund-Mackay score asymmetry, extra-sinus spread, aspergillus antigen, and pre-existing diabetes mellitus correlated with disease. A scoring system with three categories: AIFS Unlikely, Indeterminate/AIFS Suspicious, and AIFS Highly Likely was developed.

Conclusion

Patients with hematologic malignancy-related AIFS have measurable differences in lab values and standard imaging that could be used in determining the diagnostic probability of AIFS including: CRP, albumin, hematocrit, platelets, ANC, blood glucose, aspergillus antigen, Lund-Mackay score asymmetry, extra-sinus spread, and pre-existing diabetes mellitus. A novel scoring system was proposed that will require prospective validation.

Level of Evidence

3 Laryngoscope, 2022

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De‐Novo Depression, Prophylactic Antidepressant, and Survival in Patients With Head and Neck Cancer

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De-Novo Depression, Prophylactic Antidepressant, and Survival in Patients With Head and Neck Cancer

Kaplan-Meier Survival Curve Modeled for Time to Death from Enrollment stratified by Primary Outcome of Moderate or Greater Depression.


Objective

To study the association between the development of moderate or greater depression during curative-intent therapy and overall survival (OS) in patients with stages II-IV head and neck cancer (HNC).

Methods

In this secondary analysis of a randomized double-blind placebo-controlled trial, of 148 eligible participants diagnosed with stages II-IV HNC but without baseline depression, 125 were evaluable and were randomly allocated to prophylactic escitalopram oxalate (n = 60) or placebo (n = 65). Participants were followed for development of moderate or greater depression, using Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR, range 0–27, score ≥11 indicated moderate or greater depression), and were stratified by demographics; cancer site and stage; and primary treatment modality (surgery with or without radiotherapy vs. radiotherapy with or without chemotherapy). Single variable and multivariable Cox proportional-hazard models were used to evaluate differences in OS.

Results

Clinically significant depression developed in 22 of 125 patients (17.6%) during HNC treatment. The mean follow-up was 5.0 years (SD 2.4). OS was similar for patient groups, when stratified by development of moderate or greater depression (HR 0.54 [CI, 0.21–1.43]) or use of prophylactic antidepressant (HR 0.64 [CI, 0.34–1.21]).

Conclusion

There was no significant association between OS and development of moderate or greater depression in patients being treated for stages II-IV HNC, or between OS and use of prophylactic antidepressant escitalopram. Prophylactic antidepressant may be considered in patients with HNC for prevention of clinically significant depression and may offer improved quality of life outcomes.

Level of Evidence

II Laryngoscope, 2022

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VEGF and VEGFR family members are expressed by neoplastic cells of NF1-associated tumors and may play an oncogenic role in malignant peripheral nerve sheath tumor growth through an autocrine loop

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Publication date: Available online 23 June 2022

Source: Annals of Diagnostic Pathology

Author(s): Benjamin Bonsang, Laurent Maksimovic, Pascale Maille, Nadine Martin, Ingrid Laurendeau, Eric Pasmant, Ivan Bièche, Justin Deschamps, Pierre Wolkenstein, Nicolas Ortonne

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