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Pinzón-Espitia OL, Castañeda López JF, Pardo González CA. [Risk of malnutrition and food insecurity in pediatric cancer patients. The NutriCare Study]. NUTR HOSP 2024. [PMID: 39054863 DOI: 10.20960/nh.05152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION cancer and its treatments have been associated with poor nutritional status in children and adolescents. OBJECTIVE to establish the nutritional risk of pediatric patients and the degree of food and nutritional insecurity in the homes of children and adolescents with cancer who have been hospitalized in a high complexity pediatric oncology center. METHODS a prospective observational study conducted at the Fundación Hospital Pediátrico la Misericordia - HOMI. It included a sample of 41 children and adolescents aged 0 to 17 years and 11 months with a diagnosis of childhood cancer during the study period. The participants recruited during hospitalization had the application of the SCAN nutritional screening tool for childhood cancer, Spanish version, validated in HOMI and the Latin American and Caribbean Scale of Food and Nutritional Security - ELCSA, adapted and validated in Colombia. RESULTS 76 % (n = 31) of the patients were classified as "At risk of malnutrition" using the SCAN-SP nutritional screening tool. It was observed that 56 % of all households had a proportion of food insecurity, of which the classification of food (in)security was mild in 29 %, moderate in 20 % and severe in 7 % of households with children under 18 years of age. CONCLUSION in the framework of the nutritional care process, it is important to take into account factors that include a complete nutritional risk assessment and evaluation that includes the measurement of food security.
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Affiliation(s)
- Olga Lucía Pinzón-Espitia
- Facultad de Medicina. Universidad Nacional de Colombia. Fundación Hospital Pediátrico La Misericordia - HOMI. 3Escuela de Medicina y Ciencias de la Salud. Universidad del Rosario
| | - Jhon Fredy Castañeda López
- Facultad de Medicina. Universidad Nacional de Colombia. Fundación Hospital Pediátrico La Misericordia - HOMI
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Rubini M, Gozzi A, Libianchi N, Dellù E, Spanò F, Di Biasi C, Pendenza M, Sala P, Filannino F, Zaio P. Metastatic cancer and endentulism: Exploring comorbidity to assist with differential diagnosis in a case from Vico nel Lazio (Fr, Italy), 13th-15th century CE. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2022; 38:1-12. [PMID: 35679660 DOI: 10.1016/j.ijpp.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 05/13/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To differentially diagnose cranial lesions noted on a medieval skeleton and explore the importance of comorbidity. MATERIALS A skull of an adult female with osteolytic and osteoblastic lesions, edentulism, and an ectopic tooth from an ossuary of the Church of Santa Maria in Vico del Lazio, Frosinone Italy, dating to the Middle Ages. METHODS Macroscopic observations of the remains, CT scan, and differential diagnosis was undertaken. RESULTS A diagnosis of metastatic cancer (potentially breast cancer) or metastatic neuroblastoma (NBL) is offered. CONCLUSIONS Considering the noted comorbidities, this case might represent a rare case of metastatic neuroblastoma. SIGNIFICANCE The exploration of comorbidity, in this case the presence of metastatic carcinoma and edentulism, has tremendous potential to expand our knowledge about cancer in the past. LIMITATIONS Lack of postcranial elements. SUGGESTIONS FOR FURTHER RESEARCH Clinical and paleopathological investigation of comorbidity in modern and archeological populations to develop an evolutionary perspective on the presence of cancer in the past.
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Affiliation(s)
- Mauro Rubini
- S.A.B.A.P.-LAZIO, Anthropological Service, Ministry of Culture, Via Pompeo Magno 2, 00189 Roma, Italy; Department of Archeology, University of Foggia, Via Antonio Gramsci, 89, 71122 Foggia, Italy.
| | - Alessandro Gozzi
- S.A.B.A.P.-LAZIO, Anthropological Service, Ministry of Culture, Via Pompeo Magno 2, 00189 Roma, Italy
| | - Nunzia Libianchi
- S.A.B.A.P.-LAZIO, Anthropological Service, Ministry of Culture, Via Pompeo Magno 2, 00189 Roma, Italy
| | - Elena Dellù
- S.A.B.A.P.- BA, Physical Anthropology Service, Via Pier l'Eremita 25/B, 70122 Bari, Italy
| | - Ferdinando Spanò
- Emergency Diagnostics, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Claudio Di Biasi
- Emergency Diagnostics, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Matteo Pendenza
- Techniques of Medical Radiology, Imaging and Radiotherapy, Sapienza Università di Roma, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161, Rome, Italy
| | - Paola Sala
- Techniques of Medical Radiology, Imaging and Radiotherapy, Sapienza Università di Roma, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161, Rome, Italy
| | - Floriana Filannino
- Techniques of Medical Radiology, Imaging and Radiotherapy, Sapienza Università di Roma, Policlinico Umberto I, Sapienza Università di Roma, Viale del Policlinico, 155, 00161, Rome, Italy
| | - Paola Zaio
- S.A.B.A.P.-LAZIO, Anthropological Service, Ministry of Culture, Via Pompeo Magno 2, 00189 Roma, Italy
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Neighborhood disadvantage, health status, and health care utilization after blood or marrow transplant: BMTSS report. Blood Adv 2022; 7:293-301. [PMID: 35834730 PMCID: PMC9898603 DOI: 10.1182/bloodadvances.2022007548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/10/2022] [Accepted: 06/24/2022] [Indexed: 01/28/2023] Open
Abstract
Living in a disadvantaged neighborhood is associated with poor health outcomes. Blood or Marrow Transplant (BMT) survivors remain at risk of chronic health conditions requiring anticipatory management. We hypothesized that among BMT survivors, neighborhood disadvantage was associated with poor self-reported routine health care utilization and health. We leveraged data from BMTSS - a retrospective cohort study examining long-term outcomes among individuals surviving ≥2 y following BMT at three institutions between 1974 and 2014. Participants in this analysis completed the BMTSS survey (sociodemographics; chronic health conditions; time since routine check-up; self-reported health). The Area Deprivation Index (ADI) represented neighborhood disadvantage; this composite indicator of 17 census measures is a percentile rank (0 = least deprived to 100 = most deprived). Multivariable ordered logit regression adjusted for clinical factors and individual-level sociodemographics, modeling associations between ADI, time since routine check-up, and self-reported health. Among 2,857 survivors, median ADI was 24 (interquartile range: 10-46). Adjusting for self-reported individual-level socioeconomic indicators and chronic health conditions, patients in more disadvantaged neighborhoods had higher odds of reporting longer intervals since routine check-up (ORADI_continuous = 1.007, P < .001) and poorer health status (controlling for time since check-up; ORADI_continuous = 1.005, P = .003). Compared with patients living in the least disadvantaged neighborhood (ADI = 1), patients in the most disadvantaged neighborhood (ADI = 100), had twice the odds (ORADI = 1.007^99 = 2.06) of reporting no routine visits and 1.65-times the odds of reporting poor health (ORADI = 1.005^99 = 1.65). In BMT survivors, access to health care and health status are associated with area disadvantage. These findings may inform strategies to address long-term care coordination and retention for vulnerable survivors.
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Bhutada JKS, Hwang AE, Liu L, Tsai KY, Deapen D, Freyer DR. Survival of Adolescents and Young Adults with Prevalent Poor-Prognosis Metastatic Cancers: A Population-Based Study of Contemporary Patterns and Their Implications. Cancer Epidemiol Biomarkers Prev 2022; 31:900-908. [PMID: 35086824 PMCID: PMC8983591 DOI: 10.1158/1055-9965.epi-21-0913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/11/2021] [Accepted: 01/21/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Although survival has improved dramatically for most adolescents and young adults (AYA; 15-39 years old) with cancer, it remains poor for those presenting with metastatic disease. To better characterize this subset, we conducted a landscape survival comparison with older adults (40-79 years). METHODS Using Surveillance, Epidemiology, and End Results Program data from 2000 to 2016, we examined incident cases of poor-prognosis metastatic cancers (5-year survival < 50%) among AYAs (n = 11,518) and older adults (n = 345,681) and compared cause-specific survival by sociodemographic characteristics (race/ethnicity, sex, and socioeconomic status). Adjusted HRs (aHR) for death from metastatic disease [95% confidence intervals (95% CI)] were compared between AYAs and older adults (Pint). RESULTS AYAs had significantly better survival than older adults for every cancer site except kidney, where it was equivalent (range of aHRs = 0.91; 95% CI, 0.82-1.02 for kidney cancer to aHR = 0.33; 95% CI, 0.26-0.42 for rhabdomyosarcoma). Compared with their older adult counterparts, greater survival disparities existed for AYAs who were non-Hispanic Black with uterine cancer (aHR = 2.20; 95% CI, 1.25-3.86 versus aHR = 1.40; 95% CI, 1.28-1.54; Pint = 0.049) and kidney cancer (aHR = 1.51; 95% CI, 1.15-1.98 versus aHR = 1.10; 95% CI, 1.03-1.17; Pint = 0.04); non-Hispanic Asian/Pacific Islanders with ovarian cancer (aHR = 1.47; 95% CI, 1.12-1.93 versus aHR = 0.89; 95% CI, 0.84-0.95; Pint<0.001); and males with colorectal cancer (aHR = 1.21; 95% CI, 1.10-1.32 versus aHR = 1.08; 95% CI, 1.06-1.10; Pint = 0.045). CONCLUSIONS AYAs diagnosed with these metastatic cancers have better survival than older adults, but outcomes remain dismal. IMPACT Overcoming the impact of metastasis in these cancers is necessary for continuing progress in AYA oncology. Sociodemographic disparities affecting AYAs within kidney, uterine, ovarian, and colorectal cancer could indicate plausible effects of biology, environment, and/or access and should be explored.
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Affiliation(s)
| | - Amie E. Hwang
- USC Norris Comprehensive Cancer Center, Los Angeles, CA
- Los Angeles Cancer Surveillance Program, Los Angeles, CA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Lihua Liu
- USC Norris Comprehensive Cancer Center, Los Angeles, CA
- Los Angeles Cancer Surveillance Program, Los Angeles, CA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Kai-ya Tsai
- Los Angeles Cancer Surveillance Program, Los Angeles, CA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Dennis Deapen
- USC Norris Comprehensive Cancer Center, Los Angeles, CA
- Los Angeles Cancer Surveillance Program, Los Angeles, CA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - David R. Freyer
- Cancer and Blood Disease Institute, Children’s Hospital Los Angeles, Los Angeles, CA
- USC Norris Comprehensive Cancer Center, Los Angeles, CA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Higuita-Gutiérrez LF, Estrada-Mesa DA, Cardona-Arias JA. Healthcare Inequities Experienced by Patients with Cancer: A Qualitative Study in Medellín, Colombia. Patient Prefer Adherence 2022; 16:1983-1997. [PMID: 35958886 PMCID: PMC9362511 DOI: 10.2147/ppa.s369628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to understand the lived experiences of patients with cancer that facing inequities in oncological care in the city of Medellín. PATIENTS AND METHODS A qualitative study was conducted based on the theoretical and methodological elements of the grounded theory, specifically the description and conceptual ordering of Corbin and Strauss. Sixteen patients with cancer, who belonged to low (n=5), middle (n=4) and high (n=7) social classes, were included by theoretical sampling with category saturation. Data were collected using semi-structured interviews and analyzed in a category system based on the three social classes. RESULTS The patients were aged between 23 and 71 years old, and they were diagnosed with different types of cancer such as breast, cervical, prostate, stomach, leukemia and lymphoma. Patients' experiences showed that diagnosis, specialized care, treatment and hospital discharge were different based on their social class. CONCLUSION Patients' lived experiences associated with cancer reflect complex social situations, in which social determinants affect the level of citizens' empowerment and self-management against the risks of get disease and die. Being part of low and middle social classes meant being subjected to a dehumanized, cold, impersonal and discontinuous treatment, in which healthcare was focused on the disease instead of individuals' preferences and values. In contrast, patients belonging to the high class had the resources necessary to face risks, which ensured access to more humanized and individualized healthcare.
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Affiliation(s)
- Luis Felipe Higuita-Gutiérrez
- Faculty of Medicine, Universidad Cooperativa de Colombia, Medellín, Colombia
- School of Microbiology, Universidad de Antioquia, Medellín, Colombia
- Correspondence: Luis Felipe Higuita-Gutiérrez, Tel +57 312 774 52 56, Email
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