nutrition_ORL

Impact of Nutritional Status on Survival in Head and Neck Cancer Patients After Total Laryngectomy

Sat, 30 Apr 2022 08:18:13 +0000

Author Names: Santos A.,Santos I.C.,dos Reis P.F.,Rodrigues V.D.,Peres W.A.F.

Database Source: Embase Weekly Updates

Journal Title: Nutrition and Cancer,Nutrition and Cancer

Article Title: Impact of Nutritional Status on Survival in Head and Neck Cancer Patients After Total Laryngectomy

Year: 2022

Issue: 4

Volume: 74

Abstract: Malnutrition is an important prognostic indicator of laryngeal squamous cell carcinoma. Retrospective study with head and neck cancer patients who underwent total laryngectomy. 243 patients of both sex were evaluated. The univariate analyses demonstrated an increased risk of death for the patients with greater weight loss, hypoalbuminemia, radiotherapy as an initial treatment, salvage surgery, and radical neck dissection. In a Multivariate Cox regression, older age (p = 0.03, 95% confidence interval [CI] 1.003-1.06, hazard ratio [HR] 1.029), Nutritional Risk Index <=100 (p = 0.008, 95% CI 1.18-3.12, HR 1.921) and adjuvant radiotherapy (p = 0.029, 95% CI 0.31-3.12, HR 0.544) demonstrated prognostic significance in survival. Nutritional status is a modifiable variable and these findings highlight the need to adoption of simple nutritional assessment methods routinely during the treatment of head and neck cancer patients, in order to help improve prognosis after surgery. Copyright © 2021 Taylor & Francis Group, LLC.

Evidenced-based natural therapies and immune-enhancing strategies to control, prevent, and treat co-morbidities COVID-19 and cancer

Sat, 30 Apr 2022 08:18:13 +0000

Author Names: Uppala P.P.T.,Isaak S.,Wong B.,Ferreira K.,Garberoglio C.,Kelly J.

Database Source: Embase Weekly Updates

Journal Title: Clinical Cancer Research

Article Title: Evidenced-based natural therapies and immune-enhancing strategies to control, prevent, and treat co-morbidities COVID-19 and cancer

Year: 2021

Issue: 6 SUPPL 1

Volume: 27

Abstract: The purpose of this research is to provide evidence-based natural therapies and foods that will enhance the immune system to fight the virus SARS CoV-2 and cancer. Minority populations that include Black African Americans and Hispanics are experiencing higher mortality rates due to both socioeconomic and lifestyle factors in the US and globally. Successful lessons learned from controlling previous 1918 pandemic flu will be discussed. Hypotheses: We hypothesize that targeting lifestyle factors such as diet, exercise, and hydrothermal therapy that enhance the immune system can effectively control and reduce the risk to COVID-19 disease and cancer simultaneously. The target cells for the SARS CoV-2 virus contain the ACE2 and TMPRSS2 receptors which serve as portals of entry. They are expressed throughout the body including the nose, lungs, heart, bladder, pancreas, kidneys and brain found on the epithelial and vascular tissue cells of these organs. Covid-19 affects multiple organs in the body and disrupts the innate immune system, especially the natural killer cells, monocytes, and neutrophils. Studies have shown that countries where BCG was used have less than 10% of COVID-19 cases and countries that do not use the BCG vaccine such as the US and Italy had high cases. It was also seen that people who had higher natural killer cell activity had 100% survival rates. Enhancing the innate immune system through natural therapies has shown to enhance immune cells to fight COVID-19 as well as cancer and destroy it. Methodology: Our research is exploratory and is based on recently published literature on COVID-19 diseases. The following databases were searched: CINAHL, Web of Science, PubMed, EBSCOHost, Google Scholar, Academic Search Complete, AccessMedicine, MedlinePlus, Nutrition Care Manuel, JSTOR and Publons. Result(s): During the Spanish flu pandemic death rates of those who received the best medical care was 6.7% compared with those who received hydrotherapy at 1.34%. Hydrotherapy will increase the body temperature and stimulate the activity of the immune cells, which can kill the viruses. Increasing the body temperature to 39.5 degrees centigrade was shown to kill the virus. Following the hot water bath with cold treatment was shown to be even more effective. Many foods have been found to enhance the immune system and to fight the flu virus. Foods such as blueberries, garlic, and probiotics were shown to improve natural killer activity. Vitamin C, Vitamin D, Zinc, and selenium play a role in immunity. Foods rich in antioxidants such as kale, blueberries, red bell peppers, and all citrus fruits also help enhance the immune system. During the 1918 flu pandemic that received hydrotherapy and other natural remedies, out of the 120 students and staff exposed, there were 90 patients, none very sick, and there were no deaths. Natural remedies used in the Spanish flu pandemic and should be instituted to help enhance immunity and lessen the deadly impact of COVID-19 cancer patients.

Use of Neuromuscular Electrical Stimulation for the Treatment of Moderate-Severe Oropharyngeal Dysphagia Post Traumatic Brain Injury: A Case Series

Sat, 30 Apr 2022 08:18:13 +0000

Author Names: Loughnane H.

Database Source: Embase Weekly Updates

Journal Title: Brain Injury

Article Title: Use of Neuromuscular Electrical Stimulation for the Treatment of Moderate-Severe Oropharyngeal Dysphagia Post Traumatic Brain Injury: A Case Series

Year: 2022

Issue: SUPPL 1

Volume: 36

Abstract: Introduction: Aetiology of dysphagia includes stroke, traumatic brain injury (TBI), progressive neurological disease, head and neck cancer, and trauma to the aerodigestive tract. Incidence rates of dysphagia secondary to TBI are as high 93%. Dysphagia secondary to TBI can be impacted by factors including cognitive-communication, behavioral, neurological, and mechanical issues (Howle et al, 2014). Treatment of dysphagia depends on symptoms and severity, traditionally using exercises to improve muscle function (Logemann, 2006). Research specific to dysphagia rehabilitation post TBI is lacking, with dysphagia research often involving heterogeneous patient groups (Howle et al, 2014). Transcutaneous neuromuscular electrical stimulation (NMES) is usually completed in conjunction with traditional swallowing therapy. NMES aims to increase the effectiveness of swallowing therapy by strengthening the swallowing muscles and stimulating sensory pathways to help with motor cortex re-organisation and relearning (Powell et al, 2017). Ampcare is one commercially available NMES system. Most evidence for NMES in treatment of dysphagia is in stroke populations. Research Aims: We sought to examine use of NMES in conjunction with traditional therapy with patients with moderatesevere oropharyngeal dysphagia secondary to TBI. Method(s): Case series of four male patients (aged 20-65 years) with moderate-severe dysphagia secondary to TBI who were referred to inpatient Speech and Language Therapy (SLT) in the acute-stage post brain injury. Three patients were nil per oral prior to commencing treatment; two of these were receiving full nutrition and hydration via PEG, one via nasogastric tube. All patients completed traditional dysphagia rehabilitation exercises between sessions, targeting laryngeal elevation and base of tongue strengthening. All patients completed a 20 treatment session block of NMES as per Ampcare Effective Swallow Protocol (30 minute session up to 5 times weekly). Modified Barium Swallow Study was completed pre and post treatment to guide and evaluate treatment and outcomes. Result(s): Post-treatment MBS showed improvement of 2-4 points on Dysphagia Outcome Severity Scale (DOSS) in all patients. All patients resumed full oral intake post intervention. Increases in Functional Oral Intake Scale (FOIS) for all patients were also noted (2-4 points). Physiologically, improvements were noted in bolus control, bolus transit time, oropharyngeal residue, swallow reflex trigger and airway protection. Discussion(s): Use of NMES in dysphagia rehabilitation is an emerging area of practice in SLT. Limited evidence to date focuses specifically on patients post-stroke. As per this case series, NMES may be a useful therapy approach for patients with moderate-severe oropharyngeal dysphagia post TBI. Although they presented with a variety of physical and cognitive deficits, all patients were able to engage in intensive sessions. They reported benefits to structured rehab program (as per Ampcare protocol) and were motivated to engage in traditional rehabilitation exercises between SLT-led sessions. All were successfully weaned from non-oral feeding.

Efficacy of the pretreatment geriatric nutritional risk index for predicting severe adverse events in patients with head and neck cancer treated with chemoradiotherapy.

Fri, 01 Apr 2022 04:00:00 +0000

Auris Nasus Larynx; 04/01/2022
(AN 155723747); ISSN: 03858146
CINAHL Complete

Inadvertent placement of a nasogastric tube following traumatic nasal tube intubation

Fri, 31 Dec 2021 00:00:00 +0000

BMJ Case Rep. 2021 Dec 30;14(12):e247696. doi: 10.1136/bcr-2021-247696.

ABSTRACT

Adequate nutrition is necessary in head and neck surgery. Enteral feeding via a nasogastric tube is often required due to the altered anatomy and to allow sufficient intraoral healing. Insertion of a nasogastric tube is commonly performed without complication and confirmation of its position by a number of different methods. Incorrect positioning can cause significant morbidity with associated mortality. This case report describes the inadvertent placement of a nasogastric tube in a patient with a mandibular squamous cell carcinoma, into the abdominal cavity following a failed traumatic nasal tube intubation. Chest radiography and auscultation failed to identify the abnormal position with subsequent commencement of feeds for a number of days. Following a laporotomy and insertion of abdominal drains, the patient recovered and was discharged from hospital. To prevent recurrence, it is suggested that direct laryngoscopy or direct visualisation of the upper aspect be performed.

PMID:34969812 | PMC:PMC8719158 | DOI:10.1136/bcr-2021-247696

Iodine Status of Canadian Children, Adolescents, and Women of Childbearing Age.

Wed, 01 Dec 2021 05:00:00 +0000

Journal of Nutrition; 12/01/2021
(AN 153995243); ISSN: 00223166
CINAHL Complete

Decrement of prognostic nutrition index in laryngeal diseases: from precancerous lesion to squamous cell carcinoma

Fri, 26 Nov 2021 00:00:00 +0000

Acta Otolaryngol. 2021 Dec;141(12):1070-1074. doi: 10.1080/00016489.2019.1634836. Epub 2021 Nov 26.

ABSTRACT

BACKGROUND: Malnutrition and systemic inflammatory response have been confirmed to be important risk factors for various cancers.

OBJECTIVE: To compare pretreatment prognostic nutrition index (PNI) among patients with laryngeal squamous cell carcinoma (LSCC), laryngeal precancerous lesion (LPL) and laryngeal benign lesion (LBL).

METHODS: A total of 253 male patients with laryngeal lesions were divided into LBL, LPL with low risk (LPL (l)), LPL with high risk (LPL(h)), LSCC (i), LSCC (ii) and LSCC (iii) groups according to their histopathological findings and the TNM staging system. PNI and other clinical parameters were calculated. Kruskal-Wallis, Mann-Whitney U or Chi-square or Fisher's exact test were used for comparison of different parameters among groups. Logistic regression was performed to estimate the odds ratios (OR) and the corresponding 95% confidence intervals (CI).

RESULTS: The PNI in the LSCC group was significantly lower than those of the LBL and LPL groups (p = .013 and p = .004, respectively), and decreased from LPL(l) to LSCC (iii) (from 53.97 ± 3.69 to 50.02 ± 4.75). LPL patients with lower PNI values had a higher risk of LSCC, the OR was 0.91 (95% CI: 0.84, 0.97) for a one-unit decrease.

CONCLUSIONS: PNI could be a simple and reproducible marker for predicting the severity of laryngeal diseases.

PMID:34823427 | DOI:10.1080/00016489.2019.1634836

Swallowing, nutritional status, and salivary flow in patients after head and neck cancer treatment, a pilot study

Wed, 13 Oct 2021 00:00:00 +0000

Sci Rep. 2021 Oct 12;11(1):20233. doi: 10.1038/s41598-021-99208-w.

ABSTRACT

Determine the relationship between swallowing function, nutritional status, and salivary flow in patients after head and neck cancer treatment. This pilot study included 17 patients. Swallowing was assessed through videofluoroscopy and surface electromyography (sEMG), nutritional status through anthropometry and dietary assessment, and salivary flow both with and without mechanical stimulation. Test analysis showed that 66.7% of patients had functional limitations in swallowing in 58.3%, 66.7%, and 58.3% residue scale with an average of a line of barium on a structure for pudding, honey, and liquid consistencies, respectively. Laryngeal penetration was found in 8.3% during the swallowing of liquid. Surface electromyography (sEMG) showed above normal values for muscle activity time during the swallowing of pudding. Anthropometric assessment and muscle and adipose tissue indicated eutrophy. Salivary flow test with mechanical stimulus showed that 82.3% of patients' salivary production was well below the appropriate level. There was a significant correlation between muscle tissue reserve and muscle activity time during swallowing in the studied muscles (left masseter p = 0.003, right masseter p = 0.001, suprahyoid p = 0.001, orbicularis oris = 0.020), all in pudding consistency. This pilot study confirmed the relationship between swallowing and nutritional status for its participants, showing that appropriate protein intake influences muscle activity during swallowing in head and neck cancer survivors.

PMID:34642369 | PMC:PMC8511146 | DOI:10.1038/s41598-021-99208-w

Efficacy of the pretreatment geriatric nutritional risk index for predicting severe adverse events in patients with head and neck cancer treated with chemoradiotherapy

Sun, 12 Sep 2021 00:00:00 +0000

Auris Nasus Larynx. 2022 Apr;49(2):279-285. doi: 10.1016/j.anl.2021.08.009. Epub 2021 Sep 9.

ABSTRACT

OBJECTIVE: The Geriatric Nutritional Risk Index (GNRI) is a simple and well-established nutritional assessment tool. Although concurrent chemoradiotherapy (CCRT), particularly cisplatin-based CCRT, is a standard treatment for locoregional advanced head and neck squamous cell carcinoma (HNSCC), the predictive factors of adverse events related to CCRT remain to be elucidated. The present study aimed to determine the association between GNRI and CCRT-related adverse events in patients of all ages with head and neck cancer (HNC) who underwent CCRT.

METHODS: We retrospectively analyzed and compared the clinical characteristics and adverse events of 82 patients with HNC treated with CCRT according to their GNRI at the Department of Otolaryngology, Head and Neck Surgery, University of Tsukuba Hospital, between May 2014 and November 2019. The GNRI was calculated according to the equation: 1.489 × serum albumin (g/L) + 41.7 × (body weight/ideal body weight). We compared two groups: low GNRI (GNRI < 98) and normal GNRI (GNRI ≥ 98) groups.

RESULTS: Eighty-two patients were enrolled in this study. There were 61 (76%) and 21 (26%) patients in the normal GNRI group and low GNRI group, respectively. There were significant differences in the incidence of grade ≥ 3 radiation mucositis, radiation dermatitis, and leukopenia between the low GNRI group and the normal GNRI groups.

CONCLUSIONS: Patients with low GNRI scores were more likely to have severe adverse events. Pretreatment GNRI predicted severe CCRT-related adverse events in patients of all ages with HNC undergoing CCRT.

PMID:34509306 | DOI:10.1016/j.anl.2021.08.009

Objective evaluation of nutritional status using the prognostic nutritional index during and after chemoradiotherapy in Japanese patients with head and neck cancer: a retrospective study

Tue, 24 Aug 2021 00:00:00 +0000

Eur J Hosp Pharm. 2021 Sep;28(5):266-270. doi: 10.1136/ejhpharm-2019-001979. Epub 2019 Aug 17.

ABSTRACT

OBJECTIVES: The incidence of severe mucosal damage due to low nutritional status is high in patients receiving concurrent chemoradiotherapy (CCRT) for head and neck cancer. Objective assessments do not exist for discharge criteria after completion of CCRT. Although the prognostic nutritional index (PNI) is an objective indicator of postoperative outcomes in patients undergoing cancer surgery, the prognostic impact of the PNI in patients with head and neck cancer receiving CCRT is unexplored. We investigated whether the PNI could be an objective criterion for nutritional status and a discharge criterion after completion of CCRT.

METHODS: We assessed the medical records of 23 patients with head and neck cancer who received triweekly cisplatin +radiotherapy (2 Gy ×35 fractions). We evaluated whether the PNI could be a useful evaluation indicator in patients with head and neck cancer receiving CCRT and determined the cut-off PNI value by receiver operating characteristic (ROC) curve analysis as a criterion for hospital discharge.

RESULTS: The PNI pre-treatment and post-treatment values were 51.0 and 38.0, respectively (p<0.05). The median length of hospitalisation after therapy was 5 days in patients with grades 1 and 2 and 10 days in patients with grade 3 oral and pharyngeal mucositis (p<0.05). The optimal cut-off PNI value as a criterion for hospital discharge was found to be 40.4 (grades 1 and 2 mucositis) and 38.6 (grade 3 mucositis) by the ROC analysis.

CONCLUSIONS: The PNI is a simple, objective and temporal indicator which is useful in assessing the nutritional status of patients with head and neck cancer. The PNI could be used as an objective indicator to determine the time of discharge after CCRT completion.

PMID:34426479 | PMC:PMC8403783 | DOI:10.1136/ejhpharm-2019-001979

Malnutrition screening in head and neck cancer patients with oropharyngeal dysphagia

Sat, 31 Jul 2021 00:00:00 +0000

Clin Nutr ESPEN. 2021 Aug;44:348-355. doi: 10.1016/j.clnesp.2021.05.019. Epub 2021 May 31.

ABSTRACT

BACKGROUND & AIMS: Malnutrition in head and neck cancer (HNC) patients is associated with increased morbidity and mortality. The purpose of this study is two-fold: to identify the risk of malnutrition in patients with oropharyngeal dysphagia (OD) secondary to HNC, and to determine the relationship between the risk of malnutrition versus tumor characteristics, treatment modality, time interval (between the end of oncological treatment and swallowing assessment date), level of oral intake, body mass index (BMI), aspiration, pharyngeal pooling, and OD-related quality of life (QoL).

METHODS: The Short Nutritional Assessment Questionnaire (SNAQ) was used to screen patients for the risk of malnutrition. Patients underwent a standardized swallowing examination protocol including an endoscopic evaluation of swallowing.

RESULTS: Seventy-five dysphagic HNC patients were included. Forty-eight percent of the patients presented a high risk of malnutrition using SNAQ. The majority of the patients (81.3%) was on a total oral diet. Moreover, BMI did not appear to be a reliable measure to screen for malnutrition as a normal BMI was often associated with an increased risk of malnutrition on the SNAQ. In contrast, patients who were underweight or overweight did not show an association with a high risk of malnutrition. With the exception of BMI, no other patient and tumor characteristics were found to be associated with the risk of malnutrition.

CONCLUSIONS: This study emphasizes the importance of early nutritional screening in dysphagic HNC patients, as almost half of these patients presented a high risk of malnutrition. Malnutrition screening using SNAQ can identify HNC patients with OD who are at risk of malnutrition and subsequently need to be referred to a dietician for additional nutritional assessment, diagnosis of malnutrition, and nutritional support, even when their BMI is within normal range.

PMID:34330489 | DOI:10.1016/j.clnesp.2021.05.019

Iodine Status of Canadian Children, Adolescents, and Women of Childbearing Age

Tue, 27 Jul 2021 00:00:00 +0000

J Nutr. 2021 Dec 3;151(12):3710-3717. doi: 10.1093/jn/nxab268.

ABSTRACT

BACKGROUND: Adequate iodine intake is important for children and women of childbearing age because iodine is vital for fetal brain development and early life.

OBJECTIVE: Iodine status of children (n = 1875), adolescents (n = 557), and women of childbearing age (n = 567) was assessed using urinary iodine concentrations (UIC) from duplicate spot samples collected in the Canadian Health Measures Survey, cycle 5 (2016-2017).

METHODS: Daily iodine intakes were estimated from urinary iodine and creatinine concentrations using a formula based on iodine absorption and predicted 24-h creatinine excretion. Usual UIC and iodine intakes, adjusted for within-person variation, were estimated using the National Cancer Institute method. Iodine status was assessed by 1) comparing median UIC with WHO/UNICEF/ICCIDD reference ranges and 2) estimating the prevalence of inadequate and excessive intakes using the estimated average requirement (EAR) and tolerable upper intake level (UL) cut-point method, respectively.

RESULTS: Median UIC for males and females 6-11 or 12-19 y old were ≥100 μg/L, the lower cutoff for adequate intakes. For women 20-39 y old, the median UIC of an unadjusted sample was 81 μg/L (95% CI: 67, 95) and for the usual UIC was 108 μg/L (95% CI: 84, 131). The percentage of children 3 y old with iodine intake ≥EAR was 82% (95% CI: 75, 89). The corresponding estimates for males 4-8, 9-13, and 14-18 y old were 93% (95% CI: 88, 97), 91% (95% CI: 87, 96), and 84% (95% CI: 76, 91), respectively. Estimates for females 4-8, 9-13, 14-18, and 19-39 y old were 86% (95% CI: 83, 89), 87% (95% CI: 80, 95), 68% (95% CI: 55, 80), and 68% (95% CI: 59, 76), respectively. For all sex-age groups, 91-100% had iodine intakes ≤UL.

CONCLUSIONS: Iodine intakes may be insufficient for some women of childbearing age. Public health policies and programs should continue to recommend that all women who could become pregnant, or women who are pregnant or breastfeeding, take a daily multivitamin-mineral supplement containing iodine.

PMID:34313736 | DOI:10.1093/jn/nxab268

Micronutrient dietary intakes and their food sources in adults: the Hellenic National Nutrition and Health Survey (HNNHS).

Tue, 01 Jun 2021 04:00:00 +0000

Journal of Human Nutrition & Dietetics; 06/01/2021
(AN 150672337); ISSN: 09523871
CINAHL Complete

Evaluation and revision of core postoperative nursing outcomes for laryngeal carcinoma in China.

Tue, 23 Mar 2021 04:00:00 +0000

BMC Nursing; 03/23/2021
(AN 149433236); ISSN: 14726955
CINAHL Complete

Micronutrient dietary intakes and their food sources in adults: the Hellenic National Nutrition and Health Survey (HNNHS)

Tue, 26 Jan 2021 00:00:00 +0000

J Hum Nutr Diet. 2021 Jun;34(3):616-628. doi: 10.1111/jhn.12840. Epub 2021 Jan 26.

ABSTRACT

BACKGROUND: The present study aimed to assess micronutrient intake among Greek adults and to identify the main food sources that contribute to it.

METHODS: Food consumption data from 2389 participants in the Hellenic National Nutrition and Health Survey (HNNHS), collected with 24-h recalls, was used to calculate micronutrient intakes. Usual nutrient intake was estimated according to the National Cancer Institute method. Nutrient adequacy was estimated using the estimated average requirement (EAR) cut-point method, when available, or adequate intake otherwise. The probability approach was used to determine iron intake adequacy in females of reproductive age. Food group contribution for each nutrient assessed was derived to identify their main food sources.

RESULTS: Almost all individuals had vitamin D intake below EAR, whereas vitamins A, E, K and C, as well as potassium intake, were also insufficient in a considerable percentage of the population (>70% in most age groups). Calcium intake was substantially below the EAR for females aged >50 years and males >70 years; the same for magnesium in males >70 years. Furthermore, 50% of females, including those of reproductive age, had intake of folate below EAR. More than 50% of the population (to 79%) exceeded the upper tolerable limit for sodium (2300 mg day^-1 ). Food contribution analysis revealed that most vitamins were derived from low-quality foods (i.e. fast-food).

CONCLUSIONS: A significant proportion of adults residing in Greece have low nutrient intake and poor food selections. These results provide guidance to public health policy makers for developing strategies to improve the dietary quality in Greece.

PMID:33497494 | DOI:10.1111/jhn.12840

Enteral tube feeding of head and neck cancer patients undergoing definitive chemoradiotherapy in the Nordic Countries: Survey of the Scandinavian Society for Head and Neck Oncology

Sun, 03 Jan 2021 00:00:00 +0000

Eur Arch Otorhinolaryngol. 2021 Sep;278(9):3489-3496. doi: 10.1007/s00405-020-06545-z. Epub 2021 Jan 2.

ABSTRACT

PURPOSE: We assessed current policies and perceptions of enteral tube feeding in head and neck cancer (HNC) patients undergoing chemoradiotherapy (CRT). A web-based survey was used to compare the timing and method of tube feeding within and between the five Nordic countries, covering a population of 27 million.

METHODS: From each of the 21 Nordic university hospitals, one oncologist and one otorhinolaryngology-head and neck (ORL-HN) surgeon responded to a survey. The respondents were asked whether tube insertion before the onset of CRT, or during CRT as required (prophylactic vs. reactive) was preferred. The use of a pretreatment nutritional screening tool and the choice of feeding route (nasogastric vs. gastrostomy tube) were assessed. In total, we analyzed responses from 21 oncologists and 21 ORL-HN surgeons.

RESULTS: A tendency was observed towards decreasing the use of a PEG tube. Of the 21 university hospitals, only 2 (10%) reported using a prophylactic PEG tube in over half of HNC patients undergoing definitive CRT. The preferred method for reactive tube feeding was by a NG tube in 14 of 21 (67%), and by a PEG in 7 of 21 (33%). In general, both oncologists and ORL-HN surgeons were content with their current policy.

CONCLUSIONS: The practices for enteral tube feeding in HNC management vary within and between the Nordic countries. We suggest that unified protocols for tube feeding should be developed for this patient population.

PMID:33389006 | DOI:10.1007/s00405-020-06545-z

The effect of consuming voluntarily fortified food and beverages on usual nutrient intakes in the Canadian population.

Fri, 01 Jan 2021 05:00:00 +0000

Food & Nutrition Research; 01/01/2021
(AN 154640187); ISSN: 16546628
CINAHL Complete

Effect of Breast Cancer Treatment on Dietary Vitamin Intake Levels

Wed, 30 Dec 2020 00:00:00 +0000

Int J Environ Res Public Health. 2020 Dec 22;18(1):19. doi: 10.3390/ijerph18010019.

ABSTRACT

Breast cancer is the most common tumor among women, representing the second cause of cancer deaths in women. Treatment with chemotherapy negatively interferes with nutritional status. The intake of vitamins before, during and after treatment in a pilot cohort of women with non-invasive breast cancer (type I, II) treated at the Valencian Institute of Oncology (IVO) is evaluated. A 3-day anthropometric and nutritional assessment was performed using the DIAL program. Nutritional intake is compared with the values of Estimated Average Requirements (EAR) and Dietary Reference Intake (DRI) provided by the United States Department of Agriculture (USDA) and the European Food Safety Authority (EFSA). There is an overall decrease in vitamin intake during treatment which worsens at the end of said treatment. The decrease is significant in the case of vitamins B₂ (p = 0.006), B₃ (p = 0.042), B₅ (p = 0.001), and B₈ (p = 0.021). The relative risk during and after treatment increases with respect to the reference timeframe, before treatment. Deficit risks are statistically significant in the case of vitamins B₅ (p = 0.001), B₈ (p = 0.001) and B₁₂ (p = 0.001). Decreased vitamin intake during treatment suggests a negative change in the patients' dietary behaviors during this time. Nutritional intervention and support may be beneficial to optimize overall dietary intake and maintain compliance with EAR and DRI for patients during a time in which adequate nutrition is important.

PMID:33375141 | PMC:PMC7792964 | DOI:10.3390/ijerph18010019

Loss status of fat - free mass in patients with head and neck cancer during perioperative period and its influencing factors.

Tue, 15 Dec 2020 05:00:00 +0000

Chinese Nursing Research; 12/15/2020
(AN 148070882); ISSN: 10096493
CINAHL Complete

Provincial Dietary Intake Study (PDIS): Micronutrient Intakes of Children in a Representative/Random Sample of 1- to <10-Year-Old Children in Two Economically Active and Urbanized Provinces in South Africa.

Fri, 11 Dec 2020 08:58:08 +0000

Author Names: Senekal M,Nel J,Malczyk S,Drummond L,Steyn NP

Database Source: Ovid MEDLINE(R) <January Week 4 2019 to December Week 1 2020>

Journal Title: International Journal of Environmental Research & Public Health [Electronic Resource]

Article Title: Provincial Dietary Intake Study (PDIS): Micronutrient Intakes of Children in a Representative/Random Sample of 1- to <10-Year-Old Children in Two Economically Active and Urbanized Provinces in South Africa.

Year: 2020

Issue: 16

Volume: 17

Abstract: In 1999, the National Food Consumption Survey found serious risk of dietary deficiency for a number of micronutrients in 1- to 9-year-old children in South Africa. To address these shortfalls, fortification with vitamin A, thiamine, riboflavin, niacin, vitamin B6, folic acid, iron and zinc of maize meal and bread flour was made mandatory in 2003. The aim of this study was to examine micronutrient intakes of 1- to <10-year-old children after nearly 20 years of fortification in two of the most urbanized and economically active provinces, Gauteng (GTG) and the Western Cape (WC). A multistage stratified cluster random sampling design and methodology was used. Households were visited by fieldworkers who interviewed caregivers and obtained dietary intake data by means of a multiple-pass 24-h recall. Two additional 24-h recalls were completed among a nested sample of 146 participants to adjust the single 24-h recall data of the total sample using the National Cancer Institute Method. Results show that median intake of all the fortification nutrients were above the estimated average requirement (EAR), with the only concern being folate in the WC. Between a quarter and a third of children in the WC, where maize porridge intake was significantly lower than in GTG, had a folate intake below the EAR. Nutrients that are not included in the fortification mix that remain a serious concern are calcium and vitamin D, with intake of dairy and vitamin D sources being very limited in both provinces. The improvement in micronutrient intakes of children is encouraging, however the outstanding nutrient deficiency risks need attention.

Comparison of Various Methods to Determine Added Sugars Intake to Assess the Association of Added Sugars Intake and Micronutrient Adequacy.

Tue, 01 Sep 2020 04:00:00 +0000

Nutrients; 09/01/2020
(AN 146686663); ISSN: 20726643
CINAHL Complete

Provincial Dietary Intake Study (PDIS): Micronutrient Intakes of Children in a Representative/Random Sample of 1- to <10-Year-Old Children in Two Economically Active and Urbanized Provinces in South Africa

Sun, 23 Aug 2020 00:00:00 +0000

Int J Environ Res Public Health. 2020 Aug 14;17(16):5924. doi: 10.3390/ijerph17165924.

ABSTRACT

In 1999, the National Food Consumption Survey found serious risk of dietary deficiency for a number of micronutrients in 1- to 9-year-old children in South Africa. To address these shortfalls, fortification with vitamin A, thiamine, riboflavin, niacin, vitamin B6, folic acid, iron and zinc of maize meal and bread flour was made mandatory in 2003. The aim of this study was to examine micronutrient intakes of 1- to <10-year-old children after nearly 20 years of fortification in two of the most urbanized and economically active provinces, Gauteng (GTG) and the Western Cape (WC). A multistage stratified cluster random sampling design and methodology was used. Households were visited by fieldworkers who interviewed caregivers and obtained dietary intake data by means of a multiple-pass 24-h recall. Two additional 24-h recalls were completed among a nested sample of 146 participants to adjust the single 24-h recall data of the total sample using the National Cancer Institute Method. Results show that median intake of all the fortification nutrients were above the estimated average requirement (EAR), with the only concern being folate in the WC. Between a quarter and a third of children in the WC, where maize porridge intake was significantly lower than in GTG, had a folate intake below the EAR. Nutrients that are not included in the fortification mix that remain a serious concern are calcium and vitamin D, with intake of dairy and vitamin D sources being very limited in both provinces. The improvement in micronutrient intakes of children is encouraging, however the outstanding nutrient deficiency risks need attention.

PMID:32824083 | PMC:PMC7460187 | DOI:10.3390/ijerph17165924

A comparative study of three nutritional risk screening tools in surgical inpatients with laryngeal cancer

Fri, 17 Jul 2020 00:00:00 +0000

Asia Pac J Clin Nutr. 2020;29(2):227-233. doi: 10.6133/apjcn.202007_29(2).0003.

ABSTRACT

BACKGROUND AND OBJECTIVES: Nutritional screening has been recommended for hospitalized patients. The goal of this study was to compare the screening value of Nutritional Risk Screening 2002 (NRS-2002), Malnutrition Universal Screening Tool (MUST), and Malnutrition Screening Tool (MST) in inpatients with laryngeal cancer, and to identify which is the most accurate.

METHODS AND STUDY DESIGN: An observational cross-sectional study of 197 laryngeal cancer patients admitted for surgery was conducted using continuous sampling. NRS-2002, MUST, and MST were used to screen the nutritional risk of patients after admission and before discharge. Diagnostic information and the length-of-hospital stay (LOS) data were extracted from the hospital HIS system.

RESULTS: The detection rates of NRS-2002, MUST, and MST in admission or discharge patients were 14.7%/27.9%, 22.3%/26.9%, and 4.6%/11.2%, respectively. Using NRS-2002 as the reference, high sensitivity (82.8%) and a Kappa coefficient (k=0.584) were achieved using MUST in admission patients, while MST presented the lowest sensitivity (17.3%) and Kappa coefficient (k=0.208). MST maintained low sensitivity (25.5%) and Kappa coefficient (k=0.243) in discharge patients. NRS-2002 ≥3 was an independent risk factor for longer LOS in patients with laryngeal cancer (odds ratio (OR)=5.59, 95% confidence interval (CI)=1.86-16.81, p=0.002). The MUST and MST scores did not predict long LOS.

CONCLUSIONS: Compared with NRS-2002, MUST is superior to MST in sensitivity, specificity, and Kappa coefficient. NRS-2002 better identified patients at risk for longer LOS, but a consistent conclusion was not reached with MUST and MST. Further validation in larger samples is needed.

PMID:32674228 | DOI:10.6133/apjcn.202007_29(2).0003

Swallowing functional outcomes and nutritional status in head and neck cancer radiotherapy: longitudinal study

Fri, 15 May 2020 00:00:00 +0000

BMJ Support Palliat Care. 2020 Dec;10(4):452-461. doi: 10.1136/bmjspcare-2020-002216. Epub 2020 May 13.

ABSTRACT

OBJECTIVE: To explore the relationships between swallowing functional outcomes and nutritional status in patients with head and neck cancer undergoing radiotherapy (RT).

METHODS: This longitudinal study included 122 patients. Data were collected at three time points: baseline (T₁), the third week of RT (T₂) and the completion of RT (T₃). The Common Terminology Criteria for Adverse Events was used to assess the symptom of dysphagia and other toxicities; the MD Anderson Dysphagia Inventory (MDADI) was used to assess the patient-perceived swallowing functional outcomes; the nutritional status was evaluated by the weight ratio and the Patient-Generated Subjective Global Assessment (PG-SGA). The generalised estimating equation (GEE) was used to measure the correlation of MDADI with the weight ratio or PG-SGA and also to analyse the influential factors of swallowing functional outcomes.

RESULTS: The participants' acute dysphagia rates were 5.7% at T₁, 69.7% at T₂ and 77.9% at T₃. The swallowing functional outcomes worsen over RT (p<0.001) and were associated with weight ratio (β=0.032, p=0.008) and PG-SGA (β=-0.115, p<0.001). GEE models showed that patients with cancer of the pharynx region, advanced stage, chemoradiotherapy and high RT dose perceived worse swallowing functional outcomes. Oral mucositis, pharynx mucositis and salivary gland inflammation were positively correlated with swallowing functional outcomes, and the pharynx mucositis presented the highest absolute value of β.

CONCLUSION: The swallowing functional outcomes were negatively correlated with nutritional status. Healthcare professionals should identify early on the population at higher risk and focus on multiple toxicities, especially the management of pharynx mucositis, to improve nutritional status.

PMID:32404303 | DOI:10.1136/bmjspcare-2020-002216

Taste-Specific Eating Recommendation for Head and Neck Treatment Survivors: A Randomized Controlled Trial.

Fri, 01 May 2020 04:00:00 +0000

MEDSURG Nursing; 05/01/2020
(AN 143616913); ISSN: 10920811
CINAHL Complete

Meta-analysis of the association between dietary inflammatory index (DII) and upper aerodigestive tract cancer risk

Sun, 26 Apr 2020 00:00:00 +0000

Medicine (Baltimore). 2020 Apr;99(17):e19879. doi: 10.1097/MD.0000000000019879.

ABSTRACT

BACKGROUND: Epidemiological studies have reported an inconsistent relationship between dietary inflammatory index (DII) and upper aerodigestive tract (UADT) cancer risk. However, no systematic review or meta-analysis has been reported up to now. To quantify the association between DII and UADT cancer risk, we performed this meta-analysis.

METHODS: The PubMed, EMBASE, Web of Science and Cochrane Library database were searched for relevant studies from inception December 2018. All case-control studies investigating the association between DII and UADT cancer risk were selected.

RESULTS: A total of 9 case-control studies were identified, involving 13,714 participants. The adjusted pooled OR of UADT cancer for the highest (the most pro-inflammatory diet) vs lowest (the most anti-inflammatory diet) DII categories were 2.27 (95% CI: 1.89-2.73). Subgroup analysis showed that individuals with the highest category of DII score were independently associated with esophagus cancer (OR = 2.53, 95% CI: 1.74-3.68), oral cavity cancer (OR = 2.23, 95% CI: 1.73-2.86), pharyngeal cancer (OR = 2.02, 95% CI: 1.54-2.64), and laryngeal cancer (OR = 2.05, 95% CI: 0.85-4.93).

CONCLUSION: This meta-analysis suggested that the most pro-inflammatory diets (the highest DII scores) are associated with increased UADT cancer risk. However, the association between DII and laryngeal cancer risk need to be further investigated.

PMID:32332658 | PMC:PMC7220683 | DOI:10.1097/MD.0000000000019879

The Geriatric Nutritional Risk Index as a Prognostic Factor in Patients with Advanced Head and Neck Cancer

Sat, 22 Feb 2020 00:00:00 +0000

Laryngoscope. 2021 Jan;131(1):E151-E156. doi: 10.1002/lary.28587. Epub 2020 Feb 21.

ABSTRACT

OBJECTIVE: The Geriatric Nutritional Risk Index (GNRI) is a simple and well-established nutritional assessment tool and is a significant prognostic factor in various cancers. However, the role of the GNRI in predicting clinical outcomes in patients with advanced head and neck cancer (AHNC) has not been investigated. The aim of the present study was to examine the association between the GNRI and prognosis in patients with AHNC.

STUDY DESIGN: Retrospective cohort study.

METHODS: Data collected between 2002 and 2013 from Tsukuba University Hospital were reviewed. The GNRI was calculated according to the equation, 1.489 × serum albumin (g/l) + 41.7 × (body weight/ideal body weight). Characteristics and prognosis were compared among three risk groups: high (GNRI <82); intermediate (GNRI 82-98); and normal (GNRI >98). The primary endpoint was overall survival.

RESULTS: A total of 248 AHNC patients were enrolled, among whom 134 (54%) exhibited no nutritional risk, 53 (21%) had an intermediate risk for malnutrition, and 61 (25%) exhibited a high risk for malnutrition. Three-year survival rates according to the three-group GNRI scores for normal, intermediate, and high risk were 76.6%, 56.3%, and 19.5%, respectively. As the three-group GNRI score increased, the risk for mortality significantly increased (adjusted hazard ratio [HR] for intermediate to normal, 1.73 [95% CI, 1.02-2.92]; adjusted HR for high to normal, 4.31 [95% CI, 2.71-6.84]).

CONCLUSIONS: The GNRI could be considered a useful prognostic factor in patients with AHNC.

LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E151-E156, 2021.

PMID:32083731 | DOI:10.1002/lary.28587

The association between the Nutrition-Related index and morbidity following head and neck microsurgery.

Sat, 01 Feb 2020 05:00:00 +0000

Laryngoscope; 02/01/2020
(AN 141315126); ISSN: 0023852X
CINAHL Complete

Comparison of Dietary Micronutrient Intakes by Body Weight Status among Mexican-American and Non-Hispanic Black Women Aged 19-39 Years: An Analysis of NHANES 2003-2014

Sun, 24 Nov 2019 00:00:00 +0000

Nutrients. 2019 Nov 20;11(12):2846. doi: 10.3390/nu11122846.

ABSTRACT

The objective of the current study was to examine micronutrient intake from foods in women of childbearing age and to better understand potential nutritional problems varied by body weight status in minority women. A sample of women aged 19-39 years from the National Health and Nutrition Examination Surveys (NHANES) 2003-2014 was analyzed. Dietary intakes of 13 micronutrients were estimated using the National Cancer Institute method. Mexican-American and non-Hispanic Black women were categorized into normal/under-weight, overweight, or obese groups according to their body mass index (BMI). Mexican-American and non-Hispanic Black women had lower dietary intakes for vitamins A, B₂, B₆, B₁₂, and D, folate, calcium, and magnesium than non-Hispanic Whites. Among Mexican-Americans, obese women had the lowest dietary intake of vitamins A, B₂, C and D. Obese non-Hispanic Black women had significantly lower dietary intakes of iron and zinc than their normal/under-weight counterparts. Comparable percentages (>30%) of Mexican-American and non-Hispanic Black women had dietary intake less than the Estimated Average Requirements (EARs) for several key nutrients including vitamin A, C and D, folate, calcium and magnesium, and the percentages varied by body weight status. These results indicate micronutrient inadequacies persist among and within racial/ethnic and body weight groups.

PMID:31757075 | PMC:PMC6950012 | DOI:10.3390/nu11122846

Malnutrition evaluation in head and neck cancer patients: Practice patterns among otolaryngologists and radiation oncologists

Tue, 13 Aug 2019 00:00:00 +0000

Head Neck. 2019 Nov;41(11):3850-3857. doi: 10.1002/hed.25909. Epub 2019 Aug 12.

ABSTRACT

BACKGROUND: Physician practice patterns regarding diagnosis and management of malnutrition in the head and neck cancer patient population are not well studied.

METHODS: A 17-question survey was distributed to 1392 members of the American Head and Neck Society (AHNS). The impact of hospital type, fellowship training, experience, and specialty was assessed.

RESULTS: Among AHNS members, there were 124 total respondents (9% response rate), including both otolaryngologists and radiation oncologists. Respondents strongly agreed (90%) that malnutrition negatively impacts patient outcomes. The majority (63%) felt comfortable screening for malnutrition, but 13% reported no routine assessment of malnutrition; 57% were unfamiliar with relevant guidelines. Barriers to screening included lack of familiarity with screening tools/guidelines, lack of time, and lack of access to dietitian.

CONCLUSION: Although there was a strong consensus among respondents that the identification and management of malnutrition among head and neck cancer patients is critical, familiarity with relevant guidelines was poor.

PMID:31403751 | DOI:10.1002/hed.25909