暂无摘要。

OBJECTIVE: Different nutritional screening tools have been proposed in childhood cancer, but none has shown convincing predictive capacity so far. The \"nutrition screening tool for childhood cancer (SCAN)\" has been specifically designed for this population and provides an easy-to-use, promising approach to identify patients at risk of malnutrition. We aim to: 1. Validate the SCAN tool prospectively in identifying malnourished patients or those who required nutritional support 2. Validate the SCAN tool prospectively in predicting toxicities or outcome. 3. Compare performance of a pediatric screening tool (STRONGKIDS) with SCAN.
METHODS: Children in our center with a new diagnosis of cancer from August 2018 to May 2019 were offered to participate in the study. Measurements (SCAN questionnaire, weight, height, body-mass index (BMI), and mid upper-arm circumference (MUAC)) were taken at diagnosis and at regular intervals throughout therapy. The last measurement was taken 6 months after finishing the intensive treatment phase. SCAN score at diagnosis was validated prospectively against variables of interest.
RESULTS: A total of 49 patients were recruited. When considering malnutrition during therapy the SCAN tool showed a sensitivity of 37.5% and negative predictive value (NPV) of 81%. Patients who required nutritional support were identified with a sensitivity of 50% and NPV of 62%. The SCAN tool was not able to predict increased toxicities, risk of relapse or decreased survival. The pediatric screening tool STRONGKIDS was unable to discriminate nutritional risk and labeled all 49 patients (100%) as medium or high-risk. Applying SCAN periodically during therapy increased sensitivity for identifying malnutrition to 87.5%.
CONCLUSIONS: In our study, applying the SCAN tool at diagnosis showed low sensitivity in identifying patients who go on to develop malnutrition during therapy. However, patients labeled as \"not at risk\" were unlikely to need nutritional support in the form of nasogastric tube or total parenteral nutrition. Using SCAN throughout therapy could be helpful in building awareness for malnutrition and successfully discriminates between patients who need further support and those who don\'t.

OBJECTIVE: The utilization of recommended nutritional assessment measures in rehabilitation settings remains unclear. This study explored methods for identifying nutritional disorders using data from a nationwide survey conducted in convalescent rehabilitation wards.
METHODS: This cross-sectional study analyzed the annual survey, including methods for identifying malnutrition, the risk of malnutrition, and overnutrition in Kaifukuki (convalescent) rehabilitation wards. Methods identifying malnutrition and risk of malnutrition were grouped into nutritional screening tools (NSTs), nutritional assessment tools (NATs), diagnostic criteria for malnutrition (DCM), and suboptimal methods (e.g., hypoalbuminemia). NSTs, NATs, and DCM were further categorized as \"acceptable tools.\" The association between applying acceptable tools, hospital-based data (e.g., the number of beds), and ward-based data (e.g., assessor for nutritional status) was analyzed by logistic regression analysis with multiple imputations.
RESULTS: In total, 885 hospitals with Kaifukuki rehabilitation wards responded to the survey, and 754 hospitals were included in the analysis. Registered dietitians assessed the nutritional status in 88% of the hospitals, whereas other professionals (e.g., nurses) evaluated the nutritional status in the remainder. NSTs (e.g., Mini Nutritional Assessment Short-Form), NATs (e.g., Subjective Global Assessment), DCM (e.g., Global Leadership Initiative on Malnutrition criteria), and suboptimal tools were used in 13.1%, 5.4%, 4.8%, and 74.6% of cases, respectively. Most hospitals used acceptable measures (e.g., body mass index) for overnutrition (91.2%). Multiple logistic regression analysis showed that assessments by registered dietitians (adjusted odds ratio[OR]: 2.20.95% confidence interval[CI]: 1.09-4.45) and hospital-owned food services, a proxy for limited clinical practice time of dietitians, were associated with a low likelihood of implementing acceptable measures (adjusted OR: 0.64, 95%CI: 0.43-0.97).
CONCLUSIONS: Acceptable malnutrition measures, including the NSTs, NATs, and DCM, have not been widely applied in convalescent rehabilitation settings. The implementation of recommended tools for identifying malnutrition may be promoted when registered dietitians assess the patients\' nutritional status.

BACKGROUND: The scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a validated tool for the screening, assessment and monitoring of malnutrition, and triaging of interventions. It contains a patient-generated component and a healthcare professional (HCP)-generated component.
OBJECTIVE: To translate the PG-SGA into Swedish, assess the linguistic and content validity of the Swedish version, and ensure conceptional, semantic and operational equivalence to the original English PG-SGA.
METHODS: In line with the methodology used in previously translated and culturally adapted versions, the standardised 10-step process suggested by the International Society for Health Economics and Outcomes Research (ISPOR) was followed. In step 7, a cross-sectional study targeting patients n = 51 and HCPs n = 52 was performed at a university hospital in Sweden. Using separate questionnaires, patients assessed the patient component and HCPs, the professional component regarding perceived comprehensibility and difficulty (linguistic validity). The HCPs also assessed perceived relevance (content validity) of all items on the PG-SGA. Item indices for comprehensibility (I-CI), difficulty (I-DI) and content validity (I-CVI) were calculated and averaged into scale indices (S-CI, S-DI and S-CVI). Cut-off standards for item and scale indices were used as reference.
RESULTS: The Swedish version of the PG-SGA rated excellent for comprehensibility (S-CI 0.96) and difficulty (S-DI 0.93) for the patient component. The professional component rated acceptable for comprehensibility (S-CI 0.89) and below acceptable for difficulty (S-DI 0.70), with the physical examination rated most difficult (I-DI 0.39 to 0.69). Content validity for the full Swedish PG-SGA was rated excellent (S-CVI 0.94).
CONCLUSIONS: The patient component was considered clear and easy to complete. The full Swedish PG-SGA was considered relevant by HCPs for screening and assessment of malnutrition. Due to perceived difficulty with the physical examination, training of Swedish HCPs in using the PG-SGA is essential before implementing the professional component into clinical practice or research.

BACKGROUND: Multiple nutritional screening tools are available for older people; however, few screening tools include specific eating behaviours as risk factors that could lead to poor food intake. The 24-item mealtime observation checklist (MOCL), developed by the Japanese Ministry of Health, Labour and Welfare in 2015, comprises signs, symptoms and conditions during mealtime that reflect eating and swallowing functions and oral conditions.
OBJECTIVE: To examine factors associated with malnutrition among the MOCL items in older people.
METHODS: A cross-sectional study was conducted using data from a retrospective cohort study conducted at four long-term care facilities in Japan. Among the older people residing in the facilities, 198 who received oral intake support were included in the analyses. Nutritional status was assessed using the Mini Nutritional Assessment-Short Form (MNA®-SF), and comparisons were made between \'malnutrition\' and \'at-risk or well-nourished\'. The association between each MOCL item and malnutrition was assessed using multivariable logistic regression analysis.
RESULTS: Of the 198 participants, 98 (49.5%) were classified as \'malnutrition\', 98 (49.5%) as \'at-risk\' and 2 (1%) as \'well-nourished\' by MNA®-SF. After adjusting for participant characteristics such as age and sex, significant associations with malnutrition were observed for four items from the 24-item MOCL: \'Has fatigue due to extended mealtime (odds ratio [OR] = 3.20, 95% confidence interval [CI]: 1.36-7.53)\', \'Food residues in the oral cavity are conspicuous (OR = 2.77, 95% CI: 1.38-5.52)\', \'Has difficulty swallowing food and takes time to swallow (OR = 3.78, 95% CI: 1.45-9.84)\' and \'Assisted feeding is required (OR = 3.70, 95% CI: 1.73-7.91)\'.
CONCLUSIONS: The four signs, symptoms and conditions during mealtime identified in this study may be associated with malnutrition in older people.
CONCLUSIONS: These may indicate the potential eating problems that can lead to malnutrition. By incorporating them into early intervention and prevention measures, health care providers may help prevent malnutrition and improve the nutritional status of older people.

Malnutrition is a prevalent and severe issue in hospitalized patients with chronic diseases. However, malnutrition screening is often overlooked or inaccurate due to lack of awareness and experience among health care providers. This study aimed to develop and validate a novel digital smartphone-based self-administered tool that uses facial features, especially the ocular area, as indicators of malnutrition in inpatient patients with chronic diseases. Facial photographs and malnutrition screening scales were collected from 619 patients in four different hospitals. A machine learning model based on back propagation neural network was trained, validated, and tested using these data. The model showed a significant correlation (p < 0.05) and a high accuracy (area under the curve 0.834-0.927) in different patient groups. The point-of-care mobile tool can be used to screen malnutrition with good accuracy and accessibility, showing its potential for screening malnutrition in patients with chronic diseases.

OBJECTIVE: Malnutrition is prevalent among hospitalized patients in developed countries, contributing to negative health outcomes and increased healthcare costs. Timely identification and management of malnutrition are crucial. The lack of a universally accepted definition and standardized diagnostic criteria for malnutrition has led to the development of various screening tools, each with varying validity. This complicates early identification of malnutrition, hindering effective intervention strategies. This systematic review and meta-analysis aimed to identify the most valid and reliable nutritional screening tool for assessing the risk of malnutrition in hospitalized adults.
METHODS: A systematic literature search was conducted to identify validation studies published from inception to November 2023, in the Pubmed/MEDLINE, Embase, and CINAHL databases. This systematic review was registered in INPLASY (INPLASY202090028). The risk of bias and quality of included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2). Meta-analyses were performed for screening tools accuracy using the symmetric hierarchical summary receiver operative characteristics models.
RESULTS: Of the 1646 articles retrieved, 60 met the inclusion criteria and were included in the systematic review, and 21 were included in the meta-analysis. A total of 51 malnutrition risk screening tools and 9 reference standards were identified. The meta-analyses assessed four common malnutrition risk screening tools against two reference standards (Subjective Global Assessment [SGA] and European Society for Clinical Nutrition and Metabolism [ESPEN] criteria). The Malnutrition Universal Screening Tool (MUST) vs SGA had a sensitivity (95% Confidence Interval) of 0.84 (0.73-0.91), and specificity of 0.85 (0.75-0.91). The MUST vs ESPEN had a sensitivity of 0.97 (0.53-0.99) and specificity of 0.80 (0.50-0.94). The Malnutrition Screening Tool (MST) vs SGA had a sensitivity of 0.81 (0.67-0.90) and specificity of 0.79 (0.72-0.74). The Mini Nutritional Assessment-Short Form (MNA-SF) vs ESPEN had a sensitivity of 0.99 (0.41-0.99) and specificity of 0.60 (0.45-0.73). The Nutrition Universal Screening Tool-2002 (NRS-2002) vs SGA had a sensitivity of 0.76 (0.58-0.87) and specificity of 0.86 (0.76-0.93).
CONCLUSIONS: The MUST demonstrated high accuracy in detecting malnutrition risk in hospitalized adults. However, the quality of the studies included varied greatly, possibly introducing bias in the results. Future research should compare tools within a specific patient population using a valid and universal gold standard to ensure improved patient care and outcomes.

UNASSIGNED: Clinical dietitians play a crucial role in the nutritional support of patients at risk of malnutrition in primary care settings. The study aimed to evaluate the effect of an individualized nutritional intervention on clinically relevant outcomes for patients with chronic disease at nutritional risk.
UNASSIGNED: A longitudinal evaluation study was conducted in two Slovenian primary health centres. We used pre-test and post-test design. Patients with chronic disease were screened using the Malnutrition Universal Screening Tool and additional risk factors (≥70 years and BMI <22 kg/m2; lower food intake in the last five days). Patients at nutritional risk were referred to a clinical dietitian for individual nutritional intervention. The effect of the nutritional intervention was assessed six months after the patients\' first visit with a clinical dietitian.
UNASSIGNED: The sample included 94 patients. Nutritional risk was reduced significantly in high-risk and moderate-risk patients. In a subgroup of patients with a MUST score ≥1 (77 patients), body weight, BMI, Fat-Free Mass Index (FFMI), energy intake, and protein intake increased significantly (p<0.001). At the same time, the phase angle significantly increased (p<0.001), but there were no statistically significant changes in the improvement of grip strength. In a subgroup of patients with MUST score 0 (17 patients), we observed an increase in their median daily energy intake (p<0.001) and median protein intake (p=0.003).
UNASSIGNED: Nutritional intervention delivered by a clinical dietitian improved patients\' nutritional intake and nutritional and functional status.
UNASSIGNED: Preveriti učinkovitost individualnih prehranskih ukrepov, ki jih v obravnavi prehransko ogroženih pacientov s kronično boleznijo, načrtuje in izvaja klinični dietetik ter se odražajo v spremembah prehranskega in funkcionalnega stanja pacientov.
UNASSIGNED: Longitudinalno evalvacijsko raziskavo smo med majem 2020 in novembrom 2022 izvedli v dveh večjih slovenskih zdravstvenih domovih. Prehransko presejanje smo izvedli z uporabo univerzalnega orodja za prehransko presejanje Malnutrition Universal Screening Toll (MUST) in dodatnimi dejavniki tveganja (≥ 70 let in ITM < 22 kg/m2; manjši vnos hrane v zadnjih petih dneh). Prehransko ogrožene paciente smo napotili h kliničnemu dietetiku na individualno prehransko obravnavo. Skupino pacientov smo spremljali v dveh različnih časovnih točkah, uporabili smo dizajn pred postopkom/po postopku. Rezultate smo analizirali po šestih mesecih.
UNASSIGNED: V vzorec smo vključili 94 bolnikov. Prehranska ogroženost se je pri pacientih z visokim in zmernim tveganjem po šestih mesecih znatno zmanjšala. V podskupini pacientov z oceno MUST ≥ 1 (77 pacientov) so se telesna masa, indeks telesne mase, indeks puste mase, količina zaužite energije in količina zaužitih beljakovin znatno povečali (p < 0,001). Medtem ko se je fazni kot pomembno povečal (p < 0,001), je moč prijema ostala relativno stabilna. V podskupini pacientov z oceno MUST = 0 (17 bolnikov), smo po šestih mesecih opazili porast povprečne količine zaužite energije (p < 0,001) in povprečno količino zaužitih beljakovin (p = 0,003).
UNASSIGNED: Rezultati raziskave so dokazali, da lahko z individualno naravnavami prehranskimi ukrepi, ki jih izvaja klinični dietetik, pri prehransko ogroženih pacientih s kronično boleznijo pomembno izboljšamo prehransko in funkcionalno stanje ter zmanjšamo njihovo prehransko ogroženost.

Patients receiving oncology care are at risk for malnutrition, which is associated with decreased cancer treatment tolerance, lower quality of life, and increased mortality. Implementation of frequent nutritional screening is.

UNASSIGNED: It is important to assess nutritional status to determine the presence of malnutrition because poor nutritional status will reduce the efficacy and increase the side effects of radiotherapy. The aim of this research was to assess nutritional status by comparing several parameters, namely anthropometry, biochemistry, physical condition, and inflammatory parameters, with Patient Generated-Subjective Global Assessment (PG-SGA) as the gold standard.
UNASSIGNED: A cross-sectional study with 78 subjects was conducted at the General Hospital Dr. Sardjito Yogyakarta, Indonesia, in 2022. The Malnutrition Screening Tool, Simple Nutrition Screening Tool, PG-SGA, and objective parameter data were used in the nutritional assessment. The objective parameters were determined by analyzing anthropometric data [body weight, mid-upper arm circumference (MUAC), and body fat], biochemical data (albumin and a complete blood profile), physical data (hand grip strength), and food intake data using the 1×24-hour recall method. The data were analyzed using One-Way ANOVA and the Kruskal-Wallis test.
UNASSIGNED: Malnutrition was found in 33.3% of pre-radiotherapy head and neck cancer (HNC) patients. Patients with good nutritional status did not experience weight loss, decreased appetite, gastrointestinal symptoms, decreased functional capacity, or fat and/or muscle deficit (p<0.05). The findings showed a significant relationship between PG-SGA and nutritional status based on body weight, weight loss, MUACs, handgrip strength, visceral fat, resting metabolic rate (RMR), and hemoglobin (p<0.05). A better nutritional status was associated with higher parameter values.
UNASSIGNED: The method for nutritional status assessment in HNC patients undergoing radiotherapy can be performed by measuring body weight, weight loss, upper arm circumference, visceral fat, hemoglobin, and RMR in addition to PG-SGA as the gold standard.
UNASSIGNED: Kötü beslenme durumu radyoterapinin etkinliğini azaltacağından ve yan etkilerini artıracağından, malnütrisyon varlığını belirlemek için beslenme durumunu değerlendirmek önemlidir. Bu araştırmanın amacı, antropometri, biyokimya, fiziksel durum ve ayrıca enflamatuvar parametreler gibi çeşitli parametreleri altın standart olarak Hasta Tarafından Oluşturulan-Sübjektif Global Değerlendirme (PG-SGA) ile karşılaştırarak beslenme durumunu değerlendirmektir.
UNASSIGNED: Dr. Sardjito Genel Hastanesi Yogyakarta, Endonezya’da 2022 yılında 78 denekle kesitsel bir çalışma yürütüldü. Beslenme değerlendirmesinde Malnütrisyon Tarama Aracı, Basit Beslenme Tarama Aracı, PG-SGA ve objektif parametre verileri kullanıldı. Objektif parametreler antropometrik veriler [vücut ağırlığı, orta-üst kol çevresi (MUAC) ve vücut yağı], biyokimyasal veriler (albümin ve tam kan profili), fiziksel veriler (el kavrama gücü) ve 1×24 saatlik hatırlama yöntemi kullanılarak gıda alım verileri analiz edilerek belirlendi. Veriler Tek-Yönlü ANOVA ve Kruskal-Wallis testi kullanılarak değerlendirildi.
UNASSIGNED: Radyoterapi öncesi baş ve boyun kanseri (BBK) hastalarının %33,3’ünde malnütrisyon saptandı. Beslenme durumu iyi olan hastalarda kilo kaybı, iştah azalması, gastrointestinal semptomlar, fonksiyonel kapasitede azalma ve yağ ve/veya kas eksikliği görülmedi (p<0,05). Bulgular, vücut ağırlığı, kilo kaybı, MUAC, el kavrama gücü, visseral yağ, istirahat metabolizma hızı (İMH) ve hemoglobin bazında PG-SGA ile beslenme durumu arasında anlamlı bir ilişki olduğunu gösterdi (p<0,05). Daha iyi beslenme durumu daha yüksek parametre değerleri ile ilişkilendirildi.
UNASSIGNED: Radyoterapi gören BBK hastalarında beslenme durumunu değerlendirme yöntemi, altın standart olarak PG-SGA’ya ek olarak vücut ağırlığı, kilo kaybı, üst kol çevresi, visseral yağ, hemoglobin ve İMH ölçülerek yapılabilir.