Nutritional assessment with different tools in leukemia patients after hematopoietic stem cell transplantation

Objective： Correct nutritional assessment is essential for leukemia patients after hematopoietic stem cell transplantation （HSCT）. This study aimed to investigate the best nutritional assessment method for leukemia patients after HSCT, and find the possible nutritional risk of the patients during the transplantation process in order to intervene in the patients with nutritional risks and undernourished patients timely, so that the entire transplantation process could be successfully completed. Methods： A prospective study was performed in 108 leukemia patients after HSCT, and different nutritional assessment methods, including nutritional risk screening 2002 （NRS2002）, mini nutritional assessment （MNA）, subjective globe assessment （SGA） and malnutritional universal screening tools （MUST）, were used. The associations between nutritional status of these patients and nutritional assessment methods were analyzed. Results： A total of 108 patients completed SGA, and 99 patients completed NRS2002, MNA and MUST. During the treatment process, 85.2% of the patients lost weight, wherein, 50% lost weight greater than 5%, and 42.6% had significantly reduced food intake. For nutritional risk assessment, the positive rates of NRS2002, MNA and MUST were 100%, 74.7% and 63.6%, respectively. There was a significant difference （P〈0.05） among the positive rates of NRS2002, MNA and MUST. In undernutrition assessment, the positive rate of SGA （83.3%） was significantly higher than that of MNA （17.2%） （P〈0.05）, and the incidence rate of nutritional risk among leukemia patients _〈30 years old was greater than that of patients 〉30 years old （P〈0.05）. Conclusions： Patients with leukemia were in poor nutritional status during and after HSCT. The leukemia patients 〈30 years old had a greater incidence rate of nutritional risk. As nutritional risk screening tool, the specificity of NRS2002 is not high, but it can be used for evaluating nutritional deficiencies. MNA is a good nutritional risk screening tool, but not an adequate tool for nutritional assessment. If assessment of undernutrition is necessary, the combination of all these screening tools and clinical laboratory indicators should he applied to improve accuracy.

Assessment of Risk of Malnutrition in Elderly Hypertensive Patients with or without Associated Cardiovascular Risk Factors Living at Home (West Algeria) Sidi-Bel-Abbès

Undernutrition is frequently underestimated in the elderly, because clinical manifestations are non-specific. For the francophone Club geriatrics and nutrition, poly medication is one of the warning signs to be the possibility of malnutrition in an elderly person. To do this, it is particularly interesting to verify what the profiles of hypertensive patients who are at risk of malnutrition are. This component remains very little explored and studies are lacking. The authors conducted a descriptive cross-sectional study whose objective is to evaluate the prevalence of undernutrition in hypertensive patients with or without associated cardiovascular risk factors, in a population of consultants of liberal medical offices, determine the profiles of hypertensive patients who are at risk of undernutrition and describe their eating habits and their anthropometric parameters as well as the link between the number of supported antihypertensives and risk of undernutrition. 1144 patients with an average age of 65 years old have been collected during the period of recruitment. The data collection was done using a questionnaire: the MNA. Sensitive and specific, it is validated method which has international sacle. The percentage of the risk of malnutrition was estimated at 36.7%. Thus the number of associated cardiovascular risk factors becomes larger, and the risk of malnutrition is increased. The risk of malnutrition was three times higher in patients who take more than three medications per day compared with those who consumed less (75.8% vs. 24.2%). As a monotherapy, an increased risk of malnutrition is associated with diuretics. For these older hypertensives, the risk of malnutrition was linked to the type of used dual. The percentage of hypertension risk of malnutrition treated with free dual was significantly higher compared to hypertensive treated dual handset. Some associations have proved to be more favorable than others in terms of nutritional risk. Finally, a third of hypertension patients who were treated with quadruple therapy were at risk of malnutrition. This work was also designed to present an argument to a doctor to detect the risk of undernutrition in elderly hypertensives. The use of the MNA is a simple, effective and quick way for pressure balance rhymes with nutritional balance.