Primary cutaneous B-cell lymphomas (pcBCLs) are non-Hodgkin lymphomas present in the skin without evidence of extracutaneous involvement at diagnosis and include primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, intravascular large B-cell lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg-type [1]. While the etiology and pathogenesis of pcBCL is not fully understood, prior research suggests a possible association between autoimmune disease and primary cutaneous marginal zone lymphoma [2]. While it is known that patients with certain autoimmune disorders (systemic lupus erythematosus, autoimmune thyroiditis, Sjogren‘s, and sarcoidosis, among others) have an increased risk of developing non-Hodgkin lymphomas and other cancers due to chronic B-cell stimulation and immune dysregulation, little is known about the relationship between specific autoimmune diseases and pcBCL [3, 4].
原发性皮肤 B 细胞淋巴瘤（pcBCLs）是指在诊断时无皮肤外受累证据的皮肤非霍奇金淋巴瘤，包括原发性皮肤边缘区淋巴瘤、原发性皮肤滤泡中心淋巴瘤、血管内大 B 细胞淋巴瘤和原发性皮肤弥漫大 B 细胞淋巴瘤（腿型）[1]。虽然 pcBCL 的病因和发病机制尚不完全清楚，但先前的研究表明，自身免疫性疾病与原发性皮肤边缘区淋巴瘤之间可能存在关联 [2]。众所周知，某些自身免疫性疾病（系统性红斑狼疮、自身免疫性甲状腺炎、Sjogren's 和肉样瘤病）患者由于慢性 B 细胞刺激和免疫失调，患非霍奇金淋巴瘤和其他癌症的风险会增加，但人们对特定自身免疫性疾病与 pcBCL 之间的关系知之甚少 [3，4]。
{"title":"B-Zell-mediierte Autoimmunerkrankungen: Risiko für B-Zell-Lymphome?","authors":"M. Sticherling","doi":"10.1159/000535790","DOIUrl":"https://doi.org/10.1159/000535790","url":null,"abstract":"Primary cutaneous B-cell lymphomas (pcBCLs) are non-Hodgkin lymphomas present in the skin without evidence of extracutaneous involvement at diagnosis and include primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, intravascular large B-cell lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg-type [1]. While the etiology and pathogenesis of pcBCL is not fully understood, prior research suggests a possible association between autoimmune disease and primary cutaneous marginal zone lymphoma [2]. While it is known that patients with certain autoimmune disorders (systemic lupus erythematosus, autoimmune thyroiditis, Sjogren‘s, and sarcoidosis, among others) have an increased risk of developing non-Hodgkin lymphomas and other cancers due to chronic B-cell stimulation and immune dysregulation, little is known about the relationship between specific autoimmune diseases and pcBCL [3, 4].","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"14 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139451007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To develop new antiphospholipid syndrome (APS) classification criteria with high specificity for use in observational studies and trials, jointly supported by the American College of Rheumatology (ACR) and EULAR. Methods: This international multidisciplinary initiative included four phases: (1) Phase I, criteria generation by surveys and literature review; (2) Phase II, criteria reduction by modified Delphi and nominal group technique exercises; (3) Phase III, criteria definition, further reduction with the guidance of real-world patient scenarios, and weighting via consensus-based multicriteria decision analysis, and threshold identification; and (4) Phase IV, validation using independent adjudicators’ consensus as the gold standard. Results: The 2023 ACR/EULAR APS classification criteria include an entry criterion of at least one positive antiphospholipid antibody (aPL) test within 3 years of identification of an aPL-associated clinical criterion, followed by additive weighted criteria (score range 1–7 points each) clustered into six clinical domains (macrovascular venous thromboembolism, macrovascular arterial thrombosis, microvascular, obstetric, cardiac valve, and hematologic) and two laboratory domains (lupus anticoagulant functional coagulation assays, and solid-phase enzyme-linked immunosorbent assays for IgG/IgM anticardiolipin and/or IgG/IgM anti-β2-glycoprotein I antibodies). Patients accumulating at least three points each from the clinical and laboratory domains are classified as having APS. In the validation cohort, the new APS criteria vs the 2006 revised Sapporo classification criteria had a specificity of 99% vs 86%, and a sensitivity of 84% vs 99%.
{"title":"Neue Kriterien für das Anti-Phospholipid-Syndrom","authors":"M. Aringer","doi":"10.1159/000535709","DOIUrl":"https://doi.org/10.1159/000535709","url":null,"abstract":"Objective: To develop new antiphospholipid syndrome (APS) classification criteria with high specificity for use in observational studies and trials, jointly supported by the American College of Rheumatology (ACR) and EULAR. Methods: This international multidisciplinary initiative included four phases: (1) Phase I, criteria generation by surveys and literature review; (2) Phase II, criteria reduction by modified Delphi and nominal group technique exercises; (3) Phase III, criteria definition, further reduction with the guidance of real-world patient scenarios, and weighting via consensus-based multicriteria decision analysis, and threshold identification; and (4) Phase IV, validation using independent adjudicators’ consensus as the gold standard. Results: The 2023 ACR/EULAR APS classification criteria include an entry criterion of at least one positive antiphospholipid antibody (aPL) test within 3 years of identification of an aPL-associated clinical criterion, followed by additive weighted criteria (score range 1–7 points each) clustered into six clinical domains (macrovascular venous thromboembolism, macrovascular arterial thrombosis, microvascular, obstetric, cardiac valve, and hematologic) and two laboratory domains (lupus anticoagulant functional coagulation assays, and solid-phase enzyme-linked immunosorbent assays for IgG/IgM anticardiolipin and/or IgG/IgM anti-β2-glycoprotein I antibodies). Patients accumulating at least three points each from the clinical and laboratory domains are classified as having APS. In the validation cohort, the new APS criteria vs the 2006 revised Sapporo classification criteria had a specificity of 99% vs 86%, and a sensitivity of 84% vs 99%.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"76 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139164192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Interstitial lung disease (ILD) is a frequently observed comorbidity in autoimmune diseases such as dermatomyositis/polymyositis (DM/PM), and it is significantly associated with specific autoantibody types. One unique antibody type is the anti-transcription intermediate factor-1γ antibody (anti-TIF-1γ Ab), which has a positive rate of only 7%. It is often found in combination with malignancy and rarely with ILD, particularly rapidly progressive ILD (RPILD). In some cases, the presence of ILD in individuals with DM may indicate a paraneoplastic syndrome. Pneumocystis jiroveci pneumonia (PJP) typically occurs due to intensive immunosuppressive therapy, human immunodeficiency virus (HIV) infection, or malignancy, and rarely as an isolated condition. Case Presentation: A 52-year-old man with a history of rapid weight loss but non-HIV infected and not immunosuppressed who presented with fever, cough, dyspnea, weakness of the extremities, characteristic rash and mechanic’s hand. Pathogenic tests suggested PJP, laboratory tests suggested a single anti-TIF-1γ Ab positive DM, imaging suggested ILD, and pathology revealed no malignancy. RPILD and acute respiratory distress syndrome (ARDS) developed after anti-infection and steroid hormone therapy. After mechanical support therapy such as Extracorporeal Membrane Oxygenation (ECMO), the patient developed late-onset cytomegalovirus pneumonia (CMVP), complicated bacterial infection, and ultimately death. Additionally, we discuss the potential causes of rapid weight loss, the mechanisms by which anti-TIF-1γ Ab may lead to ILD, and the possible connection between anti-TIF-1γ Ab positivity, rapid weight loss, immune abnormalities, and opportunistic infections.
背景：间质性肺病（ILD）是皮肌炎/多发性肌炎（DM/PM）等自身免疫性疾病中经常出现的合并症，它与特定的自身抗体类型密切相关。其中一种独特的抗体类型是抗转录中间因子-1γ抗体（anti-TIF-1γ Ab），其阳性率仅为 7%。它通常与恶性肿瘤同时出现，很少与 ILD，尤其是快速进展性 ILD（RPILD）同时出现。在某些情况下，DM 患者出现 ILD 可能预示着一种副肿瘤综合征。吉罗韦氏肺孢子菌肺炎（PJP）通常是由于强化免疫抑制治疗、人类免疫缺陷病毒（HIV）感染或恶性肿瘤引起的，很少单独发病。病例介绍：一名 52 岁的男性，曾有体重迅速下降的病史，但未感染艾滋病毒，也未接受免疫抑制治疗，表现为发热、咳嗽、呼吸困难、四肢无力、特征性皮疹和机械手。病原学检查提示为 PJP，实验室检查提示为单个抗 TIF-1γ Ab 阳性 DM，影像学检查提示为 ILD，病理学检查未发现恶性肿瘤。经过抗感染和类固醇激素治疗后，出现了 RPILD 和急性呼吸窘迫综合征（ARDS）。在接受体外膜氧合（ECMO）等机械支持治疗后，患者出现晚期巨细胞病毒肺炎（CMVP），并发细菌感染，最终死亡。此外，我们还讨论了体重急剧下降的潜在原因、抗 TIF-1γ Ab 导致 ILD 的机制，以及抗 TIF-1γ Ab 阳性、体重急剧下降、免疫异常和机会性感染之间可能存在的联系。
{"title":"Eine Dermatomyositis mit ungewöhnlichen Befunden und letalem Ausgang","authors":"M. Polke","doi":"10.1159/000535710","DOIUrl":"https://doi.org/10.1159/000535710","url":null,"abstract":"Background: Interstitial lung disease (ILD) is a frequently observed comorbidity in autoimmune diseases such as dermatomyositis/polymyositis (DM/PM), and it is significantly associated with specific autoantibody types. One unique antibody type is the anti-transcription intermediate factor-1γ antibody (anti-TIF-1γ Ab), which has a positive rate of only 7%. It is often found in combination with malignancy and rarely with ILD, particularly rapidly progressive ILD (RPILD). In some cases, the presence of ILD in individuals with DM may indicate a paraneoplastic syndrome. Pneumocystis jiroveci pneumonia (PJP) typically occurs due to intensive immunosuppressive therapy, human immunodeficiency virus (HIV) infection, or malignancy, and rarely as an isolated condition. Case Presentation: A 52-year-old man with a history of rapid weight loss but non-HIV infected and not immunosuppressed who presented with fever, cough, dyspnea, weakness of the extremities, characteristic rash and mechanic’s hand. Pathogenic tests suggested PJP, laboratory tests suggested a single anti-TIF-1γ Ab positive DM, imaging suggested ILD, and pathology revealed no malignancy. RPILD and acute respiratory distress syndrome (ARDS) developed after anti-infection and steroid hormone therapy. After mechanical support therapy such as Extracorporeal Membrane Oxygenation (ECMO), the patient developed late-onset cytomegalovirus pneumonia (CMVP), complicated bacterial infection, and ultimately death. Additionally, we discuss the potential causes of rapid weight loss, the mechanisms by which anti-TIF-1γ Ab may lead to ILD, and the possible connection between anti-TIF-1γ Ab positivity, rapid weight loss, immune abnormalities, and opportunistic infections.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"43 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138951745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HealthyW8 aims to develop an integrated precision prevention approach for obesity, which includes an enhanced HLRS (Health Lifestyle Recommendation System) based on an emotions-aware HDT (Human Digital Twin). The HLRS will integrate multiple host factors, lifestyle aspects, and socio-economic and living contexts to provide personalized recommendations. The HDT will help forecast human behaviour, understand practical limitations of recommendations, and serve as a framework for simulation and prediction models for individual decisionmaking processes. The use of a HDT for obesity prevention is a novel approach that could revolutionize obesity management. HealthyW8 strives to encourage healthier lifestyles from an early stage of life onward, decreasing the prevalence of obesity and lowering healthcare costs. Interventions and digital solutions will allow health professionals to tailor their services to individuals without high infrastructure and administration costs. The project emphasizes improving health literacy through personalization of goals and nudging/gamification effects for motivation, Komp Nutr Diet 2023;2:83–86 DOI: 10.1159/000533903
{"title":"The Range of European Nutritional Practice – Inspiring and on the Point","authors":"","doi":"10.1159/000533903","DOIUrl":"https://doi.org/10.1159/000533903","url":null,"abstract":"HealthyW8 aims to develop an integrated precision prevention approach for obesity, which includes an enhanced HLRS (Health Lifestyle Recommendation System) based on an emotions-aware HDT (Human Digital Twin). The HLRS will integrate multiple host factors, lifestyle aspects, and socio-economic and living contexts to provide personalized recommendations. The HDT will help forecast human behaviour, understand practical limitations of recommendations, and serve as a framework for simulation and prediction models for individual decisionmaking processes. The use of a HDT for obesity prevention is a novel approach that could revolutionize obesity management. HealthyW8 strives to encourage healthier lifestyles from an early stage of life onward, decreasing the prevalence of obesity and lowering healthcare costs. Interventions and digital solutions will allow health professionals to tailor their services to individuals without high infrastructure and administration costs. The project emphasizes improving health literacy through personalization of goals and nudging/gamification effects for motivation, Komp Nutr Diet 2023;2:83–86 DOI: 10.1159/000533903","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136130916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As healthcare professionals, dietitians have a duty of care to their patients and profession to ensure that they remain aware of changes in dietetic practice. Pre-registration education programmes provide broad training, often aligning with the EFAD Academic Standards, 2018 (www.efad.org/efad-standards) within a limited timeframe that also incorporates practice learning. With experience, dietitians become increasingly skilled and often aspire to move into specialised, consultant or freelance roles. An increasingly popular trend is the development of a portfolio career, which involves engaging in multiple roles with different employers. Lifelong learning (LLL) is integral to every dietitian’s continual practice, and skill competencies are no longer «optional in health care» [1, 2]. Some countries now have specified roles requiring more formal training, such as Advanced Practice roles in the UK (BDA, 2023) (www.bda.uk.com/practice-and-education/nutrition-and-dieteticpractice/dietetic-workforce/advanced-practice.html). LLL is defined diversely across various national contexts and for distinct purposes. The European Commission published «Memorandum on Lifelong Learning» in 2000 defining LLL as «all purposeful learning activity, undertaken on an ongoing basis with the aim of improving knowledge, skills and competence» [3]. Many countries use the term Continuous Professional Development (CPD) which, in the context of healthcare, can be defined as «systematic maintenance, improvement, and continuous acquisition and/or reinforcement of the life-long knowledge, skills and competences of health professionals» [4]. CPD is pivotal to meeting patient, health service delivery, and individual professional learning needs. The term acknowledges not only the wide-ranging competences needed to practice high-quality care delivery but also the multi-disciplinary context of patient care [4, 5]. Recently, some LLL in other employment sections has been recognised through micro-credentials and digital badging. The title of «dietitian/dietician» has been protected by statutory regulation in a number of countries including the United Kingdom, USA, Canada, Australia, New Zealand [6], and also Ireland and the Komp Nutr Diet 2023;2:80–82 DOI: 10.1159/000533367
{"title":"From Novice to Expert – Unveiling the Power of Lifelong Learning in Dietetic Practice","authors":"","doi":"10.1159/000533367","DOIUrl":"https://doi.org/10.1159/000533367","url":null,"abstract":"As healthcare professionals, dietitians have a duty of care to their patients and profession to ensure that they remain aware of changes in dietetic practice. Pre-registration education programmes provide broad training, often aligning with the EFAD Academic Standards, 2018 (www.efad.org/efad-standards) within a limited timeframe that also incorporates practice learning. With experience, dietitians become increasingly skilled and often aspire to move into specialised, consultant or freelance roles. An increasingly popular trend is the development of a portfolio career, which involves engaging in multiple roles with different employers. Lifelong learning (LLL) is integral to every dietitian’s continual practice, and skill competencies are no longer «optional in health care» [1, 2]. Some countries now have specified roles requiring more formal training, such as Advanced Practice roles in the UK (BDA, 2023) (www.bda.uk.com/practice-and-education/nutrition-and-dieteticpractice/dietetic-workforce/advanced-practice.html). LLL is defined diversely across various national contexts and for distinct purposes. The European Commission published «Memorandum on Lifelong Learning» in 2000 defining LLL as «all purposeful learning activity, undertaken on an ongoing basis with the aim of improving knowledge, skills and competence» [3]. Many countries use the term Continuous Professional Development (CPD) which, in the context of healthcare, can be defined as «systematic maintenance, improvement, and continuous acquisition and/or reinforcement of the life-long knowledge, skills and competences of health professionals» [4]. CPD is pivotal to meeting patient, health service delivery, and individual professional learning needs. The term acknowledges not only the wide-ranging competences needed to practice high-quality care delivery but also the multi-disciplinary context of patient care [4, 5]. Recently, some LLL in other employment sections has been recognised through micro-credentials and digital badging. The title of «dietitian/dietician» has been protected by statutory regulation in a number of countries including the United Kingdom, USA, Canada, Australia, New Zealand [6], and also Ireland and the Komp Nutr Diet 2023;2:80–82 DOI: 10.1159/000533367","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136130507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It is not known if nutrition risk screening of older adults should be a standard practice in primary care. The evidence in support of nutrition risk screening of older adults in primary care was examined and critically analyzed using an umbrella review. The peer reviewed and grey literature were searched for clinical practice guidelines (CPGs) and systematic reviews (SRs). Titles and abstracts were independently screened by the two authors. Resources were excluded if they did not apply to older adults, did not discuss nutrition/malnutrition risk screening, or were in settings other than primary care. Full texts were independently screened by both authors, resulting in the identification of six CPGs and three SRs that met the review criteria. Guidelines were appraised with the AGREE II tool and SRs with the AMSTAR 2 tool. The quality of the CPGs was high, while the quality of the SRs was low. The CPGs and SRs acknowledged a lack of high-quality research on the benefits of regular nutrition risk screening for older adults in primary care; however, CPGs recommended annual screening for older adults in primary care practices or other community settings. High-quality research investigating nutrition risk screening of older adults in primary care is needed.
{"title":"Screening for Nutritional Risk in Primary Healthcare","authors":"Trude M. B. Mortensen","doi":"10.1159/000533930","DOIUrl":"https://doi.org/10.1159/000533930","url":null,"abstract":"It is not known if nutrition risk screening of older adults should be a standard practice in primary care. The evidence in support of nutrition risk screening of older adults in primary care was examined and critically analyzed using an umbrella review. The peer reviewed and grey literature were searched for clinical practice guidelines (CPGs) and systematic reviews (SRs). Titles and abstracts were independently screened by the two authors. Resources were excluded if they did not apply to older adults, did not discuss nutrition/malnutrition risk screening, or were in settings other than primary care. Full texts were independently screened by both authors, resulting in the identification of six CPGs and three SRs that met the review criteria. Guidelines were appraised with the AGREE II tool and SRs with the AMSTAR 2 tool. The quality of the CPGs was high, while the quality of the SRs was low. The CPGs and SRs acknowledged a lack of high-quality research on the benefits of regular nutrition risk screening for older adults in primary care; however, CPGs recommended annual screening for older adults in primary care practices or other community settings. High-quality research investigating nutrition risk screening of older adults in primary care is needed.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135887306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Low muscle mass (MM) is a common component of cancer-related malnutrition and sarcopenia, conditions that are all independently associated with an increased risk of mortality. This study aimed to (1) compare the prevalence of low MM, malnutrition, and sarcopenia and their association with survival in adults with cancer from the UK Biobank and (2) explore the influence of different allometric scaling (height [m2] or body mass index [BMI]) on low MM estimates. Methods: Participants in the UK Biobank with a cancer diagnosis within 2 years of the baseline assessment were identified. Low MM was estimated by appendicular lean soft tissue (ALST) from bioelectrical impedance analysis derived fat-free mass. Malnutrition was determined using the Global Leadership in Malnutrition criteria. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People criteria (version 2). All-cause mortality was determined from linked national mortality records. Cox-proportional hazards models were fitted to estimate the effect of low MM, malnutrition, and sarcopenia on all-cause mortality. Results: In total, 4122 adults with cancer (59.8 ± 7.1 years; 49.2% male) were included. Prevalence of low MM (8.0% vs. 1.7%), malnutrition (11.2% vs. 6.2%), and sarcopenia (1.4% vs. 0.2%) was higher when MM was adjusted using ALST/BMI compared with ALST/height2, respectively. Low MM using ALST/BMI identified more cases in participants with obesity (low MM 56.3% vs. 0%; malnutrition 50% vs. 18.5%; sarcopenia 50% vs. 0%). During a median 11.2 (interquartile range: 10.2, 12.0) years of follow up, 901 (21.7%) of the 4122 participants died, and of these, 744 (82.6%) deaths were cancer-specific All conditions were associated with a higher hazard of mortality using either method of MM adjustment: low MM (ALST/height2: HR 1.9 [95% CI 1.3, 2.8], P = 0.001; ALST/BMI: HR 1.3 [95% CI 1.1, 1.7], P = 0.005; malnutrition (ALST/height2: HR 2.5 [95% CI 1.1, 1.7], P = 0.005; ALST/BMI: HR 1.3 [95% CI 1.1, 1.7], P = 0.005; sarcopenia (ALST/height2: HR 2.9 [95% CI 1.3, 6.5], P = 0.013; ALST/BMI: HR 1.6 [95% CI 1.0, 2.4], P = 0.037).
& lt; b>背景:& lt; / b>低肌肉质量(MM)是癌症相关营养不良和肌肉减少症的常见组成部分，这些情况都与死亡风险增加独立相关。本研究旨在(1)比较来自英国生物银行(UK Biobank)的成人癌症患者中低MM、营养不良和肌肉减少症的患病率及其与生存率的关系;(2)探索不同异速测量尺度(身高[m<sup>2</sup>]或体重指数[BMI])对低MM估计的影响。& lt; b>方法:& lt; / b>英国生物银行的参与者在基线评估后2年内被诊断为癌症。通过生物电阻抗分析得出无脂质量，通过阑尾瘦软组织(ALST)估计低MM。营养不良是根据全球营养不良领导标准确定的。肌少症的定义采用欧洲老年人肌少症工作组标准(版本2)。全因死亡率根据相关的国家死亡率记录确定。拟合cox比例风险模型来估计低MM、营养不良和肌肉减少症对全因死亡率的影响。& lt; b>结果:& lt; / b>共有4122名成年癌症患者(59.8±7.1岁;49.2%为男性)。与ALST/身高sup>2< /sup>相比，使用ALST/BMI调整MM时，低MM(8.0%对1.7%)、营养不良(11.2%对6.2%)和肌肉减少症(1.4%对0.2%)的患病率更高。低MM使用ALST/BMI识别出更多的肥胖病例(低MM 56.3%对0%;营养不良50% vs. 18.5%;肌肉减少50% vs. 0%)。在中位随访11.2年(四分位数间距:10.2至12.0)期间，4122名参与者中有901人(21.7%)死亡，其中744人(82.6%)死亡是癌症特异性死亡。使用MM调整方法中的任何一种，所有疾病都与较高的死亡风险相关:低MM (ALST/height<sup>2</sup>: HR 1.9 [95% CI 1.3, 2.8]， P = 0.001;Alst / bmi: hr 1.3 [95% ci 1.1, 1.7]， p = 0.005;营养不良(ALST/height<sup>2</sup>: HR 2.5 [95% CI 1.1, 1.7]， P = 0.005;Alst / bmi: hr 1.3 [95% ci 1.1, 1.7]， p = 0.005;肌肉减少症(ALST/height<sup>2</sup>: HR 2.9 [95% CI 1.3, 6.5]， P = 0.013;Alst / bmi: hr 1.6 [95% ci 1.0, 2.4]， p = 0.037]。
{"title":"Malnutrition, Low Muscle Mass and Sarcopenia May be Underestimated in Certain Populations with Cancer. The Case For: “One Size, Does Not Fit All… Patient’s Diversity”","authors":"Adele Hug, Susana Couto Irving","doi":"10.1159/000533514","DOIUrl":"https://doi.org/10.1159/000533514","url":null,"abstract":"<b>Background:</b> Low muscle mass (MM) is a common component of cancer-related malnutrition and sarcopenia, conditions that are all independently associated with an increased risk of mortality. This study aimed to (1) compare the prevalence of low MM, malnutrition, and sarcopenia and their association with survival in adults with cancer from the UK Biobank and (2) explore the influence of different allometric scaling (height [m<sup>2</sup>] or body mass index [BMI]) on low MM estimates. <b>Methods:</b> Participants in the UK Biobank with a cancer diagnosis within 2 years of the baseline assessment were identified. Low MM was estimated by appendicular lean soft tissue (ALST) from bioelectrical impedance analysis derived fat-free mass. Malnutrition was determined using the Global Leadership in Malnutrition criteria. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People criteria (version 2). All-cause mortality was determined from linked national mortality records. Cox-proportional hazards models were fitted to estimate the effect of low MM, malnutrition, and sarcopenia on all-cause mortality. <b>Results:</b> In total, 4122 adults with cancer (59.8 ± 7.1 years; 49.2% male) were included. Prevalence of low MM (8.0% vs. 1.7%), malnutrition (11.2% vs. 6.2%), and sarcopenia (1.4% vs. 0.2%) was higher when MM was adjusted using ALST/BMI compared with ALST/height<sup>2</sup>, respectively. Low MM using ALST/BMI identified more cases in participants with obesity (low MM 56.3% vs. 0%; malnutrition 50% vs. 18.5%; sarcopenia 50% vs. 0%). During a median 11.2 (interquartile range: 10.2, 12.0) years of follow up, 901 (21.7%) of the 4122 participants died, and of these, 744 (82.6%) deaths were cancer-specific All conditions were associated with a higher hazard of mortality using either method of MM adjustment: low MM (ALST/height<sup>2</sup>: HR 1.9 [95% CI 1.3, 2.8], P = 0.001; ALST/BMI: HR 1.3 [95% CI 1.1, 1.7], P = 0.005; malnutrition (ALST/height<sup>2</sup>: HR 2.5 [95% CI 1.1, 1.7], P = 0.005; ALST/BMI: HR 1.3 [95% CI 1.1, 1.7], P = 0.005; sarcopenia (ALST/height<sup>2</sup>: HR 2.9 [95% CI 1.3, 6.5], P = 0.013; ALST/BMI: HR 1.6 [95% CI 1.0, 2.4], P = 0.037).","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"15 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135887307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent years, Meals on Wheels (MoW) services have been in a state of decline as austerity policies have become entrenched. However, this decline is occurring with little knowledge of the impact withdrawal of MoW services has on the health and well-being of those who use them. The pandemic has raised awareness of precarity and vulnerability in relation to food that affects many people in the UK and other Westernised countries and this provides further context for the analysis presented. This paper presents findings of a mixed methods ethnographic study drawing on qualitative interviews and visual methods underpinned by social practice theory to explore the household food practices of older people receiving MoW services. Interviews were conducted with 14 older people receiving MoW, eight MoW staff delivering MoW services in the east of England and one expert. The Covid-19 pandemic interrupted the study, and once the first lockdown began visits to the homes of older people were terminated and the remaining interviews were undertaken by telephone. The study found that a number of threats accumulated to change food practices and moved people towards vulnerability to food insecurity. Threats included difficulty accessing food and cooking due to sensory and physical challenges. The MoW service increased participants' coping capacity. As well as benefiting from the food provided, the relational aspect of the service was important. Brief encounters between MoW staff built caring relationships that developed over time to ensure older people felt valued and cared for. The study demonstrates how MoW services make a positive contribution to food practices, supporting vulnerable adults to continue living well in their own homes and protecting them from food insecurity and ill-being. Local authorities looking to make cost savings through ending MoW services should consider the impact this would have on the well-being of older residents.
{"title":"The Importance of Foodservice to Combat Food Insecurity and Malnutiriton in Older People","authors":"Derya Dikmen","doi":"10.1159/000534046","DOIUrl":"https://doi.org/10.1159/000534046","url":null,"abstract":"In recent years, Meals on Wheels (MoW) services have been in a state of decline as austerity policies have become entrenched. However, this decline is occurring with little knowledge of the impact withdrawal of MoW services has on the health and well-being of those who use them. The pandemic has raised awareness of precarity and vulnerability in relation to food that affects many people in the UK and other Westernised countries and this provides further context for the analysis presented. This paper presents findings of a mixed methods ethnographic study drawing on qualitative interviews and visual methods underpinned by social practice theory to explore the household food practices of older people receiving MoW services. Interviews were conducted with 14 older people receiving MoW, eight MoW staff delivering MoW services in the east of England and one expert. The Covid-19 pandemic interrupted the study, and once the first lockdown began visits to the homes of older people were terminated and the remaining interviews were undertaken by telephone. The study found that a number of threats accumulated to change food practices and moved people towards vulnerability to food insecurity. Threats included difficulty accessing food and cooking due to sensory and physical challenges. The MoW service increased participants&apos; coping capacity. As well as benefiting from the food provided, the relational aspect of the service was important. Brief encounters between MoW staff built caring relationships that developed over time to ensure older people felt valued and cared for. The study demonstrates how MoW services make a positive contribution to food practices, supporting vulnerable adults to continue living well in their own homes and protecting them from food insecurity and ill-being. Local authorities looking to make cost savings through ending MoW services should consider the impact this would have on the well-being of older residents.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135887081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Recent studies suggested that sarcopenia may be a significant comorbidity of diabetes mellitus (DM). Nonetheless, studies with nationally representative data are scarce, and the changing trend of sarcopenia prevalence over time is largely unknown. Therefore, we aimed to estimate and compare the prevalence of sarcopenia in diabetic and nondiabetic US older population, and to explore the potential predictors of sarcopenia as well as the trend of sarcopenia prevalent in the past decades. Methods: Data were retrieved from the National Health and Nutrition Examination Survey (NHANES). Sarcopenia and DM were defined according to corresponding diagnosis criteria. Weighted prevalence was calculated and compared between diabetic and nondiabetic participants. The differences among age and ethnicity groups were explored. Results: A total of 6,381 US adults (>50 years) were involved. The overall prevalence of sarcopenia was 17.8% for US elders, and the prevalence was higher (27.9% vs. 15.7%) in those with diabetes ones than those without. Stepwise regression revealed that sarcopenia was significantly associated with DM (adjusted odds ratio = 1.37, 95% CI: 1.08-1.22; p < 0.05) after controlling for potential confounders including gender, age, ethnicity, educational level, BMI, and muscle strengthening activity. A slight fluctuation but overall increasing trend of sarcopenia prevalence was observed among diabetic elders, while no obvious changing trend was observed in their counterparts in recent decades.
{"title":"Do People with Type 2 Diabetes Mellitus Have a Higher Risk of Sarcopenia?","authors":"Alyson Hill","doi":"10.1159/000533830","DOIUrl":"https://doi.org/10.1159/000533830","url":null,"abstract":"<b>Introduction:</b> Recent studies suggested that sarcopenia may be a significant comorbidity of diabetes mellitus (DM). Nonetheless, studies with nationally representative data are scarce, and the changing trend of sarcopenia prevalence over time is largely unknown. Therefore, we aimed to estimate and compare the prevalence of sarcopenia in diabetic and nondiabetic US older population, and to explore the potential predictors of sarcopenia as well as the trend of sarcopenia prevalent in the past decades. <b>Methods:</b> Data were retrieved from the National Health and Nutrition Examination Survey (NHANES). Sarcopenia and DM were defined according to corresponding diagnosis criteria. Weighted prevalence was calculated and compared between diabetic and nondiabetic participants. The differences among age and ethnicity groups were explored. <b>Results:</b> A total of 6,381 US adults (&#x3e;50 years) were involved. The overall prevalence of sarcopenia was 17.8% for US elders, and the prevalence was higher (27.9% vs. 15.7%) in those with diabetes ones than those without. Stepwise regression revealed that sarcopenia was significantly associated with DM (adjusted odds ratio = 1.37, 95% CI: 1.08-1.22; p &#x3c; 0.05) after controlling for potential confounders including gender, age, ethnicity, educational level, BMI, and muscle strengthening activity. A slight fluctuation but overall increasing trend of sarcopenia prevalence was observed among diabetic elders, while no obvious changing trend was observed in their counterparts in recent decades.","PeriodicalId":17887,"journal":{"name":"Kompass Autoimmun","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136025746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：