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BACKGROUND: Acute malnutrition in children <5 years of age has a direct relationship with medical complications and mortality. We aimed to describe the etiologic factors in children with moderate and severe non-illness-related acute malnutrition who required hospitalization for treatment of malnutrition in two high-complexity hospital centers in Bogotá, Colombia. METHODS: This is a multicenter case series (December 2016 to December 2020) including patients aged 1-59 months with a weight/height indicator less than -2 SD. Electronic health records were reviewed, and demographic (sex, age, city of origin, and socioeconomic status) and clinical data (gestational age at birth, edema, and nutrition status) were collected. Descriptive analysis of information was performed. An exploratory bivariate analysis by diagnostic categories of moderate and severe acute malnutrition vs days of hospitalization was also performed. RESULTS: Forty-five patients were included, 62.2% of whom were male, with a median age of 14 months (Q1-Q3: 7-24). The main etiologic factors of malnutrition were related to problems with total food intake (33.3%), transition in consistency of feeding (31.1%), and breastfeeding technique (22.2%). Only 13.3% had problems related to food insecurity. There were no statistically significant differences between moderate (median: 7 days; Q1-Q3: 5-12) and severe (median: 8 days; Q1-Q3: 5-16) acute malnutrition when compared by days of hospitalization. CONCLUSIONS: The main etiologic factors of malnutrition in our study population were related to problems in the amount of food provided and transition in consistency of complementary feeding.

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Respiratory diseases are one of the main causes of morbidity and mortality in children under 5 years of age. The acute respiratory disease (ERA in Spanish) room strategy implemented in Colombia is an important tool to reduce hospitalization and mortality rates in this population. OBJECTIVE: To describe the health outcomes of the implementation of the ERA room strategy in two health institutions in Bogota. PATIENTS AND METHOD: Multicenter descriptive study including 1785 patients admitted to the ERA rooms of two institutions in Bogota, between December 2019 and 2022. Data on sex, age, admission diagnosis, length of stay in ERA room, education provided, and post discharge follow-up were collected. The main outcomes were evaluated through hospitalization requirement, ICU requirement, and post discharge improvement. RESULTS: 1785 patients were included during the study period. 57% were male; median age was 26.6 months (IQR: 11.8 to 40.6); length of stay in ERA room was 2.62 hours (IQR: 1.73 to 4.88); 91.65% of family members and/or caregivers received educational measures. CONCLUSIONS: This study describes the results of the implementation of the ERA room strategy; the low proportion of patients requiring hospitalization is evident. Additionally, the education provided to parents and caregivers on home management is relevant, as well as the post discharge follow-up of this cohort of patients with acute respiratory disease.

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BACKGROUND & AIMS: Tools for screening of nutrition risk in patients with cancer are usually validated against other screening instruments. Here with the performance of Malnutrition Screening Tool (MST) and Nutritional Screening Tool (NUTRISCORE) to identify the risk of malnutrition was assessed. A full nutritional evaluation and diagnosis following criteria from the Global Leadership Initiative of Malnutrition (GLIM) was the reference standard for the classification of malnutrition. METHODS: Diagnostic test prospective analysis of adult patients with a confirmed diagnosis of cancer. MST, NUTRISCORE and nutritional evaluation and diagnosis by GLIM criteria were independently performed within 24 h of admission to a 4th tier hospital in Bogotá, Colombia. RESULTS: From 439 patients the sensitivity and specificity of MST was 75% and 94% and of NUTRISCORE 45% and 97% respectively. The area under receiver operating characteristic (ROC) curves were 0.90 for MST and 0.85 for NUTRISCORE (p = 0.003). CONCLUSION: The MST showed a significantly better diagnostic performance over NUTRISCORE for detection of malnutrition risk at admission to hospital of patients with cancer.

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RESUMEN Introducción: Uno de los factores que influyen en la desnutrición hospitalaria es la incapacidad del paciente para alimentarse correctamente. Un bajo consumo de la dieta hospitalaria aumenta el riesgo a sufrir complicaciones de salud, además genera impacto económico y ambiental, producto del aumento de desperdicio de alimentos. Generar estrategias encaminadas a mitigar este problema debe ser prioridad para el sector salud. Objetivo: Identificar herramientas técnicas utilizadas para medir el consumo y/o desperdicio de alimentos en la dieta hospitalaria. Materiales y métodos: Búsqueda sistemática de estudios publicados en las bases de datos de EMBASE y MEDLINE a través de la plataforma Pubmed, en febrero del 2019, temporalidad 20 años. Se buscaron por términos controlados sobre dieta hospitalaria, desperdicio de alimentos y la satisfacción del paciente. Resultados: Se encontraron 410 artículos en inglés, español y portugués. Se seleccionaron 21 artículos para análisis de texto completo por cumplimiento de criterios de selección. Conclusiones: Las herramientas encontradas para la medición del desperdicio de alimentos se basaron principalmente en el pesaje, y la medición visual ya sea directa o por imágenes; otras aproximaciones incluyeron cuestionarios y métodos de múltiples componentes, la mayoría sin hacer discriminación del componente alimenticio desperdiciado.

ABSTRACT Introduction: One of the factors that influences hospital malnutrition is the inability of the patient to eat properly. A low consumption of the hospital diet increases the risk of suffering health complications, in addition to generating an economic and environmental impact, as a result of the increase in food waste. Generating strategies aimed at mitigating this problem should be a priority for the health sector. Objective: Identify technical tools used to measure food consumption and / or waste in the hospital diet. Materials and methods: Systematic search for studies published in the EMBASE and MEDLINE databases through the Pubmed platform was conducted in February 2019, searching articles published in the last 20 years. We searched for controlled terms on hospital diet, food waste, and patient satisfaction. Results: 410 articles were found in English, Spanish and Portuguese. Twenty-one articles were selected for full-text analysis by meeting the selection criteria. Conclusions: The tools found for the measurement of food consumption were based mainly on weighing, and visual measurement either direct or by images; other approaches included questionnaires and multi-component methods, most of the tools did not discriminate the food component wasted.

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Resumen Objetivo: Realizar la traducción y adaptación transcultural del componente de síntomas gastrointestinales (SGI) de la escala CTCAE versión 4.02 en pacientes ambulatorios tratados con quimioterapia en el Instituto Nacional de Cancerología en Bogotá. Métodos: Se realizó una búsqueda manual en medios electrónicos de escalas en idioma inglés o español que evaluarán la presencia, frecuencia o intensidad de SGI en pacientes oncológicos. La selección de los ítems fue efectuada por consenso informal de un comité técnico, el cual verificó la concordancia entre los principales SGI descritos en la literatura y los incluidos en la escala, ya que estos podrían afectar el estado nutricional. Posteriormente, para la adaptación transcultural, se siguieron los pasos y recomendaciones del manual ISPOR y del grupo de calidad de vida EORTC. La prueba piloto se efectuó en 30 pacientes seleccionados por conveniencia, quienes cumplieron los criterios de inclusión. Resultados: El 52% eran hombres; la edad promedio fue de 54,2 años (+/- 15,3 años). Los cánceres más frecuentes fueron: colorrectal (28%), estómago (16%) y mama (12%). Los 14 SGI incluidos en la escala fueron experimentados por todos los pacientes, por lo cual se conservaron, y no se requirió adicionar ningún otro. El tiempo promedio de aplicación del instrumento fue de 5 minutos y el 90% de los participantes lo consideró adecuado. Conclusiones: Se generó un instrumento de 14 ítems para medir SGI en pacientes oncológicos ambulatorios sometidos a quimioterapia, el cual es de rápida aplicación y utiliza lenguaje de fácil comprensión para el paciente. Aunque todavía quedan por definir sus propiedades clinimétricas.

Abstract Objective: To carry out the translation and transcultural adaptation of the gastrointestinal symptoms component (GIS) of the CTCAE, scale version 4.02, in outpatient patients treated with chemotherapy at the National Cancer Institute, Bogotá (Colombia). Methods: It was performed a manual search of scales on electronic media, in English or Spanish languages, which will evaluate the presence and intensity of GIS in oncological patients. The selection of the items was made by an informal consensus of a technical committee, which verified the concordance between the main GIS described in the literature and those included in the scale, all of which could affect the nutritional status. For transcultural adaptation, there were followed the steps and recommendations of the ISPOR Handbook, as well as those of the EORTC quality of life group. The pilot test was conducted in 30 patients selected for convenience, who met the inclusion criteria. Results: 52% were men; the average age was 54.2 years (+/-15.3 years). The most frequent cancers were: colorectal (28%), stomach (16%) and breast (12%). The 14 GIS included in the scale were experienced by all patients, so they were retained, and no other addition was required. The average time of application of the instrument was 5 minutes, and 90% of the participants considered it appropriate. Conclusions: A 14-item instrument was generated to measure GIS in cancer patients who undergo outpatient chemotherapy, which is of fast application and uses a language that is easily understood by patients. Its clinimetrics properties remain to be defined.

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La prevalencia de desnutrición en el paciente oncológico se encuentra entre el 20% y 40% al momento del diagnóstico, aumenta a 80% en estadios tardíos y es mayor en pacientes hospitalizados. La tamización del riesgo nutricional busca identificar a los pacientes desnutridos o con riesgo de desnutrición e iniciar oportunamente la recuperación del estado nutricional; este proceso incluye diferentes indicadores que requieren una interpretación precisa. El objetivo de la presente revisión narrativa es establecer cuáles son las herramientas de tamizaje nutricional más utilizadas y recomendadas para ser usada en oncología, según la literatura publicada y los diferentes órganos internacionales, así como el impacto en los desenlaces clínicos al realizar su aplicación.

The prevalence of malnutrition in cancer patients is between 20% and 40% at the time of diagnosis, increases to 80% in late stages and is greater in hospitalised patients. Nutritional risk screening seeks to identify malnourished patients or those at risk of malnutrition and to initiate timely nutritional recovery; this includes using indicators which require accurate interpretation. This narrative review was aimed at establishing which nutritional screening tools are most used and recommended for use in oncology, according to a search of the published pertinent literature and international bodies' guidelines, and ascertaining their impact on clinical outcomes.