The SV of the MST showed good reliability and feasibility. The validity is moderate, and the MST could be considered a useful resource for early detection of malnutrition risk.

Background: Feeding difficulties and disorders are a common problem in the pediatric population, which involve a series of deficient behaviors about nutrition processes that can adversely affect psychomotor, psychosocial, and physical development of children. This study aimed to describe the frequency of feeding difficulties or disorders in pediatric patients with cancer. Methods: A prospective study which included 125 children from 1-19 years treated at the Department of Oncology of the Instituto Nacional de Pediatría, Mexico City, was conducted. The diagnosis of eating disorders and feeding difficulties was determined during the first 48 h since admission, and the age of the patient influenced the type of disorder and feeding difficulties. Results: Children older than 11 years presented more frequently an intense resistance of feeding because of discomfort pain (fear of feeding) than younger children (11.4 ± 4.7 vs. 7.4 ± 4.9, p ≤ 0.001). The most frequent alteration associated with malnutrition was loss of appetite (odds ratio [OR]: 8.8, confidence interval [CI] 95% 2.9-26.9, p<0.001), followed by fear of feeding (OR: 3.14, CI 95% 1.24-7.9, p=0.015), and the organic causes showed the highest risk for malnutrition (OR: 3.1, p=0.054). Conclusions: Over 90% of the studied population demonstrated at least one eating disorder or feeding difficulty. The principal effect is inadequate nutritional intake due to limited appetite and fear of feeding, which can result in undernutrition. For this reason, the identification of alterations in nutrition processes should be part of the comprehensive assessment of cancer patients.

Background: Feeding difficulties and disorders are a common problem in the pediatric population, which involve a series of deficient behaviors about nutrition processes that can adversely affect psychomotor, psychosocial, and physical development of children. This study aimed to describe the frequency of feeding difficulties or disorders in pediatric patients with cancer. Methods: A prospective study which included 125 children from 1-19 years treated at the Department of Oncology of the Instituto Nacional de Pediatría, Mexico City, was conducted. The diagnosis of eating disorders and feeding difficulties was determined during the first 48 h since admission, and the age of the patient influenced the type of disorder and feeding difficulties. Results: Children older than 11 years presented more frequently an intense resistance of feeding because of discomfort pain (fear of feeding) than younger children (11.4 ± 4.7 vs. 7.4 ± 4.9, p ≤ 0.001). The most frequent alteration associated with malnutrition was loss of appetite (odds ratio [OR]: 8.8, confidence interval [CI] 95% 2.9-26.9, p<0.001), followed by fear of feeding (OR: 3.14, CI 95% 1.24-7.9, p=0.015), and the organic causes showed the highest risk for malnutrition (OR: 3.1, p=0.054). Conclusions: Over 90% of the studied population demonstrated at least one eating disorder or feeding difficulty. The principal effect is inadequate nutritional intake due to limited appetite and fear of feeding, which can result in undernutrition. For this reason, the identification of alterations in nutrition processes should be part of the comprehensive assessment of cancer patients.

Purpose International twinning programs have been well-established between institutions in childhood cancer; and have led to pediatric cancer units in low- and middle-income countries (LMICs) adopting multidisciplinary forms of care. To advance nutritional care in LMICs, The International Initiative for Pediatrics and Nutrition (IIPAN) provided the structural framework and personnel for the delivery of nutritional care. We describe the impact of a newly established nutrition program on the delivery of nutritional care and nutrition-related clinical outcomes in children and adolescents undergoing treatment for cancer in Nicaragua and Honduras. Methods A prospective cohort (N = 126) collected clinical data over a two-year period. Collection of IIPAN’s nutritional services received during treatment, and clinical data were abstracted from medical charts and registered in REDCap database. Chi-square, ANOVA, and generalized linear mixed models were employed; P < 0.05 was considered statistically significant. Results Nutritional assessments led to a higher number of patients receiving recommended standard of care. Children classified as underweight during treatment, presented higher number of infections and toxicities, LOS and days of treatment delays during treatment. Overall, from the start to end of treatment, 32.5% of patients improved nutritional status, 35.7% maintained it and 17.5% worsened. Based in metrics, costs per consultation was under 4.80USD (Honduras) and 1.60USD (Nicaragua). Conclusion Integration and equitable access of the nutritional care process for all patients needs to be recognized as a component of the basic management in pediatric oncology care. IIPAN´s nutritional program demonstrates that nutritional care is economical and feasible in a limited resource setting.

Background Patients with systemic lupus erythematosus (SLE) may have an abnormal nutritional status, with alterations ranging from changes in body weight and composition associated with chronic glucocorticoid intake to a wasting syndrome associated with disease activity. Currently there is limited information on anthropometric characteristics and nutritional assessment of patients with SLE and the impact of malnutrition in these patients. Objectives This is an exploratory study. The objective was to perform anthropometric and nutritional assessment of hospitalized patients with SLE and to identify any association between these measures and length of hospital stay. Methods Patients with diagnosis of SLE who met the 2012 ACR/SLICC criteria, hospitalized in a single center between August 15, 2013 and January 15, 2014 were included. At hospitalization all patients were evaluated by a nutritionist, who collected anthropometric data, and calculate nutritional risk scores (Subjective Global Assessment (SGA) and nutritional risk index (NRI)), and by a rheumatologist who recorded the disease activity (SLEDAI 2K) and obtained the clinical data. The main outcome was duration of hospitalization, defined as the time until discharge or death. Results Twenty eight patients (24 women, 85.7%), with a mean age of 33.75±15.3 years were included. The time from diagnosis of SLE to the hospitalization was 12.21±10.9 years; according to SLEDAI (cutoff>6) 11 patients had active disease at the time of assessment. Mean of hospital stay was 9 days (min 2, max 33), none of the patients died during follow-up. Considering body mass index, 2 patients (7.1%) were underweight, 17 (78.6%) eutrophic, 6 (21.4%) overweight and 3 (10.7%) were obese. Fourteen patients (50%) had A in the SGA, 6 (21.4%) had B and 8 (28.6%) C. According to the NRI values, we defined four grades of nutrition-related risk: i) major risk (NRI<83.5); ii) moderate risk (NRI 83.5–97.5); iii) mild risk (NRI 97.5–100); iv) No risk (NRI >100). Nine patients (32.1%) were classified as no risk, 3 (10.7%) as mild risk, 6 (21.4%) as moderate risk, and 10 (35.7%) as major risk. None of the parameters had statistically significant correlation with the duration of hospital stay, however, when patients were classified according to the NRI in two groups (major and moderate risk vs mild and no risk) a longer stay among which were considered at higher risk was found, with a median length of hospital stay of 9 days (IQR 6.25-12.25) vs 5.5 days (IQR 2.75-8.5), p=0.036. Conclusions This study provides useful data about the characteristics of hospitalized patients with SLE. The nutritional risk index is outlined as a useful tool for the evaluation of these patients. We are currently conducting a follow-up study with a larger sample size to confirm the findings observed. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.6039