Considering the implications of adverse effects of chemotherapy (CT) and the potential impact of diet on patients’ recovery, this study aimed to prospectively evaluate the association between the consumption of food groups, patients’ Dietary Inflammatory Index (DII®) scores, and their nutritional status. Anthropometric and dietary assessments of 55 women with breast cancer (BC) were performed at three time points. T0 is the time point after the first CT cycle, T1 is the time point after the intermediate CT cycle, and T2 is the time point after the last CT cycle. We identified a significant increase in weight, body mass index, and waist circumference during CT. Consumption of poultry and eggs was higher in T1 when compared to T2, while consumption of total fruit and total vegetables was higher at T0 compared to T1 and T2. The diet became more pro-inflammatory over the course of treatment (X2(2) = 61.127), and was related to higher abdominal adiposity. Total fruit (T0: R2 = 0.208, T1: R2 = 0.095, T2: R2 = 0.120) and total vegetable consumption (T0: R2 = 0.284, T1: R2 = 0.365, T2: R2 = 0.580) predicted DII® change at the three-time points. Meanwhile, consumption of total grains was significantly associated only with T1 (R2 = 0.084) and T2 (R2 = 0.118), and consumption of simple sugars was significantly associated only with T0 (R2 = 0.137) and T1 (R2 = 0.126). Changes in food consumption led to an increase in the inflammatory profile of the diet, suggesting the necessity to improve the guidelines during and after CT. These results reinforce the need to promote healthier eating practices in concert with maintaining a healthy nutritional status in women with BC treated with CT.

BackgroundSince the release of linezolid vancomycin has been downgraded as an alternative in the treatment of central nervous system (CNS) infections caused by Gram-positive bacteria on account of its bad penetration and high incidence of nephrotoxicity. There are no studies with enough patients to support this trend.PurposeTo evaluate the efficacy and safety of vancomycin in CNS infections, and the impact of monitoring its pharmacokinetics.Material and methodsDescriptive retrospective study which included all patients with CNS infections treated with vancomycin and monitored. Patients aged under 18 and those who received less than 5 days’ treatment with vancomycin were excluded.ResultsA total of 62 patients were included, 39 with previous surgical intervention (SI) in the CNS.The most common diagnoses in the group with prior SI were bacterial meningitis (51%), fistula of cerebrospinal fluid (CSF) (21%) and shunt infection (21%). All had baseline neurological disease – neoplasms (46.2%) and subarachnoid haemorrhage (25.6%).Most patients without prior SI (n = 23) were diagnosed with bacterial meningitis (n = 21) and just 2 with a brain abscess. The infective pathogen was isolated in 39 samples of CSF. All isolated microorganisms were sensitive to vancomycin. 63.7% of the isolated microorganisms were coagulase-negative Staphylococcus, with a MIC = 2 in 23.7%.The initial and adjusted mean doses of vancomycin were 35.6 ± 9.3 mg/kg/day and 39.9 ± 15.2 mg/kg/day respectively. The median initial and adjusted Cmin were 10.04 (6.16) mcg/ml and 14.67 (3.66) mcg/ml respectively.Laboratory-confirmed CSF clearance was obtained in 26 of the 39 isolates, 73.1% during the first 10 days of treatment.The overall mortality was 5.8%, but only one death was related to the CNS infection.Although Cmin above 20 mcg/ml was recorded in 15 patients, none developed nephrotoxicity.ConclusionVancomycin is still an agent of choice for CNS infections. Vancomycin trough concentrations of 15–20 mcg/ml are recommended to achieve clinical effectiveness for CNS infections without causing nephrotoxicity.References and/or acknowledgementsNo conflict of interest.

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Context: The teaching of Humanization in the context of Nursing education is fundamental to value the human, individual and ethical dimension of Nursing Care. Objective: To identify strategies in the teaching of Humanization of Nursing Care. Methodology: Scoping Review performed on the EBSCO Host), B-On, EBSCO Discovery Science and WEB OF SCIENCE databases. The descriptors used were: “Humanization Care”; Caring; Teaching; Nurs*. Papers available in full text, peer-reviewed published in the last 5 years were included. Results: Of the 19 selected articles, the importance of active methodologies and simulation using Debriefing is highlighted. Conclusion: Strategies that allow the development of reflection, communication and relationship and group dynamics, as well as the strengthening of the teacher/student relationship seem to have some evidence of effectiveness in the teaching of Humanization, however, future research is needed with research designs with more evidence.