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ObjectiveTo evaluate the intra- and inter-reliability and the ease of measuring the quadriceps muscle thickness using bedside ultrasound.MethodsThis is a prospective, observational study. The assessment of quadriceps muscle thickness was performed at two reference points and was quantified using portable B-mode ultrasound in two healthy volunteers. For standardization of measurements and validation of image collections, the team was trained through theoretical and practical classes, with a 6-hour workload.ResultsA total of 112 images were examined by the coach and compared with the trainees. Pearson's correlation analysis found an excellent relationship between the coach and all trainees (R2 > 0.90). The best association was between the coach and the dietitians (R2: 0.99; p < 0.001), and the worst association was between the coach and the medical trainees (R2: 0.92; p < 0.001). In the Bland-Altman comparison, the highest error rate found between coach and trainees was 5.12% (95% confidence interval [CI] 3.64-12.37), and the lowest was 1.01% (95%CI 0.72 - 2.58); the highest bias of the values described was -0.12 ± 0.19, and the lowest was -0.01 ± 0.04.ConclusionThe data analyzed showed a good correlation between the measurements made by the coach and trainees, indicating that ultrasound of the quadriceps muscle is a viable and easily applicable tool.

Pressure ulcer (PU) can be classified according to tissue impairment, etiology, healing time and tissue characteristics. Currently, it is the third type of adverse event most reported by the patient safety centers of health services in the country, according to the National Report of Incidents Related to Health Care. The classification and the identification of risk factors are essential for implementation of preventive and therapeutic actions in susceptible patients. Nutritional status is a fundamental piece for the prevention and development of PU, making it essential to integrate the interdisciplinary team in the prevention and treatment of PU, with a focus on quality, safety and patient experience. In this sense, the objective of this campaign is to disseminate knowledge, providing technical support for patient care and reducing PU rates. A mnemonic was developed with the word “CICATRIZATION”, in which each letter proposes steps that help in the identification of risk, assessment, treatment and monitoring of PU. Thus, the sequence of 12 steps established in this campaign is suggested as a measure to assist health professionals in this management

BACKGROUND: Weight loss and body composition changes are common in patients with pancreatic cancer. Computed tomography (CT) images are helpful to investigate body composition and its changes and to discriminate the different kinds of body tissues. Patients with pancreatic cancer routinely undergo CT scans. OBJECTIVE: To verify the association of muscle mass and visceral fat measured by CT with toxicity and survival of patients with pancreatic cancer. METHODS: We evaluated the imaging of the abdomen of all consecutive adult patients with pancreatic cancer treated between October 2007 and September 2015 in our service, to assess skeletal muscle mass and fat, intramuscular fat and visceral fat. We graded treatment toxicity symptoms according to the Common Toxicity Criteria of the United States National Cancer Institute (version 2.0). RESULTS: The study involved 17 patients, with a mean age of 63 (±10) years (range: 51-73 years). Eleven (65%) were male. The mean initial body mass index (BMI) was 26 kg/m2 (±3) and 23 kg/m2 (±3) after treatment. The mean weight loss was 10.0 kg (±6.8; 13%). Sarcopenia was present in 47% of patients, and it was not associated with significant differences in muscle mass, visceral fat, toxicity or survival. The mean skeletal muscle attenuation was 36 Hounsfield units, not associated with survival or treatment toxicity. Mean muscle mass was not associated with toxicity either. However, there was a significant inverse association between toxicity and visceral fat. CONCLUSION: Muscle mass had no impact on the survival or on treatment toxicity among the patients with pancreatic cancer. However, the visceral fat exerted a protective effect against the treatment toxicity. We stress the importance of further studies on visceral fat associated with prognosis and toxicity in cancer patients.