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There was highly significant increase in the fibrinogen level, visceral and subcutaneous abdominal fat in the obese group with insignificant sex differences. Fibrinogen had a significant positive correlation with the different adiposity markers, blood pressure, visceral and subcutaneous fat. Visceral adipose tissue is a stronger predictor for cardiovascular risk compared to subcutaneous fat.

Background and aims Oral nutritional supplements (ONS) are considered a cornerstone in the treatment plan of malnutrition in cancer patients. However, the prevalence of inappropriate prescription of ONS is high. In this study, we aim to investigate the effect of inappropriate oral nutritional supplementation (consisting of prescription of ONS without evident clinical indication, or the absence of ONS when at risk of malnutrition) on the quality of life of cancer outpatients. Methods A cross-sectional comparative study was conducted in 104 cancer outpatients, receiving ONS without prior malnutrition risk screening (n = 51), and patients not receiving ONS (n = 53). Nutritional risk screening was performed using the abridged patient-generated subjective global assessment (ab-PG-SGA). The quality of life was assessed using EORTC QLQ-C30 version 3.0 questionnaire. Multivariate analysis was conducted to determine the predictors of quality-of-life scales. Age (years), malnutrition (ab-PG-SGA scores), BMI (kg/m2), TSF (mm), MUAC (cm), ONS (yes, no) were entered into the linear regression analysis as predictors (backward stepwise linear regression analysis). Results The prevalence of malnutrition risk (ab-PG-SGA ≥ 6) was 74%. The median score of the ab-PG-SGA for ONS receiving group was significantly higher (p = 0.045). Furthermore, univariate analysis showed that the scores of the global health status (QoL) and the role functioning (RF) scales were significantly lower for the ONS receiving group (p = 0.020 and p = 0.016, respectively). Multivariately, malnutrition, inappropriate ONS prescription, and triceps skin fold were found to be predictors of the RF scale, while malnutrition was the only predictor for the QoL. Conclusion The inappropriate ONS prescription does not improve nutritional status or quality of life of cancer outpatients.

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Background: Neutropenic enterocolitis (NEC) is a life-threatening disease with substantial morbidity and mortality, seen primarily in patients with hematologic malignancies. The frequency of NEC has increased with the widespread use of chemotherapeutic agents such as the taxanes, which cause severe gastrointestinal mucositis. Methods: This was a retrospective study at the National Cancer Institute, Cairo University. The computerized records were screened for ultrasound or computerized tomographic scan requests for abdominal pain for all Acute myeloid pediatrics inpatients (2012-2016). Retrospective case analysis was used to collect clinical data for patients with features of NEC. D 30 Mortality was reported. Results: The incidence of NEC among our inpatients was 24% (49/203). Forty-Three children had radiologically confirmed Typhlitis, and 6 had clinical features alone. Most (93%) patients were profoundly neutropenic (ANC less than 100). All of the patients received conservative management. All of them needed ICU admission. Eighteen children had a variable period of bowel rest, including 12 patients who were supported with total parenteral nutrition. Three patients had laparotomy that revealed extensive colonic bowel necrosis (1), perforated bowel loop (1), and a perforated appendix (1). Two out of three cases of Laparotomy were diagnosed with Mucormycosis. 30-Days mortality was 44.8% (22/49). Relapsing Typhlitis in subsequent courses was observed in 6/27 (22%) patients. Fulminant gram-negative sepsis without surgical intervention was the leading cause of death in this cohort. NEC related mortality was significantly higher among patients receiving high-risk protocol with more intensive chemotherapy and in patients with other Co-Morbidities [chest infections and/ or Cardiac affection] with a P-value of 0.005 and 0.037 respectively. Also, mortality was increased among patients with more than 2 presenting clinical symptoms with a P-value of 0.01. Conclusion: Although surgical intervention should be reserved for specific complications, its delay increases the incidence of NEC related mortality. Though rare, fungal infection should be suspected especially in cases with worsening signs of typhlitis despite broad antimicrobial coverage. Early management and better supportive care of underlying Co-morbid conditions can decrease NEC related mortality. Disclosures No relevant conflicts of interest to declare.

BackgroundNeutropenic enterocolitis (NEC) is a life-threatening disease with substantial morbidity and mortality, seen primarily in patients with hematologic malignancies. The frequency of NEC has increased with the widespread use of chemotherapeutic agents such as the taxanes, which cause severe gastrointestinal mucositis.MethodsThis was a retrospective study at the National Cancer Institute, Cairo University. The computerized records were screened for ultrasound or computerized tomographic scan requests for abdominal pain for all acute myeloid pediatrics inpatients (2012–2016). Retrospective case note analysis was used to collect clinical data for patients with features of Typhlitis. D 30 morbrtality was reported.ResultsThe incidence of NEC among our inpatients was 24% (49/203). Forty-three children had radiologically confirmed typhlitis, and six had clinical features alone. Most (93%) patients were profoundly neutropenic (ANC <100). All of the patients were subjected to conservative management. All of them needed ICU admission. Eighteen children had a variable period of bowel rest, including 12 patients who were supported with total parenteral nutrition. Three patients had laparotomy that revealed extensive colonic bowel necrosis (1), perforated bowel loop (1), and a perforated appendix (1).Two out of three cases of Laparotomy were diagnosed with Mucormycosis. 30-Days mortality was 44.8% (22/49).Relapsing typhlitis in subsequent courses was observed in 6/27 (22%) patients. Fulminant Gram-negative sepsis without surgical intervention was the leading cause of death in this cohort.ConclusionThe diagnosis of typhlitis was based on clinical features, supported by radiologic evidence in almost half of the study group. Surgical intervention should be reserved for specific complications or where another surgical pathologic condition cannot reasonably be ruled out. Though rare, fungal infection should be suspected specially in cases with worsening signs of typhlitis despite broad antimicrobial coverage.Disclosures All authors: No reported disclosures.