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1.
PLoS One ; 14(11): e0224540, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31774822

RESUMO

Cancer cachexia is common in patients with oesophagogastric cancer (OG) and is linked to overall survival (OS). One of the key components of cachexia is anorexia; it is not known whether anorexia impacts on OS and there is no method of routine screening in current practice. Diagnosis relies on patients describing the symptoms, clinicians diagnosing anorexia and acting upon it. Patients with oesophageal/gastroesophageal junction or gastric cancer were assessed using the Functional Assessment of Anorexia Cachexia Therapy Anorexia/Cachexia Subscale (FAACT A/CS). FAACT A/CS includes 12 questions validated previously to diagnose anorexia in patients with cancer. Of the 182 patients included, 69% scored ≤37/48 and were considered to be anorexic; FAACT A/CS was a better predictor of OS in metastatic patients than body mass index or weight loss in the six months prior to cancer diagnosis. The median OS of patients with FAACT A/CS scores of >37 was longer than patients with scores of ≤37 (19.3 months vs 6.7 months, Hazard Ratio [HR] 2.9, 95% Confidence Interval [CI] 1.4-6.0, p<0.0001). Patients with performance status (PS) 0-2 and FAACT A/CS >37 had substantially longer OS than those with PS 0-2 and FAACT A/CS ≤37 (18.7 months vs 7.9 months, HR 2.5 (95% CI 1.2-5.1, P<0.0001). The FAACT A/CS questionnaire allows clinicians to identify patients with anorexia who may benefit from early nutrition interventions. Importantly, this is the first study to show the association between anorexia and survival in patients with metastatic OG cancers. This will form the basis of future interventional studies to improve patient outcomes.


Assuntos
Adenocarcinoma/mortalidade , Anorexia/diagnóstico , Neoplasias Esofágicas/mortalidade , Junção Esofagogástrica/patologia , Avaliação Nutricional , Neoplasias Gástricas/mortalidade , Adenocarcinoma/complicações , Adenocarcinoma/patologia , Idoso , Idoso de 80 Anos ou mais , Anorexia/etiologia , Anorexia/mortalidade , Índice de Massa Corporal , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/patologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Autorrelato , Neoplasias Gástricas/complicações , Neoplasias Gástricas/patologia
2.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(9): 571-578, nov. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184380

RESUMO

Introduction: Psychological and neuroendocrine alterations are typical characteristics in anorexia nervosa patients. The role of adipokines and cytokines as mediators of body systems' adaptations to the patients' abnormal eating behavior is not well understood. The duration of disease seems to be a determinant of nutritional status and associated hormone changes. We aimed to assess whether alterations in adipokines, cytokines and cortisol do already exist in patients with a recent disease onset by means of a case-control study. Methods: Forty-one adolescent female patients on their first-episode and diagnosed with anorexia nervosa, were matched by age and socioeconomic status (SES) (1:1) with healthy girls. Leptin, soluble leptin receptor (sOB-R), adiponectin, cortisol, and the cytokines IL-1β, IL-2, IL-6 and TNF-alfa were examined. Results: The results showed reduced leptin and increased sOB-R and cortisol levels in AN patients. Adiponectin was also increased but opposite to the previous biomarkers did not correlate with BMI Z-score. Serum TNF-alfa and IL-2 showed significantly lower and higher values, respectively, in the AN patients than in the controls. Cortisol showed the strongest correlation with sOB-R (r = 0.436; P = 0.005). Conclusions: Our study confirms previous findings on adipokine and cortisol alterations in AN patients, while overall cytokine results did not show a clear disruption in AN patients with short disease duration. The results highlight the need to disentangle the role of the sOB-R in the interactions between leptin and cortisol secretion


Introducción: Las alteraciones psicológicas y neuroendocrinas son típicas de las pacientes con anorexia nerviosa (AN). El papel de las adipoquinas y citocinas como mediadores de la adaptación del organismo al comportamiento alimentario alterado no es bien conocido. La duración de la enfermedad parece ser un determinante del estado nutricional y de los cambios hormonales asociados. Nuestro objetivo ha sido establecer si existen alteraciones de adipoquinas, citocinas y cortisol en pacientes con un comienzo reciente de la enfermedad en un estudio caso-control. Métodos: Cuarenta y una chicas adolescentes diagnosticadas de AN en su primer episodio fueron emparejadas por edad y estado socioeconómico (1:1) con adolescentes sanas. Se midieron la leptina, el receptor soluble de leptina, la adiponectina, el cortisol y las citocinas IL-1β, IL-2, IL-6 y TNF-alfa. Resultados: Las pacientes con AN mostraron niveles reducidos de leptina y elevados de receptor de leptina y cortisol. La adiponectina también se observó elevada pero, al contrario que los otros marcadores, no correlacionó con el Z-score del índice de masa corporal. Las pacientes mostraron valores de TNF-alfa e IL-2 menores y mayores, respectivamente, que las controles. El cortisol y el receptor de leptina mostraron la correlación más fuerte de todas las observadas (r = 0,436; p = 0,005). Conclusiones: Se confirman los resultados previos de adipoquinas y cortisol en pacientes con AN. Sin embargo, los resultados globales de citocinas no muestran una alteración clara en pacientes con corta duración de la enfermedad. Los resultados apuntan la necesidad de desentrañar el papel del receptor soluble de leptina en las interacciones entre leptina y cortisol


Assuntos
Humanos , Feminino , Adolescente , Anorexia/diagnóstico , Anorexia/fisiopatologia , Análise Química do Sangue , Biomarcadores/análise , Leptina/sangue , Hidrocortisona/sangue , Citocinas/sangue , Estudos de Casos e Controles , Antropometria
3.
PLoS One ; 14(10): e0224354, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31648285

RESUMO

AIM: It is difficult to determine whether or not end-of-life care is necessary for frail older adults complaining of anorexia without underlying disease, such as cancer or organ failure. The main reason for this is the lack of the specification of the anorexia cause and no understanding of the cause-providing factor and the prognostic factor. This study aimed to clarify the cause of anorexia, and the determinant of the cause and recovery from anorexia. METHODS: Retrospective chart reviews were conducted on patients with anorexia without an underlying disease who were aged ≥65 years and visited the emergency department of a single tertiary care center between 2016 and 2017. Patient characteristics at hospital visit, the cause of anorexia, and diagnostic modalities were summarized. The diagnosis-providing rate, recovery rate, and the association between them were analyzed. RESULTS: Eighty-three patients (mean age 82.3 years; 50.6% male) were investigated. In 67 patients (81%), the causes of anorexia were identified, including 18 patients (22%) with infection, 13 (16%) with benign gastrointestinal diseases, and 7 (8%) with cardiovascular diseases. In 16 patients (19%), the causes of anorexia were not identified despite examinations. The modality that most contributed to diagnosis was plain computed tomography followed by blood tests. The value regarding information in history-taking and physical examinations was limited. Sixty-five patients (78%) recovered. Only 73% of patients with a definite cause recovered; all patients with an unknown cause recovered. CONCLUSIONS: Older adults with anorexia are not always at the end of life, and efforts to identify the cause are crucial. Moreover, it is vital to realize the limitations associated with the treatment of infections and cardiovascular diseases.


Assuntos
Anorexia/etiologia , Idoso , Idoso de 80 Anos ou mais , Anorexia/diagnóstico , Anorexia/epidemiologia , Feminino , Idoso Fragilizado/estatística & dados numéricos , Humanos , Masculino , Prognóstico , Estudos Retrospectivos
5.
Pediatr Blood Cancer ; 66(6): e27676, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30786157

RESUMO

BACKGROUND: Melatonin is a natural health product used for sleep disturbances. In preliminary studies of adults with advanced cancer, 20 mg of melatonin daily was associated with reduction in anorexia and weight loss-symptoms that also impact pediatric oncology patients. High doses of melatonin have not been studied in pediatrics. METHODS: This was a multicenter single-arm phase I dose-escalation study utilizing a 3 + 3 design to determine the safety and tolerability of escalating doses of melatonin in pediatric oncology patients with relapsed solid tumors. Melatonin was given for 8 weeks at three dose levels-0.075 mg/kg (maximum 5 mg), 0.15 mg/kg (maximum 10 mg), and 0.3 mg/kg (maximum 20 mg). RESULTS: Melatonin was well tolerated at all three dose levels with no significant adverse events or dose-limiting toxicities. The only grade 3/4 toxicities were myelosuppression, which was attributed to the concomitant chemotherapy and occurred at all dose levels. Weight gain occurred in seven of nine patients, with a median increase of 1.1 kg (range -3.3 to 4.5) or 3.4% (range -10.2 to 8.7), with two patients losing weight (one in dose level 1 and one level 3). CONCLUSIONS: Melatonin is well tolerated at a dose of 0.3 mg/kg (maximum 20 mg), in the pediatric population. This study provides the background for further study of high-dose melatonin in pediatric oncology patients.


Assuntos
Anorexia/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Antioxidantes/uso terapêutico , Melatonina/uso terapêutico , Neoplasias/tratamento farmacológico , Transtornos do Sono-Vigília/tratamento farmacológico , Perda de Peso/efeitos dos fármacos , Adolescente , Anorexia/induzido quimicamente , Anorexia/diagnóstico , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Masculino , Dose Máxima Tolerável , Neoplasias/patologia , Prognóstico , Transtornos do Sono-Vigília/induzido quimicamente , Transtornos do Sono-Vigília/diagnóstico
6.
Lab Med ; 50(3): 268-272, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-30615141

RESUMO

OBJECTIVE: To improve clinical laboratory contribution to the treatment of primary care patients with anorexia through automated computerized strategies. METHODS: We recorded the number of laboratory requests due to anorexia; the demographic data, laboratory values, and presence of pathological values for the applicable patients. In a prospective study, the laboratory information management system (LIMS) automatically added thyroid-stimulating hormone (TSH) and/or ferritin testing when it was not requested by general practitioners for all primary care patients with anorexia who were younger than 16 years. RESULTS: A total of 3562 patients underwent laboratory testing due to anorexia, of whom 47% were younger than 16 years. The tests in which the results most frequently were abnormal were hemoglobin, ferritin, and TSH. TSH results were abnormal in 20% of patients younger than 16 years. Through the intervention, we detected 3 low ferritin values and 7 cases of pathological TSH levels. CONCLUSIONS: The LIMS required TSH and ferritin testing in young patients even when not requested, potentially avoiding the adverse effects of iron deficiency and thyroid disorders on neurological development and cognition in those patients.


Assuntos
Anorexia/diagnóstico , Automação/métodos , Testes Diagnósticos de Rotina/métodos , Ferritinas/sangue , Gestão da Informação em Saúde/métodos , Atenção Primária à Saúde/métodos , Tireotropina/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
7.
Nutr Cancer ; 71(3): 409-417, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30273069

RESUMO

Lung cancer (LC) has a high rate of anorexia, which negatively affects quality-of-life and prognosis; however prevalence values may vary as per diagnostic test. There is no standard for anorexia diagnosis, currently the anorexia cachexia scale (A/CS) has been proposed as a tool for diagnosing anorexia with a consensus cutoff value of ≤24, nonetheless a validated cutoff value is required. The A/CS was evaluated in advanced Non-Small Cell Lung Cancer (NSCLC) patients to establish a cutoff value. The appetite item from the QLQ-C30 questionnaire and survival served as a standard reference. The cutoff value was associated with clinical and nutritional characteristics along with quality-of-life. Three hundred and twelve (312) NSCLC patients were evaluated. The mean A/CS value was 31 ± 9 and the identified cutoff value was 32.5 (sensitivity: 80.3% and specificity: 85%). The proportion of anorexia accurately diagnosed with the cutoff value of 24 was 26%, while with 32 it was 50%. The A/CS cutoff value of 32 was associated with clinical parameters, nutritional consumption, and quality-of-life, and independently associated with overall survival. A score of ≤32 in the A/CS is proposed for anorexia diagnosis in order to identify patients at risk of complications involving malnutrition related to LC.


Assuntos
Anorexia/diagnóstico , Caquexia/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/complicações , Neoplasias Pulmonares/complicações , Adenocarcinoma/complicações , Adenocarcinoma/tratamento farmacológico , Idoso , Anorexia/terapia , Apetite , Caquexia/terapia , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Comportamento Alimentar , Feminino , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Valores de Referência , Inquéritos e Questionários
8.
Heart ; 105(1): 74-88, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30282641

RESUMO

CLINICAL INTRODUCTION: A 76-year-old man with 50 years of smoking history was diagnosed in 2012 with diffuse interstitial lung disease, with radiological data of usual interstitial pneumonia. He came to the emergency room presenting with progression of dyspnoea for 1 week, concomitant with loss of 5 kg of weight, anorexia and poor general condition. He had tachypnoea at rest (30 breaths/min), peripheral cyanosis, speech interfered by cough and breathlessness, baseline oxygen saturation 90%, heart rate 40 beats/min and blood pressure 130/70 mm Hg. Chest X-ray was performed and there was basal atelectasia of the right lung. ECG and urgent echocardiogram (transthoracic echocardiogram, TTE) were also performed (figure 1). QUESTION: Which of the following best explains the patient's situation?heartjnl;105/1/74/F1F1F1Figure 1(A) ECG. (B) Long-axis parasternal view from the transthoracic echocardiogram (TTE). (C) Four-chamber view from the TTE.Acute pulmonary embolismNon-ST elevation myocardial infarctionCardiac lymphomaCardiac myxomaMobitz type II AV block.


Assuntos
Anorexia , Dispneia , Neoplasias Cardíacas , Doenças Pulmonares Intersticiais , Linfoma Difuso de Grandes Células B , Idoso , Anorexia/diagnóstico , Anorexia/etiologia , Diagnóstico Diferencial , Dispneia/diagnóstico , Dispneia/etiologia , Ecocardiografia/métodos , Eletrocardiografia/métodos , Evolução Fatal , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/fisiopatologia , Humanos , Pulmão/diagnóstico por imagem , Doenças Pulmonares Intersticiais/complicações , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/fisiopatologia , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/fisiopatologia , Masculino , Tomografia Computadorizada por Raios X/métodos , Perda de Peso
9.
Clin Nutr ESPEN ; 26: 84-90, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29908689

RESUMO

BACKGROUND: Experiencing loss of appetite after cardiac surgery is often noted during daily care and has been described by several studies. However, no information is available on either energy needs or spontaneous food intake following aortic valve replacement surgery. The goal of this study was to assess the risk of early postoperative undernutrition following aortic valve replacement in a group of patients who were preoperatively well-nourished. METHODS: Anthropometrics data (body mass index, fat free mass index, albuminemia and prealbuminemia, extracellular water), energy balance and appetite were assessed in a cross-over prospective observational study. . Each subject was enrolled in two procedures: surgery and routine coronary angiograms which were used for control matched assessment. Data were assessed during the pre-procedure period (d-15 to d-1) and the post-procedure period (d0 to d+4). Energy expenditure was determined by indirect calorimetry. RESULTS: 15 patients median aged 73 years old [65-77] were included in the study. In post-surgery period, weight and extracellular water were increased and correlated (r2 = 0.571, p = 0.003). CRP was increased from 2 [2;3] to 91 [73;138] (p = 0.001). Ingested calories decreased from 1451 [1272-1640] kcal to 372 [22-528] kcal (p = 0.001) while energy expenditure was increased from 1358 [1180-1559] kcal to 1613 [1472-1670] kcal (p = 0.002). A severe loss of appetite was noted (p = 0.011). None of these changes were observed in the control phase. CONCLUSION: Energy balance was strongly negative after cardiac surgery. Cardiac surgery increased endogenous metabolism by 20% and a severe loss of appetite decrease food intake by 75%, which does not make it possible to compensate for the increase in resting energy expenditure.


Assuntos
Anorexia/etiologia , Valva Aórtica/cirurgia , Ingestão de Alimentos , Metabolismo Energético , Implante de Prótese de Valva Cardíaca/efeitos adversos , Desnutrição/etiologia , Estado Nutricional , Idoso , Anorexia/diagnóstico , Anorexia/fisiopatologia , Anorexia/psicologia , Regulação do Apetite , Estudos Cross-Over , Ingestão de Energia , Comportamento Alimentar , Feminino , Humanos , Estudos Longitudinais , Masculino , Desnutrição/diagnóstico , Desnutrição/fisiopatologia , Desnutrição/psicologia , Valor Nutritivo , Projetos Piloto , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
10.
BMJ Case Rep ; 20182018 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-29866670

RESUMO

We report the case of a 15-year-old female patient suffering from progressive anorexia, weight loss and recurrent abdominal pain, initially diagnosed as anorexia nervosa. She eventually presented with severe malnutrition and acute bowel obstruction, revealing a mass of the transverse colon. A well-differentiated Lieberkühn adenocarcinoma was established by histology. The patient underwent transverse and right colectomy and was treated with adjuvant chemotherapy. Colorectal cancer (CRC) is predominantly a disease of older adults and is extremely rare in children and adolescents. Seldom suspected, it is more likely to be diagnosed at an advanced stage, with unfavourable tumour histology and poor outcome. Young patients diagnosed with CRC should receive genetic counselling regardless of their family history or tumour type. This reports' take-home message is that recurrent and persistent digestive symptoms in the young should alert physicians and lead to further investigations.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Anorexia Nervosa/diagnóstico , Anorexia/diagnóstico , Neoplasias Colorretais/diagnóstico por imagem , Erros de Diagnóstico , Obstrução Intestinal/diagnóstico por imagem , Desnutrição/diagnóstico , Adenocarcinoma/complicações , Adenocarcinoma/cirurgia , Adolescente , Anorexia/etiologia , Quimioterapia Adjuvante , Colectomia , Colo Transverso , Neoplasias Colorretais/complicações , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Intestino Delgado , Desnutrição/etiologia , Radiografia Abdominal , Tomografia Computadorizada por Raios X
11.
Sleep Med ; 48: 113-116, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29890462

RESUMO

OBJECTIVE: Sleep wake cycle and eating patterns undergo major changes throughout life and have been proved to be very correlated. Eating disorder prevalence is increasing and sleep problems are very common among them. The current study is concerned with investigating the sleep pattern in anorexia and bulimia female patients using both subjective and objective assessment tools. METHODS: A cross sectional study of sleep patterns using structured sleep disorder questionnaire and full night polysomnography in 23 female patients with bulimia and anorexia, patients aged 18-45 years not on any treatment for a month at least, compared to a sex and age matched control group (20 participants), all cases were collected from the Institute of Psychiatry, Ain Shams University over 18 months interval. RESULTS: Significant affection of most domains of sleep measured by subjective and objective assessment tools in patients compared with the control group. DISCUSSION: Sleep is equally affected in bulimia and anorexia patients, confirming that sleep and eating disorders are highly correlated. Sleep may be a clinical marker in eating disorders.


Assuntos
Anorexia/epidemiologia , Bulimia Nervosa/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Adulto , Anorexia/diagnóstico , Bulimia Nervosa/diagnóstico , Estudos Transversais , Depressão/psicologia , Egito/epidemiologia , Feminino , Humanos , Polissonografia , Prevalência , Inquéritos e Questionários
12.
J Vis Exp ; (135)2018 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-29806838

RESUMO

Rodents develop activity-based anorexia (ABA) when exposed to a restricted feeding schedule and allowed free access to a running wheel. These conditions lead to a life-threatening reduction in body weight. However, rodents exposed to only one of these conditions ultimately adapt to re-establish normal body weight. Although increased running coupled with reduction in voluntary food intake appear paradoxical under ABA conditions, ABA behavior is observed across numerous mammalian species. The ABA paradigm provides an animal model for anorexia nervosa (AN), an eating disorder with severe dysregulation of appetite-behavior. Subjects are singly housed with free access to a running wheel. Each day, the subject is offered food for a limited amount of time. During the course of the experiment, a subject's body weight decreases from high activity and low caloric intake. The duration of the study varies based on how long food is offered daily, the type of food offered, the strain of mouse, if drugs are being tested, and environmental factors. A lack of effective pharmacological treatments for AN patients, their low quality of life, high cost of treatment, and their high mortality rate indicate the urgency to further research AN. We provide a basic outline for performing ABA experiments with mice, offering a method to investigate AN-like behavior in order to develop novel therapies. This protocol is optimized for use in Balb/cJ mice, but can easily be manipulated for other strains, providing great flexibility in working with different questions, especially related to genetic factors of ABA.


Assuntos
Anorexia/diagnóstico , Condicionamento Físico Animal/psicologia , Animais , Modelos Animais de Doenças , Feminino , Masculino , Camundongos
13.
Appl Physiol Nutr Metab ; 43(10): 979-987, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29590534

RESUMO

Our previous study showed that interleukin-6 (IL-6) is associated with suppression of appetite after high-intensity exercise (HIEX), but an independent role in food intake (FI) was not defined. We hypothesized that IL-6 suppresses appetite and FI, independently of appetite hormones, after HIEX in normal-weight (NW) boys. We investigated the effect of HIEX, with and without the inflammation inhibitor ibuprofen (IBU), on IL-6, other biomarkers of inflammation and appetite, FI, and ratings of appetite in NW boys. Fifteen NW boys (aged 13-18 years) were randomly assigned in a crossover design to 4 sessions: (i) water and rest, (ii) IBU and rest, (iii) water and HIEX, and (iv) IBU and HIEX. HIEX consisted of three 10-min bouts of exercise at 75% of maximal oxygen uptake with 90 s of active rest between bouts. IBU (300 mg) was given as a liquid suspension. FI, ratings of appetite, and plasma biomarkers of appetite, inflammation, stress, and glucose control were measured. FI was not affected by HIEX or IBU. Appetite increased over time (p = 0.002) but was lower after HIEX (p < 0.001) and not affected by IBU. HIEX, but not IBU, resulted in higher levels of IL-6 (p < 0.001) and cortisol (p < 0.001) and lower active ghrelin (p < 0.001). IL-6 correlated with active ghrelin (r = 0.37; p = 0.036) and cortisol (r = 0.26; p = 0.049). An independent role for IL-6 in appetite suppression was not supported. However, IL-6 was correlated with active ghrelin and cortisol, thus potentially mediating appetite via these interactions.


Assuntos
Comportamento do Adolescente , Anorexia/sangue , Regulação do Apetite , Ingestão de Alimentos , Exercício Físico , Interleucina-6/sangue , Adolescente , Anorexia/diagnóstico , Anorexia/etiologia , Anorexia/psicologia , Biomarcadores/sangue , Estudos Cross-Over , Inibidores de Ciclo-Oxigenase/administração & dosagem , Ingestão de Líquidos , Grelina/sangue , Humanos , Hidrocortisona/sangue , Ibuprofeno/administração & dosagem , Masculino , Ontário
14.
Psychiatry Res ; 260: 495-499, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29291574

RESUMO

There is a substantial body of literature reporting a negative association between religiosity and psychiatric symptoms. In the context of eating disorders, however, this relationship appears to be reversed. The few studies exploring the relationship between religiosity and eating disorders have mostly focused on the Judeo-Christian religious traditions in Western nations. The present study examines this relationship among Muslim college women from the United Arab Emirates (UAE). All participants (N = 1069) independently completed the religious commitment inventory (RCI-10) and the eating attitudes test (EAT-26). As hypothesised, there was a positive association between religiosity and eating disorders symptoms. Furthermore, those scoring above the EAT-26 cut-off reported significantly greater levels of religiosity. These findings suggest that heightened religiosity among young Emirati women may represent a vulnerability factor for eating disorders. Preventative initiatives in the UAE should consider focusing on religiosity.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/etnologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Islamismo/psicologia , Religião e Psicologia , Estudantes/psicologia , Adolescente , Adulto , Anorexia/diagnóstico , Anorexia/etnologia , Anorexia/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Humanos , Masculino , Estudos Prospectivos , Religião , Inquéritos e Questionários , Emirados Árabes Unidos/etnologia , Universidades/tendências , Adulto Jovem
15.
Clin J Oncol Nurs ; 22(1): 63-68, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29350696

RESUMO

BACKGROUND: Cancer anorexia-cachexia syndrome compromises physical function and nutritional and emotional well-being. Systematic screening followed by nutrition referral for appropriate interventions is rare.
. OBJECTIVES: The purpose of this study was to pilot a screening process followed by nutritional assessment and intervention when warranted for patients with lung malignancies.
. METHODS: Adult patients with lung malignancies were invited to complete the 12-item Anorexia/Cachexia Scale (A/CS-12) on the day of chemotherapy initiation in ambulatory infusion. Those who scored at a preset threshold were referred to nutrition services for a comprehensive assessment and intervention plan. Those who scored better than the threshold completed the A/CS-12 at each infusion visit for as many as 16 weeks. 
. FINDINGS: 90 participants enrolled, and 46 scored in a moderate-to-severe-risk category; of those, 42 were referred to nutrition services.


Assuntos
Assistência Ambulatorial/métodos , Anorexia/diagnóstico , Anorexia/terapia , Caquexia/diagnóstico , Caquexia/terapia , Detecção Precoce de Câncer , Neoplasias Pulmonares/complicações , Idoso , Idoso de 80 Anos ou mais , Anorexia/etiologia , Caquexia/etiologia , Diálise/métodos , Feminino , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional , Encaminhamento e Consulta
16.
Turk J Pediatr ; 60(5): 608-611, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30968629

RESUMO

Özyurt G, Çagan-Appak Y, Karakoyun M, Eliaçik K, Baran M. Father`s role in infantile anorexia. Turk J Pediatr 2018; 60: 608-611. Organic diseases account for only 16-30% of early feeding disorders. During the infancy period, mother-child relationship is in the center of feeding and disturbances in this relationship can also cause feeding disorders. Infantile anorexia (IA) usually begins within the first three years of age, but it has most commonly been observed to emerge between 9 and 18 months of age, a time during which babies transition to spoon and self-feeding. It is also worth noting that babies start to gain autonomy during this time frame. The present study discusses the case of an 8-month-old girl diagnosed with IA after ruling out food allergies, gastro-esophageal reflux disease, malrotation, and neurological problems. The patient was diagnosed with IA was treated with the relational regulation of parents and active participation of her father during the treatment process. It is found that mother-child relational disturbances and conflicts decreased dyadic reciprocity and non-appropriate affects in feeding times are associated with IA. Effective treatment strategies for non-organic feeding disorders might be developed by giving importance to maternal mental health and providing paternal involvement in baby caregiving.


Assuntos
Anorexia/diagnóstico , Conflito Familiar/psicologia , Pai/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Relações Pais-Filho , Anorexia/etiologia , Anorexia/terapia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Feminino , Humanos , Lactente , Masculino , Psicoterapia/métodos
18.
Soins Pediatr Pueric ; 38(298): 34-37, 2017.
Artigo em Francês | MEDLINE | ID: mdl-28890102

RESUMO

Anorexia in young prepubescent patients is often linked to clinical signs occurring in early childhood. While therapies offer somatic, dietetic or medication-based treatments, the psychotherapeutic approach gives children and their families the opportunity to talk.


Assuntos
Comportamento do Adolescente/psicologia , Anorexia/diagnóstico , Anorexia/terapia , Adolescente , Anorexia/psicologia , Criança , Humanos , Fatores de Risco
19.
Clin Geriatr Med ; 33(3): 315-323, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28689565

RESUMO

Older people often experience loss of appetite and/or decreased food intake that, unavoidably, impact energy metabolism and overall health status. The association of age-related nutritional deficits with several adverse outcomes has led to the recognition of a geriatric condition referred to as "anorexia of aging." Anorexia is an independent predictor of morbidity and mortality both in the community and across clinical settings. Multidimensional interventions within personalized care plans currently represent the most effective option to ensure the provision of adequate amounts of food, limit weight loss, and prevent adverse health outcomes in older adults.


Assuntos
Envelhecimento/fisiologia , Anorexia , Idoso , Anorexia/diagnóstico , Anorexia/etiologia , Anorexia/fisiopatologia , Anorexia/terapia , Gerenciamento Clínico , Avaliação Geriátrica/métodos , Humanos , Estado Nutricional
20.
Curr Opin Clin Nutr Metab Care ; 20(5): 340-345, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28598896

RESUMO

PURPOSE OF REVIEW: Cancer anorexia is a negative prognostic factor and is broadly defined as the loss of the interest in food. However, multiple clinical domains contribute to the phenotype of cancer anorexia. The characterization of the clinical and molecular pathophysiology of cancer anorexia may enhance the efficacy of preventive and therapeutic strategies. RECENT FINDINGS: Clinical trials showed that cancer anorexia should be considered as an umbrella encompassing different signs and symptoms contributing to appetite disruption in cancer patients. Loss of appetite, early satiety, changes in taste and smell are determinants of cancer anorexia, whose presence should be assessed in cancer patients. Interestingly, neuronal correlates of cancer anorexia-related symptoms have been revealed by brain imaging techniques. SUMMARY: The pathophysiology of cancer anorexia is complex and involves different domains influencing eating behavior. Limiting the assessment of cancer anorexia to questions investigating changes in appetite may impede correct identification of the targets to address.


Assuntos
Anorexia/etiologia , Hipotálamo/fisiopatologia , Modelos Neurológicos , Neoplasias/fisiopatologia , Transtornos do Olfato/fisiopatologia , Distúrbios do Paladar/fisiopatologia , Animais , Anorexia/diagnóstico , Anorexia/prevenção & controle , Regulação do Apetite , Humanos , Hipotálamo/diagnóstico por imagem , Neoplasias/diagnóstico , Neuroimagem , Transtornos do Olfato/diagnóstico por imagem , Transtornos do Olfato/etiologia , Transtornos do Olfato/terapia , Prognóstico , Resposta de Saciedade , Distúrbios do Paladar/diagnóstico por imagem , Distúrbios do Paladar/etiologia , Distúrbios do Paladar/terapia
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