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1.
Medicine (Baltimore) ; 98(40): e16950, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577697

RESUMO

BACKGROUND: Anorexia is a common cause of malnutrition and is associated with negative effects on the quality of life (QOL) for patients with cancer. Management of appetite is the key to improving both the QOL and the prognosis for such patients. Yukgunja-tang (YGJT) is a traditional herbal medicine extensively prescribed in Korea as a remedy for various gastrointestinal syndromes. Currently, no standardized herbal medicine treatment exists for patients with cancer who are suffering from anorexia after surgery, chemotherapy, and/or radiotherapy. For that reason, this study aims to examine the efficacy and the safety of using YGJT to treat anorexia in such patients and to establish whether or not YGJT can be recommended as the primary therapy. METHODS: We will enroll 52 cancer patients diagnosed with anorexia. The enrolled participants will be randomly allocated to 2 groups: The control group will receive nutrition counseling, and the YGJT group will receive nutrition counseling and be administered YGJT at a dose of 3 g twice a day for 4 weeks (a total of 56 doses of 3.0 g per dose). The primary outcome of this study is the change in the score on the anorexia/cachexia subscale (A/CS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes are the changes in the FAACT score with the A/CS score excluded, the score on the Visual Analogue Scale (VAS) for appetite, the weight and the body mass index (BMI), and laboratory tests for compounds such as leptin, tumor necrosis factor-α (TNF-α), ghrelin, and IL-6. All variables related to the safety assessment, such as vital signs, electrocardiography results, laboratory test results (CBC, chemistry, urine test), and adverse events, will be documented on the case report form (CRF) at every visit. CONCLUSION: This study is the first randomized controlled trial to investigate the efficacy and the safety of using YGJT for treating patients with cancer-related anorexia in Korea. We designed this study based on previous research about YGJT. This study will serve as a pilot and provide data for planning further clinical trials on herbal medicine and cancer-related anorexia. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), Republic of Korea, ID: KCT0002847. Registered retrospectively on 3 April 2018.


Assuntos
Anorexia/tratamento farmacológico , Anorexia/etiologia , Caquexia/tratamento farmacológico , Caquexia/etiologia , Medicamentos de Ervas Chinesas/uso terapêutico , Neoplasias/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Apetite , Índice de Massa Corporal , Peso Corporal , Método Duplo-Cego , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Testes Hematológicos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida , República da Coreia , Projetos de Pesquisa , Adulto Jovem
3.
Nutrients ; 11(6)2019 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-31195630

RESUMO

The population of older adults is growing globally. This increase has led to an accumulation of chronic illnesses, so-called age-related diseases. Diet and nutrition are considered the main drivers of the global burden of diseases, and this situation applies especially to this population segment. It relates directly to the development of coronary heart disease, hypertension, some types of cancer, and type 2 diabetes, among other diseases, while age-associated changes in body composition (bone and muscle mass, fat, sarcopenia) constitute risk factors for functional limitations affecting health status and the quality of life. Older adults present eating and swallowing problems, dry mouth, taste loss, and anorexia among other problems causing "anorexia of aging" that affects their nutritional status. The strategies to overcome these situations are described in this study. The impact of oral food processing on nutrition is discussed, as well as approaches to improve food acceptance through the design of innovative foods. These foods should supply a growing demand as this group represents an increasing segment of the consumer market globally, whose needs must be fulfilled.


Assuntos
Envelhecimento/fisiologia , Anorexia/fisiopatologia , Dieta/métodos , Alimentos Fortificados , Sarcopenia/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Anorexia/dietoterapia , Anorexia/etiologia , Composição Corporal , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Sarcopenia/dietoterapia , Sarcopenia/etiologia
4.
Nat Commun ; 10(1): 2769, 2019 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-31235690

RESUMO

Loss of appetite or anorexia associated with inflammation impairs quality of life and increases morbidity in many diseases. However, the exact neural mechanism that mediates inflammation-associated anorexia is still poorly understood. Here we identified a population of neurons, marked by the expression of protein kinase C-delta, in the oval region of the bed nucleus of the stria terminalis (BNST), which are activated by various inflammatory signals. Silencing of these neurons attenuates the anorexia caused by these inflammatory signals. Our results demonstrate that these neurons mediate bidirectional control of general feeding behaviors. These neurons inhibit the lateral hypothalamus-projecting neurons in the ventrolateral part of BNST to regulate feeding, receive inputs from the canonical feeding regions of arcuate nucleus and parabrachial nucleus. Our data therefore define a BNST microcircuit that might coordinate canonical feeding centers to regulate food intake, which could offer therapeutic targets for feeding-related diseases such as anorexia and obesity.


Assuntos
Anorexia/fisiopatologia , Comportamento Alimentar/fisiologia , Inflamação/fisiopatologia , Neurônios/fisiologia , Núcleos Septais/fisiologia , Animais , Anorexia/etiologia , Anorexia/prevenção & controle , Núcleo Arqueado do Hipotálamo/fisiologia , Modelos Animais de Doenças , Ingestão de Alimentos/fisiologia , Feminino , Humanos , Inflamação/complicações , Masculino , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Vias Neurais/fisiologia , Obesidade/etiologia , Obesidade/fisiopatologia , Núcleos Parabraquiais/fisiologia , Proteína Quinase C-delta/genética , Proteína Quinase C-delta/metabolismo , Núcleos Septais/citologia , Técnicas Estereotáxicas
5.
Niger J Clin Pract ; 22(5): 661-668, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31089021

RESUMO

Aim: We aimed to assess the factors which may affect the quality of life (QoL) of the patients who underwent curative gastrectomy for gastric cancer. Subjects and Methods: Patients with gastric cancer, who underwent gastrectomy with curative intent at Department of Gastrointestinal Surgery, Kartal Training and Research Hospital from January 2013 to December 2015, were retrospectively reviewed. Gastrointestinal Quality of Life Index was utilized for this research. The clinical factors that might affect QoL after gastrectomy were selected. They were demographic data (age and gender), the American Society of Anesthesiologists classification, body mass index (BMI), operative variables (level and type of resection, type of dissection [D1, D2], type of reconstruction, and additional organ resections), postoperative appetite level, type of oncological treatment, and pathological stages. One hundred and eighteen patients were included in this study. Results: Eighty-seven (73.7%) of them were male and mean age was 59.4 ± 10.2 (36-74). Mean follow-up period was 25.7 ± 11.3 (6-42) months. According to multivariate analysis, advanced stage, neoadjuvant therapy, lower BMI, poor appetite, and shorter follow-up were independently associated with poorer cumulative scores. Conclusions: Advanced stage, application of neoadjuvant therapy, low BMI level, and poor postoperative appetite may deteriorate the postoperative QoL of the patients with gastric cancer.


Assuntos
Gastrectomia , Qualidade de Vida , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Idoso , Anorexia/etiologia , Índice de Massa Corporal , Feminino , Seguimentos , Gastrectomia/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Período Pós-Operatório , Estudos Retrospectivos , Neoplasias Gástricas/terapia , Fatores de Tempo , Perda de Peso
6.
Support Care Cancer ; 27(12): 4697-4704, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30949832

RESUMO

INTRODUCTION: Patient-reported outcomes (PROs) are the gold standard to describe subjective symptoms. Nurses can be successfully involved in collecting symptom information, because of their direct relationship with the patient. In order to improve clinical management of outpatients receiving active anti-cancer treatment, we introduced in routine clinical practice an assessment of patient-reported symptoms and toxicities, starting from January 2018. Our hypothesis was that this could help to better control symptoms, improving patients' quality of life (QoL). METHODS: Eligible patients were receiving an active anti-cancer treatment, as outpatients. Patients included in the control group (treated in 2017) underwent "usual" visits (group A), while patients treated in 2018, before each visit received a questionnaire by a dedicated nurse, in order to provide information about symptoms and toxicities (group B). Primary objective was the comparison of QoL changes, measured by EORTC QLQ-C30. RESULTS: A total of 211 patients have been analyzed (119 group A; 92 group B). After 1 month, mean change from baseline of global QoL was - 1.68 in group A and + 2.54 in group B (p = 0.004, effect size 0.20). Group B showed significantly better mean changes for fatigue, pain, and appetite loss. Proportion of patients obtaining a clinically significant improvement in global QoL score was higher in group B (32.6%) compared to group A (19.3%, p = 0.04). Patients' satisfaction with questionnaire was high. CONCLUSION: Introduction of PROs in clinical practice, thanks to an active role of nurses, was feasible, produced high patients' satisfaction and a significant QoL improvement, compared to the traditional modality of visit.


Assuntos
Neoplasias/diagnóstico , Neoplasias/terapia , Medidas de Resultados Relatados pelo Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anorexia/etiologia , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/fisiopatologia , Neoplasias/psicologia , Papel do Profissional de Enfermagem , Pacientes Ambulatoriais , Dor/etiologia , Qualidade de Vida , Inquéritos e Questionários
7.
Ann Palliat Med ; 8(1): 43-49, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30685983

RESUMO

The treatment of cancer cachexia remains an unmet medical need. One of the barriers to the development and approval of effective interventions has been the lack of agreement on the proper endpoints for study. The international consensus definition of cancer cachexia focuses on 3 major components of the syndrome. This includes altered body composition characterized specifically by loss of skeletal muscle mass. The muscle loss in turn is a result of negative protein and energy balance secondary to reduced food intake and abnormal metabolism. The result of muscle loss is progressive functional impairment. The assessment of interventions for cancer cachexia should include measures of all 3 components of cancer cachexia. For patients with cancer cachexia, body composition measurements of lean body mass (LBM) and fat mass may be best determined by CT imaging. Nutritional endpoints and measures of metabolism can be quite complex. However, change in appetite and body weight remain extremely useful measures of clinical benefit. The most controversial area relates to assessment of physical function. While stair climb power, 6-minute walk, hand grip strength and other measures have been used in clinical trials, none of them have shown consistent benefit that correlates with change in LBM. While we have much to learn about the inter-relationship between muscle mass and muscle function, improvement in physical function may be best measured by patient reported outcomes. Ongoing and future clinical trials in cancer cachexia should assess all 3 domains, which will improve our understanding of this syndrome and ultimately lead to better treatment options for our patients.


Assuntos
Caquexia/terapia , Neoplasias/complicações , Anorexia/etiologia , Anorexia/fisiopatologia , Composição Corporal/fisiologia , Caquexia/etiologia , Caquexia/fisiopatologia , Humanos , Neoplasias/fisiopatologia , Desnutrição Proteico-Calórica/etiologia , Desnutrição Proteico-Calórica/fisiopatologia , Resultado do Tratamento
8.
Ann Palliat Med ; 8(1): 50-58, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29860861

RESUMO

Cancer-associated anorexia, or loss of appetite, is prevalent, distressing to patients and their families, and associated with poorer outcomes in patients with advanced cancer. A well-defined therapeutic strategy remains to be defined. We present here a review of appetite loss in cancer patients with a summary of how best to manage this symptom.


Assuntos
Anorexia/terapia , Neoplasias/complicações , Cuidados Paliativos/métodos , Corticosteroides/uso terapêutico , Anorexia/etiologia , Estimulantes do Apetite/uso terapêutico , Caquexia/etiologia , Canabinoides/uso terapêutico , Humanos , Hidrazinas/uso terapêutico , Oligopeptídeos/uso terapêutico
9.
Ann Palliat Med ; 8(1): 33-42, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30525763

RESUMO

Cancer cachexia (CC) is common in advanced cancer and is accompanied by negative effects on health-related quality of life (HRQOL). However, methods to identify the impact of CC on HRQOL are limited. Single questionnaire items may provide insight on the effect of CC on HRQOL. Specifically, the use of "feeling of wellbeing" (FWB) on the Edmonton Symptom Assessment System (ESAS) questionnaire and the Distress Thermometer (DT) have been explored. Assessing how these two surrogate measures of HRQOL are impacted among CC stages and what drives these negative effects may allow for focused treatments. Five-hundred and twelve patients referred to a Cancer Rehabilitation Program completed the ESAS, with the question on FWB and the DT at baseline. Patients were separated into CC stages: non-cachexia (NC), pre-cachexia (PC), cachexia (C), refractory cachexia (RC). A mixed model ANOVA with post hoc Tukey adjustment was used to compare means of FWB and distress among the CC stages. To understand what was driving the differences between CC stages, a robust regression model was created with either distress or FWB as the outcome measure, dependent on the other measures in ESAS, age and sex. Finally, the use of cannabinoids in treating appetite loss was examined, as it has a detrimental effect on FWB; 54 patients underwent cannabinoid treatment for appetite loss within a community-based, physician-lead, medical cannabis clinic. A t-test to assess changes in ESAS appetite score after 3 months of cannabinoid treatment was examined. RC patients had a significantly poorer sense of wellbeing than the other cachexia stages (RC: 6.07±0.33). Significant differences in distress were identified between RC patients and those with NC and C, but not with PC (RC: 4.87±0.38, NC: 3.35±0.26, PC: 4.11±0.30, C: 3.60±0.28). FWB was negatively affected by worsening appetite in all CC stages except NC (PC: 0.19±0.08, P=0.022; C: 0.26±0.06, P<0.001; RC: 0.23±0.08, P=0.007). ESAS score for lack of appetite significantly improved between baseline (5.07±3.21) and follow-up (3.56±3.15, P=0.003) after cannabinoid treatment, with no significant difference in weight (baseline: 70.7±14.6 kg, 3-month follow-up: 71.0±14.8 kg). Future research should validate both multidimensional and single-item tools to measure HRQOL in patients at different stages of CC. Improvement of HRQOL via appetite stimulation, may be achieved through a multidisciplinary approach, which includes cannabinoid therapy.


Assuntos
Caquexia/psicologia , Neoplasias/psicologia , Qualidade de Vida/psicologia , Corticosteroides/uso terapêutico , Anorexia/etiologia , Estimulantes do Apetite/uso terapêutico , Canabinoides/uso terapêutico , Ciproeptadina/uso terapêutico , Feminino , Nível de Saúde , Humanos , Hidrazinas/uso terapêutico , Masculino , Acetato de Megestrol/uso terapêutico , Pessoa de Meia-Idade , Oligopeptídeos/uso terapêutico , Antagonistas da Serotonina/uso terapêutico , Índice de Gravidade de Doença , Estresse Psicológico/etiologia , Inquéritos e Questionários
10.
Food Chem Toxicol ; 123: 1-8, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30336258

RESUMO

Trichothecene mycotoxins, a family of common contaminants on cereal grains, are known to negatively impact human and animal health with adverse effect on food consumption being of particular concern. T-2 toxin has been previously demonstrated to induce anorectic response in several animal species including mouse, rat, rabbit. Although the T-2 toxin-induced anorectic response has been associated with the release of gut satiety hormone, much less is known about the role of neurotransmitter in this response. To address this gap, we employed a nocturnal mouse food refusal model to test the hypothesis that neurotransmitters 5-hydroxytryptamine (5-HT) and substance P (SP) mediate anorexia induction by T-2 toxin. Elevations of plasma 5-HT and SP markedly corresponded to anorexia induction following oral exposure to T-2 toxin. Direct administration of exogenous 5-HT and SP induced anorectic responses similar to T-2 toxin. The 5-HT3 receptor (5-HT3R) antagonist granisetron evoked a dose-dependent attenuation of both 5-HT- and T-2 toxin-induced anorectic responses. Pretreatment with neurokinin-1 receptor (NK-1R) antagonist Emend® dose-dependently attenuated both SP- and T-2 toxin-induced anorectic responses. To summarize, the results suggest that both 5-HT and SP play important roles in anorexia induction by T-2 toxin. 5-HT is more potent and long-acting than SP in this response.


Assuntos
Anorexia/etiologia , Neurotransmissores/sangue , Serotonina/sangue , Substância P/sangue , Toxina T-2/toxicidade , Animais , Anorexia/sangue , Modelos Animais de Doenças , Feminino , Humanos , Receptores da Neurocinina-1/metabolismo , Receptores 5-HT3 de Serotonina/metabolismo , Toxina T-2/metabolismo
11.
Thorac Cancer ; 10(1): 8-16, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30461213

RESUMO

Advanced lung cancer is becoming a chronic disease threatening human life and health. Cachexia has been recognized as the most common problem associated with advanced lung cancer. Lung cancer-induced cachexia seriously affects patients' quality of life. The present article summarizes the pathogenesis of advanced lung cancer-induced cachexia from three aspects: anorexia, cytokines, and energy and metabolic abnormalities. In addition, the present article proposes corresponding nursing measures based on cachexia pathogenesis to improve the quality of life and survival rate of cachectic patients with advanced lung cancer by combining continuously advancing treatment regimens and effective nursing. The present article also provides references for healthcare professionals when administering related treatments and nursing care.


Assuntos
Anorexia/patologia , Caquexia/patologia , Neoplasias Pulmonares/patologia , Anorexia/epidemiologia , Anorexia/etiologia , Anorexia/terapia , Caquexia/epidemiologia , Caquexia/etiologia , Caquexia/terapia , Citocinas/metabolismo , Metabolismo Energético , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/terapia , Qualidade de Vida , Taxa de Sobrevida
12.
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
13.
J Pediatr Surg ; 54(2): 340-344, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30301607

RESUMO

BACKGROUND: APSA guidelines do not recommend routine reimaging for pediatric blunt liver or spleen injury (BLSI). This study characterizes the symptoms, reimaging, and outcomes associated with a selective reimaging strategy for pediatric BLSI patients. METHODS: A planned secondary analysis of reimaging in a 3-year multi-site prospective study of BLSI patients was completed. Inclusion required successful nonoperative management of CT confirmed BLSI without pancreas or kidney injury and follow up at 14 or 60 days. Patients with re-injury after discharge were excluded. RESULTS: Of 1007 patients with BLSI, 534 (55%) met inclusion criteria (median age: 10.18 [IQR: 6, 14]; 62% male). Abdominal reimaging was performed on 27/534 (6%) patients; 3 of 27 studies prompting hospitalization and/or intervention. Abdominal pain was associated with reimaging, but decreased appetite predicted imaging findings associated with readmission and intervention. CONCLUSION: Selective abdominal reimaging for BLSI was done in 6% of patients, and 11% of studies identified radiologic findings associated with intervention or re-hospitalization. A selective reimaging strategy appears safe, and even reimaging symptomatic patients rarely results in intervention. Reimaging after 14 days did not prompt intervention in any of the 534 patients managed nonoperatively. LEVEL OF EVIDENCE: Level II, Prognosis.


Assuntos
Dor Abdominal/diagnóstico por imagem , Fígado/diagnóstico por imagem , Baço/diagnóstico por imagem , Ferimentos não Penetrantes/diagnóstico por imagem , Dor Abdominal/etiologia , Adolescente , Anorexia/etiologia , Criança , Pré-Escolar , Feminino , Humanos , Fígado/lesões , Masculino , Readmissão do Paciente , Estudos Prospectivos , Baço/lesões , Ferimentos não Penetrantes/complicações
14.
Dig Surg ; 36(1): 46-52, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29346784

RESUMO

BACKGROUND: The aim of this study is to improve the preoperative diagnostic accuracy and treatment results by investigating the clinical features and prognosis of primary liver sarcoma (PLS). METHODS: Clinical data, surgical treatments, adjuvant chemotherapy, and prognosis of 17 PLS patients whose diseases were pathologically confirmed were retrospectively analyzed. RESULTS: The main clinical symptoms included epigastric pain in 9 patients, epigastric distention in 7, and loss of appetite in 4; these symptoms were detected during the postoperative follow-up for gastric carcinoma in 1. The resection rate was 64.7% (12/17), including R0 resection in 10 patients and R1 resection in 2, and laparotomy with biopsy in 5. Five patients accepted an adjuvant selective hepatic artery infusion chemotherapy (mitomycin C 16-20 mg+ 5-fluorouracil 5.0 g+ epirubicin 40-50 mg), and 4 accepted adjuvant systemic chemotherapy (vincristin, cisplatin, cyclophosphamide, and adriamycin). All 5 patients with simple laparotomy died within 1 year, and the overall 1-, 3-, and 5-year survival rates for all patients were 58.8% (10/17), 29.4% (5/17) and 11.7% (2/17), respectively, whereas those were 100.0% (10/10), 50.0% (5/10), and 20.0% (2/10) for R0 resected patients respectively. CONCLUSIONS: The diagnosis of PLS is difficult before operation due to its nonspecific manifestations, and the high survival rate can be achieved by radical resection with adjuvant chemotherapy.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Hepatectomia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/terapia , Sarcoma/diagnóstico , Sarcoma/terapia , Dor Abdominal/etiologia , Adulto , Idoso , Anorexia/etiologia , Quimioterapia Adjuvante , China , Feminino , Hospitais , Humanos , Testes de Função Hepática , Neoplasias Hepáticas/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasia Residual , Prognóstico , Sarcoma/patologia , Taxa de Sobrevida , Tomografia Computadorizada por Raios X
17.
In Vivo ; 33(1): 245-249, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30587631

RESUMO

BACKGROUND/AIM: The aim of the present study was the evaluation of the influence of cancer stem cells and other parameters in stage IV colorectal cancer patients. MATERIALS AND METHODS: One hundred patients were retrospectively included in the study and 24 variables were examined for their relation with response to treatment and survival. RESULTS: A low ploidy score in the histology of colorectal cancer was associated with improvement of performance status and response to therapy. No significant correlations between the percentage of cancer stem cells from the same tissue and the remaining clinical parameters was revealed. In the multivariate analysis of all the examined parameters in Cox models, independent unfavorable prognostic factors were increased ploidy score, existence of bone metastases, use of epoetin, and existence of side-effects such as anorexia, mucositis, and weight loss. CONCLUSION: Our findings emphasize on the prognostic role of ploidy in advanced colorectal cancer, but further analysis is required to evaluate the role of cancer stem cells.


Assuntos
Neoplasias Colorretais/patologia , Células-Tronco Neoplásicas/patologia , Ploidias , Prognóstico , Adulto , Idoso , Anorexia/etiologia , Anorexia/patologia , Neoplasias Colorretais/complicações , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/genética , Feminino , Citometria de Fluxo , Humanos , Masculino , Pessoa de Meia-Idade , Mucosite/etiologia , Mucosite/patologia , Metástase Neoplásica , Estadiamento de Neoplasias , Modelos de Riscos Proporcionais , Perda de Peso/genética
18.
Issues Ment Health Nurs ; 39(10): 865-875, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30307783

RESUMO

The growing trend in the use of the Internet and social media as a method of self-managing illness presents a critical opportunity to better understand the role of pro-anorexia (pro-ana) websites for eating disorders. Therefore, 155 pro-ana website messages regarding criticism that the site was responsible for developing anorexia were inductively thematically analysed. The analysis revealed five main themes: eating disorders are mental illnesses and websites do not cause mental illness, pro-ana websites and eating disorders are more than wanting to be thin (with sub-theme residents and visitors), eating disorders develop regardless of pro-ana websites, pro-ana sites do not cause eating disorders but they may trigger or encourage them (with sub-theme the problem is the user, not the site) and pro-ana sites provide support. Pro-ana websites and online communities present clinicians with complex treatment challenges. Collaborative, therapeutic consultations about pro-ana website use may help to establish how and when accessing them may hinder the treatment process.


Assuntos
Anorexia/etiologia , Anorexia/prevenção & controle , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Mídias Sociais , Anorexia/psicologia , Imagem Corporal/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Humanos , Autocuidado/psicologia , Avaliação de Sintomas
19.
G Ital Nefrol ; 35(5)2018 Sep.
Artigo em Italiano | MEDLINE | ID: mdl-30234228

RESUMO

The Italian nephrology has a long tradition and experience in the field of dietetic-nutritional therapy (DNT), which is an important component in the conservative management of the patient suffering from a chronic kidney disease, which precedes and integrates the pharmacological therapies. The objectives of DNT include the maintenance of an optimal nutritional status, the prevention and / or correction of signs, symptoms and complications of chronic renal failure and, possibly, the delay in starting of dialysis. The DNT includes modulation of protein intake, adequacy of caloric intake, control of sodium and potassium intake, and reduction of phosphorus intake. For all dietary-nutritional therapies, and in particular those aimed at the patient with chronic renal failure, the problem of patient adherence to the dietetic-nutritional scheme is a key element for the success and safety of the DNT and it can be favored by an interdisciplinary and multi-professional approach of information, education, dietary prescription and follow-up. This consensus document, which defines twenty (20) essential points of the nutritional approach to patients with advanced chronic renal failure, has been written, discussed and shared by the Italian nephrologists together with representatives of dietitians (ANDID) and patients (ANED).


Assuntos
Insuficiência Renal Crônica/dietoterapia , Anorexia/etiologia , Proteínas na Dieta/administração & dosagem , Progressão da Doença , Ingestão de Energia , Humanos , Transplante de Rim , Desnutrição/prevenção & controle , Náusea/etiologia , Cooperação do Paciente , Fósforo na Dieta/administração & dosagem , Potássio na Dieta/administração & dosagem , Diálise Renal , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/terapia , Sódio na Dieta/administração & dosagem
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