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1.
Am J Gastroenterol ; 115(8): 1153-1155, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32496340

Assuntos
Infecções por Coronavirus/fisiopatologia , Doenças do Sistema Digestório/fisiopatologia , Pneumonia Viral/fisiopatologia , Dor Abdominal/etiologia , Dor Abdominal/metabolismo , Dor Abdominal/fisiopatologia , Dor Abdominal/terapia , Assistência Ambulatorial , Anorexia/etiologia , Anorexia/metabolismo , Anorexia/fisiopatologia , Anorexia/terapia , Antibacterianos/efeitos adversos , Antipiréticos/efeitos adversos , Antivirais/efeitos adversos , Betacoronavirus , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/fisiopatologia , Doença Hepática Induzida por Substâncias e Drogas/terapia , China , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/tratamento farmacológico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/metabolismo , Infecções por Coronavirus/terapia , Diarreia/etiologia , Diarreia/metabolismo , Diarreia/fisiopatologia , Diarreia/terapia , Doenças do Sistema Digestório/etiologia , Doenças do Sistema Digestório/metabolismo , Doenças do Sistema Digestório/terapia , Endoscopia do Sistema Digestório , Gastroenterologia , Humanos , Hepatopatias/etiologia , Hepatopatias/metabolismo , Hepatopatias/fisiopatologia , Hepatopatias/terapia , Náusea/etiologia , Náusea/metabolismo , Náusea/fisiopatologia , Náusea/terapia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/metabolismo , Pneumonia Viral/terapia , Probióticos/uso terapêutico , Sociedades Médicas , Vômito/etiologia , Vômito/metabolismo , Vômito/fisiopatologia
2.
Prim Care ; 46(3): 335-351, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31375185

RESUMO

The burden of nonpain symptoms such as anorexia, constipation, nausea, and vomiting contribute to patient suffering throughout the course of advanced illness. It is important to address symptom control throughout the disease trajectory, and especially at the end of life. Primary care clinicians must recognize these symptoms early, provide ongoing assessment, and keep abreast of evidence-based management strategies, including valid clinical protocols.


Assuntos
Estado Terminal , Cuidados Paliativos/métodos , Atenção Primária à Saúde/organização & administração , Anorexia/fisiopatologia , Anorexia/terapia , Constipação Intestinal/fisiopatologia , Constipação Intestinal/terapia , Humanos , Náusea/fisiopatologia , Náusea/terapia , Prevalência , Vômito/fisiopatologia , Vômito/terapia
3.
Prim Care ; 46(3): 461-473, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31375193

RESUMO

Pediatric palliative care and hospice medicine is a field in which a multidisciplinary team assists in the management and treatment of infants, children, and young adults with a serious condition. A therapeutic relationship is created among the team, patients, and their caregivers to address total pain. This encompasses exploration of physical pain, social, spiritual, and emotional pain. Patient-centered and family-centered shared decision-making is paramount when setting and revisiting goals of care with patients and their families. Consider a checklist when faced with a dying patient so that the family and team feel supported.


Assuntos
Família/psicologia , Cuidados Paliativos/métodos , Cuidados Paliativos/psicologia , Fatores Etários , Anorexia/terapia , Criança , Pré-Escolar , Tomada de Decisões , Delírio/terapia , Emoções , Pesar , Humanos , Lactente , Recém-Nascido , Relações Interpessoais , Manejo da Dor/métodos , Planejamento de Assistência ao Paciente , Qualidade de Vida , Espiritualidade , Assistência Terminal/métodos , Assistência Terminal/psicologia
4.
Vet Clin North Am Small Anim Pract ; 49(5): 837-854, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31176457

RESUMO

Appetite influences perceived quality of life for a dog or cat with cancer. Inappetence often is multifactorial, complicating treatment. Cancer-related anorexia/cachexia syndrome is a metabolic, paraneoplastic syndrome characterized by decreased food intake, involuntary weight loss, and loss of fat and muscle. If weight loss/cachexia has an impact on canine and feline cancer patients as in humans, management may improve survival times and quality of life. The challenge is having effective, proved therapies available for clinical use. Recent Food and Drug Administration approvals for appetite stimulation have renewed interest and discussion and has the potential to alter the course of case management.


Assuntos
Anorexia/veterinária , Caquexia/veterinária , Doenças do Gato/terapia , Doenças do Cão/terapia , Neoplasias/veterinária , Animais , Anorexia/complicações , Anorexia/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Estimulantes do Apetite/uso terapêutico , Caquexia/complicações , Caquexia/terapia , Canabidiol/uso terapêutico , Doenças do Gato/etiologia , Gatos , Doença Crônica , Doenças do Cão/etiologia , Cães , Neoplasias/complicações , Qualidade de Vida
5.
Int J Law Psychiatry ; 64: 250-259, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31122636

RESUMO

This article critically assesses the way a certain court has determined the capacity of a person diagnosed with anorexia to refuse medical treatment. It is shown that when making this determination, the court has adopted a process of circular reasoning, meaning anyone with the diagnosis will be found to lack capacity to refuse its treatment. This circular reasoning means that indicia of capacity that ought to be considered by the court is ignored. The result is a procedure in which the anorexic patient has no voice, and an outcome against which he or she has no effective legal recourse. This problem, it is argued, can be overcome in two ways. Firstly, courts must make sure that the 'functional' test of capacity is properly applied, meaning any finding of incapacity must rest on evidenced deficits in decision-making ability. Secondly, courts must properly engage with the subjective reasoning of the person making the treatment refusal.


Assuntos
Anorexia/psicologia , Competência Mental/legislação & jurisprudência , Recusa do Paciente ao Tratamento/legislação & jurisprudência , Adulto , Anorexia/terapia , Tomada de Decisões , Humanos , Jurisprudência , Competência Mental/psicologia , Recusa do Paciente ao Tratamento/psicologia
6.
Med. paliat ; 26(1): 67-76, ene.-mar. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-190123

RESUMO

OBJETIVO: Realizar una revisión sistemática de la literatura sobre las aproximaciones terapéuticas al síndrome anorexia-caquexia en pacientes oncológicos avanzados. MATERIAL Y MÉTODO: Se realizó una búsqueda de artículos científicos consultando las bases de datos: PubMed, Cochrane, Elsevier, Wiley y Google Scholar, con restricción de fecha 01/01/1990-31/12/2015, en los idiomas inglés y español. Las palabras clave utilizadas fueron: "fatigue, anorexia, cachexia, cancer, treatment" y las mismas palabras traducidas al español. En la base de datos PubMed, las ecuaciones de búsqueda utilizadas fueron: "Tumoral cachexia AND treatment" y "Fatigue, anorexia, cachexia AND cancer". Se incluyeron todos los estudios que definieran el síndrome de caquexia tumoral e indicaran al menos una línea de tratamiento para el mismo. Se excluyeron aquellos en los que la caquexia era resultado de una enfermedad terminal diferente al cáncer y en los que el tratamiento había sido enfocado únicamente en la paliación del dolor oncológico. Para seleccionar los artículos se realizó una lectura del título y/o resúmenes de los mismos. En caso de duda, se procedió a la lectura completa del trabajo. Los parámetros analizados fueron: tipo de estudio, criterios de inclusión, tamaño de la muestra, tipo de cáncer, tipos de tratamiento y eficacia de los mismos. RESULTADOS: en PubMed, con la estrategia de búsqueda "tumoral cachexia AND treatment" encontramos 16 artículos de los cuales un ensayo clínico cumplía los criterios de inclusión. En la misma base de datos, mediante la estrategia de búsqueda: "fatigue, anorexia, cachexia AND cancer" encontramos 106 artículos de los cuales incluimos ocho ensayos clínicos. Como artículo relacionado con la búsqueda anterior incluimos un ensayo clínico más. Además, realizamos una búsqueda de artículos a través de diversas plataformas, e incluimos en la revisión ocho revisiones narrativas y tres ensayos clínicos. CONCLUSIONES: 1) La diversidad de estudios revisados imposibilita la realización de un metanálisis. 2) Las medidas terapéuticas de la caquexia se basan en la modulación metabólica. 3) Sigue siendo controvertida que la utilización de suplementos nutricionales mejore el pronóstico del paciente con enfermedad avanzada. 4) La literatura propone diversos tratamientos para el síndrome de caquexia tumoral, siendo en la actualidad el acetato de megestrol el tratamiento de elección. 5) Existen fármacos en desarrollo, como los miméticos de la ghrelina, que ofrecen resultados prometedores


OBJECTIVE: To review what has been published in the scientific literature about the treatment options of the anorexia- cachexia syndrome in cancer patients. METHOD: We performed a systematic review of the literature. Databases used were: PubMed, Cochrane, Elsevier, Wiley y Google Scholar, with date restriction 01/01/1990-31/12/2015. Languages were English and Spanish, Key words used were: "fatigue, anorexia, cachexia, cancer in English and Spanish. In PubMed, search strategy were: "Tumoral cachexia AND treatment" and "Fatigue, anorexia, cachexia AND cancer". Articles included had to offer information about any treatment option to the cachexia syndrome. Articles including patients suffering from other illness than cancer were excluded. Papers selection was done base on title and abstract information. In some cases the inclusion was done after reading all the content. Information selected was: type of study, inclusion criteria, simple size, type of cancer, type of treatment and results. RESULTS: In PubMed, based on the search strategy: "tumoral cachexia AND treatment" we found 16 papers but only one was included. Based on the search strategy "fatigue, anorexia, cachexia AND cancer" we found 106 papers but only 8 clinical trials were included. Other related articles were included: 4 clinical trials and 8 narrative reviews. CONCLUSION: 1) The methodological differences among the papers reviewed make impossible to develop a methaanalisis. 2) Most of the treatment lines are based on metabolic modulation. 3) It is controversial the use of nutritional supplements to improve prognosis in advanced cancer patient. 4) Among cancer cachexia treatments suggested the megestrol acetate is the election option. 5) New drugs as ghrelin have shown optimistic results


Assuntos
Humanos , Anorexia/terapia , Caquexia/terapia , Neoplasias/complicações , Fadiga/complicações , Caquexia/patologia , Suplementos Nutricionais , Grelina , Estado Nutricional , Megestrol/uso terapêutico
7.
Qual Life Res ; 28(6): 1641-1653, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30796591

RESUMO

PURPOSE: Comprehensive (qualitative and quantitative) assessments of the 12-item functional assessment of anorexia/cachexia therapy (FAACT) anorexia/cachexia subscale (A/CS) and relevant subscales were undertaken for use in constructing potential endpoints in clinical trials of non-small cell lung cancer (NSCLC) with involuntary weight loss. METHODS: Eleven participants (≥ 18 years) from six clinical sites with a diagnosis of stage III unresectable or stage IV NSCLC and involuntary weight loss (either ≥ 5% body weight loss within six months prior to screening or screening BMI < 20 kg/m2) were interviewed to evaluate the content validity of the A/CS domain. A psychometric evaluation was conducted on the A/CS domain, and symptoms and concerns subscales, using data from previously completed phase III clinical trials (ROMANA1 [N = 474] and ROMANA2 [N = 488]). RESULTS: Anorexia-related symptoms were highly relevant to participants and had important impacts on their lives including energy levels, and physical, social, and psychological functioning. The majority of participants endorsed the A/CS domain items and found them to be easily understood, relevant, and comprehensive. Confirmatory factor analyses established that the A/CS symptoms and concerns subscales provided an acceptable fit as single factor models in ROMANA1 and ROMANA2. Reliability, validity, and responsiveness were established for the 12item A/CS domain, 5item anorexia symptoms subscale, and 4-item anorexia concerns subscale. CONCLUSIONS: These scales have good content validity, favorable psychometric properties, and can be used for characterizing the effect of treatment on anorexia symptoms and/or anorexia-related concerns in patients with NSCLC.


Assuntos
Anorexia/terapia , Caquexia/terapia , Carcinoma Pulmonar de Células não Pequenas/complicações , Neoplasias Pulmonares/complicações , Psicometria/métodos , Qualidade de Vida/psicologia , Perda de Peso/fisiologia , Idoso , Anorexia/patologia , Caquexia/patologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Reprodutibilidade dos Testes
8.
Nutrients ; 11(1)2019 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-30641897

RESUMO

(1) Background: Appetite loss in older people, the 'Anorexia of Aging' (AA), is common, associated with under-nutrition, sarcopenia, and frailty and yet receives little attention. This review had two aims: describe interventions for AA and their effectiveness, and identify the methods of appetite assessment. (2) Methods: Study inclusion: participants aged ≥65, intervention for AA, and appetite assessment, any design, and comparator. Exclusion: studies on specific health cohorts. Searches in four databases with hand searching of references and citing works. Two researchers independently assessed eligibility and quality. (3) Results: Authors screened 8729 titles, 46 full texts. Eighteen articles were included describing nine intervention types: education (n = 1), exercise (n = 1), flavor enhancement (n = 2), increased meal variety (n = 1), mealtime assistance (n = 1), fortified food (n = 1), oral nutritional supplement (ONS) (n = 8), amino acids (n = 1), and medication (n = 2). Three studies evaluated combinations: education + exercise, ONS + exercise, and ONS + medication. Five intervention types exhibited favorable effects on appetite but in single datasets or not replicated. Appetite was assessed predominantly by Likert (n = 9), or visual analogue scales (n = 7). (4) Conclusions: A variety of interventions and methods of appetite assessments were used. There was a lack of clarity about whether AA or undernutrition was the intervention target. AA is important for future research but needs standardized assessment so that effectiveness of a range of interventions can be fully explored.


Assuntos
Envelhecimento , Anorexia/terapia , Apetite , Bases de Dados Factuais , Dieta , Suplementos Nutricionais , Exercício Físico , Educação em Saúde , Humanos , Desnutrição/terapia , Refeições , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Sarcopenia/terapia , Perda de Peso
9.
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
10.
JAAPA ; 32(1): 1-2, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30589742
11.
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
12.
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
13.
J Hum Nutr Diet ; 32(1): 128-138, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30159922

RESUMO

BACKGROUND: Anorexia of ageing (AA) may be considered as a risk factor for frailty and has an important impact on quality of life, morbidity and mortality. METHODS: A systematic review and a meta-analysis were performed to summarise the results from several trials on the effectiveness of treatments in AA, as associated with depression, sensory impairment of taste and smell, decreased appetite or early satiety, and disability. Eligible studies were required to report baseline and follow-up values, the mean change (∆-change) from baseline, and/or the mean difference among intervention groups versus control group, concerning food intake (kcal/daily) and/or nutritional outcomes, such as body weight, body mass index, albumin and Mini Nutritional Assessment. RESULTS: The systematic review included 20 papers based on different therapeutic approaches concerning food intake and/or nutritional outcomes. The results of the meta-analysis indicate that the interventions for AA have an important impact on body weight [+1.59 kg; 95% confidence interval (CI) = 1.48-+1.71 kg; P < 0.001) and on energy intake (+56.09 kcal; 95% CI = -54.05 to +166.25 kcal; P = 0.32). Regarding secondary outcomes, it was not possible to meta-analyse the limited amount of data availab le. CONCLUSIONS: The different variants of AA need to be defined because diverse therapeutic approaches are available. A more precise definition of the functional impairments associated with AA may allow a more correct decision about the most appropriate therapy to be prescribed. Moreover, this may allow for a more effective performance of the different therapeutic approaches once they are better targeted to the different scenarios of AA.


Assuntos
Envelhecimento/patologia , Anorexia/terapia , Terapia Nutricional/métodos , Estado Nutricional , Idoso , Idoso de 80 Anos ou mais , Anorexia/fisiopatologia , Índice de Massa Corporal , Peso Corporal , Ingestão de Energia , Feminino , Avaliação Geriátrica , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Qualidade de Vida , Resultado do Tratamento
14.
Curr Opin Support Palliat Care ; 12(4): 404-409, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30382947

RESUMO

PURPOSE OF REVIEW: To review recent finding on MIC-1/GDF15 and re-evaluate it as a potential target for the therapy of anorexia/cachexia syndromes. RECENT FINDINGS: MIC-1/GDF15 consistently induces anorexia/cachexia in animal models. Its actions on brainstem feeding centers leads to anorexia, inducing prolonged undernutrition and consequent loss of both lean and fat mass. Epidemiological studies by multiple groups have linked substantially elevated serum levels of this cytokine to anorexia/cachexia syndromes in diverse diseases such as cancer, chronic renal and cardiac failure, and chronic obstructive lung disease. These elevated serum levels are similar to those required to induce this syndrome in animals. Recent identifications of its previously elusive receptor as GFRAL, has enhanced understanding of its biology and suggests that modulating the MIC-1/GDF15-GFRAL pathway may be a therapeutic target for anorexia/cachexia syndrome. SUMMARY: Inhibiting MIC-1/GDF15 or its receptor GFRAL are high-value potential targets for treatment of anorexia/cachexia syndrome in patients whose elevated serum levels may justify its use.


Assuntos
Anorexia/fisiopatologia , Caquexia/fisiopatologia , Fator 15 de Diferenciação de Crescimento/metabolismo , Animais , Anorexia/terapia , Caquexia/complicações , Caquexia/terapia , Fator Neurotrófico Derivado de Linhagem de Célula Glial/antagonistas & inibidores , Fator Neurotrófico Derivado de Linhagem de Célula Glial/metabolismo , Fator 15 de Diferenciação de Crescimento/antagonistas & inibidores , Humanos , Neoplasias/complicações , Síndrome , Fator de Crescimento Transformador beta/metabolismo
15.
BMC Complement Altern Med ; 18(1): 236, 2018 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-30092794

RESUMO

BACKGROUND: Cancer-related anorexia remains one of the most prevalent and troublesome clinical problems experienced by patients with cancer during and after therapy. To ensure high-quality care, systematic reviews (SRs) are seen as the best guide. Considering the methodology quality of SRs varies, we undertook a comprehensive overview, and critical appraisal of pertinent SRs. METHODS: Eight databases (between the inception of each database and September 1, 2017) were searched for SRs on the management of cancer-related anorexia. Two researchers evaluated the methodological quality of each SR by using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. Characteristics of the "high quality" SRs were abstracted, included information on relevant studies numbers, study design, population, intervention, control, outcome and result. RESULTS: Eighteen SRs met the inclusion criteria. The R-AMSTAR scores of methodological quality ranged from 18 to 41 out of 44, with an average score of 30. Totally eight SRs scored ≥31 points, which showed high methodological quality, and would be used for data extraction to make summaries. Anamorelin had some positive effects to relieve cancer anorexia-cachexia syndrome (CACS) and improve the quality of life (QoL). Megestrol Acetate (MA) could improve appetite, and was associated with slight weight gain for CACS. Oral nutritional interventions were effective in increasing nutritional intake and improving some aspects of QoL in patients with cancer who were malnourished or at nutritional risk. The use of thalidomide, Eicosapentaenoic Acid, and minerals, vitamins, proteins, or other supplements for the treatment of cachexia in cancer were uncertain, and there was inadequate evidence to recommend it to clinical practices, the same situation in Chinese Herb Medicine and acupuncture (acupuncture and related therapies were effective in improving QoL) for treating anorexia in cancer patients, warranting further RCTs in these areas. CONCLUSIONS: Anamorelin, MA, oral nutrition interventions, and acupuncture could be considered to be applied in patients with cancer-related anorexia. Future RCTs and SRs with high quality on the pharmaceutical or non-pharmaceutical interventions of anorexia in cancer patients are warranted.


Assuntos
Anorexia , Caquexia , Neoplasias/complicações , Terapia por Acupuntura , Adulto , Anorexia/etiologia , Anorexia/terapia , Caquexia/etiologia , Caquexia/terapia , Suplementos Nutricionais , Medicina Baseada em Evidências , Humanos , Hidrazinas , Medicina Tradicional Chinesa , Oligopeptídeos , Extratos Vegetais
16.
Soins Pediatr Pueric ; 39(303): 38-43, 2018.
Artigo em Francês | MEDLINE | ID: mdl-30032918

RESUMO

Body-oriented psychotherapy has been an innovative practice in the treatment of anorexia for around ten years. This body-oriented and relational care is carried out on medical prescription individually or in groups, once or twice a week for six to eighteen months. The session comprises different moments of welcome, movement and exchange. This approach constitutes an interesting therapy which needs to be validated by research.


Assuntos
Anorexia/terapia , Imagem Corporal , Psicoterapia/métodos , Criança , Humanos
17.
Artigo em Inglês | MEDLINE | ID: mdl-29848283

RESUMO

BACKGROUND AND OBJECTIVE: Anorexia Nervosa (AN), Bulimia Nervosa (BN) and their variants are characterized by persistent alteration of eating behaviour, such as restricted intake or bingeing and purging, as well as excessive concerns about body shape and body weight. Purging behaviour may include self induced vomiting and/or abuse of laxatives, diuretics and physical hyperactivity. Unlike other psychiatric disorders, patients suffering from AN and BN have a high prevalence of many different medical complications, through the sequelae of undernutrition and purging, often with a serious impairment of health status and quality of life. This article describes the main diagnostic and clinical aspects of medical complications in AN and BN. RESULTS: The medical complications of ED are extremely variable and can occur with only modest biological and physical damage up to extremely serious and life-threatening conditions; the mortality rate of young subjects with AN is 4 - 11% with a risk of death about 12 times higher than that of subjects of the same age of the general population. The management of the medical-internship aspects of AN and BN is rightly placed within complex and articulated programs of interdisciplinary treatment with different levels of intensity of care (outpatient, semi-residential/residential, hospital in cases of emergency/medical and/or psychiatric emergency). CONCLUSION: the results of the investigations carried out, describe the functions of the various organs and apparatuses and the alterations detected, the possible complications and physiological adaptations to malnutrition.


Assuntos
Anorexia/complicações , Bulimia Nervosa/complicações , Comportamento Alimentar , Desnutrição/etiologia , Estado Nutricional , Anorexia/fisiopatologia , Anorexia/psicologia , Anorexia/terapia , Bulimia Nervosa/fisiopatologia , Bulimia Nervosa/psicologia , Bulimia Nervosa/terapia , Humanos , Desnutrição/fisiopatologia , Desnutrição/psicologia , Desnutrição/terapia , Prognóstico , Qualidade de Vida , Fatores de Risco
18.
Rev Invest Clin ; 70(3): 136-146, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29943769

RESUMO

In cancer patients treated with radiotherapy to the abdominopelvic region, dietary modifications and the use of functional foods (fortified food with added ingredients to provide specific health improving benefits, such as antioxidants, omega-3 fatty acids, and glutamine), may contribute to the improvement of the toxic effects of treatment, including nausea, diarrhea, and constipation, among others. With the aim of analyzing which coadjuvant foods benefit these patients, scientific evidence was gathered by a group of experts. For these patients, the authors recommend a diet that includes sufficient foods rich in antioxidants and polyphenols instead of supplements. Docosahexaenoic and eicosapentaenoic acids have proven useful for the management of anorexia/cachexia in pancreatic cancer patients. Probiotics composed of Lactobacillus spp. and Bifidobacterium spp. are regarded as safe even in patients with neutropenia and have been proven to decrease gastrointestinal symptoms. Several factors should be considered before probiotic supplementation, these include the stage of the disease, radiation dose, and symptomatology of each patient. There is no demonstrated clear benefit to the use of glutamine, so it is not recommended due to its high cost.


Assuntos
Suplementos Nutricionais , Alimento Funcional , Neoplasias Pélvicas/terapia , Anorexia/etiologia , Anorexia/terapia , Caquexia/etiologia , Caquexia/terapia , Dieta , Humanos , Probióticos/administração & dosagem , Doses de Radiação , Lesões por Radiação/epidemiologia , Lesões por Radiação/terapia
19.
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
20.
J Ment Health ; 27(6): 490-495, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28871895

RESUMO

BACKGROUND: This is one of a number of programmatic studies on the allocation of scarce medical resources. AIMS: This study investigated whether certain characteristics about patients influence the priority they are assigned for a scarce mental health treatment. Similar studies for physical treatments have found that young, poor, and mentally healthy patients are given the highest priority. METHOD: Each participant completed one questionnaire where they ranked a list of eight hypothetical patients in order of priority for treatment for anorexia or obesity. The patients varied on three dimensions: age, social class and mental health history. This involved a ranking of prioritisation for treatment. RESULTS: Participants gave the young patients, from a low social class background, who had a mental health history the highest priority for treatment. This is in contrast to previous studies indicating that the mentally unwell are discriminated against. CONCLUSIONS: Participants seemed to be using social class as a proxy measure of ability to pay which they weighted very highly.


Assuntos
Serviços de Saúde Mental/estatística & dados numéricos , Alocação de Recursos/estatística & dados numéricos , Adulto , Idoso , Anorexia/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/terapia , Seleção de Pacientes , Estigma Social , Inquéritos e Questionários , Adulto Jovem
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