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Vicente Ruiz-García, Eduardo López-Briz, Rafael Carbonell-Sanchis, Sylvia Bort-Martí, José Luis Gonzálvez-Perales
In 1993, megestrol acetate (MA) was approved by the US Food and Drug Administration for the treatment of anorexia, cachexia, or unexplained weight loss in patients with acquired immunodeficiency syndrome. The mechanism by which MA increases appetite is unknown, and its effectiveness for anorexia and cachexia in neoplastic, elderly, and acquired immunodeficiency syndrome patients is under investigation. This is an updated version of a Cochrane systematic review first published in 2005 and later updated in 2013 entitled 'Megestrol acetate for the treatment of anorexia-cachexia syndrome'...
March 14, 2018: Journal of Cachexia, Sarcopenia and Muscle
Sarah Gray, Bertil Axelsson
INTRODUCTION: Amongst patients with incurable cancer approaching death, cachexia is common and associated with adverse outcomes. The term cachexia lacks a universally accepted definition and there is no consensus regarding which variables are to be measured. Furthermore, an elevated C-reactive protein is a common clinical challenge in this patient group. This study aims to add to the ongoing discussion regarding the definition of cancer cachexia and to study the role of C-reactive protein and s-albumin in this context...
2018: PloS One
Sabrina Rossi, Vincenzo Di Noia, Laura Tonetti, Antonia Strippoli, Michele Basso, Giovanni Schinzari, Alessandra Cassano, Antonio Leone, Carlo Barone, Ettore D'Argento
AIM: To evaluate gefitinib outcomes in EGFR-mutated non-small-cell lung cancer (NSCLC) patients harboring EGFR mutations, according to their sarcopenia status. PATIENTS & METHODS: We retrospectively evaluated 33 patients with advanced NSCLC and EGFR mutations (exon 19 or 21), dividing them into sarcopenic patients, with low skeletal muscle index ≤39 cm2 /m2 for women and ≤55 cm2 /m2 for men, and nonsarcopenic patients. RESULTS: Sarcopenia does not affect response to gefitinib treatment in EGFR mutated NSCLC patients, even if it is a bad prognostic indicator for overall survival (p = 0...
March 12, 2018: Future Oncology
S Ben Saad, B Melki, L Douik El Gharbi, F Soraya, N Chaouch, H Aouina, J Cherif, A Hamzaoui, A Merghli, H Daghfous, F Tritar
BACKGROUND: Pneumothorax is a serious complication of cavitary pulmonary tuberculosis. The aim of this study was to describe clinical futures, to highlight challenges of its management. METHODS: A retrospective multicentric and descriptive study including 65 patients treated for PT (1999-2015) was conducted to figure out clinical futures and its work-up. RESULTS: The mean age was 37.8 years. The sex ratio was 3.6. Smoking history and incarceration were noted respectively in 67...
March 6, 2018: Revue de Pneumologie Clinique
Ewa Zabrocka, Marek Z Wojtukiewicz, Ewa Sierko
Advanced cancer patients in hospice are at notably increased risk of venous thromboembolism (VTE) due to age, local and distal advancement of the malignancy and bed confinement, among other factors. Asymptomatic VTE prevalence among palliative care patients has been found to reach 50%, whereas the clinically overt form occurs in 10%. Hospice patients are frequently given medications increasing VTE risk, for instance megestrol which is a drug commonly used in cancer cachexia. Many of the available guidelines encourage the implementation of thromboprophylaxis (TPX) in cancer patients, e...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Mingzhi Xie, Xiaoju Chen, Shouming Qin, Yongjian Bao, Kunpeng Bu, Yang Lu
Objective: To discuss and assess the clinical value of treating lung cancer cachexia with thalidomide combined with cinobufagin.s. Methods: A cohort of 54 patients, who were diagnosed with lung carcinoma, was randomly divided into two groups, a trial group and a control group, respectively. The trial group was given 150 mg/day thalidomide and 2700 mg/day cinobufagin; the control group only received 2,700 mg/day cinobufagin. The therapy lasted for 12 weeks, and the nutritional status, quality of life, survival, and side effects in patients in the two groups were recorded...
January 2018: Journal of Cancer Research and Therapeutics
Hsien-Chun Chiu, Chen-Yuan Chiu, Rong-Sen Yang, Ding-Cheng Chan, Shing-Hwa Liu, Chih-Kang Chiang
BACKGROUND: A global consensus on the loss of skeletal muscle mass and function in humans refers as sarcopenia and cachexia including diabetes, obesity, renal failure, and osteoporosis. Despite a current improvement of sarcopenia or cachexia with exercise training and supportive therapies, alternative and specific managements are needed to discover for whom are unable or unwilling to embark on these treatments. Alendronate is a widely used drug for osteoporosis in the elderly and postmenopausal women...
March 6, 2018: Journal of Cachexia, Sarcopenia and Muscle
Esther Ganelin Cohen, Hanna Bessler, Meir Djaldetti, Rachel Straussberg
Prompted by findings suggesting immune instability in infantile bilateral striatal necrosis (IBSN), we evaluated levels of proinflammatory (tumor necrosis factor α, interleukin [IL]-1β, IL-6, interferon [IFN]γ) and anti-inflammatory (IL-10 and IL-1ra) cytokines produced by peripheral blood mononuclear cells (PBMC) from 6 children with IBSN and 11 age-matched controls. Compared to controls, non-stimulated PBMC from the IBSN group produced a significantly lower level of IL-1ra (by 38%; p < 0.001) and significantly lower levels of TNFα, IL-1β, and IFNγ (by 36% [p < 0...
March 6, 2018: Neuroimmunomodulation
S Zaami, A Di Luca, N M Di Luca, G Montanari Vergallo
This review illustrates some brief considerations of the medical use of cannabis recently issued in Italy. History and uses of cannabis throughout centuries and different countries are illustrated together with a description of botany and active phytocannabinoids. Then, medical use of cannabis anti-pain treatment for patients resistant to conventional therapies is described in case of chronic neuropathic pain, spasticity, for anticinetosic and antiemetic effect in nausea and vomiting caused by chemotherapy, for appetite stimulating effect in cachexia, anorexia, loss of appetite in cancer patients or patients with AIDS and in anorexia nervosa, hypotensive effect in glaucoma resistant to conventional therapies and for reduction of involuntary body and facial movements in Gilles de la Tourette syndrome...
February 2018: European Review for Medical and Pharmacological Sciences
Koji Amano, Tatsuya Morita, Jiro Miyamoto, Teruaki Uno, Hirofumi Katayama, Ryohei Tatara
PURPOSE: Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings. Therefore, we conducted a questionnaire to examine the relationship between the perception of need for nutritional support and cancer cachexia and the prevalence of specific needs, perceptions, and beliefs in nutritional support. METHODS: We conducted a questionnaire in palliative care settings. Patients were classified into two groups: (1) non-cachexia/pre-cachexia and (2) cachexia/refractory cachexia...
March 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
R Dev, E Bruera, S Dalal
Cancer cachexia, weight loss with altered body composition, is a multifactorial syndrome propagated by symptoms that impair caloric intake, tumor byproducts, chronic inflammation, altered metabolism, and hormonal abnormalities. Cachexia is associated with reduced performance status, decreased tolerance to chemotherapy, and increased mortality in cancer patients. Insulin resistance as a consequence of tumor byproducts, chronic inflammation, and endocrine dysfunction has been associated with weight loss in cancer patients...
February 1, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
S Antoun, B Raynard
In the field of oncology, it is well recognized that a decrease in mass, density, strength, or function of skeletal muscle is associated to increased treatment toxicities and postoperative complications, as well as poor progression-free survival and overall survival. The ability of amino acids to stimulate protein synthesis in cancer patients is reduced. Considering nutritional intervention, this anabolic resistance could be in a part counteracted by increasing protein or by giving specific amino acids. In particular, Leucine might counteract this anabolic resistance not only by increasing substrate availability, but also by directly modulating the anabolic signal pathway...
February 1, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
A Gigante, E Rosato, B Barbano, F Di Mario, G Di Lazzaro-Giraldi, M L Gasperini, R Pofi, A Laviano
Cardiorenal syndrome (CRS) describes the concurrent failure of cardiac and renal function, each influencing the other. Malnutrition and cachexia frequently develop in patients with heart failure or kidney failure. However, no information is currently available on the prevalence of malnutrition in CRS patients. We studied CRS patients admitted to an internal medicine ward during a 5-month period and evaluated their clinical characteristics and nutritional status. Malnutrition risk was assessed by using the validated screening tool NRS-2002 whilst body composition was assessed by bioimpedance analysis and muscle function was measured by handgrip (HG) strength...
January 2018: Journal of Biological Regulators and Homeostatic Agents
Chih-Horng Wu, Ming-Chu Chang, Vladimir K Lyadov, Po-Chin Liang, Chyi-Mong Chen, Tiffany Ting-Fang Shih, Yu-Ting Chang
BACKGROUND & AIMS: Sarcopenia and cachexia are associated with pancreatic cancer and serve as important adverse prognostic factors. Body composition can be analyzed by routine computed tomography (CT) for cancer staging and has been used to study many types of cancer. The CT measurements are robust, but the diagnostic criteria for sarcopenia vary among different studies. Age, sex and race are important factors that affect muscle and fat masses. This study aimed to analyze the effect of different sarcopenia diagnostic criteria on the prognosis of patients with pancreatic cancer...
February 20, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Mahalaqua Nazli Khatib, Anuraj H Shankar, Richard Kirubakaran, Abhay Gaidhane, Shilpa Gaidhane, Padam Simkhada, Zahiruddin Quazi Syed
BACKGROUND: Cancer sufferers are amongst the most malnourished of all the patient groups. Studies have shown that ghrelin, a gut hormone can be a potential therapeutic agent for cachexia (wasting syndrome) associated with cancer. A variety of mechanisms of action of ghrelin in people with cancer cachexia have been proposed. However, safety and efficacy of ghrelin for cancer-associated cachexia have not been systematically reviewed. The aim of this review was to assess whether ghrelin is associated with better food intake, body composition and survival than other options for adults with cancer cachexia...
February 28, 2018: Cochrane Database of Systematic Reviews
Syahrir Zaini, N G Chong Guan, Ahmad Hatim Sulaiman, Nor Zuraida Zainal, Hasniza Zaman Huri, Siti Hadijah Shamsudin
: Cancer patients are commonly associated with various physical and psychological symptoms. In view of this matter, palliative care is usually given to relieve those symptoms, improve quality of life, and increase medication adherence. Antidepressants are generally accepted for the treatment of depression among patients with or without cancer. Some other potential benefits of these medications have been experienced in clinical practice. Therefore, this study aimed to review the use of antidepressant for physical and psychological symptoms in cancer...
February 26, 2018: Current Drug Targets
Yoshinaga Okugawa, Li Yao, Yuji Toiyama, Akira Yamamoto, Tsunehiko Shigemori, Chengzeng Yin, Yusuke Omura, Shozo Ide, Takahito Kitajima, Tadanobu Shimura, Hiroyuki Fujikawa, Hiromi Yasuda, Junichiro Hiro, Shigeyuki Yoshiyama, Minako Kobayashi, Koji Tanaka, Yasuhiro Inoue, Toshimitsu Araki, Chikao Miki, Masato Kusunoki
Severe malnutrition accompanied by sarcopenia and cachexia, is strongly associated with the surgical and oncological outcomes in cancer patients. The aim of the present study was to clarify the clinical significance of sarcopenia and its correlation with sarcopenia-associated miRNA in colorectal cancer (CRC). A total of 167 CRC patients were enrolled in the present study. We evaluated psoas muscle mass index (PMI) and intramuscular adipose tissue content (IMAC). The expression of miR-21 in CRC tissues and preoperative serum was evaluated using quantitative PCR...
February 14, 2018: Oncology Reports
A Mohan, R Poulose, A Ansari, K Madan, V Hadda, G C Khilnani, R Guleria
BACKGROUND: Malnutrition is frequent in lung cancer and is measured using various tools, including the novel bioelectric impedance technique for measuring body composition. However, the validation of this technique for assessing body composition in advanced small cell lung cancer (SCLC) is untested. METHODS: Forty-one treatment naïve patients (all males) and an equal number of age- and sex-matched controls were evaluated by anthropometric measurements of skinfold thicknesses and body composition parameters such as body fat%, fat mass, fat-free mass (FFM), and total body water (TBW)...
April 2017: Indian Journal of Cancer
Muhammed Keskin, Göktük İpek, Mustafa Aldağ, Servet Altay, Mert İlker Hayıroğlu, Edibe Betül Börklü, Duygu İnan, Ömer Kozan
OBJECTIVES: The prognostic effects of poor nutritional status and cardiac cachexia on coronary artery disease (CAD) are not clearly understood. A well-accepted nutritional status parameter, the prognostic nutritional index (PNI), which was first demonstrated to be valuable in patients with cancer and those undergoing gastrointestinal surgery, was introduced to patients requiring coronary artery bypass grafting (CABG). The aim of the present study was to evaluate the prognostic value of PNI in patients with CAD undergoing CABG...
December 7, 2017: Nutrition
Linda Rhodes, Bill Zollers, Jessica A Wofford, Ernst Heinen
Ghrelin is a hormone, secreted from cells in the stomach, which is important in the regulation of appetite and food intake in mammals. It exerts its action by binding to a specific G-protein-coupled receptor, the growth hormone secretagogue receptor 1a (GHS-R1a) which is found in areas of the brain associated with the regulation of food intake. Ghrelin causes a release of growth hormone (GH) through binding to GHS-R1a in the hypothalamus and pituitary gland. A class of compounds known as growth hormone secretagogues, or ghrelin receptor agonists, were developed for therapeutic use in humans for the stimulation of GH in the frail elderly, and have subsequently been studied for their effects on increasing appetite and food intake, increasing body weight, building lean muscle mass, and treating cachexia...
February 2018: Veterinary Medicine and Science
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