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Unplanned weight loss

Denise Ackerman, Meghan Laszlo, Arlene Provisor, Adern Yu
Head and neck cancer (HNC) patients often face multiple nutritional challenges before, during, and after treatment due to the close proximity of the cancer to organs that are vital for normal eating function. Common treatment-related side effects, such as dysphagia, odynophagia, dysgeusia, xerostomia, thick saliva, mucositis, nausea, and vomiting, all further impair the patient's ability to maintain adequate oral intake. Malnutrition and unintentional weight loss in HNC patients during and after treatment are associated with poorer treatment outcomes, increased morbidity and mortality, and poor quality of life, even in overweight and obese patients whose Body Mass Index (BMI) is not suggestive of malnutrition...
2018: Cancer Treatment and Research
John D Groarke, Susanna R Stevens, Robert J Mentz, Lauren B Cooper, Justin M Vader, Omar F AbouEzzeddine, Justin L Grodin, Emer Joyce, Kevin J Anstrom, G Michael Felker, Margaret M Redfield, Lynne Warner Stevenson, Anuradha Lala
AIMS: To explore the association of changes in weight and fluid during treatment for acute heart failure (AHF) with clinical endpoints. METHODS AND RESULTS: Weight and net fluid changes recorded at 72-96 hours in 708 AHF patients enrolled in DOSE-HF, CARRESS-HF or ROSE-AHF, were compared to freedom from congestion at 72-96 hours and a composite end point of death, re-hospitalization, and unplanned hospital visit at 60 days. Weight loss was concordant with net fluid loss in 55%, discordant and less than expected for fluid loss in 34%, and paradoxically discordant or more than expected for fluid loss in 11% of patients...
January 11, 2018: Journal of Cardiac Failure
Yun-Hee Jeon, Anne-Nicole Casey, Kha Vo, Kris Rogers, Belinda Poole, Judith Fethney
Objectives To ascertain Australian multistate prevalence and incidence of five commonly collected clinical indicators of aged-care home quality and to measure associations between these clinical indicators and levels of care needs and consumer and staff satisfaction.Methods A retrospective analysis of national audit data collected from 426 facilities between 2015 and 2016 was performed. Regression models were used to examine associations between five clinical indicators (falls, pressure injury, physical restraint, unplanned weight loss and polypharmacy) and level of care needs measured by the Aged Care Funding Instrument (ACFI) and consumer and care staff survey responses...
January 16, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Eamon J McLaughlin, Jason A Brant, Andres M Bur, John P Fischer, Jinbo Chen, Steven B Cannady, Ara A Chalian, Jason G Newman
OBJECTIVES/HYPOTHESIS: To investigate national trends in admission status after thyroidectomy in the United States and to evaluate the factors associated with 30-day unplanned readmission and reoperation. STUDY DESIGN: Retrospective review of American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) METHODS: The ACS-NSQIP database was queried for patients who underwent a partial or total thyroidectomy between 2005 and 2014. Outpatient surgery was defined as discharge on the day of surgery...
October 8, 2017: Laryngoscope
Rocco Ferrandino, Scott Roof, Yue Ma, Lili Chan, Priti Poojary, Aparna Saha, Kinsuk Chauhan, Steven G Coca, Girish N Nadkarni, Marita S Teng
Objective To examine rates of readmission after parathyroidectomy in patients with chronic kidney disease and determine primary etiologies, timing, and risk factors for these unplanned readmissions. Study Design Retrospective cohort study. Setting Nationwide Readmissions Database. Subjects and Methods The Nationwide Readmissions Database was queried for parathyroidectomy procedures performed in patients with chronic kidney disease between January 2013 and November 2013. Patient-, admission-, and hospital-level characteristics were compared for patients with and without at least 1 unplanned 30-day readmission...
December 2017: Otolaryngology—Head and Neck Surgery
Julia Hippisley-Cox, Carol Coupland
Objectives To derive and validate a risk prediction equation to estimate the short term risk of death, and to develop a classification method for frailty based on risk of death and risk of unplanned hospital admission.Design Prospective open cohort study.Participants Routinely collected data from 1436 general practices contributing data to QResearch in England between 2012 and 2016. 1079 practices were used to develop the scores and a separate set of 357 practices to validate the scores. 1.47 million patients aged 65-100 years were in the derivation cohort and 0...
September 20, 2017: BMJ: British Medical Journal
S Kabir, M S Basher, H Akhter, T Latif, S N Akhter, R K Karmoker, S A Shaon, K Ahmed
Hyperemesis gravidarum is the most severe form of nausea and vomiting in pregnancy with poor pregnancy outcome. Hormonal changes, psychological and immunological factors are attributed to the condition. Recently, prevalence of Helicobacter pylori among women with Hyperemesis gravidarum has been revealed. A descriptive, cross-sectional study was carried out at antenatal ward, Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital, Mymensingh among thirty-six purposively selected patients with Hyperemesis gravidarum to assess the clinic-biochemical profile...
July 2017: Mymensingh Medical Journal: MMJ
Lauren Jan Gleason, Emily A Benton, M Loreto Alvarez-Nebreda, Michael J Weaver, Mitchel B Harris, Houman Javedan
OBJECTIVES: There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. DESIGN: Retrospective cohort study...
December 1, 2017: Journal of the American Medical Directors Association
Yuichi J Shimada, Yusuke Tsugawa, Hiroyasu Iso, David F M Brown, Kohei Hasegawa
BACKGROUND: Hypertension carries a large societal burden. Obesity is known as a risk factor for hypertension. However, little is known as to whether weight loss interventions reduce the risk of hypertension-related adverse events, such as acute care use (emergency department [ED] visit and/or unplanned hospitalization). We used bariatric surgery as an instrument for investigating the effect of large weight reduction on the risk of acute care use for hypertension-related disease in obese adults with hypertension...
August 23, 2017: BMC Medicine
Kris M Mogensen, Clare M Horkan, Steven W Purtle, Takuhiro Moromizato, James D Rawn, Malcolm K Robinson, Kenneth B Christopher
BACKGROUND: We hypothesized that preexisting malnutrition in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed an observational cohort study in 1 academic medical center in Boston. We studied 23,575 patients, aged ≥18 years, who received critical care between 2004 and 2011 and survived hospitalization. RESULTS: The exposure of interest was malnutrition determined at intensive care unit (ICU) admission by a registered dietitian using clinical judgment and on data related to unintentional weight loss, inadequate nutrient intake, and wasting of muscle mass and/or subcutaneous fat...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
Aly Elbahrawy, Alexandre Bougie, Mohammad Albader, Rajesh Aggarwal, Sebastian Demyttenaere, Amin Andalib, Olivier Court
BACKGROUND: Weight recidivism after Roux-en-Y gastric bypass (RYGB) is a common problem. Often, this weight loss failure or regain may be due to a wide gastrojejunostomy (GJ). We evaluated the feasibility and safety of a novel approach of laparoscopic wedge resection of gastrojejunostomy (LWGJ) for a wide stoma after RYGB associated with weight recidivism. METHODS: This is a single-center retrospective study of a prospectively collected database. We analyzed outcomes of patients with weight recidivism after RYGB and a documented wide GJ (>2 cm) on imaging, who underwent LWGJ between 11/2013 and 05/2016...
November 2017: Obesity Surgery
Patty Lakenman, Karen Ottens-Oussoren, Jill Witvliet-van Nierop, Donald van der Peet, Marian de van der Schueren
RATIONALE: It has been shown that early nutrition intervention improves nutrition status (NS) and treatment tolerance in patients with esophageal cancer. However, it remains unknown whether pretreatment parameters of NS are associated with treatment modifications (TMs) during neoadjuvant chemoradiation (CR) in patients who are intensively nutritionally supervised during treatment. METHODS: All outpatients with esophageal cancer who were scheduled for CR in the VU medical center from 2006-2015 were included...
October 2017: Nutrition in Clinical Practice
Yih-Lin Chung, Newman N M Pui
PURPOSE: The aim of this study was to identify patient-centered, mucositis-associated adverse impact factors and events that might confound physician-assessed oral mucositis (OM) in head and neck cancer (HNC) patients receiving chemoradiotherapy. METHODS: This was a post hoc analysis of a previously conducted randomized trial to determine the efficacy of 5% phenylbutyrate mouthwash in preventing chemoradiotherapy-induced OM. This analysis identified patient-centered symptomatic, observable, and measurable factors that may confound physician scoring of the severity of OM during chemoradiotherapy...
September 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Winnie Sun, Diane M Doran, Walter P Wodchis, Elizabeth Peter
BACKGROUND: In an era of a rapidly aging population who requires home care services, clients must possess or develop therapeutic self-care ability in order to manage their health conditions safely in their homes. Therapeutic self-care is the ability to take medications as prescribed and to recognize and manage symptoms that may be experienced, such as pain. The purpose of this research study was to investigate whether therapeutic self-care ability explained variation in the frequency and types of adverse events experienced by home care clients...
March 14, 2017: BMC Health Services Research
Priyadarshani Galappatthy, Jayan D D Jayasinghe, Sampath C Paththinige, Rezvi M H Sheriff, Lalith S Wijayaratne
OBJECTIVES: To compare the pregnancy outcomes and contraceptive practices in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and women with no chronic illness (WNCI) in a tertiary care referral center in Colombo, Sri Lanka. METHODS: Patients with SLE satisfying American College of Rheumatology criteria for diagnosis and history of pregnancies were recruited from university lupus clinic, National Hospital of Sri Lanka (NHSL). Age-matched women with history of pregnancy and RA were recruited from the rheumatology clinic, NHSL and WNCI from a surgical clinic...
February 16, 2017: International Journal of Rheumatic Diseases
Anne Jouinot, Clara Vazeille, Jean Philippe Durand, Olivier Huillard, Pascaline Boudou-Rouquette, Romain Coriat, Jeanne Chapron, Nathalie Neveux, Jean Pascal De Bandt, Jerome Alexandre, Luc Cynober, Francois Goldwasser
BACKGROUND & AIMS: Alterations of nutritional and performance status (PS) are associated with higher risk of chemotherapy toxicity. Increased resting energy expenditure (REE) is frequent in cancer patients and may contribute to cachexia. We investigated whether abnormal energetic metabolism could predict early acute limiting toxicities (ELT) of anticancer treatments. METHODS: In this observational monocentric study, REE was measured by indirect calorimetry before treatment initiation...
January 19, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Teresa E Brown, Merrilyn D Banks, Brett G M Hughes, Charles Y Lin, Lizbeth M Kenny, Judith D Bauer
BACKGROUND: The optimal method of tube feeding for patients with head and neck cancer remains unclear. A validated protocol is available that identifies high-nutritional-risk patients who would benefit from prophylactic gastrostomy tube placement. Adherence to this protocol is ultimately determined by clinical team discretion or patient decision. OBJECTIVE: The study aim was to compare outcomes after adherence and nonadherence to this validated protocol, thus comparing a prophylactic and reactive approach to nutrition support in this patient population...
December 13, 2016: Journal of the Academy of Nutrition and Dietetics
I Dedes, L Schäffer, R Zimmermann, T Burkhardt, C Haslinger
AIM: To evaluate the outcome of a cesarean myomectomy (CM) versus a cesarean delivery (CD) alone in women with uterine myomas and the risk factors for adverse outcomes. METHODS: A retrospective cohort study of all women undergoing CDs with uterine leiomyomatas and singleton pregnancies was performed. Patients with known risk factors for hemorrhage were excluded. Measured adverse outcome parameters included estimated blood loss, drop in hemoglobin levels (pre/postoperatively), operation time, and the use of additional uterotonics...
January 2017: Archives of Gynecology and Obstetrics
Gail C Rampersaud, Andrew Sokolow, Abigail Gruspe, James C Colee, Gail P A Kauwell
OBJECTIVE: To evaluate the impact of educational text messages (TMs) on folate/folic acid knowledge and consumption among college-aged women, and to evaluate the impact of providing folic acid supplements on folate/folic acid intake among college-aged women. PARTICIPANTS: A total of 162 women (18-24 years) recruited from a university. METHODS: The protocol included 3 study visits and a 6-week intervention for 4 groups: control; TM only; supplement only; and TM+supplement...
August 2016: Journal of American College Health: J of ACH
Marissa A Gowey, Jennifer Reiter-Purtill, Jennifer Becnel, James Peugh, James E Mitchell, Meg H Zeller
OBJECTIVE: Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. METHODS: Fifty-four AYA females with severe obesity (MBMI = 48...
April 1, 2016: Appetite
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