scholarly journals C-reactive protein, symptoms and activity of daily living in patients with advanced cancer receiving palliative care

2017 ◽  
Vol 8 (3) ◽  
pp. 457-465 ◽  
Author(s):  
Koji Amano ◽  
Isseki Maeda ◽  
Tatsuya Morita ◽  
Mika Baba ◽  
Tomofumi Miura ◽  
...  
2018 ◽  
Vol 33 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Jason W Boland ◽  
Victoria Allgar ◽  
Elaine G Boland ◽  
Stein Kaasa ◽  
Marianne J Hjermstad ◽  
...  

Background: Performance status, a predictor of cancer survival, and ability to maintain independent living deteriorate in advanced disease. Understanding predictors of performance status trajectory could help identify those at risk of functional deterioration, target support for independent living and reduce service costs. The relationship between symptoms, analgesics and performance status is poorly delineated. Aim: The aim of this study is to determine whether demographics, analgesics, disease characteristics, quality-of-life domains and C-reactive protein predict the trajectory of Karnofsky Performance Status (KPS) in patients with advanced cancer. Design: The study design is the secondary data analysis of the international prospective, longitudinal European Palliative Care Cancer Symptom study (ClinicalTrials.gov: NCT01362816). A multivariable regression model was built for KPS area under the curve per day (AUC). Setting and participants: This included adults with advanced, incurable cancer receiving palliative care, without severe cognitive impairment and who were not imminently dying ( n = 1739). Results: The mean daily KPS AUC ( n = 1052) was 41.1 (standard deviation = 14.1). Opioids ( p < 0.001), co-analgesics ( p = 0.023), poorer physical functioning ( p < 0.001) and appetite loss ( p = 0.009) at baseline were explanatory factors for lower KPS AUC. A subgroup analysis of participants with C-reactive protein data ( n = 240) showed that only C-reactive protein ( p = 0.040) and physical function ( p < 0.001) were associated with lower KPS AUC. Conclusion: This study is novel in determining explanatory factors for subsequent functional trajectories in an international dataset and identifying systemic inflammation as a candidate therapeutic target to improve functional performance. The effect of interventions targeting physical function, appetite and inflammation, such as those used for cachexia management, on maintaining functional status in patients with advanced cancer needs to be investigated.


Author(s):  
Livia Costa de Oliveira ◽  
Karla Santos da Costa Rosa ◽  
Ana Luísa Durante ◽  
Luciana de Oliveira Ramadas Rodrigues ◽  
Daianny Arrais de Oliveira da Cunha ◽  
...  

Background: Advanced cancer patients are part of a group likely to be more susceptible to COVID-19. Aims: To describe the profile of advanced cancer inpatients to an exclusive Palliative Care Unit (PCU) with the diagnosis of COVID-19, and to evaluate the factors associated with death in these cases. Design: Retrospective cohort study with data from advanced cancer inpatients to an exclusive PCU, from March to July 2020, with severe acute respiratory syndrome. Diagnostic of COVID-19 and death were the dependent variables. Logistic regression analyses were performed, with the odds ratio (OR) and 95% confidence interval (CI). Results: One hundred fifty-five patients were selected. The mean age was 60.9 (±13.4) years old and the most prevalent tumor type was breast (30.3%). Eighty-three (53.5%) patients had a diagnostic confirmation of COVID-19. Having diabetes mellitus (OR: 2.2; 95% CI: 1.1-6.6) and having received chemotherapy in less than 30 days before admission (OR: 3.8; 95% CI: 1.2-12.2) were associated factors to diagnosis of COVID-19. Among those infected, 81.9% died and, patients with Karnofsky Performance Status (KPS) < 30% (OR: 14.8; 95% CI 2.7-21.6) and C-reactive protein (CRP) >21.6mg/L (OR: 9.3; 95% CI 1.1-27.8), had a greater chance of achieving this outcome. Conclusion: Advanced cancer patients who underwent chemotherapy in less than 30 days before admission and who had diabetes mellitus were more likely to develop Coronavirus 2019 disease. Among the confirmed cases, those hospitalized with worse KPS and bigger CRP were more likely to die.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 3025-3025 ◽  
Author(s):  
S. J. Clarke ◽  
J. T. Smith ◽  
C. Gebbie ◽  
C. Sweeney ◽  
N. Olszewski

3025 Background: ALD518 is a humanized anti-IL-6 antibody being developed for the treatment of cancer cachexia and fatigue. The primary objective of the study was to determine the safety of ALD518. Methods: 9 patients (pts) with advanced cancer, ECOG 0–2, and C-reactive protein (CRP) >10mg/L were enrolled. Pts were assigned to 1 of 3 dose-escalating cohorts (n=3/cohort). ALD518 was given as a single i.v. infusion of 80mg, 160mg, or 320mg. Pts were followed up for 12 weeks. Data included lab safety tests (LSTs), vital signs, ECGs, adverse events, hand grip strength (HGS), FACIT-F, PK and C-reactive protein (CRP). Results: 9 pts were evaluable for dose limiting toxicity (DLT) assessment at week 4 and 5/9 pts completed all visits. Of the 4 pts who failed to complete every visit; 3 were withdrawn due to progressive disease and 1 to be treated with chemotherapy. There were no DLTs or infusion reactions. There were 4 SAEs: 3 disease progressions and 1 sepsis secondary to a blocked biliary stent. There were no grade 3/4 toxicities. Changes in LSTs, CRP, HGS and FACIT-F fatigue subscale (pooled ITT analysis) are shown (Table). Conclusions: ALD518 given to pts with advanced cancer was safe and well tolerated. ALD518 reversed fatigue, increased hemoglobin and albumin, and there was a trend to increased HGS. There was a mild decrease in platelet count that remained stable throughout the study. [Table: see text] [Table: see text]


2017 ◽  
Vol 114 (17) ◽  
pp. 4354-4359 ◽  
Author(s):  
Andrew Steptoe ◽  
Jane Wardle

Life skills play a key role in promoting educational and occupational success in early life, but their relevance at older ages is uncertain. Here we measured five life skills—conscientiousness, emotional stability, determination, control, and optimism—in 8,119 men and women aged 52 and older (mean 66.7 y). We show that the number of skills is associated with wealth, income, subjective wellbeing, less depression, low social isolation and loneliness, more close relationships, better self-rated health, fewer chronic diseases and impaired activities of daily living, faster walking speed, and favorable objective biomarkers (concentration of high-density lipoprotein cholesterol, vitamin D and C-reactive protein, and less central obesity). Life skills also predicted sustained psychological wellbeing, less loneliness, and a lower incidence of new chronic disease and physical impairment over a 4-y period. These analyses took account of age, sex, parental socioeconomic background, education, and cognitive function. No single life skill was responsible for the associations we observed, nor were they driven by factors such as socioeconomic status or health. Despite the vicissitudes of later life, life skills impact a range of outcomes, and the maintenance of these attributes may benefit the older population.


2008 ◽  
Vol 55 (4) ◽  
pp. 266-272 ◽  
Author(s):  
Lalitha Jeyasingam ◽  
Meera Agar ◽  
Michael Soares ◽  
John Plummer ◽  
David Currow

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