Diagnostic criteria of cancer cachexia: relation to quality of life, exercise capacity and survival in unselected palliative care patients

2013 ◽  
Vol 21 (6) ◽  
pp. 1569-1577 ◽  
Author(s):  
Ola Wallengren ◽  
Kent Lundholm ◽  
Ingvar Bosaeus
2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 67-67
Author(s):  
Neha Kapoor ◽  
Ihab Tewfik ◽  
Jane Naufahu ◽  
Sundus Tewfik ◽  
Rakesh Garg ◽  
...  

67 Background: The prevalence of malnutrition, amongst cancer palliative patients, is 81%. As cancer progresses, patients’ develop malnutrition owing to metabolic changes and ill-effects of treatment. The aim of this study was to improve nutritional status of female cancer patients and their quality of life by counseling and providing nutrient rich natural food (IAtta). Methods: Female cancer patients (n=45) attending palliative care clinic (AIIMS, New Delhi); with symptoms of cachexia were randomly distributed into control (Group one, n=23) and intervention group (Group two, n=22). Both groups were provided with nutritional counseling while the intervention group also received 100grams of IAtta, to be consumed daily for three months. Anthropometric measurements [weight, muscle mass, percentage body fat (%BF) and mid upper arm circumference (MUAC)], dietary intake (two day dietary recall) and quality of life (European Organisation for Research and Treatment of Cancer-Quality of Life C30 Questionnaire) were assessed at baseline and after three months. Data was analysed using paired t-test and Wilcoxon signed-rank test on the variables assessed. P-value < 0.05 was considered statistically significant at 95% confidence interval. Results: Patients in group one had significantly decreased body weight (p= 0.001), muscle mass (p= 0.021), MUAC (p= 0.005) and %BF (p= 0.001) by end of three months. While patients in group two reported significant improvement in fatigue (p= 0.001) and appetite loss score (p= 0.002) under quality of life domains. Conclusions: Nutritional counseling along with IAtta food supplementation helps in stabilising weight and improves quality of life of cancer cachexia patients undergoing palliative care treatment. Clinical trial information: RP- 02/17.06.2013. [Table: see text]


2012 ◽  
Vol 9 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Gina G Mentzer ◽  
Alex J Auseon

Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. clinically, there is acceptance that exercise is safe in hf and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for hf patients in exercise testing and therapy to provide comprehensive cardiac care. it is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from hf.


BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025692 ◽  
Author(s):  
Corita R Grudzen ◽  
Deborah J Shim ◽  
Abigail M Schmucker ◽  
Jeanne Cho ◽  
Keith S Goldfeld

IntroductionEmergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysisThis is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and disseminationInstitutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03325985; Pre-results.


Pulmonology ◽  
2021 ◽  
Author(s):  
Jhonatan Betancourt-Peña ◽  
Juan Carlos Ávila-Valencia ◽  
Diana Milena Diaz-Vidal ◽  
Vicente Benavides-Córdoba

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