scholarly journals Involuntary weight loss without specific symptoms: a clinical prediction score for malignant neoplasm

QJM ◽  
2003 ◽  
Vol 96 (9) ◽  
pp. 649-655 ◽  
Author(s):  
J.L. Hernandez ◽  
P. Matorras ◽  
J.A. Riancho ◽  
J. Gonzalez-Macias
Keyword(s):  
Weight Loss ◽  
Malignant Neoplasm ◽  
Prediction Score ◽  
Clinical Prediction ◽  
Specific Symptoms ◽  
Involuntary Weight Loss

Clinical evaluation for cancer in patients with involuntary weight loss without specific symptoms

2003 ◽  
Vol 114 (8) ◽  
pp. 631-637 ◽  
Author(s):  
José L Hernández ◽  
José A Riancho ◽  
Pedro Matorras ◽  
Jesús González-Macías
Keyword(s):  
Weight Loss ◽  
Clinical Evaluation ◽  
Specific Symptoms ◽  
Involuntary Weight Loss

scholarly journals Etiologies and 12-month mortality in patients with isolated involuntary weight loss at a rapid diagnostic unit

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257752
Author(s):  
Jordi Aligué ◽  
Mireia Vicente ◽  
Anna Arnau ◽  
Jaume Trapé ◽  
Eva Martínez ◽  
...  
Keyword(s):  
Weight Loss ◽  
Small Samples ◽  
Main Diagnosis ◽  
X Rays ◽  
Vital Status ◽  
Diagnostic Unit ◽  
Specific Symptoms ◽  
Involuntary Weight Loss ◽  
Tomography Scan ◽  
Overall Mortality

Background Numerous studies on involuntary weight loss (IWL) have been published since the 1980s, although most of them have included small samples of patients with specific symptoms. The aim of the present study was to determine the causes, demographic and clinical characteristics and mortality at 12 months in patients attended at a rapid diagnostic unit (RDU) for isolated IWL. Methods A single-center retrospective observational study including all patients presenting to the RDU for isolated IWL between 2005 and 2013. The following data were recorded: demographic and clinical variables, results of complementary tests (blood tests, x-rays, computed tomography scan and digestive endoscopy), main diagnosis and vital status at 12 months. Results Seven hundred and ninety-one patients met the criteria for IWL. Mean age was 67.9 years (SD 4.7), 50.4% were male and mean weight loss was 8.3 kg (SD 4.7). The cause for IWL was malignant disease in 23.6% of patients, non-malignant organic disease in 44.5%, psychiatric disorder in 29.0% and unknown in 3.2%. Overall mortality at 12 months was 18.6% (95%CI: 16.1–21.6). The mortality rate was highest in the group with malignancy (61.1%; 95%CI: 54.2–68.2). Conclusions Almost a quarter of all patients attended at the RDU for IWL were diagnosed with cancer. Mortality at 12 months was higher in this group than in the other three. Malignancy should therefore be ruled out during the first visit for patients attended for IWL.

scholarly journals Cancer and Involuntary Weight Loss: Failure to Validate a Prediction Score

PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e95286 ◽  
Author(s):  
Cristian Baicus ◽  
Mihai Rimbas ◽  
Anda Baicus ◽  
Simona Caraiola ◽  
Keyword(s):  
Weight Loss ◽  
Prediction Score ◽  
Weight Loss Failure ◽  
Involuntary Weight Loss

Clinical Dutch-English Lambert-Eaton Myasthenic Syndrome (LEMS) Tumor Association Prediction Score Accurately Predicts Small-Cell Lung Cancer in the LEMS

2011 ◽  
Vol 29 (7) ◽  
pp. 902-908 ◽  
Author(s):  
Maarten J. Titulaer ◽  
Paul Maddison ◽  
Jacob K. Sont ◽  
Paul W. Wirtz ◽  
David Hilton-Jones ◽  
...  
Keyword(s):  
Weight Loss ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Age At Onset ◽  
Small Cell ◽  
Prediction Score ◽  
Receiver Operating Curve ◽  
Small Cell Lung ◽  
Myasthenic Syndrome ◽  
Tumor Association

Purpose Approximately one half of patients with Lambert-Eaton myasthenic syndrome (LEMS) have small-cell lung carcinomas (SCLC), aggressive tumors with poor prognosis. In view of its profound impact on therapy and survival, we developed and validated a score to identify the presence of SCLC early in the course of LEMS. Patients and Methods We derived a prediction score for SCLC in LEMS in a nationwide cohort of 107 Dutch patients, and validated it in a similar cohort of 112 British patients. A Dutch-English LEMS Tumor Association Prediction (DELTA-P) score was developed based on multivariate logistic regression. Results Age at onset, smoking behavior, weight loss, Karnofsky performance status, bulbar involvement, male sexual impotence, and the presence of Sry-like high-mobility group box protein 1 serum antibodies were independent predictors for SCLC in LEMS. A DELTA-P score was derived allocating 1 point for the presence of each of the following items at or within 3 months from onset: age at onset ≥ 50 years, smoking at diagnosis, weight loss ≥ 5%, bulbar involvement, erectile dysfunction, and Karnofsky performance status lower than 70. The area under the curve of the receiver operating curve was 94.4% in the derivation cohort and 94.6% in the validation set. A DELTA-P score of 0 or 1 corresponded to a 0% to 2.6% chance of SCLC, whereas scores of 4, 5, and 6 corresponded to chances of SCLC of 93.5%, 96.6%, and 100%, respectively. Conclusion The simple clinical DELTA-P score discriminated patients with LEMS with and without SCLC with high accuracy early in the course of LEMS.

Alterations In Macronutrient ­Metabolism In Starvation And Disease

2018 ◽  
Author(s):  
L John Hoffer
Keyword(s):  
Weight Loss ◽  
Muscle Atrophy ◽  
Systemic Inflammation ◽  
Protein Energy Malnutrition ◽  
Metabolic Adaptation ◽  
Clinical Approach ◽  
Protein Energy ◽  
Key Words Adaptation ◽  
Disuse Muscle Atrophy ◽  
Involuntary Weight Loss

This review explains starvation as both a physiologic process and a disease. It includes a detailed explanation of the modifying effects of metabolic adaptation and systemic inflammation, as interpreted in a clinical context. It navigates the reader through the difficult shoals of vague and conflicting terminology that burden this topic and provides current definitions and nuanced explanations of the important but frequently misunderstood terms related to starvation and its modifiers and consequences. It provides a succinct explanation of the physiology of total fasting and its clinical correlates. Finally, it explains the interactions among starvation, sarcopenia, frailty, involuntary weight loss, systemic inflammation, cachexia, and disuse muscle atrophy. The multiple and interacting causes of generalized muscle atrophy are pointed out. Inadequate appreciation of these interactions can result in failure to diagnose and treat starvation-induced diseases. A clinical approach to involuntary weight loss is outlined.   This review contains 6 figures, 2 tables and 56 references Key words: adaptation, cachexia, frailty, hypoalbuminemia, inflammation, ketosis, kwashiorkor, malnutrition, marasmus, muscle atrophy, protein-energy malnutrition, sarcopenia, starvation, systemic inflammation, weight loss

scholarly journals Diagnosis of dermatomyositis and polymyositis: a study of 102 cases

2000 ◽  
Vol 58 (3B) ◽  
pp. 789-799 ◽  
Author(s):  
ROSANA HERMINIA SCOLA ◽  
LINEU CESAR WERNECK ◽  
DANIEL MONTE SERRAT PREVEDELLO ◽  
EDIMAR LEANDRO TODERKE ◽  
FÁBIO MASSAITI IWAMOTO
Keyword(s):  
Weight Loss ◽  
Creatine Kinase ◽  
Connective Tissue ◽  
Connective Tissue Diseases ◽  
Malignant Neoplasm ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Muscle Enzymes ◽  
Systemic Involvement ◽  
Perifascicular Atrophy

Patients with dermatomyositis (DM) or polymyositis (PM) were studied retrospectively. The patients were divided into four groups: definite PM 24, probable PM 19, definite DM 34 and mild-early DM 25 cases. PM patients complained more often proximal muscle weakness [p <0.01]. DM patients complained more arthralgia [p <0.05], dysphagia [p <0.03] and weight loss [p <0.04]. Five patients had a malignant neoplasm and 9 had other connective-tissue disease. DM presented higher ESR than PM [p <0.002]. PM presented more significant increase in creatine kinase (CK) [p <0.02] and in alanine aminotransferase (ALT) [p <0.001] levels. Electromyography showed myopathic pattern in 76%. Muscle biopsy was the definitive test. Perifascicular atrophy was more frequent in definite DM than in mild-early DM group [p <0.03]. CONCLUSION: A small association with connective-tissue diseases and neoplasms was found. DM and PM are clinically different. DM presents systemic involvement affecting the skin, developing more severe arthralgia, dysphagia and weight loss and presenting higher values of ESR. PM presents a restricted and more significant involvement of muscles generating more weakness complaints and higher levels of serum muscle enzymes.

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