scholarly journals Chemotherapy-Induced Cachexia and Model-Informed Dosing to Preserve Lean Mass in Cancer Treatment

2021 ◽  
Author(s):  
Suzan Farhang-Sardroodi ◽  
Michael A. La Croix ◽  
Kathleen P. Wilkie
Keyword(s):  
Quality Of Life ◽  
Mathematical Model ◽  
Side Effects ◽  
Lean Mass ◽  
Dose Dependence ◽  
Muscle Loss ◽  
Chemotherapy Treatment ◽  
Linear Dose ◽  
Non Linear

AbstractAlthough chemotherapy is a standard treatment for cancer, it comes with significant side effects. In particular, certain agents can induce severe muscle loss, known as cachexia, worsening patient quality of life and treatment outcomes. 5-fluorouracil, an anti-cancer agent used to treat several cancers, has been shown to cause muscle loss. Experimental data indicates a non-linear dose-dependence for muscle loss in mice treated with daily or week-day schedules. We present a mathematical model of chemotherapy-induced muscle wasting that captures this non-linear dose-dependence. Area-under-the-curve metrics are proposed to quantify the treatment’s effects on lean mass and tumour control. Model simulations are used to explore alternate dosing schedules, aging effects, and morphine use in chemotherapy treatment with the aim of better protecting lean mass while actively targeting the tumour, ultimately leading to improved personalization of treatment planning and improved patient quality of life.Author SummaryIn this paper we present a novel mathematical model for muscle loss due to cancer chemotherapy treatment. Loss of muscle mass relates to increased drug toxicity and side-effects, and to decreased patient quality of life and survival rates. With our model, we examine the therapeutic efficacy of various dosing schedules with the aim of controlling a growing tumour while also preserving lean mass. Preservation of body composition, in addition to consideration of inflammation and immune interactions, the gut microbiome, and other systemic health measures, may lead to improved patient-specific treatment plans that improve patient quality of life.

scholarly journals MATHEMATICAL MODELING AND CONTROL OF HIV INFECTION DYNAMICS TAKING INTO ACCOUNT HORMONAL REGULATION

2019 ◽  
Vol 23 (1) ◽  
pp. 79-103 ◽  
Author(s):  
A. A. Savinkova ◽  
R. S. Savinkov ◽  
B. A. Bakhmetyev ◽  
G. A. Bocharov
Keyword(s):  
Quality Of Life ◽  
Mathematical Model ◽  
Side Effects ◽  
Hiv Infection ◽  
Hormonal Regulation ◽  
Optimization Methods ◽  
Cost Of Drugs ◽  
The Cost ◽  
The Mathematical Model

Aims: The problem of effective treatment of HIV-infected patients is an important task of clinical virology and immunology due to the high cost of drugs, the presence of side effects and the need for strict adherence to the schedule of drug intake for patients. Therefore, the urgent task is to develop new approaches to optimize the use of antiretroviral therapy to reduce the cost of treatment and to improve the quality of life for patients. The tasks are addressed to test the hypothesis that the system of therapeutic interruptions in the treatment of HIV infection can give better results (both the duration and comfort of the patient’s life, and the need for fewer drugs) compared with regular medication in standard doses. Methods: In this work, an extended version of the mathematical model of the immune response in HIV infection (proposed in Hadjiandreou et al., 2009) was constructed to take into account the hormonal regulation of the immune response and the impact of antiretroviral drugs on the course of the disease, the calibration of the parameters of the resulting model to match the actual trends of the disease and the search for an optimal treatment strategy. The model is formulated as a system of ordinary differential equations. The therapy optimization is modeled following the structured treatment interruptionapproach using the methods of simulated annealing and the simplex method. The mathematical model and optimization methods are implemented in C ++. Results: It has been shown that in treating HIV-infected patients, it is possible to significantly (up to 3 times) reduce the total amount of required medications simultaneously with an increase in the duration of the period with a high quality of life (due to reducing the intensity of side effects) during antiretroviral therapy. Conclusion: The use of mathematical models and optimization methods opens up the possibility for the implementation of personalized approaches to the treatment of HIV infection, taking into account the side effects, the hormonal status of patients and the cost of drugs.

scholarly journals Penerapan Auricular Acupressure Untuk Mengurangi Konstipasi Pasien Kemoterapi

JKEP ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 161-170
Author(s):  
Edianto Edianto ◽  
Agung Waluyo ◽  
Sri Yona ◽  
Yunisar Gultom
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Nursing Intervention ◽  
Chemotherapy Treatment ◽  
Post Intervention ◽  
Treatment Room ◽  
Auricular Acupressure ◽  
Significant Difference

Most cancer patients receive chemotherapy which contributes to prolong life, with the most common side effects of constipation. Constipation causes general symptoms that are bad and affect the quality of life of patients. The purpose of evidance based nursing (EBN) is to identify the effectiveness of Auricular acupressure in overcoming symptoms of constipation in cancer patients receiving chemotherapy. This EBN uses quasi experiments involving 14 participants in the chemotherapy treatment room with pre and post intervention assessments. The results of the analysis of the independent t-test showed that there was a significant difference in the form of faeces on day 6 with p <0.000 (95% CI). Conclusion: Auricular acupressure can be used as a constipation management nursing intervention in cancer patients undergoing chemotherapy.

scholarly journals Avaliação da qualidade de vida de pacientes com doença oncohematológica em quimioterapia

2018 ◽  
Vol 12 (5) ◽  
pp. 1200
Author(s):  
Rhodnei Alves Gomes ◽  
Angélica Da Conceição Oliveira Coelho ◽  
Denise Cristina Alves de Moura ◽  
Jennifer Santiago da Cruz ◽  
Kelli Borges dos Santos
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Descriptive Study ◽  
Chemotherapy Treatment ◽  
Sample Analysis ◽  
Calidad De Vida ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

RESUMOObjetivo: avaliar a qualidade de vida de pacientes com diagnóstico de doenças oncohematológicas em uso de quimioterapia. Método: estudo quantitativo, transversal, exploratório, descritivo, com pacientes em tratamento quimioterápico, com diagnóstico de doença oncohematológica, em um hospital público filantrópico, utilizando-se, como instrumento para a coleta de dados, o questionário EORTC QLQ-C30 e um formulário para a caracterização do perfil da amostra. A análise dos resultados foi realizada com base no EORTC QLQ-C30 Scoring Manual. Utilizou-se p ≤ 0,05 para a caracterização da análise da amostra e suas variáveis estatisticamente significativas. Resultados: em relação à avaliação da saúde, encontrou-se escore de 69,5 para a classificação de saúde global, caracterizando os participantes com uma qualidade de vida desfavorável. Dentre as funções analisadas, a única avaliada como boa foi a função cognitiva. Em relação aos sintomas e efeitos colaterais, o mais expressivo foi a fadiga, seguida de insônia e falta de apetite, com os respectivos escores, 53,8, 38,3, 31,6. Conclusão: dentre os efeitos colaterais avaliados pelo questionário, os que apresentaram alteração foram poucos, mas deve-se levar em consideração a casuística relativamente pequena. Tais achados servem para subsidiar as ações e práticas dos profissionais de saúde no tratamento aos pacientes com doença oncohematológica. Descritores: Qualidade de Vida; Neoplasias; Leucemia; Linfoma; Enfermagem; Quimioterapia.ABSTRACT Objective: to evaluate the quality of life of patients diagnosed with oncohaematologic diseases using chemotherapy. Method: a quantitative, transversal, exploratory, descriptive study with patients undergoing chemotherapy treatment with a diagnosis of oncohaematological disease in a public philanthropic hospital using the EORTC QLQ-C30 questionnaire as a tool for data collection and a form for characterization of the sample profile. The analysis of the results was performed based on the EORTC QLQ-C30 Scoring Manual. P ≤ 0.05 was used for the characterization of the sample analysis and its statistically significant variables. Results: in relation to the health evaluation, a score of 69.5 was found for the overall health classification, characterizing the participants with an unfavorable quality of life. Among the analyzed functions, the only one evaluated as good, was the cognitive function. Regarding the symptoms and side effects, the most expressive was fatigue, followed by insomnia and lack of appetite, with the respective scores, 53.8, 38.3, 31.6. Conclusion: Among the side effects evaluated by the questionnaire, those that presented alterations were few, but one should take into account the relatively small casuistry. These findings serve to subsidize the actions and practices of health professionals in the treatment of patients with oncohaematological disease. Descriptors: Quality of Life; Neoplasms; Leukemia; Lymphoma; Nursing; Chemotherapy.                                                         RESUMEN Objetivo: evaluar la calidad de vida de pacientes con diagnóstico de enfermedades oncohematológicas, en uso de quimioterapia. Método: el estudio cuantitativo, transverso exploratorio, descriptiva, con pacientes en tratamiento de quimioterapia, con diagnóstico de enfermedad oncohematológica en un hospital público filantrópico, donde se utilizó, como instrumento para la recolección de datos, el cuestionario EORTC QLQ-C30 y un formulario para caracterización del perfil de la muestra. El análisis de los resultados se realizó con base en el EORTC QLQ-C30 Scoring Manual. Se utilizó p ≤ 0,05 para la caracterización del análisis de la muestra y sus variables estadísticamente significativas. Resultados: en relación a la evaluación de la salud, se encontró una puntuación de 69,5 para la clasificación de salud global, caracterizando a los participantes con una calidad de vida desfavorable. Entre las funciones analizadas, la única evaluada como buena fue la función cognitiva. En cuanto a los síntomas y efectos colaterales, el más expresivo fue la fatiga, seguida de insomnio y falta de apetito, con las respectivas puntuaciones, 53,8, 38,3, 31,6. Conclusión: entre los efectos colaterales evaluados por el cuestionario, fueron pocos los que presentaron alteración, pero, se debe tener en cuenta la casuística relativamente pequeña. Estos hallazgos sirven para subsidiar las acciones y las prácticas de los profesionales de salud en el tratamiento a los pacientes con enfermedad oncohematológica. Descriptores: Calidad de Vida; Neoplasias; Leucemia; Linfoma; Enfermería; Quimioterapia.                                                       

Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

2021 ◽  
pp. 263451612110217
Author(s):  
Joshua A. Sloan ◽  
Philip O. Katz
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Class ◽  
Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

scholarly journals Quality of life, symptoms and dietary habits in oncology outpatients with malnutrition: A cross-sectional study

2021 ◽  
Vol 38 (2) ◽  
Author(s):  
Mira Sonneborn-Papakostopoulos ◽  
Clara Dubois ◽  
Viktoria Mathies ◽  
Mara Heß ◽  
Nicole Erickson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Side Effects ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
University Hospital ◽  
Cross Sectional ◽  
European Organization

AbstractCancer-related malnutrition has a high prevalence, reduces survival and increases side effects. The aim of this study was to assess oncology outpatients and risk of malnutrition. Reported symptoms and quality of life (QoL) in patients found to be at risk of malnutrition or malnourished were compared to patients without malnutrition. Using a standardized questionnaire, the European Organization for Research and Treatment of Cancer Questionnaire for Quality of Life and the Mini Nutritional Assessment (MNA), patients in an outpatient cancer clinic undergoing chemotherapy treatment at a German University Hospital were assessed for nutrition, risk of malnutrition and quality of life. Based on the MNA, 39 (45.9%) patients were categorized as malnourished or at risk for malnutrition. Loss of appetite (n = 37.6%, p < 0.001) and altered taste sensation (n = 30,3%, p < 0.001) were the symptoms most frequently associated with reduced food intake. Patients with risk of malnutrition scored lower on the global health status (n = 48.15%, p = 0.001). Side effects of cancer treatments lead to a higher risk of malnutrition and as a consequence lower QoL. These side effects should be addressed more efficiently in cancer care.

scholarly journals Pilates and dance to patients with breast cancer undergoing treatment: study protocol for a randomized clinical trial – MoveMama study

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonessa Boing ◽  
Tatiana do Bem Fretta ◽  
Melissa de Carvalho Souza Vieira ◽  
Gustavo Soares Pereira ◽  
Jéssica Moratelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Physical Activity ◽  
Body Image ◽  
Side Effects ◽  
Sleep Quality ◽  
Control Group ◽  
Belly Dance ◽  
Belly Dancing

Abstract Background Breast cancer is a global public health issue. The side effects of the clinical treatment can decrease the quality of life of these women. Therefore, a healthy lifestyle is essential to minimize the physical and psychological side effects of treatment. Physical activity has several benefits for women with breast cancer, and Pilates solo and belly dancing can be an enjoyable type of physical activity for women with breast cancer undergoing clinical treatment. The purpose of this study is to provide a Pilates solo and a belly dance protocol (three times per week/16 weeks) for women undergoing breast cancer treatment and compare its effectiveness with that in the control group. Methods The participants will be allocated to either the intervention arm (Pilates solo or belly dance classes three times per week for 16 weeks) or a control group (receipt of a booklet on physical activity for patients with breast cancer and maintenance of habitual physical activity routine). The Pilates solo and belly dance classes will be divided into three stages: warmup and stretching, the main stage, and relaxation. Measurements of the study outcomes will take place at baseline; postintervention; and 6, 12, and 24 months after the end of the intervention (maintenance period). The data collection for both groups will occur with a paper questionnaire and tests covering general and clinical information. The primary outcome will be quality of life (EORT QLQ-C30 and EORT QLQ-BR23), and secondary outcomes will be physical aspects such as cardiorespiratory fitness (6-min walk test and cycle ergometer), lymphedema (sum of arm circumference), physical activity (IPAQ short version), disabilities of the arm (DASH), range of motion (goniometer test), muscular strength (dynamometer test) and flexibility (sit and reach test), and psychological aspects such as depressive symptoms (Beck Depression Inventory), body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg), fatigue (FACT-F), pain (VAS), sexual function (FSFI), and sleep quality (Pittsburgh Sleep Quality Index). Discussion In view of the high prevalence of breast cancer among women, the implementation of a specific protocol of Pilates solo and belly dancing for patients with breast cancer is important, considering the necessity to improve their physical and psychological quality of life. Pilates solo and belly dancing are two types of physical activity that involve mental and physical concentration, music, upper limb movements, femininity, and social involvement. An intervention with these two physical activities could offer options of supportive care to women with breast cancer undergoing treatment, with the aim being to improve physical and psychological quality of life. Trial registration ClinicalTrials.gov, NCT03194997. Registration date 12 August 2017. Universal Trial Number (World Health Organization), U1111-1195-1623.

scholarly journals The impact of hyperbaric oxygen therapy on late radiation toxicity and quality of life in breast cancer patients

2021 ◽  
Author(s):  
Marilot C. T. Batenburg ◽  
Wies Maarse ◽  
Femke van der Leij ◽  
Inge O. Baas ◽  
Onno Boonstra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Oxygen Therapy ◽  
Radiation Toxicity ◽  
Breast Pain ◽  
Breast Cancer Patients

Abstract Purpose To evaluate symptoms of late radiation toxicity, side effects, and quality of life in breast cancer patients treated with hyperbaric oxygen therapy (HBOT). Methods For this cohort study breast cancer patients treated with HBOT in 5 Dutch facilities were eligible for inclusion. Breast cancer patients with late radiation toxicity treated with ≥ 20 HBOT sessions from 2015 to 2019 were included. Breast and arm symptoms, pain, and quality of life were assessed by means of the EORTC QLQ-C30 and -BR23 before, immediately after, and 3 months after HBOT on a scale of 0–100. Determinants associated with persistent breast pain after HBOT were assessed. Results 1005/1280 patients were included for analysis. Pain scores decreased significantly from 43.4 before HBOT to 29.7 after 3 months (p < 0.001). Breast symptoms decreased significantly from 44.6 at baseline to 28.9 at 3 months follow-up (p < 0.001) and arm symptoms decreased significantly from 38.2 at baseline to 27.4 at 3 months follow-up (p < 0.001). All quality of life domains improved at the end of HBOT and after 3 months follow-up in comparison to baseline scores. Most prevalent side effects of HBOT were myopia (any grade, n = 576, 57.3%) and mild barotrauma (n = 179, 17.8%). Moderate/severe side effects were reported in 3.2% (n = 32) of the patients. Active smoking during HBOT and shorter time (i.e., median 17.5 vs. 22.0 months) since radiotherapy were associated with persistent breast pain after HBOT. Conclusion Breast cancer patients with late radiation toxicity reported reduced pain, breast and arm symptoms, and improved quality of life following treatment with HBOT.

scholarly journals Buprenorphine: Far Beyond the “Ceiling”

Biomolecules ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 816
Author(s):  
Rosmara Infantino ◽  
Consalvo Mattia ◽  
Pamela Locarini ◽  
Antonio Luigi Pastore ◽  
Sabatino Maione ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Drug Abuse ◽  
Side Effects ◽  
National Health System ◽  
Analgesic Drugs ◽  
Third Line ◽  
Dynamic Profile

Chronic pain, including neuropathic pain, represents an untreated disease with important repercussions on the quality of life and huge costs on the national health system. It is well known that opioids are the most powerful analgesic drugs, but they represent the second or third line in neuropathic pain, that remain difficult to manage. Moreover, these drugs show several side effects that limit their use. In addition, opioids possess addictive properties that are associated with misuse and drug abuse. Among available opioids compounds, buprenorphine has been suggested advantageous for a series of clinical reasons, including the effectiveness in neuropathic pain. Some properties are partly explained by its unique pharmacological characteristics. However, questions on the dynamic profile remain to be answered. Pharmacokinetics optimization strategies, and additional potentialities, are still to be explored. In this paper, we attempt to conceptualize the potential undiscovered dynamic profile of buprenorphine.

scholarly journals Adjuvant Radiotherapy after Surgical Excision in Keloids

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 730
Author(s):  
Jeong Won Lee ◽  
Ki Ho Seol
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adjuvant Therapy ◽  
Local Control ◽  
Adjuvant Radiotherapy ◽  
Surgical Excision ◽  
Recurrence Rates ◽  
High Tendency ◽  
Advantages And Disadvantages

Keloids are a benign fibroproliferative disease with a high tendency of recurrence. Keloids cause functional impairment, disfigurement, pruritus, and low quality of life. Many therapeutic options have been used for keloids. However, the high recurrence rates have led to the use of adjuvant therapy after surgical keloid excision. There are different radiotherapy regimens available, and the advantages and disadvantages of each are still unclear. The aim of this review is to explain the appropriate radiotherapy regimen for keloids as well as discuss the recent reports on keloid management with radiotherapy. Adjuvant radiotherapy after surgical excision for keloids yields excellent local control with tolerable side effects. Hypofractionated radiotherapy with a BED of more than 28 Gy (α/β value of 10) after excision is recommended in the light of its biologic background.

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