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Medicina Clinica Jan 2024Anorexia nervosa and bulimia nervosa are eating disorders associated with life-threatening multisystemic medical complications. This narrative review aimed to present... (Review)
Review
Anorexia nervosa and bulimia nervosa are eating disorders associated with life-threatening multisystemic medical complications. This narrative review aimed to present the medical complications most related to these disorders. In anorexia nervosa, many of them are linked to malnutrition and underweight, usually reversible with renutrition and weight restoration, although refeeding can also be linked to some medical complications. Purging behaviors observed in the anorexia nervosa binge-purging subtype and bulimia nervosa have been mainly related to hydrolectrolyte and acid-base disturbances, in addition to local complications. Thus, an early identification and therapeutic intervention of these disorders is considered crucial. Integral medical monitoring should be ensured to prevent potential serious complications from the early stages, with the involvement of physicians, psychologists, nutritionists, and other specialists in a multidisciplinary approach according to the patient's needs.
Topics: Humans; Bulimia Nervosa; Anorexia; Anorexia Nervosa; Feeding and Eating Disorders; Malnutrition
PubMed: 37598049
DOI: 10.1016/j.medcli.2023.07.028 -
Gastroenterology Clinics of North... Jun 2020Hepatitis A virus (HAV) is a positive-strand RNA virus that is transmitted feco-orally through person-to-person contact. Outbreaks are often linked to poor sanitation,... (Review)
Review
Hepatitis A virus (HAV) is a positive-strand RNA virus that is transmitted feco-orally through person-to-person contact. Outbreaks are often linked to poor sanitation, overcrowding, or food and water contamination. Infection is often asymptomatic in children, but adults present with jaundice, abdominal pain, hepatitis, and hyperbilirubinemia. Diagnosis is through detection of immunoglobulin M antibodies against HAV, and treatment is supportive. Vaccination is the mainstay of prevention and should be given before exposure whenever possible.
Topics: Abdominal Pain; Alanine Transaminase; Anorexia; Biomarkers; Hepatitis A; Hepatitis A Vaccines; Humans; Jaundice; Risk; Serologic Tests; Travel
PubMed: 32389358
DOI: 10.1016/j.gtc.2020.01.002 -
The Veterinary Clinics of North... Sep 2019Appetite influences perceived quality of life for a dog or cat with cancer. Inappetence often is multifactorial, complicating treatment. Cancer-related anorexia/cachexia... (Review)
Review
Appetite influences perceived quality of life for a dog or cat with cancer. Inappetence often is multifactorial, complicating treatment. Cancer-related anorexia/cachexia syndrome is a metabolic, paraneoplastic syndrome characterized by decreased food intake, involuntary weight loss, and loss of fat and muscle. If weight loss/cachexia has an impact on canine and feline cancer patients as in humans, management may improve survival times and quality of life. The challenge is having effective, proved therapies available for clinical use. Recent Food and Drug Administration approvals for appetite stimulation have renewed interest and discussion and has the potential to alter the course of case management.
Topics: Animals; Anorexia; Antineoplastic Combined Chemotherapy Protocols; Appetite Stimulants; Cachexia; Cannabidiol; Cat Diseases; Cats; Chronic Disease; Dog Diseases; Dogs; Neoplasms; Quality of Life
PubMed: 31176457
DOI: 10.1016/j.cvsm.2019.04.008 -
Primary Care Sep 2019Pediatric palliative care and hospice medicine is a field in which a multidisciplinary team assists in the management and treatment of infants, children, and young... (Review)
Review
Pediatric palliative care and hospice medicine is a field in which a multidisciplinary team assists in the management and treatment of infants, children, and young adults with a serious condition. A therapeutic relationship is created among the team, patients, and their caregivers to address total pain. This encompasses exploration of physical pain, social, spiritual, and emotional pain. Patient-centered and family-centered shared decision-making is paramount when setting and revisiting goals of care with patients and their families. Consider a checklist when faced with a dying patient so that the family and team feel supported.
Topics: Age Factors; Anorexia; Child; Child, Preschool; Decision Making; Delirium; Emotions; Family; Grief; Humans; Infant; Infant, Newborn; Interpersonal Relations; Pain Management; Palliative Care; Patient Care Planning; Quality of Life; Spirituality; Terminal Care
PubMed: 31375193
DOI: 10.1016/j.pop.2019.05.010 -
Anales Del Sistema Sanitario de Navarra Aug 2022Systematic review of published studies on the impact of social networks (SN) use on anorexia and bulimia in female adolescents. We selected articles published over the... (Review)
Review
Systematic review of published studies on the impact of social networks (SN) use on anorexia and bulimia in female adolescents. We selected articles published over the past 10 years, written in English, Spanish or Portu-guese found in The Cochrane Library Plus, PubMed, WOS, PsycINFO, and Scopus databases and with enough methodological quality. Nine studies were included in this review with a sample of 2,069 adolescents; 75.3% were female, mean age was 18 years, and mostly used Facebook and Instagram. Despite some positive aspects, SNs promote beauty standards in terms of thinness, allow comparisons between peers increasing concerns about weight, and create spaces that encourage anorexia and bulimia. Therefore, SN use plays a role in the development of eating disorders. The promotion of extreme thinness in girls makes this population more vulnerable.
Topics: Adolescent; Anorexia; Bulimia; Bulimia Nervosa; Female; Humans; Male; Social Networking; Thinness
PubMed: 35972299
DOI: 10.23938/ASSN.1009 -
Nutrients Feb 2023The importance of the interplay between inflammation and nutrition has generated much interest in recent times. Inflammation has been identified as a key driver for... (Review)
Review
The importance of the interplay between inflammation and nutrition has generated much interest in recent times. Inflammation has been identified as a key driver for disease-related malnutrition, leading to anorexia, reduced food intake, muscle catabolism, and insulin resistance, which are stimulating a catabolic state. Interesting recent data suggest that inflammation also modulates the response to nutritional treatment. Studies have demonstrated that patients with high inflammation show no response to nutritional interventions, while patients with lower levels of inflammation do. This may explain the contradictory results of nutritional trials to date. Several studies of heterogeneous patient populations, or in the critically ill or advanced cancer patients, have not found significant benefits on clinical outcome. Vice versa, several dietary patterns and nutrients with pro- or anti-inflammatory properties have been identified, demonstrating that nutrition influences inflammation. Within this review, we summarize and discuss recent advances in both the role of inflammation in malnutrition and the effect of nutrition on inflammation.
Topics: Humans; Nutritional Status; Malnutrition; Inflammation; Anorexia; Neoplasms
PubMed: 36904164
DOI: 10.3390/nu15051159 -
Journal of Clinical Oncology : Official... May 2023Anorexia occurs in 30%-80% of patients with advanced malignancies, which may be worsened with chemotherapy. This trial assessed the efficacy of olanzapine in stimulating... (Randomized Controlled Trial)
Randomized Controlled Trial
Randomized Double-Blind Placebo-Controlled Study of Olanzapine for Chemotherapy-Related Anorexia in Patients With Locally Advanced or Metastatic Gastric, Hepatopancreaticobiliary, and Lung Cancer.
PURPOSE
Anorexia occurs in 30%-80% of patients with advanced malignancies, which may be worsened with chemotherapy. This trial assessed the efficacy of olanzapine in stimulating appetite and improving weight gain in patients receiving chemotherapy.
METHODS
Adults (≥18 years) with untreated, locally advanced, or metastatic gastric, hepatopancreaticobiliary (HPB), and lung cancers were randomly assigned (double-blind) to receive olanzapine (2.5 mg once a day for 12 weeks) or placebo along with chemotherapy. Both groups received standard nutritional assessment and dietary advice. The primary outcomes were the proportion of patients with weight gain > 5% and the improvement in appetite (assessed by the visual analog scale [VAS] and the Functional Assessment of Chronic Illness Therapy system of Quality-of-Life questionnaires Anorexia Cachexia subscale [FAACT ACS]). Secondary end points were change in nutritional status, quality of life (QOL), and chemotherapy toxicity.
RESULTS
We enrolled 124 patients (olanzapine, 63 and placebo, 61) with a median age of 55 years (18-78 years), of whom 112 (olanzapine, 58 and placebo, 54) were analyzable. The majority (n = 99, 80%) had metastatic cancer (gastric [n = 68, 55%] > lung [n = 43, 35%] > HPB [n = 13, 10%]). The olanzapine arm had a greater proportion of patients with a weight gain of > 5% (35 of 58 [60%] 5 of 54 [9%], < .001) and improvement in appetite by VAS (25 of 58 [43%] 7 of 54 [13%], < .001) and by FAACT ACS (scores ≥37:13 of 58 [22%] 2 of 54 [4%], = .004). Patients on olanzapine had better QOL, nutritional status, and lesser chemotoxicity. Side effects attributable to olanzapine were minimal.
CONCLUSION
Low-dose, daily olanzapine is a simple, inexpensive, well-tolerated intervention that significantly improves appetite and weight gain in newly diagnosed patients on chemotherapy.
Topics: Adult; Humans; Middle Aged; Olanzapine; Anorexia; Quality of Life; Lung Neoplasms; Double-Blind Method; Weight Gain
PubMed: 36977285
DOI: 10.1200/JCO.22.01997 -
Journal of Cachexia, Sarcopenia and... Jun 2020Cancer cachexia is a multifactorial syndrome characterized by a progressive loss of skeletal muscle mass, along with adipose tissue wasting, systemic inflammation and... (Review)
Review
Cancer cachexia is a multifactorial syndrome characterized by a progressive loss of skeletal muscle mass, along with adipose tissue wasting, systemic inflammation and other metabolic abnormalities leading to functional impairment. Cancer cachexia has long been recognized as a direct cause of complications in cancer patients, reducing quality of life and worsening disease outcomes. Some related conditions, like sarcopenia (age-related muscle wasting), anorexia (appetite loss) and asthenia (reduced muscular strength and fatigue), share some key features with cancer cachexia, such as weakness and systemic inflammation. Understanding the interplay and the differences between these conditions is critical to advance basic and translational research in this field, improving the accuracy of diagnosis and contributing to finally achieve effective therapies for affected patients.
Topics: Anorexia; Asthenia; Cachexia; Humans; Quality of Life; Sarcopenia
PubMed: 32142217
DOI: 10.1002/jcsm.12528 -
Trends in Cancer May 2022The cachexia syndrome in cancer is characterized by weight loss resulting from the combination of anorexia and atrophy of adipose and skeletal muscle. For decades,... (Review)
Review
The cachexia syndrome in cancer is characterized by weight loss resulting from the combination of anorexia and atrophy of adipose and skeletal muscle. For decades, inflammatory circulatory factors have been identified to regulate wasting, but inhibitors of these factors have not yielded the same clinical benefit as in animal models. Therefore, additional mediators of cachexia likely regulate this syndrome, and such factors might be more suitable for targeted intervention. We highlight several anorexia-cachexia signaling mediators, including activin A, myostatin, GDF15, and lipocalin-2. We discuss current evidence that these factors associate with cachexia in cancer patients, and summarize translational efforts including essential early-phase clinical trials. We conclude with thoughts on targeted and personalized approaches for future anti-cachexia treatments.
Topics: Adipose Tissue; Animals; Anorexia; Cachexia; Humans; Neoplasms; Signal Transduction
PubMed: 35190301
DOI: 10.1016/j.trecan.2022.01.004 -
Nature Reviews. Clinical Oncology Apr 2023Cachexia is a devastating, multifactorial and often irreversible systemic syndrome characterized by substantial weight loss (mainly of skeletal muscle and adipose... (Review)
Review
Cachexia is a devastating, multifactorial and often irreversible systemic syndrome characterized by substantial weight loss (mainly of skeletal muscle and adipose tissue) that occurs in around 50-80% of patients with cancer. Although this condition mainly affects skeletal muscle (which accounts for approximately 40% of total body weight), cachexia is a multi-organ syndrome that also involves white and brown adipose tissue, and organs including the bones, brain, liver, gut and heart. Notably, cachexia accounts for up to 20% of cancer-related deaths. Cancer-associated cachexia is invariably associated with systemic inflammation, anorexia and increased energy expenditure. Understanding these mechanisms is essential, and the progress achieved in this area over the past decade could help to develop new therapeutic approaches. In this Review, we examine the currently available evidence on the roles of both the tumour macroenvironment and microenvironment in cancer-associated cachexia, and provide an overview of the novel therapeutic strategies developed to manage this syndrome.
Topics: Humans; Cachexia; Neoplasms; Adipose Tissue; Muscle, Skeletal; Anorexia; Tumor Microenvironment
PubMed: 36806788
DOI: 10.1038/s41571-023-00734-5