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Management of Conditions and Symptoms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
Especially in advanced disease, cachexia or wasting syndrome, often presents as weight loss, muscle loss, decreased appetite, weakness, and fatigue, and must be closely managed by multiple members of the healthcare team. Physical activity and increasing caloric expenditure, although intuitive and logical, may not initially be the best course of action without addressing the physical and nutritional deficits of these individuals.
The Thymus Gland
Published in Nate F. Cardarelli, Tin as a Vital Nutrient:, 2019
While the symptomatology of the wasting syndrome is well described, the cause remains a mystery. Cachexia almost certainly does not result from lowered defenses against exogenous agents such as bacteria, rickettsia, and viruses.98,116,339 Antibiotics will not stop wasting.98 Phagocytic cells of the reticuloendothelial system function adequately.340 However, axenic mice, i.e., those reared in a germ-free environment, do not waste after neonatal thymectomy!324,339–342 If the same mice are removed from the sterile environment, they do develop cachexia.342 This mystery has yet to be explained.
Malabsorption of nutrients and drugs in patients with AIDS and mycobacteriosis and their obviation by parenteral therapy
Published in Ronald R. Watson, NUTRIENTS and FOODS in AIDS, 2017
Intestinal infection by M. avium-intracellulare complex has evolved into a very common complication of HIV infection. It is currently the third most common opportunistic disease in patients with AIDS. The disorder is most commonly encountered in developed countries, probably secondary to lower CD4 cell counts and contamination of residential and hospital water supply systems. With advanced disease patients develop weakness, weight loss, fever, and diarrhea. Blood cultures and CT abdominal scans usually confirm the diagnosis, although endoscopy with biopsy is sometimes required for confirmation of the diagnosis. Most patients develop a wasting syndrome due to malabsorption. Additionally, drug therapy may be ineffective due to poor absorption. We have attempted to obviate these absorptive problems by parenteral hyperalimentation and increasing oral drug dosing or by intravenous administration of antimycobacterial drugs. In our experience, survival of patients with this disorder has, consequently, significantly improved. New drug regimens and liposomal encapsulation will add increased efficacy to the management of mycobacterial infections of the gastrointestinal tract in the future.
Exercise oncology: an emerging discipline in the cancer care continuum
Published in Postgraduate Medicine, 2022
Ga Watson, Zl Coyne, E Houlihan, Gd Leonard
Cancer patients often experience alterations in body composition and image during treatment, which may be related to the disease itself or its treatment. Weight gain and obesity in cancer survivors may be associated with heightened risk of cardiometabolic disease and subsequent increased mortality, while a reduction in muscular mass may result in cachexia. Cancer cachexia is a wasting syndrome, characterized by progressive loss of skeletal muscle mass, which may or may not be accompanied by reduction in fat mass. The pathogenicity is likely multifactorial and includes a complex interaction of both tumor and host factors. Cancer cachexia cannot be corrected or reversed by nutritional support, and results in progressive functional decline. Approximately 50% of all patients with cancer experience cachexia, and it has been shown to negatively impact survival in a diverse range of malignancies [76,88].
Maternal depression and infant social withdrawal as predictors of behaviour and development in vertically HIV-infected children at 3.5 years
Published in Paediatrics and International Child Health, 2021
Jani Nöthling, Barbara Laughton, Soraya Seedat
Informed consent was obtained from mothers in person, in their preferred language (English, Afrikaans, isiXhosa). A demographic questionnaire and self-report measure to determine depression status and symptom severity in mothers at 10–12 months post-partum was administered by a research assistant. Infant withdrawal was assessed by a trained research psychologist at 10–12 months during a scheduled visit with a clinician. Child developmental assessments were undertaken at 42 months by a paediatrician assisted by a trained translator, during which the mother or caregiver completed a questionnaire on the child’s behaviour in the past 6 months. CD4 percentages and absolute counts at 10–12 months and 42 months in the study children were obtained from the CHER database. HIV-associated wasting syndrome, encephalopathy and failure to thrive (at any stage between 10 and 42 months) were determined by the CHER endpoint review committee using World Health Organization (WHO) guidelines [40].
Prognostic Markers of Overall Survival in Cancer Patients Attending a Cachexia Support Service: An Evaluation of Clinically Assessed Physical Function, Malnutrition and Inflammatory Status
Published in Nutrition and Cancer, 2021
Kelcey A. Bland, Eva M. Zopf, Meg Harrison, Matthew Ely, Prue Cormie, Enwu Liu, Anna Dowd, Peter Martin
Cancer cachexia is a metabolic muscle-wasting syndrome that affects 50 to 80% of all people diagnosed with cancer (1–3). Cancer cachexia is defined as the ongoing loss of skeletal muscle mass, with or without the loss of fat mass, leading to progressive functional impairment and shortened survival (4,5). Consistent evidence suggests weight loss severity (1–3,6,7) and skeletal muscle mass loss (8–11) are associated with shortened survival, although changes in muscle mass are thought to be more relevant (5). While physical function impairments are a core component of cancer cachexia, the prognostic significance of these impairments has been understudied. Patients with cancer cachexia, or skeletal muscle depletion, are more likely to have decreased self-reported physical function (12), muscle strength (13–17), and walking distances (18), relative to those without cancer cachexia. This functional impairment may not only impact patient prognosis, but also underpins the loss of independence and decreased quality of life often reported by individuals with cancer cachexia (17,19,20).