1,721,192 research outputs found
The good physician and the great physician: why a physician should consider the ESMO guidelines on the management of cancer cachexia?
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Current guidelines for nutritional therapy in cancer: the arrival of a long journey or the starting pont?
No full textLarge epidemiological data reveal that cancer is progressively becoming a chronic and disabling disease. Implementation in daily practice of early therapies aiming at addressing patients' needs is imperative. Nutrition is a major determinant of patients' quality of life, yet it is frequently neglected. Hopefully, reverting this skeptical clinical approach to nutrition, clinical practice guidelines of nutrition care in patients with cancer have been developed and published by international oncology and nutrition societies. By analyzing the more recent guidelines, it appears that a number of issues may contribute to their insufficient implementation in daily practice. Among them are heterogeneity of recommendations across different guidelines and insufficient robustness of evidence, as well as questionable generalization of recommendations. Future guidelines should aim at providing tumor-specific recommendations for the whole clinical journey of patients with cancer. Also, new, interesting areas should be covered, including fasting metabolism and circadian rhythmicity
High protein diet in digestive cancers.
No full textPurpose of review: Recent advances in the nutritional management of patients with digestive cancers suggest that modulation of protein intake may significantly contribute to achieve nutritional and clinical benefits. By reviewing the available evidence, a quantitatively and qualitatively optimal protein intake could be derived.
Recent findings: High protein diets (i.e., 1-1.5 g/kg body weight/day) appear key to maintain the adequate nutritional status, and may also contribute to achieve clinical benefits. This target appears particularly relevant in patients with digestive cancers at risk or already malnourished, or in older patients. During active cancer treatments, protein intake should be closer to the upper limit of the recommended intake. Also, high protein intake should be maintained beyond the periods of catabolic crisis associated with active treatments. In contrast with general reasoning, animal proteins should represent the majority of the recommended intake. Based on the available evidence, the intake of no specific amino acid can be strongly recommended to enhance anabolic potentials or the immune modulating effects of high protein diets.
Summary: High protein intake, mostly based on animal proteins, should be recommended to patients with digestive cancers. However, this target should be translated into clinical prescription after considering the clinical and metabolic needs of the patients. The quest for the optimal protein intake of patients with cancer at different time points of their clinical journey is still open
What is optimal nutritional support in acutely ill cancer patients? More may not be better
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Low energy vs. high energy depositional settings related sedimentary bodies in early Senonian rudist bearing carbonate shelves (central-southern Italy)
No full textCarannante Gabriele, Laviano A., Ruberti D., Simone Lucia, Sirna G., Sirna M., Tropeano M. Low energy vs. high energy depositional settings and related sedimentary bodies in early Senenian rudist bearing carbonate shelves (central-southern Italy). In: Géologie Méditerranéenne. Tome 28, numéro 1-2, 2001. Anatomy of Carbonate Bodies / Anatomie des corps carbonates. International Meeting / Colloque international. Marseille, 9-12 mai 2001, France, sous la direction de Marc Floquet, Jérôme Hennuy et Jean-Pierre Masse. pp. 37-40
From old to new: roles of protein sources and individual amino acids in clinical nutrition.
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Nannofossil and benthic macrofossil biostratigraphy from the Upper Cretaceous slope facies of the Gargano promontory (Southern Italy).
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Cachexia: Clinical features when inflammation drives malnutrition
No full textCachexia is a clinically relevant syndrome which impacts on quality of life, morbidity and mortality of patients suffering from acute and chronic diseases. The hallmark of cachexia is muscle loss, which is triggered by disease-associated inflammatory response. Cachexia is a continuum and therefore a staging system is needed. Initially, a three-stage system (i.e. pre-cachexia, cachexia and refractory cachexia) was proposed. More recent evidence supports the use of a five-stage classification system, based on patient's BMI and severity of weight loss, to better predict clinical outcome. Also, large clinical trials in cancer patients demonstrated that cachexia emerging during chemotherapy has greater influence on survival than weight loss at baseline. Therefore, becoming widely accepted is the importance of routinely monitoring patients' nutritional status to detect early changes and diagnose cachexia in its early phases. Although cachexia is associated with the presence of anabolic resistance, it has been shown that sustained yet physiological hyperaminoacidaemia, as well as the use of specific nutrients, is able to overcome impaired protein synthesis and revert catabolism. More importantly, clinical evidence demonstrates that preservation of nutritional status during chemotherapy or improvement of body weight after weight loss is associated with longer survival in cancer patients
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