No abstract available.
Cachexia* ; Sepsis*

No abstract available.
Cachexia* ; Ductus Arteriosus, Patent* ; Heart Failure* ; Heart* ; Humans ; Infant*

External compression of the right ventricle (RV) due to a depressed sternum in patients with pectus excavatum is uncommon. Moreover, mid-RV obstruction-induced cachexia rarely occurs in patients with pectus excavatum. We report a case of cardiac cachexia caused by significant RV compression in a patient with pectus excavatum.
Cachexia ; Funnel Chest ; Heart Ventricles ; Humans ; Sternum ; Ventricular Dysfunction, Right

Sarcopenia, which is defined as a decrease in skeletal muscle mass and strength with aging, is an important risk factor in clinical medicine that is associated with mortality, and poor surgical and nonsurgical outcomes. Sarcopenia is now recognized as a multifactorial geriatric syndrome. Cachexia is defined as a metabolic syndrome with inflammation as the key feature, so cachexia can be an underlying condition of sarcopenia. Recently, cachexia has been defined as a complex metabolic syndrome associated with an underlying illness and characterized by the loss of muscle mass with or without a loss of fat mass. These two conditions overlap but are not the same. In clinical practice, many factors related to sarcopenia (decreased food intake, inactivity, and decreased hormones) are reported frequently in patients with cachexia. On the contrary, systemic inflammation, the core feature of cachexia, can also be present in apparently healthy older sarcopenic patients. This suggests that new therapeutic approaches, alone or in combination, may be appropriate in both conditions.
Aging ; Cachexia* ; Clinical Medicine ; Eating ; Humans ; Inflammation ; Mortality ; Muscle, Skeletal ; Nutrition Therapy ; Risk Factors ; Sarcopenia*

Adenosquamous carcinoma of the pancreas is a rare tumor but demonstrated an aggressive biologic behavior. A 60-year- old man with huge cystic mass in epigastrium was admitted complaining of abdominal discomfort. Initially the cystic mass was diagnosed to pancreatic pseudocyst. An abdominal computed tomography on 1 month later demonstrated a more enlarged mass in the body of the pancreas with central necrosis, which was infiltrating posterior wall of the stomach. Near total pancreatectomy, splenectomy and total gastrectomy were done. The resection specimen composed of squamous cell carcinoma components with a small area of adenocarcinoma. The patient died of cachexia 4 months after the operation. We reported an unusual case of adenosquamous carcinoma of the pancreas which was a giant cystic mass with central degeneration and gastric infiltration.
Adenocarcinoma ; Cachexia ; Carcinoma, Adenosquamous* ; Carcinoma, Squamous Cell ; Gastrectomy ; Humans ; Necrosis ; Pancreas* ; Pancreatectomy ; Pancreatic Pseudocyst ; Splenectomy ; Stomach

PURPOSE: The study was aimed to review and understand the meaning of cancer cachexia. METHODS: Using the keywords "cachexia" and "cancer cachexia" 30 oncology research published from 1974 to 2009 were selected for the review. RESULTS: The mechanism of cancer cachexia has not been fully understood, but various pathogenesis appears to be involved in the development cachexia including altered metabolism of carbohydrate, lipid, and protein associated with cytokines and hormone. As a result, muscle strength, food intake and resting energy expenditure (REE) are reduced. Most medications for the treatment of cachexia show debating results except some drugs such as megace. Supportive care including nutritional education, nursing care, and social support are found another effective treatment options. CONCLUSION: The results of this study would help oncology nurses to understand the mechanism of cancer cachexia and its management.
Cachexia ; Cytokines ; Eating ; Education, Nursing ; Energy Metabolism ; Megestrol Acetate ; Muscle Strength

A case of total aganglionic intestine in a new born infant is presented with a review of literature. Persistent vomiting, abdominal distension, failure to pass meconeum since brith were manifested. All X-rays showed multiple fluid level suggesting intestinal obstruction. In spite of colostomy with meticulous medical care, the patient expired due to cachexia. Postmortem autopsy findings were complete abscence of Auerbach's plexuses in entire intestine including esophagus, stomach, small intestine and colon.
Autopsy ; Cachexia ; Colon ; Colostomy ; Esophagus ; Humans ; Infant ; Intestinal Obstruction ; Intestine, Small ; Intestines* ; Myenteric Plexus ; Stomach ; Vomiting

BACKGROUND: Malnutrition in maintenance hemodialysis(HD) patients has been referred to underdialysis with low protein intake and to metabolic acidosis. However, the respective effects of underdialysis, protein intake and metabolic acidosis have not been clearly demonstrated. To evaluate the role of the dialysis dose, protein intake and metabolic acidosis on nutrition, we measured the predialysis serum HCO3, pH, serum albumin, PCRn, Kt/V, and BMI in 41 uremic patients on maintenance bicarbonate HD for 66.93+/-51.86 months. Patients with chronic liver diseases, malignancies, diabetes and cachexia were excluded. RESULTS: Mean age was 46+/-13 years; Kt/V, 1.22+/-0.27; PCRn, 0.90+/-0.16g/kg/day; serum albumin, 4.2+/-0.21g/dL; BMI, 20.47+/-2.09kg/m2; HCO3, 18.4+/-2.9mEq/L; Serum albumin showed a significant direct correlation with PCRn(p=0.001), and a significant inverse correlation with serum HCO3(r=0.43, p<0.01) but no correlation with Kt/V and BMI. PCRn showed a significant inverse correlation with serum HCO3(p<0.01), and a direct correlation with Kt/V(p<0.05). Multiple regression analysis confirmed the significant role of protein intake but not of Kt/V and serum bicarbonate, on serum albumin concentrations. Dividing patients into two groups, serum albumin was 4.05+/-0.34g/dL in those with HCO3 <20mEq/L and 3.95+/-0.24g/dL in those with HCO3 >or=20mEq/L. PCRn in the former was 0.94+/-0.6g/kg/day and in the latter 0.80+/-0.14g/kg/day(p<0.05). The role of PCRn appeared to be more important than metabolic acidodsis in determining the serum albumin levels. CONCLUSIONS: In patients hemodialyzed with relatively adequate Kt/V and whose serum bicarbonate levels maintained within mild acidosis range, PCRn may exert a detrimental effect on serum albumin concentration.
Acidosis ; Cachexia ; Dialysis ; Humans ; Hydrogen-Ion Concentration ; Liver Diseases ; Malnutrition* ; Renal Dialysis* ; Serum Albumin

Pancreatic cancer is the ninth common malignancy in South Korea. It has a dismal prognosis with a 5-year overall survival rate of less than 10%, and pancreatic cancer is associated with cancer cachexia, which is defined as the loss of muscle mass that is not reversible by conventional nutritional support. Cachexia is noted in over 85% of all pancreatic cancer patients and it is strongly related with the disease’s mortality. Nearly 30% of pancreatic cancer deaths are due to cachexia rather than being due to the tumor burden. Therefore, it is crucial to discover the mechanisms behind the development of muscle wasting in pancreatic cancer patients and find novel therapeutics for targeting cachexia. This review deals with the current understanding about the development of cachexia and nutritional support in those patients suffering with pancreatic cancer.
Cachexia ; Humans ; Korea ; Mortality ; Nutritional Support ; Pancreatic Neoplasms ; Prognosis ; Survival Rate ; Tumor Burden

OBJECTIVETo investigate cachexia in hospitalized patients with digestive system cancer and evaluate its impact on clinical outcomes.

METHODSBy analyzing the clinical data of 5118 hospitalized patients with digestive system cancer in Zhongshan Hospital of Fudan University from January 2012 to December 2013, cachexia was investigated and clinical outcomes between cachexia patients and non-cachexia patients was compared.

RESULTSThe total cachexia rate of hospitalized patients with digestive system cancer was 15.7%(803/5118). The highest rate of cachexia was 34.0%(89/262) in patients with pancreatic cancer followed by gastric cancer 22.4%(261/1164), colon cancer 21.7%(146/672), and rectal cancer 20.1%(117/581). In cachexia group and non-cachexia group, the overall completion rate of radical resection was 67.1%(539/803) and 74.5%(3214/4315) respectively(P<0.05). Compared to the non-cachexia group, the cachexia group was associated with longer postoperative hospital stay [(11.5±6.2) d vs. (9.4±4.9) d, P<0.05], slower postoperative recovery of bowel function [(3.4±0.9) d vs. (3.2±0.8) d, P<0.05], longer postoperative time to intake of semifluid [(4.4±1.5) d vs. (3.9±1.1) d, P<0.05], and more postoperative complications within 28 days after radical surgery [8.9%(48/539) vs. 5.8%(186/3214), P<0.05]. After radical surgery, the ICU admission rate of the cachexia group [24.3%(131/539)] was higher than that of the non-cachexia group [20.1%(646/3214)] with significant difference(P<0.05). Compared to non-cachexia group, the reoperation rate [3.2%(17/539) vs. 1.5%(48/3214), P<0.05], ventilator support rate [8.0%(43/539)vs. 5.7%(184/3214), P<0.05] and mortality [2.4%(13/539) vs. 1.1%(35/3214), P<0.05] in the cachexia group were all significantly higher(all P<0.05).

CONCLUSIONSCachexia is commen in patients with digestive system cancer. Cachexia has significant adverse effects on clinical outcomes in hospitalized patients with digestive system cancer.

Cachexia ; etiology ; Colonic Neoplasms ; complications ; Defecation ; Humans ; Postoperative Complications ; Rectal Neoplasms ; complications ; Reoperation ; Stomach Neoplasms ; complications