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Izairi-Bexheti R, Fejzulahi-Izairi M, Ristova M. Uncertainty in the range of the protons and C-ions in particle therapy due to a hydration level of a human body model. Appl Radiat Isot 2023; 200:110951. [PMID: 37487427 DOI: 10.1016/j.apradiso.2023.110951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023]
Abstract
Cancer treatment with protons and carbon ions relies on the property of the accelerated charged particles to deposit most of their energy in the vicinity of their range (around the Bragg peak). The level of hydration in a cancer patient's body may vary within hours. Some patients may be heavy to moderately dehydrated, and some may be well and even excessively hydrated. In this research, we aim to estimate the uncertainty of the protons and C-ion ranges because of the different hydration levels of the human body. For the study of the impact of body hydration level on the particle's ranges, we have designed a new phantom model - a homogeneous mixture of an Average HUuman BOdy constituting elements (AHUBO) in three states of hydration: normal (n), dehydrated (d), and excessively hydrated (e) by applying corresponding recalibration in the "atomic-stoichiometry model" due to the water sufficiency/deficiency. The purpose of the study is to estimate the shift in the ranges depending on the hydration level, possibly suggest particle beam energy adjustments to overcome the range uncertainties, to deliver the prescribed dose to the tumour while sparing the healthy tissue. Herein we present the results of the FLUKA-Flair simulations of the therapeutic range of energies of protons (50-105 MeV) and C-ions (30-210 MeV) respectively, into an AHUBO head phantom model at three levels of hydration (normal, dehydrated, and excessively hydrated). The range uncertainty was estimated via the shifts of the Bragg-peaks position for the three different hydration levels. The estimations showed that the range uncertainty (ΔR) due to body hydration for the maximum energy in the range for protons at 105 MeV is about 0.04 mm and for C-ions at 190 MeV/u is about 0.06 mm.
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Affiliation(s)
- Redona Izairi-Bexheti
- Physics Department, Faculty of Natural Sciences and Mathematics, University Ss Cyril and Methodius, Arhimedova St. 3, Skopje, Macedonia
| | - Mimoza Fejzulahi-Izairi
- Physics Department, Faculty of Natural Sciences and Mathematics, University Ss Cyril and Methodius, Arhimedova St. 3, Skopje, Macedonia
| | - Mimoza Ristova
- Physics Department, Faculty of Natural Sciences and Mathematics, University Ss Cyril and Methodius, Arhimedova St. 3, Skopje, Macedonia; SEEIIST, Southeast European International Institute for Sustainable Technologies, Geneva, Switzerland.
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2
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Yamato K, Ikeda A, Endo M, Filomeno R, Kiyohara K, Inada K, Nishimura K, Tanigawa T. An association between cancer type and delirium incidence in Japanese elderly patients: A retrospective longitudinal study. Cancer Med 2022; 12:2407-2416. [PMID: 35880545 PMCID: PMC9939101 DOI: 10.1002/cam4.5069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/03/2022] [Accepted: 07/12/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE There is not a known elevated prevalence of delirium in older adult cancer patients. However, it is unknown if the incidence of delirium varies by cancer type among older adult patients. Therefore, this study aimed to examine the association between the incidence of delirium and cancer type among older adult patients using a Japanese hospital-based administrative claims database. METHODS A total of 76,868 patients over 65 years of age or older, first diagnosed with cancer on an initial date of hospitalization between April 2008 and December 2019, were included in this retrospective longitudinal study. Delirium was defined by the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes or antipsychotic medication use. Cox proportional hazard models were performed to estimate the risk of delirium incidence according to 22 cancer types during the one-year hospitalization period. RESULTS The incidence rates of delirium were 17.1% for men and 15.3% for women. Compared to gastric cancer, the risk of delirium was significantly higher for pancreatic cancer (HR: 1.26, 95% CI: 1.11-1.42 for men; HR: 1.27, 95% CI: 1.11-1.45 for women), leukemia (HR: 1.24, 95% CI: 1.09-1.41 for men; HR: 1.20, 95% CI: 1.03-1.41 for women), and oropharyngeal cancer (HR: 1.30, 95% CI: 1.10-1.54 for men; HR: 1.32; 95% CI: 1.02-1.72 for women) after adjusting for age, initial hospitalization year, antipsychotic medications, and surgery. CONCLUSIONS As compared to gastric cancer, patients with pancreatic cancer, leukemia, oropharyngeal cancer were found to have a higher risk of developing delirium. Our study findings suggested that the risk of delirium incidence may vary by cancer type.
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Affiliation(s)
- Kentaro Yamato
- Department of Public Health, Graduate School of MedicineJuntendo UniversityTokyoJapan
| | - Ai Ikeda
- Department of Public Health, Graduate School of MedicineJuntendo UniversityTokyoJapan,Faculty of International Liberal ArtsJuntendo UniversityTokyoJapan
| | - Motoki Endo
- Department of Public Health, Graduate School of MedicineJuntendo UniversityTokyoJapan
| | - Ronald Filomeno
- Department of Public Health, Graduate School of MedicineJuntendo UniversityTokyoJapan
| | - Kosuke Kiyohara
- Department of Food ScienceOtsuma Women's UniversityTokyoJapan
| | - Ken Inada
- Department of PsychiatryTokyo Women's Medical UniversityTokyoJapan
| | | | - Takeshi Tanigawa
- Department of Public Health, Graduate School of MedicineJuntendo UniversityTokyoJapan
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Bland KA, Kouw IWK, van Loon LJC, Zopf EM, Fairman CM. Exercise-Based Interventions to Counteract Skeletal Muscle Mass Loss in People with Cancer: Can We Overcome the Odds? Sports Med 2022; 52:1009-1027. [PMID: 35118634 DOI: 10.1007/s40279-021-01638-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2021] [Indexed: 12/15/2022]
Abstract
Addressing skeletal muscle mass loss is an important focus in oncology research to improve clinical outcomes, including cancer treatment tolerability and survival. Exercise is likely a necessary component of muscle-mass-preserving interventions for people with cancer. However, randomized controlled trials with exercise that include people with cancer with increased susceptibility to more rapid and severe muscle mass loss are limited. The aim of the current review is to highlight features of cancer-related skeletal muscle mass loss, discuss the impact in patients most at risk, and describe the possible role of exercise as a management strategy. We present current gaps within the exercise oncology literature and offer several recommendations for future studies to support research translation, including (1) utilizing accurate and reliable body composition techniques to assess changes in skeletal muscle mass, (2) incorporating comprehensive assessments of patient health status to allow personalized exercise prescription, (3) coupling exercise with robust nutritional recommendations to maximize the impact on skeletal muscle outcomes, and (4) considering key exercise intervention features that may improve exercise efficacy and adherence. Ultimately, the driving forces behind skeletal muscle mass loss are complex and may impede exercise tolerability and efficacy. Our recommendations are intended to foster the design of high-quality patient-centred research studies to determine whether exercise can counteract muscle mass loss in people with cancer and, as such, improve knowledge on this topic.
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Affiliation(s)
- Kelcey A Bland
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.,The Szalmuk Family Department of Medical Oncology, Cabrini Cancer Institute, Cabrini Health, Melbourne, VIC, Australia
| | - Imre W K Kouw
- Intensive Care Unit, Royal Adelaide Hospital, Adelaide, SA, Australia.,Centre of Research Excellence in Translating Nutritional Science To Good Health, The University of Adelaide, Adelaide, SA, Australia.,Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Luc J C van Loon
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.,Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Eva M Zopf
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.,The Szalmuk Family Department of Medical Oncology, Cabrini Cancer Institute, Cabrini Health, Melbourne, VIC, Australia
| | - Ciaran M Fairman
- Exercise Science Department, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, PHRC 220, Columbia, SC, 29208, USA.
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Clifford B, Koizumi S, Wewege MA, Leake HB, Ha L, Macdonald E, Fairman CM, Hagstrom AD. The Effect of Resistance Training on Body Composition During and After Cancer Treatment: A Systematic Review and Meta-Analysis. Sports Med 2021; 51:2527-2546. [PMID: 34499338 DOI: 10.1007/s40279-021-01542-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Changes in body composition during cancer treatments have been linked with poorer outcomes, and increased morbidity and mortality. The effect of resistance training (RT) on body composition in cancer cohorts is debated. OBJECTIVE We conducted a systematic review and meta-analysis to determine the effect of RT on body composition during and after treatment. METHODS We searched five electronic databases for articles up to 1 February 2021 and included randomized controlled trials that compared RT with a non-exercise control in adults with cancer. Risk of bias was assessed using the RoB 2 tool. Pairwise, random-effects meta-analysis was used to synthesize the available data. RESULTS Overall, we included 15 studies (n = 1368). After treatment (11 studies), RT increased lean mass with moderate heterogeneity {0.41 kg [95% confidence interval (CI) 0.05, 0.76], p = 0.029; I2 = 47.1%, p = 0.02} and decreased fat mass with substantial heterogeneity (- 0.59 kg [95% CI - 1.05, - 0.12], p = 0.019; I2 = 69.1%, p < 0.001). During treatment (4 studies), RT did not increase lean mass (0.71 kg [95% CI - 0.04, 1.45], p = 0.05; I2 = 0.0%, p = 0.75) or reduce fat mass (0.00 kg [95% CI - 5.31, 5.30], p = 0.99; I2 = 0.0%, p = 0.62), both with no heterogeneity. CONCLUSION Modest improvements in body composition were observed following RT after cancer treatment; however, no changes were observed during treatment. These adaptations are markedly lower than those observed in healthy cohorts but may be clinically meaningful for the cancer survivorship population. At present it is unclear if these diminished adaptations are due to ineffective exercise prescriptions in cancer cohorts or due to an innate anabolic resistance as a result of cancer and its treatments. STUDY REGISTRATION Open Science Framework (osf.io/x6z72).
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Affiliation(s)
- Briana Clifford
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Sean Koizumi
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Michael A Wewege
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia.,Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Hayley B Leake
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia.,IIMPACT in Health, University of South Australia, Adelaide, SA, Australia
| | - Lauren Ha
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Eliza Macdonald
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Ciaran M Fairman
- Exercise Science Department, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Amanda D Hagstrom
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia.
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The why and how of maintaining hydration during cancer therapy. Curr Opin Support Palliat Care 2020; 14:324-332. [PMID: 33009008 DOI: 10.1097/spc.0000000000000526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To provide an overview of the role hydration plays in the oncology population while providing a synopsis of recent scientifically relevant published practice advancements. RECENT FINDINGS Dehydration causes substantial symptom burden in cancer patients, secondary to both disease process and treatment complications. Maintaining fluid and electrolytes balance is the key to hydration therapy. When oral intake is diminished, artificial hydration can be delivered via enteral, intravenous and subcutaneous routes. Use of artificial hydration in end-of-life care for cancer patients remains a highly debated topic with unclear benefits and lack of established standards. A holistic approach is required in the decision-making process. SUMMARY Maintaining adequate hydration is important in patients receiving cancer therapy. Challenges exist, secondary to limited clinical guidelines of hydration in patients with advanced cancer. Artificial hydration may be indicated for selected patients at the end of life if used on an individualized basis as medical treatment.
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Prado CM, Purcell SA, Laviano A. Nutrition interventions to treat low muscle mass in cancer. J Cachexia Sarcopenia Muscle 2020; 11:366-380. [PMID: 31916411 PMCID: PMC7113510 DOI: 10.1002/jcsm.12525] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/27/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022] Open
Abstract
Many patients with cancer experience poor nutritional status, which detrimentally impacts clinical outcomes. Poor nutritional status in cancer is primarily manifested by severe muscle mass (MM) depletion, which may occur at any stage (from curative to palliative) and often co-exists with obesity. The objective of this article was to discuss gaps and opportunities related to the role of nutrition in preventing and reversing low MM in cancer. It also provides a narrative review of relevant nutritional interventions for patients capable of oral intake. The impact of nutrition interventions to prevent/treat low MM in cancer is not well understood, potentially due to the limited number of studies and of clinically viable, accurate body composition assessment tools. Additionally, the type of study designs, inclusion criteria, length of intervention, and choice of nutritional strategies have not been optimal, likely underestimating the anabolic potential of nutrition interventions. Nutrition studies are also often of short duration, and interventions that adapt to the metabolic and behavioural changes during the clinical journey are needed. We discuss energy requirements (25-30 kcal/kg/day) and interventions of protein (1.0-1.5 g/kg/day), branched-chain amino acids (leucine: 2-4 g/day), β-hydroxy β-methylbutyrate (3 g/day), glutamine (0.3 g/kg/day), carnitine (4-6 g/day), creatine (5 g/day), fish oil/eicosapentanoic acid (2.0-2.2 g/day EPA and 1.5 g/day DHA), vitamin/minerals (e.g. vitamin D: 600-800 international units per day), and multimodal approaches (nutrition, exercise, and pharmaceutical) to countermeasure low MM in cancer. Although the evidence is variable by modality type, interventions were generally not specifically studied in the context of cancer. Understanding patients' nutritional requirements could lead to targeted prescriptions to prevent or attenuate low MM in cancer, with the overall aim of minimizing muscle loss during anti-cancer therapy and maximizing muscle anabolism during recovery. It is anticipated that this will, in turn, improve overall health and prognostication including tolerance to treatment and survival. However, oncology-specific interventions with more robust study designs are needed to facilitate these goals.
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Affiliation(s)
- Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Sarah A Purcell
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Division of Endocrinology, Metabolism, and Diabetes, and Division of Nutrition, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Alessandro Laviano
- Department of Translational and Precision Medicine, La Sapienza University, Rome, Italy
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Pugnaloni S, Vignini A, Borroni F, Sabbatinelli J, Alia S, Fabri M, Taus M, Mazzanti L, Berardi R. Modifications of taste sensitivity in cancer patients: a method for the evaluations of dysgeusia. Support Care Cancer 2019; 28:1173-1181. [PMID: 31203507 DOI: 10.1007/s00520-019-04930-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 06/07/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE Taste changes due to chemotherapy may contribute to the high prevalence of malnutrition in cancer patients. It is believed that 50-70% of patients with cancer suffer from taste disorders. The aim of the present study was to analyze the taste alterations in patient population compared with that in controls, also in relation to gender. In this way, it could open to a new approach for a personalized diet to prevent and/or reduce taste alterations and malnutrition in cancer patients. METHODS Forty-five cancer patients undergoing chemotherapy were compared with healthy controls (n = 32). Taste function test was used to determine taste sensitivity. Different concentrations for each of the four basic tastes (salty, sweet, sour, bitter) and also fat and water tastes were evaluated. RESULTS A significant difference in taste sensitivity between patients and control group was found, in line with previous similar studies. As in the control group, taste perception in patients was better in females than in males, suggesting interaction effect between group and gender. CONCLUSIONS Coping strategies regarding subjective taste impairment should be provided since alterations in taste sensitivity influence food preferences and appetite. Clinicians could thus have the potential to underpin changes in dietary intake and consequently in nutritional status; understanding the extent of the contribution of each taste would help in the development of effective interventions in future. Consequently, patients can adopt appropriate appetizing strategies and, based on that, change their feeding habits.
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Affiliation(s)
- Sofia Pugnaloni
- Department of Clinical Sciences, Biology and Biochemistry Section, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Arianna Vignini
- Department of Clinical Sciences, Biology and Biochemistry Section, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Francesca Borroni
- Department of Clinical Sciences, Biology and Biochemistry Section, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Jacopo Sabbatinelli
- Department of Clinical Sciences, Biology and Biochemistry Section, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Sonila Alia
- Department of Clinical Sciences, Biology and Biochemistry Section, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy
| | - Mara Fabri
- Department of Experimental and Clinical Medicine, Human Physiology Section, Università Politecnica delle Marche, Ancona, Italy
| | - Marina Taus
- Dietology and Clinical Nutrition, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona Umberto I Lancisi Salesi, Ancona, Italy
| | - Laura Mazzanti
- Department of Clinical Sciences, Biology and Biochemistry Section, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy.
| | - Rossana Berardi
- Medical Oncology Clinic, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona Umberto I Lancisi Salesi, Ancona, Italy
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Rozenbaum Z, Topilsky Y, Aviram G, Entin-Meer M, Granot Y, Pereg D, Berliner S, Steinvil A, Biner S. Prognostic implications of small left atria on hospitalized patients. Eur Heart J Cardiovasc Imaging 2019; 20:1051-1058. [DOI: 10.1093/ehjci/jey230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 12/21/2018] [Indexed: 02/05/2023] Open
Abstract
Abstract
Aims
To demonstrate the association between small left atria (LA) and outcome in a relatively large heterogeneous population of hospitalized patients.
Methods and results
In a single-centre retrospective study, all inpatients that underwent an echocardiographic assessment between 2011 and 2016 and had an available left atrial volume index (LAVI) measurement were included. The cohort consisted of 17 343 inpatients who had an available LAVI measurement, 288 with small LA (LAVI <16 mL/m2), 7531 patients had LAVI within normal limits (16–34 mL/m2) divided into low normal (16–24.9 mL/m2; n = 2636) and high normal (25–34 mL/m2; n = 4895), 4720 patients had large LAVI (34.1–45 mL/m2) and 4804 had very large LAVI (>45 mL/m2). Median follow-up time was 2.4 years. After adjustments for age, gender, and baseline characteristics with a P-value <0.2 in univariable analyses (body mass index, haemoglobin, ischaemic heart disease, valvulopathy, atrial fibrillation, diabetes mellitus, hypertension, hyperlipidaemia, smoking, renal dysfunction, lung disease, and malignancy) small LA was associated with a higher risk for in-hospital mortality (odds ratio 2.9, 95% confidence interval (CI) 1.4–5.7; P = 0.002] and all-cause mortality [hazard ratio (HR) 2.1, 95% CI 1.6–2.8; P < 0.001] compared with high normal LA. For every mL/m2 decrease below high normal LA size the risk for in-hospital and long-term all-cause mortality increased by 10% (HR 1.1, 95% CI 1.02–1.18; P = 0.005) and 8% (HR 1.08, 95% CI 1.05–1.12; P < 0.001), respectively.
Conclusion
Small LA are independently associated poorer short- and long-term mortality. LA volume should be referred to as J-shaped in terms of mortality.
Helsinki committee approval number
0170-17-TLV.
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Affiliation(s)
- Zach Rozenbaum
- Department of Cardiology, Tel Aviv Medical Center, 6 Weizman St, Tel Aviv 64239, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
| | - Yan Topilsky
- Department of Cardiology, Tel Aviv Medical Center, 6 Weizman St, Tel Aviv 64239, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
| | - Galit Aviram
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
- Department of Radiology, Tel Aviv Medical Center, 6 Weizman St, Tel Aviv 64239, Israel
| | - Michal Entin-Meer
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
- Cardiovascular Research Laboratory, Tel Aviv Medical Center, 6 Weizman St, Tel Aviv 64239, Israel
| | - Yoav Granot
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
- Department of Internal Medicine, Tel Aviv Medical Center, 6 Weizman St, Tel Aviv 64239, Israel
| | - David Pereg
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
- Department of Cardiology, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba, Israel
| | - Shlomo Berliner
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
- Department of Internal Medicine, Tel Aviv Medical Center, 6 Weizman St, Tel Aviv 64239, Israel
| | - Arie Steinvil
- Department of Cardiology, Tel Aviv Medical Center, 6 Weizman St, Tel Aviv 64239, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
| | - Simon Biner
- Department of Cardiology, Tel Aviv Medical Center, 6 Weizman St, Tel Aviv 64239, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
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Nwosu AC, Mayland CR, Mason SR, Khodabukus AF, Varro A, Ellershaw JE. Hydration in advanced cancer: can bioelectrical impedance analysis improve the evidence base? A systematic review of the literature. J Pain Symptom Manage 2013. [PMID: 23200189 DOI: 10.1016/j.jpainsymman.2012.08.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CONTEXT Decisions surrounding the administration of clinically assisted hydration to patients dying of cancer can be challenging because of the limited understanding of hydration in advanced cancer and a lack of evidence to guide health care professionals. Bioelectrical impedance analysis (BIA) has been used to assess hydration in various patient groupings, but evidence for its use in advanced cancer is limited. OBJECTIVES To critically appraise existing methods of hydration status assessment in advanced cancer and review the potential for BIA to assess hydration in advanced cancer. METHODS Searches were carried out in four electronic databases. A hand search of selected peer-reviewed journals and conference abstracts also was conducted. Studies reporting (de)hydration assessment (physical examination, biochemical measures, symptom assessment, and BIA) in patients with advanced cancer were included. RESULTS The results highlight how clinical examination and biochemical tests are standard methods of assessing hydration, but limitations exist with these methods in advanced cancer. Furthermore, there is disagreement over the evidence for some commonly associated symptoms with dehydration in cancer. Although there are limitations with using BIA alone to assess hydration in advanced cancer, analysis of BIA raw measurements through the method of bioelectrical impedance vector analysis may have a role in this population. CONCLUSION The benefits and burdens of providing clinically assisted hydration to patients dying of cancer are unclear. Bioelectrical impedance vector analysis shows promise as a hydration assessment tool but requires further study in advanced cancer. Innovative methodologies for research are required to add to the evidence base and ultimately improve the care for the dying.
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Affiliation(s)
- Amara Callistus Nwosu
- Marie Curie Palliative Care Institute Liverpool, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom.
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Inverted mitral inflow pattern in echocardiography among the elderly ? A marker of non-cardiovascular mortality and cognitive dysfunction. Int J Cardiol 2012; 155:70-4. [DOI: 10.1016/j.ijcard.2011.01.086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 01/01/2011] [Indexed: 11/20/2022]
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